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Sample records for diagnosing faulty links

  1. Message routing in HARTS with faulty components

    NASA Technical Reports Server (NTRS)

    Olson, Alan; Shin, Kang G.

    1989-01-01

    It is important to design a distributed system which is capable of delivering messages even in the presence of faulty components between their source and destination nodes. A routing scheme is developed in two steps for a wrapped hexagonal mesh, called HARTS (Hexagonal Architecture for Real-Time Systems), which assures the delivery of every message as long as there is a path between its source and destination. The proposed scheme can also detect the nonexistence of path between a pair of nodes in a finite amount of time. Moreover, the scheme requires each node in HARTS to know only the state (faulty or not) of each of its own links. The performance of the simple routing scheme is simulated for 3- and 5-dimensional H-meshes while varying the physical distribution of faulty components. It is shown that a shortest path between the source and destination of each message is taken with a high probability and a path, if it exists, is usually found very quickly.

  2. Using Bit Errors To Diagnose Fiber-Optic Links

    NASA Technical Reports Server (NTRS)

    Bergman, L. A.; Hartmayer, R.; Marelid, S.

    1989-01-01

    Technique for diagnosis of fiber-optic digital communication link in local-area network of computers based on measurement of bit-error rates. Variable optical attenuator inserted in optical fiber to vary power of received signal. Bit-error rate depends on ratio of peak signal power to root-mean-square noise in receiver. For optimum measurements, one selects bit-error rate between 10 to negative 8th power and 10 to negative 4th power. Greater rates result in low accuracy in determination of signal-to-noise ratios, while lesser rates require impractically long measurement times.

  3. Faulty assumptions for repository requirements

    SciTech Connect

    Sutcliffe, W G

    1999-06-03

    Long term performance requirements for a geologic repository for spent nuclear fuel and high-level waste are based on assumptions concerning water use and subsequent deaths from cancer due to ingesting water contaminated with radio isotopes ten thousand years in the future. This paper argues that the assumptions underlying these requirements are faulty for a number of reasons. First, in light of the inevitable technological progress, including efficient desalination of water, over the next ten thousand years, it is inconceivable that a future society would drill for water near a repository. Second, even today we would not use water without testing its purity. Third, today many types of cancer are curable, and with the rapid progress in medical technology in general, and the prevention and treatment of cancer in particular, it is improbable that cancer caused by ingesting contaminated water will be a sign&ant killer in the far future. This paper reviews the performance requirements for geological repositories and comments on the difficulties in proving compliance in the face of inherent uncertainties. The already tiny long-term risk posed by a geologic repository is presented and contrasted with contemporary every day risks. A number of examples of technological progress, including cancer treatments, are advanced. The real and significant costs resulting from the overly conservative requirements are then assessed. Examples are given of how money (and political capital) could be put to much better use to save lives today and in the future. It is concluded that although a repository represents essentially no long-term risk, monitored retrievable dry storage (above or below ground) is the current best alternative for spent fuel and high-level nuclear waste.

  4. Diagnose

    NASA Astrophysics Data System (ADS)

    Schauer, Wolfgang

    Die Zunahme der Elektronik im Kraftfahrzeug, die Nutzung von Software zur Steuerung des Fahrzeugs und die erhöhte Komplexität moderner Einspritzsysteme stellen hohe Anforderungen an das Diagnosekonzept, die Überwachung im Fahrbetrieb (On-Board-Diagnose) und die Werkstattdiagnose (Bild 1). Basis der Werkstattdiagnose ist die geführte Fehlersuche, die verschiedene Möglichkeiten von Onboard- und Offboard-Prüfmethoden und Prüfgeräten verknüpft. Im Zuge der Verschärfung der Abgasgesetzgebung und der Forderung nach laufender Überwachung hat auch der Gesetzgeber die On-Board-Diagnose als Hilfsmittel zur Abgasüberwachung erkannt und eine herstellerunabhängige Standardisierung geschaffen. Dieses zusätzlich installierte System wird OBD-System (On Board Diagnostic System) genannt.

  5. The potential of using enzyme-linked immunospot to diagnose cephalosporin-induced maculopapular exanthems.

    PubMed

    Tanvarasethee, Boonthorn; Buranapraditkun, Supranee; Klaewsongkram, Jettanong

    2013-01-01

    There is no reliable test to diagnose cephalosporin-induced maculopapular exanthems (MPE). This study aimed to evaluate the role of enzyme-linked immunospot assay in the diagnosis of cephalosporin-induced MPE compared with skin testing. A total of 25 patients with a history of cephalosporin-induced MPE were skin tested and the frequencies of cephalosporin-specific interferon-γ-, interleukin-5-, and interleukin-10-releasing cells/10(6) peripheral blood mononuclear cells were measured after stimulating with the culprit drug, compared with 20 non-allergic controls. Values greater than means+2 standard deviations of the values in non-allergic controls were considered diagnostic. The study showed that the combination of interferon-γ and interleukin-5 enzyme-linked immunospot assays was more sensitive than skin testing to diagnose cephalosporin allergy (40% vs. 8%, p = 0.008) and sensitivity increased to 57.1% when the test was performed within 2 years of the drug reaction. Enzyme-linked immunospot assay is a promising tool for confirming the diagnosis of cephalosporin-induced MPE.

  6. Faulty ECM signaling facilitates autoimmune lymphomagenesis.

    PubMed

    Brekken, Rolf A

    2014-01-01

    The contribution of the extracellular matrix (ECM) to the microenvironment of solid tumors is appreciated although not completely understood; however, the contribution of the ECM to the development of hematopoietic tumors has not been investigated in depth. A new study by Sangaletti and colleagues demonstrates that faulty ECM signaling can facilitate malignant lymphoproliferation in mice predisposed to autoimmunity. Similar changes in ECM construction, consistent with a loss of inhibitory ECM signaling, were identified in the transition from reactive lymphoid hyperplasia to malignant chronic lymphocytic leukemia in patients. These results reveal a critical contribution of reduced collagen signaling in lymphoma and highlight the importance of appropriate ECM construction for maintenance of tissue homeostasis.

  7. Method and apparatus for faulty memory utilization

    DOEpatents

    Cher, Chen-Yong; Andrade Costa, Carlos H.; Park, Yoonho; Rosenburg, Bryan S.; Ryu, Kyung D.

    2016-04-19

    A method for faulty memory utilization in a memory system includes: obtaining information regarding memory health status of at least one memory page in the memory system; determining an error tolerance of the memory page when the information regarding memory health status indicates that a failure is predicted to occur in an area of the memory system affecting the memory page; initiating a migration of data stored in the memory page when it is determined that the data stored in the memory page is non-error-tolerant; notifying at least one application regarding a predicted operating system failure and/or a predicted application failure when it is determined that data stored in the memory page is non-error-tolerant and cannot be migrated; and notifying at least one application regarding the memory failure predicted to occur when it is determined that data stored in the memory page is error-tolerant.

  8. Comparison of cancer diagnoses between the US solid organ transplant registry and linked central cancer registries.

    PubMed

    Yanik, Elizabeth L; Nogueira, Leticia M; Koch, Lori; Copeland, Glenn; Lynch, Charles F; Pawlish, Karen S; Finch, Jack L; Kahn, Amy R; Hernandez, Brenda Y; Segev, Dorry L; Pfeiffer, Ruth M; Snyder, Jon J; Kasiske, Bertram L; Engels, Eric A

    2016-04-07

    US transplant centers are required to report cancers in transplant recipients to the transplant network. The accuracy and completeness of these data, collected in the Scientific Registry of Transplant Recipients (SRTR), are unknown. We compared diagnoses in the SRTR and 15 linked cancer registries, for colorectal, liver, lung, breast, prostate, and kidney cancers, melanoma, and non-Hodgkin lymphoma (NHL). Among 187,384 transplants, 9323 cancers were documented in the SRTR or cancer registries. Only 36.8% of cancers were in both, with 47.5% and 15.7% of cases additionally documented solely in cancer registries or the SRTR, respectively. Agreement between the SRTR and cancer registries varied (kappa: 0.28 for liver cancer, 0.52-0.66 for lung, prostate, kidney, colorectum and breast cancers). Upon evaluation, some NHLs documented only in cancer registries were identified in the SRTR as another type of post-transplant lymphoproliferative disorder. Some SRTR-only cases were explained by miscoding (colorectal cancer instead of anal cancer, metastases as lung or liver cancers) or missed matches with cancer registries, partly due to out-migration from their catchment areas. Estimated sensitivity for identifying cancer was 52.5% for the SRTR and 84.3% for cancer registries. In conclusion, SRTR cancer data are substantially incomplete, limiting their usefulness for surveillance and research. This article is protected by copyright. All rights reserved.

  9. Diagnosable systems for intermittent faults

    NASA Technical Reports Server (NTRS)

    Mallela, S.; Masson, G. M.

    1978-01-01

    The fault diagnosis capabilities of systems composed of interconnected units capable of testing each other are studied for the case of systems with intermittent faults. A central role is played by the concept of t(i)-fault diagnosability. A system is said to be t(i)-fault diagnosable when it is such that if no more than t(i) units are intermittently faulty then a fault-free unit will never be diagnosed as faulty and the diagnosis at any time is at worst incomplete. Necessary and sufficient conditions for t(i)-fault diagnosability are proved, and bounds for t(i) are established. The conditions are in general more restrictive than those for permanent-fault diagnosability. For intermittent faults there is only one testing strategy (repetitive testing), and consequently only one type of intermittent-fault diagnosable system.

  10. Immunoendocrinology: faulty hormonal imprinting in the immune system.

    PubMed

    Csaba, György

    2014-06-01

    Hormonal imprinting is an epigenetic process which is taking place perinatally at the first encounter between the developing hormone receptors and their target hormones. The hormonal imprinting influences the binding capacity of receptors, the hormone synthesis of the cells, and other hormonally regulated functions, as sexual behavior, aggressivity, empathy, etc. However, during the critical period, when the window for imprinting is open, molecules similar to the physiological imprinters as synthetic hormone analogs, other members of the hormone families, environmental pollutants, etc. can cause faulty imprinting with life-long consequences. The developing immune system, the cells of which also have receptors for hormones, is very sensitive to faulty imprinting, which causes alterations in the antibody and cytokine production, in the ratio of immune cells, in the defense against bacterial and viral infections as well as against malignant tumors. Immune cells (lymphocytes, monocytes, granulocytes and mast cells) are also producing hormones which are secreted into the blood circulation as well as are transported locally (packed transport). This process is also disturbed by faulty imprinting. As immune cells are differentiating during the whole life, faulty imprinting could develop any time, however, the most decisive is the perinatal imprinting. The faulty imprinting is inherited to the progenies in general and especially in the case of immune system. In our modern world the number and amount of artificial imprinters (e.g. endocrine disruptors and drugs) are enormously increasing. The effects of the faulty imprinters most dangerous to the immune system are shown in the paper. The present and future consequences of the flood of faulty imprintings are unpredictable however, it is discussed.

  11. Drift compensation and faulty display correction in robotic nano manipulation.

    PubMed

    Liu, Lian-qing; Xi, Ning; Wang, Yue-chao; Dong, Zai-li

    2010-11-01

    Random drift and faulty visual display are the main problems in Atomic Force Microscopy (AFM) based robotic nanomanipulation. As far as we know, there are no effective methods available to solve these problems. In this paper, an On-line Sensing and Display (OSD) method is proposed to solve these problems. The OSD method mainly includes two subprocesses: Local-Scan-Before-Manipulation (LSBM) and Local-Scan-After-Manipulation (LSAM). During manipulation, LSBM and LSAM are on-line performed for random drift compensation and faulty visual display correction respectively. Through this way, the bad influence aroused from random drift and faulty visual display can be eliminated in real time. The visual feedback keeps consistent with the true environment changes during the process of manipulation, which makes several operations being finished without an image scan in between. Experiments show the increased effectiveness and efficiency of AFM based nanomanipulation.

  12. Quantitative Raman characterization of cross-linked collagen thin films as a model system for diagnosing early osteoarthritis

    NASA Astrophysics Data System (ADS)

    Wang, Chao; Durney, Krista M.; Fomovsky, Gregory; Ateshian, Gerard A.; Vukelic, Sinisa

    2016-03-01

    The onset of osteoarthritis (OA)in articular cartilage is characterized by degradation of extracellular matrix (ECM). Specifically, breakage of cross-links between collagen fibrils in the articular cartilage leads to loss of structural integrity of the bulk tissue. Since there are no broadly accepted, non-invasive, label-free tools for diagnosing OA at its early stage, Raman spectroscopyis therefore proposed in this work as a novel, non-destructive diagnostic tool. In this study, collagen thin films were employed to act as a simplified model system of the cartilage collagen extracellular matrix. Cross-link formation was controlled via exposure to glutaraldehyde (GA), by varying exposure time and concentration levels, and Raman spectral information was collected to quantitatively characterize the cross-link assignments imparted to the collagen thin films during treatment. A novel, quantitative method was developed to analyze the Raman signal obtained from collagen thin films. Segments of Raman signal were decomposed and modeled as the sum of individual bands, providing an optimization function for subsequent curve fitting against experimental findings. Relative changes in the concentration of the GA-induced pyridinium cross-links were extracted from the model, as a function of the exposure to GA. Spatially resolved characterization enabled construction of spectral maps of the collagen thin films, which provided detailed information about the variation of cross-link formation at various locations on the specimen. Results showed that Raman spectral data correlate with glutaraldehyde treatment and therefore may be used as a proxy by which to measure loss of collagen cross-links in vivo. This study proposes a promising system of identifying onset of OA and may enable early intervention treatments that may serve to slow or prevent osteoarthritis progression.

  13. Gait planning for a quadruped robot with one faulty actuator

    NASA Astrophysics Data System (ADS)

    Chen, Xianbao; Gao, Feng; Qi, Chenkun; Tian, Xinghua

    2015-01-01

    Fault tolerance is essential for quadruped robots when they work in remote areas or hazardous environments. Many fault-tolerant gaits planning method proposed in the past decade constrained more degrees of freedom(DOFs) of a robot than necessary. Thus a novel method to realize the fault-tolerant walking is proposed. The mobility of the robot is analyzed first by using the screw theory. The result shows that the translation of the center of body(CoB) can be kept with one faulty actuator if the rotations of the body are controlled. Thus the DOFs of the robot body are divided into two parts: the translation of the CoB and the rotation of the body. The kinematic model of the whole robot is built, the algorithm is developed to actively control the body orientations at the velocity level so that the planned CoB trajectory can be realized in spite of the constraint of the faulty actuator. This gait has a similar generation sequence with the normal gait and can be applied to the robot at any position. Simulations and experiments of the fault-tolerant gait with one faulty actuator are carried out. The CoB errors and the body rotation angles are measured. Comparing to the traditional fault-tolerant gait they can be reduced by at least 50%. A fault-tolerant gait planning algorithm is presented, which not only realizes the walking of a quadruped robot with a faulty actuator, but also efficiently improves the walking performances by taking full advantage of the remaining operational actuators according to the results of the simulations and experiments.

  14. Behavior of faulty double BJT BiCMOS logic gates

    NASA Technical Reports Server (NTRS)

    Menon, Sankaran M.; Malaiya, Yashwant K.; Jayasumana, Anura P.

    1992-01-01

    Logic Behavior of a Double BJT BiCMOS device under transistor level shorts and opens is examined. In addition to delay faults, faults that cause the gate to exhibit sequential behavior were observed. Several faults can be detected only by monitoring the current. The faulty behavior of Bipolar (TTL) and CMOS logic families is compared with BiCMOS, to bring out the testability differences.

  15. Enzyme-linked immunosorbent assay for detecting antibodies in cattle in a herd in which anaplasmosis was diagnosed.

    PubMed Central

    Thoen, C O; Blackburn, B; Mills, K; Lomme, J; Hopkins, M P

    1980-01-01

    An enzyme-linked immunosorbent assay (ELISA) was developed for detecting antibodies in anaplasmosis with an antigen prepared from infected bovine erythrocytes. Protein A labeled with horseradish peroxidase was used as conjugate. A comparison was made of results of ELISA, complement fixation test (CFT), and card test (CT) on sera from 97 cows in a herd in which anaplasmosis had been diagnosed. Positive ELISA reactions were observed in serum dilutions of 1:20 or greater in each of 26 cows positive by CFT and in 18 of 22 cows suspected by CFT. Of 49 cows negative by CFT, 31 were negative by ELISA. Positive ELISA reactions were observed in 45 cows positive by CT; 27 of 44 cows negative by ct were negative by ELISA. No ELISA reactions were detected in the sera of 23 cows found negative in the CFT and CT or in 8 cows negative in CFT and positive in CT. No positive CFT, CT, or ELISA reactions were observed in sera of cattle in a noninfected herd. PMID:7381017

  16. Hierarchical representation and machine learning from faulty jet engine behavioral examples to detect real time abnormal conditions

    NASA Technical Reports Server (NTRS)

    Gupta, U. K.; Ali, M.

    1988-01-01

    The theoretical basis and operation of LEBEX, a machine-learning system for jet-engine performance monitoring, are described. The behavior of the engine is modeled in terms of four parameters (the rotational speeds of the high- and low-speed sections and the exhaust and combustion temperatures), and parameter variations indicating malfunction are transformed into structural representations involving instances and events. LEBEX extracts descriptors from a set of training data on normal and faulty engines, represents them hierarchically in a knowledge base, and uses them to diagnose and predict faults on a real-time basis. Diagrams of the system architecture and printouts of typical results are shown.

  17. Runtime of unstructured search with a faulty Hamiltonian oracle

    NASA Astrophysics Data System (ADS)

    Temme, Kristan

    2014-08-01

    We show that it is impossible to obtain a quantum speedup for a faulty Hamiltonian oracle. The effect of dephasing noise to this continuous-time oracle model has first been investigated by Shenvi, Brown, and Whaley [Phys. Rev. A 68, 052313 (2003)., 10.1103/PhysRevA.68.052313]. The authors consider a faulty oracle described by a continuous-time master equation that acts as dephasing noise in the basis determined by the marked item. The analysis focuses on the implementation with a particular driving Hamiltonian. A universal lower bound for this oracle model, which rules out a better performance with a different driving Hamiltonian, has so far been lacking. Here, we derive an adversary-type lower bound which shows that the evolution time T has to be at least in the order of N, i.e., the size of the search space, when the error rate of the oracle is constant. This means that quadratic quantum speedup vanishes and the runtime assumes again the classical scaling. For the standard quantum oracle model this result was first proven by Regev and Schiff [in Automata, Languages and Programming, Lecture Notes in Computer Science Vol. 5125 (Springer, Berlin, 2008), pp. 773-781]. Here, we extend this result to the continuous-time setting.

  18. Diagnosability issues in multiprocessor systems

    SciTech Connect

    Raghavan, V.

    1989-01-01

    In a seminal paper on fault diagnosis, Preparata, Metze, and Chien introduced a graph-theoretical model. Barsi, Grandoni, and Maestrini relaxed some constraints in this model to create a different model for fault diagnosis. Both these models have become the subject of intense research in the past two decades. A major open problem for these models is the question of sequential t-diagnosability-Given an arbitrary system of units and that there are no more than t faulty units in it, can we always identify at least one faulty unit The author shows that this problem is co-NP complete in both models. Recent research has shown that there are polynomial time algorithms to find the maximum number of faulty units a system can withstand and still identify all of them from a single collection of test results. He presents improved algorithms to solve this problem in both models. Using the letters n,m, and {tau} to denote the number of units, the number of tests, and the maximum number of faulty units respectively, our results can be summarized as follows: in the model of Barsi, Grandoni, and Maestrini, the algorithm has a time complexity of O(n{tau}{sup 2}/log{tau}) improving on the currently known O(n{tau}{sup 2}); in the model of Preparata, Metze, and Chien, the algorithm has a complexity of O(n{tau}{sup 2.5}) improving on the currently known O(mn{sup 1.5}). He also presents related results in the latter model, which suggest the possibility of reducing the complexity even further. Finally, he develops a general scheme for characterizing diagnosable systems. Using this scheme, he solves the open problem of characterizing t/s and sequentially t-diagnosable systems. The characterizations are then used to rederive some known results.

  19. Accuracy of reporting maternal in-hospital diagnoses and intrapartum procedures in Washington State linked birth records.

    PubMed

    Lydon-Rochelle, Mona T; Holt, Victoria L; Nelson, Jennifer C; Cárdenas, Vicky; Gardella, Carolyn; Easterling, Thomas R; Callaghan, William M

    2005-11-01

    While the impact of maternal morbidities and intrapartum procedures is a common topic in perinatal outcomes research, the accuracy of the reporting of these variables in the large administrative databases (birth certificates, hospital discharges) often utilised for such research is largely unknown. We conducted this study to compare maternal diagnoses and procedures listed on birth certificates, hospital discharge data, and birth certificate and hospital discharge data combined, with those documented in a stratified random sample of hospital medical records of 4541 women delivering liveborn infants in Washington State in 2000. We found that birth certificate and hospital discharge data combined had substantially higher true positive fractions (TPF, proportion of women with a positive medical record assessment who were positive using the administrative databases) than did birth certificate data alone for labour induction (86% vs. 52%), cephalopelvic disproportion (83% vs. 35%), abruptio placentae (85% vs. 68%), and forceps-assisted delivery (89% vs. 55%). For procedures available only in hospital discharge data, TPFs were generally high: episiotomy (85%) and third and fourth degree vaginal lacerations (91%). Except for repeat caesarean section without labour (TPF, 81%), delivery procedures available only in birth certificate data had low TPFs, including augmentation (34%), repeat caesarean section with labour (61%), and vaginal birth after caesarean section (62%). Our data suggest that researchers conducting perinatal epidemiological studies should not rely solely on birth certificate data to detect maternal diagnoses and intrapartum procedures accurately.

  20. System and method for detecting a faulty object in a system

    DOEpatents

    Gunnels, John A.; Gustavson, Fred Gehrung; Engle, Robert Daniel

    2010-12-14

    A method (and system) for detecting at least one faulty object in a system including a plurality of objects in communication with each other in an n-dimensional architecture, includes probing a first plane of objects in the n-dimensional architecture and probing at least one other plane of objects in the n-dimensional architecture which would result in identifying a faulty object in the system.

  1. System and method for detecting a faulty object in a system

    DOEpatents

    Gunnels, John A.; Gustavson, Fred Gehrung; Engle, Robert Daniel

    2009-03-17

    A method (and system) for detecting at least one faulty object in a system including a plurality of objects in communication with each other in an n-dimensional architecture, includes probing a first plane of objects in the n-dimensional architecture and probing at least one other plane of objects in the n-dimensional architecture which would result in identifying a faulty object in the system.

  2. Multicountry prospective clinical evaluation of two enzyme-linked immunosorbent assays and two rapid diagnostic tests for diagnosing dengue fever.

    PubMed

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

    2015-04-01

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

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

    PubMed Central

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

    2015-01-01

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

  4. Getting Diagnosed

    MedlinePlus

    ... also for those with related disorders. How is Marfan syndrome diagnosed? getting_diagnosed.jpg A Marfan diagnosis ... spinal column). Is there a genetic test for Marfan syndrome? Genetic testing can provide helpful information in ...

  5. Uniqueness of the angular velocity of a rigid body: Correction of two faulty proofs

    NASA Astrophysics Data System (ADS)

    Lemos, Nivaldo A.

    2000-07-01

    The angular velocity is an absolute or intrinsic property of a rigid body; that is, all points of a rotating rigid body have the same angular velocity. This fact is well known, but its proof is often erroneous. Here we correct two faulty proofs of this result, one in Goldstein's famous textbook and the other published nearly 30 years ago in this journal.

  6. 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.

  7. Diagnosing ALS

    MedlinePlus

    ... that a person diagnosed with ALS seek a second opinion from an ALS "expert" - someone who diagnoses and treats many ALS patients and has training in this medical specialty. The ALS Association maintains a list of recognized experts in the field of ALS. See ALS Association Certified Centers of ...

  8. New detection method of faulty distribution power apparatus using thermal images

    NASA Astrophysics Data System (ADS)

    Ishino, Ryuichi

    2002-03-01

    In automatic diagnosis of a power distribution apparatus is utilizing thermal images problems arise in that there are problems, that there are many thermal patterns similar to the thermal pattern of the target apparatus and that the temperature around the apparatus influences the diagnosis. In order to solve these problems, we developed a new method whereby images of the apparatus are extracted by an image processing technique based on high-order local autocorrelation features, the attachment pattern on a pole, and a disparity map; a faulty apparatus is identified based on the local temperature gradient. In the extraction method, the distance information provided by the disparity map narrows the search area of the apparatus. The search is conducted according to the rule that an apparatus feature that is defined by high-order local autocorrelation features appears at certain intervals, according to the attachment pattern on a pole, in the search area. The local temperature gradient detects local heat in the form of leakage current on the faulty apparatus. Experiments using the proposed method were conducted under different weather conditions, at different times and seasons. An error rate of 3% was obtained from experiments on the extraction of an apparatus, and an error rate of 17% was obtained from experiments on the detection of a faulty apparatus. The proposed method can extract and detect faulty apparatuses, such as a pin insulator, a section switch and a strain insulator, except in the case where the distance between the pole and the infrared camera is so large that the sensitivity is insufficient.

  9. Newly Diagnosed?

    MedlinePlus

    ... Suggestions Examine Your Skin Newly Diagnosed? Understanding Your Pathology Biopsy: The First Step Sentinel Node Biopsy Melanoma ... start this journey: Get a copy of your pathology report. We can help you understand the report ...

  10. Newly Diagnosed

    MedlinePlus

    ... of transmitting HIV to others. Do I Have AIDS? Being HIV-positive does NOT necessarily mean you ... Children Newly Diagnosed: Older Adults Related Topics on AIDS.gov Stages of HIV Infection Immune System 101 ...

  11. Complexity of system-level fault diagnosis and diagnosability

    SciTech Connect

    Sullivan, G.F.

    1986-01-01

    It is now possible to design and build systems that incorporate a large number of processing elements. For this reason, fault-diagnosis at the system level, a research area pioneered by the work of Preparata, Metze, and Chien, is of increasing importance. The formalization of their model utilizes directed graphs together with labelings on edges and vertices. The two central problems introduced by the model are called the diagnosis and diagnosability problems. In the diagnosis problem, an algorithm must identify the faulty units of a system based on test results. In the diagnosability problem, an algorithm must determine the maximum number of faulty units a system can contain and still be guaranteed capable of successfully testing itself. One of the main open questions is resolved for this model by presenting the first polynomial time algorithm for the diagnosability problem. The solution uses network-flow techniques and runs in O(absolute value E absolute value V/sup 3/2/) time. Also presented is a new time-complexity bound of O(min(t absolute value E, t/sup 3/ + absolute value E)) for the diagnosis problem, where t is the maximum number of faulty units.

  12. [Revaluation of the concept of developmental abnormality: the importance of faulty perinatal imprinting].

    PubMed

    Csaba, György

    2015-07-12

    The classic definition of developmental abnormalities referred to malformations observed at birth. Later the functional teratogenicity was also recognized and accepted, which can be revealed in functional abnormalities caused by harms during the intrauterine development and can be manifested at any time of life. However, the ontogeny is not closed with the birth, because some systems or organs are developing for a long time after it, and can be influenced by different factors. From this aspect the perinatal period is especially important when the mutual adjustment of the receptor-hormone system is taking place and the hormonal imprinting develops. If this is faulty, it influences the hormone binding capacity of receptors that has consequences for life. The faulty hormonal imprinting is functionally teratogen; it provokes a fault up to the level of a malformation and aggravated with its heredity to the progenies. False imprinting is provoked (in animal experiments, proportioning to human doses) by drugs acting at receptor level, as oxytocin, steroid hormone analogues (pregnancy protectors, oral contraceptives, surfactants), vitamin A and D, environmental pollutant endocrine disruptors (benzpyrene, bisphenol A, pesticides, herbicides) and certain soybean components, etc. From this aspect these are functional teratogens, and their evasion in prevention as well as therapy seems to be vital. This means that the concept of developmental abnormality must be broadened, as developmental abnormalities: 1.) can originate not only in the intrauterine period, but also perinatally or even later, 2.) it can be manifested at any time of life, 3.) it can be present in a latent form which can be activated by inner or outer environmental factors, 4.) the faulty hormonal imprinting is a teratogen factor.

  13. Diagnosing Flu

    MedlinePlus

    ... your symptoms and their clinical judgment. Will my health care provider test me for flu if I have flu-like ... flu symptoms do not require testing because the test results usually do not change how you are treated. Your health care provider may diagnose you with flu based on ...

  14. Theory of Mind Deficit versus Faulty Procedural Memory in Autism Spectrum Disorders

    PubMed Central

    Romero-Munguía, Miguel Ángel

    2013-01-01

    Individuals with autism spectrum disorders (ASD) have impairments in social interaction, communicative capacity, and behavioral flexibility (core triad). Three major cognitive theories (theory of mind deficit, weak central coherence, and executive dysfunction) seem to explain many of these impairments. Currently, however, the empathizing-systemizing (a newer version of the theory of mind deficit account) and mnesic imbalance theories are the only ones that attempt to explain all these core triadic symptoms of ASD On the other hand, theory of mind deficit in empathizing-systemizing theory is the most influential account for ASD, but its counterpart in the mnesic imbalance theory, faulty procedural memory, seems to occur earlier in development; consequently, this might be a better solution to the problem of the etiology of ASD, if it truly meets the precedence criterion. Hence, in the present paper I review the reasoning in favor of the theory of mind deficit but with a new interpretation based on the mnesic imbalance theory, which posits that faulty procedural memory causes deficits in several cognitive skills, resulting in poor performance in theory of mind tasks. PMID:23862063

  15. Theory of Mind Deficit versus Faulty Procedural Memory in Autism Spectrum Disorders.

    PubMed

    Romero-Munguía, Miguel Ángel

    2013-01-01

    Individuals with autism spectrum disorders (ASD) have impairments in social interaction, communicative capacity, and behavioral flexibility (core triad). Three major cognitive theories (theory of mind deficit, weak central coherence, and executive dysfunction) seem to explain many of these impairments. Currently, however, the empathizing-systemizing (a newer version of the theory of mind deficit account) and mnesic imbalance theories are the only ones that attempt to explain all these core triadic symptoms of ASD On the other hand, theory of mind deficit in empathizing-systemizing theory is the most influential account for ASD, but its counterpart in the mnesic imbalance theory, faulty procedural memory, seems to occur earlier in development; consequently, this might be a better solution to the problem of the etiology of ASD, if it truly meets the precedence criterion. Hence, in the present paper I review the reasoning in favor of the theory of mind deficit but with a new interpretation based on the mnesic imbalance theory, which posits that faulty procedural memory causes deficits in several cognitive skills, resulting in poor performance in theory of mind tasks.

  16. The faulty Master Events Controller is carried away from STS-99 Endeavour

    NASA Technical Reports Server (NTRS)

    2000-01-01

    Workers carry away the faulty Enhanced Main Events Controller (E- MEC) from Shuttle Endeavour at Launch Pad 39A. The E-MEC became suspect during the Jan. 31 launch countdown and mission STS-99 was delayed when NASA managers decided to replace it. Each Shuttle carries two enhanced master events controllers (E-MECs), which provide relays for onboard flight computers to send signals to arm and fire pyrotechnics that separate the solid rockets and external tank during assent. Both E-MECs are needed for the Shuttle to be cleared for flight. Currently Endeavour and Columbia are the only two orbiters with the E-MECs. Built by Rockwell's Satellite Space Electronics Division, Anaheim, Calif., each unit weighs 65 pounds and is approximately 20 inches long, 13 inches wide and 8 inches tall. Previously, three Shuttle flights have been scrubbed or delayed due to faulty MECs: STS-73, STS-49 and STS-41-D. The next scheduled date for launch of STS-99 is Feb. 11 at 12:30 p.m. EST.

  17. The faulty Master Events Controller is removed from STS-99 Endeavour

    NASA Technical Reports Server (NTRS)

    2000-01-01

    Technicians remove a faulty Enhanced Main Events Controller (E- MEC) from Shuttle Endeavour at Launch Pad 39A. The E-MEC became suspect during the Jan. 31 launch countdown and mission STS-99 was delayed when NASA managers decided to replace it. Each Shuttle carries two enhanced master events controllers (E-MECs), which provide relays for onboard flight computers to send signals to arm and fire pyrotechnics that separate the solid rockets and external tank during assent. Both E-MECs are needed for the Shuttle to be cleared for flight. Currently Endeavour and Columbia are the only two orbiters with the E-MECs. Built by Rockwell's Satellite Space Electronics Division, Anaheim, Calif., each unit weighs 65 pounds and is approximately 20 inches long, 13 inches wide and 8 inches tall. Previously, three Shuttle flights have been scrubbed or delayed due to faulty MECs: STS-73, STS-49 and STS-41-D. The next scheduled date for launch of STS-99 is Feb. 11 at 12:30 p.m. EST.

  18. How Are Obesity and Overweight Diagnosed?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How are obesity & overweight diagnosed? Skip sharing on social media links ... and Blood Institute. (2012). How are overweight and obesity diagnosed? Retrieved August 8, 2012, from http://www. ...

  19. Faulty measurement substitution and control reconfiguration by using a multivariate flow control loop.

    PubMed

    Perillo, Sergio R P; Upadhyaya, Belle R; Hines, J Wesley

    2014-03-01

    A two-tank multivariate loop was designed and built to support research related to instrumentation and control, equipment and sensor monitoring. This test bed provides the framework necessary to investigate and test control strategies and fault detection methods applicable to sensors, equipment, and actuators, and was used to experimentally develop and demonstrate a fault-tolerant control strategy using six correlated variables in a single-tank configuration. This work shows the feasibility of using data-based empirical models to perform fault detection and substitute faulty measurements with predictions and to perform control reconfiguration in the presence of actuator failure in a real system. These experiments were particularly important because they offered the opportunity to prove that a system, such as the multivariate control loop, could survive degraded conditions, provided the empirical models used were accurate and representative of the process dynamics.

  20. Evaluation of the sensitivity and specificity of an enzyme-linked immunosorbent assay for diagnosing brucellosis in African buffalo (Syncerus caffer).

    PubMed

    Gorsich, Erin E; Bengis, Roy G; Ezenwa, Vanessa O; Jolles, Anna E

    2015-01-01

    Brucellosis is a disease of veterinary and public health importance worldwide. In sub-Saharan Africa, where the bacterium Brucella abortus has been identified in several free-ranging wildlife species, successful disease control may be dependent on accurate detection in wildlife reservoirs, including African buffalo (Syncerus caffer). We estimated the sensitivity and specificity of a commercial enzyme-linked immunosorbent assay (ELISA) (IDEXX Brucellosis Serum Ab test, IDEXX Laboratories, Westbrook, Maine, USA) for B. abortus based on a data set of 571 serum samples from 258 buffalo in the Kruger National Park, South Africa. We defined a pseudogold standard test result as those buffalo that were consistently positive or negative on two additional serologic tests, namely, the rose bengal test (RBT) and the complement fixation test (CFT). The ELISA's cutoff value was selected using receiver operating characteristics analysis, the pseudogold standard, and a threshold criterion that maximizes the total sensitivity and specificity. Then, we estimated the sensitivity and specificity of all three tests using Bayesian inference and latent class analysis. The ELISA had an estimated sensitivity of 0.928 (95% Bayesian posterior credibility interval [95% BCI] = 0.869-0.974) and specificity of 0.870 (95% BCI = 0.836-0.900). Compared with the ELISA, the RBT had a higher estimated sensitivity of 0.986 (95% BCI = 0.928-0.999), and both the RBT and CFT had higher specificities, estimated to be 0.992 (95% BCI = 0.971-0.996) and 0.998 (95% BCI = 0.992-0.999), respectively. Therefore, no single serologic test perfectly detected the antibody. However, after adjustment of cutoff values for South African conditions, the IDEXX Brucellosis Serum Ab Test may be a valuable additional screening test for brucellosis in Kruger National Park's African buffalo.

  1. The Temporal Relationship Between Faulty Gambling Cognitions and Gambling Severity in Young Adults.

    PubMed

    Nicholson, Ryan; Graves, Chad; Ellery, Michael; Afifi, Tracie O

    2016-12-01

    Disordered gambling in young adults is hypothesized as being related to mistaken gambling-related cognitions. Few studies have examined the temporal order of this relationship using longitudinal data. The purpose of this study is to understand the directionality of the relationship between gambling cognitions and gambling severity in a longitudinal sample of young adults. Young adults (N = 578), initially aged 18-21 years, completed the Manitoba Longitudinal Survey of Young Adults at two time points approximately 2-3 years apart. Measures of beliefs about randomness related to gambling and gambling severity, as measured by the Problem Gambling Severity Index, were utilized. A cross-sectional relationship between gambling severity and gambling-related cognitions was observed with greater gambling severity being associated with increased endorsement of mistaken cognitions. Evidence for a bidirectional longitudinal relationship was observed with faulty gambling cognitions leading to later problematic gambling behaviors and vice versa when examining a total beliefs scale. When examining specific beliefs about randomness, initial gambling group membership predicted later endorsement of certain beliefs about randomness while initial belief ratings did not impact later gambling group membership. The results of this study suggest a bidirectional relationship between gambling severity and erroneous gambling-related cognitions. However, when examining specific beliefs about randomness, evidence was found for problem gambling behaviors leading to erroneous gambling beliefs. These findings suggest that prevention efforts targeting cognitions may not be as effective in impacting those not yet demonstrating disordered gambling behaviors.

  2. Skin Barrier Function Is Not Impaired and Kallikrein 7 Gene Polymorphism Is Frequently Observed in Korean X-linked Ichthyosis Patients Diagnosed by Fluorescence in Situ Hybridization and Array Comparative Genomic Hybridization.

    PubMed

    Lee, Noo Ri; Yoon, Na Young; Jung, Minyoung; Kim, Ji-Yun; Seo, Seong Jun; Wang, Hye-Young; Lee, Hyeyoung; Sohn, Young Bae; Choi, Eung Ho

    2016-08-01

    X-linked ichthyosis (XLI) is a recessively inherited ichthyosis. Skin barrier function of XLI patients reported in Western countries presented minimally abnormal or normal. Here, we evaluated the skin barrier properties and a skin barrier-related gene mutation in 16 Korean XLI patients who were diagnosed by fluorescence in situ hybridization and array comparative genomic hybridization analysis. Skin barrier properties were measured, cytokine expression levels in the stratum corneum (SC) were evaluated with the tape stripped specimen from skin surface, and a genetic test was done on blood. XLI patients showed significantly lower SC hydration, but normal basal trans-epidermal water loss and skin surface pH as compared to a healthy control group. Histopathology of ichthyosis epidermis showed no acanthosis, and levels of the pro-inflammatory cytokines in the corneal layer did not differ between control and lesional/non-lesional skin of XLI patients. Among the mutations in filaggrin (FLG), kallikrein 7 (KLK7), and SPINK5 genes, the prevalence of KLK7 gene mutations was significantly higher in XLI patients (50%) than in controls (0%), whereas FLG and SPINK5 prevalence was comparable. Korean XLI patients exhibited unimpaired skin barrier function and frequent association with the KLK7 gene polymorphism, which may differentiate them from Western XLI patients.

  3. Clinical and Immunological Studies of 332 Japanese Patients Tentatively Diagnosed as Anti-BP180-type Mucous Membrane Pemphigoid: A Novel BP180 C-terminal Domain Enzyme-linked Immunosorbent Assay.

    PubMed

    Yasukochi, Atsushi; Teye, Kwesi; Ishii, Norito; Hashimoto, Takashi

    2016-08-23

    Diagnosis of anti-BP180-type mucous membrane pemphigoid (BP180-MMP) is frustrated by the difficulty of detecting BP180 reactivity. A total of 721 patients with suspected MMP, selected from a cohort of 4,698 patients with autoimmune bullous disease (AIBD), were included in this study. Of these, 332 patients were tentatively diagnosed as BP180-MMP if they showed IgG/IgA reactivity with the epidermal side of 1M NaCl-split-skin and/or positive reactivity with BP180 in at least one of our antigen detection methods. Clinically, a predominance of female patients was found. Oral mucosal and cutaneous lesions were found in 85.5% and 41.0% of patients, respectively, and frequent treatments were systemic steroids, tetracycline/minocycline and diaminodiphenyl sulfone. Various immunological methods, including a newly developed BP180 C-terminal domain enzyme-linked immunosorbent assay (ELISA), revealed frequent reactivity with BP180 C-terminal and NC16a domains. Some patients reacted with BP180 and other antigens, indicating that BP180-MMP tends to concur with other AIBDs. This large study of patients with suspected BP180-MMP indicates the difficulty of diagnosis of BP180-MMP and the diagnostic usefulness of BP180 C-terminal domain ELISA.

  4. Skin Barrier Function Is Not Impaired and Kallikrein 7 Gene Polymorphism Is Frequently Observed in Korean X-linked Ichthyosis Patients Diagnosed by Fluorescence in Situ Hybridization and Array Comparative Genomic Hybridization

    PubMed Central

    2016-01-01

    X-linked ichthyosis (XLI) is a recessively inherited ichthyosis. Skin barrier function of XLI patients reported in Western countries presented minimally abnormal or normal. Here, we evaluated the skin barrier properties and a skin barrier-related gene mutation in 16 Korean XLI patients who were diagnosed by fluorescence in situ hybridization and array comparative genomic hybridization analysis. Skin barrier properties were measured, cytokine expression levels in the stratum corneum (SC) were evaluated with the tape stripped specimen from skin surface, and a genetic test was done on blood. XLI patients showed significantly lower SC hydration, but normal basal trans-epidermal water loss and skin surface pH as compared to a healthy control group. Histopathology of ichthyosis epidermis showed no acanthosis, and levels of the pro-inflammatory cytokines in the corneal layer did not differ between control and lesional/non-lesional skin of XLI patients. Among the mutations in filaggrin (FLG), kallikrein 7 (KLK7), and SPINK5 genes, the prevalence of KLK7 gene mutations was significantly higher in XLI patients (50%) than in controls (0%), whereas FLG and SPINK5 prevalence was comparable. Korean XLI patients exhibited unimpaired skin barrier function and frequent association with the KLK7 gene polymorphism, which may differentiate them from Western XLI patients. PMID:27478344

  5. Modeling Methane Leakage from Faulty Wellbores in the Denver-Julesburg Basin, Colorado

    NASA Astrophysics Data System (ADS)

    Lackey, G.; Rajaram, H.; Karra, S.; Sherwood, O.; Burke, T. L.

    2015-12-01

    Regulations in the state of Colorado mandate that all oil and gas wells be constructed with surface casings that extend 50 feet below the depth of the deepest potable aquifer, and production casings that are cemented to at least 200 feet above the shallowest producing formation. Building wells in accordance with the minimum regulations leaves an uncemented annulus between the production casing and the surrounding rock matrix, extending from the bottom of the surface casing to the top of the production casing cement. In Colorado, this annulus is sealed at the ground surface by the "bradenhead valve". Stray methane can enter the uncemented annulus through faulty cement in the producing formation or an intermediate gas-bearing zone and migrate upwards along the production casing. The gas dissolves into the annular fluid and accumulates below the bradenhead valve building pressure. Data from the Colorado Oil and Gas Conservation Commission (COGCC) indicates that 1,492 wells in the Denver-Julesburg (DJ) Basin have recorded bradenhead pressures greater than 20 psi since 2007. A leak of this kind creates the potential for both the single-phase transport of dissolved methane and the multiphase transport of methane gas away from the well. The degree to which methane transport occurs depends not only on the size of the leak but also the construction of the wellbore. In Colorado, the definition of potable groundwater has changed with time. To meet increasing demands for water, drinking water wells have been drilled deeper. As a result, there are potentially 4,144 wells in the DJ Basin with surface casings too shallow to protect the deepest potable aquifer. In this work, we investigate how a methane leak into the open annulus of an oil and gas wellbore, could result in the transport of dissolved and gas phase methane into a nearby drinking water aquifer. We construct a multiphase wellbore model that computes the pressure distribution and gas fraction along the uncemented

  6. How Are Arrhythmias Diagnosed?

    MedlinePlus

    ... page from the NHLBI on Twitter. How Are Arrhythmias Diagnosed? Arrhythmias can be hard to diagnose, especially the types ... symptoms every once in a while. Doctors diagnose arrhythmias based on medical and family histories, a physical ...

  7. How Are Pelvic Floor Disorders Diagnosed?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How are pelvic floor disorders diagnosed? Skip sharing on social media links ... fee ). This test is used to evaluate the pelvic floor and rectum while the patient is having a ...

  8. How Do Health Care Providers Diagnose Hypoparathyroidism?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose hypoparathyroidism? Skip sharing on social media links Share this: Page Content A health care provider will order a blood test to determine ...

  9. How Do Health Care Providers Diagnose Pheochromocytoma?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose pheochromocytoma? Skip sharing on social media links Share this: Page Content A health care provider uses blood and urine tests that measure ...

  10. [Faulty internal tube in a co-axial ventilation tube system: cause of a massive postoperative hypercapnia].

    PubMed

    Günther, J-H; Börning, P; Bahlmann, L

    2013-03-01

    This article presents the case of a patient with massive postoperative hypercapnia during mechanical ventilation in the intensive care unit (ICU). With normal tidal volumes and clearly visible chest movements, adequate findings with regard to auscultation, oxygenation and correct respirator settings, no cause for the increasing hypercapnia was initially found; however, replacement of the respirator led to a return to normal carbon dioxide levels. When checking the replaced respirator a service technician found the cause of the respirator failure: the internal tube of the co-axial ventilation system was faulty leading to an increased dead space and rebreathing of carbon dioxide.

  11. Diagnosing oceanic nutrient deficiency

    NASA Astrophysics Data System (ADS)

    Moore, C. Mark

    2016-11-01

    The supply of a range of nutrient elements to surface waters is an important driver of oceanic production and the subsequent linked cycling of the nutrients and carbon. Relative deficiencies of different nutrients with respect to biological requirements, within both surface and internal water masses, can be both a key indicator and driver of the potential for these nutrients to become limiting for the production of new organic material in the upper ocean. The availability of high-quality, full-depth and global-scale datasets on the concentrations of a wide range of both macro- and micro-nutrients produced through the international GEOTRACES programme provides the potential for estimation of multi-element deficiencies at unprecedented scales. Resultant coherent large-scale patterns in diagnosed deficiency can be linked to the interacting physical-chemical-biological processes which drive upper ocean nutrient biogeochemistry. Calculations of ranked deficiencies across multiple elements further highlight important remaining uncertainties in the stoichiometric plasticity of nutrient ratios within oceanic microbial systems and caveats with regards to linkages to upper ocean nutrient limitation. This article is part of the themed issue 'Biological and climatic impacts of ocean trace element chemistry'.

  12. How Do Health Care Providers Diagnose Fragile X Syndrome?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose Fragile X syndrome? Skip sharing on social media links Share this: Page Content Health care providers often use a blood sample to diagnose ...

  13. How Do Health Care Providers Diagnose Traumatic Brain Injury (TBI)?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose traumatic brain injury (TBI)? Skip sharing ... links Share this: Page Content To diagnose TBI, health care providers may use one or more tests that ...

  14. How Do Health Care Providers Diagnose Menstrual Irregularities?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose menstrual irregularities? Skip sharing on social media links Share this: Page Content A health care provider diagnoses menstrual irregularities using a combination of ...

  15. How Do Health Care Providers Diagnose Spina Bifida?

    MedlinePlus

    ... and Publications How do health care providers diagnose spina bifida? Skip sharing on social media links Share this: Page Content Doctors diagnose spina bifida before or after the infant is born. Spina ...

  16. Study Links Celiac Disease, Anorexia

    MedlinePlus

    ... news/fullstory_164453.html Study Links Celiac Disease, Anorexia Chances of being diagnosed with eating disorder were ... face a heightened risk of being diagnosed with anorexia, a new study suggests. The Swedish researchers found ...

  17. How Is Sarcoidosis Diagnosed?

    MedlinePlus

    ... page from the NHLBI on Twitter. How Is Sarcoidosis Diagnosed? Your doctor will diagnose sarcoidosis based on ... Content: NEXT >> Featured Video Living With and Managing Sarcoidosis 05/18/2011 This video—presented by the ...

  18. How Is Atherosclerosis Diagnosed?

    MedlinePlus

    ... page from the NHLBI on Twitter. How Is Atherosclerosis Diagnosed? Your doctor will diagnose atherosclerosis based on ... Rate This Content: NEXT >> Featured Video What is atherosclerosis? 05/22/2014 Describes how the build-up ...

  19. System and method for diagnosing EGR performance using NOx sensor

    DOEpatents

    Mazur, Christopher John

    2003-12-23

    A method and system for diagnosing a condition of an EGR valve used in an engine system. The EGR valve controls the portion exhaust gases produced by such engine system and fed back to an intake of such engine system. The engine system includes a NOx sensor for measuring NOx in such exhaust. The method includes: determining a time rate of change in NOx measured by the NOx sensor; comparing the determined time rate of change in the measured NOx with a predetermined expected time rate of change in measured NOx; and determining the condition of the EGR valve as a function of such comparison. The method also includes: determining from NOx measured by the NOx sensor and engine operating conditions indications of instances when samples of such measured NOx are greater than an expected maximum NOx level for such engine condition and less than an expected minimum NOx level for such engine condition; and determining the condition of the EGR valve as a function of a statistical analysis of such indications. The method includes determining whether the NOx sensor is faulty and wherein the EGR condition determining includes determining whether the NOx sensor is faulty.

  20. Faulty blood typing misled by auto anti-D in AIHA.

    PubMed

    Li, Guining; Chen, Fenghua; Rao, Shenzong; Hu, Lihua

    2014-04-01

    Pre-transfusion testing is a vital link to enhance patients' safety but may be influenced by heterotypic blood transfusion and disease. Previous history of blood transfusion most of time help us determine the blood type. On the other hand, it can also mislead technicians to a wrong conclusion. Anti-D, which is clinically important in hemolytic transfusion reaction, is either alloimmunized by transfusion, pregnancy or induced in certain diseases. Here, we reported a rare case with false blood identification interfered by heterotypic blood transfusion and auto anti-D in autoimmune hemolytic anemia (AIHA).

  1. How Is Raynaud's Diagnosed?

    MedlinePlus

    ... diagnose primary Raynaud's (Raynaud's disease) or secondary Raynaud's (Raynaud's phenomenon) based on your medical history, a physical exam, and test results. Specialists Involved Primary care doctors and internists often diagnose and treat Raynaud's. If you have the disorder, you also may ...

  2. Adaptive hidden Markov model-based online learning framework for bearing faulty detection and performance degradation monitoring

    NASA Astrophysics Data System (ADS)

    Yu, Jianbo

    2017-01-01

    This study proposes an adaptive-learning-based method for machine faulty detection and health degradation monitoring. The kernel of the proposed method is an "evolving" model that uses an unsupervised online learning scheme, in which an adaptive hidden Markov model (AHMM) is used for online learning the dynamic health changes of machines in their full life. A statistical index is developed for recognizing the new health states in the machines. Those new health states are then described online by adding of new hidden states in AHMM. Furthermore, the health degradations in machines are quantified online by an AHMM-based health index (HI) that measures the similarity between two density distributions that describe the historic and current health states, respectively. When necessary, the proposed method characterizes the distinct operating modes of the machine and can learn online both abrupt as well as gradual health changes. Our method overcomes some drawbacks of the HIs (e.g., relatively low comprehensibility and applicability) based on fixed monitoring models constructed in the offline phase. Results from its application in a bearing life test reveal that the proposed method is effective in online detection and adaptive assessment of machine health degradation. This study provides a useful guide for developing a condition-based maintenance (CBM) system that uses an online learning method without considerable human intervention.

  3. How Is Neuroblastoma Diagnosed?

    MedlinePlus

    ... Neuroblastoma Early Detection, Diagnosis, and Staging How Is Neuroblastoma Diagnosed? Neuroblastomas are usually found when a child ... Ask Your Child’s Doctor About Neuroblastoma? More In Neuroblastoma About Neuroblastoma Causes, Risk Factors, and Prevention Early ...

  4. How Is Hemophilia Diagnosed?

    MedlinePlus

    ... page from the NHLBI on Twitter. How Is Hemophilia Diagnosed? If you or your child appears to ... have bleeding problems. However, some people who have hemophilia have no recent family history of the disease. ...

  5. How Is Lymphocytopenia Diagnosed?

    MedlinePlus

    ... of lymphocytes—T cells, B cells, and natural killer cells. The test can help diagnose the underlying ... cause low levels of B cells or natural killer cells. Tests for Underlying Conditions Many diseases and ...

  6. How Is Pericarditis Diagnosed?

    MedlinePlus

    ... Names Causes Who Is at Risk Signs & Symptoms Diagnosis Treatments Prevention Living With Clinical Trials Links Related Topics Cough Heart Attack Heart Palpitations Heart Surgery Hypotension Send a link ...

  7. Overriding Faulty Circuit Breakers

    NASA Technical Reports Server (NTRS)

    Robbins, Richard L.; Pierson, Thomas E.

    1987-01-01

    Retainer keeps power on in emergency. Simple mechanical device attaches to failed aircraft-type push/pull circuit breaker to restore electrical power temporarily until breaker replaced. Device holds push/pull button in closed position; unnecessary for crewmember to hold button in position by continual finger pressure. Sleeve and plug hold button in, overriding mechanical failure in circuit breaker. Windows in sleeve show button position.

  8. Faulty gene screen.

    PubMed

    Allen, Daniel

    2007-05-01

    'Designer baby' is a loaded phrase. It seems to put children on a par with consumer goods and brings to mind parents who appear more interested in fashion accessories than families. But a story in The Sunday Times (April 1) generated more compassion than scorn for the parents concerned.

  9. How a Stroke Is Diagnosed

    MedlinePlus

    ... News About Neurology Image Library Search The Internet Stroke Center Patients & Families About Stroke Stroke Diagnosis Stroke ... Diagnosis » How a Stroke is Diagnosed How a Stroke is Diagnosed How a Stroke is Diagnosed Lab ...

  10. How Is Cardiogenic Shock Diagnosed?

    MedlinePlus

    ... from the NHLBI on Twitter. How Is Cardiogenic Shock Diagnosed? The first step in diagnosing cardiogenic shock ... is cardiogenic shock. Tests and Procedures To Diagnose Shock and Its Underlying Causes Blood Pressure Test Medical ...

  11. How Are Genetic Conditions Diagnosed?

    MedlinePlus

    ... Consultation How are genetic conditions diagnosed? How are genetic conditions diagnosed? A doctor may suspect a diagnosis ... and advocacy resources. For more information about diagnosing genetic conditions: Genetics Home Reference provides information about genetic ...

  12. Methods of diagnosing alagille syndrome

    DOEpatents

    Li, Linheng; Hood, Leroy; Krantz, Ian D.; Spinner, Nancy B.

    2004-03-09

    The present invention provides an isolated polypeptide exhibiting substantially the same amino acid sequence as JAGGED, or an active fragment thereof, provided that the polypeptide does not have the amino acid sequence of SEQ ID NO:5 or SEQ ID NO:6. The invention further provides an isolated nucleic acid molecule containing a nucleotide sequence encoding substantially the same amino acid sequence as JAGGED, or an active fragment thereof, provided that the nucleotide sequence does not encode the amino acid sequence of SEQ ID NO:5 or SEQ ID NO:6. Also provided herein is a method of inhibiting differentiation of hematopoietic progenitor cells by contacting the progenitor cells with an isolated JAGGED polypeptide, or active fragment thereof. The invention additionally provides a method of diagnosing Alagille Syndrome in an individual. The method consists of detecting an Alagille Syndrome disease-associated mutation linked to a JAGGED locus.

  13. Diagnosing Abiotic Degradation

    EPA Science Inventory

    The abiotic degradation of chlorinated solvents in ground water can be difficult to diagnose. Under current practice, most of the “evidence” is negative; specifically the apparent disappearance of chlorinated solvents with an accumulation of vinyl chloride, ethane, ethylene, or ...

  14. Newly Diagnosed: Older Adults

    MedlinePlus

    ... Children Newly Diagnosed: Older Adults Related Topics on AIDS.gov Aging with HIV/AIDS National HIV/AIDS ... an Emerging Challenge Last revised: 07/10/2015 AIDS.gov HIV/AIDS Basics • Federal Resources • Using New ...

  15. How Do Health Care Providers Diagnose Down Syndrome?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose Down syndrome? Skip sharing on social media links Share this: Page Content Health care providers can check for Down syndrome during pregnancy ...

  16. How Do Health Care Providers Diagnose Turner Syndrome?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose Turner syndrome? Skip sharing on social media links Share this: Page Content Health care providers use a combination of physical symptoms and ...

  17. How Do Health Care Providers Diagnose Polycystic Ovary Syndrome (PCOS)?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose PCOS? Skip sharing on social media links Share this: Page Content Your health care provider may suspect PCOS if you have eight ...

  18. How Are Thalassemias Diagnosed?

    MedlinePlus

    ... Prevention Living With Clinical Trials Links Related Topics Anemia Blood Tests Blood Transfusion Blood and Bone Marrow ... This is because signs and symptoms, including severe anemia , often occur within the first 2 years of ...

  19. Diagnosing Deep Venous Thrombosis

    PubMed Central

    Doyle, D. Lynn

    1992-01-01

    Patients often present with unexplained lower limb pain and swelling. It is important to exclude deep venous thrombosis in the diagnosis because of the threat of sudden death. Simple clinical diagnosis is unacceptable, and noninvasive tests should be used initially. Serial testing detects proximal extension of isolated calf thrombi. Multiple diagnostic modalities are employed to diagnose a new deep venous thrombosis in patients with postphlebitic syndrome. PMID:21221369

  20. How Is Kawasaki Disease Diagnosed?

    MedlinePlus

    ... page from the NHLBI on Twitter. How Is Kawasaki Disease Diagnosed? Kawasaki disease is diagnosed based on your child's signs and ... are the first to suspect a child has Kawasaki disease. Pediatricians are doctors who specialize in treating children. ...

  1. How Is Pulmonary Hypertension Diagnosed?

    MedlinePlus

    ... Hypertension Diagnosed? Your doctor will diagnose pulmonary hypertension (PH) based on your medical and family histories, a ... exam, and the results from tests and procedures. PH can develop slowly. In fact, you may have ...

  2. Diagnosing Dementia--Positive Signs

    MedlinePlus

    ... Navigation Bar Home Current Issue Past Issues Diagnosing Dementia—Positive Signs Past Issues / Fall 2007 Table of ... easy, affordable blood test that could accurately diagnose Alzheimer's disease (AD)—even before symptoms began to show? Researchers ...

  3. Diagnosing Musculoskeletal Tumours

    PubMed Central

    Carter, Simon R.; Spooner, David; Sneath, Rodney S.

    2001-01-01

    In 1993 we became aware of a worrying increase in apparent errors in the histopathological diagnosis of musculoskeletal tumours in our Unit. As a result all cases seen over the past 8 years were reviewed by an independent panel. Of the 1996 cases reviewed there was an error in 87. In 54 cases (2.7%) this had led to some significant change in the active management of the patient. The main areas where errors arose were in those very cases where clinical and radiological features were not helpful in confirming or refuting the diagnosis. The incidence of errors rose with the passage of time, possibly related to a deterioration in the pathologist’s health. The error rate in diagnosing bone tumours in previously published series ranges from 9 to 40%. To ensure as accurate a rate of diagnosis as possible multidisciplinary working and regular audit are essential. PMID:18521309

  4. Diagnosable structured logic array

    NASA Technical Reports Server (NTRS)

    Whitaker, Sterling (Inventor); Miles, Lowell (Inventor); Gambles, Jody (Inventor); Maki, Gary K. (Inventor)

    2009-01-01

    A diagnosable structured logic array and associated process is provided. A base cell structure is provided comprising a logic unit comprising a plurality of input nodes, a plurality of selection nodes, and an output node, a plurality of switches coupled to the selection nodes, where the switches comprises a plurality of input lines, a selection line and an output line, a memory cell coupled to the output node, and a test address bus and a program control bus coupled to the plurality of input lines and the selection line of the plurality of switches. A state on each of the plurality of input nodes is verifiably loaded and read from the memory cell. A trusted memory block is provided. The associated process is provided for testing and verifying a plurality of truth table inputs of the logic unit.

  5. First Case of Zika-Linked Glaucoma Diagnosed in Infant

    MedlinePlus

    ... the range of birth defects caused by the mosquito-borne virus. During the course of their research, ... women -- to take steps to protect themselves from mosquito bites. They should use an insect repellent registered ...

  6. Diagnosing mucopolysaccharidosis IVA.

    PubMed

    Wood, Timothy C; Harvey, Katie; Beck, Michael; Burin, Maira Graeff; Chien, Yin-Hsiu; Church, Heather J; D'Almeida, Vânia; van Diggelen, Otto P; Fietz, Michael; Giugliani, Roberto; Harmatz, Paul; Hawley, Sara M; Hwu, Wuh-Liang; Ketteridge, David; Lukacs, Zoltan; Miller, Nicole; Pasquali, Marzia; Schenone, Andrea; Thompson, Jerry N; Tylee, Karen; Yu, Chunli; Hendriksz, Christian J

    2013-03-01

    Mucopolysaccharidosis IVA (MPS IVA; Morquio A syndrome) is an autosomal recessive lysosomal storage disorder resulting from a deficiency of N-acetylgalactosamine-6-sulfate sulfatase (GALNS) activity. Diagnosis can be challenging and requires agreement of clinical, radiographic, and laboratory findings. A group of biochemical genetics laboratory directors and clinicians involved in the diagnosis of MPS IVA, convened by BioMarin Pharmaceutical Inc., met to develop recommendations for diagnosis. The following conclusions were reached. Due to the wide variation and subtleties of radiographic findings, imaging of multiple body regions is recommended. Urinary glycosaminoglycan analysis is particularly problematic for MPS IVA and it is strongly recommended to proceed to enzyme activity testing even if urine appears normal when there is clinical suspicion of MPS IVA. Enzyme activity testing of GALNS is essential in diagnosing MPS IVA. Additional analyses to confirm sample integrity and rule out MPS IVB, multiple sulfatase deficiency, and mucolipidoses types II/III are critical as part of enzyme activity testing. Leukocytes or cultured dermal fibroblasts are strongly recommended for enzyme activity testing to confirm screening results. Molecular testing may also be used to confirm the diagnosis in many patients. However, two known or probable causative mutations may not be identified in all cases of MPS IVA. A diagnostic testing algorithm is presented which attempts to streamline this complex testing process.

  7. Diagnosing pulmonary embolism

    PubMed Central

    Riedel, M

    2004-01-01

    Objective testing for pulmonary embolism is necessary, because clinical assessment alone is unreliable and the consequences of misdiagnosis are serious. No single test has ideal properties (100% sensitivity and specificity, no risk, low cost). Pulmonary angiography is regarded as the final arbiter but is ill suited for diagnosing a disease present in only a third of patients in whom it is suspected. Some tests are good for confirmation and some for exclusion of embolism; others are able to do both but are often non-diagnostic. For optimal efficiency, choice of the initial test should be guided by clinical assessment of the likelihood of embolism and by patient characteristics that may influence test accuracy. Standardised clinical estimates can be used to give a pre-test probability to assess, after appropriate objective testing, the post-test probability of embolism. Multidetector computed tomography can replace both scintigraphy and angiography for the exclusion and diagnosis of this disease and should now be considered the central imaging investigation in suspected pulmonary embolism. PMID:15192162

  8. The link in Linking

    PubMed Central

    Caldwell, Jane C; Chiale, Pablo A; Gonzalez, Mario D; Baranchuk, Adrian

    2013-01-01

    We present 2 cases of the slow-fast form of AVNRT with initially narrow QRS complexes followed by sudden unexpected transition to persistently wide QRS complexes due to aberrant intraventricular conduction. Introduction of a properly timed extrastimulus in one case and critical oscillations in cycle length due to short-long coupling in the second case set the stage for the initial bundle branch block. However, persistence of the aberrancy pattern once the initial event abated was maintained by the "linking" phenomenon. Delayed, retrograde concealed activation from the contralateral bundle branch perpetuated the initial bundle branch block. PMID:23840106

  9. The link in Linking.

    PubMed

    Caldwell, Jane C; Chiale, Pablo A; Gonzalez, Mario D; Baranchuk, Adrian

    2013-05-01

    We present 2 cases of the slow-fast form of AVNRT with initially narrow QRS complexes followed by sudden unexpected transition to persistently wide QRS complexes due to aberrant intraventricular conduction. Introduction of a properly timed extrastimulus in one case and critical oscillations in cycle length due to short-long coupling in the second case set the stage for the initial bundle branch block. However, persistence of the aberrancy pattern once the initial event abated was maintained by the "linking" phenomenon. Delayed, retrograde concealed activation from the contralateral bundle branch perpetuated the initial bundle branch block.

  10. How Is Aplastic Anemia Diagnosed?

    MedlinePlus

    ... from the NHLBI on Twitter. How Is Aplastic Anemia Diagnosed? Your doctor will diagnose aplastic anemia based on your medical and family histories, a ... your primary care doctor thinks you have aplastic anemia, he or she may refer you to a ...

  11. Neuroblastoma in Children: Just Diagnosed Information

    MedlinePlus

    ... Other Press Room Employment Feedback Contact Select Page Neuroblastoma in Children – Just Diagnosed Home > Cancer Resources > Types ... Diagnosed Just Diagnosed In Treatment After Treatment Diagnosing Neuroblastoma Depending on the location of the tumor and ...

  12. Ornithine transcarbamylase deficiency diagnosed in pregnancy.

    PubMed

    Celik, Ozlem; Buyuktas, Deram; Aydin, Ahmet; Acbay, Ozer

    2011-12-01

    Urea cycle enzymes deficiencies are rare metabolic disorders. Ornithine transcarbamylase (OTC) deficiency is the most common type. The syndrome results from a deficiency of the mitochondrial enzyme OTC which catalyses the conversion of ornithine and carbamoyl phosphate to citrulline. It shows X-linked inheritance and typically remains asymptomatic until late infancy or early childhood. The severity of the symptoms depends on the age of the patient and the duration of hyperammonemia. Female heterozygotes are more difficult to diagnose. They suffer from hyperammonemic periods which can be triggered by trauma, infections, surgery, childbirth, parenteral nutrition, and by the initiation of sodium valproate therapy. The prognosis of OTC deficiency is better for those with an onset after infancy, but morbidity from brain damage does not appear to be linked to the number of episodes of hyperammonemia that have occurred. However, early diagnosis and prompt initiation of ammonia-lowering treatment are essential for survival of these patients. This case presents a patient who was diagnosed with OTC deficiency following mental confusion during pregnancy.

  13. Link direction for link prediction

    NASA Astrophysics Data System (ADS)

    Shang, Ke-ke; Small, Michael; Yan, Wei-sheng

    2017-03-01

    Almost all previous studies on link prediction have focused on using the properties of the network to predict the existence of links between pairs of nodes. Unfortunately, previous methods rarely consider the role of link direction for link prediction. In fact, many real-world complex networks are directed and ignoring the link direction will mean overlooking important information. In this study, we propose a phase-dynamic algorithm of the directed network nodes to analyse the role of link directions and demonstrate that the bi-directional links and the one-directional links have different roles in link prediction and network structure formation. From this, we propose new directional prediction methods and use six real networks to test our algorithms. In real networks, we find that compared to a pair of nodes which are connected by a one-directional link, a pair of nodes which are connected by a bi-directional link always have higher probabilities to connect to the common neighbours with only bi-directional links (or conversely by one-directional links). We suggest that, in the real networks, the bi-directional links will generally be more informative for link prediction and network structure formation. In addition, we propose a new directional randomized algorithm to demonstrate that the direction of the links plays a significant role in link prediction and network structure formation.

  14. How Is Stomach Cancer Diagnosed?

    MedlinePlus

    ... Cancer Early Detection, Diagnosis, and Staging How Is Stomach Cancer Diagnosed? Stomach cancers are usually found when ... Ask Your Doctor About Stomach Cancer? More In Stomach Cancer About Stomach Cancer Causes, Risk Factors, and ...

  15. How Is Childhood Leukemia Diagnosed?

    MedlinePlus

    ... Early Detection, Diagnosis, and Types How Is Childhood Leukemia Diagnosed? Most of the signs and symptoms of ... enlarged spleen or liver. Tests to look for leukemia in children If the doctor thinks your child ...

  16. How Is Pulmonary Embolism Diagnosed?

    MedlinePlus

    ... Doctors can use computed tomography (to-MOG-rah-fee) scans, or CT scans, to look for blood ... Pulmonary Angiography Pulmonary angiography (an-jee-OG-rah-fee) is another test used to diagnose PE. This ...

  17. How Is Atrial Fibrillation Diagnosed?

    MedlinePlus

    ... event monitor for weeks or until symptoms occur. Stress Test Some heart problems are easier to diagnose ... heart is working hard and beating fast. During stress testing , you exercise to make your heart work ...

  18. How Are Wilms Tumors Diagnosed?

    MedlinePlus

    ... Tumor Early Detection, Diagnosis, and Staging How Are Wilms Tumors Diagnosed? Wilms tumors are usually found when a ... Your Child’s Doctor About Wilms Tumor? More In Wilms Tumor About Wilms Tumor Causes, Risk Factors, and Prevention ...

  19. Serving Students Diagnosed with ADD: Avoiding Deficits in Professional Attention.

    ERIC Educational Resources Information Center

    Stoner, Gary; Carey, Sean P.

    1992-01-01

    Responds to previous article (Hakola, this issue) on legal rights of students with Attention Deficit Disorder (ADD). Presents contrasting perspective on educational services for children diagnosed with Attention Deficit Hyperactivity Disorder, linked more closely to professional research and practice than to law. Concerns discussed are grounded in…

  20. Forging Links.

    ERIC Educational Resources Information Center

    Stewig, John Warren

    Blacksmiths and their craft have changed with the times, and as times change for teachers, they too should be forgers of links. Teacher-to-teacher links should extend beyond the faculty lounge to support systems and active groups of individuals concerned about each other. Another personal link can be made by developing a grade level, system-wide…

  1. Gut Microbes Linked to Rheumatoid Arthritis

    MedlinePlus

    ... Matters November 25, 2013 Gut Microbes Linked to Rheumatoid Arthritis The presence of a specific type of gut bacteria correlates with rheumatoid arthritis in newly diagnosed, untreated people. The finding suggests ...

  2. Challenges in diagnosing hepatic encephalopathy.

    PubMed

    Weissenborn, K

    2015-02-01

    The term "hepatic encephalopathy" (HE) covers the neuropsychiatric syndrome associated with acute, chronic and acute-on-chronic liver disease (CLD). This paper deals with clinical features and diagnosis of HE in patients with liver cirrhosis and portal hypertension or porto-systemic shunts. The possible impact of concomitant disorders and the cirrhosis underlying liver disease upon brain function is described emphasizing the need of a detailed diagnostic work up of every individual case before diagnosing HE. Currently used methods for diagnosing minimal or covert hepatic encephalopathy are compared with regard to their sensitivity and specificity for diagnosing HE against the background of a multitude of concomitant disorders and diseases that could contribute to brain dysfunction.

  3. Thyroid hemangiomas diagnosed on sonography.

    PubMed

    Park, Sung Hee; Kim, Soo Jin; Jung, Hyun Kyung

    2014-04-01

    Primary thyroid hemangiomas are extremely rare, and only a few cases have been previously reported. Primary hemangiomas are developmental anomalies resulting from the inability of the angioblastic mesenchyme to form canals. Thyroid hemangiomas are generally considered difficult to diagnose preoperatively because of their low incidence and nonspecific imaging findings. Here we report 2 cases of thyroid hemangiomas that were diagnosed correctly on preoperative sonography. Our cases showed similar sonographic findings, such as well-circumscribed hypoechoic lesions with internal channel-like linear lines, and bloody content was aspirated during fine-needle aspirations. Our report shows that thyroid hemangiomas can be diagnosed correctly by sonography with or without confirmation of bloody content in the lesions by fine-needle aspiration.

  4. Diagnosing and Treating Hantavirus Pulmonary Syndrome (HPS)

    MedlinePlus

    ... CDC.gov . Hantavirus Share Compartir Diagnosing and Treating Hantavirus Pulmonary Syndrome (HPS) Diagnosing HPS Diagnosing HPS in ... of patients that develop HPS from New World Hantaviruses recover completely. No chronic infection has been detected ...

  5. How Is Fanconi Anemia Diagnosed?

    MedlinePlus

    ... from the NHLBI on Twitter. How Is Fanconi Anemia Diagnosed? People who have Fanconi anemia (FA) are born with the disorder. They may ... questions about: Any personal or family history of anemia Any surgeries you’ve had related to the ...

  6. System diagnosability using triplet assertion

    SciTech Connect

    Lombardi, F.

    1982-01-01

    A new technique for system diagnosability is presented. It is based on a triplet assertion strategy to overcome the asymmetric invalidation and the requirement of a central test controller. The basic characteristics of the triplet assertion are generalized to higher networks. The application of this technique to parallel processing is outlined. 24 references.

  7. How Do Health Care Providers Diagnose Preeclampsia, Eclampsia, and HELLP Syndrome?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose preeclampsia, eclampsia, and HELLP syndrome? Skip ... social media links Share this: Page Content A health care provider should check a pregnant woman's blood pressure ...

  8. Community Links

    ERIC Educational Resources Information Center

    Nelson, Mary

    1975-01-01

    At Moraine Valley Community College (Illinois), a chain of events, programs, activities, and services has linked the college and community in such areas as fine arts, ethnic groups, public services, community action, community service, and community education. (Author/NHM)

  9. Link Analysis

    NASA Astrophysics Data System (ADS)

    Donoho, Steve

    Link analysis is a collection of techniques that operate on data that can be represented as nodes and links. This chapter surveys a variety of techniques including subgraph matching, finding cliques and K-plexes, maximizing spread of influence, visualization, finding hubs and authorities, and combining with traditional techniques (classification, clustering, etc). It also surveys applications including social network analysis, viral marketing, Internet search, fraud detection, and crime prevention.

  10. How Is an Aneurysm Diagnosed?

    MedlinePlus

    ... genetic conditions related to thoracic aortic aneurysms. The data collected through the GenTAC registry will help doctors and researchers better understand how genes, thoracic aortic aneurysms, and heart disease are linked. To learn more about GenTAC, visit https://gentac. ...

  11. How Is Acute Lymphocytic Leukemia Diagnosed?

    MedlinePlus

    ... Adults Early Detection, Diagnosis, and Types How Is Acute Lymphocytic Leukemia Diagnosed? Certain signs and symptoms can suggest that ... described below. Tests used to diagnose and classify ALL If your doctor thinks you have leukemia, he ...

  12. How Is Heart Valve Disease Diagnosed?

    MedlinePlus

    ... page from the NHLBI on Twitter. How Is Heart Valve Disease Diagnosed? Your primary care doctor may detect a heart murmur or other signs of heart valve disease. However, a cardiologist usually will diagnose the condition. ...

  13. How Is Deep Vein Thrombosis Diagnosed?

    MedlinePlus

    ... Vein Thrombosis Diagnosed? Your doctor will diagnose deep vein thrombosis (DVT) based on your medical history, a physical exam, and test results. He or she will identify your risk factors and rule out other causes of your symptoms. ...

  14. How Is a Heart Attack Diagnosed?

    MedlinePlus

    ... from the NHLBI on Twitter. How Is a Heart Attack Diagnosed? Your doctor will diagnose a heart attack ... This Content: NEXT >> Featured Video What is a heart attack? 05/22/2014 Describes how a heart attack ...

  15. [Differential diagnoses of West syndrome].

    PubMed

    Fejerman, Natalio

    2013-09-06

    This study describes the clinical and electroencephalographic characteristics of epileptic spasms, and more especially those that occur during the first two years of life (infantile spasms). West syndrome has been clearly defined as the association between infantile spasms with an electroencephalographic pattern of hypsarrhythmia. Although intellectual deficit appears in almost all cases in which infantile spasms are not controlled with medication, this is a developmental aspect of the condition and not a manifestation that must necessarily be present in order to define the syndrome. The analysis of the interictal and ictal electroencephalogram readings, together with the clinical characteristics of the spasms and the neurological examination of patients, provides some orientation as regards the causations. Despite the spectrum that the title of this work focuses on, the study does not cover the treatment of early infants with West syndrome. Emphasis is placed on the differential diagnoses of West syndrome with other epileptic syndromes that manifest in the first two years of life, and more especially with a series of abnormal non-epileptic motor phenomena that occur in early infants. All these last non-epileptic disorders are displayed in a table, but benign myoclonus of early infancy or Fejerman syndrome is given as a paradigmatic example for the differential diagnosis. The primordial aim is to prevent neurologically healthy early infants from receiving antiepileptic drugs and even adrenocorticotropic hormone or corticoids due to a mistaken diagnosis.

  16. [Left pulmonary agenesis diagnosed late].

    PubMed

    Deleanu, Oana; Pătraşcu, Natalia; Nebunoiu, Ana-Maria; Vintilă, V; Ulmeanu, Ruxandra; Mihălţan, F D

    2010-01-01

    We present the case of a 51 years old female-patient, with severe dextroscoliosis, having like unique symptom progressive dyspnea. The blood samples reveals polycythemia, the radiological exam shows the opacification of 2/3 of the left thorax, the absence of the lung structure in the other 1/3, the deviation of the mediastinum, and dextroscoliosis; the computed tomography reveals the absence of the left lung artery and the left airways, compensatory hyperinflation of the right lung and dilatation of the trunk and right pulmonary artery; the bronchoscopy does not visualize the carina or the left main bronchus, typical for pulmonary agenesis. Echocardiography confirmed the absence of left pulmonary artery and shows mild pulmonary hypertension (systolic pressure in the pulmonary artery of 33 mmHg) with dilatation of the right cavities, but good cinetics. We face a case of pulmonary agenesis lately diagnosed, with modest functional cardiologic implications, limited therapeutic options and good survival, justified by the late appearance of the pulmonary hypertension of low severity and without worsening in time.

  17. Novel approaches in diagnosing tuberculosis

    NASA Astrophysics Data System (ADS)

    Kolk, Arend H. J.; Dang, Ngoc A.; Kuijper, Sjoukje; Gibson, Tim; Anthony, Richard; Claassens, Mareli M.; Kaal, Erwin; Janssen, Hans-Gerd

    2011-06-01

    The WHO declared tuberculosis (TB) a global emergency. An estimated 8-9 million new cases occur each year with 2-3 million deaths. Currently, TB is diagnosed mostly by chest-X ray and staining of the mycobacteria in sputum with a detection limit of 1x104 bacteria /ml. There is an urgent need for better diagnostic tools for TB especially for developing countries. We have validated the electronic nose from TD Technology for the detection of Mycobacterium tuberculosis by headspace analysis of 284 sputum samples from TB patients. We used linear discriminant function analysis resulting in a sensitivity of 75% a specificity of 67% and an accuracy of 69%. Further research is still required to improve the results by choosing more selective sensors and sampling techniques. We used a fast gas chromatography- mass spectrometry method (GC-MS). The automated procedure is based on the injection of sputum samples which are methylated inside the GC injector using thermally assisted hydrolysis and methylation (THM-GC-MS). Hexacosanoic acid in combination with tuberculostearic acid was found to be specific for the presence of M. tuberculosis. The detection limit was similar to microscopy. We found no false positives, all microscopy and culture positive samples were also found positive with the THM-GC-MS method. The detection of ribosomal RNA from the infecting organism offers great potential since rRNA molecules outnumber chromosomal DNA by a factor 1000. It thus may possible to detect the organism without amplification of the nucleic acids (NA). We used a capture and a tagged detector probe for the direct detection of M. tuberculosis in sputum. So far the detection limit is 1x106 bacteria / ml. Currently we are testing a Lab-On-A-Chip Interferometer detection system.

  18. Are Pediatricians Diagnosing Obese Children?

    PubMed Central

    Thomas, Katharine; Urrego, Fernando

    2017-01-01

    Background: Pediatric obesity is the most prevalent nutritional disorder in American children. The detrimental social, psychological, and physiological effects of obesity call for pediatricians to address this health concern. The literature demonstrates that clinicians are underreporting the diagnosis of obesity in the pediatric setting. The primary purpose of this study was to determine if pediatricians at one pediatrics clinic in the Ochsner Health System are documenting the presence of an overweight or obese body mass index (BMI) as a diagnosis in the medical record. A secondary purpose of this study was to determine the demographics of all pediatric patients in the Ochsner Health System to be used for program development. Methods: A retrospective medical record review was conducted. Records from April 1, 2012 to April 1, 2016, were reviewed for the presence of the diagnosis of BMI classified as obese or overweight. Results: We analyzed a total of 175,066 records in this study. Of these records, 1.32% documented a diagnosis of obesity, and 0.5% documented a BMI score indicating overweight. The percentages of patient visits that met the Centers for Disease Control and Prevention criteria to be classified as obese or overweight were 28.66% and 30.41%, respectively. The majority of our pediatric patients were male (51.76%), white (43.31%), and 5-12 years old (43.80%). Conclusion: This study demonstrates that pediatricians at Ochsner Health Center for Children are not diagnosing patients who have unhealthy BMI scores as overweight or obese. Interventions are needed to increase the identification of children who may benefit from receiving resources that encourage a healthy lifestyle and optimal weight maintenance. PMID:28331453

  19. Newly Diagnosed Acute Promyelocytic Leukemia

    PubMed Central

    Avvisati, Giuseppe

    2011-01-01

    Acute promyelocytic leukemia (APL) represents a medical emergency with a high rate of early mortality. As a consequence, as soon as the diagnosis is suspected based upon cytologic criteria, it is necessary to start all- trans retinoic acid (ATRA) treatment without delay. For patients with newly diagnosed APL, induction therapy with ATRA plus anthracycline based chemotherapy is recommended. At present the combination of arsenic trioxide plus ATRA should be considered for patients who are not candidates for anthracycline-based therapy. For pediatric and adult patients with APL aged < 60 years who achieve a CR with induction, I recommend 3 intensive courses of consolidation chemotherapy associated to ATRA, targeted on the basis of the risk group at diagnosis. In patients treated with a very intensive consolidation chemotherapy maintenance treatment can be omitted. However If a maintenance treatment has to be adopted I suggest the use of intermittent ATRA for 15 days every 3 months for a period of 2 years, rather than ATRA associated to chemotherapy. Moreover, taking into account the medical literature, a reduced dosage of ATRA ( 25 mg/m2) in pediatric patients and a consolidation chemotherapy of reduced intensity in elderly patients is recommended. Furthermore, in order to maximize survival, careful attention should be reserved to the coagulopathy and to the appearance of the differentiation syndrome. Finally, PCR for the PML/RARA fusion gene on a bone marrow specimen every three months for two years, and then every six months for additional three years are needed during the follow-up. PMID:22220261

  20. Testing the generalizability of the ISO model for nursing diagnoses.

    PubMed

    Harris, Marcelline; Kim, Hyeoneui; Rhudy, Lori; Savova, Guergana; Chute, Christopher

    2003-01-01

    The purpose of this study was to explore whether the ISO reference terminology model for nursing diagnoses could be generalized to the MDS data set that, like nursing terminologies standardizes expressions of the concepts within and relevant to the domain of nursing practice. We first constructed paraphrased expressions of the rubrics from the data set. Next we dissected those expressions into the reference model domains of focus and judgment, recorded any qualifiers required for either domain, and semantic links required to represent associative relations. Our findings demonstrate that the ISO model for nursing diagnoses is generalizable to the MDS data set, however expansions to the model are required if the model is to be used to represent objects rather than terms.

  1. Transatlantic link

    NASA Astrophysics Data System (ADS)

    (left) European Geophysical Society (EGS) President Rolf Meissner at AGU Headquarters with (center) Executive Director Fred Spilhaus and (right) Foreign Secretary Juan Roederer. Meissner attended the meeting of AGU's Committee on International Participation (CIP) on February 26, 1988. At that meeting, specific ways of fostering close links between AGU and EGS were discussed.A few weeks later, Roederer and AGU staff, working with EGS Secretary-General Arne Richter at the EGS meeting in Bologna, Italy, March 21-25, planned details of the establishment of an AGU office in Europe. The Copernicus Gesellschaft, a new entity located on the premises of the Max Planck Institute for Aeronomy in Lindau, Federal Republic of Germany, will provide the administrative staff and handle logistics.

  2. Critical thinking and accuracy of nurses' diagnoses.

    PubMed

    Lunney, Margaret

    2003-01-01

    Interpretations of patient data are complex and diverse, contributing to a risk of low accuracy nursing diagnoses. This risk is confirmed in research findings that accuracy of nurses' diagnoses varied widely from high to low. Highly accurate diagnoses are essential, however, to guide nursing interventions for the achievement of positive health outcomes. Development of critical thinking abilities is likely to improve accuracy of nurses' diagnoses. New views of critical thinking serve as a basis for critical thinking in nursing. Seven cognitive skills and ten habits of mind are identified as dimensions of critical thinking for use in the diagnostic process. Application of the cognitive skills of critical thinking illustrates the importance of using critical thinking for accuracy of nurses' diagnoses. Ten strategies are proposed for self-development of critical thinking abilities.

  3. How Are Overweight and Obesity Diagnosed?

    MedlinePlus

    ... body mass index (BMI) and possibly a high waist circumference, and tests to rule out other medical conditions. ... diagnosed as obese if you have a large waist circumference that suggests increased amounts of fat in your ...

  4. How Is Acute Myeloid Leukemia Diagnosed?

    MedlinePlus

    ... Detection, Diagnosis, and Types How Is Acute Myeloid Leukemia Diagnosed? Certain signs and symptoms might suggest that ... of samples used to test for acute myeloid leukemia If signs and symptoms and/or the results ...

  5. How Is Chronic Myeloid Leukemia Diagnosed?

    MedlinePlus

    ... Detection, Diagnosis, and Staging How Is Chronic Myeloid Leukemia Diagnosed? Many people with CML do not have ... About Chronic Myeloid Leukemia? More In Chronic Myeloid Leukemia About Chronic Myeloid Leukemia Causes, Risk Factors, and ...

  6. How Is Chronic Myelomonocytic Leukemia Diagnosed?

    MedlinePlus

    ... Detection, Diagnosis, and Staging How Is Chronic Myelomonocytic Leukemia Diagnosed? If signs and symptoms suggest you may ... About Chronic Myelomonocytic Leukemia? More In Chronic Myelomonocytic Leukemia About Chronic Myelomonocytic Leukemia Causes, Risk Factors, and ...

  7. How Do Health Care Providers Diagnose Endometriosis?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose endometriosis? Skip sharing on social media ... under a microscope, to confirm the diagnosis. 1 Health care providers may also use imaging methods to produce ...

  8. How Do Health Care Providers Diagnose Vaginitis?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose vaginitis? Skip sharing on social media ... out the cause of a woman's symptoms, her health care provider will Examine the vagina, the vulva, and ...

  9. How Is Sickle Cell Disease Diagnosed?

    MedlinePlus

    ... from the NHLBI on Twitter. How Is Sickle Cell Disease Diagnosed? Screening Tests People who do not ... NEXT >> Featured Video Living With and Managing Sickle Cell Disease (Nicholas) 09/02/2011 In this video— ...

  10. Diagnosing Diabetes and Learning about Prediabetes

    MedlinePlus

    ... Size: A A A Listen En Español Diagnosing Diabetes and Learning About Prediabetes There are several ways ... mg/dl – 199 mg/dl Preventing Type 2 Diabetes You will not develop type 2 diabetes automatically ...

  11. Diagnosing Asthma in Very Young Children

    MedlinePlus

    ... Listen Español Text Size Email Print Share Diagnosing Asthma in Babies & Toddlers Page Content Article Body One ... family with recurrent bronchitis or sinus problems. When Asthma is Not the Cause Your pediatrician will listen ...

  12. How Is Peripheral Arterial Disease Diagnosed?

    MedlinePlus

    ... Names Causes Who Is at Risk Signs & Symptoms Diagnosis Treatments Prevention Living With Clinical Trials Links Related Topics Atherosclerosis Coronary Heart Disease Heart Attack Smoking and Your Heart Stroke Send a link ...

  13. Mapping the x-linked lymphoproliferative syndrome

    SciTech Connect

    Skare, J.C.; Milunsky, A.; Byron, K.S.; Sullivan, J.L.

    1987-04-01

    The X-linked lymphoproliferative syndrome is triggered by Epstein-Barr virus infection and results in fatal mononucleosis, immunodeficiency, and lymphoproliferative disorders. This study shows that the mutation responsible for X-linked lymphoproliferative syndrome is genetically linked to a restriction fragment length polymorphism detected with the DXS42 probe (from Xq24-q27). The most likely recombination frequency between the loci is 4%, and the associated logarithm of the odds is 5.26. Haplotype analysis using flanking restriction fragment length polymorphism markers indicates that the locus for X-linked lymphoproliferative syndrome is distal to probe DXS42 but proximal to probe DXS99 (from Xq26-q27). It is now possible to predict which members of a family with X-linked lymphoproliferative syndrome are carrier females and to diagnose the syndrome prenatally.

  14. The causal explanatory functions of medical diagnoses.

    PubMed

    Maung, Hane Htut

    2017-02-01

    Diagnoses in medicine are often taken to serve as explanations of patients' symptoms and signs. This article examines how they do so. I begin by arguing that although some instances of diagnostic explanation can be formulated as covering law arguments, they are explanatory neither in virtue of their argumentative structures nor in virtue of general regularities between diagnoses and clinical presentations. I then consider the theory that medical diagnoses explain symptoms and signs by identifying their actual causes in particular cases. While I take this to be largely correct, I argue that for a diagnosis to function as a satisfactory causal explanation of a patient's symptoms and signs, it also needs to be supplemented by understanding the mechanisms by which the identified cause produces the symptoms and signs. This mechanistic understanding comes not from the diagnosis itself, but rather from the theoretical framework within which the physician operates.

  15. Improving Multiple Fault Diagnosability using Possible Conflicts

    NASA Technical Reports Server (NTRS)

    Daigle, Matthew J.; Bregon, Anibal; Biswas, Gautam; Koutsoukos, Xenofon; Pulido, Belarmino

    2012-01-01

    Multiple fault diagnosis is a difficult problem for dynamic systems. Due to fault masking, compensation, and relative time of fault occurrence, multiple faults can manifest in many different ways as observable fault signature sequences. This decreases diagnosability of multiple faults, and therefore leads to a loss in effectiveness of the fault isolation step. We develop a qualitative, event-based, multiple fault isolation framework, and derive several notions of multiple fault diagnosability. We show that using Possible Conflicts, a model decomposition technique that decouples faults from residuals, we can significantly improve the diagnosability of multiple faults compared to an approach using a single global model. We demonstrate these concepts and provide results using a multi-tank system as a case study.

  16. Left ventricular noncompaction diagnosed following Graves' disease

    PubMed Central

    Habib, Habib; Hawatmeh, Amer; Rampal, Upamanyu; Shamoon, Fayez

    2016-01-01

    Isolated left ventricular noncompaction (LVNC) is a rare genetic cardiomyopathy. Clinical manifestations are variable; patients may present with heart failure symptoms, arrhythmias, and systemic thromboembolism. However, it can also be asymptomatic. When asymptomatic, LVNC can manifest later in life after the onset of another unrelated condition. We report a case of LVNC which was diagnosed following a hyperthyroid state secondary to Graves' disease. The association of LVNC with other noncardiac abnormalities including neurological, hematological, and endocrine abnormalities including hypothyroidism has been described in isolated case reports before. To the best of our knowledge, this is the first reported case of LVNC diagnosed following exacerbation in contractile dysfunction triggered by Graves' disease. PMID:27843800

  17. How Do Health Care Providers Diagnose Adrenal Gland Disorders?

    MedlinePlus

    ... Gland Disorders > About > Diagnosis Page Content ​ ​How do health care providers diagnose adrenal gland disorders? Methods for diagnosing ... Tumors To diagnose an adrenal gland tumor, a health care provider may order one or more tests. 3 ...

  18. Diagnosing anomalies of spacecraft for space maintenance and servicing

    NASA Technical Reports Server (NTRS)

    Lauriente, Michael; Rolincik, Mark; Koons, Harry C.; Gorney, David

    1994-01-01

    Very often servicing of satellites is necessary to replace components which are responsible for anomalous behavior of satellite operations due to adverse interactions with the natural space environment. A major difficulty with this diagnosis is that those responsible for diagnosing these anomalies do not have the tools to assess the role of the space environment causing the anomaly. To address this issue, we have under development a new rule-based, expert system for diagnosing spacecraft anomalies. The knowledge base consists of over two-hundred rules and provides links to historical and environmental databases. Environmental causes considered are bulk charging, single event upsets (SEU), surface charging, and total radiation dose. The system's driver translates forward chaining rules into a backward chaining sequence, prompting the user for information pertinent to the causes considered. When the user selects the novice mode, the system automatically gives detailed explanations and descriptions of terms and reasoning as the session progresses, in a sense teaching the user. As such it is an effective tutoring tool. The use of heuristics frees the user from searching through large amounts of irrelevant information and allows the user to input partial information (varying degrees of confidence in an answer) or 'unknown' to any question. The system is available on-line and uses C Language Integrated Production System (CLIPS), an expert shell developed by the NASA Johnson Space Center AI Laboratory in Houston.

  19. How Is Thrombotic Thrombocytopenic Purpura Diagnosed?

    MedlinePlus

    ... specializes in diagnosing and treating blood disorders. Medical History Your doctor will ask about factors that may affect TTP. For example, he or she may ask whether you: Have certain diseases or conditions, such as cancer, HIV, lupus, or infections (or whether you're pregnant). Have ...

  20. How Is Restless Legs Syndrome Diagnosed?

    MedlinePlus

    ... to study new ways to diagnose RLS. Drug Therapy Trial If your doctor thinks you have RLS, he or she may prescribe certain medicines to relieve your symptoms. These medicines, which are used to treat people who have Parkinson's disease, also can relieve RLS symptoms. If the medicines ...

  1. Eating Disorder Diagnoses: Empirical Approaches to Classification

    ERIC Educational Resources Information Center

    Wonderlich, Stephen A.; Joiner, Thomas E., Jr.; Keel, Pamela K.; Williamson, Donald A.; Crosby, Ross D.

    2007-01-01

    Decisions about the classification of eating disorders have significant scientific and clinical implications. The eating disorder diagnoses in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) reflect the collective wisdom of experts in the field but are frequently not supported in…

  2. Autism Spectrum Disorder Diagnoses in Stockholm Preschoolers

    ERIC Educational Resources Information Center

    Fernell, Elisabeth; Gillberg, Christopher

    2010-01-01

    The aims of this study were to estimate prevalence rates of children with autism spectrum disorder (ASD) diagnoses in a cohort of 6-year-old children with birth year 2002, referred to the Autism Centre for Young Children, serving the whole of Stockholm county and on the basis of the available data discuss clinical aspects of assessment,…

  3. DIAGNOSING CAUSES OF IMPAIRMENT IN COASTAL ECOSYSTEMS

    EPA Science Inventory

    Engle, Virginia D. and Stephen J. Jordan. In press. Diagnosing Causes of Impairment in Coastal Ecosystems (Abstract). To be presented at the SETAC Fourth World Congress, 14-18 November 2004, Portland, OR. 1 p. (ERL,GB R1008).

    Estuarine and coastal ecosystems are challenge...

  4. HLA-linked rheumatoid arthritis

    SciTech Connect

    Hasstedt, S.J.; Clegg, D.O.; Ingles, L.; Ward, R.H.

    1994-10-01

    Twenty-eight pedigrees were ascertained through pairs of first-degree relatives diagnosed with rheumatoid arthritis (RA). RA was confirmed in 77 pedigree members including probands; the absence of disease was verified in an additional 261 pedigree members. Pedigree members were serologically typed for HLA. We used likelihood analysis to statistically characterize the HLA-linked RA susceptibility locus. The genetic model assumed tight linkage to HLA. The analysis supported the existence of an HLA-linked RA susceptibility locus, estimated the lifetime penetrance as 41% in male homozygotes and as 48% in female homozygotes. Inheritance was recessive in males and was nearly recessive in females. In addition, the analysis attributed 78% of the variance within genotypes to genetic or environmental effects shared by siblings. The genetic model inferred in this analysis is consistent with previous association, linkage, and familial aggregation studies of RA. The inferred HLA-linked RA susceptibility locus accounts for approximately one-fifth of the RA in the population. Although other genes may account for the remaining familial RA, a large portion of RA cases may occur sporadically. 79 refs., 9 tabs.

  5. HLA-linked rheumatoid arthritis.

    PubMed Central

    Hasstedt, S. J.; Clegg, D. O.; Ingles, L.; Ward, R. H.

    1994-01-01

    Twenty-eight pedigrees were ascertained through pairs of first-degree relatives diagnosed with rheumatoid arthritis (RA). RA was confirmed in 77 pedigree members including probands; the absence of disease was verified in an additional 261 pedigree members. Pedigree members were serologically typed for HLA. We used likelihood analysis to statistically characterize the HLA-linked RA susceptibility locus. The genetic model assumed tight linkage to HLA. The analysis supported the existence of an HLA-linked RA susceptibility locus, estimated the susceptibility allele frequency as 2.16%, and estimated the lifetime penetrance as 41% in male homozygotes and as 48% in female homozygotes. Inheritance was recessive in males and was nearly recessive in females. In addition, the analysis attributed 78% of the variance within genotypes to genetic or environmental effects shared by siblings. The genetic model inferred in this analysis is consistent with previous association, linkage, and familial aggregation studies of RA. The inferred HLA-linked RA susceptibility locus accounts for approximately one-half of familial RA, although it accounts for only approximately one-fifth of the RA in the population. Although other genes may account for the remaining familial RA, a large portion of RA cases may occur sporadically. PMID:7942852

  6. Global scale diagnoses of FGGE data

    NASA Technical Reports Server (NTRS)

    Paegle, J.

    1985-01-01

    Descriptive global scale diagnoses of the First Global Atmospheric Research Experiment SOP-1 analyses were made and compared against controlled, real data integrations of the Goddard Laboratory of Atmospheric Science (GLAS) general circulation model (GCM) as well as other data sets. The effects of critical latitudes were studied; the influence of tropical wind data and latent heating upon the GLAS GCM was diagnosed; planetary wave structure on various time scales from the diurnal to the monthly was studied; and the GLAS analyses were compared with other analyses. Short term controlled GLAS GCM integrations show that: (1) the inclusion of tropical wind data in real data integrations has an important influence in the mid-latitude prediction in both hemispheres; and (2) the tropical divergent wind reacts almost immediately to alteration of the tropical latent heating. The presence or absence of zonally averaged easterlies depends strongly upon the presence of tropical latent heating.

  7. Human Immunodeficiency Virus Infection Newly Diagnosed at Autopsy in New York City, 2008-2012.

    PubMed

    Ramaswamy, Chitra; Ellman, Tanya M; Myers, Julie; Madsen, Ann; Sepkowitz, Kent; Shepard, Colin

    2015-12-01

    Background.  Studying the most extreme example of late diagnosis, new HIV diagnoses after death, may be instructive to HIV testing efforts. Using the results of routine HIV testing of autopsies performed by the Office of Chief Medical Examiner (OCME), we identified new HIV diagnoses after death in New York City (NYC) from 2008 to 2012. Methods.  Population-based registries for HIV and deaths were linked to identify decedents not known to be HIV-infected before death. Multivariable logistic regression models were constructed to determine correlates of a new HIV diagnosis after death among all persons newly diagnosed with HIV and among all HIV-infected decedents receiving an OCME autopsy. Results.  Of 264 893 deaths, 24 426 (9.2%) were autopsied by the NYC OCME. Of these, 1623 (6.6%) were infected with HIV, including 142 (8.8%) with a new HIV diagnosis at autopsy. This represents 0.8% (142 of 18 542) of all new HIV diagnoses during the 5-year period. Decedents newly diagnosed with HIV at OCME autopsy were predominantly male (73.9%), aged 13-64 years (85.9%), non-white (85.2%), unmarried (81.7%), less than college educated (83.8%), and residents of an impoverished neighborhood (62.0%). Of all HIV-infected OCME decedents aged ≥65 years (n = 71), 22.0% were diagnosed at autopsy. The strongest independent correlate of new HIV diagnosis at autopsy in both multivariable models was age ≥65 years. Conclusions.  Human immunodeficiency virus diagnoses first made after death are rare, but, when observed, these diagnoses are more commonly found among persons ≥65 years, suggesting that despite highly visible efforts to promote HIV testing community-wide, timely diagnosis among older adults living in impoverished, high-prevalence neighborhoods may require additional strategies.

  8. [Diagnosing venous and venous/arterial ulcers].

    PubMed

    Perceau, Géraldine

    2012-01-01

    A venous ulcer can be diagnosed on the basis of elements arising from the questioning and the clinical examination of the patient. A venous Doppler ultrasound can specify the type of reverse flow (superficial and/or deep). Measuring the ankle brachial pressure index helps to eliminate or confirm any arterial involvement. Depending on the systolic pressure index, the ulcer will be considered as purely venous, mixed (arterial-venous) or predominantly arterial.

  9. Granulomatous cryptococcal prostatitis diagnosed by transrectal biopsy.

    PubMed

    Seo, Ill Young; Jeong, Hee Jong; Yun, Ki Jung; Rim, Joung Sik

    2006-05-01

    Cryptococcal infection primarily involves the lung and is hematogenously spread to other organs. Sometimes it might affect the genitourinary tract, and rare cases have been reported involving the prostate without systemic infection. We report a case of granulomatous prostatitis as a result of Cryptococcus neoformans yeast in an immunocompromised patient with alcoholic liver cirrhosis, which was diagnosed by transrectal ultrasound guided biopsy and treated with antifungal medication.

  10. Test differences in diagnosing reading comprehension deficits.

    PubMed

    Keenan, Janice M; Meenan, Chelsea E

    2014-01-01

    The authors examined the implications of test differences for defining and diagnosing comprehension deficits using reading comprehension tests. They had 995 children complete the Gray Oral Reading Test-3, the Qualitative Reading Inventory-3, the Woodcock-Johnson Passage Comprehension-3, and the Peabody Individual Achievement Test and compared which children were identified by each test as being in the lowest 10%. Although a child who performs so poorly might be expected to do poorly on all tests, the authors found that the average overlap between tests in diagnosing comprehension difficulties was only 43%. Consistency in diagnosis was greater for younger children, when comprehension deficits are the result of weaker decoding skills, than for older children. Inconsistencies between tests were just as evident when identifying the top performers. The different children identified as having a comprehension deficit by each test were compared on four profile variables-word decoding skill, IQ, ADHD symptoms, and working memory skill-to understand the nature of the different deficits assessed by each test. Theoretical and practical implications of these test differences in defining and diagnosing comprehension deficits are discussed.

  11. Pulmonary Artery Leiomyosarcoma Diagnosed without Delay.

    PubMed

    Yamasaki, Motohisa; Sumi, Yuki; Sakakibara, Yumi; Tamaoka, Meiyo; Miyazaki, Yasunari; Arai, Hirokumi; Kojima, Katsuo; Itoh, Fusahiko; Amano, Tomonari; Yoshizawa, Yasuyuki; Inase, Naohiko

    2011-05-01

    A 63-year-old female presented with abnormal lung shadows but had, apart from this, few symptoms. Computed tomography (CT) revealed multiple nodules and blockage of the pulmonary artery. She was immediately diagnosed with pulmonary artery sarcoma based on a careful differential diagnosis and underwent surgery. Her tumor was pathologically diagnosed as leiomyosarcoma (i.e. intimal sarcoma). Pulmonary artery sarcoma can be easily confounded with thromboembolism in a clinical setting and some cases are diagnosed post mortem only. In our case, clinical prediction scores (Wells score, Geneva score, and revised Geneva score) for the pulmonary embolism showed low probability. Moreover, chest CT showed uncommon findings for pulmonary thromboembolism, as the nodules were too big for thrombi. Because surgical resection can provide the only hope of long-term survival in cases of pulmonary artery sarcoma, clinicians should consider this possibility in the differential diagnosis of pulmonary embolism. Clinical prediction scores and CT findings might help to reach the correct diagnosis of pulmonary artery sarcoma.

  12. Cardiac arrhythmia and death of teenager linked to rare genetic disorder diagnosed at autopsy.

    PubMed

    Quick, Jennifer Sue; Dobersen, Michael

    2014-06-01

    A 17-year-old male adolescent sustained cardiac arrest after participating in a wrestling match, where he was thrown down. He had no pulse, and cardiopulmonary resuscitation was immediately initiated along with application of an automatic external defibrillator. Upon arrival of emergency medical services, an electrocardiogram showed the patient to be in ventricular tachycardia, torsades, and ventricular fibrillation. The patient was ultimately transported to the hospital and, with ACLS protocol being performed, was resuscitated to a junctional rhythm with bradycardia and borderline prolonged QT. His hospital stay was characterized by refractory cardiac failure, and 2 days after the incident, a decision was made to remove him from life support. At autopsy, there were no external or internal injuries that could be considered a contributing cause of death. On external examination, observations were made about the decedent's facial features including his nose, eyes, ears, fingers, and toes. A careful review of the decedent's medical history was initiated to reveal birth defects including syndactyly of the third and fourth digit of the upper extremity as well as complete lack of dental enamel. A tentative diagnosis of oculodentodigital dysplasia was made and confirmed by genetic testing of heart muscle taken from the decedent. This case report examines the rare association of oculodentodigital dysplasia with cardiac arrhythmia as well as places emphasis on the features of the disorder that can aid in its diagnosis.

  13. Analog Optical Links

    NASA Astrophysics Data System (ADS)

    Cox, Charles H., III

    2004-05-01

    Unlike books that focus on the devices used in links, such as lasers and photodiodes, among others, this text focuses on the next level. It covers the collection of devices that form a link, how the individual device performance affects the link performance, or the reverse. Analog links are used for the distribution of cable TV signals, and in conveying the signals to and from antennas (so called antenna remoting). The design of analog links differs significantly from digital links which are primarily used in telecommunications.

  14. Link performance of mobile optical links

    NASA Astrophysics Data System (ADS)

    Henniger, H.

    2007-09-01

    High data-rate atmospheric free-space optical (FSO) lasercom systems typically suffer from relatively long time duration link degradations. These are caused by pointing- and tracking-errors or deep signal-fades produced by the index of refraction fluctuations caused by atmospheric turbulence. Based on measurement results we will present in this paper a channel characterization model for free-space optical links. Further a forward-error-correction (FEC) coding scheme is introduced that is able to overcome link outages. The performance of these codes has been proven by measurements. Code design recommendations and validation test results are discussed in this paper.

  15. 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

  16. Anal melanosis diagnosed by reflectance confocal microscopy.

    PubMed

    Cinotti, Elisa; Chol, Christelle; Perrot, Jean Luc; Labeille, Bruno; Forest, Fabien; Cambazard, Frédéric

    2014-11-01

    Until now, in vivo reflectance-mode confocal microscopy (IVCM) has been applied only to pigmented lesions of the vulvar and oral mucosa, but not to anal mucosa lesions. We present the first case in which IVCM has been used to diagnose anal melanosis. Clinical and dermoscopic features were of concern while IVCM found the draped pattern already described for genital melanosis. IVCM adds information to the clinical and dermatoscopic examination and allows skin biopsies to be avoided. Further studies are needed to define the IVCM features of anal melanosis and to compare the performance of IVCM with the findings of histological examinations.

  17. An attempt to diagnose cancer by PIXE

    NASA Astrophysics Data System (ADS)

    Uda, M.; Maeda, K.; Sasa, Y.; Kusuyama, H.; Yokode, Y.

    1987-03-01

    PIXE is suitable especially for trace elemental analysis for atoms with high atomic numbers, which are contained in matrices composed mainly of light elements such as biological materials. An attempt has been made to distinguish elemental concentrations of cancer tissues from those of normal ones. Kidney, testis and urinary bladder cancer tissues were examined by PIXE. Key elements to diagnose these cancers were Ca, Ti, Cr, Fe and Zn. Enrichment of Fe and Ti, and deficiency of Zn could be seen in the kidney cancer. An opposite tendency was observed in the testicular cancer. Imbalance of these elemental concentrations in characteristic organs might give us a possibility for cancer diagnosis.

  18. From inverse problems in mathematical physiology to quantitative differential diagnoses.

    PubMed

    Zenker, Sven; Rubin, Jonathan; Clermont, Gilles

    2007-11-01

    The improved capacity to acquire quantitative data in a clinical setting has generally failed to improve outcomes in acutely ill patients, suggesting a need for advances in computer-supported data interpretation and decision making. In particular, the application of mathematical models of experimentally elucidated physiological mechanisms could augment the interpretation of quantitative, patient-specific information and help to better target therapy. Yet, such models are typically complex and nonlinear, a reality that often precludes the identification of unique parameters and states of the model that best represent available data. Hypothesizing that this non-uniqueness can convey useful information, we implemented a simplified simulation of a common differential diagnostic process (hypotension in an acute care setting), using a combination of a mathematical model of the cardiovascular system, a stochastic measurement model, and Bayesian inference techniques to quantify parameter and state uncertainty. The output of this procedure is a probability density function on the space of model parameters and initial conditions for a particular patient, based on prior population information together with patient-specific clinical observations. We show that multimodal posterior probability density functions arise naturally, even when unimodal and uninformative priors are used. The peaks of these densities correspond to clinically relevant differential diagnoses and can, in the simplified simulation setting, be constrained to a single diagnosis by assimilating additional observations from dynamical interventions (e.g., fluid challenge). We conclude that the ill-posedness of the inverse problem in quantitative physiology is not merely a technical obstacle, but rather reflects clinical reality and, when addressed adequately in the solution process, provides a novel link between mathematically described physiological knowledge and the clinical concept of differential diagnoses

  19. Linking Policy | Smokefree 60+

    Cancer.gov

    Links to individual pages within the Smokefree 60+ website are permissible, provided attribution is made to 60plus.smokefree.gov and any descriptive notes accurately reflect the content of the linked page(s).

  20. Mining Electronic Health Records using Linked Data.

    PubMed

    Odgers, David J; Dumontier, Michel

    2015-01-01

    Meaningful Use guidelines have pushed the United States Healthcare System to adopt electronic health record systems (EHRs) at an unprecedented rate. Hospitals and medical centers are providing access to clinical data via clinical data warehouses such as i2b2, or Stanford's STRIDE database. In order to realize the potential of using these data for translational research, clinical data warehouses must be interoperable with standardized health terminologies, biomedical ontologies, and growing networks of Linked Open Data such as Bio2RDF. Applying the principles of Linked Data, we transformed a de-identified version of the STRIDE into a semantic clinical data warehouse containing visits, labs, diagnoses, prescriptions, and annotated clinical notes. We demonstrate the utility of this system though basic cohort selection, phenotypic profiling, and identification of disease genes. This work is significant in that it demonstrates the feasibility of using semantic web technologies to directly exploit existing biomedical ontologies and Linked Open Data.

  1. Mental disorder diagnoses among children and adolescents who use antipsychotic drugs.

    PubMed

    Nesvåg, Ragnar; Hartz, Ingeborg; Bramness, Jørgen G; Hjellvik, Vidar; Handal, Marte; Skurtveit, Svetlana

    2016-09-01

    Antipsychotic drugs are used increasingly by children and adolescents and there is concern about off-label use. We aimed to study which substances, and for which mental disorder diagnoses, antipsychotic drugs were prescribed to 0-18-year-old boys and girls in Norway. Linked data from the national health registry for prescription drugs in 2010 and mental disorder diagnoses in 2008-2012 were used to study the prevalence of antipsychotic drug use, the type of antipsychotic drug substances used, mental disorder diagnoses in users and distribution of drugs per diagnostic category across gender. In total, 0.18% of Norwegian children and adolescents were prescribed antipsychotic drugs during 2010, of which there were more boys (0.23%) than girls (0.13%). Risperidone was the most frequently used substance among boys (57.4%) and girls (32.3%), followed by aripiprazole (19.4%) in boys and quetiapine (27.4%) in girls. The most common mental disorder diagnoses among male users were hyperkinetic (49.9%) and autism spectrum disorder (27.1%), while anxiety disorders (41.5%) and depressive illness (33.6%) were most common among female users. A schizophrenia-like psychosis diagnosis was given to 11.1% of the male and 18.2% of the female users. A hyperkinetic disorder was diagnosed among 56.9% and 52.4% of the male risperidone and aripiprazole users, respectively. Among female quetiapine users, 57.1% were diagnosed with anxiety disorders and 52.4% with depressive illness. These results demonstrate that children and adolescents who use antipsychotic drugs are predominantly diagnosed with non-psychotic mental disorders such as hyperkinetic disorder among boys and anxiety disorder or depressive illness among girls.

  2. Learning and diagnosing faults using neural networks

    NASA Technical Reports Server (NTRS)

    Whitehead, Bruce A.; Kiech, Earl L.; Ali, Moonis

    1990-01-01

    Neural networks have been employed for learning fault behavior from rocket engine simulator parameters and for diagnosing faults on the basis of the learned behavior. Two problems in applying neural networks to learning and diagnosing faults are (1) the complexity of the sensor data to fault mapping to be modeled by the neural network, which implies difficult and lengthy training procedures; and (2) the lack of sufficient training data to adequately represent the very large number of different types of faults which might occur. Methods are derived and tested in an architecture which addresses these two problems. First, the sensor data to fault mapping is decomposed into three simpler mappings which perform sensor data compression, hypothesis generation, and sensor fusion. Efficient training is performed for each mapping separately. Secondly, the neural network which performs sensor fusion is structured to detect new unknown faults for which training examples were not presented during training. These methods were tested on a task of fault diagnosis by employing rocket engine simulator data. Results indicate that the decomposed neural network architecture can be trained efficiently, can identify faults for which it has been trained, and can detect the occurrence of faults for which it has not been trained.

  3. Vehicle Fault Diagnose Based on Smart Sensor

    NASA Astrophysics Data System (ADS)

    Zhining, Li; Peng, Wang; Jianmin, Mei; Jianwei, Li; Fei, Teng

    In the vehicle's traditional fault diagnose system, we usually use a computer system with a A/D card and with many sensors connected to it. The disadvantage of this system is that these sensor can hardly be shared with control system and other systems, there are too many connect lines and the electro magnetic compatibility(EMC) will be affected. In this paper, smart speed sensor, smart acoustic press sensor, smart oil press sensor, smart acceleration sensor and smart order tracking sensor were designed to solve this problem. With the CAN BUS these smart sensors, fault diagnose computer and other computer could be connected together to establish a network system which can monitor and control the vehicle's diesel and other system without any duplicate sensor. The hard and soft ware of the smart sensor system was introduced, the oil press, vibration and acoustic signal are resampled by constant angle increment to eliminate the influence of the rotate speed. After the resample, the signal in every working cycle could be averaged in angle domain and do other analysis like order spectrum.

  4. Diagnosing faults in autonomous robot plan execution

    NASA Technical Reports Server (NTRS)

    Lam, Raymond K.; Doshi, Rajkumar S.; Atkinson, David J.; Lawson, Denise M.

    1989-01-01

    A major requirement for an autonomous robot is the capability to diagnose faults during plan execution in an uncertain environment. Many diagnostic researches concentrate only on hardware failures within an autonomous robot. Taking a different approach, the implementation of a Telerobot Diagnostic System that addresses, in addition to the hardware failures, failures caused by unexpected event changes in the environment or failures due to plan errors, is described. One feature of the system is the utilization of task-plan knowledge and context information to deduce fault symptoms. This forward deduction provides valuable information on past activities and the current expectations of a robotic event, both of which can guide the plan-execution inference process. The inference process adopts a model-based technique to recreate the plan-execution process and to confirm fault-source hypotheses. This technique allows the system to diagnose multiple faults due to either unexpected plan failures or hardware errors. This research initiates a major effort to investigate relationships between hardware faults and plan errors, relationships which were not addressed in the past. The results of this research will provide a clear understanding of how to generate a better task planner for an autonomous robot and how to recover the robot from faults in a critical environment.

  5. Diagnosing faults in autonomous robot plan execution

    NASA Technical Reports Server (NTRS)

    Lam, Raymond K.; Doshi, Rajkumar S.; Atkinson, David J.; Lawson, Denise M.

    1988-01-01

    A major requirement for an autonomous robot is the capability to diagnose faults during plan execution in an uncertain environment. Many diagnostic researches concentrate only on hardware failures within an autonomous robot. Taking a different approach, the implementation of a Telerobot Diagnostic System that addresses, in addition to the hardware failures, failures caused by unexpected event changes in the environment or failures due to plan errors, is described. One feature of the system is the utilization of task-plan knowledge and context information to deduce fault symptoms. This forward deduction provides valuable information on past activities and the current expectations of a robotic event, both of which can guide the plan-execution inference process. The inference process adopts a model-based technique to recreate the plan-execution process and to confirm fault-source hypotheses. This technique allows the system to diagnose multiple faults due to either unexpected plan failures or hardware errors. This research initiates a major effort to investigate relationships between hardware faults and plan errors, relationships which were not addressed in the past. The results of this research will provide a clear understanding of how to generate a better task planner for an autonomous robot and how to recover the robot from faults in a critical environment.

  6. Diagnosing breast cancer by using Raman spectroscopy

    NASA Astrophysics Data System (ADS)

    Haka, Abigail S.; Shafer-Peltier, Karen E.; Fitzmaurice, Maryann; Crowe, Joseph; Dasari, Ramachandra R.; Feld, Michael S.

    2005-08-01

    We employ Raman spectroscopy to diagnose benign and malignant lesions in human breast tissue based on chemical composition. In this study, 130 Raman spectra are acquired from ex vivo samples of human breast tissue (normal, fibrocystic change, fibroadenoma, and infiltrating carcinoma) from 58 patients. Data are fit by using a linear combination model in which nine basis spectra represent the morphologic and chemical features of breast tissue. The resulting fit coefficients provide insight into the chemical/morphological makeup of the tissue and are used to develop diagnostic algorithms. The fit coefficients for fat and collagen are the key parameters in the resulting diagnostic algorithm, which classifies samples according to their specific pathological diagnoses, attaining 94% sensitivity and 96% specificity for distinguishing cancerous tissues from normal and benign tissues. The excellent results demonstrate that Raman spectroscopy has the potential to be applied in vivo to accurately classify breast lesions, thereby reducing the number of excisional breast biopsies that are performed. Author contributions: M.F., J.C., R.R.D., and M.S.F. designed research; A.S.H. and K.E.S.-P. performed research; A.S.H. and M.F. analyzed data; and A.S.H. wrote the paper.This paper was submitted directly (Track II) to the PNAS office.Abbreviations: DEH, ductal epithelial hyperplasia; ROC, receiver operating characteristic; N/C, nuclear-to-cytoplasm.

  7. Illness perspectives of Thais diagnosed with schizophrenia.

    PubMed

    Sanseeha, Ladda; Chontawan, Ratanawadee; Sethabouppha, Hunsa; Disayavanish, Chamlong; Turale, Sue

    2009-09-01

    This study explored the perceptions of 18 people diagnosed with schizophrenia from 1-10 years to uncover how they perceived themselves and their illness. It also involved 12 family members who added their perceptions. The data were collected using in-depth interviews, reflective journaling, and observations. The data were analyzed through the lens of Heidegger's hermeneutic phenomenology. Four themes emerged: perceptions of mental illness, perceptions of the causes of illness, perceptions of discrimination, and attempting to live with schizophrenia. The findings included strong underlying cultural and spiritual beliefs, and attitudes unique to the Thai participants, including the causation of schizophrenia by supernatural powers, black magic, and bad karma stemming from past deeds. Understanding the perceptions of the participants might help health-care providers to be more sensitive to those living with schizophrenia in Thailand and elsewhere. In particular, the findings could be useful in informing psychiatric careproviders about developing better caring systems for clients diagnosed with schizophrenia. This should help the sufferers of schizophrenia to live their lives to their own satisfaction and as normally as possible.

  8. Commercial Web Site Links.

    ERIC Educational Resources Information Center

    Thelwall, Mike

    2001-01-01

    Discusses business use of the Web and related search engine design issues as well as research on general and academic links before reporting on a survey of the links published by a collection of business Web sites. Results indicate around 66% of Web sites do carry external links, most of which are targeted at a specific purpose, but about 17%…

  9. Prenatal diagnosis of X linked hydrocephalus without aqueductal stenosis.

    PubMed Central

    Váradi, V; Csécsei, K; Szeifert, G T; Tóth, Z; Papp, Z

    1987-01-01

    The outcome of four successive pregnancies in a woman heterozygous for X linked hydrocephalus is described. The last two were scanned by ultrasound. In one, a good prognosis was given; the fetus was male but there was no evidence of dilated cerebral ventricles. In the other, hydrocephalus was diagnosed. The absence of aqueductal stenosis in this case supports the hypothesis that in this X linked condition communicating hydrocephalus is the primary defect and aqueductal stenosis is secondary. Images PMID:3295245

  10. Diagnosing Sleep Disorders | NIH MedlinePlus the Magazine

    MedlinePlus

    ... of this page please turn JavaScript on. Feature: Sleep Disorders Diagnosing Sleep Disorders Past Issues / Summer 2015 Table of Contents ... tests when trying to diagnose a sleep disorder: Sleep history and sleep log If you believe you ...

  11. How Do Health Care Providers Diagnose Osteogenesis Imperfecta?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose osteogenesis imperfecta (OI)? Skip sharing on ... Page Content If OI is moderate or severe, health care providers usually diagnose it during prenatal ultrasound at ...

  12. How Do Health Care Providers Diagnose Primary Ovarian Insufficiency (POI)?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose POI? Skip sharing on social media ... having periods for 4 months or longer, her health care provider may take these steps to diagnose the ...

  13. Community Treatment of Extremely Troublesome Youth with Dual Mental Health/Mental Retardation Diagnoses: A Data Based Case Study.

    ERIC Educational Resources Information Center

    Fabry, Bernie D.; Reitz, Andrew L.; Luster, W. Clark

    2002-01-01

    This paper describes a data-based case study of a linked array of community-based treatment services for troublesome, dual-diagnosed children and adolescents. Factors in the program's successes are described, followed by long-term data supporting treatment effectiveness. Results support applied research at this level and present a simple…

  14. Diagnosing pseudobulbar affect in traumatic brain injury

    PubMed Central

    Engelman, William; Hammond, Flora M; Malec, James F

    2014-01-01

    Pseudobulbar affect (PBA) is defined by episodes of involuntary crying and/or laughing as a result of brain injury or other neurological disease. Epidemiology studies show that 5.3%–48.2% of people with traumatic brain injury (TBI) may have symptoms consistent with (or suggestive of) PBA. Yet it is a difficult and often overlooked condition in individuals with TBI, and is easily confused with depression or other mood disorders. As a result, it may be undertreated and persist for longer than it should. This review presents the signs and symptoms of PBA in patients with existing TBI and outlines how to distinguish PBA from other similar conditions. It also compares and contrasts the different diagnostic criteria found in the literature and briefly mentions appropriate treatments. This review follows a composite case with respect to the clinical course and treatment for PBA and presents typical challenges posed to a provider when diagnosing PBA. PMID:25336956

  15. Outcome of prenatally diagnosed trisomy 6 mosaicism.

    PubMed

    Wallerstein, Robert; Oh, Tracey; Durcan, Judy; Abdelhak, Yaakov; Clachko, Mark; Aviv, Hana

    2002-08-01

    We report the prenatal diagnosis of trisomy 6 mosaicism via amniocentesis, in which trisomy 6 cells were identified in three of five culture vessels with 33% (5/15) of colonies showing trisomic cells. The pregnancy was electively terminated and examination revealed minor abnormalities (shortening of the femurs, micrognathia, posterior malrotation of the ears, and bilateral camptomelia of the second digit of the hands and fifth digits of the feet). Cytogenetic analysis of the placenta showed trisomy 6 in 100% of 20 cells studied. Karyotype was 46,XX in 100 cells examined from fetal skin. There are relatively few prenatally diagnosed cases of mosaic trisomy 6 at amniocentesis. Confined placental mosaicism (CPM) has been postulated in other cases where follow-up cytogenetic studies were not available. The present case differs from those previously reported, as it appears to represent CPM of chromosome 6 with phenotypic effects to the fetus.

  16. What next for newly diagnosed glioblastoma?

    PubMed Central

    Domingo-Musibay, Evidio; Galanis, Evanthia

    2015-01-01

    Glioblastoma is the most common primary brain tumor in adults. Despite current multimodality treatment including surgical resection and temozolomide-based chemoradiotherapy, median survival is only 14–16 months. Characterization of molecular alterations in glioblastoma has identified prognostic subgroups and therapeutic opportunities for clinical trials across glioblastoma subsets. Following a number of negative Phase III trials testing temozolomide dose intensification and angiogenesis inhibition, recent interim analysis data indicate survival prolongation with use of a device (Optune™) delivering alternating electrical field therapy in newly diagnosed glioblastoma patients. In this review, we present an overview of the data supporting the current standard of care and discuss novel experimental therapies in early and late phase clinical testing including devices, small molecule drugs, angiogenesis inhibitors, oncolytic virotherapy and immunotherapy. PMID:26558493

  17. Optical coherence tomography for diagnosing periodontal disease

    NASA Astrophysics Data System (ADS)

    Colston, Bill W., Jr.; Everett, Matthew J.; Da Silva, Luiz B.; Otis, Linda L.; Nathel, Howard

    1997-05-01

    We have, in this preliminary study, investigated the use of optical coherence tomography for diagnosis of periodontal disease. We took in vitro OCT images of the dental and periodontal tissues from a young pig and compared them to histological sections. These images distinguish tooth and soft tissue relationships that are important in diagnosing and assessing periodontal disease. We have imaged the attachment of gingiva to the tooth surface and located the cemento-enamel junction. This junction is an important reference point for defining attachment level in the diagnosis of periodontal disease. the boundary between enamel and dentin is also visible for most of the length of the anatomical crown, allowing quantitation of enamel thickness and character.

  18. Gastroesophageal reflux diagnosed by occlusal splint tintion.

    PubMed

    Cebrián-Carretero, José Luis; López-Arcas-Calleja, José María

    2006-01-01

    The gastroesophageal reflux (GER) disease is a very frequent digestive disorder, mainly characterised by the reflux of the gastric acidic content to the esophage in abnormal quantities. There are different situations that favour this situation but almost in all of them rely an incompetence of the esophagic sphincter. The clinical consequences are many, including oral manifestations. Among all of them the most frequent is the esophagitis followed by symptoms at the pharynx or larynx and finally, the oral cavity. At this level fundamentally we will find enamel and oral mucosa erosions. We report the case of a patient who was indirectly diagnosed of her esophague disease by the observation of the alterations in the occlusal splint induced by the gastric reflux. We review the literature concerning the above topic and its possible association with the miofascial syndrome.

  19. Automated diagnostic kiosk for diagnosing diseases

    DOEpatents

    Regan, John Frederick; Birch, James Michael

    2014-02-11

    An automated and autonomous diagnostic apparatus that is capable of dispensing collection vials and collections kits to users interesting in collecting a biological sample and submitting their collected sample contained within a collection vial into the apparatus for automated diagnostic services. The user communicates with the apparatus through a touch-screen monitor. A user is able to enter personnel information into the apparatus including medical history, insurance information, co-payment, and answer a series of questions regarding their illness, which is used to determine the assay most likely to yield a positive result. Remotely-located physicians can communicate with users of the apparatus using video tele-medicine and request specific assays to be performed. The apparatus archives submitted samples for additional testing. Users may receive their assay results electronically. Users may allow the uploading of their diagnoses into a central databank for disease surveillance purposes.

  20. Diagnosing Parkinson's Diseases Using Fuzzy Neural System

    PubMed Central

    Abiyev, Rahib H.; Abizade, Sanan

    2016-01-01

    This study presents the design of the recognition system that will discriminate between healthy people and people with Parkinson's disease. A diagnosing of Parkinson's diseases is performed using fusion of the fuzzy system and neural networks. The structure and learning algorithms of the proposed fuzzy neural system (FNS) are presented. The approach described in this paper allows enhancing the capability of the designed system and efficiently distinguishing healthy individuals. It was proved through simulation of the system that has been performed using data obtained from UCI machine learning repository. A comparative study was carried out and the simulation results demonstrated that the proposed fuzzy neural system improves the recognition rate of the designed system. PMID:26881009

  1. Intrapancreatic accessory spleen diagnosed on radionuclide imaging.

    PubMed

    Belkhir, Sara Melboucy; Archambaud, Frédérique; Prigent, Alain; Chaumet-Riffaud, Philippe

    2009-09-01

    Intrapancreatic accessory spleen (IPAS) is ectopic splenic tissue distinct from the main spleen. A 46-year-old man with chronic hepatitis C, presented in 2006 with low right chest pain which led to a diagnosis of tuberculosis pleurisy. CT scan and MRI showed a round, homogenous, well limited mass of 3cm in the pancreas tail. Tc-99m heat-damaged red blood cell scintigraphy with SPECT-CT was performed to confirm the diagnosis of IPAS. Most cases of IPAS described in the literature were diagnosed by pathologists after distal pancreatectomy and splenectomy performed for a suspicion of pancreatic tumor. However, heat-damaged red blood cell scintigraphy remains the most commonly used diagnostic procedure for IPAS, even if superparamagnetic iron oxide MRI contrast agent may be used in the future.

  2. Accurately Diagnosing and Treating Borderline Personality Disorder

    PubMed Central

    Gentile, Julie P.; Correll, Terry L.

    2010-01-01

    The high prevalence of comorbid bipolar and borderline personality disorders and some diagnostic criteria similar to both conditions present both diagnostic and therapeutic challenges. This article delineates certain symptoms which, by careful history taking, may be attributed more closely to one of these two disorders. Making the correct primary diagnosis along with comorbid psychiatric conditions and choosing the appropriate type of psychotherapy and pharmacotherapy are critical steps to a patient's recovery. In this article, we will use a case example to illustrate some of the challenges the psychiatrist may face in diagnosing and treating borderline personality disorder. In addition, we will explore treatment strategies, including various types of therapy modalities and medication classes, which may prove effective in stabilizing or reducing a broad range of symptomotology associated with borderline personality disorder. PMID:20508805

  3. Anxiety symptoms in clinically diagnosed bruxers.

    PubMed

    Manfredini, D; Landi, N; Fantoni, F; Segù, M; Bosco, M

    2005-08-01

    The present work was an attempt to investigate for the existence of an association between anxiety psychopathology and bruxism. The presence of bruxism was investigated according to validated clinical criteria in 98 subjects, who also filled out a self-report questionnaire (PAS-SR) for the assessment of panic-agoraphobic spectrum. 34.7% (n = 34) of participants were diagnosed as bruxers. The prevalence of anxiety psychopathology was similar between bruxers and non-bruxers, but Mann-Whitney U-test revealed significant differences in total PAS-SR (P = 0.026) score, indicating that subclinical symptoms of the anxiety spectrum might differentiate bruxers from controls. In particular, significant differences emerged in scores of domains evaluating panic (P = 0.039), stress sensitivity (P = 0.006) and reassurance sensitivity symptoms (P = 0.005) of panic-agoraphobic spectrum. Support to the existence of an association between bruxism and certain psychopathological symptoms has been provided.

  4. Lymphoma Diagnosed at Inguinal Hernia Repair

    PubMed Central

    Veal, David R; Hammill, Chet W

    2010-01-01

    Tumors presenting in the inguinal hernia sac are considered to be extremely rare, with the more common neoplasms metastasizing from the gastrointestinal tract, ovary and prostate. We report the case of Mantle cell lymphoma identified in the inguinal hernia sac following hernia repair. While the hernia sac appeared normal to the surgeon, evaluation by the pathologist showed subtle gross irregularities, with subsequent histologic and immunochemical diagnosis of Mantle cell lymphoma. Twelve previous cases of a lymphoma diagnosed during hernia repair have been described in the English literature. This is the first report of Mantle cell lymphoma found in the hernia sac. This case illustrates the value of routine microscopic evaluation of hernia sacs found from inguinal/femoral herniorrhaphies, as it may be the primary presentation of an asymptomatic metastatic lymphoma. Additionally, it underscores the importance of the surgeon's role in screening hernia sacs if the practice of submitting only macroscopically abnormal specimens for microscopic evaluation is adopted. PMID:20358722

  5. Diagnosing overflow waters in the North Atlantic

    NASA Astrophysics Data System (ADS)

    Guo, Chuncheng; Ilicak, Mehmet; Bentsen, Mats; Fer, Ilker

    2015-04-01

    Danmark Strait overflow water (DSOW) and Iceland Faroe overflow water (ISOW) are important for the formation and transformation of deep waters in the North Atlantic. In this work the volume transport, variability, and pathways of DSOW and ISOW are diagnosed using the one degree ocean-ice coupled Norwegian Earth System Model (NorESM) that is forced by CORE2 inter-annual forcing. The oceanic component (MICOM) features an isopycnal coordinate that is referenced to 2000 db. The issues related to the coarse resolution such as the southward transport of ISOW to the western European Basin, the lack of overflow water in the western North Atlantic, and the western boundary detachment of the deep western boundary current are addressed. The effects of diapycnal mixing on the behavior of overflow descent at Denmark Strait and Faroe Bank Channel and its downstream evolution are examined.

  6. Postnatal Treatment in Antenatally Diagnosed Meconium Peritonitis.

    PubMed

    Ionescu, S; Andrei, B; Oancea, M; Licsandru, E; Ivanov, M; Marcu, V; Popa-Stanila, R; Mocanu, M

    2015-01-01

    Meconium peritonitis is a rare prenatal disease with an increased rate of morbidity and mortality in the neonatal period. Distinctive features revealed by prenatal and postnatal ultrasoundmay be present: abdominal calcifications, ascites, polyhydramnios, meconium pseudocyst, echogenic mass and dilated bowel or intestinal obstruction. Establishing clear postnatal treatment and prognosis is difficult because of the heterogeneity of the results obtained by ultrasound. The aim of the study is to determine how prenatal diagnosis of meconium peritonitis is associated with perinatal management and further evolution. Clinical results are different depending on the presence of antenatal diagnosis of meconium peritonitis and its form, which can be mild or severe. Surgical treatment and management of meconium peritonitis depend on the clinical presentation of the newborn. Meconium peritonitis diagnosed prenatally differs from that of the newborn, not only concerning the mortality rates but also through reduced morbidity and overall better prognosis.

  7. Ein mehrstufiger Algorithmus zur Diagnose seltener Genodermatosen.

    PubMed

    Tantcheva-Poór, Iliana; Oji, Vinzenz; Has, Cristina

    2016-10-01

    Jüngste Fortschritte der Genforschung haben ihren Weg in die klinische Dermatologie gefunden. Nahezu ein Drittel aller Erbkrankheiten zeigt charakteristische Hautveränderungen. Zudem können Proben menschlicher Haut als Untersuchungsmaterial zur Detektion genetischer Mosaike und der zu Grunde liegenden Defekte eingesetzt werden. Die Diagnose von Genodermatosen bleibt jedoch aufgrund ihrer unterschiedlich ausgeprägten und überlappenden Phänotypen sowie ihrer Seltenheit und Vielzahl neuer Informationen wegen eine Herausforderung für die Kliniker. Um das Interesse für dieses, sich schnell entwickelnde Feld der Dermatologie zu wecken und den Blick für einige seltene Erbkrankheiten zu schärfen, stellen wir in der hiesigen Übersicht einen Algorithmus für die Diagnostik und Evaluierung von Patienten mit fraglichen Genodermatosen vor.

  8. Alternative diagnoses at paediatric appendicitis MRI.

    PubMed

    Moore, M M; Kulaylat, A N; Brian, J M; Khaku, A; Hulse, M A; Engbrecht, B W; Methratta, S T; Boal, D K B

    2015-08-01

    As the utilization of MRI in the assessment for paediatric appendicitis increases in clinical practice, it is important to recognize alternative diagnoses as the cause of abdominal pain. The purpose of this review is to share our institution's experience using MRI in the evaluation of 510 paediatric patients presenting with suspected appendicitis over a 30 month interval (July 2011 to December 2013). An alternative diagnosis was documented in 98/510 (19.2%) patients; adnexal pathology (6.3%, n = 32), enteritis-colitis (6.3%, n = 32), and mesenteric adenitis (2.2%, n = 11) comprised the majority of cases. These common entities and other less frequent illustrative cases obtained during our overall institutional experience with MRI for suspected appendicitis are reviewed.

  9. Queer diagnoses revisited: The past and future of homosexuality and gender diagnoses in DSM and ICD.

    PubMed

    Drescher, Jack

    2015-01-01

    The American Psychiatric Association (APA) recently completed a several year process of revising the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). During that time, there were objections raised to retaining DSM's gender identity disorder diagnoses and calls to remove them, just as homosexuality had been removed from DSM-II in 1973. At the conclusion of the DSM-5 revision process, the gender diagnoses were retained, albeit in altered form and bearing the new name of 'gender dysphoria'. The author of this paper was a member of the DSM-5 Workgroup on Sexual and Gender Identity Disorders and presently serves on the WHO Working Group on Sexual Disorders and Sexual Health. Both groups faced similar tasks: reconciling patients' needs for access to care with the stigma of being given a psychiatric diagnosis. The differing nature of the two diagnostic manuals led to two different outcomes. As background, this paper updates the history of homosexuality and the gender diagnoses in the DSM and in the International Statistical Classification of Diseases and Related Health Problems (ICD) as well as what is expected to happen to the homosexuality and gender diagnoses following the current ICD-11 revision process.

  10. An expert system for diagnosing environmentally induced spacecraft anomalies

    NASA Technical Reports Server (NTRS)

    Rolincik, Mark; Lauriente, Michael; Koons, Harry C.; Gorney, David

    1992-01-01

    A new rule-based, machine independent analytical tool was designed for diagnosing spacecraft anomalies using an expert system. Expert systems provide an effective method for saving knowledge, allow computers to sift through large amounts of data pinpointing significant parts, and most importantly, use heuristics in addition to algorithms, which allow approximate reasoning and inference and the ability to attack problems not rigidly defined. The knowledge base consists of over two-hundred (200) rules and provides links to historical and environmental databases. The environmental causes considered are bulk charging, single event upsets (SEU), surface charging, and total radiation dose. The system's driver translates forward chaining rules into a backward chaining sequence, prompting the user for information pertinent to the causes considered. The use of heuristics frees the user from searching through large amounts of irrelevant information and allows the user to input partial information (varying degrees of confidence in an answer) or 'unknown' to any question. The modularity of the expert system allows for easy updates and modifications. It not only provides scientists with needed risk analysis and confidence not found in algorithmic programs, but is also an effective learning tool, and the window implementation makes it very easy to use. The system currently runs on a Micro VAX II at Goddard Space Flight Center (GSFC). The inference engine used is NASA's C Language Integrated Production System (CLIPS).

  11. MacDoctor: The Macintosh diagnoser

    NASA Technical Reports Server (NTRS)

    Lavery, David B.; Brooks, William D.

    1990-01-01

    When the Macintosh computer was first released, the primary user was a computer hobbyist who typically had a significant technical background and was highly motivated to understand the internal structure and operational intricacies of the computer. In recent years the Macintosh computer has become a widely-accepted general purpose computer which is being used by an ever-increasing non-technical audience. This has lead to a large base of users which has neither the interest nor the background to understand what is happening 'behind the scenes' when the Macintosh is put to use - or what should be happening when something goes wrong. Additionally, the Macintosh itself has evolved from a simple closed design to a complete family of processor platforms and peripherals with a tremendous number of possible configurations. With the increasing popularity of the Macintosh series, software and hardware developers are producing a product for every user's need. As the complexity of configuration possibilities grows, the need for experienced or even expert knowledge is required to diagnose problems. This presents a problem to uneducated or casual users. This problem indicates a new Macintosh consumer need; that is, a diagnostic tool able to determine the problem for the user. As the volume of Macintosh products has increased, this need has also increased.

  12. Diagnosing Anomalous Network Performance with Confidence

    SciTech Connect

    Settlemyer, Bradley W; Hodson, Stephen W; Kuehn, Jeffery A; Poole, Stephen W

    2011-04-01

    Variability in network performance is a major obstacle in effectively analyzing the throughput of modern high performance computer systems. High performance interconnec- tion networks offer excellent best-case network latencies; how- ever, highly parallel applications running on parallel machines typically require consistently high levels of performance to adequately leverage the massive amounts of available computing power. Performance analysts have usually quantified network performance using traditional summary statistics that assume the observational data is sampled from a normal distribution. In our examinations of network performance, we have found this method of analysis often provides too little data to under- stand anomalous network performance. Our tool, Confidence, instead uses an empirically derived probability distribution to characterize network performance. In this paper we describe several instances where the Confidence toolkit allowed us to understand and diagnose network performance anomalies that we could not adequately explore with the simple summary statis- tics provided by traditional measurement tools. In particular, we examine a multi-modal performance scenario encountered with an Infiniband interconnection network and we explore the performance repeatability on the custom Cray SeaStar2 interconnection network after a set of software and driver updates.

  13. Diagnosing Mitochondrial Disorder without Sophisticated Means.

    PubMed

    Finsterer, Josef; Frank, Marlies

    2015-10-01

    Mitochondrial disorders (MIDs) require biochemical or genetic investigations for being diagnosed. In some cases, however, the diagnosis can be suspected upon the syndromic phenotype or upon clinical presentation and family history, as in the following case. The patient was a 74-year-old male admitted for worsening of pre-existing left-sided ptosis and ophthalmoparesis after a birthday party. The history was positive for arterial hypertension, hypertrophic cardiomyopathy with systolic dysfunction, diabetes-type 2, mild renal insufficiency, thyroiditis, and polyneuropathy. Instrumental investigations additionally revealed hepatopathy, hyperlipidemia, hyperuricemia, bifascicular block, white matter lesions, and subacute stroke. Systolic dysfunction resolved upon adequate cardiac treatment. On hospital day 11 the patient suddenly developed asystole. He was successfully resuscitated but died a few hours later from acute myocardial infarction. Surprisingly, a more extensive family history was positive for myopathy (patient, brother, daughter), neuropathy (patient), hypoacusis (patient), Parkinson syndrome (mother), spasticity (son), diabetes (patient, son), renal failure (patient), and generalized atherosclerosis (patient). The individual and family history was strongly suggestive of an MID. In conclusion, individual and family history may strongly suggest MID. Phenotypic variability may be high between family members affected by an MID. MID may be associated with an increasing atherosclerotic risk lastly resulting in coronary heart disease and death.

  14. Neuroferritinopathy: Pathophysiology, Presentation, Differential Diagnoses and Management

    PubMed Central

    Kumar, Niraj; Rizek, Philippe; Jog, Mandar

    2016-01-01

    Background Neuroferritinopathy (NF) is a rare autosomal dominant disease caused by mutations in the ferritin light chain 1 (FTL1) gene leading to abnormal excessive iron accumulation in the brain, predominantly in the basal ganglia. Methods A literature search was performed on Pubmed, for English-language articles, utilizing the terms iron metabolism, neurodegeneration with brain iron accumulation, and NF. The relevant articles were reviewed with a focus on the pathophysiology, clinical presentation, differential diagnoses, and management of NF. Results There have been nine reported mutations worldwide in the FTL1 gene in 90 patients, the most common mutation being 460InsA. Chorea and dystonia are the most common presenting symptoms in NF. There are specific features, which appear to depend upon the genetic mutation. We discuss the occurrence of specific mutations in various regions along with their associated presenting phenomenology. We have compared and contrasted the commonly occurring syndromes in the differential diagnosis of NF to guide the clinician. Discussion NF must be considered in patients presenting clinically as a progressive movement disorder with variable phenotype and imaging evidence of iron deposition within the brain, decreased serum ferritin, and negative genetic testing for other more common movement disorders such as Huntington’s disease. In the absence of a disease-specific treatment, symptomatic drug therapy for specific movement disorders may be used, although with variable success. PMID:27022507

  15. Diagnosing convective instability using VAS data

    NASA Technical Reports Server (NTRS)

    Petersen, R. A.; Uccellini, L. W.; Chesters, D.; Mostek, A.; Keyser, D.

    1983-01-01

    The utility of combining visible and various infrared images from the VAS to produce a forecasting tool, that can be available on a near real time basis, to predict severe weather development is shown. Areas where dry air in the midtroposphere overlays substantial moisture at low levels are used to diagnose mesoscale regions that have the potential for being convectively unstable before the onset of severe convection. Specifically, 6.7 micron water vapor imagery, used for isolating regions of substantial midlevel dryness, are combined with images of low level clouds or with split-window low level moisture images to delineate regions that have the potential for convective instability. In areas where scattered low level clouds are present, computer generated, color image combinations are used to isolate those warm, low level clouds that are in potential convectively unstable environments from clouds that exist under a deeply moist atmosphere. In clear regions, the split window technique is used for delineating areas of substantial boundary layer moisture. These images are again computer overlayed by the midlevel dryness to produce a color coded image of potential convective instability.

  16. Diagnosing and managing delirium in the elderly.

    PubMed Central

    Conn, D. K.; Lieff, S.

    2001-01-01

    OBJECTIVE: To outline current approaches to diagnosing and managing delirium in the elderly. QUALITY OF EVIDENCE: A literature review was based on a MEDLINE search (1966 to 1998). Selected articles were reviewed and used as the basis for discussion of diagnosis and etiology. We planned to include all published randomized controlled trials regarding management but found only two. Consequently, we also used review articles and recent practice guidelines for delirium published by the American Psychiatric Association. MAIN FINDINGS: Clinical diagnosis of delirium can be aided by using DSM-IV criteria, the Delirium Symptom Interview, or the confusion assessment method. Management must include investigation and treatment of underlying causes and general supportive measures. Providing optimal levels of stimulation, reorienting patients, education, and supporting families are important. Pharmacologic management of delirium should be considered only for specific symptoms or behaviours, e.g., aggression, severe agitation, or psychosis. Only one randomized controlled trial of tranquilizer use for delirium in medically ill people has been published. Findings support the current belief that neuroleptics are superior to benzodiazepines in most cases of delirium. Most authorities still consider haloperidol the neuroleptic of choice. Controlled trials of the new atypical neuroleptics for treating delirium are not yet available. Benzodiazepines with relatively short half-lives, such as lorazepam, are the drugs of choice for withdrawal symptoms. CONCLUSION: Delirium is frequently underdiagnosed in clinical practice. It should be suspected with acute changes in behaviour. Careful investigation of the underlying cause permits appropriate management. PMID:11212421

  17. Glanzmann's Thrombasthenia Diagnosed following Knee Arthroscopy

    PubMed Central

    Zvijac, John E.; Ammus, Sharhabil S.; Aran, Fernando; Kiebzak, Gary M.

    2015-01-01

    A 41-year-old man with an unremarkable medical history presented with a painful knee after a sports injury. He was diagnosed with a medial meniscal tear. Symptoms did not abate after 6 months of physical therapy, and he underwent arthroscopic partial medial meniscectomy. A week after beginning physical therapy he experienced a knee effusion, decreased ROM, and inability to flex his quadriceps. His knee was aspirated. Blood tests were ordered and his complete blood count, liver functions tests, and INR/PTT were normal. The patient had recurrent effusions requiring three additional joint aspirations. Ten weeks after the initial surgery, the patient underwent a second arthroscopy, during which a hematoma was removed and a synovectomy performed. The patient continued bleeding from the incisions after portals were sutured, and he was admitted to the hospital. A hematologist was consulted and comprehensive platelet aggregation testing revealed previously undiagnosed Glanzmann's thrombasthenia. The patient began treatment with platelet infusions and desmopressin and progressed to a full recovery. Clinical suspicion for surgical patients with unusual repetitive postoperative bleeding should include previously undetected rare bleeding disorders even in adults. PMID:26000186

  18. Glanzmann's Thrombasthenia Diagnosed following Knee Arthroscopy.

    PubMed

    Zvijac, John E; Ammus, Sharhabil S; Aran, Fernando; Kiebzak, Gary M

    2015-01-01

    A 41-year-old man with an unremarkable medical history presented with a painful knee after a sports injury. He was diagnosed with a medial meniscal tear. Symptoms did not abate after 6 months of physical therapy, and he underwent arthroscopic partial medial meniscectomy. A week after beginning physical therapy he experienced a knee effusion, decreased ROM, and inability to flex his quadriceps. His knee was aspirated. Blood tests were ordered and his complete blood count, liver functions tests, and INR/PTT were normal. The patient had recurrent effusions requiring three additional joint aspirations. Ten weeks after the initial surgery, the patient underwent a second arthroscopy, during which a hematoma was removed and a synovectomy performed. The patient continued bleeding from the incisions after portals were sutured, and he was admitted to the hospital. A hematologist was consulted and comprehensive platelet aggregation testing revealed previously undiagnosed Glanzmann's thrombasthenia. The patient began treatment with platelet infusions and desmopressin and progressed to a full recovery. Clinical suspicion for surgical patients with unusual repetitive postoperative bleeding should include previously undetected rare bleeding disorders even in adults.

  19. A West African Link

    ERIC Educational Resources Information Center

    Cook, Angela; Davies, Penny

    2003-01-01

    The authors visited Ghana in West Africa to strengthen a link established the previous year as part of Channel 4's "On the Line" project. The initial link established in 1999/2000 was between an all-age special school in Enfield and a similar school in Accra. Over the course of that year further partnerships were created between five UK…

  20. School-Linked Services.

    ERIC Educational Resources Information Center

    Family Resource Coalition, Chicago, IL.

    Noting that educating children requires commitment and resources from the whole community as well as the schools, this document explores school-based collaborations with social services and family programs to improve students' performance. The document first provides a rationale for school-linked programs, then describes the School-Linked Services…

  1. Synthesising topological links

    DOE PAGES

    Baas, Nils A.; Seeman, Nadrian C.; Stacey, Andrew

    2014-10-14

    In this paper, we discuss the chemical synthesis of topological links, in particular higher order links which have the Brunnian property (namely that removal of any one component unlinks the entire system). Finally, we suggest how to obtain both two dimensional and three dimensional objects (surfaces and solids, respectively) which also have this Brunnian property.

  2. False negative clinical diagnoses of malignant melanoma.

    PubMed

    Osborne, J E; Bourke, J F; Graham-Brown, R A; Hutchinson, P E

    1999-05-01

    The false negative rate for the clinical diagnosis (FNR) for malignant melanoma is reported to be of the order of 20-50%. The aim of this study was to investigate possible predictor variables for FNR, with particular reference to the features and score of the seven-point check-list within the total population (778) of histologically proved malignant melanomas presenting in Leicestershire between 1982 and 1996. The FNR was 18.5%. The check-list would have failed as a referral indication in only 0.8-1. 1% of the lesions. The major check-list features occurred more commonly than the minor features, excepting size >/= 7 mm, confirming the diagnostic importance of the major criteria. The FNR was unaffected by age or sex. More rarely involved sites had higher rates (31-42%), and the face was a particularly difficult diagnostic site. Clinical features of lesions associated with a higher FNR were lack of irregular pigmentation and shape, altered sensation, the presence of inflammation and size < 7 mm. The FNR was inversely related to the total score and major feature score, but directly related to the minor score. The minor features, in addition to the major features, are potentially valuable in avoiding false negative diagnoses and we suggest their retention as part of the check-list. There was only one patient, in whom the diagnosis of melanoma was initially missed and who was not biopsied on presentation to hospital, who re-presented after 1 year. However, the study illustrates the importance of avoiding a false negative diagnosis as there was marked delay in the excision of such lesions.

  3. Diagnosing delayed ettringite formation in concrete structures

    SciTech Connect

    Thomas, Michael Folliard, Kevin Drimalas, Thano Ramlochan, Terry

    2008-06-15

    There has been a number of cases involving deteriorated concrete structures in North America where there has been considerable controversy surrounding the respective contributions of alkali-silica reaction (ASR) and delayed ettringite formation (DEF) to the observed damage. The problem arises because the macroscopic symptoms of distress are not unequivocal and microscopical examinations of field samples often reveal evidence of both processes making it difficult to separate the individual contributions. This paper presents the results of an investigation of a number of concrete columns carrying a raised expressway in North America; prior studies had implicated both DEF and ASR as possible causes of deterioration. Although the columns were not deliberately heat-cured, it is estimated that the peak internal temperature would have exceeded 70 deg. C and perhaps even 80 deg. C, in some cases. The forensic investigation included scanning electron microscopy with energy-dispersive X-ray analysis and expansion testing of cores extracted from the structure. Small-diameter cores stored in limewater expanded significantly (0.3 to 1.3%) and on the basis of supplementary tests on laboratory-produced concrete specimens it was concluded that expansion under such conditions is caused by DEF as the conditions of the test will not sustain ASR. In at least one column, DEF was diagnosed as the sole contributory cause of damage with no evidence of any contribution from ASR or any other deterioration process. In other cases, both ASR and DEF were observed to have contributed to the apparent damage. Of the columns examined, only concrete containing fly ash appeared to be undamaged. The results of this study confirm that, under certain conditions, the process of DEF (acting in isolation of other processes) can result in significant deterioration of cast-in-place reinforced concrete structures.

  4. Incarcerated diaphragmatic hernia--differential diagnoses.

    PubMed

    Bukvić, Nado; Versić, Ana Bosak; Bacić, Giordano; Gusić, Nadomir; Nikolić, Harry; Bukvić, Frane

    2014-12-01

    The incarceration of diaphragmatic hernia is very rare. We present a case of a four-year-old girl who developed the incarceration of left-sided diaphragmatic hernia, who, until then, was completely asymptomatic. This incarceration of the hernia represented a surgical emergency presenting as obstructive ileus and a severe respiratory distress which developed from what appeared to be full health. During a brief pre-operative examination a number of differential diagnoses were suggested. Along with the laboratory blood analysis (complete blood count and acid-base balance) a plain thoracic and abdominal radiography was done (babygram). After that, through an inserted nasal-gastric tube, barium meal of the upper gastrointestinal tract was done, showing abdominal organs in the left half of the thorax and a significant shift of the mediastinum to the right. With an urgent upper medial laparotomy we accessed the abdominal cavity and made the correct diagnosis. An opening was shown in the rear part of the left hemi-diaphragm with thickened and edematous edges, approx. 6 cm in diameter with incarcerated content. The incarcerated abdominal organs (stomach, transversal colon, small intestine and spleen) gradually moved into the abdominal cavity. The opening was closed with nonresorptive sutures (TiCron) size 2-0 with aprevious control and ventilated expansion of the well-developed left lung. In postoperative course the acid-base balance quickly recovered, as well as the general state of the patient and radiography showed a good expansion and lucency of the lung parenchyma and a return of the mediastinum into the middle part of the thorax.

  5. Diagnosing Intermittent and Persistent Faults using Static Bayesian Networks

    NASA Technical Reports Server (NTRS)

    Megshoel, Ole Jakob

    2010-01-01

    Both intermittent and persistent faults may occur in a wide range of systems. We present in this paper the introduction of intermittent fault handling techniques into ProDiagnose, an algorithm that previously only handled persistent faults. We discuss novel algorithmic techniques as well as how our static Bayesian networks help diagnose, in an integrated manner, a range of intermittent and persistent faults. Through experiments with data from the ADAPT electrical power system test bed, generated as part of the Second International Diagnostic Competition (DXC-10), we show that this novel variant of ProDiagnose diagnoses intermittent faults accurately and quickly, while maintaining strong performance on persistent faults.

  6. Latest Research: Genetic Links

    MedlinePlus

    ... Current Issue Past Issues Feature: Vision Latest Research: Genetic Links Past Issues / Summer 2008 Table of Contents ... laboratories is one way the NEI is expanding genetic testing of eye diseases. Photo courtesy of National ...

  7. Genome-first approach diagnosed Cabezas syndrome via novel CUL4B mutation detection.

    PubMed

    Okamoto, Nobuhiko; Watanabe, Miki; Naruto, Takuya; Matsuda, Keiko; Kohmoto, Tomohiro; Saito, Masako; Masuda, Kiyoshi; Imoto, Issei

    2017-01-01

    Cabezas syndrome is a syndromic form of X-linked intellectual disability primarily characterized by a short stature, hypogonadism and abnormal gait, with other variable features resulting from mutations in the CUL4B gene. Here, we report a clinically undiagnosed 5-year-old male with severe intellectual disability. A genome-first approach using targeted exome sequencing identified a novel nonsense mutation [NM_003588.3:c.2698G>T, p.(Glu900*)] in the last coding exon of CUL4B, thus diagnosing this patient with Cabezas syndrome.

  8. Genome-first approach diagnosed Cabezas syndrome via novel CUL4B mutation detection

    PubMed Central

    Okamoto, Nobuhiko; Watanabe, Miki; Naruto, Takuya; Matsuda, Keiko; Kohmoto, Tomohiro; Saito, Masako; Masuda, Kiyoshi; Imoto, Issei

    2017-01-01

    Cabezas syndrome is a syndromic form of X-linked intellectual disability primarily characterized by a short stature, hypogonadism and abnormal gait, with other variable features resulting from mutations in the CUL4B gene. Here, we report a clinically undiagnosed 5-year-old male with severe intellectual disability. A genome-first approach using targeted exome sequencing identified a novel nonsense mutation [NM_003588.3:c.2698G>T, p.(Glu900*)] in the last coding exon of CUL4B, thus diagnosing this patient with Cabezas syndrome. PMID:28144446

  9. Behçet's disease diagnosed after acute HIV infection: viral replication activating underlying autoimmunity?

    PubMed

    Roscoe, Clay; Kinney, Rebecca; Gilles, Ryan; Blue, Sky

    2015-05-01

    Behçet's disease is an autoimmune systemic vasculitis that can occur after exposure to infectious agents. Behçet's disease also has been associated with HIV infection, including de novo development of this condition during chronic HIV infection and resolution of Behçet's disease symptoms following initiation of antiretroviral therapy. We describe a patient who presented with systemic vasculitis with skin and mucous membrane ulcerations in the setting of acute HIV infection, who was eventually diagnosed with Behçet's disease, demonstrating a possible link between acute HIV infection, immune activation and development of autoimmunity.

  10. A machine independent expert system for diagnosing environmentally induced spacecraft anomalies

    NASA Technical Reports Server (NTRS)

    Rolincik, Mark J.

    1991-01-01

    A new rule-based, machine independent analytical tool for diagnosing spacecraft anomalies, the EnviroNET expert system, was developed. Expert systems provide an effective method for storing knowledge, allow computers to sift through large amounts of data pinpointing significant parts, and most importantly, use heuristics in addition to algorithms which allow approximate reasoning and inference, and the ability to attack problems not rigidly defines. The EviroNET expert system knowledge base currently contains over two hundred rules, and links to databases which include past environmental data, satellite data, and previous known anomalies. The environmental causes considered are bulk charging, single event upsets (SEU), surface charging, and total radiation dose.

  11. Linked Ocean Data

    NASA Astrophysics Data System (ADS)

    Leadbetter, Adam; Arko, Robert; Chandler, Cynthia; Shepherd, Adam

    2014-05-01

    "Linked Data" is a term used in Computer Science to encapsulate a methodology for publishing data and metadata in a structured format so that links may be created and exploited between objects. Berners-Lee (2006) outlines the following four design principles of a Linked Data system: Use Uniform Resource Identifiers (URIs) as names for things. Use HyperText Transfer Protocol (HTTP) URIs so that people can look up those names. When someone looks up a URI, provide useful information, using the standards (Resource Description Framework [RDF] and the RDF query language [SPARQL]). Include links to other URIs so that they can discover more things. In 2010, Berners-Lee revisited his original design plan for Linked Data to encourage data owners along a path to "good Linked Data". This revision involved the creation of a five star rating system for Linked Data outlined below. One star: Available on the web (in any format). Two stars: Available as machine-readable structured data (e.g. An Excel spreadsheet instead of an image scan of a table). Three stars: As two stars plus the use of a non-proprietary format (e.g. Comma Separated Values instead of Excel). Four stars: As three stars plus the use of open standards from the World Wide Web Commission (W3C) (i.e. RDF and SPARQL) to identify things, so that people can point to your data and metadata. Five stars: All the above plus link your data to other people's data to provide context Here we present work building on the SeaDataNet common vocabularies served by the NERC Vocabulary Server, connecting projects such as the Rolling Deck to Repository (R2R) and the Biological and Chemical Oceanography Data Management Office (BCO-DMO) and other vocabularies such as the Marine Metadata Interoperability Ontology Register and Repository and the NASA Global Change Master Directory to create a Linked Ocean Data cloud. Publishing the vocabularies and metadata in standard RDF XML and exposing SPARQL endpoints renders them five-star Linked

  12. TBI-ROC Part Nine: Diagnosing TBI and Psychiatric Disorders

    ERIC Educational Resources Information Center

    Elias, Eileen; Weider, Katie; Mustafa, Ruman

    2011-01-01

    This article is the ninth of a multi-part series on traumatic brain injury (TBI). It focuses on the process of diagnosing TBI and psychiatric disorders. Diagnosing traumatic brain injury can be challenging. It can be difficult differentiating TBI and psychiatric symptoms, as both have similar symptoms (e.g., memory problems, emotional outbursts,…

  13. Terahertz otoscope and potential for diagnosing otitis media

    PubMed Central

    Ji, Young Bin; Moon, In-Seok; Bark, Hyeon Sang; Kim, Sang Hoon; Park, Dong Woo; Noh, Sam Kyu; Huh, Yong-Min; Suh, Jin-Seok; Oh, Seung Jae; Jeon, Tae-In

    2016-01-01

    We designed and fabricated a novel terahertz (THz) otoscope to help physicians to diagnose otitis media (OM) with both THz diagnostics and conventional optical diagnostics. We verified the potential of this tool for diagnosing OM using mouse skin tissue and a human tympanic membrane samples prior to clinical application. PMID:27446647

  14. Terahertz otoscope and potential for diagnosing otitis media.

    PubMed

    Ji, Young Bin; Moon, In-Seok; Bark, Hyeon Sang; Kim, Sang Hoon; Park, Dong Woo; Noh, Sam Kyu; Huh, Yong-Min; Suh, Jin-Seok; Oh, Seung Jae; Jeon, Tae-In

    2016-04-01

    We designed and fabricated a novel terahertz (THz) otoscope to help physicians to diagnose otitis media (OM) with both THz diagnostics and conventional optical diagnostics. We verified the potential of this tool for diagnosing OM using mouse skin tissue and a human tympanic membrane samples prior to clinical application.

  15. Bulimia nervosa patient diagnosed with previously unsuspected ADHD in adulthood: clinical case report, literature review, and diagnostic challenges.

    PubMed

    Ioannidis, Konstantinos; Serfontein, Jaco; Müller, Ulrich

    2014-05-01

    There is increasing literature suggesting a link between attention-deficit hyperactivity disorder (ADHD) and eating disorders (EDs), especially bulimia nervosa. ADHD is under-diagnosed in girls and children of high intelligence are typically missed. We identified a case of a 23-year-old woman suffering from severe bulimia nervosa and previously unsuspected ADHD in adulthood; we diagnosed and treated her with extended-release methylphenidate. We performed a literature review on the ADHD and bulimia nervosa comorbidity. We discuss the reasons why her ADHD remained undiagnosed and the difficulties in diagnosing ADHD in patients with EDs. We suggest that identifying comorbid ADHD is crucial for these patients and argue for the use of a structured interview, collateral history and investigation of onset of symptoms to establish a diagnosis of ADHD in adults with bulimia nervosa. Comorbidities and overlap of symptomatology need to be taken into account.

  16. A Fast Test to Diagnose Flu

    SciTech Connect

    Hazi, A U

    2007-02-12

    People with flu-like symptoms who seek treatment at a medical clinic or hospital often must wait several hours before being examined, possibly exposing many people to an infectious virus. If a patient appears to need more than the routine fluids-and-rest prescription, effective diagnosis requires tests that must be sent to a laboratory. Hours or days may pass before results are available to the doctor, who in the meantime must make an educated guess about the patient's illness. The lengthy diagnostic process places a heavy burden on medical laboratories and can result in improper use of antibiotics or a costly hospital stay. A faster testing method may soon be available. An assay developed by a team of Livermore scientists can diagnose influenza and other respiratory viruses in about two hours once a sample has been taken. Unlike other systems that operate this quickly, the new device, called FluIDx (and pronounced ''fluidics''), can differentiate five types of respiratory viruses, including influenza. FluIDx can analyze samples at the point of patient care--in hospital emergency departments and clinics--allowing medical providers to quickly determine how best to treat a patient, saving time and potentially thousands of dollars per patient. The FluIDx project, which is led by Livermore chemist Mary McBride of the Physics and Advanced Technologies Directorate, received funding from the National Institute of Allergy and Infectious Diseases and the Laboratory Directed Research and Development (LDRD) Program. To test the system and make it as useful as possible, the team worked closely with the Emergency Department staff at the University of California (UC) at Davis Medical Center in Sacramento. Flu kills more than 35,000 people every year in the US. The 2003 outbreak of severe acute respiratory syndrome and the ongoing concern about a possible bird flu pandemic show the need for a fast, reliable test that can differentiate seasonal flu from a potentially pandemic

  17. The benefits of a comprehensive rehabilitation program in patients diagnosed with spastic quadriplegia.

    PubMed

    Rogoveanu, O C; Tuțescu, N C; Kamal, D; Alexandru, D O; Kamal, C; Streba, C T; Trăistaru, M R

    2016-01-01

    Spastic quadriplegia has as an etiopathogenic substrate, a non-progressive brain lesion; however, the clinical manifestations of the disease evolve over time. Children diagnosed with spastic quadriplegia show a variety of symptoms in different areas: sensorimotor, emotional, cognitive, and social. The purpose of this study was to assess the functional status in patients diagnosed with spastic quadriplegia, who followed a complex medical rehabilitation program, during a year, and highlight the importance of using physical and kinetic techniques in improving their status. A total of 10 children diagnosed with spastic quadriplegia were included in the study and the Gross Motor Function Classification System (GMFCS) and manual ability classification system (MACS) were used to evaluate the functionality status of each patient. Every patient was evaluated initially (T1), after six months of program (T2), and after they completed the study. All the children were originally monitored daily, for 5 days per week for a period of one month, then two times a week for a year. A statistically significant difference regarding the modification of the GMFCS and MACS stage was found, which occurred between the first and the third evaluation. The inverse correlation of the statistical significance between the ages of patients and the decrease in GMFCS or MACS stage was highlighted; the younger the patient, the more the scale decreased. A direct link between the gross motor function and the manual ability was noticed. Applying a complex rehabilitation program has proven efficient by improving both the gross motor functionality and the manual ability.

  18. Autoimmune and other cytopenias in primary immunodeficiencies: pathomechanisms, novel differential diagnoses, and treatment

    PubMed Central

    2014-01-01

    Autoimmunity and immune dysregulation may lead to cytopenia and represent key features of many primary immunodeficiencies (PIDs). Especially when cytopenia is the initial symptom of a PID, the order and depth of diagnostic steps have to be performed in accordance with both an immunologic and a hematologic approach and will help exclude disorders such as systemic lupus erythematosus, common variable immunodeficiency, and autoimmune lymphoproliferative syndromes, hemophagocytic disorders, lymphoproliferative diseases, and novel differential diagnoses such as MonoMac syndrome (GATA2 deficiency), CD27 deficiency, lipopolysaccharide-responsive beige-like anchor (LRBA) deficiency, activated PI3KD syndrome (APDS), X-linked immunodeficiency with magnesium defect (MAGT1 deficiency), and others. Immunosuppressive treatment often needs to be initiated urgently, which impedes further relevant immunologic laboratory analyses aimed at defining the underlying PID. Awareness of potentially involved disease spectra ranging from hematologic to rheumatologic and immunologic disorders is crucial for identifying a certain proportion of PID phenotypes and genotypes among descriptive diagnoses such as autoimmune hemolytic anemia, chronic immune thrombocytopenia, Evans syndrome, severe aplastic anemia/refractory cytopenia, and others. A synopsis of pathomechanisms, novel differential diagnoses, and advances in treatment options for cytopenias in PID is provided to facilitate multidisciplinary management and to bridge different approaches. PMID:25163701

  19. The benefits of a comprehensive rehabilitation program in patients diagnosed with spastic quadriplegia

    PubMed Central

    Rogoveanu, OC; Tuțescu, NC; Kamal, D; Alexandru, DO; Kamal, C; Streba, CT; Trăistaru, MR

    2016-01-01

    Spastic quadriplegia has as an etiopathogenic substrate, a non-progressive brain lesion; however, the clinical manifestations of the disease evolve over time. Children diagnosed with spastic quadriplegia show a variety of symptoms in different areas: sensorimotor, emotional, cognitive, and social. The purpose of this study was to assess the functional status in patients diagnosed with spastic quadriplegia, who followed a complex medical rehabilitation program, during a year, and highlight the importance of using physical and kinetic techniques in improving their status. A total of 10 children diagnosed with spastic quadriplegia were included in the study and the Gross Motor Function Classification System (GMFCS) and manual ability classification system (MACS) were used to evaluate the functionality status of each patient. Every patient was evaluated initially (T1), after six months of program (T2), and after they completed the study. All the children were originally monitored daily, for 5 days per week for a period of one month, then two times a week for a year. A statistically significant difference regarding the modification of the GMFCS and MACS stage was found, which occurred between the first and the third evaluation. The inverse correlation of the statistical significance between the ages of patients and the decrease in GMFCS or MACS stage was highlighted; the younger the patient, the more the scale decreased. A direct link between the gross motor function and the manual ability was noticed. Applying a complex rehabilitation program has proven efficient by improving both the gross motor functionality and the manual ability. PMID:27974931

  20. Diagnosing ICF gamma-ray physics

    SciTech Connect

    Herrmann, Hans W; Kim, Y H; Mc Evoy, A; Young, C S; Mack, J M; Hoffman, N; Wilson, D C; Langenbrunner, J R; Evans, S; Sedillo, T; Batha, S H; Dauffy, L; Stoeffl, W; Malone, R; Kaufman, M I; Cox, B C; Tunnel, T W; Miller, E K; Rubery, M

    2010-01-01

    Gamma rays produced in an ICF environment open up a host of physics opportunities we are just beginning to explore. A branch of the DT fusion reaction, with a branching ratio on the order of 2e-5 {gamma}/n, produces 16.7 MeV {gamma}-rays. These {gamma}-rays provide a direct measure of fusion reaction rate (unlike x-rays) without being compromised by Doppler spreading (unlike neutrons). Reaction-rate history measurements, such as nuclear bang time and burn width, are fundamental quantities that will be used to optimize ignition on the National Ignition Facility (NIF). Gas Cherenkov Detectors (GCD) that convert fusion {gamma}-rays to UV/visible Cherenkov photons for collection by fast optical recording systems established their usefulness in illuminating ICF physics in several experimental campaigns at OMEGA. Demonstrated absolute timing calibrations allow bang time measurements with accuracy better than 30 ps. System impulse response better than 95 ps fwhm have been made possible by the combination of low temporal dispersion GCDs, ultra-fast microchannel-plate photomultiplier tubes (PMT), and high-bandwidth Mach Zehnder fiber optic data links and digitizers, resulting in burn width measurement accuracy better than 10ps. Inherent variable energy-thresholding capability allows use of GCDs as {gamma}-ray spectrometers to explore other interesting nuclear processes. Recent measurements of the 4.44 MeV {sup 12}C(n,n{prime}) {gamma}-rays produced as 14.1 MeV DT fusion neutrons pass through plastic capsules is paving the way for a new CH ablator areal density measurement. Insertion of various neutron target materials near target chamber center (TCC) producing secondary, neutron-induced {gamma}y-rays are being used to study other nuclear interactions and as in-situ sources to calibrate detector response and DT branching ratio. NIF Gamma Reaction History (GRH) diagnostics, based on the GCD concept, are now being developed based on optimization of sensitivity, bandwidth

  1. Psychosocial diagnoses occurring after patients present with fatigue

    PubMed Central

    MacKean, Peter Reagh; Stewart, Moira; Maddocks, Heather L.

    2016-01-01

    Abstract Objective To discover the frequency of psychosocial and other diagnoses occurring at the end of a visit when patients present to their FPs with concerns about fatigue. Design Cross-sectional study of patient-FP encounters for fatigue. Setting Ten FP practices in southwestern Ontario. Participants A total of 259 encounters involving 167 patients presenting to their FPs between March 1, 2006, and June 30, 2010, with concerns about fatigue. Main outcome measures The frequency of psychological and social diagnoses made at the end of visits, and whether diagnoses were made by FPs at the end of the visits versus whether the code for fatigue remained. The associations between patient age, sex, fatigue presenting with other symptoms, or the presence of previous chronic conditions and the outcomes was tested. Results Psychosocial diagnoses were made 23.9% of the time. Among psychosocial diagnoses made, depressive disorder and anxiety disorder or anxiety state were diagnosed more often in women (P = .048). Slightly less than 30% of the time, the cause of patients’ fatigue remained undiagnosed at the end of the encounter. A diagnosis was made more often in men. Conclusion Causes of fatigue frequently remain undiagnosed; however, when there is a diagnosis, psychosocial diagnoses are common. Therefore, it would be appropriate for FPs to screen for psychosocial issues when their patients present with fatigue, unless some other diagnosis is evident. Depression and anxiety could be considered particularly among female patients with fatigue. PMID:27521412

  2. An in situ method for diagnosing phase shifting interferometry

    NASA Astrophysics Data System (ADS)

    Shao, J.; Ma, D.; Zhang, H.; Xie, Y.

    2016-05-01

    Current diagnosing phase shifting interferometry is a time and funds consuming process. Hence a brief and effective method is necessary to satisfy the real-time testing. In this paper, mathematical solutions for errors were deduced from the difference of intensity patterns. Based on the diversity of error distributions, an effective method for distinguishing and diagnosing the error sources is proposed and verified by an elaborative designed simulation. In the actual comparison experiment, vibration, phase-shift error and intensity fluctuation were imposed to demonstrate this method. The results showed that this method can be applied into the real-time measurement and provide an in situ diagnosing technique.

  3. [Harmonization of dementia diagnoses--a necessary quality assurance].

    PubMed

    Berg, L; Gustafson, L; Hansson, G; Kilander, L; Klingén, S; Marcusson, J; Näsman, B; Passant, U; Wahlund, L O; Wallin, A

    2001-08-22

    Classification and registration of diseases is necessary in order to monitor the proliferation of diseases in a population. Despite the presence of an international framework for classification of diseases (ICD 10) which has been approved by the Swedish authorities, the guidelines provided are not observed in the area of dementia diseases. Different diagnoses can be used to describe the same condition, and "dementia unspecified" is sometimes employed when a specified diagnosis could have been used. In order to refine consensus regarding the use of different diagnoses in the dementia field, representatives for the Swedish University hospitals and medical faculties propose a unified description of a limited number of dementia diagnoses.

  4. DSM-III-R: the conflict over new psychiatric diagnoses.

    PubMed

    Kutchins, H; Kirk, S A

    1989-05-01

    The inclusion of three new diagnoses in the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-III-R) has generated much controversy. Many women's groups and mental health organizations objected to paraphilac rapism, premenstrual dysphoric disorder, and masochistic personality disorder. Findings from a national survey of social workers' attitudes about DSM indicated that the majority of respondents did not support adoption of the proposed diagnoses, although many were undecided. The conflict has reopened the debate about the manual among mental health professionals. The opinions of social work practitioners potentially can influence whether these and other controversial diagnoses are included in the upcoming DSM-IV.

  5. Intertester reliability of shoulder complaints diagnoses in primary health care

    PubMed Central

    Storheil, Benny; Klouman, Elise; Holmvik, Stian; Emaus, Nina; Fleten, Nils

    2016-01-01

    Objective Shoulder complaints are frequently encountered in general practice, but precise diagnosing is challenging. This study investigated agreement of shoulder complaints diagnoses between clinicians in a primary health care setting. Design Cross-sectional study. Setting Four primary health care clinicians used patients’ history and functional examination of the shoulder by selective tissue tension techniques (STTs), to diagnose shoulder complaints. Subjects 62 patients, aged 18–75 years. Main outcome measure Reliability of diagnoses was assessed by observed intertester agreement and Cohen’s kappa. A total of 372 diagnostic pairs were available for intertester comparisons. Results Six diagnoses were assigned by all clinicians; supraspinatus-, infraspinatus-, subscapularis-tendinopathies; chronic subacromial bursitis; glenohumeral capsulitis, and acromioclavicular joint lesion. The observed agreement on these diagnoses ranged from 0.84 for glenohumeral capsulitis to 0.97 for acromioclavicular joint lesion. Kappa scores were 0.46 (95% CI 0.33, 0.58) for chronic subacromial bursitis; 0.53 (95% CI 0.34, 0.68), 0.59 (95% CI 0.47, 0.70), and 0.68 (95% CI 0.53, 0.82) for infraspinatus -, supraspinatus -, and subscapularis-tendinopathy, respectively. For glenohumeral capsulitis and acromioclavicular lesion kappa scores were 0.66 (95% CI 0.57, 0.73) and 0.78 (95% CI 0.61, 0.90). Kappa scores were higher for individual diagnoses than for individual tests, except for limitation in passive abduction (0.70, 95% CI 0.62, 0.78) and passive lateral rotation (0.66, 95% CI 0.57, 0.73). Conclusions Although experienced clinicians showed substantial intertester agreement, precise diagnoses of shoulder complaints in primary health care remain a challenge. The present results call for further research on refined diagnoses of shoulder complaints. Key Points Based on medical history and a systematic functional examination by selective tissue tension techniques (STTs), we

  6. Helically linked mirror arrangement

    SciTech Connect

    Ranjan, P.

    1986-08-01

    A scheme is described for helical linking of mirror sections, which endeavors to combine the better features of toroidal and mirror devices by eliminating the longitudinal loss of mirror machines, having moderately high average ..beta.. and steady state operation. This scheme is aimed at a device, with closed magnetic surfaces having rotational transform for equilibrium, one or more axisymmetric straight sections for reduced radial loss, a simple geometrical axis for the links and an overall positive magnetic well depth for stability. We start by describing several other attempts at linking of mirror sections, made both in the past and the present. Then a description of our helically linked mirror scheme is given. This example has three identical straight sections connected by three sections having helical geometric axes. A theoretical analysis of the magnetic field and single-particle orbits in them leads to the conclusion that most of the passing particles would be confined in the device and they would have orbits independent of pitch angle under certain conditions. Numerical results are presented, which agree well with the theoretical results as far as passing particle orbits are concerned.

  7. Link Influence Entropy

    NASA Astrophysics Data System (ADS)

    Singh, Priti; Chakraborty, Abhishek; Manoj, B. S.

    2017-01-01

    In this paper we propose a new metric, Link Influence Entropy (LInE), which describes importance of each node based on the influence of each link present in a network. Influence of a link can neither be effectively estimated using betweenness centrality nor using degree based probability measures. The proposed LInE metric which provides an effective way to estimate the influence of a link in the network and incorporates this influence to identify nodal characteristics, performs better compared to degree based entropy. We found that LInE can differentiate various network types which degree-based or betweenness centrality based node influence metrics cannot. Our findings show that spatial wireless networks and regular grid networks, respectively, have lowest and highest LInE values. Finally, performance analysis of LInE is carried out on a real-world network as well as on a wireless mesh network testbed to study the influence of our metric as well as influence stability of nodes in dynamic networks.

  8. TWSTFT Link Calibration Report

    DTIC Science & Technology

    2015-09-01

    Serrano, G. Brunetti (2013) Relative Calibration of the Time Transfer Link between CERN and LNGS for Precise Neutrino Time of Flight Measurements. Proc...Esteban, M. Pallavicini, Va. Pettiti, C. Plantard, A. Razeto (2012) Measurement of CNGS Muon Neutrinos Speed with Borexino: INRIM and ROA Contribution

  9. Linking Literacy and Movement

    ERIC Educational Resources Information Center

    Pica, Rae

    2010-01-01

    There are many links between literacy and movement. Movement and language are both forms of communication and self-expression. Rhythm is an essential component of both language and movement. While people may think of rhythm primarily in musical terms, there is a rhythm to words and sentences as well. Individuals develop an internal rhythm when…

  10. CERES Web Links

    Atmospheric Science Data Center

    2013-03-21

        Web Links to Relevant CERES Information Relevant information about ... questions about the CERES data can be found at the following web sites: CERES Home Page CERES TRMM Home Page ... Information page  on the Atmospheric Science Data Center site CERES "ARM" Validation Experiment (CAVE) Home Page  has ...

  11. Characterizing Failure to Establish Hepatitis C Care of Baby Boomers Diagnosed in the Emergency Department

    PubMed Central

    Overton, E. Turner; Tamhane, Ashutosh R.; Forsythe, Jordan M.; Rodgers, Joel B.; Schexnayder, Julie K.; Guthrie, Deanne; Thogaripally, Suneetha; Zinski, Anne; Saag, Michael S.; Mugavero, Michael J.; Wang, Henry E.; Galbraith, James W.

    2016-01-01

    Background. Emergency departments (EDs) are high-yield sites for hepatitis C virus (HCV) screening, but data regarding linkage to care (LTC) determinants are limited. Methods. Between September 2013 and June 2014, 4371 baby boomers unaware of their HCV status presented to the University of Alabama at Birmingham ED and underwent opt-out screening. A linkage coordinator facilitated referrals for positive cases. Demographic data, International Classification of Diseases, Ninth Revision codes, and clinic visits were collected, and patients were (retrospectively) followed up until February 2015. Linkage to care was defined as an HCV clinic visit within the hospital system. Results. Overall, 332 baby boomers had reactive HCV antibody and detectable plasma ribonucleic acid. The mean age was 57.3 years (standard deviation = 4.8); 70% were male and 61% were African Americans. Substance abuse (37%) and psychiatric diagnoses (30%) were prevalent; 9% were identified with cirrhosis. During a median follow-up of 433 days (interquartile range, 354–500), 117 (35%) linked to care and 48% needed inpatient care. In multivariable analysis, the odds of LTC failure were significantly higher for white males (adjusted odds ratio [aOR], 2.57; 95% confidence interval [CI], 1.03–6.38) and uninsured individuals (aOR, 5.16; 95% CI, 1.43–18.63) and lower for patients with cirrhosis (aOR, 0.36; 95% CI, 0.14–0.92) and access to primary care (aOR, 0.20; 95% CI, 0.10–0.41). Conclusions. In this cohort of baby boomers with newly diagnosed HCV in the ED, only 1 in 3 were linked to HCV care. Although awareness of HCV diagnosis remains important, intensive strategies to improve LTC and access to curative therapy for diagnosed individuals are needed. PMID:28066793

  12. How Are Brain and Spinal Cord Tumors in Children Diagnosed?

    MedlinePlus

    ... Children Early Detection, Diagnosis, and Staging How Are Brain and Spinal Cord Tumors Diagnosed in Children? Brain ... resonance angiography (MRA) or computerized tomographic angiography (CTA). Brain or spinal cord tumor biopsy Imaging tests such ...

  13. How Do Health Care Providers Diagnose Prader-Willi Syndrome?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose Prader-Willi syndrome (PWS)? Skip sharing ... a "floppy" body and weak muscle tone, a health care provider may conduct genetic testing for Prader-Willi ...

  14. How Do Health Care Providers Diagnose Rett Syndrome?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose Rett syndrome? Skip sharing on social ... Rett syndrome may not always be present, so health care providers also need to evaluate the child's symptoms ...

  15. How Do Health Care Providers Diagnose Phenylketonuria (PKU)?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose phenylketonuria (PKU)? Skip sharing on social ... disabilities. 2 How are newborns tested for PKU? Health care providers conduct a PKU screening test using a ...

  16. How Do Health Care Providers Diagnose Birth Defects?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose birth defects? Skip sharing on social ... to begin before health problems occur. Prenatal Screening Health care providers recommend that certain pregnant women, including those ...

  17. How Do Health Care Providers Diagnose Intellectual & Developmental Disabilities (IDDs)?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose IDDs? Skip sharing on social media ... 1 This type of test will help the health care provider examine the ability of a person to ...

  18. How Do Health Care Providers Diagnose Bacterial Vaginosis (BV)?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose bacterial vaginosis (BV)? Skip sharing on ... BV requires a vaginal exam by a qualified health care provider and the laboratory testing of fluid collected ...

  19. How Do Health Care Providers Diagnose Neural Tube Defects?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose neural tube defects? Skip sharing on ... AFP, as well as high levels of acetylcholinesterase; health care providers might conduct this test to confirm high ...

  20. How Do Health Care Providers Diagnose Klinefelter Syndrome?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose Klinefelter syndrome (KS)? Skip sharing on ... karyotype (pronounced care-EE-oh-type ) test. A health care provider will take a small blood or skin ...

  1. How Do Health Care Providers Diagnose Pregnancy Loss or Miscarriage?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose pregnancy loss or miscarriage? Skip sharing ... light spotting, or bleeding, she should contact her health care provider immediately. For diagnosis, the woman may need ...

  2. ISS Update: Diagnosing Astronauts in Space From Here on Earth

    NASA Video Gallery

    NASA Public Affairs Officer Josh Byerly interviews Ed Powers, NASA Flight Surgeon, about how flight doctors work with the crew members on board, diagnosing astronauts in space from Earth and impact...

  3. [Whose borderline is it? Reconsidering diagnosing borderline personality].

    PubMed

    Gil, Tsvi E

    2008-11-01

    The present article critically discusses diagnosing borderline personality, demonstrating ideas raised with a treated case. In contrast to routine diagnoses made by psychiatrists according to common diagnosing systems (such as the American DSM or the WHO's ICD), we wonder whether this diagnosis reflects a medico-social construct, which is associated to the female status in masculine (or even patriarch) society, and probably associated even to the context of a woman diagnosed by a psychiatric system. In the context of critically viewing aetiological hypotheses to borderline personality (presented in our former article as a personality constellated around complex and prolonged trauma) in this article we suggest viewing borderline behaviours and symptoms as manifestations of coping and survival of a woman-victim in abusing surroundings.

  4. A strategy for using multiple linked markers for genetic counseling.

    PubMed Central

    Chakravarti, A; Buetow, K H

    1985-01-01

    A strategy for using multiple linked markers for genetic counseling is to test sequentially individual markers until a diagnosis can be made. We show that in order to minimize the number of tests performed per case while diagnosing all informative cases the order in which the markers are to be tested is critical. We describe an algorithm to obtain this order using the parameter "I," the frequency of informative cases. The I value for a specific locus used depends on the marker frequency, association with the disease locus, and also on the informativeness of the marker loci already tested. Realizing that a direct assay for the beta S gene already exists, and that most cases of beta-thalassemia in Mediterraneans can be directly diagnosed using synthetic oligonucleotide probes, we illustrate the above technique by examining nine DNA polymorphisms in the human beta-globin cluster for their ability to diagnose sickle-cell anemia in American blacks and beta-thalassemia in Mediterraneans. This analysis shows that 95.39% of all sickle-cell pregnancies can be diagnosed by testing a subset of only six markers chosen by our algorithm. Furthermore, six markers can also diagnose 88.03% of beta-thalassemia in Greeks and 83.56% of beta-thalassemia in Italians. The test set is different from that suggested by the individual informative frequencies due to nonrandom associations between the restriction sites. PMID:2996337

  5. Flexible Data Link

    DTIC Science & Technology

    2015-04-01

    continuously-interleaved Reed- Solomon scheme with 8% overhead has the best trade-off of performance (net coding gain) and overhead. Therefore, this is...disparity between attenuation at sea level versus at a 9150 meter altitude. As the Flexible Data Link system is an airborne asset which may operate...Quadrature Amplitude Modulation QPSK Quadrature Phase Shift Key RF Radio Frequency RS Reed- Solomon S&E Scientist & Engineers SFP Small Form-factor

  6. MHC Genes Linked to Autoimmune Disease.

    PubMed

    Deitiker, Philip; Atassi, M Zouhair

    2015-01-01

    Autoimmune diseases (ADs), or autoinflammatoiy diseases, are growing in complexity as diagnoses improve and many factors escalate disease risk. Considerable genetic similarity is found among ADs, and they are frequently associated with major histocompatibility complex (MHC) genes. However, a given disease may be associated with more than one human leukocyte antigen (HLA) allotype, and a given HLA may be associated with more than one AD. The associations of non-MHC genes with AD present an additional problem, and the situation is further complicated by the role that other factors, such as age, diet, therapeutic drugs, and regional influences, play in disease. This review discusses some of the genetics and biochemistry of HLA-linked AD and inflammation, covering some of the best-studied examples and summarizing indicators for class I- and II-mediated disease. However, the scope of this review limits a detailed discussion of all known ADs.

  7. Shoulder diagnoses in secondary care, a one year cohort

    PubMed Central

    2014-01-01

    Background Shoulder pain is common in the general population. Reports on specific diagnoses in general populations are scarce and only from primary care. The diagnostic distribution of shoulder disorders in secondary care is not reported. Most of the clinical research in the shoulder field is done in hospital settings. The aim of this study was to identify the diagnoses in a 1-year cohort in a hospital-based outpatient clinic using standardized diagnostic criteria and to compare the results with previous studies. Methods A diagnostic routine was conducted among patients referred to our physical medicine outpatient clinic at Oslo University Hospital. Diagnostic criteria were derived from the literature and supplemented with research criteria. Results Of 766 patients diagnosed, 55% were women and the mean age was 49 years (range 19–93, SD ± 14). The most common diagnoses were subacromial pain (36%), myalgia (17%) and adhesive capsulitis (11%). Subacromial pain and adhesive capsulitis were most frequent in persons aged 40–60 years. Shoulder myalgia was most frequent in age groups under 40. Labral tears and instability problems (8%) were most frequent in young patients and not present after age 50. Full-thickness rotator cuff tears (8%) and glenohumeral osteoarthritis (4%) were more prevalent after the age of 60. Few differences were observed between sexes. We identified three studies reporting shoulder diagnoses in primary care. Conclusion Subacromial pain syndrome, myalgia and adhesive capsulitis were the most prevalent diagnoses in our study. However, large differences in prevalence between different studies were found, most likely arising from different use of diagnostic criteria and a difference in populations between primary and secondary care. Of the diagnoses in our cohort, 20% were not reported by the studies from primary care (glenohumeral osteoarthritis, full thickness rotator cuff tears, labral tears and instabilities). PMID:24642168

  8. Predictors of Linkage to Care for Newly Diagnosed HIV-Positive Adults

    PubMed Central

    Aaron, Erika; Alvare, Tyler; Gracely, Ed J.; Riviello, Ralph; Althoff, Amy

    2015-01-01

    Introduction Linkage to care following a human immunodeficiency virus (HIV) diagnosis is critical. In the U.S. only 69% of patients are successfully linked to care, which results in delayed receipt of antiretroviral therapy leading to immune system dysfunction and risk of transmission to others. Methods We evaluated predictors of failure to link to care at a large urban healthcare center in Philadelphia in order to identify potential intervention targets. We conducted a cohort study between May 2007 and November 2011 at hospital-affiliated outpatient clinics, emergency departments (EDs), and inpatient units. Results Of 87 patients with a new HIV diagnosis, 63 (72%) were linked to care: 23 (96%) from the outpatient setting and 40 (63%) from the hospital setting (ED or inpatient) (p<0.01). Those who were tested in the hospital-based settings were more likely to be black (p=0.01), homeless (p=0.03), and use alcohol or drugs (p=0.03) than those tested in the outpatient clinics. Patients tested in the ED or inpatient units had a 10.9 fold (p=0.03) higher odds of failure to link compared to those diagnosed in an outpatient clinic. When testing site was controlled, unemployment (OR 12.2;p<0.01) and substance use (OR 6.4;p<0.01) were associated with failure to link. Conclusion Our findings demonstrate the comparative success of linkage to care in outpatient medical clinics versus hospital-based settings. This study both reinforces the importance of routine opt-out HIV testing in outpatient practices, and demonstrates the need to better understand barriers to linkage. PMID:26265965

  9. EEE Links. Volume 5

    NASA Technical Reports Server (NTRS)

    Humphrey, Robert (Editor)

    1999-01-01

    The EEE Links Newsletter is a quarterly publication produced by Code 562 in support of the NASA HQ funded NASA Electronic Parts and Packaging (NEPP) Program. The newsletter is produced as an electronic format deliverable made available via the referenced www site administered by Code 562, The newsletter publishes brief articles on topics of interest to NASA programs and projects in the area of electronic parts and packaging. The newsletter does not provide information pertaining to patented or proprietary information. The information provided is at the level of that produced by industry and university researchers and is published at national and international conferences.

  10. Physicians' diagnoses compared with algorithmic differentiation of causes of jaundice.

    PubMed

    Boom, R; Chavez-Oest, J; Gonzalez, C; Cantu, M A; Rivero, F; Reyes, A; Aguilar, E; Santamaria, J

    1988-01-01

    Clinical data were collected in 194 cases of jaundiced patients treated at the "Adolfo Lopez Mateos" ISSSTE Hospital in Mexico City from July 1985 to July 1986. A copy of the clinical history of each patient was given to each of four physicians--one recently graduated from medical school, another in his first year of gastroenterology, and two others who were experienced gastroenterologists. The same clinical data were processed by a computer set up to use a modified Danish COMIC algorithm. All physicians and the computer technician were blinded to the "gold standard" pathologic diagnoses, with which their diagnoses were compared. Accuracy rates of the physicians in distinguishing intrahepatic (medical) from extrahepatic (surgical) jaundice were 78%, 86%, 86%, and 91%, and the accuracy of computer-assisted diagnoses was 96%. Chi-squared analysis of the diagnoses of three of the physicians and those of the computer showed significant differences (p between 0.1 and 0.01). For the diagnoses of the remaining physician, however, no significant difference was found after chi-squared continuity correction.

  11. Accurate Completion of Medical Report on Diagnosing Death.

    PubMed

    Savić, Slobodan; Alempijević, Djordje; Andjelić, Sladjana

    2015-01-01

    Diagnosing death and issuing a Death Diagnosing Form (DDF) represents an activity that carries a great deal of public responsibility for medical professionals of the Emergency Medical Services (EMS) and is perpetually exposed to the control of the general public. Diagnosing death is necessary so as to confirm true, to exclude apparent death and consequentially to avoid burying a person alive, i.e. apparently dead. These expert-methodological guidelines based on the most up-to-date and medically based evidence have the goal of helping the physicians of the EMS in accurately filling out a medical report on diagnosing death. If the outcome of applied cardiopulmonary resuscitation measures is negative or when the person is found dead, the physician is under obligation to diagnose death and correctly fill out the DDF. It is also recommended to perform electrocardiography (EKG) and record asystole in at least two leads. In the process of diagnostics and treatment, it is a moral obligation of each Belgrade EMS physician to apply all available achievements and knowledge of modern medicine acquired from extensive international studies, which have been indeed the major theoretical basis for the creation of these expert-methodological guidelines. Those acting differently do so in accordance with their conscience and risk professional, and even criminal sanctions.

  12. Teaching Chinese psychiatrists to make reliable dissociative disorder diagnoses.

    PubMed

    Fan, Qing; Yu, Junhan; Ross, Colin A; Keyes, Benjamin B; Dai, Yunfei; Zhang, Tianhong; Wang, Lanlan; Xiao, Zeping

    2011-09-01

    The aim of the study was to assess the outcome of an educational effort by two North American experts in dissociative disorders to teach Chinese psychiatrists to make reliable dissociative disorder diagnoses. In the final phase of the educational effort, 569 patients at Shanghai Mental Health Center completed the Chinese version of the Dissociative Experiences Scale (DES). Patients were then randomly selected in different proportions according to their DES scores: 96 selected patients were then assessed with the Dissociative Disorders Interview Schedule (DDIS) and clinical diagnostic interviews based on DSM-IV criteria. According to the clinical diagnostic interviews, 28 (4.9%) patients were diagnosed as having dissociative disorders. Agreement between the American experts and Chinese psychiatrists for presence or absence of a dissociative disorder was 0.75 using Cohen's kappa. Dissociative disorders can be diagnosed in China with good inter-rater reliability. The authors describe the steps taken to achieve this outcome.

  13. Drugs + HIV, Learn the Link

    MedlinePlus Videos and Cool Tools

    ... the Link - Drugs and HIV Learn the Link - Drugs and HIV Email Facebook Twitter 2005 –Ongoing Behaviors ... GA: CDC, DHHS. Retrieved June 2012 How are Drug Abuse and HIV Related? Drug abuse and addiction ...

  14. Leptomeningeal metastasis from gynecologic cancers diagnosed by brain MRI.

    PubMed

    Toyoshima, Masafumi; Tsuji, Keita; Shigeta, Shogo; Tokunaga, Hideki; Ito, Kiyoshi; Watanabe, Yoh; Yoshinaga, Kosuke; Otsuki, Takeo; Niikura, Hitoshi; Yaegashi, Nobuo

    Leptomeningeal metastasis (LM) is rarely observed in gynecologic cancers. As gadolinium-enhanced magnetic resonance imaging (Gd-MRI) is highly effective for diagnosing LM, the aim of this study is to describe the clinical behaviors and outcomes of LM patients who were diagnosed by Gd-MRI. After securing institutional review board approvals, we retrospectively reviewed patient records. Eight patients were found to have LM from gynecological malignancies. Primary tumors included three ovarian cancers, one tubal cancer, one peritoneal cancer, two endometrial cancers, and one cervical cancer. Gd-MRI of the brain and the spine is indicated as the high-priority inspection for the diagnosis of this devastating complication.

  15. A study on diagnosability of space station ECLSS

    NASA Technical Reports Server (NTRS)

    Padalkar, S.; Blokland, W.; Sztipanovits, J.

    1990-01-01

    The use is demonstrated of the Multigraph Architecture (MGA) for studies on the Environment Control and Life Support System (ECLSS). The objective was the following: (1) to create an updated set of models of the Potable Water Subsystem (PWS) by using the graphical model building tools of the Multigraph Programming Environment (MPE); (2) to derive a real time alarm simulator from the models; and (3) to demonstrate the effects of sensor allocation on the diagnosability of the PWS. This work may serve as a preliminary study for the detailed analysis of the sensor allocation and diagnosability problems in the ECLSS.

  16. HIV Trends in the United States: Diagnoses and Estimated Incidence

    PubMed Central

    Song, Ruiguang; Tang, Tian; An, Qian; Prejean, Joseph; Dietz, Patricia; Hernandez, Angela L; Green, Timothy; Harris, Norma; McCray, Eugene; Mermin, Jonathan

    2017-01-01

    Background The best indicator of the impact of human immunodeficiency virus (HIV) prevention programs is the incidence of infection; however, HIV is a chronic infection and HIV diagnoses may include infections that occurred years before diagnosis. Alternative methods to estimate incidence use diagnoses, stage of disease, and laboratory assays of infection recency. Using a consistent, accurate method would allow for timely interpretation of HIV trends. Objective The objective of our study was to assess the recent progress toward reducing HIV infections in the United States overall and among selected population segments with available incidence estimation methods. Methods Data on cases of HIV infection reported to national surveillance for 2008-2013 were used to compare trends in HIV diagnoses, unadjusted and adjusted for reporting delay, and model-based incidence for the US population aged ≥13 years. Incidence was estimated using a biomarker for recency of infection (stratified extrapolation approach) and 2 back-calculation models (CD4 and Bayesian hierarchical models). HIV testing trends were determined from behavioral surveys for persons aged ≥18 years. Analyses were stratified by sex, race or ethnicity (black, Hispanic or Latino, and white), and transmission category (men who have sex with men, MSM). Results On average, HIV diagnoses decreased 4.0% per year from 48,309 in 2008 to 39,270 in 2013 (P<.001). Adjusting for reporting delays, diagnoses decreased 3.1% per year (P<.001). The CD4 model estimated an annual decrease in incidence of 4.6% (P<.001) and the Bayesian hierarchical model 2.6% (P<.001); the stratified extrapolation approach estimated a stable incidence. During these years, overall, the percentage of persons who ever had received an HIV test or had had a test within the past year remained stable; among MSM testing increased. For women, all 3 incidence models corroborated the decreasing trend in HIV diagnoses, and HIV diagnoses and 2 incidence

  17. [Organisation of diagnosing patients with unspecific cancer symptoms].

    PubMed

    Fredberg, Ulrich; Vedsted, Peter

    2011-06-13

    Danish cancer patients have more advanced cancer at the time of diagnosis than cancer patients in other Scandinavian countries, probably because of a delay in the diagnosis. Only 50% of the cancer patients have specific cancer symptoms when they initially contact their doctor. In Central Region, Denmark, a specific diagnosing program for patients with suspected serious disease that could be cancer without organ specific symptoms has been established at the Diagnostic Centre in Silkeborg. The diagnosing is planned as a parallel course instead of a serial course. A very close co-operation with all internal medical specialties, radiology, clinical biochemistry and gynecology is necessary.

  18. Predicting missing links and identifying spurious links via likelihood analysis

    PubMed Central

    Pan, Liming; Zhou, Tao; Lü, Linyuan; Hu, Chin-Kun

    2016-01-01

    Real network data is often incomplete and noisy, where link prediction algorithms and spurious link identification algorithms can be applied. Thus far, it lacks a general method to transform network organizing mechanisms to link prediction algorithms. Here we use an algorithmic framework where a network’s probability is calculated according to a predefined structural Hamiltonian that takes into account the network organizing principles, and a non-observed link is scored by the conditional probability of adding the link to the observed network. Extensive numerical simulations show that the proposed algorithm has remarkably higher accuracy than the state-of-the-art methods in uncovering missing links and identifying spurious links in many complex biological and social networks. Such method also finds applications in exploring the underlying network evolutionary mechanisms. PMID:26961965

  19. Link Analysis for Space Communication Links Using ARQ Protocol

    NASA Technical Reports Server (NTRS)

    Cheung, Kar-Ming; Lau, Chi-Wung; Lee, Charles

    2014-01-01

    In space communications, standard link analysis assumes that messages are sent once. For a communication link that uses an error-correction coding scheme, bit-error-rate (BER) or frame-error-rate (FER), and link margins are common metrics that characterize the quality of a link, and they are used to determine the supportable data rate. With the advent of Automatic Repeat-reQuest (ARQ) protocols, when messages are corrupted during transmission, they can be resent multiple times automatically until they are correctly received and acknowledged. The concept of BER, FER, and link margin cannot be directly applied, and the link analysis approach for ARQ links needs to be re-examined.

  20. Predicting missing links and identifying spurious links via likelihood analysis.

    PubMed

    Pan, Liming; Zhou, Tao; Lü, Linyuan; Hu, Chin-Kun

    2016-03-10

    Real network data is often incomplete and noisy, where link prediction algorithms and spurious link identification algorithms can be applied. Thus far, it lacks a general method to transform network organizing mechanisms to link prediction algorithms. Here we use an algorithmic framework where a network's probability is calculated according to a predefined structural Hamiltonian that takes into account the network organizing principles, and a non-observed link is scored by the conditional probability of adding the link to the observed network. Extensive numerical simulations show that the proposed algorithm has remarkably higher accuracy than the state-of-the-art methods in uncovering missing links and identifying spurious links in many complex biological and social networks. Such method also finds applications in exploring the underlying network evolutionary mechanisms.

  1. Multilevel DC link inverter

    DOEpatents

    Su, Gui-Jia

    2003-06-10

    A multilevel DC link inverter and method for improving torque response and current regulation in permanent magnet motors and switched reluctance motors having a low inductance includes a plurality of voltage controlled cells connected in series for applying a resulting dc voltage comprised of one or more incremental dc voltages. The cells are provided with switches for increasing the resulting applied dc voltage as speed and back EMF increase, while limiting the voltage that is applied to the commutation switches to perform PWM or dc voltage stepping functions, so as to limit current ripple in the stator windings below an acceptable level, typically 5%. Several embodiments are disclosed including inverters using IGBT's, inverters using thyristors. All of the inverters are operable in both motoring and regenerating modes.

  2. HIV Care Outcomes Among Blacks with Diagnosed HIV - United States, 2014.

    PubMed

    Dailey, Andre F; Johnson, Anna Satcher; Wu, Baohua

    2017-02-03

    Since the release of the National HIV/AIDS Strategy (NHAS) (1) and the establishment of the federal Human Immunodeficiency Virus (HIV) Care Continuum Initiative (2), federal efforts have accelerated to improve and increase HIV testing, care, and treatment and to reduce HIV-related disparities in the United States. National HIV Surveillance System (NHSS)* data are used to monitor progress toward reaching NHAS goals,(†) and recent data indicate that blacks have lower levels of care and viral suppression than do persons of other racial and ethnic groups (3). Among persons with HIV infection diagnosed through 2012 who were alive at year-end 2013, 68.1% of blacks received any HIV medical care compared with 74.4% of whites (3). CDC used NHSS data to describe HIV care outcomes among blacks who received a diagnosis of HIV. Among blacks with HIV infection diagnosed in 2014, 21.9% had infection classified as HIV stage 3 (acquired immunodeficiency syndrome [AIDS]) at the time of diagnosis compared with 22.5% of whites; 71.6% of blacks were linked to care within 1 month after diagnosis compared with 79.0% of whites. Among blacks with HIV infection diagnosed through 2012 who were alive on December 31, 2013, 53.5% were receiving continuous HIV medical care compared with 58.2% of whites; 48.5% of blacks achieved viral suppression compared with 62.0% of whites. Intensified efforts and implementation of effective interventions and public health strategies that increase engagement in care and viral suppression among blacks (1,4) are needed to achieve NHAS goals.

  3. Mining Association Rules for Neurobehavioral and Motor Disorders in Children Diagnosed with Cerebral Palsy

    PubMed Central

    Cheng, Chihwen; Burns, T.G; Wang, May D.

    2016-01-01

    Children diagnosed with cerebral palsy (CP) appear to be at high risk for developing neurobehavioral and motor disorders. The most common disorders for these children are impaired visual-perception skills and motor planning. Besides, they often have impaired executive functions, which can contribute to problematic emotional adjustment such as depression. Additionally, literature suggests that the tendency to develop these cognitive impairments and emotional abnormalities in pediatric CP is influenced by age and IQ. Because there are many other medical co-morbidities that can occur with CP (e.g., seizures and shunt placement), prediction of what percentages of patients will incur cognitive impairment and emotional abnormality is a difficult task. The purpose of this study was to investigate the associations between possible factors mentioned above, and neurobehavioral and motor disorders from a clinical database of pediatric subjects diagnosed with CP. The study resulted in 22 rules that can predict negative outcomes. These rules reinforced the growing body of literature supporting a link between CP, executive dysfunction, and subsequent neurobehavioral problems. The antecedents and consequents of some association rules were single factors, while other statistical associations were interactions of factor combinations. Further research is needed to include children’s comprehensive treatment and medication history in order to determine additional impacts on their neurobehavioral and motor disorders.

  4. Chromosome 1 abnormalities in elderly patients with newly diagnosed multiple myeloma treated with novel therapies

    PubMed Central

    Caltagirone, Simona; Ruggeri, Marina; Aschero, Simona; Gilestro, Milena; Oddolo, Daniela; Gay, Francesca; Bringhen, Sara; Musolino, Caterina; Baldini, Luca; Musto, Pellegrino; Petrucci, Maria T.; Gaidano, Gianluca; Passera, Roberto; Bruno, Benedetto; Palumbo, Antonio; Boccadoro, Mario; Omedè, Paola

    2014-01-01

    Multiple myeloma is a plasma cell disorder characterized by malignant plasma cell infiltration in the bone marrow, serum and/or urine monoclonal protein and organ damage. The aim of this study was to investigate the impact of chromosome 1 abnormalities in a group of elderly patients (>65 years) with newly diagnosed multiple myeloma enrolled in the GIMEMA-MM-03-05 trial and treated with bortezomib, melphalan and prednisone or bortezomib, melphalan, prednisone and thalidomide followed by bortezomib and thalidomide maintenance. We also evaluated the link between chromosome 1 abnormalities and other clinical, genetic and immunophenotypic features by a multivariate logistic regression model. Interphase fluorescence in situ hybridization on immunomagnetically purified plasma cells and bone marrow multiparameter flow cytometry were employed. A multivariate Cox model showed that chromosome 1 abnormalities, age >75 years and a CD19+/CD117− immunophenotype of bone marrow plasma cells were independent risk factors for overall survival in elderly patients with newly diagnosed multiple myeloma. Moreover, a detrimental effect of thalidomide, even when administered in association with bortezomib, was observed in patients with abnormal chromosome 1 as well as in those with 17p deletion, while the benefit of adding thalidomide to the bortezomib-melphalan-prednisone regimen was noted in patients carrying an aggressive CD19+/CD117− bone marrow plasma cell immunophenotype. This trial was registered at www.clinicaltri-als.gov as #NCT01063179. PMID:25015938

  5. Identification of Legionella from clinically diagnosed pneumonia patients and environmental samples.

    PubMed

    Jahan, R; Tarafder, S; Saleh, A A; Miah, M R A

    2015-04-01

    Legionnaires' disease is a multisystem disease with life-threatening acute and severe form of pneumonia which is responsible for 2-9% pneumonia with high mortality. Eighty six respiratory tract samples and urine were collected from clinically diagnosed pneumonia patients and 12 water samples were collected from different environment. Identification of Legionella was done by culture and Polymerase Chain Reaction (PCR) of respiratory tract samples and environmental samples and Legionella Antigen (Ag) in urine was detected by Immunochromatographic test (ICT). Legionella was identified from 4 (4.65%) clinically diagnosed pneumonia patients of which 1(1.16%) case was culture positive, 1(1.16%) case was urine ICT positive and PCR was positive in all four cases. Of the 12 water samples tested, 4 (33.33%) samples were Legionella positive by PCR but culture results of these samples were negative. Identification of Legionella should be done by PCR in parallel with culture and urine ICT. Detection of Legionella in environmental samples is also needed to explore possible links between the water sources and disease transmission in population.

  6. Changes in profile of lipids and adipokines in patients with newly diagnosed hypothyroidism and hyperthyroidism

    PubMed Central

    Chen, Yanyan; Wu, Xiafang; Wu, Ruirui; Sun, Xiance; Yang, Boyi; Wang, Yi; Xu, Yuanyuan

    2016-01-01

    Changes in profile of lipids and adipokines have been reported in patients with thyroid dysfunction. But the evidence is controversial. The present study aimed to explore the relationships between thyroid function and the profile of lipids and adipokines. A cross-sectional study was conducted in 197 newly diagnosed hypothyroid patients, 230 newly diagnosed hyperthyroid patients and 355 control subjects. Hypothyroid patients presented with significantly higher serum levels of total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDLC), fasting insulin, resistin and leptin than control (p < 0.05). Hyperthyroid patients presented with significantly lower serum levels of high-density lipoprotein cholesterol, LDLC and leptin, as well as higher levels of fasting insulin, resistin, adiponectin and homeostasis model insulin resistance index (HOMA-IR) than control (p < 0.05). Nonlinear regression and multivariable linear regression models all showed significant associations of resistin or adiponectin with free thyroxine and association of leptin with thyroid-stimulating hormone (p < 0.001). Furthermore, significant correlation between resistin and HOMA-IR was observed in the patients (p < 0.001). Thus, thyroid dysfunction affects the profile of lipids and adipokines. Resistin may serve as a link between thyroid dysfunction and insulin resistance. PMID:27193069

  7. How Do Childhood Diagnoses of Type 1 Diabetes Cluster in Time?

    PubMed Central

    Muirhead, Colin R.; Cheetham, Timothy D.; Court, Simon; Begon, Michael; McNally, Richard J. Q.

    2013-01-01

    Background Previous studies have indicated that type 1 diabetes may have an infectious origin. The presence of temporal clustering—an irregular temporal distribution of cases—would provide additional evidence that occurrence may be linked with an agent that displays epidemicity. We tested for the presence and form of temporal clustering using population-based data from northeast England. Materials and Methods The study analysed data on children aged 0–14 years diagnosed with type 1 diabetes during the period 1990–2007 and resident in a defined geographical region of northeast England (Northumberland, Newcastle upon Tyne, and North Tyneside). Tests for temporal clustering by time of diagnosis were applied using a modified version of the Potthoff-Whittinghill method. Results The study analysed 468 cases of children diagnosed with type 1 diabetes. There was highly statistically significant evidence of temporal clustering over periods of a few months and over longer time intervals (p<0.001). The clustering within years did not show a consistent seasonal pattern. Conclusions The study adds to the growing body of literature that supports the involvement of infectious agents in the aetiology of type 1 diabetes in children. Specifically it suggests that the precipitating agent or agents involved might be an infection that occurs in “mini-epidemics”. PMID:23573261

  8. The role of bile carcinoembryonic antigen in diagnosing bile duct cancer.

    PubMed Central

    Joo, Kwang Ro; Kim, Do Ha; Park, Jong Ho; Bang, Sung-Jo; Shin, Jung Woo; Park, Neung Hwa; Park, Jae Hoo

    2003-01-01

    It is known that the fluids bathing tumors might contain a higher level of the carcinoembryonic antigen (CEA) than those found in the blood. Therefore, we evaluated the role of bile CEA in diagnosing bile duct cancer. One hundred and thirty two patients were prospectively studied. The patients were divided into 3 groups: the bile duct cancer (n=32), pancreatic cancer (n=16), and benign biliary diseases (n=84) groups. Bile samples were obtained on the next day of the biliary drainage procedures. The mean bile CEA level in those with bile duct cancer (120.6 +/- 156.9 ng/mL) was significantly higher than those with pancreatic cancer and benign biliary diseases (32.0 +/- 28.5 ng/mL, 29.3 +/- 56.3 ng/mL). Using the level of 20 ng/mL, the sensitivity and specificity of bile CEA in the diagnosis of bile duct cancer from benign biliary diseases were 65.6% and 66.7%, respectively. Both the bile CEA and total bilirubin level were found to be an independent factor linked to bile duct cancer. This study result suggests that bile CEA level is a useful supplementary test for diagnosing bile duct cancer. PMID:14676443

  9. Delirium in intensive care: an under-diagnosed reality

    PubMed Central

    Faria, Rita da Silva Baptista; Moreno, Rui Paulo

    2013-01-01

    Delirium occurs in up to 80% of patients admitted to intensive care units. Although under-diagnosed, delirium is associated with a significant increase in morbidity and mortality in critical patients. Here, we review the main risk factors, clinical manifestations and preventative and therapeutic approaches (pharmacological and non-pharmacological) for this illness. PMID:23917979

  10. A Testing System for Diagnosing Misconceptions in DC Electric Circuits.

    ERIC Educational Resources Information Center

    Chang, Kuo-En; Liu, Sei-Hua; Chen, Sei-Wang

    1998-01-01

    Outlines a test-based diagnosis system for misconceptions in DC electric circuits and its three parts: problem library, problem selector and diagnoser. Discusses misconception discrimination and diagnosis theories, and reports the system supports satisfactory diagnosis. Includes an analysis of nine student misconceptions about electrical circuits…

  11. Psychosocial and Moral Development of PTSD-Diagnosed Combat Veterans

    ERIC Educational Resources Information Center

    Taylor, John G.; Baker, Stanley B.

    2007-01-01

    Two related studies were conducted in order to investigate whether psychosocial and moral development appeared to have been disrupted and arrested in veterans diagnosed as having posttraumatic stress disorder (PTSD). Study 1 was devoted to developing a measure of late adolescence, early adulthood, and adulthood stages of psychosocial…

  12. MR neurography in diagnosing nondiabetic lumbosacral radiculoplexus neuropathy.

    PubMed

    Filosto, Massimiliano; Pari, Elisa; Cotelli, Mariasofia; Todeschini, Alice; Vielmi, Valentina; Rinaldi, Fabrizio; Padovani, Alessandro; Gasparotti, Roberto

    2013-10-01

    Here we describe the imaging findings in a 73-year-old woman who had pain in the right inguinal region, followed by progressive weakness of muscles innervated by the right femoral and obturator nerves, diagnosed as nondiabetic lumbosacral radiculoplexus neuropathy. Magnetic resonance neurography showed thickening and increase in signal intensity of the right femoral and obturator nerves.

  13. Is one diagnosis the whole story? patients with double diagnoses.

    PubMed

    Kurolap, Alina; Orenstein, Naama; Kedar, Inbal; Weisz Hubshman, Monika; Tiosano, Dov; Mory, Adi; Levi, Zohar; Marom, Daphna; Cohen, Lior; Ekhilevich, Nina; Douglas, Jessica; Nowak, Catherine Bearce; Tan, Wen-Hann; Baris, Hagit N

    2016-09-01

    One of the goals of evaluating a patient in the genetics clinic is to find the diagnosis that would explain his or her clinical presentation. Sometimes the patient's diagnosis remains undefined or does not explain all of the clinical findings. As clinicians are often guided by a "single disorder" paradigm, diagnosing multiple genetic conditions in the same patient requires a heightened sense of awareness. Over the last few years, we evaluated several patients (n = 14) who were found to have more than one genetic diagnosis. In this paper, we will describe their natural history and diagnoses, and draw on the lessons learned from this phenomenon, which we expect to grow in this era of next-generation diagnostic technologies. To our knowledge, this is by far the largest series of patients with double diagnoses. Based on our findings, we strongly recommend that physicians question every diagnosis to determine whether it indeed explains all of the patients' symptoms, and consider whether they should continue the diagnostic evaluation to look for a more accurate and complete set of diagnoses. © 2016 Wiley Periodicals, Inc.

  14. Hereditary spherocytosis diagnosed with the eosin-5'-maleimide binding test.

    PubMed

    Watanabe, Toru; Ono, Hiroyuki; Tajima, Iwao; Ishigaki, Hidetoshi; Hakamata, Akio; Shirai, Masami; Endoh, Akira; Hongo, Teruaki

    2014-06-01

    We describe three cases of hereditary spherocytosis (HS) diagnosed using the eosin-5'-maleimide (EMA) binding test and discuss the relevance of the EMA binding test. In Japan, this test is not widely used because the prevalence of HS is low. This test is a valuable screening test for the diagnosis of HS.

  15. Increased gluconeogenesis in youth with newly diagnosed type 2 diabetes

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The role of increased gluconeogenesis as an important contributor to fasting hyperglycaemia at diabetes onset is not known. We evaluated the contribution of gluconeogenesis and glycogenolysis to fasting hyperglycaemia in newly diagnosed youths with type 2 diabetes following an overnight fast. Basal ...

  16. Drugs, Dialogue, or Diet: Diagnosing and Treating the Hyperactive Child.

    ERIC Educational Resources Information Center

    Johnson, Harriette C.

    1988-01-01

    Clarifies issues related to medication, neurological examination, significance of soft signs, allergy and diet, and interpersonal therapies of diagnosing and treating attention deficit and hyperactivity in children. Reviews current research that offers guidelines to social work practice with these children. (Author/ABL)

  17. Disseminated mucormycosis in an adolescent with newly diagnosed diabetes mellitus.

    PubMed

    McCrory, Michael C; Moore, Blake A; Nakagawa, Thomas A; Givner, Laurence B; Jason, Donald R; Palavecino, Elizabeth L; Ajizian, Samuel J

    2014-10-01

    We report a 16-year-old, previously healthy female who presented with disseminated mucormycosis leading to multiorgan failure and death with newly diagnosed type 1 diabetes mellitus and ketoacidosis. We review previous reported cases of mucormycosis in children with diabetes to demonstrate that this uncommon invasive infection may cause significant morbidity and mortality in this population.

  18. Nursing diagnoses in patients with immune-bullous dermatosis 1

    PubMed Central

    Brandão, Euzeli da Silva; dos Santos, Iraci; Lanzillotti, Regina Serrão; Ferreira, Adriano Menis; Gamba, Mônica Antar; Azulay-Abulafia, Luna

    2016-01-01

    ABSTRACT Objective: identify nursing diagnoses in patients with immune-bullous dermatosis. Method: a quantitative and descriptive research, carried out in three institutions located in Rio de Janeiro and Mato Grosso do Sul, Brazil, using the Client Assessment Protocol in Dermatology during a nursing consultation. Simple descriptive statistics was used for data analysis. Results: 14 subjects participated in the study, nine with a diagnosis of pemphigus vulgaris, pemphigus two and three of bullous pemphigoid. The age ranged between 27 and 82 years, predominantly females (11). 14 nursing diagnoses were discussed and identified from a clinical rationale in all study participants, representing the most common human responses in this sample. The application of the Assessment Protocol in Dermatology facilitated the comprehensive assessment, in addition to providing the identification of diagnostics according to the North American Nursing Diagnosis Association International. Conclusion: the nursing diagnoses presented confirm the necessity of interdisciplinary work during the care for this clientele. For better description of the phenomena related to the client in question, it is suggested the inclusion of two risk factors related in three diagnoses of this taxonomy. It is worth noting the contribution of the findings for the care, education and research in nursing in dermatology. PMID:27533274

  19. Diagnosing Inequalities in Schooling: Ogbu's Orientation and Wider Implications

    ERIC Educational Resources Information Center

    Kalekin-Fishman, Devorah

    2004-01-01

    Throughout his life, John Ogbu worked untiringly to diagnose the educational problems of minorities, with the goal of remedying them. Although his earliest works propose a comprehensive anthropological approach, his last works seem to settle into exhortations to parents and teachers to put more pressure on (involuntary) minority children whose…

  20. Death Concerns among Individuals Newly Diagnosed with Lung Cancer

    ERIC Educational Resources Information Center

    Lehto, Rebecca; Therrien, Barbara

    2010-01-01

    Confronting the reality of death is an important challenge for individuals facing life-threatening illness such as lung cancer, the leading cause of cancer death. Few studies, however, document the nature of death-related concerns in individuals newly diagnosed with lung cancer. The aims of this exploratory study were to examine unsolicited…

  1. Counselling the (Self?) Diagnosed Client: Generative and Reflective Conversations

    ERIC Educational Resources Information Center

    Strong, Tom; Ross, Karen H.; Sesma-Vazquez, Monica

    2015-01-01

    In this paper, we address the phenomenon of clients who present their concerns in the medicalised discourse of the "Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition" ("DSM-5"). We contextualise this phenomenon, highlighting how a "diagnose-and-treat" logic increasingly pervades everyday…

  2. Another case of prenatally diagnosed 48,XYY,+21

    SciTech Connect

    Stevens, J.

    1995-02-13

    We report on a 20-month-old boy with 48,XYY,+21, the third prenatally diagnosed patient with this rare double aneuploidy syndrome. A review of 14 literature cases suggests that the Down syndrome phenotype appears unaltered by the extra Y chromosome. 24 refs., 1 fig., 1 tab.

  3. Stability of Initial Autism Spectrum Disorder Diagnoses in Community Settings

    ERIC Educational Resources Information Center

    Daniels, Amy M.; Rosenberg, Rebecca E.; Law, J. Kiely; Lord, Catherine; Kaufmann, Walter E.; Law, Paul A.

    2011-01-01

    The study's objectives were to assess diagnostic stability of initial autism spectrum disorder (ASD) diagnoses in community settings and identify factors associated with diagnostic instability using data from a national Web-based autism registry. A Cox proportional hazards model was used to assess the relative risk of change in initial ASD…

  4. Young Offenders' Diagnoses as Predictors of Subsequent Adult Criminal Behaviour.

    ERIC Educational Resources Information Center

    Bevc, Irene; Duchesne, Thierry; Rosenthal, Jeffrey; Rossman, Lianne; Theodor, Frances; Sowa, Edward

    This longitudinal study of 248 male offenders examined the relationship between psychiatric disorders, diagnosed in adolescence, and subsequent adult criminal activity. Criminal offences were tracked for an average of 8.7 years from age 18-33. Cox Proportional Intensity regression analyses were conducted to predict the rates of adult offending of…

  5. The Reliability of Diagnoses by Technician, Computer, and Algorithm.

    ERIC Educational Resources Information Center

    Johnson, James H.; And Others

    1980-01-01

    Describes a computer assisted system for intake assessment. Reports on two experiments that compared the reliability of a diagnostic procedure that involves technicians, a structured interview schedule, and a computerized diagnostic program with diagnoses made by clinicians. Results show the computer assisted technician approach is as reliable as…

  6. Diagnosing Language Impairment in Bilinguals: Professional Experience and Perception

    ERIC Educational Resources Information Center

    O'Toole, Ciara; Hickey, Tina M.

    2013-01-01

    Diagnosing specific language impairment (SLI) in monolingual children is a complex task, with some controversy regarding criteria. Diagnosis of SLI in bilinguals is made more complex by the lack of standardized assessments and poor understanding of clinical markers in languages other than English. There is an added complexity when one of the…

  7. The Emotional Lexicon of Individuals Diagnosed with Antisocial Personality Disorder

    ERIC Educational Resources Information Center

    Gawda, Barbara

    2013-01-01

    This study investigated the specific emotional lexicons in narratives created by persons diagnosed with antisocial personality disorder (ASPD) to test the hypothesis that individuals with ASPD exhibit deficiencies in emotional language. Study participants consisted of 60 prison inmates with ASPD, 40 prison inmates without ASPD, and 60 men without…

  8. A Narrative Approach to Supporting Students Diagnosed with Learning Disabilities

    ERIC Educational Resources Information Center

    Lambie, Glenn W.; Milsom, Amy

    2010-01-01

    Students diagnosed with learning disabilities experience many challenges that school counselors may address through narrative therapy. Narrative therapy is a postmodern, social constructionist approach based on the theoretical construct that individuals create their notions of truth and meaning of life through interpretive stories. This article…

  9. Object linking in repositories

    NASA Technical Reports Server (NTRS)

    Eichmann, David (Editor); Beck, Jon; Atkins, John; Bailey, Bill

    1992-01-01

    This topic is covered in three sections. The first section explores some of the architectural ramifications of extending the Eichmann/Atkins lattice-based classification scheme to encompass the assets of the full life cycle of software development. A model is considered that provides explicit links between objects in addition to the edges connecting classification vertices in the standard lattice. The second section gives a description of the efforts to implement the repository architecture using a commercially available object-oriented database management system. Some of the features of this implementation are described, and some of the next steps to be taken to produce a working prototype of the repository are pointed out. In the final section, it is argued that design and instantiation of reusable components have competing criteria (design-for-reuse strives for generality, design-with-reuse strives for specificity) and that providing mechanisms for each can be complementary rather than antagonistic. In particular, it is demonstrated how program slicing techniques can be applied to customization of reusable components.

  10. Linking to the Future

    NASA Astrophysics Data System (ADS)

    Moore, John W.

    1999-09-01

    my copy of JCE in the mail each month, and I expect you do too. I can glance at the cover to get an overview of an issue's content, and I usually am enticed inside by intriguing cover art. I can scan the table of contents to find articles I want to read, or I can just browse through the issue to see what looks interesting. Usually the editors have juxtaposed related articles so that I often find a small treasure trove. The printed Journal is quite portable and can be read in a car or airplane. It will last a long time, and until the paper deteriorates, I will never have a problem reading back issues. I have almost every issue from the first day I subscribed and have even added some older ones from collections of retired colleagues who no longer had shelf space for them. I certainly would not want to give up my printed copies, and I want to keep getting them. I find that JCE Online provides a different kind of resource that is equally valuable. It contains more information, and information that is more appropriate in electronic form. It links related ideas into a much more complex web of information than is possible in print. And it opens pathways to lots of information that is not part of JCE but resides elsewhere. Using this issue as an example, let's take a tour of what JCE Online can do.

    • Point your Web browser to http://jchemed.chem.wisc.edu
    • Click on Journal and then on Current Issue (unless September 1999 is no longer the current issue, in which case you will find it in Past Issues).
    • In the table of contents, find the article "UV Catalysis, Cyanotype Photography, and Sunscreens". Click on the title.
    • When the abstract appears, click on Full Text (PDF) to see the article, just as it appears on page 1199 in this issue.
    • When you are prompted, enter the name and subscriber number from your address label.
    • At the end of the article you will find that supplementary materials are available (including a procedure for testing

    • [Hospitals as vital links].

      PubMed

      Klink, A

      2013-01-01

      The reform of the system in 2006 aimed at reducing waiting lists in an efficient manner. Performance-linked funding and regulated competition did indeed lead to improved efficiency. The other side of the coin is overtreatment, and expensive and not infrequently damaging growth in volume. In order to control costs, three strategies have been determined: agreements with an annual cap on volume; (b) collaboration of regional health-care providers with the mission of improving results in health care (with profit-sharing if costs fall); and (c) fusions reducing the number of hospitals which reduces the burden of injuries (supply no longer creates its own demand). This article comments on these strategies. The author argues for a fourth approach: if the quality of health care improves, the number of complications will fall, overtreatment will decline and the outcome will be a decrease in burden of injuries. This requires the health care insurers to modify the way they manage their contracts and methods of payment, and stimulates competition based on quality.

    • Protective link for superconducting coil

      DOEpatents

      Umans, Stephen D.

      2009-12-08

      A superconducting coil system includes a superconducting coil and a protective link of superconducting material coupled to the superconducting coil. A rotating machine includes first and second coils and a protective link of superconducting material. The second coil is operable to rotate with respect to the first coil. One of the first and second coils is a superconducting coil. The protective link is coupled to the superconducting coil.

    • Using ATM over SATCOM links

      NASA Technical Reports Server (NTRS)

      Comparetto, Gary M.

      1995-01-01

      The Asynchronous Transfer Mode (ATM) protocol is studied from the standpoint of determining what limitations, if any, exist in using it over satellite links. It is concluded that, while there is nothing intrinsic about ATM that would generally preclude its use over satellite links, there are, however, several intrinsic characteristics of satellite links, as well as some satellite system configuration-specific issues, that must be taken into account.

    • Inhalant-Abuse Myocarditis Diagnosed by Cardiac Magnetic Resonance

      PubMed Central

      Rao, Krishnasree; Matulevicius, Susan

      2016-01-01

      Multiple reports of toxic myocarditis from inhalant abuse have been reported. We now report the case of a 23-year-old man found to have toxic myocarditis from inhalation of a hydrocarbon. The diagnosis was made by means of cardiac magnetic resonance imaging with delayed enhancement. The use of cardiac magnetic resonance to diagnose myocarditis has become increasingly common in clinical medicine, although there is not a universally accepted criterion for diagnosis. We appear to be the first to document a case of toxic myocarditis diagnosed by cardiac magnetic resonance. In patients with a history of drug abuse who present with clinical findings that suggest myocarditis or pericarditis, cardiac magnetic resonance can be considered to support the diagnosis. PMID:27303242

    • Diagnosing degradation of services in hybrid wireless tactical networks

      NASA Astrophysics Data System (ADS)

      Tati, Srikar; Novotny, Petr; Ko, Bong Jun; Wolf, Alexander; Swami, Ananthram; La Porta, Thomas

      2013-05-01

      In this paper, we consider a problem related to service management and deployment in tactical military networks. Tactical networks are typically hybrid wireless networks in which there are both static and mobile nodes with several wireless interfaces, such as 802.11, 3G, satellite, etc. In tactical networks, performance degradation in services could prove fatal, so it must be diagnosed quickly. This degradation could be due to mobility or bottlenecks in capacity at network layer. We provide a cross-layer framework to detect and diagnose these causes of performance degradation as part of service management; it includes a monitoring model of services and a network model for hybrid wireless networks. In addition, we give a working example in tactical military networks to illustrate our framework. We provide an experimental setup to simulate our hybrid wireless tactical network scenario along with preliminary results.

    • Arteriovenous fistula stent infection diagnosed with radiolabelled leucocyte scintigraphy.

      PubMed

      Yoo, Jeong Rae; Heo, Sang Taek; Kim, Miyeon; Kim, Hyun Woo; Chang, Jee Won; Song, Heesung

      2015-07-01

      Infectious complications of haemodialysis in patients with arteriovenous fistula stent are rare. In addition, patients with low-grade infection are more difficult to diagnose. Here, we report the first case of low-grade infection of an arteriovenous fistula stent diagnosed using (99m)Tc-hexamethylpropylene amine oxime (HMPAO)-labelled leucocyte scintigraphy. A 62-year-old man with end-stage renal disease was referred for prolonged fever. We performed (99m)Tc-HMPAO-labelled leucocyte scintigraphy following a work-up according to fever of unknown origin. A focal uptake on the left forearm compatible with the arteriovenous fistula stent insertion site was shown, and the stent was removed. (99m)Tc-HMPAO-labelled leucocyte scintigraphy could be a suitable method for assessing vascular stent infection in low-grade fever.

    • Insulin Oedema in Newly Diagnosed Type 1 Diabetes Mellitus

      PubMed Central

      Çetinkaya, Semra; Yılmaz Ağladıoğlu, Sebahat; Peltek Kendirici, Havva Nur; Bilgili, Hatice; Yıldırım, Nurdan; Aycan, Zehra

      2010-01-01

      Despite the essential role of insulin in the management of patients with insulin deficiency, insulin use can lead to adverse effects such as hypoglycaemia and weight gain. Rarely, crucial fluid retention can occur with insulin therapy, resulting in an oedematous condition. Peripheral or generalised oedema is an extremely rare complication of insulin therapy in the absence of heart, liver or renal involvement. It has been reported in newly diagnosed type 1 diabetes, in poorly controlled type 2 diabetes following the initiation of insulin therapy, and in underweight patients on large doses of insulin. The oedema occurs shortly after the initiation of intensive insulin therapy. We describe two adolescent girls with newly diagnosed type 1 diabetes, who presented with oedema of the lower extremities approximately one week after the initiation of insulin treatment; other causes of oedema were excluded. Spontaneous recovery was observed in both patients. Conflict of interest:None declared. PMID:21274337

    • Percussion--a new way to diagnose a pneumothorax.

      PubMed

      Winter, R; Smethurst, D

      1999-12-01

      We describe a new clinical sign in a case series of three patients who developed pneumothoraces during mechanical ventilation in the intensive care unit. All three patients were in the supine position. Two patients had x-rays that were inconclusive before insertion of chest drains and the third had a pneumothorax diagnosed on clinical findings alone. On each occasion we were able to diagnose pneumothorax using sternal percussion and simultaneous auscultation. The method relies on percussion of the sternum while simultaneously ausculating the anterior (superior) chest on the side of the suspected pneumothorax. The stethoscope is then placed on the other side of the chest. The percussion sound on the affected side has an exaggerated, resonant and booming quality. The percussion note is exaggerated partly because a stethoscope is used and partly because, in the supine patient, air localizes upwards to the anterior thorax.

    • Rural campaign to diagnose and treat mucocutaneous leishmaniasis in Bolivia.

      PubMed Central

      Dedet, J. P.; Melogno, R.; Cardenas, F.; Valda, L.; David, C.; Fernandez, V.; Torrez, M. E.; Dimier-David, L.; Lyevre, P.; Villareal, M. E.

      1995-01-01

      Mucocutaneous leishmaniasis (MCL) is endemic in the tropical Amazonian lowlands of Bolivia, an area that regularly receives influxes of migratory populations. In these new agricultural development areas, a campaign to diagnose and treat the disease was carried out between 1989 and 1992, in order to provide direct access to MCL treatment in the endemic areas at a standard equivalent to that offered in the urban centres in Bolivia. The campaign led to the creation of decentralized local centres for diagnosis and treatment of the disease. A campaign to inform the population about leishmaniasis was also undertaken and courses were run to educate medical and paramedical personnel. As a result of the campaign, 3285 cases of leishmaniasis were diagnosed, including 2152 cutaneous and 326 mucosal forms. Also, a total of 1888 cases were treated, 1677 of which cutaneous and 211, mucosal. Images Fig. 2 PMID:7614666

    • Reduced parasympathetic tone in newly diagnosed essential hypertension

      PubMed Central

      Goit, Rajesh Kumar; Ansari, Abdul Haque

      2016-01-01

      Aim The aim of the study was to compare heart rate variability (HRV) of newly diagnosed essential hypertensive subjects with controls. Methods The study was conducted on 120 hypertensive subjects and 120 controls. Results The time-domain measures, standard deviation of all RR intervals (SDNN), the square root of the mean of the sum of the squares of differences between adjacent RR intervals (RMSSD), and percentage of consecutive RR intervals that differ by more than 50 ms (pNN50) which reflect parasympathetic activity were significantly less in hypertensive subjects. In frequency-domain measures, high frequency [HF (ms2)] and [HF (nu)], which reflects parasympathetic activity, was significantly less in hypertensive subjects while LF (nu) and LF/HF (%), which reflect sympathetic activity, were comparable between the groups. Conclusion These findings suggest that HRV is reduced in subjects with newly diagnosed essential hypertension and the parasympathetic dysregulation is present in the early stage of essential hypertension. PMID:27133323

  1. [New nursing diagnoses in imaging: submission to NANDA International].

    PubMed

    Juchem, Beatriz Cavalcanti; Almeida, Míriam de Abreu; Lucena, Amália de Fátima

    2010-01-01

    The present work reports the experiment on the creation and submission to North American Nursing Diagnosis Association International (NANDA-I) of Nursing Diagnosis in the imageology area: "Adverse Reaction to Iodinated Contrast Media" and "Risk of Adverse Reaction to Iodinated Contrast Media". For this experiment the method of integrative revision of literature was utilized associated with the experience in clinical practice. The document for submission was elaborated according to guidance offered by NANDA-I and sent for appreciation to the Diagnosis Development Committee. The risk diagnose was approved and the real diagnose is still in evaluation process by the Diagnosis Development Committee. With this experiment we hope to motivate Brazilian nurses to contribute to the taxonomy of NANDA-I and participate in the building ofnursing knowledge.

  2. Psychiatric diagnoses in a group of astronaut applicants

    NASA Technical Reports Server (NTRS)

    Santy, Patricia A.; Faulk, Dean M.; Holland, Al W.

    1991-01-01

    Between 1959 and 1987, the psychiatric evaluation of astronaut candidates evolved from a 30-h intensive examination evaluating applicants for psychopathology, and studying their performance under stress, to a 2-h clinical interview whose structure and contents were determined by the individual examiner. Evaluations done during these years applied both psychiatric (or, 'select-out') criteria and psychological (or, 'select-in') criteria. In an attempt to more rigorously define the psychiatric, 'select-out' component, a standardized, semistructured clinical interview was developed to identify the presence or history of psychiatric disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, 3rd Ed. ('DSM-III'). A total of 117 astronaut applicants underwent this clinical interview as part of a comprehensive medical evaluation during a recent astronaut selection. Of the 117 applicants, 9 (7.7 percent) met DSM-III criteria for a variety of Axis I and Axis II diagnoses, including V-code diagnoses.

  3. "Conjectural" links in complex networks

    NASA Astrophysics Data System (ADS)

    Snarskii, A. A.; Zorinets, D. I.; Lande, D. V.

    2016-11-01

    This paper introduces the concept of Conjectural Link for Complex Networks, in particular, social networks. Conjectural Link we understand as an implicit link, not available in the network, but supposed to be present, based on the characteristics of its topology. It is possible, for example, when in the formal description of the network some connections are skipped due to errors, deliberately hidden or withdrawn (e.g. in the case of partial destruction of the network). Introduced a parameter that allows ranking the Conjectural Link. The more this parameter - the more likely that this connection should be present in the network. This paper presents a method of recovery of partially destroyed Complex Networks using Conjectural Links finding. Presented two methods of finding the node pairs that are not linked directly to one another, but have a great possibility of Conjectural Link communication among themselves: a method based on the determination of the resistance between two nodes, and method based on the computation of the lengths of routes between two nodes. Several examples of real networks are reviewed and performed a comparison to know network links prediction methods, not intended to find the missing links in already formed networks.

  4. Gastric ulcer penetrating to liver diagnosed by endoscopic biopsy

    PubMed Central

    Kayacetin, Ertugrul; Kayacetin, Serra

    2004-01-01

    Liver penetration is a rare but serious complication of peptic ulcer disease. Usually the diagnosis is made by operation or autopsy. Clinical and laboratory data were no specific. A 64-year-old man was admitted with upper gastrointestinal bleeding. Hepatic penetration was diagnosed as the cause of bleeding. Endoscopy showed a large gastric ulcer with a pseudotumoral mass protruding from the ulcer bed. Definitive diagnosis was established by endoscopic biopsies of the ulcer base. PMID:15188520

  5. Are We Overtreating Papillomas Diagnosed on Core Needle Biopsy?

    PubMed Central

    Cyr, Amy E.; Novack, Deborah; Trinkaus, Kathryn; Margenthaler, Julie A.; Gillanders, William E.; Eberlein, Timothy J.; Ritter, Jon; Aft, Rebecca L.

    2014-01-01

    Background Breast papillomas often are diagnosed with core needle biopsy (CNB). Most studies support excision for atypical papillomas, because as many as one half will be upgraded to malignancy on final pathology. The literature is less clear on the management of papillomas without atypia on CNB. Our goal was to determine factors associated with pathology upgrade on excision. Methods Our pathology database was searched for breast papillomas diagnosed by CNB during the past 10 years. We identified 277 charts and excluded lesions associated with atypia or malignancy on CNB. Two groups were identified: papillomas that were surgically excised (group 1) and those that were not (group 2). Charts were reviewed for the subsequent diagnosis of cancer or high-risk lesions. Appropriate statistical tests were used to analyze the data. Results A total of 193 papillomas were identified. Eighty-two lesions were excised (42%). Caucasian women were more likely to undergo excision (p = 0.03). Twelve percent of excised lesions were upgraded to malignancy. Increasing age was a predictor of upgrading, but this was not significant. Clinical presentation, lesion location, biopsy technique, and breast cancer history were not associated with pathology upgrade. Two lesions in group 2 ultimately required excision due to enlargement, and both were upgraded to malignancy. Conclusions Twenty-four percent of papillomas diagnosed on CNB have upgraded pathology on excision—half to malignancy. All of the cancers diagnosed were stage 0 or I. For patients in whom excision was not performed, 2 of 111 papillomas were later excised and upgraded to malignancy. PMID:21046266

  6. Attitudes of primary care team to diagnosing dementia.

    PubMed

    Thomas, Hywel

    2010-04-01

    Healthcare professionals in primary care are gatekeepers to specialist services and are important in terms of ensuring access to community support and appropriate referral for the sizable number of older people with mental health problems. This literature review explores the role of primary care professionals, particularly GPs and practice nurses, in diagnosing and managing patients with dementia. It recommends that education and training are required to raise awareness of the importance of accurate diagnosis and management in primary care.

  7. Interrupted aorta diagnosed in a 51-year-old woman.

    PubMed

    Stoyanov, Nik; Bullock, Andrew; Erickson, Matthew

    2014-10-01

    A 51-year-old lady presented with increasing heart failure symptoms and palpitations. She had recently been diagnosed with a congenital ventricular septal defect, bicuspid aortic valve, and Eisenmenger's syndrome. There was clinical evidence of right heart failure and differential clubbing and cyanosis affecting the feet but not hands. A cardiac magnetic resonance imaging demonstrated interruption of the aortic arch beyond the left subclavian artery, with the descending aorta perfused entirely through a large patent ductus arteriosus.

  8. The Newell Test Should Commit to Diagnosing Dysfunctions

    NASA Technical Reports Server (NTRS)

    Clancey, William J.

    2003-01-01

    "Conceptual coordination" analysis bridges connectionism and symbolic approaches by posting a "process memory" by which categories are physically coordinated (as neural networks) in time. Focusing on dysfunctions and odd behaviors like slips reveals the function of consciousness, especially taken-for-granted constructive processes, different from conventional programming constructs. Newell strongly endorsed identifying architectural limits; the heuristic of "diagnose unusual behaviors" will provide targets of opportunity that greatly strengthens the Newell Test.

  9. Preduodenal portal vein: a cause of prenatally diagnosed duodenal obstruction.

    PubMed

    Choi, S O; Park, W H

    1995-10-01

    Preduodenal portal vein is a rare congenital anomaly that causes high intestinal obstruction. The authors report on a newborn who was diagnosed as having duodenal obstruction at 30 weeks' gestation. During surgery the patient was found to have duodenal obstruction caused by a preduodenal portal vein. Malrotation was an associated finding. Treatment consisted of Ladd's procedure and a diamond-shaped duodenoduodenostomy performed anterior to the portal vein.

  10. Cardiac toxoplasmosis after heart transplantation diagnosed by endomyocardial biopsy.

    PubMed

    Petty, L A; Qamar, S; Ananthanarayanan, V; Husain, A N; Murks, C; Potter, L; Kim, G; Pursell, K; Fedson, S

    2015-10-01

    We describe a case of cardiac toxoplasmosis diagnosed by routine endomyocardial biopsy in a patient with trimethoprim-sulfamethoxazole (TMP-SMX) intolerance on atovaquone prophylaxis. Data are not available on the efficacy of atovaquone as Toxoplasma gondii prophylaxis after heart transplantation. In heart transplant patients in whom TMP-SMX is not an option, other strategies may be considered, including the addition of pyrimethamine to atovaquone.

  11. Laser-Induced Fluorescence Helps Diagnose Plasma Processes

    NASA Technical Reports Server (NTRS)

    Beattie, J. R.; Mattosian, J. N.; Gaeta, C. J.; Turley, R. S.; Williams, J. D.; Williamson, W. S.

    1994-01-01

    Technique developed to provide in situ monitoring of rates of ion sputter erosion of accelerator electrodes in ion thrusters also used for ground-based applications to monitor, calibrate, and otherwise diagnose plasma processes in fabrication of electronic and optical devices. Involves use of laser-induced-fluorescence measurements, which provide information on rates of ion etching, inferred rates of sputter deposition, and concentrations of contaminants.

  12. Augmentation of machine structure to improve its diagnosability

    NASA Technical Reports Server (NTRS)

    Hsieh, L.

    1973-01-01

    Two methods of augmenting the structure of a sequential machine so that it is diagnosable are presented. The checkable (checking sequences) and repeated symbol distinguishing sequences (RDS) are discussed. It was found that as few as twice the number of outputs of the given machine is sufficient for constructing a state-output augmentation with RDS. Techniques for minimizing the number of states in resolving convergences and in resolving equivalent and nonreduced cycles are developed.

  13. Diagnosing and treating moisture-associated skin damage.

    PubMed

    Zulkowski, Karen

    2012-05-01

    Certain types of moisture can cause debilitating damage to the skin. Terms such as perineal dermatitis, diaper rash, incontinence-associated dermatitis, or moisture-associated skin damage describe some of the conditions caused by moisture from wound drainage, fecal and/or urinary incontinence, and perspiration. It is important for clinicians to correctly diagnose and to locally treat the cause of skin damage, as well as promote appropriate cleaning techniques, to keep patients' skin healthy.

  14. Lung Cancers Diagnosed at Annual CT Screening: Volume Doubling Times

    PubMed Central

    Yankelevitz, David F.; Yip, Rowena; Reeves, Anthony P.; Farooqi, Ali; Xu, Dongming; Smith, James P.; Libby, Daniel M.; Pasmantier, Mark W.; Miettinen, Olli S.

    2012-01-01

    Purpose: To empirically address the distribution of the volume doubling time (VDT) of lung cancers diagnosed in repeat annual rounds of computed tomographic (CT) screening in the International Early Lung Cancer Action Program (I-ELCAP), first and foremost with respect to rates of tumor growth but also in terms of cell types. Materials and Methods: All CT screenings in I-ELCAP from 1993 to 2009 were performed according to HIPAA-compliant protocols approved by the institutional review boards of the collaborating institutions. All instances of first diagnosis of primary lung cancer after a negative screening result 7–18 months earlier were identified, with symptom-prompted diagnoses included. Lesion diameter was calculated by using the measured length and width of each cancer at the time when the nodule was first identified for further work-up and at the time of the most recent prior screening, 7–18 months earlier. The length and width were measured a second time for each cancer, and the geometric mean of the two calculated diameters was used to calculate the VDT. The χ2 statistic was used to compare the VDT distributions. Results: The median VDT for 111 cancers was 98 days (interquartile range, 108). For 56 (50%) cancers it was less than 100 days, and for three (3%) cancers it was more than 400 days. Adenocarcinoma was the most frequent cell type (50%), followed by squamous cell carcinoma (19%), small cell carcinoma (19%), and others (12%). Lung cancers manifesting as subsolid nodules had significantly longer VDTs than those manifesting as solid nodules (P < .0001). Conclusion: Lung cancers diagnosed in annual repeat rounds of CT screening, as manifest by the VDT and cell-type distributions, are similar to those diagnosed in the absence of screening. © RSNA, 2012 PMID:22454506

  15. Diagnosing synaesthesia with online colour pickers: maximising sensitivity and specificity.

    PubMed

    Rothen, Nicolas; Seth, Anil K; Witzel, Christoph; Ward, Jamie

    2013-04-30

    The most commonly used method for formally assessing grapheme-colour synaesthesia (i.e., experiencing colours in response to letter and/or number stimuli) involves selecting colours from a large colour palette on several occasions and measuring consistency of the colours selected. However, the ability to diagnose synaesthesia using this method depends on several factors that have not been directly contrasted. These include the type of colour space used (e.g., RGB, HSV, CIELUV, CIELAB) and different measures of consistency (e.g., city block and Euclidean distance in colour space). This study aims to find the most reliable way of diagnosing grapheme-colour synaesthesia based on maximising sensitivity (i.e., ability of a test to identify true synaesthetes) and specificity (i.e., ability of a test to identify true non-synaesthetes). We show, applying ROC (receiver operating characteristics) to binary classification of a large sample of self-declared synaesthetes and non-synaesthetes, that the consistency criterion (i.e., cut-off value) for diagnosing synaesthesia is considerably higher than the current standard in the field. We also show that methods based on perceptual CIELUV and CIELAB colour models (rather than RGB and HSV colour representations) and Euclidean distances offer an even greater sensitivity and specificity than most currently used measures. Together, these findings offer improved heuristics for the behavioural assessment of grapheme-colour synaesthesia.

  16. Prevalence of otorhinolaryngologic diagnoses in the pediatric emergency room

    PubMed Central

    Signorelli, Luiz Gabriel; Mendes, Elaine de Abreu

    2013-01-01

    Summary Introduction: Fever and pain, which are very common in ear, nose, and throat pathologies, are among the most frequent complaints recorded during emergency room pediatric patient treatment. Most of time, the pediatricians are called on to evaluate otorhinolaryngology disorders that requires specialist assessment. Aim: To determine the prevalence of otorhinolaryngologic diagnoses in a pediatric population in a reference hospital in the city of Itatiba, São Paulo. Methods: We evaluated 2,054 pediatric patients (age range, 0–12 years, 11 months) in this descriptive, transversal observational (survey) study. Data collection was performed by a single observer during 103 night shifts (07:00 p.m. to 07:00 a.m.) between January and December 2011, and included documentation of the main diagnosis, and patient age and sex. The ethics committee and research institution approved study. Patients were divided into 2 groups based on diagnosis: Group A otorhinolaryngology disease and Group B included diagnoses not contained in Group A. Results: Of the total enrolled patients, 52.2% corresponded to Group A and 47.8% to Group B; 51.9% were male and 48.1% were female. The average age was 4.5 years (Group A, 3.93 years; Group B, 5.03 years). We compared the prevalence of the diagnostic hypotheses of the 2 groups. Conclusion: A large number of patients sought treatment at pediatric emergency rooms for otorhinolaryngologic diagnoses. PMID:25991987

  17. Creutzfeldt-Jakob disease: a case report and differential diagnoses.

    PubMed

    Kojima, Gotaro; Tatsuno, Brent K; Inaba, Michiko; Velligas, Stephanie; Masaki, Kamal; Liow, Kore K

    2013-04-01

    Sporadic Creutzfeldt-Jakob disease is a rare neurodegenerative disorder of unknown etiology that causes rapidly progressive dementia. This disease is uniformly fatal and most patients die within 12 months. Clinical findings include myoclonus, visual disturbances, and cerebellar and pyramidal/extrapyramidal signs in addition to rapidly progressive cognitive and functional impairment. These findings are all non-specific and it is often difficult and challenging to diagnose premortem because of low awareness and clinical suspicion. We present a 66-year-old woman with a 5-month history of rapidly progressive dementia. After a series of extensive diagnostic examinations and continuous follow-up, she was diagnosed with probable sporadic Creutzfeldt-Jakob disease based on Centers for Disease Control and Prevention (CDC) criteria, with key findings of rapidly progressive dementia, blurry vision, extrapyramidal signs (cogwheel rigidity), and abnormal hyperintensity signals on diffusion-weighted MRI. Her symptoms progressively worsened and she died 7 months after the onset. The postmortem brain autopsy demonstrated the presence of abnormal protease-resistant prion protein by Western Blot analysis. A literature review was performed on differential diagnoses that present with rapidly progressive dementia and thereby mimic sporadic Creutzfeldt-Jakob disease. These include Alzheimer's disease, dementia with Lewy Bodies, frontotemporal dementia, meningoencephalitis, corticobasal degeneration, progressive supranuclear palsy, CADASIL, and paraneoplastic encephalomyelitis.

  18. Health care experiences among women diagnosed with gestational breast cancer.

    PubMed

    Hammarberg, K; Sullivan, E; Javid, N; Duncombe, G; Halliday, L; Boyle, F; Saunders, C; Ives, A; Dickinson, J E; Fisher, J

    2017-03-24

    Gestational breast cancer (GBC) presents many challenges for women and the clinicians who care for them. The aim of this study was to explore the health care experiences of women diagnosed with GBC to inform and improve clinical care of women in this predicament. Semi-structured interviews were conducted with 17 women who had been diagnosed with GBC in the previous 5 years. The overarching themes for perceived quality of care were "communication" and "comprehensive care." "Communication" had two sub themes: "interdisciplinary communication" (the way health professionals from different disciplines communicated with each other about the management of the woman's care) and "patient communication" (how they communicated this to the woman). The "comprehensive care" theme incorporated three sub themes: "the spirit" (psychological care); "the mind" (information provision); and "the body" (management of treatment side effects). Women's own accounts of positive and negative experiences of GBC care provide unique and specific insights which improve understanding of their concerns and needs. The findings can inform advances in quality and efficacy of clinical care; offer guidance for obstetricians, oncologists and allied health professionals about the needs of women diagnosed with GBC and how care can be optimised; and inform the development of resources to assist women and their families.

  19. Challenges in Diagnosing Narcolepsy without Cataplexy: A Consensus Statement

    PubMed Central

    Baumann, Christian R.; Mignot, Emmanuel; Lammers, Gert Jan; Overeem, Sebastiaan; Arnulf, Isabelle; Rye, David; Dauvilliers, Yves; Honda, Makoto; Owens, Judith A.; Plazzi, Giuseppe; Scammell, Thomas E.

    2014-01-01

    Background: Diagnosing narcolepsy without cataplexy is often a challenge as the symptoms are nonspecific, current diagnostic tests are limited, and there are no useful biomarkers. In this report, we review the clinical and physiological aspects of narcolepsy without cataplexy, the limitations of available diagnostic procedures, and the differential diagnoses, and we propose an approach for more accurate diagnosis of narcolepsy without cataplexy. Methods: A group of clinician-scientists experienced in narcolepsy reviewed the literature and convened to discuss current diagnostic tools, and to map out directions for research that should lead to a better understanding and more accurate diagnosis of narcolepsy without cataplexy. Recommendations: To aid in the identification of narcolepsy without cataplexy, we review key indicators of narcolepsy and present a diagnostic algorithm. A detailed clinical history is mainly helpful to rule out other possible causes of chronic sleepiness. The multiple sleep latency test remains the most important measure, and prior sleep deprivation, shift work, or circadian disorders should be excluded by actigraphy or sleep logs. A short REM sleep latency (≤ 15 minutes) on polysomnography can aid in the diagnosis of narcolepsy without cataplexy, although sensitivity is low. Finally, measurement of hypocretin levels can helpful, as levels are low to intermediate in 10% to 30% of narcolepsy without cataplexy patients. Citation: Baumann CR, Mignot E, Lammers GJ, Overeem S, Arnulf I, Rye D, Dauvilliers Y, Honda M, Owens JA, Plazzi G, Scammell TE. Challenges in diagnosing narcolepsy without cataplexy: a consensus statement. SLEEP 2014;37(6):1035-1042. PMID:24882898

  20. LinkProt: a database collecting information about biological links

    PubMed Central

    Dabrowski-Tumanski, Pawel; Jarmolinska, Aleksandra I.; Niemyska, Wanda; Rawdon, Eric J.; Millett, Kenneth C.; Sulkowska, Joanna I.

    2017-01-01

    Protein chains are known to fold into topologically complex shapes, such as knots, slipknots or complex lassos. This complex topology of the chain can be considered as an additional feature of a protein, separate from secondary and tertiary structures. Moreover, the complex topology can be defined also as one additional structural level. The LinkProt database (http://linkprot.cent.uw.edu.pl) collects and displays information about protein links — topologically non-trivial structures made by up to four chains and complexes of chains (e.g. in capsids). The database presents deterministic links (with loops closed, e.g. by two disulfide bonds), links formed probabilistically and macromolecular links. The structures are classified according to their topology and presented using the minimal surface area method. The database is also equipped with basic tools which allow users to analyze the topology of arbitrary (bio)polymers. PMID:27794552

  1. CT and MRI findings in X-linked progressive deafness.

    PubMed

    Altay, Hakan; Savaş, Recep; Oğüt, Fatih; Kirazli, Tayfun; Alper, Hüdaver

    2008-09-01

    Congenital X-linked mixed deafness is a rare anomaly that has typical features and can be diagnosed on the basis of progressive mixed hearing loss and the typical imaging findings. Recognition of these findings may alter the course of treatment and perilymph gushing can be avoided. A 10-year-old male patient presented with a history of progressive hearing loss. Computed tomography of the temporal bones showed bulbous dilatation of the fundi of the internal auditory canals (IAC) and the absence of the bony plates separating the basal turn of the cochleas and IAC. Magnetic resonance imaging demonstrated obliteration of the labyrinthine spaces at the right side.

  2. Making Effective Links for Learning

    ERIC Educational Resources Information Center

    Lawrence, Liz; Lunt, Julie

    2011-01-01

    Science and design and technology (D&T) are often linked, either formally in the curriculum or by making connections in and between lessons. There has been much debate about how this linking serves the needs of the two subjects and what, in practice, the actual relationship is, as the current English National Curriculum (DfEE, 1999) identifies…

  3. Interpreting Linked Psychomotor Performance Scores

    ERIC Educational Resources Information Center

    Looney, Marilyn A.

    2013-01-01

    Given that equating/linking applications are now appearing in kinesiology literature, this article provides an overview of the different types of linked test scores: equated, concordant, and predicted. It also addresses the different types of evidence required to determine whether the scores from two different field tests (measuring the same…

  4. Linking Assessments: Concept and History

    ERIC Educational Resources Information Center

    Kolen, Michael J.

    2004-01-01

    In this article, the history of linking is summarized, and current linking frameworks that have been proposed are considered. Key publications discussed include Flanagan (1951), Angoff (1971), Linn (1993), Mislevy (1992), and Feuer, Holland, Green, Bertenthal, and Hemphill (1999). The article further focuses on the concordance situation for…

  5. Game Changer: Linked Learning Detroit

    ERIC Educational Resources Information Center

    ConnectEd: The California Center for College and Career, 2016

    2016-01-01

    JP Morgan Chase joins the Skillman Foundation, the Ford Foundation, and the Ford Motor Company Fund, whose grants total $7 million and will connect 10,000 Detroit high school students to career education and work experiences over the next three years through Linked Learning Detroit. Learn about Linked Learning Detroit through interviews with…

  6. Mixed-method Exploration of Social Network Links to Participation

    PubMed Central

    Kreider, Consuelo M.; Bendixen, Roxanna M.; Mann, William C.; Young, Mary Ellen; McCarty, Christopher

    2015-01-01

    The people who regularly interact with an adolescent form that youth's social network, which may impact participation. We investigated the relationship of social networks to participation using personal network analysis and individual interviews. The sample included 36 youth, age 11 – 16 years. Nineteen had diagnoses of learning disability, attention disorder, or high-functioning autism and 17 were typically developing. Network analysis yielded 10 network variables, of which 8 measured network composition and 2 measured network structure, with significant links to at least one measure of participation using the Children's Assessment of Participation and Enjoyment (CAPE). Interviews from youth in the clinical group yielded description of strategies used to negotiate social interactions, as well as processes and reasoning used to remain engaged within social networks. Findings contribute to understanding the ways social networks are linked to youth participation and suggest the potential of social network factors for predicting rehabilitation outcomes. PMID:26594737

  7. Newly-diagnosed pediatric epilepsy is associated with elevated autoantibodies to glutamic acid decarboxylase but not cardiolipin.

    PubMed

    Veri, Kadi; Uibo, Oivi; Talvik, Tiina; Talvik, Inga; Metsküla, Kaja; Napa, Aita; Vaher, Ulvi; Õiglane-Šlik, Eve; Rein, Reet; Kolk, Anneli; Traat, Aili; Uibo, Raivo

    2013-07-01

    Glutamic acid decarboxylase autoantibodies (GADA) and anti-cardiolipin autoantibodies (ACA) have been detected in adult subjects with epilepsy, though the functional implications of these findings are a matter of debate. This study aimed to determine the prevalence of GADA and ACA and to investigate their clinical significance in pediatric subjects with newly-diagnosed epilepsy. For this purpose GADA and ACA were assessed by enzyme-linked immunosorbent assays in 208 pediatric patients with newly-diagnosed epilepsy and 128 controls. The clinical data (results of electroencephalography, magnetic resonance imaging, 6-month outcome etc.) was compared to antibody test results. Our study revealed GADA in 14 (6.7%) patients with epilepsy and in 1 (0.8%) control, which was a statistically significant difference (P=0.010; Chi-square test). The GADA-positive and -negative patients had similar clinical characteristics. The prevalence of ACA in patients with epilepsy (6.3%) was not significantly different than controls (2.6%). These results suggest that GADA is associated with epilepsy in a subgroup of newly-diagnosed pediatric patients. Further studies are required to determine the prognostic significance and pathogenic role of GADA among pediatric subjects with epilepsy.

  8. The Missing Link: The Use of Link Words and Phrases as a Link to Manuscript Quality

    ERIC Educational Resources Information Center

    Onwuegbuzie, Anthony J.

    2016-01-01

    In this article, I provide a typology of transition words/phrases. This typology comprises 12 dimensions of link words/phrases that capture 277 link words/phrases. Using QDA Miner, WordStat, and SPSS--a computer-assisted mixed methods data analysis software, content analysis software, and statistical software, respectively--I analyzed 74…

  9. An exome sequencing strategy to diagnose lethal autosomal recessive disorders.

    PubMed

    Ellard, Sian; Kivuva, Emma; Turnpenny, Peter; Stals, Karen; Johnson, Matthew; Xie, Weijia; Caswell, Richard; Lango Allen, Hana

    2015-03-01

    Rare disorders resulting in prenatal or neonatal death are genetically heterogeneous. For some conditions, affected fetuses can be diagnosed by ultrasound scan, but this is not usually possible until mid-gestation. There is often limited fetal DNA available for investigation. We investigated a strategy for diagnosing autosomal recessive lethal disorders in non-consanguineous pedigrees with multiple affected fetuses. Exome sequencing was performed to identify genes where each parent is heterozygous for a rare non-synonymous-coding or splicing variant. Putative pathogenic variants were tested for cosegregation in affected fetuses and unaffected siblings. In eight couples of European ancestry, we found on average 1.75 genes (range 0-4) where both parents were heterozygous for rare potentially deleterious variants. A proof-of-principle study detected heterozygous DYNC2H1 variants in a couple whose five fetuses had short-rib polydactyly. Prospective analysis of two couples with multiple pregnancy terminations for fetal akinesia syndrome was performed and a diagnosis was obtained in both the families. The first couple were each heterozygous for a previously reported GLE1 variant, p.Arg569His or p.Val617Met; both were inherited by their two affected fetuses. The second couple were each heterozygous for a novel RYR1 variant, c.14130-2A>G or p.Ser3074Phe; both were inherited by their three affected fetuses but not by their unaffected child. Biallelic GLE1 and RYR1 disease-causing variants have been described in other cases with fetal akinesia syndrome. We conclude that exome sequencing of parental samples can be an effective tool for diagnosing lethal recessive disorders in outbred couples. This permits early prenatal diagnosis in future pregnancies.

  10. An exome sequencing strategy to diagnose lethal autosomal recessive disorders

    PubMed Central

    Ellard, Sian; Kivuva, Emma; Turnpenny, Peter; Stals, Karen; Johnson, Matthew; Xie, Weijia; Caswell, Richard; Lango Allen, Hana

    2015-01-01

    Rare disorders resulting in prenatal or neonatal death are genetically heterogeneous. For some conditions, affected fetuses can be diagnosed by ultrasound scan, but this is not usually possible until mid-gestation. There is often limited fetal DNA available for investigation. We investigated a strategy for diagnosing autosomal recessive lethal disorders in non-consanguineous pedigrees with multiple affected fetuses. Exome sequencing was performed to identify genes where each parent is heterozygous for a rare non-synonymous-coding or splicing variant. Putative pathogenic variants were tested for cosegregation in affected fetuses and unaffected siblings. In eight couples of European ancestry, we found on average 1.75 genes (range 0–4) where both parents were heterozygous for rare potentially deleterious variants. A proof-of-principle study detected heterozygous DYNC2H1 variants in a couple whose five fetuses had short-rib polydactyly. Prospective analysis of two couples with multiple pregnancy terminations for fetal akinesia syndrome was performed and a diagnosis was obtained in both the families. The first couple were each heterozygous for a previously reported GLE1 variant, p.Arg569His or p.Val617Met; both were inherited by their two affected fetuses. The second couple were each heterozygous for a novel RYR1 variant, c.14130-2A>G or p.Ser3074Phe; both were inherited by their three affected fetuses but not by their unaffected child. Biallelic GLE1 and RYR1 disease-causing variants have been described in other cases with fetal akinesia syndrome. We conclude that exome sequencing of parental samples can be an effective tool for diagnosing lethal recessive disorders in outbred couples. This permits early prenatal diagnosis in future pregnancies. PMID:24961629

  11. [Psychosomatic approach to patients with headache: alternative or integrated diagnoses?].

    PubMed

    De Giorgio, Giuseppina; Ruberto, Stefania; Firenze, Caterina; Quartesan, Roberto

    2010-01-01

    Each person has an inseparable body-mind unity, with psychic factors that can also manifest themselves through changes in the functions of the body, and with changing somatic states that contribute to mental experience. This explains why somatic symptoms fall within psychiatry. When a patient complains about physical symptoms, it is essentially an integrated, multidisciplinary diagnosis which is used to identify the various factors (biological and psychological) which worsen the disorder, and a psychiatric dimensional approach is used to integrate the descriptive symptomatic diagnosis with the psychostructural diagnosis. The same symptoms, in fact, may underlie different psychological dynamics that direct the treatment and determine the prognosis, as explained in three clinical cases that we described. The literature on headaches reports a high rate of co-morbidity between migraines and psychiatric disorders, but doesn't take into account the fact that often the symptom of headache is part of the disorder, even when it presents on its own. In conclusion, a holistic approach is needed for the patient to be diagnosed as having a "psychiatric" form of headache. A medical examination of the illness leading to a diagnoses is essential, according to the criteria of the International Classification of Headache Disease (ICHD-II). In clinical practice, we have integrated the descriptive diagnosis (ICHD-II mini-Plus) with the psychological (Diagnostic Criteria of Psychosomatic Research - DCPR) and psycho-structural (Kenberg's interview, Minnesota Multiphasic Personality Inventory - MMPI) diagnoses. The clarification of the dynamics underlying the definition of symptoms and the role played by psychological factors has influenced the identification of therapeutic objectives and in the identification of the most appropriate strategies.

  12. Motor regulation problems and pain in adults diagnosed with ADHD

    PubMed Central

    2013-01-01

    Background Most children who are diagnosed with attention deficit-hyperactivity disorder (ADHD) have moderate-to-severe motor problems using the Motor Function Neurological Assessment battery (MFNU). The MFNU focuses on specific muscle adjustment problems associated with ADHD, especially motor inhibition problems and high muscle tone. Here we investigated whether adults with ADHD/hyperkinetic disorder (HKD) have similar motor problems. In our clinical experience, adults with ADHD often complain about back, shoulder, hip, and leg pain. We also investigate reported pain in adults with ADHD. Methods Twenty-five adult outpatients diagnosed with ADHD/HKD who were responders to methylphenidate (MPH) were compared to 23 non-ADHD controls on 16 MFNU subtests and using a ‘total score’ (‘TS’) parameter. The MFNU test leader was blinded to group identity. The two groups were also compared using the Pain Drawing and Numerical Pain Rating Scale. Results The adult ADHD group had significantly (p < .001) more motor problems (higher TS) than controls. On the muscle regulation subtests, 36–96% of the ADHD group showed ‘moderate’ to ‘severe’ problems compared to 13–52% of the control group, and 80% of the ADHD group reported widespread pain. Highly significant differences were found between the ADHD and control groups for the variables ‘pain level’ (p < .001) and ‘pain location’ (p < .001). Significant correlations were found between TS and ‘pain location’ and between TS and ‘pain level’. Conclusions These findings suggest that similar to children with ADHD, adults diagnosed with ADHD also have motor inhibition problems and heightened muscle tone. The presence of significantly higher pain levels and more widespread pain in the ADHD group compared to non-ADHD controls might indicate that pain is a long-term secondary effect of heightened muscle tone and restricted movement that can be demonstrated in children and adults by the MFNU

  13. Epidemiology of Otologic Diagnoses in United States Emergency Departments

    PubMed Central

    Kozin, Elliott D.; Sethi, Rosh K.V.; Remenschneider, Aaron K.; Kaplan, Alyson; del Portal, Daniel A.; Gray, Stacey T.; Shrime, Mark G.; Lee, Daniel J.

    2015-01-01

    Objective Otologic complaints may place a significant burden on emergency departments (EDs) in the United States; however, few studies have comprehensively examined this discrete patient population. We aim to identify utilization of EDs by patients with primary otologic complaints. Study Design Retrospective analysis of the Nationwide Emergency Department Sample (NEDS) from 2009 through 2011. Methods The NEDS database was queried for patient encounters with a primary otologic diagnosis based on ICD9 codes (380–389). Weighted estimates for demographic, diagnostic characteristics, SES, and trends over time were extracted. Predictors of mortality and admission were determined by multivariable logistic regression. Results A weighted total of 8,611,282 visits between 2009 and 2011 were attributed to otologic diagnoses, representing 2.21% of all ED visits. Stratified by patient age, otologic diagnoses encompassed 1.01% and 6.79% of all adult and pediatric ED visits, respectively. The majority of patients were treated and released (98.17%). The average age of patients presenting with an otologic complaint was 17.9 years (Standard Error [SE] = 0.23). Overall, 62.7% of patients that presented with an otologic complaint were 0–17 years old. The most common diagnoses among all age groups included otitis media NOS (60.6%), infected otitis externa NOS (11.8%), and otalgia NOS (6.8%). Conclusions We provide a comprehensive overview of otologic complaints that are an overlooked diagnostic category in public health research. NEDS data demonstrates significant number of visits related to otologic complaints, especially in the pediatric population, that are non-emergent. PMID:25702897

  14. Diagnosing ANCA-associated vasculitis in ANCA positive patients

    PubMed Central

    Houben, Eline; Bax, Willem A.; van Dam, Bastiaan; Slieker, Walentina A.T.; Verhave, Gideon; Frerichs, Fenneke C.P.; van Eijk, Izhar C.; Boersma, Wim G.; de Kuyper, Guido T.M.; Penne, Erik L.

    2016-01-01

    Abstract Currently no validated diagnostic system for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is available. Therefore, diagnosing AAV is often challenging. We aimed to identify factors that lead to a clinical diagnosis AAV in ANCA positive patients in a teaching hospital in The Netherlands. In this study, all patients that tested positive for ANCA proteinase 3 (PR3) and/or myeloperoxidase (MPO) between 2005 and 2015 were analysed. Patients with a clinical diagnosis of AAV were compared with patients without a clinical diagnosis of AAV. Clinical symptoms and laboratory variables at presentation, including the ANCA titre, were collected for both patients with and without AAV. Clinical and laboratory variables related with AAV were investigated, using multivariable logistic regression. Two hundred thirty seven consecutive patients with a positive ANCA were included, of whom 119 were clinically diagnosed with AAV. Of the 118 ANCA positive patients without AAV, 87 patients had an alternative diagnosis, including inflammatory bowel disease (n = 24), other rheumatic diseases (n = 23), infection (n = 11), malignancy (n = 4), and other diagnoses (n = 25). In a multivariable regression model, a high ANCA titre (odds ratio [OR] 14.16, 95% confidence interval [CI] 6.93–28.94) and a high number of affected organ systems (OR 7.67, 95% CI 3.69–15.94) were associated with AAV. MPO and PR3 ANCA can be positive in a variety of diseases that mimic AAV. A higher ANCA titre and multiple affected organ systems may help to discriminate between AAV and other systemic illnesses in anti-PR3 and anti-MPO positive patients. A diagnostic scoring system incorporating these factors should be considered. PMID:27749588

  15. Psychiatric diagnoses in 3275 suicides: a meta-analysis

    PubMed Central

    Arsenault-Lapierre, Geneviève; Kim, Caroline; Turecki, Gustavo

    2004-01-01

    Background It is well known that most suicide cases meet criteria for a psychiatric disorder. However, rates of specific disorders vary considerably between studies and little information is known about gender and geographic differences. This study provides overall rates of total and specific psychiatric disorders in suicide completers and presents evidence supporting gender and geographic differences in their relative proportion. Methods We carried out a review of studies in which psychological autopsy studies of suicide completers were performed. Studies were identified by means of MEDLINE database searches and by scanning the reference list of relevant publications. Twenty-three variables were defined, 16 of which evaluating psychiatric disorders. Mantel-Haenszel Weighted Odds Ratios were estimated for these 16 outcome variables. Results Twenty-seven studies comprising 3275 suicides were included, of which, 87.3% (SD 10.0%) had been diagnosed with a mental disorder prior to their death. There were major gender differences. Diagnoses of substance-related problems (OR = 3.58; 95% CI: 2.78–4.61), personality disorders (OR = 2.01; 95% CI: 1.38–2.95) and childhood disorders (OR = 4.95; 95% CI: 2.69–9.31) were more common among male suicides, whereas affective disorders (OR = 0.66; 95% CI: 0.53–0.83), including depressive disorders (OR = 0.53; 95% CI: 0.42–0.68) were less common among males. Geographical differences are also likely to be present in the relative proportion of psychiatric diagnoses among suicides. Conclusions Although psychopathology clearly mediates suicide risk, gender and geographical differences seem to exist in the relative proportion of the specific psychiatric disorders found among suicide completers. PMID:15527502

  16. Cochlear Implants in Children Diagnosed with CHARGE Syndrome

    PubMed Central

    Cardoso, Carolina Costa; Sales de Meneses, Michelle; Silva, Isabella Monteiro de Castro; Alves, Angela Maria Vaccaro Silva

    2013-01-01

    Introduction The CHARGE association (coloboma of the eyes; heart disease; atresia of the choanae; retarded growth and development; genital hypoplasia/genitourinary anomalies; ear anomalies and/or hearing loss) was first described in 1979 by Hall, and among its main features is hearing loss. This study presents a case aiming to establish relationships between performance on Infant Toddler Meaningful Auditory Integration Scale (IT-MAIS) and Meaningful Use of Speech Scales (MUSS) tests and the analysis of hearing and language categories of a patient diagnosed with CHARGE syndrome, before and after cochlear implant (CI) surgery. Case Report A 7-year-old girl was diagnosed with CHARGE. She had severe sensorineural hearing loss and was a prelingual unilateral CI user. We analyzed data from the patient's medical records regarding therapies and video recordings. Results The patient showed positive results in all evaluations after CI. IT-MAIS rose from 5 to 90% following the use of CI. MUSS also rose, from 75 to 72.5%, after use of CI. Classification of Auditory Skills changed from category 1 before use of CI to category 6 after use of CI. Classification of Language Skills changed from category 1 before use of CI to category 3 after use of CI. The CI is an aid but there are many factors in the therapeutic process, and great heterogeneity in individuals diagnosed with CHARGE should be investigated. Conclusion The development of listening and language skills after CI use was demonstrated by IT-MAIS and MUSS tests, and categorization of speech and hearing in this child with a diagnosis of CHARGE syndrome shows that CI can be an effective technological resource to provide information on hearing as one source for language construction. PMID:25992052

  17. Method and apparatus for diagnosing breached fuel elements

    DOEpatents

    Gross, Kenny C.; Lambert, John D. B.; Nomura, Shigeo

    1988-01-01

    The invention provides an apparatus and method for diagnosing breached fuel elements in a nuclear reactor. A detection system measures the activity of isotopes from the cover-gas in the reactor. A data acquisition and processing system monitors the detection system and corrects for the effects of the cover-gas clean up system on the measured activity and further calculates the derivative cure of the corrected activity as a function of time. A plotting system graphs the derivative curve, which represents the instantaneous release rate of fission gas from a breached fuel element.

  18. A Case of Ovarian Pregnancy Diagnosed by MRI.

    PubMed

    Io, Shingo; Hasegawa, Masaaki; Koyama, Takashi

    2015-01-01

    Ovarian pregnancy is a rare form of ectopic pregnancy, causing a great diagnostic challenge. We report a case of ovarian pregnancy in a 42-year-old woman, in whom MRI successfully demonstrated the implantation in the ovary. Transvaginal ultrasonography showed an echogenic mass in the right ovary but failed to demonstrate tubal pregnancy. T2-weighted MR images disclosed a gestational sac structure in the right ovary, which exhibited heterogeneous high intensity intermingled with punctate foci of distinct low intensity. MRI may be a useful tool for diagnosing ovarian pregnancy, by demonstrating a gestational sac in the ovary.

  19. Diagnosing early cognitive decline-When, how and for whom?

    PubMed

    Allan, Charlotte L; Behrman, Sophie; Ebmeier, Klaus P; Valkanova, Vyara

    2017-02-01

    Mild cognitive impairment (MCI) is a term used to describe cognitive impairment in one or more cognitive domains that is greater than any expected age-related changes, but not of the magnitude to warrant a diagnosis of dementia. This review considers how early cognitive decline is diagnosed, focusing on the use of neuropsychological tests and neuroimaging, as well as the differential diagnosis. Potential treatments, including secondary prevention, post-diagnostic support and self-help are discussed. Finally, medico-legal matters such as driving, lasting power of attorney and employment are outlined.

  20. Multidrug resistant tuberculosis diagnosed by synovial fluid analysis.

    PubMed

    van Zeller, M; Monteiro, R; Ramalho, J; Almeida, I; Duarte, R

    2012-01-01

    Tuberculosis remains a major public health problem worldwide. HIV co-infection is contributing to an increased incidence of the disease, particularly that caused by multidrug resistant strains of Mycobacterium tuberculosis (MT). We describe an HIV-infected patient with pleural and lymph node tuberculosis diagnosed by pleural effusion characteristics and biopsy specimens, without MT identification, that further presented with knee-joint involvement. Arthrocentesis allowed MT isolation and drug susceptibility testing, resulting in a diagnosis of multidrug-resistant tuberculosis and an appropriate treatment regimen. MT identification and drug susceptibility tests are very important, especially for HIV co-infected patients.

  1. Reflection on diagnosing as a nurse in ITU.

    PubMed

    Cutler, L

    2000-01-01

    Brookfield's (1995) four critically reflective lenses are adapted from teaching and applied to nursing within this article. The lenses are used as a framework for exploring the author's feelings associated with diagnosing a life-threatening problem in intensive care in the presence of a disagreeing doctor. The issues surrounding the distinctions between medicine and nursing are explored. Wellington and Austin's (1996) five orientations to reflection provide the framework for the author's 'metacognition'--his thoughts about his thoughts. These are communicated by way of a critical commentary.

  2. Inverse Association of Serum Docosahexaenoic Acid With Newly Diagnosed Hypertension

    PubMed Central

    Yang, Bo; Ding, Fang; Wang, Feng-Lei; Yu, Wei; Li, Duo

    2016-01-01

    Abstract Observational studies on circulating fatty acid (FA) and primary prevention of hypertension have yielded inconsistent results, and the association among the Chinese population is not fully clear. The aim of the study was to discern important FAs that can discriminate hypertensive patients from normotensive persons, and investigate associations between the important FAs and risk of hypertension. We conducted a case-control study nested within a community-based cohort of 2447 Chinese participants aged 35 to 79 years who completed a baseline assessment between October 2012 and April 2013. In all, 480 patients with newly diagnosed hypertension were identified at baseline and 480 normotensive individuals were randomly selected as matched normotensive controls. Controls were individually matched to cases by age (±2 y), sex, and recruitment center, with a 1:1 case-to-control ratio. Serum FA profile was compared between cases and controls by orthogonal partial least squares-discriminant analyses. Odds ratio (OR) with 95% confidence interval (CI) for newly diagnosed hypertension was estimated by a conditional logistical analysis. After adjustment for body mass index, education, profession, family history of hypertension, salt intake, heart rate, blood lipids, and fasting glucose levels, serum FA profile in hypertensive patients was typically characterized by higher 16:0 and 16:1n-7, and lower 18:2n-6 and 22:6n-3, compared with normotensive controls. Docosahexaenoic acid (22:6n-3) and palmitoleic acid (16:1n-7) were identified as the important FA contributing most to the intergroup separations. When comparing the highest and lowest quartile of FA composition, newly diagnosed hypertension was negatively associated with 22:6n-3 (OR 0.65; 95% CI, 0.45–0.93; P for trend = 0.02), but positively associated with 16:1n-7 (OR 2.14; 95% CI, 1.46–3.12; P for trend < 0.001). The associations remained pronounced after multiple adjustments and in further stratified

  3. Some Clinical Diagnoses are More Reliable than Others

    DTIC Science & Technology

    1989-03-29

    a more reliable measure than diagnostic type (e.g., schizophrenia versus personality disor- der). Diagnostic type, in turn, was a more reliable...diagnoses included thie following diagnostic typesý: 1) organic psychoses, 2) schizophrenia , 3) affective psychoses, 4) pala- 4 noia, 5) other...Else 1 vs 2 2 vy: 3 3 vs 4 4 vs 5 1st vs Last Last PE Board Organic Psychoses .15 .0o .16 .15 .13 .31 Schizophrenia .5F .61 .63 .73 .58 .72 Affective Pty

  4. Distinguishing and diagnosing contemporary and conventional features of dental erosion.

    PubMed

    Bassiouny, Mohamed A

    2014-01-01

    The vast number and variety of erosion lesions encountered today require reconsideration of the traditional definition. Dental erosion associated with modern dietary habits can exhibit unique features that symbolize a departure from the decades-old conventional image known as tooth surface loss. The extent and diversity of contemporary erosion lesions often cause conflicting diagnoses. Specific examples of these features are presented in this article. The etiologies, genesis, course of development, and characteristics of these erosion lesions are discussed. Contemporary and conventional erosion lesions are distinguished from similar defects, such as mechanically induced wear, carious lesions, and dental fluorosis, which affect the human dentition.

  5. [Use of echocardiography for diagnosing anomalies of sex differentiation].

    PubMed

    Calzi, P; Paesano, P L; Gargantini, L; Braggion, F; Del Maschio, A; Chiumello, G

    1989-01-01

    Real-time ultrasonography of pelvic organs is a useful tool in diagnosing disorders in sexual development. US has proved to be rapid, accurate, non invasive method to visualize normal and pathologic pelvic structures and its role in intersex disorders lies in the capacity of demonstrate the anatomy of the genital and urinary tracts. The sonographic finding of feminine internal genitalia and bilateral enlargement of the adrenal glands in a newborn is suggestive for congenital adrenal hyperplasia (CAH) and allows to prevent the symptoms of a salt-losing syndrome.

  6. Colouterine fistula complicating diverticulitis diagnosed at hysteroscopy: case report.

    PubMed

    Mandato, Vincenzo Dario; Abrate, Martino; Sandonà, Francesco; Costagliola, Luigi; Gastaldi, Alfredo; La Sala, Giovanni Battista

    2012-01-01

    Since Noecker first reported a colouterine fistula secondary to diverticulitis in 1929, about 20 cases have been reported in the literature. Methods for diagnosis have yet to be established. Herein we report the first case of a colouterine fistula at the level of the isthmus diagnosed at hysteroscopy. Diagnostic hysteroscopy enabled rapid diagnosis of the colouterine fistula. Diagnostic hysteroscopy is the first-choice diagnostic tool for investigation of any abnormal vaginal discharge such as blood or stool because it enables direct vision and biopsy of the lesions of the lower genital tract quickly and at low cost.

  7. Foray of Cytologically Diagnosed Intramuscular Sarcocystosis- A Rarity

    PubMed Central

    Krishnamurthy, Anoosha; Puttaveerachary, Ashok Kagathur; Govindashetty, Abhishek Mandya; Sahni, Swati

    2015-01-01

    Sarcocystosis is an uncommonly encountered zoonotic coccidial protozoal infestation of human beings. The sarcocystis species is known to produce intestinal and muscular infestations in humans. We report a rare case of a 35-year-old female with an intramuscular swelling in the lumbar region diagnosed cytologically as “Intramuscular Sarcocystosis” and subsequently confirmed on histopathology. This case highlights the role of fine needle aspiration cytology in the identification of Sarcocystis and its role in differentiating it from other intramuscular parasites which is of immense value in precise diagnosis and appropriate patient management. PMID:26155487

  8. Legal Responsibilities of Physicians When They Diagnose Hepatic Encephalopathy.

    PubMed

    Vierling, John M

    2015-08-01

    Both covert hepatic encephalopathy (CHE) and overt hepatic encephalopathy (OHE) impair the ability to operate machinery. The legal responsibilities of US physicians who diagnose and treat patients with hepatic encephalopathy vary among states. It is imperative that physicians know the laws regarding reporting in their state. OHE represents a neuropsychiatric impairment that meets general reporting criteria. The medical advisory boards of the states have not identified OHE as a reportable condition. In the absence of validated diagnostic guidelines, physicians are not obligated to perform tests for CHE. There is a need for explicit guidance from professional associations regarding this issue.

  9. Method and apparatus for diagnosing breached fuel elements

    DOEpatents

    Gross, K.C.; Lambert, J.D.B.; Nomura, S.

    1987-03-02

    The invention provides an apparatus and method for diagnosing breached fuel elements in a nuclear reactor. A detection system measures the activity of isotopes from the cover gas in the reactor. A data acquisition and processing system monitors the detection system and corrects for the effects of the cover-gas clean up system on the measured activity and further calculates the derivative curve of the corrected activity as a function of time. A plotting system graphs the derivative curve, which represents the instantaneous release rate of fission gas from a breached fuel element. 8 figs.

  10. Congenital left ventricular aneurysm diagnosed by spiral CT angiography

    SciTech Connect

    Beregi, J.P.; Coulette, J.M.; Ducloux, G.

    1996-05-01

    We report a rare case of congenital left ventricular aneurysm, diagnosed by spiral CT angiography. Despite 1 s time acquisition, spiral CT, with adequate acquisition parameters and bolus injection of contrast medium, produced sufficiently good images to permit visualization of the aneurysm. Subsequently, reconstructions (shaded surface display and multiplanar reformation) were performed to demonstrate the relationship of the aneurysm with the remainder of the left ventricle, the wide neck of the aneurysm, and the absence of contractility, therein permitting differentiation from a congenital diverticulum. 6 refs., 3 figs.

  11. High-Resolution Methods for Diagnosing Cartilage Damage In Vivo

    PubMed Central

    Novakofski, Kira D.; Pownder, Sarah L.; Koff, Matthew F.; Williams, Rebecca M.; Potter, Hollis G.; Fortier, Lisa A.

    2016-01-01

    Advances in current clinical modalities, including magnetic resonance imaging and computed tomography, allow for earlier diagnoses of cartilage damage that could mitigate progression to osteoarthritis. However, current imaging modalities do not detect submicrometer damage. Developments in in vivo or arthroscopic techniques, including optical coherence tomography, ultrasonography, bioelectricity including streaming potential measurement, noninvasive electroarthrography, and multiphoton microscopy can detect damage at an earlier time point, but they are limited by a lack of penetration and the ability to assess an entire joint. This article reviews current advancements in clinical and developing modalities that can aid in the early diagnosis of cartilage injury and facilitate studies of interventional therapeutics. PMID:26958316

  12. [Case of Behcet's disease diagnosed by bilateral epididymitis].

    PubMed

    Horii, Sayaka; Takada, Shingo; Kinjo, Takanori; Nonomura, Daichi; Yamamoto, Yoshiyuki; Yoneda, Suguru; Nomura, Hironori; Tei, Norihide; Matsumiya, Kiyomi; Shiroyama, Yoshimi

    2014-11-01

    A 24-year-old man visited our emergency room with testicular pain and left shoulder pain, and was admitted to our hospital for diagnosis of bilateral epididymitis. Antibiotics and anti-inflammatory medication were started, but the symptoms did not improve. During hospitalization, ulcerous lesions, erythema nodosum, folliculitis-like exanthema and multiple oral aphtha appeared. Then, we consulted the department of dermatology. As he had a combination of arthritis and epididymitis, he was diagnosed with the abortive form of Behcet's disease. After diagnosis, we began administering colchicine. Then, all symptoms improved in a few days, and he has remained free of the disease after the discontinuation of colchicine.

  13. Initial linkage and subsequent retention in HIV care for a newly diagnosed HIV-infected cohort in Denver, Colorado.

    PubMed

    Gardner, Edward M; Daniloff, Elaine; Thrun, Mark W; Reirden, Daniel H; Davidson, Arthur J; Johnson, Steven C; Wilmoth, Ralph; Connick, Elizabeth; Burman, William J

    2013-01-01

    This is a retrospective cohort study of 352 newly diagnosed HIV-infected individuals in Denver, from 2005 to 2007. Utilizing data from 3 health care systems, 2 clinical trials units, and statewide Colorado HIV laboratory reporting databases, we tracked initial linkage to HIV care, retention in care, loss to follow-up, and transitions between HIV care providers. After more than 2.6 years of follow-up, 256 (73%) individuals linked to HIV care within 180 days. Of the 301 individuals who eventually linked to care, 168 (56%) had at least one 180-day gap in care, while 49 (16%) had a 360-day gap. Transitions in care were common, with 131 (37%) individuals accessing care from 2 different providers and 15% having evidence of living outside of Colorado. In this newly diagnosed HIV-infected cohort, linkage to care was slow and long-term retention in care was poor. Transitions between HIV care providers were common and may impair engagement in care over time. Out-of-state migration was frequent and may cause an underestimation of engagement in care.

  14. [Diagnosing and expertizing asbestos-induced occupational diseases].

    PubMed

    Baur, X; Schneider, J; Woitowitz, H-J

    2011-11-01

    Due to latency periods that can last for decades, asbestos-related diseases show 18 years after the enforcement of the prohibition of asbestos application in Germany their highest numbers. In the centre of attention are asbestos-induced pleural fibroses, mesotheliomas, asbestoses, lung and laryngeal cancer. Diagnosing and expertizing these diseases causes difficulties, is hitherto non-uniform and does frequently not correspond to the current medico-scientific expertise. This induced the German Respiratory Society as well as the German Society of Occupational and Environmental Medicine in cooperation with the German Society of Pathology, the German Radiology Society and the German Society of Otorhinolaryngology, Head and Cervical Surgery, to develop the above mentioned guideline during seven meetings moderated by AWMF. The required thorough diagnosis is based on the detailed recording of a qualified occupational history. Since the sole radiological and pathological-anatomical findings cannot sufficiently contribute to the causal relationship the occupational history recorded by a general physician and a specialist is of decisive importance. These physicians have to report suspected occupational diseases and to advise patients on social and medical questions. Frequently, problems occur if the recognition of an occupational disease is neglected due to a supposedly too low exposure or too few ferruginous bodies or low fibre concentrations in lung tissue. The new S2k directive summarizing the current medico-scientific knowledge is for this reason, for diagnoses and expert opinions as well as for the determination of a reduced capacity for work a very important source of information.

  15. Delusional infestations: case series, differential diagnoses, and management strategies.

    PubMed

    Diaz, James H; Nesbitt, Lee T

    2014-01-01

    Physicians are not infrequently consulted by distraught patients with delusions of infestation who believe that they are infested with external or internal parasites and describe a crawling sensation of bugs or worms on or under their skin. Internet search engines were queried with the keywords as search terms to examine the latest articles on delusional infestations in order to describe presenting manifestations, differential diagnoses, and effective management strategies. The demographic and behavioral features of delusional infestations have remained constant and include: (1) onset in well-educated, middle-aged adults who are pet owners; (2) production of purported specimens of causative parasites; (3) pesticide overtreatment of themselves, their households, and pets; (4) excessive cleaning or vacuuming of households; (5) intense anger and resentment directed at physicians failing to confirm their self-diagnoses; and (6) sharing delusional symptoms with spouses or relatives. Although some reports have suggested that cases of delusional infestation are increasing today in the tropics, most studies have confirmed a stable incidence over time and similar disorder demographics worldwide. However, management strategies for delusional infestations have changed significantly over time with second generation, atypical antipsychotics offering safer adverse effect profiles and better prognoses than earlier therapies with first generation, typical antipsychotics. The most effective management strategies for delusional infestations include empathetic history-taking and active listening to the patient, careful exclusion of true parasitoses, and a therapeutic regimen that includes a second generation neuroleptic agent.

  16. Acute Stress in Parents of Children Newly Diagnosed With Cancer

    PubMed Central

    Patiño-Fernández, Anna Maria; Pai, Ahna L.H.; Alderfer, Melissa; Hwang, Wei-Ting; Reilly, Anne; Kazak, Anne E.

    2010-01-01

    Objective Acute Stress Disorder (ASD) and subclinical symptoms of acute stress (SAS) may be a useful framework for understanding the psychological reactions of mothers and fathers of children newly diagnosed with a pediatric malignancy. Patients and Methods Mothers (N = 129) and fathers (N = 72) of 138 children newly diagnosed with cancer completed questionnaires assessing acute distress, anxiety, and family functioning. Demographic data were also gathered. Inclusion criteria were: a confirmed diagnosis of a pediatric malignancy in a child under the age of 18 years without prior chronic or life threatening illness and fluency in English or Spanish. Results Descriptive statistics and multiple linear regressions were used to examine predictors of SAS. Fifty-one percent (N = 66) of mothers and 40% (N = 29) of fathers met DSM-IV diagnostic criteria for ASD. The majority of the sample reported experiencing at least one SAS. General anxiety, but not family functioning, was a strong predictor of SAS in both mothers and fathers even after controlling for demographic characteristics. Conclusions Immediately following their child’s diagnosis of cancer, most mothers and fathers experience SAS, with a subsample meeting criteria for ASD. More anxious parents are at heightened risk of more intense reactions. The findings support the need for evidence-based psychosocial support at diagnosis and throughout treatment for families who are at risk for acute distress reactions. PMID:17514742

  17. MOORE: A prototype expert system for diagnosing spacecraft problems

    NASA Technical Reports Server (NTRS)

    Howlin, Katherine; Weissert, Jerry; Krantz, Kerry

    1988-01-01

    MOORE is a rule-based, prototype expert system that assists in diagnosing operational Tracking and Data Relay Satellite (TDRS) problems. It is intended to assist spacecraft engineers at the TDRS ground terminal in trouble shooting problems that are not readily solved with routine procedures, and without expert counsel. An additional goal of the prototype system is to develop in-house expert system and knowledge engineering skills. The prototype system diagnoses antenna pointing and earth pointing problems that may occur within the TDRS Attitude Control System (ACS). Plans include expansion to fault isolation of problems in the most critical subsystems of the TDRS spacecraft. Long term benefits are anticipated with use of an expert system during future TDRS programs with increased mission support time, reduced problem solving time, and retained expert knowledge and experience. Phase 2 of the project is intended to provide NASA the necessary expertise and capability to define requirements, evaluate proposals, and monitor the development progress of a highly competent expert system for NASA's Tracking Data Relay Satellite. Phase 2 also envisions addressing two unexplored applications for expert systems, spacecraft integration and tests (I and T) and support to launch activities. The concept, goals, domain, tools, knowledge acquisition, developmental approach, and design of the expert system. It will explain how NASA obtained the knowledge and capability to develop the system in-house without assistance from outside consultants. Future plans will also be presented.

  18. Diagnostic frameworks and nursing diagnoses: a normative stance.

    PubMed

    Zanotti, Renzo; Chiffi, Daniele

    2015-01-01

    Diagnostic frameworks are essential to many scientific and technological activities and clinical practice. This study examines the main fundamental aspects of such frameworks. The three components required for all diagnoses are identified and examined, i.e. their normative dimension, temporal nature and structure, and teleological perspective. The normative dimension of a diagnosis is based on (1) epistemic values when associated with Hempel's inductive risk concerning the balance between false-positive and false-negative outcomes, leading to probabilistic judgements; and (2) non-epistemic values when related to ideas such as well-being, normality, illness, etc, as idealized norms or ideal points of reference. It should be noted that medical diagnoses match the three necessary components, while some essential diagnostic frameworks - the taxonomies of Gordon and NANDA - in nursing lack some components. The main lack is normative as the most popular frameworks in nursing diagnosis seem to be descriptions of observed reality rather than normative and value-based judgements in which both epistemic and non-epistemic values may coexist.

  19. Variability in Diagnosing Brain Death at an Academic Medical Center

    PubMed Central

    Pandey, Ashutosh; Sahota, Pradeep; Nattanmai, Premkumar

    2017-01-01

    Objective. Research continues to highlight variability in hospital policy and documentation of brain death. The aim of our study was to characterize how strictly new guidelines of American Academy of Neurology (AAN) for death by neurological criteria were practiced in our hospital prior to appointment of neurointensivists. Method. This is a retrospective study of adults diagnosed as brain dead from 2011 to 2015. Descriptive statistics compared five categories: preclinical testing, neurological examination, apnea tests, ancillary test, and documentation of time of death. Strict adherence to AAN guidelines for brain death determination was determined. Result. 76 patients were included in this study. Preclinical prerequisites were fulfilled in 53.9% and complete neurological examinations were documented in 76.3%. Apnea test was completed in 39.5%. Ancillary test was completed in 29.8%. Accurate documentation of time of death occurred in 59.2%. Overall, strict adherence to current AAN guidelines for death by neurological criteria was correctly documented in 38.2%. Conclusion. Our study shows wide variability in diagnosing brain death. These findings led us to update our death by neurological criteria policy and increase awareness of brain death determination with the goal of improving our documentation following current AAN guidelines. PMID:28352638

  20. Diagnosing gastrointestinal illnesses using fecal headspace volatile organic compounds

    PubMed Central

    Chan, Daniel K; Leggett, Cadman L; Wang, Kenneth K

    2016-01-01

    Volatile organic compounds (VOCs) emitted from stool are the components of the smell of stool representing the end products of microbial activity and metabolism that can be used to diagnose disease. Despite the abundance of hydrogen, carbon dioxide, and methane that have already been identified in human flatus, the small portion of trace gases making up the VOCs emitted from stool include organic acids, alcohols, esters, heterocyclic compounds, aldehydes, ketones, and alkanes, among others. These are the gases that vary among individuals in sickness and in health, in dietary changes, and in gut microbial activity. Electronic nose devices are analytical and pattern recognition platforms that can utilize mass spectrometry or electrochemical sensors to detect these VOCs in gas samples. When paired with machine-learning and pattern recognition algorithms, this can identify patterns of VOCs, and thus patterns of smell, that can be used to identify disease states. In this review, we provide a clinical background of VOC identification, electronic nose development, and review gastroenterology applications toward diagnosing disease by the volatile headspace analysis of stool. PMID:26819529

  1. Severe antenatally diagnosed renal disorders: background, prognosis and practical approach.

    PubMed

    Aulbert, Wiebke; Kemper, Markus J

    2016-04-01

    Nowadays most renal disorders, especially urinary tract malformations and renal cystic disease, are diagnosed antenatally. In cases of severe bilateral disease, intrauterine renal dysfunction may lead to renal oligohydramnios (ROH), resulting in pulmonary hypoplasia which affects perinatal mortality and morbidity as well as the long-term outcome. However, some infants may only have mild pulmonary and renal disease, and advances in postnatal and dialysis treatment have resulted in improved short- and long-term outcome even in those infants with severe ROH. Here, we review the current state of knowledge and clinical experience of patients presenting antenatally with severe bilateral renal disorders and ROH. By addressing underlying mechanisms, intrauterine tools of diagnosis and treatment as well as published outcome data, we hope to improve antenatal counselling and postnatal care. KEY SUMMARY POINTS: 1. Nowadays most renal disorders are diagnosed antenatally, especially urinary tract malformations and renal cystic disease. 2. Severe kidney dysfunction may lead to renal oligohydramnios, which can cause pulmonary hypoplasia and is a risk factor of perinatal mortality and postnatal renal outcome. However, as considerable clinical heterogeneity is present, outcome predictions need to be treated with caution. 3. Advances in postnatal and dialysis treatment have resulted in improved short- and long-term outcomes even in infants with severe renal oligohydramnios. 4. A multidisciplinary approach with specialist input is required when counselling a family with an ROH-affected fetus as the decision-making process is very challenging.

  2. [Tufting enteropathy: a case report, histopathological methodology, and differential diagnoses].

    PubMed

    Bosaleh, Andrea; Contreras, Monica; García de Dávila, María Teresa

    2015-03-01

    Tufting enteropathy (TE), previously known as intestinal epithelial dysplasia, is a rare congenital enteropathy characterized by refractory diarrhea in the neonatal period. It presents clinical and histological heterogeneity and may be associated with birth defects and punctuate keratitis. The causative gene(s) have not yet been identfied making prenatal diagnosis unavailable. Although there are milder phenotypes most require parenteral nutrition for prolonged periods with the risk of complications. TE becomes an indication for intestinal transplantation. We report the case of a 4-month-old male, born full term with a normal weight. The parents consulted because of severe malnutrition and chronic watery diarrhea. Duodenal and rectal biopsy was negative. Because of poor tolerance gastroclysis was changed to parenteral nutrition. The infant had several catheter-related infections and died at 13 months from catheter-associated complications. Histopathological autopsy was performed. The material was fixed in paraffin and studied with routine techniques. PAS and immunohistochemistry for CD10 were performed. We observed villous atrophy with intestinal epithelial dysplasia and disorganization on the surface of epithelial cells resembling tufts in jejunal and ileal tissue. The objective of this study was to present a rare case of neonatal enteropathy, especially TE, describe the methodology used to study the biopsy, and discuss the differential diagnoses. TE is a rare neonatal enteropathy that is difficult to diagnose and manage. Children in whom TE is suspected should be referred to specialized pediatric centers, with the option of intestinal transplantation.

  3. Chemotherapy in newly diagnosed primary central nervous system lymphoma

    PubMed Central

    Hashemi-Sadraei, Nooshin; Peereboom, David M.

    2010-01-01

    Primary central nervous system lymphoma (PCNSL) accounts for only 3% of brain tumors. It can involve the brain parenchyma, leptomeninges, eyes and the spinal cord. Unlike systemic lymphoma, durable remissions remain uncommon. Although phase III trials in this rare disease are difficult to perform, many phase II trials have attempted to define standards of care. Treatment modalities for patients with newly diagnosed PCNSL include radiation and/or chemotherapy. While the role of radiation therapy for initial management of PCNSL is controversial, clinical trials will attempt to improve the therapeutic index of this modality. Routes of chemotherapy administration include intravenous, intraocular, intraventricular or intra-arterial. Multiple trials have outlined different methotrexate-based chemotherapy regimens and have used local techniques to improve drug delivery. A major challenge in the management of patients with PCNSL remains the delivery of aggressive treatment with preservation of neurocognitive function. Because PCNSL is rare, it is important to perform multicenter clinical trials and to incorporate detailed measurements of long-term toxicities. In this review we focus on different chemotherapeutic approaches for immunocompetent patients with newly diagnosed PCNSL and discuss the role of local drug delivery in addition to systemic therapy. We also address the neurocognitive toxicity of treatment. PMID:21789140

  4. Diagnosing gastrointestinal illnesses using fecal headspace volatile organic compounds.

    PubMed

    Chan, Daniel K; Leggett, Cadman L; Wang, Kenneth K

    2016-01-28

    Volatile organic compounds (VOCs) emitted from stool are the components of the smell of stool representing the end products of microbial activity and metabolism that can be used to diagnose disease. Despite the abundance of hydrogen, carbon dioxide, and methane that have already been identified in human flatus, the small portion of trace gases making up the VOCs emitted from stool include organic acids, alcohols, esters, heterocyclic compounds, aldehydes, ketones, and alkanes, among others. These are the gases that vary among individuals in sickness and in health, in dietary changes, and in gut microbial activity. Electronic nose devices are analytical and pattern recognition platforms that can utilize mass spectrometry or electrochemical sensors to detect these VOCs in gas samples. When paired with machine-learning and pattern recognition algorithms, this can identify patterns of VOCs, and thus patterns of smell, that can be used to identify disease states. In this review, we provide a clinical background of VOC identification, electronic nose development, and review gastroenterology applications toward diagnosing disease by the volatile headspace analysis of stool.

  5. Advanced solderless flexible thermal link

    NASA Astrophysics Data System (ADS)

    Williams, Brian G.; Jensen, Scott M.; Batty, J. Clair

    1996-10-01

    Flexible thermal links play an important role int he thermal management of cryogenically cooled components. The purpose of these links is to provide a means of transferring heat from a cooled component to a cooler reservoir with little increase in temperature. The standard soldered approach although effective proves to be time consuming and contributes to added thermal impedances which degrade the performance of the link. For system with little tolerance for temperature differences between cooled components and a cooling source this is undesirable. The authors of this paper have developed a technique by which thin metal foil or braided wire can be attached to metal end blocks without any solder using the swaging process. Swaging provides a fast, simple method for providing a low thermal impedance between the foils and blocks. This paper describes the characteristics of these thermal links in terms of length, mass, thermal resistance, flexibility, and survivability.

  6. Linking to NSCEP's Online Publications

    EPA Pesticide Factsheets

    Each online document has a permanent URL that can be linked to for future reference. To find the short URL for a document you need to be in the document and able to view the icon bar above the document.

  7. Saturn and Enceladus Electrical Link

    NASA Video Gallery

    This animated graphic shows how Saturn and its moon Enceladus are electrically linked. Magnetic field lines, invisible to the human eye but detectable by the fields and particles instruments on NAS...

  8. Diagnosing EAP Writing Ability Using the Reduced Reparameterized Unified Model

    ERIC Educational Resources Information Center

    Kim, Youn-Hee

    2011-01-01

    Despite the increasing interest in and need for test information for use in instructional practice and student learning, there have been few attempts to systematically link a diagnostic approach to English for academic purposes (EAP) writing instruction and assessment. In response to this need for research, this study examined the extent to which…

  9. Khovanov homology of graph-links

    SciTech Connect

    Nikonov, Igor M

    2012-08-31

    Graph-links arise as the intersection graphs of turning chord diagrams of links. Speaking informally, graph-links provide a combinatorial description of links up to mutations. Many link invariants can be reformulated in the language of graph-links. Khovanov homology, a well-known and useful knot invariant, is defined for graph-links in this paper (in the case of the ground field of characteristic two). Bibliography: 14 titles.

  10. The faulty statistics of complementary alternative medicine (CAM).

    PubMed

    Pandolfi, Maurizio; Carreras, Giulia

    2014-09-01

    The authors illustrate the difficulties involved in obtaining a valid statistical significance in clinical studies especially when the prior probability of the hypothesis under scrutiny is low. Since the prior probability of a research hypothesis is directly related to its scientific plausibility, the commonly used frequentist statistics, which does not take into account this probability, is particularly unsuitable for studies exploring matters in various degree disconnected from science such as complementary alternative medicine (CAM) interventions. Any statistical significance obtained in this field should be considered with great caution and may be better applied to more plausible hypotheses (like placebo effect) than that examined - which usually is the specific efficacy of the intervention. Since achieving meaningful statistical significance is an essential step in the validation of medical interventions, CAM practices, producing only outcomes inherently resistant to statistical validation, appear not to belong to modern evidence-based medicine.

  11. Infrared Detection of Faulty Solder Joints. Phase 2.2.

    DTIC Science & Technology

    1982-03-01

    Determinations 18 3.1.6 Softening Point Determinations 24 3.2 Damage Prevention on Laminates 26 - 3.3 Laser/thermal Testing Through Conformal Coatings...possibility was conceived and implemented. The feasibility of testing solder joints covered by a conformal coat- ing was confirmed. Several...efficacy of the testing method if it had to be carried out in the presence of a conformal coating. Approximately 1,000 feed-through and lap-joints were

  12. Analytical and Experimental Vibration Analysis of a Faulty Gear System

    NASA Technical Reports Server (NTRS)

    Choy, F. K.; Braun, M. J.; Polyshchuk, V.; Zakrajsek, J. J.; Townsend, D. P.; Handschuh, R. F.

    1994-01-01

    A comprehensive analytical procedure was developed for predicting faults in gear transmission systems under normal operating conditions. A gear tooth fault model is developed to simulate the effects of pitting and wear on the vibration signal under normal operating conditions. The model uses changes in the gear mesh stiffness to simulate the effects of gear tooth faults. The overall dynamics of the gear transmission system is evaluated by coupling the dynamics of each individual gear-rotor system through gear mesh forces generated between each gear-rotor system and the bearing forces generated between the rotor and the gearbox structure. The predicted results were compared with experimental results obtained from a spiral bevel gear fatigue test rig at NASA Lewis Research Center. The Wigner-Ville distribution (WVD) was used to give a comprehensive comparison of the predicted and experimental results. The WVD method applied to the experimental results were also compared to other fault detection techniques to verify the WVD's ability to detect the pitting damage, and to determine its relative performance. Overall results show good correlation between the experimental vibration data of the damaged test gear and the predicted vibration from the model with simulated gear tooth pitting damage. Results also verified that the WVD method can successfully detect and locate gear tooth wear and pitting damage.

  13. Beamforming Arrays with Faulty Sensors in Dynamic Environments

    DTIC Science & Technology

    2004-01-01

    slightly outperforms MMSE at all SNR’s. • ALPINEX ( Swinger and Walker) degrades significantly in correlated multipath. • Single snapshot ROC for...MMSE at all SNR’s. • ALPINEX ( Swinger and Walker) degrades significantly in correlated multipath. 14 Simulated BTR for ACC vs. Clairvoyant Beamformer

  14. Hypercapnia resulting from a faulty co-axial (Bain) circuit.

    PubMed

    Singh, Ishwar; Gupta, Monika; Singh, Tarun K

    2011-07-01

    The Bain co-axial circuit is fully established in general anaesthesia practice. A major concern is the potential malfunctioning of the circuit due to avulsion of the inner fresh gas delivery tube at the machine end of the circuit. The following case report presents a case in which a patient connected to the Bain circuit developed severe hypercapnia in the early intraoperative period due to the above mentioned defect.

  15. Susceptibility to febrile seizures: more than just a faulty thermostat!

    PubMed

    Prasad, Asuri N; Seshia, Shashi S

    2009-05-01

    Febrile seizures, always a hot topic, continue to fire up the interest of a wide spectrum of clinical and basic neuroscientists. Several clinical investigators, amongst them the Halifax group (spearheaded by the Camfields to whom we owe a great debt of gratitude for their contributions in this field), have provided us with a sound foundation for clinical management. We now need to explore febrile seizures in new ways to clarify factors and identify mechanisms that contribute to the intriguing age-dependent susceptibility. The complex processes involved in thermoregulation and the febrile response are important pieces of the puzzle. The contributory factors are likely different for isolated simple febrile, recurrent febrile and complex febrile seizures. A 'systems biology approach' is needed to investigate the intricate genome-proteome-metabolome interaction in determining susceptibility. Population studies that incorporate current clinical, experimental, infectious and molecular genetic knowledge in their concept and design will help to 'conquer' the final frontiers of febrile seizures. In 2006, Engel suggested that febrile seizures could 'encompass many different entities', an increasingly plausible opinion. A higher profile for febrile seizures and related syndromes in the ILAE classification scheme will further catalyze progress in the field. The resultant knowledge can only improve management.

  16. On some faulty concepts in Soviet urban studies.

    PubMed

    Agafonov, N T; Lavrov, S B; Khorev, B S

    1983-03-01

    "The authors attack what they call 'superurbanism' and 'agglocentrism,' an excessive preoccupation among some Soviet geographers with urbanization and the formation of urban agglomerations. The authors advocate what is known in Soviet geography as a 'unified system of settlement,' meaning a harmonious blend of both urban and rural forms. The 'agglocentrists' are said to derive their ideas from Western models, and the authors [note the growing] disenchantment with excessive urbanism in the West."

  17. Does sadness impair color perception? Flawed evidence and faulty methods

    PubMed Central

    Holcombe, Alex O.; Brown, Nicholas J. L.; Goodbourn, Patrick T.; Etz, Alexander; Geukes, Sebastian

    2016-01-01

    In their 2015 paper, Thorstenson, Pazda, and Elliot offered evidence from two experiments that perception of colors on the blue–yellow axis was impaired if the participants had watched a sad movie clip, compared to participants who watched clips designed to induce a happy or neutral mood. Subsequently, these authors retracted their article, citing a mistake in their statistical analyses and a problem with the data in one of their experiments. Here, we discuss a number of other methodological problems with Thorstenson et al.’s experimental design, and also demonstrate that the problems with the data go beyond what these authors reported. We conclude that repeating one of the two experiments, with the minor revisions proposed by Thorstenson et al., will not be sufficient to address the problems with this work. PMID:27606051

  18. Techniques for the Detection of Faulty Packet Header Modifications

    DTIC Science & Technology

    2014-03-12

    shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number...66 6.3 Appsalt . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66 7 Evaluation 69 7.1 Controlled Environment...Electronic Frontier Foundation ICMP Internet Control Message Protocol ICSI International Computer Science Institute IDS intrusion detection system IEEE

  19. How Do Health Care Providers Diagnose Precocious Puberty and Delayed Puberty?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose precocious puberty & delayed puberty? Skip sharing ... and analyzing his or her medical history, a health care provider may perform tests to diagnose precocious puberty, ...

  20. Sociodemographic Study of Danish Individuals Diagnosed with Transsexualism

    PubMed Central

    Simonsen, Rikke; Hald, Gert Martin; Giraldi, Annamaria; Kristensen, Ellids

    2015-01-01

    Introduction Male-to-female (MtF) and female-to-male (FtM) individuals with transsexualism (International Classification of Diseases-10) may differ in core clinical and sociodemographic variables such as age, sexual orientation, marriage and parenthood, school, educational level, and employment. Assessing and understanding the implication of such differences may be a key to developing appropriate and effective treatment and intervention strategies for this group. However, research in the area remains sparse and is often on small populations, making the generalization of results from current studies on individuals diagnosed with transsexualism difficult. Aims (i) To describe and assess key sociodemographic and treatment-related differences between MtF and FtM individuals in a Danish population of individuals diagnosed with transsexualism; (ii) to assess possible implications of such difference, if any, for clinical treatment initiatives for individuals diagnosed with transsexualism. Methods Follow-up of 108 individuals who had permission to undergo sex reassignment surgery (SRS, meaning castration and genital plastic surgery) over a 30-year period from 1978 to 2008 through the Gender Identity Unit in Copenhagen, Denmark. The individuals were identified through Social Security numbers. Clinical and sociodemographic data from medical records were collected. Results The sex ratio was 1.16:1 (MtF : FtM). Mean age at first referral was 26.9 (standard deviation [SD] 8.8) years for FtM and 30.2 (SD 9.7) for MtF individuals. Compared with MtF, FtM had a significantly lower onset age (before 12 years of age) and lower age when permission for SRS was granted. Further, FtM individuals were significantly more often gynephilic (sexually attracted to females) during research period and less likely to start self-initiated hormonal sex reassignment (SR) (treatment with cross-sex hormones). The MtF and FtM groups did not differ in years of school, educational level, employment

  1. Bone Disease in Newly Diagnosed Lupus Nephritis Patients

    PubMed Central

    Resende, Aline Lázara; dos Reis, Luciene Machado; Dias, Cristiane Bitencourt; Custódio, Melani Ribeiro; Jorgetti, Vanda; Woronik, Viktoria

    2014-01-01

    Introduction Bone loss in Lupus Nephritis (LN) patients is common and multifactorial. The aim of this study was to evaluate the bone status of newly diagnosed LN patients and their correlation with inflammatory factors involved in LN physiopathology. Methods We studied 15 pre-menopausal patients with ≤2 months of diagnosed SLE and LN. Patients with prior kidney or bone disease were excluded. In addition to biochemical evaluation (including 25-hydroxyvitamin D3 [25(OH)D] and Monocyte Chemotactic Protein (MCP1) dosage), we performed bone biopsies followed by osteoblast culture, histomorphometric and immunohistochemistry analysis. Results LN patients presented a mean age of 29.5±10 years, a proteinuria of 4.7±2.9 g/day and an estimated glomerular filtration rate (GFR) of 37(31–87) ml/min/1,73 m2. They were on glucocorticoid therapy for 34±12 days. All patients presented vitamin D insufficiency (9.9±4.4 ng/ml, range 4–20). Urinary MCP1 correlated negatively with 25(OH)D (r = −0.53, p = 0.003) and positively with serum deoxypyridinoline (r = 0.53, p = 0.004). Osteoblasts isolated from LN bone biopsies presented a significantly higher expression of MCP-1 when compared to controls (32.0.±9.1 vs. 22.9±5.3 mean fluorescence intensities, p = 0.01). LN patients presented a significantly reduced osteoid volume, osteoid thickness, osteoid surface, mineralization surface and bone formation rate, associated with an increased eroded surface and osteoclast surface. Patient’s bone specimens demonstrated a reduced immunostaining for osteoprotegerin (0.61±0.82 vs. 1.08±0.50%, p = 0.003), and an increased expression of Receptor Activator of NF-κB ligand (RANKL) (1.76±0.92 vs. 0.41±0.28%, p<0.001) when compared to controls. Discussion Newly diagnosed LN patients presented a significant disturbance in bone metabolism, characterized by an impaired bone formation and mineralization, associated with an increase in resorption parameters

  2. Radio Links for the NASA ABTS

    NASA Technical Reports Server (NTRS)

    Jeutter, Dean C.

    1996-01-01

    The report discusses: (1) Determination Out-Link Frequency Shift Keying (FSK) Bandwidth. (2) Development FSK Out-link Transmitter. (3) Development Wideband Out-link FSK Receiver. (4) Development OOK In-Link Transmitter. (5) Development OOK In-Link Receiver. and (6) Marry Out-Link & In-Link Components. Out-link FSK Bandwidth preliminary in-link transmitter were accomplished in Summer 1995 visit. The calculation of FSK bandwidth is repeated in these notes. Spectrum analyzer measurements of the actual FSK spectrum agree well with the calculations.

  3. LinkMind: link optimization in swarming mobile sensor networks.

    PubMed

    Ngo, Trung Dung

    2011-01-01

    A swarming mobile sensor network is comprised of a swarm of wirelessly connected mobile robots equipped with various sensors. Such a network can be applied in an uncertain environment for services such as cooperative navigation and exploration, object identification and information gathering. One of the most advantageous properties of the swarming wireless sensor network is that mobile nodes can work cooperatively to organize an ad-hoc network and optimize the network link capacity to maximize the transmission of gathered data from a source to a target. This paper describes a new method of link optimization of swarming mobile sensor networks. The new method is based on combination of the artificial potential force guaranteeing connectivities of the mobile sensor nodes and the max-flow min-cut theorem of graph theory ensuring optimization of the network link capacity. The developed algorithm is demonstrated and evaluated in simulation.

  4. Indications for spine surgery: validation of an administrative coding algorithm to classify degenerative diagnoses

    PubMed Central

    Lurie, Jon D.; Tosteson, Anna N.A.; Deyo, Richard A.; Tosteson, Tor; Weinstein, James; Mirza, Sohail K.

    2014-01-01

    Study Design Retrospective analysis of Medicare claims linked to a multi-center clinical trial. Objective The Spine Patient Outcomes Research Trial (SPORT) provided a unique opportunity to examine the validity of a claims-based algorithm for grouping patients by surgical indication. SPORT enrolled patients for lumbar disc herniation, spinal stenosis, and degenerative spondylolisthesis. We compared the surgical indication derived from Medicare claims to that provided by SPORT surgeons, the “gold standard”. Summary of Background Data Administrative data are frequently used to report procedure rates, surgical safety outcomes, and costs in the management of spinal surgery. However, the accuracy of using diagnosis codes to classify patients by surgical indication has not been examined. Methods Medicare claims were link to beneficiaries enrolled in SPORT. The sensitivity and specificity of three claims-based approaches to group patients based on surgical indications were examined: 1) using the first listed diagnosis; 2) using all diagnoses independently; and 3) using a diagnosis hierarchy based on the support for fusion surgery. Results Medicare claims were obtained from 376 SPORT participants, including 21 with disc herniation, 183 with spinal stenosis, and 172 with degenerative spondylolisthesis. The hierarchical coding algorithm was the most accurate approach for classifying patients by surgical indication, with sensitivities of 76.2%, 88.1%, and 84.3% for disc herniation, spinal stenosis, and degenerative spondylolisthesis cohorts, respectively. The specificity was 98.3% for disc herniation, 83.2% for spinal stenosis, and 90.7% for degenerative spondylolisthesis. Misclassifications were primarily due to codes attributing more complex pathology to the case. Conclusion Standardized approaches for using claims data to accurately group patients by surgical indications has widespread interest. We found that a hierarchical coding approach correctly classified over 90

  5. Music therapy: a novel motivational approach for dually diagnosed patients.

    PubMed

    Ross, Stephen; Cidambi, Indra; Dermatis, Helen; Weinstein, Jason; Ziedonis, Douglas; Roth, Serena; Galanter, Marc

    2008-01-01

    Co-occurring mental illness and addiction is very common and results in worse treatment outcomes compared to singly diagnosed addicted individuals. Integrated treatment for co-occurring disorders is associated with better treatment outcomes; however there is a wide range of what is included in integrated treatment. Due to patient and staff interests, integrated treatment often includes complementary and alternative therapies, including music and art therapy. There is a need to study how these approaches effect treatment engagement, retention, and outcome. This study was a prospective naturalistic non-randomized pilot study without a control group that sought to evaluate how participation in a music therapy program affected treatment outcomes for individuals with co-occurring mental illness and addiction. In summary, music therapy appears to be a novel motivational tool in a severely impaired inpatient sample of patients with co-occurring disorders. Future studies of music therapy in integrated co-occurring disorder setting should include a control group.

  6. Diagnosing and treating urinary tract infections in older people.

    PubMed

    Armstrong, Kirsty

    2015-05-01

    Even though diagnosing and treating urinary tract infections (UTIs) in older people can be difficult, it is essential to prevent reduction in the patients' wellbeing. Near-patient testing can be useful, but guidelines on this discuss the use of urine dipstick testing and laboratory culture in some detail. In addition, there are significant differences in the management of males and females, those with recurrent infections, and those with catheters. Community nurses are well placed to assess and manage this common condition, implementing correct treatment and resolution, owing to the close relationships they cultivate with service users. This article discusses the diagnosis and management of UTIs in older people, highlighting the differentials and red flags that need to be addressed urgently.

  7. Immunodiffusion test for diagnosing and monitoring pythiosis in horses.

    PubMed Central

    Mendoza, L; Kaufman, L; Standard, P G

    1986-01-01

    A practical, sensitive, and specific immunodiffusion test was developed for diagnosing and monitoring pythiosis in horses. Culture filtrates, a soluble cell mass, and trypsinized Pythium sp. antigens were evaluated against prepared rabbit anti-Pythium sp. serum and pythiosis horse case sera. The culture filtrate antigens demonstrated the greatest capacity for detecting precipitins and the greatest stability during storage. In contrast, the trypsinized antigens had the weakest capability for detecting multiple precipitins and the poorest stability. The 13 sera from horses with proven active pythiosis were positive in immunodiffusion tests with the culture filtrate antigens. Each serum contained from three to six precipitins. Treated horses lost precipitins, and some became antibody negative. No false-positive reactions were noted in tests with sera from normal horses and humans or with sera from a variety of heterologous horse and human infections. Images PMID:3086368

  8. Diagnosing battery behavior with an expert system in PROLOG

    NASA Technical Reports Server (NTRS)

    Kirkwood, N.; Weeks, D. J.

    1986-01-01

    Power for the Hubble Space Telescope comes from a system of 20 solar panel assemblies (SPAs) and six nickel-cadmium batteries. The HST battery system is simulated by the HST Electrical Power System (EPS) testbed at Marshall Space Flight Center. The Nickel Cadmium Battery Expert System (NICBES) is being used to diagnose faults of the testbed system, evaluate battery status and provide decision support for the engineer. Extensive telemetry of system operating conditions is relayed through a DEC LSI-11. A BASIC program running on a PC monitors the flow of data, figures cell divergence and recharge ratio, and stores these values, along with other selected data, for use by the expert system.

  9. McArdle's disease diagnosed following statin-induced myositis.

    PubMed

    Livingstone, Callum; Al Riyami, Said; Wilkins, Peter; Ferns, Gordon A A

    2004-07-01

    We describe the case of a 69-year-old man with a history of muscular symptoms dating back to his childhood; McArdle's disease (glycogen-storage disease V) was diagnosed following an episode of myositis in which a statin and physical exertion appear to have been precipitating factors. This case demonstrates that the ischaemic lactate-ammonia test still has a place in screening patients with symptoms suggestive of McArdle's disease and emphasizes the importance of carrying out glycogen phosphorylase histochemistry on the skeletal muscle biopsy to confirm the diagnosis. In patients who develop a raised plasma creatine kinase level or muscular symptoms during lipid-lowering therapy, the clinician should be alert to the possibility of an underlying myopathy.

  10. A rare case of cardiac anomaly: prenatally diagnosed ectopia cordis.

    PubMed

    Çelik, Yalçın; Hallıoğlu, Olgu; Basut, Nursel; Demetgül, Hasan; Esin Kibar, A

    2015-06-01

    Ectopia cordis is a rare congenital malformation in which the heart is located partially or totally outside the thoracic cavity. The estimated prevalence of ectopia cordis is 5.5-7.9 per million births and it comprises 0.1% of congenital heart diseases. Ectopia cordis is associated with other congenital heart diseases and various tissue and organ disorders. Common cardiac anomalies associated with ectopia cordis include ventricular septal defect, atrial septal defect, pulmonary stenosis, right ventricular diverticulum, double right ventricular outflow tract and tetralogy of Fallot. Extracardiac anomalies associated with ectopia cordis reported in the literature include omphalocele, gastrochisis, cleft lip and palate, scollosis and central nervous system malformations. Here we report a newborn with ectopia cordis who was diagnosed prenatally.

  11. A rare case of cardiac anomaly: prenatally diagnosed ectopia cordis

    PubMed Central

    Çelik, Yalçın; Hallıoğlu, Olgu; Basut, Nursel; Demetgül, Hasan; Esin Kibar, A.

    2015-01-01

    Ectopia cordis is a rare congenital malformation in which the heart is located partially or totally outside the thoracic cavity. The estimated prevalence of ectopia cordis is 5.5–7.9 per million births and it comprises 0.1% of congenital heart diseases. Ectopia cordis is associated with other congenital heart diseases and various tissue and organ disorders. Common cardiac anomalies associated with ectopia cordis include ventricular septal defect, atrial septal defect, pulmonary stenosis, right ventricular diverticulum, double right ventricular outflow tract and tetralogy of Fallot. Extracardiac anomalies associated with ectopia cordis reported in the literature include omphalocele, gastrochisis, cleft lip and palate, scollosis and central nervous system malformations. Here we report a newborn with ectopia cordis who was diagnosed prenatally. PMID:26265899

  12. Zosteriform cutaneous leishmaniasis diagnosed with the help of dermoscopy

    PubMed Central

    Ramot, Yuval; Nanova, Krassimira; Alper-Pinus, Ruslana; Zlotogorski, Abraham

    2014-01-01

    Cutaneous leishmaniasis is usually easy to recognize; however, several atypical features exist, which may pose a diagnostic challenge. Here we report a 55-year-old female patient, who presented with an itchy and painful eruption localized in a dermatomal distribution along the right upper chest. Although the clinical appearance of the lesions suggested the diagnosis of herpes zoster, dermoscopic evaluation revealed erythema, hyperkeratosis, burst star whitish appearance and hairpin vessels, compatible with the diagnosis of cutaneous leishmaniasis. Indeed, leishmania amastigotes were detected by smear from the lesions. Zosteriform presentation of cutaneous leishmaniasis, as exemplified by our patient, is especially rare. In our case dermoscopy has proven to be an accessible and easy tool to diagnose such atypical presentation of cutaneous leishmaniasis, and dermatologists in endemic areas should be familiar with its typical dermoscopic features. PMID:25126460

  13. Incisional endometriosis: diagnosed by fine needle aspiration cytology.

    PubMed

    Veda, P; Srinivasaiah, M

    2010-07-01

    Incisional endometriosis (IE) is a rare entity reported in 0.03-1.08% of women following obstetric or gynecologic surgeries. Most cases reported in literature have appeared after cesarean sections and were often clinically mistaken for hernia, abscess, suture granuloma or lipoma. We hereby report a case of IE following a second trimester hysterotomy, which was diagnosed by fine needle aspiration cytology (FNAC). Our patient was 26 years old, presenting with a mass over anterior abdominal wall, associated with incapacitating pain during each menstrual cycle. FNAC showed epithelial cells, stromal cells and hemosiderin laden macrophages. Based on the typical history, clinical and cytological features, the diagnosis of IE was established. Wide surgical excision was done and the resulting rectus sheath defect was repaired. Patient was followed for 6 months during which time she was symptom free. This article also reviews the spectrum of cytological features and the rare possibility of malignant transformation that can occur in IE.

  14. The Puzzling Unidimensionality of DSM-5 Substance Use Disorder Diagnoses

    PubMed Central

    MacCoun, Robert J.

    2013-01-01

    There is a perennial expert debate about the criteria to be included or excluded for the DSM diagnoses of substance use dependence. Yet analysts routinely report evidence for the unidimensionality of the resulting checklist. If in fact the checklist is unidimensional, the experts are wrong that the criteria are distinct, so either the experts are mistaken or the reported unidimensionality is spurious. I argue for the latter position, and suggest that the traditional reflexive measurement model is inappropriate for the DSM; a formative measurement model would be a more accurate characterization of the institutional process by which the checklist is created, and a network or causal model would be a more appropriate foundation for a scientifically grounded diagnostic system. PMID:24324446

  15. Congenital intrahepatic portosystemic shunt diagnosed during intrauterine life

    PubMed Central

    Bellettini, Camila Vieira; Wagner, Rafaela; Balzanelo, Aleocídio Sette; Andretta, André Luis de Souza; de Moura, Arthur Nascimento; Fabris, Catia Carolina; Gubert, Eduardo Maranhão

    2016-01-01

    Abstract Objective: To report a patient with prenatal diagnosis of portosystemic shunt; a rare condition in humans. Case description: 17-Day-old female infant admitted for investigation of suspected diagnosis of portosystemic shunt, presumed in obstetric ultrasound. The hypothesis was confirmed after abdominal angiography and liver Doppler. Other tests such as echocardiography and electroencephalogram were performed to investigate possible co-morbidities or associated complications, and were normal. We chose conservative shunt treatment, as there were no disease-related complications and this was intrahepatic shunt, which could close spontaneously by the age of 2 years. Comments: Portosystemic shunt can lead to various complications such as hepatic encephalopathy, hypergalactosemia, liver tumors, and hepatopulmonary syndrome. Most diagnoses are done after one month of age, after such complications occur. The prenatal diagnosis of this patient provided greater security for the clinical picture management, as well as regular monitoring, which allows the anticipation of possible complications and perform interventional procedures when needed. PMID:27133713

  16. Dysregulated Breastfeeding Behaviors in Children Later Diagnosed With Autism

    PubMed Central

    Lucas, Ruth Fitts; Cutler, Ann

    2015-01-01

    ABSTRACT Newborn breastfeeding behaviors have not been characterized in children later diagnosed with autism spectrum disorder (ASD). In a qualitative interview, 16 mothers (28–56 years) of children with ASD described their 19 full-term infants’ (38–42 weeks’ gestational age) breastfeeding behaviors. Nine mothers described their infants as demonstrating a dysregulated breastfeeding pattern of sucking without stopping of their own volition. The infants’ latch, weight gain, and other behaviors were recalled as not problematic. This feature of dysregulated feeding pattern in infancy has not been reported previously for children with ASD. If supported by future research, the pattern of a dysregulated feeding pattern in newborns could be evaluated by clinicians in the general pediatric population and/or at-risk infant siblings of children with ASD. PMID:26834438

  17. Primary tibial adamantinoma diagnosed by fine needle aspiration.

    PubMed

    Bishop, Justin A; Ali, Syed Z

    2010-03-01

    Adamantinoma is one of the rarest primary bone tumors and is almost exclusively found in the tibia. Because of its scarcity, there are only a handful of reported cases of adamantinoma diagnosed by fine needle aspiration (FNA). We report a case of a 30-year-old woman seen at The Johns Hopkins Hospital for a 2.5-cm lytic lesion in the distal diaphysis of the tibia. A computed tomography-guided FNA of the lesion revealed a moderately cellular lesion consisting of a biphasic admixture of epithelioid cells seen singly and in fragments. These cells had round to oval nuclei with pale chromatin and well-formed nuclear grooves. The other population had more elongated nuclei and spindled appearance. An immunostain for cytokeratin was positive, supporting the diagnosis of adamantinoma. Due primarily to its rarity, the diagnosis of adamantinoma on FNA can be challenging and must be made in the context of its characteristic clinical and radiographic setting.

  18. Innovative computing for diagnoses from medical, magnetic-resonance imaging

    SciTech Connect

    Diegert, C.

    1997-01-01

    The author presents a final report on a Laboratory-Directed Research and Development (LDRD) project, Innovative Computing for Diagnoses from Medical, Magnetic-Resonance Imaging, performed during fiscal years 1992 and 1993. The project defined a role for high-performance computing in surgery: the supercomputer can automatically summarize the three-dimensional extents of lesions and other clinically-relevant structures, and can deliver these summaries to workstation-based, augmented-reality environments at the clinical site. The author developed methods and software to make these summaries from the digital data already acquired using clinical, magnetic-resonance machines. In joint work with Albuquerque`s Department of Veterans Affairs Hospital, the author applied this work, and obtained a basis for planning, for rehearsal, and for guidance during surgery.

  19. Using fuzzy data mining to diagnose patients' degrees of melancholia

    NASA Astrophysics Data System (ADS)

    Huang, Yo-Ping; Kuo, Wen-Lin

    2011-06-01

    The common treatments of melancholia are psychotherapy and taking medicines. The psychotherapy treatment which this study focuses on is limited by time and location. It is easier for psychiatrists to grasp information from clinical manifestation but it is difficult for psychiatrists to collect information from patients' daily conversations or emotion. To design a system which psychiatrists enable to capture patients' daily symptoms will show great help in the treatment. This study proposes to use fuzzy data mining algorithm to find association rules among keywords segmented from patients' daily voice/text messages to assist psychiatrists extract useful information before outpatient service. Patients of melancholia can use devices such as mobile phones or computers to record their own emotion anytime and anywhere and then uploading the recorded files to the back-end server for further analysis. The analytical results can be used for psychiatrists to diagnose patients' degrees of melancholia. Experimental results will be given to verify the effectiveness of the proposed methodology.

  20. Histoplasmosis diagnosed after arthroscopy of the knee: case report.

    PubMed

    Falster, Lorenzo; Marin, Maurício B; Gomes, João Luiz Ellera

    2015-01-01

    Fungal arthritis is a rare complication of arthroscopic surgeries, but its possibility should always be considered due its deleterious effects on any joint. Infection caused by the fungus Histoplasma capsulatum is the most common cause of respiratory tract infections by fungi, meanwhile histoplasmosis arthritis is more rare than all other fungal infections. However, their atypical forms of arthritis and the importance of early diagnosis and treatment cannot be over-emphasized. Herein we report a case of knee monoarthritis in an immunocompetent patient with histoplasmosis arthritis following an arthroscopic meniscetomy, diagnosed by synovial biopsy and culture performed during a second arthroscopic procedure. The joint was debrided in this second intervention and the patient received itraconazole initially and fluconazole latter on. The arthritis subsided after 10 months of treatment.

  1. Difficulties in diagnosing an intermittent mesenteroaxial gastric volvulus

    PubMed Central

    Kang, David J.; D'Alessio, Matthew; Pan, Andrew S.; Jaffe, Victor A.

    2013-01-01

    Mesenteroaxial volvulus is a form of gastric volvulus that rotates around the short axis of the stomach. Mesenteroaxial volvulus typically presents secondary to an anatomical defect with symptoms that include epigastric pain, retching, dysphagia and early satiety. Our patient presented with episodic abdominal pain, nausea and vomiting for 2 years. Previous imaging was unremarkable but an esophagogastroduodenoscopy done when the patient most recently presented with abdominal pain revealed a mesenteroaxial volvulus. He underwent a laparoscopic gastrostomy-tube gastropexy and has not had any recurrence of his symptoms to date. This case illustrates the difficulties in diagnosing an intermittent volvulus as untimely imaging of a temporarily unfolded volvulus can delay diagnosis and treatment. PMID:24964322

  2. Low-dose computed tomography to diagnose fetal bone dysplasias.

    PubMed

    Montoya Filardi, A; Guasp Vizcaíno, M; Gómez Fernández-Montes, J; Llorens Salvador, R

    We present a case of cleidocranial dysplasia diagnosed by low-dose fetal computed tomography (CT) in the 25th week of gestation. Severe bone dysplasia was suspected because of the fetus' low percentile in long bones length and the appearance of craniosynostosis on sonography. CT found no abnormalities incompatible with life. The effective dose was 5 mSv, within the recommended range for this type of examination. Low-dose fetal CT is a new technique that makes precision study of the bony structures possible from the second trimester of pregnancy. In Spain, abortion is legal even after the 22nd week of gestation in cases of severe fetal malformations. Therefore, in cases in which severe bone dysplasia is suspected, radiologists must know the strategies for reducing the dose of radiation while maintaining sufficient diagnostic quality, and they must also know which bony structures to evaluate.

  3. Diagnosing delivery problems in the White House Information Distribution System

    SciTech Connect

    Nahabedian, M.; Shrobe, H.

    1996-12-31

    As part of a collaboration with the White House Office of Media Affairs, members of the MIT Artificial Intelligence Laboratory designed a system, called COMLINK, which distributes a daily stream of documents released by the Office of Media Affairs. Approximately 4000 direct subscribers receive information from this service but more than 100,000 people receive the information through redistribution channels. The information is distributed via Email and the World Wide Web. In such a large scale distribution scheme, there is a constant problem of subscriptions becoming invalid because the user`s Email account has terminated. This causes a backwash of hundreds of {open_quotes}bounced mail{close_quotes} messages per day which must be processed by the operators of the COMLINK system. To manage this annoying but necessary task, an expert system named BMES was developed to diagnose the failures of information delivery.

  4. A novel approach to modeling and diagnosing the cardiovascular system

    SciTech Connect

    Keller, P.E.; Kangas, L.J.; Hashem, S.; Kouzes, R.T.; Allen, P.A.

    1995-07-01

    A novel approach to modeling and diagnosing the cardiovascular system is introduced. A model exhibits a subset of the dynamics of the cardiovascular behavior of an individual by using a recurrent artificial neural network. Potentially, a model will be incorporated into a cardiovascular diagnostic system. This approach is unique in that each cardiovascular model is developed from physiological measurements of an individual. Any differences between the modeled variables and the variables of an individual at a given time are used for diagnosis. This approach also exploits sensor fusion to optimize the utilization of biomedical sensors. The advantage of sensor fusion has been demonstrated in applications including control and diagnostics of mechanical and chemical processes.

  5. Diagnose human colonic tissues by terahertz near-field imaging

    NASA Astrophysics Data System (ADS)

    Chen, Hua; Ma, Shihua; Wu, Xiumei; Yang, Wenxing; Zhao, Tian

    2015-03-01

    Based on a terahertz (THz) pipe-based near-field imaging system, we demonstrate the capability of THz imaging to diagnose freshly surgically excised human colonic tissues. Through THz near-field scanning the absorbance of the colonic tissues, the acquired images can clearly distinguish cancerous tissues from healthy tissues fast and automatically without pathological hematoxylin and eosin stain diagnosis. A statistical study on 58 specimens (20 healthy tissues and 38 tissues with tumor) from 31 patients (mean age: 59 years; range: 46 to 79 years) shows that the corresponding diagnostic sensitivity and specificity on colonic tissues are both 100%. Due to its capability to perform quantitative analysis, our study indicates the potential of the THz pipe-based near-field imaging for future automation on human tumor pathological examinations.

  6. Application of FT IR microspectroscopy in diagnosing thyroid neoplasms

    NASA Astrophysics Data System (ADS)

    Schultz, Christian P.; Liu, Kan-Zhi; Salamon, Elizabeth A.; Riese, Karl T.; Mantsch, Henry H.

    1999-05-01

    Tissue biopsies and fine-needle aspirates (FNA) of patients with suspected benign or malignant thyroid neoplasms were investigated by infrared microspectroscopy and multivariate statistical methods. Unsupervised cluster analysis revealed four different spectral patterns for the aspirates analyzed, corresponding to colloid goiter, adenoma, carcinomas and negative diagnoses. Infrared microspectroscopic measurements of neoplastic cells on infrared transparent slides provide a potentially new tool for diagnostic screening of these FNA. Biopsy material obtained during surgical removal of gland tissue, was successfully used to generate statistically significant criteria for the distinction of neoplastic from normal tissue. Bivariate histogram plots demonstrate that two selected parameters, DNA and protein, are sufficient to separate control tissue from adenoma and carcinomas

  7. Diagnosing osteoporosis: A new perspective on estimating bone density

    NASA Astrophysics Data System (ADS)

    Cassia-Moura, R.; Ramos, A. D.; Sousa, C. S.; Nascimento, T. A. S.; Valença, M. M.; Coelho, L. C. B. B.; Melo, S. B.

    2007-07-01

    Osteoporosis may be characterized by low bone density and its significance is expected to grow as the population of the world both increases and ages. Our purpose here is to model human bone mineral density estimated through dual-energy x-ray absorptiometry, using local volumetric distance spline interpolants. Interpolating the values means the construction of a function F(x,y,z) that mimics the relationship implied by the data (xi,yi,zi;fi), in such a way that F(xi,yi,zi)=fi, i=1,2,…,n, where x,y and z represent, respectively, age, weight and height. This strategy greatly enhances the ability to accurately express the patient's bone density measurements, with the potential to become a framework for bone densitometry in clinical practice. The usefulness of our model is demonstrated in 424 patients and the relevance of our results for diagnosing osteoporosis is discussed.

  8. The emotional lexicon of individuals diagnosed with antisocial personality disorder.

    PubMed

    Gawda, Barbara

    2013-12-01

    This study investigated the specific emotional lexicons in narratives created by persons diagnosed with antisocial personality disorder (ASPD) to test the hypothesis that individuals with ASPD exhibit deficiencies in emotional language. Study participants consisted of 60 prison inmates with ASPD, 40 prison inmates without ASPD, and 60 men without antisocial tendencies who described situations involving love, hate and anxiety depicted by photographs. The lexical choices made in the narratives were analyzed, and a comparison of the three groups revealed differences between the emotional narratives of inmates with ASPD, inmates without ASPD, and the control group. Although the narratives of the individuals with ASPD included more words describing emotions and higher levels of emotional intensity, the valence of these words was inappropriate. The linguistic characteristics of these narratives were associated with high levels of psychopathy and low emotional reactivity.

  9. CIN III Diagnosed following Surgical Termination of Pregnancy

    PubMed Central

    Mackenzie, Ciara; Fakokunde, Abiodun; Govind, Abha; Kermani, Delaram

    2014-01-01

    We present a case of a 30-year-old mother of four who was incidentally diagnosed with cervical intraepithelial neoplasia (CIN) III following surgical termination of pregnancy. Five years previously a routine smear test had shown mild dyskaryosis but was never repeated. She was referred to colposcopy and, underwent loop excision of the transformation zone (LLETZ) and subsequently vaginal hysterectomy. Without this incidental finding she would have undoubtedly developed cervical cancer. We discuss the deficiencies in current cervical cancer prevention strategies and termination of pregnancy services. We emphasise the importance of ensuring that patients with dyskaryosis are not lost to follow-up and we consider whether there should be clearer guidance on the value of histological examination of products of conception following termination of pregnancy. PMID:24963426

  10. Research on Key Technology in Remote Education System of Spirit Diagnosing by Eye in TCM

    ERIC Educational Resources Information Center

    Guo, Feng; Li, Shaozi; Dai, Ying; Zhou, Changle; Lin, Ying

    2011-01-01

    Spirit diagnosing is an important theory in TCM (Traditional Chinese Medicine), by which a TCM doctor can diagnose a patient's body state. But this theory is complicated and difficult to master simply learned from books. To further the theory and skill of spirit diagnosing, in this paper, the authors propose a remote education system that can…

  11. Validation of Autism Spectrum Disorder Diagnoses in Large Healthcare Systems with Electronic Medical Records

    ERIC Educational Resources Information Center

    Coleman, Karen J.; Lutsky, Marta A.; Yau, Vincent; Qian, Yinge; Pomichowski, Magdalena E.; Crawford, Phillip M.; Lynch, Frances L.; Madden, Jeanne M.; Owen-Smith, Ashli; Pearson, John A.; Pearson, Kathryn A.; Rusinak, Donna; Quinn, Virginia P.; Croen, Lisa A.

    2015-01-01

    To identify factors associated with valid Autism Spectrum Disorder (ASD) diagnoses from electronic sources in large healthcare systems. We examined 1,272 charts from ASD diagnosed youth <18 years old. Expert reviewers classified diagnoses as confirmed, probable, possible, ruled out, or not enough information. A total of 845 were classified with…

  12. Wissler–Fanconi syndrome and related diagnoses: a case report

    PubMed Central

    Albustani, Mustafa Q; Howard, Robert F

    2016-01-01

    Introduction Wissler–Fanconi syndrome is a rare rheumatic syndrome that was first described during the 1940s in Europe. Since then, many papers have been written that cover all aspects of this syndrome, most of which are in French and German language, with only a very few in English (none of them recent). We report here a case that fulfils the criteria for Wissler–Fanconi syndrome. Under the more general descriptive umbrella of Wissler–Fanconi syndrome, our patient also fulfils the Modified Jones criteria, and the 2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria for rheumatoid arthritis, and was interpreted by other internists and another rheumatologist as fulfilling the Yamaguchi criteria for adult onset Still’s disease. Case presentation A middle-aged female presented to the emergency department with shortness of breath and chest pain associated with fever, polyarthritis, and had a chronic polymorphic rash on the back and lower extremities. Blood analysis showed highly elevated inflammatory markers and rheumatoid factor. After ruling out other possible deferential diagnoses and reviewing the medical literature, the patient was diagnosed with Wissler–Fanconi syndrome. A combination of nonsteroidal anti-inflammatory drugs and steroids achieved complete remission. Conclusion This case report highlights the important differential diagnosis that may be included under the nomenclature of Wissler–Fanconi syndrome (subsepsis hyperergica). Features of Wissler–Fanconi syndrome can be found in a differential diagnosis that includes true sepsis, acute rheumatic fever, rheumatoid arthritis, and adult onset Still’s disease. PMID:27843372

  13. Incidental gallbladder cancer diagnosed during and after laparoscopic cholecystectomy.

    PubMed

    Shimizu, Tetsuya; Arima, Yasuo; Yokomuro, Shigeki; Yoshida, Hiroshi; Mamada, Yasuhiro; Nomura, Tsutomu; Taniai, Nobuhiko; Aimoto, Takayuki; Nakamura, Yoshiharu; Mizuguchi, Yoshiaki; Kawahigashi, Yutaka; Uchida, Eiji; Akimaru, Koho; Tajiri, Takashi

    2006-06-01

    With the increasingly widespread acceptance of laparoscopic cholecystectomy (LC), the number of cases of incidental gallbladder carcinoma (GBC) has increased; however, management of incidental GBC is a difficult issue in the absence of established guidelines. The present study aims to evaluate the treatment of patients with incidental GBC diagnosed with LC. We performed a 14-year review of 10 patients with GBC discovered with LC. From April 1991 through March 2004, we performed LC for 1,195 patients at Nippon Medical School Main Hospital. Of these patients, 10 (0.83%) were found to have GBC. Seven patients were women and 3 were men, with a mean age of 61.4 years. Four patients had mucosal tumors (pT1a), 5 had subserosal tumors (pT2), and 1 had a serosal lesion (pT3). Eight of the 10 patients underwent radical surgery. Two patients with pT1a tumors underwent no additional surgery. All 4 patients with pT1a tumors are alive without recurrence. One patient with a pT2 tumor with metastases to the liver and pericholedochal lymph nodes found with additional resection died of recurrence of metastasis to the liver and lung 70 months after LC. One patient with a pT2 tumor died of primary lung cancer 35 months after LC. The remaining 3 patients with pT2 tumors are alive without recurrence 51 to 128 months after surgery. One patient with a pT3 tumor is alive with no recurrence for 9 months. For stage Tis or T1a tumors, LC is sufficient. Patients with T1b tumors should undergo liver-bed resection and lymphadenectomy, and patients with >pT2 tumors should undergo systematic liver resection with lymphadenectomy. Even when incidental GBC diagnosed with LC is advanced, adequate additional surgery may improve the prognosis.

  14. Sensitivity of the Cytomegalovirus Antigenemia Assay to Diagnose Cytomegalovirus Retinitis

    PubMed Central

    Lee, Joo Yong; Chong, Yong Phil; Sung, Heungsup; Lee, Sang-Oh; Choi, Sang-Ho; Kim, Yang Soo; Woo, Jun Hee

    2016-01-01

    Background Cytomegalovirus (CMV) retinitis is one of the most important tissue-invasive CMV diseases in immunocompromised patients. Since 1980, non-invasive diagnostic methods, notably the CMV antigenemia assay, have been widely used as adjunct tests to diagnose tissue-invasive CMV diseases. However, there are limited data on the diagnostic value of the CMV antigenemia assay for diagnosing CMV retinitis. Materials and Methods We performed a retrospective review of all cases of CMV retinitis at Asan Medical Center, Seoul, South Korea over a 9-year period. The diagnosis of CMV retinitis was made by experienced ophthalmologists according to medical history and an ophthalmoscopic appearance of typical retinopathy, together with absence of an alternative diagnosis. Results We analyzed 44 patients with CMV retinitis (affecting 57 eyes) for whom the CMV antigenemia assay was performed. Of the 44 patients, 31 (70%) were HIV-uninfected and 13 (30%) were HIV-infected. The overall sensitivity of the CMV antigenemia assay was 66% (95% confidence interval [CI] 50–80%). The test’s sensitivity showed a non-significant trend towards being higher in HIV-infected patients than in HIV-uninfected patients (sensitivity 85% vs 58%, respectively, P = 0.16). In a subgroup analysis of the 35 patients without other concurrent tissue-invasive CMV disease, the sensitivity of the CMV antigenemia assay was 57% (95% CI 40–74%). Conclusions The CMV antigenemia assay has limited value as a non-invasive diagnostic adjunct test for CMV retinitis. Therefore, the results of the assay need to be interpreted in the context of underlying disease, clinical presentation, and ophthalmoscopic findings. PMID:27883376

  15. Focally enhanced gastritis in newly diagnosed pediatric inflammatory bowel disease.

    PubMed

    Ushiku, Tetsuo; Moran, Christopher J; Lauwers, Gregory Y

    2013-12-01

    Although the significance of focally enhanced gastritis (FEG) as a marker of Crohn disease (CD) in adults has been contested, several studies suggest that it may be more specific of CD in pediatric patients. This study describes the detailed histologic features of FEG in pediatric inflammatory bowel disease (IBD) and clarifies its association with CD. A series of 119 consecutive newly diagnosed IBD patients (62 CD cases, 57 ulcerative colitis [UC] cases) with upper and lower gastrointestinal biopsies were evaluated. The histology of the gastric biopsies was reviewed blinded to final diagnoses and compared with age-matched healthy controls (n=66). FEG was present in 43% of IBD patients (CD 55% vs. UC 30%, P=0.0092) and in 5% of controls. Among CD patients, FEG was more common in younger patients (73% in children aged 10 y and below, 43% in children above 10 y of age, P=0.0358), with the peak in the 5- to 10-year age group (80%). The total number of glands involved in each FEG focus was higher in UC (6.4±5.1 glands) than in CD (4.0±3.0 glands, P=0.0409). Amongst the CD cohort, patients with FEG were more likely than those without FEG to have active ileitis (79% vs. 40%, P=0.0128) and granulomas elsewhere in the gastrointestinal tract (82% vs. 43%, P=0.0016). There was no correlation between FEG and other gastrointestinal findings of UC. We demonstrate that differences in FEG seen in pediatric CD and UC relate to not only their frequencies but also the morphology and relationship with other gastrointestinal lesions. Further, FEG is associated with disease activity and the presence of granulomas in pediatric CD.

  16. An on-line expert system for diagnosing environmentally induced spacecraft anomalies using CLIPS

    NASA Technical Reports Server (NTRS)

    Lauriente, Michael; Rolincik, Mark; Koons, Harry C; Gorney, David

    1993-01-01

    A new rule-based, expert system for diagnosing spacecraft anomalies is under development. The knowledge base consists of over two-hundred rules and provide links to historical and environmental databases. Environmental causes considered are bulk charging, single event upsets (SEU), surface charging, and total radiation dose. The system's driver translates forward chaining rules into a backward chaining sequence, prompting the user for information pertinent to the causes considered. The use of heuristics frees the user from searching through large amounts of irrelevant information (varying degrees of confidence in an answer) or 'unknown' to any question. The expert system not only provides scientists with needed risk analysis and confidence estimates not available in standard numerical models or databases, but it is also an effective learning tool. In addition, the architecture of the expert system allows easy additions to the knowledge base and the database. For example, new frames concerning orbital debris and ionospheric scintillation are being considered. The system currently runs on a MicroVAX and uses the C Language Integrated Production System (CLIPS).

  17. Diagnosing Vincent van Gogh, an expedition from the sources to the present "mer à boire".

    PubMed

    Voskuil, Piet

    2013-08-01

    The paintings and writings of Vincent van Gogh are widely admired for their great artistic value. This makes it interesting for doctors and patient groups to mold van Gogh's disease into a figurehead of their own specialty or illness. The recent article of ter Borg and Kasteleijn (2012) [1] in this Journal had a welcome approach by placing the diagnoses given in his lifetime in a historical and cultural context. In this article, the author will explore the diagnosis of epilepsy, adding more details without jumping quickly to conclusions. Apart from the information of eyewitnesses, special efforts are made to look critically at the medical sources as well as to investigate the original family chronicles. There is no easy access to that information. The Dutch vocabulary in the family notes made it tempting, for earlier scholars in this field, to easily link all kinds of attacks in family members to the original diagnosis of epilepsy. A part of the archives of the Willem Arntszhuis Utrecht describing the last days of Vincent's brother Theo, so far published only in Dutch (Voskuil, 2009 [16]), is included here. To integrate all this information, interdisciplinary research in a nonmutually excluding, but complementary, synthesis of today's knowledge is the most fruitful way to understand Vincent's behavior and its disturbances while continuing to admire his beautiful art.

  18. Diagnosing peak-discharge power laws observed in rainfall runoff events in Goodwin Creek experimental watershed

    NASA Astrophysics Data System (ADS)

    Furey, Peter R.; Gupta, Vijay K.

    2007-11-01

    Observations from the Goodwin Creek experimental watershed (GCEW), Mississippi show that peak-discharge Q( A) and drainage area A are related, on average, by a power law or scaling relationship, Q( A) = αAθ, during single rainfall-runoff events. Observations also show that α and θ change between events, and, based on a recent analysis of 148 events, observations indicate that α and θ change because of corresponding changes in the depth, duration, and spatial variability of excess-rainfall. To improve our physical understanding of these observations, a 5-step framework for diagnosing observed power laws, or other space-time patterns in a basin, is articulated and applied to GCEW using a combination of analysis and numerical simulations. Diagnostic results indicate how the power laws are connected to physical conditions and processes. Derived expressions for α and θ show that if excess-rainfall depth is fixed then there is a decreasing concave relationship between α and excess-rainfall duration, and an increasing and slightly convex relationship between θ and excess rainfall duration. These trends are consistent with observations only when hillslope velocity vh is given a physically realistic value near 0.1 m/s. If vh ≫ 0.1 m/s, then the predicted trends deviate from observed trends. Results also suggest that trends in α and θ can be impacted by the dependence of vh and link velocity vl on excess-rainfall rate.

  19. TiTrATE: A Novel, Evidence-Based Approach to Diagnosing Acute Dizziness and Vertigo.

    PubMed

    Newman-Toker, David E; Edlow, Jonathan A

    2015-08-01

    Diagnosing dizziness can be challenging, and the consequences of missing dangerous causes, such as stroke, can be substantial. Most physicians use a diagnostic paradigm developed more than 40 years ago that focuses on the type of dizziness, but this approach is flawed. This article proposes a new paradigm based on symptom timing, triggers, and targeted bedside eye examinations (TiTrATE). Patients fall into 1 of 4 major syndrome categories, each with its own differential diagnosis and set of targeted examination techniques that help make a specific diagnosis. Following an evidence-based approach could help reduce the frequency of misdiagnosis of serious causes of dizziness. In the spirit of the flipped classroom, the editors of this Neurologic Clinics issue on emergency neuro-otology have assembled a collection of unknown cases to be accessed electronically in multimedia format. By design, cases are not linked with specific articles, to avoid untoward cueing effects for the learner. The cases are real and are meant to demonstrate and reinforce lessons provided in this and subsequent articles. In addition to pertinent elements of medical history, cases include videos of key examination findings.

  20. Managing hope, denial or temporal anomie? Informal cancer carers' accounts of spouses' cancer diagnoses.

    PubMed

    Olson, Rebecca Eileen

    2011-09-01

    Carers of cancer patients' emotional responses to cancer diagnoses have been a central focus within psycho-oncology. Some of this literature asserts that the maladaptive coping strategy denial is prevalent amongst carers. Using semi-structured, longitudinal interviews with 32 Australian Capital Territory carers of a spouse with cancer and an interactionist sociology of emotions framework to understanding their emotions, this study aimed to both contribute to the literature on cancer carers' coping strategies and provide a richer sociological depiction of carers' emotional reactions to a cancer diagnosis. The results raise questions about the value of singularly examining denial in cancer carers. Instead, these data suggest that carers use a range of coping strategies in the short-term and do emotion work to adapt to a challenged temporal orientation. The term temporal anomie is offered to describe carers' disrupted orientations in time and facilitate further discussion on the link between time and emotion work. Findings also show the importance of medical professionals' casting of the prognosis, from imminent death to certain future, to this temporal re-orientation and emotion work process. Instead of 'managing hope,' as much of the cancer communication literature describes it, findings suggest that physicians address cancer carers' and patients' temporal anomie. Future research might benefit from moving beyond individualistic conceptualisations of carers' emotions to include the cultural, temporal and interactionist influences.

  1. Sporadic and Familial Congenital Cataracts: Mutational Spectrum and New Diagnoses Using Next‐Generation Sequencing

    PubMed Central

    Ma, Alan S.; Grigg, John R.; Ho, Gladys; Prokudin, Ivan; Farnsworth, Elizabeth; Holman, Katherine; Cheng, Anson; Billson, Frank A.; Martin, Frank; Fraser, Clare; Mowat, David; Smith, James; Christodoulou, John; Flaherty, Maree; Bennetts, Bruce

    2016-01-01

    ABSTRACT Congenital cataracts are a significant cause of lifelong visual loss. They may be isolated or associated with microcornea, microphthalmia, anterior segment dysgenesis (ASD) and glaucoma, and there can be syndromic associations. Genetic diagnosis is challenging due to marked genetic heterogeneity. In this study, next‐generation sequencing (NGS) of 32 cataract‐associated genes was undertaken in 46 apparently nonsyndromic congenital cataract probands, around half sporadic and half familial cases. We identified pathogenic variants in 70% of cases, and over 68% of these were novel. In almost two‐thirds (20/33) of these cases, this resulted in new information about the diagnosis and/or inheritance pattern. This included identification of: new syndromic diagnoses due to NHS or BCOR mutations; complex ocular phenotypes due to PAX6 mutations; de novo autosomal‐dominant or X‐linked mutations in sporadic cases; and mutations in two separate cataract genes in one family. Variants were found in the crystallin and gap junction genes, including the first report of severe microphthalmia and sclerocornea associated with a novel GJA8 mutation. Mutations were also found in rarely reported genes including MAF, VIM, MIP, and BFSP1. Targeted NGS in presumed nonsyndromic congenital cataract patients provided significant diagnostic information in both familial and sporadic cases. PMID:26694549

  2. Leishmania infection: laboratory diagnosing in the absence of a "gold standard".

    PubMed

    Rodríguez-Cortés, Alhelí; Ojeda, Ana; Francino, Olga; López-Fuertes, Laura; Timón, Marcos; Alberola, Jordi

    2010-02-01

    There is no gold standard for diagnosing leishmaniases. Our aim was to assess the operative validity of tests used in detecting Leishmania infection using samples from experimental infections, a reliable equivalent to the classic definition of gold standard. Without statistical differences, the highest sensitivity was achieved by protein A (ProtA), immunoglobulin (Ig)G2, indirect fluorescenece antibody test (IFAT), lymphocyte proliferation assay, quantitative real-time polymerase chain reaction of bone marrow (qPCR-BM), qPCR-Blood, and IgG; and the highest specificity by IgG1, IgM, IgA, qPCR-Blood, IgG, IgG2, and qPCR-BM. Maximum positive predictive value was obtained simultaneously by IgG2, qPCR-Blood, and IgG; and maximum negative predictive value by qPCR-BM. Best positive and negative likelihood ratios were obtained by IgG2. The test having the greatest, statistically significant, area under the receiver operating characteristics curve was IgG2 enzyme-linked immunosorbent assay (ELISA). Thus, according to the gold standard used, IFAT and qPCR are far from fulfilling the requirements to be considered gold standards, and the test showing the highest potential to detect Leishmania infection is Leishmania-specific ELISA IgG2.

  3. Leishmania Infection: Laboratory Diagnosing in the Absence of a “Gold Standard”

    PubMed Central

    Rodríguez-Cortés, Alhelí; Ojeda, Ana; Francino, Olga; López-Fuertes, Laura; Timón, Marcos; Alberola, Jordi

    2010-01-01

    There is no gold standard for diagnosing leishmaniases. Our aim was to assess the operative validity of tests used in detecting Leishmania infection using samples from experimental infections, a reliable equivalent to the classic definition of gold standard. Without statistical differences, the highest sensitivity was achieved by protein A (ProtA), immunoglobulin (Ig)G2, indirect fluorescenece antibody test (IFAT), lymphocyte proliferation assay, quantitative real-time polymerase chain reaction of bone marrow (qPCR-BM), qPCR-Blood, and IgG; and the highest specificity by IgG1, IgM, IgA, qPCR-Blood, IgG, IgG2, and qPCR-BM. Maximum positive predictive value was obtained simultaneously by IgG2, qPCR-Blood, and IgG; and maximum negative predictive value by qPCR-BM. Best positive and negative likelihood ratios were obtained by IgG2. The test having the greatest, statistically significant, area under the receiver operating characteristics curve was IgG2 enzyme-linked immunosorbent assay (ELISA). Thus, according to the gold standard used, IFAT and qPCR are far from fulfilling the requirements to be considered gold standards, and the test showing the highest potential to detect Leishmania infection is Leishmania-specific ELISA IgG2. PMID:20134001

  4. An Intelligent computer-aided tutoring system for diagnosing anomalies of spacecraft in operation

    NASA Technical Reports Server (NTRS)

    Rolincik, Mark; Lauriente, Michael; Koons, Harry C.; Gorney, David

    1993-01-01

    A new rule-based, expert system for diagnosing spacecraft anomalies is under development. The knowledge base consists of over two-hundred (200) rules and provides links to historical and environmental databases. Environmental causes considered are bulk charging, single event upsets (SEU), surface charging, and total radiation dose. The system's driver translates forward chaining rules into a backward chaining sequence, prompting the user for information pertinent to the causes considered. When the user selects the novice mode, the system automatically gives detailed explanations and descriptions of terms and reasoning as the session progresses, in a sense teaching the user. As such it is an effective tutoring tool. The use of heuristics frees the user from searching through large amounts of irrelevant information and allows the user to input partial information (varying degrees of confidence in an answer) or 'unknown' to any question. The system is available on-line and uses C Language Integrated Production System (CLIPS), an expert shell developed by the NASA Johnson Space Center AI Laboratory in Houston.

  5. Language of love and hate of persons diagnosed with antisocial personality.

    PubMed

    Gawda, B

    2010-01-01

    The aim of this article is to compare the description of two opposite feelings, i.e. love and hate, expressed in the narratives created by persons with an antisocial personality disorder. Several researchers point to the fact that persons suffering from antisocial personality disorder display an incapacity for love, that their descriptions of love are poor, and that their language related to love is poor. On the contrary, they have an ability to experience anger and hate, therefore their possibilities to describe hate and their language related to hate are developed. We focus on verifying these scientific opinions. We examined 50 prisoners diagnosed with antisocial personality disorder, 40 prisoners without antisocial personality, and 50 men outside of prison without antisocial tendencies. The participants had to describe situations presented at photographs linked to love and hate. The qualitative data (elements of narrative discourse) were analyzed concerning two feelings, using nonparametric statistics. The results show that persons with antisocial personality disorder are able to describe both love and hate feelings, and that their language is expressive and convincing. They have affective knowledge and the capacities to imagine the feelings. They were more concentrated on themselves than the control groups.

  6. Diagnosing the Causes and Severity of One-sided Message Contention

    SciTech Connect

    Tallent, Nathan R.; Vishnu, Abhinav; van Dam, Hubertus; Daily, Jeffrey A.; Kerbyson, Darren J.; Hoisie, Adolfy

    2015-02-11

    Two trends suggest network contention for one-sided messages is poised to become a performance problem that concerns application developers: an increased interest in one-sided programming models and a rising ratio of hardware threads to network injection bandwidth. Unfortunately, it is difficult to reason about network contention and one-sided messages because one-sided tasks can either decrease or increase contention. We present effective and portable techniques for diagnosing the causes and severity of one-sided message contention. To detect that a message is affected by contention, we maintain statistics representing instantaneous (non-local) network resource demand. Using lightweight measurement and modeling, we identify the portion of a message's latency that is due to contention and whether contention occurs at the initiator or target. We attribute these metrics to program statements in their full static and dynamic context. We characterize contention for an important computational chemistry benchmark on InfiniBand, Cray Aries, and IBM Blue Gene/Q interconnects. We pinpoint the sources of contention, estimate their severity, and show that when message delivery time deviates from an ideal model, there are other messages contending for the same network links. With a small change to the benchmark, we reduce contention up to 50% and improve total runtime as much as 20%.

  7. [Nursing diagnoses and outcomes related to the circulatory-system terms (ICNP®) represented in an ontology].

    PubMed

    Cubas, Marcia Regina; Brondani, Arianny Macedo; Malucelli, Andreia

    2013-10-01

    The aim of the present study was to develop titles of Nursing Diagnoses and Outcomes (ND/NO) through the relationship between the terms of the Focus axis, limited to the Circulatory System Process, and the terms of other ICNP® axes and to integrate these terms into an ontology. Titles were developed linking 17 terms of the focus axis, which were evaluated by expert nurses in five Brazilian cities. Titles whose use concordance was above 0.80 were included in the ontology. In total, 89 titles for ND/NO were supported in the literature, and 19 were not supported; 37 were assessed as eligible for use in healthcare practice and were included in the ontology. The construction of ND/NO titles based on the ICNP® and using a formal representation of knowledge is a task that requires deepening concepts used for nursing and adequate classification revisions. The elaborated titles will facilitate the composition of diagnostics that are more consistent with practice.

  8. Trends in clinical diagnoses of Rocky Mountain spotted fever among American Indians, 2001-2008.

    PubMed

    Folkema, Arianne M; Holman, Robert C; McQuiston, Jennifer H; Cheek, James E

    2012-01-01

    American Indians are at greater risk for Rocky Mountain spotted fever (RMSF) than the general U.S. population. The epidemiology of RMSF among American Indians was examined by using Indian Health Service inpatient and outpatient records with an RMSF International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis. For 2001-2008, 958 American Indian patients with clinical diagnoses of RMSF were reported. The average annual RMSF incidence was 94.6 per 1,000,000 persons, with a significant increasing incidence trend from 24.2 in 2001 to 139.4 in 2008 (P = 0.006). Most (89%) RMSF hospital visits occurred in the Southern Plains and Southwest regions, where the average annual incidence rates were 277.2 and 49.4, respectively. Only the Southwest region had a significant increasing incidence trend (P = 0.005), likely linked to the emergence of brown dog ticks as an RMSF vector in eastern Arizona. It is important to continue monitoring RMSF infection to inform public health interventions that target RMSF reduction in high-risk populations.

  9. Telomere Length and Pulse Pressure in Newly Diagnosed, Antipsychotic-Naive Patients With Nonaffective Psychosis

    PubMed Central

    Fernandez-Egea, Emilio; Bernardo, Miguel; Heaphy, Christopher M.; Griffith, Jeffrey K.; Parellada, Eduard; Esmatjes, Enric; Conget, Ignacio; Nguyen, Linh; George, Varghese; Stöppler, Hubert; Kirkpatrick, Brian

    2009-01-01

    Introduction: Recent studies suggest that in addition to factors such as treatment side effects, suicide, and poor health habits, people with schizophrenia may have an increased risk of diabetes prior to antipsychotic treatment. Diabetes is associated with an increased pulse pressure (PP) and a shortened telomere. We tested the hypothesis that prior to antipsychotic treatment, schizophrenia and related disorders are associated with a shortened telomere, as well as an increased PP. Methods: Telomere content (which is highly correlated with telomere length) and PP were measured in newly diagnosed, antipsychotic-naive patients with schizophrenia and related disorders on first clinical contact and in matched control subjects. Both groups were also administered an oral glucose tolerance test. Results: Compared with control subjects, the patients with psychosis had decreased telomere content and an increased PP. As previously reported, they also had increased glucose concentrations at 2 hours. These differences could not be attributed to differences in age, ethnicity, smoking, gender, body mass index, neighborhood of residence, socioeconomic status, aerobic conditioning, or an increased cortisol concentration in the psychotic subjects. Discussion: These results suggest that prior to antipsychotic use, nonaffective psychosis is associated with reduced telomere content and increased PP, indices that have been linked to an increased risk of diabetes and hypertension. PMID:19279086

  10. Exome sequencing and directed clinical phenotyping diagnose cholesterol ester storage disease presenting as autosomal recessive hypercholesterolemia

    PubMed Central

    Stitziel, Nathan O.; Fouchier, Sigrid W.; Sjouke, Barbara; Peloso, Gina M.; Moscoso, Alessa M.; Auer, Paul L.; Goel, Anuj; Gigante, Bruna; Barnes, Timothy A.; Melander, Olle; Orho-Melander, Marju; Duga, Stefano; Sivapalaratnam, Suthesh; Nikpay, Majid; Martinelli, Nicola; Girelli, Domenico; Jackson, Rebecca D.; Kooperberg, Charles; Lange, Leslie A.; Ardissino, Diego; McPherson, Ruth; Farrall, Martin; Watkins, Hugh; Reilly, Muredach P.; Rader, Daniel J.; de Faire, Ulf; Schunkert, Heribert; Erdmann, Jeanette; Samani, Nilesh J.; Charnas, Lawrence; Altshuler, David; Gabriel, Stacey; Kastelein, John J.P.; Defesche, Joep C.; Nederveen, Aart J.; Kathiresan, Sekar; Hovingh, G. Kees

    2014-01-01

    Objective Autosomal recessive hypercholesterolemia (ARH) is a rare inherited disorder characterized by extremely high total and low-density lipoprotein cholesterol levels that has been previously linked to mutations in LDLRAP1. We identified a family with ARH not explained by mutations in LDLRAP1 or other genes known to cause monogenic hypercholesterolemia. The aim of this study was to identify the molecular etiology of ARH in this family. Approach and Results We used exome sequencing to assess all protein coding regions of the genome in three family members and identified a homozygous exon 8 splice junction mutation (c.894G>A, also known as E8SJM) in LIPA that segregated with the diagnosis of hypercholesterolemia. Since homozygosity for mutations in LIPA is known to cause cholesterol ester storage disease (CESD), we performed directed follow-up phenotyping by non-invasively measuring hepatic cholesterol content. We observed abnormal hepatic accumulation of cholesterol in the homozygote individuals, supporting the diagnosis of CESD. Given previous suggestions of cardiovascular disease risk in heterozygous LIPA mutation carriers, we genotyped E8SJM in >27,000 individuals and found no association with plasma lipid levels or risk of myocardial infarction, confirming a true recessive mode of inheritance. Conclusions By integrating observations from Mendelian and population genetics along with directed clinical phenotyping, we diagnosed clinically unapparent CESD in the affected individuals from this kindred and addressed an outstanding question regarding risk of cardiovascular disease in LIPA E8SJM heterozygous carriers. PMID:24072694

  11. Can lifestyle modification increase survival in women diagnosed with breast cancer?

    PubMed

    Rock, Cheryl L; Demark-Wahnefried, Wendy

    2002-11-01

    Epidemiologic studies have linked diets high in vegetables and fruit with an increased likelihood of survival after the diagnosis of breast cancer, and clinical and epidemiologic studies have identified obesity as an important negative prognostic factor. Of the 26 studies published since 1990 that examined the relationship with obesity and survival, 17 reported a significant inverse relationship. Five of the eight cohort studies of breast cancer survivors that examined intakes of vegetables, fruit and related micronutrients published since 1985 reported a positive relationship between these factors and survival. The hypothesis that lifestyle factors such as diet and physical activity may improve the prognosis in women who have been diagnosed with breast cancer is currently under study. The Women's Healthy Eating and Living Study is a randomized controlled study that tests the effects of a diet high in vegetables, fruit and fiber and low in fat on disease-free survival after treatment for early stage breast cancer (n = 3109). In the Healthy Weight Management for Breast Cancer Survivors Study, a multifaceted approach to promoting weight loss and long-term weight maintenance is being tested in 85 women at risk for breast cancer recurrence. The intervention emphasizes increased physical activity, strategies to improve body image and self-acceptance, and cognitive-behavioral therapy to promote healthy eating attitudes and behaviors. The results of these studies will contribute to understanding the roles of diet and physical activity in the progression of breast cancer.

  12. The OceanLink Project

    NASA Astrophysics Data System (ADS)

    Narock, T.; Arko, R. A.; Carbotte, S. M.; Chandler, C. L.; Cheatham, M.; Finin, T.; Hitzler, P.; Krisnadhi, A.; Raymond, L. M.; Shepherd, A.; Wiebe, P. H.

    2014-12-01

    A wide spectrum of maturing methods and tools, collectively characterized as the Semantic Web, is helping to vastly improve the dissemination of scientific research. Creating semantic integration requires input from both domain and cyberinfrastructure scientists. OceanLink, an NSF EarthCube Building Block, is demonstrating semantic technologies through the integration of geoscience data repositories, library holdings, conference abstracts, and funded research awards. Meeting project objectives involves applying semantic technologies to support data representation, discovery, sharing and integration. Our semantic cyberinfrastructure components include ontology design patterns, Linked Data collections, semantic provenance, and associated services to enhance data and knowledge discovery, interoperation, and integration. We discuss how these components are integrated, the continued automated and semi-automated creation of semantic metadata, and techniques we have developed to integrate ontologies, link resources, and preserve provenance and attribution.

  13. High Performance Flexible Thermal Link

    NASA Astrophysics Data System (ADS)

    Sauer, Arne; Preller, Fabian

    2014-06-01

    The paper deals with the design and performance verification of a high performance and flexible carbon fibre thermal link.Project goal was to design a space qualified thermal link combining low mass, flexibility and high thermal conductivity with new approaches regarding selected materials and processes. The idea was to combine the advantages of existing metallic links regarding flexibility and the thermal performance of high conductive carbon pitch fibres. Special focus is laid on the thermal performance improvement of matrix systems by means of nano-scaled carbon materials in order to improve the thermal performance also perpendicular to the direction of the unidirectional fibres.One of the main challenges was to establish a manufacturing process which allows handling the stiff and brittle fibres, applying the matrix and performing the implementation into an interface component using unconventional process steps like thermal bonding of fibres after metallisation.This research was funded by the German Federal Ministry for Economic Affairs and Energy (BMWi).

  14. When He Said Linking, He Really Meant Linking

    ERIC Educational Resources Information Center

    Chudnov, Daniel

    2009-01-01

    There are many reasons to improve web links, starting with their design. The author tends to think about "design" on the web in terms of two things: (1) graphic/industrial design; and (2) human usability. A nice, clean URI (uniform resource identifier) that does not change, is readable to humans, is amenable to common web behaviors such as…

  15. micromap: A Package for Linked Micromaps

    EPA Science Inventory

    The R package micromap is used to create linked micromaps, which display statistical summaries associated with areal units, or polygons. Linked micromaps provide a means to simultaneously summarize and display both statistical and geographic distributions by linking statistical ...

  16. Relationships between diagnoses of sexually transmitted infections and urinary tract infections among male service members diagnosed with urethritis, active component, U.S. Armed Forces, 2000-2013.

    PubMed

    2014-07-01

    A previous MSMR report found that 42.8% of all incident (first-time) urinary tract infections (UTIs) in males, but only 0.4% of such UTIs in females, were diagnosed as "urethritis, unspecified" (ICD-9: 597.80). This study explored the possibility that many of the diagnoses of urethritis in males represented sexually transmitted infections (STIs), even though ICD-9: 597.80 is explicitly reserved for cases of urethritis that are deemed to not be sexually transmitted. Examined were relationships between diagnoses of urethritis, diagnoses of STIs, and recurrent diagnoses of UTIs. Male service members who received a diagnosis of "urethritis, unspecified" (ICD-9: 597.80) had an increased risk of a subsequent UTI diagnosis, especially of "urethritis, unspecified," compared to all male service members. Most service members who were diagnosed with "urethritis, unspecified" had no documented diagnoses of an STI in their Military Health System health records; however, recurrent UTIs were more common among service members who did have documented STIs. The most commonly diagnosed STIs in this study were "other non-gonococcal urethritis" (which includes that caused by Chlamydia trachomatis) and gonorrhea.

  17. Versatile Link PLUS transceiver development

    NASA Astrophysics Data System (ADS)

    Soós, C.; Détraz, S.; Olanterä, L.; Sigaud, C.; Troska, J.; Vasey, F.; Zeiler, M.

    2017-03-01

    The Versatile Link PLUS project targets the phase II upgrades of the ATLAS and CMS experiments. It will develop a radiation resistant optical link, operating at up to 10 Gb/s in the upstream and up to 5 Gb/s in the downstream directions with a smaller footprint and higher channel count than its predecessor. A low-profile package is being developed that allows volume production at reduced costs, but which nevertheless can be configured to suit the individual channel count needs of different detectors. This paper describes the development strategies and summarizes the status of the feasibility demonstration phase of the project.

  18. Growth in X-linked hypophosphatemic rickets.

    PubMed

    Ariceta, Gema; Langman, Craig B

    2007-04-01

    Growth failure appears frequently in children with X-linked hypophosphatemic rickets (XLHR) due to hypophosphatemia, disease severity, body disproportion, and primary bone abnormality. Recombinant human growth hormone (rhGH) increases phosphate tubular reabsorption and phosphate level in blood and, thus, constitutes an attractive but controversial therapy in short children with XLHR, those efficacy was demonstrated in small uncontrolled series. Our aim was to report our experience regarding growth in XLHR. Twenty-seven children with XLHR--20 girls, seven boys--diagnosed at a median (md) of 1.46 years of age, (range 0.39-8.5 years), were studied at 10.12 years of age (1.58-18.56), md (range). All received oral treatment with phosphate and calcitriol. At the first visit, grouped Z-height was -1; (-4.58; 0.54) md (range). After 5 years' follow-up (0.92-15.6), Z-height was -0.91 (- 4.56; 0.17), not different from that at baseline (P = 0.465). In 16 children entirely controlled in our program upon presentation, a "catch up" phenomenon after the rickets had healed (P = 0.823) or throughout the long-term was not observed (P = 0.995). Eight patients had a Z-height 2 years at diagnosis, male gender and non-adherence to treatment. Four children, all boys, received rhGH, and in two cases with sufficient follow up stature normalized. No rhGH side effects were observed, and phosphate and calcitriol doses remained stable. Linear growth failure appeared in a third of XLHR children. Efforts need to be made to reduce the age of diagnosis and to improve adherence to treatment. Treatment with rhGH should be considered early, after the rickets has been controlled, in those patients with impaired growth or delayed diagnosis.

  19. Engagement-in-care during the first 5 years after HIV diagnosis: data from a cohort of newly HIV-diagnosed individuals in a large US city.

    PubMed

    Rowan, Sarah E; Burman, William J; Johnson, Steven C; Connick, Elizabeth; Reirden, Daniel; Daniloff, Elaine; Gardner, Edward M

    2014-09-01

    Initial descriptions of the HIV engagement continuum are limited by short-term follow-up and incomplete data. We evaluated engagement in a newly HIV-diagnosed cohort. Our goals were to assess long-term engagement-in-care, evaluate the effects of out-of-state migration on engagement estimates, and determine whether engagement has improved in more recently diagnosed individuals. This is a retrospective cohort study of individuals newly HIV-diagnosed at two large HIV care centers in the Denver metropolitan area from 2005 to 2009. Clinical data were obtained from three public HIV providers and two clinical trial groups. For statewide evaluation, we used mandated laboratory reporting databases for CD4 lymphocyte counts and HIV-1 RNA levels. From 2005 to 2009, 615 individuals were diagnosed with HIV. By 18 months after HIV diagnosis, 84% of the cohort had linked to care, 73% were retained in care, 49% were prescribed antiretroviral therapy, and 36% had viral suppression. By 5 years after HIV diagnosis, 55% of the cohort were retained in care, 37% had viral suppression, 15% had moved out of state, and 3% were deceased. When censoring for outmigration and death, 66% of the cohort were retained in care and 45% of the cohort had viral suppression 5 years after HIV diagnosis. Engagement-in-care 18 months after diagnosis was better in individuals diagnosed more recently. Retention in care declined while viral suppression increased over time after HIV diagnosis. Accounting for outmigration and death significantly increased estimates of engagement-in-care. Performance in the engagement continuum 18 months after diagnosis improved significantly in individuals more recently diagnosed with HIV.

  20. Low temperature cross linking polyimides

    NASA Technical Reports Server (NTRS)

    Serafini, T. T.; Delvigs, P. (Inventor)

    1982-01-01

    A polyimide is formed by cross linking a prepolymer formed by reacting a polyfunctional ester, a polyfunctional amine, and an end-capping unit. By providing an end-capping unit, the prepolymer is curable at a relatively low temperature of about 175 to 245 C.

  1. Linking Leadership to Student Learning

    ERIC Educational Resources Information Center

    Leithwood, Kenneth; Seashore-Louis, Karen

    2011-01-01

    "Linking Leadership to Student Learning" clearly shows how school leadership improves student achievement. The book is based on an ambitious five-year study on educational leadership that was sponsored by The Wallace Foundation. The authors studied 43 districts, across 9 states and 180 elementary, middle, and secondary schools. In this book,…

  2. Linking marine biology and biotechnology.

    PubMed

    de Nys, Rocky; Steinberg, Peter D

    2002-06-01

    Studies of biological systems in which there is a direct link between the challenges faced by marine organisms and biotechnologies enable us to rationally search for active natural compounds and other novel biotechnologies. This approach is proving successful in developing new methods for the prevention of marine biofouling and for the identification of new lead compounds for the development of ultraviolet sunscreens.

  3. Experimental optical fiber communications link

    NASA Technical Reports Server (NTRS)

    Lutes, G. F.

    1980-01-01

    An optical fiber communications link 1.5 kilometers in length was installed between the Interim Frequency Standard Test Facility and the Timing and Frequency Systems Research Laboratory at JPL. It is being used to develop optical fiber technology for use in the DSN and particularly for precise time and frequency distribution.

  4. Linking climate change and groundwater

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Projected global change includes groundwater systems, which are linked with changes in climate over space and time. Consequently, global change affects key aspects of subsurface hydrology (including soil water, deeper vadose zone water, and unconfined and confined aquifer waters), surface-groundwat...

  5. Linking HRD Practice and Research.

    ERIC Educational Resources Information Center

    1999

    This document contains four symposium papers on linking human resource development (HRD) theory and practice. "Partnership Research: Ensuring More Useful HRD Collaborations" (Ronald L. Jacobs), which proceeds from the premise that most HRD research has limited impact on practice because research problems are usually generated devoid of a…

  6. Linking Outcomes to Organizational Planning.

    ERIC Educational Resources Information Center

    Ligon, Glynn; Jackson, Elaine

    Linking Outcomes to Organizational Planning (LOOP) was initiated during the 1984-85 school year in the Austin (Texas) Independent School District. LOOP was designed to ensure that evaluation, research, and informal findings became part of the instructional planning loop; to provide information to the Superintendent on progress toward priorities…

  7. Diagnosing Aircraft Icing Potential from Satellite Cloud Retrievals

    NASA Technical Reports Server (NTRS)

    Smith, William L., Jr.; Minnis, Patrick; Fleeger, Cecilia; Spangenberg, Douglas

    2013-01-01

    The threat for aircraft icing in clouds is a significant hazard that routinely impacts aviation operations. Accurate diagnoses and forecasts of aircraft icing conditions requires identifying the location and vertical distribution of clouds with super-cooled liquid water (SLW) droplets, as well as the characteristics of the droplet size distribution. Traditional forecasting methods rely on guidance from numerical models and conventional observations, neither of which currently resolve cloud properties adequately on the optimal scales needed for aviation. Satellite imagers provide measurements over large areas with high spatial resolution that can be interpreted to identify the locations and characteristics of clouds, including features associated with adverse weather and storms. This paper describes new techniques for interpreting cloud products derived from satellite data to infer the flight icing threat to aircraft. For unobscured low clouds, the icing threat is determined using empirical relationships developed from correlations between satellite imager retrievals of liquid water path and droplet size with icing conditions reported by pilots (PIREPS). For deep ice over water cloud systems, ice and liquid water content (IWC and LWC) profiles are derived by using the imager cloud properties to constrain climatological information on cloud vertical structure and water phase obtained apriori from radar and lidar observations, and from cloud model analyses. Retrievals of the SLW content embedded within overlapping clouds are mapped to the icing threat using guidance from an airfoil modeling study. Compared to PIREPS and ground-based icing remote sensing datasets, the satellite icing detection and intensity accuracies are approximately 90% and 70%, respectively, and found to be similar for both low level and deep ice over water cloud systems. The satellite-derived icing boundaries capture the reported altitudes over 90% of the time. Satellite analyses corresponding to

  8. The importance of serological tests implementation in disseminated candidiasis diagnose.

    PubMed

    Gegić, Merima; Numanović, Fatima; Delibegović, Zineta; Tihić, Nijaz; Nurkić, Mahmut; Hukić, Mirsada

    2013-03-01

    Candidiasis is defined as an infection or disease caused by a fungus of the genus Candida. Rate of disseminated candidiasis increases with the growth of the number of immunocompromised patients. In the the last few decades the incidence of disseminated candidiasis is in growth as well as the mortality rate. The aim of this survey is to show the importance of serological tests implementation in disseminated candidiasis diagnose. This is a prospective study involving 60 patients with malign diseases with and without clinical signs of disseminated candidiasis and 30 healthy people who represent the control group. Apart from hemoculture, detection of circulating mannan antigen and adequate antibodies of Candida species applying comercial ELISA test was determined in each patient. This survey deals with relevant factors causing disseminated candidiasis. This survey showed that the group of patients with clinical signs of disseminated candidiasis had more patients with positive hemoculture to Candida species, then the group of patients without clinical signs of disseminated candidiasis. The number of patients being examined and positive to antigens and antibodies was higher (p < 0.01) in the group of patients with clinical signs of disseminated candidiasis (7/30; 23.3%), then in the group of patients without clinical signs of disseminated candidiasis (0/30; 0%): Average value of titra antigen was statistically higher (p < 0.001) in patients with Candida spp. positive hemocultures rather then in patients with Candida spp. negative hemocultures. In the group of patients with clinical signs of disseminated candidiasis 6/30 (20%) of patients had Candida spp.positive hemocultures while in the group of patients without clinical signs of disseminated candidiasis 1/30 (3.3%) of patients had Candida spp. positive hemocultures, which was considerably higher (p < 0.05). Correlation of results of hemoculture and mannan antigens and antibodies in patients with disseminated

  9. Linked data and online classifications to organise mined patterns in patient data.

    PubMed

    Jay, Nicolas; d'Aquin, Mathieu

    2013-01-01

    In this paper, we investigate the use of web data resources in medicine, especially through medical classifications made available using the principles of Linked Data, to support the interpretation of patterns mined from patient care trajectories. Interpreting such patterns is naturally a challenge for an analyst, as it requires going through large amounts of results and access to sufficient background knowledge. We employ linked data, especially as exposed through the BioPortal system, to create a navigation structure within the patterns obtained form sequential pattern mining. We show how this approach provides a flexible way to explore data about trajectories of diagnoses and treatments according to different medical classifications.

  10. Linked Data and Online Classifications to Organise Mined Patterns in Patient Data

    PubMed Central

    Jay, Nicolas; d’Aquin, Mathieu

    2013-01-01

    In this paper, we investigate the use of web data resources in medicine, especially through medical classifications made available using the principles of Linked Data, to support the interpretation of patterns mined from patient care trajectories. Interpreting such patterns is naturally a challenge for an analyst, as it requires going through large amounts of results and access to sufficient background knowledge. We employ linked data, especially as exposed through the BioPortal system, to create a navigation structure within the patterns obtained form sequential pattern mining. We show how this approach provides a flexible way to explore data about trajectories of diagnoses and treatments according to different medical classifications. PMID:24551369

  11. Invariants of Boundary Link Cobordism

    NASA Astrophysics Data System (ADS)

    Sheiham, Desmond

    2001-10-01

    An n-dimensional μ-component boundary link is a codimension 2 embedding of spheres L=bigsqcup_{μ}S^n subset S^{n+2} such that there exist μ disjoint oriented embedded (n+1)-manifolds which span the components of L. An F_μ-link is a boundary link together with a cobordism class of such spanning manifolds. The F_μ-link cobordism group C_n(F_μ) is known to be trivial when n is even but not finitely generated when n is odd. Our main result is an algorithm to decide whether two odd-dimensional F_μ-links represent the same cobordism class in C_{2q-1}(F_μ) assuming q>1. We proceed to compute the isomorphism class of C_{2q-1}(F_μ), generalizing Levine's computation of the knot cobordism group C_{2q-1}(F_1). Our starting point is the algebraic formulation of Levine, Ko and Mio who identify C_{2q-1}(F_μ) with a surgery obstruction group, the Witt group G^{(-1)^q,μ}(Z) of μ-component Seifert matrices. We obtain a complete set of torsion-free invariants by passing from integer coefficients to complex coefficients and by applying the algebraic machinery of Quebbemann, Scharlau and Schulte. Signatures correspond to `algebraically integral' simple self-dual representations of a certain quiver (directed graph with loops). These representations, in turn, correspond to algebraic integers on an infinite disjoint union of real affine varieties. To distinguish torsion classes, we consider rational coefficients in place of complex coefficients, expressing G^{(-1)^q,μ}(Q) as an infinite direct sum of Witt groups of finite-dimensional division Q-algebras with involution. Numerical invariants of such Witt groups are available in the literature.

  12. No ‘cure’ within 12 years of diagnosis among breast cancer patients who are diagnosed via mammographic screening: women diagnosed in the West Midlands region of England 1989–2011

    PubMed Central

    Woods, L. M.; Morris, M.; Rachet, B.

    2016-01-01

    Background We have previously reported that there is little evidence of population ‘cure’ among two populations of women diagnosed with invasive breast cancer. ‘Cure’ has not yet been examined in the context of screen-detection. Patients and methods We examined cancer registry data on 19 800 women aged 50–70, diagnosed with a primary, invasive, non-metastatic breast cancer between 1 April 1989 and 31 March 2011 in the West Midlands region of England, linked to Hospital Episode Statistics (HES) and the National Breast Screening Service (NBSS). Follow-up was complete on all women up to 31 July 2012. Analyses were stratified by screening status, age, tumour stage, deprivation and ethnicity. We estimated net survival for the whole cohort and each subgroup. Population ‘cure’ was evaluated by fitting flexible parametric log-cumulative excess hazard regression models in which the excess hazard of breast cancer death was assumed to be equal to zero after a given follow-up time. Results There was an overall lack of evidence for ‘cure’. Across all subgroups examined, the general pattern was that of a continuous decrease in net survival over time, with no obvious asymptotic tendency within 12 years of follow-up. Model-based analyses confirmed this observation. Conclusions Despite dramatic improvements in survival over past decades, diagnosis with breast cancer remains associated with a small but persistent increased risk of death for all groups of women, including those whose cancer is detected asymptomatically. These findings are unlikely to be due to methodological inadequacies. Communication of these long-term consequences of breast cancer among women recently diagnosed and to those considering undergoing screening should take due consideration of these patterns. PMID:27573567

  13. Neck schwannoma diagnosed by core needle biopsy: a case report.

    PubMed

    Nasrollah, N; Trimboli, P; Bianchi, D; Taccogna, S

    2015-12-01

    Here we present a case of a 58 year old man referred to our hospital to undergo neck and thyroid ultrasonography (US) following palpable neck mass. US revealed a solid hypoechoic nodule in right thyroid lobe, and a solid lesion on the right laterocervical neck region with ultrasound suspicious features of neoplastic lymph node. In order to achieve a diagnosis of the neck mass and to get a proper evaluation of the thyroid nodule, we decided to perform a fine-needle aspiration (FNA) of both lesions. At cytopathologic examination the thyroid nodule appeared as benign, while cytologic sampling of the neck lesion was inadequate for a proper evaluation. Thus, we performed core needle biopsy (CNB) of the neck lesion like recently proposed for thyroid lesions; also, to definitively exclude malignancy of thyroid nodule, this also underwent CNB. Histologic report of CNB confirmed benign thyroid nodule, while the neck lesion revealed a proliferation of neuronal type consistent with schwannoma. The patient has been addressed to clinical and ultrasonographic follow-up. CNB appears as a safe and minimally-invasive approach to diagnose indeterminate neck masses and avoid unnecessary diagnostic surgery.

  14. Diagnosing erectile dysfunction: the penile dynamic colour duplex ultrasound revisited.

    PubMed

    Aversa, A; Bruzziches, R; Spera, G

    2005-12-01

    A number of disease processes of the penis including Peyronie's disease, priapism, penile fractures and tumors are clearly visualized with ultrasound. Diagnostic evaluation of erectile dysfunction (ED) by penile dynamic colour-duplex Doppler ultrasonography (D-CDDU) is actually considered a second level approach to ED patients because of the fact that intracavernous injections test IV with prostaglandin-E(1) may provide important information about the patients' erectile capacity. However, no direct vascular imaging and a high percentage of false negative diagnoses of vasculogenic ED are its major pitfalls and subsequent treatment decisions remain quite limited. The occurrence of ED and its sentinel relationship to cardiovascular disease has prompted more accurate vascular screening in all patients even in the absence of cardiovascular risk factors. The sonographic evaluation of the intima-media thickness of the carotid arteries may sometimes represent an early manifestation of diffuse atherosclerotic disease and endothelial damage. This latter finding is often the cause of failure to oral agents, i.e. phosphodiesterase inhibitors, because of inability of the dysfunctional endothelium to release nitric oxide. D-CDDU represents an accurate tool to investigate cavernous artery inflow and venous leakage when compared with more invasive diagnostic techniques i.e. selective arteriography and dynamic infusion cavernosometry along with cavernosography.

  15. [Diagnosis, evolution and prognosis of prenatally diagnosed suprasellar cysts].

    PubMed

    Di Rocco, F; André, A; Roujeau, T; Selek, L; Ville, Y; Garel, C; Zérah, M

    2016-12-01

    Suprasellar arachnoid cysts (SAC) in children are considered rare, but the incidence is increasing due to the improvement of prenatal diagnosis. We present 15 cases of SAC diagnosed during the antenatal period between 2005 and 2015. The records were reviewed retrospectively by specifying the radiological characteristics, treatment modalities, outcomes, and long-term monitoring. Mean follow-up was 71 months. The forms (SAC-1) accounted for 2 cases (13%) with hydrocephalus. We observed 8 (53%) lower forms (SAC-2) with interpeduncular cistern expansion without hydrocephalus. The 5 (33.5%) remaining patients showed asymmetrical forms (SAC-3). Six patients (40%) were treated by ventriculo-cysto-cisternostomy, 1 by fetoscopy, 1 (6.5%) by ventriculo-peritoneal shunt, 2 (13.5%) by pterional craniotomy, and 6 (40%) were simply followed. The surgical outcomes were initially favorable in 9 cases (100%), 1 patient (13%) had to be re-treated later. Non-operated patients were all type 2 and showed no radiological changes. In the long-term, 1 patient (6.5%) had endocrine disruption, 1 had delayed development, 2 (13.5%) had minor neuropsychological impairments, and 1 had epilepsy. Combined monitoring with prenatal MRI and ultrasound can be used to distinguish three subtypes of SAC. SAC-1 and SAC-3 have an excellent prognosis after treatment in the perinatal period. SAC-2 can benefit from simple monitoring and remain asymptomatic in their majority. This classification allows a better prognosis estimation and better treatment decision.

  16. Schnitzler syndrome: an under-diagnosed clinical entity

    PubMed Central

    Jain, Tania; Offord, Chetan P.; Kyle, Robert A.; Dingli, David

    2013-01-01

    Schnitzler syndrome is considered to be a rare disorder characterized by a monoclonal IgM protein and chronic urticaria that is associated with considerable morbidity. We hypothesized that the syndrome may be under-recognized and patients may be deprived of highly effective therapy in the form of anakinra. We performed a retrospective search of the dysproteinemia database at Mayo Clinic as well as the medical records of all patients with chronic urticaria to determine the true incidence of the disease. We compared patients with the diagnosis of Schnitzler syndrome and those who met the criteria but in whom the syndrome was not recognized. Comparisons between groups were performed and survival curves determined. We identified 16 patients with diagnosed Schnitzler syndrome and an additional 46 patients who met diagnostic criteria. The monoclonal protein was IgMκ in 94% of patients. Therapy with anakinra in 4 patients led to rapid and complete resolution of symptoms. The median overall survival for this syndrome is over 12.8 years. Progression to lymphoma was only observed in 8% of patients; this is lower than previous reports. Schnitzler syndrome may be present in up to 1.5% of patients with a monoclonal IgM in their serum and likely under-recognized as a clinical syndrome. PMID:23812931

  17. Dissociative disorders among Chinese inpatients diagnosed with schizophrenia.

    PubMed

    Yu, Junhan; Ross, Colin A; Keyes, Benjamin B; Li, Ying; Dai, Yunfei; Zhang, Tianhong; Wang, Lanlan; Fan, Qing; Xiao, Zeping

    2010-01-01

    The purpose of this study was to assess the prevalence of dissociative disorders in a sample of Chinese psychiatric inpatients. Participants in the study were 569 consecutively admitted inpatients at Shanghai Mental Health Center, China, of whom 84.9% had a clinical diagnosis of schizophrenia based on the Chinese Classification and Diagnostic Criteria of Mental Disorders, Version 3. All participants completed a self-report measure of dissociation (the Dissociative Experiences Scale), and none had a prior diagnosis of a dissociative disorder. A total of 96 randomly selected participants were interviewed with a structured interview (the Dissociative Disorders Interview Schedule) and a clinical interview. These 96 patients did not differ significantly from the 473 patients who were not interviewed on any demographic measures or who did not complete the self-report dissociation measure. A total of 28 patients (15.3%, after weighting of the data) received a clinical diagnosis of a dissociative disorder based on Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.) criteria. Dissociative identity disorder was diagnosed in 2 patients (0.53%, after weighting). Compared to the patients without a dissociative disorder, patients with dissociative disorders were significantly more likely to report childhood abuse (57.1% vs. 22.1%), but the 2 groups did not differ significantly on any demographic measures. Dissociative disorders were readily identified in an inpatient psychiatric population in China.

  18. Gender differences in reported AIDS-indicative diagnoses.

    PubMed

    Fleming, P L; Ciesielski, C A; Byers, R H; Castro, K G; Berkelman, R L

    1993-07-01

    To compare AIDS-defining conditions in women and men, US adult AIDS cases diagnosed between January 1988 and June 1991 and reported to the Centers for Disease Control and Prevention through June 1992 were examined. For most AIDS-defining conditions, the prevalence was similar for women and men when differences in race/ethnicity and mode of transmission were accounted for. Pneumocystis carinii pneumonia was the most prevalent condition (> 50%) regardless of gender, race/ethnicity, or mode of transmission. By logistic regression analysis, among injection drug users, conditions reported significantly more frequently in women than in men include esophageal candidiasis (odds ratio [OR], 1.51; 95% confidence interval [CI], 1.40-1.62), herpes simplex virus (HSV) disease (OR, 1.68; CI, 1.46-1.94), and cytomegalovirus (CMV) disease (OR, 1.43; CI, 1.18-1.73). More knowledge of the interrelationships in women between HIV infection and secondary opportunistic infections, including candidiasis and sexually transmitted disease (e.g., HSV and CMV) is needed.

  19. A flash x-ray system for diagnosing liner implosions

    SciTech Connect

    Anderson, B. G.; Oro, D. M.; Olson, R. T.; Studebaker, J. K.; Platts, D.

    2003-01-01

    This paper describes a low energy flash X-ray system that is ideal for radiographing a wide variety of experimental phenomenon on both capacitor-bank pulsed power facilities and explosively driven magnetic-flux compression experiments. The versatility of this system has allowed us to obtain both single X-radiographs of imploding liners and multiple, temporally resolved radiographic sequences of target evolution. The dynamic liner radiographs are acquired with radially oriented X-ray heads that are instrumental for observing and diagnosing liner shape and symmetry, Rayleigh-Taylor instability growth, and liner-glide plane interaction (see Fig. 1). Multiframe radiographs acquired along the axis of a cylindrical target are used to provide physical data on phenomena such as shock-driven target hydrodynamics, Richtmyer-Meshkov instability growth, spall, fiction, and equations of state. The flexibility of this X-ray system has also allowed it to be successfully fielded both at various gas and powder gun facilities and explosively driven shock physics experiments.

  20. Kr X-ray spectroscopy to diagnose NIF ICF implosions

    NASA Astrophysics Data System (ADS)

    Dasgupta, A.; Ouart, N.; Giuliani, J. L.; Clark, R. W.; Schneider, M. B.; Scott, H. A.; Chen, H.; Ma, T.; Apruzese, J. P.

    2016-10-01

    X ray spectroscopy is used on the NIF to diagnose the plasma conditions in the ignition target in indirect drive ICF implosions. High-energy emission spectra from mid to high atomic number elements can provide estimates of electron temperature near stagnation of an ICF implosion. A platform is being developed at NIF where small traces of krypton are used as a dopant to the fuel gas for spectroscopic diagnostics using krypton line emissions. The fraction of krypton dopant was varied in the experiments and was selected so as not to perturb the implosion. Simulations of the krypton spectra using a 1 in 104 atomic fraction of krypton in direct-drive exploding pusher with a range of electron temperatures and densities show discrepancies when different atomic models are used. We use our non-LTE atomic model with a detailed fine-structure level atomic structure and collisional-radiative rates to investigate the krypton spectra at the same conditions. Synthetic spectra are generated with a detailed multi-frequency radiation transport scheme from the emission regions of interest to analyze the experimental data and compare and contrast with the existing simulations at LLNL. Work supported by DOE/NNSA and under the auspices of DOE by LLNL under Contract # DE-AC52-07NA27344.

  1. Diagnosing Undersampling in Monte Carlo Eigenvalue and Flux Tally Estimates

    SciTech Connect

    Perfetti, Christopher M; Rearden, Bradley T

    2015-01-01

    This study explored the impact of undersampling on the accuracy of tally estimates in Monte Carlo (MC) calculations. Steady-state MC simulations were performed for models of several critical systems with varying degrees of spatial and isotopic complexity, and the impact of undersampling on eigenvalue and fuel pin flux/fission estimates was examined. This study observed biases in MC eigenvalue estimates as large as several percent and biases in fuel pin flux/fission tally estimates that exceeded tens, and in some cases hundreds, of percent. This study also investigated five statistical metrics for predicting the occurrence of undersampling biases in MC simulations. Three of the metrics (the Heidelberger-Welch RHW, the Geweke Z-Score, and the Gelman-Rubin diagnostics) are commonly used for diagnosing the convergence of Markov chains, and two of the methods (the Contributing Particles per Generation and Tally Entropy) are new convergence metrics developed in the course of this study. These metrics were implemented in the KENO MC code within the SCALE code system and were evaluated for their reliability at predicting the onset and magnitude of undersampling biases in MC eigenvalue and flux tally estimates in two of the critical models. Of the five methods investigated, the Heidelberger-Welch RHW, the Gelman-Rubin diagnostics, and Tally Entropy produced test metrics that correlated strongly to the size of the observed undersampling biases, indicating their potential to effectively predict the size and prevalence of undersampling biases in MC simulations.

  2. Insights into Population Health Management Through Disease Diagnoses Networks

    PubMed Central

    Feldman, Keith; Stiglic, Gregor; Dasgupta, Dipanwita; Kricheff, Mark; Obradovic, Zoran; Chawla, Nitesh V.

    2016-01-01

    The increasing availability of electronic health care records has provided remarkable progress in the field of population health. In particular the identification of disease risk factors has flourished under the surge of available data. Researchers can now access patient data across a broad range of demographics and geographic locations. Utilizing this Big healthcare data researchers have been able to empirically identify specific high-risk conditions found within differing populations. However to date the majority of studies approached the issue from the top down, focusing on the prevalence of specific diseases within a population. Through our work we demonstrate the power of addressing this issue bottom-up by identifying specifically which diseases are higher-risk for a specific population. In this work we demonstrate that network-based analysis can present a foundation to identify pairs of diagnoses that differentiate across population segments. We provide a case study highlighting differences between high and low income individuals in the United States. This work is particularly valuable when addressing population health management within resource-constrained environments such as community health programs where it can be used to provide insight and resource planning into targeted care for the population served. PMID:27461860

  3. Discrepancy between clinical and pathological diagnoses of CBD and PSP.

    PubMed

    Mizuno, Toshiki; Shiga, Kensuke; Nakata, Yuriko; Nagura, Junko; Nakase, Taizen; Ueda, Yoshihiro; Takanashi, Yoshiaki; Urasaki, Kohji; Oyamada, Yumiko; Fushiki, Shinji; Nishikawa, Junji; Yasuhara, Masahiro; Nakajima, Kenji; Nakagawa, Masanori

    2005-06-01

    Progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD) are often clinically confused with each other. Moreover, the discrepancy between clinical and pathological diagnoses of CBD and PSP are still controversial. We report here two atypical cases of PSP and CBD. A 73-year old woman was admitted with right hand rigidity, limb kinetic apraxia and cortical sensory loss. Brain atrophy, hypoperfusion and hypometabolism predominantly in the left frontoparietal lobes indicated CBD clinically. Pathological studies revealed neuronal loss and spongy change without ballooned neurons (BN) in the cerebral cortex. Modified Gallyas-Braak (G-B) staining revealed neurofibrillary tangles (NFTs) and tufted astrocytes, indicating pathological diagnosis of PSP. A 75-year-old man admitted with vertical gaze palsy, neck dystonia, parkinsonism and dementia. Atrophy of the frontal lobes and tegmentum of the midbrain and symmetrical frontal hypoperfusion in SPECT indicated PSP. However, neuronal loss and BN in the frontal lobes and clusters of astrocytic plaques indicated CBD pathologically. The G-B staining was useful for differentiating between CBD and PSP, but our atypical cases bring up a new issue about differential diagnosis of CBD and PSP.

  4. Violence among persons diagnosed with schizophrenia: how pharmacists can help.

    PubMed

    Stilwell, Emily N; Yates, Sarah E; Brahm, Nancy C

    2011-12-01

    Violence among those diagnosed with schizophrenia has been reported but is not a diagnostic component of the disorder. The position of the courts regarding fulfillment of the requisite intent to commit violent acts has not been extensively reported. This article discusses the impact of a diagnosis of schizophrenia in an individual and how the pharmacist can help integrate information into the health care system. The recent Supreme Court case of Clark versus Arizona and the older case of Patterson versus Cockrell are discussed with respect to the concept of intent (to commit the act) and the implications this has on an individual in the midst of a psychotic episode. Quality of life, the perception of the stigma associated with a diagnosis of schizophrenia, and pharmacotherapy are briefly discussed. The origin of schizophrenia is multifactorial. Persons with schizophrenia are not innately violent, but alteration in perception may precipitate aggressive acts. Given the complex and diverse nature of schizophrenia and the fact that even with successful pharmacological treatment residual symptoms may still be present, there is a need to provide information to health care practitioners and the court.

  5. A diagnostic dilemma in diagnosing and managing an incidental phaeochromocytoma.

    PubMed

    Tahrani, A A; Macleod, A F

    2006-04-01

    Incidental adrenal tumours are a common radiological finding. Phaeochromocytomas, though rare, are very important not to be missed, as the consequences could be fatal. Urinary catecholamines and metanephrines measurement is a commonly used method of screening for phaeochromocytomas. We report a patient who had a phaeochromocytoma presented as an incidental adrenal mass on abdominal CT during investigations for recurrent chest infections. The patient had symptoms suggestive of catecholamines excess and hypertension. Repeated urinary catecholamines measurements, plasma catecholamines, 24-hour urinary catecholamines and 24-hour urinary metanephrines all were normal. MIBG scan showed increased uptake in the adrenal mass. Histological examination of the adrenal mass was consistent with phaeochromocytoma. Removal of the adrenal mass resulted in normalisation of blood pressure and abolishing of the patient's symptoms. This case highlights the difficulty in deciding on further management of patients presenting with an adrenal incidentaloma. This case also highlights the difficulty in diagnosing phaeochromocytoma and represents a reminder that plasma and urine catecholamines measurements could be normal in patients with symptomatic phaeochromocytoma. This case also highlights that MIBG scan could reveal a phaeochromocytoma despite absence of biochemical markers.

  6. Establishing preference for unreliable reinforcement in adults with dual diagnoses.

    PubMed

    Rehfeldt, Ruth Anne; Randich, Lisette

    2003-08-01

    We evaluated the choice responding of three adults dually diagnosed with developmental and psychiatric disabilities using concurrent schedules of reinforcement. Specifically, participants were given a choice between a response option resulting in reliable reinforcement and a response option resulting in unreliable reinforcement. Our primary purpose was to shift preference from reliable to unreliable reinforcement via the systematic presentation of stimuli during delay intervals. A second purpose was to evaluate the effectiveness of intervening stimuli in shifting preference at differing delay-to-reinforcement intervals. Preference for unreliable reinforcement was first examined in the absence of stimulus presentations during delays, at three different delay values. Next, we aimed to establish preference for unreliable reinforcement by presenting pictures of reinforcers during delays preceding unreliable reinforcement. Preference was again examined at three different delay values. In the absence of stimulus presentations during delays, participants were shown to prefer reliable reinforcement, particularly at the longer delay value. When stimuli were presented during the delays, two of the three participants preferred unreliable reinforcement, particularly the longer the delay value. These results suggest that the presentation of intervening stimuli during delays may help facilitate tolerance for unreliable reinforcement.

  7. A Histologically Diagnosed Case with Infantile Osteopetrosis Complicated by Hypopituitarism

    PubMed Central

    Diniz, Gulden; Olukman, Ozgur; Calkavur, Sebnem; Buyukinan, Muammer; Altay, Canan

    2015-01-01

    Malignant infantile osteopetrosis is a rarely seen severe disorder which appears early in life with general sclerosis of the skeleton. It is caused by functionally defective osteoclasts which fail to resorb bone. Affected infants can exhibit a wide spectrum of clinical manifestations including impaired hematopoiesis, hepatosplenomegaly, visual impairment, and hypocalcemia. With the exception of secondary hyperparathyroidism, involvement of the endocrine system seems to be quite rare. Hypopituitarism is defined as underproduction of the growth hormone in combination with deficiencies of other pituitary hormones. Any lesion that damages hypothalamus, pituitary stalk, or anterior pituitary can cause secondary hypopituitarism. In this report, we presented a rare combination of malignant infantile osteopetrosis and secondary hypopituitarism in a newborn who presented predominantly with endocrinological symptoms. This is the first case report of malignant infantile osteopetrosis accompanied by hypopituitarism secondary to sclerosis of the sella turcica. On the other hand, this is a very interesting case which was diagnosed based on histological examination of bone marrow biopsy specimens despite lack of any clinical suspicion. PMID:26576309

  8. Xanthogranuloma of the sellar region diagnosed by frozen section

    PubMed Central

    Ji, Kun; Zhang, Liyan; Wang, Liwei

    2016-01-01

    Abstract Xanthogranuloma (XG) of the sellar region is uncommon and is difficult to diagnose based on intraoperative frozen sections. This study is a case presentation and review of the literature, highlighting the need to explore underlying diseases in order to guarantee an accurate patient diagnosis. Herein, we presented the case of a 43-year-old woman who was afflicted with xanthogranuloma of the sellar region; the patient had a history of headache and lengthened menstrual cycles over the 6 months prior to presentation. Endocrinology tests revealed that the patient’s levels of prolactin were high and the MRI of the patient showed a clearly defined sellar mass. As a result, the patient was considered to have prolactinoma prior to undergoing surgery. The tumor was completely removed using a transsphenoidal approach, and intraoperative frozen section revealed histology similar to xanthogranuloma. When the tumor was removed by surgical operation, the patient’s visual field defects and headache were relieved. Although intraoperative frozen section should provide some guidance with regard to the diagnosis, a pathological study is conducted to confirm the actual diagnosis. PMID:28352831

  9. Applying cybernetic technology to diagnose human pulmonary sounds.

    PubMed

    Chen, Mei-Yung; Chou, Cheng-Han

    2014-06-01

    Chest auscultation is a crucial and efficient method for diagnosing lung disease; however, it is a subjective process that relies on physician experience and the ability to differentiate between various sound patterns. Because the physiological signals composed of heart sounds and pulmonary sounds (PSs) are greater than 120 Hz and the human ear is not sensitive to low frequencies, successfully making diagnostic classifications is difficult. To solve this problem, we constructed various PS recognition systems for classifying six PS classes: vesicular breath sounds, bronchial breath sounds, tracheal breath sounds, crackles, wheezes, and stridor sounds. First, we used a piezoelectric microphone and data acquisition card to acquire PS signals and perform signal preprocessing. A wavelet transform was used for feature extraction, and the PS signals were decomposed into frequency subbands. Using a statistical method, we extracted 17 features that were used as the input vectors of a neural network. We proposed a 2-stage classifier combined with a back-propagation (BP) neural network and learning vector quantization (LVQ) neural network, which improves classification accuracy by using a haploid neural network. The receiver operating characteristic (ROC) curve verifies the high performance level of the neural network. To expand traditional auscultation methods, we constructed various PS diagnostic systems that can correctly classify the six common PSs. The proposed device overcomes the lack of human sensitivity to low-frequency sounds and various PS waves, characteristic values, and a spectral analysis charts are provided to elucidate the design of the human-machine interface.

  10. Wernicke's Encephalopathy Mimicking Acute Onset Stroke Diagnosed by CT Perfusion

    PubMed Central

    Advani, Rajiv; Kurz, Kathinka D.; Kurz, Martin W.

    2014-01-01

    Background. Metabolic syndromes such as Wernicke's encephalopathy may present with a sudden neurological deficit, thus mimicking acute onset stroke. Due to current emphasis on rapid admission and treatment of acute stroke patients, there is a significant risk that these stroke mimics may end up being treated with thrombolysis. Rigorous clinical and radiological skills are necessary to correctly identify such metabolic stroke mimics, in order to avoid doing any harm to these patients due to the unnecessary use of thrombolysis. Patient. A 51-year-old Caucasian male was admitted to our hospital with suspicion of an acute stroke due to sudden onset dysarthria and unilateral facial nerve paresis. Clinical examination revealed confusion and dysconjugate gaze. Computed tomography (CT) including a CT perfusion (CTP) scan revealed bilateral thalamic hyperperfusion. The use of both clinical and radiological findings led to correctly diagnosing Wernicke's encephalopathy. Conclusion. The application of CTP as a standard diagnostic tool in acute stroke patients can improve the detection of stroke mimics caused by metabolic syndromes as shown in our case report. PMID:24716022

  11. Uninvolved immunoglobulins predicting hematological response in newly diagnosed AL amyloidosis.

    PubMed

    Muchtar, Eli; Magen, Hila; Itchaki, Gilad; Cohen, Amos; Rosenfeld, Ra'ama; Shochat, Tzippy; Kornowski, Ran; Iakobishvili, Zaza; Raanani, Pia

    2016-02-01

    Immunoparesis serves as a marker for elevated risk for progression in plasma cell proliferative disorders. However, the impact of immunoparesis in AL amyloidosis has not been addressed. Immunoparesis was defined qualitatively as any decrease below the low reference levels of the uninvolved immunoglobulins and quantitatively, as the relative difference between the uninvolved immunoglobulins and the lower reference values. Forty-one newly diagnosed AL amyloidosis patients were included. Sixty-six percent of patients had a suppression of the uninvolved immunoglobulins. The median relative difference of the uninvolved immunoglobulins was 18% above the low reference levels [range (-71%)-210%]. Ninety percent of the patients were treated with novel agents-based regimens, mostly bortezomib-containing regimens. Nineteen percent of the patients did not attain response to first line treatment. Patients with relative difference of uninvolved immunoglobulins below -25% of the low reference levels were less likely to respond to first line treatment compared to patients with a relative difference of -25% and above [odds ratio for no response vs. partial response and better 30 [(95% CI 4.1-222.2), P=0.0004]. Patients who failed first line treatment were successfully salvaged with lenalidomide-based treatment. Immunoparesis, if assessed quantitatively, may serve as a predictor of response in AL amyloidosis patients treated with bortezomib-containing regimens.

  12. Diagnosing the decline in pharmaceutical R&D efficiency.

    PubMed

    Scannell, Jack W; Blanckley, Alex; Boldon, Helen; Warrington, Brian

    2012-03-01

    The past 60 years have seen huge advances in many of the scientific, technological and managerial factors that should tend to raise the efficiency of commercial drug research and development (RD). Yet the number of new drugs approved per billion US dollars spent on RD has halved roughly every 9 years since 1950, falling around 80-fold in inflation-adjusted terms. There have been many proposed solutions to the problem of declining RD efficiency. However, their apparent lack of impact so far and the contrast between improving inputs and declining output in terms of the number of new drugs make it sensible to ask whether the underlying problems have been correctly diagnosed. Here, we discuss four factors that we consider to be primary causes, which we call the 'better than the Beatles' problem; the 'cautious regulator' problem; the 'throw money at it' tendency; and the 'basic research-brute force' bias. Our aim is to provoke a more systematic analysis of the causes of the decline in RD efficiency.

  13. Application of Laser Induced Plasma Spectroscopy on Breast Cancer Diagnoses

    NASA Astrophysics Data System (ADS)

    Abd-Alfattah, A.; Eldakrouri, A. A.; Emam, H.; Azzouz, I. M.

    2013-03-01

    Worldwide, millions of breast cancer cases appear each year. It ranked as the first malignant tumors in Egypt. Breast cancer patients are at increased risk of developing malignant melanoma and cancers of the ovary, endometrium, colon, thyroid, and salivary glands because of similar hormonal and genetic factors. Therefore, early diagnosis by a quick and accurate method may have a great affect on healing. In this work, we investigate the feasibility of using LIPS as a simple, technique to diagnose breast cancer by measuring the concentration of trace elements in breast tissues. The accuracy of LIPS measurements was confirmed by carrying out another elemental analysis via atomic absorption spectroscopy (AAS) technique. The results obtained via these two techniques showed that the concentration of Ca, Cu, Fe, Zn and Mn in the malignant tissue cells are significantly enhanced. A voting algorithm was built for instantaneous decision of the diagnostic technique (normal or malignant). This study instigates developing a new diagnostic tool with potential use in vivo.

  14. Advances in compact proton spectrometers for diagnosing ICF experiments

    NASA Astrophysics Data System (ADS)

    Seguin, F. H.; Sinenian, N.; Manuel, M.; Rinderknecht, H. G.; Rosenberg, M.; Zylstra, A.; Frenje, J.; Li, C. K.; Petrasso, R.; Roberts, S.; Sangster, T. C.

    2011-10-01

    The compact proton spectrometer (or WRF, for Wedge-Range-Filter proton spectrometer) measures the spectra of protons in the energy range ~ 3 to 20 MeV for diagnosing ICF experiments. It utilizes CR-39 for detecting individual protons and their energies, after they pass through a ranging filter with a continuously varying thickness, and appropriate algorithms for reconstructing the incident spectrum. It has now been in use for a decade at OMEGA, and is currently being used at the NIF, for measuring spectra of primary D3He protons in D3He implosions, secondary D3He protons in DD implosions, and ablator protons in DT implosions. These spectra are used to determine proton yields, shell areal density at shock-bang time and compression-bang time, fuel areal density, and implosion symmetry. During the decade of use there have been significant changes in fabrication and in analysis algorithms. An overview will be given here of the historical development, current analysis methods, and measurement accuracy. This work was supported in part by DOE and LLE.

  15. Computer-aided intelligent system for diagnosing pediatric asthma.

    PubMed

    Zolnoori, Maryam; Fazel Zarandi, Mohammad Hossein; Moin, Mostafa; Heidarnezhad, Hassan; Kazemnejad, Anoshirvan

    2012-04-01

    Asthma is a lung chronic inflammatory disorder estimated between 1.4% and 27.1% in different area of the world. Result of various studies show that asthma is usually underdiagnosed especially in developing countries, because of limitations on access to medical specialists and laboratory facilities. In this paper, we report on the development and evaluation of a novel patient-based fuzzy system that promotes the diagnosis method of asthma. The design of this application addresses five critical issues included: 1) modular representation of asthma diagnostic variables regard to patients' perception of the disease, 2) algorithmic approaches conducting inference of diagnosing based on patient's response to questions, 4) front-end mechanism for capturing data from patient, 5) output for both patient and physician regard to asthma possibility. for the system output score (0-10) the efficacy of this system calculated in the study sample included 139 asthmatic patients and 139 non-asthmatic patients (age range 6-18) reinforce the sensitivity of 88% and specificity of 100% for cut off value 0.7.

  16. Positron emission tomography in patients with clinically diagnosed Alzheimer's disease.

    PubMed Central

    McGeer, P L; Kamo, H; Harrop, R; Li, D K; Tuokko, H; McGeer, E G; Adam, M J; Ammann, W; Beattie, B L; Calne, D B

    1986-01-01

    Fourteen patients who had clinically diagnosed Alzheimer's disease with mild to severe dementia (mean age 69.1 years) were evaluated by calculation of local cerebral metabolic rate for glucose (LCMR-gl) based on uptake of 18F-2-fluoro-2-deoxyglucose (FDG) detected with positron emission tomography (PET). PET scanning showed that the patients had significantly lower LCMR-gl values than 11 age-matched neurologically normal volunteers (mean age 66.3 years). The differences were most marked in the temporal cortex, followed by the frontal, parietal and occipital cortex. In each case the LCMR-gl value was below the lowest control value in at least one cortical area and usually in several; the reduction in LCMR-gl and the number of regions involved in the patients increased with the severity of the dementia. Deficits noted in neuropsychologic testing generally correlated with those predicted from loss of regional cortical metabolism. The patients with Alzheimer's disease were also examined with magnetic resonance imaging, computed tomography or both; the degree of atrophy found showed only a poor correlation with the neuropsychologic deficit. Significant atrophy was also noted in some of the controls. A detailed analysis of LCMR-gl values in selected cerebral regions of various sizes refuted the hypothesis that the reduction in cortical glucose metabolism in Alzheimer's disease is due to the filling by metabolically inert cerebrospinal fluid of space created by tissue atrophy. Images Fig. 2 Fig. 3 Fig. 4 Fig. 7 Fig. 8 Fig. 9 PMID:3512063

  17. Normative identity construction among women diagnosed with a gambling disorder.

    PubMed

    Gavriel-Fried, Belle; Peled, Einat; Ajzenstadt, Mimi

    2015-03-01

    Women with a gambling problem bear a negative social stigma. Based on the theory of symbolic interactionism, this study examined the construction of social identities by 17 Israeli women diagnosed with a gambling disorder. Interpretive interactionist analysis revealed how they construct their identity through correspondence with patterns of behavior that are perceived as normative, and identified 3 major themes: "I'm not actually a gambler" (the presentation of a multidimensional identity comprising other identities besides that of a gambler); "Staying normative during gambling"; and "I have changed" (reformed gamblers' presentation of themselves as having changed for the better). The findings underscore the complex dialogue behind the identity construction put forward by women with a gambling problem, their yearning to be perceived by society as normative women and to fit in despite their stigmatized behavior, and the tension they feel in society's relationship toward them. The findings also suggest that practitioners who work with women gamblers may want to pay attention to the power relations shaping identity construction in an interview setting, and look more closely at the women's awareness of the stigma they bear and the complex processes that make up their multidimensional identity.

  18. Validity of the neurological examination in diagnosing diabetic peripheral neuropathy.

    PubMed

    Höliner, Isabella; Haslinger, Vera; Lütschg, Jürg; Müller, Guido; Barbarini, Daniela Seick; Fussenegger, Jörg; Zanier, Ulrike; Saely, Christoph H; Drexel, Heinz; Simma, Burkhard

    2013-09-01

    The aim of this study was to evaluate the prevalence of diabetic peripheral neuropathy in children and adolescents with type 1 diabetes mellitus and examine whether the neurological examination validly diagnoses diabetic peripheral neuropathy as compared with the gold standard of nerve conduction velocity in these patients. Nerve conduction velocity was measured in an unselected consecutive series of patients aged 8-18 years who had been suffering from type 1 diabetes mellitus for at least 1 year. For the neurological examination, neuropathy disability scores and neuropathy sign scores were used. Of the 39 patients, six (15%) had clinically evident diabetic peripheral neuropathy, whereas nerve conduction velocity testing revealed diabetic peripheral neuropathy in 15 (38%) patients. Sensitivity and specificity of the neurological examination for the diagnosis of diabetic peripheral neuropathy were 40% and 100%, respectively. The corresponding positive and negative predictive values were 100% and 72.7%, respectively. This conclusions from this study are that in children and adolescents with type 1 diabetes mellitus, diabetic peripheral neuropathy is highly prevalent, but in the majority of patients it is subclinical. Sensitivity and negative predictive values of the neurological examination are low. Therefore, routine nerve conduction velocity measurement for the assessment of diabetic peripheral neuropathy appears to be warranted in these patients.

  19. Pre-irradiation chemotherapy for newly diagnosed high grade astrocytoma.

    PubMed

    Mathieu, N Tubiana; Genet, D; Labrousse, F; Bouillet, P; Denes, S Lavau; Martin, J; Labourey, J L; Venat, L; Clavere, P; Moreau, J J

    2004-01-01

    The purpose of this work was to determine the response rate and toxicity of a combination of Carmustine and Cisplatin administered before radiation in patients with newly diagnosed high grade astrocytoma. A good response rate has been published with this association in primary cerebral high grade tumor. This protocol was administered in a homogeneous population of 37 adult patients with measurable tumor on magnetic resonance imaging (MRI) or CT scan. After biopsy or subtotal resection, the patients received BCNU 40 mg/m2/d and CODP 40 mg/m2/d, for 3 days every 28 days for 3 cycles. Evaluation was performed before each cycle. Radiation therapy began 4 weeks after completing the chemotherapy or immediately if there was evidence of tumor progression on chemotherapy. Seven out of 37 (19%) demonstrated tumor regression with a median duration to progression of 11 months. Median survival was 6 months. Myelosuppression was the predominant but manageable toxicity. This work indicated that the first chemotherapy protocol gave poor results in a homogeneous group of patients, with bad prognosis.

  20. Dissociative Disorders Among Chinese Inpatients Diagnosed With Schizophrenia

    PubMed Central

    Yu, Junhan; Ross, Colin A.; Keyes, Benjamin B.; Li, Ying; Dai, Yunfei; Zhang, Tianhong; Wang, Lanlan; Fan, Qing; Xiao, Zeping

    2010-01-01

    The purpose of the study was to assess the prevalence of dissociative disorders in a sample of Chinese psychiatric inpatients. Participants in the study consisted of 569 consecutively admitted inpatients at Shanghai Mental Health Center, China, of whom 84.9% had a clinical diagnosis of schizophrenia based on the Chinese Classification and Diagnostic Criteria for Mental Disorders, Version 3 (CCMD-3). All participants completed a self-report measure of dissociation, the Dissociative Experiences Scale (DES) and none had a prior diagnosis of a dissociative disorder. Ninety-six randomly selected participants were interviewed with a structured interview, the Dissociative Disorders Interview Schedule (DDIS) and a clinical interview. These 96 patients did not differ significantly from the 473 patients who were not interviewed on any demographic measures or on the self-report measure dissociation. A total of 28 (15.3%, after weighting of the data) patients received a clinical diagnosis of a dissociative disorder based on DSM-IV-TR criteria. Dissociative identity disorder was diagnosed in 2 (0.53%, after weighting) patients. Compared to the patients without a dissociative disorder, patients with dissociative disorders were significantly more likely to report childhood abuse (57.1% versus 22.1%), but the two groups did not differ significantly on any demographic measures. Dissociative disorders were readily identified in an inpatient psychiatric population in China. PMID:20603768

  1. Daughter and mother diagnosed with hereditary multiple exostoses

    PubMed Central

    Mărginean, Cristina Oana; Meliţ, Lorena Elena; Mărginean, Maria Oana

    2017-01-01

    Abstract Introduction: Hereditary multiple exostoses (HME) or osteochondromatosis is a rare autosomal dominant disease characterized by multiple osteochondromas and skeletal deformities. Patient Concerns & Diagnoses: We present the case of a 5 years and 9 month-old patient who presented with inferior limb pain for approximately 6 months, associating also deformity of the right index finger for a month. Hand X-ray revealed a radiologic abnormality of the right radius, therefore the child was referred to our clinic for further investigations. The X-rays revealed multiple osteochondromas of the radius, metacarpal bones, hand phalangeal bones, femur, tibia, fibula, metatarsal bones, and foot phalangeal bones. We mention that the same radiological aspect was identified in the case of the patient's mother, undiagnosed until that moment. Outcomes: The particularity of this case consists in identification of a rare genetic pathology, HME in a 5-year-old patient, without any known familial history, after the occurrence of a nontraumatic joint dislocation of the right index finger. Conclusion: HME is a rare genetic condition, without a curative treatment, burdened by multiple complications, and whose diagnosis is usually established during childhood. PMID:28072741

  2. Diagnosing Hybrid Systems: a Bayesian Model Selection Approach

    NASA Technical Reports Server (NTRS)

    McIlraith, Sheila A.

    2005-01-01

    In this paper we examine the problem of monitoring and diagnosing noisy complex dynamical systems that are modeled as hybrid systems-models of continuous behavior, interleaved by discrete transitions. In particular, we examine continuous systems with embedded supervisory controllers that experience abrupt, partial or full failure of component devices. Building on our previous work in this area (MBCG99;MBCG00), our specific focus in this paper ins on the mathematical formulation of the hybrid monitoring and diagnosis task as a Bayesian model tracking algorithm. The nonlinear dynamics of many hybrid systems present challenges to probabilistic tracking. Further, probabilistic tracking of a system for the purposes of diagnosis is problematic because the models of the system corresponding to failure modes are numerous and generally very unlikely. To focus tracking on these unlikely models and to reduce the number of potential models under consideration, we exploit logic-based techniques for qualitative model-based diagnosis to conjecture a limited initial set of consistent candidate models. In this paper we discuss alternative tracking techniques that are relevant to different classes of hybrid systems, focusing specifically on a method for tracking multiple models of nonlinear behavior simultaneously using factored sampling and conditional density propagation. To illustrate and motivate the approach described in this paper we examine the problem of monitoring and diganosing NASA's Sprint AERCam, a small spherical robotic camera unit with 12 thrusters that enable both linear and rotational motion.

  3. Accuracy of Athletic Trainer and Physician Diagnoses in Sports Medicine.

    PubMed

    Lombardi, Nicholas J; Tucker, Bradford; Freedman, Kevin B; Austin, Luke S; Eck, Brandon; Pepe, Matthew; Tjoumakaris, Fotios P

    2016-09-01

    It is standard practice in high school athletic programs for certified athletic trainers to evaluate and treat injured student athletes. In some cases, a trainer refers an athlete to a physician for definitive medical management. This study was conducted to determine the rate of agreement between athletic trainers and physicians regarding assessment of injuries in student athletes. All high school athletes who were injured between 2010 and 2012 at 5 regional high schools were included in a research database. All patients who were referred for physician evaluation and treatment were identified and included in this analysis. A total of 286 incidents met the inclusion criteria. A total of 263 (92%) of the athletic trainer assessments and physician diagnoses were in agreement. In the 23 cases of disagreement, fractures and sprains were the most common injuries. Kappa analysis showed the highest interrater agreement in injuries classified as dislocations and concussions and the lowest interrater agreement in meniscal/labral injuries and fractures. In the absence of a confirmed diagnosis, agreement among health care providers can be used to infer accuracy. According to this principle, as agreement between athletic trainers and physicians improves, there is a greater likelihood of arriving at the correct assessment and treatment plan. Athletic trainers are highly skilled professionals who are well trained in the evaluation of athletic injuries. The current study showed that additional training in identifying fractures may be beneficial to athletic trainers and the athletes they treat. [Orthopedics. 2016; 39(5):e944-e949.].

  4. Neonatal Cholestasis – Differential Diagnoses, Current Diagnostic Procedures, and Treatment

    PubMed Central

    Götze, Thomas; Blessing, Holger; Grillhösl, Christian; Gerner, Patrick; Hoerning, André

    2015-01-01

    Cholestatic jaundice in early infancy is a complex diagnostic problem. Misdiagnosis of cholestasis as physiologic jaundice delays the identification of severe liver diseases. In the majority of infants, prolonged physiologic jaundice represent benign cases of breast milk jaundice, but few among them are masked and caused by neonatal cholestasis (NC) that requires a prompt diagnosis and treatment. Therefore, a prolonged neonatal jaundice, longer than 2 weeks after birth, must always be investigated because an early diagnosis is essential for appropriate management. To rapidly identify the cases with cholestatic jaundice, the conjugated bilirubin needs to be determined in any infant presenting with prolonged jaundice at 14 days of age with or without depigmented stool. Once NC is confirmed, a systematic approach is the key to reliably achieve the diagnosis in order to promptly initiate the specific, and in many cases, life-saving therapy. This strategy is most important to promptly identify and treat infants with biliary atresia, the most common cause of NC, as this requires a hepatoportoenterostomy as soon as possible. Here, we provide a detailed work-up approach including initial treatment recommendations and a clinically oriented overview of possible differential diagnoses in order to facilitate the early recognition and a timely diagnosis of cholestasis. This approach warrants a broad spectrum of diagnostic procedures and investigations including new methods that are described in this review. PMID:26137452

  5. Diagnosing anemia in inflammatory bowel disease: beyond the established markers.

    PubMed

    Oustamanolakis, Pantelis; Koutroubakis, Ioannis E; Kouroumalis, Elias A

    2011-10-01

    The main types of anemia in inflammatory bowel disease (IBD) are iron deficiency anemia (IDA) and anemia of inflammatory etiology, or anemia of chronic disease (ACD). In the management of IBD patients with anemia it is essential for the physician to diagnose the type of anemia in order to decide in an evidence-based manner for the appropriate treatment. However, the assessment of iron status in IBD in many cases is rather difficult due to coexistent inflammation. For this assessment several indices and markers have been suggested. Ferritin, seems to play a central role in the definition and diagnosis of anemia in IBD and transferrin, transferrin saturation (Tsat), and soluble transferrin receptors are also valuable markers. All these biochemical markers have several limitations because they are not consistently reliable indices, since they are influenced by factors other than changes in iron balance. In this review, in addition to them, we discuss the newer alternative markers for iron status that may be useful when serum ferritin and Tsat are not sufficient. The iron metabolism regulators, hepcidin and prohepcidin, are still under investigation in IBD. Erythrocytes parameters like the red cell distribution width (RDW) and the percentage of hypochromic red cells as well as reticulocyte parameters such as hemoglobin concentration of reticulocytes, red blood cell size factor and reticulocyte distribution width could be useful markers for the evaluation of anemia in IBD.

  6. Methylphenidate improves motor functions in children diagnosed with Hyperkinetic Disorder

    PubMed Central

    Stray, Liv Larsen; Stray, Torstein; Iversen, Synnøve; Ruud, Anne; Ellertsen, Bjørn

    2009-01-01

    Background A previous study showed that a high percentage of children diagnosed with Hyperkinetic Disorder (HKD) displayed a consistent pattern of motor function problems. The purpose of this study was to investigate the effect of methylphenidate (MPH) on such motor performance in children with HKD Methods 25 drug-naïve boys, aged 8–12 yr with a HKD-F90.0 diagnosis, were randomly assigned into two groups within a double blind cross-over design, and tested with a motor assessment instrument, during MPH and placebo conditions. Results The percentage of MFNU scores in the sample indicating 'severe motor problems' ranged from 44–84%, typically over 60%. Highly significant improvements in motor performance were observed with MPH compared to baseline ratings on all the 17 subtests of the MFNU 1–2 hr after administration of MPH. There were no significant placebo effects. The motor improvement was consistent with improvement of clinical symptoms. Conclusion The study confirmed our prior clinical observations showing that children with ADHD typically demonstrate marked improvements of motor functions after a single dose of 10 mg MPH. The most pronounced positive MPH response was seen in subtests measuring either neuromotor inhibition, or heightened muscular tone in the gross movement muscles involved in maintaining the alignment and balance of the body. Introduction of MPH generally led to improved balance and a generally more coordinated and controlled body movement. PMID:19439096

  7. Role of multiplex polymerase chain reaction in diagnosing tubercular meningitis

    PubMed Central

    Berwal, Anupam; Chawla, Kiran; Vishwanath, Shashidhar; Shenoy, Vishnu Prasad

    2017-01-01

    Tuberculous meningitis (TBM) is one of the most serious manifestations of extrapulmonary tuberculosis. Timely and accurate diagnosis provides a favorable prognosis in patients with TBM. The study evaluated the use of multiplex polymerase chain reaction (PCR) in the diagnosis of TBM. A study was conducted on 74 patients clinically suspected with TBM. The cerebrospinal fluid (CSF) specimens were processed for smear microscopy, middle brook 7H9 culture, and multiplex PCR using primers directed against IS6110 gene and 38 kD protein for detection of Mycobacterium tuberculosis. The results were analyzed to assess the role of multiplex PCR in the diagnosis of TBM. A total of 26 (35.1%) patients were diagnosed with TBM. Microscopy was negative in all while culture was positive in two cases only. Comparing with clinical diagnosis and CSF adenosine deaminase levels of ≥10 U/L, multiplex PCR showed sensitivity, specificity, positive predictive value, and negative predictive value of 71.4%, 89.6%, 83.3%, and 81.2%, respectively, in the diagnosis of TBM. PMID:28367034

  8. Cardiac Sarcoidosis Diagnosed by Incidental Lymph Node Biopsy.

    PubMed

    Matsuda, Jun; Fujiu, Katsuhito; Roh, Solji; Tajima, Miyu; Maki, Hisataka; Kojima, Toshiya; Ushiku, Tetsuo; Nawata, Kan; Takeda, Norihiko; Watanabe, Masafumi; Akazawa, Hiroshi; Komuro, Issei

    2017-02-07

    Cardiac involvement in systemic sarcoidosis sometimes provokes life-threatening ventricular tachyarrhythmia. Steroid administration is one of the fundamental anti-arrhythmia therapies. For an indication of steroid therapy, a definitive diagnosis of sarcoidosis is required.(1)) However, cases that are clearly suspected of cardiac sarcoidosis based on their clinical courses sometimes do not meet the current diagnostic criteria and result in the loss of an appropriate opportunity to perform steroid therapy.Here we report a case that was diagnosed as sarcoidosis by incidental biopsy of an inguinal lymph node during cardiac resuscitation for cardiac tamponade.(2)) While the inguinal lymph node was not swollen on computed tomography, a specimen obtained from an incidental biopsy during the exposure of a femoral vessel for the establishment of extracorporeal cardio-pulmonary resuscitation showed a non-caseating granuloma.This findings suggest a non-swelling lymph node biopsy might be an alternative strategy for the diagnosis for sarcoidosis if other standard strategies do not result in a diagnosis of sarcoidosis.

  9. Complex dental anomalies in a belatedly diagnosed cleidocranial dysplasia patient

    PubMed Central

    Lu, Hui; Zeng, Binghui; Yu, Dongsheng; Jing, Xiangyi; Hu, Bin; Wang, Yiming

    2015-01-01

    Cleidocranial dysplasia (CCD) is a rare congenital disorder, typically characterized by persistently open skull sutures, aplastic or hypoplastic clavicles, and supernumerary teeth. Mutations in the gene encoding the runt-related transcription factor 2 (RUNX2) protein are responsible for approximately two thirds of CCD patients. We report a 20-year-old CCD patient presenting not only with typical skeletal changes, but also complex dental anomalies. A previously undiagnosed odontoma, 14 supernumerary teeth, a cystic lesion, and previously unreported fused primary teeth were discovered on cone-beam computed tomography (CBCT) scans. Mutation analysis identified the causal c.578G>A (p.R193Q) mutation in the RUNX2 gene. At 20 years of age, the patient had already missed the optimal period for dental intervention. This report describes the complex dental anomalies in a belatedly diagnosed CCD patient, and emphasizes the significance of CBCT assessment for the detection of dental anomalies and the importance of early treatment to achieve good outcomes. PMID:26389062

  10. Diagnosing primary ciliary dyskinesia: an international patient perspective.

    PubMed

    Behan, Laura; Dunn Galvin, Audrey; Rubbo, Bruna; Masefield, Sarah; Copeland, Fiona; Manion, Michele; Rindlisbacher, Bernhard; Redfern, Beatrice; Lucas, Jane S

    2016-10-01

    Primary ciliary dyskinesia (PCD) is a rare genetic disorder characterised by progressive sino-pulmonary disease, with symptoms starting soon after birth. A European Respiratory Society (ERS) Task Force aims to address disparities in diagnostics across Europe by providing evidence-based clinical practice guidelines. We aimed to identify challenges faced by patients when referred for PCD diagnostic testing.A patient survey was developed by patient representatives and healthcare specialists to capture experience. Online versions of the survey were translated into nine languages and completed in 25 countries. Of the respondents (n=365), 74% were PCD-positive, 5% PCD-negative and 21% PCD-uncertain/inconclusive. We then interviewed 20 parents/patients. Transcripts were analysed thematically.35% of respondents visited their doctor more than 40 times with PCD-related symptoms prior to diagnostic referral. Furthermore, the most prominent theme among interviewees was a lack of PCD awareness among medical practitioners and failure to take past history into account, leading to delayed diagnosis. Patients also highlighted the need for improved reporting of results and a solution to the "inconclusive" diagnostic status.These findings will be used to advise the ERS Task Force guidelines for diagnosing PCD, and should help stakeholders responsible for improving existing services and expanding provision for diagnosis of this rare disease.

  11. Diagnosing primary ciliary dyskinesia: an international patient perspective

    PubMed Central

    Dunn Galvin, Audrey; Rubbo, Bruna; Masefield, Sarah; Copeland, Fiona; Manion, Michele; Rindlisbacher, Bernhard; Redfern, Beatrice; Lucas, Jane S.

    2016-01-01

    Primary ciliary dyskinesia (PCD) is a rare genetic disorder characterised by progressive sino-pulmonary disease, with symptoms starting soon after birth. A European Respiratory Society (ERS) Task Force aims to address disparities in diagnostics across Europe by providing evidence-based clinical practice guidelines. We aimed to identify challenges faced by patients when referred for PCD diagnostic testing. A patient survey was developed by patient representatives and healthcare specialists to capture experience. Online versions of the survey were translated into nine languages and completed in 25 countries. Of the respondents (n=365), 74% were PCD-positive, 5% PCD-negative and 21% PCD-uncertain/inconclusive. We then interviewed 20 parents/patients. Transcripts were analysed thematically. 35% of respondents visited their doctor more than 40 times with PCD-related symptoms prior to diagnostic referral. Furthermore, the most prominent theme among interviewees was a lack of PCD awareness among medical practitioners and failure to take past history into account, leading to delayed diagnosis. Patients also highlighted the need for improved reporting of results and a solution to the “inconclusive” diagnostic status. These findings will be used to advise the ERS Task Force guidelines for diagnosing PCD, and should help stakeholders responsible for improving existing services and expanding provision for diagnosis of this rare disease. PMID:27492837

  12. Diagnosing epilepsy in neurology clinics: a prospective study.

    PubMed

    Angus-Leppan, Heather

    2008-07-01

    The certainty of the initial diagnosis of epilepsy was assessed prospectively by one neurologist in outpatients. One hundred and fifty-eight consecutive referrals with loss of consciousness or possible epilepsy were seen. The relative contributions to the initial diagnosis from the referral letter, history taking in clinic, physical examination, and investigation were compared. There was a referring diagnosis in 28.5%. The neurologist reached a diagnosis in 87% of the 158 cases: in 43% epilepsy, 25% syncope, 12% non-epileptic seizures and in 7% other diagnoses. There was a low correlation between referral and specialist diagnosis. Physical examination did not change the diagnosis in any patient. Investigations changed the diagnosis in one patient. Neuro-imaging revealed a relevant abnormality in 12/43 (27.9%) scanned. The yield from EEG was 7/25 (28%), but the EEG changed the diagnosis in only one case. Cardiac testing confirmed the type of syncope in 2/47 (4.3%) of patients. Blood tests did not contribute to the diagnosis in any patient. The neurology consultation significantly increased diagnostic certainty. The diagnosis of epilepsy remains largely clinical. It is important that patients are aware of this prior to investigation.

  13. Molecular genetics of sarcomas: applications to diagnoses and therapy.

    PubMed

    Toguchida, Junya; Nakayama, Tomitaka

    2009-09-01

    Sarcomas are mesenchymal cancers consisting of tumors with various clinical and pathological features. Some of them compel affected individuals to lose important musculoskeletal functions, and some of them are highly malignant and life-threatening. A great amount of genetic information for sarcomas has accumulated during the past two decades, contributing diagnoses and treatments. From the standpoint of molecular genetics, sarcomas are classified into two groups: those with defined genetic alterations and those with various genetic alterations. The genetic alterations in the first group include reciprocal translocations resulting in fusion oncoproteins and oncogenic mutations of defined genes such as those of the c-kit gene in gastrointestinal stromal tumors. The function of fusion proteins includes transcription regulator, signal transducer, chromatic remodeling factor, and growth factor, some of which are suitable targets for the molecular therapy. In tumors belonging to the second group, the number of which is far larger than those of the first group, considerable genetic heterogeneity was found even among tumors with same pathological diagnosis. The disruption of the RB and p53 pathways was frequently found, resulting in the dysregulation of cell cycle and the genomic instability. The application of molecular target therapy for tumors in this group requires novel strategies to overcome cross talk between different signal pathways. Recent evidence from in vitro and in vivo experiments has indicated that the cells of origin of sarcomas are tissue stem cells such as mesenchymal stem cells, and the application of stem cell biology holds the promise of novel treatment options.

  14. Psychosocial problems among newly diagnosed rheumatoid arthritis patients.

    PubMed

    Gåfvels, C; Hägerström, M; Nordmark, B; Wändell, P E

    2012-03-01

    We identified patients with newly diagnosed rheumatoid arthritis (RA) in the ages 18-65 years who needed psychosocial interventions. A total of 123 patients (90 women) were asked to participate, but 19 declined and 4 dropped out early in the study, leaving a total of 100 patients (75 women) in the sample. Questionnaires used were the Epidemiological Investigation on Rheumatoid Arthritis study questionnaire, the Hospital Anxiety and Depression Scale, the Sense of Coherence (SOC) scale, and the General Coping Questionnaire. Interviews showed that 46% of the included 100 patients had psychosocial problems (PSP). One third of them had problems directly related to RA. The rest had problems with their life situation in general, without or reinforced by RA. Compared to patients without psychosocial problems, PSP patients lived in more strained social situations, especially regarding personal finances and social support. More of the PSP patients were anxious, showed lower SOC scores, and also used more emotion-based coping strategies (resignation, protest, isolation and intrusion) and less problem-oriented (minimization). They also had higher scores on depression and more frequently expected that RA would negatively affect their future. PSP patients also experienced a more negative impact of the disease, a finding not confirmed by the sickness activity score judged by the rheumatologist. Thus, early in the course of RA, screening instruments should be used to identify PSP patients. Psychosocial treatment and support by medical social workers skilled in RA care should be offered.

  15. The Prevalence of Barrett Esophagus Diagnosed in the Second Endoscopy

    PubMed Central

    Suna, Nuretdin; Parlak, Erkan; Kuzu, Ufuk Baris; Yildiz, Hakan; Koksal, Aydin Seref; Oztas, Erkin; Sirtas, Zeliha; Yuksel, Mahmut; Aydinli, Onur; Bilge, Zulfikar; Taskiran, Ismail; Sasmaz, Nurgul

    2016-01-01

    Abstract At present, we do not know the exact prevalence of Barrett esophagus (BE) developing later in patients without BE in their first endoscopic screening. The purpose of this study was to determine the prevalence of BE on the second endoscopic examination of patients who had no BE in their first endoscopic examination. The data of the patients older than 18 years who had undergone upper gastrointestinal system endoscopy more than once at the endoscopy unit of our clinic during the last 6 years were retrospectively analyzed. During the last 6 years, 44,936 patients had undergone at least one endoscopic examination. Among these patients, 2701 patients who had more than one endoscopic screening were included in the study. Of the patients, 1276 (47.3%) were females and 1425 (52.7%) were males, with an average age of 54.9 (18–94) years. BE was diagnosed in 18 (0.66%) of the patients who had no BE in the initial endoscopic examination. The patients with BE had reflux symptoms in their medical history and in both endoscopies, they revealed a higher prevalence of lower esophageal sphincter laxity, hiatal hernia, and reflux esophagitis when compared to patients without BE (P < 0.001). Our study showed that in patients receiving no diagnosis of BE on their first endoscopic examination performed for any reason, the prevalence of BE on their second endoscopy within 6 years was very low (0.66%). PMID:27057907

  16. Do colorectal cancer patients diagnosed as an emergency differ from non-emergency patients in their consultation patterns and symptoms? A longitudinal data-linkage study in England

    PubMed Central

    Renzi, C; Lyratzopoulos, G; Card, T; Chu, T P C; Macleod, U; Rachet, B

    2016-01-01

    Background: More than 20% of colorectal cancers are diagnosed following an emergency presentation. We aimed to examine pre-diagnostic primary-care consultations and related symptoms comparing patients diagnosed as emergencies with those diagnosed through non-emergency routes. Methods: Cohort study of colorectal cancers diagnosed in England 2005 and 2006 using cancer registration data individually linked to primary-care data (CPRD/GPRD), allowing a detailed analysis of clinical information referring to the 5-year pre-diagnostic period. Results: Emergency diagnosis occurred in 35% and 15% of the 1029 colon and 577 rectal cancers. ‘Background' primary-care consultations (2–5 years before diagnosis) were similar for either group. In the year before diagnosis, >95% of emergency and non-emergency presenters had consulted their doctor, but emergency presenters had less frequently relevant symptoms (colon cancer: 48% vs 71% (P<0.001); rectal cancer: 49% vs 61% (P=0.043)). ‘Alarm' symptoms were recorded less frequently in emergency presenters (e.g., rectal bleeding: 9 vs 24% (P=0.002)). However, about 1/5 of emergency presenters (18 and 23% for colon and rectal cancers) had ‘alarm' symptoms the year before diagnosis. Conclusions: Emergency presenters have similar ‘background' consultation history as non-emergency presenters. Their tumours seem associated with less typical symptoms, however opportunities for earlier diagnosis might be present in a fifth of them. PMID:27537389

  17. Increased urinary 6-hydroxymelatoninsulfate levels in attention deficit hyperactivity disorder diagnosed children and adolescent.

    PubMed

    Büber, Ahmet; Çakaloz, Burcu; Işıldar, Yetiş; Ünlü, Gülşen; Bostancı, Hayrani Eren; Aybek, Hülya; Herken, Hasan

    2016-03-23

    There are some studies in attention deficit hyperactivity disorder (ADHD) which note altered circadian rhythms, suggesting abnormalities in melatonin physiology. In order to better characterize the possible melatonin alteration in ADHD, in this study we aimed to detect daytime, nighttime and 24 h levels of 6-hydroxymelatoninsulfate (6-OH MS) in the patients diagnosed with ADHD. Twenty-seven patients between 6 and 16 years-old, who had been diagnosed initially with ADHD, but without other physical and psychiatric disease history and who had not taken psychotropic pharmacotherapy for six months, plus 28 healthy volunteer controls, were included in the study. Urine samples were collected during the whole 24 h cycle, daytime and nighttime separately to assess the time-dependent excretion of the 6-OH MS, which is the main urine metabolite of melatonin. The Enzyme-Linked Immunosorbent Assay (ELISA) method was used for measuring the urine 6-OH MS level. Daytime (15.4 (8.9-24.8) ng/ml vs 6.9 (2.5-15.9) ng/ml, p=0.002), nighttime (102.9 (65.3-197.7) ng/ml vs 61.5 (37.2-114.4) ng/ml, p=0.012) and 24 h (54.1 (34.6-83.9) ng/ml vs 27.3 (14.3-48.9) ng/ml, p=0.000) 6-OH MS levels median (25p-75p) were found to be significantly higher in the ADHD group. After adjustment for age and sex, there was a statistically significant difference between the ADHD group (59.8 ± 4.9) and control group (33.8 ± 4.8) in 24-h 6-OH MS levels (F(1, 51)=13.673, p=.001, partial η2=.211). There was no relationship between 6-OH MS levels and Conners Parent Rating Scale short form subscale scores for the ADHD group. These findings indicate that melatonin production is increased in ADHD cases. Further research is needed to determine and thereby understand the mechanisms underlying the higher melatonin production, to assess the impact of altered melatonin on the pathophysiology of ADHD.

  18. Mucosal polymerase chain reaction for diagnosing Helicobacter pylori infection in patients with bleeding peptic ulcers

    PubMed Central

    Lin, Hwai-Jeng; Lo, Wen-Ching; Perng, Chin-Lin; Tseng, Guan-Ying; Li, Anna Fen-Yau; Ou, Yueh-Hsing

    2005-01-01

    AIM: Helicobacter pylori (H pylori) has been linked to chronic gastritis, peptic ulcers, gastric cancer and MALT-lymphoma. Conventional invasive tests are less sensitive than non-invasive tests in diagnosing H pylori infection in patients with bleeding peptic ulcers. Polymerase chain reaction is a sensitive and accurate method for diagnosing H pylori infection. The aim of this study was to evaluate the diagnostic role of mucosal polymerase chain reaction for H pylori infection in patients with bleeding peptic ulcers. METHODS: In patients with bleeding, non-bleeding peptic ulcers and chronic gastritis, we checked rapid urease test, histology, bacterial culture and mucosal polymerase chain reaction for detecting H pylori infection. Positive H pylori infection was defined as positive culture or both a positive histology and a positive rapid urease test. For mucosal polymerase chain reaction of H pylori, we checked vacA (s1a, s1b, s1c, s2, m1, m1T, m2), iceA1, iceA2 and cag A. RESULTS: Between October 2000 and April 2002, 88 patients with bleeding peptic ulcers (males/females: 60/28, gastric ulcers/duodenal ulcers: 55/33), 81 patients with non-bleeding peptic ulcers (males/females: 54/27, gastric ulcers/duodenal ulcers: 45/36) and 37 patients with chronic gastritis (males/females: 24/13) were enrolled in this study. In patients with bleeding peptic ulcers, non-bleeding peptic ulcers and chronic gastritis, 45 patients (51%), 71 patients (88%) and 20 patients (54%) respectively were found to have positive H pylori infection (P<0.001). In patients with bleeding peptic ulcers, non-bleeding peptic ulcers and chronic gastritis, polymerase chain reaction for H pylori infection was positive in 54 patients (61%), 70 patients (86%) and 20 patients (54%) respectively (P<0.001). The sensitivity, positive predictive value and diagnostic accuracy of mucosal polymerase reaction for H pylori infection were significantly lower in patients with bleeding peptic ulcers (84%, 79% and 81

  19. Relationship between obstructive sleep apnea severity and sleep, depression and anxiety symptoms in newly-diagnosed patients.

    PubMed

    Macey, Paul M; Woo, Mary A; Kumar, Rajesh; Cross, Rebecca L; Harper, Ronald M

    2010-04-16

    Obstructive sleep apnea (OSA) occurs in at least 10% of the population, and leads to higher morbidity and mortality; however, relationships between OSA severity and sleep or psychological symptoms are unclear. Existing studies include samples with wide-ranging comorbidities, so we assessed relationships between severity of OSA and common sleep and psychological disturbances in recently diagnosed OSA patients with minimal co-morbidities. We studied 49 newly diagnosed, untreated OSA patients without major co-morbidities such as mental illness, cardiovascular disease, or stroke; subjects were not using psychoactive medications or tobacco (mean +/- std age: 46.8+/-9.1 years; apnea/hyponea index [AHI]: 32.1+/-20.5 events/hour; female/male: 12/37; weight <125 kg). We evaluated relationships between the AHI and daytime sleepiness (Epworth Sleepiness Scale; ESS), sleep quality (Pittsburg Sleep Quality Index; PSQI), depressive symptoms (Beck Depression Inventory-II; BDI), and anxiety symptoms (Beck Anxiety Inventory; BAI), as well as sex and body mass index (BMI). AHI was similar in females and males. Mean levels of all symptoms were above normal thresholds, but AHI was not correlated with age, ESS, PSQI, BDI, or BAI; only BMI was correlated with OSA severity. No differences in mean AHI appeared when subjects were grouped by normal versus elevated values of ESS, PSQI, BDI, or BAI. Consistent with other studies, a strong link between OSA severity and psychological symptoms did not appear in these newly diagnosed patients, suggesting that mechanisms additional to the number and frequency of hypoxic events and arousals occurring with apneas contribute to adverse health effects in OSA. OSA patients presenting with mild or moderate severity, and no major co-morbidities will not necessarily have low levels of sleep or psychological disturbances.

  20. Head Impact Exposure Sustained by Football Players on Days of Diagnosed Concussion

    PubMed Central

    Beckwith, Jonathan G.; Greenwald, Richard M.; Chu, Jeffrey J.; Crisco, Joseph J.; Rowson, Steven; Duma, Stefan M.; Broglio, Steven P.; McAllister, Thomas W.; Guskiewicz, Kevin M.; Mihalik, Jason P.; Anderson, Scott; Schnebel, Brock; Brolinson, P. Gunnar; Collins, Michael W.

    2012-01-01

    Purpose This study compares the frequency and severity of head impacts sustained by football players on days with and without diagnosed concussion and to identify the sensitivity and specificity of single impact severity measures to diagnosed injury. Methods 1,208 players from eight collegiate and six high school football teams wore instrumented helmets to measure head impacts during all team sessions, of which 95 players were diagnosed with concussion. Eight players sustained two injuries and one three, providing 105 injury cases. Measures of head kinematics (peak linear and rotational acceleration, Gadd Severity Index (GSI), Head Injury Criteria (HIC15), change in head velocity (Δv)) and the number of head impacts sustained by individual players were compared between days with and without diagnosed concussion. Receiver operator characteristic curves were generated to evaluate the sensitivity and specificity of each kinematic measure to diagnosed concussion using only those impacts that directly preceded diagnosis. Results Players sustained a higher frequency of impacts and impacts with more severe kinematic properties on days of diagnosed concussion than on days without diagnosed concussion. Forty-five injury cases were immediately diagnosed following head impact. For these cases, peak linear acceleration and HIC15 were most sensitive to immediately diagnosed concussion (AUC = 0.983). Peak rotational acceleration was less sensitive to diagnosed injury than all other kinematic measures (p = 0.01) which are derived from linear acceleration (peak linear, HIC15, GSI, and Δv). Conclusions Players sustain more impacts and impacts of higher severity on days of diagnosed concussion than on days without diagnosed concussion. Additionally, of historical measures of impact severity, those associated with peak linear acceleration are the best predictors of immediately diagnosed concussion. PMID:23135363