The Portable Patient Problem Pack: A Problem-Based Learning Unit

ERIC Educational Resources Information Center

Barrows, Howard S.; Tamblyn, Robyn M.

1977-01-01

The Portable Patient Problem Pack (P4), a method of simulating a patient's problem in a card deck format, is designed to develop the student's problem-solving or diagnostic skills in a manner consistent with the skills of the practicing clinician. Its effectiveness at McMaster University is reported. (LBH)

Students' Understanding of Acid, Base and Salt Reactions in Qualitative Analysis.

ERIC Educational Resources Information Center

Tan, Kim-Chwee Daniel; Goh, Ngoh-Khang; Chia, Lian-Sai; Treagust, David F.

2003-01-01

Uses a two-tier, multiple-choice diagnostic instrument to determine (n=915) grade 10 students' understanding of the acid, base, and salt reactions involved in basic qualitative analysis. Reports that many students did not understand the formation of precipitates and the complex salts, acid/salt-base reactions, and thermal decomposition involved in…

Giant Sialolith of the Submandibular Salivary Gland.

PubMed

Biddle, Royce J; Arora, Sandeep

2008-01-01

We report the case of a 48-year-old man who had an unusually large submandibular gland sialolith (2.6 cm in greatest dimension), which led to sialadenitis and subsequent abscess formation. We describe the management of this patient and review the literature with emphasis on the various modalities available for diagnostic imaging.

National Institute on Alcohol Abuse and Alcoholism and the study of fetal alcohol spectrum disorders. The International Consortium.

PubMed

Calhoun, Faye; Attilia, Maria Luisa; Spagnolo, Primavera Alessandra; Rotondo, Claudia; Mancinelli, Rosanna; Ceccanti, Mauro

2006-01-01

Fetal alcohol syndrome (FAS) is a large and rapidly increasing public health problem worldwide. Aside the full-blown FAS, multiple terms are used to describe the continuum of effects that result from prenatal exposure to alcohol, including the whole fetal alcohol spectrum disorders (FASD). The revised Institute of Medicine (IOM) Diagnostic Classification System and the diagnostic criteria for FAS and FASD are reported, as well as the formation of the four-state FAS International Consortium and its aims, as the development of an information base that systematizes data collection that helps to determine at-high-risk populations, and to implement and test a scientific-based prevention/intervention model for at risk women. The Consortium was further enlarged, with the inclusion of some more states (including Italy), leading to the formation of the International Consortium for the Investigation of FASD. The objectives of the Consortium are reported, as well as its previous activities, the South Africa and Italy Projects (active case ascertainment initiatives), and its future activities.

Metadata requirements for results of diagnostic imaging procedures: a BIIF profile to support user applications

NASA Astrophysics Data System (ADS)

Brown, Nicholas J.; Lloyd, David S.; Reynolds, Melvin I.; Plummer, David L.

2002-05-01

A visible digital image is rendered from a set of digital image data. Medical digital image data can be stored as either: (a) pre-rendered format, corresponding to a photographic print, or (b) un-rendered format, corresponding to a photographic negative. The appropriate image data storage format and associated header data (metadata) required by a user of the results of a diagnostic procedure recorded electronically depends on the task(s) to be performed. The DICOM standard provides a rich set of metadata that supports the needs of complex applications. Many end user applications, such as simple report text viewing and display of a selected image, are not so demanding and generic image formats such as JPEG are sometimes used. However, these are lacking some basic identification requirements. In this paper we make specific proposals for minimal extensions to generic image metadata of value in various domains, which enable safe use in the case of two simple healthcare end user scenarios: (a) viewing of text and a selected JPEG image activated by a hyperlink and (b) viewing of one or more JPEG images together with superimposed text and graphics annotation using a file specified by a profile of the ISO/IEC Basic Image Interchange Format (BIIF).

Spatial resolution requirements for soft-copy reporting in digital radiography

NASA Astrophysics Data System (ADS)

Davies, Andrew G.; Cowen, Arnold R.; Fowler, Richard C.; Bury, Robert F.; Parkin, Geoff J. S.; Lintott, David J.; Martinez, Delia; Safudim, Asif

1996-04-01

The issue of the spatial resolution required in order to present diagnostic quality digital images, especially for softcopy reporting, has received much attention over recent years. The aim of this study was to compare the diagnostic performance reporting from hardcopy and optimized softcopy image presentations. One-hundred-fifteen radiographs of the hand acquired on a photostimulable phosphor computed radiography (CR) system were chosen as the image material. The study group was taken from patients who demonstrated subtle erosions of the bone in the digits. The control group consisted of radiologically normal bands. The images were presented in three modes, the CR system's hardcopy output, and softcopy presentations at full and half spatial resolutions. Four consultant radiologists participated as observers. Results were analyzed using the receiver operating characteristic (ROC) technique, and showed a statistically significant improvement in observer performance for both softcopy formats, when compared to the hardcopy presentation. However, no significant difference in observer performance was found between the two softcopy presentations. We therefore conclude that, with appropriate attention to the processing and presentation of digital image data, softcopy reporting can, for most examinations, provide superior diagnostic performance, even for images viewed at modest (1 k2) resolutions.

Mitigation of NADPH Oxidase 2 Activity as a Strategy to Inhibit Peroxynitrite Formation*

PubMed Central

Zielonka, Jacek; Zielonka, Monika; VerPlank, Lynn; Cheng, Gang; Hardy, Micael; Ouari, Olivier; Ayhan, Mehmet Menaf; Podsiadły, Radosław; Sikora, Adam; Lambeth, J. David; Kalyanaraman, Balaraman

2016-01-01

Using high throughput screening-compatible assays for superoxide and hydrogen peroxide, we identified potential inhibitors of the NADPH oxidase (Nox2) isoform from a small library of bioactive compounds. By using multiple probes (hydroethidine, hydropropidine, Amplex Red, and coumarin boronate) with well defined redox chemistry that form highly diagnostic marker products upon reaction with superoxide (O2˙̄), hydrogen peroxide (H2O2), and peroxynitrite (ONOO−), the number of false positives was greatly decreased. Selected hits for Nox2 were further screened for their ability to inhibit ONOO− formation in activated macrophages. A new diagnostic marker product for ONOO− is reported. We conclude that the newly developed high throughput screening/reactive oxygen species assays could also be used to identify potential inhibitors of ONOO− formed from Nox2-derived O2˙̄ and nitric oxide synthase-derived nitric oxide. PMID:26839313

On Formative Assessment in Math: How Diagnostic Questions Can Help

ERIC Educational Resources Information Center

Barton, Craig

2018-01-01

In this article, the author asserts that asking and responding to diagnostic questions is the single most important part of teaching secondary school mathematics. He notes the importance of formative assessment and recommends a formative assessment strategy that requires students to be public about their answers to questions, displaying their…

Understanding diagnostic variability in breast pathology: lessons learned from an expert consensus review panel

PubMed Central

Allison, Kimberly H; Reisch, Lisa M; Carney, Patricia A; Weaver, Donald L; Schnitt, Stuart J; O’Malley, Frances P; Geller, Berta M; Elmore, Joann G

2015-01-01

Aims To gain a better understanding of the reasons for diagnostic variability, with the aim of reducing the phenomenon. Methods and results In preparation for a study on the interpretation of breast specimens (B-PATH), a panel of three experienced breast pathologists reviewed 336 cases to develop consensus reference diagnoses. After independent assessment, cases coded as diagnostically discordant were discussed at consensus meetings. By the use of qualitative data analysis techniques, transcripts of 16 h of consensus meetings for a subset of 201 cases were analysed. Diagnostic variability could be attributed to three overall root causes: (i) pathologist-related; (ii) diagnostic coding/study methodology-related; and (iii) specimen-related. Most pathologist-related root causes were attributable to professional differences in pathologists’ opinions about whether the diagnostic criteria for a specific diagnosis were met, most frequently in cases of atypia. Diagnostic coding/study methodology-related root causes were primarily miscategorizations of descriptive text diagnoses, which led to the development of a standardized electronic diagnostic form (BPATH-Dx). Specimen-related root causes included artefacts, limited diagnostic material, and poor slide quality. After re-review and discussion, a consensus diagnosis could be assigned in all cases. Conclusions Diagnostic variability is related to multiple factors, but consensus conferences, standardized electronic reporting formats and comments on suboptimal specimen quality can be used to reduce diagnostic variability. PMID:24511905

The Effect of Question Format and Task Difficulty on Reasoning Strategies and Diagnostic Performance in Internal Medicine Residents

ERIC Educational Resources Information Center

Heemskerk, Laura; Norman, Geoff; Chou, Sophia; Mintz, Marcy; Mandin, Henry; McLaughlin, Kevin

2008-01-01

Background: Previous studies have suggested an association between reasoning strategies and diagnostic success, but the influence on this relationship of variables such as question format and task difficulty, has not been studied. Our objective was to study the association between question format, task difficulty, reasoning strategies and…

Genetic disorders with heterotopic ossificans

PubMed Central

Sankar, Ruthiramurthy; Gowrishankar, Kalpana; Viswanathan, Saraswati

2015-01-01

Fibrodysplasia ossificans progressiva (FOP) and progressive ossific heteroplasia (POH) are rare genetic disorders characterized by heterotopic bone formation leading to progressive loss of mobility and function. We report three cases of these rare disorders (two cases of FOP and one case of POH), which were clinically diagnosed and underwent genetic analysis. The aim of this report is to highlight the clinical features and the differences between these two conditions. We would also like to emphasize on the morbidity that can arise from unnecessary invasive investigations for diagnostic purposes. PMID:26015640

Development of an energy analyzer as diagnostic of beam-generated plasma in negative ion beam systems

NASA Astrophysics Data System (ADS)

Sartori, E.; Carozzi, G.; Veltri, P.; Spolaore, M.; Cavazzana, R.; Antoni, V.; Serianni, G.

2017-08-01

The measurement of the plasma potential and the energy spectrum of secondary particles in the drift region of a negative ion beam offers an insight into beam-induced plasma formation and beam transport in low pressure gasses. Plasma formation in negative-ion beam systems, and the characteristics of such a plasma are of interest especially for space charge compensation, plasma formation in neutralizers, and the development of improved schemes of beam-induced plasma neutralisers for future fusion devices. All these aspects have direct implications in the ITER Heating Neutral Beam and the operation of the prototypes, SPIDER and MITICA, and also have important role in the conceptual studies for NBI systems of DEMO, while at present experimental data are lacking. In this paper we present the design and development of an ion energy analyzer to measure the beam plasma formation and space charge compensation in negative ion beams. The diagnostic is a retarding field energy analyzer (RFEA), and will measure the transverse energy spectra of plasma molecular ions. The calculations that supported the design are reported, and a method to interpret the measurements in negative ion beam systems is also proposed. Finally, the experimental results of the first test in a magnetron plasma are presented.

Infrared Spectroscopy of Star Formation in Galactic and Extragalactic Regions

NASA Technical Reports Server (NTRS)

Smith, Howard A.; Hasan, Hashima (Technical Monitor)

2002-01-01

This report details work done in a project involving spectroscopic studies, including data analysis and modeling, of star-formation regions using an ensemble of archival space-based data including some from the Infrared Space Observatory's Long Wavelength Spectrometer and Short Wavelength Spectrometer, and other spectroscopic databases. We will include four kinds of regions: (1) disks around more evolved objects; (2) young, low or high mass pre-main sequence stars in star-formation regions; (3) star formation in external, bright IR (infrared) galaxies; and (4) the galactic center. During this period, work proceeded fully on track and on time. Details on workshops and conferences attended and research results are presented. A preprint article entitled 'The Far Infrared Lines of OH as Molecular Cloud Diagnostics' is included as an appendix.

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

PubMed

Alagrund, Katariina; Orpana, Arto K

2014-01-01

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

Physical Conditions of a Lensed Star-Forming Galaxy at Z=1.7

NASA Technical Reports Server (NTRS)

Rigby, Jane; Wuyts, E.; Gladders, M.; Sharon, K.; Becker, G. D.

2010-01-01

We report rest-frame optical Keck/NIRSPEC spectroscopy of the brightest lensed galaxy yet discovered, RCSGA 032727-132609 at z=1.7037. From precise measurements of the nebular lines, we infer a number of physical properties: redshift, extinction, star formation rate, ionization parameter, electron density, electron temperature, oxygen abundance, and N/O, Ne/O, and Ar/O abundance ratios. The limit on [O III] 4363 A tightly constrains the oxygen abundance via the "direct" or Tc method, for the first time in all metallicity galaxy at z approx.2. We compare this result to several standard "bright-line" O abundance diagnostics, thereby testing these empirically calibrated diagnostics in situ. Finally, we explore the positions of lensed and unlensed galaxies in standard diagnostic diagrams, and explore the diversity of ionization conditions and mass-metallicity ratios at z=2.

The Physical Conditions of a Lensed Star-Forming Galaxy at Z=1.7

NASA Technical Reports Server (NTRS)

Rigby, Jane; Wuyts, E.; Gladders, M.; Sharon, K.; Becker, G.

2011-01-01

We report rest-frame optical Keck/NIRSPEC spectroscopy of the brightest lensed galaxy yet discovered, RCSGA 032727-132609 at z=1.7037. From precise measurements of the nebular lines, we infer a number of physical properties: redshift ' extinction, star formation rate ' ionization parameter, electron density, electron temperature, oxygen abundance, and N/O, Ne/O, and Ar/O abundance ratios, The limit on [O III] 4363 A tightly constrains the oxygen abundance via the "direct" or Te method, for the first time in an average-metallicity galaxy at z approx.2. We compare this result to several standard "bright-line" O abundance diagnostics, thereby testing these empirically-calibrated diagnostics in situ. Finally, we explore the positions of lensed and unlensed galaxies in standard diagnostic diagrams, to explore the diversity of ionization conditions and mass-metallicity ratios at z=2.

Exploring Secondary Students' Conceptions about Fire Using a Two-Tier, True/False, Easy-to-Use Diagnostic Test

ERIC Educational Resources Information Center

Potvin, Patrice; Skelling-Desmeules, Yannick; Sy, Ousmane

2015-01-01

This article describes the design of a misconception diagnostic test about fire-related phenomena. It proposes a new test format in which a certainty-measuring tier has been integrated into each of the true/false response choices. This format is argued to be easier for teachers to use than the increasingly popular three-tier format. First, we…

Factors Determining the Inter-observer Variability and Diagnostic Accuracy of High-resolution Manometry for Esophageal Motility Disorders.

PubMed

Kim, Ji Hyun; Kim, Sung Eun; Cho, Yu Kyung; Lim, Chul-Hyun; Park, Moo In; Hwang, Jin Won; Jang, Jae-Sik; Oh, Minkyung

2018-01-30

Although high-resolution manometry (HRM) has the advantage of visual intuitiveness, its diagnostic validity remains under debate. The aim of this study was to evaluate the diagnostic accuracy of HRM for esophageal motility disorders. Six staff members and 8 trainees were recruited for the study. In total, 40 patients enrolled in manometry studies at 3 institutes were selected. Captured images of 10 representative swallows and a single swallow in analyzing mode in both high-resolution pressure topography (HRPT) and conventional line tracing formats were provided with calculated metrics. Assessments of esophageal motility disorders showed fair agreement for HRPT and moderate agreement for conventional line tracing (κ = 0.40 and 0.58, respectively). With the HRPT format, the k value was higher in category A (esophagogastric junction [EGJ] relaxation abnormality) than in categories B (major body peristalsis abnormalities with intact EGJ relaxation) and C (minor body peristalsis abnormalities or normal body peristalsis with intact EGJ relaxation). The overall exact diagnostic accuracy for the HRPT format was 58.8% and rater's position was an independent factor for exact diagnostic accuracy. The diagnostic accuracy for major disorders was 63.4% with the HRPT format. The frequency of major discrepancies was higher for category B disorders than for category A disorders (38.4% vs 15.4%; P < 0.001). The interpreter's experience significantly affected the exact diagnostic accuracy of HRM for esophageal motility disorders. The diagnostic accuracy for major disorders was higher for achalasia than distal esophageal spasm and jackhammer esophagus.

Blood drop patterns: Formation and applications.

PubMed

Chen, Ruoyang; Zhang, Liyuan; Zang, Duyang; Shen, Wei

2016-05-01

The drying of a drop of blood or plasma on a solid substrate leads to the formation of interesting and complex patterns. Inter- and intra-cellular and macromolecular interactions in the drying plasma or blood drop are responsible for the final morphologies of the dried patterns. Changes in these cellular and macromolecular components in blood caused by diseases have been suspected to cause changes in the dried drop patterns of plasma and whole blood, which could be used as simple diagnostic tools to identify the health of humans and livestock. However, complex physicochemical driving forces involved in the pattern formation are not fully understood. This review focuses on the scientific development in microscopic observations and pattern interpretation of dried plasma and whole blood samples, as well as the diagnostic applications of pattern analysis. Dried drop patterns of plasma consist of intricate visible cracks in the outer region and fine structures in the central region, which are mainly influenced by the presence and concentration of inorganic salts and proteins during drying. The shrinkage of macromolecular gel and its adhesion to the substrate surface have been thought to be responsible for the formation of the cracks. Dried drop patterns of whole blood have three characteristic zones; their formation as functions of drying time has been reported in the literature. Some research works have applied engineering treatment to the evaporation process of whole blood samples. The sensitivities of the resultant patterns to the relative humidity of the environment, the wettability of the substrates, and the size of the drop have been reported. These research works shed light on the mechanisms of spreading, evaporation, gelation, and crack formation of the blood drops on solid substrates, as well as on the potential applications of dried drop patterns of plasma and whole blood in diagnosis. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

A sorrow shared is a sorrow halved? A three-arm randomized controlled trial comparing internet-based clinician-guided individual versus group treatment for social anxiety disorder.

PubMed

Schulz, Ava; Stolz, Timo; Vincent, Alessia; Krieger, Tobias; Andersson, Gerhard; Berger, Thomas

2016-09-01

A growing body of evidence suggests that internet-based cognitive behavioural treatments (ICBT) are effective to treat social anxiety disorder (SAD). Whereas the efficacy of clinician-guided ICBT has been established, ICBT in a group format has not yet been systematically investigated. This three-arm RCT compared the efficacy of clinician-guided group ICBT (GT) with clinician guided individual ICBT (IT) and a wait-list (WL). A total of 149 individuals meeting the diagnostic criteria for SAD were randomly assigned to one of three conditions. Primary endpoints were self-report measures of SAD and diagnostic status taken at baseline, after the twelve-week intervention and at six-month follow-up. Secondary endpoints were symptoms of depression, interpersonal problems and general symptomatology. At post-treatment, both active conditions showed superior outcome regarding SAD symptoms (GT vs. WL: d = 0.84-0.74; IT vs. WL: d = 0.94-1.22). The two active conditions did not differ significantly in symptom reduction (d = 0.12-0.26, all ps > 0.63), diagnostic response rate or attrition. Treatment gains were maintained at follow-up. The group format reduced weekly therapist time per participant by 71% (IT: 17 min, GT: 5 min). Findings indicate that a clinician-guided group format is a promising approach in treating SAD. Copyright © 2016 Elsevier Ltd. All rights reserved.

Synovial sarcoma of the jaw in a dog.

PubMed

Griffith, J W; Frey, R A; Sharkey, F E

1987-05-01

A case of synovial sarcoma of the jaw with pulmonary metastasis is described in a dog. It appears to be a rare or underdiagnosed neoplasm in animals and not previously reported in the jaw. Its diagnostic microscopic features are the biphasic cellular pattern and cleft formations. It may otherwise resemble haemangiopericytoma, malignant fibrous histiocytoma, reticulum cell sarcoma, fibrosarcoma, or giant-cell tumour of soft tissue.

Deep vein thrombosis and pulmonary embolus associated with a ruptured popliteal aneurysm - a cautionary note.

PubMed

Sanjay, Pandanaboyana; Lewis, Mike H

2007-12-20

Popliteal artery aneurysms representing 80% of peripheral artery aneurysms rarely rupture (a reported incidence of 0.1-2.8 %) and second commonest in frequency after aorto-iliac aneurysms. They usually present with pain, swelling, occlusion or distal embolisation and can cause diagnostic difficulties. We report a 78 year old man who was previously admitted to hospital with a pulmonary embolus secondary to deep venous thrombosis. He was heparinized then warfarinised and was readmitted with a ruptured popliteal aneurysm leading to a large pseudo aneurysm formation. The pulmonary embolus had been due to popliteal vein thrombosis and propagation of the clot. A thorough review of literature identified only one previously reported case of ruptured popliteal artery aneurysm and subsequent large pseudo aneurysm formation. We feel it is important to exclude a popliteal aneurysm in a patient with DVT. This may be more common than the published literature suggests.

Evaluating the Diagnostic Validity of a Facet-Based Formative Assessment System

ERIC Educational Resources Information Center

DeBarger, Angela Haydel; DiBello, Louis; Minstrell, Jim; Feng, Mingyu; Stout, William; Pellegrino, James; Haertel, Geneva; Harris, Christopher; Ructinger, Liliana

2011-01-01

This paper describes methods for an alignment study and psychometric analyses of a formative assessment system, Diagnoser Tools for physics. Diagnoser Tools begin with facet clusters as the interpretive framework for designing questions and instructional activities. Thus each question in the diagnostic assessments includes distractors that…

Acute Epidural Hematoma Formation in Cervical Spine After Interlaminar Epidural Steroid Injection Despite Discontinuation of Clopidogrel.

PubMed

Benyamin, Ramsin M; Vallejo, Ricardo; Wang, Victor; Kumar, Nitesh; Cedeño, David L; Tamrazi, Anobel

2016-01-01

Perioperative management of patients on anticoagulant therapy prior to interventional pain procedures creates a challenge when balancing the risk of bleeding against thromboembolic events. We report a case of epidural hematoma formation in the cervical spine following interlaminar epidural steroid injection in an elderly woman with chronic neck and arm pain, who was on clopidogrel therapy. This is the first reported case of hematoma formation immediately following an epidural steroid injection possibly associated with clopidogrel, even though established guidelines on the timing of the discontinuation of clopidogrel prior to the procedure were exceeded. Severe pain appears to be the first symptom of hematoma formation, and therefore immediate diagnostic workup and evacuation of hematoma are essential in preventing neurological damage. It may be advisable to carry out a test specific for clopidogrel such as the P2Y12 to ensure that there is no residual action on platelet aggregation function, particularly in patients who may be slow metabolizers of clopidogrel. Caution is advised prior to administering analgesics with antiplatelet effects such as ketorolac.

Mechanical valve obstruction: Review of diagnostic and treatment strategies

PubMed Central

Salamon, Jason; Munoz-Mendoza, Jerson; Liebelt, Jared J; Taub, Cynthia C

2015-01-01

Prosthetic valve obstruction (PVO) is a rare but feared complication of mechanical valve replacement. Diagnostic evaluation should focus on differentiating prosthetic valve thrombosis (PVT) from pannus formation, as their treatment options differ. History of sub-optimal anti-coagulation and post-op time course to development of PVO are useful clinical characteristics in differentiating thrombus from pannus formation. Treatment of PVT is influenced by the patient’s symptoms, valve location, degree of obstruction and thrombus size and may include thrombolysis or surgical intervention. Alternatively, pannus formation requires surgical intervention. The purpose of this article is to review the pathophysiology, epidemiology, diagnostic approach and treatment options for aortic and mitral valve PVO. PMID:26730292

Developing energy and momentum conceptual survey (EMCS) with four-tier diagnostic test items

NASA Astrophysics Data System (ADS)

Afif, Nur Faadhilah; Nugraha, Muhammad Gina; Samsudin, Achmad

2017-05-01

Students' conceptions of work and energy are important to support the learning process in the classroom. For that reason, a diagnostic test instrument is needed to diagnose students' conception of work and energy. As a result, the researcher decided to develop Energy and Momentum Conceptual Survey (EMCS) instrument test into four-tier test diagnostic items. The purpose of this research is organized as the first step of four-tier test-formatted EMCS development as one of diagnostic test instruments on work and Energy. The research method used the 4D model (Defining, Designing, Developing and Disseminating). The instrument developed has been tested to 39 students in one of Senior High Schools. The resulting research showed that four-tier test-formatted EMCS is able to diagnose students' conception level of work and energy concept. It can be concluded that the development of four-tier test-formatted EMCS is one of potential diagnostic test instruments that able to obtain the category of students who understand concepts, misconceptions and do not understand about Work and Energy concept at all.

Ground Operations Aerospace Language (GOAL). Volume 2: Compiler

NASA Technical Reports Server (NTRS)

1973-01-01

The principal elements and functions of the Ground Operations Aerospace Language (GOAL) compiler are presented. The technique used to transcribe the syntax diagrams into machine processable format for use by the parsing routines is described. An explanation of the parsing technique used to process GOAL source statements is included. The compiler diagnostics and the output reports generated during a GOAL compilation are explained. A description of the GOAL program package is provided.

Longitudinal Assessment of Disease Sites by Attachment Level Changes and Bone Density Loss by Digital Image Analysis

DTIC Science & Technology

1989-04-01

subtraction readout (Klein 1967). This technique was used to investigate the early formation of periapical lesions prior to diagnosis by clinical...have investigated the diagnostic sensitivity of radiographs by determining the size, shape and position of bony lesions that can be visualized in...radiographs. Several studies using created defects in dried skulls have reported that interproximal lesions were not visible as long as the cortical plates

TEMPLATES: Targeting Extremely Magnified Panchromatic Lensed Arcs and Their Extended Star Formation

NASA Astrophysics Data System (ADS)

Rigby, Jane; Vieira, Joaquin; Bayliss, M.; Fischer, T.; Florian, M.; Gladders, M.; Gonzalez, A.; Law, D.; Marrone, D.; Phadke, K.; Sharon, K.; Spilker, J.

2017-11-01

We propose high signal-to-noise NIRSpec and MIRI IFU spectroscopy, with accompanying imaging, for 4 gravitationally lensed galaxies at 1

Formative Assessment in Teacher Education: The Development of a Diagnostic Language Test for Trainee Teachers of German

ERIC Educational Resources Information Center

Richards, Brian J.

2008-01-01

This article describes the development and validation of a diagnostic test of German and its integration in a programme of formative assessment during a one-year initial teacher-training course. The test focuses on linguistic aspects that cause difficulty for trainee teachers of German as a foreign language and assesses implicit and explicit…

Promoting the hydrostatic conceptual change test (HCCT) with four-tier diagnostic test item

NASA Astrophysics Data System (ADS)

Purwanto, M. G.; Nurliani, R.; Kaniawati, I.; Samsudin, A.

2018-05-01

Hydrostatic Conceptual Change Test (HCCT) is a diagnostic test instrument to identify students’ conception on Hydrostatic field. It is very important to support the learning process in the classroom. Based on that point of view, the researcher decided to develop HCCT instrument test into four-tier test diagnostic items. The resolve of this research is planned as the first step of four-tier test-formatted HCCT development as one of investigative test instrument on Hydrostatic. The research method used the 4D model which has four comprehensive steps: 1) defining, 2) designing, 3) developing and 4) disseminating. The instrument developed has been tried to 30 students in one of senior high schools. The data showed that four-tier- test-formatted HCCT is able to identify student’s conception level of Hydrostatic. In conclusion, the development of four-tier test-formatted HCCT is one of potential diagnostic test instrument that able to classify the category of students who misconception, no understanding, understanding, partial understanding and no codeable about concept of Hydrostatic.

[Forensic-medical diagnostics of an electrical mark resulting from the injury inflicted by technical electricity in the aqueous environment].

PubMed

Pigolkin, Iu I; Skovorodnikov, S V; Dubrovin, I A

2014-01-01

The objective of the present study was to develop the criteria for forensic-medical diagnostics of an electrical injury inflicted in the aqueous environment based on the characteristics of the electrical mark. The specific morphological features of the electrical injuries inflicted in the aqueous environment that were discovered in the materials available for the forensic medical expertise were analysed taking into consideration the results of the relevant research reported in the forensic medical literature. It was shown that an electrical injury inflicted in the aqueous environment results in the formation of an unusual mark in the form of blisters containing no watery liquid associated with electrogenic oedema in the surrounding tissues. Macroscopic and microscopic studies of the electrical mark failed to reveal the signs of grade III and IV grade thermal burning or thermally affected hair. It is concluded that the consistent characteristics of the electrical mark resulting from the injury inflicted by technical electricity in the aqueous environment include cell lengthening, blister formation inside the corneal layer, and the separation of epidermis from the skin proper.

A Practical Illustration of Multidimensional Diagnostic Skills Profiling: Comparing Results from Confirmatory Factor Analysis and Diagnostic Classification Models

ERIC Educational Resources Information Center

Kunina-Habenicht, Olga; Rupp, Andre A.; Wilhelm, Oliver

2009-01-01

In recent years there has been an increasing international interest in fine-grained diagnostic inferences on multiple skills for formative purposes. A successful provision of such inferences that support meaningful instructional decision-making requires (a) careful diagnostic assessment design coupled with (b) empirical support for the structure…

Visualizing biofilm formation in endotracheal tubes using endoscopic three-dimensional optical coherence tomography

NASA Astrophysics Data System (ADS)

Heidari, Andrew E.; Moghaddam, Samer; Troung, Kimberly K.; Chou, Lidek; Genberg, Carl; Brenner, Matthew; Chen, Zhongping

2015-12-01

Biofilm formation has been linked to ventilator-associated pneumonia, which is a prevalent infection in hospital intensive care units. Currently, there is no rapid diagnostic tool to assess the degree of biofilm formation or cellular biofilm composition. Optical coherence tomography (OCT) is a minimally invasive, nonionizing imaging modality that can be used to provide high-resolution cross-sectional images. Biofilm deposited in critical care patients' endotracheal tubes was analyzed in vitro. This study demonstrates that OCT could potentially be used as a diagnostic tool to analyze and assess the degree of biofilm formation and extent of airway obstruction caused by biofilm in endotracheal tubes.

Radiologists' Training, Experience, and Attitudes About Elder Abuse Detection.

PubMed

Rosen, Tony; Bloemen, Elizabeth M; Harpe, Jasmin; Sanchez, Allen M; Mennitt, Kevin W; McCarthy, Thomas J; Nicola, Refky; Murphy, Kieran; LoFaso, Veronica M; Flomenbaum, Neal; Lachs, Mark S

2016-12-01

Elder abuse is underrecognized, and identification of subtle cases requires a high index of suspicion among all health care providers. Because many geriatric injury victims undergo radiographic imaging, diagnostic radiologists may be well positioned to identify injury patterns suggestive of abuse. Little is known about radiologists' experience with elder abuse. Our goal was to describe knowledge, attitudes, training, and practice experience in elder abuse detection among diagnostic radiologists. We conducted 19 interviews with diagnostic radiologists at a large urban academic medical center using a semistructured format. Data from these sessions were coded and analyzed to identify themes. Only two radiologists reported any formal or informal training in elder abuse detection. All subjects believed they had missed cases of elder abuse. Even experienced radiologists reported never having received a request from a referring physician to assess images for evidence suggestive of elder abuse. All subjects reported a desire for additional elder abuse training. Also, subjects identified radiographic findings or patterns potentially suggestive of elder abuse, including high-energy injuries such as upper rib fractures, injuries in multiple stages of healing, and injuries inconsistent with reported mechanism. Radiologists are uniquely positioned to identify elder abuse. Though training in detection is currently lacking, providers expressed a desire for increased knowledge. In addition, radiologists were able to identify radiographic findings suggestive of elder abuse. On the basis of these findings, we plan to conduct additional studies to define pathognomonic injury patterns and to explore how to empower radiologists to incorporate detection into their practice.

The IDEA Assessment Tool: Assessing the Reporting, Diagnostic Reasoning, and Decision-Making Skills Demonstrated in Medical Students' Hospital Admission Notes.

PubMed

Baker, Elizabeth A; Ledford, Cynthia H; Fogg, Louis; Way, David P; Park, Yoon Soo

2015-01-01

Construct: Clinical skills are used in the care of patients, including reporting, diagnostic reasoning, and decision-making skills. Written comprehensive new patient admission notes (H&Ps) are a ubiquitous part of student education but are underutilized in the assessment of clinical skills. The interpretive summary, differential diagnosis, explanation of reasoning, and alternatives (IDEA) assessment tool was developed to assess students' clinical skills using written comprehensive new patient admission notes. The validity evidence for assessment of clinical skills using clinical documentation following authentic patient encounters has not been well documented. Diagnostic justification tools and postencounter notes are described in the literature (1,2) but are based on standardized patient encounters. To our knowledge, the IDEA assessment tool is the first published tool that uses medical students' H&Ps to rate students' clinical skills. The IDEA assessment tool is a 15-item instrument that asks evaluators to rate students' reporting, diagnostic reasoning, and decision-making skills based on medical students' new patient admission notes. This study presents validity evidence in support of the IDEA assessment tool using Messick's unified framework, including content (theoretical framework), response process (interrater reliability), internal structure (factor analysis and internal-consistency reliability), and relationship to other variables. Validity evidence is based on results from four studies conducted between 2010 and 2013. First, the factor analysis (2010, n = 216) yielded a three-factor solution, measuring patient story, IDEA, and completeness, with reliabilities of .79, .88, and .79, respectively. Second, an initial interrater reliability study (2010) involving two raters demonstrated fair to moderate consensus (κ = .21-.56, ρ =.42-.79). Third, a second interrater reliability study (2011) with 22 trained raters also demonstrated fair to moderate agreement (intraclass correlations [ICCs] = .29-.67). There was moderate reliability for all three skill domains, including reporting skills (ICC = .53), diagnostic reasoning skills (ICC = .64), and decision-making skills (ICC = .63). Fourth, there was a significant correlation between IDEA rating scores (2010-2013) and final Internal Medicine clerkship grades (r = .24), 95% confidence interval (CI) [.15, .33]. The IDEA assessment tool is a novel tool with validity evidence to support its use in the assessment of students' reporting, diagnostic reasoning, and decision-making skills. The moderate reliability achieved supports formative or lower stakes summative uses rather than high-stakes summative judgments.

Quinone Methide Signal Amplification: Covalent Reporter Labeling of Cancer Epitopes using Alkaline Phosphatase Substrates.

PubMed

Polaske, Nathan W; Kelly, Brian D; Ashworth-Sharpe, Julia; Bieniarz, Christopher

2016-03-16

Diagnostic assays with the sensitivity required to improve cancer therapeutics depend on the development of new signal amplification technologies. Herein, we report the development and application of a novel amplification system which utilizes latent quinone methides (QMs) activated by alkaline phosphatase (AP) for signal amplification in solid-phase immunohistochemical (IHC) assays. Phosphate-protected QM precursor substrates were prepared and conjugated to either biotin or a fluorophore through an amine-functionalized linker group. Upon reaction with AP, the phosphate group is cleaved, followed by elimination of the leaving group and formation of the highly reactive and short-lived QM. The QMs either react with tissue nucleophiles in close proximity to their site of generation, or are quenched by nucleophiles in the reaction media. The reporter molecules that covalently bind to the tissue were then detected visually by fluorescence microscopy in the case of fluorophore reporters, or brightfield microscopy using diaminobenzidine (DAB) in the case of biotin reporters. With multiple reporters deposited per enzyme, significant signal amplification was observed utilizing QM precursor substrates containing either benzyl difluoro or benzyl monofluoro leaving group functionalities. However, the benzyl monofluoro leaving group gave superior results with respect to both signal intensity and discretion, the latter of which was found to be imperative for use in diagnostic IHC assays.

Immunodiagnostic Properties of Wucheraria bancrofti SXP-1, a Potential Filarial Diagnostic Candidate Expressed in Tobacco Plant, Nicotiana tabacum.

PubMed

Ganapathy, Mathangi; Chakravarthi, M; Charles, S Jason; Harunipriya, P; Jaiganesh, S; Subramonian, N; Kaliraj, P

2015-08-01

Transgenic tobacco plants were developed expressing WbSXP-1, a diagnostic antigen isolated from the cDNA library of L3 stage larvae of Wucheraria bancrofti. This antigen produced by recombinant Escherichia coli has been demonstrated by to be successful as potential diagnostic candidate against lymphatic filariasis. A rapid format simple and qualitative flow through immune-filtration diagnostic kit has been developed for the identification of IgG antibodies to the recombinant WbSXP-1 and is being marketed by M/S Span Diagnostics Ltd in India and Africa. Here, we present the results of experiments on the transformation and expression of the same filarial antigen, WbSXP-1, in tobacco plant, Nicotiana tabacum, to produce plant-based diagnostic antigen. It was possible to successfully transform the tobacco plant with WbSXP-1, the integration of the parasite-specific gene in plants was confirmed by PCR amplification and the expression of the filarial protein by Western blotting. The immunoreactivity of the plant-produced WbSXP-1 was assessed based on its reaction with the monoclonal antibodies developed against the E. coli-produced protein. Immunological screening using clinical sera from patients indicates that the plant-produced protein is comparable to E. coli-produced diagnostic antigen. The result demonstrated that plants can be used as suitable expression systems for the production of diagnostic proteins against lymphatic filariasis, a neglected tropical infectious disease which has a negative impact on socioeconomic development. This is the first report of the integration, expression and efficacy of a diagnostic candidate of lymphatic filariasis in plants.Key MessageTransgenic tobacco plants with WbSXP-1, a filarial diagnostic candidate, were developed. The plant-produced protein showed immunoreactivity on par with the E. coli product.

The detection of distant cooling flows and the formation of dark matter

NASA Technical Reports Server (NTRS)

Fabian, A. C.; Arnaud, K. A.; Nulsen, P. E. J.; Mushotzky, R. F.

1986-01-01

Cooling flows involving substantial mass inflow rates appear to be common in many nearby rich and poor clusters and in isolated galaxies. The extensive optical and ultraviolet filaments produced by the thermal instability of large flows are detectable out to redshifts greater than 1. It is proposed that this may explain the extended optical line emission reported in, and around, many distant radio galaxies, narrow-line quasars, and even nearby normal and active galaxies. An important diagnostic to distinguish cooling flows from other possible origins of emission line filaments is the presence of extensive regions at high thermal pressure. Other evidence for distant cooling flows and the resultant star formation is further discussed, together with the implications of cooling flow initial-mass functions for galaxy formation and the nature of 'dark' matter.

The Paris System for Reporting Urinary Cytology: The Quest to Develop a Standardized Terminology.

PubMed

Barkan, Güliz A; Wojcik, Eva M; Nayar, Ritu; Savic-Prince, Spasenija; Quek, Marcus L; Kurtycz, Daniel F I; Rosenthal, Dorothy L

2016-07-01

The main purpose of urine cytology is to detect high-grade urothelial carcinoma. With this principle in mind, The Paris System (TPS) Working Group, composed of cytopathologists, surgical pathologists, and urologists, has proposed and published a standardized reporting system that includes specific diagnostic categories and cytomorphologic criteria for the reliable diagnosis of high-grade urothelial carcinoma. This paper outlines the essential elements of TPS and the process that led to the formation and rationale of the reporting system. TPS Working Group, organized at the 2013 International Congress of Cytology, conceived a standardized platform on which to base cytologic interpretation of urine samples. The widespread dissemination of this approach to cytologic examination and reporting of urologic samples and the scheme's universal acceptance by pathologists and urologists is critical for its success. For urologists, understanding the diagnostic criteria, their clinical implications, and limitations of TPS is essential if they are to utilize urine cytology and noninvasive ancillary tests in a thoughtful and practical manner. This is the first international/inclusive attempt at standardizing urinary cytology. The success of TPS will depend on the pathology and urology communities working collectively to improve this seminal paradigm shift, and optimize the impact on patient care.

Gold nanoshelled liquid perfluorocarbon nanocapsules for combined dual modal ultrasound/CT imaging and photothermal therapy of cancer.

PubMed

Ke, Hengte; Yue, Xiuli; Wang, Jinrui; Xing, Sen; Zhang, Qian; Dai, Zhifei; Tian, Jie; Wang, Shumin; Jin, Yushen

2014-03-26

The integration of multimodal contrast-enhanced diagnostic imaging and therapeutic capabilities could utilize imaging guided therapy to plan the treatment strategy based on the diagnostic results and to guide/monitor the therapeutic procedures. Herein, gold nanoshelled perfluorooctylbromide (PFOB) nanocapsules with PEGylation (PGsP NCs) are constructed by oil-in-water emulsion method to form polymeric PFOB nanocapsules, followed by the formation of PEGylated gold nanoshell on the surface. PGsP NCs could not only provide excellent contrast enhancement for dual modal ultrasound and CT imaging in vitro and in vivo, but also serve as efficient photoabsorbers for photothermal ablation of tumors on xenografted nude mouse model. To our best knowledge, this is the first report of gold nanoshell serving as both CT contrast agents and photoabsorbers for photothermal therapy. The novel multifunctional nanomedicine would be of great value to offer more comprehensive diagnostic information to guide more accurate and effective cancer therapy. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

A new nanostructured Silicon biosensor for diagnostics of bovine leucosis

NASA Astrophysics Data System (ADS)

Luchenko, A. I.; Melnichenko, M. M.; Starodub, N. F.; Shmyryeva, O. M.

2010-08-01

In this report we propose a new instrumental method for the biochemical diagnostics of the bovine leucosis through the registration of the formation of the specific immune complex (antigen-antibody) with the help of biosensor based on the nano-structured silicon. The principle of the measurements is based on the determination of the photosensitivity of the surface. In spite of the existed traditional methods of the biochemical diagnostics of the bovine leucosis the proposed approach may provide the express control of the milk quality as direct on the farm and during the process raw materials. The proposed variant of the biosensor based on the nano-structured silicon may be applied for the determination of the concentration of different substances which may form the specific complex in the result of the bioaffine reactions. A new immune technique based on the nanostructured silicon and intended for the quantitative determination of some toxic substances is offered. The sensitivity of such biosensor allows determining T-2 mycotoxin at the concentration of 10 ng/ml during several minutes.

Fab MOR03268 triggers absorption shift of a diagnostic dye via packaging in a solvent-shielded Fab dimer interface.

PubMed

Hillig, Roman C; Urlinger, Stefanie; Fanghänel, Jörg; Brocks, Bodo; Haenel, Cornelia; Stark, Yvonne; Sülzle, Detlev; Svergun, Dmitri I; Baesler, Siegfried; Malawski, Guido; Moosmayer, Dieter; Menrad, Andreas; Schirner, Michael; Licha, Kai

2008-03-14

Molecular interactions between near-IR fluorescent probes and specific antibodies may be exploited to generate novel smart probes for diagnostic imaging. Using a new phage display technology, we developed such antibody Fab fragments with subnanomolar binding affinity for tetrasulfocyanine, a near-IR in vivo imaging agent. Unexpectedly, some Fabs induced redshifts of the dye absorption peak of up to 44 nm. This is the largest shift reported for a biological system so far. Crystal structure determination and absorption spectroscopy in the crystal in combination with microcalorimetry and small-angle X-ray scattering in solution revealed that the redshift is triggered by formation of a Fab dimer, with tetrasulfocyanine being buried in a fully closed protein cavity within the dimer interface. The derived principle of shifting the absorption peak of a symmetric dye via packaging within a Fab dimer interface may be transferred to other diagnostic fluorophores, opening the way towards smart imaging probes that change their wavelength upon interaction with an antibody.

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

PubMed

Tembuyser, Lien; Dequeker, Elisabeth M C

2016-01-01

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

Re-evaluation of the Haarlem Archaeopteryx and the radiation of maniraptoran theropod dinosaurs.

PubMed

Foth, Christian; Rauhut, Oliver W M

2017-12-02

Archaeopteryx is an iconic fossil that has long been pivotal for our understanding of the origin of birds. Remains of this important taxon have only been found in the Late Jurassic lithographic limestones of Bavaria, Germany. Twelve skeletal specimens are reported so far. Archaeopteryx was long the only pre-Cretaceous paravian theropod known, but recent discoveries from the Tiaojishan Formation, China, yielded a remarkable diversity of this clade, including the possibly oldest and most basal known clade of avialan, here named Anchiornithidae. However, Archaeopteryx remains the only Jurassic paravian theropod based on diagnostic material reported outside China. Re-examination of the incomplete Haarlem Archaeopteryx specimen did not find any diagnostic features of this genus. In contrast, the specimen markedly differs in proportions from other Archaeopteryx specimens and shares two distinct characters with anchiornithids. Phylogenetic analysis confirms it as the first anchiornithid recorded outside the Tiaojushan Formation of China, for which the new generic name Ostromia is proposed here. In combination with a biogeographic analysis of coelurosaurian theropods and palaeogeographic and stratigraphic data, our results indicate an explosive radiation of maniraptoran coelurosaurs probably in isolation in eastern Asia in the late Middle Jurassic and a rapid, at least Laurasian dispersal of the different subclades in the Late Jurassic. Small body size and, possibly, a multiple origin of flight capabilities enhanced dispersal capabilities of paravian theropods and might thus have been crucial for their evolutionary success.

Kindler syndrome: a case report and proposal for clinical diagnostic criteria.

PubMed

Fischer, Irena Angelova; Kazandjieva, Jana; Vassileva, Snejina; Dourmishev, Assen

2005-06-01

Kindler syndrome is a rare hereditary disorder characterized by acral blister formation in infancy and childhood, progressive poikiloderma, cutaneous atrophy and increased photosensitivity. Since it was first described in 1954, less than 100 cases have been reported worldwide. Recently it has been reported that Kindler syndrome is the first genodermatosis caused by a defect in the actin-extracellular matrix linkage, and the gene was mapped to chromosome 20p12.3. The clinical features of the syndrome have been annotated by different authors but the definite of criteria to confirm the diagnosis have not yet been generally accepted. We report a case of Kindler syndrome that presents a full spectrum of clinical manifestations, and we propose a set of clinical criteria for diagnosis.

Not all stars form in clusters - measuring the kinematics of OB associations with Gaia

NASA Astrophysics Data System (ADS)

Ward, Jacob L.; Kruijssen, J. M. Diederik

2018-04-01

It is often stated that star clusters are the fundamental units of star formation and that most (if not all) stars form in dense stellar clusters. In this monolithic formation scenario, low-density OB associations are formed from the expansion of gravitationally bound clusters following gas expulsion due to stellar feedback. N-body simulations of this process show that OB associations formed this way retain signs of expansion and elevated radial anisotropy over tens of Myr. However, recent theoretical and observational studies suggest that star formation is a hierarchical process, following the fractal nature of natal molecular clouds and allowing the formation of large-scale associations in situ. We distinguish between these two scenarios by characterizing the kinematics of OB associations using the Tycho-Gaia Astrometric Solution catalogue. To this end, we quantify four key kinematic diagnostics: the number ratio of stars with positive radial velocities to those with negative radial velocities, the median radial velocity, the median radial velocity normalized by the tangential velocity, and the radial anisotropy parameter. Each quantity presents a useful diagnostic of whether the association was more compact in the past. We compare these diagnostics to models representing random motion and the expanding products of monolithic cluster formation. None of these diagnostics show evidence of expansion, either from a single cluster or multiple clusters, and the observed kinematics are better represented by a random velocity distribution. This result favours the hierarchical star formation model in which a minority of stars forms in bound clusters and large-scale, hierarchically structured associations are formed in situ.

Emerging Human Fetuin A Assays for Biomedical Diagnostics.

PubMed

Vashist, Sandeep Kumar; Schneider, E Marion; Venkatesh, A G; Luong, John H T

2017-05-01

Human fetuin A (HFA) plays a prominent pathophysiological role in numerous diseases and pathophysiological conditions with considerable biomedical significance; one example is the formation of calciprotein particles in osteoporosis and impaired calcium metabolisms. With impressive advances in in vitro diagnostic assays during the last decade, ELISAs have become a workhorse in routine clinical diagnostics. Recent diagnostic formats involve high-sensitivity immunoassay procedures, surface plasmon resonance, rapid immunoassay chemistries, signal enhancement, and smartphone detection. The current trend is toward fully integrated lab-on-chip platforms with smartphone readouts, enabling health-care practitioners and even patients to monitor pathological changes in biomarker levels. This review provides a critical analysis of advances made in HFA assays along with the challenges and future prospects. Copyright © 2016 Elsevier Ltd. All rights reserved.

Low Reporting Quality of the Meta-Analyses in Diagnostic Pathology.

PubMed

Liu, Xulei; Kinzler, Michael; Yuan, Jiangfan; He, Guozhong; Zhang, Lanjing

2017-03-01

- Little is known regarding the reporting quality of meta-analyses in diagnostic pathology. - To compare reporting quality of meta-analyses in diagnostic pathology and medicine and to examine factors associated with reporting quality of diagnostic pathology meta-analyses. - Meta-analyses were identified in 12 major diagnostic pathology journals without specifying years and 4 major medicine journals in 2006 and 2011 using PubMed. Reporting quality of meta-analyses was evaluated using the 27-item checklist of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement published in 2009. A higher PRISMA score indicates higher reporting quality. - Forty-one diagnostic pathology meta-analyses and 118 medicine meta-analyses were included. Overall, reporting quality of meta-analyses in diagnostic pathology was lower than that in medicine (median [interquartile range] = 22 [15, 25] versus 27 [23, 28], P < .001). Compared with medicine meta-analyses, diagnostic pathology meta-analyses less likely reported 23 of the 27 items (85.2%) on the PRISMA checklist, but more likely reported the data items. Higher reporting quality of diagnostic pathology meta-analyses was associated with recent publication years (later than 2009 versus 2009 or earlier, P = .002) and non-North American first authors (versus North American, P = .001), but not journal publisher's location (P = .11). Interestingly, reporting quality was not associated with adjusted citation ratio for meta-analyses in either diagnostic pathology or medicine (P = .40 and P = .09, respectively). - Meta-analyses in diagnostic pathology had lower reporting quality than those in medicine. Reporting quality of diagnostic pathology meta-analyses is linked to publication year and first author's location, but not to journal publisher's location or article's adjusted citation ratios. More research and education on meta-analysis methodology may improve the reporting quality of diagnostic pathology meta-analyses.

Dissolvable fluidic time delays for programming multi-step assays in instrument-free paper diagnostics.

PubMed

Lutz, Barry; Liang, Tinny; Fu, Elain; Ramachandran, Sujatha; Kauffman, Peter; Yager, Paul

2013-07-21

Lateral flow tests (LFTs) are an ingenious format for rapid and easy-to-use diagnostics, but they are fundamentally limited to assay chemistries that can be reduced to a single chemical step. In contrast, most laboratory diagnostic assays rely on multiple timed steps carried out by a human or a machine. Here, we use dissolvable sugar applied to paper to create programmable flow delays and present a paper network topology that uses these time delays to program automated multi-step fluidic protocols. Solutions of sucrose at different concentrations (10-70% of saturation) were added to paper strips and dried to create fluidic time delays spanning minutes to nearly an hour. A simple folding card format employing sugar delays was shown to automate a four-step fluidic process initiated by a single user activation step (folding the card); this device was used to perform a signal-amplified sandwich immunoassay for a diagnostic biomarker for malaria. The cards are capable of automating multi-step assay protocols normally used in laboratories, but in a rapid, low-cost, and easy-to-use format.

Dissolvable fluidic time delays for programming multi-step assays in instrument-free paper diagnostics

PubMed Central

Lutz, Barry; Liang, Tinny; Fu, Elain; Ramachandran, Sujatha; Kauffman, Peter; Yager, Paul

2013-01-01

Lateral flow tests (LFTs) are an ingenious format for rapid and easy-to-use diagnostics, but they are fundamentally limited to assay chemistries that can be reduced to a single chemical step. In contrast, most laboratory diagnostic assays rely on multiple timed steps carried out by a human or a machine. Here, we use dissolvable sugar applied to paper to create programmable flow delays and present a paper network topology that uses these time delays to program automated multi-step fluidic protocols. Solutions of sucrose at different concentrations (10-70% of saturation) were added to paper strips and dried to create fluidic time delays spanning minutes to nearly an hour. A simple folding card format employing sugar delays was shown to automate a four-step fluidic process initiated by a single user activation step (folding the card); this device was used to perform a signal-amplified sandwich immunoassay for a diagnostic biomarker for malaria. The cards are capable of automating multi-step assay protocols normally used in laboratories, but in a rapid, low-cost, and easy-to-use format. PMID:23685876

Virtual humans and formative assessment to train diagnostic skills in bulimia nervosa.

PubMed

Gutiérrez-Maldonado, José; Ferrer-Garcia, Marta; Pla, Joana; Andrés-Pueyo, Antonio

2014-01-01

Carrying out a diagnostic interview requires skills that need to be taught in a controlled environment. Virtual Reality (VR) environments are increasingly used in the training of professionals, as they offer the most realistic alternative while not requiring students to face situations for which they are yet unprepared. The results of the training of diagnostic skills can also be generalized to any other situation in which effective communication skills play a major role. Our aim with this study has been to develop a procedure of formative assessment in order to increment the effectiveness of virtual learning simulation systems and then to assess their efficacy.

Does standardised structured reporting contribute to quality in diagnostic pathology? The importance of evidence-based datasets.

PubMed

Ellis, D W; Srigley, J

2016-01-01

Key quality parameters in diagnostic pathology include timeliness, accuracy, completeness, conformance with current agreed standards, consistency and clarity in communication. In this review, we argue that with worldwide developments in eHealth and big data, generally, there are two further, often overlooked, parameters if our reports are to be fit for purpose. Firstly, population-level studies have clearly demonstrated the value of providing timely structured reporting data in standardised electronic format as part of system-wide quality improvement programmes. Moreover, when combined with multiple health data sources through eHealth and data linkage, structured pathology reports become central to population-level quality monitoring, benchmarking, interventions and benefit analyses in public health management. Secondly, population-level studies, particularly for benchmarking, require a single agreed international and evidence-based standard to ensure interoperability and comparability. This has been taken for granted in tumour classification and staging for many years, yet international standardisation of cancer datasets is only now underway through the International Collaboration on Cancer Reporting (ICCR). In this review, we present evidence supporting the role of structured pathology reporting in quality improvement for both clinical care and population-level health management. Although this review of available evidence largely relates to structured reporting of cancer, it is clear that the same principles can be applied throughout anatomical pathology generally, as they are elsewhere in the health system.

Loop-Mediated Isothermal Amplification Test for Trypanosoma gambiense Group 1 with Stem Primers: A Molecular Xenomonitoring Test for Sleeping Sickness.

PubMed

Njiru, Zablon K; Mbae, Cecilia K; Mburugu, Gitonga N

2017-01-01

The World Health Organization has targeted Human African Trypanosomiasis (HAT) for elimination by 2020 with zero incidence by 2030. To achieve and sustain this goal, accurate and easy-to-deploy diagnostic tests for Gambian trypanosomiasis which accounts for over 98% of reported cases will play a crucial role. Most needed will be tools for surveillance of pathogen in vectors (xenomonitoring) since population screening tests are readily available. The development of new tests is expensive and takes a long time while incremental improvement of existing technologies that have potential for xenomonitoring may offer a shorter pathway to tools for HAT surveillance. We have investigated the effect of including a second set of reaction accelerating primers (stem primers) to the standard T. brucei gambiense LAMP test format. The new test format was analyzed with and without outer primers. Amplification was carried out using Rotorgene 6000 and the portable ESE Quant amplification unit capable of real-time data output. The stem LAMP formats indicated shorter time to results (~8 min), were 10-100-fold more sensitive, and indicated higher diagnostic sensitivity and accuracy compared to the standard LAMP test. It was possible to confirm the predicted product using ESE melt curves demonstrating the potential of combining LAMP and real-time technologies as possible tool for HAT molecular xenomonitoring.

The antiquity of riverine adaptations in Iniidae (Cetacea, Odontoceti) documented by a humerus from the late Miocene of the Ituzaingó Formation, Argentina.

PubMed

Gutstein, Carolina Simon; Cozzuol, Mario Alberto; Pyenson, Nicholas D

2014-06-01

"River dolphins" are a paraphyletic group of toothed whales (Odontoceti) that represent independent secondary invasions of freshwater habitats. Different "river dolphin" lineages display suites of convergent morphological specializations that commonly reflect adaptations to riverine and freshwater environments, such as longirostry, reduced orbits, and wide, paddle-like flippers. One lineage, the Iniidae, is presently endemic to South America, and includes several extinct Neogene taxa along with their sole extant genus, Inia (the Amazon River dolphin). We report here a humerus recovered from the late Miocene deposits of the Ituzaingó Formation in the Paraná Basin of Argentina. The specimen exhibits diagnostic features of the family Iniidae, including a scapular-sternal joint of the humerus, which is a unique anatomical connection among mammals. This joint permits enhanced parasagittal adduction of the flipper as a control surface, relative to other odontocetes, providing Inia with a high degree of maneuverability in its structurally complex and heterogenous riverine habitat. This unique anatomical connection, here documented from the late Miocene (∼9 million years-6.5 million years old), not only provides the oldest diagnostic record for Iniidae, but it also indicates a similar habitat use for this lineage, a finding coincident with the current paleoenvironmental interpretation for the Ituzaingó Formation. Copyright © 2014 Wiley Periodicals, Inc.

Incipient Soot Formation in Rich Partially Premixed Flames under High Pressure Conditions of Relevance to Compression-Ignition Engines

DTIC Science & Technology

2017-09-09

chemically. Such flames were systematically studied by measuring temperature, species 1. REPORT DATE (DD-MM-YYYY) 4. TITLE AND SUBTITLE 13...pressure) but are still well suited to quantitative diagnostics; 2) Study soot inception by measuring gaseous soot precursors and focusing on the gas-to...downstream across an envelope diffusion flame that is formed between the products of the rich premixed flame and the oxidizer. To mimic this situation, a

Hereditary hemorrhagic telangiectasia patient presenting with brain abscess due to silent pulmonary arteriovenous malformation.

PubMed

Themistocleous, Marios; Giakoumettis, Dimitrios; Mitsios, Andreas; Anagnostopoulos, Christos; Kalyvas, Aristoteles; Koutsarnakis, Christos

2016-01-01

Hereditary hemorrhagic telangiectasia is a rare autosomal dominant inherited disease that is usually complicated by visceral vascular malformations. Patients harboring such malformations are at increased risk of brain abscess formation, which despite advances in diagnostic and surgical methods remains a life threatening medical emergency with high mortality and morbidity rates. In the present report we describe a case of cerebral abscess due to silent pulmonary arteriovenous malformation (AVM) in a young patient previously undiagnosed for hereditary hemorrhagic telangiectasia syndrome (HHT).

Toward literature-based feature selection for diagnostic classification: a meta-analysis of resting-state fMRI in depression.

PubMed

Sundermann, Benedikt; Olde Lütke Beverborg, Mona; Pfleiderer, Bettina

2014-01-01

Information derived from functional magnetic resonance imaging (fMRI) during wakeful rest has been introduced as a candidate diagnostic biomarker in unipolar major depressive disorder (MDD). Multiple reports of resting state fMRI in MDD describe group effects. Such prior knowledge can be adopted to pre-select potentially discriminating features for diagnostic classification models with the aim to improve diagnostic accuracy. Purpose of this analysis was to consolidate spatial information about alterations of spontaneous brain activity in MDD, primarily to serve as feature selection for multivariate pattern analysis techniques (MVPA). Thirty two studies were included in final analyses. Coordinates extracted from the original reports were assigned to two categories based on directionality of findings. Meta-analyses were calculated using the non-additive activation likelihood estimation approach with coordinates organized by subject group to account for non-independent samples. Converging evidence revealed a distributed pattern of brain regions with increased or decreased spontaneous activity in MDD. The most distinct finding was hyperactivity/hyperconnectivity presumably reflecting the interaction of cortical midline structures (posterior default mode network components including the precuneus and neighboring posterior cingulate cortices associated with self-referential processing and the subgenual anterior cingulate and neighboring medial frontal cortices) with lateral prefrontal areas related to externally-directed cognition. Other areas of hyperactivity/hyperconnectivity include the left lateral parietal cortex, right hippocampus and right cerebellum whereas hypoactivity/hypoconnectivity was observed mainly in the left temporal cortex, the insula, precuneus, superior frontal gyrus, lentiform nucleus and thalamus. Results are made available in two different data formats to be used as spatial hypotheses in future studies, particularly for diagnostic classification by MVPA.

Incremental Validity of Multidimensional Proficiency Scores from Diagnostic Classification Models: An Illustration for Elementary School Mathematics

ERIC Educational Resources Information Center

Kunina-Habenicht, Olga; Rupp, André A.; Wilhelm, Oliver

2017-01-01

Diagnostic classification models (DCMs) hold great potential for applications in summative and formative assessment by providing discrete multivariate proficiency scores that yield statistically driven classifications of students. Using data from a newly developed diagnostic arithmetic assessment that was administered to 2032 fourth-grade students…

PathBot: A Radiology-Pathology Correlation Dashboard.

PubMed

Kelahan, Linda C; Kalaria, Amit D; Filice, Ross W

2017-12-01

Pathology is considered the "gold standard" of diagnostic medicine. The importance of radiology-pathology correlation is seen in interdepartmental patient conferences such as "tumor boards" and by the tradition of radiology resident immersion in a radiologic-pathology course at the American Institute of Radiologic Pathology. In practice, consistent pathology follow-up can be difficult due to time constraints and cumbersome electronic medical records. We present a radiology-pathology correlation dashboard that presents radiologists with pathology reports matched to their dictations, for both diagnostic imaging and image-guided procedures. In creating our dashboard, we utilized the RadLex ontology and National Center for Biomedical Ontology (NCBO) Annotator to identify anatomic concepts in pathology reports that could subsequently be mapped to relevant radiology reports, providing an automated method to match related radiology and pathology reports. Radiology-pathology matches are presented to the radiologist on a web-based dashboard. We found that our algorithm was highly specific in detecting matches. Our sensitivity was slightly lower than expected and could be attributed to missing anatomy concepts in the RadLex ontology, as well as limitations in our parent term hierarchical mapping and synonym recognition algorithms. By automating radiology-pathology correlation and presenting matches in a user-friendly dashboard format, we hope to encourage pathology follow-up in clinical radiology practice for purposes of self-education and to augment peer review. We also hope to provide a tool to facilitate the production of quality teaching files, lectures, and publications. Diagnostic images have a richer educational value when they are backed up by the gold standard of pathology.

Radiologists’ Training, Experience, and Attitudes About Elder Abuse Detection

PubMed Central

Rosen, Tony; Bloemen, Elizabeth M.; Harpe, Jasmin; Sanchez, Allen M.; Mennitt, Kevin W.; McCarthy, Thomas J.; Nicola, Refky; Murphy, Kieran; LoFaso, Veronica M.; Flomenbaum, Neal; Lachs, Mark S.

2017-01-01

OBJECTIVE Elder abuse is underrecognized, and identification of subtle cases requires a high index of suspicion among all health care providers. Because many geriatric injury victims undergo radiographic imaging, diagnostic radiologists may be well positioned to identify injury patterns suggestive of abuse. Little is known about radiologists’ experience with elder abuse. Our goal was to describe knowledge, attitudes, training, and practice experience in elder abuse detection among diagnostic radiologists. SUBJECTS AND METHODS We conducted 19 interviews with diagnostic radiologists at a large urban academic medical center using a semistructured format. Data from these sessions were coded and analyzed to identify themes. RESULTS Only two radiologists reported any formal or informal training in elder abuse detection. All subjects believed they had missed cases of elder abuse. Even experienced radiologists reported never having received a request from a referring physician to assess images for evidence suggestive of elder abuse. All subjects reported a desire for additional elder abuse training. Also, subjects identified radiographic findings or patterns potentially suggestive of elder abuse, including high-energy injuries such as upper rib fractures, injuries in multiple stages of healing, and injuries inconsistent with reported mechanism. CONCLUSION Radiologists are uniquely positioned to identify elder abuse. Though training in detection is currently lacking, providers expressed a desire for increased knowledge. In addition, radiologists were able to identify radiographic findings suggestive of elder abuse. On the basis of these findings, we plan to conduct additional studies to define pathognomonic injury patterns and to explore how to empower radiologists to incorporate detection into their practice. PMID:27732066

The use of upconverting phosphors in point-of-care (POC) testing

NASA Astrophysics Data System (ADS)

Tanke, Hans J.; Zuiderwijk, Michel; Wiesmeijer, Karien C.; Breedveld, Robert N.; Abrams, William R.; de Dood, Claudia J.; Tjon Kon Fat, Elisa M.; Corstjens, Paul L. A. M.

2014-03-01

Point-of-care (POC) testing is increasingly applied as a cost effective alternative to many diagnostic tests. Key in POC testing is to create sufficient assay sensitivity with relatively low cost reagents and equipment. For this purpose we have employed a unique reporter, upconverting phosphor (UCP) particles, in combination with lateral flow (LF) assays. UCPs, submicron ceramic particles doped with rare earth ions (lanthanides), convert infrared to visible light and do not suffer from autofluorescence which limits conventional fluorescence based assays. Low cost handheld readers and microfluidics were evaluated in various applications. Designed assays are well suited for applications outside diagnostic laboratories, in resource poor settings, and can even be used by patients at home. Using two distinctly different UCP-LF assay formats, we focussed on assays for infectious diseases based on the detection of pathogen-specific antibodies and/or antigens including nucleic acids to demonstrate active infection with HIV. Only minor adaptation of the standard UCP-LF assay format is needed to render the format suitable for applications involving low affinity capture antibodies (e.g. in the detection of neurotoxin, botulism), capture of small molecules (e.g. detection of melatonin, a key hormone in chronopharmacology) or the use of dry UCP reagents (e.g. detection of protein based fruit-ripening markers, of economic interest in agriculture). Finally, we anticipate on developments in healthcare (personalized medicine) by discussing the potential of one of the UCP-LF assay formats to measure serum trough levels of immunodrugs (e.g. infliximab or adalimumab) in patients treated for inflammatory bowel disease and rheumatoid arthritis.

Development of an electronic medical report delivery system to 3G GSM mobile (cellular) phones for a medical imaging department.

PubMed

Lim, Eugene Y; Lee, Chiang; Cai, Weidong; Feng, Dagan; Fulham, Michael

2007-01-01

Medical practice is characterized by a high degree of heterogeneity in collaborative and cooperative patient care. Fast and effective communication between medical practitioners can improve patient care. In medical imaging, the fast delivery of medical reports to referring medical practitioners is a major component of cooperative patient care. Recently, mobile phones have been actively deployed in telemedicine applications. The mobile phone is an ideal medium to achieve faster delivery of reports to the referring medical practitioners. In this study, we developed an electronic medical report delivery system from a medical imaging department to the mobile phones of the referring doctors. The system extracts a text summary of medical report and a screen capture of diagnostic medical image in JPEG format, which are transmitted to 3G GSM mobile phones.

Does exposure to simulated patient cases improve accuracy of clinicians' predictive value estimates of diagnostic test results? A within-subjects experiment at St Michael's Hospital, Toronto, Canada.

PubMed

Armstrong, Bonnie; Spaniol, Julia; Persaud, Nav

2018-02-13

Clinicians often overestimate the probability of a disease given a positive test result (positive predictive value; PPV) and the probability of no disease given a negative test result (negative predictive value; NPV). The purpose of this study was to investigate whether experiencing simulated patient cases (ie, an 'experience format') would promote more accurate PPV and NPV estimates compared with a numerical format. Participants were presented with information about three diagnostic tests for the same fictitious disease and were asked to estimate the PPV and NPV of each test. Tests varied with respect to sensitivity and specificity. Information about each test was presented once in the numerical format and once in the experience format. The study used a 2 (format: numerical vs experience) × 3 (diagnostic test: gold standard vs low sensitivity vs low specificity) within-subjects design. The study was completed online, via Qualtrics (Provo, Utah, USA). 50 physicians (12 clinicians and 38 residents) from the Department of Family and Community Medicine at St Michael's Hospital in Toronto, Canada, completed the study. All participants had completed at least 1 year of residency. Estimation accuracy was quantified by the mean absolute error (MAE; absolute difference between estimate and true predictive value). PPV estimation errors were larger in the numerical format (MAE=32.6%, 95% CI 26.8% to 38.4%) compared with the experience format (MAE=15.9%, 95% CI 11.8% to 20.0%, d =0.697, P<0.001). Likewise, NPV estimation errors were larger in the numerical format (MAE=24.4%, 95% CI 14.5% to 34.3%) than in the experience format (MAE=11.0%, 95% CI 6.5% to 15.5%, d =0.303, P=0.015). Exposure to simulated patient cases promotes accurate estimation of predictive values in clinicians. This finding carries implications for diagnostic training and practice. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Breast tuberculosis: Diagnosis, management and treatment

PubMed Central

Marinopoulos, Spyridon; Lourantou, Dionysia; Gatzionis, Thomas; Dimitrakakis, Constantine; Papaspyrou, Irini; Antsaklis, Aris

2012-01-01

INTRODUCTION Mammary (breast) tuberculosis is a rare manifestation of extra-pulmonary localization of the disease which accounts for less than 0.1% of breast conditions in developed countries, but reaches 3–4% in regions where the disease presents with high incidence (India, Africa). It appears mostly in women of reproductive age, multiparous, lactating. It has been scarcely reported to infect male patients, mainly before puberty, as well as women of older age. The most common presentation is that of a tumor in the middle or upper-outer quadrant of the breast, with multifocal involvement being rarely documented. The differential diagnosis includes breast cancer and abscess formation. PRESENTATION OF CASE We report a case of breast tuberculosis that was treated in the Breast Unit of our hospital. Differential diagnosis, imaging methods, operative diagnostic approach and surgical treatment, histological verification of the disease and further therapeutic management are described. DISCUSSION High risk population is identified, primary and secondary disease is described and clinical presentations are analyzed. Evaluation of diagnostic workup and limitations are reported. CONCLUSION In accordance with the present worldwide revival of the disease, mainly because of massive numbers of migrating population, this subject is reviewed, reminding us of a rather uncommon clinical entity. PMID:22918083

Diagnostics of Pupils' Meta-Subject Competence during Lessons on Mathematics in Secondary Schools

ERIC Educational Resources Information Center

Khuziakhmetova, Anvar N.; Naumova, Marina V.

2016-01-01

The relevance of diagnostic meta-subject competence measures in secondary schools is caused by the fact that the importance of a meta-subject competence formation was officially defined in educational standards, but there are still no qualitative and informative diagnostic tools for this competence development. The purpose of the article is to…

The main challenges that remain in applying high-throughput sequencing to clinical diagnostics.

PubMed

Loeffelholz, Michael; Fofanov, Yuriy

2015-01-01

Over the last 10 years, the quality, price and availability of high-throughput sequencing instruments have improved to the point that this technology may be close to becoming a routine tool in the diagnostic microbiology laboratory. Two groups of challenges, however, have to be resolved in order to move this powerful research technology into routine use in the clinical microbiology laboratory. The computational/bioinformatics challenges include data storage cost and privacy concerns, requiring analysis to be performed without access to cloud storage or expensive computational infrastructure. The logistical challenges include interpretation of complex results and acceptance and understanding of the advantages and limitations of this technology by the medical community. This article focuses on the approaches to address these challenges, such as file formats, algorithms, data collection, reporting and good laboratory practices.

Coronal and Prominence Plasmas

NASA Technical Reports Server (NTRS)

Poland, Arthur I. (Editor)

1986-01-01

Various aspects of solar prominences and the solar corona are discussed. The formation of prominences, prominence diagnostics and structure, prominence dissappearance, large scale coronal structure, coronal diagnostics, small scale coronal structure, and non-equilibrium/coronal heating are among the topics covered.

Star formation inside a galactic outflow.

PubMed

Maiolino, R; Russell, H R; Fabian, A C; Carniani, S; Gallagher, R; Cazzoli, S; Arribas, S; Belfiore, F; Bellocchi, E; Colina, L; Cresci, G; Ishibashi, W; Marconi, A; Mannucci, F; Oliva, E; Sturm, E

2017-04-13

Recent observations have revealed massive galactic molecular outflows that may have the physical conditions (high gas densities) required to form stars. Indeed, several recent models predict that such massive outflows may ignite star formation within the outflow itself. This star-formation mode, in which stars form with high radial velocities, could contribute to the morphological evolution of galaxies, to the evolution in size and velocity dispersion of the spheroidal component of galaxies, and would contribute to the population of high-velocity stars, which could even escape the galaxy. Such star formation could provide in situ chemical enrichment of the circumgalactic and intergalactic medium (through supernova explosions of young stars on large orbits), and some models also predict it to contribute substantially to the star-formation rate observed in distant galaxies. Although there exists observational evidence for star formation triggered by outflows or jets into their host galaxy, as a consequence of gas compression, evidence for star formation occurring within galactic outflows is still missing. Here we report spectroscopic observations that unambiguously reveal star formation occurring in a galactic outflow at a redshift of 0.0448. The inferred star-formation rate in the outflow is larger than 15 solar masses per year. Star formation may also be occurring in other galactic outflows, but may have been missed by previous observations owing to the lack of adequate diagnostics.

40 CFR 85.2223 - On-board diagnostic test report.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 18 2010-07-01 2010-07-01 false On-board diagnostic test report. 85... Tests § 85.2223 On-board diagnostic test report. (a) Motorists whose vehicles fail the on-board diagnostic test described in § 85.2222 shall be provided with the on-board diagnostic test results, including...

40 CFR 85.2223 - On-board diagnostic test report.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 18 2011-07-01 2011-07-01 false On-board diagnostic test report. 85... Tests § 85.2223 On-board diagnostic test report. (a) Motorists whose vehicles fail the on-board diagnostic test described in § 85.2222 shall be provided with the on-board diagnostic test results, including...

Strawberry gums: a clinicopathological manifestation diagnostic of Wegener's granulomatosis?

PubMed Central

Napier, S S; Allen, J A; Irwin, C R; McCluskey, D R

1993-01-01

AIMS--To highlight an uncommon but characteristic gingival lesion associated with Wegener's granulomatosis, emphasising the presence of pseudoepitheliomatous hyperplasia, microabscesses, and multinucleate giant cells; and the paucity of the currently accepted histopathological criteria of Wegener's granulomatosis--namely necrosis, vasculitis, and granulomata. METHODS--The histopathological features of a gingival biopsy specimen from a case of Wegener's granulomatosis limited to the upper aerodigestive tract in a 36 year old woman were compared with those of 14 similar reported cases. RESULTS--Pseudoepitheliomatous hyperplasia, microabscesses, and multinucleate giant cells were recorded as present in almost all cases of gingival Wegener's granulomatosis. Necrosis, vasculitis, and granuloma formation were present in only a few cases. CONCLUSIONS--The combination of pseudoepitheliomatous hyperplasia, microabscesses, and multinucleate giant cells in a gingival biopsy specimen from erythematous, swollen gums, clinically resembling over-ripe strawberries, in a patient with a severe systemic upset, is so typical of Wegener's granulomatosis as to be virtually diagnostic. Recognition of this characteristic lesion may aid early diagnosis and treatment in cases where other diagnostic variables are absent. Images PMID:8408694

Biomarkers in the Diagnosis and Prognosis of Alzheimer's Disease.

PubMed

Schaffer, Cole; Sarad, Nakia; DeCrumpe, Ashton; Goswami, Disha; Herrmann, Sara; Morales, Jose; Patel, Parth; Osborne, Jim

2015-10-01

Alzheimer's disease (AD) is a neurodegenerative disease that inhibits cognitive functions and has no cure. This report reviews the current diagnostic standards for AD with an emphasis on early diagnosis using the cerebrospinal fluid (CSF) biomarkers amyloid-beta, t-tau, and p-tau and fluorodeoxyglucose positron emission tomography imaging. Abnormal levels of these CSF biomarkers and decreased cerebral uptake of glucose have recently been used in the early diagnosis of AD in experimental studies. These promising biomarkers can be measured using immunoassays performed in singleplex or multiplex formats. Although presently, there are no Food and Drug Administration-approved in vitro diagnostics (IVDs) for early detection of AD, a multiplex immunoassay measuring a panel of promising AD biomarkers in CSF may be a likely IVD candidate for the clinical AD diagnostic market. Specifically, the INNO-BIA AlzBio3 immunoassay kit, performed using bead arrays on the xMAP Luminex analyzer, allows simultaneous quantification of amyloid-beta, t-tau, and p-tau biomarkers. AD biomarkers can also be screened using enzyme-linked immunosorbent assays that are offered as laboratory-developed tests. © 2014 Society for Laboratory Automation and Screening.

A new diagnostic approach for bilious pleural effusion.

PubMed

Saraya, Takeshi; Light, Richard W; Sakuma, Sho; Nakamoto, Yasuo; Wada, Shoko; Ishida, Manabu; Inui, Toshiya; Koide, Takashi; Ishii, Haruyuki; Takizawa, Hajime

2016-09-01

Bilious pleural effusion is an extremely rare condition associated with liver diseases, subphrenic or subhepatic abscess formation, biliary peritonitis, and invasive procedures (i.e., percutaneous biliary drainage or liver biopsy). The current diagnostic test is based on the measurement of the ratio of pleural total bilirubin to serum total bilirubin, which is greater than 1 in patients with bilious pleural effusion. Given the low incidence of bilious pleural effusion, the precise diagnostic yield of this ratio based test has not been evaluated. We retrospectively reviewed the medical records of our institution and searched the PubMed database for reports of bilious pleural effusion. We identified a total of 12 cases of bilious pleural effusion (9 from 8 Pubmed reports and 3 from our institutional records). The factors causing this condition were broadly classified into three categories based on the pathophysiology: 1) liver diseases (echinococcosis, tuberculosis and amebiasis); 2) subhepatic/subphrenic abscess or biliary peritonitis, with or without biliary tract obstruction; and 3) iatrogenic disease after percutaneous biliary drainage and/or liver biopsy. The sensitivity of detection was 76.9% when the ratio of pleural total bilirubin to serum total bilirubin was greater than 1. The sensitivity increased to 100% when a combination test including pleural glycoholic acid was adopted. This study demonstrates the high diagnostic yield for bilious pleural effusion using a combination of two test criteria; a ratio of pleural total bilirubin to serum total bilirubin greater than 1 and the presence of pleural glycoholic acid. Copyright © 2016 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

Alchemy: A Web 2.0 Real-time Quality Assurance Platform for Human Immunodeficiency Virus, Hepatitis C Virus, and BK Virus Quantitation Assays.

PubMed

Agosto-Arroyo, Emmanuel; Coshatt, Gina M; Winokur, Thomas S; Harada, Shuko; Park, Seung L

2017-01-01

The molecular diagnostics laboratory faces the challenge of improving test turnaround time (TAT). Low and consistent TATs are of great clinical and regulatory importance, especially for molecular virology tests. Laboratory information systems (LISs) contain all the data elements necessary to do accurate quality assurance (QA) reporting of TAT and other measures, but these reports are in most cases still performed manually: a time-consuming and error-prone task. The aim of this study was to develop a web-based real-time QA platform that would automate QA reporting in the molecular diagnostics laboratory at our institution, and minimize the time expended in preparing these reports. Using a standard Linux, Nginx, MariaDB, PHP stack virtual machine running atop a Dell Precision 5810, we designed and built a web-based QA platform, code-named Alchemy. Data files pulled periodically from the LIS in comma-separated value format were used to autogenerate QA reports for the human immunodeficiency virus (HIV) quantitation, hepatitis C virus (HCV) quantitation, and BK virus (BKV) quantitation. Alchemy allowed the user to select a specific timeframe to be analyzed and calculated key QA statistics in real-time, including the average TAT in days, tests falling outside the expected TAT ranges, and test result ranges. Before implementing Alchemy, reporting QA for the HIV, HCV, and BKV quantitation assays took 45-60 min of personnel time per test every month. With Alchemy, that time has decreased to 15 min total per month. Alchemy allowed the user to select specific periods of time and analyzed the TAT data in-depth without the need of extensive manual calculations. Alchemy has significantly decreased the time and the human error associated with QA report generation in our molecular diagnostics laboratory. Other tests will be added to this web-based platform in future updates. This effort shows the utility of informatician-supervised resident/fellow programming projects as learning opportunities and workflow improvements in the molecular laboratory.

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

PubMed

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

2015-12-01

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

A Python package for parsing, validating, mapping and formatting sequence variants using HGVS nomenclature.

PubMed

Hart, Reece K; Rico, Rudolph; Hare, Emily; Garcia, John; Westbrook, Jody; Fusaro, Vincent A

2015-01-15

Biological sequence variants are commonly represented in scientific literature, clinical reports and databases of variation using the mutation nomenclature guidelines endorsed by the Human Genome Variation Society (HGVS). Despite the widespread use of the standard, no freely available and comprehensive programming libraries are available. Here we report an open-source and easy-to-use Python library that facilitates the parsing, manipulation, formatting and validation of variants according to the HGVS specification. The current implementation focuses on the subset of the HGVS recommendations that precisely describe sequence-level variation relevant to the application of high-throughput sequencing to clinical diagnostics. The package is released under the Apache 2.0 open-source license. Source code, documentation and issue tracking are available at http://bitbucket.org/hgvs/hgvs/. Python packages are available at PyPI (https://pypi.python.org/pypi/hgvs). Supplementary data are available at Bioinformatics online. © The Author 2014. Published by Oxford University Press.

A Python package for parsing, validating, mapping and formatting sequence variants using HGVS nomenclature

PubMed Central

Hart, Reece K.; Rico, Rudolph; Hare, Emily; Garcia, John; Westbrook, Jody; Fusaro, Vincent A.

2015-01-01

Summary: Biological sequence variants are commonly represented in scientific literature, clinical reports and databases of variation using the mutation nomenclature guidelines endorsed by the Human Genome Variation Society (HGVS). Despite the widespread use of the standard, no freely available and comprehensive programming libraries are available. Here we report an open-source and easy-to-use Python library that facilitates the parsing, manipulation, formatting and validation of variants according to the HGVS specification. The current implementation focuses on the subset of the HGVS recommendations that precisely describe sequence-level variation relevant to the application of high-throughput sequencing to clinical diagnostics. Availability and implementation: The package is released under the Apache 2.0 open-source license. Source code, documentation and issue tracking are available at http://bitbucket.org/hgvs/hgvs/. Python packages are available at PyPI (https://pypi.python.org/pypi/hgvs). Contact: reecehart@gmail.com Supplementary information: Supplementary data are available at Bioinformatics online. PMID:25273102

Diagnostic studies of ion beam formation in inductively coupled plasma

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

Jacobs, Jenee L.

2015-01-01

This dissertation describes a variety of studies focused on the plasma and the ion beam in inductively coupled plasma mass spectrometry (ICP-MS). The ability to use ICP-MS for measurements of trace elements in samples requires the analytes to be efficiently ionized. Updated ionization efficiency tables are discussed for ionization temperatures of 6500 K and 7000 K with an electron density of 1 x 10 15 cm -3. These values are reflective of the current operating parameters of ICP-MS instruments. Calculations are also discussed for doubly charged (M 2+) ion formation, neutral metal oxide (MO) ionization, and metal oxide (MO +)more » ion dissociation for similar plasma temperature values. Ionization efficiency results for neutral MO molecules in the ICP have not been reported previously.« less

CONFERENCE REPORT: Summary of the 16th IAEA Technical Meeting on 'Research using Small Fusion Devices'

NASA Astrophysics Data System (ADS)

Gribkov, V.; Van Oost, G.; Malaquias, A.; Herrera, J.

2006-10-01

Common research topics that are being studied in small, medium and large devices such as H-mode like or improved confinement, turbulence and transport are reported. These included modelling and diagnostic developments for edge and core, to characterize plasma density, temperature, electric potential, plasma flows, turbulence scale, etc. Innovative diagnostic methods were designed and implemented which could be used to develop experiments in small devices (in some cases not possible in large devices due to higher power deposition) to allow a better understanding of plasma edge and core properties. Reports are given addressing research in linear devices that can be used to study particular plasma physics topics relevant for other magnetic confinement devices such as the radial transport and the modelling of self-organized plasma jets involved in spheromak-like plasma formation. Some aspects of the work presented are of interest to the astrophysics community since they are believed to shed light on the basis of the physics of stellar jets. On the dense magnetized plasmas (DMP) topic, the present status of research, operation of new devices, plasma dynamics modelling and diagnostic developments is reported. The main devices presented belong to the class of Z-pinches, mostly plasma foci, and several papers were presented under this topic. The physics of DMP is important both for the main-stream fusion investigations as well as for providing the basis for elaboration of new concepts. New high-current technology introduced in the DMP devices design and construction make these devices nowadays more reliably fitted to various applications and give the possibility to widen the energy range used by them in both directions—to the multi-MJ level facilities and down to miniature plasma focus devices with energy of just a few J.

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

PubMed

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

2015-12-01

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

[Periorbital edema as the initial symptom of lupus erythematosus profundus. Case report and discussion of the literature].

PubMed

Franke, W; Kuhn, A; Megahed, M; Krutmann, J; Ruzicka, T; Lehmann, P

1999-12-01

Periorbital edema may occur initially or in the course of a wide variety of diseases. One of these diseases is lupus panniculitis, a variant of lupus erythematosus, characterized by firm subcutaneous nodules that may ulcerate with subsequent scar formation. We present a case of lupus panniculitis in which the periorbital edema was the initial manifestation. Knowledge about the differential diagnostic possibilities of periorbital edema as well as the different variants of cutaneous lupus erythematosus is important to reach the correct diagnosis.

High power lasers: Sources, laser-material interactions, high excitations, and fast dynamics in laser processing and industrial applications; Proceedings of the Meeting, The Hague, Netherlands, Mar. 31-Apr. 3, 1987

NASA Technical Reports Server (NTRS)

Kreutz, E. W. (Editor); Quenzer, Alain (Editor); Schuoecker, Dieter (Editor)

1987-01-01

The design and operation of high-power lasers for industrial applications are discussed in reviews and reports. Topics addressed include the status of optical technology in the Netherlands, laser design, the deposition of optical energy, laser diagnostics, nonmetal processing, and energy coupling and plasma formation. Consideration is given to laser-induced damage to materials, fluid and gas flow dynamics, metal processing, and manufacturing. Graphs, diagrams, micrographs, and photographs are provided.

THE FORMATION OF IRIS DIAGNOSTICS. VII. THE FORMATION OF THE O i 135.56 NM LINE IN THE SOLAR ATMOSPHERE

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

Lin, Hsiao-Hsuan; Carlsson, Mats, E-mail: h.h.lin@astro.uio.no, E-mail: mats.carlsson@astro.uio.no

The O i 135.56 nm line is covered by NASA's Interface Region Imaging Spectrograph (IRIS) small explorer mission which studies how the solar atmosphere is energized. We study here the formation and diagnostic potential of this line by means of non-local thermodynamic equilibrium modeling employing both 1D semi-empirical and 3D radiation magnetohydrodynamic models. We study the basic formation mechanisms and derive a quintessential model atom that incorporates essential atomic physics for the formation of the O i 135.56 nm line. This atomic model has 16 levels and describes recombination cascades through highly excited levels by effective recombination rates. The ionizationmore » balance O i/O ii is set by the hydrogen ionization balance through charge exchange reactions. The emission in the O i 135.56 nm line is dominated by a recombination cascade and the line is optically thin. The Doppler shift of the maximum emission correlates strongly with the vertical velocity in its line forming region, which is typically located at 1.0–1.5 Mm height. The total intensity of the line emission is correlated with the square of the electron density. Since the O i 135.56 nm line is optically thin, the width of the emission line is a very good diagnostic of non-thermal velocities. We conclude that the O i 135.56 nm line is an excellent probe of the middle chromosphere, and compliments other powerful chromospheric diagnostics of IRIS such as the Mg ii h and k lines and the C ii lines around 133.5 nm.« less

Norwegian crusted scabies: an unusual case presentation.

PubMed

Maghrabi, Michael M; Lum, Shireen; Joba, Ameha T; Meier, Molly J; Holmbeck, Ryan J; Kennedy, Kate

2014-01-01

Scabies is a contagious condition that is transmitted through direct contact with an infected person and has been frequently associated with institutional and healthcare-facility outbreaks. The subtype Norwegian crusted scabies can masquerade as other dermatologic diseases owing to the heavy plaque formation. Successful treatment has been documented in published reports, including oral ivermectin and topical permethrin. Few case studies documenting the treatment of Norwegian crusted scabies have reported the use of surgical debridement as an aid to topical and/or oral treatment when severe plaque formation has been noted. A nursing home patient was admitted to the hospital for severe plaque formation of both feet. A superficial biopsy was negative for both fungus and scabies because of the severity of the plaque formation on both feet. The patient underwent a surgical, diagnostic biopsy of both feet, leading to the diagnosis of Norwegian crusted scabies. A second surgical debridement was then performed to remove the extensive plaque formation and aid the oral ivermectin and topical permethrin treatment. The patient subsequently made a full recovery and was discharged back to the nursing home. At 2 and 6 months after treatment, the patient remained free of scabies infestation, and the surgical wound had healed uneventfully. The present case presentation has demonstrated that surgical debridement can be complementary to the standard topical and oral medications in the treatment of those with Norwegian crusted scabies infestation. Copyright © 2014 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Spontaneous Intrahepatic Type II Gallbladder Perforation: A Rare Cause of Liver Abscess – Case Report

PubMed Central

Singh, Kumkum; Singh, Amit; Vidyarthi, Shivaji H; Jindal, Satyaprakash; Thounaojam, Chandra Kumar

2013-01-01

A liver abscess formation is a rare complication of a gallbladder perforation, with a cholecystohepatic communication. Niemeier, in 1934, classified free gallbladder perforations and generalised biliary peritonitis as an acute or a Type I gallbladder perforation, a pericholecystic abscess and localised peritonitis as a subacute or a Type II gallbladder perforation, and cholecystoenteric fistulas as chronic or Type III gallbladder perforations. We are describing a 50–year–old male patient who presented with right upper quadrant pain and was found to have an intrahepatic perforation of the gallbladder. Our patient had a Type II perforation. We have discussed the diagnostic work-up and the management of this rare entity. Due to the high mortality that can be caused by a delay in making the correct diagnosis, a gallbladder perforation represents a special diagnostic and surgical challenge. PMID:24179927

Digitized molecular diagnostics: reading disk-based bioassays with standard computer drives.

PubMed

Li, Yunchao; Ou, Lily M L; Yu, Hua-Zhong

2008-11-01

We report herein a digital signal readout protocol for screening disk-based bioassays with standard optical drives of ordinary desktop/notebook computers. Three different types of biochemical recognition reactions (biotin-streptavidin binding, DNA hybridization, and protein-protein interaction) were performed directly on a compact disk in a line array format with the help of microfluidic channel plates. Being well-correlated with the optical darkness of the binding sites (after signal enhancement by gold nanoparticle-promoted autometallography), the reading error levels of prerecorded audio files can serve as a quantitative measure of biochemical interaction. This novel readout protocol is about 1 order of magnitude more sensitive than fluorescence labeling/scanning and has the capability of examining multiplex microassays on the same disk. Because no modification to either hardware or software is needed, it promises a platform technology for rapid, low-cost, and high-throughput point-of-care biomedical diagnostics.

Integrating Data-Based Decision Making, Assessment for Learning and Diagnostic Testing in Formative Assessment

ERIC Educational Resources Information Center

Van der Kleij, Fabienne M.; Vermeulen, Jorine A.; Schildkamp, Kim; Eggen, Theo J. H .M.

2015-01-01

Recent research has highlighted the lack of a uniform definition of formative assessment, although its effectiveness is widely acknowledged. This paper addresses the theoretical differences and similarities amongst three approaches to formative assessment that are currently most frequently discussed in educational research literature: data-based…

Diagnostic imaging for chronic plantar heel pain: a systematic review and meta-analysis

PubMed Central

2009-01-01

Background Chronic plantar heel pain (CPHP) is a generalised term used to describe a range of undifferentiated conditions affecting the plantar heel. Plantar fasciitis is reported as the most common cause and the terms are frequently used interchangeably in the literature. Diagnostic imaging has been used by many researchers and practitioners to investigate the involvement of specific anatomical structures in CPHP. These observations help to explain the underlying pathology of the disorder, and are of benefit in forming an accurate diagnosis and targeted treatment plan. The purpose of this systematic review was to investigate the diagnostic imaging features associated with CPHP, and evaluate study findings by meta-analysis where appropriate. Methods Bibliographic databases including Medline, Embase, CINAHL, SportDiscus and The Cochrane Library were searched electronically on March 25, 2009. Eligible articles were required to report imaging findings in participants with CPHP unrelated to inflammatory arthritis, and to compare these findings with a control group. Methodological quality was evaluated by use of the Quality Index as described by Downs and Black. Meta-analysis of study data was conducted where appropriate. Results Plantar fascia thickness as measured by ultrasonography was the most widely reported imaging feature. Meta-analysis revealed that the plantar fascia of CPHP participants was 2.16 mm thicker than control participants (95% CI = 1.60 to 2.71 mm, P < 0.001) and that CPHP participants were more likely to have plantar fascia thickness values greater than 4.0 mm (OR = 105.11, 95% CI = 3.09 to 3577.28, P = 0.01). CPHP participants were also more likely to show radiographic evidence of subcalcaneal spur than control participants (OR = 8.52, 95% CI = 4.08 to 17.77, P < 0.001). Conclusion This systematic review has identified 23 studies investigating the diagnostic imaging appearance of the plantar fascia and inferior calcaneum in people with CPHP. Analysis of these studies found that people with CPHP are likely to have a thickened plantar fascia with associated fluid collection, and that thickness values >4.0 mm are diagnostic of plantar fasciitis. Additionally, subcalcaneal spur formation is strongly associated with pain beneath the heel. PMID:19912628

Quantification of DNA using the luminescent oxygen channeling assay.

PubMed

Patel, R; Pollner, R; de Keczer, S; Pease, J; Pirio, M; DeChene, N; Dafforn, A; Rose, S

2000-09-01

Simplified and cost-effective methods for the detection and quantification of nucleic acid targets are still a challenge in molecular diagnostics. Luminescent oxygen channeling assay (LOCI(TM)) latex particles can be conjugated to synthetic oligodeoxynucleotides and hybridized, via linking probes, to different DNA targets. These oligomer-conjugated LOCI particles survive thermocycling in a PCR reaction and allow quantified detection of DNA targets in both real-time and endpoint formats. The endpoint DNA quantification format utilized two sensitizer bead types that are sensitive to separate illumination wavelengths. These two bead types were uniquely annealed to target or control amplicons, and separate illuminations generated time-resolved chemiluminescence, which distinguished the two amplicon types. In the endpoint method, ratios of the two signals allowed determination of the target DNA concentration over a three-log range. The real-time format allowed quantification of the DNA target over a six-log range with a linear relationship between threshold cycle and log of the number of DNA targets. This is the first report of the use of an oligomer-labeled latex particle assay capable of producing DNA quantification and sequence-specific chemiluminescent signals in a homogeneous format. It is also the first report of the generation of two signals from a LOCI assay. The methods described here have been shown to be easily adaptable to new DNA targets because of the generic nature of the oligomer-labeled LOCI particles.

THE FORMATION OF IRIS DIAGNOSTICS. II. THE FORMATION OF THE Mg II h and k LINES IN THE SOLAR ATMOSPHERE

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

Leenaarts, J.; Pereira, T. M. D.; Carlsson, M.

NASA's Interface Region Imaging Spectrograph (IRIS) small explorer mission will study how the solar atmosphere is energized. IRIS contains an imaging spectrograph that covers the Mg II h and k lines as well as a slit-jaw imager centered at Mg II k. Understanding the observations requires forward modeling of Mg II h and k line formation from three-dimensional (3D) radiation-magnetohydrodynamic (RMHD) models. This paper is the second in a series where we undertake this modeling. We compute the vertically emergent h and k intensity from a snapshot of a dynamic 3D RMHD model of the solar atmosphere, and investigate whichmore » diagnostic information about the atmosphere is contained in the synthetic line profiles. We find that the Doppler shift of the central line depression correlates strongly with the vertical velocity at optical depth unity, which is typically located less than 200 km below the transition region (TR). By combining the Doppler shifts of the h and k lines we can retrieve the sign of the velocity gradient just below the TR. The intensity in the central line depression is anti-correlated with the formation height, especially in subfields of a few square Mm. This intensity could thus be used to measure the spatial variation of the height of the TR. The intensity in the line-core emission peaks correlates with the temperature at its formation height, especially for strong emission peaks. The peaks can thus be exploited as a temperature diagnostic. The wavelength difference between the blue and red peaks provides a diagnostic of the velocity gradients in the upper chromosphere. The intensity ratio of the blue and red peaks correlates strongly with the average velocity in the upper chromosphere. We conclude that the Mg II h and k lines are excellent probes of the very upper chromosphere just below the TR, a height regime that is impossible to probe with other spectral lines. They also provide decent temperature and velocity diagnostics of the middle chromosphere.« less

Congenital left ventricular outpouchings: a systematic review of 839 cases and introduction of a novel classification after two centuries.

PubMed

Malakan Rad, Elaheh; Awad, Sawsan; Hijazi, Ziyad M

2014-01-01

Congenital left ventricular outpouchings (LVOs) are reported under five overlapping and poorly defined terms including left ventricular accessory chamber, left ventricular aneurysm (LVA), left ventricular diverticulum (LVD), double-chambered LV, and accessory left ventricle. Diagnostic criteria are frequently mixed and not mutually exclusive. They convey no information regarding treatment strategy and prognosis. The aim of this systematic review is to provide a clear and inclusive classification, with therapeutic and prognostic implications, for congenital LVOs. We performed three separate sets of search on three subjects including "congenital left ventricular outpouchings," "important and simply measurable markers of left ventricular function," and "relationship of mechanics of intraventricular blood flow and optimal vortex formation in left ventricle and elliptical geometry of LV." We enrolled case series, review articles, and case reports with literature review. All types of acquired LVO's were excluded. We studied the abstracts of all searched articles. We focused on diagnostic criteria and patients' outcome. To examine the validity and reliability of the novel classification, fifteen previous studies were revisited using the novel classification. A total of 20 papers from 11 countries fulfilled our inclusion criteria. The age of patients ranged from prenatal age to geriatric age range. Diagnostic criteria were clearly stated only for two of the above five terms (i.e., congenital LVA and congenital LVD). Cases with mixed diagnostic criteria were frequent.Elliptical geometry of left ventricle was found to have significant impact on effective blood flow mechanics in LV. A simple inclusive classification for congenital LVOs, with therapeutic and prognostic implications, was introduced. The cornerstone of this classification is elliptical LV geometry. Large-type IIc LVO have dismal prognosis, if left untreated. LVO type I and small LVO type IIa have the best prognosis. © 2014 Wiley Periodicals, Inc.

Diagnostics of Carbon Nanotube Formation in a Laser Produced Plume

NASA Technical Reports Server (NTRS)

DeBoer, Gary

2000-01-01

This research has involved the analysis and interpretation of spectroscopic data taken over a two year period from 1998 to 1999 at the Johnson Space Center. The data was taken in an attempt to perform diagnostic studies of the formation of carbon nanotubes in a laser produced plume. Carbon nanotubes hold great promise for the development of new materials with exciting properties. Current production processes are not sufficient to meet research and development needs. A better understanding of the chemical processes involved in carbon nanotube formation will suggest better production processes that would be more able to meet the demands of research and development. Our work has focused on analysis of the emission spectra and laser induced fluorescent spectra of the carbon dimer, C2, and the laser induced fluorescence spectra of the nickel atom, which is a necessary reagent in th formation of carbon nanotubes.

Analysis of the Astronomy Diagnostic Test

ERIC Educational Resources Information Center

Brogt, Erik; Sabers, Darrell; Prather, Edward E.; Deming, Grace L.; Hufnagel, Beth; Slater, Timothy F.

2007-01-01

Seventy undergraduate class sections were examined from the database of Astronomy Diagnostic Test (ADT) results of Deming and Hufnagel to determine if course format correlated with ADT normalized gain scores. Normalized gains were calculated for four different classroom scenarios: lecture, lecture with discussion, lecture with lab, and lecture…

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

[Renal cirsoid aneurysm (congenital arteriovenous fistula): a rare cause of severe hematuria].

PubMed

Pereira Arias, José Gregorio; Ullate Jaime, Vicente; Pereda Martínez, Esther; Gutiérrez Díez, José María; Ateca Díaz-Obregón, Ricardo; Ramírez Rodríguez, Maria Mar; Berreteaga Gallastegui, José Ramón

2007-06-01

Congenital arteriovenous fistulas are an exceptional clinical feature. Although they are frequently asymptomatic, their presentation as severe hematuria pose an excellent diagnostic exercise and often immediate therapeutic action. We report the case of a 75-year-old female patient presenting with severe hematuria producing anaemia, high blood pressure and congestive heart failure. Image tests revealed right ureteral-hydronephrosis with bladder blockage by blood clots. The endoscopic study (cystoscopy and ureterorenoscopy) alerted about the origin of the hematuria from the right kidney, finally requiring nephrectomy as definitive treatment. Pathology revealed the presence of a round formation with multiple vascular channels, arterial and venous, in the pyelocalicial submucosa, with focal epithelial erosion, compatible with congenital arteriovenous fistula. We review the diagnostic and therapeutic features in the literature. Renal congenital arteriovenous fistulas represent a diagnostic dilemma. They may present asymptomatic or condition clinical features derived from the shunt and high cardiac output (hypertensive cardiopathy and congestive heart failure) or from the erosion and acute hemorrhage into the urinary tract (severe renal hematuria). Treatment should be conservative with embolization or supraselective sclerosis. Nevertheless, in cases of big fistulas, post embolization revascularization, or hemodynamic instability nephrectomy is an excellent option.

25 years and still going strong: 2'-O-(pyren-1-yl)methylribonucleotides - versatile building blocks for applications in molecular biology, diagnostics and materials science.

PubMed

Hrdlicka, Patrick J; Karmakar, Saswata

2017-11-29

Oligonucleotides (ONs) modified with 2'-O-(pyren-1-yl)methylribonucleotides have been explored for a range of applications in molecular biology, nucleic acid diagnostics, and materials science for more than 25 years. The first part of this review provides an overview of synthetic strategies toward 2'-O-(pyren-1-yl)methylribonucleotides and is followed by a summary of biophysical properties of nucleic acid duplexes modified with these building blocks. Insights from structural studies are then presented to rationalize the reported properties. In the second part, applications of ONs modified with 2'-O-(pyren-1-yl)methyl-RNA monomers are reviewed, which include detection of RNA targets, discrimination of single nucleotide polymorphisms, formation of self-assembled pyrene arrays on nucleic acid scaffolds, the study of charge transfer phenomena in nucleic acid duplexes, and sequence-unrestricted recognition of double-stranded DNA. The predictable binding mode of the pyrene moiety, coupled with the microenvironment-dependent properties and synthetic feasibility, render 2'-O-(pyren-1-yl)methyl-RNA monomers as a promising class of pyrene-functionalized nucleotide building blocks for new applications in molecular biology, nucleic acid diagnostics, and materials science.

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

EPA Science Inventory

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

Sensitivity and specificity of the American College of Rheumatology 1987 criteria for the diagnosis of rheumatoid arthritis according to disease duration: a systematic literature review and meta-analysis.

PubMed

Banal, F; Dougados, M; Combescure, C; Gossec, L

2009-07-01

To evaluate the ability of the widely used ACR set of criteria (both list and tree format) to diagnose RA compared with expert opinion according to disease duration. A systematic literature review was conducted in PubMed and Embase databases. All articles reporting the prevalence of RA according to ACR criteria and expert opinion in cohorts of early (<1 year duration) or established (>1 year) arthritis were analysed to calculate the sensitivity and specificity of ACR 1987 criteria against the "gold standard" (expert opinion). A meta-analysis using a summary receiver operating characteristic (SROC) curve was performed and pooled sensitivity and specificity were calculated with confidence intervals. Of 138 publications initially identified, 19 were analysable (total 7438 patients, 3883 RA). In early arthritis, pooled sensitivity and specificity of the ACR set of criteria were 77% (68% to 84%) and 77% (68% to 84%) in the list format versus 80% (72% to 88%) and 33% (24% to 43%) in the tree format. In established arthritis, sensitivity and specificity were respectively 79% (71% to 85%) and 90% (84% to 94%) versus 80% (71% to 85%) and 93% (86% to 97%). The SROC meta-analysis confirmed the statistically significant differences, suggesting that diagnostic performances of ACR list criteria are better in established arthritis. The specificity of ACR 1987 criteria in early RA is low, and these criteria should not be used as diagnostic tools. Sensitivity and specificity in established RA are higher, which reflects their use as classification criteria gold standard.

EPs welcome new focus on reducing diagnostic errors.

PubMed

2015-12-01

Emergency medicine leaders welcome a major new report from the Institute of Medicine (IOM) calling on providers, policy makers, and government agencies to institute changes to reduce the incidence of diagnostic errors. The 369-page report, "Improving Diagnosis in Health Care," states that the rate of diagnostic errors in this country is unacceptably high and offers a long list of recommendations aimed at addressing the problem. These include large, systemic changes that involve improvements in multiple areas, including health information technology (HIT), professional education, teamwork, and payment reform. Further, of particular interest to emergency physicians are recommended changes to the liability system. The authors of the IOM report state that while most people will likely experience a significant diagnostic error in their lifetime, the importance of this problem is under-appreciated. According to conservative estimates, the report says 5% of adults who seek outpatient care each year experience a diagnostic error. The report also notes that research over many decades shows diagnostic errors contribute to roughly 10% of all.deaths. The report says more steps need to be taken to facilitate inter-professional and intra-professional teamwork throughout the diagnostic process. Experts concur with the report's finding that mechanisms need to be developed so that providers receive ongoing feedback on their diagnostic performance.

Epitope presentation is an important determinant of the utility of antigens identified from protein arrays in the development of autoantibody diagnostic assays.

PubMed

Murphy, Mairead A; O'Connell, David J; O'Kane, Sara L; O'Brien, John K; O'Toole, Sharon; Martin, Cara; Sheils, Orla; O'Leary, John J; Cahill, Dolores J

2012-08-03

Autoantibodies represent an attractive biomarker for diagnostic assays principally due to the stability of immunoglobulin in patient serum facilitating measurement with conventional assays. Immune responses to tumorigenesis may facilitate detection of ovarian cancer in the early stages of the disease with identification of a panel of tumour specific autoantibodies. Despite the reporting of many tumour associated autoantibodies using arrays of tumour antigens, this has not led to the advance in diagnostic capability as rapidly as was initially expected. Here we examine the potential diagnostic utility of candidate autoantibody biomarkers identified via screening of serum samples on a high content human protein array from a unique cohort of early stage and late stage ovarian cancer patients. We analyse the performance of autoantibodies to the tumour suppressor protein p53 and the novel autoantigens alpha adducin and endosulfine alpha identified in our array screen. Each antigen has different performance characteristics using conventional ELISA format and Western blot immunoassay. The high attrition rate of promising autoantigens identified by array screening can in part be explained by the presentation of the epitope of the antigen in the subsequent method of validation and this study provides directions on maximising the potential of candidate biomarkers. This article is part of a Special Issue entitled: Translational Proteomics. Copyright © 2012 Elsevier B.V. All rights reserved.

Internet gaming disorder treatment: a review of definitions of diagnosis and treatment outcome.

PubMed

King, Daniel L; Delfabbro, Paul H

2014-10-01

Internet gaming disorder (IGD) is a new disorder currently positioned in the appendix of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Few clinical studies report that psychological and pharmacological interventions can significantly reduce the severity of IGD symptomatology. The aim of this review was to assess current knowledge of the short- and long-term benefits of IGD interventions. This review presents a systematic evaluation of definitions of diagnosis and treatment outcomes employed in IGD treatment studies, including an assessment of goodness of fit with the DSM-5 classification. A computer database search of Academic Search Premier, PubMed, PsychINFO, ScienceDirect, Web of Science, and Google Scholar was conducted to identify all available research evidence on Internet gaming disorder treatment (N = 8 studies). Diagnostic and treatment outcome parameters were systematically evaluated. Several weaknesses of IGD treatment literature were identified. Only 2 treatment studies have employed an equivalent method of diagnosis for IGD. Studies have not assessed formative change in diagnostic status at posttreatment or follow-up. Duration of follow-up has been inadequate to assess relapse and remission. Posttreatment assessment has been predominantly limited to IGD symptomatology, comorbidity, and frequency of gaming behavior. Currently, there is insufficient evidence to warrant suggestion that trialled IGD interventions confer a long-term therapeutic benefit. Several improvements to study design and reporting are proposed to guide future studies of IGD. © 2014 Wiley Periodicals, Inc.

Method for measuring pollutant formation

NASA Technical Reports Server (NTRS)

Stickler, David B. (Inventor); Annen, Kurt (Inventor)

2001-01-01

Diagnostic methods for determining an instantaneous rate of pollutant formation in a combustion system are based on measurement of chemiluminescence intensity generated simultaneously with the formation of the pollutant. The chemiluminescent signal is generated by an analog reaction which occurs in parallel with a key step in the formation of a specific pollutant of interest. The connection between the analog reaction and the pollution reaction is such that the chemiluminescent signal indicates the local, instantaneous formation rate of the pollutant of interest.

Tumor-induced osteomalacia (TIO): atypical presentation.

PubMed

Khaliq, Waseem; Cheripalli, Praveen; Tangella, Krishnarao

2011-05-01

Tumor-induced osteomalacia is a rare acquired condition characterized by phosphaturia, hypophosphatemia and osteomalacia. We report an unusual presentation in a 15-year-old healthy male with a two-week history of cough and chest pain. The chest radiograph showed right middle lobe opacity and chest CT revealed a mass in the extra pleural space. A biopsy showed chondro-myxoidstroma with osteoid formation. Diagnosis was confirmed with the above findings and hypophosphatemia. The patient's symptoms resolved after complete surgical excision of the mass. Tumor-induced osteomalacia, although a rare disorder, can be a diagnostic challenge, especially in patients presenting with atypical symptoms.

Quality and reporting of diagnostic accuracy studies in TB, HIV and malaria: evaluation using QUADAS and STARD standards.

PubMed

Fontela, Patricia Scolari; Pant Pai, Nitika; Schiller, Ian; Dendukuri, Nandini; Ramsay, Andrew; Pai, Madhukar

2009-11-13

Poor methodological quality and reporting are known concerns with diagnostic accuracy studies. In 2003, the QUADAS tool and the STARD standards were published for evaluating the quality and improving the reporting of diagnostic studies, respectively. However, it is unclear whether these tools have been applied to diagnostic studies of infectious diseases. We performed a systematic review on the methodological and reporting quality of diagnostic studies in TB, malaria and HIV. We identified diagnostic accuracy studies of commercial tests for TB, malaria and HIV through a systematic search of the literature using PubMed and EMBASE (2004-2006). Original studies that reported sensitivity and specificity data were included. Two reviewers independently extracted data on study characteristics and diagnostic accuracy, and used QUADAS and STARD to evaluate the quality of methods and reporting, respectively. Ninety (38%) of 238 articles met inclusion criteria. All studies had design deficiencies. Study quality indicators that were met in less than 25% of the studies included adequate description of withdrawals (6%) and reference test execution (10%), absence of index test review bias (19%) and reference test review bias (24%), and report of uninterpretable results (22%). In terms of quality of reporting, 9 STARD indicators were reported in less than 25% of the studies: methods for calculation and estimates of reproducibility (0%), adverse effects of the diagnostic tests (1%), estimates of diagnostic accuracy between subgroups (10%), distribution of severity of disease/other diagnoses (11%), number of eligible patients who did not participate in the study (14%), blinding of the test readers (16%), and description of the team executing the test and management of indeterminate/outlier results (both 17%). The use of STARD was not explicitly mentioned in any study. Only 22% of 46 journals that published the studies included in this review required authors to use STARD. Recently published diagnostic accuracy studies on commercial tests for TB, malaria and HIV have moderate to low quality and are poorly reported. The more frequent use of tools such as QUADAS and STARD may be necessary to improve the methodological and reporting quality of future diagnostic accuracy studies in infectious diseases.

Quality and Reporting of Diagnostic Accuracy Studies in TB, HIV and Malaria: Evaluation Using QUADAS and STARD Standards

PubMed Central

Fontela, Patricia Scolari; Pant Pai, Nitika; Schiller, Ian; Dendukuri, Nandini; Ramsay, Andrew; Pai, Madhukar

2009-01-01

Background Poor methodological quality and reporting are known concerns with diagnostic accuracy studies. In 2003, the QUADAS tool and the STARD standards were published for evaluating the quality and improving the reporting of diagnostic studies, respectively. However, it is unclear whether these tools have been applied to diagnostic studies of infectious diseases. We performed a systematic review on the methodological and reporting quality of diagnostic studies in TB, malaria and HIV. Methods We identified diagnostic accuracy studies of commercial tests for TB, malaria and HIV through a systematic search of the literature using PubMed and EMBASE (2004–2006). Original studies that reported sensitivity and specificity data were included. Two reviewers independently extracted data on study characteristics and diagnostic accuracy, and used QUADAS and STARD to evaluate the quality of methods and reporting, respectively. Findings Ninety (38%) of 238 articles met inclusion criteria. All studies had design deficiencies. Study quality indicators that were met in less than 25% of the studies included adequate description of withdrawals (6%) and reference test execution (10%), absence of index test review bias (19%) and reference test review bias (24%), and report of uninterpretable results (22%). In terms of quality of reporting, 9 STARD indicators were reported in less than 25% of the studies: methods for calculation and estimates of reproducibility (0%), adverse effects of the diagnostic tests (1%), estimates of diagnostic accuracy between subgroups (10%), distribution of severity of disease/other diagnoses (11%), number of eligible patients who did not participate in the study (14%), blinding of the test readers (16%), and description of the team executing the test and management of indeterminate/outlier results (both 17%). The use of STARD was not explicitly mentioned in any study. Only 22% of 46 journals that published the studies included in this review required authors to use STARD. Conclusion Recently published diagnostic accuracy studies on commercial tests for TB, malaria and HIV have moderate to low quality and are poorly reported. The more frequent use of tools such as QUADAS and STARD may be necessary to improve the methodological and reporting quality of future diagnostic accuracy studies in infectious diseases. PMID:19915664

Online Formative Assessments as Valid Correlates of Foreign Language Proficiency Levels as Measured by IL/DLPT5 Summative Tests

ERIC Educational Resources Information Center

Castro-Peet, Alma Sandra

2017-01-01

Purpose: This study explored a technological contribution to education made by the Defense Language Institute Foreign Language Center (DLIFLC) in the formative assessment field. The purpose of this quantitative correlational study was to identify the relationship between online formative (Online Diagnostic Assessment; ODA) and summative (Defense…

SDSS-IV MaNGA: identification of active galactic nuclei in optical integral field unit surveys

NASA Astrophysics Data System (ADS)

Wylezalek, Dominika; Zakamska, Nadia L.; Greene, Jenny E.; Riffel, Rogemar A.; Drory, Niv; Andrews, Brett H.; Merloni, Andrea; Thomas, Daniel

2018-02-01

In this paper, we investigate 2727 galaxies observed by MaNGA as of 2016 June to develop spatially resolved techniques for identifying signatures of active galactic nuclei (AGNs). We identify 303 AGN candidates. The additional spatial dimension imposes challenges in identifying AGNs due to contamination from diffuse ionized gas, extraplanar gas and photoionization by hot stars. We show that the combination of spatially resolved line diagnostic diagrams and additional cuts on H α surface brightness and H α equivalent width can distinguish between AGN-like signatures and high-metallicity galaxies with low-ionization nuclear emission-line regions-like spectra. Low-mass galaxies with high specific star formation rates are particularly difficult to diagnose and routinely show diagnostic line ratios outside of the standard star formation locus. We develop a new diagnostic - the distance from the standard diagnostic line in the line-ratio space - to evaluate the significance of the deviation from the star formation locus. We find 173 galaxies that would not have been selected as AGN candidates based on single-fibre spectral measurements but exhibit photoionization signatures suggestive of AGN activity in the Mapping Nearby Galaxies at APO resolved observations, underscoring the power of large integral field unit surveys. A complete census of these new AGN candidates is necessary to understand their nature and probe the complex co-evolution of supermassive black holes and their hosts.

Graphical introduction to chromospheric line formation

NASA Astrophysics Data System (ADS)

Rutten, Rob

2012-03-01

The basics of chromospheric line formation theory were laid out in the 1960s and 1970s by e.g., Thomas, Avrett, Hummer, Jefferies, Mihalas, Shine, Milkey. Since then there has been a long silence, without much progress in understanding the chromosphere or its diagnostics. At present, the situation changes thanks to better ground-based observing, space-based monitoring, and increasingly realistic numerical simulations. There is a now a strong need to revamp classical one-dimensional static modeling as basis for chromospheric line interpretation into 3D dynamic understanding of the major diagnostics, including IRIS's Mg II h&k. In this introduction I aim to explain the old wisdom in tutorial fashion, using cartoons and graphs as means towards an intuitive grasp of fads and fallacies of chromospheric line formation.

Pump-probe studies of radiation induced defects and formation of warm dense matter with pulsed ion beams

NASA Astrophysics Data System (ADS)

Schenkel, T.; Persaud, A.; Gua, H.; Seidl, P. A.; Waldron, W. L.; Gilson, E. P.; Kaganovich, I. D.; Davidson, R. C.; Friedman, A.; Barnard, J. J.; Minior, A. M.

2014-10-01

We report results from the 2nd generation Neutralized Drift Compression Experiment at Berkeley Lab. NDCX-II is a pulsed, linear induction accelerator designed to drive thin foils to warm dense matter (WDM) states with peak temperatures of ~ 1 eV using intense, short pulses of 1.2 MeV lithium ions. Tunability of the ion beam enables pump-probe studies of radiation effects in solids as a function of excitation density, from isolated collision cascades to the onset of phase-transitions and WDM. Ion channeling is an in situ diagnostic of damage evolution during ion pulses with a sensitivity of <0.1% displacements per atom. We will report results from damage evolution studies in thin silicon crystals with Li + and K + beams. Detection of channeled ions tracks lattice disorder evolution with a resolution of ~ 1 ns using fast current measurements. We will discuss pump-probe experiments with pulsed ion beams and the development of diagnostics for WDM and multi-scale (ms to fs) access to the materials physics of collision cascades e.g. in fusion reactor materials. Work performed under auspices of the US DOE under Contract No. DE-AC02-05CH11231.

Comparison of MPEG digital video with super VHS tape for diagnostic echocardiographic readings

NASA Technical Reports Server (NTRS)

Soble, J. S.; Yurow, G.; Brar, R.; Stamos, T.; Neumann, A.; Garcia, M.; Stoddard, M. F.; Cherian, P. K.; Bhamb, B.; Thomas, J. D.

1998-01-01

BACKGROUND: Digital recording of echocardiographic studies is on the clinical horizon. However, full digital capture of complete echocardiographic studies in traditional video format is impractical, given current storage capacity and network bandwidth. To overcome these constraints, we evaluated the diagnostic image quality of digital video by using MPEG (Motion Picture Experts Group) compression. METHODS AND RESULTS: Fifty-eight complete, consecutive studies were recorded simultaneously with the use of MPEG-1 and sVHS videotape. Each matched MPEG and sVHS study pair was reviewed by two from a total of six readers, and findings were recorded with the use of a detailed, computerized reporting tool. Intrareader and interreader discrepancies were characterized as major or minor and analyzed in total and for specific subgroups of findings (left and right ventricular parameters, valvular insufficiency, and left ventricular regional wall motion). Intrareader discrepancies were reviewed by a consensus panel for agreement with either MPEG or sVHS findings. There was an exact concordance between MPEG and sVHS readings in 83% of findings. The majority of discrepancies were minor, with major discrepancies in only 2.7% of findings. There was no difference in the rate of consensus panel agreement with MPEG or sVHS for instances of intrareader discrepancy, either in total or for any subgroup of findings. Interreader discrepancy rates were nearly identical for both MPEG and sVHS. CONCLUSIONS: MPEG-1 digital video is equivalent to sVHS videotape for diagnostic echocardiography. MPEG increases the range of practical options for digital echocardiography and offers, for the first time, the advantages of digital recording in a familiar video format.

Emerging technologies for diagnosis of dental caries: The road so far

NASA Astrophysics Data System (ADS)

Amaechi, Bennett T.

2009-05-01

It is now universally recognized that the development of new technologies for early detection and quantitative monitoring of dental decay at an early stage of formation could provide health and economic benefits ranging from timely preventive interventions to reduction in the time required for clinical trials of anticaries agents. The use of technologies as adjunct to clinical visual examination for caries diagnosis will facilitate preventive care in dentistry to lower treatment cost as well as reduce the cost and time for testing potential anticaries agents. This article describes the various technologies available to aid the dental practitioners in detecting dental caries at the earliest stage of its formation, assessing the activities of the detected carious lesion, and quantitatively or qualitatively monitoring of the lesion over time. The need and the importance of these technologies were also discussed. The data discussed are primarily based on published scientific studies and reviews from case reports, clinical trials, and in vitro and in vivo studies. References have been traced manually by MEDLINE® or through manufacturer's websites. While some of the devices are fully developed and commercially available, others are still under development. The devices vary in their modes of action as well as their capability as caries diagnostic aids. It is clear that the differences in caries presentations and behavior in different anatomical sites make it unlikely that any one diagnostic modality will have adequate sensitivity and specificity of detection of carious lesions for all sites; a combination of diagnostic tools will help us diagnose lesions earlier and detect failing restorations sooner, all to avoid more costly, destructive dental procedures and truly take dentistry into the preventive rather than the reactive mode.

STARD 2015 guidelines for reporting diagnostic accuracy studies: explanation and elaboration

PubMed Central

Cohen, Jérémie F; Korevaar, Daniël A; Altman, Douglas G; Bruns, David E; Gatsonis, Constantine A; Hooft, Lotty; Irwig, Les; Levine, Deborah; Reitsma, Johannes B; de Vet, Henrica C W; Bossuyt, Patrick M M

2016-01-01

Diagnostic accuracy studies are, like other clinical studies, at risk of bias due to shortcomings in design and conduct, and the results of a diagnostic accuracy study may not apply to other patient groups and settings. Readers of study reports need to be informed about study design and conduct, in sufficient detail to judge the trustworthiness and applicability of the study findings. The STARD statement (Standards for Reporting of Diagnostic Accuracy Studies) was developed to improve the completeness and transparency of reports of diagnostic accuracy studies. STARD contains a list of essential items that can be used as a checklist, by authors, reviewers and other readers, to ensure that a report of a diagnostic accuracy study contains the necessary information. STARD was recently updated. All updated STARD materials, including the checklist, are available at http://www.equator-network.org/reporting-guidelines/stard. Here, we present the STARD 2015 explanation and elaboration document. Through commented examples of appropriate reporting, we clarify the rationale for each of the 30 items on the STARD 2015 checklist, and describe what is expected from authors in developing sufficiently informative study reports. PMID:28137831

NanoCluster Beacons as reporter probes in rolling circle enhanced enzyme activity detection

NASA Astrophysics Data System (ADS)

Juul, Sissel; Obliosca, Judy M.; Liu, Cong; Liu, Yen-Liang; Chen, Yu-An; Imphean, Darren M.; Knudsen, Birgitta R.; Ho, Yi-Ping; Leong, Kam W.; Yeh, Hsin-Chih

2015-04-01

As a newly developed assay for the detection of endogenous enzyme activity at the single-catalytic-event level, Rolling Circle Enhanced Enzyme Activity Detection (REEAD) has been used to measure enzyme activity in both single human cells and malaria-causing parasites, Plasmodium sp. Current REEAD assays rely on organic dye-tagged linear DNA probes to report the rolling circle amplification products (RCPs), the cost of which may hinder the widespread use of REEAD. Here we show that a new class of activatable probes, NanoCluster Beacons (NCBs), can simplify the REEAD assays. Easily prepared without any need for purification and capable of large fluorescence enhancement upon hybridization, NCBs are cost-effective and sensitive. Compared to conventional fluorescent probes, NCBs are also more photostable. As demonstrated in reporting the human topoisomerases I (hTopI) cleavage-ligation reaction, the proposed NCBs suggest a read-out format attractive for future REEAD-based diagnostics.As a newly developed assay for the detection of endogenous enzyme activity at the single-catalytic-event level, Rolling Circle Enhanced Enzyme Activity Detection (REEAD) has been used to measure enzyme activity in both single human cells and malaria-causing parasites, Plasmodium sp. Current REEAD assays rely on organic dye-tagged linear DNA probes to report the rolling circle amplification products (RCPs), the cost of which may hinder the widespread use of REEAD. Here we show that a new class of activatable probes, NanoCluster Beacons (NCBs), can simplify the REEAD assays. Easily prepared without any need for purification and capable of large fluorescence enhancement upon hybridization, NCBs are cost-effective and sensitive. Compared to conventional fluorescent probes, NCBs are also more photostable. As demonstrated in reporting the human topoisomerases I (hTopI) cleavage-ligation reaction, the proposed NCBs suggest a read-out format attractive for future REEAD-based diagnostics. Electronic supplementary information (ESI) available: The detailed steps of NCB preparation, REEAD assay and STEM imaging. The sequences of the sNCB and the REEAD substrate. See DOI: 10.1039/c5nr01705j

Systematic reviews of diagnostic tests in endocrinology: an audit of methods, reporting, and performance.

PubMed

Spencer-Bonilla, Gabriela; Singh Ospina, Naykky; Rodriguez-Gutierrez, Rene; Brito, Juan P; Iñiguez-Ariza, Nicole; Tamhane, Shrikant; Erwin, Patricia J; Murad, M Hassan; Montori, Victor M

2017-07-01

Systematic reviews provide clinicians and policymakers estimates of diagnostic test accuracy and their usefulness in clinical practice. We identified all available systematic reviews of diagnosis in endocrinology, summarized the diagnostic accuracy of the tests included, and assessed the credibility and clinical usefulness of the methods and reporting. We searched Ovid MEDLINE, EMBASE, and Cochrane CENTRAL from inception to December 2015 for systematic reviews and meta-analyses reporting accuracy measures of diagnostic tests in endocrinology. Experienced reviewers independently screened for eligible studies and collected data. We summarized the results, methods, and reporting of the reviews. We performed subgroup analyses to categorize diagnostic tests as most useful based on their accuracy. We identified 84 systematic reviews; half of the tests included were classified as helpful when positive, one-fourth as helpful when negative. Most authors adequately reported how studies were identified and selected and how their trustworthiness (risk of bias) was judged. Only one in three reviews, however, reported an overall judgment about trustworthiness and one in five reported using adequate meta-analytic methods. One in four reported contacting authors for further information and about half included only patients with diagnostic uncertainty. Up to half of the diagnostic endocrine tests in which the likelihood ratio was calculated or provided are likely to be helpful in practice when positive as are one-quarter when negative. Most diagnostic systematic reviews in endocrine lack methodological rigor, protection against bias, and offer limited credibility. Substantial efforts, therefore, seem necessary to improve the quality of diagnostic systematic reviews in endocrinology.

Alchemy: A Web 2.0 Real-time Quality Assurance Platform for Human Immunodeficiency Virus, Hepatitis C Virus, and BK Virus Quantitation Assays

PubMed Central

Agosto-Arroyo, Emmanuel; Coshatt, Gina M.; Winokur, Thomas S.; Harada, Shuko; Park, Seung L.

2017-01-01

Background: The molecular diagnostics laboratory faces the challenge of improving test turnaround time (TAT). Low and consistent TATs are of great clinical and regulatory importance, especially for molecular virology tests. Laboratory information systems (LISs) contain all the data elements necessary to do accurate quality assurance (QA) reporting of TAT and other measures, but these reports are in most cases still performed manually: a time-consuming and error-prone task. The aim of this study was to develop a web-based real-time QA platform that would automate QA reporting in the molecular diagnostics laboratory at our institution, and minimize the time expended in preparing these reports. Methods: Using a standard Linux, Nginx, MariaDB, PHP stack virtual machine running atop a Dell Precision 5810, we designed and built a web-based QA platform, code-named Alchemy. Data files pulled periodically from the LIS in comma-separated value format were used to autogenerate QA reports for the human immunodeficiency virus (HIV) quantitation, hepatitis C virus (HCV) quantitation, and BK virus (BKV) quantitation. Alchemy allowed the user to select a specific timeframe to be analyzed and calculated key QA statistics in real-time, including the average TAT in days, tests falling outside the expected TAT ranges, and test result ranges. Results: Before implementing Alchemy, reporting QA for the HIV, HCV, and BKV quantitation assays took 45–60 min of personnel time per test every month. With Alchemy, that time has decreased to 15 min total per month. Alchemy allowed the user to select specific periods of time and analyzed the TAT data in-depth without the need of extensive manual calculations. Conclusions: Alchemy has significantly decreased the time and the human error associated with QA report generation in our molecular diagnostics laboratory. Other tests will be added to this web-based platform in future updates. This effort shows the utility of informatician-supervised resident/fellow programming projects as learning opportunities and workflow improvements in the molecular laboratory. PMID:28480121

Adherence to Standards for Reporting Diagnostic Accuracy in Emergency Medicine Research.

PubMed

Gallo, Lucas; Hua, Nadia; Mercuri, Mathew; Silveira, Angela; Worster, Andrew

2017-08-01

Diagnostic tests are used frequently in the emergency department (ED) to guide clinical decision making and, hence, influence clinical outcomes. The Standards for Reporting of Diagnostic Accuracy (STARD) criteria were developed to ensure that diagnostic test studies are performed and reported to best inform clinical decision making in the ED. The objective was to determine the extent to which diagnostic studies published in emergency medicine journals adhered to STARD 2003 criteria. Diagnostic studies published in eight MEDLINE-listed, peer-reviewed, emergency medicine journals over a 5-year period were reviewed for compliance to STARD criteria. A total of 12,649 articles were screened and 114 studies were included in our study. Twenty percent of these were randomly selected for assessment using STARD 2003 criteria. Adherence to STARD 2003 reporting standards for each criteria ranged from 8.7% adherence (criteria-reporting adverse events from performing index test or reference standard) to 100% (multiple criteria). Just over half of STARD criteria are reported in more than 80% studies. As poorly reported studies may negatively impact their clinical usefulness, it is essential that studies of diagnostic test accuracy be performed and reported adequately. Future studies should assess whether studies have improved compliance with the STARD 2015 criteria amendment. © 2017 by the Society for Academic Emergency Medicine.

78 FR 20103 - Radiation Protection Guidance for Diagnostic and Interventional X-Ray Procedures

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-03

... for Diagnostic and Interventional X-Ray Procedures AGENCY: Environmental Protection Agency (EPA... for Diagnostic and Interventional X-Ray Procedures. This document is Federal Guidance Report No. 14. It replaces Federal Guidance Report No. 9, ``Radiation Protection Guidance for Diagnostic X-rays...

How Question Types Reveal Student Thinking: An Experimental Comparison of Multiple-True-False and Free-Response Formats

PubMed Central

Hubbard, Joanna K.; Potts, Macy A.; Couch, Brian A.

2017-01-01

Assessments represent an important component of undergraduate courses because they affect how students interact with course content and gauge student achievement of course objectives. To make decisions on assessment design, instructors must understand the affordances and limitations of available question formats. Here, we use a crossover experimental design to identify differences in how multiple-true-false (MTF) and free-response (FR) exam questions reveal student thinking regarding specific conceptions. We report that correct response rates correlate across the two formats but that a higher percentage of students provide correct responses for MTF questions. We find that MTF questions reveal a high prevalence of students with mixed (correct and incorrect) conceptions, while FR questions reveal a high prevalence of students with partial (correct and unclear) conceptions. These results suggest that MTF question prompts can direct students to address specific conceptions but obscure nuances in student thinking and may overestimate the frequency of particular conceptions. Conversely, FR questions provide a more authentic portrait of student thinking but may face limitations in their ability to diagnose specific, particularly incorrect, conceptions. We further discuss an intrinsic tension between question structure and diagnostic capacity and how instructors might use multiple formats or hybrid formats to overcome these obstacles. PMID:28450446

Effects of Progress Monitoring Feedback on Early Literacy Student Achievement

ERIC Educational Resources Information Center

Lopuch, Jeremy Jon

2016-01-01

The purpose of this study was to examine the effects of diagnostic formative assessment feedback on early literacy skills. The participants were 12 first-grade general education teachers and 51 of their students who were assigned to the following treatments, diagnostic feedback and skills feedback (control) which lasted for 10 weeks. During the…

40 CFR 86.1806-04 - On-board diagnostics.

Code of Federal Regulations, 2013 CFR

2013-07-01

... codes shall be consistent with SAE J2012 “Diagnostic Trouble Code Definitions—Equivalent to ISO/DIS... sent to the scan tool over a J1850 data link shall use the Cyclic Redundancy Check and the three byte..., definitions and abbreviations shall be formatted according to SAE J1930 “Electrical/Electronic Systems...

40 CFR 86.1806-04 - On-board diagnostics.

Code of Federal Regulations, 2012 CFR

2012-07-01

... codes shall be consistent with SAE J2012 “Diagnostic Trouble Code Definitions—Equivalent to ISO/DIS... sent to the scan tool over a J1850 data link shall use the Cyclic Redundancy Check and the three byte..., definitions and abbreviations shall be formatted according to SAE J1930 “Electrical/Electronic Systems...

40 CFR 86.1806-04 - On-board diagnostics.

Code of Federal Regulations, 2011 CFR

2011-07-01

... codes shall be consistent with SAE J2012 “Diagnostic Trouble Code Definitions—Equivalent to ISO/DIS... sent to the scan tool over a J1850 data link shall use the Cyclic Redundancy Check and the three byte..., definitions and abbreviations shall be formatted according to SAE J1930 “Electrical/Electronic Systems...

Can electronic medical images replace hard-copy film? Defining and testing the equivalence of diagnostic tests.

PubMed

Obuchowski, N A

2001-10-15

Electronic medical images are an efficient and convenient format in which to display, store and transmit radiographic information. Before electronic images can be used routinely to screen and diagnose patients, however, it must be shown that readers have the same diagnostic performance with this new format as traditional hard-copy film. Currently, there exist no suitable definitions of diagnostic equivalence. In this paper we propose two criteria for diagnostic equivalence. The first criterion ('population equivalence') considers the variability between and within readers, as well as the mean reader performance. This criterion is useful for most applications. The second criterion ('individual equivalence') involves a comparison of the test results for individual patients and is necessary when patients are followed radiographically over time. We present methods for testing both individual and population equivalence. The properties of the proposed methods are assessed in a Monte Carlo simulation study. Data from a mammography screening study is used to illustrate the proposed methods and compare them with results from more conventional methods of assessing equivalence and inter-procedure agreement. Copyright 2001 John Wiley & Sons, Ltd.

Rare hatchling specimens of Araripemys Price, 1973 (Testudines, Pelomedusoides, Araripemydidae) from the Crato Formation, Araripe Basin

NASA Astrophysics Data System (ADS)

Oliveira, Gustavo R.; Kellner, Alexander W. A.

2017-11-01

Hatchling turtles are rare in the fossil record. Here we report two incomplete juvenile specimens of the genus Araripemys from the Aptian (ca. 115 Ma) Crato Formation (Araripe Basin, Brazil). Although the description of this material does not completely elucidate the ontogeny of this taxon, the analysis of these specimens yield relevant information about diagnostic features of the genus, showing their presence in hatchling such as: skull with nearly oval shape in dorsal view; closely spaced orbits; cervical vertebrae with long vertebral body indicating the presence of a long neck; the extension and the angle of curvature of the axillary (obtuse angle); and unguals arrow-shaped. The small size of the specimens (40-50 mm) and their poor degree of ossification including unfused costal bones indicate that both represent hatchling individuals. The paleoenvironment of the Crato Formation was similar to mangroves, which is corroborated by the presence of juvenile turtles and fishes, anurans and insects. Araripemys barretoi was also recorded in the Romualdo Formation, which represents a lagoon. The fact that this turtle is found in these quite distinct paleoenvironments suggests that this species could be tolerant to distinct salinities levels.

Evidence and diagnostic reporting in the IHE context.

PubMed

Loef, Cor; Truyen, Roel

2005-05-01

Capturing clinical observations and findings during the diagnostic imaging process is increasingly becoming a critical step in diagnostic reporting. Standards developers-notably HL7 and DICOM-are making significant progress toward standards that enable exchanging clinical observations and findings among the various information systems of the healthcare enterprise. DICOM-like the HL7 Clinical Document Architecture (CDA) -uses templates and constrained, coded vocabulary (SNOMED, LOINC, etc.). Such a representation facilitates automated software recognition of findings and observations, intrapatient comparison, correlation to norms, and outcomes research. The scope of DICOM Structured Reporting (SR) includes many findings that products routinely create in digital form (measurements, computed estimates, etc.). In the Integrating the Healthcare Enterprise (IHE) framework, two Integration Profiles are defined for clinical data capture and diagnostic reporting: Evidence Document, and Simple Image and Numeric Report. This report describes these two DICOM SR-based integration profiles in the diagnostic reporting process.

The next organizational challenge: finding and addressing diagnostic error.

PubMed

Graber, Mark L; Trowbridge, Robert; Myers, Jennifer S; Umscheid, Craig A; Strull, William; Kanter, Michael H

2014-03-01

Although health care organizations (HCOs) are intensely focused on improving the safety of health care, efforts to date have almost exclusively targeted treatment-related issues. The literature confirms that the approaches HCOs use to identify adverse medical events are not effective in finding diagnostic errors, so the initial challenge is to identify cases of diagnostic error. WHY HEALTH CARE ORGANIZATIONS NEED TO GET INVOLVED: HCOs are preoccupied with many quality- and safety-related operational and clinical issues, including performance measures. The case for paying attention to diagnostic errors, however, is based on the following four points: (1) diagnostic errors are common and harmful, (2) high-quality health care requires high-quality diagnosis, (3) diagnostic errors are costly, and (4) HCOs are well positioned to lead the way in reducing diagnostic error. FINDING DIAGNOSTIC ERRORS: Current approaches to identifying diagnostic errors, such as occurrence screens, incident reports, autopsy, and peer review, were not designed to detect diagnostic issues (or problems of omission in general) and/or rely on voluntary reporting. The realization that the existing tools are inadequate has spurred efforts to identify novel tools that could be used to discover diagnostic errors or breakdowns in the diagnostic process that are associated with errors. New approaches--Maine Medical Center's case-finding of diagnostic errors by facilitating direct reports from physicians and Kaiser Permanente's electronic health record--based reports that detect process breakdowns in the followup of abnormal findings--are described in case studies. By raising awareness and implementing targeted programs that address diagnostic error, HCOs may begin to play an important role in addressing the problem of diagnostic error.

Diagnostics and structure

NASA Technical Reports Server (NTRS)

Vial, J. C.

1986-01-01

The structure of prominences and the diagnostic techniques used to evaluate their physical parameters are discussed. These include electron temperature, various densities (n sub p, n sub e, n sub l), ionization degree, velocities, and magnetic field vector. UV and radio measurements have already evidenced the existence of different temperature regions, corresponding to different geometrical locations, e.g., the so called Prominence-Corona (P-C) interface. Velocity measurements are important for considering formation and mass balance of prominences but there are conflicting velocity measurements which have led to the basic question: what structure is actually observed at a given wavelength; what averaging is performed within the projected slit area during the exposure time? In optically thick lines, the question of the formation region of the radiation along the line of sight is also not a trivial one. The same is true for low resolution measurements of the magnetic field. Coupling diagnostics with structure is now a general preoccupation.

Broadband observations of the naked-eye gamma-ray burst GRB 080319B.

PubMed

Racusin, J L; Karpov, S V; Sokolowski, M; Granot, J; Wu, X F; Pal'shin, V; Covino, S; van der Horst, A J; Oates, S R; Schady, P; Smith, R J; Cummings, J; Starling, R L C; Piotrowski, L W; Zhang, B; Evans, P A; Holland, S T; Malek, K; Page, M T; Vetere, L; Margutti, R; Guidorzi, C; Kamble, A P; Curran, P A; Beardmore, A; Kouveliotou, C; Mankiewicz, L; Melandri, A; O'Brien, P T; Page, K L; Piran, T; Tanvir, N R; Wrochna, G; Aptekar, R L; Barthelmy, S; Bartolini, C; Beskin, G M; Bondar, S; Bremer, M; Campana, S; Castro-Tirado, A; Cucchiara, A; Cwiok, M; D'Avanzo, P; D'Elia, V; Valle, M Della; de Ugarte Postigo, A; Dominik, W; Falcone, A; Fiore, F; Fox, D B; Frederiks, D D; Fruchter, A S; Fugazza, D; Garrett, M A; Gehrels, N; Golenetskii, S; Gomboc, A; Gorosabel, J; Greco, G; Guarnieri, A; Immler, S; Jelinek, M; Kasprowicz, G; La Parola, V; Levan, A J; Mangano, V; Mazets, E P; Molinari, E; Moretti, A; Nawrocki, K; Oleynik, P P; Osborne, J P; Pagani, C; Pandey, S B; Paragi, Z; Perri, M; Piccioni, A; Ramirez-Ruiz, E; Roming, P W A; Steele, I A; Strom, R G; Testa, V; Tosti, G; Ulanov, M V; Wiersema, K; Wijers, R A M J; Winters, J M; Zarnecki, A F; Zerbi, F; Mészáros, P; Chincarini, G; Burrows, D N

2008-09-11

Long-duration gamma-ray bursts (GRBs) release copious amounts of energy across the entire electromagnetic spectrum, and so provide a window into the process of black hole formation from the collapse of massive stars. Previous early optical observations of even the most exceptional GRBs (990123 and 030329) lacked both the temporal resolution to probe the optical flash in detail and the accuracy needed to trace the transition from the prompt emission within the outflow to external shocks caused by interaction with the progenitor environment. Here we report observations of the extraordinarily bright prompt optical and gamma-ray emission of GRB 080319B that provide diagnostics within seconds of its formation, followed by broadband observations of the afterglow decay that continued for weeks. We show that the prompt emission stems from a single physical region, implying an extremely relativistic outflow that propagates within the narrow inner core of a two-component jet.

Three-dimensional portable document format: a simple way to present 3-dimensional data in an electronic publication.

PubMed

Danz, Jan C; Katsaros, Christos

2011-08-01

Three-dimensional (3D) models of teeth and soft and hard tissues are tessellated surfaces used for diagnosis, treatment planning, appliance fabrication, outcome evaluation, and research. In scientific publications or communications with colleagues, these 3D data are often reduced to 2-dimensional pictures or need special software for visualization. The portable document format (PDF) offers a simple way to interactively display 3D surface data without additional software other than a recent version of Adobe Reader (Adobe, San Jose, Calif). The purposes of this article were to give an example of how 3D data and their analyses can be interactively displayed in 3 dimensions in electronic publications, and to show how they can be exported from any software for diagnostic reports and communications among colleagues. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Severe splenic rupture after colorectal endoscopic submucosal dissection

PubMed Central

Herreros de Tejada, Alberto; Giménez-Alvira, Luis; Van den Brule, Enrique; Sánchez-Yuste, Rosario; Matallanos, Pilar; Blázquez, Esther; Calleja, Jose L; Abreu, Luis E

2014-01-01

Splenic rupture (SR) after colonoscopy is a very rare but potentially serious complication. Delayed diagnosis is common, and may increase morbidity and mortality associated. There is no clear relation between SR and difficult diagnostic or therapeutic procedures, but it has been suggested that loop formation and excessive torquing might be risk factors. This is a case of a 65-year-old woman who underwent endoscopic submucosal dissection (ESD) for lateral spreading tumor in the descending colon, and 36 h afterwards presented symptoms and signs of severe hypotension due to SR. Standard splenectomy was completed and the patient recovered uneventfully. Colorectal ESD is usually a long and position-demanding technique, implying torquing and loop formation. To our knowledge this is the first case of SR after colorectal ESD reported in the literature. Endoscopists performing colorectal ESD in the left colon must be aware of this potential complication. PMID:25071360

Enhancement of lateral flow assay performance by electromagnetic relocation of reporter particles

PubMed Central

Jacinto, Maria João; Trabuco, João R. C.; Vu, Binh V.; Garvey, Gavin; Khodadady, Mohammad; Azevedo, Ana M.; Aires-Barros, Maria Raquel; Chang, Long; Kourentzi, Katerina; Litvinov, Dmitri

2018-01-01

Lateral flow assays (LFAs) are a widely-used point-of care diagnostic format, but suffer from limited analytical sensitivity, especially when read by eye. It has recently been reported that LFA performance can be improved by using magnetic reporter particles and an external magnetic field applied at the test line. The mechanism of sensitivity/performance enhancement was suggested to be concentration/retardation of reporter particles at the test line. Here we demonstrate an additional mechanism of particle relocation where reporter particles from the lower depths of the translucent LFA strip relocate to more-visible locations nearer to the top surface, producing a more visible signal. With a magnetic field we observed an improvement in sensitivity of human chorionic gonadotropin (hCG) detection from 1.25 ng/mL to 0.31 ng/mL. We also observed an increase of the color intensity per particle in test lines when the magnetic field was present. PMID:29309424

Jack Rabbit Pretest 2021E PT3 Photonic Doppler Velocimetry Data Volume 3 Section 1

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

Hart, M M; Strand, O T; Bosson, S T

The Jack Rabbit Pretest (PT) 2021E PT3 was fired on March 12, 2008 at the Contained Firing Facility, Site 300, Lawrence Livermore National Laboratory. This experiment is part of an effort to determine the properties of LX-17 in a regime where corner-turning behavior and dead-zone formation are not well understood. Photonic Doppler Velocimetry (PDV) measured diagnostic plate velocities confirming the presence of a persistent LX-17 dead-zone formation and the resultant impulse gradient applied under the diagnostic plate. The Jack Rabbit Pretest 2021E PT3, 120 millimeter diameter experiment returned data on all eight PDV probes. The probes measured on the centralmore » axis and at 10, 20, 25, 30, 35, 40, 50 millimeters from the central axis. The experiment was shot at an ambient room temperature of 65 degrees Fahrenheit. The earliest PDV signal extinction was 41.7 microseconds at 30 millimeters. The latest PDV signal extinction time was 65.0 microseconds at 10 millimeters. The measured velocity ranged from meters per second to thousands of meters per second. First detonation wave induced jump-off was measured at 40 millimeters at 10.9 microseconds. The PDV data provided an unambiguous indication of dead-zone formation and an impulse gradient applied to the diagnostic plate. The central axis had a last measured velocity of 1636 meters per second. At 40 millimeters the last measured velocity was 2056 meters per second. The low-to-high velocity ratio was 0.80. Velocity data was integrated to compute diagnostic plate cross section profiles. Velocity data was differentiated to compute a peak pressure under the diagnostic plate at the central axis of 64.6 kilobars at 15.7 microseconds. Substantial motion (>1 m/s) of the diagnostic plate over the dead-zone is followed by detonation region motion within approximately 2.2 microseconds.« less

Jack Rabbit Pretest 2021E PT4 Photonic Doppler Velocimetry Data Volume 4 Section 1

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

Hart, M M; Strand, O T; Bosson, S T

The Jack Rabbit Pretest (PT) 2021E PT4 was fired on March 19, 2008 at the Contained Firing Facility, Site 300, Lawrence Livermore National Laboratory. This experiment is part of an effort to determine the properties of LX-17 in a regime where corner-turning behavior and dead-zone formation are not well understood. Photonic Doppler Velocimetry (PDV) measured diagnostic plate velocities confirming the presence of a persistent LX-17 dead-zone formation and the resultant impulse gradient applied under the diagnostic plate. The Jack Rabbit Pretest 2021E PT4, 120 millimeter diameter experiment returned data on all eight PDV probes. The probes measured on the centralmore » axis and at 10, 20, 25, 30, 35, 40, 50 millimeters from the central axis. The experiment was shot at an ambient room temperature of 64 degrees Fahrenheit. The earliest PDV signal extinction was 44.9 microseconds at 30 millimeters. The latest PDV signal extinction time was 69.5 microseconds at 10 millimeters. The measured velocity ranged from meters per second to thousands of meters per second. First detonation wave induced jump-off was measured at 50 millimeters at 13.3 microseconds. The PDV data provided an unambiguous indication of dead-zone formation and an impulse gradient applied to the diagnostic plate. The central axis had a last measured velocity of 1558 meters per second. At 40 millimeters the last measured velocity was 2019 meters per second. The low-to-high velocity ratio was 0.77. Velocity data was integrated to compute diagnostic plate cross section profiles. Velocity data was differentiated to compute a peak pressure under the diagnostic plate at the central axis of 98.6 kilobars at 15.0 microseconds. Substantial motion (>1 m/s) of the diagnostic plate over the dead-zone is followed by detonation region motion within approximately 0.7 microseconds.« less

Jack Rabbit Pretest 2021E PT6 Photonic Doppler Velocimetry Data Volume 6 Section 1

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

Hart, M M; Strand, O T; Bosson, S T

The Jack Rabbit Pretest (PT) 2021E PT6 experiment was fired on April 1, 2008 at the Contained Firing Facility, Site 300, Lawrence Livermore National Laboratory. This experiment is part of an effort to determine the properties of LX-17 in a regime where corner-turning behavior and dead-zone formation are not well understood. Photonic Doppler Velocimetry (PDV) measured diagnostic plate velocities confirming the presence of a persistent LX-17 dead-zone formation and the resultant impulse gradient applied under the diagnostic plate. The Jack Rabbit Pretest 2021E PT6, 160 millimeter diameter experiment returned data on all eight PDV probes. The probes measured on themore » central axis and at 20, 30, 35, 45, 55, 65, 75 millimeters from the central axis. The experiment was shot at an ambient room temperature of 65 degrees Fahrenheit. The earliest PDV signal extinction was 54.2 microseconds at 30 millimeters. The latest PDV signal extinction time was 64.5 microseconds at the central axis. The measured velocity ranged from meters per second to thousands of meters per second. First detonation wave induced jump-off was measured at 55 millimeters at 14.1 microseconds. The PDV data provided an unambiguous indication of dead-zone formation and an impulse gradient applied to the diagnostic plate. The central axis had a last measured velocity of 1860 meters per second. At 55 millimeters the last measured velocity was 2408 meters per second. The low-to-high velocity ratio was 0.77. Velocity data was integrated to compute diagnostic plate cross section profiles. Velocity data was differentiated to compute a peak pressure under the diagnostic plate at the central axis of 227 kilobars at 20.1 microseconds, indicating a late time chemical reaction in the LX-17 dead-zone. Substantial motion (>1 m/s) of the diagnostic plate over the dead-zone is followed by detonation region motion within approximately 1.7 microseconds.« less

Jack Rabbit Pretest 2021E PT5 Photonic Doppler Velocimetry Data Volume 5 Section 1

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

Hart, M M; Strand, O T; Bosson, S T

The Jack Rabbit Pretest (PT) 2021E PT5 was fired on March 17, 2008 at the Contained Firing Facility, Site 300, Lawrence Livermore National Laboratory. This experiment is part of an effort to determine the properties of LX-17 in a regime where corner-turning behavior and dead-zone formation are not well understood. Photonic Doppler Velocimetry (PDV) measured diagnostic plate velocities confirming the presence of a persistent LX-17 dead-zone formation and the resultant impulse gradient applied under the diagnostic plate. The Jack Rabbit Pretest 2021E PT5, 160 millimeter diameter experiment returned data on all eight PDV probes. The probes measured on the centralmore » axis and at 20, 30, 35, 45, 55, 65, 75 millimeters from the central axis. The experiment was shot at an ambient room temperature of 65 degrees Fahrenheit. The earliest PDV signal extinction was 40.0 microseconds at 45 millimeters. The latest PDV signal extinction time was 64.9 microseconds at 20 millimeters. The measured velocity ranged from meters per second to thousands of meters per second. First detonation wave induced jump-off was measured at 55 millimeters at 12.8 microseconds. The PDV data provided an unambiguous indication of dead-zone formation and an impulse gradient applied to the diagnostic plate. The central axis had a last measured velocity of 1877 meters per second. At 65 millimeters the last measured velocity was 2277 meters per second. The low-to-high velocity ratio was 0.82. Velocity data was integrated to compute diagnostic plate cross section profiles. Velocity data was differentiated to compute a peak pressure under the diagnostic plate at the central axis of 78 kilobars at 11.9 and 21.2 microseconds. Substantial motion (>1 m/s) of the diagnostic plate over the dead-zone is followed by detonation region motion within approximately 4.1 microseconds.« less

Jack Rabbit Pretest 2021E PT7 Photonic Doppler Velocimetry Data Volume 7 Section 1

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

Hart, M M; Strand, O T; Bosson, S T

The Jack Rabbit Pretest (PT) 2021E PT7 experiment was fired on April 3, 2008 at the Contained Firing Facility, Site 300, Lawrence Livermore National Laboratory. This experiment is part of an effort to determine the properties of LX-17 in a regime where corner-turning behavior and dead-zone formation are not well understood. Photonic Doppler Velocimetry (PDV) measured diagnostic plate velocities confirming the presence of a persistent LX-17 dead-zone formation and the resultant impulse gradient applied under the diagnostic plate. The Jack Rabbit Pretest 2021E PT7, 160 millimeter diameter experiment returned data on all eight PDV probes. The probes measured on themore » central axis and at 20, 30, 35, 45, 55, 65, 75 millimeters from the central axis. The experiment was shot at an ambient room temperature of 65 degrees Fahrenheit. The PDV earliest signal extinction was 50.7 microseconds at 45 millimeters. The latest PDV signal extinction time was 65.0 microseconds at 20 millimeters. The measured velocity ranged from meters per second to thousands of meters per second. First detonation wave induced jump-off was measured at 55 millimeters and at 15.2 microseconds. The PDV data provided an unambiguous indication of dead-zone formation and an impulse gradient applied to the diagnostic plate. The central axis had a last measured velocity of 1447 meters per second. At 65 millimeters the last measured velocity was 2360 meters per second. The low-to-high velocity ratio was 0.61. Velocity data was integrated to compute diagnostic plate cross section profiles. Velocity data was differentiated to compute a peak pressure under the diagnostic plate at the central axis of 49 kilobars at 23.3 microseconds. Substantial motion (>1 m/s) of the diagnostic plate over the dead-zone is followed by detonation region motion within approximately 4.6 microseconds.« less

The formation of IRIS diagnostics. III. Near-ultraviolet spectra and images

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

Pereira, T. M. D.; Leenaarts, J.; De Pontieu, B.

The Mg II h and k lines are the prime chromospheric diagnostics of NASA's Interface Region Imaging Spectrograph (IRIS). In the previous papers of this series, we used a realistic three-dimensional radiative magnetohydrodynamics model to calculate the h and k lines in detail and investigated how their spectral features relate to the underlying atmosphere. In this work, we employ the same approach to investigate how the h and k diagnostics fare when taking into account the finite resolution of IRIS and different noise levels. In addition, we investigate the diagnostic potential of several other photospheric lines and near-continuum regions presentmore » in the near-ultraviolet (NUV) window of IRIS and study the formation of the NUV slit-jaw images. We find that the instrumental resolution of IRIS has a small effect on the quality of the h and k diagnostics; the relations between the spectral features and atmospheric properties are mostly unchanged. The peak separation is the most affected diagnostic, but mainly due to limitations of the simulation. The effects of noise start to be noticeable at a signal-to-noise ratio (S/N) of 20, but we show that with noise filtering one can obtain reliable diagnostics at least down to a S/N of 5. The many photospheric lines present in the NUV window provide velocity information for at least eight distinct photospheric heights. Using line-free regions in the h and k far wings, we derive good estimates of photospheric temperature for at least three heights. Both of these diagnostics, in particular the latter, can be obtained even at S/Ns as low as 5.« less

A computational framework for converting textual clinical diagnostic criteria into the quality data model.

PubMed

Hong, Na; Li, Dingcheng; Yu, Yue; Xiu, Qiongying; Liu, Hongfang; Jiang, Guoqian

2016-10-01

Constructing standard and computable clinical diagnostic criteria is an important but challenging research field in the clinical informatics community. The Quality Data Model (QDM) is emerging as a promising information model for standardizing clinical diagnostic criteria. To develop and evaluate automated methods for converting textual clinical diagnostic criteria in a structured format using QDM. We used a clinical Natural Language Processing (NLP) tool known as cTAKES to detect sentences and annotate events in diagnostic criteria. We developed a rule-based approach for assigning the QDM datatype(s) to an individual criterion, whereas we invoked a machine learning algorithm based on the Conditional Random Fields (CRFs) for annotating attributes belonging to each particular QDM datatype. We manually developed an annotated corpus as the gold standard and used standard measures (precision, recall and f-measure) for the performance evaluation. We harvested 267 individual criteria with the datatypes of Symptom and Laboratory Test from 63 textual diagnostic criteria. We manually annotated attributes and values in 142 individual Laboratory Test criteria. The average performance of our rule-based approach was 0.84 of precision, 0.86 of recall, and 0.85 of f-measure; the performance of CRFs-based classification was 0.95 of precision, 0.88 of recall and 0.91 of f-measure. We also implemented a web-based tool that automatically translates textual Laboratory Test criteria into the QDM XML template format. The results indicated that our approaches leveraging cTAKES and CRFs are effective in facilitating diagnostic criteria annotation and classification. Our NLP-based computational framework is a feasible and useful solution in developing diagnostic criteria representation and computerization. Copyright © 2016 Elsevier Inc. All rights reserved.

Study of Mechanical and Thermal Impact of a Plasma Focus Discharge on Diagnostic Elements of PFM-72M Installation

NASA Astrophysics Data System (ADS)

Bashutin, O. A.; Savelov, A. S.; Sidorov, P. P.

2017-12-01

Mechanical and thermal impact of the plasma focus discharge on structural elements of diagnostic windows of the PFM-72m discharge installation are calculated. The absence of critical impact at early discharge stages and during the first 300 ns after the "plasma focus" formation is shown. The possibility of shock impact on the surface of diagnostic windows at later times, which may result in their substantial deformation and destruction, is demonstrated.

Optimizing Blue Persistent Luminescence in (Sr 1-δ Ba δ ) 2 MgSi 2 O 7: Eu 2+ ,Dy 3+ via Solid Solution for Use in Point-of-Care Diagnostics

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

Finley, Erin; Cobb, Angelica; Duke, Anna

Inorganic persistent luminescent phosphors are an excellent class of optical reporters for enabling sensitive point-of-care diagnostics, particularly with smartphone-based biosensing devices in testing formats such as the lateral flow assay (LFA). Here, the development of persistent phosphors for this application is focused on the solid solution (Sr 1-δBa δ) 2MgSi 2O 7:Eu 2+,Dy 3+ (δ = 0, 0.125, 0.25, 0.375), which is prepared using a high-temperature solid-state reaction as confirmed by synchrotron X-ray powder diffraction. The substitution of barium for strontium enables control over the Eu 2+ 5d-orbital crystal field splitting (CFS) as a tool for tuning the emission wavelengthmore » while maintaining luminescence lifetimes >9 min across the composition range. Thermoluminescence measurements of the solid solution provide evidence that trap states contribute to the persistent lifetimes with the trap depths also remaining constant as a function of composition. Time-gated luminescence images of these compounds are captured on a smartphone arranged in a layout to mimic a point-of-care test and demonstrate the viability of using these materials as optical reporters. Moreover, comparing the blue-emitting (Sr 0.625Ba 0.375) 2MgSi 2O 7:Eu 2+,Dy 3+ and the green-emitting SrAl 2O 4:Eu 2+,Dy 3+ in a single LFA-type format shows these two compounds can be detected and resolved simultaneously, thereby permitting the development of a multiplexed LFA.« less

Diagnostic medical physicists and their clinical activities.

PubMed

Cypel, Yasmin S; Sunshine, Jonathan H

2004-02-01

The primary objective of this study was to obtain basic, descriptive information about medical physicists involved in diagnostic radiology-related activities, the diagnostic-related activities that they performed, and the time spent on these activities. A survey was sent to a randomly selected sample of 1511 medical physicists from July through October 2001 using primarily e-mail methods; a total of 851 surveys was received, for a response rate of 56%. Of these, 427 were responses from physicists who do partly or only clinical diagnostic medical physics; it is this group for which results are presented. Fifty-four percent of the physicists who reported doing any clinical diagnostic medical physics performed clinical activities only in diagnostic medical physics. Fourteen percent of all those doing clinical diagnostic medical physics were women. Over 97% of the physicists doing clinical diagnostic medical physics reported having graduate degrees in physics; 53% had PhDs. The mean total weekly hours worked by physicists doing clinical diagnostic medical physics was 42. Medical physicists doing only clinical diagnostic activities reported working approximately 40 hours weekly, whereas those doing partly clinical diagnostic medical physics reported working 14 hours weekly in the field (approximately one-third of their work time). Radiography and fluoroscopy, computed tomography, nuclear medicine, and mammography are all fields in which the majority of those doing any clinical diagnostic medical physics are active. Full-time physicists working only in diagnostic medical physics were responsible for a median of 25 units of equipment, compared with a median of 10 units for those working only partly in the field. Number of units evaluated, frequency of evaluation, and hours per evaluation were reported for almost 20 types of equipment. Medical physicists performing diagnostic clinical activities typically are responsible for a large number and wide variety of imaging equipment. It would be helpful to study their work further, focusing in particular on whether there is a shortage, as is true of diagnostic radiologists, and whether the variety of responsibilities creates strain.

Molecular diagnostics of Galactic star-formation regions

NASA Astrophysics Data System (ADS)

Loenen, Edo; Baan, Willem; Spaans, Marco

2007-10-01

We propose a sensitive spectral survey of Galactic star-formation regions. Using the broadband correlator at two different frequencies, we expect to detect the (1-0) transition of CO, CN, HNC, HCN, HCO+, and HCO and various of their isotopes lines, as well as the (12-11) and (10-9) transitions of HC3N. The purpose of these observations is to create a consistent (public) database of molecular emission from galactic star-formation regions. The data will be interpreted using extensive physical and chemical modeling of the whole ensemble of lines, in order to get an accurate description of the molecular environment of these regions. In particular, this diagnostic approach will describe the optical depths, the densities, and the radiation fields in the medium and will allow the establishment of dominant temperature gradients. These observations are part of a program to study molecular emission on all scales, going from individual Galactic star-formation regions, through resolved nearby galaxies, to unresolved extra-galactic emission.

Making Online Products More Tangible: The Effect of Product Presentation Formats on Product Evaluations.

PubMed

Verhagen, Tibert; Vonkeman, Charlotte; van Dolen, Willemijn

2016-07-01

Although several studies have looked at the effects of online product presentations on consumer decision making, no study thus far has considered a potential key factor in online product evaluations: tangibility. The present study aims at filling this gap by developing and testing a model that relates different online product presentation formats to the three-dimensional concept of product tangibility. We test how the three tangibility dimensions influence perceived diagnosticity and, eventually, online purchase intentions. A between-subjects lab experiment (n = 366) was used to test the hypothesized effects of three common online product presentation formats (pictures vs. 360 spin rotation vs. virtual mirror). The results showed that out of these formats, virtual mirrors were superior in providing a sense of product tangibility, followed by the 360-spin rotation format and static pictures. Furthermore, in terms of predictive validity, two of the three tangibility dimensions significantly increased perceived diagnosticity, which, in turn, positively and strongly affected purchase intentions. Overall, our results add to previous works studying the relationships between online product presentation formats and consumer decision making. Also, they hold value for online practitioners by highlighting the potential benefits of applying technologically advanced product presentation formats such as the virtual mirror.

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

NASA Technical Reports Server (NTRS)

Jong, Jen-Yi

1996-01-01

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

Design and development of a fiber optic TDI CCD-based slot-scan digital mammography system

NASA Astrophysics Data System (ADS)

Toker, Emre; Piccaro, Michele F.

1993-12-01

We previously reported on the development, design, and clinical evaluation of a CCD-based, high performance, filmless imaging system for stereotactic needle biopsy procedures in mammography. The MammoVision system has a limited imaging area of 50 mm X 50 mm, since it is designed specifically for breast biopsy applications. We are currently developing a new filmless imaging system designed to cover the 18 cm X 24 cm imaging area required for screening and diagnostic mammography. The diagnostic mammography system is based on four 1100 X 330 pixel format, full-frame, scientific grade, front illuminated, MPP mode CCDs, with 24 micrometers X 24 micrometers square pixels Each CCD is coupled to an x-ray intensifying screen via a 1.7:1 fiber optic reducer. The detector assembly (180 mm long and 13.5 mm wide) is scanned across the patient's breast synchronously with the x-ray source, with the CCDs operated in time-delay integration (TDI) mode. The total scan time is 4.0 seconds.

Pedagogical Approaches to Diagnostic Imaging Education: A Narrative Review of the Literature

PubMed Central

Linaker, Kathleen L.

2015-01-01

Objective The purpose of this study was to examine literature on how radiology is taught and learned by both radiology residents and undergraduates in the health professions. Methods A review of the literature was performed using relevant key words. Articles were retrieved through December 2012 using PubMed, ScienceDirect, ERIC, Proquest, and ICL databases along with a manual review of references. Results Of the 4716 unique abstracts reviewed by the author, 91 were found to be relevant to the purpose of this study. The literature retrieved reported pedagogical approaches to teaching radiology including the following: problem solving, technology as teacher, independent learning tools, visiting lectureships, case based teaching, and conferences. There was some exploration of the relative effectiveness of educational formats. Suggestions for future research identify 7 areas of relative consistency. Conclusion Radiology is a clinical skill that requires integration science, clinical information, clinical experiences, and information recorded on diagnostic imaging studies. The research in this area focuses on problem solving, the use of algorithm/scripts, introducing uncertainty in clinical scenarios, incorporating technology in learning environments, active learning techniques, and methods of independent learning. Although the literature in this area is still in its infancy, the research examining the relative effectiveness of these various educational formats is often contradictory, suggesting that this is a complex area of study with numerous factors influencing student learning. PMID:26770173

Development of stimulation diagnostic technology

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

Warpinski, N.R.; Lorenz, J.C.

The objective of this project is to apply Sandia's expertise and technology towards the development of stimulation diagnostic technology in the areas of in situ stress, natural fracturing, stimulation processes and instrumentation systems. Initial work has concentrated on experiment planning for a site where hydraulic fracturing could be evaluated and design models and fracture diagnostics could be validated and improved. Important issues have been defined and new diagnostics, such as inclinometers, identified. In the area of in situ stress, circumferential velocity analysis is proving to be a useful diagnostic for stress orientation. Natural fracture studies of the Frontier formation aremore » progressing; two fracture sets have been found and their relation to tectonic events have been hypothesized. Analyses of stimulation data have been performed for several sites, primarily for in situ stress information. Some new ideas in stimulation diagnostics have been proposed; these ideas may significantly improve fracture diagnostic capabilities.« less

Embedding CLIPS in a database-oriented diagnostic system

NASA Technical Reports Server (NTRS)

Conway, Tim

1990-01-01

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

Reporting Diagnostic Scores in Educational Testing: Temptations, Pitfalls, and Some Solutions

ERIC Educational Resources Information Center

Sinharay, Sandip; Puhan, Gautam; Haberman, Shelby J.

2010-01-01

Diagnostic scores are of increasing interest in educational testing due to their potential remedial and instructional benefit. Naturally, the number of educational tests that report diagnostic scores is on the rise, as are the number of research publications on such scores. This article provides a critical evaluation of diagnostic score reporting…

Development and Evaluation of the Diagnostic Power for a Computer-Based Two-Tier Assessment

ERIC Educational Resources Information Center

Lin, Jing-Wen

2016-01-01

This study adopted a quasi-experimental design with follow-up interview to develop a computer-based two-tier assessment (CBA) regarding the science topic of electric circuits and to evaluate the diagnostic power of the assessment. Three assessment formats (i.e., paper-and-pencil, static computer-based, and dynamic computer-based tests) using…

Comparing Eighth-Grade Diagnostic Test Results for Korean, Czech, and American Students.

ERIC Educational Resources Information Center

Um, Eunkyoung; Dogan, Enis; Im, Seongah; Tatsuoka, Kimumi; Corter, James E.

Diagnostic analyses were conducted on data from the Third International Mathematics and Science Study second population (TIMSS-R; 1999) from the United States, Korea, and the Czech Republic in terms of test item attributes (i.e., content, processing skills, and item format) and inferred students' knowledge. The Rule Space model (K. Tatsuoka, 1998)…

Diagnostic Appraisal of Grade 12 Students' Understanding of Reaction Kinetics

ERIC Educational Resources Information Center

Yan, Yaw Kai; Subramaniam, R.

2016-01-01

The study explored grade 12 students' understanding of reaction kinetics, a topic which has not been extensively explored in the chemistry education literature at this level. A 3-tier diagnostic instrument with 11 questions was developed--this format is of very recent origin and has been the subject of only a handful of studies. The findings…

[Visualisation methods for etheric formative forces].

PubMed

Burkhard, B; Kittel, R

2009-09-01

Rudolf Steiner, the founder of anthroposophy, suggested the development of visualisation methods for "etheric formative forces". The essential methods, their "spiritual scientific" basis and indications are described and their claims critically tested. The methods are not validated, the key criteria for diagnostic tests (reproducibility, sensitivity, specifity) are not given.

Agreement between admission and discharge diagnoses: Analysis by the groups of international classification of diseases, 10th revision.

PubMed

Mihailović, Nataša; Trajković, Goran; Simić-Vukomanović, Ivana; Ristić, Svetlana; Kocić, Sanja

2016-12-01

Admission diagnosis represents the diagnosis of an illness, injury or condition due to which a patient is referred to hospital to be admitted. Discharge diagnosis represents the main reason of illness or condition due to which a patient is admitted. The aim of this study was to analyze the agreement between admission diagnostic groups and discharge diagnostic groups of patients in the Clinical Center Kragujevac in the period from January 1, 2006 to December 31, 2013 on the basis of the hospitalization report. From the basic set of reports, 5% of random samples were singled out and they contained 20,422 reports. Out of the given number of reports, 18,173 hospitalization reports were complete and then further analyzed in the paper. Admission diagnostic groups given by the primary care doctor were compared with discharge diagnostic groups filled out by the practicing physician in the hospital ward from which a patient was discharged. The agreement of these two diagnostic groups was an indication of the high-quality performance of the primary care doctor. Agreement analysis was conducted using Cohen’s Kappa statistics. Agreement analysis showed that the values of the Kappa coefficient for the five leading admission diagnostic groups were in the range of κ = 0.61 to κ = 0.94. The values of the Kappa coefficient for the five most common discharge diagnostic groups were in the range of κ = 0.55 to κ = 0.81. Hospitalization report is a reliable individual report on inpatient care, so it could be used in determining the degree of agreement between admission diagnostic groups and discharge diagnostic groups.

Innovative diagnostics for ITER physics addressed in JET

NASA Astrophysics Data System (ADS)

Murari, A.; Edlington, T.; Alfier, A.; Alonso, A.; Andrew, Y.; Arnoux, G.; Beurskens, M.; Coad, P.; Crombe, C.; Gauthier, E.; Giroud, C.; Hidalgo, C.; Hong, S.; Kempenaars, M.; Kiptily, V.; Loarer, T.; Meigs, A.; Pasqualotto, R.; Tala, T.; Contributors, JET-EFDA

2008-12-01

In recent years, JET diagnostic capability has been significantly improved to widen the range of physical phenomena that can be studied and thus contribute to the understanding of some ITER relevant issues. The most significant results reported in this paper refer to the plasma wall interactions, the interplay between core and edge physics and fast particles. A synergy between new infrared cameras, visible cameras and spectroscopy diagnostics has allowed investigating a series of new aspects of the plasma wall interactions. The power loads on the plasma facing components of JET main chambers have been assessed at steady state and during transient events like ELMs and disruptions. Evidence of filaments in the edge region of the plasma has been collected with a new fast visible camera and high resolution Thomson scattering. The physics of detached plasmas and some new aspects of dust formation have also been devoted particular attention. The influence of the edge plasma on the core has been investigated with upgraded active spectroscopy, providing new information on momentum transport and the effects of impurity injection on ELMs and ITBs and their interdependence. Given the fact that JET is the only machine with a plasma volume big enough to confine the alphas, a coherent programme of diagnostic developments for the energetic particles has been undertaken. With upgraded γ-ray spectroscopy and a new scintillator probe, it is now possible to study both the redistribution and the losses of the fast particles in various plasma conditions.

Internet-based treatment for panic disorder: A three-arm randomized controlled trial comparing guided (via real-time video sessions) with unguided self-help treatment and a waitlist control. PAXPD study results.

PubMed

Ciuca, Amalia M; Berger, Thomas; Crişan, Liviu G; Miclea, Mircea

2018-05-01

A growing body of evidence suggests that Internet-based cognitive behavioral treatments (ICBT) are effective to treat anxiety disorders. However, the effect of therapist guidance in ICBT is still under debate and guided ICBT offered in a real-time audio-video communication format has not yet been systematically investigated. This three-arm RCT compared the efficacy of guided with unguided ICBT (12 weeks intervention) and a waitlist (WL). A total of 111 individuals meeting the diagnostic criteria for panic disorder (PD) were randomly assigned to one of three conditions. Primary outcomes were the severity of self-report panic symptoms and diagnostic status. Secondary outcomes were symptoms of depression, functional impairment, catastrophic cognitions, fear of sensations and body vigilance. At post-treatment, both active conditions showed superior outcomes regarding PD and associated symptoms (guided ICBT vs. WL: d = 1.04-1.36; unguided ICBT vs. WL: d = 0.70-1.06). At post-treatment, the two active conditions did not differ significantly in self-reported symptom reduction (d = 0.21-0.54, all ps > 0.05), but the guided treatment was superior to the unguided treatment in terms of diagnostic status (χ 2 (1) = 13.15, p < 0.01). Treatment gains were maintained at successive follow-ups and the guided treatment became superior to the unguided treatment at 6 months follow-up (d = 0.72-1.05, all ps < 0.05). Copyright © 2018 Elsevier Ltd. All rights reserved.

Methodology and reporting of diagnostic accuracy studies of automated perimetry in glaucoma: evaluation using a standardised approach.

PubMed

Fidalgo, Bruno M R; Crabb, David P; Lawrenson, John G

2015-05-01

To evaluate methodological and reporting quality of diagnostic accuracy studies of perimetry in glaucoma and to determine whether there had been any improvement since the publication of the Standards for Reporting of Diagnostic Accuracy (STARD) guidelines. A systematic review of English language articles published between 1993 and 2013 reporting the diagnostic accuracy of perimetry in glaucoma. Articles were appraised for methodological quality using the 14-item Quality assessment tool for diagnostic accuracy studies (QUADAS) and evaluated for quality of reporting by applying the STARD checklist. Fifty-eight articles were appraised. Overall methodological quality of these studies was moderate with a median number of QUADAS items rated as 'yes' equal to nine (out of a maximum of 14) (IQR 7-10). The studies were often poorly reported; median score of STARD items fully reported was 11 out of 25 (IQR 10-14). A comparison of the studies published in 10-year periods before and after the publication of the STARD checklist in 2003 found quality of reporting had not substantially improved. Methodological and reporting quality of diagnostic accuracy studies of perimetry is sub-optimal and appears not to have improved substantially following the development of the STARD reporting guidance. This observation is consistent with previous studies in ophthalmology and in other medical specialities. © 2015 The Authors Ophthalmic & Physiological Optics © 2015 The College of Optometrists.

Disseminated Acanthamoeba Infection Presenting With Cutaneous Lesions in an Immunocompromised Patient: A Case Report, Review of Histomorphologic Findings, and Potential Diagnostic Pitfalls.

PubMed

Morrison, Annie O; Morris, Robert; Shannon, Amie; Lauer, Scott R; Guarner, Jeannette; Kraft, Colleen S

2016-02-01

Free-living amoebas are exceedingly rare causes of cutaneous infections and present unique diagnostic and therapeutic challenges. We describe a case of disseminated acanthamoebiasis with cutaneous manifestations and summarize additional diagnostic, prognostic, and therapeutic highlights. A 58-year-old man with relapsed chronic lymphocytic leukemia had several weeks of progressive, painful ulcerations on the forehead, arms, abdomen, and thighs. A biopsy was performed for histopathologic evaluation. The biopsy specimen showed inflammatory infiltrate with abscess formation involving the epidermis, dermis, and subcutis. Scattered cells showed nuclei with a prominent central karyosome, dispersed chromatin, and either abundant foamy basophilic cytoplasm or two well-demarcated cytoplasmic walls. Acanthamoeba species was confirmed by polymerase chain reaction from the formalin-fixed, paraffin-embedded tissue. Cutaneous lesions from acanthamoebiasis are exceptionally rare but should be included in the differential diagnosis of necrotic cutaneous lesions in immunocompromised patients. Although infrequently encountered, pathologists need to be aware of the morphologic features of free-living amoebas. Immunohistochemical and molecular studies can confirm the diagnosis. Multiagent treatment regimens, when initiated empirically, have been more successful than single-agent regimens, but infections involving the central nervous system are almost universally fatal. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

First step toward translation of thermophotonic lock-in imaging to dentistry as an early caries detection technology

NASA Astrophysics Data System (ADS)

Ojaghi, Ashkan; Parkhimchyk, Artur; Tabatabaei, Nima

2016-09-01

Early detection of the most prevalent oral disease worldwide, i.e., dental caries, still remains as one of the major challenges in dentistry. The current dental standard of care relies on caries detection methods, such as visual inspection and x-ray radiography, which lack the sufficient specificity and sensitivity to detect caries at early stages of formation when they can be healed. We report on the feasibility of early caries detection in a clinically and commercially viable thermophotonic imaging system. The system incorporates intensity-modulated laser light along with a low-cost long-wavelength infrared (LWIR; 8 to 14 μm) camera, providing diagnostic contrast based on the enhanced light absorption of early caries. The LWIR camera is highly suitable for integration into clinical platforms because of its low weight and cost. In addition, through theoretical modeling, we show that LWIR detection enhances the diagnostic contrast due to the minimal LWIR transmittance of enamel and suppression of the masking effect of the direct thermal Planck emission. Diagnostic performance of the system and its detection threshold are experimentally evaluated by monitoring the inception and progression of artificially induced occlusal and smooth surface caries. The results are suggestive of the suitability of the developed LWIR system for detecting early dental caries.

Computational Approach for Securing Radiology-Diagnostic Data in Connected Health Network using High-Performance GPU-Accelerated AES.

PubMed

Adeshina, A M; Hashim, R

2017-03-01

Diagnostic radiology is a core and integral part of modern medicine, paving ways for the primary care physicians in the disease diagnoses, treatments and therapy managements. Obviously, all recent standard healthcare procedures have immensely benefitted from the contemporary information technology revolutions, apparently revolutionizing those approaches to acquiring, storing and sharing of diagnostic data for efficient and timely diagnosis of diseases. Connected health network was introduced as an alternative to the ageing traditional concept in healthcare system, improving hospital-physician connectivity and clinical collaborations. Undoubtedly, the modern medicinal approach has drastically improved healthcare but at the expense of high computational cost and possible breach of diagnosis privacy. Consequently, a number of cryptographical techniques are recently being applied to clinical applications, but the challenges of not being able to successfully encrypt both the image and the textual data persist. Furthermore, processing time of encryption-decryption of medical datasets, within a considerable lower computational cost without jeopardizing the required security strength of the encryption algorithm, still remains as an outstanding issue. This study proposes a secured radiology-diagnostic data framework for connected health network using high-performance GPU-accelerated Advanced Encryption Standard. The study was evaluated with radiology image datasets consisting of brain MR and CT datasets obtained from the department of Surgery, University of North Carolina, USA, and the Swedish National Infrastructure for Computing. Sample patients' notes from the University of North Carolina, School of medicine at Chapel Hill were also used to evaluate the framework for its strength in encrypting-decrypting textual data in the form of medical report. Significantly, the framework is not only able to accurately encrypt and decrypt medical image datasets, but it also successfully encrypts and decrypts textual data in Microsoft Word document, Microsoft Excel and Portable Document Formats which are the conventional format of documenting medical records. Interestingly, the entire encryption and decryption procedures were achieved at a lower computational cost using regular hardware and software resources without compromising neither the quality of the decrypted data nor the security level of the algorithms.

Experience with a proposed teleradiology system for digital mammography

NASA Astrophysics Data System (ADS)

Saulnier, Emilie T.; Mitchell, Robert J.; Abdel-Malek, Aiman A.; Dudding, Kathryn E.

1995-05-01

Teleradiology offers significant improvement in efficiency and effectiveness over current practices in traditional film/screen-based diagnosis. In the context of digital mammography, the increasing number of women who need to be screened for breast cancer, including those in remote rural regions, make the advantages of teleradiology especially attractive for digital mammography. At the same time, the size and resolution of digital mammograms are among the most challenging to support in a cost effective teleradiology system. This paper describes a teleradiology architecture developed for use with digital mammography by GE Corporate Research and Development in collaboration with Massachusetts General Hospital under National Cancer Institute (NCI/NIH) grant number R01 CA60246-01. Experience with a testbed prototype is described. The telemammography architecture is intended to consist of a main mammography diagnostic site serving several remote screening sites. As patient exams become available, they are forwarded by an image server to the diagnostic site over a WAN communications link. A radiologist at the diagnostic site views a patient exam as it arrives, interprets it, and then relays a report back to the technician at the remote site. A secondary future scenario consists of mobile units which forward images to a remote site, which then forwards them to the main diagnostic site. The testbed architecture is based on the Digital Imaging and Communications in Medicine (DICOM) standard, created by the American College of Radiology (ACR) and National Electrical Manufacturers Association (NEMA). A specification of vendor-independent data formats and data transfer services for digital medical images, DICOM specifies a protocol suite starting at the application layer downward, including the TCP/IP layers. The current DICOM definition does not provide an information element that is specifically tailored to mammography, so we have used the DICOM secondary capture data format for the mammography images. In conclusion, experience with the testbed is described, as is performance analysis related to selection of network components needed to extend this architecture to clinical evaluation. Recommendations are made as to the critical areas for future work.

The impact of a focused vascular lower limb arterial duplex (F-VLAD) scan in management decisions for acute limb ischaemia.

PubMed

Normahani, Pasha; Aslam, Mohammed; Standfield, Nigel J; Jaffer, Usman

2017-01-01

To establish the diagnostic accuracy of a 'focused vascular lower limb arterial duplex scan (F-VLAD)' developed to facilitate rapid decision-making for acute limb ischaemia (ALI). Ten cases of ALI were identified from our patient database; clinical details, history and examination findings were extracted from the clinical notes. Original 'full' duplex ultrasound (DUS) pictorial reports were 're-formatted' to include only anatomical segments included in the 'F-VLAD' scan. The series of 10 reports were emailed to 1741 vascular surgeons. Each recipient received a random mixture of full and F-VLAD scans. Participants were asked regarding next step in management and confidence in decision-making (Likert scale; 1 strongly disagree, 5 strongly agree). The cases were again sent out to the same database and respondents were asked as to the cause of ischaemia (embolic or thrombosis). Eighty-one participants responded to the first survey and 43 participants to the second survey. Participants felt more confident making decisions regarding management using the full duplex report compared to the F-VLAD report (4 (3-4) vs 3 (2-4), median (IQR); p<0.001). However, there was no significant difference in diagnostic accuracy (differentiating embolus from thrombosis) when comparing the F-VLAD and full DUS reports (85.4% vs 88.3%; p=0.461). F-VLAD and 'full' DUS reports had comparable sensitivity (85.1% vs 86.8%), specificity (85.6% vs 89.2%),positive predictive value (PPV) (80.4% vs 81.9%) and negative predictive value (NPV) (89.2% vs 92.2%), respectively. The F-VLAD scan has comparable accuracy to a traditional full DUS in diagnosing the underlying aetiology of ALI. This may facilitate surgeon-performed point-of-care DUS.

Approach to building knowledge bases in information-measuring systems diagnostics of acute leukemias

NASA Astrophysics Data System (ADS)

Nikitaev, V. G.; Pronichev, A. N.; Polyakov, E. V.; Dmitrieva, V. V.

2018-01-01

The paper describes an approach for the formation of the reference base of peripheral blood cells and bone marrow in information-measuring systems of acute leukemia diagnostics. The proposed approach has allowed to create a system, that is enable peer evaluation of blood cells needed for the training of recognition systems when carrying out microscopic studies.

Promoting Secondary Teachers' Diagnostic Competence with Respect to Functions: Development of a Scalable Unit in Continuous Professional Development

ERIC Educational Resources Information Center

Busch, Julia; Barzel, Bärbel; Leuders, Timo

2015-01-01

Diagnosing student achievement in a formative way is a crucial skill for planning and carrying out effective mathematics lessons. This study takes a subject-specific view and aims at investigating diagnostic competence in the field of mathematical functions at secondary level and how to improve it. Following three evidence-based design principles,…

Constructing and Validating a Q-Matrix for Cognitive Diagnostic Analyses of a Reading Test

ERIC Educational Resources Information Center

Li, Hongli; Suen, Hoi K.

2013-01-01

Cognitive diagnostic analyses have been advocated as methods that allow an assessment to function as a formative assessment to inform instruction. To use this approach, it is necessary to first identify the skills required for each item in the test, known as a Q-matrix. However, because the construct being tested and the underlying cognitive…

LASERS IN MEDICINE: Laser diagnostics of biofractals

NASA Astrophysics Data System (ADS)

Ushenko, A. G.

1999-12-01

An optical approach to the problem of modelling and diagnostics of the structures of biofractal formations was considered in relation to human bone tissue. A model was proposed for the optical properties of this tissue, including three levels of fractal organisation: microcrystalline, macrocrystalline, and architectural. The studies were based on laser coherent polarimetry ensuring the retrieval of the fullest information about the optical and polarisation properties of bone tissue. A method was developed for contactless noninvasive diagnostics of the orientational and mineralogical structure of bone tissue considered as a biofractal.

Antibody-antigenic peptide interactions monitored by SPR and QCM-D. A model for SPR detection of IA-2 autoantibodies in human serum.

PubMed

Ayela, Cedric; Roquet, Francoise; Valera, Lionel; Granier, Claude; Nicu, Liviu; Pugnière, Martine

2007-06-15

This work reports on a complementary use of surface plasmon resonance (SPR) and quartz crystal microbalance with dissipation monitoring (QCM-D) technologies to study interactions between a peptide antigen and polyclonal antibodies, in an experimental format suitable for diagnostic assays of autoimmune diseases. In the chosen model, a synthetic peptide from the juxtamembrane region of IA-2 (a type 1 diabetes associated antigen) was immobilized by an optimized chemical protocol applicable to both BIACORE and QCM-D sensors. A thorough study of the peptide immobilization was performed to optimize the signal-to-noise ratio using mixed self-assembled monolayers (SAM) on a gold surface. Introduction of polyethylene glycol (EG(6)) chains into mixed SAM layers and addition of an anionic surfactant to the human serum reduced non-specific binding without modifying the viscoelasticity properties of the layer. Under our conditions, the antibody SPR detection limit was determined to be 0.2 nM in diluted human serum. This value is in agreement with the reported rank distribution of IA-2 antibodies in diabetic patient sera. Label-free and real-time technologies such as SPR and/or QCM-D could be precious tools in future diagnostic assays.

The Reliability and Validity of the Panic Disorder Self-Report: A New Diagnostic Screening Measure of Panic Disorder

ERIC Educational Resources Information Center

Newman, Michelle G.; Holmes, Marilyn; Zuellig, Andrea R.; Kachin, Kevin E.; Behar, Evelyn

2006-01-01

This study examined the Panic Disorder Self-Report (PDSR), a new self-report diagnostic measure of panic disorder based on the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994). PDSR diagnoses were compared with structured interview diagnoses of individuals with generalized anxiety…

Small-bowel obstruction secondary to bezoar impaction: a diagnostic dilemma.

PubMed

Ho, Thomas W; Koh, Dean C

2007-05-01

Gastrointestinal bezoar (GIB) is uncommon and is reported to occur in 4% of all admissions for small-bowel obstruction (SBO). Because of a lack of diagnostic features, it is often associated with a delay in treatment, with increased morbidity. In this article, we report our experience with managing bezoar-induced SBO and the role of early computed tomography (CT) imaging in establishing the diagnosis. We retrospectively reviewed all cases of bezoar-induced SBO treated in our unit between 1999 and 2005. There were 43 patients, of whom 2 had a recurrence, giving a total of 45 episodes. The frequency of bezoar in our patients presenting with SBO was 4.3%. All patients were of Asian origin: 41 Chinese, 1 Indian, and 1 Malay. Twenty-eight (65%) patients had previous abdominal surgery of which 26 were gastric surgery. Thirty-eight (88%) patients were edentulous. Forty-one (91%) underwent serial abdominal radiography, whereas only 4 patients (9%) had either CT imaging or contrast study alone. Only 11 (24%) cases had a correct diagnosis of bezoar impaction made preoperatively by CT imaging. The diagnostic accuracy of CT imaging in our series was 65%, with six cases of misdiagnosis. Overall, CT led to a change in management of 76% (13 in 17). The median time to surgery from admission was 2 (0-10) days. There were 2 cases of ischemic bowel that necessitated bowel resection. The median length of hospital stay was 11 (5-100) days. Ten patients (22%) had postoperative complications, and there was one death. Bezoar-induced SBO is uncommon and remains a diagnostic and management challenge. It should be suspected in patients with an increased risk of formation of GIB, such as previous gastric surgery, poor dentition, and a suggestive history of increased fibre intake. We advocate that CT imaging be performed early in these at-risk patients and in patients presenting with SBO with or without a history of abdominal surgery in order to reduce unnecessary delays before appropriate surgical intervention.

Exploring the Connection Between Star Formation and AGN Activity in the Local Universe

NASA Technical Reports Server (NTRS)

LaMassa, Stephanie M.; Heckman. T. M.; Ptak, Andrew; Schiminovich, D.; O'Dowd, M.; Bertincourt, B.

2012-01-01

We study a combined sample of 264 star-forming, 51 composite, and 73 active galaxies using optical spectra from SDSS and mid-infrared (mid-IR) spectra from the Spitzer Infrared Spectrograph. We examine optical and mid-IR spectroscopic diagnostics that probe the amount of star formation and relative energetic con- tributions from star formation and an active galactic nucleus (AGN). Overall we find good agreement between optical and mid-IR diagnostics. Misclassifications of galaxies based on the SDSS spectra are rare despite the presence of dust obscuration. The luminosity of the [NeII] 12.8 micron emission-line is well correlated with the star formation rate (SFR) measured from the SDSS spectra, and this holds for the star forming, composite, and AGN-dominated systems. AGN show a clear excess of [NeIII] 15.6 micron emission relative to star forming and composite systems. We find good qualitative agreement between various parameters that probe the relative contributions of the AGN and star formation, including: the mid-IR spectral slope, the ratio of the [NeV] 14.3 micron to [NeII] micron 12.8 fluxes, the equivalent widths of the 7.7, 11.3, and 17 micron PAH features, and the optical "D" parameter which measures the distance a source lies from the locus of star forming galaxies in the optical BPT emission-line diagnostic diagram. We also consider the behavior of the three individual PAH features by examining how their flux ratios depend upon the degree of AGN-dominance. We find that the PAH 11.3 micron feature is significantly suppressed in the most AGN-dominated systems.

Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies: The PRISMA-DTA Statement.

PubMed

McInnes, Matthew D F; Moher, David; Thombs, Brett D; McGrath, Trevor A; Bossuyt, Patrick M; Clifford, Tammy; Cohen, Jérémie F; Deeks, Jonathan J; Gatsonis, Constantine; Hooft, Lotty; Hunt, Harriet A; Hyde, Christopher J; Korevaar, Daniël A; Leeflang, Mariska M G; Macaskill, Petra; Reitsma, Johannes B; Rodin, Rachel; Rutjes, Anne W S; Salameh, Jean-Paul; Stevens, Adrienne; Takwoingi, Yemisi; Tonelli, Marcello; Weeks, Laura; Whiting, Penny; Willis, Brian H

2018-01-23

Systematic reviews of diagnostic test accuracy synthesize data from primary diagnostic studies that have evaluated the accuracy of 1 or more index tests against a reference standard, provide estimates of test performance, allow comparisons of the accuracy of different tests, and facilitate the identification of sources of variability in test accuracy. To develop the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) diagnostic test accuracy guideline as a stand-alone extension of the PRISMA statement. Modifications to the PRISMA statement reflect the specific requirements for reporting of systematic reviews and meta-analyses of diagnostic test accuracy studies and the abstracts for these reviews. Established standards from the Enhancing the Quality and Transparency of Health Research (EQUATOR) Network were followed for the development of the guideline. The original PRISMA statement was used as a framework on which to modify and add items. A group of 24 multidisciplinary experts used a systematic review of articles on existing reporting guidelines and methods, a 3-round Delphi process, a consensus meeting, pilot testing, and iterative refinement to develop the PRISMA diagnostic test accuracy guideline. The final version of the PRISMA diagnostic test accuracy guideline checklist was approved by the group. The systematic review (produced 64 items) and the Delphi process (provided feedback on 7 proposed items; 1 item was later split into 2 items) identified 71 potentially relevant items for consideration. The Delphi process reduced these to 60 items that were discussed at the consensus meeting. Following the meeting, pilot testing and iterative feedback were used to generate the 27-item PRISMA diagnostic test accuracy checklist. To reflect specific or optimal contemporary systematic review methods for diagnostic test accuracy, 8 of the 27 original PRISMA items were left unchanged, 17 were modified, 2 were added, and 2 were omitted. The 27-item PRISMA diagnostic test accuracy checklist provides specific guidance for reporting of systematic reviews. The PRISMA diagnostic test accuracy guideline can facilitate the transparent reporting of reviews, and may assist in the evaluation of validity and applicability, enhance replicability of reviews, and make the results from systematic reviews of diagnostic test accuracy studies more useful.

TEMPORAL SELF-ORGANIZATION IN GALAXY FORMATION

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

Cen, Renyue, E-mail: cen@astro.princeton.edu

We report on the discovery of a relation between the number of star formation (SF) peaks per unit time, ν{sub peak}, and the size of the temporal smoothing window function, Δt, used to define the peaks: ν{sub peak}∝Δt {sup 1} {sup –} {sup φ} (φ ∼ 1.618). This relation holds over the range of Δt = 10-1000 Myr that can be reliably computed here, using a large sample of galaxies obtained from a state-of-the-art cosmological hydrodynamic simulation. This means that the temporal distribution of SF peaks in galaxies as a population is fractal with a Hausdorff fractal dimension equal to φmore » – 1. This finding reveals, for the first time, that the superficially chaotic process of galaxy formation is underlined by temporal self-organization up to at least one gigayear. It is tempting to suggest that, given the known existence of spatial fractals (such as the power-law two-point function of galaxies), there is a joint spatio-temporal self-organization in galaxy formation. From an observational perspective, it will be urgent to devise diagnostics to probe the SF histories of galaxies with good temporal resolution to facilitate a test of this prediction. If confirmed, it would provide unambiguous evidence for a new picture of galaxy formation that is interaction driven, cooperative, and coherent in and between time and space. Unravelling its origin may hold the key to understanding galaxy formation.« less

Suggested Format and Content of a Work Sample Manual: [With Examples].

ERIC Educational Resources Information Center

Wisconsin Univ. - Stout, Menomonie. Dept. of Rehabilitation and Manpower Services. Materials Development Center.

Work samples are job tasks used as a diagnostic tool in the evaluation of vocational rehabilitation clients. The manual was developed to provide a standardized format for the construction, administration, and interpretation of necessary information from work sample assessment techniques used by vocational evaluators. The outline is divided into…

Characteristics and Implications of Diagnostic Justification Scores Based on the New Patient Note Format of the USMLE Step 2 CS Exam.

PubMed

Yudkowsky, Rachel; Park, Yoon Soo; Hyderi, Abbas; Bordage, Georges

2015-11-01

To determine the psychometric characteristics of diagnostic justification scores based on the patient note format of the United States Medical Licensing Examination Step 2 Clinical Skills exam, which requires students to document history and physical findings, differential diagnoses, diagnostic justification, and plan for immediate workup. End-of-third-year medical students at one institution wrote notes for five standardized patient cases in May 2013 (n = 180) and 2014 (n = 177). Each case was scored using a four-point rubric to rate each of the four note components. Descriptive statistics and item analyses were computed and a generalizability study done. Across cases, 10% to 48% provided no diagnostic justification or had several missing or incorrect links between history and physical findings and diagnoses. The average intercase correlation for justification scores ranged from 0.06 to 0.16; internal consistency reliability of justification scores (coefficient alpha across cases) was 0.38. Overall, justification scores had the highest mean item discrimination across cases. The generalizability study showed that person-case interaction (12%) and task-case interaction (13%) had the largest variance components, indicating substantial case specificity. The diagnostic justification task provides unique information about student achievement and curricular gaps. Students struggled to correctly justify their diagnoses; performance was highly case specific. Diagnostic justification was the most discriminating element of the patient note and had the greatest variability in student performance across cases. The curriculum should provide a wide range of clinical cases and emphasize recognition and interpretation of clinically discriminating findings to promote the development of clinical reasoning skills.

Radiology resident dictation instruction: effectiveness of the didactic lecture.

PubMed

Woodfield, Courtney A; Mainiero, Martha B

2008-07-01

The study's purpose was to determine the effectiveness of a didactic lecture for teaching and evaluating radiology resident dictation skills. A 23-question test was created to assess resident knowledge of the American College of Radiology practice guidelines for reporting and our institution-specific requirements for communication of diagnostic imaging results. The test was administered to 23 residents before and after a 40-minute didactic lecture covering the structure of radiology reports and requirements for communication of imaging findings. The pre- and postlecture tests were graded on the basis of the number of correct answers. Data were analyzed using the mixed linear model for repeated measures and the Holm test for group comparisons. Mean pre- and postlecture test scores were 74.6% +/- 2.73% and 94.6% +/- 5.94% for postgraduate year (PGY) 2, 88.1% +/- 5.55% and 95.6% +/- 4.50% for PGY 3, 94.8% +/- 2.5% and 100% +/- 0% for PGY 4, and 96.8% +/- 1.79% and 98.4% +/- 2.19% for PGY 5, respectively. The increase of pre- to postlecture test scores was statistically significant for PGY 2, PGY 3, and PGY 4 residents (P < .005). Pre- to postlecture test improvement was greatest for PGY 2 residents. Test performance of PGY 2 residents compared with PGY 5 residents was statistically different. Test scores for PGY 2 to PGY 4 residents significantly increased after didactic instruction on the reporting and communication of diagnostic imaging results. These findings suggest that a lecture and test format can be used to teach and assess radiology resident reporting and communication skills.

Contribution of the private sector healthcare service providers to malaria diagnosis in a prevention of re-introduction setting.

PubMed

Fernando, Sumadhya Deepika; Dharmawardana, Priyani; Epasinghe, Geethanee; Senanayake, Niroshana; Rodrigo, Chaturaka; Premaratne, Risintha; Wickremasinghe, Rajitha

2016-10-18

Sri Lanka is currently in the prevention of re-introduction phase of malaria. The engagement of the private sector health care institutions in malaria surveillance is important. The purpose of the study was to determine the number of diagnostic tests carried out, the number of positive cases identified and the referral system for diagnosis in the private sector and to estimate the costs involved. This prospective study of private sector laboratories within the Colombo District of Sri Lanka was carried out over a 6-month period in 2015. The management of registered private sector laboratories was contacted individually and the purpose of the study was explained. A reporting format was developed and introduced for monthly reporting. Forty-one laboratories were eligible to be included in the study and 28 participated by reporting data on a monthly basis. Excluding blood bank samples and routine testing for foreign employment, malaria diagnostic tests were carried out on 973 individuals during the 6-month period and nine malaria cases were identified. In 2015, a total of 36 malaria cases were reported from Sri Lanka. Of these, 24 (67 %) were diagnosed in the Colombo District and 50 % of them were diagnosed in private hospitals. An equal number of cases were diagnosed from the private sector and government sector in the Colombo District in 2015. The private sector being a major contributor in the detection of imported malaria cases in the country should be actively engaged in the national malaria surveillance system.

National NIF Diagnostic Program Fiscal Year 2002 Second Quarter Report

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

MacGowan, B

Since October 2001 the development of the facility diagnostics for NIF has been funded by the NIF Director through the National NIF Diagnostic Program (NNDP). The current emphasis of the NNDP is on diagnostics for the early NIF quad scheduled to be available for experiment commissioning in FY03. During the past six months the NNDP has set in place processes for funding diagnostics, developing requirements for diagnostics, design reviews and monthly status reporting. Those processes are described in an interim management plan for diagnostics (''National NIF Diagnostic Program Interim Plan'', NIF-0081315, April 2002) and a draft Program Execution Plan (''Programmore » Execution Plan for the National NlF Diagnostic Program'', NIF-0072083, October 2001) and documents cited therein. Work has been funded at Lawrence Livermore National Laboratory (LLNL), Los Alamos National Laboratory (LANL), Naval Research Laboratory (NRL), Sandia National Laboratories (SNL), Bechtel Nevada at Los Alamos and Santa Barbara. There are no major technical risks with the early diagnostics. The main concerns relate to integration of the diagnostics into the facility, all such issues are being worked. This report is organized to show the schedule and budget status and a summary of Change Control Board actions for the past six months. The following sections then provide short descriptions of the status of each diagnostic. Where design reviews or requirements documents are cited, the documents are available on the Diagnostics file server or on request.« less

Ponticulus posticus is a frequent radiographic finding on lateral cephalograms in nevoid basal cell carcinoma syndrome (Gorlin-Goltz syndrome).

PubMed

Friedrich, Reinhard E

2014-12-01

Nevoid basal cell carcinoma syndrome (NBCCS) is a predisposition to a rare tumor type with a variable phenotype. Besides tumors, skeletal alterations, such as bifid ribs or frontal bossing constitute the phenotype. Recently, a variant of the first cervical vertebra, the ponticulus posticus, was reported to occur in 50% of patients with NBCCS as revealed by analysis of lateral cephalograms. Lateral cephalograms of eight patients with NBCCS were studied for the presence of ponticulus posticus. The ponticulus posticus was present in all patients. In one case, a series of cephalograms performed during a period of 20 years allowed the slow and continuous recording of a ponticulus posticus formation. Besides the predisposition to developing neoplasms, NBCCS also affects bone development. Some diagnostic criteria for NBCCS rely on certain osseous transformations either in hard tissues, e.g. keratocystic odontogenic tumor in jaws, or in soft tissues, e.g. calcification of the falx cerebri. Furthermore, the physiognomy can be affected by skeletal alterations, e.g. frontal bossing or hypertelorism. Given this wide spectrum of osseous involvement in NBCCS, the high prevalence rate of ponticulus posticus should be added to the relevant diagnostic findings of the skull and vertebral column. However, the onset of ponticulus posticus formation in the life of such patients is unclear and thus the relevance of this finding in early diagnosis of NBCCS remains to be elucidated. Copyright© 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Nanoimaging to Prevent and Treat Alzheimer’s and Parkinson’s Diseases. Scientific/Technical report

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

Yuri L. Lyubchenko, PhD, DSc

2012-12-20

This project will develop innovative approaches to characterization of the very early stages of protein aggregation that eventually can be translated to the development of early diagnostic tools and efficient treatments for Alzheimer’s, Parkinson’s and Huntington’s diseases. Funding will be used to acquire nanoimaging technology for nanoscale imaging, manipulation and analysis of biomedical materials to develop treatments that will repair disabled proteins and cure diseases that result from protein malfunction, specifically Alzheimer’s and Parkinson’s diseases. Expected outcomes include tests for early diagnosis and therapeutic treatments for these devastating neurological diseases. To elucidate the mechanisms of protein misfolding, we will establishmore » an extensive program of experimental studies using a broad arsenal of advanced nanoscale and traditional techniques that will be integrated with molecular-scale modeling of protein misfolding and the nucleation of aggregate structures. To identify intracellular machinery or/and multicomponent complexes critically involved in protein misfolding, we will characterize interactions between targeted proteins and specific intracellular components or metabolites that impact on protein conformational pathways leading to protein misfolding accompanied by formation of toxic aggregated morphologies. To design innovative nanotechnology tools for the control of intracellular protein misfolding and aggregation processes, we will develop a predictive molecular scale model for intracellular protein misfolding and the formation of toxic aggregates. Verified through experimental studies, the objective is to establish an enabling foundation for the engineering of novel molecular diagnostics and therapeutics for various cellular pathologies.« less

New tracers identify hydraulic fracturing fluids and accidental releases from oil and gas operations.

PubMed

Warner, N R; Darrah, T H; Jackson, R B; Millot, R; Kloppmann, W; Vengosh, A

2014-11-04

Identifying the geochemical fingerprints of fluids that return to the surface after high volume hydraulic fracturing of unconventional oil and gas reservoirs has important applications for assessing hydrocarbon resource recovery, environmental impacts, and wastewater treatment and disposal. Here, we report for the first time, novel diagnostic elemental and isotopic signatures (B/Cl, Li/Cl, δ11B, and δ7Li) useful for characterizing hydraulic fracturing flowback fluids (HFFF) and distinguishing sources of HFFF in the environment. Data from 39 HFFFs and produced water samples show that B/Cl (>0.001), Li/Cl (>0.002), δ11B (25-31‰) and δ7Li (6-10‰) compositions of HFFF from the Marcellus and Fayetteville black shale formations were distinct in most cases from produced waters sampled from conventional oil and gas wells. We posit that boron isotope geochemistry can be used to quantify small fractions (∼0.1%) of HFFF in contaminated fresh water and likely be applied universally to trace HFFF in other basins. The novel environmental application of this diagnostic isotopic tool is validated by examining the composition of effluent discharge from an oil and gas brine treatment facility in Pennsylvania and an accidental spill site in West Virginia. We hypothesize that the boron and lithium are mobilized from exchangeable sites on clay minerals in the shale formations during the hydraulic fracturing process, resulting in the relative enrichment of boron and lithium in HFFF.

Clinically expedient reporting of rapid diagnostic test information.

PubMed

Doern, G V

1986-03-01

With the development of rapid diagnostic tests in the clinical microbiology laboratory has come an awareness of the importance of rapid results reporting. Clearly, the potential clinical impact of rapid diagnostic tests is dependent on expeditious reporting. Traditional manual reporting systems are encumbered by the necessity of transcription of test information onto hard copy reports and then the subsequent distribution of such reports into the hands of the user. Laboratory computers when linked directly to CRTs located in nursing stations, ambulatory clinics, or physician's offices, both inside and outside of the hospital, permit essentially instantaneous transfer of test results from the laboratory to the clinician. Computer-assisted results reporting, while representing a significant advance over manual reporting systems is not, however, without problems. Concerns include validation of test information, authorization of users with access to test information, mechanical integrity, and cost. These issues notwithstanding, computerized results reporting will undoubtedly play a central role in optimizing the clinical impact of rapid diagnostic tests.

Project DIVIDE Instrument Development. Technical Report # 0810

ERIC Educational Resources Information Center

Ketterlin-Geller, Leanne; Jung, Eunju; Geller, Josh; Yovanoff, Paul

2008-01-01

In this technical report, we describe the development of cognitive diagnostic test items that form the basis of the diagnostic system for Project DIVIDE (Dynamic Instruction Via Individually Designed Environments). The construct underlying the diagnostic test is division of fractions. We include a description of the process we used to identify the…

[THE VIRTUAL CYTOLOGIC SLIDES FOR EXTERNAL EVALUATION OF QUALITY OF IMPLEMENTATION OF CYTOLOGIC ANALYSES IN CLINICAL DIAGNOSTIC LABORATORIES: POSSIBILITIES AND PERSPECTIVES].

PubMed

Djangirova, T V; Shabalova, I P; Pronichev, A N; Polyakov, E V

2015-08-01

The article considers application of technology of analysis of cytological slides in external quality control of clinical diagnostic laboratories. The advantages of virtual slides are demonstrated against other applied technologies of external evaluation of quality i.e. slide plate and digital micro-photography. The conditions of formation of virtual slides for external evaluation of quality of clinical diagnostic laboratories. The technology of their application is described. The success of practical application of considered technology in the Federal system of external evaluation of quality is emphasized.

Heavy Ion Fusion Science Virtual National Laboratory 4th Quarter 2009 Milestone Report: Measure and simulate target temperature and dynamic response in optimized NDCX-I configurations with initial diagnostics suite

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

Bieniosek, F.M.; Barnard, J.J.; Henestroza, E.

2009-09-30

This milestone has been met. The effort contains two main components: (1) Experimental results of warm dense matter target experiments on optimized NDCX-I configurations that include measurements of target temperature and transient target behavior. (2) A theoretical model of the target response to beam heating that includes an equilibrium heating model of the target foil and a model for droplet formation in the target for comparison with experimental results. The experiments on ion-beam target heating use a 300-350-keV K{sup +} pulsed beam from the Neutralized Compression Drift Experiment (NDCX-I) accelerator at LBNL. The NDCX-I accelerator delivers an uncompressed pulse beammore » of several microseconds with a typical power density of >100 kW/cm{sup 2} over a final focus spot size of about 1 mm. An induction bunching module the NDCX-I compresses a portion of the beam pulse to reach a much higher power density over 2 nanoseconds. Under these conditions the free-standing foil targets are rapidly heated to temperatures to over 4000 K. We model the target thermal dynamics using the equation of heat conduction for the temperature T(x,t) as a function of time (t) and spatial dimension along the beam direction (x). The competing cooling processes release energy from the surface of the foil due to evaporation, radiation, and thermionic (Richardson) emission. A description of the experimental configuration of the target chamber and results from initial beam-target experiments are reported in our FY08 4th Quarter and FY09 2nd Quarter Milestone Reports. The WDM target diagnostics include a high-speed multichannel optical pyrometer, optical streak camera, VISAR, and high-speed gated cameras. The fast optical pyrometer is a unique and significant new diagnostic which provides valuable information on the temperature evolution of the heated target.« less

Development of the Technology of Vortex Diagnostics to Improve the Safety of Operation of Nuclear Reactors

NASA Astrophysics Data System (ADS)

Mitrofanova, O. V.; Ivlev, O. A.; Pozdeeva, I. G.; Urtenov, D. S.

2017-11-01

The results of studies are aimed at developing theoretical foundations and instrumentation system to ensure a technology of vortex diagnostics of the state of flows of fluids for nuclear power installations with power water reactors and fast neutrons reactors with liquid-metal coolants. The technology of vortex diagnostics is based on the study of acoustic, magneto-hydrodynamic and resonant effects related to the formation of stable vortex structures. For creation a system of monitoring and diagnostics of the crisis phenomena due to hydrodynamics of the flow, it is proposed to use acoustic method to record the radiation of elastic waves in the fluids caused by the dynamic local rearrangement of its structure.

Evaluation of Automatic Item Generation Utilities in Formative Assessment Application for Korean High School Students

ERIC Educational Resources Information Center

Choi, Jaehwa; Kim, HeeKyoung; Pak, Seohong

2018-01-01

The recent interests in research in the assessment field have been rapidly shifting from decision-maker-centered assessments to learner-centered assessments (i.e., diagnostic and/or formative assessments). In particular, it is a very important research topic in this field to analyze how these learner-centered assessments are developed more…

TME10/380: Remote Transmission of Radiological Images by means of Intranet/Internet Technology

PubMed Central

Sicurello, F; Pizzi, R

1999-01-01

At the Istituto Nazionale Neurologico C. Besta in Milano a network architecture has been developed to connect computers and diagnostic modalities, based on Intranet technology in order to allow the hospital to have an external access through the Internet. The Internet technology has become the "glue" that allows to link different computers and to develop applications able to work independently from the hardware/software platform. Using a PACS (Picture Archiving and Communication System) system integrated to the diagnostic modalities by means of the standardized DICOM image format, the digital radiological images can be transferred, displayed and processed on special visualization workstations all around the hospital. From the workstations the same images can be transferred in DICOM format to a teleconsulting workstation. In fact the hospital is involved in a national project for the remote connection between many Italian hospitals. This national network is linked to already developed regional networks like the Toscana MAN and the ATM Sirius Network. Some links are performed directly in ATM (155 Mbps), others are based on CDN (Direct Numerical Connection, 2Mbps), others are simply based on ISDN connections. The system allows to make it simpler and faster the already established daily exchange of radiological reports between the involved hospitals, especially from Istituto Nazionale Neurologico and Istituto Nazionale deiTumori. All the actions performed by the radiologist are translated by the software into "events" and replied to the remote workstation and vice-versa. In this way the radiologists can see each others, speak together and act in real time on a common "board" of diagnostic images, each one with his own pointer. The adopted technology is evolving on a system based on a web architecture and Java applications, useful for small clinical centers not endowed with expensive information systems. These centers will be able to get consulting performances by the excellence centers, making available accurate diagnoses and therapy protocols.

PSYCHIATRIC COMORBIDITY DOES NOT ONLY DEPEND ON DIAGNOSTIC THRESHOLDS: AN ILLUSTRATION WITH MAJOR DEPRESSIVE DISORDER AND GENERALIZED ANXIETY DISORDER.

PubMed

van Loo, Hanna M; Schoevers, Robert A; Kendler, Kenneth S; de Jonge, Peter; Romeijn, Jan-Willem

2016-02-01

High rates of psychiatric comorbidity are subject of debate: To what extent do they depend on classification choices such as diagnostic thresholds? This paper investigates the influence of different thresholds on rates of comorbidity between major depressive disorder (MDD) and generalized anxiety disorder (GAD). Point prevalence of comorbidity between MDD and GAD was measured in 74,092 subjects from the general population (LifeLines) according to Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) criteria. Comorbidity rates were compared for different thresholds by varying the number of necessary criteria from ≥ 1 to all nine symptoms for MDD, and from ≥ 1 to all seven symptoms for GAD. According to DSM thresholds, 0.86% had MDD only, 2.96% GAD only, and 1.14% both MDD and GAD (odds ratio (OR) 42.6). Lower thresholds for MDD led to higher rates of comorbidity (1.44% for ≥ 4 of nine MDD symptoms, OR 34.4), whereas lower thresholds for GAD hardly influenced comorbidity (1.16% for ≥ 3 of seven GAD symptoms, OR 38.8). Specific patterns in the distribution of symptoms within the population explained this finding: 37.3% of subjects with core criteria of MDD and GAD reported subthreshold MDD symptoms, whereas only 7.6% reported subthreshold GAD symptoms. Lower thresholds for MDD increased comorbidity with GAD, but not vice versa, owing to specific symptom patterns in the population. Generally, comorbidity rates result from both empirical symptom distributions and classification choices and cannot be reduced to either of these exclusively. This insight invites further research into the formation of disease concepts that allow for reliable predictions and targeted therapeutic interventions. © 2015 Wiley Periodicals, Inc.

Metrological traceability in education: A practical online system for measuring and managing middle school mathematics instruction

NASA Astrophysics Data System (ADS)

Torres Irribarra, D.; Freund, R.; Fisher, W.; Wilson, M.

2015-02-01

Computer-based, online assessments modelled, designed, and evaluated for adaptively administered invariant measurement are uniquely suited to defining and maintaining traceability to standardized units in education. An assessment of this kind is embedded in the Assessing Data Modeling and Statistical Reasoning (ADM) middle school mathematics curriculum. Diagnostic information about middle school students' learning of statistics and modeling is provided via computer-based formative assessments for seven constructs that comprise a learning progression for statistics and modeling from late elementary through the middle school grades. The seven constructs are: Data Display, Meta-Representational Competence, Conceptions of Statistics, Chance, Modeling Variability, Theory of Measurement, and Informal Inference. The end product is a web-delivered system built with Ruby on Rails for use by curriculum development teams working with classroom teachers in designing, developing, and delivering formative assessments. The online accessible system allows teachers to accurately diagnose students' unique comprehension and learning needs in a common language of real-time assessment, logging, analysis, feedback, and reporting.

The distribution of star formation and metals in the low surface brightness galaxy UGC 628

NASA Astrophysics Data System (ADS)

Young, J. E.; Kuzio de Naray, Rachel; Wang, Sharon X.

2015-09-01

We introduce the MUSCEL Programme (MUltiwavelength observations of the Structure, Chemistry and Evolution of LSB galaxies), a project aimed at determining the star-formation histories of low surface brightness galaxies. MUSCEL utilizes ground-based optical spectra and space-based UV and IR photometry to fully constrain the star-formation histories of our targets with the aim of shedding light on the processes that led low surface brightness galaxies down a different evolutionary path from that followed by high surface brightness galaxies, such as our Milky Way. Here we present the spatially resolved optical spectra of UGC 628, observed with the VIRUS-P IFU at the 2.7-m Harlen J. Smith Telescope at the McDonald Observatory, and utilize emission-line diagnostics to determine the rate and distribution of star formation as well as the gas-phase metallicity and metallicity gradient. We find highly clustered star formation throughout UGC 628, excluding the core regions, and a log(O/H) metallicity around -4.2, with more metal-rich regions near the edges of the galactic disc. Based on the emission-line diagnostics alone, the current mode of star formation, slow and concentrated in the outer disc, appears to have dominated for quite some time, although there are clear signs of a much older stellar population formed in a more standard inside-out fashion.

Formation and acceleration of uniformly filled ellipsoidal electron bunches obtained via space-charge-driven expansion from a cesium-telluride photocathode

NASA Astrophysics Data System (ADS)

Piot, P.; Sun, Y.-E.; Maxwell, T. J.; Ruan, J.; Secchi, E.; Thangaraj, J. C. T.

2013-01-01

We report the experimental generation, acceleration, and characterization of a uniformly filled electron bunch obtained via space-charge-driven expansion (often referred to as “blow-out regime”) in an L-band (1.3-GHz) radiofrequency photoinjector. The beam is photoemitted from a cesium-telluride semiconductor photocathode using a short (<200fs) ultraviolet laser pulse. The produced electron bunches are characterized with conventional diagnostics and the signatures of their ellipsoidal character are observed. We especially demonstrate the production of ellipsoidal bunches with charges up to ˜0.5nC corresponding to a ˜20-fold increase compared to previous experiments with metallic photocathodes.

Advanced biosensors for monitoring astronauts' health during long-duration space missions.

PubMed

Roda, Aldo; Mirasoli, Mara; Guardigli, Massimo; Zangheri, Martina; Caliceti, Cristiana; Calabria, Donato; Simoni, Patrizia

2018-07-15

Long-duration space missions pose important health concerns for astronauts, especially regarding the adverse effects of microgravity and exposure to high-energy cosmic rays. The long-term maintenance of crew health and performance mainly relies on prevention, early diagnoses, condition management, and medical interventions in situ. In-flight biosensor diagnostic devices and medical procedures must use few resources and operate in a microgravity environment, which complicates the collection and management of biological samples. Moreover, the biosensors must be certified for in-flight operation according to strict design and safety regulations. Herein, we report on the state of the art and recent advances in biosensing diagnostic instrumentation for monitoring astronauts' health during long-duration space missions, including portable and wearable biosensors. We discuss perspectives on new-format biosensors in autonomous space clinics. We also describe our own work in developing biosensing devices for non-invasively diagnosing space-related diseases, and how they are used in long-duration missions. Finally, we discuss the benefits of space exploration for Earth-based medicine. Copyright © 2018 Elsevier B.V. All rights reserved.

Comparison of the Sanofi Diagnostics Pasteur Chlamydia Microplate EIA shortened assay with the original standard assay and cell culture.

PubMed

Chan, E L; Brandt, K; Stoneham, H; Horsman, G

1997-08-01

The new Sanofi Diagnostics Pasteur Chlamydia Microplate EIA shortened assay was evaluated by comparison with the original standard assay and cell culture. A total of 853 paired male and female genital tract specimens was tested with both Sanofi Chlamydia Microplate EIA shortened and standard assays and the results were compared with those of cell culture. For confirmation, a blocking assay run in the shortened format was used. Discrepancies between the three methods were resolved by a direct fluorescent antibody (DFA) test on the EIA samples or the culture retentate, or both. After resolution of discrepant results, the standard assay had a sensitivity, specificity, positive predictive value and negative predictive value of 98.5%, 100%, 100% and 99.9%, respectively. The shortened assay results were 100%, 100%, 100% and 100%, respectively. The shortened assay takes approximately 1.5 h less time than the standard assay and this study demonstrated that they have equivalent sensitivity and specificity. The improvement in turnaround time enables results to be reported on the same day.

Palynostratigraphy, palaeoclimates and palaeodepositional environments of the Miocene aged Agbada Formation in the Niger Delta, Nigeria

NASA Astrophysics Data System (ADS)

Bankole, Samson I.; Schrank, Eckart; Osterloff, Peter L.

2014-07-01

A diverse assemblage of palynomorphs dominated by terrestrially derived pollen and spores is reported from three wells penetrating the Miocene Agbada Formation. The pteridophyte and bryophyte spores which form the background assemblages in the three wells are good indicators of humid tropical climates which might have prevailed in the Niger Delta during the Miocene. The abundance and variations of climate-sensitive taxa including mangrove affiliated pollen and spore types Acrostichumsporites, Psilatricolporites crassus, Zonocostites ramonae and Graminidites annulatus representing the savannah vegetation cover indicate a complex interplay between periods of wetter and drier climates. Marine-derived dinoflagellate cysts and foraminiferal test linings are significantly present in the three wells. Taxa indicating freshwater contributions including Botryococcus spp., Chomotriletes minor, Ovoidites parvus and Pediastrum spp. are also represented numerically across the three wells. The presence of age diagnostic palynomorphs such as Crassoretitriletes vanraadshooveni, Retibrevitricolporites obodoensis, Tuberculodinium vancampoae, Zonocostites ramonae and Tuberculodinium vancampoae recovered in the three sections studied suggest a Miocene age for the investigated Agbada Formation. The proposed age is supported by the ranges of key palynomorphs in contemporaneous basins in Africa, northern South America and other parts of the World.

A lateral electrophoretic flow diagnostic assay

PubMed Central

Lin, Robert; Skandarajah, Arunan; Gerver, Rachel E.; Neira, Hector D.; Fletcher, Daniel A.

2015-01-01

Immunochromatographic assays are a cornerstone tool in disease screening. To complement existing lateral flow assays (based on wicking flow) we introduce a lateral flow format that employs directed electrophoretic transport. The format is termed a “lateral e-flow assay” and is designed to support multiplexed detection using immobilized reaction volumes of capture antigen. To fabricate the lateral e-flow device, we employ mask-based UV photopatterning to selectively immobilize unmodified capture antigen along the microchannel in a barcode-like pattern. The channel-filling polyacrylamide hydrogel incorporates a photoactive moiety (benzophenone) to immobilize capture antigen to the hydrogel without a priori antigen modification. We report a heterogeneous sandwich assay using low-power electrophoresis to drive biospecimen through the capture antigen barcode. Fluorescence barcode readout is collected via a low-resource appropriate imaging system (CellScope). We characterize lateral e-flow assay performance and demonstrate a serum assay for antibodies to the hepatitis C virus (HCV). In a pilot study, the lateral e-flow assay positively identifies HCV+ human sera in 60 min. The lateral e-flow assay provides a flexible format for conducting multiplexed immunoassays relevant to confirmatory diagnosis in near-patient settings. PMID:25608872

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

NASA Astrophysics Data System (ADS)

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

2017-10-01

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

Sample size in studies on diagnostic accuracy in ophthalmology: a literature survey.

PubMed

Bochmann, Frank; Johnson, Zoe; Azuara-Blanco, Augusto

2007-07-01

To assess the sample sizes used in studies on diagnostic accuracy in ophthalmology. Design and sources: A survey literature published in 2005. The frequency of reporting calculations of sample sizes and the samples' sizes were extracted from the published literature. A manual search of five leading clinical journals in ophthalmology with the highest impact (Investigative Ophthalmology and Visual Science, Ophthalmology, Archives of Ophthalmology, American Journal of Ophthalmology and British Journal of Ophthalmology) was conducted by two independent investigators. A total of 1698 articles were identified, of which 40 studies were on diagnostic accuracy. One study reported that sample size was calculated before initiating the study. Another study reported consideration of sample size without calculation. The mean (SD) sample size of all diagnostic studies was 172.6 (218.9). The median prevalence of the target condition was 50.5%. Only a few studies consider sample size in their methods. Inadequate sample sizes in diagnostic accuracy studies may result in misleading estimates of test accuracy. An improvement over the current standards on the design and reporting of diagnostic studies is warranted.

Singlet-Oxygen Generation From Individual Semiconducting and Metallic Nanostructures During Near-Infrared Laser Trapping

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

Smith, Bennett E.; Roder, Paden B.; Hanson, Jennifer L.

2015-03-13

Photodynamic therapy has been used for several decades in the treatment of solid tumors through the generation of reactive singlet-oxygen species (1O2). Recently, nanoscale metallic and semiconducting materials have been reported to act as photosensitizing agents with additional diagnostic and therapeutic functionality. To date there have been no reports of observing the generation of singlet-oxygen at the level of single nanostructures, particularly at near infrared (NIR) wavelengths. Here we demonstrate that NIR laser-tweezers can be used to observe the formation of singlet-oxygen produced from individual silicon and gold nanowires via use of a commercially available reporting dye. The laser trapmore » also induces 2-photon photoexcitation of the dye following a chemical reaction with singlet oxygen. Corresponding 2-photon emission spectra confirms the generation of singlet oxygen from individual silicon nanowires at room temperature (30°C), suggesting a range of applications in understanding the impact of 1O2 on individual cancer cells.« less

Should radiology residents be taught evidence-based radiology? An experiment with "the EBR Journal Club".

PubMed

Heilbrun, Marta E

2009-12-01

Introduce radiology residents to evidence-based radiology (EBR) using a journal club format based on the Radiology Alliance for Health Services Research/American Alliance of Academic Chief Residents in Radiology (RAHSR/A3CR2) Critical Thinking Skills sessions and EBR series of articles published in Radiology in 2007. The club began with a presentation outlining the process that would occur in an alternating format, with topics and articles chosen by residents. In session A, questions were rephrased in a Patient/Population, Intervention, Comparison, Outcome format, and a literature search was performed. Articles were discussed in session B, with residents assigned by year to the tasks of article summary, technology assessment, and comparison to checklists (Standards for Reporting of Diagnostic Accuracy, Consolidated Standards of Reporting Trials, or Quality of Reporting of Meta-analysis). The residents collectively assigned a level of evidence to each article, and a scribe provided a summary. Twenty-two residents participated, with 12/22 (55%) of residents submitting any question, 6/22 (27.3%) submitting more than one question, and 4 residents submitting questions in more than one session. Topics included radiation risk, emergency radiology, screening examinations, modality comparisons, and technology assessment. Of the 31 articles submitted for review, 15 were in radiology journals and 5 were published before 2000. For 2/9 topics searched, no single article that the residents selected was available through our library's subscription service. The maximum level of evidence assigned by residents was level III, "limited evidence." In each session, the residents concluded that they became less confident in the "right answer." They proposed that future reading recommendations come from attendings rather than literature searches. A journal club format is an effective tool to teach radiology residents EBR principles. Resistance comes from the difficulty in accessing good literature for review and in constructing good review questions.

Appropriate Statistics for Determining Chance-Removed Interpractitioner Agreement.

PubMed

Popplewell, Michael; Reizes, John; Zaslawski, Chris

2018-05-31

Fleiss' Kappa (FK) has been commonly, but incorrectly, employed as the "standard" for evaluating chance-removed inter-rater agreement with ordinal data. This practice may lead to misleading conclusions in inter-rater agreement research. An example is presented that demonstrates the conditions where FK produces inappropriate results, compared with Gwet's AC2, which is proposed as a more appropriate statistic. A novel format for recording a Chinese Medical (CM) diagnoses, called the Diagnostic System of Oriental Medicine (DSOM), was used to record and compare patient diagnostic data, which, unlike the contemporary CM diagnostic format, allows agreement by chance to be considered when evaluating patient data obtained with unrestricted diagnostic options available to diagnosticians. Five CM practitioners diagnosed 42 subjects drawn from an open population. Subjects' diagnoses were recorded using the DSOM format. All the available data were initially used to evaluate agreement. Then, the subjects were sorted into three groups to demonstrate the effects of differing data marginality on the calculated chance-removed agreement. Agreement between the practitioners for each subject was evaluated with linearly weighted simple agreement, FK and Gwet's AC2. In all cases, overall agreement was much lower with FK than Gwet's AC2. Larger differences occurred when the data were more free marginal. Inter-rater agreement determined with FK statistics is unlikely to be correct unless it can be shown that the data from which agreement is determined are, in fact, fixed marginal. It follows that results obtained on agreement between practitioners with FK are probably incorrect. It is shown that inter-rater agreement evaluated with AC2 statistic is an appropriate measure when fixed marginal data are neither expected nor guaranteed. The AC2 statistic should be used as the standard statistical approach for determining agreement between practitioners.

Active galactic nuclei from He II: a more complete census of AGN in SDSS galaxies yields a new population of low-luminosity AGN in highly star-forming galaxies

NASA Astrophysics Data System (ADS)

Bär, Rudolf E.; Weigel, Anna K.; Sartori, Lia F.; Oh, Kyuseok; Koss, Michael; Schawinski, Kevin

2017-04-01

In order to perform a more complete census of active galactic nuclei (AGN) in the local Universe, we investigate the use of the He II λ4685 emission line diagnostic diagram by Shirazi & Brinchmann (2012) in addition to the standard methods based on other optical emission lines. The He II-based diagnostics is more sensitive to AGN ionization in the presence of strong star formation than conventional line diagnostics. We survey a magnitude-limited sample of 63 915 galaxies from the Sloan Digital Sky Survey Data Release 7 at 0.02 < z < 0.05 and use both the conventional BPT emission line diagnostic diagrams, as well as the He II diagram to identify AGN. In this sample, 1075 galaxies are selected as AGN using the BPT diagram, while additional 234 galaxies are identified as AGN using the He II diagnostic diagram, representing a 22 per cent increase of AGN in the parent galaxy sample. We explore the host galaxy properties of these new He II-selected AGN candidates and find that they are most common in star-forming galaxies on the blue cloud and on the main sequence where ionization from star formation is most likely to mask AGN emission in the BPT lines. We note in particular a high He II AGN fraction in galaxies above the high-mass end of the main sequence where quenching is expected to occur. We use archival Chandra observations to confirm the AGN nature of candidates selected through He II-based diagnostic. Finally, we discuss how this technique can help inform galaxy/black hole coevolution scenarios.

Diagnostic reliability of MMPI-2 computer-based test interpretations.

PubMed

Pant, Hina; McCabe, Brian J; Deskovitz, Mark A; Weed, Nathan C; Williams, John E

2014-09-01

Reflecting the common use of the MMPI-2 to provide diagnostic considerations, computer-based test interpretations (CBTIs) also typically offer diagnostic suggestions. However, these diagnostic suggestions can sometimes be shown to vary widely across different CBTI programs even for identical MMPI-2 profiles. The present study evaluated the diagnostic reliability of 6 commercially available CBTIs using a 20-item Q-sort task developed for this study. Four raters each sorted diagnostic classifications based on these 6 CBTI reports for 20 MMPI-2 profiles. Two questions were addressed. First, do users of CBTIs understand the diagnostic information contained within the reports similarly? Overall, diagnostic sorts of the CBTIs showed moderate inter-interpreter diagnostic reliability (mean r = .56), with sorts for the 1/2/3 profile showing the highest inter-interpreter diagnostic reliability (mean r = .67). Second, do different CBTIs programs vary with respect to diagnostic suggestions? It was found that diagnostic sorts of the CBTIs had a mean inter-CBTI diagnostic reliability of r = .56, indicating moderate but not strong agreement across CBTIs in terms of diagnostic suggestions. The strongest inter-CBTI diagnostic agreement was found for sorts of the 1/2/3 profile CBTIs (mean r = .71). Limitations and future directions are discussed. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Exploring the Case for a Global Alliance for Medical Diagnostics Initiative

PubMed Central

Mugambi, Melissa L.; Palamountain, Kara M.; Gallarda, Jim; Drain, Paul K.

2017-01-01

In recent years, the private and public sectors have increased investments in medical diagnostics for low- and middle-income countries (LMICs). Despite these investments, numerous barriers prevent the adoption of existing diagnostics and discourage the development and introduction of new diagnostics in LMICs. In the late 1990s, the global vaccine community had similar challenges, as vaccine coverage rates stagnated and the introduction of new vaccines was viewed as a distraction to delivering existing vaccines. To address these challenges, the international community came together and formed the Global Alliance for Vaccines Initiative (GAVI). Sixteen years after the formation of GAVI, we see evidence of a healthier global vaccine landscape. We discuss how GAVI’s four guiding principles (product, health systems strengthening, financing and market shaping) might apply to the advancement of medical diagnostics in LMICs. We present arguments for the international community and existing organizations to establish a Global Alliance for Medical Diagnostics Initiative (GAMDI). PMID:28134750

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

PubMed

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

2018-01-29

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

Overview of diagnostic implementation on Proto-MPEX at ORNL

NASA Astrophysics Data System (ADS)

Biewer, T. M.; Bigelow, T.; Caughman, J. B. O.; Fehling, D.; Goulding, R. H.; Gray, T. K.; Isler, R. C.; Martin, E. H.; Meitner, S.; Rapp, J.; Unterberg, E. A.; Dhaliwal, R. S.; Donovan, D.; Kafle, N.; Ray, H.; Shaw, G. C.; Showers, M.; Mosby, R.; Skeen, C.

2015-11-01

The Prototype Material Plasma Exposure eXperiment (Proto-MPEX) recently began operating with an expanded diagnostic set. Approximately 100 sightlines have been established, delivering the plasma light emission to a ``patch panel'' in the diagnostic room for distribution to a variety of instruments: narrow-band filter spectroscopy, Doppler spectroscopy, laser induced breakdown spectroscopy, optical emission spectroscopy, and Thomson scattering. Additional diagnostic systems include: IR camera imaging, in-vessel thermocouples, ex-vessel fluoroptic probes, fast pressure gauges, visible camera imaging, microwave interferometry, a retarding-field energy analyzer, rf-compensated and ``double'' Langmuir probes, and B-dot probes. A data collection and archival system has been initiated using the MDSplus format. This effort capitalizes on a combination of new and legacy diagnostic hardware at ORNL and was accomplished largely through student labor. This work was supported by the US. D.O.E. contract DE-AC05-00OR22725.

A systematic review of the PTSD Checklist's diagnostic accuracy studies using QUADAS.

PubMed

McDonald, Scott D; Brown, Whitney L; Benesek, John P; Calhoun, Patrick S

2015-09-01

Despite the popularity of the PTSD Checklist (PCL) as a clinical screening test, there has been no comprehensive quality review of studies evaluating its diagnostic accuracy. A systematic quality assessment of 22 diagnostic accuracy studies of the English-language PCL using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) assessment tool was conducted to examine (a) the quality of diagnostic accuracy studies of the PCL, and (b) whether quality has improved since the 2003 STAndards for the Reporting of Diagnostic accuracy studies (STARD) initiative regarding reporting guidelines for diagnostic accuracy studies. Three raters independently applied the QUADAS tool to each study, and a consensus among the 4 authors is reported. Findings indicated that although studies generally met standards in several quality areas, there is still room for improvement. Areas for improvement include establishing representativeness, adequately describing clinical and demographic characteristics of the sample, and presenting better descriptions of important aspects of test and reference standard execution. Only 2 studies met each of the 14 quality criteria. In addition, study quality has not appreciably improved since the publication of the STARD Statement in 2003. Recommendations for the improvement of diagnostic accuracy studies of the PCL are discussed. (c) 2015 APA, all rights reserved).

Diagnosis of aphasia in stroke populations: A systematic review of language tests

PubMed Central

2018-01-01

Background and purpose Accurate aphasia diagnosis is important in stroke care. A wide range of language tests are available and include informal assessments, tests developed by healthcare institutions and commercially published tests available for purchase in pre-packaged kits. The psychometrics of these tests are often reported online or within the purchased test manuals, not the peer-reviewed literature, therefore the diagnostic capabilities of these measures have not been systematically evaluated. This review aimed to identify both commercial and non-commercial language tests and tests used in stroke care and to examine the diagnostic capabilities of all identified measures in diagnosing aphasia in stroke populations. Methods Language tests were identified through a systematic search of 161 publisher databases, professional and resource websites and language tests reported to be used in stroke care. Two independent reviewers evaluated test manuals or associated resources for cohort or cross-sectional studies reporting the tests’ diagnostic capabilities (sensitivity, specificity, likelihood ratios or diagnostic odds ratios) in differentiating aphasic and non-aphasic stroke populations. Results Fifty-six tests met the study eligibility criteria. Six “non-specialist” brief screening tests reported sensitivity and specificity information, however none of these measures reported to meet the specific diagnostic needs of speech pathologists. The 50 remaining measures either did not report validity data (n = 7); did not compare patient test performance with a comparison group (n = 17); included non-stroke participants within their samples (n = 23) or did not compare stroke patient performance against a language reference standard (n = 3). Diagnostic sensitivity analysis was completed for six speech pathology measures (WAB, PICA, CADL-2, ASHA-FACS, Adult FAVRES and EFA-4), however all studies compared aphasic performance with that of non-stroke healthy controls and were consequently excluded from the review. Conclusions No speech pathology test was found which reported diagnostic data for identifying aphasia in stroke populations. A diagnostically validated post-stroke aphasia test is needed. PMID:29566043

Phenomenology of Schizophrenia and the Representativeness of Modern Diagnostic Criteria.

PubMed

Kendler, Kenneth S

2016-10-01

This article aims to determine the degree to which modern operationalized diagnostic criteria for schizophrenia reflect the main clinical features of the disorder as described historically by diagnostic experts. Amazon.com, the National Library of Medicine, and Forgottenbooks.com were searched for articles written or translated into English from 1900 to 1960. Clinical descriptions of schizophrenia or dementia praecox appearing in 16 textbooks or review articles published between 1899 and 1956 were reviewed and compared with the criteria for schizophrenia from 6 modern US operationalized diagnostic systems. Twenty prominent symptoms and signs were reported by 5 or more authors. A strong association was seen between the frequency with which the symptoms/signs were reported and the likelihood of their presence in modern diagnostic systems. Of these 20 symptoms/signs, 3 (thought disorder, delusions, and hallucinations) were included in all diagnostic systems and were among the 4 most frequently reported. Three symptoms/signs were added then kept in subsequent criteria: emotional blunting, changes in volition, and changes in social life. Three symptoms/signs were added but then dropped: bizarre delusions, passivity symptoms, and mood incongruity. Eleven symptoms/signs were never included in any diagnostic system. Compared with historical authors, modern criteria favored symptoms over signs. Odd movements and postures, noted by 16 of 18 historical authors, were absent from all modern criteria. DSM-5 criteria contain 6 of the 20 historically noted symptoms/signs. Although modern operationalized criteria for schizophrenia reflect symptoms and signs commonly reported by historical experts, many clinical features emphasized by these experts are absent from modern criteria. This is not necessarily problematic as diagnostic criteria are meant to index rather than thoroughly describe syndromes. However, the lack of correspondence in schizophrenia between historically important symptoms/signs and current diagnostic systems highlights the limitations of clinical evaluations and research studies that restrict the diagnostic assessments to current diagnostic criteria. We should not confuse our DSM diagnostic criteria with the disorders that they were designed to index.

Diagnostic report acquisition unit for the Mayo/IBM PACS project

NASA Astrophysics Data System (ADS)

Brooks, Everett G.; Rothman, Melvyn L.

1991-07-01

The Mayo Clinic and IBM Rochester have jointly developed a picture archive and control system (PACS) for use with Mayo's MRI and Neuro-CT imaging modalities. One of the challenges of developing a useful PACS involves integrating the diagnostic reports with the electronic images so they can be displayed simultaneously. By the time a diagnostic report is generated for a particular case, its images have already been captured and archived by the PACS. To integrate the report with the images, the authors have developed an IBM Personal System/2 computer (PS/2) based diagnostic report acquisition unit (RAU). A typed copy of the report is transmitted via facsimile to the RAU where it is stacked electronically with other reports that have been sent previously but not yet processed. By processing these reports at the RAU, the information they contain is integrated with the image database and a copy of the report is archived electronically on an IBM Application System/400 computer (AS/400). When a user requests a set of images for viewing, the report is automatically integrated with the image data. By using a hot key, the user can toggle on/off the report on the display screen. This report describes process, hardware, and software employed to integrate the diagnostic report information into the PACS, including how the report images are captured, transmitted, and entered into the AS/400 database. Also described is how the archived reports and their associated medical images are located and merged for retrieval and display. The methods used to detect and process error conditions are also discussed.

The Technologist Function in Fields Related to Radiology: Tasks in Radiation Therapy and Diagnostic Ultrasound. Research Report No. 9; Relating Technologist Tasks in Diagnostic Radiology, Ultrasound and Radiation Therapy. Research Report No. 10.

ERIC Educational Resources Information Center

Gilpatrick, Eleanor

The two research reports included in this document describe the application of the Health Services Mobility Study (HSMS) task analysis method to two technologist functions and examine the interrelationships of these tasks with those in diagnostic radiology. (The HSMS method includes processes for using the data for designing job ladders, for…

On the star-forming ability of Molecular Clouds

NASA Astrophysics Data System (ADS)

Anathpindika, S.; Burkert, A.; Kuiper, R.

2018-02-01

The star-forming ability of a molecular cloud depends on the fraction of gas it can cycle into the dense-phase. Consequently, one of the crucial questions in reconciling star formation in clouds is to understand the factors that control this process. While it is widely accepted that the variation in ambient conditions can alter significantly the ability of a cloud to spawn stars, the observed variation in the star-formation rate in nearby clouds that experience similar ambient conditions, presents an interesting question. In this work, we attempted to reconcile this variation within the paradigm of colliding flows. To this end we develop self-gravitating, hydrodynamic realizations of identical flows, but allowed to collide off-centre. Typical observational diagnostics such as the gas-velocity dispersion, the fraction of dense-gas, the column density distribution (N-PDF), the distribution of gas mass as a function of K-band extinction and the strength of compressional/solenoidal modes in the post-collision cloud were deduced for different choices of the impact parameter of collision. We find that a strongly sheared cloud is terribly inefficient in cycling gas into the dense phase and that such a cloud can possibly reconcile the sluggish nature of star formation reported for some clouds. Within the paradigm of cloud formation via colliding flows this is possible in case of flows colliding with a relatively large impact parameter. We conclude that compressional modes - though probably essential - are insufficient to ensure a relatively higher star-formation efficiency in a cloud.

Development of Improved Oil Field Waste Injection Disposal Techniques

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

Terralog Technologies

2002-11-25

The goals of this project have was to: (1) assemble and analyze a comprehensive database of past waste injection operations; (2) develop improved diagnostic techniques for monitoring fracture growth and formation changes; (3) develop operating guidelines to optimize daily operations and ultimate storage capacity of the target formation; and (4) to apply these improved models and guidelines in the field.

Case-Based Learning with Worked Examples in Complex Domains: Two Experimental Studies in Undergraduate Medical Education

ERIC Educational Resources Information Center

Stark, Robin; Kopp, Veronika; Fischer, Martin R.

2011-01-01

To investigate the effects of example format (erroneous examples vs. correct examples) and feedback format (elaborated feedback vs. knowledge of results feedback) on medical students' diagnostic competence in the context of a web-based learning environment containing case-based worked examples, two studies with a 2 x 2 design were conducted in the…

Nanoparticle forming reactive plasmas: a multidiagnostic approach

NASA Astrophysics Data System (ADS)

Hinz, Alexander; Wahl, Erik von; Faupel, Franz; Strunskus, Thomas; Kersten, Holger

2018-05-01

With an ever increasing interest in functional materials based on nanoparticles a large amount of research in this field is dedicated to the development of new production methods for nanoparticles. A promising class of methods for the production of nanoparticles is reactive plasmas. However, since the particle formation process and the interaction between the particles and the plasma are so far not completely understood, it remains difficult to control the particle formation. As the interaction between the nanoparticles and the plasma in which they are dispersed is complex the use of one or two diagnostics often provides only an incomplete understanding of the involved processes. Thus a multidiagnostic approach is needed. This contribution reviews the latest results from the study of nanoparticle formation in a hydrocarbon-based reactive plasma by such a multidiagnostic approach. It is shown that the use of various diagnostics like an IV-probe, optical emission spectroscopy, and a multipole resonance probe in conjunction with an investigation of the particle formation provides a much more detailed picture of these interesting, yet challenging, systems. Contribution to the Topical Issue "Fundamentals of Complex Plasmas", edited by Jürgen Meichsner, Michael Bonitz, Holger Fehske, Alexander Piel.

Focused ultrasound in ophthalmology

PubMed Central

Silverman, Ronald H

2016-01-01

The use of focused ultrasound to obtain diagnostically significant information about the eye goes back to the 1950s. This review describes the historical and technological development of ophthalmic ultrasound and its clinical application and impact. Ultrasound, like light, can be focused, which is crucial for formation of high-resolution, diagnostically useful images. Focused, single-element, mechanically scanned transducers are most common in ophthalmology. Specially designed transducers have been used to generate focused, high-intensity ultrasound that through thermal effects has been used to treat glaucoma (via ciliodestruction), tumors, and other pathologies. Linear and annular transducer arrays offer synthetic focusing in which precise timing of the excitation of independently addressable array elements allows formation of a converging wavefront to create a focus at one or more programmable depths. Most recently, linear array-based plane-wave ultrasound, in which the array emits an unfocused wavefront and focusing is performed solely on received data, has been demonstrated for imaging ocular anatomy and blood flow. While the history of ophthalmic ultrasound extends back over half-a-century, new and powerful technologic advances continue to be made, offering the prospect of novel diagnostic capabilities. PMID:27757007

Focused ultrasound in ophthalmology.

PubMed

Silverman, Ronald H

2016-01-01

The use of focused ultrasound to obtain diagnostically significant information about the eye goes back to the 1950s. This review describes the historical and technological development of ophthalmic ultrasound and its clinical application and impact. Ultrasound, like light, can be focused, which is crucial for formation of high-resolution, diagnostically useful images. Focused, single-element, mechanically scanned transducers are most common in ophthalmology. Specially designed transducers have been used to generate focused, high-intensity ultrasound that through thermal effects has been used to treat glaucoma (via ciliodestruction), tumors, and other pathologies. Linear and annular transducer arrays offer synthetic focusing in which precise timing of the excitation of independently addressable array elements allows formation of a converging wavefront to create a focus at one or more programmable depths. Most recently, linear array-based plane-wave ultrasound, in which the array emits an unfocused wavefront and focusing is performed solely on received data, has been demonstrated for imaging ocular anatomy and blood flow. While the history of ophthalmic ultrasound extends back over half-a-century, new and powerful technologic advances continue to be made, offering the prospect of novel diagnostic capabilities.

Heated probe diagnostic inside of the gas aggregation nanocluster source

NASA Astrophysics Data System (ADS)

Kolpakova, Anna; Shelemin, Artem; Kousal, Jaroslav; Kudrna, Pavel; Tichy, Milan; Biederman, Hynek; Surface; Plasma Science Team

2016-09-01

Gas aggregation cluster sources (GAS) usually operate outside common working conditions of most magnetrons and the size of nanoparticles created in GAS is below that commonly studied in dusty plasmas. Therefore, experimental data obtained inside the GAS are important for better understanding of process of nanoparticles formation. In order to study the conditions inside the gas aggregation chamber, special ``diagnostic GAS'' has been constructed. It allows simultaneous monitoring (or spatial profiling) by means of optical emission spectroscopy, mass spectrometry and probe diagnostic. Data obtained from Langmuir and heated probes map the plasma parameters in two dimensions - radial and axial. Titanium has been studied as an example of metal for which the reactive gas in the chamber starts nanoparticles production. Three basic situations were investigated: sputtering from clean titanium target in argon, sputtering from partially pre-oxidized target and sputtering with oxygen introduced into the discharge. It was found that during formation of nanoparticles the plasma parameters differ strongly from the situation without nanoparticles. These experimental data will support the efforts of more realistic modeling of the process. Czech Science Foundation 15-00863S.

The impact of a computerised test of attention and activity (QbTest) on diagnostic decision-making in children and young people with suspected attention deficit hyperactivity disorder: single-blind randomised controlled trial.

PubMed

Hollis, Chris; Hall, Charlotte L; Guo, Boliang; James, Marilyn; Boadu, Janet; Groom, Madeleine J; Brown, Nikki; Kaylor-Hughes, Catherine; Moldavsky, Maria; Valentine, Althea Z; Walker, Gemma M; Daley, David; Sayal, Kapil; Morriss, Richard

2018-04-26

Diagnosis of attention deficit hyperactivity disorder (ADHD) relies on subjective methods which can lead to diagnostic uncertainty and delay. This trial evaluated the impact of providing a computerised test of attention and activity (QbTest) report on the speed and accuracy of diagnostic decision-making in children with suspected ADHD. Randomised, parallel, single-blind controlled trial in mental health and community paediatric clinics in England. Participants were 6-17 years-old and referred for ADHD diagnostic assessment; all underwent assessment-as-usual, plus QbTest. Participants and their clinician were randomised to either receive the QbTest report immediately (QbOpen group) or the report was withheld (QbBlind group). The primary outcome was number of consultations until a diagnostic decision confirming/excluding ADHD within 6-months from baseline. Health economic cost-effectiveness and cost utility analysis was conducted. Assessing QbTest Utility in ADHD: A Randomised Controlled Trial was registered at ClinicalTrials.gov (https://clinicaltrials.gov/ct2/show/NCT02209116). One hundred and thirty-two participants were randomised to QbOpen group (123 analysed) and 135 to QbBlind group (127 analysed). Clinicians with access to the QbTest report (QbOpen) were more likely to reach a diagnostic decision about ADHD (hazard ratio 1.44, 95% CI 1.04-2.01). At 6-months, 76% of those with a QbTest report had received a diagnostic decision, compared with 50% without. QbTest reduced appointment length by 15% (time ratio 0.85, 95% CI 0.77-0.93), increased clinicians' confidence in their diagnostic decisions (odds ratio 1.77, 95% CI 1.09-2.89) and doubled the likelihood of excluding ADHD. There was no difference in diagnostic accuracy. Health economic analysis showed a position of strict dominance; however, cost savings were small suggesting that the impact of providing the QbTest report within this trial can best be viewed as 'cost neutral'. QbTest may increase the efficiency of ADHD assessment pathway allowing greater patient throughput with clinicians reaching diagnostic decisions faster without compromising diagnostic accuracy. © 2018 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.

Evaluation of recombinant proteins of Burkholderia mallei for serodiagnosis of glanders.

PubMed

Pal, Vijai; Kumar, Subodh; Malik, Praveen; Rai, Ganga Prasad

2012-08-01

Glanders is a contagious disease caused by the Gram-negative bacillus Burkholderia mallei. The number of equine glanders outbreaks has increased steadily during the last decade. The disease must be reported to the Office International des Epizooties, Paris, France. Glanders serodiagnosis is hampered by the considerable number of false positives and negatives of the internationally prescribed tests. The major problem leading to the low sensitivity and specificity of the complement fixation test (CFT) and enzyme-linked immunosorbent assay (ELISA) has been linked to the test antigens currently used, i.e., crude preparations of whole cells. False-positive results obtained from other diagnostic tests utilizing crude antigens lead to financial losses to animal owners, and false-negative results can turn a risk into a possible threat. In this study, we report on the identification of diagnostic targets using bioinformatics tools for serodiagnosis of glanders. The identified gene sequences were cloned and expressed as recombinant proteins. The purified recombinant proteins of B. mallei were used in an indirect ELISA format for serodiagnosis of glanders. Two recombinant proteins, 0375H and 0375TH, exhibited 100% sensitivity and specificity for glanders diagnosis. The proteins also did not cross-react with sera from patients with the closely related disease melioidosis. The results of this investigation highlight the potential of recombinant 0375H and 0375TH proteins in specific and sensitive diagnosis of glanders.

Evaluation of Recombinant Proteins of Burkholderia mallei for Serodiagnosis of Glanders

PubMed Central

Kumar, Subodh; Malik, Praveen

2012-01-01

Glanders is a contagious disease caused by the Gram-negative bacillus Burkholderia mallei. The number of equine glanders outbreaks has increased steadily during the last decade. The disease must be reported to the Office International des Epizooties, Paris, France. Glanders serodiagnosis is hampered by the considerable number of false positives and negatives of the internationally prescribed tests. The major problem leading to the low sensitivity and specificity of the complement fixation test (CFT) and enzyme-linked immunosorbent assay (ELISA) has been linked to the test antigens currently used, i.e., crude preparations of whole cells. False-positive results obtained from other diagnostic tests utilizing crude antigens lead to financial losses to animal owners, and false-negative results can turn a risk into a possible threat. In this study, we report on the identification of diagnostic targets using bioinformatics tools for serodiagnosis of glanders. The identified gene sequences were cloned and expressed as recombinant proteins. The purified recombinant proteins of B. mallei were used in an indirect ELISA format for serodiagnosis of glanders. Two recombinant proteins, 0375H and 0375TH, exhibited 100% sensitivity and specificity for glanders diagnosis. The proteins also did not cross-react with sera from patients with the closely related disease melioidosis. The results of this investigation highlight the potential of recombinant 0375H and 0375TH proteins in specific and sensitive diagnosis of glanders. PMID:22695165

Ultrasound transducer selection in clinical imaging practice.

PubMed

Szabo, Thomas L; Lewin, Peter A

2013-04-01

Many types of medical ultrasound transducers are used in clinical practice. They operate at different center frequencies, have different physical dimensions, footprints, and shapes, and provide different image formats. However, little information is available about which transducers are most appropriate for a given application, and the purpose of this article is to address this deficiency. Specifically, the relationship between the transducer, imaging format, and clinical applications is discussed, and systematic selection criteria that allow matching of transducers to specific clinical needs are presented. These criteria include access to and coverage of the region of interest, maximum scan depth, and coverage of essential diagnostic modes required to optimize a patient's diagnosis. Three comprehensive figures organize and summarize the imaging planes, scanning modes, and types of diagnostic transducers to facilitate their selection in clinical diagnosis.

Twinning of cubic diamond explains reported nanodiamond polymorphs

NASA Astrophysics Data System (ADS)

Németh, Péter; Garvie, Laurence A. J.; Buseck, Peter R.

2015-12-01

The unusual physical properties and formation conditions attributed to h-, i-, m-, and n-nanodiamond polymorphs has resulted in their receiving much attention in the materials and planetary science literature. Their identification is based on diffraction features that are absent in ordinary cubic (c-) diamond (space group: Fd-3m). We show, using ultra-high-resolution transmission electron microscope (HRTEM) images of natural and synthetic nanodiamonds, that the diffraction features attributed to the reported polymorphs are consistent with c-diamond containing abundant defects. Combinations of {113} reflection and <011> rotation twins produce HRTEM images and d-spacings that match those attributed to h-, i-, and m-diamond. The diagnostic features of n-diamond in TEM images can arise from thickness effects of c-diamonds. Our data and interpretations strongly suggest that the reported nanodiamond polymorphs are in fact twinned c-diamond. We also report a new type of twin (<11> rotational), which can give rise to grains with dodecagonal symmetry. Our results show that twins are widespread in diamond nanocrystals. A high density of twins could strongly influence their applications.

Teaching diagnostic approach to a patient through cinema.

PubMed

Kalra, Gurvinder

2011-11-01

Films are produced with the aim of entertaining people, but recently there has been increasing use of films to educate medical trainees about various disorders, symptoms of these disorders, patient-therapist interactions, and various other medical and psychiatric issues. Discussions in academic circles have moved from criticism of negative portrayals of mental illness in earlier films to their use in teaching sessions. Films can be used either in full length or clip format to conduct training modules. Use of the film Stigmata to train residents about diagnostic dilemmas and taking a diagnostic approach to patients is discussed. Copyright © 2011 Elsevier Inc. All rights reserved.

20 CFR 404.1519m - Diagnostic tests or procedures.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Diagnostic tests or procedures. 404.1519m... Report Content § 404.1519m Diagnostic tests or procedures. We will request the results of any diagnostic... will not order diagnostic tests or procedures that involve significant risk to you, such as myelograms...

The AMCP Format for Formulary Submissions: Welcome to Version 4.0.

PubMed

2016-05-01

Managed care pharmacists are increasingly presented with complex considerations related to prescription drug formulary management. As prescription drug spending soars, and new effective, but expensive drugs rush to the market, pharmacists and other health care decision makers must evaluate a myriad of important clinical and economic considerations in determining the relative value and, subsequently, the appropriate placement of a product within a formulary. The AMCP Format for Formulary Submissions, Version 4.0, is the next iteration of the Format, which was first released in 2000. Version 4.0, developed by pharmacists from health plan, manufacturer, and academic perspectives, provides updated recommendations on acquiring and evaluating clinical and economic evidence to inform formulary and medical policy decisions. It also includes new guidance related to emerging special topic considerations such as biosimilars, specialty pharmacy products, and companion diagnostic tests. Version 4.0 has been modified to improve the usability of the Format, with clarifying guidance related to logistical considerations such as a recommended time frame for implementation of Version 4.0, as well as dossier updates and ongoing communication between manufacturers and health care decision makers. The Format should be used as a framework for ongoing evidence-based dialogue between manufacturers and payers. The evolving health care landscape will require new levels of collaboration and communication among key stakeholders to successfully navigate the challenges of this new environment. The Format provides a framework to support these critical interactions related to product value by facilitating an evidence-based, transparent approach. This document was prepared by Jeff Lee, PharmD, FCCP, on behalf of the AMCP Format Executive Committee. Committee members reviewed and provided feedback on the final draft. No conflicts of interest, financial or otherwise, were reported.

Candida albicans ISW2 Regulates Chlamydospore Suspensor Cell Formation and Virulence In Vivo in a Mouse Model of Disseminated Candidiasis

PubMed Central

Lionakis, Michail S.; Nickerson, Kenneth W.

2016-01-01

Formation of chlamydospores by Candida albicans was an established medical diagnostic test to confirm candidiasis before the molecular era. However, the functional role and pathological relevance of this in vitro morphological transition to pathogenesis in vivo remain unclear. We compared the physical properties of in vitro-induced chlamydospores with those of large C. albicans cells purified by density gradient centrifugation from Candida-infected mouse kidneys. The morphological and physical properties of these cells in kidneys of mice infected intravenously with wild type C. albicans confirmed that chlamydospores can form in infected kidneys. A previously reported chlamydospore-null Δisw2/Δisw2 mutant was used to investigate its role in virulence and chlamydospore induction. Virulence of the Δisw2/Δisw2 mutant strain was reduced 3.4-fold compared to wild type C. albicans or the ISW2 reconstituted strain. Altered host inflammatory reactions to the null mutant further indicate that ISW2 is a virulence factor in C. albicans. ISW2 deletion abolished chlamydospore formation within infected mouse kidneys, whereas the reconstituted strain restored chlamydospore formation in kidneys. Under chlamydospore inducing conditions in vitro, deletion of ISW2 significantly delayed chlamydospore formation, and those late induced chlamydospores lacked associated suspensor cells while attaching laterally to hyphae via novel spore-hypha septa. Our findings establish the induction of chlamydospores by C. albicans during mouse kidney colonization. Our results indicate that ISW2 is not strictly required for chlamydospores formation but is necessary for suspensor cell formation. The importance of ISW2 in chlamydospore morphogenesis and virulence may lead to additional insights into morphological differentiation and pathogenesis of C. albicans in the host microenvironment. PMID:27727302

Clinical Application of Genome and Exome Sequencing as a Diagnostic Tool for Pediatric Patients: a Scoping Review of the Literature.

PubMed

Smith, Hadley Stevens; Swint, J Michael; Lalani, Seema R; Yamal, Jose-Miguel; de Oliveira Otto, Marcia C; Castellanos, Stephan; Taylor, Amy; Lee, Brendan H; Russell, Heidi V

2018-05-14

Availability of clinical genomic sequencing (CGS) has generated questions about the value of genome and exome sequencing as a diagnostic tool. Analysis of reported CGS application can inform uptake and direct further research. This scoping literature review aims to synthesize evidence on the clinical and economic impact of CGS. PubMed, Embase, and Cochrane were searched for peer-reviewed articles published between 2009 and 2017 on diagnostic CGS for infant and pediatric patients. Articles were classified according to sample size and whether economic evaluation was a primary research objective. Data on patient characteristics, clinical setting, and outcomes were extracted and narratively synthesized. Of 171 included articles, 131 were case reports, 40 were aggregate analyses, and 4 had a primary economic evaluation aim. Diagnostic yield was the only consistently reported outcome. Median diagnostic yield in aggregate analyses was 33.2% but varied by broad clinical categories and test type. Reported CGS use has rapidly increased and spans diverse clinical settings and patient phenotypes. Economic evaluations support the cost-saving potential of diagnostic CGS. Multidisciplinary implementation research, including more robust outcome measurement and economic evaluation, is needed to demonstrate clinical utility and cost-effectiveness of CGS.

Challenges of Making a Diagnosis in the Outpatient Setting: A Multi-Site Survey of Primary Care Physicians

PubMed Central

Sarkar, Urmimala; Bonacum, Doug; Strull, William; Spitzmueller, Christiane; Jin, Nancy; Lopez, Andrea; Giardina, Traber Davis; Meyer, Ashley N.D.; Singh, Hardeep

2013-01-01

Background Although misdiagnosis in the outpatient setting leads to significant patient harm and wasted resources, it is not well studied. We surveyed primary care physicians (PCPs) about barriers to timely diagnosis in the outpatient setting and assessed their perceptions of diagnostic difficulty. Methods We conducted a survey of general internists and family physicians practicing in an integrated health system across 10 geographically dispersed states in 2005. The survey elicited information on key cognitive failures (such as in clinical knowledge or judgment) for a specific case, and solicited strategies for reducing diagnostic delays. Content analysis was used to categorize cognitive failures and strategies for improvement. We examined the extent and predictors of diagnostic difficulty, defined as reporting >5% patients difficult to diagnose. Results Of 1817 physicians surveyed, 1054 (58%) responded; 848 (80%) respondents primarily practiced in outpatient settings and had an assigned patient panel (inclusion sample). Inadequate knowledge (19.9%) was the most commonly reported cognitive factor. Half reported >5% of their patients were difficult to diagnose; more experienced physicians reported less diagnostic difficulty. In adjusted analyses, problems with information processing (information availability and time to review it) and the referral process, were associated with greater diagnostic difficulty. Strategies for improvement most commonly involved workload issues (panel size, non-visit tasks). Conclusions PCPs report a variety of reasons for diagnostic difficulties in primary care practice. In our study, knowledge gaps appear to be a prominent concern. Interventions that address these gaps as well as practice level issues such as time to process diagnostic information and better subspecialty input may reduce diagnostic difficulties in primary care. PMID:22626738

P-MaNGA: GRADIENTS IN RECENT STAR FORMATION HISTORIES AS DIAGNOSTICS FOR GALAXY GROWTH AND DEATH

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

Li, Cheng; Wang, Enci; Lin, Lin

2015-05-10

We present an analysis of the data produced by the MaNGA prototype run (P-MaNGA), aiming to test how the radial gradients in recent star formation histories, as indicated by the 4000 Å break (D{sub n}(4000)), Hδ absorption (EW(Hδ{sub A})), and Hα emission (EW(Hα)) indices, can be useful for understanding disk growth and star formation cessation in local galaxies. We classify 12 galaxies observed on two P-MaNGA plates as either centrally quiescent (CQ) or centrally star-forming (CSF), according to whether D{sub n}(4000) measured in the central spaxel of each datacube exceeds 1.6. For each spaxel we generate both 2D maps and radialmore » profiles of D{sub n}(4000), EW(Hδ{sub A}), and EW(Hα). We find that CSF galaxies generally show very weak or no radial variation in these diagnostics. In contrast, CQ galaxies present significant radial gradients, in the sense that D{sub n}(4000) decreases, while both EW(Hδ{sub A}) and EW(Hα) increase from the galactic center outward. The outer regions of the galaxies show greater scatter on diagrams relating the three parameters than their central parts. In particular, the clear separation between centrally measured quiescent and star-forming galaxies in these diagnostic planes is largely filled in by the outer parts of galaxies whose global colors place them in the green valley, supporting the idea that the green valley represents a transition between blue-cloud and red-sequence phases, at least in our small sample. These results are consistent with a picture in which the cessation of star formation propagates from the center of a galaxy outward as it moves to the red sequence.« less

A Paper-Based Sandwich Format Hybridization Assay for Unlabeled Nucleic Acid Detection Using Upconversion Nanoparticles as Energy Donors in Luminescence Resonance Energy Transfer.

PubMed

Zhou, Feng; Noor, M Omair; Krull, Ulrich J

2015-09-24

Bioassays based on cellulose paper substrates are gaining increasing popularity for the development of field portable and low-cost diagnostic applications. Herein, we report a paper-based nucleic acid hybridization assay using immobilized upconversion nanoparticles (UCNPs) as donors in luminescence resonance energy transfer (LRET). UCNPs with intense green emission served as donors with Cy3 dye as the acceptor. The avidin functionalized UCNPs were immobilized on cellulose paper and subsequently bioconjugated to biotinylated oligonucleotide probes. Introduction of unlabeled oligonucleotide targets resulted in a formation of probe-target duplexes. A subsequent hybridization of Cy3 labeled reporter with the remaining single stranded portion of target brought the Cy3 dye in close proximity to the UCNPs to trigger a LRET-sensitized emission from the acceptor dye. The hybridization assays provided a limit of detection (LOD) of 146.0 fmol and exhibited selectivity for one base pair mismatch discrimination. The assay was functional even in undiluted serum samples. This work embodies important progress in developing DNA hybridization assays on paper. Detection of unlabeled targets is achieved using UCNPs as LRET donors, with minimization of background signal from paper substrates owing to the implementation of low energy near-infrared (NIR) excitation.

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

PubMed

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

2016-08-01

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

Field-evaluation of a new lateral flow assay for detection of cellular and humoral immunity against Mycobacterium leprae.

PubMed

Bobosha, Kidist; Tjon Kon Fat, Elisa M; van den Eeden, Susan J F; Bekele, Yonas; van der Ploeg-van Schip, Jolien J; de Dood, Claudia J; Dijkman, Karin; Franken, Kees L M C; Wilson, Louis; Aseffa, Abraham; Spencer, John S; Ottenhoff, Tom H M; Corstjens, Paul L A M; Geluk, Annemieke

2014-05-01

Field-applicable tests detecting asymptomatic Mycobacterium leprae (M. leprae) infection or predicting progression to leprosy, are urgently required. Since the outcome of M. leprae infection is determined by cellular- and humoral immunity, we aim to develop diagnostic tests detecting pro-/anti-inflammatory and regulatory cytokines as well as antibodies against M. leprae. Previously, we developed lateral flow assays (LFA) for detection of cytokines and anti-PGL-I antibodies. Here we evaluate progress of newly developed LFAs for applications in resource-poor settings. The combined diagnostic value of IP-10, IL-10 and anti-PGL-I antibodies was tested using M. leprae-stimulated blood of leprosy patients and endemic controls (EC). For reduction of the overall test-to-result time the minimal whole blood assay time required to detect distinctive responses was investigated. To accommodate LFAs for field settings, dry-format LFAs for IP-10 and anti-PGL-I antibodies were developed allowing storage and shipment at ambient temperatures. Additionally, a multiplex LFA-format was applied for simultaneous detection of anti-PGL-I antibodies and IP-10. For improved sensitivity and quantitation upconverting phosphor (UCP) reporter technology was applied in all LFAs. Single and multiplex UCP-LFAs correlated well with ELISAs. The performance of dry reagent assays and portable, lightweight UCP-LF strip readers indicated excellent field-robustness. Notably, detection of IP-10 levels in stimulated samples allowed a reduction of the whole blood assay time from 24 h to 6 h. Moreover, IP-10/IL-10 ratios in unstimulated plasma differed significantly between patients and EC, indicating the feasibility to identify M. leprae infection in endemic areas. Dry-format UCP-LFAs are low-tech, robust assays allowing detection of relevant cytokines and antibodies in response to M. leprae in the field. The high levels of IP-10 and the required shorter whole blood assay time, render this cytokine useful to discriminate between leprosy patients and EC.

Field-Evaluation of a New Lateral Flow Assay for Detection of Cellular and Humoral Immunity against Mycobacterium leprae

PubMed Central

Bobosha, Kidist; Tjon Kon Fat, Elisa M.; van den Eeden, Susan J. F.; Bekele, Yonas; van der Ploeg-van Schip, Jolien J.; de Dood, Claudia J.; Dijkman, Karin; Franken, Kees L. M. C.; Wilson, Louis; Aseffa, Abraham; Spencer, John S.; Ottenhoff, Tom H. M.; Corstjens, Paul L. A. M.; Geluk, Annemieke

2014-01-01

Background Field-applicable tests detecting asymptomatic Mycobacterium leprae (M. leprae) infection or predicting progression to leprosy, are urgently required. Since the outcome of M. leprae infection is determined by cellular- and humoral immunity, we aim to develop diagnostic tests detecting pro-/anti-inflammatory and regulatory cytokines as well as antibodies against M. leprae. Previously, we developed lateral flow assays (LFA) for detection of cytokines and anti-PGL-I antibodies. Here we evaluate progress of newly developed LFAs for applications in resource-poor settings. Methods The combined diagnostic value of IP-10, IL-10 and anti-PGL-I antibodies was tested using M. leprae-stimulated blood of leprosy patients and endemic controls (EC). For reduction of the overall test-to-result time the minimal whole blood assay time required to detect distinctive responses was investigated. To accommodate LFAs for field settings, dry-format LFAs for IP-10 and anti-PGL-I antibodies were developed allowing storage and shipment at ambient temperatures. Additionally, a multiplex LFA-format was applied for simultaneous detection of anti-PGL-I antibodies and IP-10. For improved sensitivity and quantitation upconverting phosphor (UCP) reporter technology was applied in all LFAs. Results Single and multiplex UCP-LFAs correlated well with ELISAs. The performance of dry reagent assays and portable, lightweight UCP-LF strip readers indicated excellent field-robustness. Notably, detection of IP-10 levels in stimulated samples allowed a reduction of the whole blood assay time from 24 h to 6 h. Moreover, IP-10/IL-10 ratios in unstimulated plasma differed significantly between patients and EC, indicating the feasibility to identify M. leprae infection in endemic areas. Conclusions Dry-format UCP-LFAs are low-tech, robust assays allowing detection of relevant cytokines and antibodies in response to M. leprae in the field. The high levels of IP-10 and the required shorter whole blood assay time, render this cytokine useful to discriminate between leprosy patients and EC. PMID:24810599

LETTER TO THE EDITOR: Response to 'Patient dose measurements in radiological practices'

NASA Astrophysics Data System (ADS)

Zoetelief, J.; Wambersie, A.

2006-06-01

A lack of suitable dosimetric quantities for application in diagnostic radiology is noted by Dr Moores. It is concluded by Dr Moores that it is not possible to adhere to the basic principles of the International Commission on Radiation Units and Measurements (ICRU) regarding patient dosimetry in diagnostic radiology due to the extremely wide variety of quantities and units employed. The conclusion of the ICRU on similar observations, however, was that there is a need for harmonization of quantities and terminology for dosimetry in diagnostic and interventional radiology and they established a Report Committee with the aim of formulating an ICRU report on 'dosimetric procedures in diagnostic radiology'. The report produced by this committee entitled 'Patient dosimetry for x rays used in medical imaging' was accepted for publication in December 2005 and is currently at press, and may serve to improve the current situation with regard to patient dose measurement in diagnostic and interventional radiology.

Sexuality and sexual health among female youth with borderline personality disorder pathology.

PubMed

Thompson, Katherine N; Betts, Jennifer; Jovev, Martina; Nyathi, Yolanda; McDougall, Emma; Chanen, Andrew M

2017-10-27

Borderline personality disorder (BPD) is a severe mental disorder that is characterized by unstable relationships, impulsive behaviours and identity disturbance. BPD usually has its onset between puberty and young adulthood and presents disproportionately among females in clinical settings. Taken together, this makes young women with BPD a particularly vulnerable group with regard to healthy psychosexual development. It was hypothesized that female youth with BPD pathology would be more likely to score worse on measures of sexual health and safety, and to show greater uncertainty in sexual identity formation. Fifty 15 to 24 yr-old females with 3 or more Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-IV) BPD criteria were compared with 204 females from a nationally representative sample. Both groups were interviewed using a comprehensive interview for sexual health and relationships. The patient group completed a structured diagnostic interview. Young women with borderline personality pathology engaged in sexual relationships at a younger age, with more sexual partners in the previous year, in more casual relationships. They were more likely to practice unsafe sex for their first sexual experience, to be coerced into unwanted sexual activity, to be unclear about their sexual identity or their sexual attraction, and to report worse overall health status. BPD pathology in youth is associated with poor sexual health and safety, and uncertainty in sexual identity formation. These findings support the need for assessment of the sexuality and sexual health of youth with BPD, along with the need for routine screening in sexual health services for BPD features among high-risk youth. © 2017 John Wiley & Sons Australia, Ltd.

Gender identity and sexual orientation in women with borderline personality disorder.

PubMed

Singh, Devita; McMain, Shelley; Zucker, Kenneth J

2011-02-01

In the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, text revision (DSM-IV-TR) (and earlier editions), a disturbance in "identity" is one of the defining features of borderline personality disorder (BPD). Gender identity, a person's sense of self as a male or a female, constitutes an important aspect of identity formation, but this construct has rarely been examined in patients with BPD. In the present study, the presence of gender identity disorder or confusion was examined in women diagnosed with BPD. We used a validated dimensional measure of gender dysphoria. Recalled gender identity and gender role behavior from childhood was also assessed with a validated dimensional measure, and current sexual orientation was assessed by two self-report measures. A consecutive series of 100 clinic-referred women (mean age, 34 years) with BPD participated in the study. The women were diagnosed with BPD using the International Personality Disorder Exam-BPD Section. None of the women with BPD met the criterion for caseness on the dimensional measure of gender dysphoria. Women who self-reported either a bisexual or a homosexual sexual orientation had a significantly higher score on the dimensional measure of gender dysphoria than the women who self-reported a heterosexual sexual orientation, and they also recalled significantly more cross-gender behavior during childhood. Results were compared with a previous study on a diagnostically heterogeneous group of women with other clinical problems. The importance of psychosexual assessment in the clinical evaluation of patients with BPD is discussed. © 2010 International Society for Sexual Medicine.

Performance Assessment as a Diagnostic Tool for Science Teachers

NASA Astrophysics Data System (ADS)

Kruit, Patricia; Oostdam, Ron; van den Berg, Ed; Schuitema, Jaap

2018-04-01

Information on students' development of science skills is essential for teachers to evaluate and improve their own education, as well as to provide adequate support and feedback to the learning process of individual students. The present study explores and discusses the use of performance assessments as a diagnostic tool for formative assessment to inform teachers and guide instruction of science skills in primary education. Three performance assessments were administered to more than 400 students in grades 5 and 6 of primary education. Students performed small experiments using real materials while following the different steps of the empirical cycle. The mutual relationship between the three performance assessments is examined to provide evidence for the value of performance assessments as useful tools for formative evaluation. Differences in response patterns are discussed, and the diagnostic value of performance assessments is illustrated with examples of individual student performances. Findings show that the performance assessments were difficult for grades 5 and 6 students but that much individual variation exists regarding the different steps of the empirical cycle. Evaluation of scores as well as a more substantive analysis of students' responses provided insight into typical errors that students make. It is concluded that performance assessments can be used as a diagnostic tool for monitoring students' skill performance as well as to support teachers in evaluating and improving their science lessons.

New Trends in Nuclear Data Research for Medical Applications

NASA Astrophysics Data System (ADS)

Qaim, S. M.

2005-05-01

Nuclear methods play an important role in medicine, both in diagnosis and therapy. The status of nuclear data with regard to the production of commonly used diagnostic and therapeutic radionuclides is discussed. The new trends and data needs in the development of potentially useful radionuclides are outlined. They pertain to longer-lived positron emitters (e.g., 64Cu, 76Br, 124I) for studying slow metabolic processes, to positron emitters needed for quantification purposes (94mTc, 86Y, etc.) and to soft radiation emitting therapeutic radionuclides (103Pd, 186Re, 225Ac, etc.). The imaging problems with new positron emitters are discussed. As regards radiation therapy, data on the formation of short-lived activation products in proton therapy are reported.

Systematic survey of randomized trials evaluating the impact of alternative diagnostic strategies on patient-important outcomes.

PubMed

El Dib, Regina; Tikkinen, Kari A O; Akl, Elie A; Gomaa, Huda A; Mustafa, Reem A; Agarwal, Arnav; Carpenter, Christopher R; Zhang, Yuchen; Jorge, Eliane C; Almeida, Ricardo A M B; do Nascimento Junior, Paulo; Doles, Joao Vitor P; Mustafa, Ahmad A; Sadeghirad, Behnam; Lopes, Luciane C; Bergamaschi, Cristiane C; Suzumura, Erica A; Cardoso, Marília M A; Corrente, José Eduardo; Stone, Samuel B; Schunemann, Holger J; Guyatt, Gordon H

2017-04-01

To provide a perspective on the current practice of randomized clinical trials (RCTs) of diagnostic strategies focusing on patient-important outcomes. We conducted a comprehensive search of MEDLINE and included RCTs published in full-text reports that evaluated alternative diagnostic strategies. Of 56,912 unique citations, we sampled 7,500 and included 103 eligible RCTs, therefore suggesting that MEDLINE includes approximately 781 diagnostic RCTs. The 103 eligible trials reported on: mortality (n = 41; 39.8%); morbidities (n = 63; 61.2%); symptoms/quality of life/functional status (n = 14; 13.6%); and on composite end points (n = 10; 9.7%). Of the studies that reported statistically significant results (n = 12; 11.6%), we judged 7 (58.3%) as at low risk of bias with respect to missing outcome data and 4 (33.3%) as at low risk of bias regarding blinding. Of the 41 RCTs that reported on mortality, only one (2.4%) reported statistically significant results. Of 63 RCTs addressing morbidity outcomes, 11 (17.5%) reported statistically significant results, all of which reported relative effects of greater than 20%. RCTs of diagnostic tests are not uncommon, and sometimes suggest benefits on patient-important outcomes but often suffer from limitations in sample size and conduct. Copyright © 2017 Elsevier Inc. All rights reserved.

Laser Ablation Molecular Isotopic Spectrometry for Molecules Formation Chemistry in Femtosecond-Laser Ablated Plasmas.

PubMed

Hou, Huaming; Mao, Xianglei; Zorba, Vassilia; Russo, Richard E

2017-07-18

Recently, laser ablated molecular isotopic spectrometry (LAMIS) has expanded its capability to explore molecules formation mechanism in laser-induced plasma in addition to isotope analysis. LAMIS is a powerful tool for tracking the origination of atoms that is involved in formation of investigated molecules by labeling atoms with their isotopic substitution. The evolutionary formation pathways of organic molecules, especially of C 2 dimers and CN radicals, were frequently reported. However, very little is known about the formation pathways for metallic radicals and heterodimers in laser ablated plasma. This research focuses on elucidating the formation pathways of AlO radicals in femtosecond laser ablated plasma from 18 O-labeled Al 2 O 3 pellet. Plasmas expanding with strong forward bias in the direction normal to the sample surface were generated in the wake of a weakly ionized channel created by a femtosecond laser. The formation mechanism of AlO and influence of air were investigated with multiple plasma diagnostic methods such as monochromatic fast gating imaging, spatiotemporal resolved optical emission spectroscopy, and LAMIS. An advanced LAMIS fitting procedure was used to deduce the spatiotemporal distributions of Al 18 O and Al 16 O number densities and also their ratios. We found that the Al 16 O/Al 18 O number density ratio is higher for plasma portion closer to the sample surface, which suggests that chemical reactions between the plasma plume and ambient air are more intense at the tail of the plasma. The results also reveals that direct association of free Al and O atoms is the main mechanism for the formation of AlO at the early stage of the plasma. To the contrast, chemical reactions between plasma materials and ambient oxygen molecules and the isotope exchange effect are the dominant mechanisms of the formation of AlO and evolution of Al 16 O/Al 18 O number density ratio at the late stage of the plasma.

The Purisima Formation and related rocks (upper Miocene - Pliocene), greater San Francisco Bay area, central California; review of literature and USGS collection now housed at the Museum of Paleontology, University of California, Berkeley

USGS Publications Warehouse

Powell, C.L.

1998-01-01

Sedimentary rocks more than 1.6 kilometers thick are attributed to the upper Miocene to upper Pliocene Purisima Formation in the greater San Francisco Bay area. These rocks occur as scattered, discontinuous outcrops from Point Reyes National Seashore in the north to south of Santa Cruz. Lithologic divisions of the Formation appear to be of local extent and are of limited use in correlating over this broad area. The Purisima Formation occurs in several fault-bounded terranes which demonstrate different stratigraphic histories and may be found to represent more than a single depositional basin. The precise age and stratigraphic relationship of these scattered outcrops are unresolved and until they are put into a stratigraphic and paleogeographic context the tectonic significance of the Purisima Foramtion can only be surmised. This paper will attempt to resolve some of these problems. Mollusks and echinoderms are recorded from the literature and more than 70 USGS collections that have not previously been reported. With the exception of one locality, the faunas suggest deposition in normal marine conditions at water depths of less than 50 m and with water temperatures the same or slightly cooler than exist along the present coast of central California. The single exception is a fauna from outcrops between Seal Cove and Pillar Point, where both mollusks and foraminifers suggest water depths greater than 100 m. Three molluscan faunas, the La Honda, the Pillar Point, and the Santa Cruz, are recognized based on USGS collections and published literature for the Purisima Formation. These biostratigraphically distinct faunas aid in the correlation of the scattered Purisima Formation outcrops. The lowermost La Honda fauna suggests shallow-water depths and an age of late Miocene to early Pliocene. This age is at odds with a younger age determination from an ash bed in the lower Purisima Formation along the central San Mateo County coast. The Pillar Point fauna contains only a single age diagnostic taxon, Lituyapecten purisimaensis (Arnold), which is reported as Pliocene in age, but it only occurs in the Purisima Formation, so its age here is an example of circular reasoning. However, based on tentative lithologic correlations this fauna may represent the same period of time as the upper part of the La Honda fauna. This fauna differs from either the La Honda or Santa Cruz faunas in that it represent significantly deeper water. The uppermost Santa Cruz fauna also suggests shallow-water depths and a possible age range of early to late Pliocene. The bivalve molluscan taxon Lyonsia, and gastropod taxon Rictaxis sp., cf. R. punctocaelatus (Carpenter) are reported here for the first time from the Purisima Formation.

FSCATT: Angular Dependence and Filter Options.

DTIC Science & Technology

The input routines to the code have been completely rewritten to allow for a free-form input format. The input routines now provide self-consistency checks and diagnostics for the user’s edification .

Measures to Improve Diagnostic Safety in Clinical Practice

PubMed Central

Singh, Hardeep; Graber, Mark L; Hofer, Timothy P

2016-01-01

Timely and accurate diagnosis is foundational to good clinical practice and an essential first step to achieving optimal patient outcomes. However, a recent Institute of Medicine report concluded that most of us will experience at least one diagnostic error in our lifetime. The report argues for efforts to improve the reliability of the diagnostic process through better measurement of diagnostic performance. The diagnostic process is a dynamic team-based activity that involves uncertainty, plays out over time, and requires effective communication and collaboration among multiple clinicians, diagnostic services, and the patient. Thus, it poses special challenges for measurement. In this paper, we discuss how the need to develop measures to improve diagnostic performance could move forward at a time when the scientific foundation needed to inform measurement is still evolving. We highlight challenges and opportunities for developing potential measures of “diagnostic safety” related to clinical diagnostic errors and associated preventable diagnostic harm. In doing so, we propose a starter set of measurement concepts for initial consideration that seem reasonably related to diagnostic safety, and call for these to be studied and further refined. This would enable safe diagnosis to become an organizational priority and facilitate quality improvement. Health care systems should consider measurement and evaluation of diagnostic performance as essential to timely and accurate diagnosis and to the reduction of preventable diagnostic harm. PMID:27768655

Communicating diagnostic uncertainty in surgical pathology reports: disparities between sender and receiver.

PubMed

Lindley, Sarah W; Gillies, Elizabeth M; Hassell, Lewis A

2014-10-01

Surgical pathologists use a variety of phrases to communicate varying degrees of diagnostic certainty which have the potential to be interpreted differently than intended. This study sought to: (1) assess the setting, varieties and frequency of use of phrases of diagnostic uncertainty in the diagnostic line of surgical pathology reports, (2) evaluate use of uncertainty expressions by experience and gender, (3) determine how these phrases are interpreted by clinicians and pathologists, and (4) assess solutions to this communication problem. We evaluated 1500 surgical pathology reports to determine frequency of use of uncertainty terms, identified those most commonly used, and looked for variations in usage rates on the basis of case type, experience and gender. We surveyed 76 physicians at tumor boards who were asked to assign a percentage of certainty to diagnoses containing expressions of uncertainty. We found expressions of uncertainty in 35% of diagnostic reports, with no statistically significant difference in usage based on age or gender. We found wide variation in the percentage of certainty clinicians assigned to the phrases studied. We conclude that non-standardized language used in the communication of diagnostic uncertainty is a significant source of miscommunication, both amongst pathologists and between pathologists and clinicians. Copyright © 2014 The Authors. Published by Elsevier GmbH.. All rights reserved.

Exploring undergraduates' understanding of photosynthesis using diagnostic question clusters.

PubMed

Parker, Joyce M; Anderson, Charles W; Heidemann, Merle; Merrill, John; Merritt, Brett; Richmond, Gail; Urban-Lurain, Mark

2012-01-01

We present a diagnostic question cluster (DQC) that assesses undergraduates' thinking about photosynthesis. This assessment tool is not designed to identify individual misconceptions. Rather, it is focused on students' abilities to apply basic concepts about photosynthesis by reasoning with a coordinated set of practices based on a few scientific principles: conservation of matter, conservation of energy, and the hierarchical nature of biological systems. Data on students' responses to the cluster items and uses of some of the questions in multiple-choice, multiple-true/false, and essay formats are compared. A cross-over study indicates that the multiple-true/false format shows promise as a machine-gradable format that identifies students who have a mixture of accurate and inaccurate ideas. In addition, interviews with students about their choices on three multiple-choice questions reveal the fragility of students' understanding. Collectively, the data show that many undergraduates lack both a basic understanding of the role of photosynthesis in plant metabolism and the ability to reason with scientific principles when learning new content. Implications for instruction are discussed.

Exploring Undergraduates' Understanding of Photosynthesis Using Diagnostic Question Clusters

PubMed Central

Parker, Joyce M.; Anderson, Charles W.; Heidemann, Merle; Merrill, John; Merritt, Brett; Richmond, Gail; Urban-Lurain, Mark

2012-01-01

We present a diagnostic question cluster (DQC) that assesses undergraduates' thinking about photosynthesis. This assessment tool is not designed to identify individual misconceptions. Rather, it is focused on students' abilities to apply basic concepts about photosynthesis by reasoning with a coordinated set of practices based on a few scientific principles: conservation of matter, conservation of energy, and the hierarchical nature of biological systems. Data on students' responses to the cluster items and uses of some of the questions in multiple-choice, multiple-true/false, and essay formats are compared. A cross-over study indicates that the multiple-true/false format shows promise as a machine-gradable format that identifies students who have a mixture of accurate and inaccurate ideas. In addition, interviews with students about their choices on three multiple-choice questions reveal the fragility of students' understanding. Collectively, the data show that many undergraduates lack both a basic understanding of the role of photosynthesis in plant metabolism and the ability to reason with scientific principles when learning new content. Implications for instruction are discussed. PMID:22383617

Development and Evaluation of a Diagnostic Documentation Support System using Knowledge Processing

NASA Astrophysics Data System (ADS)

Makino, Kyoko; Hayakawa, Rumi; Terai, Koichi; Fukatsu, Hiroshi

In this paper, we will introduce a system which supports creating diagnostic reports. Diagnostic reports are documents by doctors of radiology describing the existence and nonexistence of abnormalities from the inspection images, such as CT and MRI, and summarize a patient's state and disease. Our system indicates insufficiencies in these reports created by younger doctors, by using knowledge processing based on a medical knowledge dictionary. These indications are not only clerical errors, but the system also analyzes the purpose of the inspection and determines whether a comparison with a former inspection is required, or whether there is any shortage in description. We verified our system by using actual data of 2,233 report pairs, a pair comprised of a report written by a younger doctor and a check result of the report by an experienced doctor. The results of the verification showed that the rules of string analysis for detecting clerical errors and sentence wordiness obtained a recall of over 90% and a precision of over 75%. Moreover, the rules based on a medical knowledge dictionary for detecting the lack of required comparison with a former inspection and the shortage in description for the inspection purpose obtained a recall of over 70%. From these results, we confirmed that our system contributes to the quality improvement of diagnostic reports. We expect that our system can comprehensively support diagnostic documentations by cooperating with the interface which refers to inspection images or past reports.

Recent developments in Förster resonance energy transfer (FRET) diagnostics using quantum dots.

PubMed

Geißler, Daniel; Hildebrandt, Niko

2016-07-01

The exceptional photophysical properties and the nanometric dimensions of colloidal semiconductor quantum dots (QD) have strongly attracted the bioanalytical community over the last approximately 20 y. In particular, the integration of QDs in the analysis of biological components and interactions, and the related diagnostics using Förster resonance energy transfer (FRET), have allowed researchers to significantly improve and diversify fluorescence-based biosensing. In this TRENDS article, we review some recent developments in QD-FRET biosensing that have implemented this technology in electronic consumer products, multiplexed analysis, and detection without light excitation for diagnostic applications. In selected examples of smartphone-based imaging, single- and multistep FRET, steady-state and time-resolved spectroscopy, and bio/chemiluminescence detection of QDs used as both FRET donors and acceptors, we highlight the advantages of QD-based FRET biosensing for multiplexed and sensitive diagnostics. Graphical Abstract Quantum dots (QDs) can be applied as donors and/or acceptors for Förster resonance energy transfer- (FRET-) based biosensing for multiplexed and sensitive diagnostics in various assay formats.

An easy-to-use diagnostic system development shell

NASA Technical Reports Server (NTRS)

Tsai, L. C.; Ross, J. B.; Han, C. Y.; Wee, W. G.

1987-01-01

The Diagnostic System Development Shell (DSDS), an expert system development shell for diagnostic systems, is described. The major objective of building the DSDS is to create a very easy to use and friendly environment for knowledge engineers and end-users. The DSDS is written in OPS5 and CommonLisp. It runs on a VAX/VMS system. A set of domain independent, generalized rules is built in the DSDS, so the users need not be concerned about building the rules. The facts are explicitly represented in a unified format. A powerful check facility which helps the user to check the errors in the created knowledge bases is provided. A judgement facility and other useful facilities are also available. A diagnostic system based on the DSDS system is question driven and can call or be called by other knowledge based systems written in OPS5 and CommonLisp. A prototype diagnostic system for diagnosing a Philips constant potential X-ray system has been built using the DSDS.

Neopterin formation and tryptophan degradation by a human myelomonocytic cell line (THP-1) upon cytokine treatment.

PubMed

Werner-Felmayer, G; Werner, E R; Fuchs, D; Hausen, A; Reibnegger, G; Wachter, H

1990-05-15

Determination of neopterin [D-erythro-6-(1',2',3'-trihydroxypropyl)pterin] in body fluids is a powerful diagnostic tool in a variety of diseases in which activation of cellular immune mechanisms is involved, such as certain malignancies, allograft rejection, and autoimmune and infectious diseases. In vitro, neopterin is released into the supernatant by peripheral blood-derived monocytes/macrophages upon stimulation with gamma-interferon. In parallel, cleavage of tryptophan by indoleamine 2,3-dioxygenase is induced. We report here that the human myelomonocytic cell line THP-1 forms neopterin and degrades tryptophan upon treatment with gamma-interferon. Like in macrophages alpha-interferon and beta-interferon induce these pathways only to a much smaller degree. The action of interferons is enhanced by cotreatment with tumor necrosis factor alpha, lipopolysaccharide, or dexamethasone. gamma-Interferon-induced neopterin formation and indoleamine 2,3-dioxygenase activity are increased by raising extracellular tryptophan concentrations. The pattern of intracellularly formed pteridines upon stimulation with gamma-interferon shows the unique characteristics of human monocytes/macrophages. Neopterin, monapterin, and biopterin are produced in a 50:2:1 ratio. Thus, the THP-1 cell line provides a permanent, easily accessible in vitro system for studying the induction and mechanism of neopterin formation.

Gastrointestinal Stromal Tumors: Clinical Symptoms, Location, Metastasis Formation, and Associated Malignancies in a Single Center Retrospective Study.

PubMed

Aghdassi, Ali; Christoph, Agnes; Dombrowski, Frank; Döring, Paula; Barth, Christoph; Christoph, Jan; Lerch, Markus M; Simon, Peter

2018-06-05

Gastrointestinal stromal tumors (GISTs) are rare malignancies but the most common mesenchymal tumors of the digestive tract. Recent advances in diagnostic imaging and an increasing incidence will confront us more frequently with stromal tumors. This single center study aimed to characterize GIST patients in terms of tumor location, clinical presentation, metastasis formation, as well as associated secondary malignancies. In a retrospective study, 104 patients with a histologically confirmed diagnosis of GIST, collected between 1993 and 2011, were characterized for several clinical features. The most common GIST location was the stomach (67.6%) followed by the small intestine (16.2%). Gastrointestinal bleeding (55.8%) and abdominal pain (38.5%) were the most frequently reported symptoms whereas about one-third of patients remained clinically asymptomatic (31.6%); 14.4% of patients had either synchronous or metachronous metastases and there was a significant prevalence also in the low risk group. The proportion of secondary malignant associated neoplasms was 31% in our GIST cohort, among which gastrointestinal, genitourinary tumors, and breast cancer were the most prevalent. There was a considerable risk for metastasis formation and the development of secondary neoplasias that should encourage discussion about the appropriate surveillance strategy after surgery for GIST. © 2018 S. Karger AG, Basel.

Clinical Factors and Disease Course Related to Diagnostic Delay in Korean Crohn's Disease Patients: Results from the CONNECT Study.

PubMed

Moon, Chang Mo; Jung, Sung-Ae; Kim, Seong-Eun; Song, Hyun Joo; Jung, Yunho; Ye, Byong Duk; Cheon, Jae Hee; Kim, You Sun; Kim, Young-Ho; Kim, Joo Sung; Han, Dong Soo

2015-01-01

Diagnostic delay frequently occurs in Crohn's disease (CD) patients because of diagnostic limitations. However, diagnostic delay and its related factors remain poorly defined. Therefore, we aimed to identify the predictors associated with diagnostic delay and to evaluate the impact of diagnostic delay on clinical course in a Korean CD patient cohort. We performed a multicenter retrospective analysis of 1,047 CD patients registered in the Crohn's Disease Clinical Network and Cohort study in Korea. The mean interval of diagnostic delay was 16.0 ± 33.1 months. Multivariate analysis showed that older age at diagnosis (≥40 years) (p = 0.014), concomitant upper gastrointestinal (UGI) disease (p = 0.012) and penetrating disease behavior at diagnosis (p = 0.001) were positively associated with long diagnostic delay (≥18 months). During the longitudinal follow-up, long diagnostic delay was independently predictive of further development of intestinal stenosis (hazard ratio [HR], 1.43; 95% confidence interval [CI], 1.07-1.93; p = 0.017), internal fistulas (HR, 1.62; 95% CI, 1.12-2.33; p = 0.011), and perianal fistulas (HR, 1.38; 95% CI, 1.06-1.80; p = 0.016). However, as for the risk of abscess formation, bowel perforation, and CD-related abdominal surgery, no significant association with diagnostic delay was observed. Older age at diagnosis, UGI involvement, and penetrating behavior are associated with long diagnostic delay in Korean CD patients. Moreover, diagnostic delay is associated with an increased risk of CD-related complications such as intestinal stenosis, internal fistulas, and perianal fistulas.

Quantitative characterization of steady and time-varying, sooting, laminar diffusion flames using optical techniques

NASA Astrophysics Data System (ADS)

Connelly, Blair C.

In order to reduce the emission of pollutants such as soot and NO x from combustion systems, a detailed understanding of pollutant formation is required. In addition to environmental concerns, this is important for a fundamental understanding of flame behavior as significant quantities of soot lower local flame temperatures, increase overall flame length and affect the formation of such temperature-dependent species as NOx. This problem is investigated by carrying out coupled computational and experimental studies of steady and time-varying sooting, coflow diffusion flames. Optical diagnostic techniques are a powerful tool for characterizing combustion systems, as they provide a noninvasive method of probing the environment. Laser diagnostic techniques have added advantages, as systems can be probed with high spectral, temporal and spatial resolution, and with species selectivity. Experimental soot volume fractions were determined by using two-dimensional laser-induced incandescence (LII), calibrated with an on-line extinction measurement, and soot pyrometry. Measurements of soot particle size distributions are made using time-resolved LII (TR-LII). Laser-induced fluorescence measurements are made of NO and formaldehyde. These experimental measurements, and others, are compared with computational results in an effort to understand and model soot formation and to examine the coupled relationship of soot and NO x formation.

Implementation of Free Text Format Nursing Diagnoses at a University Hospital's Medical Department. Exploring Nurses' and Nursing Students' Experiences on Use and Usefulness. A Qualitative Study

PubMed Central

Frigstad, Sigrun Aasen; Nøst, Torunn Hatlen; André, Beate

2015-01-01

Background. Nursing documentation has long traditions and represents core element of nursing, but the documentation is often criticized of being incomplete. Nursing diagnoses are an important research topic in nursing in terms of quality of nursing assessment, interventions, and outcome in addition to facilitating communication and continuity. Aim. The aim of this study was to explore the nurses' and nursing students' experiences after implementing free text format nursing diagnoses in a medical department. Method. The study design included educational intervention of free text nursing diagnoses. Data was collected through five focus group interviews with 18 nurses and 6 students as informants. The data was analyzed using qualitative content analysis. Results. The informants describe positive experiences concerning free text format nursing diagnoses' use and usefulness; it promotes reflection and discussion and is described as a useful tool in the diagnostic process, though it was challenging to find the diagnosis' appropriate formulation. Conclusion. Our findings indicate a valid usability of free text format nursing diagnoses as it promotes the diagnostic process. The use seems to enhance critical thinking and may serve as valuable preparation towards an implementation of standardized nursing diagnoses. Use and support of key personnel seem valuable in an implementation process. PMID:26075091

Development and comparison of three diagnostic immunoassay formats for the detection of azoxystrobin.

PubMed

Furzer, Gordon S; Veldhuis, Linda; Hall, J Christopher

2006-02-08

The currently accepted method of detection for azoxystrobin, a strobilurin fungicide, involves a labor-intensive organic solvent extraction and gas chromatography analysis. Three diagnostic assay formats, i.e., enzyme-linked immunosorbent assay (ELISA), fluorescence polarization (FP), and time-resolved fluorescence (TR-FIA), were developed and compared with regard to detection and quantification of azoxystrobin in grape extract and river, lake, and well water samples. These three assay formats require no initial sample extraction and were not affected by any of the environmental matrices tested, and each had a linear working range of 0-400 pg/mL. The polyclonal antibodies used for each of the immunoassays were specific to azoxystrobin; that is, the highest cross-reactivity to other pesticides observed was 5.7%. The limits of detection of the immunoassays were similar at 3 (ELISA), 46 (FP), and 28 (TR-FIA) pg/mL, as were the respective IC50 values of 306, 252, and 244 pg/mL. Each of the three immunoassays developed was less labor-intensive and approximately 100-fold more sensitive than the gas chromatographic method. While the three formats were comparable in terms of performance, the fluorescence polarization assay was the least labor-intensive and required the least time to perform.

Granulomatous lobular mastitis: a complex diagnostic and therapeutic problem.

PubMed

Akcan, Alper; Akyildiz, Hizir; Deneme, Mehmet Ali; Akgun, Hulya; Aritas, Yucel

2006-08-01

Granulomatous lobular mastitis is a rare chronic inflammatory disease of the breast. Clinical and radiological features may mimic breast carcinoma. Since this entity was first described, several clinical and pathologic features of the disease have been reported, but diagnostic features and treatment alternatives are still unclear. The purpose of this study is to evaluate diagnostic difficulties and discuss the outcome of surgical treatment in a series of 21 patients with granulomatous lobular mastitis. A retrospective review of 21 patients with histologically confirmed granulomatous lobular mastitis treated in our center between January 1995 and May 2005 was analyzed to identify issues in the diagnosis and treatment of this rare condition. The most common presenting symptoms were a mass in the breast and pain. Four patients had no significant mammographic findings (MMG), but on ultrasound (US), 2 had irregular hypoechoic mass, and 2 hypoechoic nodular structures had abnormalities-one parenchymal distortion and 1 mass formation in 2 of these 4 patients' magnetic resonance imaging (MRI). In recurrent cases, limited excision under local anesthesia was performed, as the clinical examination suggested carcinoma. Although some findings on MMG and US are suggestive of benign breast disease, these modalities do not rule out malignancy. MRI may be helpful in patients who do not have significant pathology at MMG or US. Fine-needle aspiration cytology may be useful in some cases but diagnosis is potentially difficult because of its cytologic characteristics. Wide excision, particularly under general anesthesia, can be therapeutic as well as useful in providing an exact diagnosis.

EMERGENCE OF GRANULAR-SIZED MAGNETIC BUBBLES THROUGH THE SOLAR ATMOSPHERE. II. NON-LTE CHROMOSPHERIC DIAGNOSTICS AND INVERSIONS

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

Rodríguez, Jaime de la Cruz; Hansteen, Viggo; Ortiz, Ada

Magnetic flux emergence into the outer layers of the Sun is a fundamental mechanism for releasing energy into the chromosphere and the corona. In this paper, we study the emergence of granular-sized flux concentrations and the structuring of the corresponding physical parameters and atmospheric diagnostics in the upper photosphere and in the chromosphere. We make use of a realistic 3D MHD simulation of the outer layers of the Sun to study the formation of the Ca ii 8542 line. We also derive semi-empirical 3D models from non-LTE inversions of our observations. These models contain information on the line-of-sight stratifications ofmore » temperature, velocity, and the magnetic field. Our analysis explains the peculiar Ca ii 8542 Å profiles observed in the flux emerging region. Additionally, we derive detailed temperature and velocity maps describing the ascent of a magnetic bubble from the photosphere to the chromosphere. The inversions suggest that, in active regions, granular-sized bubbles emerge up to the lower chromosphere where the existing large-scale field hinders their ascent. We report hints of heating when the field reaches the chromosphere.« less

Immunologic advances in monoclonal antibody therapy: implications for oncology nursing.

PubMed

Karius, D; Marriott, M A

1997-04-01

To provide an overview of monoclonal antibody (MoAb) formation, therapeutic and diagnostic uses of MoAbs, and the implications for oncology nurses. Books and Journal articles (including research studies). Clinical trials have demonstrated the diagnostic and therapeutic potential of MoAb therapy. Advances in hybridoma technology and gene-splicing techniques have led to the formation of chimeric MoAbs, which exhibit decreased immunogenicity in the recipient. Clinical limitations with MoAb therapy include cross-reactivity with normal tissues, heterogeneity of antigen expression, presence of circulating antigen, antigenic modulation, tumor size and vascularity, and the anti-antibody response. MoAbs currently are used for diagnostic purposes and in phase I, II, and III clinical trials for cancer treatment. As research progresses, MoAbs are likely to be incorporated into the mainstream of cancer therapy as have other biologic response modifiers. Current uses of MoAb therapy in clinical trials involve nurses in many roles, including clinical nurse specialist, staff nurse, and research nurse. As more oncology nurses encounter MoAb therapy in practice, they will have to have an increased understanding of basic immunologic principles and the expertise to manage the unique toxicities associated with MoAb therapy.

System for quantifying the formation stages of corneal arcus

NASA Astrophysics Data System (ADS)

Nasution, Aulia; Fahdarina, Sally; Cahya, Deny I.

2015-07-01

Extensive research on interpreting the clinical signs of corneal-arcus formation and their related diagnostics potentials have found that there is a strong correlation of the arcus formation with the risk of coronary artery diseases and lipid stratification. Clinically the stages of the arcus formation are normally observed as separate grey-whitish arcs, that are formed at the inferior and then at the superior poles of the cornea. These arcs will by time being elongated to form a ring approximately 1 mm in width. In this paper, efforts to develop quantification system that is capable to recognize the stages of the arcus formation will be reported. The quantification was based on eye-images taken using prior developed low-cost digital image acquisition system, which self constructed from a plastic safety welding-goggle that was modified by placing two Logitec C525 webcam and LEDs lighting system. Pattern images of arcs with variation of arc's positions, lengths and thickness were used for pre-calibration purposes. Then these similar arcs are drawn on the of periphery of cornea images to simulate dummy corneal arcus, which mimick the stages of corneal arcus development. Using 672 data images, results of recognition show a good recognition rate, i.e. 93.6 % for determining arc's length (with maximum %RSD of 5.67 %) and 84.83 % for determining arc's thickness (with maximum %RSD of 5.67 %). Worser precision data were observed to happen for the small arc's length as well as small arc's thickness. Current efforts are devoted to translate the system for clinical trials.

Enhancing the Usability of an Optical Reader System to Support Point-of-Care Rapid Diagnostic Testing: An Iterative Design Approach.

PubMed

Hohenstein, Jess; O'Dell, Dakota; Murnane, Elizabeth L; Lu, Zhengda; Erickson, David; Gay, Geri

2017-11-21

In today's health care environment, increasing costs and inadequate medical resources have created a worldwide need for more affordable diagnostic tools that are also portable, fast, and easy to use. To address this issue, numerous research and commercial efforts have focused on developing rapid diagnostic technologies; however, the efficacy of existing systems has been hindered by usability problems or high production costs, making them infeasible for deployment in at-home, point-of-care (POC), or resource-limited settings. The aim of this study was to create a low-cost optical reader system that integrates with any smart device and accepts any type of rapid diagnostic test strip to provide fast and accurate data collection, sample analysis, and diagnostic result reporting. An iterative design methodology was employed by a multidisciplinary research team to engineer three versions of a portable diagnostic testing device that were evaluated for usability and overall user receptivity. Repeated design critiques and usability studies identified a number of system requirements and considerations (eg, software compatibility, biomatter contamination, and physical footprint) that we worked to incrementally incorporate into successive system variants. Our final design phase culminated in the development of Tidbit, a reader that is compatible with any Wi-Fi-enabled device and test strip format. The Tidbit includes various features that support intuitive operation, including a straightforward test strip insertion point, external indicator lights, concealed electronic components, and an asymmetric shape, which inherently signals correct device orientation. Usability testing of the Tidbit indicates high usability for potential user communities. This study presents the design process, specification, and user reception of the Tidbit, an inexpensive, easy-to-use, portable optical reader for fast, accurate quantification of rapid diagnostic test results. Usability testing suggests that the reader is usable among and can benefit a wide group of potential users, including in POC contexts. Generally, the methodology of this study demonstrates the importance of testing these types of systems with potential users and exemplifies how iterative design processes can be employed by multidisciplinary research teams to produce compelling technological solutions. ©Jess Hohenstein, Dakota O'Dell, Elizabeth L Murnane, Zhengda Lu, David Erickson, Geri Gay. Originally published in JMIR Human Factors (http://humanfactors.jmir.org), 21.11.2017.

Dynamic and quantitative assessment of blood coagulation using optical coherence elastography

PubMed Central

Xu, Xiangqun; Zhu, Jiang; Chen, Zhongping

2016-01-01

Reliable clot diagnostic systems are needed for directing treatment in a broad spectrum of cardiovascular diseases and coagulopathy. Here, we report on non-contact measurement of elastic modulus for dynamic and quantitative assessment of whole blood coagulation using acoustic radiation force orthogonal excitation optical coherence elastography (ARFOE-OCE). In this system, acoustic radiation force (ARF) is produced by a remote ultrasonic transducer, and a shear wave induced by ARF excitation is detected by the optical coherence tomography (OCT) system. During porcine whole blood coagulation, changes in the elastic property of the clots increase the shear modulus of the sample, altering the propagating velocity of the shear wave. Consequently, dynamic blood coagulation status can be measured quantitatively by relating the velocity of the shear wave with clinically relevant coagulation metrics, including reaction time, clot formation kinetics and maximum shear modulus. The results show that the ARFOE-OCE is sensitive to the clot formation kinetics and can differentiate the elastic properties of the recalcified porcine whole blood, blood added with kaolin as an activator, and blood spiked with fibrinogen. PMID:27090437

Dynamic and quantitative assessment of blood coagulation using optical coherence elastography

NASA Astrophysics Data System (ADS)

Xu, Xiangqun; Zhu, Jiang; Chen, Zhongping

2016-04-01

Reliable clot diagnostic systems are needed for directing treatment in a broad spectrum of cardiovascular diseases and coagulopathy. Here, we report on non-contact measurement of elastic modulus for dynamic and quantitative assessment of whole blood coagulation using acoustic radiation force orthogonal excitation optical coherence elastography (ARFOE-OCE). In this system, acoustic radiation force (ARF) is produced by a remote ultrasonic transducer, and a shear wave induced by ARF excitation is detected by the optical coherence tomography (OCT) system. During porcine whole blood coagulation, changes in the elastic property of the clots increase the shear modulus of the sample, altering the propagating velocity of the shear wave. Consequently, dynamic blood coagulation status can be measured quantitatively by relating the velocity of the shear wave with clinically relevant coagulation metrics, including reaction time, clot formation kinetics and maximum shear modulus. The results show that the ARFOE-OCE is sensitive to the clot formation kinetics and can differentiate the elastic properties of the recalcified porcine whole blood, blood added with kaolin as an activator, and blood spiked with fibrinogen.

Garengeot’s hernia: two case reports with CT diagnosis and literature review

PubMed Central

De la Plaza, Roberto; Arteaga, Vladimir; Lopez-Marcano, Aylhin; Ramia, Jose

2016-01-01

Abstract Garengeot’s hernia (GH) is defined as the presence of the appendix inside a femoral hernia. It occurs in 0.9% of femoral hernias and is usually an incidental finding during surgery. Its treatment is controversial and the aim of this article is to review the diagnostic methods and surgical considerations. We report two cases diagnosed preoperatively by contrast-enhanced computed tomography (CT) and discuss the treatment options based on a review of the literature published in PubMed updated on 1 December, 2015. Fifty articles reporting 64 patients (50 women, mean age 70 years) with GH were included in the analysis. Diagnosis was performed by preoperative CT in only 24 cases, including our two. The treatment of GH is emergency surgery. Several options are available laparoscopic or open approach: insertion of a mesh or simple herniorrhaphy, with or without appendectomy. Conslusion The preoperative diagnosis with CT can guide the choice of treatment. Appendectomy and hernioplasty should be performed via inguinotomy, if there is no perforation or abscess formation. PMID:28352820

Using voluntary reports from physicians to learn from diagnostic errors in emergency medicine.

PubMed

Okafor, Nnaemeka; Payne, Velma L; Chathampally, Yashwant; Miller, Sara; Doshi, Pratik; Singh, Hardeep

2016-04-01

Diagnostic errors are common in the emergency department (ED), but few studies have comprehensively evaluated their types and origins. We analysed incidents reported by ED physicians to determine disease conditions, contributory factors and patient harm associated with ED-related diagnostic errors. Between 1 March 2009 and 31 December 2013, ED physicians reported 509 incidents using a department-specific voluntary incident-reporting system that we implemented at two large academic hospital-affiliated EDs. For this study, we analysed 209 incidents related to diagnosis. A quality assurance team led by an ED physician champion reviewed each incident and interviewed physicians when necessary to confirm the presence/absence of diagnostic error and to determine the contributory factors. We generated descriptive statistics quantifying disease conditions involved, contributory factors and patient harm from errors. Among the 209 incidents, we identified 214 diagnostic errors associated with 65 unique diseases/conditions, including sepsis (9.6%), acute coronary syndrome (9.1%), fractures (8.6%) and vascular injuries (8.6%). Contributory factors included cognitive (n=317), system related (n=192) and non-remedial (n=106). Cognitive factors included faulty information verification (41.3%) and faulty information processing (30.6%) whereas system factors included high workload (34.4%) and inefficient ED processes (40.1%). Non-remediable factors included atypical presentation (31.3%) and the patients' inability to provide a history (31.3%). Most errors (75%) involved multiple factors. Major harm was associated with 34/209 (16.3%) of reported incidents. Most diagnostic errors in ED appeared to relate to common disease conditions. While sustaining diagnostic error reporting programmes might be challenging, our analysis reveals the potential value of such systems in identifying targets for improving patient safety in the ED. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Self-report assessment of the DSM-IV personality disorders. Measurement of trait and distress characteristics: the ADP-IV.

PubMed

Schotte, C K; de Doncker, D; Vankerckhoven, C; Vertommen, H; Cosyns, P

1998-09-01

Self-report instruments assessing the DSM personality disorders are characterized by overdiagnosis due to their emphasis on the measurement of personality traits rather than the impairment and distress associated with the criteria. The ADP-IV, a Dutch questionnaire, introduces an alternative assessment method: each test item assesses 'Trait' as well as 'Distress/impairment' characteristics of a DSM-IV criterion. This item format allows dimensional as well as categorical diagnostic evaluations. The present study explores the validity of the ADP-IV in a sample of 659 subjects of the Flemish population. The dimensional personality disorder subscales, measuring Trait characteristics, are internally consistent and display a good concurrent validity with the Wisconsin Personality Disorders Inventory. Factor analysis at the item-level resulted in 11 orthogonal factors, describing personality dimensions such as psychopathy, social anxiety and avoidance, negative affect and self-image. Factor analysis at the subscale-level identified two basic dimensions, reflecting hostile (DSM-IV Cluster B) and anxious (DSM-IV Cluster C) interpersonal attitudes. Categorical ADP-IV diagnoses are obtained using scoring algorithms, which emphasize the Trait or the Distress concepts in the diagnostic evaluation. Prevalences of ADP-IV diagnoses of any personality disorder according to these algorithms vary between 2.28 and 20.64%. Although further research in clinical samples is required, the present results support the validity of the ADP-IV and the potential of the measurement of trait and distress characteristics as a method for assessing personality pathology.

A High-Efficiency Superhydrophobic Plasma Separator

PubMed Central

Liu, Changchun; Liao, Shih-Chuan; Song, Jinzhao; Mauk, Michael G.; Li, Xuanwen; Wu, Gaoxiang; Ge, Dengteng; Greenberg, Robert M.; Yang, Shu; Bau, Haim H.

2016-01-01

To meet stringent limit-of-detection specifications for low abundance target molecules, a relatively large volume of plasma is needed for many blood-based clinical diagnostics. Conventional centrifugation methods for plasma separation are not suitable for on-site testing or bedside diagnostics. Here, we report a simple, yet high-efficiency, clamshell-style, superhydrophobic plasma separator that is capable of separating a relatively large volume of plasma from several hundred microliters of whole blood (finger-prick blood volume). The plasma separator consists of a superhydrophobic top cover with a separation membrane and a superhydrophobic bottom substrate. Unlike previously reported membrane-based plasma separators, the separation membrane in our device is positioned at the top of the sandwiched whole blood film to increase the membrane separation capacity and plasma yield. In addition, the device’s superhydrophobic characteristics (i) facilitates the formation of well-defined, contracted, thin blood film with a high contact angle; (ii) minimizes biomolecular adhesion to surfaces; (iii) increases blood clotting time; and (iv) reduces blood cell hemolysis. The device demonstrated a “blood in-plasma out” capability, consistently extracting 65±21.5 μL of plasma from 200 μL of whole blood in less than 10 min without electrical power. The device was used to separate plasma from Schistosoma mansoni genomic DNA-spiked whole blood with a recovery efficiency of > 84.5 ± 25.8 %. The S. mansoni genomic DNA in the separated plasma was successfully tested on our custom-made microfluidic chip by using loop mediated isothermal amplification (LAMP) method. PMID:26732765

RADON DIAGNOSTIC MEASUREMENT GUIDANCE FOR LARGE BUILDINGS - VOLUME 1. TECHNICAL REPORT

EPA Science Inventory

The report discusses the development of radon diagnostic procedures and mitigation strategies applicable to a variety of large non-residential buildings commonly found in Florida. The investigations document and evaluate the nature of radon occurrence and entry mechanisms for rad...

Strategies to Enhance Online Learning Teams. Team Assessment and Diagnostics Instrument and Agent-based Modeling

DTIC Science & Technology

2010-08-12

Strategies to Enhance Online Learning Teams Team Assessment and Diagnostics Instrument and Agent-based Modeling Tristan E. Johnson, Ph.D. Learning ...REPORT DATE AUG 2010 2. REPORT TYPE 3. DATES COVERED 00-00-2010 to 00-00-2010 4. TITLE AND SUBTITLE Strategies to Enhance Online Learning ...TeamsTeam Strategies to Enhance Online Learning Teams: Team Assessment and Diagnostics Instrument and Agent-based Modeling 5a. CONTRACT NUMBER 5b. GRANT

[Vest recorder used in diagnostics of occasionally occurring supraventricular tachycardia nearby sinus node - a case report].

PubMed

Adamczyk, Karolina; Średniawa, Beata; Mitręga, Katarzyna; Morawski, Stanisław; Musialik-Łydka, Agata; Kalarus, Zbigniew

2016-09-29

Symptoms such as palpitations, fainting, dizziness and unexplained loss of consciousness are often notified by patients in clinical practice. Cardiological causes of these ailments could be various, inter alia, atriaventricular conduction disorders, supraventricular arrythmias or more life-threatening ventricular arrythmias. Diagnostics of these disorders includes a series of basic non-invasive research and more advanced specialistic methods. Presented case report shows problems of arrythmias diagnostics and imperfections of avaible methods.

Gearbox vibration diagnostic analyzer

NASA Technical Reports Server (NTRS)

1992-01-01

This report describes the Gearbox Vibration Diagnostic Analyzer installed in the NASA Lewis Research Center's 500 HP Helicopter Transmission Test Stand to monitor gearbox testing. The vibration of the gearbox is analyzed using diagnostic algorithms to calculate a parameter indicating damaged components.

Next Generation Diagnostic System (NGDS) Increment 1 Early Fielding Report

DTIC Science & Technology

2017-06-07

for a NGDS Warrior Panel test FOB 5- Marburg Virus 2 – Marburg 1 – Staph infection 1 – Flu Yes 5 days post -exposure 70 minutes after...Director, Operational Test and Evaluation Next Generation Diagnostic System (NGDS) Increment 1 Early Fielding Report   June 2017...Increment 1 Early Fielding Report Summary This report provides the Director, Operational Test and Evaluation’s (DOT&E) operational assessment of the

[The forensic medical assessment of the results of a study of laryngeal injuries in blunt trauma to the neck].

PubMed

Svetlakov, A V; Korenev, S A; Akishin, A N

1997-01-01

Presents the methodological principles and succession of examination of the basic formations of the larynx in cases with blunt injuries of the neck. Describes variants of anatomic structure of the sublingual bone and laryngeal cartilages influencing the morphology of injuries thereof. Offers differential diagnostic criteria of various mechanisms of fractures of the basic formations and recommendations on medical criminological assessment of laryngeal injuries.

Proof-of-feasibility of using well bore deformation as a diagnostic tool to improve CO 2 sequestration

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

Murdoch, Larry; Moysey, Stephen; Germanovich, Leonid

Injecting CO 2 raises pore pressure and this causes subsurface formations to deform. The pattern and amount of deformation will reflect the distribution of pressure and formation properties in the subsurface, two quantities of interest during CO 2 storage. The hypothesis underlying this research is that the small deformation accompanying CO 2 storage can be measured and interpreted to improve the storage process.

A decision support system and rule-based algorithm to augment the human interpretation of the 12-lead electrocardiogram.

PubMed

Cairns, Andrew W; Bond, Raymond R; Finlay, Dewar D; Guldenring, Daniel; Badilini, Fabio; Libretti, Guido; Peace, Aaron J; Leslie, Stephen J

The 12-lead Electrocardiogram (ECG) has been used to detect cardiac abnormalities in the same format for more than 70years. However, due to the complex nature of 12-lead ECG interpretation, there is a significant cognitive workload required from the interpreter. This complexity in ECG interpretation often leads to errors in diagnosis and subsequent treatment. We have previously reported on the development of an ECG interpretation support system designed to augment the human interpretation process. This computerised decision support system has been named 'Interactive Progressive based Interpretation' (IPI). In this study, a decision support algorithm was built into the IPI system to suggest potential diagnoses based on the interpreter's annotations of the 12-lead ECG. We hypothesise semi-automatic interpretation using a digital assistant can be an optimal man-machine model for ECG interpretation. To improve interpretation accuracy and reduce missed co-abnormalities. The Differential Diagnoses Algorithm (DDA) was developed using web technologies where diagnostic ECG criteria are defined in an open storage format, Javascript Object Notation (JSON), which is queried using a rule-based reasoning algorithm to suggest diagnoses. To test our hypothesis, a counterbalanced trial was designed where subjects interpreted ECGs using the conventional approach and using the IPI+DDA approach. A total of 375 interpretations were collected. The IPI+DDA approach was shown to improve diagnostic accuracy by 8.7% (although not statistically significant, p-value=0.1852), the IPI+DDA suggested the correct interpretation more often than the human interpreter in 7/10 cases (varying statistical significance). Human interpretation accuracy increased to 70% when seven suggestions were generated. Although results were not found to be statistically significant, we found; 1) our decision support tool increased the number of correct interpretations, 2) the DDA algorithm suggested the correct interpretation more often than humans, and 3) as many as 7 computerised diagnostic suggestions augmented human decision making in ECG interpretation. Statistical significance may be achieved by expanding sample size. Copyright © 2017 Elsevier Inc. All rights reserved.

Comparing the dimensional structure and diagnostic algorithms between DSM-5 and ICD-11 PTSD in children and adolescents.

PubMed

Sachser, Cedric; Berliner, Lucy; Holt, Tonje; Jensen, Tine; Jungbluth, Nathaniel; Risch, Elizabeth; Rosner, Rita; Goldbeck, Lutz

2018-02-01

In contrast to the DSM-5, which expanded the posttraumatic stress disorder (PTSD) symptom profile to 20 symptoms, a workgroup of the upcoming ICD-11 suggested a reduced symptom profile with six symptoms for PTSD. Therefore, the objective of the study was to investigate the dimensional structure of DSM-5 and ICD-11 PTSD in a clinical sample of trauma-exposed children and adolescents and to compare the diagnostic rates of PTSD between diagnostic systems. The study sample consisted of 475 self-reports and 424 caregiver-reports on the child and adolescent trauma screen (CATS), which were collected at pediatric mental health clinics in the US, Norway and Germany. The factor structure of the PTSD construct as defined in the DSM-5 and in alternative models of both DSM-5 and ICD-11 was investigated using confirmatory factor analyses (CFA). To evaluate differences in PTSD prevalence, McNemar's tests for correlated proportions were used. CFA results demonstrated excellent model fit for the proposed ICD-11 model of PTSD. For the DSM-5 models we found the best fit for the hybrid model. Diagnostic rates were significantly lower according to ICD-11 (self-report: 23.4%; caregiver-report: 16.5%) compared with the DSM-5 (self-report: 37.8%; caregiver-report: 31.8%). Agreement was low between diagnostic systems. Study findings provide support for an alternative latent dimensionality of DSM-5 PTSD in children and adolescents. The conceptualization of ICD-11 PTSD shows an excellent fit. Inconsistent PTSD constructs and significantly diverging diagnostic rates between DSM-5 and the ICD-11 will result in major challenges for researchers and clinicians in the field of psychotraumatology.

Development, Use and Implications of Diagnostic Creativity Assessment App, RDCA--Reisman Diagnostic Creativity Assessment

ERIC Educational Resources Information Center

Reisman, Fredricka; Keiser, Larry; Otti, Obinna

2016-01-01

The Reisman Diagnostic Creativity Assessment (RDCA) is a free online self-report creativity assessment that provides immediate feedback to the user and is diagnostic, rather than predictive, with the focus on making the user aware of creative strengths and weaknesses. Several engineering and teacher education studies have included the RDCA over a…

Beyond Correctness: Development and Validation of Concept-Based Categorical Scoring Rubrics for Diagnostic Purposes

ERIC Educational Resources Information Center

Arieli-Attali, Meirav; Liu, Ying

2016-01-01

Diagnostic assessment approaches intend to provide fine-grained reports of what students know and can do, focusing on their areas of strengths and weaknesses. However, current application of such diagnostic approaches is limited by the scoring method for item responses; important diagnostic information, such as type of errors and strategy use is…

20 CFR 416.919m - Diagnostic tests or procedures.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Diagnostic tests or procedures. 416.919m... for Report Content § 416.919m Diagnostic tests or procedures. We will request the results of any diagnostic tests or procedures that have been performed as part of a workup by your treating source or other...

European specialist porphyria laboratories: diagnostic strategies, analytical quality, clinical interpretation, and reporting as assessed by an external quality assurance program.

PubMed

Aarsand, Aasne K; Villanger, Jørild H; Støle, Egil; Deybach, Jean-Charles; Marsden, Joanne; To-Figueras, Jordi; Badminton, Mike; Elder, George H; Sandberg, Sverre

2011-11-01

The porphyrias are a group of rare metabolic disorders whose diagnosis depends on identification of specific patterns of porphyrin precursor and porphyrin accumulation in urine, blood, and feces. Diagnostic tests for porphyria are performed by specialized laboratories in many countries. Data regarding the analytical and diagnostic performance of these laboratories are scarce. We distributed 5 sets of multispecimen samples from different porphyria patients accompanied by clinical case histories to 18-21 European specialist porphyria laboratories/centers as part of a European Porphyria Network organized external analytical and postanalytical quality assessment (EQA) program. The laboratories stated which analyses they would normally have performed given the case histories and reported results of all porphyria-related analyses available, interpretative comments, and diagnoses. Reported diagnostic strategies initially showed considerable diversity, but the number of laboratories applying adequate diagnostic strategies increased during the study period. We found an average interlaboratory CV of 50% (range 12%-152%) for analytes in absolute concentrations. Result normalization by forming ratios to the upper reference limits did not reduce this variation. Sixty-five percent of reported results were within biological variation-based analytical quality specifications. Clinical interpretation of the obtained analytical results was accurate, and most laboratories established the correct diagnosis in all distributions. Based on a case-based EQA scheme, variations were apparent in analytical and diagnostic performance between European specialist porphyria laboratories. Our findings reinforce the use of EQA schemes as an essential tool to assess both analytical and diagnostic processes and thereby to improve patient care in rare diseases.

Talbot-Lau x-ray deflectometer electron density diagnostic for laser and pulsed power high energy density plasma experiments (invited).

PubMed

Valdivia, M P; Stutman, D; Stoeckl, C; Mileham, C; Begishev, I A; Theobald, W; Bromage, J; Regan, S P; Klein, S R; Muñoz-Cordovez, G; Vescovi, M; Valenzuela-Villaseca, V; Veloso, F

2016-11-01

Talbot-Lau X-ray deflectometry (TXD) has been developed as an electron density diagnostic for High Energy Density (HED) plasmas. The technique can deliver x-ray refraction, attenuation, elemental composition, and scatter information from a single Moiré image. An 8 keV Talbot-Lau interferometer was deployed using laser and x-pinch backlighters. Grating survival and electron density mapping were demonstrated for 25-29 J, 8-30 ps laser pulses using copper foil targets. Moiré pattern formation and grating survival were also observed using a copper x-pinch driven at 400 kA, ∼1 kA/ns. These results demonstrate the potential of TXD as an electron density diagnostic for HED plasmas.

Talbot-Lau X-ray Deflectometer electron density diagnostic for laser and pulsed power high energy density plasma experiments

DOE PAGES

Valdivia, M. P.; Stutman, D.; Stoeckl, C.; ...

2016-04-21

Talbot-Lau X-ray Deflectometry has been developed as an electron density diagnostic for High Energy Density plasmas. The technique can deliver x-ray refraction, attenuation, elemental composition, and scatter information from a single Moiré image. An 8 keV Talbot-Lau interferometer was deployed using laser and x-pinch backlighters. Grating survival and electron density mapping was demonstrated for 25-29 J, 8-30 ps laser pulses using copper foil targets. Moire pattern formation and grating survival was also observed using a copper x-pinch driven at 400 kA, ~1 kA/ns. Lastly, these results demonstrate the potential of TXD as an electron density diagnostic for HED plasmas.

Clinical Factors and Disease Course Related to Diagnostic Delay in Korean Crohn’s Disease Patients: Results from the CONNECT Study

PubMed Central

Moon, Chang Mo; Jung, Sung-Ae; Kim, Seong-Eun; Song, Hyun Joo; Jung, Yunho; Ye, Byong Duk; Cheon, Jae Hee; Kim, You Sun; Kim, Young-Ho; Kim, Joo Sung; Han, Dong Soo

2015-01-01

Diagnostic delay frequently occurs in Crohn’s disease (CD) patients because of diagnostic limitations. However, diagnostic delay and its related factors remain poorly defined. Therefore, we aimed to identify the predictors associated with diagnostic delay and to evaluate the impact of diagnostic delay on clinical course in a Korean CD patient cohort. We performed a multicenter retrospective analysis of 1,047 CD patients registered in the Crohn’s Disease Clinical Network and Cohort study in Korea. The mean interval of diagnostic delay was 16.0 ± 33.1 months. Multivariate analysis showed that older age at diagnosis (≥40 years) (p = 0.014), concomitant upper gastrointestinal (UGI) disease (p = 0.012) and penetrating disease behavior at diagnosis (p = 0.001) were positively associated with long diagnostic delay (≥18 months). During the longitudinal follow-up, long diagnostic delay was independently predictive of further development of intestinal stenosis (hazard ratio [HR], 1.43; 95% confidence interval [CI], 1.07–1.93; p = 0.017), internal fistulas (HR, 1.62; 95% CI, 1.12–2.33; p = 0.011), and perianal fistulas (HR, 1.38; 95% CI, 1.06–1.80; p = 0.016). However, as for the risk of abscess formation, bowel perforation, and CD-related abdominal surgery, no significant association with diagnostic delay was observed. Older age at diagnosis, UGI involvement, and penetrating behavior are associated with long diagnostic delay in Korean CD patients. Moreover, diagnostic delay is associated with an increased risk of CD-related complications such as intestinal stenosis, internal fistulas, and perianal fistulas. PMID:26647084

pH-Sensitive polymer assisted self-aggregation of bis(pyrene) in living cells in situ with turn-on fluorescence

NASA Astrophysics Data System (ADS)

Duan, Zhongyu; Gao, Yu-Juan; Qiao, Zeng-Ying; Qiao, Shenglin; Wang, Yongmei; Hou, Chunyuan; Wang, Lei; Wang, Hao

2015-09-01

Supramolecular self-assemblies with various nanostructures in organic and aqueous solutions have been prepared with desired functions. However, in situ construction of self-assembled superstructures in physiological conditions to achieve expected biological functions remains a challenge. Here, we report a supramolecular system to realize the in situ formation of nanoaggregates in living cells. The bis(pyrene) monomers were dispersed inside of hydrophobic domains of pH-sensitive polymeric micelles and delivered to the lysosomes of cells. In the acidic lysosomes, the bis(pyrene) monomers were released and self-aggregated with turn-on fluorescence. We envision this strategy for in situ construction of supramolecular nanostructures in living cells will pave the way for molecular diagnostics in the future.

Simultaneous stimulated Raman scattering and higher harmonic generation imaging for liver disease diagnosis without labeling

NASA Astrophysics Data System (ADS)

Lin, Jian; Wang, Zi; Zheng, Wei; Huang, Zhiwei

2014-02-01

Nonlinear optical microscopy (e.g., higher harmonic (second-/third- harmonic) generation (HHG), simulated Raman scattering (SRS)) has high diagnostic sensitivity and chemical specificity, making it a promising tool for label-free tissue and cell imaging. In this work, we report a development of a simultaneous SRS and HHG imaging technique for characterization of liver disease in a bile-duct-ligation rat-modal. HHG visualizes collagens formation and reveals the cell morphologic changes associated with liver fibrosis; whereas SRS identifies the distributions of hepatic fat cells formed in steatosis liver tissue. This work shows that the co-registration of SRS and HHG images can be an effective means for label-free diagnosis and characterization of liver steatosis/fibrosis at the cellular and molecular levels.

Extremely large breast abscess in a breastfeeding mother.

PubMed

Martic, Krešimir; Vasilj, Oliver

2012-11-01

Puerperal mastitis often occurs in younger primiparous women. Most cases occur between 3 and 8 weeks postpartum. If mastitis results in the formation of a breast abscess, surgical drainage or needle aspiration is most commonly performed. We report a case of an extremely large breast abscess in a primiparous 20-year-old woman, which presented 6 weeks postpartum. Surgical incision and evacuation of 2 liters of exudate were performed, and intravenous antibiotics therapy was administered. On the sixth day after incision, we secondarily closed the wound. Examination after 3 months showed symmetrical breasts with a small scar in the incision area of the right breast. A high degree of suspicion and adequate diagnostic procedures are essential to avoid delay in the treatment of mastitis and breast abscess and thereby prevent unnecessary surgical treatment.

MAGI: a Node.js web service for fast microRNA-Seq analysis in a GPU infrastructure.

PubMed

Kim, Jihoon; Levy, Eric; Ferbrache, Alex; Stepanowsky, Petra; Farcas, Claudiu; Wang, Shuang; Brunner, Stefan; Bath, Tyler; Wu, Yuan; Ohno-Machado, Lucila

2014-10-01

MAGI is a web service for fast MicroRNA-Seq data analysis in a graphics processing unit (GPU) infrastructure. Using just a browser, users have access to results as web reports in just a few hours->600% end-to-end performance improvement over state of the art. MAGI's salient features are (i) transfer of large input files in native FASTA with Qualities (FASTQ) format through drag-and-drop operations, (ii) rapid prediction of microRNA target genes leveraging parallel computing with GPU devices, (iii) all-in-one analytics with novel feature extraction, statistical test for differential expression and diagnostic plot generation for quality control and (iv) interactive visualization and exploration of results in web reports that are readily available for publication. MAGI relies on the Node.js JavaScript framework, along with NVIDIA CUDA C, PHP: Hypertext Preprocessor (PHP), Perl and R. It is freely available at http://magi.ucsd.edu. © The Author 2014. Published by Oxford University Press.

Design criteria for developing low-resource magnetic bead assays using surface tension valves

PubMed Central

Adams, Nicholas M.; Creecy, Amy E.; Majors, Catherine E.; Wariso, Bathsheba A.; Short, Philip A.; Wright, David W.; Haselton, Frederick R.

2013-01-01

Many assays for biological sample processing and diagnostics are not suitable for use in settings that lack laboratory resources. We have recently described a simple, self-contained format based on magnetic beads for extracting infectious disease biomarkers from complex biological samples, which significantly reduces the time, expertise, and infrastructure required. This self-contained format has the potential to facilitate the application of other laboratory-based sample processing assays in low-resource settings. The technology is enabled by immiscible fluid barriers, or surface tension valves, which stably separate adjacent processing solutions within millimeter-diameter tubing and simultaneously permit the transit of magnetic beads across the interfaces. In this report, we identify the physical parameters of the materials that maximize fluid stability and bead transport and minimize solution carryover. We found that fluid stability is maximized with ≤0.8 mm i.d. tubing, valve fluids of similar density to the adjacent solutions, and tubing with ≤20 dyn/cm surface energy. Maximizing bead transport was achieved using ≥2.4 mm i.d. tubing, mineral oil valve fluid, and a mass of 1-3 mg beads. The amount of solution carryover across a surface tension valve was minimized using ≤0.2 mg of beads, tubing with ≤20 dyn/cm surface energy, and air separators. The most favorable parameter space for valve stability and bead transport was identified by combining our experimental results into a single plot using two dimensionless numbers. A strategy is presented for developing additional self-contained assays based on magnetic beads and surface tension valves for low-resource diagnostic applications. PMID:24403996

Fluorescent IgG fusion proteins made in E. coli

PubMed Central

Luria, Yael; Raichlin, Dina; Benhar, Itai

2012-01-01

Antibodies are among the most powerful tools in biological and biomedical research and are presently the fastest growing category of new bio-pharmaceutics. The most common format of antibody applied for therapeutic, diagnostic and analytical purposes is the IgG format. For medical applications, recombinant IgGs are made in cultured mammalian cells in a process that is too expensive to be considered for producing antibodies for diagnostic and analytical purposes. Therefore, for such purposes, mouse monoclonal antibodies or polyclonal sera from immunized animals are used. While looking for an easier and more rapid way to prepare full-length IgGs for therapeutic purposes, we recently developed and reported an expression and purification protocol for full-length IgGs, and IgG-based fusion proteins in E. coli, called “Inclonals.” By applying the Inclonals technology, we could generate full-length IgGs that are genetically fused to toxins. The aim of the study described herein was to evaluate the possibility of applying the “Inclonals” technology for preparing IgG-fluorophore fusion proteins. We found that IgG fused to the green fluorescent proteins enhanced GFP (EGFP) while maintaining functionality in binding, lost most of its fluorescence during the refolding process. In contrast, we found that green fluorescent Superfolder GFP (SFGFP)-fused IgG and red fluorescent mCherry-fused IgG were functional in antigen binding and maintained fluorescence intensity. In addition, we found that we can link several SFGFPs in tandem to each IgG, with fluorescence intensity increasing accordingly. Fluorescent IgGs made in E. coli may become attractive alternatives to monoclonal or polyclonal fluorescent antibodies derived from animals. PMID:22531449

CONTINUOUS MID-INFRARED STAR FORMATION RATE INDICATORS: DIAGNOSTICS FOR 0 < z < 3 STAR-FORMING GALAXIES

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

Battisti, A. J.; Calzetti, D.; Johnson, B. D.

2015-02-20

We present continuous, monochromatic star formation rate (SFR) indicators over the mid-infrared wavelength range of 6–70 μm. We use a sample of 58 star-forming galaxies (SFGs) in the Spitzer–SDSS–GALEX Spectroscopic Survey at z < 0.2, for which there is a rich suite of multi-wavelength photometry and spectroscopy from the ultraviolet through to the infrared. The data from the Spitzer Infrared Spectrograph (IRS) of these galaxies, which spans 5–40 μm, is anchored to their photometric counterparts. The spectral region between 40–70 μm is interpolated using dust model fits to the IRS spectrum and Spitzer 70 and 160 μm photometry. Since theremore » are no sharp spectral features in this region, we expect these interpolations to be robust. This spectral range is calibrated as a SFR diagnostic using several reference SFR indicators to mitigate potential bias. Our band-specific continuous SFR indicators are found to be consistent with monochromatic calibrations in the local universe, as derived from Spitzer, WISE, and Herschel photometry. Our local composite template and continuous SFR diagnostics are made available for public use through the NASA/IPAC Infrared Science Archive (IRSA) and have typical dispersions of 30% or less. We discuss the validity and range of applicability for our SFR indicators in the context of unveiling the formation and evolution of galaxies. Additionally, in the era of the James Webb Space Telescope this will become a flexible tool, applicable to any SFG up to z ∼ 3.« less

Diagnostic methods for assessing maxillary skeletal and dental transverse deficiencies: A systematic review

PubMed Central

Sawchuk, Dena; Currie, Kris; Vich, Manuel Lagravere; Palomo, Juan Martin

2016-01-01

Objective To evaluate the accuracy and reliability of the diagnostic tools available for assessing maxillary transverse deficiencies. Methods An electronic search of three databases was performed from their date of establishment to April 2015, with manual searching of reference lists of relevant articles. Articles were considered for inclusion if they reported the accuracy or reliability of a diagnostic method or evaluation technique for maxillary transverse dimensions in mixed or permanent dentitions. Risk of bias was assessed in the included articles, using the Quality Assessment of Diagnostic Accuracy Studies tool-2. Results Nine articles were selected. The studies were heterogeneous, with moderate to low methodological quality, and all had a high risk of bias. Four suggested that the use of arch width prediction indices with dental cast measurements is unreliable for use in diagnosis. Frontal cephalograms derived from cone-beam computed tomography (CBCT) images were reportedly more reliable for assessing intermaxillary transverse discrepancies than posteroanterior cephalograms. Two studies proposed new three-dimensional transverse analyses with CBCT images that were reportedly reliable, but have not been validated for clinical sensitivity or specificity. No studies reported sensitivity, specificity, positive or negative predictive values or likelihood ratios, or ROC curves of the methods for the diagnosis of transverse deficiencies. Conclusions Current evidence does not enable solid conclusions to be drawn, owing to a lack of reliable high quality diagnostic studies evaluating maxillary transverse deficiencies. CBCT images are reportedly more reliable for diagnosis, but further validation is required to confirm CBCT's accuracy and diagnostic superiority. PMID:27668196

Pseudotumoral encapsulated fat necrosis with diffuse pseudomembranous degeneration.

PubMed

Felipo, F; Vaquero, M; del Agua, C

2004-09-01

An extraordinary case of encapsulated fat necrosis characterized by its large size, diffuse formation of pseudomembranes, and tendency to recur after excision is reported. A 67-year-old Caucasian woman suffering from morbid obesity was admitted for diagnosis and surgical treatment of a soft tissue mass showing a longest diameter of 14 cm and lying adjacently to the scar from previous appendicectomy. Histopathologic features were consistent with a nodular-cystic encapsulated fat necrosis with diffuse pseudomembranous transformation. Eight months after surgery, a new larger mass (longest diameter of 18 cm) sharing identical histopathologic features appeared in the same location. Encapsulated fat necrosis is a well-defined entity even though several names have been proposed for this condition, including mobile encapsulated lipoma, encapsulated necrosis, or nodular-cystic fat necrosis. Its pathogenesis seems to be related to ischemic changes secondary to previous trauma. It may occasionally show degenerative changes, including dystrophic calcifications and presence of pseudomembranes. To our knowledge, these are the first reported cases of encapsulated fat necrosis presenting as lesions of such size and showing diffuse formation of pseudomembranes; these particular features made diagnosis difficult and led to consideration of a wide range of potential diagnostic possibilities. This case expands the clinico-pathologic spectrum of membranocystic fat necrosis, including the potential ability of this subcutaneous fatty tissue abnormality to recur after surgical excision. Felipo F, Vaquero M, del Agua C. Pseudotumoral encapsulated fat necrosis with diffuse pseudomembranous degeneration.

Using component technologies for web based wavelet enhanced mammographic image visualization.

PubMed

Sakellaropoulos, P; Costaridou, L; Panayiotakis, G

2000-01-01

The poor contrast detectability of mammography can be dealt with by domain specific software visualization tools. Remote desktop client access and time performance limitations of a previously reported visualization tool are addressed, aiming at more efficient visualization of mammographic image resources existing in web or PACS image servers. This effort is also motivated by the fact that at present, web browsers do not support domain-specific medical image visualization. To deal with desktop client access the tool was redesigned by exploring component technologies, enabling the integration of stand alone domain specific mammographic image functionality in a web browsing environment (web adaptation). The integration method is based on ActiveX Document Server technology. ActiveX Document is a part of Object Linking and Embedding (OLE) extensible systems object technology, offering new services in existing applications. The standard DICOM 3.0 part 10 compatible image-format specification Papyrus 3.0 is supported, in addition to standard digitization formats such as TIFF. The visualization functionality of the tool has been enhanced by including a fast wavelet transform implementation, which allows for real time wavelet based contrast enhancement and denoising operations. Initial use of the tool with mammograms of various breast structures demonstrated its potential in improving visualization of diagnostic mammographic features. Web adaptation and real time wavelet processing enhance the potential of the previously reported tool in remote diagnosis and education in mammography.

Self-Reported HIV-Positive Status But Subsequent HIV-Negative Test Result Using Rapid Diagnostic Testing Algorithms Among Seven Sub-Saharan African Military Populations

DTIC Science & Technology

2017-07-07

RESEARCH ARTICLE Self-reported HIV-positive status but subsequent HIV-negative test result using rapid diagnostic testing algorithms among seven sub...America * judith.harbertson.ctr@mail.mil Abstract HIV rapid diagnostic tests (RDTs) combined in an algorithm are the current standard for HIV diagnosis...in many sub-Saharan African countries, and extensive laboratory testing has con- firmed HIV RDTs have excellent sensitivity and specificity. However

Filter membrane-based automated therapeutic plasma exchange: a report of two cases from Nigeria.

PubMed

Arogundade, Fatiu A; Sanusi, Abubakr A; Akinbodewa, Akinwunmi A; Hassan, Muzamil O; Omotosho, Bolanle O; Balogun, Rasheed A; Akinsola, Adewale

2013-02-01

These case reports demonstrated the diagnostic dilemma encountered in patients with systemic lupus erythematosus and thrombotic thrombocytopenic purpura particularly in settings with limited diagnostic facilities and laboratory support. The similarities in the diagnostic criteria for both conditions make clear distinction as well as management decisions difficult. We present the difficulties encountered with both the diagnosis and the management of these two patients that were managed in our facility. Copyright © 2013 Wiley Periodicals, Inc.

Precursor B-cell lymphoblastic lymphoma of oral cavity: A case report with its diagnostic workup

PubMed Central

Talreja, Komal Ladharam; Barpande, Suresh Ramchandra; Bhavthankar, Jyoti Dilip; Mandale, Mandakini S

2016-01-01

Lymphoblastic lymphoma (LBL), seen primarily in children or young adults, is a malignant neoplasia that originates from B or T lymphocyte precursors and rarely occurs in the oral cavity. In this localization, neither the clinical features nor the radiologic appearances are pathognomic and can pose significant diagnostic problems. Histopathologically, it presents as a round blue cell tumor. An early and accurate diagnosis of this entity is very important due to its high cure rate. We report a case of B-cell LBL involving oral cavity in a 10-year-old child. The purpose of this report is to explore the diagnostic workup. PMID:27194876

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

PubMed

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

2012-01-01

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

Description of the TCERT Vetting Reports for Data Release 25

NASA Technical Reports Server (NTRS)

Coughlin, Jeffrey L,

2017-01-01

The Q1Q17 DR25 TCERT Vetting Reports are a collection of plots and diagnostics used by the Threshold Crossing Event Review Team (TCERT) to evaluate threshold crossing events (TCEs). While designation of Kepler Objects of Interest (KOIs) and classification of them as Planet Candidates (PCs) or False Positives (FPs) is completely automated via a robotic vetting procedure (the Robovetter) for the Q1Q17 DR25 planet catalog, as described in Thompson et al. (2017), these reports help to visualize the metrics used by the Robovetter and evaluate those robotic decisions for individual objects. For each Q1Q17 DR25 TCE, these reports include the following products: (a) the DV one-page summary, (b) selected pertinent diagnostics and plots from the full DV report, and (c) additional plots and diagnostics not included in the full DV report, including an alternate means of data detrending.

[Diagnostic (STARD) and prognostic (REMARK) studies].

PubMed

Altman, Douglas G; Bossuyt, Patrick Mm

2005-12-01

Deficiencies in how research studies are reported are both well-documented and widespread across all medical specialties and study designs. Although randomised trials have received the most attention in this regard, similar concerns have been expressed about reporting of other types of research including diagnostic and epidemiological studies. If a journal article describes in enough detail what was done at each stage of a study, readers will have enough information to allow them to decide on the merits of the results for themselves. From this simple idea comes the scientific rationale of developing guidelines on how to report research. Recommended processes to produce reporting guidelines have evolved over several years during the preparation of a sequence of reporting guidelines starting with CONSORT and QUOROM in the 1990s. We describe initiatives to develop reporting guidelines for diagnostic accuracy studies (STARD) and tumour marker prognostic studies (REMARK).

The Log-Linear Cognitive Diagnostic Model (LCDM) as a Special Case of The General Diagnostic Model (GDM). Research Report. ETS RR-14-40

ERIC Educational Resources Information Center

von Davier, Matthias

2014-01-01

Diagnostic models combine multiple binary latent variables in an attempt to produce a latent structure that provides more information about test takers' performance than do unidimensional latent variable models. Recent developments in diagnostic modeling emphasize the possibility that multiple skills may interact in a conjunctive way within the…

How to conduct a high-quality original study on a diagnostic research topic.

PubMed

Yao, Xiaomei; Vella, Emily

2017-09-01

As health research methodologists and journal reviewers, we noticed that the methodological rigor of many publications on diagnostic or prognostic topics in the medical literature could be improved. We present a concise and clear series of reviews to help clinicians and health researchers to master the basic key components of how to conduct a high-quality original study or systematic review on a diagnostic or prognostic research topic from a methodological perspective. This is the first review of the series, which focuses on how to conduct a high-quality diagnostic study. We are introducing four aspects: clarifying the objectives; generating an appropriate research question; planning the study design; and reporting and analyzing data. This review highlights that diagnostic test accuracy outcomes are surrogates for patient outcomes, a diagnostic test has three roles, the "PIRO" components should be included in a diagnostic research question, a new study should be registered, multiple index tests can be compared in one study, and prevalence affects test accuracy outcomes. This review also emphasizes reporting any thresholds, calculating sample size, and performing a two-by-three table to calculate diagnostic outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Plasma/Wall interaction of an insulated material by laser-induced fluorescence diagnostic

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

Claire, N.; Doveil, F.

2015-07-01

We present Argon Ion Velocity Distribution Function (IVDF) in the vicinity of an insulated BNSiO{sub 2} ceramic and a glass plate in a non magnetized plasma by laser-induced fluorescence diagnostic. Results show the rather surprising self-consistent formation of a positive or inverse sheath in the two cases. The positive plasma potential repels ions from the insulated wall and is not explained by any sheath theory. Electron secondary emission of the ceramic can be a good candidate to explain these results. (authors)

Fecal Fistula Communicating with a Femur Shaft Fracture Secondary to a Malpositioned Suprapubic Catheter: A Case Report

PubMed Central

Guled, Uday; Goni, Vijay G.; Honnurappa, Arjun R.H.; John, Rakesh; Vardhana, Harsha; Sharma, Gaurav; Pattabhiraman, Kirubakaran S.

2015-01-01

Patient: Male, 18 Final Diagnosis: Fecal fistula communicating with fracture shaft femur secondary to malpositioned SPC Symptoms: — Medication: — Clinical Procedure: Advertisement and rail fixator application Specialty: Orthopedics and Trauamtology Objective: Diagnostic/therapeutic accidents Background: Suprapubic catheter (SPC) insertion is a common urological procedure. Though considered a simple and safe procedure, complications are bound to occur if proper precautions are not taken during the procedure. The reported complications include gross hematuria, post-obstruction diuresis, insertion site skin-related complications, and intra-abdominal visceral injuries. Iatrogenic bowel injuries have been reported to occur as a complication in around 2.5% of cases. Case Report: We report a very rare case of a bowel injury due to improper insertion of a SPC leading to fecal matter tracking along the muscle planes to reach the fracture site of the femur shaft and formation of an external fecal fistula along the lateral aspect of thigh, which according to us is the first reported case in the literature. Conclusions: This case report shows the devastating complication of a technically simple procedure done in an improper manner and successful management of a rare case of femur fracture with communicating fecal fistula. The purpose of this case report is to highlight the importance of taking proper precautions before the procedure. PMID:26439133

The pursuit of better diagnostic performance: a human factors perspective.

PubMed

Henriksen, Kerm; Brady, Jeff

2013-10-01

Despite the relatively slow start in treating diagnostic error as an amenable research topic at the beginning of the patient safety movement, interest has steadily increased over the past few years in the form of solicitations for research, regularly scheduled conferences, an expanding literature and even a new professional society. Yet improving diagnostic performance increasingly is recognised as a multifaceted challenge. With the aid of a human factors perspective, this paper addresses a few of these challenges, including questions that focus on who owns the problem, treating cognitive and system shortcomings as separate issues, why knowledge in the head is not enough, and what we are learning from health information technology (IT) and the use of checklists. To encourage empirical testing of interventions that aim to improve diagnostic performance, a systems engineering approach making use of rapid-cycle prototyping and simulation is proposed. To gain a fuller understanding of the complexity of the sociotechnical space where diagnostic work is performed, a final note calls for the formation of substantive partnerships with those in disciplines beyond the clinical domain.

Localization of Diagnostically Relevant Regions of Interest in Whole Slide Images: a Comparative Study.

PubMed

Mercan, Ezgi; Aksoy, Selim; Shapiro, Linda G; Weaver, Donald L; Brunyé, Tad T; Elmore, Joann G

2016-08-01

Whole slide digital imaging technology enables researchers to study pathologists' interpretive behavior as they view digital slides and gain new understanding of the diagnostic medical decision-making process. In this study, we propose a simple yet important analysis to extract diagnostically relevant regions of interest (ROIs) from tracking records using only pathologists' actions as they viewed biopsy specimens in the whole slide digital imaging format (zooming, panning, and fixating). We use these extracted regions in a visual bag-of-words model based on color and texture features to predict diagnostically relevant ROIs on whole slide images. Using a logistic regression classifier in a cross-validation setting on 240 digital breast biopsy slides and viewport tracking logs of three expert pathologists, we produce probability maps that show 74 % overlap with the actual regions at which pathologists looked. We compare different bag-of-words models by changing dictionary size, visual word definition (patches vs. superpixels), and training data (automatically extracted ROIs vs. manually marked ROIs). This study is a first step in understanding the scanning behaviors of pathologists and the underlying reasons for diagnostic errors.

A False Positive Dengue Fever Rapid Diagnostic Test Result in a Case of Acute Parvovirus B19 Infection.

PubMed

Izumida, Toshihide; Sakata, Hidenao; Nakamura, Masahiko; Hayashibara, Yumiko; Inasaki, Noriko; Inahata, Ryo; Hasegawa, Sumiyo; Takizawa, Takenori; Kaya, Hiroyasu

2016-01-01

An outbreak of dengue fever occurred in Japan in August 2014. We herein report the case of a 63-year-old man who presented with a persistent fever in September 2014. Acute parvovirus B19 infection led to a false positive finding of dengue fever on a rapid diagnostic test (Panbio Dengue Duo Cassette(TM)). To the best of our knowledge, there are no previous reports of a false positive result for dengue IgM with the dengue rapid diagnostic test. We believe that epidemiological information on the prevalence of parvovirus B19 is useful for guiding the interpretation of a positive result with the dengue rapid diagnostic test.

Gastric volvulus following diagnostic upper gastrointestinal endoscopy: a rare complication.

PubMed

Karthikeyan, Vilvapathy Senguttuvan; Sistla, Sarath Chandra; Ram, Duvuru; Rajkumar, Nagarajan

2014-02-10

Esophagogastroduodenoscopy (EGD) is a commonly used, safe diagnostic modality for evaluation of epigastric pain and rarely its major complications include perforation, haemorrhage, dysrhythmias and death. Gastric volvulus has been reported to complicate percutaneous endoscopic gastrostomy but its occurrence after diagnostic EGD has not yet been reported in literature. The successful management relies on prompt diagnosis and gastric untwisting, decompression and gastropexy or gastrectomy in full thickness necrosis of the stomach wall. A 38-year-old woman presented with epigastric pain and EGD showed pangastritis. Immediately after EGD she developed increased severity of pain, vomiting and abdominal distension. Emergency laparotomy carried out for peritoneal signs revealed eventration of left hemidiaphragm with the stomach twisted anticlockwise in the longitudinal axis. After gastric decompression and untwisting of volvulus, anterior gastropexy and gastrostomy was carried out. Hence, we report this rare complication of diagnostic endoscopy and review the existing literature on the management.

Status and test report on the LANL-Boeing APLE/HPO flying-wire beam-profile monitor. Status report

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

Wilke, M.; Barlow, D.; Fortgang, C.

1994-07-01

The High-Power Oscillator (HPO) demonstration of the Average Power Laser Experiment (APLE) is a collaboration by Los Alamos National Laboratory and Boeing to demonstrate a 10 kW average power, 10 {mu}m free electron laser (FEL). As part of the collaboration, Los Alamos National Laboratory (LANL) is responsible for many of the electron beam diagnostics in the linac, transport, and laser sections. Because of the high duty factor and power of the electron beam, special diagnostics are required. This report describes the flying wire diagnostic required to monitor the beam profile during high-power, high-duty operation. The authors describe the diagnostic andmore » prototype tests on the Los Alamos APLE Prototype Experiment (APEX) FEL. They also describe the current status of the flying wires being built for APLE.« less

Amphitheater-headed canyons formed by megaflooding at Malad Gorge, Idaho

PubMed Central

Lamb, Michael P.; Mackey, Benjamin H.; Farley, Kenneth A.

2014-01-01

Many bedrock canyons on Earth and Mars were eroded by upstream propagating headwalls, and a prominent goal in geomorphology and planetary science is to determine formation processes from canyon morphology. A diagnostic link between process and form remains highly controversial, however, and field investigations that isolate controls on canyon morphology are needed. Here we investigate the origin of Malad Gorge, Idaho, a canyon system cut into basalt with three remarkably distinct heads: two with amphitheater headwalls and the third housing the active Wood River and ending in a 7% grade knickzone. Scoured rims of the headwalls, relict plunge pools, sediment-transport constraints, and cosmogenic (3He) exposure ages indicate formation of the amphitheater-headed canyons by large-scale flooding ∼46 ka, coeval with formation of Box Canyon 18 km to the south as well as the eruption of McKinney Butte Basalt, suggesting widespread canyon formation following lava-flow diversion of the paleo-Wood River. Exposure ages within the knickzone-headed canyon indicate progressive upstream younging of strath terraces and a knickzone propagation rate of 2.5 cm/y over at least the past 33 ka. Results point to a potential diagnostic link between vertical amphitheater headwalls in basalt and rapid erosion during megaflooding due to the onset of block toppling, rather than previous interpretations of seepage erosion, with implications for quantifying the early hydrosphere of Mars. PMID:24344293

Unravelling abiotic and biotic controls on the seasonal water balance using data-driven dimensionless diagnostics

NASA Astrophysics Data System (ADS)

Seibert, Simon Paul; Jackisch, Conrad; Ehret, Uwe; Pfister, Laurent; Zehe, Erwin

2017-06-01

The baffling diversity of runoff generation processes, alongside our sketchy understanding of how physiographic characteristics control fundamental hydrological functions of water collection, storage, and release, continue to pose major research challenges in catchment hydrology. Here, we propose innovative data-driven diagnostic signatures for overcoming the prevailing status quo in catchment inter-comparison. More specifically, we present dimensionless double mass curves (dDMC) which allow inference of information on runoff generation and the water balance at the seasonal and annual timescales. By separating the vegetation and winter periods, dDMC furthermore provide information on the role of biotic and abiotic controls in seasonal runoff formation. A key aspect we address in this paper is the derivation of dimensionless expressions of fluxes which ensure the comparability of the signatures in space and time. We achieve this by using the limiting factors of a hydrological process as a scaling reference. We show that different references result in different diagnostics. As such we define two kinds of dDMC which allow us to derive seasonal runoff coefficients and to characterize dimensionless streamflow release as a function of the potential renewal rate of the soil storage. We expect these signatures for storage controlled seasonal runoff formation to remain invariant, as long as the ratios of release over supply and supply over storage capacity develop similarly in different catchments. We test the proposed methods by applying them to an operational data set comprising 22 catchments (12-166 km2) from different environments in southern Germany and hydrometeorological data from 4 hydrological years. The diagnostics are used to compare the sites and to reveal the dominant controls on runoff formation. The key findings are that dDMC are meaningful signatures for catchment runoff formation at the seasonal to annual scale and that the type of scaling strongly influences the diagnostic potential of the dDMC. Adding discrimination between growing season and winter period was of fundamental importance and easy to implement by means of a temperature-index model. More specifically, temperature aggregates explain over 70 % of the variability of the seasonal summer runoff coefficients. The results also show that the soil topographic index, i.e. the product of topographic gradient and saturated hydraulic conductivity, is significantly correlated with winter runoff coefficients, whereas the topographic gradient and the hydraulic conductivity alone are not. We conclude that proxies for gradients and resistances should be interpreted as a pair. Lastly, the dDMC concept reveals memory effects between summer and winter runoff regimes that are not relevant in spring between the transition from winter to summer.

Radiation Protection Guidance for Diagnostic and Interventional X-Ray Procedures; Federal Guidance Report No. 14

EPA Science Inventory

Federal Guidance Report No. 14 provides federal facilities that use diagnostic and interventional x-ray equipment with updated recommendations for keeping doses as low as reasonably achievable without compromising the quality of patient care, This guidance is an update of Federal...

Agreement between patients and general practitioners on quality deviations during the cancer diagnostic pathway and associations with time to diagnosis.

PubMed

Jensen, Henry; Sperling, Cecilie; Sandager, Mette; Vedsted, Peter

2015-06-01

High quality and minimal delay are crucial and anticipated elements in the diagnostic cancer pathway as delay in the diagnosis may worsen the prognosis and cause lower patient satisfaction. The aim of this study was to describe agreement in reported quality deviations (QDs) between general practitioners (GPs) and cancer patients during the diagnostic pathway in primary care and to estimate the association between length of diagnostic interval and level of agreement on reported QDs. The study was carried out as a Danish cross-sectional study of incident cancer patients identified in the Danish National Patient Registry. Data were collected by independent questionnaires from patients (response rate: 53.0%) and their GPs (response rate: 73.8%), and 2177 pairs of questionnaires were subsequently combined. Agreement between GP- and patient-reported QDs was estimated using Cohen's Kappa, whereas the association between level of agreement and time to diagnosis was estimated using quantile regression. Patients reported QDs in 29.0% and GPs in 28.5% of the cases, but agreed only slightly on QD presence (Kappas between -0.08 and 0.26). Agreement on 'QD presence' was associated with a 54-day (95%CI: 44-64) longer time to diagnosis than agreement on 'no QD presence'. The association with a longer diagnostic interval was stronger when only GP reported a QD the association than when only patient reported a QD. Included GPs and patients agreed only slightly on QD presence although they reported the same amount of QDs; this suggests that GPs and patients see QDs as two different concepts. QD presence had a stronger impact on time to diagnosis when reported by the GP (alone or in agreement with the patient) than when reported by the patient alone. The GP may thus be the most important source of information on QD and diagnostic interval, while the patient information tends to underpin this assessment. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Evidence synthesis to inform model-based cost-effectiveness evaluations of diagnostic tests: a methodological review of health technology assessments.

PubMed

Shinkins, Bethany; Yang, Yaling; Abel, Lucy; Fanshawe, Thomas R

2017-04-14

Evaluations of diagnostic tests are challenging because of the indirect nature of their impact on patient outcomes. Model-based health economic evaluations of tests allow different types of evidence from various sources to be incorporated and enable cost-effectiveness estimates to be made beyond the duration of available study data. To parameterize a health-economic model fully, all the ways a test impacts on patient health must be quantified, including but not limited to diagnostic test accuracy. We assessed all UK NIHR HTA reports published May 2009-July 2015. Reports were included if they evaluated a diagnostic test, included a model-based health economic evaluation and included a systematic review and meta-analysis of test accuracy. From each eligible report we extracted information on the following topics: 1) what evidence aside from test accuracy was searched for and synthesised, 2) which methods were used to synthesise test accuracy evidence and how did the results inform the economic model, 3) how/whether threshold effects were explored, 4) how the potential dependency between multiple tests in a pathway was accounted for, and 5) for evaluations of tests targeted at the primary care setting, how evidence from differing healthcare settings was incorporated. The bivariate or HSROC model was implemented in 20/22 reports that met all inclusion criteria. Test accuracy data for health economic modelling was obtained from meta-analyses completely in four reports, partially in fourteen reports and not at all in four reports. Only 2/7 reports that used a quantitative test gave clear threshold recommendations. All 22 reports explored the effect of uncertainty in accuracy parameters but most of those that used multiple tests did not allow for dependence between test results. 7/22 tests were potentially suitable for primary care but the majority found limited evidence on test accuracy in primary care settings. The uptake of appropriate meta-analysis methods for synthesising evidence on diagnostic test accuracy in UK NIHR HTAs has improved in recent years. Future research should focus on other evidence requirements for cost-effectiveness assessment, threshold effects for quantitative tests and the impact of multiple diagnostic tests.

Effect of patient age awareness on diagnostic agreement of chronic or aggressive periodontitis between clinicians; a pilot study.

PubMed

Oshman, Sarah; El Chaar, Edgard; Lee, Yoonjung Nicole; Engebretson, Steven

2016-07-25

The aim of this pilot study was to test whether diagnostic agreement of aggressive and chronic periodontitis amongst Board Certified Periodontists, is influenced by knowledge of a patient's age. In 1999 at the International World Workshop age was removed as a diagnostic criteria for aggressive periodontitis. The impact of this change on the diagnostic reliability amongst clinicians has not yet been assessed. Nine periodontal case reports were twice presented to sixteen board certified periodontists, once with age withheld and again with patient age provided. Participants were instructed to choose a diagnosis of Chronic Periodontitis or Aggressive Periodontitis. Diagnostic agreement was calculated using the Fleiss Kappa test. Including the patients' age in case report information increased diagnostic agreement (the kappa statistic) from 0.49 (moderate agreement) to 0.61 (substantial agreement). These results suggest that knowledge of a patients' age influenced clinical diagnosis, when distinguishing between aggressive periodontitis and chronic periodontitis, which may in turn impact treatment decision-making.

Basic haemoglobinopathy diagnostics in Dutch laboratories; providing an informative test result.

PubMed

Kaufmann, J O; Smit, J W; Huisman, W; Idema, R N; Bakker, E; Giordano, P C

2013-08-01

After a first survey in 2001, the Dutch Association of Hematological Laboratory Research (VHL) advised its members to adopt a basic protocol for haemoglobinopathy carrier detection and to provide genetic information with all positive results to allow health-care professionals to inform carriers about potential genetic risks. This article reports on the compliance with these recommendations and their consequences. Clinical chemists of all 106 Dutch laboratories were invited to answer a survey on patient population, diagnostic techniques used, (self-reported) knowledge, use and effect of the additional information. The average increase in diagnostic output was over 60% and the recommended basic protocol was applied by 65% of the laboratories. Over 84% of the laboratories reported to be aware of the additional recommendations and 77% to be using them. Most laboratories with limited diagnostic requests were still sending their cases to other laboratories and included the genetic information received from these laboratories in their diagnostic reports. The effect of information on subsequent 'family analysis' was estimated to be between 26 and 50%. The present study shows an increase in diagnostic potential for haemoglobinopathy over the last decade, especially in the larger cities. Low 'family testing' rates were mostly found in areas with lower carrier prevalence or associated with local reluctance to pass the information to carriers. In spite of a dramatic improvement, too many carriers are still not informed because of lack of awareness among health-care providers and more education is needed. © 2012 John Wiley & Sons Ltd.

Antimicrobial susceptibility testing by Australian veterinary diagnostic laboratories.

PubMed

Hardefeldt, L Y; Marenda, M; Crabb, H; Stevenson, M A; Gilkerson, J R; Billman-Jacobe, H; Browning, G F

2018-04-01

The national strategy for tackling antimicrobial resistance highlights the need for antimicrobial stewardship in veterinary practice and for surveillance of antimicrobial susceptibility in veterinary pathogens. Diagnostic laboratories have an important role in facilitating both of these processes, but it is unclear whether data from veterinary diagnostic laboratories are similar enough to allow for compilation and if there is consistent promotion of appropriate antimicrobial use embedded in the approaches of different laboratories to susceptibility testing. A cross-sectional study of antimicrobial susceptibility testing and reporting procedures by Australian veterinary diagnostic laboratories was conducted in 2017 using an online questionnaire. All 18 veterinary diagnostic laboratories in Australia completed the questionnaire. Kirby-Bauer disc diffusion was the method predominantly used for antimicrobial susceptibility testing and was used to evaluate 86% of all isolates, although two different protocols were used across the 18 laboratories (CLSI 15/18, CDS 3/18). Minimum inhibitory concentrations were never reported by 61% of laboratories. Common isolates were consistently reported on across all species, except for gram-negative isolates in pigs, for which there was some variation in the approach to reporting. There was considerable diversity in the panels of antimicrobials used for susceptibility testing on common isolates and no consistency was apparent between laboratories for any bacterial species. We recommend that nationally agreed and consistent antimicrobial panels for routine susceptibility testing should be developed and a uniform set of guidelines should be adopted by veterinary diagnostic laboratories in Australia. © 2018 Australian Veterinary Association.

[Current perspectives on endodontic treatment of teeth with chronic periapical lesions].

PubMed

Canalda Sahli, C

1990-01-01

The author study in this article histopathological aspects of periapical lesions, intra-granulomatous epithelial proliferation phenomenon as pathogenic mechanism of microscopic cystic cavities formation, diagnostic problems of them all, as well as the most actual therapeutic perspectives.

Endobronchial Ultrasound-guided Transbronchial Needle Aspiration Using 19-G Needle for Sarcoidosis.

PubMed

Balwan, Akshu

2018-05-16

Flexible bronchoscopy with endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) is increasingly being used to obtain pathology specimens for diagnosis of sarcoidosis. There is wide variation in reported diagnostic yield in literature. New TBNA needles are available in the market but data are lacking about their diagnostic yield especially for sarcoidosis. This study reports the diagnostic yield of bronchoscopy with EBUS-TBNA using ViziShot FLEX 19-G needle in a series of patients with suspected sarcoidosis. This is a retrospective chart review for diagnostic yield of the 19-G EBUS-TBNA needle for suspected sarcoidosis. Eighty-six EBUS bronchoscopies were performed, 15 were done with clinical suspicion of sarcoidosis. The 19-G needle was used for all cases of suspected sarcoidosis. The procedure was diagnostic of sarcoidosis in 14 (93.3%) patients by TBNA with 1 nondiagnostic bronchoscopy. Procedural diagnostic yield was 93.3%. Eighty-five percent (28/33) of sampled lymph nodes were positive for noncaseating granulomas. The yield of transbronchial lung biopsy (TBLB) and endobronchial lung biopsy was 38% (5/13) and 43% (6/14), respectively. TBLB and endobronchial lung biopsy did not add to the diagnostic yield of the procedure. No significant adverse events were noted. This series reports a higher diagnostic yield than most other published studies and opens platform for direct comparison of each available needle. It also adds to the safety data for this larger needle. In addition, it raises doubt into utility of TBLB for diagnosis of sarcoidosis, which can increase the procedural complications.

Off-site smartphone reading of CT images for patients with inconclusive diagnoses of appendicitis from on-call radiologists.

PubMed

Seong, Nak Jong; Kim, Bohyoung; Lee, Sungmin; Park, Hee Sun; Kim, Hyuk Jung; Woo, Hyunsik; Kang, Heung-Sik; Lee, Kyoung Ho

2014-07-01

The purpose of this study was to simulate a mobile consultation in patients with inconclusive diagnosis of appendicitis made by on-call radiologists, as well as to measure the diagnostic confidence and performance of the mobile consultation. Two off-site abdominal radiologists interpreted the CT images from 68 patients (including 29 patients with confirmed appendicitis) on a smart-phone for whom the preliminary CT reports by 25 in-house on-call radiologists were inconclusive. The smartphone readings were compared with the preliminary reports by on-call radiologists and with the original final reports by in-house abdominal radiologists. Heat maps, kappa statistics, Wilcoxon signed-rank tests, and ROC curves were used for data analysis. The heat maps and kappa statistics showed that the smartphone readings were more similar to the final reports than to the preliminary reports. In diagnosing or ruling out appendicitis, the smartphone readings were more confident than the preliminary reports (p ≤ 0.01) and did not significantly differ in diagnostic confidence from the final reports (p ≥ 0.19). The AUCs of the smartphone readings (0.91 and 0.92) did not differ significantly from those of the preliminary (0.85) or final (0.97) reports (p ≥ 0.09). With the given study sample, the diagnostic performance of the off-site smartphone readings did not differ significantly from that of the in-house preliminary reports. However, the smartphone readings provided higher diagnostic confidence than the preliminary reports.

Protocol investigating the clinical utility of an objective measure of activity and attention (QbTest) on diagnostic and treatment decision-making in children and young people with ADHD-'Assessing QbTest Utility in ADHD' (AQUA): a randomised controlled trial.

PubMed

Hall, Charlotte L; Walker, Gemma M; Valentine, Althea Z; Guo, Boliang; Kaylor-Hughes, Catherine; James, Marilyn; Daley, David; Sayal, Kapil; Hollis, Chris

2014-12-01

The National Institute for Health and Care Excellence (NICE) guidelines for attention deficit/hyperactivity disorder (ADHD) state that young people need to have access to the best evidence-based care to improve outcome. The current 'gold standard' ADHD diagnostic assessment combines clinical observation with subjective parent, teacher and self-reports. In routine practice, reports from multiple informants may be unavailable or contradictory, leading to diagnostic uncertainty and delay. The addition of objective tests of attention and activity may help reduce diagnostic uncertainty and delays in initiating treatment leading to improved outcomes. This trial investigates whether providing clinicians with an objective report of levels of attention, impulsivity and activity can lead to an earlier, and more accurate, clinical diagnosis and improved patient outcome. This multisite randomised controlled trial will recruit young people (aged 6-17 years old) who have been referred for an ADHD diagnostic assessment at Child and Adolescent Mental Health Services (CAMHS) and Community Paediatric clinics across England. Routine clinical assessment will be augmented by the QbTest, incorporating a continuous performance test (CPT) and infrared motion tracking of activity. The participant will be randomised into one of two study arms: QbOpen (clinician has immediate access to a QbTest report): QbBlind (report is withheld until the study end). Primary outcomes are time to diagnosis and diagnostic accuracy. Secondary outcomes include clinician's diagnostic confidence and routine clinical outcome measures. Cost-effective analysis will be conducted, alongside a qualitative assessment of the feasibility and acceptability of incorporating QbTest in routine practice. The findings from the study will inform commissioners, clinicians and managers about the feasibility, acceptability, clinical utility and cost-effectiveness of incorporating QbTest into routine diagnostic assessment of young people with ADHD. The results will be submitted for publication in peer-reviewed journals. The study has received ethical approval. NCT02209116. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Protocol investigating the clinical utility of an objective measure of activity and attention (QbTest) on diagnostic and treatment decision-making in children and young people with ADHD—‘Assessing QbTest Utility in ADHD’ (AQUA): a randomised controlled trial

PubMed Central

Hall, Charlotte L; Walker, Gemma M; Valentine, Althea Z; Guo, Boliang; Kaylor-Hughes, Catherine; James, Marilyn; Daley, David; Sayal, Kapil; Hollis, Chris

2014-01-01

Introduction The National Institute for Health and Care Excellence (NICE) guidelines for attention deficit/hyperactivity disorder (ADHD) state that young people need to have access to the best evidence-based care to improve outcome. The current ‘gold standard’ ADHD diagnostic assessment combines clinical observation with subjective parent, teacher and self-reports. In routine practice, reports from multiple informants may be unavailable or contradictory, leading to diagnostic uncertainty and delay. The addition of objective tests of attention and activity may help reduce diagnostic uncertainty and delays in initiating treatment leading to improved outcomes. This trial investigates whether providing clinicians with an objective report of levels of attention, impulsivity and activity can lead to an earlier, and more accurate, clinical diagnosis and improved patient outcome. Methods and analysis This multisite randomised controlled trial will recruit young people (aged 6–17 years old) who have been referred for an ADHD diagnostic assessment at Child and Adolescent Mental Health Services (CAMHS) and Community Paediatric clinics across England. Routine clinical assessment will be augmented by the QbTest, incorporating a continuous performance test (CPT) and infrared motion tracking of activity. The participant will be randomised into one of two study arms: QbOpen (clinician has immediate access to a QbTest report): QbBlind (report is withheld until the study end). Primary outcomes are time to diagnosis and diagnostic accuracy. Secondary outcomes include clinician's diagnostic confidence and routine clinical outcome measures. Cost-effective analysis will be conducted, alongside a qualitative assessment of the feasibility and acceptability of incorporating QbTest in routine practice. Ethics and dissemination The findings from the study will inform commissioners, clinicians and managers about the feasibility, acceptability, clinical utility and cost-effectiveness of incorporating QbTest into routine diagnostic assessment of young people with ADHD. The results will be submitted for publication in peer-reviewed journals. The study has received ethical approval. Trial registration number NCT02209116. PMID:25448628

Molecular diagnostic experience of whole-exome sequencing in adult patients.

PubMed

Posey, Jennifer E; Rosenfeld, Jill A; James, Regis A; Bainbridge, Matthew; Niu, Zhiyv; Wang, Xia; Dhar, Shweta; Wiszniewski, Wojciech; Akdemir, Zeynep H C; Gambin, Tomasz; Xia, Fan; Person, Richard E; Walkiewicz, Magdalena; Shaw, Chad A; Sutton, V Reid; Beaudet, Arthur L; Muzny, Donna; Eng, Christine M; Yang, Yaping; Gibbs, Richard A; Lupski, James R; Boerwinkle, Eric; Plon, Sharon E

2016-07-01

Whole-exome sequencing (WES) is increasingly used as a diagnostic tool in medicine, but prior reports focus on predominantly pediatric cohorts with neurologic or developmental disorders. We describe the diagnostic yield and characteristics of WES in adults. We performed a retrospective analysis of consecutive WES reports for adults from a diagnostic laboratory. Phenotype composition was determined using Human Phenotype Ontology terms. Molecular diagnoses were reported for 17.5% (85/486) of adults, which is lower than that for a primarily pediatric population (25.2%; P = 0.0003); the diagnostic rate was higher (23.9%) for those 18-30 years of age compared to patients older than 30 years (10.4%; P = 0.0001). Dual Mendelian diagnoses contributed to 7% of diagnoses, revealing blended phenotypes. Diagnoses were more frequent among individuals with abnormalities of the nervous system, skeletal system, head/neck, and growth. Diagnostic rate was independent of family history information, and de novo mutations contributed to 61.4% of autosomal dominant diagnoses. Early WES experience in adults demonstrates molecular diagnoses in a substantial proportion of patients, informing clinical management, recurrence risk, and recommendations for relatives. A positive family history was not predictive, consistent with molecular diagnoses often revealed by de novo events, informing the Mendelian basis of genetic disease in adults.Genet Med 18 7, 678-685.

A readers' guide to the interpretation of diagnostic test properties: clinical example of sepsis.

PubMed

Fischer, Joachim E; Bachmann, Lucas M; Jaeschke, Roman

2003-07-01

One of the most challenging practical and daily problems in intensive care medicine is the interpretation of the results from diagnostic tests. In neonatology and pediatric intensive care the early diagnosis of potentially life-threatening infections is a particularly important issue. A plethora of tests have been suggested to improve diagnostic decision making in the clinical setting of infection which is a clinical example used in this article. Several criteria that are critical to evidence-based appraisal of published data are often not adhered to during the study or in reporting. To enhance the critical appraisal on articles on diagnostic tests we discuss various measures of test accuracy: sensitivity, specificity, receiver operating characteristic curves, positive and negative predictive values, likelihood ratios, pretest probability, posttest probability, and diagnostic odds ratio. We suggest the following minimal requirements for reporting on the diagnostic accuracy of tests: a plot of the raw data, multilevel likelihood ratios, the area under the receiver operating characteristic curve, and the cutoff yielding the highest discriminative ability. For critical appraisal it is mandatory to report confidence intervals for each of these measures. Moreover, to allow comparison to the readers' patient population authors should provide data on study population characteristics, in particular on the spectrum of diseases and illness severity.

Molecular Diagnostic Experience of Whole-Exome Sequencing in Adult Patients

PubMed Central

Posey, Jennifer E.; Rosenfeld, Jill A.; James, Regis A.; Bainbridge, Matthew; Niu, Zhiyv; Wang, Xia; Dhar, Shweta; Wiszniewski, Wojciech; Akdemir, Zeynep H.C.; Gambin, Tomasz; Xia, Fan; Person, Richard E.; Walkiewicz, Magdalena; Shaw, Chad A.; Sutton, V. Reid; Beaudet, Arthur L.; Muzny, Donna; Eng, Christine M.; Yang, Yaping; Gibbs, Richard A.; Lupski, James R.; Boerwinkle, Eric; Plon, Sharon E.

2015-01-01

Purpose Whole exome sequencing (WES) is increasingly used as a diagnostic tool in medicine, but prior reports focus on predominantly pediatric cohorts with neurologic or developmental disorders. We describe the diagnostic yield and characteristics of whole exome sequencing in adults. Methods We performed a retrospective analysis of consecutive WES reports for adults from a diagnostic laboratory. Phenotype composition was determined using Human Phenotype Ontology terms. Results Molecular diagnoses were reported for 17.5% (85/486) of adults, lower than a primarily pediatric population (25.2%; p=0.0003); the diagnostic rate was higher (23.9%) in those 18–30 years of age compared to patients over 30 years (10.4%; p=0.0001). Dual Mendelian diagnoses contributed to 7% of diagnoses, revealing blended phenotypes. Diagnoses were more frequent among individuals with abnormalities of the nervous system, skeletal system, head/neck, and growth. Diagnostic rate was independent of family history information, and de novo mutations contributed to 61.4% of autosomal dominant diagnoses. Conclusion Early WES experience in adults demonstrates molecular diagnoses in a substantial proportion of patients, informing clinical management, recurrence risk and recommendations for relatives. A positive family history was not predictive, consistent with molecular diagnoses often revealed by de novo events, informing the Mendelian basis of genetic disease in adults. PMID:26633545

NASA's Global Change Master Directory: Discover and Access Earth Science Data Sets, Related Data Services, and Climate Diagnostics

NASA Astrophysics Data System (ADS)

Aleman, A.; Olsen, L. M.; Ritz, S.; Stevens, T.; Morahan, M.; Grebas, S. K.

2011-12-01

NASA's Global Change Master Directory provides the scientific community with the ability to discover, access, and use Earth science data, data-related services, and climate diagnostics worldwide.The GCMD offers descriptions of Earth science data sets using the Directory Interchange Format (DIF) metadata standard; Earth science related data services are described using the Service Entry Resource Format (SERF); and climate visualizations are described using the Climate Diagnostic (CD) standard. The DIF, SERF and CD standards each capture data attributes used to determine whether a data set, service, or climate visualization is relevant to a user's needs.Metadata fields include: title, summary, science keywords, service keywords, data center, data set citation, personnel, instrument, platform, quality, related URL, temporal and spatial coverage, data resolution and distribution information.In addition, nine valuable sets of controlled vocabularies have been developed to assist users in normalizing the search for data descriptions. An update to the GCMD's search functionality is planned to further capitalize on the controlled vocabularies during database queries.By implementing a dynamic keyword "tree", users will have the ability to search for data sets by combining keywords in new ways.This will allow users to conduct more relevant and efficient database searches to support the free exchange and re-use of Earth science data.

How Question Types Reveal Student Thinking: An Experimental Comparison of Multiple-True-False and Free-Response Formats.

PubMed

Hubbard, Joanna K; Potts, Macy A; Couch, Brian A

2017-01-01

Assessments represent an important component of undergraduate courses because they affect how students interact with course content and gauge student achievement of course objectives. To make decisions on assessment design, instructors must understand the affordances and limitations of available question formats. Here, we use a crossover experimental design to identify differences in how multiple-true-false (MTF) and free-response (FR) exam questions reveal student thinking regarding specific conceptions. We report that correct response rates correlate across the two formats but that a higher percentage of students provide correct responses for MTF questions. We find that MTF questions reveal a high prevalence of students with mixed (correct and incorrect) conceptions, while FR questions reveal a high prevalence of students with partial (correct and unclear) conceptions. These results suggest that MTF question prompts can direct students to address specific conceptions but obscure nuances in student thinking and may overestimate the frequency of particular conceptions. Conversely, FR questions provide a more authentic portrait of student thinking but may face limitations in their ability to diagnose specific, particularly incorrect, conceptions. We further discuss an intrinsic tension between question structure and diagnostic capacity and how instructors might use multiple formats or hybrid formats to overcome these obstacles. © 2017 J. K. Hubbard et al. CBE—Life Sciences Education © 2017 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

Cost analysis of breast cancer diagnostic assessment programs.

PubMed

Honein-AbouHaidar, G N; Hoch, J S; Dobrow, M J; Stuart-McEwan, T; McCready, D R; Gagliardi, A R

2017-10-01

Diagnostic assessment programs (daps) appear to improve the diagnosis of cancer, but evidence of their cost-effectiveness is lacking. Given that no earlier study used secondary financial data to estimate the cost of diagnostic tests in the province of Ontario, we explored how to use secondary financial data to retrieve the cost of key diagnostic test services in daps, and we tested the reliability of that cost-retrieving method with hospital-reported costs in preparation for future cost-effectiveness studies. We powered our sample at an alpha of 0.05, a power of 80%, and a margin of error of ±5%, and randomly selected a sample of eligible patients referred to a dap for suspected breast cancer during 1 January-31 December 2012. Confirmatory diagnostic tests received by each patient were identified in medical records. Canadian Classification of Health Intervention procedure codes were used to search the secondary financial data Web portal at the Ontario Case Costing Initiative for an estimate of the direct, indirect, and total costs of each test. The hospital-reported cost of each test received was obtained from the host-hospital's finance department. Descriptive statistics were used to calculate the cost of individual or group confirmatory diagnostic tests, and the Wilcoxon signed-rank test or the paired t-test was used to compare the Ontario Case Costing Initiative and hospital-reported costs. For the 191 identified patients with suspected breast cancer, the estimated total cost of $72,195.50 was not significantly different from the hospital-reported total cost of $72,035.52 ( p = 0.24). Costs differed significantly when multiple tests to confirm the diagnosis were completed during one patient visit and when confirmatory tests reported in hospital data and in medical records were discrepant. The additional estimated cost for non-salaried physicians delivering diagnostic services was $28,387.50. It was feasible to use secondary financial data to retrieve the cost of key diagnostic tests in a breast cancer dap and to compare the reliability of the costs obtained by that estimation method with hospital-reported costs. We identified the strengths and challenges of each approach. Lessons learned from this study have to be taken into consideration in future cost-effectiveness studies.

Multiparametric MRI followed by targeted prostate biopsy for men with suspected prostate cancer: a clinical decision analysis

PubMed Central

Willis, Sarah R; Ahmed, Hashim U; Moore, Caroline M; Donaldson, Ian; Emberton, Mark; Miners, Alec H; van der Meulen, Jan

2014-01-01

Objective To compare the diagnostic outcomes of the current approach of transrectal ultrasound (TRUS)-guided biopsy in men with suspected prostate cancer to an alternative approach using multiparametric MRI (mpMRI), followed by MRI-targeted biopsy if positive. Design Clinical decision analysis was used to synthesise data from recently emerging evidence in a format that is relevant for clinical decision making. Population A hypothetical cohort of 1000 men with suspected prostate cancer. Interventions mpMRI and, if positive, MRI-targeted biopsy compared with TRUS-guided biopsy in all men. Outcome measures We report the number of men expected to undergo a biopsy as well as the numbers of correctly identified patients with or without prostate cancer. A probabilistic sensitivity analysis was carried out using Monte Carlo simulation to explore the impact of statistical uncertainty in the diagnostic parameters. Results In 1000 men, mpMRI followed by MRI-targeted biopsy ‘clinically dominates’ TRUS-guided biopsy as it results in fewer expected biopsies (600 vs 1000), more men being correctly identified as having clinically significant cancer (320 vs 250), and fewer men being falsely identified (20 vs 50). The mpMRI-based strategy dominated TRUS-guided biopsy in 86% of the simulations in the probabilistic sensitivity analysis. Conclusions Our analysis suggests that mpMRI followed by MRI-targeted biopsy is likely to result in fewer and better biopsies than TRUS-guided biopsy. Future research in prostate cancer should focus on providing precise estimates of key diagnostic parameters. PMID:24934207

Rapid Screening of Carboxylic Acids from Waste and Surface Waters by ESI-MS/MS Using Barium Ion Chemistry and On-Line Membrane Sampling.

PubMed

Duncan, Kyle D; Volmer, Dietrich A; Gill, Chris G; Krogh, Erik T

2016-03-01

Negative ion tandem mass spectrometric analysis of aliphatic carboxylic acids often yields only non-diagnostic ([M - H](-)) ions with limited selective fragmentation. However, carboxylates cationized with Ba(2+) have demonstrated efficient dissociation in positive ion mode, providing structurally diagnostic product ions. We report the application of barium adducts followed by collision induced dissociation (CID), to improve selectivity for rapid screening of carboxylic acids in complex aqueous samples. The quantitative MS/MS method presented utilizes common product ions of [M - H + Ba](+) precursor ions. The mechanism of product ion formation is investigated using isotopically labeled standards and a series of structurally related carboxylic acids. The results suggest that hydrogen atoms in the β and γ positions yield common product ions ([BaH](+) and [BaOH](+)). Furthermore, the diagnostic product ion at m/z 196 serves as a qualifying ion for carboxylate species. This methodology has been successfully used in conjunction with condensed phase membrane introduction mass spectrometry (CP-MIMS), with barium acetate added directly to the methanol acceptor phase. The combination enables rapid screening of carboxylic acids directly from acidified water samples (wastewater effluent, spiked natural waters) using a capillary hollow fiber PDMS membrane immersion probe. We have applied this technique for the direct analysis of complex naphthenic acid mixtures spiked into natural surface waters using CP-MIMS. Selectivity at the ionization and tandem mass spectrometry level eliminate isobaric interferences from hydroxylated species present within the samples, which have been observed in negative electrospray ionization.

SNPitty: An Intuitive Web Application for Interactive B-Allele Frequency and Copy Number Visualization of Next-Generation Sequencing Data.

PubMed

van Riet, Job; Krol, Niels M G; Atmodimedjo, Peggy N; Brosens, Erwin; van IJcken, Wilfred F J; Jansen, Maurice P H M; Martens, John W M; Looijenga, Leendert H; Jenster, Guido; Dubbink, Hendrikus J; Dinjens, Winand N M; van de Werken, Harmen J G

2018-03-01

Exploration and visualization of next-generation sequencing data are crucial for clinical diagnostics. Software allowing simultaneous visualization of multiple regions of interest coupled with dynamic heuristic filtering of genetic aberrations is, however, lacking. Therefore, the authors developed the web application SNPitty that allows interactive visualization and interrogation of variant call format files by using B-allele frequencies of single-nucleotide polymorphisms and single-nucleotide variants, coverage metrics, and copy numbers analysis results. SNPitty displays variant alleles and allelic imbalances with a focus on loss of heterozygosity and copy number variation using genome-wide heterozygous markers and somatic mutations. In addition, SNPitty is capable of generating predefined reports that summarize and highlight disease-specific targets of interest. SNPitty was validated for diagnostic interpretation of somatic events by showcasing a serial dilution series of glioma tissue. Additionally, SNPitty is demonstrated in four cancer-related scenarios encountered in daily clinical practice and on whole-exome sequencing data of peripheral blood from a Down syndrome patient. SNPitty allows detection of loss of heterozygosity, chromosomal and gene amplifications, homozygous or heterozygous deletions, somatic mutations, or any combination thereof in regions or genes of interest. Furthermore, SNPitty can be used to distinguish molecular relationships between multiple tumors from a single patient. On the basis of these data, the authors demonstrate that SNPitty is robust and user friendly in a wide range of diagnostic scenarios. Copyright © 2018 American Society for Investigative Pathology and the Association for Molecular Pathology. Published by Elsevier Inc. All rights reserved.

A Rapid and Low-Cost PCR Thermal Cycler for Infectious Disease Diagnostics

PubMed Central

Chan, Kamfai; Wong, Pui-Yan; Yu, Peter; Hardick, Justin; Wong, Kah-Yat; Wilson, Scott A.; Wu, Tiffany; Hui, Zoe; Gaydos, Charlotte; Wong, Season S.

2016-01-01

The ability to make rapid diagnosis of infectious diseases broadly available in a portable, low-cost format would mark a great step forward in global health. Many molecular diagnostic assays are developed based on using thermal cyclers to carry out polymerase chain reaction (PCR) and reverse-transcription PCR for DNA and RNA amplification and detection, respectively. Unfortunately, most commercial thermal cyclers are expensive and need continuous electrical power supply, so they are not suitable for uses in low-resource settings. We have previously reported a low-cost and simple approach to amplify DNA using vacuum insulated stainless steel thermoses food cans, which we have named it thermos thermal cycler or TTC. Here, we describe the use of an improved set up to enable the detection of viral RNA targets by reverse-transcription PCR (RT-PCR), thus expanding the TTC’s ability to identify highly infectious, RNA virus-based diseases in low resource settings. The TTC was successful in demonstrating high-speed and sensitive detection of DNA or RNA targets of sexually transmitted diseases, HIV/AIDS, Ebola hemorrhagic fever, and dengue fever. Our innovative TTC costs less than $200 to build and has a capacity of at least eight tubes. In terms of speed, the TTC’s performance exceeded that of commercial thermal cyclers tested. When coupled with low-cost endpoint detection technologies such as nucleic acid lateral-flow assay or a cell-phone-based fluorescence detector, the TTC will increase the availability of on-site molecular diagnostics in low-resource settings. PMID:26872358

Participants' barriers to diagnostic resolution and factors associated with needing patient navigation.

PubMed

Krok-Schoen, Jessica L; Brewer, Brittany M; Young, Gregory S; Weier, Rory C; Tatum, Cathy M; DeGraffinreid, Cecilia R; Paskett, Electra D

2015-08-15

Patient navigation (PN) may improve cancer care by identifying and removing patient-reported barriers to care. In 2012, the American College of Surgeons Commission on Cancer (CoC) announced that health care facilities seeking CoC accreditation must have PN processes in place by January 1, 2015. Given these unfunded mandates, hospitals are looking for cost-effective ways to implement PN. This study examined demographic and psychosocial predictors of barriers to diagnostic resolution among individuals with a cancer screening abnormality enrolled in the Ohio Patient Navigation Research Project. Data were obtained from patients who received care at 1 of 9 Ohio Patient Navigation Research Project intervention clinics. Descriptive statistics and logistic regression models were used. There were 424 participants, and 151 (35.6%) reported a barrier to diagnostic resolution within 90 days of study consent. The most commonly reported barriers were misconceptions about a test or treatment (16.4%), difficulty in communicating with the provider (15.0%), and scheduling problems (11.5%). Univariate analyses indicated that race, education, employment, income, insurance, clinic type, friend support, and physical and psychological functioning were significantly associated with reporting a barrier to diagnostic resolution. Multivariate analyses found that comorbidities (odds ratio, 1.65; 95% confidence interval, 1.04-2.61) and higher intrusive thoughts and feelings (odds ratio, 1.25; 95% confidence interval, 1.10-1.41) were significantly associated with reporting a barrier to diagnostic resolution. The results suggest that demographic and psychosocial factors are associated with barriers to diagnostic resolution. To ensure compliance with the CoC mandate and provide timely care to all patients, CoC-accredited facilities can systematically identify the patients most likely to have barriers to care and assign them to PN. © 2015 American Cancer Society.

Development and evaluation of porcine cysticercosis QuickELISA in Triturus EIA analyzer.

PubMed

Handali, Sukwan; Pattabhi, Sowmya; Lee, Yeuk-Mui; Silva-Ibanez, Maria; Kovalenko, Victor A; Levin, Andrew E; Gonzalez, Armando E; Roberts, Jacquelin M; Garcia, Hector H; Gilman, Robert H; Hancock, Kathy; Tsang, Victor C W

2010-01-01

We evaluated three diagnostic antigens (recombinant GP50, recombinant T24H, and synthetic Ts18var1) for cysticercosis and found that all three performed well in detecting cysticercosis in humans and pigs in several assay formats. These antigens were adapted to a new antibody detection format (QuickELISA). With one single incubation step which involves all reactants except the enzyme substrate, the QuickELISA is particularly suited for automation. We formatted the QuickELISA for the Triturus EIA analyzer for testing large numbers of samples. We found that in QuickELISA formats rGP50 and rT24H have better sensitivity and specificity than sTs18var1 for detecting porcine cysticercosis.

Measures to Improve Diagnostic Safety in Clinical Practice.

PubMed

Singh, Hardeep; Graber, Mark L; Hofer, Timothy P

2016-10-20

Timely and accurate diagnosis is foundational to good clinical practice and an essential first step to achieving optimal patient outcomes. However, a recent Institute of Medicine report concluded that most of us will experience at least one diagnostic error in our lifetime. The report argues for efforts to improve the reliability of the diagnostic process through better measurement of diagnostic performance. The diagnostic process is a dynamic team-based activity that involves uncertainty, plays out over time, and requires effective communication and collaboration among multiple clinicians, diagnostic services, and the patient. Thus, it poses special challenges for measurement. In this paper, we discuss how the need to develop measures to improve diagnostic performance could move forward at a time when the scientific foundation needed to inform measurement is still evolving. We highlight challenges and opportunities for developing potential measures of "diagnostic safety" related to clinical diagnostic errors and associated preventable diagnostic harm. In doing so, we propose a starter set of measurement concepts for initial consideration that seem reasonably related to diagnostic safety and call for these to be studied and further refined. This would enable safe diagnosis to become an organizational priority and facilitate quality improvement. Health-care systems should consider measurement and evaluation of diagnostic performance as essential to timely and accurate diagnosis and to the reduction of preventable diagnostic harm.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Talbot-Lau x-ray deflectometer electron density diagnostic for laser and pulsed power high energy density plasma experiments (invited)

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

Valdivia, M. P., E-mail: mpvaldivia@pha.jhu.edu; Stutman, D.; Stoeckl, C.

2016-11-15

Talbot-Lau X-ray deflectometry (TXD) has been developed as an electron density diagnostic for High Energy Density (HED) plasmas. The technique can deliver x-ray refraction, attenuation, elemental composition, and scatter information from a single Moiré image. An 8 keV Talbot-Lau interferometer was deployed using laser and x-pinch backlighters. Grating survival and electron density mapping were demonstrated for 25–29 J, 8–30 ps laser pulses using copper foil targets. Moiré pattern formation and grating survival were also observed using a copper x-pinch driven at 400 kA, ∼1 kA/ns. These results demonstrate the potential of TXD as an electron density diagnostic for HED plasmas.

Multifunctional quantum dots-based cancer diagnostics and stem cell therapeutics for regenerative medicine.

PubMed

Onoshima, Daisuke; Yukawa, Hiroshi; Baba, Yoshinobu

2015-12-01

A field of recent diagnostics and therapeutics has been advanced with quantum dots (QDs). QDs have developed into new formats of biomolecular sensing to push the limits of detection in biology and medicine. QDs can be also utilized as bio-probes or labels for biological imaging of living cells and tissues. More recently, QDs has been demonstrated to construct a multifunctional nanoplatform, where the QDs serve not only as an imaging agent, but also a nanoscaffold for diagnostic and therapeutic modalities. This review highlights the promising applications of multi-functionalized QDs as advanced nanosensors for diagnosing cancer and as innovative fluorescence probes for in vitro or in vivo stem cell imaging in regenerative medicine. Copyright © 2015 Elsevier B.V. All rights reserved.

Myositis Ossificans Mimicking Sarcoma, the Importance of Diagnostic Imaging – Case Report

PubMed Central

Łuczyńska, Elżbieta; Kasperkiewicz, Hanna; Domalik, Agnieszka; Cwierz, Anna; Bobek-Billewicz, Barbara

2014-01-01

Summary Background Myositis ossificans is localized inflammatory process affecting skeletal muscles. Very rarely it can affect one of the neck muscles and present as a neck tumor, it can be misdiagnosed as the clinical, radiological and histological examinations can mimic a sarcoma. Case Report We report a 29 year old female patient with neck tumor suspected to be a sarcoma who underwent full diagnostics imaging and open bipsy with histopatological examination, afterwards surgical excision was performed. Conclusions The aim of this study was to present the differential diagnosis based on diagnostics imaging between MO and malignant tumors, such as parosteal sarcoma, synovial sarcoma and malignant fibrous histiocytoma. PMID:25077008

Discriminant validity, diagnostic utility, and parent-child agreement on the Screen for Child Anxiety Related Emotional Disorders (SCARED) in treatment- and non-treatment-seeking youth.

PubMed

Rappaport, B I; Pagliaccio, D; Pine, D S; Klein, D N; Jarcho, J M

2017-10-01

The Screen for Child Anxiety and Related Emotional Disorder (SCARED) may be differentially sensitive to detecting specific or comorbid anxiety diagnoses in treatment-seeking and non-treatment-seeking youth. We assessed the SCARED's discriminant validity, diagnostic utility, and informant agreement using parent- and self-report from healthy and treatment-seeking anxious youth (Study 1, N=585) and from non-treatment-seeking anxious youth (Study 2, N=331) diagnosed with generalized anxiety disorder (GAD), social anxiety disorder (SAD), or comorbid GAD+SAD. Among treatment-seeking youth, the SCARED showed good diagnostic utility and specificity, differentiating healthy, comorbid, and non-comorbid anxious youth. Child-parent agreement was modest: healthy child self-reports were higher than parent-reports whereas anxious child self-reports were similar or lower than parent-reports. Less consistent results emerged for diagnostic utility, specificity, and informant agreement among non-treatment-seeking youth. Given the number of non-treatment seeking anxious youth (N=33), generalizability of these findings may be limited. Together, results suggest informants may provide distinct information about children's anxiety symptoms. Copyright © 2017 Elsevier Ltd. All rights reserved.

Discriminant validity, diagnostic utility, and parent-child agreement on the Screen for Child Anxiety Related Emotional Disorders (SCARED) in treatment- and non-treatment-seeking youth

PubMed Central

Rappaport, B. I.; Pagliaccio, D.; Pine, D. S.; Klein, D. N.; Jarcho, J. M.

2017-01-01

The Screen for Child Anxiety and Related Emotional Disorder (SCARED) may be differentially sensitive to detecting specific or comorbid anxiety diagnoses in treatment-seeking and non-treatment-seeking youth. We assessed the SCARED’s discriminant validity, diagnostic utility, and informant agreement using parent- and self-report from healthy and treatment-seeking anxious youth (Study 1, N=585) or from non-treatment-seeking anxious youth (Study 2, N=331) diagnosed with generalized anxiety disorder (GAD), social anxiety disorder (SAD), or comorbid GAD+SAD. Among treatment-seeking youth, the SCARED showed good diagnostic utility and specificity, differentiating healthy, comorbid, and non-comorbid anxious youth. Child-parent agreement was modest: healthy child self-reports were higher than parent-reports whereas anxious child self-reports were similar or lower than parent-reports. Less consistent results emerged for diagnostic utility, specificity, and informant agreement among non-treatment-seeking youth. Given the number of non-treatment seeking anxious youth (N=33), generalizability of these findings may be limited. Together, results suggest informants may provide distinct information about children’s anxiety symptoms. PMID:28886420

Analysis of oxidative stress biomarkers using a simultaneous competitive/non-competitive micromosaic immunoassay.

PubMed

Murphy, Brian M; Dandy, David S; Henry, Charles S

2009-04-27

Immunoassays represent a core workhorse methodology for many applications ranging from clinical diagnostics to environmental monitoring. In traditional formats such as the enzyme linked immunosorbent assay (ELISA), analytes are measured singly or in small sets. As more biomarkers are identified for disease states, there is a need to develop methods that can measure multiple markers simultaneously. Immunoaffinity arrays are one such chemistry that can achieve multi-marker screening. Most arrays are performed in either competitive or non-competitive formats, where the former are used predominantly for small molecules and the later for macromolecules. To date, ELISA and immunoaffinity array methods have relied exclusively on one of these formats and not the other. Here an immunoaffinity array method capable of performing simultaneous competitive and non-competitive analysis generated using micromosaic immunoassay techniques is introduced for the analysis of metabolites and proteins. In this report, three markers of oxidative stress were used as a model system. The method described here demonstrates the simultaneous analysis of 3-nitrotyrosine, by indirect competitive immunoassay while the enzymes catalase and superoxide dismutase are analyzed by non-competitive sandwich immunoassay. The method requires less than 1 microL sample and 45 min for completion. Logistic curve fits and LOD (limits of detection) statistical analysis of the binding results are presented and show good agreement with published data for these antibody-antigen systems.

Role of periostin and its antagonist PNDA-3 in gastric cancer metastasis.

PubMed

Liu, Guo-Xiao; Xi, Hong-Qing; Sun, Xiao-Yan; Wei, Bo

2015-03-07

The extracellular matrix component periostin is a secreted protein that functions as both a cell attachment protein and an autocrine or paracrine factor that signals through the cell adhesion molecule integrins αvβ3 and αvβ5. Periostin participates in normal physiological activities such as cardiac development, but is also involved in pathophysiological processes in vascular diseases, wound repair, bone formation, and tumor development. It is of increasing interest in tumor biology because it is frequently overexpressed in a variety of epithelial carcinomas and is functionally involved in multiple steps of metastasis progression. These include the maintenance of stemness, niche formation, EMT, the survival of tumor cells, and angiogenesis, all of which are indispensable for gastric cancer metastasis. Periostin has been reported to activate the PI-3K/AKT, Wnt, and FAK-mediated signaling pathways to promote metastasis. Therefore, periostin represents a potentially promising candidate for the inhibition of metastasis. In this review article, we summarize recent advances in knowledge concerning periostin, its antagonist PNDA-3, and their influence on such key processes in cancer metastasis as maintenance of stemness, niche formation, epithelial-to-mesenchymal transition, tumor cell survival, and angiogenesis. In particular, we focus our attention on the role of periostin in gastric cancer metastasis, speculate as to the usefulness of periostin as a therapeutic and diagnostic target for gastric cancer metastasis, and consider potential avenues for future research.

Diagnostic accuracy research in glaucoma is still incompletely reported: An application of Standards for Reporting of Diagnostic Accuracy Studies (STARD) 2015.

PubMed

Michelessi, Manuele; Lucenteforte, Ersilia; Miele, Alba; Oddone, Francesco; Crescioli, Giada; Fameli, Valeria; Korevaar, Daniël A; Virgili, Gianni

2017-01-01

Research has shown a modest adherence of diagnostic test accuracy (DTA) studies in glaucoma to the Standards for Reporting of Diagnostic Accuracy Studies (STARD). We have applied the updated 30-item STARD 2015 checklist to a set of studies included in a Cochrane DTA systematic review of imaging tools for diagnosing manifest glaucoma. Three pairs of reviewers, including one senior reviewer who assessed all studies, independently checked the adherence of each study to STARD 2015. Adherence was analyzed on an individual-item basis. Logistic regression was used to evaluate the effect of publication year and impact factor on adherence. We included 106 DTA studies, published between 2003-2014 in journals with a median impact factor of 2.6. Overall adherence was 54.1% for 3,286 individual rating across 31 items, with a mean of 16.8 (SD: 3.1; range 8-23) items per study. Large variability in adherence to reporting standards was detected across individual STARD 2015 items, ranging from 0 to 100%. Nine items (1: identification as diagnostic accuracy study in title/abstract; 6: eligibility criteria; 10: index test (a) and reference standard (b) definition; 12: cut-off definitions for index test (a) and reference standard (b); 14: estimation of diagnostic accuracy measures; 21a: severity spectrum of diseased; 23: cross-tabulation of the index and reference standard results) were adequately reported in more than 90% of the studies. Conversely, 10 items (3: scientific and clinical background of the index test; 11: rationale for the reference standard; 13b: blinding of index test results; 17: analyses of variability; 18; sample size calculation; 19: study flow diagram; 20: baseline characteristics of participants; 28: registration number and registry; 29: availability of study protocol; 30: sources of funding) were adequately reported in less than 30% of the studies. Only four items showed a statistically significant improvement over time: missing data (16), baseline characteristics of participants (20), estimates of diagnostic accuracy (24) and sources of funding (30). Adherence to STARD 2015 among DTA studies in glaucoma research is incomplete, and only modestly increasing over time.

Atomic Resonance Radiation Energetics Investigation as a Diagnostic Method for Non-Equilibrium Hypervelocity Flows

NASA Technical Reports Server (NTRS)

Meyer, Scott A.; Bershader, Daniel; Sharma, Surendra P.; Deiwert, George S.

1996-01-01

Absorption measurements with a tunable vacuum ultraviolet light source have been proposed as a concentration diagnostic for atomic oxygen, and the viability of this technique is assessed in light of recent measurements. The instrumentation, as well as initial calibration measurements, have been reported previously. We report here additional calibration measurements performed to study the resonance broadening line shape for atomic oxygen. The application of this diagnostic is evaluated by considering the range of suitable test conditions and requirements, and by identifying issues that remain to be addressed.

A preterm infant with intestinal lymphangiectasia: a diagnostic dilemma.

PubMed

McDonald, Karen Q; Bears, Christina M

2009-01-01

Intestinal lymphangiectasia (IL) is a potentially fatal disorder of the lymphatic system if it is not recognized and proper treatment initiated. The disease is characterized by lymphocytopenia, peripheral edema, and hypoalbuminemia. Because IL is a rare disease, the symptoms, diagnostic workup, and treatment are unfamiliar to many clinicians. Current literature documents only a few reported cases of IL in a preterm infant. This case report of a preterm infant reviews history, symptomatology, and the diagnostic workup performed. The steps in making the diagnosis, the treatment, and the prognosis of this condition are also presented.

Exploring DSM-5 criterion A in Acute Stress Disorder symptoms following natural disaster.

PubMed

Lavenda, Osnat; Grossman, Ephraim S; Ben-Ezra, Menachem; Hoffman, Yaakov

2017-10-01

The present study examines the DSM-5 Acute Stress Disorder (ASD) diagnostic criteria of exposure, in the context of a natural disaster. The study is based on the reports of 1001 Filipinos following the aftermath of super typhoon Haiyan in 2013. Participants reported exposure to injury, psychological distress and ASD symptoms. Findings indicated the association of criterion A with the prevalence of meeting all other ASD diagnostic criteria and high psychological distress. The diagnostic properties of Criterion A are discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

Medical Surveillance Monthly Report (MSMR). Volume 17, Number 08, August 2010

DTIC Science & Technology

2010-08-01

notifi able medical event reports that included diagnostic codes (ICD-9-CM) indicative of chlamydia, gonorrhea, syphilis, herpes simplex virus (HSV...infections of interest for this report Results: Condition Diagnostic codes Chlamydia 099.41, 099.5 Gonorrhea 098 Herpes simplex (HSV) 054 Human...housing arrangements may also play roles and off er opportunities for targeted prevention.6 Human papillomavirus (HPV), the cause of genital warts

Preliminary report on aerotoxic syndrome (AS) and the need for diagnostic neurophysiological tests.

PubMed

Hale, Margaret A; Al-Seffar, Judith A

2009-09-01

Researchers have found, in studies carried out over several years, that many passengers and crew, following their recent flights in commercial jet aeroplanes, have become unwell, with a range of symptoms in common. This condition, which has not yet been officially recognised, is called Aerotoxic Syndrome (AS). It seems to be caused, primarily, by neurotoxic organophosphates contaminating the air circulating in jet cabins. Patients with such symptoms may visit their GPs, who then arrange diagnostic tests. Some of their symptoms fall within the jurisdiction of diagnostic neurophysiological investigations, but neurophysiology practitioners may be unaware of this syndrome. Until AS is officially recognised as an illness, and guidelines for diagnostic procedures established, patients requiring specific investigations may not be appropriately referred, or tests may be performed unnecessarily. This report seeks to stimulate debate within the field, and facilitate studies, if needed, to help define the diagnostic criteria.

Laboratory Information Systems in Molecular Diagnostics: Why Molecular Diagnostics Data are Different.

PubMed

Lee, Roy E; Henricks, Walter H; Sirintrapun, Sahussapont J

2016-03-01

Molecular diagnostic testing presents new challenges to information management that are yet to be sufficiently addressed by currently available information systems for the molecular laboratory. These challenges relate to unique aspects of molecular genetic testing: molecular test ordering, informed consent issues, diverse specimen types that encompass the full breadth of specimens handled by traditional anatomic and clinical pathology information systems, data structures and data elements specific to molecular testing, varied testing workflows and protocols, diverse instrument outputs, unique needs and requirements of molecular test reporting, and nuances related to the dissemination of molecular pathology test reports. By satisfactorily addressing these needs in molecular test data management, a laboratory information system designed for the unique needs of molecular diagnostics presents a compelling reason to migrate away from the current paper and spreadsheet information management that many molecular laboratories currently use. This paper reviews the issues and challenges of information management in the molecular diagnostics laboratory.

Physical examination tests for screening and diagnosis of cervicogenic headache: A systematic review.

PubMed

Rubio-Ochoa, J; Benítez-Martínez, J; Lluch, E; Santacruz-Zaragozá, S; Gómez-Contreras, P; Cook, C E

2016-02-01

It has been suggested that differential diagnosis of headaches should consist of a robust subjective examination and a detailed physical examination of the cervical spine. Cervicogenic headache (CGH) is a form of headache that involves referred pain from the neck. To our knowledge, no studies have summarized the reliability and diagnostic accuracy of physical examination tests for CGH. The aim of this study was to summarize the reliability and diagnostic accuracy of physical examination tests used to diagnose CGH. A systematic review following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was performed in four electronic databases (MEDLINE, Web of Science, Embase and Scopus). Full text reports concerning physical tests for the diagnosis of CGH which reported the clinometric properties for assessment of CGH, were included and screened for methodological quality. Quality Appraisal for Reliability Studies (QAREL) and Quality Assessment of Studies of Diagnostic Accuracy (QUADAS-2) scores were completed to assess article quality. Eight articles were retrieved for quality assessment and data extraction. Studies investigating diagnostic reliability of physical examination tests for CGH scored poorer on methodological quality (higher risk of bias) than those of diagnostic accuracy. There is sufficient evidence showing high levels of reliability and diagnostic accuracy of the selected physical examination tests for the diagnosis of CGH. The cervical flexion-rotation test (CFRT) exhibited both the highest reliability and the strongest diagnostic accuracy for the diagnosis of CGH. Copyright © 2015 Elsevier Ltd. All rights reserved.

Early-Onset Neonatal Sepsis: Still Room for Improvement in Procalcitonin Diagnostic Accuracy Studies

PubMed Central

Chiesa, Claudio; Pacifico, Lucia; Osborn, John F.; Bonci, Enea; Hofer, Nora; Resch, Bernhard

2015-01-01

Abstract To perform a systematic review assessing accuracy and completeness of diagnostic studies of procalcitonin (PCT) for early-onset neonatal sepsis (EONS) using the Standards for Reporting of Diagnostic Accuracy (STARD) initiative. EONS, diagnosed during the first 3 days of life, remains a common and serious problem. Increased PCT is a potentially useful diagnostic marker of EONS, but reports in the literature are contradictory. There are several possible explanations for the divergent results including the quality of studies reporting the clinical usefulness of PCT in ruling in or ruling out EONS. We systematically reviewed PubMed, Scopus, and the Cochrane Library databases up to October 1, 2014. Studies were eligible for inclusion in our review if they provided measures of PCT accuracy for diagnosing EONS. A data extraction form based on the STARD checklist and adapted for neonates with EONS was used to appraise the quality of the reporting of included studies. We found 18 articles (1998–2014) fulfilling our eligibility criteria which were included in the final analysis. Overall, the results of our analysis showed that the quality of studies reporting diagnostic accuracy of PCT for EONS was suboptimal leaving ample room for improvement. Information on key elements of design, analysis, and interpretation of test accuracy were frequently missing. Authors should be aware of the STARD criteria before starting a study in this field. We welcome stricter adherence to this guideline. Well-reported studies with appropriate designs will provide more reliable information to guide decisions on the use and interpretations of PCT test results in the management of neonates with EONS. PMID:26222858

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

PubMed Central

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

2005-01-01

Background The use of systematic literature review to inform evidence based practice in diagnostics is rapidly expanding. Although the primary diagnostic literature is extensive, studies are often of low methodological quality or poorly reported. There has been no rigorously evaluated, evidence based tool to assess the methodological quality of diagnostic studies. The primary objective of this study was to determine the extent to which variations in the quality of primary studies impact the results of a diagnostic meta-analysis and whether this differs with diagnostic test type. A secondary objective was to contribute to the evaluation of QUADAS, an evidence-based tool for the assessment of quality in diagnostic accuracy studies. Methods This study was conducted as part of large systematic review of tests used in the diagnosis and further investigation of urinary tract infection (UTI) in children. All studies included in this review were assessed using QUADAS, an evidence-based tool for the assessment of quality in systematic reviews of diagnostic accuracy studies. The impact of individual components of QUADAS on a summary measure of diagnostic accuracy was investigated using regression analysis. The review divided the diagnosis and further investigation of UTI into the following three clinical stages: diagnosis of UTI, localisation of infection, and further investigation of the UTI. Each stage used different types of diagnostic test, which were considered to involve different quality concerns. Results Many of the studies included in our review were poorly reported. The proportion of QUADAS items fulfilled was similar for studies in different sections of the review. However, as might be expected, the individual items fulfilled differed between the three clinical stages. Regression analysis found that different items showed a strong association with test performance for the different tests evaluated. These differences were observed both within and between the three clinical stages assessed by the review. The results of regression analyses were also affected by whether or not a weighting (by sample size) was applied. Our analysis was severely limited by the completeness of reporting and the differences between the index tests evaluated and the reference standards used to confirm diagnoses in the primary studies. Few tests were evaluated by sufficient studies to allow meaningful use of meta-analytic pooling and investigation of heterogeneity. This meant that further analysis to investigate heterogeneity could only be undertaken using a subset of studies, and that the findings are open to various interpretations. Conclusion Further work is needed to investigate the influence of methodological quality on the results of diagnostic meta-analyses. Large data sets of well-reported primary studies are needed to address this question. Without significant improvements in the completeness of reporting of primary studies, progress in this area will be limited. PMID:15943861

Diagnostic Efficiency of easyCBM[R] Math: Oregon. Technical Report #1009

ERIC Educational Resources Information Center

Anderson, Daniel; Alonzo, Julie; Tindal, Gerald

2010-01-01

The easyCBM[R] assessment system is an online benchmark and progress monitoring assessment system designed for use within a response to intervention framework. Educators using easyCBM[R] are often interested in using the results to predict students' state test performance. In the following technical document, we report diagnostic efficiency…

Brief Report: Concurrent Validity of Autism Symptom Severity Measures

ERIC Educational Resources Information Center

Reszka, Stephanie S.; Boyd, Brian A.; McBee, Matthew; Hume, Kara A.; Odom, Samuel L.

2014-01-01

The autism spectrum disorder (ASD) diagnostic classifications, according to the DSM-5, include a severity rating. Several screening and/or diagnostic measures, such as the autism diagnostic and observation schedule (ADOS), Childhood Autism Rating Scale (CARS) and social responsiveness scale (SRS) (teacher and parent versions), include an…

20 CFR 404.1519m - Diagnostic tests or procedures.

Code of Federal Regulations, 2010 CFR

2010-04-01

... DISABILITY INSURANCE (1950- ) Determining Disability and Blindness Standards for the Type of Referral and for Report Content § 404.1519m Diagnostic tests or procedures. We will request the results of any diagnostic..., arteriograms, or cardiac catheterizations for the evaluation of disability under the Social Security program. A...

Investigating the Effectiveness of Classroom Diagnostic Tools

ERIC Educational Resources Information Center

Schultz, Robert K.

2012-01-01

The primary purposes of the study are to investigate what teachers experience while using the Classroom Diagnostic Tools (CDT) and to relate those experiences to the rate of growth in students' mathematics achievement. The CDT contains three components: an online computer adaptive diagnostic test, interactive web-based student reports, and…

THE EDUCATIONAL DIAGNOSTIC AND PLANNING CENTER.

ERIC Educational Resources Information Center

STOREY, GEORGE

THIS REPORT BRIEFLY DESCRIBES THE EDUCATIONAL DIAGNOSTIC AND PLANNING CENTER FUNDED UNDER TITLE III OF THE 1965 ELEMENTARY AND SECONDARY EDUCATION ACT. THE CENTER IS RESPONSIBLE FOR THE COORDINATION OF DIAGNOSTIC AND EDUCATIONAL RESOURCES FOR UNDERACHIEVING OR OTHERWISE ATYPICAL PUPILS WHO ARE POTENTIAL DROPOUTS BECAUSE OF A PARTICULAR BEHAVIOR OR…

State of the art and future needs in S.I. engine combustion

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

Maly, R.R.

1994-12-31

The paper reviews, in short, the state-of-the-art in SI engine combustion by addressing its main features: mixture formation, ignition, homogeneous combustion, pollutant formation, knock, and engine modeling. Necessary links between fundamental and practical work are clarified and discussed along with advanced diagnostics and simulation tools. The needs for further work are identified, the most important one being integration of all fundamental and practical resources to meet R and D requirements for future engines.

Megamasers: Molecular Diagnostics of the Nuclear ISM

NASA Astrophysics Data System (ADS)

Baan, Willem A.; Klöckner, Hans-R.

Molecular emissions are powerful tracers of intense heating and star-formation processes in galactic nuclei. In this paper we consider the characteristics of molecular Megamaser emission among the population of (Ultra-) Luminous Infrared Galaxies that are powered by intense star-formation or accretion onto a massive compact object. In addition, we consider the systematic behavior of the line emission of high-density tracer molecules. An evolutionary scenario is presented for ULIRGs that may explain the molecular line ratios observed in the population of FIR galaxies.

Megamasers: Molecular Diagnostics of the Nuclear Ism

NASA Astrophysics Data System (ADS)

Baan, Willem A.; Klöckner, Hans-R.

2005-01-01

Molecular emissions are powerful tracers of intense heating and star-formation processes in galactic nuclei. In this paper we consider the characteristics of molecular Megamaser emission among the population of (Ultra-) Luminous Infrared Galaxies that are powered by intense star-formation or accretion onto a massive compact object. In addition, we consider the systematic behavior of the line emission of high-density tracer molecules. An evolutionary scenario is presented for ULIRGs that may explain the molecular line ratios observed in the population of FIR galaxies.

Study of the Synchronous Operation of an Annular Field Reversed Configuration Plasma Device

DTIC Science & Technology

2008-05-05

of pulsed diagnostics were developed to explore the operational characteristics of a 40 -cm outer diameter annular theta pinch and its pre-ionization...Optimized pre-ionization conditions, neutral gas densities, and plasma transition energies were determined for the 40 cm annulus in both argon and xenon...MSNW 100 25 10 10 150 Formation 1985 HBQM U Wash 300 22 5 5 30 Formation 1986 TRX-2 STI 100 24 13 10 100 Confinement 1987 CSS U Wash 100 45 3 40 60

Statistical analysis of polarization-inhomogeneous Fourier spectra of laser radiation scattered by human skin in the tasks of differentiation of benign and malignant formations

NASA Astrophysics Data System (ADS)

Ushenko, Alexander G.; Dubolazov, Alexander V.; Ushenko, Vladimir A.; Novakovskaya, Olga Y.

2016-07-01

The optical model of formation of polarization structure of laser radiation scattered by polycrystalline networks of human skin in Fourier plane was elaborated. The results of investigation of the values of statistical (statistical moments of the 1st to 4th order) parameters of polarization-inhomogeneous images of skin surface in Fourier plane were presented. The diagnostic criteria of pathological process in human skin and its severity degree differentiation were determined.

Method matters: Understanding diagnostic reliability in DSM-IV and DSM-5.

PubMed

Chmielewski, Michael; Clark, Lee Anna; Bagby, R Michael; Watson, David

2015-08-01

Diagnostic reliability is essential for the science and practice of psychology, in part because reliability is necessary for validity. Recently, the DSM-5 field trials documented lower diagnostic reliability than past field trials and the general research literature, resulting in substantial criticism of the DSM-5 diagnostic criteria. Rather than indicating specific problems with DSM-5, however, the field trials may have revealed long-standing diagnostic issues that have been hidden due to a reliance on audio/video recordings for estimating reliability. We estimated the reliability of DSM-IV diagnoses using both the standard audio-recording method and the test-retest method used in the DSM-5 field trials, in which different clinicians conduct separate interviews. Psychiatric patients (N = 339) were diagnosed using the SCID-I/P; 218 were diagnosed a second time by an independent interviewer. Diagnostic reliability using the audio-recording method (N = 49) was "good" to "excellent" (M κ = .80) and comparable to the DSM-IV field trials estimates. Reliability using the test-retest method (N = 218) was "poor" to "fair" (M κ = .47) and similar to DSM-5 field-trials' estimates. Despite low test-retest diagnostic reliability, self-reported symptoms were highly stable. Moreover, there was no association between change in self-report and change in diagnostic status. These results demonstrate the influence of method on estimates of diagnostic reliability. (c) 2015 APA, all rights reserved).

Point of Injury Sampling Technology for Battlefield Molecular Diagnostics

DTIC Science & Technology

2011-11-14

Injury" Sampling Technology for Battlefield Molecular Diagnostics November 14, 2011 Sponsored by Defense Advanced Research Projects Agency (DOD...Date of Contract: April 25, 2011 Short Title of Work: "Point of Injury" Sampling Technology for Battlefield Molecular Diagnostics " Contract...PHASE I FINAL REPORT: Point of Injury, Sampling Technology for Battlefield Molecular Diagnostics . W31P4Q-11-C-0222 (UNCLASSIFIED) P.I: Bernardo

Reported estimates of diagnostic accuracy in ophthalmology conference abstracts were not associated with full-text publication

PubMed Central

Korevaar, Daniël A.; Cohen, Jérémie F.; Spijker, René; Saldanha, Ian J.; Dickersin, Kay; Virgili, Gianni; Hooft, Lotty; Bossuyt, Patrick M.M.

2016-01-01

Objective To assess whether conference abstracts that report higher estimates of diagnostic accuracy are more likely to reach full-text publication in a peer-reviewed journal. Study Design and Setting We identified abstracts describing diagnostic accuracy studies, presented between 2007 and 2010 at the Association for Research in Vision and Ophthalmology (ARVO) Annual Meeting. We extracted reported estimates of sensitivity, specificity, area under the receiver operating characteristic curve (AUC), and diagnostic odds ratio (DOR). Between May and July 2015, we searched MEDLINE and EMBASE to identify corresponding full-text publications; if needed, we contacted abstract authors. Cox regression was performed to estimate associations with full-text publication, where sensitivity, specificity, and AUC were logit transformed, and DOR was log transformed. Results A full-text publication was found for 226/399 (57%) included abstracts. There was no association between reported estimates of sensitivity and full-text publication (hazard ratio [HR] 1.09 [95% confidence interval {CI} 0.98, 1.22]). The same applied to specificity (HR 1.00 [95% CI 0.88, 1.14]), AUC (HR 0.91 [95% CI 0.75, 1.09]), and DOR (HR 1.01 [95% CI 0.94, 1.09]). Conclusion Almost half of the ARVO conference abstracts describing diagnostic accuracy studies did not reach full-text publication. Studies in abstracts that mentioned higher accuracy estimates were not more likely to be reported in a full-text publication. PMID:27312228

Direct Reading of Bona Fide Barcode Assays for Diagnostics with Smartphone Apps.

PubMed

Wong, Jessica X H; Li, Xiaochun; Liu, Frank S F; Yu, Hua-Zhong

2015-06-30

The desire to develop new point-of-care (POC) diagnostic tools has led to the adaptation of smartphones to tackle limitations in state-of-the-art instrumentation and centralized laboratory facilities. Today's smartphones possess the computer-like ability to image and process data using mobile apps; barcode scanners are one such type of apps. We demonstrate herein that a diagnostic assay can be performed by patterning immunoassay strips in a bona fide barcode format such that after target binding and signal enhancement, the linear barcode can be read directly with a standard smartphone app. Quantitative analysis can then be performed based on the grayscale intensities with a customized mobile app. This novel diagnostic concept has been validated for a real-world application, i.e., the detection of human chorionic gonadotropin, a pregnancy hormone. With the possibility of multiplex detection, the barcode assay protocol promises to boost POC diagnosis research by the direct adaptation of mobile devices and apps.

Direct Reading of Bona Fide Barcode Assays for Diagnostics with Smartphone Apps

PubMed Central

Wong, Jessica X. H.; Li, Xiaochun; Liu, Frank S. F.; Yu, Hua-Zhong

2015-01-01

The desire to develop new point-of-care (POC) diagnostic tools has led to the adaptation of smartphones to tackle limitations in state-of-the-art instrumentation and centralized laboratory facilities. Today’s smartphones possess the computer-like ability to image and process data using mobile apps; barcode scanners are one such type of apps. We demonstrate herein that a diagnostic assay can be performed by patterning immunoassay strips in a bona fide barcode format such that after target binding and signal enhancement, the linear barcode can be read directly with a standard smartphone app. Quantitative analysis can then be performed based on the grayscale intensities with a customized mobile app. This novel diagnostic concept has been validated for a real-world application, i.e., the detection of human chorionic gonadotropin, a pregnancy hormone. With the possibility of multiplex detection, the barcode assay protocol promises to boost POC diagnosis research by the direct adaptation of mobile devices and apps. PMID:26122608

Towards non- and minimally instrumented, microfluidics-based diagnostic devices†

PubMed Central

Weigl, Bernhard; Domingo, Gonzalo; LaBarre, Paul; Gerlach, Jay

2009-01-01

In many health care settings, it is uneconomical, impractical, or unaffordable to maintain and access a fully equipped diagnostics laboratory. Examples include home health care, developing-country health care, and emergency situations in which first responders are dealing with pandemics or biowarfare agent release. In those settings, fully disposable diagnostic devices that require no instrument support, reagent, or significant training are well suited. Although the only such technology to have found widespread adoption so far is the immunochromatographic rapid assay strip test, microfluidics holds promise to expand the range of assay technologies that can be performed in formats similar to that of a strip test. In this paper, we review progress toward development of disposable, low-cost, easy-to-use microfluidics-based diagnostics that require no instrument at all. We also present examples of microfluidic functional elements—including mixers, separators, and detectors—as well as complete microfluidic devices that function entirely without any moving parts and external power sources. PMID:19023463

Direct Reading of Bona Fide Barcode Assays for Diagnostics with Smartphone Apps

NASA Astrophysics Data System (ADS)

Wong, Jessica X. H.; Li, Xiaochun; Liu, Frank S. F.; Yu, Hua-Zhong

2015-06-01

The desire to develop new point-of-care (POC) diagnostic tools has led to the adaptation of smartphones to tackle limitations in state-of-the-art instrumentation and centralized laboratory facilities. Today’s smartphones possess the computer-like ability to image and process data using mobile apps; barcode scanners are one such type of apps. We demonstrate herein that a diagnostic assay can be performed by patterning immunoassay strips in a bona fide barcode format such that after target binding and signal enhancement, the linear barcode can be read directly with a standard smartphone app. Quantitative analysis can then be performed based on the grayscale intensities with a customized mobile app. This novel diagnostic concept has been validated for a real-world application, i.e., the detection of human chorionic gonadotropin, a pregnancy hormone. With the possibility of multiplex detection, the barcode assay protocol promises to boost POC diagnosis research by the direct adaptation of mobile devices and apps.

A systematic review of diagnostic imaging use for low back pain in the United States.

PubMed

Dagenais, Simon; Galloway, Erin K; Roffey, Darren M

2014-06-01

Various studies have reported on the increasing use and costs of diagnostic imaging for low back pain (LBP) in the United States. However, it is unclear whether the methods used in these studies allowed for meaningful comparisons or whether the reported use data can be used to develop evidence-based use benchmarks. The primary purpose of this study was to review previous estimates of the use of diagnostic imaging for LBP in the United States. The study design is a systematic review of published literature. A search through May 2012 was conducted using keywords and free text terms related to health services and LBP in Medline and Health Policy Reference; results were screened for relevance independently, and full-text studies were assessed for eligibility. Only studies published in English since the year 2000 reporting on use of diagnostic imaging for LBP using claims data from the United States were included. Reporting quality was assessed using a modified Downs and Black tool for observational studies. The search strategy yielded 1,102 citations, seven of which met the criteria for eligibility. Studies reported use from commercial health plans (N=4) and Medicare (N=3), with sample sizes ranging from 13,760 to 740,467 members with LBP from specific states or across the United States. The number of diagnostic codes used to identify nonspecific LBP ranged from 2 to 66; other heterogeneity was noted in the methods used across these studies. In commercial health plans, use of radiography occurred in 12.0% to 32.2% of patients with LBP, magnetic resonance imaging (MRI) was used in 16.0% to 21.0%, computed tomography (CT) was used in 1.4% to 3.0%, and MRI and/or CT was used in 10.9% to 16.1%. Findings in Medicare populations were 22.9% to 48.2% for radiography, 11.6% for MRI, and 10.4% to 16.3% for MRI and/or CT. The reported use of diagnostic imaging for LBP varied across the studies reviewed; differences in methodology made meaningful comparisons difficult. Standardizing methods for performing and reporting analyses of claims data related to use could facilitate efforts by third-party payers, health care providers, and researchers to identify and address the perceived overuse of diagnostic imaging for LBP. Copyright © 2014 Elsevier Inc. All rights reserved.

Exploring clinical reasoning in novices: a self-regulated learning microanalytic assessment approach

PubMed Central

Artino, Anthony R; Cleary, Timothy J; Dong, Ting; Hemmer, Paul A; Durning, Steven J

2014-01-01

Objectives The primary objectives of this study were to examine the regulatory processes of medical students as they completed a diagnostic reasoning task and to examine whether the strategic quality of these regulatory processes were related to short-term and longer-term medical education outcomes. Methods A self-regulated learning (SRL) microanalytic assessment was administered to 71 second-year medical students while they read a clinical case and worked to formulate the most probable diagnosis. Verbal responses to open-ended questions targeting forethought and performance phase processes of a cyclical model of SRL were recorded verbatim and subsequently coded using a framework from prior research. Descriptive statistics and hierarchical linear regression models were used to examine the relationships between the SRL processes and several outcomes. Results Most participants (90%) reported focusing on specific diagnostic reasoning strategies during the task (metacognitive monitoring), but only about one-third of students referenced these strategies (e.g. identifying symptoms, integration) in relation to their task goals and plans for completing the task. After accounting for prior undergraduate achievement and verbal reasoning ability, strategic planning explained significant additional variance in course grade (ΔR2 = 0.15, p < 0.01), second-year grade point average (ΔR2 = 0.14, p < 0.01), United States Medical Licensing Examination Step 1 score (ΔR2 = 0.08, p < 0.05) and National Board of Medical Examiner subject examination score in internal medicine (ΔR2 = 0.10, p < 0.05). Conclusions These findings suggest that most students in the formative stages of learning diagnostic reasoning skills are aware of and think about at least one key diagnostic reasoning process or strategy while solving a clinical case, but a substantially smaller percentage set goals or develop plans that incorporate such strategies. Given that students who developed more strategic plans achieved better outcomes, the potential importance of forethought regulatory processes is underscored. PMID:24528463

District, state or regional veterinary diagnostic laboratories.

PubMed

Gosser, H S; Morehouse, L G

1998-08-01

The district, regional or state laboratory is the local laboratory to which veterinarian practitioners usually submit samples, and consequently these laboratories are usually the first to observe a suspected disease problem. In most countries, these laboratories are under the jurisdiction of the State or region in which they are located. In the United States of America (USA), most veterinary diagnostic laboratories are State-associated and operate under the aegis of either the State Department of Agriculture or a university. The national laboratory provides reference assistance to the State laboratories. In the USA, the national Laboratory (the National Veterinary Services Laboratories) acts as a consultant to confirm difficult diagnoses and administer performance tests for State-associated laboratories. District, state or regional laboratories need to share information regarding technological advances in diagnostic procedures. This need was met in the USA by the formation of the American Association of Veterinary Laboratory Diagnosticians (AAVLD) in the late 1950s. Another requirement of district, state or regional diagnostic laboratories is a method to confirm quality assurance, which was fulfilled in the USA by an accreditation programme established through the AAVLD. The Accreditation Committee evaluates laboratories (on request) in terms of organisation, personnel, physical facilities and equipment, records, finance and budget. Those laboratories which meet the standards as established in the 'Essential Requirements for Accreditation' are given accreditation status, which indicates that they have the expertise and facilities to perform tests on food-producing animals for shipment in national or international commerce and on companion, laboratory or zoo animals. While confidentiality of test records is most important, it is becoming necessary to release certain types of animal disease test information if a country is to participate in the exportation of animals and animal products. As district, state and regional laboratories operate under many different administrative entities (i.e., universities, State governments and the Federal government), various checks at different administrative levels provide safeguards and reduce the possibility of faulty disease reporting.

A national physician survey of diagnostic error in paediatrics.

PubMed

Perrem, Lucy M; Fanshawe, Thomas R; Sharif, Farhana; Plüddemann, Annette; O'Neill, Michael B

2016-10-01

This cross-sectional survey explored paediatric physician perspectives regarding diagnostic errors. All paediatric consultants and specialist registrars in Ireland were invited to participate in this anonymous online survey. The response rate for the study was 54 % (n = 127). Respondents had a median of 9-year clinical experience (interquartile range (IQR) 4-20 years). A diagnostic error was reported at least monthly by 19 (15.0 %) respondents. Consultants reported significantly less diagnostic errors compared to trainees (p value = 0.01). Cognitive error was the top-ranked contributing factor to diagnostic error, with incomplete history and examination considered to be the principal cognitive error. Seeking a second opinion and close follow-up of patients to ensure that the diagnosis is correct were the highest-ranked, clinician-based solutions to diagnostic error. Inadequate staffing levels and excessive workload were the most highly ranked system-related and situational factors. Increased access to and availability of consultants and experts was the most highly ranked system-based solution to diagnostic error. We found a low level of self-perceived diagnostic error in an experienced group of paediatricians, at variance with the literature and warranting further clarification. The results identify perceptions on the major cognitive, system-related and situational factors contributing to diagnostic error and also key preventative strategies. • Diagnostic errors are an important source of preventable patient harm and have an estimated incidence of 10-15 %. • They are multifactorial in origin and include cognitive, system-related and situational factors. What is New: • We identified a low rate of self-perceived diagnostic error in contrast to the existing literature. • Incomplete history and examination, inadequate staffing levels and excessive workload are cited as the principal contributing factors to diagnostic error in this study.

Diagnostic agreement between the SCID-II screening questionnaire and the Personality Disorder Examination.

PubMed

Jacobsberg, L; Perry, S; Frances, A

1995-12-01

Instruments to assess personality disorders offer reliability, but at the cost of large amounts of a skilled clinician's time to make assessments. The Structured Clinical Interview for DSM-III Axis II (SCID-II; Spitzer, Williams, Gibbon, & First, 1990), incorporates a self-report screening questionnaire, reducing the number of items needing evaluation by the interviewer. However, false negative responses may cause clinically important areas to be overlooked. To establish the rate of false negative responses, we compared participant self-report on the SCID-II with Axis II diagnostic assessment done by clinicians using the Personality Disorder Examination (Loranger, Susman, Oldham, & Russakoff, 1987). The false negative rate was low for every diagnosis, supporting validity of following up with clinician questioning only those diagnostic elements endorsed in the self-report. Avoidant and dependent personality disorders were accurately self-reported. This, an efficient assessment instrument for personality disorders might combine self-report of those disorders where self-report is reliable, with clinician assessment where needed.

Understanding the geographic distribution of tropical cyclone formation for applications in climate models

NASA Astrophysics Data System (ADS)

Tory, Kevin J.; Ye, H.; Dare, R. A.

2018-04-01

Projections of Tropical cyclone (TC) formation under future climate scenarios are dependent on climate model simulations. However, many models produce unrealistic geographical distributions of TC formation, especially in the north and south Atlantic and eastern south Pacific TC basins. In order to improve confidence in projections it is important to understand the reasons behind these model errors. However, considerable effort is required to analyse the many models used in projection studies. To address this problem, a novel diagnostic is developed that provides compelling insight into why TCs form where they do, using a few summary diagrams. The diagnostic is developed after identifying a relationship between seasonal climatologies of atmospheric variables in 34 years of ECMWF reanalysis data, and TC detection distributions in the same data. Geographic boundaries of TC formation are constructed from four threshold quantities. TCs form where Emanuel's Maximum Potential Intensity, V_{{PI}}, exceeds 40 {ms}^{{ - 1}}, 700 hPa relative humidity, RH_{{700}}, exceeds 40%, and the magnitude of the difference in vector winds between 850 and 200 hPa, V_{{sh}}, is less than 20 {ms}^{{ - 1}}. The equatorial boundary is best defined by a composite quantity containing the ratio of absolute vorticity (η ) to the meridional gradient of absolute vorticity (β ^{*}), rather than η alone. {β ^*} is also identified as a potentially important ingredient for TC genesis indices. A comparison of detected Tropical Depression (TD) and Tropical Storm (TS) climatologies revealed TDs more readily intensify further to TS where {V_{PI}} is elevated and {V_{sh}} is relatively weak. The distributions of each threshold quantity identify the factors that favour and suppress TC formation throughout the tropics in the real world. This information can be used to understand why TC formation is poorly represented in some climate models, and shows potential for understanding anomalous TC formation behaviour in the real world.

Evidence assessing the diagnostic performance of medical smartphone apps: a systematic review and exploratory meta-analysis

PubMed Central

Buechi, Rahel; Faes, Livia; Bachmann, Lucas M; Thiel, Michael A; Bodmer, Nicolas S; Schmid, Martin K; Job, Oliver; Lienhard, Kenny R

2017-01-01

Objective The number of mobile applications addressing health topics is increasing. Whether these apps underwent scientific evaluation is unclear. We comprehensively assessed papers investigating the diagnostic value of available diagnostic health applications using inbuilt smartphone sensors. Methods Systematic Review—MEDLINE, Scopus, Web of Science inclusive Medical Informatics and Business Source Premier (by citation of reference) were searched from inception until 15 December 2016. Checking of reference lists of review articles and of included articles complemented electronic searches. We included all studies investigating a health application that used inbuilt sensors of a smartphone for diagnosis of disease. The methodological quality of 11 studies used in an exploratory meta-analysis was assessed with the Quality Assessment of Diagnostic Accuracy Studies 2 tool and the reporting quality with the ’STAndards for the Reporting of Diagnostic accuracy studies' (STARD) statement. Sensitivity and specificity of studies reporting two-by-two tables were calculated and summarised. Results We screened 3296 references for eligibility. Eleven studies, most of them assessing melanoma screening apps, reported 17 two-by-two tables. Quality assessment revealed high risk of bias in all studies. Included papers studied 1048 subjects (758 with the target conditions and 290 healthy volunteers). Overall, the summary estimate for sensitivity was 0.82 (95 % CI 0.56 to 0.94) and 0.89 (95 %CI 0.70 to 0.97) for specificity. Conclusions The diagnostic evidence of available health apps on Apple’s and Google’s app stores is scarce. Consumers and healthcare professionals should be aware of this when using or recommending them. PROSPERO registration number 42016033049. PMID:29247099

Sequence stratigraphy applied to the hydrocarbon productive basins of Western Indonesia

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

Courteney, S.

Oil exploration began in Indonesia in 1870, and the first commercial discovery was made in 1885 in the North Sumatra basin. Since then, over 3000 exploratory wells have been drilled in western Indonesia, with about 750 discoveries reported. By the end of 1992, over 300 fields in eleven geological basins were producing in western Indonesia, and 100 more fields were either shut in or had been abandoned. However, despite the fact that western Indonesia is a mature hydrocarbon province, all published work of a regional nature, and indeed most internal company reports, use lithostratigraphy and, to a lesser extent, biostratigraphy.more » Lithostratigraphy is based, often unwittingly, on pre-1960s work, when only relatively shallow wells and limited seismic data were available. Additional difficulties arise from companies using alternative names for a rock unit and the same formation name for different rock units. Biostratigraphy is handicapped by the lack of age diagnostic fossils in the early Miocene and older sediments in most of Sumatra and Natuna. In Java and Kalimantan, where the older section tends to be more marine and age diagnostic fossils are present, significant errors in age determination occur due to reworking of sediments. As a consequence, the [open quotes]hydrocarbon system[close quotes] in western Indonesia is inadequately understood, and exploration efforts are often poorly applied. This paper proposes a correlative framework using sequence stratigraphy for the hydrocarbon productive basins of western Indonesia, which should contribute to a better understanding of the hydrocarbon system and significantly reduce exploration risk in western Indonesia.« less

Mismatch between diagnostic reports and special educational needs classification in a public educational system.

PubMed

Teixeira, Maria Cristina Triguero Veloz; Brunoni, Décio; Carreiro, Luiz Renato Rodrigues; Braga, Ana Claudia; Silva, Naiara Adorna da; Paula, Cristiane Silvestre

2017-04-01

To assess the diagnostic status, the sociodemographic and health profiles for students with special educational needs (SEN) in a public educational system, and to map their use of educational/social services. The sample comprised 1,202 SEN students from a total of 59,344 students. Only 792 students of the 1,202 had an established diagnosis. The most prevalent SEN condition was intellectual disability. There was a low percentage (29.4%) of use of specialized educational services or support. It was found that, for some neurodevelopmental disorders, prevalence data suggest an under-reporting in the school system. Results suggest that there is a mismatch between the diagnostic reports and the SEN condition legally recognized according to Brazilian law, in addition to the under-reporting and under specialized service use of students with disabilities.

The Diagnosticity of Color for Emotional Objects

PubMed Central

McMenamin, Brenton W.; Radue, Jasmine; Trask, Joanna; Huskamp, Kristin; Kersten, Daniel; Marsolek, Chad J.

2012-01-01

Object classification can be facilitated if simple diagnostic features can be used to determine class membership. Previous studies have found that simple shapes may be diagnostic for emotional content and automatically alter the allocation of visual attention. In the present study, we analyzed whether color is diagnostic of emotional content and tested whether emotionally diagnostic hues alter the allocation of visual attention. Reddish-yellow hues are more common in (i.e., diagnostic of) emotional images, particularly images with positive emotional content. An exogenous cueing paradigm was employed to test whether these diagnostic hues orient attention differently from other hues due to the emotional diagnosticity. In two experiments, we found that participants allocated attention differently to diagnostic hues than to non-diagnostic hues, in a pattern indicating a broadening of spatial attention when cued with diagnostic hues. Moreover, the attentional broadening effect was predicted by self-reported measures of affective style, linking the behavioral effect to emotional processes. These results confirm the existence and use of diagnostic features for the rapid detection of emotional content. PMID:24659831

Clinical exome sequencing reports: current informatics practice and future opportunities.

PubMed

Swaminathan, Rajeswari; Huang, Yungui; Astbury, Caroline; Fitzgerald-Butt, Sara; Miller, Katherine; Cole, Justin; Bartlett, Christopher; Lin, Simon

2017-11-01

The increased adoption of clinical whole exome sequencing (WES) has improved the diagnostic yield for patients with complex genetic conditions. However, the informatics practice for handling information contained in whole exome reports is still in its infancy, as evidenced by the lack of a common vocabulary within clinical sequencing reports generated across genetic laboratories. Genetic testing results are mostly transmitted using portable document format, which can make secondary analysis and data extraction challenging. This paper reviews a sample of clinical exome reports generated by Clinical Laboratory Improvement Amendments-certified genetic testing laboratories at tertiary-care facilities to assess and identify common data elements. Like structured radiology reports, which enable faster information retrieval and reuse, structuring genetic information within clinical WES reports would help facilitate integration of genetic information into electronic health records and enable retrospective research on the clinical utility of WES. We identify elements listed as mandatory according to practice guidelines but are currently missing from some of the clinical reports, which might help to organize the data when stored within structured databases. We also highlight elements, such as patient consent, that, although they do not appear within any of the current reports, may help in interpreting some of the information within the reports. Integrating genetic and clinical information would assist the adoption of personalized medicine for improved patient care and outcomes. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Vehicle Integrated Prognostic Reasoner (VIPR) Metric Report

NASA Technical Reports Server (NTRS)

Cornhill, Dennis; Bharadwaj, Raj; Mylaraswamy, Dinkar

2013-01-01

This document outlines a set of metrics for evaluating the diagnostic and prognostic schemes developed for the Vehicle Integrated Prognostic Reasoner (VIPR), a system-level reasoner that encompasses the multiple levels of large, complex systems such as those for aircraft and spacecraft. VIPR health managers are organized hierarchically and operate together to derive diagnostic and prognostic inferences from symptoms and conditions reported by a set of diagnostic and prognostic monitors. For layered reasoners such as VIPR, the overall performance cannot be evaluated by metrics solely directed toward timely detection and accuracy of estimation of the faults in individual components. Among other factors, overall vehicle reasoner performance is governed by the effectiveness of the communication schemes between monitors and reasoners in the architecture, and the ability to propagate and fuse relevant information to make accurate, consistent, and timely predictions at different levels of the reasoner hierarchy. We outline an extended set of diagnostic and prognostics metrics that can be broadly categorized as evaluation measures for diagnostic coverage, prognostic coverage, accuracy of inferences, latency in making inferences, computational cost, and sensitivity to different fault and degradation conditions. We report metrics from Monte Carlo experiments using two variations of an aircraft reference model that supported both flat and hierarchical reasoning.

DSM-III as a research tool.

PubMed

Treece, C

1982-05-01

The author describes the use of the DSM-III's diagnostic criteria and classification system as a research instrument and discusses some of the advantages and drawbacks of DMS-III for a specific type of study. A rearrangement of the hierarchical order of the DSM-III diagnostic classes is suggested. This rearrangement provides for levels of certainty in analyzing interrater reliability and offers a simplified framework for summarizing group data. When this approach is combined with a structured interview and response format, it provides a flexible way of managing a large classification system for a smaller study without sacrificing standardization.

Polarization-correlation diagnostics and differentiation of cholelithiasis in patients with chronic cholecystitis combined with diabetes mellitus type 2

NASA Astrophysics Data System (ADS)

Marchuk, Yu F.; Fediv, O. I.; Ivashchuk, I. O.; Andriychuk, D. R.

2011-09-01

The principles of optical modeling of human bile polycrystalline structure are described. The main types of polycrystalline structures are detailed. It has been proposed and founded the scenarios of formation of bile microscopic images polarization structure in coherent radiation. The results of investigating the interrelation between statistical moments of the 1st-4th order are presented that characterize the coordinate distributions of intensity of laser images of bile smears of cholelithiasis patients in combination with other pathologies. The diagnostic criteria of the cholelithiasis nascency and its severity degree differentiation are determined.

Polarization-correlation diagnostics and differentiation of cholelithiasis in patients with chronic cholecystitis combined with diabetes mellitus type 2

NASA Astrophysics Data System (ADS)

Marchuk, Yu F.; Fediv, O. I.; Ivashchuk, I. O.; Andriychuk, D. R.

2012-01-01

The principles of optical modeling of human bile polycrystalline structure are described. The main types of polycrystalline structures are detailed. It has been proposed and founded the scenarios of formation of bile microscopic images polarization structure in coherent radiation. The results of investigating the interrelation between statistical moments of the 1st-4th order are presented that characterize the coordinate distributions of intensity of laser images of bile smears of cholelithiasis patients in combination with other pathologies. The diagnostic criteria of the cholelithiasis nascency and its severity degree differentiation are determined.

[The current clinical laboratory in the public health system and medical science: a lecture].

PubMed

Men'shikov, V V

2011-11-01

The analytic and diagnostic possibilities of current clinical laboratories are discussed. The roles of laboratory information in the formation of new research directions are characterized. The proposals on the development of economic basics of the development of laboratory medicine.

X-Ray Probes of Cosmic Star Formation History

NASA Technical Reports Server (NTRS)

Ghosh, Pranab; White, Nicholas E.

2001-01-01

We discuss the imprints left by a cosmological evolution of the star formation rate (SFR) on the evolution of X-ray luminosities Lx of normal galaxies, using the scheme earlier proposed by us, wherein the evolution of LX of a galaxy is driven by the evolution of its X-ray binary population. As indicated in our earlier work, the profile of Lx with redshift can both serve as a diagnostic probe of the SFR profile and constrain evolutionary models for X-ray binaries. We report here the first calculation of the expected evolution of X-ray luminosities of galaxies, updating our work by using a suite of more recently developed SFR profiles that span the currently plausible range. The first Chandra deep imaging results on Lx evolution are beginning to probe the SFR profile of bright spiral galaxies; the early results are consistent with predictions based on current SFR models. Using these new SFR profiles, the resolution of the "birthrate problem" of low-mass X-ray binaries and recycled, millisecond pulsars in terms of an evolving global SFR is more complete. We discuss the possible impact of the variations in the SFR profile of individual galaxies and galaxy types.

Comparison of MPEG-1 digital videotape with digitized sVHS videotape for quantitative echocardiographic measurements

NASA Technical Reports Server (NTRS)

Garcia, M. J.; Thomas, J. D.; Greenberg, N.; Sandelski, J.; Herrera, C.; Mudd, C.; Wicks, J.; Spencer, K.; Neumann, A.; Sankpal, B.;

Thunderstorm-environment interactions determined with three-dimensional trajectories

NASA Technical Reports Server (NTRS)

Wilson, G. S.

1980-01-01

Diagnostically determined three dimensional trajectories were used to reveal some of the scale interaction processes that occur between convective storms and their environment. Data from NASA's fourth Atmospheric Variability Experiment are analyzed. Two intense squall lines and numerous reports of severe weather occurred during the period. Convective storm systems with good temporal and spatial continuity are shown to be related to the development and movement of short wave circulation systems aloft that propagate eastward within a zonal mid tropospheric wind pattern. These short wave systems are found to produce the potential instability and dynamic triggering needed for thunderstorm formation. The environmental flow patterns, relative to convective storm systems, are shown to produce large upward air parcel movements in excess of 50 mb/3h in the immediate vicinity of the storms. The air undergoing strong lifting originates as potentially unstable low level air traveling into the storm environment from southern and southwestern directions. The thermo and hydrodynamical processes that lead to changes in atmospheric structure before, during, and after convective storm formation are described using total time derivatives of pressure or net vertical displacement, potential temperature, and vector wind calculated by following air parcels.

Sensitive and label-free detection of miRNA-145 by triplex formation.

PubMed

Aviñó, Anna; Huertas, César S; Lechuga, Laura M; Eritja, Ramon

2016-01-01

The development of new strategies for detecting microRNAs (miRNAs) has become a crucial step in the diagnostic field. miRNA profiles depend greatly on the sample and the analytical platform employed, leading sometimes to contradictory results. In this work, we study the use of modified parallel tail-clamps to detect a miRNA sequence involved in tumor suppression by triplex formation. Thermal denaturing curves and circular dichroism (CD) measurements have been performed to confirm that parallel clamps carrying 8-aminoguanine form the most stable triplex structures with their target miRNA. The modified tail-clamps have been tested as bioreceptors in a surface plasmon resonance (SPR) biosensor for the detection of miRNA-145. The detection limit was improved 2.4 times demonstrating that a stable triplex structure is formed between target miRNA and 8-aminoguanine tail-clamp bioreceptor. This new approach is an essential step toward the label-free and reliable detection of miRNA signatures for diagnostic purposes.

Are Clinical Diagnoses of Alzheimer's Disease and Other Dementias Affected by Education and Self-Reported Race?

ERIC Educational Resources Information Center

Teresi, Jeanne A.; Grober, Ellen; Eimicke, Joseph P.; Ehrlich, Amy R.

2012-01-01

A randomized controlled trial examined whether the diagnostic process for Alzheimer's disease and other dementias may be influenced by knowledge of the patient's education and/or self-reported race. Four conditions were implemented: diagnostic team knows (a) race and education, (b) education only, (c) race only, or (d) neither. Diagnosis and…

Diagnostic pitfalls associated with a large true posterior communicating artery aneurysm: a case report.

PubMed

Nagatani, Kimihiro; Otani, Naoki; Seno, Soichiro; Takeuchi, Satoru; Wada, Kojiro; Mori, Kentaro

2013-10-01

True posterior communicating artery (PCoA) aneurysm is an aneurysm that originates from the PCoA, and large or giant true PCoA aneurysms are rare. We report a case of a large true PCoA aneurysm successfully clipped after anterior clinoidectomy and discuss the diagnostic pitfalls associated with this rare clinical entity.

Diagnostic Efficiency of easyCBM[R] Math: Washington State. Technical Report #1008

ERIC Educational Resources Information Center

Anderson, Daniel; Alonzo, Julie; Tindal, Gerald

2010-01-01

easyCBM[R] is an online benchmark and progress monitoring assessment system designed for use within a response to intervention framework. Educators using easyCBM[R] are often interested in using the results to predict students' state test performance. In the following technical document, we report diagnostic efficiency statistics using a sample…

Applying a Qualitative Modeling Shell to Process Diagnosis: The Caster System. ONR Technical Report #16.

ERIC Educational Resources Information Center

Thompson, Timothy F.; Clancey, William J.

This report describes the application of a shell expert system from the medical diagnostic system, Neomycin, to Caster, a diagnostic system for malfunctions in industrial sandcasting. This system was developed to test the hypothesis that starting with a well-developed classification procedure and a relational language for stating the…

’Point of Injury’ Sampling Technology for Battlefield Molecular Diagnostics

DTIC Science & Technology

2012-03-17

Injury" Sampling Technology for Battlefield Molecular Diagnostics March 17,2012 Sponsored by Defense Advanced Research Projects Agency (DOD) Defense...Contract: April 25, 2011 Short Title of Work: "Point of Injury" Sampling Technology for Battlefield Molecular Diagnostics " Contract Expiration Date...SBIR PHASE I OPTION REPORT: Point of Injury, Sampling Technology for Battlefield Molecular Diagnostics . W31P4Q-1 l-C-0222 (UNCLASSIFIED) P.I

Diagnostic Classification Models: Are They Necessary? Commentary on Rupp and Templin (2008)

ERIC Educational Resources Information Center

Gorin, Joanna S.

2009-01-01

In their paper "Unique Characteristics of Diagnostic Classification Models: A Comprehensive Review of the Current State-of-the-Art," Andre Rupp and Jonathan Templin (2008) provide a comparative analysis of selected psychometric models useful for the analysis of multidimensional data for purposes of diagnostic score reporting. Recent assessment…

Case Report: SPECT/CT as the New Diagnostic Tool for Specific Wrist Pathology.

PubMed

Linde, Musters; Ten Broek, M; Kraan, G A

2017-01-01

Single photon emission computed tomography has been introduced as a promising new diagnostic tool in orthopaedic pathology since the early 90'. Computed tomography, the combined with SPECT, gives insight in the specific sight of wrist pathology. Literature already supports introduction of SPECT/CT in wrist pathology, but clinical application is lagging. A 40yr old patient reported first in 2004 with persisting pain after a right distal radius fracture. Several diagnostics and operative interventions were performed, all unsuccessful. Because of the persisting pain a SPECT-CT was performed which showed a cyst in the hamate bone, which was successfully enucleated. The patient was finally pain free at recent follow-up. With a QDash-score of 43 and a PRW (H) E-DLV-score of 58/150. In this case report, SPECT/CT proved a very sensitive diagnostic tool for specific pathology of the wrist. It offered precise localisation and thereby the clinically suspected diagnosis was confirmed and the patient successfully treated.

Minimizing Barriers in Learning for On-Call Radiology Residents-End-to-End Web-Based Resident Feedback System.

PubMed

Choi, Hailey H; Clark, Jennifer; Jay, Ann K; Filice, Ross W

2018-02-01

Feedback is an essential part of medical training, where trainees are provided with information regarding their performance and further directions for improvement. In diagnostic radiology, feedback entails a detailed review of the differences between the residents' preliminary interpretation and the attendings' final interpretation of imaging studies. While the on-call experience of independently interpreting complex cases is important to resident education, the more traditional synchronous "read-out" or joint review is impossible due to multiple constraints. Without an efficient method to compare reports, grade discrepancies, convey salient teaching points, and view images, valuable lessons in image interpretation and report construction are lost. We developed a streamlined web-based system, including report comparison and image viewing, to minimize barriers in asynchronous communication between attending radiologists and on-call residents. Our system provides real-time, end-to-end delivery of case-specific and user-specific feedback in a streamlined, easy-to-view format. We assessed quality improvement subjectively through surveys and objectively through participation metrics. Our web-based feedback system improved user satisfaction for both attending and resident radiologists, and increased attending participation, particularly with regards to cases where substantive discrepancies were identified.

Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports.

PubMed

Park, Brian Y; Wilson, Gary; Berger, Jonathan; Christman, Matthew; Reina, Bryn; Bishop, Frank; Klam, Warren P; Doan, Andrew P

2016-08-05

Traditional factors that once explained men's sexual difficulties appear insufficient to account for the sharp rise in erectile dysfunction, delayed ejaculation, decreased sexual satisfaction, and diminished libido during partnered sex in men under 40. This review (1) considers data from multiple domains, e.g., clinical, biological (addiction/urology), psychological (sexual conditioning), sociological; and (2) presents a series of clinical reports, all with the aim of proposing a possible direction for future research of this phenomenon. Alterations to the brain's motivational system are explored as a possible etiology underlying pornography-related sexual dysfunctions. This review also considers evidence that Internet pornography's unique properties (limitless novelty, potential for easy escalation to more extreme material, video format, etc.) may be potent enough to condition sexual arousal to aspects of Internet pornography use that do not readily transition to real-life partners, such that sex with desired partners may not register as meeting expectations and arousal declines. Clinical reports suggest that terminating Internet pornography use is sometimes sufficient to reverse negative effects, underscoring the need for extensive investigation using methodologies that have subjects remove the variable of Internet pornography use. In the interim, a simple diagnostic protocol for assessing patients with porn-induced sexual dysfunction is put forth.

Estimation of Energy Efficiency of Means of Transport According to the Results of Technical Diagnostics

NASA Astrophysics Data System (ADS)

Shalkov, Anton; Mamaeva, Mariya

2017-11-01

The article considers the questions of application of nondestructive methods control of reducers of conveyor belts as a means of transport. Particular attention is paid to such types of diagnostics of technical condition as thermal control and analysis of the state of lubricants. The urgency of carrying out types of nondestructive testing presented in the article is determined by the increase of energy efficiency of transport systems of coal and mining enterprises, in particular, reducers of belt conveyors. Periodic in-depth spectral-emission diagnostics and monitoring of a temperature mode of operation oil in the operation of the control equipment and its technical condition and prevent the MTBF allows the monitoring of the actual technical condition of the gearbox of a belt conveyor. In turn, the thermal imaging diagnostics reveals defects at the earliest stage of their formation and development, which allows planning the volumes and terms of equipment repair. Presents diagnostics of the technical condition will allow monitoring in time the technical condition of the equipment and avoiding its premature failure. Thereby it will increase the energy efficiency of both the transport system and the enterprise as a whole, and also avoid unreasonable increases in operating and maintenance costs.

Turning the Page: Advancing Paper-Based Microfluidics for Broad Diagnostic Application.

PubMed

Gong, Max M; Sinton, David

2017-06-28

Infectious diseases are a major global health issue. Diagnosis is a critical first step in effectively managing their spread. Paper-based microfluidic diagnostics first emerged in 2007 as a low-cost alternative to conventional laboratory testing, with the goal of improving accessibility to medical diagnostics in developing countries. In this review, we examine the advances in paper-based microfluidic diagnostics for medical diagnosis in the context of global health from 2007 to 2016. The theory of fluid transport in paper is first presented. The next section examines the strategies that have been employed to control fluid and analyte transport in paper-based assays. Tasks such as mixing, timing, and sequential fluid delivery have been achieved in paper and have enabled analytical capabilities comparable to those of conventional laboratory methods. The following section examines paper-based sample processing and analysis. The most impactful advancement here has been the translation of nucleic acid analysis to a paper-based format. Smartphone-based analysis is another exciting development with potential for wide dissemination. The last core section of the review highlights emerging health applications, such as male fertility testing and wearable diagnostics. We conclude the review with the future outlook, remaining challenges, and emerging opportunities.

Can Questionnaire Reports Correctly Classify Relationship Distress and Partner Physical Abuse?

PubMed Central

Heyman, Richard E.; Feldbau-Kohn, Shari R.; Ehrensaft, Miriam K.; Langhinrichsen-Rohling, Jennifer; O’Leary, K. Daniel

2006-01-01

Relationship adjustment (e.g., Dyadic Adjustment Scale; DAS) and physical aggression (e.g., Conflict Tactics Scale) measures are used both as screening tools and as the sole criterion for classification. This study created face valid diagnostic interviews for relationship distress and physical abuse, through which one could compare preliminarily the classification properties of questionnaire reports. The DAS (and a global measure of relationship satisfaction) had modest agreement with a structured diagnostic interview; both questionnaires tended to overdiagnose distress compared with the interview. Results for partner abuse reiterated the need to go beyond occurrence of aggression as the sole diagnostic criterion, because men’s aggression was more likely than women’s to rise to the level of “abuse” when diagnostic criteria (injury or substantial fear) were applied. PMID:11458637

Recommended reporting standards for test accuracy studies of infectious diseases of finfish, amphibians, molluscs and crustaceans: the STRADAS-aquatic checklist

USGS Publications Warehouse

Gardner, Ian A; Whittington, Richard J; Caraguel, Charles G B; Hick, Paul; Moody, Nicholas J G; Corbeil, Serge; Garver, Kyle A.; Warg, Janet V.; Arzul, Isabelle; Purcell, Maureen; St. J. Crane, Mark; Waltzek, Thomas B.; Olesen, Niels J; Lagno, Alicia Gallardo

2016-01-01

Complete and transparent reporting of key elements of diagnostic accuracy studies for infectious diseases in cultured and wild aquatic animals benefits end-users of these tests, enabling the rational design of surveillance programs, the assessment of test results from clinical cases and comparisons of diagnostic test performance. Based on deficiencies in the Standards for Reporting of Diagnostic Accuracy (STARD) guidelines identified in a prior finfish study (Gardner et al. 2014), we adapted the Standards for Reporting of Animal Diagnostic Accuracy Studies—paratuberculosis (STRADAS-paraTB) checklist of 25 reporting items to increase their relevance to finfish, amphibians, molluscs, and crustaceans and provided examples and explanations for each item. The checklist, known as STRADAS-aquatic, was developed and refined by an expert group of 14 transdisciplinary scientists with experience in test evaluation studies using field and experimental samples, in operation of reference laboratories for aquatic animal pathogens, and in development of international aquatic animal health policy. The main changes to the STRADAS-paraTB checklist were to nomenclature related to the species, the addition of guidelines for experimental challenge studies, and the designation of some items as relevant only to experimental studies and ante-mortem tests. We believe that adoption of these guidelines will improve reporting of primary studies of test accuracy for aquatic animal diseases and facilitate assessment of their fitness-for-purpose. Given the importance of diagnostic tests to underpin the Sanitary and Phytosanitary agreement of the World Trade Organization, the principles outlined in this paper should be applied to other World Organisation for Animal Health (OIE)-relevant species.

Recommended reporting standards for test accuracy studies of infectious diseases of finfish, amphibians, molluscs and crustaceans: the STRADAS-aquatic checklist.

PubMed

Gardner, Ian A; Whittington, Richard J; Caraguel, Charles G B; Hick, Paul; Moody, Nicholas J G; Corbeil, Serge; Garver, Kyle A; Warg, Janet V; Arzul, Isabelle; Purcell, Maureen K; Crane, Mark St J; Waltzek, Thomas B; Olesen, Niels J; Gallardo Lagno, Alicia

2016-02-25

Complete and transparent reporting of key elements of diagnostic accuracy studies for infectious diseases in cultured and wild aquatic animals benefits end-users of these tests, enabling the rational design of surveillance programs, the assessment of test results from clinical cases and comparisons of diagnostic test performance. Based on deficiencies in the Standards for Reporting of Diagnostic Accuracy (STARD) guidelines identified in a prior finfish study (Gardner et al. 2014), we adapted the Standards for Reporting of Animal Diagnostic Accuracy Studies-paratuberculosis (STRADAS-paraTB) checklist of 25 reporting items to increase their relevance to finfish, amphibians, molluscs, and crustaceans and provided examples and explanations for each item. The checklist, known as STRADAS-aquatic, was developed and refined by an expert group of 14 transdisciplinary scientists with experience in test evaluation studies using field and experimental samples, in operation of reference laboratories for aquatic animal pathogens, and in development of international aquatic animal health policy. The main changes to the STRADAS-paraTB checklist were to nomenclature related to the species, the addition of guidelines for experimental challenge studies, and the designation of some items as relevant only to experimental studies and ante-mortem tests. We believe that adoption of these guidelines will improve reporting of primary studies of test accuracy for aquatic animal diseases and facilitate assessment of their fitness-for-purpose. Given the importance of diagnostic tests to underpin the Sanitary and Phytosanitary agreement of the World Trade Organization, the principles outlined in this paper should be applied to other World Organisation for Animal Health (OIE)-relevant species.

Radiological interpretation of images displayed on tablet computers: a systematic review.

PubMed

Caffery, L J; Armfield, N R; Smith, A C

2015-06-01

To review the published evidence and to determine if radiological diagnostic accuracy is compromised when images are displayed on a tablet computer and thereby inform practice on using tablet computers for radiological interpretation by on-call radiologists. We searched the PubMed and EMBASE databases for studies on the diagnostic accuracy or diagnostic reliability of images interpreted on tablet computers. Studies were screened for inclusion based on pre-determined inclusion and exclusion criteria. Studies were assessed for quality and risk of bias using Quality Appraisal of Diagnostic Reliability Studies or the revised Quality Assessment of Diagnostic Accuracy Studies tool. Treatment of studies was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). 11 studies met the inclusion criteria. 10 of these studies tested the Apple iPad(®) (Apple, Cupertino, CA). The included studies reported high sensitivity (84-98%), specificity (74-100%) and accuracy rates (98-100%) for radiological diagnosis. There was no statistically significant difference in accuracy between a tablet computer and a digital imaging and communication in medicine-calibrated control display. There was a near complete consensus from authors on the non-inferiority of diagnostic accuracy of images displayed on a tablet computer. All of the included studies were judged to be at risk of bias. Our findings suggest that the diagnostic accuracy of radiological interpretation is not compromised by using a tablet computer. This result is only relevant to the Apple iPad and to the modalities of CT, MRI and plain radiography. The iPad may be appropriate for an on-call radiologist to use for radiological interpretation.

Patient-reported disease knowledge and educational needs in Lynch syndrome: findings of an interactive multidisciplinary patient conference

PubMed Central

2014-01-01

Background Patients with Lynch Syndrome, the most common hereditary colorectal cancer syndrome, benefit from genetic education and family counseling regarding diagnostic testing and cancer surveillance/prevention recommendations. Although genetic counseling is currently the most common venue where such education and counseling takes place, little is known about the level of disease knowledge and education needs as directly reported by patients and families with Lynch Syndrome. Furthermore, experiences with forums for larger-scale knowledge transfer have been limited in the current literature. Methods We conducted a one-day interactive multidisciplinary patient conference, designed to complement individual genetic counseling for updating disease knowledge, supportive networking and needs assessment among Lynch Syndrome patients and their family members. The patient conference was designed utilizing the conceptual framework of action research. Paired pre- and post-conference surveys were administered to 44 conference participants anonymously to assess patient-reported disease knowledge and education needs. Results A multidisciplinary team of expert providers utilized a variety of educational formats during the one-day conference. Four main focus areas were: genetic testing, surveillance/prevention, living with Lynch Syndrome, and update on research. Thirty-two participants (73%) completed the pre-conference, and 28 (64%) participants completed the post-conference surveys. Nineteen respondents were affected and the remaining were unaffected. The scores of the disease-knowledge items significantly increased from 84% pre- to 92% post-conference (p = 0.012). Patients reported a high level of satisfaction and identified further knowledge needs in nutrition (71%), surveillance/prevention options (71%), support groups (36%), cancer risk assessment (32%), active role in medical care (32%), and research opportunities (5%). Conclusion Our experience with a dedicated patient education conference focused on Lynch Syndrome demonstrated that such an educational format is effective for updating or reinforcing disease knowledge, for identifying patient-reported unmet educational needs, as well as for peer-support. PMID:24499499

Patient-reported disease knowledge and educational needs in Lynch syndrome: findings of an interactive multidisciplinary patient conference.

PubMed

Bannon, Sarah A; Mork, Maureen; Vilar, Eduardo; Peterson, Susan K; Lu, Karen; Lynch, Patrick M; Rodriguez-Bigas, Miguel A; You, Yiqian Nancy

2014-02-05

Patients with Lynch Syndrome, the most common hereditary colorectal cancer syndrome, benefit from genetic education and family counseling regarding diagnostic testing and cancer surveillance/prevention recommendations. Although genetic counseling is currently the most common venue where such education and counseling takes place, little is known about the level of disease knowledge and education needs as directly reported by patients and families with Lynch Syndrome. Furthermore, experiences with forums for larger-scale knowledge transfer have been limited in the current literature. We conducted a one-day interactive multidisciplinary patient conference, designed to complement individual genetic counseling for updating disease knowledge, supportive networking and needs assessment among Lynch Syndrome patients and their family members. The patient conference was designed utilizing the conceptual framework of action research. Paired pre- and post-conference surveys were administered to 44 conference participants anonymously to assess patient-reported disease knowledge and education needs. A multidisciplinary team of expert providers utilized a variety of educational formats during the one-day conference. Four main focus areas were: genetic testing, surveillance/prevention, living with Lynch Syndrome, and update on research. Thirty-two participants (73%) completed the pre-conference, and 28 (64%) participants completed the post-conference surveys. Nineteen respondents were affected and the remaining were unaffected. The scores of the disease-knowledge items significantly increased from 84% pre- to 92% post-conference (p = 0.012). Patients reported a high level of satisfaction and identified further knowledge needs in nutrition (71%), surveillance/prevention options (71%), support groups (36%), cancer risk assessment (32%), active role in medical care (32%), and research opportunities (5%). Our experience with a dedicated patient education conference focused on Lynch Syndrome demonstrated that such an educational format is effective for updating or reinforcing disease knowledge, for identifying patient-reported unmet educational needs, as well as for peer-support.

Report formatting in laboratory medicine - a call for harmony.

PubMed

Jones, Graham R D; Legg, Michael

2018-04-19

The results of medical laboratory testing are only useful if they lead to appropriate actions by medical practitioners and/or patients. An underappreciated component of the medical testing process is the transfer of the information from the laboratory report into the reader's brain. The format of laboratory reports can be determined by the testing laboratory, which may issue a formatted report, or by electronic systems receiving information from laboratories and controlling the report format. As doctors can receive information from many laboratories, interpreting information from reports in a safe and rapid manner is facilitated by having similar report layouts and formats. Using Australia as an example, there is a wide variation in report formats in spite of a body of work to define standards for reporting. In addition to standardising of report formats, consideration needs to be given to optimisation of report formatting to facilitate rapid and unambiguous reading of the report and also interpretation of the data. Innovative report formats have been developed by some laboratories; however, wide adoption has not followed. The need to balance uniformity of reporting with appropriate innovation is a challenge for safe reporting of laboratory results. This paper discusses the current status and opportunity for improvement in safety and efficiency of the reading of laboratory reports, using current practise and developments in Australia as examples.

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

NASA Astrophysics Data System (ADS)

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

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

Development and Evaluation of Sensor Concepts for Ageless Aerospace Vehicles: Report 5 - Phase 2 Implementation of the Concept Demonstrator

NASA Technical Reports Server (NTRS)

Batten, Adam; Dunlop, John; Edwards, Graeme; Farmer, Tony; Gaffney, Bruce; Hedley, Mark; Hoschke, Nigel; Isaacs, Peter; Johnson, Mark; Lewis, Chris;

Gastritis: the histology report.

PubMed

Rugge, Massimo; Pennelli, Gianmaria; Pilozzi, Emanuela; Fassan, Matteo; Ingravallo, Giuseppe; Russo, Valentina M; Di Mario, Francesco

2011-03-01

Gastritis is defined as inflammation of the gastric mucosa. In histological terms, it is distinguishable into two main categories, i.e. non-atrophic and atrophic. In the gastric mucosa, atrophy is defined as the loss of appropriate glands. There are several etiological types of gastritis, their different etiology being related to different clinical manifestations and pathological features. Atrophic gastritis (resulting mainly from long-standing Helicobacter pylori infection) is a major risk factor for the onset of (intestinal type) gastric cancer. The extent and site of the atrophic changes correlate significantly with the cancer risk. The current format for histology reporting in cases of gastritis fails to establish an immediate link between gastritis phenotype and risk of malignancy. Building on current knowledge of the biology of gastritis, an international group of pathologists [Operative Link for Gastritis Assessment (OLGA)] has proposed a system for reporting gastritis in terms of its stage (the OLGA Staging System): this system places the histological phenotypes of gastritis on a scale of progressively increasing gastric cancer risk, from the lowest (Stage 0) to the highest (Stage IV). The aim of this tutorial is to provide unequivocal information on how to standardize histology reports on gastritis in diagnostic practice. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd.. All rights reserved.

The STARD statement for reporting diagnostic accuracy studies: application to the history and physical examination.

PubMed

Simel, David L; Rennie, Drummond; Bossuyt, Patrick M M

2008-06-01

The Standards for Reporting of Diagnostic Accuracy (STARD) statement provided guidelines for investigators conducting diagnostic accuracy studies. We reviewed each item in the statement for its applicability to clinical examination diagnostic accuracy research, viewing each discrete aspect of the history and physical examination as a diagnostic test. Nonsystematic review of the STARD statement. Two former STARD Group participants and 1 editor of a journal series on clinical examination research reviewed each STARD item. Suggested interpretations and comments were shared to develop consensus. The STARD Statement applies generally well to clinical examination diagnostic accuracy studies. Three items are the most important for clinical examination diagnostic accuracy studies, and investigators should pay particular attention to their requirements: describe carefully the patient recruitment process, describe participant sampling and address if patients were from a consecutive series, and describe whether the clinicians were masked to the reference standard tests and whether the interpretation of the reference standard test was masked to the clinical examination components or overall clinical impression. The consideration of these and the other STARD items in clinical examination diagnostic research studies would improve the quality of investigations and strengthen conclusions reached by practicing clinicians. The STARD statement provides a very useful framework for diagnostic accuracy studies. The group correctly anticipated that there would be nuances applicable to studies of the clinical examination. We offer guidance that should enhance their usefulness to investigators embarking on original studies of a patient's history and physical examination.

A recurrent connectionist model of person impression formation.

PubMed

Van Overwalle, Frank; Labiouse, Christophe

2004-01-01

Major findings in impression formation are reviewed and modeled from a connectionist perspective. The findings are in the areas of primacy and recency in impression formation, asymmetric diagnosticity of ability- and morality-related traits, increased recall for trait-inconsistent information, assimilation and contrast in priming, and discounting of trait inferences by situational information. The majority of these phenomena are illustrated with well-known experiments and simulated with an autoassociative network architecture with linear activation update and using the delta learning algorithm for adjusting the connection weights. All of the simulations successfully reproduced the empirical findings. Moreover, the proposed model is shown to be consistent with earlier algebraic models of impression formation (Anderson, 1981; Busemeyer, 1991; Hogarth and Einhorn, 1992). The discussion centers on how our model compares to other connectionist approaches to impression formation and how it may contribute to a more parsimonious and unified theory of person perception.

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

DOE PAGES

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

2016-01-06

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

Formation and size distribution of self-assembled vesicles

PubMed Central

Huang, Changjin; Quinn, David; Suresh, Subra

2017-01-01

When detergents and phospholipid membranes are dispersed in aqueous solutions, they tend to self-assemble into vesicles of various shapes and sizes by virtue of their hydrophobic and hydrophilic segments. A clearer understanding of such vesiculation processes holds promise for better elucidation of human physiology and disease, and paves the way to improved diagnostics, drug development, and drug delivery. Here we present a detailed analysis of the energetics and thermodynamics of vesiculation by recourse to nonlinear elasticity, taking into account large deformation that may arise during the vesiculation process. The effects of membrane size, spontaneous curvature, and membrane stiffness on vesiculation and vesicle size distribution were investigated, and the critical size for vesicle formation was determined and found to compare favorably with available experimental evidence. Our analysis also showed that the critical membrane size for spontaneous vesiculation was correlated with membrane thickness, and further illustrated how the combined effects of membrane thickness and physical properties influenced the size, shape, and distribution of vesicles. These findings shed light on the formation of physiological extracellular vesicles, such as exosomes. The findings also suggest pathways for manipulating the size, shape, distribution, and physical properties of synthetic vesicles, with potential applications in vesicle physiology, the pathobiology of cancer and other diseases, diagnostics using in vivo liquid biopsy, and drug delivery methods. PMID:28265065

Multi-Wavelength Diagnostics of Starbirth in Starbursts

NASA Astrophysics Data System (ADS)

Waller, William

2005-07-01

From the Orion Nebula to the Hubble Deep Field, starburst activity can be seen transforming galaxian clouds of gas into populous clusters of stars. The pyrotechnics and chemical enrichment associated with this activity have led to outcomes as ubiquitous as interstellar dust and as exquisite as life on Earth. In this talk, I will focus on the circumstances of star formation in the environmental context of ongoing starburst activity. I begin with the premises that (1) the formation of a single star takes time, (2) the formation of a populous cluster takes even more time, and (3) ``stuff'' happens in the interim. Hubble images of the Orion Nebula and Eagle Nebula show how hot stars can excavate neighboring clouds of gas and photoevaporate the star-forming cores that are exposed. Hubble observations of giant HII regions in M33 reveal a significant variation in the stellar populations, such that the most metal-rich HII regions contain the greatest proportions of the most massive stars. ISO and Spitzer observations of these same HII regions reveal corresponding variations in the nebular response. These multi-wavelength diagnostics of the stellar-nebular feedback in galaxian starbursts suggest a star-forming mechanism which is subject to photo-evaporative ablation -- an erosive process that is mediated by the metal abundance and corresponding amounts of protective dust in the starbursting environment.

[Diagnostic and formative assessment of competencies at the beginning of undergraduate medical internship].

PubMed

Martínez-González, Adrián; Lifshitz-Guinzberg, Alberto; Trejo-Mejía, Juan Andrés; Torruco-García, Uri; Fortoul-van der Goes, Teresa I; Flores-Hernández, Fernando; Peña-Balderas, Jorge; Martínez-Franco, Adrián Israel; Hernández-Nava, Alejandro; Elena-González, Diana; Sánchez-Mendiola, Melchor

2017-01-01

Research on diagnostic and formative assessment competencies during undergraduate medical training is scarce in Latin America. To assess the level of clinical competence of students at the beginning of their medical internship in a new curriculum. This was an observational cross-sectional study in UNAM Faculty of Medicine students in Mexico City: a formative assessment of the second class of Curriculum 2010 students as part of the integral evaluation of the program. The assessment had two components: theoretical and practical. We assessed 577 students (65.5%) of the 880 total population that finished the 9th semester of Curriculum 2010. The written exam consisted of 232 items, with a mean of 61.0 ± 19.6, a difficulty index of 0.61, and Cronbach's alpha of 0.89. The mean of the objective structured clinical examination (OSCE) was 62.2 ± 16.8, with a mean Cronbach's alpha of 0.51. Results were analyzed by knowledge area and exam stations. The overall results provide evidence that students achieve sufficiently the competencies established in the curriculum at the beginning of the internship, that they have the necessary foundation for learning new and more complex information, and integrate it with existing knowledge to achieve significant learning and continue their training.

MultiNet TCP/P/IP for VAX/VMS update

NASA Technical Reports Server (NTRS)

Vance, L. Stuart

1991-01-01

Outlines of device support; DECnet interoperability; installation; MultiNet services; domain name server; Telnet; FTP; SMTP; DECwindows over TCP/IP; BSD r services; remote printing; RPC services and NFS server; NFS client; netcontrol; diagnostics; programming support; and MultiNet features are presented in viewgraph format.

Attention Deficit Disorder. NICHCY Briefing Paper.

ERIC Educational Resources Information Center

Fowler, Mary

This briefing paper uses a question-and-answer format to provide basic information about children with attention deficit disorder (ADD). Questions address the following concerns: nature and incidence of ADD; causes of ADD; signs of ADD (impulsivity, hyperactivity, disorganization, social skill deficits); the diagnostic ADD assessment; how to get…

Reviews of Selected System and Software Tools for Strategic Defense Applications

DTIC Science & Technology

1990-02-01

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

Development of a diagnostic test set to assess agreement in breast pathology: practical application of the Guidelines for Reporting Reliability and Agreement Studies (GRRAS).

PubMed

Oster, Natalia V; Carney, Patricia A; Allison, Kimberly H; Weaver, Donald L; Reisch, Lisa M; Longton, Gary; Onega, Tracy; Pepe, Margaret; Geller, Berta M; Nelson, Heidi D; Ross, Tyler R; Tosteson, Aanna N A; Elmore, Joann G

2013-02-05

Diagnostic test sets are a valuable research tool that contributes importantly to the validity and reliability of studies that assess agreement in breast pathology. In order to fully understand the strengths and weaknesses of any agreement and reliability study, however, the methods should be fully reported. In this paper we provide a step-by-step description of the methods used to create four complex test sets for a study of diagnostic agreement among pathologists interpreting breast biopsy specimens. We use the newly developed Guidelines for Reporting Reliability and Agreement Studies (GRRAS) as a basis to report these methods. Breast tissue biopsies were selected from the National Cancer Institute-funded Breast Cancer Surveillance Consortium sites. We used a random sampling stratified according to woman's age (40-49 vs. ≥50), parenchymal breast density (low vs. high) and interpretation of the original pathologist. A 3-member panel of expert breast pathologists first independently interpreted each case using five primary diagnostic categories (non-proliferative changes, proliferative changes without atypia, atypical ductal hyperplasia, ductal carcinoma in situ, and invasive carcinoma). When the experts did not unanimously agree on a case diagnosis a modified Delphi method was used to determine the reference standard consensus diagnosis. The final test cases were stratified and randomly assigned into one of four unique test sets. We found GRRAS recommendations to be very useful in reporting diagnostic test set development and recommend inclusion of two additional criteria: 1) characterizing the study population and 2) describing the methods for reference diagnosis, when applicable.

Important clinical descriptors to include in the examination and assessment of patients with femoroacetabular impingement syndrome: an international and multi-disciplinary Delphi survey.

PubMed

Reiman, M P; Thorborg, K; Covington, K; Cook, C E; Hölmich, P

2017-06-01

Determine which examination findings are key clinical descriptors of femoroacetabular impingement syndrome (FAIS) through use of an international, multi-disciplinary expert panel. A three-round Delphi survey utilizing an international, multi-disciplinary expert panel operationally defined from international publications and presentations was utilized. All six domains (subjective examination, patient-reported outcome measures, physical examination, special tests, physical performance measures, and diagnostic imaging) had at least one descriptor with 75% consensus agreement for diagnosis and assessment of FAIS. Diagnostic imaging was the domain with the highest level of agreement. Domains such as patient-reported outcome measures (PRO's) and physical examination were identified as non-diagnostic measures (rather as assessments of disease impact). Although it also had the greatest level of variability in description of examination domains, diagnostic imaging continues to be the preeminent diagnostic measure for FAIS. No single domain should be utilized as the sole diagnostic or assessment parameter for FAIS. While not all investigated domains provide diagnostic capability for FAIS, those that do not are able to serve purpose as a measure of disease impact (e.g., impairments and activity limitations). The clinical relevance of this Delphi survey is the understanding that a comprehensive assessment measuring both diagnostic capability and disease impact most accurately reflects the patient with FAIS. V.

Strategies in Interventional Radiology: Formation of an Interdisciplinary Center of Vascular Anomalies - Chances and Challenges for Effective and Efficient Patient Management.

PubMed

Sadick, Maliha; Dally, Franz Josef; Schönberg, Stefan O; Stroszczynski, Christian; Wohlgemuth, Walter A

2017-10-01

Background  Radiology is an interdisciplinary field dedicated to the diagnosis and treatment of numerous diseases and is involved in the development of multimodal treatment concepts. Method  Interdisciplinary case management, a broad spectrum of diagnostic imaging facilities and dedicated endovascular radiological treatment options are valuable tools that allow radiology to set up an interdisciplinary center for vascular anomalies. Results  Image-based diagnosis combined with endovascular treatment options is an essential tool for the treatment of patients with highly complex vascular diseases. These vascular anomalies can affect numerous parts of the body so that a multidisciplinary treatment approach is required for optimal patient care. Conclusion  This paper discusses the possibilities and challenges regarding effective and efficient patient management in connection with the formation of an interdisciplinary center for vascular anomalies with strengthening of the clinical role of radiologists. Key points   · Vascular anomalies, which include vascular tumors and malformations, are complex to diagnose and treat.. · There are far more patients with vascular anomalies requiring therapy than interdisciplinary centers for vascular anomalies - there is currently a shortage of dedicated interdisciplinary centers for vascular anomalies in Germany that can provide dedicated care for affected patients.. · Radiology includes a broad spectrum of diagnostic and minimally invasive therapeutic tools which allow the formation of an interdisciplinary center for vascular anomalies for effective, efficient and comprehensive patient management.. Citation Format · Sadick M, Dally FJ, Schönberg SO et al. Strategies in Interventional Radiology: Formation of an Interdisciplinary Center of Vascular Anomalies - Chances and Challenges for Effective and Efficient Patient Management. Fortschr Röntgenstr 2017; 189: 957 - 966. © Georg Thieme Verlag KG Stuttgart · New York.

Diagnostic Exercise: Neurologic Disorder in a Cat

DTIC Science & Technology

1989-12-21

IWORK UNIT ELEMENT NO. NO. NO. ACCESSION NO. 11. TITLE (Include Security Classification) Diagnostic Exercise - Neurologic Disorder in a Cat 12...and identify by block number) This report documents the fifth reported occurrance of cerebral phaeophyphomycosis in cats . Because mycotic...Exercise: Neurologic Disorder in a Cat Ronald C. Bell United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick

Laser program annual report, 1979

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

Coleman, L.W.; Strack, J.R.

1980-03-01

This volume contains four sections that covers the areas of target design, target fabrication, diagnostics, and experiments. Section 3 reports on target design activities, plasma theory and simulation, code development, and atomic theory. Section 4 presents the accomplishments of the target fabrication group, and Section 5 presents results of diagnostic developments and applications for the year. The results of laser-target experiments are presented. (MOW)

Assessing Autism in Adults: An Evaluation of the Developmental, Dimensional and Diagnostic Interview-Adult Version (3Di-Adult)

ERIC Educational Resources Information Center

Mandy, William; Clarke, Kiri; McKenner, Michele; Strydom, Andre; Crabtree, Jason; Lai, Meng-Chuan; Allison, Carrie; Baron-Cohen, Simon; Skuse, David

2018-01-01

We developed a brief, informant-report interview for assessing autism spectrum conditions (ASC) in adults, called the Developmental, Dimensional and Diagnostic Interview-Adult Version (3Di-Adult); and completed a preliminary evaluation. Informant reports were collected for participants with ASC (n = 39), a non-clinical comparison group (n = 29)…

Acute Hemorrhage into Adrenal Pseudocyst Presenting with Shock: Diagnostic Dilemmas — Report of Three Cases and Review of Literature

PubMed Central

Sivasankar, Amarapathy; Jeswanth, Sathyanesan; Johnson, Maria Antony; Ravichandran, Palaniappan; Rajendran, Shanmugasundaram; Kannan, Devy Gounder; Surendran, Rajagopal

2006-01-01

We report three cases of acutely bleeding adrenal pseudocysts presenting as hemorrhagic shock. Pregnancy was associated in two cases. The diagnostic dilemmas are discussed with special reference to their unusual presentations, diagnosis, and treatment. We believe that our cases, complicated by intracystic hemorrhage, may be related to pregnancy. PMID:17619705

Equivalency of the DINA Model and a Constrained General Diagnostic Model. Research Report. ETS RR-11-37

ERIC Educational Resources Information Center

von Davier, Matthias

2011-01-01

This report shows that the deterministic-input noisy-AND (DINA) model is a special case of more general compensatory diagnostic models by means of a reparameterization of the skill space and the design (Q-) matrix of item by skills associations. This reparameterization produces a compensatory model that is equivalent to the (conjunctive) DINA…

Colorectal Cancer Initial Diagnosis: Screening Colonoscopy, Diagnostic Colonoscopy, or Emergent Surgery, and Tumor Stage and Size at Initial Presentation.

PubMed

Moreno, Courtney C; Mittal, Pardeep K; Sullivan, Patrick S; Rutherford, Robin; Staley, Charles A; Cardona, Kenneth; Hawk, Natalyn N; Dixon, W Thomas; Kitajima, Hiroumi D; Kang, Jian; Small, William C; Oshinski, John; Votaw, John R

2016-03-01

Rates of colorectal cancer screening are improving but remain suboptimal. Limited information is available regarding how patients are diagnosed with colorectal cancer (for example, asymptomatic screened patients or diagnostic workup because of the presence of symptoms). The purpose of this investigation was to determine how patients were diagnosed with colorectal cancer (screening colonoscopy, diagnostic colonoscopy, or emergent surgery) and tumor stage and size at diagnosis. Adults evaluated between 2011 and 2014 with a diagnosis of colorectal cancer were identified. Clinical notes, endoscopy reports, surgical reports, radiology reports, and pathology reports were reviewed. Sex, race, ethnicity, age at the time of initial diagnosis, method of diagnosis, presenting symptom(s), and primary tumor size and stage at diagnosis were recorded. Colorectal cancer screening history was also recorded. The study population was 54% male (265 of 492) with a mean age of 58.9 years (range, 25-93 years). Initial tissue diagnosis was established at the time of screening colonoscopy in 10.7%, diagnostic colonoscopy in 79.2%, and during emergent surgery in 7.1%. Cancers diagnosed at the time of screening colonoscopy were more likely to be stage 1 than cancers diagnosed at the time of diagnostic colonoscopy or emergent surgery (38.5%, 7.2%, and 0%, respectively). Median tumor size was 3.0 cm for the screening colonoscopy group, 4.6 cm for the diagnostic colonoscopy group, and 5.0 cm for the emergent surgery group. At least 31% of patients diagnosed at the time of screening colonoscopy, 19% of patients diagnosed at the time of diagnostic colonoscopy, and 26% of patients diagnosed at the time of emergent surgery had never undergone a screening colonoscopy. Nearly 90% of colorectal cancer patients were diagnosed after development of symptoms and had more advanced disease than asymptomatic screening patients. Colorectal cancer outcomes will be improved by improving rates of colorectal cancer screening. Copyright © 2016 Elsevier Inc. All rights reserved.

Effects of Training on the Test of Diagnostic Skills. Publication No. 30.

ERIC Educational Resources Information Center

Haley, John V.

This report summarizes research performed on the Test of Diagnostic Skills, used to evaluate the clinical diagnostic skills of medical students. Forms of the test were administered to groups at different levels of medical experience to ascertain the effect of training on performance. A cross-sectional study was conducted with approximately 90…

Counselor-Client Diagnostic Agreement and Perceived Outcomes of Counseling: A Progress Report.

ERIC Educational Resources Information Center

Hurst, James C.; And Others

This study was designed to investigate the effect of congruity of counselor and client diagnoses upon client-perceived success in counseling. The Missouri Diagnostic Classification Plan (MDCP) was used as the basic diagnostic method. Agreement in the 15 categories was related to client-perceived success of counseling. Subjects, all clients at the…

Descendants of the first stars: the distinct chemical signature of second generation stars

NASA Astrophysics Data System (ADS)

Hartwig, Tilman; Yoshida, Naoki; Magg, Mattis; Frebel, Anna; Glover, Simon C. O.; Gómez, Facundo A.; Griffen, Brendan; Ishigaki, Miho N.; Ji, Alexander P.; Klessen, Ralf S.; O'Shea, Brian W.; Tominaga, Nozomu

2018-05-01

Extremely metal-poor (EMP) stars in the Milky Way (MW) allow us to infer the properties of their progenitors by comparing their chemical composition to the metal yields of the first supernovae. This method is most powerful when applied to mono-enriched stars, i.e. stars that formed from gas that was enriched by only one previous supernova. We present a novel diagnostic to identify this subclass of EMP stars. We model the first generations of star formation semi-analytically, based on dark matter halo merger trees that yield MW-like halos at the present day. Radiative and chemical feedback are included self-consistently and we trace all elements up to zinc. Mono-enriched stars account for only ˜1% of second generation stars in our fiducial model and we provide an analytical formula for this probability. We also present a novel analytical diagnostic to identify mono-enriched stars, based on the metal yields of the first supernovae. This new diagnostic allows us to derive our main results independently from the specific assumptions made regarding Pop III star formation, and we apply it to a set of observed EMP stars to demonstrate its strengths and limitations. Our results may provide selection criteria for current and future surveys and therefore contribute to a deeper understanding of EMP stars and their progenitors.

NASA's Global Change Master Directory: Discover and Access Earth Science Data Sets, Related Data Services, and Climate Diagnostics

NASA Technical Reports Server (NTRS)

Aleman, Alicia; Olsen, Lola; Ritz, Scott; Morahan, Michael; Cepero, Laurel; Stevens, Tyler

2011-01-01

NASA's Global Change Master Directory provides the scientific community with the ability to discover, access, and use Earth science data, data-related services, and climate diagnostics worldwide. The GCMD offers descriptions of Earth science data sets using the Directory Interchange Format (DIF) metadata standard; Earth science related data services are described using the Service Entry Resource Format (SERF); and climate visualizations are described using the Climate Diagnostic (CD) standard. The DIF, SERF and CD standards each capture data attributes used to determine whether a data set, service, or climate visualization is relevant to a user's needs. Metadata fields include: title, summary, science keywords, service keywords, data center, data set citation, personnel, instrument, platform, quality, related URL, temporal and spatial coverage, data resolution and distribution information. In addition, nine valuable sets of controlled vocabularies have been developed to assist users in normalizing the search for data descriptions. An update to the GCMD's search functionality is planned to further capitalize on the controlled vocabularies during database queries. By implementing a dynamic keyword "tree", users will have the ability to search for data sets by combining keywords in new ways. This will allow users to conduct more relevant and efficient database searches to support the free exchange and re-use of Earth science data. http://gcmd.nasa.gov/

A facility for gas- and condensed-phase measurements behind shock waves

NASA Astrophysics Data System (ADS)

Petersen, Eric L.; Rickard, Matthew J. A.; Crofton, Mark W.; Abbey, Erin D.; Traum, Matthew J.; Kalitan, Danielle M.

2005-09-01

A shock-tube facility consisting of two, single-pulse shock tubes for the study of fundamental processes related to gas-phase chemical kinetics and the formation and reaction of solid and liquid aerosols at elevated temperatures is described. Recent upgrades and additions include a new high-vacuum system, a new gas-handling system, a new control system and electronics, an optimized velocity-detection scheme, a computer-based data acquisition system, several optical diagnostics, and new techniques and procedures for handling experiments involving gas/powder mixtures. Test times on the order of 3 ms are possible with reflected-shock pressures up to 100 atm and temperatures greater than 4000 K. Applications for the shock-tube facility include the study of ignition delay times of fuel/oxidizer mixtures, the measurement of chemical kinetic reaction rates, the study of fundamental particle formation from the gas phase, and solid-particle vaporization, among others. The diagnostic techniques include standard differential laser absorption, FM laser absorption spectroscopy, laser extinction for particle volume fraction and size, temporally and spectrally resolved emission from gas-phase species, and a scanning mobility particle sizer for particle size distributions. Details on the set-up and operation of the shock tube and diagnostics are given, the results of a detailed uncertainty analysis on the accuracy of the test temperature inferred from the incident-shock velocity are provided, and some recent results are presented.

Dark Candles of the Universe: Black Hole Observations

NASA Astrophysics Data System (ADS)

Aykutalp, Aycin

2016-03-01

In 1916, when Karl Schwarzschild solved the Einstein field equations of general relativity for a spherically symmetric, non-rotating mass no one anticipated the impact black holes would have on astrophysics. I will review the main formation channels for black hole seeds and their evolution through cosmic time. In this, emphasis will be placed on the observational diagnostics of astrophysical black holes and their role on the assembly of galaxy formation and evolution. I then review how these observations put constrain on the seed black hole formation theories. Finally, I present an outlook for how future observations can shed light on our understanding of black holes. This work is supported by NSF Grant AST-1333360.

Diagnostic orphans: comparing self-report lifetime course to groups with DSM-IV alcohol abuse and dependence.

PubMed

McBride, Orla; Adamson, Gary; Bunting, Brendan; McCann, Siobhan

2009-01-01

Research has highlighted the significant alcohol symptoms and mental health problems experienced by diagnostic orphans - individuals who experience 1-2 criteria of DSM-IV alcohol dependence but do not meet the criteria for a DSM-IV alcohol use disorder. This study used a sub-sample (n=34827) from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), and formed mutually exclusive groups to compare the self-report retrospective course of diagnostic orphans to individuals with DSM-IV abuse and dependence. Multinomial logistic regressions were conducted to examine the associations between the groups and a range of demographic and clinical variables. Collectively, the findings demonstrate that diagnostic orphans shared similar characteristics to the abuse and dependence groups, but appeared to experience specific comorbid mental health problems. Orphan status has the potential to be a persistent condition and may result in significant dysfunction. In conclusion, diagnostic orphans represent a distinct group that may benefit from cost-effective treatment or intervention, designed to prevent the escalation of alcohol symptoms.

American Pancreatic Association Practice Guidelines in Chronic Pancreatitis: evidence-based report on diagnostic guidelines.

PubMed

Conwell, Darwin L; Lee, Linda S; Yadav, Dhiraj; Longnecker, Daniel S; Miller, Frank H; Mortele, Koenraad J; Levy, Michael J; Kwon, Richard; Lieb, John G; Stevens, Tyler; Toskes, Phillip P; Gardner, Timothy B; Gelrud, Andres; Wu, Bechien U; Forsmark, Christopher E; Vege, Santhi S

2014-11-01

The diagnosis of chronic pancreatitis remains challenging in early stages of the disease. This report defines the diagnostic criteria useful in the assessment of patients with suspected and established chronic pancreatitis. All current diagnostic procedures are reviewed, and evidence-based statements are provided about their utility and limitations. Diagnostic criteria for chronic pancreatitis are classified as definitive, probable, or insufficient evidence. A diagnostic (STEP-wise; survey, tomography, endoscopy, and pancreas function testing) algorithm is proposed that proceeds from a noninvasive to a more invasive approach. This algorithm maximizes specificity (low false-positive rate) in subjects with chronic abdominal pain and equivocal imaging changes. Furthermore, a nomenclature is suggested to further characterize patients with established chronic pancreatitis based on TIGAR-O (toxic, idiopathic, genetic, autoimmune, recurrent, and obstructive) etiology, gland morphology (Cambridge criteria), and physiologic state (exocrine, endocrine function) for uniformity across future multicenter research collaborations. This guideline will serve as a baseline manuscript that will be modified as new evidence becomes available and our knowledge of chronic pancreatitis improves.

Textual standardization and the DSM-5 "common language".

PubMed

Kelly, Patty A

2014-06-01

In February 2010, the American Psychiatric Association (APA) launched their DSM-5 website with details about the development of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The APA invited "the general public" to review the draft diagnostic criteria and provide written comments and suggestions. This revision marks the first time the APA has solicited public review of their diagnostic manual. This article analyzes reported speech on the DSM-5 draft diagnostic criteria for the classification Posttraumatic Stress Disorder. It demonstrates how textual standardization facilitates the cultural portability of the DSM-5 diagnostic criteria such that a community of speakers beyond the borders of the APA come to be seen as exemplary speakers, writers, and revisers of the professional style. Furthermore, analysis shows how co-authoring practices recontextualize the "voice" and persona of putative patient reported speech on Criterion D2. As a consequence of textual standardization, spoken discourse becomes recontextualized as the product of scientific inquiry and the organization of psychiatric knowledge.

A case of misdiagnosis of mild cognitive impairment: The utility of symptom validity testing in an outpatient memory clinic.

PubMed

Roor, Jeroen J; Dandachi-FitzGerald, Brechje; Ponds, Rudolf W H M

2016-01-01

Noncredible symptom reports hinder the diagnostic process. This fact is especially the case for medical conditions that rely on subjective report of symptoms instead of objective measures. Mild cognitive impairment (MCI) primarily relies on subjective report, which makes it potentially susceptible to erroneous diagnosis. In this case report, we describe a 59-year-old female patient diagnosed with MCI 10 years previously. The patient was referred to the neurology department for reexamination by her general practitioner because of cognitive complaints and persistent fatigue. This case study used information from the medical file, a new magnetic resonance imaging brain scan, and neuropsychological assessment. Current neuropsychological assessment, including symptom validity tests, clearly indicated noncredible test performance, thereby invalidating the obtained neuropsychological test data. We conclude that a blind spot for noncredible symptom reports existed in the previous diagnostic assessments. This case highlights the usefulness of formal symptom validity testing in the diagnostic assessment of MCI.

Reference intervals and diagnostic ranges for serum free κ and free λ immunoglobulin light chains vary by instrument platform: Implications for classification of patient results in a multi-center study.

PubMed

Cotten, Steven W; Shajani-Yi, Zahra; Cervinski, Mark A; Voorhees, Timothy; Tuchman, Sascha A; Korpi-Steiner, Nichole

2018-06-06

Serum free light chain (FLC) immunoglobulins are key biomarkers that aid in the diagnosis, prognosis and assessment of treatment response in patients with plasma cell disorders (PCD). Here we investigated the transference of manufacturer's reported κFLC, λFLC and κ to λ FLC reference intervals (RI) and established de novo FLC RI and diagnostic ranges on four instruments at three academic medical centers. In addition, we also compared the classification of patient FLC results using manufacturer's versus established RIs and diagnostic ranges. CLSI EP28-A3C protocol was applied to investigate transference and establishment of FLC reference intervals on the cobas (Roche), Immage (Beckman), Optilite and SPA Plus (Binding Site). Serum κ FLC and λ FLC were measured in reference sera (N = 126) with estimation of central 95% RIs and FLC ratio diagnostic range (total range). Frequencies (%) in patient FLC results (N > 380 per institution) classified above, below or within manufacturer's versus established FLC RI were compared. Three of four instrument platforms did not exhibit acceptable transference of manufacturer's reported κFLC RI. The manufacturer's reported FLC total diagnostic range did not encompass all values observed in reference sera for any of the four platforms evaluated. Established FLC ratio diagnostic ranges reduced the frequency of patient results classified above range for three of four platforms evaluated. Transference of manufacturer's reported FLC RIs may be inappropriate for select instrument platforms. De novo establishment of FLC RIs specific to instrument platform is highly recommended in order to assure correct patient result classification. Copyright © 2017. Published by Elsevier Inc.

Evidence assessing the diagnostic performance of medical smartphone apps: a systematic review and exploratory meta-analysis.

PubMed

Buechi, Rahel; Faes, Livia; Bachmann, Lucas M; Thiel, Michael A; Bodmer, Nicolas S; Schmid, Martin K; Job, Oliver; Lienhard, Kenny R

2017-12-14

The number of mobile applications addressing health topics is increasing. Whether these apps underwent scientific evaluation is unclear. We comprehensively assessed papers investigating the diagnostic value of available diagnostic health applications using inbuilt smartphone sensors. Systematic Review-MEDLINE, Scopus, Web of Science inclusive Medical Informatics and Business Source Premier (by citation of reference) were searched from inception until 15 December 2016. Checking of reference lists of review articles and of included articles complemented electronic searches. We included all studies investigating a health application that used inbuilt sensors of a smartphone for diagnosis of disease. The methodological quality of 11 studies used in an exploratory meta-analysis was assessed with the Quality Assessment of Diagnostic Accuracy Studies 2 tool and the reporting quality with the 'STAndards for the Reporting of Diagnostic accuracy studies' (STARD) statement. Sensitivity and specificity of studies reporting two-by-two tables were calculated and summarised. We screened 3296 references for eligibility. Eleven studies, most of them assessing melanoma screening apps, reported 17 two-by-two tables. Quality assessment revealed high risk of bias in all studies. Included papers studied 1048 subjects (758 with the target conditions and 290 healthy volunteers). Overall, the summary estimate for sensitivity was 0.82 (95 % CI 0.56 to 0.94) and 0.89 (95 %CI 0.70 to 0.97) for specificity. The diagnostic evidence of available health apps on Apple's and Google's app stores is scarce. Consumers and healthcare professionals should be aware of this when using or recommending them. 42016033049. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Systematic Review of Health Economic Evaluations of Diagnostic Tests in Brazil: How accurate are the results?

PubMed

Oliveira, Maria Regina Fernandes; Leandro, Roseli; Decimoni, Tassia Cristina; Rozman, Luciana Martins; Novaes, Hillegonda Maria Dutilh; De Soárez, Patrícia Coelho

2017-08-01

The aim of this study is to identify and characterize the health economic evaluations (HEEs) of diagnostic tests conducted in Brazil, in terms of their adherence to international guidelines for reporting economic studies and specific questions in test accuracy reports. We systematically searched multiple databases, selecting partial and full HEEs of diagnostic tests, published between 1980 and 2013. Two independent reviewers screened articles for relevance and extracted the data. We performed a qualitative narrative synthesis. Forty-three articles were reviewed. The most frequently studied diagnostic tests were laboratory tests (37.2%) and imaging tests (32.6%). Most were non-invasive tests (51.2%) and were performed in the adult population (48.8%). The intended purposes of the technologies evaluated were mostly diagnostic (69.8%), but diagnosis and treatment and screening, diagnosis, and treatment accounted for 25.6% and 4.7%, respectively. Of the reviewed studies, 12.5% described the methods used to estimate the quantities of resources, 33.3% reported the discount rate applied, and 29.2% listed the type of sensitivity analysis performed. Among the 12 cost-effectiveness analyses, only two studies (17%) referred to the application of formal methods to check the quality of the accuracy studies that provided support for the economic model. The existing Brazilian literature on the HEEs of diagnostic tests exhibited reasonably good performance. However, the following points still require improvement: 1) the methods used to estimate resource quantities and unit costs, 2) the discount rate, 3) descriptions of sensitivity analysis methods, 4) reporting of conflicts of interest, 5) evaluations of the quality of the accuracy studies considered in the cost-effectiveness models, and 6) the incorporation of accuracy measures into sensitivity analyses.

Replacing Myalgic Encephalomyelitis and Chronic Fatigue Syndrome with Systemic Exercise Intolerance Disease Is Not the Way forward

PubMed Central

Twisk, Frank N.M.

2016-01-01

Myalgic encephalomyelitis (ME), described in the medical literature since 1938, is characterized by distinctive muscular symptoms, neurological symptoms, and signs of circulatory impairment. The only mandatory feature of chronic fatigue syndrome (CFS), introduced in 1988 and redefined in 1994, is chronic fatigue, which should be accompanied by at least four or more out of eight “additional” symptoms. The use of the abstract, polythetic criteria of CFS, which define a heterogeneous patient population, and self-report has hampered both scientific progress and accurate diagnosis. To resolve the “diagnostic impasse” the Institute of Medicine proposes that a new clinical entity, systemic exercise intolerance disease (SEID), should replace the clinical entities ME and CFS. However, adopting SEID and its defining symptoms, does not resolve methodological and diagnostic issues. Firstly, a new diagnostic entity cannot replace two distinct, partially overlapping, clinical entities such as ME and CFS. Secondly, due to the nature of the diagnostic criteria, the employment of self-report, and the lack of criteria to exclude patients with other conditions, the SEID criteria seem to select an even more heterogeneous patient population, causing additional diagnostic confusion. This article discusses methodological and diagnostic issues related to SEID and proposes a methodological solution for the current “diagnostic impasse”. PMID:26861399

Measurement properties of screening and diagnostic tools for autism spectrum adults of mean normal intelligence: A systematic review.

PubMed

Baghdadli, A; Russet, F; Mottron, L

2017-07-01

The autism spectrum (AS) is a multifaceted neurodevelopmental variant associated with lifelong challenges. Despite the relevant importance of identifying AS in adults for epidemiological, public health, and quality of life issues, the measurement properties of the tools currently used to screen and diagnose adults without intellectual disabilities (ID) have not been assessed. This systematic review addresses the accuracy, reliability, and validity of the reported AS screening and diagnostic tools used in adults without ID. Electronic databases and bibliographies were searched, and identified papers evaluated against inclusion criteria. The PRISMA statement was used for reporting the review. We evaluated the quality of the papers using the COSMIN Checklist for psychometric data, and QUADAS-2 for diagnostic data. For the COSMIN assessment, evidence was considered to be strong when several methodologically good articles, or one excellent article, reported consistent evidence for or against a measurement property. For the QUADAS ratings, evidence was considered to be "satisfactory" if at least one study was rated with a low risk of bias and low concern about applicability. We included 38 articles comprising 32 studies, five reviews, and one book chapter and assessed nine tools (three diagnostic and six screening, including eight of their short versions). Among screening tools, only AQ-50, AQ-S, and RAADS-R and RAADS-14 were found to provide satisfactory or intermediate values for their psychometric properties, supported by strong or moderate evidence. Nevertheless, risks of bias and concerns on the applicability of these tools limit the evidence on their diagnostic properties. We found that none of the gold standard diagnostic tools used for children had satisfactory measurement properties. There is limited evidence for the measurement properties of the screening and diagnostic tools used for AS adults with a mean normal range of measured intelligence. This may lessen the validity of conclusions and public health decisions on an important fraction of the adult autistic population. This not only justifies further validation studies of screening and diagnostic tools for autistic adults, but also supports the parallel use of self-reported information and clinical expertise with these instruments during the diagnostic process. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Second topical conference on high-temperature plasma diagnostics

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

Jahoda, F.C.; Freese, K.B.

1978-02-01

This report contains the program and abstracts of papers presented at the Second American Physical Society Topical Conference on High Temperature Plasma Diagnostics, March 1-3, 1978, Santa Fe, New Mexico.

Laser program annual report, 1980

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

Coleman, L.W.; Krupke, W.F.; Strack, J.R.

1981-06-01

Volume 2 contains five sections that cover the areas of target design, target fabrication, diagnostics, and fusion experiments. Section 3 reports on target design activities, plasma theory and simulation, code development, and atomic theory. Section 4 presents the accomplishments of the Target Fabrication Group, Section 5 contains the results of our diagnostics development, and Section 6 describes advances made in the management and analysis of experimental data. Finally, Section 7 in Volume 2 reports the results of laser target experiments conducted during the year.

Heterocyclic Scaffolds for the Treatment of Alzheimer's Disease.

PubMed

Martorana, Annamaria; Giacalone, Valentina; Bonsignore, Riccardo; Pace, Andrea; Gentile, Carla; Pibiri, Ivana; Buscemi, Silvestre; Lauria, Antonino; Piccionello, Antonio Palumbo

2016-01-01

The treatment and diagnosis of Alzheimer's Disease (AD) are two of the most urgent goals for research around the world. The cognitive decline is generally associated with the elevated levels of extracellular senile plaques, intracellular neurofibrillary tangles (NFTs), and with a progressive shutdown of the cholinergic basal forebrain neurons transmission. Even if several key targets are under fervent investigation in the cure of AD, till now, the only approved therapeutic strategy is the treatment of symptoms by using cholinesterases inhibitors. It has been demonstrated that both acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) enzymes are not only responsible of acetylcholine levels, but also play an pivotal role in Aβ-aggregation during the early stages of senile plaque formation. On the other hand the difficult management of AD is also related to effective diagnostic methods and efficient assays for the study of pathological features. In such complex a wide framework, heterocyclic molecules are essential backbone to build new and selective drugs as well as diagnostic probes. The goal of this review is to examine a selected sample of relevant applications of five- and six-membered heterocycles in AD's therapeutic approaches. Concerning the research on AD, the contribution of heterocyclic compounds is huge and here we report some representative examples. The review is organized in two main sections focused on five and six-membered heterocycles. The analyzed cases have been classified on the base of the structural features of molecules, taking into account the progressive increase in heteroatoms number. The discovery of an effective therapy or a diagnostic protocol for AD is still far, but consistent improvements are underway and contribution of heterocyclic compounds will be consistent and hopefully determinant.

Inter-observer agreement for diagnostic classification of esophageal motility disorders defined in high-resolution manometry.

PubMed

Fox, M R; Pandolfino, J E; Sweis, R; Sauter, M; Abreu Y Abreu, A T; Anggiansah, A; Bogte, A; Bredenoord, A J; Dengler, W; Elvevi, A; Fruehauf, H; Gellersen, S; Ghosh, S; Gyawali, C P; Heinrich, H; Hemmink, M; Jafari, J; Kaufman, E; Kessing, K; Kwiatek, M; Lubomyr, B; Banasiuk, M; Mion, F; Pérez-de-la-Serna, J; Remes-Troche, J M; Rohof, W; Roman, S; Ruiz-de-León, A; Tutuian, R; Uscinowicz, M; Valdovinos, M A; Vardar, R; Velosa, M; Waśko-Czopnik, D; Weijenborg, P; Wilshire, C; Wright, J; Zerbib, F; Menne, D

2015-01-01

High-resolution esophageal manometry (HRM) is a recent development used in the evaluation of esophageal function. Our aim was to assess the inter-observer agreement for diagnosis of esophageal motility disorders using this technology. Practitioners registered on the HRM Working Group website were invited to review and classify (i) 147 individual water swallows and (ii) 40 diagnostic studies comprising 10 swallows using a drop-down menu that followed the Chicago Classification system. Data were presented using a standardized format with pressure contours without a summary of HRM metrics. The sequence of swallows was fixed for each user but randomized between users to avoid sequence bias. Participants were blinded to other entries. (i) Individual swallows were assessed by 18 practitioners (13 institutions). Consensus agreement (≤ 2/18 dissenters) was present for most cases of normal peristalsis and achalasia but not for cases of peristaltic dysmotility. (ii) Diagnostic studies were assessed by 36 practitioners (28 institutions). Overall inter-observer agreement was 'moderate' (kappa 0.51) being 'substantial' (kappa > 0.7) for achalasia type I/II and no lower than 'fair-moderate' (kappa >0.34) for any diagnosis. Overall agreement was somewhat higher among those that had performed >400 studies (n = 9; kappa 0.55) and 'substantial' among experts involved in development of the Chicago Classification system (n = 4; kappa 0.66). This prospective, randomized, and blinded study reports an acceptable level of inter-observer agreement for HRM diagnoses across the full spectrum of esophageal motility disorders for a large group of clinicians working in a range of medical institutions. Suboptimal agreement for diagnosis of peristaltic motility disorders highlights contribution of objective HRM metrics. © 2014 International Society for Diseases of the Esophagus.

The Individual Basic Facts Assessment Tool

ERIC Educational Resources Information Center

Tait-McCutcheon, Sandi; Drake, Michael

2015-01-01

There is an identified and growing need for a levelled diagnostic basic facts assessment tool that provides teachers with formative information about students' mastery of a broad range of basic fact sets. The Individual Basic Facts Assessment tool has been iteratively and cumulatively developed, trialled, and refined with input from teachers and…

Assessment and Learning Technologies: An Overview

ERIC Educational Resources Information Center

Farrell, Treasa; Rushby, Nick

2016-01-01

Assessment pervades the learning process. This paper provides an overview of the application of technology to support and enhance diagnostic, formative and summative assessment. The focus is on examining how it can replace what already exists, improve the functionality, catalyse a redesign of the process and in some circumstances, make possible…

E-Assessment Data Compatibility Resolution Methodology with Bidirectional Data Transformation

ERIC Educational Resources Information Center

Malik, Kaleem Razzaq; Ahmad, Tauqir

2017-01-01

Electronic Assessment (E-Assessment) also known as computer aided assessment for the purposes involving diagnostic, formative or summative examining using data analysis. Digital assessments come commonly from social, academic, and adaptive learning in machine readable forms to deliver the machine scoring function. To achieve real-time and smart…

A General Cognitive Diagnosis Model for Continuous-Response Data

ERIC Educational Resources Information Center

Minchen, Nathan; de la Torre, Jimmy

2018-01-01

Cognitive diagnosis models (CDMs) allow for the extraction of fine-grained, multidimensional diagnostic information from appropriately designed tests. In recent years, interest in such models has grown as formative assessment grows in popularity. Many dichotomous as well as several polytomous CDMs have been proposed in the last two decades, but…

Achievement Testing--A Look at Trends.

ERIC Educational Resources Information Center

Bligh, Harold F.

The strengths and weakness of standardized tests, and trends in achievement testing in the last 15 years are examined. The discussion of achievement tests includes survey, instructional, diagnostic, and basic skills tests, as well as tests used for formative and summative evaluation. Minimum competency tests are not examined in detail. Advantages…

Promising lines of research in the realms of laboratory nuclear astrophysics by means of powerful lasers

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

Belyaev, V. S., E-mail: belyaev@tsniimash.ru; Zagreev, B. V.; Kedrov, A. Yu.

Basic nuclear-astrophysics problems that can be studied under laboratory conditions at a laserradiation intensity of 10{sup 18} W/cm{sup 2} or more are specified. These are the lithium problem, the problem of determining neutron sources for s-processes of heavy-element formation, the formation of bypassed stable p-nuclei, and nuclear reactions involving isotopes used by astronomers for diagnostics purposes. The results of experiments at the Neodym laser facility are presented, and proposals for further studies in these realms are formulated.

Advances in diagnostic interventional pulmonology

PubMed Central

Al-Zubaidi, Nassar; Soubani, Ayman O.

2015-01-01

The recent advances in diagnostic pulmonary procedures have revolutionized the evaluation of abnormal thoracic findings including lung nodules and masses, mediastinal lymphadenopathy, and pleural diseases. Bronchoscopies with endobronchial ultrasonography and electromagnetic navigation are examples of new technology that has significantly improved the specificity and sensitivity of these procedures in diagnosis and staging of lung cancer without the need for more invasive procedures. This report describes the different diagnostic pulmonary interventions providing a description of the procedures, their indications, diagnostic yield and drawback. PMID:26229756

The development of effective behaviour change interventions to support the use of malaria rapid diagnostic tests by Tanzanian clinicians

PubMed Central

2014-01-01

Background Parasitological confirmation is now recommended for all cases of suspected malaria. The roll-out of rapid diagnostic tests (RDTs) is hoped to enable this goal in low resource settings through point of care testing. However, simply making RDTs available has not led to high uptake of the tests or adherence to results by clinicians, with malaria continuing to be overdiagnosed in many settings. We undertook to design an evidence-based intervention package that would be sufficient to support the introduction of RDTs at dispensaries in Tanzania, to be evaluated through the Targeting Artemisinin Combination Therapy (TACT) cluster randomised controlled trial. Methods We describe five steps in our intervention design: formative research, review of existing evidence and theory, a workshop to define the intervention approach and content and results of formative research, engagement with behaviour change theory and literature, detailed design of intervention materials and piloting and pretesting of intervention materials. This involved fieldwork with a total of 19 health workers and 212 community members in northeast Tanzania. Results The formative research suggested that RDTs were a potential source of conflict in the health worker-patient interaction, but that health workers used various techniques to resolve this, including provision of antimalarial drugs for RDT-negative patients. Our reviews showed that evidence was mixed regarding the effectiveness of different methods and theories to support change in prescribing practice. Our design process is presented, drawing from this collective evidence. We describe the final TACT intervention package (including interactive small group workshops, feedback text messages, motivational text messages and patient information leaflets and posters) in terms of its programme theory and implementation theory. Conclusions Our study suggests that evidence-based design of complex interventions is possible. The use of formative research to understand malaria overdiagnosis in context was central to the design of the intervention as well as empirical research to test materials and methods prior to implementation. The TACT interventions may be appropriate for other settings where clinicians face similar challenges with malaria diagnostics. Trial registration NCT01292707. PMID:24969367

Introducing the reporting system for thyroid fine-needle aspiration cytology according to the new guidelines of the Japan Thyroid Association.

PubMed

Kakudo, Kennichi; Kameyama, Kaori; Miyauchi, Akira; Nakamura, Hirotoshi

2014-01-01

The Japan Thyroid Association (JTA) recently published new guidelines for clinical management of thyroid nodules. This paper introduces their diagnostic system for reporting thyroid fine-needle aspiration cytology. There are two points where the new reporting system that differs from existing internationally-accepted ones. The first is the subclassification of the so-called indeterminate category, which is divided into 'follicular neoplasm' and 'others'. The second is the subclassification of follicular neoplasm into 'favor benign', 'borderline' and 'favor malignant'. It is characterized by self-explanatory terminologies as to histological type and probability of malignancy to establish further risk stratification as well as to facilitate communication between clinicians and cytopathologists. The different treatment strategies adopted for thyroid nodules is deeply influenced by the particular diagnostic system used for thyroid cytology. In Western countries all patients with follicular neoplasms are advised to have immediate diagnostic surgery while patients in Japan often undergo further risk stratification without immediate surgery. The JTA diagnostic system of reporting thyroid cytology is designed for further risk stratification of patients with indeterminate cytology. If a surgeon applies diagnostic lobectomy to all patients with follicular neoplasm unselectively, this subclassification of follicular neoplasm has no practical meaning and is unnecessary. Cytological risk stratification of follicular neoplasms is optional and cytopathologists can choose either a simple 6-tier system without stratification of follicular neoplasm or a complicated 8-tier system depending on their experience in thyroid cytology and clinical management.

Intraoperative neuromonitoring alerts that reverse with intervention: treatment paradox and what to do about it.

PubMed

Skinner, Stanley A; Holdefer, Robert N

2014-04-01

Intervention-mediated recovery from adversely changed evoked potential recordings may provide evidence for improved outcomes during neurophysiological intraoperative monitoring. However, these reversible signal changes (RSCs) are ambiguous because the patient's neurologic status cannot be known either at signal decline or after intervention. This article describes methods to reduce this ambiguity. Randomized control trials are not always possible or ethical. Recent thought on grading evidence has acknowledged that guidelines first described by Sir Austin Bradford Hill may support evidence for causation. Causality guidelines identified RSCs most likely to be truly positive in three reported studies. Diagnostic statistics were revised accordingly. A range of revised positive predictive values and likelihood ratios was calculated in the three studies, using causality guidelines. The revised data were similar to those reported for other diagnostic tests used in medicine. The RSCs may be assessed using causality guidelines for more accurate reporting of diagnostic statistics while preserving information related to surgical intervention and recovery that is lost with end of surgery diagnostics or when RSCs are ignored. A method is described for including RSCs in diagnostic statistics. This approach will more readily permit assessment of the value of neurophysiological intraoperative monitoring in prediction and prevention of neurologic deficits.

Advances Afoot in Microbiology

PubMed Central

Karon, Brad S.

2017-01-01

ABSTRACT In 2016, the American Academy of Microbiology convened a colloquium to examine point-of-care (POC) microbiology testing and to evaluate its effects on clinical microbiology. Colloquium participants included representatives from clinical microbiology laboratories, industry, and the government, who together made recommendations regarding the implementation, oversight, and evaluation of POC microbiology testing. The colloquium report is timely and well written (V. Dolen et al., Changing Diagnostic Paradigms for Microbiology, 2017, https://www.asm.org/index.php/colloquium-reports/item/6421-changing-diagnostic-paradigms-for-microbiology?utm_source=Commentary&utm_medium=referral&utm_campaign=diagnostics). Emerging POC microbiology tests, especially nucleic acid amplification tests, have the potential to advance medical care. PMID:28539341

Upper limb musculoskeletal complaints among technicians working in a diagnostic tuberculosis laboratory: two case reports.

PubMed

Wong, Joyce Y P; Chin, David; Fung, Henry; Li, Ann; Wong, Marcus M S; Kwok, Henry K H

2014-01-01

Upper limb musculoskeletal complaints are common among certain health professionals. We report two cases, both involving technicians working in a diagnostic tuberculosis laboratory in Hong Kong. A work process evaluation suggest that the need to repeatedly open and close small bottles, as well as to work for prolonged periods of time in confined areas, could be related to the workers' clinical presentation. The cases are also compatible with the diagnosis of repetitive strain injury (RSI) of the upper limb, but this term is not commonly used nowadays because of various definitional issues. A review of the various diagnostic issues in RSI is presented.

Radiological interpretation of images displayed on tablet computers: a systematic review

PubMed Central

Armfield, N R; Smith, A C

2015-01-01

Objective: To review the published evidence and to determine if radiological diagnostic accuracy is compromised when images are displayed on a tablet computer and thereby inform practice on using tablet computers for radiological interpretation by on-call radiologists. Methods: We searched the PubMed and EMBASE databases for studies on the diagnostic accuracy or diagnostic reliability of images interpreted on tablet computers. Studies were screened for inclusion based on pre-determined inclusion and exclusion criteria. Studies were assessed for quality and risk of bias using Quality Appraisal of Diagnostic Reliability Studies or the revised Quality Assessment of Diagnostic Accuracy Studies tool. Treatment of studies was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results: 11 studies met the inclusion criteria. 10 of these studies tested the Apple iPad® (Apple, Cupertino, CA). The included studies reported high sensitivity (84–98%), specificity (74–100%) and accuracy rates (98–100%) for radiological diagnosis. There was no statistically significant difference in accuracy between a tablet computer and a digital imaging and communication in medicine-calibrated control display. There was a near complete consensus from authors on the non-inferiority of diagnostic accuracy of images displayed on a tablet computer. All of the included studies were judged to be at risk of bias. Conclusion: Our findings suggest that the diagnostic accuracy of radiological interpretation is not compromised by using a tablet computer. This result is only relevant to the Apple iPad and to the modalities of CT, MRI and plain radiography. Advances in knowledge: The iPad may be appropriate for an on-call radiologist to use for radiological interpretation. PMID:25882691

Drinking correlates of DSM-IV alcohol use disorder diagnostic orphans in college students.

PubMed

Hagman, Brett T; Cohn, Amy M

2012-01-01

One major limitation of the DSM-IV criteria for alcohol abuse and dependence is that a cluster of individuals who endorse a subthreshold number of dependence criteria and no abuse criteria do not receive a formal diagnosis; despite elevated risk for alcohol-related problems relative to those with an abuse diagnosis. These individuals have been referred to as diagnostic orphans. The primary aim of this study was to examine alcohol use correlates of a group of diagnostic orphans in a sample of 396 nontreatment seeking college students who reported drinking on at least one occasion in the last 90 days. DSM-IV criteria were assessed using a modified version of the Composite International Diagnostic Interview-Substance Abuse Module (CIDI-SAM). Diagnostic orphans represented 34.1% (n = 135) of the original sample who did not receive a formal diagnosis; with the most frequently endorsed dependence criteria being tolerance and drinking larger/longer amounts than intended. Diagnostic orphans reported a range of alcohol-related negative consequences and reported greater frequencies of social and enhancement drinking motives in comparison to coping motives. They were similar to alcohol abusers and dissimilar to those with dependence or those without a diagnosis on alcohol consumption, alcohol problem severity, drinking motives and restraint variables. The present findings indicate that diagnostic orphans in college students represent a distinct group of drinkers who may be at risk for the development of alcohol use disorders and may be in need of intervention, given their similarity to those with an abuse diagnosis. Prevention and intervention efforts across college campuses should target this group to prevent escalation of alcohol problem severity. Copyright © American Academy of Addiction Psychiatry.

Brief Report: Telephone Administration of the Autism Diagnostic Interview-Revised--Reliability and Suitability for Use in Research

ERIC Educational Resources Information Center

Ward-King, Jessica; Cohen, Ira L.; Penning, Henderika; Holden, Jeanette J. A.

2010-01-01

The Autism Diagnostic Interview-Revised is one of the "gold standard" diagnostic tools for autism spectrum disorders. It is traditionally administered face-to-face. Cost and geographical concerns constrain the employment of the ADI-R for large-scale research projects. The telephone interview is a reasonable alternative, but has not yet been…

Research Reports from the First Pre-ICME Satellite Conference on Diagnostic and Prescriptive Mathematics (Monash University, Melbourne, Australia, August 21-22, 1984).

ERIC Educational Resources Information Center

Blane, Dudley, Ed.

Provided are the papers presented at a conference which served as an international forum on diagnostic and prescriptive mathematics education. They are: (1) "The Evolution of the Research Council for Diagnostic and Prescriptive Mathematics" by Robert Underhill; (2) "The Interaction of Knowledge and Cognitive Processes in Diagnosis…

[Leiomyosarcoma of the mesentery. A case report and clinico-diagnostic considerations].

PubMed

Ferranti, F; Mancini, G; Rossi, M D; D'Aristotile, A; Ippoliti, A; De Ascentis, G; Monteferrante, E; Rotolo, A; Gaspari, A L

1996-12-01

Leiomyosarcoma of the mesentery is a rare neoplasm. The clinical manifestation is non-specific and preoperative diagnosis is often late. Mitotic activity shows no significant correlation with the biological behavior of neoplasm. The surgical excision is the therapy of choice but local recurrence is high. The authors report a case of leiomyosarcoma which was treated by surgical removal and underline the diagnostic difficulties.

The Screening Accuracy of the Parent and Teacher-Reported Social Responsiveness Scale (SRS): Comparison with the 3Di and ADOS

ERIC Educational Resources Information Center

Duvekot, Jorieke; van der Ende, Jan; Verhulst, Frank C.; Greaves-Lord, Kirstin

2015-01-01

The screening accuracy of the parent and teacher-reported Social Responsiveness Scale (SRS) was compared with an autism spectrum disorder (ASD) classification according to (1) the Developmental, Dimensional, and Diagnostic Interview (3Di), (2) the Autism Diagnostic Observation Schedule (ADOS), (3) both the 3Di and ADOS, in 186 children referred to…

An Investigation of the Teacher Competencies Needed to Utilize Diagnostic Test Data in Prescribing Occupational Learning Experiences in Teaching EMRS. Final Report. Part II. Appendices.

ERIC Educational Resources Information Center

Nelson, Orville; And Others

These appendixes are to the final report of an action research Project conducted to determine the teacher competencies needed in order to develop valid and effective occupational learning experiences for educable mentally retarded (EMR) students based on available diagnostic test data and information. Included are (1) participant vitas and…

Multivariate Analysis As a Support for Diagnostic Flowcharts in Allergic Bronchopulmonary Aspergillosis: A Proof-of-Concept Study.

PubMed

Vitte, Joana; Ranque, Stéphane; Carsin, Ania; Gomez, Carine; Romain, Thomas; Cassagne, Carole; Gouitaa, Marion; Baravalle-Einaudi, Mélisande; Bel, Nathalie Stremler-Le; Reynaud-Gaubert, Martine; Dubus, Jean-Christophe; Mège, Jean-Louis; Gaudart, Jean

2017-01-01

Molecular-based allergy diagnosis yields multiple biomarker datasets. The classical diagnostic score for allergic bronchopulmonary aspergillosis (ABPA), a severe disease usually occurring in asthmatic patients and people with cystic fibrosis, comprises succinct immunological criteria formulated in 1977: total IgE, anti- Aspergillus fumigatus ( Af ) IgE, anti- Af "precipitins," and anti- Af IgG. Progress achieved over the last four decades led to multiple IgE and IgG(4) Af biomarkers available with quantitative, standardized, molecular-level reports. These newly available biomarkers have not been included in the current diagnostic criteria, either individually or in algorithms, despite persistent underdiagnosis of ABPA. Large numbers of individual biomarkers may hinder their use in clinical practice. Conversely, multivariate analysis using new tools may bring about a better chance of less diagnostic mistakes. We report here a proof-of-concept work consisting of a three-step multivariate analysis of Af IgE, IgG, and IgG4 biomarkers through a combination of principal component analysis, hierarchical ascendant classification, and classification and regression tree multivariate analysis. The resulting diagnostic algorithms might show the way for novel criteria and improved diagnostic efficiency in Af -sensitized patients at risk for ABPA.

Rett syndrome diagnostic criteria: lessons from the Natural History Study.

PubMed

Percy, Alan K; Neul, Jeffrey L; Glaze, Daniel G; Motil, Kathleen J; Skinner, Steven A; Khwaja, Omar; Lee, Hye-Seung; Lane, Jane B; Barrish, Judy O; Annese, Fran; McNair, Lauren; Graham, Joy; Barnes, Katherine

2010-12-01

Analysis of 819 participants enrolled in the Rett syndrome (RTT) Natural History Study validates recently revised diagnostic criteria. 765 females fulfilled 2002 consensus criteria for classic (653/85.4%) or variant (112/14.6%) RTT. All participants classified as classic RTT fulfilled each revised main criterion; supportive criteria were not uniformly present. All variant RTT participants met at least 3 of 6 main criteria in the 2002, 2 of 4 main criteria in the current format, and 5 of 11 supportive criteria in both. This analysis underscores the critical role of main criteria for classic RTT; variant RTT requires both main and supportive criteria.

Nonportable computed radiography of the chest--radiologists' acceptance

NASA Astrophysics Data System (ADS)

Gennari, Rose C.; Gur, David; Miketic, Linda M.; Campbell, William L.; Oliver, James H., III; Plunkett, Michael B.

1994-04-01

Following a large ROC study to assess diagnostic accuracy of PA chest computed radiography (CR) images displayed in a variety of formats, we asked nine experienced radiologists to subjectively assess their acceptance of and preferences for display modes in primary diagnosis of erect PA chest images. Our results indicate that radiologists felt somewhat less comfortable interpreting CR images displayed on either laser-printed films or workstations as compared to conventional films. The use of four minified images were thought to somewhat decrease diagnostic confidence, as well as to increase the time of interpretation. The reverse mode (black bone) images increased radiologists' confidence level in the detection of soft tissue abnormalities.

BIOPHYSICAL PROPERTIES OF NUCLEIC ACIDS AT SURFACES RELEVANT TO MICROARRAY PERFORMANCE.

PubMed

Rao, Archana N; Grainger, David W

2014-04-01

Both clinical and analytical metrics produced by microarray-based assay technology have recognized problems in reproducibility, reliability and analytical sensitivity. These issues are often attributed to poor understanding and control of nucleic acid behaviors and properties at solid-liquid interfaces. Nucleic acid hybridization, central to DNA and RNA microarray formats, depends on the properties and behaviors of single strand (ss) nucleic acids (e.g., probe oligomeric DNA) bound to surfaces. ssDNA's persistence length, radius of gyration, electrostatics, conformations on different surfaces and under various assay conditions, its chain flexibility and curvature, charging effects in ionic solutions, and fluorescent labeling all influence its physical chemistry and hybridization under assay conditions. Nucleic acid (e.g., both RNA and DNA) target interactions with immobilized ssDNA strands are highly impacted by these biophysical states. Furthermore, the kinetics, thermodynamics, and enthalpic and entropic contributions to DNA hybridization reflect global probe/target structures and interaction dynamics. Here we review several biophysical issues relevant to oligomeric nucleic acid molecular behaviors at surfaces and their influences on duplex formation that influence microarray assay performance. Correlation of biophysical aspects of single and double-stranded nucleic acids with their complexes in bulk solution is common. Such analysis at surfaces is not commonly reported, despite its importance to microarray assays. We seek to provide further insight into nucleic acid-surface challenges facing microarray diagnostic formats that have hindered their clinical adoption and compromise their research quality and value as genomics tools.

BIOPHYSICAL PROPERTIES OF NUCLEIC ACIDS AT SURFACES RELEVANT TO MICROARRAY PERFORMANCE

PubMed Central

Rao, Archana N.; Grainger, David W.

2014-01-01

Both clinical and analytical metrics produced by microarray-based assay technology have recognized problems in reproducibility, reliability and analytical sensitivity. These issues are often attributed to poor understanding and control of nucleic acid behaviors and properties at solid-liquid interfaces. Nucleic acid hybridization, central to DNA and RNA microarray formats, depends on the properties and behaviors of single strand (ss) nucleic acids (e.g., probe oligomeric DNA) bound to surfaces. ssDNA’s persistence length, radius of gyration, electrostatics, conformations on different surfaces and under various assay conditions, its chain flexibility and curvature, charging effects in ionic solutions, and fluorescent labeling all influence its physical chemistry and hybridization under assay conditions. Nucleic acid (e.g., both RNA and DNA) target interactions with immobilized ssDNA strands are highly impacted by these biophysical states. Furthermore, the kinetics, thermodynamics, and enthalpic and entropic contributions to DNA hybridization reflect global probe/target structures and interaction dynamics. Here we review several biophysical issues relevant to oligomeric nucleic acid molecular behaviors at surfaces and their influences on duplex formation that influence microarray assay performance. Correlation of biophysical aspects of single and double-stranded nucleic acids with their complexes in bulk solution is common. Such analysis at surfaces is not commonly reported, despite its importance to microarray assays. We seek to provide further insight into nucleic acid-surface challenges facing microarray diagnostic formats that have hindered their clinical adoption and compromise their research quality and value as genomics tools. PMID:24765522

Light-weight Parallel Python Tools for Earth System Modeling Workflows

NASA Astrophysics Data System (ADS)

Mickelson, S. A.; Paul, K.; Xu, H.; Dennis, J.; Brown, D. I.

2015-12-01

With the growth in computing power over the last 30 years, earth system modeling codes have become increasingly data-intensive. As an example, it is expected that the data required for the next Intergovernmental Panel on Climate Change (IPCC) Assessment Report (AR6) will increase by more than 10x to an expected 25PB per climate model. Faced with this daunting challenge, developers of the Community Earth System Model (CESM) have chosen to change the format of their data for long-term storage from time-slice to time-series, in order to reduce the required download bandwidth needed for later analysis and post-processing by climate scientists. Hence, efficient tools are required to (1) perform the transformation of the data from time-slice to time-series format and to (2) compute climatology statistics, needed for many diagnostic computations, on the resulting time-series data. To address the first of these two challenges, we have developed a parallel Python tool for converting time-slice model output to time-series format. To address the second of these challenges, we have developed a parallel Python tool to perform fast time-averaging of time-series data. These tools are designed to be light-weight, be easy to install, have very few dependencies, and can be easily inserted into the Earth system modeling workflow with negligible disruption. In this work, we present the motivation, approach, and testing results of these two light-weight parallel Python tools, as well as our plans for future research and development.

Compressive cervical pannus formation in a patient after 2-level disc arthroplasty: a rare complication treated with posterior instrumented fusion.

PubMed

Brophy, Carl M; Hoh, Daniel J

2018-06-01

Cervical disc arthroplasty (CDA) has received widespread attention as an alternative to anterior fusion due to its similar neurological and functional improvement, with the advantage of preservation of segmental motion. As CDA becomes more widely implemented, the potential for unexpected device-related adverse events may be identified. The authors report on a 48-year-old man who presented with progressive neurological deficits 3 years after 2-level CDA was performed. Imaging demonstrated periprosthetic osteolysis of the vertebral endplates at the CDA levels, with a heterogeneously enhancing ventral epidural mass compressing the spinal cord. Diagnostic workup for infectious and neoplastic processes was negative. The presumptive diagnosis was an inflammatory pannus formation secondary to abnormal motion at the CDA levels. Posterior cervical decompression and instrumented fusion was performed without removal of the arthroplasty devices or the ventral epidural mass. Postoperative imaging at 2 months demonstrated complete resolution of the compressive pannus, with associated improvement in clinical symptoms. Follow-up MRI at > 6 months showed no recurrence of the pannus. At 1 year postoperatively, CT scanning revealed improvement in periprosthetic osteolysis. Inflammatory pannus formation may be an unexpected complication of abnormal segmental motion after CDA. This rare etiology of an epidural mass associated with an arthroplasty device should be considered, in addition to workup for other potential infectious or neoplastic mass lesions. In symptomatic individuals, compressive pannus lesions can be effectively treated with fusion across the involved segment without removal of the device.

The STARD Statement for Reporting Diagnostic Accuracy Studies: Application to the History and Physical Examination

PubMed Central

Rennie, Drummond; Bossuyt, Patrick M. M.

2008-01-01

Summary Objective The Standards for Reporting of Diagnostic Accuracy (STARD) statement provided guidelines for investigators conducting diagnostic accuracy studies. We reviewed each item in the statement for its applicability to clinical examination diagnostic accuracy research, viewing each discrete aspect of the history and physical examination as a diagnostic test. Setting Nonsystematic review of the STARD statement. Interventions Two former STARD Group participants and 1 editor of a journal series on clinical examination research reviewed each STARD item. Suggested interpretations and comments were shared to develop consensus. Measurements and Main Results The STARD Statement applies generally well to clinical examination diagnostic accuracy studies. Three items are the most important for clinical examination diagnostic accuracy studies, and investigators should pay particular attention to their requirements: describe carefully the patient recruitment process, describe participant sampling and address if patients were from a consecutive series, and describe whether the clinicians were masked to the reference standard tests and whether the interpretation of the reference standard test was masked to the clinical examination components or overall clinical impression. The consideration of these and the other STARD items in clinical examination diagnostic research studies would improve the quality of investigations and strengthen conclusions reached by practicing clinicians. Conclusions The STARD statement provides a very useful framework for diagnostic accuracy studies. The group correctly anticipated that there would be nuances applicable to studies of the clinical examination. We offer guidance that should enhance their usefulness to investigators embarking on original studies of a patient’s history and physical examination. PMID:18347878

Addressing Barriers to the Development and Adoption of Rapid Diagnostic Tests in Global Health.

PubMed

Miller, Eric; Sikes, Hadley D

Immunochromatographic rapid diagnostic tests (RDTs) have demonstrated significant potential for use as point-of-care diagnostic tests in resource-limited settings. Most notably, RDTs for malaria have reached an unparalleled level of technological maturity and market penetration, and are now considered an important complement to standard microscopic methods of malaria diagnosis. However, the technical development of RDTs for other infectious diseases, and their uptake within the global health community as a core diagnostic modality, has been hindered by a number of extant challenges. These range from technical and biological issues, such as the need for better affinity agents and biomarkers of disease, to social, infrastructural, regulatory and economic barriers, which have all served to slow their adoption and diminish their impact. In order for the immunochromatographic RDT format to be successfully adapted to other disease targets, to see widespread distribution, and to improve clinical outcomes for patients on a global scale, these challenges must be identified and addressed, and the global health community must be engaged in championing the broader use of RDTs.

Identification of a new diagnostic antigen for glanders using immunoproteome analysis.

PubMed

Dohre, Sudhir K; Kamthan, Aayushi; Singh, Sandeep; Alam, Syed Imteyaz; Kumar, Subodh

2017-08-01

Glanders is a disease of horses, donkeys and mules. The causative agent Burkholderia mallei, is a biorisk group 3 pathogen and is also a biothreat agent. Simple and rapid diagnostic tool is essential for control of glanders. Using a proteomic approach and immunoblotting with equine sera, we identified 12 protein antigens that may have diagnostic potential. Various immunoreactive proteins e.g. GroEL, translation elongation factor Tu, elongation factor Ts, arginine deiminase, malate dehydrogenase, DNA directed RNA polymerase subunit alpha were identified on 2-dimentional immunoblots. One of these proteins, GroEL, was cloned and expressed in E. coli and purified using Ni-NTA affinity chromatography. The recombinant GroEL protein was evaluated in ELISA format on a panel of glanders positive (n=49) and negative (n=79) equine serum samples to determine its diagnostic potential. The developed ELISA had a sensitivity and specificity of 96 and 98.7% respectively. The results of this study highlight the potential of GroEL in serodiagnosis of glanders. Copyright © 2017 Elsevier Ltd. All rights reserved.

Addressing Barriers to the Development and Adoption of Rapid Diagnostic Tests in Global Health

PubMed Central

Miller, Eric; Sikes, Hadley D.

2015-01-01

Immunochromatographic rapid diagnostic tests (RDTs) have demonstrated significant potential for use as point-of-care diagnostic tests in resource-limited settings. Most notably, RDTs for malaria have reached an unparalleled level of technological maturity and market penetration, and are now considered an important complement to standard microscopic methods of malaria diagnosis. However, the technical development of RDTs for other infectious diseases, and their uptake within the global health community as a core diagnostic modality, has been hindered by a number of extant challenges. These range from technical and biological issues, such as the need for better affinity agents and biomarkers of disease, to social, infrastructural, regulatory and economic barriers, which have all served to slow their adoption and diminish their impact. In order for the immunochromatographic RDT format to be successfully adapted to other disease targets, to see widespread distribution, and to improve clinical outcomes for patients on a global scale, these challenges must be identified and addressed, and the global health community must be engaged in championing the broader use of RDTs. PMID:26594252

Requirements for diagnosis of malaria at different levels of the laboratory network in Africa.

PubMed

Long, Earl G

2009-06-01

The rapid increase of resistance to cheap, reliable antimalarials, the increasing cost of effective drugs, and the low specificity of clinical diagnosis has increased the need for more reliable diagnostic methods for malaria. The most commonly used and most reliable remains microscopic examination of stained blood smears, but this technique requires skilled personnel, precision instruments, and ideally a source of electricity. Microscopy has the advantage of enabling the examiner to identify the species, stage, and density of an infection. An alternative to microscopy is the rapid diagnostic test (RDT), which uses a labeled monoclonal antibody to detect circulating parasitic antigens. This test is most commonly used to detect Plasmodium falciparum infections and is available in a plastic cassette format. Both microscopy and RDTs should be available at all levels of laboratory service in endemic areas, but in peripheral laboratories with minimally trained staff, the RDT may be a more practical diagnostic method.

Modifications to the streamtube curvature program. Volume 1: Program modifications and user's manual. [user manuals (computer programs) for transonic flow of nacelles and intake systems of turbofan engines

NASA Technical Reports Server (NTRS)

Ferguson, D. R.; Keith, J. S.

1975-01-01

The improvements which have been incorporated in the Streamtube Curvature Program to enhance both its computational and diagnostic capabilities are described. Detailed descriptions are given of the revisions incorporated to more reliably handle the jet stream-external flow interaction at trailing edges. Also presented are the augmented boundary layer procedures and a variety of other program changes relating to program diagnostics and extended solution capabilities. An updated User's Manual, that includes information on the computer program operation, usage, and logical structure, is presented. User documentation includes an outline of the general logical flow of the program and detailed instructions for program usage and operation. From the standpoint of the programmer, the overlay structure is described. The input data, output formats, and diagnostic printouts are covered in detail and illustrated with three typical test cases.

[Infective endocarditis : Update on prophylaxis, diagnosis, and treatment].

PubMed

Dietz, S; Lemm, H; Janusch, M; Buerke, M

2016-05-01

The diagnosis of infective endocarditis is often delayed in clinical practice. Timely diagnosis and rapid antibiotic treatment is important. Higher age of patients, new risk factors, and increasing use of intravascular prosthetic materials resulted in changes in microbial spectrum. Nowadays, nonspecific symptoms, critically ill patients, and immunocompromised patients require a high level of diagnostic expertise.The new guidelines from the European Society of Cardiology provide various diagnostic algorithms and recommendations for antibiotic treatment. The new guidelines also recommend the formation of an endocarditis team with various medical disciplines, including a cardiac surgeon, to improve treatment because in half of all endocarditis patients, antibiotic therapy alone does not result in successful management of the infection. If complications occur, early surgical treatment should be performed.In this overview, diagnostic strategies and therapeutic approaches for the treatment of infectious endocarditis according to the current guidelines and aspects of surgical treatment are provided.

SPITZER IRAC COLOR DIAGNOSTICS FOR EXTENDED EMISSION IN STAR-FORMING REGIONS

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

Ybarra, Jason E.; Tapia, Mauricio; Román-Zúñiga, Carlos G.

2014-10-20

The infrared data from the Spitzer Space Telescope are an invaluable tool for identifying physical processes in star formation. In this study, we calculate the Infrared Array Camera (IRAC) color space of UV fluorescent H{sub 2} and polycyclic aromatic hydrocarbon (PAH) emission in photodissociation regions (PDRs) using the Cloudy code with PAH opacities from Draine and Li. We create a set of color diagnostics that can be applied to study the structure of PDRs and to distinguish between FUV-excited and shock-excited H{sub 2} emission. To test this method, we apply these diagnostics to Spitzer IRAC data of NGC 2316. Our analysismore » of the structure of the PDR is consistent with previous studies of the region. In addition to UV excited emission, we identify shocked gas that may be part of an outflow originating from the cluster.« less