Sample records for complete diagnostic system

  1. Improvement in the Diagnostic Evaluation of a Positive Fecal Occult Blood Test in an Integrated Health Care Organization

    PubMed Central

    Miglioretti, Diana L.; Rutter, Carolyn M.; Bradford, Susan Carol; Zauber, Ann G.; Kessler, Larry G.; Feuer, Eric J.; Grossman, David C.

    2014-01-01

    Background Screening for fecal occult blood can be effective in reducing colorectal cancer mortality only if positive tests are appropriately followed up with complete diagnostic evaluation (i.e., colonoscopy or flexible sigmoidoscopy with double contrast barium enema) and treatment. Objectives To examine whether rates of complete diagnostic evaluation following a positive fecal occult blood test (FOBT) have improved over time after the implementation of tracking systems and physician guidelines within a large integrated health care organization. Research Design From 1993 to 2005, 8513 positive FOBTs were identified on 8291 enrollees aged 50–79 of a large health care system. Automated records were used to identify repeat FOBTs, colonoscopy, flexible sigmoidoscopy, and double-contrast barium enema within one year after the positive FOBT. National rates of complete diagnostic evaluation were estimated from the 2005 National Health Interview Survey. Results In this integrated health care organization, the percentage of positive FOBTs followed by complete diagnostic evaluation within one year increased from 57%–64% in 1993–1996 to 82%–86% from 2000–2005. Use of repeat FOBT following a positive FOBT decreased from 28–31% in 1993–1996 to 6–11% in 2000–2005. Based on the National Health Interview Survey, only 52% of positive FOBTs from 2000–2005 were followed by complete diagnostic evaluation nationally. Conclusions Adherence to recommendations for complete diagnostic evaluation following a positive FOBT has greatly improved over time in an integrated group medical practice. Through the use of tracking systems and screening guidelines, it may be possible to reach levels of follow-up that are comparable to those observed in randomized trials. PMID:18725839

  2. Complete diagnostics of pyroactive structures for smart systems of optoelectronics

    NASA Astrophysics Data System (ADS)

    Bravina, Svetlana L.; Morozovsky, Nicholas V.

    1998-04-01

    The results of study of pyroelectric phenomena in ferroelectric materials for evidence of the possibility to embody the functions promising for creation of smart systems for optoelectronic applications are presented. Designing such systems requires the development of methods for non- destructive complete diagnostics preferably by developing the self-diagnostic ability inherent in materials with the features of smart/intelligent ones. The complex method of complete non-destructive qualification of pyroactive materials based on the method of dynamic photopyroelectric effect allows the determination of pyroelectric, piezoelectric, ferroelectric, dielectric and thermophysical characteristics. The measuring system which allows the study of these characteristics and also memory effects, switching effects, fatigue and degradation process, self-repair process and others is presented. Sample pyroactive system with increased intelligence, such as systems with built-in adaptive controllable domain structure promising for functional optics are developed and peculiarities of their characterization are discussed.

  3. New methodology to baseline and match AME polysilicon etcher using advanced diagnostic tools

    NASA Astrophysics Data System (ADS)

    Poppe, James; Shipman, John; Reinhardt, Barbara E.; Roussel, Myriam; Hedgecock, Raymond; Fonda, Arturo

    1999-09-01

    As process controls tighten in the semiconductor industry, the need to understand the variables that determine system performance become more important. For plasma etch systems, process success depends on the control of key parameters such as: vacuum integrity, pressure, gas flows, and RF power. It is imperative to baseline, monitor, and control these variables. This paper presents an overview of the methods and tools used by Motorola BMC fabrication facility to characterize an Applied Materials polysilicon etcher. Tool performance data obtained from our traditional measurement techniques are limited in their scope and do not provide a complete picture of the ultimate tool performance. Presently the BMC traditional characterization tools provide a snapshot of the static operation of the equipment under test (EUT); however, complete evaluation of the dynamic performance cannot be monitored without the aid of specialized diagnostic equipment. To provide us with a complete system baseline evaluation of the polysilicon etcher, three diagnostic tools were utilized: Lucas Labs Vacuum Diagnostic System, Residual Gas Analyzer, and the ENI Voltage/Impedance Probe. The diagnostic methodology used to baseline and match key parameters of qualified production equipment has had an immense impact on other equipment characterization in the facility. It has resulted in reduced cycle time for new equipment introduction as well.

  4. Electromagnetic Analysis of ITER Diagnostic Equatorial Port Plugs During Plasma Disruptions

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Y. Zhai, R. Feder, A. Brooks, M. Ulrickson, C.S. Pitcher and G.D. Loesser

    2012-08-27

    ITER diagnostic port plugs perform many functionsincluding structural support of diagnostic systems under high electromagnetic loads while allowing for diagnostic access to the plasma. The design of diagnostic equatorial port plugs (EPP) are largely driven by electromagnetic loads and associate responses of EPP structure during plasma disruptions and VDEs. This paper summarizes results of transient electromagnetic analysis using Opera 3d in support of the design activities for ITER diagnostic EPP. A complete distribution of disruption loads on the Diagnostic First Walls (DFWs), Diagnostic Shield Modules (DSMs) and the EPP structure, as well as impact on the system design integration duemore » to electrical contact among various EPP structural components are discussed.« less

  5. Electromagnetic Analysis For The Design Of ITER Diagnostic Port Plugs During Plasma Disruptions

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Zhai, Y

    2014-03-03

    ITER diagnostic port plugs perform many functions including structural support of diagnostic systems under high electromagnetic loads while allowing for diagnostic access to plasma. The design of diagnotic equatorial port plugs (EPP) are largely driven by electromagnetic loads and associate response of EPP structure during plasma disruptions and VDEs. This paper summarizes results of transient electromagnetic analysis using Opera 3d in support of the design activities for ITER diagnostic EPP. A complete distribution of disruption loads on the Diagnostic First Walls (DFWs). Diagnostic Shield Modules (DSMs) and the EPP structure, as well as impact on the system design integration duemore » to electrical contact among various EPP structural components are discussed.« less

  6. Fault diagnostic instrumentation design for environmental control and life support systems

    NASA Technical Reports Server (NTRS)

    Yang, P. Y.; You, K. C.; Wynveen, R. A.; Powell, J. D., Jr.

    1979-01-01

    As a development phase moves toward flight hardware, the system availability becomes an important design aspect which requires high reliability and maintainability. As part of continous development efforts, a program to evaluate, design, and demonstrate advanced instrumentation fault diagnostics was successfully completed. Fault tolerance designs for reliability and other instrumenation capabilities to increase maintainability were evaluated and studied.

  7. How patients navigate the diagnostic ecosystem in a fragmented health system: a qualitative study from India

    PubMed Central

    Yellapa, Vijayashree; Devadasan, Narayanan; Krumeich, Anja; Pant Pai, Nitika; Vadnais, Caroline; Pai, Madhukar; Engel, Nora

    2017-01-01

    ABSTRACT Background: Depending on a country’s diagnostic infrastructure, patients and providers play different roles in ensuring that correct and timely diagnosis is made. However, little is known about the work done by patients in accessing diagnostic services and completing the ‘test and treat’ loop. Objective: To address this knowledge gap, we traced the diagnostic journeys of patients with tuberculosis, diabetes, hypertension and typhoid, and examined the work they had to do to arrive at a diagnosis. Methods: This paper draws on a qualitative study, which included 78 semi-structured interviews and 13 focus group discussions with patients, public and private healthcare providers, community health workers, test manufacturers, laboratory technicians, program managers and policymakers. Data were collected between January and June 2013 in rural and urban Karnataka, South India, as part of a larger project on barriers to point-of-care testing. We reconstructed patient diagnostic processes retrospectively and analyzed emerging themes and patterns. Results: The journey to access diagnostic services requires a high level of involvement and immense work from patients and/or their caretakers. This process entails overcoming cost and distance, negotiating social relations, continuously making sense of their illness and diagnosis, producing and transporting samples, dealing with the social consequences of diagnosis, and returning results to the treating provider. The quality and content of interactions with providers were crucial for completion of test and treat loops. If the tasks became overwhelming, patients opted out, delayed being tested, switched providers and/or reverted to self-testing or self-treatment practices. Conclusion: Our study demonstrated how difficult it can be for patients to complete diagnostic journeys and how the health system works as far as diagnostics are concerned. If new point-of-care tests are to be implemented successfully, policymakers, program officers and test developers need to find ways to ease patient navigation through diagnostic services. PMID:28762894

  8. A Model-Based Expert System for Space Power Distribution Diagnostics

    NASA Technical Reports Server (NTRS)

    Quinn, Todd M.; Schlegelmilch, Richard F.

    1994-01-01

    When engineers diagnose system failures, they often use models to confirm system operation. This concept has produced a class of advanced expert systems that perform model-based diagnosis. A model-based diagnostic expert system for the Space Station Freedom electrical power distribution test bed is currently being developed at the NASA Lewis Research Center. The objective of this expert system is to autonomously detect and isolate electrical fault conditions. Marple, a software package developed at TRW, provides a model-based environment utilizing constraint suspension. Originally, constraint suspension techniques were developed for digital systems. However, Marple provides the mechanisms for applying this approach to analog systems such as the test bed, as well. The expert system was developed using Marple and Lucid Common Lisp running on a Sun Sparc-2 workstation. The Marple modeling environment has proved to be a useful tool for investigating the various aspects of model-based diagnostics. This report describes work completed to date and lessons learned while employing model-based diagnostics using constraint suspension within an analog system.

  9. NASA IVHM Technology Experiment for X-vehicles (NITEX)

    NASA Technical Reports Server (NTRS)

    Sandra, Hayden; Bajwa, Anupa

    2001-01-01

    The purpose of the NASA IVHM Technology Experiment for X-vehicles (NITEX) is to advance the development of selected IVHM technologies in a flight environment and to demonstrate the potential for reusable launch vehicle ground processing savings. The technologies to be developed and demonstrated include system-level and detailed diagnostics for real-time fault detection and isolation, prognostics for fault prediction, automated maintenance planning based on diagnostic and prognostic results, and a microelectronics hardware platform. Complete flight The Evolution of Flexible Insulation as IVHM consists of advanced sensors, distributed data acquisition, data processing that includes model-based diagnostics, prognostics and vehicle autonomy for control or suggested action, and advanced data storage. Complete ground IVHM consists of evolved control room architectures, advanced applications including automated maintenance planning and automated ground support equipment. This experiment will advance the development of a subset of complete IVHM.

  10. A Novel System for Supporting Autism Diagnosis Using Home Videos: Iterative Development and Evaluation of System Design.

    PubMed

    Nazneen, Nazneen; Rozga, Agata; Smith, Christopher J; Oberleitner, Ron; Abowd, Gregory D; Arriaga, Rosa I

    2015-06-17

    Observing behavior in the natural environment is valuable to obtain an accurate and comprehensive assessment of a child's behavior, but in practice it is limited to in-clinic observation. Research shows significant time lag between when parents first become concerned and when the child is finally diagnosed with autism. This lag can delay early interventions that have been shown to improve developmental outcomes. To develop and evaluate the design of an asynchronous system that allows parents to easily collect clinically valid in-home videos of their child's behavior and supports diagnosticians in completing diagnostic assessment of autism. First, interviews were conducted with 11 clinicians and 6 families to solicit feedback from stakeholders about the system concept. Next, the system was iteratively designed, informed by experiences of families using it in a controlled home-like experimental setting and a participatory design process involving domain experts. Finally, in-field evaluation of the system design was conducted with 5 families of children (4 with previous autism diagnosis and 1 child typically developing) and 3 diagnosticians. For each family, 2 diagnosticians, blind to the child's previous diagnostic status, independently completed an autism diagnosis via our system. We compared the outcome of the assessment between the 2 diagnosticians, and between each diagnostician and the child's previous diagnostic status. The system that resulted through the iterative design process includes (1) NODA smartCapture, a mobile phone-based application for parents to record prescribed video evidence at home; and (2) NODA Connect, a Web portal for diagnosticians to direct in-home video collection, access developmental history, and conduct an assessment by linking evidence of behaviors tagged in the videos to the Diagnostic and Statistical Manual of Mental Disorders criteria. Applying clinical judgment, the diagnostician concludes a diagnostic outcome. During field evaluation, without prior training, parents easily (average rating of 4 on a 5-point scale) used the system to record video evidence. Across all in-home video evidence recorded during field evaluation, 96% (26/27) were judged as clinically useful, for performing an autism diagnosis. For 4 children (3 with autism and 1 typically developing), both diagnosticians independently arrived at the correct diagnostic status (autism versus typical). Overall, in 91% of assessments (10/11) via NODA Connect, diagnosticians confidently (average rating 4.5 on a 5-point scale) concluded a diagnostic outcome that matched with the child's previous diagnostic status. The in-field evaluation demonstrated that the system's design enabled parents to easily record clinically valid evidence of their child's behavior, and diagnosticians to complete a diagnostic assessment. These results shed light on the potential for appropriately designed telehealth technology to support clinical assessments using in-home video captured by families. This assessment model can be readily generalized to other conditions where direct observation of behavior plays a central role in the assessment process.

  11. Antimicrobial susceptibility of Escherichia coli F4, Pasteurella multocida, and Streptococcus suis isolates from a diagnostic veterinary laboratory and recommendations for a surveillance system

    PubMed Central

    Glass-Kaastra, Shiona K.; Pearl, David L.; Reid-Smith, Richard J.; McEwen, Beverly; Slavic, Durda; McEwen, Scott A.; Fairles, Jim

    2014-01-01

    Antimicrobial susceptibility data on Escherichia coli F4, Pasteurella multocida, and Streptococcus suis isolates from Ontario swine (January 1998 to October 2010) were acquired from a comprehensive diagnostic veterinary laboratory in Ontario, Canada. In relation to the possible development of a surveillance system for antimicrobial resistance, data were assessed for ease of management, completeness, consistency, and applicability for temporal and spatial statistical analyses. Limited farm location data precluded spatial analyses and missing demographic data limited their use as predictors within multivariable statistical models. Changes in the standard panel of antimicrobials used for susceptibility testing reduced the number of antimicrobials available for temporal analyses. Data consistency and quality could improve over time in this and similar diagnostic laboratory settings by encouraging complete reporting with sample submission and by modifying database systems to limit free-text data entry. These changes could make more statistical methods available for disease surveillance and cluster detection. PMID:24688133

  12. Antimicrobial susceptibility of Escherichia coli F4, Pasteurella multocida, and Streptococcus suis isolates from a diagnostic veterinary laboratory and recommendations for a surveillance system.

    PubMed

    Glass-Kaastra, Shiona K; Pearl, David L; Reid-Smith, Richard J; McEwen, Beverly; Slavic, Durda; McEwen, Scott A; Fairles, Jim

    2014-04-01

    Antimicrobial susceptibility data on Escherichia coli F4, Pasteurella multocida, and Streptococcus suis isolates from Ontario swine (January 1998 to October 2010) were acquired from a comprehensive diagnostic veterinary laboratory in Ontario, Canada. In relation to the possible development of a surveillance system for antimicrobial resistance, data were assessed for ease of management, completeness, consistency, and applicability for temporal and spatial statistical analyses. Limited farm location data precluded spatial analyses and missing demographic data limited their use as predictors within multivariable statistical models. Changes in the standard panel of antimicrobials used for susceptibility testing reduced the number of antimicrobials available for temporal analyses. Data consistency and quality could improve over time in this and similar diagnostic laboratory settings by encouraging complete reporting with sample submission and by modifying database systems to limit free-text data entry. These changes could make more statistical methods available for disease surveillance and cluster detection.

  13. Conversion-Integration of MSFC Nonlinear Signal Diagnostic Analysis Algorithms for Realtime Execution of MSFC's MPP Prototype System

    NASA Technical Reports Server (NTRS)

    Jong, Jen-Yi

    1996-01-01

    NASA's advanced propulsion system Small Scale Magnetic Disturbances/Advanced Technology Development (SSME/ATD) has been undergoing extensive flight certification and developmental testing, which involves large numbers of health monitoring measurements. To enhance engine safety and reliability, detailed analysis and evaluation of the measurement signals are mandatory to assess its dynamic characteristics and operational condition. Efficient and reliable signal detection techniques will reduce the risk of catastrophic system failures and expedite the evaluation of both flight and ground test data, and thereby reduce launch turn-around time. During the development of SSME, ASRI participated in the research and development of several advanced non- linear signal diagnostic methods for health monitoring and failure prediction in turbomachinery components. However, due to the intensive computational requirement associated with such advanced analysis tasks, current SSME dynamic data analysis and diagnostic evaluation is performed off-line following flight or ground test with a typical diagnostic turnaround time of one to two days. The objective of MSFC's MPP Prototype System is to eliminate such 'diagnostic lag time' by achieving signal processing and analysis in real-time. Such an on-line diagnostic system can provide sufficient lead time to initiate corrective action and also to enable efficient scheduling of inspection, maintenance and repair activities. The major objective of this project was to convert and implement a number of advanced nonlinear diagnostic DSP algorithms in a format consistent with that required for integration into the Vanderbilt Multigraph Architecture (MGA) Model Based Programming environment. This effort will allow the real-time execution of these algorithms using the MSFC MPP Prototype System. ASRI has completed the software conversion and integration of a sequence of nonlinear signal analysis techniques specified in the SOW for real-time execution on MSFC's MPP Prototype. This report documents and summarizes the results of the contract tasks; provides the complete computer source code; including all FORTRAN/C Utilities; and all other utilities/supporting software libraries that are required for operation.

  14. [Clinical picture, diagnostics and prophylaxis of a syndrome in conditions of the Far North].

    PubMed

    Ukhocskiĭ, D M; Tegza, V Iu; Rezvantsev, M V; Vasil'chenko, V V; Belikova, T M

    2014-10-01

    The analysis of a clinical picture barometeosensitivity in a seaside zone of the Far North is carried out in the article. A diagnostic test included the following laboratory assessments: complete blood count, complete urinary analysis, biomedical measurement assessment, immunology blood research and functional renal test; analysis of the level of an electrolyte in the blood and hormone receptor status; and the following instrumental diagnostics: The auscultatory Korotkov's method of determining blood pressure, electrocardiography, variational pulsometry, chest X-ray, mechanocardiography, echocardiography and abdominal ultrasound; and also consultation of ophthalmologist and neuropathologist. Every patient should keep a diary "weather - health" before and after the treatment. Peculiarities of cardiovascular system, vegetative systems and neuroendocrine system of servicemen, coming to the Far North and mechanisms of development of barometeosensivity were revealed. It has been established that atmospheric pressure variation affects systolic and diastolic blood pressure, heart rate, systolic discharge, Kerdo index, effectiveness of myocardial function, end-diastolic and end-systolic volume, level of cholesterol, triglycerides, kalium, adrenalin, triiodothyronine, blood plasma and plasma renin activity in barometeosensetiv servicemen. The criteria of diagnostics of barometeosensivity in conditions of the Far North are suggested. The influence of baromemteosensivity on the combat capability of serviceman is researched.

  15. An SSME High Pressure Oxidizer Turbopump diagnostic system using G2 real-time expert system

    NASA Technical Reports Server (NTRS)

    Guo, Ten-Huei

    1991-01-01

    An expert system which diagnoses various seal leakage faults in the High Pressure Oxidizer Turbopump of the SSME was developed using G2 real-time expert system. Three major functions of the software were implemented: model-based data generation, real-time expert system reasoning, and real-time input/output communication. This system is proposed as one module of a complete diagnostic system for the SSME. Diagnosis of a fault is defined as the determination of its type, severity, and likelihood. Since fault diagnosis is often accomplished through the use of heuristic human knowledge, an expert system based approach has been adopted as a paradigm to develop this diagnostic system. To implement this approach, a software shell which can be easily programmed to emulate the human decision process, the G2 Real-Time Expert System, was selected. Lessons learned from this implementation are discussed.

  16. An SSME high pressure oxidizer turbopump diagnostic system using G2(TM) real-time expert system

    NASA Technical Reports Server (NTRS)

    Guo, Ten-Huei

    1991-01-01

    An expert system which diagnoses various seal leakage faults in the High Pressure Oxidizer Turbopump of the SSME was developed using G2(TM) real-time expert system. Three major functions of the software were implemented: model-based data generation, real-time expert system reasoning, and real-time input/output communication. This system is proposed as one module of a complete diagnostic system for Space Shuttle Main Engine. Diagnosis of a fault is defined as the determination of its type, severity, and likelihood. Since fault diagnosis is often accomplished through the use of heuristic human knowledge, an expert system based approach was adopted as a paradigm to develop this diagnostic system. To implement this approach, a software shell which can be easily programmed to emulate the human decision process, the G2 Real-Time Expert System, was selected. Lessons learned from this implementation are discussed.

  17. A Genuine TEAM Player

    NASA Technical Reports Server (NTRS)

    2001-01-01

    Qualtech Systems, Inc. developed a complete software system with capabilities of multisignal modeling, diagnostic analysis, run-time diagnostic operations, and intelligent interactive reasoners. Commercially available as the TEAMS (Testability Engineering and Maintenance System) tool set, the software can be used to reveal unanticipated system failures. The TEAMS software package is broken down into four companion tools: TEAMS-RT, TEAMATE, TEAMS-KB, and TEAMS-RDS. TEAMS-RT identifies good, bad, and suspect components in the system in real-time. It reports system health results from onboard tests, and detects and isolates failures within the system, allowing for rapid fault isolation. TEAMATE takes over from where TEAMS-RT left off by intelligently guiding the maintenance technician through the troubleshooting procedure, repair actions, and operational checkout. TEAMS-KB serves as a model management and collection tool. TEAMS-RDS (TEAMS-Remote Diagnostic Server) has the ability to continuously assess a system and isolate any failure in that system or its components, in real time. RDS incorporates TEAMS-RT, TEAMATE, and TEAMS-KB in a large-scale server architecture capable of providing advanced diagnostic and maintenance functions over a network, such as the Internet, with a web browser user interface.

  18. Assessment of Augmented Electronic Fuel Controls for Modular Engine Diagnostics and Condition Monitoring

    DTIC Science & Technology

    1978-12-01

    not retumn it to the originator. Unclassified READ INSTRUCTIONSJ EPORT DOCUMENTATION PAGE BEFORE COMPLETING FORMJ. GOVT ACCESSr - ECIPIENT’S CATALOG...responsible for low engine performance of an installed engine. In the case of the T700, a study was completed in Nov. 197 7 which def8 nod an analytical...ECM study has been completed . T" e results of the various systems considered areo presented below. &sateim A - Az exponsive system foaturing in- X ~(X

  19. Simplified diagnostic coding sheet for computerized data storage and analysis in ophthalmology.

    PubMed

    Tauber, J; Lahav, M

    1987-11-01

    A review of currently-available diagnostic coding systems revealed that most are either too abbreviated or too detailed. We have compiled a simplified diagnostic coding sheet based on the International Coding and Diagnosis (ICD-9), which is both complete and easy to use in a general practice. The information is transferred to a computer, which uses the relevant (ICD-9) diagnoses as database and can be retrieved later for display of patients' problems or analysis of clinical data.

  20. Computer-based route-definition system for peripheral bronchoscopy.

    PubMed

    Graham, Michael W; Gibbs, Jason D; Higgins, William E

    2012-04-01

    Multi-detector computed tomography (MDCT) scanners produce high-resolution images of the chest. Given a patient's MDCT scan, a physician can use an image-guided intervention system to first plan and later perform bronchoscopy to diagnostic sites situated deep in the lung periphery. An accurate definition of complete routes through the airway tree leading to the diagnostic sites, however, is vital for avoiding navigation errors during image-guided bronchoscopy. We present a system for the robust definition of complete airway routes suitable for image-guided bronchoscopy. The system incorporates both automatic and semiautomatic MDCT analysis methods for this purpose. Using an intuitive graphical user interface, the user invokes automatic analysis on a patient's MDCT scan to produce a series of preliminary routes. Next, the user visually inspects each route and quickly corrects the observed route defects using the built-in semiautomatic methods. Application of the system to a human study for the planning and guidance of peripheral bronchoscopy demonstrates the efficacy of the system.

  1. Testing HyDE on ADAPT

    NASA Technical Reports Server (NTRS)

    Sweet, Adam

    2008-01-01

    The IVHM Project in the Aviation Safety Program has funded research in electrical power system (EPS) health management. This problem domain contains both discrete and continuous behavior, and thus is directly relevant for the hybrid diagnostic tool HyDE. In FY2007 work was performed to expand the HyDE diagnosis model of the ADAPT system. The work completed resulted in a HyDE model with the capability to diagnose five times the number of ADAPT components previously tested. The expanded diagnosis model passed a corresponding set of new ADAPT fault injection scenario tests with no incorrect faults reported. The time required for the HyDE diagnostic system to isolate the fault varied widely between tests; this variance was reduced by tuning HyDE input parameters. These results and other diagnostic design trade-offs are discussed. Finally, possible future improvements for both the HyDE diagnostic model and HyDE itself are presented.

  2. Evaluation of the enterovirus laboratory surveillance system in Denmark, 2010 to 2013.

    PubMed

    Condell, Orla; Midgley, Sofie; Christiansen, Claus Bohn; Chen, Ming; Chen Nielsen, Xiaohui; Ellermann-Eriksen, Svend; Mølvadgaard, Mette; Schønning, Kristian; Vermedal Hoegh, Silje; Andersen, Peter Henrik; Voldstedlund, Marianne; Fischer, Thea Kølsen

    2016-05-05

    The primary aim of the Danish enterovirus (EV) surveillance system is to document absence of poliovirus infection. The conflict in Syria has left many children unvaccinated and movement from areas with polio cases to Europe calls for increased awareness to detect and respond to virus-transmission in a timely manner. We evaluate the national EV laboratory surveillance, to generate recommendations for system strengthening. The system was analysed for completeness of viral typing analysis and clinical information and timeliness of specimen collection, laboratory results and reporting of clinical information. Of 23,720 specimens screened, 2,202 (9.3%) were EV-positive. Submission of cerebrospinal fluid and faecal specimens from primary diagnostic laboratories was 79.5% complete (845/1,063), and varied by laboratory and patient age. EV genotypes were determined in 68.5% (979/1,430) of laboratory-confirmed cases, clinical information was available for 63.1% (903/1,430). Primary diagnostic results were available after a median of 1.4 days, typing results after 17 days, detailed clinical information after 33 days. The large number of samples typed demonstrated continued monitoring of EV-circulation in Denmark. The system could be strengthened by increasing the collection of supplementary faecal specimens, improving communication with primary diagnostic laboratories, adapting the laboratory typing methodology and collecting clinical information with electronic forms.

  3. Solar thermal polymerase chain reaction for smartphone-assisted molecular diagnostics.

    PubMed

    Jiang, Li; Mancuso, Matthew; Lu, Zhengda; Akar, Gunkut; Cesarman, Ethel; Erickson, David

    2014-02-20

    Nucleic acid-based diagnostic techniques such as polymerase chain reaction (PCR) are used extensively in medical diagnostics due to their high sensitivity, specificity and quantification capability. In settings with limited infrastructure and unreliable electricity, however, access to such devices is often limited due to the highly specialized and energy-intensive nature of the thermal cycling process required for nucleic acid amplification. Here we integrate solar heating with microfluidics to eliminate thermal cycling power requirements as well as create a simple device infrastructure for PCR. Tests are completed in less than 30 min, and power consumption is reduced to 80 mW, enabling a standard 5.5 Wh iPhone battery to provide 70 h of power to this system. Additionally, we demonstrate a complete sample-to-answer diagnostic strategy by analyzing human skin biopsies infected with Kaposi's Sarcoma herpesvirus (KSHV/HHV-8) through the combination of solar thermal PCR, HotSHOT DNA extraction and smartphone-based fluorescence detection. We believe that exploiting the ubiquity of solar thermal energy as demonstrated here could facilitate broad availability of nucleic acid-based diagnostics in resource-limited areas.

  4. Solar thermal polymerase chain reaction for smartphone-assisted molecular diagnostics

    NASA Astrophysics Data System (ADS)

    Jiang, Li; Mancuso, Matthew; Lu, Zhengda; Akar, Gunkut; Cesarman, Ethel; Erickson, David

    2014-02-01

    Nucleic acid-based diagnostic techniques such as polymerase chain reaction (PCR) are used extensively in medical diagnostics due to their high sensitivity, specificity and quantification capability. In settings with limited infrastructure and unreliable electricity, however, access to such devices is often limited due to the highly specialized and energy-intensive nature of the thermal cycling process required for nucleic acid amplification. Here we integrate solar heating with microfluidics to eliminate thermal cycling power requirements as well as create a simple device infrastructure for PCR. Tests are completed in less than 30 min, and power consumption is reduced to 80 mW, enabling a standard 5.5 Wh iPhone battery to provide 70 h of power to this system. Additionally, we demonstrate a complete sample-to-answer diagnostic strategy by analyzing human skin biopsies infected with Kaposi's Sarcoma herpesvirus (KSHV/HHV-8) through the combination of solar thermal PCR, HotSHOT DNA extraction and smartphone-based fluorescence detection. We believe that exploiting the ubiquity of solar thermal energy as demonstrated here could facilitate broad availability of nucleic acid-based diagnostics in resource-limited areas.

  5. Experienced and less-experienced nurses' diagnostic reasoning: implications for fostering students' critical thinking.

    PubMed

    Ferrario, Catherine G

    2003-01-01

    To compare the use of mental representations (heuristics) in diagnostic reasoning of expert (> or = 5 years' experience) and novice (< 5 years' experience) emergency nurses. Clinical simulations were completed by a nationwide randomly selected sample of 173 experienced and 46 less-experienced emergency nurses (N = 219). Experienced nurses used the heuristic, Judging by Causal Systems (diagnostic inferences deduced from systems of causal factors) significantly more did than less-experienced nurses. Standardized nursing diagnoses may cut short the time needed to develop representational thinking and spare cognitive reserves for reasoning needed for complex patients. Faculty need to promote student's cognitive development through strategies that promote active, reflective, and integrative learning.

  6. Consolidated Laser-Induced Fluorescence Diagnostic Systems for the NASA Ames Arc Jet Facilities

    NASA Technical Reports Server (NTRS)

    Grinstead, Jay H.; Wilder, Michael C.; Porter, Barry J.; Brown, Jeffrey D.; Yeung, Dickson; Battazzo, Stephen J.; Brubaker, Timothy R.

    2016-01-01

    The spectroscopic diagnostic technique of two photon absorption laser-induced fluorescence (LIF) of atomic species for non-intrusive arc jet flow property measurement was first implemented at NASA Ames in the mid-1990s. In 2013-2014, NASA combined the agency's large-scale arc jet test capabilities at NASA Ames. Concurrent with that effort, the agency also sponsored a project to establish two comprehensive LIF diagnostic systems for the Aerodynamic Heating Facility (AHF) and Interaction Heating Facility (IHF) arc jets. The scope of the project enabled further engineering development of the existing IHF LIF system as well as the complete reconstruction of the AHF LIF system. The updated LIF systems are identical in design and capability. They represent the culmination of over 20 years of development experience in transitioning a specialized laboratory research tool into a measurement system for large-scale, high-demand test facilities. This paper will document the latest improvements of the LIF system design and demonstrations of the redeveloped AHF and IHF LIF systems.

  7. The Palm Desert renewable [hydrogen] transportation system

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Chamberlin, C.E.; Lehman, P.

    1998-08-01

    This paper describes the Schatz Energy Research Center (SERC) progress on the Palm Desert Renewable Hydrogen Transportation System Project for the period June 1997 through May 1998. The project began in March 1996. The goal of the Palm Desert Project is to develop a clean and sustainable transportation system for a community. The project demonstrates the practical utility of hydrogen as a transportation fuel and the proton exchange membrane (PEM) fuel cell as a vehicle power system. The project includes designing and building 4 fuel cell powered vehicles, a solar hydrogen generating and refueling station, and a fuel cell vehiclemore » diagnostic center. Over this last year, SERC has built a fuel cell powered neighborhood electric vehicle and delivered it to the City of Palm Desert. The design of the hydrogen refueling station is near completion and it is anticipated that construction will be complete in the fall of 1998. The vehicles are currently being refueled at a temporary refueling station. The diagnostic center is being designed and maintenance procedures as well as computer diagnostic programs for the fuel cell vehicles are being developed. City employees are driving the vehicles daily and monitoring data are being collected. The drivers are pleased with the performance of the vehicles.« less

  8. Evaluation of a Diagnostic Encyclopedia Workstation for ovarian pathology.

    PubMed

    van Ginneken, A M; Baak, J P; Jansen, W; Smeulders, A W

    1990-10-01

    The Diagnostic Encyclopedia Workstation (DEW) is a computer system that provides completely integrated pictorial and textual information as reference knowledge in the field of ovarian pathology. The textual component comprises information per diagnosis such as descriptions of macroscopic and microscopic images, clinical signs, and prognosis. In addition, the system offers lists of differential diagnoses and criteria to differentiate among lists of differential diagnoses and criteria to differentiate among them. The present study evaluates to what extent the system influences the diagnostic process in efficiency and outcome. Therefore, two groups of six pathologists each, covering a wide spectrum of experience in ovarian pathology, participated in the evaluation of the DEW. The quality of the resulting diagnoses was statistically analyzed with the Wilcoxon rank sum test with respect to five different viewpoints: classification, morphology, clinical consequences, duration of diagnostic process, and consensus among the participants. The results are discussed and it is concluded that classification and morphology showed better results when books were used. The evaluation experiment was, however, very rigid and negatively biased with respect to the DEW system. Positive aspects of the encyclopedia are the easy access to diagnostic and differential diagnostic information and the large set of illustrations. Insight is acquired with respect to existing bottlenecks and how they may be overcome.

  9. Pinned, optically aligned diagnostic dock for use on the Z facility.

    PubMed

    Gomez, M R; Rochau, G A; Bailey, J E; Dunham, G S; Kernaghan, M D; Gard, P; Robertson, G K; Owen, A C; Argo, J W; Nielsen, D S; Lake, P W

    2012-10-01

    The pinned optically aligned diagnostic dock (PODD) is a multi-configuration diagnostic platform designed to measure x-ray emission on the Z facility. The PODD houses two plasma emission acquisition (PEA) systems, which are aligned with a set of precision machined pins. The PEA systems are modular, allowing a single diagnostic housing to support several different diagnostics. The PEA configurations fielded to date include both time-resolved and time-integrated, 1D spatially resolving, elliptical crystal spectrometers, and time-integrated, 1D spatially resolving, convex crystal spectrometers. Additional proposed configurations include time-resolved, monochromatic mirrored pinhole imagers and arrays of filtered x-ray diodes, diamond photo-conducting diode detectors, and bolometers. The versatility of the PODD system will allow the diagnostic configuration of the Z facility to be changed without significantly adding to the turn-around time of the machine. Additionally, the PODD has been designed to allow instrument setup to be completed entirely off-line, leaving only a refined alignment process to be performed just prior to a shot, which is a significant improvement over the instrument the PODD replaces. Example data collected with the PODD are presented.

  10. [Ankyloblepharon filiforme adnatum].

    PubMed

    Haustein, M; Reschke, F; Terai, N; Lesczcynska, A; Wozniak, K; Pillunat, L E; Sommer, F

    2014-02-01

    The ankyloblepharon filiforme adnatum is a congenital eyelid anomaly in which the development of the eyelids is completed but the eyelids are not completely separated at birth. The abnormality can occur as an isolated anomaly, together with other eye diseases or in the context of systemic syndromes. In this case report the current classification and essential diagnostics of AFA will be reviewed.

  11. Diagnosis: Reasoning from first principles and experiential knowledge

    NASA Technical Reports Server (NTRS)

    Williams, Linda J. F.; Lawler, Dennis G.

    1987-01-01

    Completeness, efficiency and autonomy are requirements for suture diagnostic reasoning systems. Methods for automating diagnostic reasoning systems include diagnosis from first principles (i.e., reasoning from a thorough description of structure and behavior) and diagnosis from experiential knowledge (i.e., reasoning from a set of examples obtained from experts). However, implementation of either as a single reasoning method fails to meet these requirements. The approach of combining reasoning from first principles and reasoning from experiential knowledge does address the requirements discussed above and can possibly ease some of the difficulties associated with knowledge acquisition by allowing developers to systematically enumerate a portion of the knowledge necessary to build the diagnosis program. The ability to enumerate knowledge systematically facilitates defining the program's scope, completeness, and competence and assists in bounding, controlling, and guiding the knowledge acquisition process.

  12. Real-time Optical Alignment and Diagnostic System (ROADS)

    NASA Technical Reports Server (NTRS)

    1972-01-01

    The ultimate and most frequent usage of ROADS will be the alignment of subassemblies (collector and collimator) prior to their installation in a chamber. The system as designed has inherent associated capabilities well applied to acceptance testing of the No. 4 mirror, prediction of in-chamber performance, generation of a catalog of test results and other data, providing data for the plotting of isointensity lines, and other applications which are discussed. The ROADS system will collect, process, display, analyze, and retain data as required for components, partial subassemblies, complete subassemblies, complete modules, and multimodular arrays.

  13. 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.

  14. Development of Thomson scattering system on Shenguang-III prototype laser facility

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Gong, Tao; Research Center of Laser Fusion, China Academy of Engineering Physics, Mianyang, Sichuan 621900; Li, Zhichao

    2015-02-15

    A Thomson scattering diagnostic system, using a 263 nm laser as the probe beam, is designed and implemented on Shenguang-III prototype laser facility. The probe beam is provided by an additional beam line completed recently. The diagnostic system allows simultaneous measurements of both ion feature and red-shifted electron feature from plasmas in a high-temperature (≥2 keV) and high-density (≥10{sup 21} cm{sup −3}) regime. Delicate design is made to satisfy the requirements for successful detection of the electron feature. High-quality ion feature spectra have already been diagnosed via this system in recent experiments with gas-filled hohlraums.

  15. Solar thermal polymerase chain reaction for smartphone-assisted molecular diagnostics

    PubMed Central

    Jiang, Li; Mancuso, Matthew; Lu, Zhengda; Akar, Gunkut; Cesarman, Ethel; Erickson, David

    2014-01-01

    Nucleic acid-based diagnostic techniques such as polymerase chain reaction (PCR) are used extensively in medical diagnostics due to their high sensitivity, specificity and quantification capability. In settings with limited infrastructure and unreliable electricity, however, access to such devices is often limited due to the highly specialized and energy-intensive nature of the thermal cycling process required for nucleic acid amplification. Here we integrate solar heating with microfluidics to eliminate thermal cycling power requirements as well as create a simple device infrastructure for PCR. Tests are completed in less than 30 min, and power consumption is reduced to 80 mW, enabling a standard 5.5 Wh iPhone battery to provide 70 h of power to this system. Additionally, we demonstrate a complete sample-to-answer diagnostic strategy by analyzing human skin biopsies infected with Kaposi's Sarcoma herpesvirus (KSHV/HHV-8) through the combination of solar thermal PCR, HotSHOT DNA extraction and smartphone-based fluorescence detection. We believe that exploiting the ubiquity of solar thermal energy as demonstrated here could facilitate broad availability of nucleic acid-based diagnostics in resource-limited areas. PMID:24553130

  16. A modern diagnostic approach for automobile systems condition monitoring

    NASA Astrophysics Data System (ADS)

    Selig, M.; Shi, Z.; Ball, A.; Schmidt, K.

    2012-05-01

    An important topic in automotive research and development is the area of active and passive safety systems. In general, it is grouped in active safety systems to prevent accidents and passive systems to reduce the impact of a crash. An example for an active system is ABS while a seat belt tensioner represents the group of passive systems. Current developments in the automotive industry try to link active with passive system components to enable a complete event sequence, beginning with the warning of the driver about a critical situation till the automatic emergency call after an accident. The cross-linking has an impact on the current diagnostic approach, which is described in this paper. Therefore, this contribution introduces a new diagnostic approach for automotive mechatronic systems. The concept is based on monitoring the messages which are exchanged via the automotive communication systems, e.g. the CAN bus. According to the authors' assumption, the messages on the bus are changing between faultless and faulty vehicle condition. The transmitted messages of the sensors and control units are different depending on the condition of the car. First experiments are carried and in addition, the hardware design of a suitable diagnostic interface is presented. Finally, first results will be presented and discussed.

  17. Time-Motion Analysis of Four Automated Systems for the Detection of Chlamydia trachomatis and Neisseria gonorrhoeae by Nucleic Acid Amplification Testing.

    PubMed

    Williams, James A; Eddleman, Laura; Pantone, Amy; Martinez, Regina; Young, Stephen; Van Der Pol, Barbara

    2014-08-01

    Next-generation diagnostics for Chlamydia trachomatis and Neisseria gonorrhoeae are available on semi- or fully-automated platforms. These systems require less hands-on time than older platforms and are user friendly. Four automated systems, the ABBOTT m2000 system, Becton Dickinson Viper System with XTR Technology, Gen-Probe Tigris DTS system, and Roche cobas 4800 system, were evaluated for total run time, hands-on time, and walk-away time. All of the systems evaluated in this time-motion study were able to complete a diagnostic test run within an 8-h work shift, instrument setup and operation were straightforward and uncomplicated, and walk-away time ranged from approximately 90 to 270 min in a head-to-head comparison of each system. All of the automated systems provide technical staff with increased time to perform other tasks during the run, offer easy expansion of the diagnostic test menu, and have the ability to increase specimen throughput. © 2013 Society for Laboratory Automation and Screening.

  18. Component-Level Electronic-Assembly Repair (CLEAR) System Architecture

    NASA Technical Reports Server (NTRS)

    Oeftering, Richard C.; Bradish, Martin A.; Juergens, Jeffrey R.; Lewis, Michael J.; Vrnak, Daniel R.

    2011-01-01

    This document captures the system architecture for a Component-Level Electronic-Assembly Repair (CLEAR) capability needed for electronics maintenance and repair of the Constellation Program (CxP). CLEAR is intended to improve flight system supportability and reduce the mass of spares required to maintain the electronics of human rated spacecraft on long duration missions. By necessity it allows the crew to make repairs that would otherwise be performed by Earth based repair depots. Because of practical knowledge and skill limitations of small spaceflight crews they must be augmented by Earth based support crews and automated repair equipment. This system architecture covers the complete system from ground-user to flight hardware and flight crew and defines an Earth segment and a Space segment. The Earth Segment involves database management, operational planning, and remote equipment programming and validation processes. The Space Segment involves the automated diagnostic, test and repair equipment required for a complete repair process. This document defines three major subsystems including, tele-operations that links the flight hardware to ground support, highly reconfigurable diagnostics and test instruments, and a CLEAR Repair Apparatus that automates the physical repair process.

  19. A tutorial on the use of ROC analysis for computer-aided diagnostic systems.

    PubMed

    Scheipers, Ulrich; Perrey, Christian; Siebers, Stefan; Hansen, Christian; Ermert, Helmut

    2005-07-01

    The application of the receiver operating characteristic (ROC) curve for computer-aided diagnostic systems is reviewed. A statistical framework is presented and different methods of evaluating the classification performance of computer-aided diagnostic systems, and, in particular, systems for ultrasonic tissue characterization, are derived. Most classifiers that are used today are dependent on a separation threshold, which can be chosen freely in many cases. The separation threshold separates the range of output values of the classification system into different target groups, thus conducting the actual classification process. In the first part of this paper, threshold specific performance measures, e.g., sensitivity and specificity, are presented. In the second part, a threshold-independent performance measure, the area under the ROC curve, is reviewed. Only the use of separation threshold-independent performance measures provides classification results that are overall representative for computer-aided diagnostic systems. The following text was motivated by the lack of a complete and definite discussion of the underlying subject in available textbooks, references and publications. Most manuscripts published so far address the theme of performance evaluation using ROC analysis in a manner too general to be practical for everyday use in the development of computer-aided diagnostic systems. Nowadays, the user of computer-aided diagnostic systems typically handles huge amounts of numerical data, not always distributed normally. Many assumptions made in more or less theoretical works on ROC analysis are no longer valid for real-life data. The paper aims at closing the gap between theoretical works and real-life data. The review provides the interested scientist with information needed to conduct ROC analysis and to integrate algorithms performing ROC analysis into classification systems while understanding the basic principles of classification.

  20. Perspective: Whither the problem list? Organ-based documentation and deficient synthesis by medical trainees.

    PubMed

    Kaplan, Daniel M

    2010-10-01

    The author argues that the well-formulated problem list is essential for both organizing and evaluating diagnostic thinking. He considers evidence of deficiencies in problem lists in the medical record. He observes a trend among medical trainees toward organizing notes in the medical record according to lists of organ systems or medical subspecialties and hypothesizes that system-based documentation may undermine the art of problem formulation and diagnostic synthesis. Citing research linking more sophisticated problem representation with diagnostic success, he suggests that documentation style and clinical reasoning are closely connected and that organ-based documentation may predispose trainees to several varieties of cognitive diagnostic error and deficient synthesis. These include framing error, premature or absent closure, failure to integrate related findings, and failure to recognize the level of diagnostic resolution attained for a given problem. He acknowledges the pitfalls of higher-order diagnostic resolution, including the application of labels unsupported by firm evidence, while maintaining that diagnostic resolution as far as evidence permits is essential to both rational care of patients and rigorous education of learners. He proposes further research, including comparison of diagnostic efficiency between organ- and problem-oriented thinkers. He hypothesizes that the subspecialty-based structure of academic medical services helps perpetuate organ-system-based thinking, and calls on clinical educators to renew their emphasis on the formulation and documentation of complete and precise problem lists and progressively refined diagnoses by trainees.

  1. Sub-nanosecond cinematography in laser fusion research: Current techniques and applications at the Lawrence Livermore Laboratory

    NASA Astrophysics Data System (ADS)

    Coleman, L. W.

    1985-01-01

    Progress in laser fusion research has increased the need for detail and precision in the diagnosis of experiments. This has spawned the development and use of sophisticated sub-nanosecond resolution diagnostic systems. These systems typically use ultrafast X-ray or optical streak cameras in combination with spatially imaging or spectrally dispersing elements. These instruments provide high resolution data essential for understanding the processes occurring in the interaction of high intensity laser light with targets. Several of these types of instruments and their capabilities will be discussed. The utilization of these kinds of diagnostics systems on the nearly completed 100 kJ Nova laser facility will be described.

  2. Improving spatial and spectral resolution of TCV Thomson scattering

    NASA Astrophysics Data System (ADS)

    Hawke, J.; Andrebe, Y.; Bertizzolo, R.; Blanchard, P.; Chavan, R.; Decker, J.; Duval, B.; Lavanchy, P.; Llobet, X.; Marlétaz, B.; Marmillod, P.; Pochon, G.; Toussaint, M.

    2017-12-01

    The recently completed MST2 upgrade to the Thomson scattering (TS) system on TCV (Tokamak à Configuration Variable) at the Swiss Plasma Center aims to provide an enhanced spatial and spectral resolution while maintaining the high level of diagnostic flexibility for the study of TCV plasmas. The MST2 (Medium Sized Tokamak) is a work program within the Eurofusion ITER physics department, aimed at exploiting Europe's medium sized tokamak programs for a better understanding of ITER physics. This upgrade to the TCV Thomson scattering system involved the installation of 40 new compact 5-channel spectrometers and modifications to the diagnostics fiber optic design. The complete redesign of the fiber optic backplane incorporates fewer larger diameter fibers, allowing for a higher resolution in both the core and edge of TCV plasmas along the laser line, with a slight decrease in the signal to noise ratio of Thomson measurements. The 40 new spectrometers added to the system are designed to cover the full range of temperatures expected in TCV, able to measure electron temperatures (Te) with high precision between (6 eV and 20 keV) . The design of these compact spectrometers stems originally from the design utilized in the MAST (Mega Amp Spherical Tokamak) TS system located in Oxfordshire, United Kingdom. This design was implemented on TCV with an overall layout of optical fibers and spectrometers to achieve an overall increase in the spatial resolution, specifically a resolution of approximately 1% of the minor radius within the plasma pedestal region. These spectrometers also enhance the diagnostic spectral resolution, especially within the plasma edge, due to the low Te measurement capabilities. These additional spectrometers allow for a much greater diagnostic flexibility, allowing for quality full Thomson profiles in 75% of TCV plasma configurations.

  3. Diagnostics monitor of the braking efficiency in the on board diagnostics system for the motor vehicles

    NASA Astrophysics Data System (ADS)

    Gajek, Andrzej

    2016-09-01

    The article presents diagnostics monitor for control of the efficiency of brakes in various road conditions in cars equipped with pressure sensor in brake (ESP) system. Now the brake efficiency of the vehicles is estimated periodically in the stand conditions on the base of brake forces measurement or in the road conditions on the base of the brake deceleration. The presented method allows to complete the stand - periodical tests of the brakes by current on board diagnostics system OBD for brakes. First part of the article presents theoretical dependences between deceleration of the vehicle and brake pressure. The influence of the vehicle mass, initial speed of braking, temperature of brakes, aerodynamic drag, rolling resistance, engine resistance, state of the road surface, angle of the road sloping on the deceleration have been analysed. The manner of the appointed of these parameters has been analysed. The results of the initial investigation have been presented. At the end of the article the strategy of the estimation and signalization of the irregular value of the deceleration are presented.

  4. Using routine diagnostic data as a method of surveillance of arboviral infection in travellers: a comparative analysis with a focus on dengue.

    PubMed

    Cleton, Natalie; Reusken, Chantal; Murk, Jean-Luc; de Jong, Menno; Reimerink, Johan; van der Eijk, Annemiek; Koopmans, Marion

    2014-01-01

    In a large part of the developing world, limited infectious disease surveillance is performed. In laboratory information management systems data on diagnostic requests is available and may be amenable to trend analyses. We explored this potential, using DENV diagnostic requests as a model. Test results and anonymised information provided by clinicians were received for 8942 patients from diagnostic centres in the Netherlands from January 2000 to May 2011. The data were evaluated for completeness of a predefined minimal dataset and trends in DENV positive results by travel destination. Population travel data were obtained from a commercial registry, and dengue case notification data by country from WHO DengueNet. Vaccination history was rarely reported (0.4%); travel destination was completed for 42% of requests; trends in diagnostic requests and IgM positive tests for this subset correlated to the WHO DENV notifications for the three main travel destinations, with some discrepancies. Additionally, this approach may provide information on disease outbreaks with other pathogens causing diseases clinically similar to DENV. PCR data proved to be insufficient for trend monitoring by country. This approach is not straightforward, but shows potential for use as a source of additional information for surveillance of disease. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. From telepathology to virtual pathology institution: the new world of digital pathology.

    PubMed

    Kayser, K; Kayser, G; Radziszowski, D; Oehmann, A

    Telepathology has left its childhood. Its technical development is mature, and its use for primary (frozen section) and secondary (expert consultation) diagnosis has been expanded to a great amount. This is in contrast to a virtual pathology laboratory, which is still under technical constraints. Similar to telepathology, which can also be used for e-learning and e-training in pathology, as exemplarily is demonstrated on Digital Lung Pathology (Klaus.Kayser@charite.de) at least two kinds of virtual pathology laboratories will be implemented in the near future: a) those with distributed pathologists and distributed (> or = 1) laboratories associated to individual biopsy stations/surgical theatres, and b) distributed pathologists (usually situated in one institution) and a centralized laboratory, which digitizes complete histological slides. Both scenarios are under intensive technical investigations. The features of virtual pathology comprise a virtual pathology institution (mode a) that accepts a complete case with the patient's history, clinical findings, and (pre-selected) images for first diagnosis. The diagnostic responsibility is that of a conventional institution. The Internet serves as platform for information transfer, and an open server such as the iPATH (http://telepath.patho.unibas.ch) for coordination and performance of the diagnostic procedure. The size and number of transferred images have to be limited, and usual different magnifications have to be used. The sender needs to possess experiences in image sampling techniques, which present with the most significant information. A group of pathologists is "on duty", or selects one member for a predefined duty period. The diagnostic statement of the pathologist(s) on duty is retransmitted to the sender with full responsibility. The first experiences of a virtual pathology institution group working with the iPATH server working with a small hospital of the Salomon islands are promising. A centralized virtual pathology institution (mode b) depends upon the digitalization of a complete slide, and the transfer of large sized images to different pathologists working in one institution. The technical performance of complete slide digitalization is still under development. Virtual pathology can be combined with e-learning and e-training, that will serve for a powerful daily-work-integrated pathology system. At present, e-learning systems are "stand-alone" solutions distributed on CD or via Internet. A characteristic example is the Digital Lung Pathology CD, which includes about 60 different rare and common lung diseases with some features of electronic communication. These features include access to scientific library systems (PubMed), distant measurement servers (EuroQuant), automated immunohisto-chemistry measurements, or electronic journals (Elec J Pathol Histol, www.pathology-online.org). It combines e-learning and e-training with some acoustic support. A new and complete database based upon this CD will combine e-learning and e-teaching with the actual workflow in a virtual pathology institution (mode a). The technological problems are solved and do not depend upon technical constraints such as slide scanning systems. At present, telepathology serves as promoter for a complete new landscape in diagnostic pathology, the so-called virtual pathology institution. Industrial and scientific efforts will probably allow an implementation of this technique within the next two years with exciting diagnostic and scientific perspectives.

  6. New developments in digital pathology: from telepathology to virtual pathology laboratory.

    PubMed

    Kayser, Klaus; Kayser, Gian; Radziszowski, Dominik; Oehmann, Alexander

    2004-01-01

    To analyse the present status and future development of computerized diagnostic pathology in terms of work-flow integrative telepathology and virtual laboratory. Telepathology has left its childhood. The technical development of telepathology is mature, in contrast to that of virtual pathology. Two kinds of virtual pathology laboratories are emerging: a) those with distributed pathologists and distributed (>=1) laboratories associated to individual biopsy stations/surgical theatres, and b) distributed pathologists working in a centralized laboratory. Both are under technical development. Telepathology can be used for e-learning and e-training in pathology, as exemplarily demonstrated on Digital Lung Pathology Pathology (www.pathology-online.org). A virtual pathology institution (mode a) accepts a complete case with the patient's history, clinical findings, and (pre-selected) images for first diagnosis. The diagnostic responsibility is that of a conventional institution. The internet serves as platform for information transfer, and an open server such as the iPATH (http://telepath.patho.unibas.ch) for coordination and performance of the diagnostic procedure. The size of images has to be limited, and usual different magnifications have to be used. A group of pathologists is "on duty", or selects one member for a predefined duty period. The diagnostic statement of the pathologist(s) on duty is retransmitted to the sender with full responsibility. First experiences of a virtual pathology institution group working with the iPATH server (Dr. L. Banach, Dr. G. Haroske, Dr. I. Hurwitz, Dr. K. Kayser, Dr. K.D. Kunze, Dr. M. Oberholzer,) working with a small hospital of the Salomon islands are promising. A centralized virtual pathology institution (mode b) depends upon the digitalisation of a complete slide, and the transfer of large sized images to different pathologists working in one institution. The technical performance of complete slide digitalisation is still under development and does not completely fulfil the requirements of a conventional pathology institution at present. VIRTUAL PATHOLOGY AND E-LEARNING: At present, e-learning systems are "stand-alone" solutions distributed on CD or via internet. A characteristic example is the Digital Lung Pathology CD (www.pathology-online.org), which includes about 60 different rare and common lung diseases and internet access to scientific library systems (PubMed), distant measurement servers (EuroQuant), or electronic journals (Elec J Pathol Histol). A new and complete data base based upon this CD will combine e-learning and e-teaching with the actual workflow in a virtual pathology institution (mode a). The technological problems are solved and do not depend upon technical constraints such as slide scanning systems. Telepathology serves as promotor for a new landscape in diagnostic pathology, the so-called virtual pathology institution. Industrial and scientific efforts will probably allow an implementation of this technique within the next two years.

  7. The Diagnostic Validity and Reliability of an Internet-Based Clinical Assessment Program for Mental Disorders

    PubMed Central

    Klein, Britt; Meyer, Denny; Austin, David William; Abbott, Jo-Anne M

    2015-01-01

    Background Internet-based assessment has the potential to assist with the diagnosis of mental health disorders and overcome the barriers associated with traditional services (eg, cost, stigma, distance). Further to existing online screening programs available, there is an opportunity to deliver more comprehensive and accurate diagnostic tools to supplement the assessment and treatment of mental health disorders. Objective The aim was to evaluate the diagnostic criterion validity and test-retest reliability of the electronic Psychological Assessment System (e-PASS), an online, self-report, multidisorder, clinical assessment and referral system. Methods Participants were 616 adults residing in Australia, recruited online, and representing prospective e-PASS users. Following e-PASS completion, 158 participants underwent a telephone-administered structured clinical interview and 39 participants repeated the e-PASS within 25 days of initial completion. Results With structured clinical interview results serving as the gold standard, diagnostic agreement with the e-PASS varied considerably from fair (eg, generalized anxiety disorder: κ=.37) to strong (eg, panic disorder: κ=.62). Although the e-PASS’ sensitivity also varied (0.43-0.86) the specificity was generally high (0.68-1.00). The e-PASS sensitivity generally improved when reducing the e-PASS threshold to a subclinical result. Test-retest reliability ranged from moderate (eg, specific phobia: κ=.54) to substantial (eg, bulimia nervosa: κ=.87). Conclusions The e-PASS produces reliable diagnostic results and performs generally well in excluding mental disorders, although at the expense of sensitivity. For screening purposes, the e-PASS subclinical result generally appears better than a clinical result as a diagnostic indicator. Further development and evaluation is needed to support the use of online diagnostic assessment programs for mental disorders. Trial Registration Australian and New Zealand Clinical Trials Registry ACTRN121611000704998; http://www.anzctr.org.au/trial_view.aspx?ID=336143 (Archived by WebCite at http://www.webcitation.org/618r3wvOG). PMID:26392066

  8. Characterization of the Auroral Electrojet and the Ambient and Modified D Region for HAARP Using Long-Path VLF Diagnostics

    DTIC Science & Technology

    2001-03-15

    order to characterize the auroral electrojet and the ambient and modified D-region directly above and near the HAARP (High Frequency Active Auroral...near the HAARP facility and along the west coast of Alaska. In addition in order to characterize the auroral electrojet on a continental scale and to...United States and Canada. Data from the complete array of D-region diagnostic systems was acquired during a number of Fall and Spring HAARP campaigns

  9. The cobas® 6800/8800 System: a new era of automation in molecular diagnostics.

    PubMed

    Cobb, Bryan; Simon, Christian O; Stramer, Susan L; Body, Barbara; Mitchell, P Shawn; Reisch, Natasa; Stevens, Wendy; Carmona, Sergio; Katz, Louis; Will, Stephen; Liesenfeld, Oliver

    2017-02-01

    Molecular diagnostics is a key component of laboratory medicine. Here, the authors review key triggers of ever-increasing automation in nucleic acid amplification testing (NAAT) with a focus on specific automated Polymerase Chain Reaction (PCR) testing and platforms such as the recently launched cobas® 6800 and cobas® 8800 Systems. The benefits of such automation for different stakeholders including patients, clinicians, laboratory personnel, hospital administrators, payers, and manufacturers are described. Areas Covered: The authors describe how molecular diagnostics has achieved total laboratory automation over time, rivaling clinical chemistry to significantly improve testing efficiency. Finally, the authors discuss how advances in automation decrease the development time for new tests enabling clinicians to more readily provide test results. Expert Commentary: The advancements described enable complete diagnostic solutions whereby specific test results can be combined with relevant patient data sets to allow healthcare providers to deliver comprehensive clinical recommendations in multiple fields ranging from infectious disease to outbreak management and blood safety solutions.

  10. Diagnostic emulation: Implementation and user's guide

    NASA Technical Reports Server (NTRS)

    Becher, Bernice

    1987-01-01

    The Diagnostic Emulation Technique was developed within the System Validation Methods Branch as a part of the development of methods for the analysis of the reliability of highly reliable, fault tolerant digital avionics systems. This is a general technique which allows for the emulation of a digital hardware system. The technique is general in the sense that it is completely independent of the particular target hardware which is being emulated. Parts of the system are described and emulated at the logic or gate level, while other parts of the system are described and emulated at the functional level. This algorithm allows for the insertion of faults into the system, and for the observation of the response of the system to these faults. This allows for controlled and accelerated testing of system reaction to hardware failures in the target machine. This document describes in detail how the algorithm was implemented at NASA Langley Research Center and gives instructions for using the system.

  11. Diagnostics of the power oil-filled transformer equipment of thermal power plants

    NASA Astrophysics Data System (ADS)

    Eltyshev, D. K.; Khoroshev, N. I.

    2016-08-01

    Problems concerning improvement of the diagnostics efficiency of the electrical facilities and functioning of the generation and distribution systems through the examples of the power oil-filled transformers, as the responsible elements referring to the electrical part of thermal power plants (TPP), were considered. Research activity is based on the fuzzy logic system allowing working both with statistical and expert information presented in the form of knowledge accumulated during operation of the power oil-filled transformer facilities. The diagnostic algorithm for various types of transformers, with the use of the intellectual estimation model of its thermal state on the basis of the key diagnostic parameters and fuzzy inference hierarchy, was developed. Criteria for taking measures allowing preventing emergencies in the electric power systems were developed. The fuzzy hierarchical model for the state assessment of the power oil-filled transformers of 110 kV, possessing high degree of credibility and setting quite strict requirements to the limits of variables of the equipment diagnostic parameters, was developed. The most frequent defects of the transformer standard elements, related with the disturbance of the isolation properties and instrumentation operation, were revealed after model testing on the real object. Presented results may be used both for the express diagnostics of the transformers state without disconnection from the power line and for more detailed analysis of the defects causes on the basis of the advanced list of the diagnostic parameters; information on those parameters may be received only after complete or partial disconnection.

  12. Overview of ion source characterization diagnostics in INTF

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bandyopadhyay, M., E-mail: mainak@iter-india.org; Sudhir, Dass; Bhuyan, M.

    2016-02-15

    INdian Test Facility (INTF) is envisaged to characterize ITER diagnostic neutral beam system and to establish the functionality of its eight inductively coupled RF plasma driver based negative hydrogen ion source and its beamline components. The beam quality mainly depends on the ion source performance and therefore, its diagnostics plays an important role for its safe and optimized operation. A number of diagnostics are planned in INTF to characterize the ion source performance. Negative ions and its cesium contents in the source will be monitored by optical emission spectroscopy (OES) and cavity ring down spectroscopy. Plasma near the extraction regionmore » will be studied using standard electrostatic probes. The beam divergence and negative ion stripping losses are planned to be measured using Doppler shift spectroscopy. During initial phase of ion beam characterization, carbon fiber composite based infrared imaging diagnostics will be used. Safe operation of the beam will be ensured by using standard thermocouples and electrical voltage-current measurement sensors. A novel concept, based on plasma density dependent plasma impedance measurement using RF electrical impedance matching parameters to characterize the RF driver plasma, will be tested in INTF and will be validated with OES data. The paper will discuss about the overview of the complete INTF diagnostics including its present status of procurement, experimentation, interface with mechanical systems in INTF, and integration with INTF data acquisition and control systems.« less

  13. Overview of ion source characterization diagnostics in INTF

    NASA Astrophysics Data System (ADS)

    Bandyopadhyay, M.; Sudhir, Dass; Bhuyan, M.; Soni, J.; Tyagi, H.; Joshi, J.; Yadav, A.; Rotti, C.; Parmar, Deepak; Patel, H.; Pillai, S.; Chakraborty, A.

    2016-02-01

    INdian Test Facility (INTF) is envisaged to characterize ITER diagnostic neutral beam system and to establish the functionality of its eight inductively coupled RF plasma driver based negative hydrogen ion source and its beamline components. The beam quality mainly depends on the ion source performance and therefore, its diagnostics plays an important role for its safe and optimized operation. A number of diagnostics are planned in INTF to characterize the ion source performance. Negative ions and its cesium contents in the source will be monitored by optical emission spectroscopy (OES) and cavity ring down spectroscopy. Plasma near the extraction region will be studied using standard electrostatic probes. The beam divergence and negative ion stripping losses are planned to be measured using Doppler shift spectroscopy. During initial phase of ion beam characterization, carbon fiber composite based infrared imaging diagnostics will be used. Safe operation of the beam will be ensured by using standard thermocouples and electrical voltage-current measurement sensors. A novel concept, based on plasma density dependent plasma impedance measurement using RF electrical impedance matching parameters to characterize the RF driver plasma, will be tested in INTF and will be validated with OES data. The paper will discuss about the overview of the complete INTF diagnostics including its present status of procurement, experimentation, interface with mechanical systems in INTF, and integration with INTF data acquisition and control systems.

  14. Computer-aided diagnosis workstation and teleradiology network system for chest diagnosis using the web medical image conference system with a new information security solution

    NASA Astrophysics Data System (ADS)

    Satoh, Hitoshi; Niki, Noboru; Eguchi, Kenji; Ohmatsu, Hironobu; Kaneko, Masahiro; Kakinuma, Ryutaro; Moriyama, Noriyuki

    2010-03-01

    Diagnostic MDCT imaging requires a considerable number of images to be read. Moreover, the doctor who diagnoses a medical image is insufficient in Japan. Because of such a background, we have provided diagnostic assistance methods to medical screening specialists by developing a lung cancer screening algorithm that automatically detects suspected lung cancers in helical CT images, a coronary artery calcification screening algorithm that automatically detects suspected coronary artery calcification and a vertebra body analysis algorithm for quantitative evaluation of osteoporosis. We also have developed the teleradiology network system by using web medical image conference system. In the teleradiology network system, the security of information network is very important subjects. Our teleradiology network system can perform Web medical image conference in the medical institutions of a remote place using the web medical image conference system. We completed the basic proof experiment of the web medical image conference system with information security solution. We can share the screen of web medical image conference system from two or more web conference terminals at the same time. An opinion can be exchanged mutually by using a camera and a microphone that are connected with the workstation that builds in some diagnostic assistance methods. Biometric face authentication used on site of teleradiology makes "Encryption of file" and "Success in login" effective. Our Privacy and information security technology of information security solution ensures compliance with Japanese regulations. As a result, patients' private information is protected. Based on these diagnostic assistance methods, we have developed a new computer-aided workstation and a new teleradiology network that can display suspected lesions three-dimensionally in a short time. The results of this study indicate that our radiological information system without film by using computer-aided diagnosis workstation and our teleradiology network system can increase diagnostic speed, diagnostic accuracy and security improvement of medical information.

  15. Consolidated Laser-Induced Fluorescence Diagnostic Systems for the NASA Ames Arc Jet Facilities

    NASA Technical Reports Server (NTRS)

    Grinstead, Jay H.; Wilder, Michael C.; Porter, Barry J.; Brown, Jeffrey D.; Yeung, Dickson; Battazzo, Stephen J.; Brubaker, Timothy R.

    2016-01-01

    The spectroscopic diagnostic technique of two photon absorption laser-induced fluorescence (TALIF) of atomic species for non-intrusive arc jet flow property measurement was first implemented at NASA Ames in the mid-1990s. Use of TALIF expanded at NASA Ames and to NASA Johnson's arc jet facility in the late 2000s. In 2013-2014, NASA combined the agency's large-scale arc jet test capabilities at NASA Ames. Concurrent with that effort, the agency also sponsored a project to establish two comprehensive LIF diagnostic systems for the Aerodynamic Heating Facility (AHF) and Interaction Heating Facility (IHF) arc jets. The scope of the project enabled further engineering development of the existing IHF LIF system as well as the complete reconstruction of the original AHF LIF system. The updated LIF systems are identical in design and capability. They represent the culmination of over 20 years of development experience in transitioning a specialized laboratory research tool into a measurement system for large-scale, high-demand test facilities. This paper documents the overall system design from measurement requirements to implementation. Representative data from the redeveloped AHF and IHF LIF systems are also presented.

  16. Consolidated Laser-Induced Fluorescence Diagnostic Systems for the NASA Ames Arc Jet Facilities

    NASA Technical Reports Server (NTRS)

    Grinstead, Jay; Wilder, Michael C.; Porter, Barry; Brown, Jeff; Yeung, Dickson; Battazzo, Steve; Brubaker, Tim

    2016-01-01

    The spectroscopic diagnostic technique of two photon absorption laser-induced fluorescence (TALIF) of atomic species for non-intrusive arc jet flow property measurement was first implemented at NASA Ames in the mid-1990s. Use of TALIF expanded at NASA Ames and to NASA Johnsons arc jet facility in the late 2000s. In 2013-2014, NASA combined the agency's large-scale arc jet test capabilities at NASA Ames. Concurrent with that effort, the agency also sponsored a project to establish two comprehensive LIF diagnostic systems for the Aerodynamic Heating Facility (AHF) and Interaction Heating Facility (IHF) arc jets. The scope of the project enabled further engineering development of the existing IHF LIF system as well as the complete reconstruction of the original AHF LIF system. The updated LIF systems are identical in design and capability. They represent the culmination of over 20 years of development experience in transitioning a specialized laboratory research tool into a measurement system for large-scale, high-demand test facilities. This paper documents the overall system design from measurement requirements to implementation. Representative data from the redeveloped AHF and IHF LIF systems are also presented.

  17. Calibration techniques for a fast duo-spectrometer

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Chapman, J.T.; Den Hartog, D.J.

    1996-06-01

    The authors have completed the upgrade and calibration of the Ion Dynamics Spectrometer (IDS), a high-speed Doppler duo-spectrometer which measures ion flow and temperature in the MST Reversed-field Pinch. This paper describes an in situ calibration of the diagnostic`s phase and frequency response. A single clock was employed to generate both a digital test signal and a digitizer trigger thus avoiding frequency drift and providing a highly resolved measurement over the system bandwidth. Additionally, they review the measurement of the spectrometer instrument function and absolute intensity response. This calibration and subsequent performance demonstrate the IDS to be one of themore » fastest, highest throughput diagnostics of its kind. Typical measurements are presented.« less

  18. Implications of DSM-5 for the diagnosis of pediatric eating disorders.

    PubMed

    Limburg, Karina; Shu, Chloe Y; Watson, Hunna J; Hoiles, Kimberley J; Egan, Sarah J

    2018-05-01

    The aim of the study was to compare the DSM-IV, DSM-5, and ICD-10 eating disorders (ED) nomenclatures to assess their value in the classification of pediatric eating disorders. We investigated the prevalence of the disorders in accordance with each system's diagnostic criteria, diagnostic concordance between the systems, and interrater reliability. Participants were 1062 children and adolescents assessed at intake to a specialist Eating Disorders Program (91.6% female, mean age 14.5 years, SD = 1.75). Measures were collected from routine intake assessments. DSM-5 categorization led to a lower prevalence of unspecified EDs when compared with DSM-IV. There was almost complete overlap for specified EDs. Kappa values indicated almost excellent agreement between the two coders on all three diagnostic systems, although there was higher interrater reliability for DSM-5 and ICD-10 when compared with DSM-IV. DSM-5 nomenclature is useful in classifying eating disorders in pediatric clinical samples. © 2018 Wiley Periodicals, Inc.

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

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    NONE

    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 demonstrationsmore » 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 5R25NS080949 and Philips Healthcare research grant C32.« less

  20. Reasoning with Incomplete and Uncertain Information

    DTIC Science & Technology

    1991-08-01

    are rationally compatible (just as is the case in the fundamental computational mechanisms of truth maintenance systems ). The logics we construct will...complete, pre- cise, and unvarying. This fundamental assumption is a principal source of the limitation of many diagnostic systems to single fault diagnoses...Air Force Systems Command Griffiss Air Force Base, NY 13441-5700 This report has been reviewed by the Rome Laboratory Public Affairs Dffice (PA) and

  1. Replacing the Engine In Your Car While You Are Still Driving It

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bjorklund, Eric A.

    Replacing your accelerator’s timing system with a completely different architecture is not something that happens very often. Perhaps even rarer is the requirement that the replacement not interfere with the accelerator’s normal operational cycle. In 2011, The Los Alamos Neutron Science Center (LANSCE) began the purchasing and installation phase of a nine-year rolling upgrade project which will eventually result in the complete replacement of the low-level RF system, the timing system, the industrial I/O system, the beam-synchronized data acquisition system, the fastprotect reporting system, and much of the diagnostic equipment. These projects are mostly independent of each other, with theirmore » own installation schedules, priorities, and time-lines. All of them, however, must interface with the timing system.« less

  2. Develop Advanced Nonlinear Signal Analysis Topographical Mapping System

    NASA Technical Reports Server (NTRS)

    Jong, Jen-Yi

    1997-01-01

    During the development of the SSME, a hierarchy of advanced signal analysis techniques for mechanical signature analysis has been developed by NASA and AI Signal Research Inc. (ASRI) to improve the safety and reliability for Space Shuttle operations. These techniques can process and identify intelligent information hidden in a measured signal which is often unidentifiable using conventional signal analysis methods. Currently, due to the highly interactive processing requirements and the volume of dynamic data involved, detailed diagnostic analysis is being performed manually which requires immense man-hours with extensive human interface. To overcome this manual process, NASA implemented this program to develop an Advanced nonlinear signal Analysis Topographical Mapping System (ATMS) to provide automatic/unsupervised engine diagnostic capabilities. The ATMS will utilize a rule-based Clips expert system to supervise a hierarchy of diagnostic signature analysis techniques in the Advanced Signal Analysis Library (ASAL). ASAL will perform automatic signal processing, archiving, and anomaly detection/identification tasks in order to provide an intelligent and fully automated engine diagnostic capability. The ATMS has been successfully developed under this contract. In summary, the program objectives to design, develop, test and conduct performance evaluation for an automated engine diagnostic system have been successfully achieved. Software implementation of the entire ATMS system on MSFC's OISPS computer has been completed. The significance of the ATMS developed under this program is attributed to the fully automated coherence analysis capability for anomaly detection and identification which can greatly enhance the power and reliability of engine diagnostic evaluation. The results have demonstrated that ATMS can significantly save time and man-hours in performing engine test/flight data analysis and performance evaluation of large volumes of dynamic test data.

  3. Reviews of Selected System and Software Tools for Strategic Defense Applications

    DTIC Science & Technology

    1990-02-01

    Interleaf and FrameMaker . IStatic Diagnostics Basic testing includes validating flows, detecting orphan activity, and checking completeness of activities...Publisher, Aldus PageMaker, Unix pic, Apple .pict metafile, Interleaf, Framemaker , or Postscript format. There are no forms for standard documents such as 3

  4. Enhancing and Customizing Laboratory Information Systems to Improve/Enhance Pathologist Workflow.

    PubMed

    Hartman, Douglas J

    2015-06-01

    Optimizing pathologist workflow can be difficult because it is affected by many variables. Surgical pathologists must complete many tasks that culminate in a final pathology report. Several software systems can be used to enhance/improve pathologist workflow. These include voice recognition software, pre-sign-out quality assurance, image utilization, and computerized provider order entry. Recent changes in the diagnostic coding and the more prominent role of centralized electronic health records represent potential areas for increased ways to enhance/improve the workflow for surgical pathologists. Additional unforeseen changes to the pathologist workflow may accompany the introduction of whole-slide imaging technology to the routine diagnostic work. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Enhancing and Customizing Laboratory Information Systems to Improve/Enhance Pathologist Workflow.

    PubMed

    Hartman, Douglas J

    2016-03-01

    Optimizing pathologist workflow can be difficult because it is affected by many variables. Surgical pathologists must complete many tasks that culminate in a final pathology report. Several software systems can be used to enhance/improve pathologist workflow. These include voice recognition software, pre-sign-out quality assurance, image utilization, and computerized provider order entry. Recent changes in the diagnostic coding and the more prominent role of centralized electronic health records represent potential areas for increased ways to enhance/improve the workflow for surgical pathologists. Additional unforeseen changes to the pathologist workflow may accompany the introduction of whole-slide imaging technology to the routine diagnostic work. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. [Expert systems and automatic diagnostic systems in histopathology--a review].

    PubMed

    Tamai, S

    1999-02-01

    In this decade, the pathological information system has gradually been settled in many hospitals in Japan. Pathological reports and images are now digitized and managed in the database, and are referred by clinicians at the peripherals. Tele-pathology is also developing; and its users are increasing. However, in many occasions, the problem solving in diagnostic pathology is completely dependent on the solo-pathologist. Considering the need for timely and efficient supports to the solo-pathologist, I reviewed the papers on the knowledge-based interactive expert systems. The interpretations of the histopathological images are dependent on the pathologist, and these expert systems have been evaluated as "educational". With the view of the success in the cytological screening, the development of "image-analysis-based" automatic "histopathological image" classifier has been on ongoing challenges. Our 3 years experience of the development of the pathological image classifier using the artificial neural networks technology is briefly presented. This classifier provides us a "fitting rate" for the individual diagnostic pattern of the breast tumors, such as "fibroadenoma pattern". The diagnosis assisting system with computer technology should provide pathologists, especially solo-pathologists, a useful tool for the quality assurance and improvement of pathological diagnosis.

  7. DSM-IV, DSM-5, and ICD-11: Identifying children with posttraumatic stress disorder after disasters.

    PubMed

    Danzi, BreAnne A; La Greca, Annette M

    2016-12-01

    Different criteria for diagnosing posttraumatic stress disorder (PTSD) have been recommended by the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the proposed 11th edition of the International Classification of Diseases (ICD-11). Although children are vulnerable to PTSD following disasters, little is known about whether these revised criteria are appropriate for preadolescents, as diagnostic revisions have been based primarily on adult research. This study investigated rates of PTSD using DSM-IV, DSM-5, and ICD-11 diagnostic criteria, and their associations with symptom severity, impairment, and PTSD risk factors. Children (7-11 years) exposed to Hurricanes Ike (n = 327) or Charley (n = 383) completed measures 8-9 months postdisaster. Using diagnostic algorithms for DSM-IV, DSM-5, and ICD-11, rates of 'probable' PTSD were calculated. Across samples, rates of PTSD were similar. However, there was low agreement across the diagnostic systems, with about a third overlap in identified cases. Children identified only by ICD-11 had higher 'core' symptom severity but lower impairment than children identified only by DSM-IV or DSM-5. ICD-11 was associated with more established risk factors for PTSD than was DSM-5. Findings revealed differences in PTSD diagnosis across major diagnostic systems for preadolescent children, with no clear advantage to any one system. Further research on developmentally sensitive PTSD criteria for preadolescent children is needed. © 2016 Association for Child and Adolescent Mental Health.

  8. Reading efficiency can be improved by minor modification of assigned duties; a pilot study on a small team of general radiologists.

    PubMed

    Yokota, Hajime; Goto, Mariko; Bamba, Chisa; Kiba, Maki; Yamada, Kei

    2017-05-01

    To assess whether alterations in the type of duty assignment system can affect the reading efficiency and stress level of diagnostic radiologists. Fourteen board-certified diagnostic radiologists were enrolled. We investigated three different reading systems for 1 week each. System 1 is our default, in which there are no assigned duties and everyone finishes when all cases are done. In system 2, two late shift readers are assigned every day, and, after everyone else leaves at a fixed time (5:30 p.m.), they take all remaining cases until they are finished. In system 3, a dedicated single reader is assigned to finish 30 cases, and everyone else will read all remaining cases. The total time required for reading and the number of cases read were recorded. In addition, participants completed two questionnaires regarding work-related stress. There was a trend toward shorter finishing time in system 2 and 3 compared to system 1 (P = 0.072 and 0.012). In terms of working stress, the subjective burden was lighter when systems 2 or 3 were employed. Minor modification of the duty assignment system has the potential to improve working efficiency and may reduce the work-related stress of diagnostic radiologists.

  9. [Coronary angioplasty with the Monorail system via 6 French diagnostic catheters].

    PubMed

    Villavicencio, R; González, H; López, J; Zavala, E; Ban Hayashi, E B; Gaspar, J; Gil, M; Martínez Ríos, M A

    1994-01-01

    We studied the use of "Monorail" system with Express (Scimed) balloon catheters for coronary angioplasty through 6 French (F) "high-flow" diagnostic catheters (Novoste, USCI). Prospectively, from July 1992 to January 1993, angioplasty of 31 lesions in 24 patients was attempted (1.3 lesions/procedure). Twenty procedures were of a single lesion and four were multi-vessel angioplasty. Fourteen lesions were in the left anterior descending or in its branches, 10 in the left circumflex or in its branches, 6 in the right coronary artery, and one in the distal anastomosis of an internal mammary artery graft. Thirteen lesions (42%) were type A, 17 (55%) type B and one (3%) type C. Balloon sizes varied between 2.0 and 3.5 mm. Twenty-nine lesions could be successfully dilated (93.5%); two cases were unsuccessful due to an acute occlusion in one and residual stenosis of more than 50% in the other. For only one case, another balloon catheter different from the "Monorail" system was necessary to complete a multi-vessel angioplasty. Coronary visualization and manipulation of the balloon through the tip of the diagnostic catheter were satisfactory in all cases, except with the 3.5 mm balloon catheter. Coronary angioplasty with "Monorail" system balloon catheters through 6 F "high-flow" diagnostic catheters is feasible and provides a high success rate in simple and moderately complex selected lesions, including multivessel angioplasty with advantages of smaller artery punction and the feasibility of performing coronary angioplasty with the same catheter used for diagnostic angiography.

  10. The Environmental Qualification Specification as a Technical Management Tool,

    DTIC Science & Technology

    1981-11-01

    CommuentI The dwell test for fatigue of the isolation system in a container is intended to be an accelerated test, in order to save test time and...diagnostic purposes * Response computation is not the only possible design approach. In the development of control system or servomechanism theory , emphasis...seldom aborts a mission in the same way as a complete failure of any function, and properly influences system effectiveness through a different type of

  11. Usability and reliability of a remotely administered adult autism assessment, the autism diagnostic observation schedule (ADOS) module 4.

    PubMed

    Schutte, Jamie L; McCue, Michael P; Parmanto, Bambang; McGonigle, John; Handen, Benjamin; Lewis, Allen; Pulantara, I Wayan; Saptono, Andi

    2015-03-01

    The Autism Diagnostic Observation Schedule (ADOS) Module 4 is an autism assessment designed for verbally fluent adolescents and adults. Because of a shortage of available clinical expertise, it can be difficult for adults to receive a proper autism spectrum disorder (ASD) diagnostic assessment. A potential option to address this shortage is remote assessment. The objective of this study was to examine the feasibility, usability, and reliability of administering the ADOS Module 4 remotely using the Versatile and Integrated System for Telerehabilitation (VISYTER). VISYTER consists of computer stations at the client site and clinician site for video communication and a Web portal for managing and coordinating the assessment process. Twenty-three adults with an ASD diagnosis participated in a within-subject crossover design study in which both a remote ADOS and a face-to-face ADOS were administered. After completing the remote ADOS, participants completed a satisfaction survey. Participant satisfaction with the remote ADOS delivery system was high. The kappa value was greater than 0.61 on 21 of 31 ADOS items. There was substantial agreement on ADOS classification (i.e., diagnosis) between assessments delivered face-to-face versus assessments delivered remotely (interclass coefficient=0.92). Non-agreement may have been due to outside factors or practice effect despite a washout period. The results of this study demonstrate that an autism assessment designed to be delivered face to face can be administered remotely using an integrated Web-based system with high levels of usability and reliability.

  12. Generation of Recombinant Ebola Viruses Using Reverse Genetics.

    PubMed

    Groseth, Allison

    2017-01-01

    Reverse genetics systems encompass a wide array of tools aimed at recapitulating some or all of the virus life cycle. In their most complete form, full-length clone systems allow us to use plasmid-encoded versions of the ribonucleoprotein (RNP) components to initiate the transcription and replication of a plasmid-encoded version of the complete viral genome, thereby initiating the complete virus life cycle and resulting in infectious virus. As such this approach is ideal for the generation of tailor-made recombinant filoviruses, which can be used to study virus biology. In addition, the generation of tagged and particularly fluorescent or luminescent viruses can be applied as tools for both diagnostic applications and for screening to identify novel countermeasures. Here we describe the generation and basic characterization of recombinant Ebola viruses rescued from cloned cDNA using a T7-driven system.

  13. MO-AB-210-03: Workshop [Advancements in high intensity focused ultrasound

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lu, Z.

    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 demonstrationsmore » 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 5R25NS080949 and Philips Healthcare research grant C32.« less

  14. MO-AB-210-02: Ultrasound Imaging and Therapy-Hands On Workshop

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Sammet, S.

    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 demonstrationsmore » 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 5R25NS080949 and Philips Healthcare research grant C32.« less

  15. MO-AB-210-01: Ultrasound Imaging and Therapy-Hands On Workshop

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lu, Z.

    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 demonstrationsmore » 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 5R25NS080949 and Philips Healthcare research grant C32.« less

  16. The National Ignition Facility Diagnostic Set at the Completion of the National Ignition Campaign, September 2012

    DOE PAGES

    Kilkenny, J. D.; Bell, P. M.; Bradley, D. K.; ...

    2016-01-06

    At the completion of the National Ignition Campaign (NIC), the National Ignition Facility (NIF) had about 36 different types of diagnostics. These were based on several decades of development on Nova and OMEGA and involved the whole U.S. inertial confinement fusion community. In 1994, the Joint Central Diagnostic Team documented a plan for a limited set of NIF diagnostics in the NIF Conceptual Design Report. Two decades later, these diagnostics, and many others, were installed workhorse tools for all users of NIF. We give a short description of each of the 36 different types of NIC diagnostics grouped by themore » function of the diagnostics, namely, target drive, target response and target assembly, stagnation, and burn. A comparison of NIF diagnostics with the Nova diagnostics shows that the NIF diagnostic capability is broadly equivalent to that of Nova in 1999. Although NIF diagnostics have a much greater degree of automation and rigor than Nova’s, new diagnostics are limited such as the higher-speed X-ray imager. Lastly, recommendations for future diagnostics on the NIF are discussed.« less

  17. Using experts feedback in clinical case resolution and arbitration as accuracy diagnosis methodology.

    PubMed

    Rodríguez-González, Alejandro; Torres-Niño, Javier; Valencia-Garcia, Rafael; Mayer, Miguel A; Alor-Hernandez, Giner

    2013-09-01

    This paper proposes a new methodology for assessing the efficiency of medical diagnostic systems and clinical decision support systems by using the feedback/opinions of medical experts. The methodology behind this work is based on a comparison between the expert feedback that has helped solve different clinical cases and the expert system that has evaluated these same cases. Once the results are returned, an arbitration process is carried out in order to ensure the correctness of the results provided by both methods. Once this process has been completed, the results are analyzed using Precision, Recall, Accuracy, Specificity and Matthews Correlation Coefficient (MCC) (PRAS-M) metrics. When the methodology is applied, the results obtained from a real diagnostic system allow researchers to establish the accuracy of the system based on objective facts. The methodology returns enough information to analyze the system's behavior for each disease in the knowledge base or across the entire knowledge base. It also returns data on the efficiency of the different assessors involved in the evaluation process, analyzing their behavior in the diagnostic process. The proposed work facilitates the evaluation of medical diagnostic systems, having a reliable process based on objective facts. The methodology presented in this research makes it possible to identify the main characteristics that define a medical diagnostic system and their values, allowing for system improvement. A good example of the results provided by the application of the methodology is shown in this paper. A diagnosis system was evaluated by means of this methodology, yielding positive results (statistically significant) when comparing the system with the assessors that participated in the evaluation process of the system through metrics such as recall (+27.54%) and MCC (+32.19%). These results demonstrate the real applicability of the methodology used. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Correction of the spectral calibration of the Joint European Torus core light detecting and ranging Thomson scattering diagnostic using ray tracing

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hawke, J.; Scannell, R.; Maslov, M.

    2013-10-15

    This work isolated the cause of the observed discrepancy between the electron temperature (T{sub e}) measurements before and after the JET Core LIDAR Thomson Scattering (TS) diagnostic was upgraded. In the upgrade process, stray light filters positioned just before the detectors were removed from the system. Modelling showed that the shift imposed on the stray light filters transmission functions due to the variations in the incidence angles of the collected photons impacted plasma measurements. To correct for this identified source of error, correction factors were developed using ray tracing models for the calibration and operational states of the diagnostic. Themore » application of these correction factors resulted in an increase in the observed T{sub e}, resulting in the partial if not complete removal of the observed discrepancy in the measured T{sub e} between the JET core LIDAR TS diagnostic, High Resolution Thomson Scattering, and the Electron Cyclotron Emission diagnostics.« less

  19. An expert system for headache diagnosis: the Computerized Headache Assessment tool (CHAT).

    PubMed

    Maizels, Morris; Wolfe, William J

    2008-01-01

    Migraine is a highly prevalent chronic disorder associated with significant morbidity. Chronic daily headache syndromes, while less common, are less likely to be recognized, and impair quality of life to an even greater extent than episodic migraine. A variety of screening and diagnostic tools for migraine have been proposed and studied. Few investigators have developed and evaluated computerized programs to diagnose headache. To develop and determine the accuracy and utility of a computerized headache assessment tool (CHAT). CHAT was designed to identify all of the major primary headache disorders, distinguish daily from episodic types, and recognize medication overuse. CHAT was developed using an expert systems approach to headache diagnosis, with initial branch points determined by headache frequency and duration. Appropriate clinical criteria are presented relevant to brief and longer-lasting headaches. CHAT was posted on a web site using Microsoft active server pages and a SQL-server database server. A convenience sample of patients who presented to the adult urgent care department with headache, and patients in a family practice waiting room, were solicited to participate. Those who completed the on-line questionnaire were contacted for a diagnostic interview. One hundred thirty-five patients completed CHAT and 117 completed a diagnostic interview. CHAT correctly identified 35/35 (100%) patients with episodic migraine and 42/49 (85.7%) of patients with transformed migraine. CHAT also correctly identified 11/11 patients with chronic tension-type headache, 2/2 with episodic tension-type headache, and 1/1 with episodic cluster headache. Medication overuse was correctly recognized in 43/52 (82.7%). The most common misdiagnoses by CHAT were seen in patients with transformed migraine or new daily persistent headache. Fifty patients were referred to their primary care physician and 62 to the headache clinic. Of 29 patients referred to the PCP with a confirmed diagnosis of migraine, 25 made a follow-up appointment, the PCP diagnosed migraine in 19, and initiated migraine-specific therapy or prophylaxis in 17. The described expert system displays high diagnostic accuracy for migraine and other primary headache disorders, including daily headache syndromes and medication overuse. As part of a disease management program, CHAT led to patients receiving appropriate diagnoses and therapy. Limitations of the system include patient willingness to utilize the program, introducing such a process into the culture of medical care, and the difficult distinction of transformed migraine.

  20. Automated fiber pigtailing machine

    DOEpatents

    Strand, Oliver T.; Lowry, Mark E.

    1999-01-01

    The Automated Fiber Pigtailing Machine (AFPM) aligns and attaches optical fibers to optoelectonic (OE) devices such as laser diodes, photodiodes, and waveguide devices without operator intervention. The so-called pigtailing process is completed with sub-micron accuracies in less than 3 minutes. The AFPM operates unattended for one hour, is modular in design and is compatible with a mass production manufacturing environment. This machine can be used to build components which are used in military aircraft navigation systems, computer systems, communications systems and in the construction of diagnostics and experimental systems.

  1. Beyond DSM-5: an alternative approach to assessing Social Anxiety Disorder.

    PubMed

    Skocic, Sonja; Jackson, Henry; Hulbert, Carol

    2015-03-01

    This article focuses on the Diagnostic and Statistical Manual of Mental Disorders (DSM) classification of Social Anxiety Disorder (SAD). The article details the diagnostic criteria for SAD that have evolved in the various editions and demonstrates that whilst there have been some positive steps taken to more comprehensively define the disorder, further revision is necessary. It will be argued that the DSM-5 (APA, 2013) has made some changes to the diagnostic criteria of SAD that do not seem to be completely in line with theory and research and do not describe SAD effectively in terms of both diversity and presentation. This article concludes with the presentation of a proposed set of diagnostic criteria that address the concerns raised in the article. The proposed criteria reflect a hybrid categorical-dimensional system of classification. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. A new diagnostic method of bolt loosening detection for thermal protection systems

    NASA Astrophysics Data System (ADS)

    Xie, Weihua; Meng, Songhe; Han, Jiecai; Du, Shanyi; Zhang, Boming; Yu, Dong

    2009-07-01

    Research and development efforts are underway to provide structural health monitoring systems to ensure the integrity of thermal protection system (TPS). An improved analytical method was proposed to assess the fastener integrity of a bolted structure in this paper. A new unsymmetrical washer was designed and fabricated, taking full advantage of piezoelectric ceramics (PZT) to play both roles as actuators and sensors, and using energy as the only extracted feature to identify abnormality. This diagnostic method is not restricted by the materials of the bracket, panel and base structure of the TPS whose condition is under inspection. A series of experiments on a metallic honeycomb sandwich panel were completed to demonstrate the capability of detecting bolt loosening on the TPS structure. Studies showed that this method can be used not only to identify the location of loosened bolts rapidly, but also to estimate the torque level of loosening bolts. Since that energy is the only extracted feature used to detect bolt loosening in this method, the diagnostic process become very simple and swift without sacrificing the accuracy of the results.

  3. Moving beyond quality control in diagnostic radiology and the role of the clinically qualified medical physicist.

    PubMed

    Delis, H; Christaki, K; Healy, B; Loreti, G; Poli, G L; Toroi, P; Meghzifene, A

    2017-09-01

    Quality control (QC), according to ISO definitions, represents the most basic level of quality. It is considered to be the snapshot of the performance or the characteristics of a product or service, in order to verify that it complies with the requirements. Although it is usually believed that "the role of medical physicists in Diagnostic Radiology is QC", this, not only limits the contribution of medical physicists, but is also no longer adequate to meet the needs of Diagnostic Radiology in terms of Quality. In order to assure quality practices more organized activities and efforts are required in the modern era of diagnostic radiology. The complete system of QC is just one element of a comprehensive quality assurance (QA) program that aims at ensuring that the requirements of quality of a product or service will consistently be fulfilled. A comprehensive Quality system, starts even before the procurement of any equipment, as the need analysis and the development of specifications are important components under the QA framework. Further expanding this framework of QA, a comprehensive Quality Management System can provide additional benefits to a Diagnostic Radiology service. Harmonized policies and procedures and elements such as mission statement or job descriptions can provide clarity and consistency in the services provided, enhancing the outcome and representing a solid platform for quality improvement. The International Atomic Energy Agency (IAEA) promotes this comprehensive quality approach in diagnostic imaging and especially supports the field of comprehensive clinical audits as a tool for quality improvement. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  4. An audit of request forms submitted in a multidisciplinary diagnostic center in Lagos.

    PubMed

    Oyedeji, Olufemi Abiola; Ogbenna, Abiola Ann; Iwuala, Sandra Omozehio

    2015-01-01

    Request forms are important means of communication between physicians and diagnostic service providers. Pre-analytical errors account for over two thirds of errors encountered in diagnostic service provision. The importance of adequate completion of request forms is usually underestimated by physicians which may result in medical errors or delay in instituting appropriate treatment. The aim of this study was to audit the level of completion of request forms presented at a multidisciplinary diagnostic center. A review of all requests forms for investigations which included radiologic, laboratory and cardiac investigations received between July and December 2011 was performed to assess their level of completeness. The data was entered into a spreadsheet and analyzed. Only 1.3% of the 7,841 request forms reviewed were fully completed. Patient's names, the referring physician's name and gender were the most completed information on the forms evaluated with 99.0%, 99.0% and 90.3% completion respectively. Patient's age was provided in 68.0%, request date in 88.2%, and clinical notes/ diagnosis in 65.9% of the requests. Patient's full address was provided in only 5.6% of requests evaluated. This study shows that investigation request forms are inadequately filled by physicians in our environment. Continuous medical education of physicians on the need for adequate completion of request forms is needed.

  5. Electronic capture of patient-reported and clinician-reported outcome measures in an elective orthopaedic setting: a retrospective cohort analysis.

    PubMed

    Malhotra, Karan; Buraimoh, Olatunbosun; Thornton, James; Cullen, Nicholas; Singh, Dishan; Goldberg, Andrew J

    2016-06-20

    To determine whether an entirely electronic system can be used to capture both patient-reported outcomes (electronic Patient-Reported Outcome Measures, ePROMs) as well as clinician-validated diagnostic and complexity data in an elective surgical orthopaedic outpatient setting. To examine patients' experience of this system and factors impacting their experience. Retrospective analysis of prospectively collected data. Single centre series. Outpatient clinics at an elective foot and ankle unit in the UK. All new adult patients attending elective orthopaedic outpatient clinics over a 32-month period. All patients were invited to complete ePROMs prior to attending their outpatient appointment. At their appointment, those patients who had not completed ePROMs were offered the opportunity to complete it on a tablet device with technical support. Matched diagnostic and complexity data were captured by the treating consultant during the appointment. Capture rates of patient-reported and clinician-reported data. All information and technology (IT) failures, language and disability barriers were captured. Patients were asked to rate their experience of using ePROMs. The scoring systems used included EQ-5D-5L, the Manchester-Oxford Foot Questionnaire (MOxFQ) and the Visual Analogue Scale (VAS) pain score. Out of 2534 new patients, 2176 (85.9%) completed ePROMs, of whom 1090 (50.09%) completed ePROMs at home/work prior to their appointment. 31.5% used a mobile (smartphone/tablet) device. Clinician-reported data were captured on 2491 patients (98.3%). The mean patient experience score of using Patient-Reported Outcome Measures (PROMs) was 8.55±1.85 out of 10 and 666 patients (30.61%) left comments. Of patients leaving comments, 214 (32.13%) felt ePROMs did not adequately capture their symptoms and these patients had significantly lower patient experience scores (p<0.001). This study demonstrates the successful implementation of technology into a service improvement programme. Excellent capture rates of ePROMs and clinician-validated diagnostic data can be achieved within a National Health Service setting. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  6. A Meta-Analysis of the Diagnostic Accuracy of Circular RNAs in Digestive System Malignancy.

    PubMed

    Chen, Zhiqiang; Zhang, Long; Han, Guoyong; Zuo, Xueliang; Zhang, Yao; Zhu, Qin; Wu, Jindao; Wang, Xuehao

    2018-01-01

    Circular RNAs (circRNAs), a novel class of noncoding RNAs, have been found to be dysregulated in various cancers. However, the clinical application value of these circRNAs in digestive system cancers remains to be clarified. We aimed to comprehensively explore the potential role of circRNAs as diagnostic indicators in digestive system malignancies. Relevant studies were systematically retrieved from PubMed, Web of Science and the Cochrane Library. The data that were required to complete 2 × 2 contingency tables were obtained from the included studies. Stratified analyses by cancer type, sample size and publication year were performed. Thirteen studies with 2,276 individuals were included in the meta-analysis. The pooled sensitivity and specificity of circRNAs in the diagnosis of digestive system malignancy were 0.72 [95% confidence interval (CI): 0.65-0.77] and 0.77 (95% CI: 0.72-0.81), respectively. The overall positive likelihood ratio was 3.09 (95% CI: 2.64-3.62), and the overall negative likelihood ratio was 0.37 (95% CI: 0.31-0.44). The pooled diagnostic odds ratio was 8.38 (95% CI: 6.86-10.25), and the overall area under the curve was 0.81 (95% CI: 0.77-0.84), indicating good discriminative ability of circRNAs as biomarkers for digestive system malignancy. circRNAs distinguish patients with digestive system cancer from controls with relatively high diagnostic accuracy. circRNAs may be used as potential biomarkers for the diagnosis of digestive system malignancy. © 2018 The Author(s). Published by S. Karger AG, Basel.

  7. New Thomson scattering diagnostic on RFX-mod.

    PubMed

    Alfier, A; Pasqualotto, R

    2007-01-01

    This article describes the completely renovated Thomson scattering (TS) diagnostic employed in the modified Reversed Field eXperiment (RFX-mod) since it restarted operation in 2005. The system measures plasma electron temperature and density profiles along an equatorial diameter, measuring in 84 positions with 7 mm spatial resolution. The custom built Nd:YLF laser produces a burst of 10 pulses at 50 Hz with energy of 3 J, providing ten profile measurements in a plasma discharge of about 300 ms duration. An optical delay system accommodates three scattering volumes in each of the 28 interference filter spectrometers. Avalanche photodiodes detect the Thomson scattering signals and allow them to be recorded by means of waveform digitizers. Electron temperature is obtained using an alternative relative calibration method, based on the use of a supercontinuum light source. Rotational Raman scattering in nitrogen has supplied the absolute calibration for the electron density measurements. During RFX-mod experimental campaigns in 2005, the TS diagnostic has demonstrated its performance, routinely providing reliable high resolution profiles.

  8. System control module diagnostic Expert Assistant

    NASA Technical Reports Server (NTRS)

    Flores, Luis M.; Hansen, Roger F.

    1990-01-01

    The Orbiter EXperiments (OEX) Program was established by NASA's Office of Aeronautics and Space Technology (OAST) to accomplish the precise data collection necessary to support a complete and accurate assessment of Space Transportation System (STS) Orbiter performance during all phases of a mission. During a mission, data generated by the various experiments are conveyed to the OEX System Control Module (SCM) which arranges for and monitors storage of the data on the OEX tape recorder. The SCM Diagnostic Expert Assistant (DEA) is an expert system which provides on demand advice to technicians performing repairs of a malfunctioning SCM. The DEA is a self-contained, data-driven knowledge-based system written in the 'C' Language Production System (CLIPS) for a portable micro-computer of the IBM PC/XT class. The DEA reasons about SCM hardware faults at multiple levels; the most detailed layer of encoded knowledge of the SCM is a representation of individual components and layouts of the custom-designed component boards.

  9. Robotically assisted ureteroscopy for kidney exploration.

    PubMed

    Talari, Hadi F; Monfaredi, Reza; Wilson, Emmanuel; Blum, Emily; Bayne, Christopher; Peters, Craig; Zhang, Anlin; Cleary, Kevin

    2017-02-01

    Ureteroscopy is a minimally invasive procedure for diagnosis and treatment of a wide range of urinary tract pathologies. It is most commonly performed in the diagnostic work-up of hematuria and the diagnosis and treatment of upper urinary tract malignancies and calculi. Ergonomic and visualization challenges as well as radiation exposure are limitations to conventional ureteroscopy. For example, for diagnostic tumor inspection, the urologist has to maneuver the ureteroscope through each of the 6 to 12 calyces in the kidney under fluoroscopy to ensure complete surveillance. Therefore, we have been developing a robotic system to "power drive" a flexible fiber-optic ureteroscope with 3D tip tracking and pre-operative image overlay. Our goal is to provide the urologist precise control of the ureteroscope tip with less radiation exposure. Our prototype system allows control of the three degrees of freedom of the ureteroscope via brushless motors and a joystick interface. The robot provides a steady platform for controlling the ureteroscope. Furthermore, the robot design facilitates a quick "snap-in" of the ureteroscope, thus allowing the ureteroscope to be mounted midway through the procedure. We have completed the mechanical system and the controlling software and begun evaluation using a kidney phantom. We put MRI-compatible fiducials on the phantom and obtained MR images. We registered these images with the robot using an electromagnetic tracking system and paired-point registration. The system is described and initial evaluation results are given in this paper.

  10. Clinical diagnosis of partial or complete anterior cruciate ligament tears using patients' history elements and physical examination tests.

    PubMed

    Décary, Simon; Fallaha, Michel; Belzile, Sylvain; Martel-Pelletier, Johanne; Pelletier, Jean-Pierre; Feldman, Debbie; Sylvestre, Marie-Pierre; Vendittoli, Pascal-André; Desmeules, François

    2018-01-01

    To assess the diagnostic validity of clusters combining history elements and physical examination tests to diagnose partial or complete anterior cruciate ligament (ACL) tears. Prospective diagnostic study. Orthopaedic clinics (n = 2), family medicine clinics (n = 2) and community-dwelling. Consecutive patients with a knee complaint (n = 279) and consulting one of the participating orthopaedic surgeons (n = 3) or sport medicine physicians (n = 2). Not applicable. History elements and physical examination tests performed independently were compared to the reference standard: an expert physicians' composite diagnosis including history elements, physical tests and confirmatory magnetic resonance imaging. Penalized logistic regression (LASSO) was used to identify history elements and physical examination tests associated with the diagnosis of ACL tear and recursive partitioning was used to develop diagnostic clusters. Diagnostic accuracy measures including sensitivity (Se), specificity (Sp), predictive values and positive and negative likelihood ratios (LR+/-) with associated 95% confidence intervals (CI) were calculated. Forty-three individuals received a diagnosis of partial or complete ACL tear (15.4% of total cohort). The Lachman test alone was able to diagnose partial or complete ACL tears (LR+: 38.4; 95%CI: 16.0-92.5). Combining a history of trauma during a pivot with a "popping" sensation also reached a high diagnostic validity for partial or complete tears (LR+: 9.8; 95%CI: 5.6-17.3). Combining a history of trauma during a pivot, immediate effusion after trauma and a positive Lachman test was able to identify individuals with a complete ACL tear (LR+: 17.5; 95%CI: 9.8-31.5). Finally, combining a negative history of pivot or a negative popping sensation during trauma with a negative Lachman or pivot shift test was able to exclude both partial or complete ACL tears (LR-: 0.08; 95%CI: 0.03-0.24). Diagnostic clusters combining history elements and physical examination tests can support the differential diagnosis of ACL tears compared to various knee disorders.

  11. Portable Bio/Chemosensoristic Devices: Innovative Systems for Environmental Health and Food Safety Diagnostics

    PubMed Central

    Dragone, Roberto; Grasso, Gerardo; Muccini, Michele; Toffanin, Stefano

    2017-01-01

    This mini-review covers the newly developed biosensoristic and chemosensoristic devices described in recent literature for detection of contaminants in both environmental and food real matrices. Current needs in environmental and food surveillance of contaminants require new simplified, sensitive systems, which are portable and allow for rapid and on-site monitoring and diagnostics. Here, we focus on optical and electrochemical bio/chemosensoristic devices as promising tools with interesting analytical features that can be potentially exploited for innovative on-site and real-time applications for diagnostics and monitoring of environmental and food matrices (e.g., agricultural waters and milk). In near future, suitably developed and implemented bio/chemosensoristic devices will be a new and modern technological solution for the identification of new quality and safety marker indexes as well as for a more proper and complete characterization of abovementioned environmental and food matrices. Integrated bio/chemosensoristic devices can also allow an “holistic approach” that may prove to be more suitable for diagnostics of environmental and food real matrices, where the copresence of more bioactive substances is frequent. Therefore, this approach can be focused on the determination of net effect (mixture effect) of bioactive substances present in real matrices. PMID:28529937

  12. Portable Bio/Chemosensoristic Devices: Innovative Systems for Environmental Health and Food Safety Diagnostics.

    PubMed

    Dragone, Roberto; Grasso, Gerardo; Muccini, Michele; Toffanin, Stefano

    2017-01-01

    This mini-review covers the newly developed biosensoristic and chemosensoristic devices described in recent literature for detection of contaminants in both environmental and food real matrices. Current needs in environmental and food surveillance of contaminants require new simplified, sensitive systems, which are portable and allow for rapid and on-site monitoring and diagnostics. Here, we focus on optical and electrochemical bio/chemosensoristic devices as promising tools with interesting analytical features that can be potentially exploited for innovative on-site and real-time applications for diagnostics and monitoring of environmental and food matrices (e.g., agricultural waters and milk). In near future, suitably developed and implemented bio/chemosensoristic devices will be a new and modern technological solution for the identification of new quality and safety marker indexes as well as for a more proper and complete characterization of abovementioned environmental and food matrices. Integrated bio/chemosensoristic devices can also allow an "holistic approach" that may prove to be more suitable for diagnostics of environmental and food real matrices, where the copresence of more bioactive substances is frequent. Therefore, this approach can be focused on the determination of net effect (mixture effect) of bioactive substances present in real matrices.

  13. Using Patient-Pathway Analysis to Inform a Differentiated Program Response to Tuberculosis: The Case of Kenya

    PubMed Central

    Masini, Enos; Hanson, Christy; Ogoro, Jeremiah; Brown, Jessie; Ngari, Faith; Mingkwan, Pia; Makayova, Julia; Osberg, Mike

    2017-01-01

    Abstract Background A recent tuberculosis prevalence survey in Kenya found that the country is home to nearly twice as many patients with tuberculosis as previously estimated. Kenya has prioritized identifying and treating the unnotified or missing cases of tuberculosis. This requires a better understanding of patient care seeking and system weaknesses. Methods A patient-pathway analysis (PPA) was completed to assess the alignment between patient care seeking and the availability of tuberculosis diagnostic and treatment services at the national level and for all 47 counties at the subnational level in Kenya. Results It was estimated that more than half of patients initiate care in the public sector. Nationally, just under half of patients encountered tuberculosis diagnostic and treatment capacity where they initiated care. Overall, there was distinct variation in diagnostic and treatment availability across counties and facility levels. Discussion The PPA results emphasized the need for a differentiated approach to tuberculosis care, by county, and the distinct need for better referral systems. The majority of Kenyans actively sought care; improving diagnostic and treatment capacity in the formal and informal private sector, as well as in the public sector, could help identify the majority of missing cases. PMID:29117349

  14. Development of a Novel and Rapid Fully Automated Genetic Testing System.

    PubMed

    Uehara, Masayuki

    2016-01-01

    We have developed a rapid genetic testing system integrating nucleic acid extraction, purification, amplification, and detection in a single cartridge. The system performs real-time polymerase chain reaction (PCR) after nucleic acid purification in a fully automated manner. RNase P, a housekeeping gene, was purified from human nasal epithelial cells using silica-coated magnetic beads and subjected to real-time PCR using a novel droplet-real-time-PCR machine. The process was completed within 13 min. This system will be widely applicable for research and diagnostic uses.

  15. Automated fiber pigtailing machine

    DOEpatents

    Strand, O.T.; Lowry, M.E.

    1999-01-05

    The Automated Fiber Pigtailing Machine (AFPM) aligns and attaches optical fibers to optoelectronic (OE) devices such as laser diodes, photodiodes, and waveguide devices without operator intervention. The so-called pigtailing process is completed with sub-micron accuracies in less than 3 minutes. The AFPM operates unattended for one hour, is modular in design and is compatible with a mass production manufacturing environment. This machine can be used to build components which are used in military aircraft navigation systems, computer systems, communications systems and in the construction of diagnostics and experimental systems. 26 figs.

  16. Enhancements to the Engine Data Interpretation System (EDIS)

    NASA Technical Reports Server (NTRS)

    Hofmann, Martin O.

    1993-01-01

    The Engine Data Interpretation System (EDIS) expert system project assists the data review personnel at NASA/MSFC in performing post-test data analysis and engine diagnosis of the Space Shuttle Main Engine (SSME). EDIS uses knowledge of the engine, its components, and simple thermodynamic principles instead of, and in addition to, heuristic rules gathered from the engine experts. EDIS reasons in cooperation with human experts, following roughly the pattern of logic exhibited by human experts. EDIS concentrates on steady-state static faults, such as small leaks, and component degradations, such as pump efficiencies. The objective of this contract was to complete the set of engine component models, integrate heuristic rules into EDIS, integrate the Power Balance Model into EDIS, and investigate modification of the qualitative reasoning mechanisms to allow 'fuzzy' value classification. The results of this contract is an operational version of EDIS. EDIS will become a module of the Post-Test Diagnostic System (PTDS) and will, in this context, provide system-level diagnostic capabilities which integrate component-specific findings provided by other modules.

  17. Early evaluation of MDIS workstations at Madigan Army Medical Center

    NASA Astrophysics Data System (ADS)

    Leckie, Robert G.; Goeringer, Fred; Smith, Donald V.; Bender, Gregory N.; Choi, Hyung-Sik; Haynor, David R.; Kim, Yongmin

    1993-06-01

    The image viewing workstation is an all-important link in the PACS (Picture Archiving and Communications System) chain since it represents the interface between the system and the user. For PACS to function, the working environment and transfer of information to the user must be the same or better than the traditional film-based system. The important characteristics of a workstation from a clinical standpoint are acceptable image quality, rapid response time, a friendly user interface, and a well-integrated, highly-reliable, fault-tolerant system which provides the user ample functions to complete his tasks successfully. Since early 1992, the MDIS (Medical Diagnostic Imaging Support) system's diagnostic and clinical workstations have been installed at Madigan Army Medical Center. Various functionalities and performance characteristics of the MDIS workstations such as image display, response time, database, and ergonomics will be presented. User comments and early experience with the workstations as well as new functionality recommended for the future will be discussed.

  18. Enhancements to the Engine Data Interpretation System (EDIS)

    NASA Technical Reports Server (NTRS)

    Hofmann, Martin O.

    1993-01-01

    The Engine Data Interpretation System (EDIS) expert system project assists the data review personnel at NASA/MSFC in performing post-test data analysis and engine diagnosis of the Space Shuttle Main Engine (SSME). EDIS uses knowledge of the engine, its components, and simple thermodynamic principles instead of, and in addition to, heuristic rules gathered from the engine experts. EDIS reasons in cooperation with human experts, following roughly the pattern of logic exhibited by human experts. EDIS concentrates on steady-state static faults, such as small leaks, and component degradations, such as pump efficiencies. The objective of this contract was to complete the set of engine component models, integrate heuristic rules into EDIS, integrate the Power Balance Model into EDIS, and investigate modification of the qualitative reasoning mechanisms to allow 'fuzzy' value classification. The result of this contract is an operational version of EDIS. EDIS will become a module of the Post-Test Diagnostic System (PTDS) and will, in this context, provide system-level diagnostic capabilities which integrate component-specific findings provided by other modules.

  19. Survey of diagnostic and typing capacity for Clostridium difficile infection in Europe, 2011 and 2014.

    PubMed

    van Dorp, Sofie M; Notermans, Daan W; Alblas, Jeroen; Gastmeier, Petra; Mentula, Silja; Nagy, Elisabeth; Spigaglia, Patrizia; Ivanova, Katiusha; Fitzpatrick, Fidelma; Barbut, Frédéric; Morris, Trefor; Wilcox, Mark H; Kinross, Pete; Suetens, Carl; Kuijper, Ed J

    2016-07-21

    Suboptimal laboratory diagnostics for Clostridium difficile infection (CDI) impedes its surveillance and control across Europe. We evaluated changes in local laboratory CDI diagnostics and changes in national diagnostic and typing capacity for CDI during the European C. difficile Infection Surveillance Network (ECDIS-Net) project, through cross-sectional surveys in 33 European countries in 2011 and 2014. In 2011, 126 (61%) of a convenience sample of 206 laboratories in 31 countries completed a survey on local diagnostics. In 2014, 84 (67%) of these 126 laboratories in 26 countries completed a follow-up survey. Among laboratories that participated in both surveys, use of CDI diagnostics deemed 'optimal' or 'acceptable' increased from 19% to 46% and from 10% to 15%, respectively (p  < 0.001). The survey of national capacity was completed by national coordinators of 31 and 32 countries in 2011 and 2014, respectively. Capacity for any C. difficile typing method increased from 22/31 countries in 2011 to 26/32 countries in 2014; for PCR ribotyping from 20/31 countries to 23/32 countries, and specifically for capillary PCR ribotyping from 7/31 countries to 16/32 countries. While our study indicates improved diagnostic capability and national capacity for capillary PCR ribotyping across European laboratories between 2011 and 2014, increased use of 'optimal' diagnostics should be promoted. This article is copyright of The Authors, 2016.

  20. Myasthenia Gravis: Tests and Diagnostic Methods

    MedlinePlus

    ... Focus on MG Newsletter MG Quarterly Test & Diagnostic methods In addition to a complete medical and neurological ... How can I help? About MGFA Test & Diagnostic methods Treatment for MG FAQ's Upcoming Events 2018 MG ...

  1. New detection system and signal processing for the tokamak ISTTOK heavy ion beam diagnostic.

    PubMed

    Henriques, R B; Nedzelskiy, I S; Malaquias, A; Fernandes, H

    2012-10-01

    The tokamak ISTTOK havy ion beam diagnostic (HIBD) operates with a multiple cell array detector (MCAD) that allows for the plasma density and the plasma density fluctuations measurements simultaneously at different sampling volumes across the plasma. To improve the capability of the plasma density fluctuations investigations, a new detection system and new signal conditioning amplifier have been designed and tested. The improvements in MCAD design are presented which allow for nearly complete suppression of the spurious plasma background signal by applying a biasing potential onto special electrodes incorporated into MCAD. The new low cost and small size transimpedance amplifiers are described with the parameters of 400 kHz, 10(7) V/A, 0.4 nA of RMS noise, adequate for the plasma density fluctuations measurements.

  2. Computer-Aided Diagnosis of Acute Lymphoblastic Leukaemia

    PubMed Central

    2018-01-01

    Leukaemia is a form of blood cancer which affects the white blood cells and damages the bone marrow. Usually complete blood count (CBC) and bone marrow aspiration are used to diagnose the acute lymphoblastic leukaemia. It can be a fatal disease if not diagnosed at the earlier stage. In practice, manual microscopic evaluation of stained sample slide is used for diagnosis of leukaemia. But manual diagnostic methods are time-consuming, less accurate, and prone to errors due to various human factors like stress, fatigue, and so forth. Therefore, different automated systems have been proposed to wrestle the glitches in the manual diagnostic methods. In recent past, some computer-aided leukaemia diagnosis methods are presented. These automated systems are fast, reliable, and accurate as compared to manual diagnosis methods. This paper presents review of computer-aided diagnosis systems regarding their methodologies that include enhancement, segmentation, feature extraction, classification, and accuracy. PMID:29681996

  3. Spatial calibration of a tokamak neutral beam diagnostic using in situ neutral beam emission

    DOE PAGES

    Chrystal, Colin; Burrell, Keith H.; Grierson, Brian A.; ...

    2015-10-20

    Neutral beam injection is used in tokamaks to heat, apply torque, drive non-inductive current, and diagnose plasmas. Neutral beam diagnostics need accurate spatial calibrations to benefit from the measurement localization provided by the neutral beam. A new technique has been developed that uses in-situ measurements of neutral beam emission to determine the spatial location of the beam and the associated diagnostic views. This technique was developed to improve the charge exchange recombination diagnostic (CER) at the DIII-D tokamak and uses measurements of the Doppler shift and Stark splitting of neutral beam emission made by that diagnostic. These measurements contain informationmore » about the geometric relation between the diagnostic views and the neutral beams when they are injecting power. This information is combined with standard spatial calibration measurements to create an integrated spatial calibration that provides a more complete description of the neutral beam-CER system. The integrated spatial calibration results are very similar to the standard calibration results and derived quantities from CER measurements are unchanged within their measurement errors. Lastly, the methods developed to perform the integrated spatial calibration could be useful for tokamaks with limited physical access.« less

  4. Spatial calibration of a tokamak neutral beam diagnostic using in situ neutral beam emission

    NASA Astrophysics Data System (ADS)

    Chrystal, C.; Burrell, K. H.; Grierson, B. A.; Pace, D. C.

    2015-10-01

    Neutral beam injection is used in tokamaks to heat, apply torque, drive non-inductive current, and diagnose plasmas. Neutral beam diagnostics need accurate spatial calibrations to benefit from the measurement localization provided by the neutral beam. A new technique has been developed that uses in situ measurements of neutral beam emission to determine the spatial location of the beam and the associated diagnostic views. This technique was developed to improve the charge exchange recombination (CER) diagnostic at the DIII-D tokamak and uses measurements of the Doppler shift and Stark splitting of neutral beam emission made by that diagnostic. These measurements contain information about the geometric relation between the diagnostic views and the neutral beams when they are injecting power. This information is combined with standard spatial calibration measurements to create an integrated spatial calibration that provides a more complete description of the neutral beam-CER system. The integrated spatial calibration results are very similar to the standard calibration results and derived quantities from CER measurements are unchanged within their measurement errors. The methods developed to perform the integrated spatial calibration could be useful for tokamaks with limited physical access.

  5. Diagnostic studies of the HxOy-NzOy-O3 photochemical system using data from NASA GTE field expeditions

    NASA Technical Reports Server (NTRS)

    Chameides, William L.

    1988-01-01

    Spring 1084 GTE CITE-1 flight data from the field exercise was obtained from a GTE Data Archive Tape. Chemical and supporting meteorological data taken over the Pacific Ocean was statistically and diagnostically analyzed to identify the key processes affecting the concentrations of ozone and its chemical precursors in the region. The analysis was completed. The analysis of the GTE CITE-2 data is being performed in collaboration with Dr. D.D. Davis and other GTE scientists. Initial results of the analysis were presented and work begun on the paper describing the results.

  6. Direct Digital Boiler Control Systems for the Navy Small Boiler Equipment.

    DTIC Science & Technology

    1983-02-01

    Hardware. Each full-size ACU a 6 caculation modules 30 arrme, modufes sation for dead time lag contains input/output circuit a 16 control mo uies a...along with lather modules of the DCS-1000 family. ’The complete instrument consists of plug-in circuit boards that allow easy Teplacement of a...Maintenance-Most systems indicate trouble areas with diagnostic routines or integral LED indicators so that circuit boards can be replaced to correct

  7. Power spectra as a diagnostic tool in probing statistical/nonstatistical behavior in unimolecular reactions

    NASA Astrophysics Data System (ADS)

    Chang, Xiaoyen Y.; Sewell, Thomas D.; Raff, Lionel M.; Thompson, Donald L.

    1992-11-01

    The possibility of utilizing different types of power spectra obtained from classical trajectories as a diagnostic tool to identify the presence of nonstatistical dynamics is explored by using the unimolecular bond-fission reactions of 1,2-difluoroethane and the 2-chloroethyl radical as test cases. In previous studies, the reaction rates for these systems were calculated by using a variational transition-state theory and classical trajectory methods. A comparison of the results showed that 1,2-difluoroethane is a nonstatistical system, while the 2-chloroethyl radical behaves statistically. Power spectra for these two systems have been generated under various conditions. The characteristics of these spectra are as follows: (1) The spectra for the 2-chloroethyl radical are always broader and more coupled to other modes than is the case for 1,2-difluoroethane. This is true even at very low levels of excitation. (2) When an internal energy near or above the dissociation threshold is initially partitioned into a local C-H stretching mode, the power spectra for 1,2-difluoroethane broaden somewhat, but discrete and somewhat isolated bands are still clearly evident. In contrast, the analogous power spectra for the 2-chloroethyl radical exhibit a near complete absence of isolated bands. The general appearance of the spectrum suggests a very high level of mode-to-mode coupling, large intramolecular vibrational energy redistribution (IVR) rates, and global statistical behavior. (3) The appearance of the power spectrum for the 2-chloroethyl radical is unaltered regardless of whether the initial C-H excitation is in the CH2 or the CH2Cl group. This result also suggests statistical behavior. These results are interpreted to mean that power spectra may be used as a diagnostic tool to assess the statistical character of a system. The presence of a diffuse spectrum exhibiting a nearly complete loss of isolated structures indicates that the dissociation dynamics of the molecule will be well described by statistical theories. If, however, the power spectrum maintains its discrete, isolated character, as is the case for 1,2-difluoroethane, the opposite conclusion is suggested. Since power spectra are very easily computed, this diagnostic method may prove to be useful.

  8. Luminescent characteristics study of Mather-type dense plasma focus and applications to short-wavelength optical pumping. Final technical report, 1 May 1984-30 September 1985

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kim, K.K.

    A Mather-type dense plasma focus (MDPF) system was designed, built, and tested specifically to study its luminescent characteristics and to assess its potential as a new light source of high-energy, short-wavelength lasers. The luminescence study of MDPF showed that the conversion efficiency from the electrical input to the optical output energies is at least 50%, up to the time the plasma compression is complete. Using the system, for the first time as an optical pump, laser activities were successfully obtained from a variety of liquid organic dyes. Diagnostic capabilities included an optical multichannel analyzer system complete with a computer control,more » a nitrogen-pumped tunable dye-laser system, a high-speed streak/framing camera, a digital laser energy meter, voltage and current probes, and a computer-based data-acquisition system.« less

  9. [The "Würzburg T". A concept for optimization of early multiple trauma care in the emergency department].

    PubMed

    Kuhnigk, H; Steinhübel, B; Keil, T; Roewer, N

    2004-07-01

    Anaesthesia management, radiological diagnostic and the concept of damage control surgery should be combined in the resuscitation room. Defined clinical targets and their realisation are a CT-scan and complete damage control surgery in the shock room. Furthermore minimised patient transfer and positioning with continuous access to the head, upper parts of the body and anaesthesia machine should be realised during diagnostic procedures. Based on a carbon-slide fixed on a turntable and innovative alignment of diagnostic devices, a three phase treatment algorithm has been established. Phase A includes primary survey, anaesthetic management and ultrasound examination. Following a turn of the table conventional x-ray diagnostic is assessed in phase B. Tracks for the slide enable immediate transfer to a spiral CT-scan without additional patient positioning (phase C). Following complete CT-scan rearrangement of the table to phase A facilitates immediate damage control surgery. To accelerate device operation and treatment the integrated anaesthesia workstation is ceiling-mounted and manoeuvres close to the patient. This concept realizes complete diagnostic procedures and damage control surgery without time consuming patient transfer or rearrangement.

  10. Design of a solar array simulator for the NASA EOS testbed

    NASA Technical Reports Server (NTRS)

    Butler, Steve J.; Sable, Dan M.; Lee, Fred C.; Cho, Bo H.

    1992-01-01

    The present spacecraft solar array simulator addresses both dc and ac characteristics as well as changes in illumination and temperature and performance degradation over the course of array service life. The computerized control system used allows simulation of a complete orbit cycle, in addition to automated diagnostics. The simulator is currently interfaced with the NASA EOS testbed.

  11. Equations for Scoring Rules When Data Are Missing

    NASA Technical Reports Server (NTRS)

    James, Mark

    2006-01-01

    A document presents equations for scoring rules in a diagnostic and/or prognostic artificial-intelligence software system of the rule-based inference-engine type. The equations define a set of metrics that characterize the evaluation of a rule when data required for the antecedence clause(s) of the rule are missing. The metrics include a primary measure denoted the rule completeness metric (RCM) plus a number of subsidiary measures that contribute to the RCM. The RCM is derived from an analysis of a rule with respect to its truth and a measure of the completeness of its input data. The derivation is such that the truth value of an antecedent is independent of the measure of its completeness. The RCM can be used to compare the degree of completeness of two or more rules with respect to a given set of data. Hence, the RCM can be used as a guide to choosing among rules during the rule-selection phase of operation of the artificial-intelligence system..

  12. Robotically assisted ureteroscopy for kidney exploration

    PubMed Central

    Talari, Hadi F.; Monfaredi, Reza; Wilson, Emmanuel; Blum, Emily; Bayne, Christopher; Peters, Craig; Zhang, Anlin; Cleary, Kevin

    2018-01-01

    Ureteroscopy is a minimally invasive procedure for diagnosis and treatment of a wide range of urinary tract pathologies. It is most commonly performed in the diagnostic work-up of hematuria and the diagnosis and treatment of upper urinary tract malignancies and calculi. Ergonomic and visualization challenges as well as radiation exposure are limitations to conventional ureteroscopy. For example, for diagnostic tumor inspection, the urologist has to maneuver the ureteroscope through each of the 6 to 12 calyces in the kidney under fluoroscopy to ensure complete surveillance. Therefore, we have been developing a robotic system to “power drive” a flexible fiber-optic ureteroscope with 3D tip tracking and pre-operative image overlay. Our goal is to provide the urologist precise control of the ureteroscope tip with less radiation exposure. Our prototype system allows control of the three degrees of freedom of the ureteroscope via brushless motors and a joystick interface. The robot provides a steady platform for controlling the ureteroscope. Furthermore, the robot design facilitates a quick “snap-in” of the ureteroscope, thus allowing the ureteroscope to be mounted midway through the procedure. We have completed the mechanical system and the controlling software and begun evaluation using a kidney phantom. We put MRI-compatible fiducials on the phantom and obtained MR images. We registered these images with the robot using an electromagnetic tracking system and paired-point registration. The system is described and initial evaluation results are given in this paper. PMID:29731536

  13. Clinical diagnosis of partial or complete anterior cruciate ligament tears using patients' history elements and physical examination tests

    PubMed Central

    Fallaha, Michel; Belzile, Sylvain; Martel-Pelletier, Johanne; Pelletier, Jean-Pierre; Feldman, Debbie; Sylvestre, Marie-Pierre; Vendittoli, Pascal-André; Desmeules, François

    2018-01-01

    Objective To assess the diagnostic validity of clusters combining history elements and physical examination tests to diagnose partial or complete anterior cruciate ligament (ACL) tears. Design Prospective diagnostic study. Settings Orthopaedic clinics (n = 2), family medicine clinics (n = 2) and community-dwelling. Participants Consecutive patients with a knee complaint (n = 279) and consulting one of the participating orthopaedic surgeons (n = 3) or sport medicine physicians (n = 2). Interventions Not applicable. Main outcome measures History elements and physical examination tests performed independently were compared to the reference standard: an expert physicians’ composite diagnosis including history elements, physical tests and confirmatory magnetic resonance imaging. Penalized logistic regression (LASSO) was used to identify history elements and physical examination tests associated with the diagnosis of ACL tear and recursive partitioning was used to develop diagnostic clusters. Diagnostic accuracy measures including sensitivity (Se), specificity (Sp), predictive values and positive and negative likelihood ratios (LR+/-) with associated 95% confidence intervals (CI) were calculated. Results Forty-three individuals received a diagnosis of partial or complete ACL tear (15.4% of total cohort). The Lachman test alone was able to diagnose partial or complete ACL tears (LR+: 38.4; 95%CI: 16.0–92.5). Combining a history of trauma during a pivot with a “popping” sensation also reached a high diagnostic validity for partial or complete tears (LR+: 9.8; 95%CI: 5.6–17.3). Combining a history of trauma during a pivot, immediate effusion after trauma and a positive Lachman test was able to identify individuals with a complete ACL tear (LR+: 17.5; 95%CI: 9.8–31.5). Finally, combining a negative history of pivot or a negative popping sensation during trauma with a negative Lachman or pivot shift test was able to exclude both partial or complete ACL tears (LR-: 0.08; 95%CI: 0.03–0.24). Conclusion Diagnostic clusters combining history elements and physical examination tests can support the differential diagnosis of ACL tears compared to various knee disorders. PMID:29894492

  14. An open access thyroid ultrasound image database

    NASA Astrophysics Data System (ADS)

    Pedraza, Lina; Vargas, Carlos; Narváez, Fabián.; Durán, Oscar; Muñoz, Emma; Romero, Eduardo

    2015-01-01

    Computer aided diagnosis systems (CAD) have been developed to assist radiologists in the detection and diagnosis of abnormalities and a large number of pattern recognition techniques have been proposed to obtain a second opinion. Most of these strategies have been evaluated using different datasets making their performance incomparable. In this work, an open access database of thyroid ultrasound images is presented. The dataset consists of a set of B-mode Ultrasound images, including a complete annotation and diagnostic description of suspicious thyroid lesions by expert radiologists. Several types of lesions as thyroiditis, cystic nodules, adenomas and thyroid cancers were included while an accurate lesion delineation is provided in XML format. The diagnostic description of malignant lesions was confirmed by biopsy. The proposed new database is expected to be a resource for the community to assess different CAD systems.

  15. Study on Unified Chaotic System-Based Wind Turbine Blade Fault Diagnostic System

    NASA Astrophysics Data System (ADS)

    Kuo, Ying-Che; Hsieh, Chin-Tsung; Yau, Her-Terng; Li, Yu-Chung

    At present, vibration signals are processed and analyzed mostly in the frequency domain. The spectrum clearly shows the signal structure and the specific characteristic frequency band is analyzed, but the number of calculations required is huge, resulting in delays. Therefore, this study uses the characteristics of a nonlinear system to load the complete vibration signal to the unified chaotic system, applying the dynamic error to analyze the wind turbine vibration signal, and adopting extenics theory for artificial intelligent fault diagnosis of the analysis signal. Hence, a fault diagnostor has been developed for wind turbine rotating blades. This study simulates three wind turbine blade states, namely stress rupture, screw loosening and blade loss, and validates the methods. The experimental results prove that the unified chaotic system used in this paper has a significant effect on vibration signal analysis. Thus, the operating conditions of wind turbines can be quickly known from this fault diagnostic system, and the maintenance schedule can be arranged before the faults worsen, making the management and implementation of wind turbines smoother, so as to reduce many unnecessary costs.

  16. [A new system of testing visual performance based on the cylindrical lens screen].

    PubMed

    Doege, E; Krause, O

    1983-09-01

    Using a special microoptical screen as a test-picture coating, a method for testing binocular function was developed. It offers the advantage of providing a separate visual impression to each eye from a diagnostic picture without using any device in front of the eyes. The person tested is unaware of this procedure, of which the diagnostic plate gives no hint. In addition to a description of its numerous uses and diagnostic possibilities, fusion pictures suitable for screening tests are described: Each eye is offered a separate impression with a completely different content. If fusion occurs correctly, a third motif with an entirely new meaning emerges. Several years of experience with this effective system (naked-eye tests) resulted in aids which are listed in the final section of the paper: exercise aids used for preparing the persons tested (especially infants) in the waiting room, recognition aids for the examination, and a partially kinetic picture for rapid, simple and very convincing representation of adjusting movements and of the squint position in cases of concomitant squint.

  17. A meta-analysis of use of Prostate Imaging Reporting and Data System Version 2 (PI-RADS V2) with multiparametric MR imaging for the detection of prostate cancer.

    PubMed

    Zhang, Li; Tang, Min; Chen, Sipan; Lei, Xiaoyan; Zhang, Xiaoling; Huan, Yi

    2017-12-01

    This meta-analysis was undertaken to review the diagnostic accuracy of PI-RADS V2 for prostate cancer (PCa) detection with multiparametric MR (mp-MR). A comprehensive literature search of electronic databases was performed by two observers independently. Inclusion criteria were original research using the PI-RADS V2 system in reporting prostate MRI. The methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Data necessary to complete 2 × 2 contingency tables were obtained from the included studies. Thirteen studies (2,049 patients) were analysed. This is an initial meta-analysis of PI-RADs V2 and the overall diagnostic accuracy in diagnosing PCa was as follows: pooled sensitivity, 0.85 (0.78-0.91); pooled specificity, 0.71 (0.60-0.80); pooled positive likelihood ratio (LR+), 2.92 (2.09-4.09); pooled negative likelihood ratio (LR-), 0.21 (0.14-0.31); pooled diagnostic odds ratio (DOR), 14.08 (7.93-25.01), respectively. Positive predictive values ranged from 0.54 to 0.97 and negative predictive values ranged from 0.26 to 0.92. Currently available evidence indicates that PI-RADS V2 appears to have good diagnostic accuracy in patients with PCa lesions with high sensitivity and moderate specificity. However, no recommendation regarding the best threshold can be provided because of heterogeneity. • PI-RADS V2 shows good diagnostic accuracy for PCa detection. • Initially pooled specificity of PI-RADS v2 remains moderate. • PCa detection is increased by experienced radiologists. • There is currently a high heterogeneity in prostate diagnostics with MRI.

  18. A Diagnostic Marker to Discriminate Childhood Apraxia of Speech From Speech Delay: I. Development and Description of the Pause Marker

    PubMed Central

    Strand, Edythe A.; Fourakis, Marios; Jakielski, Kathy J.; Hall, Sheryl D.; Karlsson, Heather B.; Mabie, Heather L.; McSweeny, Jane L.; Tilkens, Christie M.; Wilson, David L.

    2017-01-01

    Purpose The goal of this article (PM I) is to describe the rationale for and development of the Pause Marker (PM), a single-sign diagnostic marker proposed to discriminate early or persistent childhood apraxia of speech from speech delay. Method The authors describe and prioritize 7 criteria with which to evaluate the research and clinical utility of a diagnostic marker for childhood apraxia of speech, including evaluation of the present proposal. An overview is given of the Speech Disorders Classification System, including extensions completed in the same approximately 3-year period in which the PM was developed. Results The finalized Speech Disorders Classification System includes a nosology and cross-classification procedures for childhood and persistent speech disorders and motor speech disorders (Shriberg, Strand, & Mabie, 2017). A PM is developed that provides procedural and scoring information, and citations to papers and technical reports that include audio exemplars of the PM and reference data used to standardize PM scores are provided. Conclusions The PM described here is an acoustic-aided perceptual sign that quantifies one aspect of speech precision in the linguistic domain of phrasing. This diagnostic marker can be used to discriminate early or persistent childhood apraxia of speech from speech delay. PMID:28384779

  19. Using Patient-Pathway Analysis to Inform a Differentiated Program Response to Tuberculosis: The Case of Kenya.

    PubMed

    Masini, Enos; Hanson, Christy; Ogoro, Jeremiah; Brown, Jessie; Ngari, Faith; Mingkwan, Pia; Makayova, Julia; Osberg, Mike

    2017-11-06

    A recent tuberculosis prevalence survey in Kenya found that the country is home to nearly twice as many patients with tuberculosis as previously estimated. Kenya has prioritized identifying and treating the unnotified or missing cases of tuberculosis. This requires a better understanding of patient care seeking and system weaknesses. A patient-pathway analysis (PPA) was completed to assess the alignment between patient care seeking and the availability of tuberculosis diagnostic and treatment services at the national level and for all 47 counties at the subnational level in Kenya. It was estimated that more than half of patients initiate care in the public sector. Nationally, just under half of patients encountered tuberculosis diagnostic and treatment capacity where they initiated care. Overall, there was distinct variation in diagnostic and treatment availability across counties and facility levels. The PPA results emphasized the need for a differentiated approach to tuberculosis care, by county, and the distinct need for better referral systems. The majority of Kenyans actively sought care; improving diagnostic and treatment capacity in the formal and informal private sector, as well as in the public sector, could help identify the majority of missing cases. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  20. A Job-Oriented Reading Program for the Air Force: Development and Field Evaluation.

    DTIC Science & Technology

    1977-05-01

    spent in a conventional classroom setting, working on word power and phonics. At the end of the week, a diagnostic test is administered and the...and " soft " systems procedures in the Air Force. 3. The candidate career fields should have a large number of job incumbents, and be well represented...written information on page 47, where does the integral brake system obtain braking power ?". For an example of a complete Narrative worksheet, see Figure

  1. Evaluation and Selection of a Telecommunication System at the Naval Postgraduate School BOQ

    DTIC Science & Technology

    1991-03-01

    software, and operating system software as a part of a complete package. An internal modem must be included for remote diagnostic and programming...2 service delivery will follow the CCITT V.35 recommendation for physical, functional and electrical interfaces. Type 1 & 2 will transfer data at 56K ...by a dedicated access line at 4.8 kbs and 9.6 Kbps and 56k /64Kbps. PSS will follow the CCITT X.25 recommendations. E-mail service may be provided on

  2. Digital radiography: spatial and contrast resolution

    NASA Astrophysics Data System (ADS)

    Bjorkholm, Paul; Annis, M.; Frederick, E.; Stein, J.; Swift, R.

    1981-07-01

    The addition of digital image collection and storage to standard and newly developed x-ray imaging techniques has allowed spectacular improvements in some diagnostic procedures. There is no reason to expect that the developments in this area are yet complete. But no matter what further developments occur in this field, all the techniques will share a common element, digital image storage and processing. This common element alone determines some of the important imaging characteristics. These will be discussed using one system, the Medical MICRODOSE System as an example.

  3. Technical report series on global modeling and data assimilation. Volume 1: Documentation of the Goddard Earth Observing System (GEOS) General Circulation Model, version 1

    NASA Technical Reports Server (NTRS)

    Suarez, Max J. (Editor); Takacs, Lawrence L.; Molod, Andrea; Wang, Tina

    1994-01-01

    This technical report documents Version 1 of the Goddard Earth Observing System (GEOS) General Circulation Model (GCM). The GEOS-1 GCM is being used by NASA's Data Assimilation Office (DAO) to produce multiyear data sets for climate research. This report provides a documentation of the model components used in the GEOS-1 GCM, a complete description of model diagnostics available, and a User's Guide to facilitate GEOS-1 GCM experiments.

  4. Periorbital Ecchymosis (Raccoon Eye) and Orbital Hematoma following Endoscopic Retrograde Cholangiopancreatography.

    PubMed

    Nasiri, Jafar; Zamani, Farhad

    2017-01-01

    Endoscopic retrograde cholangiopancreatography (ERCP) is a conventional technique for diagnosis and treatment of pancratobiliary diseases, which is associated with various complications, including pancreatitis, hemorrhage, cholangitis, perforation, and mortality. In our case, a 69-year-old woman with positive hepatobiliary symptoms underwent ERCP, at the end of which a rare complication (raccoon eye) occurred, which was hypothesized to be due to amyloidosis, but the patient refused to complete the diagnostic procedure and became symptom free after 3 weeks. Racoon eye or periorbital ecchymosis is caused by blood tracking into periorbital tissues, which is frequently observed after head trauma but is also observed in systemic diseases, such as amyloidosis, neuroblastoma, and surgical interventions. To the best of our knowledge, this is the first report of raccoon eye after ERCP; further reports will help to confirm that this complication should also be considered before performing ERCP and that complete diagnostic tests for the predisposing diseases prior to ERCP are necessary.

  5. Periorbital Ecchymosis (Raccoon Eye) and Orbital Hematoma following Endoscopic Retrograde Cholangiopancreatography

    PubMed Central

    Nasiri, Jafar; Zamani, Farhad

    2017-01-01

    Endoscopic retrograde cholangiopancreatography (ERCP) is a conventional technique for diagnosis and treatment of pancratobiliary diseases, which is associated with various complications, including pancreatitis, hemorrhage, cholangitis, perforation, and mortality. In our case, a 69-year-old woman with positive hepatobiliary symptoms underwent ERCP, at the end of which a rare complication (raccoon eye) occurred, which was hypothesized to be due to amyloidosis, but the patient refused to complete the diagnostic procedure and became symptom free after 3 weeks. Racoon eye or periorbital ecchymosis is caused by blood tracking into periorbital tissues, which is frequently observed after head trauma but is also observed in systemic diseases, such as amyloidosis, neuroblastoma, and surgical interventions. To the best of our knowledge, this is the first report of raccoon eye after ERCP; further reports will help to confirm that this complication should also be considered before performing ERCP and that complete diagnostic tests for the predisposing diseases prior to ERCP are necessary. PMID:28611566

  6. Contrast-enhanced postmortem computed tomography in clinical pathology: enhanced value of 20 clinical autopsies.

    PubMed

    Westphal, Saskia E; Apitzsch, Jonas C; Penzkofer, Tobias; Kuhl, Christiane K; Mahnken, Andreas H; Knüchel, Ruth

    2014-09-01

    Postmortem computed tomography (PMCT) is a modern tool that complements autopsy diagnostics. In clinical autopsies, a major cause of death is cardiovascular disease. To improve the performance of PMCT in cardiovascular disease, full body angiography was developed (PMCT angiography [PMCTA]). Twenty PMCTA scans generated before autopsy were compared with native PMCT and clinical autopsy. The objective of the study was to quantify the additional diagnostic value of adding angiography to native imaging and to compare PMCT and PMCTA findings to autopsy findings. The diagnosis of the cause of death was identical or overlapped in 80% of the cases that used PMCTA and 70% that used PMCT. The additional diagnostic yield given by PMCT and PMCTA in combination with autopsy was 55%. PMCT yielded additional diagnoses in the musculoskeletal system. The greatest additional diagnostic value of PMCTA was in association with cardiovascular diagnoses. The accuracy of PMCTA for cardiac causes of death was 80%, and the positive predictive value was 90%. The findings indicate that native PMCT cannot display the cardiovascular system sufficiently clearly for high-quality diagnostic assessment. However, PMCTA is a powerful tool in autopsy cases with a history of cardiovascular disease and/or a suspected cardiovascular cause of death. The combination of PMCTA and clinical autopsy enhances diagnostic quality and completeness of the autopsy report. Furthermore, in cases without consent or with a restricted consent for clinical autopsy, PMCTA has the potential to provide information on cardiovascular causes of death. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Diagnosing periprosthetic joint infection: has the era of the biomarker arrived?

    PubMed

    Deirmengian, Carl; Kardos, Keith; Kilmartin, Patrick; Cameron, Alexander; Schiller, Kevin; Parvizi, Javad

    2014-11-01

    The diagnosis of periprosthetic joint infection (PJI) remains a serious clinical challenge. There is a pressing need for improved diagnostic testing methods; biomarkers offer one potentially promising approach. We evaluated the diagnostic characteristics of 16 promising synovial fluid biomarkers for the diagnosis of PJI. Synovial fluid was collected from 95 patients meeting the inclusion criteria of this prospective diagnostic study. All patients were being evaluated for a revision hip or knee arthroplasty, including patients with systemic inflammatory disease and those already receiving antibiotic treatment. The Musculoskeletal Infection Society (MSIS) definition was used to classify 29 PJIs and 66 aseptic joints. Synovial fluid samples were tested by immunoassay for 16 biomarkers optimized for use in synovial fluid. Sensitivity, specificity, and receiver operating characteristic curve analysis were performed to assess for diagnostic performance. Five biomarkers, including human α-defensin 1-3, neutrophil elastase 2, bactericidal/permeability-increasing protein, neutrophil gelatinase-associated lipocalin, and lactoferrin, correctly predicted the MSIS classification of all patients in this study, with 100% sensitivity and specificity for the diagnosis of PJI. An additional eight biomarkers demonstrated excellent diagnostic strength, with an area under the curve of greater than 0.9. Synovial fluid biomarkers exhibit a high accuracy in diagnosing PJI, even when including patients with systemic inflammatory disease and those receiving antibiotic treatment. Considering that these biomarkers match the results of the more complex MSIS definition of PJI, we believe that synovial fluid biomarkers can be a valuable addition to the methods utilized for the diagnosis of infection. Level II, diagnostic study. See Instructions for Authors for a complete description of levels of evidence.

  8. Targeted HIV Screening in Eight Emergency Departments: The DICI-VIH Cluster-Randomized Two-Period Crossover Trial.

    PubMed

    Leblanc, Judith; Hejblum, Gilles; Costagliola, Dominique; Durand-Zaleski, Isabelle; Lert, France; de Truchis, Pierre; Verbeke, Geert; Rousseau, Alexandra; Piquet, Hélène; Simon, François; Pateron, Dominique; Simon, Tabassome; Crémieux, Anne-Claude

    2018-07-01

    This study compares the effectiveness and cost-effectiveness of nurse-driven targeted HIV screening alongside physician-directed diagnostic testing (intervention strategy) with diagnostic testing alone (control strategy) in 8 emergency departments. In this cluster-randomized, 2-period, crossover trial, 18- to 64-year-old patients presenting for reasons other than potential exposure to HIV were included. The strategy applied first was randomly assigned. During both periods, diagnostic testing was prescribed by physicians following usual care. During the intervention periods, patients were asked to complete a self-administered questionnaire. According to their answers, the triage nurse suggested performing a rapid test to patients belonging to a high-risk group. The primary outcome was the proportion of new diagnoses among included patients, which further refers to effectiveness. A secondary outcome was the intervention's incremental cost (health care system perspective) per additional diagnosis. During the intervention periods, 74,161 patients were included, 16,468 completed the questionnaire, 4,341 belonged to high-risk groups, and 2,818 were tested by nurses, yielding 13 new diagnoses. Combined with 9 diagnoses confirmed through 97 diagnostic tests, 22 new diagnoses were established. During the control periods, 74,166 patients were included, 92 were tested, and 6 received a new diagnosis. The proportion of new diagnoses among included patients was higher during the intervention than in the control periods (3.0 per 10,000 versus 0.8 per 10,000; difference 2.2 per 10,000, 95% CI 1.3 to 3.6; relative risk 3.7, 95% CI 1.4 to 9.8). The incremental cost was €1,324 per additional new diagnosis. The combined strategy of targeted screening and diagnostic testing was effective. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

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

    PubMed Central

    2014-01-01

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

  10. Clinical Applications of Procalcitonin in Pediatrics: An Advanced Biomarker for Inflammation and Infection-Can It Also Be Used in Trauma?

    PubMed

    Koutroulis, Ioannis; Loscalzo, Steven M; Kratimenos, Panagiotis; Singh, Sabina; Weiner, Evan; Syriopoulou, Vassiliki; Theocharis, Stamatios; Chrousos, Georgios

    2014-01-01

    Background. Procalcitonin is a small molecular peptide that has gained increased support as an adjunct diagnostic marker of infection in the adult population; the concordant body of evidence for the use of procalcitonin in pediatric populations is far less complete. Objectives. Our objective is to review the current evidence supporting the utilization of procalcitonin in children in a variety of clinical scenarios including SIRS, sepsis, burns, and trauma and to identify existing knowledge gaps. Methods. A thorough review of the literature was performed utilizing PubMed. We focused on using meta-analysis from adult populations to review current practices in interpretation and methodology and find concordant pediatric studies to determine if the same applications are validated in pediatric populations. Results. Current evidence supports the usage of procalcitonin as both a sensitive and a specific marker for the differentiation of systemic inflammatory response syndrome from sepsis in pediatrics with increased diagnostic accuracy compared to commonly used biomarkers including complete blood counts and C-reactive protein. Conclusions. Although the body of evidence is limited, initial observations suggest that procalcitonin can be used in pediatric trauma and burn patients as both a prognostic and a diagnostic marker, aiding in the identification of infection in patients with extensive underlying inflammation.

  11. Clinical Applications of Procalcitonin in Pediatrics: An Advanced Biomarker for Inflammation and Infection—Can It Also Be Used in Trauma?

    PubMed Central

    Loscalzo, Steven M.; Singh, Sabina; Weiner, Evan; Syriopoulou, Vassiliki; Theocharis, Stamatios; Chrousos, Georgios

    2014-01-01

    Background. Procalcitonin is a small molecular peptide that has gained increased support as an adjunct diagnostic marker of infection in the adult population; the concordant body of evidence for the use of procalcitonin in pediatric populations is far less complete. Objectives. Our objective is to review the current evidence supporting the utilization of procalcitonin in children in a variety of clinical scenarios including SIRS, sepsis, burns, and trauma and to identify existing knowledge gaps. Methods. A thorough review of the literature was performed utilizing PubMed. We focused on using meta-analysis from adult populations to review current practices in interpretation and methodology and find concordant pediatric studies to determine if the same applications are validated in pediatric populations. Results. Current evidence supports the usage of procalcitonin as both a sensitive and a specific marker for the differentiation of systemic inflammatory response syndrome from sepsis in pediatrics with increased diagnostic accuracy compared to commonly used biomarkers including complete blood counts and C-reactive protein. Conclusions. Although the body of evidence is limited, initial observations suggest that procalcitonin can be used in pediatric trauma and burn patients as both a prognostic and a diagnostic marker, aiding in the identification of infection in patients with extensive underlying inflammation. PMID:27355024

  12. Influence of Asymptomatic Pneumonia on the Response to Hemorrhage and Resuscitation in Swine

    DTIC Science & Technology

    2010-01-01

    and complete blood count (Pentra-120 Hemato- logy Analyzer, ABX Diagnostics, Irvine, CA); 3) total plasma protein, glucose, creatinine , lactate...dehydrogenase (LDH), aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatine kinase (CK), amylase and lactate (Vitros Chemistry System...CK. Creatinine increased at 15 min in both groups and remained elevated throughout the study. Mean total protein, amylase and ALT decreased similarly

  13. Perceived Time Progression and Vigilance: Implications for Workload, Stress, and Cerebral Hemodynamics

    DTIC Science & Technology

    2013-04-01

    and maintaining the data needed , and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other...diagnostics indicate the need for immediate action (Sheridan, 1970, 1980). Consequently, vigilance has a critical impact in a wide range of automated...activating system) needed for continued alertness. Consequently, lethargy increases in observers and signal detection is reduced. However, recent findings

  14. A New Four-Barrel Pellet Injection System for the TJ-II Stellarator

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Combs, Stephen Kirk; Foust, Charles R; McGill, James M

    2011-01-01

    A new pellet injection system for the TJ-II stellarator has been developed/constructed as part of a collaboration between the Oak Ridge National Laboratory (ORNL) and the Centro de Investigaciones Energ ticas, Medioambientales y Tecnol gicas (CIEMAT). ORNL is providing most of the injector hardware and instrumentation, the pellet diagnostics, and the pellet transport tubes; CIEMAT is responsible for the injector stand/interface to the stellarator, cryogenic refrigerator, vacuum pumps/ballast volumes, gas manifolds, remote operations, plasma diagnostics, and data acquisition. The pellet injector design is an upgraded version of that used for the ORNL injector installed on the Madison Symmetric Torus (MST).more » It is a four-barrel system equipped with a cryogenic refrigerator for in situ hydrogen pellet formation and a combined mechanical punch/propellant valve system for pellet acceleration (speeds ~100 to 1000 m/s). On TJ-II, it will be used as an active diagnostic and for fueling. To accommodate the plasma experiments planned for TJ-II, pellet sizes significantly smaller than those typically used for the MST application are required. The system will initially be equipped with four different pellet sizes, with the gun barrel bores ranging between ~0.5 to 1.0 mm. The new system is almost complete and is described briefly here, highlighting the new features added since the original MST injector was constructed. Also, the future installation on TJ-II is reviewed.« less

  15. Development and construction of a comprehensive set of research diagnostics for the FLARE user facility

    NASA Astrophysics Data System (ADS)

    Yoo, Jongsoo; Jara-Almonte, J.; Majeski, S.; Frank, S.; Ji, H.; Yamada, M.

    2016-10-01

    FLARE (Facility for Laboratory Reconnection Experiments) will be operated as a flexible user facility, and so a complete set of research diagnostics is under development, including magnetic probe arrays, Langmuir probes, Mach probes, spectroscopic probes, and a laser interferometer. In order to accommodate the various requirements of users, large-scale (1 m), variable resolution (0.5-4 cm) magnetic probes have been designed, and are currently being prototyped. Moreover, a fully fiber-coupled laser interferometer has been designed to measure the line-integrated electron density. This fiber-coupled interferometer system will reduce the complexity of alignment processes and minimize maintenance of the system. Finally, improvements to the electrostatic probes and spectroscopic probes currently used in the Magnetic Reconnection Experiment (MRX) are discussed. The specifications of other subsystems, such as integrators and digitizers, are also presented. This work is supported by DoE Contract No. DE-AC0209CH11466.

  16. Pixel-based characterisation of CMOS high-speed camera systems

    NASA Astrophysics Data System (ADS)

    Weber, V.; Brübach, J.; Gordon, R. L.; Dreizler, A.

    2011-05-01

    Quantifying high-repetition rate laser diagnostic techniques for measuring scalars in turbulent combustion relies on a complete description of the relationship between detected photons and the signal produced by the detector. CMOS-chip based cameras are becoming an accepted tool for capturing high frame rate cinematographic sequences for laser-based techniques such as Particle Image Velocimetry (PIV) and Planar Laser Induced Fluorescence (PLIF) and can be used with thermographic phosphors to determine surface temperatures. At low repetition rates, imaging techniques have benefitted from significant developments in the quality of CCD-based camera systems, particularly with the uniformity of pixel response and minimal non-linearities in the photon-to-signal conversion. The state of the art in CMOS technology displays a significant number of technical aspects that must be accounted for before these detectors can be used for quantitative diagnostics. This paper addresses these issues.

  17. An overview of serological tests currently available for laboratory diagnosis of parasitic infections.

    PubMed

    Fox, J C; Jordan, H E; Kocan, K M; George, T J; Mullins, S T; Barnett, C E; Glenn, B L; Cowell, R L

    1986-03-01

    Current methods and commercial test systems for the diagnosis of parasitic infections in both animals and humans are reviewed. Lists of test kits and their manufacturers are provided along with ordering information: the only commercially available test kits are for the diagnosis of toxoplasmosis in humans or animals and dirofilariasis (heartworm) in dogs. A partial list of diagnostic laboratories and the parasite tests they perform is also provided. Complete lists of diagnostic tests that could be obtained in the private sector are not available but would be useful. Two microfluorometric solid-phase assay systems are reviewed, and adaptations to custom assays for several kinds of parasites are briefly described. User problems in performing tests and interpreting results are stressed with emphasis placed on diagnosis of dirofilariasis in dogs. False-positive serology in dogs without heartworms and negative antibody responses in micro-filariae-positive animals are discussed with respect to proper interpretation of results.

  18. Lab-on-a-Drone: Toward Pinpoint Deployment of Smartphone-Enabled Nucleic Acid-Based Diagnostics for Mobile Health Care

    PubMed Central

    2016-01-01

    We introduce a portable biochemical analysis platform for rapid field deployment of nucleic acid-based diagnostics using consumer-class quadcopter drones. This approach exploits the ability to isothermally perform the polymerase chain reaction (PCR) with a single heater, enabling the system to be operated using standard 5 V USB sources that power mobile devices (via battery, solar, or hand crank action). Time-resolved fluorescence detection and quantification is achieved using a smartphone camera and integrated image analysis app. Standard sample preparation is enabled by leveraging the drone’s motors as centrifuges via 3D printed snap-on attachments. These advancements make it possible to build a complete DNA/RNA analysis system at a cost of ∼$50 ($US). Our instrument is rugged and versatile, enabling pinpoint deployment of sophisticated diagnostics to distributed field sites. This capability is demonstrated by successful in-flight replication of Staphylococcus aureus and λ-phage DNA targets in under 20 min. The ability to perform rapid in-flight assays with smartphone connectivity eliminates delays between sample collection and analysis so that test results can be delivered in minutes, suggesting new possibilities for drone-based systems to function in broader and more sophisticated roles beyond cargo transport and imaging. PMID:26898247

  19. Lab-on-a-Drone: Toward Pinpoint Deployment of Smartphone-Enabled Nucleic Acid-Based Diagnostics for Mobile Health Care.

    PubMed

    Priye, Aashish; Wong, Season; Bi, Yuanpeng; Carpio, Miguel; Chang, Jamison; Coen, Mauricio; Cope, Danielle; Harris, Jacob; Johnson, James; Keller, Alexandra; Lim, Richard; Lu, Stanley; Millard, Alex; Pangelinan, Adriano; Patel, Neal; Smith, Luke; Chan, Kamfai; Ugaz, Victor M

    2016-05-03

    We introduce a portable biochemical analysis platform for rapid field deployment of nucleic acid-based diagnostics using consumer-class quadcopter drones. This approach exploits the ability to isothermally perform the polymerase chain reaction (PCR) with a single heater, enabling the system to be operated using standard 5 V USB sources that power mobile devices (via battery, solar, or hand crank action). Time-resolved fluorescence detection and quantification is achieved using a smartphone camera and integrated image analysis app. Standard sample preparation is enabled by leveraging the drone's motors as centrifuges via 3D printed snap-on attachments. These advancements make it possible to build a complete DNA/RNA analysis system at a cost of ∼$50 ($US). Our instrument is rugged and versatile, enabling pinpoint deployment of sophisticated diagnostics to distributed field sites. This capability is demonstrated by successful in-flight replication of Staphylococcus aureus and λ-phage DNA targets in under 20 min. The ability to perform rapid in-flight assays with smartphone connectivity eliminates delays between sample collection and analysis so that test results can be delivered in minutes, suggesting new possibilities for drone-based systems to function in broader and more sophisticated roles beyond cargo transport and imaging.

  20. System Modeling and Diagnostics for Liquefying-Fuel Hybrid Rockets

    NASA Technical Reports Server (NTRS)

    Poll, Scott; Iverson, David; Ou, Jeremy; Sanderfer, Dwight; Patterson-Hine, Ann

    2003-01-01

    A Hybrid Combustion Facility (HCF) was recently built at NASA Ames Research Center to study the combustion properties of a new fuel formulation that burns approximately three times faster than conventional hybrid fuels. Researchers at Ames working in the area of Integrated Vehicle Health Management recognized a good opportunity to apply IVHM techniques to a candidate technology for next generation launch systems. Five tools were selected to examine various IVHM techniques for the HCF. Three of the tools, TEAMS (Testability Engineering and Maintenance System), L2 (Livingstone2), and RODON, are model-based reasoning (or diagnostic) systems. Two other tools in this study, ICS (Interval Constraint Simulator) and IMS (Inductive Monitoring System) do not attempt to isolate the cause of the failure but may be used for fault detection. Models of varying scope and completeness were created, both qualitative and quantitative. In each of the models, the structure and behavior of the physical system are captured. In the qualitative models, the temporal aspects of the system behavior and the abstraction of sensor data are handled outside of the model and require the development of additional code. In the quantitative model, less extensive processing code is also necessary. Examples of fault diagnoses are given.

  1. Information management of a department of diagnostic imaging.

    PubMed

    Vincenzoni, M; Campioni, P; Vecchioli Scaldazza, A; Capocasa, G; Marano, P

    1998-01-01

    It is well-known that while RIS allows the management of all input and output data of a Radiology service, PACS plays a major role in the management of all radiologic images. However, the two systems should be closely integrated: scheduling of a radiologic exam requires direct automated integration with the system of image management for retrieval of previous exams and storage of the exam just completed. A modern information system of integration of data and radiologic images should be based on an automated work flow management in al its components, being at the same time flexible and compatible with the ward organization to support and computerize each stage of the working process. Similarly, standard protocols (DICOM 3.0, HL7) defined for interfacing with the Diagnostic Imaging (D.I.) department and the other components of modules of a modern HIS, should be used. They ensure the system to be expandable and accessible to ensure share and integration of information with HIS, emergency service or wards. Correct RIS/PACS integration allows a marked improvement in the efficiency of a modern D.I. department with a positive impact on the daily activity, prompt availability of previous data and images with sophisticated handling of diagnostic images to enhance the reporting quality. The increased diffusion of internet and intranet technology predicts future developments still to be discovered.

  2. [The history of schizophrenias: philosophical roots].

    PubMed

    Musalek, M

    2005-11-01

    Although the term "schizophrenia" has been introduced in medical usage by E. Bleuler, all variations of schizophrenia developed afterwards trace back to E. Kraepelin. In his work on dementia praecox he intended to discover a yet unknown entity from nature definitely following the principles and maxima of positivism. In the following a great number of different concepts of schizophrenia were developed and the psychiatrist of the seventies and eighties of the last century was left confronted with an abundance of varying schizophrenic criteria. The upcoming globalization in diagnostic stopped this process of diversity and the ideas of Kraepelin reappeared in the ICD-10 criteria for schizophrenia with only a few modifications. The main problem of positivistic research approaches is that nature obviously is completely unimpressed by human made principles of rules and systems. Nature itself does not know these forms and categories invented by human beings. That is one of the reasons why positivistic schizophrenic research considering human made categories as natural has not been quite successful. A possible way out of this diagnostic dilemma -- insufficient categorical classification systems on the one hand and the necessity of apprehending psychopathological phenomena for an effective therapy on the other -- can be a change of paradigms from the usual categorical diagnostics based on the maxima of positivism to dimensional diagnostics developed in the frame of post-modern strategies of thinking. Such process-oriented diagnostic approaches considering the singular phenomenon as well as its significance for the individual and its pathogenesis as main foci of diagnostics provide the possibility for post-modern psychiatrists to start a new dialogue overcoming a positivism based monologue made by experts on the sufferers.

  3. Purified umbilical cord derived mesenchymal stem cell treatment in a case of systemic lupus erythematosus.

    PubMed

    Phillips, Christopher D; Wongsaisri, Pornpatcharin; Htut, Thein; Grossman, Terry

    2017-12-01

    Systemic lupus erythematosus (SLE) is a multiple organ system autoimmune disorder for which there is no known cure. We report a case of a young adult lady with SLE and Sjogren's with diagnostic and clinical resolution following purified umbilical cord derived mesenchymal stem cell (MSC) and globulin component protein macrophage activating factor (GcMAF) therapy in a combined multidisciplinary integrative medicine protocol. Our patient had complete reversal of all clinical and laboratory markers. We recommend a prospective randomized double blind study to assess the sustained efficacy of MSC and GcMAF in the treatment of autoimmune connective tissue diseases such as systemic lupus erythematosus.

  4. What's eating you? Cheyletiella mites.

    PubMed

    Reynolds, H Harris; Elston, Dirk M

    2017-05-01

    Cheyletiella are nonburrowing mites commonly found on rabbits, dogs, and cats. The mites have been known to cause disease in humans, ranging from mild dermatitis to more severe illness with systemic symptoms. Because these mites do not complete any part of their life cycle in humans, diagnosis can be challenging. Herein, we review various clinical presentations associated with Cheyletiella mites as well as diagnostic techniques and treatment options for both humans and animals.

  5. Space Laboratory on a Table Top: A Next Generative ECLSS design and diagnostic tool

    NASA Technical Reports Server (NTRS)

    Ramachandran, N.

    2005-01-01

    This paper describes the development plan for a comprehensive research and diagnostic tool for aspects of advanced life support systems in space-based laboratories. Specifically it aims to build a high fidelity tabletop model that can be used for the purpose of risk mitigation, failure mode analysis, contamination tracking, and testing reliability. We envision a comprehensive approach involving experimental work coupled with numerical simulation to develop this diagnostic tool. It envisions a 10% scale transparent model of a space platform such as the International Space Station that operates with water or a specific matched index of refraction liquid as the working fluid. This allows the scaling of a 10 ft x 10 ft x 10 ft room with air flow to 1 ft x 1 ft x 1 ft tabletop model with water/liquid flow. Dynamic similitude for this length scale dictates model velocities to be 67% of full-scale and thereby the time scale of the model to represent 15% of the full- scale system; meaning identical processes in the model are completed in 15% of the full- scale-time. The use of an index matching fluid (fluid that matches the refractive index of cast acrylic, the model material) allows making the entire model (with complex internal geometry) transparent and hence conducive to non-intrusive optical diagnostics. So using such a system one can test environment control parameters such as core flows (axial flows), cross flows (from registers and diffusers), potential problem areas such as flow short circuits, inadequate oxygen content, build up of other gases beyond desirable levels, test mixing processes within the system at local nodes or compartments and assess the overall system performance. The system allows quantitative measurements of contaminants introduced in the system and allows testing and optimizing the tracking process and removal of contaminants. The envisaged system will be modular and hence flexible for quick configuration change and subsequent testing. The data and inferences from the tests will allow for improvements in the development and design of next generation life support systems and configurations. Preliminary experimental and modeling work in this area will be presented. This involves testing of a single inlet-exit model with detailed 3-D flow visualization and quantitative diagnostics and computational modeling of the system.

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

    NASA Astrophysics Data System (ADS)

    Xu, Jiuping; Zhong, Zhengqiang; Xu, Lei

    2015-10-01

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

  7. Patients' costs and cost-effectiveness of tuberculosis treatment in DOTS and non-DOTS facilities in Rio de Janeiro, Brazil.

    PubMed

    Steffen, Ricardo; Menzies, Dick; Oxlade, Olivia; Pinto, Marcia; de Castro, Analia Zuleika; Monteiro, Paula; Trajman, Anete

    2010-11-17

    Costs of tuberculosis diagnosis and treatment may represent a significant burden for the poor and for the health system in resource-poor countries. The aim of this study was to analyze patients' costs of tuberculosis care and to estimate the incremental cost-effectiveness ratio (ICER) of the directly observed treatment (DOT) strategy per completed treatment in Rio de Janeiro, Brazil. We interviewed 218 adult patients with bacteriologically confirmed pulmonary tuberculosis. Information on direct (out-of-pocket expenses) and indirect (hours lost) costs, loss in income and costs with extra help were gathered through a questionnaire. Healthcare system additional costs due to supervision of pill-intake were calculated considering staff salaries. Effectiveness was measured by treatment completion rate. The ICER of DOT compared to self-administered therapy (SAT) was calculated. DOT increased costs during the treatment phase, while SAT increased costs in the pre-diagnostic phase, for both the patient and the health system. Treatment completion rates were 71% in SAT facilities and 79% in DOT facilities. Costs per completed treatment were US$ 194 for patients and U$ 189 for the health system in SAT facilities, compared to US$ 336 and US$ 726 in DOT facilities. The ICER was US$ 6,616 per completed DOT treatment compared to SAT. Costs incurred by TB patients are high in Rio de Janeiro, especially for those under DOT. The DOT strategy doubles patients' costs and increases by fourfold the health system costs per completed treatment. The additional costs for DOT may be one of the contributing factors to the completion rates below the targeted 85% recommended by WHO.

  8. Variations of ultrasonic anatomy of the hepatic veins within the human liver.

    PubMed

    Lamanna, I; Bilić, A; Ljubicić, N; Bakula, B

    1990-01-01

    The aim of this study was to investigate various physiological variations of the hepatic veins within the liver of the 60 healthy subjects. All participants required physical examinations, different laboratory tests and upper abdominal ultrasonogram--all completely normal. Demonstration of the hepatic veins have been performed on sector real-time systems. The results clearly demonstrated that the physiological variations of the hepatic veins are very common. Ultrasonography obviously represents a diagnostic method of choice in the evaluation of anatomy of the hepatic venous system.

  9. Modeling and Diagnostic Software for Liquefying-Fuel Rockets

    NASA Technical Reports Server (NTRS)

    Poll, Scott; Iverson, David; Ou, Jeremy; Sanderfer, Dwight; Patterson-Hine, Ann

    2005-01-01

    A report presents a study of five modeling and diagnostic computer programs considered for use in an integrated vehicle health management (IVHM) system during testing of liquefying-fuel hybrid rocket engines in the Hybrid Combustion Facility (HCF) at NASA Ames Research Center. Three of the programs -- TEAMS, L2, and RODON -- are model-based reasoning (or diagnostic) programs. The other two programs -- ICS and IMS -- do not attempt to isolate the causes of failures but can be used for detecting faults. In the study, qualitative models (in TEAMS and L2) and quantitative models (in RODON) having varying scope and completeness were created. Each of the models captured the structure and behavior of the HCF as a physical system. It was noted that in the cases of the qualitative models, the temporal aspects of the behavior of the HCF and the abstraction of sensor data are handled outside of the models, and it is necessary to develop additional code for this purpose. A need for additional code was also noted in the case of the quantitative model, though the amount of development effort needed was found to be less than that for the qualitative models.

  10. Ophthalmologic diagnostic tool using MR images for biomechanically-based muscle volume deformation

    NASA Astrophysics Data System (ADS)

    Buchberger, Michael; Kaltofen, Thomas

    2003-05-01

    We would like to give a work-in-progress report on our ophthalmologic diagnostic software system which performs biomechanically-based muscle volume deformations using MR images. For reconstructing a three-dimensional representation of an extraocular eye muscle, a sufficient amount of high resolution MR images is used, each representing a slice of the muscle. In addition, threshold values are given, which restrict the amount of data used from the MR images. The Marching Cube algorithm is applied to the polygons, resulting in a 3D representation of the muscle, which can efficiently be rendered. A transformation to a dynamic, deformable model is applied by calculating the center of gravity of each muscle slice, approximating the muscle path and subsequently adding Hermite splines through the centers of gravity of all slices. Then, a radius function is defined for each slice, completing the transformation of the static 3D polygon model. Finally, this paper describes future extensions to our system. One of these extensions is the support for additional calculations and measurements within the reconstructed 3D muscle representation. Globe translation, localization of muscle pulleys by analyzing the 3D reconstruction in two different gaze positions and other diagnostic measurements will be available.

  11. Relating DSM-5 section II and section III personality disorder diagnostic classification systems to treatment planning.

    PubMed

    Morey, Leslie C; Benson, Kathryn T

    2016-07-01

    Beginning with DSM-III, the inclusion of a "personality" axis was designed to encourage awareness of personality disorders and the treatment-related implications of individual differences, but since that time there is little accumulated evidence that the personality disorder categories provide substantial treatment-related guidance. The DSM-5 Personality and Personality Disorders Work Group sought to develop an Alternative Model for personality disorder, and this study examined whether this model is more closely related to clinicians' decision-making processes than the traditional categorical personality disorder diagnoses. A national sample of 337 clinicians provided complete personality disorder diagnostic information and several treatment-related clinical judgments about one of their patients. The dimensional concepts of the DSM-5 Alternative Model for personality disorders demonstrated stronger relationships than categorical DSM-IV/DSM-5 Section II diagnoses to 10 of 11 clinical judgments regarding differential treatment planning, optimal treatment intensity, and long-term prognosis. The constructs of the DSM-5 Alternative Model for personality disorders may provide more clinically useful information for treatment planning than the official categorical personality disorder diagnostic system retained in DSM-5 Section II. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Introduction of the Bethesda System to Mainland China with a Web-based tutorial.

    PubMed

    Yuan, Qin; Chang, Alexander Russell; Ng, Ho Keung

    2003-01-01

    To validate the use of a Web-based tutorial to introduce the Bethesda System (TBS) to Mainland Chinese laboratories. Digitized color images of the diagnostic features in 20 Pap smears were displayed on a Web page. Participants were asked to give each smear a diagnosis using the reporting nomenclature employed in their laboratory or one that was familiar to them. This was followed by teaching images of each smear accompanied by text in English and Chinese that highlighted important features for making a diagnosis using TBS. Participants then reviewed the 20 original Pap smears and rendered a diagnosis using TBS. Pathologists and cytotechnologists at 17 laboratories located in 10 cities completed the exercise. The average diagnostic accuracy for the 20 Pap smears before and after the tutorial was 76% and 88%, respectively. Web-based tutorials can be used for disseminating cytologic information to widely dispersed laboratories in China and help enhance the practice of cytology, currently an underutilized diagnostic technique. However, such difficulties as lack of Internet connections in the laboratory, outdated computers and a lack of interest in cytology need to be overcome to ensure success.

  13. 30 CFR 250.524 - When am I required to take action from my casing diagnostic test?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... casing diagnostic test; (c) Any well that has demonstrated tubing/casing, tubing/riser, casing/casing... casing diagnostic test? 250.524 Section 250.524 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT... Gas Well-Completion Operations Casing Pressure Management § 250.524 When am I required to take action...

  14. Compounding diagnostic delays: a qualitative study of point-of-care testing in South Africa.

    PubMed

    Engel, Nora; Davids, Malika; Blankvoort, Nadine; Pai, Nitika Pant; Dheda, Keertan; Pai, Madhukar

    2015-04-01

    Successful point-of-care (POC) testing (completion of test-and-treat cycle in one patient encounter) has immense potential to reduce diagnostic and treatment delays, and improve patient and public health outcomes. We explored what tests are done and how in public/private, rural/urban hospitals and clinics in South Africa and whether they can ensure successful POC testing. This qualitative research study examined POC testing across major diseases in Cape Town, Durban and Eastern Cape. We conducted 101 semi-structured interviews and seven focus group discussions with doctors, nurses, community health workers, patients, laboratory technicians, policymakers, hospital managers and diagnostic manufacturers. In South Africa, diagnostics are characterised by a centralised system. Most tests conducted on the spot can be made to work successfully as POC tests. The majority of public/private clinics and smaller hospitals send samples via couriers to centralised laboratories and retrieve results the same way, via internet, fax or phone. The main challenge to POC testing lies in transporting samples and results, while delays risk patient loss from diagnostic/treatment pathways. Strategies to deal with associated delays create new problems, such as artificially prolonged turnaround times, strains on human resources and quality of testing, compounding additional diagnostic and treatment delays. For POC testing to succeed, particular characteristics of diagnostic ecosystems and adaptations of professional practices to overcome associated challenges must be taken into account. © 2014 John Wiley & Sons Ltd.

  15. DOE Office of Scientific and Technical Information (OSTI.GOV)

    NONE

    When the facilities design and construction team at the University of California, San Diego (UCSD) started planning to upgrade and expand their control system, they had several critical goals for the project. They wanted a building automation system (BAS) that could achieve optimum energy savings while maximizing the efficiency of the facilities staff. They needed the new system to link 26 campus buildings--containing a variety of existing systems--to one central location for monitoring and diagnostics. They wanted a single vendor to handle installation, software development, service and support--and they wanted the entire project completed without downtime. At the core ofmore » these technologies is the Metasys{reg_sign} facility management system from Johnson Controls.« less

  16. Diagnostics of severe convection and subsynoptic scale ageostrophic circulations

    NASA Technical Reports Server (NTRS)

    1985-01-01

    Diagnostics of severe convection and subsynoptic scale ageostrophic circulations are reported. Mesoscale circulations through forcing of ageostrophic motion by adiabatic, diabatic and frictional processes were studied. The development and application of a hybrid isentropic sigma coordinate numerical model was examined. The numerical model simulates mesoscale ageostrophic circulations associated with propagating jet streaks and severe convection. A complete list of publications and these completed through support of the NASA severe storms research project is included.

  17. Methods specification for diagnostic test accuracy studies in fine-needle aspiration cytology: a survey of reporting practice.

    PubMed

    Schmidt, Robert L; Factor, Rachel E; Affolter, Kajsa E; Cook, Joshua B; Hall, Brian J; Narra, Krishna K; Witt, Benjamin L; Wilson, Andrew R; Layfield, Lester J

    2012-01-01

    Diagnostic test accuracy (DTA) studies on fine-needle aspiration cytology (FNAC) often show considerable variability in diagnostic accuracy between study centers. Many factors affect the accuracy of FNAC. A complete description of the testing parameters would help make valid comparisons between studies and determine causes of performance variation. We investigated the manner in which test conditions are specified in FNAC DTA studies to determine which parameters are most commonly specified and the frequency with which they are specified and to see whether there is significant variability in reporting practice. We identified 17 frequently reported test parameters and found significant variation in the reporting of these test specifications across studies. On average, studies reported 5 of the 17 items that would be required to specify the test conditions completely. A more complete and standardized reporting of methods, perhaps by means of a checklist, would improve the interpretation of FNAC DTA studies.

  18. [Rapid analysis on phenolic compounds in Rheum palmatum based on UPLC-Q-TOF/MSE combined with diagnostic ions filter].

    PubMed

    Wang, Qing; Lu, Zhi-Wei; Liu, Yue-Hong; Wang, Ming-Ling; Fu, Shuang; Zhang, Qing-Qing; Zhao, Hui-Zhen; Zhang, Zhi-Xin; Xie, Zi-Ye; Huang, Zheng-Hai; Yu, Hong-Hong; Zhou, Wen-Juan; Gao, Xiao-Yan

    2017-05-01

    Diagnostic ions filter method was used to rapidly detect and identify the phenolic compounds in Rheum palmatum based on ultra performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF/MSE). The representative authentic standards of phenolic compounds, including gallic acid, (+)-catechin, (-)-epicatechin, (-)-epicatechin-3-O-gallate and procyanidin B2, were subjected to analysis by UPLC-Q-TOF/MSE system with negative ion mode. Fragmentation patterns of each standard were summarized based on assigned fragment ions. The prominent product ions were selected as diagnostic ions. Subsequently, diagnostic ions filter was employed to rapidly recognize analogous skeletons. Combined with retention time, accurate mass, characteristic fragments and previous literature data, the structures of the filtered compounds were identified or tentatively characterized. A total 63 phenolic compounds (36 phenolic acid derivatives, 8 flavonoid derivatives and 19 tennis derivatives) in R. palmatum were identified, including 6 potential new compounds. The method of diagnostic ions filter could rapidly detect and identify phenolic compounds in R. palmatum This study provides a method for rapid detection of phenolic compounds in R. palmatum and is expected to complete the material basis of rhubarb. Copyright© by the Chinese Pharmaceutical Association.

  19. How we process trephine biopsy specimens: epoxy resin embedded bone marrow biopsies

    PubMed Central

    Krenacs, T; Bagdi, E; Stelkovics, E; Bereczki, L; Krenacs, L

    2005-01-01

    Improved cytomorphology of semithin resin sections over paraffin wax embedded sections may be important in diagnostic haematopathology. However, resin embedding can make immunohistochemical antigen detection or DNA isolation for clonal gene rearrangement assays difficult. This review describes the processing of bone marrow biopsies using buffered formaldehyde based fixation and epoxy resin embedding, with or without EDTA decalcification. Traditional semithin resin sections are completely rehydrated after etching in home made sodium methoxide solution. Resin elimination allows high resolution staining of tissue components with common histological stains. Efficient antigen retrieval and the Envision-HRP system permit the immunohistological detection of many antigens of diagnostic relevance, with retention of high quality cytomorphology. Furthermore, DNA can be extracted for clonality analysis. The technique can be completed within a similar time period to that of paraffin wax processing with only ∼30% increase in cost. This technique has been used for diagnosis in over 4000 bone marrow biopsies over the past 14 years. By meeting traditional and contemporary demands on the haematopathologist, it offers a powerful alternative to paraffin wax processing for diagnosis and research. PMID:16126867

  20. A Novel Field-Deployable Point-of-Care Diagnostic Test for Cutaneous Leishmaniasis

    DTIC Science & Technology

    2017-10-01

    AWARD NUMBER: W81XWH-14-2-0195 TITLE: A Novel Field-Deployable Point-of-Care Diagnostic Test for Cutaneous Leishmaniasis PRINCIPAL INVESTIGATOR...Field-Deployable Point-of-Care Diagnostic Test for Cutaneous Leishmaniasis 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S...Month % completion Aim 1: To use simulated field conditions to optimize and produce the established RPA lateral flow diagnostic test for POC

  1. Determinants of Mental Health Services Utilization Among Deployed Service Members and Their Families

    DTIC Science & Technology

    2008-02-11

    Introduction Health and the Purpose of a Health Care System The World Health Organization (WHO) defines health as "a state of complete physical , mental and...surgical conditions, pharmacy services, physical examinations, dental care, and diagnostic, laboratory and radiological tests and services. There...over 23,000 have returned home with physical injuries and a range of permanent disabilities; e.g., limb loss, burns and traumatic brain injury (APA

  2. Automated Test Requirement Document Generation

    DTIC Science & Technology

    1987-11-01

    DIAGNOSTICS BASED ON THE PRINCIPLES OF ARTIFICIAL INTELIGENCE ", 1984 International Test Conference, 01Oct84, (A3, 3, Cs D3, E2, G2, H2, 13, J6, K) 425...j0O GLOSSARY OF ACRONYMS 0 ABBREVIATION DEFINITION AFSATCOM Air Force Satellite Communication Al Artificial Intelligence ASIC Application Specific...In-Test Equipment (BITE) and AI ( Artificial Intelligence) - Expert Systems - need to be fully applied before a completely automated process can be

  3. Compilation of Abstracts of Theses Submitted by Candidates for Degrees: October 1988 to September 1989

    DTIC Science & Technology

    1989-09-30

    to accommodate peripherally non -uniform flow modelling free of experimental uncertainties. It was effects (blockage) in the throughflow code...combines that experimental control functions with a detail in this thesis, and the results of a computer menu-driven, diagnostic subsystem to ensure...equations and design a complete (DSL) for both linear and non -linear models and automatic control system for the three dimensional compared. Cross

  4. Direct-Coupled Plasma-Assisted Combustion Using a Microwave Waveguide Torch

    DTIC Science & Technology

    2011-12-01

    enhance combustion by coupling an atmospheric plasma dis- charge to a premixed methane/air flame. The absorbed microwave power ranges from 60 to 150 W...The plasma system allows for complete access of the plasma- enhanced flame for laser and optical diagnostics 0093-3813/$26.00 © 2011 IEEE Report...microwave waveguide is used to initiate and enhance combustion by coupling an atmospheric plasma discharge to a premixed methane/air flame. The

  5. An integrated teaching method of gross anatomy and computed tomography radiology.

    PubMed

    Murakami, Tohru; Tajika, Yuki; Ueno, Hitoshi; Awata, Sachiko; Hirasawa, Satoshi; Sugimoto, Maki; Kominato, Yoshihiko; Tsushima, Yoshito; Endo, Keigo; Yorifuji, Hiroshi

    2014-01-01

    It is essential for medical students to learn and comprehend human anatomy in three dimensions (3D). With this in mind, a new system was designed in order to integrate anatomical dissections with diagnostic computed tomography (CT) radiology. Cadavers were scanned by CT scanners, and students then consulted the postmortem CT images during cadaver dissection to gain a better understanding of 3D human anatomy and diagnostic radiology. Students used handheld digital imaging and communications in medicine viewers at the bench-side (OsiriX on iPod touch or iPad), which enabled "pixel-to-tissue" direct comparisons of CT images and cadavers. Students had lectures and workshops on diagnostic radiology, and they completed study assignments where they discussed findings in the anatomy laboratory compared with CT radiology findings. This teaching method for gross and radiological anatomy was used beginning in 2009, and it yielded strongly positive student perspectives and significant improvements in radiology skills in later clinical courses. © 2014 American Association of Anatomists.

  6. 30 CFR 250.523 - How long do I keep records of casing pressure and diagnostic tests?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... field office nearest the well for a minimum of 2 years. The last casing diagnostic test for each casing... and diagnostic tests? 250.523 Section 250.523 Mineral Resources MINERALS MANAGEMENT SERVICE... Gas Well-Completion Operations Casing Pressure Management § 250.523 How long do I keep records of...

  7. [Medical expert systems and clinical needs].

    PubMed

    Buscher, H P

    1991-10-18

    The rapid expansion of computer-based systems for problem solving or decision making in medicine, the so-called medical expert systems, emphasize the need for reappraisal of their indication and value. Where specialist knowledge is required, in particular where medical decisions are susceptible to error these systems will probably serve as a valuable support. In the near future computer-based systems should be able to aid the interpretation of findings of technical investigations and the control of treatment, especially where rapid reactions are necessary despite the need of complex analysis of investigated parameters. In the distant future complete support of diagnostic procedures from the history to final diagnosis is possible. It promises to be particularly attractive for the diagnosis of seldom diseases, for difficult differential diagnoses, and in the decision making in the case of expensive, risky or new diagnostic or therapeutic methods. The physician needs to be aware of certain dangers, ranging from misleading information up to abuse. Patient information depends often on subjective reports and error-prone observations. Although basing on problematic knowledge computer-born decisions may have an imperative effect on medical decision making. Also it must be born in mind that medical decisions should always combine the rational with a consideration of human motives.

  8. Transparent ICD and DRG coding using information technology: linking and associating information sources with the eXtensible Markup Language.

    PubMed

    Hoelzer, Simon; Schweiger, Ralf K; Dudeck, Joachim

    2003-01-01

    With the introduction of ICD-10 as the standard for diagnostics, it becomes necessary to develop an electronic representation of its complete content, inherent semantics, and coding rules. The authors' design relates to the current efforts by the CEN/TC 251 to establish a European standard for hierarchical classification systems in health care. The authors have developed an electronic representation of ICD-10 with the eXtensible Markup Language (XML) that facilitates integration into current information systems and coding software, taking different languages and versions into account. In this context, XML provides a complete processing framework of related technologies and standard tools that helps develop interoperable applications. XML provides semantic markup. It allows domain-specific definition of tags and hierarchical document structure. The idea of linking and thus combining information from different sources is a valuable feature of XML. In addition, XML topic maps are used to describe relationships between different sources, or "semantically associated" parts of these sources. The issue of achieving a standardized medical vocabulary becomes more and more important with the stepwise implementation of diagnostically related groups, for example. The aim of the authors' work is to provide a transparent and open infrastructure that can be used to support clinical coding and to develop further software applications. The authors are assuming that a comprehensive representation of the content, structure, inherent semantics, and layout of medical classification systems can be achieved through a document-oriented approach.

  9. Transparent ICD and DRG Coding Using Information Technology: Linking and Associating Information Sources with the eXtensible Markup Language

    PubMed Central

    Hoelzer, Simon; Schweiger, Ralf K.; Dudeck, Joachim

    2003-01-01

    With the introduction of ICD-10 as the standard for diagnostics, it becomes necessary to develop an electronic representation of its complete content, inherent semantics, and coding rules. The authors' design relates to the current efforts by the CEN/TC 251 to establish a European standard for hierarchical classification systems in health care. The authors have developed an electronic representation of ICD-10 with the eXtensible Markup Language (XML) that facilitates integration into current information systems and coding software, taking different languages and versions into account. In this context, XML provides a complete processing framework of related technologies and standard tools that helps develop interoperable applications. XML provides semantic markup. It allows domain-specific definition of tags and hierarchical document structure. The idea of linking and thus combining information from different sources is a valuable feature of XML. In addition, XML topic maps are used to describe relationships between different sources, or “semantically associated” parts of these sources. The issue of achieving a standardized medical vocabulary becomes more and more important with the stepwise implementation of diagnostically related groups, for example. The aim of the authors' work is to provide a transparent and open infrastructure that can be used to support clinical coding and to develop further software applications. The authors are assuming that a comprehensive representation of the content, structure, inherent semantics, and layout of medical classification systems can be achieved through a document-oriented approach. PMID:12807813

  10. Reporting completeness and transparency of meta-analyses of depression screening tool accuracy: A comparison of meta-analyses published before and after the PRISMA statement.

    PubMed

    Rice, Danielle B; Kloda, Lorie A; Shrier, Ian; Thombs, Brett D

    2016-08-01

    Meta-analyses that are conducted rigorously and reported completely and transparently can provide accurate evidence to inform the best possible healthcare decisions. Guideline makers have raised concerns about the utility of existing evidence on the diagnostic accuracy of depression screening tools. The objective of our study was to evaluate the transparency and completeness of reporting in meta-analyses of the diagnostic accuracy of depression screening tools using the PRISMA tool adapted for diagnostic test accuracy meta-analyses. We searched MEDLINE and PsycINFO from January 1, 2005 through March 13, 2016 for recent meta-analyses in any language on the diagnostic accuracy of depression screening tools. Two reviewers independently assessed the transparency in reporting using the PRISMA tool with appropriate adaptations made for studies of diagnostic test accuracy. We identified 21 eligible meta-analyses. Twelve of 21 meta-analyses complied with at least 50% of adapted PRISMA items. Of 30 adapted PRISMA items, 11 were fulfilled by ≥80% of included meta-analyses, 3 by 50-79% of meta-analyses, 7 by 25-45% of meta-analyses, and 9 by <25%. On average, post-PRISMA meta-analyses complied with 17 of 30 items compared to 13 of 30 items pre-PRISMA. Deficiencies in the transparency of reporting in meta-analyses of the diagnostic test accuracy of depression screening tools of meta-analyses were identified. Authors, reviewers, and editors should adhere to the PRISMA statement to improve the reporting of meta-analyses of the diagnostic accuracy of depression screening tools. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. A design and implementation methodology for diagnostic systems

    NASA Technical Reports Server (NTRS)

    Williams, Linda J. F.

    1988-01-01

    A methodology for design and implementation of diagnostic systems is presented. Also discussed are the advantages of embedding a diagnostic system in a host system environment. The methodology utilizes an architecture for diagnostic system development that is hierarchical and makes use of object-oriented representation techniques. Additionally, qualitative models are used to describe the host system components and their behavior. The methodology architecture includes a diagnostic engine that utilizes a combination of heuristic knowledge to control the sequence of diagnostic reasoning. The methodology provides an integrated approach to development of diagnostic system requirements that is more rigorous than standard systems engineering techniques. The advantages of using this methodology during various life cycle phases of the host systems (e.g., National Aerospace Plane (NASP)) include: the capability to analyze diagnostic instrumentation requirements during the host system design phase, a ready software architecture for implementation of diagnostics in the host system, and the opportunity to analyze instrumentation for failure coverage in safety critical host system operations.

  12. [Diagnostic value of a predictive model for complete ruptures of the rotator cuff associated to subacromial impingement].

    PubMed

    Águila-Ledesma, I R; Córdova-Fonseca, J L; Medina-Pontaza, O; Núñez-Gómez, D A; Calvache-García, C; Pérez-Atanasio, J M; Torres-González, R

    2017-01-01

    Pathology related to the rotator cuff remains among the most prevalent musculoskeletal diseases. There is an increasing need for imaging studies (MRI, US, arthroscopy) to test the diagnostic performance of the medical history and physical examination. To prove the diagnostic value of a clinical-radiographic predictive model to find complete ruptures of the rotator cuff. Descriptive, observational, prospective, transversal and analytical study. Fifty-five patients with preoperative shoulder pain were evaluated with 13 predictive variables: age > 50 years, nocturnal pain, muscle weakness, clinical signs of Neer, Hawkins, Jobe, external rotation lag (ERLS), belly-press, bear hug, and lift-off, radiographic measurement of subacromial space, acromial index and critical shoulder angle. Sensitivity, specificity, and positive and negative predictive values were measured in each variable, comparing the results of each one against the postoperative findings. Of the 55 patients evaluated, 42 had a complete rupture of the rotator cuff in the postoperative period. The eight variables with a higher diagnostic value were selected and a ROC curve was performed, providing an area under the curve of 0.88. This predictive model uses eight variables (age > 50 years, nocturnal pain, muscle weakness, Jobe, Hawkins, ERLS, subacromial space ≤ 6 mm, and critical shoulder angle > 35°), which together add the predictive value of 0.88 (AUC) to diagnose complete ruptures of the supraspinatus tendon.

  13. Standards to support information systems integration in anatomic pathology.

    PubMed

    Daniel, Christel; García Rojo, Marcial; Bourquard, Karima; Henin, Dominique; Schrader, Thomas; Della Mea, Vincenzo; Gilbertson, John; Beckwith, Bruce A

    2009-11-01

    Integrating anatomic pathology information- text and images-into electronic health care records is a key challenge for enhancing clinical information exchange between anatomic pathologists and clinicians. The aim of the Integrating the Healthcare Enterprise (IHE) international initiative is precisely to ensure interoperability of clinical information systems by using existing widespread industry standards such as Digital Imaging and Communication in Medicine (DICOM) and Health Level Seven (HL7). To define standard-based informatics transactions to integrate anatomic pathology information to the Healthcare Enterprise. We used the methodology of the IHE initiative. Working groups from IHE, HL7, and DICOM, with special interest in anatomic pathology, defined consensual technical solutions to provide end-users with improved access to consistent information across multiple information systems. The IHE anatomic pathology technical framework describes a first integration profile, "Anatomic Pathology Workflow," dedicated to the diagnostic process including basic image acquisition and reporting solutions. This integration profile relies on 10 transactions based on HL7 or DICOM standards. A common specimen model was defined to consistently identify and describe specimens in both HL7 and DICOM transactions. The IHE anatomic pathology working group has defined standard-based informatics transactions to support the basic diagnostic workflow in anatomic pathology laboratories. In further stages, the technical framework will be completed to manage whole-slide images and semantically rich structured reports in the diagnostic workflow and to integrate systems used for patient care and those used for research activities (such as tissue bank databases or tissue microarrayers).

  14. The experiences of health-related quality of life in patients with nonspecific symptoms who undergo a diagnostic evaluation for cancer: a qualitative interview study.

    PubMed

    Moseholm, Ellen; Lindhardt, Bjarne Oerskov; Rydahl-Hansen, Susan

    2017-09-01

    The diagnostic phase of cancer can affect health-related quality of life (HRQoL). The aim of this study was to investigate how patients with nonspecific symptoms experience HRQoL while undergoing diagnostic evaluations for cancer. Twenty-one participants who had completed a fast-track evaluation for possible cancer at one of three hospitals in the Capital Region, Denmark were interviewed 2-4 weeks after completing diagnostic evaluations. The interviews were semi-structured and were supported by an interview guide based on the same themes as in The European Organisation for Research and Treatment of Cancer Quality of Life questionnaire (EORCT-QLQ-C30). Data analysis was based on qualitative content analysis by Krippendorff. The analysis generated six categories: symptoms, physical-, role-, emotional-, cognitive- and social functioning, and the diagnostic fast-track experience. From these categories, a main theme was identified: Health-related quality of life is not solely affected by the diagnostic process. The results provide a comprehensive understanding of HRQoL in the diagnostic phase of possible cancer, which can be used not only to enhance evidence-based care, but also in the interpretation of the EORTC-QLQ-C30 scores. Psycho-social support with a focus on individual informational needs during the diagnostic phase may be warranted. © 2016 Nordic College of Caring Science.

  15. Reducing Delay in Diagnosis: Multistage Recommendation Tracking.

    PubMed

    Wandtke, Ben; Gallagher, Sarah

    2017-11-01

    The purpose of this study was to determine whether a multistage tracking system could improve communication between health care providers, reducing the risk of delay in diagnosis related to inconsistent communication and tracking of radiology follow-up recommendations. Unconditional recommendations for imaging follow-up of all diagnostic imaging modalities excluding mammography (n = 589) were entered into a database and tracked through a multistage tracking system for 13 months. Tracking interventions were performed for patients for whom completion of recommended follow-up imaging could not be identified 1 month after the recommendation due date. Postintervention compliance with the follow-up recommendation required examination completion or clinical closure (i.e., biopsy, limited life expectancy or death, or subspecialist referral). Baseline radiology information system checks performed 1 month after the recommendation due date revealed timely completion of 43.1% of recommended imaging studies at our institution before intervention. Three separate tracking interventions were studied, showing effectiveness between 29.0% and 57.8%. The multistage tracking system increased the examination completion rate to 70.5% (a 52% increase) and reduced the rate of unknown follow-up compliance and the associated risk of delay in diagnosis to 13.9% (a 74% decrease). Examinations completed after tracking intervention generated revenue of 4.1 times greater than the labor cost. Performing sequential radiology recommendation tracking interventions can substantially reduce the rate of unknown follow-up compliance and add value to the health system. Unknown follow-up compliance is a risk factor for delay in diagnosis, a form of preventable medical error commonly identified in malpractice claims involving radiologists and office-based practitioners.

  16. Assessment of a Tele-education System to Enhance Retinopathy of Prematurity Training by International Ophthalmologists-in-Training in Mexico.

    PubMed

    Patel, Samir N; Martinez-Castellanos, Maria Ana; Berrones-Medina, David; Swan, Ryan; Ryan, Michael C; Jonas, Karyn E; Ostmo, Susan; Campbell, J Peter; Chiang, Michael F; Chan, R V Paul

    2017-07-01

    To evaluate a tele-education system developed to improve diagnostic competency in retinopathy of prematurity (ROP) by ophthalmologists-in-training in Mexico. Prospective, randomized cohort study. Fifty-eight ophthalmology residents and fellows from a training program in Mexico consented to participate. Twenty-nine of 58 trainees (50%) were randomized to the educational intervention (pretest, ROP tutorial, ROP educational chapters, and posttest), and 29 of 58 trainees (50%) were randomized to a control group (pretest and posttest only). A secure web-based educational system was created using clinical cases (20 pretest, 20 posttest, and 25 training chapter-based) developed from a repository of over 2500 unique image sets of ROP. For each image set used, a reference standard ROP diagnosis was established by combining the clinical diagnosis by indirect ophthalmoscope examination and image-based diagnosis by multiple experts. Trainees were presented with image-based clinical cases of ROP during a pretest, posttest, and training chapters. The accuracy of ROP diagnosis (e.g., plus disease, zone, stage, category) was determined using sensitivity and specificity calculations from the pretest and posttest results of the educational intervention group versus control group. The unweighted kappa statistic was used to analyze the intragrader agreement for ROP diagnosis by the ophthalmologists-in-training during the pretest and posttest for both groups. Trainees completing the tele-education system had statistically significant improvements (P < 0.01) in the accuracy of ROP diagnosis for plus disease, zone, stage, category, and aggressive posterior ROP (AP-ROP). Compared with the control group, trainees who completed the ROP tele-education system performed better on the posttest for accurately diagnosing plus disease (67% vs. 48%; P = 0.04) and the presence of ROP (96% vs. 91%; P < 0.01). The specificity for diagnosing AP-ROP (94% vs. 78%; P < 0.01), type 2 ROP or worse (92% vs. 84%; P = 0.04), and ROP requiring treatment (89% vs. 79%; P < 0.01) was better for the trainees completing the tele-education system compared with the control group. Intragrader agreement improved for identification of plus disease, zone, stage, and category of ROP after completion of the educational intervention. A tele-education system for ROP education was effective in improving the diagnostic accuracy of ROP by ophthalmologists-in-training in Mexico. This system has the potential to increase competency in ROP diagnosis and management for ophthalmologists-in-training from middle-income nations. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  17. Patch testers' opinions regarding diagnostic criteria for metal hypersensitivity reactions to metallic implants.

    PubMed

    Schalock, Peter C; Thyssen, Jacob P

    2013-01-01

    Metal hypersensitivity reactions to implanted devices remain a challenging and controversial topic. Diagnostic criteria and methods are not well delineated. Diagnostic criteria for hypersensitivity reactions after metallic device implantation are evaluated in this study by a multinational group of patch testers using Thyssen's previously published criteria. A total of 119 dermatologists at the 2012 European Contact Dermatitis Society and 2013 American Contact Dermatitis Society meetings answered a survey regarding their opinions on topics relating to metal hypersensitivity. Four major and 5 minor diagnostic criteria emerged. Approximately 80% of respondents found the following criteria useful (major criteria): chronic dermatitis beginning weeks to months after metallic implantation, eruption overlying the metal implant, positive patch test to a metal component of the implant, and complete clearing after removal of the potentially allergenic implant. Minor criteria (<61% of respondents) were as follows: systemic allergic dermatitis reaction, therapy-resistant dermatitis, morphology consistent with dermatitis, histology consistent with allergic contact dermatitis, and a positive in vitro test to metals (eg, lymphocyte transformation test). In the challenging situation such as a symptomatic or failing orthopedic device, applying these 4 major criteria and the 5 supportive minor criteria may be useful for guiding decision making.

  18. Design and testing of a magnetically driven implosion peak current diagnostic

    NASA Astrophysics Data System (ADS)

    Hess, M. H.; Peterson, K. J.; Ampleford, D. J.; Hutsel, B. T.; Jennings, C. A.; Gomez, M. R.; Dolan, D. H.; Robertson, G. K.; Payne, S. L.; Stygar, W. A.; Martin, M. R.; Sinars, D. B.

    2018-04-01

    A critical component of the magnetically driven implosion experiments at Sandia National Laboratories is the delivery of high-current, 10s of MA, from the Z pulsed power facility to a target. In order to assess the performance of the experiment, it is necessary to measure the current delivered to the target. Recent Magnetized Liner Inertial Fusion (MagLIF) experiments have included velocimetry diagnostics, such as PDV (Photonic Doppler Velocimetry) or Velocity Interferometer System for Any Reflector, in the final power feed section in order to infer the load current as a function of time. However, due to the nonlinear volumetrically distributed magnetic force within a velocimetry flyer, a complete time-dependent load current unfold is typically a time-intensive process and the uncertainties in the unfold can be difficult to assess. In this paper, we discuss how a PDV diagnostic can be simplified to obtain a peak current by sufficiently increasing the thickness of the flyer. This effectively keeps the magnetic force localized to the flyer surface, resulting in fast and highly accurate measurements of the peak load current. In addition, we show the results of experimental peak load current measurements from the PDV diagnostic in recent MagLIF experiments.

  19. Design of an Fiber-Coupled Laser Heterodyne Interferometer for the FLARE

    NASA Astrophysics Data System (ADS)

    Frank, Samuel; Yoo, Jongsoo; Ji, Hantao; Jara-Almonte, Jon

    2016-10-01

    The FLARE (Facility for Laboratory Reconnection Experiments), which is currently under construction at PPPL, requires a complete set of laboratory plasma diagnostics. The Langmuir probes that will be used in the device to gather local density data require a reliable interferometer system to serve as baseline for density measurement calibration. A fully fiber-coupled infrared laser heterodyne interferometer has been designed in order to serve as the primary line-integrated electron density diagnostic. Thanks to advances in the communications industry many fiber optic devices and phase detection methods have advanced significantly becoming increasingly reliable and inexpensive. Fully fiber coupling a plasma interferometer greatly simplifies alignment procedures needed since the only free space laser path needing alignment is through the plasma itself. Fiber-coupling also provides significant resistance to vibrational noise, a common problem in plasma interferometry systems. This device also uses a greatly simplified phase detection scheme in which chips, originally developed for the communications industry, capable of directly detecting the phase shift of a signal with high time resolution. The design and initial performance of the system will be discussed.

  20. Diagnostic Assessment of Preparedness of Level One Sports Science Students for Biomechanics Modules

    ERIC Educational Resources Information Center

    Dixon, Sharon J.

    2005-01-01

    The primary objective of this study was to investigate the use of a diagnostic test to assess the preparedness of level one students for a sports biomechanics module. During their first week at university, a cohort of 108 students completed a diagnostic test at the end of their first lecture in sports biomechanics, with no prior notice. Upon…

  1. Special Educator's Complete Guide to 109 Diagnostic Tests: How To Select & Interpret Tests, Use Results in IEPs, and Remediate Specific Difficulties.

    ERIC Educational Resources Information Center

    Pierangelo, Roger; Giuliani, George

    This manual is a guide to the special education diagnostic process and covers the various stages of evaluation, interpretation, diagnosis, prescription, and remediation. Test information includes: explanations of the most commonly used diagnostic tests, coverage of the areas measured by each test, interpretation of test patterns for commonly used…

  2. 30 CFR 250.525 - What do I submit if my casing diagnostic test requires action?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What do I submit if my casing diagnostic test... INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Oil and Gas Well-Completion Operations Casing Pressure Management § 250.525 What do I submit if my casing diagnostic test...

  3. Converting Radiology Operations in a Six-Hospital Healthcare System from Film-Based to Digital: Another Leadership Role for the Diagnostic Medical Physicist

    NASA Astrophysics Data System (ADS)

    Arreola, Manuel M.; Rill, Lynn N.

    2004-09-01

    As medical facilities across the United States continue to convert their radiology operations from film-based to digital environments, partially accomplished and failed endeavors are frequent because of the lack of competent and knowledgeable leadership. The diagnostic medical physicist is, without a doubt, in a privileged position to take such a leadership role, not only because of her/his understanding of the basics principles of new imaging modalities, but also because of her/his inherent participation in workflow design and educational/training activities. A well-structured approach by the physicist will certainly lead the project to a successful completion, opening, in turn, new opportunities for the medical physicist to become an active participant in the decision-making process for an institution.

  4. Recent Developments in Synthetic Carbohydrate-Based Diagnostics, Vaccines, and Therapeutics.

    PubMed

    Fernández-Tejada, Alberto; Cañada, F Javier; Jiménez-Barbero, Jesús

    2015-07-20

    Glycans are everywhere in biological systems, being involved in many cellular events with important implications for medical purposes. Building upon a detailed understanding of the functional roles of carbohydrates in molecular recognition processes and disease states, glycans are increasingly being considered as key players in pharmacological research. On the basis of the important progress recently made in glycochemistry, glycobiology, and glycomedicine, we provide a complete overview of successful applications and future perspectives of carbohydrates in the biopharmaceutical and medical fields. This review highlights the development of carbohydrate-based diagnostics, exemplified by glycan imaging techniques and microarray platforms, synthetic oligosaccharide vaccines against infectious diseases (e.g., HIV) and cancer, and finally carbohydrate-derived therapeutics, including glycomimetic drugs and glycoproteins. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  5. Common Primary and Secondary Causes of Headache in the Elderly.

    PubMed

    Sharma, Tara L

    2018-03-01

    Headache in the elderly, defined as individuals aged 65 and older, although less prevalent than younger individuals, can present as a diagnostic challenge, given the increase in potentially fatal diseases within this population. These individuals require a complete history, neurological examination, and assessment of potential secondary causes of headaches. Secondary causes include temporal or giant cell arteritis, subdural hematomas, central nervous system (CNS) tumors, strokes, and CNS infections. Once secondary conditions are ruled out, then primary causes of headache are considered such as tension-type headache, migraine, cluster headache, or hypnic headache. This article reviews the distinguishing characteristics of the most common types of headache in patients over the age of 65 years old, along with potential diagnostic tests and treatment. © 2018 American Headache Society.

  6. Development of an intelligent diagnostic system for reusable rocket engine control

    NASA Technical Reports Server (NTRS)

    Anex, R. P.; Russell, J. R.; Guo, T.-H.

    1991-01-01

    A description of an intelligent diagnostic system for the Space Shuttle Main Engines (SSME) is presented. This system is suitable for incorporation in an intelligent controller which implements accommodating closed-loop control to extend engine life and maximize available performance. The diagnostic system architecture is a modular, hierarchical, blackboard system which is particularly well suited for real-time implementation of a system which must be repeatedly updated and extended. The diagnostic problem is formulated as a hierarchical classification problem in which the failure hypotheses are represented in terms of predefined data patterns. The diagnostic expert system incorporates techniques for priority-based diagnostics, the combination of analytical and heuristic knowledge for diagnosis, integration of different AI systems, and the implementation of hierarchical distributed systems. A prototype reusable rocket engine diagnostic system (ReREDS) has been implemented. The prototype user interface and diagnostic performance using SSME test data are described.

  7. Peptide targeting of quantum dots to human breast cancer cells

    NASA Astrophysics Data System (ADS)

    Haglund, Emily M.; Seale-Goldsmith, Mary-Margaret; Dhawan, Deepika; Stewart, Jane; Ramos-Vara, Jose; Cooper, Christy L.; Reece, Lisa M.; Husk, Timothy; Bergstrom, Donald; Knapp, Deborah; Leary, James F.

    2008-02-01

    Nanomedical approaches to diseases such as cancer provide great promise with respect to diagnostic and therapeutic applications. The impact of nanomedicine versus conventional therapies will be realized with regard to their specific cell targeting capabilities. Semiconductor nanoparticles have distinct advantages due to their chemical conjugation and detection characteristics. The attachment of a peptide sequence, LTVSPWY, was completed. These nanoparticles successfully targeted in vitro and in vivo systems. This technology can be utilized as a base mechanism for the construction of a multifunctional nanomedical system. Nanomedicine has great potential for impacting the treatment of specific diseases and healthcare delivery methods.

  8. A Variational Assimilation Method for Satellite and Conventional Data: Development of Basic Model for Diagnosis of Cyclone Systems

    NASA Technical Reports Server (NTRS)

    Achtemeier, Gary L.; Scott, Robert W.; Chen, J.

    1991-01-01

    A summary is presented of the progress toward the completion of a comprehensive diagnostic objective analysis system based upon the calculus of variations. The approach was to first develop the objective analysis subject to the constraints that the final product satisfies the five basic primitive equations for a dry inviscid atmosphere: the two nonlinear horizontal momentum equations, the continuity equation, the hydrostatic equation, and the thermodynamic equation. Then, having derived the basic model, there would be added to it the equations for moist atmospheric processes and the radiative transfer equation.

  9. Evaluation of the MoleMate training program for assessment of suspicious pigmented lesions in primary care.

    PubMed

    Wood, Annabel; Morris, Helen; Emery, Jon; Hall, Per N; Cotton, Symon; Prevost, A Toby; Walter, Fiona M

    2008-01-01

    Pigmented skin lesions or 'moles' are a common presenting problem in general practice consultations: while the majority are benign, a minority are malignant melanomas. The MoleMate system is a novel diagnostic tool which incorporates spectrophotometric intracutaneous analysis (SIAscopy) within a non-invasive scanning technique and utilises a diagnostic algorithm specifically developed for use in primary care. The MoleMate training program is a short, computer-based course developed to train primary care practitioners to operate the MoleMate diagnostic tool. This pre-trial study used mixed methods to assess the effectiveness and acceptability of a computer-based training program CD-ROM, developed to teach primary care practitioners to identify the seven features of suspicious pigmented lesions (SPLs) seen with the MoleMate system. Twenty-five practitioners worked through the MoleMate training program: data on feature recognition and time taken to conduct the assessment of each lesion were collected. Acceptability of the training program and the MoleMate system in general was assessed by questionnaire. The MoleMate training program improved users' feature recognition by 10% (pre-test median 73.8%, p<0.001), and reduced the time taken to complete assessment of 30 SPLs (pre-test median 21 minutes 53 seconds, median improvement 3 minutes 17 seconds, p<0.001). All practitioners' feature recognition improved (21/21), with most also improving their time (18/21). Practitioners rated the training program as effective and easy to use. The MoleMate training program is a potentially effective and acceptable informatics tool to teach practitioners to recognise the features of SPLs identified by the MoleMate system. It will be used as part of the intervention in a randomised controlled trial to compare the diagnostic accuracy and appropriate referral rates of practitioners using the MoleMate system with best practice in primary care.

  10. Assessing High-Resolution Weather Research and Forecasting (WRF) Forecasts Using an Object-Based Diagnostic Evaluation

    DTIC Science & Technology

    2014-02-01

    Operational Model Archive and Distribution System ( NOMADS ). The RTMA product was generated using a 2-D variational method to assimilate point weather...observations and satellite-derived measurements (National Weather Service, 2013). The products were downloaded using the NOMADS General Regularly...of the completed WRF run" read Start_Date echo $Start_Date echo " " echo "Enter 2- digit , zulu, observation hour (HH) for remapping" read oHH

  11. [Imputation methods for missing data in educational diagnostic evaluation].

    PubMed

    Fernández-Alonso, Rubén; Suárez-Álvarez, Javier; Muñiz, José

    2012-02-01

    In the diagnostic evaluation of educational systems, self-reports are commonly used to collect data, both cognitive and orectic. For various reasons, in these self-reports, some of the students' data are frequently missing. The main goal of this research is to compare the performance of different imputation methods for missing data in the context of the evaluation of educational systems. On an empirical database of 5,000 subjects, 72 conditions were simulated: three levels of missing data, three types of loss mechanisms, and eight methods of imputation. The levels of missing data were 5%, 10%, and 20%. The loss mechanisms were set at: Missing completely at random, moderately conditioned, and strongly conditioned. The eight imputation methods used were: listwise deletion, replacement by the mean of the scale, by the item mean, the subject mean, the corrected subject mean, multiple regression, and Expectation-Maximization (EM) algorithm, with and without auxiliary variables. The results indicate that the recovery of the data is more accurate when using an appropriate combination of different methods of recovering lost data. When a case is incomplete, the mean of the subject works very well, whereas for completely lost data, multiple imputation with the EM algorithm is recommended. The use of this combination is especially recommended when data loss is greater and its loss mechanism is more conditioned. Lastly, the results are discussed, and some future lines of research are analyzed.

  12. Health worker perspectives on barriers to delivery of routine tuberculosis diagnostic evaluation services in Uganda: a qualitative study to guide clinic-based interventions.

    PubMed

    Cattamanchi, Adithya; Miller, Cecily R; Tapley, Asa; Haguma, Priscilla; Ochom, Emmanuel; Ackerman, Sara; Davis, J Lucian; Katamba, Achilles; Handley, Margaret A

    2015-01-22

    Studies of the quality of tuberculosis (TB) diagnostic evaluation of patients in high burden countries have generally shown poor adherence to international or national guidelines. Health worker perspectives on barriers to improving TB diagnostic evaluation are critical for developing clinic-level interventions to improve guideline implementation. We conducted structured, in-depth interviews with staff at six district-level health centers in Uganda to elicit their perceptions regarding barriers to TB evaluation. Interviews were transcribed, coded with a standardized framework, and analyzed to identify emergent themes. We used thematic analysis to develop a logic model depicting health system and contextual barriers to recommended TB evaluation practices. To identify possible clinic-level interventions to improve TB evaluation, we categorized findings into predisposing, enabling, and reinforcing factors as described by the PRECEDE model, focusing on potentially modifiable behaviors at the clinic-level. We interviewed 22 health center staff between February 2010 and November 2011. Participants identified key health system barriers hindering TB evaluation, including: stock-outs of drugs/supplies, inadequate space and infrastructure, lack of training, high workload, low staff motivation, and poor coordination of health center services. Contextual barrier challenges to TB evaluation were also reported, including the time and costs borne by patients to seek and complete TB evaluation, poor health literacy, and stigma against patients with TB. These contextual barriers interacted with health system barriers to contribute to sub-standard TB evaluation. Examples of intervention strategies that could address these barriers and are related to PRECEDE model components include: assigned mentors/peer coaching for new staff (targets predisposing factor of low motivation and need for support to conduct job duties); facilitated workshops to implement same day microscopy (targets enabling factor of patient barriers to completing TB evaluation), and recognition/incentives for good TB screening practices (targets low motivation and self-efficacy). Our findings suggest that health system and contextual barriers work together to impede TB diagnosis at health centers and, if not addressed, could hinder TB case detection efforts. Qualitative research that improves understanding of the barriers facing TB providers is critical to developing targeted interventions to improve TB care.

  13. Patient satisfaction and dissatisfaction with mandibular two-implant overdentures using different attachment systems: 5-year outcomes.

    PubMed

    Al-Zubeidi, Mohammed I; Alsabeeha, Nabeel H M; Thomson, W Murray; Payne, Alan G T

    2012-10-01

    Different attachment systems for mandibular two-implant overdentures could influence levels of patient satisfaction. Positive consensus of the majority of patients being satisfied does not preclude the possibility of dissatisfaction for some. To evaluate patient satisfaction and dissatisfaction before and after 5 years of wearing mandibular two implant overdentures using different attachment systems ; to determine the prognostic relevance of pretreatment complete denture complaints to treatment outcomes. A total of 106 edentulous participants enrolled in a clinical trial completed a preliminary self-report inventory of their original complete denture complaints.New complete maxillary dentures and mandibular two-implant overdentures were provided to each participant using one of six different attachment systems. Patient satisfaction was determined at pretreatment; at baseline with mandibular two-implant overdenture insertion; and then annually for 5 years, using visual analogue and Likert-type scales. Patient satisfaction with mandibular two-implant overdentures showed significant changes pre- to posttreatment(baseline) in all domains, but these were significant immediately and maintained without further significance for 5 years, other than pain with the overdenture. After 5 years, no significant differences were observed with all the attachment systems. Highly significant differences were found with some social and psychological aspects by the fifth year compared to baseline. Diagnostic and prognostic indicators from a pretreatment inventory identified 12 participants (13.5%) who were dissatisfied. These indicators revealed a maladaptive predisposition to mandibular two-implant overdentures. The provision of mandibular two-implant overdentures will, in the majority of patients, significantly enhance levels of patient satisfaction for 5 years, as compared to complete mandibular dentures, regardless of the attachment system. Careful evaluation of pretreatment complaints with conventional dentures can possibly identify patient dissatisfaction with mandibular two-implant overdentures [corrected]. © 2010 Wiley Periodicals, Inc.

  14. SMA Diagnosis: Detection of SMN1 Deletion with Real-Time mCOP-PCR System Using Fresh Blood DNA.

    PubMed

    Niba, Emma Tabe Eko; Ar Rochmah, Mawaddah; Harahap, Nur Imma Fatimah; Awano, Hiroyuki; Morioka, Ichiro; Iijima, Kazumoto; Saito, Toshio; Saito, Kayoko; Takeuchi, Atsuko; Lai, Poh San; Bouike, Yoshihiro; Nishio, Hisahide; Shinohara, Masakazu

    2017-12-18

    Spinal muscular atrophy (SMA) is one of the most common autosomal recessive disorders. The symptoms are caused by defects of lower motor neurons in the spinal cord. More than 95% of SMA patients are homozygous for survival motor neuron 1 (SMN1) deletion. We previously developed a screening system for SMN1 deletion based on a modified competitive oligonucleotide priming-PCR (mCOP-PCR) technique using dried blood spot (DBS) on filter paper. This system is convenient for mass screening in the large population and/or first-tier diagnostic method of the patients in the remote areas. However, this system was still time-consuming and effort-taking, because it required pre-amplification procedure to avoid non-specific amplification and gel-electrophoresis to detect the presence or absence of SMN1 deletion. When the fresh blood samples are used instead of DBS, or when the gel-electrophoresis is replaced by real-time PCR, we may have a simpler and more rapid diagnostic method for SMA. To establish a simpler and more rapid diagnostic method of SMN1 deletion using fresh blood DNA. DNA samples extracted from fresh blood and stored at 4 ℃ for 1 month. The samples were assayed using a real-time mCOP-PCR system without pre-amplification procedures. DNA samples had already been genotyped by PCR-restriction fragment length polymorphism (PCR-RFLP), showing the presence or absence of SMN1 exon 7. The DNA samples were directly subjected to the mCOP-PCR step. The amplification of mCOP-PCR was monitored in a real-time PCR apparatus. The genotyping results of the real-time mCOP-PCR system using fresh blood DNA were completely matched with those of PCR-RFLP. In this real-time mCOP-PCR system using fresh blood-DNA, it took only four hours from extraction of DNA to detection of the presence or absence of SMN1 deletion, while it took more than 12 hours in PCR-RFLP. Our real-time mCOP-PCR system using fresh blood DNA was rapid and accurate, suggesting it may be useful for the first-tier diagnostic method of SMA.

  15. Diagnostic ultrasound at MACH 20: retroperitoneal and pelvic imaging in space.

    PubMed

    Jones, J A; Sargsyan, A E; Barr, Y R; Melton, S; Hamilton, D R; Dulchavsky, S A; Whitson, P A

    2009-07-01

    An operationally available diagnostic imaging capability augments spaceflight medical support by facilitating the diagnosis, monitoring and treatment of medical or surgical conditions, by improving medical outcomes and, thereby, by lowering medical mission impacts and the probability of crew evacuation due to medical causes. Microgravity-related physiological changes occurring during spaceflight can affect the genitourinary system and potentially cause conditions such as urinary retention or nephrolithiasis for which ultrasonography (U/S) would be a useful diagnostic tool. This study describes the first genitourinary ultrasound examination conducted in space, and evaluates image quality, frame rate, resolution requirements, real-time remote guidance of nonphysician crew medical officers and evaluation of on-orbit tools that can augment image acquisition. A nonphysician crew medical officer (CMO) astronaut, with minimal training in U/S, performed a self-examination of the genitourinary system onboard the International Space Station, using a Philips/ATL Model HDI-5000 ultrasound imaging unit located in the International Space Station Human Research Facility. The CMO was remotely guided by voice commands from experienced, earth-based sonographers stationed in Mission Control Center in Houston. The crewmember, with guidance, was able to acquire all of the target images. Real-time and still U/S images received at Mission Control Center in Houston were of sufficient quality for the images to be diagnostic for multiple potential genitourinary applications. Microgravity-based ultrasound imaging can provide diagnostic quality images of the retroperitoneum and pelvis, offering improved diagnosis and treatment for onboard medical contingencies. Successful completion of complex sonographic examinations can be obtained even with minimally trained nonphysician ultrasound operators, with the assistance of ground-based real-time guidance.

  16. Fault isolation detection expert (FIDEX). Part 1: Expert system diagnostics for a 30/20 Gigahertz satellite transponder

    NASA Technical Reports Server (NTRS)

    Durkin, John; Schlegelmilch, Richard; Tallo, Donald

    1992-01-01

    LeRC has recently completed the design of a Ka-band satellite transponder system, as part of the Advanced Communication Technology Satellite (ACTS) System. To enhance the reliability of this satellite, NASA funded the University of Akron to explore the application of an expert system to provide the transponder with an autonomous diagnosis capability. The results of this research was the development of a prototype diagnosis expert system called FIDEX (fault-isolation and diagnosis expert). FIDEX is a frame-based expert system that was developed in the NEXPERT Object development environment by Neuron Data, Inc. It is a MicroSoft Windows version 3.0 application, and was designed to operate on an Intel i80386 based personal computer system.

  17. MEDIC: medical embedded device for individualized care.

    PubMed

    Wu, Winston H; Bui, Alex A T; Batalin, Maxim A; Au, Lawrence K; Binney, Jonathan D; Kaiser, William J

    2008-02-01

    Presented work highlights the development and initial validation of a medical embedded device for individualized care (MEDIC), which is based on a novel software architecture, enabling sensor management and disease prediction capabilities, and commercially available microelectronic components, sensors and conventional personal digital assistant (PDA) (or a cell phone). In this paper, we present a general architecture for a wearable sensor system that can be customized to an individual patient's needs. This architecture is based on embedded artificial intelligence that permits autonomous operation, sensor management and inference, and may be applied to a general purpose wearable medical diagnostics. A prototype of the system has been developed based on a standard PDA and wireless sensor nodes equipped with commercially available Bluetooth radio components, permitting real-time streaming of high-bandwidth data from various physiological and contextual sensors. We also present the results of abnormal gait diagnosis using the complete system from our evaluation, and illustrate how the wearable system and its operation can be remotely configured and managed by either enterprise systems or medical personnel at centralized locations. By using commercially available hardware components and software architecture presented in this paper, the MEDIC system can be rapidly configured, providing medical researchers with broadband sensor data from remote patients and platform access to best adapt operation for diagnostic operation objectives.

  18. ["Operationalised psychodynamic diagnostics in childhood and adolescence" (OPD-CA) in practice].

    PubMed

    Schulte-Markwort, Michael; Resch, Franz; Bürgin, Dieter

    2004-02-01

    "Operationalised psychodynamic diagnostics in childhood and adolescence" (OPD-CA) has been completed in its first version after years of development. In a first interview with a 13-year-old boy, the diagnostic instruments of OPD-CA are presented by means of examples. The text passages of the transcribed first interview are evaluated in four sections by representatives of the respective working groups regarding the axes--relationships, conflict, structure and preconditions for treatment--and the diagnostic conclusions resulting from this are presented, thus providing a direct insight into the specific psychodynamic diagnostics of OPD-CA.

  19. RadPath: A Web-based System for Integrating and Correlating Radiology and Pathology Findings During Cancer Diagnosis.

    PubMed

    Arnold, Corey W; Wallace, W Dean; Chen, Shawn; Oh, Andrea; Abtin, Fereidoun; Genshaft, Scott; Binder, Scott; Aberle, Denise; Enzmann, Dieter

    2016-01-01

    The current paradigm of cancer diagnosis involves uncoordinated communication of findings from radiology and pathology to downstream physicians. Discordance between these findings can require additional time from downstream users to resolve, or given incorrect resolution, may adversely impact treatment decisions. To mitigate this problem, we developed a web-based system, called RadPath, for correlating and integrating radiology and pathology reporting. RadPath includes interfaces to our institution's clinical information systems, which are used to retrieve reports, images, and test results that are structured into an interactive compendium for a diagnostic patient case. The system includes an editing interface for physicians, allowing for the inclusion of additional clinical data, as well as the ability to retrospectively correlate and contextualize imaging findings following pathology diagnosis. During pilot deployment and testing over the course of 1 year, physicians at our institution have completed 60 RadPath cases, requiring an average of 128 seconds from a radiologist and an average of 93 seconds from a pathologist per case. Several technical and workflow challenges were encountered during development, including interfacing with diverse clinical information systems, automatically structuring report contents, and determining the appropriate physicians to create RadPath summaries. Reaction to RadPath has been positive, with users valuing the system's ability to consolidate diagnostic information. With the increasing complexity of medicine and the movement toward team-based disease management, there is a need for improved clinical communication and information exchange. RadPath provides a platform for generating coherent and correlated diagnostic summaries in cancer diagnosis with minimal additional effort from physicians. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  20. Itch: a symptom of occult disease.

    PubMed

    Hiramanek, Navaz

    2004-07-01

    Pruritus, (the Latin word for itch), is defined as the 'desire to scratch'. It is a distressing, subjective symptom that may interfere significantly with the quality of a patient's life. This article summarises the systemic causes of pruritus, describes the assessment of a patient presenting with itch without dermatological cause, and discusses the management of itch in patients with cancer. Patients with pruritus that does not respond to conservative therapy should be evaluated for underlying systemic disease. Causes of systemic pruritus include cholestasis, thyroid disease, polycythaemia rubra vera, uraemia, Hodgkin disease, and HIV. A thorough history and a complete physical examination are central to the evaluation of pruritus. In the absence of skin lesions, diagnostic testing is directed by the clinical evaluation and may include a complete blood count, liver function tests, serum creatinine, blood urea nitrogen levels, measurement of thyroid stimulating hormone, and chest X-ray. Removal of the causative agent and appropriate investigation and treatment of the underlying disease are essential first line measures in the treatment of pruritus.

  1. Financial and Temporal Advantages of Virtual Consultation in Veterans Requiring Specialty Care.

    PubMed

    Abbott, Daniel E; Macke, Ryan A; Kurtz, Jodi; Safdar, Nasia; Greenberg, Caprice C; Weber, Sharon M; Voils, Corrine I; Fisher, Deborah A; Maloney, James D

    2018-01-01

    Access to specialty health care in the Veterans Affairs (VA) system continues to be problematic. Given the potential temporal and fiscal benefits of telehealth, the Madison VA developed a virtual consultation (VC) mechanism to expedite diagnostic and therapeutic interventions for Veterans with incidentally discovered pulmonary nodules. Materials and. VC, a remote encounter between referring provider and thoracic surgeon for incidentally discovered pulmonary nodules, was implemented at the Madison VA between 2009 and 2011. Time from request to completion of consultation, hospital cost, and travel costs were determined for 157 veterans. These endpoints were then compared with in-person consultations over a concurrent 6-mo period. For the entire study cohort, the mean time to completion of VC was 3.2 d (SD ± 4.4 d). For the 6-mo period of first VC availability, the mean time to VC completion versus in-person consultation was 2.8 d (SD ± 2.8 d) and 20.5 d (SD ± 15.6 d), respectively (p < 0.05). Following initial VC, 84 (53%) veterans were scheduled for virtual follow-up alone; no veteran required an additional office visit before further diagnostic or therapeutic intervention. VA hospital cost was $228 per in-person consultation versus $120 per episode for VC - a 47.4% decrease. The average distance form veteran home to center was 86 miles, with an average travel reimbursement of $112 per in-person consultation, versus no travel cost associated with VC. VC for incidentally discovered pulmonary nodules significantly decreases time to consultation completion, hospital cost, and veteran travel cost. These data suggest that a significant opportunity exists for expansion of telehealth into additional practice settings within the VA system. © Association of Military Surgeons of the United States 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  2. Predictors and Diagnostic Significance of the Adenosine Related Side Effects on Myocardial Perfusion SPECT/CT Imaging

    PubMed Central

    Yıldırım Poyraz, Nilüfer; Özdemir, Elif; Poyraz, Barış Mustafa; Kandemir, Zuhal; Keskin, Mutlay; Türkölmez, Şeyda

    2014-01-01

    Objective: The aim of this study was to investigate the relationship between patient characteristics and adenosine-related side-effects during stress myocard perfusion imaging (MPI). The effect of presence of adenosine-related side-effects on the diagnostic value of MPI with integrated SPECT/CT system for coronary artery disease (CAD), was also assessed in this study. Methods: Total of 281 patients (109 M, 172 F; mean age:62.6±10) who underwent standard adenosine stress protocol for MPI, were included in this study. All symptoms during adenosine infusion were scored according to the severity and duration. For the estimation of diagnostic value of adenosine MPI with integrated SPECT/CT system, coronary angiography (CAG) or clinical follow-up were used as gold standard. Results: Total of 173 patients (61.6%) experienced adenosine-related side-effects (group 1); flushing, dyspnea, and chest pain were the most common. Other 108 patients completed pharmacologic stress (PS) test without any side-effects (group 2). Test tolerability were similar in the patients with cardiovascular or airway disease to others, however dyspnea were observed significantly more common in patients with mild airway disease. Body mass index (BMI) ≥30 kg/m2 and age ≤45 years were independent predictors of side-effects. The diagnostic value of MPI was similar in both groups. Sensitivity of adenosine MPI SPECT/CT was calculated to be 86%, specificity was 94% and diagnostic accuracy was 92% for diagnosis of CAD. Conclusion: Adenosine MPI is a feasible and well tolerated method in patients who are not suitable for exercise stress test as well as patients with cardiopulmonary disease. However age ≤45 years and BMI ≥30 kg/m2 are the positive predictors of adenosine-related side-effects, the diagnostic value of adenosine MPI SPECT/CT is not affected by the presence of adenosine related side-effects. PMID:25541932

  3. The way to universal and correct medical presentation of diagnostic informations for complex spectrophotometry noninvasive medical diagnostic systems

    NASA Astrophysics Data System (ADS)

    Rogatkin, Dmitrii A.; Tchernyi, Vladimir V.

    2003-07-01

    The optical noninvasive diagnostic systems are now widely applied and investigated in different areas of medicine. One of the such techniques is the noninvasive spectrophotometry, the complex diagnostic technique consisting on elastic scattering spectroscopy, absorption spectroscopy, fluorescent diagnostics, photoplethismography, etc. Today a lot of real optical diagnostic systems indicate the technical parameters and physical data only as a result of the diagnostic procedure. But, it is clear that for the medical staff the more convenient medical information is needed. This presentation lights the general way for development a diagnostic system"s software, which can produce the full processing of the diagnostic data from a physical to a medical level. It is shown, that this process is a multilevel (3-level) procedure and the main diagnostic result for noninvasive spectrophotometry methods, the biochemical and morphological composition of the tested tissues, arises in it on a second level of calculations.

  4. Inadequate Diagnostic Evaluation in Young Patients Registered with a Diagnosis of Dementia: A Nationwide Register-Based Study

    PubMed Central

    Salem, Lise Cronberg; Andersen, Birgitte Bo; Nielsen, T. Rune; Stokholm, Jette; Jørgensen, Martin Balslev; Waldemar, Gunhild

    2014-01-01

    Background Establishing a diagnosis of dementia in young patients may be complex and have significant implications for the patient. The aim of this study was to evaluate the quality of the diagnostic work-up in young patients diagnosed with dementia in the clinical routine. Methods Two hundred patients were randomly selected from 891 patients aged ≤65 years registered with a diagnosis of dementia for the first time in 2008 in Danish hospitals, and 159 medical records were available for review. Three raters evaluated their medical records for the completeness of the diagnostic work-up on which the diagnosis of dementia had been based, using evidence-based guidelines for the diagnostic evaluation of dementia as reference standards. Results According to the rater review, only 111 (70%) patients met the clinical criteria for dementia. An acceptable diagnostic work-up including all items of recommended basic diagnostic evaluation was performed in only 24%, although more often (28%) in the subgroup of patients where dementia was confirmed by raters. Conclusion This first nationwide study of unselected young patients registered with a diagnosis of dementia indicated that the concept of dementia may be misinterpreted by clinicians and that a diagnosis of dementia in the young is only rarely based on a complete basic diagnostic work-up, calling for increased competency. PMID:24711812

  5. Ambient ionization and miniature mass spectrometry system for chemical and biological analysis

    PubMed Central

    Ma, Xiaoxiao; Ouyang, Zheng

    2016-01-01

    Ambien ionization and miniaturization of mass spectrometers are two fields in mass spectrometry that have advanced significantly in the last decade. The integration of the techniques developed in these two fields is leading to the development of complete miniature analytical systems that can be used for on-site or point-of-care analysis by non-expert users. In this review, we report the current status of development in ambient ionization and miniature mass spectrometers, with an emphasis on those techniques with potential impact on the point-of-care (POC) diagnostics. The challenges in the future development of the integrated systems are discussed with possible solutions presented. PMID:28042191

  6. Intelligent Elements for the ISHM Testbed and Prototypes (ITP) Project

    NASA Technical Reports Server (NTRS)

    Maul, William A.; Park, Han; Schwabacher, Mark; Watson, Michael; Mackey, Ryan; Fijany, Amir; Trevino, Luis; Weir, John

    2005-01-01

    Deep-space manned missions will require advanced automated health assessment capabilities. Requirements such as in-space assembly, long dormant periods and limited accessibility during flight, present significant challenges that should be addressed through Integrated System Health Management (ISHM). The ISHM approach will provide safety and reliability coverage for a complete system over its entire life cycle by determining and integrating health status and performance information from the subsystem and component levels. This paper will focus on the potential advanced diagnostic elements that will provide intelligent assessment of the subsystem health and the planned implementation of these elements in the ISHM Testbed and Prototypes (ITP) Project under the NASA Exploration Systems Research and Technology program.

  7. Sub-Nanosecond Cinematography In Laser Fusion Research: Current Techniques And Applications At The Lawrence Livermore National Laboratory*

    NASA Astrophysics Data System (ADS)

    Coleman, Lamar W...

    1985-02-01

    Progress in laser fusion research has increased the need for detail and precision in the diagnosis of experiments. This has spawned the development and use of sophisticated sub-nanosecond resolution diavostic systems. These systems typically use ultrafast x-ray or optical streak caAleras in combination. with spatially imaging or spectrally dispersing elements. These instruments provide high resolution data essential for understanding the processes occurrilltg in the interaction. of high. intensity laser light with targets. Several of these types of instruments and their capabilities will be discussed. The utilization of these kinds of diagnostics systems on the nearly completed 100 kJ Nova laser facility will be described.

  8. Performance results of cooperating expert systems in a distributed real-time monitoring system

    NASA Technical Reports Server (NTRS)

    Schwuttke, U. M.; Veregge, J. R.; Quan, A. G.

    1994-01-01

    There are numerous definitions for real-time systems, the most stringent of which involve guaranteeing correct system response within a domain-dependent or situationally defined period of time. For applications such as diagnosis, in which the time required to produce a solution can be non-deterministic, this requirement poses a unique set of challenges in dynamic modification of solution strategy that conforms with maximum possible latencies. However, another definition of real time is relevant in the case of monitoring systems where failure to supply a response in the proper (and often infinitesimal) amount of time allowed does not make the solution less useful (or, in the extreme example of a monitoring system responsible for detecting and deflecting enemy missiles, completely irrelevant). This more casual definition involves responding to data at the same rate at which it is produced, and is more appropriate for monitoring applications with softer real-time constraints, such as interplanetary exploration, which results in massive quantities of data transmitted at the speed of light for a number of hours before it even reaches the monitoring system. The latter definition of real time has been applied to the MARVEL system for automated monitoring and diagnosis of spacecraft telemetry. An early version of this system has been in continuous operational use since it was first deployed in 1989 for the Voyager encounter with Neptune. This system remained under incremental development until 1991 and has been under routine maintenance in operations since then, while continuing to serve as an artificial intelligence (AI) testbed in the laboratory. The system architecture has been designed to facilitate concurrent and cooperative processing by multiple diagnostic expert systems in a hierarchical organization. The diagnostic modules adhere to concepts of data-driven reasoning, constrained but complete nonoverlapping domains, metaknowledge of global consequences of anomalous data, hierarchical reporting of problems that extend beyond a single domain, and shared responsibility for problems that overlap domains. The system enables efficient diagnosis of complex system failures in real-time environments with high data volumes and moderate failure rates, as indicated by extensive performance measurements.

  9. Advanced Diagnostic and Prognostic Testbed (ADAPT) Testability Analysis Report

    NASA Technical Reports Server (NTRS)

    Ossenfort, John

    2008-01-01

    As system designs become more complex, determining the best locations to add sensors and test points for the purpose of testing and monitoring these designs becomes more difficult. Not only must the designer take into consideration all real and potential faults of the system, he or she must also find efficient ways of detecting and isolating those faults. Because sensors and cabling take up valuable space and weight on a system, and given constraints on bandwidth and power, it is even more difficult to add sensors into these complex designs after the design has been completed. As a result, a number of software tools have been developed to assist the system designer in proper placement of these sensors during the system design phase of a project. One of the key functions provided by many of these software programs is a testability analysis of the system essentially an evaluation of how observable the system behavior is using available tests. During the design phase, testability metrics can help guide the designer in improving the inherent testability of the design. This may include adding, removing, or modifying tests; breaking up feedback loops, or changing the system to reduce fault propagation. Given a set of test requirements, the analysis can also help to verify that the system will meet those requirements. Of course, a testability analysis requires that a software model of the physical system is available. For the analysis to be most effective in guiding system design, this model should ideally be constructed in parallel with these efforts. The purpose of this paper is to present the final testability results of the Advanced Diagnostic and Prognostic Testbed (ADAPT) after the system model was completed. The tool chosen to build the model and to perform the testability analysis with is the Testability Engineering and Maintenance System Designer (TEAMS-Designer). The TEAMS toolset is intended to be a solution to span all phases of the system, from design and development through health management and maintenance. TEAMS-Designer is the model-building and testability analysis software in that suite.

  10. Diagnosing Cervical Neoplasia in Rural Brazil Using a Mobile Van Equipped with In Vivo Microscopy: A Cluster-Randomized Community Trial.

    PubMed

    Hunt, Brady; Fregnani, José Humberto Tavares Guerreiro; Schwarz, Richard A; Pantano, Naitielle; Tesoni, Suelen; Possati-Resende, Júlio César; Antoniazzi, Marcio; de Oliveira Fonseca, Bruno; de Macêdo Matsushita, Graziela; Scapulatempo-Neto, Cristovam; Kerr, Ligia; Castle, Philip E; Schmeler, Kathleen; Richards-Kortum, Rebecca

    2018-06-01

    Cervical cancer is a leading cause of death in underserved areas of Brazil. This prospective randomized trial involved 200 women in southern/central Brazil with abnormal Papanicolaou tests. Participants were randomized by geographic cluster and referred for diagnostic evaluation either at a mobile van upon its scheduled visit to their local community, or at a central hospital. Participants in both arms underwent colposcopy, in vivo microscopy, and cervical biopsies. We compared rates of diagnostic follow-up completion between study arms, and also evaluated the diagnostic performance of in vivo microscopy compared with colposcopy. There was a 23% absolute and 37% relative increase in diagnostic follow-up completion rates for patients referred to the mobile van (102/117, 87%) compared with the central hospital (53/83, 64%; P = 0.0001; risk ratio = 1.37, 95% CI, 1.14-1.63). In 229 cervical sites in 144 patients, colposcopic examination identified sites diagnosed as cervical intraepithelial neoplasia grade 2 or more severe (CIN2+; 85 sites) with a sensitivity of 94% (95% CI, 87%-98%) and specificity of 50% (95% CI, 42%-58%). In vivo microscopy with real-time automated image analysis identified CIN2+ with a sensitivity of 92% (95% CI, 84%-97%) and specificity of 48% (95% CI, 40%-56%). Women referred to the mobile van were more likely to complete their diagnostic follow-up compared with those referred to a central hospital, without compromise in clinical care. In vivo microscopy in a mobile van provides automated diagnostic imaging with sensitivity and specificity similar to colposcopy. Cancer Prev Res; 11(6); 359-70. ©2018 AACR . ©2018 American Association for Cancer Research.

  11. Computer-aided testing of pilot response to critical in-flight events

    NASA Technical Reports Server (NTRS)

    Giffin, W. C.; Rockwell, T. H.

    1984-01-01

    This research on pilot response to critical in-flight events employs a unique methodology including an interactive computer-aided scenario-testing system. Navigation displays, instrument-panel displays, and assorted textual material are presented on a touch-sensitive CRT screen. Problem diagnosis scenarios, destination-diversion scenarios and combined destination/diagnostic tests are available. A complete time history of all data inquiries and responses is maintained. Sample results of diagnosis scenarios obtained from testing 38 licensed pilots are presented and discussed.

  12. Spectroscopic imaging of limiter heat and particle fluxes and the resulting impurity sources during Wendelstein 7-X startup plasmas.

    PubMed

    Stephey, L; Wurden, G A; Schmitz, O; Frerichs, H; Effenberg, F; Biedermann, C; Harris, J; König, R; Kornejew, P; Krychowiak, M; Unterberg, E A

    2016-11-01

    A combined IR and visible camera system [G. A. Wurden et al., "A high resolution IR/visible imaging system for the W7-X limiter," Rev. Sci. Instrum. (these proceedings)] and a filterscope system [R. J. Colchin et al., Rev. Sci. Instrum. 74, 2068 (2003)] were implemented together to obtain spectroscopic data of limiter and first wall recycling and impurity sources during Wendelstein 7-X startup plasmas. Both systems together provided excellent temporal and spatial spectroscopic resolution of limiter 3. Narrowband interference filters in front of the camera yielded C-III and H α photon flux, and the filterscope system provided H α , H β , He-I, He-II, C-II, and visible bremsstrahlung data. The filterscopes made additional measurements of several points on the W7-X vacuum vessel to yield wall recycling fluxes. The resulting photon flux from both the visible camera and filterscopes can then be compared to an EMC3-EIRENE synthetic diagnostic [H. Frerichs et al., "Synthetic plasma edge diagnostics for EMC3-EIRENE, highlighted for Wendelstein 7-X," Rev. Sci. Instrum. (these proceedings)] to infer both a limiter particle flux and wall particle flux, both of which will ultimately be used to infer the complete particle balance and particle confinement time τ P .

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

    PubMed

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

    2009-12-01

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

  14. A diagnostic expert system for aircraft generator control unit (GCU)

    NASA Astrophysics Data System (ADS)

    Ho, Ting-Long; Bayles, Robert A.; Havlicsek, Bruce L.

    The modular VSCF (variable-speed constant-frequency) generator families are described as using standard modules to reduce the maintenance cost and to improve the product's testability. A general diagnostic expert system shell that guides troubleshooting of modules or line replaceable units (LRUs) is introduced. An application of the diagnostic system to a particular LRU, the generator control unit (GCU) is reported. The approach to building the diagnostic expert system is first to capture general diagnostic strategy in an expert system shell. This shell can be easily applied to different devices or LRUs by writing rules to capture only additional device-specific diagnostic information from expert repair personnel. The diagnostic system has the necessary knowledge embedded in its programs and exhibits expertise to troubleshoot the GCU.

  15. [Giant inflammatory pseudotumor of the cranial base].

    PubMed

    Carrasco-Moro, Rodrigo; Martínez-San Millán, Juan; Pian, Héctor

    The inflammatory pseudotumour (IPT) is a non-neoplastic entity of unknown origin, and is characterised by a proliferation of connective tissue and a polyclonal inflammatory infiltrate. Central nervous system involvement is uncommon, and usually represents a diagnostic and therapeutic challenge even for the experienced clinician. This reports deals with the case of a 56year-old woman diagnosed with a giant, infiltrating mass centred in the left cavernous sinus, who had a rapid clinical and radiological response to steroid therapy. Biopsy specimens were diagnostic for IPT. The progression of a small orbital residual lesion was detected after steroid withdrawal. Treatment with cyclophosphamide induced a complete response that remains stable after six years of follow-up. Copyright © 2016 Sociedad Española de Neurocirugía. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Successful off-label use of the Cepheid Xpert GBS in a late-onset neonatal meningitis by Streptococcus agalactiae.

    PubMed

    Savini, Vincenzo; Marrollo, Roberta; Coclite, Eleonora; Fusilli, Paola; D'Incecco, Carmine; Fazii, Paolo

    2014-01-01

    We report the case of a late-onset neonatal meningitis by Streptococcus agalactiae (group B Streptococcus - GBS) that was diagnosed with a latex agglutination assay (on cerebrospinal fluid, CSF), as well as by using, for the first time, Xpert GBS (Cepheid, US) on CSF. Due to empirical antibiotics given before sampling, both CSF and blood culture were negative, so the abovementioned diagnostics was crucial. Moreover, the Xpert GBS assay, performed according to an off-label, modified protocol (the system is designed for GBS-carriage intrapartum screening, based on a completely automated real time-Polymerase Chain Reaction) quickly detected the organism's genome target. Although further investigation on this test's performace on CSF is required, then, we trust it may be a promising, quick and precise diagnostic method for infections in newborns.

  17. A Self-Diagnostic System for the M6 Accelerometer

    NASA Technical Reports Server (NTRS)

    Flanagan, Patrick M.; Lekki, John

    2001-01-01

    The design of a Self-Diagnostic (SD) accelerometer system for the Space Shuttle Main Engine is presented. This retrofit system connects diagnostic electronic hardware and software to the current M6 accelerometer system. This paper discusses the general operation of the M6 accelerometer SD system and procedures for developing and evaluating the SD system. Signal processing techniques using M6 accelerometer diagnostic data are explained. Test results include diagnostic data responding to changing ambient temperature, mounting torque and base mounting impedance.

  18. Diagnostic Peptide Discovery: Prioritization of Pathogen Diagnostic Markers Using Multiple Features

    PubMed Central

    Carmona, Santiago J.; Sartor, Paula A.; Leguizamón, María S.; Campetella, Oscar E.; Agüero, Fernán

    2012-01-01

    The availability of complete pathogen genomes has renewed interest in the development of diagnostics for infectious diseases. Synthetic peptide microarrays provide a rapid, high-throughput platform for immunological testing of potential B-cell epitopes. However, their current capacity prevent the experimental screening of complete “peptidomes”. Therefore, computational approaches for prediction and/or prioritization of diagnostically relevant peptides are required. In this work we describe a computational method to assess a defined set of molecular properties for each potential diagnostic target in a reference genome. Properties such as sub-cellular localization or expression level were evaluated for the whole protein. At a higher resolution (short peptides), we assessed a set of local properties, such as repetitive motifs, disorder (structured vs natively unstructured regions), trans-membrane spans, genetic polymorphisms (conserved vs. divergent regions), predicted B-cell epitopes, and sequence similarity against human proteins and other potential cross-reacting species (e.g. other pathogens endemic in overlapping geographical locations). A scoring function based on these different features was developed, and used to rank all peptides from a large eukaryotic pathogen proteome. We applied this method to the identification of candidate diagnostic peptides in the protozoan Trypanosoma cruzi, the causative agent of Chagas disease. We measured the performance of the method by analyzing the enrichment of validated antigens in the high-scoring top of the ranking. Based on this measure, our integrative method outperformed alternative prioritizations based on individual properties (such as B-cell epitope predictors alone). Using this method we ranked 10 million 12-mer overlapping peptides derived from the complete T. cruzi proteome. Experimental screening of 190 high-scoring peptides allowed the identification of 37 novel epitopes with diagnostic potential, while none of the low scoring peptides showed significant reactivity. Many of the metrics employed are dependent on standard bioinformatic tools and data, so the method can be easily extended to other pathogen genomes. PMID:23272069

  19. The Feasibility of Classifying Breast Masses Using a Computer-Assisted Diagnosis (CAD) System Based on Ultrasound Elastography and BI-RADS Lexicon.

    PubMed

    Fleury, Eduardo F C; Gianini, Ana Claudia; Marcomini, Karem; Oliveira, Vilmar

    2018-01-01

    To determine the applicability of a computer-aided diagnostic system strain elastography system for the classification of breast masses diagnosed by ultrasound and scored using the criteria proposed by the breast imaging and reporting data system ultrasound lexicon and to determine the diagnostic accuracy and interobserver variability. This prospective study was conducted between March 1, 2016, and May 30, 2016. A total of 83 breast masses subjected to percutaneous biopsy were included. Ultrasound elastography images before biopsy were interpreted by 3 radiologists with and without the aid of computer-aided diagnostic system for strain elastography. The parameters evaluated by each radiologist results were sensitivity, specificity, and diagnostic accuracy, with and without computer-aided diagnostic system for strain elastography. Interobserver variability was assessed using a weighted κ test and an intraclass correlation coefficient. The areas under the receiver operating characteristic curves were also calculated. The areas under the receiver operating characteristic curve were 0.835, 0.801, and 0.765 for readers 1, 2, and 3, respectively, without computer-aided diagnostic system for strain elastography, and 0.900, 0.926, and 0.868, respectively, with computer-aided diagnostic system for strain elastography. The intraclass correlation coefficient between the 3 readers was 0.6713 without computer-aided diagnostic system for strain elastography and 0.811 with computer-aided diagnostic system for strain elastography. The proposed computer-aided diagnostic system for strain elastography system has the potential to improve the diagnostic performance of radiologists in breast examination using ultrasound associated with elastography.

  20. Space Shuttle main engine OPAD: The search for a hardware enhanced plume

    NASA Astrophysics Data System (ADS)

    Powers, W. T.; Cooper, A. E.; Wallace, Tim L.; Buntine, W. L.; Whitaker, K. W.

    1993-11-01

    The process of applying spectroscopy to the Space Shuttle Main Engine (SSME) for plume diagnostics, as it exists today, originated at Marshall Space Flight Center in Huntsville, Alabama, and its implementation was assured largely through the efforts of Sverdrup AEDC, in Tullahoma, Tennessee. This team continues to lead and guide efforts in the plume diagnostics arena. The process, Optical Plume Anomaly Detection (OPAD), formed the basis for various activities in the development of ground-based systems as well as the development of in-flight plume spectroscopy. OPAD currently provides and will continue to provide valuable information relative to future systems definitions, instrumentation development, code validation, and data diagnostic processing. OPAD is based on the detection of anomalous atomic and molecular species in the SSME plume using two complete, stand-alone optical spectrometers. To-date OPAD has acquired data on 44 test firings of the SSME at the Technology Test Bed (TTB) at MSFC. The purpose of this paper will be to provide an introduction to the OPAD system by discussing the process of obtaining data as well as the methods of examining and interpreting the data. It will encompass such issues as selection of instrumentation correlation of data to nominal engine operation, investigation of SSME component erosion via OPAD spectral data, necessity and benefits of plume seeding, application of artificial intelligence (AI) techniques to data analysis, and the present status of efforts to quantify specie erosion utilizing standard plume and chemistry codes as well as radiative models currently under development.

  1. Space Shuttle main engine OPAD: The search for a hardware enhanced plume

    NASA Technical Reports Server (NTRS)

    Powers, W. T.; Cooper, A. E.; Wallace, Tim L.; Buntine, W. L.; Whitaker, K. W.

    1993-01-01

    The process of applying spectroscopy to the Space Shuttle Main Engine (SSME) for plume diagnostics, as it exists today, originated at Marshall Space Flight Center in Huntsville, Alabama, and its implementation was assured largely through the efforts of Sverdrup AEDC, in Tullahoma, Tennessee. This team continues to lead and guide efforts in the plume diagnostics arena. The process, Optical Plume Anomaly Detection (OPAD), formed the basis for various activities in the development of ground-based systems as well as the development of in-flight plume spectroscopy. OPAD currently provides and will continue to provide valuable information relative to future systems definitions, instrumentation development, code validation, and data diagnostic processing. OPAD is based on the detection of anomalous atomic and molecular species in the SSME plume using two complete, stand-alone optical spectrometers. To-date OPAD has acquired data on 44 test firings of the SSME at the Technology Test Bed (TTB) at MSFC. The purpose of this paper will be to provide an introduction to the OPAD system by discussing the process of obtaining data as well as the methods of examining and interpreting the data. It will encompass such issues as selection of instrumentation correlation of data to nominal engine operation, investigation of SSME component erosion via OPAD spectral data, necessity and benefits of plume seeding, application of artificial intelligence (AI) techniques to data analysis, and the present status of efforts to quantify specie erosion utilizing standard plume and chemistry codes as well as radiative models currently under development.

  2. A diagnostic expert system for structured reports, quality assessment, and training of residents in sonography.

    PubMed

    Huettig, Matthias; Buscher, Georg; Menzel, Thomas; Scheppach, Wolfgang; Puppe, Frank; Buscher, Hans-Peter

    2004-03-15

    The quality of medical reports on diagnostic procedures has a considerable impact on the quality of medical care. Handwritten or otherwise unstructured reports tend to be incomplete, whereas structured questionnaires are of limited flexibility and not considered case-adequate. Thus, medical reports of this kind may promote an incomplete and misleading documentation and, therefore, be problematic with respect to their reliability. SonoConsult (SC), an expert system for structured and case-adequate documentation of sonographic findings with an additional diagnostic component, was evaluated with respect to user acceptance and suitability for enhancing the quality of reports and supporting sonographic beginners. The expectations and the attitudes of the users toward the program were evaluated by anonymous questionnaires. The documentation of findings and the diagnostic conclusions in 103 free text reports made by experienced examiners were evaluated by subjecting their information to a subsequent input into SC. Free text reports were checked for information that was asked by SC but not mentioned in the reports. In a series of 150 cases, the system diagnoses were blinded during input of findings into SC-questionnaires and the examiners' diagnostic conclusions were compared with the uncovered SC-diagnoses with respect to forgotten diagnoses. The structured and data-driven acquisition of information by the program was well accepted by the users. However, only a medium interest in the system-delivered diagnoses was noted. The program-generated reports were characterized by a more detailed description of the findings and a higher number of diagnoses in comparison to the unstructured reports before introduction of SC as the only documentation system. When unaware of the system diagnoses, information was entered into the questionnaires, and SC generated some diagnoses which were not mentioned by the examiners in their conclusions. The possibility to inspect the system diagnoses led to an enhancement of the number of diagnoses the examiners mentioned in their conclusions. By contrast, the examiners meant that the influence of the program on their conclusions was minimal or dispensable. Beginners in sonography acknowledged that the program led them to perform a complete examination in an adequate sequence. An expert system for the data-driven, case-adequate information acquisition of abdominal ultrasound examinations may enhance the quality of the reports and, potentially, of the examinations at the same time. In addition, it may help beginners to learn a structured problem- and finding-adequate examination sequence.

  3. A Microfluidic Cytometer for Complete Blood Count With a 3.2-Megapixel, 1.1- μm-Pitch Super-Resolution Image Sensor in 65-nm BSI CMOS.

    PubMed

    Liu, Xu; Huang, Xiwei; Jiang, Yu; Xu, Hang; Guo, Jing; Hou, Han Wei; Yan, Mei; Yu, Hao

    2017-08-01

    Based on a 3.2-Megapixel 1.1- μm-pitch super-resolution (SR) CMOS image sensor in a 65-nm backside-illumination process, a lens-free microfluidic cytometer for complete blood count (CBC) is demonstrated in this paper. Backside-illumination improves resolution and contrast at the device level with elimination of surface treatment when integrated with microfluidic channels. A single-frame machine-learning-based SR processing is further realized at system level for resolution correction with minimum hardware resources. The demonstrated microfluidic cytometer can detect the platelet cells (< 2 μm) required in CBC, hence is promising for point-of-care diagnostics.

  4. Enabling digital pathology in the diagnostic setting: navigating through the implementation journey in an academic medical centre.

    PubMed

    Cheng, Chee Leong; Azhar, Rafay; Sng, Shi Hui Adeline; Chua, Yong Quan; Hwang, Jacqueline Siok Gek; Chin, Jennifer Poi Fun; Seah, Waih Khuen; Loke, Janel Chui Ling; Ang, Roy Hang Leng; Tan, Puay Hoon

    2016-09-01

    As digital pathology (DP) and whole slide imaging (WSI) technology advance and mature, there is an increasing drive to incorporate DP into the diagnostic environment. However, integration of DP into the diagnostic laboratory is a non-trivial task and filled with unexpected challenges unlike standalone implementations. We share our journey of implementing DP in the diagnostic laboratory setting, highlighting seven key guiding principles that drive the progression through implementation into deployment and beyond. The DP implementation with laboratory information system integration was completed in 8 months, including validation of the solution for diagnostic use in accordance with College of American Pathologists guidelines. We also conducted prospective validation via paired delivery of glass slides and WSI to our pathologists postdeployment. Common themes in our guiding principles included emphasis on workflow and being comprehensive in the approach, looking beyond pathologist user champions and expanding into an extended project team involving laboratory technicians, clerical/data room staff and archival staff. Concordance between glass slides and WSI ranged from 93% to 100% among various applications on validation. We also provided equal opportunities for every pathologist throughout the department to be competent and confident with DP through prospective validation, with overall concordance of 96% compared with glass slides, allowing appreciation of the advantages and limitations of WSI, hence enabling the use of DP as a useful diagnostic modality. Smooth integration of DP into the diagnostic laboratory is possible with careful planning, discipline and a systematic approach adhering to our guiding principles. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  5. Classification of stillbirths is an ongoing dilemma.

    PubMed

    Nappi, Luigi; Trezza, Federica; Bufo, Pantaleo; Riezzo, Irene; Turillazzi, Emanuela; Borghi, Chiara; Bonaccorsi, Gloria; Scutiero, Gennaro; Fineschi, Vittorio; Greco, Pantaleo

    2016-10-01

    To compare different classification systems in a cohort of stillbirths undergoing a comprehensive workup; to establish whether a particular classification system is most suitable and useful in determining cause of death, purporting the lowest percentage of unexplained death. Cases of stillbirth at gestational age 22-41 weeks occurring at the Department of Gynecology and Obstetrics of Foggia University during a 4 year period were collected. The World Health Organization (WHO) diagnosis of stillbirth was used. All the data collection was based on the recommendations of an Italian diagnostic workup for stillbirth. Two expert obstetricians reviewed all cases and classified causes according to five classification systems. Relevant Condition at Death (ReCoDe) and Causes Of Death and Associated Conditions (CODAC) classification systems performed best in retaining information. The ReCoDe system provided the lowest rate of unexplained stillbirth (14%) compared to de Galan-Roosen (16%), CODAC (16%), Tulip (18%), Wigglesworth (62%). Classification of stillbirth is influenced by the multiplicity of possible causes and factors related to fetal death. Fetal autopsy, placental histology and cytogenetic analysis are strongly recommended to have a complete diagnostic evaluation. Commonly employed classification systems performed differently in our experience, the most satisfactory being the ReCoDe. Given the rate of "unexplained" cases, none can be considered optimal and further efforts are necessary to work out a clinically useful system.

  6. The national ignition facility high-energy ultraviolet laser system

    NASA Astrophysics Data System (ADS)

    Moses, Edward I.

    2004-09-01

    The National Ignition Facility (NIF), currently under construction at the Lawrence Livermore National Laboratory, is a stadium-sized facility containing a 192-beam, 1.8 MJ, 500 TW, ultraviolet laser system together with a 10-m diameter target chamber with room for nearly 100 experimental diagnostics. When completed, NIF will be the world's largest and most energetic laser experimental system, providing an international center to study inertial confinement fusion and the physics of matter at extreme energy densities and pressures. NIF's 192 energetic laser beams will compress fusion targets to conditions required for thermonuclear burn, liberating more energy than required to initiate the fusion reactions. Other NIF experiments will allow the study of physical processes at temperatures approaching 10 8 K and 10 11 Bar, conditions that exist naturally only in the interior of stars, planets and in nuclear weapons. NIF is now entering the first phases of its laser commissioning program. The first four beams of the NIF laser system have generated 106 kJ of infrared light and over 10 kJ at the third harmonic (351 nm). NIF's target experimental systems are also being installed in preparation for experiments to begin in late 2003. This paper provides a detailed look the NIF laser systems, the significant laser and optical systems breakthroughs that were developed, the results of recent laser commissioning shots, and plans for commissioning diagnostics for experiments on NIF.

  7. Applying Diagnostics to Enhance Cable System Reliability (Cable Diagnostic Focused Initiative, Phase II)

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hartlein, Rick; Hampton, Nigel; Perkel, Josh

    2016-02-01

    The Cable Diagnostic Focused Initiative (CDFI) played a significant and powerful role in clarifying the concerns and understanding the benefits of performing diagnostic tests on underground power cable systems. This project focused on the medium and high voltage cable systems used in utility transmission and distribution (T&D) systems. While many of the analysis techniques and interpretations are applicable to diagnostics and cable systems outside of T&D, areas such as generating stations (nuclear, coal, wind, etc.) and other industrial environments were not the focus. Many large utilities in North America now deploy diagnostics or have changed their diagnostic testing approach asmore » a result of this project. Previous to the CDFI, different diagnostic technology providers individually promoted their approach as the “the best” or “the only” means of detecting cable system defects.« less

  8. Colonoscopy video quality assessment using hidden Markov random fields

    NASA Astrophysics Data System (ADS)

    Park, Sun Young; Sargent, Dusty; Spofford, Inbar; Vosburgh, Kirby

    2011-03-01

    With colonoscopy becoming a common procedure for individuals aged 50 or more who are at risk of developing colorectal cancer (CRC), colon video data is being accumulated at an ever increasing rate. However, the clinically valuable information contained in these videos is not being maximally exploited to improve patient care and accelerate the development of new screening methods. One of the well-known difficulties in colonoscopy video analysis is the abundance of frames with no diagnostic information. Approximately 40% - 50% of the frames in a colonoscopy video are contaminated by noise, acquisition errors, glare, blur, and uneven illumination. Therefore, filtering out low quality frames containing no diagnostic information can significantly improve the efficiency of colonoscopy video analysis. To address this challenge, we present a quality assessment algorithm to detect and remove low quality, uninformative frames. The goal of our algorithm is to discard low quality frames while retaining all diagnostically relevant information. Our algorithm is based on a hidden Markov model (HMM) in combination with two measures of data quality to filter out uninformative frames. Furthermore, we present a two-level framework based on an embedded hidden Markov model (EHHM) to incorporate the proposed quality assessment algorithm into a complete, automated diagnostic image analysis system for colonoscopy video.

  9. Development of a sub-cm high resolution ion Doppler tomography diagnostics for fine structure measurement of guide field reconnection in TS-U

    NASA Astrophysics Data System (ADS)

    Tanabe, Hiroshi; Koike, Hideya; Hatano, Hironori; Hayashi, Takumi; Cao, Qinghong; Himeno, Shunichi; Kaneda, Taishi; Akimitsu, Moe; Sawada, Asuka; Ono, Yasushi

    2017-10-01

    A new type of high-throughput/high-resolution 96CH ion Doppler tomography diagnostics has been developed using ``multi-slit'' spectroscopy technique for detailed investigation of fine structure formation during high guide field magnetic reconnection. In the last three years, high field merging experiment in MAST pioneered new frontiers of reconnection heating: formation of highly peaked structure around X-point in high guide field condition (Bt > 0.3 T), outflow dissipation under the influence of better plasma confinement to form high temperature ring structure which aligns with closed flux surface of toroidal plasma, and interaction between ion and electron temperature profile during transport/confinement phase to form triple peak structure (τeiE 4 ms). To investigate more detailed mechanism with in-situ magnetic measurement, the university of Tokyo starts the upgrade of plasma parameters and spatial resolution of optical diagnostics as in MAST. Now, a new type of high-throughput/high-resolution 96CH ion Doppler tomography diagnostics system construction has been completed and it successfully resolved fine structure of ion heating downstream, aligned with closed flux surface formed by reconnected field. This work was supported by JSPS KAKENHI Grant Numbers 15H05750, 15K14279 and 17H04863.

  10. Performance evaluation of Sanger sequencing for the diagnosis of primary hyperoxaluria and comparison with targeted next generation sequencing

    PubMed Central

    Williams, Emma L; Bagg, Eleanor A L; Mueller, Michael; Vandrovcova, Jana; Aitman, Timothy J; Rumsby, Gill

    2015-01-01

    Definitive diagnosis of primary hyperoxaluria (PH) currently utilizes sequential Sanger sequencing of the AGXT, GRPHR, and HOGA1 genes but efficacy is unproven. This analysis is time-consuming, relatively expensive, and delays in diagnosis and inappropriate treatment can occur if not pursued early in the diagnostic work-up. We reviewed testing outcomes of Sanger sequencing in 200 consecutive patient samples referred for analysis. In addition, the Illumina Truseq custom amplicon system was evaluated for paralleled next-generation sequencing (NGS) of AGXT,GRHPR, and HOGA1 in 90 known PH patients. AGXT sequencing was requested in all patients, permitting a diagnosis of PH1 in 50%. All remaining patients underwent targeted exon sequencing of GRHPR and HOGA1 with 8% diagnosed with PH2 and 8% with PH3. Complete sequencing of both GRHPR and HOGA1 was not requested in 25% of patients referred leaving their diagnosis in doubt. NGS analysis showed 98% agreement with Sanger sequencing and both approaches had 100% diagnostic specificity. Diagnostic sensitivity of Sanger sequencing was 98% and for NGS it was 97%. NGS has comparable diagnostic performance to Sanger sequencing for the diagnosis of PH and, if implemented, would screen for all forms of PH simultaneously ensuring prompt diagnosis at decreased cost. PMID:25629080

  11. STARD 2015: An Updated List of Essential Items for Reporting Diagnostic Accuracy Studies.

    PubMed

    Bossuyt, Patrick M; Reitsma, Johannes B; Bruns, David E; Gatsonis, Constantine A; Glasziou, Paul P; Irwig, Les; Lijmer, Jeroen G; Moher, David; Rennie, Drummond; de Vet, Henrica C W; Kressel, Herbert Y; Rifai, Nader; Golub, Robert M; Altman, Douglas G; Hooft, Lotty; Korevaar, Daniël A; Cohen, Jérémie F

    2015-12-01

    Incomplete reporting has been identified as a major source of avoidable waste in biomedical research. Essential information is often not provided in study reports, impeding the identification, critical appraisal, and replication of studies. To improve the quality of reporting of diagnostic accuracy studies, the Standards for Reporting of Diagnostic Accuracy Studies (STARD) statement was developed. Here we present STARD 2015, an updated list of 30 essential items that should be included in every report of a diagnostic accuracy study. This update incorporates recent evidence about sources of bias and variability in diagnostic accuracy and is intended to facilitate the use of STARD. As such, STARD 2015 may help to improve completeness and transparency in reporting of diagnostic accuracy studies.

  12. He Did What?: The role of diagnosticity in revising implicit evaluations

    PubMed Central

    Cone, Jeremy; Ferguson, Melissa J.

    2015-01-01

    Research suggests that implicit evaluations are relatively insensitive to single instances of new, countervailing information that contradicts prior learning. In six experiments, however, we identify the critical role of the perceived diagnosticity of that new information: counter-attitudinal information that is deemed highly diagnostic of the target's true nature leads to a complete reversal of the previous implicit evaluation. Experiments 1a and 1b establish this effect by showing that newly-formed implicit evaluations are reversed minutes later with exposure to a single piece of highly diagnostic information. Experiment 2 demonstrates a valence asymmetry in participants’ likelihood of exhibiting rapid reversals of newly formed positive versus negative implicit evaluations. Experiment 3 provides evidence that a target must be personally responsible for the counter-attitudinal behavior and not merely incidentally associated with a negative act. Experiment 4 shows that participants exhibit revision only when they judge the target's counter-attitudinal behavior as offensive and thus diagnostic of his character. Experiment 5 demonstrates the behavioral implications of newly-revised implicit evaluations. These studies show that newly-formed implicit evaluations can be completely overturned through deliberative considerations about a single piece of counter-attitudinal information. PMID:25365037

  13. Towards case-based medical learning in radiological decision making using content-based image retrieval

    PubMed Central

    2011-01-01

    Background Radiologists' training is based on intensive practice and can be improved with the use of diagnostic training systems. However, existing systems typically require laboriously prepared training cases and lack integration into the clinical environment with a proper learning scenario. Consequently, diagnostic training systems advancing decision-making skills are not well established in radiological education. Methods We investigated didactic concepts and appraised methods appropriate to the radiology domain, as follows: (i) Adult learning theories stress the importance of work-related practice gained in a team of problem-solvers; (ii) Case-based reasoning (CBR) parallels the human problem-solving process; (iii) Content-based image retrieval (CBIR) can be useful for computer-aided diagnosis (CAD). To overcome the known drawbacks of existing learning systems, we developed the concept of image-based case retrieval for radiological education (IBCR-RE). The IBCR-RE diagnostic training is embedded into a didactic framework based on the Seven Jump approach, which is well established in problem-based learning (PBL). In order to provide a learning environment that is as similar as possible to radiological practice, we have analysed the radiological workflow and environment. Results We mapped the IBCR-RE diagnostic training approach into the Image Retrieval in Medical Applications (IRMA) framework, resulting in the proposed concept of the IRMAdiag training application. IRMAdiag makes use of the modular structure of IRMA and comprises (i) the IRMA core, i.e., the IRMA CBIR engine; and (ii) the IRMAcon viewer. We propose embedding IRMAdiag into hospital information technology (IT) infrastructure using the standard protocols Digital Imaging and Communications in Medicine (DICOM) and Health Level Seven (HL7). Furthermore, we present a case description and a scheme of planned evaluations to comprehensively assess the system. Conclusions The IBCR-RE paradigm incorporates a novel combination of essential aspects of diagnostic learning in radiology: (i) Provision of work-relevant experiences in a training environment integrated into the radiologist's working context; (ii) Up-to-date training cases that do not require cumbersome preparation because they are provided by routinely generated electronic medical records; (iii) Support of the way adults learn while remaining suitable for the patient- and problem-oriented nature of medicine. Future work will address unanswered questions to complete the implementation of the IRMAdiag trainer. PMID:22032775

  14. Towards case-based medical learning in radiological decision making using content-based image retrieval.

    PubMed

    Welter, Petra; Deserno, Thomas M; Fischer, Benedikt; Günther, Rolf W; Spreckelsen, Cord

    2011-10-27

    Radiologists' training is based on intensive practice and can be improved with the use of diagnostic training systems. However, existing systems typically require laboriously prepared training cases and lack integration into the clinical environment with a proper learning scenario. Consequently, diagnostic training systems advancing decision-making skills are not well established in radiological education. We investigated didactic concepts and appraised methods appropriate to the radiology domain, as follows: (i) Adult learning theories stress the importance of work-related practice gained in a team of problem-solvers; (ii) Case-based reasoning (CBR) parallels the human problem-solving process; (iii) Content-based image retrieval (CBIR) can be useful for computer-aided diagnosis (CAD). To overcome the known drawbacks of existing learning systems, we developed the concept of image-based case retrieval for radiological education (IBCR-RE). The IBCR-RE diagnostic training is embedded into a didactic framework based on the Seven Jump approach, which is well established in problem-based learning (PBL). In order to provide a learning environment that is as similar as possible to radiological practice, we have analysed the radiological workflow and environment. We mapped the IBCR-RE diagnostic training approach into the Image Retrieval in Medical Applications (IRMA) framework, resulting in the proposed concept of the IRMAdiag training application. IRMAdiag makes use of the modular structure of IRMA and comprises (i) the IRMA core, i.e., the IRMA CBIR engine; and (ii) the IRMAcon viewer. We propose embedding IRMAdiag into hospital information technology (IT) infrastructure using the standard protocols Digital Imaging and Communications in Medicine (DICOM) and Health Level Seven (HL7). Furthermore, we present a case description and a scheme of planned evaluations to comprehensively assess the system. The IBCR-RE paradigm incorporates a novel combination of essential aspects of diagnostic learning in radiology: (i) Provision of work-relevant experiences in a training environment integrated into the radiologist's working context; (ii) Up-to-date training cases that do not require cumbersome preparation because they are provided by routinely generated electronic medical records; (iii) Support of the way adults learn while remaining suitable for the patient- and problem-oriented nature of medicine. Future work will address unanswered questions to complete the implementation of the IRMAdiag trainer.

  15. A new dump system design for stray light reduction of Thomson scattering diagnostic system on EAST.

    PubMed

    Xiao, Shumei; Zang, Qing; Han, Xiaofeng; Wang, Tengfei; Yu, Jin; Zhao, Junyu

    2016-07-01

    Thomson scattering (TS) diagnostic is an important diagnostic for measuring electron temperature and density during plasma discharge. However, the measurement of Thomson scattering signal is disturbed by the stray light easily. The stray light sources in the Experimental Advanced Superconducting Tokamak (EAST) TS diagnostic system were analyzed by a simulation model of the diagnostic system, and simulation results show that the dump system is the primary stray light source. Based on the optics theory and the simulation analysis, a novel dump system including an improved beam trap was proposed and installed. The measurement results indicate that the new dump system can reduce more than 60% of the stray light for the diagnostic system, and the influence of stray light on the error of measured density decreases.

  16. Comparison of the diagnostic yield and outcomes between standard 8 h capsule endoscopy and the new 12 h capsule endoscopy for investigating small bowel pathology.

    PubMed

    Rahman, Merajur; Akerman, Stuart; DeVito, Bethany; Miller, Larry; Akerman, Meredith; Sultan, Keith

    2015-05-14

    To evaluate the completion rate and diagnostic yield of the PillCam SB2-ex in comparison to the PillCam SB2. Two hundred cases using the 8-h PillCam SB2 were retrospectively compared to 200 cases using the 12 h PillCam SB2-ex at a tertiary academic center. Endoscopically placed capsules were excluded from the study. Demographic information, indications for capsule endoscopy, capsule type, study length, completion of exam, clinically significant findings, timestamp of most distant finding, and significant findings beyond 8 h were recorded. The 8 and 12 h capsule groups were well matched respectively for both age (70.90 ± 14.19 vs 71.93 ± 13.80, P = 0.46) and gender (45.5% vs 48% male, P = 0.69). The most common indications for the procedure in both groups were anemia and obscure gastrointestinal bleeding. PillCam SB2-ex had a significantly higher completion rate than PillCam SB2 (88% vs 79.5%, P = 0.03). Overall, the diagnostic yield was greater for the 8 h capsule (48.5% for SB2 vs 35% for SB2-ex, P = 0.01). In 4/70 (5.7%) of abnormal SB2-ex exams the clinically significant finding was noted in the small bowel beyond the 8 h mark. In our study, we found the PillCam SB2-ex to have a significantly increased completion rate, though without any improvement in diagnostic yield compared to the PillCam SB2.

  17. Embedding CLIPS in a database-oriented diagnostic system

    NASA Technical Reports Server (NTRS)

    Conway, Tim

    1990-01-01

    This paper describes the integration of C Language Production Systems (CLIPS) into a powerful portable maintenance aid (PMA) system used for flightline diagnostics. The current diagnostic target of the system is the Garrett GTCP85-180L, a gas turbine engine used as an Auxiliary Power Unit (APU) on some C-130 military transport aircraft. This project is a database oriented approach to a generic diagnostic system. CLIPS is used for 'many-to-many' pattern matching within the diagnostics process. Patterns are stored in database format, and CLIPS code is generated by a 'compilation' process on the database. Multiple CLIPS rule sets and working memories (in sequence) are supported and communication between the rule sets is achieved via the export and import commands. Work is continuing on using CLIPS in other portions of the diagnostic system and in re-implementing the diagnostic system in the Ada language.

  18. Evaluating the performance of a fault detection and diagnostic system for vapor compression equipment

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Breuker, M.S.; Braun, J.E.

    This paper presents a detailed evaluation of the performance of a statistical, rule-based fault detection and diagnostic (FDD) technique presented by Rossi and Braun (1997). Steady-state and transient tests were performed on a simple rooftop air conditioner over a range of conditions and fault levels. The steady-state data without faults were used to train models that predict outputs for normal operation. The transient data with faults were used to evaluate FDD performance. The effect of a number of design variables on FDD sensitivity for different faults was evaluated and two prototype systems were specified for more complete evaluation. Good performancemore » was achieved in detecting and diagnosing five faults using only six temperatures (2 input and 4 output) and linear models. The performance improved by about a factor of two when ten measurements (three input and seven output) and higher order models were used. This approach for evaluating and optimizing the performance of the statistical, rule-based FDD technique could be used as a design and evaluation tool when applying this FDD method to other packaged air-conditioning systems. Furthermore, the approach could also be modified to evaluate the performance of other FDD methods.« less

  19. [Intranet-based integrated information system of radiotherapy-related images and diagnostic reports].

    PubMed

    Nakamura, R; Sasaki, M; Oikawa, H; Harada, S; Tamakawa, Y

    2000-03-01

    To use an intranet technique to develop an information system that simultaneously supports both diagnostic reports and radiotherapy planning images. Using a file server as the gateway a radiation oncology LAN was connected to an already operative RIS LAN. Dose-distribution images were saved in tagged-image-file format by way of a screen dump to the file server. X-ray simulator images and portal images were saved in encapsulated postscript format in the file server and automatically converted to portable document format. The files on the file server were automatically registered to the Web server by the search engine and were available for searching and browsing using the Web browser. It took less than a minute to register planning images. For clients, searching and browsing the file took less than 3 seconds. Over 150,000 reports and 4,000 images from a six-month period were accessible. Because the intranet technique was used, construction and maintenance was completed without specialty. Prompt access to essential information about radiotherapy has been made possible by this system. It promotes public access to radiotherapy planning that may improve the quality of treatment.

  20. Improved spatial calibration for the CXRS system on EAST

    NASA Astrophysics Data System (ADS)

    Yin, X. H.; Li, Y. Y.; Fu, J.; Jiang, D.; Feng, S. Y.; Gu, Y. Q.; Cheng, Y.; Lyu, B.; Shi, Y. J.; Ye, M. Y.; Wan, B. N.

    2016-11-01

    A Charge eXchange Recombination Spectroscopy (CXRS) diagnostic system has been developed to measure profiles of ion temperature and rotation since 2014 on EAST. Several techniques have been developed to improve the spatial calibration of the CXRS diagnostic. The sightline location was obtained by measuring the coordinates of three points on each sightline using an articulated flexible coordinate measuring arm when the vessel was accessible. After vacuum pumping, the effect of pressure change in the vacuum vessel was evaluated by observing the movement of the light spot from back-illuminated sightlines on the first wall using the newly developed articulated inspection arm. In addition, the rotation of the periscope after vacuum pumping was derived by using the Doppler shift of neutral beam emission spectra without magnetic field. Combining these techniques, improved spatial calibration was implemented to provide a complete and accurate description of the EAST CXRS system. Due to the effects of the change of air pressure, a ˜0.4° periscope rotation, yielding a ˜20 mm movement of the major radius of observation positions to the lower field side, was derived. Results of Zeeman splitting of neutral beam emission spectra with magnetic field also showed good agreement with the calibration results.

  1. Training in Structured Diagnostic Assessment Using DSM-IV Criteria

    ERIC Educational Resources Information Center

    Ponniah, Kathryn; Weissman, Myrna M.; Bledsoe, Sarah E.; Verdeli, Helen; Gameroff, Marc J.; Mufson, Laura; Fitterling, Heidi; Wickramaratne, Priya

    2011-01-01

    Objectives: Determining a patient's psychiatric diagnosis is an important first step for the selection of empirically supported treatments and a critical component of evidence-based practice. Structured diagnostic assessment covers the range of psychiatric diagnoses and is usually more complete and accurate than unstructured assessment. Method: We…

  2. From Colorado to Guam: Infant Diagnostic Audiological Evaluations by Telepractice

    ERIC Educational Resources Information Center

    Hayes, Deborah; Eclavea, Elaine; Dreith, Susan; Habte, Bereket

    2012-01-01

    This manuscript describes a pilot project in which infants in Guam who refer on newborn hearing screening receive diagnostic audiological evaluation conducted by audiologists in Colorado over the Internet (telepractice). The evaluation is completed in real time using commercially-available software and personal computers to control the diagnostic…

  3. Internal Barriers to the Realization of Potential: Correlates and Interrelationships among Gifted and Talented Female Adolescents.

    ERIC Educational Resources Information Center

    Hollinger, Constance L.; Fleming, Elyse S.

    1984-01-01

    Gifted female adolescents (N=284) completed comprehensive career assessment batteries. Examination of diagnostic criteria and associated personality dimensions revealed commonalities and differences among the six diagnostic groups. Findings suggest the need for encouraging the students with low assertiveness or low achievement motivation to…

  4. A diagnostic interface for the ICOsahedral Non-hydrostatic (ICON) modelling framework based on the Modular Earth Submodel System (MESSy v2.50)

    NASA Astrophysics Data System (ADS)

    Kern, Bastian; Jöckel, Patrick

    2016-10-01

    Numerical climate and weather models have advanced to finer scales, accompanied by large amounts of output data. The model systems hit the input and output (I/O) bottleneck of modern high-performance computing (HPC) systems. We aim to apply diagnostic methods online during the model simulation instead of applying them as a post-processing step to written output data, to reduce the amount of I/O. To include diagnostic tools into the model system, we implemented a standardised, easy-to-use interface based on the Modular Earth Submodel System (MESSy) into the ICOsahedral Non-hydrostatic (ICON) modelling framework. The integration of the diagnostic interface into the model system is briefly described. Furthermore, we present a prototype implementation of an advanced online diagnostic tool for the aggregation of model data onto a user-defined regular coarse grid. This diagnostic tool will be used to reduce the amount of model output in future simulations. Performance tests of the interface and of two different diagnostic tools show, that the interface itself introduces no overhead in form of additional runtime to the model system. The diagnostic tools, however, have significant impact on the model system's runtime. This overhead strongly depends on the characteristics and implementation of the diagnostic tool. A diagnostic tool with high inter-process communication introduces large overhead, whereas the additional runtime of a diagnostic tool without inter-process communication is low. We briefly describe our efforts to reduce the additional runtime from the diagnostic tools, and present a brief analysis of memory consumption. Future work will focus on optimisation of the memory footprint and the I/O operations of the diagnostic interface.

  5. Next Generation Quality: Assessing the Physician in Clinical History Completeness and Diagnostic Interpretations Using Funnel Plots and Normalized Deviations Plots in 3,854 Prostate Biopsies.

    PubMed

    Bonert, Michael; El-Shinnawy, Ihab; Carvalho, Michael; Williams, Phillip; Salama, Samih; Tang, Damu; Kapoor, Anil

    2017-01-01

    Observational data and funnel plots are routinely used outside of pathology to understand trends and improve performance. Extract diagnostic rate (DR) information from free text surgical pathology reports with synoptic elements and assess whether inter-rater variation and clinical history completeness information useful for continuous quality improvement (CQI) can be obtained. All in-house prostate biopsies in a 6-year period at two large teaching hospitals were extracted and then diagnostically categorized using string matching, fuzzy string matching, and hierarchical pruning. DRs were then stratified by the submitting physicians and pathologists. Funnel plots were created to assess for diagnostic bias. 3,854 prostate biopsies were found and all could be diagnostically classified. Two audits involving the review of 700 reports and a comparison of the synoptic elements with the free text interpretations suggest a categorization error rate of <1%. Twenty-seven pathologists each read >40 cases and together assessed 3,690 biopsies. There was considerable inter-rater variability and a trend toward more World Health Organization/International Society of Urologic Pathology Grade 1 cancers in older pathologists. Normalized deviations plots, constructed using the median DR, and standard error can elucidate associated over- and under-calls for an individual pathologist in relation to their practice group. Clinical history completeness by submitting medical doctor varied significantly (100% to 22%). Free text data analyses have some limitations; however, they could be used for data-driven CQI in anatomical pathology, and could lead to the next generation in quality of care.

  6. Reducing beam shaper alignment complexity: diagnostic techniques for alignment and tuning

    NASA Astrophysics Data System (ADS)

    Lizotte, Todd E.

    2011-10-01

    Safe and efficient optical alignment is a critical requirement for industrial laser systems used in a high volume manufacturing environment. Of specific interest is the development of techniques to align beam shaping optics within a beam line; having the ability to instantly verify by a qualitative means that each element is in its proper position as the beam shaper module is being aligned. There is a need to reduce these types of alignment techniques down to a level where even a newbie to optical alignment will be able to complete the task. Couple this alignment need with the fact that most laser system manufacturers ship their products worldwide and the introduction of a new set of variables including cultural and language barriers, makes this a top priority for manufacturers. Tools and methodologies for alignment of complex optical systems need to be able to cross these barriers to ensure the highest degree of up time and reduce the cost of maintenance on the production floor. Customers worldwide, who purchase production laser equipment, understand that the majority of costs to a manufacturing facility is spent on system maintenance and is typically the largest single controllable expenditure in a production plant. This desire to reduce costs is driving the trend these days towards predictive and proactive, not reactive maintenance of laser based optical beam delivery systems [10]. With proper diagnostic tools, laser system developers can develop proactive approaches to reduce system down time, safe guard operational performance and reduce premature or catastrophic optics failures. Obviously analytical data will provide quantifiable performance standards which are more precise than qualitative standards, but each have a role in determining overall optical system performance [10]. This paper will discuss the use of film and fluorescent mirror devices as diagnostic tools for beam shaper module alignment off line or in-situ. The paper will also provide an overview methodology showing how it is possible to reduce complex alignment directions into a simplified set of instructions for layman service engineers.

  7. Reusable Rocket Engine Turbopump Health Management System

    NASA Technical Reports Server (NTRS)

    Surko, Pamela

    1994-01-01

    A health monitoring expert system software architecture has been developed to support condition-based health monitoring of rocket engines. Its first application is in the diagnosis decisions relating to the health of the high pressure oxidizer turbopump (HPOTP) of Space Shuttle Main Engine (SSME). The post test diagnostic system runs off-line, using as input the data recorded from hundreds of sensors, each running typically at rates of 25, 50, or .1 Hz. The system is invoked after a test has been completed, and produces an analysis and an organized graphical presentation of the data with important effects highlighted. The overall expert system architecture has been developed and documented so that expert modules analyzing other line replaceable units may easily be added. The architecture emphasizes modularity, reusability, and open system interfaces so that it may be used to analyze other engines as well.

  8. Evaluation of telemedicine in the management of dentogenous infections.

    PubMed

    Miladinović, Milan; Mladenović, Dragan; Mihailović, Branko; Djndjić, Goran Tosić Boris; Mladenović, Sanja; Hadzibeti, Mervan; Vujicić, Biljana

    2013-06-01

    The first written evidence of telemedicine dates back to the times of Sava Nemanjić (the end of 12th and the beginning of 13th century). Nowadays, the use of telemedicine in Serbia gains momentum, and the cause of this lies in the creation of a central telemedicine system XPA3 Online and the establishment of the Center for Telemedicine at the Faculty of Medicine, University of Pristina/Kosovska Mitrovica, Kosovska Mitrovica, Serbia. Dentogenous infections are among the most urgent conditions in dentistry, which may have even a fatal outcome. The aim of this study was to assess the possibility of using telemedicine methods in the pathology of dentogenous infections. This experimental randomized study included 414 patients with suspected dentogenous infection. The patients were enrolled at 7 sites, with systematic photograph-taking, collection, and digitalization of the available anamnestic and laboratory data, tests, and x-rays. Together with clinical findings, the data were uploaded on the XPA3 Online central telemedicine system; after that, 10 teleconsultants reviewed the material, set the diagnosis, and gave their opinion about the treatment. The agreement was determined using the Cohen's kappa (i) coefficient, as well as diagnostic sensitivity (SE), specificity (SP), and efficacy (EFF). Statistical significance and comparisons were done using the z-test, and testing nonparametric properties using the McNemar's X2-test for the significance threshold ofp = 0.05. The results describing agreement of telemedicine diagnosis of the areas primarily involved with infection compared to clinical inspection, indicate an almost complete diagnostic agreement (kappa= 0.971). Diagnostic agreement as to the type of infection was also almost complete (kappa = 0.951), and a similar value was obtained also for the treatment agreement (kappa> =0.892). The method of telemedicine provides us with a tool to make a correct clinical diagnosis of dentogenous infections equally well as in real time, as well as to get a deeper and wider insight into their nature and to suggest adequate treatments.

  9. NE-213-scintillator-based neutron detection system for diagnostic measurements of energy spectra for neutrons having energies greater than or equal to 0.8 MeV created during plasma operations at the Princeton Tokamak Fusion Test Reactor

    NASA Astrophysics Data System (ADS)

    Dickens, J. K.; Hill, N. W.; Hou, F. S.; McConnell, J. W.; Spencer, R. R.; Tsang, F. Y.

    1985-08-01

    A system for making diagnostic measurements of the energy spectra of greater than or equal to 0.8-MeV neutrons produced during plasma operations of the Princeton Tokamak Fusion Test Reactor (TFTR) has been fabricated and tested and is presently in operation in the TFTR Test Cell Basement. The system consists of two separate detectors, each made up of cells containing liquid NE-213 scintillator attached permanently to RCA-8850 photomultiplier tubes. Pulses obtained from each photomultiplier system are amplified and electronically analyzed to identify and separate those pulses due to neutron-induced events in the detector from those due to photon-induced events in the detector. Signals from each detector are routed to two separate Analog-to-Digital Converters, and the resulting digitized information, representing: (1) the raw neutron-spectrum data; and (2) the raw photon-spectrum data, are transmited to the CICADA data-acquisition computer system of the TFTR. Software programs have been installed on the CICADA system to analyze the raw data to provide moderate-resolution recreations of the energy spectrum of the neutron and photon fluences incident on the detector during the operation of the TFTR. A complete description of, as well as the operation of, the hardware and software is given in this report.

  10. Multi-spectral fiber spectroscopy in 0,4-16μm range for biomedical applications(Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Artyushenko, Viacheslav

    2017-02-01

    Various biomedical applications of fiber optics in a broad spectral range 0,4-16μm span from endoscopic imaging and Photo Dynamic Diagnostics (PDD) to laser power delivery for minimal invasive laser surgery, tissue coagulation and welding, Photo Dynamic Therapy (PDT), etc. Present review will highlight the latest results in advanced fiber solutions for a precise tissue diagnostics and control of some therapy methods - for so called "theranostic". Spectral fiber sensing for label free analysis of tissue composition helps to differentiate malignant and normal tissue to secure minimal invasive, but complete tumor removal or treatment. All key methods of Raman, fluorescence, diffuse reflection & MIR-absorption spectroscopy will be compared when used for the same spot of tissue - to select the most specific, sensitive and accurate method or to combine them for the synergy enhanced effect. The most informative spectral features for distinct organs/ tumor can be used to design special fiber sensors to be developed for portable and low cost applications with modern IT-features. Examples of multi-spectral tissue diagnostics promising for the future clinical applications will be presented to enable reduced mortality from cancer in the future. Translation of described methods into clinical practice will be discussed in comparison with the other method of optical diagnostics which should enhance modern medicine by less invasive, more precise and more effective methods of therapy to be fused with in-vivo diagnostics sensors & systems.

  11. Comparison of the diagnostic quality of computed tomography images of normal ocular and orbital structures acquired with and without the use of general anesthesia in the cat.

    PubMed

    Collins, Sean P; Matheson, Jodi S; Hamor, Ralph E; Mitchell, Mark A; Labelle, Amber L; O'Brien, Robert T

    2013-09-01

    To compare the diagnostic quality of computed tomography (CT) images of normal ocular and orbital structures acquired with and without the use of general anesthesia in the cat. Eleven privately owned cats with nasal disease presenting to a single referral hospital. All cats received a complete ophthalmic examination. A 16 multislice helical CT system was utilized to acquire images of the skull and neck with and without the use of general anesthesia. Images were acquired before and after the administration of intravenous iodinated contrast. Images of normal ocular and orbital structures were evaluated via consensus by two board-certified radiologists. Visibility of ocular and orbital structures, degree of motion, and streak artifact were assessed and scored for each image set in the transverse, dorsal, and sagittal planes. The use of general anesthesia did not significantly affect the diagnostic quality of images. No motion artifact was observed in any CT image. Streak artifact was significantly increased in scans performed in the transverse orientation but not in the dorsal orientation or sagittal orientation and did not affect the diagnostic quality of the images. Contrast enhancement did not significantly enhance the visibility of any ocular or orbital structures. Diagnostic CT images of normal ocular and orbital structures can be acquired without the use of general anesthesia in the cat. © 2012 American College of Veterinary Ophthalmologists.

  12. A lab-on-a-chip system with integrated sample preparation and loop-mediated isothermal amplification for rapid and quantitative detection of Salmonella spp. in food samples.

    PubMed

    Sun, Yi; Quyen, Than Linh; Hung, Tran Quang; Chin, Wai Hoe; Wolff, Anders; Bang, Dang Duong

    2015-04-21

    Foodborne disease is a major public health threat worldwide. Salmonellosis, an infectious disease caused by Salmonella spp., is one of the most common foodborne diseases. Isolation and identification of Salmonella by conventional bacterial culture or molecular-based methods are time consuming and usually take a few hours to days to complete. In response to the demand for rapid on line or on site detection of pathogens, in this study, we describe for the first time an eight-chamber lab-on-a-chip (LOC) system with integrated magnetic bead-based sample preparation and loop-mediated isothermal amplification (LAMP) for rapid and quantitative detection of Salmonella spp. in food samples. The whole diagnostic procedures including DNA isolation, isothermal amplification, and real-time detection were accomplished in a single chamber. Up to eight samples could be handled simultaneously and the system was capable to detect Salmonella at concentration of 50 cells per test within 40 min. The simple design, together with high level of integration, isothermal amplification, and quantitative analysis of multiple samples in short time, will greatly enhance the practical applicability of the LOC system for rapid on-site screening of Salmonella for applications in food safety control, environmental surveillance, and clinical diagnostics.

  13. Oral Biofluid Biomarker Research: Current Status and Emerging Frontiers

    PubMed Central

    Wang, Austin; Wang, Chris P.; Tu, Michael; Wong, David T.W.

    2016-01-01

    Salivary diagnostics is a rapidly advancing field that offers clinicians and patients the potential of rapid, noninvasive diagnostics with excellent accuracy. In order for the complete realization of the potential of saliva, however, extensive profiling of constituents must be conducted and diagnostic biomarkers must be thoroughly validated. This article briefly overviews the process of conducting a study of salivary biomarkers in a patient cohort and highlights the studies that have been conducted on different classes of molecules in the saliva. Emerging frontiers in salivary diagnostics research that may significantly advance the field will also be highlighted. PMID:27999326

  14. How to Use the DX SYSTEM of Diagnostic Testing. Methodology Project.

    ERIC Educational Resources Information Center

    McArthur, David; Cabello, Beverly

    The DX SYSTEM of Diagnostic Testing is an easy-to-use computerized system for developing and administering diagnostic tests. A diagnostic test measures a student's mastery of a specific domain (skill or content area). It examines the necessary subskills hierarchically from the most to the least complex. The DX SYSTEM features tailored testing with…

  15. A comparison of rating scales used in the diagnosis of extraesophageal reflux.

    PubMed

    Musser, Joy; Kelchner, Lisa; Neils-Strunjas, Jean; Montrose, Marshall

    2011-05-01

    To evaluate the level of agreement between reflux area index scores, the reflux symptom index (RSI), and the reflux finding score (RFS). Inter- and intrarater reliability of the RFS was assessed. A criterion of pH 5 was used to evaluate its effects on agreement. Adult participants were enrolled in this prospective study. Eighty-two participants (72 patients and 10 controls) completed the RSI, videoendoscopy, and 24-hour pH probe monitoring. The reflux area index for extraesophageal reflux (EER) events was calculated at pH 4 and 5. Two speech-language pathologists and one otolaryngologist independently rated 36 endoscopic examinations using the RFS through a web-based system. A repeated rating of six examinations was completed. Chi-square revealed poor agreement between the diagnostic tools, regardless of which pH criterion was used. Intraclass correlation coefficients revealed fair interrater reliability of the RFS and moderate intrarater reliability. Independent-sample t tests for the RFS and reflux area index (RAI) scores failed to identify patients from normal controls. The results of this study highlight the lack of agreement among the current available diagnostic tools for EER. Raters were not in agreement regarding the presence and severity of physical findings of EER. Results support the need for greater consensus among the clinical tools used in the diagnosis of EER. Physical rating scales may overidentify patients and would benefit from uniform scales and training. Assessing EER occurring at pH 5 may also yield important diagnostic information. Further research is needed to verify normative RAI cutpoints. Copyright © 2011 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  16. Efficient fault diagnosis of helicopter gearboxes

    NASA Technical Reports Server (NTRS)

    Chin, H.; Danai, K.; Lewicki, D. G.

    1993-01-01

    Application of a diagnostic system to a helicopter gearbox is presented. The diagnostic system is a nonparametric pattern classifier that uses a multi-valued influence matrix (MVIM) as its diagnostic model and benefits from a fast learning algorithm that enables it to estimate its diagnostic model from a small number of measurement-fault data. To test this diagnostic system, vibration measurements were collected from a helicopter gearbox test stand during accelerated fatigue tests and at various fault instances. The diagnostic results indicate that the MVIM system can accurately detect and diagnose various gearbox faults so long as they are included in training.

  17. Early Life Stress, Mood, and Anxiety Disorders.

    PubMed

    Syed, Shariful A; Nemeroff, Charles B

    2017-02-01

    Early life stress has been shown to exert profound short- and long-term effects on human physiology both in the central nervous system and peripherally. Early life stress has demonstrated clear association with many psychiatric disorders including major depression, posttraumatic stress disorder, and bipolar disorder. The Diagnostic and Statistics Manuel of Mental Disorders (DSM) diagnostic categorical system has served as a necessary framework for clinical service, delivery, and research, however has not been completely matching the neurobiological research perspective. Early life stress presents a complex dynamic featuring a wide spectrum of physiologic alterations: from epigenetic alterations, inflammatory changes, to dysregulation of the hypothalamic pituitary axis and has further added to the challenge of identifying biomarkers associated with psychiatric disorders. The National Institute of Mental Health's proposed Research Domain Criteria initiative incorporates a dimensional approach to assess discrete domains and constructs of behavioral function that are subserved by identifiable neural circuits. The current neurobiology of early life stress is reviewed in accordance with dimensional organization of Research Domain Criteria matrix and how the findings as a whole fit within the Research Domain Criteria frameworks.

  18. Overview of laser systems for the Orion facility at the AWE.

    PubMed

    Hopps, Nicholas; Danson, Colin; Duffield, Stuart; Egan, David; Elsmere, Stephen; Girling, Mark; Harvey, Ewan; Hillier, David; Norman, Michael; Parker, Stefan; Treadwell, Paul; Winter, David; Bett, Thomas

    2013-05-20

    The commissioning of the Orion laser facility at the Atomic Weapons Establishment (AWE) in the UK has recently been completed. The facility is a twelve beam Nd:glass-based system for studying high energy density physics. It consists of ten frequency-tripled beam-lines operating with nanosecond pulses, synchronized with two beam-lines with subpicosecond pulses, each capable of delivering 500 J to target. One of the short pulse beams has the option of frequency doubling, at reduced aperture, to yield up to 100 J at 527 nm in a subpicosecond pulse with high temporal contrast. An extensive array of target diagnostics is provided. This article describes the laser design and commissioning and presents key performance data of the facility's laser systems.

  19. Acceptance of a structured diagnostic interview in children, parents, and interviewers.

    PubMed

    Neuschwander, Murielle; In-Albon, Tina; Meyer, Andrea H; Schneider, Silvia

    2017-09-01

    The objective of this study was to investigate the satisfaction and acceptance of a structured diagnostic interview in clinical practice and in a research setting. Using the Structured Diagnostic Interview for Mental Disorders in Children and Adolescents (Kinder-DIPS), 28 certified interviewers conducted 202 interviews (115 with parents, 87 with children). After each interview, children, parents, and interviewers completed a questionnaire assessing the overall satisfaction (0 = not at all satisfied to 100 = totally satisfied) and acceptance (0 = completely disagree to 3 = completely agree) with the interview. Satisfaction ratings were highly positive, all means >82. The mean of the overall acceptance for children was 2.43 (standard deviation [SD] = 0.41), 2.54 (SD = 0.33) of the parents, 2.30 (SD = 0.43) of the children's interviewers, and 2.46 (SD = 0.32) of the parents' interviewers. Using separate univariate regression models, significant predictors for higher satisfaction and acceptance with the interview are higher children's Global Assessment of Functioning, fewer number of children's diagnoses, shorter duration of the interview, a research setting, female sex of the interviewer, and older age of the interviewer. Results indicate that structured diagnostic interviews are highly accepted by children, parents, and interviewers. Importantly, this is true for different treatment settings. Copyright © 2017 John Wiley & Sons, Ltd.

  20. 40 CFR 86.1806-01 - On-board diagnostics.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    .... The emission control diagnostic system shall record and store in computer memory diagnostic trouble... or system, “freeze frame” engine conditions present at the time shall be stored in computer memory... equipped with an onboard diagnostic (OBD) system capable of monitoring, for each vehicle's useful life, all...

  1. 40 CFR 86.1806-01 - On-board diagnostics.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    .... The emission control diagnostic system shall record and store in computer memory diagnostic trouble... or system, “freeze frame” engine conditions present at the time shall be stored in computer memory... equipped with an onboard diagnostic (OBD) system capable of monitoring, for each vehicle's useful life, all...

  2. 40 CFR 86.1806-01 - On-board diagnostics.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    .... The emission control diagnostic system shall record and store in computer memory diagnostic trouble... or system, “freeze frame” engine conditions present at the time shall be stored in computer memory... equipped with an onboard diagnostic (OBD) system capable of monitoring, for each vehicle's useful life, all...

  3. Bilateral Complete and Incomplete Fusion of Incisors and its Management.

    PubMed

    Da Costa, Godwin Clovis; Chalakkal, Paul; De Souza, Neil; Gavhane, Sanket

    2017-01-01

    This case report highlights the management of a case of bilateral complete and incomplete fusion of maxillary incisors in a 10-year-old child. A mock-up was done on the diagnostic cast. Pretreatment esthetic evaluation was done using bis-acryl composite temporaries which were transferred intraorally from the diagnostic cast using a putty index. An incisal overlap veneer preparation was done, following which, an IPS e-max veneer was cemented. A digital mock-up was carried out using the Adobe Photoshop and Corel Draw softwares to aid in laboratorial fabrication of the veneer.

  4. STARD 2015: An Updated List of Essential Items for Reporting Diagnostic Accuracy Studies.

    PubMed

    Bossuyt, Patrick M; Reitsma, Johannes B; Bruns, David E; Gatsonis, Constantine A; Glasziou, Paul P; Irwig, Les; Lijmer, Jeroen G; Moher, David; Rennie, Drummond; de Vet, Henrica C W; Kressel, Herbert Y; Rifai, Nader; Golub, Robert M; Altman, Douglas G; Hooft, Lotty; Korevaar, Daniël A; Cohen, Jérémie F

    2015-12-01

    Incomplete reporting has been identified as a major source of avoidable waste in biomedical research. Essential information is often not provided in study reports, impeding the identification, critical appraisal, and replication of studies. To improve the quality of reporting of diagnostic accuracy studies, the Standards for Reporting of Diagnostic Accuracy Studies (STARD) statement was developed. Here we present STARD 2015, an updated list of 30 essential items that should be included in every report of a diagnostic accuracy study. This update incorporates recent evidence about sources of bias and variability in diagnostic accuracy and is intended to facilitate the use of STARD. As such, STARD 2015 may help to improve completeness and transparency in reporting of diagnostic accuracy studies. © 2015 American Association for Clinical Chemistry.

  5. Year 2 Report: Protein Function Prediction Platform

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Zhou, C E

    2012-04-27

    Upon completion of our second year of development in a 3-year development cycle, we have completed a prototype protein structure-function annotation and function prediction system: Protein Function Prediction (PFP) platform (v.0.5). We have met our milestones for Years 1 and 2 and are positioned to continue development in completion of our original statement of work, or a reasonable modification thereof, in service to DTRA Programs involved in diagnostics and medical countermeasures research and development. The PFP platform is a multi-scale computational modeling system for protein structure-function annotation and function prediction. As of this writing, PFP is the only existing fullymore » automated, high-throughput, multi-scale modeling, whole-proteome annotation platform, and represents a significant advance in the field of genome annotation (Fig. 1). PFP modules perform protein functional annotations at the sequence, systems biology, protein structure, and atomistic levels of biological complexity (Fig. 2). Because these approaches provide orthogonal means of characterizing proteins and suggesting protein function, PFP processing maximizes the protein functional information that can currently be gained by computational means. Comprehensive annotation of pathogen genomes is essential for bio-defense applications in pathogen characterization, threat assessment, and medical countermeasure design and development in that it can short-cut the time and effort required to select and characterize protein biomarkers.« less

  6. Demonstration of a real-time interferometer as a bunch-length monitor in a high-current electron beam accelerator.

    PubMed

    Thangaraj, J; Andonian, G; Thurman-Keup, R; Ruan, J; Johnson, A S; Lumpkin, A; Santucci, J; Maxwell, T; Murokh, A; Ruelas, M; Ovodenko, A

    2012-04-01

    A real-time interferometer (RTI) has been developed to monitor the bunch length of an electron beam in an accelerator. The RTI employs spatial autocorrelation, reflective optics, and a fast response pyro-detector array to obtain a real-time autocorrelation trace of the coherent radiation from an electron beam thus providing the possibility of online bunch-length diagnostics. A complete RTI system has been commissioned at the A0 photoinjector facility to measure sub-mm bunches at 13 MeV. Bunch length variation (FWHM) between 0.8 ps (~0.24 mm) and 1.5 ps (~0.45 mm) has been measured and compared with a Martin-Puplett interferometer and a streak camera. The comparisons show that RTI is a viable, complementary bunch length diagnostic for sub-mm electron bunches. © 2012 American Institute of Physics

  7. Metaphyseal chondrodysplasia.

    PubMed Central

    Spranger, J. W.

    1977-01-01

    Any review of the metaphyseal chondrodysplasias is complicated by their variety and mainly unknown pathogenesis. The more familiar types display considerable clinical and radiological diversity: even more so the rarer disorders which still require complete definition, but differences in their mode of inheritance make diagnostic precision mandatory. These dysplasias present in infancy or in childhood, when the patient, usually dwarfed, may be proportionate, so that some forms may be confused with rickets or other lesions. Mental retardation is unusual, but the skin, hair, nails and facies provide valuable diagnostic features. Radiological abnormalities mainly affect the metaphyses of the shortened limb bones, less often the skull, vertebrae, pelvis, ribs and extremities, and sometimes their distribution may indicate the specific type of dysplasia. In a further complex group multiple systems are involved, notably the pancreas, intestine and lympho-reticular, causing malabsorption and haematological or immunological disorders. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 PMID:335375

  8. Demonstration of a real-time interferometer as a bunch-lenght monitor in a high-current electron beam accelerator

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Thangaraj, J.; Thurman-Keup, R.; Ruan, J.

    2012-03-01

    A real-time interferometer (RTI) has been developed to monitor the bunch length of an electron beam in an accelerator. The RTI employs spatial autocorrelation, reflective optics, and a fast response pyro-detector array to obtain a real-time autocorrelation trace of the coherent radiation from an electron beam thus providing the possibility of online bunch-length diagnostics. A complete RTI system has been commissioned at the A0 photoinjector facility to measure sub-mm bunches at 13 MeV. Bunch length variation (FWHM) between 0.8 ps (-0.24 mm) and 1.5 ps (-0.45 mm) has been measured and compared with a Martin-Puplett interferometer and a streak camera.more » The comparisons show that RTI is a viable, complementary bunch length diagnostic for sub-mm electron bunches.« less

  9. Demonstration of a real-time interferometer as a bunch-length monitor in a high-current electron beam accelerator

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Thangaraj, J.; Thurman-Keup, R.; Ruan, J.

    2012-04-15

    A real-time interferometer (RTI) has been developed to monitor the bunch length of an electron beam in an accelerator. The RTI employs spatial autocorrelation, reflective optics, and a fast response pyro-detector array to obtain a real-time autocorrelation trace of the coherent radiation from an electron beam thus providing the possibility of online bunch-length diagnostics. A complete RTI system has been commissioned at the A0 photoinjector facility to measure sub-mm bunches at 13 MeV. Bunch length variation (FWHM) between 0.8 ps ({approx}0.24 mm) and 1.5 ps ({approx}0.45 mm) has been measured and compared with a Martin-Puplett interferometer and a streak camera.more » The comparisons show that RTI is a viable, complementary bunch length diagnostic for sub-mm electron bunches.« less

  10. DDS: The Dental Diagnostic Simulation System.

    ERIC Educational Resources Information Center

    Tira, Daniel E.

    The Dental Diagnostic Simulation (DDS) System provides an alternative to simulation systems which represent diagnostic case studies of relatively limited scope. It may be used to generate simulated case studies in all of the dental specialty areas with case materials progressing through the gamut of the diagnostic process. The generation of a…

  11. Evaluation of a next generation direct whole blood enzymatic assay for hemoglobin A1c on the ARCHITECT c8000 chemistry system.

    PubMed

    Teodoro-Morrison, Tracy; Janssen, Marcel J W; Mols, Jasper; Hendrickx, Ben H E; Velmans, Mathieu H; Lotz, Johannes; Lackner, Karl; Lennartz, Lieselotte; Armbruster, David; Maine, Gregory; Yip, Paul M

    2015-01-01

    The utility of HbA1c for the diagnosis of type 2 diabetes requires an accurate, precise and robust test measurement system. Currently, immunoassay and HPLC are the most popular methods for HbA1c quantification, noting however the limitations associated with some platforms, such as imprecision or interference from common hemoglobin variants. Abbott Diagnostics has introduced a fully automated direct enzymatic method for the quantification of HbA1c from whole blood on the ARCHITECT chemistry system. Here we completed a method evaluation of the ARCHITECT HbA1c enzymatic assay for imprecision, accuracy, method comparison, interference from hemoglobin variants and specimen stability. This was completed at three independent clinical laboratories in North America and Europe. The total imprecision ranged from 0.5% to 2.2% CV with low and high level control materials. Around the diagnostic cut-off of 48 mmol/mol, the total imprecision was 0.6% CV. Mean bias using reference samples from IFCC and CAP ranged from -1.1 to 1.0 mmol/mol. The enzymatic assay also showed excellent agreement with HPLC methods, with slopes of 1.01 and correlation coefficients ranging from 0.984 to 0.996 compared to Menarini Adams HA-8160, Bio-Rad Variant II and Variant II Turbo instruments. Finally, no significant effect was observed for erythrocyte sedimentation or interference from common hemoglobin variants in patient samples containing heterozygous HbS, HbC, HbD, HbE, and up to 10% HbF. The ARCHITECT enzymatic assay for HbA1c is a robust and fully automated method that meets the performance requirements to support the diagnosis of type 2 diabetes.

  12. A new dump system design for stray light reduction of Thomson scattering diagnostic system on EAST

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Xiao, Shumei; Zang, Qing, E-mail: zangq@ipp.ac.cn; Han, Xiaofeng

    Thomson scattering (TS) diagnostic is an important diagnostic for measuring electron temperature and density during plasma discharge. However, the measurement of Thomson scattering signal is disturbed by the stray light easily. The stray light sources in the Experimental Advanced Superconducting Tokamak (EAST) TS diagnostic system were analyzed by a simulation model of the diagnostic system, and simulation results show that the dump system is the primary stray light source. Based on the optics theory and the simulation analysis, a novel dump system including an improved beam trap was proposed and installed. The measurement results indicate that the new dump systemmore » can reduce more than 60% of the stray light for the diagnostic system, and the influence of stray light on the error of measured density decreases.« less

  13. Tracking Progress in Improving Diagnosis: A Framework for Defining Undesirable Diagnostic Events.

    PubMed

    Olson, Andrew P J; Graber, Mark L; Singh, Hardeep

    2018-01-29

    Diagnostic error is a prevalent, harmful, and costly phenomenon. Multiple national health care and governmental organizations have recently identified the need to improve diagnostic safety as a high priority. A major barrier, however, is the lack of standardized, reliable methods for measuring diagnostic safety. Given the absence of reliable and valid measures for diagnostic errors, we need methods to help establish some type of baseline diagnostic performance across health systems, as well as to enable researchers and health systems to determine the impact of interventions for improving the diagnostic process. Multiple approaches have been suggested but none widely adopted. We propose a new framework for identifying "undesirable diagnostic events" (UDEs) that health systems, professional organizations, and researchers could further define and develop to enable standardized measurement and reporting related to diagnostic safety. We propose an outline for UDEs that identifies both conditions prone to diagnostic error and the contexts of care in which these errors are likely to occur. Refinement and adoption of this framework across health systems can facilitate standardized measurement and reporting of diagnostic safety.

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

    NASA Technical Reports Server (NTRS)

    Kurtoglu, Tolga; Jensen, David; Poll, Scott

    2009-01-01

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

  15. Case-Deletion Diagnostics for Nonlinear Structural Equation Models

    ERIC Educational Resources Information Center

    Lee, Sik-Yum; Lu, Bin

    2003-01-01

    In this article, a case-deletion procedure is proposed to detect influential observations in a nonlinear structural equation model. The key idea is to develop the diagnostic measures based on the conditional expectation of the complete-data log-likelihood function in the EM algorithm. An one-step pseudo approximation is proposed to reduce the…

  16. Impact of the Diagnostic Process on Parents of Infants and Preschool Children. Final Report.

    ERIC Educational Resources Information Center

    Tice, Terrence N.; Hanson, Janice L.

    In an investigation of the impact of the psychological/educational diagnostic process on the parents of young children at risk for developmental delay, 18 families completed questionnaires and were interviewed concerning their child's evaluation. Transcribed interviews conducted 1-2 weeks after the evaluation and 4 months after the evaluations…

  17. A Diagnostic Approach to Increase Reusable Dinnerware Selection in a Cafeteria

    ERIC Educational Resources Information Center

    Manuel, Jennifer C.; Sunseri, Mary Anne; Olson, Ryan; Scolari, Miranda

    2007-01-01

    The current project tested a diagnostic approach to selecting interventions to increase patron selection of reusable dinnerware in a cafeteria. An assessment survey, completed by a sample of 43 patrons, suggested that the primary causes of wasteful behavior were (a) environmental arrangement of dinnerware options and (b) competing motivational…

  18. Evaluating the Performance Diagnostic Checklist-Human Services to Assess Incorrect Error-Correction Procedures by Preschool Paraprofessionals

    ERIC Educational Resources Information Center

    Bowe, Melissa; Sellers, Tyra P.

    2018-01-01

    The Performance Diagnostic Checklist-Human Services (PDC-HS) has been used to assess variables contributing to undesirable staff performance. In this study, three preschool teachers completed the PDC-HS to identify the factors contributing to four paraprofessionals' inaccurate implementation of error-correction procedures during discrete trial…

  19. Analysis of Students' Error in Learning of Quadratic Equations

    ERIC Educational Resources Information Center

    Zakaria, Effandi; Ibrahim; Maat, Siti Mistima

    2010-01-01

    The purpose of the study was to determine the students' error in learning quadratic equation. The samples were 30 form three students from a secondary school in Jambi, Indonesia. Diagnostic test was used as the instrument of this study that included three components: factorization, completing the square and quadratic formula. Diagnostic interview…

  20. Development of short-form and screening cutoff point of the Smartphone Addiction Inventory (SPAI-SF).

    PubMed

    Lin, Yu-Hsuan; Pan, Yuan-Chien; Lin, Sheng-Hsuan; Chen, Sue-Huei

    2017-06-01

    Smartphone addiction is considered a form of technological addiction that has attracted increasing attention. The present study developed and validated the short-form Smartphone Addiction Inventory (SPAI-SF) and established cutoff point for screening smartphone addiction based on diagnostic criteria established by psychiatric interview. A total of 268 participants completed an online survey that collected demographic data, smartphone use behaviours, and responses to the 26-item SPAI. Each participant also completed a psychiatric interview. Confirmatory factor analysis (CFA) revealed that the 10-item SPAI-SF replicated the structure of original 26-item SPAI accurately, yielding a four-factor model consisting of compulsive behaviour, functional impairment, withdrawal, and tolerance. For maximal diagnostic accuracy, a cutoff point of 24/25 best discriminated cases of smartphone addiction from diagnostic negatives. The present findings suggest that both the 26-item SPAI and SPAI-SF manifest the four constructs of behavioural addiction and the characteristics of smartphone addiction. The cutoff point determined by psychiatrists' diagnostic interview will be useful for clinical screening and epidemiologic research. Copyright © 2016 John Wiley & Sons, Ltd.

  1. Tropospheric Diagnostic Modeling Studies of PEM-Tropics B Field Data: Investigation of the HOx/NOx/O3 Photochemical System and its Coupling to Sulfur Chemistry

    NASA Technical Reports Server (NTRS)

    Davis, Douglas D.

    2001-01-01

    Over the time period of this NASA grant the PI has helped plan and execute the PEM-Tropics B field program. He has also helped organize and co-chair two data workshops which have focused on the detailed analysis of PEM-Tropics B data. His direct participation in these analyses has led to his involvement in 13 manuscripts, nine of which are in print, two in press, and two submitted. A complete list of papers is given.

  2. Complete radiotherapy response in rectal cancer: A review of the evidence.

    PubMed

    Couch, Daniel G; Hemingway, David M

    2016-01-14

    Complete response to chemoradiotherapy for rectal cancer is becoming a common clinical entity. Techniques to diagnose complete response and how to survey these patients without operative intervention are still unclear. We review the most recent evidence. Barriers to firm conclusions regarding this are heterogeneity of diagnostic definitions, differing surveillance protocols, and a lack of randomised studies.

  3. CHANGING OUR DIAGNOSTIC PARADIGM: MOVEMENT SYSTEM DIAGNOSTIC CLASSIFICATION

    PubMed Central

    Kamonseki, Danilo H.; Staker, Justin L.; Lawrence, Rebekah L.; Braman, Jonathan P.

    2017-01-01

    Proper diagnosis is a first step in applying best available treatments, and prognosticating outcomes for clients. Currently, the majority of musculoskeletal diagnoses are classified according to pathoanatomy. However, the majority of physical therapy treatments are applied toward movement system impairments or pain. While advocated within the physical therapy profession for over thirty years, diagnostic classification within a movement system framework has not been uniformly developed or adopted. We propose a basic framework and rationale for application of a movement system diagnostic classification for atraumatic shoulder pain conditions, as a case for the broader development of movement system diagnostic labels. Shifting our diagnostic paradigm has potential to enhance communication, improve educational efficiency, facilitate research, directly link to function, improve clinical care, and accelerate preventive interventions. PMID:29158950

  4. Tailoring non-equilibrium atmospheric pressure plasmas for healthcare technologies

    NASA Astrophysics Data System (ADS)

    Gans, Timo

    2012-10-01

    Non-equilibrium plasmas operated at ambient atmospheric pressure are very efficient sources for energy transport through reactive neutral particles (radicals and metastables), charged particles (ions and electrons), UV radiation, and electro-magnetic fields. This includes the unique opportunity to deliver short-lived highly reactive species such as atomic oxygen and atomic nitrogen. Reactive oxygen and nitrogen species can initiate a wide range of reactions in biochemical systems, both therapeutic and toxic. The toxicological implications are not clear, e.g. potential risks through DNA damage. It is anticipated that interactions with biological systems will be governed through synergies between two or more species. Suitable optimized plasma sources are improbable through empirical investigations. Quantifying the power dissipation and energy transport mechanisms through the different interfaces from the plasma regime to ambient air, towards the liquid interface and associated impact on the biological system through a new regime of liquid chemistry initiated by the synergy of delivering multiple energy carrying species, is crucial. The major challenge to overcome the obstacles of quantifying energy transport and controlling power dissipation has been the severe lack of suitable plasma sources and diagnostic techniques. Diagnostics and simulations of this plasma regime are very challenging; the highly pronounced collision dominated plasma dynamics at very small dimensions requires extraordinary high resolution - simultaneously in space (microns) and time (picoseconds). Numerical simulations are equally challenging due to the inherent multi-scale character with very rapid electron collisions on the one extreme and the transport of chemically stable species characterizing completely different domains. This presentation will discuss our recent progress actively combining both advance optical diagnostics and multi-scale computer simulations.

  5. 21 CFR 1020.30 - Diagnostic x-ray systems and their major components.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... irradiation. Diagnostic source assembly means the tube housing assembly with a beam-limiting device attached. Diagnostic x-ray system means an x-ray system designed for irradiation of any part of the human body for the... diagnostic source assembly. Fluoroscopic irradiation time means the cumulative duration during an examination...

  6. 21 CFR 1020.30 - Diagnostic x-ray systems and their major components.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... irradiation. Diagnostic source assembly means the tube housing assembly with a beam-limiting device attached. Diagnostic x-ray system means an x-ray system designed for irradiation of any part of the human body for the... diagnostic source assembly. Fluoroscopic irradiation time means the cumulative duration during an examination...

  7. 21 CFR 1020.30 - Diagnostic x-ray systems and their major components.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... irradiation. Diagnostic source assembly means the tube housing assembly with a beam-limiting device attached. Diagnostic x-ray system means an x-ray system designed for irradiation of any part of the human body for the... diagnostic source assembly. Fluoroscopic irradiation time means the cumulative duration during an examination...

  8. Spectroscopic imaging of limiter heat and particle fluxes and the resulting impurity sources during Wendelstein 7-X startup plasmas

    DOE PAGES

    Stephey, L.; Wurden, G. A.; Schmitz, O.; ...

    2016-08-08

    A combined IR and visible camera system [G. A. Wurden et al., “A high resolution IR/visible imaging system for the W7-X limiter,” Rev. Sci. Instrum. (these proceedings)] and a filterscope system [R. J. Colchin et al., Rev. Sci. Instrum. 74, 2068 (2003)] were implemented together to obtain spectroscopic data of limiter and first wall recycling and impurity sources during Wendelstein 7-X startup plasmas. Both systems together provided excellent temporal and spatial spectroscopic resolution of limiter 3. Narrowband interference filters in front of the camera yielded C-III and Hα photon flux, and the filterscope system provided H α, H β, He-I,more » He-II, C-II, and visible bremsstrahlung data. The filterscopes made additional measurements of several points on the W7-X vacuum vessel to yield wall recycling fluxes. Finally, the resulting photon flux from both the visible camera and filterscopes can then be compared to an EMC3-EIRENE synthetic diagnostic [H. Frerichs et al., “Synthetic plasma edge diagnostics for EMC3-EIRENE, highlighted for Wendelstein 7-X,” Rev. Sci. Instrum. (these proceedings)] to infer both a limiter particle flux and wall particle flux, both of which will ultimately be used to infer the complete particle balance and particle confinement time τ P.« less

  9. IMPULSE Highlights for recent experiments at the Advanced Photon Source (2/9-2/18 2014)

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Jensen, Brian J.

    2014-03-18

    This report is a presentation, with slides noting, Over 40 experiments were completed during this run using X-ray imaging on the IMPULSE system at Sector 32 IDB; Summary of new experiments: Idealized sphere compaction – Capture progression of dynamic densification through an idealized system on 0.500 mm borosilicate glass spheres (Slide 1); Detonator and EBW Imaging Experiments on IMPULSE – First time HE was intentionally detonated at APS (Slide 2); Spall and high strain rate crack nucleation/propagation in PMMA – PCI data is providing new and unique insights for model validation (Slide 3); Fiber composite for armor applications was studiedmore » under ballistic impact of Dyneema (Collaboration with Army Research Laboratory) (Slide 4). Summary of on-going experiments; Crack propagation in vitreous carbon – observed crack motion and caustic; Jet formation experiments on large grain cerium to examine phase dependent strength; Ballistic impact of Comp-B and TNT to examine thermo-mechanical response in-situ with various penetrator geometries to vary shear concentration. Other efforts: IMPULSE system moved and installed in Sector 35 (DCS). This includes the 4-frame X-ray detection system, 4- channel PDV, and other gun diagnostics; New remotely operated mobile IMPULSE structure in fabrication – to be delivered to APS in April; 4 Mini-VISAR Systems and 4-channel PDV installed in DCS instrumentation room with all associated diagnostics.« less

  10. Undergoing Diagnostic Evaluation for Possible Cancer Affects the Health-Related Quality of Life in Patients Presenting with Non-Specific Symptoms

    PubMed Central

    Moseholm, Ellen; Rydahl-Hansen, Susan; Lindhardt, Bjarne Ørskov

    2016-01-01

    Aim Undergoing diagnostic evaluation for possible cancer can affect health-related quality of life (HRQoL). The aims of this study were to examine the HRQoL in patients undergoing a diagnostic evaluation for possible cancer due to non-specific symptoms and further to investigate the impact of socio-demographic and medical factors associated with HRQoL at the time of diagnosis. Methods This was a prospective, multicenter survey study that included patients who were referred for a diagnostic evaluation due to non-specific cancer symptoms. Participants completed the EORTC-QLQ-C30 quality of life scale before and after completing the diagnostic evaluation. The baseline and follow-up EORTC-QLQ-C30 scores were compared with reference populations. The impact of socio-demographic and medical factors on HRQoL at follow-up was explored by bootstrapped multivariate linear regression. Results A total of 838 patients participated in the study; 680 (81%) also completed follow-up. Twenty-two percent of the patients received a cancer diagnosis at the end of follow-up. Patients presented initially with a high burden of symptoms, less role and emotional functioning and a lower global health/QoL. Most domains improved after diagnosis and no clinically important difference between baseline and follow-up scores was found. Patients reported effects on HRQoL both at baseline and at follow-up compared with the Danish reference population and had similar scores as a cancer reference population. Co-morbidity, being unemployed and receiving a cancer diagnosis had the greatest effect on HRQoL around the time of diagnosis. Conclusions Patients with non-specific symptoms reported an affected HRQoL while undergoing a diagnostic evaluation for possible cancer. Morbidity, being unemployed and receiving a cancer diagnosis had the greatest effect on HRQoL around the time of diagnosis. PMID:26840866

  11. Undergoing Diagnostic Evaluation for Possible Cancer Affects the Health-Related Quality of Life in Patients Presenting with Non-Specific Symptoms.

    PubMed

    Moseholm, Ellen; Rydahl-Hansen, Susan; Lindhardt, Bjarne Ørskov

    2016-01-01

    Undergoing diagnostic evaluation for possible cancer can affect health-related quality of life (HRQoL). The aims of this study were to examine the HRQoL in patients undergoing a diagnostic evaluation for possible cancer due to non-specific symptoms and further to investigate the impact of socio-demographic and medical factors associated with HRQoL at the time of diagnosis. This was a prospective, multicenter survey study that included patients who were referred for a diagnostic evaluation due to non-specific cancer symptoms. Participants completed the EORTC-QLQ-C30 quality of life scale before and after completing the diagnostic evaluation. The baseline and follow-up EORTC-QLQ-C30 scores were compared with reference populations. The impact of socio-demographic and medical factors on HRQoL at follow-up was explored by bootstrapped multivariate linear regression. A total of 838 patients participated in the study; 680 (81%) also completed follow-up. Twenty-two percent of the patients received a cancer diagnosis at the end of follow-up. Patients presented initially with a high burden of symptoms, less role and emotional functioning and a lower global health/QoL. Most domains improved after diagnosis and no clinically important difference between baseline and follow-up scores was found. Patients reported effects on HRQoL both at baseline and at follow-up compared with the Danish reference population and had similar scores as a cancer reference population. Co-morbidity, being unemployed and receiving a cancer diagnosis had the greatest effect on HRQoL around the time of diagnosis. Patients with non-specific symptoms reported an affected HRQoL while undergoing a diagnostic evaluation for possible cancer. Morbidity, being unemployed and receiving a cancer diagnosis had the greatest effect on HRQoL around the time of diagnosis.

  12. Information sharing during diagnostic assessments: what is relevant for parents?

    PubMed

    Klein, Sheryl; Wynn, Kerry; Ray, Lynne; Demeriez, Lori; LaBerge, Patricia; Pei, Jacqueline; St Pierre, Cherie

    2011-05-01

    ABSTRACT This descriptive qualitative study facilitates the application of family-centered care within a tertiary care interdisciplinary neurodevelopmental diagnostic assessment clinic by furthering an understanding of parent perceptions of the relevance of diagnostic information provision. An interdisciplinary assessment team completed an open-ended questionnaire to describe parent information provision. Parents from 9 families completed in-depth parent interviews following clinic attendance to discuss perceptions of information received. Interviews were audiotaped, transcribed, and coded by related themes. Parents did not perceive the information in the way professionals expected. Parents acknowledged receipt of comprehensive information relevant to the diagnosis but indicated that not all their needs were met. During the interviews, parents described the assessment process, preassessment information, and "steps in their journey." They noted that a strength-based approach and a focus on parental competency would support their coping efforts. Results underscore the need for professionals to be attentive to parents' individualized needs.

  13. [Cognitive errors in diagnostic decision making].

    PubMed

    Gäbler, Martin

    2017-10-01

    Approximately 10-15% of our diagnostic decisions are faulty and may lead to unfavorable and dangerous outcomes, which could be avoided. These diagnostic errors are mainly caused by cognitive biases in the diagnostic reasoning process.Our medical diagnostic decision-making is based on intuitive "System 1" and analytical "System 2" diagnostic decision-making and can be deviated by unconscious cognitive biases.These deviations can be positively influenced on a systemic and an individual level. For the individual, metacognition (internal withdrawal from the decision-making process) and debiasing strategies, such as verification, falsification and rule out worst-case scenarios, can lead to improved diagnostic decisions making.

  14. [Complexity level simulation in the German diagnosis-related groups system: the financial effect of coding of comorbidity diagnostics in urology].

    PubMed

    Wenke, A; Gaber, A; Hertle, L; Roeder, N; Pühse, G

    2012-07-01

    Precise and complete coding of diagnoses and procedures is of value for optimizing revenues within the German diagnosis-related groups (G-DRG) system. The implementation of effective structures for coding is cost-intensive. The aim of this study was to prove whether higher costs can be refunded by complete acquisition of comorbidities and complications. Calculations were based on DRG data of the Department of Urology, University Hospital of Münster, Germany, covering all patients treated in 2009. The data were regrouped and subjected to a process of simulation (increase and decrease of patient clinical complexity levels, PCCL) with the help of recently developed software. In urology a strong dependency of quantity and quality of coding of secondary diagnoses on PCCL and subsequent profits was found. Departmental budgetary procedures can be optimized when coding is effective. The new simulation tool can be a valuable aid to improve profits available for distribution. Nevertheless, calculation of time use and financial needs by this procedure are subject to specific departmental terms and conditions. Completeness of coding of (secondary) diagnoses must be the ultimate administrative goal of patient case documentation in urology.

  15. Melanoma recognition framework based on expert definition of ABCD for dermoscopic images.

    PubMed

    Abbas, Qaisar; Emre Celebi, M; Garcia, Irene Fondón; Ahmad, Waqar

    2013-02-01

    Melanoma Recognition based on clinical ABCD rule is widely used for clinical diagnosis of pigmented skin lesions in dermoscopy images. However, the current computer-aided diagnostic (CAD) systems for classification between malignant and nevus lesions using the ABCD criteria are imperfect due to use of ineffective computerized techniques. In this study, a novel melanoma recognition system (MRS) is presented by focusing more on extracting features from the lesions using ABCD criteria. The complete MRS system consists of the following six major steps: transformation to the CIEL*a*b* color space, preprocessing to enhance the tumor region, black-frame and hair artifacts removal, tumor-area segmentation, quantification of feature using ABCD criteria and normalization, and finally feature selection and classification. The MRS system for melanoma-nevus lesions is tested on a total of 120 dermoscopic images. To test the performance of the MRS diagnostic classifier, the area under the receiver operating characteristics curve (AUC) is utilized. The proposed classifier achieved a sensitivity of 88.2%, specificity of 91.3%, and AUC of 0.880. The experimental results show that the proposed MRS system can accurately distinguish between malignant and benign lesions. The MRS technique is fully automatic and can easily integrate to an existing CAD system. To increase the classification accuracy of MRS, the CASH pattern recognition technique, visual inspection of dermatologist, contextual information from the patients, and the histopathological tests can be included to investigate the impact with this system. © 2012 John Wiley & Sons A/S.

  16. Novel diagnostic techniques for celiac disease.

    PubMed

    Kurppa, Kalle; Taavela, Juha; Saavalainen, Päivi; Kaukinen, Katri; Lindfors, Katri

    2016-07-01

    The diagnosis of celiac disease has long been based on the demonstration of gluten-induced small-bowel mucosal damage. However, due to the constantly increasing disease prevalence and limitations in the histology-based criteria there is a pressure towards more serology-based diagnostics. The serological tools are being improved and new non-invasive methods are being developed, but the constantly refined endoscopic and histologic techniques may still prove helpful. Moreover, growing understanding of the disease pathogenesis has led researchers to suggest completely novel approaches to celiac disease diagnostics regardless of disease activity. In this review, we will elucidate the most recent development and possible future innovations in the diagnostic techniques for celiac disease.

  17. Learning Agents for Autonomous Space Asset Management (LAASAM)

    NASA Astrophysics Data System (ADS)

    Scally, L.; Bonato, M.; Crowder, J.

    2011-09-01

    Current and future space systems will continue to grow in complexity and capabilities, creating a formidable challenge to monitor, maintain, and utilize these systems and manage their growing network of space and related ground-based assets. Integrated System Health Management (ISHM), and in particular, Condition-Based System Health Management (CBHM), is the ability to manage and maintain a system using dynamic real-time data to prioritize, optimize, maintain, and allocate resources. CBHM entails the maintenance of systems and equipment based on an assessment of current and projected conditions (situational and health related conditions). A complete, modern CBHM system comprises a number of functional capabilities: sensing and data acquisition; signal processing; conditioning and health assessment; diagnostics and prognostics; and decision reasoning. In addition, an intelligent Human System Interface (HSI) is required to provide the user/analyst with relevant context-sensitive information, the system condition, and its effect on overall situational awareness of space (and related) assets. Colorado Engineering, Inc. (CEI) and Raytheon are investigating and designing an Intelligent Information Agent Architecture that will provide a complete range of CBHM and HSI functionality from data collection through recommendations for specific actions. The research leverages CEI’s expertise with provisioning management network architectures and Raytheon’s extensive experience with learning agents to define a system to autonomously manage a complex network of current and future space-based assets to optimize their utilization.

  18. Autonomous microfluidic system for phosphate detection.

    PubMed

    McGraw, Christina M; Stitzel, Shannon E; Cleary, John; Slater, Conor; Diamond, Dermot

    2007-02-28

    Miniaturization of analytical devices through the advent of microfluidics and micro total analysis systems is an important step forward for applications such as medical diagnostics and environmental monitoring. The development of field-deployable instruments requires that the entire system, including all necessary peripheral components, be miniaturized and packaged in a portable device. A sensor for long-term monitoring of phosphate levels has been developed that incorporates sampling, reagent and waste storage, detection, and wireless communication into a complete, miniaturized system. The device employs a low-power detection and communication system, so the entire instrument can operate autonomously for 7 days on a single rechargeable, 12V battery. In addition, integration of a wireless communication device allows the instrument to be controlled and results to be downloaded remotely. This autonomous system has a limit of detection of 0.3mg/L and a linear dynamic range between 0 and 20mg/L.

  19. Detailed Performance Assessment for the ITER ECE Diagnostic

    NASA Astrophysics Data System (ADS)

    Rowan, W.; Austin, M.; Houshmandyar, S.; Phillips, P.; Beno, J.; Bryant, A.; Ouroua, A.; Weeks, D.; Hubbard, A.; Taylor, G.

    2017-10-01

    One of the primary diagnostics for electron temperature (Te) measurement on ITER is based on the detection of electron cyclotron emission (ECE) Here we describe the predicted performance of the newly completed ECE diagnostic design by quantitatively following the emission from the plasma to the instruments and including the calibration method to assess accuracy. Operation of the diagnostic at 5.3 T is the main interest here but critical features of the emission spectra for 2.65 T and 1.8 T will be described. ECE will be collected by two very similar optical systems: one a radial view, the other an oblique view. Both measurements are used for Te while the oblique view also allows detection of non-thermal distortion in the electron distribution. An in-vacuum calibration source is included in the front end of each view to calibrate out the effect of any degradation of in-vessel optics. Following collection, the emission is split into orthogonal polarizations and transmitted to the detection instruments via waveguides filled with dry nitrogen, a choice that simplifies construction and analysis. Near the instruments, a switchyard is used to select which polarization and view is detected by each instrument. The design for the radiometer used for 5.3 T will be described in detail. Supported by PPPL/US-DA via subcontract S013464-H to UT Austin.

  20. Multi-method automated diagnostics of rotating machines

    NASA Astrophysics Data System (ADS)

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

    2017-08-01

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

  1. Trace material detection of surfaces via single-beam femtosecond MCARS

    NASA Astrophysics Data System (ADS)

    Bowman Pilkington, Sherrie S.; Roberson, Stephen D.; Pellegrino, Paul M.

    2016-05-01

    There is a significant need for the development of optical diagnostics for rapid and accurate detection of chemical species in convoluted systems. In particular, chemical warfare agents and explosive materials are of interest, however, identification of these species is difficult for a wide variety of reasons. Low vapor pressures, for example, cause traditional Raman scattering to be ineffective due to the incredibly long signal collection times that are required. Multiplex Coherent Anti-Stokes Raman Scattering (MCARS) spectroscopy generates a complete Raman spectrum from the material of interest using a combination of a broadband pulse which drives multiple molecular vibrations simultaneously and a narrow band probe pulse. For most species, the complete Raman spectrum can be detected in milliseconds; this makes MCARS an excellent technique for trace material detection in complex systems. In this paper, we present experimental MCARS results on solid state chemical species in complex systems. The 40fs Ti:Sapphire laser used in this study has sufficient output power to produce both the broadband continuum pulse and narrow band probe pulse simultaneously. A series of explosive materials of interest have been identified and compared with spontaneous Raman spectra, showing the specificity and stability of this system.

  2. Design of New Procedures for Diagnosing Prevalent Diseases Using a Low-Cost Telemicroscopy System.

    PubMed

    Prieto-Egido, Ignacio; González-Escalada, Alba; García-Giganto, Víctor; Martínez-Fernández, Andrés

    2016-11-01

    Currently, the diagnosis of prevalent diseases such as malaria, tuberculosis, or diarrheal diseases in rural areas of developing countries requires the displacement of the patient from their community health post to their reference health center or to ship a sample. This delays diagnosis and the treatment of disease. Conduct research to develop a new method for rapid low-cost diagnosis of prevalent diseases in rural areas of developing countries (malaria, tuberculosis, parasitic infections, vaginal infections, and cervical cancer). The study was divided into three phases. The first related to the drafting and validating of new protocols for the preparation of samples that should be adapted to be carried out in areas without power and with little trained personnel. The second phase consisted of developing a telemicroscopy system looking for low cost, software compatibility, and technical quality. Finally, the third phase evaluated the system as a diagnostic tool using direct observation with a conventional microscope as the gold standard. The validation of the new protocols showed that 100% of the vaginal swabs were processed correctly when using direct smear, while they were only 86.3% correct when using Gram stain; 68.3% of fecal samples were correctly processed using Kinyoun stain; 61.7% of blood samples when using thin film; and 83.8% when using thick film. Phase 2 permitted the development of a low-cost (<$250) and low-power (<15 W) telemicroscopy system that allows real-time consultation between health technicians and specialists. Finally, phase 3 proved that there was no difference between the diagnostics obtained by direct observation in a microscope and those ones obtained through the new telemicroscopy system. This study has verified the effectiveness of the telemicroscopy system as a diagnostic tool, given the complete agreement between the diagnoses made with it and those made with the gold standard.

  3. IVHM Framework for Intelligent Integration for Vehicle Health Management

    NASA Technical Reports Server (NTRS)

    Paris, Deidre; Trevino, Luis C.; Watson, Michael D.

    2005-01-01

    Integrated Vehicle Health Management (IVHM) systems for aerospace vehicles, is the process of assessing, preserving, and restoring system functionality across flight and techniques with sensor and communication technologies for spacecraft that can generate responses through detection, diagnosis, reasoning, and adapt to system faults in support of Integrated Intelligent Vehicle Management (IIVM). These real-time responses allow the IIVM to modify the affected vehicle subsystem(s) prior to a catastrophic event. Furthermore, this framework integrates technologies which can provide a continuous, intelligent, and adaptive health state of a vehicle and use this information to improve safety and reduce costs of operations. Recent investments in avionics, health management, and controls have been directed towards IIVM. As this concept has matured, it has become clear that IIVM requires the same sensors and processing capabilities as the real-time avionics functions to support diagnosis of subsystem problems. New sensors have been proposed, in addition to augment the avionics sensors to support better system monitoring and diagnostics. As the designs have been considered, a synergy has been realized where the real-time avionics can utilize sensors proposed for diagnostics and prognostics to make better real-time decisions in response to detected failures. IIVM provides for a single system allowing modularity of functions and hardware across the vehicle. The framework that supports IIVM consists of 11 major on-board functions necessary to fully manage a space vehicle maintaining crew safety and mission objectives. These systems include the following: Guidance and Navigation; Communications and Tracking; Vehicle Monitoring; Information Transport and Integration; Vehicle Diagnostics; Vehicle Prognostics; Vehicle Mission Planning, Automated Repair and Replacement; Vehicle Control; Human Computer Interface; and Onboard Verification and Validation. Furthermore, the presented framework provides complete vehicle management which not only allows for increased crew safety and mission success through new intelligence capabilities, but also yields a mechanism for more efficient vehicle operations.

  4. Resilient actions in the diagnostic process and system performance.

    PubMed

    Smith, Michael W; Davis Giardina, Traber; Murphy, Daniel R; Laxmisan, Archana; Singh, Hardeep

    2013-12-01

    Systemic issues can adversely affect the diagnostic process. Many system-related barriers can be masked by 'resilient' actions of frontline providers (ie, actions supporting the safe delivery of care in the presence of pressures that the system cannot readily adapt to). We explored system barriers and resilient actions of primary care providers (PCPs) in the diagnostic evaluation of cancer. We conducted a secondary data analysis of interviews of PCPs involved in diagnostic evaluation of 29 lung and colorectal cancer cases. Cases covered a range of diagnostic timeliness and were analysed to identify barriers for rapid diagnostic evaluation, and PCPs' actions involving elements of resilience addressing those barriers. We rated these actions according to whether they were usual or extraordinary for typical PCP work. Resilient actions and associated barriers were found in 59% of the cases, in all ranges of timeliness, with 40% involving actions rated as beyond typical. Most of the barriers were related to access to specialty services and coordination with patients. Many of the resilient actions involved using additional communication channels to solicit cooperation from other participants in the diagnostic process. Diagnostic evaluation of cancer involves several resilient actions by PCPs targeted at system deficiencies. PCPs' actions can sometimes mitigate system barriers to diagnosis, and thereby impact the sensitivity of 'downstream' measures (eg, delays) in detecting barriers. While resilient actions might enable providers to mitigate system deficiencies in the short run, they can be resource intensive and potentially unsustainable. They complement, rather than substitute for, structural remedies to improve system performance. Measures to detect and fix system performance issues targeted by these resilient actions could facilitate diagnostic safety.

  5. Tuberculous Lymphadenitis and Parotitis.

    PubMed

    Cataño, Juan Carlos; Robledo, Jaime

    2016-12-01

    Tuberculous lymphadenitis is the most common extrapulmonary manifestation of disseminated tuberculosis (TB). It is considered to be the local manifestation of the systemic disease that has disseminated to local lymph nodes, but a high index of suspicion is needed for the diagnosis, because there are several infectious and noninfectious diseases that can mimic the same clinical picture. In recent years, different diagnostic methods have been introduced, including fine-needle aspiration cytology, which has emerged as a simple outpatient diagnostic procedure that replaced the complete excisional node biopsy, and a number of molecular methods which have greatly improved diagnostic accuracy. This chapter covers the most actual knowledge in terms of epidemiology, clinical manifestations, pathogenesis, and treatment and emphasizes current trends in diagnosis of tuberculous lymphadenitis. TB parotid gland involvement is extremely rare, even in countries in which TB is endemic. Because of the clinical similarity, parotid malignancy and other forms of parotid inflammatory disease always take priority over the rarely encountered TB parotitis when it comes to differential diagnosis. As a result, clinicians often fail to make a timely diagnosis of TB parotitis when facing a patient with a slowly growing parotid lump. This chapter highlights the most important features of this uncommon disease.

  6. 30 CFR 250.520 - When do I have to perform a casing diagnostic test?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... test? 250.520 Section 250.520 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Oil and Gas Well-Completion Operations Casing Pressure Management § 250.520 When do I have to perform a casing diagnostic test? (a) You...

  7. Complete radiotherapy response in rectal cancer: A review of the evidence

    PubMed Central

    Couch, Daniel G; Hemingway, David M

    2016-01-01

    Complete response to chemoradiotherapy for rectal cancer is becoming a common clinical entity. Techniques to diagnose complete response and how to survey these patients without operative intervention are still unclear. We review the most recent evidence. Barriers to firm conclusions regarding this are heterogeneity of diagnostic definitions, differing surveillance protocols, and a lack of randomised studies. PMID:26811600

  8. Towards intelligent diagnostic system employing integration of mathematical and engineering model

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Isa, Nor Ashidi Mat

    The development of medical diagnostic system has been one of the main research fields during years. The goal of the medical diagnostic system is to place a nosological system that could ease the diagnostic evaluation normally performed by scientists and doctors. Efficient diagnostic evaluation is essentials and requires broad knowledge in order to improve conventional diagnostic system. Several approaches on developing the medical diagnostic system have been designed and tested since the earliest 60s. Attempts on improving their performance have been made which utilizes the fields of artificial intelligence, statistical analyses, mathematical model and engineering theories. With the availability ofmore » the microcomputer and software development as well as the promising aforementioned fields, medical diagnostic prototypes could be developed. In general, the medical diagnostic system consists of several stages, namely the 1) data acquisition, 2) feature extraction, 3) feature selection, and 4) classifications stages. Data acquisition stage plays an important role in converting the inputs measured from the real world physical conditions to the digital numeric values that can be manipulated by the computer system. One of the common medical inputs could be medical microscopic images, radiographic images, magnetic resonance image (MRI) as well as medical signals such as electrocardiogram (ECG) and electroencephalogram (EEG). Normally, the scientist or doctors have to deal with myriad of data and redundant to be processed. In order to reduce the complexity of the diagnosis process, only the significant features of the raw data such as peak value of the ECG signal or size of lesion in the mammogram images will be extracted and considered in the subsequent stages. Mathematical models and statistical analyses will be performed to select the most significant features to be classified. The statistical analyses such as principal component analysis and discriminant analysis as well as mathematical model of clustering technique have been widely used in developing the medical diagnostic systems. The selected features will be classified using mathematical models that embedded engineering theory such as artificial intelligence, support vector machine, neural network and fuzzy-neuro system. These classifiers will provide the diagnostic results without human intervention. Among many publishable researches, several prototypes have been developed namely NeuralPap, Neural Mammo, and Cervix Kit. The former system (NeuralPap) is an automatic intelligent diagnostic system for classifying and distinguishing between the normal and cervical cancerous cells. Meanwhile, the Cervix Kit is a portable Field-programmable gate array (FPGA)-based cervical diagnostic kit that could automatically diagnose the cancerous cell based on the images obtained during sampling test. Besides the cervical diagnostic system, the Neural Mammo system is developed to specifically aid the diagnosis of breast cancer using a fine needle aspiration image.« less

  9. Towards intelligent diagnostic system employing integration of mathematical and engineering model

    NASA Astrophysics Data System (ADS)

    Isa, Nor Ashidi Mat

    2015-05-01

    The development of medical diagnostic system has been one of the main research fields during years. The goal of the medical diagnostic system is to place a nosological system that could ease the diagnostic evaluation normally performed by scientists and doctors. Efficient diagnostic evaluation is essentials and requires broad knowledge in order to improve conventional diagnostic system. Several approaches on developing the medical diagnostic system have been designed and tested since the earliest 60s. Attempts on improving their performance have been made which utilizes the fields of artificial intelligence, statistical analyses, mathematical model and engineering theories. With the availability of the microcomputer and software development as well as the promising aforementioned fields, medical diagnostic prototypes could be developed. In general, the medical diagnostic system consists of several stages, namely the 1) data acquisition, 2) feature extraction, 3) feature selection, and 4) classifications stages. Data acquisition stage plays an important role in converting the inputs measured from the real world physical conditions to the digital numeric values that can be manipulated by the computer system. One of the common medical inputs could be medical microscopic images, radiographic images, magnetic resonance image (MRI) as well as medical signals such as electrocardiogram (ECG) and electroencephalogram (EEG). Normally, the scientist or doctors have to deal with myriad of data and redundant to be processed. In order to reduce the complexity of the diagnosis process, only the significant features of the raw data such as peak value of the ECG signal or size of lesion in the mammogram images will be extracted and considered in the subsequent stages. Mathematical models and statistical analyses will be performed to select the most significant features to be classified. The statistical analyses such as principal component analysis and discriminant analysis as well as mathematical model of clustering technique have been widely used in developing the medical diagnostic systems. The selected features will be classified using mathematical models that embedded engineering theory such as artificial intelligence, support vector machine, neural network and fuzzy-neuro system. These classifiers will provide the diagnostic results without human intervention. Among many publishable researches, several prototypes have been developed namely NeuralPap, Neural Mammo, and Cervix Kit. The former system (NeuralPap) is an automatic intelligent diagnostic system for classifying and distinguishing between the normal and cervical cancerous cells. Meanwhile, the Cervix Kit is a portable Field-programmable gate array (FPGA)-based cervical diagnostic kit that could automatically diagnose the cancerous cell based on the images obtained during sampling test. Besides the cervical diagnostic system, the Neural Mammo system is developed to specifically aid the diagnosis of breast cancer using a fine needle aspiration image.

  10. Radiation effects in IFMIF Li target diagnostic systems

    NASA Astrophysics Data System (ADS)

    Molla, J.; Vila, R.; Shikama, T.; Horiike, H.; Simakov, S.; Ciotti, M.; Ibarra, A.

    2009-04-01

    Diagnostics for the lithium target will be crucial for the operation of IFMIF. Several parameters as the lithium temperature, target thickness or wave pattern must be monitored during operation. Radiation effects may produce malfunctioning in any of these diagnostics due to the exposure to high radiation fields. The main diagnostic systems proposed for the operation of IFMIF are reviewed in this paper from the point of view of radiation damage. The main tools for the assessment of the performance of these diagnostics are the neutronics calculations by using specialised codes and the information accumulated during the last decades on the radiation effects in functional materials, components and diagnostics for ITER. This analysis allows to conclude that the design of some of the diagnostic systems must be revised to assure the high availability required for the target system.

  11. Diagnostic accuracy of physical examination for anterior knee instability: a systematic review.

    PubMed

    Leblanc, Marie-Claude; Kowalczuk, Marcin; Andruszkiewicz, Nicole; Simunovic, Nicole; Farrokhyar, Forough; Turnbull, Travis Lee; Debski, Richard E; Ayeni, Olufemi R

    2015-10-01

    Determining diagnostic accuracy of Lachman, pivot shift and anterior drawer tests versus gold standard diagnosis (magnetic resonance imaging or arthroscopy) for anterior cruciate ligament (ACL) insufficiency cases. Secondarily, evaluating effects of: chronicity, partial rupture, awake versus anaesthetized evaluation. Searching MEDLINE, EMBASE and PubMed identified studies on diagnostic accuracy for ACL insufficiency. Studies identification and data extraction were performed in duplicate. Quality assessment used QUADAS tool, and statistical analyses were completed for pooled sensitivity and specificity. Eight studies were included. Given insufficient data, pooled analysis was only possible for sensitivity on Lachman and pivot shift test. During awake evaluation, sensitivity for the Lachman test was 89 % (95 % CI 0.76, 0.98) for all rupture types, 96 % (95 % CI 0.90, 1.00) for complete ruptures and 68 % (95 % CI 0.25, 0.98) for partial ruptures. For pivot shift in awake evaluation, results were 79 % (95 % CI 0.63, 0.91) for all rupture types, 86 % (95 % CI 0.68, 0.99) for complete ruptures and 67 % (95 % CI 0.47, 0.83) for partial ruptures. Decreased sensitivity of Lachman and pivot shift tests for partial rupture cases and for awake patients raised suspicions regarding the accuracy of these tests for diagnosis of ACL insufficiency. This may lead to further research aiming to improve the understanding of the true accuracy of these physical diagnostic tests and increase the reliability of clinical investigation for this pathology. IV.

  12. A Tabletop Tool for Modeling Life Support Systems

    NASA Technical Reports Server (NTRS)

    Ramachandran, N.; Majumdar, A.; McDaniels, D.; Stewart, E.

    2003-01-01

    This paper describes the development plan for a comprehensive research and diagnostic tool for aspects of advanced life support systems in space-based laboratories. Specifically it aims to build a high fidelity tabletop model that can be used for the purpose of risk mitigation, failure mode analysis, contamination tracking, and testing reliability. We envision a comprehensive approach involving experimental work coupled with numerical simulation to develop this diagnostic tool. It envisions a 10% scale transparent model of a space platform such as the International Space Station that operates with water or a specific matched index of refraction liquid as the working fluid. This allows the scaling of a 10 ft x 10 ft x 10 ft room with air flow to 1 ft x 1 ft x 1 ft tabletop model with water/liquid flow. Dynamic similitude for this length scale dictates model velocities to be 67% of full-scale and thereby the time scale of the model to represent 15% of the full- scale system; meaning identical processes in the model are completed in 15% of the full- scale time. The use of an index matching fluid (fluid that matches the refractive index of cast acrylic, the model material) allows making the entire model (with complex internal geometry) transparent and hence conducive to non-intrusive optical diagnostics. So using such a system one can test environment control parameters such as core flows (axial flows), cross flows (from registers and diffusers), potential problem areas such as flow short circuits, inadequate oxygen content, build up of other gases beyond desirable levels, test mixing processes within the system at local nodes or compartments and assess the overall system performance. The system allows quantitative measurements of contaminants introduced in the system and allows testing and optimizing the tracking process and removal of contaminants. The envisaged system will be modular and hence flexible for quick configuration change and subsequent testing. The data and inferences from the tests will allow for improvements in the development and design of next generation life support systems and configurations.

  13. Diagnostics barriers and innovations in rural areas: insights from junior medical doctors on the frontlines of rural care in Peru.

    PubMed

    Anticona Huaynate, Cynthia Fiorella; Pajuelo Travezaño, Monica Jehnny; Correa, Malena; Mayta Malpartida, Holger; Oberhelman, Richard; Murphy, Laura L; Paz-Soldan, Valerie A

    2015-10-05

    Worldwide, rural communities face barriers when accessing health services. In response, numerous initiatives have focused on fostering technological innovations, new management approaches and health policies. Research suggests that the most successful innovations are those involving stakeholders at all levels. However, there is little evidence exploring the opinions of local health providers that could contribute with further innovation development and research. The aims of this study were to explore the perspectives of medical doctors (MDs) working in rural areas of Peru, regarding the barriers impacting the diagnostic process, and ideas for diagnostic innovations that could assist them. Data gathered through three focus group discussions (FGG) and 18 individual semi-structured interviews (SSI) with MDs who had completed their medical service in rural areas of Peru in the last two years were analyzed using thematic analysis. Three types of barriers emerged. The first barrier was the limited access to point of care (POC) diagnostic tools. Tests were needed for: i) the differential diagnosis of malaria vs. pneumonia, ii) dengue vs. leptospirosis, iii) tuberculosis, iv) vaginal infections and cervical cancer, v) neurocysticercosis, and vi) heavy metal toxicity. Ultrasound was needed for the diagnosis of obstetric and intra-abdominal conditions. There were also health system-related barriers such as limited funding for diagnostic services, shortage of specialists, limited laboratory services and access to telecommunications, and lack of institutional support. Finally, the third type of barriers included patient related-barriers to follow through with diagnostic referrals. Ideas for innovations proposed included POC equipment and tests, and telemedicine. MDs at primary health facilities in rural Peru face diagnostic challenges that are difficult to overcome due to a limited access to diagnostic tools. Referrals to specialized facilities are constrained by deficiencies in the organization of health services and by barriers that impede the patients' travel to distant health facilities. Technological innovations suggested by the participants such as POC diagnostic tools and mobile-health (m-health) applications could help address part of the problem. However, other types of innovation to address social, adaptation and policy issues should not be dismissed.

  14. Evaluation of audit-based performance measures for dental care plans.

    PubMed

    Bader, J D; Shugars, D A; White, B A; Rindal, D B

    1999-01-01

    Although a set of clinical performance measures, i.e., a report card for dental plans, has been designed for use with administrative data, most plans do not have administrative data systems containing the data needed to calculate the measures. Therefore, we evaluated the use of a set of proxy clinical performance measures calculated from data obtained through chart audits. Chart audits were conducted in seven dental programs--three public health clinics, two dental health maintenance organizations (DHMO), and two preferred provider organizations (PPO). In all instances audits were completed by clinical staff who had been trained using telephone consultation and a self-instructional audit manual. The performance measures were calculated for the seven programs, audit reliability was assessed in four programs, and for one program the audit-based proxy measures were compared to the measures calculated using administrative data. The audit-based measures were sensitive to known differences in program performance. The chart audit procedures yielded reasonably reliable data. However, missing data in patient charts rendered the calculation of some measures problematic--namely, caries and periodontal disease assessment and experience. Agreement between administrative and audit-based measures was good for most, but not all, measures in one program. The audit-based proxy measures represent a complex but feasible approach to the calculation of performance measures for those programs lacking robust administrative data systems. However, until charts contain more complete diagnostic information (i.e., periodontal charting and diagnostic codes or reason-for-treatment codes), accurate determination of these aspects of clinical performance will be difficult.

  15. A tri-fold hybrid classification approach for diagnostics with unexampled faulty states

    NASA Astrophysics Data System (ADS)

    Tamilselvan, Prasanna; Wang, Pingfeng

    2015-01-01

    System health diagnostics provides diversified benefits such as improved safety, improved reliability and reduced costs for the operation and maintenance of engineered systems. Successful health diagnostics requires the knowledge of system failures. However, with an increasing system complexity, it is extraordinarily difficult to have a well-tested system so that all potential faulty states can be realized and studied at product testing stage. Thus, real time health diagnostics requires automatic detection of unexampled system faulty states based upon sensory data to avoid sudden catastrophic system failures. This paper presents a trifold hybrid classification (THC) approach for structural health diagnosis with unexampled health states (UHS), which comprises of preliminary UHS identification using a new thresholded Mahalanobis distance (TMD) classifier, UHS diagnostics using a two-class support vector machine (SVM) classifier, and exampled health states diagnostics using a multi-class SVM classifier. The proposed THC approach, which takes the advantages of both TMD and SVM-based classification techniques, is able to identify and isolate the unexampled faulty states through interactively detecting the deviation of sensory data from the exampled health states and forming new ones autonomously. The proposed THC approach is further extended to a generic framework for health diagnostics problems with unexampled faulty states and demonstrated with health diagnostics case studies for power transformers and rolling bearings.

  16. Fuzzy expert system for diagnosing diabetic neuropathy.

    PubMed

    Rahmani Katigari, Meysam; Ayatollahi, Haleh; Malek, Mojtaba; Kamkar Haghighi, Mehran

    2017-02-15

    To design a fuzzy expert system to help detect and diagnose the severity of diabetic neuropathy. The research was completed in 2014 and consisted of two main phases. In the first phase, the diagnostic parameters were determined based on the literature review and by investigating specialists' perspectives ( n = 8). In the second phase, 244 medical records related to the patients who were visited in an endocrinology and metabolism research centre during the first six months of 2014 and were primarily diagnosed with diabetic neuropathy, were used to test the sensitivity, specificity, and accuracy of the fuzzy expert system. The final diagnostic parameters included the duration of diabetes, the score of a symptom examination based on the Michigan questionnaire, the score of a sign examination based on the Michigan questionnaire, the glycolysis haemoglobin level, fasting blood sugar, blood creatinine, and albuminuria. The output variable was the severity of diabetic neuropathy which was shown as a number between zero and 10, had been divided into four categories: absence of the disease, (the degree of severity) mild, moderate, and severe. The interface of the system was designed by ASP.Net (Active Server Pages Network Enabled Technology) and the system function was tested in terms of sensitivity (true positive rate) (89%), specificity (true negative rate) (98%), and accuracy (a proportion of true results, both positive and negative) (93%). The system designed in this study can help specialists and general practitioners to diagnose the disease more quickly to improve the quality of care for patients.

  17. Fuzzy expert system for diagnosing diabetic neuropathy

    PubMed Central

    Rahmani Katigari, Meysam; Ayatollahi, Haleh; Malek, Mojtaba; Kamkar Haghighi, Mehran

    2017-01-01

    AIM To design a fuzzy expert system to help detect and diagnose the severity of diabetic neuropathy. METHODS The research was completed in 2014 and consisted of two main phases. In the first phase, the diagnostic parameters were determined based on the literature review and by investigating specialists’ perspectives (n = 8). In the second phase, 244 medical records related to the patients who were visited in an endocrinology and metabolism research centre during the first six months of 2014 and were primarily diagnosed with diabetic neuropathy, were used to test the sensitivity, specificity, and accuracy of the fuzzy expert system. RESULTS The final diagnostic parameters included the duration of diabetes, the score of a symptom examination based on the Michigan questionnaire, the score of a sign examination based on the Michigan questionnaire, the glycolysis haemoglobin level, fasting blood sugar, blood creatinine, and albuminuria. The output variable was the severity of diabetic neuropathy which was shown as a number between zero and 10, had been divided into four categories: absence of the disease, (the degree of severity) mild, moderate, and severe. The interface of the system was designed by ASP.Net (Active Server Pages Network Enabled Technology) and the system function was tested in terms of sensitivity (true positive rate) (89%), specificity (true negative rate) (98%), and accuracy (a proportion of true results, both positive and negative) (93%). CONCLUSION The system designed in this study can help specialists and general practitioners to diagnose the disease more quickly to improve the quality of care for patients. PMID:28265346

  18. NE-213-scintillator-based neutron detection system for diagnostic measurements of energy spectra for neutrons having energies greater than or equal to 0. 8 MeV created during plasma operations at the Princeton Tokamak Fusion Test Reactor

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Dickens, J.K.; Hill, N.W.; Hou, F.S.

    1985-08-01

    A system for making diagnostic measurements of the energy spectra of greater than or equal to 0.8-MeV neutrons produced during plasma operations of the Princeton Tokamak Fusion Test Reactor (TFTR) has been fabricated and tested and is presently in operation in the TFTR Test Cell Basement. The system consists of two separate detectors, each made up of cells containing liquid NE-213 scintillator attached permanently to RCA-8850 photomultiplier tubes. Pulses obtained from each photomultiplier system are amplified and electronically analyzed to identify and separate those pulses due to neutron-induced events in the detector from those due to photon-induced events in themore » detector. Signals from each detector are routed to two separate Analog-to-Digital Converters, and the resulting digitized information, representing: (1) the raw neutron-spectrum data; and (2) the raw photon-spectrum data, are transmited to the CICADA data-acquisition computer system of the TFTR. Software programs have been installed on the CICADA system to analyze the raw data to provide moderate-resolution recreations of the energy spectrum of the neutron and photon fluences incident on the detector during the operation of the TFTR. A complete description of, as well as the operation of, the hardware and software is given in this report.« less

  19. Vacuum system design and tritium inventory for the TFTR charge exchange diagnostic

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Medley, S.S.

    The charge exchange diagnostic for the TFTR is comprised of two analyzer systems which contain a total of twenty independent mass/energy analyzers and one diagnostic neutral beam tentatively rated at 80 keV, 15 A. The associated vacuum systems were analyzed using the Vacuum System Transient Simulator (VSTS) computer program which models the transient transport of multi-gas species through complex networks of ducts, valves, traps, vacuum pumps, and other related vacuum system components. In addition to providing improved design performance at reduced cost, the analysis yields estimates for the exchange of tritium from the torus to the diagnostic components and ofmore » the diagnostic working gases to the torus.« less

  20. Barriers to Completing TB Diagnosis in Yemen: Services Should Respond to Patients' Needs

    PubMed Central

    Anderson de Cuevas, Rachel M.; Al-Sonboli, Najla; Al-Aghbari, Nasher; Yassin, Mohammed A.; Cuevas, Luis E.; Theobald, Sally J.

    2014-01-01

    Objectives and Background Obtaining a diagnosis of tuberculosis (TB) is a prerequisite for accessing specific treatment, yet one third of estimated new cases are missed worldwide by National Programmes. This study investigated economic, geographical, socio-cultural and health system factors hindering adults' attendance and completion of the TB diagnostic process in Yemen, to inform interventions designed to improve patient access to services. Methodology The study employed a mixed methods design comprising a cross-sectional survey and In-Depth-Interviews (IDIs) and Focus Group Discussions (FGDs) among patients abandoning the diagnosis or registering for treatment. Adults with cough of ≥2 weeks attending a large governmental referral centre in Sana'a, Yemen, between 2009 and 2010, were eligible to participate. Results 497 and 446 (89.7%) participants were surveyed the first and second day of attending the services and 48 IDIs and 12 FGDs were also conducted. The majority of patients were disadvantaged and had poor literacy (61% illiterate), had travelled from rural areas (47%) and attended with companions (84%). Key barriers for attendance identified were clinic and transport costs (augmented by companions), distance from home, a preference for private services, strong social stigma and a lack of understanding of the diagnostic process. There were discrepancies between patient- and doctor-reported diagnosis and 46% of patients were unaware that TB treatment is free. Females faced more difficulties to attend than men. The laboratory practice of providing first-day negative smear results and making referrals to the private sector also discouraged patients from returning. Strategies to bring TB diagnostic services closer to communities and address the multiple barriers patients face to attend, will be important to increase access to TB diagnosis and care. PMID:25244396

  1. Non-invasive diagnostic system and its opto-mechanical probe for combining confocal Raman spectroscopy and optical coherence tomography.

    PubMed

    Klemes, Jan; Kotzianova, Adela; Pokorny, Marek; Mojzes, Peter; Novak, Jindrich; Sukova, Lada; Demuth, Jaroslav; Vesely, Jaroslav; Sasek, Ladislav; Velebny, Vladimir

    2017-11-01

    Non-invasive optical diagnostic methods allow important information about studied systems to be obtained in a non-destructive way. Complete diagnosis requires information about the chemical composition as well as the morphological structure of a sample. We report on the development of an opto-mechanical probe that combines Raman spectroscopy (RS) and optical coherence tomography (OCT), two methods that provide all the crucial information needed for a non-invasive diagnosis. The aim of this paper is to introduce the technical design, construction and optimization of a dual opto-mechanical probe combining two in-house developed devices for confocal RS and OCT. The unique benefit of the probe is a gradual acquisition of OCT and RS data, which allows to use the acquired OCT images to pinpoint locations of interest for RS measurements. The parameters and the correct functioning of the probe were verified by RS scanning of various samples (silicon wafer and ex vivo tissue) based on their OCT images - lateral as well as depth scanning was performed. Both the OCT and RS systems were developed, optimized and tested with the ultimate aim of verifying the functionality of the probe. Picture: Schematic illustration and visualization of the developed RS-OCT probe. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  2. An architecture for the development of real-time fault diagnosis systems using model-based reasoning

    NASA Technical Reports Server (NTRS)

    Hall, Gardiner A.; Schuetzle, James; Lavallee, David; Gupta, Uday

    1992-01-01

    Presented here is an architecture for implementing real-time telemetry based diagnostic systems using model-based reasoning. First, we describe Paragon, a knowledge acquisition tool for offline entry and validation of physical system models. Paragon provides domain experts with a structured editing capability to capture the physical component's structure, behavior, and causal relationships. We next describe the architecture of the run time diagnostic system. The diagnostic system, written entirely in Ada, uses the behavioral model developed offline by Paragon to simulate expected component states as reflected in the telemetry stream. The diagnostic algorithm traces causal relationships contained within the model to isolate system faults. Since the diagnostic process relies exclusively on the behavioral model and is implemented without the use of heuristic rules, it can be used to isolate unpredicted faults in a wide variety of systems. Finally, we discuss the implementation of a prototype system constructed using this technique for diagnosing faults in a science instrument. The prototype demonstrates the use of model-based reasoning to develop maintainable systems with greater diagnostic capabilities at a lower cost.

  3. Resilient Actions in the Diagnostic Process and System Performance

    PubMed Central

    Smith, Michael W.; Giardina, Traber Davis; Murphy, Daniel R.; Laxmisan, Archana; Singh, Hardeep

    2013-01-01

    Objectives Systemic issues can adversely affect the diagnostic process. Many system-related barriers can be masked by ‘resilient’ actions of frontline providers (ie, actions supporting the safe delivery of care in the presence of pressures that the system cannot readily adapt to). We explored system barriers and resilient actions of primary care providers (PCPs) in the diagnostic evaluation of cancer. Methods We conducted a secondary data analysis of interviews of PCPs involved in diagnostic evaluation of 29 lung and colorectal cancer cases. Cases covered a range of diagnostic timeliness and were analyzed to identify barriers for rapid diagnostic evaluation, and PCPs’ actions involving elements of resilience addressing those barriers. We rated these actions according to whether they were usual or extraordinary for typical PCP work. Results Resilient actions and associated barriers were found in 59% of the cases, in all ranges of timeliness, with 40% involving actions rated as beyond typical. Most of the barriers were related to access to specialty services and coordination with patients. Many of the resilient actions involved using additional communication channels to solicit cooperation from other participants in the diagnostic process. Discussion Diagnostic evaluation of cancer involves several resilient actions by PCPs targeted at system deficiencies. PCPs’ actions can sometimes mitigate system barriers to diagnosis, and thereby impact the sensitivity of ‘downstream’ measures (eg, delays) in detecting barriers. While resilient actions might enable providers to mitigate system deficiencies in the short run, they can be resource intensive and potentially unsustainable. They complement, rather than substitute for, structural remedies to improve system performance. Measures to detect and fix system performance issues targeted by these resilient actions could facilitate diagnostic safety. PMID:23813210

  4. Artificial immune system via Euclidean Distance Minimization for anomaly detection in bearings

    NASA Astrophysics Data System (ADS)

    Montechiesi, L.; Cocconcelli, M.; Rubini, R.

    2016-08-01

    In recent years new diagnostics methodologies have emerged, with particular interest into machinery operating in non-stationary conditions. In fact continuous speed changes and variable loads make non-trivial the spectrum analysis. A variable speed means a variable characteristic fault frequency related to the damage that is no more recognizable in the spectrum. To overcome this problem the scientific community proposed different approaches listed in two main categories: model-based approaches and expert systems. In this context the paper aims to present a simple expert system derived from the mechanisms of the immune system called Euclidean Distance Minimization, and its application in a real case of bearing faults recognition. The proposed method is a simplification of the original process, adapted by the class of Artificial Immune Systems, which proved to be useful and promising in different application fields. Comparative results are provided, with a complete explanation of the algorithm and its functioning aspects.

  5. The INTELSAT VI SSTDMA network diagnostic system

    NASA Astrophysics Data System (ADS)

    Tamboli, Satish P.; Zhu, Xiaobo; Wilkins, Kim N.; Gupta, Ramesh K.

    The system-level design of an expert-system-based, near-real-time diagnostic system for INTELSAT VI satellite-switched time-division multiple access (SSTDMA) network is described. The challenges of INTELSAT VI diagnostics are discussed, along with alternative approaches for network diagnostics and the rationale for choosing a method based on burst unique-word detection. The focal point of the diagnostic system is the diagnostic processor, which resides in the central control and monitoring facility known as the INTELSAT Operations Center TDMA Facility (IOCTF). As real-time information such as burst unique-word detection data, reference terminal status data, and satellite telemetry alarm data are received at the IOCTF, the diagnostic processor continuously monitors the data streams. When a burst status change is detected, a 'snapshot' of the real-time data is forwarded to the expert system. Receipt of the change causes a set of rules to be invoked which associate the traffic pattern with a set of probable causes. A user-friendly interface allows a graphical view of the burst time plan and provides the ability to browse through the knowledge bases.

  6. Using hypermedia to develop an intelligent tutorial/diagnostic system for the Space Shuttle Main Engine Controller Lab

    NASA Technical Reports Server (NTRS)

    Oreilly, Daniel; Williams, Robert; Yarborough, Kevin

    1988-01-01

    This is a tutorial/diagnostic system for training personnel in the use of the Space Shuttle Main Engine Controller (SSMEC) Simulation Lab. It also provides a diagnostic capable of isolating lab failures at least to the major lab component. The system was implemented using Hypercard, which is an program of hypermedia running on Apple Macintosh computers. Hypercard proved to be a viable platform for the development and use of sophisticated tutorial systems and moderately capable diagnostic systems. This tutorial/diagnostic system uses the basic Hypercard tools to provide the tutorial. The diagnostic part of the system uses a simple interpreter written in the Hypercard language (Hypertalk) to implement the backward chaining rule based logic commonly found in diagnostic systems using Prolog. Some of the advantages of Hypercard in developing this type of system include sophisticated graphics, animation, sound and voice capabilities, its ability as a hypermedia tool, and its ability to include digitized pictures. The major disadvantage is the slow execution time for evaluation of rules (due to the interpretive processing of the language). Other disadvantages include the limitation on the size of the cards, that color is not supported, that it does not support grey scale graphics, and its lack of selectable fonts for text fields.

  7. Progress on development of SPIDER diagnostics

    NASA Astrophysics Data System (ADS)

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

    2017-08-01

    SPIDER experiment, the full size prototype of the beam source for the ITER heating neutral beam injector, has to demonstrate extraction and acceleration to 100 kV of a large negative ion hydrogen or deuterium beam with co-extracted electron fraction e-/D- <1 and beam uniformity within 10%, for up to one hour beam pulses. Main RF source plasma and beam parameters are measured with different complementary techniques to exploit the combination of their specific features. While SPIDER plant systems are being installed, the different diagnostic systems are in the procurement phase. Their final design is described here with a focus on some key solutions and most original and cost effective implementations. Thermocouples used to measure the power load distribution in the source and over the beam dump front surface will be efficiently fixed with proven technique and acquired through commercial and custom electronics. Spectroscopy needs to use well collimated lines of sight and will employ novel design spectrometers with higher efficiency and resolution and filtered detectors with custom built amplifiers. The electrostatic probes will be operated through electronics specifically developed to cope with the challenging environment of the RF source. The instrumented calorimeter STRIKE will use new CFC tiles, still under development. Two linear cameras, one built in house, have been tested as suitable for optical beam tomography. Some diagnostic components are off the shelf, others are custom developed: some of these are being prototyped or are under test before final production and installation, which will be completed before start of SPIDER operation.

  8. Femtosecond optical parametric amplification in BBO and KTA driven by a Ti:sapphire laser for LIDT testing and diagnostic development

    NASA Astrophysics Data System (ADS)

    Meadows, Alexander R.; Cupal, Josef; Hříbek, Petr; Durák, Michal; Kramer, Daniel; Rus, Bedřich

    2017-05-01

    We present the design of a collinear femtosecond optical parametric amplification (OPA) system producing a tunable output at wavelengths between 1030 nm and 1080 nm from a Ti:Sapphire pump laser at a wavelength of 795 nm. Generation of a supercontinuum seed pulse is followed by one stage of amplification in Beta Barium Borate (BBO) and two stages of amplification in Potassium Titanyle Arsenate (KTA), resulting in a 225 μJ output pulse with a duration of 90 fs. The output of the system has been measured by self-referenced spectral interferometry to yield the complete spectrum and spectral phase of the pulse. When compared to KTP, the greater transparency of KTA in the spectral range from 3 - 4 μm allows for reduced idler absorption and enhanced gain from the OPA process when it is pumped by the fundamental frequency of a Ti:sapphire laser. In turn, the use of the Ti:sapphire fundamental at 795 nm as a pump improves the efficiency with which light can be converted to wavelengths between 1030 nm and 1080 nm and subsequently used to test components for Nd-based laser systems. This OPA system is operated at 1 kHz for diagnostic development and laser-induced damage threshold testing of optical components for the ELI-Beamlines project.

  9. Markers of data quality in computer audit: the Manchester Orthopaedic Database.

    PubMed

    Ricketts, D; Newey, M; Patterson, M; Hitchin, D; Fowler, S

    1993-11-01

    This study investigates the efficiency of the Manchester Orthopaedic Database (MOD), a computer software package for record collection and audit. Data is entered into the system in the form of diagnostic, operative and complication keywords. We have calculated the completeness, accuracy and quality (completeness x accuracy) of keyword data in the MOD in two departments of orthopaedics (Departments A and B). In each department, 100 sets of inpatient notes were reviewed. Department B obtained results which were significantly better than those in A at the 5% level. We attribute this to the presence of a systems coordinator to motivate and organise the team for audit. Senior and junior staff did not differ significantly with respect to completeness, accuracy and quality measures, but locum junior staff recorded data with a quality of 0%. Statistically, the biggest difference between the departments was the quality of operation keywords. Sample sizes were too small to permit effective statistical comparisons between the quality of complication keywords. In both departments, however, the poorest quality data was seen in complication keywords. The low complication keyword completeness contributed to this; on average, the true complication rate (39%) was twice the recorded complication rate (17%). In the recent Royal College of Surgeons of England Confidential Comparative Audit, the recorded complication rate was 4.7%. In the light of the above findings, we suggest that the true complication rate of the RCS CCA should approach 9%.

  10. An experimental study of laser-supported plasmas for laser propulsion: Center director's discretionary fund project DFP-82-33

    NASA Technical Reports Server (NTRS)

    Eskridge, R. H.; Mccay, T. D.; Vanzandt, D. M.

    1987-01-01

    The rudiments of a rocket thruster, which receives its enthalpy from an energy source which is remotely beamed from a laser, is described. An experimental study, now partially complete, is discussed which will eventually provide a detailed understanding of the physics for assessing the feasibility of using hydrogen plasmas for accepting and converting this energy to enthalpy. A plasma ignition scheme which uses a pulsed CO2 laser was develped and the properites of the ignition spark documented, including breakdown intensities in hydrogen. A complete diagnostic system capable of determining plasma temperature and the plasma absorptivitiy for subsequent steady-state absorption of a high power CO2 laser beam are developed and demonstrative use is discussed for the preliminary case study, a two atmosphere laser supported argon plasma.

  11. Assessing Autism in Adults: An Evaluation of the Developmental, Dimensional and Diagnostic Interview-Adult Version (3Di-Adult)

    ERIC Educational Resources Information Center

    Mandy, William; Clarke, Kiri; McKenner, Michele; Strydom, Andre; Crabtree, Jason; Lai, Meng-Chuan; Allison, Carrie; Baron-Cohen, Simon; Skuse, David

    2018-01-01

    We developed a brief, informant-report interview for assessing autism spectrum conditions (ASC) in adults, called the Developmental, Dimensional and Diagnostic Interview-Adult Version (3Di-Adult); and completed a preliminary evaluation. Informant reports were collected for participants with ASC (n = 39), a non-clinical comparison group (n = 29)…

  12. Endoscopic fluorescent diagnostics and PDT of early malignancies of lung and esophagus

    NASA Astrophysics Data System (ADS)

    Sokolov, Victor V.; Chissov, Valery I.; Trakhtenberg, A. K.; Mamontov, A. S.; Frank, George A.; Filonenko, E. V.; Telegina, L. V.; Gladunov, V. K.; Belous, T. A.; Aristarkhova, E. I.; Zharkova, Natalia N.; Smirnov, V. V.; Kozlov, Dmitrij N.

    1996-01-01

    In this paper the results of fluorescence diagnostics and photodynamic therapy of early stage malignancies of lung (17 patients) and esophagus (8 patients) are presented. 13 patients had multiple primary tumors. As photosensitizers the new drugs Photoheme and Photosense were used. Complete remission was obtained in 92%. The patients are followed up without relapses to 2,5 years.

  13. Proposed Rule for Modification of Federal On Board Diagnostic Regulations for: Light Duty Vehicles, Light Duty Trucks, Medium Duty Passenger Vehicles, Complete Heavy Duty Vehicles and Engines Intended for Use in Heavy Duty Vehicles Weighing 14,000 Pounds

    EPA Pesticide Factsheets

    Following is information for the proposed rule for the Modification of Federal On Board Diagnostic Regulations for Light-Duty Vehicles, Light-Duty Trucks, etc. Includes links to Federal Register and final rule.

  14. Applicability of the 2001 revised diagnostic criteria in Brazilian Vogt-Koyanagi-Harada disease patients.

    PubMed

    Cardoso, Isabel Habeyche; Zajdenweber, Moysés Eduardo; Muccioli, Cristina; Fimamor, Luciana Peixoto; Belfort, Rubens

    2008-01-01

    To determine the applicability of the international revised diagnostic criteria for Vogt-Koyanagi-Harada disease. Retrospective study. Medical charts of 140 patients with the diagnosis of Vogt-Koyanagi-Harada disease, from the Uveitis Sector of the Federal University of Sao Paulo (UNIFESP), were revised and classified following the revised diagnostic criteria. Of the 140 patients, 12.85% fulfilled the criteria for complete disease, 29.28% incomplete disease, 28.57% "probable" Vogt-Koyanagi-Harada disease and 28.27% were considered not Vogt-Koyanagi-Harada disease. The authors consider that the international revised diagnostic criteria have good applicability and are very useful to help in the diagnosis of Vogt-Koyanagi-Harada disease.

  15. [Virtual clinical diagnosis support system of degenerative stenosis of the lumbar spinal canal].

    PubMed

    Shevelev, I N; Konovalov, N A; Cherkashov, A M; Molodchenkov, A A; Sharamko, T G; Asiutin, D S; Nazarenko, A G

    2013-01-01

    The aim of the study was to develop a virtual clinical diagnostic support system of degenerative lumbar spinal stenosis on database of spine registry. Choice of criteria's for diagnostic system was made on symptom analysis of 298 patients with lumbar spinal stenosis. Also was analysed a group of patient with disc herniation's for sensitivity and specify assessment of developed diagnostic support system. Represented clinical diagnostic support system allows identifying patients with degenerative lumbar spinal stenosis on stage of patient's primary visit. System sensitivity and specify are 90 and 71% respectively. "Online" mode of diagnostic system in structure of spine registry provides maximal availability for specialists, regardless of their locations. Development of tools "medicine 2.0" is the actual direction for carrying out further researches with which carrying out the centralized baea collection by means of specialized registers helps.

  16. Technical Note: Development of a combined molecular breast imaging/ultrasound system for diagnostic evaluation of MBI-detected lesions.

    PubMed

    O'Connor, Michael K; Morrow, Melissa M; Tran, Thuy; Hruska, Carrie B; Conners, Amy L; Hunt, Katie N

    2017-02-01

    The purpose of this study was to perform a pilot evaluation of an integrated molecular breast imaging/ultrasound (MBI/US) system designed to enable, in real-time, the registration of US to MBI and diagnostic evaluation of breast lesions detected on MBI. The MBI/US system was constructed by modifying an existing dual-head cadmium zinc telluride (CZT)-based MBI gamma camera. The upper MBI detector head was replaced with a mesh panel, which allowed an ultrasound probe to access the breast. An optical tracking system was used to monitor the location of the ultrasound transducer, referenced to the MBI detector. The lesion depth at which ultrasound was targeted was estimated from analysis of previously acquired dual-head MBI datasets. A software tool was developed to project the US field of view onto the current MBI image. Correlation of lesion location between both modalities with real-time MBI/US scanning was confirmed in a breast phantom model and assessed in 12 patients with a breast lesion detected on MBI. Combined MBI/US scanning allowed for registration of lesions detected on US and MBI as validated in phantom experiments. In patient studies, successful registration was achieved in 8 of 12 (67%) patients, with complete registration achieved in seven and partial registration achieved in one patient. In 4 of 12 (37%) patients, lesion registration was not achieved, partially attributed to uncertainty in lesion depth estimates from MBI. The MBI/US system enabled successful registration of US to MBI in over half of patients studied in this pilot evaluation. Future studies are needed to determine if real-time, registered US imaging of MBI-detected lesions may obviate the need to proceed to more expensive procedures such as contrast-enhanced breast MRI for diagnostic workup or biopsy of MBI findings. © 2016 American Association of Physicists in Medicine.

  17. Laboratory automation in clinical bacteriology: what system to choose?

    PubMed

    Croxatto, A; Prod'hom, G; Faverjon, F; Rochais, Y; Greub, G

    2016-03-01

    Automation was introduced many years ago in several diagnostic disciplines such as chemistry, haematology and molecular biology. The first laboratory automation system for clinical bacteriology was released in 2006, and it rapidly proved its value by increasing productivity, allowing a continuous increase in sample volumes despite limited budgets and personnel shortages. Today, two major manufacturers, BD Kiestra and Copan, are commercializing partial or complete laboratory automation systems for bacteriology. The laboratory automation systems are rapidly evolving to provide improved hardware and software solutions to optimize laboratory efficiency. However, the complex parameters of the laboratory and automation systems must be considered to determine the best system for each given laboratory. We address several topics on laboratory automation that may help clinical bacteriologists to understand the particularities and operative modalities of the different systems. We present (a) a comparison of the engineering and technical features of the various elements composing the two different automated systems currently available, (b) the system workflows of partial and complete laboratory automation, which define the basis for laboratory reorganization required to optimize system efficiency, (c) the concept of digital imaging and telebacteriology, (d) the connectivity of laboratory automation to the laboratory information system, (e) the general advantages and disadvantages as well as the expected impacts provided by laboratory automation and (f) the laboratory data required to conduct a workflow assessment to determine the best configuration of an automated system for the laboratory activities and specificities. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  18. Programmable Bio-Nano-Chip Systems for Serum CA125 Quantification: Towards Ovarian Cancer Diagnostics at the Point-of-Care

    PubMed Central

    Raamanathan, Archana; Simmons, Glennon W.; Christodoulides, Nicolaos; Floriano, Pierre N.; Furmaga, Wieslaw B.; Redding, Spencer W.; Lu, Karen H.; Bast, Robert C.; McDevitt, John T.

    2013-01-01

    Point-of-care (POC) implementation of early detection and screening methodologies for ovarian cancer may enable improved survival rates through early intervention. Current laboratory-confined immunoanalyzers have long turnaround times and are often incompatible with multiplexing and POC implementation. Rapid, sensitive and multiplexable POC diagnostic platforms compatible with promising early detection approaches for ovarian cancer are needed. To this end, we report the adaptation of the programmable bio-nano-chip (p-BNC), an integrated, microfluidic, modular (Programmable) platform for CA125 serum quantitation, a biomarker prominently implicated in multi-modal and multi-marker screening approaches. In the p-BNC, CA125 from diseased sera (Bio) is sequestered and assessed with a fluorescence-based sandwich immunoassay, completed in the nano-nets (Nano) of sensitized agarose microbeads localized in individually addressable wells (Chip), housed in a microfluidic module, capable of integrating multiple sample, reagent and biowaste processing and handling steps. Antibody pairs that bind to distinct epitopes on CA125 were screened. To permit efficient biomarker sequestration in a 3-D microfluidic environment, the p-BNC operating variables (incubation times, flow rates and reagent concentrations) were tuned to deliver optimal analytical performance under 45 minutes. With short analysis times, competitive analytical performance (Inter- and intra-assay precision of 1.2% and 1.9% and LODs of 1.0 U/mL) was achieved on this mini-sensor ensemble. Further validation with sera of ovarian cancer patients (n=20) demonstrated excellent correlation (R2 = 0.97) with gold-standard ELISA. Building on the integration capabilities of novel microfluidic systems programmed for ovarian cancer, the rapid, precise and sensitive miniaturized p-BNC system shows strong promise for ovarian cancer diagnostics. PMID:22490510

  19. Programmable bio-nano-chip systems for serum CA125 quantification: toward ovarian cancer diagnostics at the point-of-care.

    PubMed

    Raamanathan, Archana; Simmons, Glennon W; Christodoulides, Nicolaos; Floriano, Pierre N; Furmaga, Wieslaw B; Redding, Spencer W; Lu, Karen H; Bast, Robert C; McDevitt, John T

    2012-05-01

    Point-of-care (POC) implementation of early detection and screening methodologies for ovarian cancer may enable improved survival rates through early intervention. Current laboratory-confined immunoanalyzers have long turnaround times and are often incompatible with multiplexing and POC implementation. Rapid, sensitive, and multiplexable POC diagnostic platforms compatible with promising early detection approaches for ovarian cancer are needed. To this end, we report the adaptation of the programmable bio-nano-chip (p-BNC), an integrated, microfluidic, and modular (programmable) platform for CA125 serum quantitation, a biomarker prominently implicated in multimodal and multimarker screening approaches. In the p-BNCs, CA125 from diseased sera (Bio) is sequestered and assessed with a fluorescence-based sandwich immunoassay, completed in the nano-nets (Nano) of sensitized agarose microbeads localized in individually addressable wells (Chip), housed in a microfluidic module, capable of integrating multiple sample, reagent and biowaste processing, and handling steps. Antibody pairs that bind to distinct epitopes on CA125 were screened. To permit efficient biomarker sequestration in a three-dimensional microfluidic environment, the p-BNC operating variables (incubation times, flow rates, and reagent concentrations) were tuned to deliver optimal analytical performance under 45 minutes. With short analysis times, competitive analytical performance (inter- and intra-assay precision of 1.2% and 1.9% and limit of detection of 1.0 U/mL) was achieved on this minisensor ensemble. Furthermore, validation with sera of patients with ovarian cancer (n = 20) showed excellent correlation (R(2) = 0.97) with gold-standard ELISA. Building on the integration capabilities of novel microfluidic systems programmed for ovarian cancer, the rapid, precise, and sensitive miniaturized p-BNC system shows strong promise for ovarian cancer diagnostics.

  20. Comparison of diagnostic value using a small, single channel, P-wave centric sternal ECG monitoring patch with a standard 3-lead Holter system over 24 hours.

    PubMed

    Smith, Warren M; Riddell, Fiona; Madon, Morag; Gleva, Marye J

    2017-03-01

    To compare simultaneous recordings from an external patch system specifically designed to ensure better P-wave recordings and standard Holter monitor to determine diagnostic efficacy. Holter monitors are a mainstay of clinical practice, but are cumbersome to access and wear and P-wave signal quality is frequently inadequate. This study compared the diagnostic efficacy of the P-wave centric electrocardiogram (ECG) patch (Carnation Ambulatory Monitor) to standard 3-channel (leads V1, II, and V5) Holter monitor (Northeast Monitoring, Maynard, MA). Patients were referred to a hospital Holter clinic for standard clinical indications. Each patient wore both devices simultaneously and served as their own control. Holter and Patch reports were read in a blinded fashion by experienced electrophysiologists unaware of the findings in the other corresponding ECG recording. All patients, technicians, and physicians completed a questionnaire on comfort and ease of use, and potential complications. In all 50 patients, the P-wave centric patch recording system identified rhythms in 23 patients (46%) that altered management, compared to 6 Holter patients (12%), P<.001. The patch ECG intervals PR, QRS and QT correlated well with the Holter ECG intervals having correlation coefficients of 0.93, 0.86, and 0.94, respectively. Finally, 48 patients (96%) preferred wearing the patch monitor. A single-channel ambulatory patch ECG monitor, designed specifically to ensure that the P-wave component of the ECG be visible, resulted in a significantly improved rhythm diagnosis and avoided inaccurate diagnoses made by the standard 3-channel Holter monitor. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. An easy-to-use diagnostic system development shell

    NASA Technical Reports Server (NTRS)

    Tsai, L. C.; Ross, J. B.; Han, C. Y.; Wee, W. G.

    1987-01-01

    The Diagnostic System Development Shell (DSDS), an expert system development shell for diagnostic systems, is described. The major objective of building the DSDS is to create a very easy to use and friendly environment for knowledge engineers and end-users. The DSDS is written in OPS5 and CommonLisp. It runs on a VAX/VMS system. A set of domain independent, generalized rules is built in the DSDS, so the users need not be concerned about building the rules. The facts are explicitly represented in a unified format. A powerful check facility which helps the user to check the errors in the created knowledge bases is provided. A judgement facility and other useful facilities are also available. A diagnostic system based on the DSDS system is question driven and can call or be called by other knowledge based systems written in OPS5 and CommonLisp. A prototype diagnostic system for diagnosing a Philips constant potential X-ray system has been built using the DSDS.

  2. ECRH and W7-X: An intriguing pair

    NASA Astrophysics Data System (ADS)

    Erckmann, V.; Braune, H.; Gantenbein, G.; Jelonnek, J.; Kasparek, W.; Laqua, H. P.; Lechte, C.; Marushchenko, N. B.; Michel, G.; Plaum, B.; Thumm, M.; Weissgerber, M.; Wolf, R.; W7-X ECRH Teams

    2014-02-01

    The construction of the W7-X basic machine is almost completed and the device is approaching the commissioning phase. W7-X operation will be supported by ECRH working at 140 GHz in 2nd harmonic X- or O-mode with 10 MW cw power. Presently the activities at W7-X concentrate on the implementation of wall-armour, in-vessel components and diagnostics. The ECRH-system is in stand by with 5 out of 10 gyrotrons operational. The status of both, the W7-X device and the ECRH system is reported. Further R&D activities concentrate on extending the launching capability for sophisticated confinement investigations with remote steering launchers in a poloidal plane with weak magnetic field gradient.

  3. Modelling and Decision Support of Clinical Pathways

    NASA Astrophysics Data System (ADS)

    Gabriel, Roland; Lux, Thomas

    The German health care market is under a rapid rate of change, forcing especially hospitals to provide high-quality services at low costs. Appropriate measures for more effective and efficient service provision are process orientation and decision support by information technology of clinical pathway of a patient. The essential requirements are adequate modelling of clinical pathways as well as usage of adequate systems, which are capable of assisting the complete path of a patient within a hospital, and preferably also outside of it, in a digital way. To fulfil these specifications the authors present a suitable concept, which meets the challenges of well-structured clinical pathways as well as rather poorly structured diagnostic and therapeutic decisions, by interplay of process-oriented and knowledge-based hospital information systems.

  4. A Simple Evaluation Tool (ET-CET) Indicates Increase of Diagnostic Skills From Small Bowel Capsule Endoscopy Training Courses: A Prospective Observational European Multicenter Study.

    PubMed

    Albert, J G; Humbla, O; McAlindon, M E; Davison, C; Seitz, U; Fraser, C; Hagenmüller, F; Noetzel, E; Spada, C; Riccioni, M E; Barnert, J; Filmann, N; Keuchel, M

    2015-10-01

    Small bowel capsule endoscopy (SBCE) has become a first line diagnostic tool. Several training courses with a similar format have been established in Europe; however, data on learning curve and training in SBCE remain sparse.Between 2008 and 2011, different basic SBCE training courses were organized internationally in UK (n = 2), Italy (n = 2), Germany (n = 2), Finland (n = 1), and nationally in Germany (n = 10), applying similar 8-hour curricula with 50% lectures and 50% hands-on training. The Given PillCam System was used in 12 courses, the Olympus EndoCapsule system in 5, respectively. A simple evaluation tool for capsule endoscopy training (ET-CET) was developed using 10 short SBCE videos including relevant lesions and normal or irrelevant findings. For each video, delegates were required to record a diagnosis (achievable total score from 0 to 10) and the clinical relevance (achievable total score 0 to 10). ET-CET was performed at baseline before the course and repeated, with videos in altered order, after the course.Two hundred ninety-four delegates (79.3% physicians, 16.3% nurses, 4.4% others) were included for baseline analysis, 268 completed the final evaluation. Forty percent had no previous experience in SBCE, 33% had performed 10 or less procedures. Median scores for correct diagnosis improved from 4.0 (IQR 3) to 7.0 (IQR 3) during the courses (P < 0.001, Wilcoxon), and for correct classification of relevance of the lesions from 5.0 (IQR 3) to 7.0 (IQR 3) (P < 0.001), respectively. Improvement was not dependent on experience, profession, SBCE system, or course setting. Previous experience in SBCE was associated with higher baseline scores for correct diagnosis (P < 0.001; Kruskal-Wallis). Additionally, independent nonparametric partial correlation with experience in gastroscopy (rho 0.33) and colonoscopy (rho 0.27) was observed (P < 0.001).A simple ET-CET demonstrated significant improvement of diagnostic skills on completion of formal basic SBCE courses with hands-on training, regardless of preexisting experience, profession, and course setting. Baseline scores for correct diagnoses show a plateau after interpretation of 25 SBCE before courses, supporting this number as a compromise for credentialing. Experience in flexible endoscopy may be useful before attending an SBCE course.

  5. Strategies for adding adaptive learning mechanisms to rule-based diagnostic expert systems

    NASA Technical Reports Server (NTRS)

    Stclair, D. C.; Sabharwal, C. L.; Bond, W. E.; Hacke, Keith

    1988-01-01

    Rule-based diagnostic expert systems can be used to perform many of the diagnostic chores necessary in today's complex space systems. These expert systems typically take a set of symptoms as input and produce diagnostic advice as output. The primary objective of such expert systems is to provide accurate and comprehensive advice which can be used to help return the space system in question to nominal operation. The development and maintenance of diagnostic expert systems is time and labor intensive since the services of both knowledge engineer(s) and domain expert(s) are required. The use of adaptive learning mechanisms to increment evaluate and refine rules promises to reduce both time and labor costs associated with such systems. This paper describes the basic adaptive learning mechanisms of strengthening, weakening, generalization, discrimination, and discovery. Next basic strategies are discussed for adding these learning mechanisms to rule-based diagnostic expert systems. These strategies support the incremental evaluation and refinement of rules in the knowledge base by comparing the set of advice given by the expert system (A) with the correct diagnosis (C). Techniques are described for selecting those rules in the in the knowledge base which should participate in adaptive learning. The strategies presented may be used with a wide variety of learning algorithms. Further, these strategies are applicable to a large number of rule-based diagnostic expert systems. They may be used to provide either immediate or deferred updating of the knowledge base.

  6. Benchmarking Diagnostic Algorithms on an Electrical Power System Testbed

    NASA Technical Reports Server (NTRS)

    Kurtoglu, Tolga; Narasimhan, Sriram; Poll, Scott; Garcia, David; Wright, Stephanie

    2009-01-01

    Diagnostic algorithms (DAs) are key to enabling automated health management. These algorithms are designed to detect and isolate anomalies of either a component or the whole system based on observations received from sensors. In recent years a wide range of algorithms, both model-based and data-driven, have been developed to increase autonomy and improve system reliability and affordability. However, the lack of support to perform systematic benchmarking of these algorithms continues to create barriers for effective development and deployment of diagnostic technologies. In this paper, we present our efforts to benchmark a set of DAs on a common platform using a framework that was developed to evaluate and compare various performance metrics for diagnostic technologies. The diagnosed system is an electrical power system, namely the Advanced Diagnostics and Prognostics Testbed (ADAPT) developed and located at the NASA Ames Research Center. The paper presents the fundamentals of the benchmarking framework, the ADAPT system, description of faults and data sets, the metrics used for evaluation, and an in-depth analysis of benchmarking results obtained from testing ten diagnostic algorithms on the ADAPT electrical power system testbed.

  7. [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.

  8. Ulnar hammer syndrome: a systematic review of the literature.

    PubMed

    Vartija, Larisa; Cheung, Kevin; Kaur, Manraj; Coroneos, Christopher James; Thoma, Achilleas

    2013-11-01

    Ulnar hammer syndrome is an uncommon form of arterial insufficiency. Many treatments have been described, and debate continues about the best option. The goal of this systematic review was to determine whether ulnar hammer syndrome has an occupational association, to identify the most reliable diagnostic test, and to determine the best treatment modality. A comprehensive literature search was conducted using the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, MEDLINE, CINAHL, and EMBASE. Data from articles meeting inclusion criteria were collected in duplicate. Methodological quality of studies was assessed using the Methodological Index for Nonrandomized Studies scale. Thirty studies were included in the systematic review. No randomized controlled trials were identified. There is low-quality evidence suggestive of an association between exposure to repetitive hand trauma and vibration and ulnar hammer syndrome. Various diagnostic investigations were used, but few were compared, making it difficult to determine the most reliable diagnostic test. Numerous nonoperative and operative treatments were reported. With nonoperative treatment, 12 percent had complete resolution and 70 percent had partial resolution of their symptoms. Of patients treated operatively, 42.5 percent had complete resolution and 42.5 percent had partial resolution of their symptoms. The heterogeneity in study design and outcome measures limits definitive conclusions about occupational association, best diagnostic test, and treatment for ulnar hammer syndrome. However, there is low-quality evidence that suggests that most patients with ulnar hammer syndrome will have partial relief of symptoms with nonoperative treatment, and operative treatment results in complete or partial resolution of symptoms in the majority of cases. Therapeutic, IV.

  9. Health-related quality of life, anxiety and depression in the diagnostic phase of suspected cancer, and the influence of diagnosis.

    PubMed

    Moseholm, Ellen; Rydahl-Hansen, Susan; Overgaard, Dorthe; Wengel, Hanne S; Frederiksen, Rikke; Brandt, Malene; Lindhardt, Bjarne Ø

    2016-05-20

    Undergoing diagnostic evaluation for cancer has been associated with a high prevalence of anxiety and depression and affected health-related quality of life (HRQoL). The aims of this study were to assess HRQoL, anxiety, and depression pre- and post-diagnosis in patients undergoing diagnostic evaluations for cancer due to non-specific symptoms; to examine changes over time in relation to final diagnosis (cancer yes/no); and to assess the predictive value of pre-diagnostic psychological, socio-demographic and clinical factors. A prospective, multicenter survey study of patients suspected to have cancer based on non-specific symptoms was performed. Participants completed the EORTC-QLQ-C30 quality of life scale, HADS, SOC-13 and self-rated health before and after completing diagnostic evaluations. Intra- and inter-group differences between patients diagnosed with cancer versus patients with non-cancer diagnoses were calculated. The impact of baseline psychological, socio-demographic, and medical factors on HRQoL, anxiety and depression at follow-up was explored by bootstrapped multivariate linear regression analyses and logistic regression analyses. A total of 838 patients participated in this study; 679 (81 %) completed the follow-up. Twenty-two percent of the patients received a cancer diagnosis at the end of the follow-up. Patients presented initially with a high burden of symptoms and affected role and emotional functioning and global health/QL, irrespective of diagnosis. The prevalence of clinical anxiety prior to knowledge of the diagnosis was 32 % in patients with cancer and 35 % in patients who received a non-cancer diagnosis. HRQoL and anxiety improved after diagnosis, and a larger improvement was seen in patients who received a non-cancer diagnosis. There were no intra- or inter-group differences in the depression scores. The strongest predictors of global QL, anxiety, and depression after a known diagnosis were baseline scores, co-morbidity and poor self-rated health. Patients undergoing diagnostic evaluations for cancer based on non-specific symptoms experience a high prevalence of anxiety and affected quality of life prior to knowledge of the diagnosis. The predictive value of the baseline scores is important when assessing the psychological impact of undergoing diagnostic evaluations for cancer.

  10. GDx-MM: An imaging Mueller matrix retinal polarimeter

    NASA Astrophysics Data System (ADS)

    Twietmeyer, Karen Marie

    2007-12-01

    Retinal diseases are a major cause of blindness worldwide. Although widely studied, disease mechanisms are not completely understood, and diagnostic tests may not detect disease early enough for timely intervention. The goal of this research is to contribute to research for more sensitive diagnostic tests that might use the interaction of polarized light with retinal tissue to detect subtle changes in the microstructure. This dissertation describes the GDx-MM, a scanning laser polarimeter which measures a complete 16-element Mueller matrix image of the retina. This full polarization signature may provide new comparative information on the structure of healthy and diseased retinal tissue by highlighting depolarizing structures as well as structures with varying magnitudes and orientations of retardance and diattenuation. The three major components of this dissertation are: (1) Development of methods for polarimeter optimization and error analysis; (2) Design, optimization, assembly, calibration, and validation of the GDx-MM polarimeter; and (3) Analysis of data for several human subjects. Development involved modifications to a Laser Diagnostics GDx, a commercially available scanning laser ophthalmoscope with incomplete polarization capability. Modifications included installation of polarization components, development of a data acquisition system, and implementation of algorithms to convert raw data into polarization parameter images. Optimization involved visualization of polarimeter state trajectories on the Poincare sphere and a condition number analysis of the instrument matrix. Retinal images are collected non-invasively at 20 mum resolution over a 15° visual field in four seconds. Validation of the polarimeter demonstrates a polarimetric measurement accuracy of approximately +/- 5%. Retinal polarization data was collected on normal human subjects at the University of Arizona and at Indiana University School of Optometry. Calculated polarization parameter images reveal properties of the tissue microstructure. For example, retardance images indicate nerve fiber layer thickness and orientation, and depolarization images (uniform for these normal subjects), are predicted to indicate regions of disease-related tissue disruption. This research demonstrates a method for obtaining a full polarization signature of the retina in one measurement using a polarimetrically optimized instrument, and provides a step toward the use of complete retinal imaging polarimetry in the diagnosis and monitoring of retinal disease.

  11. The computation in diagnostics for tokamaks: systems, designs, approaches

    NASA Astrophysics Data System (ADS)

    Krawczyk, Rafał; Linczuk, Paweł; Czarski, Tomasz; Wojeński, Andrzej; Chernyshova, Maryna; Poźniak, Krzysztof; Kolasiński, Piotr; Kasprowicz, Grzegorz; Zabołotny, Wojciech; Kowalska-Strzeciwilk, Ewa; Malinowski, Karol; Gaska, Michał

    2017-08-01

    The requirements given for GEM (Gaseous Electron Multiplier) detector based acquisition system for plasma impurities diagnostics triggered a need for the development of a specialized software and hardware architecture. The amount of computations with latency and throughput restrictions cause that an advanced solution is sought for. In order to provide a mechanism fitting the designated tokamaks, an insight into existing solutions was necessary. In the article there is discussed architecture of systems used for plasma diagnostics and in related scientific fields. The developed solution is compared and contrasted with other diagnostic and control systems. Particular attention is payed to specific requirements for plasma impurities diagnostics in tokamak thermal fusion reactor. Subsequently, the details are presented that justified the choice of the system architecture and the discussion on various approaches is given.

  12. Material handling robot system for flow-through storage applications

    NASA Astrophysics Data System (ADS)

    Dill, James F.; Candiloro, Brian; Downer, James; Wiesman, Richard; Fallin, Larry; Smith, Ron

    1999-01-01

    This paper describes the design, development and planned implementation of a system of mobile robots for use in flow through storage applications. The robots are being designed with on-board embedded controls so that they can perform their tasks as semi-autonomous workers distributed within a centrally controlled network. On the storage input side, boxes will be identified by bar-codes and placed into preassigned flow through bins. On the shipping side, orders will be forwarded to the robots from a central order processing station and boxes will be picked from designated storage bins following proper sequencing to permit direct loading into trucks for shipping. Because of the need to maintain high system availability, a distributed control strategy has been selected. When completed, the system will permit robots to be dynamically reassigned responsibilities if an individual unit fails. On-board health diagnostics and condition monitoring will be used to maintain high reliability of the units.

  13. An Empirically Derived Taxonomy for Personality Diagnosis: Bridging Science and Practice in Conceptualizing Personality

    PubMed Central

    Westen, Drew; Shedler, Jonathan; Bradley, Bekh; DeFife, Jared A.

    2013-01-01

    Objective The authors describe a system for diagnosing personality pathology that is empirically derived, clinically relevant, and practical for day-to-day use. Method A random national sample of psychiatrists and clinical psychologists (N=1,201) described a randomly selected current patient with any degree of personality dysfunction (from minimal to severe) using the descriptors in the Shedler-Westen Assessment Procedure–II and completed additional research forms. Results The authors applied factor analysis to identify naturally occurring diagnostic groupings within the patient sample. The analysis yielded 10 clinically coherent personality diagnoses organized into three higher-order clusters: internalizing, externalizing, and borderline-dysregulated. The authors selected the most highly rated descriptors to construct a diagnostic prototype for each personality syndrome. In a second, independent sample, research interviewers and patients’ treating clinicians were able to diagnose the personality syndromes with high agreement and minimal comorbidity among diagnoses. Conclusions The empirically derived personality prototypes described here provide a framework for personality diagnosis that is both empirically based and clinically relevant. PMID:22193534

  14. Diagnostic for a high-repetition rate electron photo-gun and first measurements

    NASA Astrophysics Data System (ADS)

    Filippetto, D.; Doolittle, L.; Huang, G.; Norum, E.; Portmann, G.; Qian, H.; Sannibale, F.

    2015-05-01

    The APEX electron source at LBNL combines the high-repetition-rate with the high beam brightness typical of photoguns, delivering low emittance electron pulses at MHz frequency. Proving the high beam quality of the beam is an essential step for the success of the experiment, opening the doors of the high average power to brightness-hungry applications as X-Ray FELs, MHz ultrafast electron diffraction etc.. As first step, a complete characterization of the beam parameters is foreseen at the Gun beam energy of 750 keV. Diagnostics for low and high current measurements have been installed and tested, and measurements of cathode lifetime and thermal emittance in a RF environment with mA current performed. The recent installation of a double slit system, a deflecting cavity and a high precision spectrometer, allow the exploration of the full 6D phase space. Here we discuss the present layout of the machine and future upgrades, showing the latest results at low and high repetition rate, together with the tools and techniques used.

  15. Delay in the Diagnosis of Adult-Onset Still’s Disease

    PubMed Central

    Pham, Cindy

    2017-01-01

    Adult-onset Still’s disease (AOSD) is a systemic autoinflammatory disease characterized by symptoms including spiking fever, arthralgia, myalgia, maculopapular rash, and pharyngitis. The lack of diagnostic biomarker, non-specific clinical presentation, and the rarity of AOSD often result in a significant delay in diagnosis and treatment. While the average time of initial presentation to diagnosis is four months, we present a case of AOSD diagnosis three years after initial onset of classical symptoms. By reporting the case of delayed diagnosis for AOSD, we hope to raise awareness in our medical community about the diagnostic difficulty in AOSD. The present case describes an otherwise healthy male who presented with typical symptoms of AOSD, but the diagnosis of AOSD was missed during his first presentation. In the second flaring episode, the diagnosis of AOSD was established. He had an excellent therapeutic response to anakinra and prednisone during the acute flaring episode. He is currently in complete remission on methotrexate as maintenance therapy. PMID:28690954

  16. A Data-Driven Diagnostic Framework for Wind Turbine Structures: A Holistic Approach

    PubMed Central

    Bogoevska, Simona; Spiridonakos, Minas; Chatzi, Eleni; Dumova-Jovanoska, Elena; Höffer, Rudiger

    2017-01-01

    The complex dynamics of operational wind turbine (WT) structures challenges the applicability of existing structural health monitoring (SHM) strategies for condition assessment. At the center of Europe’s renewable energy strategic planning, WT systems call for implementation of strategies that may describe the WT behavior in its complete operational spectrum. The framework proposed in this paper relies on the symbiotic treatment of acting environmental/operational variables and the monitored vibration response of the structure. The approach aims at accurate simulation of the temporal variability characterizing the WT dynamics, and subsequently at the tracking of the evolution of this variability in a longer-term horizon. The bi-component analysis tool is applied on long-term data, collected as part of continuous monitoring campaigns on two actual operating WT structures located in different sites in Germany. The obtained data-driven structural models verify the potential of the proposed strategy for development of an automated SHM diagnostic tool. PMID:28358346

  17. Is Ki-67 of Diagnostic Value in Distinguishing Between Partial and Complete Hydatidiform Moles? A Systematic Review and Meta-analysis.

    PubMed

    Zhao, Yue; Xiong, Guang-Wu; Zhang, Xiao-Wei; Hang, B O

    2018-02-01

    To demonstrate the value of Ki-67 in distinguishing between partial and complete hydatidiform moles. We searched electronic databases included Medline, WOK, Cochrane Library and CNKI, through January 24, 2015. Experts were consulted, and references from related articles were examined. The meta-analysis was conducted with RevMan5.3, according to the PRISMA guidelines. Mantel-Haenszel estimates were calculated and pooled under a random effect model, with data expressed as odds ratio (OR) and 95% confidence interval (CI). We analyzed eight trials with a total of 337 participants who underwent uterine curettage and met the inclusion criteria. A significantly higher expression of Ki-67 was observed in complete than in partial hydatidiform moles (OR=3.28; 95%CI=1.80-5.96; p<0.0001). The Ki-67 expression was higher in complete than in partial hydatidiform moles. Therefore, Ki-67 may be of diagnostic value in distinguishing between partial and complete hydatidiform moles. However, the present study had only a limited number of samples, so investigation of a greater number of cases is needed to confirm this conclusion. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  18. [Coma in the emergency room].

    PubMed

    Braun, M; Ploner, C J; Lindner, T; Möckel, M; Schmidt, W U

    2017-06-01

    Coma of unknown origin (CUO) is a frequent unspecific emergency symptom associated with a high mortality. A fast diagnostic work-up is essential given the wide spectrum of underlying diagnoses that are made up of approximately 50% primary central nervous system (CNS) pathologies and approximately 50% extracerebral, almost exclusively internal medical causes. Despite the high mortality associated with this symptom, there are currently no generally accepted management guidelines for adult patients presenting with CUO. We propose an interdisciplinary standard operating procedure (SOP) for patients with acute CUO as has been established in our maximum care hospital. The SOP is triggered by simple triage criteria that are sufficient to identify CUO patients before arrival in hospital. The in-hospital response team is led by a neurologist. Collaboration with nursing staff, internal medicine, anesthesiology, neurosurgery and trauma surgery is organized along structured pathways that include standardized laboratory tests, including cerebrospinal fluid (CSF), toxicology, computed tomography (CT) and CT angiography imaging (CTA). Our data suggest that neurologists and internists need to be placed at the beginning of the diagnostic work-up. Imaging should not just be carried out depending on the clinical syndrome because sensitivity, specificity and inter-rater reliability of the latter are not sufficient and because in many cases, multiple pathologies can be detected that could each explain CUO alone. Clinical examination, imaging and laboratory testing should be regarded as components of an integrative diagnostic approach and the final aetiological classification should only be made after the diagnostic work-up is complete.

  19. [Theoretical grounds of a structural and functional model for quality assurance of radiation diagnostics under conditions of development of the modern health care system in Ukraine].

    PubMed

    Korop, Oleg A; Lenskykh, Sergiy V

    2018-01-01

    Introduction: Modern changes in the health care system of Ukraine are focused on financial support in providing medical and diagnostic care to the population and are based on deep and consistent structural and functional transformations. They are aimed at providing adequate quality care, which is the main target function and a principal criterion for operation of health care system. The urgency of this problem is increasing in the context of reforming the health care system and global changes in the governmental financial guarantees for the provision of medical services to the population. The aim of the work is to provide theoretical grounds for a structural and functional model of quality assurance of radiation diagnostics at all levels of medical care given to the population under the current health care reform in Ukraine. Materials and methods: The object of the study is organizing the operation of the radiation diagnostic service; the information is based on the actual data on the characteristics of radiation diagnosis at different levels of medical care provision. Methods of systematic approach, system analysis and structural and functional analysis of the operating system of radiation diagnostics are used. Review: The basis of the quality assurance model is the cyclical process, which includes the stages of the problem identifition, planning of its solution, organization of the system for implementation of decisions, monitoring the quality management process of the radiation diagnostics, and factors influencing the quality of the radiation diagnostics service. These factors include the quality of the structure, process, results, organization of management and control of current processes and the results of radiation diagnostics management. Conclusions: The advantages of the proposed model for ensuring the quality of the radiation diagnostics service are its systemacy and complexity, elimination of identified defects and deficiencies, and achievement of profitability through modern redistribution and use of existing resources of the health care system. The results of adequate service quality management activities in radiation diagnostics are the improvement of organizational and economic principles along with legislative regulation, the implementation of a modern system of radiation diagnostics in the state health care at the national and regional levels, the increase of the accessibility, quality and efficiency of the radiation diagnostics service.

  20. An ontology-driven, diagnostic modeling system.

    PubMed

    Haug, Peter J; Ferraro, Jeffrey P; Holmen, John; Wu, Xinzi; Mynam, Kumar; Ebert, Matthew; Dean, Nathan; Jones, Jason

    2013-06-01

    To present a system that uses knowledge stored in a medical ontology to automate the development of diagnostic decision support systems. To illustrate its function through an example focused on the development of a tool for diagnosing pneumonia. We developed a system that automates the creation of diagnostic decision-support applications. It relies on a medical ontology to direct the acquisition of clinic data from a clinical data warehouse and uses an automated analytic system to apply a sequence of machine learning algorithms that create applications for diagnostic screening. We refer to this system as the ontology-driven diagnostic modeling system (ODMS). We tested this system using samples of patient data collected in Salt Lake City emergency rooms and stored in Intermountain Healthcare's enterprise data warehouse. The system was used in the preliminary development steps of a tool to identify patients with pneumonia in the emergency department. This tool was compared with a manually created diagnostic tool derived from a curated dataset. The manually created tool is currently in clinical use. The automatically created tool had an area under the receiver operating characteristic curve of 0.920 (95% CI 0.916 to 0.924), compared with 0.944 (95% CI 0.942 to 0.947) for the manually created tool. Initial testing of the ODMS demonstrates promising accuracy for the highly automated results and illustrates the route to model improvement. The use of medical knowledge, embedded in ontologies, to direct the initial development of diagnostic computing systems appears feasible.

  1. User's guide for GSMP, a General System Modeling Program. [In PL/I

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Cook, J. M.

    1979-10-01

    GSMP is designed for use by systems analysis teams. Given compiled subroutines that model the behavior of components plus instructions as to how they are to be interconnected, this program links them together to model a complete system. GSMP offers a fast response to management requests for reconfigurations of old systems and even initial configurations of new systems. Standard system-analytic services are provided: parameter sweeps, graphics, free-form input and formatted output, file storage and recovery, user-tested error diagnostics, component model and integration checkout and debugging facilities, sensitivity analysis, and a multimethod optimizer with nonlinear constraint handling capability. Steady-state or cyclicmore » time-dependence is simulated directly, initial-value problems only indirectly. The code is written in PL/I, but interfaces well with FORTRAN component models. Over the last five years GSMP has been used to model theta-pinch, tokamak, and heavy-ion fusion power plants, open- and closed-cycle magneto-hydrodynamic power plants, and total community energy systems.« less

  2. PubMed Central

    BOSCARINO, G.; CREA, M.A.; MINELLI, F.; SNIDER, F.

    2015-01-01

    SUMMARY Paragangliomas (PGL) are rare lesions of the neuroendocrine system; in the neck, they usually affect the carotid glomus (carotid body tumours-CBT). This retrospective analysis reports our experience in management of these lesions in patients treated by surgical resection. Between 2000 and 2014, 33 patients were surgically treated at our institution, obtaining a series of 44 cervical PGLs. Tumour characteristics, family history, diagnostic procedures, surgical treatment, short- and long-term outcomes were reviewed. A female prevalence was found (76% of cases). Familial cases occurred in 9 patients (20%); 6 presented with bilateral lesions and 1 had multiple paragangliomas. Lymph node metastasis was not found in any patient. All lesions were classified into three groups according to the latero-lateral diameter. Complete resection of the PGL was performed in all patients. Mortality was null; transitory cranial nerve deficit occurred in 20% of cases with permanent palsy in 6.7%. No perioperative stroke/TIA were observed. Surgical resection of PGL should be considered as the only therapeutic option because it can ensure complete removal of the disease. Patients with bilateral lesions and positive family history should be referred for genetic analysis. Preoperative planning of the surgical procedure by integrated diagnostic imaging and a full mastery of vascular surgery techniques are mandatory to minimise the risk of the most common postoperative complications. Long-term follow-up is recommended, particularly in patients with familial disease or sporadic lesions treated in an advanced stage. PMID:26019391

  3. TFTR diagnostic vacuum controller

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    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.

  4. A new classification system for lesbians: the Dyke Diagnostic Manual.

    PubMed

    Eliason, Michele J

    2010-01-01

    There has been a long-standing need for a diagnostic manual that documents the unique pathological behaviors of lesbians. The Dyke Diagnostic Manual (DDM) is meant to supplement mainstream classification systems used to identify problematic behaviors in heterosexuals. This article presents thirteen uniquely lesbian conditions that are nowhere to be found in heterosexist diagnostic systems. The DDM may help to reduce the pain and suffering found in many lesbian relationships where one or both partners are afflicted.

  5. Video Diagnostic for W7-X Stellarator

    NASA Astrophysics Data System (ADS)

    Sárközi, J.; Grosser, K.; Kocsis, G.; König, R.; Neuner, U.; Molnár, Á.; Petravich, G.; Por, G.; Porempovics, G.; Récsei, S.; Szabó, V.; Szappanos, A.; Zoletnik, S.

    2008-03-01

    The video diagnostics for W7-X—which is under development—is devoted to observe plasma and frrst wall elements during operation, to warn in case of hot spots and dangerous heat load and to give information about the plasma size, position, edge structure, the geometry and location of magnetic islands and distribution of impurities. The video diagnostics will be mounted on the tangential AEQ-ports of the torus that are not straight and have about 2m length and a typical diameter of 0.1m which makes its realization more difficult. The geometry of the 10 tangential views of the AEQ-ports allows giving an almost complete overview of the vessel interior making this diagnostic indispensable for the machine operation. Different concepts of the diagnostics were investigated and finally the following design was selected. As a large heat load is expected on the optical window located at the plasma-facing end of the AEQ-port, the port window is protected by a cooled pinhole. An uncooled shutter located behind the pinhole can be closed to prevent window contamination during vessel conditioning discharges (glow discharge cleaning) and from inter-pulse deposition of soft a-C:H layers. The imaging optics and the detection sensor are located behind the port window in the port tube, which will be under atmospheric pressure. To detect the visible radiation distribution a new camera system called Event Detection Intelligent Camera (EDICAM) is under development. The system is divided into three major separated components. The Sensor Module contains only the selected CMOS sensor, the analog digital converters and the minimal electronics necessary for the communication with the subsequent camera system module called Image Processing and Control Unit (IPCU). Its simple structure makes the Sensor Module suitable to operate despite being exposed to ionizing (neutron, γ-) radiation. The IPCU, which can be located far from the Sensor Module and therefore far from the plasma, is designed to perform real time evaluation of the images detecting predefined events, managing the sensor read-out and the input triggers and producing the output triggers generated by the detected events. The IPCU can also be used to reduce the amount of the stored data. A Standard 10 Gigabit Ethernet fiber optics connection connects the IPCU module to the PC with GigEVision communication protocol.

  6. Estimation of diagnostic test accuracy without full verification: a review of latent class methods

    PubMed Central

    Collins, John; Huynh, Minh

    2014-01-01

    The performance of a diagnostic test is best evaluated against a reference test that is without error. For many diseases, this is not possible, and an imperfect reference test must be used. However, diagnostic accuracy estimates may be biased if inaccurately verified status is used as the truth. Statistical models have been developed to handle this situation by treating disease as a latent variable. In this paper, we conduct a systematized review of statistical methods using latent class models for estimating test accuracy and disease prevalence in the absence of complete verification. PMID:24910172

  7. [Diagnostic studies in the planning process of human resources: the Central American experience].

    PubMed

    de Canales, F; Martínez Chopen, O; Tercero Talavera, I; González, G

    1987-01-01

    In this paper the authors analyze various aspects of one of the essential stages in the process of planning human resources--diagnostic studies and research which will serve as a starting point. They stress the role of diagnostic personnel studies in formulating human resources policies and planning, and describe the phases to be followed in their execution, according to the results obtained in the three Central American countries (Guatemala, Honduras, and Nicaragua) in which the studies were completed. The paper concludes with a summary of the process in the three countries.

  8. Initial results of the FUSION-X-US prototype combining 3D automated breast ultrasound and digital breast tomosynthesis.

    PubMed

    Schaefgen, Benedikt; Heil, Joerg; Barr, Richard G; Radicke, Marcus; Harcos, Aba; Gomez, Christina; Stieber, Anne; Hennigs, André; von Au, Alexandra; Spratte, Julia; Rauch, Geraldine; Rom, Joachim; Schütz, Florian; Sohn, Christof; Golatta, Michael

    2018-06-01

    To determine the feasibility of a prototype device combining 3D-automated breast ultrasound (ABVS) and digital breast tomosynthesis in a single device to detect and characterize breast lesions. In this prospective feasibility study, the FUSION-X-US prototype was used to perform digital breast tomosynthesis and ABVS in 23 patients with an indication for tomosynthesis based on current guidelines after clinical examination and standard imaging. The ABVS and tomosynthesis images of the prototype were interpreted separately by two blinded experts. The study compares the detection and BI-RADS® scores of breast lesions using only the tomosynthesis and ABVS data from the FUSION-X-US prototype to the results of the complete diagnostic workup. Image acquisition and processing by the prototype was fast and accurate, with some limitations in ultrasound coverage and image quality. In the diagnostic workup, 29 solid lesions (23 benign, including three cases with microcalcifications, and six malignant lesions) were identified. Using the prototype, all malignant lesions were detected and classified as malignant or suspicious by both investigators. Solid breast lesions can be localized accurately and fast by the Fusion-X-US system. Technical improvements of the ultrasound image quality and ultrasound coverage are needed to further study this new device. The prototype combines tomosynthesis and automated 3D-ultrasound (ABVS) in one device. It allows accurate detection of malignant lesions, directly correlating tomosynthesis and ABVS data. The diagnostic evaluation of the prototype-acquired data was interpreter-independent. The prototype provides a time-efficient and technically reliable diagnostic procedure. The combination of tomosynthesis and ABVS is a promising diagnostic approach.

  9. Genetic Mimetics of Mycobacterium tuberculosis and Methicillin-Resistant Staphylococcus aureus as Verification Standards for Molecular Diagnostics.

    PubMed

    Machowski, Edith Erika; Kana, Bavesh Davandra

    2017-12-01

    Molecular diagnostics have revolutionized the management of health care through enhanced detection of disease or infection and effective enrollment into treatment. In recognition of this, the World Health Organization approved the rollout of nucleic acid amplification technologies for identification of Mycobacterium tuberculosis using platforms such as GeneXpert MTB/RIF, the GenoType MTBDR plus line probe assay, and, more recently, GeneXpert MTB/RIF Ultra. These assays can simultaneously detect tuberculosis infection and assess rifampin resistance. However, their widespread use in health systems requires verification and quality assurance programs. To enable development of these, we report the construction of genetically modified strains of Mycobacterium smegmatis that mimic the profile of Mycobacterium tuberculosis on both the GeneXpert MTB/RIF and the MTBDR plus line probe diagnostic tests. Using site-specific gene editing, we also created derivatives that faithfully mimic the diagnostic result of rifampin-resistant M. tuberculosis , with mutations at positions 513, 516, 526, 531, and 533 in the rifampin resistance-determining region of the rpoB gene. Next, we extended this approach to other diseases and demonstrated that a Staphylococcus aureus gene sequence can be introduced into M. smegmatis to generate a positive response for the SCC mec probe in the GeneXpert SA Nasal Complete molecular diagnostic cartridge, designed for identification of methicillin-resistant S. aureus These biomimetic strains are cost-effective, have low biohazard content, accurately mimic drug resistance, and can be produced with relative ease, thus illustrating their potential for widespread use as verification standards for diagnosis of a variety of diseases. Copyright © 2017 American Society for Microbiology.

  10. Personality Mediation of Genetic Effects on Attention-Deficit/Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Martel, Michelle M.; Nikolas, Molly; Jernigan, Katherine; Friderici, Karen; Nigg, Joel T.

    2010-01-01

    Personality traits may be viable candidates for mediators of the relationship between genetic risk and ADHD. Participants were 578 children (331 boys; 320 children with ADHD) between the ages of six and 18. Parents and teachers completed a comprehensive, multi-stage diagnostic procedure to assess ADHD and comorbid disorders. Mother completed the…

  11. Overcoming limitations of model-based diagnostic reasoning systems

    NASA Technical Reports Server (NTRS)

    Holtzblatt, Lester J.; Marcotte, Richard A.; Piazza, Richard L.

    1989-01-01

    The development of a model-based diagnostic system to overcome the limitations of model-based reasoning systems is discussed. It is noted that model-based reasoning techniques can be used to analyze the failure behavior and diagnosability of system and circuit designs as part of the system process itself. One goal of current research is the development of a diagnostic algorithm which can reason efficiently about large numbers of diagnostic suspects and can handle both combinational and sequential circuits. A second goal is to address the model-creation problem by developing an approach for using design models to construct the GMODS model in an automated fashion.

  12. Extracellular proteome analysis of Leptospira interrogans serovar Lai.

    PubMed

    Zeng, Lingbing; Zhang, Yunyi; Zhu, Yongzhang; Yin, Haidi; Zhuang, Xuran; Zhu, Weinan; Guo, Xiaokui; Qin, Jinhong

    2013-10-01

    Abstract Leptospirosis is one of the most important zoonoses. Leptospira interrogans serovar Lai is a pathogenic spirochete that is responsible for leptospirosis. Extracellular proteins play an important role in the pathogenicity of this bacterium. In this study, L. interrogans serovar Lai was grown in protein-free medium; the supernatant was collected and subsequently analyzed as the extracellular proteome. A total of 66 proteins with more than two unique peptides were detected by MS/MS, and 33 of these were predicted to be extracellular proteins by a combination of bioinformatics analyses, including Psortb, cello, SoSuiGramN and SignalP. Comparisons of the transcriptional levels of these 33 genes between in vivo and in vitro conditions revealed that 15 genes were upregulated and two genes were downregulated in vivo compared to in vitro. A BLAST search for the components of secretion system at the genomic and proteomic levels revealed the presence of the complete type I secretion system and type II secretion system in this strain. Moreover, this strain also exhibits complete Sec translocase and Tat translocase systems. The extracellular proteome analysis of L. interrogans will supplement the previously generated whole proteome data and provide more information for studying the functions of specific proteins in the infection process and for selecting candidate molecules for vaccines or diagnostic tools for leptospirosis.

  13. Do mental health professionals use diagnostic classifications the way we think they do? A global survey

    PubMed Central

    First, Michael B.; Rebello, Tahilia J.; Keeley, Jared W.; Bhargava, Rachna; Dai, Yunfei; Kulygina, Maya; Matsumoto, Chihiro; Robles, Rebeca; Stona, Anne‐Claire; Reed, Geoffrey M.

    2018-01-01

    We report on a global survey of diagnosing mental health professionals, primarily psychiatrists, conducted as a part of the development of the ICD‐11 mental and behavioural disorders classification. The survey assessed these professionals' use of various components of the ICD‐10 and the DSM, their attitudes concerning the utility of these systems, and usage of “residual” (i.e., “other” or “unspecified”) categories. In previous surveys, most mental health professionals reported they often use a formal classification system in everyday clinical work, but very little is known about precisely how they are using those systems. For example, it has been suggested that most clinicians employ only the diagnostic labels or codes from the ICD‐10 in order to meet administrative requirements. The present survey was conducted with clinicians who were members of the Global Clinical Practice Network (GCPN), established by the World Health Organization as a tool for global participation in ICD‐11 field studies. A total of 1,764 GCPN members from 92 countries completed the survey, with 1,335 answering the questions with reference to the ICD‐10 and 429 to the DSM (DSM‐IV, DSM‐IV‐TR or DSM‐5). The most frequent reported use of the classification systems was for administrative or billing purposes, with 68.1% reporting often or routinely using them for that purpose. A bit more than half (57.4%) of respondents reported often or routinely going through diagnostic guidelines or criteria systematically to determine whether they apply to individual patients. Although ICD‐10 users were more likely than DSM‐5 users to utilize the classification for administrative purposes, other differences were either slight or not significant. Both classifications were rated to be most useful for assigning a diagnosis, communicating with other health care professionals and teaching, and least useful for treatment selection and determining prognosis. ICD‐10 was rated more useful than DSM‐5 for administrative purposes. A majority of clinicians reported using “residual” categories at least sometimes, with around 12% of ICD‐10 users and 19% of DSM users employing them often or routinely, most commonly for clinical presentations that do not conform to a specific diagnostic category or when there is insufficient information to make a more specific diagnosis. These results provide the most comprehensive available information about the use of diagnostic classifications of mental disorders in ordinary clinical practice. PMID:29856559

  14. Do mental health professionals use diagnostic classifications the way we think they do? A global survey.

    PubMed

    First, Michael B; Rebello, Tahilia J; Keeley, Jared W; Bhargava, Rachna; Dai, Yunfei; Kulygina, Maya; Matsumoto, Chihiro; Robles, Rebeca; Stona, Anne-Claire; Reed, Geoffrey M

    2018-06-01

    We report on a global survey of diagnosing mental health professionals, primarily psychiatrists, conducted as a part of the development of the ICD-11 mental and behavioural disorders classification. The survey assessed these professionals' use of various components of the ICD-10 and the DSM, their attitudes concerning the utility of these systems, and usage of "residual" (i.e., "other" or "unspecified") categories. In previous surveys, most mental health professionals reported they often use a formal classification system in everyday clinical work, but very little is known about precisely how they are using those systems. For example, it has been suggested that most clinicians employ only the diagnostic labels or codes from the ICD-10 in order to meet administrative requirements. The present survey was conducted with clinicians who were members of the Global Clinical Practice Network (GCPN), established by the World Health Organization as a tool for global participation in ICD-11 field studies. A total of 1,764 GCPN members from 92 countries completed the survey, with 1,335 answering the questions with reference to the ICD-10 and 429 to the DSM (DSM-IV, DSM-IV-TR or DSM-5). The most frequent reported use of the classification systems was for administrative or billing purposes, with 68.1% reporting often or routinely using them for that purpose. A bit more than half (57.4%) of respondents reported often or routinely going through diagnostic guidelines or criteria systematically to determine whether they apply to individual patients. Although ICD-10 users were more likely than DSM-5 users to utilize the classification for administrative purposes, other differences were either slight or not significant. Both classifications were rated to be most useful for assigning a diagnosis, communicating with other health care professionals and teaching, and least useful for treatment selection and determining prognosis. ICD-10 was rated more useful than DSM-5 for administrative purposes. A majority of clinicians reported using "residual" categories at least sometimes, with around 12% of ICD-10 users and 19% of DSM users employing them often or routinely, most commonly for clinical presentations that do not conform to a specific diagnostic category or when there is insufficient information to make a more specific diagnosis. These results provide the most comprehensive available information about the use of diagnostic classifications of mental disorders in ordinary clinical practice. © 2018 World Psychiatric Association.

  15. New receiving line for the remote-steering antenna of the 140 GHz CTS diagnostics in the FTU Tokamak

    NASA Astrophysics Data System (ADS)

    D'Arcangelo, O.; Bin, W.; Bruschi, A.; Cappelli, M.; Fanale, F.; Gittini, G.; Pallotta, F.; Rocchi, G.; Tudisco, O.; Garavaglia, S.; Granucci, G.; Moro, A.; Tuccillo, A. A.

    2018-01-01

    A new receiving antenna for collecting signals of the Collective Thomson Scattering (CTS) diagnostics in FTU Tokamak has been recently installed. The squared corrugated section and the precisely defined length make it possible to receive from different directions by remotely steering the receiving mirrors. This type of Remote-Steering (RS) antennas, being studied on FTU for the DEMO Electron Cyclotron Heating (ECH) system launch, is already installed on the W7- X stellarator and will be tested in the next campaign. The transmission of the signal from the antenna in the tokamak hall to the CTS diagnostics hall will be mainly realized by means of oversized circular corrugated waveguides carrying the hybrid HE11 (quasi-gaussian) waveguide mode, with inclusion of a special smooth-waveguide section and a short run of reduced-size square-corrugated waveguide through the tokamak bio-shield. The coupling between different waveguide types is made with ellipsoidal focusing mirrors, using quasi-optical matching formulas between the gaussian-shaped beams in input and output to the waveguides. In this work, after a complete study of feasibility of the overall line, a design for the receiving line will be proposed, in order to realize an executive layout to be used as a guideline for the commissioning phase.

  16. [Clinical analysis of patients with lower extremity deep venous thrombosis complicated with inferior vena cava thrombus].

    PubMed

    Dong, Dian-ning; Wu, Xue-jun; Zhang, Shi-yi; Zhong, Zhen-yue; Jin, Xing

    2013-06-04

    To explore the clinical profiles of patients with lower extremity deep venous thrombosis (DVT) complicated with inferior vena cava (IVC) thrombus and summarize their clinical diagnostic and therapeutic experiences. The clinical characteristics, diagnosis and treatment of 20 hospitalized patients with DVT complicated with inferior vena cava thrombus were analyzed retrospectively. All of them were of proximal DVT. There were phlegmasia cerulea dolens (n = 3), pulmonary embolism (n = 3) and completely occlusion of IVC (n = 5). Clinical manifestations were severe. Retrievable inferior vena cava filter (IVCF) was implanted for 17 cases. Catheter-directed thrombolysis (CDT) through ipsilateral popliteal vein was applied for 7 cases and systemic thrombolysis therapy for 8 cases. The effective rate of thrombolysis for fresh IVC thrombus was 100%. Among 5 cases with Cockett Syndrome, 3 cases underwent balloon dilatation angioplasty and endovascular stenting of iliac vein. And 17 IVCFs were retrieved successfully within 3 weeks. IVC thrombus disappeared completely in 15 cases. Systemic or local thrombolysis with protective IVCF is a safe and effective therapy for nonocclusive IVC thrombus in DVT. And CDT is recommended for symptomatic occlusive IVC thrombus.

  17. End-of-Test Performance and Wear Characterization of NASA's Evolutionary Xenon Thruster (NEXT) Long-Duration Test

    NASA Technical Reports Server (NTRS)

    Shastry, Rohit; Herman, Daniel A.; Soulas, George C.; Patterson, Michael J.

    2014-01-01

    The NASA's Evolutionary Xenon Thruster (NEXT) program is developing the next-generation solar electric ion propulsion system with significant enhancements beyond the state-of-the-art NASA Solar Electric Propulsion Technology Application Readiness (NSTAR) ion propulsion system to provide future NASA science missions with enhanced capabilities. A Long-Duration Test (LDT) was initiated in June 2005 to validate the thruster service life modeling and to quantify the thruster propellant throughput capability. Testing was recently completed in February 2014, with the thruster accumulating 51,184 hours of operation, processing 918 kg of xenon propellant, and delivering 35.5 MN-s of total impulse.As part of the test termination procedure, a comprehensive performance characterization was performed across the entire NEXT throttle table. This was performed prior to planned repairs of numerous diagnostics that had become inoperable over the course of the test. After completion of these diagnostic repairs in November 2013, a comprehensive end-of-test performance and wear characterization was performed on the test article prior to exposure to atmosphere. These data have confirmed steady thruster performance with minimal degradation as well as mitigation of numerous life limiting mechanisms encountered in the NSTAR design. Component erosion rates compare favorably to pretest predictions based on semi-empirical models used for the thruster service life assessment. Additional data relating to ion beam density profiles, facility backsputter rates, facility backpressure effects on thruster telemetry, and modulation of the neutralizer keeper current are presented as part of the end-of-test characterization. Presently the test article for the NEXT LDT has been exposed to atmosphere and placed within a clean room environment, with post-test disassembly and inspection underway.

  18. Review of medical discharge summaries and medical documentation in a metropolitan hospital: impact on diagnostic-related groups and Weighted Inlier Equivalent Separation.

    PubMed

    Chin, N; Perera, P; Roberts, A; Nagappan, R

    2013-07-01

    Accurate and comprehensive clinical documentation is crucial for effective ongoing patient care, follow up and to optimise case mix-based funding. Each Diagnostic Related Group (DRG) is assigned a 'weight', leading to Weighted Inlier Equivalent Separation (WIES), a system many public and private hospitals in Australia subscribe to. To identify the top DRG in a general medical inpatient service, the completeness of medical discharge documentation, commonly missed comorbidities and system-related issues and subsequent impact on DRG and WIES allocation. One hundred and fifty completed discharge summaries were randomly selected from the top 10 medical DRG in our health service. From a detailed review of the clinical documentation, principal diagnoses, associated comorbidities and complications, where appropriate, the DRG and WIES were modified. Seventy-two (48%) of the 150 reviewed admissions resulted in a revision of DRG and WIES equivalent to an increase of AUD 142,000. Respiratory-based DRG generated the largest revision of DRG and WIES, while 'Cellulitis' DRG had the largest relative change. Twenty-seven per cent of summaries reviewed necessitated a change in coding with no subsequent change in DRG allocation or WIES. Acute renal failure, anaemia and electrolyte disturbances were the most commonly underrepresented entities in clinical discharge documentation. Seven patients had their WIES downgraded. Comprehensive documentation of principal diagnosis/diagnoses, comorbidities and their complications is imperative to optimal DRG and WIES allocation. Regular meetings between clinical and coding staff improve the quality and timeliness of medical documentation, ensure adequate communication with general practitioners and lead to appropriate funding. © 2013 The Authors; Internal Medicine Journal © 2013 Royal Australasian College of Physicians.

  19. Validation of cytogenetic risk groups according to International Prognostic Scoring Systems by peripheral blood CD34+FISH: results from a German diagnostic study in comparison with an international control group

    PubMed Central

    Braulke, Friederike; Platzbecker, Uwe; Müller-Thomas, Catharina; Götze, Katharina; Germing, Ulrich; Brümmendorf, Tim H.; Nolte, Florian; Hofmann, Wolf-Karsten; Giagounidis, Aristoteles A. N.; Lübbert, Michael; Greenberg, Peter L.; Bennett, John M.; Solé, Francesc; Mallo, Mar; Slovak, Marilyn L.; Ohyashiki, Kazuma; Le Beau, Michelle M.; Tüchler, Heinz; Pfeilstöcker, Michael; Nösslinger, Thomas; Hildebrandt, Barbara; Shirneshan, Katayoon; Aul, Carlo; Stauder, Reinhard; Sperr, Wolfgang R.; Valent, Peter; Fonatsch, Christa; Trümper, Lorenz; Haase, Detlef; Schanz, Julie

    2015-01-01

    International Prognostic Scoring Systems are used to determine the individual risk profile of myelodysplastic syndrome patients. For the assessment of International Prognostic Scoring Systems, an adequate chromosome banding analysis of the bone marrow is essential. Cytogenetic information is not available for a substantial number of patients (5%–20%) with dry marrow or an insufficient number of metaphase cells. For these patients, a valid risk classification is impossible. In the study presented here, the International Prognostic Scoring Systems were validated based on fluorescence in situ hybridization analyses using extended probe panels applied to cluster of differentiation 34 positive (CD34+) peripheral blood cells of 328 MDS patients of our prospective multicenter German diagnostic study and compared to chromosome banding results of 2902 previously published patients with myelodysplastic syndromes. For cytogenetic risk classification by fluorescence in situ hybridization analyses of CD34+ peripheral blood cells, the groups differed significantly for overall and leukemia-free survival by uni- and multivariate analyses without discrepancies between treated and untreated patients. Including cytogenetic data of fluorescence in situ hybridization analyses of peripheral CD34+ blood cells (instead of bone marrow banding analysis) into the complete International Prognostic Scoring System assessment, the prognostic risk groups separated significantly for overall and leukemia-free survival. Our data show that a reliable stratification to the risk groups of the International Prognostic Scoring Systems is possible from peripheral blood in patients with missing chromosome banding analysis by using a comprehensive probe panel (clinicaltrials.gov identifier:01355913). PMID:25344522

  20. The Global Education Network for Retinopathy of Prematurity (Gen-Rop): Development, Implementation, and Evaluation of A Novel Tele-Education System (An American Ophthalmological Society Thesis).

    PubMed

    Chan, R V Paul; Patel, Samir N; Ryan, Michael C; Jonas, Karyn E; Ostmo, Susan; Port, Alexander D; Sun, Grace I; Lauer, Andreas K; Chiang, Michael F

    2015-01-01

    To describe the design, implementation, and evaluation of a tele-education system developed to improve diagnostic competency in retinopathy of prematurity (ROP) by ophthalmology residents. A secure Web-based tele-education system was developed utilizing a repository of over 2,500 unique image sets of ROP. For each image set used in the system, a reference standard ROP diagnosis was established. Performance by ophthalmology residents (postgraduate years 2 to 4) from the United States and Canada in taking the ROP tele-education program was prospectively evaluated. Residents were presented with image-based clinical cases of ROP during a pretest, posttest, and training chapters. Accuracy and reliability of ROP diagnosis (eg, plus disease, zone, stage, category) were determined using sensitivity, specificity, and the kappa statistic calculations of the results from the pretest and posttest. Fifty-five ophthalmology residents were provided access to the ROP tele-education program. Thirty-one ophthalmology residents completed the program. When all training levels were analyzed together, a statistically significant increase was observed in sensitivity for the diagnosis of plus disease, zone, stage, category, and aggressive posterior ROP (P<.05). Statistically significant changes in specificity for identification of stage 2 or worse (P=.027) and pre-plus (P=.028) were observed. A tele-education system for ROP education is effective in improving diagnostic accuracy of ROP by ophthalmology residents. This system may have utility in the setting of both healthcare and medical education reform by creating a validated method to certify telemedicine providers and educate the next generation of ophthalmologists.

  1. The Impact of Measurement Noise in GPA Diagnostic Analysis of a Gas Turbine Engine

    NASA Astrophysics Data System (ADS)

    Ntantis, Efstratios L.; Li, Y. G.

    2013-12-01

    The performance diagnostic analysis of a gas turbine is accomplished by estimating a set of internal engine health parameters from available sensor measurements. No physical measuring instruments however can ever completely eliminate the presence of measurement uncertainties. Sensor measurements are often distorted by noise and bias leading to inaccurate estimation results. This paper explores the impact of measurement noise on Gas Turbine GPA analysis. The analysis is demonstrated with a test case where gas turbine performance simulation and diagnostics code TURBOMATCH is used to build a performance model of a model engine similar to Rolls-Royce Trent 500 turbofan engine, and carry out the diagnostic analysis with the presence of different levels of measurement noise. Conclusively, to improve the reliability of the diagnostic results, a statistical analysis of the data scattering caused by sensor uncertainties is made. The diagnostic tool used to deal with the statistical analysis of measurement noise impact is a model-based method utilizing a non-linear GPA.

  2. Real-time diagnostics for a reusable rocket engine

    NASA Technical Reports Server (NTRS)

    Guo, T. H.; Merrill, W.; Duyar, A.

    1992-01-01

    A hierarchical, decentralized diagnostic system is proposed for the Real-Time Diagnostic System component of the Intelligent Control System (ICS) for reusable rocket engines. The proposed diagnostic system has three layers of information processing: condition monitoring, fault mode detection, and expert system diagnostics. The condition monitoring layer is the first level of signal processing. Here, important features of the sensor data are extracted. These processed data are then used by the higher level fault mode detection layer to do preliminary diagnosis on potential faults at the component level. Because of the closely coupled nature of the rocket engine propulsion system components, it is expected that a given engine condition may trigger more than one fault mode detector. Expert knowledge is needed to resolve the conflicting reports from the various failure mode detectors. This is the function of the diagnostic expert layer. Here, the heuristic nature of this decision process makes it desirable to use an expert system approach. Implementation of the real-time diagnostic system described above requires a wide spectrum of information processing capability. Generally, in the condition monitoring layer, fast data processing is often needed for feature extraction and signal conditioning. This is usually followed by some detection logic to determine the selected faults on the component level. Three different techniques are used to attack different fault detection problems in the NASA LeRC ICS testbed simulation. The first technique employed is the neural network application for real-time sensor validation which includes failure detection, isolation, and accommodation. The second approach demonstrated is the model-based fault diagnosis system using on-line parameter identification. Besides these model based diagnostic schemes, there are still many failure modes which need to be diagnosed by the heuristic expert knowledge. The heuristic expert knowledge is implemented using a real-time expert system tool called G2 by Gensym Corp. Finally, the distributed diagnostic system requires another level of intelligence to oversee the fault mode reports generated by component fault detectors. The decision making at this level can best be done using a rule-based expert system. This level of expert knowledge is also implemented using G2.

  3. Electron beam diagnostic system using computed tomography and an annular sensor

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Elmer, John W.; Teruya, Alan T.

    2015-08-11

    A system for analyzing an electron beam including a circular electron beam diagnostic sensor adapted to receive the electron beam, the circular electron beam diagnostic sensor having a central axis; an annular sensor structure operatively connected to the circular electron beam diagnostic sensor, wherein the sensor structure receives the electron beam; a system for sweeping the electron beam radially outward from the central axis of the circular electron beam diagnostic sensor to the annular sensor structure wherein the electron beam is intercepted by the annular sensor structure; and a device for measuring the electron beam that is intercepted by themore » annular sensor structure.« less

  4. Electron beam diagnostic system using computed tomography and an annular sensor

    DOEpatents

    Elmer, John W.; Teruya, Alan T.

    2014-07-29

    A system for analyzing an electron beam including a circular electron beam diagnostic sensor adapted to receive the electron beam, the circular electron beam diagnostic sensor having a central axis; an annular sensor structure operatively connected to the circular electron beam diagnostic sensor, wherein the sensor structure receives the electron beam; a system for sweeping the electron beam radially outward from the central axis of the circular electron beam diagnostic sensor to the annular sensor structure wherein the electron beam is intercepted by the annular sensor structure; and a device for measuring the electron beam that is intercepted by the annular sensor structure.

  5. Evaluation Of The Diagnostic Performance Of A Multimedia Medical Communications System.

    NASA Astrophysics Data System (ADS)

    Robertson, John G.; Coristine, Marjorie; Goldberg, Morris; Beeton, Carolyn; Belanger, Garry; Tombaugh, Jo W.; Hickey, Nancy M.; Millward, Steven F.; Davis, Michael; Whittingham, David

    1989-05-01

    The central concern of radiologists when evaluating Picture Archiving Communication System (PACS) is the diagnostic performance of digital images compared to the original analog versions of the same images. Considerable work has been done comparing the ROC curves of various types of digital systems to the corresponding analog systems for the detection of specific phantoms or diseases. Although the studies may notify the radiologists that for a specific lesion a digital system may perform as well as the analog system, it tells the radiologists very little about the impact on diagnostic performance of a digital system in the general practice of radiology. We describe in this paper an alternative method for evaluating the diagnostic performance of a digital system and a preliminary experiment we conducted to test the methodology.

  6. Development of life prediction capabilities for liquid propellant rocket engines. Post-fire diagnostic system for the SSME system architecture study

    NASA Technical Reports Server (NTRS)

    Gage, Mark; Dehoff, Ronald

    1991-01-01

    This system architecture task (1) analyzed the current process used to make an assessment of engine and component health after each test or flight firing of an SSME, (2) developed an approach and a specific set of objectives and requirements for automated diagnostics during post fire health assessment, and (3) listed and described the software applications required to implement this system. The diagnostic system described is a distributed system with a database management system to store diagnostic information and test data, a CAE package for visual data analysis and preparation of plots of hot-fire data, a set of procedural applications for routine anomaly detection, and an expert system for the advanced anomaly detection and evaluation.

  7. Diagnostics in Japan's microgravity experiments

    NASA Technical Reports Server (NTRS)

    Kadota, Toshikazu

    1995-01-01

    The achievement of the combustion research under microgravity depends substantially on the availability of diagnostic systems. The non-intrusive diagnostic systems are potentially applicable for providing the accurate, realistic and detailed information on momentum, mass and energy transport, complex gas phase chemistry, and phase change in the combustion field under microgravity. The non-intrusive nature of optical instruments is essential to the measurement of combustion process under microgravity which is very nervous to any perturbation. However, the implementation of the non-intrusive combustion diagnostic systems under microgravity is accompanied by several constraints. Usually, a very limited space is only available for constructing a highly sophisticated system which is so sensitive that it is easily affected by the magnitude of the gravitational force, vibration and heterogeneous field of temperature and density of the environments. The system should be properly adjusted prior to the experiment. Generally, it is quite difficult to tune the instruments during measurements. The programmed sequence of operation should also be provided. Extensive effort has been toward the development of non-intrusive diagnostic systems available for the combustion experiments under microgravity. This paper aims to describe the current art and the future strategy on the non-intrusive diagnostic systems potentially applicable to the combustion experiments under microgravity in Japan.

  8. DSM-5, ICD-10, ICD-11, the Psychodynamic Diagnostic Manual, and Person-Centered Integrative Diagnosis: An Overview for College Mental Health Therapists

    ERIC Educational Resources Information Center

    Cooper, Stewart E.

    2014-01-01

    Therapists in the field of college mental health counseling commonly voice an ambivalent orientation towards the utilization of formal psychological diagnostic systems yet often use diagnostic terms. Knowledge of the current and emerging diagnostic systems may contribute to greater syntheses of these differing approaches. This article will first…

  9. Classification of anthropogenic soils by new diagnostic criteria involved in the Slovak Soil Classification System (2014)

    NASA Astrophysics Data System (ADS)

    Sobocká, Jaroslava; Balkovič, Juraj; Bedrna, Zoltán

    2017-04-01

    Anthropogenic soils can be found mostly in SUITMA areas. The issue of adequate and correct description and classification of these soils occurs very often and can result in inconsistent even in contradictory opinions. In the new version of the anthropogenic soil classification system in Slovakia some new diagnostics criteria were involved and applied for better understanding the inherent nature of these soils. The group of the former anthropogenic soils was divided following scheme of soil reference groups in the WRB 2014 (Anthrozem and Technozem). According to the new version of the Slovak anthropogenic soils classification (2014) there have been distinguished 2 groups of anthropogenic soils: 1) cultivated soils group including 2 soil types (in Slovak terminology): Kultizem and Hortizem and 2) technogenic soils group having 2 soil types: Antrozem and Technozem. Cultivated soil group represents soils developing or forming "in-situ" with diagnostic horizons characterized by human deeply influenced cultivated processes. Technogenic soil group are soils developing like "ex-situ" soils. The key features recognizing technogenic soil group are human-transported and altered material (HTAM = ex-situ aspect), and artefacts content. Diagnostic horizons (top and subsoil) were described as various material affected by physical-mechanical excavation, transportation and spread, mixing, and containing artefacts (the new diagnostic feature). Kultizems are differentiated by cultivated horizon(s) and Technozems by anthropogenic horizon(s). Cultivated horizons are mostly well-known described horizon in many scientific references. Anthropogenic horizons for Technozem are developed from the human-induced transported and altered material which origin is from the other ecological locality that adjacent area. Materials (or substrates) can consist of various material (natural, technogenic or their mixing) with thickness ≥ 60 cm. Artefacts are the second diagnostic feature which presence authenticates the "artificial origin" of the soil. Natural material contains ≤ 10 % artefacts; natural-technogenic 10-40 % artefacts; and technogenic ≥ 40 %. In the soil survey anthropogenic transported or altered layer is very simply recognizable in soil profile if it is compared with adjacent natural horizons. The classification problem is to define and distinguish not only artefacts in soil profile but recognize the origin of the material. The completed manual for these issues is missing. In the contribution, there graphically individual basic soil types of Antrozems and Technozems with some subtypes will be illustrated. Also the basic schema of classification units in Slovakia will be depicted.

  10. MO-F-204-00: Preparing for the ABR Diagnostic and Nuclear Medical Physics Exams

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    NONE

    Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR 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 allmore » aspects of clinical medical physics. All 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 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 unique aspects of the nuclear exam, and how preparing for a second specialty differs from the first. Medical physicists who recently completed each ABR exam portion 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, systems, dosimetry, safety and related problem solving/calculations How to prepare for Part 3 of the ABR exam by effectively communicating the practice, methods, and significance of clinical diagnostic and/or nuclear medical physics.« less

  11. MO-F-204-02: Preparing for Part 2 of the ABR Diagnostic Physics Exam

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Szczykutowicz, T.

    Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR 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 allmore » aspects of clinical medical physics. All 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 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 unique aspects of the nuclear exam, and how preparing for a second specialty differs from the first. Medical physicists who recently completed each ABR exam portion 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, systems, dosimetry, safety and related problem solving/calculations How to prepare for Part 3 of the ABR exam by effectively communicating the practice, methods, and significance of clinical diagnostic and/or nuclear medical physics.« less

  12. MO-F-204-03: Preparing for Part 3 of the ABR Diagnostic Physics Exam

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Zambelli, J.

    Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR 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 allmore » aspects of clinical medical physics. All 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 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 unique aspects of the nuclear exam, and how preparing for a second specialty differs from the first. Medical physicists who recently completed each ABR exam portion 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, systems, dosimetry, safety and related problem solving/calculations How to prepare for Part 3 of the ABR exam by effectively communicating the practice, methods, and significance of clinical diagnostic and/or nuclear medical physics.« less

  13. MO-F-204-01: Preparing for Part 1 of the ABR Diagnostic Physics Exam

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    McKenney, S.

    Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR 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 allmore » aspects of clinical medical physics. All 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 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 unique aspects of the nuclear exam, and how preparing for a second specialty differs from the first. Medical physicists who recently completed each ABR exam portion 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, systems, dosimetry, safety and related problem solving/calculations How to prepare for Part 3 of the ABR exam by effectively communicating the practice, methods, and significance of clinical diagnostic and/or nuclear medical physics.« less

  14. WE-D-213-00: Preparing for the ABR Diagnostic and Nuclear Medicine Physics Exams

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    NONE

    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 ofmore » 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, systems, dosimetry, safety and related problem solving/calculations How to Prepare for Part 3 of the ABR exam by effectively communicating the practice, methods, and significance of clinical diagnostic and/or nuclear medical physics.« less

  15. WE-D-213-01: Preparing for Part 1 of the ABR Diagnostic Physics Exam

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Simiele, S.

    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 ofmore » 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, systems, dosimetry, safety and related problem solving/calculations How to Prepare for Part 3 of the ABR exam by effectively communicating the practice, methods, and significance of clinical diagnostic and/or nuclear medical physics.« less

  16. WE-D-213-03: Preparing for Part 3 of the ABR Diagnostic Physics Exam

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bevins, N.

    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 ofmore » 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, systems, dosimetry, safety and related problem solving/calculations How to Prepare for Part 3 of the ABR exam by effectively communicating the practice, methods, and significance of clinical diagnostic and/or nuclear medical physics.« less

  17. WE-D-213-02: Preparing for Part 2 of the ABR Diagnostic Physics Exam

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Zambelli, J.

    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 ofmore » 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, systems, dosimetry, safety and related problem solving/calculations How to Prepare for Part 3 of the ABR exam by effectively communicating the practice, methods, and significance of clinical diagnostic and/or nuclear medical physics.« less

  18. Initial surgical experience following implementation of lung cancer screening at an urban safety net hospital.

    PubMed

    Muñoz-Largacha, Juan A; Steiling, Katrina A; Kathuria, Hasmeena; Charlot, Marjory; Fitzgerald, Carmel; Suzuki, Kei; Litle, Virginia R

    2018-06-01

    Safety net hospitals provide care mostly to low-income, uninsured, and vulnerable populations, in whom delays in cancer screening are established barriers. Socioeconomic barriers might pose important challenges to the success of a lung cancer screening program at a safety net hospital. We aimed to determine screening follow-up compliance, rates of diagnostic and treatment procedures, and the rate of cancer diagnosis in patients classified as category 4 by the Lung CT Screening Reporting and Data System (Lung-RADS 4). We conducted a retrospective review of all patients enrolled in our multidisciplinary lung cancer screening program between March 2015 and July 2016. Demographics, smoking status, Lung-RADS score, and number of diagnostic and therapeutic interventions and cancer diagnoses were captured. A total of 554 patients were screened over a 16-month period. The mean patient age was 63 years (range, 47-85 years), and 60% were male. The majority (92%; 512 of 554) were classified as Lung-RADS 1 to 3, and 8% (42 of 554) were classified as Lung-RADS 4. Among the Lung-RADS 4 patients, 98% (41 of 42) completed their recommended follow-up; 29% (12 of 42) underwent a diagnostic procedure, for an overall diagnostic intervention rate of 2% (12 of 554). Eleven of these 12 patients had cancer, and 1 patient had sarcoidosis. The overall rate of surgical resection was 0.9% (5 of 554), and the rate of diagnostic intervention for noncancer diagnosis was 0.1% (1 of 554). Implementation of a multidisciplinary lung cancer screening program at a safety net hospital is feasible. Compliance with follow-up and interventional recommendations in Lung-RADS 4 patients was high despite anticipated social challenges. Overall diagnostic and surgical resection rates and interventions for noncancer diagnosis were low in our initial experience. Copyright © 2018 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  19. Increasing Access to Tuberculosis Services in Ethiopia: Findings From a Patient-Pathway Analysis.

    PubMed

    Fekadu, Lelisa; Hanson, Christy; Osberg, Mike; Makayova, Julia; Mingkwan, Pia; Chin, Daniel

    2017-11-06

    In Ethiopia, extensive scale-up of the availability of health extension workers (HEWs) at the community level has been credited with increased identification and referral of patients with presumptive tuberculosis, which has contributed to increased tuberculosis case notification and better treatment outcomes. However, nearly 30% of Ethiopia's estimated 191000 patients with tuberculosis remained unnotified in 2015. A better understanding of patient care-seeking practices may inform future government action to reach all patients with tuberculosis. A patient-pathway analysis was completed to assess the alignment between patient care initiation and the availability of diagnostic and treatment services at the national level. More than one third of patients initiated care with HEWs, who refer patients to health centers for diagnosis. An additional one third of patients initiated care at health centers. Of those health centers, >80% had microscopy services, but few had access to Xpert. Despite an extensive microscopy and radiography network at middle levels of the health system, a quarter of all notified patients with tuberculosis had no bacteriological confirmation of disease. While 30% of patients reported receiving some form of care from the private sector, private-sector facilities, especially pharmacies, were not widely accessed for tuberculosis diagnosis. The availability of HEWs can increase access to tuberculosis diagnostic and treatment support services, particularly for rural populations. Continued strengthening of referral systems from HEWs and health posts are needed to enable consistent and timely access to Xpert as an initial diagnostic test and to drug resistance screening. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  20. A cluster randomized trial evaluating the efficacy of patient navigation in improving quality of diagnostic care for patients with breast or colorectal cancer abnormalities.

    PubMed

    Wells, Kristen J; Lee, Ji-Hyun; Calcano, Ercilia R; Meade, Cathy D; Rivera, Marlene; Fulp, William J; Roetzheim, Richard G

    2012-10-01

    This study examines efficacy of a lay patient navigation (PN) program aimed to reduce time between a cancer abnormality and definitive diagnosis among racially/ethnically diverse and medically underserved populations of Tampa Bay, Florida. Using a cluster randomized design, the study consisted of 11 clinics (six navigated; five control). Patients were navigated from time of a breast or colorectal abnormality to diagnostic resolution, and to completion of cancer treatment. Using a generalized mixed-effects model to assess intervention effects, we examined: (i) length of time between abnormality and definitive diagnosis, and (ii) receipt of definitive diagnosis within the 6-month minimum follow-up period. A total of 1,267 patients participated (588 navigated; 679 control). We also included data from an additional 309 chart abstractions (139 navigated arm; 170 control arm) that assessed outcomes at baseline. PN did not have a significant effect on time to diagnostic resolution in multivariable analysis that adjusted for race-ethnicity, language, insurance status, marital status, and cancer site (P = 0.16). Although more navigated patients achieved diagnostic resolution by 180 days, results were not statistically significant (74.5% navigated vs. 68.5% control, P = 0.07). PN did not impact the overall time to completion of diagnostic care or the number of patients who reached diagnostic resolution of a cancer abnormality. Further evaluation of PN programs applied to other patient populations across the cancer continuum is necessary to gain a better perspective on its effectiveness. PN programs may not impact timely resolution of an abnormality suspicious of breast or colorectal cancer. 2012 AACR

  1. Active galactic nuclei from He II: a more complete census of AGN in SDSS galaxies yields a new population of low-luminosity AGN in highly star-forming galaxies

    NASA Astrophysics Data System (ADS)

    Bär, Rudolf E.; Weigel, Anna K.; Sartori, Lia F.; Oh, Kyuseok; Koss, Michael; Schawinski, Kevin

    2017-04-01

    In order to perform a more complete census of active galactic nuclei (AGN) in the local Universe, we investigate the use of the He II λ4685 emission line diagnostic diagram by Shirazi & Brinchmann (2012) in addition to the standard methods based on other optical emission lines. The He II-based diagnostics is more sensitive to AGN ionization in the presence of strong star formation than conventional line diagnostics. We survey a magnitude-limited sample of 63 915 galaxies from the Sloan Digital Sky Survey Data Release 7 at 0.02 < z < 0.05 and use both the conventional BPT emission line diagnostic diagrams, as well as the He II diagram to identify AGN. In this sample, 1075 galaxies are selected as AGN using the BPT diagram, while additional 234 galaxies are identified as AGN using the He II diagnostic diagram, representing a 22 per cent increase of AGN in the parent galaxy sample. We explore the host galaxy properties of these new He II-selected AGN candidates and find that they are most common in star-forming galaxies on the blue cloud and on the main sequence where ionization from star formation is most likely to mask AGN emission in the BPT lines. We note in particular a high He II AGN fraction in galaxies above the high-mass end of the main sequence where quenching is expected to occur. We use archival Chandra observations to confirm the AGN nature of candidates selected through He II-based diagnostic. Finally, we discuss how this technique can help inform galaxy/black hole coevolution scenarios.

  2. Predicting Cognitive, Functional, and Diagnostic Change over 4 Years Using Baseline Subjective Cognitive Complaints in the Sydney Memory and Ageing Study.

    PubMed

    Slavin, Melissa J; Sachdev, Perminder S; Kochan, Nicole A; Woolf, Claudia; Crawford, John D; Giskes, Katrina; Reppermund, Simone; Trollor, Julian N; Draper, Brian; Delbaere, Kim; Brodaty, Henry

    2015-09-01

    There is limited understanding of the usefulness of subjective cognitive complaint(s) (SCC) in predicting longitudinal outcome because most studies focus solely on memory (as opposed to nonmemory cognitive) complaints, do not collect data from both participants and informants, do not control for relevant covariates, and have limited outcome measures. Therefore the authors investigate the usefulness of participant and informant SCCs in predicting change in cognition, functional abilities, and diagnostic classification of mild cognitive impairment or dementia in a community-dwelling sample over 4 years. Nondemented participants (N = 620) in the Sydney Memory and Ageing Study aged between 70 and 90 years completed 15 memory and 9 nonmemory SCC questions. An informant completed a baseline questionnaire that included 15 memory and 4 nonmemory SCC questions relating to the participant. Neuropsychological, functional, and diagnostic assessments were carried out at baseline and again at 4-year follow-up. Cross-sectional and longitudinal analyses were carried out to determine the association between SCC indices and neuropsychological, functional, and diagnostic data while controlling for psychological measures. Once participant characteristics were controlled for, participant complaints were generally not predictive of cognitive or functional decline, although participant memory-specific complaints were predictive of diagnostic conversion. Informant-related memory questions were associated with global cognitive and functional decline and with diagnostic conversion over 4 years. Informant memory complaint questions were better than participant complaints in predicting cognitive and functional decline as well as diagnoses over 4 years. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  3. Development of a Diagnostic and Remedial Learning System Based on an Enhanced Concept--Effect Model

    ERIC Educational Resources Information Center

    Panjaburees, Patcharin; Triampo, Wannapong; Hwang, Gwo-Jen; Chuedoung, Meechoke; Triampo, Darapond

    2013-01-01

    With the rapid advances in computer technology during recent years, researchers have demonstrated the pivotal influences of computer-assisted diagnostic systems on student learning performance improvement. This research aims to develop a Diagnostic and Remedial Learning System (DRLS) for an algebra course in a Thai lower secondary school context…

  4. Revising the personality disorder diagnostic criteria for the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-V): consider the later life context.

    PubMed

    Balsis, Steve; Segal, Daniel L; Donahue, Cailin

    2009-10-01

    The categorical measurement approach implemented by the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) personality disorder (PD) diagnostic system is theoretically and pragmatically limited. As a result, many prominent psychologists now advocate for a shift away from this approach in favor of more conceptually sound dimensional measurement. This shift is expected to improve the psychometric properties of the personality disorder (PD) diagnostic system and make it more useful for clinicians and researchers. The current article suggests that despite the probable benefits of such a change, several limitations will remain if the new diagnostic system does not closely consider the context of later life. A failure to address the unique challenges associated with the assessment of personality in older adults likely will result in the continued limited validity, reliability, and utility of the Diagnostic and Statistical Manual of Mental Disorders (DSM) system for this growing population. This article discusses these limitations and their possible implications. (c) 2009 APA, all rights reserved.

  5. The development of a post-test diagnostic system for rocket engines

    NASA Technical Reports Server (NTRS)

    Zakrajsek, June F.

    1991-01-01

    An effort was undertaken by NASA to develop an automated post-test, post-flight diagnostic system for rocket engines. The automated system is designed to be generic and to automate the rocket engine data review process. A modular, distributed architecture with a generic software core was chosen to meet the design requirements. The diagnostic system is initially being applied to the Space Shuttle Main Engine data review process. The system modules currently under development are the session/message manager, and portions of the applications section, the component analysis section, and the intelligent knowledge server. An overview is presented of a rocket engine data review process, the design requirements and guidelines, the architecture and modules, and the projected benefits of the automated diagnostic system.

  6. Phenomenology of Schizophrenia and the Representativeness of Modern Diagnostic Criteria.

    PubMed

    Kendler, Kenneth S

    2016-10-01

    This article aims to determine the degree to which modern operationalized diagnostic criteria for schizophrenia reflect the main clinical features of the disorder as described historically by diagnostic experts. Amazon.com, the National Library of Medicine, and Forgottenbooks.com were searched for articles written or translated into English from 1900 to 1960. Clinical descriptions of schizophrenia or dementia praecox appearing in 16 textbooks or review articles published between 1899 and 1956 were reviewed and compared with the criteria for schizophrenia from 6 modern US operationalized diagnostic systems. Twenty prominent symptoms and signs were reported by 5 or more authors. A strong association was seen between the frequency with which the symptoms/signs were reported and the likelihood of their presence in modern diagnostic systems. Of these 20 symptoms/signs, 3 (thought disorder, delusions, and hallucinations) were included in all diagnostic systems and were among the 4 most frequently reported. Three symptoms/signs were added then kept in subsequent criteria: emotional blunting, changes in volition, and changes in social life. Three symptoms/signs were added but then dropped: bizarre delusions, passivity symptoms, and mood incongruity. Eleven symptoms/signs were never included in any diagnostic system. Compared with historical authors, modern criteria favored symptoms over signs. Odd movements and postures, noted by 16 of 18 historical authors, were absent from all modern criteria. DSM-5 criteria contain 6 of the 20 historically noted symptoms/signs. Although modern operationalized criteria for schizophrenia reflect symptoms and signs commonly reported by historical experts, many clinical features emphasized by these experts are absent from modern criteria. This is not necessarily problematic as diagnostic criteria are meant to index rather than thoroughly describe syndromes. However, the lack of correspondence in schizophrenia between historically important symptoms/signs and current diagnostic systems highlights the limitations of clinical evaluations and research studies that restrict the diagnostic assessments to current diagnostic criteria. We should not confuse our DSM diagnostic criteria with the disorders that they were designed to index.

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

    ERIC Educational Resources Information Center

    Cooper, Luke D.; Balsis, Steve

    2009-01-01

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

  8. A comparison of hysteroscopic mechanical tissue removal with bipolar electrical resection for the management of endometrial polyps in an ambulatory care setting: preliminary results.

    PubMed

    Pampalona, Jennifer Rovira; Bastos, Maria Degollada; Moreno, Gemma Mancebo; Pust, Andrea Buron; Montesdeoca, Gemma Escribano; Guerra Garcia, Angel; Pruñonosa, Juan Carles Mateu; Collado, Ramon Carreras; Torras, Pere Bresco

    2015-01-01

    To assess and compare efficacy, pain, and the learning curve associated with diagnostic therapeutic hysteroscopy using mechanical tissue removal versus bipolar electrical resection in the management of endometrial polyps in an ambulatory care setting. A randomized controlled clinical trial (Canadian Task Force classification I). Hospital de Igulada, Barcelona, Spain. A total of 133 patients diagnosed with endometrial polyp(s) were included and randomly assigned to 1 of the 2 hysteroscopic methods. Criteria assessed were total hysteroscopy time, full polypectomy procedure time, pain experienced by patients, and learning curve of staff in training. The average time to perform total hysteroscopy using the mechanical tissue removal system (TRUCLEAR 5.0 System; Smith & Nephew Inc., Andover, MD) was 6 minutes 49 seconds versus 11 minutes 37 seconds required for the bipolar electrosurgery system (GYNECARE VERSAPOINT; Ethicon Inc, Somerville, NJ) (p < .01). Results for complete polypectomy time favored the TRUCLEAR System at 3 minutes 7 seconds over the VERSAPOINT System at 8 minutes 25 seconds (p < .01). If a successful procedure is predicated on access to cavity, visualization, and complete resection and excision of endometrial polyp, the mechanical TRUCLEAR Tissue Removal System shows a higher success rate than the VERSAPOINT Bipolar Electrosurgery System at 92% and 77%, respectively. Analysis of pain using the visual analog scale revealed no significant differences between the 2 techniques (p > .05). A study of the residents' learning curve showed a higher level of autonomy with hysteroscopy using the TRUCLEAR Tissue Removal System with which residents showed a higher level of confidence compared with hysteroscopy with the VERSAPOINT Bipolar Electrosurgery System. In hysteroscopic polypectomy, the mechanical tissue removal system was significantly faster, achieved a greater success rate for complete polypectomy, and required a shorter learning curve from staff being trained in the management of endometrial polyps when compared with bipolar electrical resection. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

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

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Medley, S.S.

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

  10. The national ignition facility: path to ignition in the laboratory

    NASA Astrophysics Data System (ADS)

    Moses, E. I.; Bonanno, R. E.; Haynam, C. A.; Kauffman, R. L.; MacGowan, B. J.; Patterson, R. W., Jr.; Sawicki, R. H.; van Wonterghem, B. M.

    2007-08-01

    The National Ignition Facility (NIF) is a 192-beam laser facility presently under construction at LLNL. When completed, NIF will be a 1.8-MJ, 500-TW ultraviolet laser system. Its missions are to obtain fusion ignition and to perform high energy density experiments in support of the US nuclear weapons stockpile. Four of the NIF beams have been commissioned to demonstrate laser performance and to commission the target area including target and beam alignment and laser timing. During this time, NIF demonstrated on a single-beam basis that it will meet its performance goals and demonstrated its precision and flexibility for pulse shaping, pointing, timing and beam conditioning. It also performed four important experiments for Inertial Confinement Fusion and High Energy Density Science. Presently, the project is installing production hardware to complete the project in 2009 with the goal to begin ignition experiments in 2010. An integrated plan has been developed including the NIF operations, user equipment such as diagnostics and cryogenic target capability, and experiments and calculations to meet this goal. This talk will provide NIF status, the plan to complete NIF, and the path to ignition.

  11. A national physician survey of diagnostic error in paediatrics.

    PubMed

    Perrem, Lucy M; Fanshawe, Thomas R; Sharif, Farhana; Plüddemann, Annette; O'Neill, Michael B

    2016-10-01

    This cross-sectional survey explored paediatric physician perspectives regarding diagnostic errors. All paediatric consultants and specialist registrars in Ireland were invited to participate in this anonymous online survey. The response rate for the study was 54 % (n = 127). Respondents had a median of 9-year clinical experience (interquartile range (IQR) 4-20 years). A diagnostic error was reported at least monthly by 19 (15.0 %) respondents. Consultants reported significantly less diagnostic errors compared to trainees (p value = 0.01). Cognitive error was the top-ranked contributing factor to diagnostic error, with incomplete history and examination considered to be the principal cognitive error. Seeking a second opinion and close follow-up of patients to ensure that the diagnosis is correct were the highest-ranked, clinician-based solutions to diagnostic error. Inadequate staffing levels and excessive workload were the most highly ranked system-related and situational factors. Increased access to and availability of consultants and experts was the most highly ranked system-based solution to diagnostic error. We found a low level of self-perceived diagnostic error in an experienced group of paediatricians, at variance with the literature and warranting further clarification. The results identify perceptions on the major cognitive, system-related and situational factors contributing to diagnostic error and also key preventative strategies. • Diagnostic errors are an important source of preventable patient harm and have an estimated incidence of 10-15 %. • They are multifactorial in origin and include cognitive, system-related and situational factors. What is New: • We identified a low rate of self-perceived diagnostic error in contrast to the existing literature. • Incomplete history and examination, inadequate staffing levels and excessive workload are cited as the principal contributing factors to diagnostic error in this study.

  12. The clinical evaluation of infantile nystagmus: What to do first and why

    PubMed Central

    Bertsch, Morgan; Floyd, Michael; Kehoe, Taylor; Pfeifer, Wanda; Drack, Arlene V.

    2017-01-01

    Introduction Infantile nystagmus has many causes, some life threatening. We determined the most common diagnoses in order to develop a testing algorithm. Methods Retrospective chart review. Exclusion criteria were no nystagmus, acquired after 6 months, or lack of examination. Data collected: pediatric eye examination findings, ancillary testing, order of testing, referral, and final diagnoses. Final diagnosis was defined as meeting published clinical criteria and/or confirmed by diagnostic testing. Patients with a diagnosis not meeting the definition were “unknown.” Patients with incomplete testing were “incomplete.” Patients with multiple plausible etiologies were “multifactorial.” Patients with negative complete workup were “motor.” Results 284 charts were identified; 202 met inclusion criteria. The 3 most common causes were Albinism(19%), Leber Congenital Amaurosis(LCA)(14%) and Non-LCA retinal dystrophy (13%). Anatomic retinal disorders comprised 10%, motor another 10%. The most common first test was MRI (74/202) with a diagnostic yield of 16%. For 28 MRI-first patients, nystagmus alone was the indication; for 46 MRI-first patients other neurologic signs were present. 0/28 nystagmus-only patients had a diagnostic MRI while 14/46 (30%) with neurologic signs did. Yield of ERG as first test was 56%, OCT 55%, and molecular genetic testing 47%. 90% of patients had an etiology identified. Conclusion The most common causes of infantile nystagmus were retinal disorders (56%), however the most common first test was brain MRI. For patients without other neurologic stigmata complete pediatric eye examination, ERG, OCT and molecular genetic testing had a higher yield than MRI scan. If MRI is not diagnostic, a complete ophthalmologic workup should be pursued. PMID:28177849

  13. Expert Systems and Diagnostic Monitors in Psychiatry

    PubMed Central

    Gelernter, David; Gelernter, Joel

    1984-01-01

    We argue that existing expert systems for medical diagnosis have not satisfactorily addressed an important problem: how are such systems to be integrated into the clinical environment? This problem should be addressed before and not after a working system is developed, because its solution might well determine important aspects of the ultimate system structure. We propose as one solution the online diagnostic monitor, which is a diagnostic expert system designed for interactive use by a clinican during the course of a patient interview. The exchange between a diagnostic monitor and its clinican user is guided by the user, not the system, and the monitor functions as a passive advisor rather than an active decision-maker. We discuss why a system of this sort might be particularly well-suited to psychiatric diagnosis, and describe preliminary work on an experimental prototype.

  14. 38 CFR 4.87a - Schedule of ratings-other sense organs.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... ratings—other sense organs. Rating 6275Sense of smell, complete loss 10 6276Sense of taste, complete loss 10 Note: Evaluation will be assigned under diagnostic codes 6275 or 6276 only if there is an anatomical or pathological basis for the condition. (Authority: 38 U.S.C. 1155) [64 FR 25210, May 11, 1999...

  15. Hollow shaft integrated health monitoring system for railroad wheels

    NASA Astrophysics Data System (ADS)

    Frankenstein, B.; Hentschel, D.; Pridoehl, E.; Schubert, F.

    2005-05-01

    The economic efficiency and competitiveness of environment-friendly rail transportation depends on safety, availability and maintenance of single highly loaded structure components. Until now these components have been changed in fixed maintenance intervals irrespective of any usage related conditions. With the knowledge and evaluation of the component conditions, life cycle costs can be reduced by means of optimized maintenance and/or "fit for purpose" design. For example, rail-bound vehicle wheel sets are among the most highly stressed travelling gear components of the bogie. if such a component fails, a serious accident may occur. For this reason, a health monitoring system based on the interpretation of ultrasonic sound signatures has been developed. First, the ultrasonic waves generated by an artificial defect on the outer wheel tread of a railroad wheel towards an acoustic sensor, placed inside the hollow shaft of the railroad axis were simulated with a EFIT (Elastodynamic Finite Integration Technique). The results achieved proved that relevant signals can be found in a frequency range up to 300 kHz. Based on this a diagnostic unit was designed and built for application under rotation conditions, which consists of a piezo-electric sensor, primary electronics, an analog-to-digital converter, a digital signal processor, a trigger unit, and a telemetric transmitter. This diagnostic unit was integrated in the hollow shaft of a railroad wheel axis, a component of a special laboratory test rig. Algorithms which allow for the rotation-synchronized processing of acoustic signals were implemented into the rotating diagnostic unit. After successfully completing a campaign for this test rig, a second test was performed inside the wheel/railroad simulation test rig of the Deutsche Bahn AG under railroad-like conditions. The data generated inside the hollow shaft of the railroad wheel axis by the diagnostic unit were telemetrically transmitted to an industrial computer. The detection of artificial defects of different sizes is shown in correlation with theoretical assumptions.

  16. Validation of the educational needs assessment tool as a generic instrument for rheumatic diseases in seven European countries.

    PubMed

    Ndosi, Mwidimi; Bremander, Ann; Hamnes, Bente; Horton, Mike; Kukkurainen, Marja Leena; Machado, Pedro; Marques, Andrea; Meesters, Jorit; Stamm, Tanja A; Tennant, Alan; de la Torre-Aboki, Jenny; Vliet Vlieland, Theodora P M; Zangi, Heidi A; Hill, Jackie

    2014-12-01

    To validate the educational needs assessment tool (ENAT) as a generic tool for assessing the educational needs of patients with rheumatic diseases in European Countries. A convenience sample of patients from seven European countries was included comprising the following diagnostic groups: ankylosing spondylitis, psoriatic arthritis, systemic sclerosis, systemic lupus erythematosus, osteoarthritis (OA) and fibromyalgia syndrome. Translated versions of the ENAT were completed through surveys in each country. Rasch analysis was used to assess the construct validity of the adapted ENATs including differential item functioning by culture (cross-cultural DIF). Initially, the data from each country and diagnostic group were fitted to the Rasch model separately, and then the pooled data from each diagnostic group. The sample comprised 3015 patients; the majority, 1996 (66.2%), were women. Patient characteristics (stratified by diagnostic group) were comparable across countries except the educational background, which was variable. In most occasions, the 39-item ENAT deviated significantly from the Rasch model expectations (item-trait interaction χ(2) p<0.05). After correction for local dependency (grouping the items into seven domains and analysing them as 'testlets'), fit to the model was satisfied (item-trait interaction χ(2) p>0.18) in all pooled disease group datasets except OA (χ(2)=99.91; p=0.002). The internal consistency in each group was high (Person Separation Index above 0.90). There was no significant DIF by person characteristics. Cross-cultural DIF was found in some items, which required adjustments. Subsequently, interval-level scales were calibrated to enable transformation of ENAT scores when required. The adapted ENAT is a valid tool with high internal consistency providing accurate estimation of the educational needs of people with rheumatic diseases. Cross-cultural comparison of educational needs is now possible. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  17. Pharmacometabolomics Informs Quantitative Radiomics for Glioblastoma Diagnostic Innovation.

    PubMed

    Katsila, Theodora; Matsoukas, Minos-Timotheos; Patrinos, George P; Kardamakis, Dimitrios

    2017-08-01

    Applications of omics systems biology technologies have enormous promise for radiology and diagnostics in surgical fields. In this context, the emerging fields of radiomics (a systems scale approach to radiology using a host of technologies, including omics) and pharmacometabolomics (use of metabolomics for patient and disease stratification and guiding precision medicine) offer much synergy for diagnostic innovation in surgery, particularly in neurosurgery. This synthesis of omics fields and applications is timely because diagnostic accuracy in central nervous system tumors still challenges decision-making. Considering the vast heterogeneity in brain tumors, disease phenotypes, and interindividual variability in surgical and chemotherapy outcomes, we believe that diagnostic accuracy can be markedly improved by quantitative radiomics coupled to pharmacometabolomics and related health information technologies while optimizing economic costs of traditional diagnostics. In this expert review, we present an innovation analysis on a systems-level multi-omics approach toward diagnostic accuracy in central nervous system tumors. For this, we suggest that glioblastomas serve as a useful application paradigm. We performed a literature search on PubMed for articles published in English between 2006 and 2016. We used the search terms "radiomics," "glioblastoma," "biomarkers," "pharmacogenomics," "pharmacometabolomics," "pharmacometabonomics/pharmacometabolomics," "collaborative informatics," and "precision medicine." A list of the top 4 insights we derived from this literature analysis is presented in this study. For example, we found that (i) tumor grading needs to be better refined, (ii) diagnostic precision should be improved, (iii) standardization in radiomics is lacking, and (iv) quantitative radiomics needs to prove clinical implementation. We conclude with an interdisciplinary call to the metabolomics, pharmacy/pharmacology, radiology, and surgery communities that pharmacometabolomics coupled to information technologies (chemoinformatics tools, databases, collaborative systems) can inform quantitative radiomics, thus translating Big Data and information growth to knowledge growth, rational drug development and diagnostics innovation for glioblastomas, and possibly in other brain tumors.

  18. Optimal Combination of Non-Invasive Tools for the Early Detection of Potentially Life-Threatening Emergencies in Gynecology

    PubMed Central

    Varas, Catalina; Ravit, Marion; Mimoun, Camille; Panel, Pierre; Huchon, Cyrille; Fauconnier, Arnaud

    2016-01-01

    Objectives Potentially life-threatening gynecological emergencies (G-PLEs) are acute pelvic conditions that may spontaneously evolve into a life-threatening situation, or those for which there is a risk of sequelae or death in the absence of prompt diagnosis and treatment. The objective of this study was to identify the best combination of non-invasive diagnostic tools to ensure an accurate diagnosis and timely response when faced with G-PLEs for patients arriving with acute pelvic pain at the Gynecological Emergency Department (ED). Methods The data on non-invasive diagnostic tools were sourced from the records of patients presenting at the ED of two hospitals in the Parisian suburbs (France) with acute pelvic pain between September 2006 and April 2008. The medical history of the patients was obtained through a standardized questionnaire completed for a prospective observational study, and missing information was completed with data sourced from the medical forms. Diagnostic tool categories were predefined as a collection of signs or symptoms. We analyzed the association of each sign/symptom with G-PLEs using Pearson’s Chi-Square or Fischer’s exact tests. Symptoms and signs associated with G-PLEs (p-value < 0.20) were subjected to logistic regression to evaluate the diagnostic value of each of the predefined diagnostic tools and in various combinations. Results The data of 365 patients with acute pelvic pain were analyzed, of whom 103 were confirmed to have a PLE. We analyzed five diagnostic tools by logistic regression: Triage Process, History-Taking, Physical Examination, Ultrasonography, and Biological Exams. The combination of History-Taking and Ultrasonography had a C-index of 0.83, the highest for a model combining two tools. Conclusions The use of a standardized self-assessment questionnaire for history-taking and focal ultrasound examination were found to be the most successful tool combination for the diagnosis of gynecological emergencies in a Gynecological ED. Additional tools, such as physical examination, do not add substantial diagnostic value. PMID:27583697

  19. The prediction of the residual life of electromechanical equipment based on the artificial neural network

    NASA Astrophysics Data System (ADS)

    Zhukovskiy, Yu L.; Korolev, N. A.; Babanova, I. S.; Boikov, A. V.

    2017-10-01

    This article is devoted to the prediction of the residual life based on an estimate of the technical state of the induction motor. The proposed system allows to increase the accuracy and completeness of diagnostics by using an artificial neural network (ANN), and also identify and predict faulty states of an electrical equipment in dynamics. The results of the proposed system for estimation the technical condition are probability technical state diagrams and a quantitative evaluation of the residual life, taking into account electrical, vibrational, indirect parameters and detected defects. Based on the evaluation of the technical condition and the prediction of the residual life, a decision is made to change the control of the operating and maintenance modes of the electric motors.

  20. Self Diagnostic Accelerometer for Mission Critical Health Monitoring of Aircraft and Spacecraft Engines

    NASA Technical Reports Server (NTRS)

    Lekki, John; Tokars, Roger; Jaros, Dave; Riggs, M. Terrence; Evans, Kenneth P.; Gyekenyesi, Andrew

    2009-01-01

    A self diagnostic accelerometer system has been shown to be sensitive to multiple failure modes of charge mode accelerometers. These failures include sensor structural damage, an electrical open circuit and most importantly sensor detachment. In this paper, experimental work that was performed to determine the capabilities of a self diagnostic accelerometer system while operating in the presence of various levels of mechanical noise, emulating real world conditions, is presented. The results show that the system can successfully conduct a self diagnostic routine under these conditions.

  1. 9 CFR 147.21 - Flock sanitation.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ..., by private carrier, to a diagnostic laboratory for complete examination. All Salmonella cultures... effective Salmonella control program. (g) Introduction of started or mature birds should be avoided to...

  2. A comparison of tuberculosis diagnostic systems in a retrospective cohort of HIV-infected children in Rio de Janeiro, Brazil.

    PubMed

    David, Solange Gonçalves; Lovero, Kathryn L; Pombo March, Maria de Fátima B; Abreu, Thalita G; Ruffino Netto, Antonio; Kritski, Afranio L; Sant'Anna, Clemax C

    2017-06-01

    The diagnosis of pediatric tuberculosis (TB) presents many challenges, and is further complicated in HIV-infected patients. While many diagnostic systems have been proposed, there is no pediatric TB diagnosis gold standard. The outcomes of four TB diagnostic systems in HIV-infected children were compared in this study. A retrospective cohort study was conducted at a TB/HIV reference hospital in Rio de Janeiro. HIV-infected pediatric patients evaluated for TB from 1998 to 2010 were reassessed using four diagnostic systems: Kenneth Jones, 1969; Tidjani, 1986; Ben Marais, 2006; Brazilian Ministry of Health, 2010. Results were compared to standardized diagnoses made by an expert panel of physicians. Of the 121 patients in the study cohort, the expert panel diagnosed 64 as TB and 57 as not TB cases. The Tidjani system showed the highest diagnostic accuracy, with and without the inclusion of microbiological data. The Tidjani and Kenneth Jones systems produced fewer false-positives, and the Ben Marais and Ministry of Health fewer false-negatives. Across systems, there was little agreement between TB diagnoses. In HIV-infected pediatric patients, the Ben Marais and Ministry of Health systems are useful for TB diagnostic screening, whereas the Tidjani and Kenneth Jones systems are best used in a reference center setting. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  3. Built-In Diagnostics (BID) Of Equipment/Systems

    NASA Technical Reports Server (NTRS)

    Granieri, Michael N.; Giordano, John P.; Nolan, Mary E.

    1995-01-01

    Diagnostician(TM)-on-Chip (DOC) technology identifies faults and commands systems reconfiguration. Smart microcontrollers operating in conjunction with other system-control circuits, command self-correcting system/equipment actions in real time. DOC microcontroller generates commands for associated built-in test equipment to stimulate unit of equipment diagnosed, collects and processes response data obtained by built-in test equipment, and performs diagnostic reasoning on response data, using diagnostic knowledge base derived from design data.

  4. Acoustic Holographic Rendering with Two-dimensional Metamaterial-based Passive Phased Array

    PubMed Central

    Xie, Yangbo; Shen, Chen; Wang, Wenqi; Li, Junfei; Suo, Dingjie; Popa, Bogdan-Ioan; Jing, Yun; Cummer, Steven A.

    2016-01-01

    Acoustic holographic rendering in complete analogy with optical holography are useful for various applications, ranging from multi-focal lensing, multiplexed sensing and synthesizing three-dimensional complex sound fields. Conventional approaches rely on a large number of active transducers and phase shifting circuits. In this paper we show that by using passive metamaterials as subwavelength pixels, holographic rendering can be achieved without cumbersome circuitry and with only a single transducer, thus significantly reducing system complexity. Such metamaterial-based holograms can serve as versatile platforms for various advanced acoustic wave manipulation and signal modulation, leading to new possibilities in acoustic sensing, energy deposition and medical diagnostic imaging. PMID:27739472

  5. Summary and Prospect.

    PubMed

    Wei, Zhengde; Chen, Xueli; Zhang, Xiaochu

    2017-01-01

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

  6. The JET diagnostic fast central acquisition and trigger system (abstract)

    NASA Astrophysics Data System (ADS)

    Edwards, A. W.; Blackler, K.

    1995-01-01

    Most plasma physics diagnostics sample at a fixed frequency that is normally matched to available memory limits. This technique is not appropriate for long pulse machines such as JET where sampling frequencies of hundreds of kHz are required to diagnose very fast events. As a result of work using real-time event selection within the previous JET soft x-ray diagnostic, a single data acquisition and event triggering system for all suitable fast diagnostics, the fast central acquisition and trigger system (Fast CATS), has been developed for JET. The front-end analog-to-digital conversion (ADC) part samples all channels at 250 kHz, with a 100 kHz pass band and a stop band of 125 kHz. The back-end data collection system is based around Texas Instruments TMS320C40 microprocessors. Within this system, two levels of trigger algorithms are able to evaluate data. The first level typically analyzes data on a per diagnostic and individual channel basis. The second level looks at the data from one or more diagnostics in a window around the time of interest flagged by the first level system. Selection criteria defined by the diagnosticians are then imposed on the results from the second level to decide whether that data should be kept. The use of such a system involving intelligent real time trigger algorithms and fast data analysis will improve both the quantity and quality of JET diagnostic data, while providing valuable input to the design of data acquisition systems for very long pulse machines such as ITER. This paper will give an overview of the various elements of this new system. In addition, first results from this system following the restart of JET operation will be presented.

  7. Diagnostic Accuracy of Tests for Polyuria in Lithium-Treated Patients.

    PubMed

    Kinahan, James Conor; NiChorcorain, Aoife; Cunningham, Sean; Freyne, Aideen; Cooney, Colm; Barry, Siobhan; Kelly, Brendan D

    2015-08-01

    In lithium-treated patients, polyuria increases the risk of dehydration and lithium toxicity. If detected early, it is reversible. Despite its prevalence and associated morbidity in clinical practice, it remains underrecognized and therefore undertreated. The 24-hour urine collection is limited by its convenience and practicality. This study explores the diagnostic accuracy of alternative tests such as questionnaires on subjective polyuria, polydipsia, nocturia (dichotomous and ordinal responses), early morning urine sample osmolality (EMUO), and fluid intake record (FIR). This is a cross-sectional study of 179 lithium-treated patients attending a general adult and an old age psychiatry service. Participants completed the tests after completing an accurate 24-hour urine collection. The diagnostic accuracy of the individual tests was explored using the appropriate statistical techniques. Seventy-nine participants completed all of the tests. Polydipsia severity, EMUO, and FIR significantly differentiated the participants with polyuria (area under the receiver operating characteristic curve of 0.646, 0.760, and 0.846, respectively). Of the tests investigated, the FIR made the largest significant change in the probability that a patient experiences polyuria (<2000 mL/24 hours; interval likelihood ratio, 0.18 and >3500 mL/24 hours; interval likelihood ratio, 14). Symptomatic questioning, EMUO, and an FIR could be used in clinical practice to inform the prescriber of the probability that a lithium-treated patient is experiencing polyuria.

  8. Development and Evaluation of Sensor Concepts for Ageless Aerospace Vehicles: Report 6 - Development and Demonstration of a Self-Organizing Diagnostic System for Structural Health Monitoring

    NASA Technical Reports Server (NTRS)

    Batten, Adam; Edwards, Graeme; Gerasimov, Vadim; Hoschke, Nigel; Isaacs, Peter; Lewis, Chris; Moore, Richard; Oppolzer, Florien; Price, Don; Prokopenko, Mikhail; hide

    2010-01-01

    This report describes a significant advance in the capability of the CSIRO/NASA structural health monitoring Concept Demonstrator (CD). The main thrust of the work has been the development of a mobile robotic agent, and the hardware and software modifications and developments required to enable the demonstrator to operate as a single, self-organizing, multi-agent system. This single-robot system is seen as the forerunner of a system in which larger numbers of small robots perform inspection and repair tasks cooperatively, by self-organization. While the goal of demonstrating self-organized damage diagnosis was not fully achieved in the time available, much of the work required for the final element that enables the robot to point the video camera and transmit an image has been completed. A demonstration video of the CD and robotic systems operating will be made and forwarded to NASA.

  9. Diagnostics of wear in aeronautical systems

    NASA Technical Reports Server (NTRS)

    Wedeven, L. D.

    1979-01-01

    The use of appropriate diagnostic tools for aircraft oil wetted components is reviewed, noting that it can reduce direct operating costs through reduced unscheduled maintenance, particularly in helicopter engine and transmission systems where bearing failures are a significant cost factor. Engine and transmission wear modes are described, and diagnostic methods for oil and wet particle analysis, the spectrometric oil analysis program, chip detectors, ferrography, in-line oil monitor and radioactive isotope tagging are discussed, noting that they are effective over a limited range of particle sizes but compliment each other if used in parallel. Fine filtration can potentially increase time between overhauls, but reduces the effectiveness of conventional oil monitoring techniques so that alternative diagnostic techniques must be used. It is concluded that the development of a diagnostic system should be parallel and integral with the development of a mechanical system.

  10. The Diagnostic Challenge Competition: Probabilistic Techniques for Fault Diagnosis in Electrical Power Systems

    NASA Technical Reports Server (NTRS)

    Ricks, Brian W.; Mengshoel, Ole J.

    2009-01-01

    Reliable systems health management is an important research area of NASA. A health management system that can accurately and quickly diagnose faults in various on-board systems of a vehicle will play a key role in the success of current and future NASA missions. We introduce in this paper the ProDiagnose algorithm, a diagnostic algorithm that uses a probabilistic approach, accomplished with Bayesian Network models compiled to Arithmetic Circuits, to diagnose these systems. We describe the ProDiagnose algorithm, how it works, and the probabilistic models involved. We show by experimentation on two Electrical Power Systems based on the ADAPT testbed, used in the Diagnostic Challenge Competition (DX 09), that ProDiagnose can produce results with over 96% accuracy and less than 1 second mean diagnostic time.

  11. Transient Region Coverage in the Propulsion IVHM Technology Experiment

    NASA Technical Reports Server (NTRS)

    Balaban, Edward; Sweet, Adam; Bajwa, Anupa; Maul, William; Fulton, Chris; Chicatelli, amy

    2004-01-01

    Over the last several years researchers at NASA Glenn and Ames Research Centers have developed a real-time fault detection and isolation system for propulsion subsystems of future space vehicles. The Propulsion IVHM Technology Experiment (PITEX), as it is called follows the model-based diagnostic methodology and employs Livingstone, developed at NASA Ames, as its reasoning engine. The system has been tested on,flight-like hardware through a series of nominal and fault scenarios. These scenarios have been developed using a highly detailed simulation of the X-34 flight demonstrator main propulsion system and include realistic failures involving valves, regulators, microswitches, and sensors. This paper focuses on one of the recent research and development efforts under PITEX - to provide more complete transient region coverage. It describes the development of the transient monitors, the corresponding modeling methodology, and the interface software responsible for coordinating the flow of information between the quantitative monitors and the qualitative, discrete representation Livingstone.

  12. Cable Discharge System for fundamental detonator studies

    NASA Technical Reports Server (NTRS)

    Peevy, Gregg R.; Barnhart, Steven G.; Brigham, William P.

    1994-01-01

    Sandia National Laboratories has recently completed the modification and installation of a cable discharge system (CDS) which will be used to study the physics of exploding bridgewire (EBW) detonators and exploding foil initiators (EFI or slapper). Of primary interest are the burst characteristics of these devices when subjected to the constant current pulse delivered by this system. The burst process involves the heating of the bridge material to a conductive plasma and is essential in describing the electrical properties of the bridgewire foil for use in diagnostics or computer models. The CDS described herein is capable of delivering up to an 8000 A pulse of 3 micron duration. Experiments conducted with the CDS to characterize the EBW and EFI burst behavior are also described. In addition, the CDS simultaneous VISAR capability permits updating the EFI electrical Gurney analysis parameters used in our computer simulation codes. Examples of CDS generated data for a typical EFI and EBW detonator are provided.

  13. Medical and surgical evaluation and care of illness in space

    NASA Technical Reports Server (NTRS)

    Siegel, John H.

    1994-01-01

    This report summarizes the work done on the contract NAG9-567, which was activated at the New Jersey Medical School-UMDNJ in April 1992 and carried on during the 1992-93 year to the present 1993-94 year which was terminated in May 1994. The initial examination stage was completed of an interactive program for the recording of physical and physiologic injury information obtained from examination of an injured person, who might be an astronaut sustaining traumatic injury, due to a burn or physical trauma, either in space or in an earth bound training environment. In this report three aspects will be discussed: 1) a description of the system of diagnostic examination graphics, 2) a description of the organization of the therapeutic advisory systems with a demonstration of two specific modules, and 3) a brief technical description of the organization of the programming system carried out on a UNIX based work station using a WINDOWS environment.

  14. 2015 update on the diagnosis and management of neoplastic pericardial disease.

    PubMed

    Lestuzzi, Chiara; Berretta, Massimiliano; Tomkowski, Witold

    2015-04-01

    The best approach in diagnosis and treatment of neoplastic pericardial disease has not been defined yet. The authors report the most recent literature about the new diagnostic techniques that are useful to improve the diagnosis. The literature about the therapeutic options is critically reviewed, in order to give suggestions of use to the clinical practice. Pericardial effusion may require urgent drainage; the solid component, however, becomes predominant in some cases. Neoplastic pericardial disease should be assessed following oncologic criteria evaluation of the neoplastic burden; outcome classified as complete or partial response, stable or progressive disease and - in cases with progression - event-free survival. Systemic chemotherapy may be effective in lymphomas and possibly in breast carcinomas. Intrapericardial chemotherapy with systemic chemotherapy is the treatment of choice in lung cancer. Pericardial window with systemic chemotherapy is also effective in preventing the accumulation of large amount of fluid.

  15. The Roles and Developments needed for Diagnostics in the ITER Fusion Device

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Walsh, Michael

    2015-07-01

    Harnessing the power from Fusion on earth is an important and challenging task. Excellent work has been carried out in this area over the years with several demonstrations of the ability to produce power. Now, a new large device is being constructed in the south of France. This is called ITER. ITER is a large-scale scientific experiment that aims to demonstrate a possibility to produce commercial energy from fusion. This project is now well underway with the many teams working on the construction and completing various aspects of the design. This device will carry up to 15 MA of plasmamore » current and produce about 500 MW of power, 400 MW approximately in high energy neutrons. The typical temperatures of the electrons inside this device are in the region of a few hundred million Kelvin. It is maintained using a magnetic field. This device is pushing several boundaries from those currently existing. As a result of this, several technologies need to be developed or extended. This is especially true for the systems or diagnostics that measure the performance and provide the control signals for this device. A diagnostic set will be installed on the ITER machine to provide the measurements necessary to control, evaluate and optimize plasma performance in ITER and to further the understanding of plasma physics. These include amongst others, measurements of the plasma shape, temperature, density, impurity concentration, and particle and energy confinement times. The system will comprise about 45 individual measuring systems drawn from the full range of modern plasma diagnostic techniques, including magnetics, lasers, X-rays, neutron cameras, impurity monitors, particle spectrometers, radiation bolometers, pressure and gas analysis, and optical fibres. These devices will have to be made to work in the new and challenging environment inside the vacuum vessel. These systems will have to cope with a range of phenomena that extend the current knowledge in the Fusion field. One amongst them is the parasitic effect of the neutrons on the while all the performing with great accuracy and precision. The levels of neutral particle flux, neutron flux and neutron fluence will be respectively about 5, 10 and 10,000 times higher than the harshest experienced in today's machines. The pulse length of the fusion reaction-or the amount of time the reaction is sustained-will be about 100 times longer. (authors)« less

  16. Feasibility test of a UK-scalable electronic system for regular collection of patient-reported outcome measures and linkage with clinical cancer registry data: the electronic Patient-reported Outcomes from Cancer Survivors (ePOCS) system.

    PubMed

    Ashley, Laura; Jones, Helen; Forman, David; Newsham, Alex; Brown, Julia; Downing, Amy; Velikova, Galina; Wright, Penny

    2011-10-26

    Cancer survivors can face significant physical and psychosocial challenges; there is a need to identify and predict which survivors experience what sorts of difficulties. As highlighted in the UK National Cancer Survivorship Initiative, routine post-diagnostic collection of patient reported outcome measures (PROMs) is required; to be most informative, PROMs must be linked and analysed with patients' diagnostic and treatment information. We have designed and built a potentially cost-efficient UK-scalable electronic system for collecting PROMs via the internet, at regular post-diagnostic time-points, for linking these data with patients' clinical data in cancer registries, and for electronically managing the associated patient monitoring and communications; the electronic Patient-reported Outcomes from Cancer Survivors (ePOCS) system. This study aims to test the feasibility of the ePOCS system, by running it for 2 years in two Yorkshire NHS Trusts, and using the Northern and Yorkshire Cancer Registry and Information Service. Non-metastatic breast, colorectal and prostate cancer patients (largest survivor groups), within 6 months post-diagnosis, will be recruited from hospitals in the Yorkshire Cancer Network. Participants will be asked to complete PROMS, assessing a range of health-related quality-of-life outcomes, at three time-points up to 15 months post-diagnosis, and subsequently to provide opinion on the ePOCS system via a feedback questionnaire. Feasibility will be examined primarily in terms of patient recruitment and retention rates, the representativeness of participating patients, the quantity and quality of collected PROMs data, patients' feedback, the success and reliability of the underpinning informatics, and the system running costs. If sufficient data are generated during system testing, these will be analysed to assess the health-related quality-of-life outcomes reported by patients, and to explore if and how they relate to disease, treatment and/or individual differences characteristics. There is currently no system in the UK for collecting PROMs online and linking these with patients' clinical data in cancer registries. If feasible, ePOCS has potential to provide an affordable UK-scalable technical platform to facilitate and support longitudinal cohort research, and improve understanding of cancer survivors' experiences. Comprehensive understanding of survivorship difficulties is vital to inform the development and provision of supportive services and interventions.

  17. On-board fault diagnostics for fly-by-light flight control systems using neural network flight processors

    NASA Astrophysics Data System (ADS)

    Urnes, James M., Sr.; Cushing, John; Bond, William E.; Nunes, Steve

    1996-10-01

    Fly-by-Light control systems offer higher performance for fighter and transport aircraft, with efficient fiber optic data transmission, electric control surface actuation, and multi-channel high capacity centralized processing combining to provide maximum aircraft flight control system handling qualities and safety. The key to efficient support for these vehicles is timely and accurate fault diagnostics of all control system components. These diagnostic tests are best conducted during flight when all facts relating to the failure are present. The resulting data can be used by the ground crew for efficient repair and turnaround of the aircraft, saving time and money in support costs. These difficult to diagnose (Cannot Duplicate) fault indications average 40 - 50% of maintenance activities on today's fighter and transport aircraft, adding significantly to fleet support cost. Fiber optic data transmission can support a wealth of data for fault monitoring; the most efficient method of fault diagnostics is accurate modeling of the component response under normal and failed conditions for use in comparison with the actual component flight data. Neural Network hardware processors offer an efficient and cost-effective method to install fault diagnostics in flight systems, permitting on-board diagnostic modeling of very complex subsystems. Task 2C of the ARPA FLASH program is a design demonstration of this diagnostics approach, using the very high speed computation of the Adaptive Solutions Neural Network processor to monitor an advanced Electrohydrostatic control surface actuator linked through a AS-1773A fiber optic bus. This paper describes the design approach and projected performance of this on-line diagnostics system.

  18. A Scalable, Out-of-Band Diagnostics Architecture for International Space Station Systems Support

    NASA Technical Reports Server (NTRS)

    Fletcher, Daryl P.; Alena, Rick; Clancy, Daniel (Technical Monitor)

    2002-01-01

    The computational infrastructure of the International Space Station (ISS) is a dynamic system that supports multiple vehicle subsystems such as Caution and Warning, Electrical Power Systems and Command and Data Handling (C&DH), as well as scientific payloads of varying size and complexity. The dynamic nature of the ISS configuration coupled with the increased demand for payload support places a significant burden on the inherently resource constrained computational infrastructure of the ISS. Onboard system diagnostics applications are hosted on computers that are elements of the avionics network while ground-based diagnostic applications receive only a subset of available telemetry, down-linked via S-band communications. In this paper we propose a scalable, out-of-band diagnostics architecture for ISS systems support that uses a read-only connection for C&DH data acquisition, which provides a lower cost of deployment and maintenance (versus a higher criticality readwrite connection). The diagnostics processing burden is off-loaded from the avionics network to elements of the on-board LAN that have a lower overall cost of operation and increased computational capacity. A superset of diagnostic data, richer in content than the configured telemetry, is made available to Advanced Diagnostic System (ADS) clients running on wireless handheld devices, affording the crew greater mobility for troubleshooting and providing improved insight into vehicle state. The superset of diagnostic data is made available to the ground in near real-time via an out-of band downlink, providing a high level of fidelity between vehicle state and test, training and operational facilities on the ground.

  19. A Statistical Evaluation of the Diagnostic Performance of MEDAS-The Medical Emergency Decision Assistance System

    PubMed Central

    Georgakis, D. Christine; Trace, David A.; Naeymi-Rad, Frank; Evens, Martha

    1990-01-01

    Medical expert systems require comprehensive evaluation of their diagnostic accuracy. The usefulness of these systems is limited without established evaluation methods. We propose a new methodology for evaluating the diagnostic accuracy and the predictive capacity of a medical expert system. We have adapted to the medical domain measures that have been used in the social sciences to examine the performance of human experts in the decision making process. Thus, in addition to the standard summary measures, we use measures of agreement and disagreement, and Goodman and Kruskal's λ and τ measures of predictive association. This methodology is illustrated by a detailed retrospective evaluation of the diagnostic accuracy of the MEDAS system. In a study using 270 patients admitted to the North Chicago Veterans Administration Hospital, diagnoses produced by MEDAS are compared with the discharge diagnoses of the attending physicians. The results of the analysis confirm the high diagnostic accuracy and predictive capacity of the MEDAS system. Overall, the agreement of the MEDAS system with the “gold standard” diagnosis of the attending physician has reached a 90% level.

  20. Should learners reason one step at a time? A randomised trial of two diagnostic scheme designs.

    PubMed

    Blissett, Sarah; Morrison, Deric; McCarty, David; Sibbald, Matthew

    2017-04-01

    Making a diagnosis can be difficult for learners as they must integrate multiple clinical variables. Diagnostic schemes can help learners with this complex task. A diagnostic scheme is an algorithm that organises possible diagnoses by assigning signs or symptoms (e.g. systolic murmur) to groups of similar diagnoses (e.g. aortic stenosis and aortic sclerosis) and provides distinguishing features to help discriminate between similar diagnoses (e.g. carotid pulse). The current literature does not identify whether scheme layouts should guide learners to reason one step at a time in a terminally branching scheme or weigh multiple variables simultaneously in a hybrid scheme. We compared diagnostic accuracy, perceptual errors and cognitive load using two scheme layouts for cardiac auscultation. Focused on the task of identifying murmurs on Harvey, a cardiopulmonary simulator, 86 internal medicine residents used two scheme layouts. The terminally branching scheme organised the information into single variable decisions. The hybrid scheme combined single variable decisions with a chart integrating multiple distinguishing features. Using a crossover design, participants completed one set of murmurs (diastolic or systolic) with either the terminally branching or the hybrid scheme. The second set of murmurs was completed with the other scheme. A repeated measures manova was performed to compare diagnostic accuracy, perceptual errors and cognitive load between the scheme layouts. There was a main effect of the scheme layout (Wilks' λ = 0.841, F 3,80 = 5.1, p = 0.003). Use of a terminally branching scheme was associated with increased diagnostic accuracy (65 versus 53%, p = 0.02), fewer perceptual errors (0.61 versus 0.98 errors, p = 0.001) and lower cognitive load (3.1 versus 3.5/7, p = 0.023). The terminally branching scheme was associated with improved diagnostic accuracy, fewer perceptual errors and lower cognitive load, suggesting that terminally branching schemes are effective for improving diagnostic accuracy. These findings can inform the design of schemes and other clinical decision aids. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  1. 40 CFR 86.1717-99 - Emission control diagnostic system for 1999 and later light-duty vehicles and light-duty trucks.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 19 2010-07-01 2010-07-01 false Emission control diagnostic system for 1999 and later light-duty vehicles and light-duty trucks. 86.1717-99 Section 86.1717-99 Protection of... diagnostic system for 1999 and later light-duty vehicles and light-duty trucks. (a) The provisions of § 86...

  2. 40 CFR 86.1717-01 - Emission control diagnostic system for 1999 and later light-duty vehicles and light-duty trucks.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 19 2010-07-01 2010-07-01 false Emission control diagnostic system for 1999 and later light-duty vehicles and light-duty trucks. 86.1717-01 Section 86.1717-01 Protection of... diagnostic system for 1999 and later light-duty vehicles and light-duty trucks. (a) The provisions of § 86...

  3. 40 CFR 86.1717-99 - Emission control diagnostic system for 1999 and later light-duty vehicles and light-duty trucks.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 19 2011-07-01 2011-07-01 false Emission control diagnostic system for 1999 and later light-duty vehicles and light-duty trucks. 86.1717-99 Section 86.1717-99 Protection of... diagnostic system for 1999 and later light-duty vehicles and light-duty trucks. (a) The provisions of § 86...

  4. 40 CFR 86.1717-01 - Emission control diagnostic system for 1999 and later light-duty vehicles and light-duty trucks.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 19 2011-07-01 2011-07-01 false Emission control diagnostic system for 1999 and later light-duty vehicles and light-duty trucks. 86.1717-01 Section 86.1717-01 Protection of... diagnostic system for 1999 and later light-duty vehicles and light-duty trucks. (a) The provisions of § 86...

  5. Breast Cancer Diagnostic System Final Report CRADA No. TC02098.0

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Rubenchik, A. M.; DaSilva, L. B.

    This was a collaborative effort between Lawrence Livermore National Security, LLC (formerly The Regents of the University of California)/Lawrence Liver more National Laboratory (LLNL) and BioTelligent, Inc. together with a Russian Institution (BioFil, Ltd.), to develop a new system ( diagnostic device, operating procedures, algorithms and software) to accurately distinguish between benign and malignant breast tissue (Breast Cancer Diagnostic System, BCDS).

  6. The Successful Diagnosis and Typing of Systemic Amyloidosis Using A Microwave-Assisted Filter-Aided Fast Sample Preparation Method and LC/MS/MS Analysis

    PubMed Central

    Zou, Lili; Shen, Kaini; Zhong, Dingrong; Zhou, Daobin; Sun, Wei; Li, Jian

    2015-01-01

    Laser microdissection followed by mass spectrometry has been successfully used for amyloid typing. However, sample contamination can interfere with proteomic analysis, and overnight digestion limits the analytical throughput. Moreover, current quantitative analysis methods are based on the spectrum count, which ignores differences in protein length and may lead to misdiagnoses. Here, we developed a microwave-assisted filter-aided sample preparation (maFASP) method that can efficiently remove contaminants with a 10-kDa cutoff ultrafiltration unit and can accelerate the digestion process with the assistance of a microwave. Additionally, two parameters (P- and D-scores) based on the exponentially modified protein abundance index were developed to define the existence of amyloid deposits and those causative proteins with the greatest abundance. Using our protocol, twenty cases of systemic amyloidosis that were well-typed according to clinical diagnostic standards (training group) and another twenty-four cases without subtype diagnoses (validation group) were analyzed. Using this approach, sample preparation could be completed within four hours. We successfully subtyped 100% of the cases in the training group, and the diagnostic success rate in the validation group was 91.7%. This maFASP-aided proteomic protocol represents an efficient approach for amyloid diagnosis and subtyping, particularly for serum-contaminated samples. PMID:25984759

  7. Fully integrated lab-on-a-disc for nucleic acid analysis of food-borne pathogens.

    PubMed

    Kim, Tae-Hyeong; Park, Juhee; Kim, Chi-Ju; Cho, Yoon-Kyoung

    2014-04-15

    This paper describes a micro total analysis system for molecular analysis of Salmonella, a major food-borne pathogen. We developed a centrifugal microfluidic device, which integrated the three main steps of pathogen detection, DNA extraction, isothermal recombinase polymerase amplification (RPA), and detection, onto a single disc. A single laser diode was utilized for wireless control of valve actuation, cell lysis, and noncontact heating in the isothermal amplification step, thereby yielding a compact and miniaturized system. To achieve high detection sensitivity, rare cells in large volumes of phosphate-buffered saline (PBS) and milk samples were enriched before loading onto the disc by using antibody-coated magnetic beads. The entire procedure, from DNA extraction through to detection, was completed within 30 min in a fully automated fashion. The final detection was carried out using lateral flow strips by direct visual observation; detection limit was 10 cfu/mL and 10(2) cfu/mL in PBS and milk, respectively. Our device allows rapid molecular diagnostic analysis and does not require specially trained personnel or expensive equipment. Thus, we expect that it would have an array of potential applications, including in the detection of food-borne pathogens, environmental monitoring, and molecular diagnostics in resource-limited settings.

  8. Diagnostics Development for the Ignition Experiment Ignitor

    NASA Astrophysics Data System (ADS)

    Pizzicaroli, G.; Bombarda, F.; Licciulli, A.; Fersini, M.; Diso, D.; Kroegler, H.

    2008-11-01

    The Ignitor experiment is designed to reach ignition conditions. The short, but intense neutron flux will pose challenging conditions for diagnostics, such as magnetic sensors or bolometers, in direct proximity, or in direct view, of the plasma. An R&D program is in progress to manufacture mineral insulated magnetic coils with a reduced sensitivity to radiation effects. A double layer, MgO insulated Ni coil has been produced and tested. The wire is wound on an alumina core and the coil is housed in an alumina box for high refractoriness and minimum vacuum degassing. A lanthanide glass ceramic has been used as sealant for the box. At the same time, alternative methods to provide critical plasma position information during the high performance discharges in Ignitor are being explored. For example, the radiation emitted at the plasma edge by Mo^+14 can be monitored by means of a soft X- ray spectrometer equipped with a GEM detector, which allows high counting rates (> 1 MHz) and provides good energy resolution and flexibility of design. A 10x10 cm^2 multichannel prototype with its associated fast read-out system is being assembled. A layout of the complete spectrometer compatible with the Ignitor port design has been carried out, and the bolometer system design has been updated.

  9. Application Of The CSRL Language To The Design Of Diagnostic Expert Systems: The Moodis Experience, A Preliminary Report

    NASA Astrophysics Data System (ADS)

    Bravos, Angelo; Hill, Howard; Choca, James; Bresolin, Linda B.; Bresolin, Michael J.

    1986-03-01

    Computer technology is rapidly becoming an inseparable part of many health science specialties. Recently, a new area of computer technology, namely Artificial Intelligence, has been applied toward assisting the medical experts in their diagnostic and therapeutic decision making process. MOODIS is an experimental diagnostic expert system which assists Psychiatry specialists in diagnosing human Mood Disorders, better known as Affective Disorders. Its diagnostic methodology is patterned after MDX, a diagnostic expert system developed at LAIR (Laboratory for Artificial Intelligence Research) of Ohio State University. MOODIS is implemented in CSRL (Conceptual Structures Representation Language) also developed at LAIR. This paper describes MOODIS in terms of conceptualization and requirements, and discusses why the MDX approach and CSRL were chosen.

  10. Copeptin in the differential diagnosis of the polydipsia-polyuria syndrome--revisiting the direct and indirect water deprivation tests.

    PubMed

    Fenske, Wiebke; Quinkler, Marcus; Lorenz, Daniela; Zopf, Kathrin; Haagen, Ulrike; Papassotiriou, Jana; Pfeiffer, Andreas F H; Fassnacht, Martin; Störk, Stefan; Allolio, Bruno

    2011-05-01

    The water deprivation test (WDT) with direct or indirect measurement of plasma arginine vasopressin (AVP) is the method of choice for the differential diagnosis of the polydipsia-polyuria syndrome. In theory, direct measurement of AVP is highly attractive but is hampered by technical difficulties. The aim of the study was to evaluate the utility of copeptin, a surrogate of AVP secretion, in the diagnostic work-up of the polyuria-polydipsia syndrome and to compare its performance with the current diagnostic standard. In two tertiary referral centers, 20 healthy subjects and 50 patients with polydipsia-polyuria syndrome underwent WDT with measurements of both plasma AVP and copeptin levels. The reference diagnosis was based on clinical information and treatment response. Twenty-two patients (44%) were diagnosed with primary polydipsia, 17 (34%) with partial central diabetes insipidus (DI), nine (18%) with complete central DI, and two (4%) with nephrogenic DI. The indirect WDT led to a correct diagnosis in 35 of 50 patients (70%). The direct WDT with AVP or copeptin measurement correctly diagnosed 23 patients (46%) or 36 patients (72%), respectively. Baseline copeptin values greater than 20 pmol/liter identified patients with nephrogenic DI, and concentrations below 2.6 pmol/liter indicated complete central DI. The ratio between Δ copeptin (0800 to 1600 h) and serum sodium concentration at 1600 h yielded optimal diagnostic accuracy, allowing us to also discern partial central DI from primary polydipsia (sensitivity 86%, and specificity 100%). Copeptin holds promise as a diagnostic tool in the polyuria-polydipsia syndrome, improving significantly the diagnostic accuracy of the direct WDT.

  11. From Cancer Screening to Treatment: Service Delivery and Referral in the National Breast and Cervical Cancer Early Detection Program

    PubMed Central

    Miller, Jacqueline W.; Hanson, Vivien; Johnson, Gale D.; Royalty, Janet E.; Richardson, Lisa C.

    2015-01-01

    The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides breast and cervical cancer screening and diagnostic services to low-income and underserved women through a network of providers and health care organizations. Although the program serves women 40-64 years old for breast cancer screening and 21-64 years old for cervical cancer screening, the priority populations are women 50-64 years old for breast cancer and women who have never or rarely been screened for cervical cancer. From 1991 through 2011, the NBCCEDP provided screening and diagnostic services to more than 4.3 million women, diagnosing 54,276 breast cancers, 2554 cervical cancers, and 123,563 precancerous cervical lesions. A critical component of providing screening services is to ensure that all women with abnormal screening results receive appropriate and timely diagnostic evaluations. Case management is provided to assist women with overcoming barriers that would delay or prevent follow-up care. Women diagnosed with cancer receive treatment through the states' Breast and Cervical Cancer Treatment Programs (a special waiver for Medicaid) if they are eligible. The NBCCEDP has performance measures that serve as benchmarks to monitor the completeness and timeliness of care. More than 90% of the women receive complete diagnostic care and initiate treatment less than 30 days from the time of their diagnosis. Provision of effective screening and diagnostic services depends on effective program management, networks of providers throughout the community, and the use of evidence-based knowledge, procedures, and technologies. PMID:25099897

  12. A Review of Diagnostic Techniques for ISHM Applications

    NASA Technical Reports Server (NTRS)

    Patterson-Hine, Ann; Biswas, Gautam; Aaseng, Gordon; Narasimhan, Sriam; Pattipati, Krishna

    2005-01-01

    System diagnosis is an integral part of any Integrated System Health Management application. Diagnostic applications make use of system information from the design phase, such as safety and mission assurance analysis, failure modes and effects analysis, hazards analysis, functional models, fault propagation models, and testability analysis. In modern process control and equipment monitoring systems, topological and analytic , models of the nominal system, derived from design documents, are also employed for fault isolation and identification. Depending on the complexity of the monitored signals from the physical system, diagnostic applications may involve straightforward trending and feature extraction techniques to retrieve the parameters of importance from the sensor streams. They also may involve very complex analysis routines, such as signal processing, learning or classification methods to derive the parameters of importance to diagnosis. The process that is used to diagnose anomalous conditions from monitored system signals varies widely across the different approaches to system diagnosis. Rule-based expert systems, case-based reasoning systems, model-based reasoning systems, learning systems, and probabilistic reasoning systems are examples of the many diverse approaches ta diagnostic reasoning. Many engineering disciplines have specific approaches to modeling, monitoring and diagnosing anomalous conditions. Therefore, there is no "one-size-fits-all" approach to building diagnostic and health monitoring capabilities for a system. For instance, the conventional approaches to diagnosing failures in rotorcraft applications are very different from those used in communications systems. Further, online and offline automated diagnostic applications are integrated into an operations framework with flight crews, flight controllers and maintenance teams. While the emphasis of this paper is automation of health management functions, striking the correct balance between automated and human-performed tasks is a vital concern.

  13. Self-contained microfluidic systems: a review.

    PubMed

    Boyd-Moss, Mitchell; Baratchi, Sara; Di Venere, Martina; Khoshmanesh, Khashayar

    2016-08-16

    Microfluidic systems enable rapid diagnosis, screening and monitoring of diseases and health conditions using small amounts of biological samples and reagents. Despite these remarkable features, conventional microfluidic systems rely on bulky expensive external equipment, which hinders their utility as powerful analysis tools outside of research laboratories. 'Self-contained' microfluidic systems, which contain all necessary components to facilitate a complete assay, have been developed to address this limitation. In this review, we provide an in-depth overview of self-contained microfluidic systems. We categorise these systems based on their operating mechanisms into three major groups: passive, hand-powered and active. Several examples are provided to discuss the structure, capabilities and shortcomings of each group. In particular, we discuss the self-contained microfluidic systems enabled by active mechanisms, due to their unique capability for running multi-step and highly controllable diagnostic assays. Integration of self-contained microfluidic systems with the image acquisition and processing capabilities of smartphones, especially those equipped with accessory optical components, enables highly sensitive and quantitative assays, which are discussed. Finally, the future trends and possible solutions to expand the versatility of self-contained, stand-alone microfluidic platforms are outlined.

  14. The clinician in the driver's seat: part 2 - intelligent uses of space in a drag/drop user-composable electronic health record.

    PubMed

    Senathirajah, Yalini; Kaufman, David; Bakken, Suzanne

    2014-12-01

    User-composable approaches provide clinicians with the control to design and assemble information elements on screen via drag/drop. They hold considerable promise for enhancing the electronic-health-records (EHRs) user experience. We previously described this novel approach to EHR design and our illustrative system, MedWISE. The purpose of this paper is to describe clinician users' intelligent uses of space during completion of real patient case studies in a laboratory setting using MedWISE. Thirteen clinicians at a quaternary academic medical center used the system to review four real patient cases. We analyzed clinician utterances, behaviors, screen layouts (i.e., interface designs), and their perceptions associated with completing patient case studies. Clinicians effectively used the system to review all cases. Two coding schemata pertaining to human-computer interaction and diagnostic reasoning were used to analyze the data. Users adopted three main interaction strategies: rapidly gathering items on screen and reviewing ('opportunistic selection' approach); creating highly structured screens ('structured' approach); and interacting with small groups of items in sequence as their case review progressed ('dynamic stage' approach). They also used spatial arrangement in ways predicted by theory and research on workplace spatial arrangement. This includes assignment of screen regions for particular purposes (24% of spatial codes), juxtaposition to facilitate calculation or other cognitive tasks ('epistemic action'), and grouping elements with common meanings or relevance to the diagnostic facets of the case (20.3%). A left-to-right progression of orienting materials, data, and action items or reflection space was a commonly observed pattern. Widget selection was based on user assessment of what information was useful or relevant. We developed and tested an illustrative system that gives clinicians greater control of the EHR, and demonstrated its feasibility for case review by typical clinicians. Producing the simplifying inventions, such as user-composable platforms that shift control to the user, may serve to promote productive EHR use and enhance its value as an instrument of patient care. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. The Clinician in the Driver’s Seat: Part 2 – Intelligent Uses of Space in a Drag/Drop User-Composable Electronic Health Record

    PubMed Central

    Senathirajah, Yalini; Kaufman, David; Bakken, Suzanne

    2018-01-01

    User-composable approaches provide clinicians with the control to design and assemble information elements on screen via drag/drop. They hold considerable promise for enhancing the electronic-health-records (EHRs) user experience. We previously described this novel approach to EHR design and our illustrative system, MedWISE. The purpose of this paper is to describe clinician users’ intelligent uses of space during completion of real patient case studies in a laboratory setting using MedWISE. Thirteen clinicians at a quaternary academic medical center used the system to review four real patient cases. We analyzed clinician utterances, behaviors, screen layouts (i.e., interface designs), and their perceptions associated with completing patient case studies. Clinicians effectively used the system to review all cases. Two coding schemata pertaining to human-computer interaction and diagnostic reasoning were used to analyze the data. Users adopted three main interaction strategies: rapidly gathering items on screen and reviewing (‘opportunistic selection’ approach); creating highly structured screens (‘structured’ approach); and interacting with small groups of items in sequence as their case review progressed (‘dynamic stage’ approach). They also used spatial arrangement in ways predicted by theory and research on workplace spatial arrangement. This includes assignment of screen regions for particular purposes (24% of spatial codes), juxtaposition to facilitate calculation or other cognitive tasks (‘epistemic action’), and grouping elements with common meanings or relevance to the diagnostic facets of the case (20.3%). A left-to-right progression of orienting materials, data, and action items or reflection space was a commonly observed pattern. Widget selection was based on user assessment of what information was useful or relevant. We developed and tested an illustrative system that gives clinicians greater control of the EHR, and demonstrated its feasibility for case review by typical clinicians. Producing the simplifying inventions, such as user-composable platforms that shift control to the user, may serve to promote productive EHR use and enhance its value as an instrument of patient care. PMID:25445921

  16. Final-year diagnostic radiography students' perception of role models within the profession.

    PubMed

    Conway, Alinya; Lewis, Sarah; Robinson, John

    2008-01-01

    Within a clinical education setting, the value of role models and prescribed mentors can be seen as an important influence in shaping the student's future as a diagnostic radiographer. A study was undertaken to create a new understanding of how diagnostic radiography students perceive role models and professional behavior in the workforce. The study aimed to determine the impact of clinical education in determining modeling expectations, role model identification and attributes, and the integration of academic education and "hands-on" clinical practice in preparing diagnostic radiography students to enter the workplace. Thirteen final-year (third-year) diagnostic radiography students completed an hour-long interview regarding their experiences and perceptions of role models while on clinical placement. The key concepts that emerged illustrated that students gravitate toward radiographers who enjoy sharing practical experiences with students and are good communicators. Unique to diagnostic radiography, students made distinctions about the presence of role models in private versus public service delivery. This study gives insight to clinical educators in diagnostic radiography and wider allied health into how students perceive role models, interact with preceptors, and combine real-life experiences with formal learning.

  17. STARD 2015 guidelines for reporting diagnostic accuracy studies: explanation and elaboration

    PubMed Central

    Cohen, Jérémie F; Korevaar, Daniël A; Altman, Douglas G; Bruns, David E; Gatsonis, Constantine A; Hooft, Lotty; Irwig, Les; Levine, Deborah; Reitsma, Johannes B; de Vet, Henrica C W; Bossuyt, Patrick M M

    2016-01-01

    Diagnostic accuracy studies are, like other clinical studies, at risk of bias due to shortcomings in design and conduct, and the results of a diagnostic accuracy study may not apply to other patient groups and settings. Readers of study reports need to be informed about study design and conduct, in sufficient detail to judge the trustworthiness and applicability of the study findings. The STARD statement (Standards for Reporting of Diagnostic Accuracy Studies) was developed to improve the completeness and transparency of reports of diagnostic accuracy studies. STARD contains a list of essential items that can be used as a checklist, by authors, reviewers and other readers, to ensure that a report of a diagnostic accuracy study contains the necessary information. STARD was recently updated. All updated STARD materials, including the checklist, are available at http://www.equator-network.org/reporting-guidelines/stard. Here, we present the STARD 2015 explanation and elaboration document. Through commented examples of appropriate reporting, we clarify the rationale for each of the 30 items on the STARD 2015 checklist, and describe what is expected from authors in developing sufficiently informative study reports. PMID:28137831

  18. Studies on the foundation and development of diagnostic ultrasound

    PubMed Central

    Wagai, Toshio

    2007-01-01

    In recent years, various types of diagnostic imaging methods, such as CT, MRI, PET and Ultrasound, have been developed rapidly and become indispensable as clinical diagnostic tools. Among these imaging modalities, CT, MRI and PET all apply electromagnetic waves like radiation rays. In contrast, an ultrasound imaging method uses a completely different mechanical pressure wave: “sound”. Ultrasound has various features, including inaudible sound at very high frequencies, which allows its use in medical diagnoses. That is, ultrasound techniques can be applied in transmission, reflection and Doppler methods. Moreover, the sharp directivity of an ultrasound beam can also improve image resolution. Another big advantage of diagnostic ultrasound is that it does not harm the human body or cause any pain to patients. Given these various advantages, diagnostic ultrasound has recently been widely used in diagnosing cancer and cardiovascular disease and scanning fetuses (Fig. 1) as well as routine clinical examinations in hospitals. In this paper, I outline my almost 50-year history of diagnostic ultrasound research, particularly that performed at the early stage from 1950–56. PMID:24367150

  19. Laboratory Information Systems in Molecular Diagnostics: Why Molecular Diagnostics Data are Different.

    PubMed

    Lee, Roy E; Henricks, Walter H; Sirintrapun, Sahussapont J

    2016-03-01

    Molecular diagnostic testing presents new challenges to information management that are yet to be sufficiently addressed by currently available information systems for the molecular laboratory. These challenges relate to unique aspects of molecular genetic testing: molecular test ordering, informed consent issues, diverse specimen types that encompass the full breadth of specimens handled by traditional anatomic and clinical pathology information systems, data structures and data elements specific to molecular testing, varied testing workflows and protocols, diverse instrument outputs, unique needs and requirements of molecular test reporting, and nuances related to the dissemination of molecular pathology test reports. By satisfactorily addressing these needs in molecular test data management, a laboratory information system designed for the unique needs of molecular diagnostics presents a compelling reason to migrate away from the current paper and spreadsheet information management that many molecular laboratories currently use. This paper reviews the issues and challenges of information management in the molecular diagnostics laboratory.

  20. Microfluidic Capillaric Circuit for Rapid and Facile Bacteria Detection.

    PubMed

    Olanrewaju, Ayokunle Oluwafemi; Ng, Andy; DeCorwin-Martin, Philippe; Robillard, Alessandra; Juncker, David

    2017-06-20

    Urinary tract infections (UTI) are one of the most common bacterial infections and would greatly benefit from a rapid point-of-care diagnostic test. Although significant progress has been made in developing microfluidic systems for nucleic acid and whole bacteria immunoassay tests, their practical application is limited by complex protocols, bulky peripherals, and slow operation. Here we present a microfluidic capillaric circuit (CC) optimized for rapid and automated detection of bacteria in urine. Molds for CCs were constructed using previously established design rules, then 3D-printed and replicated into poly(dimethylsiloxane). CCs autonomously and sequentially performed all liquid delivery steps required for the assay. For efficient bacteria capture, on-the-spot packing of antibody-functionalized microbeads was completed in <20 s followed by autonomous sequential delivery of 100 μL of bacteria sample, biotinylated detection antibodies, fluorescent streptavidin conjugate, and wash buffer for a total volume ≈115 μL. The assay was completed in <7 min. Fluorescence images of the microbead column revealed captured bacteria as bright spots that were easily counted manually or using an automated script for user-independent assay readout. The limit of detection of E. coli in synthetic urine was 1.2 × 10 2 colony-forming-units per mL (CFU/mL), which is well below the clinical diagnostic criterion (>10 5 CFU/mL) for UTI. The self-powered, peripheral-free CC presented here has potential for use in rapid point-of-care UTI screening.

  1. Digital pathology for the primary diagnosis of breast histopathological specimens: an innovative validation and concordance study on digital pathology validation and training.

    PubMed

    Williams, Bethany Jill; Hanby, Andrew; Millican-Slater, Rebecca; Nijhawan, Anju; Verghese, Eldo; Treanor, Darren

    2018-03-01

    To train and individually validate a group of breast pathologists in specialty-specific digital primary diagnosis by using a novel protocol endorsed by the Royal College of Pathologists' new guideline for digital pathology. The protocol allows early exposure to live digital reporting, in a risk-mitigated environment, and focuses on patient safety and professional development. Three specialty breast pathologists completed training in the use of a digital microscopy system, and were exposed to a training set of 20 challenging cases, designed to help them identify personal digital diagnostic pitfalls. Following this, the three pathologists viewed a total of 694 live, entire breast cases. All primary diagnoses were made on digital slides, with immediate glass slide review and reconciliation before final case sign-out. There was complete clinical concordance between the glass and digital impression of the case in 98.8% of cases. Only 1.2% of cases had a clinically significant difference in diagnosis/prognosis on glass and digital slide reads. All pathologists elected to continue using the digital microscope as the standard for breast histopathology specimens, with deferral to glass for a limited number of clinical/histological scenarios as a safety net. Individual training and validation for digital primary diagnosis allows pathologists to develop competence and confidence in their digital diagnostic skills, and aids safe and responsible transition from the light microscope to the digital microscope. © 2017 John Wiley & Sons Ltd.

  2. Diagnostic Tools for Acute Anterior Cruciate Ligament Injury: GNRB, Lachman Test, and Telos.

    PubMed

    Ryu, Seung Min; Na, Ho Dong; Shon, Oog Jin

    2018-06-01

    The purpose of this study is to compare the accuracy of the GNRB arthrometer (Genourob), Lachman test, and Telos device (GmbH) in acute anterior cruciate ligament (ACL) injuries and to evaluate the accuracy of each diagnostic tool according to the length of time from injury to examination. From September 2015 to September 2016, 40 cases of complete ACL rupture were reviewed. We divided the time from injury to examination into three periods of 10 days each and analyzed the diagnostic tools according to the time frame. An analysis of the area under the curve (AUC) of a receiver operating characteristic curve showed that all diagnostic tools were fairly informative. The GNRB showed a higher AUC than other diagnostic tools. In 10 cases assessed within 10 days after injury, the GNRB showed statistically significant side-to-side difference in laxity (p<0.001), whereas the Telos test and Lachman test did not show significantly different laxity (p=0.541 and p=0.413, respectively). All diagnostic values of the GNRB were better than other diagnostic tools in acute ACL injuries. The GNRB was more effective in acute ACL injuries examined within 10 days of injury. The GNRB arthrometer can be a useful diagnostic tool for acute ACL injuries.

  3. Propulsion IVHM Technology Experiment

    NASA Technical Reports Server (NTRS)

    Chicatelli, Amy K.; Maul, William A.; Fulton, Christopher E.

    2006-01-01

    The Propulsion IVHM Technology Experiment (PITEX) successfully demonstrated real-time fault detection and isolation of a virtual reusable launch vehicle (RLV) main propulsion system (MPS). Specifically, the PITEX research project developed and applied a model-based diagnostic system for the MPS of the X-34 RLV, a space-launch technology demonstrator. The demonstration was simulation-based using detailed models of the propulsion subsystem to generate nominal and failure scenarios during captive carry, which is the most safety-critical portion of the X-34 flight. Since no system-level testing of the X-34 Main Propulsion System (MPS) was performed, these simulated data were used to verify and validate the software system. Advanced diagnostic and signal processing algorithms were developed and tested in real time on flight-like hardware. In an attempt to expose potential performance problems, the PITEX diagnostic system was subjected to numerous realistic effects in the simulated data including noise, sensor resolution, command/valve talkback information, and nominal build variations. In all cases, the PITEX system performed as required. The research demonstrated potential benefits of model-based diagnostics, defined performance metrics required to evaluate the diagnostic system, and studied the impact of real-world challenges encountered when monitoring propulsion subsystems.

  4. The Examination of Patient-Reported Outcomes and Postural Control Measures in Patients With and Without a History of ACL Reconstruction: A Case Control Study.

    PubMed

    Hoch, Johanna M; Sinnott, Cori W; Robinson, Kendall P; Perkins, William O; Hartman, Jonathan W

    2018-03-01

    There is a lack of literature to support the diagnostic accuracy and cut-off scores of commonly used patient-reported outcome measures (PROMs) and clinician-oriented outcomes such as postural-control assessments (PCAs) when treating post-ACL reconstruction (ACLR) patients. These scores could help tailor treatments, enhance patient-centered care and may identify individuals in need of additional rehabilitation. To determine if differences in 4-PROMs and 3-PCAs exist between post-ACLR and healthy participants, and to determine the diagnostic accuracy and cut-off scores of these outcomes. Case control. Laboratory. A total of 20 post-ACLR and 40 healthy control participants. The participants completed 4-PROMs (the Disablement in the Physically Active Scale [DPA], The Fear-Avoidance Belief Questionnaire [FABQ], the Knee Osteoarthritis Outcomes Score [KOOS] subscales, and the Tampa Scale of Kinesiophobia [TSK-11]) and 3-PCAs (the Balance Error Scoring System [BESS], the modified Star Excursion Balance Test [SEBT], and static balance on an instrumented force plate). Mann-Whitney U tests examined differences between groups. Receiver operating characteristic (ROC) curves were employed to determine sensitivity and specificity. The Area Under the Curve (AUC) was calculated to determine the diagnostic accuracy of each instrument. The Youdin Index was used to determine cut-off scores. Alpha was set a priori at P < 0.05. There were significant differences between groups for all PROMs (P < 0.05). There were no differences in PCAs between groups. The cut-off scores should be interpreted with caution for some instruments, as the scores may not be clinically applicable. Post-ACLR participants have decreased self-reported function and health-related quality of life. The PROMs are capable of discriminating between groups. Clinicians should consider using the cut-off scores in clinical practice. Further use of the instruments to examine detriments after completion of standard rehabilitation may be warranted.

  5. Insufficient evidence for the use of a physical examination to detect maltreatment in children without prior suspicion: a systematic review

    PubMed Central

    2013-01-01

    Background Although it is often performed in clinical practice, the diagnostic value of a screening physical examination to detect maltreatment in children without prior suspicion has not been reviewed. This article aims to evaluate the diagnostic value of a complete physical examination as a screening instrument to detect maltreatment in children without prior suspicion. Methods We systematically searched the databases of MEDLINE, EMBASE, PsychINFO, CINAHL, and ERIC, using a sensitive search strategy. Studies that i) presented medical findings of a complete physical examination for screening purposes in children 0–18 years, ii) specifically recorded the presence or absence of signs of child maltreatment, and iii) recorded child maltreatment confirmed by a reference standard, were included. Two reviewers independently performed study selection, data extraction, and quality appraisal using the QUADAS-2 tool. Results The search yielded 4,499 titles, of which three studies met the eligibility criteria. The prevalence of confirmed signs of maltreatment during screening physical examination varied between 0.8% and 13.5%. The designs of the studies were inadequate to assess the diagnostic accuracy of a screening physical examination for child maltreatment. Conclusions Because of the lack of informative studies, we could not draw conclusions about the diagnostic value of a screening physical examination in children without prior suspicion of child maltreatment. PMID:24313949

  6. Insufficient evidence for the use of a physical examination to detect maltreatment in children without prior suspicion: a systematic review.

    PubMed

    Hoytema van Konijnenburg, Eva Mm; Teeuw, Arianne H; Sieswerda-Hoogendoorn, Tessa; Leenders, Arnold G E; van der Lee, Johanna H

    2013-12-06

    Although it is often performed in clinical practice, the diagnostic value of a screening physical examination to detect maltreatment in children without prior suspicion has not been reviewed. This article aims to evaluate the diagnostic value of a complete physical examination as a screening instrument to detect maltreatment in children without prior suspicion. We systematically searched the databases of MEDLINE, EMBASE, PsychINFO, CINAHL, and ERIC, using a sensitive search strategy. Studies that i) presented medical findings of a complete physical examination for screening purposes in children 0-18 years, ii) specifically recorded the presence or absence of signs of child maltreatment, and iii) recorded child maltreatment confirmed by a reference standard, were included. Two reviewers independently performed study selection, data extraction, and quality appraisal using the QUADAS-2 tool. The search yielded 4,499 titles, of which three studies met the eligibility criteria. The prevalence of confirmed signs of maltreatment during screening physical examination varied between 0.8% and 13.5%. The designs of the studies were inadequate to assess the diagnostic accuracy of a screening physical examination for child maltreatment. Because of the lack of informative studies, we could not draw conclusions about the diagnostic value of a screening physical examination in children without prior suspicion of child maltreatment.

  7. Cognitive Behavioural Analysis System of Psychotherapy (CBASP) for chronic depression: clinical characteristics and six month clinical outcomes in an open case series.

    PubMed

    Swan, John S; Macvicar, Robert; Christmas, David; Durham, Rob; Rauchhaus, Petra; McCullough, James P; Matthews, Keith

    2014-01-01

    Evidence-based guidance on how best to treat chronic depression is limited. Cognitive Behavioural Analysis System of Psychotherapy (CBASP) has shown some promise with this 'difficult-to-treat' clinical group. This case series was designed to assess the acceptability and utility of this novel treatment in routine clinical practice within the U.K. National Health Service. We offered an open trial of CBASP to a cohort of 115 referred patients within primary and secondary care. Diagnostic interview and standardised outcome measures were administered before and after 6 months of CBASP with a trained, accredited therapist. Seventy-four patients entered therapy, with 46 completing. 30% met criteria for remission (≤ 8 HRSD-24 score) and a further 30% met criteria for clinically significant change (> 8 and ≤15 HRSD-24 plus 50% reduction in baseline score). Thirty-nine per cent made "No change". Group measures of quality of life, social functioning and interpersonal functioning also improved. This was an open study design with a moderate sample size and no control group. Ratings were not completed using a blinded procedure. CBASP is an acceptable therapy for a large proportion of patients with chronic depression and was associated with clinically significant change in 60% of completers. © 2013 Published by Elsevier B.V.

  8. A Framework to Debug Diagnostic Matrices

    NASA Technical Reports Server (NTRS)

    Kodal, Anuradha; Robinson, Peter; Patterson-Hine, Ann

    2013-01-01

    Diagnostics is an important concept in system health and monitoring of space operations. Many of the existing diagnostic algorithms utilize system knowledge in the form of diagnostic matrix (D-matrix, also popularly known as diagnostic dictionary, fault signature matrix or reachability matrix) gleaned from physical models. But, sometimes, this may not be coherent to obtain high diagnostic performance. In such a case, it is important to modify this D-matrix based on knowledge obtained from other sources such as time-series data stream (simulated or maintenance data) within the context of a framework that includes the diagnostic/inference algorithm. A systematic and sequential update procedure, diagnostic modeling evaluator (DME) is proposed to modify D-matrix and wrapper logic considering least expensive solution first. This iterative procedure includes conditions ranging from modifying 0s and 1s in the matrix, or adding/removing the rows (failure sources) columns (tests). We will experiment this framework on datasets from DX challenge 2009.

  9. The Global Education Network for Retinopathy of Prematurity (Gen-Rop): Development, Implementation, and Evaluation of A Novel Tele-Education System (An American Ophthalmological Society Thesis)

    PubMed Central

    Chan, R.V. Paul; Patel, Samir N.; Ryan, Michael C.; Jonas, Karyn E.; Ostmo, Susan; Port, Alexander D.; Sun, Grace I.; Lauer, Andreas K.; Chiang, Michael F.

    2015-01-01

    Purpose: To describe the design, implementation, and evaluation of a tele-education system developed to improve diagnostic competency in retinopathy of prematurity (ROP) by ophthalmology residents. Methods: A secure Web-based tele-education system was developed utilizing a repository of over 2,500 unique image sets of ROP. For each image set used in the system, a reference standard ROP diagnosis was established. Performance by ophthalmology residents (postgraduate years 2 to 4) from the United States and Canada in taking the ROP tele-education program was prospectively evaluated. Residents were presented with image-based clinical cases of ROP during a pretest, posttest, and training chapters. Accuracy and reliability of ROP diagnosis (eg, plus disease, zone, stage, category) were determined using sensitivity, specificity, and the kappa statistic calculations of the results from the pretest and posttest. Results: Fifty-five ophthalmology residents were provided access to the ROP tele-education program. Thirty-one ophthalmology residents completed the program. When all training levels were analyzed together, a statistically significant increase was observed in sensitivity for the diagnosis of plus disease, zone, stage, category, and aggressive posterior ROP (P<.05). Statistically significant changes in specificity for identification of stage 2 or worse (P=.027) and pre-plus (P=.028) were observed. Conclusions: A tele-education system for ROP education is effective in improving diagnostic accuracy of ROP by ophthalmology residents. This system may have utility in the setting of both healthcare and medical education reform by creating a validated method to certify telemedicine providers and educate the next generation of ophthalmologists. PMID:26538772

  10. Validation of cytogenetic risk groups according to International Prognostic Scoring Systems by peripheral blood CD34+FISH: results from a German diagnostic study in comparison with an international control group.

    PubMed

    Braulke, Friederike; Platzbecker, Uwe; Müller-Thomas, Catharina; Götze, Katharina; Germing, Ulrich; Brümmendorf, Tim H; Nolte, Florian; Hofmann, Wolf-Karsten; Giagounidis, Aristoteles A N; Lübbert, Michael; Greenberg, Peter L; Bennett, John M; Solé, Francesc; Mallo, Mar; Slovak, Marilyn L; Ohyashiki, Kazuma; Le Beau, Michelle M; Tüchler, Heinz; Pfeilstöcker, Michael; Nösslinger, Thomas; Hildebrandt, Barbara; Shirneshan, Katayoon; Aul, Carlo; Stauder, Reinhard; Sperr, Wolfgang R; Valent, Peter; Fonatsch, Christa; Trümper, Lorenz; Haase, Detlef; Schanz, Julie

    2015-02-01

    International Prognostic Scoring Systems are used to determine the individual risk profile of myelodysplastic syndrome patients. For the assessment of International Prognostic Scoring Systems, an adequate chromosome banding analysis of the bone marrow is essential. Cytogenetic information is not available for a substantial number of patients (5%-20%) with dry marrow or an insufficient number of metaphase cells. For these patients, a valid risk classification is impossible. In the study presented here, the International Prognostic Scoring Systems were validated based on fluorescence in situ hybridization analyses using extended probe panels applied to cluster of differentiation 34 positive (CD34(+)) peripheral blood cells of 328 MDS patients of our prospective multicenter German diagnostic study and compared to chromosome banding results of 2902 previously published patients with myelodysplastic syndromes. For cytogenetic risk classification by fluorescence in situ hybridization analyses of CD34(+) peripheral blood cells, the groups differed significantly for overall and leukemia-free survival by uni- and multivariate analyses without discrepancies between treated and untreated patients. Including cytogenetic data of fluorescence in situ hybridization analyses of peripheral CD34(+) blood cells (instead of bone marrow banding analysis) into the complete International Prognostic Scoring System assessment, the prognostic risk groups separated significantly for overall and leukemia-free survival. Our data show that a reliable stratification to the risk groups of the International Prognostic Scoring Systems is possible from peripheral blood in patients with missing chromosome banding analysis by using a comprehensive probe panel (clinicaltrials.gov identifier:01355913). Copyright© Ferrata Storti Foundation.

  11. Portable real-time optical coherence tomography system for intraoperative imaging and staging of breast cancer

    NASA Astrophysics Data System (ADS)

    Nguyen, Freddy T.; Zysk, Adam M.; Kotynek, Jan G.; Bellafiore, Frank J.; Rowland, Kendrith M.; Johnson, Patricia A.; Chaney, J. Eric; Boppart, Stephen A.

    2007-02-01

    Breast cancer continues to be one of the most widely diagnosed forms of cancer amongst women and the second leading type of cancer deaths amongst women. The recurrence rate of breast cancer is highly dependent on several factors including the complete removal of the primary tumor and the presence of cancer cells in involved lymph nodes. The metastatic spread and staging of breast cancer is also evaluated through the nodal assessment of the regional lymphatic system. A portable real-time spectral domain optical coherence tomography system is being presented as a clinical diagnostic tool in the intraoperative delineation of tumor margins as well as for real time lymph node assessment. The system employs a super luminescent diode centered at 1310 nm with a bandwidth of 92 nm. Using a spectral domain detection system, the data is acquired at a rate of 5 KHz / axial scan. The sample arm is a galvanometer scanning telecentric probe with an objective lens (f = 60 mm, confocal parameter = 1.5 mm) yielding an axial resolution of 8.3 μm and a transverse resolution of 35.0 μm. Images of tumor margins are acquired in the operating room ex vivo on freshly excised human tissue specimen. This data shows the potential of the use of OCT in defining the structural tumor margins in breast cancer. Images taken from ex-vivo samples on the bench system clearly delineate the differences between clusters of tumor cells and nearby adipose cells. In addition, the data shows the potential for OCT as a diagnostic tool in the staging of cancer metastasis through locoregional lymph node assessment.

  12. Application and preventive maintenance of neurology medical equipment in isfahan alzahra hospital.

    PubMed

    Alikhani, Parivash; Vesal, Sahar; Kashefi, Parviz; Pour, Ramin Etamadi; Khorvash, Fariborz; Askari, Gholamreza; Meamar, Rokhsareh

    2013-05-01

    Nowadays Medical equipment plays an important role in the treatment and in the medical education. Using outdated preventive maintenance (PM) system may cause problems in the cutting edge medical equipment, Nervous system disease's equipment (In diagnosis and treatment) which are crucial for every medical center. Based on above facts we focused on nervous system treat units' equipment and informed the supervisors and their colleagues about the latest equipment maintenance status and promoted methodical and correct method to be used for medical equipment maintenance. This research is an analytical descriptive and has been done on the base information from a particular time to past. We gathered our required information of 2009 from Alzahra Medical Center. We divided this research info 2 main phases. In the first phase, we picked out Neurosurgery and Neourology diseases medical equipment (diagnosis and therapy equipment) and in the second phase, we need to implement a methodical PM for every equipment. Research has shown that there are 19nervous system equipment in Alzahra Medical center, categorized in diagnostic (13 pcs), therapeutic (4 pcs) and diagnostic-therapeutic (2 pcs). As we declare in methods part of this research, we categorized medical equipment in Food and Drug Administration (FDA) segmentation. Capital-scarce equipment: Magnetic resonance imaging, Eco Doppler, Kamalaarak ultrasonic surgical aspirator, Stereotactic, computed tomography-scan, euroendoscope/vital-scarce equipment: Coblation, Sonoco, vaterjet/scarce equipment: Transcranial color Doppler, electroencephalogram, electromyography, surgical microscope. Survey of application and preventive maintenance of neurology medical equipment in Isfahan Alzahra hospital show there is no P.M system. Implementing a complete P.M system for this medical center is crucial to preventing cause problems for these medical equipment and decreasing maintenance costs and gaining uptime. Researchers of this article have tried to provide PM, use of texts, web and experts.

  13. RANZCR Body Systems Framework of diagnostic imaging examination descriptors.

    PubMed

    Pitman, Alexander G; Penlington, Lisa; Doromal, Darren; Slater, Gregory; Vukolova, Natalia

    2014-08-01

    A unified and logical system of descriptors for diagnostic imaging examinations and procedures is a desirable resource for radiology in Australia and New Zealand and is needed to support core activities of RANZCR. Existing descriptor systems available in Australia and New Zealand (including the Medicare DIST and the ACC Schedule) have significant limitations and are inappropriate for broader clinical application. An anatomically based grid was constructed, with anatomical structures arranged in rows and diagnostic imaging modalities arranged in columns (including nuclear medicine and positron emission tomography). The grid was segregated into five body systems. The cells at the intersection of an anatomical structure row and an imaging modality column were populated with short, formulaic descriptors of the applicable diagnostic imaging examinations. Clinically illogical or physically impossible combinations were 'greyed out'. Where the same examination applied to different anatomical structures, the descriptor was kept identical for the purposes of streamlining. The resulting Body Systems Framework of diagnostic imaging examination descriptors lists all the reasonably common diagnostic imaging examinations currently performed in Australia and New Zealand using a unified grid structure allowing navigation by both referrers and radiologists. The Framework has been placed on the RANZCR website and is available for access free of charge by registered users. The Body Systems Framework of diagnostic imaging examination descriptors is a system of descriptors based on relationships between anatomical structures and imaging modalities. The Framework is now available as a resource and reference point for the radiology profession and to support core College activities. © 2014 The Royal Australian and New Zealand College of Radiologists.

  14. TFTR diagnostic control and data acquisition system

    NASA Astrophysics Data System (ADS)

    Sauthoff, N. R.; Daniels, R. E.

    1985-05-01

    General computerized control and data-handling support for TFTR diagnostics is presented within the context of the Central Instrumentation, Control and Data Acquisition (CICADA) System. Procedures, hardware, the interactive man-machine interface, event-driven task scheduling, system-wide arming and data acquisition, and a hierarchical data base of raw data and results are described. Similarities in data structures involved in control, monitoring, and data acquisition afford a simplification of the system functions, based on ``groups'' of devices. Emphases and optimizations appropriate for fusion diagnostic system designs are provided. An off-line data reduction computer system is under development.

  15. TFTR diagnostic control and data acquisition system

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Sauthoff, N.R.; Daniels, R.E.; PPL Computer Division

    1985-05-01

    General computerized control and data-handling support for TFTR diagnostics is presented within the context of the Central Instrumentation, Control and Data Acquisition (CICADA) System. Procedures, hardware, the interactive man--machine interface, event-driven task scheduling, system-wide arming and data acquisition, and a hierarchical data base of raw data and results are described. Similarities in data structures involved in control, monitoring, and data acquisition afford a simplification of the system functions, based on ''groups'' of devices. Emphases and optimizations appropriate for fusion diagnostic system designs are provided. An off-line data reduction computer system is under development.

  16. Data mining approach to model the diagnostic service management.

    PubMed

    Lee, Sun-Mi; Lee, Ae-Kyung; Park, Il-Su

    2006-01-01

    Korea has National Health Insurance Program operated by the government-owned National Health Insurance Corporation, and diagnostic services are provided every two year for the insured and their family members. Developing a customer relationship management (CRM) system using data mining technology would be useful to improve the performance of diagnostic service programs. Under these circumstances, this study developed a model for diagnostic service management taking into account the characteristics of subjects using a data mining approach. This study could be further used to develop an automated CRM system contributing to the increase in the rate of receiving diagnostic services.

  17. Diagnostic quality of 50 and 100 µm computed radiography compared with screen–film mammography in operative breast specimens

    PubMed Central

    Pagliari, C M; Hoang, T; Reddy, M; Wilkinson, L S; Poloniecki, J D; Given-Wilson, R M

    2012-01-01

    Objective To compare reader ratings of the clinical diagnostic quality of 50 and 100 μm computed radiography (CR) systems with screen–film mammography (SFM) in operative specimens. Methods Mammograms of 57 fresh operative breast specimens were analysed by 10 readers. Exposures were made with identical position and compression with three mammographic systems (Fuji 100CR, 50CR and SFM). Images were anonymised and readers blinded to the CR system used. A five-point comparative scoring system (−2 to +2) was used to assess seven quality criteria and overall diagnostic value. Statistical analysis was subsequently performed of reader ratings (n=16 925). Results For most quality criteria, both CR systems were rated as equivalent to or better than SFM. The CR systems were significantly better at demonstrating skin edge and background tissue (p<1×10−5). Microcalcification was best demonstrated on the CR50 system (p<1×10−5). The overall diagnostic value of both CR systems was rated as being as good as or better than SFM (p<1×10−5). Conclusion In this clinical setting, the overall diagnostic performance of both CR systems was as good as or better than SFM, with the CR50 system performing better than the CR100. PMID:22096218

  18. The US Navy’s Helicopter Integrated Diagnostics System (HIDS) Program: Power Drive Train Crack Detection Diagnostics and Prognostics Life Usage Monitoring and Damage Tolerance; Techniques, Methodologies, and Experiences

    DTIC Science & Technology

    2000-02-01

    HIDS] Program: Power Drive Train Crack Detection Diagnostics and Prognostics ife Usage Monitoring and Damage Tolerance; Techniques, Methodologies, and...and Prognostics , Life Usage Monitoring , and Damage Tolerance; Techniques, Methodologies, and Experiences Andrew Hess Harrison Chin William Hardman...continuing program and deployed engine monitoring systems in fixed to evaluate helicopter diagnostic, prognostic , and wing aircraft, notably on the A

  19. Ultra-Compact Neuroprocessor for Automotive Diagnostic and Control

    NASA Technical Reports Server (NTRS)

    Tawel, R.; Aranki, N.; Feldkamp, L. A.; Marko, K. A.

    1998-01-01

    Demands on the performance of vehicle control and diagnostic systems are steadily increasing as a consequence of stiff global competition and government mandates. In the United States, light trucks and passenger cars are required both to meet strict emission standards and to perform continuous diagnostics of all emissions systems operating in the vehicle.

  20. Diagnoses and Presenting Symptoms in an Infant Psychiatry Clinic: Comparison of Two Diagnostic Systems.

    ERIC Educational Resources Information Center

    Frankel, Karen A.; Boyum, Lisa A.; Harmon, Robert J.

    2004-01-01

    Objective: To present data from a general infant psychiatry clinic, including range and frequency of presenting symptoms, relationship between symptoms and diagnoses, and comparison of two diagnostic systems, DSM-IV and Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC: 0-3). Method: A…

  1. Development and evaluation of a brief self-completed family history screening tool for common chronic disease prevention in primary care

    PubMed Central

    Walter, Fiona M; Prevost, A Toby; Birt, Linda; Grehan, Nicola; Restarick, Kathy; Morris, Helen C; Sutton, Stephen; Rose, Peter; Downing, Sarah; Emery, Jon D

    2013-01-01

    Background Family history is an important risk factor for many common chronic diseases, but it remains underutilised for diagnostic assessment and disease prevention in routine primary care. Aim To develop and validate a brief self-completed family history questionnaire (FHQ) for systematic primary care assessment for family history of diabetes, ischaemic heart disease, breast cancer, and colorectal cancer. Design and setting Two-stage diagnostic validation study in 10 general practices in eastern England. Method Participants aged 18–50 years were identified via random sampling from electronic searches of general practice records. Participants completed a FHQ then had a three-generational ‘gold standard’ pedigree taken, to determine disease risk category. In stage 1, the FHQ comprised 12 items; in stage 2 the shorter 6-item FHQ was validated against the same ‘gold standard’. Results There were 1147 participants (stage 1: 618; stage 2: 529). Overall, 32% were at increased risk of one or more marker conditions (diabetes 18.9%, ischaemic heart disease 13.3%, breast cancer 6.2%, colorectal cancer 2.2%). The shorter 6-item FHQ performed very well for all four conditions: pooled data from both stages show diabetes, sensitivity = 98%, specificity = 94%; ischaemic heart disease, sensitivity = 93%, specificity = 81%; breast cancer, sensitivity = 81%, specificity = 83%; colorectal cancer, sensitivity = 96%, specificity = 88%, with an area under the receiver operating characteristic curve of 0.90 for males and 0.89 for females. Conclusion This brief self-completed FHQ shows good diagnostic accuracy for identifying people at higher risk of four common chronic diseases. It could be used in routine primary care to identify patients who would be most likely to benefit from a more detailed pedigree and risk assessment, and consequent management strategies. PMID:23735410

  2. Application of the Systematic Sensor Selection Strategy for Turbofan Engine Diagnostics

    NASA Technical Reports Server (NTRS)

    Sowers, T. Shane; Kopasakis, George; Simon, Donald L.

    2008-01-01

    The data acquired from available system sensors forms the foundation upon which any health management system is based, and the available sensor suite directly impacts the overall diagnostic performance that can be achieved. While additional sensors may provide improved fault diagnostic performance, there are other factors that also need to be considered such as instrumentation cost, weight, and reliability. A systematic sensor selection approach is desired to perform sensor selection from a holistic system-level perspective as opposed to performing decisions in an ad hoc or heuristic fashion. The Systematic Sensor Selection Strategy is a methodology that optimally selects a sensor suite from a pool of sensors based on the system fault diagnostic approach, with the ability of taking cost, weight, and reliability into consideration. This procedure was applied to a large commercial turbofan engine simulation. In this initial study, sensor suites tailored for improved diagnostic performance are constructed from a prescribed collection of candidate sensors. The diagnostic performance of the best performing sensor suites in terms of fault detection and identification are demonstrated, with a discussion of the results and implications for future research.

  3. Application of the Systematic Sensor Selection Strategy for Turbofan Engine Diagnostics

    NASA Technical Reports Server (NTRS)

    Sowers, T. Shane; Kopasakis, George; Simon, Donald L.

    2008-01-01

    The data acquired from available system sensors forms the foundation upon which any health management system is based, and the available sensor suite directly impacts the overall diagnostic performance that can be achieved. While additional sensors may provide improved fault diagnostic performance there are other factors that also need to be considered such as instrumentation cost, weight, and reliability. A systematic sensor selection approach is desired to perform sensor selection from a holistic system-level perspective as opposed to performing decisions in an ad hoc or heuristic fashion. The Systematic Sensor Selection Strategy is a methodology that optimally selects a sensor suite from a pool of sensors based on the system fault diagnostic approach, with the ability of taking cost, weight and reliability into consideration. This procedure was applied to a large commercial turbofan engine simulation. In this initial study, sensor suites tailored for improved diagnostic performance are constructed from a prescribed collection of candidate sensors. The diagnostic performance of the best performing sensor suites in terms of fault detection and identification are demonstrated, with a discussion of the results and implications for future research.

  4. The diagnostic accuracy of 1.5T magnetic resonance imaging for detecting root avulsions in traumatic adult brachial plexus injuries.

    PubMed

    Wade, Ryckie G; Itte, Vinay; Rankine, James J; Ridgway, John P; Bourke, Grainne

    2018-03-01

    Identification of root avulsions is of critical importance in traumatic brachial plexus injuries because it alters the reconstruction and prognosis. Pre-operative magnetic resonance imaging is gaining popularity, but there is limited and conflicting data on its diagnostic accuracy for root avulsion. This cohort study describes consecutive patients requiring brachial plexus exploration following trauma between 2008 and 2016. The index test was magnetic resonance imaging at 1.5 Tesla and the reference test was operative exploration of the supraclavicular plexus. Complete data from 29 males was available. The diagnostic accuracy of magnetic resonance imaging for root avulsion(s) of C5-T1 was 79%. The diagnostic accuracy of a pseudomeningocoele as a surrogate marker of root avulsion(s) of C5-T1 was 68%. We conclude that pseudomeningocoles were not a reliable sign of root avulsion and magnetic resonance imaging has modest diagnostic accuracy for root avulsions in the context of adult traumatic brachial plexus injuries. III.

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

    PubMed Central

    2014-01-01

    Objective To offer a practical demonstration of receiver operating characteristic (ROC) analyses, diagnostic efficiency statistics, and their application to clinical decision making using a popular parent checklist to assess for potential mood disorder. Method Secondary analyses of data from 589 families seeking outpatient mental health services, completing the Child Behavior Checklist and semi-structured diagnostic interviews. Results Internalizing Problems raw scores discriminated mood disorders significantly better than did age- and gender-normed T scores, or an Affective Problems score. Internalizing scores <8 had a diagnostic likelihood ratio <0.3, and scores >30 had a diagnostic likelihood ratio of 7.4. Conclusions This study illustrates a series of steps in defining a clinical problem, operationalizing it, selecting a valid study design, and using ROC analyses to generate statistics that support clinical decisions. The ROC framework offers important advantages for clinical interpretation. Appendices include sample scripts using SPSS and R to check assumptions and conduct ROC analyses. PMID:23965298

  6. A primer on receiver operating characteristic analysis and diagnostic efficiency statistics for pediatric psychology: we are ready to ROC.

    PubMed

    Youngstrom, Eric A

    2014-03-01

    To offer a practical demonstration of receiver operating characteristic (ROC) analyses, diagnostic efficiency statistics, and their application to clinical decision making using a popular parent checklist to assess for potential mood disorder. Secondary analyses of data from 589 families seeking outpatient mental health services, completing the Child Behavior Checklist and semi-structured diagnostic interviews. Internalizing Problems raw scores discriminated mood disorders significantly better than did age- and gender-normed T scores, or an Affective Problems score. Internalizing scores <8 had a diagnostic likelihood ratio <0.3, and scores >30 had a diagnostic likelihood ratio of 7.4. This study illustrates a series of steps in defining a clinical problem, operationalizing it, selecting a valid study design, and using ROC analyses to generate statistics that support clinical decisions. The ROC framework offers important advantages for clinical interpretation. Appendices include sample scripts using SPSS and R to check assumptions and conduct ROC analyses.

  7. New Aspects in the Differential Diagnosis and Therapy of Bladder Pain Syndrome/Interstitial Cystitis

    PubMed Central

    Neuhaus, Jochen; Schwalenberg, Thilo; Horn, Lars-Christian; Alexander, Henry; Stolzenburg, Jens-Uwe

    2011-01-01

    Diagnosis of bladder pain syndrome/interstitial cystitis (BPS/IC) is presently based on mainly clinical symptoms. BPS/IC can be considered as a worst-case scenario of bladder overactivity of unknown origin, including bladder pain. Usually, patients are partially or completely resistant to anticholinergic therapy, and therapeutical options are especially restricted in case of BPS/IC. Therefore, early detection of patients prone to develop BPS/IC symptoms is essential for successful therapy. We propose extended diagnostics including molecular markers. Differential diagnosis should be based on three diagnostical “columns”: (i) clinical diagnostics, (ii) histopathology, and (iii) molecular diagnostics. Analysis of molecular alterations of receptor expression in detrusor smooth muscle cells and urothelial integrity is necessary to develop patient-tailored therapeutical concepts. Although more research is needed to elucidate the pathomechanisms involved, extended BPS/IC diagnostics could already be integrated into routine patient care, allowing evidence-based pharmacotherapy of patients with idiopathic bladder overactivity and BPS/IC. PMID:22028706

  8. New aspects in the differential diagnosis and therapy of bladder pain syndrome/interstitial cystitis.

    PubMed

    Neuhaus, Jochen; Schwalenberg, Thilo; Horn, Lars-Christian; Alexander, Henry; Stolzenburg, Jens-Uwe

    2011-01-01

    Diagnosis of bladder pain syndrome/interstitial cystitis (BPS/IC) is presently based on mainly clinical symptoms. BPS/IC can be considered as a worst-case scenario of bladder overactivity of unknown origin, including bladder pain. Usually, patients are partially or completely resistant to anticholinergic therapy, and therapeutical options are especially restricted in case of BPS/IC. Therefore, early detection of patients prone to develop BPS/IC symptoms is essential for successful therapy. We propose extended diagnostics including molecular markers. Differential diagnosis should be based on three diagnostical "columns": (i) clinical diagnostics, (ii) histopathology, and (iii) molecular diagnostics. Analysis of molecular alterations of receptor expression in detrusor smooth muscle cells and urothelial integrity is necessary to develop patient-tailored therapeutical concepts. Although more research is needed to elucidate the pathomechanisms involved, extended BPS/IC diagnostics could already be integrated into routine patient care, allowing evidence-based pharmacotherapy of patients with idiopathic bladder overactivity and BPS/IC.

  9. Parental Involvement in Cognitive Behavior Therapy for Children with Anxiety Disorders: 3-Year Follow-Up.

    PubMed

    Walczak, Monika; Esbjørn, Barbara H; Breinholst, Sonja; Reinholdt-Dunne, Marie Louise

    2017-06-01

    Parental factors have been linked to childhood anxiety, hence, parental involvement in cognitive behavioral therapy (CBT) for anxious children has been examined. However, findings do not consistently show added effects of parent-enhanced CBT, longitudinal investigations are scarce and long-term effects unclear. In the present study, 40 out of 54 families who, 3 years previously, completed one of two types of CBT treatment: with limited or active parental involvement, were assessed using semi-structured diagnostic interviews. Diagnostic status at 3-years follow-up was compared between groups. Changes in diagnostic status across assessment points: posttreatment, 6-month and 3-year follow-up were analyzed within groups. Diagnostic change from 6-month to 3-year follow-up was compared between groups. Intent-to-treat analyses revealed no significant difference in diagnostic status between groups at 3-year follow-up. Nonetheless, children whose parents actively participated in treatment showed significantly more remission from 6-month to 3-year follow-up than children with limited parental participation.

  10. Development of an Adaptable Display and Diagnostic System for the Evaluation of Tropical Cyclone Forecasts

    NASA Astrophysics Data System (ADS)

    Kucera, P. A.; Burek, T.; Halley-Gotway, J.

    2015-12-01

    NCAR's Joint Numerical Testbed Program (JNTP) focuses on the evaluation of experimental forecasts of tropical cyclones (TCs) with the goal of developing new research tools and diagnostic evaluation methods that can be transitioned to operations. Recent activities include the development of new TC forecast verification methods and the development of an adaptable TC display and diagnostic system. The next generation display and diagnostic system is being developed to support evaluation needs of the U.S. National Hurricane Center (NHC) and broader TC research community. The new hurricane display and diagnostic capabilities allow forecasters and research scientists to more deeply examine the performance of operational and experimental models. The system is built upon modern and flexible technology that includes OpenLayers Mapping tools that are platform independent. The forecast track and intensity along with associated observed track information are stored in an efficient MySQL database. The system provides easy-to-use interactive display system, and provides diagnostic tools to examine forecast track stratified by intensity. Consensus forecasts can be computed and displayed interactively. The system is designed to display information for both real-time and for historical TC cyclones. The display configurations are easily adaptable to meet the needs of the end-user preferences. Ongoing enhancements include improving capabilities for stratification and evaluation of historical best tracks, development and implementation of additional methods to stratify and compute consensus hurricane track and intensity forecasts, and improved graphical display tools. The display is also being enhanced to incorporate gridded forecast, satellite, and sea surface temperature fields. The presentation will provide an overview of the display and diagnostic system development and demonstration of the current capabilities.

  11. Rooftop package unit diagnostician

    DOEpatents

    Chassin, David P [Pasco, WA; Pratt, Robert G [Kennewick, WA; Reid, Larry Dean [Benton City, WA

    2004-08-17

    A diagnostic system for an HVAC system includes a number of sensors used to measure the operation of the HVAC system. Sensor readings are measured by timing the delay between when a strobe signal is sent to a sensor and when an interrupt signal from the sensor is received. A device driver used to measure the sensor readings stores the sensor readings in pseudo-character device files, which are universally accessible by different subsystems of the diagnostic system. Based on the readings from these sensors, this diagnostic system is able to determine the operational status of the HVAC system and if an economizer in the HVAC system is operating properly.

  12. Non-Contact Thermal Characterization of NASA's HERMeS Hall Thruster

    NASA Technical Reports Server (NTRS)

    Huang, Wensheng; Kamhawi, Hani; Meyers, James L.; Yim, John T.; Neff, Gregory

    2015-01-01

    The Thermal Characterization Test of NASAs 12.5-kW Hall thruster is being completed. This thruster is being developed to support of a number of potential Solar Electric Propulsion Technology Demonstration Mission concepts, including the Asteroid Redirect Robotic Mission concept. As a part of this test, an infrared-based, non-contact thermal imaging system was developed to measure Hall thruster surfaces that are exposed to high voltage or harsh environment. To increase the accuracy of the measurement, a calibration array was implemented, and a pilot test was performed to determine key design parameters for the calibration array. The raw data is analyzed in conjunction with a simplified thermal model of the channel to account for reflection. The reduced data will be used to refine the thruster thermal model, which is critical to the verification of the thruster thermal specifications. The present paper will give an overview of the decision process that led to identification of the need for a non-contact temperature diagnostic, the development of said diagnostic, the measurement results, and the simplified thermal model of the channel.

  13. Mental Health Needs and Service Utilization by Hispanic Immigrants Residing in Mid-Southern United States

    PubMed Central

    Bridges, Ana J.; Andrews, Arthur R.; Deen, Tisha L.

    2014-01-01

    Purpose This study assessed mental health needs and service utilization patterns in a convenience sample of Hispanic immigrants. Design and Method A total of 84 adult Hispanic participants completed a structured diagnostic interview and a semistructured service utilization interview with trained bilingual research assistants. Results In the sample, 36% met diagnostic criteria for at least one mental disorder. Although 42% of the sample saw a physician in the prior year, mental health services were being rendered primarily by religious leaders. The most common barriers to service utilization were cost (59%), lack of health insurance (35%), and language (31%). Although more women than men met criteria for a disorder, service utilization rates were comparable. Participants with a mental disorder were significantly more likely to have sought medical, but not psychiatric, services in the prior year and faced significantly more cost barriers than participants without a mental disorder. Conclusions Findings suggest that Hispanic immigrants, particularly those with a mental illness, need to access services but face numerous systemic barriers. The authors recommend specific ways to make services more affordable and linguistically accessible. PMID:22802297

  14. Lyme Disease Testing in a High-Incidence State: Clinician Knowledge and Patterns.

    PubMed

    Conant, Joanna L; Powers, Julia; Sharp, Gregory; Mead, Paul S; Nelson, Christina A

    2018-02-17

    Lyme disease (LD) incidence is increasing, but data suggest some clinicians are not fully aware of recommended procedures for ordering and interpreting diagnostic tests. The study objective was to assess clinicians' knowledge and practices regarding LD testing in a high-incidence region. We distributed surveys to 1,142 clinicians in the University of Vermont Medical Center region, of which 144 were completed (12.6% response rate). We also examined LD laboratory test results and logs of calls to laboratory customer service over a period of 2.5 years and 6 months, respectively. Most clinicians demonstrated basic knowledge of diagnostic protocols, but many misinterpreted Western blot results. For example, 42.4% incorrectly interpreted a positive immunoglobulin M result as an overall positive test in a patient with longstanding symptoms. Many also reported receiving patient requests for unvalidated tests. Additional education and modifications to LD test ordering and reporting systems would likely reduce errors and improve patient care. © American Society for Clinical Pathology, 2018. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  15. High performance sapphire windows

    NASA Technical Reports Server (NTRS)

    Bates, Stephen C.; Liou, Larry

    1993-01-01

    High-quality, wide-aperture optical access is usually required for the advanced laser diagnostics that can now make a wide variety of non-intrusive measurements of combustion processes. Specially processed and mounted sapphire windows are proposed to provide this optical access to extreme environment. Through surface treatments and proper thermal stress design, single crystal sapphire can be a mechanically equivalent replacement for high strength steel. A prototype sapphire window and mounting system have been developed in a successful NASA SBIR Phase 1 project. A large and reliable increase in sapphire design strength (as much as 10x) has been achieved, and the initial specifications necessary for these gains have been defined. Failure testing of small windows has conclusively demonstrated the increased sapphire strength, indicating that a nearly flawless surface polish is the primary cause of strengthening, while an unusual mounting arrangement also significantly contributes to a larger effective strength. Phase 2 work will complete specification and demonstration of these windows, and will fabricate a set for use at NASA. The enhanced capabilities of these high performance sapphire windows will lead to many diagnostic capabilities not previously possible, as well as new applications for sapphire.

  16. Advanced microscopy of star-shaped gold nanoparticles and their adsorption-uptake by macrophages

    PubMed Central

    Plascencia-Villa, Germán; Bahena, Daniel; Rodríguez, Annette R.; Ponce, Arturo; José-Yacamán, Miguel

    2013-01-01

    Metallic nanoparticles have diverse applications in biomedicine, as diagnostics, image contrast agents, nanosensors and drug delivery systems. Anisotropic metallic nanoparticles possess potential applications in cell imaging and therapy+diagnostics (theranostics), but controlled synthesis and growth of these anisotropic or branched nanostructures has been challenging and usually require use of high concentrations of surfactants. Star-shaped gold nanoparticles were synthesized in high yield through a seed mediated route using HEPES as a precise shape-directing capping agent. Characterization was performed using advanced electron microscopy techniques including atomic resolution TEM, obtaining a detailed characterization of nanostructure and atomic arrangement. Spectroscopy techniques showed that particles have narrow size distribution, monodispersity and high colloidal stability, with absorbance into NIR region and high efficiency for SERS applications. Gold nanostars showed to be biocompatible and efficiently adsorbed and internalized by macrophages, as revealed by advanced FE-SEM and backscattered electron imaging techniques of complete unstained uncoated cells. Additionally, low voltage STEM and X-ray microanalysis revealed the ultra-structural location and confirmed stability of nanoparticles after endocytosis with high spatial resolution. PMID:23443314

  17. Identifying patients with hypertension: a case for auditing electronic health record data.

    PubMed

    Baus, Adam; Hendryx, Michael; Pollard, Cecil

    2012-01-01

    Problems in the structure, consistency, and completeness of electronic health record data are barriers to outcomes research, quality improvement, and practice redesign. This nonexperimental retrospective study examines the utility of importing de-identified electronic health record data into an external system to identify patients with and at risk for essential hypertension. We find a statistically significant increase in cases based on combined use of diagnostic and free-text coding (mean = 1,256.1, 95% CI 1,232.3-1,279.7) compared to diagnostic coding alone (mean = 1,174.5, 95% CI 1,150.5-1,198.3). While it is not surprising that significantly more patients are identified when broadening search criteria, the implications are critical for quality of care, the movement toward the National Committee for Quality Assurance's Patient-Centered Medical Home program, and meaningful use of electronic health records. Further, we find a statistically significant increase in potential cases based on the last two or more blood pressure readings greater than or equal to 140/90 mm Hg (mean = 1,353.9, 95% CI 1,329.9-1,377.9).

  18. High performance sapphire windows

    NASA Astrophysics Data System (ADS)

    Bates, Stephen C.; Liou, Larry

    1993-02-01

    High-quality, wide-aperture optical access is usually required for the advanced laser diagnostics that can now make a wide variety of non-intrusive measurements of combustion processes. Specially processed and mounted sapphire windows are proposed to provide this optical access to extreme environment. Through surface treatments and proper thermal stress design, single crystal sapphire can be a mechanically equivalent replacement for high strength steel. A prototype sapphire window and mounting system have been developed in a successful NASA SBIR Phase 1 project. A large and reliable increase in sapphire design strength (as much as 10x) has been achieved, and the initial specifications necessary for these gains have been defined. Failure testing of small windows has conclusively demonstrated the increased sapphire strength, indicating that a nearly flawless surface polish is the primary cause of strengthening, while an unusual mounting arrangement also significantly contributes to a larger effective strength. Phase 2 work will complete specification and demonstration of these windows, and will fabricate a set for use at NASA. The enhanced capabilities of these high performance sapphire windows will lead to many diagnostic capabilities not previously possible, as well as new applications for sapphire.

  19. Simultaneous sensing of temperature, CO, and CO2 in a scramjet combustor using quantum cascade laser absorption spectroscopy

    NASA Astrophysics Data System (ADS)

    Spearrin, R. M.; Goldenstein, C. S.; Schultz, I. A.; Jeffries, J. B.; Hanson, R. K.

    2014-07-01

    A mid-infrared laser absorption sensor was developed for gas temperature and carbon oxide (CO, CO2) concentrations in high-enthalpy, hydrocarbon combustion flows. This diagnostic enables non-intrusive, in situ measurements in harsh environments produced by hypersonic propulsion ground test facilities. The sensing system utilizes tunable quantum cascade lasers capable of probing the fundamental mid-infrared absorption bands of CO and CO2 in the 4-5 µm wavelength domain. A scanned-wavelength direct absorption technique was employed with two lasers, one dedicated to each species, free-space fiber-coupled using a bifurcated hollow-core fiber for remote light delivery on a single line of sight. Scanned-wavelength modulation spectroscopy with second-harmonic detection was utilized to extend the dynamic range of the CO measurement. The diagnostic was field-tested on a direct-connect scramjet combustor for ethylene-air combustion. Simultaneous, laser-based measurements of carbon monoxide and carbon dioxide provide a basis for evaluating combustion completion or efficiency with temporal and spatial resolution in practical hydrocarbon-fueled engines.

  20. [What rheumatologists can learn from ophthalmologists].

    PubMed

    Becker, M D; Max, R; Dimitriou, A; Saurenmann, T; Lorenz, H-M; Jansen, A; Lortz, S; Grulich-Henn, J; Weber, M

    2018-06-07

    Intraocular inflammation with the imprecise and broad umbrella term "uveitis" is a diagnostic and therapeutic challenge in ophthalmology. Uveitis is one of the most common causes of blindness worldwide and due to the associated costs is comparable to diabetic retinopathy. Patients can be affected by uveitis at any age. Any part of the eye may be affected. The symptoms range from complete absence of symptoms, through all types of vision deterioration up to a red and even very painful eye. Uveitis can be strictly unilateral (also alternating from the left to the right eye) or bilateral with a relapsing or chronic course. The transitions are smooth and the differential diagnoses are very broad. In addition to infectious forms and ocular syndromes restricted to the eye, it also includes those with extraocular systemic diseases, such as ankylosing spondylitis or sarcoidosis. All commonly administered immunosuppressive treatment strategies in rheumatology can be used for non-infectious forms in addition to local and regional forms of treatment. The diagnostic and therapeutic impulses of this interdisciplinary interface between rheumatology and ophthalmology is discussed in more detail in this article.

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