Sample records for diagnostics timing integration

  1. Diagnostic Suite for HyperV Coaxial Plasma Gun Development for the PLX- α Project

    NASA Astrophysics Data System (ADS)

    Case, Andrew; Brockington, Sam; Witherspoon, F. Douglas

    2015-11-01

    We present the diagnostic suite to be used during development of the coaxial guns HyperV will deliver to LANL in support of the ARPA-E Accelerating Low-Cost Plasma Heating And Assembly (ALPHA) program. For plasma jet diagnostics this includes fast photodiodes for velocimetry, a ballistic pendulum for measuring total plasmoid momentum, interferometry for line integrated plasma density, deflectometry for line integrated perpendicular density gradient measurements, and spectroscopy, both time resolved high resolution spectroscopy using a novel detector developed by HyperV and time integrated survey spectroscopy, for measurements of velocity and temperature as well as impurities. In addition, we plan to use fast pressure probes for stagnation pressure, a Faraday cup for density, fast imaging for plume geometry and time integrated imaging for overall light emission. A novel low resolution long record length camera developed by HyperV will also be used for plume diagnostics. For diagnostics of gun operation, we will use Rogowski coils to measure current, voltage dividers for voltages, B-dot probes for magnetic field, and time resolved fast photodiodes to measure plasmoid velocity inside the accelerator. This work supported by the ARPA-E ALPHA program.

  2. Diagnostics and results from coaxial plasma gun development for the PLX- α project

    NASA Astrophysics Data System (ADS)

    Case, A.; Brockington, S.; Cruz, E.; Witherspoon, F. D.

    2016-10-01

    We present results from the diagnostics used during development of the contoured gap coaxial plasma guns for the PLX- α project at LANL. Plasma-jet diagnostics include fast photodiodes for velocimetry, a ballistic pendulum for total plasmoid momentum, and interferometry for line integrated density. Deflectometry will be used for line integrated perpendicular density gradients. Time-resolved high-resolution spectroscopy using a novel detector and time-integrated survey spectroscopy are used for measurements of velocity and temperature, as well as impurities. We will also use a Faraday cup for density, fast imaging for plume geometry, and time-integrated imaging for overall light emission. Experimental results are compared to the desired target parameters for the plasma jets (up to n 2 ×1016cm-3 , v 50km / s , mass 5gm , radius = 4cm , and length 10cm). This work supported by the ARPA-E ALPHA Program.

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

    PubMed

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

    2012-10-01

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

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

    NASA Technical Reports Server (NTRS)

    Jong, Jen-Yi

    1996-01-01

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

  5. Diagnostic Reasoning using Prognostic Information for Unmanned Aerial Systems

    NASA Technical Reports Server (NTRS)

    Schumann, Johann; Roychoudhury, Indranil; Kulkarni, Chetan

    2015-01-01

    With increasing popularity of unmanned aircraft, continuous monitoring of their systems, software, and health status is becoming more and more important to ensure safe, correct, and efficient operation and fulfillment of missions. The paper presents integration of prognosis models and prognostic information with the R2U2 (REALIZABLE, RESPONSIVE, and UNOBTRUSIVE Unit) monitoring and diagnosis framework. This integration makes available statistically reliable health information predictions of the future at a much earlier time to enable autonomous decision making. The prognostic information can be used in the R2U2 model to improve diagnostic accuracy and enable decisions to be made at the present time to deal with events in the future. This will be an advancement over the current state of the art, where temporal logic observers can only do such valuation at the end of the time interval. Usefulness and effectiveness of this integrated diagnostics and prognostics framework was demonstrated using simulation experiments with the NASA Dragon Eye electric unmanned aircraft.

  6. Advances and challenges in biosensor-based diagnosis of infectious diseases

    PubMed Central

    Sin, Mandy LY; Mach, Kathleen E; Wong, Pak Kin; Liao, Joseph C

    2014-01-01

    Rapid diagnosis of infectious diseases and timely initiation of appropriate treatment are critical determinants that promote optimal clinical outcomes and general public health. Conventional in vitro diagnostics for infectious diseases are time-consuming and require centralized laboratories, experienced personnel and bulky equipment. Recent advances in biosensor technologies have potential to deliver point-of-care diagnostics that match or surpass conventional standards in regards to time, accuracy and cost. Broadly classified as either label-free or labeled, modern biosensors exploit micro- and nanofabrication technologies and diverse sensing strategies including optical, electrical and mechanical transducers. Despite clinical need, translation of biosensors from research laboratories to clinical applications has remained limited to a few notable examples, such as the glucose sensor. Challenges to be overcome include sample preparation, matrix effects and system integration. We review the advances of biosensors for infectious disease diagnostics and discuss the critical challenges that need to be overcome in order to implement integrated diagnostic biosensors in real world settings. PMID:24524681

  7. Advances in point-of-care technologies for molecular diagnostics.

    PubMed

    Zarei, Mohammad

    2017-12-15

    Advances in miniaturization, nanotechnology, and microfluidics, along with developments in cloud-connected point-of-care (POC) diagnostics technologies are pushing the frontiers of POC devices toward low-cost, user-friendly, and enhanced sensitivity molecular-level diagnostics. The combination of various bio-sensing platforms within smartphone-integrated electronic readers provides accurate on-site and on-time diagnostics based on various types of chemical and biological targets. Further, 3D printing technology shows a huge potential toward fabrication and improving the performance of POC devices. Integration of skin-like flexible sensors with wireless communication technology creates a unique opportunity for continuous, real-time monitoring of patients for both preventative healthcare and during disease outbreaks. Here, we review recent developments and advances in POC technologies and describe how these advances enhance the performance of POC platforms. Also, this review describes challenges, directions, and future trends on application of emerging technologies in POC diagnostics. Copyright © 2017 Elsevier B.V. All rights reserved.

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

    PubMed Central

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

    2014-01-01

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

  9. Integration of Diagnostic Microbiology in a Model of Total Laboratory Automation.

    PubMed

    Da Rin, Giorgio; Zoppelletto, Maira; Lippi, Giuseppe

    2016-02-01

    Although automation has become widely utilized in certain areas of diagnostic testing, its adoption in diagnostic microbiology has proceeded much more slowly. To describe our real-world experience of integrating an automated instrument for diagnostic microbiology (Walk-Away Specimen Processor, WASPLab) within a model of total laboratory automation (TLA). The implementation process was divided into 2 phases. The former period, lasting approximately 6 weeks, entailed the installation of the WASPLab processor to operate as a stand-alone instrumentation, whereas the latter, lasting approximately 2 weeks, involved physical connection of the WASPLab with the automation. Using the WASPLab instrument in conjunction with the TLA model, we obtained a time savings equivalent to the work of 1.2 full-time laboratory technicians for diagnostic microbiology. The connection of WASPLab to TLA allowed its management by a generalist or clinical chemistry technician, with no need for microbiology skills on the part of either worker. Hence, diagnostic microbiology could be performed by the staff that is already using the TLA, extending their activities to include processing urgent clinical chemistry and hematology specimens. The time to result was also substantially improved. According to our experience, using the WASPLab instrument as part of a TLA in diagnostic microbiology holds great promise for optimizing laboratory workflow and improving the quality of testing. © American Society for Clinical Pathology, 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  10. CMOS Time-Resolved, Contact, and Multispectral Fluorescence Imaging for DNA Molecular Diagnostics

    PubMed Central

    Guo, Nan; Cheung, Ka Wai; Wong, Hiu Tung; Ho, Derek

    2014-01-01

    Instrumental limitations such as bulkiness and high cost prevent the fluorescence technique from becoming ubiquitous for point-of-care deoxyribonucleic acid (DNA) detection and other in-field molecular diagnostics applications. The complimentary metal-oxide-semiconductor (CMOS) technology, as benefited from process scaling, provides several advanced capabilities such as high integration density, high-resolution signal processing, and low power consumption, enabling sensitive, integrated, and low-cost fluorescence analytical platforms. In this paper, CMOS time-resolved, contact, and multispectral imaging are reviewed. Recently reported CMOS fluorescence analysis microsystem prototypes are surveyed to highlight the present state of the art. PMID:25365460

  11. Microfluidic-integrated biosensors: prospects for point-of-care diagnostics.

    PubMed

    Kumar, Suveen; Kumar, Saurabh; Ali, Md Azahar; Anand, Pinki; Agrawal, Ved Varun; John, Renu; Maji, Sagar; Malhotra, Bansi D

    2013-11-01

    There is a growing demand to integrate biosensors with microfluidics to provide miniaturized platforms with many favorable properties, such as reduced sample volume, decreased processing time, low cost analysis and low reagent consumption. These microfluidics-integrated biosensors would also have numerous advantages such as laminar flow, minimal handling of hazardous materials, multiple sample detection in parallel, portability and versatility in design. Microfluidics involves the science and technology of manipulation of fluids at the micro- to nano-liter level. It is predicted that combining biosensors with microfluidic chips will yield enhanced analytical capability, and widen the possibilities for applications in clinical diagnostics. The recent developments in microfluidics have helped researchers working in industries and educational institutes to adopt some of these platforms for point-of-care (POC) diagnostics. This review focuses on the latest advancements in the fields of microfluidic biosensing technologies, and on the challenges and possible solutions for translation of this technology for POC diagnostic applications. We also discuss the fabrication techniques required for developing microfluidic-integrated biosensors, recently reported biomarkers, and the prospects of POC diagnostics in the medical industry. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  12. Assessing clinical reasoning (ASCLIRE): Instrument development and validation.

    PubMed

    Kunina-Habenicht, Olga; Hautz, Wolf E; Knigge, Michel; Spies, Claudia; Ahlers, Olaf

    2015-12-01

    Clinical reasoning is an essential competency in medical education. This study aimed at developing and validating a test to assess diagnostic accuracy, collected information, and diagnostic decision time in clinical reasoning. A norm-referenced computer-based test for the assessment of clinical reasoning (ASCLIRE) was developed, integrating the entire clinical decision process. In a cross-sectional study participants were asked to choose as many diagnostic measures as they deemed necessary to diagnose the underlying disease of six different cases with acute or sub-acute dyspnea and provide a diagnosis. 283 students and 20 content experts participated. In addition to diagnostic accuracy, respective decision time and number of used relevant diagnostic measures were documented as distinct performance indicators. The empirical structure of the test was investigated using a structural equation modeling approach. Experts showed higher accuracy rates and lower decision times than students. In a cross-sectional comparison, the diagnostic accuracy of students improved with the year of study. Wrong diagnoses provided by our sample were comparable to wrong diagnoses in practice. We found an excellent fit for a model with three latent factors-diagnostic accuracy, decision time, and choice of relevant diagnostic information-with diagnostic accuracy showing no significant correlation with decision time. ASCLIRE considers decision time as an important performance indicator beneath diagnostic accuracy and provides evidence that clinical reasoning is a complex ability comprising diagnostic accuracy, decision time, and choice of relevant diagnostic information as three partly correlated but still distinct aspects.

  13. Nanotechnology in Diagnostics and Therapeutics for Gastrointestinal Disorders

    PubMed Central

    Laroui, Hamed; Rakhya, Poonam; Xiao, Bo; Viennois, Emilie; Merlin, Didier

    2013-01-01

    This review describes the state of art in nanoparticle and nanodevice applications for medical diagnosis and disease treatment. Nanodevices, such as cantilevers, have been integrated into high-sensitivity disease marker diagnostic detectors and devices, are stable over long periods of time, and display reliable performance properties. Nanotechnology strategies have been applied to therapeutic purposes as well. For example, nanoparticle-based delivery systems have been developed to protect drugs from degradation, thereby reducing the required dose and dose frequency, improving patient comfort and convenience during treatment, and reducing treatment expenses. The main objectives for integrating nanotechnologies into diagnostic and therapeutic applications in the context of intestinal diseases are reviewed. PMID:23660079

  14. Optical biosensor technologies for molecular diagnostics at the point-of-care

    NASA Astrophysics Data System (ADS)

    Schotter, Joerg; Schrittwieser, Stefan; Muellner, Paul; Melnik, Eva; Hainberger, Rainer; Koppitsch, Guenther; Schrank, Franz; Soulantika, Katerina; Lentijo-Mozo, Sergio; Pelaz, Beatriz; Parak, Wolfgang; Ludwig, Frank; Dieckhoff, Jan

    2015-05-01

    Label-free optical schemes for molecular biosensing hold a strong promise for point-of-care applications in medical research and diagnostics. Apart from diagnostic requirements in terms of sensitivity, specificity, and multiplexing capability, also other aspects such as ease of use and manufacturability have to be considered in order to pave the way to a practical implementation. We present integrated optical waveguide as well as magnetic nanoparticle based molecular biosensor concepts that address these aspects. The integrated optical waveguide devices are based on low-loss photonic wires made of silicon nitride deposited by a CMOS compatible plasma-enhanced chemical vapor deposition (PECVD) process that allows for backend integration of waveguides on optoelectronic CMOS chips. The molecular detection principle relies on evanescent wave sensing in the 0.85 μm wavelength regime by means of Mach-Zehnder interferometers, which enables on-chip integration of silicon photodiodes and, thus, the realization of system-on-chip solutions. Our nanoparticle-based approach is based on optical observation of the dynamic response of functionalized magneticcore/ noble-metal-shell nanorods (`nanoprobes') to an externally applied time-varying magnetic field. As target molecules specifically bind to the surface of the nanoprobes, the observed dynamics of the nanoprobes changes, and the concentration of target molecules in the sample solution can be quantified. This approach is suitable for dynamic real-time measurements and only requires minimal sample preparation, thus presenting a highly promising point-of-care diagnostic system. In this paper, we present a prototype of a diagnostic device suitable for highly automated sample analysis by our nanoparticle-based approach.

  15. Assessing Clinical Reasoning (ASCLIRE): Instrument Development and Validation

    ERIC Educational Resources Information Center

    Kunina-Habenicht, Olga; Hautz, Wolf E.; Knigge, Michel; Spies, Claudia; Ahlers, Olaf

    2015-01-01

    Clinical reasoning is an essential competency in medical education. This study aimed at developing and validating a test to assess diagnostic accuracy, collected information, and diagnostic decision time in clinical reasoning. A norm-referenced computer-based test for the assessment of clinical reasoning (ASCLIRE) was developed, integrating the…

  16. Vehicle Integrated Prognostic Reasoner (VIPR) Metric Report

    NASA Technical Reports Server (NTRS)

    Cornhill, Dennis; Bharadwaj, Raj; Mylaraswamy, Dinkar

    2013-01-01

    This document outlines a set of metrics for evaluating the diagnostic and prognostic schemes developed for the Vehicle Integrated Prognostic Reasoner (VIPR), a system-level reasoner that encompasses the multiple levels of large, complex systems such as those for aircraft and spacecraft. VIPR health managers are organized hierarchically and operate together to derive diagnostic and prognostic inferences from symptoms and conditions reported by a set of diagnostic and prognostic monitors. For layered reasoners such as VIPR, the overall performance cannot be evaluated by metrics solely directed toward timely detection and accuracy of estimation of the faults in individual components. Among other factors, overall vehicle reasoner performance is governed by the effectiveness of the communication schemes between monitors and reasoners in the architecture, and the ability to propagate and fuse relevant information to make accurate, consistent, and timely predictions at different levels of the reasoner hierarchy. We outline an extended set of diagnostic and prognostics metrics that can be broadly categorized as evaluation measures for diagnostic coverage, prognostic coverage, accuracy of inferences, latency in making inferences, computational cost, and sensitivity to different fault and degradation conditions. We report metrics from Monte Carlo experiments using two variations of an aircraft reference model that supported both flat and hierarchical reasoning.

  17. Portable Health Algorithms Test System

    NASA Technical Reports Server (NTRS)

    Melcher, Kevin J.; Wong, Edmond; Fulton, Christopher E.; Sowers, Thomas S.; Maul, William A.

    2010-01-01

    A document discusses the Portable Health Algorithms Test (PHALT) System, which has been designed as a means for evolving the maturity and credibility of algorithms developed to assess the health of aerospace systems. Comprising an integrated hardware-software environment, the PHALT system allows systems health management algorithms to be developed in a graphical programming environment, to be tested and refined using system simulation or test data playback, and to be evaluated in a real-time hardware-in-the-loop mode with a live test article. The integrated hardware and software development environment provides a seamless transition from algorithm development to real-time implementation. The portability of the hardware makes it quick and easy to transport between test facilities. This hard ware/software architecture is flexible enough to support a variety of diagnostic applications and test hardware, and the GUI-based rapid prototyping capability is sufficient to support development execution, and testing of custom diagnostic algorithms. The PHALT operating system supports execution of diagnostic algorithms under real-time constraints. PHALT can perform real-time capture and playback of test rig data with the ability to augment/ modify the data stream (e.g. inject simulated faults). It performs algorithm testing using a variety of data input sources, including real-time data acquisition, test data playback, and system simulations, and also provides system feedback to evaluate closed-loop diagnostic response and mitigation control.

  18. Plate tectonics in the classification of personality disorder: shifting to a dimensional model.

    PubMed

    Widiger, Thomas A; Trull, Timothy J

    2007-01-01

    The diagnostic categories of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders were developed in the spirit of a traditional medical model that considers mental disorders to be qualitatively distinct conditions (see, e.g., American Psychiatric Association, 2000). Work is now beginning on the fifth edition of this influential diagnostic manual. It is perhaps time to consider a fundamental shift in how psychopathology is conceptualized and diagnosed. More specifically, it may be time to consider a shift to a dimensional classification of personality disorder that would help address the failures of the existing diagnostic categories as well as contribute to an integration of the psychiatric diagnostic manual with psychology's research on general personality structure. (c) 2007 APA, all rights reserved

  19. Diagnostics in the Extendable Integrated Support Environment (EISE)

    NASA Technical Reports Server (NTRS)

    Brink, James R.; Storey, Paul

    1988-01-01

    Extendable Integrated Support Environment (EISE) is a real-time computer network consisting of commercially available hardware and software components to support systems level integration, modifications, and enhancement to weapons systems. The EISE approach offers substantial potential savings by eliminating unique support environments in favor of sharing common modules for the support of operational weapon systems. An expert system is being developed that will help support diagnosing faults in this network. This is a multi-level, multi-expert diagnostic system that uses experiential knowledge relating symptoms to faults and also reasons from structural and functional models of the underlying physical model when experiential reasoning is inadequate. The individual expert systems are orchestrated by a supervisory reasoning controller, a meta-level reasoner which plans the sequence of reasoning steps to solve the given specific problem. The overall system, termed the Diagnostic Executive, accesses systems level performance checks and error reports, and issues remote test procedures to formulate and confirm fault hypotheses.

  20. The Application of Whole Cell-Based Biosensors for Use in Environmental Analysis and in Medical Diagnostics

    PubMed Central

    Gui, Qingyuan; Lawson, Tom; Shan, Suyan; Yan, Lu; Liu, Yong

    2017-01-01

    Various whole cell-based biosensors have been reported in the literature for the last 20 years and these reports have shown great potential for their use in the areas of pollution detection in environmental and in biomedical diagnostics. Unlike other reviews of this growing field, this mini-review argues that: (1) the selection of reporter genes and their regulatory proteins are directly linked to the performance of celllular biosensors; (2) broad enhancements in microelectronics and information technologies have also led to improvements in the performance of these sensors; (3) their future potential is most apparent in their use in the areas of medical diagnostics and in environmental monitoring; and (4) currently the most promising work is focused on the better integration of cellular sensors with nano and micro scaled integrated chips. With better integration it may become practical to see these cells used as (5) real-time portable devices for diagnostics at the bedside and for remote environmental toxin detection and this in situ application will make the technology commonplace and thus as unremarkable as other ubiquitous technologies. PMID:28703749

  1. Maturation of Structural Health Management Systems for Solid Rocket Motors

    NASA Technical Reports Server (NTRS)

    Quing, Xinlin; Beard, Shawn; Zhang, Chang

    2011-01-01

    Concepts of an autonomous and automated space-compliant diagnostic system were developed for conditioned-based maintenance (CBM) of rocket motors for space exploration vehicles. The diagnostic system will provide real-time information on the integrity of critical structures on launch vehicles, improve their performance, and greatly increase crew safety while decreasing inspection costs. Using the SMART Layer technology as a basis, detailed procedures and calibration techniques for implementation of the diagnostic system were developed. The diagnostic system is a distributed system, which consists of a sensor network, local data loggers, and a host central processor. The system detects external impact to the structure. The major functions of the system include an estimate of impact location, estimate of impact force at impacted location, and estimate of the structure damage at impacted location. This system consists of a large-area sensor network, dedicated multiple local data loggers with signal processing and data analysis software to allow for real-time, in situ monitoring, and longterm tracking of structural integrity of solid rocket motors. Specifically, the system could provide easy installation of large sensor networks, onboard operation under harsh environments and loading, inspection of inaccessible areas without disassembly, detection of impact events and impact damage in real-time, and monitoring of a large area with local data processing to reduce wiring.

  2. Paper-based sample-to-answer molecular diagnostic platform for point-of-care diagnostics.

    PubMed

    Choi, Jane Ru; Tang, Ruihua; Wang, ShuQi; Wan Abas, Wan Abu Bakar; Pingguan-Murphy, Belinda; Xu, Feng

    2015-12-15

    Nucleic acid testing (NAT), as a molecular diagnostic technique, including nucleic acid extraction, amplification and detection, plays a fundamental role in medical diagnosis for timely medical treatment. However, current NAT technologies require relatively high-end instrumentation, skilled personnel, and are time-consuming. These drawbacks mean conventional NAT becomes impractical in many resource-limited disease-endemic settings, leading to an urgent need to develop a fast and portable NAT diagnostic tool. Paper-based devices are typically robust, cost-effective and user-friendly, holding a great potential for NAT at the point of care. In view of the escalating demand for the low cost diagnostic devices, we highlight the beneficial use of paper as a platform for NAT, the current state of its development, and the existing challenges preventing its widespread use. We suggest a strategy involving integrating all three steps of NAT into one single paper-based sample-to-answer diagnostic device for rapid medical diagnostics in the near future. Copyright © 2015 Elsevier B.V. All rights reserved.

  3. [Lab-on-a-chip systems in the point-of-care diagnostics].

    PubMed

    Szabó, Barnabás; Borbíró, András; Fürjes, Péter

    2015-12-27

    The need in modern medicine for near-patient diagnostics being able to accelerate therapeutic decisions and possibly replacing laboratory measurements is significantly growing. Reliable and cost-effective bioanalytical measurement systems are required which - acting as a micro-laboratory - contain integrated biomolecular recognition, sensing, signal processing and complex microfluidic sample preparation modules. These micro- and nanofabricated Lab-on-a-chip systems open new perspectives in the diagnostic supply chain, since they are able even for quantitative, high-precision and immediate analysis of special disease specific molecular markers or their combinations from a single drop of sample. Accordingly, crucial requirements regarding the instruments and the analytical methods are the high selectivity, extremely low detection limit, short response time and integrability into the healthcare information networks. All these features can make the hierarchical examination chain shorten, and revolutionize laboratory diagnostics, evolving a brand new situation in therapeutic intervention.

  4. Diagnostic report acquisition unit for the Mayo/IBM PACS project

    NASA Astrophysics Data System (ADS)

    Brooks, Everett G.; Rothman, Melvyn L.

    1991-07-01

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

  5. A high-speed two-frame, 1-2 ns gated X-ray CMOS imager used as a hohlraum diagnostic on the National Ignition Facility (invited).

    PubMed

    Chen, Hui; Palmer, N; Dayton, M; Carpenter, A; Schneider, M B; Bell, P M; Bradley, D K; Claus, L D; Fang, L; Hilsabeck, T; Hohenberger, M; Jones, O S; Kilkenny, J D; Kimmel, M W; Robertson, G; Rochau, G; Sanchez, M O; Stahoviak, J W; Trotter, D C; Porter, J L

    2016-11-01

    A novel x-ray imager, which takes time-resolved gated images along a single line-of-sight, has been successfully implemented at the National Ignition Facility (NIF). This Gated Laser Entrance Hole diagnostic, G-LEH, incorporates a high-speed multi-frame CMOS x-ray imager developed by Sandia National Laboratories to upgrade the existing Static X-ray Imager diagnostic at NIF. The new diagnostic is capable of capturing two laser-entrance-hole images per shot on its 1024 × 448 pixels photo-detector array, with integration times as short as 1.6 ns per frame. Since its implementation on NIF, the G-LEH diagnostic has successfully acquired images from various experimental campaigns, providing critical new information for understanding the hohlraum performance in inertial confinement fusion (ICF) experiments, such as the size of the laser entrance hole vs. time, the growth of the laser-heated gold plasma bubble, the change in brightness of inner beam spots due to time-varying cross beam energy transfer, and plasma instability growth near the hohlraum wall.

  6. Integrated diagnostics

    NASA Technical Reports Server (NTRS)

    Hunthausen, Roger J.

    1988-01-01

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

  7. Combining information from 3 anatomic regions in the diagnosis of glaucoma with time-domain optical coherence tomography.

    PubMed

    Wang, Mingwu; Lu, Ake Tzu-Hui; Varma, Rohit; Schuman, Joel S; Greenfield, David S; Huang, David

    2014-03-01

    To improve the diagnosis of glaucoma by combining time-domain optical coherence tomography (TD-OCT) measurements of the optic disc, circumpapillary retinal nerve fiber layer (RNFL), and macular retinal thickness. Ninety-six age-matched normal and 96 perimetric glaucoma participants were included in this observational, cross-sectional study. Or-logic, support vector machine, relevance vector machine, and linear discrimination function were used to analyze the performances of combined TD-OCT diagnostic variables. The area under the receiver-operating curve (AROC) was used to evaluate the diagnostic accuracy and to compare the diagnostic performance of single and combined anatomic variables. The best RNFL thickness variables were the inferior (AROC=0.900), overall (AROC=0.892), and superior quadrants (AROC=0.850). The best optic disc variables were horizontal integrated rim width (AROC=0.909), vertical integrated rim area (AROC=0.908), and cup/disc vertical ratio (AROC=0.890). All macular retinal thickness variables had AROCs of 0.829 or less. Combining the top 3 RNFL and optic disc variables in optimizing glaucoma diagnosis, support vector machine had the highest AROC, 0.954, followed by or-logic (AROC=0.946), linear discrimination function (AROC=0.946), and relevance vector machine (AROC=0.943). All combination diagnostic variables had significantly larger AROCs than any single diagnostic variable. There are no significant differences among the combination diagnostic indices. With TD-OCT, RNFL and optic disc variables had better diagnostic accuracy than macular retinal variables. Combining top RNFL and optic disc variables significantly improved diagnostic performance. Clinically, or-logic classification was the most practical analytical tool with sufficient accuracy to diagnose early glaucoma.

  8. DITTY - a computer program for calculating population dose integrated over ten thousand years

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

    Napier, B.A.; Peloquin, R.A.; Strenge, D.L.

    The computer program DITTY (Dose Integrated Over Ten Thousand Years) was developed to determine the collective dose from long term nuclear waste disposal sites resulting from the ground-water pathways. DITTY estimates the time integral of collective dose over a ten-thousand-year period for time-variant radionuclide releases to surface waters, wells, or the atmosphere. This document includes the following information on DITTY: a description of the mathematical models, program designs, data file requirements, input preparation, output interpretations, sample problems, and program-generated diagnostic messages.

  9. IVHM Framework for Intelligent Integration for Vehicle Health Management

    NASA Technical Reports Server (NTRS)

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

    2005-01-01

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

  10. Plasma DNA integrity index as a potential molecular diagnostic marker for breast cancer.

    PubMed

    Kamel, Azza M; Teama, Salwa; Fawzy, Amal; El Deftar, Mervat

    2016-06-01

    Plasma DNA integrity index is increased in various malignancies including breast cancer, the most common cancer in women worldwide; early detection is crucial for successful treatment. Current screening methods fail to detect many cases of breast cancer at an early stage. In this study, we evaluated the level of plasma DNA integrity index in 260 females (95 with breast cancer, 95 with benign breast lesions, and 70 healthy controls) to verify its potential value in discriminating malignant from benign breast lesions. The criteria of the American Joint Committee on Cancer were used for staging of breast cancer patients. DNA integrity index was measured by real-time PCR. DNA integrity index was significantly higher in breast cancer than in benign breast patients and healthy subjects (P = <0.001). DNA integrity index is correlated with TNM stage. Given 100 % specificity, the highest sensitivity achieved in detecting cancer group was 85.3 % at 0.55 DNA integrity index cutoff. In conclusion, the plasma DNA integrity index may be a promising molecular diagnostic marker of malignancy in breast lesions.

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

    NASA Technical Reports Server (NTRS)

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

    1991-01-01

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

  12. Video integrated measurement system. [Diagnostic display devices

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

    Spector, B.; Eilbert, L.; Finando, S.

    A Video Integrated Measurement (VIM) System is described which incorporates the use of various noninvasive diagnostic procedures (moire contourography, electromyography, posturometry, infrared thermography, etc.), used individually or in combination, for the evaluation of neuromusculoskeletal and other disorders and their management with biofeedback and other therapeutic procedures. The system provides for measuring individual diagnostic and therapeutic modes, or multiple modes by split screen superimposition, of real time (actual) images of the patient and idealized (ideal-normal) models on a video monitor, along with analog and digital data, graphics, color, and other transduced symbolic information. It is concluded that this system provides anmore » innovative and efficient method by which the therapist and patient can interact in biofeedback training/learning processes and holds considerable promise for more effective measurement and treatment of a wide variety of physical and behavioral disorders.« less

  13. Automation, consolidation, and integration in autoimmune diagnostics.

    PubMed

    Tozzoli, Renato; D'Aurizio, Federica; Villalta, Danilo; Bizzaro, Nicola

    2015-08-01

    Over the past two decades, we have witnessed an extraordinary change in autoimmune diagnostics, characterized by the progressive evolution of analytical technologies, the availability of new tests, and the explosive growth of molecular biology and proteomics. Aside from these huge improvements, organizational changes have also occurred which brought about a more modern vision of the autoimmune laboratory. The introduction of automation (for harmonization of testing, reduction of human error, reduction of handling steps, increase of productivity, decrease of turnaround time, improvement of safety), consolidation (combining different analytical technologies or strategies on one instrument or on one group of connected instruments) and integration (linking analytical instruments or group of instruments with pre- and post-analytical devices) opened a new era in immunodiagnostics. In this article, we review the most important changes that have occurred in autoimmune diagnostics and present some models related to the introduction of automation in the autoimmunology laboratory, such as automated indirect immunofluorescence and changes in the two-step strategy for detection of autoantibodies; automated monoplex immunoassays and reduction of turnaround time; and automated multiplex immunoassays for autoantibody profiling.

  14. De-escalating Antibiotic Use in the Inpatient Setting: Strategies, Controversies, and Challenges.

    PubMed

    Daniel Markley, J; Bernard, Shaina; Bearman, Gonzalo; Stevens, Michael P

    2017-04-01

    Antibiotic de-escalation (ADE) is widely accepted as an integral strategy to curtail the global antibiotic resistance crisis. However, there is significant uncertainty regarding the ideal ADE strategy and its true impact on antibiotic resistance. Rapid diagnostic testing has the potential to enhance ADE strategies. Herein, we aim to discuss the current strategies, controversies, and challenges of ADE in the inpatient setting. A consensus definition of ADE remains elusive at this time. Preliminary studies utilizing rapid diagnostic tests including matrix-assisted laser desorption/ionization time of flight (MALDI-TOF), procalcitonin, and other molecular techniques have demonstrated the potential to support ADE strategies. In the absence of evidence-based, highly specific ADE protocols, the likelihood that individual providers will make consistent, often challenging, decisions to de-escalate antibiotic therapy is low. Antimicrobial stewardship programs should support local physicians with ADE and develop innovative ways to integrate ADE into the broader construct of antimicrobial stewardship programs. The evolving field of rapid diagnostics has significant potential to improve ADE strategies, but more research is needed to fully realize this goal.

  15. Care Model Design for E-Health: Integration of Point-of-Care Testing at Dutch General Practices.

    PubMed

    Verhees, Bart; van Kuijk, Kees; Simonse, Lianne

    2017-12-21

    Point-of-care testing (POCT)-laboratory tests performed with new mobile devices and online technologies outside of the central laboratory-is rapidly outpacing the traditional laboratory test market, growing at a rate of 12 to 15% each year. POCT impacts the diagnostic process of care providers by yielding high efficiency benefits in terms of turnaround time and related quality improvements in the reduction of errors. However, the implementation of this disruptive eHealth technology requires the integration and transformation of diagnostic services across the boundaries of healthcare organizations. Research has revealed both advantages and barriers of POCT implementations, yet to date, there is no business model for the integration of POCT within general practice. The aim of this article is to contribute with a design for a care model that enables the integration of POCT in primary healthcare. In this research, we used a design modelling toolkit for data collection at five general practices. Through an iterative design process, we modelled the actors and value transactions, and designed an optimized care model for the dynamic integration of POCTs into the GP's network of care delivery. The care model design will have a direct bearing on improving the integration of POCT through the connectivity and norm guidelines between the general practice, the POC technology, and the diagnostic centre.

  16. Care Model Design for E-Health: Integration of Point-of-Care Testing at Dutch General Practices

    PubMed Central

    Verhees, Bart; van Kuijk, Kees

    2017-01-01

    Point-of-care testing (POCT)—laboratory tests performed with new mobile devices and online technologies outside of the central laboratory—is rapidly outpacing the traditional laboratory test market, growing at a rate of 12 to 15% each year. POCT impacts the diagnostic process of care providers by yielding high efficiency benefits in terms of turnaround time and related quality improvements in the reduction of errors. However, the implementation of this disruptive eHealth technology requires the integration and transformation of diagnostic services across the boundaries of healthcare organizations. Research has revealed both advantages and barriers of POCT implementations, yet to date, there is no business model for the integration of POCT within general practice. The aim of this article is to contribute with a design for a care model that enables the integration of POCT in primary healthcare. In this research, we used a design modelling toolkit for data collection at five general practices. Through an iterative design process, we modelled the actors and value transactions, and designed an optimized care model for the dynamic integration of POCTs into the GP’s network of care delivery. The care model design will have a direct bearing on improving the integration of POCT through the connectivity and norm guidelines between the general practice, the POC technology, and the diagnostic centre. PMID:29267224

  17. Engineering aspects of design and integration of ECE diagnostic in ITER

    DOE PAGES

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

    2015-03-12

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

  18. Results From the New NIF Gated LEH imager

    NASA Astrophysics Data System (ADS)

    Chen, Hui; Amendt, P.; Barrios, M.; Bradley, D.; Casey, D.; Hinkel, D.; Berzak Hopkins, L.; Kilkenny, J.; Kritcher, A.; Landen, O.; Jones, O.; Ma, T.; Milovich, J.; Michel, P.; Moody, J.; Ralph, J.; Pak, A.; Palmer, N.; Schneider, M.

    2016-10-01

    A novel ns-gated Laser Entrance Hole (G-LEH) diagnostic has been successfully implemented at the National Ignition Facility (NIF). This diagnostic has successfully acquired images from various experimental campaigns, providing critical information for inertial confinement fusion experiments. The G-LEH diagnostic which takes time-resolved gated images along a single line-of-sight, incorporates a high-speed multi-frame CMOS x-ray imager developed by Sandia National Laboratories into the existing Static X-ray Imager diagnostic at NIF. It is capable of capturing two laser-entrance-hole images per shot on its 1024x448 pixel photo-detector array, with integration times as short as 2 ns per frame. The results that will be presented include the size of the laser entrance hole vs. time, the growth of the laser-heated gold plasma bubble, the change in brightness of inner beam spots due to time-varying cross beam energy transfer, and plasma instability growth near the hohlraum wall. This work was performed under the auspices of the U.S. Department of Energy by LLNS, LLC, under Contract No. DE-AC52- 07NA27344.

  19. Exploring cognitive integration of basic science and its effect on diagnostic reasoning in novices.

    PubMed

    Lisk, Kristina; Agur, Anne M R; Woods, Nicole N

    2016-06-01

    Integration of basic and clinical science knowledge is increasingly being recognized as important for practice in the health professions. The concept of 'cognitive integration' places emphasis on the value of basic science in providing critical connections to clinical signs and symptoms while accounting for the fact that clinicians may not spontaneously articulate their use of basic science knowledge in clinical reasoning. In this study we used a diagnostic justification test to explore the impact of integrated basic science instruction on novices' diagnostic reasoning process. Participants were allocated to an integrated basic science or clinical science training group. The integrated basic science group was taught the clinical features along with the underlying causal mechanisms of four musculoskeletal pathologies while the clinical science group was taught only the clinical features. Participants completed a diagnostic accuracy test immediately after initial learning, and one week later a diagnostic accuracy and justification test. The results showed that novices who learned the integrated causal mechanisms had superior diagnostic accuracy and better understanding of the relative importance of key clinical features. These findings further our understanding of cognitive integration by providing evidence of the specific changes in clinical reasoning when basic and clinical sciences are integrated during learning.

  20. SMART Layer and SMART Suitcase for structural health monitoring applications

    NASA Astrophysics Data System (ADS)

    Lin, Mark; Qing, Xinlin; Kumar, Amrita; Beard, Shawn J.

    2001-06-01

    Knowledge of integrity of in-service structures can greatly enhance their safety and reliability and lower structural maintenance cost. Current practices limit the extent of real-time knowledge that can be obtained from structures during inspection, are labor-intensive and thereby increase life-cycle costs. Utilization of distributed sensors integrated with the structure is a viable and cost-effective means of monitoring the structure and reducing inspection costs. Acellent Technologies is developing a novel system for actively and passively interrogating the health of a structure through an integrated network of sensors and actuators. Acellent's system comprises of SMART Layers, SMART Suitcase and diagnostic software. The patented SMART Layer is a thin dielectric film with an embedded network of distributed piezoelectric actuators/sensors that can be surface-mounted on metallic structures or embedded inside composite structures. The SMART Suitcase is a portable diagnostic unit designed with multiple sensor/actuator channels to interface with the SMART Layer, generate diagnostic signals from actuators and record measurements from the embedded sensors. With appropriate diagnostic software, Acellent's system can be used for monitoring structural condition and for detecting damage while the structures are in service. This paper enumerates on the SMART Layer and SMART Suitcase and their applicability to composite and metal structures.

  1. Self-powered integrated microfluidic point-of-care low-cost enabling (SIMPLE) chip

    PubMed Central

    Yeh, Erh-Chia; Fu, Chi-Cheng; Hu, Lucy; Thakur, Rohan; Feng, Jeffrey; Lee, Luke P.

    2017-01-01

    Portable, low-cost, and quantitative nucleic acid detection is desirable for point-of-care diagnostics; however, current polymerase chain reaction testing often requires time-consuming multiple steps and costly equipment. We report an integrated microfluidic diagnostic device capable of on-site quantitative nucleic acid detection directly from the blood without separate sample preparation steps. First, we prepatterned the amplification initiator [magnesium acetate (MgOAc)] on the chip to enable digital nucleic acid amplification. Second, a simplified sample preparation step is demonstrated, where the plasma is separated autonomously into 224 microwells (100 nl per well) without any hemolysis. Furthermore, self-powered microfluidic pumping without any external pumps, controllers, or power sources is accomplished by an integrated vacuum battery on the chip. This simple chip allows rapid quantitative digital nucleic acid detection directly from human blood samples (10 to 105 copies of methicillin-resistant Staphylococcus aureus DNA per microliter, ~30 min, via isothermal recombinase polymerase amplification). These autonomous, portable, lab-on-chip technologies provide promising foundations for future low-cost molecular diagnostic assays. PMID:28345028

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

    PubMed

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

    2015-04-21

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

  3. Information management of a department of diagnostic imaging.

    PubMed

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

    1998-01-01

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

  4. A Framework for Integration of IVHM Technologies for Intelligent Integration for Vehicle Management

    NASA Technical Reports Server (NTRS)

    Paris, Deidre E.; Trevino, Luis; Watson, Mike

    2005-01-01

    As a part of the overall goal of developing Integrated Vehicle Health Management (IVHM) systems for aerospace vehicles, the NASA Faculty Fellowship Program (NFFP) at Marshall Space Flight Center has performed a pilot study on IVHM principals which integrates researched IVHM technologies in support of Integrated Intelligent Vehicle Management (IIVM). IVHM is the process of assessing, preserving, and restoring system functionality across flight and ground systems (NASA NGLT 2004). The framework presented in this paper integrates advanced computational techniques with sensor and communication technologies for spacecraft that can generate responses through detection, diagnosis, reasoning, and adapt to system faults in support of IIVM. These real-time responses allow the IIVM to modify the effected vehicle subsystem(s) prior to a catastrophic event. Furthermore, the objective of this pilot program is to develop and integrate technologies which can provide a continuous, intelligent, and adaptive health state of a vehicle and use this information to improve safety and reduce costs of operations. Recent investments in avionics, health management, and controls have been directed towards IIVM. As this concept has matured, it has become clear the IIVM requires the same sensors and processing capabilities as the real-time avionics functions to support diagnosis of subsystem problems. New sensors have been proposed, in addition, to augment the avionics sensors to support better system monitoring and diagnostics. As the designs have been considered, a synergy has been realized where the real-time avionics can utilize sensors proposed for diagnostics and prognostics to make better real-time decisions in response to detected failures. IIVM provides for a single system allowing modularity of functions and hardware across the vehicle. The framework that supports IIVM consists of 11 major on-board functions necessary to fully manage a space vehicle maintaining crew safety and mission objectives: Guidance and Navigation; Communications and Tracking; Vehicle Monitoring; Information Transport and Integration; Vehicle Diagnostics; Vehicle Prognostics; Vehicle mission Planning; Automated Repair and Replacement; Vehicle Control; Human Computer Interface; and Onboard Verification and Validation. Furthermore, the presented framework provides complete vehicle management which not only allows for increased crew safety and mission success through new intelligence capabilities, but also yields a mechanism for more efficient vehicle operations. The representative IVHM technologies for IIVH includes: 1) robust controllers for use in re-usable launch vehicles, 2) scaleable/flexible computer platform using heterogeneous communication, 3) coupled electromagnetic oscillators for enhanced communications, 4) Linux-based real-time systems, 5) genetic algorithms, 6) Bayesian Networks, 7) evolutionary algorithms, 8) dynamic systems control modeling, and 9) advanced sensing capabilities. This paper presents IVHM technologies developed under NASA's NFFP pilot project. The integration of these IVHM technologies forms the framework for IIVM.

  5. Intelligent Vehicle Health Management

    NASA Technical Reports Server (NTRS)

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

    2005-01-01

    As a part of the overall goal of developing Integrated Vehicle Health Management systems for aerospace vehicles, the NASA Faculty Fellowship Program (NFFP) at Marshall Space Flight Center has performed a pilot study on IVHM principals which integrates researched IVHM technologies in support of Integrated Intelligent Vehicle Management (IIVM). IVHM is the process of assessing, preserving, and restoring system functionality across flight and ground systems (NASA NGLT 2004). The framework presented in this paper integrates advanced computational techniques with sensor and communication technologies for spacecraft that can generate responses through detection, diagnosis, reasoning, and adapt to system faults in support of INM. These real-time responses allow the IIVM to modify the affected vehicle subsystem(s) prior to a catastrophic event. Furthermore, the objective of this pilot program is to develop and integrate technologies which can provide a continuous, intelligent, and adaptive health state of a vehicle and use this information to improve safety and reduce costs of operations. Recent investments in avionics, health management, and controls have been directed towards IIVM. As this concept has matured, it has become clear the INM requires the same sensors and processing capabilities as the real-time avionics functions to support diagnosis of subsystem problems. New sensors have been proposed, in addition, to augment the avionics sensors to support better system monitoring and diagnostics. As the designs have been considered, a synergy has been realized where the real-time avionics can utilize sensors proposed for diagnostics and prognostics to make better real-time decisions in response to detected failures. IIVM provides for a single system allowing modularity of functions and hardware across the vehicle. The framework that supports IIVM consists of 11 major on-board functions necessary to fully manage a space vehicle maintaining crew safety and mission objectives: Guidance and Navigation; Communications and Tracking; Vehicle Monitoring; Information Transport and Integration; Vehicle Diagnostics; Vehicle Prognostics; Vehicle mission Planning; Automated Repair and Replacement; Vehicle Control; Human Computer Interface; and Onboard Verification and Validation. Furthermore, the presented framework provides complete vehicle management which not only allows for increased crew safety and mission success through new intelligence capabilities, but also yields a mechanism for more efficient vehicle operations. The representative IVHM technologies for computer platform using heterogeneous communication, 3) coupled electromagnetic oscillators for enhanced communications, 4) Linux-based real-time systems, 5) genetic algorithms, 6) Bayesian Networks, 7) evolutionary algorithms, 8) dynamic systems control modeling, and 9) advanced sensing capabilities. This paper presents IVHM technologies developed under NASA's NFFP pilot project and the integration of these technologies forms the framework for IIVM.

  6. Real-time diagnostics of a jet engine exhaust using an intra-pulse quantum cascade laser spectrometer

    NASA Astrophysics Data System (ADS)

    Duxbury, Geoffrey; Hay, Kenneth G.; Langford, Nigel; Johnson, Mark P.; Black, John D.

    2011-09-01

    It has been demonstrated that an intra-pulse scanned quantum cascade laser spectrometer may be used to obtain real-time diagnostics of the amounts of carbon monoxide, carbon dioxide, and water, in the exhaust of an aero gas turbine (turbojet) engine operated in a sea level test cell. Measurements have been made of the rapid changes in composition following ignition, the composition under steady state operating conditions, and the composition changes across the exhaust plume. The minimum detection limit for CO in a double pass through a typical gas turbine plume of 50 cm in diameter, with 0.4 seconds integration time, is approximately 2 ppm.

  7. Diagnostic reasoning and underlying knowledge of students with preclinical patient contacts in PBL.

    PubMed

    Diemers, Agnes D; van de Wiel, Margje W J; Scherpbier, Albert J J A; Baarveld, Frank; Dolmans, Diana H J M

    2015-12-01

    Medical experts have access to elaborate and integrated knowledge networks consisting of biomedical and clinical knowledge. These coherent knowledge networks enable them to generate more accurate diagnoses in a shorter time. However, students' knowledge networks are less organised and students have difficulties linking theory and practice and transferring acquired knowledge. Therefore we wanted to explore the development and transfer of knowledge of third-year preclinical students on a problem-based learning (PBL) course with real patient contacts. Before and after a 10-week PBL course with real patients, third-year medical students were asked to think out loud while diagnosing four types of paper patient problems (two course cases and two transfer cases), and explain the underlying pathophysiological mechanisms of the patient features. Diagnostic accuracy and time needed to think through the cases were measured. The think-aloud protocols were transcribed verbatim and different types of knowledge were coded and quantitatively analysed. The written pathophysiological explanations were translated into networks of concepts. Both the concepts and the links between concepts in students' networks were compared to model networks. Over the course diagnostic accuracy increased, case-processing time decreased, and students used less biomedical and clinical knowledge during diagnostic reasoning. The quality of the pathophysiological explanations increased: the students used more concepts, especially more model concepts, and they used fewer wrong concepts and links. The findings differed across course and transfer cases. The effects were generally less strong for transfer cases. Students' improved diagnostic accuracy and the improved quality of their knowledge networks suggest that integration of biomedical and clinical knowledge took place during a 10-week course. The differences between course and transfer cases demonstrate that transfer is complex and time-consuming. We therefore suggest offering students many varied patient contacts with the same underlying pathophysiological mechanism and encouraging students to link biomedical and clinical knowledge. © 2015 John Wiley & Sons Ltd.

  8. Point-of-care oral-based diagnostics

    PubMed Central

    Hart, RW; Mauk, MG; Liu, C; Qiu, X; Thompson, JA; Chen, D; Malamud, D; Abrams, WR; Bau, HH

    2014-01-01

    Many of the target molecules that reside in blood are also present in oral fluids, albeit at lower concentrations. Oral fluids are, however, relatively easy and safe to collect without the need for specialized equipment and training. Thus, oral fluids provide convenient samples for medical diagnostics. Recent advances in lab-on-a-chip technologies have made minute, fully integrated diagnostic systems practical for an assortment of point-of-care tests. Such systems can perform either immunoassays or molecular diagnostics outside centralized laboratories within time periods ranging from minutes to an hour. The article briefly reviews recent advances in devices for point-of-care testing with a focus on work that has been carried out by the authors as part of a NIH program. PMID:21521419

  9. Modification of the Integrated Sasang Constitutional Diagnostic Model

    PubMed Central

    Nam, Jiho

    2017-01-01

    In 2012, the Korea Institute of Oriental Medicine proposed an objective and comprehensive physical diagnostic model to address quantification problems in the existing Sasang constitutional diagnostic method. However, certain issues have been raised regarding a revision of the proposed diagnostic model. In this paper, we propose various methodological approaches to address the problems of the previous diagnostic model. Firstly, more useful variables are selected in each component. Secondly, the least absolute shrinkage and selection operator is used to reduce multicollinearity without the modification of explanatory variables. Thirdly, proportions of SC types and age are considered to construct individual diagnostic models and classify the training set and the test set for reflecting the characteristics of the entire dataset. Finally, an integrated model is constructed with explanatory variables of individual diagnosis models. The proposed integrated diagnostic model significantly improves the sensitivities for both the male SY type (36.4% → 62.0%) and the female SE type (43.7% → 64.5%), which were areas of limitation of the previous integrated diagnostic model. The ideas of these new algorithms are expected to contribute not only to the scientific development of Sasang constitutional medicine in Korea but also to that of other diagnostic methods for traditional medicine. PMID:29317897

  10. Diagnostics of wear in aeronautical systems

    NASA Technical Reports Server (NTRS)

    Wedeven, L. D.

    1979-01-01

    The use of appropriate diagnostic tools for aircraft oil wetted components is reviewed, noting that it can reduce direct operating costs through reduced unscheduled maintenance, particularly in helicopter engine and transmission systems where bearing failures are a significant cost factor. Engine and transmission wear modes are described, and diagnostic methods for oil and wet particle analysis, the spectrometric oil analysis program, chip detectors, ferrography, in-line oil monitor and radioactive isotope tagging are discussed, noting that they are effective over a limited range of particle sizes but compliment each other if used in parallel. Fine filtration can potentially increase time between overhauls, but reduces the effectiveness of conventional oil monitoring techniques so that alternative diagnostic techniques must be used. It is concluded that the development of a diagnostic system should be parallel and integral with the development of a mechanical system.

  11. [Computerised monitoring of integrated cervical screening. Indicators of diagnostic performance].

    PubMed

    Bucchi, L; Pierri, C; Amadori, A; Folicaldi, S; Ghidoni, D; Nannini, R; Bondi, A

    2003-12-01

    In a previous issue of this journal, we presented the background, rationale, general methods, and indicators of participation of a computerised system for the monitoring of integrated cervical screening, i.e. the integration of spontaneous Pap smear practice into organised screening. We also reported the results of the application of those indicators in the general database of the Pathology Department of Imola Health District in northern Italy. In the current paper, we present the rationale and definitions of indicators of diagnostic performance (total Pap smears and rate of unsatisfactory Pap smears, distribution by cytology class reported, rate of patients without timely follow-up, detection rate, positive predictive value, distribution of cytology classes reported by histology diagnosis, and distribution of cases of CIN and carcinoma registered by detection modality) as well as the results of their application in the same database as above.

  12. Magnetic Field Diagnostics and Spatio-Temporal Variability of the Solar Transition Region

    NASA Astrophysics Data System (ADS)

    Peter, H.

    2013-12-01

    Magnetic field diagnostics of the transition region from the chromosphere to the corona faces us with the problem that one has to apply extreme-ultraviolet (EUV) spectro-polarimetry. While for the coronal diagnostics techniques already exist in the form of infrared coronagraphy above the limb and radio observations on the disk, one has to investigate EUV observations for the transition region. However, so far the success of such observations has been limited, but various current projects aim to obtain spectro-polarimetric data in the extreme UV in the near future. Therefore it is timely to study the polarimetric signals we can expect from these observations through realistic forward modeling. We employ a 3D magneto-hydrodynamic (MHD) forward model of the solar corona and synthesize the Stokes I and Stokes V profiles of C iv (1548 Å). A signal well above 0.001 in Stokes V can be expected even if one integrates for several minutes to reach the required signal-to-noise ratio, and despite the rapidly changing intensity in the model (just as in observations). This variability of the intensity is often used as an argument against transition region magnetic diagnostics, which requires exposure times of minutes. However, the magnetic field is evolving much slower than the intensity, and therefore the degree of (circular) polarization remains rather constant when one integrates in time. Our study shows that it is possible to measure the transition region magnetic field if a polarimetric accuracy on the order of 0.001 can be reached, which we can expect from planned instrumentation.

  13. Diagnostic stability of autism spectrum disorder in toddlers prospectively identified in a community-based setting: Behavioural characteristics and predictors of change over time.

    PubMed

    Barbaro, Josephine; Dissanayake, Cheryl

    2017-10-01

    Autism spectrum disorder diagnoses in toddlers have been established as accurate and stable across time in high-risk siblings and clinic-referred samples. Few studies have investigated diagnostic stability in children prospective identified in community-based settings. Furthermore, there is a dearth of evidence on the individual behaviours that predict diagnostic change over time. The stability and change of autism spectrum disorder diagnoses were investigated from 24 to 48 months in 77 children drawn from the Social Attention and Communication Study. Diagnostic stability was high, with 88.3% overall stability and 85.5% autism spectrum disorder stability. The behavioural markers at 24 months that contributed to diagnostic shift off the autism spectrum by 48 months included better eye contact, more directed vocalisations, the integration of gaze and directed vocalisations/gestures and higher non-verbal developmental quotient. These four variables correctly predicted 88.7% of children into the autism spectrum disorder-stable and autism spectrum disorder-crossover groups overall, with excellent prediction for the stable group (96.2%) and modest prediction for the crossover group (44.4%). Furthermore, non-verbal developmental quotient at 24 months accounted for the significant improvement across time in 'Social Affect' scores on the Autism Diagnostic Observation Schedule for both groups and was the only unique predictor of diagnostic crossover. These findings contribute to the body of evidence on the feasibility of diagnoses at earlier ages to facilitate children's access to interventions to promote positive developmental outcomes.

  14. Layout and results from the initial operation of the high-resolution x-ray imaging crystal spectrometer on the Large Helical Device.

    PubMed

    Pablant, N A; Bitter, M; Delgado-Aparicio, L; Goto, M; Hill, K W; Lazerson, S; Morita, S; Roquemore, A L; Gates, D; Monticello, D; Nielson, H; Reiman, A; Reinke, M; Rice, J E; Yamada, H

    2012-08-01

    First results of ion and electron temperature profile measurements from the x-ray imaging crystal spectrometer (XICS) diagnostic on the Large Helical Device (LHD) are presented. This diagnostic system has been operational since the beginning of the 2011 LHD experimental campaign and is the first application of the XICS diagnostic technique to helical plasma geometry. The XICS diagnostic provides measurements of ion and electron temperature profiles in LHD with a spatial resolution of 2 cm and a maximum time resolution of 5 ms (typically 20 ms). Ion temperature profiles from the XICS diagnostic are possible under conditions where charge exchange recombination spectroscopy (CXRS) is not possible (high density) or is perturbative to the plasma (low density or radio frequency heated plasmas). Measurements are made by using a spherically bent crystal to provide a spectrally resolved 1D image of the plasma from line integrated emission of helium-like Ar(16 +). The final hardware design and configuration are detailed along with the calibration procedures. Line-integrated ion and electron temperature measurements are presented, and the measurement accuracy is discussed. Finally central temperature measurements from the XICS system are compared to measurements from the Thomson scattering and CXRS systems, showing excellent agreement.

  15. Fully 3D printed integrated reactor array for point-of-care molecular diagnostics.

    PubMed

    Kadimisetty, Karteek; Song, Jinzhao; Doto, Aoife M; Hwang, Young; Peng, Jing; Mauk, Michael G; Bushman, Frederic D; Gross, Robert; Jarvis, Joseph N; Liu, Changchun

    2018-06-30

    Molecular diagnostics that involve nucleic acid amplification tests (NAATs) are crucial for prevention and treatment of infectious diseases. In this study, we developed a simple, inexpensive, disposable, fully 3D printed microfluidic reactor array that is capable of carrying out extraction, concentration and isothermal amplification of nucleic acids in variety of body fluids. The method allows rapid molecular diagnostic tests for infectious diseases at point of care. A simple leak-proof polymerization strategy was developed to integrate flow-through nucleic acid isolation membranes into microfluidic devices, yielding a multifunctional diagnostic platform. Static coating technology was adopted to improve the biocompatibility of our 3D printed device. We demonstrated the suitability of our device for both end-point colorimetric qualitative detection and real-time fluorescence quantitative detection. We applied our diagnostic device to detection of Plasmodium falciparum in plasma samples and Neisseria meningitides in cerebrospinal fluid (CSF) samples by loop-mediated, isothermal amplification (LAMP) within 50 min. The detection limits were 100 fg for P. falciparum and 50 colony-forming unit (CFU) for N. meningitidis per reaction, which are comparable to that of benchtop instruments. This rapid and inexpensive 3D printed device has great potential for point-of-care molecular diagnosis of infectious disease in resource-limited settings. Copyright © 2018 Elsevier B.V. All rights reserved.

  16. LEADER - An integrated engine behavior and design analyses based real-time fault diagnostic expert system for Space Shuttle Main Engine (SSME)

    NASA Technical Reports Server (NTRS)

    Gupta, U. K.; Ali, M.

    1989-01-01

    The LEADER expert system has been developed for automatic learning tasks encompassing real-time detection, identification, verification, and correction of anomalous propulsion system operations, using a set of sensors to monitor engine component performance to ascertain anomalies in engine dynamics and behavior. Two diagnostic approaches are embodied in LEADER's architecture: (1) learning and identifying engine behavior patterns to generate novel hypotheses about possible abnormalities, and (2) the direction of engine sensor data processing to perform resoning based on engine design and functional knowledge, as well as the principles of the relevant mechanics and physics.

  17. Differential temperature integrating diagnostic method and apparatus

    DOEpatents

    Doss, James D.; McCabe, Charles W.

    1976-01-01

    A method and device for detecting the presence of breast cancer in women by integrating the temperature difference between the temperature of a normal breast and that of a breast having a malignant tumor. The breast-receiving cups of a brassiere are each provided with thermally conductive material next to the skin, with a thermistor attached to the thermally conductive material in each cup. The thermistors are connected to adjacent arms of a Wheatstone bridge. Unbalance currents in the bridge are integrated with respect to time by means of an electrochemical integrator. In the absence of a tumor, both breasts maintain substantially the same temperature, and the bridge remains balanced. If the tumor is present in one breast, a higher temperature in that breast unbalances the bridge and the electrochemical cells integrate the temperature difference with respect to time.

  18. An integrated decision support system for diagnosing and managing patients with community-acquired pneumonia.

    PubMed Central

    Aronsky, D.; Haug, P. J.

    1999-01-01

    Decision support systems that integrate guidelines have become popular applications to reduce variation and deliver cost-effective care. However, adverse characteristics of decision support systems, such as additional and time-consuming data entry or manually identifying eligible patients, result in a "behavioral bottleneck" that prevents decision support systems to become part of the clinical routine. This paper describes the design and the implementation of an integrated decision support system that explores a novel approach for bypassing the behavioral bottleneck. The real-time decision support system does not require health care providers to enter additional data and consists of a diagnostic and a management component. Images Fig. 1 Fig. 2 Fig. 3 PMID:10566348

  19. Programmable Bio-Nano-Chip Systems for Serum CA125 Quantification: Towards Ovarian Cancer Diagnostics at the Point-of-Care

    PubMed Central

    Raamanathan, Archana; Simmons, Glennon W.; Christodoulides, Nicolaos; Floriano, Pierre N.; Furmaga, Wieslaw B.; Redding, Spencer W.; Lu, Karen H.; Bast, Robert C.; McDevitt, John T.

    2013-01-01

    Point-of-care (POC) implementation of early detection and screening methodologies for ovarian cancer may enable improved survival rates through early intervention. Current laboratory-confined immunoanalyzers have long turnaround times and are often incompatible with multiplexing and POC implementation. Rapid, sensitive and multiplexable POC diagnostic platforms compatible with promising early detection approaches for ovarian cancer are needed. To this end, we report the adaptation of the programmable bio-nano-chip (p-BNC), an integrated, microfluidic, modular (Programmable) platform for CA125 serum quantitation, a biomarker prominently implicated in multi-modal and multi-marker screening approaches. In the p-BNC, CA125 from diseased sera (Bio) is sequestered and assessed with a fluorescence-based sandwich immunoassay, completed in the nano-nets (Nano) of sensitized agarose microbeads localized in individually addressable wells (Chip), housed in a microfluidic module, capable of integrating multiple sample, reagent and biowaste processing and handling steps. Antibody pairs that bind to distinct epitopes on CA125 were screened. To permit efficient biomarker sequestration in a 3-D microfluidic environment, the p-BNC operating variables (incubation times, flow rates and reagent concentrations) were tuned to deliver optimal analytical performance under 45 minutes. With short analysis times, competitive analytical performance (Inter- and intra-assay precision of 1.2% and 1.9% and LODs of 1.0 U/mL) was achieved on this mini-sensor ensemble. Further validation with sera of ovarian cancer patients (n=20) demonstrated excellent correlation (R2 = 0.97) with gold-standard ELISA. Building on the integration capabilities of novel microfluidic systems programmed for ovarian cancer, the rapid, precise and sensitive miniaturized p-BNC system shows strong promise for ovarian cancer diagnostics. PMID:22490510

  20. Programmable bio-nano-chip systems for serum CA125 quantification: toward ovarian cancer diagnostics at the point-of-care.

    PubMed

    Raamanathan, Archana; Simmons, Glennon W; Christodoulides, Nicolaos; Floriano, Pierre N; Furmaga, Wieslaw B; Redding, Spencer W; Lu, Karen H; Bast, Robert C; McDevitt, John T

    2012-05-01

    Point-of-care (POC) implementation of early detection and screening methodologies for ovarian cancer may enable improved survival rates through early intervention. Current laboratory-confined immunoanalyzers have long turnaround times and are often incompatible with multiplexing and POC implementation. Rapid, sensitive, and multiplexable POC diagnostic platforms compatible with promising early detection approaches for ovarian cancer are needed. To this end, we report the adaptation of the programmable bio-nano-chip (p-BNC), an integrated, microfluidic, and modular (programmable) platform for CA125 serum quantitation, a biomarker prominently implicated in multimodal and multimarker screening approaches. In the p-BNCs, CA125 from diseased sera (Bio) is sequestered and assessed with a fluorescence-based sandwich immunoassay, completed in the nano-nets (Nano) of sensitized agarose microbeads localized in individually addressable wells (Chip), housed in a microfluidic module, capable of integrating multiple sample, reagent and biowaste processing, and handling steps. Antibody pairs that bind to distinct epitopes on CA125 were screened. To permit efficient biomarker sequestration in a three-dimensional microfluidic environment, the p-BNC operating variables (incubation times, flow rates, and reagent concentrations) were tuned to deliver optimal analytical performance under 45 minutes. With short analysis times, competitive analytical performance (inter- and intra-assay precision of 1.2% and 1.9% and limit of detection of 1.0 U/mL) was achieved on this minisensor ensemble. Furthermore, validation with sera of patients with ovarian cancer (n = 20) showed excellent correlation (R(2) = 0.97) with gold-standard ELISA. Building on the integration capabilities of novel microfluidic systems programmed for ovarian cancer, the rapid, precise, and sensitive miniaturized p-BNC system shows strong promise for ovarian cancer diagnostics.

  1. Current challenges in diagnostic imaging of venous thromboembolism.

    PubMed

    Huisman, Menno V; Klok, Frederikus A

    2015-01-01

    Because the clinical diagnosis of deep-vein thrombosis and pulmonary embolism is nonspecific, integrated diagnostic approaches for patients with suspected venous thromboembolism have been developed over the years, involving both non-invasive bedside tools (clinical decision rules and D-dimer blood tests) for patients with low pretest probability and diagnostic techniques (compression ultrasound for deep-vein thrombosis and computed tomography pulmonary angiography for pulmonary embolism) for those with a high pretest probability. This combination has led to standardized diagnostic algorithms with proven safety for excluding venous thrombotic disease. At the same time, it has become apparent that, as a result of the natural history of venous thrombosis, there are special patient populations in which the current standard diagnostic algorithms are not sufficient. In this review, we present 3 evidence-based patient cases to underline recent developments in the imaging diagnosis of venous thromboembolism. © 2015 by The American Society of Hematology. All rights reserved.

  2. Neurosurgery contact handheld probe based on sapphire shaped crystal

    NASA Astrophysics Data System (ADS)

    Shikunova, I. A.; Stryukov, D. O.; Rossolenko, S. N.; Kiselev, A. M.; Kurlov, V. N.

    2017-01-01

    A handheld contact probe based on sapphire shaped crystal is developed for intraoperative spectrally-resolved optical diagnostics, laser coagulation and aspiration of malignant brain tissue. The technology was integrated into the neurosurgical workflow for intraoperative real-time identification and removing of invasive brain cancer.

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

    PubMed

    Ferrario, Catherine G

    2003-01-01

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

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

    PubMed

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

    2017-04-01

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

  5. Practical issues in implementing whole-genome-sequencing in routine diagnostic microbiology.

    PubMed

    Rossen, J W A; Friedrich, A W; Moran-Gilad, J

    2018-04-01

    Next generation sequencing (NGS) is increasingly being used in clinical microbiology. Like every new technology adopted in microbiology, the integration of NGS into clinical and routine workflows must be carefully managed. To review the practical aspects of implementing bacterial whole genome sequencing (WGS) in routine diagnostic laboratories. Review of the literature and expert opinion. In this review, we discuss when and how to integrate whole genome sequencing (WGS) in the routine workflow of the clinical laboratory. In addition, as the microbiology laboratories have to adhere to various national and international regulations and criteria for their accreditation, we deliberate on quality control issues for using WGS in microbiology, including the importance of proficiency testing. Furthermore, the current and future place of this technology in the diagnostic hierarchy of microbiology is described as well as the necessity of maintaining backwards compatibility with already established methods. Finally, we speculate on the question of whether WGS can entirely replace routine microbiology in the future and the tension between the fact that most sequencers are designed to process multiple samples in parallel whereas for optimal diagnosis a one-by-one processing of the samples is preferred. Special reference is made to the cost and turnaround time of WGS in diagnostic laboratories. Further development is required to improve the workflow for WGS, in particular to shorten the turnaround time, reduce costs, and streamline downstream data analyses. Only when these processes reach maturity will reliance on WGS for routine patient management and infection control management become feasible, enabling the transformation of clinical microbiology into a genome-based and personalized diagnostic field. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  6. An Integrated Architecture for On-Board Aircraft Engine Performance Trend Monitoring and Gas Path Fault Diagnostics

    NASA Technical Reports Server (NTRS)

    Simon, Donald L.

    2010-01-01

    Aircraft engine performance trend monitoring and gas path fault diagnostics are closely related technologies that assist operators in managing the health of their gas turbine engine assets. Trend monitoring is the process of monitoring the gradual performance change that an aircraft engine will naturally incur over time due to turbomachinery deterioration, while gas path diagnostics is the process of detecting and isolating the occurrence of any faults impacting engine flow-path performance. Today, performance trend monitoring and gas path fault diagnostic functions are performed by a combination of on-board and off-board strategies. On-board engine control computers contain logic that monitors for anomalous engine operation in real-time. Off-board ground stations are used to conduct fleet-wide engine trend monitoring and fault diagnostics based on data collected from each engine each flight. Continuing advances in avionics are enabling the migration of portions of the ground-based functionality on-board, giving rise to more sophisticated on-board engine health management capabilities. This paper reviews the conventional engine performance trend monitoring and gas path fault diagnostic architecture commonly applied today, and presents a proposed enhanced on-board architecture for future applications. The enhanced architecture gains real-time access to an expanded quantity of engine parameters, and provides advanced on-board model-based estimation capabilities. The benefits of the enhanced architecture include the real-time continuous monitoring of engine health, the early diagnosis of fault conditions, and the estimation of unmeasured engine performance parameters. A future vision to advance the enhanced architecture is also presented and discussed

  7. Integration of basic sciences and clinical sciences in oral radiology education for dental students.

    PubMed

    Baghdady, Mariam T; Carnahan, Heather; Lam, Ernest W N; Woods, Nicole N

    2013-06-01

    Educational research suggests that cognitive processing in diagnostic radiology requires a solid foundation in the basic sciences and knowledge of the radiological changes associated with disease. Although it is generally assumed that dental students must acquire both sets of knowledge, little is known about the most effective way to teach them. Currently, the basic and clinical sciences are taught separately. This study was conducted to compare the diagnostic accuracy of students when taught basic sciences segregated or integrated with clinical features. Predoctoral dental students (n=51) were taught four confusable intrabony abnormalities using basic science descriptions integrated with the radiographic features or taught segregated from the radiographic features. The students were tested with diagnostic images, and memory tests were performed immediately after learning and one week later. On immediate and delayed testing, participants in the integrated basic science group outperformed those from the segregated group. A main effect of learning condition was found to be significant (p<0.05). The results of this study support the critical role of integrating biomedical knowledge in diagnostic radiology and shows that teaching basic sciences integrated with clinical features produces higher diagnostic accuracy in novices than teaching basic sciences segregated from clinical features.

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

    PubMed Central

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

    2013-01-01

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

  9. Real-time Raman spectroscopy for in vivo, online gastric cancer diagnosis during clinical endoscopic examination.

    PubMed

    Duraipandian, Shiyamala; Sylvest Bergholt, Mads; Zheng, Wei; Yu Ho, Khek; Teh, Ming; Guan Yeoh, Khay; Bok Yan So, Jimmy; Shabbir, Asim; Huang, Zhiwei

    2012-08-01

    Optical spectroscopic techniques including reflectance, fluorescence and Raman spectroscopy have shown promising potential for in vivo precancer and cancer diagnostics in a variety of organs. However, data-analysis has mostly been limited to post-processing and off-line algorithm development. In this work, we develop a fully automated on-line Raman spectral diagnostics framework integrated with a multimodal image-guided Raman technique for real-time in vivo cancer detection at endoscopy. A total of 2748 in vivo gastric tissue spectra (2465 normal and 283 cancer) were acquired from 305 patients recruited to construct a spectral database for diagnostic algorithms development. The novel diagnostic scheme developed implements on-line preprocessing, outlier detection based on principal component analysis statistics (i.e., Hotelling's T2 and Q-residuals) for tissue Raman spectra verification as well as for organ specific probabilistic diagnostics using different diagnostic algorithms. Free-running optical diagnosis and processing time of < 0.5 s can be achieved, which is critical to realizing real-time in vivo tissue diagnostics during clinical endoscopic examination. The optimized partial least squares-discriminant analysis (PLS-DA) models based on the randomly resampled training database (80% for learning and 20% for testing) provide the diagnostic accuracy of 85.6% [95% confidence interval (CI): 82.9% to 88.2%] [sensitivity of 80.5% (95% CI: 71.4% to 89.6%) and specificity of 86.2% (95% CI: 83.6% to 88.7%)] for the detection of gastric cancer. The PLS-DA algorithms are further applied prospectively on 10 gastric patients at gastroscopy, achieving the predictive accuracy of 80.0% (60/75) [sensitivity of 90.0% (27/30) and specificity of 73.3% (33/45)] for in vivo diagnosis of gastric cancer. The receiver operating characteristics curves further confirmed the efficacy of Raman endoscopy together with PLS-DA algorithms for in vivo prospective diagnosis of gastric cancer. This work successfully moves biomedical Raman spectroscopic technique into real-time, on-line clinical cancer diagnosis, especially in routine endoscopic diagnostic applications.

  10. Real-time Raman spectroscopy for in vivo, online gastric cancer diagnosis during clinical endoscopic examination

    NASA Astrophysics Data System (ADS)

    Duraipandian, Shiyamala; Sylvest Bergholt, Mads; Zheng, Wei; Yu Ho, Khek; Teh, Ming; Guan Yeoh, Khay; Bok Yan So, Jimmy; Shabbir, Asim; Huang, Zhiwei

    2012-08-01

    Optical spectroscopic techniques including reflectance, fluorescence and Raman spectroscopy have shown promising potential for in vivo precancer and cancer diagnostics in a variety of organs. However, data-analysis has mostly been limited to post-processing and off-line algorithm development. In this work, we develop a fully automated on-line Raman spectral diagnostics framework integrated with a multimodal image-guided Raman technique for real-time in vivo cancer detection at endoscopy. A total of 2748 in vivo gastric tissue spectra (2465 normal and 283 cancer) were acquired from 305 patients recruited to construct a spectral database for diagnostic algorithms development. The novel diagnostic scheme developed implements on-line preprocessing, outlier detection based on principal component analysis statistics (i.e., Hotelling's T2 and Q-residuals) for tissue Raman spectra verification as well as for organ specific probabilistic diagnostics using different diagnostic algorithms. Free-running optical diagnosis and processing time of < 0.5 s can be achieved, which is critical to realizing real-time in vivo tissue diagnostics during clinical endoscopic examination. The optimized partial least squares-discriminant analysis (PLS-DA) models based on the randomly resampled training database (80% for learning and 20% for testing) provide the diagnostic accuracy of 85.6% [95% confidence interval (CI): 82.9% to 88.2%] [sensitivity of 80.5% (95% CI: 71.4% to 89.6%) and specificity of 86.2% (95% CI: 83.6% to 88.7%)] for the detection of gastric cancer. The PLS-DA algorithms are further applied prospectively on 10 gastric patients at gastroscopy, achieving the predictive accuracy of 80.0% (60/75) [sensitivity of 90.0% (27/30) and specificity of 73.3% (33/45)] for in vivo diagnosis of gastric cancer. The receiver operating characteristics curves further confirmed the efficacy of Raman endoscopy together with PLS-DA algorithms for in vivo prospective diagnosis of gastric cancer. This work successfully moves biomedical Raman spectroscopic technique into real-time, on-line clinical cancer diagnosis, especially in routine endoscopic diagnostic applications.

  11. Integration of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry in blood culture diagnostics: a fast and effective approach.

    PubMed

    Klein, Sabrina; Zimmermann, Stefan; Köhler, Christine; Mischnik, Alexander; Alle, Werner; Bode, Konrad A

    2012-03-01

    Sepsis is a major cause of mortality in hospitalized patients worldwide, with lethality rates ranging from 30 to 70 %. Sepsis is caused by a variety of different pathogens, and rapid diagnosis is of outstanding importance, as early and adequate antimicrobial therapy correlates with positive clinical outcome. In recent years, matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry (MS) fingerprinting has become a powerful tool in microbiological diagnostics. The direct identification of micro-organisms in a positive blood culture by MALDI-TOF MS can shorten the diagnostic procedure significantly. Therefore, the aim of the present study was to evaluate whether identification rates could be improved by using the new Sepsityper kit from Bruker Daltonics for direct isolation and identification of bacteria from positive blood cultures by MALDI-TOF MS compared with the use of conventional separator gel columns, and to integrate the MALDI-TOF MS-based identification method into the routine course of blood culture diagnostics in the setting of a microbiological laboratory at a university hospital in Germany. The identification of Gram-negative bacteria by MALDI-TOF MS was significantly better using the Sepsityper kit compared with a separator gel tube-based method (99 and 68 % correct identification, respectively). For Gram-positive bacteria, only 73 % were correctly identified by MALDI-TOF with the Sepsityper kit and 59 % with the separator gel tube assay. A major problem of both methods was the poor identification of Gram-positive grape-like clustered cocci. As differentiation of Staphylococcus aureus from coagulase-negative staphylococci is of clinical importance, a PCR was additionally established that was capable of identifying S. aureus directly from positive blood cultures, thus closing this diagnostic gap. Another benefit of the PCR approach is the possibility of directly detecting the genes responsible for meticillin resistance in staphylococci and for vancomycin resistance in enterococci, which is of high importance for early adequate treatment. Both of the described methods were finally integrated into a protocol for fast and effective identification of bacteria from positive blood cultures.

  12. Dynamic CT myocardial perfusion imaging: performance of 3D semi-automated evaluation software.

    PubMed

    Ebersberger, Ullrich; Marcus, Roy P; Schoepf, U Joseph; Lo, Gladys G; Wang, Yining; Blanke, Philipp; Geyer, Lucas L; Gray, J Cranston; McQuiston, Andrew D; Cho, Young Jun; Scheuering, Michael; Canstein, Christian; Nikolaou, Konstantin; Hoffmann, Ellen; Bamberg, Fabian

    2014-01-01

    To evaluate the performance of three-dimensional semi-automated evaluation software for the assessment of myocardial blood flow (MBF) and blood volume (MBV) at dynamic myocardial perfusion computed tomography (CT). Volume-based software relying on marginal space learning and probabilistic boosting tree-based contour fitting was applied to CT myocardial perfusion imaging data of 37 subjects. In addition, all image data were analysed manually and both approaches were compared with SPECT findings. Study endpoints included time of analysis and conventional measures of diagnostic accuracy. Of 592 analysable segments, 42 showed perfusion defects on SPECT. Average analysis times for the manual and software-based approaches were 49.1 ± 11.2 and 16.5 ± 3.7 min respectively (P < 0.01). There was strong agreement between the two measures of interest (MBF, ICC = 0.91, and MBV, ICC = 0.88, both P < 0.01) and no significant difference in MBF/MBV with respect to diagnostic accuracy between the two approaches for both MBF and MBV for manual versus software-based approach; respectively; all comparisons P > 0.05. Three-dimensional semi-automated evaluation of dynamic myocardial perfusion CT data provides similar measures and diagnostic accuracy to manual evaluation, albeit with substantially reduced analysis times. This capability may aid the integration of this test into clinical workflows. • Myocardial perfusion CT is attractive for comprehensive coronary heart disease assessment. • Traditional image analysis methods are cumbersome and time-consuming. • Automated 3D perfusion software shortens analysis times. • Automated 3D perfusion software increases standardisation of myocardial perfusion CT. • Automated, standardised analysis fosters myocardial perfusion CT integration into clinical practice.

  13. How do organisational characteristics influence teamwork and service delivery in lung cancer diagnostic assessment programmes? A mixed-methods study

    PubMed Central

    Honein-AbouHaidar, Gladys N; Stuart-McEwan, Terri; Waddell, Tom; Salvarrey, Alexandra; Smylie, Jennifer; Dobrow, Mark J; Brouwers, Melissa C; Gagliardi, Anna R

    2017-01-01

    Objectives Diagnostic assessment programmes (DAPs) can reduce wait times for cancer diagnosis, but optimal DAP design is unknown. This study explored how organisational characteristics influenced multidisciplinary teamwork and diagnostic service delivery in lung cancer DAPs. Design A mixed-methods approach integrated data from descriptive qualitative interviews and medical record abstraction at 4 lung cancer DAPs. Findings were analysed with the Integrated Team Effectiveness Model. Setting 4 DAPs at 2 teaching and 2 community hospitals in Canada. Participants 22 staff were interviewed about organisational characteristics, target service benchmarks, and teamwork processes, determinants and outcomes; 314 medical records were reviewed for actual service benchmarks. Results Formal, informal and asynchronous team processes enabled service delivery and yielded many perceived benefits at the patient, staff and service levels. However, several DAP characteristics challenged teamwork and service delivery: referral volume/workload, time since launch, days per week of operation, rural–remote population, number and type of full-time/part-time human resources, staff colocation, information systems. As a result, all sites failed to meet target benchmarks (from referral to consultation median 4.0 visits, median wait time 35.0 days). Recommendations included improved information systems, more staff in all specialties, staff colocation and expanded roles for patient navigators. Findings were captured in a conceptual framework of lung cancer DAP teamwork determinants and outcomes. Conclusions This study identified several DAP characteristics that could be improved to facilitate teamwork and enhance service delivery, thereby contributing to knowledge of organisational determinants of teamwork and associated outcomes. Findings can be used to update existing DAP guidelines, and by managers to plan or evaluate lung cancer DAPs. Ongoing research is needed to identify ideal roles for navigators, and staffing models tailored to case volumes. PMID:28235969

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

    NASA Technical Reports Server (NTRS)

    Kobayashi, Takahisa; Simon, Donald L.

    2007-01-01

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

  15. Spiral-Bevel-Gear Damage Detected Using Decision Fusion Analysis

    NASA Technical Reports Server (NTRS)

    Dempsey, Paula J.; Handschuh, Robert F.

    2003-01-01

    Helicopter transmission integrity is critical to helicopter safety because helicopters depend on the power train for propulsion, lift, and flight maneuvering. To detect impending transmission failures, the ideal diagnostic tools used in the health-monitoring system would provide real-time health monitoring of the transmission, demonstrate a high level of reliable detection to minimize false alarms, and provide end users with clear information on the health of the system without requiring them to interpret large amounts of sensor data. A diagnostic tool for detecting damage to spiral bevel gears was developed. (Spiral bevel gears are used in helicopter transmissions to transfer power between nonparallel intersecting shafts.) Data fusion was used to integrate two different monitoring technologies, oil debris analysis and vibration, into a health-monitoring system for detecting surface fatigue pitting damage on the gears.

  16. Intelligent approach to prognostic enhancements of diagnostic systems

    NASA Astrophysics Data System (ADS)

    Vachtsevanos, George; Wang, Peng; Khiripet, Noppadon; Thakker, Ash; Galie, Thomas R.

    2001-07-01

    This paper introduces a novel methodology to prognostics based on a dynamic wavelet neural network construct and notions from the virtual sensor area. This research has been motivated and supported by the U.S. Navy's active interest in integrating advanced diagnostic and prognostic algorithms in existing Naval digital control and monitoring systems. A rudimentary diagnostic platform is assumed to be available providing timely information about incipient or impending failure conditions. We focus on the development of a prognostic algorithm capable of predicting accurately and reliably the remaining useful lifetime of a failing machine or component. The prognostic module consists of a virtual sensor and a dynamic wavelet neural network as the predictor. The virtual sensor employs process data to map real measurements into difficult to monitor fault quantities. The prognosticator uses a dynamic wavelet neural network as a nonlinear predictor. Means to manage uncertainty and performance metrics are suggested for comparison purposes. An interface to an available shipboard Integrated Condition Assessment System is described and applications to shipboard equipment are discussed. Typical results from pump failures are presented to illustrate the effectiveness of the methodology.

  17. Integrating Clinical Services for HIV, Tuberculosis, and Cryptococcal Disease in the Developing World: A Step Forward with 2 Novel Diagnostic Tests

    PubMed Central

    Vijayan, Tara; Klausner, Jeffrey D.

    2014-01-01

    The success of antiretroviral therapy (ART) programs in the developing world is limited by the lack of adequate diagnostic tests to screen for life-threatening opportunistic infections such as tuberculosis (TB) and cryptococcal disease. Furthermore, there is an increasing need for implementation research in measuring the effectiveness of currently available rapid diagnostic tests. The recently developed lateral flow assays for both cryptococcal disease and TB have the potential to improve care and greatly reduce the time to initiation of ART among individuals who need it the most. However, we caution that the data on feasibility and effectiveness of these assays are limited and such research agendas must be prioritized. PMID:24065780

  18. Automated System Checkout to Support Predictive Maintenance for the Reusable Launch Vehicle

    NASA Technical Reports Server (NTRS)

    Patterson-Hine, Ann; Deb, Somnath; Kulkarni, Deepak; Wang, Yao; Lau, Sonie (Technical Monitor)

    1998-01-01

    The Propulsion Checkout and Control System (PCCS) is a predictive maintenance software system. The real-time checkout procedures and diagnostics are designed to detect components that need maintenance based on their condition, rather than using more conventional approaches such as scheduled or reliability centered maintenance. Predictive maintenance can reduce turn-around time and cost and increase safety as compared to conventional maintenance approaches. Real-time sensor validation, limit checking, statistical anomaly detection, and failure prediction based on simulation models are employed. Multi-signal models, useful for testability analysis during system design, are used during the operational phase to detect and isolate degraded or failed components. The TEAMS-RT real-time diagnostic engine was developed to utilize the multi-signal models by Qualtech Systems, Inc. Capability of predicting the maintenance condition was successfully demonstrated with a variety of data, from simulation to actual operation on the Integrated Propulsion Technology Demonstrator (IPTD) at Marshall Space Flight Center (MSFC). Playback of IPTD valve actuations for feature recognition updates identified an otherwise undetectable Main Propulsion System 12 inch prevalve degradation. The algorithms were loaded into the Propulsion Checkout and Control System for further development and are the first known application of predictive Integrated Vehicle Health Management to an operational cryogenic testbed. The software performed successfully in real-time, meeting the required performance goal of 1 second cycle time.

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

    PubMed

    Geißler, Daniel; Hildebrandt, Niko

    2016-07-01

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

  20. Applying EVM to Satellite on Ground and In-Orbit Testing - Better Data in Less Time

    NASA Technical Reports Server (NTRS)

    Peters, Robert; Lebbink, Elizabeth-Klein; Lee, Victor; Model, Josh; Wezalis, Robert; Taylor, John

    2008-01-01

    Using Error Vector Magnitude (EVM) in satellite integration and test allows rapid verification of the Bit Error Rate (BER) performance of a satellite link and is particularly well suited to measurement of low bit rate satellite links where it can result in a major reduction in test time (about 3 weeks per satellite for the Geosynchronous Operational Environmental Satellite [GOES] satellites during ground test) and can provide diagnostic information. Empirical techniques developed to predict BER performance from EVM measurements and lessons learned about applying these techniques during GOES N, O, and P integration test and post launch testing, are discussed.

  1. Development of an Internal Real-Time Wireless Diagnostic Tool for a Proton Exchange Membrane Fuel Cell

    PubMed Central

    Lee, Chi-Yuan; Chen, Chia-Hung; Tsai, Chao-Hsuan; Wang, Yu-Syuan

    2018-01-01

    To prolong the operating time of unmanned aerial vehicles which use proton exchange membrane fuel cells (PEMFC), the performance of PEMFC is the key. However, a long-term operation can make the Pt particles of the catalyst layer and the pollutants in the feedstock gas bond together (e.g., CO), so that the catalyst loses reaction activity. The performance decay and aging of PEMFC will be influenced by operating conditions, temperature, flow and CO concentration. Therefore, this study proposes the development of an internal real-time wireless diagnostic tool for PEMFC, and uses micro-electro-mechanical systems (MEMS) technology to develop a wireless and thin (<50 μm) flexible integrated (temperature, flow and CO) microsensor. The technical advantages are (1) compactness and three wireless measurement functions; (2) elastic measurement position and accurate embedding; (3) high accuracy and sensitivity and quick response; (4) real-time wireless monitoring of dynamic performance of PEMFC; (5) customized design and development. The flexible integrated microsensor is embedded in the PEMFC, three important physical quantities in the PEMFC, which are the temperature, flow and CO, can be measured simultaneously and instantly, so as to obtain the authentic and complete reaction in the PEMFC to enhance the performance of PEMFC and to prolong the service life. PMID:29342832

  2. Development of an Internal Real-Time Wireless Diagnostic Tool for a Proton Exchange Membrane Fuel Cell.

    PubMed

    Lee, Chi-Yuan; Chen, Chia-Hung; Tsai, Chao-Hsuan; Wang, Yu-Syuan

    2018-01-13

    To prolong the operating time of unmanned aerial vehicles which use proton exchange membrane fuel cells (PEMFC), the performance of PEMFC is the key. However, a long-term operation can make the Pt particles of the catalyst layer and the pollutants in the feedstock gas bond together (e.g., CO), so that the catalyst loses reaction activity. The performance decay and aging of PEMFC will be influenced by operating conditions, temperature, flow and CO concentration. Therefore, this study proposes the development of an internal real-time wireless diagnostic tool for PEMFC, and uses micro-electro-mechanical systems (MEMS) technology to develop a wireless and thin (<50 μm) flexible integrated (temperature, flow and CO) microsensor. The technical advantages are (1) compactness and three wireless measurement functions; (2) elastic measurement position and accurate embedding; (3) high accuracy and sensitivity and quick response; (4) real-time wireless monitoring of dynamic performance of PEMFC; (5) customized design and development. The flexible integrated microsensor is embedded in the PEMFC, three important physical quantities in the PEMFC, which are the temperature, flow and CO, can be measured simultaneously and instantly, so as to obtain the authentic and complete reaction in the PEMFC to enhance the performance of PEMFC and to prolong the service life.

  3. New and developing diagnostic technologies for urinary tract infections

    PubMed Central

    Davenport, Michael; Mach, Kathleen E.; Dairiki Shortliffe, Linda M.; Banaei, Niaz; Wang, Tza-Huei; Liao, Joseph C.

    2017-01-01

    Timely and accurate identification and determination of the antimicrobial susceptibility of uropathogens is central to the management of UTIs. Urine dipsticks are fast and amenable to point-of-care testing, but do not have adequate diagnostic accuracy or provide microbiological diagnosis. Urine culture with antimicrobial susceptibility testing takes 2 3 days and requires a clinical laboratory. The common use of empirical antibiotics has contributed to the rise of multidrug-resistant organisms, reducing treatment options and increasing costs. In addition to improved antimicrobial stewardship and the development of new antimicrobials, novel diagnostics are needed for timely microbial identification and determination of antimicrobial susceptibilities. New diagnostic platforms, including nucleic acid tests and mass spectrometry, have been approved for clinical use and have improved the speed and accuracy of pathogen identification from primary cultures. Optimization for direct urine testing would reduce the time to diagnosis, yet these technologies do not provide comprehensive information on antimicrobial susceptibility. Emerging technologies including biosensors, microfluidics, and other integrated platforms could improve UTI diagnosis via direct pathogen detection from urine samples, rapid antimicrobial susceptibility testing, and point-of-care testing. Successful development and implementation of these technologies has the potential to usher in an era of precision medicine to improve patient care and public health. PMID:28248946

  4. Technical Performance Measurement, Earned Value, and Risk Management: An Integrated Diagnostic Tool for Program Management

    DTIC Science & Technology

    2002-06-01

    time, the monkey would eventually produce the collected works of Shakespeare . Unfortunately for the analogist, systems, even live ones, do not work...limited his simulated computer monkey to producing, in a single random step, the sentence uttered by Polonius in the play Hamlet : “Methinks it is

  5. Diagnostics for the Analysis of Surface Chemistry Effects on Composite Energetic Material Reactions

    DTIC Science & Technology

    2015-10-30

    integration time) and a NETZSCH STA 449 Jupiter that will allow for consistency and efficiency with its automatic 20 sample changer. (2) Together these...Purchase of the NETZSCH STA 449 Jupiter (DSC-TGA) to resolve reaction kinetics under equilibrium conditions. Images of this instrumentation are included in

  6. 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.

  7. Computational integration of nanoscale physical biomarkers and cognitive assessments for Alzheimer’s disease diagnosis and prognosis

    PubMed Central

    Yue, Tao; Jia, Xinghua; Petrosino, Jennifer; Sun, Leming; Fan, Zhen; Fine, Jesse; Davis, Rebecca; Galster, Scott; Kuret, Jeff; Scharre, Douglas W.; Zhang, Mingjun

    2017-01-01

    With the increasing prevalence of Alzheimer’s disease (AD), significant efforts have been directed toward developing novel diagnostics and biomarkers that can enhance AD detection and management. AD affects the cognition, behavior, function, and physiology of patients through mechanisms that are still being elucidated. Current AD diagnosis is contingent on evaluating which symptoms and signs a patient does or does not display. Concerns have been raised that AD diagnosis may be affected by how those measurements are analyzed. Unbiased means of diagnosing AD using computational algorithms that integrate multidisciplinary inputs, ranging from nanoscale biomarkers to cognitive assessments, and integrating both biochemical and physical changes may provide solutions to these limitations due to lack of understanding for the dynamic progress of the disease coupled with multiple symptoms in multiscale. We show that nanoscale physical properties of protein aggregates from the cerebral spinal fluid and blood of patients are altered during AD pathogenesis and that these properties can be used as a new class of “physical biomarkers.” Using a computational algorithm, developed to integrate these biomarkers and cognitive assessments, we demonstrate an approach to impartially diagnose AD and predict its progression. Real-time diagnostic updates of progression could be made on the basis of the changes in the physical biomarkers and the cognitive assessment scores of patients over time. Additionally, the Nyquist-Shannon sampling theorem was used to determine the minimum number of necessary patient checkups to effectively predict disease progression. This integrated computational approach can generate patient-specific, personalized signatures for AD diagnosis and prognosis. PMID:28782028

  8. Evidence and diagnostic reporting in the IHE context.

    PubMed

    Loef, Cor; Truyen, Roel

    2005-05-01

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

  9. Notes on the design of experiments and beam diagnostics with synchrotron light detected by a gated photomultiplier for the Fermilab superconducting electron linac and for the Integrable Optics Test Accelerator (IOTA)

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

    Stancari, Giulio; Romanov, Aleksandr; Ruan, Jinhao

    We outline the design of beam experiments for the electron linac at the Fermilab Accelerator Science and Technology (FAST) facility and for the Integrable Optics Test Accelerator (IOTA), based on synchrotron light emitted by the electrons in bend dipoles, detected with gated microchannel-plate photomultipliers (MCP-PMTs). The system can be used both for beam diagnostics (e.g., beam intensity with full dynamic range, turn-by-turn beam vibrations, etc.) and for scientific experiments, such as the direct observation of the time structure of the radiation emitted by single electrons in a storage ring. The similarity between photon pulses and spectrum at the downstream endmore » of the electron linac and in the IOTA ring allows one to test the apparatus during commissioning of the linac.« less

  10. Droplet-based Biosensing for Lab-on-a-Chip, Open Microfluidics Platforms

    PubMed Central

    Dak, Piyush; Ebrahimi, Aida; Swaminathan, Vikhram; Duarte-Guevara, Carlos; Bashir, Rashid; Alam, Muhammad A.

    2016-01-01

    Low cost, portable sensors can transform health care by bringing easily available diagnostic devices to low and middle income population, particularly in developing countries. Sample preparation, analyte handling and labeling are primary cost concerns for traditional lab-based diagnostic systems. Lab-on-a-chip (LoC) platforms based on droplet-based microfluidics promise to integrate and automate these complex and expensive laboratory procedures onto a single chip; the cost will be further reduced if label-free biosensors could be integrated onto the LoC platforms. Here, we review some recent developments of label-free, droplet-based biosensors, compatible with “open” digital microfluidic systems. These low-cost droplet-based biosensors overcome some of the fundamental limitations of the classical sensors, enabling timely diagnosis. We identify the key challenges that must be addressed to make these sensors commercially viable and summarize a number of promising research directions. PMID:27089377

  11. Nanoparticle functionalised small-core suspended-core fibre - a novel platform for efficient sensing.

    PubMed

    Doherty, Brenda; Csáki, Andrea; Thiele, Matthias; Zeisberger, Matthias; Schwuchow, Anka; Kobelke, Jens; Fritzsche, Wolfgang; Schmidt, Markus A

    2017-02-01

    Detecting small quantities of specific target molecules is of major importance within bioanalytics for efficient disease diagnostics. One promising sensing approach relies on combining plasmonically-active waveguides with microfluidics yielding an easy-to-use sensing platform. Here we introduce suspended-core fibres containing immobilised plasmonic nanoparticles surrounding the guiding core as a concept for an entirely integrated optofluidic platform for efficient refractive index sensing. Due to the extremely small optical core and the large adjacent microfluidic channels, over two orders of magnitude of nanoparticle coverage densities have been accessed with millimetre-long sample lengths showing refractive index sensitivities of 170 nm/RIU for aqueous analytes where the fibre interior is functionalised by gold nanospheres. Our concept represents a fully integrated optofluidic sensing system demanding small sample volumes and allowing for real-time analyte monitoring, both of which are highly relevant within invasive bioanalytics, particularly within molecular disease diagnostics and environmental science.

  12. Droplet-based Biosensing for Lab-on-a-Chip, Open Microfluidics Platforms.

    PubMed

    Dak, Piyush; Ebrahimi, Aida; Swaminathan, Vikhram; Duarte-Guevara, Carlos; Bashir, Rashid; Alam, Muhammad A

    2016-04-14

    Low cost, portable sensors can transform health care by bringing easily available diagnostic devices to low and middle income population, particularly in developing countries. Sample preparation, analyte handling and labeling are primary cost concerns for traditional lab-based diagnostic systems. Lab-on-a-chip (LoC) platforms based on droplet-based microfluidics promise to integrate and automate these complex and expensive laboratory procedures onto a single chip; the cost will be further reduced if label-free biosensors could be integrated onto the LoC platforms. Here, we review some recent developments of label-free, droplet-based biosensors, compatible with "open" digital microfluidic systems. These low-cost droplet-based biosensors overcome some of the fundamental limitations of the classical sensors, enabling timely diagnosis. We identify the key challenges that must be addressed to make these sensors commercially viable and summarize a number of promising research directions.

  13. A novel integration of spectral-domain optical-coherence-tomography and laser-ablation system for precision treatment.

    PubMed

    Fan, Yingwei; Zhang, Boyu; Chang, Wei; Zhang, Xinran; Liao, Hongen

    2018-03-01

    Complete resection of diseased lesions reduces the recurrence of cancer, making it critical for surgical treatment. However, precisely resecting residual tumors is a challenge during operation. A novel integrated spectral-domain optical-coherence-tomography (SD-OCT) and laser-ablation therapy system for soft-biological-tissue resection is proposed. This is a prototype optical integrated diagnosis and therapeutic system as well as an optical theranostics system. We develop an optical theranostics system, which integrates SD-OCT, a laser-ablation unit, and an automatic scanning platform. The SD-OCT image of biological tissue provides an intuitive and clear view for intraoperative diagnosis and monitoring in real time. The effect of laser ablation is analyzed using a quantitative mathematical model. The automatic endoscopic scanning platform combines an endoscopic probe and an SD-OCT sample arm to provide optical theranostic scanning motion. An optical fiber and a charge-coupled device camera are integrated into the endoscopic probe, allowing detection and coupling of the OCT-aiming beam and laser spots. The integrated diagnostic and therapeutic system combines SD-OCT imaging and laser-ablation modules with an automatic scanning platform. OCT imaging, laser-ablation treatment, and the integration and control of diagnostic and therapeutic procedures were evaluated by performing phantom experiments. Furthermore, SD-OCT-guided laser ablation provided precision laser ablation and resection for the malignant lesions in soft-biological-tissue-lesion surgery. The results demonstrated that the appropriate laser-radiation power and duration time were 10 W and 10 s, respectively. In the laser-ablation evaluation experiment, the error reached approximately 0.1 mm. Another validation experiment was performed to obtain OCT images of the pre- and post-ablated craters of ex vivo porcine brainstem. We propose an optical integrated diagnosis and therapeutic system. The primary experimental results show the high efficiency and feasibility of our theranostics system, which is promising for realizing accurate resection of tumors in vivo and in situ in the future.

  14. Integrated System Health Management (ISHM) for Test Stand and J-2X Engine: Core Implementation

    NASA Technical Reports Server (NTRS)

    Figueroa, Jorge F.; Schmalzel, John L.; Aguilar, Robert; Shwabacher, Mark; Morris, Jon

    2008-01-01

    ISHM capability enables a system to detect anomalies, determine causes and effects, predict future anomalies, and provides an integrated awareness of the health of the system to users (operators, customers, management, etc.). NASA Stennis Space Center, NASA Ames Research Center, and Pratt & Whitney Rocketdyne have implemented a core ISHM capability that encompasses the A1 Test Stand and the J-2X Engine. The implementation incorporates all aspects of ISHM; from anomaly detection (e.g. leaks) to root-cause-analysis based on failure mode and effects analysis (FMEA), to a user interface for an integrated visualization of the health of the system (Test Stand and Engine). The implementation provides a low functional capability level (FCL) in that it is populated with few algorithms and approaches for anomaly detection, and root-cause trees from a limited FMEA effort. However, it is a demonstration of a credible ISHM capability, and it is inherently designed for continuous and systematic augmentation of the capability. The ISHM capability is grounded on an integrating software environment used to create an ISHM model of the system. The ISHM model follows an object-oriented approach: includes all elements of the system (from schematics) and provides for compartmentalized storage of information associated with each element. For instance, a sensor object contains a transducer electronic data sheet (TEDS) with information that might be used by algorithms and approaches for anomaly detection, diagnostics, etc. Similarly, a component, such as a tank, contains a Component Electronic Data Sheet (CEDS). Each element also includes a Health Electronic Data Sheet (HEDS) that contains health-related information such as anomalies and health state. Some practical aspects of the implementation include: (1) near real-time data flow from the test stand data acquisition system through the ISHM model, for near real-time detection of anomalies and diagnostics, (2) insertion of the J-2X predictive model providing predicted sensor values for comparison with measured values and use in anomaly detection and diagnostics, and (3) insertion of third-party anomaly detection algorithms into the integrated ISHM model.

  15. Examining Curricular Integration Strategies To Optimize Learning Of The Anatomical Sciences

    NASA Astrophysics Data System (ADS)

    Lisk, Kristina Adriana Ayako

    Background: Integration of basic and clinical science knowledge is essential to clinical practice. Although the importance of these two knowledge domains is well-recognized, successfully supporting the development of learners' integrated basic and clinical science knowledge, remains an educational challenge. In this dissertation, I examine curricular integration strategies to optimize learning of the anatomical sciences. Objectives: The studies were designed to achieve the following research aims: 1) to objectively identify clinically relevant content for an integrated musculoskeletal anatomy curriculum; 2) to examine the value of integrated anatomy and clinical science instruction compared to clinical science instruction alone on novices' diagnostic accuracy and diagnostic reasoning process; 3) to compare the effect of integrating and segregating anatomy and clinical science instruction along with a learning strategy (self-explanation) on novices' diagnostic accuracy. Methods: A modified Delphi was used to objectively select clinically relevant content for an integrated musculoskeletal anatomy curriculum. Two experimental studies were created to compare different instructional strategies to optimize learning of the curricular content. In both of these studies, novice learners were taught the clinical features of musculoskeletal pathologies using different learning approaches. Diagnostic performance was measured immediately after instruction and one-week later. Results: The results show that the Delphi method is an effective strategy to select clinically relevant content for integrated anatomy curricula. The findings also demonstrate that novices who were explicitly taught the clinical features of musculoskeletal diseases using causal basic science descriptions had superior diagnostic accuracy and a better understanding of the relative importance of key clinical features for disease categories. Conclusions: This research demonstrates how integration strategies can be applied at multiple levels of the curriculum. Further, this work shows the value of cognitive integration of anatomy and clinical science and it emphasizes the importance of purposefully linking the anatomical and clinical sciences in day-to-day teaching.

  16. Diagnostics for Z-pinch implosion experiments on PTS

    NASA Astrophysics Data System (ADS)

    Ren, X. D.; Huang, X. B.; Zhou, S. T.; Zhang, S. Q.; Dan, J. K.; Li, J.; Cai, H. C.; Wang, K. L.; Ouyang, K.; Xu, Q.; Duan, S. C.; Chen, G. H.; Wang, M.; Feng, S. P.; Yang, L. B.; Xie, W. P.; Deng, J. J.

    2014-12-01

    The preliminary experiments of wire array implosion were performed on PTS, a 10 MA z-pinch driver with a 70 ns rise time. A set of diagnostics have been developed and fielded on PTS to study pinch physics and implosion dynamics of wire array. Radiated power measurement for soft x-rays was performed by multichannel filtered x-ray diode array, and flat spectral responses x-ray diode detector. Total x-ray yield was measured by a calibrated, unfiltered nickel bolometer which was also used to obtain pinch power. Multiple time-gated pinhole cameras were used to produce spatial-resolved images of x-ray self-emission from plasmas. Two time-integrated pinhole cameras were used respectively with 20-μm Be filter and with multilayer mirrors to record images produced by >1-keV and 277±5 eV self-emission. An optical streak camera was used to produce radial implosion trajectories, and an x-ray streak camera paired with a horizontal slit was used to record a continuous time-history of emission with one-dimensional spatial resolution. A frequency-doubled Nd:YAG laser (532 nm) was used to produce four frame laser shadowgraph images with 6 ns time interval. We will briefly describe each of these diagnostics and present some typical results from them.

  17. Real-time plasma control based on the ISTTOK tomography diagnostica)

    NASA Astrophysics Data System (ADS)

    Carvalho, P. J.; Carvalho, B. B.; Neto, A.; Coelho, R.; Fernandes, H.; Sousa, J.; Varandas, C.; Chávez-Alarcón, E.; Herrera-Velázquez, J. J. E.

    2008-10-01

    The presently available processing power in generic processing units (GPUs) combined with state-of-the-art programmable logic devices benefits the implementation of complex, real-time driven, data processing algorithms for plasma diagnostics. A tomographic reconstruction diagnostic has been developed for the ISTTOK tokamak, based on three linear pinhole cameras each with ten lines of sight. The plasma emissivity in a poloidal cross section is computed locally on a submillisecond time scale, using a Fourier-Bessel algorithm, allowing the use of the output signals for active plasma position control. The data acquisition and reconstruction (DAR) system is based on ATCA technology and consists of one acquisition board with integrated field programmable gate array (FPGA) capabilities and a dual-core Pentium module running real-time application interface (RTAI) Linux. In this paper, the DAR real-time firmware/software implementation is presented, based on (i) front-end digital processing in the FPGA; (ii) a device driver specially developed for the board which enables streaming data acquisition to the host GPU; and (iii) a fast reconstruction algorithm running in Linux RTAI. This system behaves as a module of the central ISTTOK control and data acquisition system (FIRESIGNAL). Preliminary results of the above experimental setup are presented and a performance benchmarking against the magnetic coil diagnostic is shown.

  18. Laser Scanner Tests For Single-Event Upsets

    NASA Technical Reports Server (NTRS)

    Kim, Quiesup; Soli, George A.; Schwartz, Harvey R.

    1992-01-01

    Microelectronic advanced laser scanner (MEALS) is opto/electro/mechanical apparatus for nondestructive testing of integrated memory circuits, logic circuits, and other microelectronic devices. Multipurpose diagnostic system used to determine ultrafast time response, leakage, latchup, and electrical overstress. Used to simulate some of effects of heavy ions accelerated to high energies to determine susceptibility of digital device to single-event upsets.

  19. Simultaneous fingerprint and high-wavenumber confocal Raman spectroscopy enhances early detection of cervical precancer in vivo.

    PubMed

    Duraipandian, Shiyamala; Zheng, Wei; Ng, Joseph; Low, Jeffrey J H; Ilancheran, A; Huang, Zhiwei

    2012-07-17

    Raman spectroscopy is a vibrational spectroscopic technique capable of nondestructively probing endogenous biomolecules and their changes associated with dysplastic transformation in the tissue. The main objectives of this study are (i) to develop a simultaneous fingerprint (FP) and high-wavenumber (HW) confocal Raman spectroscopy and (ii) to investigate its diagnostic utility for improving in vivo diagnosis of cervical precancer (dysplasia). We have successfully developed an integrated FP/HW confocal Raman diagnostic system with a ball-lens Raman probe for simultaneous acquistion of FP/HW Raman signals of the cervix in vivo within 1 s. A total of 476 in vivo FP/HW Raman spectra (356 normal and 120 precancer) are acquired from 44 patients at clinical colposcopy. The distinctive Raman spectral differences between normal and dysplastic cervical tissue are observed at ~854, 937, 1001, 1095, 1253, 1313, 1445, 1654, 2946, and 3400 cm(-1) mainly related to proteins, lipids, glycogen, nucleic acids and water content in tissue. Multivariate diagnostic algorithms developed based on partial least-squares-discriminant analysis (PLS-DA) together with the leave-one-patient-out, cross-validation yield the diagnostic sensitivities of 84.2%, 76.7%, and 85.0%, respectively; specificities of 78.9%, 73.3%, and 81.7%, respectively; and overall diagnostic accuracies of 80.3%, 74.2%, and 82.6%, respectively, using FP, HW, and integrated FP/HW Raman spectroscopic techniques for in vivo diagnosis of cervical precancer. Receiver operating characteristic (ROC) analysis further confirms the best performance of the integrated FP/HW confocal Raman technique, compared to FP or HW Raman spectroscopy alone. This work demonstrates, for the first time, that the simultaneous FP/HW confocal Raman spectroscopy has the potential to be a clinically powerful tool for improving early diagnosis and detection of cervical precancer in vivo during clinical colposcopic examination.

  20. A data-driven algorithm integrating clinical and laboratory features for the diagnosis and prognosis of necrotizing enterocolitis.

    PubMed

    Ji, Jun; Ling, Xuefeng B; Zhao, Yingzhen; Hu, Zhongkai; Zheng, Xiaolin; Xu, Zhening; Wen, Qiaojun; Kastenberg, Zachary J; Li, Ping; Abdullah, Fizan; Brandt, Mary L; Ehrenkranz, Richard A; Harris, Mary Catherine; Lee, Timothy C; Simpson, B Joyce; Bowers, Corinna; Moss, R Lawrence; Sylvester, Karl G

    2014-01-01

    Necrotizing enterocolitis (NEC) is a major source of neonatal morbidity and mortality. Since there is no specific diagnostic test or risk of progression model available for NEC, the diagnosis and outcome prediction of NEC is made on clinical grounds. The objective in this study was to develop and validate new NEC scoring systems for automated staging and prognostic forecasting. A six-center consortium of university based pediatric teaching hospitals prospectively collected data on infants under suspicion of having NEC over a 7-year period. A database comprised of 520 infants was utilized to develop the NEC diagnostic and prognostic models by dividing the entire dataset into training and testing cohorts of demographically matched subjects. Developed on the training cohort and validated on the blind testing cohort, our multivariate analyses led to NEC scoring metrics integrating clinical data. Machine learning using clinical and laboratory results at the time of clinical presentation led to two nec models: (1) an automated diagnostic classification scheme; (2) a dynamic prognostic method for risk-stratifying patients into low, intermediate and high NEC scores to determine the risk for disease progression. We submit that dynamic risk stratification of infants with NEC will assist clinicians in determining the need for additional diagnostic testing and guide potential therapies in a dynamic manner. http://translationalmedicine.stanford.edu/cgi-bin/NEC/index.pl and smartphone application upon request.

  1. Validation of Digital Microscopy Compared With Light Microscopy for the Diagnosis of Canine Cutaneous Tumors.

    PubMed

    Bertram, Christof A; Gurtner, Corinne; Dettwiler, Martina; Kershaw, Olivia; Dietert, Kristina; Pieper, Laura; Pischon, Hannah; Gruber, Achim D; Klopfleisch, Robert

    2018-07-01

    Integration of new technologies, such as digital microscopy, into a highly standardized laboratory routine requires the validation of its performance in terms of reliability, specificity, and sensitivity. However, a validation study of digital microscopy is currently lacking in veterinary pathology. The aim of the current study was to validate the usability of digital microscopy in terms of diagnostic accuracy, speed, and confidence for diagnosing and differentiating common canine cutaneous tumor types and to compare it to classical light microscopy. Therefore, 80 histologic sections including 17 different skin tumor types were examined twice as glass slides and twice as digital whole-slide images by 6 pathologists with different levels of experience at 4 time points. Comparison of both methods found digital microscopy to be noninferior for differentiating individual tumor types within the category epithelial and mesenchymal tumors, but diagnostic concordance was slightly lower for differentiating individual round cell tumor types by digital microscopy. In addition, digital microscopy was associated with significantly shorter diagnostic time, but diagnostic confidence was lower and technical quality was considered inferior for whole-slide images compared with glass slides. Of note, diagnostic performance for whole-slide images scanned at 200× magnification was noninferior in diagnostic performance for slides scanned at 400×. In conclusion, digital microscopy differs only minimally from light microscopy in few aspects of diagnostic performance and overall appears adequate for the diagnosis of individual canine cutaneous tumors with minor limitations for differentiating individual round cell tumor types and grading of mast cell tumors.

  2. Invited Article: A novel calibration method for the JET real-time far infrared polarimeter and integration of polarimetry-based line-integrated density measurements for machine protection of a fusion plant.

    PubMed

    Boboc, A; Bieg, B; Felton, R; Dalley, S; Kravtsov, Yu

    2015-09-01

    In this paper, we present the work in the implementation of a new calibration for the JET real-time polarimeter based on the complex amplitude ratio technique and a new self-validation mechanism of data. This allowed easy integration of the polarimetry measurements into the JET plasma density control (gas feedback control) and as well as machine protection systems (neutral beam injection heating safety interlocks). The new addition was used successfully during 2014 JET Campaign and is envisaged that will operate routinely from 2015 campaign onwards in any plasma condition (including ITER relevant scenarios). This mode of operation elevated the importance of the polarimetry as a diagnostic tool in the view of future fusion experiments.

  3. Invited Article: A novel calibration method for the JET real-time far infrared polarimeter and integration of polarimetry-based line-integrated density measurements for machine protection of a fusion plant

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

    Boboc, A., E-mail: Alexandru.Boboc@ccfe.ac.uk; Felton, R.; Dalley, S.

    2015-09-15

    In this paper, we present the work in the implementation of a new calibration for the JET real-time polarimeter based on the complex amplitude ratio technique and a new self-validation mechanism of data. This allowed easy integration of the polarimetry measurements into the JET plasma density control (gas feedback control) and as well as machine protection systems (neutral beam injection heating safety interlocks). The new addition was used successfully during 2014 JET Campaign and is envisaged that will operate routinely from 2015 campaign onwards in any plasma condition (including ITER relevant scenarios). This mode of operation elevated the importance ofmore » the polarimetry as a diagnostic tool in the view of future fusion experiments.« less

  4. Development of an integrated Sasang constitution diagnosis method using face, body shape, voice, and questionnaire information

    PubMed Central

    2012-01-01

    Background Sasang constitutional medicine (SCM) is a unique form of traditional Korean medicine that divides human beings into four constitutional types (Tae-Yang: TY, Tae-Eum: TE, So-Yang: SY, and So-Eum: SE), which differ in inherited characteristics, such as external appearance, personality traits, susceptibility to particular diseases, drug responses, and equilibrium among internal organ functions. According to SCM, herbs that belong to a certain constitution cannot be used in patients with other constitutions; otherwise, this practice may result in no effect or in an adverse effect. Thus, the diagnosis of SC type is the most crucial step in SCM practice. The diagnosis, however, tends to be subjective due to a lack of quantitative standards for SC diagnosis. Methods We have attempted to make the diagnosis method as objective as possible by basing it on an analysis of quantitative data from various Oriental medical clinics. Four individual diagnostic models were developed with multinomial logistic regression based on face, body shape, voice, and questionnaire responses. Inspired by SCM practitioners’ holistic diagnostic processes, an integrated diagnostic model was then proposed by combining the four individual models. Results The diagnostic accuracies in the test set, after the four individual models had been integrated into a single model, improved to 64.0% and 55.2% in the male and female patient groups, respectively. Using a cut-off value for the integrated SC score, such as 1.6, the accuracies increased by 14.7% in male patients and by 4.6% in female patients, which showed that a higher integrated SC score corresponded to a higher diagnostic accuracy. Conclusions This study represents the first trial of integrating the objectification of SC diagnosis based on quantitative data and SCM practitioners’ holistic diagnostic processes. Although the diagnostic accuracy was not great, it is noted that the proposed diagnostic model represents common rules among practitioners who have various points of view. Our results are expected to contribute as a desirable research guide for objective diagnosis in traditional medicine, as well as to contribute to the precise diagnosis of SC types in an objective manner in clinical practice. PMID:22762505

  5. Development of an integrated Sasang constitution diagnosis method using face, body shape, voice, and questionnaire information.

    PubMed

    Do, Jun-Hyeong; Jang, Eunsu; Ku, Boncho; Jang, Jun-Su; Kim, Honggie; Kim, Jong Yeol

    2012-07-04

    Sasang constitutional medicine (SCM) is a unique form of traditional Korean medicine that divides human beings into four constitutional types (Tae-Yang: TY, Tae-Eum: TE, So-Yang: SY, and So-Eum: SE), which differ in inherited characteristics, such as external appearance, personality traits, susceptibility to particular diseases, drug responses, and equilibrium among internal organ functions. According to SCM, herbs that belong to a certain constitution cannot be used in patients with other constitutions; otherwise, this practice may result in no effect or in an adverse effect. Thus, the diagnosis of SC type is the most crucial step in SCM practice. The diagnosis, however, tends to be subjective due to a lack of quantitative standards for SC diagnosis. We have attempted to make the diagnosis method as objective as possible by basing it on an analysis of quantitative data from various Oriental medical clinics. Four individual diagnostic models were developed with multinomial logistic regression based on face, body shape, voice, and questionnaire responses. Inspired by SCM practitioners' holistic diagnostic processes, an integrated diagnostic model was then proposed by combining the four individual models. The diagnostic accuracies in the test set, after the four individual models had been integrated into a single model, improved to 64.0% and 55.2% in the male and female patient groups, respectively. Using a cut-off value for the integrated SC score, such as 1.6, the accuracies increased by 14.7% in male patients and by 4.6% in female patients, which showed that a higher integrated SC score corresponded to a higher diagnostic accuracy. This study represents the first trial of integrating the objectification of SC diagnosis based on quantitative data and SCM practitioners' holistic diagnostic processes. Although the diagnostic accuracy was not great, it is noted that the proposed diagnostic model represents common rules among practitioners who have various points of view. Our results are expected to contribute as a desirable research guide for objective diagnosis in traditional medicine, as well as to contribute to the precise diagnosis of SC types in an objective manner in clinical practice.

  6. 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.

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

    PubMed

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

    2004-07-01

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

  8. An evidential reasoning extension to quantitative model-based failure diagnosis

    NASA Technical Reports Server (NTRS)

    Gertler, Janos J.; Anderson, Kenneth C.

    1992-01-01

    The detection and diagnosis of failures in physical systems characterized by continuous-time operation are studied. A quantitative diagnostic methodology has been developed that utilizes the mathematical model of the physical system. On the basis of the latter, diagnostic models are derived each of which comprises a set of orthogonal parity equations. To improve the robustness of the algorithm, several models may be used in parallel, providing potentially incomplete and/or conflicting inferences. Dempster's rule of combination is used to integrate evidence from the different models. The basic probability measures are assigned utilizing quantitative information extracted from the mathematical model and from online computation performed therewith.

  9. Progress in neutron-, X-ray- and VIS spectroscopic diagnostics of large-scale plasma focus experiments at ICDMP

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

    Schmidt, Hellmut

    Substantial progress has been made in various diagnostics for investigating results of experiments during the last years performed with the PF1000 device at IPPLM, Warsaw, Poland. In addition to standard diagnostics of the electrical characteristics of up to 1 MJ discharges in a Mather type plasma focus geometry, such as high speed photography, X-ray, fast electron beam and time-integrated neutron measurements, there have been made among others at least three quite successful efforts recently: 1) Setting up of a neutron time-of-flight line with up to five scintillation detectors including optical fibre based data collection equipment, 2) Use of a Mechellemore » spectrometer with CCD registration and possibility to take time-resolved spectra with resolutions down to 100 ns and 3) Setting up and using pinhole cameras equipped with solid state nuclear track detectors for the detection of fusion generated protons. Correlations of emission events as well as plasma and electrical current dynamics are investigated. Neutron emission characteristics and fusion products production mechanisms are discussed considering a generalized beam target model, called Gyrating Particle Model.« less

  10. Simultaneous 11C-Methionine Positron Emission Tomography/Magnetic Resonance Imaging of Suspected Primary Brain Tumors

    PubMed Central

    Deuschl, Cornelius; Goericke, Sophia; Grueneisen, Johannes; Sawicki, Lino Morris; Goebel, Juliane; El Hindy, Nicolai; Wrede, Karsten; Binse, Ina; Poeppel, Thorsten; Quick, Harald; Forsting, Michael; Hense, Joerg; Umutlu, Lale; Schlamann, Marc

    2016-01-01

    Introduction The objective of this study was to assess the diagnostic value of integrated 11C- methionine PET/MRI for suspected primary brain tumors, in comparison to MRI alone. Material and Methods Forty-eight consecutive patients with suspected primary brain tumor were prospectively enrolled for an integrated 11C-methionine PET/MRI. Two neuro-radiologists separately evaluated the MRI alone and the integrated PET/MRI data sets regarding most likely diagnosis and diagnostic confidence on a 5-point scale. Reference standard was histopathology or follow-up imaging. Results Fifty-one suspicious lesions were detected: 16 high-grade glioma and 25 low-grade glioma. Ten non-malignant cerebral lesions were described by the reference standard. MRI alone and integrated PET/MRI each correctly classified 42 of the 51 lesions (82.4%) as neoplastic lesions (WHO grade II, III and IV) or non-malignant lesions (infectious and neoplastic lesions). Diagnostic confidence for all lesions, low-grade astrocytoma and high-grade astrocytoma (3.7 vs. 4.2, 3,1 vs. 3.8, 4.0 vs. 4,7) were significantly (p < 0.05) better with integrated PET/MRI than in MRI alone. Conclusions The present study demonstrates the high potential of integrated 11C-methionine-PET/MRI for the assessment of suspected primary brain tumors. Although integrated methionine PET/MRI does not lead to an improvement of correct diagnoses, diagnostic confidence is significantly improved. PMID:27907162

  11. HIDRA-MAT: A Material Analysis Tool for Fusion Devices

    NASA Astrophysics Data System (ADS)

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

    2017-10-01

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

  12. Multimodal correlation and intraoperative matching of virtual models in neurosurgery

    NASA Technical Reports Server (NTRS)

    Ceresole, Enrico; Dalsasso, Michele; Rossi, Aldo

    1994-01-01

    The multimodal correlation between different diagnostic exams, the intraoperative calibration of pointing tools and the correlation of the patient's virtual models with the patient himself, are some examples, taken from the biomedical field, of a unique problem: determine the relationship linking representation of the same object in different reference frames. Several methods have been developed in order to determine this relationship, among them, the surface matching method is one that gives the patient minimum discomfort and the errors occurring are compatible with the required precision. The surface matching method has been successfully applied to the multimodal correlation of diagnostic exams such as CT, MR, PET and SPECT. Algorithms for automatic segmentation of diagnostic images have been developed to extract the reference surfaces from the diagnostic exams, whereas the surface of the patient's skull has been monitored, in our approach, by means of a laser sensor mounted on the end effector of an industrial robot. An integrated system for virtual planning and real time execution of surgical procedures has been realized.

  13. How do organisational characteristics influence teamwork and service delivery in lung cancer diagnostic assessment programmes? A mixed-methods study.

    PubMed

    Honein-AbouHaidar, Gladys N; Stuart-McEwan, Terri; Waddell, Tom; Salvarrey, Alexandra; Smylie, Jennifer; Dobrow, Mark J; Brouwers, Melissa C; Gagliardi, Anna R

    2017-02-23

    Diagnostic assessment programmes (DAPs) can reduce wait times for cancer diagnosis, but optimal DAP design is unknown. This study explored how organisational characteristics influenced multidisciplinary teamwork and diagnostic service delivery in lung cancer DAPs. A mixed-methods approach integrated data from descriptive qualitative interviews and medical record abstraction at 4 lung cancer DAPs. Findings were analysed with the Integrated Team Effectiveness Model. 4 DAPs at 2 teaching and 2 community hospitals in Canada. 22 staff were interviewed about organisational characteristics, target service benchmarks, and teamwork processes, determinants and outcomes; 314 medical records were reviewed for actual service benchmarks. Formal, informal and asynchronous team processes enabled service delivery and yielded many perceived benefits at the patient, staff and service levels. However, several DAP characteristics challenged teamwork and service delivery: referral volume/workload, time since launch, days per week of operation, rural-remote population, number and type of full-time/part-time human resources, staff colocation, information systems. As a result, all sites failed to meet target benchmarks (from referral to consultation median 4.0 visits, median wait time 35.0 days). Recommendations included improved information systems, more staff in all specialties, staff colocation and expanded roles for patient navigators. Findings were captured in a conceptual framework of lung cancer DAP teamwork determinants and outcomes. This study identified several DAP characteristics that could be improved to facilitate teamwork and enhance service delivery, thereby contributing to knowledge of organisational determinants of teamwork and associated outcomes. Findings can be used to update existing DAP guidelines, and by managers to plan or evaluate lung cancer DAPs. Ongoing research is needed to identify ideal roles for navigators, and staffing models tailored to case volumes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  14. Comparison of laser spectroscopic PNC method with laser integral fluorescence in optical caries diagnostics

    NASA Astrophysics Data System (ADS)

    Masychev, Victor I.

    2001-05-01

    In this research we represent the results of approbation of two methods of optical caries diagnostics: PNC-spectral diagnostics and caries detection by laser integral fluorescence. The research was conducted in a dental clinic. PNC-method analyzes parameters of probing laser radiation and PNC-spectrums of stimulated secondary radiations: backscattering and endogenous fluorescence of caries- involved bacteria. Ia-Ne laser ((lambda) equals632.8 nm, 1-2 mW) was used as a source of probing (stimulated) radiation. For registration of signals, received from intact and pathological teeth PDA-detector was applied. PNC-spectrums were processed by special algorithms, and were displayed on PC monitor. The method of laser integral fluorescence was used for comparison. In this case integral power of fluorescence of human teeth was measured. As a source of probing (stimulated) radiation diode lasers ((lambda) equals655 nm, 0.1 mW and 630 nm, 1 mW) and Ia-Na laser were applied. For registration of signals Si-photodetector was used. Integral power was shown in a digital indicator. Advantages and disadvantages of these methods are described in this research. It is disclosed that the method of laser integral power of fluorescence has the following characteristics: simplicity of construction and schema-technical decisions. However the method of PNC-spectral diagnostics are characterized by considerably more sensitivity in diagnostics of initial caries and capability to differentiate pathologies of various stages (for example, calculus/initial caries). Estimation of spectral characteristics of PNC-signals allows eliminating a number of drawbacks, which are character for detection by method of laser integral fluorescence (for instance, detection of fluorescent fillings, plagues, calculus, discolorations generally, amalgam, gold fillings as if it were caries).

  15. Optical caries diagnostics: comparison of laser spectroscopic PNC method with method of laser integral fluorescence

    NASA Astrophysics Data System (ADS)

    Masychev, Victor I.

    2000-11-01

    In this research we present the results of approbation of two methods of optical caries diagnostics: PNC-spectral diagnostics and caries detection by laser integral fluorescence. The research was conducted in a dental clinic. PNC-method analyses parameters of probing laser radiation and PNC-spectrums of stimulated secondary radiations: backscattering and endogenous fluorescence of caries-involved bacterias. He-Ne-laser ((lambda) =632,8 nm, 1-2mW) was used as a source of probing (stimulated) radiation. For registration of signals, received from intact and pathological teeth PDA-detector was applied. PNC-spectrums were processed by special algorithms, and were displayed on PC monitor. The method of laser integral fluorescence was used for comparison. In this case integral power of fluorescence of human teeth was measured. As a source of probing (stimulated) radiation diode lasers ((lambda) =655 nm, 0.1 mW and 630nm, 1mW) and He-Ne laser were applied. For registration of signals Si-photodetector was used. Integral power was shown in a digital indicator. Advantages and disadvantages of these methods are described in this research. It is disclosed that the method of laser integral power of fluorescence has the following characteristics: simplicity of construction and schema-technical decisions. However the method of PNC-spectral diagnostics are characterized by considerably more sensitivity in diagnostics of initial caries and capability to differentiate pathologies of various stages (for example, calculus/initial caries). Estimation of spectral characteristics of PNC-signals allows eliminating a number of drawbacks, which are character for detection by method of laser integral fluorescence (for instance, detection of fluorescent fillings, plagues, calculus, discolorations generally, amalgam, gold fillings as if it were caries.

  16. Evaluating a mobile application for improving clinical laboratory test ordering and diagnosis.

    PubMed

    Meyer, Ashley N D; Thompson, Pamela J; Khanna, Arushi; Desai, Samir; Mathews, Benji K; Yousef, Elham; Kusnoor, Anita V; Singh, Hardeep

    2018-04-20

    Mobile applications for improving diagnostic decision making often lack clinical evaluation. We evaluated if a mobile application improves generalist physicians' appropriate laboratory test ordering and diagnosis decisions and assessed if physicians perceive it as useful for learning. In an experimental, vignette study, physicians diagnosed 8 patient vignettes with normal prothrombin times (PT) and abnormal partial thromboplastin times (PTT). Physicians made test ordering and diagnosis decisions for 4 vignettes using each resource: a mobile app, PTT Advisor, developed by the Centers for Disease Control and Prevention (CDC)'s Clinical Laboratory Integration into Healthcare Collaborative (CLIHC); and usual clinical decision support. Then, physicians answered questions regarding their perceptions of the app's usefulness for diagnostic decision making and learning using a modified Kirkpatrick Training Evaluation Framework. Data from 368 vignettes solved by 46 physicians at 7 US health care institutions show advantages for using PTT Advisor over usual clinical decision support on test ordering and diagnostic decision accuracy (82.6 vs 70.2% correct; P < .001), confidence in decisions (7.5 vs 6.3 out of 10; P < .001), and vignette completion time (3:02 vs 3:53 min.; P = .06). Physicians reported positive perceptions of the app's potential for improved clinical decision making, and recommended it be used to address broader diagnostic challenges. A mobile app, PTT Advisor, may contribute to better test ordering and diagnosis, serve as a learning tool for diagnostic evaluation of certain clinical disorders, and improve patient outcomes. Similar methods could be useful for evaluating apps aimed at improving testing and diagnosis for other conditions.

  17. Non-invasive, photonics-based diagnostic, imaging, monitoring, and light delivery techniques for the recognition, quantification and treatment of malignant and chronic inflammatory conditions

    NASA Astrophysics Data System (ADS)

    Davies, N.; Davies-Shaw, D.; Shaw, J. D.

    2007-02-01

    We report firsthand on innovative developments in non-invasive, biophotonic techniques for a wide range of diagnostic, imaging and treatment options, including the recognition and quantification of cancerous, pre-cancerous cells and chronic inflammatory conditions. These techniques have benefited from the ability to target the affected site by both monochromatic light and broad multiple wavelength spectra. The employment of such wavelength or color-specific properties embraces the fluorescence stimulation of various photosensitizing drugs, and the instigation and detection of identified fluorescence signatures attendant upon laser induced fluorescence (LIF) phenomena as transmitted and propagated by precancerous, cancerous and normal tissue. In terms of tumor imaging and therapeutic and treatment options, we have exploited the abilities of various wavelengths to penetrate to different depths, through different types of tissues, and have explored quantifiable absorption and reflection characteristics upon which diagnostic assumptions can be reliably based and formulated. These biophotonic-based diagnostic, sensing and imaging techniques have also benefited from, and have been further enhanced by, the integrated ability to provide various power levels to be employed at various stages in the procedure. Applications are myriad, including non-invasive, non destructive diagnosis of in vivo cell characteristics and functions; light-based tissue analysis; real-time monitoring and mapping of brain function and of tumor growth; real time monitoring of the surgical completeness of tumor removal during laser-imaged/guided brain resection; diagnostic procedures based on fluorescence life-time monitoring, the monitoring of chronic inflammatory conditions (including rheumatoid arthritis), and continuous blood glucose monitoring in the control of diabetes.

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

    PubMed

    Uehara, Masayuki

    2016-01-01

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

  19. Autonomous power expert system

    NASA Technical Reports Server (NTRS)

    Ringer, Mark J.; Quinn, Todd M.

    1990-01-01

    The goal of the Autonomous Power System (APS) program is to develop and apply intelligent problem solving and control technologies to the Space Station Freedom Electrical Power Systems (SSF/EPS). The objectives of the program are to establish artificial intelligence/expert system technology paths, to create knowledge based tools with advanced human-operator interfaces, and to integrate and interface knowledge-based and conventional control schemes. This program is being developed at the NASA-Lewis. The APS Brassboard represents a subset of a 20 KHz Space Station Power Management And Distribution (PMAD) testbed. A distributed control scheme is used to manage multiple levels of computers and switchgear. The brassboard is comprised of a set of intelligent switchgear used to effectively switch power from the sources to the loads. The Autonomous Power Expert System (APEX) portion of the APS program integrates a knowledge based fault diagnostic system, a power resource scheduler, and an interface to the APS Brassboard. The system includes knowledge bases for system diagnostics, fault detection and isolation, and recommended actions. The scheduler autonomously assigns start times to the attached loads based on temporal and power constraints. The scheduler is able to work in a near real time environment for both scheduling and dynamic replanning.

  20. Autonomous power expert system

    NASA Technical Reports Server (NTRS)

    Ringer, Mark J.; Quinn, Todd M.

    1990-01-01

    The goal of the Autonomous Power System (APS) program is to develop and apply intelligent problem solving and control technologies to the Space Station Freedom Electrical Power Systems (SSF/EPS). The objectives of the program are to establish artificial intelligence/expert system technology paths, to create knowledge based tools with advanced human-operator interfaces, and to integrate and interface knowledge-based and conventional control schemes. This program is being developed at the NASA-Lewis. The APS Brassboard represents a subset of a 20 KHz Space Station Power Management And Distribution (PMAD) testbed. A distributed control scheme is used to manage multiple levels of computers and switchgear. The brassboard is comprised of a set of intelligent switchgear used to effectively switch power from the sources to the loads. The Autonomous Power Expert System (APEX) portion of the APS program integrates a knowledge based fault diagnostic system, a power resource scheduler, and an interface to the APS Brassboard. The system includes knowledge bases for system diagnostics, fault detection and isolation, and recommended actions. The scheduler autonomously assigns start times to the attached loads based on temporal and power constraints. The scheduler is able to work in a near real time environment for both scheduling an dynamic replanning.

  1. Materials for Microfluidic Immunoassays: A Review.

    PubMed

    Mou, Lei; Jiang, Xingyu

    2017-08-01

    Conventional immunoassays suffer from at least one of these following limitations: long processing time, high costs, poor user-friendliness, technical complexity, poor sensitivity and specificity. Microfluidics, a technology characterized by the engineered manipulation of fluids in channels with characteristic lengthscale of tens of micrometers, has shown considerable promise for improving immunoassays that could overcome these limitations in medical diagnostics and biology research. The combination of microfluidics and immunoassay can detect biomarkers with faster assay time, reduced volumes of reagents, lower power requirements, and higher levels of integration and automation compared to traditional approaches. This review focuses on the materials-related aspects of the recent advances in microfluidics-based immunoassays for point-of-care (POC) diagnostics of biomarkers. We compare the materials for microfluidic chips fabrication in five aspects: fabrication, integration, function, modification and cost, and describe their advantages and drawbacks. In addition, we review materials for modifying antibodies to improve the performance of the reaction of immunoassay. We also review the state of the art in microfluidic immunoassays POC platforms, from the laboratory to routine clinical practice, and also commercial products in the market. Finally, we discuss the current challenges and future developments in microfluidic immunoassays. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  2. Determining integral density distribution in the mach reflection of shock waves

    NASA Astrophysics Data System (ADS)

    Shevchenko, A. M.; Golubev, M. P.; Pavlov, A. A.; Pavlov, Al. A.; Khotyanovsky, D. V.; Shmakov, A. S.

    2017-05-01

    We present a method for and results of determination of the field of integral density in the structure of flow corresponding to the Mach interaction of shock waves at Mach number M = 3. The optical diagnostics of flow was performed using an interference technique based on self-adjusting Zernike filters (SA-AVT method). Numerical simulations were carried out using the CFS3D program package for solving the Euler and Navier-Stokes equations. Quantitative data on the distribution of integral density on the path of probing radiation in one direction of 3D flow transillumination in the region of Mach interaction of shock waves were obtained for the first time.

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

    DOE PAGES

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

    2015-10-20

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

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

    NASA Astrophysics Data System (ADS)

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

    2015-10-01

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

  5. Integrated Data Analysis for Fusion: A Bayesian Tutorial for Fusion Diagnosticians

    NASA Astrophysics Data System (ADS)

    Dinklage, Andreas; Dreier, Heiko; Fischer, Rainer; Gori, Silvio; Preuss, Roland; Toussaint, Udo von

    2008-03-01

    Integrated Data Analysis (IDA) offers a unified way of combining information relevant to fusion experiments. Thereby, IDA meets with typical issues arising in fusion data analysis. In IDA, all information is consistently formulated as probability density functions quantifying uncertainties in the analysis within the Bayesian probability theory. For a single diagnostic, IDA allows the identification of faulty measurements and improvements in the setup. For a set of diagnostics, IDA gives joint error distributions allowing the comparison and integration of different diagnostics results. Validation of physics models can be performed by model comparison techniques. Typical data analysis applications benefit from IDA capabilities of nonlinear error propagation, the inclusion of systematic effects and the comparison of different physics models. Applications range from outlier detection, background discrimination, model assessment and design of diagnostics. In order to cope with next step fusion device requirements, appropriate techniques are explored for fast analysis applications.

  6. Data Sources for Biosurveillance

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

    Walters, Ronald A.; Harlan, MS, Pete A.; Nelson, Noele P.

    2010-03-01

    Biosurveillance analyzes timely data, often fusing time series of many different types of data, to infer the status of public health rather than solely exploiting data having diagnostic specificity. Integrated biosurveillance requires a synthesis of analytic approaches derived from the natural disaster, public health, medical, meteorological, and social science communities, among others, and it is the cornerstone of early disease detection. This paper summarizes major systems dedicated to such an endeavor and emphasizes system capabilities that if creatively exploited could contribute to creation of an effective global biosurveillance enterprise.

  7. The Right Place at the Right Time: Priming Facial Expressions with Emotional Face Components in Developmental Visual Agnosia

    PubMed Central

    Aviezer, Hillel; Hassin, Ran. R.; Perry, Anat; Dudarev, Veronica; Bentin, Shlomo

    2012-01-01

    The current study examined the nature of deficits in emotion recognition from facial expressions in case LG, an individual with a rare form of developmental visual agnosia (DVA). LG presents with profoundly impaired recognition of facial expressions, yet the underlying nature of his deficit remains unknown. During typical face processing, normal sighted individuals extract information about expressed emotions from face regions with activity diagnostic for specific emotion categories. Given LG’s impairment, we sought to shed light on his emotion perception by examining if priming facial expressions with diagnostic emotional face components would facilitate his recognition of the emotion expressed by the face. LG and control participants matched isolated face components with components appearing in a subsequently presented full-face and then categorized the face’s emotion. Critically, the matched components were from regions which were diagnostic or non-diagnostic of the emotion portrayed by the full face. In experiment 1, when the full faces were briefly presented (150 ms), LG’s performance was strongly influenced by the diagnosticity of the components: His emotion recognition was boosted within normal limits when diagnostic components were used and was obliterated when non-diagnostic components were used. By contrast, in experiment 2, when the face-exposure duration was extended (2000 ms), the beneficial effect of the diagnostic matching was diminished as was the detrimental effect of the non-diagnostic matching. These data highlight the impact of diagnostic facial features in normal expression recognition and suggest that impaired emotion recognition in DVA results from deficient visual integration across diagnostic face components. PMID:22349446

  8. Electron temperature diagnostics of aluminium plasma in a z-pinch experiment at the “QiangGuang-1" facility

    NASA Astrophysics Data System (ADS)

    Li, Mo; Wu, Jian; Wang, Liang-Ping; Wu, Gang; Han, Juan-Juan; Guo, Ning; Qiu, Meng-Tong

    2012-12-01

    Two curved crystal spectrometers are set up on the “QiangGuang-1" generator to measure the z-pinch plasma spectra emitted from planar aluminum wire array loads. Kodak Biomax-MS film and an IRD AXUVHS5# array are employed to record time-integrated and time-resolved free-bound radiation, respectively. The photon energy recorded by each detector is ascertained by using the L-shell lines of molybdenum plasma. Based on the exponential relation between the continuum power and photon energies, the aluminum plasma electron temperatures are measured. For the time-integrated diagnosis, several “bright spots" indicate electron temperatures between (450 eV ~ 520 eV) ± 35%. And for the time-resolved ones, the result shows that the electron temperature reaches about 800 eV ± 30% at peak power. The system satisfies the demand of z-pinch plasma electron temperature diagnosis on a ~ 1 MA facility.

  9. Getting expert systems off the ground: Lessons learned from integrating model-based diagnostics with prototype flight hardware

    NASA Technical Reports Server (NTRS)

    Stephan, Amy; Erikson, Carol A.

    1991-01-01

    As an initial attempt to introduce expert system technology into an onboard environment, a model based diagnostic system using the TRW MARPLE software tool was integrated with prototype flight hardware and its corresponding control software. Because this experiment was designed primarily to test the effectiveness of the model based reasoning technique used, the expert system ran on a separate hardware platform, and interactions between the control software and the model based diagnostics were limited. While this project met its objective of showing that model based reasoning can effectively isolate failures in flight hardware, it also identified the need for an integrated development path for expert system and control software for onboard applications. In developing expert systems that are ready for flight, artificial intelligence techniques must be evaluated to determine whether they offer a real advantage onboard, identify which diagnostic functions should be performed by the expert systems and which are better left to the procedural software, and work closely with both the hardware and the software developers from the beginning of a project to produce a well designed and thoroughly integrated application.

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

    PubMed

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

    2014-10-20

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

  11. Integrated Modeling of Time Evolving 3D Kinetic MHD Equilibria and NTV Torque

    NASA Astrophysics Data System (ADS)

    Logan, N. C.; Park, J.-K.; Grierson, B. A.; Haskey, S. R.; Nazikian, R.; Cui, L.; Smith, S. P.; Meneghini, O.

    2016-10-01

    New analysis tools and integrated modeling of plasma dynamics developed in the OMFIT framework are used to study kinetic MHD equilibria evolution on the transport time scale. The experimentally observed profile dynamics following the application of 3D error fields are described using a new OMFITprofiles workflow that directly addresses the need for rapid and comprehensive analysis of dynamic equilibria for next-step theory validation. The workflow treats all diagnostic data as fundamentally time dependent, provides physics-based manipulations such as ELM phase data selection, and is consistent across multiple machines - including DIII-D and NSTX-U. The seamless integration of tokamak data and simulation is demonstrated by using the self-consistent kinetic EFIT equilibria and profiles as input into 2D particle, momentum and energy transport calculations using TRANSP as well as 3D kinetic MHD equilibrium stability and neoclassical transport modeling using General Perturbed Equilibrium Code (GPEC). The result is a smooth kinetic stability and NTV torque evolution over transport time scales. Work supported by DE-AC02-09CH11466.

  12. Is this the real time for genomics?

    PubMed

    Guarnaccia, Maria; Gentile, Giulia; Alessi, Enrico; Schneider, Claudio; Petralia, Salvatore; Cavallaro, Sebastiano

    2014-01-01

    In the last decades, molecular biology has moved from gene-by-gene analysis to more complex studies using a genome-wide scale. Thanks to high-throughput genomic technologies, such as microarrays and next-generation sequencing, a huge amount of information has been generated, expanding our knowledge on the genetic basis of various diseases. Although some of this information could be transferred to clinical diagnostics, the technologies available are not suitable for this purpose. In this review, we will discuss the drawbacks associated with the use of traditional DNA microarrays in diagnostics, pointing out emerging platforms that could overcome these obstacles and offer a more reproducible, qualitative and quantitative multigenic analysis. New miniaturized and automated devices, called Lab-on-Chip, begin to integrate PCR and microarray on the same platform, offering integrated sample-to-result systems. The introduction of this kind of innovative devices may facilitate the transition of genome-based tests into clinical routine. Copyright © 2014. Published by Elsevier Inc.

  13. Infrared Thermography-based Biophotonics: Integrated Diagnostic Technique for Systemic Reaction Monitoring

    NASA Astrophysics Data System (ADS)

    Vainer, Boris G.; Morozov, Vitaly V.

    A peculiar branch of biophotonics is a measurement, visualisation and quantitative analysis of infrared (IR) radiation emitted from living object surfaces. Focal plane array (FPA)-based IR cameras make it possible to realize in medicine the so called interventional infrared thermal diagnostics. An integrated technique aimed at the advancement of this new approach in biomedical science and practice is described in the paper. The assembled system includes a high-performance short-wave (2.45-3.05 μm) or long-wave (8-14 μm) IR camera, two laser Doppler flowmeters (LDF) and additional equipment and complementary facilities implementing the monitoring of human cardiovascular status. All these means operate synchronously. It is first ascertained the relationship between infrared thermography (IRT) and LDF data in humans in regard to their systemic cardiovascular reactivity. Blood supply real-time dynamics in a narcotized patient is first visualized and quantitatively represented during surgery in order to observe how the general hyperoxia influences thermoregulatory mechanisms; an abrupt increase in temperature of the upper limb is observed using IRT. It is outlined that the IRT-based integrated technique may act as a take-off runway leading to elaboration of informative new methods directly applicable to medicine and biomedical sciences.

  14. Integration of radiographic images with an electronic medical record.

    PubMed Central

    Overhage, J. M.; Aisen, A.; Barnes, M.; Tucker, M.; McDonald, C. J.

    2001-01-01

    Radiographic images are important and expensive diagnostic tests. However, the provider caring for the patient often does not review the images directly due to time constraints. Institutions can use picture archiving and communications systems to make images more available to the provider, but this may not be the best solution. We integrated radiographic image review into the Regenstrief Medical Record System in order to address this problem. To achieve adequate performance, we store JPEG compressed images directly in the RMRS. Currently, physicians review about 5% of all radiographic studies using the RMRS image review function. PMID:11825241

  15. Synchronized operation by field programmable gate array based signal controller for the Thomson scattering diagnostic system in KSTAR.

    PubMed

    Lee, W R; Kim, H S; Park, M K; Lee, J H; Kim, K H

    2012-09-01

    The Thomson scattering diagnostic system is successfully installed in the Korea Superconducting Tokamak Advanced Research (KSTAR) facility. We got the electron temperature and electron density data for the first time in 2011, 4th campaign using a field programmable gate array (FPGA) based signal control board. It operates as a signal generator, a detector, a controller, and a time measuring device. This board produces two configurable trigger pulses to operate Nd:YAG laser system and receives a laser beam detection signal from a photodiode detector. It allows a trigger pulse to be delivered to a time delay module to make a scattered signal measurement, measuring an asynchronous time value between the KSTAR timing board and the laser system injection signal. All functions are controlled by the embedded processor running on operating system within a single FPGA. It provides Ethernet communication interface and is configured with standard middleware to integrate with KSTAR. This controller has operated for two experimental campaigns including commissioning and performed the reconfiguration of logic designs to accommodate varying experimental situation without hardware rebuilding.

  16. A New ELISA Using the ANANAS Technology Showing High Sensitivity to diagnose the Bovine Rhinotracheitis from Individual Sera to Pooled Milk.

    PubMed

    Casarin, Elisabetta; Lucchese, Laura; Grazioli, Santina; Facchin, Sonia; Realdon, Nicola; Brocchi, Emiliana; Morpurgo, Margherita; Nardelli, Stefano

    2016-01-01

    Diagnostic tests for veterinary surveillance programs should be efficient, easy to use and, possibly, economical. In this context, classic Enzyme linked ImmunoSorbent Assay (ELISA) remains the most common analytical platform employed for serological analyses. The analysis of pooled samples instead of individual ones is a common procedure that permits to certify, with one single test, entire herds as "disease-free". However, diagnostic tests for pooled samples need to be particularly sensitive, especially when the levels of disease markers are low, as in the case of anti-BoHV1 antibodies in milk as markers of Infectious Bovine Rhinotracheitis (IBR) disease. The avidin-nucleic-acid-nanoassembly (ANANAS) is a novel kind of signal amplification platform for immunodiagnostics based on colloidal poly-avidin nanoparticles that, using model analytes, was shown to strongly increase ELISA test performance as compared to monomeric avidin. Here, for the first time, we applied the ANANAS reagent integration in a real diagnostic context. The monoclonal 1G10 anti-bovine IgG1 antibody was biotinylated and integrated with the ANANAS reagents for indirect IBR diagnosis from pooled milk mimicking tank samples from herds with IBR prevalence between 1 to 8%. The sensitivity and specificity of the ANANAS integrated method was compared to that of a classic test based on the same 1G10 antibody directly linked to horseradish peroxidase, and a commercial IDEXX kit recently introduced in the market. ANANAS integration increased by 5-fold the sensitivity of the 1G10 mAb-based conventional ELISA without loosing specificity. When compared to the commercial kit, the 1G10-ANANAS integrated method was capable to detect the presence of anti-BHV1 antibodies from bulk milk of gE antibody positive animals with 2-fold higher sensitivity and similar specificity. The results demonstrate the potentials of this new amplification technology, which permits improving current classic ELISA sensitivity limits without the need for new hardware investments.

  17. CT and Ultrasound Guided Stereotactic High Intensity Focused Ultrasound (HIFU)

    NASA Astrophysics Data System (ADS)

    Wood, Bradford J.; Yanof, J.; Frenkel, V.; Viswanathan, A.; Dromi, S.; Oh, K.; Kruecker, J.; Bauer, C.; Seip, R.; Kam, A.; Li, K. C. P.

    2006-05-01

    To demonstrate the feasibility of CT and B-mode Ultrasound (US) targeted HIFU, a prototype coaxial focused ultrasound transducer was registered and integrated to a CT scanner. CT and diagnostic ultrasound were used for HIFU targeting and monitoring, with the goals of both thermal ablation and non-thermal enhanced drug delivery. A 1 megahertz coaxial ultrasound transducer was custom fabricated and attached to a passive position-sensing arm and an active six degree-of-freedom robotic arm via a CT stereotactic frame. The outer therapeutic transducer with a 10 cm fixed focal zone was coaxially mounted to an inner diagnostic US transducer (2-4 megahertz, Philips Medical Systems). This coaxial US transducer was connected to a modified commercial focused ultrasound generator (Focus Surgery, Indianapolis, IN) with a maximum total acoustic power of 100 watts. This pre-clinical paradigm was tested for ability to heat tissue in phantoms with monitoring and navigation from CT and live US. The feasibility of navigation via image fusion of CT with other modalities such as PET and MRI was demonstrated. Heated water phantoms were tested for correlation between CT numbers and temperature (for ablation monitoring). The prototype transducer and integrated CT/US imaging system enabled simultaneous multimodality imaging and therapy. Pre-clinical phantom models validated the treatment paradigm and demonstrated integrated multimodality guidance and treatment monitoring. Temperature changes during phantom cooling corresponded to CT number changes. Contrast enhanced or non-enhanced CT numbers may potentially be used to monitor thermal ablation with HIFU. Integrated CT, diagnostic US, and therapeutic focused ultrasound bridges a gap between diagnosis and therapy. Preliminary results show that the multimodality system may represent a relatively inexpensive, accessible, and simple method of both targeting and monitoring HIFU effects. Small animal pre-clinical models may be translated to large animals and humans for HIFU-induced ablation and drug delivery. Integrated CT-guided focused ultrasound holds promise for tissue ablation, enhancing local drug delivery, and CT thermometry for monitoring ablation in near real-time.

  18. Implementation of an Integrated On-Board Aircraft Engine Diagnostic Architecture

    NASA Technical Reports Server (NTRS)

    Armstrong, Jeffrey B.; Simon, Donald L.

    2012-01-01

    An on-board diagnostic architecture for aircraft turbofan engine performance trending, parameter estimation, and gas-path fault detection and isolation has been developed and evaluated in a simulation environment. The architecture incorporates two independent models: a realtime self-tuning performance model providing parameter estimates and a performance baseline model for diagnostic purposes reflecting long-term engine degradation trends. This architecture was evaluated using flight profiles generated from a nonlinear model with realistic fleet engine health degradation distributions and sensor noise. The architecture was found to produce acceptable estimates of engine health and unmeasured parameters, and the integrated diagnostic algorithms were able to perform correct fault isolation in approximately 70 percent of the tested cases

  19. The SUCCESS model for laboratory performance and execution of rapid molecular diagnostics in patients with sepsis.

    PubMed

    Dekmezian, Mhair; Beal, Stacy G; Damashek, Mary Jane; Benavides, Raul; Dhiman, Neelam

    2015-04-01

    Successful performance and execution of rapid diagnostics in a clinical laboratory hinges heavily on careful validation, accurate and timely communication of results, and real-time quality monitoring. Laboratories must develop strategies to integrate diagnostics with stewardship and evidence-based clinical practice guidelines. We present a collaborative SUCCESS model for execution and monitoring of rapid sepsis diagnostics to facilitate timely treatment. Six months after execution of the Verigene Gram-Positive Blood Culture (BC-GP) and the AdvanDx PNA-FISH assays, data were collected on 579 and 28 episodes of bacteremia and fungemia, respectively. Clinical testing was executed using a SUCCESS model comprising the following components: stewardship, utilization of resources, core strategies, concierge services, education, support, and surveillance. Stewardship needs were identified by evaluating the specialty services benefiting from new testing. Utilization of resources was optimized by reviewing current treatment strategies and antibiogram and formulary options. Core strategies consisted of input from infectious disease leadership, pharmacy, and laboratory staff. Concierge services included automated Micro-eUpdate and physician-friendly actionable reports. Education modules were user-specific, and support was provided through a dedicated 24/7 microbiology hotline. Surveillance was performed by daily audit by the director. Using the SUCCESS model, the turnaround time for the detailed report with actionable guidelines to the physician was ∼3 hours from the time of culture positivity. The overall correlation between rapid methods and culture was 94% (546/579). Discrepant results were predominantly contaminants such as a coagulase-negative staphylococci or viridans streptococci in mixed cultures. SUCCESS is a cost-effective and easily adaptable model for clinical laboratories with limited stewardship resources.

  20. Molecular Dynamics and Theoretical Chemistry

    DTIC Science & Technology

    2013-03-08

    and structural stability compared to H-Si(111) • Air- and electrochemical-stability enables advanced sensors, fuel and solar cells , etc. • Probes...Diagnostics ARO – plasmonics AFOSR - Endo fuels, combustion, solar PNNL – Institute for Integrated Catalysis Navy, DTRA – Clusters AFRL, NASA, DoD...Propellants • Real-time probing of reactions • Hybrid Chemical Lasers • Sensors for Trace Detection Distribution A: Approved for public release

  1. Diagnostic, Predictive and Compositional Modeling with Data Mining in Integrated Learning Environments

    ERIC Educational Resources Information Center

    Lee, Chien-Sing

    2007-01-01

    Models represent a set of generic patterns to test hypotheses. This paper presents the CogMoLab student model in the context of an integrated learning environment. Three aspects are discussed: diagnostic and predictive modeling with respect to the issues of credit assignment and scalability and compositional modeling of the student profile in the…

  2. An Energy efficient application specific integrated circuit for electrocardiogram feature detection and its potential for ambulatory cardiovascular disease detection

    PubMed Central

    Bhaumik, Basabi

    2016-01-01

    A novel algorithm based on forward search is developed for real-time electrocardiogram (ECG) signal processing and implemented in application specific integrated circuit (ASIC) for QRS complex related cardiovascular disease diagnosis. The authors have evaluated their algorithm using MIT-BIH database and achieve sensitivity of 99.86% and specificity of 99.93% for QRS complex peak detection. In this Letter, Physionet PTB diagnostic ECG database is used for QRS complex related disease detection. An ASIC for cardiovascular disease detection is fabricated using 130-nm CMOS high-speed process technology. The area of the ASIC is 0.5 mm2. The power dissipation is 1.73 μW at the operating frequency of 1 kHz with a supply voltage of 0.6 V. The output from the ASIC is fed to their Android application that generates diagnostic report and can be sent to a cardiologist through email. Their ASIC result shows average failed detection rate of 0.16% for six leads data of 290 patients in PTB diagnostic ECG database. They also have implemented a low-leakage version of their ASIC. The ASIC dissipates only 45 pJ with a supply voltage of 0.9 V. Their proposed ASIC is most suitable for energy efficient telemetry cardiovascular disease detection system. PMID:27284458

  3. An Energy efficient application specific integrated circuit for electrocardiogram feature detection and its potential for ambulatory cardiovascular disease detection.

    PubMed

    Jain, Sanjeev Kumar; Bhaumik, Basabi

    2016-03-01

    A novel algorithm based on forward search is developed for real-time electrocardiogram (ECG) signal processing and implemented in application specific integrated circuit (ASIC) for QRS complex related cardiovascular disease diagnosis. The authors have evaluated their algorithm using MIT-BIH database and achieve sensitivity of 99.86% and specificity of 99.93% for QRS complex peak detection. In this Letter, Physionet PTB diagnostic ECG database is used for QRS complex related disease detection. An ASIC for cardiovascular disease detection is fabricated using 130-nm CMOS high-speed process technology. The area of the ASIC is 0.5 mm(2). The power dissipation is 1.73 μW at the operating frequency of 1 kHz with a supply voltage of 0.6 V. The output from the ASIC is fed to their Android application that generates diagnostic report and can be sent to a cardiologist through email. Their ASIC result shows average failed detection rate of 0.16% for six leads data of 290 patients in PTB diagnostic ECG database. They also have implemented a low-leakage version of their ASIC. The ASIC dissipates only 45 pJ with a supply voltage of 0.9 V. Their proposed ASIC is most suitable for energy efficient telemetry cardiovascular disease detection system.

  4. An Integrated Quantum Dot Barcode Smartphone Optical Device for Wireless Multiplexed Diagnosis of Infected Patients

    NASA Astrophysics Data System (ADS)

    Ming, Kevin

    Integrating mobile-cellular devices with multiplex molecular diagnostics can potentially provide the most powerful platform for tracking, managing and preventing the transmission of infectious diseases. With over 6.9 billion subscriptions globally, handheld mobile-cellular devices can be programmed to spatially map, temporally track, and transmit information on infections over wide geographical space and boundaries. Current cell phone diagnostic technologies have poor limit of detection, dynamic range, and cannot detect multiple pathogen targets simultaneously, limiting their utility to single infections with high load. Here we combined recent advances in quantum dot barcode technology for molecular detection with smartphones to engineer a simple and low-cost chip-based wireless multiplex diagnostic device. We validated our device using a variety of synthetic genomic targets for the respiratory virus and blood-borne pathogens, and demonstrated that it could detect clinical samples after simple amplification. More importantly, we confirmed that the device is capable of detecting patients infected with a single or multiple infectious pathogens (e.g., HIV and hepatitis B) in a single test. This device advances the capacity for global surveillance of infectious diseases and has the potential to accelerate knowledge exchange-transfer of emerging or exigent disease threats with healthcare and military organizations in real-time.

  5. Advanced Monitoring to Improve Combustion Turbine/Combined Cycle Reliability, Availability & Maintainability

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

    Leonard Angello

    2005-09-30

    Power generators are concerned with the maintenance costs associated with the advanced turbines that they are purchasing. Since these machines do not have fully established Operation and Maintenance (O&M) track records, power generators face financial risk due to uncertain future maintenance costs. This risk is of particular concern, as the electricity industry transitions to a competitive business environment in which unexpected O&M costs cannot be passed through to consumers. These concerns have accelerated the need for intelligent software-based diagnostic systems that can monitor the health of a combustion turbine in real time and provide valuable information on the machine's performancemore » to its owner/operators. EPRI, Impact Technologies, Boyce Engineering, and Progress Energy have teamed to develop a suite of intelligent software tools integrated with a diagnostic monitoring platform that, in real time, interpret data to assess the 'total health' of combustion turbines. The 'Combustion Turbine Health Management System' (CTHMS) will consist of a series of 'Dynamic Link Library' (DLL) programs residing on a diagnostic monitoring platform that accepts turbine health data from existing monitoring instrumentation. CTHMS interprets sensor and instrument outputs, correlates them to a machine's condition, provide interpretative analyses, project servicing intervals, and estimate remaining component life. In addition, the CTHMS enables real-time anomaly detection and diagnostics of performance and mechanical faults, enabling power producers to more accurately predict critical component remaining useful life and turbine degradation.« less

  6. Recent Advances in Fluorescence Lifetime Analytical Microsystems: Contact Optics and CMOS Time-Resolved Electronics.

    PubMed

    Wei, Liping; Yan, Wenrong; Ho, Derek

    2017-12-04

    Fluorescence spectroscopy has become a prominent research tool with wide applications in medical diagnostics and bio-imaging. However, the realization of combined high-performance, portable, and low-cost spectroscopic sensors still remains a challenge, which has limited the technique to the laboratories. A fluorescence lifetime measurement seeks to obtain the characteristic lifetime from the fluorescence decay profile. Time-correlated single photon counting (TCSPC) and time-gated techniques are two key variations of time-resolved measurements. However, commercial time-resolved analysis systems typically contain complex optics and discrete electronic components, which lead to bulkiness and a high cost. These two limitations can be significantly mitigated using contact sensing and complementary metal-oxide-semiconductor (CMOS) implementation. Contact sensing simplifies the optics, whereas CMOS technology enables on-chip, arrayed detection and signal processing, significantly reducing size and power consumption. This paper examines recent advances in contact sensing and CMOS time-resolved circuits for the realization of fully integrated fluorescence lifetime measurement microsystems. The high level of performance from recently reported prototypes suggests that the CMOS-based contact sensing microsystems are emerging as sound technologies for application-specific, low-cost, and portable time-resolved diagnostic devices.

  7. Recent Advances in Fluorescence Lifetime Analytical Microsystems: Contact Optics and CMOS Time-Resolved Electronics

    PubMed Central

    Yan, Wenrong; Ho, Derek

    2017-01-01

    Fluorescence spectroscopy has become a prominent research tool with wide applications in medical diagnostics and bio-imaging. However, the realization of combined high-performance, portable, and low-cost spectroscopic sensors still remains a challenge, which has limited the technique to the laboratories. A fluorescence lifetime measurement seeks to obtain the characteristic lifetime from the fluorescence decay profile. Time-correlated single photon counting (TCSPC) and time-gated techniques are two key variations of time-resolved measurements. However, commercial time-resolved analysis systems typically contain complex optics and discrete electronic components, which lead to bulkiness and a high cost. These two limitations can be significantly mitigated using contact sensing and complementary metal-oxide-semiconductor (CMOS) implementation. Contact sensing simplifies the optics, whereas CMOS technology enables on-chip, arrayed detection and signal processing, significantly reducing size and power consumption. This paper examines recent advances in contact sensing and CMOS time-resolved circuits for the realization of fully integrated fluorescence lifetime measurement microsystems. The high level of performance from recently reported prototypes suggests that the CMOS-based contact sensing microsystems are emerging as sound technologies for application-specific, low-cost, and portable time-resolved diagnostic devices. PMID:29207568

  8. Screening in toddlers and preschoolers at risk for autism spectrum disorder: Evaluating a novel mobile-health screening tool.

    PubMed

    Kanne, Stephen M; Carpenter, Laura Arnstein; Warren, Zachary

    2018-05-07

    There are many available tools with varying levels of accuracy designed to screen for Autism Spectrum Disorder (ASD) in young children, both in the general population and specifically among those referred for developmental concerns. With burgeoning waitlists for comprehensive diagnostic ASD assessments, finding accurate methods and tools for advancing diagnostic triage becomes increasingly important. The current study compares the efficacy of four oft used paper and pencil measures, the Modified Checklist for Autism in Toddlers Revised with Follow-up, the Social Responsiveness Scale, Second Edition, and the Social Communication Questionnaire, and the Child Behavior Checklist to a novel mobile-health screening tool developed by Cognoa, Inc. (Cognoa) in a group of children 18-72 months of age. The Cognoa tool may have potential benefits as it integrates a series of parent-report questions with remote clinical ratings of brief video segments uploaded via parent's smartphones to calculate level of ASD risk. Participants were referred to one of three tertiary care diagnostic centers for ASD-related concerns (n = 230) and received a best estimate ASD diagnosis. Analysis and comparison of psychometric properties indicated potential advantages for Cognoa within this clinical sample across age ranges not often covered by another single measure/tool. Autism Res 2018. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. With the wait times getting longer for comprehensive Autism Spectrum Disorder (ASD) diagnostic assessments, it is becoming increasingly important to find accurate tools to screen for ASD. The current study compares four screening measures that have been in use for some time to a novel mobile-health screening tool, called Cognoa. The Cognoa tool is novel because it integrates parent-report questions with clinical ratings of brief video segments uploaded via parent's smartphones to calculate ASD risk. Two hundred thirty children who were referred to one of three ASD specialty diagnostic centers to see if they had ASD participated in the study. A direct comparison indicated potential advantages for Cognoa not often covered by another single measure/tool. © 2018 International Society for Autism Research, Wiley Periodicals, Inc.

  9. The terminal area simulation system. Volume 1: Theoretical formulation

    NASA Technical Reports Server (NTRS)

    Proctor, F. H.

    1987-01-01

    A three-dimensional numerical cloud model was developed for the general purpose of studying convective phenomena. The model utilizes a time splitting integration procedure in the numerical solution of the compressible nonhydrostatic primitive equations. Turbulence closure is achieved by a conventional first-order diagnostic approximation. Open lateral boundaries are incorporated which minimize wave reflection and which do not induce domain-wide mass trends. Microphysical processes are governed by prognostic equations for potential temperature water vapor, cloud droplets, ice crystals, rain, snow, and hail. Microphysical interactions are computed by numerous Orville-type parameterizations. A diagnostic surface boundary layer is parameterized assuming Monin-Obukhov similarity theory. The governing equation set is approximated on a staggered three-dimensional grid with quadratic-conservative central space differencing. Time differencing is approximated by the second-order Adams-Bashforth method. The vertical grid spacing may be either linear or stretched. The model domain may translate along with a convective cell, even at variable speeds.

  10. Time Projection Compton Spectrometer (TPCS). User`s guide

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

    Landron, C.O.; Baldwin, G.T.

    1994-04-01

    The Time Projection Compton Spectrometer (TPCS) is a radiation diagnostic designed to determine the time-integrated energy spectrum between 100 keV -- 2 MeV of flash x-ray sources. This guide is intended as a reference for the routine operator of the TPCS. Contents include a brief overview of the principle of operation, detailed component descriptions, detailed assembly and disassembly procedures, guide to routine operations, and troubleshooting flowcharts. Detailed principle of operation, signal analysis and spectrum unfold algorithms are beyond the scope of this guide; however, the guide makes reference to sources containing this information.

  11. A field-deployable mobile molecular diagnostic system for malaria at the point of need.

    PubMed

    Choi, Gihoon; Song, Daniel; Shrestha, Sony; Miao, Jun; Cui, Liwang; Guan, Weihua

    2016-11-01

    In response to the urgent need of a field-deployable and highly sensitive malaria diagnosis, we developed a standalone, "sample-in-answer-out" molecular diagnostic system (AnyMDx) to enable quantitative molecular analysis of blood-borne malaria in low resource areas. The system consists of a durable battery-powered analyzer and a disposable microfluidic compact disc loaded with reagents ready for use. A low power thermal module and a novel fluorescence-sensing module are integrated into the analyzer for real-time monitoring of loop-mediated isothermal nucleic acid amplification (LAMP) of target parasite DNA. With 10 μL of raw blood sample, the AnyMDx system automates the nucleic acid sample preparation and subsequent LAMP and real-time detection. Under laboratory conditions with whole-blood samples spiked with cultured Plasmodium falciparum, we achieved a detection limit of ∼0.6 parasite per μL, much lower than those for the conventional microscopy and rapid diagnostic tests (∼50-100 parasites per μL). The turnaround time from sample to answer is less than 40 minutes. The AnyMDx is user-friendly requiring minimal technological training. The analyzer and the disposable reagent compact discs are cost-effective, making AnyMDx a potential tool for malaria molecular diagnosis under field settings for malaria elimination.

  12. A Compact, Tunable Near-UV Source for Quantitative Microgravity Combustion Diagnostics

    NASA Technical Reports Server (NTRS)

    Peterson, K. A.; Oh, D. B.

    1999-01-01

    There is a need for improved optical diagnostic methods for use in microgravity combustion research. Spectroscopic methods with fast time response that can provide absolute concentrations and concentration profiles of important chemical species in flames are needed to facilitate the understanding of combustion kinetics in microgravity. Although a variety of sophisticated laser-based diagnostics (such as planar laser induced fluorescence, degenerate four wave mixing and coherent Raman methods) have been applied to the study of combustion in laboratory flames, the instrumentation associated with these methods is not well suited to microgravity drop tower or space station platforms. Important attributes of diagnostic systems for such applications include compact size, low power consumption, ruggedness, and reliability. We describe a diode laser-based near-UV source designed with the constraints of microgravity research in mind. Coherent light near 420 nm is generated by frequency doubling in a nonlinear crystal. This light source is single mode with a very narrow bandwidth suitable for gas phase diagnostics, can be tuned over several 1/cm and can be wavelength modulated at up to MHz frequencies. We demonstrate the usefulness of this source for combustion diagnostics by measuring CH radical concentration profiles in an atmospheric pressure laboratory flame. The radical concentrations are measured using wavelength modulation spectroscopy (WMS) to obtain the line-of-sight integrated absorption for different paths through the flame. Laser induced fluorescence (LIF) measurements are also demonstrated with this instrument, showing the feasibility of simultaneous WMS absorption and LIF measurements with the same light source. LIF detection perpendicular to the laser beam can be used to map relative species densities along the line-of-sight while the integrated absorption available through WMS provides a mathematical constraint on the extraction of quantitative information from the LIF data. Combining absorption with LIF - especially if the measurements are made simultaneously with the same excitation beam - may allow elimination of geometrical factors and effects of intensity fluctuations (common difficulties with the analysis of LIF data) from the analysis.

  13. The relationship between waiting times and 'adherence' to the Scottish Intercollegiate Guidelines Network 98 guideline in autism spectrum disorder diagnostic services in Scotland.

    PubMed

    McKenzie, Karen; Forsyth, Kirsty; O'Hare, Anne; McClure, Iain; Rutherford, Marion; Murray, Aja; Irvine, Linda

    2016-05-01

    The aim of this study was to explore the extent to which the Scottish Intercollegiate Guidelines Network 98 guidelines on the assessment and diagnosis of autism spectrum disorder were adhered to in child autism spectrum disorder diagnostic services in Scotland and whether there was a significant relationship between routine practice which more closely reflected these recommendations (increased adherence) and increased waiting times. Retrospective, cross-sectional case note analysis was applied to data from 80 case notes. Adherence ranged from a possible 0 (no adherence) to 19 (full adherence). Overall, 17/22 of the recommendations were adhered to in over 50 of the 80 cases and in 70 or more cases for 11/22 of the recommendations, with a mean adherence score of 16 (standard deviation = 1.9). No significant correlation was found between adherence and total wait time for untransformed (r = 0.15, p = 0.32) or transformed data (r = 0.12, p = 0.20). The results indicated that the assessment and diagnostic practices were consistent with the relevant Scottish Intercollegiate Guidelines Network 98 guideline recommendations. Increased adherence to the 19 included recommendations was not significantly related to increased total waiting times, indicating that the Scottish Intercollegiate Guidelines Network 98 recommendations have generally been integrated into practice, without a resultant increase in patient waits. © The Author(s) 2015.

  14. A real-time laser feedback control method for the three-wave laser source used in the polarimeter-interferometer diagnostic on Joint-TEXT tokamak

    NASA Astrophysics Data System (ADS)

    Xiong, C. Y.; Chen, J.; Li, Q.; Liu, Y.; Gao, L.

    2014-12-01

    A three-wave laser polarimeter-interferometer, equipped with three independent far-infrared laser sources, has been developed on Joint-TEXT (J-TEXT) tokamak. The diagnostic system is capable of high-resolution temporal and phase measurement of the Faraday angle and line-integrated density. However, for long-term operation (>10 min), the free-running lasers can lead to large drifts of the intermediate frequencies (˜100-˜500 kHz/10 min) and decay of laser power (˜10%-˜20%/10 min), which act to degrade diagnostic performance. In addition, these effects lead to increased maintenance cost and limit measurement applicability to long pulse/steady state experiments. To solve this problem, a real-time feedback control method of the laser source is proposed. By accurately controlling the length of each laser cavity, both the intermediate frequencies and laser power can be simultaneously controlled: the intermediate frequencies are controlled according to the pre-set values, while the laser powers are maintained at an optimal level. Based on this approach, a real-time feedback control system has been developed and applied on J-TEXT polarimeter-interferometer. Long-term (theoretically no time limit) feedback of intermediate frequencies (maximum change less than ±12 kHz) and laser powers (maximum relative power change less than ±7%) has been successfully achieved.

  15. A real-time laser feedback control method for the three-wave laser source used in the polarimeter-interferometer diagnostic on Joint-TEXT tokamak.

    PubMed

    Xiong, C Y; Chen, J; Li, Q; Liu, Y; Gao, L

    2014-12-01

    A three-wave laser polarimeter-interferometer, equipped with three independent far-infrared laser sources, has been developed on Joint-TEXT (J-TEXT) tokamak. The diagnostic system is capable of high-resolution temporal and phase measurement of the Faraday angle and line-integrated density. However, for long-term operation (>10 min), the free-running lasers can lead to large drifts of the intermediate frequencies (∼100-∼500 kHz/10 min) and decay of laser power (∼10%-∼20%/10 min), which act to degrade diagnostic performance. In addition, these effects lead to increased maintenance cost and limit measurement applicability to long pulse/steady state experiments. To solve this problem, a real-time feedback control method of the laser source is proposed. By accurately controlling the length of each laser cavity, both the intermediate frequencies and laser power can be simultaneously controlled: the intermediate frequencies are controlled according to the pre-set values, while the laser powers are maintained at an optimal level. Based on this approach, a real-time feedback control system has been developed and applied on J-TEXT polarimeter-interferometer. Long-term (theoretically no time limit) feedback of intermediate frequencies (maximum change less than ±12 kHz) and laser powers (maximum relative power change less than ±7%) has been successfully achieved.

  16. Integrating nursing diagnostic concepts into the medical entities dictionary using the ISO Reference Terminology Model for Nursing Diagnosis.

    PubMed

    Hwang, Jee-In; Cimino, James J; Bakken, Suzanne

    2003-01-01

    The purposes of the study were (1) to evaluate the usefulness of the International Standards Organization (ISO) Reference Terminology Model for Nursing Diagnoses as a terminology model for defining nursing diagnostic concepts in the Medical Entities Dictionary (MED) and (2) to create the additional hierarchical structures required for integration of nursing diagnostic concepts into the MED. The authors dissected nursing diagnostic terms from two source terminologies (Home Health Care Classification and the Omaha System) into the semantic categories of the ISO model. Consistent with the ISO model, they selected Focus and Judgment as required semantic categories for creating intensional definitions of nursing diagnostic concepts in the MED. Because the MED does not include Focus and Judgment hierarchies, the authors developed them to define the nursing diagnostic concepts. The ISO model was sufficient for dissecting the source terminologies into atomic terms. The authors identified 162 unique focus concepts from the 266 nursing diagnosis terms for inclusion in the Focus hierarchy. For the Judgment hierarchy, the authors precoordinated Judgment and Potentiality instead of using Potentiality as a qualifier of Judgment as in the ISO model. Impairment and Alteration were the most frequently occurring judgments. Nursing care represents a large proportion of health care activities; thus, it is vital that terms used by nurses are integrated into concept-oriented terminologies that provide broad coverage for the domain of health care. This study supports the utility of the ISO Reference Terminology Model for Nursing Diagnoses as a facilitator for the integration process.

  17. Integrating Nursing Diagnostic Concepts into the Medical Entities Dictionary Using the ISO Reference Terminology Model for Nursing Diagnosis

    PubMed Central

    Hwang, Jee-In; Cimino, James J.; Bakken, Suzanne

    2003-01-01

    Objective: The purposes of the study were (1) to evaluate the usefulness of the International Standards Organization (ISO) Reference Terminology Model for Nursing Diagnoses as a terminology model for defining nursing diagnostic concepts in the Medical Entities Dictionary (MED) and (2) to create the additional hierarchical structures required for integration of nursing diagnostic concepts into the MED. Design and Measurements: The authors dissected nursing diagnostic terms from two source terminologies (Home Health Care Classification and the Omaha System) into the semantic categories of the ISO model. Consistent with the ISO model, they selected Focus and Judgment as required semantic categories for creating intensional definitions of nursing diagnostic concepts in the MED. Because the MED does not include Focus and Judgment hierarchies, the authors developed them to define the nursing diagnostic concepts. Results: The ISO model was sufficient for dissecting the source terminologies into atomic terms. The authors identified 162 unique focus concepts from the 266 nursing diagnosis terms for inclusion in the Focus hierarchy. For the Judgment hierarchy, the authors precoordinated Judgment and Potentiality instead of using Potentiality as a qualifier of Judgment as in the ISO model. Impairment and Alteration were the most frequently occurring judgments. Conclusions: Nursing care represents a large proportion of health care activities; thus, it is vital that terms used by nurses are integrated into concept-oriented terminologies that provide broad coverage for the domain of health care. This study supports the utility of the ISO Reference Terminology Model for Nursing Diagnoses as a facilitator for the integration process. PMID:12668692

  18. The right place at the right time: priming facial expressions with emotional face components in developmental visual agnosia.

    PubMed

    Aviezer, Hillel; Hassin, Ran R; Perry, Anat; Dudarev, Veronica; Bentin, Shlomo

    2012-04-01

    The current study examined the nature of deficits in emotion recognition from facial expressions in case LG, an individual with a rare form of developmental visual agnosia (DVA). LG presents with profoundly impaired recognition of facial expressions, yet the underlying nature of his deficit remains unknown. During typical face processing, normal sighted individuals extract information about expressed emotions from face regions with activity diagnostic for specific emotion categories. Given LG's impairment, we sought to shed light on his emotion perception by examining if priming facial expressions with diagnostic emotional face components would facilitate his recognition of the emotion expressed by the face. LG and control participants matched isolated face components with components appearing in a subsequently presented full-face and then categorized the face's emotion. Critically, the matched components were from regions which were diagnostic or non-diagnostic of the emotion portrayed by the full face. In experiment 1, when the full faces were briefly presented (150 ms), LG's performance was strongly influenced by the diagnosticity of the components: his emotion recognition was boosted within normal limits when diagnostic components were used and was obliterated when non-diagnostic components were used. By contrast, in experiment 2, when the face-exposure duration was extended (2000 ms), the beneficial effect of the diagnostic matching was diminished as was the detrimental effect of the non-diagnostic matching. These data highlight the impact of diagnostic facial features in normal expression recognition and suggest that impaired emotion recognition in DVA results from deficient visual integration across diagnostic face components. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. Electrochemistry-based Approaches to Low Cost, High Sensitivity, Automated, Multiplexed Protein Immunoassays for Cancer Diagnostics

    PubMed Central

    Dixit, Chandra K.; Kadimisetty, Karteek; Otieno, Brunah A.; Tang, Chi; Malla, Spundana; Krause, Colleen E.; Rusling, James F.

    2015-01-01

    Early detection and reliable diagnostics are keys to effectively design cancer therapies with better prognoses. Simultaneous detection of panels of biomarker proteins holds great promise as a general tool for reliable cancer diagnostics. A major challenge in designing such a panel is to decide upon a coherent group of biomarkers which have higher specificity for a given type of cancer. The second big challenge is to develop test devices to measure these biomarkers quantitatively with high sensitivity and specificity, such that there are no interferences from the complex serum or tissue matrices. Lastly, integrating all these tests into a technology that doesn’t require exclusive training to operate, and can be used at point-of-care (POC) is another potential bottleneck in futuristic cancer diagnostics. In this article, we review electrochemistry-based tools and technologies developed and/or used in our laboratories to construct low-cost microfluidic protein arrays for highly sensitive detection of the panel of cancer-specific biomarkers with high specificity and at the same time have the potential to be translated into a POC. PMID:26525998

  20. Electrochemistry-based approaches to low cost, high sensitivity, automated, multiplexed protein immunoassays for cancer diagnostics.

    PubMed

    Dixit, Chandra K; Kadimisetty, Karteek; Otieno, Brunah A; Tang, Chi; Malla, Spundana; Krause, Colleen E; Rusling, James F

    2016-01-21

    Early detection and reliable diagnostics are keys to effectively design cancer therapies with better prognoses. The simultaneous detection of panels of biomarker proteins holds great promise as a general tool for reliable cancer diagnostics. A major challenge in designing such a panel is to decide upon a coherent group of biomarkers which have higher specificity for a given type of cancer. The second big challenge is to develop test devices to measure these biomarkers quantitatively with high sensitivity and specificity, such that there are no interferences from the complex serum or tissue matrices. Lastly, integrating all these tests into a technology that does not require exclusive training to operate, and can be used at point-of-care (POC) is another potential bottleneck in futuristic cancer diagnostics. In this article, we review electrochemistry-based tools and technologies developed and/or used in our laboratories to construct low-cost microfluidic protein arrays for the highly sensitive detection of a panel of cancer-specific biomarkers with high specificity which at the same time has the potential to be translated into POC applications.

  1. [The Revision and 5th Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5): Consequences for the Diagnostic Work with Children and Adolescents].

    PubMed

    Zulauf Logoz, Marina

    2014-01-01

    The Revision and 5th Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5): Consequences for the Diagnostic Work with Children and Adolescents.The present paper describes and discusses the major revisions in DSM-5 for children and adolescents. A major modification is that the separate chapter for disorders first diagnosed in childhood and adolescence was abandoned in favour of the integration of these clinical pictures into the relevant disorder-specific chapters. Several new diagnoses and diagnostic groups were introduced: "Disruptive mood regulation disorder" is a new diagnosis; the different diagnoses for autism were brought together into one, and a new diagnostic group for obsessive-compulsive disorders has been established. The developmental approach of DSM-5 and the integration of dimensional assessment tools are to be welcomed. Practice will show if the critiques afraid of possible increases in prevalences or those who approve the changes will end up being right.

  2. Point-of-Care Diagnostics in Low-Resource Settings and Their Impact on Care in the Age of the Noncommunicable and Chronic Disease Epidemic.

    PubMed

    Weigl, Bernhard H; Neogi, Tina; McGuire, Helen

    2014-06-01

    The emergence of point-of-care (POC) diagnostics specifically designed for low-resource settings coupled with the rapid increase in need for routine care of patients with chronic diseases should prompt reconsideration of how health care can be delivered most beneficially and cost-effectively in developing countries. Bolstering support for primary care to provide rapid and appropriate integrated acute and chronic care treatment may be a possible solution. POC diagnostics can empower local and primary care providers and enable them to make better clinical decisions. This article explores the opportunity for POC diagnostics to strengthen primary care and chronic disease diagnosis and management in a low-resource setting (LRS) to deliver appropriate, consistent, and integrated care. We analyze the requirements of resource-appropriate chronic disease care, the characteristics of POC diagnostics in LRS versus the developed world, the many roles of diagnostics in the care continuum in LRS, and the process and economics of developing LRS-compatible POC diagnostics. © 2013 Society for Laboratory Automation and Screening.

  3. X-ray absorption spectroscopy of aluminum z-pinch plasma with tungsten backlighter planar wire array source.

    PubMed

    Osborne, G C; Kantsyrev, V L; Safronova, A S; Esaulov, A A; Weller, M E; Shrestha, I; Shlyaptseva, V V; Ouart, N D

    2012-10-01

    Absorption features from K-shell aluminum z-pinch plasmas have recently been studied on Zebra, the 1.7 MA pulse power generator at the Nevada Terawatt Facility. In particular, tungsten plasma has been used as a semi-backlighter source in the generation of aluminum K-shell absorption spectra by placing a single Al wire at or near the end of a single planar W array. All spectroscopic experimental results were recorded using a time-integrated, spatially resolved convex potassium hydrogen phthalate (KAP) crystal spectrometer. Other diagnostics used to study these plasmas included x-ray detectors, optical imaging, laser shadowgraphy, and time-gated and time-integrated x-ray pinhole imagers. Through comparisons with previous publications, Al K-shell absorption lines are shown to be from much lower electron temperature (∼10-40 eV) plasmas than emission spectra (∼350-500 eV).

  4. Converging Human and Malaria Vector Diagnostics with Data Management towards an Integrated Holistic One Health Approach.

    PubMed

    Mitsakakis, Konstantinos; Hin, Sebastian; Müller, Pie; Wipf, Nadja; Thomsen, Edward; Coleman, Michael; Zengerle, Roland; Vontas, John; Mavridis, Konstantinos

    2018-02-03

    Monitoring malaria prevalence in humans, as well as vector populations, for the presence of Plasmodium , is an integral component of effective malaria control, and eventually, elimination. In the field of human diagnostics, a major challenge is the ability to define, precisely, the causative agent of fever, thereby differentiating among several candidate (also non-malaria) febrile diseases. This requires genetic-based pathogen identification and multiplexed analysis, which, in combination, are hardly provided by the current gold standard diagnostic tools. In the field of vectors, an essential component of control programs is the detection of Plasmodium species within its mosquito vectors, particularly in the salivary glands, where the infective sporozoites reside. In addition, the identification of species composition and insecticide resistance alleles within vector populations is a primary task in routine monitoring activities, aiming to support control efforts. In this context, the use of converging diagnostics is highly desirable for providing comprehensive information, including differential fever diagnosis in humans, and mosquito species composition, infection status, and resistance to insecticides of vectors. Nevertheless, the two fields of human diagnostics and vector control are rarely combined, both at the diagnostic and at the data management end, resulting in fragmented data and mis- or non-communication between various stakeholders. To this direction, molecular technologies, their integration in automated platforms, and the co-assessment of data from multiple diagnostic sources through information and communication technologies are possible pathways towards a unified human vector approach.

  5. Converging Human and Malaria Vector Diagnostics with Data Management towards an Integrated Holistic One Health Approach

    PubMed Central

    Mitsakakis, Konstantinos; Hin, Sebastian; Wipf, Nadja; Coleman, Michael; Zengerle, Roland; Vontas, John; Mavridis, Konstantinos

    2018-01-01

    Monitoring malaria prevalence in humans, as well as vector populations, for the presence of Plasmodium, is an integral component of effective malaria control, and eventually, elimination. In the field of human diagnostics, a major challenge is the ability to define, precisely, the causative agent of fever, thereby differentiating among several candidate (also non-malaria) febrile diseases. This requires genetic-based pathogen identification and multiplexed analysis, which, in combination, are hardly provided by the current gold standard diagnostic tools. In the field of vectors, an essential component of control programs is the detection of Plasmodium species within its mosquito vectors, particularly in the salivary glands, where the infective sporozoites reside. In addition, the identification of species composition and insecticide resistance alleles within vector populations is a primary task in routine monitoring activities, aiming to support control efforts. In this context, the use of converging diagnostics is highly desirable for providing comprehensive information, including differential fever diagnosis in humans, and mosquito species composition, infection status, and resistance to insecticides of vectors. Nevertheless, the two fields of human diagnostics and vector control are rarely combined, both at the diagnostic and at the data management end, resulting in fragmented data and mis- or non-communication between various stakeholders. To this direction, molecular technologies, their integration in automated platforms, and the co-assessment of data from multiple diagnostic sources through information and communication technologies are possible pathways towards a unified human vector approach. PMID:29401670

  6. [EYECUBE as 3D multimedia imaging in macular diagnostics].

    PubMed

    Hassenstein, Andrea; Scholz, F; Richard, G

    2011-11-01

    In the new generation of EYECUBE devices, the angiography image and the OCT are included in a 3D illustration as an integration. Other diagnostic procedures such as autofluorescence and ICG can also be correlated to the OCT. The aim was to precisely classify various two-dimensional findings in relation to each other. The new generation of OCT devices enables imaging with a low incidence of motion artefacts with very good fundus image quality - and with that, permits a largely automatic classification. The feature enabling the integration of the EYECUBE was further developed with new software, so that not only the topographic image (red-free, autofluorescence) can be correlated to the Cirrus OCT, but also all other findings gathered within the same time frame can be correlated to each other. These were brightened and projected onto the cube surface in a defined interval. The imaging procedures can be selected in a menu toolbar. Topographic volumetry OCT images can be overlayed. The practical application of the new method was tested on patients with macular disorders. By lightening up the results from various diagnostic procedures, it is possible of late to directly compare pathologies to each other and to the OCT results. In all patients (n = 45 eyes) with good single-image quality, the automated integration into the EYECUBE was possible (to a great extent). The application is not dependent on a certain type of device used in the procedures performed. The increasing level of precision in imaging procedures and the handling of large data volumes has led to the possibility of examining each macular diagnostics procedure from the comparative perspective: imaging (photo) with perfusion (FLA, ICG) and morphology (OCT). The exclusion of motion artefacts and the reliable scan position in the course of the imaging process increases the informative value of OCT. © Georg Thieme Verlag KG Stuttgart · New York.

  7. 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…

  8. [Management of spine injuries in polytraumatized patients].

    PubMed

    Heyde, C E; Ertel, W; Kayser, R

    2005-09-01

    The management of spine injuries in polytraumatized patients remains a great challenge for the diagnostic procedures and institution of appropriate treatment by integrating spinal trauma treatment into the whole treatment concept as well as following the treatment steps for the injured spine itself. The established concept of "damage control" and criteria regarding the optimal time and manner for operative treatment of the injured spine in the polytrauma setting is presented and discussed.

  9. Fan Noise Source Diagnostic Test: Vane Unsteady Pressure Results

    NASA Technical Reports Server (NTRS)

    Envia, Edmane

    2002-01-01

    To investigate the nature of fan outlet guide vane pressure fluctuations and their link to rotor-stator interaction noise, time histories of vane fluctuating pressures were digitally acquired as part of the Fan Noise Source Diagnostic Test. Vane unsteady pressures were measured at seven fan tip speeds for both a radial and a swept vane configuration. Using time-domain averaging and spectral analysis, the blade passing frequency (BPF) harmonic and broadband contents of the vane pressures were individually analyzed. Significant Sound Pressure Level (SPL) reductions were observed for the swept vane relative to the radial vane for the BPF harmonics of vane pressure, but vane broadband reductions due to sweep turned out to be much smaller especially on an average basis. Cross-correlation analysis was used to establish the level of spatial coherence of broadband pressures between different locations on the vane and integral length scales of pressure fluctuations were estimated from these correlations. Two main results of this work are: (1) the average broadband level on the vane (in dB) increases linearly with the fan tip speed for both the radial and swept vanes, and (2) the broadband pressure distribution on the vane is nearly homogeneous and its integral length scale is a monotonically decreasing function of fan tip speed.

  10. Integrated LTCC pressure/flow/temperature multisensor for compressed air diagnostics.

    PubMed

    Fournier, Yannick; Maeder, Thomas; Boutinard-Rouelle, Grégoire; Barras, Aurélie; Craquelin, Nicolas; Ryser, Peter

    2010-01-01

    We present a multisensor designed for industrial compressed air diagnostics and combining the measurement of pressure, flow, and temperature, integrated with the corresponding signal conditioning electronics in a single low-temperature co-fired ceramic (LTCC) package. The developed sensor may be soldered onto an integrated electro-fluidic platform by using standard surface mount device (SMD) technology, e.g., as a standard electronic component would be on a printed circuit board, obviating the need for both wires and tubes and thus paving the road towards low-cost integrated electro-fluidic systems. Several performance aspects of this device are presented and discussed, together with electronics design issues.

  11. Multifunctional, inexpensive, and reusable nanoparticle-printed biochip for cell manipulation and diagnosis

    PubMed Central

    Esfandyarpour, Rahim; DiDonato, Matthew J.; Yang, Yuxin; Durmus, Naside Gozde; Harris, James S.; Davis, Ronald W.

    2017-01-01

    Isolation and characterization of rare cells and molecules from a heterogeneous population is of critical importance in diagnosis of common lethal diseases such as malaria, tuberculosis, HIV, and cancer. For the developing world, point-of-care (POC) diagnostics design must account for limited funds, modest public health infrastructure, and low power availability. To address these challenges, here we integrate microfluidics, electronics, and inkjet printing to build an ultra–low-cost, rapid, and miniaturized lab-on-a-chip (LOC) platform. This platform can perform label-free and rapid single-cell capture, efficient cellular manipulation, rare-cell isolation, selective analytical separation of biological species, sorting, concentration, positioning, enumeration, and characterization. The miniaturized format allows for small sample and reagent volumes. By keeping the electronics separate from microfluidic chips, the former can be reused and device lifetime is extended. Perhaps most notably, the device manufacturing is significantly less expensive, time-consuming, and complex than traditional LOC platforms, requiring only an inkjet printer rather than skilled personnel and clean-room facilities. Production only takes 20 min (vs. up to weeks) and $0.01—an unprecedented cost in clinical diagnostics. The platform works based on intrinsic physical characteristics of biomolecules (e.g., size and polarizability). We demonstrate biomedical applications and verify cell viability in our platform, whose multiplexing and integration of numerous steps and external analyses enhance its application in the clinic, including by nonspecialists. Through its massive cost reduction and usability we anticipate that our platform will enable greater access to diagnostic facilities in developed countries as well as POC diagnostics in resource-poor and developing countries. PMID:28167769

  12. A new fast two-color interferometer at Alcator C-Mod for turbulence measurements and comparison with phase contrast imaging

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

    Kasten, C. P., E-mail: ckasten@alum.mit.edu; White, A. E.; Irby, J. H.

    2014-04-15

    Accurately predicting the turbulent transport properties of magnetically confined plasmas is a major challenge of fusion energy research. Validation of transport models is typically done by applying so-called “synthetic diagnostics” to the output of nonlinear gyrokinetic simulations, and the results are compared to experimental data. As part of the validation process, comparing two independent turbulence measurements to each other provides the opportunity to test the synthetic diagnostics themselves; a step which is rarely possible due to limited availability of redundant fluctuation measurements on magnetic confinement experiments. At Alcator C-Mod, phase-contrast imaging (PCI) is a commonly used turbulence diagnostic. PCI measuresmore » line-integrated electron density fluctuations with high sensitivity and wavenumber resolution (1.6 cm{sup −1}≲|k{sub R}|≲11 cm{sup −1}). A new fast two-color interferometry (FTCI) diagnostic on the Alcator C-Mod tokamak measures long-wavelength (|k{sub R}|≲3.0 cm{sup −1}) line-integrated electron density fluctuations. Measurements of coherent and broadband fluctuations made by PCI and FTCI are compared here for the first time. Good quantitative agreement is found between the two measurements. This provides experimental validation of the low-wavenumber region of the PCI calibration, and also helps validate the low-wavenumber portions of the synthetic PCI diagnostic that has been used in gyrokinetic model validation work in the past. We discuss possibilities to upgrade FTCI, so that a similar comparison could be done at higher wavenumbers in the future.« less

  13. Google glass based immunochromatographic diagnostic test analysis

    NASA Astrophysics Data System (ADS)

    Feng, Steve; Caire, Romain; Cortazar, Bingen; Turan, Mehmet; Wong, Andrew; Ozcan, Aydogan

    2015-03-01

    Integration of optical imagers and sensors into recently emerging wearable computational devices allows for simpler and more intuitive methods of integrating biomedical imaging and medical diagnostics tasks into existing infrastructures. Here we demonstrate the ability of one such device, the Google Glass, to perform qualitative and quantitative analysis of immunochromatographic rapid diagnostic tests (RDTs) using a voice-commandable hands-free software-only interface, as an alternative to larger and more bulky desktop or handheld units. Using the built-in camera of Glass to image one or more RDTs (labeled with Quick Response (QR) codes), our Glass software application uploads the captured image and related information (e.g., user name, GPS, etc.) to our servers for remote analysis and storage. After digital analysis of the RDT images, the results are transmitted back to the originating Glass device, and made available through a website in geospatial and tabular representations. We tested this system on qualitative human immunodeficiency virus (HIV) and quantitative prostate-specific antigen (PSA) RDTs. For qualitative HIV tests, we demonstrate successful detection and labeling (i.e., yes/no decisions) for up to 6-fold dilution of HIV samples. For quantitative measurements, we activated and imaged PSA concentrations ranging from 0 to 200 ng/mL and generated calibration curves relating the RDT line intensity values to PSA concentration. By providing automated digitization of both qualitative and quantitative test results, this wearable colorimetric diagnostic test reader platform on Google Glass can reduce operator errors caused by poor training, provide real-time spatiotemporal mapping of test results, and assist with remote monitoring of various biomedical conditions.

  14. [Improving malaria management through Rapid Diagnostic Tests: appropriation by providers communities (Sénégal)].

    PubMed

    Faye, S L

    2012-08-01

    Introduced in the public health services in Senegal since 2007, Rapid Diagnostic Tests (RDTs) are a new technical opportunity for clinical diagnosis of malaria. We analyze how different categories of caregivers, who are the providers, assume appropriation of their professional practices. Similarly, we document, from the analysis of their application for care, attitudes of recipients towards RDTs. The results show a time lag between the uses of this tool and the recommendations. RDTs have a recognized epidemiological usefulness. However, their positive integration requires a change in behaviors that caregivers and recipients are not always willing to assume. Indeed, the architecture, working conditions and applications for care influence the modes of appropriation of this technical innovation.

  15. New Planar Wire Array Experiments on the LTD Generator at U Michigan

    NASA Astrophysics Data System (ADS)

    Weller, M. E.; Safronova, A. S.; Kantsyrev, V. L.; Shrestha, I.; Shlyaptseva, V. V.; Cooper, M. C.; Lorance, M. Y.; Stafford, A.; Petkov, E. E.; Jordan, N. M.; Patel, S. G.; Steiner, A. M.; Yager-Elorriaga, D. A.; Gilgenbach, R. M.

    2014-10-01

    Experiments on planar wire array z-pinches have been carried out on the MAIZE Linear Transformer Driver (LTD) generator at the University of Michigan (UM) for the first time. Specifically, Al (Al 5056, 95% Al, 5% Mg) double planar wire arrays (DPWAs) comprising six wires in each plane with interplanar gaps of 3.0 mm and 6.0 mm and interwire gaps of 0.7 mm and 1.0 mm were imploded with x-ray time-integrated spectra indicating electron temperatures of over 450 eV for K-shell Al and Mg, while producing mostly optically thin lines. In addition to x-ray time-integrated spectra, the diagnostics included x-ray time-integrated pinhole cameras, two silicon diodes, and shadowgraphy, which are analyzed and compared. The MAIZE LTD is capable of supplying up 1.0 MA, 100 kV pulses with 100 ns rise time into a matched load. However, for these experiments the LTD was charged to +-70 kV resulting in up to 0.5 MA with a current rise time of approximately 150 ns. Future experiments and the importance of studying planar wire arrays on LTD devices are discussed. This work supported by NNSA under DOE Cooperative Agreement DE-NA0001984. S. Patel & A. Steiner supported by Sandia. D. Yager-Elorriaga supported by NSF GF.

  16. Enabling Equal Access to Molecular Diagnostics: What Are the Implications for Policy and Health Technology Assessment?

    PubMed

    Plun-Favreau, Juliette; Immonen-Charalambous, Kaisa; Steuten, Lotte; Strootker, Anja; Rouzier, Roman; Horgan, Denis; Lawler, Mark

    2016-01-01

    Molecular diagnostics can offer important benefits to patients and are a key enabler of the integration of personalised medicine into health care systems. However, despite their promise, few molecular diagnostics are embedded into clinical practice (especially in Europe) and access to these technologies remains unequal across countries and sometimes even within individual countries. If research translation and the regulatory environments have proven to be more challenging than expected, reimbursement and value assessment remain the main barriers to providing patients with equal access to molecular diagnostics. Unclear or non-existent reimbursement pathways, together with the lack of clear evidence requirements, have led to significant delays in the assessment of molecular diagnostics technologies in certain countries. Additionally, the lack of dedicated diagnostics budgets and the siloed nature of resource allocation within certain health care systems have significantly delayed diagnostics commissioning. This article will consider the perspectives of different stakeholders (patients, health care payers, health care professionals, and manufacturers) on the provision of a research-enabled, patient-focused molecular diagnostics platform that supports optimal patient care. Through the discussion of specific case studies, and building on the experience from countries that have successfully integrated molecular diagnostics into clinical practice, this article will discuss the necessary evolutions in policy and health technology assessment to ensure that patients can have equal access to appropriate molecular diagnostics. © 2016 S. Karger AG, Basel.

  17. Comparison of a real-time PCR method with a culture method for the detection of Salmonella enterica serotype enteritidis in naturally contaminated environmental samples from integrated poultry houses.

    PubMed

    Lungu, Bwalya; Waltman, W Douglas; Berghaus, Roy D; Hofacre, Charles L

    2012-04-01

    Conventional culture methods have traditionally been considered the "gold standard" for the isolation and identification of foodborne bacterial pathogens. However, culture methods are labor-intensive and time-consuming. A Salmonella enterica serotype Enteritidis-specific real-time PCR assay that recently received interim approval by the National Poultry Improvement Plan for the detection of Salmonella Enteritidis was evaluated against a culture method that had also received interim National Poultry Improvement Plan approval for the analysis of environmental samples from integrated poultry houses. The method was validated with 422 field samples collected by either the boot sock or drag swab method. The samples were cultured by selective enrichment in tetrathionate broth followed by transfer onto a modified semisolid Rappaport-Vassiliadis medium and then plating onto brilliant green with novobiocin and xylose lysine brilliant Tergitol 4 plates. One-milliliter aliquots of the selective enrichment broths from each sample were collected for DNA extraction by the commercial PrepSEQ nucleic acid extraction assay and analysis by the Salmonella Enteritidis-specific real-time PCR assay. The real-time PCR assay detected no significant differences between the boot sock and drag swab samples. In contrast, the culture method detected a significantly higher number of positive samples from boot socks. The diagnostic sensitivity of the real-time PCR assay for the field samples was significantly higher than that of the culture method. The kappa value obtained was 0.46, indicating moderate agreement between the real-time PCR assay and the culture method. In addition, the real-time PCR method had a turnaround time of 2 days compared with 4 to 8 days for the culture method. The higher sensitivity as well as the reduction in time and labor makes this real-time PCR assay an excellent alternative to conventional culture methods for diagnostic purposes, surveillance, and research studies to improve food safety.

  18. A Comparison of Vibration and Oil Debris Gear Damage Detection Methods Applied to Pitting Damage

    NASA Technical Reports Server (NTRS)

    Dempsey, Paula J.

    2000-01-01

    Helicopter Health Usage Monitoring Systems (HUMS) must provide reliable, real-time performance monitoring of helicopter operating parameters to prevent damage of flight critical components. Helicopter transmission diagnostics are an important part of a helicopter HUMS. In order to improve the reliability of transmission diagnostics, many researchers propose combining two technologies, vibration and oil monitoring, using data fusion and intelligent systems. Some benefits of combining multiple sensors to make decisions include improved detection capabilities and increased probability the event is detected. However, if the sensors are inaccurate, or the features extracted from the sensors are poor predictors of transmission health, integration of these sensors will decrease the accuracy of damage prediction. For this reason, one must verify the individual integrity of vibration and oil analysis methods prior to integrating the two technologies. This research focuses on comparing the capability of two vibration algorithms, FM4 and NA4, and a commercially available on-line oil debris monitor to detect pitting damage on spur gears in the NASA Glenn Research Center Spur Gear Fatigue Test Rig. Results from this research indicate that the rate of change of debris mass measured by the oil debris monitor is comparable to the vibration algorithms in detecting gear pitting damage.

  19. Enhancements in medicine by integrating content based image retrieval in computer-aided diagnosis

    NASA Astrophysics Data System (ADS)

    Aggarwal, Preeti; Sardana, H. K.

    2010-02-01

    Computer-aided diagnosis (CAD) has become one of the major research subjects in medical imaging and diagnostic radiology. With cad, radiologists use the computer output as a "second opinion" and make the final decisions. Retrieving images is a useful tool to help radiologist to check medical image and diagnosis. The impact of contentbased access to medical images is frequently reported but existing systems are designed for only a particular context of diagnosis. The challenge in medical informatics is to develop tools for analyzing the content of medical images and to represent them in a way that can be efficiently searched and compared by the physicians. CAD is a concept established by taking into account equally the roles of physicians and computers. To build a successful computer aided diagnostic system, all the relevant technologies, especially retrieval need to be integrated in such a manner that should provide effective and efficient pre-diagnosed cases with proven pathology for the current case at the right time. In this paper, it is suggested that integration of content-based image retrieval (CBIR) in cad can bring enormous results in medicine especially in diagnosis. This approach is also compared with other approaches by highlighting its advantages over those approaches.

  20. Nanoporous Glass Integrated in Volumetric Bar-Chart Chip for Point-of-Care Diagnostics of Non-Small Cell Lung Cancer.

    PubMed

    Li, Ying; Xuan, Jie; Song, Yujun; Qi, Wenjin; He, Bangshun; Wang, Ping; Qin, Lidong

    2016-01-26

    Point-of-care (POC) testing has the potential to enable rapid, low-cost, and large-scale screening. POC detection of a multiplexed biomarker panel can facilitate the early diagnosis of non-small cell lung cancer (NSCLC) and, thus, may allow for more timely surgical intervention for life-saving treatment. Herein, we report the nanoporous glass (NPG) integrated volumetric bar-chart chip (V-Chip) for POC detection of the three NSCLC biomarkers CEA, CYFRA 21-1, and SCCA, by the naked eye. The 3D nanostructures in the NPG membrane efficiently increase the number of binding sites for antibodies and decrease the diffusion distance between antibody and antigen, enabling the low detection limit and rapid analysis time of the NPG-V-Chip. We utilized the NPG-V-Chip to test the NSCLC biomarker panel and found that the limit of detection can reach 50 pg/mL (10-fold improvement over the original V-Chip), and the total assay time can be decreased from 4 to 0.5 h. We then detected CEA in 21 serum samples from patients with common cancers, and the on-chip results showed good correlation with the clinical results. We further assayed 10 lung cancer samples using the device and confirmed the results obtained using conventional ELISA methods. In summary, the NPG-V-Chip platform has the ability of multiplex, low detection limit, low cost, lack of need for accessory equipment, and rapid analysis time, which may render the V-Chip a useful platform for quantitative POC detection in resource-limited settings and personalized diagnostics.

  1. Evaluation and Integration of Genetic Signature for Prediction Risk of Nasopharyngeal Carcinoma in Southern China

    PubMed Central

    Winkler, Cheryl A.; Li, Ji; Guan, Li; Tang, Minzhong; Liao, Jian; Deng, Hong; de Thé, Guy; Zeng, Yi; O'Brien, Stephen J.

    2014-01-01

    Genetic factors, as well as environmental factors, play a role in development of nasopharyngeal carcinoma (NPC). A number of single nucleotide polymorphisms (SNPs) have been reported to be associated with NPC. To confirm these genetic associations with NPC, two independent case-control studies from Southern China comprising 1166 NPC cases and 2340 controls were conducted. Seven SNPs in ITGA9 at 3p21.3 and 9 SNPs within the 6p21.3 HLA region were genotyped. To explore the potential clinical application of these genetic markers in NPC, we further evaluate the predictive/diagnostic role of significant SNPs by calculating the area under the curve (AUC). Results. The reported associations between ITGA9 variants and NPC were not replicated. Multiple loci of GABBR1, HLA-F, HLA-A, and HCG9 were statistically significant in both cohorts (P combined range from 5.96 × 10−17 to 0.02). We show for the first time that these factors influence NPC development independent of environmental risk factors. This study also indicated that the SNP alone cannot serve as a predictive/diagnostic marker for NPC. Integrating the most significant SNP with IgA antibodies status to EBV, which is presently used as screening/diagnostic marker for NPC in Chinese populations, did not improve the AUC estimate for diagnosis of NPC. PMID:25180181

  2. Evaluation and integration of genetic signature for prediction risk of nasopharyngeal carcinoma in Southern China.

    PubMed

    Guo, Xiuchan; Winkler, Cheryl A; Li, Ji; Guan, Li; Tang, Minzhong; Liao, Jian; Deng, Hong; de Thé, Guy; Zeng, Yi; O'Brien, Stephen J

    2014-01-01

    Genetic factors, as well as environmental factors, play a role in development of nasopharyngeal carcinoma (NPC). A number of single nucleotide polymorphisms (SNPs) have been reported to be associated with NPC. To confirm these genetic associations with NPC, two independent case-control studies from Southern China comprising 1166 NPC cases and 2340 controls were conducted. Seven SNPs in ITGA9 at 3p21.3 and 9 SNPs within the 6p21.3 HLA region were genotyped. To explore the potential clinical application of these genetic markers in NPC, we further evaluate the predictive/diagnostic role of significant SNPs by calculating the area under the curve (AUC). The reported associations between ITGA9 variants and NPC were not replicated. Multiple loci of GABBR1, HLA-F, HLA-A, and HCG9 were statistically significant in both cohorts (P(combined) range from 5.96 × 10(-17) to 0.02). We show for the first time that these factors influence NPC development independent of environmental risk factors. This study also indicated that the SNP alone cannot serve as a predictive/diagnostic marker for NPC. Integrating the most significant SNP with IgA antibodies status to EBV, which is presently used as screening/diagnostic marker for NPC in Chinese populations, did not improve the AUC estimate for diagnosis of NPC.

  3. EOS MLS Level 1B Data Processing Software. Version 3

    NASA Technical Reports Server (NTRS)

    Perun, Vincent S.; Jarnot, Robert F.; Wagner, Paul A.; Cofield, Richard E., IV; Nguyen, Honghanh T.; Vuu, Christina

    2011-01-01

    This software is an improvement on Version 2, which was described in EOS MLS Level 1B Data Processing, Version 2.2, NASA Tech Briefs, Vol. 33, No. 5 (May 2009), p. 34. It accepts the EOS MLS Level 0 science/engineering data, and the EOS Aura spacecraft ephemeris/attitude data, and produces calibrated instrument radiances and associated engineering and diagnostic data. This version makes the code more robust, improves calibration, provides more diagnostics outputs, defines the Galactic core more finely, and fixes the equator crossing. The Level 1 processing software manages several different tasks. It qualifies each data quantity using instrument configuration and checksum data, as well as data transmission quality flags. Statistical tests are applied for data quality and reasonableness. The instrument engineering data (e.g., voltages, currents, temperatures, and encoder angles) is calibrated by the software, and the filter channel space reference measurements are interpolated onto the times of each limb measurement with the interpolates being differenced from the measurements. Filter channel calibration target measurements are interpolated onto the times of each limb measurement, and are used to compute radiometric gain. The total signal power is determined and analyzed by each digital autocorrelator spectrometer (DACS) during each data integration. The software converts each DACS data integration from an autocorrelation measurement in the time domain into a spectral measurement in the frequency domain, and estimates separately the spectrally, smoothly varying and spectrally averaged components of the limb port signal arising from antenna emission and scattering effects. Limb radiances are also calibrated.

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

    NASA Astrophysics Data System (ADS)

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

    1999-09-01

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

  5. 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.

  6. Cause and Effect: Testing a Mechanism and Method for the Cognitive Integration of Basic Science.

    PubMed

    Kulasegaram, Kulamakan; Manzone, Julian C; Ku, Cheryl; Skye, Aimee; Wadey, Veronica; Woods, Nicole N

    2015-11-01

    Methods of integrating basic science with clinical knowledge are still debated in medical training. One possibility is increasing the spatial and temporal proximity of clinical content to basic science. An alternative model argues that teaching must purposefully expose relationships between the domains. The authors compared different methods of integrating basic science: causal explanations linking basic science to clinical features, presenting both domains separately but in proximity, and simply presenting clinical features First-year undergraduate health professions students were randomized to four conditions: (1) science-causal explanations (SC), (2) basic science before clinical concepts (BC), (3) clinical concepts before basic science (CB), and (4) clinical features list only (FL). Based on assigned conditions, participants were given explanations for four disorders in neurology or rheumatology followed by a memory quiz and diagnostic test consisting of 12 cases which were repeated after one week. Ninety-four participants completed the study. No difference was found on memory test performance, but on the diagnostic test, a condition by time interaction was found (F[3,88] = 3.05, P < .03, ηp = 0.10). Although all groups had similar immediate performance, the SC group had a minimal decrease in performance on delayed testing; the CB and FL groups had the greatest decreases. These results suggest that creating proximity between basic science and clinical concepts may not guarantee cognitive integration. Although cause-and-effect explanations may not be possible for all domains, making explicit and specific connections between domains will likely facilitate the benefits of integration for learners.

  7. Results from the commissioning of a multi-modal endoscope for ultrasound and time of flight PET

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

    Bugalho, Ricardo

    2015-07-01

    The EndoTOFPET-US collaboration has developed a multi-modal imaging system combining Ultrasound with Time-of-Flight Positron Emission Tomography into an endoscopic imaging device. The objective of the project is to obtain a coincidence time resolution of about 200 ps FWHM and to achieve about 1 mm spatial resolution of the PET system, while integrating all the components in a very compact detector suitable for endoscopic use. This scanner aims to be exploited for diagnostic and surgical oncology, as well as being instrumental in the clinical test of new biomarkers especially targeted for prostate and pancreatic cancer. (authors)

  8. An Overview of Prognosis Health Management Research at Glenn Research Center for Gas Turbine Engine Structures With Special Emphasis on Deformation and Damage Modeling

    NASA Technical Reports Server (NTRS)

    Arnold, Steven M.; Goldberg, Robert K.; Lerch, Bradley A.; Saleeb, Atef F.

    2009-01-01

    Herein a general, multimechanism, physics-based viscoelastoplastic model is presented in the context of an integrated diagnosis and prognosis methodology which is proposed for structural health monitoring, with particular applicability to gas turbine engine structures. In this methodology, diagnostics and prognostics will be linked through state awareness variable(s). Key technologies which comprise the proposed integrated approach include (1) diagnostic/detection methodology, (2) prognosis/lifing methodology, (3) diagnostic/prognosis linkage, (4) experimental validation, and (5) material data information management system. A specific prognosis lifing methodology, experimental characterization and validation and data information management are the focal point of current activities being pursued within this integrated approach. The prognostic lifing methodology is based on an advanced multimechanism viscoelastoplastic model which accounts for both stiffness and/or strength reduction damage variables. Methods to characterize both the reversible and irreversible portions of the model are discussed. Once the multiscale model is validated the intent is to link it to appropriate diagnostic methods to provide a full-featured structural health monitoring system.

  9. An Overview of Prognosis Health Management Research at GRC for Gas Turbine Engine Structures With Special Emphasis on Deformation and Damage Modeling

    NASA Technical Reports Server (NTRS)

    Arnold, Steven M.; Goldberg, Robert K.; Lerch, Bradley A.; Saleeb, Atef F.

    2009-01-01

    Herein a general, multimechanism, physics-based viscoelastoplastic model is presented in the context of an integrated diagnosis and prognosis methodology which is proposed for structural health monitoring, with particular applicability to gas turbine engine structures. In this methodology, diagnostics and prognostics will be linked through state awareness variable(s). Key technologies which comprise the proposed integrated approach include 1) diagnostic/detection methodology, 2) prognosis/lifing methodology, 3) diagnostic/prognosis linkage, 4) experimental validation and 5) material data information management system. A specific prognosis lifing methodology, experimental characterization and validation and data information management are the focal point of current activities being pursued within this integrated approach. The prognostic lifing methodology is based on an advanced multi-mechanism viscoelastoplastic model which accounts for both stiffness and/or strength reduction damage variables. Methods to characterize both the reversible and irreversible portions of the model are discussed. Once the multiscale model is validated the intent is to link it to appropriate diagnostic methods to provide a full-featured structural health monitoring system.

  10. 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.

  11. Intermittent explosive disorder: development of integrated research criteria for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.

    PubMed

    Coccaro, Emil F

    2011-01-01

    This study was designed to develop a revised diagnostic criteria set for intermittent explosive disorder (IED) for consideration for inclusion in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). This revised criteria set was developed by integrating previous research criteria with elements from the current DSM-IV set of diagnostic criteria. Evidence supporting the reliability and validity of IED-IR ("IED Integrated Criteria") in a new and well-characterized group of subjects with personality disorder is presented. Clinical, phenomenologic, and diagnostic data from 201 individuals with personality disorder were reviewed. All IED diagnoses were assigned using a best-estimate process (eg, kappa for IED-IR >0.85). In addition, subjects meeting IED-IR criteria had higher scores on dimensional measures of aggression and had lower global functioning scores than non-IED-IR subjects, even when related variables were controlled. The IED-IR criteria were more sensitive than the DSM-IV criteria only in identifying subjects with significant impulsive-aggressive behavior by a factor of 16. We conclude that the IED-IR criteria can be reliably applied and have sufficient validity to warrant consideration as DSM-V criteria for IED. Copyright © 2011 Elsevier Inc. All rights reserved.

  12. A fully-integrated aptamer-based affinity assay platform for monitoring astronaut health in space.

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

    Yang, Xianbin; Durland, Ross H.; Hecht, Ariel H.

    2010-07-01

    Here we demonstrate the suitability of robust nucleic acid affinity reagents in an integrated point-of-care diagnostic platform for monitoring proteomic biomarkers indicative of astronaut health in spaceflight applications. A model thioaptamer targeting nuclear factor-kappa B (NF-{kappa}B) is evaluated in an on-chip electrophoretic gel-shift assay for human serum. Key steps of (i) mixing sample with the aptamer, (ii) buffer exchange, and (iii) preconcentration of sample were successfully integrated upstream of fluorescence-based detection. Challenges due to (i) nonspecific interactions with serum, and (ii) preconcentration at a nanoporous membrane are discussed and successfully resolved to yield a robust, rapid, and fully-integrated diagnostic system.

  13. Moving Raman spectroscopy into real-time, online diagnosis and detection of precancer and cancer in vivo in the upper GI during clinical endoscopic examination

    NASA Astrophysics Data System (ADS)

    Huang, Zhiwei; Bergholt, Mads Sylvest; Zheng, Wei; Ho, Khek Yu; Yeoh, Khay Guan; Teh, Ming; So, Jimmy Bok Yan; Shabbir, Asim

    2013-03-01

    A rapid image-guided Raman endoscopy system integrated with on-line diagnostic scheme is developed for in vivo Raman tissue diagnosis (optical biopsy) in the upper GI during clinical gastrointestinal endoscopy under multimodal wide-field imaging guidance. The real-time Raman endoscopy technique was tested prospectively on new gastric patients (n=4) and could identify dysplasia in vivo with sensitivity of 81.5% (22/27) and specificity of 87.9% (29/33). This study realizes for the first time the novel image-guided Raman endoscopy as a screening tool for real-time, online diagnosis of gastric cancer and precancer in vivo at endoscopy.

  14. Dielectrophoresis-Based Sample Handling in General-Purpose Programmable Diagnostic Instruments

    PubMed Central

    Gascoyne, Peter R. C.; Vykoukal, Jody V.

    2009-01-01

    As the molecular origins of disease are better understood, the need for affordable, rapid, and automated technologies that enable microscale molecular diagnostics has become apparent. Widespread use of microsystems that perform sample preparation and molecular analysis could ensure that the benefits of new biomedical discoveries are realized by a maximum number of people, even those in environments lacking any infrastructure. While progress has been made in developing miniaturized diagnostic systems, samples are generally processed off-device using labor-intensive and time-consuming traditional sample preparation methods. We present the concept of an integrated programmable general-purpose sample analysis processor (GSAP) architecture where raw samples are routed to separation and analysis functional blocks contained within a single device. Several dielectrophoresis-based methods that could serve as the foundation for building GSAP functional blocks are reviewed including methods for cell and particle sorting, cell focusing, cell ac impedance analysis, cell lysis, and the manipulation of molecules and reagent droplets. PMID:19684877

  15. Point-of-Care Diagnostics in Low Resource Settings: Present Status and Future Role of Microfluidics

    PubMed Central

    Sharma, Shikha; Zapatero-Rodríguez, Julia; Estrela, Pedro; O’Kennedy, Richard

    2015-01-01

    The inability to diagnose numerous diseases rapidly is a significant cause of the disparity of deaths resulting from both communicable and non-communicable diseases in the developing world in comparison to the developed world. Existing diagnostic instrumentation usually requires sophisticated infrastructure, stable electrical power, expensive reagents, long assay times, and highly trained personnel which is not often available in limited resource settings. This review will critically survey and analyse the current lateral flow-based point-of-care (POC) technologies, which have made a major impact on diagnostic testing in developing countries over the last 50 years. The future of POC technologies including the applications of microfluidics, which allows miniaturisation and integration of complex functions that facilitate their usage in limited resource settings, is discussed The advantages offered by such systems, including low cost, ruggedness and the capacity to generate accurate and reliable results rapidly, are well suited to the clinical and social settings of the developing world. PMID:26287254

  16. [Role of contemporary pathological diagnostics in the personalized treatment of cancer].

    PubMed

    Tímár, József

    2013-03-01

    Due to the developments of pathology in the past decades (immunohistochemistry and molecular pathology) classification of cancers changed fundamentally, laying a ground for personalized management of cancer patients. Our picture of cancer is more complex today, identifying the genetic basis of the morphological variants. On the other hand, this picture has a much higher resolution enabling us to subclassify similar histological cancer types based on molecular markers. This redefined classification of cancers helps us to better predict the possible biological behavior of the disease and/or the therapeutic sensitivity, opening the way toward a more personalized treatment of this disease. The redefined molecular classification of cancer may affect the universal application of treatment protocols. To achieve this goal molecular diagnostics must be an integral and reimbursed part of the routine pathological diagnostics. On the other hand, it is time to extend the multidisciplinary team with molecular pathologist to improve the decision making process of the management of cancer patients.

  17. A new multidimensional diagnostic method for measuring the properties of intense ion beams

    NASA Astrophysics Data System (ADS)

    Yasuike, Kazuhito; Miyamoto, Shuji; Nakai, Sadao

    1996-02-01

    A new arrayed pinhole camera (APC) diagnostic method for intense ion beams has been developed. The APC diagnostic technique permits the acquisition of the angular divergences and the ion fluxes of high intensity ion beams, in one shot, with a spatial resolution on the source of better than 1 mm and an effective angular divergence resolution of better than 10 mrad. A prototype time integrated APC has been designed and evaluated. The demonstration experiments have been performed on a Reiden-IV, 1 MV and 1 Ω pulsed power machine [1 T W (tera-watt or trillion watts)]. Proton beams of 0.7 MeV, with a pulse duration of ˜50 ns and an ion current density of about 100 A/cm2, were generated in an applied-Br type ion diode source using paraffin-filled grooves. These experimental results show that the APC can measure nonuniformities in the ion beam intensity generated from the ion source and the dependence of beam angular divergence on ion beam intensity.

  18. Stabilization of biothreat diagnostic samples through vitrification matrices.

    PubMed

    Minogue, Timothy Devin; Kalina, Warren Vincent; Coyne, Susan Rajnik

    2014-06-01

    Diagnostics for biothreat agents require sample shipment to reference labs for diagnosis of disease; however high/fluctuating temperatures during sample transport negatively affect sample quality and results. Vitrification additives preserve sample integrity for molecular-based assay diagnostics in the absence of refrigeration by imparting whole molecule stability to a plethora of environmental insults. Therefore, we have evaluated commercially available vitrification matrices' (Biomatrica's CloneStable® and RNAStable®) ability to stabilize samples of Yersinia pestis and Venezuelan Equine Encephalitis Virus. When heated to 95°C in RNAStable®, Y. pestis had a 13-fold improvement in detection via real-time PCR compared to heated samples in buffer. VEEV, in RNAStable® at 55°C, had a ~10-fold improved detection versus heated samples in buffer. CloneStable® also preserved Y. pestis antigens for 7days after exposure to cycling temperatures. Overall, RNAStable® and CloneStable® respectively offered superior stabilization to nucleic acids and proteins in response to temperature fluctuations. Copyright © 2014. Published by Elsevier B.V.

  19. An overview of optical diagnostics developed for the Lockheed Martin compact fusion reactor

    NASA Astrophysics Data System (ADS)

    Sommers, Bradley; Raymond, Anthony; Gucker, Sarah; Lockheed Martin Compact Fusion Reactor Team

    2017-10-01

    The T4B experiment is a linear, encapsulated ring cusp confinement device, designed to develop a physics and technology basis for a follow-on high beta machine as part of the compact fusion reactor program. Toward this end, a collection of non-invasive optical diagnostics have been developed to investigate confinement, neutral beam heating, and source behavior on the T4B device. These diagnostics include: (1) a multipoint Thomson scattering system employing a 532 nm Nd:YAG laser and high throughput spectrometer to measure 1D profiles of electron density and temperature, (2) a dispersion interferometer utilizing a continuous-wave CO2 laser (10.6 μm) to measure time resolved, line-integrated electron density, and (3) a bolometer suite utilizing four AXUV photodiodes with 64 lines of sight to generate 2D reconstructions of total radiative power and soft x-ray emission (via beryllium filters). An overview of design methods, including laser systems, detection schemes, and data analysis techniques is presented as well as results to date.

  20. Physics and Engineering Design of the ITER Electron Cyclotron Emission Diagnostic

    NASA Astrophysics Data System (ADS)

    Rowan, W. L.; Austin, M. E.; Houshmandyar, S.; Phillips, P. E.; Beno, J. H.; Ouroua, A.; Weeks, D. A.; Hubbard, A. E.; Stillerman, J. A.; Feder, R. E.; Khodak, A.; Taylor, G.; Pandya, H. K.; Danani, S.; Kumar, R.

    2015-11-01

    Electron temperature (Te) measurements and consequent electron thermal transport inferences will be critical to the non-active phases of ITER operation and will take on added importance during the alpha heating phase. Here, we describe our design for the diagnostic that will measure spatial and temporal profiles of Te using electron cyclotron emission (ECE). Other measurement capability includes high frequency instabilities (e.g. ELMs, NTMs, and TAEs). Since results from TFTR and JET suggest that Thomson Scattering and ECE differ at high Te due to driven non-Maxwellian distributions, non-thermal features of the ITER electron distribution must be documented. The ITER environment presents other challenges including space limitations, vacuum requirements, and very high-neutron-fluence. Plasma control in ITER will require real-time Te. The diagnosic design that evolved from these sometimes-conflicting needs and requirements will be described component by component with special emphasis on the integration to form a single effective diagnostic system. Supported by PPPL/US-DA via subcontract S013464-C to UT Austin.

  1. Nanostructured plasmonic interferometers for ultrasensitive label-free biosensing

    NASA Astrophysics Data System (ADS)

    Gao, Yongkang

    Optical biosensors that utilize surface plasmon resonance (SPR) technique to analyze the biomolecular interactions have been extensively explored in the last two decades and have become the gold standard for label-free biosensing. These powerful sensing tools allow fast, highly-sensitive monitoring of the interaction between biomolecules in real time, without the need for laborious fluorescent labeling, and have found widely ranging applications from biomedical diagnostics and drug discovery, to environmental sensing and food safety monitoring. However, the prism-coupling SPR geometry is complex and bulky, and has severely limited the integration of this technique into low-cost portable biomedical devices for point-of-care diagnostics and personal healthcare applications. Also, the complex prism-coupling scheme prevents the use of high numerical aperture (NA) optics to increase the spatial resolution for multi-channel, high-throughput detection in SPR imaging mode. This dissertation is focused on the design and fabrication of a promising new class of nanopatterned interferometric SPR sensors that integrate the strengths of miniaturized nanoplasmonic architectures with sensitive optical interferometry techniques to achieve bold advances in SPR biosensing. The nanosensor chips developed provide superior sensing performance comparable to conventional SPR systems, but employing a far simpler collinear optical transmission geometry, which largely facilitates system integration, miniaturization, and low-cost production. Moreover, the fabricated nanostructure-based SPR sensors feature a very small sensor footprint, allowing massive multiplexing on a chip for high-throughput detection. The successful transformation of SPR technique from bulky prism-coupling setup into this low-cost compact plasmonic platform would have a far-reaching impact on point-of-care diagnostic tools and also lead to advances in high-throughput sensing applications in proteomics, immunology, drug discovery, and fundamental cell biology research.

  2. Optical Diagnostic System For Observation Of Laser-Produced Shock Waves

    NASA Astrophysics Data System (ADS)

    Wilke, Mark D.; Stone, Sidney N.

    1980-11-01

    Several standard plasma and gas dynamic diagnostic techniques have been integrated into a system for observing the formation and propagation of high-power Nd:glass-laser generated one- and two-dimensional shockwaves in air from 0.1 torr to atmospheric pres-sures. Diagnostics include either single-frame, two-wavelength holographic ruby-laser interferometry or single-frame, single-wavelength interferometry with ten frames of shadow-graphy. Streaks or ten frames of the early luminous shocked region also are taken on all shots, as well as time-resolved luminosity measurements using high-speed biplanar vacuum photodiodes with various wavelength interference filters. Shadowgraphy frames are 200-ns long at 1-μs intervals, while emission frames are variable with a maximum 10-ns exposure and 50-ns interval. Both the streak mode and emission measurements with the vacuum diode allow subnanosecond time resolution. The interferometry provides 20-ns exposures from 500 ns to late times. Methods for reducing and interpreting the data have been, or are currently being, developed. Interactive computer programs for digitizing the fringe patterns provide fringe-shift profiles for Abel inversion. This has provided neutral gas and electron density information in the spherical, one-dimensional cases. Diagrams and photographs of the experiment will be shown as well as examples of the data that have been taken. Methods for data reduction will be outlined and some of the results shown.

  3. Development of computer informational system of diagnostics integrated optical materials, elements, and devices

    NASA Astrophysics Data System (ADS)

    Volosovitch, Anatoly E.; Konopaltseva, Lyudmila I.

    1995-11-01

    Well-known methods of optical diagnostics, database for their storage, as well as expert system (ES) for their development are analyzed. A computer informational system is developed, which is based on a hybrid ES built on modern DBMS. As an example, the structural and constructive circuits of the hybrid integrated-optical devices based on laser diodes, diffusion waveguides, geodetic lenses, package-free linear photodiode arrays, etc. are presented. The features of methods and test results as well as the advanced directions of works related to the hybrid integrated-optical devices in the field of metrology are discussed.

  4. Integrating palliative care into disease management guidelines.

    PubMed

    Emanuel, Linda; Alexander, Carla; Arnold, Robert M; Bernstein, Richard; Dart, Richard; Dellasantina, Christopher; Dykstra, Lee; Tulsky, James

    2004-12-01

    Palliative care should not be reserved for those who are close to dying; as a comprehensive approach to minimizing illness-related suffering, it is appropriate for patients with significant illness from the time of diagnosis on. The American Hospice Foundation Guidelines Committee's initiative aims to provide a practical approach for guideline writers and others to integrate palliative care into disease management and care services whenever it is relevant. A consensus approach was used to design recommendations for upgrading existing disease management and service guidelines to include palliative care. A template is described for identifying stages in disease management guidelines when integration of palliative care is appropriate: (1) Introductory sections to disease management guidelines should include prognosis and other disease consequences; (2) Diagnostic sections should include recommendations for conducting a whole patient assessment; (3) Treatment sections should include discernment of patient goals for care, continuous goal reassessment, palliative care interventions to reduce suffering as needed, and treatment decisions should include discussion of the type of expected improvement. Service guidelines should note the role of interdisciplinary team care as well as palliative care consultative or care services; (4) Sections that conclude the care provided to incurable patients should not end without recommendations on grief and bereavement care, and care during the last hours of living. The American Hospice Foundation Guidelines Committee recommends integration of relevant aspects of palliative care in introductory, diagnostic, treatment, and closing sections of management guidelines for all significant illnesses.

  5. Turfgrass diagnostics and new, advanced technologies

    USDA-ARS?s Scientific Manuscript database

    Strategies for sustainable, integrated disease management start with reliable pathogen identification. Conventional identification methods such as disease symptomology, host association, morphology and biochemical tests are still key diagnostic indicators for many phytopathogens; however, nucleic ac...

  6. Device for wavelength-selective imaging

    DOEpatents

    Frangioni, John V.

    2010-09-14

    An imaging device captures both a visible light image and a diagnostic image, the diagnostic image corresponding to emissions from an imaging medium within the object. The visible light image (which may be color or grayscale) and the diagnostic image may be superimposed to display regions of diagnostic significance within a visible light image. A number of imaging media may be used according to an intended application for the imaging device, and an imaging medium may have wavelengths above, below, or within the visible light spectrum. The devices described herein may be advantageously packaged within a single integrated device or other solid state device, and/or employed in an integrated, single-camera medical imaging system, as well as many non-medical imaging systems that would benefit from simultaneous capture of visible-light wavelength images along with images at other wavelengths.

  7. Time-resolved magnetic spectrometer measurements of the SABRE positive polarity magnetically insulated transmission line voltage

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

    Menge, P.R.; Cuneo, M.E.; Hanson, D.L.

    A magnetic spectrometer has been fielded on the coaxial magnetically insulated transmission line (MITL) of the SABRE ten-cavity inductive voltage adder operated in positive polarity (6 MV, 300 kA, 50 ns). Located 1 m upstream from an extraction ion diode, this diagnostic is capable of measuring the SABRE voltage pulse with a 2 ns resolution. Ions (protons and carbon) from either a flashover or plasma gun source are accelerated from the inner anode across the gap to the outer cathode and into a drift tube terminated by the magnetic spectrometer. The magnetically deflected ions are recorded on up to sixteenmore » PIN diodes (diameter = 1 mm, thickness = 35 {mu}). The voltage waveform is produced from the time-of-flight information. Results confirm previous observations of a vacuum wave precursor separated from the magnetically insulated wave. Verification of upstream precursor erosion techniques are possible with this instrument. Measurements of peak voltage show good agreement with other time-integrated voltage diagnostics. Comparisons with theoretical voltage predictions derived from a flow impedance model of MITL behavior will be presented.« less

  8. Spectroscopy of T Tauri stars with UVES. Observations and analysis of RU Lup

    NASA Astrophysics Data System (ADS)

    Stempels, H. C.; Piskunov, N.

    2002-08-01

    We present the first results of our observations of classical T Tauri Stars with UVES/VLT. The data consists of high signal-to-noise (ge 150) and high spectral resolution (R ~ 60 000) spectra. A large simultaneous wavelength coverage throughout most of the visible spectrum and comparatively short integration times allow us to study variability on short time-scales, using a number of diagnostics reflecting a wide range of physical processes. In particular we concentrate on the properties and geometry of the accretion process in the strongly accreting and highly variable CTTS RU Lup. We use the evolution of the level of veiling, the shapes of absorption and emission lines, and correlations between these diagnostics, to make new measurements of the fundamental stellar parameters as well as constraints on the accretion process and its geometry. We also derive the shortest time-scale of incoherent changes, which has implications for the nature of the accretion process in RU Lup. Based on observations collected at the European Southern Observatory, Chile (proposal 65.I-0404).

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

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

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

    2012-08-27

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

  10. New Aspects in the Differential Diagnosis and Therapy of Bladder Pain Syndrome/Interstitial Cystitis

    PubMed Central

    Neuhaus, Jochen; Schwalenberg, Thilo; Horn, Lars-Christian; Alexander, Henry; Stolzenburg, Jens-Uwe

    2011-01-01

    Diagnosis of bladder pain syndrome/interstitial cystitis (BPS/IC) is presently based on mainly clinical symptoms. BPS/IC can be considered as a worst-case scenario of bladder overactivity of unknown origin, including bladder pain. Usually, patients are partially or completely resistant to anticholinergic therapy, and therapeutical options are especially restricted in case of BPS/IC. Therefore, early detection of patients prone to develop BPS/IC symptoms is essential for successful therapy. We propose extended diagnostics including molecular markers. Differential diagnosis should be based on three diagnostical “columns”: (i) clinical diagnostics, (ii) histopathology, and (iii) molecular diagnostics. Analysis of molecular alterations of receptor expression in detrusor smooth muscle cells and urothelial integrity is necessary to develop patient-tailored therapeutical concepts. Although more research is needed to elucidate the pathomechanisms involved, extended BPS/IC diagnostics could already be integrated into routine patient care, allowing evidence-based pharmacotherapy of patients with idiopathic bladder overactivity and BPS/IC. PMID:22028706

  11. New aspects in the differential diagnosis and therapy of bladder pain syndrome/interstitial cystitis.

    PubMed

    Neuhaus, Jochen; Schwalenberg, Thilo; Horn, Lars-Christian; Alexander, Henry; Stolzenburg, Jens-Uwe

    2011-01-01

    Diagnosis of bladder pain syndrome/interstitial cystitis (BPS/IC) is presently based on mainly clinical symptoms. BPS/IC can be considered as a worst-case scenario of bladder overactivity of unknown origin, including bladder pain. Usually, patients are partially or completely resistant to anticholinergic therapy, and therapeutical options are especially restricted in case of BPS/IC. Therefore, early detection of patients prone to develop BPS/IC symptoms is essential for successful therapy. We propose extended diagnostics including molecular markers. Differential diagnosis should be based on three diagnostical "columns": (i) clinical diagnostics, (ii) histopathology, and (iii) molecular diagnostics. Analysis of molecular alterations of receptor expression in detrusor smooth muscle cells and urothelial integrity is necessary to develop patient-tailored therapeutical concepts. Although more research is needed to elucidate the pathomechanisms involved, extended BPS/IC diagnostics could already be integrated into routine patient care, allowing evidence-based pharmacotherapy of patients with idiopathic bladder overactivity and BPS/IC.

  12. Targeted therapies with companion diagnostics in the management of breast cancer: current perspectives.

    PubMed

    Myers, Meagan B

    2016-01-01

    Breast cancer is a multifaceted disease exhibiting both intertumoral and intratumoral heterogeneity as well as variable disease course. Over 2 decades of research has advanced the understanding of the molecular substructure of breast cancer, directing the development of new therapeutic strategies against these actionable targets. In vitro diagnostics, and specifically companion diagnostics, have been integral in the successful development and implementation of these targeted therapies, such as those directed against the human epidermal growth factor receptor 2. Lately, there has been a surge in the development, commercialization, and marketing of diagnostic assays to assist in breast cancer patient care. More recently, multigene signature assays, such as Oncotype DX, MammaPrint, and Prosigna, have been integrated in the clinical setting in order to tailor decisions on adjuvant endocrine and chemotherapy treatment. This review provides an overview of the current state of breast cancer management and the use of companion diagnostics to direct personalized approaches in the treatment of breast cancer.

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

    DTIC Science & Technology

    2010-04-01

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

  14. Diagnostic Validity of an Automated Probabilistic Tractography in Amnestic Mild Cognitive Impairment

    PubMed Central

    Jung, Won Sang; Um, Yoo Hyun; Kang, Dong Woo; Lee, Chang Uk; Woo, Young Sup; Bahk, Won-Myong

    2018-01-01

    Objective Although several prior works showed the white matter (WM) integrity changes in amnestic mild cognitive impairment (aMCI) and Alzheimer’s disease, it is still unclear the diagnostic accuracy of the WM integrity measurements using diffusion tensor imaging (DTI) in discriminating aMCI from normal controls. The aim of this study is to explore diagnostic validity of whole brain automated probabilistic tractography in discriminating aMCI from normal controls. Methods One hundred-two subjects (50 aMCI and 52 normal controls) were included and underwent DTI scans. Whole brain WM tracts were reconstructed with automated probabilistic tractography. Fractional anisotropy (FA) and mean diffusivity (MD) values of the memory related WM tracts were measured and compared between the aMCI and the normal control groups. In addition, the diagnostic validities of these WM tracts were evaluated. Results Decreased FA and increased MD values of memory related WM tracts were observed in the aMCI group compared with the control group. Among FA and MD value of each tract, the FA value of left cingulum angular bundle showed the highest area under the curve (AUC) of 0.85 with a sensitivity of 88.2%, a specificity of 76.9% in differentiating MCI patients from control subjects. Furthermore, the combination FA values of WM integrity measures of memory related WM tracts showed AUC value of 0.98, a sensitivity of 96%, a specificity of 94.2%. Conclusion Our results with good diagnostic validity of WM integrity measurements suggest DTI might be promising neuroimaging tool for early detection of aMCI and AD patients. PMID:29739127

  15. Measures of accuracy and performance of diagnostic tests.

    PubMed

    Drobatz, Kenneth J

    2009-05-01

    Diagnostic tests are integral to the practice of veterinary cardiology, any other specialty, and general veterinary medicine. Developing and understanding diagnostic tests is one of the cornerstones of clinical research. This manuscript describes the diagnostic test properties including sensitivity, specificity, predictive value, likelihood ratio, receiver operating characteristic curve. Review of practical book chapters and standard statistics manuscripts. Diagnostics such as sensitivity, specificity, predictive value, likelihood ratio, and receiver operating characteristic curve are described and illustrated. Basic understanding of how diagnostic tests are developed and interpreted is essential in reviewing clinical scientific papers and understanding evidence based medicine.

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

    PubMed Central

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

    2017-01-01

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

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

    PubMed

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

    2017-01-01

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

  18. Characterization of ultrafast laser-ablation plasma plumes at various Ar ambient pressures

    DOE PAGES

    Diwakar, P. K.; Harilal, S. S.; Phillips, M. C.; ...

    2015-07-30

    Expansion dynamics and internal plume structures of fs laser ablated brass plasma in Ar at various pressure levels ranging from vacuum to atmospheric were studied using multitude of diagnostic tools including time resolved and time integrated 2-dimensional imaging, optical time of flight measurements and visible emission spectroscopy. Temporal evolution of excited Cu and Zn species in the plume were imaged using band pass interference filters and compared its hydrodynamic expansion features with spectrally integrated images of the plume. 2D imaging coupled with monochromatic line selection showed several interesting features at various pressure levels which include velocity differences among the plumemore » species, emission intensity distribution, plasma temperature, electron density etc. Plume confinement, enhanced signal intensity, and dual peak structures in time-of-flight profiles were observed at intermediate pressure range of ~10 Torr. Optimum signal to background ratio was also observed in this pressure range. As a result, possible mechanisms for observed changes in plume shape, optical emission intensity and dual peak structures in time-of-flight profiles were discussed.« less

  19. [Revision of McDonald's new diagnostic criteria for multiple sclerosis].

    PubMed

    Wiendl, H; Kieseier, B C; Gold, R; Hohlfeld, R; Bendszus, M; Hartung, H-P

    2006-10-01

    In 2001, an international panel suggested new diagnostic criteria for multiple sclerosis (MS). These criteria integrate clinical, imaging (MRI), and paraclinical results in order to facilitate diagnosis. Since then, these so-called McDonald criteria have been broadly accepted and widely propagated. In the meantime a number of publications have dealt with the sensitivity and specificity for MS diagnosis and with implementing these new criteria in clinical practice. Based on these empirical values and newer data on MS, an international expert group recently proposed a revision of the criteria. Substantial changes affect (1) MRI criteria for the dissemination of lesions over time, (2) the role of spinal cord lesions in the MRI and (3) diagnosis of primary progressive MS. In this article we present recent experiences with the McDonald and revised criteria.

  20. Microfluidics-Enabled Diagnostic Systems: Markets, Challenges, and Examples.

    PubMed

    Becker, Holger; Gärtner, Claudia

    2017-01-01

    Microfluidics has become an important tool for the commercial product development in diagnostics. This article will focus on current technical demands during the development process such as material and integration challenges. Furthermore, we present data on the diagnostics market as well as examples of microfluidics-enabled systems currently under commercial development or already on the market.

  1. Embedded Reasoning Supporting Aerospace IVHM

    DTIC Science & Technology

    2007-01-01

    c method (BIT or health assessment algorithm) which the monitoring diagnostic relies on input information tics and Astronautics In the diagram...viewing of the current health state of all monitored subsystems, while also providing a means to probe deeper in the event anomalous operation is...seeks to integrate detection , diagnostic, and prognostic capabilities with a hierarchical diagnostic reasoning architecture into a single

  2. Software Testbed for Developing and Evaluating Integrated Autonomous Subsystems

    NASA Technical Reports Server (NTRS)

    Ong, James; Remolina, Emilio; Prompt, Axel; Robinson, Peter; Sweet, Adam; Nishikawa, David

    2015-01-01

    To implement fault tolerant autonomy in future space systems, it will be necessary to integrate planning, adaptive control, and state estimation subsystems. However, integrating these subsystems is difficult, time-consuming, and error-prone. This paper describes Intelliface/ADAPT, a software testbed that helps researchers develop and test alternative strategies for integrating planning, execution, and diagnosis subsystems more quickly and easily. The testbed's architecture, graphical data displays, and implementations of the integrated subsystems support easy plug and play of alternate components to support research and development in fault-tolerant control of autonomous vehicles and operations support systems. Intelliface/ADAPT controls NASA's Advanced Diagnostics and Prognostics Testbed (ADAPT), which comprises batteries, electrical loads (fans, pumps, and lights), relays, circuit breakers, invertors, and sensors. During plan execution, an experimentor can inject faults into the ADAPT testbed by tripping circuit breakers, changing fan speed settings, and closing valves to restrict fluid flow. The diagnostic subsystem, based on NASA's Hybrid Diagnosis Engine (HyDE), detects and isolates these faults to determine the new state of the plant, ADAPT. Intelliface/ADAPT then updates its model of the ADAPT system's resources and determines whether the current plan can be executed using the reduced resources. If not, the planning subsystem generates a new plan that reschedules tasks, reconfigures ADAPT, and reassigns the use of ADAPT resources as needed to work around the fault. The resource model, planning domain model, and planning goals are expressed using NASA's Action Notation Modeling Language (ANML). Parts of the ANML model are generated automatically, and other parts are constructed by hand using the Planning Model Integrated Development Environment, a visual Eclipse-based IDE that accelerates ANML model development. Because native ANML planners are currently under development and not yet sufficiently capable, the ANML model is translated into the New Domain Definition Language (NDDL) and sent to NASA's EUROPA planning system for plan generation. The adaptive controller executes the new plan, using augmented, hierarchical finite state machines to select and sequence actions based on the state of the ADAPT system. Real-time sensor data, commands, and plans are displayed in information-dense arrays of timelines and graphs that zoom and scroll in unison. A dynamic schematic display uses color to show the real-time fault state and utilization of the system components and resources. An execution manager coordinates the activities of the other subsystems. The subsystems are integrated using the Internet Communications Engine (ICE). an object-oriented toolkit for building distributed applications.

  3. Mucosal Impedance: a New Approach to Diagnosing Gastroesophageal Reflux Disease and Eosinophilic Esophagitis.

    PubMed

    Barrett, Caroline; Choksi, Yash; Vaezi, Michael F

    2018-06-09

    In this review, we discuss current diagnostic testing modalities for both gastroesophageal reflux disease (GERD) and eosinophilic esophagitis (EoE) and then introduce mucosal impedance (MI), a novel technology that measures epithelial integrity in real time during endoscopy. We describe the advantages and disadvantages of MI as compared with traditional diagnostic testing. We review studies that demonstrate that GERD and EoE have distinct MI patterns, and that physicians can accurately diagnose and distinguish the two during endoscopy with minimal time added to the procedure. We also review studies showing that MI has the capability to assess treatment response in both GERD and EoE and that it can be used to diagnose GERD in patients with extraesophageal reflux symptoms. Mucosal impedance testing is a major advancement in the diagnosis of GERD and EoE. Future studies are planned to assess whether MI can be used as a treatment endpoint in EoE and whether it can be used to predict response to anti-reflux surgery.

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

    NASA Astrophysics Data System (ADS)

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

    1993-06-01

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

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

    NASA Astrophysics Data System (ADS)

    Toker, Emre; Piccaro, Michele F.

    1993-12-01

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

  6. Synthetic neutron camera and spectrometer in JET based on AFSI-ASCOT simulations

    NASA Astrophysics Data System (ADS)

    Sirén, P.; Varje, J.; Weisen, H.; Koskela, T.; contributors, JET

    2017-09-01

    The ASCOT Fusion Source Integrator (AFSI) has been used to calculate neutron production rates and spectra corresponding to the JET 19-channel neutron camera (KN3) and the time-of-flight spectrometer (TOFOR) as ideal diagnostics, without detector-related effects. AFSI calculates fusion product distributions in 4D, based on Monte Carlo integration from arbitrary reactant distribution functions. The distribution functions were calculated by the ASCOT Monte Carlo particle orbit following code for thermal, NBI and ICRH particle reactions. Fusion cross-sections were defined based on the Bosch-Hale model and both DD and DT reactions have been included. Neutrons generated by AFSI-ASCOT simulations have already been applied as a neutron source of the Serpent neutron transport code in ITER studies. Additionally, AFSI has been selected to be a main tool as the fusion product generator in the complete analysis calculation chain: ASCOT - AFSI - SERPENT (neutron and gamma transport Monte Carlo code) - APROS (system and power plant modelling code), which encompasses the plasma as an energy source, heat deposition in plant structures as well as cooling and balance-of-plant in DEMO applications and other reactor relevant analyses. This conference paper presents the first results and validation of the AFSI DD fusion model for different auxiliary heating scenarios (NBI, ICRH) with very different fast particle distribution functions. Both calculated quantities (production rates and spectra) have been compared with experimental data from KN3 and synthetic spectrometer data from ControlRoom code. No unexplained differences have been observed. In future work, AFSI will be extended for synthetic gamma diagnostics and additionally, AFSI will be used as part of the neutron transport calculation chain to model real diagnostics instead of ideal synthetic diagnostics for quantitative benchmarking.

  7. Diagnostic microbiology in veterinary dermatology: present and future.

    PubMed

    Guardabassi, Luca; Damborg, Peter; Stamm, Ivonne; Kopp, Peter A; Broens, Els M; Toutain, Pierre-Louis

    2017-02-01

    The microbiology laboratory can be perceived as a service provider rather than an integral part of the healthcare team. The aim of this review is to discuss the current challenges of providing a state-of-the-art diagnostic veterinary microbiology service including the identification (ID) and antimicrobial susceptibility testing (AST) of key pathogens in veterinary dermatology. The Study Group for Veterinary Microbiology (ESGVM) of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) identified scientific, technological, educational and regulatory issues impacting the predictive value of AST and the quality of the service offered by microbiology laboratories. The advent of mass spectrometry has significantly reduced the time required for ID of key pathogens such as Staphylococcus pseudintermedius. However, the turnaround time for validated AST methods has remained unchanged for many years. Beyond scientific and technological constraints, AST methods are not harmonized and clinical breakpoints for some antimicrobial drugs are either missing or inadequate. Small laboratories, including in-clinic laboratories, are usually not adequately equipped to run up-to-date clinical microbiologic diagnostic tests. ESGVM recommends the use of laboratories employing mass spectrometry for ID and broth micro-dilution for AST, and offering assistance by expert microbiologists on pre- and post-analytical issues. Setting general standards for veterinary clinical microbiology, promoting antimicrobial stewardship, and the development of new, validated and rapid diagnostic methods, especially for AST, are among the missions of ESGVM. © 2017 The Authors. Veterinary Dermatology published by John Wiley & Sons Ltd on behalf of the ESVD and ACVD.

  8. Imaging of high-energy x-ray emission from cryogenic thermonuclear fuel implosions on the NIF.

    PubMed

    Ma, T; Izumi, N; Tommasini, R; Bradley, D K; Bell, P; Cerjan, C J; Dixit, S; Döppner, T; Jones, O; Kline, J L; Kyrala, G; Landen, O L; LePape, S; Mackinnon, A J; Park, H-S; Patel, P K; Prasad, R R; Ralph, J; Regan, S P; Smalyuk, V A; Springer, P T; Suter, L; Town, R P J; Weber, S V; Glenzer, S H

    2012-10-01

    Accurately assessing and optimizing the implosion performance of inertial confinement fusion capsules is a crucial step to achieving ignition on the NIF. We have applied differential filtering (matched Ross filter pairs) to provide broadband time-integrated absolute x-ray self-emission images of the imploded core of cryogenic layered implosions. This diagnostic measures the temperature- and density-sensitive bremsstrahlung emission and provides estimates of hot spot mass, mix mass, and pressure.

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

    DTIC Science & Technology

    1983-02-01

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

  10. The rare and undiagnosed diseases diagnostic service - application of massively parallel sequencing in a state-wide clinical service.

    PubMed

    Baynam, Gareth; Pachter, Nicholas; McKenzie, Fiona; Townshend, Sharon; Slee, Jennie; Kiraly-Borri, Cathy; Vasudevan, Anand; Hawkins, Anne; Broley, Stephanie; Schofield, Lyn; Verhoef, Hedwig; Walker, Caroline E; Molster, Caron; Blackwell, Jenefer M; Jamieson, Sarra; Tang, Dave; Lassmann, Timo; Mina, Kym; Beilby, John; Davis, Mark; Laing, Nigel; Murphy, Lesley; Weeramanthri, Tarun; Dawkins, Hugh; Goldblatt, Jack

    2016-06-11

    The Rare and Undiagnosed Diseases Diagnostic Service (RUDDS) refers to a genomic diagnostic platform operating within the Western Australian Government clinical services delivered through Genetic Services of Western Australia (GSWA). GSWA has provided a state-wide service for clinical genetic care for 28 years and it serves a population of 2.5 million people across a geographical area of 2.5milion Km(2). Within this context, GSWA has established a clinically integrated genomic diagnostic platform in partnership with other public health system managers and service providers, including but not limited to the Office of Population Health Genomics, Diagnostic Genomics (PathWest Laboratories) and with executive level support from the Department of Health. Herein we describe report presents the components of this service that are most relevant to the heterogeneity of paediatric clinical genetic care. Briefly the platform : i) offers multiple options including non-genetic testing; monogenic and genomic (targeted in silico filtered and whole exome) analysis; and matchmaking; ii) is delivered in a patient-centric manner that is resonant with the patient journey, it has multiple points for entry, exit and re-entry to allow people access to information they can use, when they want to receive it; iii) is synchronous with precision phenotyping methods; iv) captures new knowledge, including multiple expert review; v) is integrated with current translational genomic research activities and best practice; and vi) is designed for flexibility for interactive generation of, and integration with, clinical research for diagnostics, community engagement, policy and models of care. The RUDDS has been established as part of routine clinical genetic services and is thus sustainable, equitably managed and seeks to translate new knowledge into efficient diagnostics and improved health for the whole community.

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

    PubMed

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

    2016-09-01

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

  12. Amplitude Integrated Electroencephalography Compared With Conventional Video EEG for Neonatal Seizure Detection: A Diagnostic Accuracy Study.

    PubMed

    Rakshasbhuvankar, Abhijeet; Rao, Shripada; Palumbo, Linda; Ghosh, Soumya; Nagarajan, Lakshmi

    2017-08-01

    This diagnostic accuracy study compared the accuracy of seizure detection by amplitude-integrated electroencephalography with the criterion standard conventional video EEG in term and near-term infants at risk of seizures. Simultaneous recording of amplitude-integrated EEG (2-channel amplitude-integrated EEG with raw trace) and video EEG was done for 24 hours for each infant. Amplitude-integrated EEG was interpreted by a neonatologist; video EEG was interpreted by a neurologist independently. Thirty-five infants were included in the analysis. In the 7 infants with seizures on video EEG, there were 169 seizure episodes on video EEG, of which only 57 were identified by amplitude-integrated EEG. Amplitude-integrated EEG had a sensitivity of 33.7% for individual seizure detection. Amplitude-integrated EEG had an 86% sensitivity for detection of babies with seizures; however, it was nonspecific, in that 50% of infants with seizures detected by amplitude-integrated EEG did not have true seizures by video EEG. In conclusion, our study suggests that amplitude-integrated EEG is a poor screening tool for neonatal seizures.

  13. Orthogonal system of fractural and integrated diagnostic features in vibration analysis

    NASA Astrophysics Data System (ADS)

    Kostyukov, V. N.; Boychenko, S. N.

    2017-08-01

    The paper presents the results obtained in the studies of the orthogonality of the vibration diagnostic features system comprising the integrated features, particularly - root mean square values of vibration acceleration, vibration velocity, vibration displacement and fractal feature (Hurst exponent). To diagnose the condition of the equipment by the vibration signal, the orthogonality of the vibration diagnostic features is important. The fact of orthogonality shows that the system of features is not superfluous and allows the maximum coverage of the state space of the object being diagnosed. This, in turn, increases reliability of the machinery condition monitoring results. The studies were carried out on the models of vibration signals using the programming language R.

  14. 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.

  15. Application of computer-aided diagnosis (CAD) in MR-mammography (MRM): do we really need whole lesion time curve distribution analysis?

    PubMed

    Baltzer, Pascal Andreas Thomas; Renz, Diane M; Kullnig, Petra E; Gajda, Mieczyslaw; Camara, Oumar; Kaiser, Werner A

    2009-04-01

    The identification of the most suspect enhancing part of a lesion is regarded as a major diagnostic criterion in dynamic magnetic resonance mammography. Computer-aided diagnosis (CAD) software allows the semi-automatic analysis of the kinetic characteristics of complete enhancing lesions, providing additional information about lesion vasculature. The diagnostic value of this information has not yet been quantified. Consecutive patients from routine diagnostic studies (1.5 T, 0.1 mmol gadopentetate dimeglumine, dynamic gradient-echo sequences at 1-minute intervals) were analyzed prospectively using CAD. Dynamic sequences were processed and reduced to a parametric map. Curve types were classified by initial signal increase (not significant, intermediate, and strong) and the delayed time course of signal intensity (continuous, plateau, and washout). Lesion enhancement was measured using CAD. The most suspect curve, the curve-type distribution percentage, and combined dynamic data were compared. Statistical analysis included logistic regression analysis and receiver-operating characteristic analysis. Fifty-one patients with 46 malignant and 44 benign lesions were enrolled. On receiver-operating characteristic analysis, the most suspect curve showed diagnostic accuracy of 76.7 +/- 5%. In comparison, the curve-type distribution percentage demonstrated accuracy of 80.2 +/- 4.9%. Combined dynamic data had the highest diagnostic accuracy (84.3 +/- 4.2%). These differences did not achieve statistical significance. With appropriate cutoff values, sensitivity and specificity, respectively, were found to be 80.4% and 72.7% for the most suspect curve, 76.1% and 83.6% for the curve-type distribution percentage, and 78.3% and 84.5% for both parameters. The integration of whole-lesion dynamic data tends to improve specificity. However, no statistical significance backs up this finding.

  16. Diagnostic crossover and outcome predictors in eating disorders according to DSM-IV and DSM-V proposed criteria: a 6-year follow-up study.

    PubMed

    Castellini, Giovanni; Lo Sauro, Carolina; Mannucci, Edoardo; Ravaldi, Claudia; Rotella, Carlo Maria; Faravelli, Carlo; Ricca, Valdo

    2011-04-01

    To evaluate in a 6-year follow-up study the course of a large clinical sample of patients with eating disorders (EDs) who were treated with individual cognitive behavior therapy. The diagnostic crossover, recovery, and relapses were assessed, applying both Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and the DSM-V proposed criteria. Patients with EDs move in and out of illness states over time, display frequent relapses, show a relevant lifetime psychiatric comorbidity, and migrate between different diagnoses. A total of 793 patients (including anorexia nervosa, bulimia nervosa, binge eating disorder, and EDs not otherwise specified) were evaluated on the first day of admission, at the end of treatment, 3 years after the end of treatment, and 3 years after the first follow-up. Clinical data were collected through a face-to-face interview; diagnosis was performed by means of the Structured Clinical Interview for DSM-IV and the Eating Disorder Examination Questionnaire was applied. A consistent rate of relapse and crossover between the different diagnoses over time was observed. Mood disorders comorbidity has been found to be an important determinant of diagnostic instability, whereas the severity of shape concern represented a relevant outcome modifier. Using the DSM-V proposed criteria, most patients of EDs not otherwise specified were reclassified, so that the large majority of ED patients seeking treatment would be included in full-blown diagnoses. Among EDs, there are different subgroups of patients displaying various courses and outcomes. The diagnostic instability involves the large majority of patients. An integration of categorical and dimensional approaches could improve the psychopathological investigation and the treatment choices.

  17. Characterization and optimization of the HyperV PLX- α coaxial-gun plasma jet

    NASA Astrophysics Data System (ADS)

    Case, Andrew; Brockington, Sam; Cruz, Edward; Witherspoon, F. Douglas

    2017-10-01

    We present results from characterizing and optimizing performance of the contoured gap coaxial plasma guns under development for the ARPA-E Accelerating Low-Cost Plasma Heating And Assembly (ALPHA) program. Plasma jet diagnostics include fast photodiodes for velocimetry and interferometry for line integrated density. Additionally we present results from spectroscopy, both time resolved high resolution spectroscopy using a novel detector and time integrated survey spectroscopy, for measurements of velocity and temperature as well as impurities. Fast imaging gives plume geometry and time integrated imaging gives overall light emission. Results from a novel long record length camera developed by HyperV will also be presented. Experimental results are compared to the desired target parameters for the plasma jets. The target values for the plasmoid are velocity of 50 km/s, mass of 3.5 mg, and length of 10 cm. The best results so far from the exploration of parameter space for gun operation are: 4 mg at >50 km/s, with a length of 10 cm. Peak axial density 34 cm downstream from the muzzle is 2 ×1016 cm-3. This work supported by the ARPA-E ALPHA Program under contract DE-AR0000566.

  18. Real-Time Sensor Validation, Signal Reconstruction, and Feature Detection for an RLV Propulsion Testbed

    NASA Technical Reports Server (NTRS)

    Jankovsky, Amy L.; Fulton, Christopher E.; Binder, Michael P.; Maul, William A., III; Meyer, Claudia M.

    1998-01-01

    A real-time system for validating sensor health has been developed in support of the reusable launch vehicle program. This system was designed for use in a propulsion testbed as part of an overall effort to improve the safety, diagnostic capability, and cost of operation of the testbed. The sensor validation system was designed and developed at the NASA Lewis Research Center and integrated into a propulsion checkout and control system as part of an industry-NASA partnership, led by Rockwell International for the Marshall Space Flight Center. The system includes modules for sensor validation, signal reconstruction, and feature detection and was designed to maximize portability to other applications. Review of test data from initial integration testing verified real-time operation and showed the system to perform correctly on both hard and soft sensor failure test cases. This paper discusses the design of the sensor validation and supporting modules developed at LeRC and reviews results obtained from initial test cases.

  19. The US Navy’s Helicopter Integrated Diagnostics System (HIDS) Program: Power Drive Train Crack Detection Diagnostics and Prognostics Life Usage Monitoring and Damage Tolerance; Techniques, Methodologies, and Experiences

    DTIC Science & Technology

    2000-02-01

    HIDS] Program: Power Drive Train Crack Detection Diagnostics and Prognostics ife Usage Monitoring and Damage Tolerance; Techniques, Methodologies, and...and Prognostics , Life Usage Monitoring , and Damage Tolerance; Techniques, Methodologies, and Experiences Andrew Hess Harrison Chin William Hardman...continuing program and deployed engine monitoring systems in fixed to evaluate helicopter diagnostic, prognostic , and wing aircraft, notably on the A

  20. Continued under-recognition of acute respiratory distress syndrome after the Berlin definition: what is the solution?

    PubMed

    Laffey, John G; Pham, Tài; Bellani, Giacomo

    2017-02-01

    Timely recognition of acute respiratory distress syndrome (ARDS) may allow for more prompt management and less exacerbation of lung injury. However, the absence of a diagnostic test for ARDS means that the diagnosis of ARDS requires clinician recognition in what is usually a complicated and evolving illness. We review data concerning the extent of recognition of ARDS in the era of the Berlin definition of ARDS. ARDS continues to be under-recognized - even in the era of the more recent 'Berlin' definition, and significant delay in its recognition is common. Factors contributing to under-recognition may include the complexity of ARDS biology, low specificity of the consensus (diagnostic) criteria, and concerns about reliable interpretation of the chest radiograph. Understandably, 'external' factors are also at play: ICU occupancy and higher patient to clinician ratio impair recognition of ARDS. Timely recognition of ARDS appears important, as it is associated with the use of higher PEEP, prone positioning and neuromuscular blockade which can lower mortality. Computer-aided decision tools seem diagnostically useful, and together with the integration of reliable biomarkers, may further enhance and speed recognition of this syndrome. Significant numbers of patients with ARDS are still unrecognized by clinicians in the era of the Berlin definition of ARDS, with potentially important consequences for patient management and outcome.

  1. Monitoring fetal heart rate during pregnancy: contributions from advanced signal processing and wearable technology.

    PubMed

    Signorini, Maria G; Fanelli, Andrea; Magenes, Giovanni

    2014-01-01

    Monitoring procedures are the basis to evaluate the clinical state of patients and to assess changes in their conditions, thus providing necessary interventions in time. Both these two objectives can be achieved by integrating technological development with methodological tools, thus allowing accurate classification and extraction of useful diagnostic information. The paper is focused on monitoring procedures applied to fetal heart rate variability (FHRV) signals, collected during pregnancy, in order to assess fetal well-being. The use of linear time and frequency techniques as well as the computation of non linear indices can contribute to enhancing the diagnostic power and reliability of fetal monitoring. The paper shows how advanced signal processing approaches can contribute to developing new diagnostic and classification indices. Their usefulness is evaluated by comparing two selected populations: normal fetuses and intra uterine growth restricted (IUGR) fetuses. Results show that the computation of different indices on FHRV signals, either linear and nonlinear, gives helpful indications to describe pathophysiological mechanisms involved in the cardiovascular and neural system controlling the fetal heart. As a further contribution, the paper briefly describes how the introduction of wearable systems for fetal ECG recording could provide new technological solutions improving the quality and usability of prenatal monitoring.

  2. [The interplay of diagnostic and antimicrobial stewardship for the management of septic patients: the Tuscan model.

    PubMed

    Forni, Silvia; Toccafondi, Giulio; Viaggi, Bruno; Grazzini, Maddalena; D'Arienzo, Sara; Gemmi, Fabrizio; Vannucci, Andrea; Tulli, Giorgio

    2018-02-01

    Antimicrobial resistance is a global threat caused by the rapid spread of multiresistant microorganisms. Antimicrobial stewardship (AS) is a coordinated intervention designed to improve the appropriate use of antimicrobials by promoting the selection of the optimal drug regimen, dose, duration of therapy and route of administration. AS programs have proved effective in reducing antimicrobial resistance, inappropriate antimicrobial use and in improving patient outcomes. Recently developed rapid diagnostic technologies in microbiology (RDTM) allows a faster and etiological diagnosis of infection and a reduction in the use of unnecessary empirical therapies. This may result in important advancement in time-critical care pathways for septic patients. Nevertheless, RDTM are costly and if not rationally positioned may consume resources and hinder the efficacy of AS programs. In this regard, Tuscany Region is engaged in designing, through a systemic approach, an effective high-quality clinical microbiological service grid. In order to develop a sustainable and equitable model for integrating diagnostic and antimicrobial stewardship we conducted a survey in the regional network of 14 microbiological laboratories. The results shows that in order to develop a sustainable service we need to improve the communication at the interface between laboratories and care unit, harmonize the time windows for processing samples and to devise a robust score for stratifying patient with suspected sepsis.

  3. New diagnostics for latent and active tuberculosis: state of the art and future prospects.

    PubMed

    Pai, Madhukar; O'Brien, Richard

    2008-10-01

    Tuberculosis (TB) continues to be the world's most important infectious cause of morbidity and mortality among adults. Nearly 9 million people develop TB disease each year, and an estimated 1.6 million die from the disease. Despite this enormous global burden, case detection rates are low, posing serious hurdles for TB control. Conventional TB diagnosis continues to rely on antiquated tests such as sputum smear microscopy, culture, tuberculin skin test, and chest radiography. These tests have several limitations and perform poorly in populations affected by the HIV epidemic. Conventional tests for detection of drug resistance are time consuming, tedious, and inaccessible in most settings. In this review, we describe recent advances in the diagnosis of latent and active TB, and detection of drug resistance. Although the perfect test will not be ready for large-scale roll-out and integration into routine TB care services for some time, substantial progress has been made in expanding the TB diagnostic product pipeline. With the resurgence of interest in the development of new tools for TB control, and the recent influx of funding and political support, it is likely that the next few years will see the introduction of new diagnostic tools into routine TB control programs.

  4. High-Resolution and Frequency, Printed Miniature Magnetic Probes

    NASA Astrophysics Data System (ADS)

    Prager, James; Ziemba, Timothy; Miller, Kenneth; Picard, Julian

    2013-10-01

    Eagle Harbor Technologies, Inc. (EHT) is developing a technique to significantly reduce the cost and development time of producing magnetic field diagnostics. EHT is designing probes that can be printed on flexible PCBs thereby allowing for extremely small coils to be produced while essentially eliminating the time to wind the coils. The coil size can be extremely small when coupled with the EHT Hybrid Integrator, which is capable of high bandwidth measurements over short and long pulse durations. This integrator is currently being commercialized with the support of a DOE SBIR. Additionally, the flexible PCBs allow probes to be attached to complex surface and/or probes that have a complex 3D structure to be designed and fabricated. During the Phase I, EHT will design and construct magnetic field probes on flexible PCBs, which will be tested at the University of Washington's HIT-SI experiment and in EHT's material science plasma reactor. Funding provided by DOE SBIR/STTR Program.

  5. A Magnetic Tracking System based on Highly Sensitive Integrated Hall Sensors

    NASA Astrophysics Data System (ADS)

    Schlageter, Vincent; Drljaca, Predrag; Popovic, Radivoje S.; KuČERA, Pavel

    A tracking system with five degrees of freedom based on a 2D-array of 16 Hall sensors and a permanent magnet is presented in this paper. The sensitivity of the Hall sensors is increased by integrated micro- and external macro-flux-concentrators. Detection distance larger than 20cm (during one hour without calibration) is achieved using a magnet of 0.2cm3. This corresponds to a resolution of the sensors of 0.05µTrms. The position and orientation of the marker is displayed in real time at least 20 times per second. The sensing system is small enough to be hand-held and can be used in a normal environment. This presented tracking system has been successfully applied to follow a small swallowed magnet through the entire human digestive tube. This approach is extremely promising as a new non-invasive diagnostic technique in gastro-enterology.

  6. Color sensor and neural processor on one chip

    NASA Astrophysics Data System (ADS)

    Fiesler, Emile; Campbell, Shannon R.; Kempem, Lother; Duong, Tuan A.

    1998-10-01

    Low-cost, compact, and robust color sensor that can operate in real-time under various environmental conditions can benefit many applications, including quality control, chemical sensing, food production, medical diagnostics, energy conservation, monitoring of hazardous waste, and recycling. Unfortunately, existing color sensor are either bulky and expensive or do not provide the required speed and accuracy. In this publication we describe the design of an accurate real-time color classification sensor, together with preprocessing and a subsequent neural network processor integrated on a single complementary metal oxide semiconductor (CMOS) integrated circuit. This one-chip sensor and information processor will be low in cost, robust, and mass-producible using standard commercial CMOS processes. The performance of the chip and the feasibility of its manufacturing is proven through computer simulations based on CMOS hardware parameters. Comparisons with competing methodologies show a significantly higher performance for our device.

  7. DNA sequencing using polymerase substrate-binding kinetics

    PubMed Central

    Previte, Michael John Robert; Zhou, Chunhong; Kellinger, Matthew; Pantoja, Rigo; Chen, Cheng-Yao; Shi, Jin; Wang, BeiBei; Kia, Amirali; Etchin, Sergey; Vieceli, John; Nikoomanzar, Ali; Bomati, Erin; Gloeckner, Christian; Ronaghi, Mostafa; He, Molly Min

    2015-01-01

    Next-generation sequencing (NGS) has transformed genomic research by decreasing the cost of sequencing. However, whole-genome sequencing is still costly and complex for diagnostics purposes. In the clinical space, targeted sequencing has the advantage of allowing researchers to focus on specific genes of interest. Routine clinical use of targeted NGS mandates inexpensive instruments, fast turnaround time and an integrated and robust workflow. Here we demonstrate a version of the Sequencing by Synthesis (SBS) chemistry that potentially can become a preferred targeted sequencing method in the clinical space. This sequencing chemistry uses natural nucleotides and is based on real-time recording of the differential polymerase/DNA-binding kinetics in the presence of correct or mismatch nucleotides. This ensemble SBS chemistry has been implemented on an existing Illumina sequencing platform with integrated cluster amplification. We discuss the advantages of this sequencing chemistry for targeted sequencing as well as its limitations for other applications. PMID:25612848

  8. Integrated 68Gallium Labelled Prostate-Specific Membrane Antigen-11 Positron Emission Tomography/Magnetic Resonance Imaging Enhances Discriminatory Power of Multi-Parametric Prostate Magnetic Resonance Imaging.

    PubMed

    Al-Bayati, Mohammad; Grueneisen, Johannes; Lütje, Susanne; Sawicki, Lino M; Suntharalingam, Saravanabavaan; Tschirdewahn, Stephan; Forsting, Michael; Rübben, Herbert; Herrmann, Ken; Umutlu, Lale; Wetter, Axel

    2018-01-01

    To evaluate diagnostic accuracy of integrated 68Gallium labelled prostate-specific membrane antigen (68Ga-PSMA)-11 positron emission tomography (PET)/MRI in patients with primary prostate cancer (PCa) as compared to multi-parametric MRI. A total of 22 patients with recently diagnosed primary PCa underwent clinically indicated 68Ga-PSMA-11 PET/CT for initial staging followed by integrated 68Ga-PSMA-11 PET/MRI. Images of multi-parametric magnetic resonance imaging (mpMRI), PET and PET/MRI were evaluated separately by applying Prostate Imaging Reporting and Data System (PIRADSv2) for mpMRI and a 5-point Likert scale for PET and PET/MRI. Results were compared with pathology reports of biopsy or resection. Statistical analyses including receiver operating characteristics analysis were performed to compare the diagnostic performance of mpMRI, PET and PET/MRI. PET and integrated PET/MRI demonstrated a higher diagnostic accuracy than mpMRI (area under the curve: mpMRI: 0.679, PET and PET/MRI: 0.951). The proportion of equivocal results (PIRADS 3 and Likert 3) was considerably higher in mpMRI than in PET and PET/MRI. In a notable proportion of equivocal PIRADS results, PET led to a correct shift towards higher suspicion of malignancy and enabled correct lesion classification. Integrated 68Ga-PSMA-11 PET/MRI demonstrates higher diagnostic accuracy than mpMRI and is particularly valuable in tumours with equivocal results from PIRADS classification. © 2018 S. Karger AG, Basel.

  9. Diagnostic indicators for integrated assessment models of climate policy

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

    Kriegler, Elmar; Petermann, Nils; Krey, Volker

    2015-01-01

    Integrated assessments of how climate policy interacts with energy-economic systems can be performed by a variety of models with different functional structures. This article proposes a diagnostic scheme that can be applied to a wide range of integrated assessment models to classify differences among models based on their carbon price responses. Model diagnostics can uncover patterns and provide insights into why, under a given scenario, certain types of models behave in observed ways. Such insights are informative since model behavior can have a significant impact on projections of climate change mitigation costs and other policy-relevant information. The authors propose diagnosticmore » indicators to characterize model responses to carbon price signals and test these in a diagnostic study with 11 global models. Indicators describe the magnitude of emission abatement and the associated costs relative to a harmonized baseline, the relative changes in carbon intensity and energy intensity and the extent of transformation in the energy system. This study shows a correlation among indicators suggesting that models can be classified into groups based on common patterns of behavior in response to carbon pricing. Such a classification can help to more easily explain variations among policy-relevant model results.« less

  10. Integrating rapid diagnostics and antimicrobial stewardship improves outcomes in patients with antibiotic-resistant Gram-negative bacteremia.

    PubMed

    Perez, Katherine K; Olsen, Randall J; Musick, William L; Cernoch, Patricia L; Davis, James R; Peterson, Leif E; Musser, James M

    2014-09-01

    An intervention for Gram-negative bloodstream infections that integrated mass spectrometry technology for rapid diagnosis with antimicrobial stewardship oversight significantly improved patient outcomes and reduced hospital costs. As antibiotic resistance rates continue to grow at an alarming speed, the current study was undertaken to assess the impact of this intervention in a challenging patient population with bloodstream infections caused by antibiotic-resistant Gram-negative bacteria. A total of 153 patients with antibiotic-resistant Gram-negative bacteremia hospitalized prior to the study intervention were compared to 112 patients treated post-implementation. Outcomes assessed included time to optimal antibiotic therapy, time to active treatment when inactive, hospital and intensive care unit length of stay, all-cause 30-day mortality, and total hospital expenditures. Integrating rapid diagnostics with antimicrobial stewardship improved time to optimal antibiotic therapy (80.9 h in the pre-intervention period versus 23.2 h in the intervention period, P < 0.001) and effective antibiotic therapy (89.7 h versus 32 h, P < 0.001). Patients in the pre-intervention period had increased duration of hospitalization compared to those in the intervention period (23.3 days versus 15.3 days, P = 0.0001) and longer intensive care unit length of stay (16 days versus 10.7 days, P = 0.008). Mortality among patients during the intervention period was lower (21% versus 8.9%, P = 0.01) and our study intervention remained a significant predictor of survival (OR, 0.3; 95% confidence interval [CI], 0.12-0.79) after multivariate logistic regression. Mean hospital costs for each inpatient survivor were reduced $26,298 in the intervention cohort resulting in an estimated annual cost savings of $2.4 million (P = 0.002). Integration of rapid identification and susceptibility techniques with antimicrobial stewardship resulted in significant improvements in clinical and financial outcomes for patients with bloodstream infections caused by antibiotic-resistant Gram-negatives. The intervention decreased hospital and intensive care unit length of stay, total hospital costs, and reduced all-cause 30-day mortality. Copyright © 2014. Published by Elsevier Ltd.

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

    NASA Astrophysics Data System (ADS)

    Xu, Jiuping; Zhong, Zhengqiang; Xu, Lei

    2015-10-01

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

  12. Simultaneous broadband laser ranging and photonic Doppler velocimetry for dynamic compression experiments

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

    La Lone, B. M., E-mail: lalonebm@nv.doe.gov; Marshall, B. R.; Miller, E. K.

    2015-02-15

    A diagnostic was developed to simultaneously measure both the distance and velocity of rapidly moving surfaces in dynamic compression experiments, specifically non-planar experiments where integrating the velocity in one direction does not always give the material position accurately. The diagnostic is constructed mainly from fiber-optic telecommunications components. The distance measurement is based on a technique described by Xia and Zhang [Opt. Express 18, 4118 (2010)], which determines the target distance every 20 ns and is independent of the target speed. We have extended the full range of the diagnostic to several centimeters to allow its use in dynamic experiments, andmore » we multiplexed it with a photonic Doppler velocimetry (PDV) system so that distance and velocity histories can be measured simultaneously using one fiber-optic probe. The diagnostic was demonstrated on a spinning square cylinder to show how integrating a PDV record can give an incorrect surface position and how the ranging diagnostic described here obtains it directly. The diagnostic was also tested on an explosive experiment where copper fragments and surface ejecta were identified in both the distance and velocity signals. We show how the distance measurements complement the velocity data. Potential applications are discussed.« less

  13. Medical image computing for computer-supported diagnostics and therapy. Advances and perspectives.

    PubMed

    Handels, H; Ehrhardt, J

    2009-01-01

    Medical image computing has become one of the most challenging fields in medical informatics. In image-based diagnostics of the future software assistance will become more and more important, and image analysis systems integrating advanced image computing methods are needed to extract quantitative image parameters to characterize the state and changes of image structures of interest (e.g. tumors, organs, vessels, bones etc.) in a reproducible and objective way. Furthermore, in the field of software-assisted and navigated surgery medical image computing methods play a key role and have opened up new perspectives for patient treatment. However, further developments are needed to increase the grade of automation, accuracy, reproducibility and robustness. Moreover, the systems developed have to be integrated into the clinical workflow. For the development of advanced image computing systems methods of different scientific fields have to be adapted and used in combination. The principal methodologies in medical image computing are the following: image segmentation, image registration, image analysis for quantification and computer assisted image interpretation, modeling and simulation as well as visualization and virtual reality. Especially, model-based image computing techniques open up new perspectives for prediction of organ changes and risk analysis of patients and will gain importance in diagnostic and therapy of the future. From a methodical point of view the authors identify the following future trends and perspectives in medical image computing: development of optimized application-specific systems and integration into the clinical workflow, enhanced computational models for image analysis and virtual reality training systems, integration of different image computing methods, further integration of multimodal image data and biosignals and advanced methods for 4D medical image computing. The development of image analysis systems for diagnostic support or operation planning is a complex interdisciplinary process. Image computing methods enable new insights into the patient's image data and have the future potential to improve medical diagnostics and patient treatment.

  14. Optical Diagnostics for High-Temperature Thermal Barrier Coatings

    NASA Technical Reports Server (NTRS)

    Eldridge, Jeffrey I.

    2009-01-01

    Thermal barrier coatings (TBCs) are typically composed of translucent ceramic oxides that provide thermal protection for metallic components exposed to high-temperature environments, such as in jet turbine engines. Taking advantage of the translucent nature of TBCs, optical diagnostics have been developed that can provide an informed assessment of TBC health that will allow mitigating action to be taken before TBC degradation threatens performance or safety. In particular, rare-earth-doped luminescent sublayers have been integrated into the TBC structure to produce luminescence that monitors TBC erosion, delamination, and temperature gradients. Erosion monitoring of TBC-coated specimens is demonstrated by utilizing visible luminescence that is excited from a sublayer that is exposed by erosion. TBC delamination monitoring is achieved in TBCs with a base rare-earth-doped luminescent sublayer by the reflectance-enhanced increase in luminescence produced in regions containing buried delamination cracks. TBC temperature monitoring is demonstrated using the temperature-dependent decay time for luminescence originating from the specific coating depth associated with a rare-earth-doped luminescent sublayer. The design and implementation of these TBCs with integrated luminescent sublayers is discussed, including co-doping strategies to produce more penetrating near-infrared luminescence. It is demonstrated that integration of the rare-earth-doped sublayers is achieved with no reduction in TBC life. In addition, results for multilayer TBCs designed to also perform as radiation barriers are also presented.

  15. Comparison of Two Commercial Automated Nucleic Acid Extraction and Integrated Quantitation Real-Time PCR Platforms for the Detection of Cytomegalovirus in Plasma

    PubMed Central

    Tsai, Huey-Pin; Tsai, You-Yuan; Lin, I-Ting; Kuo, Pin-Hwa; Chen, Tsai-Yun; Chang, Kung-Chao; Wang, Jen-Ren

    2016-01-01

    Quantitation of cytomegalovirus (CMV) viral load in the transplant patients has become a standard practice for monitoring the response to antiviral therapy. The cut-off values of CMV viral load assays for preemptive therapy are different due to the various assay designs employed. To establish a sensitive and reliable diagnostic assay for preemptive therapy of CMV infection, two commercial automated platforms including m2000sp extraction system integrated the Abbott RealTime (m2000rt) and the Roche COBAS AmpliPrep for extraction integrated COBAS Taqman (CAP/CTM) were evaluated using WHO international CMV standards and 110 plasma specimens from transplant patients. The performance characteristics, correlation, and workflow of the two platforms were investigated. The Abbott RealTime assay correlated well with the Roche CAP/CTM assay (R2 = 0.9379, P<0.01). The Abbott RealTime assay exhibited higher sensitivity for the detection of CMV viral load, and viral load values measured with Abbott RealTime assay were on average 0.76 log10 IU/mL higher than those measured with the Roche CAP/CTM assay (P<0.0001). Workflow analysis on a small batch size at one time, using the Roche CAP/CTM platform had a shorter hands-on time than the Abbott RealTime platform. In conclusion, these two assays can provide reliable data for different purpose in a clinical virology laboratory setting. PMID:27494707

  16. Automated innovative diagnostic, data management and communication tool, for improving malaria vector control in endemic settings.

    PubMed

    Vontas, John; Mitsakakis, Konstantinos; Zengerle, Roland; Yewhalaw, Delenasaw; Sikaala, Chadwick Haadezu; Etang, Josiane; Fallani, Matteo; Carman, Bill; Müller, Pie; Chouaïbou, Mouhamadou; Coleman, Marlize; Coleman, Michael

    2016-01-01

    Malaria is a life-threatening disease that caused more than 400,000 deaths in sub-Saharan Africa in 2015. Mass prevention of the disease is best achieved by vector control which heavily relies on the use of insecticides. Monitoring mosquito vector populations is an integral component of control programs and a prerequisite for effective interventions. Several individual methods are used for this task; however, there are obstacles to their uptake, as well as challenges in organizing, interpreting and communicating vector population data. The Horizon 2020 project "DMC-MALVEC" consortium will develop a fully integrated and automated multiplex vector-diagnostic platform (LabDisk) for characterizing mosquito populations in terms of species composition, Plasmodium infections and biochemical insecticide resistance markers. The LabDisk will be interfaced with a Disease Data Management System (DDMS), a custom made data management software which will collate and manage data from routine entomological monitoring activities providing information in a timely fashion based on user needs and in a standardized way. The ResistanceSim, a serious game, a modern ICT platform that uses interactive ways of communicating guidelines and exemplifying good practices of optimal use of interventions in the health sector will also be a key element. The use of the tool will teach operational end users the value of quality data (relevant, timely and accurate) to make informed decisions. The integrated system (LabDisk, DDMS & ResistanceSim) will be evaluated in four malaria endemic countries, representative of the vector control challenges in sub-Saharan Africa, (Cameroon, Ivory Coast, Ethiopia and Zambia), highly representative of malaria settings with different levels of endemicity and vector control challenges, to support informed decision-making in vector control and disease management.

  17. KRAS mutation testing in borderline ovarian tumors and low-grade ovarian carcinomas with a rapid, fully integrated molecular diagnostic system.

    PubMed

    Sadlecki, Pawel; Antosik, Paulina; Grzanka, Dariusz; Grabiec, Marek; Walentowicz-Sadlecka, Malgorzata

    2017-10-01

    Epithelial ovarian neoplasms are a heterogeneous group of tumors, including various malignancies with distinct clinicopathologic and molecular features. Mutations in BRAF and KRAS genes are the most frequent genetic aberrations found in low-grade serous ovarian carcinomas and serous and mucinous borderline tumors. Implementation of targeted therapeutic strategies requires access to highly specific and highly sensitive diagnostic tests for rapid determination of mutation status. One candidate for such test is fully integrated, real-time polymerase chain reaction-based Idylla™ system for quick and simple detection of KRAS mutations in formaldehyde fixed-paraffin embedded tumor samples. The primary aim of this study was to verify whether fully integrated real-time polymerase chain reaction-based Idylla system may be useful in determination of KRAS mutation status in patients with borderline ovarian tumors and low-grade ovarian carcinomas. The study included tissue specimens from 37 patients with histopathologically verified ovarian masses, operated on at the Department of Obstetrics and Gynecology, Nicolaus Copernicus University Collegium Medicum in Bydgoszcz (Poland) between January 2009 and June 2012. Based on histopathological examination of surgical specimens, 30 lesions were classified as low-grade ovarian carcinomas and 7 as borderline ovarian tumors. Seven patients examined with Idylla KRAS Mutation Test tested positive for KRAS mutation. No statistically significant association was found between the incidence of KRAS mutations and histopathological type of ovarian tumors. Mean survival of the study subjects was 48.51 months (range 3-60 months). Presence of KRAS mutation did not exert a significant effect on the duration of survival in our series. Our findings suggest that Idylla KRAS Mutation Test may be a useful tool for rapid detection of KRAS mutations in ovarian tumor tissue.

  18. How is Version 6 different than earlier versions?

    Atmospheric Science Data Center

    2015-10-28

    ... integrated a priori CO profile. Second, the diagnostic 'Water Vapor Climatology Content' has been deleted. This diagnostic was included in previous products because of a data quality issue with the NCEP water vapor profiles. MERRA-based water vapor ...

  19. Establishing Ebola Virus Disease (EVD) diagnostics using GeneXpert technology at a mobile laboratory in Liberia: Impact on outbreak response, case management and laboratory systems strengthening

    PubMed Central

    Condell, Orla; Wasunna, Christine; Kpaka, Jonathan; Zwizwai, Ruth; Nuha, Mahmood; Fallah, Mosoka; Freeman, Maxwell; Harris, Victoria; Miller, Mark; Baller, April; Massaquoi, Moses; Katawera, Victoria; Saindon, John; Bemah, Philip; Hamblion, Esther; Castle, Evelyn; Williams, Desmond; Gasasira, Alex; Nyenswah, Tolbert

    2018-01-01

    The 2014–16 Ebola Virus Disease (EVD) outbreak in West Africa highlighted the necessity for readily available, accurate and rapid diagnostics. The magnitude of the outbreak and the re-emergence of clusters of EVD cases following the declaration of interrupted transmission in Liberia, reinforced the need for sustained diagnostics to support surveillance and emergency preparedness. We describe implementation of the Xpert Ebola Assay, a rapid molecular diagnostic test run on the GeneXpert platform, at a mobile laboratory in Liberia and the subsequent impact on EVD outbreak response, case management and laboratory system strengthening. During the period of operation, site coordination, management and operational capacity was supported through a successful collaboration between Ministry of Health (MoH), World Health Organization (WHO) and international partners. A team of Liberian laboratory technicians were trained to conduct EVD diagnostics and the laboratory had capacity to test 64–100 blood specimens per day. Establishment of the laboratory significantly increased the daily testing capacity for EVD in Liberia, from 180 to 250 specimens at a time when the effectiveness of the surveillance system was threatened by insufficient diagnostic capacity. During the 18 months of operation, the laboratory tested a total of 9,063 blood specimens, including 21 EVD positives from six confirmed cases during two outbreaks. Following clearance of the significant backlog of untested EVD specimens in November 2015, a new cluster of EVD cases was detected at the laboratory. Collaboration between surveillance and laboratory coordination teams during this and a later outbreak in March 2016, facilitated timely and targeted response interventions. Specimens taken from cases during both outbreaks were analysed at the laboratory with results informing clinical management of patients and discharge decisions. The GeneXpert platform is easy to use, has relatively low running costs and can be integrated into other national diagnostic algorithms. The technology has on average a 2-hour sample-to-result time and allows for single specimen testing to overcome potential delays of batching. This model of a mobile laboratory equipped with Xpert Ebola test, staffed by local laboratory technicians, could serve to strengthen outbreak preparedness and response for future outbreaks of EVD in Liberia and the region. PMID:29304039

  20. Establishing Ebola Virus Disease (EVD) diagnostics using GeneXpert technology at a mobile laboratory in Liberia: Impact on outbreak response, case management and laboratory systems strengthening.

    PubMed

    Raftery, Philomena; Condell, Orla; Wasunna, Christine; Kpaka, Jonathan; Zwizwai, Ruth; Nuha, Mahmood; Fallah, Mosoka; Freeman, Maxwell; Harris, Victoria; Miller, Mark; Baller, April; Massaquoi, Moses; Katawera, Victoria; Saindon, John; Bemah, Philip; Hamblion, Esther; Castle, Evelyn; Williams, Desmond; Gasasira, Alex; Nyenswah, Tolbert

    2018-01-01

    The 2014-16 Ebola Virus Disease (EVD) outbreak in West Africa highlighted the necessity for readily available, accurate and rapid diagnostics. The magnitude of the outbreak and the re-emergence of clusters of EVD cases following the declaration of interrupted transmission in Liberia, reinforced the need for sustained diagnostics to support surveillance and emergency preparedness. We describe implementation of the Xpert Ebola Assay, a rapid molecular diagnostic test run on the GeneXpert platform, at a mobile laboratory in Liberia and the subsequent impact on EVD outbreak response, case management and laboratory system strengthening. During the period of operation, site coordination, management and operational capacity was supported through a successful collaboration between Ministry of Health (MoH), World Health Organization (WHO) and international partners. A team of Liberian laboratory technicians were trained to conduct EVD diagnostics and the laboratory had capacity to test 64-100 blood specimens per day. Establishment of the laboratory significantly increased the daily testing capacity for EVD in Liberia, from 180 to 250 specimens at a time when the effectiveness of the surveillance system was threatened by insufficient diagnostic capacity. During the 18 months of operation, the laboratory tested a total of 9,063 blood specimens, including 21 EVD positives from six confirmed cases during two outbreaks. Following clearance of the significant backlog of untested EVD specimens in November 2015, a new cluster of EVD cases was detected at the laboratory. Collaboration between surveillance and laboratory coordination teams during this and a later outbreak in March 2016, facilitated timely and targeted response interventions. Specimens taken from cases during both outbreaks were analysed at the laboratory with results informing clinical management of patients and discharge decisions. The GeneXpert platform is easy to use, has relatively low running costs and can be integrated into other national diagnostic algorithms. The technology has on average a 2-hour sample-to-result time and allows for single specimen testing to overcome potential delays of batching. This model of a mobile laboratory equipped with Xpert Ebola test, staffed by local laboratory technicians, could serve to strengthen outbreak preparedness and response for future outbreaks of EVD in Liberia and the region.

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

    PubMed

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

    2009-11-01

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

  2. Regional process redesign of lung cancer care: a learning health system pilot project.

    PubMed

    Fung-Kee-Fung, M; Maziak, D E; Pantarotto, J R; Smylie, J; Taylor, L; Timlin, T; Cacciotti, T; Villeneuve, P J; Dennie, C; Bornais, C; Madore, S; Aquino, J; Wheatley-Price, P; Ozer, R S; Stewart, D J

    2018-02-01

    The Ottawa Hospital (toh) defined delay to timely lung cancer care as a system design problem. Recognizing the patient need for an integrated journey and the need for dynamic alignment of providers, toh used a learning health system (lhs) vision to redesign regional diagnostic processes. A lhs is driven by feedback utilizing operational and clinical information to drive system optimization and innovation. An essential component of a lhs is a collaborative platform that provides connectivity across silos, organizations, and professions. To operationalize a lhs, we developed the Ottawa Health Transformation Model (ohtm) as a consensus approach that addresses process barriers, resistance to change, and conflicting priorities. A regional Community of Practice (cop) was established to engage stakeholders, and a dedicated transformation team supported process improvements and implementation. The project operationalized the lung cancer diagnostic pathway and optimized patient flow from referral to initiation of treatment. Twelve major processes in referral, review, diagnostics, assessment, triage, and consult were redesigned. The Ottawa Hospital now provides a diagnosis to 80% of referrals within the provincial target of 28 days. The median patient journey from referral to initial treatment decreased by 48% from 92 to 47 days. The initiative optimized regional integration from referral to initial treatment. Use of a lhs lens enabled the creation of a system that is standardized to best practice and open to ongoing innovation. Continued transformation initiatives across the continuum of care are needed to incorporate best practice and optimize delivery systems for regional populations.

  3. Miniaturized devices towards an integrated lab-on-a-chip platform for DNA diagnostics

    NASA Astrophysics Data System (ADS)

    Kaprou, G.; Papadakis, G.; Kokkoris, G.; Papadopoulos, V.; Kefala, I.; Papageorgiou, D.; Gizeli, E.; Tserepi, A.

    2015-06-01

    Microfluidics is an emerging technology enabling the development of Lab-on-a-chip (LOC) systems for clinical diagnostics, drug discovery and screening, food safety and environmental analysis. LOC systems integrate and scale down one or several laboratory functions on a single chip of a few mm2 to cm2 in size, and account for many advantages on biochemical analyses, such as low sample and reagent consumption, low cost, reduced analysis time, portability and point-of-need compatibility. Currently, available nucleic acid diagnostic tests take advantage of Polymerase Chain Reaction (PCR) that allows exponential amplification of portions of nucleic acid sequences that can be used as indicators for the identification of various diseases. Here, we present a comparison between static chamber and continuous flow miniaturized PCR devices, in terms of energy consumption for devices fabricated on the same material stack, with identical sample volume and channel dimensions. The comparison is implemented by a computational study coupling heat transfer in both solid and fluid, mass conservation of species, and joule heating. Based on the conclusions of this study, we develop low-cost and fast DNA amplification devices for both PCR and isothermal amplification, and we implement them in the detection of mutations related to breast cancer. The devices are fabricated by mass production amenable technologies on printed circuit board (PCB) substrates, where copper facilitates the incorporation of on-chip microheaters, defining the thermal zones necessary for PCR or isothermal amplification methods.

  4. Improved diagnostic yield compared with targeted gene sequencing panels suggests a role for whole-genome sequencing as a first-tier genetic test

    PubMed Central

    Lionel, Anath C; Costain, Gregory; Monfared, Nasim; Walker, Susan; Reuter, Miriam S; Hosseini, S Mohsen; Thiruvahindrapuram, Bhooma; Merico, Daniele; Jobling, Rebekah; Nalpathamkalam, Thomas; Pellecchia, Giovanna; Sung, Wilson W L; Wang, Zhuozhi; Bikangaga, Peter; Boelman, Cyrus; Carter, Melissa T; Cordeiro, Dawn; Cytrynbaum, Cheryl; Dell, Sharon D; Dhir, Priya; Dowling, James J; Heon, Elise; Hewson, Stacy; Hiraki, Linda; Inbar-Feigenberg, Michal; Klatt, Regan; Kronick, Jonathan; Laxer, Ronald M; Licht, Christoph; MacDonald, Heather; Mercimek-Andrews, Saadet; Mendoza-Londono, Roberto; Piscione, Tino; Schneider, Rayfel; Schulze, Andreas; Silverman, Earl; Siriwardena, Komudi; Snead, O Carter; Sondheimer, Neal; Sutherland, Joanne; Vincent, Ajoy; Wasserman, Jonathan D; Weksberg, Rosanna; Shuman, Cheryl; Carew, Chris; Szego, Michael J; Hayeems, Robin Z; Basran, Raveen; Stavropoulos, Dimitri J; Ray, Peter N; Bowdin, Sarah; Meyn, M Stephen; Cohn, Ronald D; Scherer, Stephen W; Marshall, Christian R

    2018-01-01

    Purpose Genetic testing is an integral diagnostic component of pediatric medicine. Standard of care is often a time-consuming stepwise approach involving chromosomal microarray analysis and targeted gene sequencing panels, which can be costly and inconclusive. Whole-genome sequencing (WGS) provides a comprehensive testing platform that has the potential to streamline genetic assessments, but there are limited comparative data to guide its clinical use. Methods We prospectively recruited 103 patients from pediatric non-genetic subspecialty clinics, each with a clinical phenotype suggestive of an underlying genetic disorder, and compared the diagnostic yield and coverage of WGS with those of conventional genetic testing. Results WGS identified diagnostic variants in 41% of individuals, representing a significant increase over conventional testing results (24% P = 0.01). Genes clinically sequenced in the cohort (n = 1,226) were well covered by WGS, with a median exonic coverage of 40 × ±8 × (mean ±SD). All the molecular diagnoses made by conventional methods were captured by WGS. The 18 new diagnoses made with WGS included structural and non-exonic sequence variants not detectable with whole-exome sequencing, and confirmed recent disease associations with the genes PIGG, RNU4ATAC, TRIO, and UNC13A. Conclusion WGS as a primary clinical test provided a higher diagnostic yield than conventional genetic testing in a clinically heterogeneous cohort. PMID:28771251

  5. Diagnostics aid for mass spectrometer trouble-shooting

    NASA Astrophysics Data System (ADS)

    Filby, E. E.; Rankin, R. A.; Webb, G. W.

    The MS Expert system provides problem diagnostics for instruments used in the Mass Spectrometry Laboratory (MSL). The most critical results generated on these mass spectrometers are the uranium concentration and isotopic content data used for process control and materials accountability at the Idaho Chemical Processing Plant. The two purposes of the system are: (1) to minimize instrument downtime and thereby provide the best possible support to the Plant, and (2) to improve long-term data quality. This system combines the knowledge of several experts on mass spectrometry to provide a diagnostic tool, and can make these skills available on a more timely basis. It integrates code written in the Pascal language with a knowledge base entered into a commercial expert system shell. The user performs some preliminary status checks, and then selects from among several broad diagnostic categories. These initial steps provide input to the rule base. The overall analysis provides the user with a set of possible solutions to the observed problems, graded as to their probabilities. Besides the trouble-shooting benefits expected from this system, it will also provide structures diagnostic training for lab personnel. In addition, development of the system knowledge base has already produced a better understanding of instrument behavior. Two key findings are that a good user interface is necessary for full acceptance of the tool, and a development system should include standard programming capabilities as well as the expert system shell.

  6. Improved diagnostic yield compared with targeted gene sequencing panels suggests a role for whole-genome sequencing as a first-tier genetic test.

    PubMed

    Lionel, Anath C; Costain, Gregory; Monfared, Nasim; Walker, Susan; Reuter, Miriam S; Hosseini, S Mohsen; Thiruvahindrapuram, Bhooma; Merico, Daniele; Jobling, Rebekah; Nalpathamkalam, Thomas; Pellecchia, Giovanna; Sung, Wilson W L; Wang, Zhuozhi; Bikangaga, Peter; Boelman, Cyrus; Carter, Melissa T; Cordeiro, Dawn; Cytrynbaum, Cheryl; Dell, Sharon D; Dhir, Priya; Dowling, James J; Heon, Elise; Hewson, Stacy; Hiraki, Linda; Inbar-Feigenberg, Michal; Klatt, Regan; Kronick, Jonathan; Laxer, Ronald M; Licht, Christoph; MacDonald, Heather; Mercimek-Andrews, Saadet; Mendoza-Londono, Roberto; Piscione, Tino; Schneider, Rayfel; Schulze, Andreas; Silverman, Earl; Siriwardena, Komudi; Snead, O Carter; Sondheimer, Neal; Sutherland, Joanne; Vincent, Ajoy; Wasserman, Jonathan D; Weksberg, Rosanna; Shuman, Cheryl; Carew, Chris; Szego, Michael J; Hayeems, Robin Z; Basran, Raveen; Stavropoulos, Dimitri J; Ray, Peter N; Bowdin, Sarah; Meyn, M Stephen; Cohn, Ronald D; Scherer, Stephen W; Marshall, Christian R

    2018-04-01

    PurposeGenetic testing is an integral diagnostic component of pediatric medicine. Standard of care is often a time-consuming stepwise approach involving chromosomal microarray analysis and targeted gene sequencing panels, which can be costly and inconclusive. Whole-genome sequencing (WGS) provides a comprehensive testing platform that has the potential to streamline genetic assessments, but there are limited comparative data to guide its clinical use.MethodsWe prospectively recruited 103 patients from pediatric non-genetic subspecialty clinics, each with a clinical phenotype suggestive of an underlying genetic disorder, and compared the diagnostic yield and coverage of WGS with those of conventional genetic testing.ResultsWGS identified diagnostic variants in 41% of individuals, representing a significant increase over conventional testing results (24%; P = 0.01). Genes clinically sequenced in the cohort (n = 1,226) were well covered by WGS, with a median exonic coverage of 40 × ±8 × (mean ±SD). All the molecular diagnoses made by conventional methods were captured by WGS. The 18 new diagnoses made with WGS included structural and non-exonic sequence variants not detectable with whole-exome sequencing, and confirmed recent disease associations with the genes PIGG, RNU4ATAC, TRIO, and UNC13A.ConclusionWGS as a primary clinical test provided a higher diagnostic yield than conventional genetic testing in a clinically heterogeneous cohort.

  7. Gear Damage Detection Integrating Oil Debris and Vibration Measurement Technologies Developed

    NASA Technical Reports Server (NTRS)

    Gyekeyeski, Andrew L.; Sawicki, Jerzy T.

    2001-01-01

    The development of highly reliable health-monitoring systems is one technology area recommended for reducing the number of helicopter accidents. Helicopter transmission diagnostics are an important part of a helicopter health-monitoring system because helicopters depend on the power train for propulsion, lift, and flight maneuvering. One technique currently being tested for increasing the reliability and decreasing the false alarm rate of current transmission diagnostic tools is the replacement of simple single-sensor limits with multisensor systems integrating different measurement technologies.

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

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

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

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

  9. Strengthening your ties to referring physicians through RIS/PACS integration.

    PubMed

    Worthy, Susan; Rounds, Karla C; Soloway, Connie B

    2003-01-01

    Many imaging centers are turning to technology solutions to increase refering physician satisfaction, implementing such enhancements as automated report distribution, picture archiving and communications system (PACS), radiology information systems (RIS), and web-based results access. However, without seamless integration, these technology investments don't address the challenge at its core: convenient and reliable, two-way communication and interaction with referring physicians. In an integrated RIS/PACS solution, patient tracking in the RIS and PACS study status are logged and available to users. The time of the patient's registration at the imaging center, the exam start and completion time, the patient's departure time from the imaging center, and results status are all tracked and logged. An integrated RIS/PACS solution provides additional support to the radiologist, a critical factor that can improve the turnaround time of results to referring physicians. The RIS/PACS enhances the interpretation by providing the patient's history, which gives the radiologist additional insight and decreases the likelihood of missing a diagnostic element. In a tightly integrated RIS/PACS solution, results information is more complete. Physicians can view reports with associated images selected by the radiologist. They will also have full order information and complete imaging history including prior reports and images. Referring physicians can access and view images and exam notes at the same time that the radiologist is interpreting the exam. Without the benefit of an integrated RIS/PACS system, the referring physician would have to wait for the signed transcription to be released. In a seamlessly integrated solution, film-tracking modules within the RIS are fused with digital imaging workflow in the PACS. Users can see at a glance if a historical exam is available on film and benefit when a complete study history--both film-based and digital--is presented with the current case. It is up to the imaging center to market the benefits of reduced errors, reduced turnaround times, and a higher level of service to referring physician community, and encourage them to take advantage of the convenience it provides. The savvy imaging center will also regard the integrated RIS/PACS as a valuable marketing tool for use in attracting radiologists.

  10. Better Tests, Better Care: Improved Diagnostics for Infectious Diseases

    PubMed Central

    Caliendo, Angela M.; Gilbert, David N.; Ginocchio, Christine C.; Hanson, Kimberly E.; May, Larissa; Quinn, Thomas C.; Tenover, Fred C.; Alland, David; Blaschke, Anne J.; Bonomo, Robert A.; Carroll, Karen C.; Ferraro, Mary Jane; Hirschhorn, Lisa R.; Joseph, W. Patrick; Karchmer, Tobi; MacIntyre, Ann T.; Reller, L. Barth; Jackson, Audrey F.

    2013-01-01

    In this IDSA policy paper, we review the current diagnostic landscape, including unmet needs and emerging technologies, and assess the challenges to the development and clinical integration of improved tests. To fulfill the promise of emerging diagnostics, IDSA presents recommendations that address a host of identified barriers. Achieving these goals will require the engagement and coordination of a number of stakeholders, including Congress, funding and regulatory bodies, public health agencies, the diagnostics industry, healthcare systems, professional societies, and individual clinicians. PMID:24200831

  11. Diagnostic accuracy of integrated intravascular ultrasound and optical coherence tomography (IVUS-OCT) system for coronary plaque characterization

    NASA Astrophysics Data System (ADS)

    Li, Jiawen; Ma, Teng; Mohar, Dilbahar; Correa, Adrian; Minami, Hataka; Jing, Joseph; Zhou, Qifa; Patel, Pranav M.; Chen, Zhongping

    2014-03-01

    Intravascular ultrasound (IVUS) imaging and optical coherence tomography (OCT), two commonly used intracoronary imaging modalities, play important roles in plaque evaluation. The combined use of IVUS (to visualize the entire plaque volume) and OCT (to quantify the thickness of the plaque cap, if any) is hypothesized to increase plaque diagnostic accuracy. Our group has developed a fully-integrated dual-modality IVUS-OCT imaging system and 3.6F catheter for simultaneous IVUS-OCT imaging with a high resolution and deep penetration depth. However, the diagnostic accuracy of an integrated IVUS-OCT system has not been investigated. In this study, we imaged 175 coronary artery sites (241 regions of interest) from 20 cadavers using our previous reported integrated IVUS-OCT system. IVUS-OCT images were read by two skilled interventional cardiologists. Each region of interest was classified as either calcification, lipid pool or fibrosis. Comparing the diagnosis by cardiologists using IVUSOCT images with the diagnosis by the pathologist, we calculated the sensitivity and specificity for characterization of calcification, lipid pool or fibrosis with this integrated system. In vitro imaging of cadaver coronary specimens demonstrated the complementary nature of these two modalities for plaques classification. A higher accuracy was shown than using a single modality alone.

  12. Examining the effect of self-explanation on cognitive integration of basic and clinical sciences in novices.

    PubMed

    Lisk, Kristina; Agur, Anne M R; Woods, Nicole N

    2017-12-01

    Several studies have shown that cognitive integration of basic and clinical sciences supports diagnostic reasoning in novices; however, there has been limited exploration of the ways in which educators can translate this model of mental activity into sound instructional strategies. The use of self-explanation during learning has the potential to promote and support the development of integrated knowledge by encouraging novices to elaborate on the causal relationship between clinical features and basic science mechanisms. To explore the effect of this strategy, we compared diagnostic efficacy of teaching students (n = 71) the clinical features of four musculoskeletal pathologies using either (1) integrated causal basic science descriptions (BaSci group); (2) integrated causal basic science descriptions combined with self-explanation prompts (SE group); (3) basic science mechanisms segregated from the clinical features (SG group). All participants completed a diagnostic accuracy test immediately after learning and 1-week later. The results showed that the BaSci group performed significantly better compared to the SE (p = 0.019) and SG groups (p = 0.004); however, no difference was observed between the SE and SG groups (p = 0.91). We hypothesize that the structure of the self-explanation task may not have supported the development of a holistic conceptual understanding of each disease. These findings suggest that integration strategies need to be carefully structured and applied in ways that support the holistic story created by integrated basic science instruction in order to foster conceptual coherence and to capitalize on the benefits of cognition integration.

  13. Data integration of structured and unstructured sources for assigning clinical codes to patient stays

    PubMed Central

    Luyckx, Kim; Luyten, Léon; Daelemans, Walter; Van den Bulcke, Tim

    2016-01-01

    Objective Enormous amounts of healthcare data are becoming increasingly accessible through the large-scale adoption of electronic health records. In this work, structured and unstructured (textual) data are combined to assign clinical diagnostic and procedural codes (specifically ICD-9-CM) to patient stays. We investigate whether integrating these heterogeneous data types improves prediction strength compared to using the data types in isolation. Methods Two separate data integration approaches were evaluated. Early data integration combines features of several sources within a single model, and late data integration learns a separate model per data source and combines these predictions with a meta-learner. This is evaluated on data sources and clinical codes from a broad set of medical specialties. Results When compared with the best individual prediction source, late data integration leads to improvements in predictive power (eg, overall F-measure increased from 30.6% to 38.3% for International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnostic codes), while early data integration is less consistent. The predictive strength strongly differs between medical specialties, both for ICD-9-CM diagnostic and procedural codes. Discussion Structured data provides complementary information to unstructured data (and vice versa) for predicting ICD-9-CM codes. This can be captured most effectively by the proposed late data integration approach. Conclusions We demonstrated that models using multiple electronic health record data sources systematically outperform models using data sources in isolation in the task of predicting ICD-9-CM codes over a broad range of medical specialties. PMID:26316458

  14. The ITER bolometer diagnostic: Status and plansa)

    NASA Astrophysics Data System (ADS)

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

    2008-10-01

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

  15. A dynamic integrated fault diagnosis method for power transformers.

    PubMed

    Gao, Wensheng; Bai, Cuifen; Liu, Tong

    2015-01-01

    In order to diagnose transformer fault efficiently and accurately, a dynamic integrated fault diagnosis method based on Bayesian network is proposed in this paper. First, an integrated fault diagnosis model is established based on the causal relationship among abnormal working conditions, failure modes, and failure symptoms of transformers, aimed at obtaining the most possible failure mode. And then considering the evidence input into the diagnosis model is gradually acquired and the fault diagnosis process in reality is multistep, a dynamic fault diagnosis mechanism is proposed based on the integrated fault diagnosis model. Different from the existing one-step diagnosis mechanism, it includes a multistep evidence-selection process, which gives the most effective diagnostic test to be performed in next step. Therefore, it can reduce unnecessary diagnostic tests and improve the accuracy and efficiency of diagnosis. Finally, the dynamic integrated fault diagnosis method is applied to actual cases, and the validity of this method is verified.

  16. A Dynamic Integrated Fault Diagnosis Method for Power Transformers

    PubMed Central

    Gao, Wensheng; Liu, Tong

    2015-01-01

    In order to diagnose transformer fault efficiently and accurately, a dynamic integrated fault diagnosis method based on Bayesian network is proposed in this paper. First, an integrated fault diagnosis model is established based on the causal relationship among abnormal working conditions, failure modes, and failure symptoms of transformers, aimed at obtaining the most possible failure mode. And then considering the evidence input into the diagnosis model is gradually acquired and the fault diagnosis process in reality is multistep, a dynamic fault diagnosis mechanism is proposed based on the integrated fault diagnosis model. Different from the existing one-step diagnosis mechanism, it includes a multistep evidence-selection process, which gives the most effective diagnostic test to be performed in next step. Therefore, it can reduce unnecessary diagnostic tests and improve the accuracy and efficiency of diagnosis. Finally, the dynamic integrated fault diagnosis method is applied to actual cases, and the validity of this method is verified. PMID:25685841

  17. Changing needs, opportunities and constraints for the 21st century microbiology laboratory.

    PubMed

    Van Eldere, J

    2005-04-01

    Clinical microbiologists and microbiology laboratories are experiencing changes due to evolving views on 'healthcare delivery' as an economic activity, due to changes in the medical environment and the demographics of the workforce, and technical evolution. Cost-effectiveness of laboratory procedures has been achieved through consolidation and integration of laboratories. Consolidation offers economy of scale and reduction in numbers of on-site staff, but also leads to separation of microbiologists from their clinical colleagues. Integration puts different laboratory disciplines under a single management, and leads to reorganisation of laboratories along common work-lines. Cost-savings combined with on-site availability of laboratories are achieved at the expense of a reduction in the influence of microbiologists in the daily running of the laboratory. Medically, there is growing emphasis on evidence-based diagnostics. Because of time-delays inherent in culturing, microbiology through rapid testing is mandatory. There is an increasing shortage in Europe and the USA of trained microbiology laboratory technicians and microbiologists. This reinforces the trend towards more automation and integration. Technological advances, particularly in molecular diagnostics, offer the possibility of rapid reporting and improvement of the impact of clinical microbiology on patient management. Molecular tests, however, fit perfectly the concept of an integrated laboratory and may further loosen the link between microbiologist and microbiology tests. The challenge for clinical microbiology will be to use new techniques to improve its cost-effectiveness and impact on infectious disease management. The future organisation of microbiology laboratories must support this but is itself of secondary importance. The training of future microbiologist must prepare them for this changing environment.

  18. In situ monitoring of the integrity of bonded repair patches on aircraft and civil infrastructures

    NASA Astrophysics Data System (ADS)

    Kumar, Amrita; Roach, Dennis; Beard, Shawn; Qing, Xinlin; Hannum, Robert

    2006-03-01

    Monitoring the continued health of aircraft subsystems and identifying problems before they affect airworthiness has been a long-term goal of the aviation industry. Because in-service conditions and failure modes experienced by structures are generally complex and unknown, conservative calendar-based or usage-based scheduled maintenance practices are overly time-consuming, labor-intensive and expensive. Metal structures such as helicopters and other transportation systems are likely to develop fatigue cracks under cyclic loads and corrosive service environments. Early detection of cracks is a key element to prevent catastrophic failure and prolong structural life. Furthermore, as structures age, maintenance service frequency and costs increase while performance and availability decrease. Current non-destructive inspection (NDI) techniques that can potentially be used for this purpose typically involve complex, time-intensive procedures, which are labor-intensive and expensive. Most techniques require access to the damaged area on at least one side, and sometimes on both sides. This can be very difficult for monitoring of certain inaccessible regions. In those cases, inspection may require removal of access panels or even structural disassembly. Once access has been obtained, automated inspection techniques likely will not be practical due to the bulk of the required equipment. Results obtained from these techniques may also be sensitive to the sweep speed, tool orientation, and downward pressure. This can be especially problematic for hand-held inspection tools where none of these parameters is mechanically controlled. As a result, data can vary drastically from one inspection to the next, from one technician to the next, and even from one sweep to the next. Structural health monitoring (SHM) offers the promise of a paradigm shift from schedule-driven maintenance to condition-based maintenance (CBM) of assets. Sensors embedded permanently in aircraft safety critical structures that can monitor damage can provide for improved reliability and streamlining of aircraft maintenance. Early detection of damage such as fatigue crack initiation can improve personnel safety and prolong service life. This paper presents the testing of an acousto-ultrasonic piezoelectric sensor based structural health monitoring system for real-time monitoring of fatigue cracks and disbonds in bonded repairs. The system utilizes a network of distributed miniature piezoelectric sensors/actuators embedded on a thin dielectric carrier film, to query, monitor and evaluate the condition of a structure. The sensor layers are extremely flexible and can be integrated with any type of metal or composite structure. Diagnostic signals obtained from a structure during structural monitoring are processed by a portable diagnostic unit. With appropriate diagnostic software, the signals can be analyzed to ascertain the integrity of the structure being monitored. Details on the system, its integration and examples of detection of fatigue crack and disbond growth and quantification for bonded repairs will be presented here.

  19. Rapid and simple detection of foot-and-mouth disease virus: Evaluation of a cartridge-based molecular detection system for use in basic laboratories.

    PubMed

    Goller, K V; Dill, V; Madi, M; Martin, P; Van der Stede, Y; Vandenberge, V; Haas, B; Van Borm, S; Koenen, F; Kasanga, C J; Ndusilo, N; Beer, M; Liu, L; Mioulet, V; Armson, B; King, D P; Fowler, V L

    2018-04-01

    Highly contagious transboundary animal diseases such as foot-and-mouth disease (FMD) are major threats to the productivity of farm animals. To limit the impact of outbreaks and to take efficient steps towards a timely control and eradication of the disease, rapid and reliable diagnostic systems are of utmost importance. Confirmatory diagnostic assays are typically performed by experienced operators in specialized laboratories, and access to this capability is often limited in the developing countries with the highest disease burden. Advances in molecular technologies allow implementation of modern and reliable techniques for quick and simple pathogen detection either in basic laboratories or even at the pen-side. Here, we report on a study to evaluate a fully automated cartridge-based real-time RT-PCR diagnostic system (Enigma MiniLab ® ) for the detection of FMD virus (FMDV). The modular system integrates both nucleic acid extraction and downstream real-time RT-PCR (rRT-PCR). The analytical sensitivity of this assay was determined using serially diluted culture grown FMDV, and the performance of the assay was evaluated using a selected range of FMDV positive and negative clinical samples of bovine, porcine and ovine origin. The robustness of the assay was evaluated in an international inter-laboratory proficiency test and by deployment into an African laboratory. It was demonstrated that the system is easy to use and can detect FMDV with high sensitivity and specificity, roughly on par with standard laboratory methods. This cartridge-based automated real-time RT-PCR system for the detection of FMDV represents a reliable and easy to use diagnostic tool for the early and rapid disease detection of acutely infected animals even in remote areas. This type of system could be easily deployed for routine surveillance within endemic regions such as Africa or could alternatively be used in the developed world. © 2017 The Authors. Transboundary and Emerging Diseases Published by Blackwell Verlag GmbH.

  20. Learning curve in transradial cardiac catheterization: procedure-related parameters stratified by operators' transradial volume.

    PubMed

    Kasasbeh, Ehab S; Parvez, Babar; Huang, Robert L; Hasselblad, Michele Marie; Glazer, Mark D; Salloum, Joseph G; Cleator, John H; Zhao, David X

    2012-11-01

    To determine whether radial artery access is associated with a reduction in fluoroscopy time, procedure time, and other procedural variables over a 27-month period during which the radial artery approach was incorporated in a single academic Medical Center. Although previous studies have demonstrated a relationship between increased volume and decreased procedural time, no studies have looked at the integration of radial access over time. Data were collected from consecutive patients who presented to the Vanderbilt University Medical Center cardiac catheterization laboratory from January 1, 2009 to April 1, 2011. Patients who underwent radial access diagnostic catheterization with and without percutaneous coronary intervention were included in this study. A total of 1112 diagnostic cardiac catheterizations through the radial access site were analyzed. High-volume, intermediate-volume, and low-volume operators were grouped based on the percentage of procedures performed through a radial approach. From 2009 to 2011, there was a significant decrease in fluoroscopy time in all operator groups for diagnostic catheterization (P=.035). The high-volume operator group had 1.88 and 3.66 minute reductions in fluoroscopy time compared to the intermediate- and low-volume operator groups, respectively (both P<.001). Likewise, the intermediate-volume operator group had a 1.77 minute improvement compared to the low-volume operator group, but this did not reach statistical significance (P=.102). The improvement in fluoroscopy time and other procedure-related parameters was seen after approximately 25 cases with further improvement after 75 cases. The incorporation of the radial access approach in the cardiac catheterization laboratory led to a decrease in fluoroscopy time for each operator and operator group over the last 3 years. Our data demonstrated that higher-volume radial operators have better procedure, room, and fluoroscopy times when compared to intermediate- and low-volume operators. However, lower-volume operators have a reduction in procedure-related parameters with increased radial cases. Number of procedures needed to become sufficient was demonstrated in the current study.

  1. A Digital Microfluidics Platform for Loop-Mediated Isothermal Amplification Detection

    PubMed Central

    Veigas, Bruno; Águas, Hugo; Fortunato, Elvira; Martins, Rodrigo; Baptista, Pedro Viana; Igreja, Rui

    2017-01-01

    Digital microfluidics (DMF) arises as the next step in the fast-evolving field of operation platforms for molecular diagnostics. Moreover, isothermal schemes, such as loop-mediated isothermal amplification (LAMP), allow for further simplification of amplification protocols. Integrating DMF with LAMP will be at the core of a new generation of detection devices for effective molecular diagnostics at point-of-care (POC), providing simple, fast, and automated nucleic acid amplification with exceptional integration capabilities. Here, we demonstrate for the first time the role of coupling DMF and LAMP, in a dedicated device that allows straightforward mixing of LAMP reagents and target DNA, as well as optimum temperature control (reaction droplets undergo a temperature variation of just 0.3 °C, for 65 °C at the bottom plate). This device is produced using low-temperature and low-cost production processes, adaptable to disposable and flexible substrates. DMF-LAMP is performed with enhanced sensitivity without compromising reaction efficacy or losing reliability and efficiency, by LAMP-amplifying 0.5 ng/µL of target DNA in just 45 min. Moreover, on-chip LAMP was performed in 1.5 µL, a considerably lower volume than standard bench-top reactions. PMID:29144379

  2. Helicase dependent OnChip-amplification and its use in multiplex pathogen detection.

    PubMed

    Andresen, Dennie; von Nickisch-Rosenegk, Markus; Bier, Frank F

    2009-05-01

    The need for fast, specific and sensitive multiparametric detection methods is an ever growing demand in molecular diagnostics. Here we report on a newly developed method, the helicase dependent OnChip amplification (OnChip-HDA). This approach integrates the analysis and detection in one single reaction thus leading to time and cost savings in multiparametric analysis. HDA is an isothermal amplification method that is not depending on thermocycling as known from PCR due to the helicases' ability to unwind DNA double-strands. We have combined the HDA with microarray based detection, making it suitable for multiplex detection. As an example we used the OnChip HDA in single and multiplex amplifications for the detection of the two pathogens N. gonorrhoeae and S. aureus directly on surface bound primers. We have successfully shown the OnChip-HDA and applied it for single- and duplex-detection of the pathogens N. gonorrhoeae and S. aureus. We have developed a new method, the OnChip-HDA for the multiplex detection of pathogens. Its simplicity in reaction setup and potential for miniaturization and multiparametric analysis is advantageous for the integration in miniaturized Lab on Chip systems, e.g. needed in point of care diagnostics.

  3. High Resolution Integrated Hohlraum-Capsule Simulations for Virtual NIF Ignition Campaign

    NASA Astrophysics Data System (ADS)

    Jones, O. S.; Marinak, M. M.; Cerjan, C. J.; Clark, D. S.; Edwards, M. J.; Haan, S. W.; Langer, S. H.; Salmonson, J. D.

    2009-11-01

    We have undertaken a virtual campaign to assess the viability of the sequence of NIF experiments planned for 2010 that will experimentally tune the shock timing, symmetry, and ablator thickness of a cryogenic ignition capsule prior to the first ignition attempt. The virtual campaign consists of two teams. The ``red team'' creates realistic simulated diagnostic data for a given experiment from the output of a detailed radiation hydrodynamics calculation that has physics models that have been altered in a way that is consistent with probable physics uncertainties. The ``blue team'' executes a series of virtual experiments and interprets the simulated diagnostic data from those virtual experiments. To support this effort we have developed a capability to do very high spatial resolution integrated hohlraum-capsule simulations using the Hydra code. Surface perturbations for all ablator layer surfaces and the DT ice layer are calculated explicitly through mode 30. The effects of the fill tube, cracks in the ice layer, and defects in the ablator are included in models extracted from higher resolution calculations. Very high wave number mix is included through a mix model. We will show results from these calculations in the context of the ongoing virtual campaign.

  4. Bayesian wavelet PCA methodology for turbomachinery damage diagnosis under uncertainty

    NASA Astrophysics Data System (ADS)

    Xu, Shengli; Jiang, Xiaomo; Huang, Jinzhi; Yang, Shuhua; Wang, Xiaofang

    2016-12-01

    Centrifugal compressor often suffers various defects such as impeller cracking, resulting in forced outage of the total plant. Damage diagnostics and condition monitoring of such a turbomachinery system has become an increasingly important and powerful tool to prevent potential failure in components and reduce unplanned forced outage and further maintenance costs, while improving reliability, availability and maintainability of a turbomachinery system. This paper presents a probabilistic signal processing methodology for damage diagnostics using multiple time history data collected from different locations of a turbomachine, considering data uncertainty and multivariate correlation. The proposed methodology is based on the integration of three advanced state-of-the-art data mining techniques: discrete wavelet packet transform, Bayesian hypothesis testing, and probabilistic principal component analysis. The multiresolution wavelet analysis approach is employed to decompose a time series signal into different levels of wavelet coefficients. These coefficients represent multiple time-frequency resolutions of a signal. Bayesian hypothesis testing is then applied to each level of wavelet coefficient to remove possible imperfections. The ratio of posterior odds Bayesian approach provides a direct means to assess whether there is imperfection in the decomposed coefficients, thus avoiding over-denoising. Power spectral density estimated by the Welch method is utilized to evaluate the effectiveness of Bayesian wavelet cleansing method. Furthermore, the probabilistic principal component analysis approach is developed to reduce dimensionality of multiple time series and to address multivariate correlation and data uncertainty for damage diagnostics. The proposed methodology and generalized framework is demonstrated with a set of sensor data collected from a real-world centrifugal compressor with impeller cracks, through both time series and contour analyses of vibration signal and principal components.

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

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

    Zhai, Y

    2014-03-03

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

  6. Biosensors in Health Care: The Milestones Achieved in Their Development towards Lab-on-Chip-Analysis

    PubMed Central

    Patel, Suprava; Nanda, Rachita; Sahoo, Sibasish; Mohapatra, Eli

    2016-01-01

    Immense potentiality of biosensors in medical diagnostics has driven scientists in evolution of biosensor technologies and innovating newer tools in time. The cornerstone of the popularity of biosensors in sensing wide range of biomolecules in medical diagnostics is due to their simplicity in operation, higher sensitivity, ability to perform multiplex analysis, and capability to be integrated with different function by the same chip. There remains a huge challenge to meet the demands of performance and yield to its simplicity and affordability. Ultimate goal stands for providing point-of-care testing facility to the remote areas worldwide, particularly the developing countries. It entails continuous development in technology towards multiplexing ability, fabrication, and miniaturization of biosensor devices so that they can provide lab-on-chip-analysis systems to the community. PMID:27042353

  7. Multi-Point Thomson Scattering Diagnostic for the Helicity Injected Torus

    NASA Astrophysics Data System (ADS)

    Liptac, J. E.; Smith, R. J.; Hoffman, C. S.; Jarboe, T. R.; Nelson, B. A.; Leblanc, B. P.; Phillips, P.

    1999-11-01

    The multi-point Thomson scattering system on the Helicity Injected Torus--II can determine electron temperature and density at 11 radial positions at a single time during the plasma discharge. The system includes components on loan from both PPPL and from the University of Texas. The collection optics and Littrow spectrometer from Princeton, and the 1 GW laser and multi-anode microchannel plate detector from Texas have been integrated into a compact structure, creating a mobile and reliable diagnostic. The mobility of the system allows alignment to occur in a room adjacent to the experiment, greatly reducing the disturbance to normal machine operation. The four main parts of the Thomson scattering system, namely, the laser, the beam line, the collection optics, and the mobile structure are presented and discussed.

  8. Exploitation of biotechnology in a large company.

    PubMed

    Dart, E C

    1989-08-31

    Almost from the outset, most large companies saw the 'new biotechnology' not as a new business but as a set of very powerful techniques that, in time, would radically improve the understanding of biological systems. This new knowledge was generally seen by them as enhancing the process of invention and not as a substitute for tried and tested ways of meeting clearly identified targets. As the knowledge base grows, so the big-company response to biotechnology becomes more positive. Within ICI, biotechnology is now integrated into five bio-businesses (Pharmaceuticals, Agrochemicals, Seeds, Diagnostics and Biological Products). Within the Central Toxicology Laboratory it also contributes to the understanding of the mechanisms of toxic action of chemicals as part of assessing risk. ICI has entered two of these businesses (Seeds and Diagnostics) because it sees biotechnology making a major contribution to the profitability of each.

  9. Detection biomarkers of lung cancer using mini-GC-PID system integrated with micro GC column and micro pre-concentrator

    PubMed Central

    2014-01-01

    The survival rate of lung cancer can be significantly improved by monitoring biomarkers in exhaled air that indicate diseases in early stage, so it is very important to develop micro analytical systems which can offer a fast, on-site, real-time detecting biomarkers in exhaled air. In this paper, a mini-gas chromatography (GC)-photo-ionization detector (PID) system integrated with a micro GC column and a micro pre-concentrator was developed for forming an inexpensive, fast, and non-invasive diagnostic tool for lung cancer. This system has very strong concentrate ability owing to its integrated micro pre-concentrator, which make the detection of trace components in exhaled air very easy. In addition, the integrated micro GC column can separate complex mixtures, which overcome low resolution and poor anti-interference ability of other instruments. The results indicated that the mini-GC-PID system can effectively separate and detect the biomarkers at parts-per-billion (ppb) level. PMID:25339856

  10. Autonomous System for Monitoring the Integrity of Composite Fan Housings

    NASA Technical Reports Server (NTRS)

    Qing, Xinlin P.; Aquino, Christopher; Kumar, Amrita

    2010-01-01

    A low-cost and reliable system assesses the integrity of composite fan-containment structures. The system utilizes a network of miniature sensors integrated with the structure to scan the entire structural area for any impact events and resulting structural damage, and to monitor degradation due to usage. This system can be used to monitor all types of composite structures on aircraft and spacecraft, as well as automatically monitor in real time the location and extent of damage in the containment structures. This diagnostic information is passed to prognostic modeling that is being developed to utilize the information and provide input on the residual strength of the structure, and maintain a history of structural degradation during usage. The structural health-monitoring system would consist of three major components: (1) sensors and a sensor network, which is permanently bonded onto the structure being monitored; (2) integrated hardware; and (3) software to monitor in-situ the health condition of in-service structures.

  11. A Fiber Interferometer for the Magnetized Shock Experiment

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

    Yoo, Christian

    2012-08-30

    The Magnetized Shock Experiment (MSX) at Los Alamos National Laboratory requires remote diagnostics of plasma density. Laser interferometry can be used to determine the line-integrated density of the plasma. A multi-chord heterodyne fiber optic Mach-Zehnder interferometer is being assembled and integrated into the experiment. The advantage of the fiber coupling is that many different view chords can be easily obtained by simply moving transmit and receive fiber couplers. Several such fiber sets will be implemented to provide a time history of line-averaged density for several chords at once. The multiple chord data can then be Abel inverted to provide radiallymore » resolved spatial profiles of density. We describe the design and execution of this multiple fiber interferometer.« less

  12. Integrated health monitoring and controls for rocket engines

    NASA Technical Reports Server (NTRS)

    Merrill, W. C.; Musgrave, J. L.; Guo, T. H.

    1992-01-01

    Current research in intelligent control systems at the Lewis Research Center is described in the context of a functional framework. The framework is applicable to a variety of reusable space propulsion systems for existing and future launch vehicles. It provides a 'road map' technology development to enable enhanced engine performance with increased reliability, durability, and maintainability. The framework hierarchy consists of a mission coordination level, a propulsion system coordination level, and an engine control level. Each level is described in the context of the Space Shuttle Main Engine. The concept of integrating diagnostics with control is discussed within the context of the functional framework. A distributed real time simulation testbed is used to realize and evaluate the functionalities in closed loop.

  13. A Fiber Interferometer for the Magnetized Shock Experiment

    NASA Astrophysics Data System (ADS)

    Yoo, C. B.; Gao, K. W.; Weber, T. E.; Intrator, T. P.

    2012-10-01

    The Magnetized Shock Experiment (MSX) at Los Alamos National Laboratory requires remote diagnostics of plasma density. Laser interferometry can be used to determine the line-integrated density of the plasma. A multi-chord heterodyne fiber optic Mach-Zehnder interferometer is being assembled and integrated into the experiment. The advantage of the fiber coupling is that many different view chords can be easily obtained by simply moving transmit and receive fiber couplers. Several such fiber sets will be implemented to provide a time history of line-averaged density for several chords at once. The multiple chord data can then be Abel inverted to provide radially resolved spatial profiles of density. We describe the design and execution of this multiple fiber interferometer.

  14. On performing of interference technique based on self-adjusting Zernike filters (SA-AVT method) to investigate flows and validate 3D flow numerical simulations

    NASA Astrophysics Data System (ADS)

    Pavlov, Al. A.; Shevchenko, A. M.; Khotyanovsky, D. V.; Pavlov, A. A.; Shmakov, A. S.; Golubev, M. P.

    2017-10-01

    We present a method for and results of determination of the field of integral density in the structure of flow corresponding to the Mach interaction of shock waves at Mach number M = 3. The optical diagnostics of flow was performed using an interference technique based on self-adjusting Zernike filters (SA-AVT method). Numerical simulations were carried out using the CFS3D program package for solving the Euler and Navier-Stokes equations. Quantitative data on the distribution of integral density on the path of probing radiation in one direction of 3D flow transillumination in the region of Mach interaction of shock waves were obtained for the first time.

  15. Genetic tests in major psychiatric disorders-integrating molecular medicine with clinical psychiatry-why is it so difficult?

    PubMed

    Demkow, U; Wolańczyk, T

    2017-06-13

    With the advent of post-genomic era, new technologies create extraordinary possibilities for diagnostics and personalized therapy, transforming todays' medicine. Rooted in both medical genetics and clinical psychiatry, the paper is designed as an integrated source of information of the current and potential future application of emerging genomic technologies as diagnostic tools in psychiatry, moving beyond the classical concept of patient approach. Selected approaches are presented, starting from currently used technologies (next-generation sequencing (NGS) and microarrays), followed by newer options (reverse phenotyping). Next, we describe an old concept in a new light (endophenotypes), subsequently coming up with a sophisticated and complex approach (gene networks) ending by a nascent field (computational psychiatry). The challenges and barriers that exist to translate genomic research to real-world patient assessment are further discussed. We emphasize the view that only a paradigm shift can bring a fundamental change in psychiatric practice, allowing to disentangle the intricacies of mental diseases. All the diagnostic methods, as described, are directed at uncovering the integrity of the system including many types of relations within a complex structure. The integrative system approach offers new opportunity to connect genetic background with specific diseases entities, or concurrently, with symptoms regardless of a diagnosis. To advance the field, we propose concerted cross-disciplinary effort to provide a diagnostic platform operating at the general level of genetic pathogenesis of complex-trait psychiatric disorders rather than at the individual level of a specific disease.

  16. Genetic tests in major psychiatric disorders—integrating molecular medicine with clinical psychiatry—why is it so difficult?

    PubMed Central

    Demkow, U; Wolańczyk, T

    2017-01-01

    With the advent of post-genomic era, new technologies create extraordinary possibilities for diagnostics and personalized therapy, transforming todays’ medicine. Rooted in both medical genetics and clinical psychiatry, the paper is designed as an integrated source of information of the current and potential future application of emerging genomic technologies as diagnostic tools in psychiatry, moving beyond the classical concept of patient approach. Selected approaches are presented, starting from currently used technologies (next-generation sequencing (NGS) and microarrays), followed by newer options (reverse phenotyping). Next, we describe an old concept in a new light (endophenotypes), subsequently coming up with a sophisticated and complex approach (gene networks) ending by a nascent field (computational psychiatry). The challenges and barriers that exist to translate genomic research to real-world patient assessment are further discussed. We emphasize the view that only a paradigm shift can bring a fundamental change in psychiatric practice, allowing to disentangle the intricacies of mental diseases. All the diagnostic methods, as described, are directed at uncovering the integrity of the system including many types of relations within a complex structure. The integrative system approach offers new opportunity to connect genetic background with specific diseases entities, or concurrently, with symptoms regardless of a diagnosis. To advance the field, we propose concerted cross-disciplinary effort to provide a diagnostic platform operating at the general level of genetic pathogenesis of complex-trait psychiatric disorders rather than at the individual level of a specific disease. PMID:28608853

  17. Integrating Oil Debris and Vibration Gear Damage Detection Technologies Using Fuzzy Logic

    NASA Technical Reports Server (NTRS)

    Dempsey, Paula J.; Afjeh, Abdollah A.

    2002-01-01

    A diagnostic tool for detecting damage to spur gears was developed. Two different measurement technologies, wear debris analysis and vibration, were integrated into a health monitoring system for detecting surface fatigue pitting damage on gears. This integrated system showed improved detection and decision-making capabilities as compared to using individual measurement technologies. This diagnostic tool was developed and evaluated experimentally by collecting vibration and oil debris data from fatigue tests performed in the NASA Glenn Spur Gear Fatigue Test Rig. Experimental data were collected during experiments performed in this test rig with and without pitting. Results show combining the two measurement technologies improves the detection of pitting damage on spur gears.

  18. Molecular Diagnostics in Pathology: Time for a Next-Generation Pathologist?

    PubMed

    Fassan, Matteo

    2018-03-01

    - Comprehensive molecular investigations of mainstream carcinogenic processes have led to the use of effective molecular targeted agents in most cases of solid tumors in clinical settings. - To update readers regarding the evolving role of the pathologist in the therapeutic decision-making process and the introduction of next-generation technologies into pathology practice. - Current literature on the topic, primarily sourced from the PubMed (National Center for Biotechnology Information, Bethesda, Maryland) database, were reviewed. - Adequate evaluation of cytologic-based and tissue-based predictive diagnostic biomarkers largely depends on both proper pathologic characterization and customized processing of biospecimens. Moreover, increased requests for molecular testing have paralleled the recent, sharp decrease in tumor material to be analyzed-material that currently comprises cytology specimens or, at minimum, small biopsies in most cases of metastatic/advanced disease. Traditional diagnostic pathology has been completely revolutionized by the introduction of next-generation technologies, which provide multigene, targeted mutational profiling, even in the most complex of clinical cases. Combining traditional and molecular knowledge, pathologists integrate the morphological, clinical, and molecular dimensions of a disease, leading to a proper diagnosis and, therefore, the most-appropriate tailored therapy.

  19. Optimized acoustic biochip integrated with microfluidics for biomarkers detection in molecular diagnostics.

    PubMed

    Papadakis, G; Friedt, J M; Eck, M; Rabus, D; Jobst, G; Gizeli, E

    2017-09-01

    The development of integrated platforms incorporating an acoustic device as the detection element requires addressing simultaneously several challenges of technological and scientific nature. The present work was focused on the design of a microfluidic module, which, combined with a dual or array type Love wave acoustic chip could be applied to biomedical applications and molecular diagnostics. Based on a systematic study we optimized the mechanics of the flow cell attachment and the sealing material so that fluidic interfacing/encapsulation would impose minimal losses to the acoustic wave. We have also investigated combinations of operating frequencies with waveguide materials and thicknesses for maximum sensitivity during the detection of protein and DNA biomarkers. Within our investigations neutravidin was used as a model protein biomarker and unpurified PCR amplified Salmonella DNA as the model genetic target. Our results clearly indicate the need for experimental verification of the optimum engineering and analytical parameters, in order to develop commercially viable systems for integrated analysis. The good reproducibility of the signal together with the ability of the array biochip to detect multiple samples hold promise for the future use of the integrated system in a Lab-on-a-Chip platform for application to molecular diagnostics.

  20. Quality control in diagnostic immunohistochemistry: integrated on-slide positive controls.

    PubMed

    Bragoni, A; Gambella, A; Pigozzi, S; Grigolini, M; Fiocca, R; Mastracci, L; Grillo, F

    2017-11-01

    Standardization in immunohistochemistry is a priority in modern pathology and requires strict quality control. Cost containment has also become fundamental and auditing of all procedures must take into account both these principles. Positive controls must be routinely performed so that their positivity guarantees the appropriateness of the immunohistochemical procedure. The aim of this study is to develop a low cost (utilizing a punch biopsy-PB-tool) procedure to construct positive controls which can be integrated in the patient's tissue slide. Sixteen frequently used control blocks were selected and multiple cylindrical samples were obtained using a 5-mm diameter punch biopsy tool, separately re-embedding them in single blocks. For each diagnostic immunoreaction requiring a positive control, an integrated PB-control section (cut from the appropriate PB-control block) was added to the top right corner of the diagnostic slide before immunostaining. This integrated control technique permitted a saving of 4.75% in total direct lab costs and proved to be technically feasible and reliable. Our proposal is easy to perform and within the reach of all pathology labs, requires easily available tools, its application costs is less than using external paired controls and ensures that a specific control for each slide is always available.

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

    PubMed

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

    2015-08-01

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

  2. A Review of Diagnostic Techniques for ISHM Applications

    NASA Technical Reports Server (NTRS)

    Patterson-Hine, Ann; Biswas, Gautam; Aaseng, Gordon; Narasimhan, Sriam; Pattipati, Krishna

    2005-01-01

    System diagnosis is an integral part of any Integrated System Health Management application. Diagnostic applications make use of system information from the design phase, such as safety and mission assurance analysis, failure modes and effects analysis, hazards analysis, functional models, fault propagation models, and testability analysis. In modern process control and equipment monitoring systems, topological and analytic , models of the nominal system, derived from design documents, are also employed for fault isolation and identification. Depending on the complexity of the monitored signals from the physical system, diagnostic applications may involve straightforward trending and feature extraction techniques to retrieve the parameters of importance from the sensor streams. They also may involve very complex analysis routines, such as signal processing, learning or classification methods to derive the parameters of importance to diagnosis. The process that is used to diagnose anomalous conditions from monitored system signals varies widely across the different approaches to system diagnosis. Rule-based expert systems, case-based reasoning systems, model-based reasoning systems, learning systems, and probabilistic reasoning systems are examples of the many diverse approaches ta diagnostic reasoning. Many engineering disciplines have specific approaches to modeling, monitoring and diagnosing anomalous conditions. Therefore, there is no "one-size-fits-all" approach to building diagnostic and health monitoring capabilities for a system. For instance, the conventional approaches to diagnosing failures in rotorcraft applications are very different from those used in communications systems. Further, online and offline automated diagnostic applications are integrated into an operations framework with flight crews, flight controllers and maintenance teams. While the emphasis of this paper is automation of health management functions, striking the correct balance between automated and human-performed tasks is a vital concern.

  3. Diagnostic and interventional musculoskeletal ultrasound: part 1. Fundamentals.

    PubMed

    Smith, Jay; Finnoff, Jonathan T

    2009-01-01

    Musculoskeletal ultrasound involves the use of high-frequency sound waves to image soft tissues and bony structures in the body for the purposes of diagnosing pathology or guiding real-time interventional procedures. Recently, an increasing number of physicians have integrated musculoskeletal ultrasound into their practices to facilitate patient care. Technological advancements, improved portability, and reduced costs continue to drive the proliferation of ultrasound in clinical medicine. This increased interest creates a need for education pertaining to all aspects of musculoskeletal ultrasound. The primary purpose of this article is to review diagnostic ultrasound technology and its potential clinical applications in the evaluation and treatment of patients with neurologic and musculoskeletal disorders. After reviewing this article, physicians should be able to (1) list the advantages and disadvantages of ultrasound compared with other available imaging modalities, (2) describe how ultrasound machines produce images using sound waves, (3) discuss the steps necessary to acquire and optimize an ultrasound image, (4) understand the different ultrasound appearances of tendons, nerves, muscles, ligaments, blood vessels, and bones, and (5) identify multiple applications for diagnostic and interventional musculoskeletal ultrasound in musculoskeletal practice. Part 1 of this 2-part article reviews the fundamentals of clinical ultrasonographic imaging, including relevant physics, equipment, training, image optimization, and scanning principles for diagnostic and interventional purposes.

  4. Diagnostic and interventional musculoskeletal ultrasound: part 2. Clinical applications.

    PubMed

    Smith, Jay; Finnoff, Jonathan T

    2009-02-01

    Musculoskeletal ultrasound involves the use of high-frequency sound waves to image soft tissues and bony structures in the body for the purposes of diagnosing pathology or guiding real-time interventional procedures. Recently, an increasing number of physicians have integrated musculoskeletal ultrasound into their practices to facilitate patient care. Technological advancements, improved portability, and reduced costs continue to drive the proliferation of ultrasound in clinical medicine. This increased interest creates a need for education pertaining to all aspects of musculoskeletal ultrasound. The primary purpose of this article is to review diagnostic ultrasound technology and its potential clinical applications in the evaluation and treatment of patients with neurological and musculoskeletal disorders. After reviewing this article, physicians should be able to (1) list the advantages and disadvantages of ultrasound compared to other available imaging modalities; (2) describe how ultrasound machines produce images using sound waves; (3) discuss the steps necessary to acquire and optimize an ultrasound image; (4) understand the difference ultrasound appearances of tendons, nerves, muscles, ligaments, blood vessels, and bones; and (5) identify multiple applications for diagnostic and interventional musculoskeletal ultrasound. Part 2 of this 2-part article will focus on the clinical applications of musculoskeletal ultrasound in clinical practice, including the ultrasonographic appearance of normal and abnormal tissues as well as specific diagnostic and interventional applications in major body regions.

  5. Experimental investigation of adiabatic compression and heating using collision of an MHD-driven jet with a gas target cloud for magnetized target fusion

    NASA Astrophysics Data System (ADS)

    Seo, Byonghoon; Li, Hui; Bellan, Paul

    2017-10-01

    We are studying magnetized target fusion using an experimental method where an imploding liner compressing a plasma is simulated by a high-speed MHD-driven plasma jet colliding with a gas target cloud. This has the advantage of being non-destructive so orders of magnitude more shots are possible. Since the actual density and temperature are much more modest than fusion-relevant values, the goal is to determine the scaling of the increase in density and temperature when an actual experimental plasma is adiabatically compressed. Two new-developed diagnostics are operating and providing data. The first new diagnostic is a fiber-coupled interferometer which measures line-integrated electron density not only as a function of time, but also as a function of position along the jet. The second new diagnostic is laser Thomson scattering which measures electron density and temperature at the location where the jet collides with the cloud. These diagnostics show that when the jet collides with a target cloud the jet slows down substantially and both the electron density and temperature increase. The experimental measurements are being compared with 3D MHD and hybrid kinetic numerical simulations that model the actual experimental geometry.

  6. Non-invasive biomedical research and diagnostics enabled by innovative compact lasers

    NASA Astrophysics Data System (ADS)

    Litvinova, Karina S.; Rafailov, Ilya E.; Dunaev, Andrey V.; Sokolovski, Sergei G.; Rafailov, Edik U.

    2017-11-01

    For over half a century, laser technology has undergone a technological revolution. These technologies, particularly semiconductor lasers, are employed in a myriad of fields. Optical medical diagnostics, one of the emerging areas of laser application, are on the forefront of application around the world. Optical methods of non- or minimally invasive bio-tissue investigation offer significant advantages over alternative methods, including rapid real-time measurement, non-invasiveness and high resolution (guaranteeing the safety of a patient). These advantages demonstrate the growing success of such techniques. In this review, we will outline the recent status of laser technology applied in the biomedical field, focusing on the various available approaches, particularly utilising compact semiconductor lasers. We will further consider the advancement and integration of several complimentary biophotonic techniques into single multimodal devices, the potential impact of such devices and their future applications. Based on our own studies, we will also cover the simultaneous collection of physiological data with the aid a multifunctional diagnostics system, concentrating on the optimisation of the new technology towards a clinical application. Such data is invaluable for developing algorithms capable of delivering consistent, reliable and meaningful diagnostic information, which can ultimately be employed for the early diagnosis of disease conditions in individuals from around the world.

  7. Preliminary results of real-time in-vitro electronic speckle pattern interferometry (ESPI) measurements in otolaryngology

    NASA Astrophysics Data System (ADS)

    Conerty, Michelle D.; Castracane, James; Cacace, Anthony T.; Parnes, Steven M.; Gardner, Glendon M.; Miller, Mitchell B.

    1995-05-01

    Electronic Speckle Pattern Interferometry (ESPI) is a nondestructive optical evaluation technique that is capable of determining surface and subsurface integrity through the quantitative evaluation of static or vibratory motion. By utilizing state of the art developments in the areas of lasers, fiber optics and solid state detector technology, this technique has become applicable in medical research and diagnostics. Based on initial support from NIDCD and continued support from InterScience, Inc., we have been developing a range of instruments for improved diagnostic evaluation in otolaryngological applications based on the technique of ESPI. These compact fiber optic instruments are capable of making real time interferometric measurements of the target tissue. Ongoing development of image post- processing software is currently capable of extracting the desired quantitative results from the acquired interferometric images. The goal of the research is to develop a fully automated system in which the image processing and quantification will be performed in hardware in near real-time. Subsurface details of both the tympanic membrane and vocal cord dynamics could speed the diagnosis of otosclerosis, laryngeal tumors, and aid in the evaluation of surgical procedures.

  8. Detection of malignant lesions in vivo in the upper gastrointestinal tract using image-guided Raman endoscopy

    NASA Astrophysics Data System (ADS)

    Bergholt, Mads Sylvest; Zheng, Wei; Lin, Kan; Ho, Khek Yu; Yeoh, Khay Guan; Teh, Ming; So, Jimmy Bok Yan; Huang, Zhiwei

    2012-01-01

    Raman spectroscopy is a vibrational analytic technique sensitive to the changes in biomolecular composition and conformations occurring in tissue. With our most recent development of near-infrared (NIR) Raman endoscopy integrated with diagnostic algorithms, in vivo real-time Raman diagnostics has been realized under multimodal wide-field imaging (i.e., white- light reflectance (WLR), narrow-band imaging (NBI), autofluorescence imaging (AFI)) modalities. A selection of 177 patients who previously underwent Raman endoscopy (n=2510 spectra) was used to render two robust models based on partial least squares - discriminant analysis (PLS-DA) for esophageal and gastric cancer diagnosis. The Raman endoscopy technique was validated prospectively on 4 new gastric and esophageal patients for in vivo tissue diagnosis. The Raman endoscopic technique could identify esophageal cancer in vivo with a sensitivity of 88.9% (8/9) and specificity of 100.0% (11/11) and gastric cancers with a sensitivity of 77.8% (14/18) and specificity of 100.0% (13/13). This study realizes for the first time the image-guided Raman endoscopy for real-time in vivo diagnosis of malignancies in the esophagus and gastric at the biomolecular level.

  9. Useful diagnostic biometabolic data obtained by PET/CT and MR fusion imaging using open source software.

    PubMed

    Antonica, Filippo; Asabella, Artor Niccoli; Ferrari, Cristina; Rubini, Domenico; Notaristefano, Antonio; Nicoletti, Adriano; Altini, Corinna; Merenda, Nunzio; Mossa, Emilio; Guarini, Attilio; Rubini, Giuseppe

    2014-01-01

    In the last decade numerous attempts were considered to co-register and integrate different imaging data. Like PET/CT the integration of PET to MR showed great interest. PET/MR scanners are recently tested on different distrectual or systemic pathologies. Unfortunately PET/MR scanners are expensive and diagnostic protocols are still under studies and investigations. Nuclear Medicine imaging highlights functional and biometabolic information but has poor anatomic details. The aim of this study is to integrate MR and PET data to produce distrectual or whole body fused images acquired from different scanners even in different days. We propose an offline method to fuse PET with MR data using an open-source software that has to be inexpensive, reproducible and capable to exchange data over the network. We also evaluate global quality, alignment quality, and diagnostic confidence of fused PET-MR images. We selected PET/CT studies performed in our Nuclear Medicine unit, MR studies provided by patients on DICOM CD media or network received. We used Osirix 5.7 open source version. We aligned CT slices with the first MR slice, pointed and marked for co-registration using MR-T1 sequence and CT as reference and fused with PET to produce a PET-MR image. A total of 100 PET/CT studies were fused with the following MR studies: 20 head, 15 thorax, 24 abdomen, 31 pelvis, 10 whole body. An interval of no more than 15 days between PET and MR was the inclusion criteria. PET/CT, MR and fused studies were evaluated by two experienced radiologist and two experienced nuclear medicine physicians. Each one filled a five point based evaluation scoring scheme based on image quality, image artifacts, segmentation errors, fusion misalignment and diagnostic confidence. Our fusion method showed best results for head, thorax and pelvic districts in terms of global quality, alignment quality and diagnostic confidence,while for the abdomen and pelvis alignement quality and global quality resulted poor due to internal organs filling variation and time shifting beetwen examinations. PET/CT images with time of flight reconstruction and real attenuation correction were combined with anatomical detailed MRI images. We used Osirix, an image processing Open Source Software dedicated to DICOM images. No additional costs, to buy and upgrade proprietary software are required for combining data. No high technology or very expensive PET/MR scanner, that requires dedicated shielded room spaces and personnel to be employed or to be trained, are needed. Our method allows to share patient PET/MR fused data with different medical staff using dedicated networks. The proposed method may be applied to every MR sequence (MR-DWI and MR-STIR, magnet enhanced sequences) to characterize soft tissue alterations and improve discrimination diseases. It can be applied not only to PET with MR but virtually to every DICOM study.

  10. Integrated Maintenance Information System (IMIS) Diagnostic Module Redesign

    DTIC Science & Technology

    1990-12-01

    Government- related procurement, the United States Government incurs no responsibility or any obligation whatsoever. The fact that the Government may have...invention that may in any way be related thereto. The Public Affairs Office has reviewed this report, and it is releasable to the National Technical...instance of the controller class is needed to perform diagnostics. This instance creates, monitors, and controls one or more diagnostic groups . This process

  11. 2012 HIV Diagnostics Conference: the molecular diagnostics perspective.

    PubMed

    Branson, Bernard M; Pandori, Mark

    2013-04-01

    2012 HIV Diagnostic Conference Atlanta, GA, USA, 12-14 December 2012. This report highlights the presentations and discussions from the 2012 National HIV Diagnostic Conference held in Atlanta (GA, USA), on 12-14 December 2012. Reflecting changes in the evolving field of HIV diagnostics, the conference provided a forum for evaluating developments in molecular diagnostics and their role in HIV diagnosis. In 2010, the HIV Diagnostics Conference concluded with the proposal of a new diagnostic algorithm which included nucleic acid testing to resolve discordant screening and supplemental antibody test results. The 2012 meeting, picking up where the 2010 meeting left off, focused on scientific presentations that assessed this new algorithm and the role played by RNA testing and new developments in molecular diagnostics, including detection of total and integrated HIV-1 DNA, detection and quantification of HIV-2 RNA, and rapid formats for detection of HIV-1 RNA.

  12. Integrating molecular diagnostics into histopathology training: the Belfast model.

    PubMed

    Flynn, C; James, J; Maxwell, P; McQuaid, S; Ervine, A; Catherwood, M; Loughrey, M B; McGibben, D; Somerville, J; McManus, D T; Gray, M; Herron, B; Salto-Tellez, M

    2014-07-01

    Molecular medicine is transforming modern clinical practice, from diagnostics to therapeutics. Discoveries in research are being incorporated into the clinical setting with increasing rapidity. This transformation is also deeply changing the way we practise pathology. The great advances in cell and molecular biology which have accelerated our understanding of the pathogenesis of solid tumours have been embraced with variable degrees of enthusiasm by diverse medical professional specialties. While histopathologists have not been prompt to adopt molecular diagnostics to date, the need to incorporate molecular pathology into the training of future histopathologists is imperative. Our goal is to create, within an existing 5-year histopathology training curriculum, the structure for formal substantial teaching of molecular diagnostics. This specialist training has two main goals: (1) to equip future practising histopathologists with basic knowledge of molecular diagnostics and (2) to create the option for those interested in a subspecialty experience in tissue molecular diagnostics to pursue this training. It is our belief that this training will help to maintain in future the role of the pathologist at the centre of patient care as the integrator of clinical, morphological and molecular information. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  13. Potential Application of Digitally Linked Tuberculosis Diagnostics for Real-Time Surveillance of Drug-Resistant Tuberculosis Transmission: Validation and Analysis of Test Results.

    PubMed

    Ng, Kamela Charmaine; Meehan, Conor Joseph; Torrea, Gabriela; Goeminne, Léonie; Diels, Maren; Rigouts, Leen; de Jong, Bouke Catherine; André, Emmanuel

    2018-02-27

    Tuberculosis (TB) is the highest-mortality infectious disease in the world and the main cause of death related to antimicrobial resistance, yet its surveillance is still paper-based. Rifampicin-resistant TB (RR-TB) is an urgent public health crisis. The World Health Organization has, since 2010, endorsed a series of rapid diagnostic tests (RDTs) that enable rapid detection of drug-resistant strains and produce large volumes of data. In parallel, most high-burden countries have adopted connectivity solutions that allow linking of diagnostics, real-time capture, and shared repository of these test results. However, these connected diagnostics and readily available test results are not used to their full capacity, as we have yet to capitalize on fully understanding the relationship between test results and specific rpoB mutations to elucidate its potential application to real-time surveillance. We aimed to validate and analyze RDT data in detail, and propose the potential use of connected diagnostics and associated test results for real-time evaluation of RR-TB transmission. We selected 107 RR-TB strains harboring 34 unique rpoB mutations, including 30 within the rifampicin resistance-determining region (RRDR), from the Belgian Coordinated Collections of Microorganisms, Antwerp, Belgium. We subjected these strains to Xpert MTB/RIF, GenoType MTBDRplus v2.0, and Genoscholar NTM + MDRTB II, the results of which were validated against the strains' available rpoB gene sequences. We determined the reproducibility of the results, analyzed and visualized the probe reactions, and proposed these for potential use in evaluating transmission. The RDT probe reactions detected most RRDR mutations tested, although we found a few critical discrepancies between observed results and manufacturers' claims. Based on published frequencies of probe reactions and RRDR mutations, we found specific probe reactions with high potential use in transmission studies: Xpert MTB/RIF probes A, Bdelayed, C, and Edelayed; Genotype MTBDRplus v2.0 WT2, WT5, and WT6; and Genoscholar NTM + MDRTB II S1 and S3. Inspection of probe reactions of disputed mutations may potentially resolve discordance between genotypic and phenotypic test results. We propose a novel approach for potential real-time detection of RR-TB transmission through fully using digitally linked TB diagnostics and shared repository of test results. To our knowledge, this is the first pragmatic and scalable work in response to the consensus of world-renowned TB experts in 2016 on the potential of diagnostic connectivity to accelerate efforts to eliminate TB. This is evidenced by the ability of our proposed approach to facilitate comparison of probe reactions between different RDTs used in the same setting. Integrating this proposed approach as a plug-in module to a connectivity platform will increase usefulness of connected TB diagnostics for RR-TB outbreak detection through real-time investigation of suspected RR-TB transmission cases based on epidemiologic linking. ©Kamela Charmaine Ng, Conor Joseph Meehan, Gabriela Torrea, Léonie Goeminne, Maren Diels, Leen Rigouts, Bouke Catherine de Jong, Emmanuel André. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 27.02.2018.

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

    PubMed

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

    2009-12-01

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

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

    PubMed

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

    2014-10-01

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

  16. Early signs that predict later haemodynamically significant patent ductus arteriosus.

    PubMed

    Engür, Defne; Deveci, Murat; Türkmen, Münevver K

    2016-03-01

    Our aim was to determine the optimal cut-off values, sensitivity, specificity, and diagnostic power of 12 echocardiographic parameters on the second day of life to predict subsequent ductal patency. We evaluated preterm infants, born at ⩽32 weeks of gestation, starting on their second day of life, and they were evaluated every other day until ductal closure or until there were clinical signs of re-opening. We measured transductal diameter; pulmonary arterial diastolic flow; retrograde aortic diastolic flow; pulsatility index of the left pulmonary artery and descending aorta; left atrium and ventricle/aortic root ratio; left ventricular output; left ventricular flow velocity time integral; mitral early/late diastolic flow; and superior caval vein diameter and flow as well as performed receiver operating curve analysis. Transductal diameter (>1.5 mm); pulmonary arterial diastolic flow (>25.6 cm/second); presence of retrograde aortic diastolic flow; ductal diameter by body weight (>1.07 mm/kg); left pulmonary arterial pulsatility index (⩽0.71); and left ventricle to aortic root ratio (>2.2) displayed high sensitivity and specificity (p0.9). Parameters with moderate sensitivity and specificity were as follows: left atrial to aortic root ratio; left ventricular output; left ventricular flow velocity time integral; and mitral early/late diastolic flow ratio (p0.05) had low diagnostic value. Left pulmonary arterial pulsatility index, left ventricle/aortic root ratio, and ductal diameter by body weight are useful adjuncts offering a broader outlook for predicting ductal patency.

  17. Integrated Artificial Intelligence Approaches for Disease Diagnostics.

    PubMed

    Vashistha, Rajat; Chhabra, Deepak; Shukla, Pratyoosh

    2018-06-01

    Mechanocomputational techniques in conjunction with artificial intelligence (AI) are revolutionizing the interpretations of the crucial information from the medical data and converting it into optimized and organized information for diagnostics. It is possible due to valuable perfection in artificial intelligence, computer aided diagnostics, virtual assistant, robotic surgery, augmented reality and genome editing (based on AI) technologies. Such techniques are serving as the products for diagnosing emerging microbial or non microbial diseases. This article represents a combinatory approach of using such approaches and providing therapeutic solutions towards utilizing these techniques in disease diagnostics.

  18. Hardware Timestamping for an Image Acquisition System Based on FlexRIO and IEEE 1588 v2 Standard

    NASA Astrophysics Data System (ADS)

    Esquembri, S.; Sanz, D.; Barrera, E.; Ruiz, M.; Bustos, A.; Vega, J.; Castro, R.

    2016-02-01

    Current fusion devices usually implement distributed acquisition systems for the multiple diagnostics of their experiments. However, each diagnostic is composed by hundreds or even thousands of signals, including images from the vessel interior. These signals and images must be correctly timestamped, because all the information will be analyzed to identify plasma behavior using temporal correlations. For acquisition devices without synchronization mechanisms the timestamp is given by another device with timing capabilities when signaled by the first device. Later, each data should be related with its timestamp, usually via software. This critical action is unfeasible for software applications when sampling rates are high. In order to solve this problem this paper presents the implementation of an image acquisition system with real-time hardware timestamping mechanism. This is synchronized with a master clock using the IEEE 1588 v2 Precision Time Protocol (PTP). Synchronization, image acquisition and processing, and timestamping mechanisms are implemented using Field Programmable Gate Array (FPGA) and a timing card -PTP v2 synchronized. The system has been validated using a camera simulator streaming videos from fusion databases. The developed architecture is fully compatible with ITER Fast Controllers and has been integrated with EPICS to control and monitor the whole system.

  19. Flexible substrate-based devices for point-of-care diagnostics

    PubMed Central

    Wang, ShuQi; Chinnasamy, Thiruppathiraja; Lifson, Mark; Inci, Fatih; Demirci, Utkan

    2016-01-01

    Point-of-care (POC) diagnostics play an important role in delivering healthcare, particularly for clinical management and disease surveillance in both developed and developing countries. Currently, the majority of POC diagnostics utilize paper substrates owing to their affordability, disposability, and mass production capability. Recently, flexible polymer substrates have been investigated due to their enhanced physicochemical properties, potential to be integrated into wearable devices with wireless communications for personalized health monitoring, and ability to be customized for POC diagnostics. Here, we focus on the latest advances in developing flexible substrate-based diagnostic devices, including paper and polymers, and their clinical applications at the POC. PMID:27344425

  20. Flexible Substrate-Based Devices for Point-of-Care Diagnostics.

    PubMed

    Wang, ShuQi; Chinnasamy, Thiruppathiraja; Lifson, Mark A; Inci, Fatih; Demirci, Utkan

    2016-11-01

    Point-of-care (POC) diagnostics play an important role in delivering healthcare, particularly for clinical management and disease surveillance in both developed and developing countries. Currently, the majority of POC diagnostics utilize paper substrates owing to affordability, disposability, and mass production capability. Recently, flexible polymer substrates have been investigated due to their enhanced physicochemical properties, potential to be integrated into wearable devices with wireless communications for personalized health monitoring, and ability to be customized for POC diagnostics. Here, we focus on the latest advances in developing flexible substrate-based diagnostic devices, including paper and polymers, and their clinical applications. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. A decision-theoretic approach to the display of information for time-critical decisions: The Vista project

    NASA Technical Reports Server (NTRS)

    Horvitz, Eric; Ruokangas, Corinne; Srinivas, Sampath; Barry, Matthew

    1993-01-01

    We describe a collaborative research and development effort between the Palo Alto Laboratory of the Rockwell Science Center, Rockwell Space Operations Company, and the Propulsion Systems Section of NASA JSC to design computational tools that can manage the complexity of information displayed to human operators in high-stakes, time-critical decision contexts. We shall review an application from NASA Mission Control and describe how we integrated a probabilistic diagnostic model and a time-dependent utility model, with techniques for managing the complexity of computer displays. Then, we shall describe the behavior of VPROP, a system constructed to demonstrate promising display-management techniques. Finally, we shall describe our current research directions on the Vista 2 follow-on project.

  2. vECTlab—A fully integrated multi-modality Monte Carlo simulation framework for the radiological imaging sciences

    NASA Astrophysics Data System (ADS)

    Peter, Jörg; Semmler, Wolfhard

    2007-10-01

    Alongside and in part motivated by recent advances in molecular diagnostics, the development of dual-modality instruments for patient and dedicated small animal imaging has gained attention by diverse research groups. The desire for such systems is high not only to link molecular or functional information with the anatomical structures, but also for detecting multiple molecular events simultaneously at shorter total acquisition times. While PET and SPECT have been integrated successfully with X-ray CT, the advance of optical imaging approaches (OT) and the integration thereof into existing modalities carry a high application potential, particularly for imaging small animals. A multi-modality Monte Carlo (MC) simulation approach at present has been developed that is able to trace high-energy (keV) as well as optical (eV) photons concurrently within identical phantom representation models. We show that the involved two approaches for ray-tracing keV and eV photons can be integrated into a unique simulation framework which enables both photon classes to be propagated through various geometry models representing both phantoms and scanners. The main advantage of such integrated framework for our specific application is the investigation of novel tomographic multi-modality instrumentation intended for in vivo small animal imaging through time-resolved MC simulation upon identical phantom geometries. Design examples are provided for recently proposed SPECT-OT and PET-OT imaging systems.

  3. Study protocol for a comparative effectiveness trial of two models of perinatal integrated psychosocial assessment: the PIPA project.

    PubMed

    Reilly, Nicole; Black, Emma; Chambers, Georgina M; Schmied, Virginia; Matthey, Stephen; Farrell, Josephine; Kingston, Dawn; Bisits, Andrew; Austin, Marie-Paule

    2017-07-20

    Studies examining psychosocial and depression assessment programs in maternity settings have not adequately considered the context in which psychosocial assessment occurs or how broader components of integrated care, including clinician decision-making aids, may optimise program delivery and its cost-effectiveness. There is also limited evidence relating to the diagnostic accuracy of symptom-based screening measures used in this context. The Perinatal Integrated Psychosocial Assessment (PIPA) Project was developed to address these knowledge gaps. The primary aims of the PIPA Project are to examine the clinical- and cost-effectiveness of two alternative models of integrated psychosocial care during pregnancy: 'care as usual' (the SAFE START model) and an alternative model (the PIPA model). The acceptability and perceived benefit of each model of care from the perspective of both pregnant women and their healthcare providers will also be assessed. Our secondary aim is to examine the psychometric properties of a number of symptom-based screening tools for depression and anxiety when used in pregnancy. This is a comparative-effectiveness study comparing 'care as usual' to an alternative model sequentially over two 12-month periods. Data will be collected from women at Time 1 (initial antenatal psychosocial assessment), Time 2 (2-weeks after Time 1) and from clinicians at Time 3 for each condition. Primary aims will be evaluated using a between-groups design, and the secondary aim using a within group design. The PIPA Project will provide evidence relating to the clinical- and cost- effectiveness of psychosocial assessment integrated with electronic clinician decision making prompts, and referral options that are tailored to the woman's psychosocial risk, in the maternity care setting. It will also address research recommendations from the Australian (2011) and NICE (2015) Clinical Practice Guidelines. ACTRN12617000932369.

  4. Diode pumped solid state kilohertz disk laser system for time-resolved combustion diagnostics under microgravity at the drop tower Bremen

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

    Wagner, Volker; Paa, Wolfgang; Triebel, Wolfgang

    We describe a specially designed diode pumped solid state laser system based on the disk laser architecture for combustion diagnostics under microgravity (μg) conditions at the drop tower in Bremen. The two-stage oscillator-amplifier-system provides an excellent beam profile (TEM{sub 00}) at narrowband operation (Δλ < 1 pm) and is tunable from 1018 nm to 1052 nm. The laser repetition rate of up to 4 kHz at pulse durations of 10 ns enables the tracking of processes on a millisecond time scale. Depending on the specific issue it is possible to convert the output radiation up to the fourth harmonic aroundmore » 257 nm. The very compact laser system is integrated in a slightly modified drop capsule and withstands decelerations of up to 50 g (>11 ms). At first the concept of the two-stage disk laser is briefly explained, followed by a detailed description of the disk laser adaption to the drop tower requirements with special focus on the intended use under μg conditions. In order to demonstrate the capabilities of the capsule laser as a tool for μg combustion diagnostics, we finally present an investigation of the precursor-reactions before the droplet ignition using 2D imaging of the Laser Induced Fluorescence of formaldehyde.« less

  5. On-chip integrated labelling, transport and detection of tumour cells.

    PubMed

    Woods, Jane; Docker, Peter T; Dyer, Charlotte E; Haswell, Stephen J; Greenman, John

    2011-11-01

    Microflow cytometry represents a promising tool for the investigation of diagnostic and prognostic cellular cancer markers, particularly if integrated within a device that allows primary cells to be freshly isolated from the solid tumour biopsies that more accurately reflect patient-specific in vivo tissue microenvironments at the time of staining. However, current tissue processing techniques involve several sequential stages with concomitant cell losses, and as such are inappropriate for use with small biopsies. Accordingly, we present a simple method for combined antibody-labelling and dissociation of heterogeneous cells from a tumour mass, which reduces the number of processing steps. Perfusion of ex vivo tissue at 4°C with antibodies and enzymes slows cellular activity while allowing sufficient time for the diffusion of minimally active enzymes. In situ antibody-labelled cells are then dissociated at 37°C from the tumour mass, whereupon hydrogel-filled channels allow the release of relatively low cell numbers (<1000) into a biomimetic microenvironment. This novel approach to sample processing is then further integrated with hydrogel-based electrokinetic transport of the freshly liberated fluorescent cells for downstream detection. It is anticipated that this integrated microfluidic methodology will have wide-ranging biomedical and clinical applications. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  6. Mechanical phenotyping of tumor cells using a microfluidic cell squeezer device

    NASA Astrophysics Data System (ADS)

    Khan, Zeina S.; Kamyabi, Nabiollah; Vanapalli, Siva A.

    2013-03-01

    Studies have indicated that cancer cells have distinct mechanical properties compared to healthy cells. We are investigating the potential of cell mechanics as a biophysical marker for diagnostics and prognosis of cancer. To establish the significance of mechanical properties for cancer diagnostics, a high throughput method is desired. Although techniques such as atomic force microscopy are very precise, they are limited in throughput for cellular mechanical property measurements. To develop a device for high throughput mechanical characterization of tumor cells, we have fabricated a microfludic cell squeezer device that contains narrow micrometer-scale pores. Fluid flow is used to drive cells into these pores mimicking the flow-induced passage of circulating tumor cells through microvasculature. By integrating high speed imaging, the device allows for the simultaneous characterization of five different parameters including the blockage pressure, cell velocity, cell size, elongation and the entry time into squeezer. We have tested a variety of in vitro cell lines, including brain and prostate cancer cell lines, and have found that the entry time is the most sensitive measurement capable of differentiating between cell lines with differing invasiveness.

  7. Exploitation of microbial forensics and nanotechnology for the monitoring of emerging pathogens.

    PubMed

    Bokhari, Habib

    2018-03-07

    Emerging infectious diseases remain among the leading causes of global mortality. Traditional laboratory diagnostic approaches designed to detect and track infectious disease agents provide a framework for surveillance of bio threats. However, surveillance and outbreak investigations using such time-consuming approaches for early detection of pathogens remain the major pitfall. Hence, reasonable real-time surveillance systems to anticipate threats to public health and environment are critical for identifying specific aetiologies and preventing the global spread of infectious disease. The current review discusses the growing need for monitoring and surveillance of pathogens with the same zeal and approach as adopted by microbial forensics laboratories, and further strengthening it by integrating with the innovative nanotechnology for rapid detection of microbial pathogens. Such innovative diagnostics platforms will help to track pathogens from high risk areas and environment by pre-emptive approach that will minimize damages. The various scenarios with the examples are discussed where the high risk associated human pathogens in particular were successfully detected using various nanotechnology approaches with potential future prospects in the field of microbial forensics.

  8. An Efficient Model-based Diagnosis Engine for Hybrid Systems Using Structural Model Decomposition

    NASA Technical Reports Server (NTRS)

    Bregon, Anibal; Narasimhan, Sriram; Roychoudhury, Indranil; Daigle, Matthew; Pulido, Belarmino

    2013-01-01

    Complex hybrid systems are present in a large range of engineering applications, like mechanical systems, electrical circuits, or embedded computation systems. The behavior of these systems is made up of continuous and discrete event dynamics that increase the difficulties for accurate and timely online fault diagnosis. The Hybrid Diagnosis Engine (HyDE) offers flexibility to the diagnosis application designer to choose the modeling paradigm and the reasoning algorithms. The HyDE architecture supports the use of multiple modeling paradigms at the component and system level. However, HyDE faces some problems regarding performance in terms of complexity and time. Our focus in this paper is on developing efficient model-based methodologies for online fault diagnosis in complex hybrid systems. To do this, we propose a diagnosis framework where structural model decomposition is integrated within the HyDE diagnosis framework to reduce the computational complexity associated with the fault diagnosis of hybrid systems. As a case study, we apply our approach to a diagnostic testbed, the Advanced Diagnostics and Prognostics Testbed (ADAPT), using real data.

  9. [Value of 3T magnetic resonance dynamic contrast-enhanced and diffusion-weighted imaging in differential diagnosis of musculoskeletal tumors].

    PubMed

    Qi, Zi-hua; Li, Chuan-fu; Ma, Xiang-xing; Yang, Hui; Jiang, Bao-dong; Zhang, Kai; Yu, De-xin

    2012-04-01

    To evaluate the value of magnetic resonance dynamic contrast-enhanced (MR-DCE) and magnetic resonance diffusion-weighted imaging (MR-DWI) in the differentiation of benign and malignant musculoskeletal tumors. Sixty-three patients with pathologically confirmed musculoskeletal tumors were examined with MR-DCE and MR-DWI. Using single shot spin echo planar imaging sequence and different b values of 400, 600, 800 and 1000 s/mm(2), we obtained the apparent diffusion coefficient (ADC) of the lesions. ADC values were measured before and after MR-DCE, with a b value of 600 s/mm(2). The 3D fast acquired multiple phase enhanced fast spoiled gradient recalled echo sequence was obtained for multi-slice of the entire lesion. The time-signal intensity curve (TIC), dynamic contrast-enhanced parameters, maximum slope of increase (MSI), positive enhancement integral, signal enhancement ratio, and time to peak (T(peak)) were also recorded. ADC showed no significant difference between benign and malignant tumors when the b value was 400, 600, 800, or 1000 s/mm(2), and it was not significantly different between benign and malignant tumors in both pre-MR-DCE and post-MR-DCE with b value of 600 s/mm(2). TIC were classified into four types type1 showed rapid progression and gradual drainage; type2 showed rapid progression but had no or slight progression; type 3 showed gradual progression; and type 4 had no or slight progression. Most lesions of type1 or type2 were malignant, whereas most lesions of type 3 or type 4 were benign. When using type1 and type 2 as the standards of malignancy, the diagnostic sensitivity and specificity was 87.23% and 50.00%, respectively. The types of TIC showed significant difference between benign and malignant musculoskeletal tumors(χ(2)=17.009,P=0.001). When using MSI 366.62 ± 174.84 as the standard of malignancy, the diagnostic sensitivity and specificity was 86.78% and 78.67%, respectively. When using T(peak)≤70s as the standard of malignancy, the diagnostic sensitivity and specificity was 82.89%and 85.78%, respectively. Positive enhancement integral and signal enhancement ratio showed no significant difference between benign and malignant musculoskeletal tumors. TIC, MSI and T(peak) of MR-DCE are valuable in differentiating benign from malignant musculoskeletal tumors. T(peak) has the highest diagnostic specificity, and TIC has the highest diagnostic sensitivity. The mean ADC value are no significant difference between benign and malignant tumors.

  10. Integrated Circuits for Rapid Sample Processing and Electrochemical Detection of Biomarkers

    NASA Astrophysics Data System (ADS)

    Besant, Justin

    The trade-off between speed and sensitivity of detection is a fundamental challenge in the design of point-of-care diagnostics. As the relevant molecules in many diseases exist natively at extremely low levels, many gold-standard diagnostic tests are designed with high sensitivity at the expense of long incubations needed to amplify the target analytes. The central aim of this thesis is to design new strategies to detect biologically relevant analytes with both high speed and sensitivity. The response time of a biosensor is limited by the ability of the target analyte to accumulate to detectable levels at the sensor surface. We overcome this limitation by designing a range of integrated devices to optimize the flux of the analyte to the sensor by increasing the effective analyte concentration, shortening the required diffusion distance, and confining the analyte in close proximity to the sensor. We couple these devices with novel ultrasensitive electrochemical transduction strategies to convert rare analytes into a detectable signal. We showcase the clinical utility of these approaches with several applications including cancer diagnosis, bacterial identification, and antibiotic susceptibility profiling. We design and optimize a device to isolate rare cancer cells from the bloodstream with near 100% efficiency and 10 000-fold specificity. We analyse pathogen specific nucleic acids by lysing bacteria in close proximity to an electrochemical sensor and find that this approach has 10-fold higher sensitivity than standard lysis in bulk solution. We design an electronic chip to readout the antibiotic susceptibility profile with an hour-long incubation by concentrating bacteria into nanoliter chambers with integrated electrodes. Finally, we report a strategy for ultrasensitive visual readout of nucleic acids as low as 100 fM within 10 minutes using an amplification cascade. The strategies presented could guide the development of fast, sensitive and low-cost diagnostics for diseases not previously detectable at the point-of-care.

  11. Full Life Cycle of Data Analysis with Climate Model Diagnostic Analyzer (CMDA)

    NASA Astrophysics Data System (ADS)

    Lee, S.; Zhai, C.; Pan, L.; Tang, B.; Zhang, J.; Bao, Q.; Malarout, N.

    2017-12-01

    We have developed a system that supports the full life cycle of a data analysis process, from data discovery, to data customization, to analysis, to reanalysis, to publication, and to reproduction. The system called Climate Model Diagnostic Analyzer (CMDA) is designed to demonstrate that the full life cycle of data analysis can be supported within one integrated system for climate model diagnostic evaluation with global observational and reanalysis datasets. CMDA has four subsystems that are highly integrated to support the analysis life cycle. Data System manages datasets used by CMDA analysis tools, Analysis System manages CMDA analysis tools which are all web services, Provenance System manages the meta data of CMDA datasets and the provenance of CMDA analysis history, and Recommendation System extracts knowledge from CMDA usage history and recommends datasets/analysis tools to users. These four subsystems are not only highly integrated but also easily expandable. New datasets can be easily added to Data System and scanned to be visible to the other subsystems. New analysis tools can be easily registered to be available in the Analysis System and Provenance System. With CMDA, a user can start a data analysis process by discovering datasets of relevance to their research topic using the Recommendation System. Next, the user can customize the discovered datasets for their scientific use (e.g. anomaly calculation, regridding, etc) with tools in the Analysis System. Next, the user can do their analysis with the tools (e.g. conditional sampling, time averaging, spatial averaging) in the Analysis System. Next, the user can reanalyze the datasets based on the previously stored analysis provenance in the Provenance System. Further, they can publish their analysis process and result to the Provenance System to share with other users. Finally, any user can reproduce the published analysis process and results. By supporting the full life cycle of climate data analysis, CMDA improves the research productivity and collaboration level of its user.

  12. Residual gas analyzer mass spectrometry for human breath analysis: a new tool for the non-invasive diagnosis of Helicobacter pylori infection.

    PubMed

    Maity, Abhijit; Banik, Gourab D; Ghosh, Chiranjit; Som, Suman; Chaudhuri, Sujit; Daschakraborty, Sunil B; Ghosh, Shibendu; Ghosh, Barnali; Raychaudhuri, Arup K; Pradhan, Manik

    2014-03-01

    A residual gas analyzer (RGA) coupled with a high vacuum chamber is described for the non-invasive diagnosis of the Helicobacter pylori (H. pylori) infection through ¹³C-urea breath analysis. The present RGA-based mass spectrometry (MS) method is capable of measuring high-precision ¹³CO₂ isotope enrichments in exhaled breath samples from individuals harboring the H. pylori infection. The system exhibited 100% diagnostic sensitivity, and 93% specificity alongside positive and negative predictive values of 95% and 100%, respectively, compared with invasive endoscopy-based biopsy tests. A statistically sound diagnostic cut-off value for the presence of H. pylori was determined to be 3.0‰ using a receiver operating characteristic curve analysis. The diagnostic accuracy and validity of the results are also supported by optical off-axis integrated cavity output spectroscopy measurements. The δ¹³(DOB)C‰ values of both methods correlated well (R² = 0.9973 at 30 min). The RGA-based instrumental setup described here is simple, robust, easy-to-use and more portable and cost-effective compared to all other currently available detection methods, thus making it a new point-of-care medical diagnostic tool for the purpose of large-scale screening of the H. pylori infection in real time. The RGA-MS technique should have broad applicability for ¹³C-breath tests in a wide range of biomedical research and clinical diagnostics for many other diseases and metabolic disorders.

  13. Potential point of care tests (POCTs) for maternal health in Peru, perspectives of pregnant women and their partners

    PubMed Central

    2014-01-01

    Background Globally, no qualitative studies have explored the perspectives of women and their partners about the integration of technology – and specifically diagnostic testing technologies – into antenatal care. The study objective was to describe the demand side for pregnancy-related diagnostic tests from the perspective of Peruvian consumers, including female and male community members, by engaging participants about their awareness of and care-seeking for pregnancy-related diagnostic tests and their preferred characteristics and testing conditions for pregnancy-related point-of-care diagnostic tests (POCTs). Methods Sixty-seven mothers and fathers of children under one from the peri-urban coast and the peri-urban and rural highlands and jungle of Peru participated in ten focus groups. Results Participants think that pregnancy-related diagnostic tests are important and they and their fellow community members are committed to ensuring that pregnant women receive the tests they need. Participants expressed clear demands for pregnancy-related POCTs, including important characteristics for the tests themselves (certification, rapid, reliable results) and for test implementation (well-trained, personable good communicators as test administrators at well-equipped, convenient testing sites). Participants emphasized the importance of short waiting times and explained that many people have some ability to pay for POCTs, particularly if they are innovative, rapid or multiplex. Conclusions Engaging future POCT users as consumers who are able to make key decisions about the development and implementation of pregnancy-related POCTs is valuable and informative. PMID:24433514

  14. Quality and safety of integrated community case management of malaria using rapid diagnostic tests and pneumonia by community health workers

    PubMed Central

    Hamer, Davidson H; Brooks, Erin Twohig; Semrau, Katherine; Pilingana, Portipher; MacLeod, William B; Siazeele, Kazungu; Sabin, Lora L; Thea, Donald M; Yeboah-Antwi, Kojo

    2012-01-01

    Objectives To assess the quality and safety of having community health workers (CHWs) in rural Zambia use rapid diagnostic tests (RDTs) and provide integrated management of malaria and pneumonia. Design/methods In the context of a cluster-randomized controlled trial of two models for community-based management of malaria and/or non-severe pneumonia in children under 5 years old, CHWs in the intervention arm were trained to use RDTs, follow a simple algorithm for classification and treat malaria with artemether–lumefantrine (AL) and pneumonia with amoxicillin. CHW records were reviewed to assess the ability of the CHWs to appropriately classify and treat malaria and pneumonia, and account for supplies. Patients were also followed up to assess treatment safety. Results During the 12-month study, the CHWs evaluated 1017 children with fever and/or fast/difficult breathing and performed 975 RDTs. Malaria and/or pneumonia were appropriately classified 94–100% of the time. Treatment based on disease classification was correct in 94–100% of episodes. Supply management was excellent with over 98% of RDTs, amoxicillin, and AL properly accounted for. The use of RDTs, amoxicillin, and AL was associated with few minor adverse events. Most febrile children (90%) with negative RDT results recovered after being treated with an antipyretic alone. Conclusions Volunteer CHWs in rural Zambia are capable of providing integrated management of malaria and pneumonia to children safely and at high quality. PMID:22595272

  15. Quality and safety of integrated community case management of malaria using rapid diagnostic tests and pneumonia by community health workers.

    PubMed

    Hamer, Davidson H; Brooks, Erin Twohig; Semrau, Katherine; Pilingana, Portipher; MacLeod, William B; Siazeele, Kazungu; Sabin, Lora L; Thea, Donald M; Yeboah-Antwi, Kojo

    2012-03-01

    To assess the quality and safety of having community health workers (CHWs) in rural Zambia use rapid diagnostic tests (RDTs) and provide integrated management of malaria and pneumonia. In the context of a cluster-randomized controlled trial of two models for community-based management of malaria and/or non-severe pneumonia in children under 5 years old, CHWs in the intervention arm were trained to use RDTs, follow a simple algorithm for classification and treat malaria with artemether-lumefantrine (AL) and pneumonia with amoxicillin. CHW records were reviewed to assess the ability of the CHWs to appropriately classify and treat malaria and pneumonia, and account for supplies. Patients were also followed up to assess treatment safety. During the 12-month study, the CHWs evaluated 1017 children with fever and/or fast/difficult breathing and performed 975 RDTs. Malaria and/or pneumonia were appropriately classified 94-100% of the time. Treatment based on disease classification was correct in 94-100% of episodes. Supply management was excellent with over 98% of RDTs, amoxicillin, and AL properly accounted for. The use of RDTs, amoxicillin, and AL was associated with few minor adverse events. Most febrile children (90%) with negative RDT results recovered after being treated with an antipyretic alone. Volunteer CHWs in rural Zambia are capable of providing integrated management of malaria and pneumonia to children safely and at high quality.

  16. Telehealth: current practices and future directions

    NASA Astrophysics Data System (ADS)

    David, Yadin B.

    1996-02-01

    When we review the positive impact that the integration of ostensibly independent patient-care services have on the efficient management of quality care, education, and collaborative research, it is not surprising that telehealth deployment is on the rise. The forces that drive this phenomenon include: the need to manage the entire disease episode; the desire for wider geographically-distributed quality health care; the escalation of customer expectations; globalization of healthcare and its support services; an increase in patient and provider convenience; and the acceptance of the present technological community. At the Telehealth Center at the Texas Children's Hospital, current classifications of clinical applications are listed: (1) initial urgent evaluation of patients, (2) triage decisions and pretransfer arrangements, (3) medical and surgical follow-up and medication review, (4) consultation for primary care encounters, (5) real-time subspecialty care consultation and planning, (6) management of chronic diseases and conditions, (7) extended diagnostic work-ups, (8) review of diagnostic images, and (9) preventive medicine and patient education. The delivery of such services is associated with challenges and opportunities. As we move forward from limited data processing to an integrated communication system, from centralized main frame functions to personalized and location-independent workstations, and from hospitals to clinics and homecare, an increase in the minimum features provided by the equipment and the communication systems must accompany the widening variety of clinical applications. Future expansion of telehealth systems stands to revolutionize the delivery of services to the benefits of providers' networks, our economy, and patients through integration.

  17. Integrated sample-to-detection chip for nucleic acid test assays.

    PubMed

    Prakash, R; Pabbaraju, K; Wong, S; Tellier, R; Kaler, K V I S

    2016-06-01

    Nucleic acid based diagnostic techniques are routinely used for the detection of infectious agents. Most of these assays rely on nucleic acid extraction platforms for the extraction and purification of nucleic acids and a separate real-time PCR platform for quantitative nucleic acid amplification tests (NATs). Several microfluidic lab on chip (LOC) technologies have been developed, where mechanical and chemical methods are used for the extraction and purification of nucleic acids. Microfluidic technologies have also been effectively utilized for chip based real-time PCR assays. However, there are few examples of microfluidic systems which have successfully integrated these two key processes. In this study, we have implemented an electro-actuation based LOC micro-device that leverages multi-frequency actuation of samples and reagents droplets for chip based nucleic acid extraction and real-time, reverse transcription (RT) PCR (qRT-PCR) amplification from clinical samples. Our prototype micro-device combines chemical lysis with electric field assisted isolation of nucleic acid in a four channel parallel processing scheme. Furthermore, a four channel parallel qRT-PCR amplification and detection assay is integrated to deliver the sample-to-detection NAT chip. The NAT chip combines dielectrophoresis and electrostatic/electrowetting actuation methods with resistive micro-heaters and temperature sensors to perform chip based integrated NATs. The two chip modules have been validated using different panels of clinical samples and their performance compared with standard platforms. This study has established that our integrated NAT chip system has a sensitivity and specificity comparable to that of the standard platforms while providing up to 10 fold reduction in sample/reagent volumes.

  18. Self-assembled gemcitabine-gadolinium nanoparticles for magnetic resonance imaging and cancer therapy.

    PubMed

    Li, Lele; Tong, Rong; Li, Mengyuan; Kohane, Daniel S

    2016-03-01

    Nanoparticles with combined diagnostic and therapeutic functions are promising tools for cancer diagnosis and treatment. Here, we demonstrate a theranostic nanoparticle that integrates an active gemcitabine metabolite and a gadolinium-based magnetic resonance imaging agent via a facile supramolecular self-assembly synthesis, where the anti-cancer drug gemcitabine-5'-monophosphate (a phosphorylated active metabolite of the anti-cancer drug gemcitabine) was used to coordinate with Gd(III) to self-assemble into theranostic nanoparticles. The formulation exhibits a strong T1 contrast signal for magnetic resonance imaging of tumors in vivo, with enhanced retention time. Furthermore, the nanoparticles did not require other inert nanocarriers or excipients and thus had an exceptionally high drug loading (55 wt%), resulting in the inhibition of MDA-MB-231 tumor growth in mice. Recent advances in nanoparticle-based drug delivery systems have spurred the development of "theranostic" multifunctional nanoparticles, which combine therapeutic and diagnostic functionalities in a single formulation. Developing simple and efficient synthetic strategies for the construction of nanotheranostics with high drug loading remains a challenge. Here, we demonstrate a theranostic nanoparticle that integrates high loadings of an active gemcitabine metabolite and a gadolinium-based magnetic resonance imaging agent via a facile synthesis. The nanoparticles were better T1 contrast agents than currently used Gd-DTPA and had prolonged retention in tumor. Moreover they exhibited enhanced in vivo antitumor activity compared to free drug in a breast cancer xenograft mouse model. The strategy provides a scalable way to fabricate nanoparticles that enables enhancement of both therapeutic and diagnostic capabilities. Published by Elsevier Ltd.

  19. Leveling the Playing Field: Bringing Development of Biomarkers and Molecular Diagnostics up to the Standards for Drug Development

    PubMed Central

    Poste, George; Carbone, David P.; Parkinson, David R.; Verweij, Jaap; Hewitt, Stephen; Jessup, J. Milburn

    2012-01-01

    Molecular diagnostics are increasingly important in clinical research to stratify or identify molecularly profiled patient cohorts for targeted therapies, to modify the dose of a therapeutic, or to assess early response to therapy or monitor patients. Molecular diagnostics can also be used to identify pharmocogenetic risk of adverse drug reactions. The articles of this CCR Focus section on Molecular Diagnosis describe the development and use of markers for medical decision-making in the cancer patient. They define the sources of preanalytic variability to minimize as well as the regulatory and financial challenges in diagnostic development and integration into clinical practice. They also outline an NCI program to assist diagnostic development. Molecular diagnostic clinical tests require rigor in their development and clinical validation with sufficient sensitivity, specificity and validity that is comparable to that used for development of therapeutics. These diagnostics must be offered at a realistic cost that reflects both their clinical value and the costs associated with their development. When genome sequencing technologies move into the clinic, they must be integrated with and traceable to current technology because they may identify more efficient and accurate approaches to drug development. In addition, regulators may define progressive drug approval for companion diagnostics that requires further evidence regarding efficacy and safety before full approval. A way to accomplish this is to emphasize Phase IV post-marketing hypothesis driven clinical trials with biological characterization that permits accurate definition of the association of low prevalence gene alterations with toxicity or response in large cohorts. PMID:22422403

  20. Leveling the playing field: bringing development of biomarkers and molecular diagnostics up to the standards for drug development.

    PubMed

    Poste, George; Carbone, David P; Parkinson, David R; Verweij, Jaap; Hewitt, Stephen M; Jessup, J Milburn

    2012-03-15

    Molecular diagnostics are becoming increasingly important in clinical research to stratify or identify molecularly profiled patient cohorts for targeted therapies, to modify the dose of a therapeutic, and to assess early response to therapy or monitor patients. Molecular diagnostics can also be used to identify the pharmacogenetic risk of adverse drug reactions. The articles in this CCR Focus section on molecular diagnosis describe the development and use of markers to guide medical decisions regarding cancer patients. They define sources of preanalytic variability that need to be minimized, as well as the regulatory and financial challenges involved in developing diagnostics and integrating them into clinical practice. They also outline a National Cancer Institute program to assist diagnostic development. Molecular diagnostic clinical tests require rigor in their development and clinical validation, with sensitivity, specificity, and validity comparable to those required for the development of therapeutics. These diagnostics must be offered at a realistic cost that reflects both their clinical value and the costs associated with their development. When genome-sequencing technologies move into the clinic, they must be integrated with and traceable to current technology because they may identify more efficient and accurate approaches to drug development. In addition, regulators may define progressive drug approval for companion diagnostics that requires further evidence regarding efficacy and safety before full approval can be achieved. One way to accomplish this is to emphasize phase IV postmarketing, hypothesis-driven clinical trials with biological characterization that would permit an accurate definition of the association of low-prevalence gene alterations with toxicity or response in large cohorts.

  1. Role of Arrival Time Difference Between Lesions and Lung Tissue on Contrast-Enhanced Sonography in the Differential Diagnosis of Subpleural Pulmonary Lesions.

    PubMed

    Bai, Jing; Yang, Wei; Wang, Song; Guan, Rui-Hong; Zhang, Hui; Fu, Jing-Jing; Wu, Wei; Yan, Kun

    2016-07-01

    The purpose of this study was to explore the diagnostic value of the arrival time difference between lesions and surrounding lung tissue on contrast-enhanced sonography of subpleural pulmonary lesions. A total of 110 patients with subpleural pulmonary lesions who underwent both conventional and contrast-enhanced sonography and had a definite diagnosis were enrolled. After contrast agent injection, the arrival times in the lesion, lung, and chest wall were recorded. The arrival time differences between various tissues were also calculated. Statistical analysis showed a significant difference in the lesion arrival time, the arrival time difference between the lesion and lung, and the arrival time difference between the chest wall and lesion (all P < .001) for benign and malignant lesions. Receiver operating characteristic curve analysis revealed that the optimal diagnostic criterion was the arrival time difference between the lesion and lung, and that the best cutoff point was 2.5 seconds (later arrival signified malignancy). This new diagnostic criterion showed superior diagnostic accuracy (97.1%) compared to conventional diagnostic criteria. The individualized diagnostic method based on an arrival time comparison using contrast-enhanced sonography had high diagnostic accuracy (97.1%) with good feasibility and could provide useful diagnostic information for subpleural pulmonary lesions.

  2. Gold-modified indium tin oxide as a transparent window in optoelectronic diagnostics of electrochemically active biofilms.

    PubMed

    Schmidt, Igor; Gad, Alaaeldin; Scholz, Gregor; Boht, Heidi; Martens, Michael; Schilling, Meinhard; Suryo Wasisto, Hutomo; Waag, Andreas; Schröder, Uwe

    2017-08-15

    Microbial electrochemical technologies (METs) are one of the emerging green bioenergy domains that are utilizing microorganisms for wastewater treatment or electrosynthesis. Real-time monitoring of bioprocess during operation is a prerequisite for understanding and further improving bioenergy harvesting. Optical methods are powerful tools for this, but require transparent, highly conductive and biocompatible electrodes. Whereas indium tin oxide (ITO) is a well-known transparent conductive oxide, it is a non-ideal platform for biofilm growth. Here, a straightforward approach of surface modification of ITO anodes with gold (Au) is demonstrated, to enhance direct microbial biofilm cultivation on their surface and to improve the produced current densities. The trade-off between the electrode transmittance (critical for the underlying integrated sensors) and the enhanced growth of biofilms (crucial for direct monitoring) is studied. Au-modified ITO electrodes show a faster and reproducible biofilm growth with three times higher maximum current densities and about 6.9 times thicker biofilms compared to their unmodified ITO counterparts. The electrochemical analysis confirms the enhanced performance and the reversibility of the ITO/Au electrodes. The catalytic effect of Au on the ITO surface seems to be the key factor of the observed performance improvement since the changes in the electrode conductivity and their surface wettability are relatively small and in the range of ITO. An integrated platform for the ITO/Au transparent electrode with light-emitting diodes was fabricated and its feasibility for optical biofilm thickness monitoring is demonstrated. Such transparent electrodes with embedded catalytic metals can serve as multifunctional windows for biofilm diagnostic microchips. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. An experimental system for spectral line ratio measurements in the TJ-II stellarator.

    PubMed

    Zurro, B; Baciero, A; Fontdecaba, J M; Peláez, R; Jiménez-Rey, D

    2008-10-01

    The chord-integrated emissions of spectral lines have been monitored in the TJ-II stellarator by using a spectral system with time and space scanning capabilities and relative calibration over the entire UV-visible spectral range. This system has been used to study the line ratio of lines of different ionization stages of carbon (C(5+) 5290 A and C(4+) 2271 A) for plasma diagnostic purposes. The local emissivity of these ions has been reconstructed, for quasistationary profiles, by means of the inversion Fisher method described previously. The experimental line ratio is being empirically studied and in parallel a simple spectroscopic model has been developed to account for that ratio. We are investigating whether the role played by charge exchange processes with neutrals and the existence of non-Maxwellian electrons, intrinsic to Electron Cyclotron Resonance Heating (ECRH) heating, leave any distinguishable mark on this diagnostic method.

  4. CNS embryonal tumours: WHO 2016 and beyond.

    PubMed

    Pickles, J C; Hawkins, C; Pietsch, T; Jacques, T S

    2018-02-01

    Embryonal tumours of the central nervous system (CNS) present a significant clinical challenge. Many of these neoplasms affect young children, have a very high mortality and therapeutic strategies are often aggressive with poor long-term outcomes. There is a great need to accurately diagnose embryonal tumours, predict their outcome and adapt therapy to the individual patient's risk. For the first time in 2016, the WHO classification took into account molecular characteristics for the diagnosis of CNS tumours. This integration of histological features with genetic information has significantly changed the diagnostic work-up and reporting of tumours of the CNS. However, this remains challenging in embryonal tumours due to their previously unaccounted tumour heterogeneity. We describe the recent revisions made to the 4th edition of the WHO classification of CNS tumours and review the main changes, while highlighting some of the more common diagnostic testing strategies. © 2017 British Neuropathological Society.

  5. Surveillance at the molecular level: Developing an integrated network for detecting variation in avian influenza viruses in Indonesia.

    PubMed

    Hartaningsih, Nining; Wibawa, Hendra; Pudjiatmoko; Rasa, Fadjar Sumping Tjatur; Irianingsih, Sri Handayani; Dharmawan, Rama; Azhar, Muhammad; Siregar, Elly Sawitri; McGrane, James; Wong, Frank; Selleck, Paul; Allen, John; Broz, Ivano; Torchetti, Mia Kim; Dauphin, Gwenaelle; Claes, Filip; Sastraningrat, Wiryadi; Durr, Peter A

    2015-06-01

    Since 2006, Indonesia has used vaccination as the principal means of control of H5N1-HPAI. During this time, the virus has undergone gradual antigenic drift, which has necessitated changes in seed strains for vaccine production and associated modifications to diagnostic antigens. In order to improve the system of monitoring such viral evolution, the Government of Indonesia, with the assistance of FAO/OFFLU, has developed an innovative network whereby H5N1 isolates are antigenically and genetically characterised. This molecular surveillance network ("Influenza Virus Monitoring" or "IVM") is based on the regional network of veterinary diagnostic laboratories, and is supported by a web-based data management system ("IVM Online"). The example of the Indonesian IVM network has relevance for other countries seeking to establish laboratory networks for the molecular surveillance of avian influenza and other pathogens. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. ICIASF '85 - International Congress on Instrumentation in Aerospace Simulation Facilities, 11th, Stanford University, CA, August 26-28, 1985, Record

    NASA Technical Reports Server (NTRS)

    1985-01-01

    Developments related to laser Doppler velocimetry are discussed, taking into account a three-component dual beam laser-Doppler-anemometer to be operated in large wind tunnels, a new optical system for three-dimensional laser-Doppler-anemometry using an argon-ion and a dye laser, and a two-component laser Doppler velocimeter by switching fringe orientation. Other topics studied are concerned with facilities, instrumentation, control, hot wire/thin film measurements, optical diagnostic techniques, signal and data processing, facilities and adaptive wall test sections, data acquisition and processing, ballistic instrument systems, dynamic testing and material deformation measurements, optical flow measurements, test techniques, force measurement systems, and holography. Attention is given to nonlinear calibration of integral wind tunnel balances, a microcomputer system for real time digitized image compression, and two phase flow diagnostics in propulsion systems.

  7. Far-forward collective scattering measurements by FIR polarimeter-interferometer on J-TEXT tokamak

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

    Shi, P.; Chen, J., E-mail: jiech@hust.edu.cn; Gao, L.

    The multi-channel three-wave polarimeter-interferometer system on J-TEXT tokamak has been exploited to measure far-forward collective scattering from electron density fluctuations. The diagnostic utilizes far infrared lasers operated at 432 μm with 17-channel vertical chords (3 cm chord spacing), covering the entire cross section of plasma. Scattering laser power is measured using a high-sensitivity Schottky planar diode mixer which can also detect polarimetric and interferometric phase simultaneously. The system provides a line-integrated measurement of density fluctuations with maximum measurable wave number: k{sub ⊥max} ≤ 2 cm{sup −1} and time response up to 350 kHz. Feasibility of the diagnostic has been tested,more » showing higher sensitivity to detect fluctuation than interferometric measurement. Capability of providing spatial-resolved information of fluctuation has also been demonstrated in preliminary experimental applications.« less

  8. Degree of vertical integration between the undergraduate program and clinical internship with respect to cervical and cranial diagnostic and therapeutic procedures taught at the canadian memorial chiropractic college.

    PubMed

    Leppington, Charmody; Gleberzon, Brian; Fortunato, Lisa; Doucet, Nicolea; Vandervalk, Kyle

    2012-01-01

    The purpose of this study was to determine if diagnostic and therapeutic procedures for the cervical and cranial spine taught to students during the undergraduate program at Canadian Memorial Chiropractic College are required to be used during their internship by their supervising clinicians and, if so, to what extent these procedures are used. Course manuals and course syllabi from the Applied Chiropractic and Clinical Diagnosis faculty of the undergraduate chiropractic program for the academic year 2009-2010 were consulted and a list of all diagnostic and therapeutic procedures for the cranial and cervical spine was compiled. This survey asked clinicians to indicate if they themselves used or if they required the students they were supervising to use each procedure listed and, if so, to what extent each procedure was used. Demographic information of each clinician was also obtained. In general, most diagnostic procedures of the head and neck were seldom used, with the exception of postural observation and palpation. By contrast, most cervical orthopaedic tests were often used, with the exception of tests for vertigo. Most therapeutic procedures were used frequently with the exception of prone cervical and "muscle" adjustments. There was a low degree of vertical integration for cranial procedures as compared to a much higher degree of vertical integration for cervical procedures between the undergraduate and clinical internship programs taught. Vertical integration is an important element of curricular planning and these results may be helpful to aid educators to more appropriately allocate classroom instruction.

  9. [CONTEMPORARY MOLECULAR-GENETIC METHODS USED FOR ETIOLOGIC DIAGNOSTICS OF SEPSIS].

    PubMed

    Gavrilov, S N; Skachkova, T S; Shipulina, O Yu; Savochkina, Yu A; Shipulin, G A; Maleev, V V

    2016-01-01

    Etiologic diagnostics of sepsis is one of the most difficult problems of contemporary medicine due to a wide variety of sepsis causative agents, many of which are components of normal human microflora. Disadvantages of contemporary "golden standard" of microbiologic diagnostics of sepsis etiology by seeding of blood for sterility are duration of cultivation, limitation in detection of non-cultivable forms of microorganisms, significant effect of preliminary empiric antibiotics therapy on results of the analysis. Methods of molecular diagnostics that are being actively developed and integrated during the last decade are deprived of these disadvantages. Main contemporary methods of molecular-biological diagnostics are examined in the review, actualdata on their diagnostic characteristic are provided. Special attention is given to methods of PCR-diagnostics, including novel Russian developments. Methods of nucleic acid hybridization and proteomic analysis are examined in comparative aspect. Evaluation of application and perspectives of development of methods of molecular diagnostics of sepsis is given.

  10. The electronics system for the LBNL positron emission mammography (PEM) camera

    NASA Astrophysics Data System (ADS)

    Moses, W. W.; Young, J. W.; Baker, K.; Jones, W.; Lenox, M.; Ho, M. H.; Weng, M.

    2001-06-01

    Describes the electronics for a high-performance positron emission mammography (PEM) camera. It is based on the electronics for a human brain positron emission tomography (PET) camera (the Siemens/CTI HRRT), modified to use a detector module that incorporates a photodiode (PD) array. An application-specified integrated circuit (ASIC) services the photodetector (PD) array, amplifying its signal and identifying the crystal of interaction. Another ASIC services the photomultiplier tube (PMT), measuring its output and providing a timing signal. Field-programmable gate arrays (FPGAs) and lookup RAMs are used to apply crystal-by-crystal correction factors and measure the energy deposit and the interaction depth (based on the PD/PMT ratio). Additional FPGAs provide event multiplexing, derandomization, coincidence detection, and real-time rebinning. Embedded PC/104 microprocessors provide communication, real-time control, and configure the system. Extensive use of FPGAs make the overall design extremely flexible, allowing many different functions (or design modifications) to be realized without hardware changes. Incorporation of extensive onboard diagnostics, implemented in the FPGAs, is required by the very high level of integration and density achieved by this system.

  11. A Neural Signature of Divisive Normalization at the Level of Multisensory Integration in Primate Cortex.

    PubMed

    Ohshiro, Tomokazu; Angelaki, Dora E; DeAngelis, Gregory C

    2017-07-19

    Studies of multisensory integration by single neurons have traditionally emphasized empirical principles that describe nonlinear interactions between inputs from two sensory modalities. We previously proposed that many of these empirical principles could be explained by a divisive normalization mechanism operating in brain regions where multisensory integration occurs. This normalization model makes a critical diagnostic prediction: a non-preferred sensory input from one modality, which activates the neuron on its own, should suppress the response to a preferred input from another modality. We tested this prediction by recording from neurons in macaque area MSTd that integrate visual and vestibular cues regarding self-motion. We show that many MSTd neurons exhibit the diagnostic form of cross-modal suppression, whereas unisensory neurons in area MT do not. The normalization model also fits population responses better than a model based on subtractive inhibition. These findings provide strong support for a divisive normalization mechanism in multisensory integration. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Integrating exhaled breath diagnostics by disease-sniffing dogs with instrumental laboratory analysis

    EPA Science Inventory

    Dogs have been studied for many years as a medical diagnostic tool to detect a pre-clinical disease state by sniffing emissions directly from a human or an in vitro biological sample. Some of the studies report high sensitivity and specificity in blinded case-control studies. How...

  13. Enhancing ADHD and LD Diagnostic Accuracy Using Career Instruments

    ERIC Educational Resources Information Center

    Dipeolu, Abiola; Hargrave, Stephanie; Storlie, Cassandra A.

    2015-01-01

    Individuals diagnosed with mental health disorders may have work-related difficulties that impact functioning in all life domains. With limited research on the integration of career and mental health counseling, authors used a discriminant function analysis to assess the predictability of accurately identifying diagnostic categories among 258…

  14. The Validity of Projective Techniques and Their Clinical and Research Contributions

    ERIC Educational Resources Information Center

    Blatt, Sidney J.

    1975-01-01

    Questions about the limitations and potential contributions of projective techniques in research are considered and issues which limit the contributions of diagnostic assessment and projective techniques in clinical practice are examined. A proposal is made for conceptualizing diagnostic assessment as a more integral part of the therapeutic…

  15. Controlled Trial Using Computerized Feedback to Improve Physicians' Diagnostic Judgments.

    ERIC Educational Resources Information Center

    Poses, Roy M.; And Others

    1992-01-01

    A study involving 14 experienced physicians investigated the effectiveness of a computer program (providing statistical feedback to teach a clinical diagnostic rule that predicts the probability of streptococcal pharyngitis), in conjunction with traditional lecture and periodic disease-prevalence reports. Results suggest the integrated method is a…

  16. Improved Diagnostic Accuracy of SPECT Through Statistical Analysis and the Detection of Hot Spots at the Primary Sensorimotor Area for the Diagnosis of Alzheimer Disease in a Community-Based Study: "The Osaki-Tajiri Project".

    PubMed

    Kaneta, Tomohiro; Nakatsuka, Masahiro; Nakamura, Kei; Seki, Takashi; Yamaguchi, Satoshi; Tsuboi, Masahiro; Meguro, Kenichi

    2016-01-01

    SPECT is an important diagnostic tool for dementia. Recently, statistical analysis of SPECT has been commonly used for dementia research. In this study, we evaluated the accuracy of visual SPECT evaluation and/or statistical analysis for the diagnosis (Dx) of Alzheimer disease (AD) and other forms of dementia in our community-based study "The Osaki-Tajiri Project." Eighty-nine consecutive outpatients with dementia were enrolled and underwent brain perfusion SPECT with 99mTc-ECD. Diagnostic accuracy of SPECT was tested using 3 methods: visual inspection (SPECT Dx), automated diagnostic tool using statistical analysis with easy Z-score imaging system (eZIS Dx), and visual inspection plus eZIS (integrated Dx). Integrated Dx showed the highest sensitivity, specificity, and accuracy, whereas eZIS was the second most accurate method. We also observed that a higher than expected rate of SPECT images indicated false-negative cases of AD. Among these, 50% showed hypofrontality and were diagnosed as frontotemporal lobar degeneration. These cases typically showed regional "hot spots" in the primary sensorimotor cortex (ie, a sensorimotor hot spot sign), which we determined were associated with AD rather than frontotemporal lobar degeneration. We concluded that the diagnostic abilities were improved by the integrated use of visual assessment and statistical analysis. In addition, the detection of a sensorimotor hot spot sign was useful to detect AD when hypofrontality is present and improved the ability to properly diagnose AD.

  17. Hybrid diagnostic system: beacon-based exception analysis for multimissions - Livingstone integration

    NASA Technical Reports Server (NTRS)

    Park, Han G.; Cannon, Howard; Bajwa, Anupa; Mackey, Ryan; James, Mark; Maul, William

    2004-01-01

    This paper describes the initial integration of a hybrid reasoning system utilizing a continuous domain feature-based detector, Beacon-based Exceptions Analysis for Multimissions (BEAM), and a discrete domain model-based reasoner, Livingstone.

  18. Vehicle Integrated Propulsion Research for the Study of Health Management Capabilities

    NASA Technical Reports Server (NTRS)

    Lekki, John D.; Simon, Donald L.; Hunter, Gary W.; Woike, Mary; Tokars, Roger P.

    2012-01-01

    Presentation on vehicle integrated propulsion research results and planning. This research emphasizes the testing of advanced health management sensors and diagnostics in an aircraft engine that is operated through multiple baseline and fault conditions.

  19. Polarized near-infrared autofluorescence imaging combined with near-infrared diffuse reflectance imaging for improving colonic cancer detection.

    PubMed

    Shao, Xiaozhuo; Zheng, Wei; Huang, Zhiwei

    2010-11-08

    We evaluate the diagnostic feasibility of the integrated polarized near-infrared (NIR) autofluorescence (AF) and NIR diffuse reflectance (DR) imaging technique developed for colonic cancer detection. A total of 48 paired colonic tissue specimens (normal vs. cancer) were measured using the integrated NIR DR (850-1100 nm) and NIR AF imaging at the 785 nm laser excitation. The results showed that NIR AF intensities of cancer tissues are significantly lower than those of normal tissues (p<0.001, paired 2-sided Student's t-test, n=48). NIR AF imaging under polarization conditions gives a higher diagnostic accuracy (of ~92-94%) compared to non-polarized NIR AF imaging or NIR DR imaging. Further, the ratio imaging of NIR DR to NIR AF with polarization provides the best diagnostic accuracy (of ~96%) among the NIR AF and NIR DR imaging techniques. This work suggests that the integrated NIR AF/DR imaging under polarization condition has the potential to improve the early diagnosis and detection of malignant lesions in the colon.

  20. Engineering integrated digital circuits with allosteric ribozymes for scaling up molecular computation and diagnostics.

    PubMed

    Penchovsky, Robert

    2012-10-19

    Here we describe molecular implementations of integrated digital circuits, including a three-input AND logic gate, a two-input multiplexer, and 1-to-2 decoder using allosteric ribozymes. Furthermore, we demonstrate a multiplexer-decoder circuit. The ribozymes are designed to seek-and-destroy specific RNAs with a certain length by a fully computerized procedure. The algorithm can accurately predict one base substitution that alters the ribozyme's logic function. The ability to sense the length of RNA molecules enables single ribozymes to be used as platforms for multiple interactions. These ribozymes can work as integrated circuits with the functionality of up to five logic gates. The ribozyme design is universal since the allosteric and substrate domains can be altered to sense different RNAs. In addition, the ribozymes can specifically cleave RNA molecules with triplet-repeat expansions observed in genetic disorders such as oculopharyngeal muscular dystrophy. Therefore, the designer ribozymes can be employed for scaling up computing and diagnostic networks in the fields of molecular computing and diagnostics and RNA synthetic biology.

  1. Trauma-induced dissociative amnesia in World War I combat soldiers. II. Treatment dimensions.

    PubMed

    Brown, P; van der Hart, O; Graafland, M

    1999-06-01

    This is the second part of a study of posttraumatic amnesia in World War I (WW I) soldiers. It moves beyond diagnostic validation of posttraumatic amnesia (PTA), to examine treatment findings, and relates these to contemporary treatment of dissociative amnesia, including treatment of victims of civilian trauma (e.g. childhood sexual abuse). Key WW I studies are surveyed which focus on the treatment of PTA and traumatic memories. The dissociation-integration and repression-abreaction models are contrasted. Descriptive evidence is cited in support of preferring Myers' and McDougalls' dissociation-integration treatment approach over Brown's repression-abreaction model. Therapeutic findings in this paper complement diagnostic data from the first report. Although effective treatment includes elements of both the dissociative-integrative and abreactive treatment approaches, cognitive integration of dissociated traumatic memories and personality functions is primary, while emotional release is secondary.

  2. Electrically controlled microvalves to integrate microchip polymerase chain reaction and capillary electrophoresis.

    PubMed

    Kaigala, Govind V; Hoang, Viet N; Backhouse, Christopher J

    2008-07-01

    Microvalves are key in realizing portable miniaturized diagnostic platforms. We present a scalable microvalve that integrates well with standard lab on a chip (LOC) implementations, yet which requires essentially no external infrastructure for its operation. This electrically controlled, phase-change microvalve is used to integrate genetic amplification and analysis via capillary electrophoresis--the basis of many diagnostics. The microvalve is actuated using a polymer (polyethylene glycol, PEG) that exhibits a large volumetric change between its solid and liquid phases. Both the phase change of the PEG and the genetic amplification via polymerase chain reaction (PCR) are thermally controlled using thin film resistive elements that are patterned using standard microfabrication methods. By contrast with many other valve technologies, these microvalves and their control interface scale down in size readily. The novelty here lies in the use of fully integrated microvalves that require only electrical connections to realize a portable and inexpensive genetic analysis platform.

  3. Content-based image retrieval in medical applications for picture archiving and communication systems

    NASA Astrophysics Data System (ADS)

    Lehmann, Thomas M.; Guld, Mark O.; Thies, Christian; Fischer, Benedikt; Keysers, Daniel; Kohnen, Michael; Schubert, Henning; Wein, Berthold B.

    2003-05-01

    Picture archiving and communication systems (PACS) aim to efficiently provide the radiologists with all images in a suitable quality for diagnosis. Modern standards for digital imaging and communication in medicine (DICOM) comprise alphanumerical descriptions of study, patient, and technical parameters. Currently, this is the only information used to select relevant images within PACS. Since textual descriptions insufficiently describe the great variety of details in medical images, content-based image retrieval (CBIR) is expected to have a strong impact when integrated into PACS. However, existing CBIR approaches usually are limited to a distinct modality, organ, or diagnostic study. In this state-of-the-art report, we present first results implementing a general approach to content-based image retrieval in medical applications (IRMA) and discuss its integration into PACS environments. Usually, a PACS consists of a DICOM image server and several DICOM-compliant workstations, which are used by radiologists for reading the images and reporting the findings. Basic IRMA components are the relational database, the scheduler, and the web server, which all may be installed on the DICOM image server, and the IRMA daemons running on distributed machines, e.g., the radiologists" workstations. These workstations can also host the web-based front-ends of IRMA applications. Integrating CBIR and PACS, a special focus is put on (a) location and access transparency for data, methods, and experiments, (b) replication transparency for methods in development, (c) concurrency transparency for job processing and feature extraction, (d) system transparency at method implementation time, and (e) job distribution transparency when issuing a query. Transparent integration will have a certain impact on diagnostic quality supporting both evidence-based medicine and case-based reasoning.

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

    Gilbert, Jack A.; Quinn, Robert A.; Debelius, Justine

    Rapid advances in DNA sequencing, metabolomics, proteomics and computation dramatically increase accessibility of microbiome studies and identify links between the microbiome and disease. Microbial time-series and multiple molecular perspectives enable Microbiome-Wide Association Studies (MWAS), analogous to Genome-Wide Association Studies (GWAS). Rapid research advances point towards actionable results, although approved clinical tests based on MWAS are still in the future. Appreciating the complexity of interactions between diet, chemistry, health and the microbiome, and determining the frequency of observations needed to capture and integrate this dynamic interface, is paramount for addressing the need for personalized and precision microbiome-based diagnostics and therapies.

  5. The Enduring Value of the Physical Examination.

    PubMed

    Zaman, Junaid A B

    2018-05-01

    This article focuses exclusively on physical examination (PE) in the context of clinical medicine, that is, the interaction between a health care provider and patient. In essence, there is not only benefit (value) to PE but also that it will last (endure) for some time. Both "enduring" and "value" are explored in more depth with respect to the future integration of PE into the clinical assessment of a patient and how its value extends well beyond current diagnostic/cost-based metrics. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  6. Xanthos

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

    2017-05-30

    Xanthos is a Python package designed to quantify and analyze global water availability in history and in future at 0.5° × 0.5° spatial resolution and a monthly time step under a changing climate. Its performance was also tested through real applications. It is open-source, extendable and convenient to researchers who work on long-term climate data for studies of global water supply, and Global Change Assessment Model (GCAM). This package integrates inherent global gridded data maps, I/O modules, Water-Balance Model modules and diagnostics modules by user-defined configuration.

  7. A very sensitive ion collection device for plasma-laser characterization.

    PubMed

    Cavallaro, S; Torrisi, L; Cutroneo, M; Amato, A; Sarta, F; Wen, L

    2012-06-01

    In this paper a very sensitive ion collection device, for diagnostic of laser ablated-target plasma, is described. It allows for reducing down to few microvolts the signal threshold at digital scope input. A standard ion collector is coupled to a transimpedance amplifier, specially designed, which increases data acquisition sensitivity by a gain ≈1100 and does not introduce any significant distortion of input signal. By time integration of current intensity, an amount of charge as small as 2.7 × 10(-2) pC can be detected for photopeak events.

  8. Low Power Shoe Integrated Intelligent Wireless Gait Measurement System

    NASA Astrophysics Data System (ADS)

    Wahab, Y.; Mazalan, M.; Bakar, N. A.; Anuar, A. F.; Zainol, M. Z.; Hamzah, F.

    2014-04-01

    Gait analysis measurement is a method to assess and identify gait events and the measurements of dynamic, motion and pressure parameters involving the lowest part of the body. This significant analysis is widely used in sports, rehabilitation as well as other health diagnostic towards improving the quality of life. This paper presents a new system empowered by Inertia Measurement Unit (IMU), ultrasonic sensors, piezoceramic sensors array, XBee wireless modules and Arduino processing unit. This research focuses on the design and development of a low power ultra-portable shoe integrated wireless intelligent gait measurement using MEMS and recent microelectronic devices for foot clearance, orientation, error correction, gait events and pressure measurement system. It is developed to be cheap, low power, wireless, real time and suitable for real life in-door and out-door environment.

  9. Research and technology goals and objectives for Integrated Vehicle Health Management (IVHM)

    NASA Technical Reports Server (NTRS)

    1992-01-01

    Integrated Vehicle Health Management (IVHM) is defined herein as the capability to efficiently perform checkout, testing, and monitoring of space transportation vehicles, subsystems, and components before, during, and after operational This includes the ability to perform timely status determination, diagnostics, and prognostics. IVHM must support fault-tolerant response including system/subsystem reconfiguration to prevent catastrophic failures; and IVHM must support the planning and scheduling of post-operational maintenance. The purpose of this document is to establish the rationale for IVHM and IVHM research and technology planning, and to develop technical goals and objectives. This document is prepared to provide a broad overview of IVHM for technology and advanced development activities and, more specifically, to provide a planning reference from an avionics viewpoint under the OAST Transportation Technology Program Strategic Plan.

  10. When Medicine Meets Engineering—Paradigm Shifts in Diagnostics and Therapeutics

    PubMed Central

    Wang, Hann; Silva, Aleidy; Ho, Chih-Ming

    2013-01-01

    During the last two decades, the manufacturing techniques of microfluidics-based devices have been phenomenally advanced, offering unlimited potential for bio-medical technologies. However, the direct applications of these technologies toward diagnostics and therapeutics are still far from maturity. The present challenges lay at the interfaces between the engineering systems and the biocomplex systems. A precisely designed engineering system with narrow dynamic range is hard to seamlessly integrate with the adaptive biological system in order to achieve the design goals. These differences remain as the roadblock between two fundamentally non-compatible systems. This paper will not extensively review the existing microfluidic sensors and actuators; rather, we will discuss the sources of the gaps for integration. We will also introduce system interface technologies for bridging the differences to lead toward paradigm shifts in diagnostics and therapeutics. PMID:26835672

  11. Evaluation of Chest Ultrasound Integrated Teaching of Respiratory System Physiology to Medical Students

    ERIC Educational Resources Information Center

    Paganini, Matteo; Bondì, Michela; Rubini, Alessandro

    2017-01-01

    Ultrasound imaging is a widely used diagnostic technique, whose integration in medical education is constantly growing. The aim of this study was to evaluate chest ultrasound usefulness in teaching respiratory system physiology, students' perception of chest ultrasound integration into a traditional lecture in human physiology, and short-term…

  12. A COMPACTRIO-BASED BEAM LOSS MONITOR FOR THE SNS RF TEST CAVE

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

    Blokland, Willem; Armstrong, Gary A

    2009-01-01

    An RF Test Cave has been built at the Spallation Neutron Source (SNS) to be able to test RF cavities without interfering the SNS accelerator operations. In addition to using thick concrete wall to minimize radiation exposure, a Beam Loss Monitor (BLM) must abort the operation within 100 usec when the integrated radiation within the cave exceeds a threshold. We choose the CompactRIO platform to implement the BLM based on its performance, cost-effectiveness, and rapid development. Each in/output module is connected through an FPGA to provide point-by-point processing. Every 10 usec the data is acquired analyzed and compared to themore » threshold. Data from the FPGA is transferred using DMA to the real-time controller, which communicates to a gateway PC to talk to the SNS control system. The system includes diagnostics to test the hardware and integrates the losses in real-time. In this paper we describe our design, implementation, and results« less

  13. Automated live cell screening system based on a 24-well-microplate with integrated micro fluidics.

    PubMed

    Lob, V; Geisler, T; Brischwein, M; Uhl, R; Wolf, B

    2007-11-01

    In research, pharmacologic drug-screening and medical diagnostics, the trend towards the utilization of functional assays using living cells is persisting. Research groups working with living cells are confronted with the problem, that common endpoint measurement methods are not able to map dynamic changes. With consideration of time as a further dimension, the dynamic and networked molecular processes of cells in culture can be monitored. These processes can be investigated by measuring several extracellular parameters. This paper describes a high-content system that provides real-time monitoring data of cell parameters (metabolic and morphological alterations), e.g., upon treatment with drug compounds. Accessible are acidification rates, the oxygen consumption and changes in adhesion forces within 24 cell cultures in parallel. Addressing the rising interest in biomedical and pharmacological high-content screening assays, a concept has been developed, which integrates multi-parametric sensor readout, automated imaging and probe handling into a single embedded platform. A life-maintenance system keeps important environmental parameters (gas, humidity, sterility, temperature) constant.

  14. Wearable salivary uric acid mouthguard biosensor with integrated wireless electronics.

    PubMed

    Kim, Jayoung; Imani, Somayeh; de Araujo, William R; Warchall, Julian; Valdés-Ramírez, Gabriela; Paixão, Thiago R L C; Mercier, Patrick P; Wang, Joseph

    2015-12-15

    This article demonstrates an instrumented mouthguard capable of non-invasively monitoring salivary uric acid (SUA) levels. The enzyme (uricase)-modified screen printed electrode system has been integrated onto a mouthguard platform along with anatomically-miniaturized instrumentation electronics featuring a potentiostat, microcontroller, and a Bluetooth Low Energy (BLE) transceiver. Unlike RFID-based biosensing systems, which require large proximal power sources, the developed platform enables real-time wireless transmission of the sensed information to standard smartphones, laptops, and other consumer electronics for on-demand processing, diagnostics, or storage. The mouthguard biosensor system offers high sensitivity, selectivity, and stability towards uric acid detection in human saliva, covering the concentration ranges for both healthy people and hyperuricemia patients. The new wireless mouthguard biosensor system is able to monitor SUA level in real-time and continuous fashion, and can be readily expanded to an array of sensors for different analytes to enable an attractive wearable monitoring system for diverse health and fitness applications. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. Wearable salivary uric acid mouthguard biosensor with integrated wireless electronics

    PubMed Central

    Kim, Jayoung; Imani, Somayeh; de Araujo, William R.; Warchall, Julian; Valdés-Ramírez, Gabriela; Paixão, Thiago R.L.C.; Mercier, Patrick P.; Wang, Joseph

    2016-01-01

    This article demonstrates an instrumented mouthguard capable of non-invasively monitoring salivary uric acid (SUA) levels. The enzyme (uricase)-modified screen printed electrode system has been integrated onto a mouthguard platform along with anatomically-miniaturized instrumentation electronics featuring a potentiostat, microcontroller, and a Bluetooth Low Energy (BLE) transceiver. Unlike RFID-based biosensing systems, which require large proximal power sources, the developed platform enables real-time wireless transmission of the sensed information to standard smartphones, laptops, and other consumer electronics for on-demand processing, diagnostics, or storage. The mouthguard biosensor system offers high sensitivity, selectivity, and stability towards uric acid detection in human saliva, covering the concentration ranges for both healthy people and hyperuricemia patients. The new wireless mouthguard biosensor system is able to monitor SUA level in real-time and continuous fashion, and can be readily expanded to an array of sensors for different analytes to enable an attractive wearable monitoring system for diverse health and fitness applications. PMID:26276541

  16. Advancing point of care diagnostics for the control and prevention of STIs: the way forward.

    PubMed

    Toskin, Igor; Blondeel, Karel; Peeling, Rosanna W; Deal, Carolyn; Kiarie, James

    2017-12-01

    WHO recognises the global impact of sexually transmitted infections (STIs) on global public health and individual sexual and reproductive health and well-being. As a component of the WHO Global Health Sector Strategy for the control and prevention of STIs, there has been a growing recognition of the importance of integrating point-of-care tests (POCTs) into overall strategic planning. The process of integrating STI POCTs, in addition to providing a definitive diagnosis and appropriate treatment in a single visit, also includes innovative delivery options, such as on-site delivery, community-based testing (including screening), as well as self-testing at home after purchase of a test online or over-the-counter. WHO organised two technical consultations in May 2014 and July 2015. This article summarises the discussions of the meeting participants on advancing the use of POCTs to control and prevent STIs. The following priorities were identified: the need for pathogens' target discovery; encouragement of multiplexing, miniaturisation, simplification and connectivity; promotion of standardisation of evaluation of new diagnostic platforms across all stages of the evaluation pipeline; the need for an investment case, modelling and scenarios to ensure buy-in among key stakeholders, including developers and the private sector; the need for norms and standards, including guidelines, to support introduction of STI POCTs in programmes; anticipating potential tensions between different parties at the implementation level; and leveraging on the global initiative, Sustainable Development Goals (SDGs)/global health sector STI strategy, to sustain investment in STI POCT programmes. There is a rich pipeline of diagnostic products, but some have stalled in development. An approach to accelerate the evaluation of new diagnostics is to set up a competent network of evaluation sites ahead of time, harmonise regulatory approval processes with development of models to estimate cost-effectiveness, informed by better STI data. This should result in accelerating policy development. Although it may be some time before good POCTs can be widely implemented in low resource settings, it is important to be a catalyst for continued development and use of these essential tools as an integral part of both the WHO Global Health Sector Strategy and the agenda for 2030. © World Health Organization 2017. Licensee BMJPublishing Group Limited. This is an open access articledistributed under the terms of the Creative CommonsAttribution IGO License (https://creativecommons.org/licenses/by/3.0/igo), which permits use, distribution,and reproduction for non-commercial purposes in anymedium, provided the original work is properly cited. Inany reproduction of this article there should not be anysuggestion that WHO or this article endorse any specificorganization or products. The use of the WHO logo isnot permitted. This notice should be preserved alongwith the article’s original URL.

  17. Demonstration of a time-integrated short line of sight neutron imaging system for inertial confinement fusion

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

    Simpson, R., E-mail: raspberry@lanl.gov; Danly, C.; Fatherley, V. E.

    2015-12-15

    The Neutron Imaging System (NIS) is an important diagnostic for understanding implosions of deuterium-tritium capsules at the National Ignition Facility. While the detectors for the existing system must be positioned 28 m from the source to produce sufficient imaging magnification and resolution, recent testing of a new short line of sight neutron imaging system has shown sufficient resolution to allow reconstruction of the source image with quality similar to that of the existing NIS on a 11.6 m line of sight. The new system used the existing pinhole aperture array and a stack of detectors composed of 2 mm thickmore » high-density polyethylene converter material followed by an image plate. In these detectors, neutrons enter the converter material and interact with protons, which recoil and deposit energy within the thin active layer of the image plate through ionization losses. The described system produces time-integrated images for all neutron energies passing through the pinhole. We present details of the measurement scheme for this novel technique to produce energy-integrated neutron images as well as source reconstruction results from recent experiments at NIF.« less

  18. Programmatic cost evaluation of nontargeted opt-out rapid HIV screening in the emergency department.

    PubMed

    Haukoos, Jason S; Campbell, Jonathan D; Conroy, Amy A; Hopkins, Emily; Bucossi, Meggan M; Sasson, Comilla; Al-Tayyib, Alia A; Thrun, Mark W

    2013-01-01

    The Centers for Disease Control and Prevention recommends nontargeted opt-out HIV screening in healthcare settings. Cost effectiveness is critical when considering potential screening methods. Our goal was to compare programmatic costs of nontargeted opt-out rapid HIV screening with physician-directed diagnostic rapid HIV testing in an urban emergency department (ED) as part of the Denver ED HIV Opt-Out Trial. This was a prospective cohort study nested in a larger quasi-experiment. Over 16 months, nontargeted rapid HIV screening (intervention) and diagnostic rapid HIV testing (control) were alternated in 4-month time blocks. During the intervention phase, patients were offered HIV testing using an opt-out approach during registration; during the control phase, physicians used a diagnostic approach to offer HIV testing to patients. Each method was fully integrated into ED operations. Direct program costs were determined using the perspective of the ED. Time-motion methodology was used to estimate personnel activity costs. Costs per patient newly-diagnosed with HIV infection by intervention phase, and incremental cost effectiveness ratios were calculated. During the intervention phase, 28,043 eligible patients were included, 6,933 (25%) completed testing, and 15 (0.2%, 95% CI: 0.1%-0.4%) were newly-diagnosed with HIV infection. During the control phase, 29,925 eligible patients were included, 243 (0.8%) completed testing, and 4 (1.7%, 95% CI: 0.4%-4.2%) were newly-diagnosed with HIV infection. Total annualized costs for nontargeted screening were $148,997, whereas total annualized costs for diagnostic HIV testing were $31,355. The average costs per HIV diagnosis were $9,932 and $7,839, respectively. Nontargeted HIV screening identified 11 more HIV infections at an incremental cost of $10,693 per additional infection. Compared to diagnostic testing, nontargeted HIV screening was more costly but identified more HIV infections. More effective and less costly testing strategies may be required to improve the identification of patients with undiagnosed HIV infection in the ED.

  19. Modular initiator with integrated optical diagnostic

    DOEpatents

    Alam, M Kathleen [Cedar Crest, NM; Schmitt, Randal L [Tijeras, NM; Welle, Eric J [Niceville, FL; Madden, Sean P [Arlington, MA

    2011-05-17

    A slapper detonator which integrally incorporates an optical wavequide structure for determining whether there has been degradation of the explosive in the explosive device that is to be initiated by the detonator. Embodiments of this invention take advantage of the barrel-like character of a typical slapper detonator design. The barrel assembly, being in direct contact with the energetic material, incorporates an optical diagnostic device into the barrel assembly whereby one can monitor the state of the explosive material. Such monitoring can be beneficial because the chemical degradation of the explosive plays an important in achieving proper functioning of a detonator/initiator device.

  20. A design and implementation methodology for diagnostic systems

    NASA Technical Reports Server (NTRS)

    Williams, Linda J. F.

    1988-01-01

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

  1. Nanomedicine: nanoparticles, molecular biosensors, and targeted gene/drug delivery for combined single-cell diagnostics and therapeutics

    NASA Astrophysics Data System (ADS)

    Prow, Tarl W.; Salazar, Jose H.; Rose, William A.; Smith, Jacob N.; Reece, Lisa; Fontenot, Andrea A.; Wang, Nan A.; Lloyd, R. Stephen; Leary, James F.

    2004-07-01

    Next generation nanomedicine technologies are being developed to provide for continuous and linked molecular diagnostics and therapeutics. Research is being performed to develop "sentinel nanoparticles" which will seek out diseased (e.g. cancerous) cells, enter those living cells, and either perform repairs or induce those cells to die through apoptosis. These nanoparticles are envisioned as multifunctional "smart drug delivery systems". The nanosystems are being developed as multilayered nanoparticles (nanocrystals, nanocapsules) containing cell targeting molecules, intracellular re-targeting molecules, molecular biosensor molecules, and drugs/enzymes/gene therapy. These "nanomedicine systems" are being constructed to be autonomous, much like present-day vaccines, but will have sophisticated targeting, sensing, and feedback control systems-much more sophisticated than conventional antibody-based therapies. The fundamental concept of nanomedicine is to not to just kill all aberrant cells by surgery, radiation therapy, or chemotherapy. Rather it is to fix cells, when appropriate, one cell-at-a-time, to preserve and re-build organ systems. When cells should not be fixed, such as in cases where an improperly repaired cell might give rise to cancer cells, the nanomedical therapy would be to induce apoptosis in those cells to eliminate them without the damagin bystander effects of the inflammatory immune response system reacting to necrotic cells or those which have died from trauma or injury. The ultimate aim of nanomedicine is to combine diagnostics and therapeutics into "real-time medicine", using where possible in-vivo cytometry techniques for diagnostics and therapeutics. A number of individual components of these multi-component nanoparticles are already working in in-vitro and ex-vivo cell and tissue systems. Work has begun on construction of integrated nanomedical systems.

  2. Raman spectroscopy for medical diagnostics--From in-vitro biofluid assays to in-vivo cancer detection.

    PubMed

    Kong, Kenny; Kendall, Catherine; Stone, Nicholas; Notingher, Ioan

    2015-07-15

    Raman spectroscopy is an optical technique based on inelastic scattering of light by vibrating molecules and can provide chemical fingerprints of cells, tissues or biofluids. The high chemical specificity, minimal or lack of sample preparation and the ability to use advanced optical technologies in the visible or near-infrared spectral range (lasers, microscopes, fibre-optics) have recently led to an increase in medical diagnostic applications of Raman spectroscopy. The key hypothesis underpinning this field is that molecular changes in cells, tissues or biofluids, that are either the cause or the effect of diseases, can be detected and quantified by Raman spectroscopy. Furthermore, multivariate calibration and classification models based on Raman spectra can be developed on large "training" datasets and used subsequently on samples from new patients to obtain quantitative and objective diagnosis. Historically, spontaneous Raman spectroscopy has been known as a low signal technique requiring relatively long acquisition times. Nevertheless, new strategies have been developed recently to overcome these issues: non-linear optical effects and metallic nanoparticles can be used to enhance the Raman signals, optimised fibre-optic Raman probes can be used for real-time in-vivo single-point measurements, while multimodal integration with other optical techniques can guide the Raman measurements to increase the acquisition speed and spatial accuracy of diagnosis. These recent efforts have advanced Raman spectroscopy to the point where the diagnostic accuracy and speed are compatible with clinical use. This paper reviews the main Raman spectroscopy techniques used in medical diagnostics and provides an overview of various applications. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

  3. Usefulness and Validity of Continuous Performance Tests in the Diagnosis of Attention-Deficit Hyperactivity Disorder Children.

    PubMed

    Berger, Itai; Slobodin, Ortal; Cassuto, Hanoch

    2017-02-01

    Despite the popularity of continuous performance tests (CPT) in supporting the diagnostic procedure of attention-deficit hyperactivity disorder (ADHD), these measures are still controversial mainly due to limited sensitivity, specificity, and ecological validity. Thus, there continues to be a need for further validation of these objective attention measures. The purpose of this study was to evaluate the usefulness of a CPT that includes environmental distracting stimuli, in supporting the diagnosis of ADHD in children. Participants were 798 children aged 7-12 years (493 boys and 305 girls). The ADHD group included 339 children, whereas the control group included 459 children without ADHD. The study employed the MOXO-CPT, which incorporates visual and auditory stimuli serving as environmental distractors. Compared to their unaffected peers, children with ADHD received significantly lower scores in all 4 CPT indices: attention, timing, hyperactivity, and impulsivity. Specifically, ADHD children were less attended to the stimuli and performed fewer reactions on accurate timing. Furthermore, children with ADHD performed significantly more impulsive and hyperactive responses than controls. Receiver operating characteristic analysis revealed fair to excellent diagnostic ability of all CPT indices except impulsivity, which showed poor ability to distinguish ADHD children from controls. The test's total score yielded excellent diagnostic performance. MOXO-CPT consistently distinguished between children with ADHD and their unaffected peers, so that children with ADHD performed worse than controls in all study indices. Integration of CPT indices improves the diagnostic capacity of ADHD and may better reflect the complexity and heterogeneity of ADHD. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  4. [No exchange of information without technology : modern infrastructure in radiology].

    PubMed

    Hupperts, H; Hermann, K-G A

    2014-01-01

    Modern radiology cannot accomplish the daily numbers of examinations without supportive technology. Even though technology seems to be becoming increasingly more indispensable, business continuity should be ensured at any time and if necessary even with a limited technical infrastructure by business continuity management. An efficient information security management system forms the basis. The early radiology information systems were islands of information processing. A modern radiology department must be able to be modularly integrated into an informational network of a bigger organization. The secondary use of stored data for clinical decision-making support poses new challenges for the integrity of the data or systems because medical knowledge is displayed and provided in a context of treatment. In terms of imaging the creation and distribution radiology services work in a fully digital manner which is often different for radiology reports. Legally secure electronic diagnostic reports require a complex technical infrastructure; therefore, diagnostic findings still need to be filed as a paper document. The internal exchange and an improved dose management can be simplified by systems which continuously and automatically record the doses and thus provide the possibility of permanent analysis and reporting. Communication between patient and radiologist will gain ongoing importance. Intelligent use of technology will convey this to the radiologist and it will facilitate the understanding of the information by the patient.

  5. Non-invasive 13C-glucose breath test using residual gas analyzer-mass spectrometry: a novel tool for screening individuals with pre-diabetes and type 2 diabetes.

    PubMed

    Ghosh, Chiranjit; Maity, Abhijit; Banik, Gourab D; Som, Suman; Chakraborty, Arpita; Selvan, Chitra; Ghosh, Shibendu; Ghosh, Barnali; Chowdhury, Subhankar; Pradhan, Manik

    2014-09-01

    We report, for the first time, the clinical feasibility of a novel residual gas analyzer mass spectrometry (RGA-MS) method for accurate evaluation of the (13)C-glucose breath test ((13)C-GBT) in the diagnosis of pre-diabetes (PD) and type 2 diabetes mellitus (T2D). In T2D or PD, glucose uptake is impaired and results in blunted isotope enriched (13)CO2 production in exhaled breath samples. Using the Receiver operating characteristics (ROC) curve analysis, an optimal diagnostic cut-off point of the (13)CO2/(12)CO2 isotope ratios expressed as the delta-over-baseline (DOB) value, was determined to be δDOB(13)C‰ = 28.81‰ for screening individuals with non-diabetes controls (NDC) and pre-diabetes (PD), corresponding to a sensitivity of 100% and specificity of 94.4%. We also determined another optimal diagnostic cut-off point of δDOB(13)C‰ = 19.88‰ between individuals with PD and T2D, which exhibited 100% sensitivity and 95.5% specificity. Our RGA-MS methodology for the (13)C-GBT also manifested a typical diagnostic positive and negative predictive value of 96% and 100%, respectively. The diagnostic accuracy, precision and validity of the results were also confirmed by high-resolution optical cavity enhanced integrated cavity output spectroscopy (ICOS) measurements. The δDOB(13)C‰ values measured with RGA-MS method, correlated favourably (R(2) = 0.979) with those determined by the laser based ICOS method. Moreover, we observed that the effects of endogenous CO2 production related to basal metabolic rates in individuals were statistically insignificant (p = 0.37 and 0.73) on the diagnostic accuracy. Our findings suggest that the RGA-MS is a valid and sufficiently robust method for the (13)C-GBT which may serve as an alternative non-invasive point-of-care diagnostic tool for routine clinical practices as well as for large-scale diabetes screening purposes in real-time.

  6. Real-Time Processing System for the JET Hard X-Ray and Gamma-Ray Profile Monitor Enhancement

    NASA Astrophysics Data System (ADS)

    Fernandes, Ana M.; Pereira, Rita C.; Neto, André; Valcárcel, Daniel F.; Alves, Diogo; Sousa, Jorge; Carvalho, Bernardo B.; Kiptily, Vasily; Syme, Brian; Blanchard, Patrick; Murari, Andrea; Correia, Carlos M. B. A.; Varandas, Carlos A. F.; Gonçalves, Bruno

    2014-06-01

    The Joint European Torus (JET) is currently undertaking an enhancement program which includes tests of relevant diagnostics with real-time processing capabilities for the International Thermonuclear Experimental Reactor (ITER). Accordingly, a new real-time processing system was developed and installed at JET for the gamma-ray and hard X-ray profile monitor diagnostic. The new system is connected to 19 CsI(Tl) photodiodes in order to obtain the line-integrated profiles of the gamma-ray and hard X-ray emissions. Moreover, it was designed to overcome the former data acquisition (DAQ) limitations while exploiting the required real-time features. The new DAQ hardware, based on the Advanced Telecommunication Computer Architecture (ATCA) standard, includes reconfigurable digitizer modules with embedded field-programmable gate array (FPGA) devices capable of acquiring and simultaneously processing data in real-time from the 19 detectors. A suitable algorithm was developed and implemented in the FPGAs, which are able to deliver the corresponding energy of the acquired pulses. The processed data is sent periodically, during the discharge, through the JET real-time network and stored in the JET scientific databases at the end of the pulse. The interface between the ATCA digitizers, the JET control and data acquisition system (CODAS), and the JET real-time network is provided by the Multithreaded Application Real-Time executor (MARTe). The work developed allowed attaining two of the major milestones required by next fusion devices: the ability to process and simultaneously supply high volume data rates in real-time.

  7. Colloidal core-seeded semiconductor nanorods as fluorescent labels for in-vitro diagnostics (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Chan, YinThai

    2016-03-01

    Colloidal semiconductor nanocrystals are ideal fluorophores for clinical diagnostics, therapeutics, and highly sensitive biochip applications due to their high photostability, size-tunable color of emission and flexible surface chemistry. The relatively recent development of core-seeded semiconductor nanorods showed that the presence of a rod-like shell can confer even more advantageous physicochemical properties than their spherical counterparts, such as large multi-photon absorption cross-sections and facet-specific chemistry that can be exploited to deposit secondary nanoparticles. It may be envisaged that these highly fluorescent nanorods can be integrated with large scale integrated (LSI) microfluidic systems that allow miniaturization and integration of multiple biochemical processes in a single device at the nanoliter scale, resulting in a highly sensitive and automated detection platform. In this talk, I will describe a LSI microfluidic device that integrates RNA extraction, reverse transcription to cDNA, amplification and target pull-down to detect histidine decarboxylase (HDC) gene directly from human white blood cells samples. When anisotropic colloidal semiconductor nanorods (NRs) were used as the fluorescent readout, the detection limit was found to be 0.4 ng of total RNA, which was much lower than that obtained using spherical quantum dots (QDs) or organic dyes. This was attributed to the large action cross-section of NRs and their high probability of target capture in a pull-down detection scheme. The combination of large scale integrated microfluidics with highly fluorescent semiconductor NRs may find widespread utility in point-of-care devices and multi-target diagnostics.

  8. Measures to Improve Diagnostic Safety in Clinical Practice

    PubMed Central

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

    2016-01-01

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

  9. The road map towards providing a robust Raman spectroscopy-based cancer diagnostic platform and integration into clinic

    NASA Astrophysics Data System (ADS)

    Lau, Katherine; Isabelle, Martin; Lloyd, Gavin R.; Old, Oliver; Shepherd, Neil; Bell, Ian M.; Dorney, Jennifer; Lewis, Aaran; Gaifulina, Riana; Rodriguez-Justo, Manuel; Kendall, Catherine; Stone, Nicolas; Thomas, Geraint; Reece, David

    2016-03-01

    Despite the demonstrated potential as an accurate cancer diagnostic tool, Raman spectroscopy (RS) is yet to be adopted by the clinic for histopathology reviews. The Stratified Medicine through Advanced Raman Technologies (SMART) consortium has begun to address some of the hurdles in its adoption for cancer diagnosis. These hurdles include awareness and acceptance of the technology, practicality of integration into the histopathology workflow, data reproducibility and availability of transferrable models. We have formed a consortium, in joint efforts, to develop optimised protocols for tissue sample preparation, data collection and analysis. These protocols will be supported by provision of suitable hardware and software tools to allow statistically sound classification models to be built and transferred for use on different systems. In addition, we are building a validated gastrointestinal (GI) cancers model, which can be trialled as part of the histopathology workflow at hospitals, and a classification tool. At the end of the project, we aim to deliver a robust Raman based diagnostic platform to enable clinical researchers to stage cancer, define tumour margin, build cancer diagnostic models and discover novel disease bio markers.

  10. Optical Diagnostic System for Solar Sails: Phase 1 Final Report

    NASA Technical Reports Server (NTRS)

    Pappa, Richard S.; Blandino, Joseph R.; Caldwell, Douglas W.; Carroll, Joseph A.; Jenkins, Christopher H. M.; Pollock, Thomas C.

    2004-01-01

    NASA's In-Space Propulsion program recently selected AEC-ABLE Engineering and L'Garde, Inc. to develop scale-model solar sail hardware and demonstrate its functionality on the ground. Both are square sail designs with lightweight diagonal booms (<100 g/m) and ultra-thin membranes (<10 g/sq m). To support this technology, the authors are developing an integrated diagnostics instrumentation package for monitoring solar sail structures such as these in a near-term flight experiment. We refer to this activity as the "Optical Diagnostic System (ODS) for Solar Sails" project. The approach uses lightweight optics and photogrammetric techniques to measure solar sail membrane and boom shape and dynamics, thermography to map temperature, and non-optical sensors including MEMS accelerometers and load cells. The diagnostics package must measure key structural characteristics including deployment dynamics, sail support tension, boom and sail deflection, boom and sail natural frequencies, sail temperature, and sail integrity. This report summarizes work in the initial 6-month Phase I period (conceptual design phase) and complements the final presentation given in Huntsville, AL on January 14, 2004.

  11. Periodic Application of Concurrent Error Detection in Processor Array Architectures. PhD. Thesis -

    NASA Technical Reports Server (NTRS)

    Chen, Paul Peichuan

    1993-01-01

    Processor arrays can provide an attractive architecture for some applications. Featuring modularity, regular interconnection and high parallelism, such arrays are well-suited for VLSI/WSI implementations, and applications with high computational requirements, such as real-time signal processing. Preserving the integrity of results can be of paramount importance for certain applications. In these cases, fault tolerance should be used to ensure reliable delivery of a system's service. One aspect of fault tolerance is the detection of errors caused by faults. Concurrent error detection (CED) techniques offer the advantage that transient and intermittent faults may be detected with greater probability than with off-line diagnostic tests. Applying time-redundant CED techniques can reduce hardware redundancy costs. However, most time-redundant CED techniques degrade a system's performance.

  12. MRI-guided stereotactic neurosurgical procedures in a diagnostic MRI suite: Background and safe practice recommendations.

    PubMed

    Larson, Paul S; Willie, Jon T; Vadivelu, Sudhakar; Azmi-Ghadimi, Hooman; Nichols, Amy; Fauerbach, Loretta Litz; Johnson, Helen Boehm; Graham, Denise

    2017-07-01

    The development of navigation technology facilitating MRI-guided stereotactic neurosurgery has enabled neurosurgeons to perform a variety of procedures ranging from deep brain stimulation to laser ablation entirely within an intraoperative or diagnostic MRI suite while having real-time visualization of brain anatomy. Prior to this technology, some of these procedures required multisite workflow patterns that presented significant risk to the patient during transport. For those facilities with access to this technology, safe practice guidelines exist only for procedures performed within an intraoperative MRI. There are currently no safe practice guidelines or parameters available for facilities looking to integrate this technology into practice in conventional MRI suites. Performing neurosurgical procedures in a diagnostic MRI suite does require precautionary measures. The relative novelty of technology and workflows for direct MRI-guided procedures requires consideration of safe practice recommendations, including those pertaining to infection control and magnet safety issues. This article proposes a framework of safe practice recommendations designed for assessing readiness and optimization of MRI-guided neurosurgical interventions in the diagnostic MRI suite in an effort to mitigate patient risk. The framework is based on existing clinical evidence, recommendations, and guidelines related to infection control and prevention, health care-associated infections, and magnet safety, as well as the clinical and practical experience of neurosurgeons utilizing this technology. © 2017 American Society for Healthcare Risk Management of the American Hospital Association.

  13. Soft X-ray tomography in support of impurity control in tokamaks

    NASA Astrophysics Data System (ADS)

    Mlynar, J.; Mazon, D.; Imrisek, M.; Loffelmann, V.; Malard, P.; Odstrcil, T.; Tomes, M.; Vezinet, D.; Weinzettl, V.

    2016-10-01

    This contribution reviews an important example of current developments in diagnostic systems and data analysis tools aimed at improved understanding and control of transport processes in magnetically confined high temperature plasmas. The choice of tungsten for the plasma facing components of ITER and probably also DEMO means that impurity control in fusion plasmas is now a crucial challenge. Soft X-ray (SXR) diagnostic systems serve as a key sensor for experimental studies of plasma impurity transport with a clear prospective of its control via actuators based mainly on plasma heating systems. The SXR diagnostic systems typically feature high temporal resolution but limited spatial resolution due to access restrictions. In order to reconstruct the spatial distribution of the SXR radiation from line integrated measurements, appropriate tomographic methods have been developed and validated, while novel numerical methods relevant for real-time control have been proposed. Furthermore, in order to identify the main contributors to the SXR plasma radiation, at least partial control over the spectral sensitivity range of the detectors would be beneficial, which motivates for developments of novel SXR diagnostic methods. Last, but not least, semiconductor photosensitive elements cannot survive in harsh conditions of future fusion reactors due to radiation damage, which calls for development of radiation hard SXR detectors. Present research in this field is exemplified on recent results from tokamaks COMPASS, TORE SUPRA and the Joint European Torus JET. Further planning is outlined.

  14. Intelligent monitoring of critical pathological events during anesthesia.

    PubMed

    Gohil, Bhupendra; Gholamhhosseini, Hamid; Harrison, Michael J; Lowe, Andrew; Al-Jumaily, Ahmed

    2007-01-01

    Expert algorithms in the field of intelligent patient monitoring have rapidly revolutionized patient care thereby improving patient safety. Patient monitoring during anesthesia requires cautious attention by anesthetists who are monitoring many modalities, diagnosing clinically critical events and performing patient management tasks simultaneously. The mishaps that occur during day-to-day anesthesia causing disastrous errors in anesthesia administration were classified and studied by Reason [1]. Human errors in anesthesia account for 82% of the preventable mishaps [2]. The aim of this paper is to develop a clinically useful diagnostic alarm system for detecting critical events during anesthesia administration. The development of an expert diagnostic alarm system called ;RT-SAAM' for detecting critical pathological events in the operating theatre is presented. This system provides decision support to the anesthetist by presenting the diagnostic results on an integrative, ergonomic display and thus enhancing patient safety. The performance of the system was validated through a series of offline and real-time testing in the operation theatre. When detecting absolute hypovolaemia (AHV), moderate level of agreement was observed between RT-SAAM and the human expert (anesthetist) during surgical procedures. RT-SAAM is a clinically useful diagnostic tool which can be easily modified for diagnosing additional critical pathological events like relative hypovolaemia, fall in cardiac output, sympathetic response and malignant hyperpyrexia during surgical procedures. RT-SAAM is currently being tested at the Auckland City Hospital with ethical approval from the local ethics committees.

  15. Diagnostic value of commercially available shear-wave elastography for breast cancers: integration into BI-RADS classification with subcategories of category 4.

    PubMed

    Youk, Ji Hyun; Gweon, Hye Mi; Son, Eun Ju; Han, Kyung Hwa; Kim, Jeong-Ah

    2013-10-01

    To evaluate the diagnostic performance of shear-wave elastography (SWE) for breast cancer and to determine whether the integration of SWE into BI-RADS with subcategories of category 4 improves the diagnostic performance. A total of 389 breast masses (malignant 120, benign 269) in 324 women who underwent SWE before ultrasound-guided core biopsy or surgery were included. The qualitative SWE feature was assessed using a four-colour overlay pattern. Quantitative elasticity values including the lesion-to-fat elasticity ratio (Eratio) were measured. Diagnostic performance of B-mode ultrasound, SWE, or their combined studies was compared using the area under the ROC curve (AUC). AUC of Eratio (0.952) was the highest among elasticity values (mean, maximum, and minimum elasticity, 0.949, 0.939, and 0.928; P = 0.04) and AUC of colour pattern was 0.947. AUC of combined studies was significantly higher than for a single study (P < 0.0001). When adding SWE to category 4 lesions, lesions were dichotomised according to % of malignancy: 2.1 % vs. 43.2 % (category 4a) and 0 % vs. 100 % (category 4b) for Eratio and 2.4 % vs. 25.8 % (category 4a) for colour pattern (P < 0.05). Shear-wave elastography showed a good diagnostic performance. Adding SWE features to BI-RADS improved the diagnostic performance and may be helpful to stratify category 4 lesions. • Quantitative and qualitative shear-wave elastography provides further diagnostic information during breast ultrasound. • The elasticity ratio (E ratio ) showed the best diagnostic performance in SWE. • E ratio and four-colour overlay pattern significantly differed between benign and malignant lesions. • SWE features allowed further stratification of BI-RADS category 4 lesions.

  16. Reducing Diagnostic Errors through Effective Communication: Harnessing the Power of Information Technology

    PubMed Central

    Naik, Aanand Dinkar; Rao, Raghuram; Petersen, Laura Ann

    2008-01-01

    Diagnostic errors are poorly understood despite being a frequent cause of medical errors. Recent efforts have aimed to advance the "basic science" of diagnostic error prevention by tracing errors to their most basic origins. Although a refined theory of diagnostic error prevention will take years to formulate, we focus on communication breakdown, a major contributor to diagnostic errors and an increasingly recognized preventable factor in medical mishaps. We describe a comprehensive framework that integrates the potential sources of communication breakdowns within the diagnostic process and identifies vulnerable steps in the diagnostic process where various types of communication breakdowns can precipitate error. We then discuss potential information technology-based interventions that may have efficacy in preventing one or more forms of these breakdowns. These possible intervention strategies include using new technologies to enhance communication between health providers and health systems, improve patient involvement, and facilitate management of information in the medical record. PMID:18373151

  17. Embedding CLIPS in a database-oriented diagnostic system

    NASA Technical Reports Server (NTRS)

    Conway, Tim

    1990-01-01

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

  18. Diagnosis of Growth Hormone Deficiency in Childhood

    PubMed Central

    Stanley, Takara

    2012-01-01

    Purpose of Review The diagnosis of growth hormone deficiency (GHD) in childhood is challenging, in large part due to the lack of a true gold standard and the relatively poor performance of available diagnostic testing. This review discusses recent literature on this topic. Recent Findings Auxology and clinical judgment remain the foundation for the diagnosis of GHD. Provocative GH testing is poorly reproducible, dependent on factors such as body composition and pubertal status, and further limited by significant variability among commercially available GH assays. Measurement of IGF-I and IGFBP-3 is not diagnostically useful in isolation but is helpful in combination with other diagnostic measures. Neuroimaging is also useful to inform diagnosis, as pituitary abnormalities suggest a higher likelihood of GHD persisting into adulthood. Although genetic testing is not routinely performed in the diagnosis of GHD at the present time, multiple recent reports raise the possibility that it may play a more important role in diagnosing GHD in the future. Summary Beyond physicians’ integrated assessment of auxology, clinical presentation, and bone age, current tools to diagnose GHD are sub-optimal. Recent literature emphasizes the need to reappraise our current practice and to consider new tools for diagnosis. PMID:22157400

  19. Assimilation of surface NO2 and O3 observations into the SILAM chemistry transport model

    NASA Astrophysics Data System (ADS)

    Vira, J.; Sofiev, M.

    2015-02-01

    This paper describes the assimilation of trace gas observations into the chemistry transport model SILAM (System for Integrated modeLling of Atmospheric coMposition) using the 3D-Var method. Assimilation results for the year 2012 are presented for the prominent photochemical pollutants ozone (O3) and nitrogen dioxide (NO2). Both species are covered by the AirBase observation database, which provides the observational data set used in this study. Attention was paid to the background and observation error covariance matrices, which were obtained primarily by the iterative application of a posteriori diagnostics. The diagnostics were computed separately for 2 months representing summer and winter conditions, and further disaggregated by time of day. This enabled the derivation of background and observation error covariance definitions, which included both seasonal and diurnal variation. The consistency of the obtained covariance matrices was verified using χ2 diagnostics. The analysis scores were computed for a control set of observation stations withheld from assimilation. Compared to a free-running model simulation, the correlation coefficient for daily maximum values was improved from 0.8 to 0.9 for O3 and from 0.53 to 0.63 for NO2.

  20. Riems influenza a typing array (RITA): An RT-qPCR-based low density array for subtyping avian and mammalian influenza a viruses.

    PubMed

    Hoffmann, Bernd; Hoffmann, Donata; Henritzi, Dinah; Beer, Martin; Harder, Timm C

    2016-06-03

    Rapid and sensitive diagnostic approaches are of the utmost importance for the detection of humans and animals infected by specific influenza virus subtype(s). Cascade-like diagnostics starting with the use of pan-influenza assays and subsequent subtyping devices are normally used. Here, we demonstrated a novel low density array combining 32 TaqMan(®) real-time RT-PCR systems in parallel for the specific detection of the haemagglutinin (HA) and neuraminidase (NA) subtypes of avian and porcine hosts. The sensitivity of the newly developed system was compared with that of the pan-influenza assay, and the specificity of all RT-qPCRs was examined using a broad panel of 404 different influenza A virus isolates representing 45 different subtypes. Furthermore, we analysed the performance of the RT-qPCR assays with diagnostic samples obtained from wild birds and swine. Due to the open format of the array, adaptations to detect newly emerging influenza A virus strains can easily be integrated. The RITA array represents a competitive, fast and sensitive subtyping tool that requires neither new machinery nor additional training of staff in a lab where RT-qPCR is already established.

  1. Collaboratively reframing mental health for integration of HIV care in Ethiopia†

    PubMed Central

    Wissow, Lawrence S.; Tegegn, Teketel; Asheber, Kassahun; McNabb, Marion; Weldegebreal, Teklu; Jerene, Degu; Ruff, Andrea

    2015-01-01

    Background Integrating mental health with general medical care can increase access to mental health services, but requires helping generalists acquire a range of unfamiliar knowledge and master potentially complex diagnostic and treatment processes. Method We describe a model for integrating complex specialty care with generalist/primary care, using as an illustration the integration of mental health into hospital-based HIV treatment services in Ethiopia. Generalists and specialists collaboratively developed mental health treatments to fit the knowledge, skills and resources of the generalists. The model recognizes commonalities between mental health and general medical care, focusing on practical interventions acceptable to patients. It was developed through a process of literature review, interviews, observing clinical practice, pilot trainings and expert consultation. Preliminary evaluation results were obtained by debriefing generalist trainees after their return to their clinical sites. Results In planning interviews, generalists reported discomfort making mental health diagnoses but recognition of symptom groups including low mood, anxiety, thought problems, poor child behaviour, seizures and substance use. Diagnostic and treatment algorithms were developed for these groups and tailored to the setting by including possible medical causes and burdens of living with HIV. First-line treatment included modalities familiar to generalists: empathetic patient–provider interactions, psychoeducation, cognitive reframing, referral to community supports and elements of symptom-specific evidence-informed counselling. Training introduced basic skills, with evolving expertise supported by job aides and ongoing support from mental health nurses cross-trained in HIV testing. Feedback from trainees suggested the programme fit well with generalists’ settings and clinical goals. Conclusions An integration model based on collaboratively developing processes that fit the generalist setting shows promise as a method for incorporating complex, multi-faceted interventions into general medical settings. Formal evaluations will be needed to compare the quality of care provided with more traditional approaches and to determine the resources required to sustain quality over time. PMID:25012090

  2. Collaboratively reframing mental health for integration of HIV care in Ethiopia.

    PubMed

    Wissow, Lawrence S; Tegegn, Teketel; Asheber, Kassahun; McNabb, Marion; Weldegebreal, Teklu; Jerene, Degu; Ruff, Andrea

    2015-07-01

    Integrating mental health with general medical care can increase access to mental health services, but requires helping generalists acquire a range of unfamiliar knowledge and master potentially complex diagnostic and treatment processes. We describe a model for integrating complex specialty care with generalist/primary care, using as an illustration the integration of mental health into hospital-based HIV treatment services in Ethiopia. Generalists and specialists collaboratively developed mental health treatments to fit the knowledge, skills and resources of the generalists. The model recognizes commonalities between mental health and general medical care, focusing on practical interventions acceptable to patients. It was developed through a process of literature review, interviews, observing clinical practice, pilot trainings and expert consultation. Preliminary evaluation results were obtained by debriefing generalist trainees after their return to their clinical sites. In planning interviews, generalists reported discomfort making mental health diagnoses but recognition of symptom groups including low mood, anxiety, thought problems, poor child behaviour, seizures and substance use. Diagnostic and treatment algorithms were developed for these groups and tailored to the setting by including possible medical causes and burdens of living with HIV. First-line treatment included modalities familiar to generalists: empathetic patient-provider interactions, psychoeducation, cognitive reframing, referral to community supports and elements of symptom-specific evidence-informed counselling. Training introduced basic skills, with evolving expertise supported by job aides and ongoing support from mental health nurses cross-trained in HIV testing. Feedback from trainees suggested the programme fit well with generalists' settings and clinical goals. An integration model based on collaboratively developing processes that fit the generalist setting shows promise as a method for incorporating complex, multi-faceted interventions into general medical settings. Formal evaluations will be needed to compare the quality of care provided with more traditional approaches and to determine the resources required to sustain quality over time. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

  3. Preventive overhaul time for power transformers

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

    Sarmadi, M.; Rouhi, J.; Fayyaz, A.

    Power transformers are the major piece of equipment in high-voltage substations. A considerable number of these transformers exist in Iran`s integrated network. Due to the climate diversity and improper usage, many of these transformers age rapidly, suffer failure and are taken out of service before half their useful life. At the present time the utility companies have no specific time-frame and plan for preventive overhaul. Detection of preventive overhaul time will increase the remaining life of transformers and improve the reliability of substations. An exact check of the remaining lifetime of transformers is not yet possible by available diagnostic techniques.more » In this paper, the authors present a method of identifying the right time for preventive overhaul in 63 kV power transformers. This method is developed based on 25 year transformer performance records in Northern Iran (subtropical climate) and with the utilization of studies done by electrical engineering communities world-wide.« less

  4. Genetic and Diagnostic Biomarker Development in ASD Toddlers Using Resting State Functional MRI

    DTIC Science & Technology

    2017-11-01

    Integration Theory of intelligence (Jung and Haier, Behave Brain Sci, 2007...predicting a number of age-related phenotypes. Measures of white matter integrity in the brain are heritable and highly sensitive to both normal and...pathological aging processes. We consider the phenotypic and genetic interrelationships between epigenetic age acceleration and white matter integrity

  5. VLSI (Very Large Scale Integrated Circuits) Design with the MacPitts Silicon Compiler.

    DTIC Science & Technology

    1985-09-01

    the background. If the algorithm is not fully debugged, then issue instead macpitts basename herald so MacPitts diagnostics and Liszt diagnostics both...command interpreter. Upon compilation, however, the following LI!F compiler ( Liszt ) diagnostic results, Error: Non-number to minus nil where the first...language used in the MacPitts source code. The more instructive solution is to write the Franz LISP code to decide if a jumper wire is needed, and if so, to

  6. Degree of Vertical Integration Between the Undergraduate Program and Clinical Internship With Respect to Cervical and Cranial Diagnostic and Therapeutic Procedures Taught at the Canadian Memorial Chiropractic College

    PubMed Central

    Leppington, Charmody; Gleberzon, Brian; Fortunato, Lisa; Doucet, Nicolea; Vandervalk, Kyle

    2012-01-01

    Objective: The purpose of this study was to determine if diagnostic and therapeutic procedures for the cervical and cranial spine taught to students during the undergraduate program at Canadian Memorial Chiropractic College are required to be used during their internship by their supervising clinicians and, if so, to what extent these procedures are used. Methods: Course manuals and course syllabi from the Applied Chiropractic and Clinical Diagnosis faculty of the undergraduate chiropractic program for the academic year 2009–2010 were consulted and a list of all diagnostic and therapeutic procedures for the cranial and cervical spine was compiled. This survey asked clinicians to indicate if they themselves used or if they required the students they were supervising to use each procedure listed and, if so, to what extent each procedure was used. Demographic information of each clinician was also obtained. Results: In general, most diagnostic procedures of the head and neck were seldom used, with the exception of postural observation and palpation. By contrast, most cervical orthopaedic tests were often used, with the exception of tests for vertigo. Most therapeutic procedures were used frequently with the exception of prone cervical and “muscle” adjustments. Conclusion: There was a low degree of vertical integration for cranial procedures as compared to a much higher degree of vertical integration for cervical procedures between the undergraduate and clinical internship programs taught. Vertical integration is an important element of curricular planning and these results may be helpful to aid educators to more appropriately allocate classroom instruction PMID:22778531

  7. Deep Learning Role in Early Diagnosis of Prostate Cancer

    PubMed Central

    Reda, Islam; Khalil, Ashraf; Elmogy, Mohammed; Abou El-Fetouh, Ahmed; Shalaby, Ahmed; Abou El-Ghar, Mohamed; Elmaghraby, Adel; Ghazal, Mohammed; El-Baz, Ayman

    2018-01-01

    The objective of this work is to develop a computer-aided diagnostic system for early diagnosis of prostate cancer. The presented system integrates both clinical biomarkers (prostate-specific antigen) and extracted features from diffusion-weighted magnetic resonance imaging collected at multiple b values. The presented system performs 3 major processing steps. First, prostate delineation using a hybrid approach that combines a level-set model with nonnegative matrix factorization. Second, estimation and normalization of diffusion parameters, which are the apparent diffusion coefficients of the delineated prostate volumes at different b values followed by refinement of those apparent diffusion coefficients using a generalized Gaussian Markov random field model. Then, construction of the cumulative distribution functions of the processed apparent diffusion coefficients at multiple b values. In parallel, a K-nearest neighbor classifier is employed to transform the prostate-specific antigen results into diagnostic probabilities. Finally, those prostate-specific antigen–based probabilities are integrated with the initial diagnostic probabilities obtained using stacked nonnegativity constraint sparse autoencoders that employ apparent diffusion coefficient–cumulative distribution functions for better diagnostic accuracy. Experiments conducted on 18 diffusion-weighted magnetic resonance imaging data sets achieved 94.4% diagnosis accuracy (sensitivity = 88.9% and specificity = 100%), which indicate the promising results of the presented computer-aided diagnostic system. PMID:29804518

  8. Bioelectronic Sensors and Devices

    NASA Astrophysics Data System (ADS)

    Reed, Mark

    Nanoscale electronic devices have recently enabled the ability to controllably probe biological systems, from the molecular to the cellular level, opening up new applications and understanding of biological function and response. This talk reviews some of the advances in the field, ranging from diagnostic and therapeutic applications, to cellular manipulation and response, to the emulation of biological response. In diagnostics, integrated nanodevice biosensors compatible with CMOS technology have achieved unprecedented sensitivity, enabling a wide range of label-free biochemical and macromolecule sensing applications down to femtomolar concentrations. These systems have demonstrated integrated assays of biomarkers at clinically important concentrations for both diagnostics and as a quantitative tool for drug design and discovery. Cellular level response can also be observed, including immune response function and dynamics. Finally, the field is beginning to create devices that emulate function, and the demonstration of a solid state artificial ion channel will be discussed.

  9. A wave model of refraction of laser beams with a discrete change in intensity in their cross section and their application for diagnostics of extended nonstationary phase objects

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

    Raskovskaya, I L

    2015-08-31

    A beam model with a discrete change in the cross-sectional intensity is proposed to describe refraction of laser beams formed on the basis of diffractive optical elements. In calculating the wave field of the beams of this class under conditions of strong refraction, in contrast to the traditional asymptotics of geometric optics which assumes a transition to the infinite limits of integration and obtaining an analytical solution, it is proposed to calculate the integral in the vicinity of stationary points. This approach allows the development of a fast algorithm for correct calculation of the wave field of the laser beamsmore » that are employed in probing and diagnostics of extended optically inhomogeneous media. Examples of the algorithm application for diagnostics of extended nonstationary objects in liquid are presented. (laser beams)« less

  10. Biosensors-on-chip: a topical review

    NASA Astrophysics Data System (ADS)

    Chen, Sensen; Shamsi, Mohtashim H.

    2017-08-01

    This review will examine the integration of two fields that are currently at the forefront of science, i.e. biosensors and microfluidics. As a lab-on-a-chip (LOC) technology, microfluidics has been enriched by the integration of various detection tools for analyte detection and quantitation. The application of such microfluidic platforms is greatly increased in the area of biosensors geared towards point-of-care diagnostics. Together, the merger of microfluidics and biosensors has generated miniaturized devices for sample processing and sensitive detection with quantitation. We believe that microfluidic biosensors (biosensors-on-chip) are essential for developing robust and cost effective point-of-care diagnostics. This review is relevant to a variety of disciplines, such as medical science, clinical diagnostics, LOC technologies including MEMs/NEMs, and analytical science. Specifically, this review will appeal to scientists working in the two overlapping fields of biosensors and microfluidics, and will also help new scientists to find their directions in developing point-of-care devices.

  11. Computer modeling and design of diagnostic workstations and radiology reading rooms

    NASA Astrophysics Data System (ADS)

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

    2000-05-01

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

  12. Bayesian tomography and integrated data analysis in fusion diagnostics

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

    Li, Dong, E-mail: lid@swip.ac.cn; Dong, Y. B.; Deng, Wei

    2016-11-15

    In this article, a Bayesian tomography method using non-stationary Gaussian process for a prior has been introduced. The Bayesian formalism allows quantities which bear uncertainty to be expressed in the probabilistic form so that the uncertainty of a final solution can be fully resolved from the confidence interval of a posterior probability. Moreover, a consistency check of that solution can be performed by checking whether the misfits between predicted and measured data are reasonably within an assumed data error. In particular, the accuracy of reconstructions is significantly improved by using the non-stationary Gaussian process that can adapt to the varyingmore » smoothness of emission distribution. The implementation of this method to a soft X-ray diagnostics on HL-2A has been used to explore relevant physics in equilibrium and MHD instability modes. This project is carried out within a large size inference framework, aiming at an integrated analysis of heterogeneous diagnostics.« less

  13. [Guidelines for the diagnosis and treatment of patients with bacteriemia. Guidelines of the Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica].

    PubMed

    Cisneros-Herreros, José Miguel; Cobo-Reinoso, Javier; Pujol-Rojo, Miquel; Rodríguez-Baño, Jesús; Salavert-Lletí, Miguel

    2007-02-01

    Bacteremia is a complex clinical syndrome in constant transformation that is an important, growing cause of morbidity and mortality. Even though there is a great deal of specific information about bacteremia, few comprehensive reviews integrate this information with a practical AIM. The main objective of these Guidelines, which target hospital physicians, is to improve the clinical care provided to patients with bacteremia by integrating blood culture results with clinical data, and optimizing the use of diagnostic procedures and antimicrobial testing. The document is structured into sections that cover the epidemiology and etiology of bacteremia, stratified according to the various patient populations, and the diagnostic work-up, therapy, and follow-up of patients with bacteremia. Diagnostic and therapeutic decisions are presented as recommendations based on the grade of available scientific evidence.

  14. Expert diagnostics system as a part of analysis software for power mission operations

    NASA Technical Reports Server (NTRS)

    Harris, Jennifer A.; Bahrami, Khosrow A.

    1993-01-01

    The operation of interplanetary spacecraft at JPL has become an increasingly complex activity. This complexity is due to advanced spacecraft designs and ambitious mission objectives which lead to operations requirements that are more demanding than those of any previous mission. For this reason, several productivity enhancement measures are underway at JPL within mission operations, particularly in the spacecraft analysis area. These measures aimed at spacecraft analysis include: the development of a multi-mission, multi-subsystem operations environment; the introduction of automated tools into this environment; and the development of an expert diagnostics system. This paper discusses an effort to integrate the above mentioned productivity enhancement measures. A prototype was developed that integrates an expert diagnostics system into a multi-mission, multi-subsystem operations environment using the Galileo Power / Pyro Subsystem as a testbed. This prototype will be discussed in addition to background information associated with it.

  15. Influence of excited state spatial distributions on plasma diagnostics: Atmospheric pressure laser-induced He-H2 plasma

    NASA Astrophysics Data System (ADS)

    Monfared, Shabnam K.; Hüwel, Lutz

    2012-10-01

    Atmospheric pressure plasmas in helium-hydrogen mixtures with H2 molar concentrations ranging from 0.13% to 19.7% were investigated at times from 1 to 25 μs after formation by a Q-switched Nd:YAG laser. Spatially integrated electron density values are obtained using time resolved optical emission spectroscopic techniques. Depending on mixture concentration and delay time, electron densities vary from almost 1017 cm-3 to about 1014 cm-3. Helium based results agree reasonably well with each other, as do values extracted from the Hα and Hβ emission lines. However, in particular for delays up to about 7 μs and in mixtures with less than 1% hydrogen, large discrepancies are observed between results obtained from the two species. Differences decrease with increasing hydrogen partial pressure and/or increasing delay time. In mixtures with molecular hydrogen fraction of 7% or more, all methods yield electron densities that are in good agreement. These findings seemingly contradict the well-established idea that addition of small amounts of hydrogen for diagnostic purposes does not perturb the plasma. Using Abel inversion analysis of the experimental data and a semi-empirical numerical model, we demonstrate that the major part of the detected discrepancies can be traced to differences in the spatial distributions of excited helium and hydrogen neutrals. The model yields spatially resolved emission intensities and electron density profiles that are in qualitative agreement with experiment. For the test case of a 1% H2 mixture at 5 μs delay, our model suggests that high electron temperatures cause an elevated degree of ionization and thus a reduction of excited hydrogen concentration relative to that of helium near the plasma center. As a result, spatially integrated analysis of hydrogen emission lines leads to oversampling of the plasma perimeter and thus to lower electron density values compared to those obtained from helium lines.

  16. Monitoring System for Storm Readiness and Recovery of Test Facilities: Integrated System Health Management (ISHM) Approach

    NASA Technical Reports Server (NTRS)

    Figueroa, Fernando; Morris, Jon; Turowski, Mark; Franzl, Richard; Walker, Mark; Kapadia, Ravi; Venkatesh, Meera; Schmalzel, John

    2010-01-01

    Severe weather events are likely occurrences on the Mississippi Gulf Coast. It is important to rapidly diagnose and mitigate the effects of storms on Stennis Space Center's rocket engine test complex to avoid delays to critical test article programs, reduce costs, and maintain safety. An Integrated Systems Health Management (ISHM) approach and technologies are employed to integrate environmental (weather) monitoring, structural modeling, and the suite of available facility instrumentation to provide information for readiness before storms, rapid initial damage assessment to guide mitigation planning, and then support on-going assurance as repairs are effected and finally support recertification. The system is denominated Katrina Storm Monitoring System (KStorMS). Integrated Systems Health Management (ISHM) describes a comprehensive set of capabilities that provide insight into the behavior the health of a system. Knowing the status of a system allows decision makers to effectively plan and execute their mission. For example, early insight into component degradation and impending failures provides more time to develop work around strategies and more effectively plan for maintenance. Failures of system elements generally occur over time. Information extracted from sensor data, combined with system-wide knowledge bases and methods for information extraction and fusion, inference, and decision making, can be used to detect incipient failures. If failures do occur, it is critical to detect and isolate them, and suggest an appropriate course of action. ISHM enables determining the condition (health) of every element in a complex system-of-systems or SoS (detect anomalies, diagnose causes, predict future anomalies), and provide data, information, and knowledge (DIaK) to control systems for safe and effective operation. ISHM capability is achieved by using a wide range of technologies that enable anomaly detection, diagnostics, prognostics, and advise for control: (1) anomaly detection algorithms and strategies, (2) fusion of DIaK for anomaly detection (model-based, numerical, statistical, empirical, expert-based, qualitative, etc.), (3) diagnostics/prognostics strategies and methods, (4) user interface, (5) advanced control strategies, (6) integration architectures/frameworks, (7) embedding of intelligence. Many of these technologies are mature, and they are being used in the KStorMS. The paper will describe the design, implementation, and operation of the KStorMS; and discuss further evolution to support other needs such as condition-based maintenance (CBM).

  17. Novel immunoassay formats for integrated microfluidic circuits: diffusion immunoassays (DIA)

    NASA Astrophysics Data System (ADS)

    Weigl, Bernhard H.; Hatch, Anson; Kamholz, Andrew E.; Yager, Paul

    2000-03-01

    Novel designs of integrated fluidic microchips allow separations, chemical reactions, and calibration-free analytical measurements to be performed directly in very small quantities of complex samples such as whole blood and contaminated environmental samples. This technology lends itself to applications such as clinical diagnostics, including tumor marker screening, and environmental sensing in remote locations. Lab-on-a-Chip based systems offer many *advantages over traditional analytical devices: They consume extremely low volumes of both samples and reagents. Each chip is inexpensive and small. The sampling-to-result time is extremely short. They perform all analytical functions, including sampling, sample pretreatment, separation, dilution, and mixing steps, chemical reactions, and detection in an integrated microfluidic circuit. Lab-on-a-Chip systems enable the design of small, portable, rugged, low-cost, easy to use, yet extremely versatile and capable diagnostic instruments. In addition, fluids flowing in microchannels exhibit unique characteristics ('microfluidics'), which allow the design of analytical devices and assay formats that would not function on a macroscale. Existing Lab-on-a-chip technologies work very well for highly predictable and homogeneous samples common in genetic testing and drug discovery processes. One of the biggest challenges for current Labs-on-a-chip, however, is to perform analysis in the presence of the complexity and heterogeneity of actual samples such as whole blood or contaminated environmental samples. Micronics has developed a variety of Lab-on-a-Chip assays that can overcome those shortcomings. We will now present various types of novel Lab- on-a-Chip-based immunoassays, including the so-called Diffusion Immunoassays (DIA) that are based on the competitive laminar diffusion of analyte molecules and tracer molecules into a region of the chip containing antibodies that target the analyte molecules. Advantages of this technique are a reduction in reagents, higher sensitivity, minimal preparation of complex samples such as blood, real-time calibration, and extremely rapid analysis.

  18. The identification of unfolding facial expressions.

    PubMed

    Fiorentini, Chiara; Schmidt, Susanna; Viviani, Paolo

    2012-01-01

    We asked whether the identification of emotional facial expressions (FEs) involves the simultaneous perception of the facial configuration or the detection of emotion-specific diagnostic cues. We recorded at high speed (500 frames s-1) the unfolding of the FE in five actors, each expressing six emotions (anger, surprise, happiness, disgust, fear, sadness). Recordings were coded every 10 frames (20 ms of real time) with the Facial Action Coding System (FACS, Ekman et al 2002, Salt Lake City, UT: Research Nexus eBook) to identify the facial actions contributing to each expression, and their intensity changes over time. Recordings were shown in slow motion (1/20 of recording speed) to one hundred observers in a forced-choice identification task. Participants were asked to identify the emotion during the presentation as soon as they felt confident to do so. Responses were recorded along with the associated response times (RTs). The RT probability density functions for both correct and incorrect responses were correlated with the facial activity during the presentation. There were systematic correlations between facial activities, response probabilities, and RT peaks, and significant differences in RT distributions for correct and incorrect answers. The results show that a reliable response is possible long before the full FE configuration is reached. This suggests that identification is reached by integrating in time individual diagnostic facial actions, and does not require perceiving the full apex configuration.

  19. Small business development for molecular diagnostics.

    PubMed

    Anagostou, Anthanasia; Liotta, Lance A

    2012-01-01

    Molecular profiling, which is the application of molecular diagnostics technology to tissue and blood -specimens, is an integral element in the new era of molecular medicine and individualized therapy. Molecular diagnostics is a fertile ground for small business development because it can generate products that meet immediate demands in the health-care sector: (a) Detection of disease risk, or early-stage disease, with a higher specificity and sensitivity compared to previous testing methods, and (b) "Companion diagnostics" for stratifying patients to receive a treatment choice optimized to their individual disease. This chapter reviews the promise and challenges of business development in this field. Guidelines are provided for the creation of a business model and the generation of a marketing plan around a candidate molecular diagnostic product. Steps to commercialization are outlined using existing molecular diagnostics companies as learning examples.

  20. Incorporating DNA Sequencing into Current Prenatal Screening Practice for Down's Syndrome

    PubMed Central

    Wald, Nicholas J.; Bestwick, Jonathan P.

    2013-01-01

    Background Prenatal screening for Down's syndrome is performed using biochemical and ultrasound markers measured in early pregnancy such as the Integrated test using first and second trimester markers. Recently, DNA sequencing methods have been introduced on free DNA in maternal plasma, yielding a high screening performance. These methods are expensive and there is a test failure rate. We determined the screening performance of merging the Integrated test with the newer DNA techniques in a protocol that substantially reduces the cost compared with universal DNA testing and still achieves high screening performance with no test failures. Methods Published data were used to model screening performance of a protocol in which all women receive the first stage of the Integrated test at about 11 weeks of pregnancy. On the basis of this higher risk women have reflex DNA testing and lower risk women as well as those with a failed DNA test complete the Integrated test at about 15 weeks. Results The overall detection rate was 95% with a 0.1% false-positive rate if 20% of women were selected to receive DNA testing. If all women had DNA testing the detection rate would be 3 to 4 percentage points higher with a false-positive rate 30 times greater if women with failed tests were treated as positive and offered a diagnostic amniocentesis, or 3 times greater if they had a second trimester screening test (Quadruple test) and treated as positive only if this were positive. The cost per women screened would be about one-fifth, compared with universal DNA testing, if the DNA test were 20 times the cost of the Integrated test. Conclusion The proposed screening protocol achieves a high screening performance without programme test failures and at a substantially lower cost than offering all women DNA testing. PMID:23527014

  1. New portable instrument for combined reflectance, time-resolved and steady-state luminescence measurements on works of art

    NASA Astrophysics Data System (ADS)

    Romani, Aldo; Grazia, Chiara; Anselmi, Chiara; Miliani, Costanza; Brunetti, Brunetto Giovanni

    2011-06-01

    In this paper a new compact and portable instrument for combined reflectance, time-resolved and steady-state fluorescence is presented. All the optical parts of the apparatus, carefully described in the text, were chosen after an extensive market survey in order to obtain the best performances coupled with the smallest dimensions. This instrument through the use of a dedicated multiple fiber optic probe, allows the complete photophysical behaviors of investigated materials to be collected from the same point of the analyzed surface. In this way, the resultant instrumental setup is a portable device, usable in situ for non destructive and non invasive diagnostic purposes in the field of cultural heritage. Preliminary results concerning organic dyes characterization, which is the main application of luminescence-based diagnostic techniques in artworks, are presented and compared with those previously obtained using separate devices. Concerning reflectance data, improvements in the deep detectable UV spectral range have been achieved switching from the integrating sphere of the old instrument to bifurcated optical fibers used as probe in the new one. Special attention was devoted to test the instrument capability in order to obtain the true emission spectrum, corrected for the selfabsorption effect, for which good results were found. This particular experimental procedure is strongly recommended, by a diagnostic point of view, to avoid distortions in the instrumental responses, namely the spectral shape and emission maximum wavelength of a fluorophore as function of the color saturation.

  2. Integrated multi-sensor package (IMSP) for unmanned vehicle operations

    NASA Astrophysics Data System (ADS)

    Crow, Eddie C.; Reichard, Karl; Rogan, Chris; Callen, Jeff; Seifert, Elwood

    2007-10-01

    This paper describes recent efforts to develop integrated multi-sensor payloads for small robotic platforms for improved operator situational awareness and ultimately for greater robot autonomy. The focus is on enhancements to perception through integration of electro-optic, acoustic, and other sensors for navigation and inspection. The goals are to provide easier control and operation of the robot through fusion of multiple sensor outputs, to improve interoperability of the sensor payload package across multiple platforms through the use of open standards and architectures, and to reduce integration costs by embedded sensor data processing and fusion within the sensor payload package. The solutions investigated in this project to be discussed include: improved capture, processing and display of sensor data from multiple, non-commensurate sensors; an extensible architecture to support plug and play of integrated sensor packages; built-in health, power and system status monitoring using embedded diagnostics/prognostics; sensor payload integration into standard product forms for optimized size, weight and power; and the use of the open Joint Architecture for Unmanned Systems (JAUS)/ Society of Automotive Engineers (SAE) AS-4 interoperability standard. This project is in its first of three years. This paper will discuss the applicability of each of the solutions in terms of its projected impact to reducing operational time for the robot and teleoperator.

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

    PubMed

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

    2016-01-01

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

  4. Meeting the Challenges of Exploration Systems: Health Management Technologies for Aerospace Systems With Emphasis on Propulsion

    NASA Technical Reports Server (NTRS)

    Melcher, Kevin J.; Sowers, T. Shane; Maul, William A.

    2005-01-01

    The constraints of future Exploration Missions will require unique Integrated System Health Management (ISHM) capabilities throughout the mission. An ambitious launch schedule, human-rating requirements, long quiescent periods, limited human access for repair or replacement, and long communication delays all require an ISHM system that can span distinct yet interdependent vehicle subsystems, anticipate failure states, provide autonomous remediation, and support the Exploration Mission from beginning to end. NASA Glenn Research Center has developed and applied health management system technologies to aerospace propulsion systems for almost two decades. Lessons learned from past activities help define the approach to proper ISHM development: sensor selection- identifies sensor sets required for accurate health assessment; data qualification and validation-ensures the integrity of measurement data from sensor to data system; fault detection and isolation-uses measurements in a component/subsystem context to detect faults and identify their point of origin; information fusion and diagnostic decision criteria-aligns data from similar and disparate sources in time and use that data to perform higher-level system diagnosis; and verification and validation-uses data, real or simulated, to provide variable exposure to the diagnostic system for faults that may only manifest themselves in actual implementation, as well as faults that are detectable via hardware testing. This presentation describes a framework for developing health management systems and highlights the health management research activities performed by the Controls and Dynamics Branch at the NASA Glenn Research Center. It illustrates how those activities contribute to the development of solutions for Integrated System Health Management.

  5. Sustainable dengue prevention and control through a comprehensive integrated approach: the Sri Lankan perspective.

    PubMed

    Tissera, Hasitha; Pannila-Hetti, Nimalka; Samaraweera, Preshila; Weeraman, Jayantha; Palihawadana, Paba; Amarasinghe, Ananda

    2016-09-01

    Dengue is a leading public health problem in Sri Lanka. All 26 districts and all age groups are affected, with high disease transmission; the estimated average annual incidence is 175/100 000 population. Harnessing the World Health Organization Global strategy for dengue prevention and control, 2012-2020, Sri Lanka has pledged in its National Strategic Framework to achieve a mortality from dengue below 0.1% and to reduce morbidity by 50% (from the average of the last 5 years) by 2020. Turning points in the country's dengue-control programme have been the restructuring and restrategizing of the core functions; this has involved establishment of a separate dengue-control unit to coordinate integrated vector management, and creation of a presidential task force. There has been great progress in disease surveillance, clinical management and vector control. Enhanced real-time surveillance for early warning allows ample preparedness for an outbreak. National guidelines with enhanced diagnostics have significantly improved clinical management of dengue, reducing the case-fatality rate to 0.2%. Proactive integrated vector management, with multisector partnership, has created a positive vector-control environment; however, sustaining this momentum is a challenge. Robust surveillance, evidence-based clinical management, sustainable vector control and effective communication are key strategies that will be implemented to achieve set targets. Improved early detection and a standardized treatment protocol with enhanced diagnostics at all medical care institutions will lead to further reduction in mortality. Making the maximum effort to minimize outbreaks through sustainable vector control in the three dimensions of risk mapping, innovation and risk modification will enable a reduction in morbidity.

  6. EDITORIAL: Integrated non-invasive sensing techniques and geophysical methods for the study and conservation of architectural, archaeological and artistic heritage Integrated non-invasive sensing techniques and geophysical methods for the study and conservation of architectural, archaeological and artistic heritage

    NASA Astrophysics Data System (ADS)

    Masini, N.; Soldovieri, F.

    2011-09-01

    In the last two decades, the use of non-invasive methods for the study and conservation of cultural heritage, from artefacts and historical sites to recent architectural structures, has gained increasing interest. This is due to several reasons: (i) the improvement of performance and information resolution of sensors and devices; (ii) the increasing availability of user-friendly data/image analysis, and processing software and routines; (iii) the ever greater awareness of archaeologists and conservators of the benefits of these technologies, in terms of reduction of costs, time and the risk associated with direct and destructive investigations of archaeological sites (excavation) and monuments (i.e. masonry coring). The choice of diagnostic strategy depends on the spatial and physical characteristics of the cultural objects or sites, the aim of the investigation (knowledge, conservation, restoration) and the issues to be addressed (monitoring, decay assessment, etc). This makes the set up and validation of ad hoc procedures based on data processing and post-processing methods necessary, generally developed to address issues in other fields of application. This methodological perspective based on an integrated and multi-scale approach characterizes the papers of this special issue, which is focused on integrated non-invasive sensing techniques and geophysical methods for the study and conservation of architectural, archaeological and artistic heritage. In particular, attention is given to the advanced application of the synthetic aperture radar (SAR) from the satellite-based platform for deformation monitoring thanks to the innovative differential SAR interferometry (DInSAR) technique; Zeni et al show the significant possibilities of the proposed methodology in achieving a global vision not only of cultural heritage but also of the embedding territory. This collection also deals with the application of non-invasive diagnostics to archaeological prospecting, and cultural heritage monitoring and diagnostics. The paper by Conyers et al gives a very good review of the limitations and advantages of ground penetrating radar (GPR) in archaeological prospecting, where the focus is on aspects of data processing and image visualization. Kadioglu et al describe a case that exploits GPR to define buried archaeological remains at the Zeynel Bey Tomb in the ancient city of Hasankeyf, Turkey. In particular, attention is given to a new three-dimensional visualization of the scene which provides a clearer representation compared to the usual constant depth slices. The paper by Bavusi et al is concerned with the use of GPR as a tool to monitor an important recent architectural masterpiece and critical piece of infrastructure, the Musmeci bridge in Potenza; in particular, the complexity of this civil engineering structure is tackled by adopting advanced data processing tools such as microwave tomography. A microwave tomographic approach is also exploited for GPR data processing in cultural heritage diagnostics by Brancaccio et al, where their survey is concerned with the masonry diagnostics at St Carmine's Church, one of the more ancient and important monuments of Naples. This special issue also gives a good overview of state-of-the-art methodologies and appealing cases of data integration and correlation. Nordebo et al present a new and advanced approach to information fusion, used here to combine ERT data from different orientations. The approach is general, suitable for sensor integration, and opens up a new route to data fusion for diagnostics and monitoring. Some very interesting cases of data integration in archaeological prospecting and cultural heritage monitoring are also presented. Loperte et al present an interesting case of an integrated geophysical approach based on magnetic, GPR and geoelectric techniques used to investigate the Greek and Roman settlement of Paestum in southern Italy; their aim is to undertake preventive archaeological research on an area of the ancient settlement affected by new construction. Another interesting case of on-field integration of GPR and seismic techniques is presented by Leucci et al; their aim is to characterize the deterioration status of the pillars of the cathedral of Tricarico, in the Basilicata region of southern Italy, where the diagnostics have provided crucial information that is helping to drive the restoration work. Another example of sensor integration is presented by Carlomagno et al, which is focused on the joint exploitation of infrared thermography and GPR for inspection of architectonic structures. Two important studies are presented: the first aims to evaluate the conservation of frescoes as well as the state of the underground masonry structure at Pompei (Naples); the second aims to evaluate the state of degradation of remnants of a theatre at a site in Nora (Cagliari). The integration of different diagnostic techniques is shown to be important also for movable pieces such as the sculpture of the Pharaoh with the god Amun, one of the most important pieces in the 'Museo delle Antichitá Egizie' of Turin. In particular, Sambuelli et al demonstrate the joint use of GPR ultrasonic 2D tomographies to assess the integrity of the base of the statue. Capizzi et al propose the integration of a pacometer, high frequency GPR and ultrasonic techniques to investigate the internal extension of all the visible fractures (and to search for hidden ones) of a marble slab (second to third century AD) from the archaeological museum of Rome, which was damaged in transit for an exhibition. Finally, this special issue also presents cases of surface and material characterization, which is a field of increasing interest in monumental heritage monitoring. Camaiti et al present a survey that uses a portable hyperspectral device to characterize the alteration affecting the marble facade of the Santa Maria Novella church (13th century) in Florence. Their analysis shows how hyperspectral instruments may be considered a powerful tool for characterizing historical surfaces in a non-destructive and non-invasive way. Fort et al describe an advanced petrophysical analysis of several types of natural stone used in Spain that can be used to determine their anisotropy, which is one of the key factors affecting the quality and resistance to decay caused by a variety of different agents, such as water.

  7. Characterization of a low-level unknown isomeric degradation product using an integrated online-offline top-down tandem mass spectrometry platform.

    PubMed

    Yu, Xiang; Warme, Christopher; Lee, Dinah; Zhang, Jing; Zhong, Wendy

    2013-10-01

    An integrated online-offline platform was developed combining automated online LC-MS fraction collection, continuous accumulation of selected ions (CASI), and offline top-down electron capture dissociation (ECD) tandem mass spectrometry experiments to identify a low-level, unknown isomeric degradant in a formulated drug product during an accelerated stability study. By identifying the diagnostic ions of the isoaspartic acid (isoAsp), the top-down ECD experiment showed that the Asp9 in exenatide was converted to isoAsp9 to form the unknown isomeric degradant. The platform described here provides an accurate, straightforward, and low limit of detection method for the analysis of Asp isomerization as well as other potential low-level degradants in therapeutic polypeptides and proteins. It is especially useful for unstable and time-sensitive degradants and impurities.

  8. Integrated failure detection and management for the Space Station Freedom external active thermal control system

    NASA Technical Reports Server (NTRS)

    Mesloh, Nick; Hill, Tim; Kosyk, Kathy

    1993-01-01

    This paper presents the integrated approach toward failure detection, isolation, and recovery/reconfiguration to be used for the Space Station Freedom External Active Thermal Control System (EATCS). The on-board and on-ground diagnostic capabilities of the EATCS are discussed. Time and safety critical features, as well as noncritical failures, and the detection coverage for each provided by existing capabilities are reviewed. The allocation of responsibility between on-board software and ground-based systems, to be shown during ground testing at the Johnson Space Center, is described. Failure isolation capabilities allocated to the ground include some functionality originally found on orbit but moved to the ground to reduce on-board resource requirements. Complex failures requiring the analysis of multiple external variables, such as environmental conditions, heat loads, or station attitude, are also allocated to ground personnel.

  9. 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…

  10. A comparison of the boomerang wire vascular access management system versus manual compression alone during percutaneous diagnostic and interventional cardiovascular procedures.

    PubMed

    Echeverria, Angela; Krajcer, Zvonimir

    2016-01-01

    Vascular closure devices allow for early sheath removal, allowing for earlier patient mobilization The Boomerang vascular access management system does not alter arterial integrity for future interventions Access site complications provide significant morbidity in diagnostic and therapeutic interventions. © 2016 Wiley Periodicals, Inc.

  11. Image processing and machine learning for fully automated probabilistic evaluation of medical images.

    PubMed

    Sajn, Luka; Kukar, Matjaž

    2011-12-01

    The paper presents results of our long-term study on using image processing and data mining methods in a medical imaging. Since evaluation of modern medical images is becoming increasingly complex, advanced analytical and decision support tools are involved in integration of partial diagnostic results. Such partial results, frequently obtained from tests with substantial imperfections, are integrated into ultimate diagnostic conclusion about the probability of disease for a given patient. We study various topics such as improving the predictive power of clinical tests by utilizing pre-test and post-test probabilities, texture representation, multi-resolution feature extraction, feature construction and data mining algorithms that significantly outperform medical practice. Our long-term study reveals three significant milestones. The first improvement was achieved by significantly increasing post-test diagnostic probabilities with respect to expert physicians. The second, even more significant improvement utilizes multi-resolution image parametrization. Machine learning methods in conjunction with the feature subset selection on these parameters significantly improve diagnostic performance. However, further feature construction with the principle component analysis on these features elevates results to an even higher accuracy level that represents the third milestone. With the proposed approach clinical results are significantly improved throughout the study. The most significant result of our study is improvement in the diagnostic power of the whole diagnostic process. Our compound approach aids, but does not replace, the physician's judgment and may assist in decisions on cost effectiveness of tests. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  12. Integral electrical characteristics and local plasma parameters of a RF ion thruster

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

    Masherov, P. E.; Riaby, V. A., E-mail: riaby2001@yahoo.com; Godyak, V. A.

    2016-02-15

    Comprehensive diagnostics has been carried out for a RF ion thruster based on inductively coupled plasma (ICP) source with an external flat antenna coil enhanced by ferrite core. The ICP was confined within a cylindrical chamber with low aspect ratio to minimize plasma loss to the chamber wall. Integral diagnostics of the ICP electrical parameters (RF power balance and coil current) allowed for evaluation of the antenna coils, matching networks, and eddy current loss and the true RF power deposited to plasma. Spatially resolved electron energy distribution functions, plasma density, electron temperatures, and plasma potentials were measured with movable Langmuirmore » probes.« less

  13. Developing a semantic web model for medical differential diagnosis recommendation.

    PubMed

    Mohammed, Osama; Benlamri, Rachid

    2014-10-01

    In this paper we describe a novel model for differential diagnosis designed to make recommendations by utilizing semantic web technologies. The model is a response to a number of requirements, ranging from incorporating essential clinical diagnostic semantics to the integration of data mining for the process of identifying candidate diseases that best explain a set of clinical features. We introduce two major components, which we find essential to the construction of an integral differential diagnosis recommendation model: the evidence-based recommender component and the proximity-based recommender component. Both approaches are driven by disease diagnosis ontologies designed specifically to enable the process of generating diagnostic recommendations. These ontologies are the disease symptom ontology and the patient ontology. The evidence-based diagnosis process develops dynamic rules based on standardized clinical pathways. The proximity-based component employs data mining to provide clinicians with diagnosis predictions, as well as generates new diagnosis rules from provided training datasets. This article describes the integration between these two components along with the developed diagnosis ontologies to form a novel medical differential diagnosis recommendation model. This article also provides test cases from the implementation of the overall model, which shows quite promising diagnostic recommendation results.

  14. Improving the existing diagnostic strategy by accounting for characteristics of the women in the diagnostic work up for postmenopausal bleeding.

    PubMed

    Opmeer, B C; van Doorn, H C; Heintz, A P M; Burger, C W; Bossuyt, P M M; Mol, B W J

    2007-01-01

    The aim of this study was to evaluate whether the efficiency of the current diagnostic work up following postmenopausal bleeding could be improved by diagnostic strategies that take into account characteristics of the women in addition to the currently recommended transvaginal measurement of endometrial thickness to determine for subsequent histological assessment. Multicenter, prospective cohort study. A university hospital and seven teaching hospitals in the Netherlands. Consecutive women not using hormone replacement therapy, presenting with postmenopausal bleeding. Five hundred and forty women underwent transvaginal sonography, and in case of endometrial thickness (double layer) above 4 mm, subsequent endometrial sampling was performed. Presence of carcinoma was ruled out by the absence of abnormalities in histological specimen or by an uneventful follow up of at least 6 months. Probability of endometrial carcinoma was estimated by multivariable logistic regression models. For each diagnostic strategy, we calculated diagnostic accuracy (area under receiver operating characteristic curve [AUC]), negative predictive value (NPV) and the number of diagnostic procedures. A strategy with transvaginal sonography alone with a fixed threshold incorrectly classified 0.7% of the women as nonmalignant (NPV: 99.3% [98.5-100%]), with 97% sensitivity and 56% specificity. A strategy integrating characteristics of the women with transvaginal sonography could result in less false reassurances (NPV: 99.6% [99.2-100%]), with only marginal decrease in diagnostic procedures, or a minor increase in false reassurances (NPV: 99.0% [98.3-100%]), with a substantial reduction (15-20%) in the procedures. AUCs associated with these strategies could improve from 0.76 (0.73-0.79) for transvaginal sonography alone to 0.90 (0.87-0.93) for the integrated strategy. Taking into account the characteristics of the women could increase the efficiency of the diagnostic work up for postmenopausal bleeding.

  15. Biomedical Diagnostics Enabled by Integrated Organic and Printed Electronics.

    PubMed

    Ahmadraji, Termeh; Gonzalez-Macia, Laura; Ritvonen, Tapio; Willert, Andreas; Ylimaula, Satu; Donaghy, David; Tuurala, Saara; Suhonen, Mika; Smart, Dave; Morrin, Aoife; Efremov, Vitaly; Baumann, Reinhard R; Raja, Munira; Kemppainen, Antti; Killard, Anthony J

    2017-07-18

    Organic and printed electronics integration has the potential to revolutionize many technologies, including biomedical diagnostics. This work demonstrates the successful integration of multiple printed electronic functionalities into a single device capable of the measurement of hydrogen peroxide and total cholesterol. The single-use device employed printed electrochemical sensors for hydrogen peroxide electroreduction integrated with printed electrochromic display and battery. The system was driven by a conventional electronic circuit designed to illustrate the complete integration of silicon integrated circuits via pick and place or using organic electronic circuits. The device was capable of measuring 8 μL samples of both hydrogen peroxide (0-5 mM, 2.72 × 10 -6 A·mM -1 ) and total cholesterol in serum from 0 to 9 mM (1.34 × 10 -8 A·mM -1 , r 2 = 0.99, RSD < 10%, n = 3), and the result was output on a semiquantitative linear bar display. The device could operate for 10 min via a printed battery, and display the result for many hours or days. A mobile phone "app" was also capable of reading the test result and transmitting this to a remote health care provider. Such a technology could allow improved management of conditions such as hypercholesterolemia.

  16. Timely Diagnostic Feedback for Database Concept Learning

    ERIC Educational Resources Information Center

    Lin, Jian-Wei; Lai, Yuan-Cheng; Chuang, Yuh-Shy

    2013-01-01

    To efficiently learn database concepts, this work adopts association rules to provide diagnostic feedback for drawing an Entity-Relationship Diagram (ERD). Using association rules and Asynchronous JavaScript and XML (AJAX) techniques, this work implements a novel Web-based Timely Diagnosis System (WTDS), which provides timely diagnostic feedback…

  17. Status of US ITER Diagnostics

    NASA Astrophysics Data System (ADS)

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

    2013-10-01

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

  18. Experience with an integrated control and monitoring system at the El Segundo generating station

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

    Papilla, R.P.; McKinley, J.H.; Blanco, M.A.

    1992-01-01

    This paper describes the EPRI/Southern California Edison (SCE) El Segundo Integrated Control and Monitoring System (ICMS) project and relates key project experiences. The ICMS project is a cost-shared effort between EPRI and SCE designed to address the issues involved with integrating power plant diagnostic and condition monitoring with control. A digital distributed control system retrofit for SCE's El Segundo Units 3 and 4 provided the case study. although many utilities have retrofitted power plant units with distributed control systems (DCS's) and have applied diagnostics and monitoring programs to improve operations and performance, the approach taken in this project, that is,more » integrating the monitoring function with the control function, is profoundly new and unique. Over the life of the El Segundo ICMS, SCE expects to realize savings form life optimization, increased operating flexibility, improved heat rate, reduced NO{sub x} emissions, and lower maintenance costs. These savings are expected to be significant over the life of the system.« less

  19. Recent Advances in Flexible and Stretchable Bio-Electronic Devices Integrated with Nanomaterials.

    PubMed

    Choi, Suji; Lee, Hyunjae; Ghaffari, Roozbeh; Hyeon, Taeghwan; Kim, Dae-Hyeong

    2016-06-01

    Flexible and stretchable electronics and optoelectronics configured in soft, water resistant formats uniquely address seminal challenges in biomedicine. Over the past decade, there has been enormous progress in the materials, designs, and manufacturing processes for flexible/stretchable system subcomponents, including transistors, amplifiers, bio-sensors, actuators, light emitting diodes, photodetector arrays, photovoltaics, energy storage elements, and bare die integrated circuits. Nanomaterials prepared using top-down processing approaches and synthesis-based bottom-up methods have helped resolve the intrinsic mechanical mismatch between rigid/planar devices and soft/curvilinear biological structures, thereby enabling a broad range of non-invasive, minimally invasive, and implantable systems to address challenges in biomedicine. Integration of therapeutic functional nanomaterials with soft bioelectronics demonstrates therapeutics in combination with unconventional diagnostics capabilities. Recent advances in soft materials, devices, and integrated systems are reviewes, with representative examples that highlight the utility of soft bioelectronics for advanced medical diagnostics and therapies. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  20. Neutron Radiation Shielding For The NIF Streaked X-Ray Detector (SXD) Diagnostic

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

    Song, P; Holder, J; Young, B

    2006-11-02

    The National Ignition Facility (NIF) at Lawrence Livermore National Laboratory (LLNL) is preparing for the National Ignition Campaign (NIC) scheduled in 2010. The NIC is comprised of several ''tuning'' physics subcampaigns leading up to a demonstration of Inertial Confinement Fusion (ICF) ignition. In some of these experiments, time-resolved x-ray imaging of the imploding capsule may be required to measure capsule trajectory (shock timing) or x-ray ''bang-time''. A capsule fueled with pure tritium (T) instead of a deutriun-tritium (DT) mixture is thought to offer useful physics surrogacy, with reduced yields of up to 5e14 neutrons. These measurements will require the usemore » of the NIF streak x-ray detector (SXD). The resulting prompt neutron fluence at the planned SXD location ({approx}1.7 m from the target) would be {approx}1.4e9/cm{sup 2}. Previous measurements suggest the onset of significant background at a neutron fluence of {approx} 1e8/cm{sup 2}. The radiation damage and operational upsets which starts at {approx}1e8 rad-Si/sec must be factored into an integrated experimental campaign plan. Monte Carlo analyses were performed to predict the neutron and gamma/x-ray fluences and radiation doses for the proposed diagnostic configuration. A possible shielding configuration is proposed to mitigate radiation effects. The primary component of this shielding is an 80 cm thickness of Polyethylene (PE) between target chamber center (TCC) and the SXD diagnostic. Additionally, 6-8 cm of PE around the detector provide from the large number of neutrons that scatter off the inside of the target chamber. This proposed shielding configuration reduces the high-energy neutron fluence at the SXD by approximately a factor {approx}50.« less

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

    PubMed

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

    2014-09-01

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

  2. Flexible opto-electronics enabled microfluidics systems with cloud connectivity for point-of-care micronutrient analysis.

    PubMed

    Lee, Stephen; Aranyosi, A J; Wong, Michelle D; Hong, Ji Hyung; Lowe, Jared; Chan, Carol; Garlock, David; Shaw, Scott; Beattie, Patrick D; Kratochvil, Zachary; Kubasti, Nick; Seagers, Kirsten; Ghaffari, Roozbeh; Swanson, Christina D

    2016-04-15

    In developing countries, the deployment of medical diagnostic technologies remains a challenge because of infrastructural limitations (e.g. refrigeration, electricity), and paucity of health professionals, distribution centers and transportation systems. Here we demonstrate the technical development and clinical testing of a novel electronics enabled microfluidic paper-based analytical device (EE-μPAD) for quantitative measurement of micronutrient concentrations in decentralized, resource-limited settings. The system performs immune-detection using paper-based microfluidics, instrumented with flexible electronics and optoelectronic sensors in a mechanically robust, ultrathin format comparable in size to a credit card. Autonomous self-calibration, plasma separation, flow monitoring, timing and data storage enable multiple devices to be run simultaneously. Measurements are wirelessly transferred to a mobile phone application that geo-tags the data and transmits it to a remote server for real time tracking of micronutrient deficiencies. Clinical tests of micronutrient levels from whole blood samples (n=95) show comparable sensitivity and specificity to ELISA-based tests. These results demonstrate instantaneous acquisition and global aggregation of diagnostics data using a fully integrated point of care system that will enable rapid and distributed surveillance of disease prevalence and geographical progression. Copyright © 2015 Elsevier B.V. All rights reserved.

  3. Multimodality bonchoscopic imaging of tracheopathica osteochondroplastica

    NASA Astrophysics Data System (ADS)

    Colt, Henri; Murgu, Septimiu D.; Ahn, Yeh-Chan; Brenner, Matt

    2009-05-01

    Results of a commercial optical coherence tomography system used as part of a multimodality diagnostic bronchoscopy platform are presented for a 61-year-old patient with central airway obstruction from tracheopathica osteochondroplastica. Comparison to results of white-light bronchoscopy, histology, and endobronchial ultrasound examination are accompanied by a discussion of resolution, penetration depth, contrast, and field of view of these imaging modalities. White-light bronchoscopy revealed irregularly shaped, firm submucosal nodules along cartilaginous structures of the anterior and lateral walls of the trachea, sparing the muscular posterior membrane. Endobronchial ultrasound showed a hyperechoic density of 0.4 cm thickness. optical coherence tomography (OCT) was performed using a commercially available, compact time-domain OCT system (Niris System, Imalux Corp., Cleveland, Ohio) with a magnetically actuating probe (two-dimensional, front imaging, and inside actuation). Images showed epithelium, upper submucosa, and osseous submucosal nodule layers corresponding with histopathology. To our knowledge, this is the first time these commercially available systems are used as part of a multimodality bronchoscopy platform to study diagnostic imaging of a benign disease causing central airway obstruction. Further studies are needed to optimize these systems for pulmonary applications and to determine how new-generation imaging modalities will be integrated into a multimodality bronchoscopy platform.

  4. 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.

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

    Shafer, Morgan W; Battaglia, D. J.; Unterberg, Ezekial A

    A new tangential 2D Soft X-Ray Imaging System (SXRIS) is being designed to examine the edge magnetic island structure in the lower X-point region of DIII-D. A synthetic diagnostic calculation coupled to 3D emissivity estimates is used to generate phantom images. Phillips-Tikhonov regularization is used to invert the phantom images for comparison to the original emissivity model. Noise level, island size, and equilibrium accuracy are scanned to assess the feasibility of detecting edge island structures. Models of typical DIII-D discharges indicate integration times > 1 ms with accurate equilibrium reconstruction are needed for small island (< 3 cm) detection.

  6. Neurosurgical sapphire handheld probe for intraoperative optical diagnostics, laser coagulation and aspiration of malignant brain tissue

    NASA Astrophysics Data System (ADS)

    Shikunova, Irina A.; Zaytsev, Kirill I.; Stryukov, Dmitrii O.; Dubyanskaya, Evgenia N.; Kurlov, Vladimir N.

    2017-07-01

    In this paper, a handheld contact probe based on sapphire shaped crystal was developed for the intraoperative optical diagnosis and aspiration of malignant brain tissue combined with the laser hemostasis. Such a favorable combination of several functions in a single instrument significantly increases its clinical relevance. It makes possible highly-accurate real-time detection and removal of either large-scale malignancies or even separate invasive cancer cells. The proposed neuroprobe was integrated into the clinical neurosurgical workflow for the intraoperative fluorescence identification and removal of malignant tissues of the brain.

  7. Reaching out to take on TB in Somalia.

    PubMed

    Moore, David A J; Granat, Simo M

    2014-01-01

    Among the many challenges facing populations disrupted by complex emergencies, personal security and food security rank much higher than access to healthcare. However, over time health needs assume increasing importance. Many complex crises occur in settings where the background incidence of TB is already high; social and economic conditions in crises are then highly conducive to amplification of the existing TB problem. Innovative approaches to delivery of diagnostic and treatment services, transition planning and integration with other healthcare providers and services are vital. In the extremely challenging environment of Somalia, multiple partners are making headway though collaboration and innovation.

  8. First results from protective ECRH diagnostics for Wendelstein 7-X

    NASA Astrophysics Data System (ADS)

    Marsen, S.; Corre, Y.; Laqua, H. P.; Moncada, V.; Moseev, D.; Niemann, H.; Preynas, M.; Stange, T.; The W7-X Team

    2017-08-01

    Wendelstein 7-X (W7-X) is a steady state capable optimised stellarator. The main heating system is electron cyclotron resonance heating (ECRH) operating at 140 GHz providing up to 9 MW microwave power. The power is launched into the machine by front steerable quasi-optical launchers in X- or O-mode. While in X-mode the first pass absorption is 99%, it is only 40... 70% in O-mode. O2-mode heating is forseen for high density operation above the X2 cutoff density of 1.2\\centerdot {{10}20} m-3. A set of diagnostics has been developed to protect the machine from non absorbed ECRH power which can easily damage in vessel components. The non absorbed power hitting the inner wall is measured by waveguides embedded in the first wall (ECA diagnostic). In order to prevent the inner wall from overheating or arcing, a near-infra red sensitive video diagnostic with a dynamic range of 450...1200 °C was integrated in the ECRH launchers. Thermal calculations for the carbon tiles predict a temperature increase above the detection threshold for scenarios of plasma start-up failure or poor absorption on a time scale of 50 ms. However, the temperature increase measured by an IR camera in experiments with failed break down, i.e. no ECRH absorption for up to 50 ms, was only Δ T≈ 70{{~}\\circ} C. In discharges with ≈ 5% transmission the measured temperature increase was comparable. The stray radiation level inside the machine is measured by so called sniffer probes resembling microwave diode detectors which were designed to collect all radiation approaching the probing surface independent of incident angle and polarization. Five sniffer probes are installed at different toroidal positions. They were integrated in the ECRH interlock system. During the first operational phase of W7-X this was the only available plasma interlock system. The signal quality proofed to be high enough for a reliable termination in case of poor absorption. After a breakdown phase of 10 ms, the sniffer probe signals dropped by more than an order of magnitude. Especially in the very first days of operation, most discharges died by a radiative collapse due to impurity influx. In this case the heating power was reliably switched off due to the increased level of stray radiation. Moreover, ECRH bolometers with a slower response time in the launcher ports and an empty diagnostic port were used to estimate the stray radiation level in the ports. In the launcher ports it could be shown that the stray radiation could lead to an overheating of the bellows in long discharges. Possible counter measures are discussed.

  9. Diagnostic doses and times for Phlebotomus papatasi and Lutzomyia longipalpis sand flies (Diptera: Psychodidae: Phlebotominae) using the CDC bottle bioassay to assess insecticide resistance.

    PubMed

    Denlinger, David S; Creswell, Joseph A; Anderson, J Laine; Reese, Conor K; Bernhardt, Scott A

    2016-04-15

    Insecticide resistance to synthetic chemical insecticides is a worldwide concern in phlebotomine sand flies (Diptera: Psychodidae), the vectors of Leishmania spp. parasites. The CDC bottle bioassay assesses resistance by testing populations against verified diagnostic doses and diagnostic times for an insecticide, but the assay has been used limitedly with sand flies. The objective of this study was to determine diagnostic doses and diagnostic times for laboratory Lutzomyia longipalpis (Lutz & Nieva) and Phlebotomus papatasi (Scopoli) to ten insecticides, including pyrethroids, organophosphates, carbamates, and DDT, that are used worldwide to control vectors. Bioassays were conducted in 1,000-ml glass bottles each containing 10-25 sand flies from laboratory colonies of L. longipalpis or P. papatasi. Four pyrethroids, three organophosphates, two carbamates and one organochlorine, were evaluated. A series of concentrations were tested for each insecticide, and four replicates were conducted for each concentration. Diagnostic doses were determined only during the exposure bioassay for the organophosphates and carbamates. For the pyrethroids and DDT, diagnostic doses were determined for both the exposure bioassay and after a 24-hour recovery period. Both species are highly susceptible to the carbamates as their diagnostic doses are under 7.0 μg/ml. Both species are also highly susceptible to DDT during the exposure assay as their diagnostic doses are 7.5 μg/ml, yet their diagnostic doses for the 24-h recovery period are 650.0 μg/ml for Lu. longipalpis and 470.0 μg/ml for P. papatasi. Diagnostic doses and diagnostic times can now be incorporated into vector management programs that use the CDC bottle bioassay to assess insecticide resistance in field populations of Lu. longipalpis and P. papatasi. These findings provide initial starting points for determining diagnostic doses and diagnostic times for other sand fly vector species and wild populations using the CDC bottle bioassay.

  10. Time stretch and its applications

    NASA Astrophysics Data System (ADS)

    Mahjoubfar, Ata; Churkin, Dmitry V.; Barland, Stéphane; Broderick, Neil; Turitsyn, Sergei K.; Jalali, Bahram

    2017-06-01

    Observing non-repetitive and statistically rare signals that occur on short timescales requires fast real-time measurements that exceed the speed, precision and record length of conventional digitizers. Photonic time stretch is a data acquisition method that overcomes the speed limitations of electronic digitizers and enables continuous ultrafast single-shot spectroscopy, imaging, reflectometry, terahertz and other measurements at refresh rates reaching billions of frames per second with non-stop recording spanning trillions of consecutive frames. The technology has opened a new frontier in measurement science unveiling transient phenomena in nonlinear dynamics such as optical rogue waves and soliton molecules, and in relativistic electron bunching. It has also created a new class of instruments that have been integrated with artificial intelligence for sensing and biomedical diagnostics. We review the fundamental principles and applications of this emerging field for continuous phase and amplitude characterization at extremely high repetition rates via time-stretch spectral interferometry.

  11. Mobile diagnostics: next-generation technologies for in vitro diagnostics.

    PubMed

    Shin, Joonchul; Chakravarty, Sudesna; Choi, Wooseok; Lee, Kyungyeon; Han, Dongsik; Hwang, Hyundoo; Choi, Jaekyu; Jung, Hyo-Il

    2018-03-26

    The emergence of a wide range of applications of smartphones along with advances in 'liquid biopsy' has significantly propelled medical research particularly in the field of in vitro diagnostics (IVD). Herein, we have presented a detailed analysis of IVD, its associated critical concerns and probable solutions. It also demonstrates the transition in terms of analytes from minimally invasive (blood) to non-invasive (urine, saliva and sweat) and depicts how the different features of a smartphone can be integrated for specific diagnostic purposes. This review basically highlights recent advances in the applications of smartphone-based biosensors in IVD taking into account the following factors: accuracy and portability; quantitative and qualitative analysis; and centralization and decentralization tests. Furthermore, the critical concerns and future direction of diagnostics based on smartphones are also discussed.

  12. IT-based diagnostic instrumentation systems for personalized healthcare services.

    PubMed

    Chun, Honggu; Kang, Jaemin; Kim, Ki-Jung; Park, Kwang Suk; Kim, Hee Chan

    2005-01-01

    This paper describes recent research and development activities on the diagnostic instruments for personalized healthcare services in Seoul National University. Utilizing the state-of-the-art information technologies (IT), various diagnostic medical instruments have been integrated into a personal wearable device and a home telehealthcare system. We developed a wrist-worn integrated health monitoring device (WIHMD) which performs the measurements of non-invasive blood pressure (NIBP), pulse oximetry (SpO2), electrocardiogram (ECG), respiration rate, heart rate, and body surface temperature and the detection of falls to determine the onset of emergency situation. The WIHMD also analyzes the acquired bio-signals and transmits the resultant data to a healthcare service center through a commercial cellular phone. Two different kinds of IT-based blood glucometer have been developed using a cellular phone and PDA(personal digital assistant) as a main unit. A blood glucometer was also integrated within a wrist pressure measurement module which is interfaced with a cellular phone via Telecommunications Technology Association (TTA) standard in order to provide users with easiness in measuring and handling two important health parameters. Non-intrusive bio-signal measurement systems were developed for the ease of home use. One can measure his ECG on a bed while he is sleeping; measure his ECG, body temperature, bodyfat ratio and weight on a toilet seat; measure his ECG on a chair; and estimate the degree of activity by motion analysis using a camera. Another integrated diagnostic system for home telehealthcare services has been developed to include a 12 channels ECG, a pressure meter for NIBP, a blood glucometer, a bodyfat meter and a spirometer. It is an expert system to analyze the measured health data and based on the diagnostic result, the system provides an appropriate medical consultation. The measured data can be either stored on the system or transmitted to the central server through the internet. We have installed the developed systems on a model house for the performance evaluation and confirmed the possibility of the system as an effective tool for the personalized healthcare services.

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

    ERIC Educational Resources Information Center

    Richards, Brian J.

    2008-01-01

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

  14. Autonomous power expert fault diagnostic system for Space Station Freedom electrical power system testbed

    NASA Technical Reports Server (NTRS)

    Truong, Long V.; Walters, Jerry L.; Roth, Mary Ellen; Quinn, Todd M.; Krawczonek, Walter M.

    1990-01-01

    The goal of the Autonomous Power System (APS) program is to develop and apply intelligent problem solving and control to the Space Station Freedom Electrical Power System (SSF/EPS) testbed being developed and demonstrated at NASA Lewis Research Center. The objectives of the program are to establish artificial intelligence technology paths, to craft knowledge-based tools with advanced human-operator interfaces for power systems, and to interface and integrate knowledge-based systems with conventional controllers. The Autonomous Power EXpert (APEX) portion of the APS program will integrate a knowledge-based fault diagnostic system and a power resource planner-scheduler. Then APEX will interface on-line with the SSF/EPS testbed and its Power Management Controller (PMC). The key tasks include establishing knowledge bases for system diagnostics, fault detection and isolation analysis, on-line information accessing through PMC, enhanced data management, and multiple-level, object-oriented operator displays. The first prototype of the diagnostic expert system for fault detection and isolation has been developed. The knowledge bases and the rule-based model that were developed for the Power Distribution Control Unit subsystem of the SSF/EPS testbed are described. A corresponding troubleshooting technique is also described.

  15. Development of an EMC3-EIRENE Synthetic Imaging Diagnostic

    NASA Astrophysics Data System (ADS)

    Meyer, William; Allen, Steve; Samuell, Cameron; Lore, Jeremy

    2017-10-01

    2D and 3D flow measurements are critical for validating numerical codes such as EMC3-EIRENE. Toroidal symmetry assumptions preclude tomographic reconstruction of 3D flows from single camera views. In addition, the resolution of the grids utilized in numerical code models can easily surpass the resolution of physical camera diagnostic geometries. For these reasons we have developed a Synthetic Imaging Diagnostic capability for forward projection comparisons of EMC3-EIRENE model solutions with the line integrated images from the Doppler Coherence Imaging diagnostic on DIII-D. The forward projection matrix is 2.8 Mpixel by 6.4 Mcells for the non-axisymmetric case we present. For flow comparisons, both simple line integral, and field aligned component matrices must be calculated. The calculation of these matrices is a massive embarrassingly parallel problem and performed with a custom dispatcher that allows processing platforms to join mid-problem as they become available, or drop out if resources are needed for higher priority tasks. The matrices are handled using standard sparse matrix techniques. Prepared by LLNL under Contract DE-AC52-07NA27344. This material is based upon work supported by the U.S. DOE, Office of Science, Office of Fusion Energy Sciences. LLNL-ABS-734800.

  16. [Role of cytology in hematopathological diagnostics].

    PubMed

    Bode, B; Tinguely, M

    2012-07-01

    The role of cytology has so far been underrecognized in the diagnostic process of hematopathological questions. This article presents an algorithm which allows a stepwise work-up of cytology specimens obtained by minimally invasive ultrasound-guided fine needle aspiration in patients with unexplained lymph node swelling. Moreover, it is shown how the selective separation of cytology specimens allows the application of immunophenotypic analysis including flow cytometry and immunohistochemistry as well as molecular analyses, such as fluorescence in situ hybridization (FISH) and polymerase chain reaction (PCR) strategies. With the integrative procedure presented, cytology offers an excellent cost-effective tool for the diagnostic approach of patients with suspected hematopathological malignancies allowing a high diagnostic accuracy, ideal for initial diagnosis or follow-up.

  17. Physics Design Considerations for Diagnostic X Electron Beam Transport System

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

    Chen, Y-J

    2000-04-10

    The Diagnostic X (D-X) beamlines will transport the DARHT-II beam from the end of the accelerator to the Diagnostic X firing point providing four lines of sight for x-ray radiography. The design goal for the Diagnostic X beamline is to deliver four x-ray pulses with the DARHT-II dose format and time integrated spot size on each line of sight. The D-X beamline's final focus should be compatible with a range of first conjugates from 1 m-5 m. Furthermore, the D-X beamline operational parameters and the beamline layout should not preclude a possible upgrade to additional lines of sight. The DARHT-IImore » accelerator is designed to deliver beams at a rate of 1 pulse per minute or less. Tuning the D-X beamline with several hundred optical elements would be time consuming. Therefore, minimizing the required number of tuning shots for the D-X beamline is also an important design goal. Many different beamline configurations may be able to accomplish these design objectives, and high beam quality (i.e., high current and low emittance) must be maintained throughout the chosen beamline configuration in order to achieve the DARHT-II x-ray dose format. In general, the longer the distance a beam travels, the harder it is to preserve the beam quality. Therefore, from the point of view of maintaining beam quality, it is highly desirable to minimize the beamline length. Lastly, modification to the DARHT-II building and the downstream transport should be minimized. Several processes can degrade beam quality by increasing the beam emittance, increasing the time-varying transverse beam motion, creating a beam halo, or creating a time-varying beam envelope. In this report, we consider those processes in the passive magnet lattice beamline and indicate how they constrain the beamline design. The physics design considerations for the active components such as the kicker system will be discussed in Ref. 2. In Sec. I, we discuss how beam emittance affects the x-ray forward dose. We also establish a physics design goal for the emittance growth budget. In Sec. II, we discuss how the conductivity and size of the beam pipe affects the transverse beam motion. We also discuss the emittance growth arise from the beam centroid offset. In Sec. III, we discuss the background gas focusing effects and establish the vacuum requirements. In Sec. IV, we consider the emittance growth in a bend. In Sec. V, we discuss the misalignment and corkscrew motion. The design specifications for misalignment are established. In Secs. VI and VII, we discuss the design objectives on how to extract beams from the DARHT-II beamline and how to minimize the tuning shots. The integrated spot size and final focusing are discussed in Sec. VIII. A conclusion will be presented in Sec. IX.« less

  18. Interactive Electronic Decision Trees for the Integrated Primary Care Management of Febrile Children in Low Resource Settings - Review of existing tools.

    PubMed

    Keitel, Kristina; D'Acremont, Valérie

    2018-04-20

    The lack of effective, integrated diagnostic tools pose a major challenge to the primary care management of febrile childhood illnesses. These limitations are especially evident in low-resource settings and are often inappropriately compensated by antimicrobial over-prescription. Interactive electronic decision trees (IEDTs) have the potential to close these gaps: guiding antibiotic use and better identifying serious disease. This narrative review summarizes existing IEDTs, to provide an overview of their degree of validation, as well as to identify gaps in current knowledge and prospects for future innovation. Structured literature review in PubMed and Embase complemented by google search and contact with developers. Six integrated IEDTs were identified: three (eIMCI, REC, and Bangladesh digital IMCI) based on Integrated Management of Childhood Illnesses (IMCI); four (SL eCCM, MEDSINC, e-iCCM, and D-Tree eCCM) on Integrated Community Case Management (iCCM); two (ALMANACH, MSFeCARE) with a modified IMCI content; and one (ePOCT) that integrates novel content with biomarker testing. The types of publications and evaluation studies varied greatly: the content and evidence-base was published for two (ALMANACH and ePOCT), ALMANACH and ePOCT were validated in efficacy studies. Other types of evaluations, such as compliance, acceptability were available for D-Tree eCCM, eIMCI, ALMANACH. Several evaluations are still ongoing. Future prospects include conducting effectiveness and impact studies using data gathered through larger studies to adapt the medical content to local epidemiology, improving the software and sensors, and Assessing factors that influence compliance and scale-up. IEDTs are valuable tools that have the potential to improve management of febrile children in primary care and increase the rational use of diagnostics and antimicrobials. Next steps in the evidence pathway should be larger effectiveness and impact studies (including cost analysis) and continuous integration of clinically useful diagnostic and treatment innovations. Copyright © 2018. Published by Elsevier Ltd.

  19. An ultra-low-cost smartphone octochannel spectrometer for mobile health diagnostics.

    PubMed

    Wang, Li-Ju; Naudé, Nicole; Chang, Yu-Chung; Crivaro, Anne; Kamoun, Malek; Wang, Ping; Li, Lei

    2018-03-30

    With the rapid development and proliferation of mobile devices with powerful computing power and the ability of integrating sensors into mobile devices, the potential impact of mobile health (mHealth) diagnostics on the public health is drawing researchers' attention. We developed a Smartphone Octo-channel Spectrometer (SOS) as a mHealth diagnostic tool. The SOS has nanoscale wavelength resolution, is self-illuminated from the smartphone itself, and is ultra-low cost (less than $20). A user interface controls the optical sensing parameters and precise alignment. After calibrating and testing the SOS by quantifying protein concentrations, we clinically validated the SOS by comparing the diagnostic performance of our device with that of a clinical spectrophotometer. About 180 serum samples from de-identified patients with 4 types of autoantibodies were blindly read the ELISA results. The accuracy of the SOS achieved 100% across the clinical reportable range compared with the FDA-approved instrument. Furthermore, the self-illuminated SOS only requires about half of the light intensity of the FDA-approved instrument to achieve clinical-level sensitivity. The low-energy-consumption and low-cost SOS enables point-of-care spectrophotometric sensing in low-resource areas, and can be integrated into point-of-care diagnostic systems for rapid multiplex readout and analysis at patient bedside or at home. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  20. Oriented conjugation of single-domain antibodies and quantum dots.

    PubMed

    Brazhnik, Kristina; Nabiev, Igor; Sukhanova, Alyona

    2014-01-01

    Nanoparticle-based biodetection routinely employs monoclonal antibodies (mAbs) for targeting. However, the large size of mAbs limits the number of ligands per nanoparticle and severely restricts the bioavailability and distribution of these probes in a sample. Furthermore, conventional conjugation techniques provide nanoprobes with irregular orientation of mAbs on the nanoparticle surface and often provoke mAb unfolding. Here, we describe a protocol for engineering a new generation of ultrasmall diagnostic nanoprobes through oriented conjugation of semiconductor quantum dots (QDs) with 13 kDa single-domain antibodies (sdAbs) derived from llama immunoglobulin G (IgG). The sdAbs are conjugated with QDs in a highly oriented manner via an additional cysteine residue specifically integrated into the sdAb C-terminus. The resultant nanoprobes are <12 nm in diameter, ten times smaller in volume compared to the known alternatives. They have been proved highly efficient in flow cytometry and immunuhistochemical diagnostics. This approach can be easily extended to other semiconductor and plasmonic nanoparticles.

  1. Diagnostic-management system and test pulse acquisition for WEST plasma measurement system

    NASA Astrophysics Data System (ADS)

    Wojenski, A.; Kasprowicz, G.; Pozniak, K. T.; Byszuk, A.; Juszczyk, B.; Zabolotny, W.; Zienkiewicz, P.; Chernyshova, M.; Czarski, T.; Mazon, D.; Malard, P.

    2014-11-01

    This paper describes current status of electronics, firmware and software development for new plasma measurement system for use in WEST facility. The system allows to perform two dimensional plasma visualization (in time) with spectrum measurement. The analog front-end is connected to Gas Electron Multiplier detector (GEM detector). The system architecture have high data throughput due to use of PCI-Express interface, Gigabit Transceivers and sampling frequency of ADC integrated circuits. The hardware is based on several years of experience in building X-ray spectrometer system for Joint European Torus (JET) facility. Data streaming is done using Artix7 FPGA devices. The system in basic configuration can work with up to 256 channels, while the maximum number of measurement channels is 2048. Advanced firmware for the FPGA is required in order to perform high speed data streaming and analog signal sampling. Diagnostic system management has been developed in order to configure measurement system, perform necessary calibration and prepare hardware for data acquisition.

  2. Implementation of the new multichannel X-mode edge density profile reflectometer for the ICRF antenna on ASDEX Upgrade

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

    Aguiam, D. E., E-mail: daguiam@ipfn.tecnico.ulisboa.pt; Silva, A.; Carvalho, P. J.

    A new multichannel frequency modulated continuous-wave reflectometry diagnostic has been successfully installed and commissioned on ASDEX Upgrade to measure the plasma edge electron density profile evolution in front of the Ion Cyclotron Range of Frequencies (ICRF) antenna. The design of the new three-strap ICRF antenna integrates ten pairs (sending and receiving) of microwave reflectometry antennas. The multichannel reflectometer can use three of these to measure the edge electron density profiles up to 2 × 10{sup 19} m{sup −3}, at different poloidal locations, allowing the direct study of the local plasma layers in front of the ICRF antenna. ICRF power coupling,more » operational effects, and poloidal variations of the plasma density profile can be consistently studied for the first time. In this work the diagnostic hardware architecture is described and the obtained density profile measurements were used to track outer radial plasma position and plasma shape.« less

  3. Gold Nanorod-based Photo-PCR System for One-Step, Rapid Detection of Bacteria

    PubMed Central

    Kim, Jinjoo; Kim, Hansol; Park, Ji Ho; Jon, Sangyong

    2017-01-01

    The polymerase chain reaction (PCR) has been an essential tool for diagnosis of infectious diseases, but conventional PCR still has some limitations with respect to applications to point-of-care (POC) diagnostic systems that require rapid detection and miniaturization. Here we report a light-based PCR method, termed as photo-PCR, which enables rapid detection of bacteria in a single step. In the photo-PCR system, poly(enthylene glycol)-modified gold nanorods (PEG-GNRs), used as a heat generator, are added into the PCR mixture, which is subsequently periodically irradiated with a 808-nm laser to create thermal cycling. Photo-PCR was able to significantly reduce overall thermal cycling time by integrating bacterial cell lysis and DNA amplification into a single step. Furthermore, when combined with KAPA2G fast polymerase and cooling system, the entire process of bacterial genomic DNA extraction and amplification was further shortened, highlighting the potential of photo-PCR for use in a portable, POC diagnostic system. PMID:29071186

  4. Integrated secure solution for electronic healthcare records sharing

    NASA Astrophysics Data System (ADS)

    Yao, Yehong; Zhang, Chenghao; Sun, Jianyong; Jin, Jin; Zhang, Jianguo

    2007-03-01

    The EHR is a secure, real-time, point-of-care, patient-centric information resource for healthcare providers. Many countries and regional districts have set long-term goals to build EHRs, and most of EHRs are usually built based on the integration of different information systems with different information models and platforms. A number of hospitals in Shanghai are also piloting the development of an EHR solution based on IHE XDS/XDS-I profiles with a service-oriented architecture (SOA). The first phase of the project targets the Diagnostic Imaging domain and allows seamless sharing of images and reports across the multiple hospitals. To develop EHRs for regional coordinated healthcare, some factors should be considered in designing architecture, one of which is security issue. In this paper, we present some approaches and policies to improve and strengthen the security among the different hospitals' nodes, which are compliant with the security requirements defined by IHE IT Infrastructure (ITI) Technical Framework. Our security solution includes four components: Time Sync System (TSS), Digital Signature Manage System (DSMS), Data Exchange Control Component (DECC) and Single Sign-On (SSO) System. We give a design method and implementation strategy of these security components, and then evaluate the performance and overheads of the security services or features by integrating the security components into an image-based EHR system.

  5. [Analysis of characteristics and influence factors of diagnostic delay of endometriosis].

    PubMed

    Han, X T; Guo, H Y; Kong, D L; Han, J S; Zhang, L F

    2018-02-25

    Objective: To access the influence factors of diagnostic delay of endometriosis. Methods: We designed a questionnaire of diagnostic delay of endometriosis. From February 2014 to February 2016, 400 patients who had dysmenorrhea and diagnosed with endometriosis by surgery in Peking University Third Hospital were surveyed retrospectively. Time and risk factors of diagnostic delay were analyzed. Results: The diagnostic delay of 400 patients was 13.0 years (0.2-43.0 years), 78.5%(314/400) patients thought pain was a normal phenomenon and didn't see the doctor. Patients who suffered dysmenorrhea at menarche experienced longer diagnostic delay than those who had dysmenorrhea after menarche (18.0 vs 4.5 years; Z= 191.800, P< 0.01) . Patients who suffered aggravating dysmenorrhea experienced shorter delay time than those who suffered stable or relieving dysmenorrhea (11.0 vs 12.5 vs 18.0 years; Z= 8.270, P< 0.05) , with the difference statistically significant, single factor analysis shows. Severe dysmenorrhea, deep infiltration endometriosis (DIE) , family history of dysmenorrhea or endometriosis, previous surgical history of endometriosis, high stage, with infertility, adenomyoma or other symptoms, could help to shorten diagnostic delay with no significant difference ( P> 0.05) . By multiple logistic regression analysis, the results shown that whether have dysmenorrhea at menarche and clinical diagnosis time were the independent factors affecting delayed diagnosis ( P< 0.01) . Conclusions: Diagnostic delay of endometriosis is common and the mean delay time is 13.0 years mainly due to the unawareness of dysmenorrhea. Dysmenorrhea at menarche, clinical diagnosis time and dysmenorrhea intensity are the factors affecting time of diagnostic delay.

  6. Nano-enabled sensors, electronics and energy source on polymer, paper and thread substrates

    NASA Astrophysics Data System (ADS)

    Mostafalu, Pooria

    Over the past decades, design and development of portable devices for monitoring of biomarkers especially for at risk patients is receiving considerable attention. These devices are either single use diagnostic platforms, wearable on body or on fabric, or they are implanted close to the tissue and organ that it monitors and cures. Sensors, energy sources, and data acquisition devices are the main components of a such monitoring platform. Sensors collect the information using bio-recognition tools such as enzymes and antibodies. Then, the transducers (electrodes, fluorophore, etc) convert it to the appropriate format, for instance electrical and optical signals. After that, data acquisition system amplifies and digitizes the signal and transfers the data to the recording instruments for further processing. Moreover, energy sources are necessary for powering the sensors and electronics. In wearable and implantable applications, these devices need to be flexible, light weight and biocompatible, and their performance should be similar to their rigid counterparts. In this dissertation we address these requirement for wearable and implantable devices. We showed integrated sensors, electronics, and energy sources on flexible polymers, paper, and thread. These devices provide many advantages for monitoring of the physiological condition of a patient and treatment accordingly. Real-time capability of the platform was enabled using wireless telemetry. One of the major innovations of this dissertation is the use of thread as a substrate for making medical diagnostic devices. While conventional substrates (glass, silicon, polyimide, PDMS etc) hold great promise for making wearable and implantable devices, their overall structure and form has remained essentially two dimensional, limiting their function to tissue surfaces such as skin. However, the ability to integrate functional components such as sensors, actuators, and electronics in a way that they penetrate multiple layers of tissues in a 3D topology would be a significant surgical advance. We have devised an integrated thread-based diagnostic (TDD) system with the ability to measure physical (strain and temperature) and chemical (pH and glucose) markers in the body in vivo. Such device was made from threads, which have been widely used in the apparel industry and is readily available as a low-cost biocompatible material.

  7. Design considerations for highly effective fluorescence excitation and detection optical systems for molecular diagnostics

    NASA Astrophysics Data System (ADS)

    Kasper, Axel; Van Hille, Herbert; Kuk, Sola

    2018-02-01

    Modern instruments for molecular diagnostics are continuously optimized for diagnostic accuracy, versatility and throughput. The latest progress in LED technology together with tailored optics solutions allows developing highly efficient photonics engines perfectly adapted to the sample under test. Super-bright chip-on-board LED light sources are a key component for such instruments providing maximum luminous intensities in a multitude of narrow spectral bands. In particular the combination of white LEDs with other narrow band LEDs allows achieving optimum efficiency outperforming traditional Xenon light sources in terms of energy consumption, heat dissipation in the system, and switching time between spectral channels. Maximum sensitivity of the diagnostic system can only be achieved with an optimized optics system for the illumination and imaging of the sample. The illumination beam path must be designed for optimum homogeneity across the field while precisely limiting the angular distribution of the excitation light. This is a necessity for avoiding spill-over to the detection beam path and guaranteeing the efficiency of the spectral filtering. The imaging optics must combine high spatial resolution, high light collection efficiency and optimized suppression of excitation light for good signal-to-noise ratio. In order to achieve minimum cross-talk between individual wells in the sample, the optics design must also consider the generation of stray light and the formation of ghost images. We discuss what parameters and limitations have to be considered in an integrated system design approach covering the full path from the light source to the detector.

  8. Integrated Rapid-Diagnostic-Test Reader Platform on a Cellphone

    PubMed Central

    Mudanyali, Onur; Dimitrov, Stoyan; Sikora, Uzair; Padmanabhan, Swati; Navruz, Isa; Ozcan, Aydogan

    2012-01-01

    We demonstrate a cellphone based Rapid-Diagnostic-Test (RDT) reader platform that can work with various lateral flow immuno-chromatographic assays and similar tests to sense the presence of a target analyte in a sample. This compact and cost-effective digital RDT reader, weighing only ~65 grams, mechanically attaches to the existing camera unit of a cellphone, where various types of RDTs can be inserted to be imaged in reflection or transmission modes under light-emitting-diode (LED) based illumination. Captured raw images of these tests are then digitally processed (within less than 0.2 sec/image) through a smart application running on the cellphone for validation of the RDT as well as for automated reading of its diagnostic result. The same smart application running on the cellphone then transmits the resulting data, together with the RDT images and other related information (e.g., demographic data) to a central server, which presents the diagnostic results on a world-map through geo-tagging. This dynamic spatio-temporal map of various RDT results can then be viewed and shared using internet browsers or through the same cellphone application. We tested this platform using malaria, tuberculosis (TB) as well as HIV RDTs by installing it on both Android based smart-phones as well as an iPhone. Providing real-time spatio-temporal statistics for the prevalence of various infectious diseases, this smart RDT reader platform running on cellphones might assist health-care professionals and policy makers to track emerging epidemics worldwide and help epidemic preparedness. PMID:22596243

  9. Patterns of diagnostic marker assessment in adult diffuse glioma: a survey of the European Confederation of Neuropathological Societies (Euro-CNS)

    PubMed Central

    Woehrer, Adelheid; Kristensen, Bjarne W.; Vital, Anne; Hainfellner, Johannes A.

    2017-01-01

    The 2016 update of the WHO classification has introduced an integrated diagnostic approach that incorporates both tumor morphology and molecular information. This conceptual change has far-reaching implications, especially for neuropathologists who are in the forefront of translating molecular markers to routine diagnostic use. Adult diffuse glioma is a prototypic example for a group of tumors that underwent substantial regrouping, and it represents a major workload for surgical neuropathologists. Hence, we conducted a survey among members of the European Confederation of Neuropathological Societies (Euro-CNS) in order to assess 1) the extent to which molecular markers have already been incorporated in glioma diagnoses, 2) which molecular techniques are in daily use, and 3) to set a baseline for future surveys in this field. Based on 130 responses from participants across 40 nations neuropathologists uniformly rate molecular marker testing as highly relevant and already incorporate molecular information in their diagnostic assessments. At the same time however, the survey documents substantial differences in access to crucial biomarkers and molecular techniques across geographic regions and within individual countries. Concerns are raised concerning the validity of test assays with MGMT, 1p19q, and ATRX; being perceived as most problematic. Neuropathologists advocate the need for international harmonization of standards and consensus guidelines, and the majority is willing to actively engage in interlaboratory trials aiming at quality control (Figure 1). PMID:27966427

  10. An Integrative, Cognitive-Behavioral, Systemic Approach to Working with Students Diagnosed with Attention Deficit Hyperactive Disorder

    ERIC Educational Resources Information Center

    Shillingford, Margaret Ann; Lambie, Glenn W.; Walter, Sara Meghan

    2007-01-01

    Attention deficit hyperactive disorder (ADHD) is a prevalent diagnostic disorder for many students, which correlates with negative academic, social, and personal consequences. This article presents an integrative, cognitive-behavioral, systemic approach that offers behaviorally based interventions for professional school counselors to support…

  11. Violence Survivors with Posttraumatic Stress Disorder: Treatment by Integrating Existential and Narrative Therapies

    ERIC Educational Resources Information Center

    Day, Kristen W.

    2009-01-01

    In this article, the author proposes an integration of existential and narrative therapies with current evidence-supported approaches to treating the aforementioned population. First, she briefly defines interpersonal violence, then provides a history and review of the diagnostic criteria for Posttraumatic Stress Disorder (PTSD), which frequently…

  12. Development of a South African integrated syndromic respiratory disease guideline for primary care.

    PubMed

    English, René G; Bateman, Eric D; Zwarenstein, Merrick F; Fairall, Lara R; Bheekie, Angeni; Bachmann, Max O; Majara, Bosielo; Ottmani, Salah-Eddine; Scherpbier, Robert W

    2008-09-01

    The Practical Approach to Lung Health in South Africa (PALSA) initiative aimed to develop an integrated symptom- and sign-based (syndromic) respiratory disease guideline for nurse care practitioners working in primary care in a developing country. A multidisciplinary team developed the guideline after reviewing local barriers to respiratory health care provision, relevant health care policies, existing respiratory guidelines, and literature. Guideline drafts were evaluated by means of focus group discussions. Existing evidence-based guideline development methodologies were tailored for development of the guideline. A locally-applicable guideline based on syndromic diagnostic algorithms was developed for the management of patients 15 years and older who presented to primary care facilities with cough or difficulty breathing. PALSA has developed a guideline that integrates and presents diagnostic and management recommendations for priority respiratory diseases in adults using a symptom- and sign-based algorithmic guideline for nurses in developing countries.

  13. Integrated photoacoustic, ultrasound and fluorescence platform for diagnostic medical imaging-proof of concept study with a tissue mimicking phantom.

    PubMed

    James, Joseph; Murukeshan, Vadakke Matham; Woh, Lye Sun

    2014-07-01

    The structural and molecular heterogeneities of biological tissues demand the interrogation of the samples with multiple energy sources and provide visualization capabilities at varying spatial resolution and depth scales for obtaining complementary diagnostic information. A novel multi-modal imaging approach that uses optical and acoustic energies to perform photoacoustic, ultrasound and fluorescence imaging at multiple resolution scales from the tissue surface and depth is proposed in this paper. The system comprises of two distinct forms of hardware level integration so as to have an integrated imaging system under a single instrumentation set-up. The experimental studies show that the system is capable of mapping high resolution fluorescence signatures from the surface, optical absorption and acoustic heterogeneities along the depth (>2cm) of the tissue at multi-scale resolution (<1µm to <0.5mm).

  14. Moving forward in plant food safety and security through NanoBioSensors: Adopt or adapt biomedical technologies?

    PubMed

    Sharma, Tarun K; Ramanathan, Rajesh; Rakwal, Randeep; Agrawal, Ganesh K; Bansal, Vipul

    2015-05-01

    Plant-based foods are integral part of our day-to-day diet. Increasing world population has put forth an ever increasing demand for plant-based foods, and food security remains a major concern. Similarly, biological, chemical, and physical threats to our food and increasing regulatory demands to control the presence of foreign species in food products have made food safety a growing issue. Nanotechnology has already established its roots in diverse disciplines. However, the food industry is yet to harness the full potential of the unique capabilities offered by this next-generation technology. While there might be safety concerns in regards to integration of nanoproducts with our food products, an aspect of nanotechnology that can make remarkable contribution to different elements of the food chain is the use of nanobiosensors and diagnostic platforms for monitoring food traceability, quality, safety, and nutritional value. This brings us to an important question that whether existing diagnostic platforms that have already been well developed for biomedical and clinical application are suitable for food industry or whether the demands of the food industry are altogether different that may not allow adoption/adaptation of the existing technology. This review is an effort to raise this important "uncomfortable" yet "timely" question. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  15. 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.

  16. Development of the FPI+ as facility science instrument for SOFIA cycle four observations

    NASA Astrophysics Data System (ADS)

    Pfüller, Enrico; Wiedemann, Manuel; Wolf, Jürgen; Krabbe, Alfred

    2016-08-01

    The Stratospheric Observatory for Infrared Astronomy (SOFIA) is a heavily modified Boeing 747SP aircraft, accommodating a 2.5m infrared telescope. This airborne observation platform takes astronomers to flight altitudes of up to 13.7 km (45,000ft) and therefore allows an unobstructed view of the infrared universe at wavelengths between 0.3 m and 1600 m. SOFIA is currently completing its fourth cycle of observations and utilizes eight different imaging and spectroscopic science instruments. New instruments for SOFIAs cycle 4 observations are the High-resolution Airborne Wideband Camera-plus (HAWC+) and the Focal Plane Imager (FPI+). The latter is an integral part of the telescope assembly and is used on every SOFIA flight to ensure precise tracking on the desired targets. The FPI+ is used as a visual-light photometer in its role as facility science instrument. Since the upgrade of the FPI camera and electronics in 2013, it uses a thermo-electrically cooled science grade EM-CCD sensor inside a commercial-off-the-shelf Andor camera. The back-illuminated sensor has a peak quantum efficiency of 95% and the dark current is as low as 0.01 e-/pix/sec. With this new hardware the telescope has successfully tracked on 16th magnitude stars and thus the sky coverage, e.g. the area of sky that has suitable tracking stars, has increased to 99%. Before its use as an integrated tracking imager, the same type of camera has been used as a standalone diagnostic tool to analyze the telescope pointing stability at frequencies up to 200 Hz (imaging with 400 fps). These measurements help to improve the telescope pointing control algorithms and therefore reduce the image jitter in the focal plane. Science instruments benefit from this improvement with smaller image sizes for longer exposure times. The FPI has also been used to support astronomical observations like stellar occultations by the dwarf planet Pluto and a number of exoplanet transits. Especially the observation of the occultation events benefits from the high camera sensitivity, fast readout capability and the low read noise and it was possible to achieve high time resolution on the photometric light curves. This paper will give an overview of the development from the standalone diagnostic camera to the upgraded guiding/tracking camera, fully integrated into the telescope, while still offering the diagnostic capabilities and finally to the use as a facility science instrument on SOFIA.

  17. Microfluidic immunosensor with integrated liquid core waveguides for sensitive Mie scattering detection of avian influenza antigens in a real biological matrix.

    PubMed

    Heinze, Brian C; Gamboa, Jessica R; Kim, Keesung; Song, Jae-Young; Yoon, Jeong-Yeol

    2010-11-01

    This work presents the use of integrated, liquid core, optical waveguides for measuring immunoagglutination-induced light scattering in a microfluidic device, towards rapid and sensitive detection of avian influenza (AI) viral antigens in a real biological matrix (chicken feces). Mie scattering simulations were performed and tested to optimize the scattering efficiency of the device through proper scatter angle waveguide geometry. The detection limit is demonstrated to be 1 pg mL(-1) in both clean buffer and real biological matrix. This low detection limit is made possible through on-chip diffusional mixing of AI target antigens and high acid content microparticle assay reagents, coupled with real-time monitoring of immunoagglutination-induced forward Mie scattering via high refractive index liquid core optical waveguides in close proximity (100 μm) to the sample chamber. The detection time for the assay is <2 min. This device could easily be modified to detect trace levels of any biological molecules that antibodies are available for, moving towards a robust platform for point-of-care disease diagnostics.

  18. Single n+-i-n+ InP nanowires for highly sensitive terahertz detection.

    PubMed

    Peng, Kun; Parkinson, Patrick; Gao, Qian; Boland, Jessica L; Li, Ziyuan; Wang, Fan; Mokkapati, Sudha; Fu, Lan; Johnston, Michael B; Tan, Hark Hoe; Jagadish, Chennupati

    2017-03-24

    Developing single-nanowire terahertz (THz) electronics and employing them as sub-wavelength components for highly-integrated THz time-domain spectroscopy (THz-TDS) applications is a promising approach to achieve future low-cost, highly integrable and high-resolution THz tools, which are desirable in many areas spanning from security, industry, environmental monitoring and medical diagnostics to fundamental science. In this work, we present the design and growth of n + -i-n + InP nanowires. The axial doping profile of the n + -i-n + InP nanowires has been calibrated and characterized using combined optical and electrical approaches to achieve nanowire devices with low contact resistances, on which the highly-sensitive InP single-nanowire photoconductive THz detectors have been demonstrated. While the n + -i-n + InP nanowire detector has a only pA-level response current, it has a 2.5 times improved signal-to-noise ratio compared with the undoped InP nanowire detector and is comparable to traditional bulk THz detectors. This performance indicates a promising path to nanowire-based THz electronics for future commercial applications.

  19. Measures to Improve Diagnostic Safety in Clinical Practice.

    PubMed

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

    2016-10-20

    Timely and accurate diagnosis is foundational to good clinical practice and an essential first step to achieving optimal patient outcomes. However, a recent Institute of Medicine report concluded that most of us will experience at least one diagnostic error in our lifetime. The report argues for efforts to improve the reliability of the diagnostic process through better measurement of diagnostic performance. The diagnostic process is a dynamic team-based activity that involves uncertainty, plays out over time, and requires effective communication and collaboration among multiple clinicians, diagnostic services, and the patient. Thus, it poses special challenges for measurement. In this paper, we discuss how the need to develop measures to improve diagnostic performance could move forward at a time when the scientific foundation needed to inform measurement is still evolving. We highlight challenges and opportunities for developing potential measures of "diagnostic safety" related to clinical diagnostic errors and associated preventable diagnostic harm. In doing so, we propose a starter set of measurement concepts for initial consideration that seem reasonably related to diagnostic safety and call for these to be studied and further refined. This would enable safe diagnosis to become an organizational priority and facilitate quality improvement. Health-care systems should consider measurement and evaluation of diagnostic performance as essential to timely and accurate diagnosis and to the reduction of preventable diagnostic harm.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

  20. Spiral Bevel Gear Damage Detection Using Decision Fusion Analysis

    NASA Technical Reports Server (NTRS)

    Dempsey, Paula J.; Handschuh, Robert F.; Afjeh, Abdollah A.

    2002-01-01

    A diagnostic tool for detecting damage to spiral bevel gears was developed. Two different monitoring technologies, oil debris analysis and vibration, were integrated using data fusion into a health monitoring system for detecting surface fatigue pitting damage on gears. This integrated system showed improved detection and decision-making capabilities as compared to using individual monitoring technologies. This diagnostic tool was evaluated by collecting vibration and oil debris data from fatigue tests performed in the NASA Glenn Spiral Bevel Gear Fatigue Rigs. Data was collected during experiments performed in this test rig when pitting damage occurred. Results show that combining the vibration and oil debris measurement technologies improves the detection of pitting damage on spiral bevel gears.

  1. Intellectual property considerations for molecular diagnostic development with emphasis on companion diagnostics.

    PubMed

    Glorikian, Harry; Warburg, Richard Jeremy; Moore, Kelly; Malinowski, Jennifer

    2018-02-01

    The development of molecular diagnostics is a complex endeavor, with multiple regulatory pathways to consider and numerous approaches to development and commercialization. Companion diagnostics, devices which are "essential for the safe and effective use of a corresponding drug or diagnostic product" (see U.S. Food & Drug Administration, In Vitro Diagnostics - Companion Diagnostics, U.S. Dept. of Health & Human Services(2016), available at https://www.fda.gov/medicaldevices/productsandmedicalprocedures/invitrodiagnostics/ucm407297.htm ) and complementary diagnostics, which are more broadly associated with a class of drug, are becoming increasingly important as integral components of the implementation of precision medicine. Areas covered: The following article will highlight the intellectual property ('IP') considerations pertinent to molecular diagnostics development with special emphasis on companion diagnostics. Expert opinion/commentary Summary: For all molecular diagnostics, intellectual property (IP) concerns are of paramount concern, whether the device will be marketed only in the United States or abroad. Taking steps to protect IP at each stage of product development is critical to optimize profitability of a diagnostic product. Also the legal framework around IP protection of diagnostic technologies has been changing over the previous few years and can be expected to continue to change in the foreseeable near future, thus, a comprehensive IP strategy should take into account the fact that changes in the law can be expected.

  2. Early sensory over-responsivity in toddlers with autism spectrum disorders as a predictor of family impairment and parenting stress.

    PubMed

    Ben-Sasson, A; Soto, T W; Martínez-Pedraza, F; Carter, A S

    2013-08-01

    Sensory over-responsivity (SOR) affects many individuals with autism spectrum disorders (ASD), often leading to stressful encounters during daily routines. This study describes the associations between early SOR symptoms and the longitudinal course of restrictions in family life activities and parenting stress across three time-points in families raising a child with ASD (n = 174). Covariates were child diagnostic severity, emotional problems, and maternal affective symptoms. At time 1 mean chronological age was 28.5 months. Children were administered the Autism Diagnostic Observation Schedule (ADOS) and Mullen Scales of Early Learning (MSEL). Parents completed the Infant Toddler Sensory Profile (ITSP), Infant-Toddler Social Emotional Assessment (ITSEA), Beck Anxiety Index (BAI), and the Center for Epidemiologic Studies Depression Inventory (CES-D) at time 1; and the Parenting Stress Index (PSI) and Family Life Impairment Scale (FLIS) at the three annual time-points. Latent Growth Curve Models indicated that higher SOR scores on the ITSP at time 1 were associated with higher initial levels of family life impairment and parenting stress and with a smaller magnitude of change over time. These associations were independent of severity of ADOS social-communication symptoms, MSEL composite score, ITSEA externalizing and anxiety symptoms, and maternal affective symptoms as measured by the BAI and CES-D. On average FLIS and PSI did not change over time, however, there was significant individual variability. Concurrently, SOR at time 1 explained 39-45% of the variance in family stress and impairment variables. An evaluation of SOR should be integrated into the assessment of toddlers with ASD considering their role in family life impairment and stress. © 2013 The Authors. Journal of Child Psychology and Psychiatry © 2013 Association for Child and Adolescent Mental Health.

  3. MR imaging of silicone breast implants: evaluation of prospective and retrospective interpretations and interobserver agreement.

    PubMed

    Quinn, S F; Neubauer, N M; Sheley, R C; Demlow, T A; Szumowski, J

    1996-01-01

    MR imaging was used to evaluate the integrity of silicone breast implants in 54 women with 108 implants. MR images were interpreted by relatively inexperienced readers who tried to reproduce the experiences reported in the literature. The study examines the interobserver agreement using different diagnostic signs and the influence of experience on interpretation errors. Prospective and retrospective interpretations were compared with surgical findings at the time of explanation. Diagnostic indicators, including the linguine sign, the inverted tear drop sign, the C sign, water droplets mixed with silicone, and extracapsular globules of silicone, were evaluated for diagnostic efficacy and interobserver agreement. The prospective sensitivity and specificity were 87% and 78%, respectively. With the retrospective interpretations, the sensitivity and specificity increased to 93% and 92%, respectively. Most of the prospective false-positive interpretations were due to misinterpreting radial folds as signs of implant rupture. Six implants interpreted retrospectively as false positives had gross amounts of silicone around the implants at surgery but there were no obvious rents in the implant shells. There was fair to excellent interobserver agreement with the individual diagnostic signs except for extracapsular globules of silicone. All of the signs had specificities of greater than 90%. The sensitivities of the individual signs were less than the overall retrospective sensitivity. With experience, the sensitivity improved from 87% to 93% and the specificity improved from 78% to 92%. This study helps substantiate the use of diagnostic signs used by other authors to detect silicone loss from breast implants by MR imaging; however, questions remain as to the clinical role of MR imaging in evaluating implants for silicone loss.

  4. White Paper: Movement System Diagnoses in Neurologic Physical Therapy.

    PubMed

    Hedman, Lois D; Quinn, Lori; Gill-Body, Kathleen; Brown, David A; Quiben, Myla; Riley, Nora; Scheets, Patricia L

    2018-04-01

    The APTA recently established a vision for physical therapists to transform society by optimizing movement to promote health and wellness, mitigate impairments, and prevent disability. An important element of this vision entails the integration of the movement system into the profession, and necessitates the development of movement system diagnoses by physical therapists. At this point in time, the profession as a whole has not agreed upon diagnostic classifications or guidelines to assist in developing movement system diagnoses that will consistently capture an individual's movement problems. We propose that, going forward, diagnostic classifications of movement system problems need to be developed, tested, and validated. The Academy of Neurologic Physical Therapy's Movement System Task Force was convened to address these issues with respect to management of movement system problems in patients with neurologic conditions. The purpose of this article is to report on the work and recommendations of the Task Force. The Task Force identified 4 essential elements necessary to develop and implement movement system diagnoses for patients with primarily neurologic involvement from existing movement system classifications. The Task Force considered the potential impact of using movement system diagnoses on clinical practice, education and, research. Recommendations were developed and provided recommendations for potential next steps to broaden this discussion and foster the development of movement system diagnostic classifications. The Task Force proposes that diagnostic classifications of movement system problems need to be developed, tested, and validated with the long-range goal to reach consensus on and adoption of a movement system diagnostic framework for clients with neurologic injury or disease states.Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A198).

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

    PubMed

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

    2014-01-01

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

  6. Real-time label-free biosensing with integrated planar waveguide ring resonators

    NASA Astrophysics Data System (ADS)

    Sohlström, Hans; Gylfason, Kristinn B.; Hill, Daniel

    2010-05-01

    We review the use of planar integrated optical waveguide ring resonators for label free bio-sensing and present recent results from two European biosensor collaborations: SABIO and InTopSens. Planar waveguide ring resonators are attractive for label-free biosensing due to their small footprint, high Q-factors, and compatibility with on-chip optics and microfluidics. This enables integrated sensor arrays for compact labs-on-chip. One application of label-free sensor arrays is for point-of-care medical diagnostics. Bringing such powerful tools to the single medical practitioner is an important step towards personalized medicine, but requires addressing a number of issues: improving limit of detection, managing the influence of temperature, parallelization of the measurement for higher throughput and on-chip referencing, efficient light-coupling strategies to simplify alignment, and packaging of the optical chip and integration with microfluidics. From the SABIO project we report refractive index measurement and label-free biosensing in an 8-channel slotwaveguide ring resonator sensor array, within a compact cartridge with integrated microfluidics. The sensors show a volume sensing detection limit of 5 x 10-6 RIU and a surface sensing detection limit of 0.9 pg/mm2. From the InTopSens project we report early results on silicon-on-insulator racetrack resonators.

  7. The clinical benefits, ethics, and economics of stratified medicine and companion diagnostics.

    PubMed

    Trusheim, Mark R; Berndt, Ernst R

    2015-12-01

    The stratified medicine companion diagnostic (CDx) cut-off decision integrates scientific, clinical, ethical, and commercial considerations, and determines its value to developers, providers, payers, and patients. Competition already sharpens these issues in oncology, and might soon do the same for emerging stratified medicines in autoimmune, cardiovascular, neurodegenerative, respiratory, and other conditions. Of 53 oncology targets with a launched therapeutic, 44 have competing therapeutics. Only 12 of 141 Phase III candidates addressing new targets face no competition. CDx choices might alter competitive positions and reimbursement. Under current diagnostic incentives, payers see novel stratified medicines that improve public health and increase costs, but do not observe companion diagnostics for legacy treatments that would reduce costs. It would be in the interests of payers to rediscover their heritage of direct investment in diagnostic development. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. 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.

  9. A new SMART sensing system for aerospace structures

    NASA Astrophysics Data System (ADS)

    Zhang, David C.; Yu, Pin; Beard, Shawn; Qing, Peter; Kumar, Amrita; Chang, Fu-Kuo

    2007-04-01

    It is essential to ensure the safety and reliability of in-service structures such as unmanned vehicles by detecting structural cracking, corrosion, delamination, material degradation and other types of damage in time. Utilization of an integrated sensor network system can enable automatic inspection of such damages ultimately. Using a built-in network of actuators and sensors, Acellent is providing tools for advanced structural diagnostics. Acellent's integrated structural health monitoring system consists of an actuator/sensor network, supporting signal generation and data acquisition hardware, and data processing, visualization and analysis software. This paper describes the various features of Acellent's latest SMART sensing system. The new system is USB-based and is ultra-portable using the state-of-the-art technology, while delivering many functions such as system self-diagnosis, sensor diagnosis, through-transmission mode and pulse-echo mode of operation and temperature measurement. Performance of the new system was evaluated for assessment of damage in composite structures.

  10. The NeuroDevNet Autism Spectrum Disorders Demonstration Project.

    PubMed

    Zwaigenbaum, Lonnie; Scherer, Stephen; Szatmari, Peter; Fombonne, Eric; Bryson, Susan E; Hyde, Krista; Anagnostou, Evdokia; Anognostou, Evdokia; Brian, Jessica; Evans, Alan; Hall, Geoff; Nicholas, David; Roberts, Wendy; Smith, Isabel; Vaillancourt, Tracy; Volden, Joanne

    2011-03-01

    The NeuroDevNet Autism Spectrum Disorder Demonstration Project interfaces at many levels with the network's research themes and priorities. Our interdisciplinary team aims to improve understanding of genetic factors underlying vulnerability to autism spectrum disorders (ASDs) to develop better diagnostic strategies and, ultimately, to pinpoint molecular pathways relevant to developing biologically based treatments. Linking our existing longitudinal ASD cohorts with both genetics and neuroimaging studies will provide, for the first time, integrated data on how the genetic variation influences brain and behavioral development in ASD. Importantly, as our science progresses and we translate this information to the health care system, we will also educate policy makers, media, and business, so an informed society is prepared to capitalize on new genomic advances and effectively integrate these into health services for the broader community. We believe that this research has the potential to transform assessment and care for individuals with ASD. Copyright © 2011 Elsevier Inc. All rights reserved.

  11. eHXI: A permanently installed, hard x-ray imager for the National Ignition Facility

    DOE PAGES

    Doppner, T.; Bachmann, B.; Albert, F.; ...

    2016-06-14

    We have designed and built a multi-pinhole imaging system for high energy x-rays (≥ 50 keV) that is permanently installed in the equatorial plane outside of the target chamber at the National Ignition Facility (NIF). It records absolutely-calibrated, time-integrated x-ray images with the same line-of-sight as the multi-channel, spatially integrating hard x-ray detector FFLEX [McDonald et al., Rev. Sci. Instrum. 75 (2004) 3753], having a side view of indirect-drive inertial confinement fusion (ICF) implosion targets. The equatorial hard x-ray imager (eHXI) has recorded images on the majority of ICF implosion experiments since May 2011. Lastly, eHXI provides valuable information onmore » hot electron distribution in hohlraum experiments, target alignment, potential hohlraum drive asymmetries and serves as a long term reference for the FFLEX diagnostics.« less

  12. Natural Variability and Anthropogenic Trends in the Ocean Carbon Sink

    NASA Astrophysics Data System (ADS)

    McKinley, Galen A.; Fay, Amanda R.; Lovenduski, Nicole S.; Pilcher, Darren J.

    2017-01-01

    Since preindustrial times, the ocean has removed from the atmosphere 41% of the carbon emitted by human industrial activities. Despite significant uncertainties, the balance of evidence indicates that the globally integrated rate of ocean carbon uptake is increasing in response to increasing atmospheric CO2 concentrations. The El Niño-Southern Oscillation in the equatorial Pacific dominates interannual variability of the globally integrated sink. Modes of climate variability in high latitudes are correlated with variability in regional carbon sinks, but mechanistic understanding is incomplete. Regional sink variability, combined with sparse sampling, means that the growing oceanic sink cannot yet be directly detected from available surface data. Accurate and precise shipboard observations need to be continued and increasingly complemented with autonomous observations. These data, together with a variety of mechanistic and diagnostic models, are needed for better understanding, long-term monitoring, and future projections of this critical climate regulation service.

  13. Attachment, loss, and complicated grief.

    PubMed

    Shear, Katherine; Shair, Harry

    2005-11-01

    Bereavement is a highly disruptive experience that is usually followed by a painful but time-limited period of acute grief. An unfortunate minority of individuals experience prolonged and impairing complicated grief, an identifiable syndrome that differs from usual grief, major depression, and other DSM IV diagnostic entities. Underlying processes guiding symptoms are not well understood for either usual or complicated grief. We propose a provisional model of bereavement, guided by Myron Hofer's question "What exactly is lost when a loved one dies?" We integrate insights about biobehavioral regulation from Hofer's animal studies of infant separation, research on adult human attachment, and new ideas from bereavement research. In this model, death of an attachment figure produces a state of traumatic loss and symptoms of acute grief. These symptoms usually resolve following revision of the internalized representation of the deceased to incorporate the reality of the death. Failure to accomplish this integration results in the syndrome of complicated grief. Copyright 2005 Wiley Periodicals, Inc.

  14. First results from the Wendelstein 7-X Phase Contrast Imaging Diagnostic

    NASA Astrophysics Data System (ADS)

    Edlund, Eric; Porkolab, Miklos; Grulke, Olaf; von Stechow, Adrian; Böttger, Lukas-Georg

    2017-10-01

    Experiments in the first W7-X campaign achieved conditions of Te > 8 keV, Ti > 2 keV and line-integrated densities of 3 ×1019 m-2, with energy confinement times close to the ISS04 scaling at about 100 ms. The addition of an island divertor for the OP1.2 campaign is expected to lead to improved plasma performance. Experiments from this campaign will investigate the relative balance of neoclassical and turbulent transport of energy and particles and further test the ISS04 scaling. Gyrokinetic modeling indicates that there may be measurable differences in turbulence amplitude and quality as the mirror ratio and rotational transform of the magnetic geometry are changed. Among the new W7-X diagnostics is a Phase Contrast Imaging (PCI) system, a joint effort between MIT and IPP. The PCI diagnostic measures electron density fluctuations that may arise from turbulence or coherent modes. The system is capable of detecting fluctuations spanning a frequency range of about 1 kHz to 2 MHz, and wavenumbers of about 0.5 cm-1 to 30 cm-1, depending on the optical configuration. We present initial PCI measurements of turbulent fluctuations in relation to global system parameters. This work is supported by the US DOE under Grant Number DE-SC0014229.

  15. Profile of Instrumentation Laboratory's HemosIL® AcuStar HIT-Ab(PF4-H) assay for diagnosis of heparin-induced thrombocytopenia.

    PubMed

    Nagler, Michael; Cuker, Adam

    2017-05-01

    Immunoassays play an essential role in the diagnosis of heparin-induced thrombocytopenia (HIT). The objective of this article is to review HemosIL® AcuStar HIT-Ab(PF4-H) (Instrumentation Laboratory, Bedford, MA, USA), a new chemiluminescent immunoassay for HIT. Areas covered: The authors searched the published literature for evaluation studies of HemosIL® AcuStar HIT-Ab(PF4-H) and sought information from the manufacturer. In this paper, the authors discuss the analytical principle and technical aspects of the assay; describe its diagnostic performance in validation studies; report on its reproducibility, cost-effectiveness, and regulatory status; and discuss the implications of the assay on clinical practice and means of integrating it in diagnostic pathways. HemosIL® AcuStar HIT-Ab(PF4-H) is compared with other rapid assays and widely used enzyme-linked immunoassays for the diagnosis of HIT. Expert commentary: HemosIL® AcuStar HIT-Ab(PF4-H) is automatable, can be performed 24 h per day, offers a rapid turnaround time, and appears to have favorable diagnostic accuracy, particularly at thresholds above that listed in the label. These advantages could lead to improved patient outcomes through rapid provision of results at the point of care, enhancing the accuracy of initial diagnosis.

  16. A rapid diagnostic workflow for cefotaxime-resistant Escherichia coli and Klebsiella pneumoniae detection from blood cultures by MALDI-TOF mass spectrometry.

    PubMed

    De Carolis, Elena; Paoletti, Silvia; Nagel, Domenico; Vella, Antonietta; Mello, Enrica; Palucci, Ivana; De Angelis, Giulia; D'Inzeo, Tiziana; Sanguinetti, Maurizio; Posteraro, Brunella; Spanu, Teresa

    2017-01-01

    Nowadays, the global spread of resistance to oxyimino-cephalosporins in Enterobacteriaceae implies the need for novel diagnostics that can rapidly target resistant organisms from these bacterial species. In this study, we developed and evaluated a Direct Mass Spectrometry assay for Beta-Lactamase (D-MSBL) that allows direct identification of (oxyimino)cephalosporin-resistant Escherichia coli or Klebsiella pneumoniae from positive blood cultures (BCs), by using the matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) technology. The D-MSBL assay was performed on 93 E. coli or K. pneumoniae growing BC samples that were shortly co-incubated with cefotaxime (CTX) as the indicator cephalosporin. Susceptibility and resistance defining peaks from the samples' mass spectra were analyzed by a novel algorithm for bacterial organism classification. The D-MSBL assay allowed discrimination between E. coli and K. pneumoniae that were resistant or susceptible to CTX with a sensitivity of 86.8% and a specificity of 98.2%. The proposed algorithm-based D-MSBL assay, if integrated in the routine laboratory diagnostic workflow, may be useful to enhance the establishment of appropriate antibiotic therapy and to control the threat of oxyimino-cephalosporin resistance in hospital.

  17. TH-E-201-01: Diagnostic Radiology Residents Physics Curriculum and Updates

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

    Sensakovic, W.

    The ABR Core Examination stresses integrating physics into real-world clinical practice and, accordingly, has shifted its focus from passive recall of facts to active application of physics principles. Physics education of radiology residents poses a challenge. The traditional method of didactic lectures alone is insufficient, yet it is difficult to incorporate physics teaching consistently into clinical rotations due to time constraints. Faced with this challenge, diagnostic medical physicists who teach radiology residents, have been thinking about how to adapt their teaching to the new paradigm, what to teach and meet expectation of the radiology resident and the radiology residency program.more » The proposed lecture attempts to discuss above questions. Newly developed diagnostic radiology residents physics curriculum by the AAPM Imaging Physics Curricula Subcommittee will be reviewed. Initial experience on hands-on physics teaching will be discussed. Radiology resident who will have taken the BAR Core Examination will share the expectation of physics teaching from a resident perspective. The lecture will help develop robust educational approaches to prepare radiology residents for safer and more effective lifelong practice. Learning Objectives: Learn updated physics requirements for radiology residents Pursue effective approaches to teach physics to radiology residents Learn expectation of physics teaching from resident perspective J. Zhang, This topic is partially supported by RSNA Education Scholar Grant.« less

  18. Analytical Protein Microarrays: Advancements Towards Clinical Applications

    PubMed Central

    Sauer, Ursula

    2017-01-01

    Protein microarrays represent a powerful technology with the potential to serve as tools for the detection of a broad range of analytes in numerous applications such as diagnostics, drug development, food safety, and environmental monitoring. Key features of analytical protein microarrays include high throughput and relatively low costs due to minimal reagent consumption, multiplexing, fast kinetics and hence measurements, and the possibility of functional integration. So far, especially fundamental studies in molecular and cell biology have been conducted using protein microarrays, while the potential for clinical, notably point-of-care applications is not yet fully utilized. The question arises what features have to be implemented and what improvements have to be made in order to fully exploit the technology. In the past we have identified various obstacles that have to be overcome in order to promote protein microarray technology in the diagnostic field. Issues that need significant improvement to make the technology more attractive for the diagnostic market are for instance: too low sensitivity and deficiency in reproducibility, inadequate analysis time, lack of high-quality antibodies and validated reagents, lack of automation and portable instruments, and cost of instruments necessary for chip production and read-out. The scope of the paper at hand is to review approaches to solve these problems. PMID:28146048

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

    PubMed Central

    2016-01-01

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

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

    PubMed

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

    2016-05-03

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

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