Final Technical Report -- Bridging the PSI Knowledge Gap: A Multiscale Approach

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

Whyte, Dennis

2014-12-12

The Plasma Surface Interactions (PSI) Science Center formed by the grant undertook a multidisciplinary set of studies on the complex interface between the plasma and solid states of matter. The strategy of the center was to combine and integrate the experimental, diagnostic and modeling toolkits from multiple institutions towards specific PSI problems. In this way the Center could tackle integrated science issues which were not addressable by single institutions, as well as evolve the underlying science of the PSI in a more general way than just for fusion applications. The overall strategy proved very successful. The research result and highlightsmore » of the MIT portion of the Center are primarily described. A particular highlight is the study of tungsten nano-tendril growth in the presence of helium plasmas. The Center research provided valuable new insights to the mechanisms controlling the nano-tendrils by developing coupled modeling and in situ diagnostic methods which could be directly compared. For example, the role of helium accumulation in tungsten distortion in the surface was followed with unique in situ helium concentration diagnostics developed. These depth-profiled, time-resolved helium concentration measurements continue to challenge the numerical models of nano-tendrils. The Center team also combined its expertise on tungsten nano-tendrils to demonstrate for the first time the growth of the tendrils in a fusion environment on the Alcator C-Mod fusion experiment, thus having significant impact on the broader fusion research effort. A new form of isolated nano-tendril “columns” were identified which are now being used to understand the underlying mechanisms controlling the tendril growth. The Center also advanced PSI science on a broader front with a particular emphasis on developing a wide range of in situ PSI diagnostic tools at the DIONISOS facility at MIT. For example the strong suppression of sputtering by the certain combination of light-species plasmas and metals was experimentally studied with independent measurement methods across the Center. This surprising result challenges the universal use of the binary-collision approximation in sputtering predictions and continues to be the subject of study. In order to address this issue MIT developed a new in situ erosion measurement technique based on ion beam analysis which can be used at elevated material temperatures. This exciting new technique is now being used to study material erosion in high performance plasma thrusters for space exploration and is being adopted to fusion experimental devices. This is an indicator of the positive synergies that arise from such a Center, with the research having impact beyond the initial area of study. The Center also served successfully as an organizing force for communication to the science community. The MIT members of the Center provided many high-profile overview presentations at prestigious international conferences and national workshops. The research resulted in three student theses and 24 peer-reviewed publications. PSI research continues to be identified as a critical area for fusion energy.« less

Advancing Patient-centered Outcomes in Emergency Diagnostic Imaging: A Research Agenda.

PubMed

Kanzaria, Hemal K; McCabe, Aileen M; Meisel, Zachary M; LeBlanc, Annie; Schaffer, Jason T; Bellolio, M Fernanda; Vaughan, William; Merck, Lisa H; Applegate, Kimberly E; Hollander, Judd E; Grudzen, Corita R; Mills, Angela M; Carpenter, Christopher R; Hess, Erik P

2015-12-01

Diagnostic imaging is integral to the evaluation of many emergency department (ED) patients. However, relatively little effort has been devoted to patient-centered outcomes research (PCOR) in emergency diagnostic imaging. This article provides background on this topic and the conclusions of the 2015 Academic Emergency Medicine consensus conference PCOR work group regarding "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization." The goal was to determine a prioritized research agenda to establish which outcomes related to emergency diagnostic imaging are most important to patients, caregivers, and other key stakeholders and which methods will most optimally engage patients in the decision to undergo imaging. Case vignettes are used to emphasize these concepts as they relate to a patient's decision to seek care at an ED and the care received there. The authors discuss applicable research methods and approaches such as shared decision-making that could facilitate better integration of patient-centered outcomes and patient-reported outcomes into decisions regarding emergency diagnostic imaging. Finally, based on a modified Delphi process involving members of the PCOR work group, prioritized research questions are proposed to advance the science of patient-centered outcomes in ED diagnostic imaging. © 2015 by the Society for Academic Emergency Medicine.

Discovery of and Use of Fragments of DOC1 as Antiangiogenic and Antitumor Therapy | NCI Technology Transfer Center | TTC

Cancer.gov

This invention describes small cDNA fragments of the coding region for wild type filamin A interacting protein 1-like (FILIP1L) and variant 2 of FILIP1L genes that encode proteins inhibit cell migration and motility, induce cell apoptosis and inhibit cell proliferation. The significance of this invention is that it could provide for a series of new anti-cancer therapeutics and for the diagnostic means to follow their expression levels.

Center of Cancer Nanotechnology Excellence for Translational Diagnostics

Cancer.gov

The Center of Cancer Nanotechnology Excellence for Translational Diagnostics, which forms the third cycle CCNE Program at Stanford University, is a consortium that has three highly synchronized Projects and three Cores.

Training Initiatives within the AFHSC-Global Emerging Infections Surveillance and Response System: Support for IHR (2005)

DTIC Science & Technology

2011-03-04

Medical Research Unit-Kenya (USAMRU- K) Malaria Diagnostics Center of Excellence The continued operation of the Malaria Diagnostics Center of Excellence...MDCoE) in Kisumu, Kenya, pro- vided important contributions in professional malaria diagnostic training. The MDCoE was established in 2004 with AFHSC...202009.pdf]. 11. Ohrt C, Obare P, Nanakorn A, et al: Establishing a malaria diagnostics centre of excellence in Kisumu, Kenya. Malar J 2007, 6(79). 12

Rapid-Response Parenting Intervention in Diagnostic Centers as a Patient-Centered Innovation for Autism Spectrum Disorders

ERIC Educational Resources Information Center

McMillin, Stephen Edward; Bultas, Margaret W.; Wilmott, Jennifer; Grafeman, Sarah; Zand, Debra H.

2015-01-01

Parents of children newly diagnosed with autism spectrum disorders are a high-need population for whom skills-based parenting interventions likely help. Diagnostic centers are compelling locations to deliver parenting interventions because families are served in an accessible location and at a time they receive overwhelming treatment…

42 CFR 415.180 - Teaching setting requirements for the interpretation of diagnostic radiology and other diagnostic...

Code of Federal Regulations, 2011 CFR

2011-10-01

... interpretation of diagnostic radiology and other diagnostic tests. 415.180 Section 415.180 Public Health CENTERS... for the interpretation of diagnostic radiology and other diagnostic tests. (a) General rule. Physician fee schedule payment is made for the interpretation of diagnostic radiology and other diagnostic tests...

42 CFR 415.180 - Teaching setting requirements for the interpretation of diagnostic radiology and other diagnostic...

Code of Federal Regulations, 2010 CFR

2010-10-01

... interpretation of diagnostic radiology and other diagnostic tests. 415.180 Section 415.180 Public Health CENTERS... for the interpretation of diagnostic radiology and other diagnostic tests. (a) General rule. Physician fee schedule payment is made for the interpretation of diagnostic radiology and other diagnostic tests...

Slit disk for modified faraday cup diagnostic for determining power density of electron and ion beams

DOEpatents

Teruya, Alan T [Livermore, CA; Elmer,; John, W [Danville, CA; Palmer, Todd A [State College, PA

2011-03-08

A diagnostic system for characterization of an electron beam or an ion beam includes an electrical conducting disk of refractory material having a circumference, a center, and a Faraday cup assembly positioned to receive the electron beam or ion beam. At least one slit in the disk provides diagnostic characterization of the electron beam or ion beam. The at least one slit is located between the circumference and the center of the disk and includes a radial portion that is in radial alignment with the center and a portion that deviates from radial alignment with the center. The electron beam or ion beam is directed onto the disk and translated to the at least one slit wherein the electron beam or ion beam enters the at least one slit for providing diagnostic characterization of the electron beam or ion beam.

Raptor: A Portable Biosensor Upgraded for Reliability and Sensitivity

DTIC Science & Technology

2003-07-01

Research Center for Molecular Diagnostics and Therapy. The F. tularensis antigen (killed vaccine strain), affinity-purified rabbit anti-B...Russian Research Center of Molecular Diagnostics and Therapies, for their generous donations materials. The views expressed here are those of the

Study of plasma convection and wall interactions in magnetic confinement systems

NASA Astrophysics Data System (ADS)

York, T. M.

1986-06-01

The subject contract research effort was initiated in September 1976 with two specific tasks: (1) to study the fundamental physics of confinement of an alternate concept (i.e., theta pinch based) devices; and (2) to study and to develop new diagnostic systems for use on major experiments at other locations in the country. There has been active collaboration with Los Alamos National Laboratory and Lawrence Livermore National Laboratory; there has been proposed collaboration with Princeton Plasma Physics Laboratory, Fusion Research Center at the University of Texas, and General Atomics.

The exchange of radiotherapy data as part of an electronic patient-referral system.

PubMed

Lomax, A; Grossmann, M; Cozzi, L; Tercier, P A; Boehringer, T; Schneider, U; Logean, M; Volken, W; Ratib, O; Miralbell, R

2000-07-15

To describe the implementation and use of an electronic patient-referral system as an aid to the efficient referral of patients to a remote and specialized treatment center. A system for the exchange of radiotherapy data between different commercial planning systems and a specially developed planning system for proton therapy has been developed through the use of the PAPYRUS diagnostic image standard as an intermediate format. To ensure the cooperation of the different TPS manufacturers, the number of data sets defined for transfer has been restricted to the three core data sets of CT, VOIs, and three-dimensional dose distributions. As a complement to the exchange of data, network-wide application-sharing (video-conferencing) technologies have been adopted to provide methods for the interactive discussion and assessment of treatments plans with one or more partner clinics. Through the use of evaluation plans based on the exchanged data, referring clinics can accurately assess the advantages offered by proton therapy on a patient-by-patient basis, while the practicality or otherwise of the proposed treatments can simultaneously be assessed by the proton therapy center. Such a system, along with the interactive capabilities provided by video-conferencing methods, has been found to be an efficient solution to the problem of patient assessment and selection at a specialized treatment center, and is a necessary first step toward the full electronic integration of such centers with their remotely situated referral centers.

[The quality management in clinical diagnostic laboratory in conditions of the Federal Center of traumatology, orthopedics and endoprosthesis replacement of Minzdrav of Russia (Cheboksary)].

PubMed

Nikolaev, N S; Nazarova, V V; Dobrovol'skaia, N Iu; Orlova, A V; Pchelova, N N

2014-10-01

The article presents experience of clinical diagnostic laboratory of the Federal Center of traumatology, orthopedics and endoprosthesis replacement of Minzdrav of Russia (Cheboksary) in the area of quality management of medical laboratory services on the basis of evaluation of efficacy and effectiveness of processes. The factors effecting quality of functioning of clinical diagnostic laboratory are indicated. The criteria and indicators of efficacy of work of employees of clinical diagnostic laboratory are presented.

Center conductor diagnostic for multipactor detection in inaccessible geometries

NASA Astrophysics Data System (ADS)

Chaplin, Vernon H.; Hubble, Aimee A.; Clements, Kathryn A.; Graves, Timothy P.

2017-01-01

Electron collecting current probes are the most reliable diagnostic of multipactor and radiofrequency (RF) ionization breakdown; however, stand-alone probes can only be used in test setups where the breakdown region is physically accessible. This paper describes techniques for measuring multipactor current directly on the center conductor of a coaxial RF device (or more generally, on the signal line in any two-conductor RF system) enabling global multipactor detection with improved sensitivity compared to other common diagnostics such as phase null, third harmonic, and reflected power. The center conductor diagnostic may be AC coupled for use in systems with a low DC impedance between the center conductor and ground. The effect of DC bias on the breakdown threshold was studied: in coaxial geometry, the change in threshold was <1 dB for positive biases satisfying VD C/VR F 0 <0.8 , where VRF0 is the RF voltage amplitude at the unperturbed breakdown threshold. In parallel plate geometry, setting VD C/VR F 0 <0.2 was necessary to avoid altering the threshold by more than 1 dB. In most cases, the center conductor diagnostic functions effectively with no bias at all—this is the preferred implementation, but biases in the range VD C=0 -10 V may be applied if necessary. The polarity of the detected current signal may be positive or negative depending on whether there is net electron collection or emission globally.

Center conductor diagnostic for multipactor detection in inaccessible geometries.

PubMed

Chaplin, Vernon H; Hubble, Aimee A; Clements, Kathryn A; Graves, Timothy P

2017-01-01

Electron collecting current probes are the most reliable diagnostic of multipactor and radiofrequency (RF) ionization breakdown; however, stand-alone probes can only be used in test setups where the breakdown region is physically accessible. This paper describes techniques for measuring multipactor current directly on the center conductor of a coaxial RF device (or more generally, on the signal line in any two-conductor RF system) enabling global multipactor detection with improved sensitivity compared to other common diagnostics such as phase null, third harmonic, and reflected power. The center conductor diagnostic may be AC coupled for use in systems with a low DC impedance between the center conductor and ground. The effect of DC bias on the breakdown threshold was studied: in coaxial geometry, the change in threshold was <1 dB for positive biases satisfying V DC /V RF0 <0.8, where V RF0 is the RF voltage amplitude at the unperturbed breakdown threshold. In parallel plate geometry, setting V DC /V RF0 <0.2 was necessary to avoid altering the threshold by more than 1 dB. In most cases, the center conductor diagnostic functions effectively with no bias at all-this is the preferred implementation, but biases in the range V DC =0-10V may be applied if necessary. The polarity of the detected current signal may be positive or negative depending on whether there is net electron collection or emission globally.

Biosensor Detection of Neuropathy Target Esterase in Whole Blood as a Biomarker of Exposure to Neuropathic Organophosphorus Compounds

DTIC Science & Technology

2002-10-15

Chernogolovka, Moscow Region, Russia Arkady V. Eremenko Research Center for Molecular Diagnostics and Therapy, Moscow, Russia Ilya N. Kurochkin...Faculty of Chemistry, M. V. Lomonosov Moscow State University, and Research Center for Molecular Diagnostics and Therapy, Moscow, Russia Vladimir V

Summary and Evaluation of the Regional Educational Diagnostic Treatment Center 1966-1969.

ERIC Educational Resources Information Center

Bureau of Elementary and Secondary Education (DHEW/OE), Washington, DC.

A diagnostic treatment center for learning disabilities and emotional problems was developed to serve six school systems. Evaluation by the multidisciplinary staff covered behavior, family background, health, and intellectual, perceptual motor, emotional, and educational functioning. Treatment plans, developed by the team which subsequently met…

Climate Prediction Center - Monitoring and Data Index

Science.gov Websites

Weather Service NWS logo - Click to go to the NWS home page Climate Prediction Center Home Site Map News ; Atmospheric Monitoring and Data Monitoring Weather & Climate in Realtime Climate Diagnostics Bulletin Preliminary Climate Diagnostics Bulletin Figures Monthly Atmospheric & Sea Surface Temperature Indices

Hall Effect Thruster Interactions Data From the Russian Express-A2 and Express-A3 Satellites

NASA Technical Reports Server (NTRS)

Sitnikova, N.; Volkov, D.; Maximov, I.; Petrusevich, V.; Allen, D.

2003-01-01

This 12-part report documents the data obtained from various sensor measurements taken aboard the Russian Express-A2 and Express-A3 spacecraft in Geosynchronous Earth Orbit (GEO). These GEO communications satellites, which were designed and built by NPO Prikladnoy Mekhaniki (NPO PM) of Zheleznogorsk, Russia, utilize Hall thruster propulsion systems for north-south and east-west stationkeeping and as of June 2002, were still operating at 80 E. and 11 W., respectively. Express-A2 was launched on March 12, 2000, while Express-A3 was launched on June 24, 2000. The diagnostic equipment from which these data were taken includes electric field strength sensors, ion current and energy sensors, and pressure sensors. The diagnostics and the Hall thruster propulsion systems are described in detail along with lists of tabular data from those diagnostics and propulsion system and other satellite systems. Space Power, Inc., now part of Pratt & Whitney's Chemical Systems Division, under contract NAS3 99151 to the NASA Glenn Research Center, obtained these data over several periods from March 12, 2000, through September 30, 2001. Each of the 12 individual reports describe, in detail, the propulsion systems as well as the diagnostic sensors utilized. Finally, parts 11 and 12 include the requirements to which NPO PM prepared and delivered these data.

42 CFR 440.130 - Diagnostic, screening, preventive, and rehabilitative services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Diagnostic, screening, preventive, and rehabilitative services. 440.130 Section 440.130 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Definitions § 440.130 Diagnostic, screening, preventive, and rehabilitative services. (a) “Diagnostic services...

Sixth NASA Glenn Research Center Propulsion Control and Diagnostics (PCD) Workshop

NASA Technical Reports Server (NTRS)

Litt, Jonathan S. (Compiler)

2018-01-01

The Intelligent Control and Autonomy Branch at NASA Glenn Research Center hosted the Sixth Propulsion Control and Diagnostics Workshop on August 22-24, 2017. The objectives of this workshop were to disseminate information about research being performed in support of NASA Aeronautics programs; get feedback from peers on the research; and identify opportunities for collaboration. There were presentations and posters by NASA researchers, Department of Defense representatives, and engine manufacturers on aspects of turbine engine modeling, control, and diagnostics.

[Psychotherapeutically-Systemic Acting in the Integrated Family Counseling Presented by the Example of Child-Centered Educational Counseling].

PubMed

Herrmann, Ines

2015-01-01

The article gives an insight into the practice of Integrated Family Counseling and identifies their interfaces with psychotherapeutic approaches. The example of the child-centered educational counseling shows how consultancy, systemic and psychotherapeutic interventions interact in order to meet the parents educational needs defined by the parents. The first part of the article explains the term of Integrated Family Counseling, differentiates the various substantive areas of work and outlines the systematic attitude. The second part describes the psychotherapy-systemic action in the child-centered educational counseling from the perspective of the practice. Main priorities in the course of counseling, including cause-related behavioral and developmental diagnostics, play therapy intervention and parental involvement are presented. Here the systemic approach, major methodological elements as well as their effects are pointed up. The third part is devoted to the reflection of the relationship between counseling and psychotherapy. It becomes clear that in particular the intended effectiveness of an intervention determines their methodological design to a large extent.

Blood compatibility--a perspective.

PubMed

Ratner, B D

2000-01-01

This perspective on blood- materials interactions is intended to introduce the set of papers stemming from the symposium, "Devices and Diagnostics in Contact with Blood: Issues in Blood Compatibility at the Close of the 20th Century," organized on August 4-6, 1999 at the University of Washington by the University of Washington Engineered Biomaterials (UWEB) Engineering Research Center. This article outlines some of the history of blood contacting materials, overviews the work that has originated at the University of Washington over the past 28 years, speculates on the origins of the controversies on blood compatibility and considers the issues that should be addressed in future studies.

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…

The Use of Information Based Evaluation in Evaluating the Diagnostic Teaching Center.

ERIC Educational Resources Information Center

Poteet, James A.

Information Based Evaluation (IBE) is identified as a design procedure for assessing a variety of projects, programs, and educational changes. IBE was used to evaluate a Comprehensive Diagnostic Teaching Center (DTC) which, in addition to providing teacher training and services to handicapped pupils, would bring together and focus all of the…

[Evaluation of quality of HIV diagnostic procedures in Poland].

PubMed

Parczewski, Miłosz; Madaliński, Kazimierz; Leszczyszyn-Pynka, Magdalena; Boroń-Kaczmarska, Anna

2010-01-01

The aim of this work was quality assessment of HIV diagnostic procedures in Poland, including human and technical resources as well as laboratory practice. Sixty questionnaires were distributed among diagnostic centers to obtain qualitative data. Basing on the survey data serological control using coded panels of HIV-1/2 samples was performed. Thirty-one filled questionnaires were received (50.8%). Surveyed laboratories perform from 350 to 5500 serological screening tests per year. In most of laboratories fourth generation assays are available, while Blood Donation Centers screen the blood both with serological assays and by HIV-RNA detection. Sanitary and Epidemiological Stations and academic laboratories hold the ISO/IEC 17025 or IS0 9001:2001 accreditation, five of the surveyed centers participate in Labquality assurance and two in Quality Control in Molecular Diagnostics programs. Data of control serological testing were received from 21 centers. In the quality control assessment 194 analyses were performed with 91 true negative, 2 false negative, 96 true positive and 5 false positive results. False negative rate of % and false positive rate of 5.2% was noted for this study. Currently, virtually no guidelines related to the HIV-diagnostics quality assurance and control in Poland are in delineated. Development of the national unified quality control system, basing on the central institution is highly desirable. National certification within the frames of the quality control and assurance program should be mandatory for all the diagnostic labs, and aim at improvement of reliability of the result distributed among clinicians and patients.

42 CFR 409.16 - Other diagnostic or therapeutic services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Other diagnostic or therapeutic services. 409.16 Section 409.16 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Access Hospital Services § 409.16 Other diagnostic or therapeutic services. Diagnostic or therapeutic...

42 CFR 413.122 - Payment for hospital outpatient radiology services and other diagnostic procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... and other diagnostic procedures. 413.122 Section 413.122 Public Health CENTERS FOR MEDICARE & MEDICAID... radiology services and other diagnostic procedures. (a) Basis and purpose. (1) This section implements... services and other diagnostic procedures performed by a hospital on an outpatient basis. (2) For purposes...

42 CFR 409.16 - Other diagnostic or therapeutic services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Other diagnostic or therapeutic services. 409.16 Section 409.16 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Access Hospital Services § 409.16 Other diagnostic or therapeutic services. Diagnostic or therapeutic...

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

PubMed

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

2015-01-22

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

Diagnostic issues and capabilities in 48 isolation facilities in 16 European countries: data from EuroNHID surveys.

PubMed

Thiberville, Simon-Djamel; Schilling, Stefan; De Iaco, Giuseppina; Fusco, Francesco Maria; Thomson, Gail; Maltezou, Helen C; Gottschalk, Rene; Brodt, Reinhard H; Bannister, Barbara; Puro, Vincenzo; Ippolito, Giuseppe; Brouqui, Philippe

2012-09-25

Highly infectious diseases (HIDs) are defined as being transmissible from person to person, causing life-threatening illnesses and presenting a serious public health hazard. The sampling, handling and transport of specimens from patients with HIDs present specific bio-safety concerns. The European Network for HID project aimed to record, in a cross-sectional study, the infection control capabilities of referral centers for HIDs across Europe and assesses the level of achievement to previously published guidelines. In this paper, we report the current diagnostic capabilities and bio-safety measures applied to diagnostic procedures in these referral centers. Overall, 48 isolation facilities in 16 European countries were evaluated. Although 81% of these referral centers are located near a biosafety level 3 laboratory, 11% and 31% of them still performed their microbiological and routine diagnostic analyses, respectively, without bio-safety measures. The discrepancies among the referral centers surveyed between the level of practices and the European Network of Infectious Diseases (EUNID) recommendations have multiple reasons of which the interest of the individuals in charge and the investment they put in preparedness to emerging outbreaks. Despite the fact that the less prepared centers can improve by just updating their practice and policies any support to help them to achieve an acceptable level of biosecurity is welcome.

Effects of high-frequency activity on latent heat flux of MJO

NASA Astrophysics Data System (ADS)

Gao, Yingxia; Hsu, Pang-Chi; Li, Tim

2018-04-01

The effect of high-frequency (HF) variability on latent heat flux (LHF) associated with the Madden-Julian Oscillation (MJO) during the boreal winter is investigated through diagnosis using two reanalysis datasets and numerical experiments of an atmospheric general circulation model (AGCM). The diagnostic results show that the HF activities exert an impact on the variability of MJO LHF mainly through their interactions with the longer than 90-day low-frequency background state (LFBS). The contribution of intraseasonal LHF induced by the interactions between LFBS and HF activities accounts for more than 20% of the total intraseasonal LHF over active MJO regions. The intraseasonal LHF induced by the LFBS-HF interaction is in phase with the MJO convection, while the total intraseasonal LHF appears at and to the west of the MJO convection center. This suggests that the intraseasonal LHF via the feedback of HF activity interacting with LFBS is conducive to the maintenance and eastward propagation of MJO convection. To confirm the role of HF disturbances in MJO convection activity, we carry out a series of experiments using the AGCM of ECHAM4, which captures well the general features of MJO. We select a number of MJO cases with enhanced convective signals and significant eastward propagation from a 30-year climatological simulation. Once the HF components of surface wind and moisture fields in LHF are excluded in model integration for each MJO case, most of the simulated MJO convection shows weakened activity and a slower propagation speed compared to the simulations containing all time-scale components. The outputs of these sensitivity experiments support the diagnostic results that HF activities contribute to the maintenance and propagation of MJO convection through the intraseasonal LHF induced by the scale interaction of HF activities with lower frequency variability.

Investigating the nature of co-occurring depression and anxiety: Comparing diagnostic and dimensional research approaches.

PubMed

Kircanski, Katharina; LeMoult, Joelle; Ordaz, Sarah; Gotlib, Ian H

2017-07-01

Although approximately half of adults diagnosed with a depressive or anxiety disorder exhibit their simultaneous co-occurrence, traditional research has centered on single-target diagnoses, overlooking comorbidities within samples. In this article, we review and extend the literature that directly investigates co-occurring depression and anxiety, with the goal of shifting the focus from co-occurring diagnoses to symptom dimensions. First, we review studies that have directly compared psychobiological features (neural, neuroendocrine, autonomic) across depression, anxiety, and their co-occurrence, defined either categorically or dimensionally. Second, we analyze adults' diurnal cortisol secretion to examine the independent and interactive relations of continuously-assessed depressive and anxiety symptoms to neuroendocrine function. Previous findings on the psychobiology of diagnostic co-occurrence are mixed. While nascent, evidence from dimensionally focused studies suggests that co-occurring levels of depressive and anxiety symptoms can interact with one another, as reflected in a distinct psychobiological profile for individuals with high levels of both symptom dimensions. Results of our analyses support this formulation: we found that depressive and anxiety symptom dimensions interacted consistently in their relation to the measures of diurnal cortisol. The illustrative sample was relatively small and included only women; future research should examine generalizability of these findings. A dimensional approach to investigating the psychobiology of co-occurring depression and anxiety affords both conceptual and practical advantages. Simultaneously assessing depressive and anxiety symptom dimensions can efficiently capture their unique, shared, and interactive features, thereby identifying targets for intervention across a wide range of symptom presentations. Published by Elsevier B.V.

National Centers for Environmental Prediction

Science.gov Websites

Operational Forecast Graphics Experimental Forecast Graphics Verification and Diagnostics Model Configuration /EXPERIMENTAL MODEL FORECAST GRAPHICS OPERATIONAL VERIFICATION / DIAGNOSTICS PARALLEL VERIFICATION / DIAGNOSTICS Developmental Air Quality Forecasts and Verification Back to Table of Contents 2. PARALLEL/EXPERIMENTAL GRAPHICS

Gearbox vibration diagnostic analyzer

NASA Technical Reports Server (NTRS)

1992-01-01

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

42 CFR 414.506 - Procedures for public consultation for payment for a new clinical diagnostic laboratory test.

Code of Federal Regulations, 2010 CFR

2010-10-01

... a new clinical diagnostic laboratory test. 414.506 Section 414.506 Public Health CENTERS FOR... FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.506 Procedures for public consultation for payment for a new clinical diagnostic laboratory test...

42 CFR 414.506 - Procedures for public consultation for payment for a new clinical diagnostic laboratory test.

Code of Federal Regulations, 2011 CFR

2011-10-01

... a new clinical diagnostic laboratory test. 414.506 Section 414.506 Public Health CENTERS FOR... FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.506 Procedures for public consultation for payment for a new clinical diagnostic laboratory test...

Planetary wave-mean flow interaction in the stratosphere: A comparison between the Northern and Southern Hemispheres

NASA Technical Reports Server (NTRS)

Shiotani, M.; Hirota, I.

1985-01-01

Based on satellite-derived data supplied by the National Meteorological Center (NMC), the dynamical interaction between planetary waves and mean zonal winds in the stratosphere is investigated. Special attention is paid to the differences between the Northern Hemisphere (NH) and the Southern Hemisphere (SH). An analysis is made using Eliassen-Palm (E-P) flux diagnostics for the period from June 1981 to May 1982. In a climatological sense, different seasonal evolutions of large-scale motions between the NH and the SH in the stratosphere are demonstrated. Vertical cross-section analysis is presented to show the day-to-day variation in the mean zonal wind and wave activity, in particular, the following phenomena: (1) the poleward shifting of the westerly jet, and (2) episodes after the shifting of the westerly jet.

The Role of Radiology in the Diagnostic Process: Information, Communication, and Teamwork.

PubMed

Larson, David B; Langlotz, Curtis P

2017-11-01

The diagnostic radiology process represents a partnership between clinical and radiology teams. As such, breakdowns in interpersonal interactions and communication can result in patient harm. We explore the role of radiology in the diagnostic process, focusing on key concepts of information and communication, as well as key interpersonal interactions of teamwork, collaboration, and collegiality, all based on trust. We propose 10 principles to facilitate effective information flow in the diagnostic process.

Diagnostics Tools Identify Faults Prior to Failure

NASA Technical Reports Server (NTRS)

2013-01-01

Through the SBIR program, Rochester, New York-based Impact Technologies LLC collaborated with Ames Research Center to commercialize the Center s Hybrid Diagnostic Engine, or HyDE, software. The fault detecting program is now incorporated into a software suite that identifies potential faults early in the design phase of systems ranging from printers to vehicles and robots, saving time and money.

Crossing the Great Divide: Adoption of New Technologies, Therapeutics and Diagnostics at Academic Medical Centers

ERIC Educational Resources Information Center

DeMonaco, Harold J.; Koski, Greg

2007-01-01

The role of new technology in healthcare continues to expand from both the clinical and financial perspectives. Despite the importance of innovation, most academic medical centers do not have a clearly defined process for technology assessment. Recognizing the importance of new drugs, diagnostics and procedures in the care of patients and in the…

Integration of symbolic and algorithmic hardware and software for the automation of space station subsystems

NASA Technical Reports Server (NTRS)

Gregg, Hugh; Healey, Kathleen; Hack, Edmund; Wong, Carla

1987-01-01

Traditional expert systems, such as diagnostic and training systems, interact with users only through a keyboard and screen, and are usually symbolic in nature. Expert systems that require access to data bases, complex simulations and real-time instrumentation have both symbolic as well as algorithmic computing needs. These needs could both be met using a general purpose workstation running both symbolic and algorithmic code, or separate, specialized computers networked together. The latter approach was chosen to implement TEXSYS, the thermal expert system, developed by NASA Ames Research Center in conjunction with Johnson Space Center to demonstrate the ability of an expert system to autonomously monitor the thermal control system of the space station. TEXSYS has been implemented on a Symbolics workstation, and will be linked to a microVAX computer that will control a thermal test bed. This paper will explore the integration options, and present several possible solutions.

Bioinformatics Meets Virology: The European Virus Bioinformatics Center's Second Annual Meeting.

PubMed

Ibrahim, Bashar; Arkhipova, Ksenia; Andeweg, Arno C; Posada-Céspedes, Susana; Enault, François; Gruber, Arthur; Koonin, Eugene V; Kupczok, Anne; Lemey, Philippe; McHardy, Alice C; McMahon, Dino P; Pickett, Brett E; Robertson, David L; Scheuermann, Richard H; Zhernakova, Alexandra; Zwart, Mark P; Schönhuth, Alexander; Dutilh, Bas E; Marz, Manja

2018-05-14

The Second Annual Meeting of the European Virus Bioinformatics Center (EVBC), held in Utrecht, Netherlands, focused on computational approaches in virology, with topics including (but not limited to) virus discovery, diagnostics, (meta-)genomics, modeling, epidemiology, molecular structure, evolution, and viral ecology. The goals of the Second Annual Meeting were threefold: (i) to bring together virologists and bioinformaticians from across the academic, industrial, professional, and training sectors to share best practice; (ii) to provide a meaningful and interactive scientific environment to promote discussion and collaboration between students, postdoctoral fellows, and both new and established investigators; (iii) to inspire and suggest new research directions and questions. Approximately 120 researchers from around the world attended the Second Annual Meeting of the EVBC this year, including 15 renowned international speakers. This report presents an overview of new developments and novel research findings that emerged during the meeting.

Health and Prevention Enhancement (H-PEACE): a retrospective, population-based cohort study conducted at the Seoul National University Hospital Gangnam Center, Korea.

PubMed

Lee, Changhyun; Choe, Eun Kyung; Choi, Ji Min; Hwang, Yunji; Lee, Young; Park, Boram; Chung, Su Jin; Kwak, Min-Sun; Lee, Jong-Eun; Kim, Joo Sung; Park, Sue Kyung; Cho, Sang-Heon

2018-04-19

The Health and Prevention Enhancement (H-PEACE) study was designed to investigate the association of diagnostic imaging results, biomarkers and the predisease stage of non-communicable diseases (NCDs), such as malignancies and metabolic diseases, in an average-risk population in Korea. This study enrolled a large-scale retrospective cohort at the Healthcare System Gangnam Center, Seoul National University Hospital, from October 2003 to December 2014. The baseline and follow-up information collected in the predisease stage of NCDs allows for evaluation of an individual's potential NCD risk, which is necessary for establishing personalised prevention strategies. A total of 91 336 health examinees were included in the cohort, and we repeatedly measured and collected information for 50.9% (n=46 484) of the cohort members. All participants completed structured questionnaires (lifestyle, medical history, mini-dietary assessment index, sex-specific variables and psychiatric assessment), doctors' physical examinations, laboratory blood and urine tests and digital chest X-ray imaging. For participants with available data, we also obtained information on specific diagnostic variables using advanced diagnostic tests, including coronary CT for coronary calcium scores, colonoscopy and brain MRI. Furthermore, 17 455 of the participants who provided informed consent and donated blood samples were enrolled into the Gene-environmental interaction and phenotype study, a subcohort of the H-PEACE, from October 2013, and we analysed genome-wide single-nucleotide polymorphism array data for 6579 of these blood samples. The data obtained from this cohort will be used to facilitate advanced and accurate diagnostic techniques related to NCDs while considering various phenotypes. Potential collaborators can access the dataset after receiving approval from our institutional review board. Applications can be submitted on the study homepage (http://en-healthcare.snuh.org/HPEACEstudy). © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

42 CFR 414.509 - Reconsideration of basis for and amount of payment for a new clinical diagnostic laboratory test.

Code of Federal Regulations, 2010 CFR

2010-10-01

... for a new clinical diagnostic laboratory test. 414.509 Section 414.509 Public Health CENTERS FOR... FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.509 Reconsideration of basis for and amount of payment for a new clinical diagnostic laboratory...

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

Hall Effect Thruster Interactions Data From the Russian Express-A2 and Express-A3 Satellites. Part 7; Acquire Express-A3 SPT-100 Based Propulsion Subsystem and Other Subsystem Flight Operation TM-Data, Task 32

NASA Technical Reports Server (NTRS)

Sitnikova, N.; Volkov, D.; Maximov, I.; Petrusevich, V.; Allen, D.

2003-01-01

This 12-part report documents the data obtained from various sensor measurements taken aboard the Russian Express-A2 and Express-A3 spacecraft in Geosynchronous Earth Orbit (GEO). These GEO communications satellites, which were designed and built by NPO Prikladnoy Mekhaniki (NPO PM) of Zheleznogorsk, Russia, utilize Hall thruster propulsion systems for north-south and east-west stationkeeping and as of June 2002, were still operating at 80 E. and 11 W., respectively. Express-A2 was launched on March 12, 2000, while Express-A3 was launched on June 24, 2000. The diagnostic equipment from which these data were taken includes electric field strength sensors, ion current and energy sensors, and pressure sensors. The diagnostics and the Hall thruster propulsion systems are described in detail along with lists of tabular data from those diagnostics and propulsion system and other satellite systems. Space Power, Inc., now part of Pratt & Whitney's Chemical Systems Division, to the NASA Glenn Research Center, obtained these data over several periods from March 12, 2000, through September 30, 2001. Each of the 12 individual reports describe, in detail, the propulsion systems as well as the diagnostic sensors utilized. Finally, parts 11 and 12 include the requirements to which NPO PM prepared and delivered these data.

Genetic testing: new challenges in the healthcare of women. Interview by Hannah Branch.

PubMed

Hofmann, Wera; Branch, Hannah

2013-11-01

Dr Wera Hofmann is an expert in biochemistry and has over 12 years of human genetic diagnostics experience. Until 2006, she supervised a diagnostic unit for BRCA gene testing at the Interdisciplinary Center for Hereditary Breast Cancer (Max Delbrück Center, Berlin, Germany). She has also been the Managing Director of the Professional Association of German Human Geneticists, BVDH, which is a trade association. In 2008, Hofmann became a Medical Director at LifeCodexx (Konstanz, Germany), where she has worked on the development of a noninvasive prenatal diagnostic test that detects chromosomal aneuploidies in fetuses.

Fan Noise Source Diagnostic Test Computation of Rotor Wake Turbulence Noise

NASA Technical Reports Server (NTRS)

Nallasamy, M.; Envia, E.; Thorp, S. A.; Shabbir, A.

2002-01-01

An important source mechanism of fan broadband noise is the interaction of rotor wake turbulence with the fan outlet guide vanes. A broadband noise model that utilizes computed rotor flow turbulence from a RANS code is used to predict fan broadband noise spectra. The noise model is employed to examine the broadband noise characteristics of the 22-inch Source Diagnostic Test fan rig for which broadband noise data were obtained in wind tunnel tests at the NASA Glenn Research Center. A 9-case matrix of three outlet guide vane configurations at three representative fan tip speeds are considered. For all cases inlet and exhaust acoustic power spectra are computed and compared with the measured spectra where possible. In general, the acoustic power levels and shape of the predicted spectra are in good agreement with the measured data. The predicted spectra show the experimentally observed trends with fan tip speed, vane count, and vane sweep. The results also demonstrate the validity of using CFD-based turbulence information for fan broadband noise calculations.

Trichomonas vaginalis Genital Infections: Progress and Challenges

PubMed Central

Hobbs, Marcia M.; Seña, Arlene C.; Sobel, Jack D.; Schwebke, Jane R.; Krieger, John N.; McClelland, R. Scott; Workowski, Kimberly A.

2011-01-01

Trichomonas vaginalis (TV) infection is the most prevalent curable sexually transmitted infection in the United States and worldwide. Most TV infections are asymptomatic, and the accurate diagnosis of this infection has been limited by lack of sufficiently sensitive and specific diagnostic tests, particularly for men. To provide updates for the 2010 Centers for Disease Control and Prevention’s Sexually Transmitted Diseases Treatment Guidelines, a PubMed search was conducted of all TV literature published from 9 January 2004 through 24 September 2008. Approximately 175 pertinent abstracts and articles were reviewed and discussed with national experts. This article describes advances in TV diagnostics which have led to an improved understanding of the epidemiology of this pathogen, as well as potential biologic and epidemiological interactions between TV and human immunodeficiency virus (HIV). New data on treatment outcomes, metronidazole-resistant TV, management of nitroimidazole-allergic patients, frequency of recurrent TV infection following treatment, and screening considerations for TV in certain populations are also presented. PMID:22080269

A Framework for Assessing Operational Madden–Julian Oscillation Forecasts: A CLIVAR MJO Working Group Project

DOE PAGES

Gottschalck, J.; Wheeler, M.; Weickmann, K.; ...

2010-09-01

The U.S. Climate Variability and Predictability (CLIVAR) MJO Working Group (MJOWG) has taken steps to promote the adoption of a uniform diagnostic and set of skill metrics for analyzing and assessing dynamical forecasts of the MJO. Here we describe the framework and initial implementation of the approach using real-time forecast data from multiple operational numerical weather prediction (NWP) centers. The objectives of this activity are to provide a means to i) quantitatively compare skill of MJO forecasts across operational centers, ii) measure gains in forecast skill over time by a given center and the community as a whole, and iii)more » facilitate the development of a multimodel forecast of the MJO. The MJO diagnostic is based on extensive deliberations among the MJOWG in conjunction with input from a number of operational centers and makes use of the MJO index of Wheeler and Hendon. This forecast activity has been endorsed by the Working Group on Numerical Experimentation (WGNE), the international body that fosters the development of atmospheric models for NWP and climate studies. The Climate Prediction Center (CPC) within the National Centers for Environmental Prediction (NCEP) is hosting the acquisition of the forecast data, application of the MJO diagnostic, and real-time display of the standardized forecasts. The activity has contributed to the production of 1–2-week operational outlooks at NCEP and activities at other centers. Further enhancements of the diagnostic's implementation, including more extensive analysis, comparison, illustration, and verification of the contributions from the participating centers, will increase the usefulness and application of these forecasts and potentially lead to more skillful predictions of the MJO and indirectly extratropical and other weather variability (e.g., tropical cyclones) influenced by the MJO. The purpose of this article is to inform the larger scientific and operational forecast communities of the MJOWG forecast effort and invite participation from additional operational centers.« less

Quantification of protein interaction kinetics in a micro droplet

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

Yin, L. L.; College of Chemistry and Chemical Engineering, Chongqing University, Chongqing 400044; Wang, S. P., E-mail: shaopeng.wang@asu.edu, E-mail: njtao@asu.edu

Characterization of protein interactions is essential to the discovery of disease biomarkers, the development of diagnostic assays, and the screening for therapeutic drugs. Conventional flow-through kinetic measurements need relative large amount of sample that is not feasible for precious protein samples. We report a novel method to measure protein interaction kinetics in a single droplet with sub microliter or less volume. A droplet in a humidity-controlled environmental chamber is replacing the microfluidic channels as the reactor for the protein interaction. The binding process is monitored by a surface plasmon resonance imaging (SPRi) system. Association curves are obtained from the averagemore » SPR image intensity in the center area of the droplet. The washing step required by conventional flow-through SPR method is eliminated in the droplet method. The association and dissociation rate constants and binding affinity of an antigen-antibody interaction are obtained by global fitting of association curves at different concentrations. The result obtained by this method is accurate as validated by conventional flow-through SPR system. This droplet-based method not only allows kinetic studies for proteins with limited supply but also opens the door for high-throughput protein interaction study in a droplet-based microarray format that enables measurement of many to many interactions on a single chip.« less

Quantification of protein interaction kinetics in a micro droplet

NASA Astrophysics Data System (ADS)

Yin, L. L.; Wang, S. P.; Shan, X. N.; Zhang, S. T.; Tao, N. J.

2015-11-01

Characterization of protein interactions is essential to the discovery of disease biomarkers, the development of diagnostic assays, and the screening for therapeutic drugs. Conventional flow-through kinetic measurements need relative large amount of sample that is not feasible for precious protein samples. We report a novel method to measure protein interaction kinetics in a single droplet with sub microliter or less volume. A droplet in a humidity-controlled environmental chamber is replacing the microfluidic channels as the reactor for the protein interaction. The binding process is monitored by a surface plasmon resonance imaging (SPRi) system. Association curves are obtained from the average SPR image intensity in the center area of the droplet. The washing step required by conventional flow-through SPR method is eliminated in the droplet method. The association and dissociation rate constants and binding affinity of an antigen-antibody interaction are obtained by global fitting of association curves at different concentrations. The result obtained by this method is accurate as validated by conventional flow-through SPR system. This droplet-based method not only allows kinetic studies for proteins with limited supply but also opens the door for high-throughput protein interaction study in a droplet-based microarray format that enables measurement of many to many interactions on a single chip.

International External Quality Assurance for Laboratory Diagnosis of Diphtheria ▿

PubMed Central

Neal, S. E.; Efstratiou, A.

2009-01-01

The diphtheria surveillance network (DIPNET) encompassing National Diphtheria Reference Centers from 25 European countries is a Dedicated Surveillance Network recognized by the European Commission. A key DIPNET objective is the quality assessment of microbiological procedures for diphtheria across the European Union and beyond. A detailed questionnaire on the level of reference laboratory services and an external quality assessment (EQA) panel comprising six simulated throat specimens were sent to 34 centers. Twenty-three centers are designated National Diphtheria Reference Centers, with the laboratory in the United Kingdom being the only WHO Collaborating Centre. A variety of screening and identification tests were used, including the cysteinase test (20/34 centers), pyrazinamidase test (17/34 centers), and commercial kits (25/34 centers). The classic Elek test for toxigenicity testing is mostly used (28/34 centers), with variations in serum sources and antitoxin concentrations. Many laboratories reported problems obtaining Elek reagents or media. Only six centers produced acceptable results for all six specimens. Overall, 21% of identification and 13% of toxigenicity reports were unacceptable. Many centers could not isolate the target organism, and most found difficulties with the specimens that contained Corynebacterium striatum as a commensal contaminant. Nineteen centers generated either false-positive or negative toxigenic results, which may have caused inappropriate medical management. The discrepancies in this diphtheria diagnostics EQA alarmingly reflect the urgent need to improve laboratory performance in diphtheria diagnostics in Europe, standardize feasible and robust microbiological methods, and build awareness among public health authorities. Therefore, DIPNET recommends that regular workshops and EQA distributions for diphtheria diagnostics should be supported and maintained. PMID:19828749

DSM-5, ICD-10, ICD-11, the Psychodynamic Diagnostic Manual, and Person-Centered Integrative Diagnosis: An Overview for College Mental Health Therapists

ERIC Educational Resources Information Center

Cooper, Stewart E.

2014-01-01

Therapists in the field of college mental health counseling commonly voice an ambivalent orientation towards the utilization of formal psychological diagnostic systems yet often use diagnostic terms. Knowledge of the current and emerging diagnostic systems may contribute to greater syntheses of these differing approaches. This article will first…

THE INTERACTIVE AUTOMATIC SYNDROME DIAGNOSTIC PROGRAM OF DIGESTIVE SYSTEM DISEASES "ELECTRONIC POLICLINIC".

PubMed

Mishlanov, V Yu; Katkova, A V; Dugina, A A; Kuznetzova, V D; Tepanyan, A T; Zhygulev, A N

The aim of the study was to estimate clinical efficiency of the interactive automatic program of digestive system diseases diagnostics "Electronic policlinic". Material was presented by 22 patients with different gastroenterological diseases (duodenal ulcer, chronical gastritis, chronical pancreatitis) and the comparative group consisted of 20 healthy people. The plan of the research included the interactive questionnaire using diagnostic module digestive system diseases of the digestive system of the automated program "Electronic policlinic" (Certificate No. 2012614202 from 12.05.12) posted on the Internet (http://klinikcity.ru). For the purpose of verification of diagnosis patients underwent fibrogastroduodenoscopy, ultrasound examination of abdominal cavity organs, CT scan, sigmoidoscopy, colonoscopy, barium enema. As the result of the study there were showed that interactive automated system was able to reveal 85,7% of patients with chronical gastritis, duodenal ulcer and chronical pancreatitis and 75% of patients with colonopathy. The specify of diagnostic procedure was 80% in the first case and 100% in the second. Prevalence of digestive system diseases basic symptoms was studied too. The conclusion of the study demonstrated interactive questionnaire good ability in preliminary digestive problem patient examination procedure for individual diagnostic plan making.

The Perils of "Adjustment Disorder" as a Diagnostic Category

ERIC Educational Resources Information Center

Daniels, John

2009-01-01

"Adjustment disorder" occupies a peculiar position in the diagnostic system of the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000) straddling the boundary between normal and abnormal psychology. A more human-centered approach in counseling offers a defense of "normal" adjustment as…

Elucidating the Ultrafast Dynamics of Photoinduced Charge Separation in Metalloporphyrin-Fullerene Dyads Across the Electromagnetic Spectrum

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

Zhang, J.; Pápai, M.; Hirsch, A.

Metalloporphyrins are prominent building blocks in the synthetic toolbox of advanced photodriven molecular devices. When the central ion is paramagnetic, the relaxation pathways within the manifold of excited states are highly intricate so that unravelling the intramolecular energy and electron transfer processes is usually a very complex task. This fact is critically hampering the development of applications based on the enhanced coupling offered by the electronic exchange interaction. In this work, the dynamics of charge separation in a copper porphyrin-fullerene are studied with several complementary spectroscopic tools across the electromagnetic spectrum (from near infra-red to X-ray wavelengths), each of themmore » providing specific diagnostics. Correlating the various rates clearly demonstrates that the lifetime of the photoinduced charge-separated state exceeds by about 10 fold that of the isolated photoexcited CuII porphyrin. As revealed by the spectral modifications in the XANES region, this stabilization is accompanied by a transient change in covalency around the CuII center, which is induced by an enhanced interaction with the C60 moiety. This experimental finding is further confirmed by state-of-the art calculations using DFT and TD-DFT including dispersion effects that explain the electrostatic and structural origins of this interaction, as the CuIIP cation becomes ruffled and approaches closer to the fullerene in the charge-separated state. From a methodological point of view, these results exemplify the potential of multielectron excitation features in transient X-ray spectra as future diagnostics of sub-femtosecond electronic dynamics. From a practical point of view, this work is paving the way for elucidating out-of-equilibrium electron transfer events coupled to magnetic interaction processes on their intrinsic time-scales.« less

Performance of Local Light Microscopy and the ParaScreen Pan/Pf Rapid Diagnostic Test to Detect Malaria in Health Centers in Northwest Ethiopia

PubMed Central

Endeshaw, Tekola; Graves, Patricia M.; Ayele, Berhan; Mosher, Aryc W.; Gebre, Teshome; Ayalew, Firew; Genet, Asrat; Mesfin, Alemayehu; Shargie, Estifanos Biru; Tadesse, Zerihun; Teferi, Tesfaye; Melak, Berhanu; Richards, Frank O.; Emerson, Paul M.

2012-01-01

Background Diagnostic tests are recommended for suspected malaria cases before treatment, but comparative performance of microscopy and rapid diagnostic tests (RDTs) at rural health centers has rarely been studied compared to independent expert microscopy. Methods Participants (N = 1997) with presumptive malaria were recruited from ten health centers with a range of transmission intensities in Amhara Regional State, Northwest Ethiopia during October to December 2007. Microscopy and ParaScreen Pan/Pf® RDT were done immediately by health center technicians. Blood slides were re-examined later at a central laboratory by independent expert microscopists. Results Of 1,997 febrile patients, 475 (23.8%) were positive by expert microscopists, with 57.7% P.falciparum, 24.6% P.vivax and 17.7% mixed infections. Sensitivity of health center microscopists for any malaria species was >90% in five health centers (four of which had the highest prevalence), >70% in nine centers and 44% in one site with lowest prevalence. Specificity for health center microscopy was very good (>95%) in all centers. For ParaScreen RDT, sensitivity was ≥90% in three centers, ≥70% in six and <60% in four centers. Specificity was ≥90% in all centers except one where it was 85%. Conclusions Health center microscopists performed well in nine of the ten health centers; while for ParaScreen RDT they performed well in only six centers. Overall the accuracy of local microscopy exceeded that of RDT for all outcomes. This study supports the introduction of RDTs only if accompanied by appropriate training, frequent supervision and quality control at all levels. Deficiencies in RDT use at some health centers must be rectified before universal replacement of good routine microscopy with RDTs. Maintenance and strengthening of good quality microscopy remains a priority at health center level. PMID:22536317

Performance of local light microscopy and the ParaScreen Pan/Pf rapid diagnostic test to detect malaria in health centers in Northwest Ethiopia.

PubMed

Endeshaw, Tekola; Graves, Patricia M; Ayele, Berhan; Mosher, Aryc W; Gebre, Teshome; Ayalew, Firew; Genet, Asrat; Mesfin, Alemayehu; Shargie, Estifanos Biru; Tadesse, Zerihun; Teferi, Tesfaye; Melak, Berhanu; Richards, Frank O; Emerson, Paul M

2012-01-01

Diagnostic tests are recommended for suspected malaria cases before treatment, but comparative performance of microscopy and rapid diagnostic tests (RDTs) at rural health centers has rarely been studied compared to independent expert microscopy. Participants (N = 1997) with presumptive malaria were recruited from ten health centers with a range of transmission intensities in Amhara Regional State, Northwest Ethiopia during October to December 2007. Microscopy and ParaScreen Pan/Pf® RDT were done immediately by health center technicians. Blood slides were re-examined later at a central laboratory by independent expert microscopists. Of 1,997 febrile patients, 475 (23.8%) were positive by expert microscopists, with 57.7% P. falciparum, 24.6% P. vivax and 17.7% mixed infections. Sensitivity of health center microscopists for any malaria species was >90% in five health centers (four of which had the highest prevalence), >70% in nine centers and 44% in one site with lowest prevalence. Specificity for health center microscopy was very good (>95%) in all centers. For ParaScreen RDT, sensitivity was ≥90% in three centers, ≥70% in six and <60% in four centers. Specificity was ≥90% in all centers except one where it was 85%. Health center microscopists performed well in nine of the ten health centers; while for ParaScreen RDT they performed well in only six centers. Overall the accuracy of local microscopy exceeded that of RDT for all outcomes. This study supports the introduction of RDTs only if accompanied by appropriate training, frequent supervision and quality control at all levels. Deficiencies in RDT use at some health centers must be rectified before universal replacement of good routine microscopy with RDTs. Maintenance and strengthening of good quality microscopy remains a priority at health center level.

Effect of enhanced information, values clarification, and removal of financial barriers on use of prenatal genetic testing: a randomized clinical trial.

PubMed

Kuppermann, Miriam; Pena, Sherri; Bishop, Judith T; Nakagawa, Sanae; Gregorich, Steven E; Sit, Anita; Vargas, Juan; Caughey, Aaron B; Sykes, Susan; Pierce, Lasha; Norton, Mary E

2014-09-24

Prenatal genetic testing guidelines recommend providing patients with detailed information to allow informed, preference-based screening and diagnostic testing decisions. The effect of implementing these guidelines is not well understood. To analyze the effect of a decision-support guide and elimination of financial barriers to testing on use of prenatal genetic testing and decision making among pregnant women of varying literacy and numeracy levels. Randomized trial conducted from 2010-2013 at prenatal clinics at 3 county hospitals, 1 community clinic, 1 academic center, and 3 medical centers of an integrated health care delivery system in the San Francisco Bay area. Participants were English- or Spanish-speaking women who had not yet undergone screening or diagnostic testing and remained pregnant at 11 weeks' gestation (n = 710). A computerized, interactive decision-support guide and access to prenatal testing with no out-of-pocket expense (n = 357) or usual care as per current guidelines (n = 353). The primary outcome was invasive diagnostic test use, obtained via medical record review. Secondary outcomes included testing strategy undergone, and knowledge about testing, risk comprehension, and decisional conflict and regret at 24 to 36 weeks' gestation. Women randomized to the intervention group, compared with those randomized to the control group, were less likely to have invasive diagnostic testing (5.9% vs 12.3%; odds ratio [OR], 0.45 [95% CI, 0.25-0.80]) and more likely to forgo testing altogether (25.6% vs 20.4%; OR, 3.30 [95% CI, 1.43-7.64], reference group screening followed by invasive testing). Women randomized to the intervention group also had higher knowledge scores (9.4 vs 8.6 on a 15-point scale; mean group difference, 0.82 [95% CI, 0.34-1.31]) and were more likely to correctly estimate the amniocentesis-related miscarriage risk (73.8% vs 59.0%; OR, 1.95 [95% CI, 1.39-2.75]) and their estimated age-adjusted chance of carrying a fetus with trisomy 21 (58.7% vs 46.1%; OR, 1.66 [95% CI, 1.22-2.28]). Significant differences did not emerge in decisional conflict or regret. Full implementation of prenatal testing guidelines using a computerized, interactive decision-support guide in the absence of financial barriers to testing resulted in less test use and more informed choices. If validated in additional populations, this approach may result in more informed and preference-based prenatal testing decision making and fewer women undergoing testing. clinicaltrials.gov Identifier: NCT00505596.

Classification and diagnostic prediction of cancers using gene expression profiling and artificial neural networks | Center for Cancer Research

Cancer.gov

The purpose of this study was to develop a method of classifying cancers to specific diagnostic categories based on their gene expression signatures using artificial neural networks (ANNs). We trained the ANNs using the small, round blue-cell tumors (SRBCTs) as a model. These cancers belong to four distinct diagnostic categories and often present diagnostic dilemmas in

Effectiveness of whole-exome sequencing and costs of the traditional diagnostic trajectory in children with intellectual disability.

PubMed

Monroe, Glen R; Frederix, Gerardus W; Savelberg, Sanne M C; de Vries, Tamar I; Duran, Karen J; van der Smagt, Jasper J; Terhal, Paulien A; van Hasselt, Peter M; Kroes, Hester Y; Verhoeven-Duif, Nanda M; Nijman, Isaäc J; Carbo, Ellen C; van Gassen, Koen L; Knoers, Nine V; Hövels, Anke M; van Haelst, Mieke M; Visser, Gepke; van Haaften, Gijs

2016-09-01

This study investigated whole-exome sequencing (WES) yield in a subset of intellectually disabled patients referred to our clinical diagnostic center and calculated the total costs of these patients' diagnostic trajectory in order to evaluate early WES implementation. We compared 17 patients' trio-WES yield with the retrospective costs of diagnostic procedures by comprehensively examining patient records and collecting resource use information for each patient, beginning with patient admittance and concluding with WES initiation. We calculated cost savings using scenario analyses to evaluate the costs replaced by WES when used as a first diagnostic tool. WES resulted in diagnostically useful outcomes in 29.4% of patients. The entire traditional diagnostic trajectory average cost was $16,409 per patient, substantially higher than the $3,972 trio-WES cost. WES resulted in average cost savings of $3,547 for genetic and metabolic investigations in diagnosed patients and $1,727 for genetic investigations in undiagnosed patients. The increased causal variant detection yield by WES and the relatively high costs of the entire traditional diagnostic trajectory suggest that early implementation of WES is a relevant and cost-efficient option in patient diagnostics. This information is crucial for centers considering implementation of WES and serves as input for future value-based research into diagnostics.Genet Med 18 9, 949-956.

Ventilator-associated pneumonia rates at major trauma centers compared with a national benchmark: a multi-institutional study of the AAST.

PubMed

Michetti, Christopher P; Fakhry, Samir M; Ferguson, Pamela L; Cook, Alan; Moore, Forrest O; Gross, Ronald

2012-05-01

Ventilator-associated pneumonia (VAP) rates reported by the National Healthcare Safety Network (NHSN) are used as a benchmark and quality measure, yet different rates are reported from many trauma centers. This multi-institutional study was undertaken to elucidate VAP rates at major trauma centers. VAP rate/1,000 ventilator days, diagnostic methods, institutional, and aggregate patient data were collected retrospectively from a convenience sample of trauma centers for 2008 and 2009 and analyzed with descriptive statistics. At 47 participating Level I and II centers, the pooled mean VAP rate was 17.2 versus 8.1 for NHSN (2006-2008). Hospitals' rates were highly variable (range, 1.8-57.6), with 72.3% being above NHSN's mean. Rates differed based on who determined the rate (trauma service, 27.5; infection control or quality or epidemiology, 11.9; or collaborative effort, 19.9) and the frequency with which VAP was excluded based on aspiration or diagnosis before hospital day 5. In 2008 and 2009, blunt trauma patients had higher VAP rates (17.3 and 17.6, respectively) than penetrating patients (11.0 and 10.9, respectively). More centers used a clinical diagnostic strategy (57%) than a bacteriologic strategy (43%). Patients with VAP had a mean Injury Severity Score of 28.7, mean Intensive Care Unit length of stay of 20.8 days, and a 12.2% mortality rate. 50.5% of VAP patients had a traumatic brain injury. VAP rates at major trauma centers are markedly higher than those reported by NHSN and vary significantly among centers. Available data are insufficient to set benchmarks, because it is questionable whether any one data set is truly representative of most trauma centers. Application of a single benchmark to all centers may be inappropriate, and reliable diagnostic and reporting standards are needed. Prospective analysis of a larger data set is warranted, with attention to injury severity, risk factors specific to trauma patients, diagnostic method used, VAP definitions and exclusions, and reporting guidelines. III, prognostic study.

ObspyDMT: a Python toolbox for retrieving and processing large seismological data sets

NASA Astrophysics Data System (ADS)

Hosseini, Kasra; Sigloch, Karin

2017-10-01

We present obspyDMT, a free, open-source software toolbox for the query, retrieval, processing and management of seismological data sets, including very large, heterogeneous and/or dynamically growing ones. ObspyDMT simplifies and speeds up user interaction with data centers, in more versatile ways than existing tools. The user is shielded from the complexities of interacting with different data centers and data exchange protocols and is provided with powerful diagnostic and plotting tools to check the retrieved data and metadata. While primarily a productivity tool for research seismologists and observatories, easy-to-use syntax and plotting functionality also make obspyDMT an effective teaching aid. Written in the Python programming language, it can be used as a stand-alone command-line tool (requiring no knowledge of Python) or can be integrated as a module with other Python codes. It facilitates data archiving, preprocessing, instrument correction and quality control - routine but nontrivial tasks that can consume much user time. We describe obspyDMT's functionality, design and technical implementation, accompanied by an overview of its use cases. As an example of a typical problem encountered in seismogram preprocessing, we show how to check for inconsistencies in response files of two example stations. We also demonstrate the fully automated request, remote computation and retrieval of synthetic seismograms from the Synthetics Engine (Syngine) web service of the Data Management Center (DMC) at the Incorporated Research Institutions for Seismology (IRIS).

A diagnostic technique used to obtain cross range radiation centers from antenna patterns

NASA Technical Reports Server (NTRS)

Lee, T. H.; Burnside, W. D.

1988-01-01

A diagnostic technique to obtain cross range radiation centers based on antenna radiation patterns is presented. This method is similar to the synthetic aperture processing of scattered fields in the radar application. Coherent processing of the radiated fields is used to determine the various radiation centers associated with the far-zone pattern of an antenna for a given radiation direction. This technique can be used to identify an unexpected radiation center that creates an undesired effect in a pattern; on the other hand, it can improve a numerical simulation of the pattern by identifying other significant mechanisms. Cross range results for two 8' reflector antennas are presented to illustrate as well as validate that technique.

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.

The IHS diagnostic X-ray equipment radiation protection program

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

Knapp, A.; Byrns, G.; Suleiman, O.

The Indian Health Service (IHS) operates or contracts with Tribal groups to operate 50 hospitals and approximately 165 primary ambulatory care centers. These facilities contain approximately 275 medical and 800 dental diagnostic x-ray machines. IHS environmental health personnel in collaboration with the Food and Drug Administration's (FDA) Center for Devices and Radiological Health (CDRH) developed a diagnostic x-ray protection program including standard survey procedures and menu-driven calculations software. Important features of the program include the evaluation of equipment performance collection of average patient entrance skin exposure (ESE) measurements for selected procedures, and quality assurance. The ESE data, collected using themore » National Evaluation of X-ray Trends (NEXT) protocol, will be presented. The IHS Diagnostic X-ray Radiation Protection Program is dynamic and is adapting to changes in technology and workload.« less

Verification and classification bias interactions in diagnostic test accuracy studies for fine-needle aspiration biopsy.

PubMed

Schmidt, Robert L; Walker, Brandon S; Cohen, Michael B

2015-03-01

Reliable estimates of accuracy are important for any diagnostic test. Diagnostic accuracy studies are subject to unique sources of bias. Verification bias and classification bias are 2 sources of bias that commonly occur in diagnostic accuracy studies. Statistical methods are available to estimate the impact of these sources of bias when they occur alone. The impact of interactions when these types of bias occur together has not been investigated. We developed mathematical relationships to show the combined effect of verification bias and classification bias. A wide range of case scenarios were generated to assess the impact of bias components and interactions on total bias. Interactions between verification bias and classification bias caused overestimation of sensitivity and underestimation of specificity. Interactions had more effect on sensitivity than specificity. Sensitivity was overestimated by at least 7% in approximately 6% of the tested scenarios. Specificity was underestimated by at least 7% in less than 0.1% of the scenarios. Interactions between verification bias and classification bias create distortions in accuracy estimates that are greater than would be predicted from each source of bias acting independently. © 2014 American Cancer Society.

Chest pain emergency centers: improving acute myocardial infarction care.

PubMed

Ornato, J P

1999-08-01

Uncertainty and delay are common in the diagnosis of acute coronary syndromes (ACS). In the last 20 years, the need for faster, more accurate, and more cost-effective diagnosis gave rise to the concept of specialized treatment of patients with chest pain in emergency departments (EDs). The original strategy dedicated a separate section of the ED and a nursing staff to the task of rapid intervention in patients with acute myocardial infarction (MI) and triage of low-risk patients. Chest pain centers grew quickly in popularity but evolved with a variety of goals, staffing plans, diagnostic resources, and levels of commitment. There existing centers--the University of Cincinnati Heart ER, Brigham and Women's Hospital, and the Medical College of Virginia--have implemented chest pain strategies with the common aims of (1) screening for the entire spectrum of coronary artery disease, (2) avoiding unnecessary admissions, and (3) using multiple diagnostic modalities. Yet, they differ in the specifics of their approaches and diagnostic methods (e.g., echocardiography vs. treadmill vs. myocardial perfusion imaging). The safety and cost effectiveness of these centers are discussed.

Prevalence of Autism Spectrum Disorder in Children Referred for Diagnostic Autism Evaluation.

PubMed

Monteiro, Sonia A; Spinks-Franklin, Adiaha; Treadwell-Deering, Diane; Berry, Leandra; Sellers-Vinson, Sherry; Smith, Eboni; Proud, Monica; Voigt, Robert G

2015-12-01

Increased public awareness of autism spectrum disorders (ASD) and routine screening in primary care have contributed to increased requests for diagnostic ASD evaluations. However, given the scarcity of subspecialty autism diagnostic resources, overreferral of children suspected of having ASD may be contributing to long waiting lists at tertiary care autism centers and delaying diagnosis for those children who truly have ASD. To determine whether children are being excessively referred to ASD-specific diagnostic clinics, our objective was to determine the prevalence of true ASD diagnoses in children referred for diagnostic ASD evaluation. Charts of all patients referred to a regional autism center between April 2011 and August 2012 for suspicion of a possible ASD were retrospectively reviewed and demographic and clinical diagnoses abstracted. Only 214 of 348 patients evaluated (61%) received an ASD diagnosis. Thus, concerns about autism are not confirmed by an ASD diagnosis in a significant number of children. © The Author(s) 2015.

Hall Effect Thruster Interactions Data From the Russian Express-A2 and Express-A3 Satellites. Part 2; Acquire TM Date for Type B Sensors for "Express-A" Number 2 Satellite for the Period of March 12, 2000 to and Including June 15, 2000, Task 25

NASA Technical Reports Server (NTRS)

Dunning, John (Technical Monitor); Sitnikova, N.; Volkov, D.; Maximov, I.; Petrusevich, V.; Allen, D.

2003-01-01

This 12-part report documents the data obtained from various sensor measurements taken aboard the Russian Express-A2 and Express-A3 spacecraft in Geosynchronous Earth Orbit (GEO). These GEO communications satellites, which were designed and built by NPO Prikladnoy Mekhaniki (NPO PM) of Zheleznogorsk, Russia, utilize Hall thruster propulsion systems for north-south and east-west stationkeeping and as of June 2002, were still operating at 80 E. and 11 W., respectively. Express-A2 was launched on March 12, 2000, while Express-A3 was launched on June 24, 2000. The diagnostic equipment from which these data were taken includes electric field strength sensors, ion current and energy sensors, and pressure sensors. The diagnostics and the Hall thruster propulsion systems are described in detail along with lists of tabular data from those diagnostics and propulsion system and other satellite systems. Space Power, Inc., now part of Pratt & Whitney's Chemical Systems Division, under contract NAS3 99151 to the NASA Glenn Research Center, obtained these data over several periods from March 12, 2000, through September 30, 2001. Each of the 12 individual reports describe, in detail, the propulsion systems as well as the diagnostic sensors utilized. Finally, parts 11 and 12 include the requirements to which NPO PM prepared and delivered these data.

Hall Effect Thruster Interactions Data from the Russian Express-A2 and Express-A3 Satellites. Part 4; Acquire TM-Data for Type A and Type B Sensors for "Express-A" Number 3 Satellite, Task 27A

NASA Technical Reports Server (NTRS)

Sitnikova, N.; Volkov, D.; Maximov, I.; Petrusevich, V.; Allen, D.

2003-01-01

This 12-part report documents the data obtained from various sensor measurements taken aboard the Russian Express-A2 and Express-A3 spacecraft in Geosynchronous Earth Orbit (GEO). These GEO communications satellites, which were designed and built by NPO Prikladnoy Mekhaniki (NPO PM) of Zheleznogorsk, Russia, utilize Hall thruster propulsion systems for north-south and east-west stationkeeping and as of June 2002, were still operating at 80deg E., and 11deg W., respectively. Express-A2 was launched on March 12, 2000, while Express-A3 was launched on June 24, 2000. The diagnostic equipment from which these data were taken includes electric field strength sensors, ion current and energy sensors, and pressure sensors. The diagnostics and the Hall thruster propulsion systems are described in detail along with lists of tabular data from those diagnostics and propulsion system and other satellite systems. Space Power, Inc., now part of Pratt & Whitney's Chemical Systems Division, under contract NAS3-99151 to the NASA Glenn Research Center, obtained these data over several periods from March 12, 2000, through September 30, 2001. Each of the 12 individual reports describe, in detail, the propulsion systems as well as the diagnostic sensors utilized. Finally, parts 11 and 12 include the requirements to which NPO PM prepared and delivered these data.

Hall Effect Thruster Interactions Data From the Russian Express-A2 and Express-A3 Satellites. Acquire Express-A2 SPT-100 Based Propulsion Subsystem and Other Subsystem Flight Operation TM-Data for the Period of March 12, 2000 to and Including June 15, 2000, Task 29

NASA Technical Reports Server (NTRS)

Sitnikova, N.; Volkov, D.; Maximov, I.; Petrusevich, V.; Allen, D.

2003-01-01

This 12-part report documents the data obtained from various sensor measurements taken aboard the Russian Express-A2 and Express-A3 spacecraft in Geosynchronous Earth Orbit (GEO). These GEO communications satellites, which were designed and built by NPO Prikladnoy Mekhaniki (NPO PM) of Zheleznogorsk, Russia, utilize Hall thruster propulsion systems for north-south and east-west stationkeeping and as of June 2002, were still operating at 80 E. and 11 W., respectively. Express-A2 was launched on March 12, 2000, while Express-A3 was launched on June 24, 2000. The diagnostic equipment from which these data were taken includes electric field strength sensors, ion current and energy sensors, and pressure sensors. The diagnostics and the Hall thruster propulsion systems are described in detail along with lists of tabular data from those diagnostics and propulsion system and other satellite systems. Space Power, Inc., now part of Pratt & Whitney s Chemical Systems Division, under contract NAS3 99151 to the NASA Glenn Research Center, obtained these data over several periods from March 12, 2000, through September 30, 2001. Each of the 12 individual reports describe, in detail, the propulsion systems as well as the diagnostic sensors utilized. Finally, parts 11 and 12 include the requirements to which NPO PM prepared and delivered these data.

Hall Effect Thruster Interactions Data From the Russian Express-A2 and Express-A3 Satellites. Part 11; Express/T-160E Project Express A2 and A3 Data Agreement Document

NASA Technical Reports Server (NTRS)

Sitnikova, N.; Volkov, D.; Maximov, I.; Petrusevich, V.; Allen, D.; Dunning, John (Technical Monitor)

2003-01-01

This 12-part report documents the data obtained from various sensor measurements taken aboard the Russian Express-A2 and Express-A3 spacecraft in Geosynchronous Earth Orbit (GEO). These GEO communications satellites, which were designed and built by NPO Prikladnoy Mekhaniki (NPO PM) of Zheleznogorsk, Russia, utilize Hall thruster propulsion systems for north-south and east-west stationkeeping and as of June 2002, were still operating at 80deg E. and 11deg W., respectively. Express-A2 was launched on March 12, 2000, while Express-A3 was launched on June 24, 2000. The diagnostic equipment from which these data were taken includes electric field strength sensors, ion current and energy sensors, and pressure sensors. The diagnostics and the Hall thruster propulsion systems are described in detail along with lists of tabular data from those diagnostics and propulsion system and other satellite systems. Space Power, Inc., now part of Pratt & Whitney's Chemical Systems Division, under contract NAS3-99151 to the NASA Glenn Research Center, obtained these data over several periods from March 12, 2000, through September 30, 2001. Each of the 12 individual reports describe, in detail, the propulsion systems as well as the diagnostic sensors utilized. Finally, parts 11 and 12 include the requirements to which NPO PM prepared and delivered these data.

Hall Effect Thruster Interactions Data from the Russian Express-A2 and Express-A3 Satellites. Part 5; Acquire Express-A3 SPT?100 Based Propulsion Subsystem and Other Subsystem Flight Operation TM-Data, Task 31

NASA Technical Reports Server (NTRS)

Sitnikova, N.; Volkov, D.; Maximov, I.; Petrusevich, V.; Allen, D.

2003-01-01

This 12-part report documents the data obtained from various sensor measurements taken aboard the Russian Express-A2 and Express-A3 spacecraft in Geosynchronous Earth Orbit (GEO). These GEO communications satellites, which were designed and built by NPO Prikladnoy Mekhaniki (NPO PM) of Zheleznogorsk, Russia, utilize Hall thruster propulsion systems for north-south and east-west stationkeeping and as of June 2002, were still operating at 80deg E. and 11deg W., respectively. Express-A2 was launched on March 12, 2000, while Express-A3 was launched on June 24, 2000. The diagnostic equipment from which these data were taken includes electric field strength sensors, ion current and energy sensors, and pressure sensors. The diagnostics and the Hall thruster propulsion systems are described in detail along with lists of tabular data from those diagnostics and propulsion system and other satellite systems. Space Power, Inc., now part of Pratt & Whitney's Chemical Systems Division, under contract NAS3-99151 to the NASA Glenn Research Center, obtained these data over several periods from March 12, 2000, through September 30, 2001. Each of the 12 individual reports describe, in detail, the propulsion systems as well as the diagnostic sensors utilized. Finally, parts 11 and 12 include the requirements to which NPO PM prepared and delivered these data.

Hall Effect Thruster Interactions Data From the Russian Express-A2 and Express-A3 Satellites. Part 12; Express/T-160 Project Express A2 and A3 Sensors Operations Procedures Document

NASA Technical Reports Server (NTRS)

Dunning, John (Technical Monitor); Sitnikova, N.; Volkov, D.; Maximov, I.; Petrusevich, V.; Allen, D.

2003-01-01

This 12-part report documents the data obtained from various sensor measurements taken aboard the Russian Express-A2 and Express-A3 spacecraft in Geosynchronous Earth Orbit (GEO). These GEO communications satellites, which were designed and built by NPO Prikladnoy Mekhaniki (NPO PM) of Zheleznogorsk, Russia, utilize Hall thruster propulsion systems for north-south and east-west stationkeeping and as of June 2002, were still operating at 80 deg. E. and 11 deg. W respectively. Express-A2 was launched on March 12, 2000, while Express-A3 was launched on June 24, 2000. The diagnostic equipment from which these data were taken includes electric field strength sensors, ion current and energy sensors, and pressure sensors. The diagnostics and the Hall thruster propulsion systems are described in detail along with lists of tabular data from those diagnostics and propulsion system and other satellite systems. Space Power, Inc., now part of Pratt & Whitney's Chemical Systems Division, under contract NAS3 99151 to the NASA Glenn Research Center, obtained these data over several periods from March 12, 2000, through September 30, 2001. Each of the 12 individual reports describe, in detail, the propulsion systems as well as the diagnostic sensors utilized. Finally, parts 11 and 12 include the requirements to which NPO PM prepared and delivered these data.

Hall Effect Thruster Interactions Data From the Russian Express-A2 and Express-A3 Satellites. Acquire Express-A3 SPT 100 Based Propulsion Subsystem and Other Subsystem Flight Operation TM-Data, Task 33

NASA Technical Reports Server (NTRS)

Sitnikova, N.; Volkov, D.; Maximov, I.; Petrusevich, V.; Allen, D.

2003-01-01

This 12-part report documents the data obtained from various sensor measurements taken aboard the Russian Express-A2 and Express-A3 spacecraft in Geosynchronous Earth Orbit (GEO). These GEO communications satellites, which were designed and built by NPO Prikladnoy Mekhaniki (NPO PM) of Zheleznogorsk, Russia, utilize Hall thruster propulsion systems for north-south and east-west stationkeeping and as of June 2002, were still operating at 80 deg E and 11 deg W, respectively. Express-A2 was launched on March 12, 2000, while Express-A3 was launched on June 24, 2000. The diagnostic equipment from which these data were taken includes electric field strength sensors, ion current and energy sensors, and pressure sensors. The diagnostics and the Hall thruster propulsion systems are described in detail along with lists of tabular data from those diagnostics and propulsion system and other satellite systems. Space Power, Inc., now part of Pratt & Whitney's Chemical Systems Division, under contract NAS3-99151 to the NASA Glenn Research Center, obtained these data over several periods from March 12, 2000, through September 30, 2001. Each of the 12 individual reports describe, in detail, the propulsion systems as well as the diagnostic sensors utilized. Finally, parts 11 and 12 include the requirements to which NPO PM prepared and delivered these data.

Study of shock waves and related phenomena motivated by astrophysics

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

Drake, R. P.; Keiter, P. A.; Kuranz, C. C.

This study discusses the recent research in High-Energy-Density Physics at our Center. Our work in complex hydrodynamics is now focused on mode coupling in the Richtmyer-Meshkov process and on the supersonic Kelvin-Helmholtz instability. These processes are believed to occur in a wide range of astrophysical circumstances. In radiation hydrodynamics, we are studying radiative reverse shocks relevant to cataclysmic variable stars. Our work on magnetized flows seeks to produce magnetized jets and study their interactions. We build the targets for all these experiments, and simulate them using our CRASH code. We also conduct diagnostic research, focused primarily on imaging x-ray spectroscopymore » and its applications to scattering and fluorescence.« less

Study of shock waves and related phenomena motivated by astrophysics

DOE PAGES

Drake, R. P.; Keiter, P. A.; Kuranz, C. C.; ...

2016-04-01

This study discusses the recent research in High-Energy-Density Physics at our Center. Our work in complex hydrodynamics is now focused on mode coupling in the Richtmyer-Meshkov process and on the supersonic Kelvin-Helmholtz instability. These processes are believed to occur in a wide range of astrophysical circumstances. In radiation hydrodynamics, we are studying radiative reverse shocks relevant to cataclysmic variable stars. Our work on magnetized flows seeks to produce magnetized jets and study their interactions. We build the targets for all these experiments, and simulate them using our CRASH code. We also conduct diagnostic research, focused primarily on imaging x-ray spectroscopymore » and its applications to scattering and fluorescence.« less

An integrated approach to system design, reliability, and diagnosis

NASA Technical Reports Server (NTRS)

Patterson-Hine, F. A.; Iverson, David L.

1990-01-01

The requirement for ultradependability of computer systems in future avionics and space applications necessitates a top-down, integrated systems ingeneering approach for design, implementation, testing, and operation. The functional analyses of hardware and software systems must be combined by models that are flexible enough to represent their interactions and behavior. The information contained in these models must be accessible throughout all phases of the system life cycle in order to maintain consistency and accuracy in design and operational decisions. One approach being taken by researchers at Ames Research Center is the creation of an object-oriented environment that integrates information about system components required in the reliability evaluation with behavioral information useful for diagnostic algorithms.

Center of Excellence for Laser Applications in Medicine, Microlaser Microscope

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

Webb, R. H.

The Center of Excellence for Laser Applications in Medicine at the Schepens Eye Research Institute (SERI) is a Center for: A core group of researchers who support each other and their various projects for real-time medical imaging and diagnostics in contiguous space at SERI. Clinical collaborators who participate in the core research at SERI, MEEI, and local ophthalmology practices, and at associated sites around the world. Industrial partners who transfer our technology to commercial products that will reach clinical usage everywhere. Students, post-doctoral associates and medical fellows who work with us and learn how to practice real-time medical imaging andmore » diagnostics.« less

NO PLIF Visualizations of the Orion Capsule in LENS-I

NASA Technical Reports Server (NTRS)

Combs, C.; Clemens, N.; Danehy, P. M.; Bathel, B.; Parker, R.; Wadhams, T.; Holden, M.; Kirk, B.

2013-01-01

Planar laser-induced fluorescence (PLIF) of nitric oxide (NO) was used to visualize the interaction of reaction-control-system (RCS) jet flows in the wake of a hypersonic capsule reentry vehicle. The tests were performed at the Calspan University at Buffalo Research Center's (CUBRC) LENS-I reflected shock tunnel facility. This was the first application of PLIF to study RCS jets in a large-scale pulsed hypersonic facility. The LENS-I facility allowed RCS jet flows to be studied while varying the flow enthalpy, Reynolds number, angle of attack and jet configuration. The interaction of pitch and roll jets with the flowfield was investigated. Additionally, thin film sensors were used to monitor heat transfer on the surface of the model to detect any localized heating resulting from the firing of the RCS jets. Tests were conducted with the model held at angles of attack of 18deg and 22deg. The nominal Mach number in all tests was 8, while Reynolds number based on model diameter ranged from 2.2x10(exp 6) - 1.5x10(exp 7). Images were processed using the Virtual Diagnostics Interface (ViDI) system developed at NASA Langley Research Center to provide a three-dimensional display of the experimental data.

National Centers for Environmental Prediction

Science.gov Websites

/ VISION | About EMC EMC > NAM > EXPERIMENTAL DATA Home NAM Operational Products HIRESW Operational Products Operational Forecast Graphics Experimental Forecast Graphics Verification and Diagnostics Model PARALLEL/EXPERIMENTAL MODEL FORECAST GRAPHICS OPERATIONAL VERIFICATION / DIAGNOSTICS PARALLEL VERIFICATION

Gear noise, vibration, and diagnostic studies at NASA Lewis Research Center

NASA Technical Reports Server (NTRS)

Zakrajsek, James J.; Oswald, Fred B.; Townsend, Dennis P.; Coy, John J.

1990-01-01

The NASA Lewis Research Center and the U.S. Army Aviation Systems Command are involved in a joint research program to advance the technology of rotorcraft transmissions. This program consists of analytical as well as experimental efforts to achieve the overall goals of reducing weight, noise, and vibration, while increasing life and reliability. Recent analytical activities are highlighted in the areas of gear noise, vibration, and diagnostics performed in-house and through NASA and U.S. Army sponsored grants and contracts. These activities include studies of gear tooth profiles to reduce transmission error and vibration as well as gear housing and rotordynamic modeling to reduce structural vibration transmission and noise radiation, and basic research into current gear failure diagnostic methodologies. Results of these activities are presented along with an overview of near term research plans in the gear noise, vibration, and diagnostics area.

Final Report - DOE Center for Laser Imaging and Cancer Diagnostics

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

Alfano, Robert R.; Koutcher, Jason A.

2002-10-31

This Final Report summarizes the significant progress made by the researchers, students and staff of the Center for Laser Imaging and Cancer Diagnostics (CLICD) from January 1998 through May 2002. During this period, the Center supported several projects. Most projects were proposed initially, some were added subsequently as their relevance and importance to the DOE mission became evident. DOE support has been leveraged to obtain continuing funding for some projects. Leveraged funds come from various sources, including NIH, Army, NSF and the Air Force. The goal of the Center was to develop laser-based instruments for use in the detection andmore » diagnosis of major diseases, with an emphasis on detection and diagnosis of various cancers. Each of the supported projects is a collaborative effort between physicists and laser scientists and the City College of New York and noted physicians, surgeons, pathologists, and biologists located at medical centers in the Metropolitan area. The participating institutions were: City College of New York Institute for Ultrafast Lasers and Spectroscopy, Hackensack University Medical Center, Lawrence Livermore National Laboratory, Memorial Sloan Kettering Cancer Center, and New York Eye and Ear Institute. Each of the projects funded by the Center is grouped into one of four research categories: a) Disease Detection, b) Non-Disease Applications, c) New Diagnostic Tools, and, d) Education, Training, Outreach and Dissemination. The progress achieved by the multidisciplinary teams was reported in 51 publications and 32 presentations at major national conferences. Also, one U.S. patent was obtained and six U.S. patent applications have been filed for innovations resulting from the projects sponsored by the Center.« less

Telemedicine-based collaborative care for posttraumatic stress disorder: a randomized clinical trial.

PubMed

Fortney, John C; Pyne, Jeffrey M; Kimbrell, Timothy A; Hudson, Teresa J; Robinson, Dean E; Schneider, Ronald; Moore, William M; Custer, Paul J; Grubbs, Kathleen M; Schnurr, Paula P

2015-01-01

Posttraumatic stress disorder (PTSD) is prevalent, persistent, and disabling. Although psychotherapy and pharmacotherapy have proven efficacious in randomized clinical trials, geographic barriers impede rural veterans from engaging in these evidence-based treatments. To test a telemedicine-based collaborative care model designed to improve engagement in evidence-based treatment of PTSD. The Telemedicine Outreach for PTSD (TOP) study used a pragmatic randomized effectiveness trial design with intention-to-treat analyses. Outpatients were recruited from 11 Department of Veterans Affairs (VA) community-based outpatient clinics serving predominantly rural veterans. Inclusion required meeting diagnostic criteria for current PTSD according to the Clinician-Administered PTSD Scale. Exclusion criteria included receiving PTSD treatment at a VA medical center or a current diagnosis of schizophrenia, bipolar disorder, or substance dependence. Two hundred sixty-five veterans were enrolled from November 23, 2009, through September 28, 2011, randomized to usual care (UC) or the TOP intervention, and followed up for 12 months. Off-site PTSD care teams located at VA medical centers supported on-site community-based outpatient clinic providers. Off-site PTSD care teams included telephone nurse care managers, telephone pharmacists, telepsychologists, and telepsychiatrists. Nurses conducted care management activities. Pharmacists reviewed medication histories. Psychologists delivered cognitive processing therapy via interactive video. Psychiatrists supervised the team and conducted interactive video psychiatric consultations. The primary outcome was PTSD severity as measured by the Posttraumatic Diagnostic Scale. Process-of-care outcomes included medication prescribing and regimen adherence and initiation of and adherence to cognitive processing therapy. During the 12-month follow-up period, 73 of the 133 patients randomized to TOP (54.9%) received cognitive processing therapy compared with 16 of 132 randomized to UC (12.1%) (odds ratio, 18.08 [95% CI, 7.96-41.06]; P < .001). Patients in the TOP arm had significantly larger decreases in Posttraumatic Diagnostic Scale scores (from 35.0 to 29.1) compared with those in the UC arm (from 33.5 to 32.1) at 6 months (β = -3.81; P = .002). Patients in the TOP arm also had significantly larger decreases in Posttraumatic Diagnostic Scale scores (from 35.0 to 30.1) compared with those in the UC arm (from 33.5 to 31.7) at 12 months (β = -2.49; P=.04). There were no significant group differences in the number of PTSD medications prescribed and adherence to medication regimens were not significant. Attendance at 8 or more sessions of cognitive processing therapy significantly predicted improvement in Posttraumatic Diagnostic Scale scores (β = -3.86 [95% CI, -7.19 to -0.54]; P = .02) and fully mediated the intervention effect at 12 months. Telemedicine-based collaborative care can successfully engage rural veterans in evidence-based psychotherapy to improve PTSD outcomes. clinicaltrials.gov Identifier: NCT00821678.

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…

42 CFR 414.509 - Reconsideration of basis for and amount of payment for a new clinical diagnostic laboratory test.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) or § 414.509(a)(3) that the basis for payment for a new test will be gapfilling, CMS posts interim... for a new clinical diagnostic laboratory test. 414.509 Section 414.509 Public Health CENTERS FOR... FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests...

Virtual Diagnostic Interface: Aerospace Experimentation in the Synthetic Environment

NASA Technical Reports Server (NTRS)

Schwartz, Richard J.; McCrea, Andrew C.

2009-01-01

The Virtual Diagnostics Interface (ViDI) methodology combines two-dimensional image processing and three-dimensional computer modeling to provide comprehensive in-situ visualizations commonly utilized for in-depth planning of wind tunnel and flight testing, real time data visualization of experimental data, and unique merging of experimental and computational data sets in both real-time and post-test analysis. The preparation of such visualizations encompasses the realm of interactive three-dimensional environments, traditional and state of the art image processing techniques, database management and development of toolsets with user friendly graphical user interfaces. ViDI has been under development at the NASA Langley Research Center for over 15 years, and has a long track record of providing unique and insightful solutions to a wide variety of experimental testing techniques and validation of computational simulations. This report will address the various aspects of ViDI and how it has been applied to test programs as varied as NASCAR race car testing in NASA wind tunnels to real-time operations concerning Space Shuttle aerodynamic flight testing. In addition, future trends and applications will be outlined in the paper.

Virtual Diagnostic Interface: Aerospace Experimentation in the Synthetic Environment

NASA Technical Reports Server (NTRS)

Schwartz, Richard J.; McCrea, Andrew C.

2010-01-01

The Virtual Diagnostics Interface (ViDI) methodology combines two-dimensional image processing and three-dimensional computer modeling to provide comprehensive in-situ visualizations commonly utilized for in-depth planning of wind tunnel and flight testing, real time data visualization of experimental data, and unique merging of experimental and computational data sets in both real-time and post-test analysis. The preparation of such visualizations encompasses the realm of interactive three-dimensional environments, traditional and state of the art image processing techniques, database management and development of toolsets with user friendly graphical user interfaces. ViDI has been under development at the NASA Langley Research Center for over 15 years, and has a long track record of providing unique and insightful solutions to a wide variety of experimental testing techniques and validation of computational simulations. This report will address the various aspects of ViDI and how it has been applied to test programs as varied as NASCAR race car testing in NASA wind tunnels to real-time operations concerning Space Shuttle aerodynamic flight testing. In addition, future trends and applications will be outlined in the paper.

Extended family and friendship support networks are both protective and risk factors for major depressive disorder and depressive symptoms among African-Americans and black Caribbeans.

PubMed

Taylor, Robert Joseph; Chae, David H; Lincoln, Karen D; Chatters, Linda M

2015-02-01

This study explores relationships between lifetime and 12-month Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) major depressive disorder (MDD), depressive symptoms, and involvement with family and friends within a national sample of African-American and Black Caribbean adults (n = 5191). MDD was assessed using the DSM-IV World Mental Health Composite International Diagnostic Interview and depressive symptoms were assessed using the Center for Epidemiologic Studies-Depression subscale and the K6. Findings indicated that among both populations, close supportive ties with family members and friends are associated with lower rates of depression and MDD. For African-Americans, closeness to family members was important for both 12-month and lifetime MDD, and both family and friend closeness were important for depressive symptoms. For Caribbean Blacks, family closeness had more limited associations with outcomes and was directly associated with psychological distress only. Negative interactions with family (conflict, criticisms), however, were associated with higher MDD and depressive symptoms among both African-Americans and Black Caribbeans.

Singapore National Medical Image Resource Centre (SN.MIRC): a world wide web resource for radiology education.

PubMed

Yang, Guo-Liang; Lim, C C Tchoyoson

2006-08-01

Radiology education is heavily dependent on visual images, and case-based teaching files comprising medical images can be an important tool for teaching diagnostic radiology. Currently, hardcopy film is being rapidly replaced by digital radiological images in teaching hospitals, and an electronic teaching file (ETF) library would be desirable. Furthermore, a repository of ETFs deployed on the World Wide Web has the potential for e-learning applications to benefit a larger community of learners. In this paper, we describe a Singapore National Medical Image Resource Centre (SN.MIRC) that can serve as a World Wide Web resource for teaching diagnostic radiology. On SN.MIRC, ETFs can be created using a variety of mechanisms including file upload and online form-filling, and users can search for cases using the Medical Image Resource Center (MIRC) query schema developed by the Radiological Society of North America (RSNA). The system can be improved with future enhancements, including multimedia interactive teaching files and distance learning for continuing professional development. However, significant challenges exist when exploring the potential of using the World Wide Web for radiology education.

DHB Task Force Review of DoD Biodefense Infrastructure and Biological Research Portfolio

DTIC Science & Technology

2009-04-29

Center and Biological Defense and Research Directorate (BORD) biodefense research portfolio includes vaccines, molecular diagnostics , genomics, and...human monoclonal antibodies, and innate immune agonists); molecular diagnostics (including recombinant reagents, assay development, reagent production

National Centers for Environmental Prediction

Science.gov Websites

Products Operational Forecast Graphics Experimental Forecast Graphics Verification and Diagnostics Model PARALLEL/EXPERIMENTAL MODEL FORECAST GRAPHICS OPERATIONAL VERIFICATION / DIAGNOSTICS PARALLEL VERIFICATION Developmental Air Quality Forecasts and Verification Back to Table of Contents 2. PARALLEL/EXPERIMENTAL GRAPHICS

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.

Outpatient imaging center valuations: do you need a fair-market value analysis?

PubMed

Koonsman, G S

2001-01-01

Typically, outpatient diagnostic imaging centers are formed as partnerships between radiologists, radiologists and hospitals, and/or radiologists and diagnostic imaging center management companies. As a result of these partnership structures, the question of equity valuation frequently arises. It is not only important to understand when an independent valuation would be required, but also what "type" of valuation needs to be performed. The type of valuation may vary based upon the use of the valuation. In partnerships that involve hospitals and physicians, the federal anti-kickback statutes (fraud and abuse laws) require that all transactions between referring physicians and hospitals be consummated at fair-market value. In addition, tax-exempt hospitals that enter into partnerships with physicians are required to enter into those transactions at fair-market value or risk losing their tax-exempt status. Fair-market value is also typically the standard of value that all partnerships strive to conduct equity transactions with shareholders. Qualifications required by those who perform independent fair-market value opinions include: Proper business valuation training and focus on valuations as a primary business Focus on the healthcare industry and specifically on the valuation of diagnostic imaging centers In order to perform a reasonable business valuation analysis, the appraiser must have access to a significant amount of financial, operational and legal information. The analyst must be able to understand the history of the imaging center as well as the projected future of the center. Ultimately, a valuation is a measurement of the estimated future cash flows of the center--risk adjusted--in order to quantify the present value of those cash flows.

42 CFR 414.509 - Reconsideration of basis for and amount of payment for a new clinical diagnostic laboratory test.

Code of Federal Regulations, 2013 CFR

2013-10-01

...) or § 414.509(a)(3) that the basis for payment for a new test will be gapfilling, CMS posts interim... for a new clinical diagnostic laboratory test. 414.509 Section 414.509 Public Health CENTERS FOR... Laboratory Tests § 414.509 Reconsideration of basis for and amount of payment for a new clinical diagnostic...

75 FR 11894 - Center For Scientific Review; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-12

... personal privacy. Name of Committee: Center for Scientific Review Special Emphasis Panel; Cancer Diagnostics and Therapeutics SBIR/STTR. Date: March 18, 2010. Time: 2 p.m. to 5 p.m. Agenda: To review and... of Committee: Center for Scientific Review Special Emphasis Panel; Member Conflict: Cancer Therapy...

SHADOZ (Southern Hemisphere Additional Ozonesondes): A Tropical Ozonesonde-Radiosonde Network for the Atmospheric Community

NASA Technical Reports Server (NTRS)

Thompson, Anne M.; Witte, Jacquelyn C.; Oltmans, Samuel J.; Schmidlin, Francis J.

2003-01-01

A lack of sounding data has limited the accuracy of ozone satellite retrievals in the tropics and our understanding of chemical-dynamical interactions in a region strongly influenced by natural variability and anthropogenic activity. In 1998, NASA s Goddard Space Flight Center, NOAA's Climate Monitoring and Diagnostics Laboratory (CMDL) and a team of international sponsors established the SHADOZ (Southern Hemisphere ADditional OZonesondes) project to address the gap in tropical ozone soundings. SHADOZ augments launches at selected sites and provides a public archive of ozonesonde and radiosonde data from twelve tropical and subtropical stations at http://croc.gsfc.nasa.gov/shadoz. Instrumentation, data and a summary of the first scientific findings from SHADOZ are presented.

Laser Irradiated Foam Targets: Absorption and Radiative Properties

NASA Astrophysics Data System (ADS)

Salvadori, Martina; Luigi Andreoli, Pier; Cipriani, Mattia; Consoli, Fabrizio; Cristofari, Giuseppe; De Angelis, Riccardo; di Giorgio, Giorgio; Giulietti, Danilo; Ingenito, Francesco; Gus'kov, Sergey Yu.; Rupasov, Alexander A.

2018-01-01

An experimental campaign to characterize the laser radiation absorption of foam targets and the subsequent emission of radiation from the produced plasma was carried out in the ABC facility of the ENEA Research Center in Frascati (Rome). Different targets have been used: plastic in solid or foam state and aluminum targets. The activated different diagnostics allowed to evaluate the plasma temperature, the density distribution, the fast particle spectrum and the yield of the X-Ray radiation emitted by the plasma for the different targets. These results confirm the foam homogenization action on laser-plasma interaction, mainly attributable to the volume absorption of the laser radiation propagating in such structured materials. These results were compared with simulation absorption models of the laser propagating into a foam target.

Hall Effect Thruster Interactions Data From the Russian Express-A2 and Express-A3 Satellites. Part 3; Acquire Express-A3 SPT-100 Based Propulsion Subsystem and Other Subsystem Flight Operation TM-Data for the Period of June 24, 2000 to and Including September 30, 2000, Task 30

NASA Technical Reports Server (NTRS)

Sitnikova, N.; Volkov, D.; Maximov, I.; Petrusevich, V.; Allen, D.

2003-01-01

This 12-part report documents the data obtained from various sensor measurements taken aboard the Russian Express-A2 and Express-A3 spacecraft in Geosynchronous Earth Orbit (GEO). These GEO communications satellites, which were designed and built by NPO Prikladnoy Mekhaniki (NPO PM) of Zheleznogorsk, Russia, utilize Hall thruster propulsion systems for north-south and east-west stationkeeping and as of June 2002, were still operating at 80 E. and 11 W., respectively. Express-A2 was launched on March 12, 2000, while Express-A3 was launched on June 24, 2000. The diagnostic equipment from which these data were taken includes electric field strength sensors, ion current and energy sensors, and pressure sensors. The diagnostics and the Hall thruster propulsion systems are described in detail along with lists of tabular data from those diagnostics and propulsion system and other satellite systems. Space Power, Inc., now part of Pratt & Whitney's Chemical Systems Division, under contract NAS3 99151 to the NASA Glenn Research Center, obtained these data over several periods from March 12, 2000, through September 30, 2001. Each of the 12 individual reports describe, in detail, the propulsion systems as well as the diagnostic sensors utilized. Finally, parts 11 and 12 include the requirements to which NPO PM prepared and delivered these data.

Hall Effect Thruster Interactions Data from the Russian Express-A2 and Express-A3 Satellites. Part 8; Acquire TM-Data for Type A and Type B Sensors for "Express A" Number 3 Satellite for the Period of January 1, 2001 to and Including March 31, 2001, Task 27C

NASA Technical Reports Server (NTRS)

Dunning, John (Technical Monitor); Sitnikova, N.; Volkov, D.; Maximov, I.; Petrusevich, V.; Allen, D.

2003-01-01

This 12-part report documents the data obtained from various sensor measurements taken aboard the Russian Express-A2 and Express-A3 spacecraft in Geosynchronous Earth Orbit (GEO). These GEO communications satellites, which were designed and built by NPO Prikladnoy Mekhaniki (NPO PM) of Zheleznogorsk, Russia, utilize Hall thruster propulsion systems for north-south and east-west stationkeeping and as of June 2002, were still operating at 80deg E. and 11deg W., respectively. Express-A2 was launched on March 12, 2000, while Express-A3 was launched on June 24, 2000. The diagnostic equipment from which these data were taken includes electric field strength sensors, ion current and energy sensors, and pressure sensors. The diagnostics and the Hall thruster propulsion systems are described in detail along with lists of tabular data from those diagnostics and propulsion system and other satellite systems. Space Power, Inc., now part of Pratt & Whitney's Chemical Systems Division, under contract NAS3 99151 to the NASA Glenn Research Center, obtained these data over several periods from March 12, 2000, through September 30, 2001. Each of the 12 individual reports describe, in detail, the propulsion systems as well as the diagnostic sensors utilized. Finally, parts 11 and 12 include the requirements to which NPO PM prepared and delivered these data.

Hall Effect Thruster Interactions Data From the Russian Express-A2 and Express-A3 Satellites. Part 10; Acquire TM-Data for Type A and Type B Sensors for "Express-A" Number 3 Satellite for the Period of July 1, 2001 to and Including September 30, 2001, Task 27D

NASA Technical Reports Server (NTRS)

Dunning, John (Technical Monitor); Sitnikova, N.; Volkov, D.; Maximov, I.; Petrusevich, V.; Allen, D.

2003-01-01

This 12-part report documents the data obtained from various sensor measurements taken aboard the Russian Express-A2 and Express-A3 spacecraft in Geosynchronous Earth Orbit (GEO). These GEO communications satellites, which were designed and built by NPO Prikladnoy Mekhaniki (NPO PM) of Zheleznogorsk, Russia, utilize Hall thruster propulsion systems for north-south and east-west stationkeeping and as of June 2002, were still operating at 80 E. and 11 W., respectively. Express-A2 was launched on March 12, 2000, while Express-A3 was launched on June 24, 2000. The diagnostic equipment from which these data were taken includes electric field strength sensors, ion current and energy sensors, and pressure sensors. The diagnostics and the Hall thruster propulsion systems are described in detail along with lists of tabular data from those diagnostics and propulsion system and other satellite systems. Space Power, Inc., now part of Pratt & Whitney's Chemical Systems Division, under contract NAS3 99151 to the NASA Glenn Research Center, obtained these data over several periods from March 12, 2000, through September 30, 2001. Each of the 12 individual reports describe, in detail, the propulsion systems as well as the diagnostic sensors utilized. Finally, parts 11 and 12 include the requirements to which NPO PM prepared and delivered these data.

Electromagnetic Pulses Generated From Laser Target Interactions at Shenguang II Laser Facility

NASA Astrophysics Data System (ADS)

Yang, Jinwen; Li, Tingshuai; Yi, Tao; Wang, Chuanke; Yang, Ming; Yang, Weiming; Liu, Shenye; Jiang, Shaoen; Ding, Yongkun

2016-10-01

Significant electromagnetic pulses (EMP) can be generated by the intensive laser irradiating solid targets in inertial confinement fusion (ICF). To evaluate the EMP intensity and distribution in and outside the laser chamber, we designed and fabricated a discone antenna with ultra-wide bands of over 10 GHz. The return loss (S11 parameter) of this antenna was below -10 dB and could even achieve under -30 dB at 3.1 GHz. The EMP intensity in this study at 80 cm and 40 cm away from the target chamber center (TCC) reached 400 kV/m and 2000 kV/m. The current results are expected to offer preliminary information to study physics regarding laser plasma interactions and will also lay experimental foundation for EMI shielding design to protect various diagnostics. supported by the Fundamental Research Funds for the Central Universities of China (No. ZYGX2015J108) and National Natural Science Foundation of China (Nos. 11575166 and 51581140)

Visible and infrared spin scanning radiometer /VISSR/ atmospheric sounder /VAS/ ground data system

NASA Astrophysics Data System (ADS)

Dalton, J. T.; Jamros, R. K.; Helfer, D. P.; Howell, D. R.

1981-01-01

The interactive system developed at NASA/Goddard Space Flight Center to receive data from the infrared radiometer on GOES-4 in near real time and to perform interactive display and analysis of the 12-channel infrared imagery is described. The system is minicomputer based and uses a menu approach in guiding the analyst through spacecraft instrument programming, area and band selection, image acquisition, enhancement, analysis, and presentation of results. The system is linked by dual port disks to Goddard's Atmospheric and Oceanographic Information Processing System for comparing the sounding results with parameters derived from conventional data and from time lapse analysis of visible and IR imagery from other geostationary satellites. It is pointed out that the system hardware and software are being expanded to add capabilities for the integration and assimilation of VAS data with data from other sources, the comparison of severe storm observations from space with special ground network data, and the development of diagnostic models.

42 CFR 493.833 - Condition: Diagnostic immunology.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Condition: Diagnostic immunology. 493.833 Section 493.833 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... for Laboratories Performing Tests of Moderate Complexity (including the Subcategory), High Complexity...

42 CFR 493.833 - Condition: Diagnostic immunology.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Diagnostic immunology. 493.833 Section 493.833 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... for Laboratories Performing Tests of Moderate Complexity (including the Subcategory), High Complexity...

NCI: DCTD: Biometric Research Branch

Cancer.gov

The Biometric Research Branch (BRP) is the statistical and biomathematical component of the Division of Cancer Treatment, Diagnosis and Centers (DCTDC). Its members provide statistical leadership for the national and international research programs of the division in developmental therapeutics, developmental diagnostics, diagnostic imaging and clinical trials.

NCI: DCTD: Biometric Research Program

Cancer.gov

The Biometric Research Program (BRP) is the statistical and biomathematical component of the Division of Cancer Treatment, Diagnosis and Centers (DCTDC). Its members provide statistical leadership for the national and international research programs of the division in developmental therapeutics, developmental diagnostics, diagnostic imaging and clinical trials.

NCI: DCTD: Biometric Research Branch

Cancer.gov

The Biometric Research Branch (BRB) is the statistical and biomathematical component of the Division of Cancer Treatment, Diagnosis and Centers (DCTDC). Its members provide statistical leadership for the national and international research programs of the division in developmental therapeutics, developmental diagnostics, diagnostic imaging and clinical trials.

NCI: DCTD: Biometric Research Program

Cancer.gov

The Biometric Research Program (BRB) is the statistical and biomathematical component of the Division of Cancer Treatment, Diagnosis and Centers (DCTDC). Its members provide statistical leadership for the national and international research programs of the division in developmental therapeutics, developmental diagnostics, diagnostic imaging and clinical trials.

Bladder Monitor

NASA Technical Reports Server (NTRS)

1993-01-01

Diagnostic Ultrasound Corporation's Bladder Scan Monitor continuously records and monitors bladder fullness and alerts the wearer or caretaker when voiding is required. The sensor is held against the lower abdomen by a belt and connected to the monitor by a cable. The sensor obtains bladder volume data from sound waves reflecting off the bladder wall. The device was developed by Langley Research Center, the Ames Research Center and the NASA Technology Applications Team. It utilizes Langley's advanced ultrasound technology. It is licensed to the ARC for medical applications, and sublicensed to Diagnostics Ultrasound. Central monitoring systems are planned for the future.

76 FR 13192 - Mark E. Van Wormer: Debarment Order

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-10

...: The Food and Drug Administration (FDA) is issuing an order under the Federal Food, Drug, and Cosmetic... Medical Center, also known as the Union County Medical, Diagnostic Imaging and Laser Surgery Center, PC...

Systematic Benchmarking of Diagnostic Technologies for an Electrical Power System

NASA Technical Reports Server (NTRS)

Kurtoglu, Tolga; Jensen, David; Poll, Scott

2009-01-01

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

Wildlife mortality investigation and disease research: contributions of the USGS National Wildlife Health Center to endangered species management and recovery

USGS Publications Warehouse

Brand, Christopher J.

2013-01-01

The U.S. Geological Survey—National Wildlife Health Center (NWHC) provides diagnostic services, technical assistance, applied research, and training to federal, state, territorial, and local government agencies and Native American tribes on wildlife diseases and wildlife health issues throughout the United States and its territories, commonwealth, and freely associated states. Since 1975, >16,000 carcasses and specimens from vertebrate species listed under the Endangered Species Act have been submitted to NWHC for determination of causes of morbidity or mortality or assessment of health/disease status. Results from diagnostic investigations, analyses of the diagnostic database, technical assistance and consultation, field investigation of epizootics, and wildlife disease research by NWHC wildlife disease specialists have contributed importantly to the management and recovery of listed species.

Wildlife mortality investigation and disease research: contributions of the USGS National Wildlife Health Center to endangered species management and recovery.

PubMed

Brand, Christopher J

2013-12-01

The U.S. Geological Survey-National Wildlife Health Center (NWHC) provides diagnostic services, technical assistance, applied research, and training to federal, state, territorial, and local government agencies and Native American tribes on wildlife diseases and wildlife health issues throughout the United States and its territories, commonwealth, and freely associated states. Since 1975, >16,000 carcasses and specimens from vertebrate species listed under the Endangered Species Act have been submitted to NWHC for determination of causes of morbidity or mortality or assessment of health/disease status. Results from diagnostic investigations, analyses of the diagnostic database, technical assistance and consultation, field investigation of epizootics, and wildlife disease research by NWHC wildlife disease specialists have contributed importantly to the management and recovery of listed species.

Argonne Collaborative Center for Energy Storage Science (ACCESS)

Science.gov Websites

Analysis and Diagnostics Laboratory (EADL) Post- Test Facility Access Proven Capabilities Argonne has Analysis, Modeling and Prototyping (CAMP) Electrochemical Analysis and Diagnostics Laboratory (EADL) Post -Test Facility Argonne User Facilities Industries Transportation Consumer Electronics Defense Electric

Rayleigh Scattering Diagnostics Workshop

NASA Technical Reports Server (NTRS)

Seasholtz, Richard (Compiler)

1996-01-01

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

Behavioral Health in the Patient Centered Medical Home: Meeting the Quadruple Aim Part 1

DTIC Science & Technology

2011-01-24

visits)  Pre-clinician diagnostic aid  Patient education materials  Psychosocial options  Care Facilitator assisted follow-up option  Aggressive...clinician diagnostic aid  Patient education materials  Psychosocial options  Care Facilitator assisted follow-up option  Aggressive facilitator outreach...visits)  Pre-clinician diagnostic aid  Patient education materials  Psychosocial options  Care Facilitator assisted follow-up option  Aggressive

Using a Checklist to Improve Family Communication in Trauma Care.

PubMed

Dennis, Bradley M; Nolan, Tracy L; Brown, Cecil E; Vogel, Robert L; Flowers, Kristin A; Ashley, Dennis W; Nakayama, Don K

2016-01-01

Modern concepts of patient-centered care emphasize effective communication with patients and families, an essential requirement in acute trauma settings. We hypothesized that using a checklist to guide the initial family conversation would improve the family's perception of the interaction. Institutional Review Board-approved, prospective pre/post study involving families of trauma patients admitted to our Level I trauma center for >24 hours. In the control group, families received information according to existing practices. In the study group, residents gave patient information to a first-degree family member using a checklist that guided the interaction. The checklist included a physician introduction, patient condition, list of known injuries, admission unit or intensive care unit, any consultants involved, plans for additional studies or operations, and opportunity for family to ask questions. An 11-item survey was administered 24 to 48 hours after admission to each group that evaluated the trauma team's communication in the areas of physician introduction, patient condition, ongoing treatment, and family perception of the interaction. Responses were on a Likert scale and analyzed using the Wilcoxon-Mann-Whitney test. There were 130 patients in each group. The study group had significantly (P < 0.05) better responses in 8 of 11 items surveyed: physician spoke to family, physician introduction, understanding of their relative's injuries, admitting unit, consultants involved, urgent surgical procedures required, ongoing diagnostic studies, and understanding of the treatment plan. In conclusion, using a checklist improves the perception of the initial communication between the trauma team and family members of trauma patients, especially their understanding of the treatment plan.

Distribution and Availability of Essential Tuberculosis Diagnostic Items in Amhara Region, Ethiopia.

PubMed

Sinishaw, Mulusew Alemneh; Gebregergs, Gebremedhin Berhe; Shiferaw, Melashu Balew

2015-01-01

Adequate supplies of tuberculosis laboratory reagents and consumables are necessary for tuberculosis diagnosis and monitoring of treatment response. This study assessed the distribution and stock levels of laboratory commodities used in tuberculosis control in health centers of Amhara region, Ethiopia. A cross-sectional study was conducted in 82 health centers, among 801, providing sputum microscopy services. Stock levels were calculated, and distribution of reagents and consumables assessed. Thirty three (40.2%) health centers were under stocked for at least one of the key items for tuberculosis diagnosis at the time of visit. Fifteen (18.3%) health centers had no stocks of at least one of the key items (methylene blue (11%), carbol fuchsin (11%), acid alcohol (8.5%) and sputum cups (3.7%)). Of the 82 health centers, 77 (93.9%) did not fulfill the criteria for effective distribution of tuberculosis laboratory reagents and consumables. There were many health centers that had no or only low stocks of key tuberculosis laboratory reagents and consumables as a result of ineffective distribution system. It is necessary to strengthen supply chain management to ensure uninterrupted TB diagnostic service.

Distribution and Availability of Essential Tuberculosis Diagnostic Items in Amhara Region, Ethiopia

PubMed Central

2015-01-01

Adequate supplies of tuberculosis laboratory reagents and consumables are necessary for tuberculosis diagnosis and monitoring of treatment response. This study assessed the distribution and stock levels of laboratory commodities used in tuberculosis control in health centers of Amhara region, Ethiopia. A cross-sectional study was conducted in 82 health centers, among 801, providing sputum microscopy services. Stock levels were calculated, and distribution of reagents and consumables assessed. Thirty three (40.2%) health centers were under stocked for at least one of the key items for tuberculosis diagnosis at the time of visit. Fifteen (18.3%) health centers had no stocks of at least one of the key items (methylene blue (11%), carbol fuchsin (11%), acid alcohol (8.5%) and sputum cups (3.7%)). Of the 82 health centers, 77 (93.9%) did not fulfill the criteria for effective distribution of tuberculosis laboratory reagents and consumables. There were many health centers that had no or only low stocks of key tuberculosis laboratory reagents and consumables as a result of ineffective distribution system. It is necessary to strengthen supply chain management to ensure uninterrupted TB diagnostic service. PMID:26641097

Establishment of a university academic spine center: from concept to reality.

PubMed

Arnold, Paul M; Burton, Douglas C; Khan, Talal W; Dixon, Kimberly A; Asher, Marc A; Varghese, George

2013-01-01

In fewer than five years, the University of Kansas Hospital Spine Center became the largest and most comprehensive spine care facility in the greater metropolitan Kansas City area. The 22,000-square-foot facility has 27 exam rooms, four specialized diagnostic rooms, 11 pre-/post-interventional procedure rooms, and a 4000-square-foot outpatient rehabilitation gym. Patients can meet with their physicians, undergo diagnostic tests and treatment, and attend therapy sessions in one location. The multidisciplinary Spine Center brings together orthopedic surgeons, neurosurgeons, neurologists, physical medicine and rehabilitation physicians, psychiatrists, psychologists, pain-management anesthesiologists, radiologists, and physical and occupational therapists. The Spine Center became successful because a group of physicians bought into the philosophy of a comprehensive interdisciplinary program, were willing to sacrifice some territorial claims, and were willing to put patient care and the good of the institution above individual egos.

Proceedings of the Annual Tri-Service Meeting for Aircraft Engine Monitoring and Diagnostics (7th) Held on 5-7 December 1978, at Arnold Engineering Development Center, Arnold AFS, Tennessee

DTIC Science & Technology

1979-07-01

Annual Tri-Service meeting on Aircraft Engine Monitoring and Diagnostics held last fall. 2. For all turbojet and turbofan engines , low cycle fatigue...7 December 1978. Each presentation contains an over-, view of the results and conclusions of the aircraft turbine engine diagnostic efforts that have... AIRCRAFT ENGINE 2-41 MONITORING AND DIAGNOSTIC MEETING T-38 EHMS UPDATE 2-43 A-10 TURBINE ENGINE EVALUATION (TEMS) 2-47 USAF TERMINOLOGY FOR SCORING

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

ERIC Educational Resources Information Center

von Davier, Matthias

2014-01-01

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

Evidence of clinical utility: an unmet need in molecular diagnostics for patients with cancer.

PubMed

Parkinson, David R; McCormack, Robert T; Keating, Susan M; Gutman, Steven I; Hamilton, Stanley R; Mansfield, Elizabeth A; Piper, Margaret A; Deverka, Patricia; Frueh, Felix W; Jessup, J Milburn; McShane, Lisa M; Tunis, Sean R; Sigman, Caroline C; Kelloff, Gary J

2014-03-15

This article defines and describes best practices for the academic and business community to generate evidence of clinical utility for cancer molecular diagnostic assays. Beyond analytical and clinical validation, successful demonstration of clinical utility involves developing sufficient evidence to demonstrate that a diagnostic test results in an improvement in patient outcomes. This discussion is complementary to theoretical frameworks described in previously published guidance and literature reports by the U.S. Food and Drug Administration, Centers for Disease Control and Prevention, Institute of Medicine, and Center for Medical Technology Policy, among others. These reports are comprehensive and specifically clarify appropriate clinical use, adoption, and payer reimbursement for assay manufacturers, as well as Clinical Laboratory Improvement Amendments-certified laboratories, including those that develop assays (laboratory developed tests). Practical criteria and steps for establishing clinical utility are crucial to subsequent decisions for reimbursement without which high-performing molecular diagnostics will have limited availability to patients with cancer and fail to translate scientific advances into high-quality and cost-effective cancer care. See all articles in this CCR Focus section, "The Precision Medicine Conundrum: Approaches to Companion Diagnostic Co-development." ©2014 AACR.

Formulations in Psychotherapy: Admission Interviews and the Conversational Construction of Diagnosis.

PubMed

Bonnin, Juan Eduardo

2017-09-01

In this article, we contribute to understanding the interactional aspects of making clinical diagnosis in mental health care. We observe that therapists, during the "problem presentation" sequence in clinical encounters, often use a specific form of diagnostic formulations to elicit more diagnostically relevant information. By doing so, they often substitute one type of verb with another, following a diagnostic hypothesis. Specifically, in interviews that arrive at a diagnosis of neurosis, therapists formulate with behavioral verbal processes; in interviews that arrive at a diagnosis of psychosis, they do so with material ones. Such formulations often prove useful to define clinical diagnoses. They can, however, also be dangerous in that they may favor the therapist's agenda over the patient's. Our analysis helps therapists not only better understand the diagnostic process but also reflect upon their own use of diagnostic formulations and become aware of the clinical effects of their interactional performance.

Inferring tie strength from online directed behavior.

PubMed

Jones, Jason J; Settle, Jaime E; Bond, Robert M; Fariss, Christopher J; Marlow, Cameron; Fowler, James H

2013-01-01

Some social connections are stronger than others. People have not only friends, but also best friends. Social scientists have long recognized this characteristic of social connections and researchers frequently use the term tie strength to refer to this concept. We used online interaction data (specifically, Facebook interactions) to successfully identify real-world strong ties. Ground truth was established by asking users themselves to name their closest friends in real life. We found the frequency of online interaction was diagnostic of strong ties, and interaction frequency was much more useful diagnostically than were attributes of the user or the user's friends. More private communications (messages) were not necessarily more informative than public communications (comments, wall posts, and other interactions).

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

ERIC Educational Resources Information Center

Choi, Jaehwa; Kim, HeeKyoung; Pak, Seohong

2018-01-01

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

Assessment Instruments Used in the Education and Treatment of Persons with Autism: Brief Report of a Survey of National Service Centers.

ERIC Educational Resources Information Center

Luiselli, James K.; Campbell, Susan; Cannon, Barbara; DiPietro, Ellette; Ellis, James T.; Taras, Marie; Lifter, Karin

2001-01-01

Data from 30 national service centers found the number of assessment instruments endorsed increased as centers adopted a multidisciplinary approach to education and treatment, the largest proportion of instruments fell within intellectual, motor, and language/communication domains, and instruments were used most frequently for diagnostic and…

Scaffolding Learner-Centered Curricular Coherence Using Learning Maps and Diagnostic Assessments Designed around Mathematics Learning Trajectories

ERIC Educational Resources Information Center

Confrey, Jere; Gianopulos, Garron; McGowan, William; Shah, Meetal; Belcher, Michael

2017-01-01

The paper describes how designers used the construct of learning trajectories to create a tool, Math-Mapper 6-8, to help scaffold curricula toward increased learner-centered coherence. It defines "learner-centered curricular coherence" as "an organizational means to promote a high likelihood that each learner traverses one of many…

Investigating the Effectiveness of Classroom Diagnostic Tools

ERIC Educational Resources Information Center

Schultz, Robert K.

2012-01-01

The primary purposes of the study are to investigate what teachers experience while using the Classroom Diagnostic Tools (CDT) and to relate those experiences to the rate of growth in students' mathematics achievement. The CDT contains three components: an online computer adaptive diagnostic test, interactive web-based student reports, and…

Washington Hospital Center defends its position. Changing situation calls for a new approach.

PubMed

Botvin, J D

2000-01-01

Washington Hospital Center, in the nation's capital, found cardiac care, its leading source of revenue, challenged by new contenders. This launched an aggressive campaign directly at patients, encouraging them to use WHC's diagnostic testing services.

The role of informatics in patient-centered care and personalized medicine.

PubMed

Hanna, Matthew G; Pantanowitz, Liron

2017-06-01

The practice of cytopathology has dramatically changed due to advances in genomics and information technology. Cytology laboratories have accordingly become increasingly dependent on pathology informatics support to meet the emerging demands of precision medicine. Pathology informatics deals with information technology in the laboratory, and the impact of this technology on workflow processes and staff who interact with these tools. This article covers the critical role that laboratory information systems, electronic medical records, and digital imaging plays in patient-centered personalized medicine. The value of integrated diagnostic reports, clinical decision support, and the use of whole-slide imaging to better evaluate cytology samples destined for molecular testing is discussed. Image analysis that offers more precise and quantitative measurements in cytology is addressed, as well as the role of bioinformatics tools to cope with Big Data from next-generation sequencing. This article also highlights the barriers to the widespread adoption of these disruptive technologies due to regulatory obstacles, limited commercial solutions, poor interoperability, and lack of standardization. Cancer Cytopathol 2017;125(6 suppl):494-501. © 2017 American Cancer Society. © 2017 American Cancer Society.

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

Healthcare Transformation and Changing Roles for Nursing

PubMed Central

Salmond, Susan W.; Echevarria, Mercedes

2017-01-01

Factors driving healthcare transformation include fragmentation, access problems, unsustainable costs, suboptimal outcomes, and disparities. Cost and quality concerns along with changing social and disease-type demographics created the greatest urgency for the need for change. Caring for and paying for medical treatments for patients suffering from chronic health conditions are a significant concern. The Affordable Care Act includes programs now led by the Centers for Medicare & Medicaid Services aiming to improve quality and control cost. Greater coordination of care—across providers and across settings—will improve quality care, improve outcomes, and reduce spending, especially attributed to unnecessary hospitalization, unnecessary emergency department utilization, repeated diagnostic testing, repeated medical histories, multiple prescriptions, and adverse drug interactions. As a nation, we have taken incremental steps toward achieving better quality and lower costs for decades. Nurses are positioned to contribute to and lead the transformative changes that are occurring in healthcare by being a fully contributing member of the interprofessional team as we shift from episodic, provider-based, fee-for-service care to team-based, patient-centered care across the continuum that provides seamless, affordable, and quality care. These shifts require a new or an enhanced set of knowledge, skills, and attitudes around wellness and population care with a renewed focus on patient-centered care, care coordination, data analytics, and quality improvement. PMID:28107295

Virtual Diagnostics Interface: Real Time Comparison of Experimental Data and CFD Predictions for a NASA Ares I-Like Vehicle

NASA Technical Reports Server (NTRS)

Schwartz, Richard J.; Fleming, Gary A.

2007-01-01

Virtual Diagnostics Interface technology, or ViDI, is a suite of techniques utilizing image processing, data handling and three-dimensional computer graphics. These techniques aid in the design, implementation, and analysis of complex aerospace experiments. LiveView3D is a software application component of ViDI used to display experimental wind tunnel data in real-time within an interactive, three-dimensional virtual environment. The LiveView3D software application was under development at NASA Langley Research Center (LaRC) for nearly three years. LiveView3D recently was upgraded to perform real-time (as well as post-test) comparisons of experimental data with pre-computed Computational Fluid Dynamics (CFD) predictions. This capability was utilized to compare experimental measurements with CFD predictions of the surface pressure distribution of the NASA Ares I Crew Launch Vehicle (CLV) - like vehicle when tested in the NASA LaRC Unitary Plan Wind Tunnel (UPWT) in December 2006 - January 2007 timeframe. The wind tunnel tests were conducted to develop a database of experimentally-measured aerodynamic performance of the CLV-like configuration for validation of CFD predictive codes.

Impact of patient navigation in eliminating economic disparities in cancer care.

PubMed

Rodday, Angie Mae; Parsons, Susan K; Snyder, Frederick; Simon, Melissa A; Llanos, Adana A M; Warren-Mears, Victoria; Dudley, Donald; Lee, Ji-Hyun; Patierno, Steven R; Markossian, Talar W; Sanders, Mechelle; Whitley, Elizabeth M; Freund, Karen M

2015-11-15

Patient navigation may reduce cancer disparities associated with socioeconomic status (SES) and household factors. This study examined whether these factors were associated with delays in diagnostic resolution among patients with cancer screening abnormalities and whether patient navigation ameliorated these delays. This study analyzed data from 5 of 10 centers of the National Cancer Institute's Patient Navigation Research Program, which collected SES and household data on employment, income, education, housing, marital status, and household composition. The primary outcome was the time to diagnostic resolution after a cancer screening abnormality. Separate adjusted Cox proportional hazard models were fit for each SES and household factor, and an interaction between that factor and the intervention status was included. Among the 3777 participants (1968 in the control arm and 1809 in the navigation intervention arm), 91% were women, and the mean age was 44 years; 43% were Hispanic, 28% were white, and 27% were African American. Within the control arm, the unemployed experienced a longer time to resolution than those employed full-time (hazard ratio [HR], 0.85; P = .02). Renters (HR, 0.81; P = .02) and those with other (ie, unstable) housing (HR, 0.60; P < .001) had delays in comparison with homeowners. Never married (HR, 0.70; P < .001) and previously married participants (HR, 0.85; P = .03) had a longer time to care than married participants. There were no differences in the time to diagnostic resolution with any of these variables within the navigation intervention arm. Delays in diagnostic resolution exist by employment, housing type, and marital status. Patient navigation eliminated these disparities in the study sample. These findings demonstrate the value of providing patient navigation to patients at high risk for delays in cancer care. © 2015 American Cancer Society.

High-Pressure Gaseous Burner (HPGB) Facility Completed for Quantitative Laser Diagnostics Calibration

NASA Technical Reports Server (NTRS)

Nguyen, Quang-Viet

2002-01-01

A gas-fueled high-pressure combustion facility with optical access, which was developed over the last 2 years, has just been completed. The High Pressure Gaseous Burner (HPGB) rig at the NASA Glenn Research Center can operate at sustained pressures up to 60 atm with a variety of gaseous fuels and liquid jet fuel. The facility is unique as it is the only continuous-flow, hydrogen-capable, 60-atm rig in the world with optical access. It will provide researchers with new insights into flame conditions that simulate the environment inside the ultra-high-pressure-ratio combustion chambers of tomorrow's advanced aircraft engines. The facility provides optical access to the flame zone, enabling the calibration of nonintrusive optical diagnostics to measure chemical species and temperature. The data from the HPGB rig enables the validation of numerical codes that simulate gas turbine combustors, such as the National Combustor Code (NCC). The validation of such numerical codes is often best achieved with nonintrusive optical diagnostic techniques that meet these goals: information-rich (multispecies) and quantitative while providing good spatial and time resolution. Achieving these goals is a challenge for most nonintrusive optical diagnostic techniques. Raman scattering is a technique that meets these challenges. Raman scattering occurs when intense laser light interacts with molecules to radiate light at a shifted wavelength (known as the Raman shift). This shift in wavelength is unique to each chemical species and provides a "fingerprint" of the different species present. The facility will first be used to gather a comprehensive data base of laser Raman spectra at high pressures. These calibration data will then be used to quantify future laser Raman measurements of chemical species concentration and temperature in this facility and other facilities that use Raman scattering.

The impact of patient navigation in eliminating economic disparities in cancer care

PubMed Central

Rodday, Angie Mae; Parsons, Susan K.; Snyder, Frederick; Simon, Melissa A.; Llanos, Adana A.M.; Warren-Mears, Victoria; Dudley, Donald; Lee, Ji-Hyun; Patierno, Steve R.; Markossian, Talar W.; Sanders, Mechelle; Whitley, Elizabeth; Freund, Karen M.

2015-01-01

Background Patient navigation may reduce cancer disparities associated with socioeconomic status (SES) and household factors. We examined whether these factors were associated with delays in diagnostic resolution among patients with cancer screening abnormalities and whether patient navigation ameliorated these delays. Methods We analyzed data from five of ten centers from the NCI Patient Navigation Research Program that collected SES and household data on employment, income, education, housing, marital status, and household composition. The primary outcome was time to diagnostic resolution following a cancer screening abnormality. We fit separate adjusted Cox proportional hazard models for each SES and household factor and included an interaction between that factor and intervention status. Results Among 3777 participants (n=1968 control, n=1809 navigation intervention), 91% were women, with a mean age of 44 years, and 43% were Hispanic, 28% White, and 27% African American. Within the control arm, the unemployed experienced longer time to resolution than the full-time employed (HR=0.85, p=0.02). Renters (HR=0.81, p=0.02) and those with other (i.e., unstable) housing (HR=0.60, p<0.001) had delays compared to homeowners. Never married (HR=0.70, p<0.001) and previously married participants (HR=0.85, p=0.03) had longer time to care than married participants. There were no differences in time to diagnostic resolution by any of these variables within the navigation intervention arm. Conclusions Delays in diagnostic resolution exist by employment, housing type, and marital status. Patient navigation eliminated these disparities in our study sample. Our findings demonstrate the value of providing patient navigation to patients at high risk for delays in cancer care. PMID:26348120

Statistical innovations in diagnostic device evaluation.

PubMed

Yu, Tinghui; Li, Qin; Gray, Gerry; Yue, Lilly Q

2016-01-01

Due to rapid technological development, innovations in diagnostic devices are proceeding at an extremely fast pace. Accordingly, the needs for adopting innovative statistical methods have emerged in the evaluation of diagnostic devices. Statisticians in the Center for Devices and Radiological Health at the Food and Drug Administration have provided leadership in implementing statistical innovations. The innovations discussed in this article include: the adoption of bootstrap and Jackknife methods, the implementation of appropriate multiple reader multiple case study design, the application of robustness analyses for missing data, and the development of study designs and data analyses for companion diagnostics.

[Diagnostic criteria and risk assessment of complications after gastric cancer surgery in western countries].

PubMed

Wu, Zhouqiao; Wang, Qi; Shi, Jinyao; Cherry, Koh; Desiderio, Jacopo; Li, Ziyu; Ji, Jiafu

2017-02-25

Postoperative complications are important outcome measurements for surgical quality and safety control. However, the complication registration has always been problematic due to the lack of definition consensus and the other practical difficulties. This narrative review summarizes the data registry system for single institutional registry, national data registry, international multi-center trial registries in the western world, aiming to share the experience of complication classification and data registration. We interviewed Dr. Koh from Royal Prince Alfred Hospital in Australia for single institutional experience, Dr. van der Wielen and Dr. Desideriofor, from two international multi-center trial(STOMACH) and registry (IMIGASTRIC) respectively, and Prof. Dr. Wijnhoven from the Dutch Upper GI Audit(DUCA). The major questions include which complications are obligated to report in the respective registry, what are the definitions of those complications, who perform the registration, and how are the complications evaluated or classified. Four telephone conferences were initiated to discuss the above-mentioned topics. The DUCA and IMGASTRIC provided the definition of the major complications. The consent definition provided by DUCA was based on the LOW classification which came out after a four-year discussion and consensus meeting among international experts in the according field. However, none of the four registries asked for an obligatory standardization of the diagnostic criteria among the participating centers or surgeons. Instead, all the registries required a detailed recording of the diagnostic strategy and classification of the complications with the Clavien-Dindo scoring system. Most data were registered by surgeons or data managers during or immediately after the hospitalization. The investigators or an independent third party conducted the auditing of the data quality. Standardization of complication diagnosis among different centers is a difficult task, consuming much effort and time. On top of that, standardization of the complication registration is of critical and practical importance. We encourage all centers to register complications with the diagnostic criteria and following intervention. Based on this, the Clavien-Dindo classification can be properly justified, which has been widely accepted by most centers and should be routinely used as the standard evaluation system for postoperative complications in gastric tumor surgery.

Impact of a Reference Center on Leprosy Control under a Decentralized Public Health Care Policy in Brazil.

PubMed

Barbieri, Raquel Rodrigues; Sales, Anna Maria; Hacker, Mariana Andrea; Nery, José Augusto da Costa; Duppre, Nádia Cristina; Machado, Alice de Miranda; Moraes, Milton Ozório; Sarno, Euzenir Nunes

2016-10-01

We evaluated the profile of patients referred to the Fiocruz Outpatient Clinic, a reference center for the diagnosis and treatment of leprosy in Rio de Janeiro, RJ, and analyzed the origins and outcomes of these referrals. This is an observational retrospective study based on information collected from the Leprosy Laboratory database at Fiocruz, Rio de Janeiro, RJ, Brazil. A total of 1,845 suspected leprosy cases examined at the reference center between 2010 and 2014 were included. The originating health service referrals and diagnostic outcomes were analyzed as well as the clinical and epidemiological data of patients diagnosed with leprosy. Our data show that the profile of the patients treated at the Clinic has changed in recent years. There was an increase in both the proportion of patients with other skin diseases and those who had visited only one health service prior to our Clinic. Among the total 1,845 cases analyzed, the outcomes of 1,380 were linked to other diseases and, in 74% of these cases, a biopsy was not necessary to reach a diagnostic conclusion. A decrease in new leprosy case detection among our patients was also observed. Yet, among the leprosy patients, 40% had some degree of disability at diagnosis. The results of the present study demonstrated the importance of referral centers in support of basic health services within the decentralization strategy. But, the success of the program depends on the advent of new developmental tools to augment diagnostic accuracy for leprosy. However, it should be emphasized that for new diagnostic methods to be developed, a greater commitment on the part of the health care system regarding research is urgently needed.

The Ebola Spatial Care Path™: Accelerating point-of-care diagnosis, decision making, and community resilience in outbreaks.

PubMed

Kost, Gerald J; Ferguson, William J; Hoe, Jackie; Truong, Anh-Thu; Banpavichit, Arirat; Kongpila, Surin

2015-01-01

To present a vision where point-of-care testing (POCT) accelerates an Ebola Spatial Care Path™ (SCP) and future molecular diagnostics enable facilitated-access self-testing (FAST POC); to design an alternate care facility (ACF) for the SCP; to innovate an Ebola diagnostic center (DC); and to propel rapid POCT to the frontline to create resilience that stops future outbreaks. PubMed, literature, and web searches. Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA), Medicine Without Frontiers, and World Health Organization (WHO) document analyses. Investigations in China, the Philippines, Thailand, and the United States. Review of SE Asia, US, and West Africa isolation-treatment centers. Innovation of a SCP, ACF, and DC suitable for American and other communities. The authors designed an ACF and DC to integrate SCP principles for urgent Ebola care. FDA emergency use authorizations for Ebola molecular diagnostics were discovered, but no portable, handheld, or self-contained molecular POC instruments are yet available, although feasible. The WHO initiated design criteria and an acceptance protocol for testing. Financial investment in POCT will downsize Ebola outbreaks. POCT is facilitating global health. Now, global health problems are elevating POCT to new levels of importance for accelerating diagnosis and evidence-based decision making during disease outbreaks. Authorities concur that rapid diagnosis has potential to stop disease spread. With embedded POCT, strategic SCPs planned by communities fulfill CDC recommendations. POC devices should consolidate multiplex test clusters supporting patients with Ebola in isolation. The ultimate future solution is FAST POC. New technologies offer minimally significant risks. Diagnostic centers in ACFs and transportable formats also will optimize Ebola SCPs.

Comparison of the Effectiveness of Interactive Didactic Lecture Versus Online Simulation-Based CME Programs Directed at Improving the Diagnostic Capabilities of Primary Care Practitioners.

PubMed

McFadden, Pam; Crim, Andrew

2016-01-01

Diagnostic errors in primary care contribute to increased morbidity and mortality, and billions in costs each year. Improvements in the way practicing physicians are taught so as to optimally perform differential diagnosis can increase patient safety and lower the costs of care. This study represents a comparison of the effectiveness of two approaches to CME training directed at improving the primary care practitioner's diagnostic capabilities against seven common and important causes of joint pain. Using a convenience sampling methodology, one group of primary care practitioners was trained by a traditional live, expert-led, multimedia-based training activity supplemented with interactive practice opportunities and feedback (control group). The second group was trained online with a multimedia-based training activity supplemented with interactive practice opportunities and feedback delivered by an artificial intelligence-driven simulation/tutor (treatment group). Before their respective instructional intervention, there were no significant differences in the diagnostic performance of the two groups against a battery of case vignettes presenting with joint pain. Using the same battery of case vignettes to assess postintervention diagnostic performance, there was a slight but not statistically significant improvement in the control group's diagnostic accuracy (P = .13). The treatment group, however, demonstrated a significant improvement in accuracy (P < .02; Cohen d, effect size = 0.79). These data indicate that within the context of a CME activity, a significant improvement in diagnostic accuracy can be achieved by the use of a web-delivered, multimedia-based instructional activity supplemented by practice opportunities and feedback delivered by an artificial intelligence-driven simulation/tutor.

Feature diagnosticity and task context shape activity in human scene-selective cortex.

PubMed

Lowe, Matthew X; Gallivan, Jason P; Ferber, Susanne; Cant, Jonathan S

2016-01-15

Scenes are constructed from multiple visual features, yet previous research investigating scene processing has often focused on the contributions of single features in isolation. In the real world, features rarely exist independently of one another and likely converge to inform scene identity in unique ways. Here, we utilize fMRI and pattern classification techniques to examine the interactions between task context (i.e., attend to diagnostic global scene features; texture or layout) and high-level scene attributes (content and spatial boundary) to test the novel hypothesis that scene-selective cortex represents multiple visual features, the importance of which varies according to their diagnostic relevance across scene categories and task demands. Our results show for the first time that scene representations are driven by interactions between multiple visual features and high-level scene attributes. Specifically, univariate analysis of scene-selective cortex revealed that task context and feature diagnosticity shape activity differentially across scene categories. Examination using multivariate decoding methods revealed results consistent with univariate findings, but also evidence for an interaction between high-level scene attributes and diagnostic visual features within scene categories. Critically, these findings suggest visual feature representations are not distributed uniformly across scene categories but are shaped by task context and feature diagnosticity. Thus, we propose that scene-selective cortex constructs a flexible representation of the environment by integrating multiple diagnostically relevant visual features, the nature of which varies according to the particular scene being perceived and the goals of the observer. Copyright © 2015 Elsevier Inc. All rights reserved.

UNUSUAL FINDINGS IN ZEBRAFISH, DANIO RERIO, FROM TOXICOLOGICAL STUDIES AND THE ZEBRAFISH INTERNATIONAL RESOURCE CENTER DIAGNOSTIC SERVICE

EPA Science Inventory

A number of interesting and unusual lesions have been diagnosed in zebrafish that have been evaluated from toxicological studies or submitted as cases to the Diagnostic Service at Oregon State University. Lesions were observed in various wild-type and mutant lines of zebrafish an...

Rocket Engine Plume Diagnostics at Stennis Space Center

NASA Technical Reports Server (NTRS)

Tejwani, Gopal D.; Langford, Lester A.; VanDyke, David B.; McVay, Gregory P.; Thurman, Charles C.

2003-01-01

The Stennis Space Center has been at the forefront of development and application of exhaust plume spectroscopy to rocket engine health monitoring since 1989. Various spectroscopic techniques, such as emission, absorption, FTIR, LIF, and CARS, have been considered for application at the engine test stands. By far the most successful technology h a been exhaust plume emission spectroscopy. In particular, its application to the Space Shuttle Main Engine (SSME) ground test health monitoring has been invaluable in various engine testing and development activities at SSC since 1989. On several occasions, plume diagnostic methods have successfully detected a problem with one or more components of an engine long before any other sensor indicated a problem. More often, they provide corroboration for a failure mode, if any occurred during an engine test. This paper gives a brief overview of our instrumentation and computational systems for rocket engine plume diagnostics at SSC. Some examples of successful application of exhaust plume spectroscopy (emission as well as absorption) to the SSME testing are presented. Our on-going plume diagnostics technology development projects and future requirements are discussed.

Inferring Tie Strength from Online Directed Behavior

PubMed Central

Jones, Jason J.; Settle, Jaime E.; Bond, Robert M.; Fariss, Christopher J.; Marlow, Cameron; Fowler, James H.

2013-01-01

Some social connections are stronger than others. People have not only friends, but also best friends. Social scientists have long recognized this characteristic of social connections and researchers frequently use the term tie strength to refer to this concept. We used online interaction data (specifically, Facebook interactions) to successfully identify real-world strong ties. Ground truth was established by asking users themselves to name their closest friends in real life. We found the frequency of online interaction was diagnostic of strong ties, and interaction frequency was much more useful diagnostically than were attributes of the user or the user’s friends. More private communications (messages) were not necessarily more informative than public communications (comments, wall posts, and other interactions). PMID:23300964

How Do Gut Feelings Feature in Tutorial Dialogues on Diagnostic Reasoning in GP Traineeship?

ERIC Educational Resources Information Center

Stolper, C. F.; Van de Wiel, M. W. J.; Hendriks, R. H. M.; Van Royen, P.; Van Bokhoven, M. A.; Van der Weijden, T.; Dinant, G. J.

2015-01-01

Diagnostic reasoning is considered to be based on the interaction between analytical and non-analytical cognitive processes. Gut feelings, a specific form of non-analytical reasoning, play a substantial role in diagnostic reasoning by general practitioners (GPs) and may activate analytical reasoning. In GP traineeships in the Netherlands, trainees…

Immune Humanization of Immunodeficient Mice Using Diagnostic Bone Marrow Aspirates from Carcinoma Patients

PubMed Central

Werner-Klein, Melanie; Proske, Judith; Werno, Christian; Schneider, Katharina; Hofmann, Hans-Stefan; Rack, Brigitte; Buchholz, Stefan; Ganzer, Roman; Blana, Andreas; Seelbach-Göbel, Birgit; Nitsche, Ulrich

2014-01-01

Tumor xenografts in immunodeficient mice, while routinely used in cancer research, preclude studying interactions of immune and cancer cells or, if humanized by allogeneic immune cells, are of limited use for tumor-immunological questions. Here, we explore a novel way to generate cancer models with an autologous humanized immune system. We demonstrate that hematopoietic stem and progenitor cells (HSPCs) from bone marrow aspirates of non-metastasized carcinoma patients, which are taken at specialized centers for diagnostic purposes, can be used to generate a human immune system in NOD-scid IL2rγ(null) (NSG) and HLA-I expressing NSG mice (NSG-HLA-A2/HHD) comprising both, lymphoid and myeloid cell lineages. Using NSG-HLA-A2/HHD mice, we show that responsive and self-tolerant human T cells develop and human antigen presenting cells can activate human T cells. As critical factors we identified the low potential of bone marrow HSPCs to engraft, generally low HSPC numbers in patient-derived bone marrow samples, cryopreservation and routes of cell administration. We provide here an optimized protocol that uses a minimum number of HSPCs, preselects high-quality bone marrow samples defined by the number of initially isolated leukocytes and intra-femoral or intra-venous injection. In conclusion, the use of diagnostic bone marrow aspirates from non-metastasized carcinoma patients for the immunological humanization of immunodeficient mice is feasible and opens the chance for individualized analyses of anti-tumoral T cell responses. PMID:24830425

Using computerised interactive response technology to assess electrocardiographers and for aggregating diagnoses.

PubMed

Peace, Aaron; Ramsewak, Adesh; Cairns, Andrew; Finlay, Dewar; Guldenring, Daniel; Clifford, Gari; Bond, Raymond

2015-01-01

The 12-lead electrocardiogram (ECG) is a crucial diagnostic tool. However, the ideal method to assess competency in ECG interpretation remains unclear. We sought to evaluate whether keypad response technology provides a rapid, interactive way to assess ECG knowledge. 75 participants were enrolled [32 (43%) Primary Care Physicians, 24 (32%) Hospital Medical Staff and 19 (25%) Nurse Practitioners]. Nineteen ECGs with 4 possible answers were interpreted. Out of 1425 possible decisions 1054 (73.9%) responses were made. Only 570/1425 (40%) of the responses were correct. Diagnostic accuracy varied (0% to 78%, mean 42%±21%) across the entire cohort. Participation was high, (median 83%, IQR 50%-100%). Hospital Medical Staff had significantly higher diagnostic accuracy than nurse practitioners (50±20% vs. 38±19%, p=0.04) and Primary Care Physicians (50±20% vs. 40±21%, p=0.07) although not significant. Interactive voting systems can be rapidly and successfully used to assess ECG interpretation. Further education is necessary to improve diagnostic accuracy. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

Ontario multidetector computed tomographic coronary angiography study: field evaluation of diagnostic accuracy.

PubMed

Chow, Benjamin J W; Freeman, Michael R; Bowen, James M; Levin, Leslie; Hopkins, Robert B; Provost, Yves; Tarride, Jean-Eric; Dennie, Carole; Cohen, Eric A; Marcuzzi, Dan; Iwanochko, Robert; Moody, Alan R; Paul, Narinder; Parker, John D; O'Reilly, Daria J; Xie, Feng; Goeree, Ron

2011-06-13

Computed tomographic coronary angiography (CTCA) has gained clinical acceptance for the detection of obstructive coronary artery disease. Although single-center studies have demonstrated excellent accuracy, multicenter studies have yielded variable results. The true diagnostic accuracy of CTCA in the "real world" remains uncertain. We conducted a field evaluation comparing multidetector CTCA with invasive CA (ICA) to understand CTCA's diagnostic accuracy in a real-world setting. A multicenter cohort study of patients awaiting ICA was conducted between September 2006 and June 2009. All patients had either a low or an intermediate pretest probability for coronary artery disease and underwent CTCA and ICA within 10 days. The results of CTCA and ICA were interpreted visually by local expert observers who were blinded to all clinical data and imaging results. Using a patient-based analysis (diameter stenosis ≥50%) of 169 patients, the sensitivity, specificity, positive predictive value, and negative predictive value were 81.3% (95% confidence interval [CI], 71.0%-89.1%), 93.3% (95% CI, 85.9%-97.5%), 91.6% (95% CI, 82.5%-96.8%), and 84.7% (95% CI, 76.0%-91.2%), respectively; the area under receiver operating characteristic curve was 0.873. The diagnostic accuracy varied across centers (P < .001), with a sensitivity, specificity, positive predictive value, and negative predictive value ranging from 50.0% to 93.2%, 92.0% to 100%, 84.6% to 100%, and 42.9% to 94.7%, respectively. Compared with ICA, CTCA appears to have good accuracy; however, there was variability in diagnostic accuracy across centers. Factors affecting institutional variability need to be better understood before CTCA is universally adopted. Additional real-world evaluations are needed to fully understand the impact of CTCA on clinical care. clinicaltrials.gov Identifier: NCT00371891.

78 FR 34261 - Final Priority-National Institute on Disability and Rehabilitation Research-Rehabilitation...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-07

..., such as observational research or research toward the development of diagnostic or outcome assessment... Institute on Disability and Rehabilitation Research--Rehabilitation Research and Training Centers AGENCY... for the Disability and Rehabilitation Research Projects and Centers Program administered by the...

Research of the Heart Information Monitoring Robert Based on the 3G Wireless Communication Platform

NASA Astrophysics Data System (ADS)

Zhang, Fuli; Yang, Huazhe; Li, Gensong; Hong, Yang; Hu, Qingzhe

Electrocardiogram (ECG) of a person can be recorded and the diagnostic results can be displayed through touching the heart information monitoring Robert. In addition, the heart rate, phonocardiogram (PCG) and the dynamic three-dimensional echocardiography can also be displayed synchronously. Then the difficult ECG can be transmitted to the service center through 3G wireless communication center, followed by diagnosing the ECG by doctors and transmitting the feedback diagnostic results. I-lead ECG of the person can be recorded by the amplification circuit with high gain and low noise. Then, the heart rate and output phonocardiogram are displayed and the model of heart beat are started to trace through the recognition of R wave. Finally, the difficult ECG is transmitted to the service center via 3G communication chips. The displayed ECG is clear, and the stimulated heart beat is synchronous with that of the person. Furthermore, ECG received by the service center is in accordance with the one recorded by the Robert.

Rocket engine diagnostics using qualitative modeling techniques

NASA Technical Reports Server (NTRS)

Binder, Michael; Maul, William; Meyer, Claudia; Sovie, Amy

1992-01-01

Researchers at NASA Lewis Research Center are presently developing qualitative modeling techniques for automated rocket engine diagnostics. A qualitative model of a turbopump interpropellant seal system has been created. The qualitative model describes the effects of seal failures on the system steady-state behavior. This model is able to diagnose the failure of particular seals in the system based on anomalous temperature and pressure values. The anomalous values input to the qualitative model are generated using numerical simulations. Diagnostic test cases include both single and multiple seal failures.

Rocket engine diagnostics using qualitative modeling techniques

NASA Technical Reports Server (NTRS)

Binder, Michael; Maul, William; Meyer, Claudia; Sovie, Amy

1992-01-01

Researchers at NASA Lewis Research Center are presently developing qualitative modeling techniques for automated rocket engine diagnostics. A qualitative model of a turbopump interpropellant seal system was created. The qualitative model describes the effects of seal failures on the system steady state behavior. This model is able to diagnose the failure of particular seals in the system based on anomalous temperature and pressure values. The anomalous values input to the qualitative model are generated using numerical simulations. Diagnostic test cases include both single and multiple seal failures.

The role of diagnostic laboratories in support of animal disease surveillance systems.

PubMed

Zepeda, C

2007-01-01

Diagnostic laboratories are an essential component of animal disease surveillance systems. To understand the occurrence of disease in populations, surveillance systems rely on random or targeted surveys using three approaches: clinical, serological and virological surveillance. Clinical surveillance is the basis for early detection of disease and is usually centered on the detection of syndromes and clinical findings requiring confirmation by diagnostic laboratories. Although most of the tests applied usually perform to an acceptable standard, several have not been properly validated in terms of their diagnostic sensitivity and specificity. Sensitivity and specificity estimates can vary according to local conditions and, ideally, should be determined by national laboratories where the tests are to be applied. The importance of sensitivity and specificity estimates in the design and interpretation of statistically based surveys and risk analysis is fundamental to establish appropriate disease control and prevention strategies. The World Organisation for Animal Health's (OIE) network of reference laboratories acts as centers of expertise for the diagnosis of OIE listed diseases and have a role in promoting the validation of OIE prescribed tests for international trade. This paper discusses the importance of the epidemiological evaluation of diagnostic tests and the role of the OIE Reference Laboratories and Collaborating Centres in this process.

Ares I-X Ground Diagnostic Prototype

NASA Technical Reports Server (NTRS)

Schwabacher, Mark A.; Martin, Rodney Alexander; Waterman, Robert D.; Oostdyk, Rebecca Lynn; Ossenfort, John P.; Matthews, Bryan

2010-01-01

The automation of pre-launch diagnostics for launch vehicles offers three potential benefits: improving safety, reducing cost, and reducing launch delays. The Ares I-X Ground Diagnostic Prototype demonstrated anomaly detection, fault detection, fault isolation, and diagnostics for the Ares I-X first-stage Thrust Vector Control and for the associated ground hydraulics while the vehicle was in the Vehicle Assembly Building at Kennedy Space Center (KSC) and while it was on the launch pad. The prototype combines three existing tools. The first tool, TEAMS (Testability Engineering and Maintenance System), is a model-based tool from Qualtech Systems Inc. for fault isolation and diagnostics. The second tool, SHINE (Spacecraft Health Inference Engine), is a rule-based expert system that was developed at the NASA Jet Propulsion Laboratory. We developed SHINE rules for fault detection and mode identification, and used the outputs of SHINE as inputs to TEAMS. The third tool, IMS (Inductive Monitoring System), is an anomaly detection tool that was developed at NASA Ames Research Center. The three tools were integrated and deployed to KSC, where they were interfaced with live data. This paper describes how the prototype performed during the period of time before the launch, including accuracy and computer resource usage. The paper concludes with some of the lessons that we learned from the experience of developing and deploying the prototype.

Current use of imaging and electromagnetic source localization procedures in epilepsy surgery centers across Europe.

PubMed

Mouthaan, Brian E; Rados, Matea; Barsi, Péter; Boon, Paul; Carmichael, David W; Carrette, Evelien; Craiu, Dana; Cross, J Helen; Diehl, Beate; Dimova, Petia; Fabo, Daniel; Francione, Stefano; Gaskin, Vladislav; Gil-Nagel, Antonio; Grigoreva, Elena; Guekht, Alla; Hirsch, Edouard; Hecimovic, Hrvoje; Helmstaedter, Christoph; Jung, Julien; Kalviainen, Reetta; Kelemen, Anna; Kimiskidis, Vasilios; Kobulashvili, Teia; Krsek, Pavel; Kuchukhidze, Giorgi; Larsson, Pål G; Leitinger, Markus; Lossius, Morten I; Luzin, Roman; Malmgren, Kristina; Mameniskiene, Ruta; Marusic, Petr; Metin, Baris; Özkara, Cigdem; Pecina, Hrvoje; Quesada, Carlos M; Rugg-Gunn, Fergus; Rydenhag, Bertil; Ryvlin, Philippe; Scholly, Julia; Seeck, Margitta; Staack, Anke M; Steinhoff, Bernhard J; Stepanov, Valentin; Tarta-Arsene, Oana; Trinka, Eugen; Uzan, Mustafa; Vogt, Viola L; Vos, Sjoerd B; Vulliémoz, Serge; Huiskamp, Geertjan; Leijten, Frans S S; Van Eijsden, Pieter; Braun, Kees P J

2016-05-01

In 2014 the European Union-funded E-PILEPSY project was launched to improve awareness of, and accessibility to, epilepsy surgery across Europe. We aimed to investigate the current use of neuroimaging, electromagnetic source localization, and imaging postprocessing procedures in participating centers. A survey on the clinical use of imaging, electromagnetic source localization, and postprocessing methods in epilepsy surgery candidates was distributed among the 25 centers of the consortium. A descriptive analysis was performed, and results were compared to existing guidelines and recommendations. Response rate was 96%. Standard epilepsy magnetic resonance imaging (MRI) protocols are acquired at 3 Tesla by 15 centers and at 1.5 Tesla by 9 centers. Three centers perform 3T MRI only if indicated. Twenty-six different MRI sequences were reported. Six centers follow all guideline-recommended MRI sequences with the proposed slice orientation and slice thickness or voxel size. Additional sequences are used by 22 centers. MRI postprocessing methods are used in 16 centers. Interictal positron emission tomography (PET) is available in 22 centers; all using 18F-fluorodeoxyglucose (FDG). Seventeen centers perform PET postprocessing. Single-photon emission computed tomography (SPECT) is used by 19 centers, of which 15 perform postprocessing. Four centers perform neither PET nor SPECT in children. Seven centers apply magnetoencephalography (MEG) source localization, and nine apply electroencephalography (EEG) source localization. Fourteen combinations of inverse methods and volume conduction models are used. We report a large variation in the presurgical diagnostic workup among epilepsy surgery centers across Europe. This diversity underscores the need for high-quality systematic reviews, evidence-based recommendations, and harmonization of available diagnostic presurgical methods. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.

Planning for the Mercy Center for Breast Health.

PubMed

Olivares, V Ed

2002-01-01

During the last months of 2000, administrators at the Mercy San Juan Medical Center in Carmichael, Calif., convened a steering committee to plan the Mercy Center for Breast Health. The Steering Committee was composed of the director of ancillary and support services, the oncology clinical nurse specialist, the RN manager of the oncology nursing unit, the RN surgery center manager, and me, the manager of imaging services. The committee was responsible for creating a new business with five specific objectives: to position the Center as a comprehensive diagnostic and resource center for women; to generate physician referrals to the Breast Center through various vehicles; to create awareness of the Breast Center's capabilities among area radiologists; to create awareness of the Breast Center among employees of six sister facilities; to create "brand awareness" for the Mercy Center for Breast Health among referring physicians and patients who could use competing centers in the area. The Steering Committee's charter was to design a center with a feminine touch and ambience and to provide a "one-stop shopping" experience for patients. A major component of the Breast Center is the Dianne Haselwood Resource Center, which provides patients with educational support and information. The Steering Committee brought its diverse experience and interests to bear on arranging for equipment acquisition, information and clerical systems, staffing, clinic office design, patient care and marketing. Planning the Mercy Center for Breast Health has been a positive challenge that brought together many elements of the organization and people from different departments and specialties to create a new business venture. Our charge now is to grow and to live up to our vision of offering complete breast diagnostic, education and support services in one location.

Laser-induced fluorescence spectrometer based on tunable color center laser for low-impurity-solution diagnostic and analysis

NASA Astrophysics Data System (ADS)

Basiev, Tasoltan T.; Fedorov, Vladimir V.; Karasik, Alexander Y.; Lin'kov, S. I.; Orlovskii, Yurii V.; Osiko, Vyacheslav V.; Panov, Vitaly A.; Prokhorov, Alexander M.; Vorob'ev, Ivan N.; Zverev, Peter G.

1996-11-01

Solid state (SS) tunable LiF:F2 color center laser with second and fourth harmonic generation for visible and ultra violet spectral ranges was developed for the laser induced fluorescence spectroscopy (LIFS). The construction and properties of excitation, registration and flame atomization systems for water solution diagnostic are discussed. The testing experiment with low iron concentrated water sample exhibits ultrahigh sensitivity which was estimated to be 0.05 ppb in our set-up. The SS LIFS spectrometer developed is usable to measure more than 42 metal elements in solution on the ppm, ppb level for various medical and biological applications.

Propulsion Integrated Vehicle Health Management Technology Experiment (PITEX) Conducted

NASA Technical Reports Server (NTRS)

Maul, William A.; Chicatelli, Amy K.; Fulton, Christopher E.

2004-01-01

The Propulsion Integrated Vehicle Health Management (IVHM) Technology Experiment (PITEX) is a continuing NASA effort being conducted cooperatively by the NASA Glenn Research Center, the NASA Ames Research Center, and the NASA Kennedy Space Center. It was a key element of a Space Launch Initiative risk-reduction task performed by the Northrop Grumman Corporation in El Segundo, California. PITEX's main objectives are the continued maturation of diagnostic technologies that are relevant to second generation reusable launch vehicle (RLV) subsystems and the assessment of the real-time performance of the PITEX diagnostic solution. The PITEX effort has considerable legacy in the NASA IVHM Technology Experiment for X-vehicles (NITEX) that was selected to fly on the X-34 subscale RLV that was being developed by Orbital Sciences Corporation. NITEX, funded through the Future-X Program Office, was to advance the technology-readiness level of selected IVHM technologies within a flight environment and to begin the transition of these technologies from experimental status into RLV baseline designs. The experiment was to perform realtime fault detection and isolation and suggest potential recovery actions for the X-34 main propulsion system (MPS) during all mission phases by using a combination of system-level analysis and detailed diagnostic algorithms.

Plasma diagnostics package. Volume 2: Spacelab 2 section, part A

NASA Technical Reports Server (NTRS)

Pickett, Jolene S. (Compiler); Frank, L. A. (Compiler); Kurth, W. S. (Compiler)

1988-01-01

This volume (2), which consists of two parts (A and B), of the Plasma Diagnostics Package (PDP) Final Science Report contains a summary of all of the data reduction and scientific analyses which were performed using PDP data obtained on STS-51F as a part of the Spacelab 2 (SL-2) payload. This work was performed during the period of launch, July 29, l985, through June 30, l988. During this period the primary data reduction effort consisted of processing summary plots of the data received by 12 of the 14 instruments located on the PDP and submitting these data to the National Space Science Data Center (NSSDC). The scientific analyses during the performance period consisted of follow-up studies of shuttle orbiter environment and orbiter/ionosphere interactions and various plasma particle and wave studies which dealt with data taken when the PDP was on the Remote Manipulator System (RMS) arm and when the PDP was in free flight. Of particular interest during the RMS operations and free flight were the orbiter wake studies and joint studies of beam/plasma interactions with the SL-2 Fast Pulse Electron Generator (FPEG) of the Vehicle Charging and Potential Investigation (VCAP). Internal reports, published papers and presentations which involve PDP/SL-2 data are listed in Sections 3 and 4. A PDP/SL-2 scientific results meeting was held at the University of Iowa on June 10, l986. This meeting was attended by most of the PDP and VCAP investigators and provided a forum for discussing and comparing the various results, particularly with regard to the PDP free flight.

Measuring time of flight of fusion products in an inertial electrostatic confinement fusion device for spatial profiling of fusion reactions

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

Donovan, D. C.; Boris, D. R.; Kulcinski, G. L.

2013-03-15

A new diagnostic has been developed that uses the time of flight (TOF) of the products from a nuclear fusion reaction to determine the location where the fusion reaction occurred. The TOF diagnostic uses charged particle detectors on opposing sides of the inertial electrostatic confinement (IEC) device that are coupled to high resolution timing electronics to measure the spatial profile of fusion reactions occurring between the two charged particle detectors. This diagnostic was constructed and tested by the University of Wisconsin-Madison Inertial Electrostatic Confinement Fusion Group in the IEC device, HOMER, which accelerates deuterium ions to fusion relevant energies inmore » a high voltage ({approx}100 kV), spherically symmetric, electrostatic potential well [J. F. Santarius, G. L. Kulcinski, R. P. Ashley, D. R. Boris, B. B. Cipiti, S. K. Murali, G. R. Piefer, R. F. Radel, T. E. Radel, and A. L. Wehmeyer, Fusion Sci. Technol. 47, 1238 (2005)]. The TOF diagnostic detects the products of D(d,p)T reactions and determines where along a chord through the device the fusion event occurred. The diagnostic is also capable of using charged particle spectroscopy to determine the Doppler shift imparted to the fusion products by the center of mass energy of the fusion reactants. The TOF diagnostic is thus able to collect spatial profiles of the fusion reaction density along a chord through the device, coupled with the center of mass energy of the reactions occurring at each location. This provides levels of diagnostic detail never before achieved on an IEC device.« less

Transcutaneous bowel sonography for inflammatory bowel disease is sensitive and specific when performed in a nonexpert low-volume North American center.

PubMed

Sey, Michael Sai Lai; Gregor, Jamie; Chande, Nilesh; Ponich, Terry; Bhaduri, Mousumi; Lum, Andrea; Zaleski, Witek; Yan, Brian

2013-08-01

Transcutaneous bowel sonography is a nonionizing imaging modality used in inflammatory bowel disease. Although available in Europe, its uptake in North America has been limited. Since the accuracy of bowel sonography is highly operator dependent, low-volume centers in North America may not achieve the same diagnostic accuracy reported in the European literature. Our objective was to determine the diagnostic accuracy of bowel sonography in a nonexpert low-volume center. All cases of bowel sonography at a single tertiary care center during an 18-month period were reviewed. Bowel sonography was compared with reference standards, including small-bowel follow-through, computed tomography, magnetic resonance imaging, colonoscopy, and surgical findings. A total of 103 cases were included for analysis during the study period. The final diagnoses included Crohn disease (72), ulcerative colitis (8), hemolytic uremic syndrome (1), and normal (22). The sensitivity and specificity of bowel sonography for intestinal wall inflammation were 87.8% and 92.6%, respectively. In the subset of patients who had complications of Crohn disease, the sensitivity and specificity were 50% and 100% for fistulas and 14% and 100% for strictures. One patient had an abscess, which was detected by bowel sonography. Abnormal bowel sonographic findings contributed to the escalation of treatment in 55% of cases. Bowel sonography for inflammatory bowel disease can be performed in low-volume centers and provides diagnostic accuracy for luminal disease comparable with published data, although it is less sensitive for complications of Crohn disease.

Tomsk Cardiology Center program on lasers in cardiovascular: first results

NASA Astrophysics Data System (ADS)

Gordov, Eugeni P.; Karpov, Rostislav S.; Dudko, Victor A.; Shipulin, Vladimir M.

1994-12-01

Recent progress in biomedical optics resulted in increased activity in this area at a number of different centers. Reported are the first results of the program directed to incorporate at Tomsk Cardiology Center experience gained in Tomsk optical profile research institutions in areas of light-matter interaction, high resolution spectroscopy, laser physics and relevant software and their usage in cardiac therapy, surgery, and diagnostics. To coordinate research work in this direction the special unit-laboratory of laser medicine is organized at the Center. Laboratory activity goes in the following directions: study of spectral properties of vessel walls in norm and atherosclerosis, comparative study of different wavelength laser radiation action on normal and atherosclerotically damaged tissues, novel approach to intravascular imaging, and usage of high sensitive laser spectroscopy for early diagnosis of cardiac diseases. The spectroscopic study of AP and normal tissue is aimed at understanding of differences in internal energy structures and ways of energy migration which are of critical importance for reaching selective laser action on normal and deceased tissues. To compare thermal, mechanical, and photo-chemical variations of tissues caused by laser radiation the XeCl excimer laser with Raman shifting cell and Nd:YAG laser with second, third, and fourth harmonic converters are employed. Fine influence of pulse duration, intensity, and repetition rates on AP removal is considered in laboratory experiments with vessel samples. Preliminary results on theoretical consideration for determination of spectroscopically detectable markers of some cardiac diseases are reported as well.

Healthcare provider and patient perspectives on diagnostic imaging investigations.

PubMed

Makanjee, Chandra R; Bergh, Anne-Marie; Hoffmann, Willem A

2015-05-20

Much has been written about the patient-centred approach in doctor-patient consultations. Little is known about interactions and communication processes regarding healthcare providers' and patients' perspectives on expectations and experiences of diagnostic imaging investigations within the medical encounter. Patients journey through the health system from the point of referral to the imaging investigation itself and then to the post-imaging consultation. AIM AND SETTING: To explore healthcare provider and patient perspectives on interaction and communication processes during diagnostic imaging investigations as part of their clinical journey through a healthcare complex. A qualitative study was conducted, with two phases of data collection. Twenty-four patients were conveniently selected at a public district hospital complex and were followed throughout their journey in the hospital system, from admission to discharge. The second phase entailed focus group interviews conducted with providers in the district hospital and adjacent academic hospital (medical officers and family physicians, nurses, radiographers, radiology consultants and registrars). Two main themes guided our analysis: (1) provider perspectives; and (2) patient dispositions and reactions. Golden threads that cut across these themes are interactions and communication processes in the context of expectations, experiences of the imaging investigations and the outcomes thereof. Insights from this study provide a better understanding of the complexity of the processes and interactions between providers and patients during the imaging investigations conducted as part of their clinical pathway. The interactions and communication processes are provider-patient centred when a referral for a diagnostic imaging investigation is included.

[Depressed mothers: the impact of depression on early interactions. An analysis of Anglo-Saxon studies].

PubMed

Guedeney, N

1993-10-01

Maternal depression remains a public health problem as indicated by many studies focusing on depression in mothers of young children. Although the high prevalence of depression in mothers of infants and young children is now a recognized fact, the detection and management of maternal depression in everyday practice still raises significant problems. This initial review centers on studies providing diagnostic guidelines. The problem of maternal depression and of its impact on the offspring is relevant to the issue of how qualities, abilities, and vulnerabilities are transmitted from one generation to the next. Psychoanalysts, infant psychiatrists, and developmental psychologists show great interest in this field. The current review was restricted to recent Anglo-Saxon studies on depression-related changes in early maternal behavior. The most striking findings are as follows: although depression affects maternal behavior overall, there is considerable variation across mothers; timing alterations (in terms of micro and macro sequences) in mother-child interactions occur in every case and are among the obstacles to harmony and synchronization; subtle alterations in the mother's response to her baby's signals preclude flexibility and anticipation.

A Multifaceted Model of Training in Psychological Assessment.

ERIC Educational Resources Information Center

Levy, Leon H.

Much of the controversy over training in diagnostic testing between internship training centers and universities results from the implicit producer-consumer relationship which exists between them. A collaborative relationship is proposed as an alternative, in which the training activities of universities and internship centers are seen as…

Mental Health Issues among College Students: Who Gets Referred for Psychopharmacology Evaluation?

ERIC Educational Resources Information Center

Kirsch, Daniel J.; Doerfler, Leonard A.; Truong, Debbie

2015-01-01

Objective: To describe diagnostic and psychotropic medication prescription characteristics among college students referred by college counseling centers for psychopharmacologic evaluation. Participants: Participants were 540 college students referred by 6 college counseling centers in Massachusetts between November 2005 and May 2011. Methods:…

Evidence-Centered Design for Diagnostic Assessment within Digital Learning Environments: Integrating Modern Psychometrics and Educational Data Mining

ERIC Educational Resources Information Center

Rupp, André A.; Nugent, Rebecca; Nelson, Brian

2012-01-01

In recent years the educational community has increasingly embraced digital technologies for the purposes of developing alternative learning environments, providing diagnostic feedback, and fostering the development of so-called 21st-century skills. This special issue is dedicated to bridging recent work from the disciplines of educational and…

21 CFR 864.9160 - Blood group substances of nonhuman origin for in vitro diagnostic use.

Code of Federal Regulations, 2011 CFR

2011-04-01

... licensed by the Center for Biologics Evaluation and Research of the Food and Drug Administration. (b... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Blood group substances of nonhuman origin for in vitro diagnostic use. 864.9160 Section 864.9160 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT...

21 CFR 864.9160 - Blood group substances of nonhuman origin for in vitro diagnostic use.

Code of Federal Regulations, 2010 CFR

2010-04-01

... licensed by the Center for Biologics Evaluation and Research of the Food and Drug Administration. (b... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Blood group substances of nonhuman origin for in vitro diagnostic use. 864.9160 Section 864.9160 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT...

Value of diagnostic imaging for the symptomatic male breast: Can we avoid unnecessary biopsies?

PubMed

Foo, Eric T; Lee, Amie Y; Ray, Kimberly M; Woodard, Genevieve A; Freimanis, Rita I; Joe, Bonnie N

To review the use of diagnostic breast imaging and outcomes for symptomatic male patients. We retrospectively evaluated 122 males who underwent diagnostic imaging for breast symptoms at our academic center. The majority (94%) of cases had negative or benign imaging, with gynecomastia being the most common diagnosis (78%). There were two malignancies, both of which had positive imaging. Fifteen patients underwent percutaneous biopsy, and over half (53%) were palpation-guided biopsies initiated by the referring clinician despite negative imaging. Diagnostic imaging demonstrated 100% sensitivity and 96% specificity for identifying cancer. Malignancy is rarely a cause of male breast symptoms. Diagnostic breast imaging is useful to establish benignity and avert unnecessary biopsies. Copyright © 2017 Elsevier Inc. All rights reserved.

Photovoltaic array space power plus diagnostics experiment

NASA Technical Reports Server (NTRS)

Guidice, Donald A.

1990-01-01

The objective of the Photovoltaic Array Space Power Plus Diagnostics (PASP Plus) experiment is to measure the effects of the interaction of the low- to mid-altitude space environment on the performance of a diverse set of small solar-cell arrays (planar and concentrator, representative of present and future military technologies) under differing conditions of velocity-vector orientation and simulated (by biasing) high-voltage operation. Solar arrays to be tested include Si and GaAs planar arrays and several types of GaAs concentrator arrays. Diagnostics (a Langmuir probe and a pressure gauge) and a transient pulse monitor (to measure radiated and conducted EMI during arcing) will be used to determine the impact of the environment on array operation to help verify various interactions models. Results from a successful PASP Plus flight will furnish answers to important interactions questions and provide inputs for design and test standards for photovoltaic space-power subsystems.

LMP1 and Dynamic Progressive Telomere Dysfunction: A Major Culprit in EBV-Associated Hodgkin's Lymphoma.

PubMed

Knecht, Hans; Mai, Sabine

2017-06-27

Epstein-Barr virus (EBV)-encoded latent membrane protein 1 (LMP1) is expressed in germinal-center-derived, mononuclear Hodgkin (H) and multinuclear, diagnostic Reed-Sternberg (RS) cells in classical EBV-positive Hodgkin's lymphoma (cHL). LMP1 expression in EBV-negative H-cell lines results in a significantly increased number of RS cells. In a conditional, germinal-center-derived B-cell in vitro system, LMP1 reversibly down-regulates the shelterin proteins, telomeric repeat binding factor (TRF)1, TRF2, and protection of telomeres (POT)1. This down-regulation is associated with progressive 3D shelterin disruption, resulting in telomere dysfunction, progression of complex chromosomal rearrangements, and multinuclearity. TRF2 appears to be the key player. Thus, we hypothesize that the 3D interaction of telomeres and TRF2 is disrupted in H cells, and directly associated with the formation of H and RS cells. Using quantitative 3D co-immuno-TRF2-telomere fluorescent in situ hybridization (3D TRF2/Telo-Q-FISH) applied to monolayers of primary H and RS cells, we demonstrate TRF2-telomere dysfunction in EBV-positive cHL. However, in EBV-negative cHL a second molecular mechanism characterized by massive up-regulation of TRF2, but attrition of telomere signals, is also identified. These facts point towards a shelterin-related pathogenesis of cHL, where two molecularly disparate mechanisms converge at the level of 3D Telomere-TRF2 interactions, leading to the formation of RS cells.

Diagnostic Categories in Autobiographical Accounts of Illness.

PubMed

Kelly, Michael P

2015-01-01

Working within frameworks drawn from the writings of Immanuel Kant, Alfred Schutz, and Kenneth Burke, this article examines the role that diagnostic categories play in autobiographical accounts of illness, with a special focus on chronic disease. Four lay diagnostic categories, each with different connections to formal medical diagnostic categories, serve as typifications to make sense of the way the lifeworld changes over the course of chronic illness. These diagnostic categories are used in conjunction with another set of typifications: lay epidemiologies, lay etiologies, lay prognostics, and lay therapeutics. Together these serve to construct and reconstruct the self at the center of the lifeworld. Embedded within the lay diagnostic categories are narratives of progression, regression, or stability, forms of typification derived from literary and storytelling genres. These narratives are developed by the self in autobiographical accounts of illness.

A Response to Factory Closings: A Career Development Approach.

ERIC Educational Resources Information Center

Deady, John; White, Winifred Parker

This report describes the Career Planning Center, formerly the Institute for Vocational Readiness program, run by the Student Services Division of the Milwaukee Area Technical College. It briefly describes services offered by the center which are focused around a comprehensive diagnostic approach, offering students help in developing a positive…

Aeroacoustic Codes for Rotor Harmonic and BVI Noise. CAMRAD.Mod1/HIRES: Methodology and Users' Manual

NASA Technical Reports Server (NTRS)

Boyd, D. Douglas, Jr.; Brooks, Thomas F.; Burley, Casey L.; Jolly, J. Ralph, Jr.

1998-01-01

This document details the methodology and use of the CAMRAD.Mod1/HIRES codes, which were developed at NASA Langley Research Center for the prediction of helicopter harmonic and Blade-Vortex Interaction (BVI) noise. CANMAD.Mod1 is a substantially modified version of the performance/trim/wake code CANMAD. High resolution blade loading is determined in post-processing by HIRES and an associated indicial aerodynamics code. Extensive capabilities of importance to noise prediction accuracy are documented, including a new multi-core tip vortex roll-up wake model, higher harmonic and individual blade control, tunnel and fuselage correction input, diagnostic blade motion input, and interfaces for acoustic and CFD aerodynamics codes. Modifications and new code capabilities are documented with examples. A users' job preparation guide and listings of variables and namelists are given.

Dual-Porosity Hollow Nanoparticles for the Immunoprotection and Delivery of Nonhuman Enzymes

PubMed Central

2015-01-01

Although enzymes of nonhuman origin have been studied for a variety of therapeutic and diagnostic applications, their use has been limited by the immune responses generated against them. The described dual-porosity hollow nanoparticle platform obviates immune attack on nonhuman enzymes paving the way to in vivo applications including enzyme-prodrug therapies and enzymatic depletion of tumor nutrients. This platform is manufactured with a versatile, scalable, and robust fabrication method. It efficiently encapsulates macromolecular cargos filled through mesopores into a hollow interior, shielding them from antibodies and proteases once the mesopores are sealed with nanoporous material. The nanoporous shell allows small molecule diffusion allowing interaction with the large macromolecular payload in the hollow center. The approach has been validated in vivo using l-asparaginase to achieve l-asparagine depletion in the presence of neutralizing antibodies. PMID:24471767

Examination of Sex Differences in a Large Sample of Young Children with Autism Spectrum Disorder and Typical Development

PubMed Central

Reinhardt, Vanessa P.; Wetherby, Amy M.; Schatschneider, Christopher

2014-01-01

Despite consistent and substantive research documenting a large male to female ratio in Autism Spectrum Disorder (ASD), only a modest body of research exists examining sex differences in characteristics. This study examined sex differences in developmental functioning and early social communication in children with ASD as compared to children with typical development. Sex differences in adaptive behavior and autism symptoms were also examined in children with ASD. Participants (n = 511) were recruited from the Florida State University FIRST WORDS® Project and University of Michigan Autism and Communication Disorders Center. Analyses did not reveal significant effects of sex or a diagnostic group by sex interaction, suggesting a similar phenotype in males and females early in development. Further research is needed to examine sex differences across development. PMID:25189824

PLIF Study of Mars Science Laboratory Capsule Reaction Control System Jets

NASA Technical Reports Server (NTRS)

Johansen, C. T.; Danehy, P. M.; Ashcraft, S. W.; Bathel, B. F.; Inman, J. A.; Jones, S. B.

2011-01-01

Nitric-oxide planar laser-induced fluorescence (NO PLIF) was used to visualize the flow in the wake of a Mars Science Lab (MSL) entry capsule with activated reaction control system (RCS) jets in NASA Langley Research Center s 31-Inch Mach 10 Air Tunnel facility. Images were processed using the Virtual Diagnostics Interface (ViDI) method, which brings out the three-dimensional nature of the flow visualization data while showing the relative location of the data with respect to the model. Comparison of wind-on and wind-off results illustrates the effect that the hypersonic crossflow has on the trajectory and structure of individual RCS jets. The visualization and comparison of both single and multiple activated RCS jets indicate low levels of jet-jet interaction. Quantitative streamwise velocity was also obtained via NO PLIF molecular tagging velocimetry (MTV).

PLIF Study of Mars Science Laboratory Capsule Reaction Control System Jets

NASA Technical Reports Server (NTRS)

Johansen, C. T.; Danehy, P. M.; Ashcraft, S. W.; Bathel, B. F.; Inman, J. A.; Jones, S. B.

2011-01-01

Nitric-oxide planar laser-induced fluorescence (NO PLIF) was used to visualize the flow in the wake of a Mars Science Lab (MSL) entry capsule with activated reaction control system (RCS) jets in NASA Langley Research Center's 31-Inch Mach 10 Air Tunnel facility. Images were processed using the Virtual Diagnostics Interface (ViDI) method, which brings out the three-dimensional nature of the flow visualization data while showing the relative location of the data with respect to the model. Comparison of wind-on and wind-off results illustrates the effect that the hypersonic crossflow has on the trajectory and structure of individual RCS jets. The visualization and comparison of both single and multiple activated RCS jets indicate low levels of jet-jet interaction. Quantitative streamwise velocity was also obtained via NO PLIF molecular tagging velocimetry (MTV).

Improving Pathologists' Communication Skills.

PubMed

Dintzis, Suzanne

2016-08-01

The 2015 Institute of Medicine report on diagnostic error has placed a national spotlight on the importance of improving communication among clinicians and between clinicians and patients [1]. The report emphasizes the critical role that communication plays in patient safety and outlines ways that pathologists can support this process. Despite recognition of communication as an essential element in patient care, pathologists currently undergo limited (if any) formal training in communication skills. To address this gap, we at the University of Washington Medical Center developed communication training with the goal of establishing best practice procedures for effective pathology communication. The course includes lectures, role playing, and simulated clinician-pathologist interactions for training and evaluation of pathology communication performance. Providing communication training can help create reliable communication pathways that anticipate and address potential barriers and errors before they happen. © 2016 American Medical Association. All Rights Reserved.

Effects of the Caregiver Interaction Profile Training on Caregiver-Child Interactions in Dutch Child Care Centers: A Randomized Controlled Trial

ERIC Educational Resources Information Center

Helmerhorst, Katrien O.; Riksen-Walraven, J. Marianne; Fukkink, Ruben G.; Tavecchio, Louis W. C.; Gevers Deynoot-Schaub, Mirjam J. J. M.

2017-01-01

Background: Previous studies underscore the need to improve caregiver-child interactions in early child care centers. Objective: In this study we used a randomized controlled trial to examine whether a 5-week video feedback training can improve six key interactive skills of caregivers in early child care centers: Sensitive responsiveness, respect…

University of Saskatchewan Radiology Courseware (USRC): an assessment of its utility for teaching diagnostic imaging in the medical school curriculum.

PubMed

Burbridge, Brent; Kalra, Neil; Malin, Greg; Trinder, Krista; Pinelle, David

2015-01-01

We have found it very challenging to integrate images from our radiology digital imaging repository into the curriculum of our local medical school. Thus, it has been difficult to convey important knowledge related to viewing and interpreting diagnostic radiology images. We sought to determine if we could create a solution for this problem and evaluate whether students exposed to this solution were able to learn imaging concepts pertinent to medical practice. We developed University of Saskatchewan Radiology Courseware (USRC), a novel interactive web application that enables preclinical medical students to acquire image interpretation skills fundamental to clinical practice. This web application reformats content stored in Medical Imaging Resource Center teaching cases for BlackBoard Learn™, a popular learning management system. We have deployed this solution for 2 successive years in a 1st-year basic sciences medical school course at the College of Medicine, University of Saskatchewan. The "courseware" content covers both normal anatomy and common clinical pathologies in five distinct modules. We created two cohorts of learners consisting of an intervention cohort of students who had used USRC for their 1st academic year, whereas the nonintervention cohort was students who had not been exposed to this learning opportunity. To assess the learning experience of the users we designed an online questionnaire and image review quiz delivered to both of the student groups. Comparisons between the groups revealed statistically significant differences in both confidence with image interpretation and the ability to answer knowledge-based questions. Students were satisfied with the overall usability, functions, and capabilities of USRC. USRC is an innovative technology that provides integration between Medical Imaging Resource Center, a teaching solution used in radiology, and a Learning Management System.

Transbronchial cryobiopsy for diffuse parenchymal lung disease: a state-of-the-art review of procedural techniques, current evidence, and future challenges.

PubMed

Lentz, Robert J; Argento, A Christine; Colby, Thomas V; Rickman, Otis B; Maldonado, Fabien

2017-07-01

Transbronchial lung biopsy with a cryoprobe, or cryobiopsy, is a promising new bronchoscopic biopsy technique capable of obtaining larger and better-preserved samples than previously possible using traditional biopsy forceps. Over two dozen case series and several small randomized trials are now available describing experiences with this technique, largely for the diagnosis of diffuse parenchymal lung disease (DPLD), in which the reported diagnostic yield is typically 70% to 80%. Cryobiopsy technique varies widely between centers and this predominantly single center-based retrospective literature heterogeneously defines diagnostic yield and complications, limiting the degree to which this technique can be compared between centers or to surgical lung biopsy (SLB). This review explores the broad range of cryobiopsy techniques currently in use, their rationale, the current state of the literature, and suggestions for the direction of future study into this promising but unproven procedure.

iCBLS: An interactive case-based learning system for medical education.

PubMed

Ali, Maqbool; Han, Soyeon Caren; Bilal, Hafiz Syed Muhammad; Lee, Sungyoung; Kang, Matthew Jee Yun; Kang, Byeong Ho; Razzaq, Muhammad Asif; Amin, Muhammad Bilal

2018-01-01

Medical students should be able to actively apply clinical reasoning skills to further their interpretative, diagnostic, and treatment skills in a non-obtrusive and scalable way. Case-Based Learning (CBL) approach has been receiving attention in medical education as it is a student-centered teaching methodology that exposes students to real-world scenarios that need to be solved using their reasoning skills and existing theoretical knowledge. In this paper, we propose an interactive CBL System, called iCBLS, which supports the development of collaborative clinical reasoning skills for medical students in an online environment. The iCBLS consists of three modules: (i) system administration (SA), (ii) clinical case creation (CCC) with an innovative semi-automatic approach, and (iii) case formulation (CF) through intervention of medical students' and teachers' knowledge. Two evaluations under the umbrella of the context/input/process/product (CIPP) model have been performed with a Glycemia study. The first focused on the system satisfaction, evaluated by 54 students. The latter aimed to evaluate the system effectiveness, simulated by 155 students. The results show a high success rate of 70% for students' interaction, 76.4% for group learning, 72.8% for solo learning, and 74.6% for improved clinical skills. Copyright © 2017 Elsevier B.V. All rights reserved.

Research Reports from the First Pre-ICME Satellite Conference on Diagnostic and Prescriptive Mathematics (Monash University, Melbourne, Australia, August 21-22, 1984).

ERIC Educational Resources Information Center

Blane, Dudley, Ed.

Provided are the papers presented at a conference which served as an international forum on diagnostic and prescriptive mathematics education. They are: (1) "The Evolution of the Research Council for Diagnostic and Prescriptive Mathematics" by Robert Underhill; (2) "The Interaction of Knowledge and Cognitive Processes in Diagnosis…

Script-theory virtual case: A novel tool for education and research.

PubMed

Hayward, Jake; Cheung, Amandy; Velji, Alkarim; Altarejos, Jenny; Gill, Peter; Scarfe, Andrew; Lewis, Melanie

2016-11-01

Context/Setting: The script theory of diagnostic reasoning proposes that clinicians evaluate cases in the context of an "illness script," iteratively testing internal hypotheses against new information eventually reaching a diagnosis. We present a novel tool for teaching diagnostic reasoning to undergraduate medical students based on an adaptation of script theory. We developed a virtual patient case that used clinically authentic audio and video, interactive three-dimensional (3D) body images, and a simulated electronic medical record. Next, we used interactive slide bars to record respondents' likelihood estimates of diagnostic possibilities at various stages of the case. Responses were dynamically compared to data from expert clinicians and peers. Comparative frequency distributions were presented to the learner and final diagnostic likelihood estimates were analyzed. Detailed student feedback was collected. Over two academic years, 322 students participated. Student diagnostic likelihood estimates were similar year to year, but were consistently different from expert clinician estimates. Student feedback was overwhelmingly positive: students found the case was novel, innovative, clinically authentic, and a valuable learning experience. We demonstrate the successful implementation of a novel approach to teaching diagnostic reasoning. Future study may delineate reasoning processes associated with differences between novice and expert responses.

[Operation and interaction peculiarities of diagnostic laboratories involved in providing protection from infectious diseases during the XXII Olympic Winter Games and XI Paralympic Winter Games 2014 in Sochi].

PubMed

Onishenko, G G; Popova, A Iu; Bragina, I V; Kuz'kin, B P; Ezhlova, E B; Demina, Iu V; Gus'kov, A S; Ivanov, G E; Chikina, L V; Klindukhova, V P; Grechanaia, T V; Tesheva, S Ch; Kulichenko, A N; Efremenko, D B; Manin, E A; Kuznetsova, I V; Parkhomenko, V V; Kulichenko, O A; Rafeenko, G K; Shcherbina, L I; Zavora, D L; Briukhanov, A F; Eldinova, V E; Iunicheva, Iu V; Derliatko, S K; Komarov, N S

2015-01-01

The experience of the organization and functioning of the laboratory network during the XXII Olympic Winter Games and XI Paralympic Winter Games of 2014 in Sochi is considered. Efforts to establish an effective system of laboratory support, the order of work and interaction of diagnostic laboratories involved in diseases control of population during the Olympic Games are analyzed.

Patchwork diagnoses: the production of coherence, uncertainty, and manageable bodies.

PubMed

Gardner, John; Dew, Kevin; Stubbe, Maria; Dowell, Tony; Macdonald, Lindsay

2011-09-01

Using a material semiotics methodology, this paper explores the link between diagnostic practices, patient awareness of the body, and biopolitical governance. We collected video and audio recordings of a patient with chest pain involved in three medical interactions (a general practitioner [GP] consultation, an electrocardiogram stress test and a consultation with a cardiologist) in Wellington, New Zealand. Following the work of Annemarie Mol, we argue that each of these diagnostics interactions bring together a range of material and non-material entities that enact the body and disease. Consequently, we note how the diagnostic practices associated with cardiovascular medicine enable and prompt an awareness of the body based on uncertainty, and thus promotes the self-management of cardiac health and risk. This paper illustrates that a material semiotics methodology makes important contributions to the sociology of diagnosis. Firstly, it draws attention to the relationship between humans and material entities in rendering the body intelligible. Secondly, it illustrates that different diagnostic procedures can produce multiple, potentially conflicting, forms of self-awareness. Alongside these practices generating multiplicity, however, are those that presuppose and produce singularity and coherence. We illustrate how the cardiologist "patches" two potentially conflicting diagnoses together in order to provide a sense of coherence to the interactions. Thirdly, material semiotics illustrates how various diagnostic practices can reify risk, and produce bodies that lend themselves to particular forms of governance. Copyright © 2011 Elsevier Ltd. All rights reserved.

A Study in Child Care (Case Study from Volume II-A): "Children as 'Kids'." Day Care Programs Reprint Series.

ERIC Educational Resources Information Center

O'Farrell, Brigid

The Georgetown Day Care Center, in Washington, D.C., is dually sponsored by a large hospital and a private non-profit organization and offers day care services to a small number of the children of parents who work at the hospital. The center also functions as a halfway house for children in a diagnostic center which identifies preschool children…

Quasi-Experimental Study: Head Start Preschoolers' Cognitive Development as Assessed by the Learning Accomplishment Profile--Diagnostic

ERIC Educational Resources Information Center

Hines, Jeanne M.

2014-01-01

Abstract Preschoolers' cognitive abilities were assessed each year as part of the Head Start Program requirements. The Head Start PK-4 Center evaluated preschoolers' cognition by administering the Learning Accomplishment Profile-Diagnostic (LAP-D), as a pretest and posttest measure. The LAP-D study used archival data collected from the 2009-2010…

78 FR 28866 - Cooperative Research and Development Agreement (CRADA) Opportunity With the Department of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-16

...-Mouth Disease 3ABC ELISA Diagnostic Kit AGENCY: Science and Technology Directorate, Plum Island Animal... Center (PIADC), is seeking industry collaborators to aid DHS S&T in developing an ELISA diagnostic test... and Mouth Disease virus (FMDV) non-structural proteins (NSP): 3A, 3B, or 3C. This new FMDV 3ABC ELISA...

View of the Challenger's payload bay and the Plasma Diagnostic package

NASA Technical Reports Server (NTRS)

1985-01-01

The solar optical universal polarimeter (SOUP) experiment is visible among the cluster of Spacelab 2 hardware in the cargo bay of the Shuttle Challenger. Various components of the instrument positioning system (IPS) are conspicuous at the center of the frame. The Plasma Diagnostic package (PDP) is seen attached to the remote manipulator system (RMS) above the open payload bay.

Reductions in Circulating Endocannabinoid Levels in Individuals with Post-Traumatic Stress Disorder Following Exposure to the World Trade Center Attacks

PubMed Central

Hill, Matthew N.; Bierer, Linda M.; Makotkine, Iouri; Golier, Julia A.; Galea, Sandro; McEwen, Bruce S.; Hillard, Cecilia J.; Yehuda, Rachel

2013-01-01

Endocannabinoid (eCB) signaling has been identified as a modulator of adaptation to stress, and is integral to basal and stress-induced glucocorticoid regulation. Furthermore, interactions between eCBs and glucocorticoids have been shown to be necessary for the regulation of emotional memories, suggesting that eCB function may relate to the development of post-traumatic stress disorder (PTSD). To examine this, plasma eCBs were measured in a sample (n=46) drawn from a population-based cohort selected for physical proximity to the World Trade Center (WTC) at the time of the 9/11 attacks. Participants received a structured diagnostic interview and were grouped according to whether they met diagnostic criteria for PTSD (no PTSD, n=22; lifetime diagnosis of PTSD = 24). eCB content (2-arachidonoylglycerol (2-AG) and anandamide (AEA)) and cortisol were measured from 8 a.m. plasma samples. Circulating 2-AG content was significantly reduced among individuals meeting diagnostic criteria for PTSD. The effect of reduced 2-AG content in PTSD remained significant after controlling for the stress of exposure to the WTC collapse, gender, depression and alcohol abuse. There were no significant group differences for AEA or cortisol levels; however, across the whole sample AEA levels positively correlated with circulating cortisol, and AEA levels exhibited a negative relationship with the degree of intrusive symptoms within the PTSD sample. This report shows that PTSD is associated with a reduction in circulating levels of the eCB 2-AG. Given the role of 2-AG in the regulation of the stress response, these data support the hypothesis that deficient eCB signaling may be a component of the glucocorticoid dysregulation associated with PTSD. The negative association between AEA levels and intrusive symptoms is consistent with animal data indicating that reductions in AEA promote retention of aversive emotional memories. Future work will aim to replicate these findings and extend their relevance to clinical pathophysiology, as well as to neuroendocrine and molecular markers of PTSD. PMID:24035186

Multispectral autofluorescence diagnosis of non-melanoma cutaneous tumors

NASA Astrophysics Data System (ADS)

Borisova, Ekaterina; Dogandjiiska, Daniela; Bliznakova, Irina; Avramov, Latchezar; Pavlova, Elmira; Troyanova, Petranka

2009-07-01

Fluorescent analysis of basal cell carcinoma (BCC), squamous cell carcinoma (SCC), keratoacanthoma and benign cutaneous lesions is carried out under initial phase of clinical trial in the National Oncological Center - Sofia. Excitation sources with maximum of emission at 365, 380, 405, 450 and 630 nm are applied for better differentiation between nonmelanoma malignant cutaneous lesions fluorescence and spectral discrimination from the benign pathologies. Major spectral features are addressed and diagnostic discrimination algorithms based on lesions' emission properties are proposed. The diagnostic algorithms and evaluation procedures found will be applied for development of an optical biopsy clinical system for skin cancer detection in the frames of National Oncological Center and other university hospital dermatological departments in our country.

Proposed biopsy performance benchmarks for MRI based on an audit of a large academic center.

PubMed

Sedora Román, Neda I; Mehta, Tejas S; Sharpe, Richard E; Slanetz, Priscilla J; Venkataraman, Shambhavi; Fein-Zachary, Valerie; Dialani, Vandana

2018-05-01

Performance benchmarks exist for mammography (MG); however, performance benchmarks for magnetic resonance imaging (MRI) are not yet fully developed. The purpose of our study was to perform an MRI audit based on established MG and screening MRI benchmarks and to review whether these benchmarks can be applied to an MRI practice. An IRB approved retrospective review of breast MRIs was performed at our center from 1/1/2011 through 12/31/13. For patients with biopsy recommendation, core biopsy and surgical pathology results were reviewed. The data were used to derive mean performance parameter values, including abnormal interpretation rate (AIR), positive predictive value (PPV), cancer detection rate (CDR), percentage of minimal cancers and axillary node negative cancers and compared with MG and screening MRI benchmarks. MRIs were also divided by screening and diagnostic indications to assess for differences in performance benchmarks amongst these two groups. Of the 2455 MRIs performed over 3-years, 1563 were performed for screening indications and 892 for diagnostic indications. With the exception of PPV2 for screening breast MRIs from 2011 to 2013, PPVs were met for our screening and diagnostic populations when compared to the MRI screening benchmarks established by the Breast Imaging Reporting and Data System (BI-RADS) 5 Atlas ® . AIR and CDR were lower for screening indications as compared to diagnostic indications. New MRI screening benchmarks can be used for screening MRI audits while the American College of Radiology (ACR) desirable goals for diagnostic MG can be used for diagnostic MRI audits. Our study corroborates established findings regarding differences in AIR and CDR amongst screening versus diagnostic indications. © 2017 Wiley Periodicals, Inc.

Finding the Missing Patients With Tuberculosis: Lessons Learned From Patient-Pathway Analyses in 5 Countries.

PubMed

Hanson, Christy; Osberg, Mike; Brown, Jessie; Durham, George; Chin, Daniel P

2017-11-06

Despite significant progress in diagnosis and treatment of tuberculosis over the past 2 decades, millions of patients with tuberculosis go unreported every year. The patient-pathway analysis (PPA) is designed to assess the alignment between tuberculosis care-seeking patterns and the availability of tuberculosis services. The PPA can help programs understand where they might find the missing patients with tuberculosis. This analysis aggregates and compares the PPAs from case studies in Kenya, Ethiopia, Indonesia, the Philippines, and Pakistan. Across the 5 countries, 24% of patients with tuberculosis initiated care seeking in a facility with tuberculosis diagnostic capacity. Forty-two percent of patients sought care at level 0 facilities, where there was generally no tuberculosis diagnostic capacity; another 42% of patients sought care at level 1 facilities, of which 39% had diagnostic capacity. Sixty-six percent of patients initially sought care in private facilities, which had considerably less tuberculosis diagnostic capacity than public facilities; only 7% of notified cases were from the private sector. The GeneXpert system was available in 14%-41% of level 2 facilities in the 3 countries for which there were data. Tuberculosis treatment capacity tracked closely with the availability of diagnostic capacity. There were substantial subnational differences in care-seeking patterns and service availability. The PPA can be a valuable planning and programming tool to ensure that diagnostic and treatment services are available to patients where they seek care. Patient-centered care will require closing the diagnostic gap and engaging the private sector. Extensive subnational differences in patient pathways to care call for differentiated approaches to patient-centered care. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Variation in Results Release and Patient Portal Access to Diagnostic Test Results at an Academic Medical Center

PubMed Central

Krasowski, Matthew D.; Grieme, Caleb V.; Cassady, Brian; Dreyer, Nicholas R.; Wanat, Karolyn A.; Hightower, Maia; Nepple, Kenneth G.

2017-01-01

Background: Electronic health records (EHRs) are commonplace in industrialized countries. Many hospitals are granting their patients access to their medical information through online patient portals. In this report, we describe a retrospective analysis of patient access to diagnostic test results released through the patient portal (MyChart; Epic, Inc.) at a state academic medical center. Methods: We analyzed 6 months of data for anatomic pathology, clinical laboratory, and radiology test results to evaluate variations in results release (automated vs. manual) and subsequent patient access to the institutional patient portal. During this period, diagnostic test results were released for all patient encounters including inpatient units, outpatient clinics, and the emergency department. Results: Manual results release by providers before automated release time occurred most commonly in the outpatient setting. The highest rates of access of diagnostic test results occurred for outpatients (about 30% overall view rate), females (two times or more compared to males in nearly every age bracket), and 20–45-year-old. Access rates of diagnostic tests in the emergency department or inpatient units were <10% across all populations. Access of diagnostic test results was very low for 12–17-year-old, likely influenced by institutional policies limiting parental proxy access within this pediatric age range. Approximately 20% of outpatient laboratory results were viewed by patients within 8 h of release from the EHR to the patient portal and 10% within 2 h of release. Conclusions: Patient accessing of diagnostic test results were generally higher for females, outpatients, and 20–45-year-old. Approximately, 20% of outpatient results were viewed quickly by patients after release to the EHR. PMID:29226008

Variation in Results Release and Patient Portal Access to Diagnostic Test Results at an Academic Medical Center.

PubMed

Krasowski, Matthew D; Grieme, Caleb V; Cassady, Brian; Dreyer, Nicholas R; Wanat, Karolyn A; Hightower, Maia; Nepple, Kenneth G

2017-01-01

Electronic health records (EHRs) are commonplace in industrialized countries. Many hospitals are granting their patients access to their medical information through online patient portals. In this report, we describe a retrospective analysis of patient access to diagnostic test results released through the patient portal (MyChart; Epic, Inc.) at a state academic medical center. We analyzed 6 months of data for anatomic pathology, clinical laboratory, and radiology test results to evaluate variations in results release (automated vs. manual) and subsequent patient access to the institutional patient portal. During this period, diagnostic test results were released for all patient encounters including inpatient units, outpatient clinics, and the emergency department. Manual results release by providers before automated release time occurred most commonly in the outpatient setting. The highest rates of access of diagnostic test results occurred for outpatients (about 30% overall view rate), females (two times or more compared to males in nearly every age bracket), and 20-45-year-old. Access rates of diagnostic tests in the emergency department or inpatient units were <10% across all populations. Access of diagnostic test results was very low for 12-17-year-old, likely influenced by institutional policies limiting parental proxy access within this pediatric age range. Approximately 20% of outpatient laboratory results were viewed by patients within 8 h of release from the EHR to the patient portal and 10% within 2 h of release. Patient accessing of diagnostic test results were generally higher for females, outpatients, and 20-45-year-old. Approximately, 20% of outpatient results were viewed quickly by patients after release to the EHR.

Finding the Missing Patients With Tuberculosis: Lessons Learned From Patient-Pathway Analyses in 5 Countries

PubMed Central

Hanson, Christy; Osberg, Mike; Brown, Jessie; Durham, George; Chin, Daniel P

2017-01-01

Abstract Background Despite significant progress in diagnosis and treatment of tuberculosis over the past 2 decades, millions of patients with tuberculosis go unreported every year. The patient-pathway analysis (PPA) is designed to assess the alignment between tuberculosis care-seeking patterns and the availability of tuberculosis services. The PPA can help programs understand where they might find the missing patients with tuberculosis. Methods This analysis aggregates and compares the PPAs from case studies in Kenya, Ethiopia, Indonesia, the Philippines, and Pakistan. Results Across the 5 countries, 24% of patients with tuberculosis initiated care seeking in a facility with tuberculosis diagnostic capacity. Forty-two percent of patients sought care at level 0 facilities, where there was generally no tuberculosis diagnostic capacity; another 42% of patients sought care at level 1 facilities, of which 39% had diagnostic capacity. Sixty-six percent of patients initially sought care in private facilities, which had considerably less tuberculosis diagnostic capacity than public facilities; only 7% of notified cases were from the private sector. The GeneXpert system was available in 14%–41% of level 2 facilities in the 3 countries for which there were data. Tuberculosis treatment capacity tracked closely with the availability of diagnostic capacity. There were substantial subnational differences in care-seeking patterns and service availability. Discussion The PPA can be a valuable planning and programming tool to ensure that diagnostic and treatment services are available to patients where they seek care. Patient-centered care will require closing the diagnostic gap and engaging the private sector. Extensive subnational differences in patient pathways to care call for differentiated approaches to patient-centered care. PMID:29117351

Key Results of Interaction Models with Centering

ERIC Educational Resources Information Center

Afshartous, David; Preston, Richard A.

2011-01-01

We consider the effect on estimation of simultaneous variable centering and interaction effects in linear regression. We technically define, review, and amplify many of the statistical issues for interaction models with centering in order to create a useful and compact reference for teachers, students, and applied researchers. In addition, we…

Strategic planning for radiology: opening an outpatient diagnostic imaging center.

PubMed

Leepson, Evan

2003-01-01

Launching a new diagnostic imaging center involves very specific requirements and roadmaps, including five major areas of change that have a direct impact on planning: Imaging and communication technology Finances and reimbursement Ownership structure of imaging entities Critical workforce shortages Imaging is moving outside radiology First, planning must focus on the strategic level of any organization, whether it is a multi-national corporation or a six-person radiology group. Think of all organizations as a triangle with three horizontal levels: strategic, managerial and operational. The strategic level of decision-making is at the top of the triangle, and here is where planning must take place. For strategic planning to work, there must be focused time and energy spent on this activity, usually away from the reading room and imaging center. There are five planning strategies, which must have the explicit goal of developing and growing the imaging center. The five strategies are: Clinical and quality issues, Governance and administration, Technology, Relationships, Marketing and business development. The best way to plan and implement these strategies is to create work groups of radiologists, technologists, and administrative and support staff. Once the group agrees on the strategy and tactic, it takes responsibility for implementation. Embarking on the launch of a new outpatient diagnostic imaging center is no small undertaking, and anyone who has struggled with such an endeavor can readily attest to the associated challenges and benefits. Success depends on many things, and one of the most important factors relates to the amount of time and the quality of effort spent on strategic planning at the outset. Neglecting or skimping on this phase may lead to unforeseen obstacles that could potentially derail the project.

Glycoconjugates in Host-Helminth Interactions

PubMed Central

Prasanphanich, Nina Salinger; Mickum, Megan L.; Heimburg-Molinaro, Jamie; Cummings, Richard D.

2013-01-01

Helminths are multicellular parasitic worms that comprise a major class of human pathogens and cause an immense amount of suffering worldwide. Helminths possess an abundance of complex and unique glycoconjugates that interact with both the innate and adaptive arms of immunity in definitive and intermediate hosts. These glycoconjugates represent a major untapped reservoir of immunomodulatory compounds, which have the potential to treat autoimmune and inflammatory disorders, and antigenic glycans, which could be exploited as vaccines and diagnostics. This review will survey current knowledge of the interactions between helminth glycans and host immunity and highlight the gaps in our understanding which are relevant to advancing therapeutics, vaccine development, and diagnostics. PMID:24009607

Clinical Research and Development of Tuberculosis Diagnostics: Moving From Silos to Synergy

PubMed Central

Kim, Peter S.; Evans, Carlton A.; Alland, David; Barer, Michael; Diefenbach, Jane; Ellner, Jerrold; Hafner, Richard; Hamilton, Carol Dukes; Iademarco, Michael F.; Ireton, Gregory; Kimerling, Michael E.; Lienhardt, Christian; MacKenzie, William R.; Murray, Megan; Perkins, Mark D.; Posey, Jamie E.; Roberts, Teri; Sizemore, Christine; Stevens, Wendy S.; Via, Laura; Williams, Sharon D.; Yew, Wing W.; Swindells, Susan

2012-01-01

The development, evaluation, and implementation of new and improved diagnostics have been identified as critical needs by human immunodeficiency virus (HIV) and tuberculosis researchers and clinicians alike. These needs exist in international and domestic settings and in adult and pediatric populations. Experts in tuberculosis and HIV care, researchers, healthcare providers, public health experts, and industry representatives, as well as representatives of pertinent US federal agencies (Centers for Disease Control and Prevention, Food and Drug Administration, National Institutes of Health, United States Agency for International Development) assembled at a workshop proposed by the Diagnostics Working Group of the Federal Tuberculosis Taskforce to review the state of tuberculosis diagnostics development in adult and pediatric populations. PMID:22476718

The relative frequency of common neuromuscular diagnoses in a reference center.

PubMed

Cotta, Ana; Paim, Júlia Filardi; Carvalho, Elmano; da-Cunha-Júnior, Antonio Lopes; Navarro, Monica M; Valicek, Jaquelin; Menezes, Miriam Melo; Nunes, Simone Vilela; Xavier-Neto, Rafael; Baptista, Sidney; Lima, Luciano Romero; Takata, Reinaldo Issao; Vargas, Antonio Pedro

2017-11-01

The diagnostic procedure in neuromuscular patients is complex. Knowledge of the relative frequency of neuromuscular diseases within the investigated population is important to allow the neurologist to perform the most appropriate diagnostic tests. To report the relative frequency of common neuromuscular diagnoses in a reference center. A 17-year chart review of patients with suspicion of myopathy. Among 3,412 examinations, 1,603 (46.98%) yielded confirmatory results: 782 (48.78%) underwent molecular studies, and 821 (51.21%) had muscle biopsies. The most frequent diagnoses were: dystrophinopathy 460 (28.70%), mitochondriopathy 330 (20.59%), spinal muscular atrophy 158 (9.86%), limb girdle muscular dystrophy 157 (9.79%), Steinert myotonic dystrophy 138 (8.61%), facioscapulohumeral muscular dystrophy 99 (6.17%), and other diagnoses 261 (16.28%). Using the presently-available diagnostic techniques in this service, a specific limb girdle muscular dystrophy subtype diagnosis was reached in 61% of the patients. A neuromuscular-appropriate diagnosis is important for genetic counseling, rehabilitation orientation, and early treatment of respiratory and cardiac complications.

The utilization of circulating cell-free fetal DNA testing and decrease in invasive diagnostic procedures: an institutional experience.

PubMed

Pettit, K E; Hull, A D; Korty, L; Jones, M C; Pretorius, D H

2014-10-01

To characterize the patient population utilizing circulating cell-free fetal DNA (ccffDNA) testing at a large academic center and evaluate trends in the performance of invasive diagnostic procedures. A retrospective cohort study of all patients who underwent cell-free DNA testing from May to December 2012 was performed. During the study period, 206 patients had cell-free DNA testing. Of those, 75% (155/206) were of ages ⩾ 35 years. Of those undergoing ccffDNA testing, 41% had positive aneuploidy screening and 38% had abnormal ultrasound findings. Only 7% of the patients with negative ccffDNA testing opted for an invasive diagnostic procedure compared with 60% with positive testing (P<0.01). The rate of invasive procedures decreased from 5.9% of all visits to the center during a similar 8-month period in 2010 to 4.1% of all visits during the study period (P<0.01). Our data suggest that ccffDNA testing leads to reduced uptake of invasive procedures.

The Palm Desert renewable [hydrogen] transportation system

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

Chamberlin, C.E.; Lehman, P.

1998-08-01

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

National Site for the Regional IPM Centers

Science.gov Websites

Agriculture USDA Soybean Rust Web Site Latest News - Southern Plant Diagnostic Network Soybean Rust Pest Alert , contact: Kent Smith, (202) 720-3186, ksmith@ars.usda.gov United States Department of Agriculture - National Institute of Food and Agriculture Website managed by the Southern IPM Center. Design adapted from

Research Technology

NASA Image and Video Library

2002-07-01

Dr. Tom Markusic, a propulsion research engineer at the Marshall Space Flight Center (MSFC), adjusts a diagnostic laser while a pulsed plasma thruster (PPT) fires in a vacuum chamber in the background. NASA/MSFC's Propulsion Research Center (PRC) is presently investigating plasma propulsion for potential use on future nuclear-powered spacecraft missions, such as human exploration of Mars.

Bringing Precision Medicine to Community Oncologists.

PubMed

2017-01-01

Quest Diagnostics has teamed up with Memorial Sloan Kettering Cancer Center and IBM Watson Health to offer IBM Watson Genomics to its network of community cancer centers and hospitals. This new service aims to advance precision medicine by combining genomic tumor sequencing with the power of cognitive computing. ©2017 American Association for Cancer Research.

76 FR 33322 - Center for Scientific Review; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-08

... Scientific Review Special Emphasis Panel, Member Conflict: Cancer Therapeutics. Date: June 29, 2011. Time: 1... . Name of Committee: Center for Scientific Review Special Emphasis Panel, Small Business: Cancer Diagnostics and Treatments. Date: July 12-13, 2011. Time: 10 a.m. to 6 p.m. Agenda: To review and evaluate...

National Centers for Environmental Prediction

Science.gov Websites

available at IMD Click here to go to the Special Report page Aug 2016 - IITM started experimental real-time Experimental version of GFS 10.0.0 ported to IITM & NCMRWF - February 2012 EnKF Hybrid GSI update - Spring diagnostics *Experimental* Climate Prediction Center (CPC) links... African Desk: SWFDP GFS forecasts South

Measuring the spacecraft and environmental interactions of the 8-cm mercury ion thrusters on the P80-1 mission

NASA Technical Reports Server (NTRS)

Power, J. L.

1981-01-01

The subject interface measurements are described for the Ion Auxiliary Propulsion System (IAPS) flight test of two 8-cm thrusters. The diagnostic devices and the effects to be measured include: 1) quartz crystal microbalances to detect nonvolatile deposition due to thruster operation; 2) warm and cold solar cell monitors for nonvolatile and volatile (mercury) deposition; 3) retarding potential ion collectors to characterize the low energy thruster ionic efflux; and 4) a probe to measure the spacecraft potential and thruster generated electron currents to biased spacecraft surfaces. The diagnostics will also assess space environmental interactions of the spacecraft and thrusters. The diagnostic data will characterize mercury thruster interfaces and provide data useful for future applications.

Mapping the filaments in NGC 1275

NASA Astrophysics Data System (ADS)

Cobos, Aracely Susan; Rich, Jeffrey; Great Observatories All-sky LIRG Survey (GOALS)

2018-01-01

The giant elliptical brightest cluster galaxies (BCGs) at the centers of many massive clusters are often surrounded by drawn-out forms of gaseous material. It is believed that this gaseous material is gas condensing from the intracluster medium (ICM) in a “cooling flow,” and it can directly impact the growth of the BCG. The galaxy NGC 1275 is one of the closest giant elliptical BCGs and lies at the center of the Perseus cluster. NGC 1275 has large filaments that are thought to be associated with a cooling flow, but they may also be affected by its AGN. To investigate the relationship between the AGN and the cooling flow we have mapped the filaments around NGC 1275 with the Cosmic Web Imager, an image-slicing integral field spectrograph at Palomar Observatories. We employ standard emission-line ratio diagnostics to determine the source of ionizing radiation. We use our analysis to investigate whether the formation of the extended filaments is a result of gas from the ICM collapsing onto the galaxy as it cools or if it is possible that the filaments are a result of the cluster’s interaction with the outflow driven by the AGN.

Multimedia communications and services for the healthcare community

NASA Astrophysics Data System (ADS)

Robinson, James M.

1994-11-01

The NYNEX Media Broadband Service Trials in Boston examined the use of several multiple media applications from healthcare in conjunction with high speed fiber optic networks. As part of these trials, NYNEX developed a network-based software technology that simplifies and coordinates the delivery of complex voice, data, image, and video information. This permits two or more users to interact and collaborate with one another while sharing, displaying, and manipulating various media types. Different medical applications were trialed at four of Boston's major hospitals, ranging from teleradiology (which tested the quality of the diagnostic images and the need to collaborate) to telecardiology (which displayed diagnostic quality digital movies played in synchronicity). These trials allowed NYNEX to uniquely witness the needs and opportunities in the healthcare community for broadband communications with the necessary control capabilities and simplified user interface. As a result of the success of the initial trials, NYNEX has created a new business unit, Media Communications Services (MCS), to deliver a service offering based on this capability. New England Medical Center, as one of the initial trial sites, was chosen as a beta trial candidate, and wanted to further its previous work in telecardiology as well as telepsychiatry applications. Initial and subsequent deployments have been completed, and medical use is in progress.

The effect of information technology on hospital performance.

PubMed

Williams, Cynthia; Asi, Yara; Raffenaud, Amanda; Bagwell, Matt; Zeini, Ibrahim

2016-12-01

While healthcare entities have integrated various forms of health information technology (HIT) into their systems due to claims of increased quality and decreased costs, as well as various incentives, there is little available information about which applications of HIT are actually the most beneficial and efficient. In this study, we aim to assist administrators in understanding the characteristics of top performing hospitals. We utilized data from the Health Information and Management Systems Society and the Center for Medicare and Medicaid to assess 1039 hospitals. Inputs considered were full time equivalents, hospital size, and technology inputs. Technology inputs included personal health records (PHR), electronic medical records (EMRs), computerized physician order entry systems (CPOEs), and electronic access to diagnostic results. Output variables were measures of quality, hospital readmission and mortality rate. The analysis was conducted in a two-stage methodology: Data Envelopment Analysis (DEA) and Automatic Interaction Detector Analysis (AID), decision tree regression (DTreg). Overall, we found that electronic access to diagnostic results systems was the most influential technological characteristics; however organizational characteristics were more important than technological inputs. Hospitals that had the highest levels of quality indicated no excess in the use of technology input, averaging one use of a technology component. This study indicates that prudent consideration of organizational characteristics and technology is needed before investing in innovative programs.

Molecular modeling and SPRi investigations of interleukin 6 (IL6) protein and DNA aptamers.

PubMed

Rhinehardt, Kristen L; Vance, Stephen A; Mohan, Ram V; Sandros, Marinella; Srinivas, Goundla

2018-06-01

Interleukin 6 (IL6), an inflammatory response protein has major implications in immune-related inflammatory diseases. Identification of aptamers for the IL6 protein aids in diagnostic, therapeutic, and theranostic applications. Three different DNA aptamers and their interactions with IL6 protein were extensively investigated in a phosphate buffed saline (PBS) solution. Molecular-level modeling through molecular dynamics provided insights of structural, conformational changes and specific binding domains of these protein-aptamer complexes. Multiple simulations reveal consistent binding region for all protein-aptamer complexes. Conformational changes coupled with quantitative analysis of center of mass (COM) distance, radius of gyration (R g ), and number of intermolecular hydrogen bonds in each IL6 protein-aptamer complex was used to determine their binding performance strength and obtain molecular configurations with strong binding. A similarity comparison of the molecular configurations with strong binding from molecular-level modeling concurred with Surface Plasmon Resonance imaging (SPRi) for these three aptamer complexes, thus corroborating molecular modeling analysis findings. Insights from the natural progression of IL6 protein-aptamer binding modeled in this work has identified key features such as the orientation and location of the aptamer in the binding event. These key features are not readily feasible from wet lab experiments and impact the efficacy of the aptamers in diagnostic and theranostic applications.

Development of a center for light ion therapy and accurate tumor diagnostics at karolinska institutet and hospital

NASA Astrophysics Data System (ADS)

Brahme, Anders; Lind, Bengt K.

2002-04-01

Radiation therapy is today in a state of very rapid development with new intensity modulated treatment techniques continuously being developed. This has made intensity modulated electron and photon beams almost as powerful as conventional uniform beam proton therapy. To be able to cure also the most advanced hypoxic and radiation resistant tumors of complex local spread, intensity modulated light ion beams are really the ultimate tool and only slightly more expensive than proton therapy. The aim of the new center for ion therapy and tumor diagnostics in Stockholm is to develop radiobiologically optimized 3-dimensional pencil beam scanning techniques. Beside the "classical" approaches using low ionization density hydrogen ions (protons, but also deuterons and tritium nuclei) and high ionization density carbon ions, two new approaches will be developed. In the first one lithium or beryllium ions, that induce the least detrimental biological effect to normal tissues for a given biological effect in a small volume of the tumor, will be key particles. In the second approach, referred patients will be given a high-dose high-precision "boost" treatment with carbon or oxygen ions during one week preceding the final treatment with conventional radiations in the referring hospital. The rationale behind these approaches is to reduce the high ionization density dose to the normal tissue stroma inside the tumor and to ensure a microscopically uniform dose delivery. The principal idea of the center is to closely integrate ion therapy into the clinical routine and research of a large radiotherapy department. The light ion therapy center will therefore be combined with advanced tumor diagnostics including MR and PET-CT imaging to facilitate efficient high-precision high-dose boost treatment of remitted patients. The possibility to do 3D tumor diagnostics and 3D dose delivery verification with the same PET camera will be the ultimate step in high quality adaptive radiation therapy where alterations in the delivered dose can be corrected by subsequent treatments

Using Fault Trees to Advance Understanding of Diagnostic Errors.

PubMed

Rogith, Deevakar; Iyengar, M Sriram; Singh, Hardeep

2017-11-01

Diagnostic errors annually affect at least 5% of adults in the outpatient setting in the United States. Formal analytic techniques are only infrequently used to understand them, in part because of the complexity of diagnostic processes and clinical work flows involved. In this article, diagnostic errors were modeled using fault tree analysis (FTA), a form of root cause analysis that has been successfully used in other high-complexity, high-risk contexts. How factors contributing to diagnostic errors can be systematically modeled by FTA to inform error understanding and error prevention is demonstrated. A team of three experts reviewed 10 published cases of diagnostic error and constructed fault trees. The fault trees were modeled according to currently available conceptual frameworks characterizing diagnostic error. The 10 trees were then synthesized into a single fault tree to identify common contributing factors and pathways leading to diagnostic error. FTA is a visual, structured, deductive approach that depicts the temporal sequence of events and their interactions in a formal logical hierarchy. The visual FTA enables easier understanding of causative processes and cognitive and system factors, as well as rapid identification of common pathways and interactions in a unified fashion. In addition, it enables calculation of empirical estimates for causative pathways. Thus, fault trees might provide a useful framework for both quantitative and qualitative analysis of diagnostic errors. Future directions include establishing validity and reliability by modeling a wider range of error cases, conducting quantitative evaluations, and undertaking deeper exploration of other FTA capabilities. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

Progress in diagnostics of the COMPASS tokamak

NASA Astrophysics Data System (ADS)

Weinzettl, V.; Adamek, J.; Berta, M.; Bilkova, P.; Bogar, O.; Bohm, P.; Cavalier, J.; Dejarnac, R.; Dimitrova, M.; Ficker, O.; Fridrich, D.; Grover, O.; Hacek, P.; Havlicek, J.; Havranek, A.; Horacek, J.; Hron, M.; Imrisek, M.; Komm, M.; Kovarik, K.; Krbec, J.; Markovic, T.; Matveeva, E.; Mitosinkova, K.; Mlynar, J.; Naydenkova, D.; Panek, R.; Paprok, R.; Peterka, M.; Podolnik, A.; Seidl, J.; Sos, M.; Stockel, J.; Tomes, M.; Varavin, M.; Varju, J.; Vlainic, M.; Vondracek, P.; Zajac, J.; Zacek, F.; Stano, M.; Anda, G.; Dunai, D.; Krizsanoczi, T.; Refy, D.; Zoletnik, S.; Silva, A.; Gomes, R.; Pereira, T.; Popov, Tsv.; Sarychev, D.; Ermak, G. P.; Zebrowski, J.; Jakubowski, M.; Rabinski, M.; Malinowski, K.; Nanobashvili, S.; Spolaore, M.; Vianello, N.; Gauthier, E.; Gunn, J. P.; Devitre, A.

2017-12-01

The COMPASS tokamak at IPP Prague is a small-size device with an ITER-relevant plasma geometry and operating in both the Ohmic as well as neutral beam assisted H-modes since 2012. A basic set of diagnostics installed at the beginning of the COMPASS operation has been gradually broadened in type of diagnostics, extended in number of detectors and collected channels and improved by an increased data acquisition speed. In recent years, a significant progress in diagnostic development has been motivated by the improved COMPASS plasma performance and broadening of its scientific programme (L-H transition and pedestal scaling studies, magnetic perturbations, runaway electron control and mitigation, plasma-surface interaction and corresponding heat fluxes, Alfvenic and edge localized mode observations, disruptions, etc.). In this contribution, we describe major upgrades of a broad spectrum of the COMPASS diagnostics and discuss their potential for physical studies. In particular, scrape-off layer plasma diagnostics will be represented by a new concept for microsecond electron temperature and heat flux measurements - we introduce a new set of divertor Langmuir and ball-pen probe arrays, newly constructed probe heads for reciprocating manipulators as well as several types of standalone probes. Among optical tools, an upgraded high-resolution edge Thomson scattering diagnostic for pedestal studies and a set of new visible light and infrared (plasma-surface interaction investigations) cameras will be described. Particle and beam diagnostics will be covered by a neutral particle analyzer, diagnostics on a lithium beam, Cherenkov detectors (for a direct detection of runaway electrons) and neutron detectors. We also present new modifications of the microwave reflectometer for fast edge density profile measurements.

An Evaluation of the Performance Diagnostic Checklist-Human Services to Assess an Employee Performance Problem in a Center-Based Autism Treatment Facility

ERIC Educational Resources Information Center

Ditzian, Kyle; Wilder, David A.; King, Allison; Tanz, Jeanine

2015-01-01

The Performance Diagnostic Checklist-Human Services (PDC-HS) is an informant-based tool designed to assess the environmental variables that contribute to poor employee performance in human services settings. We administered the PDC-HS to 3 supervisors to assess the variables that contributed to poor performance by 4 staff members when securing…

Assessment of postural balance function.

PubMed

Kostiukow, Anna; Rostkowska, Elzbieta; Samborski, Włodzimierz

2009-01-01

Postural balance is defined as the ability to stand unassisted without falling. Examination of the patient's postural balance function is a difficult diagnostic task. Most of the balance tests used in medicine provide incomplete information on this coordination ability of the human body. The aim of this study was to review methods of assessment of the patient's postural balance function, including various tests used in medical diagnostics centers.

GapMap: Enabling Comprehensive Autism Resource Epidemiology

PubMed Central

Albert, Nikhila; Schwartz, Jessey; Du, Michael

2017-01-01

Background For individuals with autism spectrum disorder (ASD), finding resources can be a lengthy and difficult process. The difficulty in obtaining global, fine-grained autism epidemiological data hinders researchers from quickly and efficiently studying large-scale correlations among ASD, environmental factors, and geographical and cultural factors. Objective The objective of this study was to define resource load and resource availability for families affected by autism and subsequently create a platform to enable a more accurate representation of prevalence rates and resource epidemiology. Methods We created a mobile application, GapMap, to collect locational, diagnostic, and resource use information from individuals with autism to compute accurate prevalence rates and better understand autism resource epidemiology. GapMap is hosted on AWS S3, running on a React and Redux front-end framework. The backend framework is comprised of an AWS API Gateway and Lambda Function setup, with secure and scalable end points for retrieving prevalence and resource data, and for submitting participant data. Measures of autism resource scarcity, including resource load, resource availability, and resource gaps were defined and preliminarily computed using simulated or scraped data. Results The average distance from an individual in the United States to the nearest diagnostic center is approximately 182 km (50 miles), with a standard deviation of 235 km (146 miles). The average distance from an individual with ASD to the nearest diagnostic center, however, is only 32 km (20 miles), suggesting that individuals who live closer to diagnostic services are more likely to be diagnosed. Conclusions This study confirmed that individuals closer to diagnostic services are more likely to be diagnosed and proposes GapMap, a means to measure and enable the alleviation of increasingly overburdened diagnostic centers and resource-poor areas where parents are unable to diagnose their children as quickly and easily as needed. GapMap will collect information that will provide more accurate data for computing resource loads and availability, uncovering the impact of resource epidemiology on age and likelihood of diagnosis, and gathering localized autism prevalence rates. PMID:28473303

GapMap: Enabling Comprehensive Autism Resource Epidemiology.

PubMed

Albert, Nikhila; Daniels, Jena; Schwartz, Jessey; Du, Michael; Wall, Dennis P

2017-05-04

For individuals with autism spectrum disorder (ASD), finding resources can be a lengthy and difficult process. The difficulty in obtaining global, fine-grained autism epidemiological data hinders researchers from quickly and efficiently studying large-scale correlations among ASD, environmental factors, and geographical and cultural factors. The objective of this study was to define resource load and resource availability for families affected by autism and subsequently create a platform to enable a more accurate representation of prevalence rates and resource epidemiology. We created a mobile application, GapMap, to collect locational, diagnostic, and resource use information from individuals with autism to compute accurate prevalence rates and better understand autism resource epidemiology. GapMap is hosted on AWS S3, running on a React and Redux front-end framework. The backend framework is comprised of an AWS API Gateway and Lambda Function setup, with secure and scalable end points for retrieving prevalence and resource data, and for submitting participant data. Measures of autism resource scarcity, including resource load, resource availability, and resource gaps were defined and preliminarily computed using simulated or scraped data. The average distance from an individual in the United States to the nearest diagnostic center is approximately 182 km (50 miles), with a standard deviation of 235 km (146 miles). The average distance from an individual with ASD to the nearest diagnostic center, however, is only 32 km (20 miles), suggesting that individuals who live closer to diagnostic services are more likely to be diagnosed. This study confirmed that individuals closer to diagnostic services are more likely to be diagnosed and proposes GapMap, a means to measure and enable the alleviation of increasingly overburdened diagnostic centers and resource-poor areas where parents are unable to diagnose their children as quickly and easily as needed. GapMap will collect information that will provide more accurate data for computing resource loads and availability, uncovering the impact of resource epidemiology on age and likelihood of diagnosis, and gathering localized autism prevalence rates. ©Nikhila Albert, Jena Daniels, Jessey Schwartz, Michael Du, Dennis P Wall. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 04.05.2017.

Cloud Radiation Forcings and Feedbacks: General Circulation Model Tests and Observational Validation

NASA Technical Reports Server (NTRS)

Lee,Wan-Ho; Iacobellis, Sam F.; Somerville, Richard C. J.

1997-01-01

Using an atmospheric general circulation model (the National Center for Atmospheric Research Community Climate Model: CCM2), the effects on climate sensitivity of several different cloud radiation parameterizations have been investigated. In addition to the original cloud radiation scheme of CCM2, four parameterizations incorporating prognostic cloud water were tested: one version with prescribed cloud radiative properties and three other versions with interactive cloud radiative properties. The authors' numerical experiments employ perpetual July integrations driven by globally constant sea surface temperature forcings of two degrees, both positive and negative. A diagnostic radiation calculation has been applied to investigate the partial contributions of high, middle, and low cloud to the total cloud radiative forcing, as well as the contributions of water vapor, temperature, and cloud to the net climate feedback. The high cloud net radiative forcing is positive, and the middle and low cloud net radiative forcings are negative. The total net cloud forcing is negative in all of the model versions. The effect of interactive cloud radiative properties on global climate sensitivity is significant. The net cloud radiative feedbacks consist of quite different shortwave and longwave components between the schemes with interactive cloud radiative properties and the schemes with specified properties. The increase in cloud water content in the warmer climate leads to optically thicker middle- and low-level clouds and in turn to negative shortwave feedbacks for the interactive radiative schemes, while the decrease in cloud amount simply produces a positive shortwave feedback for the schemes with a specified cloud water path. For the longwave feedbacks, the decrease in high effective cloudiness for the schemes without interactive radiative properties leads to a negative feedback, while for the other cases, the longwave feedback is positive. These cloud radiation parameterizations are empirically validated by using a single-column diagnostic model. together with measurements from the Atmospheric Radiation Measurement program and from the Tropical Ocean Global Atmosphere Combined Ocean-Atmosphere Response Experiment. The inclusion of prognostic cloud water produces a notable improvement in the realism of the parameterizations, as judged by these observations. Furthermore, the observational evidence suggests that deriving cloud radiative properties from cloud water content and microphysical characteristics is a promising route to further improvement.

A Systems Approach to Diagnostic Prescriptive Instruction.

ERIC Educational Resources Information Center

Kozma, Robert B.; And Others

This five-part document presents three approaches to research on instructional improvement, with the final two sections concentrating on problems and implications for diagnostic prescriptive instruction. Part 1 reviews comparative instructional effectiveness studies. Part 2 discusses the Trait-Treatment Interaction Approach (TTI) which is…

A computerized handheld decision-support system to improve pulmonary embolism diagnosis: a randomized trial.

PubMed

Roy, Pierre-Marie; Durieux, Pierre; Gillaizeau, Florence; Legall, Catherine; Armand-Perroux, Aurore; Martino, Ludovic; Hachelaf, Mohamed; Dubart, Alain-Eric; Schmidt, Jeannot; Cristiano, Mirko; Chretien, Jean-Marie; Perrier, Arnaud; Meyer, Guy

2009-11-17

Testing for pulmonary embolism often differs from that recommended by evidence-based guidelines. To assess the effectiveness of a handheld clinical decision-support system to improve the diagnostic work-up of suspected pulmonary embolism among patients in the emergency department. Cluster randomized trial. Assignment was by random-number table, providers were not blinded, and outcome assessment was automated. (ClinicalTrials.gov registration number: NCT00188032). 20 emergency departments in France. 1103 and 1768 consecutive outpatients with suspected pulmonary embolism. After a preintervention period involving 20 centers and 1103 patients, in which providers grew accustomed to inputting clinical data into handheld devices and investigators assessed baseline testing, emergency departments were randomly assigned to activation of a decision-support system on the devices (10 centers, 753 patients) or posters and pocket cards that showed validated diagnostic strategies (10 centers, 1015 patients). Appropriateness of diagnostic work-up, defined as any sequence of tests that yielded a posttest probability less than 5% or greater than 85% (primary outcome) or as strict adherence to guideline recommendations (secondary outcome); number of tests per patient (secondary outcome). The proportion of patients who received appropriate diagnostic work-ups was greater during the trial than in the preintervention period in both groups, but the increase was greater in the computer-based guidelines group (adjusted mean difference in increase, 19.3 percentage points favoring computer-based guidelines [95% CI, 2.9 to 35.6 percentage points]; P = 0.023). Among patients with appropriate work-ups, those in the computer-based guidelines group received slightly fewer tests than did patients in the paper guidelines group (mean tests per patient, 1.76 [SD, 0.98] vs. 2.25 [SD, 1.04]; P < 0.001). The study was not designed to show a difference in the clinical outcomes of patients during follow-up. A handheld decision-support system improved diagnostic decision making for patients with suspected pulmonary embolism in the emergency department.

Gender incongruence: a comparative study using ICD-10 and DSM-5 diagnostic criteria.

PubMed

Soll, Bianca M; Robles-García, Rebeca; Brandelli-Costa, Angelo; Mori, Daniel; Mueller, Andressa; Vaitses-Fontanari, Anna M; Cardoso-da-Silva, Dhiordan; Schwarz, Karine; Abel-Schneider, Maiko; Saadeh, Alexandre; Lobato, Maria-Inês-Rodrigues

2018-01-01

To compare the presence of criteria listed in the DSM-5 and ICD-10 diagnostic manuals in a Brazilian sample of transgender persons seeking health services specifically for physical transition. This multicenter cross-sectional study included a sample of 103 subjects who sought services for gender identity disorder in two main reference centers in Brazil. The method involved a structured interview encompassing the diagnostic criteria in the two manuals. The results revealed that despite theoretical disagreement about the criteria, the manuals overlap regarding diagnosis confirmation; the DSM-5 was more inclusive (97.1%) than the ICD-10 (93.2%) in this population. Although there is no consensus on diagnostic criteria on transgenderism in the diversity of social and cultural contexts, more comprehensive diagnostic criteria are evolving due to society's increasing inclusivity.

More Than Just Accuracy: A Novel Method to Incorporate Multiple Test Attributes in Evaluating Diagnostic Tests Including Point of Care Tests.

PubMed

Thompson, Matthew; Weigl, Bernhard; Fitzpatrick, Annette; Ide, Nicole

2016-01-01

Current frameworks for evaluating diagnostic tests are constrained by a focus on diagnostic accuracy, and assume that all aspects of the testing process and test attributes are discrete and equally important. Determining the balance between the benefits and harms associated with new or existing tests has been overlooked. Yet, this is critically important information for stakeholders involved in developing, testing, and implementing tests. This is particularly important for point of care tests (POCTs) where tradeoffs exist between numerous aspects of the testing process and test attributes. We developed a new model that multiple stakeholders (e.g., clinicians, patients, researchers, test developers, industry, regulators, and health care funders) can use to visualize the multiple attributes of tests, the interactions that occur between these attributes, and their impacts on health outcomes. We use multiple examples to illustrate interactions between test attributes (test availability, test experience, and test results) and outcomes, including several POCTs. The model could be used to prioritize research and development efforts, and inform regulatory submissions for new diagnostics. It could potentially provide a way to incorporate the relative weights that various subgroups or clinical settings might place on different test attributes. Our model provides a novel way that multiple stakeholders can use to visualize test attributes, their interactions, and impacts on individual and population outcomes. We anticipate that this will facilitate more informed decision making around diagnostic tests.

Unconstrained Structural Equation Models of Latent Interactions: Contrasting Residual- and Mean-Centered Approaches

ERIC Educational Resources Information Center

Marsh, Herbert W.; Wen, Zhonglin; Hau, Kit-Tai; Little, Todd D.; Bovaird, James A.; Widaman, Keith F.

2007-01-01

Little, Bovaird and Widaman (2006) proposed an unconstrained approach with residual centering for estimating latent interaction effects as an alternative to the mean-centered approach proposed by Marsh, Wen, and Hau (2004, 2006). Little et al. also differed from Marsh et al. in the number of indicators used to infer the latent interaction factor…

Knowledge-based diagnosis for aerospace systems

NASA Technical Reports Server (NTRS)

Atkinson, David J.

1988-01-01

The need for automated diagnosis in aerospace systems and the approach of using knowledge-based systems are examined. Research issues in knowledge-based diagnosis which are important for aerospace applications are treated along with a review of recent relevant research developments in Artificial Intelligence. The design and operation of some existing knowledge-based diagnosis systems are described. The systems described and compared include the LES expert system for liquid oxygen loading at NASA Kennedy Space Center, the FAITH diagnosis system developed at the Jet Propulsion Laboratory, the PES procedural expert system developed at SRI International, the CSRL approach developed at Ohio State University, the StarPlan system developed by Ford Aerospace, the IDM integrated diagnostic model, and the DRAPhys diagnostic system developed at NASA Langley Research Center.

Voxel-Based Morphometry for Separation of Schizophrenia From Other Types of Psychosis in First-Episode Psychosis: Diagnostic Test Review.

PubMed

Palaniyappan, Lena; Maayan, Nicola; Bergman, Hanna; Davenport, Clare; Adams, Clive E; Soares-Weiser, Karla

2016-03-01

Subtle but widespread deficit in the cortical and subcortical grey matter is a consistent neuroimaging observation in schizophrenia. Several studies have used voxel based morphometry (VBM) to investigate the nature of this structural deficit. We conducted a diagnostic test review to explore the diagnostic potential of VBM in differentiating schizophrenia from other types of first-episode psychoses. © The Author 2016. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Image-Capture Devices Extend Medicine's Reach

NASA Technical Reports Server (NTRS)

2009-01-01

Johnson Space Center, Henry Ford Hospital in Detroit, and Houston-based Wyle Laboratories collaborated on NASA's Advanced Diagnostic Ultrasound in Microgravity (ADUM) experiment, which developed revolutionary medical ultrasound diagnostic techniques for long-distance use. Mediphan, a Canadian company with U.S. operations in Springfield, New Jersey drew on NASA expertise to create frame-grabber and data archiving technology that enables ultrasound users with minimal training to send diagnostic-quality ultrasound images and video to medical professionals via the Internet in near real time allowing patients as varied as professional athletes, Olympians, and mountain climbers to receive medical attention as soon as it is needed.

Evaluation of radiation exposure from diagnostic radiology examination; availability of final recommendations--FDA. Notice.

PubMed

1986-02-19

The Food and Drug Administration (FDA) is announcing the availability of a document entitled "Recommendations for Evaluation of Radiation Exposure from Diagnostic Radiology Examinations". The recommendations, prepared by FDA's Center for Devices and Radiological Health (CDRH), encourage diagnostic radiology facilities to take voluntary action to: Become aware of the radiation levels experienced by patients undergoing the projections commonly given in the facility; compare their radiation levels to generally accepted levels for these projections; and bring the exposures back into line if their levels fall consistently outside these generally accepted levels.

Diagnostics of breast cancer by analysis of spectra diffuse reflections

NASA Astrophysics Data System (ADS)

Kuzmina, Natalya V.; Plaksin, Fedor G.; Polovnikov, Eugeny S.

2001-05-01

The work is dedicated to problems of diagnostic oncologic diseases by a spectroscopic-optical method and is prolongation of long-term examinations held earlier by Vovk S.M, Naumov S.A. and Pushkarev S.V. The actual spectra of a diffuse reflection removed in vivo and in vitro are given, is angry- and good-quality neoplasms, healthy tissue and blood of breast and other organs. Problems of a clinical oncology are in a center of attention in medicine because the cases of disease malignant swellings increase, which is stipulated by an irregularity of present methods of diagnostic.

[POSSIBILITIES OF APPLICATION OF MALDI-TOF MASS-SPECTROMETRY FOR STUDY OF CARBOHYDRATE-SPECIFIC RECEPTORS FOR DIAGNOSTIC BACTERIOPHAGE EL TOR].

PubMed

Telesmanich, N R; Goncharenko, E V; Chaika, S O; Chaika, I A; Telicheva, V O

2016-01-01

Study mechanisms of interaction of diagnostic bacteriophage El Tor with sensitive strain Vibrio cholerae El Tor 18507 using direct protein profiling, identification of constant and variable proteins, taking part in interaction of the phage and cell, as well as carbohydrate-specific phage receptors. . A commercial preparation of cholera diagnostic bacteriophage El Tor, strain V. cholerae El Tor 18507 were used. Effect of carbohydrates on bacteriophage activity was determined in experiments with phage by a classic and modified by us method. Protein profiles of the studied objects were studied using MSP-analysis method. Sucrose was shown to inhibit lytic activity of bacteriophage. Proteome profiles of El Tor bacteriophage and sensitive indicator strains were studied, identification of constant and variable proteins of the studied objects by MSP Peak-list program was carried out. Analysis of changes of profiles of phage and microbial cell during interaction with sucrose gave a basis for assuming, that sucrose in the mixture of culture-phage enters interaction namely with phage protein receptors, blocking receptors specific for cholera vibrio, that subsequently manifests in a sharp decrease of phage activity against the sensitive strain.

Endocrine Therapy of Breast Cancer

DTIC Science & Technology

2006-06-01

Becker muscular dystrophy (BMD, hypomorphic for dys- trophin, n = 5), Dysferlin deficiency (putative vesicle traf- fic defect, n = 9), and Calpain III...this study. (1) Limb-girdle muscular dystrophy (LGMD, provided by Children National Medical Center, Center for Genetic Medicine): 4 diagnostic...groups, Fukutin related protein de- ficiency (FKRP) (homozygous missense for glycosylation enzyme, limb-girdle muscular dystrophy sub-type, n = 7

p-Medicine: From data sharing and integration via VPH models to personalized medicine.

PubMed

Rossi, S; Christ-Neumann, Ml; Rüping, S; Buffa, Fm; Wegener, D; McVie, G; Coveney, Pv; Graf, N; Delorenzi, M

2011-01-01

The Worldwide innovative Networking in personalized cancer medicine (WIN) initiated by the Institute Gustave Roussy (France) and The University of Texas MD Anderson Cancer Center (USA) has dedicated its 3rd symposium (Paris, 6-8 July 2011) to discussion on gateways to increase the efficacy of cancer diagnostics and therapeutics (http://www.winconsortium.org/symposium.html).Speakers ranged from clinical oncologist to researchers, industrial partners, and tools developers; a famous patient was present: Janelle Hail, a 30-year breast cancer survivor, founder and CEO of the National Breast Cancer Foundation, Inc. (NBCF).The p-medicine consortium found this venue a perfect occasion to present a poster about its activities that are in accordance with the take home message of the symposium.In this communication, we summarize what we presented with particular attention to the interaction between the symposium's topic and content and our project.

FDNS CFD Code Benchmark for RBCC Ejector Mode Operation

NASA Technical Reports Server (NTRS)

Holt, James B.; Ruf, Joe

1999-01-01

Computational Fluid Dynamics (CFD) analysis results are compared with benchmark quality test data from the Propulsion Engineering Research Center's (PERC) Rocket Based Combined Cycle (RBCC) experiments to verify fluid dynamic code and application procedures. RBCC engine flowpath development will rely on CFD applications to capture the multi-dimensional fluid dynamic interactions and to quantify their effect on the RBCC system performance. Therefore, the accuracy of these CFD codes must be determined through detailed comparisons with test data. The PERC experiments build upon the well-known 1968 rocket-ejector experiments of Odegaard and Stroup by employing advanced optical and laser based diagnostics to evaluate mixing and secondary combustion. The Finite Difference Navier Stokes (FDNS) code was used to model the fluid dynamics of the PERC RBCC ejector mode configuration. Analyses were performed for both Diffusion and Afterburning (DAB) and Simultaneous Mixing and Combustion (SMC) test conditions. Results from both the 2D and the 3D models are presented.

An Object-Oriented Graphical User Interface for a Reusable Rocket Engine Intelligent Control System

NASA Technical Reports Server (NTRS)

Litt, Jonathan S.; Musgrave, Jeffrey L.; Guo, Ten-Huei; Paxson, Daniel E.; Wong, Edmond; Saus, Joseph R.; Merrill, Walter C.

1994-01-01

An intelligent control system for reusable rocket engines under development at NASA Lewis Research Center requires a graphical user interface to allow observation of the closed-loop system in operation. The simulation testbed consists of a real-time engine simulation computer, a controls computer, and several auxiliary computers for diagnostics and coordination. The system is set up so that the simulation computer could be replaced by the real engine and the change would be transparent to the control system. Because of the hard real-time requirement of the control computer, putting a graphical user interface on it was not an option. Thus, a separate computer used strictly for the graphical user interface was warranted. An object-oriented LISP-based graphical user interface has been developed on a Texas Instruments Explorer 2+ to indicate the condition of the engine to the observer through plots, animation, interactive graphics, and text.

A large high vacuum, high pumping speed space simulation chamber for electric propulsion

NASA Technical Reports Server (NTRS)

Grisnik, Stanley P.; Parkes, James E.

1994-01-01

Testing high power electric propulsion devices poses unique requirements on space simulation facilities. Very high pumping speeds are required to maintain high vacuum levels while handling large volumes of exhaust products. These pumping speeds are significantly higher than those available in most existing vacuum facilities. There is also a requirement for relatively large vacuum chamber dimensions to minimize facility wall/thruster plume interactions and to accommodate far field plume diagnostic measurements. A 4.57 m (15 ft) diameter by 19.2 m (63 ft) long vacuum chamber at NASA Lewis Research Center is described. The chamber utilizes oil diffusion pumps in combination with cryopanels to achieve high vacuum pumping speeds at high vacuum levels. The facility is computer controlled for all phases of operation from start-up, through testing, to shutdown. The computer control system increases the utilization of the facility and reduces the manpower requirements needed for facility operations.

Numerical design of a magnetized turbulence experiment at the National Ignition Facility

NASA Astrophysics Data System (ADS)

Feister, Scott; Tzeferacos, Petros; Meinecke, Jena; Bott, Archie; Caprioli, Damiano; Laune, Jt; Bell, Tony; Casner, Alexis; Koenig, Michel; Li, Chikang; Miniati, Francesco; Petrasso, Richard; Remington, Bruce; Reville, Brian; Ross, J. Steven; Ryu, Dongsu; Ryutov, Dmitri; Sio, Hong; Turnbull, David; Zylstra, Alex; Schekochihin, Alexander; Froula, Dustin; Park, Hye-Sook; Lamb, Don; Gregori, Gianluca

2017-10-01

The origin and amplification of magnetic fields remains an active astrophysical research topic. We discuss design (using three-dimensional FLASH simulations) of a magnetized turbulence experiment at the National Ignition Facility (NIF). NIF lasers drive together two counter-propagating plasma flows to form a hot, turbulent plasma at the center. In the simulations, plasma temperatures are high enough to reach super-critical values of magnetic Reynolds number (Rm). Biermann battery seed magnetic fields (generated during laser-target interaction) are advected into the turbulent region and amplified by fluctuation dynamo in the above-unity Prandtl number regime. Plasma diagnostics are modeled with FLASH for planning and direct comparison with NIF experimental data. This work was supported in part at the University of Chicago by the DOE NNSA, the DOE Office of Science, and the NSF. The numerical simulations were conducted at ALCF's Mira under the auspices of the DOE Office of Science ALCC program.

p-Medicine: From data sharing and integration via VPH models to personalized medicine

PubMed Central

Rossi, S; Christ-Neumann, ML; Rüping, S; Buffa, FM; Wegener, D; McVie, G; Coveney, PV; Graf, N; Delorenzi, M

2011-01-01

The Worldwide innovative Networking in personalized cancer medicine (WIN) initiated by the Institute Gustave Roussy (France) and The University of Texas MD Anderson Cancer Center (USA) has dedicated its 3rd symposium (Paris, 6–8 July 2011) to discussion on gateways to increase the efficacy of cancer diagnostics and therapeutics (http://www.winconsortium.org/symposium.html). Speakers ranged from clinical oncologist to researchers, industrial partners, and tools developers; a famous patient was present: Janelle Hail, a 30-year breast cancer survivor, founder and CEO of the National Breast Cancer Foundation, Inc. (NBCF). The p-medicine consortium found this venue a perfect occasion to present a poster about its activities that are in accordance with the take home message of the symposium. In this communication, we summarize what we presented with particular attention to the interaction between the symposium’s topic and content and our project. PMID:22276060

Revised criteria for mild cognitive impairment may compromise the diagnosis of Alzheimer disease dementia.

PubMed

Morris, John C

2012-06-01

To evaluate the potential impact of revised criteria for mild cognitive impairment (MCI), developed by a work group sponsored by the National Institute on Aging and the Alzheimer's Association, on the diagnosis of very mild and mild Alzheimer disease (AD)dementia. Retrospective review of ratings of functional impairment across diagnostic categories. Alzheimer's Disease Centers and the National Alzheimer's Coordinating Center. Individuals (N=17 535) with normal cognition,MCI, or AD dementia. The functional ratings of individuals with normal cognition, MCI, or AD dementia who were evaluated at Alzheimer's Disease Centers and submitted to the National Alzheimer's Coordinating Center were assessed in accordance with the definition of "functional independence" allowed by the revised criteria. Pairwise demographic differences between the 3 diagnostic groups were tested using t tests for continuous variables and 2 for categorical variables. Almost all (99.8%) individuals currently diagnosed with very mild AD dementia and the large majority(92.7%) of those diagnosed with mild AD dementia could be reclassified as having MCI with the revised criteria,based on their level of impairment in the Clinical Dementia Rating domains for performance of instrumental activities of daily living in the community and at home.Large percentages of these individuals with AD dementia also meet the revised "functional independence" criterion for MCI as measured by the Functional Assessment Questionnaire. The categorical distinction between MCI and milder stages of AD dementia has been compromised by the revised criteria. The resulting diagnostic overlap supports the premise that "MCI due to AD" represents the earliest symptomatic stage of AD.

Multi-dimensional optical and laser-based diagnostics of low-temperature ionized plasma discharges

DOE PAGES

Barnat, Edward V.

2011-09-15

In this paper, a review of work centered on the utilization of multi-dimensional optical diagnostics to study phenomena arising in radiofrequency plasma discharges is given. The diagnostics range from passive techniques such as optical emission to more active techniques utilizing nanosecond lasers capable of both high temporal and spatial resolution. In this review, emphasis is placed on observations that would have been more difficult, if not impossible, to make without the use of such diagnostic techniques. Examples include the sheath structure around an electrode consisting of two different metals, double layers that arise in magnetized hydrogen discharges, or a largemore » region of depleted argon 1s 4 levels around a biased probe in an rf discharge.« less

Exploring utilitarian and hedonic antecedents for adopting information from a recommendation agent and unplanned purchase behaviour

NASA Astrophysics Data System (ADS)

Huang, Li-Ting

2016-01-01

Research indicated that in order for properly utilizing recommendation agents (RAs), customers must rationally evaluate capability and suggestions of RAs during the interaction process. However, enjoying interactive processes and interface is also important. Methods for increasing user enjoyment of RAs are yet unknown. This study investigated the influences of utilitarian and hedonic factors on intention to adopt RAs suggestions and their antecedents. Involvement influences relative importance of utilitarian and hedonic factors. Contrary to common assumptions, customers may make unplanned purchases, rather than rational purchase. A field experiment with 2 × 2 × 2 factorial design reveals main findings. First, information diagnosticity and enjoyment enhance adoption intention simultaneously. Information diagnosticity is more important than enjoyment. Diagnosticity was determined by outcome similarity, and enjoyment was determined by both outcome similarity and atmospherics. The context of interacting with RAs is important. Outcome similarity even directly affects adoption intention. Second, highly involved users considered enjoyment and diagnosticity when forming adoption intentions, while users with low involvement only considered enjoyment. Third, information cascades altered the relationship between adoption intention and unplanned purchases. Most customers change selection after seeing ratings from other customers, even if they originally strongly want to adoption suggestion from RAs. Theoretical and managerial implications are proposed.

Genetic heterogeneity of hemoglobin AEBart's disease: a large cohort data from a single referral center in northeast Thailand.

PubMed

Chaibunruang, Attawut; Karnpean, Rossarin; Fucharoen, Goonnapa; Fucharoen, Supan

2014-04-01

AEBart's disease is a thalassemia intermedia usually characterized by the interaction of α(0)-thalassemia with either deletional or non-deletional α(+)-thalassemia in Hb E heterozygote. Genotypic and phenotypic features are heterogeneous. We studied the hematologic and molecular characteristics of this disease in a cohort of 173 Thai patients encountered at our center in northeast Thailand. Hemoglobin and DNA analyses identified patients with deletional AEBart's disease (n=84), Hb Constant Spring AEBart's disease (n=81), Hb Paksé-AEBart's disease (n=5), AEBart's disease with codon 30 mutation (n=1) and two hitherto un-described forms of AEBart's disease due to interaction of Hb E heterozygote and α(0)-thalassemia with the -α(16.6)kb deletional α(+)-thalassemia (n=1) and Hb Q-Thailand (n=1). Different phenotypic expression of these AEBart's diseases with low Hb, Hct and MCV and increased RDW values with marked reduction in Hb E levels were observed. It was found that all these forms of AEBart's disease showed similar thalassemia intermedia phenotypes but those with non-deletional forms were relatively more anemic. Our data confirm that in such area with high prevalence of hemoglobinopathies such as Southeast Asia, identification of rare thalassemia alleles in a thalassemia intermedia patient should not be ignored. Careful consideration of different phenotypic expression may help in providing presumptive diagnosis of this disease where access to molecular testing is limited. However, molecular diagnostic is useful for predicting the clinical outcome and improving genetic counseling of these complex hemoglobinopathies. Copyright © 2013 Elsevier Inc. All rights reserved.

Occupational exposure to mineral turpentine and heavy fuels: a possible risk factor for Alzheimer's disease.

PubMed

Helou, Rafik; Jaecker, Pierre

2014-05-01

The association between solvents and Alzheimer's disease (AD) has been the subject of several studies. Yet, only few studies have examined the various solvents separately, and the controls have rarely been monitored long enough. For these reasons and others, we believe that further studies are required. The objective of this study was to identify solvents associated with the clinicoradiological diagnostic of AD or mixed-type dementia (MD). A retrospective case-control study was performed in 156 patients followed up at the Memory Diagnostic Center of Bertinot Juel Hospital (France). The inclusion criteria were known occupation(s), a Mini-Mental State Examination (MMSE) score ≥10 at the first visit, a neuropsychological evaluation performed and a diagnosis established in our Memory Diagnostic Center. The diagnostics were crossed with 9 solvents belonging to two classes of solvents. Exposure was evaluated using French national job-exposure matrices. Certain petroleum-based solvents and fuels (i.e. mineral turpentine, diesel fuel, fuel oil and kerosene) were associated with a diagnosis of AD or MD. This association was still significant after adjustment for age, sex and education (adjusted OR: 6.5; 95% CI: 2-20). Occupational exposure to mineral turpentine and heavy fuels may be a risk factor for AD and MD.

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

PubMed

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

2015-01-01

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

Photolithography diagnostic expert systems: a systematic approach to problem solving in a wafer fabrication facility

NASA Astrophysics Data System (ADS)

Weatherwax Scott, Caroline; Tsareff, Christopher R.

1990-06-01

One of the main goals of process engineering in the semiconductor industry is to improve wafer fabrication productivity and throughput. Engineers must work continuously toward this goal in addition to performing sustaining and development tasks. To accomplish these objectives, managers must make efficient use of engineering resources. One of the tools being used to improve efficiency is the diagnostic expert system. Expert systems are knowledge based computer programs designed to lead the user through the analysis and solution of a problem. Several photolithography diagnostic expert systems have been implemented at the Hughes Technology Center to provide a systematic approach to process problem solving. This systematic approach was achieved by documenting cause and effect analyses for a wide variety of processing problems. This knowledge was organized in the form of IF-THEN rules, a common structure for knowledge representation in expert system technology. These rules form the knowledge base of the expert system which is stored in the computer. The systems also include the problem solving methodology used by the expert when addressing a problem in his area of expertise. Operators now use the expert systems to solve many process problems without engineering assistance. The systems also facilitate the collection of appropriate data to assist engineering in solving unanticipated problems. Currently, several expert systems have been implemented to cover all aspects of the photolithography process. The systems, which have been in use for over a year, include wafer surface preparation (HMDS), photoresist coat and softbake, align and expose on a wafer stepper, and develop inspection. These systems are part of a plan to implement an expert system diagnostic environment throughout the wafer fabrication facility. In this paper, the systems' construction is described, including knowledge acquisition, rule construction, knowledge refinement, testing, and evaluation. The roles played by the process engineering expert and the knowledge engineer are discussed. The features of the systems are shown, particularly the interactive quality of the consultations and the ease of system use.

Anion-π interactions in active centers of superoxide dismutases.

PubMed

Ribić, Vesna R; Stojanović, Srđan Đ; Zlatović, Mario V

2018-01-01

We investigated 1060 possible anion-π interactions in a data set of 41 superoxide dismutase active centers. Our observations indicate that majority of the aromatic residues are capable to form anion-π interactions, mainly by long-range contacts, and that there is preference of Trp over other aromatic residues in these interactions. Furthermore, 68% of total predicted interactions in the dataset are multiple anion-π interactions. Anion-π interactions are distance and orientation dependent. We analyzed the energy contribution resulting from anion-π interactions using ab initio calculations. The results showed that, while most of their interaction energies lay in the range from -0 to -4kcalmol -1 , those energies can be up to -9kcalmol -1 and about 34% of interactions were found to be repulsive. Majority of the suggested anion-π interacting residues in ternary complexes are metal-assisted. Stabilization centers for these proteins showed that all the six residues found in predicted anion-π interactions are important in locating one or more of such centers. The anion-π interacting residues in these proteins were found to be highly conserved. We hope that these studies might contribute useful information regarding structural stability and its interaction in future designs of novel metalloproteins. Copyright © 2017 Elsevier B.V. All rights reserved.

Mental health issues among college students: who gets referred for psychopharmacology evaluation?

PubMed

Kirsch, Daniel J; Doerfler, Leonard A; Truong, Debbie

2015-01-01

To describe diagnostic and psychotropic medication prescription characteristics among college students referred by college counseling centers for psychopharmacologic evaluation. Participants were 540 college students referred by 6 college counseling centers in Massachusetts between November 2005 and May 2011. Students completed self-report measures of depression, anxiety, suicidal ideation and attempts, and substance use. Information regarding DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th edition) diagnosis, previous history of medication prescription, and current psychotropic medication(s) prescribed by the consulting psychiatrist was obtained from medical records. Depression, anxiety, and attention-deficit/hyperactivity disorder (ADHD) were the most common psychiatric problems identified in students. Half of these students had been prescribed mediation prior to evaluation. Antidepressant medication was the most frequently prescribed medication. A large proportion of students reported previous thoughts of suicide, and 12% had made at least 1 suicide attempt. Depression, anxiety, and ADHD are common among students referred by college counseling centers for medication evaluation and treatment.

Telltale signs of patient-centered diagnosis.

PubMed

Millenson, Michael L

2014-01-01

A best-selling book from the mid-1980s was entitled, All I Really Need to Know I Learned in Kindergarten. Some doctors may similarly feel that well-worn epigrams from Hippocrates, Osler and others have told them all they really need to know about patient-centered care. The problem is that aphorisms and action are not one and the same. The workup for patient-centered diagnosis takes work, and there are telltale signs along the way. Effective patient engagement requires training and practice. It means incorporating patient-generated data into the diagnostic process. And it means being sensitive to new economic constraints on patients. Ensuring that diagnostic processes and decisions meet the test of patient-centeredness poses a challenge. The new criteria do not replace the professional obligation of beneficence; rather they add an additional obligation of power sharing. While that is neither simple nor easy, it promises better care for patients, a more satisfying clinical encounter and a better health care system for all.

Social Interaction and Design in an Online Multiliteracy Center

ERIC Educational Resources Information Center

Beaver, Alaina Feltenberger

2016-01-01

This qualitative study investigates tutor and student interaction in an online multiliteracy center (the Hub) at a major public research university. This study addresses a gap in the current literature on how writing centers transition to multiliteracy centers and prepare their tutors for consulting with students around aspects of design. There is…

Parent-Child Diagnostic Agreement on Anxiety Symptoms with a Structured Diagnostic Interview for Mental Disorders in Children.

PubMed

Popp, Lukka; Neuschwander, Murielle; Mannstadt, Sandra; In-Albon, Tina; Schneider, Silvia

2017-01-01

Objective: In clinical structured diagnostic interviews, diagnoses based on parent and child reports have low to moderate agreement. The aims of the present study are (1) to examine diagnostic agreement on anxiety disorders between parents and children on the levels of current and lifetime diagnostic category and diagnoses focusing in particular on diagnostic criteria and (2) to identify parent- and child-related predictors for diagnostic agreement. Method: The sample consisted of 166 parent-child dyads interviewed with the Structured Diagnostic Interview for Mental Disorders in Children (Kinder-DIPS, Schneider et al., 2009). The children (51.8% girls) were between the ages of 7 and 18 years ( M = 10.94; SD = 2.22). Results: Overall, parent-child agreement on the diagnostic category of anxiety disorder ( k = 0.21; k = 0.22) and the specific anxiety diagnoses (base rate > 10%) of social phobia, specific phobia and separation anxiety disorder ( k = 0.24-0.52; k = 0.19-0.43) and corresponding diagnostic criteria ( k = 0.22-0.67; k = 0.24-0.41) were low to moderate with the highest agreement on separation anxiety disorder ( k > 0.43). Lower maternal depression, and higher social support reported by mother and father were associated with higher parent-child agreement. Maternal depression was indicated as the strongest predictor. Parental sense of competence, parental anxiety, the amount of parent-child interaction and the child's age and gender had no predictive value. Conclusions: Parent-child agreement can be expected to be higher on the level of anxiety criteria compared to specific anxiety diagnoses and diagnostic anxiety category. Psychological strains in the family-especially maternal depression and low social support-lower the parent-child agreement on anxiety symptoms. Child- and relation-related variables (age, gender, amount of time parent(s) and children interact) play no role in the prediction of low parent-child agreement.

Parent-Child Diagnostic Agreement on Anxiety Symptoms with a Structured Diagnostic Interview for Mental Disorders in Children

PubMed Central

Popp, Lukka; Neuschwander, Murielle; Mannstadt, Sandra; In-Albon, Tina; Schneider, Silvia

2017-01-01

Objective: In clinical structured diagnostic interviews, diagnoses based on parent and child reports have low to moderate agreement. The aims of the present study are (1) to examine diagnostic agreement on anxiety disorders between parents and children on the levels of current and lifetime diagnostic category and diagnoses focusing in particular on diagnostic criteria and (2) to identify parent- and child-related predictors for diagnostic agreement. Method: The sample consisted of 166 parent-child dyads interviewed with the Structured Diagnostic Interview for Mental Disorders in Children (Kinder-DIPS, Schneider et al., 2009). The children (51.8% girls) were between the ages of 7 and 18 years (M = 10.94; SD = 2.22). Results: Overall, parent-child agreement on the diagnostic category of anxiety disorder (k = 0.21; k = 0.22) and the specific anxiety diagnoses (base rate > 10%) of social phobia, specific phobia and separation anxiety disorder (k = 0.24–0.52; k = 0.19–0.43) and corresponding diagnostic criteria (k = 0.22–0.67; k = 0.24–0.41) were low to moderate with the highest agreement on separation anxiety disorder (k > 0.43). Lower maternal depression, and higher social support reported by mother and father were associated with higher parent-child agreement. Maternal depression was indicated as the strongest predictor. Parental sense of competence, parental anxiety, the amount of parent-child interaction and the child's age and gender had no predictive value. Conclusions: Parent-child agreement can be expected to be higher on the level of anxiety criteria compared to specific anxiety diagnoses and diagnostic anxiety category. Psychological strains in the family—especially maternal depression and low social support—lower the parent-child agreement on anxiety symptoms. Child- and relation-related variables (age, gender, amount of time parent(s) and children interact) play no role in the prediction of low parent-child agreement. PMID:28396644

Diagnostic Tests and Procedures

MedlinePlus

... Daily Conferences Fellowships and Residencies School of Perfusion Technology Education Resources Library & Learning Resource Center CME Resources THI Journal THI Cardiac Society Save the Date: International Symposium on Cardiovascular Regenerative ...

Interaction of Intense Lasers and Relativistic Electron Beams with Solids, Gases and Plasmas

DTIC Science & Technology

1993-06-01

June 18, 1993. The main subject was the identification of research opportunities and needs that are at- tractive for investigation using the HAARP ...warming and global change. Highly leveraged cooperative or collaborative programs exploring the HAARP facility and diagnostic complement in conjunction...1. Diagnostic issues - HF diagnostics. 1.1 Possible use of HAARP transmitter as a receiving antenna. 1.2 Possible addition of a "big" receiving

Label-Free Biosensor Imaging on Photonic Crystal Surfaces.

PubMed

Zhuo, Yue; Cunningham, Brian T

2015-08-28

We review the development and application of nanostructured photonic crystal surfaces and a hyperspectral reflectance imaging detection instrument which, when used together, represent a new form of optical microscopy that enables label-free, quantitative, and kinetic monitoring of biomaterial interaction with substrate surfaces. Photonic Crystal Enhanced Microscopy (PCEM) has been used to detect broad classes of materials which include dielectric nanoparticles, metal plasmonic nanoparticles, biomolecular layers, and live cells. Because PCEM does not require cytotoxic stains or photobleachable fluorescent dyes, it is especially useful for monitoring the long-term interactions of cells with extracellular matrix surfaces. PCEM is only sensitive to the attachment of cell components within ~200 nm of the photonic crystal surface, which may correspond to the region of most interest for adhesion processes that involve stem cell differentiation, chemotaxis, and metastasis. PCEM has also demonstrated sufficient sensitivity for sensing nanoparticle contrast agents that are roughly the same size as protein molecules, which may enable applications in "digital" diagnostics with single molecule sensing resolution. We will review PCEM's development history, operating principles, nanostructure design, and imaging modalities that enable tracking of optical scatterers, emitters, absorbers, and centers of dielectric permittivity.

Variability in the efficacy of psychopharmaceuticals: contributions from pharmacogenomics, ethnopsychopharmacology, and psychological and psychiatric anthropologies.

PubMed

Ninnemann, Kristi M

2012-03-01

Psychological and psychiatric anthropology have long questioned the universality of psychiatric diagnoses, bringing to light the fluidity of mental disorder, and recognizing that the experience and expression of psychopathology is influenced by complex and interacting genetic, environmental, and cultural factors. The majority of our discussions, however, have remained centered around the role of culture in shaping mental illness: drawing attention to subjective experiences of mental illness and culturally patterned modes of symptom presentation, and interrogating the cogency of universal diagnostic rubrics. Psychological and psychiatric anthropology have yet to robustly engage the broadly assumed universal validity of psychiatric medications and the ways in which they are prescribed and experienced. This article provides an introduction into the fields of pharmacogenomics and ethnopsychopharmacology, areas of inquiry seeking to understand the ways in which genetic variability occurring between, and within, large population groups influences individual ability to metabolize psychotropic medications. This piece further addresses the complex issue of psychopharmaceutical efficacy, stressing the ways in which, just as with psychopathology, medications and their outcomes are likewise influenced by the complex interactions of genes, environment, and culture. Lastly, ways in which anthropology can and should engage with the growing fields of pharmacogenomics and ethnopsychopharmacology are suggested.

Experimental Testing of a Metamaterial Slow Wave Structure for High-Power Microwave Generation

NASA Astrophysics Data System (ADS)

Shipman, K.; Prasad, S.; Andreev, D.; Fisher, D. M.; Reass, D. B.; Schamiloglu, E.; Gilmore, M.

2017-10-01

A high-power L band source has been developed using a metamaterial (MTM) to produce a double negative slow wave structure (SWS) for interaction with an electron beam. The beam is generated by a 700 kV, 6 kA short pulse (10 ns) accelerator. The design of the SWS consists of a cylindrical waveguide, loaded with alternating split-rings that are arrayed axially down the waveguide. The beam is guided down the center of the rings, where electrons interact with the MTM-SWS producing radiation. Power is extracted axially via a circular waveguide, and radiated by a horn antenna. Microwaves are characterized by an external detector placed in a waveguide. Mode characterization is performed using a neon bulb array. The bulbs are lit by the electric field, resulting in an excitation pattern that resembles the field pattern. This is imaged using an SLR camera. The MTM structure has electrically small features so breakdown is a concern. In addition to high speed cameras, a fiber-optic-fed, sub-ns photomultiplier tube array diagnostic has been developed and used to characterize breakdown light. Work supported by the Air Force Office of Scientific Research, MURI Grant FA9550-12-1-0489.

Label-Free Biosensor Imaging on Photonic Crystal Surfaces

PubMed Central

Zhuo, Yue; Cunningham, Brian T.

2015-01-01

We review the development and application of nanostructured photonic crystal surfaces and a hyperspectral reflectance imaging detection instrument which, when used together, represent a new form of optical microscopy that enables label-free, quantitative, and kinetic monitoring of biomaterial interaction with substrate surfaces. Photonic Crystal Enhanced Microscopy (PCEM) has been used to detect broad classes of materials which include dielectric nanoparticles, metal plasmonic nanoparticles, biomolecular layers, and live cells. Because PCEM does not require cytotoxic stains or photobleachable fluorescent dyes, it is especially useful for monitoring the long-term interactions of cells with extracellular matrix surfaces. PCEM is only sensitive to the attachment of cell components within ~200 nm of the photonic crystal surface, which may correspond to the region of most interest for adhesion processes that involve stem cell differentiation, chemotaxis, and metastasis. PCEM has also demonstrated sufficient sensitivity for sensing nanoparticle contrast agents that are roughly the same size as protein molecules, which may enable applications in “digital” diagnostics with single molecule sensing resolution. We will review PCEM’s development history, operating principles, nanostructure design, and imaging modalities that enable tracking of optical scatterers, emitters, absorbers, and centers of dielectric permittivity. PMID:26343684

Features of Fragile X Syndrome

MedlinePlus

... Since many children with FXS are interested in social interactions, they may not meet the diagnostic criteria for ... as appropriate. The core deficit in ASD is social interaction. The core deficit in FXS is intellectual function ...

Reference intervals and diagnostic ranges for serum free κ and free λ immunoglobulin light chains vary by instrument platform: Implications for classification of patient results in a multi-center study.

PubMed

Cotten, Steven W; Shajani-Yi, Zahra; Cervinski, Mark A; Voorhees, Timothy; Tuchman, Sascha A; Korpi-Steiner, Nichole

2018-06-06

Serum free light chain (FLC) immunoglobulins are key biomarkers that aid in the diagnosis, prognosis and assessment of treatment response in patients with plasma cell disorders (PCD). Here we investigated the transference of manufacturer's reported κFLC, λFLC and κ to λ FLC reference intervals (RI) and established de novo FLC RI and diagnostic ranges on four instruments at three academic medical centers. In addition, we also compared the classification of patient FLC results using manufacturer's versus established RIs and diagnostic ranges. CLSI EP28-A3C protocol was applied to investigate transference and establishment of FLC reference intervals on the cobas (Roche), Immage (Beckman), Optilite and SPA Plus (Binding Site). Serum κ FLC and λ FLC were measured in reference sera (N = 126) with estimation of central 95% RIs and FLC ratio diagnostic range (total range). Frequencies (%) in patient FLC results (N > 380 per institution) classified above, below or within manufacturer's versus established FLC RI were compared. Three of four instrument platforms did not exhibit acceptable transference of manufacturer's reported κFLC RI. The manufacturer's reported FLC total diagnostic range did not encompass all values observed in reference sera for any of the four platforms evaluated. Established FLC ratio diagnostic ranges reduced the frequency of patient results classified above range for three of four platforms evaluated. Transference of manufacturer's reported FLC RIs may be inappropriate for select instrument platforms. De novo establishment of FLC RIs specific to instrument platform is highly recommended in order to assure correct patient result classification. Copyright © 2017. Published by Elsevier Inc.

Development of an Information Fusion System for Engine Diagnostics and Health Management

NASA Technical Reports Server (NTRS)

Volponi, Allan J.; Brotherton, Tom; Luppold, Robert; Simon, Donald L.

2004-01-01

Aircraft gas-turbine engine data are available from a variety of sources including on-board sensor measurements, maintenance histories, and component models. An ultimate goal of Propulsion Health Management (PHM) is to maximize the amount of meaningful information that can be extracted from disparate data sources to obtain comprehensive diagnostic and prognostic knowledge regarding the health of the engine. Data Fusion is the integration of data or information from multiple sources, to achieve improved accuracy and more specific inferences than can be obtained from the use of a single sensor alone. The basic tenet underlying the data/information fusion concept is to leverage all available information to enhance diagnostic visibility, increase diagnostic reliability and reduce the number of diagnostic false alarms. This paper describes a basic PHM Data Fusion architecture being developed in alignment with the NASA C17 Propulsion Health Management (PHM) Flight Test program. The challenge of how to maximize the meaningful information extracted from disparate data sources to obtain enhanced diagnostic and prognostic information regarding the health and condition of the engine is the primary goal of this endeavor. To address this challenge, NASA Glenn Research Center (GRC), NASA Dryden Flight Research Center (DFRC) and Pratt & Whitney (P&W) have formed a team with several small innovative technology companies to plan and conduct a research project in the area of data fusion as applied to PHM. Methodologies being developed and evaluated have been drawn from a wide range of areas including artificial intelligence, pattern recognition, statistical estimation, and fuzzy logic. This paper will provide a broad overview of this work, discuss some of the methodologies employed and give some illustrative examples.

Training and quality assurance with the Structured Clinical Interview for DSM-IV (SCID-I/P).

PubMed

Ventura, J; Liberman, R P; Green, M F; Shaner, A; Mintz, J

1998-06-15

Accuracy in psychiatric diagnosis is critical for evaluating the suitability of the subjects for entry into research protocols and for establishing comparability of findings across study sites. However, training programs in the use of diagnostic instruments for research projects are not well systematized. Furthermore, little information has been published on the maintenance of interrater reliability of diagnostic assessments. At the UCLA Research Center for Major Mental Illnesses, a Training and Quality Assurance Program for SCID interviewers was used to evaluate interrater reliability and diagnostic accuracy. Although clinically experienced interviewers achieved better interrater reliability and overall diagnostic accuracy than neophyte interviewers, both groups were able to achieve and maintain high levels of interrater reliability, diagnostic accuracy, and interviewer skill. At the first quality assurance check after training, there were no significant differences between experienced and neophyte interviewers in interrater reliability or diagnostic accuracy. Standardization of training and quality assurance procedures within and across research projects may make research findings from study sites more comparable.

Diagnostic laryngeal electromyography: The Wake Forest experience 1995-1999.

PubMed

Koufman, J A; Postma, G N; Whang, C S; Rees, C J; Amin, M R; Belafsky, P C; Johnson, P E; Connolly, K M; Walker, F O

2001-06-01

Laryngeal electromyography (LEMG) is a valuable diagnostic/prognostic test for patients with suspected laryngeal neuromuscular disorders. To report our experience with diagnostic LEMG at the Center for Voice Disorders of Wake Forest University and to evaluate the impact of LEMG on clinical management. Retrospective chart review of 415 patients who underwent diagnostic LEMG over a 5-year period (1995-1999). Of 415 studies, 83% (346 of 415) were abnormal, indicating a neuropathic process. LEMG results altered the diagnostic evaluation (eg, the type of radiographic imaging) in 11% (46 of 415) of the patients. Unexpected LEMG findings (eg, contralateral neuropathy) were found in 26% (107 of 415) of the patients, and LEMG results differentiated vocal fold paralysis from fixation in 12% (49 of 415). Finally, LEMG results altered the clinical management (eg, changed the timing and/or type of surgical procedure) in 40% (166 of 415) of the patients. LEMG is a valuable diagnostic test that aids the clinician in the diagnosis and management of laryngeal neuromuscular disorders.

The INTELSAT VI SSTDMA network diagnostic system

NASA Astrophysics Data System (ADS)

Tamboli, Satish P.; Zhu, Xiaobo; Wilkins, Kim N.; Gupta, Ramesh K.

The system-level design of an expert-system-based, near-real-time diagnostic system for INTELSAT VI satellite-switched time-division multiple access (SSTDMA) network is described. The challenges of INTELSAT VI diagnostics are discussed, along with alternative approaches for network diagnostics and the rationale for choosing a method based on burst unique-word detection. The focal point of the diagnostic system is the diagnostic processor, which resides in the central control and monitoring facility known as the INTELSAT Operations Center TDMA Facility (IOCTF). As real-time information such as burst unique-word detection data, reference terminal status data, and satellite telemetry alarm data are received at the IOCTF, the diagnostic processor continuously monitors the data streams. When a burst status change is detected, a 'snapshot' of the real-time data is forwarded to the expert system. Receipt of the change causes a set of rules to be invoked which associate the traffic pattern with a set of probable causes. A user-friendly interface allows a graphical view of the burst time plan and provides the ability to browse through the knowledge bases.

Assessment and mitigation of diagnostic-generated electromagnetic interference at the National Ignition Facilitya)

NASA Astrophysics Data System (ADS)

Brown, C. G.; Ayers, J.; Felker, B.; Ferguson, W.; Holder, J. P.; Nagel, S. R.; Piston, K. W.; Simanovskaia, N.; Throop, A. L.; Chung, M.; Hilsabeck, T.

2012-10-01

Electromagnetic interference (EMI) is an ever-present challenge at laser facilities such as the National Ignition Facility (NIF). The major source of EMI at such facilities is laser-target interaction that can generate intense electromagnetic fields within, and outside of, the laser target chamber. In addition, the diagnostics themselves can be a source of EMI, even interfering with themselves. In this paper we describe EMI generated by ARIANE and DIXI, present measurements, and discuss effects of the diagnostic-generated EMI on ARIANE's CCD and on a PMT nearby DIXI. Finally we present some of the efforts we have made to mitigate the effects of diagnostic-generated EMI on NIF diagnostics.

Diagnostics development for E-beam excited air channels

NASA Astrophysics Data System (ADS)

Eckstrom, D. J.; Dickenson, J. S.

1982-02-01

As the tempo of development of particle beam weapons increases, more detailed diagnostics of the interaction of the particle beam with the atmosphere are being proposed and implemented. Some of these diagnostics involve probing of the excited air channel with visible wavelength laser radiation. Examples include the use of visible wavelength interferometry to measure electron density profiles in the nose of the beam Ri81 and Stark shift measurements to determine self-induced electric fields Hi81, DR81. In these diagnostics, the change in laser intensity due to the desired diagnostic effect can be quite small, leading to the possibility that other effects, such as gas phase absorption, could seriously interfere with the measurement.

Comparison of O-antigen gene clusters of all O-serogroups of Escherichia coli and proposal for adopting a new nomenclature for O-typing

USDA-ARS?s Scientific Manuscript database

The Genetics Analysis Core Facility at the Eastern Regional Research Center (ERRC) is a centralized laboratory working in support of the United States Department of Agriculture scientists within the ERRC. The application of molecular diagnostics within the Center has resulted in the morphing of the...

Quantitative Species Measurements in Microgravity Combustion Flames

NASA Technical Reports Server (NTRS)

Silver, Joel A.; Wood, William R.; Chen, Shin-Juh; Dahm, Werner J. A.; Piltch, Nancy D.

2001-01-01

Flame-vortex interactions are canonical configurations that can be used to study the underlying processes occurring in complicated turbulent reacting flows. The elegant simplicity of the flame-vortex interaction permits the study of these complex interactions under relatively controllable experimental configurations, in contrast to direct measurements in turbulent flames. The ability to measure and model the fundamental phenomena that occur in a turbulent flame, but with time and spatial scales which are amenable to our diagnostics, permits significant improvements in the understanding of turbulent combustion under both normal and reduced gravity conditions. In this paper, we report absolute mole fraction measurements of methane in a reacting vortex ring. These microgravity experiments are performed in the 2.2-sec drop tower at NASA Glenn Research Center. In collaboration with Drs. Chen and Dahm at the University of Michigan, measured methane absorbances are incorporated into a new model from which the temperature and concentrations of all major gases in the flame can be determined at all positions and times in the development of the vortex ring. This is the first demonstration of the ITAC (Iterative Temperature with Assumed Chemistry) approach, and the results of these computations and analyses are presented in a companion paper by Dahm and Chen at this Workshop. We believe that the ITAC approach will become a powerful tool in understanding a wide variety of combustion flames under both equilibrium and non-equilibrium conditions.

Impact of an interactive video on decision making of patients with ischemic heart disease.

PubMed

Liao, L; Jollis, J G; DeLong, E R; Peterson, E D; Morris, K G; Mark, D B

1996-06-01

An experimental pilot study using repeated measures to examine the impact of an interactive video program on the decision making of patients with ischemic heart disease was carried on at a tertiary care center and a Veterans Affairs hospital. The patients (n = 80, mean age 61.1 years, 77% male, 75% white, 26.7% with acute myocardial infarction), who had undergone diagnostic cardiac catheterization and were found to have significant coronary artery disease (> or = 75% stenosis in at least one vessel), watched the Shared Decision-Making Program (SDP) for Ischemic Heart Disease (IHD), a novel interactive video system designed to provide information necessary for patients to participate actively in decision making. This program compares medical therapy, angioplasty, and bypass surgery through a physician narrator, patient testimonials, and empirically-based, patient-specific outcome estimates of short-time complications and long-term survival. Before and after viewing the SDP, patients completed surveys containing multiple choice questions and Likert scales. They rated the program as more helpful than all other decision aids except the physician, and after viewing the SDP they expressed increased confidence in their treatment choice and decreased confidence in alternative options (p = .0001). The greatest effects appeared to be concentrated in those patients with less education (p = .04), and the program appeared to increase anxiety in nonwhite patients compared with white patients (p = 0.07).

White Matter Fractional Anisotrophy Differences and Correlates of Diagnostic Symptoms in Autism

ERIC Educational Resources Information Center

Cheung, C.; Chua, S. E.; Cheung, V.; Khong, P. L.; Tai, K. S.; Wong, T. K. W.; Ho, T. P.; McAlonan, G. M.

2009-01-01

Background: Individuals with autism have impairments in 3 domains: communication, social interaction and repetitive behaviours. Our previous work suggested early structural and connectivity abnormalities in prefrontal-striato-temporal-cerebellar networks but it is not clear how these are linked to diagnostic indices. Method: Children with autism…

Dynamic Assessment in Combination with Video Interaction Guidance in Preschool Education

ERIC Educational Resources Information Center

Krejcová, Kristýna

2015-01-01

Dynamic assessment represents an alternative diagnostic approach focused on the revelation of the tested persons' learning potential. The learning potential is observed via the emphasis on the achievement process. It aims at meaningful connection with the intervention that immediately applies diagnostic findings to support the development of an…

[Hi-tech center of outpatient care (To the 40th anniversary of the Branch N 6 of the Vishnevsky Central military clinical hospital N 3)].

PubMed

Popov, A P

2015-10-01

The authors present the history of the branch N 6 of the Federal States Organization "the Vishnevsky Central Military Clinical Hospital N 3" of the Ministry of Defense of the Russian Federation, which dates back to November 1, 1974. Over the past years, organizational and staff structure; and the name of the clinic (45th central polyclinic, 45th central consultative-diagnostic polyclinic, 52nd Advisory Diagnostic Center of Defense) has repeatedly changed, but the core the work stays unchangeable--to continually improve patient care technology, to be the leader in the outpatient care for soldiers, reserve officers (retired), members of their families. The. branch consists of 58 medical and 19 specialized diagnostic departments, including 4 hospital departments, 1845 employee work at the branch. Among them 4 doctors of medical science and 43 candidates of medical sciences, 20 honoured physicians and 10 honoured health workers of republic. 70% of doctors and 93% of nurses have the highest qualification category. To health care in the Branch are more than 110 thousand people.

A Review of Transmission Diagnostics Research at NASA Lewis Research Center

NASA Technical Reports Server (NTRS)

Zakajsek, James J.

1994-01-01

This paper presents a summary of the transmission diagnostics research work conducted at NASA Lewis Research Center over the last four years. In 1990, the Transmission Health and Usage Monitoring Research Team at NASA Lewis conducted a survey to determine the critical needs of the diagnostics community. Survey results indicated that experimental verification of gear and bearing fault detection methods, improved fault detection in planetary systems, and damage magnitude assessment and prognostics research were all critical to a highly reliable health and usage monitoring system. In response to this, a variety of transmission fault detection methods were applied to experimentally obtained fatigue data. Failure modes of the fatigue data include a variety of gear pitting failures, tooth wear, tooth fracture, and bearing spalling failures. Overall results indicate that, of the gear fault detection techniques, no one method can successfully detect all possible failure modes. The more successful methods need to be integrated into a single more reliable detection technique. A recently developed method, NA4, in addition to being one of the more successful gear fault detection methods, was also found to exhibit damage magnitude estimation capabilities.

Malaria Diagnosis across the International Centers of Excellence for Malaria Research: Platforms, Performance, and Standardization

PubMed Central

Kobayashi, Tamaki; Gamboa, Dionicia; Ndiaye, Daouda; Cui, Liwang; Sutton, Patrick L.; Vinetz, Joseph M.

2015-01-01

Diagnosis is “the act of identifying a disease, illness, or problem by examining someone or something.” When an individual with acute fever presents for clinical attention, accurate diagnosis leading to specific, prompt treatment often saves lives. As applied to malaria, not only individual patient diagnosis is important but also assessing population-level malaria prevalence using appropriate diagnostic methods is essential for public health purposes. Similarly, identifying (diagnosing) fake antimalarial medications prevents the use of counterfeit drugs that can have disastrous effects. Therefore, accurate diagnosis in broad areas related to malaria is fundamental to improving health-care delivery, informing funding agencies of current malaria situations, and aiding in the prioritization of regional and national control efforts. The International Centers of Excellence for Malaria Research (ICEMR), supported by the U.S. National Institute of Allergy and Infectious Diseases, has collaborated on global efforts to improve malaria diagnostics by working to harmonize and systematize procedures across different regions where endemicity and financial resources vary. In this article, the different diagnostic methods used across each ICEMR are reviewed and challenges are discussed. PMID:26259937

Autism Spectrum Disorder and Fragile X Syndrome

MedlinePlus

... Since many children with FXS are interested in social interactions, they may not meet the diagnostic criteria for ... as appropriate. The core deficit in ASD is social interaction. The core deficit in FXS is intellectual function ...

Towards first principle medical diagnostics: on the importance of disease-disease and sign-sign interactions

NASA Astrophysics Data System (ADS)

Ramezanpour, Abolfazl; Mashaghi, Alireza

2017-07-01

A fundamental problem in medicine and biology is to assign states, e.g. healthy or diseased, to cells, organs or individuals. State assignment or making a diagnosis is often a nontrivial and challenging process and, with the advent of omics technologies, the diagnostic challenge is becoming more and more serious. The challenge lies not only in the increasing number of measured properties and dynamics of the system (e.g. cell or human body) but also in the co-evolution of multiple states and overlapping properties, and degeneracy of states. We develop, from first principles, a generic rational framework for state assignment in cell biology and medicine, and demonstrate its applicability with a few simple theoretical case studies from medical diagnostics. We show how disease-related statistical information can be used to build a comprehensive model that includes the relevant dependencies between clinical and laboratory findings (signs) and diseases. In particular, we include disease-disease and sign-sign interactions and study how one can infer the probability of a disease in a patient with given signs. We perform comparative analysis with simple benchmark models to check the performances of our models. We find that including interactions can significantly change the statistical importance of the signs and diseases. This first principles approach, as we show, facilitates the early diagnosis of disease by taking interactions into accounts, and enables the construction of consensus diagnostic flow charts. Additionally, we envision that our approach will find applications in systems biology, and in particular, in characterizing the phenome via the metabolome, the proteome, the transcriptome, and the genome.

Consensus statement on screening, diagnosis, classification and treatment of endemic (Balkan) nephropathy

PubMed Central

Jelaković, Bojan; Nikolić, Jovan; Radovanović, Zoran; Nortier, Joelle; Cosyns, Jean-Pierre; Grollman, Arthur P.; Bašić-Jukić, Nikolina; Belicza, Mladen; Bukvić, Danica; Čavaljuga, Semra; Čvorišćec, Dubravka; Cvitković, Ante; Dika, Živka; Dimitrov, Plamen; Đukanović, Ljubica; Edwards, Karen; Ferluga, Dušan; Fuštar-Preradović, Ljubica; Gluhovschi, Gheorghe; Imamović, Goran; Jakovina, Tratinčica; Kes, Petar; Leko, Ninoslav; Medverec, Zvonimir; Mesić, Enisa; Miletić-Medved, Marica; Miller, Frederick; Pavlović, Nikola; Pasini, Josip; Pleština, Stjepko; Polenaković, Momir; Stefanović, Vladislav; Tomić, Karla; Trnačević, Senaid; Vuković Lela, Ivana; Štern-Padovan, Ranka

2014-01-01

Currently used diagnostic criteria in different endemic (Balkan) nephropathy (EN) centers involve different combinations of parameters, various cut-off values and many of them are not in agreement with proposed international guidelines. Leaders of EN centers began to address these problems at scientific meetings, and this paper is the outgrowth of those discussions. The main aim is to provide recommendations for clinical work on current knowledge and expertise. This document is developed for use by general physicians, nephrologists, urologist, public health experts and epidemiologist, and it is hoped that it will be adopted by responsible institutions in countries harboring EN. National medical providers should cover costs of screening and diagnostic procedures and treatment of EN patients with or without upper urothelial cancers. PMID:24166461

A Lagrangian analysis of a sudden stratospheric warming - Comparison of a model simulation and LIMS observations

NASA Technical Reports Server (NTRS)

Pierce, R. B.; Remsberg, Ellis E.; Fairlie, T. D.; Blackshear, W. T.; Grose, William L.; Turner, Richard E.

1992-01-01

Lagrangian area diagnostics and trajectory techniques are used to investigate the radiative and dynamical characteristics of a spontaneous sudden warming which occurred during a 2-yr Langley Research Center model simulation. The ability of the Langley Research Center GCM to simulate the major features of the stratospheric circulation during such highly disturbed periods is illustrated by comparison of the simulated warming to the observed circulation during the LIMS observation period. The apparent sink of vortex area associated with Rossby wave-breaking accounts for the majority of the reduction of the size of the vortex and also acts to offset the radiatively driven increase in the area occupied by the 'surf zone'. Trajectory analysis of selected material lines substantiates the conclusions from the area diagnostics.

[Work-related medical rehabilitation for patients with rheumatic diseases].

PubMed

Ehlebracht-König, I; Dorn, M

2014-02-01

In recent years work-related rehabilitation has been intensified. Several studies have shown the effectiveness of work-related interventions in medical rehabilitation by improving participation in the work force and reducing sick leave. The German pension insurance fund has developed standardized requirements for medical work-related rehabilitation which include diagnostic procedures to identify patients with specific occupational problems and vocation-related interventions. These requirements address patients across different indications and diagnoses. Rehabilitation centers are assigned to different levels of work-related interventions depending on the intensity and specificity of the profile. Centers providing the complete range of work-related interventions offer differentiated work-related diagnostics, job training and occupational groups in addition to general social advice. In this article four case studies with different priorities regarding vocational interventions are presented.

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 Value of Reliable Data: Interactive Data Tools from the National Comprehensive Center for Teacher Quality. Policy-to-Practice Brief. Number 1

ERIC Educational Resources Information Center

National Comprehensive Center for Teacher Quality, 2008

2008-01-01

The National Comprehensive Center for Teacher Quality (TQ Center) designed the Interactive Data Tools to provide users with access to state and national data that can be helpful in assessing the qualifications of teachers in the states and the extent to which a state's teacher policy climate generally supports teacher quality. The Interactive Data…

Where Lies the Fault in Diagnosing Dhat Syndrome among Females? Understanding through a Case Study.

PubMed

Kar, Sujita Kumar; Singh, Amit

2017-01-01

Dhat syndrome is a culture-bound syndrome of South-East Asia, common in young men. However, similar entity has also been described in female patients who attribute their symptoms to nonpathological or physiological vaginal discharge. The current diagnostic system for psychiatric illnesses does not encompass Dhat syndrome in females, and so these group of patients receive alternative diagnoses such as somatoform disorder or depression. As a result of which the focus of unique Dhat syndrome-centered management gets weakened, affecting the clinical outcome. This case study focuses on the diagnostic dilemmas related to Dhat syndrome in females and pitfalls in the current diagnostic system.

A Learner-Centered Technique and Clinical Reasoning, Reflection, and Case Presentation Attributes in Athletic Training Students

PubMed Central

Heinerichs, Scott; Vela, Luzita I.; Drouin, Joshua M.

2013-01-01

Context: Providing opportunities to develop clinical decision-making skills, including clinical reasoning, is an important aspect of clinical education. The learner-centered technique of summarizing the history and findings, narrowing the differential, analyzing the differential, probing the instructor about uncertainties, plan management, and selecting an issue for self-directed study (SNAPPS) is used in medicine to express clinical reasoning. Objective: To investigate the effects of SNAPPS on the clinical reasoning, reflection, and 4 case presentation attributes (length, conciseness, case summary, and expression of clinical reasoning) in athletic training students. Design: Randomized controlled clinical trial. Setting: Three undergraduate programs accredited by the Commission on Accreditation of Athletic Training Education. Patients or Other Participants: We randomly assigned 38 athletic training students (17 men, 21 women; age = 21.53 ± 1.18 years, grade point average = 3.25 ± 0.31) who had completed at least 1 year of clinical education and all orthopaedic evaluation coursework to the SNAPPS group or the usual and customary group using a stratification scheme. Intervention(s): The SNAPPS group completed four 45-minute clinical reasoning and case presentation learning modules led by an investigator to learn the SNAPPS technique, whereas the usual and customary group received no formal instruction. Both groups audio recorded all injury evaluations performed over a 2-week period. Main Outcome Measures: Participants completed the Diagnostic Thinking Inventory and Reflection in Learning Scale twice. Case presentations were analyzed for 4 attributes: length, conciseness, case summary, and expression of clinical reasoning. Results: Case presentations were longer (t18.806 = −5.862, P < .001) but were more concise (t32 = 11.297, P < .001) for the SNAPPS group than for the usual and customary group. The SNAPPS group performed better on both the case summary subscale (t32 = 2.857, P = .007) and the clinical reasoning subscale (t25.773 = −14.162, P < .001) than the other group. We found a time effect for Diagnostic Thinking Inventory scores (F1,34 = 6.230, P = .02) but observed no group effects (F1,34 = 0.698, P = .41) or time-by-group interaction (F1,34 = 1.050, P = .31). The Reflection in Learning Scale scores analysis revealed no group-by-time interaction (F1,34 = 1.470, P = .23) and no group (F1,34 = 3.751, P = .06) or time (F1,34 = 0.835, P = .37) effects. Conclusions: The SNAPPS is an effective and feasible clinical education technique for case presentations. This learner-centered technique provides the opportunity for the expression of clinical reasoning skills. PMID:23675796

Biopsy of Liver Target Lesions under Contrast-Enhanced Ultrasound Guidance - A Multi-Center Study.

PubMed

Francica, Giampiero; Meloni, Maria Franca; de Sio, Ilario; Terracciano, Fulvia; Caturelli, Eugenio; Riccardi, Laura; Roselli, Paola; Iadevaia, Maddalena Diana; Scaglione, Mariano; Lenna, Giovanni; Chiang, Jason; Pompili, Maurizio

2017-12-12

Purpose  To retrospectively characterize the prevalence and impact of contrast-enhanced ultrasound (CEUS) as a guidance technique for the biopsy of liver target lesions (LTLs) at six interventional ultrasound centers. Materials and Methods  The six participating centers retrospectively selected all patients in whom biopsy needles were positioned in LTLs during CEUS. The prevalence of CEUS-guided biopsies at each center between 2005 and 2016, contrast agent consumption, procedure indications, diagnostic yield and complications were assessed. Informed consent was obtained for all patients. Results  CEUS-guided biopsy of LTLs was carried out in 103 patients (68 M/35 F, median age: 69 yrs) with 103 liver target lesions (median size: 20 mm) using cutting needles (18 - 20 g) in 94 cases (91.2 %). CEUS-guided biopsy represented 2.6 % (range: 0.8 - 7.7 %) of 3818 biopsies on LTLs carried out at the participating centers. Indications to CEUS-guided biopsy were: a target lesion not visible on non-enhanced US (27.2 %), improvement of conspicuity of the target (33 %), choice of non-necrotic area inside the target (39.8 %). 26 patients (25.2 %) had a previously non-diagnostic cyto-histological exam. The diagnostic accuracy of the technique was 99 %. No major complications followed infusion of contrast agent or biopsy performance. Conclusion  The indications for CEUS-guided biopsy for LTLs are limited, but CEUS can be useful in challenging clinical scenarios, e. g. poorly visualized or invisible lesions or sampling of non-necrotic areas in the target lesions. There is also a potential advantage in using CEUS to guide repeat biopsies after unsuccessful sampling performed using the standard ultrasound technique. © Georg Thieme Verlag KG Stuttgart · New York.

Measuring the Interactive Skills of Caregivers in Child Care Centers: Development and Validation of the Caregiver Interaction Profile Scales

ERIC Educational Resources Information Center

Helmerhorst, Katrien O. W.; Riksen-Walraven, J. Marianne; Vermeer, Harriet J.; Fukkink, Ruben G.; Tavecchio, Louis W. C.

2014-01-01

Research Findings: High-quality caregiver-child interactions constitute the core of high-quality child care for young children. This article describes the background and development of the Caregiver Interaction Profile (CIP) scales to rate 6 key skills of caregivers for interacting with 0-to 4-year-old children in child care centers: sensitive…

Astrophysical neutrino production diagnostics with the Glashow resonance

NASA Astrophysics Data System (ADS)

Biehl, Daniel; Fedynitch, Anatoli; Palladino, Andrea; Weiler, Tom J.; Winter, Walter

2017-01-01

We study the Glashow resonance bar nue + e- → W- → hadrons at 6.3 PeV as diagnostic of the production processes of ultra-high energy neutrinos. The focus lies on describing the physics of neutrino production from pion decay as accurate as possible by including the kinematics of weak decays and Monte Carlo simulations of pp and pγ interactions. We discuss optically thick (to photohadronic interactions) sources, sources of cosmic ray ``nuclei'' and muon damped sources. Even in the proposed upgrade IceCube-Gen2, a discrimination of scenarios such as pp versus pγ is extremely challenging under realistic assumptions. Nonetheless, the Glashow resonance can serve as a smoking gun signature of neutrino production from photohadronic (Aγ) interactions of heavier nuclei, as the expected Glashow event rate exceeds that of pp interactions. We finally quantify the exposures for which the non-observation of Glashow events exerts pressure on certain scenarios.

Rural People with Disabilities

MedlinePlus

... Toolkits Economic Impact Analysis Tool Community Health Gateway Sustainability Planning Tools Testing New Approaches Rural Health IT ... problems Accessible treatment and diagnostic equipment A 2017 report from the Centers for Medicare and Medicaid Services ( ...

Data Fusion for Enhanced Aircraft Engine Prognostics and Health Management

NASA Technical Reports Server (NTRS)

Volponi, Al

2005-01-01

Aircraft gas-turbine engine data is available from a variety of sources, including on-board sensor measurements, maintenance histories, and component models. An ultimate goal of Propulsion Health Management (PHM) is to maximize the amount of meaningful information that can be extracted from disparate data sources to obtain comprehensive diagnostic and prognostic knowledge regarding the health of the engine. Data fusion is the integration of data or information from multiple sources for the achievement of improved accuracy and more specific inferences than can be obtained from the use of a single sensor alone. The basic tenet underlying the data/ information fusion concept is to leverage all available information to enhance diagnostic visibility, increase diagnostic reliability and reduce the number of diagnostic false alarms. This report describes a basic PHM data fusion architecture being developed in alignment with the NASA C-17 PHM Flight Test program. The challenge of how to maximize the meaningful information extracted from disparate data sources to obtain enhanced diagnostic and prognostic information regarding the health and condition of the engine is the primary goal of this endeavor. To address this challenge, NASA Glenn Research Center, NASA Dryden Flight Research Center, and Pratt & Whitney have formed a team with several small innovative technology companies to plan and conduct a research project in the area of data fusion, as it applies to PHM. Methodologies being developed and evaluated have been drawn from a wide range of areas including artificial intelligence, pattern recognition, statistical estimation, and fuzzy logic. This report will provide a chronology and summary of the work accomplished under this research contract.

Edema is not a reliable diagnostic sign to exclude small brain metastases.

PubMed

Schneider, Tanja; Kuhne, Jan Felix; Bittrich, Paul; Schroeder, Julian; Magnus, Tim; Mohme, Malte; Grosser, Malte; Schoen, Gerhard; Fiehler, Jens; Siemonsen, Susanne

2017-01-01

No prior systematic study on the extent of vasogenic edema (VE) in patients with brain metastases (BM) exists. Here, we aim to determine 1) the general volumetric relationship between BM and VE, 2) a threshold diameter above which a BM shows VE, and 3) the influence of the primary tumor and location of the BM in order to improve diagnostic processes and understanding of edema formation. This single center, retrospective study includes 173 untreated patients with histologically proven BM. Semi-manual segmentation of 1416 BM on contrast-enhanced T1-weighted images and of 865 VE on fluid-attenuated inversion recovery/T2-weighted images was conducted. Statistical analyses were performed using a paired-samples t-test, linear regression/generalized mixed-effects model, and receiver-operating characteristic (ROC) curve controlling for the possible effect of non-uniformly distributed metastases among patients. For BM with non-confluent edema (n = 545), there was a statistically significant positive correlation between the volumes of the BM and the VE (P < 0.001). The optimal threshold for edema formation was a diameter of 9.4 mm for all BM. The primary tumors as interaction term in multivariate analysis had a significant influence on VE formation whereas location had not. Hence VE development is dependent on the volume of the underlying BM and the site of the primary neoplasm, but not from the location of the BM.

The clinician's guide to autism.

PubMed

Harrington, John W; Allen, Korrie

2014-02-01

On the basis of the most recent epidemiologic research, Autism Spectrum Disorder (ASD) affects approximately 1% to 2% of all children. (1)(2) On the basis of some research evidence and consensus, the Modified Checklist for Autism in Toddlers isa helpful tool to screen for autism in children between ages 16 and 30 months. (11) The Diagnostic Statistical Manual of Mental Disorders, Fourth Edition, changes to a 2-symptom category from a 3-symptom category in the Diagnostic Statistical Manual of Mental Disorders, Fifth Edition(DSM-5): deficits in social communication and social interaction are combined with repetitive and restrictive behaviors, and more criteria are required per category. The DSM-5 subsumes all the previous diagnoses of autism (classic autism, Asperger syndrome, and pervasive developmental disorder not otherwise specified) into just ASDs. On the basis of moderate to strong evidence, the use of applied behavioral analysis and intensive behavioral programs has a beneficial effect on language and the core deficits of children with autism. (16) Currently, minimal or no evidence is available to endorse most complementary and alternative medicine therapies used by parents, such as dietary changes (gluten free), vitamins, chelation, and hyperbaric oxygen. (16) On the basis of consensus and some studies, pediatric clinicians should improve their capacity to provide children with ASD a medical home that is accessible and provides family-centered, continuous, comprehensive and coordinated, compassionate, and culturally sensitive care. (20)

A 300 GHz collective scattering diagnostic for low temperature plasmas.

PubMed

Hardin, Robert A; Scime, Earl E; Heard, John

2008-10-01

A compact and portable 300 GHz collective scattering diagnostic employing a homodyne detection scheme has been constructed and installed on the hot helicon experiment (HELIX). Verification of the homodyne detection scheme was accomplished with a rotating grooved aluminum wheel to Doppler shift the interaction beam. The HELIX chamber geometry and collection optics allow measurement of scattering angles ranging from 60 degrees to 90 degrees. Artificially driven ion-acoustic waves are also being investigated as a proof-of-principle test for the diagnostic system.

Assessment and Mitigation of Diagnostic-Generated Electromagnetic Interference at the National Ignition Facility

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

Brown, C G; Ayers, M J; Felker, B

2012-04-20

Electromagnetic interference (EMI) is an ever-present challenge at laser facilities such as the National Ignition Facility (NIF). The major source of EMI at such facilities is laser-target interaction that can generate intense electromagnetic fields within, and outside of, the laser target chamber. In addition, the diagnostics themselves can be a source of EMI, even interfering with themselves. In this paper we describe EMI generated by ARIANE and DIXI, present measurements, and discuss effects of the diagnostic-generated EMI on ARIANE's CCD and on a PMT nearby DIXI. Finally we present some of the efforts we have made to mitigate the effectsmore » of diagnostic-generated EMI on NIF diagnostics.« less

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.

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.

[Improvement of work of chiefs of therapeutic and diagnostic hospital departments--chief medical specialists of military districts (fleet)].

PubMed

Tregubov, V N; Kostiuchenko, A I; Stetsenko, B G

2009-03-01

In now-day conditions, on the background of enlargement and complication of tasks', solved by military health service, it's supervised the increase of significance of qualitative and effective administration by collectives of military-medical organizations. An important role belongs to activity of chiefs of treatment-diagnostic units (centers) of military hospitals. These chiefs in the same time are staff or inorganic medical specialists of military regions (NAVYs).

Higher cost of implementing Xpert(®) MTB/RIF in Ugandan peripheral settings: implications for cost-effectiveness.

PubMed

Hsiang, E; Little, K M; Haguma, P; Hanrahan, C F; Katamba, A; Cattamanchi, A; Davis, J L; Vassall, A; Dowdy, D

2016-09-01

Initial cost-effectiveness evaluations of Xpert(®) MTB/RIF for tuberculosis (TB) diagnosis have not fully accounted for the realities of implementation in peripheral settings. To evaluate costs and diagnostic outcomes of Xpert testing implemented at various health care levels in Uganda. We collected empirical cost data from five health centers utilizing Xpert for TB diagnosis, using an ingredients approach. We reviewed laboratory and patient records to assess outcomes at these sites and10 sites without Xpert. We also estimated incremental cost-effectiveness of Xpert testing; our primary outcome was the incremental cost of Xpert testing per newly detected TB case. The mean unit cost of an Xpert test was US$21 based on a mean monthly volume of 54 tests per site, although unit cost varied widely (US$16-58) and was primarily determined by testing volume. Total diagnostic costs were 2.4-fold higher in Xpert clinics than in non-Xpert clinics; however, Xpert only increased diagnoses by 12%. The diagnostic costs of Xpert averaged US$119 per newly detected TB case, but were as high as US$885 at the center with the lowest volume of tests. Xpert testing can detect TB cases at reasonable cost, but may double diagnostic budgets for relatively small gains, with cost-effectiveness deteriorating with lower testing volumes.

A Magnetoencephalographic (MEG) Study of Gulf War Illness (GWI).

PubMed

Engdahl, Brian E; James, Lisa M; Miller, Ryan D; Leuthold, Arthur C; Lewis, Scott M; Carpenter, Adam F; Georgopoulos, Apostolos P

2016-10-01

Gulf War Illness (GWI) has affected many Gulf War veterans. It involves several organs, most notably the brain. Neurological-cognitive-mood-related symptoms frequently dominate and are at the root of chronic ill-health and disability in GWI. Here we investigated the neural mechanisms underlying brain dysfunction in GWI in the absence of mental health disorders. Eighty-six veterans completed diagnostic interviews to establish the presence of GWI and assess mental health status. Participants diagnosed with GWI met both Center for Disease Control and Kansas criteria. We studied 46 healthy controls and 40 veterans with GWI without mental illness. They all underwent a resting-state magnetoencephalographic (MEG) scan to assess brain communication based on synchronous neural interactions (SNI; Georgopoulos et al., 2007). We found substantial differences in SNI between control and GWI groups centered on the cerebellum and frontal cortex. In addition, using the maxima and minima of SNI per sensor as predictors, we successfully classified 94.2% of the 86 participants (95% sensitivity, 93.5% specificity). These findings document distinct differences in brain function between control and GWI in the absence of mental health comorbidities, differences that are excellent predictors of GWI. U.S. Department of Veterans Affairs and University of Minnesota. Published by Elsevier B.V.

Patient-Reported Experience of Diagnosis, Management, and Burden of Neuroendocrine Tumors

PubMed Central

Wolin, Edward M.; Leyden, John; Goldstein, Grace; Kolarova, Teodora; Hollander, Ron; Warner, Richard R.P.

2017-01-01

Objectives The aim of this survey was to examine the experience of patients with neuroendocrine tumors (NETs) to raise awareness of the NET-related burden and identify unmet needs. Here, we report data from patients in the United States. Methods Patients with NETs participated in a 25-minute anonymous survey, conducted primarily online from February to May 2014. Survey questions captured information on sociodemographics, clinical characteristics, NET diagnostic experience, disease impact/management, interaction with medical teams, and NETs knowledge/awareness. Results Of 1928 patients who participated globally, the largest percentage was from the United States (39%). Approximately 50% of US patients reported being diagnosed with other conditions before receiving their NET diagnosis, which for 34% took 5 years or more. Patients experienced many symptoms on a daily basis as a result of NETs, which had a substantial negative impact on their work and daily lives. Numerous improvements were suggested by patients, including better access to NET-specific treatments and medical teams/centers and better education for the management of disease-related and treatment-related symptoms. Conclusions This survey demonstrated the significant burden of NETs on patients' lives and identified key areas for improvement in diagnosis and long-term management, including better access to NET-specific treatments and specialist medical teams/centers. PMID:28328615

An emerging cyberinfrastructure for biodefense pathogen and pathogen-host data.

PubMed

Zhang, C; Crasta, O; Cammer, S; Will, R; Kenyon, R; Sullivan, D; Yu, Q; Sun, W; Jha, R; Liu, D; Xue, T; Zhang, Y; Moore, M; McGarvey, P; Huang, H; Chen, Y; Zhang, J; Mazumder, R; Wu, C; Sobral, B

2008-01-01

The NIAID-funded Biodefense Proteomics Resource Center (RC) provides storage, dissemination, visualization and analysis capabilities for the experimental data deposited by seven Proteomics Research Centers (PRCs). The data and its publication is to support researchers working to discover candidates for the next generation of vaccines, therapeutics and diagnostics against NIAID's Category A, B and C priority pathogens. The data includes transcriptional profiles, protein profiles, protein structural data and host-pathogen protein interactions, in the context of the pathogen life cycle in vivo and in vitro. The database has stored and supported host or pathogen data derived from Bacillus, Brucella, Cryptosporidium, Salmonella, SARS, Toxoplasma, Vibrio and Yersinia, human tissue libraries, and mouse macrophages. These publicly available data cover diverse data types such as mass spectrometry, yeast two-hybrid (Y2H), gene expression profiles, X-ray and NMR determined protein structures and protein expression clones. The growing database covers over 23 000 unique genes/proteins from different experiments and organisms. All of the genes/proteins are annotated and integrated across experiments using UniProt Knowledgebase (UniProtKB) accession numbers. The web-interface for the database enables searching, querying and downloading at the level of experiment, group and individual gene(s)/protein(s) via UniProtKB accession numbers or protein function keywords. The system is accessible at http://www.proteomicsresource.org/.

42 CFR 414.65 - Payment for telehealth services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... professional service via an interactive telecommunications system is made according to the following... psychotherapy, psychiatric diagnostic interview examination, pharmacologic management, end-stage renal disease... intervention services furnished via an interactive telecommunications system is equal to the current fee...

Computers for Interactive Learning.

ERIC Educational Resources Information Center

Grabowski, Barbara; Aggen, William

1984-01-01

Analyzes features of computer-based interactive video including sophisticated answer judging, diagnostic feedback, simulation, animation, audible tones, touch sensitive screen, function keys, and video enhancements, and matches these to the characteristics and pedagogical styles of learners. The learner characteristics discussed include internal…

Intelligent Data Visualization for Cross-Checking Spacecraft System Diagnosis

NASA Technical Reports Server (NTRS)

Ong, James C.; Remolina, Emilio; Breeden, David; Stroozas, Brett A.; Mohammed, John L.

2012-01-01

Any reasoning system is fallible, so crew members and flight controllers must be able to cross-check automated diagnoses of spacecraft or habitat problems by considering alternate diagnoses and analyzing related evidence. Cross-checking improves diagnostic accuracy because people can apply information processing heuristics, pattern recognition techniques, and reasoning methods that the automated diagnostic system may not possess. Over time, cross-checking also enables crew members to become comfortable with how the diagnostic reasoning system performs, so the system can earn the crew s trust. We developed intelligent data visualization software that helps users cross-check automated diagnoses of system faults more effectively. The user interface displays scrollable arrays of timelines and time-series graphs, which are tightly integrated with an interactive, color-coded system schematic to show important spatial-temporal data patterns. Signal processing and rule-based diagnostic reasoning automatically identify alternate hypotheses and data patterns that support or rebut the original and alternate diagnoses. A color-coded matrix display summarizes the supporting or rebutting evidence for each diagnosis, and a drill-down capability enables crew members to quickly view graphs and timelines of the underlying data. This system demonstrates that modest amounts of diagnostic reasoning, combined with interactive, information-dense data visualizations, can accelerate system diagnosis and cross-checking.

Physician Interactions with Electronic Health Records in Primary Care

PubMed Central

Montague, Enid; Asan, Onur

2013-01-01

Objective It is essential to design technologies and systems that promote appropriate interactions between physicians and patients. This study explored how physicians interact with Electronic Health Records (EHRs) to understand the qualities of the interaction between the physician and the EHR that may contribute to positive physician-patient interactions. Study Design Video-taped observations of 100 medical consultations were used to evaluate interaction patterns between physicians and EHRs. Quantified observational methods were used to contribute to ecological validity. Methods Ten primary care physicians and 100 patients from five clinics participated in the study. Clinical encounters were recorded with video cameras and coded using a validated objective coding methodology in order to examine how physicians interact with electronic health records. Results Three distinct styles were identified that characterize physician interactions with the EHR: technology-centered, human-centered, and mixed. Physicians who used a technology-centered style spent more time typing and gazing at the computer during the visit. Physicians who used a mixed style shifted their attention and body language between their patients and the technology throughout the visit. Physicians who used the human-centered style spent the least amount of time typing and focused more on the patient. Conclusion A variety of EHR interaction styles may be effective in facilitating patient-centered care. However, potential drawbacks of each style exist and are discussed. Future research on this topic and design strategies for effective health information technology in primary care are also discussed. PMID:24009982

Cone beam tomographic imaging anatomy of the maxillofacial region.

PubMed

Angelopoulos, Christos

2008-10-01

Multiplanar imaging is a fairly new concept in diagnostic imaging available with a number of contemporary imaging modalities such as CT, MR imaging, diagnostic ultrasound, and others. This modality allows reconstruction of images in different planes (flat or curved) from a volume of data that was acquired previously. This concept makes the diagnostic process more interactive, and proper use may increase diagnostic potential. At the same time, the complexity of the anatomical structures on the maxillofacial region may make it harder for these images to be interpreted. This article reviews the anatomy of maxillofacial structures in planar imaging, and more specifically cone-beam CT images.

Repeatability and Diagnostic Value of Nasal Potential Difference in a Genetically Admixed Population.

PubMed

Sad, Izabela Rocha; Higa, Laurinda Yoko Shinzato; Leal, Teresinha; Martins, Raisa da Silva; de Almeida, Ana Claudia; Ramos, Eloane Goncalves; de Cabello, Giselda Maria Kalil; Peixoto, Maria Virginia Marques

2016-01-01

The genetic diversity of the Brazilian population results from three ethnic groups admixture: Europeans, Africans and Amerindians, thus increasing the difficulty of performing cystic fibrosis (CF) diagnosis. The nasal potential difference (NPD) evaluates the cystic fibrosis transmembrane conductance regulator (CFTR) and epithelial sodium channel (ENaC) activity. Despite being a useful CF diagnostic test and a biomarker of CFTR-modulator drugs, it is also highly operator dependent. Therefore, it may be difficult to get accurate results and to interpret them. Wilschanski and Sermet scores were proposed to address these issues. This study aimed to evaluate repeatability and diagnostic value of NPD parameters and Wilschanski and Sermet scores in a CF center in Rio de Janeiro. NPD was performed in 78 subjects. Maximal PD, amiloride response, total chloride response, and Wilschanski and Sermet scores were explored as means (confidence interval, CI). One-way ANOVA was used to compare mean differences and Scheffe test was used to pair-wise comparisons. Repeatability was evaluated by scatter and Bland-Altman plots. The Ethics Committee of the CF Center has approved the study protocol. Parents and adult participants signed an informed consent form. Forty-eight healthy-volunteers, 19 non-CF and 11 CF patients were enrolled in this study. Significant differences were found when comparing CF patients' NPD parameters to the other two groups (P = 0.000). Moreover, no significant differences were found when parameters from non-CF patients were compared with those from healthy volunteers (P > 0.05). The means of NPD parameters and diagnostic scores of each group were in concordance with disease/non-disease conditions. The repeatability data - Wilschanski and Sermet and NPD - allow NPD to be performed in this Brazilian CF Center. The present study gathered consistent data for Bland-Altman plots. The results of Wilschanski and Sermet diagnostic scores suggest that they were concordant with CF/non-CF conditions. More NPD tests should be performed in the Rio de Janeiro CF dynamic cohort to contribute to international NPD validation studies and to provide NPD as a biomarker in Brazil.

Repeatability and Diagnostic Value of Nasal Potential Difference in a Genetically Admixed Population

PubMed Central

Sad, Izabela Rocha; Higa, Laurinda Yoko Shinzato; Leal, Teresinha; Martins, Raisa da Silva; de Almeida, Ana Claudia; Ramos, Eloane Goncalves; de Cabello, Giselda Maria Kalil; Peixoto, Maria Virginia Marques

2016-01-01

Background The genetic diversity of the Brazilian population results from three ethnic groups admixture: Europeans, Africans and Amerindians, thus increasing the difficulty of performing cystic fibrosis (CF) diagnosis. The nasal potential difference (NPD) evaluates the cystic fibrosis transmembrane conductance regulator (CFTR) and epithelial sodium channel (ENaC) activity. Despite being a useful CF diagnostic test and a biomarker of CFTR-modulator drugs, it is also highly operator dependent. Therefore, it may be difficult to get accurate results and to interpret them. Wilschanski and Sermet scores were proposed to address these issues. This study aimed to evaluate repeatability and diagnostic value of NPD parameters and Wilschanski and Sermet scores in a CF center in Rio de Janeiro. Methods NPD was performed in 78 subjects. Maximal PD, amiloride response, total chloride response, and Wilschanski and Sermet scores were explored as means (confidence interval, CI). One-way ANOVA was used to compare mean differences and Scheffe test was used to pair-wise comparisons. Repeatability was evaluated by scatter and Bland-Altman plots. The Ethics Committee of the CF Center has approved the study protocol. Parents and adult participants signed an informed consent form. Results Forty-eight healthy-volunteers, 19 non-CF and 11 CF patients were enrolled in this study. Significant differences were found when comparing CF patients’ NPD parameters to the other two groups (P = 0.000). Moreover, no significant differences were found when parameters from non-CF patients were compared with those from healthy volunteers (P > 0.05). The means of NPD parameters and diagnostic scores of each group were in concordance with disease/non-disease conditions. The repeatability data - Wilschanski and Sermet and NPD - allow NPD to be performed in this Brazilian CF Center. Conclusions The present study gathered consistent data for Bland-Altman plots. The results of Wilschanski and Sermet diagnostic scores suggest that they were concordant with CF/non-CF conditions. More NPD tests should be performed in the Rio de Janeiro CF dynamic cohort to contribute to international NPD validation studies and to provide NPD as a biomarker in Brazil. PMID:26668678

New and Noteworthy in Tuberculosis Diagnostics and Treatment.

PubMed

Swindells, Susan

2018-06-01

People with HIV infection with latent tuberculosis (TB) infection (LTBI) are at a 10-fold greater risk of developing active disease. Interferon gamma release assays and tuberculin skin testing have approximately 65% to 70% specificity for diagnosing LTBI in HIV-infected patients. LTBI can be successfully treated with isoniazid preventive therapy and early antiretroviral therapy (ART). Rapid molecular diagnostics have approximately 88% sensitivity and 98% specificity for identifying active TB. ART should be started early in patients with TB. A number of ART regimens are recommended in co-treatment that minimize the risk of drug-drug interactions. Although progress has been made, better diagnostics and TB regimens with lower risks of drug-drug interactions and shorter treatment durations are still needed. This article summarizes a presentation by Susan Swindells, MBBS, at the Ryan White HIV/AIDS Program Clinical Care Conference held in San Antonio in August 2017.

Array-based sensing using nanoparticles: an alternative approach for cancer diagnostics.

PubMed

Le, Ngoc D B; Yazdani, Mahdieh; Rotello, Vincent M

2014-07-01

Array-based sensing using nanoparticles (NPs) provides an attractive alternative to specific biomarker-focused strategies for cancer diagnosis. The physical and chemical properties of NPs provide both the recognition and transduction capabilities required for biosensing. Array-based sensors utilize a combined response from the interactions between sensors and analytes to generate a distinct pattern (fingerprint) for each analyte. These interactions can be the result of either the combination of multiple specific biomarker recognition (specific binding) or multiple selective binding responses, known as chemical nose sensing. The versatility of the latter array-based sensing using NPs can facilitate the development of new personalized diagnostic methodologies in cancer diagnostics, a necessary evolution in the current healthcare system to better provide personalized treatments. This review will describe the basic principle of array-based sensors, along with providing examples of both invasive and noninvasive samples used in cancer diagnosis.

Conventional and molecular diagnostic strategies for prosthetic joint infections.

PubMed

Esteban, Jaime; Sorlí, Luisa; Alentorn-Geli, Eduard; Puig, Lluís; Horcajada, Juan P

2014-01-01

An accurate diagnosis of prosthetic joint infection (PJI) is the mainstay for an optimized clinical management. This review analyzes different diagnostic strategies of PJI, with special emphasis on molecular diagnostic tools and their current and future applications. Until now, the culture of periprosthetic tissues has been considered the gold standard for the diagnosis of PJI. However, sonication of the implant increases the sensitivity of those cultures and is being increasingly adopted by many centers. Molecular diagnostic methods compared with intraoperative tissue culture, especially if combined with sonication, have a higher sensitivity, a faster turnaround time and are not influenced by previous antimicrobial therapy. However, they still lack a system for detection of antimicrobial susceptibility, which is crucial for an optimized and less toxic therapy of PJI. More studies are needed to assess the clinical value of these methods and their cost-effectiveness.

Diagnosis, monitoring, and treatment of primary ciliary dyskinesia: PCD foundation consensus recommendations based on state of the art review.

PubMed

Shapiro, Adam J; Zariwala, Maimoona A; Ferkol, Thomas; Davis, Stephanie D; Sagel, Scott D; Dell, Sharon D; Rosenfeld, Margaret; Olivier, Kenneth N; Milla, Carlos; Daniel, Sam J; Kimple, Adam J; Manion, Michele; Knowles, Michael R; Leigh, Margaret W

2016-02-01

Primary ciliary dyskinesia (PCD) is a genetically heterogeneous, rare lung disease resulting in chronic oto-sino-pulmonary disease in both children and adults. Many physicians incorrectly diagnose PCD or eliminate PCD from their differential diagnosis due to inexperience with diagnostic testing methods. Thus far, all therapies used for PCD are unproven through large clinical trials. This review article outlines consensus recommendations from PCD physicians in North America who have been engaged in a PCD centered research consortium for the last 10 years. These recommendations have been adopted by the governing board of the PCD Foundation to provide guidance for PCD clinical centers for diagnostic testing, monitoring, and appropriate short and long-term therapeutics in PCD patients. © 2015 The Authors. Pediatric Pulmonology Published by Wiley Periodicals, Inc.

Evaluation of an Intelligent Tutoring System in Pathology: Effects of External Representation on Performance Gains, Metacognition, and Acceptance

PubMed Central

Crowley, Rebecca S.; Legowski, Elizabeth; Medvedeva, Olga; Tseytlin, Eugene; Roh, Ellen; Jukic, Drazen

2007-01-01

Objective Determine effects of computer-based tutoring on diagnostic performance gains, meta-cognition, and acceptance using two different problem representations. Describe impact of tutoring on spectrum of diagnostic skills required for task performance. Identify key features of student-tutor interaction contributing to learning gains. Design Prospective, between-subjects study, controlled for participant level of training. Resident physicians in two academic pathology programs spent four hours using one of two interfaces which differed mainly in external problem representation. The case-focused representation provided an open-learning environment in which students were free to explore evidence-hypothesis relationships within a case, but could not visualize the entire diagnostic space. The knowledge-focused representation provided an interactive representation of the entire diagnostic space, which more tightly constrained student actions. Measurements Metrics included results of pretest, post-test and retention-test for multiple choice and case diagnosis tests, ratios of performance to student reported certainty, results of participant survey, learning curves, and interaction behaviors during tutoring. Results Students had highly significant learning gains after one tutoring session. Learning was retained at one week. There were no differences between the two interfaces in learning gains on post-test or retention test. Only students in the knowledge-focused interface exhibited significant metacognitive gains from pretest to post-test and pretest to retention test. Students rated the knowledge-focused interface significantly higher than the case-focused interface. Conclusions Cognitive tutoring is associated with improved diagnostic performance in a complex medical domain. The effect is retained at one-week post-training. Knowledge-focused external problem representation shows an advantage over case-focused representation for metacognitive effects and user acceptance. PMID:17213494

Evaluation of an intelligent tutoring system in pathology: effects of external representation on performance gains, metacognition, and acceptance.

PubMed

Crowley, Rebecca S; Legowski, Elizabeth; Medvedeva, Olga; Tseytlin, Eugene; Roh, Ellen; Jukic, Drazen

2007-01-01

Determine effects of computer-based tutoring on diagnostic performance gains, meta-cognition, and acceptance using two different problem representations. Describe impact of tutoring on spectrum of diagnostic skills required for task performance. Identify key features of student-tutor interaction contributing to learning gains. Prospective, between-subjects study, controlled for participant level of training. Resident physicians in two academic pathology programs spent four hours using one of two interfaces which differed mainly in external problem representation. The case-focused representation provided an open-learning environment in which students were free to explore evidence-hypothesis relationships within a case, but could not visualize the entire diagnostic space. The knowledge-focused representation provided an interactive representation of the entire diagnostic space, which more tightly constrained student actions. Metrics included results of pretest, post-test and retention-test for multiple choice and case diagnosis tests, ratios of performance to student reported certainty, results of participant survey, learning curves, and interaction behaviors during tutoring. Students had highly significant learning gains after one tutoring session. Learning was retained at one week. There were no differences between the two interfaces in learning gains on post-test or retention test. Only students in the knowledge-focused interface exhibited significant metacognitive gains from pretest to post-test and pretest to retention test. Students rated the knowledge-focused interface significantly higher than the case-focused interface. Cognitive tutoring is associated with improved diagnostic performance in a complex medical domain. The effect is retained at one-week post-training. Knowledge-focused external problem representation shows an advantage over case-focused representation for metacognitive effects and user acceptance.

The clinician in the driver's seat: part 2 - intelligent uses of space in a drag/drop user-composable electronic health record.

PubMed

Senathirajah, Yalini; Kaufman, David; Bakken, Suzanne

2014-12-01

User-composable approaches provide clinicians with the control to design and assemble information elements on screen via drag/drop. They hold considerable promise for enhancing the electronic-health-records (EHRs) user experience. We previously described this novel approach to EHR design and our illustrative system, MedWISE. The purpose of this paper is to describe clinician users' intelligent uses of space during completion of real patient case studies in a laboratory setting using MedWISE. Thirteen clinicians at a quaternary academic medical center used the system to review four real patient cases. We analyzed clinician utterances, behaviors, screen layouts (i.e., interface designs), and their perceptions associated with completing patient case studies. Clinicians effectively used the system to review all cases. Two coding schemata pertaining to human-computer interaction and diagnostic reasoning were used to analyze the data. Users adopted three main interaction strategies: rapidly gathering items on screen and reviewing ('opportunistic selection' approach); creating highly structured screens ('structured' approach); and interacting with small groups of items in sequence as their case review progressed ('dynamic stage' approach). They also used spatial arrangement in ways predicted by theory and research on workplace spatial arrangement. This includes assignment of screen regions for particular purposes (24% of spatial codes), juxtaposition to facilitate calculation or other cognitive tasks ('epistemic action'), and grouping elements with common meanings or relevance to the diagnostic facets of the case (20.3%). A left-to-right progression of orienting materials, data, and action items or reflection space was a commonly observed pattern. Widget selection was based on user assessment of what information was useful or relevant. We developed and tested an illustrative system that gives clinicians greater control of the EHR, and demonstrated its feasibility for case review by typical clinicians. Producing the simplifying inventions, such as user-composable platforms that shift control to the user, may serve to promote productive EHR use and enhance its value as an instrument of patient care. Copyright © 2014 Elsevier Inc. All rights reserved.

The Clinician in the Driver’s Seat: Part 2 – Intelligent Uses of Space in a Drag/Drop User-Composable Electronic Health Record

PubMed Central

Senathirajah, Yalini; Kaufman, David; Bakken, Suzanne

2018-01-01

User-composable approaches provide clinicians with the control to design and assemble information elements on screen via drag/drop. They hold considerable promise for enhancing the electronic-health-records (EHRs) user experience. We previously described this novel approach to EHR design and our illustrative system, MedWISE. The purpose of this paper is to describe clinician users’ intelligent uses of space during completion of real patient case studies in a laboratory setting using MedWISE. Thirteen clinicians at a quaternary academic medical center used the system to review four real patient cases. We analyzed clinician utterances, behaviors, screen layouts (i.e., interface designs), and their perceptions associated with completing patient case studies. Clinicians effectively used the system to review all cases. Two coding schemata pertaining to human-computer interaction and diagnostic reasoning were used to analyze the data. Users adopted three main interaction strategies: rapidly gathering items on screen and reviewing (‘opportunistic selection’ approach); creating highly structured screens (‘structured’ approach); and interacting with small groups of items in sequence as their case review progressed (‘dynamic stage’ approach). They also used spatial arrangement in ways predicted by theory and research on workplace spatial arrangement. This includes assignment of screen regions for particular purposes (24% of spatial codes), juxtaposition to facilitate calculation or other cognitive tasks (‘epistemic action’), and grouping elements with common meanings or relevance to the diagnostic facets of the case (20.3%). A left-to-right progression of orienting materials, data, and action items or reflection space was a commonly observed pattern. Widget selection was based on user assessment of what information was useful or relevant. We developed and tested an illustrative system that gives clinicians greater control of the EHR, and demonstrated its feasibility for case review by typical clinicians. Producing the simplifying inventions, such as user-composable platforms that shift control to the user, may serve to promote productive EHR use and enhance its value as an instrument of patient care. PMID:25445921

Teledermatology. Current status and future directions.

PubMed

Whited, J D

2001-01-01

Teledermatology is becoming an increasingly common means of delivering dermatologic healthcare worldwide and will almost certainly play a greater role in the future. The type of technology used distinguishes the 2 modes of teledermatology consultation. The store and forward technique uses still digital images generated by a digital camera. Consultations of this type are considered asynchronous since the images are obtained, sent, and reviewed at different times. In contrast, real-time interactive consultations are synchronous. Patients and clinicians interact in real-time through an audio-video communication link. Each modality has its advantages and disadvantages, and studies appear in the literature that assess both technologies. Although diagnostic reliability (precision) assessments for teledermatology are subject to limitations, existing information indicates that both store and forward and real-time interactive technology result in reliable diagnostic outcomes when compared with clinic-based evaluations. Less information regarding diagnostic accuracy is available; however, one evaluation that used store and forward technology found comparable diagnostic accuracy between teledermatology consultations and clinic-based examinations. Currently, little information is available regarding cost effectiveness and patient outcomes. Existing evidence, while inconclusive, suggests that teledermatology may be more costly than traditional clinic-based care, especially when using real-time interactive technology. Teledermatology has been shown to have utility as a triage mechanism for determining the urgency or need for a clinic-based consultation. Overall, patients appear to accept teledermatology and are satisfied with it as a means of obtaining healthcare. Clinicians have also generally reported positive experiences with teledermatology. Future studies that focus on cost effectiveness, patient outcomes, and patient and clinician satisfaction will help further define the potential of teledermatology as a means of dermatologic healthcare delivery.

Need for an (n,α) Apparatus at the LANSCE

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

Koehler, Paul E.

2014-03-05

There is an urgent need for a new (n,α) measurement capability at the Los Alamos Neutrons Science Center (LANSCE) for several reasons. First, it has been shown that (n,α) measurements on medium- to heavy-mass nuclides can provide some of the best constraints on some of the most important reaction rates for explosive nucleosynthesis studies. A few such measurements have been made, but many more are needed. Second, there are a few (n,p) and (n,α) cross sections on lighter nuclides of importance to nuclear astrophysics that remain unmeasured. Third, it has been shown that (n,α) measurements can constrain photon strength functionsmore » (PSFs) at very low energies. This is important because recent experiments, theory, and astrophysical calculations have demonstrated that enhanced PSFs at these energies can have large impacts on nucleosynthesis occurring in explosive environments. Also, enhanced low-energy PSFs could have significant impact on (n,γ) cross sections of interest to radiochemical diagnostics of nuclear devices. However, the shape of PSFs at low energies is a subject of considerable controversy, so new data are badly needed. Fourth, previous (n,α) data have revealed a number of puzzles and hints of exotic atomic-nuclear interactions. In addition to being interesting in their own light, these interactions could be important for understanding high-energy-density environments such as in nuclear explosion and at the National Ignition Facility. Simulations indicate that the high neutron flux at the Manuel Lujan Jr. Neutron Scattering Center (MLNSC) at the LANSCE will make many more of the needed measurements feasible. Hence, a new (n,α) instrument at the MLNSC would enable a wide range of important and interesting basic and applied science.« less

Benchmarking Diagnostic Algorithms on an Electrical Power System Testbed

NASA Technical Reports Server (NTRS)

Kurtoglu, Tolga; Narasimhan, Sriram; Poll, Scott; Garcia, David; Wright, Stephanie

2009-01-01

Diagnostic algorithms (DAs) are key to enabling automated health management. These algorithms are designed to detect and isolate anomalies of either a component or the whole system based on observations received from sensors. In recent years a wide range of algorithms, both model-based and data-driven, have been developed to increase autonomy and improve system reliability and affordability. However, the lack of support to perform systematic benchmarking of these algorithms continues to create barriers for effective development and deployment of diagnostic technologies. In this paper, we present our efforts to benchmark a set of DAs on a common platform using a framework that was developed to evaluate and compare various performance metrics for diagnostic technologies. The diagnosed system is an electrical power system, namely the Advanced Diagnostics and Prognostics Testbed (ADAPT) developed and located at the NASA Ames Research Center. The paper presents the fundamentals of the benchmarking framework, the ADAPT system, description of faults and data sets, the metrics used for evaluation, and an in-depth analysis of benchmarking results obtained from testing ten diagnostic algorithms on the ADAPT electrical power system testbed.

Optimizing Diagnostic Imaging in the Emergency Department

PubMed Central

Mills, Angela M.; Raja, Ali S.; Marin, Jennifer R.

2015-01-01

While emergency diagnostic imaging use has increased significantly, there is a lack of evidence for corresponding improvements in patient outcomes. Optimizing emergency department (ED) diagnostic imaging has the potential to improve the quality, safety, and outcomes of ED patients, but to date, there have not been any coordinated efforts to further our evidence-based knowledge in this area. The objective of this article is to discuss six aspects of diagnostic imaging in order to provide background information on the underlying framework for the 2015 Academic Emergency Medicine consensus conference, “Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization.” The consensus conference aims to generate a high priority research agenda for emergency diagnostic imaging that will inform the design of future investigations. The six components herein will serve as the group topics for the conference: 1) patient-centered outcomes research; 2) clinical decision rules; 3) training, education, and competency; 4) knowledge translation and barriers to image optimization; 5) use of administrative data; and 6) comparative effectiveness research: alternatives to traditional CT use. PMID:25731864

Optimizing diagnostic imaging in the emergency department.

PubMed

Mills, Angela M; Raja, Ali S; Marin, Jennifer R

2015-05-01

While emergency diagnostic imaging use has increased significantly, there is a lack of evidence for corresponding improvements in patient outcomes. Optimizing emergency department (ED) diagnostic imaging has the potential to improve the quality, safety, and outcomes of ED patients, but to date, there have not been any coordinated efforts to further our evidence-based knowledge in this area. The objective of this article is to discuss six aspects of diagnostic imaging to provide background information on the underlying framework for the 2015 Academic Emergency Medicine consensus conference, "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization." The consensus conference aims to generate a high priority research agenda for emergency diagnostic imaging that will inform the design of future investigations. The six components herein will serve as the group topics for the conference: 1) patient-centered outcomes research; 2) clinical decision rules; 3) training, education, and competency; 4) knowledge translation and barriers to image optimization; 5) use of administrative data; and 6) comparative effectiveness research: alternatives to traditional CT use. © 2015 by the Society for Academic Emergency Medicine.

[SCAN system--semi-structured interview based on diagnostic criteria].

PubMed

Adamowski, Tomasz; Kiejna, Andrzej; Hadryś, Tomasz

2006-01-01

This paper presents the main features of contemporary diagnostic systems which are implemented into the SCAN--modern and semi-structured diagnostic interview. The concepts of further development of the classifications, rationale for operationalized diagnostic criteria and for the divisional approach to mental diagnoses will be in focus. The structure and components of SCAN ver. 2.1 (WHO), i.e. Present State Examination--10th edition, Item Group Checklist, Clinical History Schedule, Glossary of Definitions and computer software with the diagnostic algorithm: I-Shell, as well as rules for a reliable use of diagnostic rating scales, will be discussed within the scope of this paper. The materials and training sets necessary for the learning of proper use of the SCAN, especially training sets for SCAN Training Centers and the Reference Manual--a form of guidebook for SCAN shall be introduced. Finally the paper will present evidence that SCAN is an instrument feasible in different cultural settings. Reliability and validity data of SCAN will also be dealt with indicating that SCAN could be widely used in research studies as well as in everyday clinical practice facilitating more detailed diagnostic approach to a patient.

DMS augmented monitoring and diganosis application (DMS AMDA) prototype

NASA Technical Reports Server (NTRS)

Patterson-Hine, F. A.; Boyd, Mark A.; Iverson, David L.; Donnell, Brian; Lauritsen, Janet; Doubek, Sharon; Gibson, Jim; Monahan, Christine; Rosenthal, Donald A.

1993-01-01

The Data Management System Augmented Monitoring and Diagnosis Application (DMS AMDA) is currently under development at NASA Ames Research Center (ARC). It will provide automated monitoring and diagnosis capabilities for the Space Station Freedom (SSF) Data Management System (DMS) in the Control Center Complex (CCC) at NASA Johnson Space Center. Several advanced automation applications are under development for use in the CCC for other SSF subsystems. The DMS AMDA, however, is the first application to utilize digraph failure analysis techniques and the Extended Realtime FEAT (ERF) application as the core of its diagnostic system design, since the other projects were begun before the digraph tools were available. Model-based diagnosis and expert systems techniques will provide additional capabilities and augment ERF where appropriate. Utilization of system knowledge captured in the design phase of a system in digraphs should result in both a cost savings and a technical advantage during implementation of the diagnostic software. This paper addresses both the programmatic and technical considerations of this approach, and describes the software design and initial prototyping effort.

[Primary hyperaldosteronism: problems of diagnostic approaches].

PubMed

Widimský, Jiří

2015-05-01

Primary hyperaldosteronism (PH) is common cause of endocrine/secondary hypertension with autonomous aldosterone overproduction by adrenal cortex. PH is typically characterized by hypertension, hypokalemia, high plasma aldosterone/renin ratio, high aldosterone, suppressed renin and nonsupressibilty of aldosterone during confirmatory tests. Diagnosis of PH can be difficult since hypokalemia is found only in 50 % of cases and measurement of the parameters of renin-angiotensin-aldosterone system can be influenced by several factors. Morphological dia-gnosis requires in majority of cases adrenal venous sampling. Early diagnostic and therapeutic measures are very important due to high prevalence of PH and potential cure. Patients with suspicion to PH should be investigated in experienced hypertensive centers due to relatively difficult laboratory and morphological diagnostic approaches.

A linguistic study of patient-centered interviewing: emergent interactional effects.

PubMed

Hesson, Ashley M; Sarinopoulos, Issidoros; Frankel, Richard M; Smith, Robert C

2012-09-01

To evaluate interactional effects of patient-centered interviewing (PCI) compared to isolated clinician-centered interviewing (CCI). We conducted a pilot study comparing PCI (N=4) to CCI (N=4) for simulated new-patient visits. We rated interviews independently and measured patient satisfaction with the interaction via a validated questionnaire. We conducted interactional sociolinguistic analysis on the interviews and compared across three levels of analysis: turn, topic, and interaction. We found significant differences between PCI and CCI in physician responses to patients' psychosocial cues and concerns. The number and type of physician questions also differed significantly across PCI and CCI sets. Qualitatively, we noted several indicators of physician-patient attunement in the PCI interviews that were not present in the CCI interviews. They spanned diverse aspects of physician and patient speech, suggesting interactional accommodation on the part of both participants. This small pilot study highlights a variety of interactional variables that may underlie the effects associated with patient-centered interviewing (e.g., positive relationships, health outcomes). Question form, phonological accommodation processes, and use of stylistic markers are relatively unexplored in controlled studies of physician-patient interaction. This study characterizes several interactional variables for larger scale studies and contributes to models of patient-centeredness in practice. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

A Proposal for a Diagnostic and Remedial Reading Center for the Educational Park Complex of the ESUHSD [East Side Union High School District, San Jose, California].

ERIC Educational Resources Information Center

Gillespie, Barbara

The emphases of the reading center proposed in this study are on the assessment of reading strengths, the isolation of reading deficiencies, and--in an instructor-learner environment--diagnosis and the prescription of action which will enable students to master the reading skills necessary for independent reading in their high school careers. This…

Surface Spectroscopy Center Of Excellence Project

NASA Technical Reports Server (NTRS)

Wooden, Diane

2014-01-01

We propose to develop a national center of excellence in Regolith Radiative Transfer (RRT), i.e., in modeling spectral reflectivity and emissivity of grainy or structured surfaces. The focus is the regime where the structural elements of grainy surfaces have grain sizes and separations of tens of microns, comparable to the wavelengths carrying diagnostic compositional information. This regime is of fundamental interest to remote sensing of planetary and terrestrial surfaces.

Epigenetic Biomarkers as Predictors and Correlates of Symptom Improvement Following Psychotherapy in Combat Veterans with PTSD

DTIC Science & Technology

2013-09-27

of Clinical Neuroendocrinology and Neurochemistry, James J. Peters Veterans Affairs Medical Center, Bronx , NY, USA 3 Fishberg Department of...Kingsbridge Road, Bronx , NY 10468, USA e-mail: rachel.yehuda@va.gov Epigenetic alterations offer promise as diagnostic or prognostic markers, but it...Laboratory of Clinical Neuroendocrinology and Neurochemistry,James J. Peters Veterans Affairs Medical Center, Bronx ,NY,10468 8. PERFORMING ORGANIZATION

Confirmatory Factor Analysis of the Adult Asperger Assessment: The Association of Symptom Domains within a Clinical Population

ERIC Educational Resources Information Center

Kuenssberg, Renate; McKenzie, Karen

2011-01-01

Autism Spectrum Disorder (ASD) is a behaviourally defined disorder characterised by impairments in three domains of social interaction, communication, and repetitive, stereotyped behaviours and activities. Proposed changes to diagnostic criteria suggest that the diagnostic triad may no longer fit as the best way to conceptualise ASD, and that…

Granulomatous mastitis - a diagnostic dilemma.

PubMed

Mote, Dajiram G; Gungi, Raghavendra P; Satyanarayana, V; Premsunder, T

2008-10-01

Granulomatous lobular mastitis is a rare benign breast disease. It is characterized by chronic, non-caseating granulomatous lobulitis. It may be misdiagnosed as a carcinoma of the breast and may lead to mastectomy. Diagnostic criteria include-A) Granulomatous infl ammation with multinucleated giant cells, epithelioid histiocytes. B) It is centered on lobules with minor ductal and periductal infl ammation. C) It nearly always follows the pregnancy. A case of GLM, which was treated with local excision and postoperative steroid therapy is being reported to increase awareness amongst surgeons and pathologist.

Statistical analysis of Turbine Engine Diagnostic (TED) field test data

NASA Astrophysics Data System (ADS)

Taylor, Malcolm S.; Monyak, John T.

1994-11-01

During the summer of 1993, a field test of turbine engine diagnostic (TED) software, developed jointly by U.S. Army Research Laboratory and the U.S. Army Ordnance Center and School, was conducted at Fort Stuart, GA. The data were collected in conformance with a cross-over design, some of whose considerations are detailed. The initial analysis of the field test data was exploratory, followed by a more formal investigation. Technical aspects of the data analysis insights that were elicited are reported.

Stennis Space Center's approach to liquid rocket engine health monitoring using exhaust plume diagnostics

NASA Technical Reports Server (NTRS)

Gardner, D. G.; Tejwani, G. D.; Bircher, F. E.; Loboda, J. A.; Van Dyke, D. B.; Chenevert, D. J.

1991-01-01

Details are presented of the approach used in a comprehensive program to utilize exhaust plume diagnostics for rocket engine health-and-condition monitoring and assessing SSME component wear and degradation. This approach incorporates both spectral and video monitoring of the exhaust plume. Video monitoring provides qualitative data for certain types of component wear while spectral monitoring allows both quantitative and qualitative information. Consideration is given to spectral identification of SSME materials and baseline plume emissions.

Recommendations to minimize diagnostic nuclear medicine exposure to the embryo, fetus, and infant; availability of final recommendations--FDA. Notice.

PubMed

1986-02-19

Food and Drug Administration (FDA) is announcing the availability of final recommendations to minimize diagnostic nuclear medicine exposure to the embryo, fetus, and breastfeeding infant. The final recommendations, prepared by FDA's Center for Devices and Radiological Health (CDRH), include the agency's rationale for the recommendations as well as the endorsement of the recommendations by several professional organizations. The final recommendations are being published in a pamphlet that is being made available to interested persons.

Extreme ultraviolet and soft x-ray diagnostics of high-temperature plasmas. Annual progress report

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

Moos, H W; Armstrong, L Jr

1980-01-01

The work performed from mid-January 1979 through 1980 is described. EUV diagnostic studies have been performed at the Alcator A and C Tokamaks, and on TMX. A toroidal asymmetry has been found in the low density phase of Alcator A. The confinement time of impurities has been measured on Alcator A. Impurity concentrations in the center cell of TMX have been studied using EUV spectroscopic techniques. A time resolving spectrograph with 1024 detector elements is essentially complete.

ODISEES Data Portal Announcement

Atmospheric Science Data Center

2015-11-13

... larger image The Ontology-Driven Interactive Search Environment for Earth Science, developed at the Atmospheric Science Data Center ... The Ontology-Driven Interactive Search Environment for Earth Science, developed at the Atmospheric Science Data Center ...

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

The 2016 Academic Emergency Medicine Consensus Conference, "Shared Decision Making in the Emergency Department: Development of a Policy-relevant Patient-centered Research Agenda" Diagnostic Testing Breakout Session Report.

PubMed

Barrett, Tyler W; Rising, Kristin L; Bellolio, M Fernanda; Hall, M Kennedy; Brody, Aaron; Dodd, Kenneth W; Grieser, Mira; Levy, Phillip D; Raja, Ali S; Self, Wesley H; Weingarten, Gail; Hess, Erik P; Hollander, Judd E

2016-12-01

Diagnostic testing is an integral component of patient evaluation in the emergency department (ED). Emergency clinicians frequently use diagnostic testing to more confidently exclude "worst-case" diagnoses rather than to determine the most likely etiology for a presenting complaint. Increased utilization of diagnostic testing has not been associated with reductions in disease-related mortality but has led to increased overall healthcare costs and other unintended consequences (e.g., incidental findings requiring further workup, unnecessary exposure to ionizing radiation or potentially nephrotoxic contrast). Shared decision making (SDM) presents an opportunity for clinicians to discuss the benefits and harms associated with diagnostic testing with patients to more closely tailor testing to patient risk. This article introduces the challenges and opportunities associated with incorporating SDM into emergency care by summarizing the conclusions of the diagnostic testing group at the 2016 Academic Emergency Medicine Consensus Conference on SDM. Three primary domains emerged: 1) characteristics of a condition or test appropriate for SDM, 2) critical elements of and potential barriers to SDM discussions on diagnostic testing, and 3) financial aspects of SDM applied to diagnostic testing. The most critical research questions to improve engagement of patients in their acute care diagnostic decisions were determined by consensus. © 2016 by the Society for Academic Emergency Medicine.

Strategies in Interventional Radiology: Formation of an Interdisciplinary Center of Vascular Anomalies - Chances and Challenges for Effective and Efficient Patient Management.

PubMed

Sadick, Maliha; Dally, Franz Josef; Schönberg, Stefan O; Stroszczynski, Christian; Wohlgemuth, Walter A

2017-10-01

Background  Radiology is an interdisciplinary field dedicated to the diagnosis and treatment of numerous diseases and is involved in the development of multimodal treatment concepts. Method  Interdisciplinary case management, a broad spectrum of diagnostic imaging facilities and dedicated endovascular radiological treatment options are valuable tools that allow radiology to set up an interdisciplinary center for vascular anomalies. Results  Image-based diagnosis combined with endovascular treatment options is an essential tool for the treatment of patients with highly complex vascular diseases. These vascular anomalies can affect numerous parts of the body so that a multidisciplinary treatment approach is required for optimal patient care. Conclusion  This paper discusses the possibilities and challenges regarding effective and efficient patient management in connection with the formation of an interdisciplinary center for vascular anomalies with strengthening of the clinical role of radiologists. Key points   · Vascular anomalies, which include vascular tumors and malformations, are complex to diagnose and treat.. · There are far more patients with vascular anomalies requiring therapy than interdisciplinary centers for vascular anomalies - there is currently a shortage of dedicated interdisciplinary centers for vascular anomalies in Germany that can provide dedicated care for affected patients.. · Radiology includes a broad spectrum of diagnostic and minimally invasive therapeutic tools which allow the formation of an interdisciplinary center for vascular anomalies for effective, efficient and comprehensive patient management.. Citation Format · Sadick M, Dally FJ, Schönberg SO et al. Strategies in Interventional Radiology: Formation of an Interdisciplinary Center of Vascular Anomalies - Chances and Challenges for Effective and Efficient Patient Management. Fortschr Röntgenstr 2017; 189: 957 - 966. © Georg Thieme Verlag KG Stuttgart · New York.

PANDAS: The Need to Use Definitive Diagnostic Criteria.

PubMed

Singer, Harvey S

2015-01-01

In Response to: Helm CE, Blackwood RA. Pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections (PANDAS): Experience at a tertiary referral center. Tremor Other Hyperkinet Mov. 2015; 5. doi: 10.7916/D8348JCX.

Cellular Imaging | Center for Cancer Research

Cancer.gov

Innovative imaging methods developed and refined within CCR revealed atomic-level structures of biological molecules and unveiled dynamic views of a cell’s interior that are driving the design of new treatments and diagnostics for cancer.

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

NASA Astrophysics Data System (ADS)

Buchberger, Michael; Kaltofen, Thomas

2003-05-01

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

Diagnosis of condensation-induced waterhammer: Case studies

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

Izenson, M.G.; Rothe, P.H.; Wallis, G.B.

1988-10-01

This guidebook provides reference material and diagnostic procedures concerning condensation-induced waterhammer in nuclear power plants. Condensation-induced waterhammer is the most damaging form of waterhammer, and its diagnosis is complicated by the complex nature of the underlying phenomena. In Volume 1, the guidebook groups condensation-induced waterhammers into five event classes which have similar phenomena and levels of damage. Diagnostic guidelines focus on locating the event center where condensation and slug acceleration take place. Diagnosis is described in three stages: an initial assessment, detailed evaluation and final confirmation. Graphical scoping analyses are provided to evaluate whether an event from one of themore » event classes could have occurred at the event center. Examples are provided for each type of waterhammer. Special instructions are provided for walking down damaged piping and evaluating damage due to waterhammer. To illustrate the diagnostic methods and document past experience, six case studies have been compiled in Volume 2. These case studies, based on actual condensation-induced waterhammer events at nuclear plants, present detailed data and work through the event diagnosis using the tools introduced in the first volume. 20 refs., 21 figs., 6 tabs.« less

Role of endoscopic ultrasonography in evaluation of metastatic lesions to the pancreas: a tertiary cancer center experience.

PubMed

Atiq, Muslim; Bhutani, Manoop S; Ross, William A; Raju, Gottumukkala S; Gong, Yun; Tamm, Eric P; Javle, Milind; Wang, Xuemei; Lee, Jeffrey H

2013-04-01

Metastatic lesions to the pancreas pose diagnostic challenges with regards to their differentiation from primary pancreatic cancer. Data on the yield of endoscopic ultrasonography (EUS)-guided fine-needle aspiration in detection of these lesions are limited. This is a retrospective review of 23 patients referred to a tertiary referral center for further evaluation of suspected pancreatic metastases. Main outcome measures were diagnostic yield of endoscopic ultrasonography-guided fine-needle aspiration in evaluation of metastatic lesions to the pancreas. Of 644 patients, 23 (3.6%) undergoing EUS of the pancreas were diagnosed to have metastatic disease to the pancreas based on clinical, radiological, and cytological results. Mean (SD) age was 64.3 (11.7) years. Of the 23 patients, 18 (78.3%) were asymptomatic. Mean (SD) size of lesion on EUS was 39.1 (19.9) mm. A diagnosis of malignant lesion was made in 21 of 23 cases, with a diagnostic accuracy of 91.3%. Metastatic lesions to the pancreas present as incidental, solitary mass lesions on staging or surveillance imaging. Endoscopic ultrasonography-guided fine-needle aspiration is an important tool in the characterization and further differentiation of metastatic lesions to the pancreas from primary pancreatic cancer.

Diagnosis of condensation-induced waterhammer: Methods and background

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

Izenson, M.G.; Rothe, P.H.; Wallis, G.B.

This guidebook provides reference material and diagnostic procedures concerning condensation-induced waterhammer in nuclear power plants. Condensation-induced waterhammer is the most damaging form of waterhammer and its diagnosis is complicated by the complex nature of the underlying phenomena. In Volume 1, the guidebook groups condensation-induced waterhammers into five event classes which have similar phenomena and levels of damage. Diagnostic guidelines focus on locating the event center where condensation and slug acceleration take place. Diagnosis is described in three stages: an initial assessment, detailed evaluation and final confirmation. Graphical scoping analyses are provided to evaluate whether an event from one of themore » event classes could have occurred at the event center. Examples are provided for each type of waterhammer. Special instructions are provided for walking down damaged piping and evaluating damage due to waterhammer. To illustrate the diagnostic methods and document past experience, six case studies have been compiled in Volume 2. These case studies, based on actual condensation-induced waterhammer events at nuclear plants, present detailed data and work through the event diagnosis using the tools introduced in the first volume. 65 figs., 8 tabs.« less

New diagnostic methods for laser plasma- and microwave-enhanced combustion

PubMed Central

Miles, Richard B; Michael, James B; Limbach, Christopher M; McGuire, Sean D; Chng, Tat Loon; Edwards, Matthew R; DeLuca, Nicholas J; Shneider, Mikhail N; Dogariu, Arthur

2015-01-01

The study of pulsed laser- and microwave-induced plasma interactions with atmospheric and higher pressure combusting gases requires rapid diagnostic methods that are capable of determining the mechanisms by which these interactions are taking place. New rapid diagnostics are presented here extending the capabilities of Rayleigh and Thomson scattering and resonance-enhanced multi-photon ionization (REMPI) detection and introducing femtosecond laser-induced velocity and temperature profile imaging. Spectrally filtered Rayleigh scattering provides a method for the planar imaging of temperature fields for constant pressure interactions and line imaging of velocity, temperature and density profiles. Depolarization of Rayleigh scattering provides a measure of the dissociation fraction, and multi-wavelength line imaging enables the separation of Thomson scattering from Rayleigh scattering. Radar REMPI takes advantage of high-frequency microwave scattering from the region of laser-selected species ionization to extend REMPI to atmospheric pressures and implement it as a stand-off detection method for atomic and molecular species in combusting environments. Femtosecond laser electronic excitation tagging (FLEET) generates highly excited molecular species and dissociation through the focal zone of the laser. The prompt fluorescence from excited molecular species yields temperature profiles, and the delayed fluorescence from recombining atomic fragments yields velocity profiles. PMID:26170432

On the practice of ignoring center-patient interactions in evaluating hospital performance.

PubMed

Varewyck, Machteld; Vansteelandt, Stijn; Eriksson, Marie; Goetghebeur, Els

2016-01-30

We evaluate the performance of medical centers based on a continuous or binary patient outcome (e.g., 30-day mortality). Common practice adjusts for differences in patient mix through outcome regression models, which include patient-specific baseline covariates (e.g., age and disease stage) besides center effects. Because a large number of centers may need to be evaluated, the typical model postulates that the effect of a center on outcome is constant over patient characteristics. This may be violated, for example, when some centers are specialized in children or geriatric patients. Including interactions between certain patient characteristics and the many fixed center effects in the model increases the risk for overfitting, however, and could imply a loss of power for detecting centers with deviating mortality. Therefore, we assess how the common practice of ignoring such interactions impacts the bias and precision of directly and indirectly standardized risks. The reassuring conclusion is that the common practice of working with the main effects of a center has minor impact on hospital evaluation, unless some centers actually perform substantially better on a specific group of patients and there is strong confounding through the corresponding patient characteristic. The bias is then driven by an interplay of the relative center size, the overlap between covariate distributions, and the magnitude of the interaction effect. Interestingly, the bias on indirectly standardized risks is smaller than on directly standardized risks. We illustrate our findings by simulation and in an analysis of 30-day mortality on Riksstroke. © 2015 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd.

Gut feelings as a third track in general practitioners' diagnostic reasoning.

PubMed

Stolper, Erik; Van de Wiel, Margje; Van Royen, Paul; Van Bokhoven, Marloes; Van der Weijden, Trudy; Dinant, Geert Jan

2011-02-01

General practitioners (GPs) are often faced with complicated, vague problems in situations of uncertainty that they have to solve at short notice. In such situations, gut feelings seem to play a substantial role in their diagnostic process. Qualitative research distinguished a sense of alarm and a sense of reassurance. However, not every GP trusted their gut feelings, since a scientific explanation is lacking. This paper explains how gut feelings arise and function in GPs' diagnostic reasoning. The paper reviews literature from medical, psychological and neuroscientific perspectives. Gut feelings in general practice are based on the interaction between patient information and a GP's knowledge and experience. This is visualized in a knowledge-based model of GPs' diagnostic reasoning emphasizing that this complex task combines analytical and non-analytical cognitive processes. The model integrates the two well-known diagnostic reasoning tracks of medical decision-making and medical problem-solving, and adds gut feelings as a third track. Analytical and non-analytical diagnostic reasoning interacts continuously, and GPs use elements of all three tracks, depending on the task and the situation. In this dual process theory, gut feelings emerge as a consequence of non-analytical processing of the available information and knowledge, either reassuring GPs or alerting them that something is wrong and action is required. The role of affect as a heuristic within the physician's knowledge network explains how gut feelings may help GPs to navigate in a mostly efficient way in the often complex and uncertain diagnostic situations of general practice. Emotion research and neuroscientific data support the unmistakable role of affect in the process of making decisions and explain the bodily sensation of gut feelings.The implications for health care practice and medical education are discussed.

Gut Feelings as a Third Track in General Practitioners’ Diagnostic Reasoning

PubMed Central

Van de Wiel, Margje; Van Royen, Paul; Van Bokhoven, Marloes; Van der Weijden, Trudy; Dinant, Geert Jan

2010-01-01

Background General practitioners (GPs) are often faced with complicated, vague problems in situations of uncertainty that they have to solve at short notice. In such situations, gut feelings seem to play a substantial role in their diagnostic process. Qualitative research distinguished a sense of alarm and a sense of reassurance. However, not every GP trusted their gut feelings, since a scientific explanation is lacking. Objective This paper explains how gut feelings arise and function in GPs’ diagnostic reasoning. Approach The paper reviews literature from medical, psychological and neuroscientific perspectives. Conclusions Gut feelings in general practice are based on the interaction between patient information and a GP’s knowledge and experience. This is visualized in a knowledge-based model of GPs’ diagnostic reasoning emphasizing that this complex task combines analytical and non-analytical cognitive processes. The model integrates the two well-known diagnostic reasoning tracks of medical decision-making and medical problem-solving, and adds gut feelings as a third track. Analytical and non-analytical diagnostic reasoning interacts continuously, and GPs use elements of all three tracks, depending on the task and the situation. In this dual process theory, gut feelings emerge as a consequence of non-analytical processing of the available information and knowledge, either reassuring GPs or alerting them that something is wrong and action is required. The role of affect as a heuristic within the physician’s knowledge network explains how gut feelings may help GPs to navigate in a mostly efficient way in the often complex and uncertain diagnostic situations of general practice. Emotion research and neuroscientific data support the unmistakable role of affect in the process of making decisions and explain the bodily sensation of gut feelings.The implications for health care practice and medical education are discussed. PMID:20967509

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

PubMed

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

2009-07-01

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

The quality of assessments for childhood psychopathology within a regional medical center.

PubMed

Sattler, Adam F; Leffler, Jarrod M; Harrison, Nicole L; Bieber, Ewa D; Kosmach, Joseph J; Sim, Leslie A; Whiteside, Stephen P H

2018-05-17

Accurate assessment is essential to implementing effective mental health treatment; however, little research has explored child clinicians' assessment practices in applied settings. The current study thus examines practitioners' use of evidence-based assessment (EBA) instruments (i.e., self-report measures and structured interviews), specificity of identified diagnoses (i.e., use of specific diagnostic labels vs. nonstandardized labels, not otherwise specified [NOS] diagnoses, and adjustment disorder diagnoses), and documentation of Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev., DSM-IV-TR, American Psychiatric Association, 2000) criteria. Use of these practices was evaluated via analysis of documentation contained within a regional medical center's medical records. This analysis was limited to 2,499 session notes from patient appointments associated with psychiatric disorders newly diagnosed during 2013. In total, session notes were linked to 694 children aged 7 to 17. Results indicated that EBA use was low overall, although self-report measures were utilized relatively frequently versus structured interviews. Diagnostic specificity was also low overall and clinicians rarely documented full diagnostic criteria; however, EBA use was associated with increased diagnostic specificity. Further, clinicians practicing in psychological, psychiatric, and primary care settings were more likely to use self-report measures as compared to those practicing in an integrated behavioral health social work setting. In addition, structured interviews were most likely to be utilized by clinicians practicing in a psychological services setting. Finally, clinicians were more likely to use self-report measures when the identified primary concern was a mood disorder or attention-deficit/hyperactivity disorder (ADHD). Based on these results, we provide suggestions and references to resources for clinicians seeking to improve the quality of their assessments via implementation of EBA. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Diagnostic PCR assays to unravel food web interactions in cereal crops with focus on biological control of aphids.

PubMed

Staudacher, Karin; Jonsson, Mattias; Traugott, Michael

Successful biological control of agricultural pests is dependent on a thorough understanding of the underlying trophic interactions between predators and prey. Studying trophic interactions can be challenging, particularly when generalist predators that frequently use multiple prey and interact with both pest and alternative prey are considered. In this context, diagnostic PCR proved to be a suitable approach, however at present, prey-specific PCR primers necessary for assessing such interactions across trophic levels are missing. Here we present a new set of 45 primers designed to target a wide range of invertebrate taxa common to temperate cereal crops: cereal aphids, their natural enemies such as carabid beetles, ladybeetles, lacewings, and spiders, and potential alternative prey groups (earthworms, springtails, and dipterans). These primers were combined in three 'ready to use' multiplex PCR assays for quick and cost-effective analyses of large numbers of predator samples. The assays were tested on 560 carabids collected in barley fields in Sweden. Results from this screening suggest that aphids constitute a major food source for carabids in cereal crops (overall DNA detection rate: 51 %), whereas alternative extraguild and intraguild prey appear to be less frequently preyed upon when aphids are present (11 % for springtails and 12 % for earthworms; 1 % for spiders and 4 % for carabids). In summary, the newly developed molecular assays proved reliable and effective in assessing previously cryptic predator-prey trophic interactions, specifically with focus on biological control of aphids. The diagnostic PCR assays will be applicable manifold as the targeted invertebrates are common to many agricultural systems of the temperate region.

Gold Nanoparticles for Diagnostics: Advances towards Points of Care

PubMed Central

Cordeiro, Mílton; Ferreira Carlos, Fábio; Pedrosa, Pedro; Lopez, António; Baptista, Pedro Viana

2016-01-01

The remarkable physicochemical properties of gold nanoparticles (AuNPs) have prompted developments in the exploration of biomolecular interactions with AuNP-containing systems, in particular for biomedical applications in diagnostics. These systems show great promise in improving sensitivity, ease of operation and portability. Despite this endeavor, most platforms have yet to reach maturity and make their way into clinics or points of care (POC). Here, we present an overview of emerging and available molecular diagnostics using AuNPs for biomedical sensing that are currently being translated to the clinical setting. PMID:27879660

Test Review: Lord, C., Luyster, R. J., Gotham, K., & Guthrie, W. (2012). "Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) Manual (Part II): Toddler Module." Torrance, CA: Western Psychological Services, 2012. Lord, C., Rutter, M., DiLavore, P. C., Risi, S., Gotham, K., & Bishop, S. "Autism Diagnostic Observation Schedule, Second Edition." Torrance, CA: Western Psychological Services, 2012

ERIC Educational Resources Information Center

McCrimmon, Adam; Rostad, Kristin

2014-01-01

This article reviews the "Autism Diagnostic Observation Schedule, Second Edition" (ADOS-2; Lord, Luyster, Gotham, & Guthrie, 2012; Lord, Rutter et al., 2012), a newly updated, semistructured, standardized measure of communication, social interaction, play/imagination, and restricted and/or repetitive behaviors published by Western…

Institutionalization in Action: Interactive Science Center Interactivity and Materiality from the Family Perspective

ERIC Educational Resources Information Center

Crain, Rhiannon Lorraine

2009-01-01

Interactive science centers are unique players in the science education community, but their positioning as both authorities on science and providers of "free choice" learning presents learning researchers with a problematic contradiction rooted in the complexities of trying to be both "scientific" and "education" organizations. Using insight from…

Professional Acceptance Of Electronic Images In Radiologic Practice

NASA Astrophysics Data System (ADS)

Gitlin, Joseph N.; Curtis, David J.; Kerlin, Barbara D.; Olmsted, William W.

1983-05-01

During the past four years, a large number of radiographic images have been interpreted in both film and video modes in an effort to determine the utility of digital/analogue systems in general practice. With the cooperation of the Department of Defense, the MITRE Corporation, and several university-based radiology departments, the Public Health Service has participated in laboratory experiments and a teleradiology field trial to meet this objective. During the field trial, 30 radiologists participated in the interpretation of more than 4,000 diagnostic x-ray examinations that were performed at distant clinics, digitized, and transmitted to a medical center for interpretation on video monitors. As part of the evaluation, all of the participating radiologists and the attending physicians at the clinics were queried regarding the teleradiology system, particularly with respect to the diagnostic quality of the electronic images. The original films for each of the 4,000 examinations were read independently, and the findings and impressions from each mode were compared to identify discrepancies. In addition, a sample of 530 cases was reviewed and interpreted by a consensus panel to measure the accuracy of findings and impressions of both film and video readings. The sample has been retained in an automated archive for future study at the National Center of Devices and Radiological Health facilities in Rockville, Maryland. The studies include a comparison of diagnostic findings and impressions from 1024 x 1024 matrices with those obtained from the 512 x 512 format used in the field trial. The archive also provides a database for determining the effect of data compression techniques on diagnostic interpretations and establishing the utility of image processing algorithms. The paper will include an analysis of the final results of the field trial and preliminary findings from the ongoing studies using the archive of cases at the National Center for Devices and Radiological Health. This paper was not available at the time of printing of the Proceedings.

SU-E-P-01: An Informative Review On the Role of Diagnostic Medical Physicist in the Academic and Private Medical Centers

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

Weir, V; Zhang, J

Purpose: The role of physicist in the academic and private hospital environment continues to evolve and expand. This becomes more obvious with the newly revised requirements of the Joint Commission (JC) on imaging modalities and the continued updated requirements of ACR accreditation for medical physics (i.e., starting in June 2014, a physicists test will be needed before US accreditation). We provide an informative review on the role of diagnostic medical physicist and hope that our experience will expedite junior physicists in understanding their role in medical centers, and be ready to more opportunities. Methods: Based on our experience, diagnostic medicalmore » physicists in both academic and private medical centers perform several clinical functions. These include providing clinical service and physics support, ensuring that all ionizing radiation devices are tested and operated in compliance with the State and Federal laws, regulations and guidelines. We also discuss the training and education required to ensure that the radiation exposure to patients and staff is as low as reasonably achievable. We review the overlapping roles of medical and health physicist in some institutions. Results: A detailed scheme on the new requirements (effective 7/1/2014) of the JC is provided. In 2015, new standards for fluoroscopy, cone beam CT and the qualifications of staff will be phased in. A summary of new ACR requirements for different modalities is presented. Medical physicist have other duties such as sitting on CT and fluoroscopy committees for protocols design, training of non-radiologists to meet the new fluoroscopy rules, as well as helping with special therapies such as Yittrium 90 cases. Conclusion: Medical physicists in both academic and private hospitals are positioned to be more involved and prominent. Diagnostic physicists need to be more proactive to involve themselves in the day to day activities of the radiology department.« less

CI-KNOW: Cyberinfrastructure Knowledge Networks on the Web. A Social Network Enabled Recommender System for Locating Resources in Cyberinfrastructures

NASA Astrophysics Data System (ADS)

Green, H. D.; Contractor, N. S.; Yao, Y.

2006-12-01

A knowledge network is a multi-dimensional network created from the interactions and interconnections among the scientists, documents, data, analytic tools, and interactive collaboration spaces (like forums and wikis) associated with a collaborative environment. CI-KNOW is a suite of software tools that leverages automated data collection, social network theories, analysis techniques and algorithms to infer an individual's interests and expertise based on their interactions and activities within a knowledge network. The CI-KNOW recommender system mines the knowledge network associated with a scientific community's use of cyberinfrastructure tools and uses relational metadata to record connections among entities in the knowledge network. Recent developments in social network theories and methods provide the backbone for a modular system that creates recommendations from relational metadata. A network navigation portlet allows users to locate colleagues, documents, data or analytic tools in the knowledge network and to explore their networks through a visual, step-wise process. An internal auditing portlet offers administrators diagnostics to assess the growth and health of the entire knowledge network. The first instantiation of the prototype CI-KNOW system is part of the Environmental Cyberinfrastructure Demonstration project at the National Center for Supercomputing Applications, which supports the activities of hydrologic and environmental science communities (CLEANER and CUAHSI) under the umbrella of the WATERS network environmental observatory planning activities (http://cleaner.ncsa.uiuc.edu). This poster summarizes the key aspects of the CI-KNOW system, highlighting the key inputs, calculation mechanisms, and output modalities.

Utility of LRF/Pokemon and NOTCH1 Protein Expression in the Distinction of Nodular Lymphocyte-Predominant Hodgkin Lymphoma and Classical Hodgkin Lymphoma

PubMed Central

Bohn, Olga; Maeda, Takahiro; Filatov, Alexander; Lunardi, Andrea; Pandolfi, Pier Paolo; Teruya-Feldstein, Julie

2014-01-01

Classical Hodgkin lymphoma (CHL) and nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) are considered separate entities with different prognosis and treatment. However, morphologic features can be similar and immunohistochemical studies are essential in the distinction; thus, determination of additional biomarkers is of utmost importance. LRF/Pokemon is a protooncogene, an interacting partner co-expressed with BCL6 in germinal centers and highly expressed in diffuse large B-cell lymphoma and follicular lymphoma. Conversely, loss of the LRF gene in mouse hematopoietic stem cells results in complete block of early B cell development with concomitant Notch derepression, indicating its critical role in B versus T cell fate decision at the hematopoietic stem cell stage. For the first time, we show that LRF/Pokemon is predominantly expressed in NLPHL cases as is BCL6 with low to absent NOTCH1 protein expression; while Hodgkin Reed-Sternberg (HRS) cells in CHL show low to absent BCL6 and LRF/Pokemon expression with higher NOTCH1 expression. We illustrate a potential functional interaction between LRF and BCL6 in NLPHL pathogenesis, and differential expression of LRF/Pokemon and NOTCH1 proteins in CHL thus showing differential expression, making for an additional diagnostic marker and therapeutic target. PMID:24326827

Utility of LRF/Pokemon and NOTCH1 protein expression in the distinction between nodular lymphocyte-predominant Hodgkin lymphoma and classical Hodgkin lymphoma.

PubMed

Bohn, Olga; Maeda, Takahiro; Filatov, Alexander; Lunardi, Andrea; Pandolfi, Pier Paolo; Teruya-Feldstein, Julie

2014-02-01

Classical Hodgkin lymphoma (CHL) and nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) are considered separate entities with different prognosis and treatment. However, morphologic features can be similar and immunohistochemical studies are essential in the distinction; thus, determination of additional biomarkers is of utmost importance. LRF/Pokemon is a proto-oncogene, an interacting partner co-expressed with BCL6 in germinal centers and highly expressed in diffuse large B-cell lymphoma and follicular lymphoma. Conversely, loss of the LRF gene in mouse hematopoietic stem cells results in complete block of early B cell development with concomitant Notch de-repression, indicating its critical role in B versus T cell fate decision at the hematopoietic stem cell stage. For the first time, we show that LRF/Pokemon is predominantly expressed in NLPHL cases as is BCL6 with low to absent NOTCH1 protein expression; while Hodgkin Reed-Sternberg (HRS) cells in CHL show low to absent BCL6 and LRF/Pokemon expression with higher NOTCH1 expression. We illustrate a potential functional interaction between LRF and BCL6 in NLPHL pathogenesis, and differential expression of LRF/Pokemon and NOTCH1 proteins in CHL thus showing differential expression, making for an additional diagnostic marker and therapeutic target.

Why epilepsy challenges social life.

PubMed

Steiger, Bettina K; Jokeit, Hennric

2017-01-01

Social bonds are at the center of our daily living and are an essential determinant of our quality of life. In people with epilepsy, numerous factors can impede cognitive and affective functions necessary for smooth social interactions. Psychological and psychiatric complications are common in epilepsy and may hinder the processing of social information. In addition, neuropsychological deficits such as slowed processing speed, memory loss or attentional difficulties may interfere with enjoyable reciprocity of social interactions. We consider societal, psychological, and neuropsychological aspects of social life with particular emphasis on socio-cognitive functions in temporal lobe epilepsy. Deficits in emotion recognition and theory of mind, two main aspects of social cognition, are frequently observed in individuals with mesial temporal lobe epilepsy. Results from behavioural studies targeting these functions will be presented with a focus on their relevance for patients' daily life. Furthermore, we will broach the issue of pitfalls in current diagnostic tools and potential directions for future research. By giving a broad overview of individual and interpersonal determinants of social functioning in epilepsy, we hope to provide a basis for future research to establish social cognition as a key component in the comprehensive assessment and care of those with epilepsy. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Advanced and applied remote sensing of environmental conditions

USGS Publications Warehouse

Slonecker, E. Terrence; Fisher, Gary B.; Marr, David A.; Milheim, Lesley E.; Roig-Silva, Coral M.

2013-01-01

"Remote sensing” is a general term for monitoring techniques that collect information without being in physical contact with the object of study. Overhead imagery from aircraft and satellite sensors provides the most common form of remotely sensed data and records the interaction of electromagnetic energy (usually visible light) with matter, such as the Earth’s surface. Remotely sensed data are fundamental to geographic science. The U.S. Geological Survey’s (USGS) Eastern Geographic Science Center (EGSC) is currently conducting and promoting the research and development of several different aspects of remote sensing science in both the laboratory and from overhead instruments. Spectroscopy is the science of recording interactions of energy and matter and is the bench science for all remote sensing. Visible and infrared analysis in the laboratory with special instruments called spectrometers enables the transfer of this research from the laboratory to multispectral (5–15 broad bands) and hyperspectral (50–300 narrow contiguous bands) analyses from aircraft and satellite sensors. In addition, mid-wave (3–5 micrometers, µm) and long-wave (8–14 µm) infrared data analysis, such as attenuated total reflectance (ATR) spectral analysis, are also conducted. ATR is a special form of vibrational infrared spectroscopy that has many applications in chemistry and biology but has recently been shown to be especially diagnostic for vegetation analysis.

Microgravity Combustion Diagnostics Workshop

NASA Technical Reports Server (NTRS)

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

1988-01-01

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

Hybrid Neural-Network: Genetic Algorithm Technique for Aircraft Engine Performance Diagnostics Developed and Demonstrated

NASA Technical Reports Server (NTRS)

Kobayashi, Takahisa; Simon, Donald L.

2002-01-01

As part of the NASA Aviation Safety Program, a unique model-based diagnostics method that employs neural networks and genetic algorithms for aircraft engine performance diagnostics has been developed and demonstrated at the NASA Glenn Research Center against a nonlinear gas turbine engine model. Neural networks are applied to estimate the internal health condition of the engine, and genetic algorithms are used for sensor fault detection, isolation, and quantification. This hybrid architecture combines the excellent nonlinear estimation capabilities of neural networks with the capability to rank the likelihood of various faults given a specific sensor suite signature. The method requires a significantly smaller data training set than a neural network approach alone does, and it performs the combined engine health monitoring objectives of performance diagnostics and sensor fault detection and isolation in the presence of nominal and degraded engine health conditions.

Increased Learning Observed in Redesigned Introductory Biology Course that Employed Web-enhanced, Interactive Pedagogy

PubMed Central

Lister, Bradford C.; Hanna, Michael H.; Roy, Harry

2007-01-01

Our Introduction to Biology course (BIOL 1010) changed in 2004 from a standard instructor-centered, lecture-homework-exam format to a student-centered format that used Web-enhanced, interactive pedagogy. To measure and compare conceptual learning gains in the traditional course in fall 2003 with a section of the interactive course in fall 2004, we created concept inventories for both evolution and ecology. Both classes were taught by the same instructor who had taught BIOL 1010 since 1976, and each had a similar student composition with comparable biological knowledge. A significant increase in learning gain was observed with the Web-enhanced, interactive pedagogy in evolution (traditional, 0.10; interactive, 0.19; p = 0.024) and ecology (traditional, −0.05; interactive, 0.14; p = 0.000009) when assessment was made unannounced and for no credit in the last week of classes. These results strengthen the case for augmenting or replacing instructor-centered teaching with Web-enhanced, interactive, student-centered teaching. When assessment was made using the final exam in the interactive course, for credit and after studying, significantly greater learning gains were made in evolution (95%, 0.37, p = 0.0001) and ecology (143%, 0.34, p = 0.000003) when compared with learning gains measured without credit or study in the last week of classes. PMID:17785407

Oligodeoxynucleotides as Anti-Cancer Therapeutics and Diagnostics | NCI Technology Transfer Center | TTC

Cancer.gov

The National Cancer Institute Laboratory of Experimental Immunology is seeking statements of capability or interest from parties interested in licensing or collaborative research to further develop, evaluate, or commercialize anti-cancer oligodeoxynucleotides.  

Climate Prediction Center: ENSO Diagnostic Discussion

Science.gov Websites

: English Version Spanish Version Adobe PDF Reader (Click icon for Adobe PDF Reader) Word: English Version Spanish Version MS Word Viewer (Click icon for MS Word Viewer) HTML: English Version Spanish Version NOAA

The Effect of Diagnostic Labels on the Affective Responses of College Students towards Peers with "Asperger's Syndrome" and "Autism Spectrum Disorder"

ERIC Educational Resources Information Center

Brosnan, Mark; Mills, Elizabeth

2016-01-01

Given the removal of Asperger's Syndrome label in "Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition," the impact of clinical labels upon the affective responses of college students was explored. A total of 120 college students read two vignettes depicting social interactions typical of a person with autism spectrum…

New Opportunity for Improved Nuclear Forensics, Radiochemical Diagnostics, and Nuclear Astrophysics: Need for a Total-Cross-Section Apparatus at the LANSCE

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

Koehler, Paul E.; Hayes-Sterbenz, Anna C.; Bredeweg, Todd Allen

Total-cross-section measurements are feasible on a much wider range of radioactive samples than (n,γ) cross-section measurements, and information extracted from the former can be used to set tight constraints on the latter. There are many (n,γ) cross sections of great interest to radiochemical diagnostics, nuclear forensics, and nuclear astrophysics which are beyond the reach of current direct measurement, that could be obtained in this way. Our simulations indicate that measurements can be made at the Manuel Lujan Jr. Neutron Scattering Center at the Los Alamos Neutron Science Center for samples as small as 10μg. There are at least 40 high-interestmore » nuclides which should be measurable, including 88Y, 167,168,170,171Tm, 173,174Lu, and 189,190,192Ir.« less

WORK-UP OF STILLBIRTH: A REVIEW OF THE EVIDENCE

PubMed Central

SILVER, Robert M.; VARNER, Michael W.; REDDY, Uma; GOLDENBERG, Robert; PINAR, Halit; CONWAY, Deborah; BUKOWSKI, Radek; CARPENTER, Marshall; HOGUE, Carol; WILLINGER, Marian; DUDLEY, Donald; SAADE, George; STOLL, Barbara

2009-01-01

Despite improvements in antenatal and intrapartum care, stillbirth, defined as in utero fetal death at 20 weeks of gestation or greater, remains an important, largely unstudied, and poignant problem in obstetrics. Over 26,000 stillbirths were reported in the US in 2001. Although several conditions have been linked to stillbirth, it is difficult to define the precise etiology in many cases. This paper reviews known and suspected causes of stillbirth including genetic abnormalities, infection, fetal-maternal hemorrhage, and a variety of medical conditions in the mother. The proportion of stillbirths that have a diagnostic explanation is higher in centers that conduct a defined and systematic evaluation. Recommended diagnostic tests for stillbirth are discussed. The on-going work of the NICHD Stillbirth Collaborative Research Network, a consortium of 5 academic centers in the United States that are studying the scope and causes of stillbirth, is presented. PMID:17466694

An intelligent tele-healthcare environment offering person-centric and wellness-maintenance services.

PubMed

Abidi, S S

2001-06-01

Worldwide healthcare delivery trends are undergoing a subtle paradigm shift--patient centered services as opposed to provider centered services and wellness maintenance as opposed to illness management. In this paper we present a Tele-Healthcare project TIDE--Tele-Healthcare Information and Diagnostic Environment. TIDE manifests an 'intelligent' healthcare environment that aims to ensure lifelong coverage of person-specific health maintenance decision-support services--i.e., both wellness maintenance and illness management services--ubiquitously available via the Internet/WWW. Taking on an all-encompassing health maintenance role--spanning from wellness to illness issues--the functionality of TIDE involves the generation and delivery of (a) Personalized, Pro-active, Persistent, Perpetual, and Present wellness maintenance services, and (b) remote diagnostic services for managing noncritical illnesses. Technically, TIDE is an amalgamation of diverse computer technologies--Artificial Intelligence, Internet, Multimedia, Databases, and Medical Informatics--to implement a sophisticated healthcare delivery infostructure.

Sodium 18F-Fluoride PET/CT of Bone, Joint and Other Disorders

PubMed Central

Jadvar, Hossein; Desai, Bhushan; Conti, Peter S.

2014-01-01

The use of 18F-sodium fluoride (18F-NaF) with positron emission tomography-computed tomography (PET/CT) is increasing. This resurgence of an old tracer has been fueled by several factors including superior diagnostic performance over standard 99mTc-based bone scintigraphy, growth in the availability of PET/CT imaging systems, increase in the number of regional commercial distribution centers for PET radiotracers, the recent concerns about potential chronic shortages with 99mTc based radiotracers, and the recent decision by the Centers for Medicare and Medicaid Services to reimburse for 18F-NaF PET/CT for evaluation of patients with known or suspected bone metastases through the National Oncologic PET Registry. The major goal of this article is to review the current evidence on the diagnostic utility of 18F-NaF in the imaging assessment of bone and joint in a variety of clinical conditions. PMID:25475379

Strategies For Clinical Implementation: Precision Oncology At Three Distinct Institutions.

PubMed

Nadauld, Lincoln D; Ford, James M; Pritchard, Daryl; Brown, Thomas

2018-05-01

Despite rapid advances in molecular diagnostics and targeted therapeutics, the adoption of precision medicine into clinical oncology workflows has been slow. Questions about clinical utility, inconsistent reimbursement for molecular diagnostics, and limited access to targeted therapies are some of the major hurdles that have hampered clinical adoption. Despite these challenges, providers have invested in precision medicine programs in an ongoing search for innovative care models to deliver improved patient outcomes and achieve economic gains. We describe the precision oncology medicine programs implemented by an integrated delivery system, a community care center, and an academic medical center, to demonstrate the approaches and challenges associated with clinical implementation efforts designed to advance this treatment paradigm. Payer policies that include coverage for broad genomic testing panels would support the broader application of precision medicine, deepen research benefits, and bring targeted therapies to more patients with advanced cancer.

Diagnosis, monitoring, and treatment of primary ciliary dyskinesia: PCD foundation consensus recommendations based on state of the art review

PubMed Central

Zariwala, Maimoona A.; Ferkol, Thomas; Davis, Stephanie D.; Sagel, Scott D.; Dell, Sharon D.; Rosenfeld, Margaret; Olivier, Kenneth N.; Milla, Carlos; Daniel, Sam J.; Kimple, Adam J.; Manion, Michele; Knowles, Michael R.; Leigh, Margaret W.

2015-01-01

Summary Primary ciliary dyskinesia (PCD) is a genetically heterogeneous, rare lung disease resulting in chronic oto‐sino‐pulmonary disease in both children and adults. Many physicians incorrectly diagnose PCD or eliminate PCD from their differential diagnosis due to inexperience with diagnostic testing methods. Thus far, all therapies used for PCD are unproven through large clinical trials. This review article outlines consensus recommendations from PCD physicians in North America who have been engaged in a PCD centered research consortium for the last 10 years. These recommendations have been adopted by the governing board of the PCD Foundation to provide guidance for PCD clinical centers for diagnostic testing, monitoring, and appropriate short and long‐term therapeutics in PCD patients. Pediatr Pulmonol. 2016;51:115–132. © 2015 The Authors. Pediatric Pulmonology Published by Wiley Periodicals, Inc. PMID:26418604

Local condensate depletion at trap center under strong interactions

NASA Astrophysics Data System (ADS)

Yukalov, V. I.; Yukalova, E. P.

2018-04-01

Cold trapped Bose-condensed atoms, interacting via hard-sphere repulsive potentials are considered. Simple mean-field approximations show that the condensate distribution inside a harmonic trap always has the shape of a hump with the maximum condensate density occurring at the trap center. However, Monte Carlo simulations at high density and strong interactions display the condensate depletion at the trap center. The explanation of this effect of local condensate depletion at trap center is suggested in the frame of self-consistent theory of Bose-condensed systems. The depletion is shown to be due to the existence of the anomalous average that takes into account pair correlations and appears in systems with broken gauge symmetry.

Equipment for nuclear medical centers, production capabilities of Rosatom enterprises

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

Gavrish, Yu. N., E-mail: gavrish@luts.niiefa.spb.su; Koloskov, S. A.; Smirnov, V. P.

2015-12-15

Analysis of the capabilities of the State Corporation Rosatom enterprises on the development and production of diagnostic and therapeutic equipment for nuclear medicine centers is presented. Prospects of the development of accelerator equipment for the production of a wide range of radioisotope products are shown, and the trends of its development are determined. A comparative analysis of the technical parameters of domestic tomographs and devices for brachytherapy with foreign counterparts is given.

Educational Applications of Astronomy & Space Flight Operations at the Kennedy Space Center

NASA Astrophysics Data System (ADS)

Erickson, L. K.

1999-09-01

Within two years, the Kennedy Space Center will complete a total redesign of NASA's busiest Visitor's Center. Three million visitors per year will be witness to a new program focused on expanding the interests of the younger public in NASA's major space programs, in space operations, and in astronomy. This project, being developed through the Visitor's Center director, a NASA faculty fellow, and the Visitor's Center contractor, is centered on the interaction between NASA programs, the visiting youth, and their parents. The goal of the Center's program is to provide an appealing learning experience for teens and pre teens using stimulating displays and interactive exhibits that are also educational.

Comparison of Heat Flux Gages for High Enthalpy Flows - NASA Ames and IRS

NASA Technical Reports Server (NTRS)

Loehle, Stefan; Nawaz, Anuscheh; Herdrich, Georg; Fasoulas, Stefanos; Martinez, Edward; Raiche, George

2016-01-01

This article is a companion to a paper on heat flux measurements as initiated under a Space Act Agreement in 2011. The current focus of this collaboration between the Institute of Space Systems (IRS) of the University of Stuttgart and NASA Ames Research Center is the comparison and refinement of diagnostic measurements. A first experimental campaign to test different heat flux gages in the NASA Interaction Heating Facility (IHF) and the Plasmawindkanaele (PWK) at IRS was established. This paper focuses on the results of the measurements conducted at IRS. The tested gages included a at face and hemispherical probe head, a 4" hemispherical slug calorimeter, a null-point calorimeter from Ames and a null-point calorimeter developed for this purpose at IRS. The Ames null-point calorimeter was unfortunately defective upon arrival. The measured heat fluxes agree fairly well with each other. The reason for discrepancies can be attributed to signal-to-noise levels and the probe geometry.

FDNS CFD Code Benchmark for RBCC Ejector Mode Operation: Continuing Toward Dual Rocket Effects

NASA Technical Reports Server (NTRS)

West, Jeff; Ruf, Joseph H.; Turner, James E. (Technical Monitor)

2000-01-01

Computational Fluid Dynamics (CFD) analysis results are compared with benchmark quality test data from the Propulsion Engineering Research Center's (PERC) Rocket Based Combined Cycle (RBCC) experiments to verify fluid dynamic code and application procedures. RBCC engine flowpath development will rely on CFD applications to capture the multi -dimensional fluid dynamic interactions and to quantify their effect on the RBCC system performance. Therefore, the accuracy of these CFD codes must be determined through detailed comparisons with test data. The PERC experiments build upon the well-known 1968 rocket-ejector experiments of Odegaard and Stroup by employing advanced optical and laser based diagnostics to evaluate mixing and secondary combustion. The Finite Difference Navier Stokes (FDNS) code [2] was used to model the fluid dynamics of the PERC RBCC ejector mode configuration. Analyses were performed for the Diffusion and Afterburning (DAB) test conditions at the 200-psia thruster operation point, Results with and without downstream fuel injection are presented.

Predictors of patient communication in psychiatric medication encounters among veterans with serious mental illnesses.

PubMed

Hack, Samantha M; Medoff, Deborah R; Brown, Clayton H; Fang, Lijuan; Dixon, Lisa B; Klingaman, Elizabeth A; Park, Stephanie G; Kreyenbuhl, Julie A

2016-06-01

Person-centered psychiatric services rely on consumers actively sharing personal information, opinions, and preferences with their providers. This research examined predictors of consumer communication during appointments for psychiatric medication prescriptions. The Roter Interaction Analysis System was used to code recorded Veterans Affairs psychiatric appointments with 175 consumers and 21 psychiatric medication prescribers and categorize communication by purpose: biomedical, psychosocial, facilitation, or rapport-building. Regression analyses found that greater provider communication, symptomology, orientation to psychiatric recovery, and functioning on the Repeatable Battery for the Assessment of Neuropsychological Status Attention and Language indices, as well as consumer diagnostic label, were positive predictors of consumer communication, though the types of communication impacted varied. Provider communication is the easiest variable to intervene on to create changes in consumer communication. Future research should also consider how cognitive and symptom factors may impact specific types of consumer communication in order to identify subgroups for targeted interventions. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

MITK global tractography

NASA Astrophysics Data System (ADS)

Neher, Peter F.; Stieltjes, Bram; Reisert, Marco; Reicht, Ignaz; Meinzer, Hans-Peter; Fritzsche, Klaus H.

2012-02-01

Fiber tracking algorithms yield valuable information for neurosurgery as well as automated diagnostic approaches. However, they have not yet arrived in the daily clinical practice. In this paper we present an open source integration of the global tractography algorithm proposed by Reisert et.al.1 into the open source Medical Imaging Interaction Toolkit (MITK) developed and maintained by the Division of Medical and Biological Informatics at the German Cancer Research Center (DKFZ). The integration of this algorithm into a standardized and open development environment like MITK enriches accessibility of tractography algorithms for the science community and is an important step towards bringing neuronal tractography closer to a clinical application. The MITK diffusion imaging application, downloadable from www.mitk.org, combines all the steps necessary for a successful tractography: preprocessing, reconstruction of the images, the actual tracking, live monitoring of intermediate results, postprocessing and visualization of the final tracking results. This paper presents typical tracking results and demonstrates the steps for pre- and post-processing of the images.

A system architecture for sharing de-identified, research-ready brain scans and health information across clinical imaging centers.

PubMed

Chervenak, Ann L; van Erp, Theo G M; Kesselman, Carl; D'Arcy, Mike; Sobell, Janet; Keator, David; Dahm, Lisa; Murry, Jim; Law, Meng; Hasso, Anton; Ames, Joseph; Macciardi, Fabio; Potkin, Steven G

2012-01-01

Progress in our understanding of brain disorders increasingly relies on the costly collection of large standardized brain magnetic resonance imaging (MRI) data sets. Moreover, the clinical interpretation of brain scans benefits from compare and contrast analyses of scans from patients with similar, and sometimes rare, demographic, diagnostic, and treatment status. A solution to both needs is to acquire standardized, research-ready clinical brain scans and to build the information technology infrastructure to share such scans, along with other pertinent information, across hospitals. This paper describes the design, deployment, and operation of a federated imaging system that captures and shares standardized, de-identified clinical brain images in a federation across multiple institutions. In addition to describing innovative aspects of the system architecture and our initial testing of the deployed infrastructure, we also describe the Standardized Imaging Protocol (SIP) developed for the project and our interactions with the Institutional Review Board (IRB) regarding handling patient data in the federated environment.

A System Architecture for Sharing De-Identified, Research-Ready Brain Scans and Health Information Across Clinical Imaging Centers

PubMed Central

Chervenak, Ann L.; van Erp, Theo G.M.; Kesselman, Carl; D’Arcy, Mike; Sobell, Janet; Keator, David; Dahm, Lisa; Murry, Jim; Law, Meng; Hasso, Anton; Ames, Joseph; Macciardi, Fabio; Potkin, Steven G.

2015-01-01

Progress in our understanding of brain disorders increasingly relies on the costly collection of large standardized brain magnetic resonance imaging (MRI) data sets. Moreover, the clinical interpretation of brain scans benefits from compare and contrast analyses of scans from patients with similar, and sometimes rare, demographic, diagnostic, and treatment status. A solution to both needs is to acquire standardized, research-ready clinical brain scans and to build the information technology infrastructure to share such scans, along with other pertinent information, across hospitals. This paper describes the design, deployment, and operation of a federated imaging system that captures and shares standardized, de-identified clinical brain images in a federation across multiple institutions. In addition to describing innovative aspects of the system architecture and our initial testing of the deployed infrastructure, we also describe the Standardized Imaging Protocol (SIP) developed for the project and our interactions with the Institutional Review Board (IRB) regarding handling patient data in the federated environment. PMID:22941984

Letting the story unfold: a case study of client-centered therapy for childhood traumatic grief.

PubMed

Goodman, Robin F; Morgan, Alison V; Juriga, Sandra; Brown, Elissa J

2004-01-01

There has been increasing interest in the newly identified condition of childhood traumatic grief (CTG) since the 2001 attack on the World Trade Center. The case presented here is one of an adolescent girl who was diagnosed with CTG following the death of her father, a firefighter killed in the line of duty on September 11, 2001. Literature on CTG, its treatment, and adolescent development will be discussed. The application of client-centered treatment to CTG will be highlighted by the case description and diagnostic findings prior to, during, and following treatment.

The Cloud Feedback Model Intercomparison Project (CFMIP) Diagnostic Codes Catalogue – metrics, diagnostics and methodologies to evaluate, understand and improve the representation of clouds and cloud feedbacks in climate models

DOE PAGES

Tsushima, Yoko; Brient, Florent; Klein, Stephen A.; ...

2017-11-27

The CFMIP Diagnostic Codes Catalogue assembles cloud metrics, diagnostics and methodologies, together with programs to diagnose them from general circulation model (GCM) outputs written by various members of the CFMIP community. This aims to facilitate use of the diagnostics by the wider community studying climate and climate change. Here, this paper describes the diagnostics and metrics which are currently in the catalogue, together with examples of their application to model evaluation studies and a summary of some of the insights these diagnostics have provided into the main shortcomings in current GCMs. Analysis of outputs from CFMIP and CMIP6 experiments willmore » also be facilitated by the sharing of diagnostic codes via this catalogue. Any code which implements diagnostics relevant to analysing clouds – including cloud–circulation interactions and the contribution of clouds to estimates of climate sensitivity in models – and which is documented in peer-reviewed studies, can be included in the catalogue. We very much welcome additional contributions to further support community analysis of CMIP6 outputs.« less

The Cloud Feedback Model Intercomparison Project (CFMIP) Diagnostic Codes Catalogue – metrics, diagnostics and methodologies to evaluate, understand and improve the representation of clouds and cloud feedbacks in climate models

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

Tsushima, Yoko; Brient, Florent; Klein, Stephen A.

The CFMIP Diagnostic Codes Catalogue assembles cloud metrics, diagnostics and methodologies, together with programs to diagnose them from general circulation model (GCM) outputs written by various members of the CFMIP community. This aims to facilitate use of the diagnostics by the wider community studying climate and climate change. Here, this paper describes the diagnostics and metrics which are currently in the catalogue, together with examples of their application to model evaluation studies and a summary of some of the insights these diagnostics have provided into the main shortcomings in current GCMs. Analysis of outputs from CFMIP and CMIP6 experiments willmore » also be facilitated by the sharing of diagnostic codes via this catalogue. Any code which implements diagnostics relevant to analysing clouds – including cloud–circulation interactions and the contribution of clouds to estimates of climate sensitivity in models – and which is documented in peer-reviewed studies, can be included in the catalogue. We very much welcome additional contributions to further support community analysis of CMIP6 outputs.« less

On the Relationality of Centers, Peripheries and Interactional Regimes: Translanguaging in a Community Interpreting Event

ERIC Educational Resources Information Center

Baynham, Mike; Hanušová, Jolana

2017-01-01

In this paper we discuss a multilingual interactional event that involves both interpreting and literacy work, part of a large scale study on translanguaging in superdiverse urban settings. In the first part of the interaction, the center/periphery dynamic is played out in what might be called "contested translanguaging" between Standard…

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

PubMed

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

2015-11-01

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

Cultural health capital and the interactional dynamics of patient-centered care

PubMed Central

Dubbin, Leslie A.; Chang, Jamie Suki; Shim, Janet K.

2014-01-01

As intuitive and inviting as it may appear, the concept of patient-centered care has been difficult to conceptualize, institutionalize and operationalize. Informed by Bourdieu's concepts of cultural capital and habitus, we employ the framework of cultural health capital to uncover the ways in which both patients' and providers' cultural resources, assets, and interactional styles influence their abilities to mutually achieve patient-centered care. Cultural health capital is defined as a specialized collection of cultural skills, attitudes, behaviors and interactional styles that are valued, leveraged, and exchanged by both patients and providers during clinical interactions. In this paper, we report the findings of a qualitative study conducted from 2010 to 2011 in the Western United States. We investigated the various elements of cultural health capital, how patients and providers used cultural health capital to engage with each other, and how this process shaped the patient-centeredness of interactions. We find that the accomplishment of patient-centered care is highly dependent upon habitus and the cultural health capital that both patients and providers bring to health care interactions. Not only are some cultural resources more highly valued than others, their differential mobilization can facilitate or impede engagement and communication between patients and their providers. The focus of cultural health capital on the ways fundamental social inequalities are manifest in clinical interactions enables providers, patients, and health care organizations to consider how such inequalities can confound patient-centered care. PMID:23906128

Systematic errors in Monsoon simulation: importance of the equatorial Indian Ocean processes

NASA Astrophysics Data System (ADS)

Annamalai, H.; Taguchi, B.; McCreary, J. P., Jr.; Nagura, M.; Miyama, T.

2015-12-01

H. Annamalai1, B. Taguchi2, J.P. McCreary1, J. Hafner1, M. Nagura2, and T. Miyama2 International Pacific Research Center, University of Hawaii, USA Application Laboratory, JAMSTEC, Japan In climate models, simulating the monsoon precipitation climatology remains a grand challenge. Compared to CMIP3, the multi-model-mean (MMM) errors for Asian-Australian monsoon (AAM) precipitation climatology in CMIP5, relative to GPCP observations, have shown little improvement. One of the implications is that uncertainties in the future projections of time-mean changes to AAM rainfall may not have reduced from CMIP3 to CMIP5. Despite dedicated efforts by the modeling community, the progress in monsoon modeling is rather slow. This leads us to wonder: Has the scientific community reached a "plateau" in modeling mean monsoon precipitation? Our focus here is to better understanding of the coupled air-sea interactions, and moist processes that govern the precipitation characteristics over the tropical Indian Ocean where large-scale errors persist. A series idealized coupled model experiments are performed to test the hypothesis that errors in the coupled processes along the equatorial Indian Ocean during inter-monsoon seasons could potentially influence systematic errors during the monsoon season. Moist static energy budget diagnostics has been performed to identify the leading moist and radiative processes that account for the large-scale errors in the simulated precipitation. As a way forward, we propose three coordinated efforts, and they are: (i) idealized coupled model experiments; (ii) process-based diagnostics and (iii) direct observations to constrain model physics. We will argue that a systematic and coordinated approach in the identification of the various interactive processes that shape the precipitation basic state needs to be carried out, and high-quality observations over the data sparse monsoon region are needed to validate models and further improve model physics.

Determining the utility and durability of medical equipment donated to a rural clinic in a low-income country

PubMed Central

Bauserman, Melissa; Hailey, Claire; Gado, Justin; Lokangaka, Adrien; Williams, Jessica; Richards-Kortum, Rebecca; Tshefu, Antoinette; Bose, Carl

2015-01-01

Background Health centers in low-income countries often depend on donations to provide appropriate diagnostic equipment. However, donations are sometimes made without an understanding of the recipient's needs, practical constraints or sustainability of supplies. Methods We donated a set of physical diagnostic equipment, non-invasive instrument tests and laboratory supplies to a rural health center in the Democratic Republic of Congo. We collected information on the usage and durability of equipment and supplies for each patient encounter over a 1-year period. Results We recorded 913 patient encounters. The most commonly used physical diagnostic equipment were the stethoscope (98.9%; 903/913), thermometer (81.7%; 746/913), adult scale (81.4%; 744/913), stop watch (62.6%; 572/913), adult sphygmomanometer (55.8%; 510/913), infant scale (24.9%; 228/913), measuring tape (24.3%; 222/913) and fetoscope (23.8%; 218/913). The most commonly used laboratory tests were the blood smear for malaria (53.7%; 491/913), hematocrit (23.5%; 215/913), urinalysis (20.1%; 184/913) and sputum stain for TB (13.3%; 122/913). With the exception of a penlight and solar lantern, all equipment remained functional. Conclusions This study adds valuable information about the utility and durability of equipment supplied to a health center in the Democratic Republic of Congo. Our results might aid in determining the appropriateness of donated medical equipment in similar settings. The selection of donated goods should be made with knowledge of the context in which it will be used, and utilization should be monitored. PMID:25525132

Increasing Access to Tuberculosis Services in Ethiopia: Findings From a Patient-Pathway Analysis.

PubMed

Fekadu, Lelisa; Hanson, Christy; Osberg, Mike; Makayova, Julia; Mingkwan, Pia; Chin, Daniel

2017-11-06

In Ethiopia, extensive scale-up of the availability of health extension workers (HEWs) at the community level has been credited with increased identification and referral of patients with presumptive tuberculosis, which has contributed to increased tuberculosis case notification and better treatment outcomes. However, nearly 30% of Ethiopia's estimated 191000 patients with tuberculosis remained unnotified in 2015. A better understanding of patient care-seeking practices may inform future government action to reach all patients with tuberculosis. A patient-pathway analysis was completed to assess the alignment between patient care initiation and the availability of diagnostic and treatment services at the national level. More than one third of patients initiated care with HEWs, who refer patients to health centers for diagnosis. An additional one third of patients initiated care at health centers. Of those health centers, >80% had microscopy services, but few had access to Xpert. Despite an extensive microscopy and radiography network at middle levels of the health system, a quarter of all notified patients with tuberculosis had no bacteriological confirmation of disease. While 30% of patients reported receiving some form of care from the private sector, private-sector facilities, especially pharmacies, were not widely accessed for tuberculosis diagnosis. The availability of HEWs can increase access to tuberculosis diagnostic and treatment support services, particularly for rural populations. Continued strengthening of referral systems from HEWs and health posts are needed to enable consistent and timely access to Xpert as an initial diagnostic test and to drug resistance screening. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Mealtime Interactions and Life Satisfaction Among Older Adults in Shanghai.

PubMed

Ye, Minzhi; Chen, Lin; Kahana, Eva

2017-06-01

We examined the association between older adults' mealtime interactions at senior centers in Shanghai and their life satisfaction. Competing hypotheses, derived from socioemotional selectivity theory and activity theory, were tested. Data were obtained from the 2011 Shanghai senior center service utilization survey ( N = 320). Relationships between respondents' mealtime interactions and life satisfaction were tested using multilevel regression modeling. After adjusting for demographics, interactions with tablemates (companionship, self-disclosure, and instrumental support) were positively associated with respondents' life satisfaction. These associations varied by senior centers. However, the number of tablemates was not significantly associated with respondents' life satisfaction. Findings support the activity-theory-based hypothesis that mealtime interactions are related to older adults' life satisfaction independent of the number of tablemates. This study illuminates the value of social interactions in the context of community dining programs for the rapidly increasing older population in urban China.

Are health care provider organizations ready to tackle diagnostic error? A survey of Leapfrog-participating hospitals.

PubMed

Newman-Toker, David E; Austin, J Matthew; Derk, Jordan; Danforth, Melissa; Graber, Mark L

2017-06-27

A 2015 National Academy of Medicine report on improving diagnosis in health care made recommendations for direct action by hospitals and health systems. Little is known about how health care provider organizations are addressing diagnostic safety/quality. This study is an anonymous online survey of safety professionals from US hospitals and health systems in July-August 2016. The survey was sent to those attending a Leapfrog Group webinar on misdiagnosis (n=188). The instrument was focused on knowledge, attitudes, and capability to address diagnostic errors at the institutional level. Overall, 61 (32%) responded, including community hospitals (42%), integrated health networks (25%), and academic centers (21%). Awareness was high, but commitment and capability were low (31% of leaders understand the problem; 28% have sufficient safety resources; and 25% have made diagnosis a top institutional safety priority). Ongoing efforts to improve diagnostic safety were sparse and mostly included root cause analysis and peer review feedback around diagnostic errors. The top three barriers to addressing diagnostic error were lack of awareness of the problem, lack of measures of diagnostic accuracy and error, and lack of feedback on diagnostic performance. The top two tools viewed as critically important for locally tackling the problem were routine feedback on diagnostic performance and culture change to emphasize diagnostic safety. Although hospitals and health systems appear to be aware of diagnostic errors as a major safety imperative, most organizations (even those that appear to be making a strong commitment to patient safety) are not yet doing much to improve diagnosis. Going forward, efforts to activate health care organizations will be essential to improving diagnostic safety.

A report on the Academic Emergency Medicine 2015 consensus conference "Diagnostic imaging in the emergency department: a research agenda to optimize utilization".

PubMed

Gunn, Martin L; Marin, Jennifer R; Mills, Angela M; Chong, Suzanne T; Froemming, Adam T; Johnson, Jamlik O; Kumaravel, Manickam; Sodickson, Aaron D

2016-08-01

In May 2015, the Academic Emergency Medicine consensus conference "Diagnostic imaging in the emergency department: a research agenda to optimize utilization" was held. The goal of the conference was to develop a high-priority research agenda regarding emergency diagnostic imaging on which to base future research. In addition to representatives from the Society of Academic Emergency Medicine, the multidisciplinary conference included members of several radiology organizations: American Society for Emergency Radiology, Radiological Society of North America, the American College of Radiology, and the American Association of Physicists in Medicine. The specific aims of the conference were to (1) understand the current state of evidence regarding emergency department (ED) diagnostic imaging utilization and identify key opportunities, limitations, and gaps in knowledge; (2) develop a consensus-driven research agenda emphasizing priorities and opportunities for research in ED diagnostic imaging; and (3) explore specific funding mechanisms available to facilitate research in ED diagnostic imaging. Through a multistep consensus process, participants developed targeted research questions for future research in six content areas within emergency diagnostic imaging: clinical decision rules; use of administrative data; patient-centered outcomes research; training, education, and competency; knowledge translation and barriers to imaging optimization; and comparative effectiveness research in alternatives to traditional computed tomography use.

Does NGAL reduce costs? A cost analysis of urine NGAL (uNGAL) & serum creatinine (sCr) for acute kidney injury (AKI) diagnosis.

PubMed

Parikh, Amay; Rizzo, John A; Canetta, Pietro; Forster, Catherine; Sise, Meghan; Maarouf, Omar; Singer, Eugenia; Elger, Antje; Elitok, Saban; Schmidt-Ott, Kai; Barasch, Jonathon; Nickolas, Thomas L

2017-01-01

Urine neutrophil gelatinase-associated lipocalin (uNGAL) is a sensitive and specific diagnostic test for acute kidney injury (AKI) in the Emergency Department (ED), but its economic impact has not been investigated. We hypothesized that uNGAL used in combination with serum creatinine (sCr) would reduce costs in the management of AKI in patients presenting to the ED in comparison to using sCr alone. A cost simulation model was developed for clinical algorithms to diagnose AKI based on sCr alone vs. uNGAL plus sCr (uNGAL+sCr). A cost minimization analysis was performed to determine total expected costs for patients with AKI. uNGAL test characteristics were validated with eight-hundred forty-nine patients with sCr ≥1.5 from a completed study of 1635 patients recruited from EDs at two U.S. hospitals from 2007-8. Biomarker test, AKI work-up, and diagnostic imaging costs were incorporated. For a hypothetical cohort of 10,000 patients, the model predicted that the expected costs were $900 per patient (pp) in the sCr arm and $950 in the uNGAL+sCr arm. uNGAL+sCr resulted in 1,578 fewer patients with delayed diagnosis and treatment than sCr alone (2,013 vs. 436 pts) at center 1 and 1,973 fewer patients with delayed diagnosis and treatment than sCr alone at center 2 (2,227 vs. 254 patients). Although initial evaluation costs at each center were $50 pp higher in with uNGAL+sCr, total costs declined by $408 pp at Center 1 and by $522 pp at Center 2 due to expected reduced delays in diagnosis and treatment. Sensitivity analyses confirmed savings with uNGAL + sCr for a range of cost inputs. Using uNGAL with sCr as a clinical diagnostic test for AKI may improve patient management and reduce expected costs. Any cost savings would likely result from avoiding delays in diagnosis and treatment and from avoidance of unnecessary testing in patients given a false positive AKI diagnosis by use of sCr alone.

Recommended Approaches for Pharmacokinetic Natural Product-Drug Interaction Research: a NaPDI Center Commentary.

PubMed

Paine, Mary F; Shen, Danny D; McCune, Jeannine S

2018-05-07

Sales of botanical dietary supplements and other purported medicinal natural products (NPs) have escalated over the past ~25 years, increasing the potential for NPs to precipitate clinically significant pharmacokinetic interactions with United States Food and Drug Administration (FDA)-approved medications (NP-drug interactions or NPDIs). Published NPDI studies to date often lack consistency in design, implementation, and documentation, which present difficulties in assessing the clinical significance of the results. Common hurdles include large variability in the admixture composition of phytoconstituents between and within batches of a given NP, limited knowledge on the pharmacokinetics of precipitant NP constituents, and use of animal and/or in vitro models which, in some cases, are not mechanistically appropriate for extrapolation to humans. The National Center for Complementary and Integrative Health has created a Center of Excellence for Natural Product-Drug Interaction (NaPDI Center) to address these unmet research needs. The NaPDI Center has two overarching goals: 1) develop Recommended Approaches to guide researchers in the proper conduct of NPDI studies, which will evolve over time concurrent with emerging technologies and new research data; and 2) apply the Recommended Approaches in evaluating four model NPs as precipitants of NPDIs with clinically relevant object drugs. The major objectives of this commentary are to 1) explain the rationale for creating the NaPDI Center; 2) describe the Decision Trees developed by the NaPDI Center to enhance the planning, rigor, and consistency of NPDI studies; and 3) provide a framework for communicating results to the multidisciplinary scientists interested in the NaPDI Center&rsquo's Interaction Projects. The American Society for Pharmacology and Experimental Therapeutics.

76 FR 35228 - Center for Scientific Review; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-16

... Review Special Emphasis Panel, Small Business: Cancer Diagnostics and Treatments (CDT). Date: July 14-15... Musculoskeletal, Oral, and Skin Systems. Date: July 15, 2011. Time: 8 a.m. to 5 p.m. Agenda: To review and...

42 CFR 493.1264 - Standard: Parasitology.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Systems § 493.1264 Standard: Parasitology. (a) The laboratory must have available a reference collection... these references in the laboratory for appropriate comparison with diagnostic specimens. (b) The...

Renal Cancer Biomarkers | NCI Technology Transfer Center | TTC

Cancer.gov

The National Cancer Institute's Laboratory of Proteomics and Analytical Technologies is seeking statements of capability or interest from parties interested in collaborative research to further develop, evaluate, or commercialize diagnostic, therapeutic and prognostic cancer biomarkers from clinical specimens.

National Centers for Environmental Prediction

Science.gov Websites

/ VISION | About EMC EMC > Mesoscale Modeling > PEOPLE Home Mission Models R & D Collaborators Documentation Change Log People Calendar References Verification/Diagnostics Tropical & Extratropical Cyclone Tracks & Verification Implementation Info FAQ Disclaimer More Info MESOSCALE MODELING PEOPLE

Selected National Cancer Institute Breast Cancer Research Topics | NIH MedlinePlus the Magazine

MedlinePlus

... effective treatments for these women. The Integrative Cancer Biology Program combines experimental and clinical research with mathematical modeling to gain new insights into cancer biology, prevention, diagnostics, and treatments. Multiple centers are developing ...

Automated EEG acquisition

NASA Technical Reports Server (NTRS)

Frost, J. D., Jr.; Hillman, C. E., Jr.

1977-01-01

Automated self-contained portable device can be used by technicians with minimal training. Data acquired from patient at remote site are transmitted to centralized interpretation center using conventional telephone equipment. There, diagnostic information is analyzed, and results are relayed back to remote site.

Efficient genome-wide association in biobanks using topic modeling identifies multiple novel disease loci.

PubMed

McCoy, Thomas H; Castro, Victor M; Snapper, Leslie A; Hart, Kamber L; Perlis, Roy H

2017-08-31

Biobanks and national registries represent a powerful tool for genomic discovery, but rely on diagnostic codes that may be unreliable and fail to capture the relationship between related diagnoses. We developed an efficient means of conducting genome-wide association studies using combinations of diagnostic codes from electronic health records (EHR) for 10845 participants in a biobanking program at two large academic medical centers. Specifically, we applied latent Dirichilet allocation to fit 50 disease topics based on diagnostic codes, then conducted genome-wide common-variant association for each topic. In sensitivity analysis, these results were contrasted with those obtained from traditional single-diagnosis phenome-wide association analysis, as well as those in which only a subset of diagnostic codes are included per topic. In meta-analysis across three biobank cohorts, we identified 23 disease-associated loci with p<1e-15, including previously associated autoimmune disease loci. In all cases, observed significant associations were of greater magnitude than for single phenome-wide diagnostic codes, and incorporation of less strongly-loading diagnostic codes enhanced association. This strategy provides a more efficient means of phenome-wide association in biobanks with coded clinical data.

Efficient Genome-wide Association in Biobanks Using Topic Modeling Identifies Multiple Novel Disease Loci

PubMed Central

McCoy, Thomas H; Castro, Victor M; Snapper, Leslie A; Hart, Kamber L; Perlis, Roy H

2017-01-01

Biobanks and national registries represent a powerful tool for genomic discovery, but rely on diagnostic codes that can be unreliable and fail to capture relationships between related diagnoses. We developed an efficient means of conducting genome-wide association studies using combinations of diagnostic codes from electronic health records for 10,845 participants in a biobanking program at two large academic medical centers. Specifically, we applied latent Dirichilet allocation to fit 50 disease topics based on diagnostic codes, then conducted a genome-wide common-variant association for each topic. In sensitivity analysis, these results were contrasted with those obtained from traditional single-diagnosis phenome-wide association analysis, as well as those in which only a subset of diagnostic codes were included per topic. In meta-analysis across three biobank cohorts, we identified 23 disease-associated loci with p < 1e-15, including previously associated autoimmune disease loci. In all cases, observed significant associations were of greater magnitude than single phenome-wide diagnostic codes, and incorporation of less strongly loading diagnostic codes enhanced association. This strategy provides a more efficient means of identifying phenome-wide associations in biobanks with coded clinical data. PMID:28861588

Parsing dimensional vs diagnostic category-related patterns of reward circuitry function in behaviorally and emotionally dysregulated youth in the Longitudinal Assessment of Manic Symptoms study.

PubMed

Bebko, Genna; Bertocci, Michele A; Fournier, Jay C; Hinze, Amanda K; Bonar, Lisa; Almeida, Jorge R C; Perlman, Susan B; Versace, Amelia; Schirda, Claudiu; Travis, Michael; Gill, Mary Kay; Demeter, Christine; Diwadkar, Vaibhav A; Ciuffetelli, Gary; Rodriguez, Eric; Olino, Thomas; Forbes, Erika; Sunshine, Jeffrey L; Holland, Scott K; Kowatch, Robert A; Birmaher, Boris; Axelson, David; Horwitz, Sarah M; Arnold, L Eugene; Fristad, Mary A; Youngstrom, Eric A; Findling, Robert L; Phillips, Mary L

2014-01-01

Pediatric disorders characterized by behavioral and emotional dysregulation pose diagnostic and treatment challenges because of high comorbidity, suggesting that they may be better conceptualized dimensionally rather than categorically. Identifying neuroimaging measures associated with behavioral and emotional dysregulation in youth may inform understanding of underlying dimensional vs disorder-specific pathophysiologic features. To identify, in a large cohort of behaviorally and emotionally dysregulated youth, neuroimaging measures that (1) are associated with behavioral and emotional dysregulation pathologic dimensions (behavioral and emotional dysregulation measured with the Parent General Behavior Inventory 10-Item Mania Scale [PGBI-10M], mania, depression, and anxiety) or (2) differentiate diagnostic categories (bipolar spectrum disorders, attention-deficit/hyperactivity disorder, anxiety, and disruptive behavior disorders). A multisite neuroimaging study was conducted from February 1, 2011, to April 15, 2012, at 3 academic medical centers: University Hospitals Case Medical Center, Cincinnati Children's Hospital Medical Center, and University of Pittsburgh Medical Center. Participants included a referred sample of behaviorally and emotionally dysregulated youth from the Longitudinal Assessment of Manic Symptoms (LAMS) study (n = 85) and healthy youth (n = 20). Region-of-interest analyses examined relationships among prefrontal-ventral striatal reward circuitry during a reward paradigm (win, loss, and control conditions), symptom dimensions, and diagnostic categories. Regardless of diagnosis, higher PGBI-10M scores were associated with greater left middle prefrontal cortical activity (r = 0.28) and anxiety with greater right dorsal anterior cingulate cortical (r = 0.27) activity to win. The 20 highest (t = 2.75) and 20 lowest (t = 2.42) PGBI-10M-scoring youth showed significantly greater left middle prefrontal cortical activity to win compared with 20 healthy youth. Disruptive behavior disorders were associated with lower left ventrolateral prefrontal cortex activity to win (t = 2.68) (all P < .05, corrected). Greater PGBI-10M-related left middle prefrontal cortical activity and anxiety-related right dorsal anterior cingulate cortical activity to win may reflect heightened reward sensitivity and greater attention to reward in behaviorally and emotionally dysregulated youth regardless of diagnosis. Reduced left ventrolateral prefrontal cortex activity to win may reflect reward insensitivity in youth with disruptive behavior disorders. Despite a distinct reward-related neurophysiologic feature in disruptive behavior disorders, findings generally support a dimensional approach to studying neural mechanisms in behaviorally and emotionally dysregulated youth.

The implications of alcohol intoxication and the Uniform Policy Provision Law on trauma centers; a national trauma data bank analysis of minimally injured patients.

PubMed

O'Keeffe, Terence; Shafi, Shahid; Sperry, Jason L; Gentilello, Larry M

2009-02-01

Alcohol intoxication may confound the initial assessment of trauma patients, resulting in increased use of diagnostic and therapeutic procedures, thereby increasing hospital costs. The Uniform Policy Provision Law (UPPL) exists in many states and allows insurance companies to deny payment for medical treatment for alcohol-related injuries. If intoxication increases resource utilization, these denials compound the financial burden of alcohol use on trauma centers. We hypothesized that patients injured while under the influence of alcohol require more diagnostic tests, procedures, and hospital admissions, leading to higher hospital charges. The National Trauma Databank (2000-2004) was analyzed to identify adult trauma patients (age > or = 16 years) who were discharged alive, had a length of stay < or = 1 day and minor injuries (Injury Severity Score < 9), and were tested for blood alcohol. The study was confined to minimally injured patients to facilitate identification of unexpected resource use most likely attributable to alcohol use. Resource utilization was compared among patients who tested positive or negative for alcohol use. Results are presented as odds ratio (OR) with 95% confidence intervals (CI). Sixty-eight thousand eight patients met study criteria, of which 31,020 were positive for alcohol. Despite similar baseline characteristics, alcohol-positive patients required significantly more invasive procedures, including intubation (OR 4.16, 95% CI = 3.56-4.85) and Foley catheter insertion (OR 1.52, 95% CI = 1.39-1.67) as well as diagnostic tests (CT scan OR 1.16, 95% CI = 1.12-1.20). They were also less likely to be discharged from the emergency department (OR 0.61, 95% CI = 0.58-0.64), and more frequently required hospital (OR 1.64, 95% CI = 1.57-1.73) or intensive care unit admission (OR 1.82, 95% CI = 1.71-1.94). Mean hospital charges were $1,833 greater ($10,405 +/- 225 vs. 8,572 +/- 68). A significant amount of trauma center costs are primarily attributable to alcohol use rather than injury severity or outcome. The financial costs associated with alcohol use and UPPL-related cost-shifting to trauma centers is a significant burden to trauma centers. UPPL laws that penalize trauma centers for identifying intoxicated patients should be repealed in states where they exist.

MUW Approach of PS OCT

NASA Astrophysics Data System (ADS)

Hitzenberger, Christoph K.; Pircher, Michael

Polarization sensitive (PS) OCT is a functional extension of OCT that exploits the light's polarization state to generate intrinsic, tissue specific contrast and enables quantitative measurements of tissue parameters. This chapter explains the technique, discusses polarization-changing light-tissue interactions and demonstrates the application of PS-OCT to retinal imaging. Two polarization-changing light-tissue interactions are discussed and their use for retinal diagnostics are demonstrated: (i) birefringence, which is found in fibrous tissues like the retinal nerve fiber layer and can be used for glaucoma diagnostics; and (ii) depolarization, which is observed in the retinal pigment epithelium (RPE) and can be used to segment the RPE and associated lesions like drusen or geographic atrophies in age related macular degeneration.

Diagnostic Dilemmas and Cultural Diversity in Emergency Rooms

PubMed Central

Weaver, Charlotte; Sklar, David

1980-01-01

Language and cultural beliefs play an extremely important role in the interaction between patients from diverse cultural groups and physicians. Especially in emergency rooms, there are many dangers in missed communications. A patient from a foreign culture, especially one who does not speak English, often expresses symptoms in ways that are unfamiliar to many American physicians. Specific areas of cultural vulnerability can be identified for the major ethnic groups in the United States as they interact with the scientific medical system. A short review of folk medical beliefs and recommendations for improving diagnostic accuracy and treatment may assist emergency room staffs in offering care that is culturally acceptable to patients of diverse ethnic backgrounds. PMID:7347053

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

PubMed

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

2008-03-14

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

Beyond feedback control: the interactive use of performance management systems. Implications for process innovation in Italian healthcare organizations.

PubMed

Demartini, Chiara; Mella, Piero

2014-01-01

This paper shows how the use of performance management systems affects managers' perception of satisfaction, the effectiveness of the control system and the performance related to process innovation. An exploratory empirical research has been conducted on 85 managers operating in Italian healthcare organizations. Empirical findings put forward that the interactive--as opposed to diagnostic--use of performance management systems enhances managerial satisfaction with the control system and managerial perception of effectiveness. The present study then showed that it is not the control itself that is an obstacle to innovation in organizations in general (and in health organizations in particular) but the diagnostic use of the control mechanisms, which impedes the interaction between the control personnel and those subject to the control. Finally, this paper addresses managerial implications and further research avenues. Copyright © 2013 John Wiley & Sons, Ltd.

Launch vehicle operations cost reduction through artificial intelligence techniques

NASA Technical Reports Server (NTRS)

Davis, Tom C., Jr.

1988-01-01

NASA's Kennedy Space Center has attempted to develop AI methods in order to reduce the cost of launch vehicle ground operations as well as to improve the reliability and safety of such operations. Attention is presently given to cost savings estimates for systems involving launch vehicle firing-room software and hardware real-time diagnostics, as well as the nature of configuration control and the real-time autonomous diagnostics of launch-processing systems by these means. Intelligent launch decisions and intelligent weather forecasting are additional applications of AI being considered.

How clinicians should use the diagnostic laboratory in a changing medical world.

PubMed

Lundberg, G D

1999-02-01

In developed countries, clinicians are faced with a plethora of diagnostic tests to apply to patients to guide their clinical management. The quality, effectiveness, and efficiency of patient care should be foremost in the clinician's mind. Laboratory directors should make every effort to guide clinicians in appropriate laboratory test ordering, interpretation, and resulting actions. Medicine, being at its center a moral enterprise grounded in a covenant of trust, and laboratory medicine being a subset of medicine, must first care and advocate for the patient, and consider clinical outcomes as most important.

Diagnostic Marker for Improving Treatment Outcomes of Hepatitis C | NCI Technology Transfer Center | TTC

Cancer.gov

NCI Researchers have discovered Interferon-lambda 4 (IFNL4), a protein found through analysis of genomic data. Preliminary studies indicate that this protein may play a role in the clearance of HCV and may be a new target for diagnosing and treating HCV infection. The National Cancer Institute (NCI) Division of Cancer Epidemiology and Genetics (DCEG) Immunoepidemiology Branch is seeking statements of capability or interest from parties interested in in-licensing or collaborative research to further co-develop a gene-based diagnostic for Hepatitis C virus (HepC, HCV).

Accuracy of a Rapid Diagnostic Test (Cypress Chagas Quick Test®) for the Diagnosis of Chronic Chagas Disease in a Nonendemic Area: A Retrospective Longitudinal Study.

PubMed

Angheben, Andrea; Staffolani, Silvia; Anselmi, Mariella; Tais, Stefano; Degani, Monica; Gobbi, Federico; Buonfrate, Dora; Gobbo, Maria; Bisoffi, Zeno

2017-11-01

We analyzed the accuracy of Chagas Quick Test ® , a rapid diagnostic test, for the diagnosis of chronic Chagas disease through a retrospective study on a cohort of 669 patients consecutively examined at a single reference center in Italy, during a 7-year period. We observed high concordance with serological reference standard but low accuracy for screening purposes (sensitivity/specificity: 82.8%/98.7%) at least in our nonendemic context.

Upper Extremity Injuries in Tennis Players: Diagnosis, Treatment, and Management

PubMed Central

Chung, Kevin C.; Lark, Meghan E.

2016-01-01

Synopsis Upper extremity tennis injuries are most commonly characterized as overuse injuries to the wrist, elbow and shoulder. The complex anatomy of these structures and their interaction with biomechanical properties of tennis strokes contributes to the diagnostic challenges. A thorough understanding of tennis kinetics, in combination with the current literature surrounding diagnostic and treatment methods, will improve clinical decision-making. PMID:27886833

Effects of the Caregiver Interaction Profile Training on Caregiver-Child Interactions in Dutch Child Care Centers: A Randomized Controlled Trial.

PubMed

Helmerhorst, Katrien O W; Riksen-Walraven, J Marianne A; Fukkink, Ruben G; Tavecchio, Louis W C; Gevers Deynoot-Schaub, Mirjam J J M

2017-01-01

Previous studies underscore the need to improve caregiver-child interactions in early child care centers. In this study we used a randomized controlled trial to examine whether a 5-week video feedback training can improve six key interactive skills of caregivers in early child care centers: Sensitive responsiveness, respect for autonomy, structuring and limit setting, verbal communication, developmental stimulation, and fostering positive peer interactions. A total of 139 caregivers from 68 early child care groups for 0- to 4-year-old children in Dutch child care centers participated in this RCT, 69 in the intervention condition and 70 in the control condition. Caregiver interactive skills during everyday interactions with the children were rated from videotape using the Caregiver Interaction Profile (CIP) scales at pretest, posttest, and follow-up 3 months after the posttest. Results at posttest indicate a significant positive training effect on all six caregiver interactive skills. Effect sizes of the CIP training range between d  = 0.35 and d  = 0.79. Three months after the posttest, caregivers in the intervention group still scored significantly higher on sensitive responsiveness, respect for autonomy, verbal communication, and fostering positive peer interactions than caregivers in the control group with effect sizes ranging between d  = 0.47 and d  = 0.70. This study shows that the quality of caregiver-child interactions can be improved for all six important caregiver skills, with a relatively short training program. Possible ways to further improve the training and to implement it in practice and education are discussed.

Plasma diagnostics package. Volume 1: OSS-1 section

NASA Technical Reports Server (NTRS)

Pickett, Jolene S. (Compiler); Frank, L. A. (Compiler); Kurth, W. S. (Compiler)

1988-01-01

This volume (1) of the Plasma Diagnostics Package (PDP) final science report contains a summary of all of the data reduction and scientific analyses which were performed using PDP data obtained on STS-3 as a part of the Office of Space Science first payload (OSS-1). This work was performed during the period of launch, March 22, l982, through June 30, l983. During this period the primary data reduction effort consisted of processing summary plots of the data received by the 14 instruments located on the PDP and submitting these data to the National Space Science Data Center (NSSDC). The scientific analyses during the performance period consisted of general studies which incorporated the results of several of the PDP's instruments, detailed studies which concentrated on data from only one or two of the instruments, and joint studies of beam-plasma interactions with the OSS-1 Fast Pulse Electron Generator (FPEG) of the Vehicle Charging and Potential Investigation (VCAP). Internal reports, published papers and oral presentations which involve PDP/OSS-1 data are listed in Sections 3 and 4. A PDP/OSS-1 scientific results meeting was held at the University of Iowa on April 19-20, 1983. This meeting was attended by most of the PDP and VCAP investigators and provided a forum for discussing and comparing the various results, particularly with regard to the shuttle orbiter environment. One of the most important functional objectives of the PDP on OSS-1 was to characterize the orbiter environment.

Who Is Watching and Who Is Playing: Parental Engagement with Children at a Hands-On Science Center

ERIC Educational Resources Information Center

Nadelson, Louis S.

2013-01-01

Family interactions are common phenomenon at visits to science centers and natural history museums. Through interactions the family can support each other as the members individually and collectively learn from their visits. Interaction is particularly important between child(ren) and parent, which may be facilitated by media provided to parents.…

Preschool Children's Observed Disruptive Behavior: Variations across Sex, Interactional Context, and Disruptive Psychopathology

ERIC Educational Resources Information Center

Gray, Sarah A. O.; Carter, Alice S.; Briggs-Gowan, Margaret J.; Hill, Carri; Danis, Barbara; Keenan, Kate; Wakschlag, Lauren S.

2012-01-01

Sex differences in disruptive behavior and sensitivity to social context are documented, but the intersection between them is rarely examined empirically. This report focuses on sex differences in observed disruptive behavior across interactional contexts and diagnostic status. Preschoolers (n = 327) were classified as nondisruptive (51%),…

Diagnostic Approach to Acute Diarrheal Illness in a Military Population on Training Exercises in Thailand, a Region of Campylobacter Hyperendemicity

DTIC Science & Technology

2008-04-01

Center (Silver Spring, MD) and the Armed Forces Research Institute FIG. 1. Posttest probability of Campylobacter-associated illness based on the...Sanders5 Enteric Diseases Department, Naval Medical Research Center, Silver Spring, Maryland1; Armed Forces Research Institute of Medical Sciences, Bangkok...Thailand2; Walter Reed Army Institute of Research , Silver Spring, Maryland3; Naval Environmental Preventive Medicine Unit 6, Pearl Harbor, Hawaii4

Use of laparoscopy in trauma at a level II trauma center.

PubMed

Barzana, Daniel C; Kotwall, Cyrus A; Clancy, Thomas V; Hope, William W

2011-01-01

Enthusiasm for the use of laparoscopy in trauma has not rivaled that for general surgery. The purpose of this study was to evaluate our experience with laparoscopy at a level II trauma center. A retrospective review of all trauma patients undergoing diagnostic or therapeutic laparoscopy was performed from January 2004 to July 2010. Laparoscopy was performed in 16 patients during the study period. The average age was 35 years. Injuries included left diaphragm in 4 patients, mesenteric injury in 2, and vaginal laceration, liver laceration, small bowel injury, renal laceration, urethral/pelvic, and colon injury in 1 patient each. Diagnostic laparoscopy was performed in 11 patients (69%) with 3 patients requiring conversion to an open procedure. Successful therapeutic laparoscopy was performed in 5 patients for repair of isolated diaphragm injuries (2), a small bowel injury, a colon injury, and placement of a suprapubic bladder catheter. Average length of stay was 5.6 days (range, 0 to 23), and 75% of patients were discharged home. Morbidity rate was 13% with no mortalities or missed injuries. Laparoscopy is a seldom-used modality at our trauma center; however, it may play a role in a select subset of patients.

Books, Read-Alouds, and Voluntary Book Interactions: What Do We Know about Centers Serving Three-Year-Olds?

ERIC Educational Resources Information Center

Mesmer, Heidi Anne

2018-01-01

This study examined the quality of books, the quality of read-alouds, and children's voluntary interactions with books in childcare centers serving low-income 3-year-olds (N = 30). Although a large percentage of centers had book areas, the features of book areas differed. The highest percentage of books was highly recommended and appropriate (39%)…

Whole exome sequencing in neurogenetic odysseys: An effective, cost- and time-saving diagnostic approach.

PubMed

Córdoba, Marta; Rodriguez-Quiroga, Sergio Alejandro; Vega, Patricia Analía; Salinas, Valeria; Perez-Maturo, Josefina; Amartino, Hernán; Vásquez-Dusefante, Cecilia; Medina, Nancy; González-Morón, Dolores; Kauffman, Marcelo Andrés

2018-01-01

Diagnostic trajectories for neurogenetic disorders frequently require the use of considerable time and resources, exposing patients and families to so-called "diagnostic odysseys". Previous studies have provided strong evidence for increased diagnostic and clinical utility of whole-exome sequencing in medical genetics. However, specific reports assessing its utility in a setting such as ours- a neurogeneticist led academic group serving in a low-income country-are rare. To assess the diagnostic yield of WES in patients suspected of having a neurogenetic condition and explore the cost-effectiveness of its implementation in a research group located in an Argentinean public hospital. This is a prospective study of the clinical utility of WES in a series of 40 consecutive patients selected from a Neurogenetic Clinic of a tertiary Hospital in Argentina. We evaluated patients retrospectively for previous diagnostic trajectories. Diagnostic yield, clinical impact on management and economic diagnostic burden were evaluated. We demonstrated the clinical utility of Whole Exome Sequencing in our patient cohort, obtaining a diagnostic yield of 40% (95% CI, 24.8%-55.2%) among a diverse group of neurological disorders. The average age at the time of WES was 23 (range 3-70). The mean time elapsed from symptom onset to WES was 11 years (range 3-42). The mean cost of the diagnostic workup prior to WES was USD 1646 (USD 1439 to 1853), which is 60% higher than WES cost in our center. WES for neurogenetics proved to be an effective, cost- and time-saving approach for the molecular diagnosis of this heterogeneous and complex group of patients.

Learning from epidemiological, clinical, and immunological studies on Mycobacterium africanum for improving current understanding of host-pathogen interactions, and for the development and evaluation of diagnostics, host-directed therapies, and vaccines for tuberculosis.

PubMed

Zumla, Alimuddin; Otchere, Isaac Darko; Mensah, Gloria Ivy; Asante-Poku, Adwoa; Gehre, Florian; Maeurer, Markus; Bates, Matthew; Mwaba, Peter; Ntoumi, Francine; Yeboah-Manu, Dorothy

2017-03-01

Mycobacterium africanum comprises two phylogenetic lineages within the Mycobacterium tuberculosis complex (MTBC). M. africanum was first described and isolated in 1968 from the sputum of a Senegalese patient with pulmonary tuberculosis (TB) and it has been identified increasingly as an important cause of human TB, particularly prevalent in West Africa. The restricted geographical distribution of M. africanum, in contrast to the widespread global distribution of other species of MTBC, requires explanation. Available data indicate that M. africanum may also have important differences in transmission, pathogenesis, and host-pathogen interactions, which could affect the evaluation of new TB intervention tools (diagnostics and vaccines)-those currently in use and those under development. The unequal geographical distribution and spread of MTBC species means that individual research findings from one country or region cannot be generalized across the continent. Thus, generalizing data from previous and ongoing research studies on MTBC may be inaccurate and inappropriate. A major rethink is required regarding the design and structure of future clinical trials of new interventions. The West, Central, East, and Southern African EDCTP Networks of Excellence provide opportunities to take forward these pan-Africa studies. More investments into molecular, epidemiological, clinical, diagnostic, and immunological studies across the African continent are required to enable further understanding of host-M. africanum interactions, leading to the development of more specific diagnostics, biomarkers, host-directed therapies, and vaccines for TB. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

TFTR diagnostic control and data acquisition system

NASA Astrophysics Data System (ADS)

Sauthoff, N. R.; Daniels, R. E.

1985-05-01

General computerized control and data-handling support for TFTR diagnostics is presented within the context of the Central Instrumentation, Control and Data Acquisition (CICADA) System. Procedures, hardware, the interactive man-machine interface, event-driven task scheduling, system-wide arming and data acquisition, and a hierarchical data base of raw data and results are described. Similarities in data structures involved in control, monitoring, and data acquisition afford a simplification of the system functions, based on ``groups'' of devices. Emphases and optimizations appropriate for fusion diagnostic system designs are provided. An off-line data reduction computer system is under development.

TFTR diagnostic control and data acquisition system

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

Sauthoff, N.R.; Daniels, R.E.; PPL Computer Division

1985-05-01

General computerized control and data-handling support for TFTR diagnostics is presented within the context of the Central Instrumentation, Control and Data Acquisition (CICADA) System. Procedures, hardware, the interactive man--machine interface, event-driven task scheduling, system-wide arming and data acquisition, and a hierarchical data base of raw data and results are described. Similarities in data structures involved in control, monitoring, and data acquisition afford a simplification of the system functions, based on ''groups'' of devices. Emphases and optimizations appropriate for fusion diagnostic system designs are provided. An off-line data reduction computer system is under development.

American Pancreatic Association Practice Guidelines in Chronic Pancreatitis: Evidence-Based Report on Diagnostic Guidelines

PubMed Central

Conwell, Darwin L.; Lee, Linda S.; Yadav, Dhiraj; Longnecker, Daniel S.; Miller, Frank H.; Mortele, Koenraad J.; Levy, Michael J.; Kwon, Richard; Lieb, John G.; Stevens, Tyler; Toskes, Philip P.; Gardner, Timothy B.; Gelrud, Andres; Wu, Bechien U.; Forsmark, Christopher E.; Vege, Santhi S.

2016-01-01

The diagnosis of chronic pancreatitis remains challenging in early stages of the disease. This report defines the diagnostic criteria useful in the assessment of patients with suspected and established chronic pancreatitis. All current diagnostic procedures are reviewed and evidence based statements are provided about their utility and limitations. Diagnostic criteria for chronic pancreatitis are classified as definitive, probable or insufficient evidence. A diagnostic (STEP-wise; S-survey, T-tomography, E-endoscopy and P-pancreas function testing) algorithm is proposed that proceeds from a non-invasive to a more invasive approach. This algorithm maximizes specificity (low false positive rate) in subjects with chronic abdominal pain and equivocal imaging changes. Futhermore, a nomenclature is suggested to further characterize patients with established chronic pancreatitis based on TIGAR-O (T-toxic, I-idiopathic, G-genetic, A- autoimmune, R-recurrent and O-obstructive) etiology, gland morphology (Cambridge criteria) and physiologic state (exocrine, endocrine function) for uniformity across future multi-center research collaborations. This guideline will serve as a baseline manuscript that will be modified as new evidence becomes available and our knowledge of chronic pancreatitis improves. PMID:25333398

Development of PETAL diagnostics: PETAPhys project

NASA Astrophysics Data System (ADS)

Raffestin, D.; Boutoux, G.; Baggio, J.; Batani, D.; Blanchot, N.; Bretheau, D.; Hulin, S.; D'Humieres, E.; Granet, F.; Longhi, Th.; Meyer, Ch.; Moreno, Q.; Nuter, R.; Rault, J.; Tikhonchuk, V.; Universite de Bordeaux/Celia Team; CEA. DAM/Cesta Team

2017-10-01

Beginning of autumn 2017, PETAL, a Petawatt laser beam, will be operated for experiments on the LMJ facility at the CEA/ Cesta research center. The PETAPhys project provides a support to the qualification phase of the PETAL laser operation. Within the PETAPhys project, we are developing two simple and robust diagnostics permitting both to characterize the focal spot of the PETAL beam and to measure the hard X-ray spectrum at each shot. The first diagnostic consists in optical imaging of the PETAL beam focal spot in the spectral range of the second and third harmonic radiation emitted from the target. The second diagnostic is a hard X-ray dosimeter consisting in a stack of imaging plates (IP) and filters, either placed inside a re-entrant tube or inserted close to target. Numerical simulations as well as experiments on small scale facilities have been performed to design these diagnostics. If available, preliminary results from PETAL experiments will be discussed. We acknowledge the financial support from the French National Research Agency (ANR) in the framework of ``the investments for the future'' Programme IdEx Bordeaux-LAPHIA (ANR-10-IDEX-03-02).

The Multi-User Droplet Combustion Apparatus: the Development and Integration Concept for Droplet Combustion Payloads in the Fluids and Combustion Facility Combustion Integrated Rack

NASA Astrophysics Data System (ADS)

Myhre, C. A.

2002-01-01

The Multi-user Droplet Combustion Apparatus (MDCA) is a multi-user facility designed to accommodate four different droplet combustion science experiments. The MDCA will conduct experiments using the Combustion Integrated Rack (CIR) of the NASA Glenn Research Center's Fluids and Combustion Facility (FCF). The payload is planned for the International Space Station. The MDCA, in conjunction with the CIR, will allow for cost effective extended access to the microgravity environment, not possible on previous space flights. It is currently in the Engineering Model build phase with a planned flight launch with CIR in 2004. This paper provides an overview of the capabilities and development status of the MDCA. The MDCA contains the hardware and software required to conduct unique droplet combustion experiments in space. It consists of a Chamber Insert Assembly, an Avionics Package, and a multiple array of diagnostics. Its modular approach permits on-orbit changes for accommodating different fuels, fuel flow rates, soot sampling mechanisms, and varying droplet support and translation mechanisms to accommodate multiple investigations. Unique diagnostic measurement capabilities for each investigation are also provided. Additional hardware provided by the CIR facility includes the structural support, a combustion chamber, utilities for the avionics and diagnostic packages, and the fuel mixing capability for PI specific combustion chamber environments. Common diagnostics provided by the CIR will also be utilized by the MDCA. Single combustible fuel droplets of varying sizes, freely deployed or supported by a tether are planned for study using the MDCA. Such research supports how liquid-fuel-droplets ignite, spread, and extinguish under quiescent microgravity conditions. This understanding will help us develop more efficient energy production and propulsion systems on Earth and in space, deal better with combustion generated pollution, and address fire hazards associated with using liquid combustibles on Earth and in space. As a result of the concurrent design process of MDCA and CIR, the MDCA team continues to work closely with the CIR team, developing Integration Agreements and an Interface Control Document during preliminary integration activities. Integrated testing of hardware and software systems will occur at the Engineering Model and Flight Model phases. Because the engineering model is a high fidelity unit, it will be upgraded to a flight equivalent Ground Integration Unit (GIU) when the engineering model phase is completed. The GIU will be available on the ground for troubleshooting of any on-orbit problems. Integrated verification testing will be conducted with the MDCA flight unit and the CIR flight unit. Upon successful testing, the MDCA will be shipped to the Kennedy Space Center for a post-shipment checkout and final turn-over to CIR for final processing and launch to the International Space Station. Once on-orbit, the MDCA is managed from the GRC Telescience Support Center (TSC). The MDCA operations team resides at the TSC. Data is transmitted to the PI's at their home sites by means of TREK workstations, allowing direct interaction between the PI and operations staff to maximum science. Upon completion of a PI's experiment, the MDCA is reconfigured for the next of the three follow-on experiments or ultimately removed from the CIR, placed into stowage, and returned to Earth.

Functional and performance requirements of the next NOAA-Kasas City computer system

NASA Technical Reports Server (NTRS)

Mosher, F. R.

1985-01-01

The development of the Advanced Weather Interactive Processing System for the 1990's (AWIPS-90) will result in more timely and accurate forecasts with improved cost effectiveness. As part of the AWIPS-90 initiative, the National Meteorological Center (NMC), the National Severe Storms Forecast Center (NSSFC), and the National Hurricane Center (NHC) are to receive upgrades of interactive processing systems. This National Center Upgrade program will support the specialized inter-center communications, data acquisition, and processing needs of these centers. The missions, current capabilities and general functional requirements for the upgrade to the NSSFC are addressed. System capabilities are discussed along with the requirements for the upgraded system.

An emerging cyberinfrastructure for biodefense pathogen and pathogen–host data

PubMed Central

Zhang, C.; Crasta, O.; Cammer, S.; Will, R.; Kenyon, R.; Sullivan, D.; Yu, Q.; Sun, W.; Jha, R.; Liu, D.; Xue, T.; Zhang, Y.; Moore, M.; McGarvey, P.; Huang, H.; Chen, Y.; Zhang, J.; Mazumder, R.; Wu, C.; Sobral, B.

2008-01-01

The NIAID-funded Biodefense Proteomics Resource Center (RC) provides storage, dissemination, visualization and analysis capabilities for the experimental data deposited by seven Proteomics Research Centers (PRCs). The data and its publication is to support researchers working to discover candidates for the next generation of vaccines, therapeutics and diagnostics against NIAID's Category A, B and C priority pathogens. The data includes transcriptional profiles, protein profiles, protein structural data and host–pathogen protein interactions, in the context of the pathogen life cycle in vivo and in vitro. The database has stored and supported host or pathogen data derived from Bacillus, Brucella, Cryptosporidium, Salmonella, SARS, Toxoplasma, Vibrio and Yersinia, human tissue libraries, and mouse macrophages. These publicly available data cover diverse data types such as mass spectrometry, yeast two-hybrid (Y2H), gene expression profiles, X-ray and NMR determined protein structures and protein expression clones. The growing database covers over 23 000 unique genes/proteins from different experiments and organisms. All of the genes/proteins are annotated and integrated across experiments using UniProt Knowledgebase (UniProtKB) accession numbers. The web-interface for the database enables searching, querying and downloading at the level of experiment, group and individual gene(s)/protein(s) via UniProtKB accession numbers or protein function keywords. The system is accessible at http://www.proteomicsresource.org/. PMID:17984082

Recent Advances in Narrowband Stimulated Electromagnetic Emission NSEE Investigations at HAARP and EISCAT

NASA Astrophysics Data System (ADS)

Scales, Wayne

2016-07-01

Investigation of stimulated radiation, commonly known as Stimulated Electromagnetic Emissions (SEE), produced by the interaction of high-power, High Frequency HF radiowaves with the ionospheric plasma has been a vibrant area of research since the early 1980's. Substantial diagnostic information about ionospheric plasma characteristics, dynamics, and turbulence can be obtained from the frequency spectrum of the stimulated radiation. During the past several decades, so-called wideband SEE (WSEE) which exists in a frequency band of ±100 KHz or so of the transmit wave frequency (which is several MHz) has been investigated relatively thoroughly. Upgrades both in transmitter power and diagnostic receiver frequency sensitivity at major ionosphere interaction facilities (i.e. HAARP and EISCAT) have allowed new breakthroughs in the ability to study a plethora of processes associated with the ionospheric plasma during these active experiments. A primary advance is in observations of so-called narrowband SEE (NSEE) which exists roughly within ±1 kHz of the transmit wave frequency. NSEE investigation has opened the door for a potentially powerful tool for aeronomy investigations as well. An overview of several important new results associated with NSEE are discussed in this presentation, including observations, theory, computational modeling, as well as implications to new diagnostics of space plasma physics occurring during ionospheric interaction experiments.

78 FR 24222 - Center for Scientific Review; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-24

... Diagnostics and Treatments. Date: May 3, 2013. Time: 1:00 p.m. to 2:00 p.m. Agenda: To review and evaluate... Federal Domestic Assistance Program Nos. 93.306, Comparative Medicine; 93.333, Clinical Research, 93.306...

77 FR 6915 - Medical Diagnostic Equipment Accessibility Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-09

... Israel Deaconess Medical Center (October 22, 2009) accessible facilities and accessible medical equipment... of types of accessible medical equipment required in different types of health care facilities. If... facilities, accessible medical equipment, and auxiliary aids and services; University of Southern California...

National Centers for Environmental Prediction

Science.gov Websites

/ VISION | About EMC EMC > NAM > Home NAM Operational Products HIRESW Operational Products Operational Forecast Graphics Experimental Forecast Graphics Verification and Diagnostics Model Configuration Collaborators Documentation and Code FAQ Operational Change Log Parallel Experiment Change Log Contacts

Clinical Laboratories – Production Factories or Specialized Diagnostic Centers

PubMed Central

Tóth, Judit

2016-01-01

Since a large proportion of medical decisions are based on laboratory results, clinical laboratories should meet the increasing demand of clinicians and their patients. Huge central laboratories may process over 10 million tests annually; they act as production factories, measuring emergency and routine tests with sufficient speed and accuracy. At the same time, they also serve as specialized diagnostic centers where well-trained experts analyze and interpret special test results. It is essential to improve and constantly monitor this complex laboratory service, by several methods. Sample transport by pneumatic tube system, use of an advanced laboratory information system and point-of-care testing may result in decreased total turnaround time. The optimization of test ordering may result in a faster and more cost-effective laboratory service. Autovalidation can save time for laboratory specialists, when the analysis of more complex results requires their attention. Small teams of experts responsible for special diagnostic work, and their interpretative reporting according to predetermined principles, may help to minimize subjectivity of these special reports. Although laboratory investigations have become so diversely developed in the past decades, it is essential that the laboratory can provide accurate results relatively quickly, and that laboratory specialists can support the diagnosis and monitoring of patients by adequate interpretation of esoteric laboratory methods. PMID:27683528

Laboratory diagnosis of Ebola virus disease and corresponding biosafety considerations in the China Ebola Treatment Center.

PubMed

Huang, Qing; Fu, Wei-Ling; You, Jian-Ping; Mao, Qing

2016-10-01

Ebola virus disease (EVD), caused by Ebola virus (EBOV), is a potent acute infectious disease with a high case-fatality rate. Etiological and serological EBOV detection methods, including techniques that involve the detection of the viral genome, virus-specific antigens and anti-virus antibodies, are standard laboratory diagnostic tests that facilitate confirmation or exclusion of EBOV infection. In addition, routine blood tests, liver and kidney function tests, electrolytes and coagulation tests and other diagnostic examinations are important for the clinical diagnosis and treatment of EVD. Because of the viral load in body fluids and secretions from EVD patients, all body fluids are highly contagious. As a result, biosafety control measures during the collection, transport and testing of clinical specimens obtained from individuals scheduled to undergo EBOV infection testing (including suspected, probable and confirmed cases) are crucial. This report has been generated following extensive work experience in the China Ebola Treatment Center (ETC) in Liberia and incorporates important information pertaining to relevant diagnostic standards, clinical significance, operational procedures, safety controls and other issues related to laboratory testing of EVD. Relevant opinions and suggestions are presented in this report to provide contextual awareness associated with the development of standards and/or guidelines related to EVD laboratory testing.

Diagnostic guidelines for newborns who screen positive in newborn screening.

PubMed

Kronn, David; Mofidi, Shideh; Braverman, Nancy; Harris, Katharine

2010-12-01

Recent expansion of the newborn screening panels has presented an interesting challenge to specialty care centers, especially the clinical genetics community. Some of the conditions in the core and secondary newborn screening panels have extremely variable clinical presentations; others are so rare that only a handful of newborns have been diagnosed with them to date (Region 4 Collaborative MS/MS project-http://region4genetics.org/msms_data_project/data_project_home.aspx). Definition of some disorders is problematic-does continued abnormality of the screening analyte constitute diagnosis or is further testing necessary? A work group of the New York Mid-Atlantic Consortium for Genetic and Newborn Screening Services (region 2), one of seven regional collaboratives funded by the Federal Health Resources and Services Administration and administered by the Maternal and Child Health Bureau (U22MC03956), has developed guidelines for the confirmation of diagnosis of the conditions in the newborn screening panels for use by the specialty care centers. The diagnostic guidelines are a work in progress and are being reviewed and revised regularly as our understanding of the newborn screened disorders improves. The aim is to make it a relevant guide for specialty care physicians and other healthcare professionals in the diagnostic workup of these patients.

Sex/Gender Differences in Screening for Autism Spectrum Disorder: Implications for Evidence-Based Assessment.

PubMed

Evans, Spencer C; Boan, Andrea D; Bradley, Catherine; Carpenter, Laura A

2018-03-30

Autism spectrum disorder (ASD) is diagnosed more often in boys than in girls; however, little is known about the nature of this sex/gender discrepancy or how it relates to diagnostic assessment practices. This study examined the performance of the Social Communication Questionnaire (SCQ) in screening for ASD among boys and girls. Data were drawn from the South Carolina Children's Educational Surveillance Study, a population-based study of ASD prevalence among children 8-10 years of age. Analyses were conducted using SCQ data from 3,520 children, with direct assessment data from 272 with elevated SCQ scores. A bifactor model based on the Diagnostic and Statistical Manual of Mental Disorders's (5th ed.) two ASD symptom domains fit the data well and performed slightly better for girls. In the general population sample, girls exhibited fewer social communication/interaction and restricted-repetitive behavior symptoms than boys. In the direct assessment sample, however, girls with ASD showed greater impairment in social communication/interaction than boys with ASD. Items pertaining to social communication/interaction problems at ages 4-5 were among the most diagnostically efficient overall and particularly for girls. Similarly, receiver operating characteristic analyses suggested that the SCQ performs adequately among boys and well among girls. Results support the use of the SCQ in screening for ASD but do not indicate sex/gender-specific cutoffs. Girls with ASD may exhibit pronounced intraindividual deficits in social communication/interaction compared to male peers with ASD and female peers without ASD. Although more research is needed, careful attention to social communication/interaction deficits around 4-5 years of age may be especially useful for assessing ASD in girls.

Coronary Heart Disease Preoperative Gesture Interactive Diagnostic System Based on Augmented Reality.

PubMed

Zou, Yi-Bo; Chen, Yi-Min; Gao, Ming-Ke; Liu, Quan; Jiang, Si-Yu; Lu, Jia-Hui; Huang, Chen; Li, Ze-Yu; Zhang, Dian-Hua

2017-08-01

Coronary heart disease preoperative diagnosis plays an important role in the treatment of vascular interventional surgery. Actually, most doctors are used to diagnosing the position of the vascular stenosis and then empirically estimating vascular stenosis by selective coronary angiography images instead of using mouse, keyboard and computer during preoperative diagnosis. The invasive diagnostic modality is short of intuitive and natural interaction and the results are not accurate enough. Aiming at above problems, the coronary heart disease preoperative gesture interactive diagnostic system based on Augmented Reality is proposed. The system uses Leap Motion Controller to capture hand gesture video sequences and extract the features which that are the position and orientation vector of the gesture motion trajectory and the change of the hand shape. The training planet is determined by K-means algorithm and then the effect of gesture training is improved by multi-features and multi-observation sequences for gesture training. The reusability of gesture is improved by establishing the state transition model. The algorithm efficiency is improved by gesture prejudgment which is used by threshold discriminating before recognition. The integrity of the trajectory is preserved and the gesture motion space is extended by employing space rotation transformation of gesture manipulation plane. Ultimately, the gesture recognition based on SRT-HMM is realized. The diagnosis and measurement of the vascular stenosis are intuitively and naturally realized by operating and measuring the coronary artery model with augmented reality and gesture interaction techniques. All of the gesture recognition experiments show the distinguish ability and generalization ability of the algorithm and gesture interaction experiments prove the availability and reliability of the system.

The role of stabilization centers in protein thermal stability

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

Magyar, Csaba; Gromiha, M. Michael; Sávoly, Zoltán

2016-02-26

The definition of stabilization centers was introduced almost two decades ago. They are centers of noncovalent long range interaction clusters, believed to have a role in maintaining the three-dimensional structure of proteins by preventing their decay due to their cooperative long range interactions. Here, this hypothesis is investigated from the viewpoint of thermal stability for the first time, using a large protein thermodynamics database. The positions of amino acids belonging to stabilization centers are correlated with available experimental thermodynamic data on protein thermal stability. Our analysis suggests that stabilization centers, especially solvent exposed ones, do contribute to the thermal stabilizationmore » of proteins. - Highlights: • Stabilization centers contribute to thermal stabilization of protein structures. • Stabilization center content correlates with melting temperature of proteins. • Exposed stabilization center content correlates with stability even in hyperthermophiles. • Stability changing mutations are frequently found at stabilization centers.« less

Developing Opportunities for Senior Citizens and 3- and 4-Year-Old Children in a Northeast U.S. Jewish Community Center to Interact.

ERIC Educational Resources Information Center

Weeks, Joyce

Due to changes in society, young children and senior citizens have little opportunity for interaction. This practicum report formulated a plan for intergenerational interaction opportunities between 3- and 4-year-olds and senior citizens at a Jewish community center where separate programs for preschool children and senior citizens typified the…

Patient-centered communication of community treatment assistants in Tanzania predicts coverage of future mass drug administration for trachoma.

PubMed

Jenson, Alexander; Roter, Debra L; Mkocha, Harran; Munoz, Beatriz; West, Sheila

2018-06-01

Prevention of Trachoma, the leading cause of infectious blindness, requires community treatment assistants (CTAs) to perform mass drug administration (MDA) of azithromycin. Previous research has shown that female CTAs have higher MDA coverage, but no studies have focused on the content of conversation. We hypothesize that female CTAs had more patient-centered communication and higher MDA coverage. In 2011, CTAs from 23 distribution sites undergoing MDA as part of the Partnership for Rapid Elimination of Trachoma were selected. CTA - villager interactions were audio recorded. Audio was analyzed using an adaptation of the Roter Interaction Analysis System. The outcome of interest was the proportion of adults receiving MDA in 2011 who returned in 2012. 58 CTAs and 3122 interactions were included. Sites with female CTAs had significantly higher patient-centeredness ratio (0.548 vs 0.400) when compared to sites with male CTAs. Sites with more patient-centered interactions had higher proportion of patients return (p = 0.009). Female CTAs had higher proportion of patient-centered communication. Patient centered communication was associated with higher rates of return for MDA. Greater patient-centered connection with health care providers affects participation in public health efforts, even when those providers are lay health workers. Copyright © 2018 Elsevier B.V. All rights reserved.

Eye center localization and gaze gesture recognition for human-computer interaction.

PubMed

Zhang, Wenhao; Smith, Melvyn L; Smith, Lyndon N; Farooq, Abdul

2016-03-01

This paper introduces an unsupervised modular approach for accurate and real-time eye center localization in images and videos, thus allowing a coarse-to-fine, global-to-regional scheme. The trajectories of eye centers in consecutive frames, i.e., gaze gestures, are further analyzed, recognized, and employed to boost the human-computer interaction (HCI) experience. This modular approach makes use of isophote and gradient features to estimate the eye center locations. A selective oriented gradient filter has been specifically designed to remove strong gradients from eyebrows, eye corners, and shadows, which sabotage most eye center localization methods. A real-world implementation utilizing these algorithms has been designed in the form of an interactive advertising billboard to demonstrate the effectiveness of our method for HCI. The eye center localization algorithm has been compared with 10 other algorithms on the BioID database and six other algorithms on the GI4E database. It outperforms all the other algorithms in comparison in terms of localization accuracy. Further tests on the extended Yale Face Database b and self-collected data have proved this algorithm to be robust against moderate head poses and poor illumination conditions. The interactive advertising billboard has manifested outstanding usability and effectiveness in our tests and shows great potential for benefiting a wide range of real-world HCI applications.

Beam diagnostics at high-intensity storage rings

NASA Astrophysics Data System (ADS)

Plum, Mike

1994-10-01

Beam diagnostics at high-intensity facilities feature their own special set of problems and characteristics, issues peculiar to high-intensity storage rings include beam loss, beam halos, extraction efficiency, beam in the gap, clearing electrodes, and beam-profile measurement. The Los Alamos Proton Storage Ring (PSR) is a nice example of a high-intensity storage ring. I will discuss in some detail three diagnostic systems currently in use at the PSR: the beam-loss-monitor system, the electron-clearing system, and the beam-in-the-gap monitor. Much of our discussion is inspired by the problems we have encountered and the useful things we have learned while commissioning and developing the PSR. Another inspiration is our work on the next-generation neutron-spallation source, also known as the National Center for Neutron Research (NCNR).

Enhancements to the timing of the OMEGA laser system to improve illumination uniformity

NASA Astrophysics Data System (ADS)

Donaldson, W. R.; Katz, J.; Kosc, T. Z.; Kelly, J. H.; Hill, E. M.; Bahr, R. E.

2016-09-01

Two diagnostics have been developed to improve the uniformity on the OMEGA Laser System, which is used for inertial confinement fusion (ICF) research. The first diagnostic measures the phase of an optical modulator (used for the spectral dispersion technique employed on OMEGA to enhance spatial smoothing), which adds bandwidth to the optical pulse. Setting this phase precisely is required to reduce pointing errors. The second diagnostic ensures that the arrival times of all the beams are synchronized. The arrival of each of the 60 OMEGA beams is measured by placing a 1-mm diffusing sphere at target chamber center. By comparing the arrival time of each beam with respect to a reference pulse, the measured timing spread of the OMEGA Laser System is now 3.8 ps.

A distinct language and a historic pendulum: the evolution of the Diagnostic and Statistical Manual of Mental Disorders.

PubMed

Sanders, James L

2011-12-01

Historically, the Diagnostic and Statistical Manual of Mental Disorders (DSM) has met an important need in defining a common language of psychiatric diagnosis in North America. Understanding the development of the DSM can help researchers and practitioners better understand this diagnostic language. The history of the DSM, from its precursors to recent proposed revisions for its fifth edition, is reviewed and compared while avoiding the presentist bias. The development of DSM resembles a historic pendulum, from DSM-I emphasizing psychodynamics and causality to DSM-III and DSM-IV emphasizing empiricism and logical positivism. The proposed changes in etiological- and dimensional-based classification for DSM-V represent a slight backswing toward the center. 2011 Elsevier Inc. All rights reserved.

The challenges of oral-based diagnostics in extending the role of dentistry as a health care profession: property rights, privacy, and informed consent.

PubMed

Vernillo, Anthony; Welie, Jos V M; Naidoo, Sudeshni; Malamud, Daniel

2011-01-01

Saliva may be a legal and ethical counterpart of other bodily fluids in diagnostic testing to blood and urine, with regard to its role in diagnostic testing. Two paradigms that have been proposed in the literature to address these challenges are reviewed in this paper. The first is centered on ownership and property rights to saliva, including financial compensation from commercially developed products using saliva. The commodification of saliva as property is also discussed. The second paradigm is related to privacy and the potential for genetic discrimination, given the unwarranted disclosure of confidential information. The management of saliva specimens from dental patients and research participants will also require the implementation of innovative approaches to obtain informed consent.

Changes in social interaction over 20 years and the effects of community resources use among community-dwelling elderly persons.

PubMed

Watanabe, Kumi; Tanaka, Emiko; Wu, Bailiang; Kobayashi, Zyunko; Mochizuki, Yukiko; Kim, Yeon; Watanabe, Taeko; Okumura, Rika; Ito, Sumio; Anme, Tokie

2017-01-01

Objectives　Recently, social isolation has been reported to be a critical problem among Japanese elderly persons. However, few studies have compared social interaction in the past and the present or investigated its predictive factors. This study aimed to clarify the transitional changes in social interaction over 20 years and explore the factors related to social interaction focusing on the use of community resources.Methods　The participants were community-dwelling elderly persons aged 65 years and over. A survey was conducted 8 times from 1994 to 2014 in the suburban area of Tobishima, Japan. The Index of Social Interaction Scale was used and each subscale and the total score were calculated. Subsequently, the 2014 scores were compared with the 1994 scores using the Wilcoxon rank sum test. Logistic regression analysis was conducted to clarify the factors related to social interaction, focusing on the association between the use of community resources (local elderly management center, health care center, health promotion facility, library) in 2011 and social interaction 3 years later. Age, gender, disease, and mobility were also entered into the model as control variables.Results　Comparing social interaction in 1994 and 2014, total scores were found to have significantly increased in all age groups. Independence scores significantly increased in the overall group and in females aged 75-84. Curiosity scores also increased in both males and females. These results show that social interaction has increased over 2 decades. In addition, the use of local elderly management and health care centers, and health promotion facilities was associated with total social interaction scores 3 years later.Conclusion　The current study clarified changes in social interaction, both comprehensively and for each of its aspects, among community-dwelling elderly adults. Increasing social isolation has been reported in recent years; however, the current study showed that social interaction, including social curiosity and independence, has increased over 20 years. The effect of preventive intervention in local elderly management centers, health care centers, and health promotion facilities may be one of the causes for this increase.

Idiopathic inflammatory myopathies in adults: A comparative study of Bohan and Peter and European Neuromuscular Center 2004 criteria.

PubMed

Challa, Sundaram; Jakati, Saumya; Uppin, Megha S; Kannan, Meena A; Liza, Rajasekhar; Murthy Jagarlapudi, M K

2018-01-01

Bohan and Peter criteria are widely used for the diagnosis of idiopathic inflammatory myopathies (IIMs). Recently, European Neuromuscular Center (ENMC) formulated criteria to identify subgroups of IIMs. To compare the two diagnostic criteria in adult IIMs. This was a retrospective review of case records of histologically confirmed IIMs in adults between January 2014 and May 2015. Both the Bohan and Peter, and ENMC 2004 criteria were applied in the same group of patients to subgroup the IIMs. Muscle biopsy was evaluated in all the four domains: muscle fiber, inflammatory, connective tissue, and vascular, with the basic panel of histological stains. Sporadic inclusion body myositis (s-IBM) was diagnosed using ENMC IBM diagnostic research criteria 2011. During the study period, 69 patients fulfilled the ENMC criteria for IIMs including 16 patients with s-IBM. The subgrouping as per the ENMC criteria (53) was: dermatomyositis (DM) in 30; polymyositis (PM) in 2; immune-mediated necrotizing myopathy (IMNM) in 9; and nonspecific myositis (NM) in 12 patients, whereas subgrouping by the Bohan and Peter criteria was DM in 9 and PM with and without connective tissue disease (CTD) in 26 patients only. There was underdiagnosis of DM, as perifascicular atrophy is not recognized as a diagnostic histological feature, and overdiagnosis of PM with and without CTD due to poor characterization of histological features in PM by the Bohan and Peter criteria. Systematic evaluation of muscle biopsy according to the ENMC criteria with basic panel of histochemical stains improved the diagnostic yield of IIM significantly when compared to the Bohan and Peter criteria.

An in situ accelerator-based diagnostic for plasma-material interactions science on magnetic fusion devices.

PubMed

Hartwig, Zachary S; Barnard, Harold S; Lanza, Richard C; Sorbom, Brandon N; Stahle, Peter W; Whyte, Dennis G

2013-12-01

This paper presents a novel particle accelerator-based diagnostic that nondestructively measures the evolution of material surface compositions inside magnetic fusion devices. The diagnostic's purpose is to contribute to an integrated understanding of plasma-material interactions in magnetic fusion, which is severely hindered by a dearth of in situ material surface diagnosis. The diagnostic aims to remotely generate isotopic concentration maps on a plasma shot-to-shot timescale that cover a large fraction of the plasma-facing surface inside of a magnetic fusion device without the need for vacuum breaks or physical access to the material surfaces. Our instrument uses a compact (~1 m), high-current (~1 milliamp) radio-frequency quadrupole accelerator to inject 0.9 MeV deuterons into the Alcator C-Mod tokamak at MIT. We control the tokamak magnetic fields--in between plasma shots--to steer the deuterons to material surfaces where the deuterons cause high-Q nuclear reactions with low-Z isotopes ~5 μm into the material. The induced neutrons and gamma rays are measured with scintillation detectors; energy spectra analysis provides quantitative reconstruction of surface compositions. An overview of the diagnostic technique, known as accelerator-based in situ materials surveillance (AIMS), and the first AIMS diagnostic on the Alcator C-Mod tokamak is given. Experimental validation is shown to demonstrate that an optimized deuteron beam is injected into the tokamak, that low-Z isotopes such as deuterium and boron can be quantified on the material surfaces, and that magnetic steering provides access to different measurement locations. The first AIMS analysis, which measures the relative change in deuterium at a single surface location at the end of the Alcator C-Mod FY2012 plasma campaign, is also presented.

New diagnostic technique for the study of turbulent boundary-layer separation

NASA Technical Reports Server (NTRS)

Horstman, C. C.; Owen, F. K.

1974-01-01

Description of a diagnostic technique for determining the unsteady character of turbulent boundary-layer separation. The technique uses thin platinum films mounted flush with the model surface. Voltages from these films provide measurements related to the flow character above the film. For illustration, results obtained by this technique are presented for the interaction of a hypersonic shock wave and a turbulent boundary layer, with and without separation.

Upper Extremity Injuries in Tennis Players: Diagnosis, Treatment, and Management.

PubMed

Chung, Kevin C; Lark, Meghan E

2017-02-01

Upper extremity tennis injuries are most commonly characterized as overuse injuries to the wrist, elbow, and shoulder. The complex anatomy of these structures and their interaction with biomechanical properties of tennis strokes contributes to the diagnostic challenges. A thorough understanding of tennis kinetics, in combination with the current literature surrounding diagnostic and treatment methods, will improve clinical decision-making. Copyright © 2016 Elsevier Inc. All rights reserved.

Methods and means of diagnostics of oncological diseases on the basis of pattern recognition: intelligent morphological systems - problems and solutions

NASA Astrophysics Data System (ADS)

Nikitaev, V. G.

2017-01-01

The development of methods of pattern recognition in modern intelligent systems of clinical cancer diagnosis are discussed. The histological (morphological) diagnosis - primary diagnosis for medical setting with cancer are investigated. There are proposed: interactive methods of recognition and structure of intellectual morphological complexes based on expert training-diagnostic and telemedicine systems. The proposed approach successfully implemented in clinical practice.

The Dartmouth Center for Cancer Nanotechnology Excellence: magnetic hyperthermia.

PubMed

Baker, Ian; Fiering, Steve N; Griswold, Karl E; Hoopes, P Jack; Kekalo, Katerina; Ndong, Christian; Paulsen, Keith; Petryk, Alicea A; Pogue, Brian; Shubitidze, Fridon; Weaver, John

2015-01-01

The Dartmouth Center for Cancer Nanotechnology Excellence - one of nine funded by the National Cancer Institute as part of the Alliance for Nanotechnology in Cancer - focuses on the use of magnetic nanoparticles for cancer diagnostics and hyperthermia therapy. It brings together a diverse team of engineers and biomedical researchers with expertise in nanomaterials, molecular targeting, advanced biomedical imaging and translational in vivo studies. The goal of successfully treating cancer is being approached by developing nanoparticles, conjugating them with Fabs, hyperthermia treatment, immunotherapy and sensing treatment response.

Dana-Farber Cancer Institute: Identification of Therapeutic Targets Across Cancer Types | Office of Cancer Genomics

Cancer.gov

The Dana Farber Cancer Institute CTD2 Center focuses on the use of high-throughput genetic and bioinformatic approaches to identify and credential oncogenes and co-dependencies in cancers. This Center aims to provide the cancer research community with information that will facilitate the prioritization of targets based on both genomic and functional evidence, inform the most appropriate genetic context for downstream mechanistic and validation studies, and enable the translation of this information into therapeutics and diagnostics.

Influenza research database: an integrated bioinformatics resource for influenza virus research

USDA-ARS?s Scientific Manuscript database

The Influenza Research Database (IRD) is a U.S. National Institute of Allergy and Infectious Diseases (NIAID)-sponsored Bioinformatics Resource Center dedicated to providing bioinformatics support for influenza virus research. IRD facilitates the research and development of vaccines, diagnostics, an...

Ammonia Adsorption and Co-adsorption with Water in HKUST-1: Spectroscopic Evidence for Cooperative Interactions

DOE PAGES

Nijem, Nour; Fürsich, Katrin; Bluhm, Hendrik; ...

2015-10-09

Ammonia interactions and competition with water at the interface of nanoporous metal organic framework thin films of HKUST-1 (Cu 3Btc 2 , Btc = 1,3,5-benzenedicarboxylate) are investigated with ambient pressure X-ray photoelectron spectroscopy (APXPS). In the absence of water, ammonia adsorption at the Cu 2+ metal center weakens the metal-linker bond of the framework. In the presence of water, due to the higher binding energy (adsorption strength) of ammonia compared to water, ammonia replaces water at the unsaturated Cu 2+ metal centers. The water molecules remaining in the pores are stabilized by hydrogen bonding to ammonia. Hydrogen bonding between themore » water and ammonia strengthens the metal-ammonia interaction due to cooperative interactions. Cooperative interactions result in a reduction in the metal center oxidation state facilitating linker replacement by other species explaining the previously reported structure degradation.« less

Ammonia Adsorption and Co-adsorption with Water in HKUST-1: Spectroscopic Evidence for Cooperative Interactions

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

Nijem, Nour; Fürsich, Katrin; Bluhm, Hendrik

Ammonia interactions and competition with water at the interface of nanoporous metal organic framework thin films of HKUST-1 (Cu 3Btc 2 , Btc = 1,3,5-benzenedicarboxylate) are investigated with ambient pressure X-ray photoelectron spectroscopy (APXPS). In the absence of water, ammonia adsorption at the Cu 2+ metal center weakens the metal-linker bond of the framework. In the presence of water, due to the higher binding energy (adsorption strength) of ammonia compared to water, ammonia replaces water at the unsaturated Cu 2+ metal centers. The water molecules remaining in the pores are stabilized by hydrogen bonding to ammonia. Hydrogen bonding between themore » water and ammonia strengthens the metal-ammonia interaction due to cooperative interactions. Cooperative interactions result in a reduction in the metal center oxidation state facilitating linker replacement by other species explaining the previously reported structure degradation.« less

Activity Theory and Technology Mediated Interaction: Cognitive Scaffolding Using Question-Based Consultation on "Facebook"

ERIC Educational Resources Information Center

Rambe, Patient

2012-01-01

Studies that employed activity theory as a theoretical lens for exploring computer-mediated interaction have not adopted social media as their object of study. However, social media provides lecturers with personalised learning environments for diagnostic and prognostic assessments of student mastery of content and deep learning. The integration…

Internal Model Deficits Impair Joint Action in Children and Adolescents with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Stoit, Astrid M. B.; van Schie, Hein T.; Riem, Madelon; Meulenbroek, Ruud G. J.; Newman-Norlund, Roger D.; Slaats-Willemse, Dorine I. E.; Bekkering, Harold; Buitelaar, Jan K.

2011-01-01

Qualitative differences in social interaction and communication are diagnostic hallmarks in autism spectrum disorders (ASD). The present study investigated the hypothesis that impaired social interaction in ASD reflects a deficit to internally model the behavior of a co-actor. Children and adolescents with ASD and matched controls performed a…

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…

Disposable blast shields for use on NIF imaging diagnostics

NASA Astrophysics Data System (ADS)

Smith, Cal A.; Wang, Karen M.; Masters, Nathan

2015-08-01

The NIFs 192 lasers can deliver 2 MJ of energy to Target Chamber Center (TCC) to produce environments not available in any other experimental laboratory. The NIFs ability to deliver such intense energy to a small volume causes harsh consequences to experimental equipment and supporting diagnostics such as holhraums, support packages, target positioners, diagnostic equipment, and laser optics. Of these, the hohlraum and support packages are typically quickly vaporized and transformed into an expanding shell of high-hypersonic gases referred to as debris wind. During an experimental event such as fusion implosion, the target diagnostic components used to measure key observables in the experiment are subjected to extreme pressures and impact shocks due to incident debris wind loading. As diagnostics are positioned closer to TCC, the diagnostic pinhole stacks and other components along the diagnostic structure become more likely to be at or above the yield strength of the materials commonly used. In particular, the pinhole stack components and data recording instruments behind the pinholes are the most costly to replace. Thus, a conceptual configuration for a pinhole shield is proposed, analyzed, and tested with the intent of mitigating damage to the pinhole stack and imaging equipment and allowing immediate re-use of this diagnostic equipment. This pinhole shield would be a replaceable window that can be replaced quickly by inserting and removing it before and after each experimental laser shot, which will allow NIF to benefit from significant material and labor costs.

[Stress-ECG is adequate to detect myocardial ischemia: when are additional diagnostic tests needed?].

PubMed

Baer, F M

2007-09-01

The stress-ECG is the most often adopted and most cost effective initial diagnostic test for the assessment of myocardial ischemia in patients with suspected coronary artery disease (CAD). Prerequisites for the diagnostic usefullness of stress-ECG are a clearly interpretable ST-segment, ability to reach the predicted work load, an intermediate pretest probability for CAD ranging between 10% and 90% and the absence of any contraindications for dynamic exercise. Because of the limited diagnostic sensitivity of about 70%, and a high percentage of patients, who are unable to exercise, a negative stress ECG can definitely not exclude hemodynamically significant CAD. Therefore, stress imaging techniques like myocardial scintigraphy, stress-echocardiography and stress magnetic resonance imaging play a major role in the stepwise diagnostic work-up of patients with suspected CAD. These stress imaging techniques are basically interchangeable since no method is definitely superior to one of the others. However, each method has its specific pros and cons and inherent contraindications. Therefore the choice of the stress imaging method and the form of stress applied should be based on the individual patients characteristics to gain optimal image quality and diagnostic accuracy. Moreover, the decision for one method should take the local availability and institutional expertise of diagnostic centers into account. Although partly substituted by stress imaging techniques the stress-ECG still remains the workhorse for a stepwise diagnostic work-up of patients with suspected CAD.

Plasma diagnostic development and UHV testing for the ALPHA collaboration at Marquette University

NASA Astrophysics Data System (ADS)

Tharp, T. D.; Alpha Collaboration

2017-10-01

At Marquette, we are developing the next generation of nonneutral plasma diagnostics for the ALPHA experiment at CERN. ALPHA is building a new vertical experiment to test the gravitational interaction of antihydrogen with Earth. This expansion requires significant changes to the design of our plasma diagnostic suites: the next generation of tools must be able to measure plasmas from two directions, and must be capable of operating in a horizontal position. The diagnostic suite includes measurements of plasma density, shape, and temperature. The hardware used includes a MicroChannel Plate (MCP), a Faraday Cup, and an electron gun. In addition, we are building a vacuum chamber to test the viability of 3-d printed components for UHV compatibility, with target pressures of 10-10 mbar.

Diagnostic Machine Learning Models for Acute Abdominal Pain: Towards an e-Learning Tool for Medical Students.

PubMed

Khumrin, Piyapong; Ryan, Anna; Judd, Terry; Verspoor, Karin

2017-01-01

Computer-aided learning systems (e-learning systems) can help medical students gain more experience with diagnostic reasoning and decision making. Within this context, providing feedback that matches students' needs (i.e. personalised feedback) is both critical and challenging. In this paper, we describe the development of a machine learning model to support medical students' diagnostic decisions. Machine learning models were trained on 208 clinical cases presenting with abdominal pain, to predict five diagnoses. We assessed which of these models are likely to be most effective for use in an e-learning tool that allows students to interact with a virtual patient. The broader goal is to utilise these models to generate personalised feedback based on the specific patient information requested by students and their active diagnostic hypotheses.

Concordance between the old and new diagnostic criteria for periprosthetic joint infection.

PubMed

Honkanen, Meeri; Jämsen, Esa; Karppelin, Matti; Huttunen, Reetta; Lyytikäinen, Outi; Syrjänen, Jaana

2017-10-01

There is no uniform definition for periprosthetic joint infection (PJI). New diagnostic criteria were formulated in an international consensus meeting in 2013 and adopted by Centers for Disease Control (CDC) in 2016. The purpose of this study is to compare the new diagnostic criteria with the old CDC criteria from the year 1992. Patients, who had been treated for PJI of hip or knee from 2002 to 2014, in a tertiary care hospital, were identified. Patient records were reviewed by a physician to identify PJI cases fulfilling the old or new CDC criteria and to record data concerning the diagnostic criteria. PJI frequencies were calculated for the two diagnostic criteria sets. Cross tables were formed to compare the concordance between the two sets of criteria in the whole material and in different clinical subgroups. Overall 405 cases fulfilling either or both sets of criteria for PJI were identified. 73 (18%) of the patients fulfilled only the old criteria, whereas only one (0.2%) fulfilled only the new criteria. Of the patients who did not fulfil the new criteria, in 39 (53%) the diagnosis was based solely on the clinician's opinion. The number of PJIs is notably lower when using the new, more objective, diagnostic criteria. A large portion of the cases diagnosed as infection by the treating clinician, did not fulfil the new diagnostic criteria.

Interpretation of plasma diagnostics package results in terms of large space structure plasma interactions

NASA Technical Reports Server (NTRS)

Kurth, William S.

1991-01-01

The Plasma Diagnostics Package (PDP) is a spacecraft which was designed and built at The University of Iowa and which contained several scientific instruments. These instruments were used for measuring Space Shuttle Orbiter environmental parameters and plasma parameters. The PDP flew on two Space Shuttle flights. The first flight of the PDP was on Space Shuttle Mission STS-3 and was a part of the NASA/Office of Space Science payload (OSS-1). The second flight of the PDP was on Space Shuttle Mission STS/51F and was a part of Spacelab 2. The interpretation of both the OSS-1 and Spacelab 2 PDP results in terms of large space structure plasma interactions is emphasized.

Diagnostics for the optimization of an 11 keV inverse Compton scattering x-ray source

NASA Astrophysics Data System (ADS)

Chauchat, A.-S.; Brasile, J.-P.; Le Flanchec, V.; Nègre, J.-P.; Binet, A.; Ortega, J.-M.

2013-04-01

In a scope of a collaboration between Thales Communications & Security and CEA DAM DIF, 11 keV Xrays were produced by inverse Compton scattering on the ELSA facility. In this type of experiment, X-ray observation lies in the use of accurate electron and laser beam interaction diagnostics and on fitted X-ray detectors. The low interaction probability between < 100 μm width, 12 ps [rms] length electron and photon pulses requires careful optimization of pulse spatial and temporal covering. Another issue was to observe 11 keV X-rays in the ambient radioactive noise of the linear accelerator. For that, we use a very sensitive detection scheme based on radio luminescent screens.

30-kW class Arcjet Advanced Technology Transition Demonstration (ATTD) flight experiment diagnostic package

NASA Astrophysics Data System (ADS)

Kriebel, M. M.; Stevens, N. J.

1992-07-01

TRW, Rocket Research Co and Defense Systems Inc are developing a space qualified 30-kW class arcjet flight unit as a part of the Arcjet ATTD program. During space operation the package will measure plume deposition and contamination, electromagnetic interference, thermal radiation, arcjet thruster performance, and plume heating in order to quantify arcjet operational interactions. The Electric Propulsion Space Experiment (ESEX) diagnostic package is described. The goals of ESEX are the demonstration of a high powered arcjet performance and the measurement of potential arcjet-spacecraft interactions which cannot be determined in ground facilities. Arcjet performance, plume characterization, thermal radiation flux and the electromagnetic interference (EMI) experiment as well as experiment operations with a preliminary operations plan are presented.

Behavioural phenotyping assays for mouse models of autism

PubMed Central

Silverman, Jill L.; Yang, Mu; Lord, Catherine; Crawley, Jacqueline N.

2011-01-01

Autism is a heterogeneous neurodevelopmental disorder of unknown aetiology that affects 1 in 100–150 individuals. Diagnosis is based on three categories of behavioural criteria: abnormal social interactions, communication deficits and repetitive behaviours. Strong evidence for a genetic basis has prompted the development of mouse models with targeted mutations in candidate genes for autism. As the diagnostic criteria for autism are behavioural, phenotyping these mouse models requires behavioural assays with high relevance to each category of the diagnostic symptoms. Behavioural neuroscientists are generating a comprehensive set of assays for social interaction, communication and repetitive behaviours to test hypotheses about the causes of austism. Robust phenotypes in mouse models hold great promise as translational tools for discovering effective treatments for components of autism spectrum disorders. PMID:20559336