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.

Assessing Disease Class-Specific Diagnostic Ability: A Practical Adaptive Test Approach.

ERIC Educational Resources Information Center

Papa, Frank J.; Schumacker, Randall E.

Measures of the robustness of disease class-specific diagnostic concepts could play a central role in training programs designed to assure the development of diagnostic competence. In the pilot study, the authors used disease/sign-symptom conditional probability estimates, Monte Carlo procedures, and artificial intelligence (AI) tools to create…

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

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

Zhai, Y

2014-03-03

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

Using qualitative research to inform development of a diagnostic algorithm for UTI in children.

PubMed

de Salis, Isabel; Whiting, Penny; Sterne, Jonathan A C; Hay, Alastair D

2013-06-01

Diagnostic and prognostic algorithms can help reduce clinical uncertainty. The selection of candidate symptoms and signs to be measured in case report forms (CRFs) for potential inclusion in diagnostic algorithms needs to be comprehensive, clearly formulated and relevant for end users. To investigate whether qualitative methods could assist in designing CRFs in research developing diagnostic algorithms. Specifically, the study sought to establish whether qualitative methods could have assisted in designing the CRF for the Health Technology Association funded Diagnosis of Urinary Tract infection in Young children (DUTY) study, which will develop a diagnostic algorithm to improve recognition of urinary tract infection (UTI) in children aged <5 years presenting acutely unwell to primary care. Qualitative methods were applied using semi-structured interviews of 30 UK doctors and nurses working with young children in primary care and a Children's Emergency Department. We elicited features that clinicians believed useful in diagnosing UTI and compared these for presence or absence and terminology with the DUTY CRF. Despite much agreement between clinicians' accounts and the DUTY CRFs, we identified a small number of potentially important symptoms and signs not included in the CRF and some included items that could have been reworded to improve understanding and final data analysis. This study uniquely demonstrates the role of qualitative methods in the design and content of CRFs used for developing diagnostic (and prognostic) algorithms. Research groups developing such algorithms should consider using qualitative methods to inform the selection and wording of candidate symptoms and signs.

[Digital learning object for diagnostic reasoning in nursing applied to the integumentary system].

PubMed

da Costa, Cecília Passos Vaz; Luz, Maria Helena Barros Araújo

2015-12-01

To describe the creation of a digital learning object for diagnostic reasoning in nursing applied to the integumentary system at a public university of Piaui. A methodological study applied to technological production based on the pedagogical framework of problem-based learning. The methodology for creating the learning object observed the stages of analysis, design, development, implementation and evaluation recommended for contextualized instructional design. The revised taxonomy of Bloom was used to list the educational goals. The four modules of the developed learning object were inserted into the educational platform Moodle. The theoretical assumptions allowed the design of an important online resource that promotes effective learning in the scope of nursing education. This study should add value to nursing teaching practices through the use of digital learning objects for teaching diagnostic reasoning applied to skin and skin appendages.

SMASH: A Diagnostic Tool to Monitor Student Metacognition, Affect, and Study Habits in an Undergraduate Science Course

ERIC Educational Resources Information Center

Metzger, Kelsey J.; Smith, Brittany A.; Brown, Ethan; Soneral, Paula A. G.

2018-01-01

This study describes the development and implementation of an iterative diagnostic and intervention routine designed to elicit and quantitatively describe aspects of student metacognition, affect, and study habits in a first-year undergraduate biology course. The Student Metacognition, Affect, and Study Habits (SMASH) inventory is a…

The Swedish Version of the Ritvo Autism and Asperger Diagnostic Scale: Revised (RAADS-R). A Validation Study of a Rating Scale for Adults

ERIC Educational Resources Information Center

Andersen, Lisa M. J.; Naswall, Katharina; Manouilenko, Irina; Nylander, Lena; Edgar, Johan; Ritvo, Riva Ariella; Ritvo, Edward; Bejerot, Susanne

2011-01-01

There is a paucity of diagnostic instruments for adults with autism spectrum disorder (ASD). This study evaluates the psychometric properties of the Swedish version of the Ritvo Autism and Asperger Diagnostic Scale-Revised (RAADS-R), an 80-item self-rating scale designed to assist clinicians diagnosing ASD in adults. It was administered to 75…

Diagnostic value of serum squamous cell carcinoma antigen for hepatocellular carcinoma: a systematic review and meta-analysis.

PubMed

Yu, Jing; Wang, Zhao-Juan; Chen, Long-Hua; Dong, Wen-Zhu

2017-02-01

The aim of this study was to ascertain the diagnostic value of serum squamous cell carcinoma antigen (SCCA) and SCCA-IgM for hepatocellular carcinoma (HCC). After a comprehensive search of PubMed and Web of Science databases, we identified eligible studies on the diagnostic value serum SCCAs for HCC. The quality of the eligible studies was assessed using the revised Quality Assessment for Studies of Diagnostic Accuracy (QUADAS-2) tool. The overall diagnostic value of SCCAs for HCC was pooled using a bivariate model. Twelve studies were included in this systematic review and meta-analysis. The pooled sensitivities for SCCA and SCCA-IgM were 0.61 (95% confidence interval [CI], 0.37-0.81) and 0.70 (95% CI, 0.55-0.82), respectively. The corresponding specificities were 0.80 (95% CI, 0.52-0.94) and 0.62 (95% CI, 0.51-0.72), respectively. The areas under summary receiver operating characteristic (sROC) curves for SCCA and SCCA-IgM were 0.76 (95% CI, 0.72-0.80) and 0.70 (95% CI, 0.66-0.74), respectively. Major design deficiencies of the included studies were two-gate design and partial verification bias. Therefore, we concluded that both serum SCCA and SCCA-IgM have a fair diagnostic value for HCC.

ITER ECE Diagnostic: Design Progress of IN-DA and the diagnostic role for Physics

NASA Astrophysics Data System (ADS)

Pandya, H. K. B.; Kumar, Ravinder; Danani, S.; Shrishail, P.; Thomas, Sajal; Kumar, Vinay; Taylor, G.; Khodak, A.; Rowan, W. L.; Houshmandyar, S.; Udintsev, V. S.; Casal, N.; Walsh, M. J.

2017-04-01

The ECE Diagnostic system in ITER will be used for measuring the electron temperature profile evolution, electron temperature fluctuations, the runaway electron spectrum, and the radiated power in the electron cyclotron frequency range (70-1000 GHz), These measurements will be used for advanced real time plasma control (e.g. steering the electron cyclotron heating beams), and physics studies. The scope of the Indian Domestic Agency (IN-DA) is to design and develop the polarizer splitter units; the broadband (70 to 1000 GHz) transmission lines; a high temperature calibration source in the Diagnostics Hall; two Michelson Interferometers (70 to 1000 GHz) and a 122-230 GHz radiometer. The remainder of the ITER ECE diagnostic system is the responsibility of the US domestic agency and the ITER Organization (IO). The design needs to conform to the ITER Organization’s strict requirements for reliability, availability, maintainability and inspect-ability. Progress in the design and development of various subsystems and components considering various engineering challenges and solutions will be discussed in this paper. This paper will also highlight how various ECE measurements can enhance understanding of plasma physics in ITER.

Electromagnetic Analysis of ITER Diagnostic Equatorial Port Plugs During Plasma Disruptions

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

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

2012-08-27

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

ACER Physics Unit Tests: Unit Tests, Diagnostic Aids, [and] Teachers Handbook.

ERIC Educational Resources Information Center

Australian Council for Educational Research, Hawthorn.

The Physics Unit Tests are designed to assist in the diagnostic evaluation of students' progress in the study of physics during the last two years of secondary schooling. They consist of a collection of 21 separate tests, each related to a different topic, and 21 diagnostic aids corresponding to the tests. The topics covered are: physical…

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…

ROC curves in clinical chemistry: uses, misuses, and possible solutions.

PubMed

Obuchowski, Nancy A; Lieber, Michael L; Wians, Frank H

2004-07-01

ROC curves have become the standard for describing and comparing the accuracy of diagnostic tests. Not surprisingly, ROC curves are used often by clinical chemists. Our aims were to observe how the accuracy of clinical laboratory diagnostic tests is assessed, compared, and reported in the literature; to identify common problems with the use of ROC curves; and to offer some possible solutions. We reviewed every original work using ROC curves and published in Clinical Chemistry in 2001 or 2002. For each article we recorded phase of the research, prospective or retrospective design, sample size, presence/absence of confidence intervals (CIs), nature of the statistical analysis, and major analysis problems. Of 58 articles, 31% were phase I (exploratory), 50% were phase II (challenge), and 19% were phase III (advanced) studies. The studies increased in sample size from phase I to III and showed a progression in the use of prospective designs. Most phase I studies were powered to assess diagnostic tests with ROC areas >/=0.70. Thirty-eight percent of studies failed to include CIs for diagnostic test accuracy or the CIs were constructed inappropriately. Thirty-three percent of studies provided insufficient analysis for comparing diagnostic tests. Other problems included dichotomization of the gold standard scale and inappropriate analysis of the equivalence of two diagnostic tests. We identify available software and make some suggestions for sample size determination, testing for equivalence in diagnostic accuracy, and alternatives to a dichotomous classification of a continuous-scale gold standard. More methodologic research is needed in areas specific to clinical chemistry.

Status of the design of the ITER ECE diagnostic

DOE PAGES

Taylor, G.; Austin, M. E.; Beno, J. H.; ...

2015-03-12

In this study, the baseline design for the ITER electron cyclotron emission (ECE) diagnostic has entered the detailed preliminary design phase. Two plasma views are planned, a radial view and an oblique view that is sensitive to distortions in the electron momentum distribution near the average thermal momentum. Both views provide high spatial resolution electron temperature profiles when the momentum distribution remains Maxwellian. The ECE diagnostic system consists of the front-end optics, including two 1000 K calibration sources, in equatorial port plug EP9, the 70-1000 GHz transmission system from the front-end to the diagnostics hall, and the ECE instrumentation inmore » the diagnostics hall. The baseline ECE instrumentation will include two Michelson interferometers that can simultaneously measure ordinary and extraordinary mode ECE from 70 to 1000 GHz, and two heterodyne radiometer systems, covering 122-230 GHz and 244-355 GHz. Significant design challenges include 1) developing highly-reliable 1000 K calibration sources and the associated shutters/mirrors, 2) providing compliant couplings between the front-end optics and the polarization splitter box that accommodate displacements of the vacuum vessel during plasma operations and bake out, 3) protecting components from damage due to stray ECH radiation and other intense millimeter wave emission and 4) providing the low-loss broadband transmission system.« less

Creation of a diagnostic wait times measurement framework based on evidence and consensus.

PubMed

Gilbert, Julie E; Dobrow, Mark J; Kaan, Melissa; Dobranowski, Julian; Srigley, John R; Jusko Friedman, Audrey; Irish, Jonathan C

2014-09-01

Public reporting of wait times worldwide has to date focused largely on treatment wait times and is limited in its ability to capture earlier parts of the patient journey. The interval between suspicion and diagnosis or ruling out of cancer is a complex phase of the cancer journey. Diagnostic delays and inefficient use of diagnostic imaging procedures can result in poor patient outcomes, both physical and psychosocial. This study was designed to develop a framework that could be adopted for multiple disease sites across different jurisdictions to enable the measurement of diagnostic wait times and diagnostic delay. Diagnostic benchmarks and targets in cancer systems were explored through a targeted literature review and jurisdictional scan. Cancer system leaders and clinicians were interviewed to validate the information found in the jurisdictional scan. An expert panel was assembled to review and, through a modified Delphi consensus process, provide feedback on a diagnostic wait times framework. The consensus process resulted in agreement on a measurement framework that identified suspicion, referral, diagnosis, and treatment as the main time points for measuring this critical phase of the patient journey. This work will help guide initiatives designed to improve patient access to health services by developing an evidence-based approach to standardization of the various waypoints during the diagnostic pathway. The diagnostic wait times measurement framework provides a yardstick to measure the performance of programs that are designed to manage and expedite care processes between referral and diagnosis or ruling out of cancer. Copyright © 2014 by American Society of Clinical Oncology.

Study design requirements for RNA sequencing-based breast cancer diagnostics.

PubMed

Mer, Arvind Singh; Klevebring, Daniel; Grönberg, Henrik; Rantalainen, Mattias

2016-02-01

Sequencing-based molecular characterization of tumors provides information required for individualized cancer treatment. There are well-defined molecular subtypes of breast cancer that provide improved prognostication compared to routine biomarkers. However, molecular subtyping is not yet implemented in routine breast cancer care. Clinical translation is dependent on subtype prediction models providing high sensitivity and specificity. In this study we evaluate sample size and RNA-sequencing read requirements for breast cancer subtyping to facilitate rational design of translational studies. We applied subsampling to ascertain the effect of training sample size and the number of RNA sequencing reads on classification accuracy of molecular subtype and routine biomarker prediction models (unsupervised and supervised). Subtype classification accuracy improved with increasing sample size up to N = 750 (accuracy = 0.93), although with a modest improvement beyond N = 350 (accuracy = 0.92). Prediction of routine biomarkers achieved accuracy of 0.94 (ER) and 0.92 (Her2) at N = 200. Subtype classification improved with RNA-sequencing library size up to 5 million reads. Development of molecular subtyping models for cancer diagnostics requires well-designed studies. Sample size and the number of RNA sequencing reads directly influence accuracy of molecular subtyping. Results in this study provide key information for rational design of translational studies aiming to bring sequencing-based diagnostics to the clinic.

Considerations of study design.

PubMed

Koretz, Ronald L

2007-12-01

Research projects attempt to answer specific questions. The particular study design that is selected will depend in large measure on the nature of the question and the time and resources available. There are 5 common categories of clinical questions; they relate to etiology, prognosis, utility of diagnostic tests, efficacy of proposed interventions, and cost of treatment in specific disease states. A number of study designs can be used. Case reports serve to memorialize unusual or novel aspects of diseases. Retrospective case series are useful for defining natural history. Case-control studies are used by epidemiologists to elucidate potential etiologies of diseases. Prospective cohort studies can be used to assess natural history or to assess potential disease etiologies. Controlled trials are designed to assess the efficacy of therapeutic interventions. Studies that define the sensitivity and specificity of diagnostic tests can be used to assess the utility of those tests. Economic analyses estimate the costs that particular diseases or therapies will require. Each of these study designs has limitations; with the exception of high-quality randomized trials, none of these study designs can establish a causative relationship between putative etiologic (or therapeutic) factors and disease (outcomes).

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.

The LeRC rail accelerators: Test designs and diagnostic techniques

NASA Technical Reports Server (NTRS)

Zana, L. M.; Kerslake, W. R.; Sturman, J. C.; Wang, S. Y.; Terdan, F. F.

1983-01-01

The feasibility of using rail accelerators for various in-space and to-space propulsion applications was investigated. A 1 meter, 24 sq mm bore accelerator was designed with the goal of demonstrating projectile velocities of 15 km/sec using a peak current of 200 kA. A second rail accelerator, 1 meter long with a 156.25 sq mm bore, was designed with clear polycarbonate sidewalls to permit visual observation of the plasma arc. A study of available diagnostic techniques and their application to the rail accelerator is presented. Specific topics of discussion include the use of interferometry and spectroscopy to examine the plasma armature as well as the use of optical sensors to measure rail displacement during acceleration. Standard diagnostics such as current and voltage measurements are also discussed.

Effects of a Web-Based Decision Aid Regarding Diagnostic Self-Testing. A Single-Blind Randomized Controlled Trial

ERIC Educational Resources Information Center

Ickenroth, Martine H. P.; Grispen, J. E. J.; de Vries, N. K.; Dinant, G. J.; Ronda, G.; van der Weijden, T.

2016-01-01

Currently, there are many diagnostic self-tests on body materials available to consumers. The aim of this study was to assess the effect of an online decision aid on diagnostic self-testing for cholesterol and diabetes on knowledge among consumers with an intention to take these tests. A randomized controlled trial was designed. A total of 1259…

Diagnostic techniques for measurement of aerodynamic noise in free field and reverberant environment of wind tunnels

NASA Technical Reports Server (NTRS)

El-Sum, H. M. A.; Mawardi, O. K.

1973-01-01

Techniques for studying aerodynamic noise generating mechanisms without disturbing the flow in a free field, and in the reverberation environment of the ARC wind tunnel were investigated along with the design and testing of an acoustic antenna with an electronic steering control. The acoustic characteristics of turbojet as a noise source, detection of direct sound from a source in a reverberant background, optical diagnostic methods, and the design characteristics of a high directivity acoustic antenna. Recommendations for further studies are included.

Benefit-risk Evaluation for Diagnostics: A Framework (BED-FRAME).

PubMed

Evans, Scott R; Pennello, Gene; Pantoja-Galicia, Norberto; Jiang, Hongyu; Hujer, Andrea M; Hujer, Kristine M; Manca, Claudia; Hill, Carol; Jacobs, Michael R; Chen, Liang; Patel, Robin; Kreiswirth, Barry N; Bonomo, Robert A

2016-09-15

The medical community needs systematic and pragmatic approaches for evaluating the benefit-risk trade-offs of diagnostics that assist in medical decision making. Benefit-Risk Evaluation of Diagnostics: A Framework (BED-FRAME) is a strategy for pragmatic evaluation of diagnostics designed to supplement traditional approaches. BED-FRAME evaluates diagnostic yield and addresses 2 key issues: (1) that diagnostic yield depends on prevalence, and (2) that different diagnostic errors carry different clinical consequences. As such, evaluating and comparing diagnostics depends on prevalence and the relative importance of potential errors. BED-FRAME provides a tool for communicating the expected clinical impact of diagnostic application and the expected trade-offs of diagnostic alternatives. BED-FRAME is a useful fundamental supplement to the standard analysis of diagnostic studies that will aid in clinical decision making. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

An overview of ITER diagnostics (invited)

NASA Astrophysics Data System (ADS)

Young, Kenneth M.; Costley, A. E.; ITER-JCT Home Team; ITER Diagnostics Expert Group

1997-01-01

The requirements for plasma measurements for operating and controlling the ITER device have now been determined. Initial criteria for the measurement quality have been set, and the diagnostics that might be expected to achieve these criteria have been chosen. The design of the first set of diagnostics to achieve these goals is now well under way. The design effort is concentrating on the components that interact most strongly with the other ITER systems, particularly the vacuum vessel, blankets, divertor modules, cryostat, and shield wall. The relevant details of the ITER device and facility design and specific examples of diagnostic design to provide the necessary measurements are described. These designs have to take account of the issues associated with very high 14 MeV neutron fluxes and fluences, nuclear heating, high heat loads, and high mechanical forces that can arise during disruptions. The design work is supported by an extensive research and development program, which to date has concentrated on the effects these levels of radiation might cause on diagnostic components. A brief outline of the organization of the diagnostic development program is given.

Sensory Over-Responsivity, Psychopathology, and Family Impairment in School-Aged Children

ERIC Educational Resources Information Center

Carter, Alice S.; Ben-Sasson, Ayelet; Briggs-Gowan, Margaret J.

2011-01-01

Objective: To establish the diagnostic validity of sensory overresponsivity (SOR), there is a need to document rates of SOR and the co-occurrence of SOR with other psychiatric disorders. Although this was not a diagnostic study of SOR, this study was designed to investigate rates of elevated SOR symptoms and associations between elevated SOR…

A design and implementation methodology for diagnostic systems

NASA Technical Reports Server (NTRS)

Williams, Linda J. F.

1988-01-01

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

Modular biowaste monitoring system conceptual design

NASA Technical Reports Server (NTRS)

Fogal, G. L.

1974-01-01

The objective of the study was to define requirements and generate a conceptual design for a Modular Biowaste Monitoring System for specifically supporting shuttle life science experimental and diagnostic programs.

Transforming information from silicon testing and design characterization into numerical data sets for yield learning

NASA Astrophysics Data System (ADS)

Yang, Thomas; Shen, Yang; Zhang, Yifan; Sweis, Jason; Lai, Ya-Chieh

2017-03-01

Silicon testing results are regularly collected for a particular lot of wafers to study yield loss from test result diagnostics. Product engineers will analyze the diagnostic results and perform a number of physical failure analyses to detect systematic defects which cause yield loss for these sets of wafers in order to feedback the information to process engineers for process improvements. Most of time, the systematic defects that are detected are major issues or just one of the causes for the overall yield loss. This paper will present a working flow for using design analysis techniques combined with diagnostic methods to systematically transform silicon testing information into physical layout information. A new set of the testing results are received from a new lot of wafers for the same product. We can then correlate all the diagnostic results from different periods of time to check which blocks or nets have been highlighted or stop occurring on the failure reports in order to monitor process changes which impact the yield. The design characteristic analysis flow is also implemented to find 1) the block connections on a design that have failed electrical test or 2) frequently used cells that been highlighted multiple times.

A diagnosis of bipolar spectrum disorder predicts diagnostic conversion from unipolar depression to bipolar disorder: a 5-year retrospective study.

PubMed

Woo, Young Sup; Shim, In Hee; Wang, Hee-Ryung; Song, Hoo Rim; Jun, Tae-Youn; Bahk, Won-Myong

2015-03-15

The major aims of this study were to identify factors that may predict the diagnostic conversion from major depressive disorder (MDD) to bipolar disorder (BP) and to evaluate the predictive performance of the bipolar spectrum disorder (BPSD) diagnostic criteria. The medical records of 250 patients with a diagnosis of MDD for at least 5 years were retrospectively reviewed for this study. The diagnostic conversion from MDD to BP was observed in 18.4% of 250 MDD patients, and the diagnostic criteria for BPSD predicted this conversion with high sensitivity (0.870) and specificity (0.917). A family history of BP, antidepressant-induced mania/hypomania, brief major depressive episodes, early age of onset, antidepressant wear-off, and antidepressant resistance were also independent predictors of this conversion. This study was conducted using a retrospective design and did not include structured diagnostic interviews. The diagnostic criteria for BPSD were highly predictive of the conversion from MDD to BP, and conversion was associated with several clinical features of BPSD. Thus, the BPSD diagnostic criteria may be useful for the prediction of bipolar diathesis in MDD patients. Copyright © 2014 Elsevier B.V. All rights reserved.

Influences of OSCE design on students' diagnostic reasoning.

PubMed

Lafleur, Alexandre; Côté, Luc; Leppink, Jimmie

2015-02-01

Some characteristics of assessments exert a strong influence on how students study. Understanding these pre-assessment learning effects is of key importance to the designing of medical assessments that foster students' reasoning abilities. Perceptions of the task demands of an assessment significantly influence students' cognitive processes. However, why and how certain tasks positively 'drive' learning remain unknown. Medical tasks can be assessed as coherent meaningful whole tasks (e.g. examining a patient based on his complaint to find the diagnosis) or can be divided into simpler part tasks (e.g. demonstrating the physical examination of a pre-specified disease). Comparing the benefits of whole-task and part-task assessments in a randomised controlled experiment could guide the design of 'assessments for learning'. The purpose of this study was to determine whether the knowledge that an objective structured clinical examination (OSCE) will contain whole tasks, as opposed to part tasks, increases the use of diagnostic reasoning by medical students when they study for this assessment. In this randomised, controlled, mixed-methods experiment, 40 medical students were randomly paired and filmed while studying together for two imminent physical examination OSCE stations. Each 25-minute study period began with video cues and ended with a questionnaire on cognitive loads. Cues disclosed either a part-task OSCE station (examination of a healthy patient) or a whole-task OSCE station (hypothesis-driven physical examination [HDPE]). In a crossover design, sequences were randomised for both task and content (shoulder or spine). Two blinded and independent authors scored all 40 videos in distinct randomised orders, listening to participants studying freely. Mentioning a diagnosis in association with a sign was scored as a backward association, and the opposite was scored as a forward association; both revealed the use of diagnostic reasoning. Qualitative data were obtained through group interviews. Studying for whole-task OSCE stations resulted in a greater use of diagnostic reasoning. Qualitative data triangulate these findings and show the precedence of cues sourced from the 'student grapevine'. In comparison with 'traditional' part-task OSCEs, whole-task OSCEs like the HDPE increase students' use of diagnostic reasoning during study time. © 2015 John Wiley & Sons Ltd.

Intelligent Diagnostic Assistant for Complicated Skin Diseases through C5's Algorithm.

PubMed

Jeddi, Fatemeh Rangraz; Arabfard, Masoud; Kermany, Zahra Arab

2017-09-01

Intelligent Diagnostic Assistant can be used for complicated diagnosis of skin diseases, which are among the most common causes of disability. The aim of this study was to design and implement a computerized intelligent diagnostic assistant for complicated skin diseases through C5's Algorithm. An applied-developmental study was done in 2015. Knowledge base was developed based on interviews with dermatologists through questionnaires and checklists. Knowledge representation was obtained from the train data in the database using Excel Microsoft Office. Clementine Software and C5's Algorithms were applied to draw the decision tree. Analysis of test accuracy was performed based on rules extracted using inference chains. The rules extracted from the decision tree were entered into the CLIPS programming environment and the intelligent diagnostic assistant was designed then. The rules were defined using forward chaining inference technique and were entered into Clips programming environment as RULE. The accuracy and error rates obtained in the training phase from the decision tree were 99.56% and 0.44%, respectively. The accuracy of the decision tree was 98% and the error was 2% in the test phase. Intelligent diagnostic assistant can be used as a reliable system with high accuracy, sensitivity, specificity, and agreement.

Statistical innovations in the medical device world sparked by the FDA.

PubMed

Campbell, Gregory; Yue, Lilly Q

2016-01-01

The world of medical devices while highly diverse is extremely innovative, and this facilitates the adoption of innovative statistical techniques. Statisticians in the Center for Devices and Radiological Health (CDRH) at the Food and Drug Administration (FDA) have provided leadership in implementing statistical innovations. The innovations discussed include: the incorporation of Bayesian methods in clinical trials, adaptive designs, the use and development of propensity score methodology in the design and analysis of non-randomized observational studies, the use of tipping-point analysis for missing data, techniques for diagnostic test evaluation, bridging studies for companion diagnostic tests, quantitative benefit-risk decisions, and patient preference studies.

A systematic review of diagnostic criteria for psoriasis in adults and children: evidence from studies with a primary aim to develop or validate diagnostic criteria.

PubMed

Burden-Teh, E; Phillips, R C; Thomas, K S; Ratib, S; Grindlay, D; Murphy, R

2017-11-06

The diagnosis of psoriasis in adults and children is made clinically, for both patient management and the selection of participants in research. Diagnostic criteria provide a structure for clinical assessment, which in turn helps standardize patient recruitment into clinical trials and case definitions in observational studies. The aim of this systematic review was to identify and critically appraise the published studies to date that had a primary research aim to develop or validate diagnostic criteria for psoriasis. A search of Ovid MEDLINE and Ovid Embase was conducted in October 2016. The primary objective was to record the sensitivity and specificity of diagnostic criteria for psoriasis. Secondary objectives included diagnostic recommendations, applicability to children and study characteristics. Diagnostic accuracy studies were critically appraised for risk of bias using the QUADAS-2 tool. Twenty-three studies met the inclusion criteria. None detailed clinical examination-based diagnostic criteria. The included criteria varied from genetic and molecular diagnostic models to skin imaging, histopathology, and questionnaire-based, computer-aided and traditional Chinese medicine criteria. High sensitivity and specificity (> 90%) were reported in many studies. However, the study authors often did not specify how the criteria would be used clinically or in research. This review identified studies with varying risk of bias, and due to each study developing separate criteria meta-analysis was not possible. Clinical examination-based diagnostic criteria are currently lacking for psoriasis. Future research could follow an international collaborative approach and employ study designs allowing high-quality diagnostic accuracy testing. Existing and newly developed criteria require validation. © 2017 British Association of Dermatologists.

Diagnostic Yield of Chromosomal Microarray Analysis in a Cohort of Patients with Autism Spectrum Disorders from a Highly Consanguineous Population

ERIC Educational Resources Information Center

Al-Mamari, Watfa; Al-Saegh, Abeer; Al-Kindy, Adila; Bruwer, Zandre; Al-Murshedi, Fathiya; Al-Thihli, Khalid

2015-01-01

Autism Spectrum Disorders are a complicated group of disorders characterized with heterogeneous genetic etiologies. The genetic investigations for this group of disorders have expanded considerably over the past decade. In our study we designed a tired approach and studied the diagnostic yield of chromosomal microarray analysis on patients…

HIDRA-MAT: A Material Analysis Tool for Fusion Devices

NASA Astrophysics Data System (ADS)

Andruczyk, Daniel; Rizkallah, Rabel; Bedoya, Felipe; Kapat, Aveek; Schamis, Hanna; Allain, Jean Paul

2017-10-01

The former WEGA stellarator which is now operating as HIDRA at the University of Illinois will be almost exclusively used to study the intimate relationship between the plasma interacting with surfaces of different materials. A Material Analysis Tool (HIDRA-MAT) is being designed and will be built based on the successful Material Analysis and Particle Probe (MAPP) which is currently used on NSTX-U at PPPL. This will be an in-situ material diagnostic probe, meaning that all analysis can be done without breaking vacuum. This allows surface changes to be studied in real-time. HIDRA-MAT will consist of several in-situ diagnostics including Langmuir probes (LP), Thermal Desorption Spectroscopy (TDS), X-ray Photo Spectroscopy (XPS) and Ion Scattering Spectroscopy (ISS). This presentation will outline the HIDRA-MAT diagnostic and initial design, as well as its integration into the HIDRA system.

Influence of perceived difficulty of cases on student osteopaths' diagnostic reasoning: a cross sectional study.

PubMed

Noyer, Aurelien L; Esteves, Jorge E; Thomson, Oliver P

2017-01-01

Diagnostic reasoning refers to the cognitive processes by which clinicians formulate diagnoses. Despite the implications for patient safety and professional identity, research on diagnostic reasoning in osteopathy remains largely theoretical. The aim of this study was to investigate the influence of perceived task difficulty on the diagnostic reasoning of students osteopaths. Using a single-blinded, cross sectional study design, sixteen final year pre-registration osteopathy students diagnosed two standardized cases under two context conditions (complex versus control). Context difficulty was manipulated via verbal manipulation and case order was randomized and counterbalanced across subjects to ensure that each case was diagnosed evenly under both conditions (i.e. half of the subjects performed either case A or B first). After diagnosis, participants were presented with items (literal, inferred and filler) designed to represent analytical and non-analytical reasoning. Response time and error rate for each item were measured. A repeated measures analysis of variance (concept type x context) was performed to identify differences across conditions and make inferences on diagnostic reasoning. Participants made significantly more errors when judging literal concepts and took significantly less time to recognize filler concepts in the complex context. No significant difference in ability to judge inferred concepts across contexts was found. Although speculative and preliminary, our findings suggest the perception of complexity led to an increased reliance on analytical reasoning at the detriment of non-analytical reasoning. To reduce the associated cognitive load, osteopathic educational institutions could consider developing the intuitive diagnostic capabilities of pre-registration students. Postgraduate mentorship opportunities could be considered to enhance the diagnostic reasoning of professional osteopaths, particularly recent graduates. Further research exploring the influence of expertise is required to enhance the validity of this study.

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…

Application of Diagnostic Analysis Tools to the Ares I Thrust Vector Control System

NASA Technical Reports Server (NTRS)

Maul, William A.; Melcher, Kevin J.; Chicatelli, Amy K.; Johnson, Stephen B.

2010-01-01

The NASA Ares I Crew Launch Vehicle is being designed to support missions to the International Space Station (ISS), to the Moon, and beyond. The Ares I is undergoing design and development utilizing commercial-off-the-shelf tools and hardware when applicable, along with cutting edge launch technologies and state-of-the-art design and development. In support of the vehicle s design and development, the Ares Functional Fault Analysis group was tasked to develop an Ares Vehicle Diagnostic Model (AVDM) and to demonstrate the capability of that model to support failure-related analyses and design integration. One important component of the AVDM is the Upper Stage (US) Thrust Vector Control (TVC) diagnostic model-a representation of the failure space of the US TVC subsystem. This paper first presents an overview of the AVDM, its development approach, and the software used to implement the model and conduct diagnostic analysis. It then uses the US TVC diagnostic model to illustrate details of the development, implementation, analysis, and verification processes. Finally, the paper describes how the AVDM model can impact both design and ground operations, and how some of these impacts are being realized during discussions of US TVC diagnostic analyses with US TVC designers.

Microbial Diagnostic Array Workstation (MDAW): a web server for diagnostic array data storage, sharing and analysis

PubMed Central

Scaria, Joy; Sreedharan, Aswathy; Chang, Yung-Fu

2008-01-01

Background Microarrays are becoming a very popular tool for microbial detection and diagnostics. Although these diagnostic arrays are much simpler when compared to the traditional transcriptome arrays, due to the high throughput nature of the arrays, the data analysis requirements still form a bottle neck for the widespread use of these diagnostic arrays. Hence we developed a new online data sharing and analysis environment customised for diagnostic arrays. Methods Microbial Diagnostic Array Workstation (MDAW) is a database driven application designed in MS Access and front end designed in ASP.NET. Conclusion MDAW is a new resource that is customised for the data analysis requirements for microbial diagnostic arrays. PMID:18811969

Microbial Diagnostic Array Workstation (MDAW): a web server for diagnostic array data storage, sharing and analysis.

PubMed

Scaria, Joy; Sreedharan, Aswathy; Chang, Yung-Fu

2008-09-23

Microarrays are becoming a very popular tool for microbial detection and diagnostics. Although these diagnostic arrays are much simpler when compared to the traditional transcriptome arrays, due to the high throughput nature of the arrays, the data analysis requirements still form a bottle neck for the widespread use of these diagnostic arrays. Hence we developed a new online data sharing and analysis environment customised for diagnostic arrays. Microbial Diagnostic Array Workstation (MDAW) is a database driven application designed in MS Access and front end designed in ASP.NET. MDAW is a new resource that is customised for the data analysis requirements for microbial diagnostic arrays.

How to: evaluate a diagnostic test.

PubMed

Leeflang, Mariska M G; Allerberger, Franz

2018-06-12

The development of an in vitro diagnostic test from a good idea to a clinically relevant tool takes several steps, with more stringent requirements at every step. This article aims to summarize the necessary questions to be asked about a test and to illustrate study designs answering these questions. We also aim to relate the Regulation (EU) 2017/746 to the needs of evidence-based diagnostic testing, where applicable. We used literature on evidence-based diagnostics, a text book on clinical trials in the development and marketing of medical devices and the English version of Regulation 2017/746 of the European Parliament and of the Council on in vitro diagnostic medical devices. The combination of different test uses and different stages of development determine the required test characteristics and suitability of study designs. In an earlier stage of test development it may be crucial to know whether a test can differentiate diseased persons from healthy controls, while this tells us little about how a test will perform in practice. Later stages focus on the diagnostic accuracy of a test in a clinically relevant situation. However, a test that perfectly distinguishes between patients with and without a certain condition may still have little effect on patient outcomes. Therefore, randomized controlled trials of testing may be needed, as well as post-marketing monitoring. Both researchers and users of tests need to be aware of the limitations of diagnostic test accuracy and realize that accuracy is only indirectly linked to people's health status. Copyright © 2018. Published by Elsevier Ltd.

Status of US ITER Diagnostics

NASA Astrophysics Data System (ADS)

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

2013-10-01

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

TROUBLE 3: A fault diagnostic expert system for Space Station Freedom's power system

NASA Technical Reports Server (NTRS)

Manner, David B.

1990-01-01

Designing Space Station Freedom has given NASA many opportunities to develop expert systems that automate onboard operations of space based systems. One such development, TROUBLE 3, an expert system that was designed to automate the fault diagnostics of Space Station Freedom's electric power system is described. TROUBLE 3's design is complicated by the fact that Space Station Freedom's power system is evolving and changing. TROUBLE 3 has to be made flexible enough to handle changes with minimal changes to the program. Three types of expert systems were studied: rule-based, set-covering, and model-based. A set-covering approach was selected for TROUBLE 3 because if offered the needed flexibility that was missing from the other approaches. With this flexibility, TROUBLE 3 is not limited to Space Station Freedom applications, it can easily be adapted to handle any diagnostic system.

Investigation of the feasibility of optical diagnostic measurements at the exit of the SSME

NASA Technical Reports Server (NTRS)

Shirley, John A.; Boedeker, Laurence R.

1993-01-01

Under Contract NAS8-36861 sponsored by NASA Marshall Space Flight Center, the United Technologies Research Center is conducting an investigation of the feasibility of remote optical diagnostics to measure temperature, species concentration and velocity at the exit of the Space Shuttle Main Engine (SSME). This is a two phase study consisting of a conceptual design phase followed by a laboratory experimental investigation. The first task of the conceptual design studies is to screen and evaluate the techniques which can be used for the measurements. The second task is to select the most promising technique or techniques, if as expected, more than one type of measurement must be used to measure all the flow variables of interest. The third task is to examine in detail analytically the capabilities and limitations of the selected technique(s). The results of this study are described in the section of this report entitled Conceptual Design Investigations. The conceptual design studies identified spontaneous Raman scattering and photodissociative flow-tagging for measurements respectively of gas temperature and major species concentration and for velocity. These techniques and others that were considered are described in the section describing the conceptual design. The objective of the second phase of investigations was to investigate experimentally the techniques identified in the first phase. The first task of the experimental feasibility study is to design and assemble laboratory scale experimental apparatus to evaluate the best approaches for SSME exit optical diagnostics for temperature, species concentrations and velocity, as selected in the Phase I conceptual design study. The second task is to evaluate performance, investigate limitations, and establish actual diagnostic capabilities, accuracies and precision for the selected optical systems. The third task is to evaluate design requirements and system trade-offs of conceptual instruments. Spontaneous Raman scattering excited by a KrF excimer laser pulse was investigated for SSME exit plane temperature and major species concentration measurements. The relative concentrations of molecular hydrogen and water vapor would be determined by measuring the integrated Q-branch scattering signals through narrow bandpass filters in front of photomultipliers. The temperature would be determined by comparing the signal from a single hydrogen rotational Raman line to the total hydrogen Q-branch signal. The rotational Raman line would be isolated by a monochromator and detected with a PMT.

An Investigation of Diagnostic Accuracy and Confidence Associated with Diagnostic Checklists as Well as Gender Biases in Relation to Mental Disorders.

PubMed

Cwik, Jan C; Papen, Fabienne; Lemke, Jan-Erik; Margraf, Jürgen

2016-01-01

This study examines the utility of checklists in attaining more accurate diagnoses in the context of diagnostic decision-making for mental disorders. The study also aimed to replicate results from a meta-analysis indicating that there is no association between patients' gender and misdiagnoses. To this end, 475 psychotherapists were asked to judge three case vignettes describing patients with Major Depressive Disorder (MDD), Generalized Anxiety Disorder, and Borderline Personality Disorder. Therapists were randomly assigned to experimental conditions in a 2 (diagnostic method: with using diagnostic checklists vs. without using diagnostic checklists) × 2 (gender: male vs. female case vignettes) between-subjects design. Multinomial logistic and linear regression analyses were used to examine the association between the usage of diagnostic checklists as well as patients' gender and diagnostic decisions. The results showed that when checklists were used, fewer incorrect co-morbid diagnoses were made, but clinicians were less likely to diagnose MDD even when the criteria were met. Additionally, checklists improved therapists' confidence with diagnostic decisions, but were not associated with estimations of patients' characteristics. As expected, there were no significant associations between gender and diagnostic decisions.

TummyTrials: A Feasibility Study of Using Self-Experimentation to Detect Individualized Food Triggers.

PubMed

Karkar, Ravi; Schroeder, Jessica; Epstein, Daniel A; Pina, Laura R; Scofield, Jeffrey; Fogarty, James; Kientz, Julie A; Munson, Sean A; Vilardaga, Roger; Zia, Jasmine

2017-05-02

Diagnostic self-tracking, the recording of personal information to diagnose or manage a health condition, is a common practice, especially for people with chronic conditions. Unfortunately, many who attempt diagnostic self-tracking have trouble accomplishing their goals. People often lack knowledge and skills needed to design and conduct scientifically rigorous experiments, and current tools provide little support. To address these shortcomings and explore opportunities for diagnostic self-tracking, we designed, developed, and evaluated a mobile app that applies a self-experimentation framework to support patients suffering from irritable bowel syndrome (IBS) in identifying their personal food triggers. TummyTrials aids a person in designing, executing, and analyzing self-experiments to evaluate whether a specific food triggers their symptoms. We examined the feasibility of this approach in a field study with 15 IBS patients, finding that participants could use the tool to reliably undergo a self-experiment. However, we also discovered an underlying tension between scientific validity and the lived experience of self-experimentation. We discuss challenges of applying clinical research methods in everyday life, motivating a need for the design of self-experimentation systems to balance rigor with the uncertainties of everyday life.

Case study: design and implementation of training for scientists deploying to Ebola diagnostic field laboratories in Sierra Leone: October 2014 to February 2016

PubMed Central

Lewis, Suzanna M.; Lansley, Amber; Fraser, Sara; Shieber, Clare; Shah, Sonal; Semper, Amanda; Bailey, Daniel; Busuttil, Jason; Evans, Liz; Carroll, Miles W.; Silman, Nigel J.; Brooks, Tim; Shallcross, Jane A.

2017-01-01

As part of the UK response to the 2013–2016 Ebola virus disease (EVD) epidemic in West Africa, Public Health England (PHE) were tasked with establishing three field Ebola virus (EBOV) diagnostic laboratories in Sierra Leone by the UK Department for International Development (DFID). These provided diagnostic support to the Ebola Treatment Centre (ETC) facilities located in Kerry Town, Makeni and Port Loko. The Novel and Dangerous Pathogens (NADP) Training group at PHE, Porton Down, designed and implemented a pre-deployment Ebola diagnostic laboratory training programme for UK volunteer scientists being deployed to the PHE EVD laboratories. Here, we describe the training, workflow and capabilities of these field laboratories for use in response to disease epidemics and in epidemiological surveillance. We discuss the training outcomes, the laboratory outputs, lessons learned and the legacy value of the support provided. We hope this information will assist in the recruitment and training of staff for future responses and in the design and implementation of rapid deployment diagnostic field laboratories for future outbreaks of high consequence pathogens. This article is part of the themed issue ‘The 2013–2016 West African Ebola epidemic: data, decision-making and disease control’. PMID:28396470

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…

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

An Analysis of 16-17-Year-Old Students' Understanding of Solution Chemistry Concepts Using a Two-Tier Diagnostic Instrument

ERIC Educational Resources Information Center

Adadan, Emine; Savasci, Funda

2012-01-01

This study focused on the development of a two-tier multiple-choice diagnostic instrument, which was designed and then progressively modified, and implemented to assess students' understanding of solution chemistry concepts. The results of the study are derived from the responses of 756 Grade 11 students (age 16-17) from 14 different high schools…

Advancing Diagnostics to Address Antibacterial Resistance: The Diagnostics and Devices Committee of the Antibacterial Resistance Leadership Group

PubMed Central

Tsalik, Ephraim L.; Petzold, Elizabeth; Kreiswirth, Barry N.; Bonomo, Robert A.; Banerjee, Ritu; Lautenbach, Ebbing; Evans, Scott R.; Hanson, Kimberly E.; Klausner, Jeffrey D.

2017-01-01

Abstract Diagnostics are a cornerstone of the practice of infectious diseases. However, various limitations frequently lead to unmet clinical needs. In most other domains, diagnostics focus on narrowly defined questions, provide readily interpretable answers, and use true gold standards for development. In contrast, infectious diseases diagnostics must contend with scores of potential pathogens, dozens of clinical syndromes, emerging pathogens, rapid evolution of existing pathogens and their associated resistance mechanisms, and the absence of gold standards in many situations. In spite of these challenges, the importance and value of diagnostics cannot be underestimated. Therefore, the Antibacterial Resistance Leadership Group has identified diagnostics as 1 of 4 major areas of emphasis. Herein, we provide an overview of that development, highlighting several examples where innovation in study design, content, and execution is advancing the field of infectious diseases diagnostics. PMID:28350903

Software Users Manual (SUM): Extended Testability Analysis (ETA) Tool

NASA Technical Reports Server (NTRS)

Maul, William A.; Fulton, Christopher E.

2011-01-01

This software user manual describes the implementation and use the Extended Testability Analysis (ETA) Tool. The ETA Tool is a software program that augments the analysis and reporting capabilities of a commercial-off-the-shelf (COTS) testability analysis software package called the Testability Engineering And Maintenance System (TEAMS) Designer. An initial diagnostic assessment is performed by the TEAMS Designer software using a qualitative, directed-graph model of the system being analyzed. The ETA Tool utilizes system design information captured within the diagnostic model and testability analysis output from the TEAMS Designer software to create a series of six reports for various system engineering needs. The ETA Tool allows the user to perform additional studies on the testability analysis results by determining the detection sensitivity to the loss of certain sensors or tests. The ETA Tool was developed to support design and development of the NASA Ares I Crew Launch Vehicle. The diagnostic analysis provided by the ETA Tool was proven to be valuable system engineering output that provided consistency in the verification of system engineering requirements. This software user manual provides a description of each output report generated by the ETA Tool. The manual also describes the example diagnostic model and supporting documentation - also provided with the ETA Tool software release package - that were used to generate the reports presented in the manual

Diagnostic Crossover in Anorexia Nervosa and Bulimia Nervosa: Implications for DSM-V

PubMed Central

Eddy, Kamryn T.; Dorer, David J.; Franko, Debra L.; Tahilani, Kavita; Thompson-Brenner, Heather; Herzog, David B.

2011-01-01

Objective The Diagnostic and Statistical Manual of Mental Disorders (DSM) is designed primarily as a clinical tool. Yet high rates of diagnostic “crossover” among the anorexia nervosa subtypes and bulimia nervosa may reflect problems with the validity of the current diagnostic schema, thereby limiting its clinical utility. This study was designed to examine diagnostic crossover longitudinally in anorexia nervosa and bulimia nervosa to inform the validity of the DSM-IV-TR eating disorders classification system. Method A total of 216 women with a diagnosis of anorexia nervosa or bulimia nervosa were followed for 7 years; weekly eating disorder symptom data collected using the Eating Disorder Longitudinal Interval Follow-Up Examination allowed for diagnoses to be made throughout the follow-up period. Results Over 7 years, the majority of women with anorexia nervosa experienced diagnostic crossover: more than half crossed between the restricting and binge eating/purging anorexia nervosa subtypes over time; one-third crossed over to bulimia nervosa but were likely to relapse into anorexia nervosa. Women with bulimia nervosa were unlikely to cross over to anorexia nervosa. Conclusions These findings support the longitudinal distinction of anorexia nervosa and bulimia nervosa but do not support the anorexia nervosa subtyping schema. PMID:18198267

Activation of host immune responses in neonatal calves and interference with TB diagnostics after immunization with a commercial heat-killed vaccine

USDA-ARS?s Scientific Manuscript database

A major drawback of current whole-cell vaccines for Mycobacterium avium subsp. paratuberculosis is the potential interference with diagnostic tests for bovine tuberculosis and paratuberculosis. The current study was designed to explore cross-reactivity of the current USDA commercial vaccine for MAP ...

Activation of host immune responses in neonatal calves and interference with TB diagnostics after immunization with a commercial heat-killed vaccine

USDA-ARS?s Scientific Manuscript database

A major drawback of current whole-cell vaccines for Mycobacterium avium subsp. paratuberculosis (MAP) is the potential interference with diagnostic tests for bovine tuberculosis and paratuberculosis. The current study was designed to explore cross-reactivity of the current USDA commercial vaccine fo...

The Rorschach Perceptual-Thinking Index (PTI): An Examination of Reliability, Validity, and Diagnostic Efficiency

ERIC Educational Resources Information Center

Hilsenroth, Mark J.; Eudell-Simmons, Erin M.; DeFife, Jared A.; Charnas, Jocelyn W.

2007-01-01

This study investigates the reliability, validity, and diagnostic efficiency of the Rorschach Perceptual-Thinking Index (PTI) in relation to the accurate identification of psychotic disorder (PTD) patients. The PTI is a revision of the Rorschach Schizophrenia Index (SCZI), designed to achieve several criteria, including an increase in the…

Simulated performance of the optical Thomson scattering diagnostic designed for the National Ignition Facility.

PubMed

Ross, J S; Datte, P; Divol, L; Galbraith, J; Froula, D H; Glenzer, S H; Hatch, B; Katz, J; Kilkenny, J; Landen, O; Manuel, A M; Molander, W; Montgomery, D S; Moody, J D; Swadling, G; Weaver, J

2016-11-01

An optical Thomson scattering diagnostic has been designed for the National Ignition Facility to characterize under-dense plasmas. We report on the design of the system and the expected performance for different target configurations. The diagnostic is designed to spatially and temporally resolve the Thomson scattered light from laser driven targets. The diagnostic will collect scattered light from a 50 × 50 × 200 μm volume. The optical design allows operation with different probe laser wavelengths. A deep-UV probe beam (λ 0 = 210 nm) will be used to Thomson scatter from electron plasma densities of ∼5 × 10 20 cm -3 while a 3ω probe will be used for plasma densities of ∼1 × 10 19 cm -3 . The diagnostic package contains two spectrometers: the first to resolve Thomson scattering from ion acoustic wave fluctuations and the second to resolve scattering from electron plasma wave fluctuations. Expected signal levels relative to background will be presented for typical target configurations (hohlraums and a planar foil).

Comparison of study designs for acute otitis media trials.

PubMed

Pichichero, Michael E; Casey, Janet R

2008-06-01

A framework for evaluating the efficacy of antibiotics in development as well as those currently approved for acute otitis media (AOM) is needed. Review strengths and limitations of various antibiotic trial designs and their outcome measures. A review of 157 published trials involving 36,710 subjects for the treatment of AOM. AOM trials have three designs: (1) clinical, clinical diagnosis and assessment of outcomes; (2) single tympanocentesis, microbiologic diagnosis (by middle ear fluid culture) and clinical assessment of outcomes; and (3) double tympanocentesis, microbiologic diagnosis and microbiologic outcome assessment. Identifiable strengths and limitations of each design are reviewed. Case definitions for entry of children in trials of AOM vary widely. The lack of stringent diagnostic criteria in a clinical design allows for inclusion of a significant proportion of children with a non-bacterial etiology (i.e., viral AOM or otitis media with effusion). Tympanocentesis increases diagnostic accuracy at study entry; however, the procedure is confounding because of its potentially therapeutic benefit and the procedure is not performed in a uniform manner. A second tympanocentesis allows a high sensitivity to detect microbiologic eradication, but it does not correlate with clinical outcomes in half of the cases. The timing of outcome assessment also varies widely among trials. Improved clinical diagnosis criteria for AOM are needed to enhance specificity; emphasis on a bulging tympanic membrane has the best evidence base. Tympanocentesis within study designs has merits. At study entry it assures diagnostic accuracy but may alter outcomes and it is useful to document microbiologic outcomes but lacks specificity for clinical outcomes. For all designs, test of cure assessment 2-7 days after completion of therapy seems most appropriate.

Optimized and Automated design of Plasma Diagnostics for Additive Manufacture

NASA Astrophysics Data System (ADS)

Stuber, James; Quinley, Morgan; Melnik, Paul; Sieck, Paul; Smith, Trevor; Chun, Katherine; Woodruff, Simon

2016-10-01

Despite having mature designs, diagnostics are usually custom designed for each experiment. Most of the design can be now be automated to reduce costs (engineering labor, and capital cost). We present results from scripted physics modeling and parametric engineering design for common optical and mechanical components found in many plasma diagnostics and outline the process for automated design optimization that employs scripts to communicate data from online forms through proprietary and open-source CAD and FE codes to provide a design that can be sent directly to a printer. As a demonstration of design automation, an optical beam dump, baffle and optical components are designed via an automated process and printed. Supported by DOE SBIR Grant DE-SC0011858.

It's time to change perspective! New diagnostic tools for lateral elbow pain.

PubMed

Arrigoni, P; Cucchi, D; Menon, A; Randelli, P

2017-12-01

The presence of intra-articular findings that may complement the extra-articular pathology in lateral epicondilytis has been suggested, and a role for minor instability of the elbow as part of the causative process of this disease has been postulated. This study was designed to describe two new clinical tests, aimed at detecting intra-articular pathology in patients affected by recalcitrant lateral epicondylitis and investigate their diagnostic performance. Ten patients suffering of atraumatic lateral elbow pain unresponsive to conservative treatment were considered in this study. Two clinical tests were developed and administrated prior to arthroscopy: Supination and Antero-Lateral pain Test (SALT); Posterior Elbow Pain by Palpation-Extension of the Radiocapitellar joint (PEPPER). Sensitivity, specificity, predictive values and accuracy of SALT and PEPPER as diagnostic tests for seven intra-articular findings were calculated. In 90% of the patients, at least one test was positive. All patients with signs of lateral ligamentous patholaxity or intra-articular abnormal findings had a positive response to at least one of the two tests. SALT proved to have a high sensitivity but a low specificity and is accurate in detecting the presence of intra-articular abnormal findings, especially synovitis. PEPPER test was sensible, specific and accurate in the detection of radial head chondropathy. Two new diagnostic tests (SALT and PEPPER) were specifically designed to evoke pain from intra-articular structures. These tests could be a valid support in the diagnostic algorithm of recalcitrant lateral elbow pain. Positive findings may be indicative of a minor instability of the lateral elbow condition. Diagnostic study, development of diagnostic criteria on basis of consecutive patients, level II.

75 FR 35439 - Medical Diagnostic Equipment Accessibility Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-22

... ARCHITECTURAL AND TRANSPORTATION BARRIERS COMPLIANCE BOARD Medical Diagnostic Equipment... accessibility standards for medical diagnostic equipment to ensure that such equipment is accessible to, and... respect to medical diagnostic equipment and existing guidance for designing accessible medical diagnostic...

The Dresden Predictor Study of anxiety and depression: objectives, design, and methods.

PubMed

Trumpf, Julia; Vriends, Noortje; Meyer, Andrea H; Becker, Eni S; Neumer, Simon-Peter; Margraf, Jürgen

2010-09-01

The present report describes the objectives, design, and methods of the Dresden Predictor Study (DPS) of anxiety and depression, a prospective epidemiological study investigating anxiety disorders and depression in 3,065 young German women (18-25 years of age). The DPS consists of a baseline and one follow-up investigation separated by approximately 17 months. At both time points, respondents were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) using an extended German version of the Anxiety Disorders Interview Schedule (ADIS-IV-L). In addition to diagnostic assessment, respondents completed a battery of self-report questionnaires that provided detailed information about potential predictors of disorders and a comprehensive dimensional assessment of psychopathology. Results on both response bias in the baseline investigation and effects of dropout at follow-up are presented, and strengths and limitations of the study design are discussed.

Development of Simple Designs of Multitip Probe Diagnostic Systems for RF Plasma Characterization

PubMed Central

Naz, M. Y.; Shukrullah, S.; Ghaffar, A.; Rehman, N. U.

2014-01-01

Multitip probes are very useful diagnostics for analyzing and controlling the physical phenomena occurring in low temperature discharge plasmas. However, DC biased probes often fail to perform well in processing plasmas. The objective of the work was to deduce simple designs of DC biased multitip probes for parametric study of radio frequency plasmas. For this purpose, symmetric double probe, asymmetric double probe, and symmetric triple probe diagnostic systems and their driving circuits were designed and tested in an inductively coupled plasma (ICP) generated by a 13.56 MHz radio frequency (RF) source. Using I-V characteristics of these probes, electron temperature, electron number density, and ion saturation current was measured as a function of input power and filling gas pressure. An increasing trend was noticed in electron temperature and electron number density for increasing input RF power whilst a decreasing trend was evident in these parameters when measured against filling gas pressure. In addition, the electron energy probability function (EEPF) was also studied by using an asymmetric double probe. These studies confirmed the non-Maxwellian nature of the EEPF and the presence of two groups of the energetic electrons at low filling gas pressures. PMID:24683326

Parkinson's Disease Diagnostic Observations (PADDO): study rationale and design of a prospective cohort study for early differentiation of parkinsonism.

PubMed

van Rumund, Anouke; Aerts, Marjolein B; Esselink, Rianne A J; Meijer, Frederick J A; Verbeek, Marcel M; Bloem, Bastiaan R

2018-05-16

Differentiation of Parkinson's disease (PD) from the various types of atypical parkinsonism (AP) such as multiple system atrophy (MSA), progressive supranuclear palsy (PSP), dementia with Lewy bodies (DLB), corticobasal syndrome (CBS) and vascular parkinsonism (VP), can be challenging, especially early in the disease course when symptoms overlap. A major unmet need in the diagnostic workup of these disorders is a diagnostic tool that differentiates the various disorders, preferably in the earliest disease stages when the clinical presentation is similar. Many diagnostic tests have been evaluated, but their added value was studied mostly in retrospective case-control studies that included patients with a straightforward clinical diagnosis. Here, we describe the design of a prospective cohort study in patients with parkinsonism in an early disease stage who have an uncertain clinical diagnosis. Our aim is to evaluate the diagnostic accuracy of (1) detailed clinical examination by a movement disorder specialist, (2) magnetic resonance imaging (MRI) techniques and (3) cerebrospinal fluid (CSF) biomarkers. Patients with parkinsonism with an uncertain clinical diagnosis and a disease course less than three years will be recruited. Patients will undergo extensive neurological examination, brain MRI including conventional and advanced sequences, and a lumbar puncture. The diagnosis (including level of certainty) will be defined by a movement disorders expert, neuroradiologist and neurochemist based on clinical data, MRI results and CSF results, respectively. The clinical diagnosis after three years' follow-up will serve as the "gold standard" reference diagnosis, based on consensus criteria and as established by two movement disorder specialists (blinded to the test results). Diagnostic accuracy of individual instruments and added value of brain MRI and CSF analysis after evaluation by a movement disorder expert will be calculated, expressed as the change in percentage of individuals that are correctly diagnosed with PD or AP. This study will yield new insights into the diagnostic value of clinical evaluation by a movement disorder specialist, brain MRI and CSF analysis in discriminating PD from AP in early disease stages. The outcome has the potential to help clinicians in choosing the optimal diagnostic strategy for patients with an uncertain clinical diagnosis. NCT01249768, registered November 26 2010.

Development of the ITER magnetic diagnostic set and specification.

PubMed

Vayakis, G; Arshad, S; Delhom, D; Encheva, A; Giacomin, T; Jones, L; Patel, K M; Pérez-Lasala, M; Portales, M; Prieto, D; Sartori, F; Simrock, S; Snipes, J A; Udintsev, V S; Watts, C; Winter, A; Zabeo, L

2012-10-01

ITER magnetic diagnostics are now in their detailed design and R&D phase. They have passed their conceptual design reviews and a working diagnostic specification has been prepared aimed at the ITER project requirements. This paper highlights specific design progress, in particular, for the in-vessel coils, steady state sensors, saddle loops and divertor sensors. Key changes in the measurement specifications, and a working concept of software and electronics are also outlined.

Impact of Molecular Diagnostics for Tuberculosis on Patient-Important Outcomes: A Systematic Review of Study Methodologies

PubMed Central

Schumacher, Samuel G.; Sohn, Hojoon; Qin, Zhi Zhen; Gore, Genevieve; Davis, J. Lucian; Denkinger, Claudia M.; Pai, Madhukar

2016-01-01

Background Several reviews on the accuracy of Tuberculosis (TB) Nucleic Acid Amplification Tests (NAATs) have been performed but the evidence on their impact on patient-important outcomes has not been systematically reviewed. Given the recent increase in research evaluating such outcomes and the growing list of TB NAATs that will reach the market over the coming years, there is a need to bring together the existing evidence on impact, rather than accuracy. We aimed to assess the approaches that have been employed to measure the impact of TB NAATs on patient-important outcomes in adults with possible pulmonary TB and/or drug-resistant TB. Methods We first develop a conceptual framework to clarify through which mechanisms the improved technical performance of a novel TB test may lead to improved patient outcomes and outline which designs may be used to measure them. We then systematically review the literature on studies attempting to assess the impact of molecular TB diagnostics on such outcomes and provide a narrative synthesis of designs used, outcomes assessed and risk of bias across different study designs. Results We found 25 eligible studies that assessed a wide range of outcomes and utilized a variety of experimental and observational study designs. Many potentially strong design options have never been used. We found that much of the available evidence on patient-important outcomes comes from a small number of settings with particular epidemiological and operational context and that confounding, time trends and incomplete outcome data receive insufficient attention. Conclusions A broader range of designs should be considered when designing studies to assess the impact of TB diagnostics on patient outcomes and more attention needs to be paid to the analysis as concerns about confounding and selection bias become relevant in addition to those on measurement that are of greatest concern in accuracy studies. PMID:26954678

Methodological quality of diagnostic accuracy studies on non-invasive coronary CT angiography: influence of QUADAS (Quality Assessment of Diagnostic Accuracy Studies included in systematic reviews) items on sensitivity and specificity.

PubMed

Schueler, Sabine; Walther, Stefan; Schuetz, Georg M; Schlattmann, Peter; Dewey, Marc

2013-06-01

To evaluate the methodological quality of diagnostic accuracy studies on coronary computed tomography (CT) angiography using the QUADAS (Quality Assessment of Diagnostic Accuracy Studies included in systematic reviews) tool. Each QUADAS item was individually defined to adapt it to the special requirements of studies on coronary CT angiography. Two independent investigators analysed 118 studies using 12 QUADAS items. Meta-regression and pooled analyses were performed to identify possible effects of methodological quality items on estimates of diagnostic accuracy. The overall methodological quality of coronary CT studies was merely moderate. They fulfilled a median of 7.5 out of 12 items. Only 9 of the 118 studies fulfilled more than 75 % of possible QUADAS items. One QUADAS item ("Uninterpretable Results") showed a significant influence (P = 0.02) on estimates of diagnostic accuracy with "no fulfilment" increasing specificity from 86 to 90 %. Furthermore, pooled analysis revealed that each QUADAS item that is not fulfilled has the potential to change estimates of diagnostic accuracy. The methodological quality of studies investigating the diagnostic accuracy of non-invasive coronary CT is only moderate and was found to affect the sensitivity and specificity. An improvement is highly desirable because good methodology is crucial for adequately assessing imaging technologies. • Good methodological quality is a basic requirement in diagnostic accuracy studies. • Most coronary CT angiography studies have only been of moderate design quality. • Weak methodological quality will affect the sensitivity and specificity. • No improvement in methodological quality was observed over time. • Authors should consider the QUADAS checklist when undertaking accuracy studies.

Additive manufacture (3d printing) of plasma diagnostic components and assemblies for fusion experiments

NASA Astrophysics Data System (ADS)

Sieck, Paul; Woodruff, Simon; Stuber, James; Romero-Talamas, Carlos; Rivera, William; You, Setthivoine; Card, Alexander

2015-11-01

Additive manufacturing (or 3D printing) is now becoming sufficiently accurate with a large range of materials for use in printing sensors needed universally in fusion energy research. Decreasing production cost and significantly lowering design time of energy subsystems would realize significant cost reduction for standard diagnostics commonly obtained through research grants. There is now a well-established set of plasma diagnostics, but these expensive since they are often highly complex and require customization, sometimes pace the project. Additive manufacturing (3D printing) is developing rapidly, including open source designs. Basic components can be printed for (in some cases) less than 1/100th costs of conventional manufacturing. We have examined the impact that AM can have on plasma diagnostic cost by taking 15 separate diagnostics through an engineering design using Conventional Manufacturing (CM) techniques to determine costs of components and labor costs associated with getting the diagnostic to work as intended. With that information in hand, we set about optimizing the design to exploit the benefits of AM. Work performed under DOE Contract DE-SC0011858.

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…

Development of stimulation diagnostic technology. Annual report, May 1990--December 1991

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

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

Decision making about healthcare-related tests and diagnostic test strategies. Paper 2: a review of methodological and practical challenges.

PubMed

Mustafa, Reem A; Wiercioch, Wojtek; Cheung, Adrienne; Prediger, Barbara; Brozek, Jan; Bossuyt, Patrick; Garg, Amit X; Lelgemann, Monika; Büehler, Diedrich; Schünemann, Holger J

2017-12-01

In this first of a series of five articles, we provide an overview of how and why healthcare-related tests and diagnostic strategies are currently applied. We also describe how our findings can be integrated with existing frameworks for making decisions that guide the use of healthcare-related tests and diagnostic strategies. We searched MEDLINE, references of identified articles, chapters in relevant textbooks, and identified articles citing classic literature on this topic. We provide updated frameworks for the potential roles and applications of tests with suggested definitions and practical examples. We also discuss study designs that are commonly used to assess tests' performance and the effects of tests on people's health. These designs include diagnostic randomized controlled trials and retrospective validation. We describe the utility of these and other currently suggested designs, which questions they can answer and which ones they cannot. In addition, we summarize the challenges unique to decision-making resulting from the use of tests. This overview highlights current challenges in the application of tests in decision-making in healthcare, provides clarifications, and informs the proposed solutions. Copyright © 2017 Elsevier Inc. All rights reserved.

Design of the optical backscatter diagnostic for laser plasma interaction measurements on NIF

NASA Astrophysics Data System (ADS)

Moody, J. D.; Datte, P.; Ng, E.; Maitland, K.; Hsing, W.; MacGowan, B. J.; Froula, D. H.; Neumayer, P.; Sutter, L.; Meezan, N.; Glenzer, S. H.; Kirkwood, R. K.; Divol, L.; Andrews, S.; Jackson, J.; MacKinnon, A.; Jovanovic, I.; Beeler, R.; Bertolini, L.; Landon, M.; Alvarez, S.; Lee, T.; Watts, P.

2007-11-01

We describe the design of the backscatter diagnostic for NIF laser-plasma interaction (LPI) studies. It will initially be used to validate the 280 eV point design hohlraum and select phase plates for the ignition experiments. Backscatter measurements are planned for two separate groups of 4 beams (a quad). One quad is 30^o from the hohlraum axis and the other at 50^o. The backscatter measurement utilizes 2 instruments for each beam quad. The full aperture backscatter system (FABS) measures light backscattered into the final focus lens of each beam in the quad. The near backscatter imager (NBI) measures light backscattered outside of the beam quad. Both instruments must work in conjunction to provide spectrally and temporally resolved backscatter power. We describe the design of the diagnostic and its capabilities as well as plans for calibrating it and analyzing the resulting data. This work was performed under the auspices of the U.S. Department of Energy by University of California, Lawrence Livermore National Laboratory under Contract W-7405-Eng-48.

A recoverable gas-cell diagnostic for the National Ignition Facility.

PubMed

Ratkiewicz, A; Berzak Hopkins, L; Bleuel, D L; Bernstein, L A; van Bibber, K; Cassata, W S; Goldblum, B L; Siem, S; Velsko, C A; Wiedeking, M; Yeamans, C B

2016-11-01

The high-fluence neutron spectrum produced by the National Ignition Facility (NIF) provides an opportunity to measure the activation of materials by fast-spectrum neutrons. A new large-volume gas-cell diagnostic has been designed and qualified to measure the activation of gaseous substances at the NIF. This in-chamber diagnostic is recoverable, reusable and has been successfully fielded. Data from the qualification of the diagnostic have been used to benchmark an Monte Carlo N-Particle Transport Code simulation describing the downscattered neutron spectrum seen by the gas cell. We present early results from the use of this diagnostic to measure the activation of nat Xe and discuss future work to study the strength of interactions between plasma and nuclei.

Receiver operating characteristic (ROC) curves: review of methods with applications in diagnostic medicine

NASA Astrophysics Data System (ADS)

Obuchowski, Nancy A.; Bullen, Jennifer A.

2018-04-01

Receiver operating characteristic (ROC) analysis is a tool used to describe the discrimination accuracy of a diagnostic test or prediction model. While sensitivity and specificity are the basic metrics of accuracy, they have many limitations when characterizing test accuracy, particularly when comparing the accuracies of competing tests. In this article we review the basic study design features of ROC studies, illustrate sample size calculations, present statistical methods for measuring and comparing accuracy, and highlight commonly used ROC software. We include descriptions of multi-reader ROC study design and analysis, address frequently seen problems of verification and location bias, discuss clustered data, and provide strategies for testing endpoints in ROC studies. The methods are illustrated with a study of transmission ultrasound for diagnosing breast lesions.

Simulation of a tangential soft x-ray imaging system.

PubMed

Battaglia, D J; Shafer, M W; Unterberg, E A; Bell, R E; Hillis, D L; LeBlanc, B P; Maingi, R; Sabbagh, S; Stratton, B C

2010-10-01

Tangentially viewing soft x-ray (SXR) cameras are capable of detecting nonaxisymmetric plasma structures in magnetically confined plasmas. They are particularly useful for studying stationary perturbations or phenomenon that occur on a timescale faster than the plasma rotation period. Tangential SXR camera diagnostics are planned for the DIII-D and NSTX tokamaks to elucidate the static edge magnetic structure during the application of 3D perturbations. To support the design of the proposed diagnostics, a synthetic diagnostic model was developed using the CHIANTI database to estimate the SXR emission. The model is shown to be in good agreement with the measurements from an existing tangential SXR camera diagnostic on NSTX.

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.

Simulated performance of the optical Thomson scattering diagnostic designed for the National Ignition Facility

DOE PAGES

Ross, J. S.; Datte, P.; Divol, L.; ...

2016-07-28

An optical Thomson scattering diagnostic has been designed for the National Ignition Facility to characterize under-dense plasmas. Here, we report on the design of the system and the expected performance for different target configurations. The diagnostic is designed to spatially and temporally resolve the Thomson scattered light from laser driven targets. The diagnostic will collect scattered light from a 50 × 50 × 200 μm volume. The optical design allows operation with different probe laser wavelengths. A deep-UV probe beam (λ 0 = 210 nm) will be used to Thomson scatter from electron plasma densities of ~5 × 10 20more » cm -3 while a 3ω probe will be used for plasma densities of ~1 × 10 19 cm -3. The diagnostic package contains two spectrometers: the first to resolve Thomson scattering from ion acoustic wave fluctuations and the second to resolve scattering from electron plasma wave fluctuations. Expected signal levels relative to background will be presented for typical target configurations (hohlraums and a planar foil).« less

Simulated performance of the optical Thomson scattering diagnostic designed for the National Ignition Facility

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

Ross, J. S., E-mail: ross36@llnl.gov; Datte, P.; Divol, L.

2016-11-15

An optical Thomson scattering diagnostic has been designed for the National Ignition Facility to characterize under-dense plasmas. We report on the design of the system and the expected performance for different target configurations. The diagnostic is designed to spatially and temporally resolve the Thomson scattered light from laser driven targets. The diagnostic will collect scattered light from a 50 × 50 × 200 μm volume. The optical design allows operation with different probe laser wavelengths. A deep-UV probe beam (λ{sub 0} = 210 nm) will be used to Thomson scatter from electron plasma densities of ∼5 × 10{sup 20} cm{supmore » −3} while a 3ω probe will be used for plasma densities of ∼1 × 10{sup 19} cm{sup −3}. The diagnostic package contains two spectrometers: the first to resolve Thomson scattering from ion acoustic wave fluctuations and the second to resolve scattering from electron plasma wave fluctuations. Expected signal levels relative to background will be presented for typical target configurations (hohlraums and a planar foil).« less

System Related Interventions to Reduce Diagnostic Error: A Narrative Review

PubMed Central

Singh, Hardeep; Graber, Mark L.; Kissam, Stephanie M.; Sorensen, Asta V.; Lenfestey, Nancy F.; Tant, Elizabeth M.; Henriksen, Kerm; LaBresh, Kenneth A.

2013-01-01

Background Diagnostic errors (missed, delayed, or wrong diagnosis) have gained recent attention and are associated with significant preventable morbidity and mortality. We reviewed the recent literature to identify interventions that have been, or could be, implemented to address systems-related factors that contribute directly to diagnostic error. Methods We conducted a comprehensive search using multiple search strategies. We first identified candidate articles in English between 2000 and 2009 from a PubMed search that exclusively evaluated for articles related to diagnostic error or delay. We then sought additional papers from references in the initial dataset, searches of additional databases, and subject matter experts. Articles were included if they formally evaluated an intervention to prevent or reduce diagnostic error; however, we also included papers if interventions were suggested and not tested in order to inform the state-of-the science on the topic. We categorized interventions according to the step in the diagnostic process they targeted: patient-provider encounter, performance and interpretation of diagnostic tests, follow-up and tracking of diagnostic information, subspecialty and referral-related; and patient-specific. Results We identified 43 articles for full review, of which 6 reported tested interventions and 37 contained suggestions for possible interventions. Empirical studies, though somewhat positive, were non-experimental or quasi-experimental and included a small number of clinicians or health care sites. Outcome measures in general were underdeveloped and varied markedly between studies, depending on the setting or step in the diagnostic process involved. Conclusions Despite a number of suggested interventions in the literature, few empirical studies have tested interventions to reduce diagnostic error in the last decade. Advancing the science of diagnostic error prevention will require more robust study designs and rigorous definitions of diagnostic processes and outcomes to measure intervention effects. PMID:22129930

The ITER bolometer diagnostic: Status and plansa)

NASA Astrophysics Data System (ADS)

Meister, H.; Giannone, L.; Horton, L. D.; Raupp, G.; Zeidner, W.; Grunda, G.; Kalvin, S.; Fischer, U.; Serikov, A.; Stickel, S.; Reichle, R.

2008-10-01

A consortium consisting of four EURATOM Associations has been set up to develop the project plan for the full development of the ITER bolometer diagnostic and to continue urgent R&D activities. An overview of the current status is given, including detector development, line-of-sight optimization, performance analysis as well as the design of the diagnostic components and their integration in ITER. This is complemented by the presentation of plans for future activities required to successfully implement the bolometer diagnostic, ranging from the detector development over diagnostic design and prototype testing to RH tools for calibration.

Educational agenda for diagnostic error reduction

PubMed Central

Trowbridge, Robert L; Dhaliwal, Gurpreet; Cosby, Karen S

2013-01-01

Diagnostic errors are a major patient safety concern. Although the majority of diagnostic errors are partially attributable to cognitive mistakes, the most effective means of improving clinician cognition in order to achieve gains in diagnostic reliability are unclear. We propose a tripartite educational agenda for improving diagnostic performance among students, residents and practising physicians. This agenda includes strengthening the metacognitive abilities of clinicians, fostering intuitive reasoning and increasing awareness of the role of systems in the diagnostic process. The evidence supporting initiatives in each of these realms is reviewed and a course of future implementation and study is proposed. The barriers to designing and implementing this agenda are substantial and include limited evidence supporting these initiatives and the challenges of changing the practice patterns of practising physicians. Implementation will need to be accompanied by rigorous evaluation. PMID:23764435

A clinical utility study of exome sequencing versus conventional genetic testing in pediatric neurology.

PubMed

Vissers, Lisenka E L M; van Nimwegen, Kirsten J M; Schieving, Jolanda H; Kamsteeg, Erik-Jan; Kleefstra, Tjitske; Yntema, Helger G; Pfundt, Rolph; van der Wilt, Gert Jan; Krabbenborg, Lotte; Brunner, Han G; van der Burg, Simone; Grutters, Janneke; Veltman, Joris A; Willemsen, Michèl A A P

2017-09-01

Implementation of novel genetic diagnostic tests is generally driven by technological advances because they promise shorter turnaround times and/or higher diagnostic yields. Other aspects, including impact on clinical management or cost-effectiveness, are often not assessed in detail prior to implementation. We studied the clinical utility of whole-exome sequencing (WES) in complex pediatric neurology in terms of diagnostic yield and costs. We analyzed 150 patients (and their parents) presenting with complex neurological disorders of suspected genetic origin. In a parallel study, all patients received both the standard diagnostic workup (e.g., cerebral imaging, muscle biopsies or lumbar punctures, and sequential gene-by-gene-based testing) and WES simultaneously. Our unique study design allowed direct comparison of diagnostic yield of both trajectories and provided insight into the economic implications of implementing WES in this diagnostic trajectory. We showed that WES identified significantly more conclusive diagnoses (29.3%) than the standard care pathway (7.3%) without incurring higher costs. Exploratory analysis of WES as a first-tier diagnostic test indicates that WES may even be cost-saving, depending on the extent of other tests being omitted. Our data support such a use of WES in pediatric neurology for disorders of presumed genetic origin.Genet Med advance online publication 23 March 2017.

A clinical utility study of exome sequencing versus conventional genetic testing in pediatric neurology

PubMed Central

Vissers, Lisenka E.L.M.; van Nimwegen, Kirsten J.M.; Schieving, Jolanda H.; Kamsteeg, Erik-Jan; Kleefstra, Tjitske; Yntema, Helger G.; Pfundt, Rolph; van der Wilt, Gert Jan; Krabbenborg, Lotte; Brunner, Han G.; van der Burg, Simone; Grutters, Janneke; Veltman, Joris A.; Willemsen, Michèl A.A.P.

2017-01-01

Purpose: Implementation of novel genetic diagnostic tests is generally driven by technological advances because they promise shorter turnaround times and/or higher diagnostic yields. Other aspects, including impact on clinical management or cost-effectiveness, are often not assessed in detail prior to implementation. Methods: We studied the clinical utility of whole-exome sequencing (WES) in complex pediatric neurology in terms of diagnostic yield and costs. We analyzed 150 patients (and their parents) presenting with complex neurological disorders of suspected genetic origin. In a parallel study, all patients received both the standard diagnostic workup (e.g., cerebral imaging, muscle biopsies or lumbar punctures, and sequential gene-by-gene–based testing) and WES simultaneously. Results: Our unique study design allowed direct comparison of diagnostic yield of both trajectories and provided insight into the economic implications of implementing WES in this diagnostic trajectory. We showed that WES identified significantly more conclusive diagnoses (29.3%) than the standard care pathway (7.3%) without incurring higher costs. Exploratory analysis of WES as a first-tier diagnostic test indicates that WES may even be cost-saving, depending on the extent of other tests being omitted. Conclusion: Our data support such a use of WES in pediatric neurology for disorders of presumed genetic origin. Genet Med advance online publication 23 March 2017 PMID:28333917

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.

Advancing Diagnostics to Address Antibacterial Resistance: The Diagnostics and Devices Committee of the Antibacterial Resistance Leadership Group.

PubMed

Tsalik, Ephraim L; Petzold, Elizabeth; Kreiswirth, Barry N; Bonomo, Robert A; Banerjee, Ritu; Lautenbach, Ebbing; Evans, Scott R; Hanson, Kimberly E; Klausner, Jeffrey D; Patel, Robin

2017-03-15

Diagnostics are a cornerstone of the practice of infectious diseases. However, various limitations frequently lead to unmet clinical needs. In most other domains, diagnostics focus on narrowly defined questions, provide readily interpretable answers, and use true gold standards for development. In contrast, infectious diseases diagnostics must contend with scores of potential pathogens, dozens of clinical syndromes, emerging pathogens, rapid evolution of existing pathogens and their associated resistance mechanisms, and the absence of gold standards in many situations. In spite of these challenges, the importance and value of diagnostics cannot be underestimated. Therefore, the Antibacterial Resistance Leadership Group has identified diagnostics as 1 of 4 major areas of emphasis. Herein, we provide an overview of that development, highlighting several examples where innovation in study design, content, and execution is advancing the field of infectious diseases diagnostics. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Chronic kidney disease-associated pruritus: impact on quality of life and current management challenges

PubMed Central

Shirazian, Shayan; Aina, Olufemi; Park, Youngjun; Chowdhury, Nawsheen; Leger, Kathleen; Hou, Linle; Miyawaki, Nobuyuki; Mathur, Vandana S

2017-01-01

Chronic kidney disease-associated pruritus (CKD-aP) is a distressing, often overlooked condition in patients with CKD and end-stage renal disease. It affects ~40% of patients with end-stage renal disease and has been associated with poor quality of life, poor sleep, depression, and mortality. Prevalence estimates vary based on the instruments used to diagnose CKD-aP, and standardized diagnostic instruments are sorely needed. Treatment studies have often yielded conflicting results. This is likely related to studies that are limited by small sample size, flawed designs, and nonstandardized diagnostic instruments. Several large well-designed treatment trials have recently been completed and may soon influence CKD-aP management. PMID:28176969

The Targeted Reading Intervention (TRI): A Classroom Teacher Tier 2 Intervention to Help Struggling Readers in Early Elementary School

ERIC Educational Resources Information Center

Vernon-Feagans, Lynne; Amendum, Steve; Kainz, Kirsten; Ginsburg, Marnie

2009-01-01

The two studies presented in this report were designed to test the effectiveness of a new diagnostic-based reading intervention for classroom teachers, called the Targeted Reading Intervention (TRI). This TRI Tier 2 intervention stressed diagnostic teaching as the key to helping struggling readers make rapid progress in reading in the regular…

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,…

The Impact of Model Misspecification on Parameter Estimation and Item-Fit Assessment in Log-Linear Diagnostic Classification Models

ERIC Educational Resources Information Center

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

2012-01-01

Using a complex simulation study we investigated parameter recovery, classification accuracy, and performance of two item-fit statistics for correct and misspecified diagnostic classification models within a log-linear modeling framework. The basic manipulated test design factors included the number of respondents (1,000 vs. 10,000), attributes (3…

State Special Education Criteria for Identifying Intellectual Disability: A Review Following Revised Diagnostic Criteria and Rosa's Law

ERIC Educational Resources Information Center

McNicholas, Patrick J.; Floyd, Randy G.; Woods, Isaac L.; Singh, Leah J.; Manguno, Meredith S.; Maki, Kathrin E.

2018-01-01

Across the last century, the condition known as "intellectual disability" (ID) has been labeled by assorted terms, its key features have varied, and recommendations for its identification have been divided. In light of recent changes to the diagnostic criteria for ID and to federal legislation, this study was designed to compile and…

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

Factors Associated with the Performance and Cost-Effectiveness of Using Lymphatic Filariasis Transmission Assessment Surveys for Monitoring Soil-Transmitted Helminths: A Case Study in Kenya

PubMed Central

Smith, Jennifer L.; Sturrock, Hugh J. W.; Assefa, Liya; Nikolay, Birgit; Njenga, Sammy M.; Kihara, Jimmy; Mwandawiro, Charles S.; Brooker, Simon J.

2015-01-01

Transmission assessment surveys (TAS) for lymphatic filariasis have been proposed as a platform to assess the impact of mass drug administration (MDA) on soil-transmitted helminths (STHs). This study used computer simulation and field data from pre- and post-MDA settings across Kenya to evaluate the performance and cost-effectiveness of the TAS design for STH assessment compared with alternative survey designs. Variations in the TAS design and different sample sizes and diagnostic methods were also evaluated. The district-level TAS design correctly classified more districts compared with standard STH designs in pre-MDA settings. Aggregating districts into larger evaluation units in a TAS design decreased performance, whereas age group sampled and sample size had minimal impact. The low diagnostic sensitivity of Kato-Katz and mini-FLOTAC methods was found to increase misclassification. We recommend using a district-level TAS among children 8–10 years of age to assess STH but suggest that key consideration is given to evaluation unit size. PMID:25487730

Issues of diagnostic review in brain tumor studies: from the Brain Tumor Epidemiology Consortium.

PubMed

Davis, Faith G; Malmer, Beatrice S; Aldape, Ken; Barnholtz-Sloan, Jill S; Bondy, Melissa L; Brännström, Thomas; Bruner, Janet M; Burger, Peter C; Collins, V Peter; Inskip, Peter D; Kruchko, Carol; McCarthy, Bridget J; McLendon, Roger E; Sadetzki, Siegal; Tihan, Tarik; Wrensch, Margaret R; Buffler, Patricia A

2008-03-01

Epidemiologists routinely conduct centralized single pathology reviews to minimize interobserver diagnostic variability, but this practice does not facilitate the combination of studies across geographic regions and institutions where diagnostic practices differ. A meeting of neuropathologists and epidemiologists focused on brain tumor classification issues in the context of protocol needs for consortial studies (http://epi.grants.cancer.gov/btec/). It resulted in recommendations relevant to brain tumors and possibly other rare disease studies. Two categories of brain tumors have enough general agreement over time, across regions, and between individual pathologists that one can consider using existing diagnostic data without further review: glioblastomas and meningiomas (as long as uniform guidelines such as those provided by the WHO are used). Prospective studies of these tumors benefit from collection of pathology reports, at a minimum recording the pathology department and classification system used in the diagnosis. Other brain tumors, such as oligodendroglioma, are less distinct and require careful histopathologic review for consistent classification across study centers. Epidemiologic study protocols must consider the study specific aims, diagnostic changes that have taken place over time, and other issues unique to the type(s) of tumor being studied. As diagnostic changes are being made rapidly, there are no readily available answers on disease classification issues. It is essential that epidemiologists and neuropathologists collaborate to develop appropriate study designs and protocols for specific hypothesis and populations.

Italian Survey on Prevalence and Disease Management of Chronic Heart Failure and Chronic Obstructive Pulmonary Disease comorbidity in ambulatory patients. SUSPIRIUM study rationale and design.

PubMed

Griffo, Raffaele; Spanevello, Antonio; Temporelli, Pier Luigi; Faggiano, Pompilio; Carones, Mauro; Magni, Giovanna; Ambrosino, Nicolino; Tavazzi, Luigi

2014-03-01

Chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD) are leading causes of morbidity and mortality worldwide. Through shared risk factors and pathophysiological mechanisms, CHF and COPD frequently coexist. The concurrent disease has important therapeutic implications and independently predicts worsened mortality, impaired functional status, and health service use. However, assessment of the comorbidity varies widely according to the population studied, diagnostic criteria and measurement tools applied. Both syndromes have been studied extensively but largely separately, mostly in the domain of the pulmonologist for COPD and in the domain of the cardiologist for CHF. The aim of the study is to evaluate in an Italian outpatients setting (10 cardiology and 10 pulmonology centers from the same institution) the prevalence, clinical profile and the routine diagnostic, functional and therapeutic work-up applied by cardiologists and pulmonologists in the presence/suspicion of concurrent disease in patients in a stable phase of their disease. For this purpose, CHF and COPU outpatients will be enrolled in a multicenter, nationwide, prospective observational study. Risk estimation of comorbidity will be based on suspected, documented or patient-reported diagnosis of COPD/CHF. In the absence of documented concurrent diagnosis, each specialist will describe the diagnostic, functional and therapeutic work-up applied. The design of the study focused on the diagnostic validation of the CHF-COPD comorbidity aims to provide relevant new information on the assessment of the coexistent condition in the cardiac and pulmonary outpatients setting and on specialty-related different diagnostic and therapeutic strategies of comorbidity utilized in real life clinical practice. The symptomatic and prognostic benefits resulting from a combined approach to CHF/COPD could outweigh those attainable by treating either condition alone.

Diagnostic Accuracy of Chinese Medicine Diagnosis Scale of Phlegm and Blood Stasis Syndrome in Coronary Heart Disease: A Study Protocol.

PubMed

Liu, Xiao-Qi; Peng, Dan-Hong; Wang, Yan-Ping; Xie, Rong; Chen, Xin-Lin; Yu, Chun-Quan; Li, Xian-Tao

2018-05-03

Phlegm and blood stasis syndrome (PBSS) is one of the main syndromes in coronary heart disease (CHD). Syndromes of Chinese medicine (CM) are lack of quantitative and easyimplementation diagnosis standards. To quantify and standardize the diagnosis of PBSS, scales are usually applied. To evaluate the diagnostic accuracy of CM diagnosis scale of PBSS in CHD. Six hundred patients with stable angina pectoris of CHD, 300 in case group and 300 in control group, will be recruited from 5 hospitals across China. Diagnosis from 2 experts will be considered as the "gold standard". The study design consists of 2 phases: pilot test is used to evaluate the reliability and validity, and diagnostic test is used to assess the diagnostic accuracy of the scale, including sensitivity, specififi city, likelihood ratio and area under the receiver operator characteristic (ROC) curve. This study will evaluate the diagnostic accuracy of CM diagnosis scale of PBSS in CHD. The consensus of 2 experts may not be ideal as a "gold standard", and itself still requires further study. (No. ChiCTR-OOC-15006599).

Indexing of Diagnostic Accuracy Studies in MEDLINE and EMBASE

PubMed Central

Wilczynski, Nancy L.; Haynes, R. Brian

2007-01-01

Background: STAndards for Reporting of Diagnostic Accuracy (STARD) were published in 2003 and endorsed by some journals but not others. Objective: To determine whether the quality of indexing of diagnostic accuracy studies in MEDLINE and EMBASE has improved since the STARD statement was published. Design: Evaluate the change in the mean number of “accurate index terms” assigned to diagnostic accuracy studies, comparing STARD (endorsing) and non-STARD (non-endorsing) journals, for 2 years before and after STARD publication. Results: In MEDLINE, no differences in indexing quality were found for STARD and non-STARD journals before or after the STARD statement was published in 2003. In EMBASE, indexing in STARD journals improved compared with non-STARD journals (p = 0.02). However, articles in STARD journals had half the number of accurate indexing terms as articles in non-STARD journals, both before and after STARD statement publication (p < 0.001). PMID:18693947

Structure and Computation in Immunoreagent Design: From Diagnostics to Vaccines.

PubMed

Gourlay, Louise; Peri, Claudio; Bolognesi, Martino; Colombo, Giorgio

2017-12-01

Novel immunological tools for efficient diagnosis and treatment of emerging infections are urgently required. Advances in the diagnostic and vaccine development fields are continuously progressing, with reverse vaccinology and structural vaccinology (SV) methods for antigen identification and structure-based antigen (re)design playing increasingly relevant roles. SV, in particular, is predicted to be the front-runner in the future development of diagnostics and vaccines targeting challenging diseases such as AIDS and cancer. We review state-of-the-art methodologies for structure-based epitope identification and antigen design, with specific applicative examples. We highlight the implications of such methods for the engineering of biomolecules with improved immunological properties, potential diagnostic and/or therapeutic uses, and discuss the perspectives of structure-based rational design for the production of advanced immunoreagents. Copyright © 2017 Elsevier Ltd. All rights reserved.

A recoverable gas-cell diagnostic for the National Ignition Facility

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

Ratkiewicz, A., E-mail: ratkiewicz1@llnl.gov; Berzak Hopkins, L.; Bleuel, D. L.

2016-11-15

The high-fluence neutron spectrum produced by the National Ignition Facility (NIF) provides an opportunity to measure the activation of materials by fast-spectrum neutrons. A new large-volume gas-cell diagnostic has been designed and qualified to measure the activation of gaseous substances at the NIF. This in-chamber diagnostic is recoverable, reusable and has been successfully fielded. Data from the qualification of the diagnostic have been used to benchmark an Monte Carlo N-Particle Transport Code simulation describing the downscattered neutron spectrum seen by the gas cell. We present early results from the use of this diagnostic to measure the activation of {sup nat}Xemore » and discuss future work to study the strength of interactions between plasma and nuclei.« less

A recoverable gas-cell diagnostic for the National Ignition Facility

DOE PAGES

Ratkiewicz, A.; Hopkins, L. Berzak; Bleuel, D. L.; ...

2016-08-22

Here, the high-fluence neutron spectrum produced by the National Ignition Facility (NIF) provides an opportunity to measure the activation of materials by fast-spectrum neutrons. A new large-volume gas-cell diagnostic has been designed and qualified to measure the activation of gaseous substances at the NIF. This in-chamber diagnostic is recoverable, reusable and has been successfully fielded. Data from the qualification of the diagnostic have been used to benchmark an Monte Carlo N-Particle Transport Code simulation describing the downscattered neutron spectrum seen by the gas cell. We present early results from the use of this diagnostic to measure the activation of natXemore » and discuss future work to study the strength of interactions between plasma and nuclei.« less

Asymptotic Properties of the Sequential Empirical ROC, PPV and NPV Curves Under Case-Control Sampling.

PubMed

Koopmeiners, Joseph S; Feng, Ziding

2011-01-01

The receiver operating characteristic (ROC) curve, the positive predictive value (PPV) curve and the negative predictive value (NPV) curve are three measures of performance for a continuous diagnostic biomarker. The ROC, PPV and NPV curves are often estimated empirically to avoid assumptions about the distributional form of the biomarkers. Recently, there has been a push to incorporate group sequential methods into the design of diagnostic biomarker studies. A thorough understanding of the asymptotic properties of the sequential empirical ROC, PPV and NPV curves will provide more flexibility when designing group sequential diagnostic biomarker studies. In this paper we derive asymptotic theory for the sequential empirical ROC, PPV and NPV curves under case-control sampling using sequential empirical process theory. We show that the sequential empirical ROC, PPV and NPV curves converge to the sum of independent Kiefer processes and show how these results can be used to derive asymptotic results for summaries of the sequential empirical ROC, PPV and NPV curves.

Asymptotic Properties of the Sequential Empirical ROC, PPV and NPV Curves Under Case-Control Sampling

PubMed Central

Koopmeiners, Joseph S.; Feng, Ziding

2013-01-01

The receiver operating characteristic (ROC) curve, the positive predictive value (PPV) curve and the negative predictive value (NPV) curve are three measures of performance for a continuous diagnostic biomarker. The ROC, PPV and NPV curves are often estimated empirically to avoid assumptions about the distributional form of the biomarkers. Recently, there has been a push to incorporate group sequential methods into the design of diagnostic biomarker studies. A thorough understanding of the asymptotic properties of the sequential empirical ROC, PPV and NPV curves will provide more flexibility when designing group sequential diagnostic biomarker studies. In this paper we derive asymptotic theory for the sequential empirical ROC, PPV and NPV curves under case-control sampling using sequential empirical process theory. We show that the sequential empirical ROC, PPV and NPV curves converge to the sum of independent Kiefer processes and show how these results can be used to derive asymptotic results for summaries of the sequential empirical ROC, PPV and NPV curves. PMID:24039313

LASER BIOLOGY AND MEDICINE: Application of tunable diode lasers for a highly sensitive analysis of gaseous biomarkers in exhaled air

NASA Astrophysics Data System (ADS)

Stepanov, E. V.; Milyaev, Varerii A.

2002-11-01

The application of tunable diode lasers for a highly sensitive analysis of gaseous biomarkers in exhaled air in biomedical diagnostics is discussed. The principle of operation and the design of a laser analyser for studying the composition of exhaled air are described. The results of detection of gaseous biomarkers in exhaled air, including clinical studies, which demonstrate the diagnostic possibilities of the method, are presented.

The Spanish Diagnostic Interview Schedule. Reliability and comparison with clinical diagnoses.

PubMed

Burnam, M A; Karno, M; Hough, R L; Escobar, J I; Forsythe, A B

1983-11-01

The National Institute of Mental Health Diagnostic Interview Schedule (DIS) was translated into Spanish. The reliability of the Spanish instrument, its equivalence to the English version, and its agreement with clinical diagnoses were examined in a study of 90 bilingual (English-and Spanish-speaking) and 61 monolingual (Spanish-speaking only) patients from a community mental health center. The study design involved two independent DIS administrations and one independent clinical evaluation of each subject.

Establishing a European research agenda on 'gut feelings' in general practice. A qualitative study using the nominal group technique.

PubMed

Stolper, Erik; van Leeuwen, Yvonne; van Royen, Paul; van de Wiel, Margaretha; van Bokhoven, Marloes; Houben, Paul; Hobma, Sjoerd; van der Weijden, Trudy; Dinant, Geert Jan

2010-06-01

Although 'gut feelings' are perceived as playing a substantial role in the diagnostic reasoning of the general practitioner (GP), there is little evidence about their diagnostic and prognostic value. Consensus on both types of 'gut feelings' (a 'sense of alarm', a 'sense of reassurance') has enabled us to operationalize the concept. As a next step we wanted to identify research questions that are considered relevant to validate the concept of 'gut feelings' and to estimate its usefulness for daily practice and medical education. Moreover, we were interested in the study designs considered appropriate to study these research questions. The nominal group technique (NGT) is a qualitative research method of judgmental decision-making involving four phases: generating ideas, recording them, evaluation and prioritization. Dutch and Belgian academics whose subject is general practice (n = 18), attended one of three meetings during which NGT was used to produce a 'research agenda' on 'gut feelings'. NGT yielded ten research questions and nine corresponding appropriate designs on four topics, i.e. the diagnostic value of 'gut feelings', the validation of its determinants, the opportunities for integrating 'gut feelings' in medical education and a rest group. The study designs respectively included recording and follow-up of 'gut feelings', video recording of consultations with stimulated recall using simulated and real patients respectively, analysing trainees' consultation stories and videos, linguistic analyses, and vignette studies. Furthermore, two experimental designs were proposed. A European research agenda on 'gut feelings' in general practice has been established and could be used in collaborative research.

Reliability of Chinese medicine diagnostic variables in the examination of patients with osteoarthritis of the knee.

PubMed

Hua, Bin; Abbas, Estelle; Hayes, Alan; Ryan, Peter; Nelson, Lisa; O'Brien, Kylie

2012-11-01

Chinese medicine (CM) has its own diagnostic indicators that are used as evidence of change in a patient's condition. The majority of studies investigating efficacy of Chinese herbal medicine (CHM) have utilized biomedical diagnostic endpoints. For CM clinical diagnostic variables to be incorporated into clinical trial designs, there would need to be evidence that these diagnostic variables are reliable. Previous studies have indicated that the reliability of CM syndrome diagnosis is variable. Little information is known about where the variability stems from--the basic data collection level or the synthesis of diagnostic data, or both. No previous studies have investigated systematically the reliability of all four diagnostic methods used in the CM diagnostic process (Inquiry, Inspection, Auscultation/Olfaction, and Palpation). The objective of this study was to assess the inter-rater reliability of data collected using the four diagnostic methods of CM in Australian patients with knee osteoarthritis (OA), in order to investigate if CM variables could be used with confidence as diagnostic endpoints in a clinical trial investigating the efficacy of a CHM in treating OA. An inter-rater reliability study was conducted as a substudy of a clinical trial investigating the treatment of knee OA with Chinese herbal medicine. Two (2) experienced CM practitioners conducted a CM examination separately, within 2 hours of each other, in 40 participants. A CM assessment form was utilized to record the diagnostic data. Cohen's κ coefficient was used as a measure of the level of agreement between 2 practitioners. There was a relatively good level of agreement for Inquiry and Auscultation variables, and, in general, a low level of agreement for (visual) Inspection and Palpation variables. There was variation in the level of agreement between 2 practitioners on clinical information collected using the Four Diagnostic Methods of a CM examination. Some aspects of CM diagnosis appear to be reliable, while others are not. Based on these results, it was inappropriate to use CM diagnostic variables as diagnostic endpoints in the main study, which was an investigation of efficacy of CHM treatment of knee OA.

Parametric Thermal and Flow Analysis of ITER Diagnostic Shield Module

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

Khodak, A.; Zhai, Y.; Wang, W.

As part of the diagnostic port plug assembly, the ITER Diagnostic Shield Module (DSM) is designed to provide mechanical support and the plasma shielding while allowing access to plasma diagnostics. Thermal and hydraulic analysis of the DSM was performed using a conjugate heat transfer approach, in which heat transfer was resolved in both solid and liquid parts, and simultaneously, fluid dynamics analysis was performed only in the liquid part. ITER Diagnostic First Wall (DFW) and cooling tubing were also included in the analysis. This allowed direct modeling of the interface between DSM and DFW, and also direct assessment of themore » coolant flow distribution between the parts of DSM and DFW to ensure DSM design meets the DFW cooling requirements. Design of the DSM included voids filled with Boron Carbide pellets, allowing weight reduction while keeping shielding capability of the DSM. These voids were modeled as a continuous solid with smeared material properties using analytical relation for thermal conductivity. Results of the analysis lead to design modifications improving heat transfer efficiency of the DSM. Furthermore, the effect of design modifications on thermal performance as well as effect of Boron Carbide will be presented.« less

Designs and adaptive analysis plans for pivotal clinical trials of therapeutics and companion diagnostics.

PubMed

Simon, Richard

2008-06-01

Developments in genomics and biotechnology provide unprecedented opportunities for the development of effective therapeutics and companion diagnostics for matching the right drug to the right patient. Effective co-development involves many new challenges with increased opportunity for success as well as delay and failure. Clinical trial designs and adaptive analysis plans for the prospective design of pivotal trials of new therapeutics and companion diagnostics are reviewed. Effective co-development requires careful prospective planning of the design and analysis strategy for pivotal clinical trials. Randomized clinical trials continue to be important for evaluating the effectiveness of new treatments, but the target populations for analysis should be prospectively specified based on the companion diagnostic. Post hoc analyses of traditionally designed randomized clinical trials are often deeply problematic. Clear separation is generally required of the data used for developing the diagnostic test, including their threshold of positivity, from the data used for evaluating treatment effectiveness in subsets determined by the test. Adaptive analysis can be used to provide flexibility to the analysis but the use of such methods requires careful planning and prospective definition in order to assure that the pivotal trial adequately limits the chance of erroneous conclusions.

Parametric Thermal and Flow Analysis of ITER Diagnostic Shield Module

DOE PAGES

Khodak, A.; Zhai, Y.; Wang, W.; ...

2017-06-19

As part of the diagnostic port plug assembly, the ITER Diagnostic Shield Module (DSM) is designed to provide mechanical support and the plasma shielding while allowing access to plasma diagnostics. Thermal and hydraulic analysis of the DSM was performed using a conjugate heat transfer approach, in which heat transfer was resolved in both solid and liquid parts, and simultaneously, fluid dynamics analysis was performed only in the liquid part. ITER Diagnostic First Wall (DFW) and cooling tubing were also included in the analysis. This allowed direct modeling of the interface between DSM and DFW, and also direct assessment of themore » coolant flow distribution between the parts of DSM and DFW to ensure DSM design meets the DFW cooling requirements. Design of the DSM included voids filled with Boron Carbide pellets, allowing weight reduction while keeping shielding capability of the DSM. These voids were modeled as a continuous solid with smeared material properties using analytical relation for thermal conductivity. Results of the analysis lead to design modifications improving heat transfer efficiency of the DSM. Furthermore, the effect of design modifications on thermal performance as well as effect of Boron Carbide will be presented.« less

Design of the radiation shielding for the time of flight enhanced diagnostics neutron spectrometer at Experimental Advanced Superconducting Tokamak

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

Du, T. F.; Chen, Z. J.; Peng, X. Y.

A radiation shielding has been designed to reduce scattered neutrons and background gamma-rays for the new double-ring Time Of Flight Enhanced Diagnostics (TOFED). The shielding was designed based on simulation with the Monte Carlo code MCNP5. Dedicated model of the EAST tokamak has been developed together with the emission neutron source profile and spectrum; the latter were simulated with the Nubeam and GENESIS codes. Significant reduction of background radiation at the detector can be achieved and this satisfies the requirement of TOFED. The intensities of the scattered and direct neutrons in the line of sight of the TOFED neutron spectrometermore » at EAST are studied for future data interpretation.« less

Evaluation of thermal helium beam and line-ratio fast diagnostic on the National Spherical Torus Experiment-Upgrade

DOE PAGES

Munoz Burgos, Jorge M.; Agostini, Matteo; Scarin, Paolo; ...

2015-05-06

A 1-D kinetic collisional radiative model (CRM) with state-of-the-art atomic data is developed and employed to simulate line emission to evaluate the Thermal Helium Beam (THB) diagnostic on NSTX-U. This diagnostic is currently in operation on RFX-mod, and it is proposed to be installed on NSTX-U. The THB system uses the intensity ratios of neutral helium lines 667.8, 706.5, and 728.1 nm to derive electron temperature (eV ) and density (cm –3) profiles. The purpose of the present analysis is to evaluate the applications of this diagnostic for determining fast (~4 μs) electron temperature and density radial profiles on themore » scrape-off layer (SOL) and edge regions of NSTX-U that are needed in turbulence studies. The diagnostic is limited by the level of detection of the 728.1 nm line, which is the weakest of the three. In conclusion, this study will also aid in future design of a similar 2-D diagnostic systems on the divertor.« less

Comparative genome analysis identifies novel nucleic acid diagnostic targets for use in the specific detection of Haemophilus influenzae.

PubMed

Coughlan, Helena; Reddington, Kate; Tuite, Nina; Boo, Teck Wee; Cormican, Martin; Barrett, Louise; Smith, Terry J; Clancy, Eoin; Barry, Thomas

2015-10-01

Haemophilus influenzae is recognised as an important human pathogen associated with invasive infections, including bloodstream infection and meningitis. Currently used molecular-based diagnostic assays lack specificity in correctly detecting and identifying H. influenzae. As such, there is a need to develop novel diagnostic assays for the specific identification of H. influenzae. Whole genome comparative analysis was performed to identify putative diagnostic targets, which are unique in nucleotide sequence to H. influenzae. From this analysis, we identified 2H. influenzae putative diagnostic targets, phoB and pstA, for use in real-time PCR diagnostic assays. Real-time PCR diagnostic assays using these targets were designed and optimised to specifically detect and identify all 55H. influenzae strains tested. These novel rapid assays can be applied to the specific detection and identification of H. influenzae for use in epidemiological studies and could also enable improved monitoring of invasive disease caused by these bacteria. Copyright © 2015 Elsevier Inc. All rights reserved.

The development of a post-test diagnostic system for rocket engines

NASA Technical Reports Server (NTRS)

Zakrajsek, June F.

1991-01-01

An effort was undertaken by NASA to develop an automated post-test, post-flight diagnostic system for rocket engines. The automated system is designed to be generic and to automate the rocket engine data review process. A modular, distributed architecture with a generic software core was chosen to meet the design requirements. The diagnostic system is initially being applied to the Space Shuttle Main Engine data review process. The system modules currently under development are the session/message manager, and portions of the applications section, the component analysis section, and the intelligent knowledge server. An overview is presented of a rocket engine data review process, the design requirements and guidelines, the architecture and modules, and the projected benefits of the automated diagnostic system.

Design Decisions in Developing Learning Trajectories-Based Assessments in Mathematics: A Case Study

ERIC Educational Resources Information Center

Penuel, William R.; Confrey, Jere; Maloney, Alan; Rupp, André A.

2014-01-01

This article analyzes the design decisions of a team developing diagnostic assessments for a learning trajectory focused on rational number reasoning. The analysis focuses on the design rationale for key decisions about how to develop the cognitive assessments and related validity arguments within a fluid state and national policy context. The…

Willingness to pay for diagnostic technologies: a review of the contingent valuation literature.

PubMed

Lin, Pei-Jung; Cangelosi, Michael J; Lee, David W; Neumann, Peter J

2013-01-01

To understand how people value information from diagnostic technologies, we reviewed and analyzed published willingness-to-pay (WTP) studies on the topic. We searched PubMed for English-language articles related to WTP for diagnostic laboratory tests published from 1985 through 2011. We characterized methodological differences across studies, examined individual- and technology-level factors associated with WTP, and summarized median WTP values across different diagnostic tests. We identified 66 relevant WTP studies. Half focused on oncology, while others analyzed infectious diseases (n = 11, 16.1%) and obstetric or gynecological conditions (n = 8, 11.7%), among others. Most laboratory tests included in studies were biological samples/genetic testing (n = 44, 61.1%) or imaging tests (n = 23, 31.9%). Approximately one third of the analyses (n = 20, 30.3%) used discrete-choice questions to elicit WTP values. Higher income, education, disease severity, perceived disease risk, family history, and more accurate tests were in general associated with higher WTP values for diagnostic information. Of the 44 studies with median WTP values available, most reported a median WTP value below $100. The median WTP value for colon or colorectal cancer screening ranged from below $100 to over $1000. The contingent valuation literature in diagnostics has grown rapidly, and suggests that many respondents place considerable value on diagnostic information. There exists, however, great variation in studies with respect to the type of technologies and diseases assessed, respondent characteristics, and study methodology. The perceived value of diagnostic technologies is also influenced by the study design and elicitation methods. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

First among Equals: Hybridization of Cognitive Diagnostic Assessment and Evidence-Centered Game Design

ERIC Educational Resources Information Center

Leighton, Jacqueline P.; Chu, Man-Wai

2016-01-01

The objective of the present article is to explore differences and similarities between cognitive diagnostic assessment (CDA) and evidence-centered game design (ECgD) in the service of intentional hybridization. Although some testing specialists might argue that both are essentially the same given their origins in principled assessment design and…

Laser-plasma interaction experiments and diagnostics at NRL (Naval Research Laboratory). Memorandum report

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

Ripin, B.H.; Grun, J.; Herbst, M.J.

Laser plasma interaction experiments have now advanced to the point where very quantitative measurements are required to elucidate the physic issues important for laser fusion and other applications. Detailed time-resolved knowledge of the plasma density, temperature, velocity gradients, spatial structure, heat flow characteristics, radiation emission, etc, are needed over tremendou ranges of plasma density and temperature. Moreover, the time scales are very short, aggrevating the difficulty of the measurements further. Nonetheless, such substantial progress has been made in diagnostic development during the past few years that we are now able to do well diagnosed experiments. In this paper the authorsmore » review recent diagnostic developments for laser-plasma interactions, outline their regimes of applicability, and show examples of their utility. In addition to diagnostics for the high densities and temperature characteristic of laser fusion physics studies, diagnostics designed to study the two-stream interactions of laser created plasma flowing through an ambient low density plasma will be described.« less

A Primer on Receiver Operating Characteristic Analysis and Diagnostic Efficiency Statistics for Pediatric Psychology: We Are Ready to ROC

PubMed Central

2014-01-01

Objective To offer a practical demonstration of receiver operating characteristic (ROC) analyses, diagnostic efficiency statistics, and their application to clinical decision making using a popular parent checklist to assess for potential mood disorder. Method Secondary analyses of data from 589 families seeking outpatient mental health services, completing the Child Behavior Checklist and semi-structured diagnostic interviews. Results Internalizing Problems raw scores discriminated mood disorders significantly better than did age- and gender-normed T scores, or an Affective Problems score. Internalizing scores <8 had a diagnostic likelihood ratio <0.3, and scores >30 had a diagnostic likelihood ratio of 7.4. Conclusions This study illustrates a series of steps in defining a clinical problem, operationalizing it, selecting a valid study design, and using ROC analyses to generate statistics that support clinical decisions. The ROC framework offers important advantages for clinical interpretation. Appendices include sample scripts using SPSS and R to check assumptions and conduct ROC analyses. PMID:23965298

A primer on receiver operating characteristic analysis and diagnostic efficiency statistics for pediatric psychology: we are ready to ROC.

PubMed

Youngstrom, Eric A

2014-03-01

To offer a practical demonstration of receiver operating characteristic (ROC) analyses, diagnostic efficiency statistics, and their application to clinical decision making using a popular parent checklist to assess for potential mood disorder. Secondary analyses of data from 589 families seeking outpatient mental health services, completing the Child Behavior Checklist and semi-structured diagnostic interviews. Internalizing Problems raw scores discriminated mood disorders significantly better than did age- and gender-normed T scores, or an Affective Problems score. Internalizing scores <8 had a diagnostic likelihood ratio <0.3, and scores >30 had a diagnostic likelihood ratio of 7.4. This study illustrates a series of steps in defining a clinical problem, operationalizing it, selecting a valid study design, and using ROC analyses to generate statistics that support clinical decisions. The ROC framework offers important advantages for clinical interpretation. Appendices include sample scripts using SPSS and R to check assumptions and conduct ROC analyses.

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

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

Medley, S.S.

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

Diagnostic performance of alpha-fetoprotein, lens culinaris agglutinin-reactive alpha-fetoprotein, des-gamma carboxyprothrombin, and glypican-3 for the detection of hepatocellular carcinoma: a systematic review and meta-analysis protocol

PubMed Central

2013-01-01

Background Diagnosis of early-stage hepatocellular carcinoma (HCC) followed by curative resection or liver transplantation offers the best chance for long-term patient survival. Clinically, ultrasonography has suboptimal sensitivity for detecting early-stage HCC. Several serological tests including alpha-fetoprotein (AFP), the ratio of lens culinaris agglutinin-reactive alpha-fetoprotein to total AFP (AFP-L3/AFP), des-gamma carboxyprothrombin (DCP), and glypican-3 (GPC-3) have been widely investigated as diagnostic biomarkers for early-stage HCC in at-risk populations. However, these tests are not recommended for routine HCC screening. Our objective is to determine the diagnostic performance of AFP, AFP-L3/AFP, DCP, and GPC-3 for the detection of HCC, particularly early-stage tumors meeting the Milan criteria. Methods/design We will include cross-sectional studies that consecutively or randomly recruit target populations. We will search the Cochrane Library, Medline, Embase, Science Citation Index, and the Chinese National Knowledge Infrastructure. We will also search the MEDION and ARIF databases to identify diagnostic systematic reviews that include primary studies. Reference lists of relevant reviews will be searched for additional trials. Language restrictions will not be applied. Two reviewers will independently screen study eligibility and extract data. Methodological quality will be assessed according to the revised tool for the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). Two authors will apply the QUADAS-2 assessment to all the included studies, and any discrepancies will be resolved by the third author. The following test characteristics will be extracted into 2 × 2 tables for all included studies: true positives, false positives, true negatives, and false negatives. Study-specific estimates of sensitivity and specificity with 95% confidence intervals will be displayed in forest plots. When possible, we will use the bivariate random-effects model or the Rutter and Gatsonis hierarchical summary receiver operating characteristic model for statistical analysis. To investigate heterogeneity, we will include study designs, population characteristics, test characteristics, and types of reference standard as the study-level variables. Discussion Our systematic review will allow patients, clinicians, and researchers to determine the diagnostic performance of AFP, AFP-L3/AFP, DCP, and GPC-3 for the detection of early-stage HCC and the potential roles of these diagnostic biomarkers in the existing diagnostic pathways. Systematic Review Registration: PROSPERO 2013; CRD42013003879 PMID:23738605

Accuracy of biochemical markers for predicting nasogastric tube placement in adults--a systematic review of diagnostic studies.

PubMed

Fernandez, Ritin S; Chau, Janita Pak-Chun; Thompson, David R; Griffiths, Rhonda; Lo, Hoi-Shan

2010-08-01

The objective of this study was to investigate the diagnostic performance of biochemical tests used to determine placement of nasogastric (NG) tubes after insertion in adults. A systematic review of diagnostic studies was undertaken. A literature search of the bibliographic databases and the World Wide Web was performed to locate original diagnostic studies in English or Chinese on biochemical markers for detecting NG tube location. Studies in which one or more different tests were evaluated with a reference standard, and diagnostic values were reported or could be calculated were included. Two reviewers independently checked all abstracts and full text studies for inclusion criteria. Included studies were assessed for their quality using the QUADAS tool. Study features and diagnostic values were extracted from the included studies. Of the 10 studies included in this review, seven investigated the diagnostic accuracy of pH, one investigated the diagnostic accuracy of pH and bilirubin respectively, two a combination of pH and bilirubin and one a combination of pH, pepsin and trypsin levels in identifying NG tube location. All studies used X-rays as the reference standard for comparison. Pooled results demonstrated that a pH of

Adjusting for partial verification or workup bias in meta-analyses of diagnostic accuracy studies.

PubMed

de Groot, Joris A H; Dendukuri, Nandini; Janssen, Kristel J M; Reitsma, Johannes B; Brophy, James; Joseph, Lawrence; Bossuyt, Patrick M M; Moons, Karel G M

2012-04-15

A key requirement in the design of diagnostic accuracy studies is that all study participants receive both the test under evaluation and the reference standard test. For a variety of practical and ethical reasons, sometimes only a proportion of patients receive the reference standard, which can bias the accuracy estimates. Numerous methods have been described for correcting this partial verification bias or workup bias in individual studies. In this article, the authors describe a Bayesian method for obtaining adjusted results from a diagnostic meta-analysis when partial verification or workup bias is present in a subset of the primary studies. The method corrects for verification bias without having to exclude primary studies with verification bias, thus preserving the main advantages of a meta-analysis: increased precision and better generalizability. The results of this method are compared with the existing methods for dealing with verification bias in diagnostic meta-analyses. For illustration, the authors use empirical data from a systematic review of studies of the accuracy of the immunohistochemistry test for diagnosis of human epidermal growth factor receptor 2 status in breast cancer patients.

Remote network control plasma diagnostic system for Tokamak T-10

NASA Astrophysics Data System (ADS)

Troynov, V. I.; Zimin, A. M.; Krupin, V. A.; Notkin, G. E.; Nurgaliev, M. R.

2016-09-01

The parameters of molecular plasma in closed magnetic trap is studied in this paper. Using the system of molecular diagnostics, which was designed by the authors on the «Tokamak T-10» facility, the radiation of hydrogen isotopes at the plasma edge is investigated. The scheme of optical radiation registration within visible spectrum is described. For visualization, identification and processing of registered molecular spectra a new software is developed using MatLab environment. The software also includes electronic atlas of electronic-vibrational-rotational transitions for molecules of protium and deuterium. To register radiation from limiter cross-section a network control system is designed using the means of the Internet/Intranet. Remote control system diagram and methods are given. The examples of web-interfaces for working out equipment control scenarios and viewing of results are provided. After test run in Intranet, the remote diagnostic system will be accessible through Internet.

A Quasi-Universal Nonword Repetition Task as a Diagnostic Tool for Bilingual Children Learning Dutch as a Second Language

ERIC Educational Resources Information Center

Boerma, Tessel; Chiat, Shula; Leseman, Paul; Timmermeister, Mona; Wijnen, Frank; Blom, Elma

2015-01-01

Purpose: This study evaluated a newly developed quasi-universal nonword repetition task (Q-U NWRT) as a diagnostic tool for bilingual children with language impairment (LI) who have Dutch as a 2nd language. The Q-U NWRT was designed to be minimally influenced by knowledge of 1 specific language in contrast to a language-specific NWRT with which it…

The Air Force Phillips Laboratory multimegawatt quasi-steady MPD thruster facility

NASA Astrophysics Data System (ADS)

Castillo, Salvador; Tilley, Dennis L.

1992-07-01

The operational multimegawatt quasi-steady MPD thruster facility is described in terms of its general design emphasizing the impulse thrust stand and diagnostics capabilities. The vacuum, propellant, and electrical systems are discussed with schematic diagrams of the respective component configurations and explanations of the needs of MPD thruster testing. The impulse thrust stand comprises an accelerometer/pendulum-impulse stand which can be used to correlate thruster impulse with accelerometer readings and thereby reduce measurement uncertainties. The diagnostics of the terminal characteristics of the thruster operation are complemented by diagnostics platforms that study plasma properties in the plume and the thruster. Preliminary tests indicate that the MPD thruster facility is prepared for detailed investigations of MPD thruster performance and plume diagnostics.

Multi-energy x-ray imaging and sensing for diagnostic and control of the burning plasma.

PubMed

Stutman, D; Tritz, K; Finkenthal, M

2012-10-01

New diagnostic and sensor designs are needed for future burning plasma (BP) fusion experiments, having good space and time resolution and capable of prolonged operation in the harsh BP environment. We evaluate the potential of multi-energy x-ray imaging with filtered detector arrays for BP diagnostic and control. Experimental studies show that this simple and robust technique enables measuring with good accuracy, speed, and spatial resolution the T(e) profile, impurity content, and MHD activity in a tokamak. Applied to the BP this diagnostic could also serve for non-magnetic sensing of the plasma position, centroid, ELM, and RWM instability. BP compatible x-ray sensors are proposed using "optical array" or "bi-cell" detectors.

A Quasi-Universal Nonword Repetition Task as a Diagnostic Tool for Bilingual Children Learning Dutch as a Second Language.

PubMed

Boerma, Tessel; Chiat, Shula; Leseman, Paul; Timmermeister, Mona; Wijnen, Frank; Blom, Elma

2015-12-01

This study evaluated a newly developed quasi-universal nonword repetition task (Q-U NWRT) as a diagnostic tool for bilingual children with language impairment (LI) who have Dutch as a 2nd language. The Q-U NWRT was designed to be minimally influenced by knowledge of 1 specific language in contrast to a language-specific NWRT with which it was compared. One hundred twenty monolingual and bilingual children with and without LI participated (30 per group). A mixed-design analysis of variance was used to investigate the effects of LI and bilingualism on the NWRTs. Receiver operating characteristic analyses were conducted to evaluate the instruments' diagnostic value. Large negative effects of LI were found on both NWRTs, whereas negative effects of bilingualism only occurred on the language-specific NWRT. Both instruments had high clinical accuracy in the monolingual group, but only the Q-U NWRT had high clinical accuracy in the bilingual group. This study indicates that the Q-U NWRT is a promising diagnostic tool to help identify LI in bilingual children learning Dutch as a 2nd language. The instrument was clinically accurate in both a monolingual and bilingual group of children and seems better able to disentangle LI from language disadvantage than more language-specific measures.

[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).

Design in Four Diagnostic Language Assessments

ERIC Educational Resources Information Center

Cumming, Alister

2015-01-01

The studies documented in the four articles in this special issue uniquely exemplify principles of design-based research as follows: by taking innovative approaches to significant problems in the contexts of real educational practices; by addressing fundamental pedagogical and policy issues related to language, learning, and teaching; and, in the…

Vacuum system design and tritium inventory for the charge exchange diagnostic on the Tokamak Fusion Test Reactor

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

Medley, S.S.

The application of charge exchange analyzers for the measurement of ion temperature in fusion plasma experiments requires a direct connection between the diagnostic and plasma-discharge vacuum chambers. Differential pumping of the gas load from the diagnostic stripping cell operated at > or approx. = 10/sup -3/ Torr is required to maintain the analyzer chamber at a pressure of < or approx. = 10/sup -6/ Torr. The migration of gases between the diagnostic and plasma vacuum chambers must be minimized. In particular, introduction of the analyzer stripping cell gas into the plasma chamber having a base pressure of < or approx.more » = 10/sup -8/ Torr must be suppressed. The charge exchange diagnostic for the Tokamak Fusion Test Reactor (TFTR) is comprised of two analyzer systems designed to contain a total of 18 independent mass/energy analyzers and one diagnostic neutral beam rated at 80 keV, 15 A. The associated arrays of multiple, interconnected vacuum systems were analyzed using the Vacuum System Transient Simulator (Vsts) computer program which models the transient transport of multigas species through complex networks of ducts, valves, traps, vacuum pumps, and other related vacuum system components. In addition to providing improved design performance at reduced costs, the analysis yields estimates for the exchange of tritium from the torus to the diagnostic components and of the diagnostic working gases to the torus.« less

Integrated diagnostics

NASA Technical Reports Server (NTRS)

Hunthausen, Roger J.

1988-01-01

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

Clinical Validation Trial of a Diagnostic for Ebola Zaire Antigen Detection: Design Rationale and Challenges to Implementation

PubMed Central

Schieffelin, John; Moses, Lina M; Shaffer, Jeffrey; Goba, Augustine; Grant, Donald S

2015-01-01

The current Ebola outbreak in West Africa has affected more people than all previous outbreaks combined. The current diagnostic method of choice, quantitative polymerase chain reaction, requires specialized conditions as well as specially trained technicians. Insufficient testing capacity has extended the time from sample collection to results. These delays have led to further delays in the transfer and treatment to Ebola Treatment Units. A sensitive and specific point-of-care device that could be used reliably in low resource settings by healthcare workers with minimal training would increase the efficiency of triage and appropriate transfer of care. This article describes a study designed to validate the sensitivity and specificity of the ReEBOVTM RDT using venous whole blood and capillary blood obtained via fingerprick. We present the scientific and clinical rationale for the decisions made in the design of a diagnostic validation study to be conducted in an outbreak setting. The multi-site strategy greatly complicated implementation. In addition, a decrease in cases in one geographic area along with a concomitant increase in other areas made site selection challenging. Initiation of clinical trials during rapidly evolving outbreaks requires significant cooperation on a national level between research teams implementing studies and clinical care providers. Coordination and streamlining of approval process is essential if trials are to be implemented in a timely fashion. PMID:26768566

Diagnostic Value of Endorectal Ultrasound in Preoperative Assessment of Lymph Node Involvement in Colorectal Cancer: a Meta-analysis.

PubMed

Li, Li; Chen, Shi; Wang, Ke; Huang, Jiao; Liu, Li; Wei, Sheng; Gao, Hong-Yu

2015-01-01

Nodal invasion by colorectal cancer is a critical determinant in estimating patient survival and in choosing appropriate preoperative treatment. The present meta-analysis was designed to evaluate the diagnostic value of endorectal ultrasound (EUS) in preoperative assessment of lymph node involvement in colorectal cancer. We systematically searched PubMed, Web of Science, Embase, and China National Knowledge Infrastructure (CNKI) databases for relevant studies published on or before December 10th, 2014. The sensitivity, specificity, likelihood ratios, diagnostic odds ratio (DOR) and area under the summary receiver operating characteristics curve (AUC) were assessed to estimate the diagnostic value of EUS. Subgroup analysis and meta-regression were performed to explore heterogeneity across studies. Thirty-three studies covering 3,016 subjects were included. The pooled sensitivity and specificity were 0.69 (95%CI: 0.63-0.75) and 0.77 (95%CI: 0.73-0.82), respectively. The positive and negative likelihood ratios were 3.09 (95%CI: 2.52-3.78) and 0.39 (95%CI: 0.32-0.48), respectively. The DOR was 7.84 (95%CI: 5.56-11.08), and AUC was 0.80 (95%CI: 0.77-0.84). This meta-analysis indicated that EUS has moderate diagnostic value in preoperative assessment of lymph node involvement in colorectal cancer. Further refinements in technology and diagnostic criteria are necessary to improve the diagnostic accuracy of EUS.

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

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

Debono, Josephine C, E-mail: josephine.debono@bci.org.au; Poulos, Ann E; Westmead Breast Cancer Institute, Westmead, New South Wales

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

Should learners reason one step at a time? A randomised trial of two diagnostic scheme designs.

PubMed

Blissett, Sarah; Morrison, Deric; McCarty, David; Sibbald, Matthew

2017-04-01

Making a diagnosis can be difficult for learners as they must integrate multiple clinical variables. Diagnostic schemes can help learners with this complex task. A diagnostic scheme is an algorithm that organises possible diagnoses by assigning signs or symptoms (e.g. systolic murmur) to groups of similar diagnoses (e.g. aortic stenosis and aortic sclerosis) and provides distinguishing features to help discriminate between similar diagnoses (e.g. carotid pulse). The current literature does not identify whether scheme layouts should guide learners to reason one step at a time in a terminally branching scheme or weigh multiple variables simultaneously in a hybrid scheme. We compared diagnostic accuracy, perceptual errors and cognitive load using two scheme layouts for cardiac auscultation. Focused on the task of identifying murmurs on Harvey, a cardiopulmonary simulator, 86 internal medicine residents used two scheme layouts. The terminally branching scheme organised the information into single variable decisions. The hybrid scheme combined single variable decisions with a chart integrating multiple distinguishing features. Using a crossover design, participants completed one set of murmurs (diastolic or systolic) with either the terminally branching or the hybrid scheme. The second set of murmurs was completed with the other scheme. A repeated measures manova was performed to compare diagnostic accuracy, perceptual errors and cognitive load between the scheme layouts. There was a main effect of the scheme layout (Wilks' λ = 0.841, F 3,80 = 5.1, p = 0.003). Use of a terminally branching scheme was associated with increased diagnostic accuracy (65 versus 53%, p = 0.02), fewer perceptual errors (0.61 versus 0.98 errors, p = 0.001) and lower cognitive load (3.1 versus 3.5/7, p = 0.023). The terminally branching scheme was associated with improved diagnostic accuracy, fewer perceptual errors and lower cognitive load, suggesting that terminally branching schemes are effective for improving diagnostic accuracy. These findings can inform the design of schemes and other clinical decision aids. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Does the delivery of diagnostic news affect the likelihood of whether or not patients ask questions about the results? A conversation analytical study.

PubMed

Murtagh, Ged M; Thomas, Anne L; Furber, Lynn

2018-05-03

Asymmetries in knowledge and competence in the medical encounter often mean that doctor-patient communication can be compromised. This study explores this issue and examines whether the likelihood of patient question asking is increased following the delivery of diagnostic test results. It also examines whether that likelihood is related to the way in which the test results are delivered. To examine when and how patients initiate questions following diagnostic news announcements. We audio-recorded oncology consultations (n = 47) consisting of both first consultations and follow-up consultations with patients with different types of cancer, at a leading UK teaching hospital. From the primary sample, we identified 30 consultations based on a basic count of the frequency of patient questions and their positioning in relation to diagnostic announcements. This subset of 30 consultations consisted of a mix of first and follow-up consultations. Our data demonstrate how the design and delivery of diagnostic news announcements can either discourage or provide the opportunity for a patient-initiated question in the next turn of talk. We identified two types of announcement. Q+ generally provided for a patient-initiated question as a relevant next turn following the news announcement, whereas Q- did not. Q+ was sometimes followed up with the explanation of test results, which appeared to encourage further patient questions. The design and delivery of diagnostic news announcements can make a patient-initiated question more or less appropriate, in the next turn of talk. In addition, showing and explaining test results can encourage further opportunities for patients' questions. © 2018 The Authors. Health Expectations published by John Wiley & Sons Ltd.

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

PubMed

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

2016-07-01

People with intellectual disabilities often have a multitude of concurrent problems due to the combination of cognitive impairments, psychiatric disorders (particularly anxiety) and related challenging behaviours. Diagnoses in people with intellectual disabilities are complicated. This study evaluates the quality of the diagnoses and treatment plans after using a guideline that was developed to support professionals in their diagnostic tasks. A comparative multiple case study with an experimental and control condition, applying deductive analyses of diagnoses and treatment plans. The analyses revealed that the number of diagnostic statements and planned treatment actions in the experimental group was significantly larger and more differentiated than in the control condition. In the control group, consequential harm and protective factors were hardly mentioned in diagnoses and treatment plans. Working with the 'Diagnostic Guideline for Anxiety and CB' leads to improved diagnoses and treatment plans compared with care as usual. © 2015 John Wiley & Sons Ltd.

Improving spatial and spectral resolution of TCV Thomson scattering

NASA Astrophysics Data System (ADS)

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

2017-12-01

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

The impact of study design and diagnostic approach in a large multi-centre ADHD study. Part 1: ADHD symptom patterns

PubMed Central

2011-01-01

Background The International Multi-centre ADHD Genetics (IMAGE) project with 11 participating centres from 7 European countries and Israel has collected a large behavioural and genetic database for present and future research. Behavioural data were collected from 1068 probands with the combined type of attention deficit/hyperactivity disorder (ADHD-CT) and 1446 'unselected' siblings. The aim was to analyse the IMAGE sample with respect to demographic features (gender, age, family status, and recruiting centres) and psychopathological characteristics (diagnostic subtype, symptom frequencies, age at symptom detection, and comorbidities). A particular focus was on the effects of the study design and the diagnostic procedure on the homogeneity of the sample in terms of symptom-based behavioural data, and potential consequences for further analyses based on these data. Methods Diagnosis was based on the Parental Account of Childhood Symptoms (PACS) interview and the DSM-IV items of the Conners' teacher questionnaire. Demographics of the full sample and the homogeneity of a subsample (all probands) were analysed by using robust statistical procedures which were adjusted for unequal sample sizes and skewed distributions. These procedures included multi-way analyses based on trimmed means and winsorised variances as well as bootstrapping. Results Age and proband/sibling ratios differed between participating centres. There was no significant difference in the distribution of gender between centres. There was a significant interaction between age and centre for number of inattentive, but not number of hyperactive symptoms. Higher ADHD symptom frequencies were reported by parents than teachers. The diagnostic symptoms differed from each other in their frequencies. The face-to-face interview was more sensitive than the questionnaire. The differentiation between ADHD-CT probands and unaffected siblings was mainly due to differences in hyperactive/impulsive symptoms. Conclusions Despite a symptom-based standardized inclusion procedure according to DSM-IV criteria with defined symptom thresholds, centres may differ markedly in probands' ADHD symptom frequencies. Both the diagnostic procedure and the multi-centre design influence the behavioural characteristics of a sample and, thus, may bias statistical analyses, particularly in genetic or neurobehavioral studies. PMID:21473745

Development of GEM detector for plasma diagnostics application: simulations addressing optimization of its performance

NASA Astrophysics Data System (ADS)

Chernyshova, M.; Malinowski, K.; Kowalska-Strzęciwilk, E.; Czarski, T.; Linczuk, P.; Wojeński, A.; Krawczyk, R. D.

2017-12-01

The advanced Soft X-ray (SXR) diagnostics setup devoted to studies of the SXR plasma emissivity is at the moment a highly relevant and important for ITER/DEMO application. Especially focusing on the energy range of tungsten emission lines, as plasma contamination by W and its transport in the plasma must be understood and monitored for W plasma-facing material. The Gas Electron Multiplier, with a spatial and energy-resolved photon detecting chamber, based SXR radiation detection system under development by our group may become such a diagnostic setup considering and solving many physical, technical and technological aspects. This work presents the results of simulations aimed to optimize a design of the detector's internal chamber and its performance. The study of the effect of electrodes alignment allowed choosing the gap distances which maximizes electron transmission and choosing the optimal magnitudes of the applied electric fields. Finally, the optimal readout structure design was identified suitable to collect a total formed charge effectively, basing on the range of the simulated electron cloud at the readout plane which was in the order of ~ 2 mm.

Homogeneity tests of clustered diagnostic markers with applications to the BioCycle Study

PubMed Central

Tang, Liansheng Larry; Liu, Aiyi; Schisterman, Enrique F.; Zhou, Xiao-Hua; Liu, Catherine Chun-ling

2014-01-01

Diagnostic trials often require the use of a homogeneity test among several markers. Such a test may be necessary to determine the power both during the design phase and in the initial analysis stage. However, no formal method is available for the power and sample size calculation when the number of markers is greater than two and marker measurements are clustered in subjects. This article presents two procedures for testing the accuracy among clustered diagnostic markers. The first procedure is a test of homogeneity among continuous markers based on a global null hypothesis of the same accuracy. The result under the alternative provides the explicit distribution for the power and sample size calculation. The second procedure is a simultaneous pairwise comparison test based on weighted areas under the receiver operating characteristic curves. This test is particularly useful if a global difference among markers is found by the homogeneity test. We apply our procedures to the BioCycle Study designed to assess and compare the accuracy of hormone and oxidative stress markers in distinguishing women with ovulatory menstrual cycles from those without. PMID:22733707

Diagnostics and control for the steady state and pulsed tokamak DEMO

NASA Astrophysics Data System (ADS)

Orsitto, F. P.; Villari, R.; Moro, F.; Todd, T. N.; Lilley, S.; Jenkins, I.; Felton, R.; Biel, W.; Silva, A.; Scholz, M.; Rzadkiewicz, J.; Duran, I.; Tardocchi, M.; Gorini, G.; Morlock, C.; Federici, G.; Litnovsky, A.

2016-02-01

The present paper is devoted to a first assessment of the DEMO diagnostics systems and controls in the context of pulsed and steady state reactor design under study in Europe. In particular, the main arguments treated are: (i) The quantities to be measured in DEMO and the requirements for the measurements; (ii) the present capability of the diagnostic and control technology, determining the most urgent gaps, and (iii) the program and strategy of the research and development (R&D) needed to fill the gaps. Burn control, magnetohydrodynamic stability, and basic machine protection require improvements to the ITER technology, and moderated efforts in R&D can be dedicated to infrared diagnostics (reflectometry, electron cyclotron emission, polarimetry) and neutron diagnostics. Metallic Hall sensors appear to be a promising candidate for magnetic measurements in the high neutron fluence and long/steady state discharges of DEMO.

BRIEF REPORT: Beyond Clinical Experience: Features of Data Collection and Interpretation That Contribute to Diagnostic Accuracy

PubMed Central

Nendaz, Mathieu R; Gut, Anne M; Perrier, Arnaud; Louis-Simonet, Martine; Blondon-Choa, Katherine; Herrmann, François R; Junod, Alain F; Vu, Nu V

2006-01-01

BACKGROUND Clinical experience, features of data collection process, or both, affect diagnostic accuracy, but their respective role is unclear. OBJECTIVE, DESIGN Prospective, observational study, to determine the respective contribution of clinical experience and data collection features to diagnostic accuracy. METHODS Six Internists, 6 second year internal medicine residents, and 6 senior medical students worked up the same 7 cases with a standardized patient. Each encounter was audiotaped and immediately assessed by the subjects who indicated the reasons underlying their data collection. We analyzed the encounters according to diagnostic accuracy, information collected, organ systems explored, diagnoses evaluated, and final decisions made, and we determined predictors of diagnostic accuracy by logistic regression models. RESULTS Several features significantly predicted diagnostic accuracy after correction for clinical experience: early exploration of correct diagnosis (odds ratio [OR] 24.35) or of relevant diagnostic hypotheses (OR 2.22) to frame clinical data collection, larger number of diagnostic hypotheses evaluated (OR 1.08), and collection of relevant clinical data (OR 1.19). CONCLUSION Some features of data collection and interpretation are related to diagnostic accuracy beyond clinical experience and should be explicitly included in clinical training and modeled by clinical teachers. Thoroughness in data collection should not be considered a privileged way to diagnostic success. PMID:17105525

Equipment concept design and development plans for microgravity science and applications research on space station: Combustion tunnel, laser diagnostic system, advanced modular furnace, integrated electronics laboratory

NASA Technical Reports Server (NTRS)

Uhran, M. L.; Youngblood, W. W.; Georgekutty, T.; Fiske, M. R.; Wear, W. O.

1986-01-01

Taking advantage of the microgravity environment of space NASA has initiated the preliminary design of a permanently manned space station that will support technological advances in process science and stimulate the development of new and improved materials having applications across the commercial spectrum. Previous studies have been performed to define from the researcher's perspective, the requirements for laboratory equipment to accommodate microgravity experiments on the space station. Functional requirements for the identified experimental apparatus and support equipment were determined. From these hardware requirements, several items were selected for concept designs and subsequent formulation of development plans. This report documents the concept designs and development plans for two items of experiment apparatus - the Combustion Tunnel and the Advanced Modular Furnace, and two items of support equipment the Laser Diagnostic System and the Integrated Electronics Laboratory. For each concept design, key technology developments were identified that are required to enable or enhance the development of the respective hardware.

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

Code of Federal Regulations, 2012 CFR

2012-04-01

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

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

Code of Federal Regulations, 2013 CFR

2013-04-01

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

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

Code of Federal Regulations, 2014 CFR

2014-04-01

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

Diagnosing students' misconceptions in algebra: results from an experimental pilot study.

PubMed

Russell, Michael; O'Dwyer, Laura M; Miranda, Helena

2009-05-01

Computer-based diagnostic assessment systems hold potential to help teachers identify sources of poor performance and to connect teachers and students to learning activities designed to help advance students' conceptual understandings. The present article presents findings from a study that examined how students' performance in algebra and their overcoming of common algebraic misconceptions were affected by the use of a diagnostic assessment system that focused on important algebra concepts. This study used a four-group randomized cluster trial design in which teachers were assigned randomly to one of four groups: a "business as usual" control group, a partial intervention group that was provided with access to diagnostic tests results, a partial intervention group that was provided with access to the learning activities, and a full intervention group that was given access to the test results and learning activities. Data were collected from 905 students (6th-12th grade) nested within 44 teachers. We used hierarchical linear modeling techniques to compare the effects of full, partial, and no (control) intervention on students' algebraic ability and misconceptions. The analyses indicate that full intervention had a net positive effect on ability and misconception measures.

Sample size for positive and negative predictive value in diagnostic research using case–control designs

PubMed Central

Steinberg, David M.; Fine, Jason; Chappell, Rick

2009-01-01

Important properties of diagnostic methods are their sensitivity, specificity, and positive and negative predictive values (PPV and NPV). These methods are typically assessed via case–control samples, which include one cohort of cases known to have the disease and a second control cohort of disease-free subjects. Such studies give direct estimates of sensitivity and specificity but only indirect estimates of PPV and NPV, which also depend on the disease prevalence in the tested population. The motivating example arises in assay testing, where usage is contemplated in populations with known prevalences. Further instances include biomarker development, where subjects are selected from a population with known prevalence and assessment of PPV and NPV is crucial, and the assessment of diagnostic imaging procedures for rare diseases, where case–control studies may be the only feasible designs. We develop formulas for optimal allocation of the sample between the case and control cohorts and for computing sample size when the goal of the study is to prove that the test procedure exceeds pre-stated bounds for PPV and/or NPV. Surprisingly, the optimal sampling schemes for many purposes are highly unbalanced, even when information is desired on both PPV and NPV. PMID:18556677

Integration of molecular dynamics simulation and hotspot residues grafting for de novo scFv design against Salmonella Typhi TolC protein.

PubMed

Leong, Siew Wen; Lim, Theam Soon; Ismail, Asma; Choong, Yee Siew

2018-05-01

With the development of de novo binders for protein targets from non-related scaffolds, many possibilities for therapeutics and diagnostics have been created. In this study, we described the use of de novo design approach to create single-chain fragment variable (scFv) for Salmonella enterica subspecies enterica serovar Typhi TolC protein. Typhoid fever is a global health concern in developing and underdeveloped countries. Rapid typhoid diagnostics will improve disease management and therapy. In this work, molecular dynamics simulation was first performed on a homology model of TolC protein in POPE membrane bilayer to obtain the central structure that was subsequently used as the target for scFv design. Potential hotspot residues capable of anchoring the binders to the target were identified by docking "disembodied" amino acid residues against TolC surface. Next, scFv scaffolds were selected from Protein Data Bank to harbor the computed hotspot residues. The hotspot residues were then incorporated into the scFv scaffold complementarity determining regions. The designs recapitulated binding energy, shape complementarity, and interface surface area of natural protein-antibody interfaces. This approach has yielded 5 designs with high binding affinity against TolC that may be beneficial for the future development of antigen-based detection agents for typhoid diagnostics. Copyright © 2017 John Wiley & Sons, Ltd.

Overcoming limitations of model-based diagnostic reasoning systems

NASA Technical Reports Server (NTRS)

Holtzblatt, Lester J.; Marcotte, Richard A.; Piazza, Richard L.

1989-01-01

The development of a model-based diagnostic system to overcome the limitations of model-based reasoning systems is discussed. It is noted that model-based reasoning techniques can be used to analyze the failure behavior and diagnosability of system and circuit designs as part of the system process itself. One goal of current research is the development of a diagnostic algorithm which can reason efficiently about large numbers of diagnostic suspects and can handle both combinational and sequential circuits. A second goal is to address the model-creation problem by developing an approach for using design models to construct the GMODS model in an automated fashion.

Effect of specialized diagnostic assessment units on the time to diagnosis in screen-detected breast cancer patients.

PubMed

Jiang, L; Gilbert, J; Langley, H; Moineddin, R; Groome, P A

2015-05-26

The duration of the cancer diagnostic process has considerable influence on patients' psychosocial well-being. Breast diagnostic assessment units (DAUs) in Ontario, Canada are designed to improve the quality and timeliness of care during a breast cancer diagnosis. We compared the diagnostic duration of patients diagnosed through a DAU vs usual care (UC). Retrospective population-based cohort study of 2499 screen-detected breast cancers (2011) using administrative health-care databases linked to the Ontario Cancer Registry. The diagnostic interval was measured from the initial screen to cancer diagnosis. Diagnostic assessment unit use was based on the biopsy and/or surgery hospital. We compared the length of the diagnostic interval between the DAU groups using multivariable quantile regression. Diagnostic assessment units had a higher proportion of patients diagnosed within the 7-week target compared with UC (79.1% vs 70.2%, P<0.001). The median time to diagnosis at DAUs was 26 days, which was 9 days shorter compared with UC (95% CI: 6.4-11.6). This effect was reduced to 8.3 days after adjusting for all study covariates. Adjusted DAU differences were similar at the 75th and 90th percentiles of the diagnostic interval distribution. Diagnosis through an Ontario DAU was associated with a reduced time to diagnosis for screen-detected breast cancer patients, which likely reduces the anxiety and distress associated with waiting for a diagnosis.

Evaluating Secondary Students' Scientific Reasoning in Genetics Using a Two-Tier Diagnostic Instrument

NASA Astrophysics Data System (ADS)

Tsui, Chi-Yan; Treagust, David

2010-05-01

While genetics has remained as one key topic in school science, it continues to be conceptually and linguistically difficult for students with the concomitant debates as to what should be taught in the age of biotechnology. This article documents the development and implementation of a two-tier multiple-choice instrument for diagnosing grades 10 and 12 students' understanding of genetics in terms of reasoning. The pretest and posttest forms of the diagnostic instrument were used alongside other methods in evaluating students' understanding of genetics in a case-based qualitative study on teaching and learning with multiple representations in three Western Australian secondary schools. Previous studies have shown that a two-tier diagnostic instrument is useful in probing students' understanding or misunderstanding of scientific concepts and ideas. The diagnostic instrument in this study was designed and then progressively refined, improved, and implemented to evaluate student understanding of genetics in three case schools. The final version of the instrument had Cronbach's alpha reliability of 0.75 and 0.64, respectively, for its pretest and the posttest forms when it was administered to a group of grade 12 students (n = 17). This two-tier diagnostic instrument complemented other qualitative data collection methods in this research in generating a more holistic picture of student conceptual learning of genetics in terms of scientific reasoning. Implications of the findings of this study using the diagnostic instrument are discussed.

Identification of factors associated with diagnostic error in primary care.

PubMed

Minué, Sergio; Bermúdez-Tamayo, Clara; Fernández, Alberto; Martín-Martín, José Jesús; Benítez, Vivian; Melguizo, Miguel; Caro, Araceli; Orgaz, María José; Prados, Miguel Angel; Díaz, José Enrique; Montoro, Rafael

2014-05-12

Missed, delayed or incorrect diagnoses are considered to be diagnostic errors. The aim of this paper is to describe the methodology of a study to analyse cognitive aspects of the process by which primary care (PC) physicians diagnose dyspnoea. It examines the possible links between the use of heuristics, suboptimal cognitive acts and diagnostic errors, using Reason's taxonomy of human error (slips, lapses, mistakes and violations). The influence of situational factors (professional experience, perceived overwork and fatigue) is also analysed. Cohort study of new episodes of dyspnoea in patients receiving care from family physicians and residents at PC centres in Granada (Spain). With an initial expected diagnostic error rate of 20%, and a sampling error of 3%, 384 episodes of dyspnoea are calculated to be required. In addition to filling out the electronic medical record of the patients attended, each physician fills out 2 specially designed questionnaires about the diagnostic process performed in each case of dyspnoea. The first questionnaire includes questions on the physician's initial diagnostic impression, the 3 most likely diagnoses (in order of likelihood), and the diagnosis reached after the initial medical history and physical examination. It also includes items on the physicians' perceived overwork and fatigue during patient care. The second questionnaire records the confirmed diagnosis once it is reached. The complete diagnostic process is peer-reviewed to identify and classify the diagnostic errors. The possible use of heuristics of representativeness, availability, and anchoring and adjustment in each diagnostic process is also analysed. Each audit is reviewed with the physician responsible for the diagnostic process. Finally, logistic regression models are used to determine if there are differences in the diagnostic error variables based on the heuristics identified. This work sets out a new approach to studying the diagnostic decision-making process in PC, taking advantage of new technologies which allow immediate recording of the decision-making process.

Identification of factors associated with diagnostic error in primary care

PubMed Central

2014-01-01

Background Missed, delayed or incorrect diagnoses are considered to be diagnostic errors. The aim of this paper is to describe the methodology of a study to analyse cognitive aspects of the process by which primary care (PC) physicians diagnose dyspnoea. It examines the possible links between the use of heuristics, suboptimal cognitive acts and diagnostic errors, using Reason’s taxonomy of human error (slips, lapses, mistakes and violations). The influence of situational factors (professional experience, perceived overwork and fatigue) is also analysed. Methods Cohort study of new episodes of dyspnoea in patients receiving care from family physicians and residents at PC centres in Granada (Spain). With an initial expected diagnostic error rate of 20%, and a sampling error of 3%, 384 episodes of dyspnoea are calculated to be required. In addition to filling out the electronic medical record of the patients attended, each physician fills out 2 specially designed questionnaires about the diagnostic process performed in each case of dyspnoea. The first questionnaire includes questions on the physician’s initial diagnostic impression, the 3 most likely diagnoses (in order of likelihood), and the diagnosis reached after the initial medical history and physical examination. It also includes items on the physicians’ perceived overwork and fatigue during patient care. The second questionnaire records the confirmed diagnosis once it is reached. The complete diagnostic process is peer-reviewed to identify and classify the diagnostic errors. The possible use of heuristics of representativeness, availability, and anchoring and adjustment in each diagnostic process is also analysed. Each audit is reviewed with the physician responsible for the diagnostic process. Finally, logistic regression models are used to determine if there are differences in the diagnostic error variables based on the heuristics identified. Discussion This work sets out a new approach to studying the diagnostic decision-making process in PC, taking advantage of new technologies which allow immediate recording of the decision-making process. PMID:24884984

Expert Systems Based Clinical Assessment and Tutorial Project.

ERIC Educational Resources Information Center

Papa, Frank; Shores, Jay

This project at the Texas College of Osteopathic Medicine (Fort Worth) evaluated the use of an artificial-intelligence-derived measure, "Knowledge-Based Inference Tool" (KBIT), as the basis for assessing medical students' diagnostic capabilities and designing instruction to improve diagnostic skills. The instrument was designed to…

The computation in diagnostics for tokamaks: systems, designs, approaches

NASA Astrophysics Data System (ADS)

Krawczyk, Rafał; Linczuk, Paweł; Czarski, Tomasz; Wojeński, Andrzej; Chernyshova, Maryna; Poźniak, Krzysztof; Kolasiński, Piotr; Kasprowicz, Grzegorz; Zabołotny, Wojciech; Kowalska-Strzeciwilk, Ewa; Malinowski, Karol; Gaska, Michał

2017-08-01

The requirements given for GEM (Gaseous Electron Multiplier) detector based acquisition system for plasma impurities diagnostics triggered a need for the development of a specialized software and hardware architecture. The amount of computations with latency and throughput restrictions cause that an advanced solution is sought for. In order to provide a mechanism fitting the designated tokamaks, an insight into existing solutions was necessary. In the article there is discussed architecture of systems used for plasma diagnostics and in related scientific fields. The developed solution is compared and contrasted with other diagnostic and control systems. Particular attention is payed to specific requirements for plasma impurities diagnostics in tokamak thermal fusion reactor. Subsequently, the details are presented that justified the choice of the system architecture and the discussion on various approaches is given.

Beamlet diagnostics

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

Theys, M.

1994-05-06

Beamlet is a high power laser currently being built at Lawrence Livermore National Lab as a proof of concept for the National Ignition Facility (NIF). Beamlet is testing several areas of laser advancements, such as a 37cm Pockels cell, square amplifier, and propagation of a square beam. The diagnostics on beamlet tell the operators how much energy the beam has in different locations, the pulse shape, the energy distribution, and other important information regarding the beam. This information is being used to evaluate new amplifier designs, and extrapolate performance to the NIF laser. In my term at Lawrence Livermore Nationalmore » Laboratory I have designed and built a diagnostic, calibrated instruments used on diagnostics, setup instruments, hooked up communication lines to the instruments, and setup computers to control specific diagnostics.« less

Leading Antibacterial Laboratory Research by Integrating Conventional and Innovative Approaches: The Laboratory Center of the Antibacterial Resistance Leadership Group.

PubMed

Manca, Claudia; Hill, Carol; Hujer, Andrea M; Patel, Robin; Evans, Scott R; Bonomo, Robert A; Kreiswirth, Barry N

2017-03-15

The Antibacterial Resistance Leadership Group (ARLG) Laboratory Center (LC) leads the evaluation, development, and implementation of laboratory-based research by providing scientific leadership and supporting standard/specialized laboratory services. The LC has developed a physical biorepository and a virtual biorepository. The physical biorepository contains bacterial isolates from ARLG-funded studies located in a centralized laboratory and they are available to ARLG investigators. The Web-based virtual biorepository strain catalogue includes well-characterized gram-positive and gram-negative bacterial strains published by ARLG investigators. The LC, in collaboration with the ARLG Leadership and Operations Center, developed procedures for review and approval of strain requests, guidance during the selection process, and for shipping strains from the distributing laboratories to the requesting investigators. ARLG strains and scientific and/or technical guidance have been provided to basic research laboratories and diagnostic companies for research and development, facilitating collaboration between diagnostic companies and the ARLG Master Protocol for Evaluating Multiple Infection Diagnostics (MASTERMIND) initiative for evaluation of multiple diagnostic devices from a single patient sampling event. In addition, the LC has completed several laboratory-based studies designed to help evaluate new rapid molecular diagnostics by developing, testing, and applying a MASTERMIND approach using purified bacterial strains. In collaboration with the ARLG's Statistical and Data Management Center (SDMC), the LC has developed novel analytical strategies that integrate microbiologic and genetic data for improved and accurate identification of antimicrobial resistance. These novel approaches will aid in the design of future ARLG studies and help correlate pathogenic markers with clinical outcomes. The LC's accomplishments are the result of a successful collaboration with the ARLG's Leadership and Operations Center, Diagnostics and Devices Committee, and SDMC. This interactive approach has been pivotal for the success of LC projects. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Evaluating Intervention Effects in a Diagnostic Classification Model Framework

ERIC Educational Resources Information Center

Madison, Matthew J.; Bradshaw, Laine

2018-01-01

The evaluation of intervention effects is an important objective of educational research. One way to evaluate the effectiveness of an intervention is to conduct an experiment that assigns individuals to control and treatment groups. In the context of pretest/posttest designed studies, this is referred to as a control-group pretest/posttest design.…

Heaping-Induced Bias in Regression-Discontinuity Designs. NBER Working Paper No. 17408

ERIC Educational Resources Information Center

Barreca, Alan I.; Lindo, Jason M.; Waddell, Glen R.

2011-01-01

This study uses Monte Carlo simulations to demonstrate that regression-discontinuity designs arrive at biased estimates when attributes related to outcomes predict heaping in the running variable. After showing that our usual diagnostics are poorly suited to identifying this type of problem, we provide alternatives. We also demonstrate how the…

READING DIAGNOSTIC APPROACHES.

ERIC Educational Resources Information Center

PURDY, ROBERT J.; AND OTHERS

A DIAGNOSTIC KIT DESIGNED TO HELP CLASSROOM TEACHERS DIAGNOSE READING DIFFICULTIES MORE ADEQUATELY AND MOTIVATE PUPILS MORE EFFECTIVELY IS PRESENTED. SUGGESTIONS ARE APPLICABLE TO LOWER PRIMARY CHILDREN. DIAGNOSTIC TECHNIQUES ARE OUTLINED FOR SUBJECTIVE AND OBJECTIVE OBSERVATION OF LANGUAGE ABILITY, VISUAL PERCEPTION SKILLS, AUDITORY…

Diagnostic accuracy of physical examination tests of the ankle/foot complex: a systematic review.

PubMed

Schwieterman, Braun; Haas, Deniele; Columber, Kirby; Knupp, Darren; Cook, Chad

2013-08-01

Orthopedic special tests of the ankle/foot complex are routinely used during the physical examination process in order to help diagnose ankle/lower leg pathologies. The purpose of this systematic review was to investigate the diagnostic accuracy of ankle/lower leg special tests. A search of the current literature was conducted using PubMed, CINAHL, SPORTDiscus, ProQuest Nursing and Allied Health Sources, Scopus, and Cochrane Library. Studies were eligible if they included the following: 1) a diagnostic clinical test of musculoskeletal pathology in the ankle/foot complex, 2) description of the clinical test or tests, 3) a report of the diagnostic accuracy of the clinical test (e.g. sensitivity and specificity), and 4) an acceptable reference standard for comparison. The quality of included studies was determined by two independent reviewers using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. Nine diagnostic accuracy studies met the inclusion criteria for this systematic review; analyzing a total of 16 special tests of the ankle/foot complex. After assessment using the QUADAS-2, only one study had low risk of bias and low concerns regarding applicability. Most ankle/lower leg orthopedic special tests are confirmatory in nature and are best utilized at the end of the physical examination. Most of the studies included in this systematic review demonstrate notable biases, which suggest that results and recommendations in this review should be taken as a guide rather than an outright standard. There is need for future research with more stringent study design criteria so that more accurate diagnostic power of ankle/lower leg special tests can be determined. 3a.

DIAGNOSTIC ACCURACY OF PHYSICAL EXAMINATION TESTS OF THE ANKLE/FOOT COMPLEX: A SYSTEMATIC REVIEW

PubMed Central

Schwieterman, Braun; Haas, Deniele; Columber, Kirby; Knupp, Darren

2013-01-01

Background: Orthopedic special tests of the ankle/foot complex are routinely used during the physical examination process in order to help diagnose ankle/lower leg pathologies. Purpose: The purpose of this systematic review was to investigate the diagnostic accuracy of ankle/lower leg special tests. Methods: A search of the current literature was conducted using PubMed, CINAHL, SPORTDiscus, ProQuest Nursing and Allied Health Sources, Scopus, and Cochrane Library. Studies were eligible if they included the following: 1) a diagnostic clinical test of musculoskeletal pathology in the ankle/foot complex, 2) description of the clinical test or tests, 3) a report of the diagnostic accuracy of the clinical test (e.g. sensitivity and specificity), and 4) an acceptable reference standard for comparison. The quality of included studies was determined by two independent reviewers using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. Results: Nine diagnostic accuracy studies met the inclusion criteria for this systematic review; analyzing a total of 16 special tests of the ankle/foot complex. After assessment using the QUADAS-2, only one study had low risk of bias and low concerns regarding applicability. Conclusion: Most ankle/lower leg orthopedic special tests are confirmatory in nature and are best utilized at the end of the physical examination. Most of the studies included in this systematic review demonstrate notable biases, which suggest that results and recommendations in this review should be taken as a guide rather than an outright standard. There is need for future research with more stringent study design criteria so that more accurate diagnostic power of ankle/lower leg special tests can be determined. Level of Evidence: 3a PMID:24175128

Auditory brainstem response (ABR) profiling tests as diagnostic support for schizophrenia and adult attention-deficit hyperactivity disorder (ADHD).

PubMed

Juselius Baghdassarian, Eva; Nilsson Markhed, Maria; Lindström, Eva; Nilsson, Björn M; Lewander, Tommy

2018-06-01

To evaluate the performances of two auditory brainstem response (ABR) profiling tests as potential biomarkers and diagnostic support for schizophrenia and adult attention-deficit hyperactivity disorder (ADHD), respectively, in an investigator-initiated blinded study design. Male and female patients with schizophrenia (n=26) and adult ADHD (n=24) meeting Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM IV) diagnostic criteria and healthy controls (n=58) comprised the analysis set (n=108) of the total number of study participants (n=119). Coded sets of randomized ABR recordings were analysed by an independent party blinded to clinical diagnoses before a joint code-breaking session. The ABR profiling test for schizophrenia identified schizophrenia patients versus controls with a sensitivity of 84.6% and a specificity of 93.1%. The ADHD test identified patients with adult ADHD versus controls with a sensitivity of 87.5% and a specificity of 91.4%. The ABR profiling tests discriminated schizophrenia and ADHD versus healthy controls with high sensitivity and specificity. The methods deserve to be further explored in larger clinical studies including a broad range of psychiatric disorders to determine their utility as potential diagnostic biomarkers.

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

A Prospective Study of the Concordance of DSM-IV and DSM-5 Diagnostic Criteria for Autism Spectrum Disorder.

PubMed

Mazurek, Micah O; Lu, Frances; Symecko, Heather; Butter, Eric; Bing, Nicole M; Hundley, Rachel J; Poulsen, Marie; Kanne, Stephen M; Macklin, Eric A; Handen, Benjamin L

2017-09-01

The transition from DSM-IV to DSM-5 criteria for autism spectrum disorder (ASD) sparked considerable concern about the potential implications of these changes. This study was designed to address limitations of prior studies by prospectively examining the concordance of DSM-IV and final DSM-5 criteria on a consecutive sample of 439 children referred for autism diagnostic evaluations. Concordance and discordance were assessed using a consistent diagnostic battery. DSM-5 criteria demonstrated excellent overall specificity and good sensitivity relative to DSM-IV criteria. Sensitivity and specificity were strongest for children meeting DSM-IV criteria for autistic disorder, but poor for those meeting criteria for Asperger's disorder and pervasive developmental disorder. Higher IQ, older age, female sex, and less pronounced ASD symptoms were associated with greater discordance.

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.

The Design, Development, and Evaluation of an Evaluative Computer Simulation.

ERIC Educational Resources Information Center

Ehrlich, Lisa R.

This paper discusses evaluation design considerations for a computer based evaluation simulation developed at the University of Iowa College of Medicine in Cardiology to assess the diagnostic skills of primary care physicians and medical students. The simulation developed allows for the assessment of diagnostic skills of physicians in the…

XPERT DESIGN AND DIAGNOSTICS' (XDD) IN-SITU CHEMICAL OXIDATION PROCESS USING POTASSIUM PERMANGANATE (KMNO4)

EPA Science Inventory

Xpert Design and Diagnostic's (XDD)potassium permanganate in situ chemical oxidation (ISCO) process was evaluated under the EPA Superfund Innovative Technology Evaluation (SITE) Program at the former MEC Building site located in Hudson, New Hampshire. At this site, both soil and ...

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…

Diagnostic accuracy of clinical tests for assessment of hamstring injury: a systematic review.

PubMed

Reiman, Michael P; Loudon, Janice K; Goode, Adam P

2013-04-01

Systematic literature review. The diagnosis of a hamstring injury has traditionally relied on various clinical measures (eg, palpation, swelling, manual resistance), as well as the use of diagnostic imaging. But a few studies have suggested the use of specific clinical tests that may be helpful for the diagnostic process. To summarize the current literature on the diagnostic accuracy of orthopaedic special tests for hamstring injuries and to determine their clinical utility. A computer-assisted literature search of the MEDLINE, CINAHL, and Embase databases (along with a manual search of grey literature) was conducted using key words related to diagnostic accuracy of hamstring injuries. To be considered for inclusion in the review, the study required (1) patients with hamstring or posterior thigh pain; (2) a cohort, case-control, or cross-sectional design; (3) inclusion of at least 1 clinical examination test used to evaluate hamstring pathology; (4) comparison against an acceptable reference standard; (5) reporting of diagnostic accuracy of the measures (sensitivity [SN], specificity [SP], or likelihood ratios); and (6) publication in English. SN, SP, and positive and negative likelihood ratios were calculated for each diagnostic test. The search strategy identified 602 potential articles, of which only 3 articles met the inclusion criteria, with only 1 of these 3 articles being of high quality. Two of the studies investigated a single special test, whereas the third article examined a composite clinical assessment employing various special tests. The SN values ranged from 0.55 (95% confidence interval [CI]: 0.46, 0.69) for the active range-of-motion test to 1.00 (95% CI: 0.97, 1.00) for the taking-off-the-shoe test. The SP values ranged from 0.03 (95% CI: 0.00, 0.22) for the composite clinical assessment to 1.00 (95% CI: 0.97, 1.00) for the taking-off-the-shoe test, active range-of-motion test, passive range-of-motion test, and resisted range-of-motion test. The use of a single special test demonstrated stronger SP than SN properties, whereas the composite clinical assessment demonstrated stronger SN than SP properties. Very few studies have investigated the utilization of clinical special tests for the diagnosis of hamstring injuries. Further studies of higher quality design are suggested prior to advocating independent clinical utilization of these special tests. Diagnosis, level 3b.

CAD-Based Shielding Analysis for ITER Port Diagnostics

NASA Astrophysics Data System (ADS)

Serikov, Arkady; Fischer, Ulrich; Anthoine, David; Bertalot, Luciano; De Bock, Maartin; O'Connor, Richard; Juarez, Rafael; Krasilnikov, Vitaly

2017-09-01

Radiation shielding analysis conducted in support of design development of the contemporary diagnostic systems integrated inside the ITER ports is relied on the use of CAD models. This paper presents the CAD-based MCNP Monte Carlo radiation transport and activation analyses for the Diagnostic Upper and Equatorial Port Plugs (UPP #3 and EPP #8, #17). The creation process of the complicated 3D MCNP models of the diagnostics systems was substantially accelerated by application of the CAD-to-MCNP converter programs MCAM and McCad. High performance computing resources of the Helios supercomputer allowed to speed-up the MCNP parallel transport calculations with the MPI/OpenMP interface. The found shielding solutions could be universal, reducing ports R&D costs. The shield block behind the Tritium and Deposit Monitor (TDM) optical box was added to study its influence on Shut-Down Dose Rate (SDDR) in Port Interspace (PI) of EPP#17. Influence of neutron streaming along the Lost Alpha Monitor (LAM) on the neutron energy spectra calculated in the Tangential Neutron Spectrometer (TNS) of EPP#8. For the UPP#3 with Charge eXchange Recombination Spectroscopy (CXRS-core), an excessive neutron streaming along the CXRS shutter, which should be prevented in further design iteration.

Power accounting of plasma discharges in the linear device Proto-MPEX

NASA Astrophysics Data System (ADS)

Showers, M.; Piotrowicz, P. A.; Beers, C. J.; Biewer, T. M.; Caneses, J.; Canik, J.; Caughman, J. B. O.; Donovan, D. C.; Goulding, R. H.; Lumsdaine, A.; Kafle, N.; Owen, L. W.; Rapp, J.; Ray, H.

2018-06-01

Plasma material interaction (PMI) studies are crucial to the successful development of future fusion reactors. Prototype Material Plasma Exposure eXperiment (Proto-MPEX) is a prototype design for the MPEX, a steady-state linear device being developed to study PMI. The primary purpose of Proto-MPEX is developing the plasma heating source concepts for MPEX. A power accounting study of Proto-MPEX works to identify machine operating parameters that could improve its performance, thereby increasing its PMI research capabilities, potentially impacting the MPEX design concept. To build a comprehensive power balance, an analysis of the helicon region has been performed implementing a diagnostic suite and software modeling to identify mechanisms and locations of heat loss from the main plasma. Of the 106.3 kW of input power, up to 90.5% of the power has been accounted for in the helicon region. When the analysis was extended to encompass the device to its end plates, 49.2% of the input power was accounted for and verified diagnostically. Areas requiring further diagnostic analysis are identified. The required improvements will be implemented in future work. The data acquisition and analysis processes will be streamlined to form a working model for future power balance studies of Proto-MPEX. ).

Design of a Neutron Temporal Diagnostic for measuring DD or DT burn histories at the NIF

NASA Astrophysics Data System (ADS)

Lahmann, B.; Frenje, J. A.; Sio, H.; Petrasso, R. D.; Bradley, D. K.; Le Pape, S.; MacKinnon, A. J.; Isumi, N.; Macphee, A.; Zayas, C.; Spears, B. K.; Hermann, H.; Hilsabeck, T. J.; Kilkenny, J. D.

2015-11-01

The DD or DT burn history in Inertial Confinement Fusion (ICF) implosions provides essential information about implosion performance and helps to constrain numerical modeling. The capability of measuring this burn history is thus important for the NIF in its pursuit of ignition. Currently, the Gamma Reaction History (GRH) diagnostic is the only system capable of measuring the burn history for DT implosions with yields greater than ~ 1e14. To complement GRH, a new NIF Neutron Temporal Diagnostic (NTD) is being designed for measuring the DD or DT burn history with yields greater than ~ 1e10. A traditional scintillator-based design and a pulse-dilation-based design are being considered. Using MCNPX simulations, both designs have been optimized, validated and contrasted for various types of implosions at the NIF. This work was supported in part by the U.S. DOE, LLNL and LLE.

An Artificial Intelligence Approach for Gears Diagnostics in AUVs

PubMed Central

Marichal, Graciliano Nicolás; Del Castillo, María Lourdes; López, Jesús; Padrón, Isidro; Artés, Mariano

2016-01-01

In this paper, an intelligent scheme for detecting incipient defects in spur gears is presented. In fact, the study has been undertaken to determine these defects in a single propeller system of a small-sized unmanned helicopter. It is important to remark that although the study focused on this particular system, the obtained results could be extended to other systems known as AUVs (Autonomous Unmanned Vehicles), where the usage of polymer gears in the vehicle transmission is frequent. Few studies have been carried out on these kinds of gears. In this paper, an experimental platform has been adapted for the study and several samples have been prepared. Moreover, several vibration signals have been measured and their time-frequency characteristics have been taken as inputs to the diagnostic system. In fact, a diagnostic system based on an artificial intelligence strategy has been devised. Furthermore, techniques based on several paradigms of the Artificial Intelligence (Neural Networks, Fuzzy systems and Genetic Algorithms) have been applied altogether in order to design an efficient fault diagnostic system. A hybrid Genetic Neuro-Fuzzy system has been developed, where it is possible, at the final stage of the learning process, to express the fault diagnostic system as a set of fuzzy rules. Several trials have been carried out and satisfactory results have been achieved. PMID:27077868

An Artificial Intelligence Approach for Gears Diagnostics in AUVs.

PubMed

Marichal, Graciliano Nicolás; Del Castillo, María Lourdes; López, Jesús; Padrón, Isidro; Artés, Mariano

2016-04-12

In this paper, an intelligent scheme for detecting incipient defects in spur gears is presented. In fact, the study has been undertaken to determine these defects in a single propeller system of a small-sized unmanned helicopter. It is important to remark that although the study focused on this particular system, the obtained results could be extended to other systems known as AUVs (Autonomous Unmanned Vehicles), where the usage of polymer gears in the vehicle transmission is frequent. Few studies have been carried out on these kinds of gears. In this paper, an experimental platform has been adapted for the study and several samples have been prepared. Moreover, several vibration signals have been measured and their time-frequency characteristics have been taken as inputs to the diagnostic system. In fact, a diagnostic system based on an artificial intelligence strategy has been devised. Furthermore, techniques based on several paradigms of the Artificial Intelligence (Neural Networks, Fuzzy systems and Genetic Algorithms) have been applied altogether in order to design an efficient fault diagnostic system. A hybrid Genetic Neuro-Fuzzy system has been developed, where it is possible, at the final stage of the learning process, to express the fault diagnostic system as a set of fuzzy rules. Several trials have been carried out and satisfactory results have been achieved.

A Diagnostic Post-Occupancy Evaluation of the Nacadia® Therapy Garden.

PubMed

Sidenius, Ulrik; Karlsson Nyed, Patrik; Linn Lygum, Victoria; K Stigsdotter, Ulrika

2017-08-05

The design of the Nacadia® therapy garden is based on a model for evidence-based health design in landscape architecture (EBHDL). One element of the model is a diagnostic post-occupancy evaluation (DPOE), which has not previously been fully developed. The present study develops a generic DPOE for therapy gardens, with a focus on studying the effects of the design on patients' health outcomes. This is done in order to identify successes and failures in the design. By means of a triangulation approach, the DPOE employs a mixture of methods, and data is interpreted corroborating. The aim of the present study is to apply the DPOE to the Nacadia® therapy garden. The results of the DPOE suggest that the design of the Nacadia® therapy garden fulfills its stated aims and objectives. The overall environment of the Nacadia ® therapy garden was experienced as protective and safe, and successfully incorporated the various elements of the nature-based therapy programme. The participants encountered meaningful spaces and activities which suited their current physical and mental capabilities, and the health outcome measured by EQ-VAS (self-estimated general health) indicated a significant increase. Some design failures were identified, of which visual exposure was the most noteworthy. The DPOE model presented appears to be efficient but would nonetheless profit from being validated by other cases.

A Diagnostic Post-Occupancy Evaluation of the Nacadia® Therapy Garden

PubMed Central

Sidenius, Ulrik; Karlsson Nyed, Patrik; Linn Lygum, Victoria; K. Stigsdotter, Ulrika

2017-01-01

The design of the Nacadia® therapy garden is based on a model for evidence-based health design in landscape architecture (EBHDL). One element of the model is a diagnostic post-occupancy evaluation (DPOE), which has not previously been fully developed. The present study develops a generic DPOE for therapy gardens, with a focus on studying the effects of the design on patients’ health outcomes. This is done in order to identify successes and failures in the design. By means of a triangulation approach, the DPOE employs a mixture of methods, and data is interpreted corroborating. The aim of the present study is to apply the DPOE to the Nacadia® therapy garden. The results of the DPOE suggest that the design of the Nacadia® therapy garden fulfills its stated aims and objectives. The overall environment of the Nacadia ® therapy garden was experienced as protective and safe, and successfully incorporated the various elements of the nature-based therapy programme. The participants encountered meaningful spaces and activities which suited their current physical and mental capabilities, and the health outcome measured by EQ-VAS (self-estimated general health) indicated a significant increase. Some design failures were identified, of which visual exposure was the most noteworthy. The DPOE model presented appears to be efficient but would nonetheless profit from being validated by other cases. PMID:28783060

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

PubMed

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

2015-03-01

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

Microfluidic point-of-care diagnostics for resource-poor environments

NASA Astrophysics Data System (ADS)

Laksanasopin, Tassaneewan; Chin, Curtis D.; Moore, Hannah; Wang, Jennifer; Cheung, Yuk Kee; Sia, Samuel K.

2009-05-01

Point-of-care (POC) diagnostics have tremendous potential to improve human health in remote and resource-poor settings. However, the design criteria for diagnostic tests appropriate in settings with limited infrastructure are unique and challenging. Here we present a custom optical reader which quantifies silver absorbance from heterogeneous immunoassays. The reader is simple and low-cost and suited for POC diagnostics.

A comprehensive custom panel design for routine hereditary cancer testing: preserving control, improving diagnostics and revealing a complex variation landscape.

PubMed

Castellanos, Elisabeth; Gel, Bernat; Rosas, Inma; Tornero, Eva; Santín, Sheila; Pluvinet, Raquel; Velasco, Juan; Sumoy, Lauro; Del Valle, Jesús; Perucho, Manuel; Blanco, Ignacio; Navarro, Matilde; Brunet, Joan; Pineda, Marta; Feliubadaló, Lidia; Capellá, Gabi; Lázaro, Conxi; Serra, Eduard

2017-01-04

We wanted to implement an NGS strategy to globally analyze hereditary cancer with diagnostic quality while retaining the same degree of understanding and control we had in pre-NGS strategies. To do this, we developed the I2HCP panel, a custom bait library covering 122 hereditary cancer genes. We improved bait design, tested different NGS platforms and created a clinically driven custom data analysis pipeline. The I2HCP panel was developed using a training set of hereditary colorectal cancer, hereditary breast and ovarian cancer and neurofibromatosis patients and reached an accuracy, analytical sensitivity and specificity greater than 99%, which was maintained in a validation set. I2HCP changed our diagnostic approach, involving clinicians and a genetic diagnostics team from panel design to reporting. The new strategy improved diagnostic sensitivity, solved uncertain clinical diagnoses and identified mutations in new genes. We assessed the genetic variation in the complete set of hereditary cancer genes, revealing a complex variation landscape that coexists with the disease-causing mutation. We developed, validated and implemented a custom NGS-based strategy for hereditary cancer diagnostics that improved our previous workflows. Additionally, the existence of a rich genetic variation in hereditary cancer genes favors the use of this panel to investigate their role in cancer risk.

Design of a receiver operating characteristic (ROC) study of 10:1 lossy image compression

NASA Astrophysics Data System (ADS)

Collins, Cary A.; Lane, David; Frank, Mark S.; Hardy, Michael E.; Haynor, David R.; Smith, Donald V.; Parker, James E.; Bender, Gregory N.; Kim, Yongmin

1994-04-01

The digital archiving system at Madigan Army Medical Center (MAMC) uses a 10:1 lossy data compression algorithm for most forms of computed radiography. A systematic study on the potential effect of lossy image compression on patient care has been initiated with a series of studies focused on specific diagnostic tasks. The studies are based upon the receiver operating characteristic (ROC) method of analysis for diagnostic systems. The null hypothesis is that observer performance with approximately 10:1 compressed and decompressed images is not different from using original, uncompressed images for detecting subtle pathologic findings seen on computed radiographs of bone, chest, or abdomen, when viewed on a high-resolution monitor. Our design involves collecting cases from eight pathologic categories. Truth is determined by committee using confirmatory studies performed during routine clinical practice whenever possible. Software has been developed to aid in case collection and to allow reading of the cases for the study using stand-alone Siemens Litebox workstations. Data analysis uses two methods, ROC analysis and free-response ROC (FROC) methods. This study will be one of the largest ROC/FROC studies of its kind and could benefit clinical radiology practice using PACS technology. The study design and results from a pilot FROC study are presented.

Research Support for the Instructional Strategy Diagnostic Profile. Technical Report No. 3

ERIC Educational Resources Information Center

Merrill, M. David; And Others

By using a taxonomy of instructional strategy variables, an Instructional Strategy Diagnostic Profile (ISDP) was developed which can be used either to determine a judged index of instructional effectiveness for a previously designed instructional product or to guide the design and development of a new instructional product. Existing experimental…

A subscale facility for liquid rocket propulsion diagnostics at Stennis Space Center

NASA Technical Reports Server (NTRS)

Raines, N. G.; Bircher, F. E.; Chenevert, D. J.

1991-01-01

The Diagnostics Testbed Facility (DTF) at NASA's John C. Stennis Space Center in Mississippi was designed to provide a testbed for the development of rocket engine exhaust plume diagnostics instrumentation. A 1200-lb thrust liquid oxygen/gaseous hydrogen thruster is used as the plume source for experimentation and instrument development. Theoretical comparative studies have been performed with aerothermodynamic codes to ensure that the DTF thruster (DTFT) has been optimized to produce a plume with pressure and temperature conditions as much like the plume of the Space Shuttle Main Engine as possible. Operation of the DTFT is controlled by an icon-driven software program using a series of soft switches. Data acquisition is performed using the same software program. A number of plume diagnostics experiments have utilized the unique capabilities of the DTF.

Design of the algorithm of photons migration in the multilayer skin structure

NASA Astrophysics Data System (ADS)

Bulykina, Anastasiia B.; Ryzhova, Victoria A.; Korotaev, Valery V.; Samokhin, Nikita Y.

2017-06-01

Design of approaches and methods of the oncological diseases diagnostics has special significance. It allows determining any kind of tumors at early stages. The development of optical and laser technologies provided increase of a number of methods allowing making diagnostic studies of oncological diseases. A promising area of biomedical diagnostics is the development of automated nondestructive testing systems for the study of the skin polarizing properties based on backscattered radiation detection. Specification of the examined tissue polarizing properties allows studying of structural properties change influenced by various pathologies. Consequently, measurement and analysis of the polarizing properties of the scattered optical radiation for the development of methods for diagnosis and imaging of skin in vivo appear relevant. The purpose of this research is to design the algorithm of photons migration in the multilayer skin structure. In this research, the algorithm of photons migration in the multilayer skin structure was designed. It is based on the use of the Monte Carlo method. Implemented Monte Carlo method appears as a tracking the paths of photons experiencing random discrete direction changes before they are released from the analyzed area or decrease their intensity to negligible levels. Modeling algorithm consists of the medium and the source characteristics generation, a photon generating considering spatial coordinates of the polar and azimuthal angles, the photon weight reduction calculating due to specular and diffuse reflection, the photon mean free path definition, the photon motion direction angle definition as a result of random scattering with a Henyey-Greenstein phase function, the medium's absorption calculation. Biological tissue is modeled as a homogeneous scattering sheet characterized by absorption, a scattering and anisotropy coefficients.

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

PubMed

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

2015-06-17

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

Engineering aspects of design and integration of ECE diagnostic in ITER

DOE PAGES

Udintsev, V. S.; Taylor, G.; Pandya, H. K.B.; ...

2015-03-12

ITER ECE diagnostic [1] needs not only to meet measurement requirements, but also to withstand various loads, such as electromagnetic, mechanical, neutronic and thermal, and to be protected from stray ECH radiation at 170 GHz and other millimeter wave emission, like Collective Thomson scattering which is planned to operate at 60 GHz. Same or similar loads will be applied to other millimetre-wave diagnostics [2], located both in-vessel and in-port plugs. These loads must be taken into account throughout the design phases of the ECE and other microwave diagnostics to ensure their structural integrity and maintainability. The integration of microwave diagnosticsmore » with other ITER systems is another challenging activity which is currently ongoing through port integration and in-vessel integration work. Port Integration has to address the maintenance and the safety aspects of diagnostics, too. Engineering solutions which are being developed to support and to operate ITER ECE diagnostic, whilst complying with safety and maintenance requirements, are discussed in this paper.« less

Custom oligonucleotide array-based CGH: a reliable diagnostic tool for detection of exonic copy-number changes in multiple targeted genes

PubMed Central

Vasson, Aurélie; Leroux, Céline; Orhant, Lucie; Boimard, Mathieu; Toussaint, Aurélie; Leroy, Chrystel; Commere, Virginie; Ghiotti, Tiffany; Deburgrave, Nathalie; Saillour, Yoann; Atlan, Isabelle; Fouveaut, Corinne; Beldjord, Cherif; Valleix, Sophie; Leturcq, France; Dodé, Catherine; Bienvenu, Thierry; Chelly, Jamel; Cossée, Mireille

2013-01-01

The frequency of disease-related large rearrangements (referred to as copy-number mutations, CNMs) varies among genes, and search for these mutations has an important place in diagnostic strategies. In recent years, CGH method using custom-designed high-density oligonucleotide-based arrays allowed the development of a powerful tool for detection of alterations at the level of exons and made it possible to provide flexibility through the possibility of modeling chips. The aim of our study was to test custom-designed oligonucleotide CGH array in a diagnostic laboratory setting that analyses several genes involved in various genetic diseases, and to compare it with conventional strategies. To this end, we designed a 12-plex CGH array (135k; 135 000 probes/subarray) (Roche Nimblegen) with exonic and intronic oligonucleotide probes covering 26 genes routinely analyzed in the laboratory. We tested control samples with known CNMs and patients for whom genetic causes underlying their disorders were unknown. The contribution of this technique is undeniable. Indeed, it appeared reproducible, reliable and sensitive enough to detect heterozygous single-exon deletions or duplications, complex rearrangements and somatic mosaicism. In addition, it improves reliability of CNM detection and allows determination of boundaries precisely enough to direct targeted sequencing of breakpoints. All of these points, associated with the possibility of a simultaneous analysis of several genes and scalability ‘homemade' make it a valuable tool as a new diagnostic approach of CNMs. PMID:23340513

A Qualitative Analysis of Physician Perspectives on Missed and Delayed Outpatient Diagnosis: The Focus on System-Related Factors.

PubMed

Sarkar, Urmimala; Simchowitz, Brett; Bonacum, Doug; Strull, William; Lopez, Andrea; Rotteau, Leahora; Shojania, Kaveh G

2014-10-01

Delayed and missed diagnoses lead to significant patient harm. Because physician actions are fundamental to the outpatient diagnostic process, a study was conducted to explore physician perspectives on diagnosis. As part of a quality improvement initiative, an integrated health system conducted six physician focus groups in 2004 and 2005. The focus groups included questions about the process of diagnosis, specific factors contributing to missed diagnosis, use of guidelines, atypical vs. typical presentations of disease, diagnostic tools, and follow-up, all with regard to delays in the diagnostic process. The interviews were analyzed (1) deductively, with application of the Systems Engineering Initiative for Patient Safety (SEIPS) model, which addresses systems design, quality management, job design, and technology implementations that affect safety-related patient and organizational and/or staff outcomes, and (2) inductively, with identification of novel themes using content analysis. A total of 25 physicians participated in the six focus groups, which yielded 12 hours of discussion. Providers identified multiple barriers to timely and accurate diagnosis, including organizational culture, information availability, and communication factors. Multiple themes relating to each of the participants in the diagnostic process-health system, provider, and patient-emerged. Concerns about health system structure and providers' interactions with one another and with patients far exceeded discussion of the cognitive factors that might affect the diagnostic process. The results suggest that, at least in physicians' views, improving the diagnostic process requires attention to the organization of the health system in addition to the cognitive aspects of diagnosis.

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

Stutman, D.; Tritz, K.; Finkenthal, M.

New diagnostic and sensor designs are needed for future burning plasma (BP) fusion experiments, having good space and time resolution and capable of prolonged operation in the harsh BP environment. We evaluate the potential of multi-energy x-ray imaging with filtered detector arrays for BP diagnostic and control. Experimental studies show that this simple and robust technique enables measuring with good accuracy, speed, and spatial resolution the T{sub e} profile, impurity content, and MHD activity in a tokamak. Applied to the BP this diagnostic could also serve for non-magnetic sensing of the plasma position, centroid, ELM, and RWM instability. BP compatiblemore » x-ray sensors are proposed using 'optical array' or 'bi-cell' detectors.« less

Turbine Engine Diagnostic Development. Phase I Report

DTIC Science & Technology

1972-11-01

was designed to Increase compressor stall margin at low power. It operates as a function of low pressure compressor discharge pressure (PS3) and...aircraft of the 1980-8? time frame. The IEDDS will be designed to replace conventional cockpit gages and will provide output messages pertaining to...testing, a specifica- tion for a Request For Proposal will be formulated for the IEDDS. (■ sumRY A turbine engine diagnostics system was designed

Scanning and Measuring Device for Diagnostic of Barrel Bore

NASA Astrophysics Data System (ADS)

Marvan, Ales; Hajek, Josef; Vana, Jan; Dvorak, Radim; Drahansky, Martin; Jankovych, Robert; Skvarek, Jozef

The article discusses the design, mechanical design, electronics and software for robot diagnosis of barrels with caliber of 120 mm to 155 mm. This diagnostic device is intended primarily for experimental research and verification of appropriate methods and technologies for the diagnosis of the main bore guns. Article also discusses the design of sensors and software, the issue of data processing and image reconstruction obtained by scanning of the surface of the bore.

Dielectrophoresis-based microfluidic platforms for cancer diagnostics.

PubMed

Chan, Jun Yuan; Ahmad Kayani, Aminuddin Bin; Md Ali, Mohd Anuar; Kok, Chee Kuang; Yeop Majlis, Burhanuddin; Hoe, Susan Ling Ling; Marzuki, Marini; Khoo, Alan Soo-Beng; Ostrikov, Kostya Ken; Ataur Rahman, Md; Sriram, Sharath

2018-01-01

The recent advancement of dielectrophoresis (DEP)-enabled microfluidic platforms is opening new opportunities for potential use in cancer disease diagnostics. DEP is advantageous because of its specificity, low cost, small sample volume requirement, and tuneable property for microfluidic platforms. These intrinsic advantages have made it especially suitable for developing microfluidic cancer diagnostic platforms. This review focuses on a comprehensive analysis of the recent developments of DEP enabled microfluidic platforms sorted according to the target cancer cell. Each study is critically analyzed, and the features of each platform, the performance, added functionality for clinical use, and the types of samples, used are discussed. We address the novelty of the techniques, strategies, and design configuration used in improving on existing technologies or previous studies. A summary of comparing the developmental extent of each study is made, and we conclude with a treatment of future trends and a brief summary.

Fusion programs in applied plasma physics

NASA Astrophysics Data System (ADS)

1992-07-01

The Applied Plasma Physics (APP) program at General Atomics (GA) described here includes four major elements: (1) Applied Plasma Physics Theory Program, (2) Alpha Particle Diagnostic, (3) Edge and Current Density Diagnostic, and (4) Fusion User Service Center (USC). The objective of the APP theoretical plasma physics research at GA is to support the DIII-D and other tokamak experiments and to significantly advance our ability to design a commercially-attractive fusion reactor. We categorize our efforts in three areas: magnetohydrodynamic (MHD) equilibria and stability; plasma transport with emphasis on H-mode, divertor, and boundary physics; and radio frequency (RF). The objective of the APP alpha particle diagnostic is to develop diagnostics of fast confined alpha particles using the interactions with the ablation cloud surrounding injected pellets and to develop diagnostic systems for reacting and ignited plasmas. The objective of the APP edge and current density diagnostic is to first develop a lithium beam diagnostic system for edge fluctuation studies on the Texas Experimental Tokamak (TEXT). The objective of the Fusion USC is to continue to provide maintenance and programming support to computer users in the GA fusion community. The detailed progress of each separate program covered in this report period is described.

Automated knowledge generation

NASA Technical Reports Server (NTRS)

Myler, Harley R.; Gonzalez, Avelino J.

1988-01-01

The general objectives of the NASA/UCF Automated Knowledge Generation Project were the development of an intelligent software system that could access CAD design data bases, interpret them, and generate a diagnostic knowledge base in the form of a system model. The initial area of concentration is in the diagnosis of the process control system using the Knowledge-based Autonomous Test Engineer (KATE) diagnostic system. A secondary objective was the study of general problems of automated knowledge generation. A prototype was developed, based on object-oriented language (Flavors).

A New Design for Survey Feedback

ERIC Educational Resources Information Center

Alderfer, Clayton P.; Holbrook, John

1973-01-01

Presents a theoretical discussion analyzing and explaining the use of group methods in feeding back diagnostic data to organizations, illustrating a new peer group--intergroup model with a study of senior officers at a bank. (Author/JM)

The Application of Cognitive Diagnostic Approaches via Neural Network Analysis of Serious Educational Games

NASA Astrophysics Data System (ADS)

Lamb, Richard L.

Serious Educational Games (SEGs) have been a topic of increased popularity within the educational realm since the early millennia. SEGs are generalized form of Serious Games to mean games for purposes other than entertainment but, that also specifically include training, educational purpose and pedagogy within their design. This rise in popularity (for SEGs) has occurred at a time when school systems have increased the type, number, and presentations of student achievement tests for decision-making purposes. These tests often task the form of end of course (year) tests and periodic benchmark testing. As the use of these tests, has increased policymakers have suggested their use as a measure for teacher accountability. The change in testing resulted from a push by school districts and policy makers at various component levels for a data-driven decision-making (D3M) approach. With the data-driven decision making approaches by school districts, there has been an increased focus on the measurement and assessment of student content knowledge with little focus on the contributing factors and cognitive attributes within learning that cross multiple-content areas. One-way to increase the focus on these aspects of learning (factors and attributes) that are additional to content learning is through assessments based in cognitive diagnostics. Cognitive diagnostics are a family of methodological approaches in which tasks tie to specific cognitive attributes for analytical purposes. This study explores data derived from computer data logging (n=158,000) in an observational design, using traditional statistical techniques such as clustering (exploratory and confirmatory), item response theory and through data mining techniques such as artificial neural network analysis. From these analyses, a model of student learning emerges illustrating student thinking and learning while engaged in SEG Design. This study seeks to use cognitive diagnostic type approaches to measure student learning while designing science task based SEGs. In addition, the study suggests that it may be possible to use SEGs to provide a means to administer cognitive diagnostic based assessments in real time. Results of this study suggest the confirmation of four families (factors) of traits illustrating a simple factor loading structure. Item response theory (IRT) results illustrate a 2-parameter logistic model (2PLM) fit allowing for parameterization using the IRT-True Score Method (chi2=1.70, df=1, p=0.19). Finally, fit statistics for the artificial neural network suggest the developed model adequately fits the current data set and provides a means to explore cognitive attributes and their effect on task outcomes. This study has developed a justification for combining and developing two distinct areas of research related to student learning. The first is the use of cognitive diagnostic approaches to assess student learning as it relates to the cognitive attributes used during science processing. The second area is an examination and modeling of the relationship between attributes as propagated in an artificial neural network. Results of the study provide for an ANN model of student cognition while designing science based SEGs (r 2=0.73, RMSE= 0.21) at a convergence of 1000 training iterations. The literature presented in this dissertation work integrates work from multiple field areas. Fields represented in this work range from science education, educational psychology, measurement, and computational psychology.

Multicenter Evaluation Of Coronary Dual-Source CT angiography in patients with intermediate Risk of Coronary Artery Stenoses (MEDIC): study design and rationale.

PubMed

Marwan, Mohamed; Hausleiter, Jörg; Abbara, Suhny; Hoffmann, Udo; Becker, Christoph; Ovrehus, Kristian; Ropers, Dieter; Bathina, Ravi; Berman, Dan; Anders, Katharina; Uder, Michael; Meave, Aloha; Alexánderson, Erick; Achenbach, Stephan

2014-01-01

The diagnostic performance of multidetector row CT to detect coronary artery stenosis has been evaluated in numerous single-center studies, with only limited data from large cohorts with low-to-intermediate likelihood of coronary disease and in multicenter trials. The Multicenter Evaluation of Coronary Dual-Source CT Angiography in Patients with Intermediate Risk of Coronary Artery Stenoses (MEDIC) trial determines the accuracy of dual-source CT (DSCT) to identify persons with at least 1 coronary artery stenosis among patients with low-to-intermediate pretest likelihood of disease. The MEDIC trial was designed as a prospective, multicenter, international trial to evaluate the diagnostic performance of DSCT for the detection of coronary artery stenosis compared with invasive coronary angiography. The study includes 8 sites in Germany, India, Mexico, the United States, and Denmark. The study population comprises patients referred for a diagnostic coronary angiogram because of suspected coronary artery disease with an intermediate pretest likelihood as determined by sex, age, and symptoms. All evaluations are performed by blinded core laboratory readers. The primary outcome of the MEDIC trial is the accuracy of DSCT to identify the presence of coronary artery stenoses with a luminal diameter narrowing of 50% or more on a per-vessel basis. Secondary outcome parameters include per-patient and per-segment diagnostic accuracy for 50% stenoses and accuracy to identify stenoses of 70% or more. Furthermore, secondary outcome parameters include the influence of heart rate, Agatston score, body weight, body mass index, image quality, and diagnostic confidence on the accuracy to detect coronary artery stenoses >50% on a per-vessel basis. The results of the MEDIC trial will assess the clinical utility of coronary CT angiography in the evaluation of patients with intermediate pretest likelihood of coronary artery disease. Copyright © 2014 Society of Cardiovascular Computed Tomography. All rights reserved.

Electromagnetic Nanoparticles for Sensing and Medical Diagnostic Applications

PubMed Central

Vegni, Lucio

2018-01-01

A modeling and design approach is proposed for nanoparticle-based electromagnetic devices. First, the structure properties were analytically studied using Maxwell’s equations. The method provides us a robust link between nanoparticles electromagnetic response (amplitude and phase) and their geometrical characteristics (shape, geometry, and dimensions). Secondly, new designs based on “metamaterial” concept are proposed, demonstrating great performances in terms of wide-angle range functionality and multi/wide behavior, compared to conventional devices working at the same frequencies. The approach offers potential applications to build-up new advanced platforms for sensing and medical diagnostics. Therefore, in the final part of the article, some practical examples are reported such as cancer detection, water content measurements, chemical analysis, glucose concentration measurements and blood diseases monitoring. PMID:29652853

Socio-demographic and academic correlates of clinical reasoning in a dental school in South Africa.

PubMed

Postma, T C; White, J G

2017-02-01

There are no empirical studies that describe factors that may influence the development of integrated clinical reasoning skills in dental education. Hence, this study examines the association between outcomes of clinical reasoning in relation with differences in instructional design and student factors. Progress test scores, including diagnostic and treatment planning scores, of fourth and fifth year dental students (2009-2011) at the University of Pretoria, South Africa served as the outcome measures in stepwise linear regression analyses. These scores were correlated with the instructional design (lecture-based teaching and learning (LBTL = 0) or case-based teaching and learning (CBTL = 1), students' grades in Oral Biology, indicators of socio-economic status (SES) and gender. CBTL showed an independent association with progress test scores. Oral Biology scores correlated with diagnostic component scores. Diagnostic component scores correlated with treatment planning scores in the fourth year of study but not in the fifth year of study. 'SES' correlated with progress test scores in year five only, while gender showed no correlation. The empirical evidence gathered in this study provides support for scaffolded inductive teaching and learning methods to develop clinical reasoning skills. Knowledge in Oral Biology and reading skills may be important attributes to develop to ensure that students are able to reason accurately in a clinical setting. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

1983 AFOSR/AFRPL Chemical Rocket Research Meeting, Abstracts and Agenda. Includes: Abstracts on Advanced Diagnostics of Reacting Flow, 28 February - 3 March 1983, Lancaster, California.

DTIC Science & Technology

1983-02-01

blow-off stability and fractional conversion was evaluated for design of an experimental study of these phenomena. The apparatus designed will be...the development of an array of experimental methods and test strategies designed to unravel a complex process that is very difficult to observe directly...this effort of lead field theoretic analysis as a design basis has made that possible. The experimental phase of the effort has three major

Laboratory-based validation of the baseline sensors of the ITER diagnostic residual gas analyzer

NASA Astrophysics Data System (ADS)

Klepper, C. C.; Biewer, T. M.; Marcus, C.; Andrew, P.; Gardner, W. L.; Graves, V. B.; Hughes, S.

2017-10-01

The divertor-specific ITER Diagnostic Residual Gas Analyzer (DRGA) will provide essential information relating to DT fusion plasma performance. This includes pulse-resolving measurements of the fuel isotopic mix reaching the pumping ducts, as well as the concentration of the helium generated as the ash of the fusion reaction. In the present baseline design, the cluster of sensors attached to this diagnostic's differentially pumped analysis chamber assembly includes a radiation compatible version of a commercial quadrupole mass spectrometer, as well as an optical gas analyzer using a plasma-based light excitation source. This paper reports on a laboratory study intended to validate the performance of this sensor cluster, with emphasis on the detection limit of the isotopic measurement. This validation study was carried out in a laboratory set-up that closely prototyped the analysis chamber assembly configuration of the baseline design. This includes an ITER-specific placement of the optical gas measurement downstream from the first turbine of the chamber's turbo-molecular pump to provide sufficient light emission while preserving the gas dynamics conditions that allow for \\textasciitilde 1 s response time from the sensor cluster [1].

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.

Development of “-omics” research in Schistosoma spp. and -omics-based new diagnostic tools for schistosomiasis

PubMed Central

Wang, Shuqi; Hu, Wei

2014-01-01

Schistosomiasis, caused by dioecious flatworms in the genus Schistosoma, is torturing people from many developing countries nowadays and frequently leads to severe morbidity and mortality of the patients. Praziquantel based chemotherapy and morbidity control for this disease adopted currently necessitate viable and efficient diagnostic technologies. Fortunately, those “-omics” researches, which rely on high-throughput experimental technologies to produce massive amounts of informative data, have substantially contributed to the exploitation and innovation of diagnostic tools of schistosomiasis. In its first section, this review provides a concise conclusion on the progresses pertaining to schistosomal “-omics” researches to date, followed by a comprehensive section on the diagnostic methods of schistosomiasis, especially those innovative ones based on the detection of antibodies, antigens, nucleic acids, and metabolites with a focus on those achievements inspired by “-omics” researches. Finally, suggestions about the design of future diagnostic tools of schistosomiasis are proposed, in order to better harness those data produced by “-omics” studies. PMID:25018752

Evaluation of the Revised Algorithm of Autism Diagnostic Observation Schedule (ADOS) in the Diagnostic Investigation of High-Functioning Children and Adolescents with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Kamp-Becker, Inge; Ghahreman, Mardjan; Heinzel-Gutenbrunner, Monika; Peters, Mira; Remschmidt, Helmut; Becker, Katja

2013-01-01

The Autism Diagnostic Observation Schedule (ADOS) is a semi-structured, standardized assessment designed for use in diagnostic evaluation of individuals with suspected autism spectrum disorder (ASD). The ADOS has been effective in categorizing children who definitely have autism or not, but has lower specificity and sometimes sensitivity for…

Efficient design and verification of diagnostics for impurity transport experiments.

PubMed

Chilenski, M A; Greenwald, M J; Marzouk, Y M; Rice, J E; White, A E

2018-01-01

Recent attempts to measure impurity transport in Alcator C-Mod using an x-ray imaging crystal spectrometer and laser blow-off impurity injector have failed to yield unique reconstructions of the transport coefficient profiles. This paper presents a fast, linearized model which was constructed to estimate diagnostic requirements for impurity transport experiments. The analysis shows that the spectroscopic diagnostics on Alcator C-Mod should be capable of inferring simple profiles of impurity diffusion D Z and convection V Z accurate to better than ±10% uncertainty, suggesting that the failure to infer unique D Z and V Z from experimental data is attributable to an inadequate analysis procedure rather than the result of insufficient diagnostics. Furthermore, the analysis reveals that even a modest spatial resolution can overcome a low time resolution. This approach can be adapted to design and verify diagnostics for transport experiments on any magnetic confinement device.

Precision medicine for hepatocelluar carcinoma using molecular pattern diagnostics: results from a preclinical pilot study.

PubMed

Agarwal, Rahul; Cao, Yuan; Hoffmeier, Klaus; Krezdorn, Nicolas; Jost, Lukas; Meisel, Alejandro Rodriguez; Jüngling, Ruth; Dituri, Francesco; Mancarella, Serena; Rotter, Björn; Winter, Peter; Giannelli, Gianluigi

2017-06-08

The aim of this study was to design a road map for personalizing cancer therapy in hepatocellular carcinoma (HCC) by using molecular pattern diagnostics. As an exploratory study, we investigated molecular patterns of tissues of two tumors from individual HCC patients, which in previous experiments had shown contrasting reactions to the phase 2 transforming growth factor beta receptor 1 inhibitor galunisertib. Cancer-driving molecular patterns encompass - inter alias - altered transcription profiles and somatic mutations in coding regions differentiating tumors from their respective peritumoral tissues and from each other. Massive analysis of cDNA ends and all-exome sequencing demonstrate a highly divergent transcriptional and mutational landscape, respectively, for the two tumors, that offers potential explanations for the tumors contrasting responses to galunisertib. Molecular pattern diagnostics (MPDs) suggest alternative, individual-tumor-specific therapies, which in both cases deviate from the standard sorafenib treatment and from each other. Suggested personalized therapies use kinase inhibitors and immune-focused drugs as well as low-toxicity natural compounds identified using an advanced bioinformatics routine included in the MPD protocol. The MPD pipeline we describe here for the prediction of suitable drugs for treatment of two contrasting HCCs may serve as a blueprint for the design of therapies for various types of cancer.

The role of nurses/social workers in using a multidimensional guideline for diagnosis of anxiety and challenging behaviour in people with intellectual disabilities.

PubMed

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

2015-07-01

This study seeks (1) to investigate the impact of the implementation of the 'Diagnostic Guideline for Anxiety and challenging behaviours in clients with intellectual disability' on nurses/social workers' knowledge and self-efficacy; and (2) to evaluate the role of nurses/social workers in the diagnostic process when applying the guideline. Nurses/social workers have extensive contact with clients with intellectual disabilities. Despite this key position, the contribution of nurses/social workers to the diagnosis of mental health problems and challenging behaviours is rather limited. The authors developed the multidimensional 'Diagnostic Guideline for Anxiety and challenging behaviours'. In this article, the implementation of this guideline is evaluated concerning knowledge and self-efficacy of nurses/social workers, as well the role of nurses/social workers in the diagnostic process. This study employed a comparative multiple case study design. Qualitative and quantitative research methods. Working with the 'Diagnostic Guideline for Anxiety and challenging behaviours' led to a statistically significant increase in knowledge and self-efficacy among the nurses/social workers in the experimental condition, compared with nurses/social workers in the control condition. Nurses/social workers and psychologists appreciated the more active contribution of the nurses/social workers in the diagnostic process. Working with the guideline increased the knowledge and self-efficacy of nurses/social workers, and led to more active participation of nurses/social workers in the diagnostic process. After following a training programme, nurses/social workers can effectively contribute to the diagnostic process in clients with anxiety and related challenging behaviours. © 2015 John Wiley & Sons Ltd.

Diffusion of Molecular Diagnostic Lung Cancer Tests: A Survey of German Oncologists

PubMed Central

Steffen, Julius Alexander

2014-01-01

This study was aimed at examining the diffusion of diagnostic lung cancer tests in Germany. It was motivated by the high potential of detecting and targeting oncogenic drivers. Recognizing that the diffusion of diagnostic tests is a conditio sine qua non for the success of personalized lung cancer therapies, this study analyzed the diffusion of epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) tests in Germany. Qualitative and quantitative research strategies were combined in a mixed-method design. A literature review and subsequent Key Opinion Leader interviews identified a set of qualitative factors driving the diffusion process, which were then translated into an online survey. The survey was conducted among a sample of 961 oncologists (11.34% response rate). The responses were analyzed in a multiple linear regression which identified six statistically significant factors driving the diffusion of molecular diagnostic lung cancer tests: reimbursement, attitude towards R&D, information self-assessment, perceived attitudes of colleagues, age and test-pathway strategies. Besides the important role of adequate reimbursement and relevant guidelines, the results of this study suggest that an increasing usage of test-pathway strategies, especially in an office-based setting, can increase the diffusion of molecular diagnostic lung cancer tests in the future. PMID:25562146

Digital Smile Design concept delineates the final potential result of crown lengthening and porcelain veneers to correct a gummy smile.

PubMed

Trushkowsky, Richard; Arias, David Montalvo; David, Steven

Prior to initiating any treatment, it is necessary to visualize the desired outcomes. It then becomes possible to formulate the steps required to achieve this result. Digital Smile Design (DSD) utilizes patient input and information gathered through diagnostic procedures to create an esthetic treatment scheme. In the case presented here, the NYUCD Esthetic Evaluation Form, intraoral and extraoral photographs, mounted diagnostic casts, physical examination, and radiographs were the diagnostic modalities. The gathered information served as a starting point for a wax-up and intraoral mock-up. This case report demonstrates how the DSD served as a template for crown lengthening procedures and design of the final porcelain veneer restorations.

A Self-Diagnostic System for the M6 Accelerometer

NASA Technical Reports Server (NTRS)

Flanagan, Patrick M.; Lekki, John

2001-01-01

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

The Swedish version of the Ritvo autism and asperger diagnostic scale: revised (RAADS-R). A validation study of a rating scale for adults.

PubMed

Andersen, Lisa M J; Näswall, Katharina; Manouilenko, Irina; Nylander, Lena; Edgar, Johan; Ritvo, Riva Ariella; Ritvo, Edward; Bejerot, Susanne

2011-12-01

There is a paucity of diagnostic instruments for adults with autism spectrum disorder (ASD). This study evaluates the psychometric properties of the Swedish version of the Ritvo Autism and Asperger Diagnostic Scale-Revised (RAADS-R), an 80-item self-rating scale designed to assist clinicians diagnosing ASD in adults. It was administered to 75 adults with ASD and 197 comparison cases. Also, a subset completed the Autism Spectrum Quotient (AQ). Three out of four subscales had high internal consistency. Sensitivity was 91% and specificity was 93%. The ASD subjects had significantly higher mean scores on all subscales. ASD females had higher scores than ASD males on the sensory motor subscale, a dimension not included in the AQ. RAADS-R showed promising test re-test reliability.

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 Correlated Lecture Laboratory Series in Diagnostic Radiological Physics.

ERIC Educational Resources Information Center

Lamel, David A.; And Others

This series in diagnostic radiological physics has been designed to provide the physics background requisite for the proper conduct of medical diagnostic x-ray examinations. The basic goal of the series is to bridge physics theory and radiological practice, achieved by combining pertinent lecture material with laboratory exercises that illustrate…

Diagnostic Teaching of the Language Arts.

ERIC Educational Resources Information Center

Burns, Paul C.

This book is based on the premise that learning can best be facilitated when the teacher takes a diagnostic view of the instructional process. To further this end, each chapter contains materials, models, and techniques designed to implement diagnostic teaching in the language arts program. The seven chapters are "Foundations for Diagnostic…

Modeling Diagnostic Assessments with Bayesian Networks

ERIC Educational Resources Information Center

Almond, Russell G.; DiBello, Louis V.; Moulder, Brad; Zapata-Rivera, Juan-Diego

2007-01-01

This paper defines Bayesian network models and examines their applications to IRT-based cognitive diagnostic modeling. These models are especially suited to building inference engines designed to be synchronous with the finer grained student models that arise in skills diagnostic assessment. Aspects of the theory and use of Bayesian network models…

Meta-analysis of diagnostic accuracy studies accounting for disease prevalence: alternative parameterizations and model selection.

PubMed

Chu, Haitao; Nie, Lei; Cole, Stephen R; Poole, Charles

2009-08-15

In a meta-analysis of diagnostic accuracy studies, the sensitivities and specificities of a diagnostic test may depend on the disease prevalence since the severity and definition of disease may differ from study to study due to the design and the population considered. In this paper, we extend the bivariate nonlinear random effects model on sensitivities and specificities to jointly model the disease prevalence, sensitivities and specificities using trivariate nonlinear random-effects models. Furthermore, as an alternative parameterization, we also propose jointly modeling the test prevalence and the predictive values, which reflect the clinical utility of a diagnostic test. These models allow investigators to study the complex relationship among the disease prevalence, sensitivities and specificities; or among test prevalence and the predictive values, which can reveal hidden information about test performance. We illustrate the proposed two approaches by reanalyzing the data from a meta-analysis of radiological evaluation of lymph node metastases in patients with cervical cancer and a simulation study. The latter illustrates the importance of carefully choosing an appropriate normality assumption for the disease prevalence, sensitivities and specificities, or the test prevalence and the predictive values. In practice, it is recommended to use model selection techniques to identify a best-fitting model for making statistical inference. In summary, the proposed trivariate random effects models are novel and can be very useful in practice for meta-analysis of diagnostic accuracy studies. Copyright 2009 John Wiley & Sons, Ltd.

A macro-ergonomic work system analysis of the diagnostic testing process in an outpatient health care facility for process improvement and patient safety.

PubMed

Hallock, M L; Alper, S J; Karsh, B

The diagnosis of illness is important for quality patient care and patient safety and is greatly aided by diagnostic testing. For diagnostic tests, such as pathology and radiology, to positively impact patient care, the tests must be processed and the physician and patient must be notified of the results in a timely fashion. There are many steps in the diagnostic testing process, from ordering to result dissemination, where the process can break down and therefore delay patient care and reduce patient safety. This study was carried out to examine the diagnostic testing process (i.e. from ordering to result notification) and used a macro-ergonomic work system analysis to uncover system design flaws that contributed to delayed physician and patient notification of results. The study was carried out in a large urban outpatient health-care facility made up of 30 outpatient clinics. Results indicated a number of variances that contributed to delays, the majority of which occurred across the boundaries of different systems and were related to poor or absent feedback structures. Recommendations for improvements are discussed.

Uncertainty during breast diagnostic evaluation: state of the science.

PubMed

Montgomery, Mariann

2010-01-01

To present the state of the science on uncertainty in relationship to the experiences of women undergoing diagnostic evaluation for suspected breast cancer. Published articles from Medline, CINAHL, PubMED, and PsycINFO from 1983-2008 using the following key words: breast biopsy, mammography, uncertainty, reframing, inner strength, and disruption. Fifty research studies were examined with all reporting the presence of anxiety persisting throughout the diagnostic evaluation until certitude is achieved through the establishment of a definitive diagnosis. Indirect determinants of uncertainty for women undergoing breast diagnostic evaluation include measures of anxiety, depression, social support, emotional responses, defense mechanisms, and the psychological impact of events. Understanding and influencing the uncertainty experience have been suggested to be key in relieving psychosocial distress and positively influencing future screening behaviors. Several studies examine correlational relationships among anxiety, selection of coping methods, and demographic factors that influence uncertainty. A gap exists in the literature with regard to the relationship of inner strength and uncertainty. Nurses can be invaluable in assisting women in coping with the uncertainty experience by providing positive communication and support. Nursing interventions should be designed and tested for their effects on uncertainty experienced by women undergoing a breast diagnostic evaluation.

Indoor Air Quality in 24 California Residences Designed as High-Performance Homes

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

Less, Brennan; Mullen, Nasim; Singer, Brett

2015-07-01

Today’s high performance green homes are reaching previously unheard of levels of airtightness and are using new materials, technologies and strategies, whose impacts on Indoor Air Quality (IAQ) cannot be fully anticipated from prior studies. This research study used pollutant measurements, home inspections, diagnostic testing and occupant surveys to assess IAQ in 24 new or deeply retrofitted homes designed to be high performance green buildings in California.

Picosecond x-ray diagnostics for third and fourth generation synchrotron sources

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

DeCamp, Matthew

2016-03-30

In the DOE-EPSCoR State/National Laboratory partnership grant ``Picosecond x-ray diagnostics for third and fourth generation synchrotron sources'' Dr. DeCamp set forth a partnership between the University of Delaware and Argonne National Laboratory. This proposal aimed to design and implement a series of experiments utilizing, or improving upon, existing time-domain hard x-ray spectroscopies at a third generation synchrotron source. Specifically, the PI put forth three experimental projects to be explored in the grant cycle: 1) implementing a picosecond ``x-ray Bragg switch'' using a laser excited nano-structured metallic film, 2) designing a robust x-ray optical delay stage for x-ray pump-probe studies atmore » a hard x-ray synchrotron source, and 3) building/installing a laser based x-ray source at the Advanced Photon Source for two-color x-ray pump-probe studies.« less

Being smart or getting smarter: Implicit theory of intelligence moderates stereotype threat and stereotype lift effects.

PubMed

Froehlich, Laura; Martiny, Sarah E; Deaux, Kay; Goetz, Thomas; Mok, Sog Yee

2016-09-01

This research explores implicit theory of intelligence (TOI) as a moderator of stereotype activation effects on test performance for members of negatively stereotyped and of favourably stereotyped groups. In Germany, Turkish-origin migrants are stereotyped as low in verbal ability. We predicted that on a test diagnostic of verbal intelligence, endorsement of an entity TOI predicts stereotype threat effects for Turkish-origin students and stereotype lift effects for German students. This effect could account for some of the performance gap between immigrants and host society members after stereotype activation. Study 1 (N = 107) established structural equivalence of implicit theories across the ethnic groups. In two experimental studies (Study 2: N = 182, Study 3: N = 190), we tested the moderating effect of TOI in a 2 (stereotype activation: diagnostic vs. non-diagnostic test) × 2 (ethnicity: German vs. Turkish migration background) experimental design. The results showed that when the test was described as diagnostic of verbal intelligence, higher entity theory endorsement predicted stereotype threat effects for Turkish-origin students (Study 2 and Study 3) and stereotype lift effects for German students (Study 3). The results are discussed in terms of practical implications for educational settings and theoretical implications for processes underlying stereotype activation effects. © 2016 The British Psychological Society.

Designing Probes for Immunodiagnostics: Structural Insights into an Epitope Targeting Burkholderia Infections.

PubMed

Capelli, Riccardo; Matterazzo, Elena; Amabili, Marco; Peri, Claudio; Gori, Alessandro; Gagni, Paola; Chiari, Marcella; Lertmemongkolchai, Ganjana; Cretich, Marina; Bolognesi, Martino; Colombo, Giorgio; Gourlay, Louise J

2017-10-13

Structure-based epitope prediction drives the design of diagnostic peptidic probes to reveal specific antibodies elicited in response to infections. We previously identified a highly immunoreactive epitope from the peptidoglycan-associated lipoprotein (Pal) antigen from Burkholderia pseudomallei, which could also diagnose Burkholderia cepacia infections. Here, considering the high phylogenetic conservation within Burkholderia species, we ask whether cross-reactivity can be reciprocally displayed by the synthetic epitope from B. cenocepacia. We perform comparative analyses of the conformational preferences and diagnostic performances of the corresponding epitopes from the two Burkholderia species when presented in the context of the full-length proteins or as isolated peptides. The effects of conformation on the diagnostic potential and cross-reactivity of Pal peptide epitopes are rationalized on the basis of the 1.8 Å crystal structure of B. cenocepacia Pal and through computational analyses. Our results are discussed in the context of designing new diagnostic molecules for the early detection of infectious diseases.

A computer-aided ECG diagnostic tool.

PubMed

Oweis, Rami; Hijazi, Lily

2006-03-01

Jordan lacks companies that provide local medical facilities with products that are of help in daily performed medical procedures. Because of this, the country imports most of these expensive products. Consequently, a local interest in producing such products has emerged and resulted in serious research efforts in this area. The main goal of this paper is to provide local (the north of Jordan) clinics with a computer-aided electrocardiogram (ECG) diagnostic tool in an attempt to reduce time and work demands for busy physicians especially in areas where only one general medicine doctor is employed and a bulk of cases are to be diagnosed. The tool was designed to help in detecting heart defects such as arrhythmias and heart blocks using ECG signal analysis depending on the time-domain representation, the frequency-domain spectrum, and the relationship between them. The application studied here represents a state of the art ECG diagnostic tool that was designed, implemented, and tested in Jordan to serve wide spectrum of population who are from poor families. The results of applying the tool on randomly selected representative sample showed about 99% matching with those results obtained at specialized medical facilities. Costs, ease of interface, and accuracy indicated the usefulness of the tool and its use as an assisting diagnostic tool.

Coronary artery calcification (CAC) classification with deep convolutional neural networks

NASA Astrophysics Data System (ADS)

Liu, Xiuming; Wang, Shice; Deng, Yufeng; Chen, Kuan

2017-03-01

Coronary artery calcification (CAC) is a typical marker of the coronary artery disease, which is one of the biggest causes of mortality in the U.S. This study evaluates the feasibility of using a deep convolutional neural network (DCNN) to automatically detect CAC in X-ray images. 1768 posteroanterior (PA) view chest X-Ray images from Sichuan Province Peoples Hospital, China were collected retrospectively. Each image is associated with a corresponding diagnostic report written by a trained radiologist (907 normal, 861 diagnosed with CAC). Onequarter of the images were randomly selected as test samples; the rest were used as training samples. DCNN models consisting of 2,4,6 and 8 convolutional layers were designed using blocks of pre-designed CNN layers. Each block was implemented in Theano with Graphics Processing Units (GPU). Human-in-the-loop learning was also performed on a subset of 165 images with framed arteries by trained physicians. The results from the DCNN models were compared to the diagnostic reports. The average diagnostic accuracies for models with 2,4,6,8 layers were 0.85, 0.87, 0.88, and 0.89 respectively. The areas under the curve (AUC) were 0.92, 0.95, 0.95, and 0.96. As the model grows deeper, the AUC or diagnostic accuracies did not have statistically significant changes. The results of this study indicate that DCNN models have promising potential in the field of intelligent medical image diagnosis practice.

Filterscope diagnostic system on the Experimental Advanced Superconducting Tokamak (EAST)

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

Xu, Z.; Wu, C. R.; Yao, X. J.

2016-11-15

A filterscope diagnostic system has been mounted to observe the line emission and visible bremsstrahlung emission from plasma on the experimental advanced superconducting tokamak during the 2014 campaign. By this diagnostic system, multiple wavelengths including D{sub α} (656.1 nm), D{sub γ} (433.9 nm), He II (468.5 nm), Li I (670.8 nm), Li II (548.3 nm), C III (465.0 nm), O II (441.5 nm), Mo I (386.4 nm), W I (400.9 nm), and visible bremsstrahlung radiation (538.0 nm) are monitored with corresponding wavelength filters. All these multi-channel signals are digitized at up to 200 kHz simultaneously. This diagnostic plays a crucialmore » role in studying edge localized modes and H-mode plasmas, due to the high temporal resolution and spatial resolution that have been designed into it.« less

Broadband Liner Optimization for the Source Diagnostic Test Fan

NASA Technical Reports Server (NTRS)

Nark, Douglas M.; Jones, Michael G.

2012-01-01

The broadband component of fan noise has grown in relevance with the utilization of increased bypass ratio and advanced fan designs. Thus, while the attenuation of fan tones remains paramount, the ability to simultaneously reduce broadband fan noise levels has become more appealing. This paper describes a broadband acoustic liner optimization study for the scale model Source Diagnostic Test fan. Specifically, in-duct attenuation predictions with a statistical fan source model are used to obtain optimum impedance spectra over a number of flow conditions for three liner locations in the bypass duct. The predicted optimum impedance information is then used with acoustic liner modeling tools to design liners aimed at producing impedance spectra that most closely match the predicted optimum values. Design selection is based on an acceptance criterion that provides the ability to apply increased weighting to specific frequencies and/or operating conditions. Typical tonal liner designs targeting single frequencies at one operating condition are first produced to provide baseline performance information. These are followed by multiple broadband design approaches culminating in a broadband liner targeting the full range of frequencies and operating conditions. The broadband liner is found to satisfy the optimum impedance objectives much better than the tonal liner designs. In addition, the broadband liner is found to provide better attenuation than the tonal designs over the full range of frequencies and operating conditions considered. Thus, the current study successfully establishes a process for the initial design and evaluation of novel broadband liner concepts for complex engine configurations.

Designing high speed diagnostics

NASA Astrophysics Data System (ADS)

Veliz Carrillo, Gerardo; Martinez, Adam; Mula, Swathi; Prestridge, Kathy; Extreme Fluids Team Team

2017-11-01

Timing and firing for shock-driven flows is complex because of jitter in the shock tube mechanical drivers. Consequently, experiments require dynamic triggering of diagnostics from pressure transducers. We explain the design process and criteria for setting up re-shock experiments at the Los Alamos Vertical Shock Tube facility, and the requirements for particle image velocimetry and planar laser induced fluorescence measurements necessary for calculating Richtmeyer-Meshkov variable density turbulent statistics. Dynamic triggering of diagnostics allows for further investigation of the development of the Richtemeyer-Meshkov instability at both initial shock and re-shock. Thanks to the Los Alamos National Laboratory for funding our project.

A hybrid Bayesian hierarchical model combining cohort and case-control studies for meta-analysis of diagnostic tests: Accounting for partial verification bias.

PubMed

Ma, Xiaoye; Chen, Yong; Cole, Stephen R; Chu, Haitao

2016-12-01

To account for between-study heterogeneity in meta-analysis of diagnostic accuracy studies, bivariate random effects models have been recommended to jointly model the sensitivities and specificities. As study design and population vary, the definition of disease status or severity could differ across studies. Consequently, sensitivity and specificity may be correlated with disease prevalence. To account for this dependence, a trivariate random effects model had been proposed. However, the proposed approach can only include cohort studies with information estimating study-specific disease prevalence. In addition, some diagnostic accuracy studies only select a subset of samples to be verified by the reference test. It is known that ignoring unverified subjects may lead to partial verification bias in the estimation of prevalence, sensitivities, and specificities in a single study. However, the impact of this bias on a meta-analysis has not been investigated. In this paper, we propose a novel hybrid Bayesian hierarchical model combining cohort and case-control studies and correcting partial verification bias at the same time. We investigate the performance of the proposed methods through a set of simulation studies. Two case studies on assessing the diagnostic accuracy of gadolinium-enhanced magnetic resonance imaging in detecting lymph node metastases and of adrenal fluorine-18 fluorodeoxyglucose positron emission tomography in characterizing adrenal masses are presented. © The Author(s) 2014.

A Hybrid Bayesian Hierarchical Model Combining Cohort and Case-control Studies for Meta-analysis of Diagnostic Tests: Accounting for Partial Verification Bias

PubMed Central

Ma, Xiaoye; Chen, Yong; Cole, Stephen R.; Chu, Haitao

2014-01-01

To account for between-study heterogeneity in meta-analysis of diagnostic accuracy studies, bivariate random effects models have been recommended to jointly model the sensitivities and specificities. As study design and population vary, the definition of disease status or severity could differ across studies. Consequently, sensitivity and specificity may be correlated with disease prevalence. To account for this dependence, a trivariate random effects model had been proposed. However, the proposed approach can only include cohort studies with information estimating study-specific disease prevalence. In addition, some diagnostic accuracy studies only select a subset of samples to be verified by the reference test. It is known that ignoring unverified subjects may lead to partial verification bias in the estimation of prevalence, sensitivities and specificities in a single study. However, the impact of this bias on a meta-analysis has not been investigated. In this paper, we propose a novel hybrid Bayesian hierarchical model combining cohort and case-control studies and correcting partial verification bias at the same time. We investigate the performance of the proposed methods through a set of simulation studies. Two case studies on assessing the diagnostic accuracy of gadolinium-enhanced magnetic resonance imaging in detecting lymph node metastases and of adrenal fluorine-18 fluorodeoxyglucose positron emission tomography in characterizing adrenal masses are presented. PMID:24862512

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)

A fuzzy logic intelligent diagnostic system for spacecraft integrated vehicle health management

NASA Technical Reports Server (NTRS)

Wu, G. Gordon

1995-01-01

Due to the complexity of future space missions and the large amount of data involved, greater autonomy in data processing is demanded for mission operations, training, and vehicle health management. In this paper, we develop a fuzzy logic intelligent diagnostic system to perform data reduction, data analysis, and fault diagnosis for spacecraft vehicle health management applications. The diagnostic system contains a data filter and an inference engine. The data filter is designed to intelligently select only the necessary data for analysis, while the inference engine is designed for failure detection, warning, and decision on corrective actions using fuzzy logic synthesis. Due to its adaptive nature and on-line learning ability, the diagnostic system is capable of dealing with environmental noise, uncertainties, conflict information, and sensor faults.

Diagnostic Accuracy of Molecular Amplification Tests for Human African Trypanosomiasis—Systematic Review

PubMed Central

Boer, Kimberly R.; Dyserinck, Heleen C.; Büscher, Philippe; Schallig, Henk D. H. F.; Leeflang, Mariska M. G.

2012-01-01

Background A range of molecular amplification techniques have been developed for the diagnosis of Human African Trypanosomiasis (HAT); however, careful evaluation of these tests must precede implementation to ensure their high clinical accuracy. Here, we investigated the diagnostic accuracy of molecular amplification tests for HAT, the quality of articles and reasons for variation in accuracy. Methodology Data from studies assessing diagnostic molecular amplification tests were extracted and pooled to calculate accuracy. Articles were included if they reported sensitivity and specificity or data whereby values could be calculated. Study quality was assessed using QUADAS and selected studies were analysed using the bivariate random effects model. Results 16 articles evaluating molecular amplification tests fulfilled the inclusion criteria: PCR (n = 12), NASBA (n = 2), LAMP (n = 1) and a study comparing PCR and NASBA (n = 1). Fourteen articles, including 19 different studies were included in the meta-analysis. Summary sensitivity for PCR on blood was 99.0% (95% CI 92.8 to 99.9) and the specificity was 97.7% (95% CI 93.0 to 99.3). Differences in study design and readout method did not significantly change estimates although use of satellite DNA as a target significantly lowers specificity. Sensitivity and specificity of PCR on CSF for staging varied from 87.6% to 100%, and 55.6% to 82.9% respectively. Conclusion Here, PCR seems to have sufficient accuracy to replace microscopy where facilities allow, although this conclusion is based on multiple reference standards and a patient population that was not always representative. Future studies should, therefore, include patients for which PCR may become the test of choice and consider well designed diagnostic accuracy studies to provide extra evidence on the value of PCR in practice. Another use of PCR for control of disease could be to screen samples collected from rural areas and test in reference laboratories, to spot epidemics quickly and direct resources appropriately. PMID:22253934

Diagnostic accuracy of molecular amplification tests for human African trypanosomiasis--systematic review.

PubMed

Mugasa, Claire M; Adams, Emily R; Boer, Kimberly R; Dyserinck, Heleen C; Büscher, Philippe; Schallig, Henk D H F; Leeflang, Mariska M G

2012-01-01

A range of molecular amplification techniques have been developed for the diagnosis of Human African Trypanosomiasis (HAT); however, careful evaluation of these tests must precede implementation to ensure their high clinical accuracy. Here, we investigated the diagnostic accuracy of molecular amplification tests for HAT, the quality of articles and reasons for variation in accuracy. Data from studies assessing diagnostic molecular amplification tests were extracted and pooled to calculate accuracy. Articles were included if they reported sensitivity and specificity or data whereby values could be calculated. Study quality was assessed using QUADAS and selected studies were analysed using the bivariate random effects model. 16 articles evaluating molecular amplification tests fulfilled the inclusion criteria: PCR (n = 12), NASBA (n = 2), LAMP (n = 1) and a study comparing PCR and NASBA (n = 1). Fourteen articles, including 19 different studies were included in the meta-analysis. Summary sensitivity for PCR on blood was 99.0% (95% CI 92.8 to 99.9) and the specificity was 97.7% (95% CI 93.0 to 99.3). Differences in study design and readout method did not significantly change estimates although use of satellite DNA as a target significantly lowers specificity. Sensitivity and specificity of PCR on CSF for staging varied from 87.6% to 100%, and 55.6% to 82.9% respectively. Here, PCR seems to have sufficient accuracy to replace microscopy where facilities allow, although this conclusion is based on multiple reference standards and a patient population that was not always representative. Future studies should, therefore, include patients for which PCR may become the test of choice and consider well designed diagnostic accuracy studies to provide extra evidence on the value of PCR in practice. Another use of PCR for control of disease could be to screen samples collected from rural areas and test in reference laboratories, to spot epidemics quickly and direct resources appropriately.

Clinical outcomes and cost effectiveness of accelerated diagnostic protocol in a chest pain center compared with routine care of patients with chest pain.

PubMed

Asher, Elad; Reuveni, Haim; Shlomo, Nir; Gerber, Yariv; Beigel, Roy; Narodetski, Michael; Eldar, Michael; Or, Jacob; Hod, Hanoch; Shamiss, Arie; Matetzky, Shlomi

2015-01-01

The aim of this study was to compare in patients presenting with acute chest pain the clinical outcomes and cost-effectiveness of an accelerated diagnostic protocol utilizing contemporary technology in a chest pain unit versus routine care in an internal medicine department. Hospital and 90-day course were prospectively studied in 585 consecutive low-moderate risk acute chest pain patients, of whom 304 were investigated in a designated chest pain center using a pre-specified accelerated diagnostic protocol, while 281 underwent routine care in an internal medicine ward. Hospitalization was longer in the routine care compared with the accelerated diagnostic protocol group (p<0.001). During hospitalization, 298 accelerated diagnostic protocol patients (98%) vs. 57 (20%) routine care patients underwent non-invasive testing, (p<0.001). Throughout the 90-day follow-up, diagnostic imaging testing was performed in 125 (44%) and 26 (9%) patients in the routine care and accelerated diagnostic protocol patients, respectively (p<0.001). Ultimately, most patients in both groups had non-invasive imaging testing. Accelerated diagnostic protocol patients compared with those receiving routine care was associated with a lower incidence of readmissions for chest pain [8 (3%) vs. 24 (9%), p<0.01], and acute coronary syndromes [1 (0.3%) vs. 9 (3.2%), p<0.01], during the follow-up period. The accelerated diagnostic protocol remained a predictor of lower acute coronary syndromes and readmissions after propensity score analysis [OR = 0.28 (CI 95% 0.14-0.59)]. Cost per patient was similar in both groups [($2510 vs. $2703 for the accelerated diagnostic protocol and routine care group, respectively, (p = 0.9)]. An accelerated diagnostic protocol is clinically superior and as cost effective as routine in acute chest pain patients, and may save time and resources.

Clinical Outcomes and Cost Effectiveness of Accelerated Diagnostic Protocol in a Chest Pain Center Compared with Routine Care of Patients with Chest Pain

PubMed Central

Asher, Elad; Reuveni, Haim; Shlomo, Nir; Gerber, Yariv; Beigel, Roy; Narodetski, Michael; Eldar, Michael; Or, Jacob; Hod, Hanoch; Shamiss, Arie; Matetzky, Shlomi

2015-01-01

Aims The aim of this study was to compare in patients presenting with acute chest pain the clinical outcomes and cost-effectiveness of an accelerated diagnostic protocol utilizing contemporary technology in a chest pain unit versus routine care in an internal medicine department. Methods and Results Hospital and 90-day course were prospectively studied in 585 consecutive low-moderate risk acute chest pain patients, of whom 304 were investigated in a designated chest pain center using a pre-specified accelerated diagnostic protocol, while 281 underwent routine care in an internal medicine ward. Hospitalization was longer in the routine care compared with the accelerated diagnostic protocol group (p<0.001). During hospitalization, 298 accelerated diagnostic protocol patients (98%) vs. 57 (20%) routine care patients underwent non-invasive testing, (p<0.001). Throughout the 90-day follow-up, diagnostic imaging testing was performed in 125 (44%) and 26 (9%) patients in the routine care and accelerated diagnostic protocol patients, respectively (p<0.001). Ultimately, most patients in both groups had non-invasive imaging testing. Accelerated diagnostic protocol patients compared with those receiving routine care was associated with a lower incidence of readmissions for chest pain [8 (3%) vs. 24 (9%), p<0.01], and acute coronary syndromes [1 (0.3%) vs. 9 (3.2%), p<0.01], during the follow-up period. The accelerated diagnostic protocol remained a predictor of lower acute coronary syndromes and readmissions after propensity score analysis [OR = 0.28 (CI 95% 0.14–0.59)]. Cost per patient was similar in both groups [($2510 vs. $2703 for the accelerated diagnostic protocol and routine care group, respectively, (p = 0.9)]. Conclusion An accelerated diagnostic protocol is clinically superior and as cost effective as routine in acute chest pain patients, and may save time and resources. PMID:25622029

Declic: design, integration and testing of a multi configurable instrument using optical diagnostics to study directional solidification and critical fluids

NASA Astrophysics Data System (ADS)

Durieux, A.; Martin, B.; Laubier, D.

2017-11-01

DECLIC, a Facility dedicated to the study of transparent media under microgravity, will be used in an ISS EXPRESS Rack. This paper focuses on the EXL which contains two optical boxes disposed on two opposite sides of the cavity where the Inserts to be studied shall be locked. At the moment, three types of inserts are planned to be accommodated in the EXL. Various optical diagnostics are available by configuring the EXL (sources, sensors, mechanisms). After the presentation of the EXL design, this article deals with some manufacturing and testing aspects, such as the use of COTS (cameras). Specific OGSE have been developed in order to simulate the optical interfaces and the propagation of beams in the inserts. Three models of the EXL have been integrated and fully tested, including the Flight Model. The sequence of tests, the performances measured, and then some images of the experiments performed with the inserts will be presented.

Diagnostic accuracy of clinical tests of the hip: a systematic review with meta-analysis.

PubMed

Reiman, Michael P; Goode, Adam P; Hegedus, Eric J; Cook, Chad E; Wright, Alexis A

2013-09-01

Hip Physical Examination (HPE) tests have long been used to diagnose a myriad of intra-and extra-articular pathologies of the hip joint. Useful clinical utility is necessary to support diagnostic imaging and subsequent surgical decision making. Summarise and evaluate the current research and utility on the diagnostic accuracy of HPE tests for the hip joint germane to sports related injuries and pathology. A computer-assisted literature search of MEDLINE, CINHAL and EMBASE databases (January 1966 to January 2012) using keywords related to diagnostic accuracy of the hip joint. This systematic review with meta-analysis utilised the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for the search and reporting phases of the study. Der-Simonian and Laird random effects models were used to summarise sensitivities (SN), specificities (SP), likelihood ratios and diagnostic OR. The employed search strategy revealed 25 potential articles, with 10 demonstrating high quality. Fourteen articles qualified for meta-analysis. The meta-analysis demonstrated that most tests possess weak diagnostic properties with the exception of the patellar-pubic percussion test, which had excellent pooled SN 95 (95% CI 92 to 97%) and good specificity 86 (95% CI 78 to 92%). Several studies have investigated pathology in the hip. Few of the current studies are of substantial quality to dictate clinical decision-making. Currently, only the patellar-pubic percussion test is supported by the data as a stand-alone HPE test. Further studies involving high quality designs are needed to fully assess the value of HPE tests for patients with intra- and extra-articular hip dysfunction.

Application of digital diagnostic impression, virtual planning, and computer-guided implant surgery for a CAD/CAM-fabricated, implant-supported fixed dental prosthesis: a clinical report.

PubMed

Stapleton, Brandon M; Lin, Wei-Shao; Ntounis, Athanasios; Harris, Bryan T; Morton, Dean

2014-09-01

This clinical report demonstrated the use of an implant-supported fixed dental prosthesis fabricated with a contemporary digital approach. The digital diagnostic data acquisition was completed with a digital diagnostic impression with an intraoral scanner and cone-beam computed tomography with a prefabricated universal radiographic template to design a virtual prosthetically driven implant surgical plan. A surgical template fabricated with computer-aided design and computer-aided manufacturing (CAD/CAM) was used to perform computer-guided implant surgery. The definitive digital data were then used to design the definitive CAD/CAM-fabricated fixed dental prosthesis. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Repeated significance tests of linear combinations of sensitivity and specificity of a diagnostic biomarker

PubMed Central

Wu, Mixia; Shu, Yu; Li, Zhaohai; Liu, Aiyi

2016-01-01

A sequential design is proposed to test whether the accuracy of a binary diagnostic biomarker meets the minimal level of acceptance. The accuracy of a binary diagnostic biomarker is a linear combination of the marker’s sensitivity and specificity. The objective of the sequential method is to minimize the maximum expected sample size under the null hypothesis that the marker’s accuracy is below the minimal level of acceptance. The exact results of two-stage designs based on Youden’s index and efficiency indicate that the maximum expected sample sizes are smaller than the sample sizes of the fixed designs. Exact methods are also developed for estimation, confidence interval and p-value concerning the proposed accuracy index upon termination of the sequential testing. PMID:26947768

Dermatologic Practice: Implications for a Primary Care Residency Curriculum.

ERIC Educational Resources Information Center

Branch, William T., Jr.; And Others

1983-01-01

The problems encountered, diagnostic procedures performed, and treatments prescribed in dermatology were studied in a primary care practice and in a dermatology clinic. It is proposed that the findings of this study be the basis for designing a curriculum in dermatology for residents in primary care medicine. (Author/MLW)

Diagnostic Lumbar Puncture

PubMed Central

Doherty, Carolynne M; Forbes, Raeburn B

2014-01-01

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

Additive Manufacture of Plasma Diagnostic Components Final Report Phase II

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

Woodruff, Simon; Romero-Talamas, Carlos; You, Setthivoine

There is now a well-established set of plasma diagnostics (see e.g. [3]), but these remain some of the mostexpensive assemblies in fusion systems since for every system they have to be custom built, and time fordiagnostic development can pace the project. Additive manufacturing (AM) has the potential to decreaseproduction cost and significantly lower design time of fusion diagnostic subsystems, which would realizesignificant cost reduction for standard diagnostics. In some cases, these basic components can be additivelymanufactured for less than 1/100th costs of conventional manufacturing.In our DOE Phase II SBIR, we examined the impact that AM can have on plasma diagnosticmore » cost bytaking 15 separate diagnostics through an engineering design using Conventional Manufacturing (CM) tech-niques, then optimizing the design to exploit the benefits of AM. The impact of AM techniques on cost isfound to be in several areas. First, the cost of materials falls because AM parts can be manufactured withlittle to no waste, and engineered to use less material than CM. Next, the cost of fabrication falls for AMparts relative to CM since the fabrication time can be computed exactly, and often no post-processing isrequired for the part to be functional. We find that AM techniques are well suited for plasma diagnosticssince typical diagnostic complexity comes at no additional cost. Cooling channels, for example, can be builtin to plasma-facing components at no extra cost. Fabrication costs associated with assembly are lower forAM parts because many components can be combined and printed as monoliths, thereby mitigating the needfor alignment or calibration. Finally, the cost of engineering is impacted by exploiting AM design tools thatallow standard components to be customized through web-interfaces. Furthermore, we find that conceptdesign costs can be impacted by scripting interfaces for online engineering design tools.« less

Usual interstitial pneumonia: typical, possible, and “inconsistent” patterns

PubMed Central

Torres, Pedro Paulo Teixeira e Silva; Rabahi, Marcelo Fouad; Moreira, Maria Auxiliadora Carmo; Meirelles, Gustavo de Souza Portes; Marchiori, Edson

2017-01-01

ABSTRACT Idiopathic pulmonary fibrosis is a severe and progressive chronic fibrosing interstitial lung disease, a definitive diagnosis being established by specific combinations of clinical, radiological, and pathological findings. According to current international guidelines, HRCT plays a key role in establishing a diagnosis of usual interstitial pneumonia (UIP). Current guidelines describe three UIP patterns based on HRCT findings: a typical UIP pattern; a pattern designated “possible UIP”; and a pattern designated “inconsistent with UIP”, each pattern having important diagnostic implications. A typical UIP pattern on HRCT is highly accurate for the presence of histopathological UIP, being currently considered to be diagnostic of UIP. The remaining patterns require further diagnostic investigation. Other known causes of a UIP pattern include drug-induced interstitial lung disease, chronic hypersensitivity pneumonitis, occupational diseases (e.g., asbestosis), and connective tissue diseases, all of which should be included in the clinical differential diagnosis. Given the importance of CT studies in establishing a diagnosis and the possibility of interobserver variability, the objective of this pictorial essay was to illustrate all three UIP patterns on HRCT. PMID:29160385

Diagnosis of Acceleration, Reconnection, Turbulence, and Heating

NASA Astrophysics Data System (ADS)

Dufor, Mikal T.; Jemiolo, Andrew J.; Keesee, Amy; Cassak, Paul; Tu, Weichao; Scime, Earl E.

2017-10-01

The DARTH (Diagnosis of Acceleration, Reconnection, Turbulence, and Heating) experiment is an intermediate-scale, experimental facility designed to study magnetic reconnection at and below the kinetic scale of ions and electrons. The experiment will have non-perturbative diagnostics with high temporal and three-dimensional spatial resolution, giving it the capability to investigate kinetic-scale physics. Of specific scientific interest are particle acceleration, plasma heating, turbulence and energy dissipation during reconnection. Here we will describe the magnetic field system and the two plasma guns used to create flux ropes that then merge through magnetic reconnection. We will also describe the key diagnostic systems: laser induced fluorescence (LIF) for ion vdf measurements, a 300 GHz microwave scattering system for sub-mm wavelength fluctuation measurements and a Thomson scattering laser for electron vdf measurements. The vacuum chamber is designed to provide unparalleled access for these particle diagnostics. The scientific goals of DARTH are to examine particle acceleration and heating during, the role of three-dimensional instabilities during reconnection, how reconnection ceases, and the role of impurities and asymmetries in reconnection. This work was supported by the by the O'Brien Energy Research Fund.

Design issues in a randomized controlled trial of a pre-emptive versus empiric antifungal strategy for invasive aspergillosis in patients with high-risk hematologic malignancies.

PubMed

Morrissey, C Orla; Chen, Sharon C-A; Sorrell, Tania C; Bradstock, Kenneth F; Szer, Jeffrey; Halliday, Catriona L; Gilroy, Nicole M; Schwarer, Anthony P; Slavin, Monica A

2011-02-01

Invasive aspergillosis (IA) is a major cause of mortality in patients with hematological malignancies, due largely to the inability of traditional culture and biopsy methods to make an early or accurate diagnosis. Diagnostic accuracy studies suggest that Aspergillus galactomannan (GM) enzyme immunoassay (ELISA) and Aspergillus PCR-based methods may overcome these limitations, but their impact on patient outcomes should be evaluated in a diagnostic randomized controlled trial (D-RCT). This article describes the methodology of a D-RCT which compares a new pre-emptive strategy (GM-ELISA- and Aspergillus PCR-driven antifungal therapy) with the standard fever-driven empiric antifungal treatment strategy. Issues including primary end-point and patient selection, duration of screening, choice of tests for the pre-emptive strategy, antifungal prophylaxis and bias control, which were considered in the design of the trial, are discussed. We suggest that the template presented herein is considered by researchers when evaluating the utility of new diagnostic tests (ClinicalTrials.gov number, NCT00163722).

[Concordance among invasive diagnostic procedures for Helicobacter pylori infection in adults].

PubMed

Sánchez-Cuén, Jaime Alberto; Canizalez-Román, Vicente Adrián; León-Sicairos, Nidia Maribel; Irineo-Cabrales, Ana Bertha; Bernal-Magaña, Gregorio

2015-01-01

Compare the strength of concordance between culture, histology, rapid urease test for diagnosis of Helicobacter pylori infection and histopathological findings relationship and frequency of positivity among such diagnostic procedures. Diagnostic test study. The study population were subjects with endoscopy and take samples of gastric antral. Rapid urease test (one sample), histology (two samples) and culture (two samples), and histopathological findings of gastric mucosa were performed. Statistical design with Student's t, Fisher exact test, Kappa coefficient. We reviewed 108 subjects, 28 (25.9%) men, 80 (74.1%) women, mean age was 49.1 years (SD 15.1). The Kappa coefficient was 0.729 and 0.377 between culture with histology and rapid urease test, respectively; likewise the Kappa coefficient was 0.565 between histology and rapid urease test. The strength of concordance was higher between histology with culture and rapid urease test; the most recommended being histology in clinical practice for the detection of Helicobacter pylori infection.

Complete diagnostics of pyroactive structures for smart systems of optoelectronics

NASA Astrophysics Data System (ADS)

Bravina, Svetlana L.; Morozovsky, Nicholas V.

1998-04-01

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

The Difficulty of Selecting the NANDA-I Nursing Diagnosis (2015-2017) of "Death Anxiety" in Japan.

PubMed

Shimomai, Kimiyo; Furukawa, Hidetoshi; Kuroda, Yuko; Fukuda, Kazuaki; Masuda, Mitsumi; Koizumi, Junko

2018-01-01

The purpose of our study was to clarify any difficulties or problems that exist in Japanese healthcare sites regarding the selection of death anxiety as a nursing diagnosis. This study was a qualitative, inductive research design. The semistructured interviews were conducted on the participants who were nurses and had 3 or more years of clinical experience in Japan. Results showed four categories: "The Japanese have a culture of avoiding death," "It is extremely difficult to match diagnostic indicators and related factors with specific patient cases," "Other diagnoses exist that are effective and enable proactive intervention," and "The definition of death anxiety and the meaning of its diagnostic indicators are unintelligible." It is thought that nursing diagnoses that reflect specific cultural backgrounds require definitions appropriate to each country and appropriate revisions to diagnostic indicators. © 2016 NANDA International, Inc.

Development and validation of risk models and molecular diagnostics to permit personalized management of cancer.

PubMed

Pu, Xia; Ye, Yuanqing; Wu, Xifeng

2014-01-01

Despite the advances made in cancer management over the past few decades, improvements in cancer diagnosis and prognosis are still poor, highlighting the need for individualized strategies. Toward this goal, risk prediction models and molecular diagnostic tools have been developed, tailoring each step of risk assessment from diagnosis to treatment and clinical outcomes based on the individual's clinical, epidemiological, and molecular profiles. These approaches hold increasing promise for delivering a new paradigm to maximize the efficiency of cancer surveillance and efficacy of treatment. However, they require stringent study design, methodology development, comprehensive assessment of biomarkers and risk factors, and extensive validation to ensure their overall usefulness for clinical translation. In the current study, the authors conducted a systematic review using breast cancer as an example and provide general guidelines for risk prediction models and molecular diagnostic tools, including development, assessment, and validation. © 2013 American Cancer Society.

Mid-infrared Laser Absorption Diagnostics for Detonation Studies

NASA Astrophysics Data System (ADS)

Spearrin, R. M.; Goldenstein, C. S.; Jeffries, J. B.; Hanson, R. K.

Detonation-based engines represent a challenging application for diagnostics due to the wide range of thermodynamic conditions involved (T~500-3000 K, P~2-60 atm) and the short time scales of change (~10- 6 to 10- 4 sec) associated with such systems. Non-intrusive laser absorption diagnostics can provide high time-resolution and have been employed extensively in shock tube kinetics experiments (P~1-20 atm), offering high potential for application in detonation environments with modest utilization to date [1-4]. Limiting factors in designing effective tunable laser absorption sensors for detonation engines can be divided into two sets of challenges: high-pressure, high-temperature absorption spectroscopy and harsh thermo-mechanical environments. The present work, conducted in a high-pressure shock tube and operating detonation combustor, addresses both sets of difficulties, with the objective of developing time-resolved, in-situ temperature and concentration sensors for detonation studies.

Diagnostic accuracy of lymphoma established by fine-needle aspiration cytological biopsy

NASA Astrophysics Data System (ADS)

Delyuzar; Amir, Z.; Suryadi, D.

2018-03-01

Based on Globocan data in 2012, it is estimated that about 14,495 Indonesians suffer from lymphoma, both Hodgkin’s lymphoma, and non-Hodgkin’s lymphoma. Some areas of specialization still doubt the accuracy of cytology diagnosis of fine needle aspiration biopsy.This study is a diagnostic test with a cross sectional analytic design to see how the cytology diagnostic accuracy of fine needle aspiration aspirate in lymphoma. It was in Department of Anatomical Pathology Faculty of Medicine USU, Haji Adam Malik Hospital, Dr.Pirngadi hospital, or private clinic in Medan. Peripheral cytology technique biopsy of fine needle aspiration on lymph node subsequently stained with Giemsa, when the cytology of lymphoma is obtained and confirmed by histopathologic examination. Cytology and histopathologic examination will be tested by Diagnostic Test and assessed for its sensitivity and specificity. The diagnostic of lymphoma cytology provides 93.33% sensitivity and 92.31% specificity when confirmed by histopathological examination. Positive predictive value and negative predictive value of 96.55% and 85.71% respectively. In conclusion, the cytology of fine needle aspiration biopsy is accurate enough to be used as a diagnostic tool, so it is advisable to establish a lymphoma diagnosis to perform a needle aspiration biopsy examination.

Implementation of immunochemical faecal occult blood test in general practice: a study protocol using a cluster-randomised stepped-wedge design.

PubMed

Juul, Jakob Søgaard; Bro, Flemming; Hornung, Nete; Andersen, Berit Sanne; Laurberg, Søren; Olesen, Frede; Vedsted, Peter

2016-07-11

Colorectal cancer is a common malignancy and a leading cause of cancer-related death. Half of patients with colorectal cancer initially present with non-specific or vague symptoms. In the need for a safe low-cost test, the immunochemical faecal occult blood test (iFOBT) may be part of the evaluation of such patients in primary care. Currently, Danish general practitioners have limited access to this test. The aim of this article is to describe a study that will assess the uptake and clinical use of iFOBT in general practice. Furthermore, it will investigate the diagnostic value and the clinical implications of using iFOBT in general practice on patients presenting with non-alarm symptoms of colorectal cancer. The study uses a cluster-randomised stepped-wedge design and is conducted in the Central Denmark Region among 836 GPs in 381 general practices. The municipalities of the Region and their appertaining general practitioners will be included sequentially in the study during the first 7 months of the 1-year study period. The following intervention has been developed for the study: a mandatory intervention providing all general practitioners with a starting package of 10 iFOBTs, a clinical instruction on iFOBT use in general practice and online information material from the date of inclusion, and an optional intervention consisting of a continuous medical education on colorectal cancer diagnostics and use of iFOBT. This study is among the first and largest trials to investigate the diagnostic use and the clinical value of iFOBT on patients presenting with non-alarm symptoms of colorectal cancer. The findings will be of national and international importance for the future planning of colorectal cancer diagnostics, particularly for 'low-risk-but-not-no-risk' patients with non-alarm symptoms of colorectal cancer. A Trial of the Implementation of iFOBT in General Practice NCT02308384 . Date of registration: 26 November 2014.

Experimental studies of characteristic combustion-driven flows for CFD validation

NASA Technical Reports Server (NTRS)

Santoro, R. J.; Moser, M.; Anderson, W.; Pal, S.; Ryan, H.; Merkle, C. L.

1992-01-01

A series of rocket-related studies intended to develop a suitable data base for validation of Computational Fluid Dynamics (CFD) models of characteristic combustion-driven flows was undertaken at the Propulsion Engineering Research Center at Penn State. Included are studies of coaxial and impinging jet injectors as well as chamber wall heat transfer effects. The objective of these studies is to provide fundamental understanding and benchmark quality data for phenomena important to rocket combustion under well-characterized conditions. Diagnostic techniques utilized in these studies emphasize determinations of velocity, temperature, spray and droplet characteristics, and combustion zone distribution. Since laser diagnostic approaches are favored, the development of an optically accessible rocket chamber has been a high priority in the initial phase of the project. During the design phase for this chamber, the advice and input of the CFD modeling community were actively sought through presentations and written surveys. Based on this procedure, a suitable uni-element rocket chamber was fabricated and is presently under preliminary testing. Results of these tests, as well as the survey findings leading to the chamber design, were presented.

Basic principles of test-negative design in evaluating influenza vaccine effectiveness.

PubMed

Fukushima, Wakaba; Hirota, Yoshio

2017-08-24

Based on the unique characteristics of influenza, the concept of "monitoring" influenza vaccine effectiveness (VE) across the seasons using the same observational study design has been developed. In recent years, there has been a growing number of influenza VE reports using the test-negative design, which can minimize both misclassification of diseases and confounding by health care-seeking behavior. Although the test-negative designs offer considerable advantages, there are some concerns that widespread use of the test-negative design without knowledge of the basic principles of epidemiology could produce invalid findings. In this article, we briefly review the basic concepts of the test-negative design with respect to classic study design such as cohort studies or case-control studies. We also mention selection bias, which may be of concern in some countries where rapid diagnostic testing is frequently used in routine clinical practices, as in Japan. Copyright © 2017. Published by Elsevier Ltd.

A Diagnostic System for Studying Energy Partitioning and Assessing the Response of the Ionosphere during HAARP Modification Experiments

NASA Technical Reports Server (NTRS)

Djuth, Frank T.; Elder, John H.; Williams, Kenneth L.

1996-01-01

This research program focused on the construction of several key radio wave diagnostics in support of the HF Active Auroral Ionospheric Research Program (HAARP). Project activities led to the design, development, and fabrication of a variety of hardware units and to the development of several menu-driven software packages for data acquisition and analysis. The principal instrumentation includes an HF (28 MHz) radar system, a VHF (50 MHz) radar system, and a high-speed radar processor consisting of three separable processing units. The processor system supports the HF and VHF radars and is capable of acquiring very detailed data with large incoherent scatter radars. In addition, a tunable HF receiver system having high dynamic range was developed primarily for measurements of stimulated electromagnetic emissions (SEE). A separate processor unit was constructed for the SEE receiver. Finally, a large amount of support instrumentation was developed to accommodate complex field experiments. Overall, the HAARP diagnostics are powerful tools for studying diverse ionospheric modification phenomena. They are also flexible enough to support a host of other missions beyond the scope of HAARP. Many new research programs have been initiated by applying the HAARP diagnostics to studies of natural atmospheric processes.

Influence of newly designed monorail pressure sensor catheter on coronary diagnostic parameters: an in vitro study.

PubMed

Banerjee, Rupak K; Peelukhana, Srikara V; Goswami, Ishan

2014-02-07

The decision to perform intervention on a patient with coronary stenosis is often based on functional diagnostic parameters obtained from pressure and flow measurements using sensor-tipped guidewire at maximal vasodilation (hyperemia). Recently, a rapid exchange Monorail Pressure Sensor catheter of 0.022″ diameter (MPS22), with pressure sensor at distal end has been developed for improved assessment of stenosis severity. The hollow shaft of the MPS22 is designed to slide over any standard 0.014″ guidewire (G14). Hence, influence of MPS22 diameter on coronary diagnostic parameters needs investigation. An in vitro experiment was conducted to replicate physiologic flows in three representative area stenosis (AS): mild (64% AS), intermediate (80% AS), and severe (90% AS), for two arterial diameters, 3mm (N2; more common) and 2.5mm (N1). Influence of MPS22 on diagnostic parameters: fractional flow reserve (FFR) and pressure drop coefficient (CDP) was evaluated both at hyperemic and basal conditions, while comparing it with G14. The FFR values decreased for the MPS22 in comparison to G14, (Mild: 0.87 vs 0.88, Intermediate: 0.68 vs 0.73, Severe: 0.48 vs 0.56) and CDP values increased (Mild: 16 vs 14, Intermediate: 75 vs 56, Severe: 370 vs 182) for N2. Similar trend was observed in the case of N1. The FFR values were found to be well above (mild) and below (intermediate and severe) the diagnostic cut-off of 0.75. Therefore, MPS22 catheter can be used as a possible alternative to G14. Further, irrespective of the MPS22 or G14, basal FFR (FFRb) had overlapping ranges in close proximity for clinically relevant mild and intermediate stenoses that will lead to diagnostic uncertainty under both N1 and N2. However, CDPb had distinct ranges for different stenosis severities and could be a potential diagnostic parameter under basal conditions. Copyright © 2013 Elsevier Ltd. All rights reserved.

Spontaneous Raman Scattering Diagnostics: Applications in Practical Combustion Systems. Chapter 5

NASA Technical Reports Server (NTRS)

Kojima, Jun; Viet-Nguyen, Quang; Lackner, Maximilian (Editor); Winter, Franz (Editor); Agarwal, Avinash (Editor)

2010-01-01

In this chapter, the recent advancements and practical aspects of laser SRS diagnostics have been reviewed wi til regards to applications in practical combustion systems. Clearly, SRS represents a theoretically and experimentally mature diagnostic technology that has become an essential tool for multiscalar measurements in turbulent combustion at elevated pressures. Today, time-, space-, spectrally, and even polarization-resolved S RS diagnostics is at hand, with aid from recent innovations in theoretical and technological developments on electro-optical or electromechanical devices. Whilst a linear increase in SRS signals can be expected in high-pressure systems (this is perhaps one of the most important advantages for using SRS in high-pressure systems), there are practical (often severe) restrictions associated with pressurized vessels, due mainly to the limited degree of optical access. This narrows ti,e available choice of diagnostics that can be employed at any given time. Point-wise SRS diagnostics provides the highest accuracy on the chemical species and temperature measurements, and will continue to remain a vital approach for the study in such harsh environments. The practical design considerations and hands-on set-up guide for SRS diagnostics provided in this chapter are rarely presented elsewhere. Although the second-harmonic Nd:YAG pulsed laser (532 nm), combined with pulse-stretching optics or the recently introduced White Cell-based laser, seems to be the most favored excitation source of choice by the research community, UV excitation will undoubtedly continue to be used on many occasions, and especially in sooting flames. Detection methods may be divided into ICCD-based nanosecond-gate detection or a rotary-chopper electromechanical shutter-based CCD array detection, and the levels of background flame emission in individual cases would determine this critical design choice. Here, a process of Raman signal calibration based on ti,e crosstalk matrix formalism was explained step-by-step. As tI,is process may be very time-consuming and expensive, a well-planned experimental approach (01' building a transferable calibration database or library (at least with in a user's own facility over a series of different testing and runs) is vitally important. Hands on advice on the design and construction of flow control systems for high pressure burner facilities were also presented.

Clinical Use of the Pediatric Attention Disorders Diagnostic Screener for Children at Risk for Attention Deficit Hyperactivity Disorder: Case Illustrations

ERIC Educational Resources Information Center

Keiser, Ashley; Reddy, Linda

2013-01-01

The Pediatric Attention Disorders Diagnostic Screener is a multidimensional, computerized screening tool designed to assess attention and global aspects of executive functioning in children at risk for attention disorders. The screener consists of a semi-structured diagnostic interview, brief parent and teacher rating scales, 3 computer-based…

Diagnostic Care: Grade 9. Technology Learning Activity. Teacher Edition. Level 2. Technology Education Series.

ERIC Educational Resources Information Center

Oklahoma State Dept. of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.

This Technology Learning Activity (TLA) on exploring diagnostic care careers for Grade 9 is designed for use in eight class periods. It gives students experience in using standard health care equipment to perform basic diagnostic procedures. This teacher's edition begins with an overview of technology education. The second section describes…

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

Han, S; Ji, Y; Kim, K

Purpose: A diagnostics Multileaf Collimator (MLC) was designed for diagnostic radiography dose reduction. Monte Carlo simulation was used to evaluate efficiency of shielding material for producing leaves of Multileaf collimator. Material & Methods: The general radiography unit (Rex-650R, Listem, Korea) was modeling with Monte Carlo simulation (MCNPX, LANL, USA) and we used SRS-78 program to calculate the energy spectrum of tube voltage (80, 100, 120 kVp). The shielding materials was SKD 11 alloy tool steel that is composed of 1.6% carbon(C), 0.4% silicon (Si), 0.6% manganese (Mn), 5% chromium (Cr), 1% molybdenum (Mo), and vanadium (V). The density of itmore » was 7.89 g/m3. We simulated leafs diagnostic MLC using SKD 11 with general radiography unit. We calculated efficiency of diagnostic MLC using tally6 card of MCNPX depending on energy. Results: The diagnostic MLC consisted of 25 individual metal shielding leaves on both sides, with dimensions of 10 × 0.5 × 0.5 cm3. The leaves of MLC were controlled by motors positioned on both sides of the MLC. According to energy (tube voltage), the shielding efficiency of MLC in Monte Carlo simulation was 99% (80 kVp), 96% (100 kVp) and 93% (120 kVp). Conclusion: We certified efficiency of diagnostic MLC fabricated from SKD11 alloy tool steel. Based on the results, the diagnostic MLC was designed. We will make the diagnostic MLC for dose reduction of diagnostic radiography.« less

Modeling and design of a beam emission spectroscopy diagnostic for the negative ion source NIO1

NASA Astrophysics Data System (ADS)

Barbisan, M.; Zaniol, B.; Cavenago, M.; Pasqualotto, R.

2014-02-01

Consorzio RFX and INFN-LNL are building a flexible small ion source (Negative Ion Optimization 1, NIO1) capable of producing about 130 mA of H- ions accelerated at 60 KeV. Aim of the experiment is to test and develop the instrumentation for SPIDER and MITICA, the prototypes, respectively, of the negative ion sources and of the whole neutral beam injectors which will operate in the ITER experiment. As SPIDER and MITICA, NIO1 will be monitored with beam emission spectroscopy (BES), a non-invasive diagnostic based on the analysis of the spectrum of the Hα emission produced by the interaction of the energetic ions with the background gas. Aim of BES is to monitor direction, divergence, and uniformity of the ion beam. The precision of these measurements depends on a number of factors related to the physics of production and acceleration of the negative ions, to the geometry of the beam, and to the collection optics. These elements were considered in a set of codes developed to identify the configuration of the diagnostic which minimizes the measurement errors. The model was already used to design the BES diagnostic for SPIDER and MITICA. The paper presents the model and describes its application to design the BES diagnostic in NIO1.

Intelligent Engine Systems: Bearing System

NASA Technical Reports Server (NTRS)

Singh, Arnant P.

2008-01-01

The overall requirements necessary for sensing bearing distress and the related criteria to select a particular rotating sensor were established during the phase I. The current phase II efforts performed studies to evaluate the Robustness and Durability Enhancement of the rotating sensors, and to design, and develop the Built-in Telemetry System concepts for an aircraft engine differential sump. A generic test vehicle that can test the proposed bearing diagnostic system was designed, developed, and built. The Timken Company, who also assisted with testing the GE concept of using rotating sensors for the differential bearing diagnostics during previous phase, was selected as a subcontractor to assist General Electric (GE) for the design, and procurement of the test vehicle. A purchase order was prepared to define the different sub-tasks, and deliverables for this task. The University of Akron was selected to provide the necessary support for installing, and integrating the test vehicle with their newly designed test facility capable of simulating the operating environment for the planned testing. The planned testing with good and damaged bearings will be on hold pending further continuation of this effort during next phase.

Expression and Purification of a Novel Computationally Designed Antigen for Simultaneously Detection of HTLV-1 and HBV Antibodies.

PubMed

Heydari Zarnagh, Hafez; Ravanshad, Mehrdad; Pourfatollah, Ali Akbar; Rasaee, Mohammad Javad

2015-04-01

Computational tools are reliable alternatives to laborious work in chimeric protein design. In this study, a chimeric antigen was designed using computational techniques for simultaneous detection of anti-HTLV-I and anti-HBV in infected sera. Databases were searched for amino acid sequences of HBV/HLV-I diagnostic antigens. The immunodominant fragments were selected based on propensity scales. The diagnostic antigen was designed using these fragments. Secondary and tertiary structures were predicted and the B-cell epitopes were mapped on the surface of built model. The synthetic DNA coding antigen was sub-cloned into pGS21a expression vector. SDS-PAGE analysis showed that glutathione fused antigen was highly expressed in E. coli BL21 (DE3) cells. The recombinant antigen was purified by nickel affinity chromatography. ELISA results showed that soluble antigen could specifically react with the HTLV-I and HBV infected sera. This specific antigen could be used as suitable agent for antibody-antigen based screening tests and can help clinicians in order to perform quick and precise screening of the HBV and HTLV-I infections.

The neutron imaging diagnostic at NIF (invited).

PubMed

Merrill, F E; Bower, D; Buckles, R; Clark, D D; Danly, C R; Drury, O B; Dzenitis, J M; Fatherley, V E; Fittinghoff, D N; Gallegos, R; Grim, G P; Guler, N; Loomis, E N; Lutz, S; Malone, R M; Martinson, D D; Mares, D; Morley, D J; Morgan, G L; Oertel, J A; Tregillis, I L; Volegov, P L; Weiss, P B; Wilde, C H; Wilson, D C

2012-10-01

A neutron imaging diagnostic has recently been commissioned at the National Ignition Facility (NIF). This new system is an important diagnostic tool for inertial fusion studies at the NIF for measuring the size and shape of the burning DT plasma during the ignition stage of Inertial Confinement Fusion (ICF) implosions. The imaging technique utilizes a pinhole neutron aperture, placed between the neutron source and a neutron detector. The detection system measures the two dimensional distribution of neutrons passing through the pinhole. This diagnostic has been designed to collect two images at two times. The long flight path for this diagnostic, 28 m, results in a chromatic separation of the neutrons, allowing the independently timed images to measure the source distribution for two neutron energies. Typically the first image measures the distribution of the 14 MeV neutrons and the second image of the 6-12 MeV neutrons. The combination of these two images has provided data on the size and shape of the burning plasma within the compressed capsule, as well as a measure of the quantity and spatial distribution of the cold fuel surrounding this core.

Monitoring nanoparticle synthesis in a carbon arc discharge environment, in situ

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

Mitrani, James

This work presents experimental and theoretical studies of gas-phase synthesis of fullerenes and carbon nanoparticles in the presence of an atmospheric-pressure, arc discharge plasma. Carbon arc discharges have been used for synthesizing carbon nanotubes for over 25 years, and have the potential for economically synthesizing industrial-scale quantities of fullerenes. However, the efficiency and selectivity of fullerene synthesis with carbon arc discharges are quite low. Optimizing carbon arc discharges for fullerene synthesis requires a thorough understanding of the dynamics behind gas-phase nanoparticle synthesis in the presence of an arc discharge plasma. We built a carbon arc discharge setup to study nanoparticlemore » and fullerene synthesis. The laser-induced incandescence (LII) diagnostic was applied for monitoring nanoparticle synthesis, in situ. The LII diagnostic had previously been applied as a combustion diagnostic for in situ measurements of concentrations and sizes of soot particles in flame environments. Prior to the present study, it had never been applied for studying fullerenes, nor had it been applied to study nanoparticles in the presence of an atmospheric-pressure plasma. Therefore, experiments were designed that allowed for the calibration of the LII diagnostic with research-grade, arc-synthesized soot particles and carbon nanotubes. Additionally, the theory and models underpinning the LII diagnostic were adapted to include the presence of an atmospheric-pressure, arc-discharge plasma. Results presented in this work confirm the ability of the LII diagnostic to measure sizes of arc-synthesized nanoparticles in situ, and show the spatial location of high densities of arc-synthesized nanoparticles with respect to the arc discharge plasma. Determining the spatial location of nanoparticle synthesis and growth is crucial for understanding the background conditions (e.g. background gas temperature, electron densities ...) in which nanoparticles nucleate and grow in the arc discharge environment. Future work would involve combining the LII diagnostic with other laser-based diagnostics (e.g. Rayleigh scattering, laser-induced fluorescence) for a more comprehensive study of gas-phase nanoparticle synthesis and investigating fundamental basic-science questions related to low temperature plasma physics, and laser-nanoparticle interactions.« less

Monitoring Nanoparticle Synthesis in a Carbon Arc Discharge Environment, In Situ

NASA Astrophysics Data System (ADS)

Mitrani, James

This work presents experimental and theoretical studies of gas-phase synthesis of fullerenes and carbon nanoparticles in the presence of an atmospheric-pressure, arc discharge plasma. Carbon arc discharges have been used for synthesizing carbon nanotubes for over 25 years, and have the potential for economically synthesizing industrial-scale quantities of fullerenes. However, the efficiency and selectivity of fullerene synthesis with carbon arc discharges are quite low. Optimizing carbon arc discharges for fullerene synthesis requires a thorough understanding of the dynamics behind gas-phase nanoparticle synthesis in the presence of an arc discharge plasma. We built a carbon arc discharge setup to study nanoparticle and fullerene synthesis. The laser-induced incandescence (LII) diagnostic was applied for monitoring nanoparticle synthesis, in situ. The LII diagnostic had previously been applied as a combustion diagnostic for in situ measurements of concentrations and sizes of soot particles in flame environments. Prior to the present study, it had never been applied for studying fullerenes, nor had it been applied to study nanoparticles in the presence of an atmospheric-pressure plasma. Therefore, experiments were designed that allowed for the calibration of the LII diagnostic with research-grade, arc-synthesized soot particles and carbon nanotubes. Additionally, the theory and models underpinning the LII diagnostic were adapted to include the presence of an atmospheric-pressure, arc-discharge plasma. Results presented in this work confirm the ability of the LII diagnostic to measure sizes of arc-synthesized nanoparticles in situ, and show the spatial location of high densities of arc-synthesized nanoparticles with respect to the arc discharge plasma. Determining the spatial location of nanoparticle synthesis and growth is crucial for understanding the background conditions (e.g. background gas temperature, electron densities ...) in which nanoparticles nucleate and grow in the arc discharge environment. Future work would involve combining the LII diagnostic with other laser-based diagnostics (e.g. Rayleigh scattering, laser-induced fluorescence) for a more comprehensive study of gas-phase nanoparticle synthesis and investigating fundamental basic-science questions related to low temperature plasma physics, and laser-nanoparticle interactions.

Integration of On-Line and Off-Line Diagnostic Algorithms for Aircraft Engine Health Management

NASA Technical Reports Server (NTRS)

Kobayashi, Takahisa; Simon, Donald L.

2007-01-01

This paper investigates the integration of on-line and off-line diagnostic algorithms for aircraft gas turbine engines. The on-line diagnostic algorithm is designed for in-flight fault detection. It continuously monitors engine outputs for anomalous signatures induced by faults. The off-line diagnostic algorithm is designed to track engine health degradation over the lifetime of an engine. It estimates engine health degradation periodically over the course of the engine s life. The estimate generated by the off-line algorithm is used to update the on-line algorithm. Through this integration, the on-line algorithm becomes aware of engine health degradation, and its effectiveness to detect faults can be maintained while the engine continues to degrade. The benefit of this integration is investigated in a simulation environment using a nonlinear engine model.

The design of the optical Thomson scattering diagnostic for the National Ignition Facility [The preliminary design of the optical Thomson scattering diagnostic for the National Ignition Facility

DOE PAGES

Datte, P. S.; Ross, J. S.; Froula, D. H.; ...

2016-09-21

Here, the National Ignition Facility (NIF) is a 192 laser beam facility designed to support the Stockpile Stewardship, High Energy Density and Inertial Confinement Fusion (ICF) programs. We report on the design of an Optical Thomson Scattering (OTS) diagnostic that has the potential to transform the community’s understanding of NIF hohlraum physics by providing first principle, local, time-resolved measurements of under-dense plasma conditions. The system design allows operation with different probe laser wavelengths by manual selection of the appropriate beam splitter and gratings before the shot. A deep-UV probe beam (λ 0-210 nm) will be used to optimize the scatteredmore » signal for plasma densities of 5 × 10 20 electrons/cm 3 while a 3ω probe will be used for experiments investigating lower density plasmas of 1 × 10 19 electrons/cm 3. We report the phase I design of a two phase design strategy. Phase I includes the OTS telescope, spectrometer, and streak camera; these will be used to assess the background levels at NIF. Phase II will include the design and installation of a probe laser.« less

The design of the optical Thomson scattering diagnostic for the National Ignition Facility [The preliminary design of the optical Thomson scattering diagnostic for the National Ignition Facility

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

Datte, P. S.; Ross, J. S.; Froula, D. H.

Here, the National Ignition Facility (NIF) is a 192 laser beam facility designed to support the Stockpile Stewardship, High Energy Density and Inertial Confinement Fusion (ICF) programs. We report on the design of an Optical Thomson Scattering (OTS) diagnostic that has the potential to transform the community’s understanding of NIF hohlraum physics by providing first principle, local, time-resolved measurements of under-dense plasma conditions. The system design allows operation with different probe laser wavelengths by manual selection of the appropriate beam splitter and gratings before the shot. A deep-UV probe beam (λ 0-210 nm) will be used to optimize the scatteredmore » signal for plasma densities of 5 × 10 20 electrons/cm 3 while a 3ω probe will be used for experiments investigating lower density plasmas of 1 × 10 19 electrons/cm 3. We report the phase I design of a two phase design strategy. Phase I includes the OTS telescope, spectrometer, and streak camera; these will be used to assess the background levels at NIF. Phase II will include the design and installation of a probe laser.« less

[Development of a diagnostic test system for early non-invasive detection of prostate cancer based on PCA3 mRNA levels in urine sediment using quantitative reverse tanscription polymerase chain reaction (qRT-PCR)].

PubMed

Pavlov, K A; Shkoporov, A N; Khokhlova, E V; Korchagina, A A; Sidorenkov, A V; Grigor'ev, M É; Pushkar', D Iu; Chekhonin, V P

2013-01-01

The wide introduction of prostatic specific antigen (PSA) determination into clinical practice has resulted in a larger number of prostate biopsies, while the lower age threshold for PSA has led to a larger number of unnecessary prostate biopsies. Hence, there is a need for new biomarkers that can detect prostate cancer. PCA3 is a noncoding messenger ribonucleic acid (mRNA) that is expressed exclusively in prostate cells. The aim of the study has been to develop a diagnostic test system for early non-invasive detection of prostate cancer based on PCA3 mRNA levels in urine sediment using quantitative reverse transcription polymerase chain reaction (qRT-PCR). As part of the study, a laboratory diagnostic test system prototype has been designed, an application methodology has been developed and specificity and sensitivity data of the method has been assessed. The diagnostic system has demonstrated its ability to detect significantly elevated levels of PCA 3/KLK 3 in samples from prostate cancer (PCa) patients compared with those from healthy men. The findings have shown relatively high diagnostic sensitivity, specificity and negative-predictive values for an early non-invasive screening of prostate cancer

Methods for the Joint Meta-Analysis of Multiple Tests

ERIC Educational Resources Information Center

Trikalinos, Thomas A.; Hoaglin, David C.; Small, Kevin M.; Terrin, Norma; Schmid, Christopher H.

2014-01-01

Existing methods for meta-analysis of diagnostic test accuracy focus primarily on a single index test. We propose models for the joint meta-analysis of studies comparing multiple index tests on the same participants in paired designs. These models respect the grouping of data by studies, account for the within-study correlation between the tests'…

Conceptual design of a divertor Thomson scattering diagnostic for NSTX-U

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

McLean, A. G., E-mail: mclean@fusion.gat.com; Soukhanovskii, V. A.; Allen, S. L.

2014-11-15

A conceptual design for a divertor Thomson scattering (DTS) diagnostic has been developed for the NSTX-U device to operate in parallel with the existing multipoint Thomson scattering system. Higher projected peak heat flux in NSTX-U will necessitate application of advanced magnetics geometries and divertor detachment. Interpretation and modeling of these divertor scenarios will depend heavily on local measurement of electron temperature, T{sub e}, and density, n{sub e}, which DTS provides in a passive manner. The DTS design for NSTX-U adopts major elements from the successful DIII-D DTS system including 7-channel polychromators measuring T{sub e} to 0.5 eV. If implemented onmore » NSTX-U, the divertor TS system would provide an invaluable diagnostic for the boundary program to characterize the edge plasma.« less

Patterns of diagnostic imaging and associated radiation exposure among long-term survivors of young adult cancer: a population-based cohort study.

PubMed

Daly, Corinne; Urbach, David R; Stukel, Thérèse A; Nathan, Paul C; Deitel, Wayne; Paszat, Lawrence F; Wilton, Andrew S; Baxter, Nancy N

2015-09-03

Survivors of young adult malignancies are at risk of accumulated exposures to radiation from repetitive diagnostic imaging. We designed a population-based cohort study to describe patterns of diagnostic imaging and cumulative diagnostic radiation exposure among survivors of young adult cancer during a survivorship time period where surveillance imaging is not typically warranted. Young adults aged 20-44 diagnosed with invasive malignancy in Ontario from 1992-1999 who lived at least 5 years from diagnosis were identified using the Ontario Cancer Registry and matched 5 to 1 to randomly selected cancer-free persons. We determined receipt of 5 modalities of diagnostic imaging and associated radiation dose received by survivors and controls from years 5-15 after diagnosis or matched referent date through administrative data. Matched pairs were censored six months prior to evidence of recurrence. 20,911 survivors and 104,524 controls had a median of 13.5 years observation. Survivors received all modalities of diagnostic imaging at significantly higher rates than controls. Survivors received CT at a 3.49-fold higher rate (95% Confidence Interval [CI]:3.37, 3.62) than controls in years 5 to 15 after diagnosis. Survivors received a mean radiation dose of 26 miliSieverts solely from diagnostic imaging in the same time period, a 4.57-fold higher dose than matched controls (95% CI: 4.39, 4.81). Long-term survivors of young adult cancer have a markedly higher rate of diagnostic imaging over time than matched controls, imaging associated with substantial radiation exposure, during a time period when surveillance is not routinely recommended.

Molecular Tools for Diagnosis of Visceral Leishmaniasis: Systematic Review and Meta-Analysis of Diagnostic Test Accuracy

PubMed Central

de Ruiter, C. M.; van der Veer, C.; Leeflang, M. M. G.; Deborggraeve, S.; Lucas, C.

2014-01-01

Molecular methods have been proposed as highly sensitive tools for the detection of Leishmania parasites in visceral leishmaniasis (VL) patients. Here, we evaluate the diagnostic accuracy of these tools in a meta-analysis of the published literature. The selection criteria were original studies that evaluate the sensitivities and specificities of molecular tests for diagnosis of VL, adequate classification of study participants, and the absolute numbers of true positives and negatives derivable from the data presented. Forty studies met the selection criteria, including PCR, real-time PCR, nucleic acid sequence-based amplification (NASBA), and loop-mediated isothermal amplification (LAMP). The sensitivities of the individual studies ranged from 29 to 100%, and the specificities ranged from 25 to 100%. The pooled sensitivity of PCR in whole blood was 93.1% (95% confidence interval [CI], 90.0 to 95.2), and the specificity was 95.6% (95% CI, 87.0 to 98.6). The specificity was significantly lower in consecutive studies, at 63.3% (95% CI, 53.9 to 71.8), due either to true-positive patients not being identified by parasitological methods or to the number of asymptomatic carriers in areas of endemicity. PCR for patients with HIV-VL coinfection showed high diagnostic accuracy in buffy coat and bone marrow, ranging from 93.1 to 96.9%. Molecular tools are highly sensitive assays for Leishmania detection and may contribute as an additional test in the algorithm, together with a clear clinical case definition. We observed wide variety in reference standards and study designs and now recommend consecutively designed studies. PMID:24829226

Well-Designed Bone-Seeking Radiolabeled Compounds for Diagnosis and Therapy of Bone Metastases

PubMed Central

2015-01-01

Bone-seeking radiopharmaceuticals are frequently used as diagnostic agents in nuclear medicine, because they can detect bone disorders before anatomical changes occur. Furthermore, their effectiveness in the palliation of metastatic bone cancer pain has been demonstrated in the clinical setting. With the aim of developing superior bone-seeking radiopharmaceuticals, many compounds have been designed, prepared, and evaluated. Here, several well-designed bone-seeking compounds used for diagnostic and therapeutic use, having the concept of radiometal complexes conjugated to carrier molecules to bone, are reviewed. PMID:26075256

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

Oral phenotype and scoring of vascular Ehlers–Danlos syndrome: a case–control study

PubMed Central

Frank, Michael; Gogly, Bruno; Golmard, Lisa; Naveau, Adrien; Chérifi, Hafida; Emmerich, Joseph; Gaultier, Frédérick; Berdal, Ariane; Jeunemaitre, Xavier; Fournier, Benjamin P J

2012-01-01

Objective Vascular Ehlers–Danlos syndrome (vEDS) is a rare genetic condition related to mutations in the COL3A1 gene, responsible of vascular, digestive and uterine accidents. Difficulty of clinical diagnosis has led to the design of diagnostic criteria, summarised in the Villefranche classification. The goal was to assess oral features of vEDS. Gingival recession is the only oral sign recognised as a minor diagnostic criterion. The authors aimed to check this assumption since bibliographical search related to gingival recession in vEDS proved scarce. Design Prospective case–control study. Setting Dental surgery department in a French tertiary hospital. Participants 17 consecutive patients with genetically proven vEDS, aged 19–55 years, were compared with 46 age- and sex-matched controls. Observations Complete oral examination (clinical and radiological) with standardised assessment of periodontal structure, temporomandibular joint function and dental characteristics were performed. COL3A1 mutations were identified by direct sequencing of genomic or complementary DNA. Results Prevalence of gingival recession was low among patients with vEDS, as for periodontitis. Conversely, patients showed marked gingival fragility, temporomandibular disorders, dentin formation defects, molar root fusion and increased root length. After logistic regression, three variables remained significantly associated to vEDS. These variables were integrated in a diagnostic oral score with 87.5% and 97% sensitivity and specificity, respectively. Conclusions Gingival recession is an inappropriate diagnostic criterion for vEDS. Several new specific oral signs of the disease were identified, whose combination may be of greater value in diagnosing vEDS. PMID:22492385

Safety in numbers 3: Authenticity, Building knowledge & skills and Competency development & assessment: the ABC of safe medication dosage calculation problem-solving pedagogy.

PubMed

Weeks, Keith W; Meriel Hutton, B; Coben, Diana; Clochesy, John M; Pontin, David

2013-03-01

When designing learning and assessment environments it is essential to articulate the underpinning education philosophy, theory, model and learning style support mechanisms that inform their structure and content. We elaborate on original PhD research that articulates the design rationale of authentic medication dosage calculation problem-solving (MDC-PS) learning and diagnostic assessment environments. These environments embody the principles of authenticity, building knowledge and skills and competency assessment and are designed to support development of competence and bridging of the theory-practice gap. Authentic learning and diagnostic assessment environments capture the features and expert practices that are located in real world practice cultures and recreate them in authentic virtual clinical environments. We explore how this provides students with a safe virtual authentic environment to actively experience, practice and undertake MDC-PS learning and assessment activities. We argue that this is integral to the construction and diagnostic assessment of schemata validity (mental constructions and frameworks that are an individual's internal representation of their world), bridging of the theory-practice gap and cognitive and functional competence development. We illustrate these principles through the underpinning pedagogical design of two online virtual authentic learning and diagnostic assessment environments (safeMedicate and eDose™). Copyright © 2012. Published by Elsevier Ltd.

A Testbed for Data Fusion for Helicopter Diagnostics and Prognostics

DTIC Science & Technology

2003-03-01

and algorithm design and tuning in order to develop advanced diagnostic and prognostic techniques for air craft health monitoring . Here a...and development of models for diagnostics, prognostics , and anomaly detection . Figure 5 VMEP Server Browser Interface 7 Download... detections , and prognostic prediction time horizons. The VMEP system and in particular the web component are ideal for performing data collection

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

PubMed

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

2012-10-01

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

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

[Discussion on development of four diagnostic information scale for clinical re-evaluation of postmarketing herbs].

PubMed

He, Wei; Xie, Yanming; Wang, Yongyan

2011-12-01

Post-marketing re-evaluation of Chinese herbs can well reflect Chinese medicine characteristics, which is the most easily overlooked the clinical re-evaluation content. Since little attention has been paid to this, study on the clinical trial design method was lost. It is difficult to improving the effectiveness and safety of traditional Chinese medicine. Therefore, more attention should be paid on re-evaluation of the clinical trial design method point about tcm syndrome such as the type of research program design, the study of Chinese medical information collection scale and statistical analysis methods, so as to improve the clinical trial design method study about tcm syndrome of Chinese herbs postmarketing re-evalutation status.

Added value of cost-utility analysis in simple diagnostic studies of accuracy: (18)F-fluoromethylcholine PET/CT in prostate cancer staging.

PubMed

Gerke, Oke; Poulsen, Mads H; Høilund-Carlsen, Poul Flemming

2015-01-01

Diagnostic studies of accuracy targeting sensitivity and specificity are commonly done in a paired design in which all modalities are applied in each patient, whereas cost-effectiveness and cost-utility analyses are usually assessed either directly alongside to or indirectly by means of stochastic modeling based on larger randomized controlled trials (RCTs). However the conduct of RCTs is hampered in an environment such as ours, in which technology is rapidly evolving. As such, there is a relatively limited number of RCTs. Therefore, we investigated as to which extent paired diagnostic studies of accuracy can be also used to shed light on economic implications when considering a new diagnostic test. We propose a simple decision tree model-based cost-utility analysis of a diagnostic test when compared to the current standard procedure and exemplify this approach with published data from lymph node staging of prostate cancer. Average procedure costs were taken from the Danish Diagnosis Related Groups Tariff in 2013 and life expectancy was estimated for an ideal 60 year old patient based on prostate cancer stage and prostatectomy or radiation and chemotherapy. Quality-adjusted life-years (QALYs) were deduced from the literature, and an incremental cost-effectiveness ratio (ICER) was used to compare lymph node dissection with respective histopathological examination (reference standard) and (18)F-fluoromethylcholine positron emission tomography/computed tomography (FCH-PET/CT). Lower bounds of sensitivity and specificity of FCH-PET/CT were established at which the replacement of the reference standard by FCH-PET/CT comes with a trade-off between worse effectiveness and lower costs. Compared to the reference standard in a diagnostic accuracy study, any imperfections in accuracy of a diagnostic test imply that replacing the reference standard generates a loss in effectiveness and utility. We conclude that diagnostic studies of accuracy can be put to a more extensive use, over and above a mere indication of sensitivity and specificity of an imaging test, and that health economic considerations should be undertaken when planning a prospective diagnostic accuracy study. These endeavors will prove especially fruitful when comparing several imaging techniques with one another, or the same imaging technique using different tracers, with an independent reference standard for the evaluation of results.

The National Comorbidity Survey Adolescent Supplement (NCS-A): I. Background and Measures

PubMed Central

Merikangas, Kathleen R.; Avenevoli, Shelli; Costello, E. Jane; Koretz, Doreen; Kessler, Ronald C.

2009-01-01

Objective This paper presents an overview of the background and measures used in the National Comorbidity Survey Replication Adolescent Supplement (NCS-A). Methods The NCS-A is a national psychiatric epidemiological survey of adolescents ages 13–17. Results The NCS-A was designed to provide the first nationally representative estimates of the prevalence, correlates and patterns of service use for DSM-V mental disorders among US adolescents and to lay the groundwork for follow-up studies of risk-protective factors, consequences, and early expressions of adult mental disorders. The core NCS-A diagnostic interview, the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI), is a fully-structured research diagnostic interview designed for use by trained lay interviewers. A multi-construct, multi-method, multi-informant battery was also included to assess risk and protective factors and barriers to service use. Design limitations due to the NCS-A evolving as a supplement to an ongoing survey of mental disorders of US adults include restricted age range of youth, cross-sectional assessment, and lack of full parental/surrogate informant reports on youth mental disorders and correlates. Conclusions Despite these limitations, the NCS-A contains unparalleled information that can be used to generate national estimates of prevalence and correlates of adolescent mental disorders, risk and protective factors, patterns of service use, and barriers to receiving treatment for these disorders. The retrospective NCS-A data on the development of psychopathology can additionally complement data from longitudinal studies based on more geographically restricted samples and serve as a useful baseline for future prospective studies of the onset and progression of mental disorders in adulthood. PMID:19242382

Diagnostic accuracy of spot urinary protein and albumin to creatinine ratios for detection of significant proteinuria or adverse pregnancy outcome in patients with suspected pre-eclampsia: systematic review and meta-analysis

PubMed Central

Morris, R K; Riley, R D; Doug, M; Deeks, J J

2012-01-01

Objective To determine the diagnostic accuracy of two “spot urine” tests for significant proteinuria or adverse pregnancy outcome in pregnant women with suspected pre-eclampsia. Design Systematic review and meta-analysis. Data sources Searches of electronic databases 1980 to January 2011, reference list checking, hand searching of journals, and contact with experts. Inclusion criteria Diagnostic studies, in pregnant women with hypertension, that compared the urinary spot protein to creatinine ratio or albumin to creatinine ratio with urinary protein excretion over 24 hours or adverse pregnancy outcome. Study characteristics, design, and methodological and reporting quality were objectively assessed. Data extraction Study results relating to diagnostic accuracy were extracted and synthesised using multivariate random effects meta-analysis methods. Results Twenty studies, testing 2978 women (pregnancies), were included. Thirteen studies examining protein to creatinine ratio for the detection of significant proteinuria were included in the multivariate analysis. Threshold values for protein to creatinine ratio ranged between 0.13 and 0.5, with estimates of sensitivity ranging from 0.65 to 0.89 and estimates of specificity from 0.63 to 0.87; the area under the summary receiver operating characteristics curve was 0.69. On average, across all studies, the optimum threshold (that optimises sensitivity and specificity combined) seems to be between 0.30 and 0.35 inclusive. However, no threshold gave a summary estimate above 80% for both sensitivity and specificity, and considerable heterogeneity existed in diagnostic accuracy across studies at most thresholds. No studies looked at protein to creatinine ratio and adverse pregnancy outcome. For albumin to creatinine ratio, meta-analysis was not possible. Results from a single study suggested that the most predictive result, for significant proteinuria, was with the DCA 2000 quantitative analyser (>2 mg/mmol) with a summary sensitivity of 0.94 (95% confidence interval 0.86 to 0.98) and a specificity of 0.94 (0.87 to 0.98). In a single study of adverse pregnancy outcome, results for perinatal death were a sensitivity of 0.82 (0.48 to 0.98) and a specificity of 0.59 (0.51 to 0.67). Conclusion The maternal “spot urine” estimate of protein to creatinine ratio shows promising diagnostic value for significant proteinuria in suspected pre-eclampsia. The existing evidence is not, however, sufficient to determine how protein to creatinine ratio should be used in clinical practice, owing to the heterogeneity in test accuracy and prevalence across studies. Insufficient evidence is available on the use of albumin to creatinine ratio in this area. Insufficient evidence exists for either test to predict adverse pregnancy outcome. PMID:22777026

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

PubMed

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

2009-12-01

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

High-resolution melting PCR assay, applicable for diagnostics and screening studies, allowing detection and differentiation of several Babesia spp. infecting humans and animals.

PubMed

Rozej-Bielicka, Wioletta; Masny, Aleksander; Golab, Elzbieta

2017-10-01

The goal of the study was to design a single tube PCR test for detection and differentiation of Babesia species in DNA samples obtained from diverse biological materials. A multiplex, single tube PCR test was designed for amplification of approximately 400 bp region of the Babesia 18S rRNA gene. Universal primers were designed to match DNA of multiple Babesia spp. and to have low levels of similarity to DNA sequences of other intracellular protozoa and Babesia hosts. The PCR products amplified from Babesia DNA isolated from human, dog, rodent, deer, and tick samples were subjected to high-resolution melting analysis for Babesia species identification. The designed test allowed detection and differentiation of four Babesia species, three zoonotic (B. microti, B. divergens, B. venatorum) and one that is generally not considered zoonotic-Babesia canis. Both detection and identification of all four species were possible based on the HRM curves of the PCR products in samples obtained from the following: humans, dogs, rodents, and ticks. No cross-reactivity with DNA of Babesia hosts or Plasmodium falciparum and Toxoplasma gondii was observed. The lack of cross-reactivity with P. falciparum DNA might allow using the assay in endemic malaria areas. The designed assay is the first PCR-based test for detection and differentiation of several Babesia spp. of medical and veterinary importance, in a single tube reaction. The results of the study show that the designed assay for Babesia detection and identification could be a practical and inexpensive tool for diagnostics and screening studies of diverse biological materials.

Clinical data miner: an electronic case report form system with integrated data preprocessing and machine-learning libraries supporting clinical diagnostic model research.

PubMed

Installé, Arnaud Jf; Van den Bosch, Thierry; De Moor, Bart; Timmerman, Dirk

2014-10-20

Using machine-learning techniques, clinical diagnostic model research extracts diagnostic models from patient data. Traditionally, patient data are often collected using electronic Case Report Form (eCRF) systems, while mathematical software is used for analyzing these data using machine-learning techniques. Due to the lack of integration between eCRF systems and mathematical software, extracting diagnostic models is a complex, error-prone process. Moreover, due to the complexity of this process, it is usually only performed once, after a predetermined number of data points have been collected, without insight into the predictive performance of the resulting models. The objective of the study of Clinical Data Miner (CDM) software framework is to offer an eCRF system with integrated data preprocessing and machine-learning libraries, improving efficiency of the clinical diagnostic model research workflow, and to enable optimization of patient inclusion numbers through study performance monitoring. The CDM software framework was developed using a test-driven development (TDD) approach, to ensure high software quality. Architecturally, CDM's design is split over a number of modules, to ensure future extendability. The TDD approach has enabled us to deliver high software quality. CDM's eCRF Web interface is in active use by the studies of the International Endometrial Tumor Analysis consortium, with over 4000 enrolled patients, and more studies planned. Additionally, a derived user interface has been used in six separate interrater agreement studies. CDM's integrated data preprocessing and machine-learning libraries simplify some otherwise manual and error-prone steps in the clinical diagnostic model research workflow. Furthermore, CDM's libraries provide study coordinators with a method to monitor a study's predictive performance as patient inclusions increase. To our knowledge, CDM is the only eCRF system integrating data preprocessing and machine-learning libraries. This integration improves the efficiency of the clinical diagnostic model research workflow. Moreover, by simplifying the generation of learning curves, CDM enables study coordinators to assess more accurately when data collection can be terminated, resulting in better models or lower patient recruitment costs.

Diagnostic evaluation of sentinel lymph node biopsy using indocyanine green and infrared or fluorescent imaging in gastric cancer: a systematic review and meta-analysis.

PubMed

Skubleny, Daniel; Dang, Jerry T; Skulsky, Samuel; Switzer, Noah; Tian, Chunhong; Shi, Xinzhe; de Gara, Christopher; Birch, Daniel W; Karmali, Shahzeer

2018-06-01

Sentinel node navigation surgery (SNNS) for gastric cancer using infrared visualization of indocyanine green (ICG) is intriguing because it may limit operative morbidity. We are the first to systematically review and perform meta-analysis on the diagnostic utility of ICG and infrared electronic endoscopy (IREE) or near infrared fluorescent imaging (NIFI) for SNNS exclusively in gastric cancer. A search of electronic databases MEDLINE, EMBASE, SCOPUS, Web of Science, and the Cochrane Library using search terms "gastric/stomach" AND "tumor/carcinoma/cancer/neoplasm/adenocarcinoma/malignancy" AND "indocyanine green" was completed in May 2017. Articles were selected by two independent reviewers based on the following major inclusion criteria: (1) diagnostic accuracy study design; (2) indocyanine green was injected at tumor site; (3) IREE or NIFI was used for intraoperative visualization. 327 titles or abstracts were screened. The quality of included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2. Ten full text studies were selected. 643 patients were identified with the majority of patients possessing T1 tumors (79.8%). Pooled identification rate, diagnostic odds ratio, sensitivity, and specificity were 0.99 (0.97-1.0), 380.0 (68.71-2101), 0.87 (0.80-0.93), and 1.00 (0.99-1.00), respectively. The summary receiver operator characteristic for ICG + IREE/NIFI demonstrated a test accuracy of 98.3%. Subgroup analysis found improved test performance for studies with low-risk QUADAS-2 scores, studies published after 2010 and submucosal ICG injection. IREE had improved diagnostic odds ratio, sensitivity, and identification rate compared to NIFI. Heterogeneity among studies ranged from low (I 2  < 25%) to high (I 2  > 75%). We found encouraging results regarding the accuracy, diagnostic odds ratio, and specificity of the test. The sensitivity was not optimal but may be improved by a strict protocol to augment the technique. Given the number and heterogeneity of studies, our results must be viewed with caution.

Morphometrical study on senile larynx.

PubMed

Zieliński, R

2001-01-01

The aim of the study was a morphometrical macroscopic evaluation of senile larynges, according to its usefulness in ORL diagnostic and operational methods. Larynx preparations were taken from cadavers of both sexes, of age 65 and over, about 24 hours after death. Clinically important laryngeal diameters were collected using common morphometrical methods. A few body features were also being gathered. Computer statistical methods were used in data assessment, including basic statistics and linear correlations between diameters and between diameters and body features. The data presented in the study may be very helpful in evaluation of diagnostic methods. It may also help in selection of right operational tool' sizes, the most appropriate operational technique choice, preoperative preparations and designing and building virtual and plastic models for physicians' training.

Final design of thermal diagnostic system in SPIDER ion source

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

Brombin, M., E-mail: matteo.brombin@igi.cnr.it; Dalla Palma, M.; Pasqualotto, R.

The prototype radio frequency source of the ITER heating neutral beams will be first tested in SPIDER test facility to optimize H{sup −} production, cesium dynamics, and overall plasma characteristics. Several diagnostics will allow to fully characterise the beam in terms of uniformity and divergence and the source, besides supporting a safe and controlled operation. In particular, thermal measurements will be used for beam monitoring and system protection. SPIDER will be instrumented with mineral insulated cable thermocouples, both on the grids, on other components of the beam source, and on the rear side of the beam dump water cooled elements.more » This paper deals with the final design and the technical specification of the thermal sensor diagnostic for SPIDER. In particular the layout of the diagnostic, together with the sensors distribution in the different components, the cables routing and the conditioning and acquisition cubicles are described.« less

Initial operation of a newly developed multichord motional Stark effect diagnostic in KSTAR

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

Chung, J., E-mail: jinil@nfri.re.kr; Ko, J.; Wi, H.

2016-11-15

A photo-elastic modulator based 25-chord motional Stark effect (MSE) diagnostic has been successfully developed and commissioned in Korea Superconducting Tokamak Advanced Research. The diagnostic measures the radial magnetic pitch angle profile of the Stark splitting of a D-alpha line at 656.1 nm by the electric field associated with the neutral deuterium heating beam. A tangential view of the neutral beam provides a good spatial resolution of 1–3 cm for covering the major radius from 1.74 m to 2.28 m, and the time resolution is achieved at 10 ms. An in-vessel calibration before the vacuum closing as well as an inmore » situ calibration during the tokamak operation was performed by means of specially designed polarized lighting sources. In this work, we present the final design of the installed MSE diagnostic and the first results of the commissioning.« less

Final design of thermal diagnostic system in SPIDER ion source

NASA Astrophysics Data System (ADS)

Brombin, M.; Dalla Palma, M.; Pasqualotto, R.; Pomaro, N.

2016-11-01

The prototype radio frequency source of the ITER heating neutral beams will be first tested in SPIDER test facility to optimize H- production, cesium dynamics, and overall plasma characteristics. Several diagnostics will allow to fully characterise the beam in terms of uniformity and divergence and the source, besides supporting a safe and controlled operation. In particular, thermal measurements will be used for beam monitoring and system protection. SPIDER will be instrumented with mineral insulated cable thermocouples, both on the grids, on other components of the beam source, and on the rear side of the beam dump water cooled elements. This paper deals with the final design and the technical specification of the thermal sensor diagnostic for SPIDER. In particular the layout of the diagnostic, together with the sensors distribution in the different components, the cables routing and the conditioning and acquisition cubicles are described.

A Laboratory Model of a Hydrogen/Oxygen Engine for Combustion and Nozzle Studies

NASA Technical Reports Server (NTRS)

Morren, Sybil Huang; Myers, Roger M.; Benko, Stephen E.; Arrington, Lynn A.; Reed, Brian D.

1993-01-01

A small laboratory diagnostic thruster was developed to augment present low thrust chemical rocket optical and heat flux diagnostics at the NASA Lewis Research Center. The objective of this work was to evaluate approaches for the use of temperature and pressure sensors for the investigation of low thrust rocket flow fields. The nominal engine thrust was 110 N. Tests were performed at chamber pressures of about 255 kPa, 370 kPa, and 500 kPa with oxidizer to fuel mixture ratios between 4.0 and 8.0. Two gaseous hydrogen/gaseous oxygen injector designs were tested with 60 percent and 75 percent fuel film cooling. The thruster and instrumentation designs were proven to be effective via hot fire testing. The thruster diagnostics provided inner wall temperature and static pressure measurements which were compared to the thruster global performance data. For several operating conditions, the performance data exhibited unexpected trends which were correlated with changes in the axial wall temperature distribution. Azimuthal temperature distributions were found to be a function of operating conditions and hardware configuration. The static pressure profiles showed that no severe pressure gradients were present in the rocket. The results indicated that small differences in injector design can result in dramatically different thruster performance and wall temperature behavior, but that these injector effects may be overshadowed by operating at a high fuel film cooling rate.

Practical perspectives of personalized healthcare in oncology.

PubMed

Hodgson, Darren R; Wellings, Robert; Harbron, Christopher

2012-09-15

There is an increasing prevalence of drug-diagnostic combinations in oncology. This has placed diagnostic stakeholders directly into the complex benefit-risk, cost, value and uncertainty-driven development paradigm traditionally the preserve of the drug development community. In this review we focus on the delivery of the clinical data required to advance such drug-diagnostic combination development programmes and ultimately satisfy regulators and payors of the value of contemporaneous changes in diagnostic and treatment practice. Ideally all stakeholders would like to initially estimate, and ultimately specify, the comparative benefit-risk for a new treatment option with and without changing diagnostic practice. Hence, in an ideal world clinical trial design is focused on acquiring biomarker treatment interaction data. In this review we describe the key scientific and feasibility inputs required to design and deliver such trials and the drivers, advantages and disadvantages associated with departing from this model. We do not discuss the discovery of new biomarkers nor the analytical validation and marketing of diagnostic products. Following on from trial design we describe how subsequent success then depends upon the concepts that guide trial design being driven into the complex world of large, multinational clinical trial delivery. For every aspect of a traditional clinical drug trial such as supply, recruitment and adherence, there is a corresponding concept for the diagnostic element. In practice, this means that each patient's contribution to the decision making data-set is subject to double jeopardy (attrition on clinical outcome and biomarker status). Historically, this has led to significantly reduced power for detecting biomarker-treatment interactions, reduced decision making confidence and a waste of valuable human and financial resources. We describe recent practice changes and experience that have led to the successful delivery of such trials focusing on both pre- and on trial aspects. The former includes the pivotal role of tissue banks in accurate estimation of evaluability and prevalence for biomarker assays and the latter several practices designed to engage and incentivize key stakeholders particularly CRAs and pathologists. The result is that in the new world of developing personalized treatments for cancer patients the real-time acquisition and monitoring of biomarker data receives similar support to that traditionally reserved for clinical outcome data and far more patients contribute to the testing of personalized medicine hypotheses. Copyright © 2012 Elsevier B.V. All rights reserved.

The development, evaluation and performance of molecular diagnostics for detection of Mycobacterium tuberculosis.

PubMed

Bates, Matthew; Zumla, Alimuddin

2016-01-01

The unique pathogenesis of tuberculosis (TB) poses several barriers to the development of accurate diagnostics: a) the establishment of life-long latency by Mycobacterium tuberculosis (M.tb) after primary infection confounds the development of classical antibody or antigen based assays; b) our poor understanding of the molecular pathways that influence progression from latent to active disease; c) the intracellular nature of M.tb infection in tissues means that M.tb and/or its components, are not readily detectable in peripheral specimens; and d) the variable presence of M.tb bacilli in specimens from patients with extrapulmonary TB or children. The literature on the current portfolio of molecular diagnostics tests for TB is reviewed here and the developmental pipeline is summarized. Also reviewed are data from recently published operational research on the GeneXpert MTB/RIF assay and discussed are the lessons that can be taken forward for the design of studies to evaluate the impact of TB diagnostics.

Kinematic Tests of Small Arms

DTIC Science & Technology

2016-03-15

muzzle devices, such as flash suppressors and muzzle compensators, if the items are designed to be operator removable. Use the ammunition that will...muzzle brake or adding a sound suppressor . A kinematics study is also a diagnostic tool to investigate weapon problems such as poor functioning with

Synthetic biology and regulatory networks: where metabolic systems biology meets control engineering

PubMed Central

He, Fei; Murabito, Ettore; Westerhoff, Hans V.

2016-01-01

Metabolic pathways can be engineered to maximize the synthesis of various products of interest. With the advent of computational systems biology, this endeavour is usually carried out through in silico theoretical studies with the aim to guide and complement further in vitro and in vivo experimental efforts. Clearly, what counts is the result in vivo, not only in terms of maximal productivity but also robustness against environmental perturbations. Engineering an organism towards an increased production flux, however, often compromises that robustness. In this contribution, we review and investigate how various analytical approaches used in metabolic engineering and synthetic biology are related to concepts developed by systems and control engineering. While trade-offs between production optimality and cellular robustness have already been studied diagnostically and statically, the dynamics also matter. Integration of the dynamic design aspects of control engineering with the more diagnostic aspects of metabolic, hierarchical control and regulation analysis is leading to the new, conceptual and operational framework required for the design of robust and productive dynamic pathways. PMID:27075000

Designing a Micromixer for Rolling Circle Amplification in Cancer Biomarker Detection

NASA Astrophysics Data System (ADS)

Altural, Hayriye

2015-03-01

Rolling circle amplification (RCA) is an alternative method to the Polymerase Chain Reaction based amplification for point-of-care (POC) diagnosis. In future personalized cancer diagnostic for POC applications, smaller, faster and cheaper methods are needed instead of costly and time-consuming laboratory tests. Microfluidic chips can perform the detection of cancer biomarkers within less analysis time, and provide for improvement in the sensitivity and specificity required for biochemical analysis as well. Rapid mixing is essential in the chips used in cancer diagnostic. The goal of this study is to design a micromixer for rapid RCA-based analysis and develop the assay time in cancer biomarker detection. By combining assays with micromixers, multi-step bioreactions in microfluidic chips may be achieved with minimal external control. Here, simulation results related to the micromixer are obtained by COMSOL software. The Scientific and Technological Research Council of Turkey (TUBITAK) is acknowledged for granting of H. Altural postdoctoral study in the framework of TUBITAK-BIDEB 2219-International Postdoctoral Research Scholarship Program.

Description of the prototype diagnostic residual gas analyzer for ITER.

PubMed

Younkin, T R; Biewer, T M; Klepper, C C; Marcus, C

2014-11-01

The diagnostic residual gas analyzer (DRGA) system to be used during ITER tokamak operation is being designed at Oak Ridge National Laboratory to measure fuel ratios (deuterium and tritium), fusion ash (helium), and impurities in the plasma. The eventual purpose of this instrument is for machine protection, basic control, and physics on ITER. Prototyping is ongoing to optimize the hardware setup and measurement capabilities. The DRGA prototype is comprised of a vacuum system and measurement technologies that will overlap to meet ITER measurement requirements. Three technologies included in this diagnostic are a quadrupole mass spectrometer, an ion trap mass spectrometer, and an optical penning gauge that are designed to document relative and absolute gas concentrations.

Expanding the PACS archive to support clinical review, research, and education missions

NASA Astrophysics Data System (ADS)

Honeyman-Buck, Janice C.; Frost, Meryll M.; Drane, Walter E.

1999-07-01

Designing an image archive and retrieval system that supports multiple users with many different requirements and patterns of use without compromising the performance and functionality required by diagnostic radiology is an intellectual and technical challenge. A diagnostic archive, optimized for performance when retrieving diagnostic images for radiologists needed to be expanded to support a growing clinical review network, the University of Florida Brain Institute's demands for neuro-imaging, Biomedical Engineering's imaging sciences, and an electronic teaching file. Each of the groups presented a different set of problems for the designers of the system. In addition, the radiologists did not want to see nay loss of performance as new users were added.

Characterizing a Hidden Group of At-Risk Drinkers: Epidemiological Profiles of Alcohol-Use Disorder Diagnostic Orphans.

PubMed

Gilbert, Paul A; Marzell, Miesha

2017-11-29

Drinkers who report some symptoms of alcohol-use disorder (AUD) but fail to meet full criteria are "diagnostic orphans." To improve risk-reduction efforts, we sought to develop better epidemiologic profiles of this underrecognized subgroup. This study estimated the population prevalence and described AUD symptoms of diagnostic orphans using the 2012-2013 National Epidemiological Survey of Alcohol and Related Conditions-III. Multivariate logistic regression was used to model odds of being a diagnostic orphan or meeting mild, moderate, and severe AUD criteria versus no AUD symptoms. Models were adjusted for the complex survey design using sampling weights and survey procedures (e.g., proc surveylogistic). Among drinkers, 14% of men and 11% of women were classified as diagnostic orphans. The most common symptoms were drinking more or for longer periods than intended, wanting or trying unsuccessfully to quit or cut back, and drinking in ways that increased risk of injury. We noted broad similarities between diagnostic orphans and mild/moderate AUD groups. There were no differences in odds of diagnostic orphans status by race/ethnicity; however, female gender was associated with lower odds of diagnostic orphan status and all levels of AUD. Individual history of AUD, family history of problem drinking, concurrent smoking, and concurrent marijuana use were associated with greater odds of problem drinking, with stronger associations as AUD severity increased. Diagnostic orphans remain a sizeable and overlooked population of problem drinkers. Clarifying the array of symptoms and cooccurring disorders can improve screening and facilitate alcohol risk-reduction intervention efforts.

Integrated Diagnostic and Treatment Devices for Enroute Critical Care of Patients within Theater

DTIC Science & Technology

2010-04-01

are all indicated for both adult and pediatric patients, are lightweight systems designed to attach either directly to a NATO litter or attach to a...external defibrillator and blood chemistry analysis system. Figure 1: Patient Being Transported with the Life Support for Trauma and Transport...be difficult to replace or refill. The LSTAT was also designed to accept external oxygen sources. Integrated Diagnostic and Treatment Devices for

Blast-Loading Assessment of Multi-Energy Flash Computed Tomography (MEFCT) Diagnostic

DTIC Science & Technology

2016-08-01

Perrella JA, Sturgill JM. Design of a simple blast pressure gauge based on a heterodyne velocimetry measuring technique. Aberdeen Proving Ground (MD...position unless so designated by other authorized documents. Citation of manufacturer’s or trade names does not constitute an official endorsement or...of the radiation dose throughout the angular span of the 150-, 300-, and 450-kV flash X-ray sources used in the MEFCT diagnostic: left image shows

Computer modeling and design of diagnostic workstations and radiology reading rooms

NASA Astrophysics Data System (ADS)

Ratib, Osman M.; Amato, Carlos L.; Balbona, Joseph A.; Boots, Kevin; Valentino, Daniel J.

2000-05-01

We used 3D modeling techniques to design and evaluate the ergonomics of diagnostic workstation and radiology reading room in the planning phase of building a new hospital at UCLA. Given serious space limitations, the challenge was to provide more optimal working environment for radiologists in a crowded and busy environment. A particular attention was given to flexibility, lighting condition and noise reduction in rooms shared by multiple users performing diagnostic tasks as well as regular clinical conferences. Re-engineering workspace ergonomics rely on the integration of new technologies, custom designed cabinets, indirect lighting, sound-absorbent partitioning and geometric arrangement of workstations to allow better privacy while optimizing space occupation. Innovations included adjustable flat monitors, integration of videoconferencing and voice recognition, control monitor and retractable keyboard for optimal space utilization. An overhead compartment protecting the monitors from ambient light is also used as accessory lightbox and rear-view projection screen for conferences.

Experimental Design and Data Analysis in Receiver Operating Characteristic Studies: Lessons Learned from Reports in Radiology from 1997 to 20061

PubMed Central

Shiraishi, Junji; Pesce, Lorenzo L.; Metz, Charles E.; Doi, Kunio

2009-01-01

Purpose: To provide a broad perspective concerning the recent use of receiver operating characteristic (ROC) analysis in medical imaging by reviewing ROC studies published in Radiology between 1997 and 2006 for experimental design, imaging modality, medical condition, and ROC paradigm. Materials and Methods: Two hundred ninety-five studies were obtained by conducting a literature search with PubMed with two criteria: publication in Radiology between 1997 and 2006 and occurrence of the phrase “receiver operating characteristic.” Studies returned by the query that were not diagnostic imaging procedure performance evaluations were excluded. Characteristics of the remaining studies were tabulated. Results: Two hundred thirty-three (79.0%) of the 295 studies reported findings based on observers' diagnostic judgments or objective measurements. Forty-three (14.6%) did not include human observers, with most of these reporting an evaluation of a computer-aided diagnosis system or functional data obtained with computed tomography (CT) or magnetic resonance (MR) imaging. The remaining 19 (6.4%) studies were classified as reviews or meta-analyses and were excluded from our subsequent analysis. Among the various imaging modalities, MR imaging (46.0%) and CT (25.7%) were investigated most frequently. Approximately 60% (144 of 233) of ROC studies with human observers published in Radiology included three or fewer observers. Conclusion: ROC analysis is widely used in radiologic research, confirming its fundamental role in assessing diagnostic performance. However, the ROC studies reported in Radiology were not always adequate to support clear and clinically relevant conclusions. © RSNA, 2009 Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.2533081632/-/DC1 PMID:19864510

Nanoparticles for multimodal in vivo imaging in nanomedicine

PubMed Central

Key, Jaehong; Leary, James F

2014-01-01

While nanoparticles are usually designed for targeted drug delivery, they can also simultaneously provide diagnostic information by a variety of in vivo imaging methods. These diagnostic capabilities make use of specific properties of nanoparticle core materials. Near-infrared fluorescent probes provide optical detection of cells targeted by real-time nanoparticle-distribution studies within the organ compartments of live, anesthetized animals. By combining different imaging modalities, we can start with deep-body imaging by magnetic resonance imaging or computed tomography, and by using optical imaging, get down to the resolution required for real-time fluorescence-guided surgery. PMID:24511229

Automated System of Diagnostic Monitoring at Bureya HPP Hydraulic Engineering Installations: a New Level of Safety

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

Musyurka, A. V., E-mail: musyurkaav@burges.rushydro.ru

This article presents the design, hardware, and software solutions developed and placed in service for the automated system of diagnostic monitoring (ASDM) for hydraulic engineering installations at the Bureya HPP, and assuring a reliable process for monitoring hydraulic engineering installations. Project implementation represents a timely solution of problems addressed by the hydraulic engineering installation diagnostics section.

Ultrasound for Distal Forearm Fracture: A Systematic Review and Diagnostic Meta-Analysis

PubMed Central

Douma-den Hamer, Djoke; Blanker, Marco H.; Edens, Mireille A.; Buijteweg, Lonneke N.; Boomsma, Martijn F.; van Helden, Sven H.; Mauritz, Gert-Jan

2016-01-01

Study Objective To determine the diagnostic accuracy of ultrasound for detecting distal forearm fractures. Methods A systematic review and diagnostic meta-analysis was performed according to the PRISMA statement. We searched MEDLINE, Web of Science and the Cochrane Library from inception to September 2015. All prospective studies of the diagnostic accuracy of ultrasound versus radiography as the reference standard were included. We excluded studies with a retrospective design and those with evidence of verification bias. We assessed the methodological quality of the included studies with the QUADAS-2 tool. We performed a meta-analysis of studies evaluating ultrasound to calculate the pooled sensitivity and specificity with 95% confidence intervals (CI95%) using a bivariate model with random effects. Subgroup and sensitivity analysis were used to examine the effect of methodological differences and other study characteristics. Results Out of 867 publications we included 16 studies with 1,204 patients and 641 fractures. The pooled test characteristics for ultrasound were: sensitivity 97% (CI95% 93–99%), specificity 95% (CI95% 89–98%), positive likelihood ratio (LR) 20.0 (8.5–47.2) and negative LR 0.03 (0.01–0.08). The corresponding pooled diagnostic odds ratio (DOR) was 667 (142–3,133). Apparent differences were shown for method of viewing, with the 6-view method showing higher specificity, positive LR, and DOR, compared to the 4-view method. Conclusion The present meta-analysis showed that ultrasound has a high accuracy for the diagnosis of distal forearm fractures in children when used by proper viewing method. Based on this, ultrasound should be considered a reliable alternative, which has the advantages of being radiation free. PMID:27196439

Insufficient evidence for the use of a physical examination to detect maltreatment in children without prior suspicion: a systematic review

PubMed Central

2013-01-01

Background Although it is often performed in clinical practice, the diagnostic value of a screening physical examination to detect maltreatment in children without prior suspicion has not been reviewed. This article aims to evaluate the diagnostic value of a complete physical examination as a screening instrument to detect maltreatment in children without prior suspicion. Methods We systematically searched the databases of MEDLINE, EMBASE, PsychINFO, CINAHL, and ERIC, using a sensitive search strategy. Studies that i) presented medical findings of a complete physical examination for screening purposes in children 0–18 years, ii) specifically recorded the presence or absence of signs of child maltreatment, and iii) recorded child maltreatment confirmed by a reference standard, were included. Two reviewers independently performed study selection, data extraction, and quality appraisal using the QUADAS-2 tool. Results The search yielded 4,499 titles, of which three studies met the eligibility criteria. The prevalence of confirmed signs of maltreatment during screening physical examination varied between 0.8% and 13.5%. The designs of the studies were inadequate to assess the diagnostic accuracy of a screening physical examination for child maltreatment. Conclusions Because of the lack of informative studies, we could not draw conclusions about the diagnostic value of a screening physical examination in children without prior suspicion of child maltreatment. PMID:24313949

Insufficient evidence for the use of a physical examination to detect maltreatment in children without prior suspicion: a systematic review.

PubMed

Hoytema van Konijnenburg, Eva Mm; Teeuw, Arianne H; Sieswerda-Hoogendoorn, Tessa; Leenders, Arnold G E; van der Lee, Johanna H

2013-12-06

Although it is often performed in clinical practice, the diagnostic value of a screening physical examination to detect maltreatment in children without prior suspicion has not been reviewed. This article aims to evaluate the diagnostic value of a complete physical examination as a screening instrument to detect maltreatment in children without prior suspicion. We systematically searched the databases of MEDLINE, EMBASE, PsychINFO, CINAHL, and ERIC, using a sensitive search strategy. Studies that i) presented medical findings of a complete physical examination for screening purposes in children 0-18 years, ii) specifically recorded the presence or absence of signs of child maltreatment, and iii) recorded child maltreatment confirmed by a reference standard, were included. Two reviewers independently performed study selection, data extraction, and quality appraisal using the QUADAS-2 tool. The search yielded 4,499 titles, of which three studies met the eligibility criteria. The prevalence of confirmed signs of maltreatment during screening physical examination varied between 0.8% and 13.5%. The designs of the studies were inadequate to assess the diagnostic accuracy of a screening physical examination for child maltreatment. Because of the lack of informative studies, we could not draw conclusions about the diagnostic value of a screening physical examination in children without prior suspicion of child maltreatment.

Tissue classification and diagnostics using a fiber probe for combined Raman and fluorescence spectroscopy

NASA Astrophysics Data System (ADS)

Cicchi, Riccardo; Anand, Suresh; Rossari, Susanna; Sturiale, Alessandro; Giordano, Flavio; De Giorgi, Vincenzo; Maio, Vincenza; Massi, Daniela; Nesi, Gabriella; Buccoliero, Anna Maria; Tonelli, Francesco; Guerrini, Renzo; Pimpinelli, Nicola; Pavone, Francesco S.

2015-03-01

Two different optical fiber probes for combined Raman and fluorescence spectroscopic measurements were designed, developed and used for tissue diagnostics. Two visible laser diodes were used for fluorescence spectroscopy, whereas a laser diode emitting in the NIR was used for Raman spectroscopy. The two probes were based on fiber bundles with a central multimode optical fiber, used for delivering light to the tissue, and 24 surrounding optical fibers for signal collection. Both fluorescence and Raman spectra were acquired using the same detection unit, based on a cooled CCD camera, connected to a spectrograph. The two probes were successfully employed for diagnostic purposes on various tissues in a good agreement with common routine histology. This study included skin, brain and bladder tissues and in particular the classification of: malignant melanoma against melanocytic lesions and healthy skin; urothelial carcinoma against healthy bladder mucosa; brain tumor against dysplastic brain tissue. The diagnostic capabilities were determined using a cross-validation method with a leave-one-out approach, finding very high sensitivity and specificity for all the examined tissues. The obtained results demonstrated that the multimodal approach is crucial for improving diagnostic capabilities. The system presented here can improve diagnostic capabilities on a broad range of tissues and has the potential of being used for endoscopic inspections in the near future.

Tissue classification and diagnostics using a fiber probe for combined Raman and fluorescence spectroscopy

NASA Astrophysics Data System (ADS)

Cicchi, Riccardo; Anand, Suresh; Crisci, Alfonso; Giordano, Flavio; Rossari, Susanna; De Giorgi, Vincenzo; Maio, Vincenza; Massi, Daniela; Nesi, Gabriella; Buccoliero, Anna Maria; Guerrini, Renzo; Pimpinelli, Nicola; Pavone, Francesco S.

2015-07-01

Two different optical fiber probes for combined Raman and fluorescence spectroscopic measurements were designed, developed and used for tissue diagnostics. Two visible laser diodes were used for fluorescence spectroscopy, whereas a laser diode emitting in the NIR was used for Raman spectroscopy. The two probes were based on fiber bundles with a central multimode optical fiber, used for delivering light to the tissue, and 24 surrounding optical fibers for signal collection. Both fluorescence and Raman spectra were acquired using the same detection unit, based on a cooled CCD camera, connected to a spectrograph. The two probes were successfully employed for diagnostic purposes on various tissues in a good agreement with common routine histology. This study included skin, brain and bladder tissues and in particular the classification of: malignant melanoma against melanocytic lesions and healthy skin; urothelial carcinoma against healthy bladder mucosa; brain tumor against dysplastic brain tissue. The diagnostic capabilities were determined using a cross-validation method with a leave-one-out approach, finding very high sensitivity and specificity for all the examined tissues. The obtained results demonstrated that the multimodal approach is crucial for improving diagnostic capabilities. The system presented here can improve diagnostic capabilities on a broad range of tissues and has the potential of being used for endoscopic inspections in the near future.

Isothermal multiple displacement amplification: a methodical approach enhancing molecular routine diagnostics of microcarcinomas and small biopsies.

PubMed

Mairinger, Fabian D; Walter, Robert Fh; Vollbrecht, Claudia; Hager, Thomas; Worm, Karl; Ting, Saskia; Wohlschläger, Jeremias; Zarogoulidis, Paul; Zarogoulidis, Konstantinos; Schmid, Kurt W

2014-01-01

Isothermal multiple displacement amplification (IMDA) can be a powerful tool in molecular routine diagnostics for homogeneous and sequence-independent whole-genome amplification of notably small tumor samples, eg, microcarcinomas and biopsies containing a small amount of tumor. Currently, this method is not well established in pathology laboratories. We designed a study to confirm the feasibility and convenience of this method for routine diagnostics with formalin-fixed, paraffin-embedded samples prepared by laser-capture microdissection. A total of 250 μg DNA (concentration 5 μg/μL) was generated by amplification over a period of 8 hours with a material input of approximately 25 cells, approximately equivalent to 175 pg of genomic DNA. In the generated DNA, a representation of all chromosomes could be shown and the presence of elected genes relevant for diagnosis in clinical samples could be proven. Mutational analysis of clinical samples could be performed without any difficulty and showed concordance with earlier diagnostic findings. We established the feasibility and convenience of IMDA for routine diagnostics. We also showed that small amounts of DNA, which were not analyzable with current molecular methods, could be sufficient for a wide field of applications in molecular routine diagnostics when they are preamplified with IMDA.

Validation of N-glycan markers that improve the performance of CA19-9 in pancreatic cancer.

PubMed

Zhao, Yun-Peng; Zhou, Ping-Ting; Ji, Wei-Ping; Wang, Hao; Fang, Meng; Wang, Meng-Meng; Yin, Yue-Peng; Jin, Gang; Gao, Chun-Fang

2017-02-01

Pancreatic cancer (PC) has a high mortality rate because it is usually diagnosed late. Glycosylation of proteins is known to change in tumor cells during the development of PC. The objectives of this study were to identify and validate the diagnostic value of novel biomarkers based on N-glycomic profiling for PC. In total, 217 individuals including subjects with PC, pancreatitis, and healthy controls were divided randomly into a training group (n = 164) and validation groups (n = 53). Serum N-glycomic profiling was analyzed by DSA-FACE. The diagnostic model was constructed based on N-glycan markers with logistic stepwise regression. The diagnostic performance of the model was assessed further in validation cohort. The level of total core fucose residues was increased significantly in PC. Two diagnostic models designated GlycoPCtest and PCmodel (combining GlycoPCtest and CA19-9) were constructed to differentiate PC from normal. The area under the receiver operating characteristic curve (AUC) of PCmodel was higher than that of CA19-9 (0.925 vs. 0.878). The diagnostic models based on N-glycans are new, valuable, noninvasive alternatives for identifying PC. The diagnostic efficacy is improved by combined GlycoPCtest and CA19-9 for the discrimination of patients with PC from healthy controls.

Autoimmune diagnostics: the technology, the strategy and the clinical governance.

PubMed

Bizzaro, Nicola; Tozzoli, Renato; Villalta, Danilo

2015-02-01

In recent years, there has been a profound change in autoimmune diagnostics. From long, tiring and inaccurate manual methods, the art of diagnostics has turned to modern, rapid and automated technology. New antibody tests have been developed, and almost all autoimmune diseases now have some specific diagnostic markers. The current need to make the most of available economic and human resources has led to the production of diagnostic algorithms and guidelines designated for optimal strategic use of the tests and to increase the diagnostic appropriateness. An important role in this scenario was assumed by the laboratory autoimmunologist, whose task is not only to govern the analytical phase, but also to help clinicians in correctly choosing the most suitable test for each clinical situation and provide consultancy support. In this review, we summarize recent advances in technology, describe the diagnostic strategies and highlight the current role of the laboratory autoimmunologist in the clinical governance of autoimmune diagnostics.

Quantifying Attitude to Chemistry in Students at the University of the South Pacific

ERIC Educational Resources Information Center

Brown, S. J.; Sharma, B. N.; Wakeling, L.; Naiker, M.; Chandra, S.; Gopalan, R. D.; Bilimoria, V. B.

2014-01-01

The attitude towards the study of chemistry for new entrant chemistry students from a multi-national, regional, tertiary educational institution in the South Pacific was investigated using a purpose-designed diagnostic instrument. The Attitude toward the Study of Chemistry Inventory (ASCI) was used to quantify attitude in a cohort of first year…

"Psych-Out": Using a Team-Based Game to Teach Diagnosis and Interventions

ERIC Educational Resources Information Center

Pearson, Quinn M.; Townsend, Karen M.

2012-01-01

"Psych-Out" is a team-based game designed to motivate graduate counseling students to study diagnostic symptoms and related interventions associated with reading assignments. At least 83% of students agreed or strongly agreed that the game contributed to their enjoyment of the class, increased their motivation to study for class, and contributed…

Cell separation using tilted-angle standing surface acoustic waves

PubMed Central

Ding, Xiaoyun; Peng, Zhangli; Lin, Sz-Chin Steven; Geri, Michela; Li, Sixing; Li, Peng; Chen, Yuchao; Dao, Ming; Suresh, Subra; Huang, Tony Jun

2014-01-01

Separation of cells is a critical process for studying cell properties, disease diagnostics, and therapeutics. Cell sorting by acoustic waves offers a means to separate cells on the basis of their size and physical properties in a label-free, contactless, and biocompatible manner. The separation sensitivity and efficiency of currently available acoustic-based approaches, however, are limited, thereby restricting their widespread application in research and health diagnostics. In this work, we introduce a unique configuration of tilted-angle standing surface acoustic waves (taSSAW), which are oriented at an optimally designed inclination to the flow direction in the microfluidic channel. We demonstrate that this design significantly improves the efficiency and sensitivity of acoustic separation techniques. To optimize our device design, we carried out systematic simulations of cell trajectories, matching closely with experimental results. Using numerically optimized design of taSSAW, we successfully separated 2- and 10-µm-diameter polystyrene beads with a separation efficiency of ∼99%, and separated 7.3- and 9.9-µm-polystyrene beads with an efficiency of ∼97%. We illustrate that taSSAW is capable of effectively separating particles–cells of approximately the same size and density but different compressibility. Finally, we demonstrate the effectiveness of the present technique for biological–biomedical applications by sorting MCF-7 human breast cancer cells from nonmalignant leukocytes, while preserving the integrity of the separated cells. The method introduced here thus offers a unique route for separating circulating tumor cells, and for label-free cell separation with potential applications in biological research, disease diagnostics, and clinical practice. PMID:25157150

Cell separation using tilted-angle standing surface acoustic waves.

PubMed

Ding, Xiaoyun; Peng, Zhangli; Lin, Sz-Chin Steven; Geri, Michela; Li, Sixing; Li, Peng; Chen, Yuchao; Dao, Ming; Suresh, Subra; Huang, Tony Jun

2014-09-09

Separation of cells is a critical process for studying cell properties, disease diagnostics, and therapeutics. Cell sorting by acoustic waves offers a means to separate cells on the basis of their size and physical properties in a label-free, contactless, and biocompatible manner. The separation sensitivity and efficiency of currently available acoustic-based approaches, however, are limited, thereby restricting their widespread application in research and health diagnostics. In this work, we introduce a unique configuration of tilted-angle standing surface acoustic waves (taSSAW), which are oriented at an optimally designed inclination to the flow direction in the microfluidic channel. We demonstrate that this design significantly improves the efficiency and sensitivity of acoustic separation techniques. To optimize our device design, we carried out systematic simulations of cell trajectories, matching closely with experimental results. Using numerically optimized design of taSSAW, we successfully separated 2- and 10-µm-diameter polystyrene beads with a separation efficiency of ∼ 99%, and separated 7.3- and 9.9-µm-polystyrene beads with an efficiency of ∼ 97%. We illustrate that taSSAW is capable of effectively separating particles-cells of approximately the same size and density but different compressibility. Finally, we demonstrate the effectiveness of the present technique for biological-biomedical applications by sorting MCF-7 human breast cancer cells from nonmalignant leukocytes, while preserving the integrity of the separated cells. The method introduced here thus offers a unique route for separating circulating tumor cells, and for label-free cell separation with potential applications in biological research, disease diagnostics, and clinical practice.

Multi-scale Modeling of the Cardiovascular System: Disease Development, Progression, and Clinical Intervention.

PubMed

Zhang, Yanhang; Barocas, Victor H; Berceli, Scott A; Clancy, Colleen E; Eckmann, David M; Garbey, Marc; Kassab, Ghassan S; Lochner, Donna R; McCulloch, Andrew D; Tran-Son-Tay, Roger; Trayanova, Natalia A

2016-09-01

Cardiovascular diseases (CVDs) are the leading cause of death in the western world. With the current development of clinical diagnostics to more accurately measure the extent and specifics of CVDs, a laudable goal is a better understanding of the structure-function relation in the cardiovascular system. Much of this fundamental understanding comes from the development and study of models that integrate biology, medicine, imaging, and biomechanics. Information from these models provides guidance for developing diagnostics, and implementation of these diagnostics to the clinical setting, in turn, provides data for refining the models. In this review, we introduce multi-scale and multi-physical models for understanding disease development, progression, and designing clinical interventions. We begin with multi-scale models of cardiac electrophysiology and mechanics for diagnosis, clinical decision support, personalized and precision medicine in cardiology with examples in arrhythmia and heart failure. We then introduce computational models of vasculature mechanics and associated mechanical forces for understanding vascular disease progression, designing clinical interventions, and elucidating mechanisms that underlie diverse vascular conditions. We conclude with a discussion of barriers that must be overcome to provide enhanced insights, predictions, and decisions in pre-clinical and clinical applications.

Multi-scale Modeling of the Cardiovascular System: Disease Development, Progression, and Clinical Intervention

PubMed Central

Zhang, Yanhang; Barocas, Victor H.; Berceli, Scott A.; Clancy, Colleen E.; Eckmann, David M.; Garbey, Marc; Kassab, Ghassan S.; Lochner, Donna R.; McCulloch, Andrew D.; Tran-Son-Tay, Roger; Trayanova, Natalia A.

2016-01-01

Cardiovascular diseases (CVDs) are the leading cause of death in the western world. With the current development of clinical diagnostics to more accurately measure the extent and specifics of CVDs, a laudable goal is a better understanding of the structure-function relation in the cardiovascular system. Much of this fundamental understanding comes from the development and study of models that integrate biology, medicine, imaging, and biomechanics. Information from these models provides guidance for developing diagnostics, and implementation of these diagnostics to the clinical setting, in turn, provides data for refining the models. In this review, we introduce multi-scale and multi-physical models for understanding disease development, progression, and designing clinical interventions. We begin with multi-scale models of cardiac electrophysiology and mechanics for diagnosis, clinical decision support, personalized and precision medicine in cardiology with examples in arrhythmia and heart failure. We then introduce computational models of vasculature mechanics and associated mechanical forces for understanding vascular disease progression, designing clinical interventions, and elucidating mechanisms that underlie diverse vascular conditions. We conclude with a discussion of barriers that must be overcome to provide enhanced insights, predictions, and decisions in pre-clinical and clinical applications. PMID:27138523

A Diagnostic Assessment of Evolutionary Multiobjective Optimization for Water Resources Systems

NASA Astrophysics Data System (ADS)

Reed, P.; Hadka, D.; Herman, J.; Kasprzyk, J.; Kollat, J.

2012-04-01

This study contributes a rigorous diagnostic assessment of state-of-the-art multiobjective evolutionary algorithms (MOEAs) and highlights key advances that the water resources field can exploit to better discover the critical tradeoffs constraining our systems. This study provides the most comprehensive diagnostic assessment of MOEAs for water resources to date, exploiting more than 100,000 MOEA runs and trillions of design evaluations. The diagnostic assessment measures the effectiveness, efficiency, reliability, and controllability of ten benchmark MOEAs for a representative suite of water resources applications addressing rainfall-runoff calibration, long-term groundwater monitoring (LTM), and risk-based water supply portfolio planning. The suite of problems encompasses a range of challenging problem properties including (1) many-objective formulations with 4 or more objectives, (2) multi-modality (or false optima), (3) nonlinearity, (4) discreteness, (5) severe constraints, (6) stochastic objectives, and (7) non-separability (also called epistasis). The applications are representative of the dominant problem classes that have shaped the history of MOEAs in water resources and that will be dominant foci in the future. Recommendations are provided for which modern MOEAs should serve as tools and benchmarks in the future water resources literature.

Impact of lossy compression on diagnostic accuracy of radiographs for periapical lesions

NASA Technical Reports Server (NTRS)

Eraso, Francisco E.; Analoui, Mostafa; Watson, Andrew B.; Rebeschini, Regina

2002-01-01

OBJECTIVES: The purpose of this study was to evaluate the lossy Joint Photographic Experts Group compression for endodontic pretreatment digital radiographs. STUDY DESIGN: Fifty clinical charge-coupled device-based, digital radiographs depicting periapical areas were selected. Each image was compressed at 2, 4, 8, 16, 32, 48, and 64 compression ratios. One root per image was marked for examination. Images were randomized and viewed by four clinical observers under standardized viewing conditions. Each observer read the image set three times, with at least two weeks between each reading. Three pre-selected sites per image (mesial, distal, apical) were scored on a five-scale score confidence scale. A panel of three examiners scored the uncompressed images, with a consensus score for each site. The consensus score was used as the baseline for assessing the impact of lossy compression on the diagnostic values of images. The mean absolute error between consensus and observer scores was computed for each observer, site, and reading session. RESULTS: Balanced one-way analysis of variance for all observers indicated that for compression ratios 48 and 64, there was significant difference between mean absolute error of uncompressed and compressed images (P <.05). After converting the five-scale score to two-level diagnostic values, the diagnostic accuracy was strongly correlated (R (2) = 0.91) with the compression ratio. CONCLUSION: The results of this study suggest that high compression ratios can have a severe impact on the diagnostic quality of the digital radiographs for detection of periapical lesions.

Accuracy of clinical tests in the diagnosis of anterior cruciate ligament injury: a systematic review

PubMed Central

2014-01-01

Background Numerous clinical tests are used in the diagnosis of anterior cruciate ligament (ACL) injury but their accuracy is unclear. The purpose of this study is to evaluate the diagnostic accuracy of clinical tests for the diagnosis of ACL injury. Methods Study Design: Systematic review. The review protocol was registered through PROSPERO (CRD42012002069). Electronic databases (PubMed, MEDLINE, EMBASE, CINAHL) were searched up to 19th of June 2013 to identify diagnostic studies comparing the accuracy of clinical tests for ACL injury to an acceptable reference standard (arthroscopy, arthrotomy, or MRI). Risk of bias was appraised using the QUADAS-2 checklist. Index test accuracy was evaluated using a descriptive analysis of paired likelihood ratios and displayed as forest plots. Results A total of 285 full-text articles were assessed for eligibility, from which 14 studies were included in this review. Included studies were deemed to be clinically and statistically heterogeneous, so a meta-analysis was not performed. Nine clinical tests from the history (popping sound at time of injury, giving way, effusion, pain, ability to continue activity) and four from physical examination (anterior draw test, Lachman’s test, prone Lachman’s test and pivot shift test) were investigated for diagnostic accuracy. Inspection of positive and negative likelihood ratios indicated that none of the individual tests provide useful diagnostic information in a clinical setting. Most studies were at risk of bias and reported imprecise estimates of diagnostic accuracy. Conclusion Despite being widely used and accepted in clinical practice, the results of individual history items or physical tests do not meaningfully change the probability of ACL injury. In contrast combinations of tests have higher diagnostic accuracy; however the most accurate combination of clinical tests remains an area for future research. Clinical relevance Clinicians should be aware of the limitations associated with the use of clinical tests for diagnosis of ACL injury. PMID:25187877

Modeling Complex Workflow in Molecular Diagnostics

PubMed Central

Gomah, Mohamed E.; Turley, James P.; Lu, Huimin; Jones, Dan

2010-01-01

One of the hurdles to achieving personalized medicine has been implementing the laboratory processes for performing and reporting complex molecular tests. The rapidly changing test rosters and complex analysis platforms in molecular diagnostics have meant that many clinical laboratories still use labor-intensive manual processing and testing without the level of automation seen in high-volume chemistry and hematology testing. We provide here a discussion of design requirements and the results of implementation of a suite of lab management tools that incorporate the many elements required for use of molecular diagnostics in personalized medicine, particularly in cancer. These applications provide the functionality required for sample accessioning and tracking, material generation, and testing that are particular to the evolving needs of individualized molecular diagnostics. On implementation, the applications described here resulted in improvements in the turn-around time for reporting of more complex molecular test sets, and significant changes in the workflow. Therefore, careful mapping of workflow can permit design of software applications that simplify even the complex demands of specialized molecular testing. By incorporating design features for order review, software tools can permit a more personalized approach to sample handling and test selection without compromising efficiency. PMID:20007844

UWGSP6: a diagnostic radiology workstation of the future

NASA Astrophysics Data System (ADS)

Milton, Stuart W.; Han, Sang; Choi, Hyung-Sik; Kim, Yongmin

1993-06-01

The Univ. of Washington's Image Computing Systems Lab. (ICSL) has been involved in research into the development of a series of PACS workstations since the middle 1980's. The most recent research, a joint UW-IBM project, attempted to create a diagnostic radiology workstation using an IBM RISC System 6000 (RS6000) computer workstation and the X-Window system. While the results are encouraging, there are inherent limitations in the workstation hardware which prevent it from providing an acceptable level of functionality for diagnostic radiology. Realizing the RS6000 workstation's limitations, a parallel effort was initiated to design a workstation, UWGSP6 (Univ. of Washington Graphics System Processor #6), that provides the required functionality. This paper documents the design of UWGSP6, which not only addresses the requirements for a diagnostic radiology workstation in terms of display resolution, response time, etc., but also includes the processing performance necessary to support key functions needed in the implementation of algorithms for computer-aided diagnosis. The paper includes a description of the workstation architecture, and specifically its image processing subsystem. Verification of the design through hardware simulation is then discussed, and finally, performance of selected algorithms based on detailed simulation is provided.

Proceedings of Workshop on Laser Diagnostics in Fluid Mechanics and Combustion

NASA Astrophysics Data System (ADS)

1993-10-01

Proceedings of the Workshop on Laser Diagnostics in Fluid Mechanics and Combustion are presented. Topics included are: Accuracy of Laser Doppler Anemometry; Applications of Raman-Rayleigh-LIF Diagnostics in Combustion Research; Phase Doppler Anemometer Technique Concepts and Applications; CARS; Particle Image Velocimetry; Practical Consideration in the Use and Design of Laser Velocimetry Systems in Turbomachinery Applications; Phase Doppler Measurements of Gas-Particle Flow Through a Tube Bank; Degenerate Four Wave Mixing for Shock Tunnel Studies of Supersonic Combustion; Laser Induced Photodissociation and Fluorescence (LIPF) of Sodium Species Present in Coal Combustion; 3D Holographic Measurements Inside a Spark Ignition Engine; Laser Doppler Velocimeter Measurements in Compressible Flow; Bursting in a Tornado Vortex; Quantitative Imaging of OH and Temperature Using a Single Laser Source and Single Intensified Camera; and Laser Doppler Measurements Inside an Artificial Heart Valve.

Power Balance Analysis of the Prototype-Material Plasma Exposure eXperiment

NASA Astrophysics Data System (ADS)

Showers, M. A.; Biewer, T. M.; Caneses, J. F.; Caughman, J. B. O.; Lumsdaine, A.; Owen, L.; Rapp, J.; Youchison, D.; Beers, C. J.; Donovan, D. C.; Kafle, N.; Ray, H. B.

2017-10-01

The Prototype-Material Plasma Exposure eXperiment (Proto-MPEX) is a test bed for the plasma source concept for the planned Material Plasma Exposure eXperiment (MPEX), a steady-state linear device studying plasma material interactions for fusion reactors. A power balance of Proto-MPEX attempts to identify machine operating parameters that will improve Proto-MPEX's performance, potentially impacting the MPEX design concept. A power balance has been performed utilizing an extensive diagnostic suite to identify mechanisms and locations of power loss from the main plasma. The diagnostic package includes infrared cameras, double Langmuir probes, fluoroptic probes, Mach probes, a Thomson scattering diagnostic, a McPherson spectrometer and in-vessel thermocouples. Radiation losses are estimated with absolute calibrated spectroscopic signals. This work was supported by the U.S. D.O.E. contract DE-AC05-00OR22725.

Protocol for accuracy of point of care (POC) or in-office urine drug testing (immunoassay) in chronic pain patients: a prospective analysis of immunoassay and liquid chromatography tandem mass spectometry (LC/MS/MS).

PubMed

Manchikanti, Laxmaiah; Malla, Yogesh; Wargo, Bradley W; Cash, Kimberly A; Pampati, Vidyasagar; Damron, Kim S; McManus, Carla D; Brandon, Doris E

2010-01-01

Therapeutic use, overuse, abuse, and diversion of controlled substances in managing chronic non-cancer pain continues to be an issue for physicians and patients. It has been stated that physicians, along with the public and federal, state, and local government; professional associations; and pharmaceutical companies all share responsibility for preventing abuse of controlled prescription drugs. The challenge is to eliminate or significantly curtail abuse of controlled prescription drugs while still assuring the proper treatment of those patients. A number of techniques, instruments, and tools have been described to monitor controlled substance use and abuse. Thus, multiple techniques and tools available for adherence monitoring include urine drug testing in conjunction with prescription monitoring programs and other screening tests. However, urine drug testing is associated with multiple methodological flaws. Multiple authors have provided conflicting results in relation to diagnostic accuracy with differing opinions about how to monitor adherence in a non-systematic fashion. Thus far, there have not been any studies systematically assessing the diagnostic accuracy of immunoassay with laboratory testing. A diagnostic accuracy study of urine drug testing. An interventional pain management practice, a specialty referral center, a private practice setting in the United States. To compare the information obtained by point of care (POC) or in-office urine drug testing (index test) to the information found when all drugs and analytes are tested by liquid chromatography tandem mass spectroscopy (LC/MS/MS) reference test in the same urine sample. The study is designed to include 1,000 patients with chronic pain receiving controlled substances. The primary outcome measure is the diagnostic accuracy. Patients will be tested for various controlled substances, including opioids, benzodiazepines, and illicit drugs. The diagnostic accuracy study is performed utilizing the Standards for Reporting of Diagnostic Accuracy Studies (STARD) initiative which established reporting guidelines for diagnostic accuracy studies to improve the quality of reporting. The prototypical flow diagram of diagnostic accuracy study as described by STARD will be utilized. Results of diagnostic accuracy and correlation of clinical factors in relation to threshold levels, prevalence of abuse, false-positives, false-negatives, influence of other drugs, and demographic characteristics will be calculated. The limitations include lack of availability of POC testing with lower cutoff levels. This article presents a protocol for a diagnostic accuracy study of urine drug testing. The protocol also will permit correlation of various clinical factors in relation to threshold levels, prevalence of abuse, false-positives, false-negatives, influence of other drugs, and demographic characteristics. NCT 01052155.

Eponymous Psychiatric Syndromes Revisited.

PubMed

Naguy, Ahmed

2018-02-22

This report provides an anthology of psychiatric eponyms. Clinically, many of these described syndromes represent valid diagnostic constructs and may accommodate the atypical cases that defy the official diagnostic designation in the current classificatory systems in psychiatry. © Copyright 2018 Physicians Postgraduate Press, Inc.

Verification bias an underrecognized source of error in assessing the efficacy of medical imaging.

PubMed

Petscavage, Jonelle M; Richardson, Michael L; Carr, Robert B

2011-03-01

Diagnostic tests are validated by comparison against a "gold standard" reference test. When the reference test is invasive or expensive, it may not be applied to all patients. This can result in biased estimates of the sensitivity and specificity of the diagnostic test. This type of bias is called "verification bias," and is a common problem in imaging research. The purpose of our study is to estimate the prevalence of verification bias in the recent radiology literature. All issues of the American Journal of Roentgenology (AJR), Academic Radiology, Radiology, and European Journal of Radiology (EJR) between November 2006 and October 2009 were reviewed for original research articles mentioning sensitivity or specificity as endpoints. Articles were read to determine whether verification bias was present and searched for author recognition of verification bias in the design. During 3 years, these journals published 2969 original research articles. A total of 776 articles used sensitivity or specificity as an outcome. Of these, 211 articles demonstrated potential verification bias. The fraction of articles with potential bias was respectively 36.4%, 23.4%, 29.5%, and 13.4% for AJR, Academic Radiology, Radiology, and EJR. The total fraction of papers with potential bias in which the authors acknowledged this bias was 17.1%. Verification bias is a common and frequently unacknowledged source of error in efficacy studies of diagnostic imaging. Bias can often be eliminated by proper study design. When it cannot be eliminated, it should be estimated and acknowledged. Published by Elsevier Inc.

[Evaluation (assessment) of three tests for diagnosis of geohelmints in Colombia].

PubMed

López, Myriam Consuelo; Moncada, Ligia Inés; Ariza-Araújo, Yoseth; Fernández-Niño, Julián Alfredo; Reyes, Patricia; Nicholls, Rubén Santiago

2013-01-01

Soil-transmitted helminth infections are considered a public health problem in developing countries. The diagnostic tests, both for individual parient diagnosis as for population studies should be evaluated in terms of validity and reliability. To compare the direct examination, the modified Ritchie-Frick method, a Kato-Katz designed by a Brazilian group and one designed by the WHO, for the diagnosis of soil-transmitted helminthes. A diagnostic test reliability study was performed. The same stool sample was analyzed by the same observer using four diagnostic tests. 204 samples were obtained, 194 of those fulfilled the inclusion criteria and were analyzed. The observers did not know the participants' identity neither the other tests results. For the analysis the Kato-Katz (WHO) was considered as the gold standard. For the reliability assessment percent agreement, positive percent agreement, Kappa statistic, and intraclass correlation were performed. The Brazilian Kato-Katz showed a good performance with high sensitivity and specificity for T. trichiura and Hookworm with values of 0.97 and 0.96 respectively, and a high specificity with mild sensitivity for A. lumbricoides (0.95 and 0.79) meanwhile the direct examination and the Ritche-Frick method showed a performance between mild and poor. The differences were higher for hookworm and Trichiuris trichiura than for Ascaris lumbricoides. The Brazilian Kato Katz test could be implemented, but further studies are needed to correlate its operative capacity with its feasibility, availability and cost.

Intraoral ultrasonography: development of a specific high-frequency probe and clinical pilot study.

PubMed

Salmon, Benjamin; Le Denmat, Dominique

2012-04-01

Although ultrasonography is a non-invasive, inexpensive and painless diagnostic tool for soft tissue imaging, this technique is not currently used for oral exploration. Therefore, we developed a 25-MHz high-frequency ultrasound probe, specially designed for intraoral applications. This paper aims to present clinical intraoral ultrasound images actually interpretable, in order to identify the relevant applications of this novel tool and to design future oral studies. Two independent radiologists performed ultrasound examinations on three healthy volunteers. All the teeth were explored on the lingual and buccal sides (162 samples) to evaluate the ergonomics of the system and the visualisation of anatomic structures. Osseointegrated dental implants and a mucocele were also scanned. At the gingivodental junction of the maxillary and mandibular teeth, the device clearly identifies the tooth surfaces, the alveolar bone reflection with its surrounding subepithelial connective tissue of the gingiva and the gingival epithelia. The bone level and the thickness of soft tissue around the implant are measurable on the buccal and lingual sides. Therefore, intraoral ultrasonography provides additional morphological information that is not accessible by conventional dental x-rays. We propose a novel diagnostic tool that explores the biological width and is able to define the thin or thick nature of the gums. Moreover, intraoral ultrasonography may help to monitor precancerous lesions. This promising device requires large-scale clinical studies to determine whether it should remain a research tool or be used as a diagnostic tool for daily dental practice.

Debris and shrapnel assessments for National Ignition Facility targets and diagnostics

NASA Astrophysics Data System (ADS)

Masters, N. D.; Fisher, A.; Kalantar, D.; Stölken, J.; Smith, C.; Vignes, R.; Burns, S.; Doeppner, T.; Kritcher, A.; Park, H.-S.

2016-05-01

High-energy laser experiments at the National Ignition Facility (NIF) can create debris and shrapnel capable of damaging laser optics and diagnostic instruments. The size, composition and location of target components and sacrificial shielding (e.g., disposable debris shields, or diagnostic filters) and the protection they provide is constrained by many factors, including: chamber and diagnostic geometries, experimental goals and material considerations. An assessment of the generation, nature and velocity of shrapnel and debris and their potential threats is necessary prior to fielding targets or diagnostics. These assessments may influence target and shielding design, filter configurations and diagnostic selection. This paper will outline the approach used to manage the debris and shrapnel risk associated with NIF targets and diagnostics and present some aspects of two such cases: the Material Strength Rayleigh- Taylor campaign and the Mono Angle Crystal Spectrometer (MACS).

Radiation effects in IFMIF Li target diagnostic systems

NASA Astrophysics Data System (ADS)

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

2009-04-01

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

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 value of soluble triggering receptor expressed on myeloid cells in paediatric sepsis: a systematic review.

PubMed

Pontrelli, Giuseppe; De Crescenzo, Franco; Buzzetti, Roberto; Calò Carducci, Francesca; Jenkner, Alessandro; Amodio, Donato; De Luca, Maia; Chiurchiù, Sara; Davies, Elin Haf; Simonetti, Alessandra; Ferretti, Elena; Della Corte, Martina; Gramatica, Luca; Livadiotti, Susanna; Rossi, Paolo

2016-04-27

Differential diagnosis between sepsis and non-infectious inflammatory disorders demands improved biomarkers. Soluble Triggering Receptor Expression on Myeloid cells (sTREM-1) is an activating receptor whose role has been studied throughout the last decade. We performed a systematic review to evaluate the accuracy of plasma sTREM-1 levels in the diagnosis of sepsis in children with Systemic Inflammatory Response Syndrome (SIRS). A literature search of PubMed, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and ISI Web of Knowledge databases was performed using specific search terms. Studies were included if they assessed the diagnostic accuracy of plasma sTREM-1 for sepsis in paediatric patients with SIRS. Data on sensitivity, specificity, positive predictive value, negative predictive value, area under receiver operating characteristic curve were extracted. The methodological quality of each study was assessed using a checklist based on the Quality Assessment Tool for Diagnostic Accuracy Studies. Nine studies comprising 961 patients were included, four of which were in newborns, three in children and two in children with febrile neutropenia. Some data from single studies support a role of sTREM-1 as a diagnostic tool in pediatric sepsis, but cannot be considered conclusive, because a quantitative synthesis was not possible, due to heterogeneity in studies design. This systematic review suggests that available data are insufficient to support a role for sTREM in the diagnosis and follow-up of paediatric sepsis.

Exploration of Analysis Methods for Diagnostic Imaging Tests: Problems with ROC AUC and Confidence Scores in CT Colonography

PubMed Central

Mallett, Susan; Halligan, Steve; Collins, Gary S.; Altman, Doug G.

2014-01-01

Background Different methods of evaluating diagnostic performance when comparing diagnostic tests may lead to different results. We compared two such approaches, sensitivity and specificity with area under the Receiver Operating Characteristic Curve (ROC AUC) for the evaluation of CT colonography for the detection of polyps, either with or without computer assisted detection. Methods In a multireader multicase study of 10 readers and 107 cases we compared sensitivity and specificity, using radiological reporting of the presence or absence of polyps, to ROC AUC calculated from confidence scores concerning the presence of polyps. Both methods were assessed against a reference standard. Here we focus on five readers, selected to illustrate issues in design and analysis. We compared diagnostic measures within readers, showing that differences in results are due to statistical methods. Results Reader performance varied widely depending on whether sensitivity and specificity or ROC AUC was used. There were problems using confidence scores; in assigning scores to all cases; in use of zero scores when no polyps were identified; the bimodal non-normal distribution of scores; fitting ROC curves due to extrapolation beyond the study data; and the undue influence of a few false positive results. Variation due to use of different ROC methods exceeded differences between test results for ROC AUC. Conclusions The confidence scores recorded in our study violated many assumptions of ROC AUC methods, rendering these methods inappropriate. The problems we identified will apply to other detection studies using confidence scores. We found sensitivity and specificity were a more reliable and clinically appropriate method to compare diagnostic tests. PMID:25353643

Exploration of analysis methods for diagnostic imaging tests: problems with ROC AUC and confidence scores in CT colonography.

PubMed

Mallett, Susan; Halligan, Steve; Collins, Gary S; Altman, Doug G

2014-01-01

Different methods of evaluating diagnostic performance when comparing diagnostic tests may lead to different results. We compared two such approaches, sensitivity and specificity with area under the Receiver Operating Characteristic Curve (ROC AUC) for the evaluation of CT colonography for the detection of polyps, either with or without computer assisted detection. In a multireader multicase study of 10 readers and 107 cases we compared sensitivity and specificity, using radiological reporting of the presence or absence of polyps, to ROC AUC calculated from confidence scores concerning the presence of polyps. Both methods were assessed against a reference standard. Here we focus on five readers, selected to illustrate issues in design and analysis. We compared diagnostic measures within readers, showing that differences in results are due to statistical methods. Reader performance varied widely depending on whether sensitivity and specificity or ROC AUC was used. There were problems using confidence scores; in assigning scores to all cases; in use of zero scores when no polyps were identified; the bimodal non-normal distribution of scores; fitting ROC curves due to extrapolation beyond the study data; and the undue influence of a few false positive results. Variation due to use of different ROC methods exceeded differences between test results for ROC AUC. The confidence scores recorded in our study violated many assumptions of ROC AUC methods, rendering these methods inappropriate. The problems we identified will apply to other detection studies using confidence scores. We found sensitivity and specificity were a more reliable and clinically appropriate method to compare diagnostic tests.

Measuring the Diagnostic Features of Social (Pragmatic) Communication Disorder: An Exploratory Study.

PubMed

Yuan, Haiying; Dollaghan, Christine

2018-03-27

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition introduced a new neurodevelopmental disorder, social (pragmatic) communication disorder (SPCD), that is characterized by deficits in 4 areas of communication. Although descriptions of these areas are provided, no assessment tools for SPCD are recommended. The purpose of this study was to examine the extent to which items from measurement tools commonly used in assessing pragmatic language impairment and related disorders might be useful in assessing the characteristics of social communication that define SPCD in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Based on a literature search, 594 items from assessment tools commonly used to measure social communication abilities in people with pragmatic language impairment were identified. The first author judged whether each item reflected 1, more than 1, or none of the 4 SPCD diagnostic characteristics. After a brief training process, 5 second raters independently mapped subsets of items to the 6 categories. We calculated the percentage of agreement and Cohen's kappa for each pair of raters in assigning items to categories. Percentages of agreement ranged from 76% to 82%, and Cohen's kappa values ranged from .69 to .76, indicating substantial agreement. Sources and item numbers for the 206 items that both raters assigned to the same SPCD feature are provided. These items may provide guidance in assessing SPCD and in designing standardized screening and diagnostic measures for SPCD.

[Subjective memory loss--a sign of cognitive impairment in the elderly? An overview of the status of research].

PubMed

Riedel-Heller, S G; Schork, A; Matschinger, H; Angermeyer, M C

2000-02-01

According to the growing clinical interest in early indicators of dementia, numerous studies have examined the association between subjective memory complaints and cognitive performance in old age. Their results are contradictory. In this paper, studies carried out over the last 10 years are compared with regard to the study design and the assessment instruments used. The results are discussed with particular reference to the diagnostic validity of subjective memory complaints. The majority of case-control studies and cross-sectional studies of non-representative samples could not demonstrate an association between subjective memory complaints and cognitive performance. Most field studies of larger representative population samples, however, have come to the opposite conclusion. A consistent assessment of these statistically significant associations against the background of diagnostic validity showed that memory complaints cannot be taken as a clear clinical indicator for cognitive impairment. Subjective memory complaints may reflect depressive disorders and a multitude of other processes, of which an objective impairment of cognitive performance is just one aspect. As a consequence, an inclusion of subjective memory complaints as a diagnostic criterion for the diagnosis of "mild cognitive disorder" according to ICD-10 is not justified.

Active spectroscopic measurements using the ITER diagnostic system.

PubMed

Thomas, D M; Counsell, G; Johnson, D; Vasu, P; Zvonkov, A

2010-10-01

Active (beam-based) spectroscopic measurements are intended to provide a number of crucial parameters for the ITER device being built in Cadarache, France. These measurements include the determination of impurity ion temperatures, absolute densities, and velocity profiles, as well as the determination of the plasma current density profile. Because ITER will be the first experiment to study long timescale (∼1 h) fusion burn plasmas, of particular interest is the ability to study the profile of the thermalized helium ash resulting from the slowing down and confinement of the fusion alphas. These measurements will utilize both the 1 MeV heating neutral beams and a dedicated 100 keV hydrogen diagnostic neutral beam. A number of separate instruments are being designed and built by several of the ITER partners to meet the different spectroscopic measurement needs and to provide the maximum physics information. In this paper, we describe the planned measurements, the intended diagnostic ensemble, and we will discuss specific physics and engineering challenges for these measurements in ITER.

Supervisory control and diagnostics system for the mirror fusion test facility: overview and status 1980

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

McGoldrick, P.R.

1981-01-01

The Mirror Fusion Test Facility (MFTF) is a complex facility requiring a highly-computerized Supervisory Control and Diagnostics System (SCDS) to monitor and provide control over ten subsystems; three of which require true process control. SCDS will provide physicists with a method of studying machine and plasma behavior by acquiring and processing up to four megabytes of plasma diagnostic information every five minutes. A high degree of availability and throughput is provided by a distributed computer system (nine 32-bit minicomputers on shared memory). Data, distributed across SCDS, is managed by a high-bandwidth Distributed Database Management System. The MFTF operators' control roommore » consoles use color television monitors with touch sensitive screens; this is a totally new approach. The method of handling deviations to normal machine operation and how the operator should be notified and assisted in the resolution of problems has been studied and a system designed.« less

Molecular tools for diagnosis of visceral leishmaniasis: systematic review and meta-analysis of diagnostic test accuracy.

PubMed

de Ruiter, C M; van der Veer, C; Leeflang, M M G; Deborggraeve, S; Lucas, C; Adams, E R

2014-09-01

Molecular methods have been proposed as highly sensitive tools for the detection of Leishmania parasites in visceral leishmaniasis (VL) patients. Here, we evaluate the diagnostic accuracy of these tools in a meta-analysis of the published literature. The selection criteria were original studies that evaluate the sensitivities and specificities of molecular tests for diagnosis of VL, adequate classification of study participants, and the absolute numbers of true positives and negatives derivable from the data presented. Forty studies met the selection criteria, including PCR, real-time PCR, nucleic acid sequence-based amplification (NASBA), and loop-mediated isothermal amplification (LAMP). The sensitivities of the individual studies ranged from 29 to 100%, and the specificities ranged from 25 to 100%. The pooled sensitivity of PCR in whole blood was 93.1% (95% confidence interval [CI], 90.0 to 95.2), and the specificity was 95.6% (95% CI, 87.0 to 98.6). The specificity was significantly lower in consecutive studies, at 63.3% (95% CI, 53.9 to 71.8), due either to true-positive patients not being identified by parasitological methods or to the number of asymptomatic carriers in areas of endemicity. PCR for patients with HIV-VL coinfection showed high diagnostic accuracy in buffy coat and bone marrow, ranging from 93.1 to 96.9%. Molecular tools are highly sensitive assays for Leishmania detection and may contribute as an additional test in the algorithm, together with a clear clinical case definition. We observed wide variety in reference standards and study designs and now recommend consecutively designed studies. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

Accuracy of administrative data for surveillance of healthcare-associated infections: a systematic review

PubMed Central

van Mourik, Maaike S M; van Duijn, Pleun Joppe; Moons, Karel G M; Bonten, Marc J M; Lee, Grace M

2015-01-01

Objective Measuring the incidence of healthcare-associated infections (HAI) is of increasing importance in current healthcare delivery systems. Administrative data algorithms, including (combinations of) diagnosis codes, are commonly used to determine the occurrence of HAI, either to support within-hospital surveillance programmes or as free-standing quality indicators. We conducted a systematic review evaluating the diagnostic accuracy of administrative data for the detection of HAI. Methods Systematic search of Medline, Embase, CINAHL and Cochrane for relevant studies (1995–2013). Methodological quality assessment was performed using QUADAS-2 criteria; diagnostic accuracy estimates were stratified by HAI type and key study characteristics. Results 57 studies were included, the majority aiming to detect surgical site or bloodstream infections. Study designs were very diverse regarding the specification of their administrative data algorithm (code selections, follow-up) and definitions of HAI presence. One-third of studies had important methodological limitations including differential or incomplete HAI ascertainment or lack of blinding of assessors. Observed sensitivity and positive predictive values of administrative data algorithms for HAI detection were very heterogeneous and generally modest at best, both for within-hospital algorithms and for formal quality indicators; accuracy was particularly poor for the identification of device-associated HAI such as central line associated bloodstream infections. The large heterogeneity in study designs across the included studies precluded formal calculation of summary diagnostic accuracy estimates in most instances. Conclusions Administrative data had limited and highly variable accuracy for the detection of HAI, and their judicious use for internal surveillance efforts and external quality assessment is recommended. If hospitals and policymakers choose to rely on administrative data for HAI surveillance, continued improvements to existing algorithms and their robust validation are imperative. PMID:26316651

A prospective study of the diagnostic utility of sputum Gram stain in pneumonia.

PubMed

Anevlavis, Stavros; Petroglou, Niki; Tzavaras, Athanasios; Maltezos, Efstratios; Pneumatikos, Ioannis; Froudarakis, Marios; Anevlavis, Eleftherios; Bouros, Demosthenes

2009-08-01

Sputum Gram stain and culture have been said to be unreliable indicators of the microbiological diagnosis of bacterial pneumonia. The etiological diagnosis of pneumonia is surrounded by great degree of uncertainty. This uncertainty should be and can be calculated and incorporated in the diagnosis and treatment. To determine the diagnostic accuracy and diagnostic value of sputum Gram stain in etiological diagnosis and initial selection of antimicrobial therapy of bacterial community acquired pneumonia (CAP). DESIGN-METHOD: Prospective study of 1390 patients with CAP admitted January 2002-June 2008, to our institutions. Of the 1390 patients, 178 (12.8%) fulfilled the criteria for inclusion into this study (good-quality sputa and presence of the same microorganism in blood and sputum cultures which was used as gold standard for assessing the diagnostic accuracy and diagnostic value of sputum Gram stain). The sensitivity of sputum Gram stain was 0.82 for Pneumococcal pneumonia, 0.76 for Staphylococcal pneumonia, 0.79 for Haemophilus influenzae pneumonia and 0.78 for Gram-negative bacilli pneumonia. The specificity of sputum Gram stain was 0.93 for Pneumococcal pneumonia, 0.96 for Staphylococcal pneumonia, 0.96 for H. influenzae pneumonia and 0.95 for Gram-negative bacilli pneumonia. The positive likelihood ratio (LR+) was 11.58 for Pneumococcal pneumonia, 19.38 for Staphylococcal pneumonia, 16.84 for H. influenzae pneumonia, 14.26 for Gram-negative bacilli pneumonia. The negative likelihood ratio (LR-) was 0.20 for Pneumococcal pneumonia, 0.25 for Staphylococcal pneumonia, 0.22 for H. influenzae pneumonia, and 0.23 for Gram-negative bacilli pneumonia. Sputum Gram stain is a dependable diagnostic test for the early etiological diagnosis of bacterial CAP that helps in choosing orthological and appropriate initial antimicrobial therapy.

Diagnostic Accuracy of the Slump Test for Identifying Neuropathic Pain in the Lower Limb.

PubMed

Urban, Lawrence M; MacNeil, Brian J

2015-08-01

Diagnostic accuracy study with nonconsecutive enrollment. To assess the diagnostic accuracy of the slump test for neuropathic pain (NeP) in those with low to moderate levels of chronic low back pain (LBP), and to determine whether accuracy of the slump test improves by adding anatomical or qualitative pain descriptors. Neuropathic pain has been linked with poor outcomes, likely due to inadequate diagnosis, which precludes treatment specific for NeP. Current diagnostic approaches are time consuming or lack accuracy. A convenience sample of 21 individuals with LBP, with or without radiating leg pain, was recruited. A standardized neurosensory examination was used to determine the reference diagnosis for NeP. Afterward, the slump test was administered to all participants. Reports of pain location and quality produced during the slump test were recorded. The neurosensory examination designated 11 of the 21 participants with LBP/sciatica as having NeP. The slump test displayed high sensitivity (0.91), moderate specificity (0.70), a positive likelihood ratio of 3.03, and a negative likelihood ratio of 0.13. Adding the criterion of pain below the knee significantly increased specificity to 1.00 (positive likelihood ratio = 11.9). Pain-quality descriptors did not improve diagnostic accuracy. The slump test was highly sensitive in identifying NeP within the study sample. Adding a pain-location criterion improved specificity. Combining the diagnostic outcomes was very effective in identifying all those without NeP and half of those with NeP. Limitations arising from the small and narrow spectrum of participants with LBP/sciatica sampled within the study prevent application of the findings to a wider population. Diagnosis, level 4-.

Improved Data Acquisition Methods for Uninterrupted Signal Monitoring and Ultra-Fast Plasma Diagnostics in LHD

NASA Astrophysics Data System (ADS)

Nakanishi, Hideya; Imazu, Setsuo; Ohsuna, Masaki; Kojima, Mamoru; Nonomura, Miki; Shoji, Mamoru; Emoto, Masahiko; Yoshida, Masanobu; Iwata, Chie; Miyake, Hitoshi; Nagayama, Yoshio; Kawahata, Kazuo

To deal with endless data streams acquired in LHD steady-state experiments, the LHD data acquisition system was designed with a simple concept that divides a long pulse into a consecutive series of 10-s “subshots”. Latest digitizers applying high-speed PCI-Express technology, however, output nonstop gigabyte per second data streams whose subshot intervals would be extremely long if 10-s rule was applied. These digitizers need shorter subshot intervals, less than 10-s long. In contrast, steady-state fusion plants need uninterrupted monitoring of the environment and device soundness. They adopt longer subshot lengths of either 10 min or 1 day. To cope with both uninterrupted monitoring and ultra-fast diagnostics, the ability to vary the subshot length according to the type of operation is required. In this study, a design modification that enables variable subshot lengths was implemented and its practical effectiveness in LHD was verified.

Health care sensor--based systems for point of care monitoring and diagnostic applications: a brief survey.

PubMed

Tsakalakis, Michail; Bourbakis, Nicolaos G

2014-01-01

Continuous, real-time remote monitoring through medical point--of--care (POC) systems appears to draw the interest of the scientific community for healthcare monitoring and diagnostic applications the last decades. Towards this direction a significant merit has been due to the advancements in several scientific fields. Portable, wearable and implantable apparatus may contribute to the betterment of today's healthcare system which suffers from fundamental hindrances. The number and heterogeneity of such devices and systems regarding both software and hardware components, i.e sensors, antennas, acquisition circuits, as well as the medical applications that are designed for, is impressive. Objective of the current study is to present the major technological advancements that are considered to be the driving forces in the design of such systems, to briefly state the new aspects they can deliver in healthcare and finally, the identification, categorization and a first level evaluation of them.

Design of a Tablet Computer App for Facilitation of a Molecular Blood Culture Test in Clinical Microbiology and Preliminary Usability Evaluation.

PubMed

Samson, Lasse L; Pape-Haugaard, Louise; Meltzer, Michelle C; Fuchs, Martin; Schønheyder, Henrik C; Hejlesen, Ole

2016-03-18

User mobility is an important aspect of the development of clinical information systems for health care professionals. Mobile phones and tablet computers have obtained widespread use by health care professionals, offering an opportunity for supporting the access to patient information through specialized applications (apps) while supporting the mobility of the users. The use of apps for mobile phones and tablet computers may support workflow of complex tasks, for example, molecular-based diagnostic tests in clinical microbiology. Multiplex Blood Culture Test (MuxBCT) is a molecular-based diagnostic test used for rapid identification of pathogens in positive blood cultures. To facilitate the workflow of the MuxBCT, a specialized tablet computer app was developed as an accessory to the diagnostic test. The app aims to reduce the complexity of the test by step-by-step guidance of microscopy and to assist users in reaching an exact bacterial or fungal diagnosis based on blood specimen observations and controls. Additionally, the app allows for entry of test results, and communication thereof to the laboratory information system (LIS). The objective of the study was to describe the design considerations of the MuxBCT app and the results of a preliminary usability evaluation. The MuxBCT tablet app was developed and set up for use in a clinical microbiology laboratory. A near-live simulation study was conducted in the clinical microbiology laboratory to evaluate the usability of the MuxBCT app. The study was designed to achieve a high degree of realism as participants carried out a scenario representing the context of use for the MuxBCT app. As the MuxBCT was under development, the scenario involved the use of molecular blood culture tests similar to the MuxBCT for identification of microorganisms from positive blood culture samples. The study participants were observed, and their interactions with the app were recorded. After the study, the participants were debriefed to clarify observations. Four medical laboratory technicians, for example, representative of end users of the app, participated in the clinical simulation study. Using the MuxBCT app, the study participants successfully identified and reported all microorganisms from the positive blood cultures examined. Three of the four participants reported that they found the app useful, while one study participant reported that she would prefer to make notes on paper and later enter them into the LIS. The preliminary usability evaluation results indicate that use of the MuxBCT tablet app can facilitate the workflow of the MuxBCT diagnostic test.

Conceptual Design of the ITER ECE Diagnostic - An Update

NASA Astrophysics Data System (ADS)

Austin, M. E.; Pandya, H. K. B.; Beno, J.; Bryant, A. D.; Danani, S.; Ellis, R. F.; Feder, R.; Hubbard, A. E.; Kumar, S.; Ouroua, A.; Phillips, P. E.; Rowan, W. L.

2012-09-01

The ITER ECE diagnostic has recently been through a conceptual design review for the entire system including front end optics, transmission line, and back-end instruments. The basic design of two viewing lines, each with a single ellipsoidal mirror focussing into the plasma near the midplane of the typical operating scenarios is agreed upon. The location and design of the hot calibration source and the design of the shutter that directs its radiation to the transmission line are issues that need further investigation. In light of recent measurements and discussion, the design of the broadband transmission line is being revisited and new options contemplated. For the instruments, current systems for millimeter wave radiometers and broad-band spectrometers will be adequate for ITER, but the option for employing new state-of-the-art techniques will be left open.

Consultation-Based Academic Intervention for Children with Attention Deficit Hyperactivity Disorder: School Functioning Outcomes

ERIC Educational Resources Information Center

Jitendra, Asha K.; DuPaul, George J.; Volpe, Robert J.; Tresco, Katy E.; Junod, Rosemary E. Vile; Lutz, J. Gary; Cleary, Kristi S.; Flammer-Rivera, Lizette M.; Manella, Mark C.

2007-01-01

This study evaluated the effectiveness of two consultation-based models for designing academic interventions to enhance the educational functioning of children with attention deficit hyperactivity disorder. Children (N = 167) meeting "Diagnostic and Statistical Manual" (4th ed.--text revision; American Psychiatric Association, 2000) criteria for…

Immune activation after immunization of the neonatal calves with a commercial heat-killed vaccine

USDA-ARS?s Scientific Manuscript database

A major drawback of current whole-cell vaccines for Mycobacterium avium subsp. paratuberculosis is the interference with diagnostic tests for bovine tuberculosis and paratuberculosis. The current study was designed to explore cross-reactivity of the current USDA commercial vaccine for MAP with diagn...

Integrated Theoretical, Computational, and Experimental Studies for Transition Estimation and Control

DTIC Science & Technology

2014-06-03

nozzle exit) was developed to aid in porting the VENOM diagnostic to high-enthalpy impulse tunnels. Measurements were also made in the supersonic high...Colonius T, Fedorov AV. 2009. Alternate designs of ultrasonic absorptive coatings for hypersonic boundary layer control. AIAA Pap. No. 2009-4217 51. Craig

Diagnostic Accuracy of Traditional Measures of Phonological Ability for Bilingual Preschoolers and Kindergarteners

ERIC Educational Resources Information Center

Fabiano-Smith, Leah; Hoffman, Katherine

2018-01-01

Purpose: Bilingual children whose phonological skills are evaluated using measures designed for monolingual English speakers are at risk for misdiagnosis of speech sound disorders (De Lamo White & Jin, 2011). Method: Forty-four children participated in this study: 15 typically developing monolingual English speakers, 7 monolingual English…

The Middle Latency Response (MLR) and Steady State Evoked Potential (SSEP) in Neonates.

DTIC Science & Technology

1985-05-01

diagnostic audiologic information will enhance habilitation efforts in prescribing hearing aids and designing appropriate language intervention strategies...auditory evoked brain stem response. A study of patients with sensory hearing loss. SCANDINAVIAN AUDIOLOGY 8: 67-70, 1979. Page 165 "- FILMED 10-85 DTIC * 4 N . . -. N

Alignment-free design of highly discriminatory diagnostic primer sets for Escherichia coli O104:H4 outbreak strains.

PubMed

Pritchard, Leighton; Holden, Nicola J; Bielaszewska, Martina; Karch, Helge; Toth, Ian K

2012-01-01

An Escherichia coli O104:H4 outbreak in Germany in summer 2011 caused 53 deaths, over 4000 individual infections across Europe, and considerable economic, social and political impact. This outbreak was the first in a position to exploit rapid, benchtop high-throughput sequencing (HTS) technologies and crowdsourced data analysis early in its investigation, establishing a new paradigm for rapid response to disease threats. We describe a novel strategy for design of diagnostic PCR primers that exploited this rapid draft bacterial genome sequencing to distinguish between E. coli O104:H4 outbreak isolates and other pathogenic E. coli isolates, including the historical hæmolytic uræmic syndrome (HUSEC) E. coli HUSEC041 O104:H4 strain, which possesses the same serotype as the outbreak isolates. Primers were designed using a novel alignment-free strategy against eleven draft whole genome assemblies of E. coli O104:H4 German outbreak isolates from the E. coli O104:H4 Genome Analysis Crowd-Sourcing Consortium website, and a negative sequence set containing 69 E. coli chromosome and plasmid sequences from public databases. Validation in vitro against 21 'positive' E. coli O104:H4 outbreak and 32 'negative' non-outbreak EHEC isolates indicated that individual primer sets exhibited 100% sensitivity for outbreak isolates, with false positive rates of between 9% and 22%. A minimal combination of two primers discriminated between outbreak and non-outbreak E. coli isolates with 100% sensitivity and 100% specificity. Draft genomes of isolates of disease outbreak bacteria enable high throughput primer design and enhanced diagnostic performance in comparison to traditional molecular assays. Future outbreak investigations will be able to harness HTS rapidly to generate draft genome sequences and diagnostic primer sets, greatly facilitating epidemiology and clinical diagnostics. We expect that high throughput primer design strategies will enable faster, more precise responses to future disease outbreaks of bacterial origin, and help to mitigate their societal impact.

A Prospective Study of the Concordance of DSM-IV and DSM-5 Diagnostic Criteria for Autism Spectrum Disorder

ERIC Educational Resources Information Center

Mazurek, Micah O.; Lu, Frances; Symecko, Heather; Butter, Eric; Bing, Nicole M.; Hundley, Rachel J.; Poulsen, Marie; Kanne, Stephen M.; Macklin, Eric A.; Handen, Benjamin L.

2017-01-01

The transition from DSM-IV to DSM-5 criteria for autism spectrum disorder (ASD) sparked considerable concern about the potential implications of these changes. This study was designed to address limitations of prior studies by prospectively examining the concordance of DSM-IV and final DSM-5 criteria on a consecutive sample of 439 children…

On-board fault diagnostics for fly-by-light flight control systems using neural network flight processors

NASA Astrophysics Data System (ADS)

Urnes, James M., Sr.; Cushing, John; Bond, William E.; Nunes, Steve

1996-10-01

Fly-by-Light control systems offer higher performance for fighter and transport aircraft, with efficient fiber optic data transmission, electric control surface actuation, and multi-channel high capacity centralized processing combining to provide maximum aircraft flight control system handling qualities and safety. The key to efficient support for these vehicles is timely and accurate fault diagnostics of all control system components. These diagnostic tests are best conducted during flight when all facts relating to the failure are present. The resulting data can be used by the ground crew for efficient repair and turnaround of the aircraft, saving time and money in support costs. These difficult to diagnose (Cannot Duplicate) fault indications average 40 - 50% of maintenance activities on today's fighter and transport aircraft, adding significantly to fleet support cost. Fiber optic data transmission can support a wealth of data for fault monitoring; the most efficient method of fault diagnostics is accurate modeling of the component response under normal and failed conditions for use in comparison with the actual component flight data. Neural Network hardware processors offer an efficient and cost-effective method to install fault diagnostics in flight systems, permitting on-board diagnostic modeling of very complex subsystems. Task 2C of the ARPA FLASH program is a design demonstration of this diagnostics approach, using the very high speed computation of the Adaptive Solutions Neural Network processor to monitor an advanced Electrohydrostatic control surface actuator linked through a AS-1773A fiber optic bus. This paper describes the design approach and projected performance of this on-line diagnostics system.

Reliability studies of diagnostic methods in Indian traditional Ayurveda medicine: An overview

PubMed Central

Kurande, Vrinda Hitendra; Waagepetersen, Rasmus; Toft, Egon; Prasad, Ramjee

2013-01-01

Recently, a need to develop supportive new scientific evidence for contemporary Ayurveda has emerged. One of the research objectives is an assessment of the reliability of diagnoses and treatment. Reliability is a quantitative measure of consistency. It is a crucial issue in classification (such as prakriti classification), method development (pulse diagnosis), quality assurance for diagnosis and treatment and in the conduct of clinical studies. Several reliability studies are conducted in western medicine. The investigation of the reliability of traditional Chinese, Japanese and Sasang medicine diagnoses is in the formative stage. However, reliability studies in Ayurveda are in the preliminary stage. In this paper, examples are provided to illustrate relevant concepts of reliability studies of diagnostic methods and their implication in practice, education, and training. An introduction to reliability estimates and different study designs and statistical analysis is given for future studies in Ayurveda. PMID:23930037

Next-generation confirmatory disease diagnostics

NASA Astrophysics Data System (ADS)

Lin, Robert; Gerver, Rachel; Karns, Kelly; Apori, Akwasi A.; Denisin, Aleksandra K.; Herr, Amy E.

2014-06-01

Microfluidic tools are advancing capabilities in screening diagnostics for use in near-patient settings. Here, we review three case studies to illustrate the flexibility and analytical power offered by microanalytical tools. We first overview a near-patient tool for detection of protein markers found in cerebrospinal fluid (CSF), as a means to identify the presence of cerebrospinal fluid in nasal mucous - an indication that CSF is leaking into the nasal cavity. Microfluidic design allowed integration of several up-stream preparatory steps and rapid, specific completion of the human CSF protein assay. Second, we overview a tear fluid based assay for lactoferrin, a protein produced in the lacrimal gland, then secreted into tear fluid. Tear Lf is a putative biomarker for primary SS. A critical contribution of this and related work being measurement of Lf, even in light of well-known and significant matrix interactions and losses during the tear fluid collection and preparation. Lastly, we review a microfluidic barcode platform that enables rapid measurement of multiple infectious disease biomarkers in human sera. The assay presents a new approach to multiplexed biomarker detection, yet in a simple straight microchannel - thus providing a streamlined, simplified microanalytical platform, as is relevant to robust operation in diagnostic settings. We view microfluidic design and analytical chemistry as the basis for emerging, sophisticated assays that will advance not just screening diagnostic technology, but confirmatory assays, sample preparation and handling, and thus introduction and utilization of new biomarkers and assay formats.

Trends in radiation exposure from clinical nuclear medicine procedures in Shanghai, China.

PubMed

Yi, Yanling; Zheng, Junzheng; Zhuo, Weihai; Gao, Linfeng

2012-03-01

This study was designed to assess the trends in the frequencies of nuclear medicine procedures in Shanghai, China, and to determine their contributions to the per capita effective dose to the Shanghai population. The mean activities of radionuclides administered by nuclear medicine departments were compared with the Chinese national guidelines on diagnostic reference levels. On the basis of the three surveys carried out by Shanghai Municipal Center for Disease Control and Prevention in 1996, 1998, and 2008, the typically administered radiopharmaceuticals, levels of activity, the number of procedures, and population were systematically analyzed to assess the frequencies of nuclear medicine procedures and the per capita effective dose. The frequencies were approximately 2.77, 3.46, and 6.63 per 1000 people in 1996, 1998, and 2008, respectively. The annual per capita doses from diagnostic nuclear medicine were estimated to be 0.016, 0.022, and 0.032 mSv in 1996, 1998, and 2008, respectively. The annual frequency of therapeutic nuclear medicine procedures increased from 0.131 to 0.430 per 1000 people in the intervening 12 years. In the 12 years before 2008, diagnostic and therapeutic procedures in nuclear medicine in Shanghai increased continuously, and the annual per capita dose doubled. Increases in PET imaging and bone scans were the major contributors to the increasing frequency and magnitude of radiation exposure to the population. The activities administered for most diagnostic procedures were generally consistent with the designated reference levels.

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.

Not All Biofluids Are Created Equal: Chewing Over Salivary Diagnostics and the Epigenome

PubMed Central

Wren, M.E.; Shirtcliff, E.A.; Drury, Stacy S.

2015-01-01

Purpose This article describes progress to date in the characterization of the salivary epigenome and considers the importance of previous work in the salivary microbiome, proteome, endocrine analytes, genome, and transcriptome. Methods PubMed and Web of Science were used to extensively search the existing literature (original research and reviews) related to salivary diagnostics and bio-marker development, of which 125 studies were examined. This article was derived from the most relevant 73 sources highlighting the recent state of the evolving field of salivary epigenomics and contributing significantly to the foundational work in saliva-based research. Findings Validation of any new saliva-based diagnostic or analyte will require comparison to previously accepted standards established in blood. Careful attention to the collection, processing, and analysis of salivary analytes is critical for the development and implementation of newer applications that include genomic, transcriptomic, and epigenomic markers. All these factors must be integrated into initial study design. Implications This commentary highlights the appeal of the salivary epigenome for translational applications and its utility in future studies of development and the interface among environment, disease, and health. PMID:25778408

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

PubMed

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

2016-07-01

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

Microfluidic technology for molecular diagnostics.

PubMed

Robinson, Tom; Dittrich, Petra S

2013-01-01

Molecular diagnostics have helped to improve the lives of millions of patients worldwide by allowing clinicians to diagnose patients earlier as well as providing better ongoing therapies. Point-of-care (POC) testing can bring these laboratory-based techniques to the patient in a home setting or to remote settings in the developing world. However, despite substantial progress in the field, there still remain many challenges. Progress in molecular diagnostics has benefitted greatly from microfluidic technology. This chapter aims to summarise the more recent advances in microfluidic-based molecular diagnostics. Sections include an introduction to microfluidic technology, the challenges of molecular diagnostics, how microfluidic advances are working to solve these issues, some alternative design approaches, and detection within these systems.

Two different PCR approaches for universal diagnosis of brown rot and identification of Monilinia spp. in stone fruit trees.

PubMed

Gell, I; Cubero, J; Melgarejo, P

2007-12-01

To design a protocol for the universal diagnosis of brown rot by polymerase chain reaction (PCR) in plant material and subsequently Monilinia spp. identification. Primers for discrimination of Monilinia spp. from other fungal genera by PCR were designed following a ribosomal DNA analysis. Discrimination among species of Monilinia was subsequently achieved by developing primers using SCAR (Sequence Characterised Amplified Region) markers obtained after a random amplified polymorphic DNA study. In addition, an internal control (IC) based on the utilization of a mimic plasmid was designed to be used in the diagnostic protocol of brown rot to recognize false negatives due to the inhibition of PCR. The four sets of primers designed allowed detection and discrimination of all Monilinia spp. causing brown rot in fruit trees. Addition of an IC in each PCR reaction performed increased the reliability of the diagnostic protocol. The detection protocol presented here, that combined a set of universal primers and the inclusion of the plasmid pGMON as an IC for diagnosis of all Monilinia spp., and three sets of primers to discriminate the most important species of Monilinia, could be an useful and valuable tool for epidemiological studies. The method developed could be used in programmes to avoid the spread and introduction of this serious disease in new areas.

External prolonged electrocardiogram monitoring in unexplained syncope and palpitations: results of the SYNARR-Flash study.

PubMed

Locati, E T; Moya, A; Oliveira, M; Tanner, H; Willems, R; Lunati, M; Brignole, M

2016-08-01

SYNARR-Flash study (Monitoring of SYNcopes and/or sustained palpitations of suspected ARRhythmic origin) is an international, multicentre, observational, prospective trial designed to evaluate the role of external 4-week electrocardiogram (ECG) monitoring in clinical work-up of unexplained syncope and/or sustained palpitations of suspected arrhythmic origin. Consecutive patients were enrolled within 1 month after unexplained syncope or palpitations (index event) after being discharged from emergency room or hospitalization without a conclusive diagnosis. A 4-week ECG monitoring was obtained by external high-capacity loop recorder (SpiderFlash-T(®), Sorin) storing patient-activated and auto-triggered tracings. Diagnostic monitorings included (i) conclusive events with reoccurrence of syncope or palpitation with concomitant ECG recording (with/without arrhythmias) and (ii) events with asymptomatic predefined significant arrhythmias (sustained supraventricular or ventricular tachycardia, advanced atrio-ventricular block, sinus bradycardia <30 b.p.m., pauses >6 s). SYNARR-Flash study enrolled 395 patients (57.7% females, 56.9 ± 18.7 years, 28.1% with syncope, and 71.9% with palpitations) from 10 European centres. For syncope, the 4-week diagnostic yield was 24.5%, and predictors of diagnostic events were early start of recording (0-15 vs. >15 days after index event) (OR 6.2, 95% CI 1.3-29.6, P = 0.021) and previous history of supraventricular arrhythmias (OR 3.6, 95% CI 1.4-9.7, P = 0.018). For palpitations, the 4-week diagnostic yield was 71.6% and predictors of diagnostic events were history of recurrent palpitations (P < 0.001) and early start of recording (P = 0.001). The 4-week external ECG monitoring can be considered as first-line tool in the diagnostic work-up of syncope and palpitation. Early recorder use, history of supraventricular arrhythmia, and frequent previous events increased the likelihood of diagnostic events during the 4-week external ECG monitoring. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Cardiology.

Comparative study on the efficiency of some optical methods for artwork diagnostics

NASA Astrophysics Data System (ADS)

Schirripa Spagnolo, Giuseppe; Ambrosini, Dario; Paoletti, Domenica

2001-10-01

Scientific investigation methods are founding their place besides the stylistic-historical study methods in art research works. In particular, optical techniques, transferred from other fields or developed ad hoc, can make a strong contribution to the safeguarding and exploitation of cultural heritage. This paper describes the use of different optical techniques, such as holographic interferometry, decorrelation, shearography and ESPI, in the diagnostics of works of art. A comparison between different methods is obtained by performing tests on specially designed models, prepared using typical techniques and materials. Inside the model structure, a number of defects of known types, form and extension are inserted. The different features of each technique are outlined and a comparison with IR thermography is also carried out.

The influence of local pressure on evaluation parameters of skin blood perfusion and fluorescence

NASA Astrophysics Data System (ADS)

Zherebtsov, E. A.; Kandurova, K. Y.; Seryogina, E. S.; Kozlov, I. O.; Dremin, V. V.; Zherebtsova, A. I.; Dunaev, A. V.; Meglinski, I.

2017-03-01

This article presents the results of the study of the pressure applied on optical diagnostic probes as a significant factor affecting the results of measurements. During stepwise increasing and decreasing of local pressure on skin we conducted measurements using the methods of laser Doppler flowmetry and fluorescence spectroscopy. It was found out that pressure on optical probe has sufficient impact on skin microcirculation to affect registered fluorescence intensity. Data obtained in this study are of interest for design and development of diagnostic technologies for wearable devices. This data will also inform further investigation into issues of compensation of blood absorption influence on fluorescence spectrum, allowing increased accuracy and reproducibility of measurements by fluorescence spectroscopy methods in optical diagnosis.

A comparison of the millon behavioral medical diagnostic and millon behavioral health inventory with medical populations.

PubMed

Wise, Edward A; Streiner, David L

2010-12-01

There is a lack of normative data on broadband omnibus types of personality tests with medical populations. In fact, the only two tests normed on medical populations are the Millon Behavioral Medicine Diagnostic (MBMD) and the Millon Behavioral Health Inventory (MBHI). The internal consistency, test-retest reliabilities, and validity studies of these instruments are reviewed and compared in an effort to aid clinicians in discerning their relative psychometric strengths and weaknesses. Due to the lack of validity studies with the MBMD and the fact that reliability limits the ceiling of validity coefficients, the MBMD has yet to meet the challenges it was designed to meet. Implications for practice are addressed. © 2010 Wiley Periodicals, Inc.

Does more favourable handling of the cerebrospinal fluid increase the diagnostic sensitivity of Borrelia burgdorferi sensu lato-specific PCR in Lyme neuroborreliosis?

PubMed

Forselv, Kristine J N; Lorentzen, Åslaug R; Ljøstad, Unn; Mygland, Åse; Eikeland, Randi; Kjelland, Vivian; Noraas, Sølvi; Quarsten, Hanne

2018-04-01

Tests for direct detection of Borrelia burgdorferi sensu lato (Bb) in Lyme neuroborreliosis (LNB) are needed. Detection of Bb DNA using PCR is promising, but clinical utility is hampered by low diagnostic sensitivity. We aimed to examine whether diagnostic sensitivity can be improved by the use of larger cerebrospinal fluid (CSF) volumes and faster handling of samples. Patients who underwent CSF examination for LNB were included. We collected two millilitres of CSF for PCR analysis, extracted DNA from the pellets within 24 h and analysed the eluate by two real-time PCR protocols (16S rRNA and OspA). Patients who fulfilled diagnostic criteria for LNB were classified as LNB cases and the rest as controls. Bb DNA in CSF was detected by PCR in seven of 28 adults with LNB. Two were Bb antibody negative. No Bb DNA was detected in CSF from 137 controls. Diagnostic sensitivity was 25% and specificity 100%. There was a non-significant trend towards larger CSF sample volume, faster handling of the sample, shorter duration of symptoms, and higher CSF cell count in the PCR-positive cases. We did not find that optimized handling of CSF increased diagnostic sensitivity of PCR in adults with LNB. However, our case series is small and we hypothesize that the importance of these factors will be clarified in further studies with larger case series and altered study design. PCR for diagnosis of LNB may be useful in cases without Bb antibodies due to short duration of symptoms.

Integrating Nursing Diagnostic Concepts into the Medical Entities Dictionary Using the ISO Reference Terminology Model for Nursing Diagnosis

PubMed Central

Hwang, Jee-In; Cimino, James J.; Bakken, Suzanne

2003-01-01

Objective: The purposes of the study were (1) to evaluate the usefulness of the International Standards Organization (ISO) Reference Terminology Model for Nursing Diagnoses as a terminology model for defining nursing diagnostic concepts in the Medical Entities Dictionary (MED) and (2) to create the additional hierarchical structures required for integration of nursing diagnostic concepts into the MED. Design and Measurements: The authors dissected nursing diagnostic terms from two source terminologies (Home Health Care Classification and the Omaha System) into the semantic categories of the ISO model. Consistent with the ISO model, they selected Focus and Judgment as required semantic categories for creating intensional definitions of nursing diagnostic concepts in the MED. Because the MED does not include Focus and Judgment hierarchies, the authors developed them to define the nursing diagnostic concepts. Results: The ISO model was sufficient for dissecting the source terminologies into atomic terms. The authors identified 162 unique focus concepts from the 266 nursing diagnosis terms for inclusion in the Focus hierarchy. For the Judgment hierarchy, the authors precoordinated Judgment and Potentiality instead of using Potentiality as a qualifier of Judgment as in the ISO model. Impairment and Alteration were the most frequently occurring judgments. Conclusions: Nursing care represents a large proportion of health care activities; thus, it is vital that terms used by nurses are integrated into concept-oriented terminologies that provide broad coverage for the domain of health care. This study supports the utility of the ISO Reference Terminology Model for Nursing Diagnoses as a facilitator for the integration process. PMID:12668692

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.

Intelligent Engine Systems

NASA Technical Reports Server (NTRS)

Xie, Ming

2008-01-01

A high bypass jet engine fan case represents one of the largest, heaviest single components in an engine. In addition to supporting the inlet and providing the fan flowpath, the most critical function is the containment of a failed fan blade. In this development program, a lightweight, low-cost composite containment case with diagnostic capabilities was developed, fabricated, and tested. The fan case design, containment methods, and diagnostic concepts evaluated in the initial Propulsion 21 program were improved and scaled up to a full case design.

Self-Diagnostics Digitally Controlled Pacemaker/Defibrillators: A Design Plan for Incorporating Diagnostics and Digital Control in the schema of a Pacemaker/Defibrillator Design

DTIC Science & Technology

2005-09-01

of a system to store and retrieve digital/ wireless communication information from a pacemaker/ defibrillator, or other device , and to alert medical... wireless communication information from a pacemaker/defibrillator, or other device , and to alert medical personnel when a person is experiencing...with heart, pacing, program, test, sensor , circuit) where the individual needs immediate attention an audible alert will go off at the nurse’s

Diagnostic grand rounds: a new teaching concept to train diagnostic reasoning.

PubMed

Stieger, Stefan; Praschinger, Andrea; Kletter, Kurt; Kainberger, Franz

2011-06-01

Diagnostic reasoning is a core skill in teaching and learning in undergraduate curricula. Diagnostic grand rounds (DGRs) as a subform of grand rounds are intended to train the students' skills in the selection of appropriate tests and in the interpretation of test results. The aim of this study was to test DGRs for their ability to improve diagnostic reasoning by using a pre-post-test design. During one winter term, all 398 fifth-year students (36.1% male, 63.9% female) solved 23 clinical cases presented in 8 DGRs. In an online questionnaire, a Diagnostic Thinking Inventory (DTI) with 41 items was evaluated for flexibility in thinking and structure of knowledge in memory. Results were correlated with those from a summative multiple-choice knowledge test and of the learning objectives in a logbook. The students' DTI scores in the post-test were significantly higher than those reported in the pre-test. DTI scores at either testing time did not correlate with medical knowledge as assessed by a multiple-choice knowledge test. Abilities acquired during clinical clerkships as documented in a logbook could only account for a small proportion of the increase in the flexibility subscale score. This effect still remained significant after accounting for potential confounders. Establishing DGRs proofed to be an effective way of successfully improving both students' diagnostic reasoning and the ability to select the appropriate test method in routine clinical practice. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

An Exploratory Study of the Diagnostic Teaching of Heuristic Problem Solving Strategies in Calculus.

ERIC Educational Resources Information Center

Lucas, John Frank

The aims of the study were to explore the effects of teaching heuristics in a calculus course and to generate hypotheses about related changes in heuristic usage and problem solving performance. Thirty college students in two classes participated and a Solomon four-group research design was used. Students from one group in each class were…

A Diagnostic Study of Pre-Service Teachers' Competency in Multiple-Choice Item Development

ERIC Educational Resources Information Center

Asim, Alice E.; Ekuri, Emmanuel E.; Eni, Eni I.

2013-01-01

Large class size is an issue in testing at all levels of Education. As a panacea to this, multiple choice test formats has become very popular. This case study was designed to diagnose pre-service teachers' competency in constructing questions (IQT); direct questions (DQT); and best answer (BAT) varieties of multiple choice items. Subjects were 88…

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

ERIC Educational Resources Information Center

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

2016-01-01

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

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…

Feasibility of streamlining an interactive Bayesian-based diagnostic support tool designed for clinical practice

NASA Astrophysics Data System (ADS)

Chen, Po-Hao; Botzolakis, Emmanuel; Mohan, Suyash; Bryan, R. N.; Cook, Tessa

2016-03-01

In radiology, diagnostic errors occur either through the failure of detection or incorrect interpretation. Errors are estimated to occur in 30-35% of all exams and contribute to 40-54% of medical malpractice litigations. In this work, we focus on reducing incorrect interpretation of known imaging features. Existing literature categorizes cognitive bias leading a radiologist to an incorrect diagnosis despite having correctly recognized the abnormal imaging features: anchoring bias, framing effect, availability bias, and premature closure. Computational methods make a unique contribution, as they do not exhibit the same cognitive biases as a human. Bayesian networks formalize the diagnostic process. They modify pre-test diagnostic probabilities using clinical and imaging features, arriving at a post-test probability for each possible diagnosis. To translate Bayesian networks to clinical practice, we implemented an entirely web-based open-source software tool. In this tool, the radiologist first selects a network of choice (e.g. basal ganglia). Then, large, clearly labeled buttons displaying salient imaging features are displayed on the screen serving both as a checklist and for input. As the radiologist inputs the value of an extracted imaging feature, the conditional probabilities of each possible diagnosis are updated. The software presents its level of diagnostic discrimination using a Pareto distribution chart, updated with each additional imaging feature. Active collaboration with the clinical radiologist is a feasible approach to software design and leads to design decisions closely coupling the complex mathematics of conditional probability in Bayesian networks with practice.

Overview of experiment design and comparison of models participating in phase 1 of the SPARC Quasi-Biennial Oscillation initiative (QBOi)

NASA Astrophysics Data System (ADS)

Butchart, Neal; Anstey, James A.; Hamilton, Kevin; Osprey, Scott; McLandress, Charles; Bushell, Andrew C.; Kawatani, Yoshio; Kim, Young-Ha; Lott, Francois; Scinocca, John; Stockdale, Timothy N.; Andrews, Martin; Bellprat, Omar; Braesicke, Peter; Cagnazzo, Chiara; Chen, Chih-Chieh; Chun, Hye-Yeong; Dobrynin, Mikhail; Garcia, Rolando R.; Garcia-Serrano, Javier; Gray, Lesley J.; Holt, Laura; Kerzenmacher, Tobias; Naoe, Hiroaki; Pohlmann, Holger; Richter, Jadwiga H.; Scaife, Adam A.; Schenzinger, Verena; Serva, Federico; Versick, Stefan; Watanabe, Shingo; Yoshida, Kohei; Yukimoto, Seiji

2018-03-01

The Stratosphere-troposphere Processes And their Role in Climate (SPARC) Quasi-Biennial Oscillation initiative (QBOi) aims to improve the fidelity of tropical stratospheric variability in general circulation and Earth system models by conducting coordinated numerical experiments and analysis. In the equatorial stratosphere, the QBO is the most conspicuous mode of variability. Five coordinated experiments have therefore been designed to (i) evaluate and compare the verisimilitude of modelled QBOs under present-day conditions, (ii) identify robustness (or alternatively the spread and uncertainty) in the simulated QBO response to commonly imposed changes in model climate forcings (e.g. a doubling of CO2 amounts), and (iii) examine model dependence of QBO predictability. This paper documents these experiments and the recommended output diagnostics. The rationale behind the experimental design and choice of diagnostics is presented. To facilitate scientific interpretation of the results in other planned QBOi studies, consistent descriptions of the models performing each experiment set are given, with those aspects particularly relevant for simulating the QBO tabulated for easy comparison.

Design of a Web-tool for diagnostic clinical trials handling medical imaging research.

PubMed

Baltasar Sánchez, Alicia; González-Sistal, Angel

2011-04-01

New clinical studies in medicine are based on patients and controls using different imaging diagnostic modalities. Medical information systems are not designed for clinical trials employing clinical imaging. Although commercial software and communication systems focus on storage of image data, they are not suitable for storage and mining of new types of quantitative data. We sought to design a Web-tool to support diagnostic clinical trials involving different experts and hospitals or research centres. The image analysis of this project is based on skeletal X-ray imaging. It involves a computerised image method using quantitative analysis of regions of interest in healthy bone and skeletal metastases. The database is implemented with ASP.NET 3.5 and C# technologies for our Web-based application. For data storage, we chose MySQL v.5.0, one of the most popular open source databases. User logins were necessary, and access to patient data was logged for auditing. For security, all data transmissions were carried over encrypted connections. This Web-tool is available to users scattered at different locations; it allows an efficient organisation and storage of data (case report form) and images and allows each user to know precisely what his task is. The advantages of our Web-tool are as follows: (1) sustainability is guaranteed; (2) network locations for collection of data are secured; (3) all clinical information is stored together with the original images and the results derived from processed images and statistical analysis that enable us to perform retrospective studies; (4) changes are easily incorporated because of the modular architecture; and (5) assessment of trial data collected at different sites is centralised to reduce statistical variance.

Built-In Diagnostics (BID) Of Equipment/Systems

NASA Technical Reports Server (NTRS)

Granieri, Michael N.; Giordano, John P.; Nolan, Mary E.

1995-01-01

Diagnostician(TM)-on-Chip (DOC) technology identifies faults and commands systems reconfiguration. Smart microcontrollers operating in conjunction with other system-control circuits, command self-correcting system/equipment actions in real time. DOC microcontroller generates commands for associated built-in test equipment to stimulate unit of equipment diagnosed, collects and processes response data obtained by built-in test equipment, and performs diagnostic reasoning on response data, using diagnostic knowledge base derived from design data.

A fluorescence color-encoded lipid-supported polymeric particle.

PubMed

Shin, Seung Won; Park, Kyung Soo; Baek, Changyoon; Min, Junhong; Cho, Seung-Woo; Choi, Jeong-Woo; Kim, Dong-Ik; Um, Soong Ho

2014-10-01

Several fluorescent or luminescent organisms with biological, chemical, and ecological diversity have been proposed as substitutes for use in new imaging and diagnostic technologies. Inspired by these trends, we designed a synthetic fluorescent light-encoding particulate to serve as a novel and prospective cancer-diagnostic imaging platform. The fluorescence-emitting particulate was used practically for both in vitro and in vivo selective cancer diagnostic imaging. Copyright © 2014 Elsevier B.V. All rights reserved.

Electromagnetic diagnostic system for the Keda Torus eXperiment

NASA Astrophysics Data System (ADS)

Tu, Cui; Liu, Adi; Li, Zichao; Tan, Mingsheng; Luo, Bing; You, Wei; Li, Chenguang; Bai, Wei; Fu, Chenshuo; Huang, Fangcheng; Xiao, Bingjia; Shen, Biao; Shi, Tonghui; Chen, Dalong; Mao, Wenzhe; Li, Hong; Xie, Jinglin; Lan, Tao; Ding, Weixing; Xiao, Chijin; Liu, Wandong

2017-09-01

A system for electromagnetic measurements was designed and installed on the Keda Torus eXperiment (KTX) reversed field pinch device last year. Although the unique double-C structure of the KTX, which allows the machine to be opened easily without disassembling the poloidal field windings, makes the convenient replacement and modification of the internal inductive coils possible, it can present difficulties in the design of flux coils and magnetic probes at the two vertical gaps. Moreover, the KTX has a composite shell consisting of a 6 mm stainless steel vacuum chamber and a 1.5 mm copper shell, which results in limited space for the installation of saddle sensors. Therefore, the double-C structure and composite shell should be considered, especially during the design and installation of the electromagnetic diagnostic system (EDS). The inner surface of the vacuum vessel includes two types of probes. One type is for the measurement of the global plasma parameters, and the other type is for studying the local behavior of the plasma and operating the new saddle coils. In addition, the probes on the outer surface of the composite shell are used for measurements of eddy currents. Finally, saddle sensors for radial field measurements for feedback control were installed between the conducting shell and the vacuum vessel. The entire system includes approximately 1100 magnetic probes, 14 flux coils, 4 ×26 ×2 saddle sensors, and 16 Rogowski coils. Considering the large number of probes and limited space available in the vacuum vessel, the miniaturization of the probes and optimization of the probe distribution are necessary. In addition, accurate calibration and careful mounting of the probes are also required. The frequency response of the designed magnetic probes is up to 200 kHz, and the resolution is 1 G. The EDS, being spherical and of high precision, is one of the most basic and effective diagnostic tools of the KTX and meets the demands imposed by requirements on basic machine operating information and future studies.

Design and implementation of a status at a glance user interface for a power distribution expert system

NASA Technical Reports Server (NTRS)

Liberman, Eugene M.; Manner, David B.; Dolce, James L.; Mellor, Pamela A.

1993-01-01

A user interface to the power distribution expert system for Space Station Freedom is discussed. The importance of features which simplify assessing system status and which minimize navigating through layers of information are examined. Design rationale and implementation choices are also presented. The amalgamation of such design features as message linking arrows, reduced information content screens, high salience anomaly icons, and color choices with failure detection and diagnostic explanation from an expert system is shown to provide an effective status-at-a-glance monitoring system for power distribution. This user interface design offers diagnostic reasoning without compromising the monitoring of current events. The display can convey complex concepts in terms that are clear to its users.

Designing an activity-based costing model for a non-admitted prisoner healthcare setting.

PubMed

Cai, Xiao; Moore, Elizabeth; McNamara, Martin

2013-09-01

To design and deliver an activity-based costing model within a non-admitted prisoner healthcare setting. Key phases from the NSW Health clinical redesign methodology were utilised: diagnostic, solution design and implementation. The diagnostic phase utilised a range of strategies to identify issues requiring attention in the development of the costing model. The solution design phase conceptualised distinct 'building blocks' of activity and cost based on the speciality of clinicians providing care. These building blocks enabled the classification of activity and comparisons of costs between similar facilities. The implementation phase validated the model. The project generated an activity-based costing model based on actual activity performed, gained acceptability among clinicians and managers, and provided the basis for ongoing efficiency and benchmarking efforts.

Diagnostic Assessment of Disadvantaged Vocational Learners.

ERIC Educational Resources Information Center

Gemmill, Perry R.; Kiss, Mary Ellen

This learning activity package (LAP) titled Diagnostic Assessment of Disadvantaged Vocational Learners is one of a series designed to develop competencies needed by vocational teachers working with disadvantaged students. Each LAP concentrates on one general vocational teacher competency and contains the following sections: an introduction, a…

Estimating Classification Consistency and Accuracy for Cognitive Diagnostic Assessment

ERIC Educational Resources Information Center

Cui, Ying; Gierl, Mark J.; Chang, Hua-Hua

2012-01-01

This article introduces procedures for the computation and asymptotic statistical inference for classification consistency and accuracy indices specifically designed for cognitive diagnostic assessments. The new classification indices can be used as important indicators of the reliability and validity of classification results produced by…

VRUSE--a computerised diagnostic tool: for usability evaluation of virtual/synthetic environment systems.

PubMed

Kalawsky, R S

1999-02-01

A special questionnaire (VRUSE) has been designed to measure the usability of a VR system according to the attitude and perception of its users. Important aspects of VR systems were carefully derived to produce key usability factors for the questionnaire. Unlike questionnaires designed for generic interfaces VRUSE is specifically designed to cater for evaluating virtual environments, being a diagnostic tool providing a wealth of information about a user's viewpoint of the interface. VRUSE can be used to great effect with other evaluation techniques to pinpoint problematical areas of a VR interface. Other applications include bench-marking of competitor VR systems.

Delirium diagnosis defined by cluster analysis of symptoms versus diagnosis by DSM and ICD criteria: diagnostic accuracy study.

PubMed

Sepulveda, Esteban; Franco, José G; Trzepacz, Paula T; Gaviria, Ana M; Meagher, David J; Palma, José; Viñuelas, Eva; Grau, Imma; Vilella, Elisabet; de Pablo, Joan

2016-05-26

Information on validity and reliability of delirium criteria is necessary for clinicians, researchers, and further developments of DSM or ICD. We compare four DSM and ICD delirium diagnostic criteria versions, which were developed by consensus of experts, with a phenomenology-based natural diagnosis delineated using cluster analysis of delirium features in a sample with a high prevalence of dementia. We also measured inter-rater reliability of each system when applied by two evaluators from distinct disciplines. Cross-sectional analysis of 200 consecutive patients admitted to a skilled nursing facility, independently assessed within 24-48 h after admission with the Delirium Rating Scale-Revised-98 (DRS-R98) and for DSM-III-R, DSM-IV, DSM-5, and ICD-10 criteria for delirium. Cluster analysis (CA) delineated natural delirium and nondelirium reference groups using DRS-R98 items and then diagnostic systems' performance were evaluated against the CA-defined groups using logistic regression and crosstabs for discriminant analysis (sensitivity, specificity, percentage of subjects correctly classified by each diagnostic system and their individual criteria, and performance for each system when excluding each individual criterion are reported). Kappa Index (K) was used to report inter-rater reliability for delirium diagnostic systems and their individual criteria. 117 (58.5 %) patients had preexisting dementia according to the Informant Questionnaire on Cognitive Decline in the Elderly. CA delineated 49 delirium subjects and 151 nondelirium. Against these CA groups, delirium diagnosis accuracy was highest using DSM-III-R (87.5 %) followed closely by DSM-IV (86.0 %), ICD-10 (85.5 %) and DSM-5 (84.5 %). ICD-10 had the highest specificity (96.0 %) but lowest sensitivity (53.1 %). DSM-III-R had the best sensitivity (81.6 %) and the best sensitivity-specificity balance. DSM-5 had the highest inter-rater reliability (K =0.73) while DSM-III-R criteria were the least reliable. Using our CA-defined, phenomenologically-based delirium designations as the reference standard, we found performance discordance among four diagnostic systems when tested in subjects where comorbid dementia was prevalent. The most complex diagnostic systems have higher accuracy and the newer DSM-5 have higher reliability. Our novel phenomenological approach to designing a delirium reference standard may be preferred to guide revisions of diagnostic systems in the future.

[Mathematical model of technical equipment of a clinical-diagnostic laboratory].

PubMed

Bukin, S I; Busygin, D V; Tilevich, M E

1990-01-01

The paper is concerned with the problems of technical equipment of standard clinico-diagnostic laboratories (CDL) in this country. The authors suggest a mathematic model that may minimize expenditures for laboratory studies. The model enables the following problems to be solved: to issue scientifically-based recommendations for technical equipment of CDL; to validate the medico-technical requirements for newly devised items; to select the optimum types of uniform items; to define optimal technical decisions at the stage of the design; to determine the lab assistant's labour productivity and the cost of some investigations; to compute the medical laboratory engineering requirement for treatment and prophylactic institutions of this country.

Nonneutral plasma diagnostic commissioning for the ALPHA Antihydrogen experiment

NASA Astrophysics Data System (ADS)

Konewko, S.; Friesen, T.; Tharp, T. D.; Alpha Collaboration

2017-10-01

The ALPHA experiment at CERN creates antihydrogen by mixing antiproton and positron plasmas. Diagnostic measurements of the precursor plasmas are performed using a diagnostic suite, colloquially known as the ``stick.'' This stick has a variety of sensors and is able to move to various heights to align the desired diagnostic with the beamline. A cylindrical electrode, a faraday cup, an electron gun, and a microchannel-plate detector (MCP) are regularly used to control and diagnose plasmas in ALPHA. We have designed, built, and tested a new, upgraded stick which includes measurement capabilities in both beamline directions.

Rocket Engine Oscillation Diagnostics

NASA Technical Reports Server (NTRS)

Nesman, Tom; Turner, James E. (Technical Monitor)

2002-01-01

Rocket engine oscillating data can reveal many physical phenomena ranging from unsteady flow and acoustics to rotordynamics and structural dynamics. Because of this, engine diagnostics based on oscillation data should employ both signal analysis and physical modeling. This paper describes an approach to rocket engine oscillation diagnostics, types of problems encountered, and example problems solved. Determination of design guidelines and environments (or loads) from oscillating phenomena is required during initial stages of rocket engine design, while the additional tasks of health monitoring, incipient failure detection, and anomaly diagnostics occur during engine development and operation. Oscillations in rocket engines are typically related to flow driven acoustics, flow excited structures, or rotational forces. Additional sources of oscillatory energy are combustion and cavitation. Included in the example problems is a sampling of signal analysis tools employed in diagnostics. The rocket engine hardware includes combustion devices, valves, turbopumps, and ducts. Simple models of an oscillating fluid system or structure can be constructed to estimate pertinent dynamic parameters governing the unsteady behavior of engine systems or components. In the example problems it is shown that simple physical modeling when combined with signal analysis can be successfully employed to diagnose complex rocket engine oscillatory phenomena.

The AcCell series 2000 as a support system for training and evaluation in educational and clinical settings.

PubMed

Greening, S E; Grohs, D H; Guidos, B J

1997-01-01

Providing effective training, retraining and evaluation programs, including proficiency testing programs, for cytoprofessionals is a challenge shared by many academic and clinical educators internationally. In cytopathology the quality of training has immediately transferable and critically important impacts on satisfactory performance in the clinical setting. Well-designed interactive computer-assisted instruction and testing programs have been shown to enhance initial learning and to reinforce factual and conceptual knowledge. Computer systems designed not only to promote diagnostic accuracy but to integrate and streamline work flow in clinical service settings are candidates for educational adaptation. The AcCell 2000 system, designed as a diagnostic screening support system, offers technology that is adaptable to educational needs during basic and in-service training as well as testing of screening proficiency in both locator and identification skills. We describe the considerations, approaches and applications of the AcCell 2000 system in education programs for both training and evaluation of gynecologic diagnostic screening proficiency.

Design of the 2D electron cyclotron emission imaging instrument for the J-TEXT tokamak.

PubMed

Pan, X M; Yang, Z J; Ma, X D; Zhu, Y L; Luhmann, N C; Domier, C W; Ruan, B W; Zhuang, G

2016-11-01

A new 2D Electron Cyclotron Emission Imaging (ECEI) diagnostic is being developed for the J-TEXT tokamak. It will provide the 2D electron temperature information with high spatial, temporal, and temperature resolution. The new ECEI instrument is being designed to support fundamental physics investigations on J-TEXT including MHD, disruption prediction, and energy transport. The diagnostic contains two dual dipole antenna arrays corresponding to F band (90-140 GHz) and W band (75-110 GHz), respectively, and comprises a total of 256 channels. The system can observe the same magnetic surface at both the high field side and low field side simultaneously. An advanced optical system has been designed which permits the two arrays to focus on a wide continuous region or two radially separate regions with high imaging spatial resolution. It also incorporates excellent field curvature correction with field curvature adjustment lenses. An overview of the diagnostic and the technical progress including the new remote control technique are presented.

Design of the 2D electron cyclotron emission imaging instrument for the J-TEXT tokamak

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

Pan, X. M.; Yang, Z. J., E-mail: yangzj@hust.edu.cn; Ma, X. D.

2016-11-15

A new 2D Electron Cyclotron Emission Imaging (ECEI) diagnostic is being developed for the J-TEXT tokamak. It will provide the 2D electron temperature information with high spatial, temporal, and temperature resolution. The new ECEI instrument is being designed to support fundamental physics investigations on J-TEXT including MHD, disruption prediction, and energy transport. The diagnostic contains two dual dipole antenna arrays corresponding to F band (90-140 GHz) and W band (75-110 GHz), respectively, and comprises a total of 256 channels. The system can observe the same magnetic surface at both the high field side and low field side simultaneously. An advancedmore » optical system has been designed which permits the two arrays to focus on a wide continuous region or two radially separate regions with high imaging spatial resolution. It also incorporates excellent field curvature correction with field curvature adjustment lenses. An overview of the diagnostic and the technical progress including the new remote control technique are presented.« less

Physics and Engineering Design of the ITER Electron Cyclotron Emission Diagnostic

NASA Astrophysics Data System (ADS)

Rowan, W. L.; Austin, M. E.; Houshmandyar, S.; Phillips, P. E.; Beno, J. H.; Ouroua, A.; Weeks, D. A.; Hubbard, A. E.; Stillerman, J. A.; Feder, R. E.; Khodak, A.; Taylor, G.; Pandya, H. K.; Danani, S.; Kumar, R.

2015-11-01

Electron temperature (Te) measurements and consequent electron thermal transport inferences will be critical to the non-active phases of ITER operation and will take on added importance during the alpha heating phase. Here, we describe our design for the diagnostic that will measure spatial and temporal profiles of Te using electron cyclotron emission (ECE). Other measurement capability includes high frequency instabilities (e.g. ELMs, NTMs, and TAEs). Since results from TFTR and JET suggest that Thomson Scattering and ECE differ at high Te due to driven non-Maxwellian distributions, non-thermal features of the ITER electron distribution must be documented. The ITER environment presents other challenges including space limitations, vacuum requirements, and very high-neutron-fluence. Plasma control in ITER will require real-time Te. The diagnosic design that evolved from these sometimes-conflicting needs and requirements will be described component by component with special emphasis on the integration to form a single effective diagnostic system. Supported by PPPL/US-DA via subcontract S013464-C to UT Austin.

Diagnostic accuracy of laparoscopy following computed tomography (CT) scanning for assessing the resectability with curative intent in pancreatic and periampullary cancer.

PubMed

Allen, Victoria B; Gurusamy, Kurinchi Selvan; Takwoingi, Yemisi; Kalia, Amun; Davidson, Brian R

2016-07-06

Surgical resection is the only potentially curative treatment for pancreatic and periampullary cancer. A considerable proportion of patients undergo unnecessary laparotomy because of underestimation of the extent of the cancer on computed tomography (CT) scanning. Laparoscopy can detect metastases not visualised on CT scanning, enabling better assessment of the spread of cancer (staging of cancer). This is an update to a previous Cochrane Review published in 2013 evaluating the role of diagnostic laparoscopy in assessing the resectability with curative intent in people with pancreatic and periampullary cancer. To determine the diagnostic accuracy of diagnostic laparoscopy performed as an add-on test to CT scanning in the assessment of curative resectability in pancreatic and periampullary cancer. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE via PubMed, EMBASE via OvidSP (from inception to 15 May 2016), and Science Citation Index Expanded (from 1980 to 15 May 2016). We included diagnostic accuracy studies of diagnostic laparoscopy in people with potentially resectable pancreatic and periampullary cancer on CT scan, where confirmation of liver or peritoneal involvement was by histopathological examination of suspicious (liver or peritoneal) lesions obtained at diagnostic laparoscopy or laparotomy. We accepted any criteria of resectability used in the studies. We included studies irrespective of language, publication status, or study design (prospective or retrospective). We excluded case-control studies. Two review authors independently performed data extraction and quality assessment using the QUADAS-2 tool. The specificity of diagnostic laparoscopy in all studies was 1 because there were no false positives since laparoscopy and the reference standard are one and the same if histological examination after diagnostic laparoscopy is positive. The sensitivities were therefore meta-analysed using a univariate random-effects logistic regression model. The probability of unresectability in people who had a negative laparoscopy (post-test probability for people with a negative test result) was calculated using the median probability of unresectability (pre-test probability) from the included studies, and the negative likelihood ratio derived from the model (specificity of 1 assumed). The difference between the pre-test and post-test probabilities gave the overall added value of diagnostic laparoscopy compared to the standard practice of CT scan staging alone. We included 16 studies with a total of 1146 participants in the meta-analysis. Only one study including 52 participants had a low risk of bias and low applicability concern in the patient selection domain. The median pre-test probability of unresectable disease after CT scanning across studies was 41.4% (that is 41 out of 100 participants who had resectable cancer after CT scan were found to have unresectable disease on laparotomy). The summary sensitivity of diagnostic laparoscopy was 64.4% (95% confidence interval (CI) 50.1% to 76.6%). Assuming a pre-test probability of 41.4%, the post-test probability of unresectable disease for participants with a negative test result was 0.20 (95% CI 0.15 to 0.27). This indicates that if a person is said to have resectable disease after diagnostic laparoscopy and CT scan, there is a 20% probability that their cancer will be unresectable compared to a 41% probability for those receiving CT alone.A subgroup analysis of people with pancreatic cancer gave a summary sensitivity of 67.9% (95% CI 41.1% to 86.5%). The post-test probability of unresectable disease after being considered resectable on both CT and diagnostic laparoscopy was 18% compared to 40.0% for those receiving CT alone. Diagnostic laparoscopy may decrease the rate of unnecessary laparotomy in people with pancreatic and periampullary cancer found to have resectable disease on CT scan. On average, using diagnostic laparoscopy with biopsy and histopathological confirmation of suspicious lesions prior to laparotomy would avoid 21 unnecessary laparotomies in 100 people in whom resection of cancer with curative intent is planned.

Lyme disease: the promise of Big Data, companion diagnostics and precision medicine

PubMed Central

Stricker, Raphael B; Johnson, Lorraine

2016-01-01

Lyme disease caused by the spirochete Borrelia burgdorferi has become a major worldwide epidemic. Recent studies based on Big Data registries show that >300,000 people are diagnosed with Lyme disease each year in the USA, and up to two-thirds of individuals infected with B. burgdorferi will fail conventional 30-year-old antibiotic therapy for Lyme disease. In addition, animal and human evidence suggests that sexual transmission of the Lyme spirochete may occur. Improved companion diagnostic tests for Lyme disease need to be implemented, and novel treatment approaches are urgently needed to combat the epidemic. In particular, therapies based on the principles of precision medicine could be modeled on successful “designer drug” treatment for HIV/AIDS and hepatitis C virus infection featuring targeted protease inhibitors. The use of Big Data registries, companion diagnostics and precision medicine will revolutionize the diagnosis and treatment of Lyme disease. PMID:27672336

A Clinicopathological Study of Various Oral Cancer Diagnostic Techniques

PubMed Central

Ulaganathan, G.; Mohamed Niazi, K. Thanvir; Srinivasan, Soundarya; Balaji, V. R.; Manikandan, D.; Hameed, K. A. Shahul; Banumathi, A.

2017-01-01

Oral cancer is one of the most commonly occurring malignant tumors in the head and neck regions with high incident rate and mortality rate in the developed countries than in the developing countries. Generally, the survival rate of cancer patients may increase when diagnosed at early stage, followed by prompt treatment and therapy. Recently, cancer diagnosis and therapy design for a specific cancer patient have been performed with the advanced computer-aided techniques. The responses of the cancer therapy could be continuously monitored to ensure the effectiveness of the treatment process that hardly requires diagnostic result as quick as possible to improve the quality and patient care. This paper gives an overview of oral cancer occurrence, different types, and various diagnostic techniques. In addition, a brief introduction is given to various stages of immunoanalysis including tissue image preparation, whole slide imaging, and microscopic image analysis. PMID:29284926

Two-dimensional AXUV-based radiated power density diagnostics on NSTX-Ua)

NASA Astrophysics Data System (ADS)

Faust, I.; Delgado-Aparicio, L.; Bell, R. E.; Tritz, K.; Diallo, A.; Gerhardt, S. P.; LeBlanc, B.; Kozub, T. A.; Parker, R. R.; Stratton, B. C.

2014-11-01

A new set of radiated-power-density diagnostics for the National Spherical Torus Experiment Upgrade (NSTX-U) tokamak have been designed to measure the two-dimensional poloidal structure of the total photon emissivity profile in order to perform power balance, impurity transport, and magnetohydrodynamic studies. Multiple AXUV-diode based pinhole cameras will be installed in the same toroidal angle at various poloidal locations. The local emissivity will be obtained from several types of tomographic reconstructions. The layout and response expected for the new radially viewing poloidal arrays will be shown for different impurity concentrations to characterize the diagnostic sensitivity. The radiated power profile inverted from the array data will also be used for estimates of power losses during transitions from various divertor configurations in NSTX-U. The effect of in-out and top/bottom asymmetries in the core radiation from high-Z impurities will be addressed.

Two-dimensional AXUV-based radiated power density diagnostics on NSTX-U.

PubMed

Faust, I; Delgado-Aparicio, L; Bell, R E; Tritz, K; Diallo, A; Gerhardt, S P; LeBlanc, B; Kozub, T A; Parker, R R; Stratton, B C

2014-11-01

A new set of radiated-power-density diagnostics for the National Spherical Torus Experiment Upgrade (NSTX-U) tokamak have been designed to measure the two-dimensional poloidal structure of the total photon emissivity profile in order to perform power balance, impurity transport, and magnetohydrodynamic studies. Multiple AXUV-diode based pinhole cameras will be installed in the same toroidal angle at various poloidal locations. The local emissivity will be obtained from several types of tomographic reconstructions. The layout and response expected for the new radially viewing poloidal arrays will be shown for different impurity concentrations to characterize the diagnostic sensitivity. The radiated power profile inverted from the array data will also be used for estimates of power losses during transitions from various divertor configurations in NSTX-U. The effect of in-out and top/bottom asymmetries in the core radiation from high-Z impurities will be addressed.

Breast MRI in nonpalpable breast lesions: a randomized trial with diagnostic and therapeutic outcome – MONET – study

PubMed Central

Peters, Nicky HGM; Borel Rinkes, Inne HM; Mali, Willem PTM; van den Bosch, Maurice AAJ; Storm, Remmert K; Plaisier, Peter W; de Boer, Erwin; van Overbeeke, Adriaan J; Peeters, Petra HM

2007-01-01

Background In recent years there has been an increasing interest in MRI as a non-invasive diagnostic modality for the work-up of suspicious breast lesions. The additional value of Breast MRI lies mainly in its capacity to detect multicentric and multifocal disease, to detect invasive components in ductal carcinoma in situ lesions and to depict the tumor in a 3-dimensional image. Breast MRI therefore has the potential to improve the diagnosis and provide better preoperative staging and possibly surgical care in patients with breast cancer. The aim of our study is to assess whether performing contrast enhanced Breast MRI can reduce the number of surgical procedures due to better preoperative staging and whether a subgroup of women with suspicious nonpalpable breast lesions can be identified in which the combination of mammography, ultrasound and state-of-the-art contrast-enhanced Breast MRI can provide a definite diagnosis. Methods/Design The MONET – study (MR mammography Of Nonpalpable BrEast Tumors) is a randomized controlled trial with diagnostic and therapeutic endpoints. We aim to include 500 patients with nonpalpable suspicious breast lesions who are referred for biopsy. With this number of patients, the expected 12% reduction in surgical procedures due to more accurate preoperative staging with Breast MRI can be detected with a high power (90%). The secondary outcome is the positive and negative predictive value of contrast enhanced Breast MRI. If the predictive values are deemed sufficiently close to those for large core biopsy then the latter, invasive, procedure could possibly be avoided in some women. The rationale, study design and the baseline characteristics of the first 100 included patients are described. Trial registration Study protocol number NCT00302120 PMID:18045470

Diagnostic Capability of Spectral Domain Optical Coherence Tomography for Glaucoma

PubMed Central

Wu, Huijuan; de Boer, Johannes F.; Chen, Teresa C.

2012-01-01

Purpose To determine the diagnostic capability of spectral domain optical coherence tomography (OCT) in glaucoma patients with visual field (VF) defects. Design Prospective, cross-sectional study. Methods Setting Participants were recruited from a university hospital clinic. Study Population One eye of 85 normal subjects and 61 glaucoma patients [with average VF mean deviation (MD) of -9.61 ± 8.76 dB] were randomly selected for the study. A subgroup of the glaucoma patients with early VF defects was calculated separately. Observation Procedures Spectralis OCT circular scans were performed to obtain peripapillary retinal nerve fiber layer (RNFL) thicknesses. The RNFL diagnostic parameters based on the normative database were used alone or in combination for identifying glaucomatous RNFL thinning. Main Outcome Measures To evaluate diagnostic performance, calculations included areas under the receiver operating characteristic curve (AROC), sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio. Results Overall RNFL thickness had the highest AROC value (0.952 for all patients, 0.895 for the early glaucoma subgroup). For all patients, the highest sensitivity (98.4%, CI 96.3-100%) was achieved by using two criteria: ≥1 RNFL sectors being abnormal at the < 5% level, and overall classification of borderline or outside normal limits, with specificities of 88.9% (CI 84.0-94.0%) and 87.1% (CI 81.6-92.5%) respectively for these two criteria. Conclusions Statistical parameters for evaluating the diagnostic performance of the Spectralis spectral domain OCT were good for early perimetric glaucoma and excellent for moderately-advanced perimetric glaucoma. PMID:22265147

The Diagnostic Efficacy of Cone-beam Computed Tomography in Endodontics: A Systematic Review and Analysis by a Hierarchical Model of Efficacy.

PubMed

Rosen, Eyal; Taschieri, Silvio; Del Fabbro, Massimo; Beitlitum, Ilan; Tsesis, Igor

2015-07-01

The aim of this study was to evaluate the diagnostic efficacy of cone-beam computed tomographic (CBCT) imaging in endodontics based on a systematic search and analysis of the literature using an efficacy model. A systematic search of the literature was performed to identify studies evaluating the use of CBCT imaging in endodontics. The identified studies were subjected to strict inclusion criteria followed by an analysis using a hierarchical model of efficacy (model) designed for appraisal of the literature on the levels of efficacy of a diagnostic imaging modality. Initially, 485 possible relevant articles were identified. After title and abstract screening and a full-text evaluation, 58 articles (12%) that met the inclusion criteria were analyzed and allocated to levels of efficacy. Most eligible articles (n = 52, 90%) evaluated technical characteristics or the accuracy of CBCT imaging, which was defined in this model as low levels of efficacy. Only 6 articles (10%) proclaimed to evaluate the efficacy of CBCT imaging to support the practitioner's decision making; treatment planning; and, ultimately, the treatment outcome, which was defined as higher levels of efficacy. The expected ultimate benefit of CBCT imaging to the endodontic patient as evaluated by its level of diagnostic efficacy is unclear and is mainly limited to its technical and diagnostic accuracy efficacies. Even for these low levels of efficacy, current knowledge is limited. Therefore, a cautious and rational approach is advised when considering CBCT imaging for endodontic purposes. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Compact soft x-ray multichord camera: Design and initial operation

NASA Astrophysics Data System (ADS)

Franz, P.; Gadani, G.; Pasqualotto, R.; Marrelli, L.; Martin, P.; Spizzo, G.; Brunsell, P.; Chapman, B. E.; Paganucci, F.; Rossetti, P.; Xiao, C.

2003-03-01

A compact and low cost diagnostic for spatially resolved measurements of soft x-ray or total radiation emission has been designed and realized to be flexibly applied to different plasma physics experiments. Its reduced size (outer diameter=35 mm) makes it suited to a variety of devices. The line integrated emissivity (brightness) has been measured along up to 20 lines of sight, using an array of miniaturized silicon photodiodes. Preliminary prototypes of the diagnostic have been installed in the Madison Symmetric Torus reversed field pinch (RFP) device at University of Wisconsin and in the EXTRAP T2 RFP device at the Royal Institute of Technology in Stockholm. Application of the diagnostic to a gas-fed (argon, helium) magnetoplasma dynamic thruster (MPDT) with an external magnetic field will also be discussed.

Design considerations for highly effective fluorescence excitation and detection optical systems for molecular diagnostics

NASA Astrophysics Data System (ADS)

Kasper, Axel; Van Hille, Herbert; Kuk, Sola

2018-02-01

Modern instruments for molecular diagnostics are continuously optimized for diagnostic accuracy, versatility and throughput. The latest progress in LED technology together with tailored optics solutions allows developing highly efficient photonics engines perfectly adapted to the sample under test. Super-bright chip-on-board LED light sources are a key component for such instruments providing maximum luminous intensities in a multitude of narrow spectral bands. In particular the combination of white LEDs with other narrow band LEDs allows achieving optimum efficiency outperforming traditional Xenon light sources in terms of energy consumption, heat dissipation in the system, and switching time between spectral channels. Maximum sensitivity of the diagnostic system can only be achieved with an optimized optics system for the illumination and imaging of the sample. The illumination beam path must be designed for optimum homogeneity across the field while precisely limiting the angular distribution of the excitation light. This is a necessity for avoiding spill-over to the detection beam path and guaranteeing the efficiency of the spectral filtering. The imaging optics must combine high spatial resolution, high light collection efficiency and optimized suppression of excitation light for good signal-to-noise ratio. In order to achieve minimum cross-talk between individual wells in the sample, the optics design must also consider the generation of stray light and the formation of ghost images. We discuss what parameters and limitations have to be considered in an integrated system design approach covering the full path from the light source to the detector.

Child and adolescent psychiatry patients coming of age: a retrospective longitudinal study of inpatient treatment in Tyrol.

PubMed

Fuchs, Martin; Kemmler, Georg; Steiner, Hans; Marksteiner, Josef; Haring, Christian; Miller, Carl; Hausmann, Armand; Sevecke, Kathrin

2016-07-08

Mental illness is a common phenomenon at all ages. Various independent studies have shown that psychopathology is often expressed on a continuum from youth to adulthood. The aim of our study was to demonstrate a) the frequency of admission of former child and adolescent psychiatry inpatients (CAP-IP) to adult inpatient mental health facilities, and b) a potential longitudinal diagnostic shift. This is the first Austrian study designed to shed light on these issues. Nearly 1000 inpatient cases at a specialized child and adolescent care center were analyzed. These cases were then tracked using data matching with registry data from adult psychiatric institutions. Overall, our observational period was 23 years. 26 % of our sample of former CAP-IP used psychiatric inpatient mental health services as adults, thus indicating chronicity or reoccurrence. In line with previous literature, there were patients who stayed in the same diagnostic category as well as patients with a diagnostic shift from childhood to adulthood. Childhood and adolescence is a very important period for early intervention and prevention of mental illness. Our findings support the notion of the continuity of psychopathology from youth into adulthood.

Implementation of ECIRR model based on virtual simulation media to reduce students’ misconception on kinetic theory of gases

NASA Astrophysics Data System (ADS)

Prastiwi, A. C.; Kholiq, A.; Setyarsih, W.

2018-03-01

The purposed of this study are to analyse reduction of students’ misconceptions after getting ECIRR with virtual simulation. The design of research is the pre-experimental design with One Group Pretest-Posttest Design. Subjects of this research were 36 students of class XI MIA-5 SMAN 1 Driyorejo Gresik 2015/2016 school year. Students misconceptions was determined by Three-tier Diagnostic Test. The result shows that the average percentage of misconceptions reduced on topics of ideal gas law, equation of ideal gases and kinetic theory of gases respectively are 38%, 34% and 38%.

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

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

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

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

Diagnostic and laboratory test ordering in Northern Portuguese Primary Health Care: a cross-sectional study

PubMed Central

Sá, Luísa; Teixeira, Andreia Sofia Costa; Tavares, Fernando; Costa-Santos, Cristina; Couto, Luciana; Costa-Pereira, Altamiro; Hespanhol, Alberto Pinto; Santos, Paulo

2017-01-01

Objectives To characterise the test ordering pattern in Northern Portugal and to investigate the influence of context-related factors, analysing the test ordered at the level of geographical groups of family physicians and at the level of different healthcare organisations. Design Cross-sectional study. Setting Northern Primary Health Care, Portugal. Participants Records about diagnostic and laboratory tests ordered from 2035 family physicians working at the Northern Regional Health Administration, who served approximately 3.5 million Portuguese patients, in 2014. Outcomes To determine the 20 most ordered diagnostic and laboratory tests in the Northern Regional Health Administration; to identify the presence and extent of variations in the 20 most ordered diagnostic and laboratory tests between the Groups of Primary Care Centres and between health units; and to study factors that may explain these variations. Results The 20 most ordered diagnostic and laboratory tests almost entirely comprise laboratory tests and account for 70.9% of the total tests requested. We can trace a major pattern of test ordering for haemogram, glucose, lipid profile, creatinine and urinalysis. There was a significant difference (P<0.001) in test orders for all tests between Groups of Primary Care Centres and for all tests, except glycated haemoglobin (P=0.06), between health units. Generally, the Personalised Healthcare Units ordered more than Family Health Units. Conclusions The results from this study show that the most commonly ordered tests in Portugal are laboratory tests, that there is a tendency for overtesting and that there is a large variability in diagnostic and laboratory test ordering in different geographical and organisational Portuguese primary care practices, suggesting that there may be considerable potential for the rationalisation of test ordering. The existence of Family Health Units seems to be a strong determinant in decreasing test ordering by Portuguese family physicians. Approaches to ensuring more rational testing are needed. PMID:29146654

Diagnostic Accuracy of Fall Risk Assessment Tools in People With Diabetic Peripheral Neuropathy

PubMed Central

Pohl, Patricia S.; Mahnken, Jonathan D.; Kluding, Patricia M.

2012-01-01

Background Diabetic peripheral neuropathy affects nearly half of individuals with diabetes and leads to increased fall risk. Evidence addressing fall risk assessment for these individuals is lacking. Objective The purpose of this study was to identify which of 4 functional mobility fall risk assessment tools best discriminates, in people with diabetic peripheral neuropathy, between recurrent “fallers” and those who are not recurrent fallers. Design A cross-sectional study was conducted. Setting The study was conducted in a medical research university setting. Participants The participants were a convenience sample of 36 individuals between 40 and 65 years of age with diabetic peripheral neuropathy. Measurements Fall history was assessed retrospectively and was the criterion standard. Fall risk was assessed using the Functional Reach Test, the Timed “Up & Go” Test, the Berg Balance Scale, and the Dynamic Gait Index. Sensitivity, specificity, positive and negative likelihood ratios, and overall diagnostic accuracy were calculated for each fall risk assessment tool. Receiver operating characteristic curves were used to estimate modified cutoff scores for each fall risk assessment tool; indexes then were recalculated. Results Ten of the 36 participants were classified as recurrent fallers. When traditional cutoff scores were used, the Dynamic Gait Index and Functional Reach Test demonstrated the highest sensitivity at only 30%; the Dynamic Gait Index also demonstrated the highest overall diagnostic accuracy. When modified cutoff scores were used, all tools demonstrated improved sensitivity (80% or 90%). Overall diagnostic accuracy improved for all tests except the Functional Reach Test; the Timed “Up & Go” Test demonstrated the highest diagnostic accuracy at 88.9%. Limitations The small sample size and retrospective fall history assessment were limitations of the study. Conclusions Modified cutoff scores improved diagnostic accuracy for 3 of 4 fall risk assessment tools when testing people with diabetic peripheral neuropathy. PMID:22836004

Rasch Analysis of the Geriatric Depression Scale--Short Form

ERIC Educational Resources Information Center

Chiang, Karl S.; Green, Kathy E.; Cox, Enid O.

2009-01-01

Purpose: The purpose of this study was to examine scale dimensionality, reliability, invariance, targeting, continuity, cutoff scores, and diagnostic use of the Geriatric Depression Scale-Short Form (GDS-SF) over time with a sample of 177 English-speaking U.S. elders. Design and Methods: An item response theory, Rasch analysis, was conducted with…

Mediation of host immune responses after immunization of neonatal calves with a heat-killed Mycobacterium avium subsp. paratuberculosis vaccine

USDA-ARS?s Scientific Manuscript database

A major drawback of current whole-cell vaccines for Mycobacterium avium subsp. paratuberculosis(MAP) is the interference with diagnostic tests for bovine tuberculosis and paratuberculosis. The current study was designed to explore effects of immunization with a heat-killed whole cell vaccine (Mycop...

Stereotype Threat Effects on African American and Latina/o Elementary Students Tested Together

ERIC Educational Resources Information Center

Wasserberg, Martin James

2017-01-01

Purpose: This study aimed to investigate whether a diagnostic testing condition leads to stereotype threat effects for African American and Latina/o children (N = 81) when tested together at an urban elementary school in Miami, Florida. Design/methodology/approach: To analyze the effect of stereotype threat on participants' reading test…

A Diagnostic Study of Computer Application of Structural Communication Grid

ERIC Educational Resources Information Center

Bahar, Mehmet; Aydin, Fatih; Karakirik, Erol

2009-01-01

In this article, Structural communication grid (SCG), an alternative measurement and evaluation technique, has been firstly summarised and the design, development and implementation of a computer based SCG system have been introduced. The system is then tested on a sample of 154 participants consisting of candidate students, science teachers and…

Infant Abuse, Neglect, and Failure-to-Thrive: Mother-Infant Interaction.

ERIC Educational Resources Information Center

Dietrich, Kim N.; And Others

This study was designed to investigate whether or not degree of child maltreatment is related in some meaningful way to the interactional characteristics of the mother/infant dyad and to the infant's developmental status. A group of 53 mother/infant dyads was divided into five diagnostic groups: nonaccidental trauma combined with…

The design and development of a space laboratory to conduct magnetospheric and plasma research

NASA Technical Reports Server (NTRS)

Rosen, A.

1974-01-01

A design study was conducted concerning a proposed shuttle-borne space laboratory for research on magnetospheric and plasma physics. A worldwide survey found two broad research disciplines of interest: geophysical studies of the dynamics and structure of the magnetosphere (including wave characteristics, wave-particle interactions, magnetospheric modifications, beam-plasma interactions, and energetic particles and tracers) and plasma physics studies (plasma physics in space, wake and sheath studies, and propulsion and devices). The Plasma Physics and Environmental Perturbation Laboratory (PPEPL) designed to perform experiments in these areas will include two 50-m booms and two maneuverable subsatellites, a photometer array, standardized proton, electron, and plasma accelerators, a high-powered transmitter for frequencies above 100 kHz, a low-power transmitter for VLF and below, and complete diagnostic packages. Problem areas in the design of a space plasma physics laboratory are indicated.

Validation of Living Donor Nephrectomy Codes

PubMed Central

Lam, Ngan N.; Lentine, Krista L.; Klarenbach, Scott; Sood, Manish M.; Kuwornu, Paul J.; Naylor, Kyla L.; Knoll, Gregory A.; Kim, S. Joseph; Young, Ann; Garg, Amit X.

2018-01-01

Background: Use of administrative data for outcomes assessment in living kidney donors is increasing given the rarity of complications and challenges with loss to follow-up. Objective: To assess the validity of living donor nephrectomy in health care administrative databases compared with the reference standard of manual chart review. Design: Retrospective cohort study. Setting: 5 major transplant centers in Ontario, Canada. Patients: Living kidney donors between 2003 and 2010. Measurements: Sensitivity and positive predictive value (PPV). Methods: Using administrative databases, we conducted a retrospective study to determine the validity of diagnostic and procedural codes for living donor nephrectomies. The reference standard was living donor nephrectomies identified through the province’s tissue and organ procurement agency, with verification by manual chart review. Operating characteristics (sensitivity and PPV) of various algorithms using diagnostic, procedural, and physician billing codes were calculated. Results: During the study period, there were a total of 1199 living donor nephrectomies. Overall, the best algorithm for identifying living kidney donors was the presence of 1 diagnostic code for kidney donor (ICD-10 Z52.4) and 1 procedural code for kidney procurement/excision (1PC58, 1PC89, 1PC91). Compared with the reference standard, this algorithm had a sensitivity of 97% and a PPV of 90%. The diagnostic and procedural codes performed better than the physician billing codes (sensitivity 60%, PPV 78%). Limitations: The donor chart review and validation study was performed in Ontario and may not be generalizable to other regions. Conclusions: An algorithm consisting of 1 diagnostic and 1 procedural code can be reliably used to conduct health services research that requires the accurate determination of living kidney donors at the population level. PMID:29662679

Diagnostic accuracy of the Eurotest for dementia: a naturalistic, multicenter phase II study

PubMed Central

Carnero-Pardo, Cristobal; Gurpegui, Manuel; Sanchez-Cantalejo, Emilio; Frank, Ana; Mola, Santiago; Barquero, M Sagrario; Montoro-Rios, M Teresa

2006-01-01

Background Available screening tests for dementia are of limited usefulness because they are influenced by the patient's culture and educational level. The Eurotest, an instrument based on the knowledge and handling of money, was designed to overcome these limitations. The objective of this study was to evaluate the diagnostic accuracy of the Eurotest in identifying dementia in customary clinical practice. Methods A cross-sectional, multi-center, naturalistic phase II study was conducted. The Eurotest was administered to consecutive patients, older than 60 years, in general neurology clinics. The patients' condition was classified as dementia or no dementia according to DSM-IV diagnostic criteria. We calculated sensitivity (Sn), specificity (Sp) and area under the ROC curves (aROC) with 95% confidence intervals. The influence of social and educational factors on scores was evaluated with multiple linear regression analysis, and the influence of these factors on diagnostic accuracy was evaluated with logistic regression. Results Sixteen neurologists recruited a total of 516 participants: 101 with dementia, 380 without dementia, and 35 who were excluded. Of the 481 participants who took the Eurotest, 38.7% were totally or functionally illiterate and 45.5% had received no formal education. Mean time needed to administer the test was 8.2+/-2.0 minutes. The best cut-off point was 20/21, with Sn = 0.91 (0.84–0.96), Sp = 0.82 (0.77–0.85), and aROC = 0.93 (0.91–0.95). Neither the scores on the Eurotest nor its diagnostic accuracy were influenced by social or educational factors. Conclusion This naturalistic and pragmatic study shows that the Eurotest is a rapid, simple and useful screening instrument, which is free from educational influences, and has appropriate internal and external validity. PMID:16606455

Schizoaffective disorder diagnosed according to different diagnostic criteria--systematic literature search and meta-analysis of key clinical characteristics and heterogeneity.

PubMed

Pagel, Tobias; Franklin, Jeremy; Baethge, Christopher

2014-03-01

Schizoaffective disorder is viewed as a heterogeneous diagnosis among psychotic illnesses. Different diagnostic systems differ in their definition with DSM (-IIIR, -IV, and -V) providing a narrower definition than RDC and ICD-10. It is unclear whether this difference is reflected in patient samples diagnosed according to different diagnostic systems. Exploratory study based on a systematic review of studies of schizoaffective disorder samples diagnosed by either RDC and ICD-10 (group of "broad criteria") or DSM-IIIR and -IV ("narrow criteria"); comparison (by Mann-Whitney-U-tests) of key characteristics, such as age, number of hospitalizations, or scores in psychometric tests, between more broadly and more narrowly defined schizoaffective disorder samples using standard deviations as a measurement of heterogeneity as well as weighted means and percentages. To reduce selection bias only studies including schizoaffective patient samples together with affective disorder and schizophrenia samples were selected. 55 studies were included, 14 employing RDC, 4 ICD-10, 20 DSM-IIIR, and 17 DSM-IV. Thirteen characteristics were compared: patients diagnosed according to broader criteria had fewer previous hospitalizations (2.2 vs. 5.4) and were both less often male (42 vs. 51%) and married (21 vs. 40%). Heterogeneity was similar in both groups but slightly higher in RDC and ICD-10 samples than in DSM-IIIR and -IV-samples: +4% regarding demographic and clinical course data and +13% regarding psychometric tests (pooled SD). Secular trends and different designs may have confounded the results and limit generalizability. Some comparisons were underpowered. Differences in diagnostic criteria are reflected in key characteristics of samples. The association of larger heterogeneity with wider diagnostic criteria supports employing standard deviations as a measurement of heterogeneity. Copyright © 2013 Elsevier B.V. All rights reserved.

Accuracy of i-Scan for Optical Diagnosis of Colonic Polyps: A Meta-Analysis

PubMed Central

Guo, Chuan-Guo; Ji, Rui; Li, Yan-Qing

2015-01-01

Background i-Scan is a novel virtual chromoendoscopy system designed to enhance surface and vascular patterns to improve optical diagnostic performance. Numerous prospective studies have been done to evaluate the accuracy of i-Scan in differentiating colonic neoplasms from non-neoplasms. i-Scan could be an effective endoscopic technique for optical diagnosis of colonic polyps. Objective Our aim of this study was to perform a meta-analysis of published data to establish the diagnostic accuracy of i-Scan for optical diagnosis of colonic polyps. Methods We searched PubMed, Medline, Elsevier ScienceDirect and Cochrane Library databases. We used a bivariate meta-analysis following a random effects model to summarize the data and plotted hierarchical summary receiver-operating characteristic (HSROC) curves. The area under the HSROC curve (AUC) serves as an indicator of the diagnostic accuracy. Results The meta-analysis included a total of 925 patients and 2312 polyps. For the overall studies, the area under the HSROC curve was 0.96. The summary sensitivity was 90.4% (95%CI 85%-94.1%) and specificity was 90.9% (95%CI 84.3%-94.9%). In 11 studies predicting polyps histology in real-time, the summary sensitivity and specificity was 91.5% (95%CI 85.7%-95.1%) and 92.1% (95%CI 84.5%-96.1%), respectively, with the AUC of 0.97. For three different diagnostic criteria (Kudo, NICE, others), the sensitivity was 86.3%, 93.0%, 85.0%, respectively and specificity was 84.8%, 94.4%, 91.8%, respectively. Conclusions Endoscopic diagnosis with i-Scan has accurate optical diagnostic performance to differentiate neoplastic from non-neoplastic polyps with an area under the HSROC curve exceeding 0.90. Both the sensitivity and specificity for diagnosing colonic polyps are over 90%. PMID:25978459

Effect of Bovine Serum Albumin Treatment on the Aging and Activity of Antibodies in Paper Diagnostics.

PubMed

Huang, Ziwei; Gengenbach, Thomas; Tian, Junfei; Shen, Wei; Garnier, Gil

2018-01-01

Paper and cellulosic films are used in many designs of low-cost diagnostics such as paper-based blood grouping devices. A major issue limiting their commercialization is the short stability of the functional biomolecules. To address this problem, the effect of relative humidity (RH) and bovine serum albumin (BSA) on the antibody bioactivity and the surface chemical composition of a paper blood typing biodiagnostic were studied. An IgM blood typing antibody was physisorbed from solution onto paper - with or without BSA pretreatment, and aged for periods up to 9 weeks under various conditions with a series of RH. The blood typing efficiency of the antibodies and the substrate surface chemical composition were analyzed by image analysis and X-ray photoelectron spectroscopy (XPS), respectively. This study tests two hypotheses. The first is that the hydroxyl groups in paper promote antibody denaturation on paper; the second hypothesis is that proteins such as BSA can partially block the hydroxyl groups within paper, thus preserving antibody bioactivity. Results show that high RH is detrimental to antibody longevity on paper, while BSA can block hydroxyl groups and prolong antibody longevity by almost an order of magnitude-regardless of humidity. This study opens up new engineering concepts to develop robust and marketable paper diagnostics. The simplest is to store paper and antibody based diagnostics in moisture proof packages.

Diagnostic accuracy of presepsin (sCD14-ST) as a biomarker of infection and sepsis in the emergency department.

PubMed

de Guadiana Romualdo, Luis García; Torrella, Patricia Esteban; Acebes, Sergio Rebollo; Otón, María Dolores Albaladejo; Sánchez, Roberto Jiménez; Holgado, Ana Hernando; Santos, Enrique Jiménez; Freire, Alejandro Ortín

2017-01-01

Presepsin is a promising biomarker for the diagnosis and prognosis of sepsis. However, results reported about its value to diagnose sepsis in an emergency department (ED) are controversial, probably due to differences in the design of the studies. We have evaluated the diagnostic accuracy of presepsin for infection and sepsis, compared with procalcitonin (PCT) and C-reactive protein (CRP), in patients presenting to the emergency department (ED) with suspected infection. 223 patients with suspected infection were enrolled for the study. Blood samples were collected on admission for measurement of biomarkers. Definitive diagnosis was obtained afterwards by analysis of digital medical records. Receiver operating characteristic (ROC) curve analysis was conducted to determine the diagnostic accuracy. Infection was confirmed in 200 patients, including 130 with non-complicated infection and 70 with sepsis. Median CRP, PCT and presepsin levels were significantly higher in patients with infection and sepsis. PCT was the biomarker with the highest performance for infection (ROC AUC: 0.910); for sepsis, PCT (ROC AUC: 0.815) and presepsin (ROC AUC: 0.775) shown a similar performance. Although presepsin is a valuable biomarker for diagnosis of infection and sepsis, its diagnostic accuracy in our study does not improve that of PCT. Its introduction in clinical practice is not justified. Copyright © 2016 Elsevier B.V. All rights reserved.

Effect of Bovine Serum Albumin Treatment on the Aging and Activity of Antibodies in Paper Diagnostics

NASA Astrophysics Data System (ADS)

Huang, Ziwei; Gengenbach, Thomas; Tian, Junfei; Shen, Wei; Garnier, Gil

2018-05-01

Paper and cellulosic films are used in many designs of low-cost diagnostics such as paper-based blood grouping devices. A major issue limiting their commercialization is the short stability of the functional biomolecules. To address this problem, the effect of relative humidity (RH) and bovine serum albumin (BSA) on the antibody bioactivity and the surface chemical composition of a paper blood typing biodiagnostic were studied. An IgM blood typing antibody was physisorbed from solution onto paper - with or without BSA pretreatment, and aged for periods up to 9 weeks at room temperature and under different RH conditions. The blood typing efficiency of the antibodies and the substrate surface chemical composition were analyzed by image analysis and X-ray photoelectron spectroscopy (XPS), respectively. This study tests two hypotheses. The first is that the hydroxyl groups in paper promote antibody denaturation on paper; the second hypothesis is that proteins such as BSA can partially block the hydroxyl groups with paper, thus preserving antibody bioactivity. Results show that high RH is detrimental to antibody longevity on paper, while BSA can block hydroxyl groups and prolong antibody longevity by almost an order of magnitude – regardless of humidity. This study opens up new engineering concepts to develop robust and marketable paper diagnostics. The simplest is to store paper and antibody based diagnostics in moisture proof packages.

Design Study of an X-ray Crystal Spectrometer for the HANBIT Mirror Machine

NASA Astrophysics Data System (ADS)

Lee, S. G.; Hwang, S. M.; Bitter, M. L.

1997-11-01

X-ray crystal spectroscopy is expected to play a major role for the diagnostics of the reactor-like plasmas produced in future large tokamaks, such as KSTAR and ITER. However, it is also desirable to extend the observable spectral range to longer wavelengths (7-15 dotA), which is of interest for the diagnostics of plasmas with much lower electron densities (10^11-10^12 cm-3) and electron temperatures (100 - 200 eV) in other magnetic-confinement experiments, such as the HANBIT mirror machine. The construction of crystal spectrometers for this wavelength range and these plasma conditions is challenging because of the low X-ray emissivity and the fact that the low-energy X-rays are strongly attenuated by even very thin foils or windows. New types of detectors other than the presently used multi-wire proportional counters are therefore needed to obtain a high detection efficiency. In this paper, we present a design study for a vacuum spectrometer with a CCD array detector and detailed estimates of the instrument performance for the observation of spectra from O, Ne and Al ions.

Synthetic biology and regulatory networks: where metabolic systems biology meets control engineering.

PubMed

He, Fei; Murabito, Ettore; Westerhoff, Hans V

2016-04-01

Metabolic pathways can be engineered to maximize the synthesis of various products of interest. With the advent of computational systems biology, this endeavour is usually carried out through in silico theoretical studies with the aim to guide and complement further in vitro and in vivo experimental efforts. Clearly, what counts is the result in vivo, not only in terms of maximal productivity but also robustness against environmental perturbations. Engineering an organism towards an increased production flux, however, often compromises that robustness. In this contribution, we review and investigate how various analytical approaches used in metabolic engineering and synthetic biology are related to concepts developed by systems and control engineering. While trade-offs between production optimality and cellular robustness have already been studied diagnostically and statically, the dynamics also matter. Integration of the dynamic design aspects of control engineering with the more diagnostic aspects of metabolic, hierarchical control and regulation analysis is leading to the new, conceptual and operational framework required for the design of robust and productive dynamic pathways. © 2016 The Author(s).

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

Biewer, Theodore M.; Marcus, Chris; Klepper, C Christopher

The divertor-specific ITER Diagnostic Residual Gas Analyzer (DRGA) will provide essential information relating to DT fusion plasma performance. This includes pulse-resolving measurements of the fuel isotopic mix reaching the pumping ducts, as well as the concentration of the helium generated as the ash of the fusion reaction. In the present baseline design, the cluster of sensors attached to this diagnostic's differentially pumped analysis chamber assembly includes a radiation compatible version of a commercial quadrupole mass spectrometer, as well as an optical gas analyzer using a plasma-based light excitation source. This paper reports on a laboratory study intended to validate themore » performance of this sensor cluster, with emphasis on the detection limit of the isotopic measurement. This validation study was carried out in a laboratory set-up that closely prototyped the analysis chamber assembly configuration of the baseline design. This includes an ITER-specific placement of the optical gas measurement downstream from the first turbine of the chamber's turbo-molecular pump to provide sufficient light emission while preserving the gas dynamics conditions that allow for \\textasciitilde 1 s response time from the sensor cluster [1].« less

Update on the status of the ITER ECE diagnostic design

NASA Astrophysics Data System (ADS)

Taylor, G.; Austin, M. E.; Basile, A.; Beno, J. H.; Danani, S.; Feder, R.; Houshmandyar, S.; Hubbard, A. E.; Johnson, D. W.; Khodak, A.; Kumar, R.; Kumar, S.; Ouroua, A.; Padasalagi, S. B.; Pandya, H. K. B.; Phillips, P. E.; Rowan, W. L.; Stillerman, J.; Thomas, S.; Udintsev, V. S.; Vayakis, G.; Walsh, M.; Weeks, D.

2017-07-01

Considerable progress has been made on the design of the ITER electron cyclotron emission (ECE) diagnostic over the past two years. Radial and oblique views are still included in the design in order to measure distortions in the electron momentum distribution, but the oblique view has been redirected to reduce stray millimeter radiation from the electron cyclotron heating system. A major challenge has been designing the 1000 K calibration sources and remotely activated mirrors located in the ECE diagnostic shield module (DSM) in the equatorial port plug #09. These critical systems are being modeled and prototypes are being developed. Providing adequate neutron shielding in the DSM while allowing sufficient space for optical components is also a significant challenge. Four 45-meter long low-loss transmission lines transport the 70-1000 GHz ECE from the DSM to the ECE instrumentation room. Prototype transmission lines are being tested, as are the polarization splitter modules that separate O-mode and X-mode polarized ECE. A highly integrated prototype 200-300 GHz radiometer is being tested on the DIII-D tokamak in the USA. Design activities also include integration of ECE signals into the ITER plasma control system and determining the hardware and software architecture needed to control and calibrate the ECE instruments.

Care Model Design for E-Health: Integration of Point-of-Care Testing at Dutch General Practices.

PubMed

Verhees, Bart; van Kuijk, Kees; Simonse, Lianne

2017-12-21

Point-of-care testing (POCT)-laboratory tests performed with new mobile devices and online technologies outside of the central laboratory-is rapidly outpacing the traditional laboratory test market, growing at a rate of 12 to 15% each year. POCT impacts the diagnostic process of care providers by yielding high efficiency benefits in terms of turnaround time and related quality improvements in the reduction of errors. However, the implementation of this disruptive eHealth technology requires the integration and transformation of diagnostic services across the boundaries of healthcare organizations. Research has revealed both advantages and barriers of POCT implementations, yet to date, there is no business model for the integration of POCT within general practice. The aim of this article is to contribute with a design for a care model that enables the integration of POCT in primary healthcare. In this research, we used a design modelling toolkit for data collection at five general practices. Through an iterative design process, we modelled the actors and value transactions, and designed an optimized care model for the dynamic integration of POCTs into the GP's network of care delivery. The care model design will have a direct bearing on improving the integration of POCT through the connectivity and norm guidelines between the general practice, the POC technology, and the diagnostic centre.

Care Model Design for E-Health: Integration of Point-of-Care Testing at Dutch General Practices

PubMed Central

Verhees, Bart; van Kuijk, Kees

2017-01-01

Point-of-care testing (POCT)—laboratory tests performed with new mobile devices and online technologies outside of the central laboratory—is rapidly outpacing the traditional laboratory test market, growing at a rate of 12 to 15% each year. POCT impacts the diagnostic process of care providers by yielding high efficiency benefits in terms of turnaround time and related quality improvements in the reduction of errors. However, the implementation of this disruptive eHealth technology requires the integration and transformation of diagnostic services across the boundaries of healthcare organizations. Research has revealed both advantages and barriers of POCT implementations, yet to date, there is no business model for the integration of POCT within general practice. The aim of this article is to contribute with a design for a care model that enables the integration of POCT in primary healthcare. In this research, we used a design modelling toolkit for data collection at five general practices. Through an iterative design process, we modelled the actors and value transactions, and designed an optimized care model for the dynamic integration of POCTs into the GP’s network of care delivery. The care model design will have a direct bearing on improving the integration of POCT through the connectivity and norm guidelines between the general practice, the POC technology, and the diagnostic centre. PMID:29267224

Knowledge Acquisition Methods for the IHDS Diagnostic Review Expert System

DOT National Transportation Integrated Search

1997-12-01

The Federal Highway Administration's Interactive Highway Safety Design Model (IHSDM) is a suite of CADD-compatible programs that highway designers can use to evaluate the safety effects of various design alternatives. The IHSDM will include a Policy ...

Application Of The CSRL Language To The Design Of Diagnostic Expert Systems: The Moodis Experience, A Preliminary Report

NASA Astrophysics Data System (ADS)

Bravos, Angelo; Hill, Howard; Choca, James; Bresolin, Linda B.; Bresolin, Michael J.

1986-03-01

Computer technology is rapidly becoming an inseparable part of many health science specialties. Recently, a new area of computer technology, namely Artificial Intelligence, has been applied toward assisting the medical experts in their diagnostic and therapeutic decision making process. MOODIS is an experimental diagnostic expert system which assists Psychiatry specialists in diagnosing human Mood Disorders, better known as Affective Disorders. Its diagnostic methodology is patterned after MDX, a diagnostic expert system developed at LAIR (Laboratory for Artificial Intelligence Research) of Ohio State University. MOODIS is implemented in CSRL (Conceptual Structures Representation Language) also developed at LAIR. This paper describes MOODIS in terms of conceptualization and requirements, and discusses why the MDX approach and CSRL were chosen.

Implementation of a multichannel soft x-ray diagnostic for electron temperature measurements in TJ-II high-density plasmas

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

Baiao, D.; Varandas, C.; Medina, F.

2012-10-15

Based on the multi-foil technique, a multichannel soft x-ray diagnostic for electron temperature measurements has been recently implemented in the TJ-II stellarator. The diagnostic system is composed by four photodiodes arrays with beryllium filters of different thickness. An in-vacuum amplifier board is coupled to each array, aiming at preventing induced noise currents. The Thomson scattering and the vacuum ultraviolet survey diagnostics are used for assessing plasma profiles and composition, being the analysis carried out with the radiation code IONEQ. The electron temperature is determined through the different signal-pair ratios with temporal and spatial resolution. The design and preliminary results frommore » the diagnostic are presented.« less

Constructing and Implementing a Four Tier Test about Static Electricity to Diagnose Pre-service Elementary School Teacher’ Misconceptions

NASA Astrophysics Data System (ADS)

Hermita, N.; Suhandi, A.; Syaodih, E.; Samsudin, A.; Isjoni; Johan, H.; Rosa, F.; Setyaningsih, R.; Sapriadil; Safitri, D.

2017-09-01

We have already constructed and implemented the diagnostic test formed in the four tier test to diagnose pre-service elementary teachers’ misconceptions about static electricity. The method which is utilized in this study is 3D-1I (Define, Design, Develop and Implementation) conducted to the pre-service elementary school teachers. The number of respondents involved in the study is 78 students of PGSD FKIP Universitas Riau. The data was collected by administering diagnostic test items in the form of four tier test. The result indicates that there are several misconceptions related to static electricity concept, these include: 1) Electrostatic objects cannot attract neutral objects, 2) A neutral object is an object that does not contain an electrical charge, and 3) the magnitude of the tensile force between two charged objects depends on the size of the charge. Moreover, the research’s results establish that the diagnostic test is able to analyse number of misconceptions and classify level of understanding pre-service elementary school teachers that is scientific knowledge, misconception, lack knowledge, and error. In conclusion, the diagnostic test item in the form of four tier test has already been constructed and implemented to diagnose students’ conceptions on static electricity.

Ruling Out Brain CT Contraindications prior to Intravenous Thrombolysis: Diagnostic Equivalence between a Primary Interpretation Workstation and a Mobile Tablet Computer.

PubMed

Salazar, Antonio J; Useche, Nicolás; Granja, Manuel; Morillo, Aníbal J; Bermúdez, Sonia

2017-01-01

The aim of this study was to evaluate the equivalence of brain CT interpretations performed using a diagnostic workstation and a mobile tablet computer, in a telestroke service. The ethics committee of our institution approved this retrospective study. A factorial design with 1452 interpretations was used. The assessed variables were the type of stroke classification, the presence of contraindications to the tPA administration, the presence of a hyperdense intracranial artery sign (HMCA), and the Alberta Stroke Program Early CT Score (ASPECTS) score. These variables were evaluated to determine the effect that the reading system had on their magnitudes. The achieved distribution of observed lesions using both the reading systems was not statistically different. The differences between the two reading systems to claim equivalence were 1.6% for hemorrhagic lesions, 4.5% for cases without lesion, and 5.2 for overall ischemic lesion. Equivalence was achieved at 2.1% for ASPECTS ≤ 6, 6.5% for the presence of imaging contraindication to the tPA administration, and 7.2% for the presence of HMCA. The diagnostic performance for detecting acute stroke is likely equivalent whether a tablet computer or a diagnostic workstation is used or not.

Ruling Out Brain CT Contraindications prior to Intravenous Thrombolysis: Diagnostic Equivalence between a Primary Interpretation Workstation and a Mobile Tablet Computer

PubMed Central

Useche, Nicolás; Granja, Manuel; Morillo, Aníbal J.; Bermúdez, Sonia

2017-01-01

Objective The aim of this study was to evaluate the equivalence of brain CT interpretations performed using a diagnostic workstation and a mobile tablet computer, in a telestroke service. Materials and Methods The ethics committee of our institution approved this retrospective study. A factorial design with 1452 interpretations was used. The assessed variables were the type of stroke classification, the presence of contraindications to the tPA administration, the presence of a hyperdense intracranial artery sign (HMCA), and the Alberta Stroke Program Early CT Score (ASPECTS) score. These variables were evaluated to determine the effect that the reading system had on their magnitudes. Results The achieved distribution of observed lesions using both the reading systems was not statistically different. The differences between the two reading systems to claim equivalence were 1.6% for hemorrhagic lesions, 4.5% for cases without lesion, and 5.2 for overall ischemic lesion. Equivalence was achieved at 2.1% for ASPECTS ≤ 6, 6.5% for the presence of imaging contraindication to the tPA administration, and 7.2% for the presence of HMCA. Conclusion The diagnostic performance for detecting acute stroke is likely equivalent whether a tablet computer or a diagnostic workstation is used or not. PMID:29250111

Effect of station examination item sampling on generalizability of student performance.

PubMed

Stratford, P W; Thomson, M A; Sanford, J; Saarinen, H; Dilworth, P; Solomon, P; Nixon, P; Fraser-MacDougall, V; Pierce-Fenn, H

1990-01-01

This article may be of interest to physical therapy educators who are responsible for structuring station or practical examinations used to evaluate physical therapy students. The global intent of the article is to provide information that may be useful in selecting test items. Specifically, the purposes of this study were 1) to examine how two item-sampling strategies (one based on different diagnostic concepts, or diagnostic probes, and the other based on different anatomical sites) influenced the generalizability of a station examination, 2) to determine the interrater reliability during the station examination, and 3) to determine whether the status of the rater (that of observer or simulated patient) influenced the rating. Using a nested study design, 24 physical therapy students were assessed by eight raters. The raters were randomly and equally assigned to four teams. Each team assessed six students. One rater acted as the simulated patient for the first three students in each group, and the other rater acted as observer. This order was reversed for the last three students. Each student performed nine mini-diagnostic patient cases consisting of three diagnostic probes reproduced at three different anatomical sites. The results demonstrate that 1) similar diagnostic concepts can be generalized across anatomical sites, although different concepts or skills cannot be generalized at a given anatomical site or across sites; 2) interrater reliability was excellent; and 3) the status of the raters (ie, simulated patient or observer) did not bias the ratings.(ABSTRACT TRUNCATED AT 250 WORDS)

Ontology and medical diagnosis.

PubMed

Bertaud-Gounot, Valérie; Duvauferrier, Régis; Burgun, Anita

2012-03-01

Ontology and associated generic tools are appropriate for knowledge modeling and reasoning, but most of the time, disease definitions in existing description logic (DL) ontology are not sufficient to classify patient's characteristics under a particular disease because they do not formalize operational definitions of diseases (association of signs and symptoms=diagnostic criteria). The main objective of this study is to propose an ontological representation which takes into account the diagnostic criteria on which specific patient conditions may be classified under a specific disease. This method needs as a prerequisite a clear list of necessary and sufficient diagnostic criteria as defined for lots of diseases by learned societies. It does not include probability/uncertainty which Web Ontology Language (OWL 2.0) cannot handle. We illustrate it with spondyloarthritis (SpA). Ontology has been designed in Protégé 4.1 OWL-DL2.0. Several kinds of criteria were formalized: (1) mandatory criteria, (2) picking two criteria among several diagnostic criteria, (3) numeric criteria. Thirty real patient cases were successfully classified with the reasoner. This study shows that it is possible to represent operational definitions of diseases with OWL and successfully classify real patient cases. Representing diagnostic criteria as descriptive knowledge (instead of rules in Semantic Web Rule Language or Prolog) allows us to take advantage of tools already available for OWL. While we focused on Assessment of SpondyloArthritis international Society SpA criteria, we believe that many of the representation issues addressed here are relevant to using OWL-DL for operational definition of other diseases in ontology.

Optical system for the Protein Crystallisation Diagnostics Facility (PCDF) on board the ISS

NASA Astrophysics Data System (ADS)

Joannes, Luc; Dupont, Olivier; Dewandel, Jean-Luc; Ligot, Renaud; Algrain, Hervé

2004-06-01

The Protein Crystallisation Diagnostic Facility (PCDF) is a multi-user facility to study the protein crystallisation under the conditions of micro-gravity onboard the International Space Station (ISS) Columbus facility. Large size protein crystals will growth under reduced gravity in thermally controlled reactors. A combination of diagnostic tools like video system, microscope, interferometer, and light scattering device shall help to understand the growth phenomena. Common methods of protein crystallisation shall be performed in PCDF: Dialysis where the protein solution and the salt solution are separated by a semi-permeable membrane. Extended Length Dialysis Batch where the saturation to get crystals is achieved by changing the concentration of the protein in the sample liquid. The overall ESA project is leaded by EADS Space Transportation, Friedrichshafen, Germany. Lambda-X is responsible for the Optical System (OS), with Verhaert Design and Development as sub-contractor for the mechanical design. The OS includes different compact parts: Original illumination systems based on LEDs of difference colours; Quantitative Mach-Zehnder interferometers to measure the concentration distribution around crystals; Imaging assemblies to visualize the protein volume with different field of views. The paper concentrates on the description of each part, and in particular on the imaging assembly which allow switching from one field of view to another by passive elements only.

The Popcorn Book: A Diagnostic Teaching Unit.

ERIC Educational Resources Information Center

Bock, Marjorie A.; Barger, Rita.

1998-01-01

Presents a diagnostic teaching unit designed to identify effective teaching strategies for fourth- or fifth-grade students with learning or behavior disorders. The unit uses "The Popcorn Book" (de Paola) for activities to evaluate the effectiveness of teaching strategies across the content areas of reading, writing, and mathematics. (CR)

Noise level measurements on the UMTA Mark I Diagnostic Car (R42 MODEL)

DOT National Transportation Integrated Search

1971-10-01

The R42 Model mass transit car currently operating on the "N" line of the new York City Transit System was selected for experimentation and tests. For this purpose, the car was instrumented and designated as the UMTA Mark I Diagnostic Car. Noise leve...

Hemlock woolly adelgid biological control: molecular methods to distinguish Laricobius nigrinus, L. rubidus, and their hybrids

Treesearch

Nathan P. Havill; Gina Davis; Joanne Klein; Adalgisa Caccone; Scott Salom

2011-01-01

Molecular diagnostics use DNA-based methods to assign unknown organisms to species. As such, they rely on a priori species designation by taxonomists and require validation with enough samples to capture the variation within species for accurately selecting diagnostic characters.

Outbreak!: Teaching Clinical and Diagnostic Microbiology Methodologies with an Interactive Online Game

ERIC Educational Resources Information Center

Clark, Sherri; Smith, Geoffrey Battle

2004-01-01

Outbreak! is an online, interactive educational game that helps students and teachers learn and evaluate clinical microbiology skills. When the game was used in introductory microbiology laboratories, qualitative evaluation by students showed very positive responses and increased learning. Outbreak! allows students to design diagnostic tests and…

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

Code of Federal Regulations, 2010 CFR

2010-04-01

.... Diagnostic x-ray system means an x-ray system designed for irradiation of any part of the human body for the... HUMAN SERVICES (CONTINUED) RADIOLOGICAL HEALTH PERFORMANCE STANDARDS FOR IONIZING RADIATION EMITTING... for the radiographic visualization and measurement of the dimensions of the human head. Coefficient of...

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

Code of Federal Regulations, 2011 CFR

2011-04-01

.... Diagnostic x-ray system means an x-ray system designed for irradiation of any part of the human body for the... HUMAN SERVICES (CONTINUED) RADIOLOGICAL HEALTH PERFORMANCE STANDARDS FOR IONIZING RADIATION EMITTING... for the radiographic visualization and measurement of the dimensions of the human head. Coefficient of...

Exploring Undergraduates' Understanding of Photosynthesis Using Diagnostic Question Clusters

ERIC Educational Resources Information Center

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…

Terahertz otoscope and potential for diagnosing otitis media

PubMed Central

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

2016-01-01

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

The Development of a Vocational Diagnostic Program. Interim Report.

ERIC Educational Resources Information Center

Barnard, William W.

A five-phased project is described which was designed to develop more specific diagnostic procedures and instrumentation that would allow both the vocational counselor and the prospective student to determine more effectively specific occupational programs and occupational objectives for education at the postsecondary level. Phases of the project…

Pressure Dynamic Characteristics of Pressure Controlled Ventilation System of a Lung Simulator

PubMed Central

Shi, Yan; Ren, Shuai; Cai, Maolin; Xu, Weiqing; Deng, Qiyou

2014-01-01

Mechanical ventilation is an important life support treatment of critically ill patients, and air pressure dynamics of human lung affect ventilation treatment effects. In this paper, in order to obtain the influences of seven key parameters of mechanical ventilation system on the pressure dynamics of human lung, firstly, mechanical ventilation system was considered as a pure pneumatic system, and then its mathematical model was set up. Furthermore, to verify the mathematical model, a prototype mechanical ventilation system of a lung simulator was proposed for experimental study. Last, simulation and experimental studies on the air flow dynamic of the mechanical ventilation system were done, and then the pressure dynamic characteristics of the mechanical system were obtained. The study can be referred to in the pulmonary diagnostics, treatment, and design of various medical devices or diagnostic systems. PMID:25197318

Use of 3×2 tables with an intention to diagnose approach to assess clinical performance of diagnostic tests: meta-analytical evaluation of coronary CT angiography studies

PubMed Central

Schuetz, Georg M; Schlattmann, Peter

2012-01-01

Objective To determine whether a 3×2 table, using an intention to diagnose approach, is better than the “classic” 2×2 table at handling transparent reporting and non-evaluable results, when assessing the accuracy of a diagnostic test. Design Based on a systematic search for diagnostic accuracy studies of coronary computed tomography (CT) angiography, full texts of relevant studies were evaluated to determine whether they could calculate an alternative 3×2 table. To quantify an overall effect, we pooled diagnostic accuracy values according to a meta-analytical approach. Data sources Medline (via PubMed), Embase (via Ovid), and ISI Web of Science electronic databases. Eligibility criteria Prospective English or German language studies comparing coronary CT with conventional coronary angiography in all patients and providing sufficient data for a patient level analysis. Results 120 studies (10 287 patients) were eligible. Studies varied greatly in their approaches to handling non-evaluable findings. We found 26 studies (including 2298 patients) that allowed us to calculate both 2×2 tables and 3×2 tables. Using a bivariate random effects model, we compared the 2×2 table with the 3×2 table, and found significant differences for pooled sensitivity (98.2 (95% confidence interval 96.7 to 99.1) v 92.7 (88.5 to 95.3)), area under the curve (0.99 (0.98 to 1.00) v 0.93 (0.91 to 0.95)), positive likelihood ratio (9.1 (6.2 to 13.3) v 4.4 (3.3 to 6.0)), and negative likelihood ratio (0.02 (0.01 to 0.04) v 0.09 (0.06 to 0.15); (P<0.05)). Conclusion Parameters for diagnostic performance significantly decrease if non-evaluable results are included by a 3×2 table for analysis (intention to diagnose approach). This approach provides a more realistic picture of the clinical potential of diagnostic tests. PMID:23097549

Validation of a Host Response Assay, Septicyte™ LAB, for Discriminating Sepsis from SIRS in the ICU.

PubMed

Miller Iii, Russell R; Lopansri, Bert K; Burke, John P; Levy, Mitchell; Opal, Steven; Rothman, Richard E; D'Alessio, Franco R; Sidhaye, Venkataramana K; Aggarwal, Neil R; Balk, Robert; Greenberg, Jared A; Yoder, Mark; Patel, Gourang; Gilbert, Emily; Afshar, Majid; Parada, Jorge P; Martin, Greg S; Esper, Annette M; Kempker, Jordan A; Narasimhan, Mangala; Tsegaye, Adey; Hahn, Stella; Mayo, Paul; van der Poll, Tom; Schultz, Marcus J; Scicluna, Brendon P; Klein Klouwenberg, Peter; Rapisarda, Antony; Seldon, Therese A; McHugh, Leo C; Yager, Thomas D; Cermelli, Silvia; Sampson, Dayle; Rothwell, Victoria; Newman, Richard; Bhide, Shruti; Kirk, James T; Navalkar, Krupa; Davis, Roy F; Brandon, Roslyn A; Brandon, Richard B

2018-04-06

A molecular test to distinguish between sepsis and systemic inflammation of non-infectious etiology could potentially have clinical utility. This study evaluated the diagnostic performance of a molecular host response assay (SeptiCyte™ LAB) designed to distinguish between sepsis and non-infectious systemic inflammation in critically ill adults. The study employed a prospective, observational, non-interventional design, and recruited a heterogeneous cohort of adult critical care patients from seven sites in the USA (N=249). An additional group of 198 patients, recruited in the large MARS consortium trial in the Netherlands (clinicaltrials.gov identifier: NCT01905033), was also tested and analyzed, making a grand total of 447 patients in our study. Performance of SeptiCyte™ LAB was compared to retrospective physician diagnosis by a panel of three experts. In receiver operating characteristic curve analysis, SeptiCyte™ LAB had an estimated area under curve of 0.82-0.89 for discriminating sepsis from non-infectious systemic inflammation. The relative likelihood of sepsis versus non-infectious systemic inflammation was found to increase with increasing test score (range 0-10). In a forward logistic regression analysis, the diagnostic performance of the assay was improved only marginally when used in combination with other clinical and laboratory variables including procalcitonin. Performance of the assay was not significantly affected by demographic variables including age, sex, or race/ethnicity. SeptiCyte™ LAB appears to be a promising diagnostic tool to complement physician assessment of infection likelihood in critically ill adult patients with systemic inflammation. Clinical trial registrations available at clinicaltrials.gov, IDs NCT02127502 and NCT01905033.

Pathways to Lung Cancer Diagnosis: A Qualitative Study of Patients and General Practitioners about Diagnostic and Pretreatment Intervals.

PubMed

Rankin, Nicole M; York, Sarah; Stone, Emily; Barnes, David; McGregor, Deborah; Lai, Michelle; Shaw, Tim; Butow, Phyllis N

2017-05-01

Pathways to lung cancer diagnosis and treatment are complex. International evidence shows significant variations in pathways. Qualitative research investigating pathways to lung cancer diagnosis rarely considers both patient and general practitioner views simultaneously. To describe the lung cancer diagnostic pathway, focusing on the perspective of patients and general practitioners about diagnostic and pretreatment intervals. This qualitative study of patients with lung cancer and general practitioners in Australia used qualitative interviews or a focus group in which participants responded to a semistructured questionnaire designed to explore experiences of the diagnostic pathway. The Model of Pathways to Treatment (the Model) was used as a framework for analysis, with data organized into (1) events, (2) processes, and (3) contributing factors for variations in diagnostic and pretreatment intervals. Thirty participants (19 patients with lung cancer and 11 general practitioners) took part. Nine themes were identified during analysis. For the diagnostic interval, these were: (1) taking patient concerns seriously, (2) a sense of urgency, (3) advocacy that is doctor-driven or self-motivated, and (4) referral: "knowing who to refer to." For the pretreatment interval, themes were: (5) uncertainty, (6) psychosocial support for the patient and family before treatment, and (7) communication among the multidisciplinary team and general practitioners. Two cross-cutting themes were: (8) coordination of care and "handing over" the patient, and (9) general practitioner knowledge about lung cancer. Events were perceived as complex, with diagnosis often being revealed over time, rather than as a single event. Contributing factors at patient, system, and disease levels are described for both intervals. Patients and general practitioners expressed similar themes across the diagnostic and pretreatment intervals. Significant improvements could be made to health systems to facilitate better patient and general practitioner experiences of the diagnostic pathway. This novel presentation of patient and general practitioner perspectives indicates that systemic interventions have a role in timely and appropriate referrals to specialist care and coordination of investigations. Systemic interventions may alleviate concerns about urgency of diagnostic workup, communication, and coordination of care as patients transition from primary to specialist care.

The Role of Nanoparticle Design in Determining Analytical Performance of Lateral Flow Immunoassays.

PubMed

Zhan, Li; Guo, Shuang-Zhuang; Song, Fayi; Gong, Yan; Xu, Feng; Boulware, David R; McAlpine, Michael C; Chan, Warren C W; Bischof, John C

2017-12-13

Rapid, simple, and cost-effective diagnostics are needed to improve healthcare at the point of care (POC). However, the most widely used POC diagnostic, the lateral flow immunoassay (LFA), is ∼1000-times less sensitive and has a smaller analytical range than laboratory tests, requiring a confirmatory test to establish truly negative results. Here, a rational and systematic strategy is used to design the LFA contrast label (i.e., gold nanoparticles) to improve the analytical sensitivity, analytical detection range, and antigen quantification of LFAs. Specifically, we discovered that the size (30, 60, or 100 nm) of the gold nanoparticles is a main contributor to the LFA analytical performance through both the degree of receptor interaction and the ultimate visual or thermal contrast signals. Using the optimal LFA design, we demonstrated the ability to improve the analytical sensitivity by 256-fold and expand the analytical detection range from 3 log 10 to 6 log 10 for diagnosing patients with inflammatory conditions by measuring C-reactive protein. This work demonstrates that, with appropriate design of the contrast label, a simple and commonly used diagnostic technology can compete with more expensive state-of-the-art laboratory tests.

Intermittent explosive disorder: development of integrated research criteria for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.

PubMed

Coccaro, Emil F

2011-01-01

This study was designed to develop a revised diagnostic criteria set for intermittent explosive disorder (IED) for consideration for inclusion in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). This revised criteria set was developed by integrating previous research criteria with elements from the current DSM-IV set of diagnostic criteria. Evidence supporting the reliability and validity of IED-IR ("IED Integrated Criteria") in a new and well-characterized group of subjects with personality disorder is presented. Clinical, phenomenologic, and diagnostic data from 201 individuals with personality disorder were reviewed. All IED diagnoses were assigned using a best-estimate process (eg, kappa for IED-IR >0.85). In addition, subjects meeting IED-IR criteria had higher scores on dimensional measures of aggression and had lower global functioning scores than non-IED-IR subjects, even when related variables were controlled. The IED-IR criteria were more sensitive than the DSM-IV criteria only in identifying subjects with significant impulsive-aggressive behavior by a factor of 16. We conclude that the IED-IR criteria can be reliably applied and have sufficient validity to warrant consideration as DSM-V criteria for IED. Copyright © 2011 Elsevier Inc. All rights reserved.

Two vicious circles contributing to a diagnostic delay for tuberculosis patients in Arkhangelsk

PubMed Central

Kuznetsov, Vladimir N.; Grjibovski, Andrej M.; Mariandyshev, Andrej O.; Johansson, Eva; Bjune, Gunnar A.

2014-01-01

Setting Delay in tuberculosis (TB) diagnosis increases the infectious pool in the community and the risk of development of resistance of mycobacteria, which results in an increased number of deaths. Objective To describe patients’ and doctors’ perceptions of diagnostic delay in TB patients in the Arkhangelsk region and to develop a substantive model to better understand the mechanisms of how these delays are linked to each other. Design A grounded theory approach was used to study the phenomenon of diagnostic delay. Patients with TB diagnostic delay and doctors–phthisiatricians were interviewed. Results A model named ‘sickness trajectory in health-seeking behaviour among tuberculosis patients’ was developed and included two core categories describing two vicious circles of diagnostic delay in patients with TB: ‘limited awareness of the importance to contact the health system’ and ‘limited resources of the health system’ and the categories: ‘factors influencing health-seeking behaviour’ and ‘factors influencing the health system effectiveness’. Men were more likely to report patient delay, while women were more likely to report health system delay. Conclusions To involve people in early medical examinations, it is necessary to increase alertness on TB among patients and to improve health systems in the districts. PMID:25163673

Why patients' disruptive behaviours impair diagnostic reasoning: a randomised experiment.

PubMed

Mamede, Sílvia; Van Gog, Tamara; Schuit, Stephanie C E; Van den Berge, Kees; Van Daele, Paul L A; Bueving, Herman; Van der Zee, Tim; Van den Broek, Walter W; Van Saase, Jan L C M; Schmidt, H G

2017-01-01

Patients who display disruptive behaviours in the clinical encounter (the so-called 'difficult patients') may negatively affect doctors' diagnostic reasoning, thereby causing diagnostic errors. The present study aimed at investigating the mechanisms underlying the negative influence of difficult patients' behaviours on doctors' diagnostic performance. A randomised experiment with 74 internal medicine residents. Doctors diagnosed eight written clinical vignettes that were exactly the same except for the patients' behaviours (either difficult or neutral). Each participant diagnosed half of the vignettes in a difficult patient version and the other half in a neutral version in a counterbalanced design. After diagnosing each vignette, participants were asked to recall the patient's clinical findings and behaviours. Main measurements were: diagnostic accuracy scores; time spent on diagnosis, and amount of information recalled from patients' clinical findings and behaviours. Mean diagnostic accuracy scores (range 0-1) were significantly lower for difficult than neutral patients' vignettes (0.41 vs 0.51; p<0.01). Time spent on diagnosing was similar. Participants recalled fewer clinical findings (mean=29.82% vs mean=32.52%; p<0.001) and more behaviours (mean=25.51% vs mean=17.89%; p<0.001) from difficult than from neutral patients. Difficult patients' behaviours induce doctors to make diagnostic errors, apparently because doctors spend part of their mental resources on dealing with the difficult patients' behaviours, impeding adequate processing of clinical findings. Efforts should be made to increase doctors' awareness of the potential negative influence of difficult patients' behaviours on diagnostic decisions and their ability to counteract such influence. 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/.

Comparison of Established Diagnostic Methodologies and a Novel Bacterial smpB Real-Time PCR Assay for Specific Detection of Haemophilus influenzae Isolates Associated with Respiratory Tract Infections.

PubMed

Reddington, Kate; Schwenk, Stefan; Tuite, Nina; Platt, Gareth; Davar, Danesh; Coughlan, Helena; Personne, Yoann; Gant, Vanya; Enne, Virve I; Zumla, Alimuddin; Barry, Thomas

2015-09-01

Haemophilus influenzae is a significant causative agent of respiratory tract infections (RTI) worldwide. The development of a rapid H. influenzae diagnostic assay that would allow for the implementation of infection control measures and also improve antimicrobial stewardship for patients is required. A number of nucleic acid diagnostics approaches that detect H. influenzae in RTIs have been described in the literature; however, there are reported specificity and sensitivity limitations for these assays. In this study, a novel real-time PCR diagnostic assay targeting the smpB gene was designed to detect all serogroups of H. influenzae. The assay was validated using a panel of well-characterized Haemophilus spp. Subsequently, 44 Haemophilus clinical isolates were collected, and 36 isolates were identified as H. influenzae using a gold standard methodology that combined the results of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) and a fucK diagnostic assay. Using the novel smpB diagnostic assay, 100% concordance was observed with the gold standard, demonstrating a sensitivity of 100% (95% confidence interval [CI], 90.26% to 100.00%) and a specificity of 100% (95% CI, 63.06% to 100.00%) when used on clinical isolates. To demonstrate the clinical utility of the diagnostic assay presented, a panel of lower RTI samples (n = 98) were blindly tested with the gold standard and smpB diagnostic assays. The results generated were concordant for 94/98 samples tested, demonstrating a sensitivity of 90.91% (95% CI, 78.33% to 97.47%) and a specificity of 100% (95% CI, 93.40% to 100.00%) for the novel smpB assay when used directly on respiratory specimens. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Comparison of Established Diagnostic Methodologies and a Novel Bacterial smpB Real-Time PCR Assay for Specific Detection of Haemophilus influenzae Isolates Associated with Respiratory Tract Infections

PubMed Central

Reddington, Kate; Schwenk, Stefan; Tuite, Nina; Platt, Gareth; Davar, Danesh; Coughlan, Helena; Personne, Yoann; Gant, Vanya; Enne, Virve I.; Zumla, Alimuddin

2015-01-01

Haemophilus influenzae is a significant causative agent of respiratory tract infections (RTI) worldwide. The development of a rapid H. influenzae diagnostic assay that would allow for the implementation of infection control measures and also improve antimicrobial stewardship for patients is required. A number of nucleic acid diagnostics approaches that detect H. influenzae in RTIs have been described in the literature; however, there are reported specificity and sensitivity limitations for these assays. In this study, a novel real-time PCR diagnostic assay targeting the smpB gene was designed to detect all serogroups of H. influenzae. The assay was validated using a panel of well-characterized Haemophilus spp. Subsequently, 44 Haemophilus clinical isolates were collected, and 36 isolates were identified as H. influenzae using a gold standard methodology that combined the results of matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS) and a fucK diagnostic assay. Using the novel smpB diagnostic assay, 100% concordance was observed with the gold standard, demonstrating a sensitivity of 100% (95% confidence interval [CI], 90.26% to 100.00%) and a specificity of 100% (95% CI, 63.06% to 100.00%) when used on clinical isolates. To demonstrate the clinical utility of the diagnostic assay presented, a panel of lower RTI samples (n = 98) were blindly tested with the gold standard and smpB diagnostic assays. The results generated were concordant for 94/98 samples tested, demonstrating a sensitivity of 90.91% (95% CI, 78.33% to 97.47%) and a specificity of 100% (95% CI, 93.40% to 100.00%) for the novel smpB assay when used directly on respiratory specimens. PMID:26109443

Feasibility of a far infrared laser based polarimeter diagnostic system for the JT-60SA fusion experiment

NASA Astrophysics Data System (ADS)

Boboc, A.; Gil, C.; Terranova, D.; Orsitto, F. P.; Soare, S.; Lotte, P.; Sozzi, C.; Imazawa, R.; Kubo, H.

2018-07-01

JT-60SA is the large Tokamak device that is being built in Japan under the Broader Approach Satellite Tokamak Programme and the Japanese National Programme and will operate as a satellite machine for ITER. The main goal of the JT-60SA Programme is to provide valuable information for the ITER steady-state scenario and for the design of DEMO, where the real-time control of the safety factor profile is very important, in connection with both MHD stability and plasma confinement. It has been demonstrated in this work that to this end polarimetry measurements are necessary, in particular in order to reconstruct the safety factor profile in reversed shear scenarios. In this paper we present the main steps of a conceptual feasibility study of a multi-channel polarimeter diagnostic and the resulting optimised geometry. In this study, magnetic scenario modelling, a realistic CAD-driven design and long-term operation requirements, rarely even considered at this stage, have been considered. It is shown that a far infrared polarimeter system, with a laser operating at a wavelength of 194.7 μm and up to twelve channels can be envisaged for JT-60SA. The top requirements can be attained, i.e., that the polarimeter, together with other diagnostic measurements, should provide q-profile reconstruction with an accuracy of 10% for the entire plasma cycle and suitable time resolution for real-time applications, in particular in high density and ITER-relevant plasma scenarios.

Design of T-GEM detectors for X-ray diagnostics on JET

NASA Astrophysics Data System (ADS)

Rzadkiewicz, J.; Dominik, W.; Scholz, M.; Chernyshova, M.; Czarski, T.; Czyrkowski, H.; Dabrowski, R.; Jakubowska, K.; Karpinski, L.; Kasprowicz, G.; Kierzkowski, K.; Pozniak, K.; Salapa, Z.; Zabolotny, W.; Blanchard, P.; Tyrrell, S.; Zastrow, K.-D.; JET EFDA Contributors

2013-08-01

Upgraded high-resolution X-ray diagnostics on JET is expected to monitor the plasma radiation emitted by W46+ and Ni26+ ions at 2.4 keV and 7.8 keV photon energies, respectively. Both X-ray lines will be monitored by new generation energy-resolved micropattern gas detectors with 1-D position reconstruction capability. The detection structure is based on triple GEM (T-GEM) amplification structure followed by the strip readout electrode. This article presents a design of new detectors and prototype detector tests.

Oropharyngeal dysphagia in myotonic dystrophy type 1: a systematic review.

PubMed

Pilz, Walmari; Baijens, Laura W J; Kremer, Bernd

2014-06-01

A systematic review was conducted to investigate the pathophysiology of and diagnostic procedures for oropharyngeal dysphagia in myotonic dystrophy (MD). The electronic databases Embase, PubMed, and The Cochrane Library were used. The search was limited to English, Dutch, French, German, Spanish, and Portuguese publications. Sixteen studies met the inclusion criteria. Two independent reviewers assessed the methodological quality of the included articles. Swallowing assessment tools, the corresponding protocols, the studies' outcome measurements, and main findings are summarized and presented. The body of literature on pathophysiology of swallowing in dysphagic patients with MD type 1 remains scant. The included studies are heterogeneous with respect to design and outcome measures and hence are not directly comparable. More importantly, most studies had methodological problems. These are discussed in detail and recommendations for further research on diagnostic examinations for swallowing disorders in patients with MD type 1 are provided.

Design criteria of the bolometer diagnostic for steady-state operation of the W7-X stellaratora)

NASA Astrophysics Data System (ADS)

Zhang, D.; Burhenn, R.; Koenig, R.; Giannone, L.; Grodzki, P. A.; Klein, B.; Grosser, K.; Baldzuhn, J.; Ewert, K.; Erckmann, V.; Hirsch, M.; Laqua, H. P.; Oosterbeek, J. W.

2010-10-01

A bolometric diagnostic system with features necessary for steady-state operation in the superconducting stellarator W7-X was designed. During a pulse length of 1800 s with an ECRH (electron cyclotron resonance heating) power of 10 MW, the components suffer not only from a large thermal load but also from stray radiation of the nonabsorbed isotropic microwaves. This paper gives an overview of the technical problems encountered during the design work and the solutions to individual problems to meet the special requirements in W7-X, e.g., component thermal protection, detector offset thermal drift suppression, as well as a microwave shielding technique.

Design advances of the Core Plasma Thomson Scattering diagnostic for ITER

NASA Astrophysics Data System (ADS)

Scannell, R.; Maslov, M.; Naylor, G.; O'Gorman, T.; Kempenaars, M.; Carr, M.; Bilkova, P.; Bohm, P.; Giudicotti, L.; Pasqualotto, R.; Bassan, M.; Vayakis, G.; Walsh, M.; Huxford, R.

2017-11-01

The Core Plasma Thomson Scattering (CPTS) diagnostic on ITER performs measurements of the electron temperature and density profiles which are critical to the understanding of the ITER plasma. The diagnostic must satisfy the ITER project requirements, which translate to requirements on performance as well as reliability, safety and engineering. The implications are particularly challenging for beam dump lifetime, the need for continuous active alignment of the diagnostic during operation, allowable neutron flux in the interspace and the protection of the first mirror from plasma deposition. The CPTS design has been evolving over a number of years. One recent improvement is that the collection optics have been modified to include freeform surfaces. These freeform surfaces introduce extra complexity to the manufacturing but provide greater flexibility in the design. The greater flexibility introduced allows for example to lower neutron throughput or use fewer surfaces while improving optical performance. Performance assessment has shown that scattering from a 1064 nm laser will be sufficient to meet the measurement requirements, at least for the system at the start of operations. Optical transmission at λ < 600 nm is expected to degrade over the ITER lifetime due to fibre darkening and deposition on the first mirror. For this reason, it is proposed that the diagnostic should additionally include measurements of TS 'depolarised light' and a 1319 nm laser system. These additional techniques have different spectral and polarisation dependencies compared to scattering from a 1064 nm laser and hence provide greater robustness into the inferred measurements of Te and ne in the core.

Dentist age, period and cohort effects on provision of dental services in Australia: 1983-84 to 2009-10.

PubMed

Ju, Xiangqun; Spencer, A John; Brennan, David S

2017-06-01

To examine age, period and cohort factors of dentists in relation to diagnostic, preventive and total dental services over time in Australia. The Longitudinal Study of Dentists' Practice Activity (LSDPA) was designed to monitor dental practice activity and service provision in Australia. Participating dentists were sampled randomly from the dental registers in Australia from 1983 to 1984, and dental services provision was collected by mailed questionnaire with a log of dental services provided over one or two typical days. The data collection has been repeated every 5 years until 2009-2010. Sample supplementation of newly registered dentists occurred at successive waves. This study focused on diagnostic, preventive and total services. The time trends in the mean rates of the services were described using a standard cohort table, and negative binomial regression was applied to estimate age, period and cohort effects. The response rates were 73%, 75%, 74%, 71%, 76% and 67% in 1983, 1988, 1993, 1998, 2003 and 2009, respectively. The mean rates of diagnostic, preventive and total services increased between 1983 and 2009 across all age groups. The period effect showed a higher rate of diagnostic (rate ratios [RR]: 1.21 in 1993 to 1.80 in 2009), preventive (RR: 1.19 in 1988 to 1.85 in 2009) and the total service (RR: 1.08 in 1988 to 1.39 in 2009) over time, compared with the reference group of 1983. Older cohorts had a lower rate, and the younger cohorts had a higher rate of diagnostic, preventive and the total number of services over the study period. The highest rate of diagnostic (RR=2.53), preventive (RR=2.44) and the total service (RR=1.52) was in those aged 25-29 years in 1983 compared with the reference group of 30-34 years in 1983. Trends in dental services provision can be associated with age, period and cohort effects. The study found the rate of diagnostic, preventive and total services increased over time. Meanwhile, an increasing rate of diagnostic, preventive and the total services was observed when moving from older cohorts to younger cohorts among Australian dentists suggesting a sustained shift towards these services into the future. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Reasoning process characteristics in the diagnostic skills of beginner, competent, and expert dentists.

PubMed

Crespo, Kathleen E; Torres, José E; Recio, María E

2004-12-01

The purpose of this study was to evaluate qualitative differences in the diagnostic reasoning process at different developmental stages of expertise. A qualitative design was used to study cognitive processes that characterize the diagnosis of oral disease at the stages of beginner (five junior students who had passed the NBDE I), competent (five GPR first-year residents), and expert dentists (five general dentists with ten or more years of experience). Individually, each participant was asked to determine the diagnosis of an oral condition based on a written clinical case, using the think aloud technique and retrospective reports. A subsequent interview was conducted to obtain the participants' diagnostic process model and pathophysiology of the case. The analysis of the verbal protocols indicated that experts referred to the patient's sociomedical context more frequently, demonstrated better organization of ideas, could determine key clinical findings, and had an ability to plan for the search of pertinent information. Fewer diagnostic hypotheses were formulated by participants who used forward reasoning, independent of the stage of development. Beginners requested additional diagnostic aids (radiographs, laboratory tests) more frequently than the competent/expert dentists. Experts recalled typical experiences with patients, while competent/beginner dentists recalled information from didactic courses. Experts evidenced cognitive diagnostic schemas that integrate pathophysiology of disease, while competent and beginner participants had not achieved this integration. We conclude that expert performance is a combination of a knowledge base, reasoning skills, and an accumulation of experiences with patients that is qualitatively different from that of competent and beginner dentists. It is important for dental education to emphasize the teaching of cognitive processes and to incorporate a wide variety of clinical experiences in addition to the teaching of disciplinary content.

A cluster randomized trial evaluating the efficacy of patient navigation in improving quality of diagnostic care for patients with breast or colorectal cancer abnormalities.

PubMed

Wells, Kristen J; Lee, Ji-Hyun; Calcano, Ercilia R; Meade, Cathy D; Rivera, Marlene; Fulp, William J; Roetzheim, Richard G

2012-10-01

This study examines efficacy of a lay patient navigation (PN) program aimed to reduce time between a cancer abnormality and definitive diagnosis among racially/ethnically diverse and medically underserved populations of Tampa Bay, Florida. Using a cluster randomized design, the study consisted of 11 clinics (six navigated; five control). Patients were navigated from time of a breast or colorectal abnormality to diagnostic resolution, and to completion of cancer treatment. Using a generalized mixed-effects model to assess intervention effects, we examined: (i) length of time between abnormality and definitive diagnosis, and (ii) receipt of definitive diagnosis within the 6-month minimum follow-up period. A total of 1,267 patients participated (588 navigated; 679 control). We also included data from an additional 309 chart abstractions (139 navigated arm; 170 control arm) that assessed outcomes at baseline. PN did not have a significant effect on time to diagnostic resolution in multivariable analysis that adjusted for race-ethnicity, language, insurance status, marital status, and cancer site (P = 0.16). Although more navigated patients achieved diagnostic resolution by 180 days, results were not statistically significant (74.5% navigated vs. 68.5% control, P = 0.07). PN did not impact the overall time to completion of diagnostic care or the number of patients who reached diagnostic resolution of a cancer abnormality. Further evaluation of PN programs applied to other patient populations across the cancer continuum is necessary to gain a better perspective on its effectiveness. PN programs may not impact timely resolution of an abnormality suspicious of breast or colorectal cancer. 2012 AACR

Patient navigation and time to diagnostic resolution: results for a cluster randomized trial evaluating the efficacy of patient navigation among patients with breast cancer screening abnormalities, Tampa, FL.

PubMed

Lee, Ji-Hyun; Fulp, William; Wells, Kristen J; Meade, Cathy D; Calcano, Ercilia; Roetzheim, Richard

2013-01-01

The objective of this study was to evaluate a patient navigation (PN) program that attempts to reduce the time between a breast cancer screening abnormality and definitive diagnosis among medically underserved populations of Tampa Bay, Florida. The Moffitt Patient Navigation Research Program conducted a cluster randomized design with 10 primary care clinics. Patients were navigated from time of a breast screening abnormality to diagnostic resolution. This paper examined the length of time between breast abnormality and definitive diagnosis, using a shared frailty Cox proportional hazard model to assess PN program effect. 1,039 patients were eligible for the study because of an abnormal breast cancer screening/clinical abnormality (494 navigated; 545 control). Analysis of PN effect by two time periods of resolution (0-3 months and > 3 months) showed a lagged effect of PN. For patients resolving in the first three months, the adjusted Hazard Ratio (aHR) was 0.85 (95% Confidence Interval [CI]: 0.64-1.13) suggesting that PN had no effect on resolution time during this period. Beyond three months, however, navigated patients resolved more quickly to diagnostic resolution compared with the control group (aHR 2.8, 95%CI: 1.30-6.13). The predicted aHR at 3 months was 1.2, which was not statistically significant, while PN had a significant positive effect beyond 4.7 months. PN programs may increase the timeliness of diagnostic resolution for patients with a breast cancer-related abnormality. PN did not speed diagnostic resolution during the initial three months of follow up but started to reduce time to diagnostic resolution after three months and showed a significant effect after 4.7 months. ClinicalTrials.gov NCT00375024.

VLSI (Very Large Scale Integrated Circuits) Design with the MacPitts Silicon Compiler.

DTIC Science & Technology

1985-09-01

the background. If the algorithm is not fully debugged, then issue instead macpitts basename herald so MacPitts diagnostics and Liszt diagnostics both...command interpreter. Upon compilation, however, the following LI!F compiler ( Liszt ) diagnostic results, Error: Non-number to minus nil where the first...language used in the MacPitts source code. The more instructive solution is to write the Franz LISP code to decide if a jumper wire is needed, and if so, to

Preserving the Person in Contemporary Psychiatry.

PubMed

Gabbard, Glen O

2018-06-01

Psychodynamic psychiatry is a way of thinking that places the person at the heart of diagnostic understanding and treatment. This emphasis on unique characteristics of an individual is at odds with much of contemporary psychiatric thought, which is geared to identifying a set of criteria designed to identify discrete diagnostic categories with biological underpinnings. This article addresses component parts of the person that are linked to psychodynamic constructs and lie at the heart of diagnostic understanding and treatment in psychodynamic psychiatry. Copyright © 2018 Elsevier Inc. All rights reserved.

Interceptive Beam Diagnostics - Signal Creation and Materials Interactions

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

Plum, Michael; Spallation Neutron Source, Oak Ridge National Laboratory, P.O. Box 2008, Oak Ridge, TN

2004-11-10

The focus of this tutorial will be on interceptive beam diagnostics such as wire scanners, screens, and harps. We will start with an overview of the various ways beams interact with materials to create signals useful for beam diagnostics systems. We will then discuss the errors in a harp or wire scanner profile measurement caused by errors in wire position, number of samples, and signal errors. Finally we will apply our results to two design examples-the SNS wire scanner system and the SNS target harp.

HEART Pathway Accelerated Diagnostic Protocol Implementation: Prospective Pre-Post Interrupted Time Series Design and Methods.

PubMed

Mahler, Simon A; Burke, Gregory L; Duncan, Pamela W; Case, Larry D; Herrington, David M; Riley, Robert F; Wells, Brian J; Hiestand, Brian C; Miller, Chadwick D

2016-01-22

Most patients presenting to US Emergency Departments (ED) with chest pain are hospitalized for comprehensive testing. These evaluations cost the US health system >$10 billion annually, but have a diagnostic yield for acute coronary syndrome (ACS) of <10%. The history/ECG/age/risk factors/troponin (HEART) Pathway is an accelerated diagnostic protocol (ADP), designed to improve care for patients with acute chest pain by identifying patients for early ED discharge. Prior efficacy studies demonstrate that the HEART Pathway safely reduces cardiac testing, while maintaining an acceptably low adverse event rate. The purpose of this study is to determine the effectiveness of HEART Pathway ADP implementation within a health system. This controlled before-after study will accrue adult patients with acute chest pain, but without ST-segment elevation myocardial infarction on electrocardiogram for two years and is expected to include approximately 10,000 patients. Outcomes measures include hospitalization rate, objective cardiac testing rates (stress testing and angiography), length of stay, and rates of recurrent cardiac care for participants. In pilot data, the HEART Pathway decreased hospitalizations by 21%, decreased hospital length (median of 12 hour reduction), without increasing adverse events or recurrent care. At the writing of this paper, data has been collected on >5000 patient encounters. The HEART Pathway has been fully integrated into health system electronic medical records, providing real-time decision support to our providers. We hypothesize that the HEART Pathway will safely reduce healthcare utilization. This study could provide a model for delivering high-value care to the 8-10 million US ED patients with acute chest pain each year. Clinicaltrials.gov NCT02056964; https://clinicaltrials.gov/ct2/show/NCT02056964 (Archived by WebCite at http://www.webcitation.org/6ccajsgyu).

Diagnostic utility of patient history and physical examination data to detect spondylolysis and spondylolisthesis in athletes with low back pain: A systematic review.

PubMed

Grødahl, Linn Helen J; Fawcett, Louise; Nazareth, Madeleine; Smith, Richard; Spencer, Simon; Heneghan, Nicola; Rushton, Alison

2016-08-01

In adolescent athletes, low back pain has a 1-year prevalence of 57% and causes include spondylolysis and spondylolisthesis. An accurate diagnosis enables healing, prevention of progression and return to sport. To evaluate the diagnostic utility of patient history and physical examination data to identify spondylolysis and/or spondylolisthesis in athletes. Systematic review was undertaken according to published guidelines, and reported in line with PRISMA. Key databases were searched up to 13/11/15. athletic population with LBP, patient history and/or physical examination accuracy data for spondylolysis and/or spondylolisthesis, any study design including raw data. Two reviewers independently assessed risk of bias (ROB) using QUADAS-2. A data extraction sheet was pre-designed. Pooling of data and investigation for heterogeneity enabled a qualitative synthesis of data across studies. Of the eight included studies, two were assessed as low ROB, one of which also had no concerns regarding applicability. Age (<20 years) demonstrated 81% sensitivity and 44% specificity and gender (male) 73% sensitivity and 57% specificity for spondylolysis. Difficulty falling asleep, waking up because of pain, pain worse with sitting and walking all have sensitivity >75% for spondylolisthesis. Step-deformity palpation demonstrated 60-88% sensitivity and 87-100% specificity for spondylolisthesis. The one-legged hyperextension test was not supported for spondylolysis (sensitivity 50-73%, specificity 0-87%). No recommendations can be made utilising patient history data. Based on one low ROB study, step deformity palpation may be useful in diagnosing spondylolisthesis. No physical tests demonstrated diagnostic utility for spondylolysis. Further research is required. Copyright © 2016 Elsevier Ltd. All rights reserved.