White-Nose Syndrome Disease Severity and a Comparison of Diagnostic Methods.

PubMed

McGuire, Liam P; Turner, James M; Warnecke, Lisa; McGregor, Glenna; Bollinger, Trent K; Misra, Vikram; Foster, Jeffrey T; Frick, Winifred F; Kilpatrick, A Marm; Willis, Craig K R

2016-03-01

White-nose syndrome is caused by the fungus Pseudogymnoascus destructans and has killed millions of hibernating bats in North America but the pathophysiology of the disease remains poorly understood. Our objectives were to (1) assess non-destructive diagnostic methods for P. destructans infection compared to histopathology, the current gold-standard, and (2) to evaluate potential metrics of disease severity. We used data from three captive inoculation experiments involving 181 little brown bats (Myotis lucifugus) to compare histopathology, quantitative PCR (qPCR), and ultraviolet fluorescence as diagnostic methods of P. destructans infection. To assess disease severity, we considered two histology metrics (wing area with fungal hyphae, area of dermal necrosis), P. destructans fungal load (qPCR), ultraviolet fluorescence, and blood chemistry (hematocrit, sodium, glucose, pCO2, and bicarbonate). Quantitative PCR was most effective for early detection of P. destructans, while all three methods were comparable in severe infections. Correlations among hyphae and necrosis scores, qPCR, ultraviolet fluorescence, blood chemistry, and hibernation duration indicate a multi-stage pattern of disease. Disruptions of homeostasis occurred rapidly in late hibernation. Our results provide valuable information about the use of non-destructive techniques for monitoring, and provide novel insight into the pathophysiology of white-nose syndrome, with implications for developing and implementing potential mitigation strategies.

FNA diagnostic value in patients with neck masses in two teaching hospitals in Iran.

PubMed

Saatian, Minoo; Badie, Banafsheh Moradmand; Shahriari, Sogol; Fattahi, Fahimeh; Rasoolinejad, Mehrnaz

2011-01-01

The FNA (fine needle aspiration) procedure is simple, inexpensive, available and a safe method for the diagnosis of a neck mass. FNA has numerous advantages over open surgical biopsies as an initial diagnostic tool; therefore we decided to compare the accuracy of this method with open biopsy. This retrospective as well as descriptive study comparing preoperative FNA results with existing data in the Pathology Department in Bu-Ali and Amir Alam Hospitals. Our study included 100 patients with neck masses of which 22 were thyroid masses, 31 were salivary gland masses, and 47 were other masses. Age ranged from 3 years to 80 years with the mean age of 42.6 years. There were 59 men and 41 women. The Sensitivity was 72%, Specificity 87%, PPV 85%, NPV 75% and diagnostic Accuracy 79%. In this study we had also 26% false negative and 15% false positive. FNA is a valuable diagnostic tool in the management of neck masses; also it has been used for staging and planning of treatment for the wide and metastatic malignancy. This technique reduces the need for more invasive and costly procedures. According to the high sensitivity and high accuracy in this study, FNA can be used as the first step of diagnoses test in neck masses.

Aptamer Database

PubMed Central

Lee, Jennifer F.; Hesselberth, Jay R.; Meyers, Lauren Ancel; Ellington, Andrew D.

2004-01-01

The aptamer database is designed to contain comprehensive sequence information on aptamers and unnatural ribozymes that have been generated by in vitro selection methods. Such data are not normally collected in ‘natural’ sequence databases, such as GenBank. Besides serving as a storehouse of sequences that may have diagnostic or therapeutic utility, the database serves as a valuable resource for theoretical biologists who describe and explore fitness landscapes. The database is updated monthly and is publicly available at http://aptamer.icmb.utexas.edu/. PMID:14681367

Balloon-assisted enteroscopy for suspected Meckel’s diverticulum and indefinite diagnostic imaging workup

PubMed Central

Gomes, Guilherme Francisco; Bonin, Eduardo Aimore; Noda, Rafael William; Cavazzola, Leandro Totti; Bartholomei, Thiago Ferreira

2016-01-01

Meckel’s diverticulum (MD) is estimated to affect 1%-2% of the general population, and it represents a clinically silent finding of a congenital anomaly in up to 85% of the cases. In adults, MD may cause symptoms, such as overt occult lower gastrointestinal bleeding. The diagnostic imaging workup includes computed tomography scan, magnetic resonance imaging enterography, technetium 99m scintigraphy (99mTc) using either labeled red blood cells or pertechnetate (known as the Meckel’s scan) and angiography. The preoperative detection rate of MD in adults is low, and many patients ultimately undergo exploratory laparoscopy. More recently, however, endoscopic identification of MD has been possible with the use of balloon-assisted enteroscopy via direct luminal access, which also provides visualization of the diverticular ostium. The aim of this study was to review the diagnosis by double-balloon enteroscopy of 4 adults with symptomatic MD but who had negative diagnostic imaging workups. These cases indicate that balloon-assisted enteroscopy is a valuable diagnostic method and should be considered in adult patients who have suspected MD and indefinite findings on diagnostic imaging workup, including negative Meckel’s scan. PMID:27803776

Optical coherence tomography in dermatology

NASA Astrophysics Data System (ADS)

Sattler, Elke; Kästle, Raphaela; Welzel, Julia

2013-06-01

Optical coherence tomography (OCT) is a noninvasive diagnostic method that offers a view into the superficial layers of the skin in vivo in real-time. An infrared broadband light source allows the investigation of skin architecture and changes up to a depth of 1 to 2 mm with a resolution between 15 and 3 μm, depending on the system used. Thus OCT enables evaluation of skin lesions, especially nonmelanoma skin cancers and inflammatory diseases, quantification of skin changes, visualization of parasitic infestations, and examination of other indications such as the investigation of nails. OCT provides a quick and useful diagnostic imaging technique for a number of clinical questions and is a valuable addition or complement to other noninvasive imaging tools such as dermoscopy, high-frequency ultrasound, and confocal laser scan microscopy.

[Manual-medical differential diagnosis of low back pain including osteopathic procedures].

PubMed

Buchmann, J; Arens, U; Harke, G; Smolenski, U C; Kayser, R

2012-06-01

The differential diagnostic evaluation of painful functional disorders of the lumbosacral and lumbopelvic region, i. e. the so-called “low back pain” is very extensive, but is often reduced to the question of chronicity. The manual medical diagnosis can make a valuable contribution in such cases for determination of structural and functional pathology. Early application of manual medical therapies seems to be effective for peracute complaints. The mobilization of restrictions of the pelvic visceral attachments should be included. In the following review manual medical syndromes are presented that summarize the findings from the musculoskeletal and visceral system. This is intended to facilitate the primary differential diagnostic evaluation, as well as treatment planning. The combination with osteopathic methods is very profitable. A necessary specialist differential diagnosis remains essential.

Molecular testing for clinical diagnosis and epidemiological investigations of intestinal parasitic infections.

PubMed

Verweij, Jaco J; Stensvold, C Rune

2014-04-01

Over the past few decades, nucleic acid-based methods have been developed for the diagnosis of intestinal parasitic infections. Advantages of nucleic acid-based methods are numerous; typically, these include increased sensitivity and specificity and simpler standardization of diagnostic procedures. DNA samples can also be stored and used for genetic characterization and molecular typing, providing a valuable tool for surveys and surveillance studies. A variety of technologies have been applied, and some specific and general pitfalls and limitations have been identified. This review provides an overview of the multitude of methods that have been reported for the detection of intestinal parasites and offers some guidance in applying these methods in the clinical laboratory and in epidemiological studies.

Molecular Testing for Clinical Diagnosis and Epidemiological Investigations of Intestinal Parasitic Infections

PubMed Central

Stensvold, C. Rune

2014-01-01

SUMMARY Over the past few decades, nucleic acid-based methods have been developed for the diagnosis of intestinal parasitic infections. Advantages of nucleic acid-based methods are numerous; typically, these include increased sensitivity and specificity and simpler standardization of diagnostic procedures. DNA samples can also be stored and used for genetic characterization and molecular typing, providing a valuable tool for surveys and surveillance studies. A variety of technologies have been applied, and some specific and general pitfalls and limitations have been identified. This review provides an overview of the multitude of methods that have been reported for the detection of intestinal parasites and offers some guidance in applying these methods in the clinical laboratory and in epidemiological studies. PMID:24696439

Advanced Diagnostics for the Study of Linearly Polarized Emission. II. Application to Diffuse Interstellar Radio Synchrotron Emission

NASA Astrophysics Data System (ADS)

Herron, C. A.; Burkhart, Blakesley; Gaensler, B. M.; Lewis, G. F.; McClure-Griffiths, N. M.; Bernardi, G.; Carretti, E.; Haverkorn, M.; Kesteven, M.; Poppi, S.; Staveley-Smith, L.

2018-03-01

Diagnostics of polarized emission provide us with valuable information on the Galactic magnetic field and the state of turbulence in the interstellar medium, which cannot be obtained from synchrotron intensity alone. In Paper I, we derived polarization diagnostics that are rotationally and translationally invariant in the Q–U plane, similar to the polarization gradient. In this paper, we apply these diagnostics to simulations of ideal magnetohydrodynamic turbulence that have a range of sonic and Alfvénic Mach numbers. We generate synthetic images of Stokes Q and U for these simulations for the cases where the turbulence is illuminated from behind by uniform polarized emission and where the polarized emission originates from within the turbulent volume. From these simulated images, we calculate the polarization diagnostics derived in Paper I for different lines of sight relative to the mean magnetic field and for a range of frequencies. For all of our simulations, we find that the polarization gradient is very similar to the generalized polarization gradient and that both trace spatial variations in the magnetoionic medium for the case where emission originates within the turbulent volume, provided that the medium is not supersonic. We propose a method for distinguishing the cases of emission coming from behind or within a turbulent, Faraday rotating medium and a method to partly map the rotation measure of the observed region. We also speculate on statistics of these diagnostics that may allow us to constrain the physical properties of an observed turbulent region.

Diagnosing periprosthetic joint infection: has the era of the biomarker arrived?

PubMed

Deirmengian, Carl; Kardos, Keith; Kilmartin, Patrick; Cameron, Alexander; Schiller, Kevin; Parvizi, Javad

2014-11-01

The diagnosis of periprosthetic joint infection (PJI) remains a serious clinical challenge. There is a pressing need for improved diagnostic testing methods; biomarkers offer one potentially promising approach. We evaluated the diagnostic characteristics of 16 promising synovial fluid biomarkers for the diagnosis of PJI. Synovial fluid was collected from 95 patients meeting the inclusion criteria of this prospective diagnostic study. All patients were being evaluated for a revision hip or knee arthroplasty, including patients with systemic inflammatory disease and those already receiving antibiotic treatment. The Musculoskeletal Infection Society (MSIS) definition was used to classify 29 PJIs and 66 aseptic joints. Synovial fluid samples were tested by immunoassay for 16 biomarkers optimized for use in synovial fluid. Sensitivity, specificity, and receiver operating characteristic curve analysis were performed to assess for diagnostic performance. Five biomarkers, including human α-defensin 1-3, neutrophil elastase 2, bactericidal/permeability-increasing protein, neutrophil gelatinase-associated lipocalin, and lactoferrin, correctly predicted the MSIS classification of all patients in this study, with 100% sensitivity and specificity for the diagnosis of PJI. An additional eight biomarkers demonstrated excellent diagnostic strength, with an area under the curve of greater than 0.9. Synovial fluid biomarkers exhibit a high accuracy in diagnosing PJI, even when including patients with systemic inflammatory disease and those receiving antibiotic treatment. Considering that these biomarkers match the results of the more complex MSIS definition of PJI, we believe that synovial fluid biomarkers can be a valuable addition to the methods utilized for the diagnosis of infection. Level II, diagnostic study. See Instructions for Authors for a complete description of levels of evidence.

[Comparative study of diagnostic methods for visceral leishmaniasis in dogs from Ilha Solteira, SP].

PubMed

de Assis, Juliana; de Queiroz, Nina Marí Gual Pimenta; da Silveira, Rita de Cássia Vieira; Nunes, Cáris Maroni; Oliveira, Trícia Maria Ferreira de Sousa; Junior, Antonio Carlos Faconti de Noronha; Neves, Maria Francisca; Machado, Rosangela Zacarias; Buzetti, Wilma Aparecida Starke

2010-01-01

The purpose of the present work was a comparative study of diagnostic methods for Canine Visceral Leishmaniasis (CVL) using serological methods, enzyme-linked immunosorbent assay (ELISA) and indirect fluorescent antibody test (IFAT), histochemical (HE) and immunohistochemical (IMHC) tests using spleen, lymph node and liver canine tissues. In addition, Polymerase Chain Reaction (PCR) was done in blood and in tissues in order to compare and confirm no conclusive and negative diagnosis by the methods above. For this study, 34 dogs were divided according to clinical signs in asymptomatic, oligosymptomatic and polisymptomatic Leishmania-infected dogs euthanized by Zoonotic Disease Control Center (CCZ) from Ilha Solteira, SP, Brazil. The positivism indexes of ELISA, IMHC, IFAT and HE were 65.0, 62.0, 56.0 and 56.0%, respectively with the highest numbers of positive dogs in polisymptomatic (92.0%) followed by oligosymptomatic (57.0%) and asymptomatic dogs (12.5%). Furthermore, PCR confirmed the positive results and detected DNA in tissues from 100% of negative dogs and 89.0% suspects raising the animal positivism index up to 97.0%. In conclusion, PCR was the most sensitive and a valuable method for a definitive CVL diagnosis.

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

PubMed Central

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

2015-01-01

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

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.

Monitoring the outcomes of interventions against Taenia solium: options and suggestions.

PubMed

Lightowlers, M W; Garcia, H H; Gauci, C G; Donadeu, M; Abela-Ridder, B

2016-03-01

There is an increasing interest in reducing the incidence of human neurocysticercosis, caused by infection with the larval stage of Taenia solium. Several intervention trials are currently assessing various options for control of T. solium transmission. A critical aspect of these trials will be the evaluation of whether the interventions have been successful. However, there is no consensus about the most appropriate or valuable methods that should be used. Here, we undertake a critical assessment of the diagnostic tests which are currently available for human T. solium taeniasis and human and porcine cysticercosis, as well as their suitability for evaluation of intervention trial outcomes. Suggestions are made about which of the measures that are available for evaluation of T. solium interventions would be most suitable, and which methodologies are the most appropriate given currently available technologies. Suggestions are also made in relation to the most urgent research needs in order to address deficiencies in current diagnostic methods. © 2015 The Authors. Parasite Immunology Published by John Wiley & Sons Ltd.

A real-time algorithm for the harmonic estimation and frequency tracking of dominant components in fusion plasma magnetic diagnostics

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

Alves, D.; Coelho, R.; Collaboration: JET-EFDA Contributors

2013-08-15

The real-time tracking of instantaneous quantities such as frequency, amplitude, and phase of components immerse in noisy signals has been a common problem in many scientific and engineering fields such as power systems and delivery, telecommunications, and acoustics for the past decades. In magnetically confined fusion research, extracting this sort of information from magnetic signals can be of valuable assistance in, for instance, feedback control of detrimental magnetohydrodynamic modes and disruption avoidance mechanisms by monitoring instability growth or anticipating mode-locking events. This work is focused on nonlinear Kalman filter based methods for tackling this problem. Similar methods have already provenmore » their merits and have been successfully employed in this scientific domain in applications such as amplitude demodulation for the motional Stark effect diagnostic. In the course of this work, three approaches are described, compared, and discussed using magnetic signals from the Joint European Torus tokamak plasma discharges for benchmarking purposes.« less

Investigation of Doppler spectra of laser radiation scattered inside hand skin during occlusion test

NASA Astrophysics Data System (ADS)

Kozlov, I. O.; Zherebtsov, E. A.; Zherebtsova, A. I.; Dremin, V. V.; Dunaev, A. V.

2017-11-01

Laser Doppler flowmetry (LDF) is a method widely used in diagnosis of microcirculation diseases. It is well known that information about frequency distribution of Doppler spectrum of the laser radiation scattered by moving red blood cells (RBC) usually disappears after signal processing procedure. Photocurrent’s spectrum distribution contains valuable diagnostic information about velocity distribution of the RBC. In this research it is proposed to compute the indexes of microcirculation in the sub-ranges of the Doppler spectrum as well as investigate the frequency distribution of the computed indexes.

Raman spectroscopic characterization of urine of normal and cervical cancer subjects

NASA Astrophysics Data System (ADS)

Pappu, Raja; Prakasarao, Aruna; Dornadula, Koteeswaran; Singaravelu, Ganesan

2017-02-01

Cervical cancer is the fourth most common malignancy in female worldwide; the present method for diagnosis is the biopsy, Pap smear, colposcopy etc. To overcome the drawbacks of diagnosis an alternative technique is required, optical spectroscopy is a new technique where the discrimination of normal and cancer subjects provides valuable potential information in the diagnostic oncology at an early stage. Raman peaks in the spectra suggest interesting differences in various bio molecules. In this regard, non invasive optical detection of cervical cancer using urine samples by Raman Spectroscopy combined with LDA diagnostic algorithm yields an accuracy of 100% for original and cross validated group respectively. As the results were appreciable it is necessary to carry out the analysis for more number of samples to explore the facts hidden at different stages during the development of cervical cancer.

On a gas electron multiplier based synthetic diagnostic for soft x-ray tomography on WEST with focus on impurity transport studies

NASA Astrophysics Data System (ADS)

Jardin, A.; Mazon, D.; Malard, P.; O'Mullane, M.; Chernyshova, M.; Czarski, T.; Malinowski, K.; Kasprowicz, G.; Wojenski, A.; Pozniak, K.

2017-08-01

The tokamak WEST aims at testing ITER divertor high heat flux component technology in long pulse operation. Unfortunately, heavy impurities like tungsten (W) sputtered from the plasma facing components can pollute the plasma core by radiation cooling in the soft x-ray (SXR) range, which is detrimental for the energy confinement and plasma stability. SXR diagnostics give valuable information to monitor impurities and study their transport. The WEST SXR diagnostic is composed of two new cameras based on the Gas Electron Multiplier (GEM) technology. The WEST GEM cameras will be used for impurity transport studies by performing 2D tomographic reconstructions with spectral resolution in tunable energy bands. In this paper, we characterize the GEM spectral response and investigate W density reconstruction thanks to a synthetic diagnostic recently developed and coupled with a tomography algorithm based on the minimum Fisher information (MFI) inversion method. The synthetic diagnostic includes the SXR source from a given plasma scenario, the photoionization, electron cloud transport and avalanche in the detection volume using Magboltz, and tomographic reconstruction of the radiation from the GEM signal. Preliminary studies of the effect of transport on the W ionization equilibrium and on the reconstruction capabilities are also presented.

Mass spectrometric profiling of low-molecular-weight volatile compounds--diagnostic potential and latest applications.

PubMed

Lechner, Matthias; Rieder, Josef

2007-01-01

The theoretical use of mass spectrometric profiling of low-molecular-weight volatile compounds, as one possible method to non-invasively and rapidly diagnose a variety of diseases, such as cancer, infection, and metabolic disorders has greatly raised the profile of this technique over the last ten years. Despite a number of promising results, this technique has not been introduced into common clinical practice yet. The use of mass spectrometric profiling of exhaled air is particularly hampered by various technical problems and basic methodological issues which have only been partially overcome. However, breath analysis aside, recently published studies reveal completely new ideas and concepts on how to establish fast and reliable diagnosis by using this valuable tool. These studies focussed on the headspace screening of various bodily fluids and sample fluids obtained during diagnostic procedures, as well as microbial cell cultures and demonstrated the vast diagnostic potential of this technique in a wide variety of settings, predominantly in vitro. It is the aim of the present review to discuss the most commonly detected low-molecular-weight volatile compounds and to summarize the current potential applications, latest developments and future perspectives of this promising diagnostic approach.

Development of Molecular Methods to Detect Macrophomina phaseolina from Strawberry Plants and Soil.

PubMed

Burkhardt, Alyssa; Ramon, Marina L; Smith, Brett; Koike, Steven T; Martin, Frank N

2018-06-05

Macrophomina phaseolina is a broad-host range fungus that shows some degree of host preference on strawberry, and causes symptoms including crown rot and root rot. Recently, this pathogen has impacted strawberry production as fumigation practices have changed, leaving many growers in California and around the world in need of accurate, rapid diagnostic tools for M. phaseolina in soil and infected plants. This study uses next-generation sequencing and comparative genomics to identify a locus that is unique to isolates within a main genotype shared by a majority of isolates that infect strawberry. This locus was used to develop a quantitative single-tube nested TaqMan qPCR assay which is able to quantify as little as 2-3 microsclerotia/g of soil with 100% genotype specificity. An isothermal assay using recombinase polymerase amplification (RPA) was developed from the same locus and has been validated on over 200 infected strawberry plants with a diagnostic sensitivity of 93% and a diagnostic specificity of 99%, respectively. Together, this work demonstrates the value of using new approaches to identify loci for detection and provides valuable diagnostic tools that can be used to monitor soil and strawberry plant samples for M. phaseolina.

The Diagnostic Value of the Vacuum Phenomenon during Hip Arthroscopy

PubMed Central

Rath, Ehud; Gortzak, Yair; Schwarzkopf, Ran; Benkovich, Vadim; Cohen, Eugene; Atar, Dan

2011-01-01

The diagnostic value of the vacuum phenomenon between the femoral head and the acetabulum, and time frame of its occurrence after application of traction is an important clinical question. The resulting arthrogram may outline the shape, location, and extent of cartilage lesions prior to arthroscopy of the hip joint. The presence, duration, and diagnostic information of the vacuum phenomenon were evaluated in 24 hips that underwent arthroscopy. The operative diagnosis was compared to the results of imaging studies and to findings obtained during a traction trial prior to arthroscopy. Indications for arthroscopy included avascular necrosis, labral tears, loose bodies, osteoarthrosis, and intractable hip pain. In 22 hips the vacuum phenomenon developed within 30 seconds after application of traction. The most important data obtained from the vacuum phenomenon was the location and extent of femoral head articular cartilage detachment and the presence of nonossified loose bodies. The vacuum phenomenon did not reveal labral or acetabular cartilage pathology in any of these patients. The vacuum phenomenon obtained during the trial of traction can add valuable information prior to hip arthroscopy. Femoral head articular cartilage detachment was best documented by this method. The hip arthroscopist should utilize this diagnostic window routinely prior to hip arthroscopy. PMID:24977068

The Diagnostic Value of the Vacuum Phenomenon during Hip Arthroscopy.

PubMed

Rath, Ehud; Gortzak, Yair; Schwarzkopf, Ran; Benkovich, Vadim; Cohen, Eugene; Atar, Dan

2011-01-01

The diagnostic value of the vacuum phenomenon between the femoral head and the acetabulum, and time frame of its occurrence after application of traction is an important clinical question. The resulting arthrogram may outline the shape, location, and extent of cartilage lesions prior to arthroscopy of the hip joint. The presence, duration, and diagnostic information of the vacuum phenomenon were evaluated in 24 hips that underwent arthroscopy. The operative diagnosis was compared to the results of imaging studies and to findings obtained during a traction trial prior to arthroscopy. Indications for arthroscopy included avascular necrosis, labral tears, loose bodies, osteoarthrosis, and intractable hip pain. In 22 hips the vacuum phenomenon developed within 30 seconds after application of traction. The most important data obtained from the vacuum phenomenon was the location and extent of femoral head articular cartilage detachment and the presence of nonossified loose bodies. The vacuum phenomenon did not reveal labral or acetabular cartilage pathology in any of these patients. The vacuum phenomenon obtained during the trial of traction can add valuable information prior to hip arthroscopy. Femoral head articular cartilage detachment was best documented by this method. The hip arthroscopist should utilize this diagnostic window routinely prior to hip arthroscopy.

Laboratory development and testing of spacecraft diagnostics

NASA Astrophysics Data System (ADS)

Amatucci, William; Tejero, Erik; Blackwell, Dave; Walker, Dave; Gatling, George; Enloe, Lon; Gillman, Eric

2017-10-01

The Naval Research Laboratory's Space Chamber experiment is a large-scale laboratory device dedicated to the creation of large-volume plasmas with parameters scaled to realistic space plasmas. Such devices make valuable contributions to the investigation of space plasma phenomena under controlled, reproducible conditions, allowing for the validation of theoretical models being applied to space data. However, in addition to investigations such as plasma wave and instability studies, such devices can also make valuable contributions to the development and testing of space plasma diagnostics. One example is the plasma impedance probe developed at NRL. Originally developed as a laboratory diagnostic, the sensor has now been flown on a sounding rocket, is included on a CubeSat experiment, and will be included on the DoD Space Test Program's STP-H6 experiment on the International Space Station. In this talk, we will describe how the laboratory simulation of space plasmas made this development path possible. Work sponsored by the US Naval Research Laboratory Base Program.

Narrowing of the Diagnostic Gap of Acute Gastroenteritis in Children 0-6 Years of Age Using a Combination of Classical and Molecular Techniques, Delivers Challenges in Syndromic Approach Diagnostics.

PubMed

Steyer, Andrej; Jevšnik, Monika; Petrovec, Miroslav; Pokorn, Marko; Grosek, Štefan; Fratnik Steyer, Adela; Šoba, Barbara; Uršič, Tina; Cerar Kišek, Tjaša; Kolenc, Marko; Trkov, Marija; Šparl, Petra; Duraisamy, Raja; Lipkin, W Ian; Terzić, Sara; Kolnik, Mojca; Mrvič, Tatjana; Kapoor, Amit; Strle, Franc

2016-09-01

Twenty-five percent to 50% of acute gastroenteritis (AGE) cases remain etiologically undiagnosed. Our main aim was to determine the most appropriate list of enteric pathogens to be included in the daily diagnostics scheme of AGE, ensuring the lowest possible diagnostic gap. Two hundred ninety seven children ≤6 years of age, admitted to hospital in Slovenia, October 2011 to October 2012, with AGE, and 88 ≤6 years old healthy children were included in the study. A broad spectrum of enteric pathogens was targeted with molecular methods, including 8 viruses, 6 bacteria and 2 parasites. At least one enteric pathogen was detected in 91.2% of cases with AGE and 27.3% of controls. Viruses were the most prevalent (82.5% and 15.9%), followed by bacteria (27.3% and 10.2%) and parasites (3.0% and 1.1%) in cases and controls, respectively. A high proportion (41.8%) of mixed infections was observed in the cases. For cases with undetermined etiology (8.8%), stool samples were analyzed with next generation sequencing, and a potential viral pathogen was detected in 17 additional samples (5.8%). Our study suggests that tests for rotaviruses, noroviruses genogroup II, adenoviruses 40/41, astroviruses, Campylobacter spp. and Salmonella sp. should be included in the initial diagnostic algorithm, which revealed the etiology in 83.5% of children tested. The use of molecular methods in diagnostics of gastroenteritis is preferable because of their high sensitivity, specificity, fast performance and the possibility of establishing the concentration of the target. The latter may be valuable for assessing the clinical significance of the detected enteric, particularly viral pathogens.

The Autogram: An effective approach for selecting the optimal demodulation band in rolling element bearings diagnosis

NASA Astrophysics Data System (ADS)

Moshrefzadeh, Ali; Fasana, Alessandro

2018-05-01

Envelope analysis is one of the most advantageous methods for rolling element bearing diagnostics but finding a suitable frequency band for demodulation has been a substantial challenge for a long time. Introduction of the Spectral Kurtosis (SK) and Kurtogram mostly solved this problem but in situations where signal to noise ratio is very low or in presence of non-Gaussian noise these methods will fail. This major drawback may noticeably decrease their effectiveness and goal of this paper is to overcome this problem. Vibration signals from rolling element bearings exhibit high levels of second-order cyclostationarity, especially in the presence of localized faults. The autocovariance function of a 2nd order cyclostationary signal is periodic and the proposed method, named Autogram, takes advantage of this property to enhance the conventional Kurtogram. The method computes the kurtosis of the unbiased Autocorrelation (AC) of the squared envelope of the demodulated signal, rather than the kurtosis of the filtered time signal. Moreover, to take advantage of unique features of the lower and upper portions of the AC, two modified forms of kurtosis are introduced and the resulting colormaps are called Upper and Lower Autogram. In addition, a thresholding method is also proposed to enhance the quality of the frequency spectrum analysis. A new indicator, Combined Squared Envelope Spectrum, is employed to consider all the frequency bands with valuable diagnostic information and to improve the fault detectability of the Autogram. The proposed method is tested on experimental data and compared with literature results so to assess its performances in rolling element bearing diagnostics.

Three-dimensional reconstruction of TMJ MR images: a technical note and case report.

PubMed

Kitai, Noriyuki; Eriksson, Lars; Kreiborg, Sven; Wagner, Aase; Takada, Kenji

2004-01-01

MR images of the temporomandibular joint at occlusion and at various stages of mouth opening were registered and reconstructed three-dimensionally before and after a modified condylotomy in a patient with painful disk displacement. Following the condylotomy, the condyle/disk relationship had become normalized in all three planes of space at closed mouth and during mouth opening. The post-operative distances of the condylar and diskal paths had increased when compared with the preoperative distances. The three-dimensional visualizing method may, besides providing diagnostic advantages, be a valuable tool for qualitative and quantitative documentation of the efficiency of different treatment methods for normalization of the disk/condyle relationship in patients with TMJ disk displacement.

Ultrasound-based elastography for the diagnosis of portal hypertension in cirrhotics

PubMed Central

Şirli, Roxana; Sporea, Ioan; Popescu, Alina; Dănilă, Mirela

2015-01-01

Progressive fibrosis is encountered in almost all chronic liver diseases. Its clinical signs are diagnostic in advanced cirrhosis, but compensated liver cirrhosis is harder to diagnose. Liver biopsy is still considered the reference method for staging the severity of fibrosis, but due to its drawbacks (inter and intra-observer variability, sampling errors, unequal distribution of fibrosis in the liver, and risk of complications and even death), non-invasive methods were developed to assess fibrosis (serologic and elastographic). Elastographic methods can be ultrasound-based or magnetic resonance imaging-based. All ultrasound-based elastographic methods are valuable for the early diagnosis of cirrhosis, especially transient elastography (TE) and acoustic radiation force impulse (ARFI) elastography, which have similar sensitivities and specificities, although ARFI has better feasibility. TE is a promising method for predicting portal hypertension in cirrhotic patients, but it cannot replace upper digestive endoscopy. The diagnostic accuracy of using ARFI in the liver to predict portal hypertension in cirrhotic patients is debatable, with controversial results in published studies. The accuracy of ARFI elastography may be significantly increased if spleen stiffness is assessed, either alone or in combination with liver stiffness and other parameters. Two-dimensional shear-wave elastography, the ElastPQ technique and strain elastography all need to be evaluated as predictors of portal hypertension. PMID:26556985

Verification of examination procedures in clinical laboratory for imprecision, trueness and diagnostic accuracy according to ISO 15189:2012: a pragmatic approach.

PubMed

Antonelli, Giorgia; Padoan, Andrea; Aita, Ada; Sciacovelli, Laura; Plebani, Mario

2017-08-28

Background The International Standard ISO 15189 is recognized as a valuable guide in ensuring high quality clinical laboratory services and promoting the harmonization of accreditation programmes in laboratory medicine. Examination procedures must be verified in order to guarantee that their performance characteristics are congruent with the intended scope of the test. The aim of the present study was to propose a practice model for implementing procedures employed for the verification of validated examination procedures already used for at least 2 years in our laboratory, in agreement with the ISO 15189 requirement at the Section 5.5.1.2. Methods In order to identify the operative procedure to be used, approved documents were identified, together with the definition of performance characteristics to be evaluated for the different methods; the examination procedures used in laboratory were analyzed and checked for performance specifications reported by manufacturers. Then, operative flow charts were identified to compare the laboratory performance characteristics with those declared by manufacturers. Results The choice of performance characteristics for verification was based on approved documents used as guidance, and the specific purpose tests undertaken, a consideration being made of: imprecision and trueness for quantitative methods; diagnostic accuracy for qualitative methods; imprecision together with diagnostic accuracy for semi-quantitative methods. Conclusions The described approach, balancing technological possibilities, risks and costs and assuring the compliance of the fundamental component of result accuracy, appears promising as an easily applicable and flexible procedure helping laboratories to comply with the ISO 15189 requirements.

Comparison of rapid diagnostic tests for the detection of Plasmodium vivax malaria in South Korea.

PubMed

Kim, Jung-Yeon; Ji, So-Young; Goo, Youn-Kyoung; Na, Byoung-Kuk; Pyo, Hyo-Joo; Lee, Han-Na; Lee, Juyoung; Kim, Nam Hee; von Seidlein, Lorenz; Cheng, Qin; Cho, Shin-Hyung; Lee, Won-Ja

2013-01-01

South Korea is one of many countries with endemic Plasmodium vivax malaria. Here we report the evaluation of four rapid diagnostic tests (RDTs) for diagnosis of this disease. A total of 253 subjects were enrolled in the study. The sensitivities, specificities and agreement frequencies were estimated by comparing the four RDTs against the standard of nested-PCR and microscopic examination. The CareStart(TM) and SD Bioline had higher test sensitivities (99.4 and 98.8%, respectively) compared with the NanoSign and Asan Easy tests (93.0 and 94.7%, respectively). The CareStart(TM) and SD Bioline tests could detect P. vivax in samples with parasite densities <150/μl, which was a slightly better performance than the other two RDTs. The quantitative accuracy of the four RDTs was also estimated by comparing results with P. vivax counts from blood samples. Lower test price would result in increased use of these RDTs in the field. The results of this study contribute valuable information that will aid in the selection of a diagnostic method for the detection of malaria.

Comparison of Rapid Diagnostic Tests for the Detection of Plasmodium vivax Malaria in South Korea

PubMed Central

Goo, Youn-Kyoung; Na, Byoung-Kuk; Pyo, Hyo-Joo; Lee, Han-Na; Lee, Juyoung; Kim, Nam Hee; von Seidlein, Lorenz; Cheng, Qin; Cho, Shin-Hyung; Lee, Won-Ja

2013-01-01

South Korea is one of many countries with endemic Plasmodium vivax malaria. Here we report the evaluation of four rapid diagnostic tests (RDTs) for diagnosis of this disease. A total of 253 subjects were enrolled in the study. The sensitivities, specificities and agreement frequencies were estimated by comparing the four RDTs against the standard of nested-PCR and microscopic examination. The CareStartTM and SD Bioline had higher test sensitivities (99.4 and 98.8%, respectively) compared with the NanoSign and Asan Easy tests (93.0 and 94.7%, respectively). The CareStartTM and SD Bioline tests could detect P. vivax in samples with parasite densities <150/μl, which was a slightly better performance than the other two RDTs. The quantitative accuracy of the four RDTs was also estimated by comparing results with P. vivax counts from blood samples. Lower test price would result in increased use of these RDTs in the field. The results of this study contribute valuable information that will aid in the selection of a diagnostic method for the detection of malaria. PMID:23667710

The Diagnostic Accuracy of Cytology for the Diagnosis of Hepatobiliary and Pancreatic Cancers.

PubMed

Al-Hajeili, Marwan; Alqassas, Maryam; Alomran, Astabraq; Batarfi, Bashaer; Basunaid, Bashaer; Alshail, Reem; Alaydarous, Shahad; Bokhary, Rana; Mosli, Mahmoud

2018-06-13

Although cytology testing is considered a valuable method to diagnose tumors that are difficult to access such as hepato-biliary-pancreatic (HBP) malignancies, its diagnostic accuracy remains unclear. We therefore aimed to investigate the diagnostic accuracy of cytology testing for HBP tumors. We performed a retrospective study of all cytology samples that were used to confirm radiologically detected HBP tumors between 2002 and 2016. The cytology techniques used in our center included fine needle aspiration (FNA), brush cytology, and aspiration of bile. Sensitivity, specificity, positive and negative predictive values, and likelihood ratios were calculated in comparison to histological confirmation. From a total of 133 medical records, we calculated an overall sensitivity of 76%, specificity of 74%, a negative likelihood ratio of 0.30, and a positive likelihood ratio of 2.9. Cytology was more accurate in diagnosing lesions of the liver (sensitivity 79%, specificity 57%) and biliary tree (sensitivity 100%, specificity 50%) compared to pancreatic (sensitivity 60%, specificity 83%) and gallbladder lesions (sensitivity 50%, specificity 85%). Cytology was more accurate in detecting primary cancers (sensitivity 77%, specificity 73%) when compared to metastatic cancers (sensitivity 73%, specificity 100%). FNA was the most frequently used cytological technique to diagnose HBP lesions (sensitivity 78.8%). Cytological testing is efficient in diagnosing HBP cancers, especially for hepatobiliary tumors. Given its relative simplicity, cost-effectiveness, and paucity of alternative diagnostic methods, cytology should still be considered as a first-line tool for diagnosing HBP malignancies. © 2018 S. Karger AG, Basel.

Detection of Lipid and Amphiphilic Biomarkers for Disease Diagnostics

PubMed Central

Vu, Dung M.; Mendez, Heather M.; Jakhar, Shailja; Mukundan, Harshini

2017-01-01

Rapid diagnosis is crucial to effectively treating any disease. Biological markers, or biomarkers, have been widely used to diagnose a variety of infectious and non-infectious diseases. The detection of biomarkers in patient samples can also provide valuable information regarding progression and prognosis. Interestingly, many such biomarkers are composed of lipids, and are amphiphilic in biochemistry, which leads them to be often sequestered by host carriers. Such sequestration enhances the difficulty of developing sensitive and accurate sensors for these targets. Many of the physiologically relevant molecules involved in pathogenesis and disease are indeed amphiphilic. This chemical property is likely essential for their biological function, but also makes them challenging to detect and quantify in vitro. In order to understand pathogenesis and disease progression while developing effective diagnostics, it is important to account for the biochemistry of lipid and amphiphilic biomarkers when creating novel techniques for the quantitative measurement of these targets. Here, we review techniques and methods used to detect lipid and amphiphilic biomarkers associated with disease, as well as their feasibility for use as diagnostic targets, highlighting the significance of their biochemical properties in the design and execution of laboratory and diagnostic strategies. The biochemistry of biological molecules is clearly relevant to their physiological function, and calling out the need for consideration of this feature in their study, and use as vaccine, diagnostic and therapeutic targets is the overarching motivation for this review. PMID:28677660

Diagnostic methods for mastitis in cows are not appropriate for use in humans: commentary.

PubMed

Kvist, Linda J

2016-01-01

Healthcare workers are now being targeted for marketing of diagnostic tools for mastitis that were developed for the dairy industry and which aim to provide information regarding choice of antibiotic treatment. Meanwhile, scientists are striving to understand how the human microbiome affects health and wellbeing and the importance of maintenance of bacterial balance in the human body. Breast milk supplies a multitude of bacteria to populate the baby's intestinal tract and kick-start the immune system. Researchers propose a paradigm shift in the understanding of bacterial content in breast milk and an alternative paradigm for the understanding of lactational mastitis: there is the beginning of evidence that many cases of lactational mastitis will resolve spontaneously. An international group of researchers is attempting to answer how dietary habits, birth mode, genetics and environmental factors may impact the bacterial content of breast milk. Until we have more comprehensive knowledge about the human milk microbiome, diagnostic aids for identification of women in need of antibiotic therapy for mastitis remain unreliable. Diagnostic aids could lead to the injudicious use of antibiotic therapy, which in turn may rob the infant of bacteria valuable for development of its immune system. The marketing of diagnostic aids for use in human medicine, that were originally developed for use in cows, is neither evidence-based nor good ethical practice.

A Methodology for Anatomic Ultrasound Image Diagnostic Quality Assessment.

PubMed

Hemmsen, Martin Christian; Lange, Theis; Brandt, Andreas Hjelm; Nielsen, Michael Bachmann; Jensen, Jorgen Arendt

2017-01-01

This paper discusses the methods for the assessment of ultrasound image quality based on our experiences with evaluating new methods for anatomic imaging. It presents a methodology to ensure a fair assessment between competing imaging methods using clinically relevant evaluations. The methodology is valuable in the continuing process of method optimization and guided development of new imaging methods. It includes a three phased study plan covering from initial prototype development to clinical assessment. Recommendations to the clinical assessment protocol, software, and statistical analysis are presented. Earlier uses of the methodology has shown that it ensures validity of the assessment, as it separates the influences between developer, investigator, and assessor once a research protocol has been established. This separation reduces confounding influences on the result from the developer to properly reveal the clinical value. This paper exemplifies the methodology using recent studies of synthetic aperture sequential beamforming tissue harmonic imaging.

Minority carrier diffusion lengths and absorption coefficients in silicon sheet material

NASA Technical Reports Server (NTRS)

Dumas, K. A.; Swimm, R. T.

1980-01-01

Most of the methods which have been developed for the measurement of the minority carrier diffusion length of silicon wafers require that the material have either a Schottky or an ohmic contact. The surface photovoltage (SPV) technique is an exception. The SPV technique could, therefore, become a valuable diagnostic tool in connection with current efforts to develop low-cost processes for the production of solar cells. The technique depends on a knowledge of the optical absorption coefficient. The considered investigation is concerned with a reevaluation of the absorption coefficient as a function of silicon processing. A comparison of absorption coefficient values showed these values to be relatively consistent from sample to sample, and independent of the sample growth method.

Use and limitations of malaria rapid diagnostic testing by community health workers in war-torn Democratic Republic of Congo

PubMed Central

2009-01-01

Background Accurate and practical malaria diagnostics, such as immunochromatographic rapid diagnostic tests (RDTs), have the potential to avert unnecessary treatments and save lives. Volunteer community health workers (CHWs) represent a potentially valuable human resource for expanding this technology to where it is most needed, remote rural communities in sub-Saharan Africa with limited health facilities and personnel. This study reports on a training programme for CHWs to incorporate RDTs into their management strategy for febrile children in the Democratic Republic of Congo, a tropical African setting ravaged by human conflict. Methods Prospective cohort study, satisfaction questionnaire and decision analysis. Results Twelve CHWs were trained to safely and accurately perform and interpret RDTs, then successfully implemented rapid diagnostic testing in their remote community in a cohort of 357 febrile children. CHWs were uniformly positive in evaluating RDTs for their utility and ease of use. However, high malaria prevalence in this cohort (93% by RDTs, 88% by light microscopy) limited the cost-effectiveness of RDTs compared to presumptive treatment of all febrile children, as evidenced by findings from a simplified decision analysis. Conclusions CHWs can safely and effectively use RDTs in their management of febrile children; however, cost-effectiveness of RDTs is limited in zones of high malaria prevalence. PMID:20028563

Colonoscopy video quality assessment using hidden Markov random fields

NASA Astrophysics Data System (ADS)

Park, Sun Young; Sargent, Dusty; Spofford, Inbar; Vosburgh, Kirby

2011-03-01

With colonoscopy becoming a common procedure for individuals aged 50 or more who are at risk of developing colorectal cancer (CRC), colon video data is being accumulated at an ever increasing rate. However, the clinically valuable information contained in these videos is not being maximally exploited to improve patient care and accelerate the development of new screening methods. One of the well-known difficulties in colonoscopy video analysis is the abundance of frames with no diagnostic information. Approximately 40% - 50% of the frames in a colonoscopy video are contaminated by noise, acquisition errors, glare, blur, and uneven illumination. Therefore, filtering out low quality frames containing no diagnostic information can significantly improve the efficiency of colonoscopy video analysis. To address this challenge, we present a quality assessment algorithm to detect and remove low quality, uninformative frames. The goal of our algorithm is to discard low quality frames while retaining all diagnostically relevant information. Our algorithm is based on a hidden Markov model (HMM) in combination with two measures of data quality to filter out uninformative frames. Furthermore, we present a two-level framework based on an embedded hidden Markov model (EHHM) to incorporate the proposed quality assessment algorithm into a complete, automated diagnostic image analysis system for colonoscopy video.

Unilateral Opening of Rat Blood-Brain Barrier Assisted by Diagnostic Ultrasound Targeted Microbubbles Destruction.

PubMed

Xu, Yali; Cui, Hai; Zhu, Qiong; Hua, Xing; Xia, Hongmei; Tan, Kaibin; Gao, Yunhua; Zhao, Jing; Liu, Zheng

2016-01-01

Objective. Blood-brain barrier (BBB) is a key obstacle that prevents the medication from blood to the brain. Microbubble-enhanced cavitation by focused ultrasound can open the BBB and proves to be valuable in the brain drug delivery. The study aimed to explore the feasibility, efficacy, and safety of unilateral opening of BBB using diagnostic ultrasound targeted microbubbles destruction in rats. Methods. A transtemporal bone irradiation of diagnostic ultrasound and intravenous injection of lipid-coated microbubbles were performed at unilateral hemisphere. Pathological changes were monitored. Evans Blue extravasation grades, extraction from brain tissue, and fluorescence optical density were quantified. Lanthanum nitrate was traced by transmission electron microscopy. Results. After diagnostic ultrasound mediated microbubbles destruction, Evans Blue extravasation and fluorescence integrated optical density were significantly higher in the irradiated hemisphere than the contralateral side (all p < 0.01). Erythrocytes extravasations were demonstrated in the ultrasound-exposed hemisphere (4 ± 1, grade 2) while being invisible in the control side. Lanthanum nitrate tracers leaked through interendothelial cleft and spread to the nerve fiber existed in the irradiation side. Conclusions. Transtemporal bone irradiation under DUS mediated microbubble destruction provides us with a more accessible, safer, and higher selective BBB opening approach in rats, which is advantageous in brain targeted drugs delivery.

Diagnosis of Brucellosis in Livestock and Wildlife

PubMed Central

Godfroid, Jacques; Nielsen, Klaus; Saegerman, Claude

2010-01-01

Aim To describe and discuss the merits of various direct and indirect methods applied in vitro (mainly on blood or milk) or in vivo (allergic test) for the diagnosis of brucellosis in animals. Methods The recent literature on brucellosis diagnostic tests was reviewed. These diagnostic tests are applied with different goals, such as national screening, confirmatory diagnosis, certification, and international trade. The validation of such diagnostic tests is still an issue, particularly in wildlife. The choice of the testing strategy depends on the prevailing brucellosis epidemiological situation and the goal of testing. Results Measuring the kinetics of antibody production after Brucella spp. infection is essential for analyzing serological results correctly and may help to predict abortion. Indirect ELISAs help to discriminate 1) between false positive serological reactions and true brucellosis and 2) between vaccination and infection. Biotyping of Brucella spp. provides valuable epidemiological information that allows tracing an infection back to the sources in instances where several biotypes of a given Brucella species are circulating. Polymerase chain reaction and new molecular methods are likely to be used as routine typing and fingerprinting methods in the coming years. Conclusion The diagnosis of brucellosis in livestock and wildlife is complex and serological results need to be carefully analyzed. The B. abortus S19 and B. melitensis Rev. 1 vaccines are the cornerstones of control programs in cattle and small ruminants, respectively. There is no vaccine available for pigs or for wildlife. In the absence of a human brucellosis vaccine, prevention of human brucellosis depends on the control of the disease in animals. PMID:20718082

Recent Progress in Nanomedicine: Therapeutic, Diagnostic and Theranostic Applications

PubMed Central

Rizzo, Larissa Y.; Theek, Benjamin; Storm, Gert; Kiessling, Fabian; Lammers, Twan

2013-01-01

In recent years, the use of nanomedicine formulations for therapeutic and diagnostic applications has increased exponentially. Many different systems and strategies have been developed for drug targeting to pathological sites, as well as for visualizing and quantifying important (patho-) physiological processes. In addition, ever more efforts have been undertaken to combine diagnostic and therapeutic properties within a single nanomedicine formulation. These so-called nanotheranostics are able to provide valuable information on drug delivery, drug release and drug efficacy, and they are considered to be highly useful for personalizing nanomedicine-based (chemo-) therapeutic interventions. PMID:23578464

Uncertainties in cylindrical anode current inferences on pulsed power drivers

NASA Astrophysics Data System (ADS)

Porwitzky, Andrew; Brown, Justin

2018-06-01

For over a decade, velocimetry based techniques have been used to infer the electrical current delivered to dynamic materials properties experiments on pulsed power drivers such as the Z Machine. Though originally developed for planar load geometries, in recent years, inferring the current delivered to cylindrical coaxial loads has become a valuable diagnostic tool for numerous platforms. Presented is a summary of uncertainties that can propagate through the current inference technique when applied to expanding cylindrical anodes. An equation representing quantitative uncertainty is developed which shows the unfold method to be accurate to a few percent above 10 MA of load current.

[Scanning electron microscopy of peripheral blood erythrocytes in the diagnosis and treatment of hemorrhagic vasculitis in children].

PubMed

Nagaeva, T A; Balasheva, I I; Saratikov, A S; Bocharova, M N; Mikhalenko, A N

2001-01-01

Twenty-four children aged 3-15 years were examined, 16 of these with cutaneous and articulo-cutaneous hemorrhagic vasculitis (HV) and 8 normal controls. The patients were divided into 2 groups: 10 patients treated by basic therapy and 6 children whose treatment protocols were supplemented by membranoprotector locheine. The children were repeatedly examined 1 month after discharge from hospital. Scanning electron microscopy of peripheral blood erythrocytes provides valuable diagnostic data on erythrocyte membrane morphology and function in children with HV and can serve as a method for monitoring the efficiency of new approaches to therapy of this disease.

Computer-assisted virtual autopsy using surgical navigation techniques.

PubMed

Ebert, Lars Christian; Ruder, Thomas D; Martinez, Rosa Maria; Flach, Patricia M; Schweitzer, Wolf; Thali, Michael J; Ampanozi, Garyfalia

2015-01-01

OBJECTIVE; Virtual autopsy methods, such as postmortem CT and MRI, are increasingly being used in forensic medicine. Forensic investigators with little to no training in diagnostic radiology and medical laypeople such as state's attorneys often find it difficult to understand the anatomic orientation of axial postmortem CT images. We present a computer-assisted system that permits postmortem CT datasets to be quickly and intuitively resliced in real time at the body to narrow the gap between radiologic imaging and autopsy. Our system is a potentially valuable tool for planning autopsies, showing findings to medical laypeople, and teaching CT anatomy, thus further closing the gap between radiology and forensic pathology.

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

PubMed Central

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

2017-01-01

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

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

Detection of Lipid and Amphiphilic Biomarkers for Disease Diagnostics

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

Kubicek-Sutherland, Jessica Z.; Vu, Dung M.; Mendez, Heather M.

Rapid diagnosis is crucial to effectively treating any disease. Biological markers, or biomarkers, have been widely used to diagnose a variety of infectious and non-infectious diseases. The detection of biomarkers in patient samples can also provide valuable information regarding progression and prognosis. Interestingly, many such biomarkers are composed of lipids, and are amphiphilic in biochemistry, which leads them to be often sequestered by host carriers. Such sequestration enhances the difficulty of developing sensitive and accurate sensors for these targets. Many of the physiologically relevant molecules involved in pathogenesis and disease are indeed amphiphilic. This chemical property is likely essential formore » their biological function, but also makes them challenging to detect and quantify in vitro. In order to understand pathogenesis and disease progression while developing effective diagnostics, it is important to account for the biochemistry of lipid and amphiphilic biomarkers when creating novel techniques for the quantitative measurement of these targets. Here, we review techniques and methods used to detect lipid and amphiphilic biomarkers associated with disease, as well as their feasibility for use as diagnostic targets, highlighting the significance of their biochemical properties in the design and execution of laboratory and diagnostic strategies. Furthermore, the biochemistry of biological molecules is clearly relevant to their physiological function, and calling out the need for consideration of this feature in their study, and use as vaccine, diagnostic and therapeutic targets is the overarching motivation for this review.« less

Detection of Lipid and Amphiphilic Biomarkers for Disease Diagnostics

DOE PAGES

Kubicek-Sutherland, Jessica Z.; Vu, Dung M.; Mendez, Heather M.; ...

2017-07-04

Rapid diagnosis is crucial to effectively treating any disease. Biological markers, or biomarkers, have been widely used to diagnose a variety of infectious and non-infectious diseases. The detection of biomarkers in patient samples can also provide valuable information regarding progression and prognosis. Interestingly, many such biomarkers are composed of lipids, and are amphiphilic in biochemistry, which leads them to be often sequestered by host carriers. Such sequestration enhances the difficulty of developing sensitive and accurate sensors for these targets. Many of the physiologically relevant molecules involved in pathogenesis and disease are indeed amphiphilic. This chemical property is likely essential formore » their biological function, but also makes them challenging to detect and quantify in vitro. In order to understand pathogenesis and disease progression while developing effective diagnostics, it is important to account for the biochemistry of lipid and amphiphilic biomarkers when creating novel techniques for the quantitative measurement of these targets. Here, we review techniques and methods used to detect lipid and amphiphilic biomarkers associated with disease, as well as their feasibility for use as diagnostic targets, highlighting the significance of their biochemical properties in the design and execution of laboratory and diagnostic strategies. Furthermore, the biochemistry of biological molecules is clearly relevant to their physiological function, and calling out the need for consideration of this feature in their study, and use as vaccine, diagnostic and therapeutic targets is the overarching motivation for this review.« less

Analysis of selected data from the triservice missile data base

NASA Technical Reports Server (NTRS)

Allen, Jerry M.; Shaw, David S.; Sawyer, Wallace C.

1989-01-01

An extremely large, systematic, axisymmetric-body/tail-fin data base has been gathered through tests of an innovative missile model design which is described herein. These data were originally obtained for incorporation into a missile aerodynamics code based on engineering methods (Program MISSILE3), but these data are also valuable as diagnostic test cases for developing computational methods because of the individual-fin data included in the data base. Detailed analyses of four sample cases from these data are presented to illustrate interesting individual-fin force and moment trends. These samples quantitatively show how bow shock, fin orientation, fin deflection, and body vortices can produce strong, unusual, and computationally challenging effects on individual fin loads. Flow-visualization photographs are examined to provide physical insight into the cause of these effects.

Diagnostic reasoning by hospital pharmacists: assessment of attitudes, knowledge, and skills.

PubMed

Chernushkin, Kseniya; Loewen, Peter; de Lemos, Jane; Aulakh, Amneet; Jung, Joanne; Dahri, Karen

2012-07-01

Hospital pharmacists participate in activities that may be considered diagnostic. Two reasoning approaches to diagnosis have been described: non-analytic and analytic. Of the 6 analytic traditions, the probabilistic tradition has been shown to improve diagnostic accuracy and reduce unnecessary testing. To the authors' knowledge, pharmacists' attitudes toward having a diagnostic role and their diagnostic knowledge and skills have never been studied. To describe pharmacists' attitudes toward the role of diagnosis in pharmacotherapeutic problem-solving and to characterize the extent of pharmacists' knowledge and skills related to diagnostic literacy. Pharmacists working within Lower Mainland Pharmacy Services (British Columbia) who spent at least 33% of their time in direct patient care were invited to participate in a prospective observational survey. The survey sought information about demographic characteristics and attitudes toward diagnosis. Diagnostic knowledge and skills were tested by means of 3 case scenarios. The analysis included simple descriptive statistics and inferential statistics to evaluate relationships between responses and experience and training. Of 266 pharmacists invited to participate, 94 responded. The attitudes section of the survey was completed by 90 pharmacists; of these, 80 (89%) agreed with the definition of "diagnosis" proposed in the survey, and 83 (92%) agreed that it is important for pharmacists to have diagnosis-related skills. Respondents preferred an analytic to a non-analytic approach to diagnostic decision-making. The probabilistic tradition was not the preferred method in any of the 3 cases. In evaluating 5 clinical scenarios that might require diagnostic skills, on average 84% of respondents agreed that they should be involved in assessing such problems. Respondents' knowledge of and ability to apply probabilistic diagnostic tools were highest for test sensitivity (average of 61% of respondents with the correct answers) and lower for test specificity (average of 48% with correct answers) and likelihood ratios (average of 39% with correct answers). Respondents to this survey strongly believed that diagnostic skills were important for solving drug-related problems, but they demonstrated low levels of knowledge and ability to apply concepts of probabilistic diagnostic reasoning. Opportunities to expand pharmacists' knowledge of diagnostic reasoning exist, and the findings reported here indicate that pharmacists would consider such professional development valuable.

Motion tracking and electromyography assist the removal of mirror hand contributions to fNIRS images acquired during a finger tapping task performed by children with cerebral palsy

NASA Astrophysics Data System (ADS)

Hervey, Nathan; Khan, Bilal; Shagman, Laura; Tian, Fenghua; Delgado, Mauricio R.; Tulchin-Francis, Kirsten; Shierk, Angela; Smith, Linsley; Reid, Dahlia; Clegg, Nancy J.; Liu, Hanli; MacFarlane, Duncan; Alexandrakis, George

2013-03-01

Functional neurological imaging has been shown to be valuable in evaluating brain plasticity in children with cerebral palsy (CP). In recent studies it has been demonstrated that functional near-infrared spectroscopy (fNIRS) is a viable and sensitive method for imaging motor cortex activities in children with CP. However, during unilateral finger tapping tasks children with CP often exhibit mirror motions (unintended motions in the non-tapping hand), and current fNIRS image formation techniques do not account for this. Therefore, the resulting fNIRS images contain activation from intended and unintended motions. In this study, cortical activity was mapped with fNIRS on four children with CP and five controls during a finger tapping task. Finger motion and arm muscle activation were concurrently measured using motion tracking cameras and electromyography (EMG). Subject-specific regressors were created from motion capture and EMG data and used in a general linear model (GLM) analysis in an attempt to create fNIRS images representative of different motions. The analysis provided an fNIRS image representing activation due to motion and muscle activity for each hand. This method could prove to be valuable in monitoring brain plasticity in children with CP by providing more consistent images between measurements. Additionally, muscle effort versus cortical effort was compared between control and CP subjects. More cortical effort was required to produce similar muscle effort in children with CP. It is possible this metric could be a valuable diagnostic tool in determining response to treatment.

Computer assisted axial tomography (Emi scan) in neurologic investigation

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

Campbell, J.K.; Baker, H.L.; Laws, E.R. Jr.

1974-01-01

Cerebral angiography, pneumoencephalography, and radioisotope brain scan with their differing diagnostic abilities have provided the neurologist and neurosurgeon with extremely valuable diagnostic techniques. It is doubtful, however, if any of these now conventional methods had the enormous impact on the practice of neurology that computer assisted axial tomography (C.A.T.) is beginning to have. Here, for the first time, is a test which, without significant risk or discomfort, can demonstrate some normal intracranial (and intraorbital) structures, can demonstrate some normal intracranial pathology and, in many cases, can make the potentially dangerous contrast studies unnecessary. After only a few months experience withmore » C.A.T. in a clinical setting, it has become obvious that there will have to be a reappraisal of the accepted investigative work-up of many conditions. While it is too early to have formulated strict criteria for the use of C.A.T., this paper is an attempt to show how the technique is proving useful in the investigation of many conditions.« less

Significance of CEA and VEGF as Diagnostic Markers of Colorectal Cancer in Lebanese Patients.

PubMed

Dbouk, Hashem A; Tawil, Ayman; Nasr, Fahd; Kandakarjian, Loucine; Abou-Merhi, Raghida

2007-11-08

Carcinoembryonic antigen and vascular endothelial growth factors are among the most important prognostic markers of colorectal cancer. Testing for these markers independently has been of limited value in screening for this tumor. The aim of this study is to determine the importance of simultaneous blood CEA and VEGF level determinations in diagnosis of colorectal cancer. Thirty-six patients diagnosed with colorectal cancer along with eight healthy controls were tested by ELISA for CEA and VEGF levels in serum and plasma, respectively. The positive predictive value of these markers was 95.4% for CEA and 89.5% for VEGF, and for combined CEA and VEGF was also high at 88%. Combined CEA and VEGF blood level assay constitutes a useful panel in detecting patients with colorectal cancer. Positive results allow selection of a subgroup of patients with a high tumor risk; therefore, such tests comprise valuable tumor diagnostic tests to add to current detection methods.

Reference intervals for acute phase protein and serum protein electrophoresis values in captive Asian elephants (Elephas maximus).

PubMed

Isaza, Ramiro; Wiedner, Ellen; Hiser, Sarah; Cray, Carolyn

2014-09-01

Acute phase protein (APP) immunoassays and serum protein electrophoresis (SPEP) are assays for evaluating the inflammatory response and have use as diagnostic tools in a variety of species. Acute phase proteins are markers of inflammation that are highly conserved across different species while SPEP separates and quantifies serum protein fractions based on their physical properties. In the current study, serum samples from 35 clinically healthy Asian elephants (Elephas maximus) were analyzed using automated assays for C-reactive protein, serum amyloid A, and haptoglobin and SPEP. Robust methods were used to generate reference intervals for the APPs: C-reactive protein (1.3-12.8 mg/l), serum amyloid A (0-47.5 mg/l), and haptoglobin (0-1.10 mg/ml). In addition, SPEP was performed on these samples to establish reference intervals for each protein fraction. A combination of APPs and SPEP measurements are valuable adjunctive diagnostic tools in elephant health care. © 2014 The Author(s).

Diagnostic imaging in bovine orthopedics.

PubMed

Kofler, Johann; Geissbühler, Urs; Steiner, Adrian

2014-03-01

Although a radiographic unit is not standard equipment for bovine practitioners in hospital or field situations, ultrasound machines with 7.5-MHz linear transducers have been used in bovine reproduction for many years, and are eminently suitable for evaluation of orthopedic disorders. The goal of this article is to encourage veterinarians to use radiology and ultrasonography for the evaluation of bovine orthopedic disorders. These diagnostic imaging techniques improve the likelihood of a definitive diagnosis in every bovine patient but especially in highly valuable cattle, whose owners demand increasingly more diagnostic and surgical interventions that require high-level specialized techniques. Copyright © 2014 Elsevier Inc. All rights reserved.

Digamma diagnostics for the mixed-phase generation at NICA

NASA Astrophysics Data System (ADS)

Kukulin, V. I.; Platonova, M. N.

2017-03-01

A novel type of diagnostics for dense and/or hot nuclear matter produced in heavy-ion collisions at NICA and similar future colliders (FAIR, etc.) is suggested. The diagnostics is based on an assumption (confirmed in many experiments worldwide) about intensive generation of light scalar mesons (σ) the consequent decay of which produces γγ pairs with the mass and width dependent upon density and temperature of the fireball produced in the collision process. Thus, measurements of the absolute yield, mass and width of the γγ signal carry valuable information about the state of fireball generated during the high-energy nuclear collision.

Immunoelectrophoresis: a method with many faces.

PubMed

Csako, Gyorgy

2012-01-01

Immunoelectrophoresis (IEP) was the first practical method that combined electrophoresis and -immunoprecipitation for identifying and characterizing proteins within complex mixtures. Over the years, IEP has been extended to include a variety of techniques and, as a general name, has been applied to virtually any technique that involves electrophoresis and antigen-antibody precipitin reaction for proteins. Because of the diversity in technical details of different IEP versions, the method described here deals only with classic IEP. Although it requires some manual expertise, IEP is versatile, relatively easy to customize, and economical with no need for expensive instrumentation. Further, it can discern identity, partial identity, and nonidentity of the proteins. Any low-viscosity body fluid specimen or, possibly, culture fluid and tissue extract could be tested with IEP if proper antibodies are available. With these attributes, classic IEP remains a valuable tool for clinical diagnostic testing, purity checking of biochemical and pharmaceutical products, and research.

Conventional forceps or hot biopsy: comparative study of two methods in diagnosis of endobronchial lesions.

PubMed

Jabbari, Hamidreza; Fakhri, Mohammad; Lotfaliani, Mojtaba; Kiani, Arda

2013-01-01

It is suggested that hot electrocoagulation-enabled forceps (hot biopsy) may reduce hemorrhage risk after the biopsy in endobronchial tumors. The main concern in this method is possible reduction of the specimen's quality. To compare the procedure related hemorrhage with hot biopsy and conventional forceps biopsy and the diagnostic quality of the obtained specimens with either technique. In this prospective study, assessment of the biopsy samples and quantity of hemorrhage were done in a blind fashion. At first, for each patient a definite clinical diagnosis was made based on pathologic examination of all available samples, clinical data, and imaging findings. Then, second pathologist reviewed all samples to evaluate the quality of the samples. A total of 36 patients with endobronchial lesions were included in this study. Definite diagnosis was made in 83% of the patients. Diagnostic yield of the two methods were not statistically different, while the mean hemorrhage grades of all hot biopsy protocols were significantly lower as compared to that of conventional biopsy (p=0.003, p<0.001 and p<0.001 for 10,20and40 voltages respectively). No significant difference was detected between the qualities of specimens obtained by hot biopsy methods in comparison with conventional biopsy (p>0.05 for all three voltages). Hot biopsy can be a valuable alternative to forceps biopsy in evaluating endobronchial lesions.

Inpatient Consultative Dermatology.

PubMed

Biesbroeck, Lauren K; Shinohara, Michi M

2015-11-01

Dermatology consultation can improve diagnostic accuracy in the hospitalized patient with cutaneous disease. Dermatology consultation can streamline and improve treatment plans, and potentially lead to cost savings. Dermatology consultants can be a valuable resource for education for trainees, patients, and families. Inpatient consultative dermatology spans a breadth of conditions, including inflammatory dermatoses,infectious processes, adverse medication reactions, and neoplastic disorders, many of which can be diagnosed based on dermatologic examination alone, but when necessary, bedside skin biopsies can contribute important diagnostic information. Copyright © 2015 Elsevier Inc. All rights reserved.

Clinical experience with iodine-123-iodophenylpentadecanoic acid.

PubMed

Corbett, J

1994-04-01

Initial research in dogs and later research in normal volunteers and patients with coronary artery disease indicated that 123I-iodophenylpentadecanoic acid (IPPA) can provide valuable diagnostic information. This agent compared favorably to 201Tl in detecting stenosed coronary arteries and identified reversible lesions with greater frequency. Testing with both 201Tl and IPPA before and after percutaneous transluminal coronary angioplasty produced similar results, supporting the notion that IPPA deserves inclusion among the diagnostic tools used to evaluate coronary heart disease.

Profile of the Roche cobas® EGFR mutation test v2 for non-small cell lung cancer.

PubMed

Malapelle, Umberto; Sirera, Rafael; Jantus-Lewintre, Eloísa; Reclusa, Pablo; Calabuig-Fariñas, Silvia; Blasco, Ana; Pisapia, Pasquale; Rolfo, Christian; Camps, Carlos

2017-03-01

The discovery of driver mutations in non-small cell lung cancer (NSCLC) has led to the development of genome-based personalized medicine. Fifteen to 20% of adenocarcinomas harbor an epidermal growth factor receptor (EGFR) activating mutation associated with responses to EGFR tyrosine kinase inhibitors (TKIs). Individual laboratories' expertise and the availability of appropriate equipment are valuable assets in predictive molecular pathology, although the choice of methods should be determined by the nature of the samples to be tested and whether the detection of only well-characterized EGFR mutations or rather, of all detectable mutations, is required. Areas covered: The EGFR mutation testing landscape is manifold and includes both screening and targeted methods, each with their own pros and cons. Here we review one of these companion tests, the Roche cobas® EGFR mutation test v2, from a methodological point of view, also exploring its liquid-biopsy applications. Expert commentary: The Roche cobas® EGFR mutation test v2, based on real time RT-PCR, is a reliable option for testing EGFR mutations in clinical practice, either using tissue-derived DNA or plasma-derived cfDNA. This application will be valuable for laboratories with whose purpose is purely diagnostic and lacking high-throughput technologies.

AB 66. One-year experience of the pulmonary department of Aristotle University of Thessaloniki in thoracoscopy with local anaesthesia (medical thoracoscopy)

PubMed Central

Spyropoulos, George; Kontakiotis, Theodoros; Spyratos, Dionysios; Iakovidis, Dimitrios; Zoglopitis, Fotis; Zarogoulidis, Konstantinos

2012-01-01

Background Thoracoscopy with local anesthesia or medical thoracoscopy is an invasive method which is rather valuable not only for the approach of undiagnosed exudative pleural effusions but also for the treatment of symptomatic malignant effusions with the conduct of pleurodesis. This is a review of those patients who underwent medical thoracoscopy in the period May 2011 to September 2012 in the Pulmonary Department the Aristotle University of Thessaloniki. Patients and methods Thirty nine thoracoscopies were conducted in our Department since May 2011. Twenty nine patients with cytological test negative for malignancy underwent diagnostic thoracoscopy. Eleven of those procedures were diagnostic and positive for malignancy, while 12 were non-diagnostic and 2 with limited evidence of malignancy. The biopsy results of 2 thoracoscopies showed granulomatous infection and other 2 nonspecific chronic inflammation. Out of all the diagnoses which were positive for malignancy, 2 were related to mesothelioma, 5 to adenocarcinoma (4 of them originated from lungs and one of unknown primary origin) while 1 patient was diagnosed with metastatic papillary adenocarcinoma originated from the thyroid and another one with lymphoma. There were also patients carrying diagnosed illness intending pleurodesis in cases of malignant recrudescent pleural effusions in mesothelioma, lung adenocarcinoma and biliary carcinoma who underwent thoracoscopy. Another patient with recrudescent pneumothorax underwent pleurodesis with talc. Results The major complications which emerged either during the procedure or after the thoracoscopy were two: one patient developed allergy in lidocaine intake for the local anesthesia having as a result to quit the procedure while another patient developed an empyema several weeks later. Conclusions Thoracoscopy with local anesthesia is a safe procedure, tolerable for the patient, which has a significant diagnostic value and only a small percentage of complications.

ALEXI analysis of water consumption in the Nile Basin

USDA-ARS?s Scientific Manuscript database

Remote sensing can be used to generate diagnostic estimates of evapotranspiration (ET) that provide information regarding consumptive water use across landscapes. These satellite-based assessments can be a valuable complement to prognostic simulations of basin-scale water budgets, providing an inde...

Polarization visualization of changes of anisotropic meat structure

NASA Astrophysics Data System (ADS)

Blokhina, Anastasia A.; Ryzhova, Victoria A.; Kleshchenok, Maksim A.; Lobanova, Anastasiya Y.

2017-06-01

The main aspect in developing methods for optical diagnostics and visualization of biological tissues using polarized radiation is the transformation analysis of the state of light polarization when it is scattered by the medium. The polarization characteristic spatial distributions of the detected scattered radiation, in particular the degree of depolarization, have a pronounced anisotropy. The presence of optical anisotropy can provide valuable additional information on the structural features of the biological object and its physiological status. Analysis of the polarization characteristics of the scattered radiation of biological tissues in some cases provides a qualitatively new results in the study of biological samples. These results can be used in medicine and food industry.

Nailfold capillaroscopy in juvenile rheumatic diseases: known measures, patterns and indications.

PubMed

Gerhold, K; Becker, M O

2014-01-01

Nailfold capillaroscopy has become an established method in adults for the evaluation of structural abnormalities of the microcirculation associated with rheumatic disease. It is a cornerstone for the diagnostic work-up of patients with Raynaud's phenomenon and the early diagnosis of systemic sclerosis. However, this non-invasive examination may also be valuable in children and adolescents with rheumatic diseases. Based on the scarce data available, this review focuses on capillaroscopic findings in healthy children and adolescents as well as in children with juvenile systemic sclerosis, juvenile dermatomyositis, juvenile idiopathic arthritis, and Raynaud's phenomenon. In addition, it outlines the potential benefits and limitations of nailfold capillaroscopy for routine care in paediatric rheumatology.

Visual acuity loss and OCT changes as initial signs of leukaemia

PubMed Central

Ortiz, Jose M; Ruiz-Moreno, Jose M; Pozo-Martos, Paola; Montero, Javier A

2010-01-01

AIM To report two cases where decreased visual acuity was the first symptom of leukaemia and optical coherence tomography (OCT) allowed identification and localization of the retinal lesions. METHODS Retrospective, interventional, case reports. RESULTS One case of lymphoblastic acute leukaemia and chronic lymphoid leukaemia were diagnosed following decreased visual acuity. OCT showed macular serous detachment in the first case. The second case presented hypo fluorescent retinal infiltrates which appeared as hyper reflective lesions by OCT. Retinal changes disappeared and visual acuity was recovered following complete remission of the neoplasm. CONCLUSION OCT is a valuable, non invasive diagnostic tool permitting detection, localization and follow-up of ocular dissemination of neoplasms. PMID:22553573

Characterization of specific anti-Candida IgM, IgA and IgE: diagnostic value in deep-seated infections.

PubMed

Aubert, D; Puygauthier-Toubas, D; Leon, P; Pignon, B; Foudrinier, F; Marnef, F; Boulant, J; Pinon, J M

1996-01-01

The proposed serological diagnosis of systemic Candida infections is based on a microplate immunocapture technique detecting IgM, IgA and IgE anti-Candida antibodies. Activity is revealed with a suspension of human erythrocytes sensitized with somatic antigen of Candida albicans, and is quantified on an automated plate reader. The sera were obtained from patients with deep-seated (n = 56) and superficial (n = 193) candidosis. We compared this immunological method with a combination of indirect immunofluorescence and co-immunoelectrodiffusion. The immunocapture method was more sensitive (80.4% vs. 48.2% with indirect immunofluorescence and 58.9% with co-immunoelectrodiffusion), and often provided the diagnosis at an earlier stage, with clear therapeutic advantages. The IgA isotype was a particularly valuable marker of deep-seated Candida infections.

Adaptive Tutorials Versus Web-Based Resources in Radiology: A Mixed Methods Comparison of Efficacy and Student Engagement.

PubMed

Wong, Vincent; Smith, Ariella J; Hawkins, Nicholas J; Kumar, Rakesh K; Young, Noel; Kyaw, Merribel; Velan, Gary M

2015-10-01

Diagnostic imaging is under-represented in medical curricula globally. Adaptive tutorials, online intelligent tutoring systems that provide a personalized learning experience, have the potential to bridge this gap. However, there is limited evidence of their effectiveness for learning about diagnostic imaging. We performed a randomized mixed methods crossover trial to determine the impact of adaptive tutorials on perceived engagement and understanding of the appropriate use and interpretation of common diagnostic imaging investigations. Although concurrently engaged in disparate blocks of study, 99 volunteer medical students (from years 1-4 of the 6-year program) were randomly allocated to one of two groups. In the first arm of the trial on chest X-rays, one group received access to an adaptive tutorial, whereas the other received links to an existing peer-reviewed Web resource. These two groups crossed over in the second arm of the trial, which focused on computed tomography scans of the head, chest, and abdomen. At the conclusion of each arm of the trial, both groups completed an examination-style assessment, comprising questions both related and unrelated to the topics covered by the relevant adaptive tutorial. Online questionnaires were used to evaluate student perceptions of both learning resources. In both arms of the trial, the group using adaptive tutorials obtained significantly higher assessment scores than controls. This was because of higher assessment scores by senior students in the adaptive tutorial group when answering questions related to topics covered in those tutorials. Furthermore, students indicated significantly better engagement with adaptive tutorials than the Web resource and rated the tutorials as a significantly more valuable tool for learning. Medical students overwhelmingly accept adaptive tutorials for diagnostic imaging. The tutorials significantly improve the understanding of diagnostic imaging by senior students. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

Diagnostic Accuracy of Full-Body Linear X-Ray Scanning in Multiple Trauma Patients in Comparison to Computed Tomography.

PubMed

Jöres, A P W; Heverhagen, J T; Bonél, H; Exadaktylos, A; Klink, T

2016-02-01

The purpose of this study was to evaluate the diagnostic accuracy of full-body linear X-ray scanning (LS) in multiple trauma patients in comparison to 128-multislice computed tomography (MSCT). 106 multiple trauma patients (female: 33; male: 73) were retrospectively included in this study. All patients underwent LS of the whole body, including extremities, and MSCT covering the neck, thorax, abdomen, and pelvis. The diagnostic accuracy of LS for the detection of fractures of the truncal skeleton and pneumothoraces was evaluated in comparison to MSCT by two observers in consensus. Extremity fractures detected by LS were documented. The overall sensitivity of LS was 49.2 %, the specificity was 93.3 %, the positive predictive value was 91 %, and the negative predictive value was 57.5 %. The overall sensitivity for vertebral fractures was 16.7 %, and the specificity was 100 %. The sensitivity was 48.7 % and the specificity 98.2 % for all other fractures. Pneumothoraces were detected in 12 patients by CT, but not by LS. 40 extremity fractures were detected by LS, of which 4 fractures were dislocated, and 2 were fully covered by MSCT. The diagnostic accuracy of LS is limited in the evaluation of acute trauma of the truncal skeleton. LS allows fast whole-body X-ray imaging, and may be valuable for detecting extremity fractures in trauma patients in addition to MSCT.  The overall sensitivity of LS for truncal skeleton injuries in multiple-trauma patients was < 50 %. The diagnostic reference standard MSCT is the preferred and reliable imaging modality. LS may be valuable for quick detection of extremity fractures. © Georg Thieme Verlag KG Stuttgart · New York.

Managing marine mollusc diseases in the context of regional and international commerce: policy issues and emerging concerns.

PubMed

Carnegie, Ryan B; Arzul, Isabelle; Bushek, David

2016-03-05

Marine mollusc production contributes to food and economic security worldwide and provides valuable ecological services, yet diseases threaten these industries and wild populations. Although the infrastructure for mollusc aquaculture health management is well characterized, its foundations are not without flaws. Use of notifiable pathogen lists can leave blind spots with regard to detection of unlisted and emerging pathogens. Increased reliance on molecular tools has come without similar attention to diagnostic validation, raising questions about assay performance, and has been accompanied by a reduced emphasis on microscopic diagnostic expertise that could weaken pathogen detection capabilities. Persistent questions concerning pathogen biology and ecology promote regulatory paralysis that impedes trade and which could weaken biosecurity by driving commerce to surreptitious channels. Solutions that might be pursued to improve shellfish aquaculture health management include the establishment of more broad-based surveillance programmes, wider training and use of general methods like histopathology to ensure alertness to emerging diseases, an increased focus on assay assessment and validation as fundamental to assay development, investment in basic research, and application of risk analyses to improve regulation. A continual sharpening of diagnostic tools and approaches and deepening of scientific knowledge is necessary to manage diseases and promote sustainable molluscan shellfish industries. © 2016 The Author(s).

Clonality Testing in Veterinary Medicine: A Review With Diagnostic Guidelines.

PubMed

Keller, S M; Vernau, W; Moore, P F

2016-07-01

The accurate distinction of reactive and neoplastic lymphoid proliferations can present challenges. Given the different prognoses and treatment strategies, a correct diagnosis is crucial. Molecular clonality assays assess rearranged lymphocyte antigen receptor gene diversity and can help differentiate reactive from neoplastic lymphoid proliferations. Molecular clonality assays are commonly used to assess atypical, mixed, or mature lymphoid proliferations; small tissue fragments that lack architecture; and fluid samples. In addition, clonality testing can be utilized to track neoplastic clones over time or across anatomic sites. Molecular clonality assays are not stand-alone tests but useful adjuncts that follow clinical, morphologic, and immunophenotypic assessment. Even though clonality testing provides valuable information in a variety of situations, the complexities and pitfalls of this method, as well as its dependency on the experience of the interpreter, are often understated. In addition, a lack of standardized terminology, laboratory practices, and interpretational guidelines hinders the reproducibility of clonality testing across laboratories in veterinary medicine. The objectives of this review are twofold. First, the review is intended to familiarize the diagnostic pathologist or interested clinician with the concepts, potential pitfalls, and limitations of clonality testing. Second, the review strives to provide a basis for future harmonization of clonality testing in veterinary medicine by providing diagnostic guidelines. © The Author(s) 2016.

Using targeted active-learning exercises and diagnostic question clusters to improve students' understanding of carbon cycling in ecosystems.

PubMed

Maskiewicz, April Cordero; Griscom, Heather Peckham; Welch, Nicole Turrill

2012-01-01

In this study, we used targeted active-learning activities to help students improve their ways of reasoning about carbon flow in ecosystems. The results of a validated ecology conceptual inventory (diagnostic question clusters [DQCs]) provided us with information about students' understanding of and reasoning about transformation of inorganic and organic carbon-containing compounds in biological systems. These results helped us identify specific active-learning exercises that would be responsive to students' existing knowledge. The effects of the active-learning interventions were then examined through analysis of students' pre- and postinstruction responses on the DQCs. The biology and non-biology majors participating in this study attended a range of institutions and the instructors varied in their use of active learning; one lecture-only comparison class was included. Changes in pre- to postinstruction scores on the DQCs showed that an instructor's teaching method had a highly significant effect on student reasoning following course instruction, especially for questions pertaining to cellular-level, carbon-transforming processes. We conclude that using targeted in-class activities had a beneficial effect on student learning regardless of major or class size, and argue that using diagnostic questions to identify effective learning activities is a valuable strategy for promoting learning, as gains from lecture-only classes were minimal.

Managing marine mollusc diseases in the context of regional and international commerce: policy issues and emerging concerns

PubMed Central

Carnegie, Ryan B.; Arzul, Isabelle; Bushek, David

2016-01-01

Marine mollusc production contributes to food and economic security worldwide and provides valuable ecological services, yet diseases threaten these industries and wild populations. Although the infrastructure for mollusc aquaculture health management is well characterized, its foundations are not without flaws. Use of notifiable pathogen lists can leave blind spots with regard to detection of unlisted and emerging pathogens. Increased reliance on molecular tools has come without similar attention to diagnostic validation, raising questions about assay performance, and has been accompanied by a reduced emphasis on microscopic diagnostic expertise that could weaken pathogen detection capabilities. Persistent questions concerning pathogen biology and ecology promote regulatory paralysis that impedes trade and which could weaken biosecurity by driving commerce to surreptitious channels. Solutions that might be pursued to improve shellfish aquaculture health management include the establishment of more broad-based surveillance programmes, wider training and use of general methods like histopathology to ensure alertness to emerging diseases, an increased focus on assay assessment and validation as fundamental to assay development, investment in basic research, and application of risk analyses to improve regulation. A continual sharpening of diagnostic tools and approaches and deepening of scientific knowledge is necessary to manage diseases and promote sustainable molluscan shellfish industries. PMID:26880834

Using Targeted Active-Learning Exercises and Diagnostic Question Clusters to Improve Students' Understanding of Carbon Cycling in Ecosystems

PubMed Central

Maskiewicz, April Cordero; Griscom, Heather Peckham; Welch, Nicole Turrill

2012-01-01

In this study, we used targeted active-learning activities to help students improve their ways of reasoning about carbon flow in ecosystems. The results of a validated ecology conceptual inventory (diagnostic question clusters [DQCs]) provided us with information about students' understanding of and reasoning about transformation of inorganic and organic carbon-containing compounds in biological systems. These results helped us identify specific active-learning exercises that would be responsive to students' existing knowledge. The effects of the active-learning interventions were then examined through analysis of students' pre- and postinstruction responses on the DQCs. The biology and non–biology majors participating in this study attended a range of institutions and the instructors varied in their use of active learning; one lecture-only comparison class was included. Changes in pre- to postinstruction scores on the DQCs showed that an instructor's teaching method had a highly significant effect on student reasoning following course instruction, especially for questions pertaining to cellular-level, carbon-transforming processes. We conclude that using targeted in-class activities had a beneficial effect on student learning regardless of major or class size, and argue that using diagnostic questions to identify effective learning activities is a valuable strategy for promoting learning, as gains from lecture-only classes were minimal. PMID:22383618

Evaluating Diagnostic Point-of-Care Tests in Resource-Limited Settings

PubMed Central

Drain, Paul K; Hyle, Emily P; Noubary, Farzad; Freedberg, Kenneth A; Wilson, Douglas; Bishai, William; Rodriguez, William; Bassett, Ingrid V

2014-01-01

Diagnostic point-of-care (POC) testing is intended to minimize the time to obtain a test result, thereby allowing clinicians and patients to make an expeditious clinical decision. As POC tests expand into resource-limited settings (RLS), the benefits must outweigh the costs. To optimize POC testing in RLS, diagnostic POC tests need rigorous evaluations focused on relevant clinical outcomes and operational costs, which differ from evaluations of conventional diagnostic tests. Here, we reviewed published studies on POC testing in RLS, and found no clearly defined metric for the clinical utility of POC testing. Therefore, we propose a framework for evaluating POC tests, and suggest and define the term “test efficacy” to describe a diagnostic test’s capacity to support a clinical decision within its operational context. We also proposed revised criteria for an ideal diagnostic POC test in resource-limited settings. Through systematic evaluations, comparisons between centralized diagnostic testing and novel POC technologies can be more formalized, and health officials can better determine which POC technologies represent valuable additions to their clinical programs. PMID:24332389

Machine learning-based in-line holographic sensing of unstained malaria-infected red blood cells.

PubMed

Go, Taesik; Kim, Jun H; Byeon, Hyeokjun; Lee, Sang J

2018-04-19

Accurate and immediate diagnosis of malaria is important for medication of the infectious disease. Conventional methods for diagnosing malaria are time consuming and rely on the skill of experts. Therefore, an automatic and simple diagnostic modality is essential for healthcare in developing countries that lack the expertise of trained microscopists. In the present study, a new automatic sensing method using digital in-line holographic microscopy (DIHM) combined with machine learning algorithms was proposed to sensitively detect unstained malaria-infected red blood cells (iRBCs). To identify the RBC characteristics, 13 descriptors were extracted from segmented holograms of individual RBCs. Among the 13 descriptors, 10 features were highly statistically different between healthy RBCs (hRBCs) and iRBCs. Six machine learning algorithms were applied to effectively combine the dominant features and to greatly improve the diagnostic capacity of the present method. Among the classification models trained by the 6 tested algorithms, the model trained by the support vector machine (SVM) showed the best accuracy in separating hRBCs and iRBCs for training (n = 280, 96.78%) and testing sets (n = 120, 97.50%). This DIHM-based artificial intelligence methodology is simple and does not require blood staining. Thus, it will be beneficial and valuable in the diagnosis of malaria. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Serum Protein KNG1, APOC3, and PON1 as Potential Biomarkers for Yin-Deficiency-Heat Syndrome.

PubMed

Liu, Changming; Mao, Liangen; Ping, Zepeng; Jiang, Tingting; Wang, Chong; Chen, Zhongliang; Li, Zhongjie; Li, Jicheng

2016-01-01

Yin-deficiency-heat (YDH) syndrome is a concept in Traditional Chinese Medicine (TCM) for describing subhealth status. However, there are few efficient diagnostic methods available for confirming YDH syndrome. To explore the novel method for diagnosing YDH syndrome, we applied iTRAQ to observe the serum protein profiles in YDH syndrome rats and confirmed protein levels by ELISA. A total of 92 differentially expressed proteins (63 upregulated proteins and 29 downregulated proteins), which were mainly involved in complement and coagulation cascades and glucose metabolism pathway, were identified by the proteomic experiments. Kininogen 1 (KNG1) was significantly increased ( p < 0.0001), while apolipoprotein C-III (APOC3, p < 0.005) and paraoxonase 1 (PON1, p < 0.001) were significantly decreased in the serum of YDH syndrome rats. The combination of KNG1, APOC3, and PON1 constituted a diagnostic model with 100.0% sensitivity and 85.0% specificity. The results indicated that KNG1, APOC3, and PON1 may act as potential biomarkers for diagnosing YDH syndrome. KNG1 may regulate cytokines and chemokines release in YDH syndrome, and the low levels of PON1 and APOC3 may increase oxidative stress and lipolysis in YDH syndrome, respectively. Our work provides a novel method for YDH syndrome diagnosis and also provides valuable experimental basis to understand the molecular mechanism of YDH syndrome.

Ocular static and dynamic light scattering: a noninvasive diagnostic tool for eye research and clinical practice

NASA Technical Reports Server (NTRS)

Ansari, Rafat R.

2004-01-01

The noninvasive techniques of static and dynamic light scattering are emerging as valuable diagnostic tools for the early detection of ocular and systemic diseases. These include corneal abnormalities, pigmentary dispersion syndrome, glaucoma, cataract, diabetic vitreopathy, and possibly macular degeneration. Systemic conditions such as diabetes and possibly Alzheimer's disease can potentially be detected early via ocular tissues. The current state of development of these techniques for application to ophthalmic research and ultimately clinical practice is reviewed. (c) 2004 Society of Photo-Optical Instrumentation Engineers.

Commercial Molecular Tests for Fungal Diagnosis from a Practical Point of View.

PubMed

Lackner, Michaela; Lass-Flörl, Cornelia

2017-01-01

The increasing interest in molecular diagnostics is a result of tremendously improved knowledge on fungal infections in the past 20 years and the rapid development of new methods, in particular polymerase chain reaction. High expectations have been placed on molecular diagnostics, and the number of laboratories now using the relevant technology is rapidly increasing-resulting in an obvious need for standardization and definition of laboratory organization. In the past 10 years, multiple new molecular tools were marketed for the detection of DNA, antibodies, cell wall components, or other antigens. In contrast to classical culture methods, molecular methods do not detect a viable organisms, but only molecules which indicate its presence; this can be nucleic acids, cell components (antigens), or antibodies (Fig. 1). In this chapter, an overview is provided on commercially available detection tools, their strength and how to use them. A main focus is laid on providing tips and tricks that make daily life easier. We try to focus and mention methodical details which are not highlighted in the manufacturer's instructions of these test kits, but are based on our personal experience in the laboratory. Important to keep in mind is that molecular tools cannot replace culture, microscopy, or a critical view on patients' clinical history, signs, and symptoms, but provide a valuable add on tool. Diagnosis should not be based solely on a molecular test, but molecular tools might deliver an important piece of information that helps matching the diagnostic puzzle to a diagnosis, in particular as few tests are in vitro diagnostic tests (IVD) or only part of the whole test carries the IVD certificate (e.g., DNA extraction is often not included). Please be aware that the authors do not claim to provide a complete overview on all commercially available diagnostic assays being currently marketed for fungal detection, as those are subject to constant change. A main focus is put on commonly used panfungal assays and pathogen-specific assays, including Aspergillus-specific, Candida-specific, Cryptococcus specific, Histoplasma-specific, and Pneumocystis-specific assays. Assays are categorized according to their underlying principle in either antigen-detecting or antibody-detecting or DNA-detecting (Fig. 1). Other non-DNA-detecting nucleic acid methods such as FISH and PNA FISH are not summarized in this chapter and an overview on test performance, common false positives, and the clinical evaluation of commercial tests in studies is provided already in a previous book series by Javier Yugueros Marcos and David H. Pincus (Marcos and Pincus, Methods Mol Biol 968:25-54, 2013).

Nonperturbative measurement of the local magnetic field using pulsed polarimetry for fusion reactor conditions (invited)a)

NASA Astrophysics Data System (ADS)

Smith, Roger J.

2008-10-01

A novel diagnostic technique for the remote and nonperturbative sensing of the local magnetic field in reactor relevant plasmas is presented. Pulsed polarimetry [Patent No. 12/150,169 (pending)] combines optical scattering with the Faraday effect. The polarimetric light detection and ranging (LIDAR)-like diagnostic has the potential to be a local Bpol diagnostic on ITER and can achieve spatial resolutions of millimeters on high energy density (HED) plasmas using existing lasers. The pulsed polarimetry method is based on nonlocal measurements and subtle effects are introduced that are not present in either cw polarimetry or Thomson scattering LIDAR. Important features include the capability of simultaneously measuring local Te, ne, and B∥ along the line of sight, a resiliency to refractive effects, a short measurement duration providing near instantaneous data in time, and location for real-time feedback and control of magnetohydrodynamic (MHD) instabilities and the realization of a widely applicable internal magnetic field diagnostic for the magnetic fusion energy program. The technique improves for higher neB∥ product and higher ne and is well suited for diagnosing the transient plasmas in the HED program. Larger devices such as ITER and DEMO are also better suited to the technique, allowing longer pulse lengths and thereby relaxing key technology constraints making pulsed polarimetry a valuable asset for next step devices. The pulsed polarimetry technique is clarified by way of illustration on the ITER tokamak and plasmas within the magnetized target fusion program within present technological means.

Reliability and validity of a Chinese version of the Diagnostic Interview for Borderlines-Revised.

PubMed

Wang, Lanlan; Yuan, Chenmei; Qiu, Jianying; Gunderson, John; Zhang, Min; Jiang, Kaida; Leung, Freedom; Zhong, Jie; Xiao, Zeping

2014-09-01

Borderline personality disorder (BPD) is the most studied of the axis II disorders. One of the most widely used diagnostic instruments is the Diagnostic Interview for Borderline Patients-Revised (DIB-R). The aim of this study was to test the reliability and validity of DIB-R for use in the Chinese culture. The reliability and validity of the DIB-R Chinese version were assessed in a sample of 236 outpatients with a probable BPD diagnosis. The Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II) was used as a standard. Test-retest reliability was tested six months later with 20 patients, and inter-rater reliability was tested on 32 patients. The Chinese version of the DIB-R showed good internal global consistency (Cronbach's α of 0.916), good test-retest reliability (Pearson correlation of 0.704), good inter-rater reliability (intra-class correlation coefficient of 0.892 and kappa of 0.861). When compared with the DSM-IV diagnosis as measured by the SCID-II, the DIB-R showed relatively good sensitivity (0.768) and specificity (0.891) at the cutoff of 7, moderate diagnostic convergence (kappa of 0.631), as well as good discriminating validity. The Chinese version of the DIB-R has good psychometric properties, which renders it a valuable method for examining the presence, the severity, and component phenotypes of BPD in Chinese samples. © 2013 Wiley Publishing Asia Pty Ltd.

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

PubMed Central

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

2013-01-01

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

Does the Alpha-defensin Immunoassay or the Lateral Flow Test Have Better Diagnostic Value for Periprosthetic Joint Infection? A Systematic Review.

PubMed

Eriksson, Hannah K; Nordström, Jakob; Gabrysch, Katja; Hailer, Nils P; Lazarinis, Stergios

2018-05-01

Measuring alpha-defensin concentrations in synovial fluid may help to diagnose periprosthetic joint infection (PJI). There are two commercially available methods for measuring alpha-defensin in synovial fluid: the enzyme-linked immunosorbent assay-based Synovasure® alpha-defensin immunoassay, which gives a numeric readout within 24 hours, and the Synovasure lateral flow test, which gives a binary readout within 20 minutes. There is no compilation of the existing literature to support the use of one of these two tests over the other. Does the immunoassay or the lateral flow test have better diagnostic value (sensitivity and specificity) in diagnosing PJI? We followed PRISMA guidelines and identified all studies on alpha-defensin concentration in synovial fluid as a PJI diagnostic marker, indexed to April 14, 2017, in PubMed, JSTOR, Google Scholar, and OVID databases. The search retrieved 1578 records. All prospective and retrospective studies on alpha-defensin as a PJI marker (PJI classified according to the criteria of the Musculoskeletal Infection Society) after THA or TKA were included in the analysis. All studies used only one of the two commercially available test methods, but none of them was comparative. After excluding studies with overlapping patient populations, four studies investigating the alpha-defensin immunoassay and three investigating the lateral flow test remained. Alpha-defensin immunoassay studies included 482 joints and lateral flow test studies included 119. The quality of the trials was assessed according to the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. The heterogeneity among studies was evaluated by the I index, indicating that the heterogeneity of the included studies was low. Pooled sensitivity, specificity, positive and negative likelihood ratios, and receiver operating curves were calculated for each method and compared with each other. The alpha-defensin immunoassay had superior overall diagnostic value compared with the lateral flow test (area under the curve, 0.98 versus 0.75) with higher sensitivity (96% [90%-98%] versus 71% [55%-83%], p < 0.001), but no difference in specificity with the numbers available (96% [93%-97%] versus 90% [81%-95%], p = 0.060). Measurement of alpha-defensin in synovial fluid is a valuable complement to existing diagnostic criteria, and the immunoassay test detects PJI more accurately than the lateral flow test. The lateral flow test has lower sensitivity, making it difficult to rule out infection, but its relatively high specificity combined with the advantage of a quick response time can make it useful to rule in infection perioperatively. Level III, diagnostic study.

Teaching Evidence-based Medicine: Caveats and Challenges.

ERIC Educational Resources Information Center

Welch, H. Gilbert; Lurie, Jon D.

2000-01-01

Discusses three caveats to the evidence-based paradigm in medical education: (1) detection of abnormalities that may not ever be overtly expressed inflates apparent diagnostic test performance; (2) probability revision is valuable primarily as an exercise to gain qualitative insights; and (3) patients are likely to be interested in more than just…

Alternative Surfactants for Improved Efficiency of In Situ Tryptic Proteolysis of Fingermarks

NASA Astrophysics Data System (ADS)

Patel, Ekta; Clench, Malcolm R.; West, Andy; Marshall, Peter S.; Marshall, Nathan; Francese, Simona

2015-06-01

Despite recent improvements to in situ proteolysis strategies, a higher efficiency is still needed to increase both the number of peptides detected and the associated ion intensity, leading to a complete and reliable set of biomarkers for diagnostic or prognostic purposes. In the study presented here, an extract of a systematic study is illustrated investigating a range of surfactants assisting trypsin proteolytic activity. Method development was trialled on fingermarks; this specimen results from a transfer of sweat from an individual's fingertip to a surface upon contact. As sweat carries a plethora of biomolecules, including peptides and proteins, fingermarks are, potentially, a very valuable specimen for non-invasive prognostic or diagnostic screening. A recent study has demonstrated the opportunity to quickly detect peptides and small proteins in fingermarks using Matrix Assisted Laser Desorption Ionization Mass Spectrometry Profiling (MALDI MSP). However, intact detection bears low sensitivity and does not allow species identification; therefore, a shotgun proteomic approach was employed involving in situ proteolysis. Data demonstrate that in fingermarks, further improvements to the existing method can be achieved using MEGA-8 as surfactant in higher percentages as well as combinations of different detergents. Also, for the first time, Rapigest SF, normally used in solution digestions, has been shown to successfully work also for in situ proteolysis.

Virtopsy: postmortem imaging of laryngeal foreign bodies.

PubMed

Oesterhelweg, Lars; Bolliger, Stephan A; Thali, Michael J; Ross, Steffen

2009-05-01

Death from corpora aliena in the larynx is a well-known entity in forensic pathology. The correct diagnosis of this cause of death is difficult without an autopsy, and misdiagnoses by external examination alone are common. To determine the postmortem usefulness of modern imaging techniques in the diagnosis of foreign bodies in the larynx, multislice computed tomography, magnetic resonance imaging, and postmortem full-body computed tomography-angiography were performed. Three decedents with a suspected foreign body in the larynx underwent the 3 different imaging techniques before medicolegal autopsy. Multislice computed tomography has a high diagnostic value in the noninvasive localization of a foreign body and abnormalities in the larynx. The differentiation between neoplasm or soft foreign bodies (eg, food) is possible, but difficult, by unenhanced multislice computed tomography. By magnetic resonance imaging, the discrimination of the soft tissue structures and soft foreign bodies is much easier. In addition to the postmortem multislice computed tomography, the combination with postmortem angiography will increase the diagnostic value. Postmortem, cross-sectional imaging methods are highly valuable procedures for the noninvasive detection of corpora aliena in the larynx.

Diagnostic accuracy of fundal height and handheld ultrasound-measured abdominal circumference to screen for fetal growth abnormalities

PubMed Central

Haragan, Adriane F.; Hulsey, Thomas C.; Hawk, Angela F.; Newman, Roger B.; Chang, Eugene Y.

2015-01-01

OBJECTIVE We sought to compare fundal height and handheld ultrasound–measured fetal abdominal circumference (HHAC) for the prediction of fetal growth restriction (FGR) or large for gestational age. STUDY DESIGN This was a diagnostic accuracy study in nonanomalous singleton pregnancies between 24 and 40 weeks’ gestation. Patients underwent HHAC and fundal height measurement prior to formal growth ultrasound. FGR was defined as estimated fetal weight less than 10%, whereas large for gestational age was defined as estimated fetal weight greater than 90%. Sensitivity and specificity were calculated and compared using methods described elsewhere. RESULTS There were 251 patients included in this study. HHAC had superior sensitivity and specificity for the detection of FGR (sensitivity, 100% vs 42.86%) and (specificity, 92.62% vs 85.24%). HHAC had higher specificity but lower sensitivity when screening for LGA (specificity, 85.66% vs 66.39%) and (sensitivity, 57.14% vs 71.43%). CONCLUSION HHAC could prove to be a valuable screening tool in the detection of FGR. Further studies are needed in a larger population. PMID:25818672

Rift Valley Fever Virus Structural and Nonstructural Proteins: Recombinant Protein Expression and Immunoreactivity Against Antisera from Sheep

PubMed Central

Faburay, Bonto; Wilson, William; McVey, D. Scott; Drolet, Barbara S.; Weingartl, Hana; Madden, Daniel; Young, Alan; Ma, Wenjun

2013-01-01

Abstract The Rift Valley fever virus (RVFV) encodes the structural proteins nucleoprotein (N), aminoterminal glycoprotein (Gn), carboxyterminal glycoprotein (Gc), and L protein, 78-kD, and the nonstructural proteins NSm and NSs. Using the baculovirus system, we expressed the full-length coding sequence of N, NSs, NSm, Gc, and the ectodomain of the coding sequence of the Gn glycoprotein derived from the virulent strain of RVFV ZH548. Western blot analysis using anti-His antibodies and monoclonal antibodies against Gn and N confirmed expression of the recombinant proteins, and in vitro biochemical analysis showed that the two glycoproteins, Gn and Gc, were expressed in glycosylated form. Immunoreactivity profiles of the recombinant proteins in western blot and in indirect enzyme-linked immunosorbent assay against a panel of antisera obtained from vaccinated or wild type (RVFV)-challenged sheep confirmed the results obtained with anti-His antibodies and demonstrated the suitability of the baculo-expressed antigens for diagnostic assays. In addition, these recombinant proteins could be valuable for the development of diagnostic methods that differentiate infected from vaccinated animals (DIVA). PMID:23962238

Rapid diagnosis of equine influenza by highly sensitive silver amplification immunochromatography system.

PubMed

Yamanaka, Takashi; Nemoto, Manabu; Bannai, Hiroshi; Tsujimura, Koji; Kondo, Takashi; Matsumura, Tomio; Fu, Tao Qi Huang; Fernandez, Charlene Judith; Gildea, Sarah; Cullinane, Ann

2017-06-16

Equine influenza (EI) is a respiratory disease caused by equine influenza A virus (EIV, H3N8) infection. Rapid diagnosis is essential to limit the disease spread. We previously reported that some rapid antigen detection (RAD) tests are fit for diagnosing EI although their sensitivity is not optimal. Here, we evaluated the performance of the newly developed RAD test using silver amplification immunochromatography (Quick Chaser Auto Flu A, B: QCA) to diagnose EI. The detection limits of QCA for EIVs were five-fold lower than the conventional RAD tests. The duration of virus antigen detection in the infected horses was longer than the conventional RAD tests. We conclude that QCA could be a valuable diagnostic method for EI.

Free jet feasibility study of a thermal acoustic shield concept for AST/VCE application: Single stream nozzles

NASA Technical Reports Server (NTRS)

Majjigi, R. K.; Brausch, J. F.; Janardan, B. A.; Balsa, T. F.; Knott, P. R.; Pickup, N.

1984-01-01

A technology base for the thermal acoustic shield concept as a noise suppression device for single stream exhaust nozzles was developed. Acoustic data for 314 test points for 9 scale model nozzle configurations were obtained. Five of these configurations employed an unsuppressed annular plug core jet and the remaining four nozzles employed a 32 chute suppressor core nozzle. Influence of simulated flight and selected geometric and aerodynamic flow variables on the acoustic behavior of the thermal acoustic shield was determined. Laser velocimeter and aerodynamic measurements were employed to yield valuable diagnostic information regarding the flow field characteristics of these nozzles. An existing theoretical aeroacoustic prediction method was modified to predict the acoustic characteristics of partial thermal acoustic shields.

Loop-mediated isothermal amplification (LAMP) assay-A rapid detection tool for identifying red fox (Vulpes vulpes) DNA in the carcasses of harbour porpoises (Phocoena phocoena).

PubMed

Heers, Teresa; van Neer, Abbo; Becker, André; Grilo, Miguel Luca; Siebert, Ursula; Abdulmawjood, Amir

2017-01-01

Carcasses of wild animals are often visited by different scavengers. However, determining which scavenger caused certain types of bite marks is particularly difficult and knowledge thereof is lacking. Therefore, a loop-mediated isothermal amplification (LAMP) assay (target sequence cytochrome b) was developed to detect red fox DNA in carcasses of harbour porpoises. The MSwab™ method for direct testing without prior DNA isolation was validated. As a detection device, the portable real-time fluorometer Genie® II was used, which yields rapid results and can be used in field studies without huge laboratory equipment. In addition to in vitro evaluation and validation, a stranded and scavenged harbour porpoise carcass was successfully examined for red fox DNA residues. The developed LAMP method is a valuable diagnostic tool for confirming presumable red fox bite wounds in harbour porpoises without further DNA isolation steps.

Nonlinear modeling of chaotic time series: Theory and applications

NASA Astrophysics Data System (ADS)

Casdagli, M.; Eubank, S.; Farmer, J. D.; Gibson, J.; Desjardins, D.; Hunter, N.; Theiler, J.

We review recent developments in the modeling and prediction of nonlinear time series. In some cases, apparent randomness in time series may be due to chaotic behavior of a nonlinear but deterministic system. In such cases, it is possible to exploit the determinism to make short term forecasts that are much more accurate than one could make from a linear stochastic model. This is done by first reconstructing a state space, and then using nonlinear function approximation methods to create a dynamical model. Nonlinear models are valuable not only as short term forecasters, but also as diagnostic tools for identifying and quantifying low-dimensional chaotic behavior. During the past few years, methods for nonlinear modeling have developed rapidly, and have already led to several applications where nonlinear models motivated by chaotic dynamics provide superior predictions to linear models. These applications include prediction of fluid flows, sunspots, mechanical vibrations, ice ages, measles epidemics, and human speech.

Dynamic markers based on blood perfusion fluctuations for selecting skin melanocytic lesions for biopsy

NASA Astrophysics Data System (ADS)

Lancaster, Gemma; Stefanovska, Aneta; Pesce, Margherita; Marco Vezzoni, Gian; Loggini, Barbara; Pingitore, Raffaele; Ghiara, Fabrizio; Barachini, Paolo; Cervadoro, Gregorio; Romanelli, Marco; Rossi, Marco

2015-08-01

Skin malignant melanoma is a highly angiogenic cancer, necessitating early diagnosis for positive prognosis. The current diagnostic standard of biopsy and histological examination inevitably leads to many unnecessary invasive excisions. Here, we propose a non-invasive method of identification of melanoma based on blood flow dynamics. We consider a wide frequency range from 0.005-2 Hz associated with both local vascular regulation and effects of cardiac pulsation. Combining uniquely the power of oscillations associated with individual physiological processes we obtain a marker which distinguishes between melanoma and atypical nevi with sensitivity of 100% and specificity of 90.9%. The method reveals valuable functional information about the melanoma microenvironment. It also provides the means for simple, accurate, in vivo distinction between malignant melanoma and atypical nevi, and may lead to a substantial reduction in the number of biopsies currently undertaken.

Tracing Magnetic Fields With The Polarization Of Submillimeter Lines

NASA Astrophysics Data System (ADS)

Zhang, Heshou; Yan, Huirong

2017-10-01

Magnetic fields play important roles in many astrophysical processes. However, there is no universal diagnostic for the magnetic fields in the interstellar medium (ISM) and each magnetic tracer has its limitation. Any new detection method is thus valuable. Theoretical studies have shown that submillimeter fine-structure lines are polarized due to atomic alignment by Ultraviolet (UV) photon-excitation, which opens up a new avenue to probe interstellar magnetic fields. The method is applicable to all radiative-excitation dominant region, e.g., H II Regions, PDRs. The polarization of the submillimeter fine-structure lines induced by atomic alignment could be substantial and the applicability of using the spectro-polarimetry of atomic lines to trace magnetic fields has been supported by synthetic observations of simulated ISM in our recent paper. Our results demonstrate that the polarization of submillimeter atomic lines is a powerful magnetic tracer and add great value to the observational studies of the submilimeter astronomy.

Vibrotactile perception threshold measurements for diagnosis of sensory neuropathy. Description of a reference population.

PubMed

Lundström, R; Strömberg, T; Lundborg, G

1992-01-01

Recognition of the fact that impairment of the tactile sense may occur independently of other disturbances in the vibration syndrome has rekindled an interest in developing a diagnostic method for early detection of vibration-induced neuropathy. There is also evidence suggesting that vibrotactile measurements represent a valuable diagnostic tool in compressive neuropathies, such as the carpal tunnel syndrome. The method may also become useful for diagnosing sensory neuropathies caused by other factors, such as solvents, pesticides, heavy metals, alcoholism, and diabetes. However, before vibrotactile measurement can be accepted and established as a tool for clinical diagnostic purposes, for screening, and in research, the level and the shape of the normal threshold curve have to be specified. With the purpose of assembling normative data, the vibrotactile perception thresholds (8-500 Hz) of the right index fingertip were measured in 171 healthy males (19-75 years) not exposed to vibration. A Békésy audiometer was modified to operate in combination with a vibration exciter, instead of headphones, at frequencies lower than usual (8-500 Hz). The results showed that the perception thresholds increased from about 100 dB to about 140 dB (rel. 10(-6) m/s2rms) as a function of frequency and age. The frequency-dependent changes were not linear, however, but displayed a peak in sensitivity at 125 Hz. Threshold changes due to aging were most pronounced at the highest frequencies. It is of the utmost importance that these natural changes are taken into account when making comparisons between groups or individuals.

Simple and robust diagnosis of early, small and AFP-negative primary hepatic carcinomas: an integrative approach of serum fluorescence and conventional blood tests.

PubMed

Wang, Ting; Zhang, Kun-He; Hu, Piao-Ping; Huang, Zeng-Yong; Zhang, Pan; Wan, Qin-Si; Huang, De-Qiang; Lv, Nong-Hua

2016-09-27

The diagnosis of early, small and alpha-fetoprotein (AFP)-negative primary hepatic carcinomas (PHCs) remains a significant challenge. We developed a simple and robust approach to noninvasively detect these PHCs. A rapid, high-throughput and single-tube method was firstly developed to measure serum autofluorescence and cell-free DNA (cfDNA)-related fluorescence using a real-time PCR system, and both types of serum fluorescence were measured and routine laboratory data were collected in 1229 subjects, including 353 PHC patients, 331 liver cirrhosis (LC) patients, 213 chronic hepatitis (CH) patients and 332 normal controls (NC). The results showed that fluorescence indicators of PHC differed from those of NC, CH and LC to various extents, and all of them were not associated with age, gender, or AFP level. The logistic regression models established with the fluorescence indicators alone and combined with AFP, hepatic function tests and blood cell analyses were valuable for distinguishing early, small, AFP-negative and all PHC from LC, CH, NC and all non-PHC, with areas under the receiver operating characteristic curves 0.857-0.993 and diagnostic accuracies 80.2-97.7%. Conclusively, serum autofluorescence and cfDNA-related fluorescence are able to be rapidly and simultaneously measured by our simple method and valuable for diagnosing early, small and AFP-negative PHCs, especially integrating with AFP and conventional blood tests.

From accuracy to patient outcome and cost-effectiveness evaluations of diagnostic tests and biomarkers: an exemplary modelling study

PubMed Central

2013-01-01

Background Proper evaluation of new diagnostic tests is required to reduce overutilization and to limit potential negative health effects and costs related to testing. A decision analytic modelling approach may be worthwhile when a diagnostic randomized controlled trial is not feasible. We demonstrate this by assessing the cost-effectiveness of modified transesophageal echocardiography (TEE) compared with manual palpation for the detection of atherosclerosis in the ascending aorta. Methods Based on a previous diagnostic accuracy study, actual Dutch reimbursement data, and evidence from literature we developed a Markov decision analytic model. Cost-effectiveness of modified TEE was assessed for a life time horizon and a health care perspective. Prevalence rates of atherosclerosis were age-dependent and low as well as high rates were applied. Probabilistic sensitivity analysis was applied. Results The model synthesized all available evidence on the risk of stroke in cardiac surgery patients. The modified TEE strategy consistently resulted in more adapted surgical procedures and, hence, a lower risk of stroke and a slightly higher number of life-years. With 10% prevalence of atherosclerosis the incremental cost-effectiveness ratio was €4,651 and €481 per quality-adjusted life year in 55-year-old men and women, respectively. In all patients aged 65 years or older the modified TEE strategy was cost saving and resulted in additional health benefits. Conclusions Decision analytic modelling to assess the cost-effectiveness of a new diagnostic test based on characteristics, costs and effects of the test itself and of the subsequent treatment options is both feasible and valuable. Our case study on modified TEE suggests that it may reduce the risk of stroke in cardiac surgery patients older than 55 years at acceptable cost-effectiveness levels. PMID:23368927

Diagnostic efficacy of contrast-enhanced sonography by combined qualitative and quantitative analysis in breast lesions: a comparative study with magnetic resonance imaging.

PubMed

Wang, Lin; Du, Jing; Li, Feng-Hua; Fang, Hua; Hua, Jia; Wan, Cai-Feng

2013-10-01

The purpose of this study was to evaluate the diagnostic efficacy of contrast-enhanced sonography for differentiation of breast lesions by combined qualitative and quantitative analyses in comparison to magnetic resonance imaging (MRI). Fifty-six patients with American College of Radiology Breast Imaging Reporting and Data System category 3 to 5 breast lesions on conventional sonography were evaluated by contrast-enhanced sonography and MRI. A comparative analysis of diagnostic results between contrast-enhanced sonography and MRI was conducted in light of the pathologic findings. Pathologic analysis showed 26 benign and 30 malignant lesions. The predominant enhancement patterns of the benign lesions on contrast-enhanced sonography were homogeneous, centrifugal, and isoenhancement or hypoenhancement, whereas the patterns of the malignant lesions were mainly heterogeneous, centripetal, and hyperenhancement. The detection rates for perfusion defects and peripheral radial vessels in the malignant group were much higher than those in the benign group (P < .05). As to quantitative analysis, statistically significant differences were found in peak and time-to-peak values between the groups (P < .05). With pathologic findings as the reference standard, the sensitivity, specificity, and accuracy of contrast-enhanced sonography and MRI were 90.0%, 92.3%, 91.1% and 96.7%, 88.5%, and 92.9%, respectively. The two methods had a concordant rate of 87.5% (49 of 56), and the concordance test gave a value of κ = 0.75, indicating that there was high concordance in breast lesion assessment between the two diagnostic modalities. Contrast-enhanced sonography provided typical enhancement patterns and valuable quantitative parameters, which showed good agreement with MRI in diagnostic efficacy and may potentially improve characterization of breast lesions.

Diagnosis and treatment of viral diseases in recipients of allogeneic hematopoietic stem cell transplantation

PubMed Central

2013-01-01

Viral infections are important causes of morbidity and mortality after allogeneic stem cell hematopoietic transplantation (allo-HSCT). Although most viral infections present with asymptomatic or subclinical manifestations, viruses may result in fatal complications in severe immunocompromised recipients. Reactivation of latent viruses, such as herpesviruses, is frequent during the immunosuppression that occurs with allo-HSCT. Viruses acquired from community, such as the respiratory and gastrointestinal viruses, are also important pathogens of post-transplant viral diseases. Currently, molecular diagnostic methods have replaced or supplemented traditional methods, such as viral culture and antigen detection, in diagnosis of viral infections. The utilization of polymerase chain reaction facilitates the early diagnosis. In view of lacking efficacious agents for treatment of viral diseases, prevention of viral infections is extremely valuable. Application of prophylactic strategies including preemptive therapy reduces viral infections and diseases. Adoptive cellular therapy for restoring virus-specific immunity is a promising method in the treatment of viral diseases. PMID:24341630

18F-FDG PET/CT in Detecting Metastatic Infection in Children.

PubMed

Kouijzer, Ilse J E; Blokhuis, Gijsbert J; Draaisma, Jos M T; Oyen, Wim J G; de Geus-Oei, Lioe-Fee; Bleeker-Rovers, Chantal P

2016-04-01

Metastatic infection is a severe complication of bacteremia with high morbidity and mortality. The aim of this study was to investigate the diagnostic value of 18F-FDG PET combined with CT (FDG PET/CT) in children suspected of having metastatic infection. The results of FDG PET/CT scans performed in children because of suspected metastatic infection from September 2003 to June 2013 were analyzed retrospectively. The results were compared with the final clinical diagnosis. FDG PET/CT was performed in 13 children with suspected metastatic infection. Of the total number of FDG PET/CT scans, 38% were clinically helpful. Positive predictive value of FDG PET/CT was 71%, and negative predictive value was 100%. FDG PET/CT appears to be a valuable diagnostic technique in children with suspected metastatic infection. Prospective studies of FDG PET/CT as part of a structured diagnostic protocol are needed to assess the exact additional diagnostic value.

Diagnostic and therapeutic value of laparoscopy for small bowel blunt injuries: A case report.

PubMed

Addeo, Pietro; Calabrese, Daniela Paola

2011-01-01

Small bowel injuries after blunt abdominal trauma represent both a diagnostic and a therapeutic challenge. Early diagnosis and prompt treatment are necessary in order to avoid a dangerous diagnostic delay. Laparoscopy can represent a diagnostic and therapeutic tool in patients with uncertain clinical symptoms. We report the case of a 25-year-old man, haemodynamically stable, admitted for acute abdominal pain a few hours after a physical assault. Giving the persistence of the abdominal pain and the presence of free fluids at the computed tomography examination, an exploratory laparoscopy was performed. At the laparoscopic exploration, an isolated small bowel perforation was found, 60 cm distal from the ligament of Treitz. The injury was repaired by laparoscopic suturing and the patient was discharged home at postoperative day 3 after an uneventful postoperative course. Laparoscopy represents a valuable tool for patients with small bowel blunt injuries allowing a timely diagnosis and a prompt treatment.

Bone sialoprotein in laboratory diagnostic work-up of osteoarthritis.

PubMed

Lis, Kinga

2008-01-01

Changes in osteoarthritis joint appear in the articular cartilage, synovium and in subchondral bone. It is necessary to find, apart from markers of cartilage destruction, a sensitive and specific biochemical marker which would reflect the metabolism as well as degradation of subchondral bone. Bone sialoprotein is mostly synthesized in osseous tissue found directly under the surface of joint cartilage. As a result, it is being increasingly perceived as a valuable marker of the metabolism rate of this layer of bone. Bone sialoprotein seems to be of use as a marker for subchondral bone degradation rate in laboratory diagnostic work-up of osteoarthritis.

Action Research to Improve the Learning Space for Diagnostic Techniques.

PubMed

Ariel, Ellen; Owens, Leigh

2015-12-01

The module described and evaluated here was created in response to perceived learning difficulties in diagnostic test design and interpretation for students in third-year Clinical Microbiology. Previously, the activities in lectures and laboratory classes in the module fell into the lower cognitive operations of "knowledge" and "understanding." The new approach was to exchange part of the traditional activities with elements of interactive learning, where students had the opportunity to engage in deep learning using a variety of learning styles. The effectiveness of the new curriculum was assessed by means of on-course student assessment throughout the module, a final exam, an anonymous questionnaire on student evaluation of the different activities and a focus group of volunteers. Although the new curriculum enabled a major part of the student cohort to achieve higher pass grades (p < 0.001), it did not meet the requirements of the weaker students, and the proportion of the students failing the module remained at 34%. The action research applied here provided a number of valuable suggestions from students on how to improve future curricula from their perspective. Most importantly, an interactive online program that facilitated flexibility in the learning space for the different reagents and their interaction in diagnostic tests was proposed. The methods applied to improve and assess a curriculum refresh by involving students as partners in the process, as well as the outcomes, are discussed. Journal of Microbiology & Biology Education.

Nonperturbative measurement of the local magnetic field using pulsed polarimetry for fusion reactor conditions (invited).

PubMed

Smith, Roger J

2008-10-01

A novel diagnostic technique for the remote and nonperturbative sensing of the local magnetic field in reactor relevant plasmas is presented. Pulsed polarimetry [Patent No. 12/150,169 (pending)] combines optical scattering with the Faraday effect. The polarimetric light detection and ranging (LIDAR)-like diagnostic has the potential to be a local B(pol) diagnostic on ITER and can achieve spatial resolutions of millimeters on high energy density (HED) plasmas using existing lasers. The pulsed polarimetry method is based on nonlocal measurements and subtle effects are introduced that are not present in either cw polarimetry or Thomson scattering LIDAR. Important features include the capability of simultaneously measuring local T(e), n(e), and B(parallel) along the line of sight, a resiliency to refractive effects, a short measurement duration providing near instantaneous data in time, and location for real-time feedback and control of magnetohydrodynamic (MHD) instabilities and the realization of a widely applicable internal magnetic field diagnostic for the magnetic fusion energy program. The technique improves for higher n(e)B(parallel) product and higher n(e) and is well suited for diagnosing the transient plasmas in the HED program. Larger devices such as ITER and DEMO are also better suited to the technique, allowing longer pulse lengths and thereby relaxing key technology constraints making pulsed polarimetry a valuable asset for next step devices. The pulsed polarimetry technique is clarified by way of illustration on the ITER tokamak and plasmas within the magnetized target fusion program within present technological means.

Evaluation of diagnostic value of AgNOR and PAP in early detection of dysplastic changes in leukoplakia and lichen planus - a preliminary case-control study.

PubMed

Rao, Dhanya S; Ali, I M; Annigeri, Rajeshwari G

2017-01-01

Early detection of oral cancer has been the most effective approach to reduce morbidity and mortality of cancer patients. If a lesion is clinically considered suspicious, an easily practicable, non-invasive, painless, safe, and accurate screening method for detection of the dysplastic changes is necessary. In an attempt to procure this, a study was conducted with the aim of determining the diagnostic accuracy of rapid Papanicolaou stain (PAP) and silver-stained nucleolar organizer regions (AgNOR) in brush biopsies of potentially malignant lesions for early detection of oral cancer. Brush biopsies taken from 25 cases of leukoplakia and lichen planus each were stained with rapid PAP and silver nitrate stains. Histopathological correlation was performed and further compared with rapid PAP and AgNOR for its diagnostic validity. Statistically significant increase in the mean AgNOR count was seen from normal epithelium to lichen planus to that of leukoplakia. When compared with rapid PAP, a linear correlation was seen in AgNOR counts and stages of dysplasia in leukoplakia which was also found to be statistically significant. Diagnostic accuracy for AgNOR in leukoplakia was found to be 84%, lichen planus 73%, whereas RAPID PAP showed 72% accuracy. AgNOR analysis may be useful as a quantitative marker of incipient cellular alterations and hence would be helpful in assessing suspicious lesions and thus can be regarded as a valuable adjunct. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Experimental investigation of commercially available lead composite aprons used for diagnostic X-rays

NASA Astrophysics Data System (ADS)

Shousha, Hany A.; Rabie, N.; Hassan, G. M.

2011-12-01

One of the principal diagnostic methods used in all fields of medical services is radiographic examination. To keep the radiation dose received by hospital personnel under normal working conditions as low as reasonably achievable, lead composite apron shields are provided as valuable aids. Intensive use of these accessories could lead to softening and surface defects due to poor handling and being worn-out over time, giving rise to multiple defects across the entire apron. Without routine control, these lead aprons will, within time, contribute significantly to the over-radiation burden to the wearer. However, local defects are highly likely to lead to gross changes in the radiation dose received by the wearer. For this reason, we evaluate the exposure dose resulting from diagnostic X-ray radiation during different imaging procedures. In this study, we used TLD LiF-700 chips to measure the attenuation percentage for four groups of commercial lead composite aprons and to calculate the effective doses to different organs during diagnostic radiological procedures. The results show the importance of lead composite aprons in minimizing effective doses, and the attenuation percentage varied for different vendors; this is due to variations in the constituent material. The average attenuation for lead composite aprons varies from 93.3% to 96.7%, and the average attenuation (%)/weight varies from 16.7% to 20.5%. Acceptance testing of lead composite aprons is essential to ensure that lead composite aprons meet their manufacturers' specifications and provide the necessary radiation protection for their intended use. The combined and expanded uncertainties accompanying these measurements are 2.78% and 5.57%, respectively.

Innovations in air sampling to detect plant pathogens

PubMed Central

West, JS; Kimber, RBE

2015-01-01

Many innovations in the development and use of air sampling devices have occurred in plant pathology since the first description of the Hirst spore trap. These include improvements in capture efficiency at relatively high air-volume collection rates, methods to enhance the ease of sample processing with downstream diagnostic methods and even full automation of sampling, diagnosis and wireless reporting of results. Other innovations have been to mount air samplers on mobile platforms such as UAVs and ground vehicles to allow sampling at different altitudes and locations in a short space of time to identify potential sources and population structure. Geographical Information Systems and the application to a network of samplers can allow a greater prediction of airborne inoculum and dispersal dynamics. This field of technology is now developing quickly as novel diagnostic methods allow increasingly rapid and accurate quantifications of airborne species and genetic traits. Sampling and interpretation of results, particularly action-thresholds, is improved by understanding components of air dispersal and dilution processes and can add greater precision in the application of crop protection products as part of integrated pest and disease management decisions. The applications of air samplers are likely to increase, with much greater adoption by growers or industry support workers to aid in crop protection decisions. The same devices are likely to improve information available for detection of allergens causing hay fever and asthma or provide valuable metadata for regional plant disease dynamics. PMID:25745191

Diagnostic accuracy of repetition tasks for the identification of specific language impairment (SLI) in bilingual children: evidence from Russian and Hebrew.

PubMed

Armon-Lotem, Sharon; Meir, Natalia

2016-11-01

Previous research demonstrates that repetition tasks are valuable tools for diagnosing specific language impairment (SLI) in monolingual children in English and a variety of other languages, with non-word repetition (NWR) and sentence repetition (SRep) yielding high levels of sensitivity and specificity. Yet, only a few studies have addressed the diagnostic accuracy of repetition tasks in bilingual children, and most available research focuses on English-Spanish sequential bilinguals. To evaluate the efficacy of three repetition tasks (forward digit span (FWD), NWR and SRep) in order to distinguish mono- and bilingual children with and without SLI in Russian and Hebrew. A total of 230 mono- and bilingual children aged 5;5-6;8 participated in the study: 144 bilingual Russian-Hebrew-speaking children (27 with SLI); and 52 monolingual Hebrew-speaking children (14 with SLI) and 34 monolingual Russian-speaking children (14 with SLI). Parallel repetition tasks were designed in both Russian and Hebrew. Bilingual children were tested in both languages. The findings confirmed that NWR and SRep are valuable tools in distinguishing monolingual children with and without SLI in Russian and Hebrew, while the results for FWD were mixed. Yet, testing of bilingual children with the same tools using monolingual cut-off points resulted in inadequate diagnostic accuracy. We demonstrate, however, that the use of bilingual cut-off points yielded acceptable levels of diagnostic accuracy. The combination of SRep tasks in L1/Russian and L2/Hebrew yielded the highest overall accuracy (i.e., 94%), but even SRep alone in L2/Hebrew showed excellent levels of sensitivity (i.e., 100%) and specificity (i.e., 89%), reaching 91% of total diagnostic accuracy. The results are very promising for identifying SLI in bilingual children and for showing that testing in the majority language with bilingual cut-off points can provide an accurate classification. © 2016 Royal College of Speech and Language Therapists.

Ana o 3-specific IgE is a good predictor for clinically relevant cashew allergy in children.

PubMed

Lange, L; Lasota, L; Finger, A; Vlajnic, D; Büsing, S; Meister, J; Broekaert, I; Pfannenstiel, C; Friedrichs, F; Price, M; Trendelenburg, V; Niggemann, B; Beyer, K

2017-04-01

Component-resolved diagnostics using specific IgE to 2 S albumins has shown to be a valuable new option in diagnostic procedure. Ana o 3 is a 2 S albumin from cashew. The aim of this study was to investigate the role of Ana o 3-specific serum IgE in the diagnosis of cashew allergy and to identify cut-off levels to replace oral food challenges. Moreover, the value of additional determination of total IgE has been investigated. In a multicentre study, we analysed specific IgE to cashew extract and Ana o 3 as well as total IgE in children with suspected cashew allergy using the ImmunoCAP-FEIA and a standardized diagnostic procedure including oral challenges where indicated. A total of 61 patients were included in the study. Forty-two were allergic to cashew, and 19 were tolerant. In receiver operating curves, Ana o 3 discriminates between allergic and tolerant children better than cashew-specific IgE with an area under the curve of 0.94 vs 0.78. The ratio of Ana o 3-specific IgE to total IgE did not further improve the diagnostic procedure. Probability curves for Ana o 3-specific IgE have been calculated, and a 95% probability could be estimated at 2.0 kU/l. Specific IgE to Ana o 3 is a valuable tool for the diagnosis of cashew allergy. Considering its positive predictive value, it might allow to make a considerable number of oral challenges superfluous. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

An overview of glomerular filtration rate testing in dogs and cats

PubMed Central

Von Hendy-Willson, Vanessa E.; Pressler, Barrak M.

2010-01-01

Determination of glomerular filtration rate (GFR) is a valuable, yet underused, diagnostic tool for evaluating renal function in dogs and cats. This article first reviews the hormonal and hemodynamic factors which contribute to GFR, followed by a description of considerations when selecting a pharmacokinetic model and methods of animal-to-animal standardization. The best-characterized existing GFR markers, including creatinine, radiolabeled markers, and iohexol, are reviewed in depth, as well as alternative but lesser-used techniques. A weighted means analysis of reported GFR measurements in healthy dogs and cats and a review of selected studies that have examined GFR alterations in animals with naturally-occurring and experimental diseases provide the reader with preliminary guidelines on expected GFR results in these species and disease conditions. PMID:20541957

Importance of the lung perfusion scintigraphy in single lung transplantation.

PubMed

Rodríguez Mesa, N V; Guerrero Cancio, M C; Cordero Jiménez, M D; Alvarez Velázquez, I K

2012-01-01

Lung perfusion scintigraphy (LPS) with (99m)Tc-MAA gives valuable information about patients who will undergo a single lung transplantation. This technique makes it possible to evaluate and quantify the relative function of both lungs to select the organ to be transplanted. Once the surgery has been performed, the LPS represents a diagnostic method to study the status of the transplanted organ. Two patients who underwent single lung transplantation were studied in our hospital. In both cases, a pre-operative LPS was performed before surgery for selection of the organ to be transplanted and the scintigraphy study was performed a few months after transplantation to establish the perfusion function of the transplanted lung. Copyright © 2011 Elsevier España, S.L. y SEMNIM. All rights reserved.

Applying Evidence-Centered Design for the Development of Game-Based Assessments in Physics Playground

ERIC Educational Resources Information Center

Kim, Yoon Jeon; Almond, Russell G.; Shute, Valerie J.

2016-01-01

Game-based assessment (GBA) is a specific use of educational games that employs game activities to elicit evidence for educationally valuable skills and knowledge. While this approach can provide individualized and diagnostic information about students, the design and development of assessment mechanics for a GBA is a nontrivial task. In this…

Should fine needle aspiration biopsy be the first pathological investigation in the diagnosis of a bone lesion? An algorithmic approach with review of literature

PubMed Central

Mehrotra, Ravi; Singh, Mamta; Singh, Premala A; Mannan, Rahul; Ojha, Vinod K; Singh, Pradumyn

2007-01-01

Background Fine needle aspiration biopsy (FNAB) is gaining increasing popularity in the diagnosis of musculoskeletal lesions; and in many patients, a definitive diagnosis can be rendered from aspiration smears alone. Its applicability in bone pathology, however, has been controversial due to a high percentage of inadequate smears, difficulty in evaluation of tissue architecture and nonspecific results in the diagnosis of primary bone lesions. In this study, the value of aspiration as the first pathological investigation in the diagnosis of a bone lesion was evaluated. Methods 91 cases of clinically suspected cases of bone lesions were aspirated over a period of two years. Direct or cytospin smears were fixed in 95% alcohol and stained by Hematoxylin and Eosin or air-dried and later fixed in methanol for May Grŭnwald Giemsa staining. Results Of the 91 patients who were subjected to FNAB, 81 were considered satisfactory and 10.9 % (10) were inadequate\\inconclusive for diagnosis. Cyto-histological concordance was obtained in 78.5 % (51/65) patients. Positive and negative predictive values were 87.5% and 97.2 % respectively. Sensitivity as a preliminary diagnostic technique was 93.3%, whereas specificity was 94.5 %. Overall, diagnostic accuracy was 94.2 %. Metastatic lesions were detected with 100% accuracy. Two cases were reported as false positive and one case as false negative. Conclusion Cytology provides valuable information to the clinician to make an informed decision regarding appropriate therapy. We conclude that time-consuming and costly investigations may be reduced by choosing FNAB as the initial pathological diagnostic method for skeletal lesions of unknown origin. The choice of radiological examinations, laboratory tests and surgical biopsies can be determined after the FNAB diagnosis. PMID:17439659

Metabolic markers and microecological characteristics of tongue coating in patients with chronic gastritis

PubMed Central

2013-01-01

Background In Traditional Chinese Medicine (TCM), tongue diagnosis has been an important diagnostic method for the last 3000 years. Tongue diagnosis is a non-invasive, simple and valuable diagnostic tool. TCM treats the tongue coating on a very sensitive scale that reflects physiological and pathological changes in the organs, especially the spleen and stomach. Tongue coating can diagnose disease severity and determine the TCM syndrome (“Zheng” in Chinese). The biological bases of different tongue coating appearances are still poorly understood and lack systematic investigation at the molecular level. Methods Tongue coating samples were collected from 70 chronic gastritis patients and 20 normal controls. 16S rRNA denatured gradient gel electrophoresis (16S rRNA–DGGE) and liquid chromatography and mass spectrometry (LC–MS) were designed to profile tongue coatings. The statistical techniques used were principal component analysis and partial least squares–discriminate analysis. Results Ten potential metabolites or markers were found in chronic gastritis patients, including UDP-D-galactose, 3-ketolactose, and vitamin D2, based on LC–MS. Eight significantly different strips were observed in samples from chronic gastritis patients based on 16S rRNA–DGGE. Two strips, Strips 8 and 10, were selected for gene sequencing. Strip 10 sequencing showed a 100% similarity to Rothia mucilaginosa. Strip 8 sequencing showed a 96.2% similarity to Moraxella catarrhalis. Conclusions Changes in glucose metabolism could possibly form the basis of tongue coating conformation in chronic gastritis patients. The study revealed important connections between metabolic components, microecological components and tongue coating in chronic gastritis patients. Compared with other diagnostic regimens, such as blood tests or tissue biopsies, tongue coating is more amenable to, and more convenient for, both patients and doctors. PMID:24041039

[Clinical and electrophysiological findings in carpal tunnel syndrome].

PubMed

Kohara, Nobuo

2007-11-01

Carpal tunnel syndrome (CTS) is the most common nerve entrapment disorder. The clinical features of CTS are variable, but usually include pain and paresthesia in the thumb, first two fingers, and the radial-half of the ring finger. Paresthesia and sensory deficits might involve the entire palm area in some cases. Pain frequently radiate proximally into the forearm, and occasionally to the shoulder. Many patients experience pain at night and are awakened by abnormal sensations. Shaking hand relief the symptom. The two classic tests for nerve compression at the wrist are the Tinel test and the Phalen maneuver, which diagnostic value is limited. Golden standard for the diagnosis is the combination of the clinical findings and the electrophysiological study. Routine median nerve conduction study is valuable. Prolonged terminal latency of motor or sensory nerve would be found in most CTS hands. If the routine study showed equivocal, more sensitive methods are needed. Those include segmental sensory conduction study across the carpal tunnel by median stimulation at midpalm, a comparison of median and ulnar sensory nerve latencies at ring finger and a comparison of median and radial sensory nerve latencies at thumb. A difference between the median motor latency to the second lumbrical and the ulnar motor latency to the interossei muscles has also diagnostic value in some cases. In addition, inching method can localized the compression site. Using these techniques, the diagnosis of CTS would become more reliable.

Quantitative measurement of a candidate serum biomarker peptide derived from α2-HS-glycoprotein, and a preliminary trial of multidimensional peptide analysis in females with pregnancy-induced hypertension.

PubMed

Hamamura, Kensuke; Yanagida, Mitsuaki; Ishikawa, Hitoshi; Banzai, Michio; Yoshitake, Hiroshi; Nonaka, Daisuke; Tanaka, Kenji; Sakuraba, Mayumi; Miyakuni, Yasuka; Takamori, Kenji; Nojima, Michio; Yoshida, Koyo; Fujiwara, Hiroshi; Takeda, Satoru; Araki, Yoshihiko

2018-03-01

Purpose We previously attempted to develop quantitative enzyme-linked immunosorbent assay (ELISA) systems for the PDA039/044/071 peptides, potential serum disease biomarkers (DBMs) of pregnancy-induced hypertension (PIH), primarily identified by a peptidomic approach (BLOTCHIP®-mass spectrometry (MS)). However, our methodology did not extend to PDA071 (cysteinyl α2-HS-glycoprotein 341-367 ), due to difficulty to produce a specific antibody against the peptide. The aim of the present study was to establish an alternative PDA071 quantitation system using liquid chromatography-multiple reaction monitoring (LC-MRM)/MS, to explore the potential utility of PDA071 as a DBM for PIH. Methods We tested heat/acid denaturation methods in efforts to purify serum PDA071 and developed an LC-MRM/MS method allowing for specific quantitation thereof. We measured serum PDA071 concentrations, and these results were validated including by three-dimensional (3D) plotting against PDA039 (kininogen-1 439-456 )/044 (kininogen-1 438-456 ) concentrations, followed by discriminant analysis. Results PDA071 was successfully extracted from serum using a heat denaturation method. Optimum conditions for quantitation via LC-MRM/MS were developed; the assayed serum PDA071 correlated well with the BLOTCHIP® assay values. Although the PDA071 alone did not significantly differ between patients and controls, 3D plotting of PDA039/044/071 peptide concentrations and construction of a Jackknife classification matrix were satisfactory in terms of PIH diagnostic precision. Conclusions Combination analysis using both PDA071 and PDA039/044 concentrations allowed PIH diagnostic accuracy to be attained, and our method will be valuable in future pathophysiological studies of hypertensive disorders of pregnancy.

Diagnostic Applications of Next Generation Sequencing in Immunogenetics and Molecular Oncology

PubMed Central

Grumbt, Barbara; Eck, Sebastian H.; Hinrichsen, Tanja; Hirv, Kaimo

2013-01-01

Summary With the introduction of the next generation sequencing (NGS) technologies, remarkable new diagnostic applications have been established in daily routine. Implementation of NGS is challenging in clinical diagnostics, but definite advantages and new diagnostic possibilities make the switch to the technology inevitable. In addition to the higher sequencing capacity, clonal sequencing of single molecules, multiplexing of samples, higher diagnostic sensitivity, workflow miniaturization, and cost benefits are some of the valuable features of the technology. After the recent advances, NGS emerged as a proven alternative for classical Sanger sequencing in the typing of human leukocyte antigens (HLA). By virtue of the clonal amplification of single DNA molecules ambiguous typing results can be avoided. Simultaneously, a higher sample throughput can be achieved by tagging of DNA molecules with multiplex identifiers and pooling of PCR products before sequencing. In our experience, up to 380 samples can be typed for HLA-A, -B, and -DRB1 in high-resolution during every sequencing run. In molecular oncology, NGS shows a markedly increased sensitivity in comparison to the conventional Sanger sequencing and is developing to the standard diagnostic tool in detection of somatic mutations in cancer cells with great impact on personalized treatment of patients. PMID:23922545

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

PubMed

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

2016-11-01

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

Tracking of multimodal therapeutic nanocomplexes targeting breast cancer in vivo.

PubMed

Bardhan, Rizia; Chen, Wenxue; Bartels, Marc; Perez-Torres, Carlos; Botero, Maria F; McAninch, Robin Ward; Contreras, Alejandro; Schiff, Rachel; Pautler, Robia G; Halas, Naomi J; Joshi, Amit

2010-12-08

Nanoparticle-based therapeutics with local delivery and external electromagnetic field modulation holds extraordinary promise for soft-tissue cancers such as breast cancer; however, knowledge of the distribution and fate of nanoparticles in vivo is crucial for clinical translation. Here we demonstrate that multiple diagnostic capabilities can be introduced in photothermal therapeutic nanocomplexes by simultaneously enhancing both near-infrared fluorescence and magnetic resonance imaging (MRI). We track nanocomplexes in vivo, examining the influence of HER2 antibody targeting on nanocomplex distribution over 72 h. This approach provides valuable, detailed information regarding the distribution and fate of complex nanoparticles designed for specific diagnostic and therapeutic functions.

Antenatal diagnosis of anophthalmia by three-dimensional ultrasound: a novel application of the reverse face view.

PubMed

Wong, H S; Parker, S; Tait, J; Pringle, K C

2008-07-01

The prenatal diagnosis of anophthalmia can be made on the demonstration of absent eye globe and lens on the affected side(s) on two-dimensional ultrasound examination, but when the fetal head position is unfavorable three-dimensional (3D) ultrasound may reveal additional diagnostic sonographic features, including sunken eyelids and small or hypoplastic orbit on the affected side(s). We present two cases of isolated anophthalmia diagnosed on prenatal ultrasound examination in which 3D ultrasound provided additional diagnostic information. The reverse face view provides valuable information about the orbits and the eyeballs for prenatal diagnosis and assessment of anophthalmia.

Soft x-ray pinhole imaging diagnostics for compact toroid plasmas

NASA Astrophysics Data System (ADS)

Crawford, E. A.; Taggart, D. P.; Bailey, A. D., III

1990-10-01

Soft x-ray pinhole imaging has recently become established as a valuable diagnostic for visualization of field reversed configuration (FRC) plasmas in the TRX-2, FRX-C/LSM devices. Gated MCP image converter devices with CsI cathodes and Be filters with a peak response around 11 nm wavelength are used for exposure durations ranging from a few tenths up to several microseconds. Results of experiments with single and Chevron channel plates are discussed along with estimates of linear exposure limitations with both film and CCD cameras as recording media. Plans for multiframe devices on the FRX-C/LSM and the LSX devices are also discussed.

Tracking of Multimodal Therapeutic Nanocomplexes Targeting Breast Cancer in Vivo

PubMed Central

Bardhan, Rizia; Chen, Wenxue; Bartels, Marc; Perez-Torres, Carlos; Botero, Maria F.; McAninch, Robin Ward; Contreras, Alejandro; Schiff, Rachel; Pautler, Robia G.; Halas, Naomi J.; Joshi, Amit

2014-01-01

Nanoparticle-based therapeutics with local delivery and external electromagnetic field modulation holds extraordinary promise for soft-tissue cancers such as breast cancer; however, knowledge of the distribution and fate of nanoparticles in vivo is crucial for clinical translation. Here we demonstrate that multiple diagnostic capabilities can be introduced in photothermal therapeutic nanocomplexes by simultaneously enhancing both near-infrared fluorescence and magnetic resonance imaging (MRI). We track nanocomplexes in vivo, examining the influence of HER2 antibody targeting on nanocomplex distribution over 72 h. This approach provides valuable, detailed information regarding the distribution and fate of complex nanoparticles designed for specific diagnostic and therapeutic functions. PMID:21090693

Laboratory simulation of space plasma phenomena*

NASA Astrophysics Data System (ADS)

Amatucci, B.; Tejero, E. M.; Ganguli, G.; Blackwell, D.; Enloe, C. L.; Gillman, E.; Walker, D.; Gatling, G.

2017-12-01

Laboratory devices, such as the Naval Research Laboratory's Space Physics Simulation Chamber, are large-scale experiments dedicated to the creation of large-volume plasmas with parameters realistically scaled to those found in various regions of the near-Earth space plasma environment. Such devices make valuable contributions to the understanding of space plasmas by investigating phenomena under carefully controlled, reproducible conditions, allowing for the validation of theoretical models being applied to space data. By working in collaboration with in situ experimentalists to create realistic conditions scaled to those found during the observations of interest, the microphysics responsible for the observed events can be investigated in detail not possible in space. To date, numerous investigations of phenomena such as plasma waves, wave-particle interactions, and particle energization have been successfully performed in the laboratory. In addition to investigations such as plasma wave and instability studies, the laboratory devices can also make valuable contributions to the development and testing of space plasma diagnostics. One example is the plasma impedance probe developed at NRL. Originally developed as a laboratory diagnostic, the sensor has now been flown on a sounding rocket, is included on a CubeSat experiment, and will be included on the DoD Space Test Program's STP-H6 experiment on the International Space Station. In this presentation, we will describe several examples of the laboratory investigation of space plasma waves and instabilities and diagnostic development. *This work supported by the NRL Base Program.

[Medical expert systems and clinical needs].

PubMed

Buscher, H P

1991-10-18

The rapid expansion of computer-based systems for problem solving or decision making in medicine, the so-called medical expert systems, emphasize the need for reappraisal of their indication and value. Where specialist knowledge is required, in particular where medical decisions are susceptible to error these systems will probably serve as a valuable support. In the near future computer-based systems should be able to aid the interpretation of findings of technical investigations and the control of treatment, especially where rapid reactions are necessary despite the need of complex analysis of investigated parameters. In the distant future complete support of diagnostic procedures from the history to final diagnosis is possible. It promises to be particularly attractive for the diagnosis of seldom diseases, for difficult differential diagnoses, and in the decision making in the case of expensive, risky or new diagnostic or therapeutic methods. The physician needs to be aware of certain dangers, ranging from misleading information up to abuse. Patient information depends often on subjective reports and error-prone observations. Although basing on problematic knowledge computer-born decisions may have an imperative effect on medical decision making. Also it must be born in mind that medical decisions should always combine the rational with a consideration of human motives.

Computer-based diagnostic expert systems in rheumatology: where do we stand in 2014?

PubMed

Alder, Hannes; Michel, Beat A; Marx, Christian; Tamborrini, Giorgio; Langenegger, Thomas; Bruehlmann, Pius; Steurer, Johann; Wildi, Lukas M

2014-01-01

Background. The early detection of rheumatic diseases and the treatment to target have become of utmost importance to control the disease and improve its prognosis. However, establishing a diagnosis in early stages is challenging as many diseases initially present with similar symptoms and signs. Expert systems are computer programs designed to support the human decision making and have been developed in almost every field of medicine. Methods. This review focuses on the developments in the field of rheumatology to give a comprehensive insight. Medline, Embase, and Cochrane Library were searched. Results. Reports of 25 expert systems with different design and field of application were found. The performance of 19 of the identified expert systems was evaluated. The proportion of correctly diagnosed cases was between 43.1 and 99.9%. Sensitivity and specificity ranged from 62 to 100 and 88 to 98%, respectively. Conclusions. Promising diagnostic expert systems with moderate to excellent performance were identified. The validation process was in general underappreciated. None of the systems, however, seemed to have succeeded in daily practice. This review identifies optimal characteristics to increase the survival rate of expert systems and may serve as valuable information for future developments in the field.

INVASIVE AND NON-INVASIVE TECHNIQUES FOR DETECTING PORTAL HYPERTENSION AND PREDICTING VARICEAL BLEEDING IN CIRRHOSIS: A REVIEW

PubMed Central

Zardi, Enrico Maria; Di Matteo, Francesco Maria; Pacella, Claudio Maurizio; Sanyal, Arun J

2016-01-01

Portal hypertension is a severe syndrome that may derive from pre-sinusoidal, sinusoidal and post-sinusoidal causes. As a consequence, several complications (i.e., ascites, oesophageal varices) may develop. In sinusoidal portal hypertension, hepatic venous pressure gradient (HVPG) is a reliable method for defining the grade of portal pressure, establishing the effectiveness of the treatment and predicting the occurrence of complications; however, some questions exist regarding its ability to discriminate bleeding from nonbleeding varices in cirrhotic patients. Other imaging techniques (transient elastography, endoscopy, endosonography and duplex Doppler sonography) for assessing causes and complications of portal hypertensive syndrome are available and may be valuable for the management of these patients. In this review, we evaluate invasive and non-invasive techniques currently employed to obtain a clinical prediction of deadly complications, such as variceal bleeding in patients affected by sinusoidal portal hypertension, in order to create a diagnostic algorithm to manage them. Again, HVPG appears to be the reference standard to evaluate portal hypertension and monitor the response to treatment, but its ability to predict several complications and support management decisions might be further improved through the diagnostic combination with other imaging techniques. PMID:24328372

A naked-eye colorimetric "PCR developer"

NASA Astrophysics Data System (ADS)

Valentini, Paola; Pompa, Pier Paolo

2016-04-01

Despite several advances in molecular biology and diagnostics, Polymerase Chain Reaction (PCR) is currently the gold standard for nucleic acids amplification and detection, due to its versatility, low-cost and universality, with estimated <10 billion reactions per year and a worldwide market of several billion dollars/year. Nevertheless, PCR still relies on the laborious, time-consuming, and multi-step gel electrophoresis-based detection, which includes gel casting, electrophoretic run, gel staining, and gel visualization. In this work, we propose a "PCR developer", namely a universal one-step, one-tube method, based on controlled aggregation of gold nanoparticles (AuNPs), to detect PCR products by naked eye in few minutes, with no need for any instrumentation. We demonstrated the specificity and sensitivity of the PCR developer on different model targets, suitable for a qualitative detection in real-world diagnostics (i.e., gene rearrangements, genetically modified organisms, and pathogens). The PCR developer proved to be highly specific and ultra-sensitive, discriminating down to few copies of HIV viral DNA, diluted in an excess of interfering human genomic DNA, which is a clinically relevant viral load. Hence, it could be a valuable tool for both academic research and clinical applications.

Invasive and non-invasive techniques for detecting portal hypertension and predicting variceal bleeding in cirrhosis: a review.

PubMed

Zardi, Enrico Maria; Di Matteo, Francesco Maria; Pacella, Claudio Maurizio; Sanyal, Arun J

2014-02-01

Portal hypertension is a severe syndrome that may derive from pre-sinusoidal, sinusoidal, and post-sinusoidal causes. As a consequence, several complications (i.e. ascites, oesophageal varices) may develop. In sinusoidal portal hypertension, hepatic venous pressure gradient (HVPG) is a reliable method for defining the grade of portal pressure, establishing the effectiveness of the treatment, and predicting the occurrence of complications; however, some questions exist regarding its ability to discriminate bleeding from non-bleeding varices in cirrhotic patients. Other imaging techniques (transient elastography, endoscopy, endosonography, and duplex Doppler sonography) for assessing causes and complications of portal hypertensive syndrome are available and may be valuable for the management of these patients. In this review, we evaluate invasive and non-invasive techniques currently employed to obtain a clinical prediction of deadly complications, such as variceal bleeding in patients affected by sinusoidal portal hypertension, in order to create a diagnostic algorithm to manage them. Again, HVPG appears to be the reference standard to evaluate portal hypertension and monitor the response to treatment, but its ability to predict several complications and support management decisions might be further improved through the diagnostic combination with other imaging techniques.

Platelet proteomics: from discovery to diagnosis.

PubMed

Looße, Christina; Swieringa, Frauke; Heemskerk, Johan W M; Sickmann, Albert; Lorenz, Christin

2018-05-22

Platelets are the smallest cells within the circulating blood with key roles in physiological haemostasis and pathological thrombosis regulated by the onset of activating/inhibiting processes via receptor responses and signalling cascades. Areas covered: Proteomics as well as genomic approaches have been fundamental in identifying and quantifying potential targets for future diagnostic strategies in the prevention of bleeding and thrombosis, and uncovering the complexity of platelet functions in health and disease. In this article, we provide a critical overview on current functional tests used in diagnostics and the future perspectives for platelet proteomics in clinical applications. Expert commentary: Proteomics represents a valuable tool for the identification of patients with diverse platelet associated defects. In-depth validation of identified biomarkers, e.g. receptors, signalling proteins, post-translational modifications, in large cohorts is decisive for translation into routine clinical diagnostics.

Diagnostics in Ebola Virus Disease in Resource-Rich and Resource-Limited Settings

PubMed Central

Shorten, Robert J; Brown, Colin S; Jacobs, Michael; Rattenbury, Simon; Simpson, Andrew J.; Mepham, Stephen

2016-01-01

The Ebola virus disease (EVD) outbreak in West Africa was unprecedented in scale and location. Limited access to both diagnostic and supportive pathology assays in both resource-rich and resource-limited settings had a detrimental effect on the identification and isolation of cases as well as individual patient management. Limited access to such assays in resource-rich settings resulted in delays in differentiating EVD from other illnesses in returning travellers, in turn utilising valuable resources until a diagnosis could be made. This had a much greater impact in West Africa, where it contributed to the initial failure to contain the outbreak. This review explores diagnostic assays of use in EVD in both resource-rich and resource-limited settings, including their respective limitations, and some novel assays and approaches that may be of use in future outbreaks. PMID:27788135

RNA-Seq of Tumor-Educated Platelets Enables Blood-Based Pan-Cancer, Multiclass, and Molecular Pathway Cancer Diagnostics

PubMed Central

Best, Myron G.; Sol, Nik; Kooi, Irsan; Tannous, Jihane; Westerman, Bart A.; Rustenburg, François; Schellen, Pepijn; Verschueren, Heleen; Post, Edward; Koster, Jan; Ylstra, Bauke; Ameziane, Najim; Dorsman, Josephine; Smit, Egbert F.; Verheul, Henk M.; Noske, David P.; Reijneveld, Jaap C.; Nilsson, R. Jonas A.; Tannous, Bakhos A.; Wesseling, Pieter; Wurdinger, Thomas

2015-01-01

Summary Tumor-educated blood platelets (TEPs) are implicated as central players in the systemic and local responses to tumor growth, thereby altering their RNA profile. We determined the diagnostic potential of TEPs by mRNA sequencing of 283 platelet samples. We distinguished 228 patients with localized and metastasized tumors from 55 healthy individuals with 96% accuracy. Across six different tumor types, the location of the primary tumor was correctly identified with 71% accuracy. Also, MET or HER2-positive, and mutant KRAS, EGFR, or PIK3CA tumors were accurately distinguished using surrogate TEP mRNA profiles. Our results indicate that blood platelets provide a valuable platform for pan-cancer, multiclass cancer, and companion diagnostics, possibly enabling clinical advances in blood-based “liquid biopsies”. PMID:26525104

Specific Pathogen Free Macaque Colonies: A Review of Principles and Recent Advances for Viral Testing and Colony Management

PubMed Central

Yee, JoAnn L.; Vandeford, Thomas H.; Didier, Elizabeth S.; Gray, Stanton; Lewis, Anne; Roberts, Jeffrey; Taylor, Kerry; Bohm, Rudolf P.

2016-01-01

Specific Pathogen Free (SPF) macaques provide valuable animal models for biomedical research. In 1989 the National Center for Research Resources (now Office of Research Infrastructure Programs ORIP) of the National Institutes of Health initiated experimental research contracts to establish and maintain SPF colonies. The derivation and maintenance of SPF macaque colonies is a complex undertaking requiring knowledge of the biology of the agents for exclusion and normal physiology and behavior of macaques, application of the latest diagnostic technology, facilities management, and animal husbandry. This review provides information on the biology of the four viral agents targeted for exclusion in ORIP SPF macaque colonies, describes current state-of-the-art viral diagnostic algorithms, presents data from proficiency testing of diagnostic assays between laboratories at institutions participating in the ORIP SPF program, and outlines management strategies for maintaining the integrity of SPF colonies using results of diagnostic testing as a guide to decision making. PMID:26932456

Democratizing molecular diagnostics for the developing world.

PubMed

Abou Tayoun, Ahmad N; Burchard, Paul R; Malik, Imran; Scherer, Axel; Tsongalis, Gregory J

2014-01-01

Infectious diseases that are largely treatable continue to pose a tremendous burden on the developing world despite the availability of highly potent drugs. The high mortality and morbidity rates of these diseases are largely due to a lack of affordable diagnostics that are accessible to resource-limited areas and that can deliver high-quality results. In fact, modified molecular diagnostics for infectious diseases were rated as the top biotechnology to improve health in developing countries. In this review, we describe the characteristics of accessible molecular diagnostic tools and discuss the challenges associated with implementing such tools at low infrastructure sites. We highlight our experience as part of the "Grand Challenge" project supported by the Gates Foundation for addressing global health inequities and describe issues and solutions associated with developing adequate technologies or molecular assays needed for broad access in the developing world. We believe that sharing this knowledge will facilitate the development of new molecular technologies that are extremely valuable for improving global health.

The Monosyllable Imitation Test for Toddlers: Influence of Stimulus Characteristics on Imitation, Compliance and Diagnostic Accuracy

ERIC Educational Resources Information Center

Hodges, Rosemary; Munro, Natalie; Baker, Elise; McGregor, Karla; Heard, Rob

2017-01-01

Background: Although verbal imitation can provide a valuable window into the developing language abilities of toddlers, some toddlers find verbal imitation challenging and will not comply with tests that involve elicited verbal imitation. The characteristics of stimuli that are offered to toddlers for imitation may influence how easy or hard it is…

Diagnostic Accuracy of Repetition Tasks for the Identification of Specific Language Impairment (SLI) in Bilingual Children: Evidence from Russian and Hebrew

ERIC Educational Resources Information Center

Armon-Lotem, Sharon; Meir, Natalia

2016-01-01

Background: Previous research demonstrates that repetition tasks are valuable tools for diagnosing specific language impairment (SLI) in monolingual children in English and a variety of other languages, with non-word repetition (NWR) and sentence repetition (SRep) yielding high levels of sensitivity and specificity. Yet, only a few studies have…

Predicate calculus, artificial intelligence, and workers' compensation.

PubMed

Harber, P; McCoy, J M

1989-05-01

Application of principles of predicate calculus (PC) and artificial intelligence (AI) search methods to occupational medicine can meet several goals. First, they can improve understanding of the diagnostic process and recognition of the sources of uncertainty in knowledge and in case specific information. Second, PC provides a rational means of resolving differences in conclusion based upon the same premises. Third, understanding of these principles allows separation of knowledge (facts) from the process by which they are used and therefore facilitates development of AI-based expert systems. Application of PC to recognizing causation of pulmonary fibrosis is demonstrated in this paper, providing a method that can be generalized to other problems in occupational medicine. Application of PC and understanding of AI search routines may be particularly applicable to workers' compensation where explicit statement of rational and inferential process is necessary. This approach is useful in the diagnosis of occupational lung disease and may be particularly valuable in workers' compensation considerations, wherein explicit statement of rationale is needed.

Nonlinear modeling of chaotic time series: Theory and applications

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

Casdagli, M.; Eubank, S.; Farmer, J.D.

1990-01-01

We review recent developments in the modeling and prediction of nonlinear time series. In some cases apparent randomness in time series may be due to chaotic behavior of a nonlinear but deterministic system. In such cases it is possible to exploit the determinism to make short term forecasts that are much more accurate than one could make from a linear stochastic model. This is done by first reconstructing a state space, and then using nonlinear function approximation methods to create a dynamical model. Nonlinear models are valuable not only as short term forecasters, but also as diagnostic tools for identifyingmore » and quantifying low-dimensional chaotic behavior. During the past few years methods for nonlinear modeling have developed rapidly, and have already led to several applications where nonlinear models motivated by chaotic dynamics provide superior predictions to linear models. These applications include prediction of fluid flows, sunspots, mechanical vibrations, ice ages, measles epidemics and human speech. 162 refs., 13 figs.« less

Malignant central airway obstruction

PubMed Central

Mudambi, Lakshmi; Miller, Russell

2017-01-01

This review comprehensively describes recent advances in the management of malignant central airway obstruction (CAO). Malignant CAO can be a dramatic and devastating manifestation of primary lung cancer or metastatic disease. A variety of diagnostic modalities are available to provide valuable information to plan a therapeutic intervention. Clinical heterogeneity in the presentation of malignant CAO provides opportunities to adapt and utilize endoscopic technology and tools in many ways. Mechanical debulking, thermal tools, cryotherapy and airway stents are methods and instruments used to rapidly restore airway patency. Delayed bronchoscopic methods, such as photodynamic therapy (PDT) and brachytherapy can also be utilized in specific non-emergent situations to establish airway patency. Although data regarding the success and complications of therapeutic interventions are retrospective and characterized by clinical and outcome measure variability, the symptoms of malignant CAO can often be successfully palliated. Assessment of risks and benefits of interventions in each individual patient during the decision-making process forms the critical foundation of the management of malignant CAO. PMID:29214067

PCR detection and identification of oral streptococci in saliva samples using gtf genes.

PubMed

Hoshino, Tomonori; Kawaguchi, Mamoru; Shimizu, Noriko; Hoshino, Naoko; Ooshima, Takashi; Fujiwara, Taku

2004-03-01

Oral streptococci are major constituents of dental plaque, and their prevalence is implicated in various pathologies. Therefore, accurate identification of oral streptococci would be valuable for studies of cariogenic plaque and for diagnostic use in infective endocarditis. Many oral streptococci possess glucosyltransferase enzymes that synthesize glucan, which is an obligate component of dental plaque. We established a rapid and precise method to identify oral streptococci by PCR using the species-specific region from the glucosyltransferase gene. With the species-specific primers, Streptococcus mutans, S. sobrinus, S. salivarius, S. sanguinis, S. oralis, and S. gordonii could be successfully distinguished. Further, we developed a simple method to extract the bacterial DNA from saliva. Using the resultant DNA as a template, the proposed PCR detection was performed. Their distribution was in accord with results of conventional biochemical tests. These findings indicate that the present PCR method is useful for the analysis of oral streptococci and can be successfully used in clinical applications to identify pathogenic bacteria associated with oral infectious disease and/or endocarditis.

SXR measurement and W transport survey using GEM tomographic system on WEST

NASA Astrophysics Data System (ADS)

Mazon, D.; Jardin, A.; Malard, P.; Chernyshova, M.; Coston, C.; Malard, P.; O'Mullane, M.; Czarski, T.; Malinowski, K.; Faisse, F.; Ferlay, F.; Verger, J. M.; Bec, A.; Larroque, S.; Kasprowicz, G.; Wojenski, A.; Pozniak, K.

2017-11-01

Measuring Soft X-Ray (SXR) radiation (0.1-20 keV) of fusion plasmas is a standard way of accessing valuable information on particle transport. Since heavy impurities like tungsten (W) could degrade plasma core performances and cause radiative collapses, it is necessary to develop new diagnostics to be able to monitor the impurity distribution in harsh fusion environments like ITER. A gaseous detector with energy discrimination would be a very good candidate for this purpose. The design and implementation of a new SXR diagnostic developed for the WEST project, based on a triple Gas Electron Multiplier (GEM) detector is presented. This detector works in photon counting mode and presents energy discrimination capabilities. The SXR system is composed of two 1D cameras (vertical and horizontal views respectively), located in the same poloidal cross-section to allow for tomographic reconstruction. An array (20 cm × 2 cm) consists of up to 128 detectors in front of a beryllium pinhole (equipped with a 1 mm diameter diaphragm) inserted at about 50 cm depth inside a cooled thimble in order to retrieve a wide plasma view. Acquisition of low energy spectrum is insured by a helium buffer installed between the pinhole and the detector. Complementary cooling systems (water) are used to maintain a constant temperature (25oC) inside the thimble. Finally a real-time automatic extraction system has been developed to protect the diagnostic during baking phases or any overheating unwanted events. Preliminary simulations of plasma emissivity and W distribution have been performed for WEST using a recently developed synthetic diagnostic coupled to a tomographic algorithm based on the minimum Fisher information (MFI) inversion method. First GEM acquisitions are presented as well as estimation of transport effect in presence of ICRH on W density reconstruction capabilities of the GEM.

Transnasal endoscopy: no gagging no panic!

PubMed Central

Parker, Clare; Alexandridis, Estratios; Plevris, John; O'Hara, James; Panter, Simon

2016-01-01

Background Transnasal endoscopy (TNE) is performed with an ultrathin scope via the nasal passages and is increasingly used. This review covers the technical characteristics, tolerability, safety and acceptability of TNE and also diagnostic accuracy, use as a screening tool and therapeutic applications. It includes practical advice from an ear, nose, throat (ENT) specialist to optimise TNE practice, identify ENT pathology and manage complications. Methods A Medline search was performed using the terms “transnasal”, “ultrathin”, “small calibre”, “endoscopy”, “EGD” to identify relevant literature. Results There is increasing evidence that TNE is better tolerated than standard endoscopy as measured using visual analogue scales, and the main area of discomfort is nasal during insertion of the TN endoscope, which seems remediable with adequate topical anaesthesia. The diagnostic yield has been found to be similar for detection of Barrett's oesophagus, gastric cancer and GORD-associated diseases. There are some potential issues regarding the accuracy of TNE in detecting small early gastric malignant lesions, especially those in the proximal stomach. TNE is feasible and safe in a primary care population and is ideal for screening for upper gastrointestinal pathology. It has an advantage as a diagnostic tool in the elderly and those with multiple comorbidities due to fewer adverse effects on the cardiovascular system. It has significant advantages for therapeutic procedures, especially negotiating upper oesophageal strictures and insertion of nasoenteric feeding tubes. Conclusions TNE is well tolerated and a valuable diagnostic tool. Further evidence is required to establish its accuracy for the diagnosis of early and small gastric malignancies. There is an emerging role for TNE in therapeutic endoscopy, which needs further study. PMID:28839865

Superior Diagnostic Performance of Malaria Rapid Diagnostic Tests as compared to Blood Smears in U.S. Clinical Practice

PubMed Central

Stauffer, William M.; Cartwright, Charles P.; Olson, Douglas; Juni, Billie Anne; Taylor, Charlotte M; Bowers, Susan H.; Hanson, Kevan L.; Rosenblatt, Jon E.; Boulware, David R.

2010-01-01

Background Approximately 4 million U.S. travelers to developing countries are ill enough to seek healthcare with 1,500 malaria cases reported in the U.S. annually. The diagnosis of malaria is frequently delayed due to the time to prepare malaria blood films and lack of technical expertise. An easy, reliable rapid diagnostic test (RDT) with high sensitivity and negative predictive value (NPV), particularly for Plasmodium falciparum, would be clinically useful. The study objective was to determine the diagnostic performance of the FDA-approved NOW® Malaria Test in comparison to traditional thick and thin blood smears for malaria diagnosis. Methods This prospective study tested 852 consecutive blood samples sent for thick and thin smears with blinded, malaria rapid tests at three hospital laboratories during 2003–2006. Polymerase chain reaction (PCR) verified positive tests and discordant results. Results Malaria occurred in 11% (95/852). The rapid test had superior performance than the standard Giemsa thick blood smear (P=.003). The rapid test’s sensitivity for all malaria was 97% (92/95) vs. 85% (81/95) by blood smear, and the RDT had superior NPV of 99.6% vs. 98.2% (P=.001). The P. falciparum performance was excellent with 100% rapid test sensitivity versus only 88% (65/74) by blood smear (P=.003). Conclusions This operational study demonstrates the FDA-approved rapid malaria test is superior to a single set of blood smears performed under routine U.S. clinical laboratory conditions. The most valuable clinical role of the RDT is in the rapid diagnosis or the exclusion of P. falciparum malaria, which is particularly useful in outpatient settings when evaluating febrile travelers. PMID:19686072

Space Shuttle main engine OPAD: The search for a hardware enhanced plume

NASA Astrophysics Data System (ADS)

Powers, W. T.; Cooper, A. E.; Wallace, Tim L.; Buntine, W. L.; Whitaker, K. W.

1993-11-01

The process of applying spectroscopy to the Space Shuttle Main Engine (SSME) for plume diagnostics, as it exists today, originated at Marshall Space Flight Center in Huntsville, Alabama, and its implementation was assured largely through the efforts of Sverdrup AEDC, in Tullahoma, Tennessee. This team continues to lead and guide efforts in the plume diagnostics arena. The process, Optical Plume Anomaly Detection (OPAD), formed the basis for various activities in the development of ground-based systems as well as the development of in-flight plume spectroscopy. OPAD currently provides and will continue to provide valuable information relative to future systems definitions, instrumentation development, code validation, and data diagnostic processing. OPAD is based on the detection of anomalous atomic and molecular species in the SSME plume using two complete, stand-alone optical spectrometers. To-date OPAD has acquired data on 44 test firings of the SSME at the Technology Test Bed (TTB) at MSFC. The purpose of this paper will be to provide an introduction to the OPAD system by discussing the process of obtaining data as well as the methods of examining and interpreting the data. It will encompass such issues as selection of instrumentation correlation of data to nominal engine operation, investigation of SSME component erosion via OPAD spectral data, necessity and benefits of plume seeding, application of artificial intelligence (AI) techniques to data analysis, and the present status of efforts to quantify specie erosion utilizing standard plume and chemistry codes as well as radiative models currently under development.

Comparative value of blood and skin samples for diagnosis of spotted fever group rickettsial infection in model animals.

PubMed

Levin, Michael L; Snellgrove, Alyssa N; Zemtsova, Galina E

2016-07-01

The definitive diagnosis of spotted fever group (SFG) rickettsioses in humans is challenging due to the retrospective nature and cross reactivity of the serological methods and the absence of reliable and consistent samples for molecular diagnostics. Existing data indicate the transient character of bacteremia in experimentally infected animals. The ability of arthropod vectors to acquire rickettsial infection from the laboratory animals in the absence of systemic infection and known tropism of rickettsial agents to endothelial cells of peripheral blood vessels underline the importance of local infection and consequently the diagnostic potential of skin samples. In order to evaluate the diagnostic sensitivity of rickettsial DNA detection in blood and skin samples, we compared results of PCR testing in parallel samples collected from model laboratory animals infected with Rickettsia rickettsii, Rickettsia parkeri and Rickettsia slovaca-like agent at different time points after infection. Skin samples were collected from ears - away from the site of tick placement and without eschars. Overall, testing of skin samples resulted in a higher proportion of positive results than testing of blood samples. Presented data from model animals demonstrates that testing of skin samples from sites of rickettsial proliferation can provide definitive molecular diagnosis of up to 60-70% of tick-borne SFG rickettsial infections during the acute stage of illness. Detection of pathogen DNA in cutaneous samples is a valuable alternative to blood-PCR at least in model animals. Published by Elsevier GmbH.

Diagnostic Cutoff Value for Ultrasonography of the Common Fibular Neuropathy at the Fibular Head

PubMed Central

2016-01-01

Objective To establish the diagnostic cutoff value of ultrasonographic measurement for common fibular neuropathy (CFN) at the fibular head (FH). Methods Twenty patients with electrodiagnostically diagnosed CFN at the FH and 30 healthy controls were included in the study. The cross-sectional area (CSA) of sciatic nerve at mid-thigh level, common fibular nerve at popliteal fossa (PF), and common fibular (CF) nerve at FH were measured. Additionally, the difference of CF nerve CSA at the FH between symptomatic side and asymptomatic side (ΔSx–Asx), the ratio of CF nerve CSA at FH to at PF (FH/PF), and the ratio of CF nerve CSA at the FH symptomatic side to asymptomatic side (Ratio Sx–Asx) were calculated. Results CSA at the FH, FH/PF, ΔSx–Asx, and Ratio Sx–Asx showed significant differences between the patient and control groups. The cutoff value for diagnosing CFN at the FH was 11.7 mm2 for the CSA at the FH (sensitivity 85.0%, specificity 90.0%), 1.70 mm2 for the ΔSx–Asx (sensitivity 83.3%, specificity 97.0%), 1.11 for the FH/PF (sensitivity 47.1%, specificity 93.3%), and 1.24 for the Ratio Sx–Asx (sensitivity 72.2%, specificity 96.7%). Conclusion The ultrasonographic measurement and cutoff value could be a valuable reference in diagnosing CFN at the FH and improving diagnostic reliability and efficacy. PMID:28119836

Space Shuttle main engine OPAD: The search for a hardware enhanced plume

NASA Technical Reports Server (NTRS)

Powers, W. T.; Cooper, A. E.; Wallace, Tim L.; Buntine, W. L.; Whitaker, K. W.

1993-01-01

The process of applying spectroscopy to the Space Shuttle Main Engine (SSME) for plume diagnostics, as it exists today, originated at Marshall Space Flight Center in Huntsville, Alabama, and its implementation was assured largely through the efforts of Sverdrup AEDC, in Tullahoma, Tennessee. This team continues to lead and guide efforts in the plume diagnostics arena. The process, Optical Plume Anomaly Detection (OPAD), formed the basis for various activities in the development of ground-based systems as well as the development of in-flight plume spectroscopy. OPAD currently provides and will continue to provide valuable information relative to future systems definitions, instrumentation development, code validation, and data diagnostic processing. OPAD is based on the detection of anomalous atomic and molecular species in the SSME plume using two complete, stand-alone optical spectrometers. To-date OPAD has acquired data on 44 test firings of the SSME at the Technology Test Bed (TTB) at MSFC. The purpose of this paper will be to provide an introduction to the OPAD system by discussing the process of obtaining data as well as the methods of examining and interpreting the data. It will encompass such issues as selection of instrumentation correlation of data to nominal engine operation, investigation of SSME component erosion via OPAD spectral data, necessity and benefits of plume seeding, application of artificial intelligence (AI) techniques to data analysis, and the present status of efforts to quantify specie erosion utilizing standard plume and chemistry codes as well as radiative models currently under development.

Digital PCR on a SlipChip.

PubMed

Shen, Feng; Du, Wenbin; Kreutz, Jason E; Fok, Alice; Ismagilov, Rustem F

2010-10-21

This paper describes a SlipChip to perform digital PCR in a very simple and inexpensive format. The fluidic path for introducing the sample combined with the PCR mixture was formed using elongated wells in the two plates of the SlipChip designed to overlap during sample loading. This fluidic path was broken up by simple slipping of the two plates that removed the overlap among wells and brought each well in contact with a reservoir preloaded with oil to generate 1280 reaction compartments (2.6 nL each) simultaneously. After thermal cycling, end-point fluorescence intensity was used to detect the presence of nucleic acid. Digital PCR on the SlipChip was tested quantitatively by using Staphylococcus aureus genomic DNA. As the concentration of the template DNA in the reaction mixture was diluted, the fraction of positive wells decreased as expected from the statistical analysis. No cross-contamination was observed during the experiments. At the extremes of the dynamic range of digital PCR the standard confidence interval determined using a normal approximation of the binomial distribution is not satisfactory. Therefore, statistical analysis based on the score method was used to establish these confidence intervals. The SlipChip provides a simple strategy to count nucleic acids by using PCR. It may find applications in research applications such as single cell analysis, prenatal diagnostics, and point-of-care diagnostics. SlipChip would become valuable for diagnostics, including applications in resource-limited areas after integration with isothermal nucleic acid amplification technologies and visual readout.

The Diagnostic Efficiency of 99mTc-EDDA/HYNIC-Octreotate SPECT-CT in Comparison with 111In-Pentetrotide in the Detection of Neuroendocrine Tumours

PubMed Central

Koçyiğit Deveci, Emel; Ocak, Meltem; Bozkurt, Murat Fani; Türker, Selcan; Kabasakal, Levent; Uğur, Ömer

2013-01-01

Objective: The aim of this study was to assess the diagnostic efficiency of 99mTc-EDDA/HYNIC-Octreotate in comparison with 111Inpentetrotide scintigraphy in the detection of neuroendocrine tumors. This study also evaluates the impact of SPECT-CT hybrid imaging on somatostatin receptor scintigraphy (SRS) interpretation and clinical management of these tumors. Methods: Fourteen patients were included in the study. All patients underwent a whole body and SPECT-CT imaging with both 99mTc- EDDA/HYNIC-octreotate and 111In-pentetrotide. Images were evaluated both visually and semiquantitatively. Results: On patient basis, the diagnostic results of both studies were similar. The number of lesions detected by 99mTc- EDDA/HYNICOctreotate were higher than the number of lesions detected by 111In-pentetrotide however the difference was not significant (40/43( 93%), 36/43 (83%) p=0.109). Semiquantitative analysis showed higher tumor/organ count ratios for both whole-body and SPECT 99mTc- EDDA/HYNIC-Octreotate scans. Conclusion: The results of this study suggested that, 99mTc- EDDA/HYNIC-Octreotate may be a better alternative to 111In- pentetrotide due to high image quality and lower radiation dose. SPECT/CT is a valuable tool for the assessment of neuroendocrine tumors by providing the precise anatomic localization of scintigraphic findings thus improving lesion detectability and characterization. Conflict of interest:None declared. PMID:24416622

Action Research to Improve the Learning Space for Diagnostic Techniques†

PubMed Central

Ariel, Ellen; Owens, Leigh

2015-01-01

The module described and evaluated here was created in response to perceived learning difficulties in diagnostic test design and interpretation for students in third-year Clinical Microbiology. Previously, the activities in lectures and laboratory classes in the module fell into the lower cognitive operations of “knowledge” and “understanding.” The new approach was to exchange part of the traditional activities with elements of interactive learning, where students had the opportunity to engage in deep learning using a variety of learning styles. The effectiveness of the new curriculum was assessed by means of on-course student assessment throughout the module, a final exam, an anonymous questionnaire on student evaluation of the different activities and a focus group of volunteers. Although the new curriculum enabled a major part of the student cohort to achieve higher pass grades (p < 0.001), it did not meet the requirements of the weaker students, and the proportion of the students failing the module remained at 34%. The action research applied here provided a number of valuable suggestions from students on how to improve future curricula from their perspective. Most importantly, an interactive online program that facilitated flexibility in the learning space for the different reagents and their interaction in diagnostic tests was proposed. The methods applied to improve and assess a curriculum refresh by involving students as partners in the process, as well as the outcomes, are discussed. Journal of Microbiology & Biology Education PMID:26753024

Polarization of submillimetre lines from interstellar medium

NASA Astrophysics Data System (ADS)

Zhang, Heshou; Yan, Huirong

2018-04-01

Magnetic fields play important roles in many astrophysical processes. However, there is no universal diagnostic for the magnetic fields in the interstellar medium (ISM) and each magnetic tracer has its limitation. Any new detection method is thus valuable. Theoretical studies have shown that submillimetre fine-structure lines are polarized due to atomic alignment by ultraviolet photon-excitation, which opens up a new avenue to probe interstellar magnetic fields. We will, for the first time, perform synthetic observations on the simulated three-dimensional ISM to demonstrate the measurability of the polarization of submillimetre atomic lines. The maximum polarization for different absorption and emission lines expected from various sources, including star-forming regions are provided. Our results demonstrate that the polarization of submillimetre atomic lines is a powerful magnetic tracer and add great value to the observational studies of the submilimetre astronomy.

Walking on thin ice! Identifying methamphetamine “drug mules” on digital plain radiography

PubMed Central

Abdul Rashid, S N; Mohamad Saini, S B; Abdul Hamid, S; Muhammad, S J; Mahmud, R; Thali, M J

2014-01-01

Objective: The purpose of this study was to retrospectively evaluate the sensitivity, specificity and accuracy of identifying methamphetamine (MA) internal payloads in “drug mules” by plain abdominal digital radiography (DR). Methods: The study consisted of 35 individuals suspected of internal MA drug containers. A total of 59 supine digital radiographs were collected. An overall calculation regarding the diagnostic accuracy for all “drug mules” and a specific evaluation concerning the radiological appearance of drug packs as well as the rate of clearance and complications in correlation with the reader's experience were performed. The gold standard was the presence of secured drug packs in the faeces. Results: There were 16 true-positive “drug mules” identified. DR of all drug carriers for Group 1 (forensic imaging experienced readers, n = 2) exhibited a sensitivity of 100%, a mean specificity of 76.3%, positive predictive value (PPV) of 78.5%, negative predictive value (NPV) of 100% and a mean accuracy 87.2%. Group 2 (inexperienced readers, n = 3) showed a lower sensitivity (93.7%), a mean specificity of 86%, a PPV of 86.5%, an NPV of 94.1% and a mean accuracy of 89.5%. The interrater agreement within Group 1 was 0.72 and within Group 2 averaged to 0.79, indicating a fair to very good agreement. Conclusion: DR is a valuable screening tool in cases of MA body packers with huge internal payloads being associated with a high diagnostic insecurity. Diagnostic insecurity on plain films may be overcome by low-dose CT as a cross-sectional imaging modality and addressed by improved radiological education in reporting drug carriers on imaging. Advances in knowledge: Diagnostic signs (double-condom and halo signs) on digital plain radiography are specific in MA “drug mules”, although DR is associated with high diagnostic insecurity and underreports the total internal payload. PMID:24472728

Neuroimaging of classic neuralgic amyotrophy.

PubMed

Lieba-Samal, Doris; Jengojan, Suren; Kasprian, Gregor; Wöber, Christian; Bodner, Gerd

2016-12-01

Neuralgic amyotrophy (NA) often imposes diagnostic problems. Recently, MRI and high-resolution ultrasound (HRUS) have proven useful in diagnosing peripheral nerve disorders. We performed a chart and imaging review of patients who were examined using neuroimaging and who were referred because of clinically diagnosed NA between March 1, 2014 and May 1, 2015. Six patients were included. All underwent HRUS, and 5 underwent MRI. Time from onset to evaluation ranged from 2 weeks to 6 months. HRUS showed segmental swelling of all clinically affected nerves/trunks. Atrophy of muscles was detected in those assessed >1 month after onset. MRI showed T2-weighted hyperintensity in all clinically affected nerves, except for the long thoracic nerve, and denervation edema of muscles. HRUS and MRI are valuable diagnostic tools in NA. This could change the diagnostic approach from one now focused on excluding other disorders to confirming NA through imaging markers. Muscle Nerve 54: 1079-1085, 2016. © 2016 Wiley Periodicals, Inc.

RNA-Seq of Tumor-Educated Platelets Enables Blood-Based Pan-Cancer, Multiclass, and Molecular Pathway Cancer Diagnostics.

PubMed

Best, Myron G; Sol, Nik; Kooi, Irsan; Tannous, Jihane; Westerman, Bart A; Rustenburg, François; Schellen, Pepijn; Verschueren, Heleen; Post, Edward; Koster, Jan; Ylstra, Bauke; Ameziane, Najim; Dorsman, Josephine; Smit, Egbert F; Verheul, Henk M; Noske, David P; Reijneveld, Jaap C; Nilsson, R Jonas A; Tannous, Bakhos A; Wesseling, Pieter; Wurdinger, Thomas

2015-11-09

Tumor-educated blood platelets (TEPs) are implicated as central players in the systemic and local responses to tumor growth, thereby altering their RNA profile. We determined the diagnostic potential of TEPs by mRNA sequencing of 283 platelet samples. We distinguished 228 patients with localized and metastasized tumors from 55 healthy individuals with 96% accuracy. Across six different tumor types, the location of the primary tumor was correctly identified with 71% accuracy. Also, MET or HER2-positive, and mutant KRAS, EGFR, or PIK3CA tumors were accurately distinguished using surrogate TEP mRNA profiles. Our results indicate that blood platelets provide a valuable platform for pan-cancer, multiclass cancer, and companion diagnostics, possibly enabling clinical advances in blood-based "liquid biopsies". Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Best practices recommendations in the application of immunohistochemistry in urologic pathology: report from the International Society of Urological Pathology consensus conference.

PubMed

Amin, Mahul B; Epstein, Jonathan I; Ulbright, Thomas M; Humphrey, Peter A; Egevad, Lars; Montironi, Rodolfo; Grignon, David; Trpkov, Kiril; Lopez-Beltran, Antonio; Zhou, Ming; Argani, Pedram; Delahunt, Brett; Berney, Daniel M; Srigley, John R; Tickoo, Satish K; Reuter, Victor E

2014-08-01

Members of the International Society of Urological Pathology (ISUP) participated in a half-day consensus conference to discuss guidelines and recommendations regarding best practice approaches to use of immunohistochemistry (IHC) in differential diagnostic situations in urologic pathology, including bladder, prostate, testis and, kidney lesions. Four working groups, selected by the ISUP leadership, identified several high-interest topics based on common or relevant challenging diagnostic situations and proposed best practice recommendations, which were discussed by the membership. The overall summary of the discussions and the consensus opinion forms the basis of a series of articles, one for each organ site. This Special Article summarizes the overall recommendations made by the four working groups. It is anticipated that this ISUP effort will be valuable to the entire practicing community in the appropriate use of IHC in diagnostic urologic pathology.

Comparison of Prognostic and Diagnostic Approaches to Modeling Evapotranspiration in the Nile River Basin

NASA Astrophysics Data System (ADS)

Yilmaz, M.; Anderson, M. C.; Zaitchik, B. F.; Crow, W. T.; Hain, C.; Ozdogan, M.; Chun, J. A.

2012-12-01

Actual evapotranspiration (ET) can be estimated using both prognostic and diagnostic modeling approaches, providing independent yet complementary information for hydrologic applications. Both approaches have advantages and disadvantages. When provided with temporally continuous atmospheric forcing data, prognostic models offer continuous sub-daily ET information together with the full set of water and energy balance fluxes and states (i.e. soil moisture, runoff, sensible and latent heat). On the other hand, the diagnostic modeling approach provides ET estimates over regions where reliable information about available soil water is not known (e.g., due to irrigation practices or shallow ground water levels not included in the prognostic model structure, unknown soil texture or plant rooting depth, etc). Prognostic model-based ET estimates are of great interest whenever consistent and complete water budget information is required or when there is a need to project ET for climate or land use change scenarios. Diagnostic models establish a stronger link to remote sensing observations, can be applied in regions with limited or questionable atmospheric forcing data, and provide valuable observation-derived information about the current land-surface state. Analysis of independently obtained ET estimates is particularly important in data poor regions. Such comparisons can help to reduce the uncertainty in the modeled ET estimates and to exclude outliers based on physical considerations. The Nile river basin is home to tens of millions of people whose daily life depends on water extracted from the river Nile. Yet the complete basin scale water balance of the Nile has been studied only a few times, and the temporal and the spatial distribution of hydrological fluxes (particularly ET) are still a subject of active research. This is due in part to a scarcity of ground-based station data for validation. In such regions, comparison between prognostic and diagnostic model output may be a valuable model evaluation tool. Motivated by the complementary information that exists in prognostic and diagnostic energy balance modeling, as well as the need for evaluation of water consumption estimates over the Nile basin, the purpose of this study is to 1) better describe the conceptual differences between prognostic and diagnostic modeling, 2) present the potential for diagnostic models to capture important hydrologic features that are not explicitly represented in prognostic model, 3) explore the differences in these two approaches over the Nile Basin, where ground data are sparse and transnational data sharing is unreliable. More specifically, we will compare output from the Noah prognostic model and the Atmosphere-Land Exchange Inverse (ALEXI) diagnostic model generated over ground truth data-poor Nile basin. Preliminary results indicate spatially, temporally, and magnitude wise consistent flux estimates for ALEXI and NOAH over irrigated Delta region, while there are differences over river-fed wetlands.

An intelligent remote control system for ECEI on EAST

NASA Astrophysics Data System (ADS)

Chen, Dongxu; Zhu, Yilun; Zhao, Zhenling; Qu, Chengming; Liao, Wang; Xie, Jinlin; Liu, Wandong

2017-08-01

An intelligent remote control system based on a power distribution unit (PDU) and Arduino has been designed for the electron cyclotron emission imaging (ECEI) system on Experimental Advanced Superconducting Tokamak (EAST). This intelligent system has three major functions: ECEI system reboot, measurement region adjustment and signal amplitude optimization. The observation region of ECEI can be modified for different physics proposals by remotely tuning the optical and electronics systems. Via the remote adjustment of the attenuation level, the ECEI intermediate frequency signal amplitude can be efficiently optimized. The remote control system provides a feasible and reliable solution for the improvement of signal quality and the efficiency of the ECEI diagnostic system, which is also valuable for other diagnostic systems.

Depressive disorders co-existing with Addison-Biermer anemia - case report.

PubMed

Just, Mark Jean; Kozakiewicz, Mariusz

2015-01-01

Anemia is a disease that can co-exist with depression, other mental disorders, or somatic diseases. Anemia can imitate symptoms of depression, while depression symptoms can mask concurring symptoms of anemia. I am presenting a case of a 48-year-old woman with Addison-Biermer anemia, with co-existing mood disorders. The clinical analysis of the presented patient's history indicates diagnostic problems and a need for a detailed analysis of drug-related complications that occurred during previous treatment, eg, in the form of neuroleptic malignant syndrome. The presented case report contains valuable guidelines that can be of assistance in diagnostics and treatment of patients treated for mental disorders, who are also diagnosed with somatic diseases.

Summary of ECE presentations at EC-18

DOE PAGES

Taylor, G.

2015-03-12

There were nine ECE and one EBE presentation at EC-18. Four of the presentations were on various aspects of ECE on ITER. The ITER ECE diagnostic has entered an important detailed preliminary design phase and faces several design challenges in the next 2-3 years. Most of the other ECE presentations at the workshop were focused on applications of ECE diagnostics to plasma measurements, rather than improvements in technology, although it was apparent that heterodyne receiver technology continues to improve. CECE, ECE imaging and EBE imaging are increasingly providing valuable insights into plasma behavior that is important to understand if futuremore » burning plasma devices, such as ITER, FNSF and DEMO, are to be successful.« less

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

PubMed

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

2017-02-01

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

Haemothorax after mediastinoscopy: a word of caution.

PubMed

Elsayed, Hany

2012-01-01

Mediastinoscopy is used for the staging of lung cancer and for the diagnosis of mediastinal lesions. It is a valuable diagnostic tool but, in a few cases, it could result in major complications. We describe a simple technique to avoid the development of a major complication--massive haemothorax--after a mediastinoscopy, which should be applied in cases of inadvertent injury of the pleura during the procedure.

Inverse analysis of non-uniform temperature distributions using multispectral pyrometry

NASA Astrophysics Data System (ADS)

Fu, Tairan; Duan, Minghao; Tian, Jibin; Shi, Congling

2016-05-01

Optical diagnostics can be used to obtain sub-pixel temperature information in remote sensing. A multispectral pyrometry method was developed using multiple spectral radiation intensities to deduce the temperature area distribution in the measurement region. The method transforms a spot multispectral pyrometer with a fixed field of view into a pyrometer with enhanced spatial resolution that can give sub-pixel temperature information from a "one pixel" measurement region. A temperature area fraction function was defined to represent the spatial temperature distribution in the measurement region. The method is illustrated by simulations of a multispectral pyrometer with a spectral range of 8.0-13.0 μm measuring a non-isothermal region with a temperature range of 500-800 K in the spot pyrometer field of view. The inverse algorithm for the sub-pixel temperature distribution (temperature area fractions) in the "one pixel" verifies this multispectral pyrometry method. The results show that an improved Levenberg-Marquardt algorithm is effective for this ill-posed inverse problem with relative errors in the temperature area fractions of (-3%, 3%) for most of the temperatures. The analysis provides a valuable reference for the use of spot multispectral pyrometers for sub-pixel temperature distributions in remote sensing measurements.

The diagnostic value of a globulin/platelet model for evaluating liver fibrosis in chronic hepatitis B patients.

PubMed

Coskun, Banu Demet; Altinkaya, Engin; Sevinc, Eylem; Ozen, Mustafa; Karaman, Hatice; Karaman, Ahmet; Poyrazoglu, Orhan

2015-12-01

Liver biopsy, which is considered the best method for evaluating hepatic fibrosis, has important adverse events. Therefore, non-invasive tests have been developed to determine the degree of hepatic fibrosis in patients with chronic hepatitis B. To verify the usefulness of a new fibrosis index the globulin/platelet model in patients with chronic hepatitis B and to compare it with other noninvasive tests for predicting significant fibrosis. This study was the second to evaluate the globulin/platelet model in HBV patients. We retrospectively investigated 228 patients with chronic hepatitis B who performed liver biopsy from 2013 to 2014. The globulin/platelet model, APGA [AST/Platelet/Gamma-glutamyl transpeptidase/Alfa-fetoprotein], FIB4, fibrosis index, cirrhosis discriminate score, and Fibro-quotient were calculated, and the diagnostic accuracies of all of the fibrosis indices were compared between the F0-2 (no-mild fibrosis) and F3-6 (significant fibrosis) groups. All of the noninvasive markers were significantly correlated with the stage of liver fibrosis (p < 0,001). To predict significant fibrosis (F ≥ 3), the area under the curve (95% CI) was found to be greatest for APGA (0.83 [0.74-0.86]), followed by FIB-4 (0.75[0.69-0.80]), the globulin/platelet model (0.74 [0.68-0.79]), fibrosis index (0.72 [0.6-0.78], cirrhosis discriminate score (0.71 [0.64-0.76]) and Fibro-quotient (0.62 [0.55-0.7]). The area under the receiver operating characteristic curves of APGA was significantly higher than that of the other noninvasive fibrosis markers (p < 0.05). While the APGA index was found to be the most valuable test for the prediction significant fibrosis in patients with chronic hepatitis B, GP model was the thirth valuable test. Therefore, we recommended that APGA could be used instead of the GP model for prediction liver fibrosis.

The importance of transmission electron microscopy analysis of spermatozoa: Diagnostic applications and basic research.

PubMed

Moretti, Elena; Sutera, Gaetano; Collodel, Giulia

2016-06-01

This review is aimed at discussing the role of ultrastructural studies on human spermatozoa and evaluating transmission electron microscopy as a diagnostic tool that can complete andrology protocols. It is clear that morphological sperm defects may explain decreased fertilizing potential and acquire particular value in the field of male infertility. Electron microscopy is the best method to identify systematic or monomorphic and non-systematic or polymorphic sperm defects. The systematic defects are characterized by a particular anomaly that affects the vast majority of spermatozoa in a semen sample, whereas a heterogeneous combination of head and tail defects found in variable percentages are typically non-systematic or polymorphic sperm defects. A correct diagnosis of these specific sperm alterations is important for choosing the male infertility's therapy and for deciding to turn to assisted reproduction techniques. Transmission electron microscopy (TEM) also represents a valuable method to explore the in vitro effects of different compounds (for example drugs with potential spermicidal activity) on the morphology of human spermatozoa. Finally, TEM used in combination with immunohistochemical techniques, integrates structural and functional aspects that provide a wide horizon in the understanding of sperm physiology and pathology. transmission electron microscopy: TEM; World Health Organization: WHO; light microscopy: LM; motile sperm organelle morphology examination: MSOME; intracytoplasmic morphologically selected sperm injection: IMSI; intracytoplasmic sperm injection: ICSI; dysplasia of fibrous sheath: DFS; primary ciliary dyskinesia: PCD; outer dense fibers: ODF; assisted reproduction technologies: ART; scanning electron microscopy: SEM; polyvinylpirrolidone: PVP; tert-butylhydroperoxide: TBHP.

Chromosomal microarray in clinical diagnosis: a study of 337 patients with congenital anomalies and developmental delays or intellectual disability.

PubMed

Sansović, Ivona; Ivankov, Ana-Maria; Bobinec, Adriana; Kero, Mijana; Barišić, Ingeborg

2017-06-14

To determine the diagnostic yield and criteria that could help to classify and interpret the copy number variations (CNVs) detected by chromosomal microarray (CMA) technique in patients with congenital and developmental abnormalities including dysmorphia, developmental delay (DD) or intellectual disability (ID), autism spectrum disorders (ASD) and congenital anomalies (CA). CMA analysis was performed in 337 patients with DD/ID with or without dysmorphism, ASD, and/or CA. In 30 of 337 patients, chromosomal imbalances had previously been detected by classical cytogenetic and molecular cytogenetic methods. In 73 of 337 patients, clinically relevant variants were detected and better characterized. Most of them were >1 Mb. Variants of unknown clinical significance (VOUS) were discovered in 35 patients. The most common VOUS size category was <300 kb (40.5%). Deletions and de novo imbalances were more frequent in pathogenic CNV than in VOUS category. CMA had a high diagnostic yield of 43/307, excluding patients previously detected by other methods. CMA was valuable in establishing the diagnosis in a high proportion of patients. Criteria for classification and interpretation of CNVs include CNV size and type, mode of inheritance, and genotype-phenotype correlation. Agilent ISCA v2 Human Genome 8x60 K oligonucleotide microarray format proved to be reasonable resolution for clinical use, particularly in the regions that are recommended by the International Standard Cytogenomic Array (ISCA) Consortium and associated with well-established syndromes.

MALDI-TOF mass spectrometry following short incubation on a solid medium is a valuable tool for rapid pathogen identification from positive blood cultures.

PubMed

Kohlmann, Rebekka; Hoffmann, Alexander; Geis, Gabriele; Gatermann, Sören

2015-01-01

Rapid identification of the causative microorganism is a key element in appropriate antimicrobial therapy of bloodstream infections. Whereas traditional analysis of positive blood cultures requires subculture over at least 16-24h prior to pathogen identification by, e.g. matrix-assisted laser-desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), sample preparation procedures enabling direct MALDI-TOF MS, i.e. without preceding subculture, are associated with additional effort and costs. Hence, we integrated an alternative MALDI-TOF MS approach in diagnostic routine using a short incubation on a solid medium. Positive blood cultures were routinely plated on chocolate agar plates and incubated for 4h (37 °C, 5% CO2). Subsequently, MALDI-TOF MS using a Microflex LT instrument (Bruker Daltonics) and direct smear method was performed once per sample. For successful identification of bacteria at species level, score cut-off values were used as proposed by the manufacturer (≥ 2.0) and in a modified form (≥ 1.5 for MALDI-TOF MS results referring to Gram-positive cocci and ≥ 1.7 for MALDI-TOF MS results referring to bacteria other than Gram-positive cocci). Further data analysis also included an assessment of the clinical impact of the MALDI-TOF MS result. Applying the modified score cut-off values, our approach led to an overall correct species identification in 69.5% with misidentification in 3.4% (original cut-offs: 49.2% and 1.8%, respectively); for Gram-positive cocci, correct identification in 68.4% (100% for Staphylococcus aureus and enterococci, 80% for beta-hemolytic streptococci), for Gram-negative bacteria, correct identification in 97.6%. In polymicrobial blood cultures, in 72.7% one of the pathogens was correctly identified. Results were not reliable for Gram-positive rods and yeasts. The approach was easy to implement in diagnostic routine. In cases with available clinical data and successful pathogen identification, in 51.1% our approach allowed an optimized treatment recommendation. MALDI-TOF MS following 4h pre-culture is a valuable tool for rapid pathogen identification from positive blood cultures, allowing easy integration in diagnostic routine and the opportunity of considerably earlier treatment adaptation. Copyright © 2015 Elsevier GmbH. All rights reserved.

LUNGx Challenge for computerized lung nodule classification

DOE PAGES

Armato, Samuel G.; Drukker, Karen; Li, Feng; ...

2016-12-19

The purpose of this work is to describe the LUNGx Challenge for the computerized classification of lung nodules on diagnostic computed tomography (CT) scans as benign or malignant and report the performance of participants’ computerized methods along with that of six radiologists who participated in an observer study performing the same Challenge task on the same dataset. The Challenge provided sets of calibration and testing scans, established a performance assessment process, and created an infrastructure for case dissemination and result submission. We present ten groups that applied their own methods to 73 lung nodules (37 benign and 36 malignant) thatmore » were selected to achieve approximate size matching between the two cohorts. Area under the receiver operating characteristic curve (AUC) values for these methods ranged from 0.50 to 0.68; only three methods performed statistically better than random guessing. The radiologists’ AUC values ranged from 0.70 to 0.85; three radiologists performed statistically better than the best-performing computer method. The LUNGx Challenge compared the performance of computerized methods in the task of differentiating benign from malignant lung nodules on CT scans, placed in the context of the performance of radiologists on the same task. Lastly, the continued public availability of the Challenge cases will provide a valuable resource for the medical imaging research community.« less

LUNGx Challenge for computerized lung nodule classification

PubMed Central

Armato, Samuel G.; Drukker, Karen; Li, Feng; Hadjiiski, Lubomir; Tourassi, Georgia D.; Engelmann, Roger M.; Giger, Maryellen L.; Redmond, George; Farahani, Keyvan; Kirby, Justin S.; Clarke, Laurence P.

2016-01-01

Abstract. The purpose of this work is to describe the LUNGx Challenge for the computerized classification of lung nodules on diagnostic computed tomography (CT) scans as benign or malignant and report the performance of participants’ computerized methods along with that of six radiologists who participated in an observer study performing the same Challenge task on the same dataset. The Challenge provided sets of calibration and testing scans, established a performance assessment process, and created an infrastructure for case dissemination and result submission. Ten groups applied their own methods to 73 lung nodules (37 benign and 36 malignant) that were selected to achieve approximate size matching between the two cohorts. Area under the receiver operating characteristic curve (AUC) values for these methods ranged from 0.50 to 0.68; only three methods performed statistically better than random guessing. The radiologists’ AUC values ranged from 0.70 to 0.85; three radiologists performed statistically better than the best-performing computer method. The LUNGx Challenge compared the performance of computerized methods in the task of differentiating benign from malignant lung nodules on CT scans, placed in the context of the performance of radiologists on the same task. The continued public availability of the Challenge cases will provide a valuable resource for the medical imaging research community. PMID:28018939

LUNGx Challenge for computerized lung nodule classification

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

Armato, Samuel G.; Drukker, Karen; Li, Feng

The purpose of this work is to describe the LUNGx Challenge for the computerized classification of lung nodules on diagnostic computed tomography (CT) scans as benign or malignant and report the performance of participants’ computerized methods along with that of six radiologists who participated in an observer study performing the same Challenge task on the same dataset. The Challenge provided sets of calibration and testing scans, established a performance assessment process, and created an infrastructure for case dissemination and result submission. We present ten groups that applied their own methods to 73 lung nodules (37 benign and 36 malignant) thatmore » were selected to achieve approximate size matching between the two cohorts. Area under the receiver operating characteristic curve (AUC) values for these methods ranged from 0.50 to 0.68; only three methods performed statistically better than random guessing. The radiologists’ AUC values ranged from 0.70 to 0.85; three radiologists performed statistically better than the best-performing computer method. The LUNGx Challenge compared the performance of computerized methods in the task of differentiating benign from malignant lung nodules on CT scans, placed in the context of the performance of radiologists on the same task. Lastly, the continued public availability of the Challenge cases will provide a valuable resource for the medical imaging research community.« less

Differential Diagnosis of Malaria on Truelab Uno®, a Portable, Real-Time, MicroPCR Device for Point-Of-Care Applications

PubMed Central

Nair, Chandrasekhar Bhaskaran; Manjula, Jagannath; Subramani, Pradeep Annamalai; Nagendrappa, Prakash B.; Manoj, Mulakkapurath Narayanan; Malpani, Sukriti; Pullela, Phani Kumar; Subbarao, Pillarisetti Venkata; Ramamoorthy, Siva; Ghosh, Susanta K.

2016-01-01

Background Sensitive and specific detection of malarial parasites is crucial in controlling the significant malaria burden in the developing world. Also important is being able to identify life threatening Plasmodium falciparum malaria quickly and accurately to reduce malaria related mortality. Existing methods such as microscopy and rapid diagnostic tests (RDTs) have major shortcomings. Here, we describe a new real-time PCR-based diagnostic test device at point-of-care service for resource-limited settings. Methods Truenat® Malaria, a chip-based microPCR test, was developed by bigtec Labs, Bangalore, India, for differential identification of Plasmodium falciparum and Plasmodium vivax parasites. The Truenat Malaria tests runs on bigtec’s Truelab Uno® microPCR device, a handheld, battery operated, and easy-to-use real-time microPCR device. The performance of Truenat® Malaria was evaluated versus the WHO nested PCR protocol. The Truenat® Malaria was further evaluated in a triple-blinded study design using a sample panel of 281 specimens created from the clinical samples characterized by expert microscopy and a rapid diagnostic test kit by the National Institute of Malaria Research (NIMR). A comparative evaluation was done on the Truelab Uno® and a commercial real-time PCR system. Results The limit of detection of the Truenat Malaria assay was found to be <5 parasites/μl for both P. falciparum and P. vivax. The Truenat® Malaria test was found to have sensitivity and specificity of 100% each, compared to the WHO nested PCR protocol based on the evaluation of 100 samples. The sensitivity using expert microscopy as the reference standard was determined to be around 99.3% (95% CI: 95.5–99.9) at the species level. Mixed infections were identified more accurately by Truenat Malaria (32 samples identified as mixed) versus expert microscopy and RDTs which detected 4 and 5 mixed samples, respectively. Conclusion The Truenat® Malaria microPCR test is a valuable diagnostic tool and implementation should be considered not only for malaria diagnosis but also for active surveillance and epidemiological intervention. PMID:26784111

A distributed computational search strategy for the identification of diagnostics targets: application to finding aptamer targets for methicillin-resistant staphylococci.

PubMed

Flanagan, Keith; Cockell, Simon; Harwood, Colin; Hallinan, Jennifer; Nakjang, Sirintra; Lawry, Beth; Wipat, Anil

2014-06-30

The rapid and cost-effective identification of bacterial species is crucial, especially for clinical diagnosis and treatment. Peptide aptamers have been shown to be valuable for use as a component of novel, direct detection methods. These small peptides have a number of advantages over antibodies, including greater specificity and longer shelf life. These properties facilitate their use as the detector components of biosensor devices. However, the identification of suitable aptamer targets for particular groups of organisms is challenging. We present a semi-automated processing pipeline for the identification of candidate aptamer targets from whole bacterial genome sequences. The pipeline can be configured to search for protein sequence fragments that uniquely identify a set of strains of interest. The system is also capable of identifying additional organisms that may be of interest due to their possession of protein fragments in common with the initial set. Through the use of Cloud computing technology and distributed databases, our system is capable of scaling with the rapidly growing genome repositories, and consequently of keeping the resulting data sets up-to-date. The system described is also more generically applicable to the discovery of specific targets for other diagnostic approaches such as DNA probes, PCR primers and antibodies.

Performance specifications for the extra-analytical phases of laboratory testing: Why and how.

PubMed

Plebani, Mario

2017-07-01

An important priority in the current healthcare scenario should be to address errors in laboratory testing, which account for a significant proportion of diagnostic errors. Efforts made in laboratory medicine to enhance the diagnostic process have been directed toward improving technology, greater volumes and more accurate laboratory tests being achieved, but data collected in the last few years highlight the need to re-evaluate the total testing process (TTP) as the unique framework for improving quality and patient safety. Valuable quality indicators (QIs) and extra-analytical performance specifications are required for guidance in improving all TTP steps. Yet in literature no data are available on extra-analytical performance specifications based on outcomes, and nor is it possible to set any specification using calculations involving biological variability. The collection of data representing the state-of-the-art based on quality indicators is, therefore, underway. The adoption of a harmonized set of QIs, a common data collection and standardised reporting method is mandatory as it will not only allow the accreditation of clinical laboratories according to the International Standard, but also assure guidance for promoting improvement processes and guaranteeing quality care to patients. Copyright © 2017 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

An automated cell analysis sensing system based on a microfabricated rheoscope for the study of red blood cells physiology.

PubMed

Bransky, Avishay; Korin, Natanel; Nemirovski, Yael; Dinnar, Uri

2006-08-15

An automated rheoscope has been developed, utilizing a microfabricated glass flow cell, high speed camera and advanced image-processing software. RBCs suspended in a high viscosity medium were filmed flowing through a microchannel. Under these conditions, RBCs exhibit different orientations and deformations according to their location in the velocity profile. The rheoscope system produces valuable data such as velocity profile of RBCs, spatial distribution within a microchannel and deformation index (DI) curves. The variation of DI across the channel height, due to change in shear stress, was measured carrying implications for diffractometry methods. These curves of DI were taken at a constant flow rate and cover most of the relevant shear stress spectrum. This is an improvement of the existing techniques for deformability measurements and may serve as a diagnostic tool for certain blood disorders. The DI curves were compared to measurements of the flowing RBCs velocity profile. In addition, we found that RBCs flowing in a microchannel are mostly gathered in the center of the flow and maintain a characteristic spatial distribution. The spatial distribution in this region changes slightly with increasing flow rate. Hence, the system described, provides means for examining the behavior of individual RBCs, and may serve as a microfabricated diagnostic device for deformability measurement.

Genital Ulcer Disease: How Worrisome Is It Today? A Status Report from New Delhi, India

PubMed Central

Muralidhar, Sumathi; Talwar, Richa; Anil Kumar, Deepa; Kumar, Joginder; Bala, Manju; Khan, Nilofar; Ramesh, V.

2013-01-01

Background and Objectives. Genital ulcer diseases represent a diagnostic dilemma, especially in India, where few STI clinics have access to reliable laboratory facility. The changing STI trends require that a correct diagnosis be made in order to institute appropriate treatment and formulate control policies. The objective of this study was to determine recent trends in aetiology of genital ulcers, by using accurate diagnostic tools. Methods. Specimens from 90 ulcer patients were processed for dark field microscopy, stained smears, culture for H. ducreyi, and real-time PCR. Blood samples were collected for serological tests. Results. Prevalence of GUD was 7.45 with mean age at initial sexual experience as 19.2 years. Use of condom with regular and nonregular partners was 19.5% and 42.1%, respectively. Sexual orientation was heterosexual (92.2%) or homosexual (2.2%). There were 8 cases positive for HIV (8.9%). Herpes simplex virus ulcers were the commonest, followed by syphilis and chancroid. There were no cases of donovanosis and LGV. Conclusions. A valuable contribution of this study was in validating clinical and syndromic diagnoses of genital ulcers with an accurate aetiological diagnosis. Such reliable data will aid treatment and better define control measures of common agents and help eliminate diseases amenable to elimination, like donovanosis. PMID:26316954

The role of spectrophotometry in the diagnosis of melanoma

PubMed Central

2010-01-01

Background Spectrophotometry (SPT) could represent a promising technique for the diagnosis of cutaneous melanoma (CM) at earlier stages of the disease. Starting from our experience, we further assessed the role of SPT in CM early detection. Methods During a health campaign for malignant melanoma at National Cancer Institute of Naples, we identified a subset of 54 lesions to be addressed to surgical excision and histological examination. Before surgery, all patients were investigated by clinical and epiluminescence microscopy (ELM) screenings; selected lesions underwent spectrophotometer analysis. For SPT, we used a video spectrophotometer imaging system (Spectroshade® MHT S.p.A., Verona, Italy). Results Among the 54 patients harbouring cutaneous pigmented lesions, we performed comparison between results from the SPT screening and the histological diagnoses as well as evaluation of both sensitivity and specificity in detecting CM using either SPT or conventional approaches. For all pigmented lesions, agreement between histology and SPT classification was 57.4%. The sensitivity and specificity of SPT in detecting melanoma were 66.6% and 76.2%, respectively. Conclusions Although SPT is still considered as a valuable diagnostic tool for CM, its low accuracy, sensitivity, and specificity represent the main hamper for the introduction of such a methodology in clinical practice. Dermoscopy remains the best diagnostic tool for the preoperative diagnosis of pigmented skin lesions. PMID:20707921

Neural-network-based state of health diagnostics for an automated radioxenon sampler/analyzer

NASA Astrophysics Data System (ADS)

Keller, Paul E.; Kangas, Lars J.; Hayes, James C.; Schrom, Brian T.; Suarez, Reynold; Hubbard, Charles W.; Heimbigner, Tom R.; McIntyre, Justin I.

2009-05-01

Artificial neural networks (ANNs) are used to determine the state-of-health (SOH) of the Automated Radioxenon Analyzer/Sampler (ARSA). ARSA is a gas collection and analysis system used for non-proliferation monitoring in detecting radioxenon released during nuclear tests. SOH diagnostics are important for automated, unmanned sensing systems so that remote detection and identification of problems can be made without onsite staff. Both recurrent and feed-forward ANNs are presented. The recurrent ANN is trained to predict sensor values based on current valve states, which control air flow, so that with only valve states the normal SOH sensor values can be predicted. Deviation between modeled value and actual is an indication of a potential problem. The feed-forward ANN acts as a nonlinear version of principal components analysis (PCA) and is trained to replicate the normal SOH sensor values. Because of ARSA's complexity, this nonlinear PCA is better able to capture the relationships among the sensors than standard linear PCA and is applicable to both sensor validation and recognizing off-normal operating conditions. Both models provide valuable information to detect impending malfunctions before they occur to avoid unscheduled shutdown. Finally, the ability of ANN methods to predict the system state is presented.

A distributed computational search strategy for the identification of diagnostics targets: Application to finding aptamer targets for methicillin-resistant staphylococci.

PubMed

Flanagan, Keith; Cockell, Simon; Harwood, Colin; Hallinan, Jennifer; Nakjang, Sirintra; Lawry, Beth; Wipat, Anil

2014-06-01

The rapid and cost-effective identification of bacterial species is crucial, especially for clinical diagnosis and treatment. Peptide aptamers have been shown to be valuable for use as a component of novel, direct detection methods. These small peptides have a number of advantages over antibodies, including greater specificity and longer shelf life. These properties facilitate their use as the detector components of biosensor devices. However, the identification of suitable aptamer targets for particular groups of organisms is challenging. We present a semi-automated processing pipeline for the identification of candidate aptamer targets from whole bacterial genome sequences. The pipeline can be configured to search for protein sequence fragments that uniquely identify a set of strains of interest. The system is also capable of identifying additional organisms that may be of interest due to their possession of protein fragments in common with the initial set. Through the use of Cloud computing technology and distributed databases, our system is capable of scaling with the rapidly growing genome repositories, and consequently of keeping the resulting data sets up-to-date. The system described is also more generically applicable to the discovery of specific targets for other diagnostic approaches such as DNA probes, PCR primers and antibodies.

Standardised imaging technique for guided M-mode and Doppler echocardiography in the horse.

PubMed

Long, K J; Bonagura, J D; Darke, P G

1992-05-01

Eighteen echocardiographic images useful for diagnostic imaging, M-mode echocardiography, and Doppler echocardiography of the equine heart were standardised by relating the position of the axial beam to various intracardiac landmarks. The transducer orientation required for each image was recorded in 14 adult horses by describing the degree of sector rotation and the orientation of the axial beam relative to the thorax. Repeatable images could be obtained within narrow limits of angulation and rotation for 14 of the 18 standardised images evaluated. Twenty-seven National Hunt horses were subsequently examined using this standardised technique. Selected cardiac dimensions were measured from two-dimensional and guided M-mode studies. Satisfactory results were achieved in 26 of the 27 horses. There was no linear correlation between any of the measured cardiac values and bodyweight. There was no significant difference between measurements taken from the left and the right hemithorax. Six horses were imaged on three consecutive days to assess the repeatability of the measurements. No significant difference was found between measurements obtained on different days. This study demonstrates a method for standardised echocardiographic evaluation of the equine heart that is repeatable, valuable for teaching techniques of equine echocardiography, applicable for diagnostic imaging and quantification of cardiac size, and useful for the evaluation of blood-flow patterns by Doppler ultrasound.

Full range line-field parallel swept source imaging utilizing digital refocusing

NASA Astrophysics Data System (ADS)

Fechtig, Daniel J.; Kumar, Abhishek; Drexler, Wolfgang; Leitgeb, Rainer A.

2015-12-01

We present geometric optics-based refocusing applied to a novel off-axis line-field parallel swept source imaging (LPSI) system. LPSI is an imaging modality based on line-field swept source optical coherence tomography, which permits 3-D imaging at acquisition speeds of up to 1 MHz. The digital refocusing algorithm applies a defocus-correcting phase term to the Fourier representation of complex-valued interferometric image data, which is based on the geometrical optics information of the LPSI system. We introduce the off-axis LPSI system configuration, the digital refocusing algorithm and demonstrate the effectiveness of our method for refocusing volumetric images of technical and biological samples. An increase of effective in-focus depth range from 255 μm to 4.7 mm is achieved. The recovery of the full in-focus depth range might be especially valuable for future high-speed and high-resolution diagnostic applications of LPSI in ophthalmology.

Functional Nonlinear Mixed Effects Models For Longitudinal Image Data

PubMed Central

Luo, Xinchao; Zhu, Lixing; Kong, Linglong; Zhu, Hongtu

2015-01-01

Motivated by studying large-scale longitudinal image data, we propose a novel functional nonlinear mixed effects modeling (FN-MEM) framework to model the nonlinear spatial-temporal growth patterns of brain structure and function and their association with covariates of interest (e.g., time or diagnostic status). Our FNMEM explicitly quantifies a random nonlinear association map of individual trajectories. We develop an efficient estimation method to estimate the nonlinear growth function and the covariance operator of the spatial-temporal process. We propose a global test and a simultaneous confidence band for some specific growth patterns. We conduct Monte Carlo simulation to examine the finite-sample performance of the proposed procedures. We apply FNMEM to investigate the spatial-temporal dynamics of white-matter fiber skeletons in a national database for autism research. Our FNMEM may provide a valuable tool for charting the developmental trajectories of various neuropsychiatric and neurodegenerative disorders. PMID:26213453

Magnetic Affinity Enzyme-Linked Immunoassay for Diagnosis of Schistosomiasis Japonicum in Persons with Low-Intensity Infection

PubMed Central

Yu, Qin; Yang, Hai; Feng, Youmei; Zhu, Yanhong; Yang, Xiangliang

2012-01-01

Most schistosome-endemic areas in China are characterized by low-intensity infections that are independent of prevalence. To establish an effective diagnostic method, we developed a magnetic affinity enzyme-linked immunoassay based on soluble egg antigens (SEA-MEIA) for diagnosing schistosomiasis in persons with low-intensity infection with Schistosoma japonicum by comparing it with a conventional enzyme-linked immunosorbent assay (ELISA). Our results showed that the SEA-MEIA had a higher sensitivity and greater precision in the diagnosis of low-intensity S. japonicum infections than the ELISA. In addition, when we used Pearson's correlation in associating SEA-MEIA with ELISA, a significant correlation existed between the two assays (r = 0.845, P < 0.001). Our data indicated that SEA-MEIA, with a higher sensitivity and greater ease of performance, would be valuable for diagnosis of schistosomiasis japonicum in persons with low-intensity infections. PMID:22869635

Color Doppler imaging of retinal diseases.

PubMed

Dimitrova, Galina; Kato, Satoshi

2010-01-01

Color Doppler imaging (CDI) is a widely used method for evaluating ocular circulation that has been used in a number of studies on retinal diseases. CDI assesses blood velocity parameters by using ultrasound waves. In ophthalmology, these assessments are mainly performed on the retrobulbar blood vessels: the ophthalmic, the central retinal, and the short posterior ciliary arteries. In this review, we discuss CDI use for the assessment of retinal diseases classified into the following: vascular diseases, degenerations, dystrophies, and detachment. The retinal vascular diseases that have been investigated by CDI include diabetic retinopathy, retinal vein occlusions, retinal artery occlusions, ocular ischemic conditions, and retinopathy of prematurity. Degenerations and dystrophies included in this review are age-related macular degeneration, myopia, and retinitis pigmentosa. CDI has been used for the differential diagnosis of retinal detachment, as well as the evaluation of retrobulbar circulation in this condition. CDI is valuable for research and is a potentially useful diagnostic tool in the clinical setting.

3D reconstruction of emergency cranial computed tomography scans as a tool in clinical forensic radiology after survived blunt head trauma--report of two cases.

PubMed

Grassberger, M; Gehl, A; Püschel, K; Turk, E E

2011-04-15

When requested to evaluate surviving victims of blunt head trauma the forensic expert has to draw mainly on medical documentation from the time of hospital admission. In many cases these consist of written clinical records, radiographs and in some cases photographic documentation of the injuries. We report two cases of survived severe blunt head trauma where CT images, which had primarily been obtained for clinical diagnostic purposes, were used for forensic assessment. 3D reconstructions of the clinical CT-images yielded valuable information regarding the sequence, number and direction of the impacts to the head, their gross morphology and the inflicting weapon. We conclude that computed tomography and related imaging methods, along with their 3D reconstruction capabilities, provide a useful tool to approach questions in clinical forensic casework. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Refining Measures for Assessing Problematic/Addictive Digital Gaming Use in Clinical and Research Settings.

PubMed

Faust, Kyle; Faust, David

2015-08-12

Problematic or addictive digital gaming (including all types of electronic devices) can and has had extremely adverse impacts on the lives of many individuals across the world. The understanding of this phenomenon, and the effectiveness of treatment design and monitoring, can be improved considerably by continuing refinement of assessment tools. The present article briefly overviews tools designed to measure problematic or addictive use of digital gaming, the vast majority of which are founded on the Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria for other addictive disorders, such as pathological gambling. Although adapting DSM content and strategies for measuring problematic digital gaming has proven valuable, there are some potential issues with this approach. We discuss the strengths and limitations of current methods for measuring problematic or addictive gaming and provide various recommendations that might help in enhancing or supplementing existing tools, or in developing new and even more effective tools.

Refining Measures for Assessing Problematic/Addictive Digital Gaming Use in Clinical and Research Settings

PubMed Central

Faust, Kyle; Faust, David

2015-01-01

Problematic or addictive digital gaming (including all types of electronic devices) can and has had extremely adverse impacts on the lives of many individuals across the world. The understanding of this phenomenon, and the effectiveness of treatment design and monitoring, can be improved considerably by continuing refinement of assessment tools. The present article briefly overviews tools designed to measure problematic or addictive use of digital gaming, the vast majority of which are founded on the Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria for other addictive disorders, such as pathological gambling. Although adapting DSM content and strategies for measuring problematic digital gaming has proven valuable, there are some potential issues with this approach. We discuss the strengths and limitations of current methods for measuring problematic or addictive gaming and provide various recommendations that might help in enhancing or supplementing existing tools, or in developing new and even more effective tools. PMID:26274977

Recorded Behavior as a Valuable Resource for Diagnostics in Mobile Phone Addiction: Evidence from Psychoinformatics.

PubMed

Montag, Christian; Błaszkiewicz, Konrad; Lachmann, Bernd; Sariyska, Rayna; Andone, Ionut; Trendafilov, Boris; Markowetz, Alexander

2015-10-19

Psychologists and psychiatrists commonly rely on self-reports or interviews to diagnose or treat behavioral addictions. The present study introduces a novel source of data: recordings of the actual problem behavior under investigation. A total of N = 58 participants were asked to fill in a questionnaire measuring problematic mobile phone behavior featuring several questions on weekly phone usage. After filling in the questionnaire, all participants received an application to be installed on their smartphones, which recorded their phone usage for five weeks. The analyses revealed that weekly phone usage in hours was overestimated; in contrast, numbers of call and text message related variables were underestimated. Importantly, several associations between actual usage and being addicted to mobile phones could be derived exclusively from the recorded behavior, but not from self-report variables. The study demonstrates the potential benefit to include methods of psychoinformatics in the diagnosis and treatment of problematic mobile phone use.

Ambulatory or home measurement of blood pressure?

PubMed

Gosse, Philippe; Coulon, Paul

2009-04-01

Ambulatory blood pressure monitoring (ABPM) and home blood pressure (HBPM) monitoring have been shown to be superior to conventional measurement of blood pressure in terms of reproducibility, relationship to the impact of high blood pressure on target organs, and the prediction of cardiovascular events. Nevertheless, these 2 techniques have yet to find their place in the diagnosis of hypertension and during evaluation of the efficacy of antihypertensive treatment. Although these 2 methods do not give identical results in approximately 20% of cases, their diagnostic performance and prognostic value are quite comparable. Although ABPM remains a valuable tool in clinical research, its utilization in routine clinical practice is limited by cost and availability. HBPM is increasingly employed for informed and well-managed patients, and it can help to improve control of the patient's blood pressure. Physicians involved in the management of hypertensive patients should be aware of its value in order to assist patients in their care.

Automated retinal layer segmentation and characterization

NASA Astrophysics Data System (ADS)

Luisi, Jonathan; Briley, David; Boretsky, Adam; Motamedi, Massoud

2014-05-01

Spectral Domain Optical Coherence Tomography (SD-OCT) is a valuable diagnostic tool in both clinical and research settings. The depth-resolved intensity profiles generated by light backscattered from discrete layers of the retina provide a non-invasive method of investigating progressive diseases and injury within the eye. This study demonstrates the application of steerable convolution filters capable of automatically separating gradient orientations to identify edges and delineate tissue boundaries. The edge maps were recombined to measure thickness of individual retinal layers. This technique was successfully applied to longitudinally monitor changes in retinal morphology in a mouse model of laser-induced choroidal neovascularization (CNV) and human data from age-related macular degeneration patients. The steerable filters allow for direct segmentation of noisy images, while novel recombination of weaker segmentations allow for denoising post-segmentation. The segmentation before denoising strategy allows the rapid detection of thin retinal layers even under suboptimal imaging conditions.

Excitation-emission matrices and synchronous fluorescence spectroscopy for the diagnosis of gastrointestinal cancers

NASA Astrophysics Data System (ADS)

Genova, Ts; Borisova, E.; Penkov, N.; Vladimirov, B.; Zhelyazkova, A.; Avramov, L.

2016-06-01

We report the development of an improved fluorescence technique for cancer diagnostics in the gastrointestinal tract. We investigate the fluorescence of ex vivo colorectal (cancerous and healthy) tissue samples using excitation-emission matrix (EEM) and synchronous fluorescence spectroscopy (SFS) steady-state approaches. The obtained results are processed for revealing characteristic fluorescence spectral features with a valuable diagnostic meaning. The main tissue fluorophores, contributing to the observed fluorescence, are tyrosine, tryptophan, NADH, FAD, collagen and elastin. Based on the results of the Mann-Whitney test as useful parameters for differentiation of gastrointestinal cancer from normal mucosa, we suggest using excitation wavelengths in the range 300 - 360 nm for fluorescence spectroscopy and wavelengths intervals of 60 nm and 90 nm for SFS.

Chemical burns of the oral mucosa: report of a case.

PubMed

Isenberg, S R; Hier, L A; Chauvin, P J

1996-03-01

Clinical diagnosis of a chemical burn of the oral mucous membranes may be a diagnostic challenge. This article's intent is to illustrate the typical appearance of a chemical mucosal burn and to increase awareness of the various compounds which, when in contact with the mucous membranes, can result in a burn. The authors present a case involving a self-inflicted chemical injury of the oral mucous membranes and illustrate how the submission of an easily-obtained tissue specimen for pathologic examination may aid in the diagnosis. Because these superficial tissues can be obtained and submitted without the need for local anesthetic, pathologic examination is a quick, easy, and valuable diagnostic test when a patient's history is difficult to obtain or intentionally misleading.

The role of bronchoscopy in the diagnosis of airway disease

PubMed Central

Dixon, Jennifer; Tieu, Brandon H.

2016-01-01

Endoscopy of the airway is a valuable tool for the evaluation and management of airway disease. It can be used to evaluate many different bronchopulmonary diseases including airway foreign bodies, tumors, infectious and inflammatory conditions, airway stenosis, and bronchopulmonary hemorrhage. Traditionally, options for evaluation were limited to flexible and rigid bronchoscopy. Recently, more sophisticated technology has led to the development of endobronchial ultrasound (EBUS) and electromagnetic navigational bronchoscopy (ENB). These technological advances, combined with increasing provider experience have resulted in a higher diagnostic yield with endoscopic biopsies. This review will focus on the role of bronchoscopy, including EBUS, ENB, and rigid bronchoscopy in the diagnosis of bronchopulmonary diseases. In addition, it will cover the anesthetic considerations, equipment, diagnostic yield, and potential complications. PMID:28149583

Installing logic gates in permeability controllable polyelectrolyte-carbon nitride films for detecting proteases and nucleases.

PubMed

Chen, Lichan; Zeng, Xiaoting; Dandapat, Anirban; Chi, Yuwu; Kim, Donghwan

2015-09-01

Proteases and nucleases are enzymes heavily involved in many important biological processes, such as cancer initiation, progression, and metastasis; hence, they are indicative of potential diagnostic biomarkers. Here, we demonstrate a new label free and sensitive electrochemiluminescent (ECL) sensing strategy for protease and nuclease assays that utilize target-triggered desorption of programmable polyelectrolyte films assembled on graphite-like carbon nitride (g-C3N4) film to regulate the diffusion flux of a coreactant. Furthermore, we have built Boolean logic gates OR and AND into the polyelectrolyte films, capable of simultaneously sensing proteases and nucleases in a complicated system by breaking it into simple functions. The developed intelligent permeability controlled enzyme sensor may prove valuable in future medical diagnostics.

Determining the utility and durability of medical equipment donated to a rural clinic in a low-income country

PubMed Central

Bauserman, Melissa; Hailey, Claire; Gado, Justin; Lokangaka, Adrien; Williams, Jessica; Richards-Kortum, Rebecca; Tshefu, Antoinette; Bose, Carl

2015-01-01

Background Health centers in low-income countries often depend on donations to provide appropriate diagnostic equipment. However, donations are sometimes made without an understanding of the recipient's needs, practical constraints or sustainability of supplies. Methods We donated a set of physical diagnostic equipment, non-invasive instrument tests and laboratory supplies to a rural health center in the Democratic Republic of Congo. We collected information on the usage and durability of equipment and supplies for each patient encounter over a 1-year period. Results We recorded 913 patient encounters. The most commonly used physical diagnostic equipment were the stethoscope (98.9%; 903/913), thermometer (81.7%; 746/913), adult scale (81.4%; 744/913), stop watch (62.6%; 572/913), adult sphygmomanometer (55.8%; 510/913), infant scale (24.9%; 228/913), measuring tape (24.3%; 222/913) and fetoscope (23.8%; 218/913). The most commonly used laboratory tests were the blood smear for malaria (53.7%; 491/913), hematocrit (23.5%; 215/913), urinalysis (20.1%; 184/913) and sputum stain for TB (13.3%; 122/913). With the exception of a penlight and solar lantern, all equipment remained functional. Conclusions This study adds valuable information about the utility and durability of equipment supplied to a health center in the Democratic Republic of Congo. Our results might aid in determining the appropriateness of donated medical equipment in similar settings. The selection of donated goods should be made with knowledge of the context in which it will be used, and utilization should be monitored. PMID:25525132

Energy dependence measurement of small-type optically stimulated luminescence (OSL) dosimeter by means of characteristic X-rays induced with general diagnostic X-ray equipment.

PubMed

Takegami, Kazuki; Hayashi, Hiroaki; Okino, Hiroki; Kimoto, Natsumi; Maehata, Itsumi; Kanazawa, Yuki; Okazaki, Tohru; Hashizume, Takuya; Kobayashi, Ikuo

2016-01-01

For X-ray inspections by way of general X-ray equipment, it is important to measure an entrance-skin dose. Recently, a small optically stimulated luminescence (OSL) dosimeter was made commercially available by Landauer, Inc. The dosimeter does not interfere with the medical images; therefore, it is expected to be a convenient detector for measuring personal exposure doses. In an actual clinical situation, it is assumed that X-rays of different energies will be detected by a dosimeter. For evaluation of the exposure dose measured by a dosimeter, it is necessary to know the energy dependence of the dosimeter. Our aim in this study was to measure the energy dependence of the OSL dosimeter experimentally in the diagnostic X-ray region. Metal samples weighing several grams were irradiated and, in this way, characteristic X-rays having energies ranging from 8 to 85 keV were generated. Using these mono-energetic X-rays, the dosimeter was irradiated. Simultaneously, the fluence of the X-rays was determined with a CdTe detector. The energy-dependent efficiency of the dosimeter was derived from the measured value of the dosimeter and the fluence. Moreover, the energy-dependent efficiency was calculated by Monte-Carlo simulation. The efficiency obtained in the experiment was in good agreement with that of the simulation. In conclusion, our proposed method, in which characteristic X-rays are used, is valuable for measurement of the energy dependence of a small OSL dosimeter in the diagnostic X-ray region.

Common Fluorescence In Situ Hybridization Applications in Cytology.

PubMed

Savic, Spasenija; Bubendorf, Lukas

2016-12-01

- Fluorescence in situ hybridization (FISH) is a well-established method for detection of genomic aberrations in diagnostic, prognostic, and predictive marker testing. - To review common applications of FISH in cytology. - The published literature was reviewed. - Cytology is particularly well suited for all kinds of FISH applications, which is highlighted in respiratory tract cytology with an increasing demand for predictive FISH testing in lung cancer. Fluorescence in situ hybridization is the gold standard for detection of predictive anaplastic lymphoma kinase gene (ALK) rearrangements, and the same evaluation criteria as in histology apply to cytology. Several other gene rearrangements, including ROS proto-oncogene 1 receptor tyrosine kinase (ROS1), are becoming clinically important and share the same underlining cytogenetic mechanisms with ALK. MET amplification is one of the most common mechanisms of acquired resistance to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors and can be targeted by crizotinib. As genomic aberrations are a hallmark of malignant cells, FISH is a valuable objective ancillary diagnostic tool. In urinary tract cytology, atypical urothelial cells equivocal for malignancy are a common diagnostic dilemma and multitarget FISH can help clarify such cells. Diagnosis of malignant mesothelioma remains one of the most challenging fields in effusion cytology, and ancillary FISH is useful in establishing the diagnosis. Fluorescence in situ hybridization is a morphology-based technique, and the prerequisite for reliable FISH results is a targeted evaluation of the cells in question (eg, cancer or atypical cells). Cytopathologists and cytotechnicians should therefore be involved in molecular testing in order to select the best material and to provide their morphologic expertise.

Pleural fluid neopterin levels in tuberculous pleurisy.

PubMed

Cok, Gursel; Parildar, Zuhal; Basol, Gunes; Kabaroglu, Ceyda; Bayindir, Ulku; Habif, Sara; Bayindir, Oya

2007-08-01

Neopterin is produced by stimulated macrophages under the influence of gamma interferon of lymphocyte origin. It is regarded as a biochemical marker of cell-mediated immune response. This study was designed to assess the diagnostic value of pleural fluid neopterin levels in tuberculous pleurisy in comparison with adenosine deaminase activity. Pleural fluid adenosine deaminase (ADA) activity and neopterin levels were measured in 16 patients with tuberculous pleurisy (TP) and 19 patients with malignant pleurisy (MP). ADA activity was determined by a colorimetric method, whereas neopterin levels were determined by a reversed-phase liquid chromatography technique. All values were given as median (min-max). The mean age was 45.43+/-20.39 years in the TP group and 60.42+/-11.02 years in the MP group (p=0.026). The median pleural fluid ADA activity was 51.75 U/L (3.50-62.40 U/L) in the TP group and was 2.30 U/L (1-8.20 U/L) in the MP group. The difference was statistically significant (p<0.001). The median pleural fluid neopterin levels were 13.15 nmol/L (1.86-59.50 nmol/L) and 2.44 nmol/L (0.92-27.60 nmol/L) in the TP group and the MP group, respectively (p=0.021). In order to evaluate the diagnostic value of pleural fluid neopterin concentrations, receiver-operating-characteristic curve analysis was performed. Pleural fluid neopterin concentration is significantly higher in TP when compared to MP, however when compared, its clinical use as a diagnostic marker is not valuable as ADA.

Field evaluation of a blood based test for active tuberculosis in endemic settings

PubMed Central

Hussainy, Syed Fahadulla; Krishnan, Viwanathan V.; Ambreen, Atiqa; Yusuf, Noshin Wasim; Irum, Shagufta; Rashid, Abdul; Jamil, Muhammad; Zaffar, Fareed; Chaudhry, Muhammad Nawaz; Gupta, Puneet K.; Akhtar, Muhammad Waheed; Khan, Imran H.

2017-01-01

Over 9 million new active tuberculosis (TB) cases emerge each year from an enormous pool of 2 billion individuals latently infected with Mycobacterium tuberculosis (M. tb.) worldwide. About 3 million new TB cases per year are unaccounted for, and 1.5 million die. TB, however, is generally curable if diagnosed correctly and in a timely manner. The current diagnostic methods for TB, including state-of-the-art molecular tests, have failed in delivering the capacity needed in endemic countries to curtail this ongoing pandemic. Efficient, cost effective and scalable diagnostic approaches are critically needed. We report a multiplex TB serology panel using microbead suspension array containing a combination of 11 M.tb. antigens that demonstrated overall sensitivity of 91% in serum/plasma samples from TB patients confirmed by culture. Group wise sensitivities for sputum smear positive and negative patients were 95%, and 88%, respectively. Specificity of the test was 96% in untreated COPD patients and 91% in general healthy population. The sensitivity of this test is superior to that of the frontline sputum smear test with a comparable specificity (30–70%, and 93–99%, respectively). The multiplex serology test can be performed with scalability from 1 to 360 patients per day, and is amenable to automation for higher (1000s per day) throughput, thus enabling a scalable clinical work flow model for TB endemic countries. Taken together, the above results suggest that well defined antibody profiles in blood, analyzed by an appropriate technology platform, offer a valuable approach to TB diagnostics in endemic countries. PMID:28380055

Diagnosis is a team sport - partnering with allied health professionals to reduce diagnostic errors.

PubMed

Thomas, Dana B; Newman-Toker, David E

2016-06-01

Diagnostic errors are the most common, most costly, and most catastrophic of medical errors. Interdisciplinary teamwork has been shown to reduce harm from therapeutic errors, but sociocultural barriers may impact the engagement of allied health professionals (AHPs) in the diagnostic process. A qualitative case study of the experience at a single institution around involvement of an AHP in the diagnostic process for acute dizziness and vertigo. We detail five diagnostic error cases in which the input of a physical therapist was central to correct diagnosis. We further describe evolution of the sociocultural milieu at the institution as relates to AHP engagement in diagnosis. Five patients with acute vestibular symptoms were initially misdiagnosed by physicians and then correctly diagnosed based on input from a vestibular physical therapist. These included missed labyrinthine concussion and post-traumatic benign paroxysmal positional vertigo (BPPV); BPPV called gastroenteritis; BPPV called stroke; stroke called BPPV; and multiple sclerosis called BPPV. As a consequence of surfacing these diagnostic errors, initial resistance to physical therapy input to aid medical diagnosis has gradually declined, creating a more collaborative environment for 'team diagnosis' of patients with dizziness and vertigo at the institution. Barriers to AHP engagement in 'team diagnosis' include sociocultural norms that establish medical diagnosis as something reserved only for physicians. Drawing attention to the valuable diagnostic contributions of AHPs may help facilitate cultural change. Future studies should seek to measure diagnostic safety culture and then implement proven strategies to breakdown sociocultural barriers that inhibit effective teamwork and transdisciplinary diagnosis.

Diagnosis is a team sport - partnering with allied health professionals to reduce diagnostic errors: A case study on the role of a vestibular therapist in diagnosing dizziness.

PubMed

Thomas, Dana B; Newman-Toker, David E

2016-06-01

Diagnostic errors are the most common, most costly, and most catastrophic of medical errors. Interdisciplinary teamwork has been shown to reduce harm from therapeutic errors, but sociocultural barriers may impact the engagement of allied health professionals (AHPs) in the diagnostic process. A qualitative case study of the experience at a single institution around involvement of an AHP in the diagnostic process for acute dizziness and vertigo. We detail five diagnostic error cases in which the input of a physical therapist was central to correct diagnosis. We further describe evolution of the sociocultural milieu at the institution as relates to AHP engagement in diagnosis. Five patients with acute vestibular symptoms were initially misdiagnosed by physicians and then correctly diagnosed based on input from a vestibular physical therapist. These included missed labyrinthine concussion and post-traumatic benign paroxysmal positional vertigo (BPPV); BPPV called gastroenteritis; BPPV called stroke; stroke called BPPV; and multiple sclerosis called BPPV. As a consequence of surfacing these diagnostic errors, initial resistance to physical therapy input to aid medical diagnosis has gradually declined, creating a more collaborative environment for 'team diagnosis' of patients with dizziness and vertigo at the institution. Barriers to AHP engagement in 'team diagnosis' include sociocultural norms that establish medical diagnosis as something reserved only for physicians. Drawing attention to the valuable diagnostic contributions of AHPs may help facilitate cultural change. Future studies should seek to measure diagnostic safety culture and then implement proven strategies to breakdown sociocultural barriers that inhibit effective teamwork and transdisciplinary diagnosis.

The role of Fluorine-18-Fluorodeoxyglucose positron emission tomography in staging and restaging of patients with osteosarcoma

PubMed Central

Quartuccio, Natale; Treglia, Giorgio; Salsano, Marco; Mattoli, Maria Vittoria; Muoio, Barbara; Piccardo, Arnoldo; Lopci, Egesta; Cistaro, Angelina

2013-01-01

Background The objective of this study is to systematically review the role of positron emission tomography (PET) and PET/computed tomography (PET/CT) with Fluorine-18-Fluorodeoxyglucose (FDG) in patients with osteosarcoma (OS). Methods A comprehensive literature search of published studies through October 10th, 2012 in PubMed/MEDLINE, Embase and Scopus databases regarding whole-body FDG-PET and FDG-PET/CT in patients with OS was performed. Results We identified 13 studies including 289 patients with OS. With regard to the staging and restaging of OS, the diagnostic performance of FDG-PET and PET/CT seem to be high; FDG-PET and PET/CT seem to be superior to bone scintigraphy and conventional imaging methods in detecting bone metastases; conversely, spiral CT seems to be superior to FDG-PET in detecting pulmonary metastases from OS Conclusions Metabolic imaging may provide additional information in the evaluation of OS patients. The combination of FDG-PET or FDG-PET/CT with conventional imaging methods seems to be a valuable tool in the staging and restaging of OS and may have a relevant impact on the treatment planning. PMID:23801904

Probabilistic brain tissue segmentation in neonatal magnetic resonance imaging.

PubMed

Anbeek, Petronella; Vincken, Koen L; Groenendaal, Floris; Koeman, Annemieke; van Osch, Matthias J P; van der Grond, Jeroen

2008-02-01

A fully automated method has been developed for segmentation of four different structures in the neonatal brain: white matter (WM), central gray matter (CEGM), cortical gray matter (COGM), and cerebrospinal fluid (CSF). The segmentation algorithm is based on information from T2-weighted (T2-w) and inversion recovery (IR) scans. The method uses a K nearest neighbor (KNN) classification technique with features derived from spatial information and voxel intensities. Probabilistic segmentations of each tissue type were generated. By applying thresholds on these probability maps, binary segmentations were obtained. These final segmentations were evaluated by comparison with a gold standard. The sensitivity, specificity, and Dice similarity index (SI) were calculated for quantitative validation of the results. High sensitivity and specificity with respect to the gold standard were reached: sensitivity >0.82 and specificity >0.9 for all tissue types. Tissue volumes were calculated from the binary and probabilistic segmentations. The probabilistic segmentation volumes of all tissue types accurately estimated the gold standard volumes. The KNN approach offers valuable ways for neonatal brain segmentation. The probabilistic outcomes provide a useful tool for accurate volume measurements. The described method is based on routine diagnostic magnetic resonance imaging (MRI) and is suitable for large population studies.

To fine needle aspiration or not? An endosonographer's approach to pancreatic cystic lesions

PubMed Central

But, David Yiu-Kuen; Poley, Jan-Werner

2014-01-01

Endoscopic ultrasound (EUS) guided fine needle aspiration (FNA) is an established diagnostic tool in the management of pancreatic cystic lesions (PCLs). Due to the proximity to the target lesion, the fine diagnostic needle travels through only minimal normal tissues. The risks of bleeding, pancreatitis and infection are small. Valuable diagnostic morphological information can be obtained by EUS before the use of FNA. The additional cytopathologic and cyst fluid analysis for the conventional markers such as amylase, carcinoembryonic antigen (CEA) and CA19.9 improves the diagnostic capability. Pancreatic cyst fluid CEA concentration of 192 ng/mL is generally the most agreed cutoff to differentiate mucinous from non-mucinous lesion. A fluid amylase level of <250 IU/L excludes the diagnosis of pseudocyst. Technical tips of EUS-FNA and the limitations of the procedure are discussed. Promising technique and FNA needle modifications have been described to improve the diagnostic yield at the cytopathologic analysis. The use of novel cyst fluid proteomics and deoxyribonucleic acid-based biomarkers of the PCLs are reviewed. Although it is considered a safe procedure, EUS-FNA is not a routine in every patient. Recommendations of the role of EUS-FNA at various common clinical scenarios are discussed. PMID:24955337

Understanding missed opportunities for more timely diagnosis of cancer in symptomatic patients after presentation

PubMed Central

Lyratzopoulos, G; Vedsted, P; Singh, H

2015-01-01

The diagnosis of cancer is a complex, multi-step process. In this paper, we highlight factors involved in missed opportunities to diagnose cancer more promptly in symptomatic patients and discuss responsible mechanisms and potential strategies to shorten intervals from presentation to diagnosis. Missed opportunities are instances in which post-hoc judgement indicates that alternative decisions or actions could have led to more timely diagnosis. They can occur in any of the three phases of the diagnostic process (initial diagnostic assessment; diagnostic test performance and interpretation; and diagnostic follow-up and coordination) and can involve patient, doctor/care team, and health-care system factors, often in combination. In this perspective article, we consider epidemiological ‘signals' suggestive of missed opportunities and draw on evidence from retrospective case reviews of cancer patient cohorts to summarise factors that contribute to missed opportunities. Multi-disciplinary research targeting such factors is important to shorten diagnostic intervals post presentation. Insights from the fields of organisational and cognitive psychology, human factors science and informatics can be extremely valuable in this emerging research agenda. We provide a conceptual foundation for the development of future interventions to minimise the occurrence of missed opportunities in cancer diagnosis, enriching current approaches that chiefly focus on clinical decision support or on widening access to investigations. PMID:25734393

Diagnostic implication of fibrin degradation products and D-dimer in aortic dissection

NASA Astrophysics Data System (ADS)

Dong, Jian; Duan, Xianli; Feng, Rui; Zhao, Zhiqing; Feng, Xiang; Lu, Qingsheng; Jing, Qing; Zhou, Jian; Bao, Junmin; Jing, Zaiping

2017-03-01

Fibrin degradation products (FDP) and D-dimer have been considered to be involved in many vascular diseases. In this study we aimed to explore the diagnostic implication of FDP and D-dimer in aortic dissection patients. 202 aortic dissection patients were collected as the case group, 150 patients with other cardiovascular diseases, including myocardial infarction (MI, n = 45), pulmonary infarction (n = 51) and abdominal aortic aneurysm (n = 54) were collected as non-dissection group, and 27 healthy people were in the blank control group. The FDP and D-dimer levels were detected with immune nephelometry. Logist regression analysis was performed to evaluate the influence of FDP and D-dimer for the aortic dissection patients. ROC curve was used to determine the diagnostic value of FDP and D-dimer. The FDP and D-dimer levels were significantly higher in aortic dissection patients than in non-dissection patients and the healthy controls. FDP and D-dimer were both the risk factors for patients with aortic dissection. From the ROC analysis, diagnostic value of FDP and D-dimer were not high to distinguish aortic dissection patients from the non-dissection patients. However FDP and D-dimer could be valuable diagnostic marker to differentiate aortic dissection patients and healthy controls with both AUC 0.863.

DNA barcode-based delineation of putative species: efficient start for taxonomic workflows

PubMed Central

Kekkonen, Mari; Hebert, Paul D N

2014-01-01

The analysis of DNA barcode sequences with varying techniques for cluster recognition provides an efficient approach for recognizing putative species (operational taxonomic units, OTUs). This approach accelerates and improves taxonomic workflows by exposing cryptic species and decreasing the risk of synonymy. This study tested the congruence of OTUs resulting from the application of three analytical methods (ABGD, BIN, GMYC) to sequence data for Australian hypertrophine moths. OTUs supported by all three approaches were viewed as robust, but 20% of the OTUs were only recognized by one or two of the methods. These OTUs were examined for three criteria to clarify their status. Monophyly and diagnostic nucleotides were both uninformative, but information on ranges was useful as sympatric sister OTUs were viewed as distinct, while allopatric OTUs were merged. This approach revealed 124 OTUs of Hypertrophinae, a more than twofold increase from the currently recognized 51 species. Because this analytical protocol is both fast and repeatable, it provides a valuable tool for establishing a basic understanding of species boundaries that can be validated with subsequent studies. PMID:24479435

Proteomics Tracing the Footsteps of Infectious Disease*

PubMed Central

Greco, Todd M.; Cristea, Ileana M.

2017-01-01

Every year, a major cause of human disease and death worldwide is infection with the various pathogens—viruses, bacteria, fungi, and protozoa—that are intrinsic to our ecosystem. In efforts to control the prevalence of infectious disease and develop improved therapies, the scientific community has focused on building a molecular picture of pathogen infection and spread. These studies have been aimed at defining the cellular mechanisms that allow pathogen entry into hosts cells, their replication and transmission, as well as the core mechanisms of host defense against pathogens. The past two decades have demonstrated the valuable implementation of proteomic methods in all these areas of infectious disease research. Here, we provide a perspective on the contributions of mass spectrometry and other proteomics approaches to understanding the molecular details of pathogen infection. Specifically, we highlight methods used for defining the composition of viral and bacterial pathogens and the dynamic interaction with their hosts in space and time. We discuss the promise of MS-based proteomics in supporting the development of diagnostics and therapies, and the growing need for multiomics strategies for gaining a systems view of pathogen infection. PMID:28163258

The role of Fluorine-18-Fluorodeoxyglucose positron emission tomography in staging and restaging of patients with osteosarcoma.

PubMed

Quartuccio, Natale; Treglia, Giorgio; Salsano, Marco; Mattoli, Maria Vittoria; Muoio, Barbara; Piccardo, Arnoldo; Lopci, Egesta; Cistaro, Angelina

2013-06-01

The objective of this study is to systematically review the role of positron emission tomography (PET) and PET/computed tomography (PET/CT) with Fluorine-18-Fluorodeoxyglucose (FDG) in patients with osteosarcoma (OS). A comprehensive literature search of published studies through October 10(th), 2012 in PubMed/MEDLINE, Embase and Scopus databases regarding whole-body FDG-PET and FDG-PET/CT in patients with OS was performed. We identified 13 studies including 289 patients with OS. With regard to the staging and restaging of OS, the diagnostic performance of FDG-PET and PET/CT seem to be high; FDG-PET and PET/CT seem to be superior to bone scintigraphy and conventional imaging methods in detecting bone metastases; conversely, spiral CT seems to be superior to FDG-PET in detecting pulmonary metastases from OS. Metabolic imaging may provide additional information in the evaluation of OS patients. The combination of FDG-PET or FDG-PET/CT with conventional imaging methods seems to be a valuable tool in the staging and restaging of OS and may have a relevant impact on the treatment planning.

Disentangling the stochastic behavior of complex time series

NASA Astrophysics Data System (ADS)

Anvari, Mehrnaz; Tabar, M. Reza Rahimi; Peinke, Joachim; Lehnertz, Klaus

2016-10-01

Complex systems involving a large number of degrees of freedom, generally exhibit non-stationary dynamics, which can result in either continuous or discontinuous sample paths of the corresponding time series. The latter sample paths may be caused by discontinuous events - or jumps - with some distributed amplitudes, and disentangling effects caused by such jumps from effects caused by normal diffusion processes is a main problem for a detailed understanding of stochastic dynamics of complex systems. Here we introduce a non-parametric method to address this general problem. By means of a stochastic dynamical jump-diffusion modelling, we separate deterministic drift terms from different stochastic behaviors, namely diffusive and jumpy ones, and show that all of the unknown functions and coefficients of this modelling can be derived directly from measured time series. We demonstrate appli- cability of our method to empirical observations by a data-driven inference of the deterministic drift term and of the diffusive and jumpy behavior in brain dynamics from ten epilepsy patients. Particularly these different stochastic behaviors provide extra information that can be regarded valuable for diagnostic purposes.

Dermatological Feasibility of Multimodal Facial Color Imaging Modality for Cross-Evaluation of Facial Actinic Keratosis

PubMed Central

Bae, Youngwoo; Son, Taeyoon; Nelson, J. Stuart; Kim, Jae-Hong; Choi, Eung Ho; Jung, Byungjo

2010-01-01

Background/Purpose Digital color image analysis is currently considered as a routine procedure in dermatology. In our previous study, a multimodal facial color imaging modality (MFCIM), which provides a conventional, parallel- and cross-polarization, and fluorescent color image, was introduced for objective evaluation of various facial skin lesions. This study introduces a commercial version of MFCIM, DermaVision-PRO, for routine clinical use in dermatology and demonstrates its dermatological feasibility for cross-evaluation of skin lesions. Methods/Results Sample images of subjects with actinic keratosis or non-melanoma skin cancers were obtained at four different imaging modes. Various image analysis methods were applied to cross-evaluate the skin lesion and, finally, extract valuable diagnostic information. DermaVision-PRO is potentially a useful tool as an objective macroscopic imaging modality for quick prescreening and cross-evaluation of facial skin lesions. Conclusion DermaVision-PRO may be utilized as a useful tool for cross-evaluation of widely distributed facial skin lesions and an efficient database management of patient information. PMID:20923462

Secretome Identifies Tenascin-X as a Potent Marker of Ovarian Cancer

PubMed Central

Kramer, Marianne; Pierredon, Sandra; Ribaux, Pascale; Tille, Jean-Christophe; Cohen, Marie

2015-01-01

CA-125 has been a valuable marker for the follow-up of ovarian cancer patients but it is not sensitive enough to be used as diagnostic marker. We had already used secretomic methods to identify proteins differentially secreted by serous ovarian cancer cells compared to healthy ovarian cells. Here, we evaluated the secretion of these proteins by ovarian cancer cells during the follow-up of one patient. Proteins that correlated with CA-125 levels were screened using serum samples from ovarian cancer patients as well as benign and healthy controls. Tenascin-X secretion was shown to correlate with CA-125 value in the initial case study. The immunohistochemical detection of increased amount of tenascin-X in ovarian cancer tissues compared to healthy tissues confirms the potent interest in tenascin-X as marker. We then quantified the tenascin-X level in serum of patients and identified tenascin-X as potent marker for ovarian cancer, showing that secretomic analysis is suitable for the identification of protein biomarkers when combined with protein immunoassay. Using this method, we determined tenascin-X as a new potent marker for serous ovarian cancer. PMID:26090390

Immunosignature: Serum Antibody Profiling for Cancer Diagnostics.

PubMed

Chapoval, Andrei I; Legutki, J Bart; Stafford, Philip; Trebukhov, Andrey V; Johnston, Stephen A; Shoikhet, Yakov N; Lazarev, Alexander F

2015-01-01

Biomarkers for preclinical diagnosis of cancer are valuable tools for detection of malignant tumors at early stages in groups at risk and screening healthy people, as well as monitoring disease recurrence after treatment of cancer. However the complexity of the body's response to the pathological processes makes it virtually impossible to evaluate this response to the development of the disease using a single biomarker that is present in the serum at low concentrations. An alternative approach to standard biomarker analysis is called immunosignature. Instead of going after biomarkers themselves this approach rely on the analysis of the humoral immune response to molecular changes associated with the development of pathological processes. It is known that antibodies are produced in response to proteins expressed during cancer development. Accordingly, the changes in antibody repertoire associated with tumor growth can serve as biomarkers of cancer. Immunosignature is a highly sensitive method for antibody repertoire analysis utilizing high density peptide microarrays. In the present review we discuss modern methods for antibody detection, as well as describe the principles and applications of immunosignature in research and clinical practice.

Experimental Study of Ultrasound Contrast Agent Mediated Heat Transfer for Therapeutic Applications

NASA Astrophysics Data System (ADS)

Razansky, D.; Adam, D. R.; Einziger, P. D.

2006-05-01

Ultrasound Contrast Agents (UCA) have been recently suggested as efficient enhancers of ultrasonic power deposition in tissue. The ultrasonic energy absorption by UCA, considered as disadvantageous in diagnostic imaging, might be valuable in therapeutic applications such as targeted hyperthermia or ablation treatments. The current study, based on theoretical predictions, was designed to experimentally measure the dissipation and heating effects of encapsulated UCA (Optison™) in a well-controlled and calibrated environment.

Endophthalmitis: state of the art

PubMed Central

Vaziri, Kamyar; Schwartz, Stephen G; Kishor, Krishna; Flynn, Harry W

2015-01-01

Endophthalmitis is an uncommon diagnosis but can have devastating visual outcomes. Endophthalmitis may be endogenous or exogenous. Exogenous endophthalmitis is caused by introduction of pathogens through mechanisms such as ocular surgery, open-globe trauma, and intravitreal injections. Endogenous endophthalmitis occurs as a result of hematogenous spread of bacteria or fungi into the eye. These categories of endophthalmitis have different risk factors and causative pathogens, and thus require different diagnostic, prevention, and treatment strategies. Novel diagnostic techniques such as real-time polymerase chain reaction (RT-PCR) have been reported to provide improved diagnostic results over traditional culture techniques and may have a more expanded role in the future. While the role of povidone-iodine in prophylaxis of postoperative endophthalmitis is established, there remains controversy with regard to the effectiveness of other measures, including prophylactic antibiotics. The Endophthalmitis Vitrectomy Study (EVS) has provided us with valuable treatment guidelines. However, these guidelines cannot be directly applied to all categories of endophthalmitis, highlighting the need for continued research into attaining improved treatment outcomes. PMID:25609911

Iridology: not useful and potentially harmful.

PubMed

Ernst, E

2000-01-01

More than 1,000 licensed naturopathic physicians practice in the United States, and iridology is being described as "the most valuable diagnostic tool of the naturopath." Some therapists are using iridology as a basis for recommending dietary supplements and/or herbs. Several US iridologist organizations exist: the National Iridology Research Association is an iridologists' service organization, the International Association of Iridologists is the leading organization for European-style iridology and runs training programs (minimum of 72 hours in class), and the Bastyr Naturopathic College in Seattle, Wash, has an elective course on iridology (J. Colton, e-mail communication, December 2, 1998). In the United States, insurance programs do not normally cover iridology, but in some European countries, they do. In Germany, for instance, 80% of the Heilpraktiker (nonmedically qualified health practitioners) practice iridology. Ophthalmologists may therefore ask what is iridology and how valuable is it?

Immunoproteomic and bioinformatic approaches to identify secreted Leishmania amazonensis, L. braziliensis, and L. infantum proteins with specific reactivity using canine serum.

PubMed

Lima, B S S; Fialho, L C; Pires, S F; Tafuri, W L; Andrade, H M

2016-06-15

Leishmania spp have a wide range of hosts, and each host can harbor several Leishmania species. Dogs, for example, are frequently infected by Leishmania infantum, where they constitute its main reservoir, but they also serve as hosts for L. braziliensis and L. amazonensis. Serological tests for antibody detection are valuable tools for diagnosis of L. infantum infection due to the high levels of antibodies induced, unlike what is observed in L. amazonensis and L. braziliensis infections. Likewise, serology-based antigen-detection can be useful as an approach to diagnose any Leishmania species infection using different corporal fluid samples. Immunogenic and secreted proteins constitute powerful targets for diagnostic methods in antigen detection. As such, we performed immunoproteomic (2-DE, western blot and mass spectrometry) and bioinformatic screening to search for reactive and secreted proteins from L. amazonensis, L. braziliensis, and L. infantum. Twenty-eight non-redundant proteins were identified, among which, six were reactive only in L. amazonensis extracts, 10 in L. braziliensis extracts, and seven in L. infantum extracts. After bioinformatic analysis, seven proteins were predicted to be secreted, two of which were reactive only in L. amazonensis extracts (52kDa PDI and the glucose-regulated protein 78), one in L. braziliensis extracts (pyruvate dehydrogenase E1 beta subunit) and three in L. infantum extracts (two conserved hypothetical proteins and elongation factor 1-beta). We propose that proteins can be suitable targets for diagnostic methods based on antigen detection. Copyright © 2016 Elsevier B.V. All rights reserved.

Reliability and precision of stress sonography of the ulnar collateral ligament.

PubMed

Bica, David; Armen, Joseph; Kulas, Anthony S; Youngs, Kevin; Womack, Zachary

2015-03-01

Musculoskeletal sonography has emerged as an additional diagnostic tool that can be used to assess medial elbow pain and laxity in overhead throwers. It provides a dynamic, rapid, and noninvasive modality in the evaluation of ligamentous structural integrity. Many studies have demonstrated the utility of dynamic sonography for medial elbow and ulnar collateral ligament (UCL) integrity. However, evaluating the reliabilityand precision of these measurements is critical if sonography is ultimately used as a clinical diagnostic tool. The purpose of this study was to evaluate the reliability and precision of stress sonography applied to the medial elbow. We conducted a cross-sectional study during the 2011 baseball off-season. Eighteen National Collegiate Athletic Association Division I pitchers were enrolled, and 36 elbows were studied. Using sonography, the medial elbow was assessed, and measurements of the UCL length and ulnohumeral joint gapping were performed twice under two conditions (unloaded and loaded) and bilaterally. Intraclass correlation coefficients (0.72-0.94) and standard errors of measurements (0.3-0.9 mm) for UCL length and ulnohumeral joint gapping were good to excellent. Mean differences between unloaded and loaded conditions for the dominant arms were 1.3 mm (gapping; P < .001) and 1.4 mm (UCL length; P < .001). Medial elbow stress sonography is a reliable and precise method for detecting changes in ulnohumeral joint gapping and UCL lengthening. Ultimately, this method may provide clinicians valuable information regarding the medial elbow's response to valgus loading and may help guide treatment options. © 2015 by the American Institute of Ultrasound in Medicine.

Diagnostic possibilities with multidimensional images in head and neck area using efficient registration and visualization methods

NASA Astrophysics Data System (ADS)

Zeilhofer, Hans-Florian U.; Krol, Zdzislaw; Sader, Robert; Hoffmann, Karl-Heinz; Gerhardt, Paul; Schweiger, Markus; Horch, Hans-Henning

1997-05-01

For several diseases in the head and neck area different imaging modalities are applied to the same patient.Each of these image data sets has its specific advantages and disadvantages. The combination of different methods allows to make the best use of the advantageous properties of each method while minimizing the impact of its negative aspects. Soft tissue alterations can be judged better in an MRI image while it may be unrecognizable in the relating CT. Bone tissue, on the other hand, is optimally imaged in CT. Inflammatory nuclei of the bone can be detected best by their increased signal in SPECT. Only the combination of all modalities let the physical come to an exact statement on pathological processes that involve multiple tissue structures. Several surfaces and voxel based matching functions we have tested allowed a precise merging by means of numerical optimization methods like e.g. simulated annealing without the complicated assertion of fiducial markers or the localization landmarks in 2D cross sectional slice images. The quality of the registration depends on the choice of the optimization procedure according to the complexity of the matching function landscape. Precise correlation of the multimodal head and neck area images together with its 2D and 3D presentation techniques provides a valuable tool for physicians.

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

Brun, E., E-mail: emmanuel.brun@esrf.fr; Grandl, S.; Sztrókay-Gaul, A.

Purpose: Phase contrast computed tomography has emerged as an imaging method, which is able to outperform present day clinical mammography in breast tumor visualization while maintaining an equivalent average dose. To this day, no segmentation technique takes into account the specificity of the phase contrast signal. In this study, the authors propose a new mathematical framework for human-guided breast tumor segmentation. This method has been applied to high-resolution images of excised human organs, each of several gigabytes. Methods: The authors present a segmentation procedure based on the viscous watershed transform and demonstrate the efficacy of this method on analyzer basedmore » phase contrast images. The segmentation of tumors inside two full human breasts is then shown as an example of this procedure’s possible applications. Results: A correct and precise identification of the tumor boundaries was obtained and confirmed by manual contouring performed independently by four experienced radiologists. Conclusions: The authors demonstrate that applying the watershed viscous transform allows them to perform the segmentation of tumors in high-resolution x-ray analyzer based phase contrast breast computed tomography images. Combining the additional information provided by the segmentation procedure with the already high definition of morphological details and tissue boundaries offered by phase contrast imaging techniques, will represent a valuable multistep procedure to be used in future medical diagnostic applications.« less

Diagnostic value of three-dimensional magnetic resonance imaging of inner ear after intratympanic gadolinium injection, and clinical application of magnetic resonance imaging scoring system in patients with delayed endolymphatic hydrops.

PubMed

Gu, X; Fang, Z-M; Liu, Y; Lin, S-L; Han, B; Zhang, R; Chen, X

2014-01-01

Three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging of the inner ear after intratympanic injection of gadolinium, together with magnetic resonance imaging scoring of the perilymphatic space, were used to investigate the positive identification rate of hydrops and determine the technique's diagnostic value for delayed endolymphatic hydrops. Twenty-five patients with delayed endolymphatic hydrops underwent pure tone audiometry, bithermal caloric testing, vestibular-evoked myogenic potential testing and three-dimensional magnetic resonance imaging of the inner ear after bilateral intratympanic injection of gadolinium. The perilymphatic space of the scanned images was analysed to investigate the positive identification rate of endolymphatic hydrops. According to the magnetic resonance imaging scoring of the perilymphatic space and the diagnostic standard, 84 per cent of the patients examined had endolymphatic hydrops. In comparison, the positive identification rates for vestibular-evoked myogenic potential and bithermal caloric testing were 52 per cent and 72 per cent respectively. Three-dimensional magnetic resonance imaging after intratympanic injection of gadolinium is valuable in the diagnosis of delayed endolymphatic hydrops and its classification. The perilymphatic space scoring system improved the diagnostic accuracy of magnetic resonance imaging.

[Rapid diagnostic tests for the serodiagnosis of human cystic echinococcosis].

PubMed

Tamarozzi, F; Mariconti, M; Covini, I; Brunetti, E

2017-02-01

Cystic echinococcosis (CE) is a parasitic zoonosis especially affecting resource-poor populations in livestock raising areas. Imaging, in particular ultrasound (US), is crucial for the diagnosis, staging, and clinical management of abdominal CE in humans. Serology is a valuable complement to imaging, especially when ultrasound features of CE are absent or unclear. In rural endemic areas, where expertise in US is scant, and conventional serology techniques are unavailable due to lack of laboratory equipment, rapid diagnostic tests (RDTs) may be very useful. Several reports have described the performance of commercial and experimental RDTs in the diagnosis of CE, including a recent study by our group that compared the diagnostic performances of three commercial RDTs for the diagnosis of hepatic CE. To put RDTs for CE in context, we reviewed the available literature in English on this topic. Overall, RDTs appear to be useful in resourcepoor settings where they may replace conventional serodiagnostic tests. However, like other serodiagnostic tests, RDTs lack standardization and show unsatisfactory sensitivity and specificity. An important issue that needs to be addressed is that studies on the diagnostic performance of RDTs fail to take into account the variables known to influence results such as anatomical location and cyst stage.

Molecular markers and new diagnostic methods to differentiate malignant from benign mesothelial pleural proliferations: a literature review.

PubMed

Bruno, Rossella; Alì, Greta; Fontanini, Gabriella

2018-01-01

Malignant pleural mesothelioma (MPM) is an aggressive tumor associated with asbestos exposure. Histopathological analysis of pleural tissues is the gold standard for diagnosis; however, it can be difficult to differentiate malignant from benign pleural lesions. The purpose of this review is to describe the most important biomarkers and new diagnostic tools suggested for this differential diagnosis. There are many studies concerning the separation between MPM and benign pleural proliferations from both pleural tissues or effusions; most of them are based on the evaluation of one or few biomarkers by immunohistochemistry (IHC) or enzyme-linked immunosorbent assays (ELISAs), whereas others focused on the identification of MPM signatures given by microRNA (miRNA) or gene expression profiles as well as on the combination of molecular data and classification algorithms. None of the reported biomarkers showed adequate diagnostic accuracy, except for p16 [evaluated by fluorescent in situ hybridization (FISH)] and BAP1 (evaluated by IHC), both biomarkers are recommended by the International Mesothelioma Interest Group guidelines for histological and cytological diagnosis. BAP1 and p16 showed a specificity of 100% in discerning malignant from benign lesions because they are exclusively unexpressed or deleted in MPM. However, their sensitivity, even when used together, is not completely sufficient, and absence of their alterations cannot confirm the benign nature of the lesion. Recently, the availability of new techniques and increasing knowledge regarding MPM genetics led to the definition of some molecular panels, including genes or miRNAs specifically deregulated in MPM, that are extremely valuable for differential diagnosis. Moreover, the development of classification algorithms is facilitating the application of molecular data for clinical practice. Data regarding new diagnostic tools and MPM signatures are absolutely promising; however, before their application in clinical practice, a prospective validation is necessary, as these approaches could surely improve the differential diagnosis between malignant and benign pleural lesions.

Transthoracic needle biopsy of the lung

PubMed Central

DiBardino, David M.; Yarmus, Lonny B.

2015-01-01

Background Image guided transthoracic needle aspiration (TTNA) is a valuable tool used for the diagnosis of countless thoracic diseases. Computed tomography (CT) is the most common imaging modality used for guidance followed by ultrasound (US) for lesions abutting the pleural surface. Novel approaches using virtual CT guidance have recently been introduced. The objective of this review is to examine the current literature for TTNA biopsy of the lung focusing on diagnostic accuracy and safety. Methods MEDLINE was searched from inception to October 2015 for all case series examining image guided TTNA. Articles focusing on fluoroscopic guidance as well as influence of rapid on-site evaluation (ROSE) on yield were excluded. The diagnostic accuracy, defined as the number of true positives divided by the number of biopsies done, as well as the complication rate [pneumothorax (PTX), bleeding] was examined for CT guided TTNA, US guided TTNA as well as CT guided electromagnetic navigational-TTNA (E-TTNA). Of the 490 articles recovered 75 were included in our analysis. Results The overall pooled diagnostic accuracy for CT guided TTNA using 48 articles that met the inclusion and exclusion criteria was 92.1% (9,567/10,383). A similar yield was obtained examining ten articles using US guided TTNA of 88.7% (446/503). E-TTNA, being a new modality, only had one pilot study citing a diagnostic accuracy of 83% (19/23). Pooled PTX and hemorrhage rates were 20.5% and 2.8% respectively for CT guided TTNA. The PTX rate was lower in US guided TTNA at a pooled rate of 4.4%. E-TTNA showed a similar rate of PTX at 20% with no incidence of bleeding in a single pilot study available. Conclusions Image guided TTNA is a safe and accurate modality for the biopsy of lung pathology. This study found similar yield and safety profiles with the three imaging modalities examined. PMID:26807279

Mydriasis during Orbital Floor Fracture Reconstruction: A Novel Diagnostic and Treatment Algorithm

PubMed Central

Yeo, Matthew S.; Al-Mousa, Radwan; Sundar, Gangadhara; Lim, Thiam Chye

2010-01-01

Orbital floor fractures are the most commonly encountered traumatic fractures in the facial skeleton. Mydriasis that is detected during orbital floor fracture reconstruction may cause significant distress to surgeons, as it may be associated with sinister events such as visual loss. It is not an uncommon problem; previous studies have shown the incidence of mydriasis to be 2.1%. The combination of careful preoperative evaluation and planning, as well as specific intraoperative investigations when mydriasis is encountered, can be immensely valuable in allaying surgeons' anxiety during orbital floor fracture reconstruction. In this review article, the authors discuss the common causes of mydriasis and present a novel systematic approach to its diagnostic evaluation devised by our unit that has been successfully implemented since 2008. PMID:22132259

Assessment of cortical auditory evoked potentials in children with specific language impairment.

PubMed

Włodarczyk, Elżbieta; Szkiełkowska, Agata; Pilka, Adam; Skarżyński, Henryk

2018-02-28

The proper course of speech development heavily influences the cognitive and personal development of children. It is a condition for achieving preschool and school successes - it facilitates socializing and expressing feelings and needs. Impairment of language and its development in children represents a major diagnostic and therapeutic challenge for physicians and therapists. Early diagnosis of coexisting deficits and starting the therapy influence the therapeutic success. One of the basic diagnostic tests for children suffering from specific language impairment (SLI) is audiometry, thus far referred to as a hearing test. Auditory processing is just as important as a proper hearing threshold. Therefore, diagnosis of central auditory disorder may be a valuable supplementation of diagnosis of language impairment. Early diagnosis and implementation of appropriate treatment may contribute to an effective language therapy.

Economic evaluation of diagnostic methods used in dentistry. A systematic review.

PubMed

Christell, Helena; Birch, Stephen; Horner, Keith; Lindh, Christina; Rohlin, Madeleine

2014-11-01

To review the literature of economic evaluations regarding diagnostic methods used in dentistry. Four databases (MEDLINE, Web of Science, The Cochrane library, the NHS Economic Evaluation Database) were searched for studies, complemented by hand search, until February 2013. Two authors independently screened all titles or abstracts and then applied inclusion and exclusion criteria to select full-text publications published in English, which reported an economic evaluation comparing at least two alternative methods. Studies of diagnostic methods were assessed by four reviewers using a protocol based on the QUADAS tool regarding diagnostic methods and a check-list for economic evaluations. The results of the data extraction were summarized in a structured table and as a narrative description. From 476 identified full-text publications, 160 were considered to be economic evaluations. Only 12 studies (7%) were on diagnostic methods, whilst 78 studies (49%) were on prevention and 70 (40%) on treatment. Among studies on diagnostic methods, there was between-study heterogeneity methodologically, regarding the diagnostic method analysed and type of economic evaluation addressed. Generally, the choice of economic evaluation method was not justified and the perspective of the study not stated. Costing of diagnostic methods varied. A small body of literature addresses economic evaluation of diagnostic methods in dentistry. Thus, there is a need for studies from various perspectives with well defined research questions and measures of the cost and effectiveness. Economic resources in healthcare are finite. For diagnostic methods, an understanding of efficacy provides only part of the information needed for evidence-based practice. This study highlighted a paucity of economic evaluations of diagnostic methods used in dentistry, indicating that much of what we practise lacks sufficient evidence.

[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.

[Diagnostic and therapeutic use of human anti-D (Rho) monoclonal antibodies. Evaluation and perspectives].

PubMed

Rouger, P; Goossens, D; Champomier, F; Tsikas, G; Liberge, G; Leblanc, J; Richard, C; Bailleul, C; Salmon, C

1985-12-01

Human monoclonal antibodies will be essential in medicine. They are valuable tools for biological diagnosis and therapeutics. Our model, human monoclonal antibodies directed against the Rhesus D antigen can be used for the determination of the Rhesus D phenotype and for the suppression of Rh(D) immunisation in women. These new products require new procedures of preparation, new regulations for the quality controls, which will be discussed in this paper.

Epigenetic Patterns of PTSD: DNA Methylation In Serum of OIF/OEF Servicemembers

DTIC Science & Technology

2011-01-01

ascertained via query of the International Classification of Diseases , 9th Revision (ICD-9) codes 290-320. To attempt to control for confounding by other...other CNS tissues is not clear. Although relevant to a different class of disease , many of the aberrations that have been detected in the DNA of...valuable diagnostic tool in various diseases . (50-53) Compared with cultured cells, clinical specimens, such as whole blood, serum, and even brain

Diagnostic value of perinatal autopsies: analysis of 486 cases.

PubMed

Neşe, Nalan; Bülbül, Yeşim

2018-02-23

Autopsy is a beneficial procedure to determine the cause of death and the frequency of anomalies in perinatal losses. Even in the event of an autopsy not providing any additional information, completion of the procedure confirming the clinical diagnoses gives reassurance to both clinicians and parents. Here we present a 15-year archival study based on findings of perinatal autopsies. Four hundred and eighty-six cases from our archive were reviewed and according to the findings they were divided into three subcategories; (1) miscarriages (MCF); (2) fetuses terminated (FTA) for vital anomalies detected by prenatal ultrasonography; (3) premature or term newborns died within first month of life (neonates: NN). Autopsies were documented and classified according to week/age of cases, anomalies and causes of abortion or death. Two hundred and twenty-six of 486 cases (46.5%) were in MCF group while 227 (46.7%) and 33 (6.8%) were of them in FTA and NN groups, respectively. In FTA group, the most frequent anomaly detected was neural tube defects. In NN group, prematurity related complications were the most common cause of death. The autopsy process was found valuable in 39.7% of all cases. We suggest that autopsy procedure is diagnostically valuable even in situations when there is USG findings that are confirming FTAs or there is no important major fetal or placental anomaly detected in MCFs.

Biomarkers for cognitive decline in patients with diabetes mellitus: evidence from clinical studies

PubMed Central

Zhao, Xue; Han, Qing; Lv, You; Sun, Lin; Gang, Xiaokun; Wang, Guixia

2018-01-01

Diabetes mellitus is considered as an important factor for cognitive decline and dementia in recent years. However, cognitive impairment in diabetic patients is often underestimated and kept undiagnosed, leading to thousands of diabetic patients suffering from worsening memory. Available reviews in this field were limited and not comprehensive enough. Thus, the present review aimed to summarize all available clinical studies on diabetic patients with cognitive decline, and to find valuable biomarkers that might be applied as diagnostic and therapeutic targets of cognitive impairment in diabetes. The biomarkers or risk factors of cognitive decline in diabetic patients could be classified into the following three aspects: serum molecules or relevant complications, functional or metabolic changes by neuroimaging tools, and genetic variants. Specifically, factors related to poor glucose metabolism, insulin resistance, inflammation, comorbid depression, micro-/macrovascular complications, adipokines, neurotrophic molecules and Tau protein presented significant changes in diabetic patients with cognitive decline. Besides, neuroimaging platform could provide more clues on the structural, functional and metabolic changes during the cognitive decline progression of diabetic patients. Genetic factors related to cognitive decline showed inconsistency based on the limited studies. Future studies might apply above biomarkers as diagnostic and treatment targets in a large population, and regulation of these parameters might shed light on a more valuable, sensitive and specific strategy for the diagnosis and treatment of cognitive decline in diabetic patients. PMID:29484146

Assessment of different biomarkers provides valuable diagnostic standards in the evaluation of the risk of acute rejection.

PubMed

Zheng, Jin; Ding, Xiaoming; Tian, Xiaohui; Jin, Zhankui; Pan, Xiaoming; Yan, Hang; Feng, Xinshun; Hou, Jun; Xiang, Heli; Ren, Li; Tian, Puxun; Xue, Wujun

2012-09-01

Acute rejection (AR) is a strong risk factor for chronic rejection in renal transplant recipients. Accurate and timely diagnosis of AR episodes is very important for disease control and prognosis. Therefore, objectively evaluated the immune status of patients is essential in the field of post-transplantation treatment. This longitudinal study investigated the usefulness of five biomarkers, human leukocyte antigen (HLA)-G5 and sCD30 level in sera, intracellular adenosine triphosphate (iATP) release level of CD4(+) T cells, and granzyme B/perforin expression in peripheral blood mononuclear cells (PBMCs) and biopsies, to detect AR and the resolution of biomarkers in a total of 84 cases of renal transplantation. The data demonstrated that recipients with clinical or biopsy proven rejection significantly increased iATP release level of CD4(+) T cells, and elevated sCD30 but lowered HLA-G5 level in sera compared with individuals with stable graft function. Expression levels of granzyme B and perforin were also elevated in PBMCs and graft biopsies of AR patients. Taken together, we identified that upregulation of sCD30, iATP, granzyme B, perforin, and downregulation of HLA-G5 could provide valuable diagnostic standards to identify those recipients in the risk of AR. And iATP may be a better biomarker than others for predicting the graft rejection episode.

The effect of a simulation training package on skill acquisition for duplex arterial stenosis detection.

PubMed

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

2015-01-01

In vascular surgery, duplex ultrasonography is a valuable diagnostic tool in patients with peripheral vascular disease, and there is increasing demand for vascular surgeons to be able to perform duplex scanning. This study evaluates the role of a novel simulation training package on vascular ultrasound (US) skill acquisition. A total of 19 novices measured predefined stenosis in a simulated pulsatile vessel using both peak systolic velocity ratio (PSVR) and diameter reduction (DR) methods before and after a short period of training using a simulated training package. The training package consisted of a simulated pulsatile vessel phantom, a set of instructional videos, duplex ultrasound objective structured assessment of technical skills (DUOSATS) tool, and a portable US scanner. Quantitative metrics (procedure time, percentage error using PSVR and DR methods, DUOSAT scores, and global rating scores) before and after training were compared. Subjects spent a median time of 144 mins (IQR: 60-195) training using the simulation package. Subjects exhibited statistically significant improvements when comparing pretraining and posttraining DUOSAT scores (pretraining = 17 [16-19.3] vs posttraining = 30 [27.8-31.8]; p < 0.01), global rating score (pretraining = 1 [1-2] vs posttraining = 4 [3.8-4]; p < 0.01), percentage error using both the DR (pretraining = 12.6% [9-29.6] vs posttraining = 10.3% [8.9-11.1]; p = 0.03) and PSVR (pretraining = 60% [40-60] vs posttraining = 20% [6.7-20]; p < 0.01) methods. In this study, subjects with no previous practical US experience developed the ability to both acquire and interpret arterial duplex images in a pulsatile simulated phantom following a short period of goal direct training using a simulation training package. A simulation training package may be a valuable tool for integration into a vascular training program. However, further work is needed to explore whether these newly attained skills are translated into clinical assessment. Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.

Use and isolation of urinary exosomes as biomarkers for diabetic nephropathy.

PubMed

Musante, Luca; Tataruch, Dorota Ewa; Holthofer, Harry

2014-01-01

Diabetes represents a major threat to public health and the number of patients is increasing alarmingly in the global scale. Particularly, the diabetic kidney disease (nephropathy, DN) together with its cardiovascular complications cause immense human suffering, highly increased risk of premature deaths, and lead to huge societal costs. DN is first detected when protein appears in urine (microalbuminuria). As in other persisting proteinuric diseases (like vasculitis) it heralds irreversible damage of kidney functions up to non-functional (end-stage) kidney and ultimately calls for kidney replacement therapy (dialysis or kidney transplantation). While remarkable progress has been made in understanding the genetic and molecular factors associating with chronic kidney diseases, breakthroughs are still missing to provide comprehensive understanding of events and mechanisms associated. Non-invasive diagnostic tools for early diagnostics of kidney damage are badly needed. Exosomes - small vesicular structures present in urine are released by all cell types along kidney structures to present with distinct surface assembly. Furthermore, exosomes carry a load of special proteins and nucleic acids. This "cargo" faithfully reflects the physiological state of their respective cells of origin and appears to serve as a new pathway for downstream signaling to target cells. Accordingly, exosome vesicles are emerging as a valuable source for disease stage-specific information and as fingerprints of disease progression. Unfortunately, technical issues of exosome isolation are challenging and, thus, their full potential remains untapped. Here, we review the molecular basis of exosome secretion as well as their use to reveal events along the nephron. In addition to novel molecular information, the new methods provide the needed accurate, personalized, non-invasive, and inexpensive future diagnostics.

Use and Isolation of Urinary Exosomes as Biomarkers for Diabetic Nephropathy

PubMed Central

Musante, Luca; Tataruch, Dorota Ewa; Holthofer, Harry

2014-01-01

Diabetes represents a major threat to public health and the number of patients is increasing alarmingly in the global scale. Particularly, the diabetic kidney disease (nephropathy, DN) together with its cardiovascular complications cause immense human suffering, highly increased risk of premature deaths, and lead to huge societal costs. DN is first detected when protein appears in urine (microalbuminuria). As in other persisting proteinuric diseases (like vasculitis) it heralds irreversible damage of kidney functions up to non-functional (end-stage) kidney and ultimately calls for kidney replacement therapy (dialysis or kidney transplantation). While remarkable progress has been made in understanding the genetic and molecular factors associating with chronic kidney diseases, breakthroughs are still missing to provide comprehensive understanding of events and mechanisms associated. Non-invasive diagnostic tools for early diagnostics of kidney damage are badly needed. Exosomes – small vesicular structures present in urine are released by all cell types along kidney structures to present with distinct surface assembly. Furthermore, exosomes carry a load of special proteins and nucleic acids. This “cargo” faithfully reflects the physiological state of their respective cells of origin and appears to serve as a new pathway for downstream signaling to target cells. Accordingly, exosome vesicles are emerging as a valuable source for disease stage-specific information and as fingerprints of disease progression. Unfortunately, technical issues of exosome isolation are challenging and, thus, their full potential remains untapped. Here, we review the molecular basis of exosome secretion as well as their use to reveal events along the nephron. In addition to novel molecular information, the new methods provide the needed accurate, personalized, non-invasive, and inexpensive future diagnostics. PMID:25309511

Right atrial and right ventricular ultrasound-guided biopsy technique in standing horses.

PubMed

Decloedt, A; de Clercq, D; Ven, S; van der Vekens, N; Chiers, K; van Loon, G

2016-05-01

Endomyocardial biopsies could be a valuable tool in equine cardiology for diagnosing myocardial disease, which is probably underdiagnosed in horses because of lack of specific diagnostic measures and limitations of currently available diagnostic methods. To describe a technique for serial right atrial and right ventricular endomyocardial biopsy in standing horses using a percutaneous approach through the jugular vein. Prospective study. Biopsy was performed in 10 healthy standing horses sedated with detomidine, under continuous electrocardiography monitoring. A 10 cm (n = 6), 45 cm (n = 1) or 98 cm (n = 3) introducer sheath was inserted into the right jugular vein. Under echocardiographic guidance, a biopsy forceps was introduced through the sheath into the right ventricle and right atrium and endomyocardial biopsies were acquired. In all horses, 3 right ventricular biopsies were obtained from the right ventricular apex and 3 right atrial biopsies were obtained from the dorsal right atrial wall near the tuberculum intervenosum. The presence of myocardial tissue was confirmed by histology. All horses showed atrial and ventricular premature depolarisations associated with acquisition of the biopsies. In 9 horses, the arrhythmia disappeared after retraction of the forceps and introducer sheath. In one horse, ventricular premature depolarisations disappeared only after 8 h. No other complications were observed. Endomyocardial biopsy of the right atrium and right ventricle could be performed in standing horses using a percutaneous approach through the jugular vein and was not associated with complications other than temporary arrhythmias. This technique may be useful for research purposes or as a diagnostic tool, although further research is needed to establish the safety of the technique in clinical patients with myocardial disease. © 2015 EVJ Ltd.

Diagnostic performance of a multiple real-time PCR assay in patients with suspected sepsis hospitalized in an internal medicine ward.

PubMed

Pasqualini, Leonella; Mencacci, Antonella; Leli, Christian; Montagna, Paolo; Cardaccia, Angela; Cenci, Elio; Montecarlo, Ines; Pirro, Matteo; di Filippo, Francesco; Cistaro, Emma; Schillaci, Giuseppe; Bistoni, Francesco; Mannarino, Elmo

2012-04-01

Early identification of causative pathogen in sepsis patients is pivotal to improve clinical outcome. SeptiFast (SF), a commercially available system for molecular diagnosis of sepsis based on PCR, has been mostly used in patients hospitalized in hematology and intensive care units. We evaluated the diagnostic accuracy and clinical usefulness of SF, compared to blood culture (BC), in 391 patients with suspected sepsis, hospitalized in a department of internal medicine. A causative pathogen was identified in 85 patients (22%). Sixty pathogens were detected by SF and 57 by BC. No significant differences were found between the two methods in the rates of pathogen detection (P = 0.74), even after excluding 9 pathogens which were isolated by BC and were not included in the SF master list (P = 0.096). The combination of SF and BC significantly improved the diagnostic yield in comparison to BC alone (P < 0.001). Compared to BC, SF showed a significantly lower contamination rate (0 versus 19 cases; P < 0.001) with a higher specificity for pathogen identification (1.00, 95% confidence interval [CI] of 0.99 to 1.00, versus 0.94, 95% CI of 0.90 to 0.96; P = 0.005) and a higher positive predictive value (1.00, 95% CI of 1.00 to 0.92%, versus 0.75, 95% CI of 0.63 to 0.83; P = 0.005). In the subgroup of patients (n = 191) who had been receiving antibiotic treatment for ≥24 h, SF identified more pathogens (16 versus 6; P = 0.049) compared to BC. These results suggest that, in patients with suspected sepsis, hospitalized in an internal medicine ward, SF could be a highly valuable adjunct to conventional BC, particularly in patients under antibiotic treatment.

Copper Capture in a Thioether-Functionalized Porous Polymer Applied to the Detection of Wilson’s Disease

PubMed Central

2016-01-01

Copper is an essential nutrient for life, but at the same time, hyperaccumulation of this redox-active metal in biological fluids and tissues is a hallmark of pathologies such as Wilson’s and Menkes diseases, various neurodegenerative diseases, and toxic environmental exposure. Diseases characterized by copper hyperaccumulation are currently challenging to identify due to costly diagnostic tools that involve extensive technical workup. Motivated to create simple yet highly selective and sensitive diagnostic tools, we have initiated a program to develop new materials that can enable monitoring of copper levels in biological fluid samples without complex and expensive instrumentation. Herein, we report the design, synthesis, and properties of PAF-1-SMe, a robust three-dimensional porous aromatic framework (PAF) densely functionalized with thioether groups for selective capture and concentration of copper from biofluids as well as aqueous samples. PAF-1-SMe exhibits a high selectivity for copper over other biologically relevant metals, with a saturation capacity reaching over 600 mg/g. Moreover, the combination of PAF-1-SMe as a material for capture and concentration of copper from biological samples with 8-hydroxyquinoline as a colorimetric indicator affords a method for identifying aberrant elevations of copper in urine samples from mice with Wilson’s disease and also tracing exogenously added copper in serum. This divide-and-conquer sensing strategy, where functional and robust porous materials serve as molecular recognition elements that can be used to capture and concentrate analytes in conjunction with molecular indicators for signal readouts, establishes a valuable starting point for the use of porous polymeric materials in noninvasive diagnostic applications. PMID:27285482

Comparison of diagnostic capability of macular ganglion cell complex and retinal nerve fiber layer among primary open angle glaucoma, ocular hypertension, and normal population using Fourier-domain optical coherence tomography and determining their functional correlation in Indian population

PubMed Central

Barua, Nabanita; Sitaraman, Chitra; Goel, Sonu; Chakraborti, Chandana; Mukherjee, Sonai; Parashar, Hemandra

2016-01-01

Context: Analysis of diagnostic ability of macular ganglionic cell complex and retinal nerve fiber layer (RNFL) in glaucoma. Aim: To correlate functional and structural parameters and comparing predictive value of each of the structural parameters using Fourier-domain (FD) optical coherence tomography (OCT) among primary open angle glaucoma (POAG) and ocular hypertension (OHT) versus normal population. Setting and Design: Single centric, cross-sectional study done in 234 eyes. Materials and Methods: Patients were enrolled in three groups: POAG, ocular hypertensive and normal (40 patients in each group). After comprehensive ophthalmological examination, patients underwent standard automated perimetry and FD-OCT scan in optic nerve head and ganglion cell mode. The relationship was assessed by correlating ganglion cell complex (GCC) parameters with mean deviation. Results were compared with RNFL parameters. Statistical Analysis: Data were analyzed with SPSS, analysis of variance, t-test, Pearson's coefficient, and receiver operating curve. Results: All parameters showed strong correlation with visual field (P < 0.001). Inferior GCC had highest area under curve (AUC) for detecting glaucoma (0.827) in POAG from normal population. However, the difference was not statistically significant (P > 0.5) when compared with other parameters. None of the parameters showed significant diagnostic capability to detect OHT from normal population. In diagnosing early glaucoma from OHT and normal population, only inferior GCC had statistically significant AUC value (0.715). Conclusion: In this study, GCC and RNFL parameters showed equal predictive capability in perimetric versus normal group. In early stage, inferior GCC was the best parameter. In OHT population, single day cross-sectional imaging was not valuable. PMID:27221682

Latent class analysis to evaluate performance of point-of-care CCA for low-intensity Schistosoma mansoni infections in Burundi.

PubMed

Clements, Michelle N; Corstjens, Paul L A M; Binder, Sue; Campbell, Carl H; de Dood, Claudia J; Fenwick, Alan; Harrison, Wendy; Kayugi, Donatien; King, Charles H; Kornelis, Dieuwke; Ndayishimiye, Onesime; Ortu, Giuseppina; Lamine, Mariama Sani; Zivieri, Antonio; Colley, Daniel G; van Dam, Govert J

2018-02-23

Kato-Katz examination of stool smears is the field-standard method for detecting Schistosoma mansoni infection. However, Kato-Katz misses many active infections, especially of light intensity. Point-of-care circulating cathodic antigen (CCA) is an alternative field diagnostic that is more sensitive than Kato-Katz when intensity is low, but interpretation of CCA-trace results is unclear. To evaluate trace results, we tested urine and stool specimens from 398 pupils from eight schools in Burundi using four approaches: two in Burundi and two in a laboratory in Leiden, the Netherlands. In Burundi, we used Kato-Katz and point-of-care CCA (CCAB). In Leiden, we repeated the CCA (CCAL) and also used Up-Converting Phosphor Circulating Anodic Antigen (CAA). We applied Bayesian latent class analyses (LCA), first considering CCA traces as negative and then as positive. We used the LCA output to estimate validity of the prevalence estimates of each test in comparison to the population-level infection prevalence and estimated the proportion of trace results that were likely true positives. Kato-Katz yielded the lowest prevalence (6.8%), and CCAB with trace considered positive yielded the highest (53.5%). There were many more trace results recorded by CCA in Burundi (32.4%) than in Leiden (2.3%). Estimated prevalence with CAA was 46.5%. LCA indicated that Kato-Katz had the lowest sensitivity: 15.9% [Bayesian Credible Interval (BCI): 9.2-23.5%] with CCA-trace considered negative and 15.0% with trace as positive (BCI: 9.6-21.4%), implying that Kato-Katz missed approximately 85% of infections. CCAB underestimated disease prevalence when trace was considered negative and overestimated disease prevalence when trace was considered positive, by approximately 12 percentage points each way, and CAA overestimated prevalence in both models. Our results suggest that approximately 52.2% (BCI: 37.8-5.8%) of the CCAB trace readings were true infections. Whether measured in the laboratory or the field, CCA outperformed Kato-Katz at the low infection intensities in Burundi. CCA with trace as negative likely missed many infections, whereas CCA with trace as positive overestimated prevalence. In the absence of a field-friendly gold standard diagnostic, the use of a variety of diagnostics with differing properties will become increasingly important as programs move towards elimination of schistosomiasis. It is clear that CCA is a valuable tool for the detection and mapping of S. mansoni infection in the field and CAA may be a valuable field tool in the future.

[The use of superselective embolization of the maxillary artery in treatment of bleedings in the Rendu-Osler-Weber syndrome].

PubMed

Kantor, Ireneusz; Winiarski, Michał; Jurkiewicz, Dariusz; Osiecki, Mirosław; Brzozowski, Krzysztof

2005-01-01

Rendu-Osler-Weber syndrome is a rare genetically determined disorder that affects blood vessels throughout the body and results in a tendency for bleeding. Authors describe the case of superselective embolization of the left maxillary artery with polyvinyl alcohol particles in a patient with the Rendu-Osler-Weber syndrome hospitalized and treated in the Department of Otolaryngology and the Department of Radiology of the Military Institute in Warszawa, Poland due to persistent, severe and difficult to manage nasal bleeding. After the procedure had been performed patient condition improved and frequency and severity of nasal bleeding significantly diminished. Authors conclude that superselective embolization of the maxillary artery in a patient with Rendu-Osler-Weber syndrome is safe and effective and can be a valuable alternative to the maxillary artery or the carotis externa artery ligation. Authors also describe other methods of nasal bleeding management: laser photocoagulation, argon plasma coagulation, nasal dermoplasty and pharmacological treatment. Authors indicate that treating patients with Rendu-Osler-Weber syndrome is a diagnostic and therapeutic challenge for a physician and surgeon that require special approach to a patient due to difficult to manage symptoms. Patients with Rendu-Osler-Weber syndrome should be treated in a hospital setting due to access to diagnostic imaging techniques that can be helpful in revealing possible life threatening conditions.

Fever of unknown origin as initial manifestation of large vessel giant cell arteritis: diagnosis by colour-coded sonography and 18-FDG-PET.

PubMed

Czihal, M; Tatò, F; Förster, S; Rademacher, A; Schulze-Koops, H; Hoffmann, U

2010-01-01

To evaluate the clinical characteristics and imaging results (CDS, 18-FDG-PET) of patients with large vessel giant cell arteritis (LV-GCA) presenting as fever of unknown origin (FUO). From a series of 82 patients with GCA we identified 8 patients with FUO as initial disease manifestation. Clinical characteristics and results of CDS and 18-FDG-PET were analysed. Patients with FUO and those with other clinical manifestations of GCA were compared. 18-FDG-PET-scans were available for 6/8 patients, revealing enhanced tracer uptake of the thoracic aorta and the aortic branches in all patients. CDS was performed in 8/8 patients, with detection of hypoechogenic wall thickening related to LV-GCA in 7/8 patients. Subjects with FUO were significantly younger (60.9 vs. 69.3 years, p<0.01) and had a stronger humoral inflammatory response (CRP 12.6 vs. 7.1 mg/dl, p<0.01; ESR 110 vs. 71 mm/hour, p<0.01), when compared to the other GCA-patients. LV-GCA should be considered as important differential diagnosis in patients with FUO. In addition to 18-FDG-PET, which is known to be a valuable method in the diagnostic work-up of FUO, we recommend CDS of the supraaortal and femoropopliteal arteries for the initial diagnostic work-up.

Introductory lecture. Advanced laser spectroscopy in combustion chemistry: from elementary steps to practical devices.

PubMed

Wolfrum, J

2001-01-01

In recent years a large number of linear and nonlinear laser-based diagnostic techniques for nonintrusive measurements of species concentrations, temperatures, and gas velocities in a wide pressure and temperature range with high temporal and spatial resolution have been developed and have become extremely valuable tools to study many aspects of combustion. Beside the nonintrusive diagnostics of technical combustion devices the kinetics and microscopic dynamics of elementary chemical combustion reactions can be investigated in great detail by laser spectroscopy. These investigations show, that a small number of relatively simple elementary steps like H + O2-->OH + O, H2O2-->2OH, O + N2-->NO + N, NH2 + NO-->H2O + N2, OH + N2H control a large variety of combustion phenomena and pollutant formation processes. Laminar flames are ideal objects to develop the application of laser spectroscopic methods for practical combustion systems and to test and improve the gas-phase reaction mechanism in combustion models. Nonintrusive laser point and field measurements are of basic importance in the validation and further development of turbulent combustion models. Nonlinear laser spectroscopic techniques using infrared-visible sum-frequency generation can now bridge the pressure and materials gap to provide kinetic data for catalytic combustion. Finally, the potential of laser techniques for active combustion control in municipal waste incinerators is illustrated.

Assessing ADHD symptoms in children and adults: evaluating the role of objective measures.

PubMed

Emser, Theresa S; Johnston, Blair A; Steele, J Douglas; Kooij, Sandra; Thorell, Lisa; Christiansen, Hanna

2018-05-18

Diagnostic guidelines recommend using a variety of methods to assess and diagnose ADHD. Applying subjective measures always incorporates risks such as informant biases or large differences between ratings obtained from diverse sources. Furthermore, it has been demonstrated that ratings and tests seem to assess somewhat different constructs. The use of objective measures might thus yield valuable information for diagnosing ADHD. This study aims at evaluating the role of objective measures when trying to distinguish between individuals with ADHD and controls. Our sample consisted of children (n = 60) and adults (n = 76) diagnosed with ADHD and matched controls who completed self- and observer ratings as well as objective tasks. Diagnosis was primarily based on clinical interviews. A popular pattern recognition approach, support vector machines, was used to predict the diagnosis. We observed relatively high accuracy of 79% (adults) and 78% (children) applying solely objective measures. Predicting an ADHD diagnosis using both subjective and objective measures exceeded the accuracy of objective measures for both adults (89.5%) and children (86.7%), with the subjective variables proving to be the most relevant. We argue that objective measures are more robust against rater bias and errors inherent in subjective measures and may be more replicable. Considering the high accuracy of objective measures only, we found in our study, we think that they should be incorporated in diagnostic procedures for assessing ADHD.

Evaluation of the malaria rapid diagnostic test VIKIA malaria Ag Pf/Pan™ in endemic and non-endemic settings

PubMed Central

2013-01-01

Background Malaria rapid diagnostic tests (RDTs) are a useful tool in endemic malaria countries, where light microscopy is not feasible. In non-endemic countries they can be used as complementary tests to provide timely results in case of microscopy inexperience. This study aims to compare the new VIKIA Malaria Ag Pf/Pan™ RDT with PCR-corrected microscopy results and the commonly used CareStart™ RDT to diagnose falciparum and non-falciparum malaria in the endemic setting of Bamako, Mali and the non-endemic setting of Lyon, France. Methods Blood samples were collected during a 12-months and six-months period in 2011 from patients suspected to have malaria in Lyon and Bamako respectively. The samples were examined by light microscopy, the VIKIA Malaria Ag Pf/Pan™ test and in Bamako additionally with the CareStart™ RDT. Discordant results were corrected by real-time PCR. Sensitivity, specificity, positive predictive value and negative predictive value were used to evaluate test performance. Results Samples of 877 patients from both sites were included. The VIKIA Malaria Ag Pf/Pan™ had a sensitivity of 98% and 96% for Plasmodium falciparum in Lyon and Bamako, respectively, performing similar to PCR-corrected microscopy. Conclusions The VIKIA Malaria Ag Pf/Pan™ performs similar to PCR-corrected microscopy for the detection of P. falciparum, making it a valuable tool in malaria endemic and non-endemic regions. PMID:23742633

The value of the first trimester ultrasound in the era of cell free DNA screening.

PubMed

Rao, Rashmi R; Valderramos, Stephanie G; Silverman, Neil S; Han, Christina S; Platt, Lawrence D

2016-12-01

To describe the clinically relevant findings detected by the first trimester ultrasound (FTU) and to determine the additional value of the FTU compared to cell free DNA (cfDNA) alone. Retrospective cohort study of patients undergoing a FTU at a maternal-fetal medicine referral practice. Fetal, gynecologic, and placental findings detected by ultrasound were analyzed with available cfDNA and diagnostic testing results. A subgroup analysis of positive ultrasound findings and cfDNA results was performed to assess the additional benefit of ultrasound evaluation in FT prenatal screening. There were 1906 FTU between 1 October 2013 and 1 October 2014. CfDNA results were available for 959 (50%) patients. FTU detected: 42 fetal (2.2%), 286 gynecologic (15.0%), and 317 placental (16.6%) findings. CfDNA results were discordant with invasive testing results in 8/61 cases (13%) and with ultrasound findings in 18/42 (42%) cases. There were six false positive and two false negative cfDNA results confirmed by diagnostic testing. Subgroup analysis revealed that cfDNA as the sole method of prenatal screening in the FT would miss 95% of the fetal findings detected with ultrasound. The comprehensive FTU provides valuable clinical information about fetal and maternal anatomy that cannot be detected with cfDNA alone. © 2016 John Wiley & Sons, Ltd. © 2016 John Wiley & Sons, Ltd.

CANcer-specific Evaluation System (CANES): a high-accuracy platform, for preclinical single/multi-biomarker discovery

PubMed Central

Kwon, Min-Seok; Nam, Seungyoon; Lee, Sungyoung; Ahn, Young Zoo; Chang, Hae Ryung; Kim, Yon Hui; Park, Taesung

2017-01-01

The recent creation of enormous, cancer-related “Big Data” public depositories represents a powerful means for understanding tumorigenesis. However, a consistently accurate system for clinically evaluating single/multi-biomarkers remains lacking, and it has been asserted that oft-failed clinical advancement of biomarkers occurs within the very early stages of biomarker assessment. To address these challenges, we developed a clinically testable, web-based tool, CANcer-specific single/multi-biomarker Evaluation System (CANES), to evaluate biomarker effectiveness, across 2,134 whole transcriptome datasets, from 94,147 biological samples (from 18 tumor types). For user-provided single/multi-biomarkers, CANES evaluates the performance of single/multi-biomarker candidates, based on four classification methods, support vector machine, random forest, neural networks, and classification and regression trees. In addition, CANES offers several advantages over earlier analysis tools, including: 1) survival analysis; 2) evaluation of mature miRNAs as markers for user-defined diagnostic or prognostic purposes; and 3) provision of a “pan-cancer” summary view, based on each single marker. We believe that such “landscape” evaluation of single/multi-biomarkers, for diagnostic therapeutic/prognostic decision-making, will be highly valuable for the discovery and “repurposing” of existing biomarkers (and their specific targeted therapies), leading to improved patient therapeutic stratification, a key component of targeted therapy success for the avoidance of therapy resistance. PMID:29050243

Presymptomatic detection of Parkinson's disease.

PubMed

Jenner, P

1993-01-01

Presymptomatic detection of Parkinson's disease is necessary if neuroprotective therapies are to be utilized in its treatment. Various methods (PET, electrophysiology, enzyme assays, olfactory function) may be applicable but none has been rigorously evaluated. Other possible approaches are now considered. Plasma HVA levels (pHVA) in the presence of debrisoquine may reflect cerebral dopamine function. However, there are no detectable differences in pHVA between newly diagnosed and untreated parkinsonian patients and control subjects. Compensatory increases in dopamine turnover may mask a decrease in pHVA in the early stages of the disease. So, at present this technique could not be used as a diagnostic tool. Post-mortem studies of brain in Parkinson's disease may provide clues to biochemical markers indicative of nigral pathology. Mitochondrial complex I activity is reduced in substantia nigra in Parkinson's disease and it was reported also to be markedly reduced in blood platelets. However, subsequent studies suggest that the difference in platelet complex I activity is too small to be diagnostic of Parkinson's disease. There are also selective reductions in brain glutathione levels in Parkinson's disease restricted to substantia nigra, which do not occur in other neurodegenerative disorders and are not due to drug treatment. Importantly, in incidental Lewy body disease (preclinical Parkinson's disease) nigral glutathione levels are reduced to the same degree as in advanced Parkinson's disease. So, some peripheral index of altered glutathione function may be valuable in the early detection of the disease process.

Two different PCR approaches for universal diagnosis of brown rot and identification of Monilinia spp. in stone fruit trees.

PubMed

Gell, I; Cubero, J; Melgarejo, P

2007-12-01

To design a protocol for the universal diagnosis of brown rot by polymerase chain reaction (PCR) in plant material and subsequently Monilinia spp. identification. Primers for discrimination of Monilinia spp. from other fungal genera by PCR were designed following a ribosomal DNA analysis. Discrimination among species of Monilinia was subsequently achieved by developing primers using SCAR (Sequence Characterised Amplified Region) markers obtained after a random amplified polymorphic DNA study. In addition, an internal control (IC) based on the utilization of a mimic plasmid was designed to be used in the diagnostic protocol of brown rot to recognize false negatives due to the inhibition of PCR. The four sets of primers designed allowed detection and discrimination of all Monilinia spp. causing brown rot in fruit trees. Addition of an IC in each PCR reaction performed increased the reliability of the diagnostic protocol. The detection protocol presented here, that combined a set of universal primers and the inclusion of the plasmid pGMON as an IC for diagnosis of all Monilinia spp., and three sets of primers to discriminate the most important species of Monilinia, could be an useful and valuable tool for epidemiological studies. The method developed could be used in programmes to avoid the spread and introduction of this serious disease in new areas.

Alkaline phosphatase activity in human colostrum as a valuable predictive biomarker for lactational mastitis in nursing mothers.

PubMed

Bjelakovic, Ljiljana; Kocic, Gordana; Bjelakovic, Bojko; Zivkovic, Nikola; Stojanović, Dusica; Sokolovic, Danka; Mladenovic-Ciric, Ivana; Sokolovic, Dusan

2012-08-01

Biochemical investigations have shown that an indigenous milk enzyme - alkaline phosphatase (ALP) - which is detectable in the lactocytes, plays a very important diagnostic role in clinical medicine, since its activity varies in different tissues and serves as a specific indicator of disease states. The purpose of this study was to evaluate ALP activity in human colostrum as a possible early predictive biomarker for lactational mastitis in nursing mothers. During a period from May to July 2010, a total of 60 healthy nursing mothers were recruited for this study. The mean level of colostrum ALP activity from the affected breasts was significantly higher when compared with ALP activity from the contralateral asymptomatic as well as 'healthy' breasts (p < 0.01). Determining ALP activity in colostrum could be a valuable biochemical marker for an early prediction of mastitis in nursing mothers.

The valuable diagnosis of DIC and pre-DIC and prediction of a poor outcome by the evaluation of diagnostic criteria for DIC in patients with hematopoietic injury established by the Japanese Society of Thrombosis and Hemostasis.

PubMed

Aota, Takumi; Wada, Hideo; Fujimoto, Naoki; Sugimoto, Kazushi; Yamashita, Yoshiki; Matsumoto, Takeshi; Ohishi, Kohshi; Suzuki, Kei; Imai, Hiroshi; Kawasugi, Kazuo; Madoiwa, Seiji; Asakura, Hidesaku; Katayama, Naoyuki

2016-11-01

We evaluated the modified diagnostic criteria for disseminated intravascular coagulation (DIC), which was published by the Japanese Society of Thrombosis and Hemostasis (JSTH), in 274 suspected DIC patients with hematopoietic injury. The diagnoses of the patients were as follows: DIC (n=125); pre-DIC (n=42) and non-DIC (n=107). The efficacy of the diagnostic criteria for DIC was evaluated using a receiver operating characteristic (ROC) analysis. The area under the curve (ARC) and odd's ratio for the global coagulation test (GCT) scores in the diagnosis of "DIC" were high, while those for the diagnosis of "DIC and pre-DIC" were low, suggesting that the addition of antithrombin (AT) and soluble fibrin (SF)/thrombin antithrobin complex (TAT) was required to diagnose "DIC and pre-DIC". Although the addition of the AT and SF/TAT values to the GCT did not increase its ability to predict a poor outcome, the JSTH's modified diagnostic criteria scores were correlated with the odds ratio for death. The JSTH's modified diagnostic criteria for DIC, which included the GCT score, and the AT, and TAT/SF values, were useful for diagnosing DIC and pre-DIC, and predicting a poor outcome. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Laboratory diagnostics in transient loss of consciousness : Serum lactate compared to serum creatine kinase as diagnostic indicator for generalized tonic-clonic seizures].

PubMed

Dafotakis, M; Heckelmann, J; Zechbauer, S; Litmathe, J; Brokmann, J; Willmes, K; Surges, R; Matz, O

2018-03-21

Laboratory parameters can help in the differential diagnostics of acute episodes of transient loss of consciousness. Especially serum lactate and serum creatine kinase (CK) levels may provide valuable hints to distinguish generalized tonic-clonic seizures (GTCS) from syncope. Serum lactate levels at admission and CK levels 10-48 h after the episodes that led to admission were compared between patients with GTCS (n = 30) and those with syncope (n = 15). In addition, sensitivity and specificity of lactate and CK as diagnostic markers for syncope and GTCS were determined. The serum lactate and serum CK levels were significantly increased in patients with GTCS as compared to syncope patients (serum lactate: p < 0.001; CK: p < 0.005). The area under the curve (AUC) for serum lactate as an indicator for GTCS was 0.94 (95% confidence interval [CI] 0.88-1.0). For CK the receiver operating characteristics (ROC) analysis produced an AUC of only 0.77 (95% CI: 0.63-0.9). The determination of the lactate value as point-of-care diagnostics appears to be highly relevant in the rapid clarification of unclear episodes with transient loss of consciousness. The CK level at follow-up is also suitable for distinguishing GTCS from syncope but is inferior to the serum lactate value.

The pituitary gland under infrared light - in search of a representative spectrum for homogeneous regions.

PubMed

Banas, A; Banas, K; Furgal-Borzych, A; Kwiatek, W M; Pawlicki, B; Breese, M B H

2015-04-07

The pituitary gland is a small but vital organ in the human body. It is located at the base of the brain and is often described as the master gland due to its multiple functions. The pituitary gland secretes and stores hormones, such as the thyroid-stimulating hormone (TSH), adrenocorticotropic hormone (ACTH), growth hormone (hGH), prolactin, gonadotropins, and luteinizing hormones, as well as the antidiuretic hormone (ADH). A proper diagnosis of pituitary disorders is of utmost importance as this organ participates in regulating a variety of body functions. Typical histopathological analysis provides much valuable information, but it gives no insight into the biochemical background of the changes that occur within the gland. One approach that could be used to evaluate the biochemistry of tissue sections obtained from pituitary disorders is Fourier Transform Infra-Red (FTIR) spectromicroscopy. In order to collect diagnostically valuable information large areas of tissue must be investigated. This work focuses on obtaining a unique and representative FTIR spectrum characteristic of one type of cell architecture within a sample. The idea presented is based on using hierarchical cluster analysis (HCA) for data evaluation to search for uniform patterns within samples from the perspective of FTIR spectra. The results obtained demonstrate that FTIR spectromicroscopy, combined with proper statistical evaluation, can be treated as a complementary method for histopathological analysis and ipso facto can increase the sensitivity and specificity for detecting various disorders not only for the pituitary gland, but also for other human tissues.

Desmopressin test during petrosal sinus sampling: a valuable tool to discriminate pituitary or ectopic ACTH-dependent Cushing's syndrome.

PubMed

Castinetti, F; Morange, I; Dufour, H; Jaquet, P; Conte-Devolx, B; Girard, N; Brue, T

2007-09-01

Corticotropin-releasing hormone (CRH)-stimulated petrosal sinus sampling is currently the gold standard method for the differential diagnosis between pituitary and ectopic ACTH-dependent Cushing's syndrome. Our objective was to determine sensitivity and specificity of desmopressin test during petrosal sinus sampling. Forty-three patients had petrosal sinus sampling because of the lack of visible adenoma on magnetic resonance imaging (MRI) and/or because of discordant cortisol response to high-dose dexamethasone suppression test. ACTH sampling was performed in an antecubital vein, right and left petrosal sinuses, then at each location 5 and 10 min after injection of desmopressin. Diagnosis was based on the ACTH ratio between petrosal sinus and humeral vein ACTH after desmopressin test. Diagnosis was confirmed after surgery. A receiver operating characteristics curve was used to determine optimal sensitivity and specificity. Thirty-six patients had Cushing's disease (CD) and seven had ectopic ACTH secretion. A ratio > 2 after desmopressin was found in 35 of the 36 cases of CD (sensitivity: 95%). A ratio < or = 2 was found in the seven patients with ectopic ACTH secretion (specificity: 100%). Sinus sampling was ineffective in determining the left or right localization of the adenoma (sensitivity = 50%). No major adverse effects were observed during or after the procedure. Desmopressin test during petrosal sinus sampling is a safe and effective diagnostic procedure in ACTH-dependent Cushing's syndrome. It thus represents a valuable alternative to CRH.

Simulation of computed tomography dose based on voxel phantom

NASA Astrophysics Data System (ADS)

Liu, Chunyu; Lv, Xiangbo; Li, Zhaojun

2017-01-01

Computed Tomography (CT) is one of the preferred and the most valuable imaging tool used in diagnostic radiology, which provides a high-quality cross-sectional image of the body. It still causes higher doses of radiation to patients comparing to the other radiological procedures. The Monte-Carlo method is appropriate for estimation of the radiation dose during the CT examinations. The simulation of the Computed Tomography Dose Index (CTDI) phantom was developed in this paper. Under a similar conditions used in physical measurements, dose profiles were calculated and compared against the measured values that were reported. The results demonstrate a good agreement between the calculated and the measured doses. From different CT exam simulations using the voxel phantom, the highest absorbed dose was recorded for the lung, the brain, the bone surface. A comparison between the different scan type shows that the effective dose for a chest scan is the highest one, whereas the effective dose values during abdomen and pelvis scan are very close, respectively. The lowest effective dose resulted from the head scan. Although, the dose in CT is related to various parameters, such as the tube current, exposure time, beam energy, slice thickness and patient size, this study demonstrates that the MC simulation is a useful tool to accurately estimate the dose delivered to any specific organs for patients undergoing the CT exams and can be also a valuable technique for the design and the optimization of the CT x-ray source.

The real malady of Marcel Proust and what it reveals about diagnostic errors in medicine.

PubMed

Douglas, Yellowlees

2016-05-01

Marcel Proust, author of À La Recherche du Temps Perdu, was considered a hypochondriac not only by the numerous specialists he consulted during his lifetime but also by every literary critic who ventured an opinion on his health, among them several clinicians. However, Proust's voluminous correspondence, as detailed in its attention to his every symptom as his novel, provides valuable clues to Proust's real, organic, and rare illness. Proust, in fact, was not only genuinely ill but far sicker than he even he believed, most likely suffering from the vascular subtype of Ehlers-Danlos Syndrome. Ironically, Proust's own doctors and his clinician-critics replicated the same kinds of diagnostic errors clinicians still routinely make today, shedding light on the plight of patients with rare illnesses. Copyright © 2016 Elsevier Ltd. All rights reserved.

Advanced Pharmacotherapy Evidenced by Pathogenesis of Autism Spectrum Disorder

PubMed Central

Lee, Yeon Jung; Oh, Soo Hyun; Park, Chanmin; Hong, Minha; Lee, Ah Rah; Yoo, Hee Jeong; Shin, Chan Young; Cheon, Keun-Ah

2014-01-01

In clinical practice, pharmacological treatment is mostly focused on behavioral symptoms in everyday life. Nevertheless, persistent effort continues to develop medication for causal treatment. Recent changes in diagnostic criteria from Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR) to DSM-5 would affect not only diagnosing approaches, but also therapeutic approaches. Because previous pervasive developmental disorders have been integrated into a single entity, the autism spectrum disorder (ASD), we have to prepare for what medications are valuable for the ASD. In this article, we reviewed the following etiological treatment: acetylcholine and glutamate related medicine; amino acid medicine such as secretin, endogenous opioid, and oxytocin; complementary and alternative medicine such as chelating agents, vitamins, and omega-3; promising drugs related to the scope of pharmacogenetics currently under study. PMID:24851117

[The diagnostic value of cine-MR imaging in diseases of great vessels].

PubMed

Sasaki, S; Yoshida, H; Matsui, Y; Sakuma, M; Yasuda, K; Tanabe, T; Chouji, H

1990-02-01

The diagnostic value of cine magnetic resonance imaging (cine-MRI) was evaluated in 10 patients with disease of great vessels. The parameters necessary to decide the appropriate treatment, such as presence and extension of intimal flap, DeBakey type classification, identification of the entry, differentiation between true and false lumen, and between thrombosis and slow flow were demonstrated in all patients with dissecting aortic aneurysm. However, abdominal aortic branches could not be demonstrated enough by cine-MRI, therefore conventional AOG was necessary to choose the operative procedure in these cases. In patients with thoracic aortic aneurysm (TAA), cine-MRI was valuable in demonstrating both blood flow and thrombus in the lumen of aneurysm, and AOG was thought to be unnecessary in most cases. Cine-MRI is a promising new technique for the evaluation of diseases of great vessels.

Valid methods: the quality assurance of test method development, validation, approval, and transfer for veterinary testing laboratories.

PubMed

Wiegers, Ann L

2003-07-01

Third-party accreditation is a valuable tool to demonstrate a laboratory's competence to conduct testing. Accreditation, internationally and in the United States, has been discussed previously. However, accreditation is only I part of establishing data credibility. A validated test method is the first component of a valid measurement system. Validation is defined as confirmation by examination and the provision of objective evidence that the particular requirements for a specific intended use are fulfilled. The international and national standard ISO/IEC 17025 recognizes the importance of validated methods and requires that laboratory-developed methods or methods adopted by the laboratory be appropriate for the intended use. Validated methods are therefore required and their use agreed to by the client (i.e., end users of the test results such as veterinarians, animal health programs, and owners). ISO/IEC 17025 also requires that the introduction of methods developed by the laboratory for its own use be a planned activity conducted by qualified personnel with adequate resources. This article discusses considerations and recommendations for the conduct of veterinary diagnostic test method development, validation, evaluation, approval, and transfer to the user laboratory in the ISO/IEC 17025 environment. These recommendations are based on those of nationally and internationally accepted standards and guidelines, as well as those of reputable and experienced technical bodies. They are also based on the author's experience in the evaluation of method development and transfer projects, validation data, and the implementation of quality management systems in the area of method development.

Moorea BIOCODE barcode library as a tool for understanding predator-prey interactions: insights into the diet of common predatory coral reef fishes

NASA Astrophysics Data System (ADS)

Leray, M.; Boehm, J. T.; Mills, S. C.; Meyer, C. P.

2012-06-01

Identifying species involved in consumer-resource interactions is one of the main limitations in the construction of food webs. DNA barcoding of prey items in predator guts provides a valuable tool for characterizing trophic interactions, but the method relies on the availability of reference sequences to which prey sequences can be matched. In this study, we demonstrate that the COI sequence library of the Moorea BIOCODE project, an ecosystem-level barcode initiative, enables the identification of a large proportion of semi-digested fish, crustacean and mollusks found in the guts of three Hawkfish and two Squirrelfish species. While most prey remains lacked diagnostic morphological characters, 94% of the prey found in 67 fishes had >98% sequence similarity with BIOCODE reference sequences. Using this species-level prey identification, we demonstrate how DNA barcoding can provide insights into resource partitioning, predator feeding behaviors and the consequences of predation on ecosystem function.

Palpebral portion of the orbicularis oculi muscle to repetitive nerve stimulation testing: A potential assessment indicator in patients with generalized myasthenia gravis.

PubMed

Yan, Chong; Song, Jie; Pang, Song; Yi, Fangfang; Xi, Jianying; Zhou, Lei; Ding, Ding; Wang, Weifeng; Qiao, Kai; Zhao, Chongbo

2018-02-01

Repetitive nerve stimulation (RNS) is a valuable diagnostic method for myasthenia gravis (MG). However, its association with clinical severity was scarcely studied. We reviewed medical records and retrospectively enrolled 121 generalized MG patients. Sensitivity of different muscles to RNS and clinical scoring systems was evaluated. RNS testing revealed facial muscles have the highest positive rate, followed by proximal muscles and distal muscles, with the palpebral portion of the orbicularis oculi muscle most sensitive. Amplitude decrement of compound muscle action potential (CMAP) in the palpebral portion of the orbicularis oculi muscle is related to quantitative myasthenia gravis (QMG) scores, MG-specific manual muscle testing (MMT) scores and myasthenia gravis-related activities of daily living (MG-ADL) scores. We suggest that RNS testing of the palpebral portion of the orbicularis oculi muscle is a potential assessment indicator in patients with generalized MG. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Role of 3 Tesla MRA in the Detection of Intracranial Aneurysms

PubMed Central

Kapsalaki, Eftychia Z.; Rountas, Christos D.; Fountas, Kostas N.

2012-01-01

Intracranial aneurysms constitute a common pathological entity, affecting approximately 1–8% of the general population. Their early detection is essential for their prompt treatment. Digital subtraction angiography is considered the imaging method of choice. However, other noninvasive methodologies such as CTA and MRA have been employed in the investigation of patients with suspected aneurysms. MRA is a noninvasive angiographic modality requiring no radiation exposure. However, its sensitivity and diagnostic accuracy were initially inadequate. Several MRA techniques have been developed for overcoming all these drawbacks and for improving its sensitivity. 3D TOF MRA and contrast-enhanced MRA are the most commonly employed techniques. The introduction of 3 T magnetic field further increased MRA's sensitivity, allowing detection of aneurysms smaller than 3 mm. The development of newer MRA techniques may provide valuable information regarding the flow characteristics of an aneurysm. Meticulous knowledge of MRA's limitations and pitfalls is of paramount importance for avoiding any erroneous interpretation of its findings. PMID:22292121

Retrospective Analysis of Duodenal Injuries: A Comprehensive Overview

PubMed Central

Pandey, Sanjay; Niranjan, Ashutosh; Mishra, Shashank; Agrawal, Tarun; Singhal, Basant M.; Prakash, Akhil; Attri, Prakash C.

2011-01-01

Background/Aim: Duodenal injury is an uncommon finding, accounting for about about 3 – 5% of abdominal trauma, mainly resulting from both penetrating and blunt trauma, and is associated with significant mortality (6 - 25%) and morbidity (30 - 60%). Patients and Methods: Retrospective analysis was performed in terms of presentation, management, morbidity and mortality on 14 patients of duodenal injuries out of a total of 172 patients of abdominal trauma attending Subharti Medical College. Results: Epigastric pain (100%) along with vomiting (100%) is the usual presentation of duodenal injuries in blunt abdominal trauma, especially to the upper abdomen. Computed tomography (CT) was diagnostic in all cases. Isolated duodenal injury is a rare finding and the second part is mostly affected. Conclusion: Duodenal injury should always be suspected in blunt upper abdominal trauma, especially in those presenting with epigastric pain and vomiting. Investigation by CT and early surgical intervention in these patients are valuable tools to reduce the morbidity and mortality. PMID:21372354

Flow Cytometric Methods for Circulating Tumor Cell Isolation and Molecular Analysis.

PubMed

Bhagwat, Neha; Carpenter, Erica L

2017-01-01

Circulating tumor cells provide a non-invasive source of tumor material that can be valuable at all stages of disease management, including screening and early diagnosis, monitoring response to therapy, identifying therapeutic targets, and assessing development of drug resistance. Cells isolated from the blood of cancer patients can be used for phenotypic analysis, tumor genotyping, transcriptional profiling, as well as for ex vivo culture of isolated cells. There are a variety of novel technologies currently being developed for the detection and analysis of rare cells in circulation of cancer patients. Flow cytometry is a powerful cell analysis platform that is increasingly being used in this field of study due to its relatively high throughput and versatility with respect to the large number of commercially available antibodies and fluorescent probes available to translational and clinical researchers. More importantly, it offers the ability to easily recover viable cells with high purity that are suitable for downstream molecular analysis, thus making it an attractive technology for cancer research and as a diagnostic tool.

3D DNA origami as programmable anchoring points for bioreceptors in fiber optic surface plasmon resonance biosensing.

PubMed

Daems, Devin; Pfeifer, Wolfgang; Rutten, Iene; Sacca, Barbara; Spasic, Dragana; Lammertyn, Jeroen

2018-06-27

Many challenges in biosensing originate from the fact that the all-important nano-architecture of the biosensor's surface, including precise density and orientation of bioreceptors, is not entirely comprehended. Here we introduced a 3D DNA origami as bioreceptor carrier to functionalize the fiber optic surface plasmon resonance (FO-SPR) sensor with nanoscale precision. Starting from a 24-helix bundle, two distinct DNA origami structures were designed to position thrombin-specific aptamers with different density and distance (27 and 113 nm) from the FO-SPR surface. The origami-based biosensors proved to be not only capable of reproducible, label-free thrombin detection, but revealed also valuable innovative features: (1) a significantly better performance in the absence of backfilling, known as essential in biosensing field, suggesting improved bioreceptor orientation and accessibility and (2) a wider linear range compared to previously reported thrombin biosensors. We envisage that our method will be beneficial both for scientists and clinicians looking for new surface (bio)chemistry and improved diagnostics.

A comparative in silico linear B-cell epitope prediction and characterization for South American and African Trypanosoma vivax strains.

PubMed

Guedes, Rafael Lucas Muniz; Rodrigues, Carla Monadeli Filgueira; Coatnoan, Nicolas; Cosson, Alain; Cadioli, Fabiano Antonio; Garcia, Herakles Antonio; Gerber, Alexandra Lehmkuhl; Machado, Rosangela Zacarias; Minoprio, Paola Marcella Camargo; Teixeira, Marta Maria Geraldes; de Vasconcelos, Ana Tereza Ribeiro

2018-02-27

Trypanosoma vivax is a parasite widespread across Africa and South America. Immunological methods using recombinant antigens have been developed aiming at specific and sensitive detection of infections caused by T. vivax. Here, we sequenced for the first time the transcriptome of a virulent T. vivax strain (Lins), isolated from an outbreak of severe disease in South America (Brazil) and performed a computational integrated analysis of genome, transcriptome and in silico predictions to identify and characterize putative linear B-cell epitopes from African and South American T. vivax. A total of 2278, 3936 and 4062 linear B-cell epitopes were respectively characterized for the transcriptomes of T. vivax LIEM-176 (Venezuela), T. vivax IL1392 (Nigeria) and T. vivax Lins (Brazil) and 4684 for the genome of T. vivax Y486 (Nigeria). The results presented are a valuable theoretical source that may pave the way for highly sensitive and specific diagnostic tools. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Cryptochrome-1 expression: a new prognostic marker in B-cell chronic lymphocytic leukemia.

PubMed

Lewintre, Eloisa Jantus; Martín, Cristina Reinoso; Ballesteros, Carlos García; Montaner, David; Rivera, Rosa Farrás; Mayans, José Ramón; García-Conde, Javier

2009-02-01

Chronic lymphocytic leukemia is an adult-onset leukemia with a heterogeneous clinical behavior. When chronic lymphocytic leukemia cases were divided on the basis of IgV(H) mutational status, widely differing clinical courses were revealed. Since IgV(H) sequencing is difficult to perform in a routine diagnostic laboratory, finding a surrogate for IgV(H) mutational status seems an important priority. In the present study, we proposed the use of Cryptochrome-1 as a new prognostic marker in early-stage chronic lymphocytic leukemia. Seventy patients (Binet stage A, without treatment) were included in the study. We correlated Cryptochrome-1 mRNA with well established prognostic markers such as IgV(H) mutations, ZAP70, LPL or CD38 expression and chromosomal abnormalities. High Cryptochrome-1 expression correlated with IgV(H) unmutated samples. In addition, Cryptochrome-1 was a valuable predictor of disease progression in early-stage chronic lymphocytic leukemia, therefore it can be introduced in clinical practice with the advantage of a simplified method of quantification.

Evaluation of living liver transplant donors: method for precise anatomic definition by using a dedicated contrast-enhanced MR imaging protocol.

PubMed

Sahani, Dushyant; D'souza, Roy; Kadavigere, Rajagopal; Hertl, Martin; McGowan, Jennifer; Saini, Sanjay; Mueller, Peter R

2004-01-01

Liver transplantation from a living donor involves removal of part of the donor liver in a fashion that does not endanger its vascular supply or metabolic function. The radiologist plays an important role in evaluation of the living donor to define the conditions under which graft donation is contraindicated and to identify anatomic variations that may alter the surgical approach. In the past, diagnostic work-up of the donor involved costly and invasive tests. Currently, dynamic contrast material-enhanced computed tomography and magnetic resonance (MR) imaging are the imaging tests performed, each of which has advantages and limitations. MR imaging performed with liver-specific and extravascular contrast agents may be used as a single imaging test for comprehensive noninvasive evaluation of living liver transplant donors. MR imaging provides valuable information about variations in the vascular and biliary anatomy and allows evaluation of the hepatic parenchyma for diffuse or focal abnormalities. Copyright RSNA, 2004

Comprehensive Identification of Proteins from MALDI Imaging*

PubMed Central

Maier, Stefan K.; Hahne, Hannes; Gholami, Amin Moghaddas; Balluff, Benjamin; Meding, Stephan; Schoene, Cédrik; Walch, Axel K.; Kuster, Bernhard

2013-01-01

Matrix-assisted laser desorption/ionization imaging mass spectrometry (MALDI IMS) is a powerful tool for the visualization of proteins in tissues and has demonstrated considerable diagnostic and prognostic value. One main challenge is that the molecular identity of such potential biomarkers mostly remains unknown. We introduce a generic method that removes this issue by systematically identifying the proteins embedded in the MALDI matrix using a combination of bottom-up and top-down proteomics. The analyses of ten human tissues lead to the identification of 1400 abundant and soluble proteins constituting the set of proteins detectable by MALDI IMS including >90% of all IMS biomarkers reported in the literature. Top-down analysis of the matrix proteome identified 124 mostly N- and C-terminally fragmented proteins indicating considerable protein processing activity in tissues. All protein identification data from this study as well as the IMS literature has been deposited into MaTisse, a new publically available database, which we anticipate will become a valuable resource for the IMS community. PMID:23782541

[Cinema and neurology: early educational applications].

PubMed

Collado-Vázquez, Susana; Carrillo, Jesús M

2015-03-01

Since its earliest days, cinema has been used in the teaching of neurology both to illustrate the professor's explanations and to make learning easier for students. To analyse some of the first applications of cinema to the teaching and learning of neurology. Shortly after the birth of the film projector it became apparent that it could be a valuable aid in teaching medicine, and especially neurology. Initially, actual recordings made by doctors themselves were used, and later documentaries, short films and feature films were employed as means of showing diagnostic and therapeutic methods, as well as different pathological signs, such as movement disorders. The intention was not to replace other methodologies but instead to complement them and to make the process of acquiring knowledge easier. Applying cinema in teaching is a useful way to portray the contents of different subjects, especially in the field of neurology, and to favour the acquisition of both specific and cross-disciplinary competences, with very positive results being obtained among students.

Recorded Behavior as a Valuable Resource for Diagnostics in Mobile Phone Addiction: Evidence from Psychoinformatics

PubMed Central

Montag, Christian; Błaszkiewicz, Konrad; Lachmann, Bernd; Sariyska, Rayna; Andone, Ionut; Trendafilov, Boris; Markowetz, Alexander

2015-01-01

Psychologists and psychiatrists commonly rely on self-reports or interviews to diagnose or treat behavioral addictions. The present study introduces a novel source of data: recordings of the actual problem behavior under investigation. A total of N = 58 participants were asked to fill in a questionnaire measuring problematic mobile phone behavior featuring several questions on weekly phone usage. After filling in the questionnaire, all participants received an application to be installed on their smartphones, which recorded their phone usage for five weeks. The analyses revealed that weekly phone usage in hours was overestimated; in contrast, numbers of call and text message related variables were underestimated. Importantly, several associations between actual usage and being addicted to mobile phones could be derived exclusively from the recorded behavior, but not from self-report variables. The study demonstrates the potential benefit to include methods of psychoinformatics in the diagnosis and treatment of problematic mobile phone use. PMID:26492275

Bat white-nose syndrome: a real-time TaqMan polymerase chain reaction test targeting the intergenic spacer region of Geomyces destructanstructans.

USGS Publications Warehouse

Muller, Laura K.; Lorch, Jeffrey M.; Lindner, Daniel L.; O'Connor, Michael; Gargas, Andrea; Blehert, David S.

2013-01-01

The fungus Geomyces destructans is the causative agent of white-nose syndrome (WNS), a disease that has killed millions of North American hibernating bats. We describe a real-time TaqMan PCR test that detects DNA from G. destructans by targeting a portion of the multicopy intergenic spacer region of the rRNA gene complex. The test is highly sensitive, consistently detecting as little as 3.3 fg of genomic DNA from G. destructans. The real-time PCR test specifically amplified genomic DNA from G. destructans but did not amplify target sequence from 54 closely related fungal isolates (including 43 Geomyces spp. isolates) associated with bats. The test was further qualified by analyzing DNA extracted from 91 bat wing skin samples, and PCR results matched histopathology findings. These data indicate the real-time TaqMan PCR method described herein is a sensitive, specific, and rapid test to detect DNA from G. destructans and provides a valuable tool for WNS diagnostics and research.

[99mTc] HYNIC-hEGF, a potential agent for imaging of EGF receptors in vivo: preparation and pre-clinical evaluation.

PubMed

Babaei, Mohammad Hossein; Almqvist, Ylva; Orlova, Anna; Shafii, Mohammad; Kairemo, Kalevi; Tolmachev, Vladimir

2005-06-01

Expression of epidermal growth factor receptors (EGFR) has prognostic and predictive value in many kinds of tumors. Imaging of expression of EGFR in vivo may give valuable diagnostic information. The epidermal growth factor (EGF), a natural ligand, is a possible candidate for the targeting of EGFR. The present study describes a method for preparation of (99m)Tc-EGF via the hydrazinopyridine-3-carboxylic acid (HYNIC) conjugation using tricine and ethylenediamine-N,N'-diacetic acid (EDDA) as co-ligands. Both conjugates bound EGFR expressing cells with nanomolar affinity, and demonstrated good intracellular retention. The complex with EDDA demonstrated much higher stability in blood serum and during cysteine challenge. Biodistribution of (99m)Tc-EDDA-HYNIC-EGF in normal mice demonstrated fast blood clearance of conjugate, and its ability to bind EGFR in vivo. (99m)Tc-EDDA-HYNIC-EGF is a promising candidate for visualization of EGFR expression in vivo.

Label-free nanoplasmonic sensing of tumor-associate autoantibodies for early diagnosis of colorectal cancer.

PubMed

Soler, Maria; Estevez, M-Carmen; Villar-Vazquez, Roi; Casal, J Ignacio; Lechuga, Laura M

2016-08-03

Colorectal cancer is treatable and curable when detected at early stages. However there is a lack of less invasive and more specific screening and diagnosis methods which would facilitate its prompt identification. Blood circulating autoantibodies which are immediately produced by the immune system at tumor appearance have become valuable biomarkers for preclinical diagnosis of cancer. In this work, we present the rapid and label-free detection of colorectal cancer autoantibodies directly in blood serum or plasma using a recently developed nanoplasmonic biosensor. Our nanoplasmonic device offers sensitive and real-time quantification of autoantibodies with excellent selectivity and reproducibility, achieving limits of detection around 1 nM (150-160 ng mL(-1)). A preliminary evaluation of clinical samples of colorectal cancer patients has shown good correlation with ELISA. These results demonstrate the reliability of the nanobiosensor strategy and pave the way towards the achievement of a sensitive diagnostic tool for early detection of colorectal cancer. Copyright © 2016 Elsevier B.V. All rights reserved.

Laser-Induced Breakdown Spectroscopy (LIBS) for the Measurement of Spatial Structures and Fuel Distribution in Flames.

PubMed

Kotzagianni, Maria; Kakkava, Eirini; Couris, Stelios

2016-04-01

Laser-induced breakdown spectroscopy (LIBS) is used for the mapping of local structures (i.e., reactants and products zones) and for the determination of fuel distribution by means of the local equivalence ratio ϕ in laminar, premixed air-hydrocarbon flames. The determination of laser threshold energy to induce breakdown in the different zones of flames is employed for the identification and demarcation of the local structures of a premixed laminar flame, while complementary results about fuel concentration were obtained from measurements of the cyanogen (CN) band Β(2)Σ(+)--Χ(2)Σ(+), (Δυ = 0) at 388.3 nm and the ratio of the atomic lines of hydrogen (Hα) and oxygen (O(I)), Hα/O. The combination of these LIBS-based methods provides a relatively simple to use, rapid, and accurate tool for online and in situ combustion diagnostics, providing valuable information about the fuel distribution and the spatial variations of the local structures of a flame. © The Author(s) 2016.

Label-Free Discovery Array Platform for the Characterization of Glycan Binding Proteins and Glycoproteins.

PubMed

Gray, Christopher J; Sánchez-Ruíz, Antonio; Šardzíková, Ivana; Ahmed, Yassir A; Miller, Rebecca L; Reyes Martinez, Juana E; Pallister, Edward; Huang, Kun; Both, Peter; Hartmann, Mirja; Roberts, Hannah N; Šardzík, Robert; Mandal, Santanu; Turnbull, Jerry E; Eyers, Claire E; Flitsch, Sabine L

2017-04-18

The identification of carbohydrate-protein interactions is central to our understanding of the roles of cell-surface carbohydrates (the glycocalyx), fundamental for cell-recognition events. Therefore, there is a need for fast high-throughput biochemical tools to capture the complexity of these biological interactions. Here, we describe a rapid method for qualitative label-free detection of carbohydrate-protein interactions on arrays of simple synthetic glycans, more complex natural glycosaminoglycans (GAG), and lectins/carbohydrate binding proteins using matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry. The platform can unequivocally identify proteins that are captured from either purified or complex sample mixtures, including biofluids. Identification of proteins bound to the functionalized array is achieved by analyzing either the intact protein mass or, after on-chip proteolytic digestion, the peptide mass fingerprint and/or tandem mass spectrometry of selected peptides, which can yield highly diagnostic sequence information. The platform described here should be a valuable addition to the limited analytical toolbox that is currently available for glycomics.

Diagnostic Challenges in Prostate Cancer and 68Ga-PSMA PET Imaging: A Game Changer?

PubMed

Zaman, Maseeh uz; Fatima, Nosheen; Zaman, Areeba; Sajid, Mahwsih; Zaman, Unaiza; Zaman, Sidra

2017-10-26

Prostate cancer (PC) is the most frequent solid tumor in men and the third most common cause of cancer mortality among men in developed countries. Current imaging modalities like ultrasound (US), computerized tomography (CT), magnetic resonance imaging (MRI) and choline based positron emission (PET) tracing have disappointing sensitivity for detection of nodal metastasis and small tumor recurrence. This poses a diagnostic challenge in staging of intermediate to high risk PC and restaging of patients with biochemical recurrence (PSA >0.2 ng/ml). Gallium-68 labeled prostate specific membrane antigen (68Ga-PSMA) PET imaging has now emerged with a higher diagnostic yield. 68Ga-PSMA PET/CT or PET/MRI can be expected to offer a one-stop-shop for staging and restaging of PC. PSMA ligands labeled with alpha and beta emitters have also shown promising therapeutic efficacy for nodal, bone and visceral metastasis. Therefore a PSMA based theranostics approach for detection, staging, treatment, and follow-up of PC would appear to be highly valuable to achieve personalized PC treatment. Creative Commons Attribution License

Bleeding duodenal ulcer after Roux-en-Y gastric bypass surgery: the value of laparoscopic gastroduodenoscopy.

PubMed

Issa, Hussain; Al-Saif, Osama; Al-Momen, Sami; Bseiso, Bahaa; Al-Salem, Ahmed

2010-01-01

Roux-en-Y gastric bypass is a common surgical procedure used to treat patients with morbid obesity. One of the rare, but potentially fatal complications of gastric bypass is upper gastrointestinal bleeding, which can pose diagnostic and therapeutic dilemmas. This report describes a 39-year-old male with morbid obesity who underwent a Roux-en-Y gastric bypass. Three months postoperatively, he sustained repeated and severe upper attacks of upper gastrointestinal bleeding. He received multiple blood transfusions, and had repeated upper and lower endoscopies with no diagnostic yield. Finally, he underwent laparoscopic endoscopy which revealed a bleeding duodenal ulcer. About 5 ml of saline with adrenaline was injected, followed by electrocoagulation to seal the overlying cleft and blood vessel. He was also treated with a course of a proton pump inhibitor and given treatment for H pylori eradication with no further attacks of bleeding. Taking in consideration the difficulties in accessing the bypassed stomach endoscopically, laparoscopic endoscopy is a feasible and valuable diagnostic and therapeutic procedure in patients who had gastric bypass.

Model-based diagnostics for Space Station Freedom

NASA Technical Reports Server (NTRS)

Fesq, Lorraine M.; Stephan, Amy; Martin, Eric R.; Lerutte, Marcel G.

1991-01-01

An innovative approach to fault management was recently demonstrated for the NASA LeRC Space Station Freedom (SSF) power system testbed. This project capitalized on research in model-based reasoning, which uses knowledge of a system's behavior to monitor its health. The fault management system (FMS) can isolate failures online, or in a post analysis mode, and requires no knowledge of failure symptoms to perform its diagnostics. An in-house tool called MARPLE was used to develop and run the FMS. MARPLE's capabilities are similar to those available from commercial expert system shells, although MARPLE is designed to build model-based as opposed to rule-based systems. These capabilities include functions for capturing behavioral knowledge, a reasoning engine that implements a model-based technique known as constraint suspension, and a tool for quickly generating new user interfaces. The prototype produced by applying MARPLE to SSF not only demonstrated that model-based reasoning is a valuable diagnostic approach, but it also suggested several new applications of MARPLE, including an integration and testing aid, and a complement to state estimation.

MicroRNAs: A Puzzling Tool in Cancer Diagnostics and Therapy.

PubMed

D'Angelo, Barbara; Benedetti, Elisabetta; Cimini, Annamaria; Giordano, Antonio

2016-11-01

MicroRNAs (miRNAs) constitute a dominating class of small RNAs that regulate diverse cellular functions. Due the pivotal role of miRNAs in biological processes, a deregulated miRNA expression is likely involved in human cancers. MicroRNAs possess tumor suppressor capability, as well as display oncogenic characteristics. Interestingly, miRNAs exist in various biological fluids as circulating entities. Changes in the profile of circulating miRNAs are indicative of pathophysiological conditions in human cancer. This concept has led to consider circulating miRNAs valid biomarkers in cancer diagnostics. Furthermore, current research promotes the use of miRNAs as a target in cancer therapy. However, miRNAs are an evolving research field. Although miRNAs have been demonstrated to be potentially valuable tools both in cancer diagnosis and treatment, a greater effort should be made to improve our understanding of miRNAs biology. This review describes the biology of microRNAs, emphasizing on the use of miRNAs in cancer diagnostics and therapy. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Breast tumor segmentation in high resolution x-ray phase contrast analyzer based computed tomography.

PubMed

Brun, E; Grandl, S; Sztrókay-Gaul, A; Barbone, G; Mittone, A; Gasilov, S; Bravin, A; Coan, P

2014-11-01

Phase contrast computed tomography has emerged as an imaging method, which is able to outperform present day clinical mammography in breast tumor visualization while maintaining an equivalent average dose. To this day, no segmentation technique takes into account the specificity of the phase contrast signal. In this study, the authors propose a new mathematical framework for human-guided breast tumor segmentation. This method has been applied to high-resolution images of excised human organs, each of several gigabytes. The authors present a segmentation procedure based on the viscous watershed transform and demonstrate the efficacy of this method on analyzer based phase contrast images. The segmentation of tumors inside two full human breasts is then shown as an example of this procedure's possible applications. A correct and precise identification of the tumor boundaries was obtained and confirmed by manual contouring performed independently by four experienced radiologists. The authors demonstrate that applying the watershed viscous transform allows them to perform the segmentation of tumors in high-resolution x-ray analyzer based phase contrast breast computed tomography images. Combining the additional information provided by the segmentation procedure with the already high definition of morphological details and tissue boundaries offered by phase contrast imaging techniques, will represent a valuable multistep procedure to be used in future medical diagnostic applications.

A rapid method of accurate detection and differentiation of Newcastle disease virus pathotypes by demonstrating multiple bands in degenerate primer based nested RT-PCR.

PubMed

Desingu, P A; Singh, S D; Dhama, K; Kumar, O R Vinodh; Singh, R; Singh, R K

2015-02-01

A rapid and accurate method of detection and differentiation of virulent and avirulent Newcastle disease virus (NDV) pathotypes was developed. The NDV detection was carried out for different domestic avian field isolates and pigeon paramyxo virus-1 (25 field isolates and 9 vaccine strains) by using APMV-I "fusion" (F) gene Class II specific external primer A and B (535bp), internal primer C and D (238bp) based reverses transcriptase PCR (RT-PCR). The internal degenerative reverse primer D is specific for F gene cleavage position of virulent strain of NDV. The nested RT-PCR products of avirulent strains showed two bands (535bp and 424bp) while virulent strains showed four bands (535bp, 424bp, 349bp and 238bp) on agar gel electrophoresis. This is the first report regarding development and use of degenerate primer based nested RT-PCR for accurate detection and differentiation of NDV pathotypes by demonstrating multiple PCR band patterns. Being a rapid, simple, and economical test, the developed method could serve as a valuable alternate diagnostic tool for characterizing NDV isolates and carrying out molecular epidemiological surveillance studies for this important pathogen of poultry. Copyright © 2014 Elsevier B.V. All rights reserved.

External quality assurance as a revalidation method for pathologists in pediatric histopathology: Comparison of four international programs

PubMed Central

Sergi, Consolato; Mikuz, Gregor

2008-01-01

Aim External quality assurance (EQA) is an extremely valuable resource for clinical pathologists to maintain high standards, improve diagnostic skills, and possibly revalidate medical license. The aim of this study was to participate in and compare four international slide survey programs (UK, IAP-Germany, USA-Canada, Australasia) in pediatric histopathology for clinical pathologists with the aim to use it as a revalidation method. Methods The following parameters were evaluated: number of circulations per year, number of slides, membership requirement, proof of significant pediatric pathology work, open to overseas participants, laboratory accreditation, issue of continuing professional development certificates and credits, slides discussion meeting, use of digital images, substandard performance letter, and anonymity of responses. Results The UK scheme, which has sampling procedure over several time frames (2 circulations/year, 30 slides), partial confidentiality, and multiple sources of data and assessors, can be used as a model for revalidation. The US-Canadian and Australasian schemes only partially fulfill the revalidation requirements. The IAP scheme appears to be essentially an educational program and may be unsuitable for revalidation. Conclusion The purposes and programs of EQA schemes vary worldwide. In order for it to be used for revalidation, it is advisable that EQA schemes are immediately unified. PMID:19014480

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

PubMed

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

2017-11-06

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

The JET diagnostic fast central acquisition and trigger system (abstract)

NASA Astrophysics Data System (ADS)

Edwards, A. W.; Blackler, K.

1995-01-01

Most plasma physics diagnostics sample at a fixed frequency that is normally matched to available memory limits. This technique is not appropriate for long pulse machines such as JET where sampling frequencies of hundreds of kHz are required to diagnose very fast events. As a result of work using real-time event selection within the previous JET soft x-ray diagnostic, a single data acquisition and event triggering system for all suitable fast diagnostics, the fast central acquisition and trigger system (Fast CATS), has been developed for JET. The front-end analog-to-digital conversion (ADC) part samples all channels at 250 kHz, with a 100 kHz pass band and a stop band of 125 kHz. The back-end data collection system is based around Texas Instruments TMS320C40 microprocessors. Within this system, two levels of trigger algorithms are able to evaluate data. The first level typically analyzes data on a per diagnostic and individual channel basis. The second level looks at the data from one or more diagnostics in a window around the time of interest flagged by the first level system. Selection criteria defined by the diagnosticians are then imposed on the results from the second level to decide whether that data should be kept. The use of such a system involving intelligent real time trigger algorithms and fast data analysis will improve both the quantity and quality of JET diagnostic data, while providing valuable input to the design of data acquisition systems for very long pulse machines such as ITER. This paper will give an overview of the various elements of this new system. In addition, first results from this system following the restart of JET operation will be presented.

Use and limitations of malaria rapid diagnostic testing by community health workers in war-torn Democratic Republic of Congo.

PubMed

Hawkes, Michael; Katsuva, Jean Paul; Masumbuko, Claude K

2009-12-23

Accurate and practical malaria diagnostics, such as immunochromatographic rapid diagnostic tests (RDTs), have the potential to avert unnecessary treatments and save lives. Volunteer community health workers (CHWs) represent a potentially valuable human resource for expanding this technology to where it is most needed, remote rural communities in sub-Saharan Africa with limited health facilities and personnel. This study reports on a training programme for CHWs to incorporate RDTs into their management strategy for febrile children in the Democratic Republic of Congo, a tropical African setting ravaged by human conflict. Prospective cohort study, satisfaction questionnaire and decision analysis. Twelve CHWs were trained to safely and accurately perform and interpret RDTs, then successfully implemented rapid diagnostic testing in their remote community in a cohort of 357 febrile children. CHWs were uniformly positive in evaluating RDTs for their utility and ease of use. However, high malaria prevalence in this cohort (93% by RDTs, 88% by light microscopy) limited the cost-effectiveness of RDTs compared to presumptive treatment of all febrile children, as evidenced by findings from a simplified decision analysis. CHWs can safely and effectively use RDTs in their management of febrile children; however, cost-effectiveness of RDTs is limited in zones of high malaria prevalence.

Myasthenia Gravis: Tests and Diagnostic Methods

MedlinePlus

... Focus on MG Newsletter MG Quarterly Test & Diagnostic methods In addition to a complete medical and neurological ... How can I help? About MGFA Test & Diagnostic methods Treatment for MG FAQ's Upcoming Events 2018 MG ...

Molecular diagnosis of skin infections using paraffin-embedded tissue - review and interdisciplinary consensus.

PubMed

Sunderkötter, Cord; Becker, Karsten; Kutzner, Heinz; Meyer, Thomas; Blödorn-Schlicht, Norbert; Reischl, Udo; Nenoff, Pietro; Geißdörfer, Walter; Gräser, Yvonne; Herrmann, Mathias; Kühn, Joachim; Bogdan, Christian

2018-02-01

Nucleic acid amplification techniques (NATs), such as PCR, are highly sensitive and specific methods that have become valuable supplements to culture and serology in the diagnosis of infectious disorders. However, especially when using formalin-fixed and paraffin-embedded tissue, these techniques are associated with both false-negative and false-positive results, a pitfall that is frequently misjudged. Representatives of the German Society of Hygiene and Microbiology (DGHM) and the German Society of Dermatology (DDG) therefore set out to develop a consensus - in the form of a review article - on the appropriate indications for NATs using paraffin-embedded tissue, its contraindications, and the key points to be considered in the pre- and post-analytical phase. Given that fresh, naive tissue is preferably to be used in the workup of a suspected infection, PCR analysis on paraffin sections represents an exception. The latter may be considered if an infection is suspected at a later point in time and fresh tissue has not been preserved or can no longer be obtained. Potential indications include confirmation of histologically suspected infections with Leishmania spp., Bartonella spp., Rickettsia spp., or in case of ecthyma contagiosum. Infections with, for example, mycobacteria or RNA viruses, on the other hand, are not considered useful indications for NATs using paraffin sections. In order to avoid misinterpretation of test results, it is essential that laboratory reports on NATs using paraffin-embedded tissue contain information on the indication/diagnostic circumstances, the required and chosen pre-analytical steps, the limitations of the method, and on diagnostic alternatives. © 2018 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

Rapid antigen detection tests for malaria diagnosis in severely ill Papua New Guinean children: a comparative study using Bayesian latent class models.

PubMed

Manning, Laurens; Laman, Moses; Rosanas-Urgell, Anna; Turlach, Berwin; Aipit, Susan; Bona, Cathy; Warrell, Jonathan; Siba, Peter; Mueller, Ivo; Davis, Timothy M E

2012-01-01

Although rapid diagnostic tests (RDTs) have practical advantages over light microscopy (LM) and good sensitivity in severe falciparum malaria in Africa, their utility where severe non-falciparum malaria occurs is unknown. LM, RDTs and polymerase chain reaction (PCR)-based methods have limitations, and thus conventional comparative malaria diagnostic studies employ imperfect gold standards. We assessed whether, using Bayesian latent class models (LCMs) which do not require a reference method, RDTs could safely direct initial anti-infective therapy in severe ill children from an area of hyperendemic transmission of both Plasmodium falciparum and P. vivax. We studied 797 Papua New Guinean children hospitalized with well-characterized severe illness for whom LM, RDT and nested PCR (nPCR) results were available. For any severe malaria, the estimated prevalence was 47.5% with RDTs exhibiting similar sensitivity and negative predictive value (NPV) to nPCR (≥96.0%). LM was the least sensitive test (87.4%) and had the lowest NPV (89.7%), but had the highest specificity (99.1%) and positive predictive value (98.9%). For severe falciparum malaria (prevalence 42.9%), the findings were similar. For non-falciparum severe malaria (prevalence 6.9%), no test had the WHO-recommended sensitivity and specificity of >95% and >90%, respectively. RDTs were the least sensitive (69.6%) and had the lowest NPV (96.7%). RDTs appear a valuable point-of-care test that is at least equivalent to LM in diagnosing severe falciparum malaria in this epidemiologic situation. None of the tests had the required sensitivity/specificity for severe non-falciparum malaria but the number of false-negative RDTs in this group was small.

Thermographic inspection and quality assurance of energy conservation procedures for electric buses

NASA Astrophysics Data System (ADS)

Fennell, Henri C.

1998-03-01

Electric buses are one of the solutions for improving air quality in our cities. Many states are adopting 'no new diesel bus' policies, thus increasing the pressure to develop alternative vehicles. The fledgling electric vehicle technology suffers from acceptance problems by major transit authorities due primarily to limited travel range from each battery charge. Utilizing electric buses in the Northeast has the added problem of maintaining an adequate cabin temperature without the availability of heat from a diesel motor. Heating the passenger cabin with an electric heater which draws from the batteries' stored energy significantly reduces the already modest range of these vehicles; therefore, energy conservation measures play an important role in allowing electric vehicles to provide practical transit services. IR thermography, in conjunction with air leakage pressurization diagnostics, has proven to be an excellent tool for developing energy-efficient bus designs as well as a valuable in-service performance testing method. This paper is based on tests performed on several Advanced Vehicle Systems, Inc. electric buses during research performed under Northeast Alternative Vehicle Consortium and Defense Advanced Research Projects Agency grants. The work demonstrates the thermographic methods used and the real- world increased performance of retrofitted and newly designed buses resulting from this initial Portland Transit retrofit project and in a follow-up project to develop a cold weather specification for a new generation of electric buses. Early diagnostic and new-technology follow-up thermographic performance testing was paralleled by energy modeling of early baseline and re-designed vehicles. Modeling and performance data are included. As a result of this research, thermography, air-leakage/pressurization testing, and fog analysis techniques are now being used regularly in research and development and quality assurance procedures by electric bus manufacturers.

Evaluation of commercial ELISA kits for the detection of antibodies against bluetongue virus.

PubMed

Niedbalski, W

2011-01-01

The aim of this study was to estimate the diagnostic value of different commercially available ELISA kits for the detection of bluetongue virus (BTV) antibodies in infected and vaccinated animals. The relative specificity of ELISA kits was evaluated using a panel of sera originating from healthy cattle, never vaccinated nor exposed to BTV. All ELISA kits applied had a high relative specificity (99.3 - 100%). The relative sensitivity of ELISA kits assessed using a panel of sera collected from BTV infected cattle was also high and similar for all the kits (97.3 - 100%). However, the relative sensitivity evaluated on the basis of testing vaccinated animals was different: the highest sensitivity was found for Ingenasa, PrioCHECK and ID VET ELISAs (96.5 - 98.3%). Slightly lower sensitivity was calculated for Pourquier and LSI kits (82.8% and 85.4%, respectively) and much lower sensitivity was found for VMRD ELISA kit (69.5%). The repeatability of BTV ELISA kits was expressed as a coefficient of variation (CV) of results of sera tested 5 times in the same day and in different days by the period of 2 months, by the same person, in the same conditions, and by using the same equipment. The CVs of sera tested in all ELISA kits ranged from 6.1 to 9.8% and were below 10% threshold adopted as a maximum for the acceptable repeatability of the method. In conclusion, it can be stated that the applied ELISA kits can be a valuable diagnostic tool for the serological monitoring studies in the BTV contaminated premises. All the methods are very specific and sensitive when testing BTV infected animals. Nevertheless, the Ingenasa and PrioCHECK can be the most useful in sero-surveillance of livestock following vaccination.

[Evaluation of serology as a diagnostic method for Helicobacter pylori infection in the local population of Guayaquil].

PubMed

Zapatier, Jorge A; Gómez, Néstor A; Vargas, Paola E; Maya, Susana V

2007-06-01

The infection with Helicobacter pylori (H. pylori), and the diagnostic efficacy of the serologic tests has certain variability among the different geographic regions. The objective of the present work was to find the local validation of serological methods for diagnosis of H. pylori infection and to determine the best cutoff value for the local population. Forty-eight patients were evaluated, 27 males and 21 females, with a mean age of 29.2 years. On each patient, 3 tests for H. pylori diagnosis were performed: IgG serology, IgA serology and histology. We performed IgG and IgA serologic test for H. pylori infection and a histological examination for each patient. Efficacy parameters as well as the ROC curve were obtained for the IgG and IgA serology using histology as the gold standard. The cutoff point with the highest efficacy for IgG serology was 16 U/ml (sensitivity 81%, specificity 65%, positive predictive value 81%, negative predictive value 65%, and accuracy 75%), and for IgA serology was 17 U/ml (sensitivity 61%, specificity 53%, positive predictive value 70%, negative predictive value 43%, and accuracy 58%). The area under the curve was 67.1% (CI 95%: 50 to 84.1) and 54.4% (CI 95%: 38.3 to 72.5) for IgG and IgA respectively. The serology is a valuable tool in our population with high prevalence of H. pylori, especially due to its low cost and easy performance, but a reduction ofthe cutoff value was necessary to obtain more sensibility and a more adequate identification of true positives cases.

Certified reference materials for testing of the presence/absence of Staphylococcus aureus enterotoxin A (SEA) in cheese.

PubMed

Zeleny, Reinhard; Nia, Yacine; Schimmel, Heinz; Mutel, Isabelle; Hennekinne, Jacques-Antoine; Emteborg, Håkan; Charoud-Got, Jean; Auvray, Frédéric

2016-08-01

Staphylococcal enterotoxins (SEs) account for a substantial number of food-poisoning outbreaks. European legislation (Commission Regulation 1441/2007) stipulates the reference procedure for SE analysis in milk and dairy products, which is based on extraction, dialysis concentration and immunochemical detection using one of two approved assays (VIDAS(®) SET2, Ridascreen(®) SET Total). However, certified reference materials (CRMs) are lacking to support laboratories in performing reliable detection of Staphylococcus aureus enterotoxin A (SEA) in relevant matrices at sub-nanogram per gram levels. The certification of a set of three reference materials (blank and two SEA-containing materials) for testing of the presence/absence of SEA in cheese is described. The reference procedure was applied in an intercomparison with 15 laboratories, and results were reported in a qualitative manner (presence or absence of SEA in the sample). No false-negative or false-positive results were obtained. The certified values were stated as diagnostic specificity (blank material) or diagnostic sensitivity (SEA-containing materials) and were 100 % in all cases. Stability studies demonstrated suitable material stability when stored cooled or frozen. An in-house study on the recovery of SEA in the cheese materials using a double-sandwich enzyme-linked immunosorbent assay (ELISA) revealed comparable recovery values of around 45 % at the two spiking levels and in both the SEA-containing CRMs as well as blank CRM freshly spiked prior to analysis. The values were also comparable over time and among different analysts. The materials provide valuable support to laboratories for method validation and method performance verification and will increase the reliability of measuring SEA in cheese.

Serological approaches for the diagnosis of schistosomiasis - A review.

PubMed

Hinz, Rebecca; Schwarz, Norbert G; Hahn, Andreas; Frickmann, Hagen

2017-02-01

Schistosomiasis is a common disease in endemic areas of Sub-Saharan Africa, South America and Asia. It is rare in Europe, mainly imported from endemic countries due to travelling or human migration. Available methods for the diagnosis of schistosomiasis comprise microscopic, molecular and serological approaches, with the latter detecting antigens or antibodies associated with Schistosoma spp. infection. The serological approach is a valuable screening tool in low-endemicity settings and for travel medicine, though the interpretation of any diagnostic results requires knowledge of test characteristics and a patient's history. Specific antibody detection by most currently used assays is only possible in a relatively late stage of infection and does not allow for the differentiation of acute from previous infections for therapeutic control or the discrimination between persisting infection and re-infection. Throughout the last decades, new target antigens have been identified, and assays with improved performance and suitability for use in the field have been developed. For numerous assays, large-scale studies are still required to reliably characterise assay characteristics alone and in association with other available methods for the diagnosis of schistosomiasis. Apart from S. mansoni, S. haematobium and S. japonicum, for which most available tests were developed, other species of Schistosoma that occur less frequently need to be taken into account. This narrative review describes and critically discusses the results of published studies on the evaluation of serological assays that detect antibodies against different Schistosoma species of humans. It provides insights into the diagnostic performance and an overview of available assays and their suitability for large-scale use or individual diagnosis, and thus sets the scene for serological diagnosis of schistosomiasis and the interpretation of results. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Exosome separation using microfluidic systems: size-based, immunoaffinity-based and dynamic methodologies.

PubMed

Yang, Fang; Liao, Xiangzhi; Tian, Yuan; Li, Guiying

2017-04-01

Exosomes, nanovesicles secreted by most types of cells, exist in virtually all bodily fluids. Their rich nucleic acid and protein content make them potentially valuable biomarkers for noninvasive molecular diagnostics. They also show promise, after further development, to serve as a drug delivery system. Unfortunately, existing exosome separation technologies, such as ultracentrifugation and methods incorporating magnetic beads, are time-consuming, laborious and separate only exosomes of low purity. Thus, a more effective separation method is highly desirable. Microfluidic platforms are ideal tools for exosome separation, since they enable fast, cost-efficient, portable and precise processing of nanoparticles and small volumes of liquid samples. Recently, several microfluidic-based exosome separation technologies have been studied. In this article, the advantages of the most recent technologies, as well as their limitations, challenges and potential uses in novel microfluidic exosome separation and collection applications is reviewed. This review outlines the uses of new powerful microfluidic exosome detection tools for biologists and clinicians, as well as exosome separation tools for microfluidic engineers. Current challenges of exosome separation methodologies are also described, in order to highlight areas for future research and development. Copyright © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Method for detecting damage in carbon-fibre reinforced plastic-steel structures based on eddy current pulsed thermography

NASA Astrophysics Data System (ADS)

Li, Xuan; Liu, Zhiping; Jiang, Xiaoli; Lodewijks, Gabrol

2018-01-01

Eddy current pulsed thermography (ECPT) is well established for non-destructive testing of electrical conductive materials, featuring the advantages of contactless, intuitive detecting and efficient heating. The concept of divergence characterization of the damage rate of carbon fibre-reinforced plastic (CFRP)-steel structures can be extended to ECPT thermal pattern characterization. It was found in this study that the use of ECPT technology on CFRP-steel structures generated a sizeable amount of valuable information for comprehensive material diagnostics. The relationship between divergence and transient thermal patterns can be identified and analysed by deploying mathematical models to analyse the information about fibre texture-like orientations, gaps and undulations in these multi-layered materials. The developed algorithm enabled the removal of information about fibre texture and the extraction of damage features. The model of the CFRP-glue-steel structures with damage was established using COMSOL Multiphysics® software, and quantitative non-destructive damage evaluation from the ECPT image areas was derived. The results of this proposed method illustrate that damaged areas are highly affected by available information about fibre texture. This proposed work can be applied for detection of impact induced damage and quantitative evaluation of CFRP structures.

Telepsychiatry and Virtual Reality an the Teatment of Patients with Intellectual and Developmental Disabilities.

PubMed

Krysta, Krzysztof; Krzystanek, Marek; Cubała, Wiesław J; Wiglusz, Mariusz S; Jakuszkowiak-Wojten, Katarzyna; Gałuszko-Węgielnik, Maria; Czarnowska-Cubała, Monika; Szarmach, Joanna; Włodarczyk, Adam; Janas-Kozik, Małgorzata

2017-09-01

Treatment and rehabilitation of people with intellectual and developmental disabilities is a multidisciplinary challenge, which require implementing new attitudes. The use of modern technology solutions like telepsychiatry or virtual reality may be a valuable addition to the traditional methods. The objective of this review was to explore the usability of new technological solutions in this special population of patients. The search in the PubMed was conducted using the following terms: (intellectual disability (Title/Abstract) OR developmental disability OR learning disorder (Title/Abstract)) AND virtual reality (Title/Abstract) OR telepsychiatry OR telemedicine OR e-mental health AND English (lang) AND (1995/01/01(PDAT): 2017/07/31(PDAT)). Telepsychiatry may be a useful tool in situations, when the direct access to professional assistance is limited, in solving particular problems like e.g. managing challenging behavior, also to support patients' parents and for diagnostic and educational purposes. Virtual reality can be a safe and effective method of improving different skills, developing physical fitness, and enriching the ways of spending the leisure time. Using modern technology is a relatively new and promising field in which new ideas may develop to support the already existing services for patients with intellectual and developmental disabilities.

Early-Stage Aggregation of Human Islet Amyloid Polypeptide

NASA Astrophysics Data System (ADS)

Guo, Ashley; de Pablo, Juan

Human islet amyloid polypeptide (hIAPP, or human amylin) is implicated in the development of type II diabetes. hIAPP is known to aggregate into amyloid fibrils; however, it is prefibrillar oligomeric species, rather than mature fibrils, that are proposed to be cytotoxic. In order to better understand the role of hIAPP aggregation in the onset of disease, as well as to design effective diagnostics and therapeutics, it is crucial to understand the mechanism of early-stage hIAPP aggregation. In this work, we use atomistic molecular dynamics simulations combined with multiple advanced sampling techniques to examine the formation of the hIAPP dimer and trimer. Metadynamics calculations reveal a free energy landscape for the hIAPP dimer, which suggest multiple possible transition pathways. We employ finite temperature string method calculations to identify favorable pathways for dimer and trimer formation, along with relevant free energy barriers and intermediate structures. Results provide valuable insights into the mechanisms and energetics of hIAPP aggregation. In addition, this work demonstrates that the finite temperature string method is an effective tool in the study of protein aggregation. Funded by National Institute of Standards and Technology.

Proteomics Tracing the Footsteps of Infectious Disease.

PubMed

Greco, Todd M; Cristea, Ileana M

2017-04-01

Every year, a major cause of human disease and death worldwide is infection with the various pathogens-viruses, bacteria, fungi, and protozoa-that are intrinsic to our ecosystem. In efforts to control the prevalence of infectious disease and develop improved therapies, the scientific community has focused on building a molecular picture of pathogen infection and spread. These studies have been aimed at defining the cellular mechanisms that allow pathogen entry into hosts cells, their replication and transmission, as well as the core mechanisms of host defense against pathogens. The past two decades have demonstrated the valuable implementation of proteomic methods in all these areas of infectious disease research. Here, we provide a perspective on the contributions of mass spectrometry and other proteomics approaches to understanding the molecular details of pathogen infection. Specifically, we highlight methods used for defining the composition of viral and bacterial pathogens and the dynamic interaction with their hosts in space and time. We discuss the promise of MS-based proteomics in supporting the development of diagnostics and therapies, and the growing need for multiomics strategies for gaining a systems view of pathogen infection. © 2017 by The American Society for Biochemistry and Molecular Biology, Inc.

Differential Targeting of Unpaired Bases within Duplex DNA by the Natural Compound Clerocidin: A Valuable Tool to Dissect DNA Secondary Structure

PubMed Central

Nadai, Matteo; Palù, Giorgio; Palumbo, Manlio; Richter, Sara N.

2012-01-01

Non-canonical DNA structures have been postulated to mediate protein-nucleic acid interactions and to function as intermediates in the generation of frame-shift mutations when errors in DNA replication occur, which result in a variety of diseases and cancers. Compounds capable of binding to non-canonical DNA conformations may thus have significant diagnostic and therapeutic potential. Clerocidin is a natural diterpenoid which has been shown to selectively react with single-stranded bases without targeting the double helix. Here we performed a comprehensive analysis on several non-canonical DNA secondary structures, namely mismatches, nicks, bulges, hairpins, with sequence variations in both the single-stranded region and the double-stranded flanking segment. By analysis of clerocidin reactivity, we were able to identify the exposed reactive residues which provided information on both the secondary structure and the accessibility of the non-paired sites. Mismatches longer than 1 base were necessary to be reached by clerocidin reactive groups, while 1-base nicks were promptly targeted by clerocidin; in hairpins, clerocidin reactivity increased with the length of the hairpin loop, while, interestingly, reactivity towards bulges reached a maximum in 3-base-long bulges and declined in longer bulges. Electrophoretic mobility shift analysis demonstrated that bulges longer than 3 bases (i.e. 5- and 7-bases) folded or stacked on the duplex region therefore being less accessible by the compound. Clerocidin thus represents a new valuable diagnostic tool to dissect DNA secondary structures. PMID:23285245

Differential targeting of unpaired bases within duplex DNA by the natural compound clerocidin: a valuable tool to dissect DNA secondary structure.

PubMed

Nadai, Matteo; Palù, Giorgio; Palumbo, Manlio; Richter, Sara N

2012-01-01

Non-canonical DNA structures have been postulated to mediate protein-nucleic acid interactions and to function as intermediates in the generation of frame-shift mutations when errors in DNA replication occur, which result in a variety of diseases and cancers. Compounds capable of binding to non-canonical DNA conformations may thus have significant diagnostic and therapeutic potential. Clerocidin is a natural diterpenoid which has been shown to selectively react with single-stranded bases without targeting the double helix. Here we performed a comprehensive analysis on several non-canonical DNA secondary structures, namely mismatches, nicks, bulges, hairpins, with sequence variations in both the single-stranded region and the double-stranded flanking segment. By analysis of clerocidin reactivity, we were able to identify the exposed reactive residues which provided information on both the secondary structure and the accessibility of the non-paired sites. Mismatches longer than 1 base were necessary to be reached by clerocidin reactive groups, while 1-base nicks were promptly targeted by clerocidin; in hairpins, clerocidin reactivity increased with the length of the hairpin loop, while, interestingly, reactivity towards bulges reached a maximum in 3-base-long bulges and declined in longer bulges. Electrophoretic mobility shift analysis demonstrated that bulges longer than 3 bases (i.e. 5- and 7-bases) folded or stacked on the duplex region therefore being less accessible by the compound. Clerocidin thus represents a new valuable diagnostic tool to dissect DNA secondary structures.

Detection of Mycobacterium tuberculosis resistance mutations to rifampin and isoniazid by real-time PCR.

PubMed

Hristea, A; Otelea, D; Paraschiv, S; Macri, A; Baicus, C; Moldovan, O; Tinischi, M; Arama, V; Streinu-Cercel, A

2010-01-01

The objective of our study was to evaluate the use of a real-time polymerase chain reaction (PCR)-based technique for the prediction of phenotypic resistance of Mycobacterium tuberculosis. We tested 67 M tuberculosis strains (26 drug resistant and 41 drug susceptible) using a method recommended for the LightCycler platform. The susceptibility testing was performed by the absolute concentration method. For rifampin resistance, two regions of the rpoB gene were targeted, while for identification of isoniazid resistance, we searched for mutations in katG and inhA genes. The sensitivity and specificity of this method for rapid detection of mutations for isoniazid resistance were 96% (95% CI: 88% to 100%) and 95% (95% CI: 89% to 100%), respectively. For detection of rifampin resistance, the sensitivity and specificity were 92% (95% CI: 81% to 100%) and 74% (95% CI: 61% to 87%), respectively. The main isoniazid resistance mechanism identified in our isolates is related to changes in the katG gene that encodes catalase. We found that for rifampin resistance the concordance between the predicted and observed phenotype was less than satisfactory. Using this method, the best accuracy for genotyping compared with phenotypic resistance testing was obtained for detecting isoniazid resistance mutations. Although real-time PCR assay may be a valuable diagnostic tool, it is not yet completely satisfactory for detection of drug resistance mutations in M tuberculosis.

[Current macro-diagnostic trends of forensic medicine in the Czech Republic].

PubMed

Frišhons, Jan; Kučerová, Štěpánka; Jurda, Mikoláš; Sokol, Miloš; Vojtíšek, Tomáš; Hejna, Petr

2017-01-01

Over the last few years, advanced diagnostic methods have penetrated in the realm of forensic medicine in addition to standard autopsy techniques supported by traditional X-ray examination and macro-diagnostic laboratory tests. Despite the progress of imaging methods, the conventional autopsy has remained basic and essential diagnostic tool in forensic medicine. Postmortem computed tomography and magnetic resonance imaging are far the most progressive modern radio diagnostic methods setting the current trend of virtual autopsies all over the world. Up to now, only two institutes of forensic medicine have available postmortem computed tomography for routine diagnostic purposes in the Czech Republic. Postmortem magnetic resonance is currently unattainable for routine diagnostic use and was employed only for experimental purposes. Photogrammetry is digital method focused primarily on body surface imaging. Recently, the most fruitful results have been yielded from the interdisciplinary cooperation between forensic medicine and forensic anthropology with the implementation of body scanning techniques and 3D printing. Non-invasive and mini-invasive investigative methods such as postmortem sonography and postmortem endoscopy was unsystematically tested for diagnostic performance with good outcomes despite of limitations of these methods in postmortem application. Other futuristic methods, such as the use of a drone to inspect the crime scene are still experimental tools. The authors of the article present a basic overview of the both routinely and experimentally used investigative methods and current macro-diagnostic trends of the forensic medicine in the Czech Republic.

Diagnostic Profiles: A Standard Setting Method for Use with a Cognitive Diagnostic Model

ERIC Educational Resources Information Center

Skaggs, Gary; Hein, Serge F.; Wilkins, Jesse L. M.

2016-01-01

This article introduces the Diagnostic Profiles (DP) standard setting method for setting a performance standard on a test developed from a cognitive diagnostic model (CDM), the outcome of which is a profile of mastered and not-mastered skills or attributes rather than a single test score. In the DP method, the key judgment task for panelists is a…

Reticulocyte hemoglobin measurement--comparison of two methods in the diagnosis of iron-restricted erythropoiesis.

PubMed

Thomas, Lothar; Franck, Susanne; Messinger, Maren; Linssen, Jo; Thomé, Marcus; Thomas, Christian

2005-01-01

The aims of this study were to diagnose iron-restricted erythropoiesis (functional iron deficiency) in patients with classic iron deficiency (ID), anemia of chronic disease (ACD) and the combined state of ID/ACD with the use of two hematological methods for the measurement of reticulocyte hemoglobinization. In comparison, the biochemical markers of iron status were determined. We studied 474 anemic patients admitted to hospital with a broad spectrum of diseases. We measured indicators of reticulocyte hemoglobinization. CHr was determined on an Advia 120 hematology analyzer. A Sysmex XE-2100 hematology analyzer was used to determine RET-Y, the forward scatter of fluorescence-labeled reticulocytes, which can also be expressed as the reticulocyte hemoglobin equivalent (RET-H(e)), as well as RBC-Y, the forward scatter of fluorescence-labeled erythrocytes, which can be expressed as the erythrocyte hemoglobin equivalent. Ferritin, soluble transferrin receptor (sTfR) and the sTfR/log ferritin ratio (sTfR-F index) were used as biochemical markers. The comparison of RET-Y with CHr demonstrated an excellent curvilinear relationship between the two parameters. The normal reference range for Ret-Y was 1630-1860 arbitrary units (AU); mathematical transformation to RET-H(e) gave a range of 28.2-35.7 pg. Correlations of biochemical iron markers with RET-H(e) were as weak as with CHr in patients with ACD and acute phase response. In a diagnostic plot to identify iron status, RET-H(e) could replace CHr without any loss of sensitivity or specificity. Patient mismatch analysis between RET-H(e) and CHr in the diagnostic plot demonstrated agreement for 449 of 474 patients (94.4%). Patient specific anemia mismatches were 2.9-6.2%. According to our results, the indicators of reticulocyte hemoglobinization, RET-H(e) and CHr, measure the same phenomenon. RET-H(e) is as valuable as CHr for the diagnosis of iron-restricted erythropoiesis. The combination of RET-H(e) and the sTfR-F index in a diagnostic plot offers an attractive tool for the evaluation of iron status and identification of the progression of ID.

The diagnostic value and histologic correlate of distinct patterns of shiny white streaks for the diagnosis of melanoma: A retrospective, case-control study.

PubMed

Verzi, Anna Eliza; Quan, Victor L; Walton, Kara E; Martini, Mary C; Marghoob, Ashfaq A; Garfield, Erin M; Kong, Betty Y; Isales, Maria Cristina; VandenBoom, Timothy; Zhang, Bin; West, Dennis P; Gerami, Pedram

2018-05-01

Shiny white streaks (SWSs) are best visualized with polarized dermoscopy and correlate with dermal fibroplasia histopathologically. SWSs have been described at higher frequencies in melanomas than in benign nevi. We assessed the diagnostic value of different patterns of SWSs and their histologic correlate in melanocytic lesions. Polarized dermoscopic images of 1507 histopathologically diagnosed melanocytic neoplasms were analyzed for presence and pattern of SWSs. Histology was also reviewed for correlation. Among 1507 melanocytic neoplasms, SWSs were observed in 31 of 144 melanomas (22%) and 22 of 1363 benign neoplasms (1.6%) (P < .001). The sensitivity and specificity of SWSs for melanoma were 22% and 98%, respectively. Diffuse SWSs exhibited the greatest diagnostic value for melanoma, with sensitivity of 11.8% and specificity of 99.5%. Focal central and peripheral SWSs were comparable in diagnostic significance. The presence of SWSs was highly uncommon in dysplastic nevi, whereas in certain benign subgroups of nevi such as Spitz nevi and atypical genital special site nevi, SWSs were not uncommon. Diffuse SWSs correlated with greater breadth of deep fibroplasia than focal SWSs (P = .009), and SWSs correlated with greater Breslow depth among melanomas (P = .007). This study was retrospective. Polarized dermoscopy is a valuable diagnostic tool in the identification of SWSs, a feature that is highly specific for melanoma. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Non-invasive vascular radial/circumferential strain imaging and wall shear rate estimation using video images of diagnostic ultrasound.

PubMed

Wan, Jinjin; He, Fangli; Zhao, Yongfeng; Zhang, Hongmei; Zhou, Xiaodong; Wan, Mingxi

2014-03-01

The aim of this work was to develop a convenient method for radial/circumferential strain imaging and shear rate estimation that could be used as a supplement to the current routine screening for carotid atherosclerosis using video images of diagnostic ultrasound. A reflection model-based correction for gray-scale non-uniform distribution was applied to B-mode video images before strain estimation to improve the accuracy of radial/circumferential strain imaging when applied to vessel transverse cross sections. The incremental and cumulative radial/circumferential strain images can then be calculated based on the displacement field between consecutive B-mode images. Finally, the transverse Doppler spectra acquired at different depths along the vessel diameter were used to construct the spatially matched instantaneous wall shear values in a cardiac cycle. Vessel phantom simulation results revealed that the signal-to-noise ratio and contrast-to-noise ratio of the radial and circumferential strain images were increased by 2.8 and 5.9 dB and by 2.3 and 4.4 dB, respectively, after non-uniform correction. Preliminary results for 17 patients indicated that the accuracy of radial/circumferential strain images was improved in the lateral direction after non-uniform correction. The peak-to-peak value of incremental strain and the maximum cumulative strain for calcified plaques are evidently lower than those for other plaque types, and the echolucent plaques had higher values, on average, than the mixed plaques. Moreover, low oscillating wall shear rate values, found near the plaque and stenosis regions, are closely related to plaque formation. In conclusion, the method described can provide additional valuable results as a supplement to the current routine ultrasound examination for carotid atherosclerosis and, therefore, has significant potential as a feasible screening method for atherosclerosis diagnosis in the future. Copyright © 2014 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Hotspot electron temperature from x-ray continuum measurements on the NIF

NASA Astrophysics Data System (ADS)

Jarrott, L. C.; Benedetti, L. R.; Chen, H.; Izumi, N.; Khan, S. F.; Ma, T.; Nagel, S. R.; Landen, O. L.; Pak, A.; Patel, P. K.; Schneider, M.; Scott, H. A.

2016-11-01

We report on measurements of the electron temperature in the hotspot of inertially confined, layered, spherical implosions on the National Ignition Facility using a differential filtering diagnostic. Measurements of the DT and DD ion temperatures using neutron time-of-flight detectors are complicated by the contribution of hot spot motion to the peak width, which produce an apparent temperature higher than the thermal temperature. The electron temperature is not sensitive to this non-thermal velocity and is thus a valuable input to interpreting the stagnated hot spot conditions. Here we show that the current differential filtering diagnostic provides insufficient temperature resolution for the hot spot temperatures of interest. We then propose a new differential filter configuration utilizing larger pinhole size to increase spectral fluence, as well as thicker filtration. This new configuration will improve measurement uncertainty by more than a factor of three, allowing for a more accurate hotspot temperature.

The history of imaging in obstetrics.

PubMed

Benson, Carol B; Doubilet, Peter M

2014-11-01

During the past century, imaging of the pregnant patient has been performed with radiography, scintigraphy, computed tomography, magnetic resonance imaging, and ultrasonography (US). US imaging has emerged as the primary imaging modality, because it provides real-time images at relatively low cost without the use of ionizing radiation. This review begins with a discussion of the history and current status of imaging modalities other than US for the pregnant patient. The discussion then turns to an in-depth description of how US technology advanced to become such a valuable diagnostic tool in the obstetric patient. Finally, the broad range of diagnostic uses of US in these patients is presented, including its uses for distinguishing an intrauterine pregnancy from a failed or ectopic pregnancy in the first trimester; assigning gestational age and assessing fetal weight; evaluating the fetus for anomalies and aneuploidy; examining the uterus, cervix, placenta, and amniotic fluid; and guiding obstetric interventional procedures.

Development of a miRNA-based diagnostic assay for pancreatic ductal adenocarcinoma.

PubMed

Szafranska-Schwarzbach, Anna E; Adai, Alex T; Lee, Linda S; Conwell, Darwin L; Andruss, Bernard F

2011-04-01

Diagnosis of pancreatic cancer remains a clinical challenge. Both chronic pancreatitis and pancreatic cancer may present with similar symptoms and similar imaging features, often leading to incorrect interpretation. Thus, the use of an objective molecular test that can discriminate between chronic pancreatitis and pancreatic cancer will be a valuable asset in obtaining a definitive diagnosis of pancreatic cancer. Following Clinical Laboratory Improvement Amendments and College of American Pathologists guidelines, Asuragen Clinical Services Laboratory has developed and validated a laboratory-developed test, miRInform(®) Pancreas, to aid in the identification of pancreatic ductal adenocarcinoma. This molecular diagnostic tool uses reverse-transcription quantitative PCR to measure the expression difference between two miRNAs, miR-196a and miR-217, in fixed tissue specimens. This article describes the test validation process as well as determination of performance parameters of miRInform Pancreas.

Hotspot electron temperature from x-ray continuum measurements on the NIF.

PubMed

Jarrott, L C; Benedetti, L R; Chen, H; Izumi, N; Khan, S F; Ma, T; Nagel, S R; Landen, O L; Pak, A; Patel, P K; Schneider, M; Scott, H A

2016-11-01

We report on measurements of the electron temperature in the hotspot of inertially confined, layered, spherical implosions on the National Ignition Facility using a differential filtering diagnostic. Measurements of the DT and DD ion temperatures using neutron time-of-flight detectors are complicated by the contribution of hot spot motion to the peak width, which produce an apparent temperature higher than the thermal temperature. The electron temperature is not sensitive to this non-thermal velocity and is thus a valuable input to interpreting the stagnated hot spot conditions. Here we show that the current differential filtering diagnostic provides insufficient temperature resolution for the hot spot temperatures of interest. We then propose a new differential filter configuration utilizing larger pinhole size to increase spectral fluence, as well as thicker filtration. This new configuration will improve measurement uncertainty by more than a factor of three, allowing for a more accurate hotspot temperature.

Practical diagnostic testing for human immunodeficiency virus.

PubMed Central

Jackson, J B; Balfour, H H

1988-01-01

Since the discovery of human immunodeficiency virus (HIV) as the causative agent of acquired immunodeficiency syndrome in 1983, there has been a proliferation of diagnostic tests. These assays can be used to detect the presence of HIV antibody, HIV antigen, HIV ribonucleic and deoxyribonucleic acids, and HIV reverse transcriptase. Enzyme-linked immunosorbent assays, Western blot, radioimmunoprecipitation assays, indirect immunofluorescence assays, reverse transcriptase assays, and several molecular hybridization techniques are currently available. Enzyme-linked immunosorbent, Western blot, and indirect immunofluorescence assays for HIV antibody are very sensitive, specific, and adaptable to most laboratories. An enzyme-linked immunosorbent assay for HIV antigen is also readily adaptable to most laboratories and will be commercially available soon. While the other assays are more tedious, they are valuable confirmatory tests and are suitable for reference laboratories. The biohazards of performing HIV testing can be minimized with proper biosafety measures. Images PMID:3060241

Metaphyseal chondrodysplasia.

PubMed Central

Spranger, J. W.

1977-01-01

Any review of the metaphyseal chondrodysplasias is complicated by their variety and mainly unknown pathogenesis. The more familiar types display considerable clinical and radiological diversity: even more so the rarer disorders which still require complete definition, but differences in their mode of inheritance make diagnostic precision mandatory. These dysplasias present in infancy or in childhood, when the patient, usually dwarfed, may be proportionate, so that some forms may be confused with rickets or other lesions. Mental retardation is unusual, but the skin, hair, nails and facies provide valuable diagnostic features. Radiological abnormalities mainly affect the metaphyses of the shortened limb bones, less often the skull, vertebrae, pelvis, ribs and extremities, and sometimes their distribution may indicate the specific type of dysplasia. In a further complex group multiple systems are involved, notably the pancreas, intestine and lympho-reticular, causing malabsorption and haematological or immunological disorders. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 PMID:335375

Testing of the masonry arches of the Brooklyn Bridge approaches

NASA Astrophysics Data System (ADS)

Limaye, Hemant S.

1996-11-01

Diagnostic procedures play an important role in performing a condition survey of a structure. Specialized tests are used during a field survey to supplement visual observations. The tests provide valuable information regarding the internal condition of the structure and quality of the construction materials. The tests also help in determining the extent of damage, if any. Recently, a team of consulting engineers performed a study to determine the remaining capacity of the Brooklyn Bridge approaches for the Department of Transportation, City of New York. Using advanced diagnostic procedures such as impact-echo and flatjack testing, additional information was gathered to assist in the study. Impact-echo testing was helpful in identifying the condition of the brick soffits which were covered with pneumatically- applied concrete, and flatjack testing was useful in determining in-situ compressive strength and compression modulus of the brick masonry. The paper describes the work and the testing results.

Advancing the research agenda for diagnostic error reduction.

PubMed

Zwaan, Laura; Schiff, Gordon D; Singh, Hardeep

2013-10-01

Diagnostic errors remain an underemphasised and understudied area of patient safety research. We briefly summarise the methods that have been used to conduct research on epidemiology, contributing factors and interventions related to diagnostic error and outline directions for future research. Research methods that have studied epidemiology of diagnostic error provide some estimate on diagnostic error rates. However, there appears to be a large variability in the reported rates due to the heterogeneity of definitions and study methods used. Thus, future methods should focus on obtaining more precise estimates in different settings of care. This would lay the foundation for measuring error rates over time to evaluate improvements. Research methods have studied contributing factors for diagnostic error in both naturalistic and experimental settings. Both approaches have revealed important and complementary information. Newer conceptual models from outside healthcare are needed to advance the depth and rigour of analysis of systems and cognitive insights of causes of error. While the literature has suggested many potentially fruitful interventions for reducing diagnostic errors, most have not been systematically evaluated and/or widely implemented in practice. Research is needed to study promising intervention areas such as enhanced patient involvement in diagnosis, improving diagnosis through the use of electronic tools and identification and reduction of specific diagnostic process 'pitfalls' (eg, failure to conduct appropriate diagnostic evaluation of a breast lump after a 'normal' mammogram). The last decade of research on diagnostic error has made promising steps and laid a foundation for more rigorous methods to advance the field.

Method matters: Understanding diagnostic reliability in DSM-IV and DSM-5.

PubMed

Chmielewski, Michael; Clark, Lee Anna; Bagby, R Michael; Watson, David

2015-08-01

Diagnostic reliability is essential for the science and practice of psychology, in part because reliability is necessary for validity. Recently, the DSM-5 field trials documented lower diagnostic reliability than past field trials and the general research literature, resulting in substantial criticism of the DSM-5 diagnostic criteria. Rather than indicating specific problems with DSM-5, however, the field trials may have revealed long-standing diagnostic issues that have been hidden due to a reliance on audio/video recordings for estimating reliability. We estimated the reliability of DSM-IV diagnoses using both the standard audio-recording method and the test-retest method used in the DSM-5 field trials, in which different clinicians conduct separate interviews. Psychiatric patients (N = 339) were diagnosed using the SCID-I/P; 218 were diagnosed a second time by an independent interviewer. Diagnostic reliability using the audio-recording method (N = 49) was "good" to "excellent" (M κ = .80) and comparable to the DSM-IV field trials estimates. Reliability using the test-retest method (N = 218) was "poor" to "fair" (M κ = .47) and similar to DSM-5 field-trials' estimates. Despite low test-retest diagnostic reliability, self-reported symptoms were highly stable. Moreover, there was no association between change in self-report and change in diagnostic status. These results demonstrate the influence of method on estimates of diagnostic reliability. (c) 2015 APA, all rights reserved).

The use of optical coherence tomography in maxillofacial surgery

NASA Astrophysics Data System (ADS)

Al-Obaidi, Mohammed; Tandon, Rahul; Tiwana, Paul

2015-02-01

The ever-evolving medical field continues to trend toward less invasive approaches to the diagnosis and treatment of pathological conditions. Basic sciences research has allowed for improved technologies that are translated to the clinical sciences. Similarly, advancements in imaging modalities continue to improve and their applications become more varied. As such, surgeons and pathologists are able to depend on smaller samples for tissue diagnosis of pathological disease, where once large sections of tissue were needed. Optical coherence tomography (OCT), a high-resolution imaging technique, has been used extensively in different medical fields to improve diagnostic yield. Its use in dental fields, particularly in oral and maxillofacial surgery, remains limited. Our goal is to assess the use of OCT for improving soft tissue analysis and diagnosis, particularly for its applications in the field of oral and maxillofacial surgery. Optical coherence tomography is a modality that uses an optical signal using safe near-infrared light which is reflected off the sub-surface structures. This allows for high-resolution cross-sectional images of the tissue morphology to be obtained. Ophthalmologists have been using OCT to obtain images of the retina to assess for age-related macular degeneration. More recently, OCT has been used by Interventional Cardiology to image coronary arteries, and assess plaque thickness and morphology. This technology is now being investigated in several medical fields as a form of optical biopsy, providing in situ images with high-resolution morphology of tissues. We are particularly interested in its use on epithelial tissues, and therefore performed a literature review on the use of OCT for assessing epithelium. Evaluation of histologically-diagnosed actinic keratosis, for example, was found to correlate well with the imaging discrepancies found on OCT; and the in vivo assessment of atypical keratinocytes was firmly established. Additionally, studies have shown a potential application in that OCT may provide a method for studying the evolution of epithelial lesions OCT's potential in producing high-resolution images of tissue morphology can prove to be a valuable tool for characterizing different soft tissue pathological disorders. Furthermore, it has been shown to measure changes in light intensity at tissue-fluid interfaces, which can provide surgeons the ability to characterize oral mucosal surfaces noninvasively. OCT can also prove to be valuable in detecting oral cancerous and pre-cancerous lesions, as altered epithelium containing increased dysplasia shows differences in light scattering than normal epithelium. Additionally, OCT has been shown to analyze deeper collagen tissues of the oral mucosa and is not limited to the surface epithelium. This can aid in characterizing such inflammatory conditions that alter these tissues. Several tissue samples from the maxillofacial region were obtained and assessed using an OCT device at our institution. The analysis has shown high-resolution images of soft tissue-bone interface, titanium implant-bone interface, and other anatomical sites within the oral cavity. OCT has been shown to be a valuable modality in different medical fields. Its use in oral and maxillofacial surgery can potentially aid in diagnostic techniques. Alongside traditional histological technique, it can be help characterize tissues at the cellular level, which would improve costs, time, and most importantly, patient care. We aim to introduce OCT and its diagnostic abilities to the field of oral and maxillofacial surgery to help aid clinicians and provide improved care for patients.

Antibodies against C1q Are a Valuable Serological Marker for Identification of Systemic Lupus Erythematosus Patients with Active Lupus Nephritis

PubMed Central

Chi, Shuhong; Yu, Yunxia; Shi, Juan; Zhang, Yurong; Yang, Jijuan; Yang, Lijuan; Liu, Xiaoming

2015-01-01

Objective. An early diagnosis of lupus nephritis (LN) has an important clinical implication in guiding treatments of systemic lupus erythematosus (SLE) in clinical settings. In this study, the diagnostic values of circulating autoantibodies to C1q alone or in combination with other markers for accessing active SLE and LN were evaluated. Methods. The diagnostic value of anti-C1q autoantibodies for identification of patients with active SLE disease and LN was evaluated by analyzing the level of anti-C1q antibodies in sera from 95 SLE patients, 40 non-SLE patients, and 34 healthy cohorts. Results. The prevalence of anti-C1q antibodies was significantly higher in patients with SLE (50/95, 52.6%), active SLE (40/51, 78.4%), and LN (30/35, 85.7%) in comparison with non-SLE patient controls, patients with inactive SLE, and non-LN, respectively. A combination of anti-C1q with anti-dsDNA and/or levels of complements C3 and C4 exhibited an increased specificity but a decreased sensitivity for identification of patients with active SLE and LN diseases relative to each of these markers alone. Conclusion. Anti-C1q antibodies were strongly associated with disease activity and LN in SLE patients, suggesting that it may be a reliable serological marker for identification of SLE patients with active LN and active SLE disease. PMID:26549923

Association between mean platelet volume and bone mineral density in patients with ankylosing spondylitis and diagnostic value of diffusion-weighted magnetic resonance imaging

PubMed Central

Resorlu, Hatice; Resorlu, Mustafa; Gokmen, Ferhat; Akbal, Ayla; Adam, Gurhan; Komurcu, Erkam; Goksel, Ferdi; Guven, Mustafa; Aras, Adem Bozkurt; Sariyildirim, Abdullah; Cevizci, Sibel

2015-01-01

[Purpose] The aim this study was to assess the relation between bone mineral density (BMD) and mean platelet volume (MPV) in ankylosing spondylitis (AS) patients, and evaluate the diagnostic role of the diffusion-weighted magnetic resonance imaging (MRI). [Subjects and Methods] Fifty patients diagnosed with AS were divided into two groups on the basis of BMD, a normal group (n=30) and an osteopenic (n=20) group. [Results] Duration of disease in the group with a normal BMD was 10.3±7.0 years, while it was 16.7±12.2 years in the osteopenia group. MPV was high in the osteopenia group, while no significant differences were observed between the groups in terms of apparent diffusion coefficient (ADC) and platelet distribution width (PDW). There was a positive correlation between MPV and duration of disease. Correlations between ADC value and the lumbar T score, femoral neck T score, and duration of disease were insignificant. A negative correlation was observed between BMD and disease duration. [Conclusion] Diffusion-weighted imaging provides valuable results in osteoporosis but is not a suitable technique for evaluating BMD in patients with AS because of the local and systemic inflammatory effects in the musculoskeletal system. The common pathophysiology of atherosclerosis and osteoporosis plays an important role in the negative correlation observed between MPV and BMD in patients with AS. PMID:25995574

Bioabsorbable Stent Quo Vadis: A Case for Nano-Theranostics

PubMed Central

Gundogan, Buket; Tan, Aaron; Farhatnia, Yasmin; Alavijeh, Mohammad S.; Cui, Zhanfeng; Seifalian, Alexander M.

2014-01-01

Percutaneous coronary intervention (PCI) is one of the most commonly performed invasive medical procedures in medicine today. Since the first coronary balloon angioplasty in 1977, interventional cardiology has seen a wide array of developments in PCI. Bare metal stents (BMS) were soon superseded by the revolutionary drug-eluting stents (DES), which aimed to address the issue of restenosis found with BMS. However, evidence began to mount against DES, with late-stent thrombosis (ST) rates being higher than that of BMS. The bioabsorbable stent may be a promising alternative, providing vessel patency and support for the necessary time required and thereafter degrade into safe non-toxic compounds which are reabsorbed by the body. This temporary presence provides no triggers for ST, which is brought about by non-endothelialized stent struts and drug polymers remaining in vivo for extended periods of time. Likewise, nano-theranostics incorporated into a bioabsorbable stent of the future may provide an incredibly valuable single platform offering both therapeutic and diagnostic capabilities. Such a stent may allow delivery of therapeutic particles to specific sites thus keeping potential toxicity to a minimum, improved ease of tracking delivery in vivo by embedding imaging agents, controlled rate of therapy release and protection of the implanted therapy. Indeed, nanocarriers may allow an increased therapeutic index as well as offer novel post-stent implantation imaging and diagnostic methods for atherosclerosis, restenosis and thrombosis. It is envisioned that a nano-theranostic stent may well form the cornerstone of future stent designs in clinical practice. PMID:24672583

A parallelizable real-time motion tracking algorithm with applications to ultrasonic strain imaging.

PubMed

Jiang, J; Hall, T J

2007-07-07

Ultrasound-based mechanical strain imaging systems utilize signals from conventional diagnostic ultrasound systems to image tissue elasticity contrast that provides new diagnostically valuable information. Previous works (Hall et al 2003 Ultrasound Med. Biol. 29 427, Zhu and Hall 2002 Ultrason. Imaging 24 161) demonstrated that uniaxial deformation with minimal elevation motion is preferred for breast strain imaging and real-time strain image feedback to operators is important to accomplish this goal. The work reported here enhances the real-time speckle tracking algorithm with two significant modifications. One fundamental change is that the proposed algorithm is a column-based algorithm (a column is defined by a line of data parallel to the ultrasound beam direction, i.e. an A-line), as opposed to a row-based algorithm (a row is defined by a line of data perpendicular to the ultrasound beam direction). Then, displacement estimates from its adjacent columns provide good guidance for motion tracking in a significantly reduced search region to reduce computational cost. Consequently, the process of displacement estimation can be naturally split into at least two separated tasks, computed in parallel, propagating outward from the center of the region of interest (ROI). The proposed algorithm has been implemented and optimized in a Windows system as a stand-alone ANSI C++ program. Results of preliminary tests, using numerical and tissue-mimicking phantoms, and in vivo tissue data, suggest that high contrast strain images can be consistently obtained with frame rates (10 frames s(-1)) that exceed our previous methods.

Autism in Action: Reduced Bodily Connectedness during Social Interactions?

PubMed

Peper, C Lieke E; van der Wal, Sija J; Begeer, Sander

2016-01-01

Autism is a lifelong disorder, defined by deficits in social interactions and flexibility. To date, diagnostic markers for autism primarily include limitations in social behavior and cognition. However, such tests have often shown to be inadequate for individuals with autism who are either more cognitively able or intellectually disabled. The assessment of the social limitations of autism would benefit from new tests that capture the dynamics of social initiative and reciprocity in interaction processes, and that are not dependent on intellectual or verbal skills. New entry points for the development of such assessments may be found in 'bodily connectedness', the attunement of bodily movement between two individuals. In typical development, bodily connectedness is related to psychological connectedness, including social skills and relation quality. Limitations in bodily connectedness could be a central mechanism underlying the social impairment in autism. While bodily connectedness can be minutely assessed with advanced techniques, our understanding of these skills in autism is limited. This Perspective provides examples of how the potential relation between bodily connectedness and specific characteristics of autism can be examined using methods from the coordination dynamics approach. Uncovering this relation is particularly important for developing sensitive tools to assess the tendency to initiate social interactions and the dynamics of mutual adjustments during social interactions, as current assessments are not suited to grasp ongoing dynamics and reciprocity in behavior. The outcomes of such research may yield valuable openings for the development of diagnostic markers for autism that can be applied across the lifespan.

Estimation of the diagnostic performance of two ELISAs to detect PCV2 antibodies in pig sera using a Bayesian method.

PubMed

Fablet, C; Rose, N; Bernard, C; Messager, I; Piel, Y; Grasland, B

2017-11-01

This study was designed to assess the diagnostic characteristics of two PCV2 ELISAs without a gold standard. Four hundred and sixty-five serum samples from finishing pigs (25 herds) not vaccinated against PCV2 were used. Samples were tested by two ELISAs: an in-house ELISA (I-ELISA) and the commercial SERELISA ® PCV2 Ab Mono Blocking kit (S-ELISA). A ROC curve was used to assess the S-ELISA's optimal threshold by taking the I-ELISA as a reference and using the cut-off previously determined by comparison to an cccmonolayer assay (IPMA). This led to an S-ELISA result ≥170 being considered as positive. The sensitivity (Se) and specificity (Sp) of each ELISA were then estimated without a gold standard using a Bayesian approach. The mean Se and Sp values of the I-ELISA were slightly higher than those of the S-ELISA (mean Se I-ELISA=0.90 vs. mean Se S-ELISA=0.86; mean Sp I-ELISA=0.92 vs. mean Sp S-ELISA=0.85). However, the 95% credibility intervals (CI95%) overlapped (Se I-ELISA CI95%=0.85-0.95 vs. Se S-ELISA CI95%=0.82-0.90; Sp I-ELISA CI95%=0.82-0.98 vs. Sp S-ELISA CI95%=0.75-0.94). Both ELISAs appeared to be valuable tools for detecting PCV2 antibodies. Copyright © 2017 Elsevier B.V. All rights reserved.

Plasma lipidomics reveals potential lipid markers of major depressive disorder.

PubMed

Liu, Xinyu; Li, Jia; Zheng, Peng; Zhao, Xinjie; Zhou, Chanjuan; Hu, Chunxiu; Hou, Xiaoli; Wang, Haiyang; Xie, Peng; Xu, Guowang

2016-09-01

Major depressive disorder (MDD) is a grave debilitating mental disease with a high incidence and severely impairs quality of life. Therefore, its physiopathological basis study and diagnostic biomarker discovery are extremely valuable. In this study, a non-targeted lipidomics strategy using ultra performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF/MS) was performed to reveal differential lipids between MDD (n = 60) and healthy controls (HCs, n = 60). Validation of changed lipid species was performed in an independent batch including 75 MDD and 52 HC using the same lipidomic method. Pronouncedly changed lipid species in MDD were discovered, which mainly were lysophosphatidylcholine (LPC), lysophosphatidylethanolamine (LPE), phosphatidylcholine (PC), phosphatidylethanolamine (PE), phosphatidylinositol (PI), 1-O-alkyl-2-acyl-PE (PE O), 1-O-alkyl-2-acyl-PC (PC O), sphingomyelin (SM), diacylglycerol (DG), and triacylglycerol (TG). Among these lipid species, LPC, LPE, PC, PE, PI, TG, etc. remarkably increased in MDD and showed pronounced positive relationships with depression severity, while 1-O-alkyl-2-acyl-PE and SM with odd summed carbon number significantly decreased in MDD and demonstrated negative relationships with depression severity. A combinational lipid panel including LPE 20:4, PC 34:1, PI 40:4, SM 39:1, 2, and TG 44:2 was defined as potential diagnostic biomarker with a good sensitivity and specificity for distinguishing MDD from HCs. Our study brings insights into lipid metabolism disorder in MDD and provides a specific potential biomarker for MDD diagnose.

Evaluation of an automated connective tissue disease screening assay in Korean patients with systemic rheumatic diseases

PubMed Central

Jeong, Seri; Yang, Heeyoung; Hwang, Hyunyong

2017-01-01

This study aimed to evaluate the diagnostic utilities of the automated connective tissues disease screening assay, CTD screen, in patients with systemic rheumatic diseases. A total of 1093 serum samples were assayed using CTD screen and indirect immunofluorescent (IIF) methods. Among them, 162 were diagnosed with systemic rheumatic disease, including rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and mixed connective tissue disease (MCT). The remaining 931 with non-systemic rheumatic disease were assigned to the control group. The median ratios of CTD screen tests were significantly higher in the systemic rheumatic disease group than in the control group. The positive likelihood ratios of the CTD screen were higher than those of IIF in patients with total rheumatic diseases (4.1 vs. 1.6), including SLE (24.3 vs. 10.7). The areas under the receiver operating characteristic curves (ROC-AUCs) of the CTD screen for discriminating total rheumatic diseases, RA, SLE, and MCT from controls were 0.68, 0.56, 0.92 and 0.80, respectively. The ROC-AUCs of the combinations with IIF were significantly higher in patients with total rheumatic diseases (0.72) and MCT (0.85) than in those of the CTD screen alone. Multivariate analysis indicated that both the CTD screen and IIF were independent variables for predicting systemic rheumatic disease. CTD screen alone and in combination with IIF were a valuable diagnostic tool for predicting systemic rheumatic diseases, particularly for SLE. PMID:28273146

Evaluation of an automated connective tissue disease screening assay in Korean patients with systemic rheumatic diseases.

PubMed

Jeong, Seri; Yang, Heeyoung; Hwang, Hyunyong

2017-01-01

This study aimed to evaluate the diagnostic utilities of the automated connective tissues disease screening assay, CTD screen, in patients with systemic rheumatic diseases. A total of 1093 serum samples were assayed using CTD screen and indirect immunofluorescent (IIF) methods. Among them, 162 were diagnosed with systemic rheumatic disease, including rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and mixed connective tissue disease (MCT). The remaining 931 with non-systemic rheumatic disease were assigned to the control group. The median ratios of CTD screen tests were significantly higher in the systemic rheumatic disease group than in the control group. The positive likelihood ratios of the CTD screen were higher than those of IIF in patients with total rheumatic diseases (4.1 vs. 1.6), including SLE (24.3 vs. 10.7). The areas under the receiver operating characteristic curves (ROC-AUCs) of the CTD screen for discriminating total rheumatic diseases, RA, SLE, and MCT from controls were 0.68, 0.56, 0.92 and 0.80, respectively. The ROC-AUCs of the combinations with IIF were significantly higher in patients with total rheumatic diseases (0.72) and MCT (0.85) than in those of the CTD screen alone. Multivariate analysis indicated that both the CTD screen and IIF were independent variables for predicting systemic rheumatic disease. CTD screen alone and in combination with IIF were a valuable diagnostic tool for predicting systemic rheumatic diseases, particularly for SLE.

WE-G-217BCD-04: Diagnostic Image Quality Evaluation of a Dedicated Extremity Cone- Beam CT Scanner: Pre-Clinical Studies and First Clinical Results.

PubMed

Muhit, A; Zbijewski, W; Stayman, J; Thawait, G; Yorkston, J; Foos, D; Packard, N; Yang, D; Senn, R; Carrino, J; Siewerdsen, J

2012-06-01

To assess the diagnostic performance of a prototype cone-beam CT (CBCT) scanner developed for musculoskeletal extremity imaging. Studies involved controlled observer studies conducted subsequent to rigorous technical assessment as well as patient images from the first clinical trial in imaging the hand and knee. Performance assessment included: 1.) rigorous technical assessment; 2.) controlled observer studies using CBCT images of cadaveric specimens; and 3.) first clinical images. Technical assessment included measurement of spatial resolution (MTF), constrast, and noise (SDNR) versus kVp and dose using standard CT phantoms. Diagnostic performance in comparison to multi- detector CT (MDCT) was assessed in controlled observer studies involving 12 cadaveric hands and knees scanned with and without abnormality (fracture). Observer studies involved five radiologists rating pertinent diagnostics tasks in 9-point preference and 10-point diagnostic satisfaction scales. Finally, the first clinical images from an ongoing pilot study were assessed in terms of diagnostic utility in disease assessment and overall workflow in patient setup. Quantitative assessment demonstrated sub-mm spatial resolution (MTF exceeding 10% out to 15-20 cm-1) and SDNR sufficient for relevant soft-tissue visualization tasks at dose <10 mGy. Observer studies confirmed optimal acquisition techniques and demonstrated superior utility of combined soft-tissue visualization and isotropic spatial resolution in diagnostic tasks. Images from the patient trial demonstrate exquisite contrast and detail and the ability to detect tissue impingement in weight-bearing exams. The prototype CBCT scanner provides isotropic spatial resolution superior to standard-protocol MDCT with soft-tissue visibility sufficient for a broad range of diagnostic tasks in musculoskeletal radiology. Dosimetry and workflow were advantageous in comparison to whole-body MDCT. Multi-mode and weight-bearing capabilities add valuable functionality. An ongoing clinical study further assesses diagnostic utility and defines the role of such technology in the diagnostic arsenal. - Research Grant, Carestream Health - Research Grant, National Institutes of Health 2R01-CA-112163. © 2012 American Association of Physicists in Medicine.

X-rays from the eclipsing pulsar 1957+20

NASA Technical Reports Server (NTRS)

Fruchter, A. S.; Bookbinder, J.; Garcia, M. R.; Bailyn, C. D.

1992-01-01

The detection of soft X-rays of about 1 keV energy from the eclipsing pulsar PSR1957+20 is reported. This high-energy radiation should be a valuable diagnostic of the wind in this recycled pulsar system. Possible sources of the X-ray emission are the interstellar nebula driven by the pulsar wind, the interaction between the pulsar and its evaporating companion, and the pulsar itself. The small apparent size of the X-ray object argues against the first of these possibilities and suggests that the X-rays are produced within the binary.

What is the fate of runaway positrons in tokamaks?

DOE PAGES

Liu, Jian; Qin, Hong; Fisch, Nathaniel J.; ...

2014-06-19

In this study, massive runaway positrons are generated by runaway electrons in tokamaks. The fate of these positrons encodes valuable information about the runaway dynamics. The phase space dynamics of a runaway position is investigated using a Lagrangian that incorporates the tokamak geometry, loop voltage, radiation and collisional effects. It is found numerically that runaway positrons will drift out of the plasma to annihilate on the first wall, with an in-plasma annihilation possibility less than 0.1%. The dynamics of runaway positrons provides signatures that can be observed as diagnostic tools.

Atypical psychotic symptoms and Dandy-Walker variant.

PubMed

Williams, Aislinn J; Wang, Zhenni; Taylor, Stephan F

2016-10-01

New-onset psychotic symptoms often respond well to antipsychotic treatment; however, symptoms may be difficult to treat when an underlying brain malformation is present. Here, we present a case of atypical psychotic symptoms in the context of a congenital cerebellar malformation (Dandy-Walker variant). The patient ultimately improved with paliperidone palmitate after multiple antipsychotic medication trials (both oral and one long-acting injectable) were ineffective. Neuroimaging may provide valuable diagnostic and prognostic information in cases of new-onset psychosis with atypical features and treatment resistance, even in the absence of neurologic signs and symptoms.

Recognition of Potentially Novel Human Disease-Associated Pathogens by Implementation of Systematic 16S rRNA Gene Sequencing in the Diagnostic Laboratory▿ †

PubMed Central

Keller, Peter M.; Rampini, Silvana K.; Büchler, Andrea C.; Eich, Gerhard; Wanner, Roger M.; Speck, Roberto F.; Böttger, Erik C.; Bloemberg, Guido V.

2010-01-01

Clinical isolates that are difficult to identify by conventional means form a valuable source of novel human pathogens. We report on a 5-year study based on systematic 16S rRNA gene sequence analysis. We found 60 previously unknown 16S rRNA sequences corresponding to potentially novel bacterial taxa. For 30 of 60 isolates, clinical relevance was evaluated; 18 of the 30 isolates analyzed were considered to be associated with human disease. PMID:20631113

Laryngeal Electromyography Techniques and Clinical Use.

PubMed

Kimaid, Paulo Andre Teixeira; Crespo, Agrício Nubiato; Moreira, Ana Lucila; Wolf, Aline Epiphanio; França, Marcondes Cavalcante

2015-08-01

Laryngeal electromyography is considered a valuable diagnostic tool for voice disorders. The technique, described almost 70 years ago, evolved 3 decades later, mainly because of the growing interest of laryngologists and speech pathologists. In the authors' opinion, the reduced number of neurophysiologists involved in laryngeal electromyography groups is, at some instance, related to the difficulty to start the learning process and the multidisciplinary approach the field requires. This review highlights the anatomy and physiology needed to perform laryngeal electromyography and its clinical usefulness in the new field known as neurolaryngology.

What is the fate of runaway positrons in tokamaks?

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

Liu, Jian; Qin, Hong, E-mail: hongqin@ustc.edu.cn; Princeton Plasma Physics Laboratory, Princeton University, Princeton, New Jersey 08543

2014-06-15

Massive runaway positrons are generated by runaway electrons in tokamaks. The fate of these positrons encodes valuable information about the runaway dynamics. The phase space dynamics of a runaway position is investigated using a Lagrangian that incorporates the tokamak geometry, loop voltage, radiation and collisional effects. It is found numerically that runaway positrons will drift out of the plasma to annihilate on the first wall, with an in-plasma annihilation possibility less than 0.1%. The dynamics of runaway positrons provides signatures that can be observed as diagnostic tools.

Engineered proteins as specific binding reagents.

PubMed

Binz, H Kaspar; Plückthun, Andreas

2005-08-01

Over the past 30 years, monoclonal antibodies have become the standard binding proteins and currently find applications in research, diagnostics and therapy. Yet, monoclonal antibodies now face strong competition from synthetic antibody libraries in combination with powerful library selection technologies. More recently, an increased understanding of other natural binding proteins together with advances in protein engineering, selection and evolution technologies has also triggered the exploration of numerous other protein architectures for the generation of designed binding molecules. Valuable protein-binding scaffolds have been obtained and represent promising alternatives to antibodies for biotechnological and, potentially, clinical applications.

[Gas gangrene or inflammation of the neck--diagnostic difficulties].

PubMed

Kedzierski, B; Całka, K; Wilczyński, K; Bojarski, B; Jaźwiec, P; Bogdał, M T; Stokrocki, W

2000-01-01

The authors describe a patient with an extensive inflammation of the neck soft tissues as a complication of the peritonsillar abscess. Follow-up computed tomography revealed gasi-form follicles in the inflammed neck soft tissues, suggesting gas gangrene. We report disseminate ways of the inflammation process on the financial tonsil, reasons of the gangrene also the infections of soft tissues caused by anaerobic bacteries--Clostridium. CT--examination in inflammatory tumors of the neck is valuable, permits to exclude expansion process, but it cannot give unequivocal answer to differentiate gas gangrene and phlegmon.

Aircraft Engine Gas Path Diagnostic Methods: Public Benchmarking Results

NASA Technical Reports Server (NTRS)

Simon, Donald L.; Borguet, Sebastien; Leonard, Olivier; Zhang, Xiaodong (Frank)

2013-01-01

Recent technology reviews have identified the need for objective assessments of aircraft engine health management (EHM) technologies. To help address this issue, a gas path diagnostic benchmark problem has been created and made publicly available. This software tool, referred to as the Propulsion Diagnostic Method Evaluation Strategy (ProDiMES), has been constructed based on feedback provided by the aircraft EHM community. It provides a standard benchmark problem enabling users to develop, evaluate and compare diagnostic methods. This paper will present an overview of ProDiMES along with a description of four gas path diagnostic methods developed and applied to the problem. These methods, which include analytical and empirical diagnostic techniques, will be described and associated blind-test-case metric results will be presented and compared. Lessons learned along with recommendations for improving the public benchmarking processes will also be presented and discussed.

Proposal for a recovery prediction method for patients affected by acute mediastinitis

PubMed Central

2012-01-01

Background An attempt to find a prediction method of death risk in patients affected by acute mediastinitis. There is not such a tool described in available literature for that serious disease. Methods The study comprised 44 consecutive cases of acute mediastinitis. General anamnesis and biochemical data were included. Factor analysis was used to extract the risk characteristic for the patients. The most valuable results were obtained for 8 parameters which were selected for further statistical analysis (all collected during few hours after admission). Three factors reached Eigenvalue >1. Clinical explanations of these combined statistical factors are: Factor1 - proteinic status (serum total protein, albumin, and hemoglobin level), Factor2 - inflammatory status (white blood cells, CRP, procalcitonin), and Factor3 - general risk (age, number of coexisting diseases). Threshold values of prediction factors were estimated by means of statistical analysis (factor analysis, Statgraphics Centurion XVI). Results The final prediction result for the patients is constructed as simultaneous evaluation of all factor scores. High probability of death should be predicted if factor 1 value decreases with simultaneous increase of factors 2 and 3. The diagnostic power of the proposed method was revealed to be high [sensitivity =90%, specificity =64%], for Factor1 [SNC = 87%, SPC = 79%]; for Factor2 [SNC = 87%, SPC = 50%] and for Factor3 [SNC = 73%, SPC = 71%]. Conclusion The proposed prediction method seems a useful emergency signal during acute mediastinitis control in affected patients. PMID:22574625

Glaucoma history and risk factors.

PubMed

McMonnies, Charles W

Apart from the risk of developing glaucoma there is also the risk that it is not detected and irreversible loss of vision ensues. Some studies of methods of glaucoma diagnosis have examined the results of instrument-based examinations with great if not complete reliance on objective findings in arriving at a diagnosis. The very valuable advances in glaucoma detection instrument technologies, and apparent increasing dependence on them, may have led to reduced consideration of information available from a patient history in those studies. Dependence on objective evidence of glaucomatous pathology may reduce the possibility of detecting glaucoma suspects or patients at risk for becoming glaucoma suspects. A valid positive family history of glaucoma is very valuable information. However, negative family histories can often be unreliable due to large numbers of glaucoma cases being undiagnosed. No evidence of family history is appropriate rather than no family history. In addition the unreliability of a negative family history is increased when patients with glaucoma fail to inform their family members. A finding of no family history can only be stated as no known family history. In examining the potential diagnostic contribution from a patient history, this review considers, age, frailty, race, type and degree of refractive error, systemic hyper- and hypotension, vasospasm, migraine, pigmentary dispersion syndrome, pseudoexfoliation syndrome, obstructive sleep apnea syndrome, diabetes, medication interactions and side effects, the degree of exposure to intraocular and intracranial pressure elevations and fluctuations, smoking, and symptoms in addition to genetics and family history of the disease. Copyright © 2016 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.

Calibrating the X-ray attenuation of liquid water and correcting sample movement artefacts during in operando synchrotron X-ray radiographic imaging of polymer electrolyte membrane fuel cells.

PubMed

Ge, Nan; Chevalier, Stéphane; Hinebaugh, James; Yip, Ronnie; Lee, Jongmin; Antonacci, Patrick; Kotaka, Toshikazu; Tabuchi, Yuichiro; Bazylak, Aimy

2016-03-01

Synchrotron X-ray radiography, due to its high temporal and spatial resolutions, provides a valuable means for understanding the in operando water transport behaviour in polymer electrolyte membrane fuel cells. The purpose of this study is to address the specific artefact of imaging sample movement, which poses a significant challenge to synchrotron-based imaging for fuel cell diagnostics. Specifically, the impact of the micrometer-scale movement of the sample was determined, and a correction methodology was developed. At a photon energy level of 20 keV, a maximum movement of 7.5 µm resulted in a false water thickness of 0.93 cm (9% higher than the maximum amount of water that the experimental apparatus could physically contain). This artefact was corrected by image translations based on the relationship between the false water thickness value and the distance moved by the sample. The implementation of this correction method led to a significant reduction in false water thickness (to ∼0.04 cm). Furthermore, to account for inaccuracies in pixel intensities due to the scattering effect and higher harmonics, a calibration technique was introduced for the liquid water X-ray attenuation coefficient, which was found to be 0.657 ± 0.023 cm(-1) at 20 keV. The work presented in this paper provides valuable tools for artefact compensation and accuracy improvements for dynamic synchrotron X-ray imaging of fuel cells.

A multispectral imaging approach for diagnostics of skin pathologies

NASA Astrophysics Data System (ADS)

Lihacova, Ilze; Derjabo, Aleksandrs; Spigulis, Janis

2013-06-01

Noninvasive multispectral imaging method was applied for different skin pathology such as nevus, basal cell carcinoma, and melanoma diagnostics. Developed melanoma diagnostic parameter, using three spectral bands (540 nm, 650 nm and 950 nm), was calculated for nevus, melanoma and basal cell carcinoma. Simple multispectral diagnostic device was established and applied for skin assessment. Development and application of multispectral diagnostics method described further in this article.

Validation of Diagnostic Groups Based on Health Care Utilization Data Should Adjust for Sampling Strategy.

PubMed

Cadieux, Geneviève; Tamblyn, Robyn; Buckeridge, David L; Dendukuri, Nandini

2017-08-01

Valid measurement of outcomes such as disease prevalence using health care utilization data is fundamental to the implementation of a "learning health system." Definitions of such outcomes can be complex, based on multiple diagnostic codes. The literature on validating such data demonstrates a lack of awareness of the need for a stratified sampling design and corresponding statistical methods. We propose a method for validating the measurement of diagnostic groups that have: (1) different prevalences of diagnostic codes within the group; and (2) low prevalence. We describe an estimation method whereby: (1) low-prevalence diagnostic codes are oversampled, and the positive predictive value (PPV) of the diagnostic group is estimated as a weighted average of the PPV of each diagnostic code; and (2) claims that fall within a low-prevalence diagnostic group are oversampled relative to claims that are not, and bias-adjusted estimators of sensitivity and specificity are generated. We illustrate our proposed method using an example from population health surveillance in which diagnostic groups are applied to physician claims to identify cases of acute respiratory illness. Failure to account for the prevalence of each diagnostic code within a diagnostic group leads to the underestimation of the PPV, because low-prevalence diagnostic codes are more likely to be false positives. Failure to adjust for oversampling of claims that fall within the low-prevalence diagnostic group relative to those that do not leads to the overestimation of sensitivity and underestimation of specificity.

The provision of out-of-hours care and associated costs in an urban area of Switzerland: a cost description study

PubMed Central

2010-01-01

Background In Switzerland, General Practitioners (GPs) play an important role for out-of-hours emergency care as one service option beside freely accessible and costly emergency departments of hospitals. The aim of this study was to evaluate the services provided and the economic consequences of a Swiss GP out-of-hours service. Methods GPs participating in the out-of-hours service in the city of Zurich collected data on medical problems (ICPC coding), mode of contact, mode of resource use and services provided (time units; diagnostics; treatments). From a health care insurance perspective, we assessed the association between total costs and its two components (basic costs: charges for time units and emergency surcharge; individual costs: charges for clinical examination, diagnostics and treatment in the discretion of the GP). Results 125 GPs collected data on 685 patient contacts. The most prevalent health problems were of respiratory (24%), musculoskeletal (13%) and digestive origin (12%). Home visits (61%) were the most common contact mode, followed by practice (25%) and telephone contacts (14%). 82% of patients could be treated by ambulatory care. In 20% of patients additional technical diagnostics, most often laboratory tests, were used. The mean total costs for one emergency patient contact were €144 (95%-CI: 137-151). The mode of contact was an important determinant of total costs (mean total costs for home visits: €176 [95%-CI: 168-184]; practice contact: €90 [95%-CI: 84-98]; telephone contact: €48 [95%-CI: 40-55]). Basic costs contributed 83% of total costs for home visits and 70% of total costs for practice contacts. Individual mean costs were similarly low for home visits (€30) and practice contacts (€27). Medical problems had no relevant influence on this cost pattern. Conclusions GPs managed most emergency demand in their out-of-hours service by ambulatory care. They applied little diagnostic testing and basic care. Our findings are of relevance for policy makers even from other countries with different pricing policies. Policy makers should be interested in a reimbursement system promoting out-of-hours care run by GPs as one valuable service option. PMID:21171989

Differential Diagnosis of Malaria on Truelab Uno®, a Portable, Real-Time, MicroPCR Device for Point-Of-Care Applications.

PubMed

Nair, Chandrasekhar Bhaskaran; Manjula, Jagannath; Subramani, Pradeep Annamalai; Nagendrappa, Prakash B; Manoj, Mulakkapurath Narayanan; Malpani, Sukriti; Pullela, Phani Kumar; Subbarao, Pillarisetti Venkata; Ramamoorthy, Siva; Ghosh, Susanta K

2016-01-01

Sensitive and specific detection of malarial parasites is crucial in controlling the significant malaria burden in the developing world. Also important is being able to identify life threatening Plasmodium falciparum malaria quickly and accurately to reduce malaria related mortality. Existing methods such as microscopy and rapid diagnostic tests (RDTs) have major shortcomings. Here, we describe a new real-time PCR-based diagnostic test device at point-of-care service for resource-limited settings. Truenat® Malaria, a chip-based microPCR test, was developed by bigtec Labs, Bangalore, India, for differential identification of Plasmodium falciparum and Plasmodium vivax parasites. The Truenat Malaria tests runs on bigtec's Truelab Uno® microPCR device, a handheld, battery operated, and easy-to-use real-time microPCR device. The performance of Truenat® Malaria was evaluated versus the WHO nested PCR protocol. The Truenat® Malaria was further evaluated in a triple-blinded study design using a sample panel of 281 specimens created from the clinical samples characterized by expert microscopy and a rapid diagnostic test kit by the National Institute of Malaria Research (NIMR). A comparative evaluation was done on the Truelab Uno® and a commercial real-time PCR system. The limit of detection of the Truenat Malaria assay was found to be <5 parasites/μl for both P. falciparum and P. vivax. The Truenat® Malaria test was found to have sensitivity and specificity of 100% each, compared to the WHO nested PCR protocol based on the evaluation of 100 samples. The sensitivity using expert microscopy as the reference standard was determined to be around 99.3% (95% CI: 95.5-99.9) at the species level. Mixed infections were identified more accurately by Truenat Malaria (32 samples identified as mixed) versus expert microscopy and RDTs which detected 4 and 5 mixed samples, respectively. The Truenat® Malaria microPCR test is a valuable diagnostic tool and implementation should be considered not only for malaria diagnosis but also for active surveillance and epidemiological intervention.

Neutrophil-to-lymphocyte ratio as a diagnostic biomarker for the diagnosis of acute mesenteric ischemia.

PubMed

Aktimur, R; Cetinkunar, S; Yildirim, K; Aktimur, S H; Ugurlucan, M; Ozlem, N

2016-06-01

Due to the diagnostic challenges and dreadful consequences of delayed treatment of acute mesenteric ischemia (AMI), a variety of diagnostic markers have been previously studied. However, the diagnostic value of neutrophil-to-lymphocyte ratio (NLR), which has been suggested to be a predictor of inflammation, has never been studied for AMI. The data of 70 patients who underwent laparotomy (n = 8) and/or bowel resection (n = 62) for AMI (n = 70) between January 2009 and March 2014 were retrospectively analyzed. To investigate the studied parameters' role in the differential diagnosis of AMI, control groups were selected from most common reasons of inflammation-related emergent surgery, acute appendicitis (AA, n = 62) and normal appendix (NA, n = 61). White blood cell (WBC), red cell distribution width (RDW), NLR and mean platelet volume (MPV) values were recorded. Outcome variables of the study were defined as diagnostic and prognostic role of NLR in AMI. RDW and NLR values were found to be higher in the AMI group than the AA group (p < 0.001 and p < 0.001). Also, WBC and MPV values were higher in the AMI group than the NA group (p = 0.001 and p < 0.001). Combined sensitivity, specificity, positive predictive value and negative predictive value of RDW and NLR for recommended cut-off values were 69.4, 71.2, 57.8 and 80.4 %, respectively. High NLR value (>9.9) seems to be a valuable diagnostic marker of acute mesenteric ischemia. Combined use of NLR, RDW and other clinical assessment, could help the diagnosis of AMI, especially in the absence of advanced imaging modalities and expert radiologic interpretation.

Propulsion Diagnostic Method Evaluation Strategy (ProDiMES) User's Guide

NASA Technical Reports Server (NTRS)

Simon, Donald L.

2010-01-01

This report is a User's Guide for the Propulsion Diagnostic Method Evaluation Strategy (ProDiMES). ProDiMES is a standard benchmarking problem and a set of evaluation metrics to enable the comparison of candidate aircraft engine gas path diagnostic methods. This Matlab (The Mathworks, Inc.) based software tool enables users to independently develop and evaluate diagnostic methods. Additionally, a set of blind test case data is also distributed as part of the software. This will enable the side-by-side comparison of diagnostic approaches developed by multiple users. The Users Guide describes the various components of ProDiMES, and provides instructions for the installation and operation of the tool.

[Methods of statistical analysis in differential diagnostics of the degree of brain glioma anaplasia during preoperative stage].

PubMed

Glavatskiĭ, A Ia; Guzhovskaia, N V; Lysenko, S N; Kulik, A V

2005-12-01

The authors proposed a possible preoperative diagnostics of the degree of supratentorial brain gliom anaplasia using statistical analysis methods. It relies on a complex examination of 934 patients with I-IV degree anaplasias, which had been treated in the Institute of Neurosurgery from 1990 to 2004. The use of statistical analysis methods for differential diagnostics of the degree of brain gliom anaplasia may optimize a diagnostic algorithm, increase reliability of obtained data and in some cases avoid carrying out irrational operative intrusions. Clinically important signs for the use of statistical analysis methods directed to preoperative diagnostics of brain gliom anaplasia have been defined

Diagnostic accuracy of presepsin (sCD14-ST) as a biomarker of infection and sepsis in the emergency department.

PubMed

de Guadiana Romualdo, Luis García; Torrella, Patricia Esteban; Acebes, Sergio Rebollo; Otón, María Dolores Albaladejo; Sánchez, Roberto Jiménez; Holgado, Ana Hernando; Santos, Enrique Jiménez; Freire, Alejandro Ortín

2017-01-01

Presepsin is a promising biomarker for the diagnosis and prognosis of sepsis. However, results reported about its value to diagnose sepsis in an emergency department (ED) are controversial, probably due to differences in the design of the studies. We have evaluated the diagnostic accuracy of presepsin for infection and sepsis, compared with procalcitonin (PCT) and C-reactive protein (CRP), in patients presenting to the emergency department (ED) with suspected infection. 223 patients with suspected infection were enrolled for the study. Blood samples were collected on admission for measurement of biomarkers. Definitive diagnosis was obtained afterwards by analysis of digital medical records. Receiver operating characteristic (ROC) curve analysis was conducted to determine the diagnostic accuracy. Infection was confirmed in 200 patients, including 130 with non-complicated infection and 70 with sepsis. Median CRP, PCT and presepsin levels were significantly higher in patients with infection and sepsis. PCT was the biomarker with the highest performance for infection (ROC AUC: 0.910); for sepsis, PCT (ROC AUC: 0.815) and presepsin (ROC AUC: 0.775) shown a similar performance. Although presepsin is a valuable biomarker for diagnosis of infection and sepsis, its diagnostic accuracy in our study does not improve that of PCT. Its introduction in clinical practice is not justified. Copyright © 2016 Elsevier B.V. All rights reserved.

Secondary prevention at 360°: the important role of diagnostic imaging.

PubMed

Ciarrapico, Anna Micaela; Manenti, Guglielmo; Pistolese, Chiara; Fabiano, Sebastiano; Fiori, Roberto; Romagnoli, Andrea; Sergiacomi, Gianluigi; Stefanini, Matteo; Simonetti, Giovanni

2015-06-01

The aim of this paper is to underline the importance of the role of general practitioners (GPs) in distributing vital information about prevention to citizens, to highlight the importance of the so-called voluntary prevention programmes, both for conditions for which no organised screening programmes exist and for those for which they do exist but may well be obsolete or inefficient. Nowadays, voluntary prevention is made more effective thanks to the new sophisticated diagnostic technologies applied worldwide by diagnostic imaging. Epidemiological data about the incidence and causes of death among the Italian population have shown that screening programmes should be aimed first at fighting the following diseases: prostatic carcinoma, lung cancer, colorectal carcinoma, breast cancer, cardiovascular disease, cerebrovascular disease, aortic and peripheral vascular disease. GPs do not generally give good or adequate instructions concerning voluntary prevention programmes; GPs may not even be aware of this type of prevention which could represent a valuable option together with the existing mass screening programmes. Therefore, in the following analysis, we aim to outline the correct diagnostic pathway for the prevention of diseases having the highest incidence in our country and which represent the most frequent causes of death. If used correctly, these screening programmes may contribute to the success of secondary prevention, limiting the use of tertiary prevention and thus producing savings for the Italian National Health System.

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

NASA Technical Reports Server (NTRS)

Maul, William A.; Fulton, Christopher E.

2011-01-01

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

The predictive value of ventricular CSF removal in normal pressure hydrocephalus.

PubMed

Krauss, J K; Regel, J P

1997-08-01

We report the impact of diagnostic ventricular CSF removal (VCR) on the gait disturbance in 24 patients with suspected normal pressure hydrocephalus (NPH) who had an intraventricular catheter for studies of CSF dynamics in order to select patients for shunt surgery. There were no complications related to removal of 24 ml CSF over a period of 6 hours in four instances or to the removal of 15-18 ml at one time in twenty instances. Seventeen out of 24 patients were diagnosed as having NPH. Two of those patients who had relatively mild symptoms had a prolonged amelioration of their gait disturbance after diagnostic VCR. Thirteen patients underwent subsequent shunt operations. Eleven of them had good functional and symptomatic improvement on follow-up. In those six patients who had a marked amelioration of their gait disturbance after diagnostic VCR, not only improvement of the gait disturbance was observed after shunting, but a consistent overall improvement as well. The predictive value of VCR was more variable in those six patients who had only a moderate response to VCR. No change of the gait disturbance after VCR was noted in seven patients in whom the diagnosis of NPH was not confirmed. Diagnostic VCR might be a valuable ancillary test in specialized centers which routinely use intraventricular CSF monitoring in the selection of patients for shunt surgery.

Polarization of Coronal Forbidden Lines

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

Li, Hao; Qu, Zhongquan; Landi Degl’Innocenti, Egidio, E-mail: sayahoro@ynao.ac.cn

Since the magnetic field is responsible for most manifestations of solar activity, one of the most challenging problems in solar physics is the diagnostics of solar magnetic fields, particularly in the outer atmosphere. To this end, it is important to develop rigorous diagnostic tools to interpret polarimetric observations in suitable spectral lines. This paper is devoted to analyzing the diagnostic content of linear polarization imaging observations in coronal forbidden lines. Although this technique is restricted to off-limb observations, it represents a significant tool to diagnose the magnetic field structure in the solar corona, where the magnetic field is intrinsically weakmore » and still poorly known. We adopt the quantum theory of polarized line formation developed in the framework of the density matrix formalism, and synthesize images of the emergent linear polarization signal in coronal forbidden lines using potential-field source-surface magnetic field models. The influence of electronic collisions, active regions, and Thomson scattering on the linear polarization of coronal forbidden lines is also examined. It is found that active regions and Thomson scattering are capable of conspicuously influencing the orientation of the linear polarization. These effects have to be carefully taken into account to increase the accuracy of the field diagnostics. We also found that linear polarization observation in suitable lines can give valuable information on the long-term evolution of the magnetic field in the solar corona.« less

The impact of systemic cortical alterations on perception

NASA Astrophysics Data System (ADS)

Zhang, Zheng

2011-12-01

Perception is the process of transmitting and interpreting sensory information, and the primary somatosensory (SI) area in the human cortex is the main sensory receptive area for the sensation of touch. The elaborate neuroanatomical connectivity that subserves the neuronal communication between adjacent and near-adjacent regions within sensory cortex has been widely recognized to be essential to normal sensory function. As a result, systemic cortical alterations that impact the cortical regional interaction, as associated with many neurological disorders, are expected to have significant impact on sensory perception. Recently, our research group has developed a novel sensory diagnostic system that employs quantitative sensory testing methods and is able to non-invasively assess central nervous system healthy status. The intent of this study is to utilize quantitative sensory testing methods that were designed to generate discriminable perception to objectively and quantitatively assess the impacts of different conditions on human sensory information processing capacity. The correlation between human perceptions with observations from animal research enables a better understanding of the underlying neurophysiology of human perception. Additional findings on different subject populations provide valuable insight of the underlying mechanisms for the development and maintenance of different neurological diseases. During the course of the study, several protocols were designed and utilized. And this set of sensory-based perceptual metrics was employed to study the effects of different conditions (non-noxious thermal stimulation, chronic pain stage, and normal aging) on sensory perception. It was found that these conditions result in significant deviations of the subjects' tactile information processing capacities from normal values. Although the observed shift of sensory detection sensitivity could be a result of enhanced peripheral activity, the changes in the effects of adaptation most likely reflect changes in central nervous system. The findings in this work provide valuable information for better understanding the underlying mechanisms involved in the development and maintenance of different neurological conditions.

Parametric estimates for the receiver operating characteristic curve generalization for non-monotone relationships.

PubMed

Martínez-Camblor, Pablo; Pardo-Fernández, Juan C

2017-01-01

Diagnostic procedures are based on establishing certain conditions and then checking if those conditions are satisfied by a given individual. When the diagnostic procedure is based on a continuous marker, this is equivalent to fix a region or classification subset and then check if the observed value of the marker belongs to that region. Receiver operating characteristic curve is a valuable and popular tool to study and compare the diagnostic ability of a given marker. Besides, the area under the receiver operating characteristic curve is frequently used as an index of the global discrimination ability. This paper revises and widens the scope of the receiver operating characteristic curve definition by setting the classification subsets in which the final decision is based in the spotlight of the analysis. We revise the definition of the receiver operating characteristic curve in terms of particular classes of classification subsets and then focus on a receiver operating characteristic curve generalization for situations in which both low and high values of the marker are associated with more probability of having the studied characteristic. Parametric and non-parametric estimators of the receiver operating characteristic curve generalization are investigated. Monte Carlo studies and real data examples illustrate their practical performance.

Thai Grade 11 students' alternative conceptions for acid-base chemistry

NASA Astrophysics Data System (ADS)

Artdej, Romklao; Ratanaroutai, Thasaneeya; Coll, Richard Kevin; Thongpanchang, Tienthong

2010-07-01

This study involved the development of a two-tier diagnostic instrument to assess Thai high school students' understanding of acid-base chemistry. The acid-base diagnostic test (ABDT) comprising 18 items was administered to 55 Grade 11 students in a science and mathematics programme during the second semester of the 2008 academic year. Analysis of students' responses from this study followed the methodology outlined by Çalik and Ayas. The research findings suggest that the ABDT, the multiple choice diagnostic instrument, enables researchers and teachers to classify students' understanding at different levels. Most students exhibited alternative conceptions for several concepts: acid-base theory, dissociation of strong acids or bases, and dissociation of weak acids/bases. Interestingly, one of the concepts that students appeared to find most difficult, and for which they exhibited the most alternative conceptions, was acid-base theory. Some alternative conceptions revealed in this study differ from earlier reports, such as the concept of electrolyte and non-electrolyte solutions as well as the concentration changes of H3O+and OH- in water. These research findings present valuable information for facilitating better understanding of acid-base chemistry by providing insight into the preventable and correctable alternative conceptions exhibited by students.

Advances in diagnosis and treatment of latent tuberculosis infection.

PubMed

Chapman, Helena J; Lauzardo, Michael

2014-01-01

In the United States, latent tuberculosis infection (LTBI) affects between 10 and 15 million people, of whom 10% may develop active tuberculosis disease. People at increased risk for tuberculosis reactivation include recent immigrants from countries with a high incidence of tuberculosis, children younger than age 5, people who have been infected with Mycobacterium tuberculosis within the past 2 years, or people with immunosuppression for a variety of reasons. Appropriate diagnosis and treatment of LTBI are critical for controlling and eventually eliminating tuberculosis as a public health problem. Although the tuberculin skin test is the traditional diagnostic measure for LTBI, reduced specificity has promoted the development and utilization of the interferon-γ release assays as an in vitro blood test with specific antigens to M. tuberculosis (QuantiFERON-TB Gold In-Tube test and the T.SPOT-TB test are commercially available). Despite the rise of the new diagnostic tests, however, there is still no gold standard for diagnosing LTBI, and epidemiologic risks and comorbidities need to be taken into account before initiating therapy. Current diagnostic tests combined with recommended treatment regimens are valuable tools that, when used correctly, promise to hurry the elimination of tuberculosis. © Copyright 2014 by the American Board of Family Medicine.

Non-invasive imaging techniques in assessing non-alcoholic fatty liver disease: a current status of available methods

PubMed Central

Lăpădat, AM; Jianu, IR; Ungureanu, BS; Florescu, LM; Gheonea, DI; Sovaila, S; Gheonea, IA

2017-01-01

Non-alcoholic fatty liver disease (NAFLD) is an ailment affecting and increasing a number of people worldwide diagnosed via non-invasive imaging techniques, at a time when a minimum harm caused by medical procedures is rightfully emphasized, more sought after, than ever before. Liver steatosis should not be taken lightly even if its evolution is largely benign as it has the potential to develop into non-alcoholic steatohepatitis (NASH) or even more concerning, hepatic cirrhosis, and hepatocellular carcinoma (HCC). Traditionally, liver biopsy has been the standard for diagnosing this particular liver disease, but nowadays, a consistent number of imagistic methods are available for diagnosing hepatosteatosis and choosing the one appropriate to the clinical context is the key. Although different in sensitivity and specificity when it comes to determining the hepatic fat fraction (FF), these imaging techniques possessing a diverse availability, operating difficulty, cost, and reproducibility are invaluable to any modern physician. Ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), elastography, and spectroscopy will be discussed in order to lay out the advantages and disadvantages of their diagnostic potential and application. Although imagistics has given physicians a valuable insight into the means of managing NAFLD, the current methods are far from perfect, but given the time, they will surely be improved and the use of liver biopsy will be completely removed. PMID:28255371

Clinical Reasoning in Massage Therapy

PubMed Central

LeMoon, Kim

2008-01-01

Background: Clinical reasoning has long been a valuable tool for health care practitioners, but it has been under-researched in the field of massage therapy. Case reports have been a useful method for exploring the clinical reasoning process in various fields of manual therapy and can provide a model for similar research in the field of massage therapy. A diagnostically challenging case concerning a client with low back pain serves as a guideline for examining the clinical reasoning process of a massage therapist. Methods: A two-part methodology was employed: Client profileReflective inquiry The inquiry included questions pertaining to beliefs about health problems; beliefs about the mechanisms of pain; medical conditions that could explain the client’s symptoms; knowledge of the client’s anatomy, assessment, and treatment choices; observations made during treatment; extent of experience in treating similar problems; and ability to recognize clinical patterns. Results: The clinical reasoning process of a massage therapist contributed to a differential diagnosis, which provided an explanation for the client’s symptoms and led to a satisfactory treatment resolution. Conclusion: The present report serves as an example of the value of clinical reasoning in the field of massage therapy, and the need for expanded research into its methods and applications. The results of such research could be beneficial in teaching the clinical reasoning process at both the introductory and the advanced levels of massage therapy education. PMID:21589814

Next-generation sequencing identifies a novel compound heterozygous mutation in MYO7A in a Chinese patient with Usher Syndrome 1B.

PubMed

Wei, Xiaoming; Sun, Yan; Xie, Jiansheng; Shi, Quan; Qu, Ning; Yang, Guanghui; Cai, Jun; Yang, Yi; Liang, Yu; Wang, Wei; Yi, Xin

2012-11-20

Targeted enrichment and next-generation sequencing (NGS) have been employed for detection of genetic diseases. The purpose of this study was to validate the accuracy and sensitivity of our method for comprehensive mutation detection of hereditary hearing loss, and identify inherited mutations involved in human deafness accurately and economically. To make genetic diagnosis of hereditary hearing loss simple and timesaving, we designed a 0.60 MB array-based chip containing 69 nuclear genes and mitochondrial genome responsible for human deafness and conducted NGS toward ten patients with five known mutations and a Chinese family with hearing loss (never genetically investigated). Ten patients with five known mutations were sequenced using next-generation sequencing to validate the sensitivity of the method. We identified four known mutations in two nuclear deafness causing genes (GJB2 and SLC26A4), one in mitochondrial DNA. We then performed this method to analyze the variants in a Chinese family with hearing loss and identified compound heterozygosity for two novel mutations in gene MYO7A. The compound heterozygosity identified in gene MYO7A causes Usher Syndrome 1B with severe phenotypes. The results support that the combination of enrichment of targeted genes and next-generation sequencing is a valuable molecular diagnostic tool for hereditary deafness and suitable for clinical application. Copyright © 2012 Elsevier B.V. All rights reserved.

Diagnostic value of FDG-PET/(CT) in children with fever of unknown origin and unexplained fever during immune suppression.

PubMed

Blokhuis, Gijsbert J; Bleeker-Rovers, Chantal P; Diender, Marije G; Oyen, Wim J G; Draaisma, Jos M Th; de Geus-Oei, Lioe-Fee

2014-10-01

Fever of unknown origin (FUO) and unexplained fever during immune suppression in children are challenging medical problems. The aim of this study is to investigate the diagnostic value of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) and FDG-PET combined with computed tomography (FDG-PET/CT) in children with FUO and in children with unexplained fever during immune suppression. All FDG-PET/(CT) scans performed in the Radboud university medical center for the evaluation of FUO or unexplained fever during immune suppression in the last 10 years were reviewed. Results were compared with the final clinical diagnosis. FDG-PET/(CT) scans were performed in 31 children with FUO. A final diagnosis was established in 16 cases (52 %). Of the total number of scans, 32 % were clinically helpful. The sensitivity and specificity of FDG-PET/CT in these patients was 80 % and 78 %, respectively. FDG-PET/(CT) scans were performed in 12 children with unexplained fever during immune suppression. A final diagnosis was established in nine patients (75 %). Of the total number of these scans, 58 % were clinically helpful. The sensitivity and specificity of FDG-PET/CT in children with unexplained fever during immune suppression was 78 % and 67 %, respectively. FDG-PET/CT appears a valuable imaging technique in the evaluation of children with FUO and in the diagnostic process of children with unexplained fever during immune suppression. Prospective studies of FDG-PET/CT as part of a structured diagnostic protocol are warranted to assess the additional diagnostic value.

Diagnostic value of [(18)F]-FDG PET/CT in children with fever of unknown origin or unexplained signs of inflammation.

PubMed

Jasper, Niklas; Däbritz, Jan; Frosch, Michael; Loeffler, Markus; Weckesser, Matthias; Foell, Dirk

2010-01-01

Fever of unknown origin (FUO) and unexplained signs of inflammation are challenging medical problems especially in children and predominantly caused by infections, malignancies or noninfectious inflammatory diseases. The aim of this study was to assess the diagnostic value of (18)F-FDG PET and PET/CT in the diagnostic work-up in paediatric patients. In this retrospective study, 47 FDG PET and 30 PET/CT scans from 69 children (median age 8.1 years, range 0.2-18.1 years, 36 male, 33 female) were analysed. The diagnostic value of PET investigations in paediatric patients presenting with FUO (44 scans) or unexplained signs of inflammation without fever (33 scans) was analysed. A diagnosis in paediatric patients with FUO or unexplained signs of inflammation could be established in 32 patients (54%). Of all scans, 63 (82%) were abnormal, and of the total number of 77 PET and PET/CT scans 35 (45%) were clinically helpful. In patients with a final diagnosis, scans were found to have contributed to the diagnosis in 73%. Laboratory, demographic or clinical parameters of the children did not predict the usefulness of FDG PET scans. This is the first larger study demonstrating that FDG PET and PET/CT may be valuable diagnostic tools for the evaluation of children with FUO and unexplained signs of inflammation. Depicting inflammation in the whole body, while not being traumatic, it is attractive for use especially in children. The combination of PET with CT seems to be superior, since the site of inflammation can be localized more accurately.

Immunochromatographic diagnostic test analysis using Google Glass.

PubMed

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

2014-03-25

We demonstrate a Google Glass-based rapid diagnostic test (RDT) reader platform capable of qualitative and quantitative measurements of various lateral flow immunochromatographic assays and similar biomedical diagnostics tests. Using a custom-written Glass application and without any external hardware attachments, one or more RDTs labeled with Quick Response (QR) code identifiers are simultaneously imaged using the built-in camera of the Google Glass that is based on a hands-free and voice-controlled interface and digitally transmitted to a server for digital processing. The acquired JPEG images are automatically processed to locate all the RDTs and, for each RDT, to produce a quantitative diagnostic result, which is returned to the Google Glass (i.e., the user) and also stored on a central server along with the RDT image, QR code, and other related information (e.g., demographic data). The same server also provides a dynamic spatiotemporal map and real-time statistics for uploaded RDT results accessible through Internet browsers. We tested this Google Glass-based diagnostic platform using qualitative (i.e., yes/no) human immunodeficiency virus (HIV) and quantitative prostate-specific antigen (PSA) tests. For the quantitative RDTs, we measured activated tests at various concentrations ranging from 0 to 200 ng/mL for free and total PSA. This wearable RDT reader platform running on Google Glass combines a hands-free sensing and image capture interface with powerful servers running our custom image processing codes, and it can be quite useful for real-time spatiotemporal tracking of various diseases and personal medical conditions, providing a valuable tool for epidemiology and mobile health.

Immunochromatographic Diagnostic Test Analysis Using Google Glass

PubMed Central

2014-01-01

We demonstrate a Google Glass-based rapid diagnostic test (RDT) reader platform capable of qualitative and quantitative measurements of various lateral flow immunochromatographic assays and similar biomedical diagnostics tests. Using a custom-written Glass application and without any external hardware attachments, one or more RDTs labeled with Quick Response (QR) code identifiers are simultaneously imaged using the built-in camera of the Google Glass that is based on a hands-free and voice-controlled interface and digitally transmitted to a server for digital processing. The acquired JPEG images are automatically processed to locate all the RDTs and, for each RDT, to produce a quantitative diagnostic result, which is returned to the Google Glass (i.e., the user) and also stored on a central server along with the RDT image, QR code, and other related information (e.g., demographic data). The same server also provides a dynamic spatiotemporal map and real-time statistics for uploaded RDT results accessible through Internet browsers. We tested this Google Glass-based diagnostic platform using qualitative (i.e., yes/no) human immunodeficiency virus (HIV) and quantitative prostate-specific antigen (PSA) tests. For the quantitative RDTs, we measured activated tests at various concentrations ranging from 0 to 200 ng/mL for free and total PSA. This wearable RDT reader platform running on Google Glass combines a hands-free sensing and image capture interface with powerful servers running our custom image processing codes, and it can be quite useful for real-time spatiotemporal tracking of various diseases and personal medical conditions, providing a valuable tool for epidemiology and mobile health. PMID:24571349

Cerebrospinal fluid dynamics study in communicating hydrocephalus

PubMed Central

Ramesh, Vengalathur Ganesan; Narasimhan, Vidhya; Balasubramanian, Chandramouli

2017-01-01

Context: Communicating hydrocephalus often poses a challenge in diagnosis and management decisions. Aims: The objective of this study is to measure the opening pressure (Po), pressure volume index (PVI), and cerebrospinal fluid outflow resistance (Rout), in patients with communicating hydrocephalus using bolus lumbar injection method and to evaluate its diagnostic and prognostic value. Materials and Methods: The study was conducted in 50 patients with communicating hydrocephalus, including normal pressure hydrocephalus (NPH) (19), post-meningitic hydrocephalus (23) and post-traumatic hydrocephalus (8). An improvised bolus lumbar injection method [the Madras Institute of Neurology (MIN) method] was used. Results: In the NPH Group, the CSF dynamics studies correlated well with the clinico-radiological classification. The prediction of shunt responsiveness by CSF dynamics studies correlated with good outcome in 87.5%. In the post-meningitic hydrocephalus group, the value of CSF dynamics studies in predicting patients needing shunt was 89.5%. The CSF dynamics studies detected patients who needed shunt earlier than clinical or radiological indications. In the post-traumatic hydrocephalus group, 62.5% of patients improved with the treatment based on CSF dynamics studies. Conclusions: The improvised bolus lumbar injection method (MIN method) is a very simple test with fairly reliable and reproducible results. Study of CSF dynamics is a valuable tool in communicating hydrocephalus for confirmation of diagnosis and predicting shunt responsiveness. This is the first time that the value of CSF dynamics has been studied in patients with post-meningitic hydrocephalus. It was also useful for early selection of cases for shunting and for identifying patients with atrophic ventriculomegaly, thereby avoiding unnecessary shunt. PMID:28484522

Method for in situ heating of hydrocarbonaceous formations

DOEpatents

Little, William E.; McLendon, Thomas R.

1987-01-01

A method for extracting valuable constituents from underground hydrocarbonaceous deposits such as heavy crude tar sands and oil shale is disclosed. Initially, a stratum containing a rich deposit is hydraulically fractured to form a horizontally extending fracture plane. A conducting liquid and proppant is then injected into the fracture plane to form a conducting plane. Electrical excitations are then introduced into the stratum adjacent the conducting plate to retort the rich stratum along the conducting plane. The valuable constituents from the stratum adjacent the conducting plate are then recovered. Subsequently, the remainder of the deposit is also combustion retorted to further recover valuable constituents from the deposit. Various R.F. heating systems are also disclosed for use in the present invention.

Development and application of loop-mediated isothermal amplification methods targeting the seM gene for detection of Streptococcus equi subsp. equi.

PubMed

Hobo, Seiji; Niwa, Hidekazu; Oku, Kazuomi

2012-03-01

Loop-mediated isothermal amplification (LAMP) constitutes a potentially valuable diagnostic tool for rapid diagnosis of contagious diseases. In this study, we developed a novel LAMP method (seM-LAMP) to detect the seM gene of Streptococcus equi subsp. equi (S. equi), the causative agent of strangles in equids. The seM-LAMP successfully amplified the target sequence of the seM gene at 63°C within 60 min. The sensitivity of the seM-LAMP was slightly lower than the 2nd reaction of the seM semi-nested PCR. To evaluate the species specificity of the seM-LAMP, we tested 100 S. equi and 189 non-S. equi strains. Significant amplification of the DNA originating from S. equi was observed within 60 min incubation, but no amplification of non-S. equi DNA occurred. The results were identical to those of seM semi-nested PCR. To investigate the clinical usefulness of the methods, the seM-LAMP and the seM semi-nested PCR were used to screen 590 nasal swabs obtained during an outbreak of strangles. Both methods showed that 79 and 511 swabs were S. equi positive and negative, respectively, and the results were identical to those of the culture examination. These results indicate that the seM-LAMP is potentially useful for the reliable routine diagnosis of Streptococcus equi subsp. equi infections.

One time quantitative PCR detection of Pseudomonas aeruginosa to discriminate intermittent from chronic infection in cystic fibrosis.

PubMed

Boutin, Sébastien; Weitnauer, Michael; Hassel, Selina; Graeber, Simon Y; Stahl, Mirjam; Dittrich, A Susanne; Mall, Marcus A; Dalpke, Alexander H

2018-05-01

Chronic airway infection with Pseudomonas aeruginosa is a major risk factor of progression of lung disease in patients with cystic fibrosis (CF). Chronic P. aeruginosa infection evolves from intermittent infection that is amenable to antibiotic eradication, whereas chronically adapted P. aeruginosa becomes resistant to antibiotic therapy. Discrimination of intermittent versus chronic infection is therefore of high therapeutic relevance, yet the available diagnostic methods are only partly satisfactory. The aim of the present study was, therefore, to evaluate the usage of quantitative PCR (qPCR) to measure pathogen abundance and to discriminate between intermittent and chronic Pseudomonas infection in patients with CF. Using an established qPCR protocol, we analyzed the abundance of P. aeruginosa in 141 throats swabs and 238 sputa from CF patients with intermittent or chronic infection with P. aeruginosa, as determined by standard culture based diagnostics. We observed a large increase of abundance of P. aeruginosa in throat swabs and sputum samples from patients with chronic compared to intermittent infections with P. aeruginosa. The data show that abundance of P. aeruginosa as measured by qPCR is a valuable tool to discriminate intermittent from chronic infection. Of note, P. aeruginosa burden seems more sensitive than mucoidity phenotype to discriminate chronic from intermittent strains. Furthermore we observed that molecular detection in throat swabs was linked to a viable culture in the sputum when sputum was available. This result is of special interest in young patients with cystic fibrosis that often cannot expectorate sputum. We also observed that qPCR in comparison to culture detected the infection earlier. The results suggest that qPCR detection and quantification of P. aeruginosa is a precious tool to be added to the diagnostic toolbox in cystic fibrosis. Copyright © 2018 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

Molecular Phylogeny of the Neotropical Genus Christensonella (Orchidaceae, Maxillariinae): Species Delimitation and Insights into Chromosome Evolution

PubMed Central

Koehler, Samantha; Cabral, Juliano S.; Whitten, W. Mark; Williams, Norris H.; Singer, Rodrigo B.; Neubig, Kurt M.; Guerra, Marcelo; Souza, Anete P.; Amaral, Maria do Carmo E.

2008-01-01

Background and Aims Species' boundaries applied within Christensonella have varied due to the continuous pattern of variation and mosaic distribution of diagnostic characters. The main goals of this study were to revise the species' delimitation and propose a more stable classification for this genus. In order to achieve these aims phylogenetic relationships were inferred using DNA sequence data and cytological diversity within Christensonella was examined based on chromosome counts and heterochromatin patterns. The results presented describe sets of diagnostic morphological characters that can be used for species' identification. Methods Phylogenetic studies were based on sequence data of nuclear and plastid regions, analysed using maximum parsimony and maximum likelihood criteria. Cytogenetic observations of mitotic cells were conducted using CMA and DAPI fluorochromes. Key Results Six of 21 currently accepted species were recovered. The results also support recognition of the ‘C. pumila’ clade as a single species. Molecular phylogenetic relationships within the ‘C. acicularis–C. madida’ and ‘C. ferdinandiana–C. neowiedii’ species' complexes were not resolved and require further study. Deeper relationships were incongruent between plastid and nuclear trees, but with no strong bootstrap support for either, except for the position of C. vernicosa. Cytogenetic data indicated chromosome numbers of 2n = 36, 38 and 76, and with substantial variation in the presence and location of CMA/DAPI heterochromatin bands. Conclusions The recognition of ten species of Christensonella is proposed according to the molecular and cytogenetic patterns observed. In addition, diagnostic morphological characters are presented for each recognized species. Banding patterns and chromosome counts suggest the occurrence of centric fusion/fission events, especially for C. ferdinandiana. The results suggest that 2n = 36 karyotypes evolved from 2n = 38 through descendent dysploidy. Patterns of heterochromatin distribution and other karyotypic data proved to be a valuable source of information to understand evolutionary patterns within Maxillariinae orchids. PMID:18687799

CSF neurofilament proteins as diagnostic and prognostic biomarkers for amyotrophic lateral sclerosis.

PubMed

Rossi, Daniela; Volanti, Paolo; Brambilla, Liliana; Colletti, Tiziana; Spataro, Rossella; La Bella, Vincenzo

2018-03-01

Elevated cerebrospinal fluid (CSF), Neurofilament Light (NF-L) and phosphorylated Heavy (pNF-H) chain levels have been found in Amyotrophic Lateral Sclerosis (ALS), with studies reporting a correlation of both neurofilaments (NFs) with the disease progression. Here, we measured NF-L and pNF-H concentrations in the CSF of ALS patients from a single tertiary Center and investigated their relationship with disease-related variables. A total of 190 ALS patients (Bulbar, 29.9%; Spinal, 70.1%; M/F = 1.53) and 130 controls with mixed neurological diseases were recruited. Demographic and clinical variables were recorded, and ΔFS was used to rate the disease progression. Controls were divided into two cohorts: (1) patients with non-inflammatory neurological diseases (CTL-1); (2) patients with acute/subacute inflammatory diseases and tumors, expected to lead to significant axonal and tissue damage (CTL-2). For each patient and control, CSF was taken at the time of the diagnostic work-up and stored following the published guidelines. CSF NF-L and pNF-H were assayed with commercially available ELISA-based methods. Standard curves (from independent ELISA kits) were highly reproducible for both NFs, with a coefficient of variation < 20%. We found that CSF NF-L and pNF-H levels in ALS were significantly increased when compared to CTL-1 (NF-L: ALS, 4.7 ng/ml vs CTL-1, 0.61 ng/ml, p < 0.001; pNF-H: ALS, 1.7 ng/ml vs CTL-1, 0.03 ng/ml, p < 0.0001), but not to CTL-2. Analysis of different clinical and prognostic variables disclosed meaningful correlations with both NF-L and pNF-H levels. Our results, from a relatively large ALS cohort, confirm that CSF NF-L and pNF-H represent valuable diagnostic and prognostic biomarkers in ALS.

Equal vibrotactile sense thresholds of the fingers and its diagnostic significance for hand-arm vibration syndrome.

PubMed

Cheng, H; Zhang, X C; Duan, L; Ma, Y; Wang, J X

1995-01-01

The vibrotactile sense thresholds (VSTs) of the middle fingers of 60 healthy persons and 97 patients with Hand-Arm Vibration Syndrome (HAVS) or subclinical HAVS were measured quantitatively. Intermittent vibratory irritations were adopted, with vibration stimulus frequencies at 8, 16, 31.5, 63, 125, 250, and 500 Hz. The equal VST contours of the fingers were mapped. Results showed that the VSTs of the normal group were not correlated with sex or handedness. From 8 Hz to 250 Hz the equal VST contours of the normal group were relatively flat; at more than 250 Hz the contours began an abrupt ascent. The VST values had a logarithmic rising tendency with the increasing age of subjects. In the equal VST contours the frequency of the most sensitive threshold value was 125 Hz in the normal group and 8 Hz in the HAVS group. The patients' VST values were higher than that of the healthy persons. The vibrotactilegram showed that the VST values of the patient groups first shifted at high frequencies and VST loss displayed a "V"-type hollow at 125 Hz and 250 Hz. The quantitative test method of VST was a valuable auxiliary detection method for HAVS. The "V"-type hollow of VST was an early clinical manifestation of HAVS.

Overview of condition monitoring and operation control of electric power conversion systems in direct-drive wind turbines under faults

NASA Astrophysics Data System (ADS)

Huang, Shoudao; Wu, Xuan; Liu, Xiao; Gao, Jian; He, Yunze

2017-09-01

Electric power conversion system (EPCS), which consists of a generator and power converter, is one of the most important subsystems in a direct-drive wind turbine (DD-WT). However, this component accounts for the most failures (approximately 60% of the total number) in the entire DD-WT system according to statistical data. To improve the reliability of EPCSs and reduce the operation and maintenance cost of DD-WTs, numerous researchers have studied condition monitoring (CM) and fault diagnostics (FD). Numerous CM and FD techniques, which have respective advantages and disadvantages, have emerged. This paper provides an overview of the CM, FD, and operation control of EPCSs in DD-WTs under faults. After introducing the functional principle and structure of EPCS, this survey discusses the common failures in wind generators and power converters; briefly reviewed CM and FD methods and operation control of these generators and power converters under faults; and discussed the grid voltage faults related to EPCSs in DD-WTs. These theories and their related technical concepts are systematically discussed. Finally, predicted development trends are presented. The paper provides a valuable reference for developing service quality evaluation methods and fault operation control systems to achieve high-performance and high-intelligence DD-WTs.

An Innovative Approach to Automatically Detect and Interpret Salient Spatiotemporal Features of a Numeric Field: A Case Study in Electrocardiographic Imaging

NASA Astrophysics Data System (ADS)

Ironi, Liliana; Tentoni, Stefania

2009-08-01

The last decade has witnessed major advancements in the direct application of functional imaging techniques to several clinical contexts. Unfortunately, this is not the case of Electrocardiology. As a matter of fact, epicardial maps, which can hit electrical conduction pathologies that routine surface ECG's analysis may miss, can be obtained non invasively from body surface data through mathematical model-based reconstruction methods. But, their interpretation still requires highly specialized skills that belong to few experts. The automated detection of salient patterns in the map, grounded on the existing interpretation rationale, would therefore represent a major contribution towards the clinical use of such valuable tools, whose diagnostic potential is still largely unexploited. We focus on epicardial activation isochronal maps, which convey information about the heart electric function in terms of the depolarization wavefront kinematics. An approach grounded on the integration of a Spatial Aggregation (SA) method with concepts borrowed from Computational Geometry provides a computational framework to extract, from the given activation data, a few basic features that characterize the wavefront propagation, as well as a more specific set of features that identify an important class of heart rhythm pathologies, namely reentry arrhythmias due to block of conduction.

Development of a multiplex PCR assay for detection and discrimination of Theileria annulata and Theileria sergenti in cattle.

PubMed

Junlong, Liu; Li, Youquan; Liu, Aihong; Guan, Guiquan; Xie, Junren; Yin, Hong; Luo, Jianxun

2015-07-01

Aim to construct a simple and efficient diagnostic assay for Theileria annulata and Theileria sergenti, a multiplex polymerase chain reaction (PCR) method was developed in this study. Following the alignment of the related sequences, two primer sets were designed specific targeting on T. annulata cytochrome b (COB) gene and T. sergenti internal transcribed spacer (ITS) sequences. It was found that the designed primers could react in one PCR system and generating amplifications of 818 and 393 base pair for T. sergenti and T. annulata, respectively. The standard genomic DNA of both species Theileria was serial tenfold diluted for testing the sensitivity, while specificity test confirmed both primer sets have no cross-reaction with other Theileria and Babesia species. In addition, 378 field samples were used for evaluation of the utility of the multiplex PCR assay for detection of the pathogens infection. The detection results were compared with the other two published PCR methods which targeting on T. annulata COB gene and T. sergenti major piroplasm surface protein (MPSP) gene, respectively. The developed multiplex PCR assay has similar efficient detection with COB and MPSP PCR, which indicates this multiplex PCR may be a valuable assay for the epidemiological studies for T. annulata and T. sergenti.

A luminescent hybridoma-based biosensor for rapid detection of V. cholerae upon induction of calcium signaling pathway.

PubMed

Zamani, Parichehr; Sajedi, Reza H; Hosseinkhani, Saman; Zeinoddini, Mehdi; Bakhshi, Bita

2016-05-15

In this study, a hybridoma based biosensor was developed for rapid, sensitive and selective detection of Vibrio cholerae O1 which converts the antibody-antigen binding to bioluminescence light. After investigation on hybridoma performance, the biosensor was constructed by transfecting specific hybridoma cells with aequorin reporter gene and the bioluminescence activities of stable biosensor were measured. The sensitivity of biosensor was as few as 50 CFU/ml and it showed no responses to other entric bacteria. Moreover, the response time of biosensor was estimated in 7th second which means this method is considerably faster than many available detection assays. In addition, this biosensor was successfully applied to V. cholerae detection in environmental samples with no significant loss in sensitivity, demonstrating our proposed biosensor provides a sensitive and reliable method for detection of V. cholerae in natural samples. The application of whole hybridoma cell directly as a sensing element in biosensor construction which mentioned for the first time in present study suggests that hybridoma cells could provide a valuable tool for future studies in both basic and diagnostic sciences and could be considered as a fast and specific sensing element for detection of other pathogens in different applications. Copyright © 2015 Elsevier B.V. All rights reserved.

Blood flow quantification using 1D CFD parameter identification

NASA Astrophysics Data System (ADS)

Brosig, Richard; Kowarschik, Markus; Maday, Peter; Katouzian, Amin; Demirci, Stefanie; Navab, Nassir

2014-03-01

Patient-specific measurements of cerebral blood flow provide valuable diagnostic information concerning cerebrovascular diseases rather than visually driven qualitative evaluation. In this paper, we present a quantitative method to estimate blood flow parameters with high temporal resolution from digital subtraction angiography (DSA) image sequences. Using a 3D DSA dataset and a 2D+t DSA sequence, the proposed algorithm employs a 1D Computational Fluid Dynamics (CFD) model for estimation of time-dependent flow values along a cerebral vessel, combined with an additional Advection Diffusion Equation (ADE) for contrast agent propagation. The CFD system, followed by the ADE, is solved with a finite volume approximation, which ensures the conservation of mass. Instead of defining a new imaging protocol to obtain relevant data, our cost function optimizes the bolus arrival time (BAT) of the contrast agent in 2D+t DSA sequences. The visual determination of BAT is common clinical practice and can be easily derived from and be compared to values, generated by a 1D-CFD simulation. Using this strategy, we ensure that our proposed method fits best to clinical practice and does not require any changes to the medical work flow. Synthetic experiments show that the recovered flow estimates match the ground truth values with less than 12% error in the mean flow rates.

Characterizing optical properties and spatial heterogeneity of human ovarian tissue using spatial frequency domain imaging

NASA Astrophysics Data System (ADS)

Nandy, Sreyankar; Mostafa, Atahar; Kumavor, Patrick D.; Sanders, Melinda; Brewer, Molly; Zhu, Quing

2016-10-01

A spatial frequency domain imaging (SFDI) system was developed for characterizing ex vivo human ovarian tissue using wide-field absorption and scattering properties and their spatial heterogeneities. Based on the observed differences between absorption and scattering images of different ovarian tissue groups, six parameters were quantitatively extracted. These are the mean absorption and scattering, spatial heterogeneities of both absorption and scattering maps measured by a standard deviation, and a fitting error of a Gaussian model fitted to normalized mean Radon transform of the absorption and scattering maps. A logistic regression model was used for classification of malignant and normal ovarian tissues. A sensitivity of 95%, specificity of 100%, and area under the curve of 0.98 were obtained using six parameters extracted from the SFDI images. The preliminary results demonstrate the diagnostic potential of the SFDI method for quantitative characterization of wide-field optical properties and the spatial distribution heterogeneity of human ovarian tissue. SFDI could be an extremely robust and valuable tool for evaluation of the ovary and detection of neoplastic changes of ovarian cancer.

THE USE OF MULTIPLE DISPLACEMENT AMPLIFICATION TO INCREASE THE DETECTION AND GENOTYPING OF TRYPANOSOMA SPECIES SAMPLES IMMOBILISED ON FTA FILTERS

PubMed Central

MORRISON, LIAM J.; McCORMACK, GILLIAN; SWEENEY, LINDSAY; LIKEUFACK, ANNE C. L.; TRUC, PHILIPPE; TURNER, C. MICHAEL; TAIT, ANDY; MacLEOD, ANNETTE

2007-01-01

Whole genome amplification methods are a recently developed tool for amplifying DNA from limited template. We report its application in trypanosome infections, characterised by low parasitaemias. Multiple Displacement Amplification (MDA) amplifies DNA with a simple in vitro step, and was evaluated on mouse blood samples on FTA filter cards with known numbers of Trypanosoma brucei parasites. The data showed a twenty-fold increase in the number of PCRs possible per sample, using primers diagnostic for the multi-copy ribosomal ITS region or 177 bp repeats, and a twenty-fold increase in sensitivity over nested PCR against a single copy microsatellite. Using MDA for microsatellite genotyping caused allele dropout at low DNA concentrations, which was overcome by pooling multiple MDA reactions. The validity of using MDA was established with samples from Human African Trypanosomiasis patients. The use of MDA allows maximal use of finite DNA samples and may prove a valuable tool in studies where multiple reactions are necessary, such as population genetic analyses. PMID:17556624

FISH in polycythemia vera (PCV)

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

Amiel, A.; Gaber, E.; Manor, Y.

1994-09-01

Trisomies 8 and 9 are the most common numerical abnormalities in polycythemia vera (PCV). However, their role in the pathogenesis of the disease is unclear as is their diagnostic or prognostic value. We evaluated the role of fluorescent in-situ hybridization (FISH) as compared to chromosome analysis in the detection of trisomies 8 or 9 in peripheral blood cells of 14 PCV and 5 secondary PCV patients. Using FISH, we found trisomies 8 and 9 in 10 PCV patients above the cutoff levels of 5%. However, no patient with the secondary PCV reached the cutoff level. Out of 10 PCV patientsmore » in whom the trisomy was detected by FISH, only in 3 was this trisomy also detected by routine cytogenetics. The incidence of the finding of trisomy 9 correlates with the duration of the disease, suggesting that this is not the primary event in PCV. FISH is a sensitive, convenient and rapid method for diagnosis and follow-up of chromosome aberrations in PCV patients. Application of FISH to larger cohort of patients may provide valuable information regarding their role in initiation and progession of the disease.« less

3-Tesla MRI-assisted detection of compression points in ulnar neuropathy at the elbow in correlation with intraoperative findings.

PubMed

Hold, Alina; Mayr-Riedler, Michael S; Rath, Thomas; Pona, Igor; Nierlich, Patrick; Breitenseher, Julia; Kasprian, Gregor

2018-03-06

Releasing the ulnar nerve from all entrapments is the primary objective of every surgical method in ulnar neuropathy at the elbow (UNE). The aim of this retrospective diagnostic study was to validate preoperative 3-Tesla MRI results by comparing the MRI findings with the intraoperative aspects during endoscopic-assisted or open surgery. Preoperative MRI studies were assessed by a radiologist not informed about intraoperative findings in request for the exact site of nerve compression. The localizations of compression were then correlated with the intraoperative findings obtained from the operative records. Percent agreement and Cohen's kappa (κ) values were calculated. From a total of 41 elbows, there was a complete agreement in 27 (65.8%) cases and a partial agreement in another 12 (29.3%) cases. Cohen's kappa showed fair-to-moderate agreement. High-resolution MRI cannot replace thorough intraoperative visualization of the ulnar nerve and its surrounding structures but may provide valuable information in ambiguous cases or relapses. Copyright © 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Direct composite fillings: an optical coherence tomography and microCT investigation

NASA Astrophysics Data System (ADS)

Negrutiu, Meda L.; Sinescu, Cosmin; Borlea, Mugurel V.; Manescu, Adrian; Duma, Virgil F.; Rominu, Mihai; Podoleanu, Adrian G.

2015-03-01

The treatment of carious lesions requires removal of affected dental tissue thus creating cavities that are to be filled with dedicated materials. There are several methods known which are used to assess the quality of direct dental restorations, but most of them are invasive. Optical tomographic techniques are of particular importance in the medical imaging field, because these techniques can provide non-invasive diagnostic images. Using an en-face version of OCT, we have recently demonstrated real time thorough evaluation of quality of dental fillings. The major aim of this study was to analyses the optical performance of adhesives modified with zirconia particles in different concentrations in order to improve the contrast of OCT imaging of the interface between the tooth structure, adhesive and composite resin. The OCT investigations were validated by micro CT using synchrotron radiation. The OCT Swept Source is a valuable investigation tool for the clinical evaluation of class II direct composite restorations. The unmodified adhesive layer shows poor contrast on regular OCT investigations. Adding zirconia particles to the adhesive layer provides a better scattering which allows a better characterization and quantification of direct restorations.

Recommendations of the Spanish Societies of Radiation Oncology (SEOR), Nuclear Medicine & Molecular Imaging (SEMNiM), and Medical Physics (SEFM) on (18)F-FDG PET-CT for radiotherapy treatment planning.

PubMed

Caballero Perea, Begoña; Villegas, Antonio Cabrera; Rodríguez, José Miguel Delgado; Velloso, María José García; Vicente, Ana María García; Cabrerizo, Carlos Huerga; López, Rosa Morera; Romasanta, Luis Alberto Pérez; Beltrán, Moisés Sáez

2012-01-01

Positron emission tomography (PET) with (18)F-fluorodeoxyglucose (FDG) is a valuable tool for diagnosing and staging malignant lesions. The fusion of PET and computed tomography (CT) yields images that contain both metabolic and morphological information, which, taken together, have improved the diagnostic precision of PET in oncology. The main imaging modality for planning radiotherapy treatment is CT. However, PET-CT is an emerging modality for use in planning treatments because it allows for more accurate treatment volume definition. The use of PET-CT for treatment planning is highly complex, and protocols and standards for its use are still being developed. It seems probable that PET-CT will eventually replace current CT-based planning methods, but this will require a full understanding of the relevant technical aspects of PET-CT planning. The aim of the present document is to review these technical aspects and to provide recommendations for clinical use of this imaging modality in the radiotherapy planning process.

Laboratory space physics: Investigating the physics of space plasmas in the laboratory

NASA Astrophysics Data System (ADS)

Howes, Gregory G.

2018-05-01

Laboratory experiments provide a valuable complement to explore the fundamental physics of space plasmas without the limitations inherent to spacecraft measurements. Specifically, experiments overcome the restriction that spacecraft measurements are made at only one (or a few) points in space, enable greater control of the plasma conditions and applied perturbations, can be reproducible, and are orders of magnitude less expensive than launching spacecraft. Here, I highlight key open questions about the physics of space plasmas and identify the aspects of these problems that can potentially be tackled in laboratory experiments. Several past successes in laboratory space physics provide concrete examples of how complementary experiments can contribute to our understanding of physical processes at play in the solar corona, solar wind, planetary magnetospheres, and the outer boundary of the heliosphere. I present developments on the horizon of laboratory space physics, identifying velocity space as a key new frontier, highlighting new and enhanced experimental facilities, and showcasing anticipated developments to produce improved diagnostics and innovative analysis methods. A strategy for future laboratory space physics investigations will be outlined, with explicit connections to specific fundamental plasma phenomena of interest.

Recommendations of the Spanish Societies of Radiation Oncology (SEOR), Nuclear Medicine & Molecular Imaging (SEMNiM), and Medical Physics (SEFM) on 18F-FDG PET-CT for radiotherapy treatment planning

PubMed Central

Caballero Perea, Begoña; Villegas, Antonio Cabrera; Rodríguez, José Miguel Delgado; Velloso, María José García; Vicente, Ana María García; Cabrerizo, Carlos Huerga; López, Rosa Morera; Romasanta, Luis Alberto Pérez; Beltrán, Moisés Sáez

2012-01-01

Positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) is a valuable tool for diagnosing and staging malignant lesions. The fusion of PET and computed tomography (CT) yields images that contain both metabolic and morphological information, which, taken together, have improved the diagnostic precision of PET in oncology. The main imaging modality for planning radiotherapy treatment is CT. However, PET-CT is an emerging modality for use in planning treatments because it allows for more accurate treatment volume definition. The use of PET-CT for treatment planning is highly complex, and protocols and standards for its use are still being developed. It seems probable that PET-CT will eventually replace current CT-based planning methods, but this will require a full understanding of the relevant technical aspects of PET-CT planning. The aim of the present document is to review these technical aspects and to provide recommendations for clinical use of this imaging modality in the radiotherapy planning process. PMID:24377032

Raman imaging at biological interfaces: applications in breast cancer diagnosis.

PubMed

Surmacki, Jakub; Musial, Jacek; Kordek, Radzislaw; Abramczyk, Halina

2013-05-24

One of the most important areas of Raman medical diagnostics is identification and characterization of cancerous and noncancerous tissues. The methods based on Raman scattering has shown significant potential for probing human breast tissue to provide valuable information for early diagnosis of breast cancer. A vibrational fingerprint from the biological tissue provides information which can be used to identify, characterize and discriminate structures in breast tissue, both in the normal and cancerous environment. The paper reviews recent progress in understanding structure and interactions at biological interfaces of the human tissue by using confocal Raman imaging and IR spectroscopy. The important differences between the noncancerous and cancerous human breast tissues were found in regions characteristic for vibrations of carotenoids, fatty acids, proteins, and interfacial water. Particular attention was paid to the role played by unsaturated fatty acids and their derivatives as well as carotenoids and interfacial water. We demonstrate that Raman imaging has reached a clinically relevant level in regard to breast cancer diagnosis applications. The results presented in the paper may have serious implications on understanding mechanisms of interactions in living cells under realistically crowded conditions of biological tissue.

Data Processing and Text Mining Technologies on Electronic Medical Records: A Review

PubMed Central

Sun, Wencheng; Li, Yangyang; Liu, Fang; Fang, Shengqun; Wang, Guoyan

2018-01-01

Currently, medical institutes generally use EMR to record patient's condition, including diagnostic information, procedures performed, and treatment results. EMR has been recognized as a valuable resource for large-scale analysis. However, EMR has the characteristics of diversity, incompleteness, redundancy, and privacy, which make it difficult to carry out data mining and analysis directly. Therefore, it is necessary to preprocess the source data in order to improve data quality and improve the data mining results. Different types of data require different processing technologies. Most structured data commonly needs classic preprocessing technologies, including data cleansing, data integration, data transformation, and data reduction. For semistructured or unstructured data, such as medical text, containing more health information, it requires more complex and challenging processing methods. The task of information extraction for medical texts mainly includes NER (named-entity recognition) and RE (relation extraction). This paper focuses on the process of EMR processing and emphatically analyzes the key techniques. In addition, we make an in-depth study on the applications developed based on text mining together with the open challenges and research issues for future work. PMID:29849998

Development of real-time PCR for detection and quantitation of Streptococcus parauberis.

PubMed

Nguyen, T L; Lim, Y J; Kim, D-H; Austin, B

2016-01-01

Streptococcus parauberis is an increasing threat to aquaculture of olive flounder, Paralichthys olivaceus Temminck & Schlegel, in South Korea. We developed a real-time polymerase chain reaction (PCR) method using the TaqMan probe assay to detect and quantify S. parauberis by targeting the gyrB gene sequences, which are effective for molecular analysis of the genus Streptococcus. Our real-time PCR assay is capable of detecting 10 fg of genomic DNA per reaction. The intra- and interassay coefficient of variation (CV) values ranged from 0.42-1.95%, demonstrating that the assay has good reproducibility. There was not any cross-reactivity to Streptococcus iniae or to other streptococcal/lactococcal fish pathogens, such as S. agalactiae and Lactococcus garvieae, indicating that the assay is highly specific to S. parauberis. The results of the real-time PCR assay corresponded well to those of conventional culture assays for S. parauberis from inoculated tissue homogenates (r = 0.957; P < 0.05). Hence, this sensitive and specific real-time PCR is a valuable tool for diagnostic quantitation of S. parauberis in clinical samples. © 2014 John Wiley & Sons Ltd.

Thermo-mechanical actuator-based miniature tagging module for localization in capsule endoscopy

NASA Astrophysics Data System (ADS)

Chandrappan, Jayakrishnan; Ruiqi, Lim; Su, Nandar; Yen Yi, Germaine Hoe; Vaidyanathan, Kripesh

2011-04-01

Capsule endoscopy is a frontline medical diagnostic tool for the gastro intestinal tract disorders. During diagnosis, efficient localization techniques are essential to specify a pathological area that may require further diagnosis or treatment. This paper presents the development of a miniature tagging module that relies on a novel concept to label the region of interest and has the potential to integrate with a capsule endoscope. The tagging module is a compact thermo-mechanical actuator loaded with a biocompatible micro tag. A low power microheater attached to the module serves as the thermal igniter for the mechanical actuator. At optimum temperature, the actuator releases the micro tag instantly and penetrates the mucosa layer of a GI tract, region of interest. Ex vivo animal trials are conducted to verify the feasibility of the tagging module concept. X-ray imaging is used to detect the location of the micro tag embedded in the GI tract wall. The method is successful, and radiopaque micro tags can provide valuable pre-operative position information on the infected area to facilitate further clinical procedures.

Properties of added variable plots in Cox's regression model.

PubMed

Lindkvist, M

2000-03-01

The added variable plot is useful for examining the effect of a covariate in regression models. The plot provides information regarding the inclusion of a covariate, and is useful in identifying influential observations on the parameter estimates. Hall et al. (1996) proposed a plot for Cox's proportional hazards model derived by regarding the Cox model as a generalized linear model. This paper proves and discusses properties of this plot. These properties make the plot a valuable tool in model evaluation. Quantities considered include parameter estimates, residuals, leverage, case influence measures and correspondence to previously proposed residuals and diagnostics.

Three-Dimensional Model for Preservation and Restoration of Architectural Heritage

NASA Technical Reports Server (NTRS)

Marchis, Elena

2011-01-01

Thc aim of the research will be to create a model, three-dimensional mathematical. implementation. consultation and assistance to "large" restoration projects that will assist the structural analysis, allowing easier display of dynamic strain. analysis and lighting noise. It could also be a valuable tool for decision support. therefore. may simulate several possible scenarios for intervention, This model appears therefore an excellent support for recovering. ordering and monitoring information about materials and data (stage of restoration. photographs. sampling points. results of diagnostic tests, etc.) collected dynamically during the "life" of the cultural heritage. allowing to document its complete history

Hip Dysplasia: Clinical Signs and Physical Examination Findings.

PubMed

Syrcle, Jason

2017-07-01

Hip dysplasia is a common developmental disorder of the dog, consisting of varying degrees of hip laxity, progressive remodeling of the structures of the hip, and subsequent development of osteoarthritis. It is a juvenile-onset condition, with clinical signs often first evident at 4 to 12 months of age. A tentative diagnosis of hip dysplasia can be made based on signalment, history, and physical examination findings. The Ortolani test is a valuable tool for identifying juvenile dogs affected with this condition. Further diagnostics can then be prioritized, contributing to prompt diagnosis and appropriate treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

Appropriate Use Criteria for Echocardiography: Evolving Applications in the Era of Value-Based Healthcare

PubMed Central

Singh, Amita

2017-01-01

The current climate in healthcare is increasingly emphasizing a value-based approach to diagnostic testing. Cardiac imaging, including echocardiography, has been a primary target of ongoing reforms in healthcare delivery and reimbursement. The Appropriate Use Criteria (AUC) for echocardiography is a physician-derived tool intended to guide utilization in optimal patient care. To date, the AUC have primarily been employed solely as justification for reimbursement, though evolving broader applications to guide clinical decision-making suggest a far more valuable role in the delivery of high-quality and high-value healthcare. PMID:27553788

Qualitative and quantitative mass spectrometry imaging of drugs and metabolites in tissue at therapeutic levels.

PubMed

Sun, Na; Walch, Axel

2013-08-01

Mass spectrometry imaging (MSI) is a rapidly evolving technology that yields qualitative and quantitative distribution maps of small pharmaceutical-active molecules and their metabolites in tissue sections in situ. The simplicity, high sensitivity and ability to provide comprehensive spatial distribution maps of different classes of biomolecules make MSI a valuable tool to complement histopathology for diagnostics and biomarker discovery. In this review, qualitative and quantitative MSI of drugs and metabolites in tissue at therapeutic levels are discussed and the impact of this technique in drug discovery and clinical research is highlighted.

Dynamic imaging and RCS measurements of aircraft

NASA Astrophysics Data System (ADS)

Jain, Atul; Patel, Indu

1995-01-01

Results on radar cross section (RCS) measurements and inverse synthetic aperture radar images of a Mooney 231 aircraft using a ground-to-air measurement system (GTAMS) and a KC-135 airplane using an airborne radar are presented. The Mooney 231 flew in a controlled path in both clockwise and counterclockwise orbits, and successively with the gear down, flaps in the take-off position and with the speed brakes up. The data indicates that RCS pattern measurements from both ground-based and airborne radar of flying aircraft are useful and that the inverse synthetic aperture radar (ISAR) images obtained are valuable for signature diagnostics.

An Overview of Countertransference With Borderline Patients

PubMed Central

GABBARD, GLEN O.

1993-01-01

Successful management of countertransference is critical to the psychotherapy of borderline patients. The author discusses the most common countertransference reactions encountered in such treatments. A theoretical framework is also proposed that conceptualizes countertransference as a joint creation between therapist and patient. It follows from this conceptual framework that therapists must constantly monitor their own contributions from past relationships as well as the aspects of countertransference evoked by the patient’s behavior. Countertransference in the psychotherapy of borderline patients must be viewed as a source of valuable diagnostic and therapeutic information and not simply as interference with the therapeutic process. PMID:22700123

Transcranial magnetic stimulation: physics, electrophysiology, and applications.

PubMed

Fatemi-Ardekani, Ali

2008-01-01

Transcranial magnetic stimulation (TMS) is a noninvasive technique used to stimulate the brain. This review will examine the fundamental principles of physics upon which magnetic stimulation is based, the design considerations of the TMS device, and hypotheses about its electrophysiological effects resulting in neuromodulation. TMS is valuable in neurophysiology research and has significant therapeutic potential in clinical neurology and psychiatry. While TMS can modify neuronal currents in the brain, its underlying mechanism remains unknown. Salient applications are included and some suggestions are outlined for future development of magnetic stimulators that could lead to more effective neuronal stimulation and therefore better therapeutic and diagnostic applications.

Increasing role of arthropod bites in tularaemia transmission in Poland - case reports and diagnostic methods.

PubMed

Formińska, Kamila; Zasada, Aleksandra A; Rastawicki, Waldemar; Śmietańska, Karolina; Bander, Dorota; Wawrzynowicz-Syczewska, Marta; Yanushevych, Mariya; Niścigórska-Olsen, Jolanta; Wawszczak, Marek

2015-01-01

The study describes four cases of tularaemia - one developed after contact with rabbits and three developed after an arthropod bite. Due to non-specific clinical symptoms, accurate diagnosis of tularaemia may be difficult. The increasing contribution of the arthropod vectors in the transmission of the disease indicates that special effort should be made to apply sensitive and specific diagnostic methods for tularaemia, and to remind health-care workers about this route of Francisella tularensis infections. The advantages and disadvantages of various diagnostic methods - molecular, serological and microbiological culture - are discussed. The PCR as a rapid and proper diagnostic method for ulceroglandular tularaemia is presented.

Diagnostic efficacy of in vitro methods vs. skin testing in patients with inhalant allergies

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

Corey, J.P.; Liudahl, J.J.; Young, S.A.

1991-03-01

The purpose of our study was to investigate the diagnostic efficacy of two selected methods of in vitro allergy testing. Specifically, the PRIST/modified RAST I125 isotope systems and the Quantizyme/modified EAST alkaline phosphatase method were compared. The time, expense, convenience, and diagnostic efficacy of the two procedures are discussed. Special attention is given to the practicality of each method for the practicing physician.

[Results of a study of the diagnostic qualities of brucellosis and tularemic antigenic erythrocytic diagnostica].

PubMed

Tsybin, B P; Taran, I F; Tinker, A I

1975-09-01

The authors elaborated methods of preparation of brucella and tularemia antigenic erythrocytic diagnostic agents which were characterized as highly specific, specific and stable preparations in mass examination of humans and animals at various stages of the vaccinal and infectous processes. The simplicity of obtaining specific antigens intended for the sensitization of formalinized erythrocytes and stability of the results of results of reproduction of the methods of preparation of the antigenic erythrocytic diagnostic agents offered a possibility of recommending the mentioned methods of industrial preparation of the diagnostic agents.

Systematic Review and Meta-Analysis of Studies Evaluating Diagnostic Test Accuracy: A Practical Review for Clinical Researchers-Part II. Statistical Methods of Meta-Analysis

PubMed Central

Lee, Juneyoung; Kim, Kyung Won; Choi, Sang Hyun; Huh, Jimi

2015-01-01

Meta-analysis of diagnostic test accuracy studies differs from the usual meta-analysis of therapeutic/interventional studies in that, it is required to simultaneously analyze a pair of two outcome measures such as sensitivity and specificity, instead of a single outcome. Since sensitivity and specificity are generally inversely correlated and could be affected by a threshold effect, more sophisticated statistical methods are required for the meta-analysis of diagnostic test accuracy. Hierarchical models including the bivariate model and the hierarchical summary receiver operating characteristic model are increasingly being accepted as standard methods for meta-analysis of diagnostic test accuracy studies. We provide a conceptual review of statistical methods currently used and recommended for meta-analysis of diagnostic test accuracy studies. This article could serve as a methodological reference for those who perform systematic review and meta-analysis of diagnostic test accuracy studies. PMID:26576107

Cerebrospinal fluid dynamics study in communicating hydrocephalus.

PubMed

Ramesh, Vengalathur Ganesan; Narasimhan, Vidhya; Balasubramanian, Chandramouli

2017-01-01

Communicating hydrocephalus often poses a challenge in diagnosis and management decisions. The objective of this study is to measure the opening pressure (P o ), pressure volume index (PVI), and cerebrospinal fluid outflow resistance (R out ), in patients with communicating hydrocephalus using bolus lumbar injection method and to evaluate its diagnostic and prognostic value. The study was conducted in 50 patients with communicating hydrocephalus, including normal pressure hydrocephalus (NPH) (19), post-meningitic hydrocephalus (23) and post-traumatic hydrocephalus (8). An improvised bolus lumbar injection method [the Madras Institute of Neurology (MIN) method] was used. In the NPH Group, the CSF dynamics studies correlated well with the clinico-radiological classification. The prediction of shunt responsiveness by CSF dynamics studies correlated with good outcome in 87.5%. In the post-meningitic hydrocephalus group, the value of CSF dynamics studies in predicting patients needing shunt was 89.5%. The CSF dynamics studies detected patients who needed shunt earlier than clinical or radiological indications. In the post-traumatic hydrocephalus group, 62.5% of patients improved with the treatment based on CSF dynamics studies. The improvised bolus lumbar injection method (MIN method) is a very simple test with fairly reliable and reproducible results. Study of CSF dynamics is a valuable tool in communicating hydrocephalus for confirmation of diagnosis and predicting shunt responsiveness. This is the first time that the value of CSF dynamics has been studied in patients with post-meningitic hydrocephalus. It was also useful for early selection of cases for shunting and for identifying patients with atrophic ventriculomegaly, thereby avoiding unnecessary shunt.

Repeatability of pleural adenosine deaminase measurements in diagnostic evaluation of pleural effusions.

PubMed

Kotsiou, Ourania S; Tzortzi, Panagiota; Beta, Rafailia A A; Kyritsis, Athanasios; Gourgoulianis, Konstantinos I

2018-06-01

A follow-up thoracentesis is proposed in suspected atypical tuberculosis cases. The study aimed to define the variability of pleural ADA values across repeated thoracenteses in different types of pleural effusions (PEs) and to evaluate whether ADA variance, in regard to the cutoff value of 40 U/L, affected final diagnosis. A total of 131 patients with PEs of various etiologies underwent three repeated thoracenteses. ADA values were subsequently estimated. 82% and 55% of patients had greater than 10% and 20% deviation from the highest ADA value, respectively. From those patients who had a variance of 20%, 36% had only increasing ADA values, while 19% had only decreasing values. Considering the cutoff value of 40 U/L, only in two cases, ADA decreased below this threshold, which concerned a man with tuberculous pleurisy and a woman with lymphoma both in the course of treatment. Furthermore, only in two cases with rising values, ADA finally exceeded the cutoff limit, which concerned a man with rheumatoid pleurisy and a man with tuberculous pleurisy. Surprisingly, malignant PEs (MPEs) showed a higher percentage of increasing values compared to all other exudates that did not, however, exceed the threshold. The determination of pleural ADA levels is a reproducible method for rapid tuberculosis diagnosis. The detected measurement deviations do not appear to affect final diagnosis. In specific situations, repeated ADA measurements may be valuable in directing further diagnostic evaluation. More investigation is needed to elucidate the possible prognostic significance of the increasing trend in ADA values in MPEs. © 2017 Wiley Periodicals, Inc.

A parallelizable real-time motion tracking algorithm with applications to ultrasonic strain imaging

NASA Astrophysics Data System (ADS)

Jiang, J.; Hall, T. J.

2007-07-01

Ultrasound-based mechanical strain imaging systems utilize signals from conventional diagnostic ultrasound systems to image tissue elasticity contrast that provides new diagnostically valuable information. Previous works (Hall et al 2003 Ultrasound Med. Biol. 29 427, Zhu and Hall 2002 Ultrason. Imaging 24 161) demonstrated that uniaxial deformation with minimal elevation motion is preferred for breast strain imaging and real-time strain image feedback to operators is important to accomplish this goal. The work reported here enhances the real-time speckle tracking algorithm with two significant modifications. One fundamental change is that the proposed algorithm is a column-based algorithm (a column is defined by a line of data parallel to the ultrasound beam direction, i.e. an A-line), as opposed to a row-based algorithm (a row is defined by a line of data perpendicular to the ultrasound beam direction). Then, displacement estimates from its adjacent columns provide good guidance for motion tracking in a significantly reduced search region to reduce computational cost. Consequently, the process of displacement estimation can be naturally split into at least two separated tasks, computed in parallel, propagating outward from the center of the region of interest (ROI). The proposed algorithm has been implemented and optimized in a Windows® system as a stand-alone ANSI C++ program. Results of preliminary tests, using numerical and tissue-mimicking phantoms, and in vivo tissue data, suggest that high contrast strain images can be consistently obtained with frame rates (10 frames s-1) that exceed our previous methods.

Enhancing the diagnosis of fabry disease in cardiology with a targeted information: a before–after control–impact study

PubMed Central

Savary, Anne-Louise; Morello, Remy; Brasse-Lagnel, Carole; Milliez, Paul; Bekri, Soumeya; Labombarda, Fabien

2017-01-01

Background Cardiac complications in Fabry disease are frequent and dominated by a high frequency of left ventricular hypertrophy; therefore, cardiologists may have an essential role in screening for this disease. Providing cardiologists with targeted information on Fabry disease would be valuable and could reduce both diagnostic and therapeutic delays. The aim of this study was to evaluate the efficiency of such strategy for Fabry screening. Methods We conducted a before–after control–impact study by comparing observations made before and after targeted information on Fabry disease among cardiologists. The information on Fabry disease consisted of (1) an educational booklet, (2) oral information and (3) screening kits. The programme was evaluated at the end of a 12-month study period. Results Forty-two cardiologists participated to this study. None of them had conducted screening test and new diagnostic for Fabry disease in the 3 years prior the information. After the information, screening with dried blood spots was performed in 55 patients (ranged 18–77 years, men: 39) with cardiac monitoring for supposed sarcomeric hypertrophic cardiomyopathy (n=41) or unexplained left ventricular hypertrophy (n=14) from January 2015 to January 2016. Two new cases of Fabry disease were diagnosed (3.4%) in two men (ages 58 and 51 years). The information was deemed relevant in both content and structure and was deemed useful for everyday practice. Conclusion Cardiologists valued the targeted information on Fabry disease. This information had a direct clinical impact by allowing the diagnosis of two new families with Fabry disease. PMID:28409012

Zwitterionic-hydrophilic interaction capillary liquid chromatography coupled to tandem mass spectrometry for the characterization of human alpha-acid-glycoprotein N-glycan isomers.

PubMed

Mancera-Arteu, Montserrat; Giménez, Estela; Barbosa, José; Peracaula, Rosa; Sanz-Nebot, Victòria

2017-10-23

In this work, a μZIC-HILIC-MS/MS methodology was established in negative ion mode for the characterization of glycan isomers. The possibility to separate the glycan isomers by the μZIC-HILIC strategy coupled to a high resolution tandem mass spectrometry detection permitted us to obtain valuable information about each glycan structure. The most important diagnostic ion fragments previously described to characterize structural features of glycans, were evaluated in this study using hAGP as model glycoprotein. The assignation of hAGP glycan isomers performed in our previous work using the GRIL strategy in combination with exoglycosidase digestion [1] was used in this paper to confirm or discard some ion fragments reported in the literature and delve into the structural characterization of glycan isomers. Sialic acid as well as fucose linkage-type glycan isomers were assigned using this approach and daughter ions with higher diagnostic value were determined. The location of α2-3/α2-6 sialic acids on antennas and a deeper characterization of several highly sialylated tri- and tetraantennary glycans was also possible using the established MS/MS method. Moreover, relying on the characterization performed in Ref. [1], core and antenna fucosylation were differentiated in this work using specific ion fragments obtained in the tandem mass spectra. This methodology was also applied to hAGP purified from control and pathological serum samples, which corroborated its robustness and its potential for finding novel glycan-based biomarkers in patho-glycomic studies. Copyright © 2017 Elsevier B.V. All rights reserved.

Correcting AUC for Measurement Error.

PubMed

Rosner, Bernard; Tworoger, Shelley; Qiu, Weiliang

2015-12-01

Diagnostic biomarkers are used frequently in epidemiologic and clinical work. The ability of a diagnostic biomarker to discriminate between subjects who develop disease (cases) and subjects who do not (controls) is often measured by the area under the receiver operating characteristic curve (AUC). The diagnostic biomarkers are usually measured with error. Ignoring measurement error can cause biased estimation of AUC, which results in misleading interpretation of the efficacy of a diagnostic biomarker. Several methods have been proposed to correct AUC for measurement error, most of which required the normality assumption for the distributions of diagnostic biomarkers. In this article, we propose a new method to correct AUC for measurement error and derive approximate confidence limits for the corrected AUC. The proposed method does not require the normality assumption. Both real data analyses and simulation studies show good performance of the proposed measurement error correction method.

Computer-aided psychotherapy based on multimodal elicitation, estimation and regulation of emotion.

PubMed

Cosić, Krešimir; Popović, Siniša; Horvat, Marko; Kukolja, Davor; Dropuljić, Branimir; Kovač, Bernard; Jakovljević, Miro

2013-09-01

Contemporary psychiatry is looking at affective sciences to understand human behavior, cognition and the mind in health and disease. Since it has been recognized that emotions have a pivotal role for the human mind, an ever increasing number of laboratories and research centers are interested in affective sciences, affective neuroscience, affective psychology and affective psychopathology. Therefore, this paper presents multidisciplinary research results of Laboratory for Interactive Simulation System at Faculty of Electrical Engineering and Computing, University of Zagreb in the stress resilience. Patient's distortion in emotional processing of multimodal input stimuli is predominantly consequence of his/her cognitive deficit which is result of their individual mental health disorders. These emotional distortions in patient's multimodal physiological, facial, acoustic, and linguistic features related to presented stimulation can be used as indicator of patient's mental illness. Real-time processing and analysis of patient's multimodal response related to annotated input stimuli is based on appropriate machine learning methods from computer science. Comprehensive longitudinal multimodal analysis of patient's emotion, mood, feelings, attention, motivation, decision-making, and working memory in synchronization with multimodal stimuli provides extremely valuable big database for data mining, machine learning and machine reasoning. Presented multimedia stimuli sequence includes personalized images, movies and sounds, as well as semantically congruent narratives. Simultaneously, with stimuli presentation patient provides subjective emotional ratings of presented stimuli in terms of subjective units of discomfort/distress, discrete emotions, or valence and arousal. These subjective emotional ratings of input stimuli and corresponding physiological, speech, and facial output features provides enough information for evaluation of patient's cognitive appraisal deficit. Aggregated real-time visualization of this information provides valuable assistance in patient mental state diagnostics enabling therapist deeper and broader insights into dynamics and progress of the psychotherapy.

Hotspot electron temperature from x-ray continuum measurements on the NIF

DOE PAGES

Jarrott, L. C.; Benedetti, L. R.; Chen, H.; ...

2016-08-24

We report on measurements of the electron temperature in the hotspot of inertially confined, layered, spherical implosions on the National Ignition Facility using a differential filtering diagnostic. Measurements of the DT and DD ion temperatures using neutron time-of-flight detectors are complicated by the contribution of hot spot motion to the peak width, which produce an apparent temperature higher than the thermal temperature. The electron temperature is not sensitive to this non-thermal velocity and is thus a valuable input to interpreting the stagnated hot spot conditions. Here we show that the current differential filtering diagnostic provides insufficient temperature resolution for themore » hot spot temperatures of interest. We then propose a new differential filter configuration utilizing larger pinhole size to increase spectral fluence, as well as thicker filtration. In conclusion, this new configuration will improve measurement uncertainty by more than a factor of three, allowing for a more accurate hotspot temperature.« less

Development and Validation of Water Vapor Tracers as Diagnostics for the Atmospheric Hydrologic Cycle

NASA Technical Reports Server (NTRS)

Bosilovich, Michael G.; Schubert, Siegfried D.; Einaudi, Franco (Technical Monitor)

2000-01-01

Understanding of the local and remote sources of water vapor can be a valuable diagnostic in understanding the regional atmospheric hydrologic cycle. In the present study, we have implemented passive tracers as prognostic variables to follow water vapor evaporated in predetermined regions until the water tracer precipitates. The formulation of the sources and sinks of tracer water is generally proportional to the prognostic water vapor variable. Because all water has been accounted for in tracers, the water vapor variable provides the validation of the tracer water and the formulation of the sources and sinks. The tracers have been implemented in a GEOS General Circulation Model (GCM) simulation consisting of several summer periods to determine the source regions of precipitation for the United States and India. The recycling of water and interannual variability of the sources of water will be examined. Potential uses in GCM sensitivity studies, predictability studies and data assimilation will be discussed.

Diagnostic imaging of blunt abdominal trauma in pediatric patients.

PubMed

Miele, Vittorio; Piccolo, Claudia Lucia; Trinci, Margherita; Galluzzo, Michele; Ianniello, Stefania; Brunese, Luca

2016-05-01

Trauma is a leading cause of morbidity and mortality in childhood, and blunt trauma accounts for 80-90 % of abdominal injuries. The mechanism of trauma is quite similar to that of the adults, but there are important physiologic differences between children and adults in this field, such as the smaller blood vessels and the high vasoconstrictive response, leading to the spreading of a non-operative management. The early imaging of children undergoing a low-energy trauma can be performed by CEUS, a valuable diagnostic tool to demonstrate solid organ injuries with almost the same sensitivity of CT scans; nevertheless, as for as urinary tract injuries, MDCT remains still the technique of choice, because of its high sensitivity and accuracy, helping to discriminate between an intra-peritoneal form a retroperitoneal urinary leakage, requiring two different managements. The liver is the most common organ injured in blunt abdominal trauma followed by the spleen. Renal, pancreatic, and bowel injuries are quite rare. In this review we present various imaging findings of blunt abdominal trauma in children.

Multiphoton gradient index endoscopy for evaluation of diseased human prostatic tissue ex vivo

NASA Astrophysics Data System (ADS)

Huland, David M.; Jain, Manu; Ouzounov, Dimitre G.; Robinson, Brian D.; Harya, Diana S.; Shevchuk, Maria M.; Singhal, Paras; Xu, Chris; Tewari, Ashutosh K.

2014-11-01

Multiphoton microscopy can instantly visualize cellular details in unstained tissues. Multiphoton probes with clinical potential have been developed. This study evaluates the suitability of multiphoton gradient index (GRIN) endoscopy as a diagnostic tool for prostatic tissue. A portable and compact multiphoton endoscope based on a 1-mm diameter, 8-cm length GRIN lens system probe was used. Fresh ex vivo samples were obtained from 14 radical prostatectomy patients and benign and malignant areas were imaged and correlated with subsequent H&E sections. Multiphoton GRIN endoscopy images of unfixed and unprocessed prostate tissue at a subcellular resolution are presented. We note several differences and identifying features of benign versus low-grade versus high-grade tumors and are able to identify periprostatic tissues such as adipocytes, periprostatic nerves, and blood vessels. Multiphoton GRIN endoscopy can be used to identify both benign and malignant lesions in ex vivo human prostate tissue and may be a valuable diagnostic tool for real-time visualization of suspicious areas of the prostate.

Magnetic navigation and catheter ablation of right atrial ectopic tachycardia in the presence of a hemi-azygos continuation: a magnetic navigation case using 3D electroanatomical mapping.

PubMed

Ernst, Sabine; Chun, Julian K R; Koektuerk, Buelent; Kuck, Karl-Heinz

2009-01-01

We report on a 63-year-old female patient in whom an electrophysiologic study discovered a hemi-azygos continuation. Using the magnetic navigation system, remote-controlled ablation was performed in conjunction with the 3D electroanatomical mapping system. Failing the attempt to advance a diagnostic catheter from the femoral vein, a diagnostic catheter was advanced via the left subclavian vein into the coronary sinus. The soft magnetic catheter was positioned in the right atrium via the hemi-azygos vein, and 3D mapping demonstrated an ectopic atrial tachycardia. Successful ablation was performed entirely remote controlled. Fluoroscopy time was only 7.1 minutes, of which 45 seconds were required during remote navigation. Remote-controlled catheter ablation using magnetic navigation in conjunction with the electroanatomical mapping system proved to be a valuable tool to perform successful ablation in the presence of a hemi-azygos continuation.

Magnetic resonance imaging-a diagnostic tool for postoperative evaluation of dental implants: a case report.

PubMed

Wanner, Laura; Ludwig, Ute; Hövener, Jan-Bernd; Nelson, Katja; Flügge, Tabea

2018-04-01

Compared with cone beam computed tomography (CBCT), magnetic resonance imaging (MRI) might be superior for the diagnosis of nerve lesions associated with implant placement. A patient presented with unilateral pain associated with dysesthesia in the region of the right lower lip and chin after implant placement. Conventional orthopantomography could not identify an association between the position of the inferior alveolar nerve and the implant. For 3-dimensional display of the implant in relation to the surrounding anatomy, CBCT was compared with MRI. MRI enabled the precise depiction of the implant position and its spatial relation to the inferior alveolar nerve, whereas the nerve position and its exact course within the mandible could not be directly displayed in CBCT. MRI may be a valuable, radiation-free diagnostic tool for the visualization of intraoral hard and soft tissues, offering an objective assessment of nerve injuries by a direct visualization of the inferior alveolar neurovascular bundle. Copyright © 2018 Elsevier Inc. All rights reserved.

DXplain: a Web-based diagnostic decision support system for medical students.

PubMed

London, S

1998-01-01

DXplain is a diagnostic decision support program, with a new World Wide Web interface, designed to help medical students and physicians formulate differential diagnoses based on clinical findings. It covers over 2000 diseases and 5000 clinical manifestations. DXplain suggests possible diagnoses, and provides brief descriptions of every disease in the database. Not all diseases are included, nor does DXplain take into account preexisting conditions or the chronological sequence of clinical manifestations. Despite these limitations, it is a useful educational tool, particularly for problem-based learning (PBL) cases and for students in clinical rotations, as it fills a niche not adequately covered by MEDLINE or medical texts. The system is relatively self-explanatory, requiring little or no end-user training. Medical libraries offering, or planning to offer, their users access to Web-based materials and resources may find this system a valuable addition to their electronic collections. Should it prove popular with the local users, provision of access may also establish or enhance the library's image as a partner in medical education.

Indocyanine Green Liposomes for Diagnosis and Therapeutic Monitoring of Cerebral Malaria.

PubMed

Portnoy, Emma; Vakruk, Natalia; Bishara, Ameer; Shmuel, Miriam; Magdassi, Shlomo; Golenser, Jacob; Eyal, Sara

2016-01-01

Cerebral malaria (CM) is a major cause of death of Plasmodium falciparum infection. Misdiagnosis of CM often leads to treatment delay and mortality. Conventional brain imaging technologies are rarely applicable in endemic areas. Here we address the unmet need for a simple, non-invasive imaging methodology for early diagnosis of CM. This study presents the diagnostic and therapeutic monitoring using liposomes containing the FDA-approved fluorescent dye indocyanine green (ICG) in a CM murine model. Increased emission intensity of liposomal ICG was demonstrated in comparison with free ICG. The Liposomal ICG's emission was greater in the brains of the infected mice compared to naïve mice and drug treated mice (where CM was prevented). Histological analyses suggest that the accumulation of liposomal ICG in the cerebral vasculature is due to extensive uptake mediated by activated phagocytes. Overall, liposomal ICG offers a valuable diagnostic tool and a biomarker for effectiveness of CM treatment, as well as other diseases that involve inflammation and blood vessel occlusion.

Utility gas turbine combustor viewing system: Volume 2, Engine operating envelope test: Final report

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

Morey, W.W.

1988-12-01

This report summarizes the development and field testing of a combustor viewing probe (CVP) as a flame diagnostic monitor for utility gas turbine engines. The prototype system is capable of providing a visual record of combustor flame images, recording flame spectral data, analyzing image and spectral data, and diagnosing certain engine malfunctions. The system should provide useful diagnostic information to utility plant operators, and reduced maintenance costs. The field tests demonstrated the ability of the CVP to monitor combustor flame condition and to relate changes in the engine operation with variations in the flame signature. Engine light off, run upmore » to full speed, the addition of load, and the effect of water injection for NO/sub x/ control could easily be identified on the video monitor. The viewing probe was also valuable in identifying hard startups and shutdowns, as well as transient effects that can seriously harm the engine.« less

Utility gas turbine combustor viewing system: Volume 1, Conceptual design and initial field testing: Final report

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

Morey, W.W.

1988-12-01

This report summarizes the development and field testing of a combustor viewing probe (CVP) as a flame diagnostic monitor for utility gas turbine engines. The prototype system is capable of providing a visual record of combustor flame images, recording flame spectral data, analyzing image and spectral data, and diagnosing certain engine malfunctions. The system should provide useful diagnostic information to utility plant operators, and reduce maintenance costs. The field tests demonstrated the ability of the CVP to monitor combustor flame condition and to relate changes in the engine operation with variations in the flame signature. Engine light off, run upmore » to full speed, the addition of load, and the effect of water injection for NO/sub x/ control could easily be identified on the video monitor. The viewing probe was also valuable in identifying hard startups and shutdowns, as well as transient effects that can seriously harm the engine. 11 refs.« less

Telemedicine and international disaster response: Medical consultation to Armenia and Russia via a telemedicine spacebridge

NASA Technical Reports Server (NTRS)

Houtchens, Bruce A.; Clemmer, Terry P.; Holloway, Harry C.; Kiselev, Alexander A.; Logan, James S.; Merrell, Ronald C.; Nicogossian, Arnauld E.; Nikogossian, Haik A.; Rayman, Russell B.; Sarkisian, Ashot E.

1991-01-01

The Telemedicine Spacebridge, a satellite mediated audio-video-fax link between four U.S. and two Armenian and Russian medical centers, permitted remote American consultants to assist Armenian and Russian physicians in the management of medical problems following the December 1988 earthquake in Armenia and the June 1989 gas explosion near Ufa. During 12 weeks of operations, 247 Armenian and Russian and 175 American medical professionals participated in 34 half-day clinical conferences. 209 patients were discussed, requiring expertise in 20 specialty areas. Telemedicine consultations resulted in altered diagnoses for 54, new diagnostic studies for 70, altered diagnostic processes for 47, and modified treatment plans for 47 of 185 Armenian patients presented. Simultaneous participation of several U.S. medical centers was judged beneficial; quality of data transmission was judged excellent. These results suggest that interactive consultation by remote specialists can provide valuable assistance to onsite physicians and favorably influence clinical decisions in the aftermath of major disasters.

Response assessment with the CXCR4-directed positron emission tomography tracer [68Ga]Pentixafor in a patient with extranodal marginal zone lymphoma of the orbital cavities.

PubMed

Herhaus, Peter; Habringer, Stefan; Vag, Tibor; Steiger, Katja; Slotta-Huspenina, Julia; Gerngroß, Carlos; Wiestler, Benedikt; Wester, Hans-Jürgen; Schwaiger, Markus; Keller, Ulrich

2017-12-01

CXCR4 belongs to the family of chemokine receptors. Together with its sole known ligand CXCL12 (SDF-1alpha), it has a pivotal role during organogenesis and for homing of hematopoietic stem cells. CXCR4 is overexpressed in various malignancies, and this is often associated with poor prognosis. Therefore, molecular imaging of CXCR4 bears a great potential for diagnostics and selecting patients for CXCR4-directed therapies. The CXCR4-directed positron emission tomography (PET) tracer [ 68 Ga]Pentixafor has been shown to visualize CXCR4 expression in various malignancies in vivo. Whereas this tracer has limitations compared to 18 F-Fluorodeoxyglucose ([ 18 F]FDG) in diagnostic PET imaging in peripheral tumour lesions, it might add valuable information in routine diagnostics and response assessment of tumours in close proximity to the central nervous system (CNS) and malignancies within this organ. As a proof-of-concept, we performed [ 68 Ga]Pentixafor PET imaging in a patient with extranodal marginal zone lymphoma (MZL) of the orbital cavities at diagnosis and for post-therapy response assessment. Compared to routinely conducted [ 18 F]FDG PET, the lymphoma lesions determined by magnetic resonance imaging (MRI) showed high tracer accumulation at diagnosis, which decreased upon treatment. We therefore propose that imaging of CXCR4 with [ 68 Ga]Pentixafor is a potential diagnostic tool for tumours close to or within the CNS and suggest this being studied in clinical trials.

Outcomes of children after esophagogastroduodenoscopy for chronic abdominal pain.

PubMed

Thakkar, Kalpesh; Chen, Leon; Tessier, Mary E; Gilger, Mark A

2014-06-01

Chronic abdominal pain is the most common indication for esophagogastroduodenoscopy (EGD) in children. However, little is known about the accuracy of EGD-based diagnosis or the outcomes of the patients who undergo this procedure. We examined the diagnostic yield of EGD and short-term outcomes of children who underwent this procedure for chronic abdominal pain. We conducted a prospective study of 290 children (4-18 years old; mean age, 11.9 ± 3.5 years; 93 girls) who underwent EGD for the primary indication of chronic abdominal pain (216 with at least 1 alarm feature) at a US pediatric gastroenterology referral center. We collected data on demographic features (age, sex), clinical characteristics (alarm features, Rome III criteria), and EGD results for each patient. All subjects with diagnostic lesions were followed for at least 1 year after EGD to determine short-term outcomes. Overall, EGD provided an accurate diagnosis for 109 children (38%). Diagnoses included esophagitis (21.0%), eosinophilic gastroenteritis (4.1%), eosinophilic esophagitis (3.8%), Helicobacter pylori infection (2.0%), celiac disease (0.6%), and Crohn's disease (0.4%). Short-term outcomes were available for 81% of patients with diagnostic findings, and medical therapy was effective in approximately 67% of these children. EGD is valuable for the diagnosis of children with abdominal pain, with a 38% diagnostic yield. EGD identified disorders for which medical therapy was effective in 67% of children during the year after diagnosis. Copyright © 2014 AGA Institute. Published by Elsevier Inc. All rights reserved.

Diagnosis of stinging insect allergy: utility of cellular in-vitro tests.

PubMed

Scherer, Kathrin; Bircher, Andreas J; Heijnen, Ingmar Afm

2009-08-01

Diagnosis of stinging insect allergy is based on a detailed history, venom skin tests, and detection of venom-specific IgE. As an additional diagnostic tool, basophil responsiveness to venom allergens has been shown to be helpful in selected patients. This review summarizes the current diagnostic procedures for stinging insect allergy and discusses the latest developments in cellular in-vitro tests. Cellular assays have been evaluated in patients with Hymenoptera venom allergy. The diagnostic performance of the cellular mediator release test is similar to that of the flow cytometric basophil activation test (BAT), but the BAT has been the most intensively studied. BAT offers the possibility to assess basophil reactivity to allergens in their natural environment and to simultaneously analyze surface marker expression and intracellular signaling. It has been demonstrated that BAT represents a valuable additional diagnostic tool in selected patients when used in combination with other well established tests. A major limitation is the current lack of unified, standardized protocols. Flow cytometry offers huge possibilities to enhance knowledge of basophil functions. The BAT may be used as an additional test to confirm the diagnosis of stinging insect allergy in selected patients, provided that it is performed by an experienced laboratory using a validated assay. Test results have to be interpreted by clinicians familiar with the methodological aspects. The utility of the BAT to confirm allergy diagnosis and to predict the risk of subsequent systemic reactions may be improved by combined analysis of multiple surface markers and intracellular signaling pathways.

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

The use of anti-Müllerian hormone as diagnostic for gonadectomy status in dogs.

PubMed

Themmen, Axel P N; Kalra, Bhanu; Visser, Jenny A; Kumar, Ajay; Savjani, Gopal; de Gier, Jeffrey; Jaques, Scott

2016-10-01

In the veterinary practice, there is a need for a diagnostic tool to check the gonadal status in female dogs because it may be difficult to determine whether a female animal has been spayed or whether there are ovarian remnants. Although less prevalent, a similar situation pertains to male dogs. Anti-Müllerian hormone (AMH) is an important regulator of gonadal function and is a specific gonadal product that can be determined in circulation. The objective of this study was to develop and test a canine blood AMH assay as a diagnostic tool to determine the presence of functional gonadal tissue in dogs. A prospective study with a training-validation set paradigm was used. A canine AMH assay was developed and serum and plasma AMH concentrations were determined in blood samples from 46 intact female dogs, 48 spayed females, 50 intact males, and 48 castrated males collected at two separate institutes. Using a training-validation set paradigm, it was found that using cutoff values of 1.1 ng/mL (female) and 5.5 ng/mL (male) AMH, the assay reported excellent specificity and sensitivity of 100% and 90% in female dogs, and good specificity and sensitivity of 100% and 76%, in male dogs, respectively. The sensitivity in male dogs could be further enhanced by including a serum testosterone determination. This newly developed canine AMH assay is a valuable diagnostic tool to determine gonadal status in veterinary medicine. Copyright © 2016 Elsevier Inc. All rights reserved.

EDITORIAL: Recent developments in biomedical optics

NASA Astrophysics Data System (ADS)

Wang, Ruikang K.; Hebden, Jeremy C.; Tuchin, Valery V.

2004-04-01

The rapid growth in laser and photonic technology has resulted in new tools being proposed and developed for use in the medical and biological sciences. Specifically, a discipline known as biomedical optics has emerged which is providing a broad variety of optical techniques and instruments for diagnostic, therapeutic and basic science applications. New laser sources, detectors and measurement techniques are yielding powerful new methods for the study of diseases on all scales, from single molecules, to specific tissues and whole organs. For example, novel laser microscopes permit spectroscopic and force measurements to be performed on single protein molecules; new optical devices provide information on molecular dynamics and structure to perform `optical biopsy' non-invasively and almost instantaneously; and optical coherence tomography and diffuse optical tomography allow visualization of specific tissues and organs. Using genetic promoters to derive luciferase expression, bioluminescence methods can generate molecular light switches, which serve as functional indicator lights reporting cellular conditions and responses in living animals. This technique could allow rapid assessment of and response to the effects of anti-tumour drugs, antibiotics, or antiviral drugs. This issue of Physics in Medicine and Biology highlights recent research in biomedical optics, and is based on invited contributions to the International Conference on Advanced Laser Technology (Focused on Biomedical Optics) held at Cranfield University at Silsoe on 19--23 September 2003. This meeting included sessions devoted to: diffuse optical imaging and spectroscopy; optical coherence tomography and coherent domain techniques; optical sensing and applications in life science; microscopic, spectroscopic and opto-acoustic imaging; therapeutic and diagnostic applications; and laser interaction with organic and inorganic materials. Twenty-one papers are included in this special issue. The first paper gives an overview on the current status of scanning laser ophthalmoscopy and its role in bioscience and medicine, while the second paper describes the current problems in tissue engineering and the potential role for optical coherence tomography. The following seven papers present and discuss latest developments in infrared spectroscopy and diffuse optical tomography for medical diagnostics. Eight further papers report recent advances in optical coherence tomography, covering new and evolving methods and instrumentation, theoretical and numerical modelling, and its clinical applications. The remaining papers cover miscellaneous topics in biomedical optics, including new developments in opto-acoustic imaging techniques, laser speckle imaging of blood flow in microcirculations, and potential of hollow-core photonic-crystal fibres for laser dentistry. We thank all the authors for their valuable contributions and their prompt responses to reviewers' comments. We are also very grateful to the reviewers for their hard work and their considerable efforts to meet tight deadlines.

The modern trends of the evolution laser information technology in oncology

NASA Astrophysics Data System (ADS)

Mikov, A. A.; Svirin, V. N.

2008-04-01

Laser-optical information technologies and devices develop since the 70- years at the end of 20 century and are broadly used for diagnostics and treatment of oncological diseases to date. Although such methods as photodynamic therapy (PDT), laser-induce thermotherapy (LITT), fluorescent diagnostics and spectrophotometry already more than 30 years are used for treatment and diagnostics of oncological diseases, nevertheless, they are enough new methods and, as a rule, are used in large scientific centers and medical institutions. This is bound, first of all, with lack of information on modern method of cancer treatment, the absence of widely available laser procedures and corresponding devices in the polyclinics and even in district hospitals, as well as insufficient understanding of application areas, where laser methods has an advantage by comparison, for instance, with beam or chemotherapy. At present day laser methods are fast upcoming direction of the treatment oncological diseases. This is explained by progress in development essentially laser, particularly diode, improvement electronic and computing components and broad introduction software-algorithmic methods of control the undertaking therapeutic and diagnostic procedures. In article are considered new laser methods of the undertaking diagnostic and therapeutic procedures and is shown that introduction multiwave laser radiation for probe and influences on tissue, the different methods of the determination of the functional state of tissues, realization of the on-line diagnostics when carrying out the therapeutic procedures, automatic control systems of the power laser radiation, which depends on state patient tissue, as well as software-algorithmic methods of management session therapeutic and diagnostic procedures greatly raises efficiency of the treatment oncological diseases. On an example of the multipurpose laser therapeutic devices("MLTA") developed and introduced in clinical practice and multipurpose laser diagnostic complexes ("MLDC"), the realizing offered methods, are shown the basic tendencies of development laser methods in oncology, concrete technical decisions and the experimental clinical material showing increase of efficiency of treatment of a cancer at their realization are resulted. It is shown, that realization of the offered methods and technical technologies opens new competitive advantages laser technologies in comparison with beam and chemical-therapy at treatment of oncological diseases.

Traumatic Brain Injury Detection Using Electrophysiological Methods

PubMed Central

Rapp, Paul E.; Keyser, David O.; Albano, Alfonso; Hernandez, Rene; Gibson, Douglas B.; Zambon, Robert A.; Hairston, W. David; Hughes, John D.; Krystal, Andrew; Nichols, Andrew S.

2015-01-01

Measuring neuronal activity with electrophysiological methods may be useful in detecting neurological dysfunctions, such as mild traumatic brain injury (mTBI). This approach may be particularly valuable for rapid detection in at-risk populations including military service members and athletes. Electrophysiological methods, such as quantitative electroencephalography (qEEG) and recording event-related potentials (ERPs) may be promising; however, the field is nascent and significant controversy exists on the efficacy and accuracy of the approaches as diagnostic tools. For example, the specific measures derived from an electroencephalogram (EEG) that are most suitable as markers of dysfunction have not been clearly established. A study was conducted to summarize and evaluate the statistical rigor of evidence on the overall utility of qEEG as an mTBI detection tool. The analysis evaluated qEEG measures/parameters that may be most suitable as fieldable diagnostic tools, identified other types of EEG measures and analysis methods of promise, recommended specific measures and analysis methods for further development as mTBI detection tools, identified research gaps in the field, and recommended future research and development thrust areas. The qEEG study group formed the following conclusions: (1) Individual qEEG measures provide limited diagnostic utility for mTBI. However, many measures can be important features of qEEG discriminant functions, which do show significant promise as mTBI detection tools. (2) ERPs offer utility in mTBI detection. In fact, evidence indicates that ERPs can identify abnormalities in cases where EEGs alone are non-disclosing. (3) The standard mathematical procedures used in the characterization of mTBI EEGs should be expanded to incorporate newer methods of analysis including non-linear dynamical analysis, complexity measures, analysis of causal interactions, graph theory, and information dynamics. (4) Reports of high specificity in qEEG evaluations of TBI must be interpreted with care. High specificities have been reported in carefully constructed clinical studies in which healthy controls were compared against a carefully selected TBI population. The published literature indicates, however, that similar abnormalities in qEEG measures are observed in other neuropsychiatric disorders. While it may be possible to distinguish a clinical patient from a healthy control participant with this technology, these measures are unlikely to discriminate between, for example, major depressive disorder, bipolar disorder, or TBI. The specificities observed in these clinical studies may well be lost in real world clinical practice. (5) The absence of specificity does not preclude clinical utility. The possibility of use as a longitudinal measure of treatment response remains. However, efficacy as a longitudinal clinical measure does require acceptable test–retest reliability. To date, very few test–retest reliability studies have been published with qEEG data obtained from TBI patients or from healthy controls. This is a particular concern because high variability is a known characteristic of the injured central nervous system. PMID:25698950

Traumatic brain injury detection using electrophysiological methods.

PubMed

Rapp, Paul E; Keyser, David O; Albano, Alfonso; Hernandez, Rene; Gibson, Douglas B; Zambon, Robert A; Hairston, W David; Hughes, John D; Krystal, Andrew; Nichols, Andrew S

2015-01-01

Measuring neuronal activity with electrophysiological methods may be useful in detecting neurological dysfunctions, such as mild traumatic brain injury (mTBI). This approach may be particularly valuable for rapid detection in at-risk populations including military service members and athletes. Electrophysiological methods, such as quantitative electroencephalography (qEEG) and recording event-related potentials (ERPs) may be promising; however, the field is nascent and significant controversy exists on the efficacy and accuracy of the approaches as diagnostic tools. For example, the specific measures derived from an electroencephalogram (EEG) that are most suitable as markers of dysfunction have not been clearly established. A study was conducted to summarize and evaluate the statistical rigor of evidence on the overall utility of qEEG as an mTBI detection tool. The analysis evaluated qEEG measures/parameters that may be most suitable as fieldable diagnostic tools, identified other types of EEG measures and analysis methods of promise, recommended specific measures and analysis methods for further development as mTBI detection tools, identified research gaps in the field, and recommended future research and development thrust areas. The qEEG study group formed the following conclusions: (1) Individual qEEG measures provide limited diagnostic utility for mTBI. However, many measures can be important features of qEEG discriminant functions, which do show significant promise as mTBI detection tools. (2) ERPs offer utility in mTBI detection. In fact, evidence indicates that ERPs can identify abnormalities in cases where EEGs alone are non-disclosing. (3) The standard mathematical procedures used in the characterization of mTBI EEGs should be expanded to incorporate newer methods of analysis including non-linear dynamical analysis, complexity measures, analysis of causal interactions, graph theory, and information dynamics. (4) Reports of high specificity in qEEG evaluations of TBI must be interpreted with care. High specificities have been reported in carefully constructed clinical studies in which healthy controls were compared against a carefully selected TBI population. The published literature indicates, however, that similar abnormalities in qEEG measures are observed in other neuropsychiatric disorders. While it may be possible to distinguish a clinical patient from a healthy control participant with this technology, these measures are unlikely to discriminate between, for example, major depressive disorder, bipolar disorder, or TBI. The specificities observed in these clinical studies may well be lost in real world clinical practice. (5) The absence of specificity does not preclude clinical utility. The possibility of use as a longitudinal measure of treatment response remains. However, efficacy as a longitudinal clinical measure does require acceptable test-retest reliability. To date, very few test-retest reliability studies have been published with qEEG data obtained from TBI patients or from healthy controls. This is a particular concern because high variability is a known characteristic of the injured central nervous system.

Walking on thin ice! Identifying methamphetamine "drug mules" on digital plain radiography.

PubMed

Abdul Rashid, S N; Mohamad Saini, S B; Abdul Hamid, S; Muhammad, S J; Mahmud, R; Thali, M J; Flach, P M

2014-04-01

The purpose of this study was to retrospectively evaluate the sensitivity, specificity and accuracy of identifying methamphetamine (MA) internal payloads in "drug mules" by plain abdominal digital radiography (DR). The study consisted of 35 individuals suspected of internal MA drug containers. A total of 59 supine digital radiographs were collected. An overall calculation regarding the diagnostic accuracy for all "drug mules" and a specific evaluation concerning the radiological appearance of drug packs as well as the rate of clearance and complications in correlation with the reader's experience were performed. The gold standard was the presence of secured drug packs in the faeces. There were 16 true-positive "drug mules" identified. DR of all drug carriers for Group 1 (forensic imaging experienced readers, n = 2) exhibited a sensitivity of 100%, a mean specificity of 76.3%, positive predictive value (PPV) of 78.5%, negative predictive value (NPV) of 100% and a mean accuracy 87.2%. Group 2 (inexperienced readers, n = 3) showed a lower sensitivity (93.7%), a mean specificity of 86%, a PPV of 86.5%, an NPV of 94.1% and a mean accuracy of 89.5%. The interrater agreement within Group 1 was 0.72 and within Group 2 averaged to 0.79, indicating a fair to very good agreement. DR is a valuable screening tool in cases of MA body packers with huge internal payloads being associated with a high diagnostic insecurity. Diagnostic insecurity on plain films may be overcome by low-dose CT as a cross-sectional imaging modality and addressed by improved radiological education in reporting drug carriers on imaging. Diagnostic signs (double-condom and halo signs) on digital plain radiography are specific in MA "drug mules", although DR is associated with high diagnostic insecurity and underreports the total internal payload.

The value of FDG PET/CT for follow-up of patients with melanoma: a retrospective analysis

PubMed Central

Vensby, Philip H; Schmidt, Grethe; Kjær, Andreas; Fischer, Barbara M

2017-01-01

The incidence of melanoma (MM) is among the fastest rising cancers in the western countries. Positron Emission Tomography with Computed Tomography (PET/CT) is a valuable non-invasive tool for the diagnosis and staging of patients with MM. However, research on the value of PET/CT in follow-up of melanoma patients is limited. This study assesses the diagnostic value of PET/CT for follow-up after melanoma surgery. This retrospective study includes patients with MM who performed at least one PET/CT scan after initial surgery and staging. PET/CT findings were compared to histology, MRI or fine needle aspiration (FNA) to estimate the diagnostic accuracy. The diagnostic performance of PET/CT performed in patients with and without a clinical suspicion of relapse was compared. 238 patients (526 scans) were included. Of the 526 scans 130 (25%) scans were PET-positive, 365 (69%) PET-negative, and 28 (5%) had equivocal findings. Sensitivity was 89% [0.82-0.94], specificity 92% [0.89-0.95], positive and negative predictive values of 78% [0.70-0.84] and 97% [0.94-0.98] respectively. When stratified for reason of referral there was no statistical significant difference in the diagnostic accuracy of PET/CT between patients referred with or without a clinical suspicion of relapse. This study demonstrates that PET/CT despite a moderate sensitivity has a high negative predictive value in the follow-up of melanoma patients. Thus, a negative PET/CT-scan essentially rules out relapse. However, the frequency of false positive findings is relatively high, especially among patients undergoing a “routine” PET/CT with no clinical suspicion of relapse, potentially causing anxiety and leading to further diagnostic procedures. PMID:29348980

The value of FDG PET/CT for follow-up of patients with melanoma: a retrospective analysis.

PubMed

Vensby, Philip H; Schmidt, Grethe; Kjær, Andreas; Fischer, Barbara M

2017-01-01

The incidence of melanoma (MM) is among the fastest rising cancers in the western countries. Positron Emission Tomography with Computed Tomography (PET/CT) is a valuable non-invasive tool for the diagnosis and staging of patients with MM. However, research on the value of PET/CT in follow-up of melanoma patients is limited. This study assesses the diagnostic value of PET/CT for follow-up after melanoma surgery. This retrospective study includes patients with MM who performed at least one PET/CT scan after initial surgery and staging. PET/CT findings were compared to histology, MRI or fine needle aspiration (FNA) to estimate the diagnostic accuracy. The diagnostic performance of PET/CT performed in patients with and without a clinical suspicion of relapse was compared. 238 patients (526 scans) were included. Of the 526 scans 130 (25%) scans were PET-positive, 365 (69%) PET-negative, and 28 (5%) had equivocal findings. Sensitivity was 89% [0.82-0.94], specificity 92% [0.89-0.95], positive and negative predictive values of 78% [0.70-0.84] and 97% [0.94-0.98] respectively. When stratified for reason of referral there was no statistical significant difference in the diagnostic accuracy of PET/CT between patients referred with or without a clinical suspicion of relapse. This study demonstrates that PET/CT despite a moderate sensitivity has a high negative predictive value in the follow-up of melanoma patients. Thus, a negative PET/CT-scan essentially rules out relapse. However, the frequency of false positive findings is relatively high, especially among patients undergoing a "routine" PET/CT with no clinical suspicion of relapse, potentially causing anxiety and leading to further diagnostic procedures.

Cystic Fibrosis Diagnostic Challenges over 4 Decades: Historical Perspectives and Lessons Learned.

PubMed

Farrell, Philip M; White, Terry B; Derichs, Nico; Castellani, Carlo; Rosenstein, Beryl J

2017-02-01

Because cystic fibrosis (CF) can be difficult to diagnose, and because information about the genetic complexities and pathologic basis of the disease has grown so rapidly over the decades, several consensus conferences have been held by the US CF Foundation, and a variety of other efforts to improve diagnostic practices have been organized by the European CF Society. Despite these efforts, the application of diagnostic criteria has been variable and caused confusion. To improve diagnosis and achieve standardization in terms and definitions worldwide, the CF Foundation in 2015 convened a committee of 32 experts in the diagnosis of CF from 9 countries. As part of the process, all previous consensus-seeking exercises sponsored by the CF Foundation, along with the important efforts of the European CF Society, were comprehensively and critically reviewed. The goal was to better understand why consensus conferences and their publications have not led to the desired results. Lessons learned from previous diagnosis consensus processes and products were identified. It was decided that participation in developing a consensus was generally not inclusive enough for global impact. It was also found that many efforts to address sweat test issues were valuable but did not always improve clinical practices as CF diagnostic testing evolved. It also became clear from this review that premature applications of potential diagnostic tests such as nasal potential difference and intestinal current measurement should be avoided until validation and standardization occur. Finally, we have learned that due to the significant and growing number of cases that are challenging to diagnose, an associated continuing medical education program is both desirable and necessary. It is necessary but not sufficient to organize and publish CF diagnosis consensus processes. Follow-up implementation efforts and monitoring practices seem essential. Copyright © 2016. Published by Elsevier Inc.

A new species of pouched octopus, Cistopus Gray, 1849 (Cephalopoda: Octopodidae) from the southwest coast of India.

PubMed

Sreeja, Vijayamma; Norman, Mark D; Kumar, Appukuttannair Biju

2015-12-16

Octopuses of the genus Cistopus Gray, 1849 are commercially valuable catches in the cephalopod fisheries of India. The primary and unique diagnostic character of this genus is the possession of eight small mucous pouches embedded in the oral faces of the webs between the bases of each arm. Historically only a single species of Cistopus, C. indicus, had been reported from Indian waters. In reviewing the octopod fauna off the Kerala coast, we have detected three species of Cistopus, of which one is described here as a new species. Cistopus platinoidus sp. nov. is distinct from Cistopus species described to date (C. indicus, C. taiwanicus and C. chinensis) on the basis of sucker counts, the number and position of enlarged suckers in males, and presence/absence of a calamus. Our studies of catch composition of Kerala octopod fisheries indicate a higher diversity of target species than previously suspected, including a number of undescribed species. Taxonomic resolution and collation of biological and distributional data are required for effective monitoring and management of these valuable fisheries.

Prevalence of congenital Toxoplasma gondii infection among newborns from the Poznań region of Poland: validation of a new combined enzyme immunoassay for Toxoplasma gondii-specific immunoglobulin A and immunoglobulin M antibodies.

PubMed

Paul, M; Petersen, E; Szczapa, J

2001-05-01

We determined the value of a new serological assay detecting Toxoplasma-specific immunoglobulin M (IgM) and IgA antibodies at birth for use in mass neonatal screening. The incidence of congenital infection in newborns was compared with data from an epidemiological investigation on the seroprevalence of Toxoplasma in the studied population. Peripheral blood was collected on Guthrie cards during the first 3 days of life and tested for anti-Toxoplasma IgA and IgM using a noncommercial immunocapture enzyme-linked immunosorbent assay (ELISA). When the screening assay was positive, serum samples from the child and the mother were collected for use in Western blotting comparative immunological profile analysis and traditional serological tests for determination of specific IgG, IgM, and IgA antibodies. From December 1998 to April 2000, 17,653 filter paper samples from live-born neonates were successively screened. Congenital T. gondii infection was finally confirmed in 19 newborns. In traditional assays, 13 of 19 infants were IgM and IgA positive using filter paper eluates at birth, 1 child was positive only for IgM, 1 patient was positive for IgM and borderline for IgA, 1 had an equivocal level of IgA, and 3 cases were confirmed only by the Western blot assay. The prevalence of Toxoplasma-specific IgA and/or IgM in filter paper samples at birth was 1 per 929 live-born neonates (1.08/1,000) or about 1 per 523 children (1.9/1,000) born to nonimmune women with a potential risk of primary T. gondii infection during pregnancy, compared to the actual seropositivity rate of 43.7%. The diagnostic sensitivity of the combined IgA-IgM ELISA using neonatal filter paper specimens was not more than 95%, the positive predictive value of the test was 82.6%, and the diagnostic specificity was calculated to be 99.9%. The combined IgA-IgM ELISA is a valuable method for the diagnosis of congenital toxoplasmosis at birth and fulfills criteria for neonatal screening programs. The method showed a good diagnostic sensitivity in neonates untreated prenatally who were born in an area of high seroprevalence of T. gondii infection.

Nontraditional carbon reducing agents in smelting FMn78B ferromanganese and valuable manganese slag

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

P.A. Kravchenko; O.N. Sezonenko; O.L. Bespalov

The smelting of FeMn78B ferromanganese (0.7% P) by a flux-free method, with the production of valuable slag (36-38% Mn), is considered in the case where some of the coke nuts are replaced by anthracite and sometimes by long-flame coal.

Differentiation of orbital lymphoma and idiopathic orbital inflammatory pseudotumor: combined diagnostic value of conventional MRI and histogram analysis of ADC maps.

PubMed

Ren, Jiliang; Yuan, Ying; Wu, Yingwei; Tao, Xiaofeng

2018-05-02

The overlap of morphological feature and mean ADC value restricted clinical application of MRI in the differential diagnosis of orbital lymphoma and idiopathic orbital inflammatory pseudotumor (IOIP). In this paper, we aimed to retrospectively evaluate the combined diagnostic value of conventional magnetic resonance imaging (MRI) and whole-tumor histogram analysis of apparent diffusion coefficient (ADC) maps in the differentiation of the two lesions. In total, 18 patients with orbital lymphoma and 22 patients with IOIP were included, who underwent both conventional MRI and diffusion weighted imaging before treatment. Conventional MRI features and histogram parameters derived from ADC maps, including mean ADC (ADC mean ), median ADC (ADC median ), skewness, kurtosis, 10th, 25th, 75th and 90th percentiles of ADC (ADC 10 , ADC 25 , ADC 75 , ADC 90 ) were evaluated and compared between orbital lymphoma and IOIP. Multivariate logistic regression analysis was used to identify the most valuable variables for discriminating. Differential model was built upon the selected variables and receiver operating characteristic (ROC) analysis was also performed to determine the differential ability of the model. Multivariate logistic regression showed ADC 10 (P = 0.023) and involvement of orbit preseptal space (P = 0.029) were the most promising indexes in the discrimination of orbital lymphoma and IOIP. The logistic model defined by ADC 10 and involvement of orbit preseptal space was built, which achieved an AUC of 0.939, with sensitivity of 77.30% and specificity of 94.40%. Conventional MRI feature of involvement of orbit preseptal space and ADC histogram parameter of ADC 10 are valuable in differential diagnosis of orbital lymphoma and IOIP.

Cell-Free Circulating Methylated SEPT9 for Noninvasive Diagnosis and Monitoring of Colorectal Cancer

PubMed Central

Fu, Bo; Yan, Peng; Zhang, Shan; Lu, Yan; Pan, Li; Tang, Wenqiang; Chen, Shen; Chen, Shuangfeng

2018-01-01

Identification of early-stage tumor and monitoring therapeutic efficacy and recurrence or metastasis of colorectal cancer (CRC) are urgently warranted for improving the outcome of CRC patients and reducing the disease-related mortality. In this study, we evaluated the diagnostic value of cell-free circulating methylated SEPT9 (mSEPT9) for CRC and beyond CRC and examined the potentiality of mSEPT9 in assessing therapeutic efficacy and monitoring recurrence of CRC. Our results confirmed the favorable diagnostic value of plasma mSEPT9 for CRC, with a sensitivity of 61.22% (95% confidence interval (CI): 51.33%–70.27%) and specificity of 93.7% (95% CI: 91.09%–95.57%) using 2/3 algorithm. The positive rate of mSEPT9 in CRC was correlated with tumor size, histological grade, and general histological type (P < 0.05). Beyond CRC, gastric cancer patients also presented a high positive rate of plasma mSEPT9 (70%). The conversions between preoperative and postoperative plasma mSEPT9 reflected the therapeutic efficacy of curatively intended surgery for CRC patients. The persistent positivity of plasma mSEPT9 after surgery (within 7–14 days) was highly associated with impending recurrences or metastases (within one year), with a sensitivity of 100%. Postoperative mSEPT9 status during follow-up also provided valuable indication for CRC recurrence or metastases, with a good consistency (kappa = 0.818, P = 0.001). Our results verified the reliability of plasma mSEPT9 as a biomarker for noninvasive diagnosis of CRC. More significantly, we revealed its valuable role in appraising CRC therapeutic efficacy and monitoring CRC recurrences or metastases. Further studies with larger sample sizes are needed to verify and elucidate the clinical utility of the promising findings. PMID:29849824

The MIT HEDP Accelerator Facility for Diagnostic Development for OMEGA, Z, and the NIF

NASA Astrophysics Data System (ADS)

Parker, C. E.; Gatu Johnson, M.; Birkel, A.; Kabadi, N. V.; Lahmann, B.; Milanese, L. M.; Simpson, R. A.; Sio, H.; Sutcliffe, G. D.; Wink, C.; Frenje, J. A.; Li, C. K.; Seguin, F. H.; Petrasso, R. D.; Leeper, R.; Ruiz, C. L.; Sangster, T. C.

2016-10-01

The MIT HEDP Accelerator Facility utilizes a 135-keV linear electrostatic ion accelerator, DT and DD neutron sources, and two x-ray sources for development and characterization of nuclear diagnostics for OMEGA, Z, and the NIF. The accelerator generates DD and D3He fusion products through the acceleration of D+ ions onto a 3He-doped Erbium-Deuteride target. Accurately characterized fusion product rates of around 106 s-1 are routinely achieved. The DT and DD neutron sources generate up to 6x108, and 1x107 neutrons/s, respectively. One x-ray generator is a thick-target W source with a peak energy of 225 keV and a maximum dose rate of 12 Gy/min; the other uses Cu, Mo, or Ti elemental tubes to generate x-rays with a maximum energy of 40 keV. Diagnostics developed and calibrated at this facility include CR-39-based charged-particle spectrometers, neutron detectors, and the particle Time-Of-Flight (pTOF) and Magnetic PTOF CVD-diamond-based bang time detectors. The accelerator is also a valuable hands-on tool for graduate and undergraduate education at MIT. This work was supported in part by the U.S. DoE, SNL, LLE and LLNL.

The MIT HEDP Accelerator Facility for Diagnostic Development for OMEGA, Z, and the NIF

NASA Astrophysics Data System (ADS)

Sio, H.; Gatu Johnson, M.; Birkel, A.; Doeg, E.; Frankel, R.; Kabadi, N. V.; Lahmann, B.; Manzin, M.; Simpson, R. A.; Parker, C. E.; Sutcliffe, G. D.; Wink, C.; Frenje, J. A.; Li, C. K.; Seguin, F. H.; Petrasso, R. D.; Leeper, R.; Hahn, K.; Ruiz, C. L.; Sangster, T. C.; Hilsabeck, T.

2017-10-01

The MIT HEDP Accelerator Facility utilizes a 135-keV, linear electrostatic ion accelerator; DT and DD neutron sources; and two x-ray sources for development and characterization of nuclear diagnostics for OMEGA, Z, and the NIF. The accelerator generates DD and D3He fusion products through the acceleration of D+ ions onto a 3He-doped Erbium-Deuteride target. Accurately characterized fusion product rates of around 106 s- 1 are routinely achieved. The DT and DD neutron sources generate up to 6×108 and 1×107 neutrons/s, respectively. One x-ray generator is a thick-target W source with a peak energy of 225 keV and a maximum dose rate of 12 Gy/min; the other uses Cu, Mo, or Ti elemental tubes to generate x-rays with a maximum energy of 40 keV. Diagnostics developed and calibrated at this facility include CR-39-based charged-particle spectrometers, neutron detectors, and the particle Time-Of-Flight (pTOF) and Magnetic PTOF CVD-diamond-based bang time detectors. The accelerator is also a valuable hands-on tool for graduate and undergraduate education at MIT. This work was supported in part by the U.S. DoE, SNL, LLE and LLNL.

Development of diagnostic SPR based biosensor for the detection of pharmaceutical compounds in saliva

NASA Astrophysics Data System (ADS)

Sonny, Susanna; Sesay, Adama M.; Virtanen, Vesa

2010-11-01

The aim of the study is to develop diagnostic tests for the detection of pharmaceutical compounds in saliva. Oral fluid is increasingly being considered as an ideal sample matrix. It can be collected non-invasively and causes less stress to the person being tested. The detection of pharmaceutical compounds and drugs in saliva can give valuable information on individual bases on dose response, usage, characterization and clinical diagnostics. Surface plasmon resonance (SPR) is a highly sensitive, fast and label free analytical technique for the detection of molecular interactions. The specific binding of measured analyte onto the active gold sensing surface of the SPR device induces a refractive index change that can be monitored. To monitor these pharmaceutical compounds in saliva the immunoassays were developed using a SPR instrument. The instrument is equipped with a 670nm laser diode and has two sensing channels. Monoclonal antibodies against the pharmaceutical compounds were used to specifically recognise and capture the compounds which intern will have an effect of the refractive index monitored. Preliminary results show that the immunoassays for cocaine and MDMA (3,4-methylenedioxymethamphetamine) are very sensitive and have linear ranges of 0.01 pg/ml - 1 ng/ml and 0.1 pg/ml - 100 ng/ml, respectively.

Non-invasive assessment of negative pressure wound therapy using high frequency diagnostic ultrasound: oedema reduction and new tissue accumulation.

PubMed

Young, Stephen R; Hampton, Sylvie; Martin, Robin

2013-08-01

Tissue oedema plays an important role in the pathology of chronic and traumatic wounds. Negative pressure wound therapy (NPWT) is thought to contribute to active oedema reduction, yet few studies have showed this effect. In this study, high frequency diagnostic ultrasound at 20 MHz with an axial resolution of 60 µm was used to assess the effect of NPWT at - 80 mmHg on pressure ulcers and the surrounding tissue. Wounds were monitored in four patients over a 3-month period during which changes in oedema and wound bed thickness (granulation tissue) were measured non-invasively. The results showed a rapid reduction of periwound tissue oedema in all patients with levels falling by a mean of 43% after 4 days of therapy. A 20% increase in the thickness of the wound bed was observed after 7 days due to new granulation tissue formation. Ultrasound scans through the in situ gauze NPWT filler also revealed the existence of macrodeformation in the tissue produced by the negative pressure. These preliminary studies suggest that non-invasive assessment using high frequency diagnostic ultrasound could be a valuable tool in clinical studies of NPWT. © 2012 The Authors. International Wound Journal © 2012 John Wiley & Sons Ltd and Medicalhelplines.com Inc.

Diagnostic value of chest radiographs in bedridden patients suspected of having pneumonia.

PubMed

Esayag, Yaacov; Nikitin, Irina; Bar-Ziv, Jacob; Cytter, Ruth; Hadas-Halpern, Irith; Zalut, Todd; Yinnon, Amos M

2010-01-01

To assess the diagnostic value of the chest radiograph for the diagnosis of pneumonia in bedridden patients, using non-contrast-enhanced high-resolution chest computed tomography (CT) as the gold standard. We prospectively evaluated bedridden patients hospitalized with moderate to high clinical probability of pneumonia. Chest radiographs were interpreted in a blinded fashion by 3 observers and classified as definite, normal, or uncertain for pneumonia. Chest CT was obtained within 12 hours of chest radiograph. We applied Bayesian analysis to assess the accuracy of chest radiograph in the diagnosis of pneumonia. In a 5-month period, 58 patients were evaluated, 31 (53%) were female. Their chest radiographs were interpreted as negative, uncertain, or positive for pneumonia in 31 (53%), 15 (26%), and 12 (21%) patients, respectively, while CT confirmed pneumonia in 11 (35%), 10 (67%), and in 10 (83%). The sensitivity of the chest radiograph to diagnose pneumonia was 65%, the specificity was 93%, the positive and negative predictive values were, respectively, 83% and 65%, while the overall accuracy was 69% (95% confidence interval, 50%-79%). In bedridden patients with suspected pneumonia, a normal chest radiograph does not rule out the diagnosis, hence, a chest CT scan might provide valuable diagnostic information. Copyright 2010 Elsevier Inc. All rights reserved.

A flexible data-driven comorbidity feature extraction framework.

PubMed

Sideris, Costas; Pourhomayoun, Mohammad; Kalantarian, Haik; Sarrafzadeh, Majid

2016-06-01

Disease and symptom diagnostic codes are a valuable resource for classifying and predicting patient outcomes. In this paper, we propose a novel methodology for utilizing disease diagnostic information in a predictive machine learning framework. Our methodology relies on a novel, clustering-based feature extraction framework using disease diagnostic information. To reduce the data dimensionality, we identify disease clusters using co-occurrence statistics. We optimize the number of generated clusters in the training set and then utilize these clusters as features to predict patient severity of condition and patient readmission risk. We build our clustering and feature extraction algorithm using the 2012 National Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP) which contains 7 million hospital discharge records and ICD-9-CM codes. The proposed framework is tested on Ronald Reagan UCLA Medical Center Electronic Health Records (EHR) from 3041 Congestive Heart Failure (CHF) patients and the UCI 130-US diabetes dataset that includes admissions from 69,980 diabetic patients. We compare our cluster-based feature set with the commonly used comorbidity frameworks including Charlson's index, Elixhauser's comorbidities and their variations. The proposed approach was shown to have significant gains between 10.7-22.1% in predictive accuracy for CHF severity of condition prediction and 4.65-5.75% in diabetes readmission prediction. Copyright © 2016 Elsevier Ltd. All rights reserved.

Peptidomics of urine and other biofluids for cancer diagnostics.

PubMed

Bauça, Josep Miquel; Martínez-Morillo, Eduardo; Diamandis, Eleftherios P

2014-08-01

Cancer is a leading cause of death worldwide. The low diagnostic sensitivity and specificity of most current cancer biomarkers make early cancer diagnosis a challenging task. The comprehensive study of peptides and small proteins in a living system, known as "peptidomics," represents an alternative technological approach to the discovery of potential biomarkers for the assessment of a wide variety of pathologies. This review examines the current status of peptidomics for several body fluids, with a focus on urine, for cancer diagnostics applications. Several studies have used high-throughput technologies to characterize the peptide content of different body fluids. Because of its noninvasive collection and high stability, urine is a valuable source of candidate cancer biomarkers. A wide variety of preanalytical issues concerning patient selection and sample handling need to be considered, because not doing so can affect the quality of the results by introducing bias and artifacts. Optimization of both the analytical strategies and the processing of bioinformatics data is also essential to minimize the false-discovery rate. Peptidomics-based studies of urine and other body fluids have yielded a number of biomolecules and peptide panels with potential for diagnosing different types of cancer, especially of the ovary, prostate, and bladder. Large-scale studies are needed to validate these molecules as cancer biomarkers. © 2013 American Association for Clinical Chemistry.

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

NASA Astrophysics Data System (ADS)

Aleman, A.; Olsen, L. M.; Ritz, S.; Stevens, T.; Morahan, M.; Grebas, S. K.

2011-12-01

NASA's Global Change Master Directory provides the scientific community with the ability to discover, access, and use Earth science data, data-related services, and climate diagnostics worldwide.The GCMD offers descriptions of Earth science data sets using the Directory Interchange Format (DIF) metadata standard; Earth science related data services are described using the Service Entry Resource Format (SERF); and climate visualizations are described using the Climate Diagnostic (CD) standard. The DIF, SERF and CD standards each capture data attributes used to determine whether a data set, service, or climate visualization is relevant to a user's needs.Metadata fields include: title, summary, science keywords, service keywords, data center, data set citation, personnel, instrument, platform, quality, related URL, temporal and spatial coverage, data resolution and distribution information.In addition, nine valuable sets of controlled vocabularies have been developed to assist users in normalizing the search for data descriptions. An update to the GCMD's search functionality is planned to further capitalize on the controlled vocabularies during database queries.By implementing a dynamic keyword "tree", users will have the ability to search for data sets by combining keywords in new ways.This will allow users to conduct more relevant and efficient database searches to support the free exchange and re-use of Earth science data.

Contrast-enhanced peripheral MRA: technique and contrast agents.

PubMed

Nielsen, Yousef W; Thomsen, Henrik S

2012-09-01

In the last decade contrast-enhanced magnetic resonance angiography (CE-MRA) has gained wide acceptance as a valuable tool in the diagnostic work-up of patients with peripheral arterial disease. This review presents current concepts in peripheral CE-MRA with emphasis on MRI technique and contrast agents. Peripheral CE-MRA is defined as an MR angiogram of the arteries from the aortic bifurcation to the feet. Advantages of CE-MRA include minimal invasiveness and lack of ionizing radiation. The basic technique employed for peripheral CE-MRA is the bolus-chase method. With this method a paramagnetic MRI contrast agent is injected intravenously and T1-weighted images are acquired in the subsequent arterial first-pass phase. In order to achieve high quality MR angiograms without interfering venous contamination or artifacts, a number of factors need to be taken into account. This includes magnetic field strength of the MRI system, receiver coil configuration, use of parallel imaging, contrast bolus timing technique, and k-space filling strategies. Furthermore, it is possible to optimize peripheral CE-MRA using venous compression techniques, hybrid scan protocols, time-resolved imaging, and steady-state MRA. Gadolinium(Gd)-based contrast agents are used for CE-MRA of the peripheral arteries. Extracellular Gd agents have a pharmacokinetic profile similar to iodinated contrast media. Accordingly, these agents are employed for first-pass MRA. Blood-pool Gd-based agents are characterized by prolonged intravascular stay, due to macromolecular structure or protein binding. These agents can be used for first-pass, as well as steady-state MRA. Some Gd-based contrast agents with low thermodynamic stability have been linked to development of nephrogenic systemic fibrosis in patients with severe renal insufficiency. Using optimized technique and a stable MRI contrast agent, peripheral CE-MRA is a safe procedure with diagnostic accuracy close to that of conventional catheter X-ray angiography.

Use of calcofluor-blue brightener for the diagnosis of Pneumocystis jirovecii pneumonia in bronchial-alveolar lavage fluids: A single-center prospective study.

PubMed

Desoubeaux, Guillaume; Franck-Martel, Claire; Caille, Agnès; Drillaud, Nicolas; Lestrade Carluer de Kyvon, Marie-Alix; Bailly, Éric; Chandenier, Jacques

2017-04-01

The biological diagnosis of Pneumocystis jirovecii pneumonia (PjP) is based on the investigation of respiratory fluids by conventional staining methods and/or molecular biology. Diagnostic performance of an in-house technique based on calcofluor-blue brightener for the direct detection of P. jirovecii cysts was prospectively assessed in bronchial-alveolar lavage fluids (BALF) from patients with a suspected PjP infection over a three-year period in a single center: the diagnostic yield was compared to that of a commercial kit based on monoclonal immunofluorescence assay (IFA) on replicate smears. May-Grünwald Giemsa (MGG) staining and quantitative Polymerase Chain Reaction (qPCR) were also performed. The gold standard for each patient was the definitive diagnosis of PjP infection by an independent committee based on clinical, radiological, and biological data. Overall, 481 BALF were assessed: 42 were found to be positive for the detection of P. jirovecii by at least one laboratory technique, but only 35 were actually judged to be in agreement with the definitive diagnosis of PjP infection. The sensitivity of the calcofluor-blue brightener technique was 74.3% vs. 60.0%, 34.6%, and 82.9% for IFA, MGG, and qPCR, respectively; and its specificity was 99.6% vs. 99.3%, 100.0%, and 99.4% for IFA, MGG, and qPCR. No technique was shown to be statistically superior to calcofluor-blue brightener. Further validation of the test through multicenter studies is now required, but in light of its low cost and easy preparation, the use of calcofluor-blue brightener in BALF appears to be a valuable alternative method for the routine first-line diagnosis of PjP infection. © The Author 2016. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Aspergillus antibody detection: diagnostic strategy and technical considerations from the Société Française de Mycologie Médicale (French Society for Medical Mycology) expert committee.

PubMed

Persat, F; Hennequin, C; Gangneux, J P

2017-04-01

Until now, there has been no consensus on the best method for the detection of anti-Aspergillus antibodies, a key diagnostic tool for chronic aspergilloses. To better appreciate the usage of and confidence in these techniques, the Société Française de Mycologie Médicale (French Society for Medical Mycology; SFMM) performed a two-step survey of French experts. First, we administered an initial survey to French labs performing Aspergillus serology to depict usage of the different techniques available for Aspergillus serology. Second, an opinion poll was conducted of 40 experts via an online questionnaire. Each item was rated from 1 to 9 according to the level of agreement. The initial survey revealed that enzyme-linked immunosorbent assay (ELISA) (81%) and immunoelectrophoresis (IEP) (67%) were the most commonly used techniques for screening and confirmation, respectively. The distinction between screening and confirmation techniques was confirmed by the experts (median = 7) with a 44.2% variation coefficient. Only ELISA for screening and IEP and Western blot (WB) for confirmation were clearly considered valuable methods (median ≥8 with variation coefficients less than 30%). The use of a confirmation technique was recommended in the case of a positive result in a compatible clinical context (cystic fibrosis, for example) or during the patient's follow-up. In the case of discordant results between the screening and confirmation techniques, the experts recommended greater confidence in the results obtained with the confirmation technique. All experts emphasized the need to standardize Aspergillus serology techniques and to better define the place of each of them in the diagnosis of aspergillosis. © The Author 2016. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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

PubMed

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

2018-01-29

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

Detection of Babesia bovis carrier cattle by using polymerase chain reaction amplification of parasite DNA.

PubMed Central

Fahrimal, Y; Goff, W L; Jasmer, D P

1992-01-01

Carrier cattle infected with Babesia bovis are difficult to detect because of the low numbers of parasites that occur in peripheral blood. However, diagnosis of low-level infections with the parasite is important for evaluating the efficacies of vaccines and in transmission and epidemiological studies. We used the polymerase chain reaction (PCR) to amplify a portion of the apocytochrome b gene from the parasite and tested the ability of this method to detect carrier cattle. The target sequence is associated with a 7.4-kb DNA element in undigested B. bovis genomic DNA (as shown previously), and the amplified product was detected by Southern and dot blot hybridization. The assay was specific for B. bovis, since no amplification was detected with Babesia bigemina, Trypanosoma brucei, Anaplasma marginale, or leukocyte DNA. The target sequence was amplified in DNA from B. bovis Mexico, Texas, and Australia S and L strains, demonstrating the applicability of the method to strains from different geographic regions. The sensitivity of the method ranged from 1 to 10 infected erythrocytes extracted from 0.5 ml of blood. This sensitivity was about 1,000 times greater than that from the use of unamplified parasite DNA. By the PCR method, six B. bovis carrier cattle were detected 86% of the time (range, 66 to 100%) when they were tested 11 times, while with microscopic examination of thick blood smears, the same carrier cattle were detected only 36% of the time (range, 17 to 66%). The method provides a useful diagnostic tool for detecting B. bovis carrier cattle, and the sensitivity is significantly improved over that of current methods. The results also suggest that characteristics of the apocytchrome b gene may make this a valuable target DNA for PCR-based detection of other hemoparasites. Images PMID:1624551

Diagnostic performance of optical coherence tomography ganglion cell--inner plexiform layer thickness measurements in early glaucoma.

PubMed

Mwanza, Jean-Claude; Budenz, Donald L; Godfrey, David G; Neelakantan, Arvind; Sayyad, Fouad E; Chang, Robert T; Lee, Richard K

2014-04-01

To evaluate the glaucoma diagnostic performance of ganglion cell inner-plexiform layer (GCIPL) parameters used individually and in combination with retinal nerve fiber layer (RNFL) or optic nerve head (ONH) parameters measured with Cirrus HD-OCT (Carl Zeiss Meditec, Inc, Dublin, CA). Prospective cross-sectional study. Fifty patients with early perimetric glaucoma and 49 age-matched healthy subjects. Three peripapillary RNFL and 3 macular GCIPL scans were obtained in 1 eye of each participant. A patient was considered glaucomatous if at least 2 of the 3 RNFL or GCIPL scans had the average or at least 1 sector measurement flagged at 1% to 5% or less than 1%. The diagnostic performance was determined for each GCIPL, RNFL, and ONH parameter as well as for binary or-logic and and-logic combinations of GCIPL with RNFL or ONH parameters. Sensitivity, specificity, positive likelihood ratio (PLR), and negative likelihood ratio (NLR). Among GCIPL parameters, the minimum had the best diagnostic performance (sensitivity, 82.0%; specificity, 87.8%; PLR, 6.69; and NLR, 0.21). Inferior quadrant was the best RNFL parameter (sensitivity, 74%; specificity, 95.9%; PLR, 18.13; and NLR, 0.27), as was rim area (sensitivity, 68%; specificity, 98%; PLR, 33.3; and NLR, 0.33) among ONH parameters. The or-logic combination of minimum GCIPL and average RNFL provided the overall best diagnostic performance (sensitivity, 94%; specificity, 85.7%; PRL, 6.58; and NLR, 0.07) as compared with the best RNFL, best ONH, and best and-logic combination (minimum GCIPL and inferior quadrant RNFL; sensitivity, 64%; specificity, 100%; PLR, infinity; and NPR, 0.36). The binary or-logic combination of minimum GCIPL and average RNFL or rim area provides better diagnostic performances than those of and-logic combinations or best single GCIPL, RNFL, or ONH parameters. This finding may be clinically valuable for the diagnosis of early glaucoma. Copyright © 2014 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

GENE-07. MOLECULAR NEUROPATHOLOGY 2.0 - INCREASING DIAGNOSTIC ACCURACY IN PEDIATRIC NEUROONCOLOGY

PubMed Central

Sturm, Dominik; Jones, David T.W.; Capper, David; Sahm, Felix; von Deimling, Andreas; Rutkoswki, Stefan; Warmuth-Metz, Monika; Bison, Brigitte; Gessi, Marco; Pietsch, Torsten; Pfister, Stefan M.

2017-01-01

Abstract The classification of central nervous system (CNS) tumors into clinically and biologically distinct entities and subgroups is challenging. Children and adolescents can be affected by >100 histological variants with very variable outcomes, some of which are exceedingly rare. The current WHO classification has introduced a number of novel molecular markers to aid routine neuropathological diagnostics, and DNA methylation profiling is emerging as a powerful tool to distinguish CNS tumor classes. The Molecular Neuropathology 2.0 study aims to integrate genome wide (epi-)genetic diagnostics with reference neuropathological assessment for all newly-diagnosed pediatric brain tumors in Germany. To date, >350 patients have been enrolled. A molecular diagnosis is established by epigenetic tumor classification through DNA methylation profiling and targeted panel sequencing of >130 genes to detect diagnostically and/or therapeutically useful DNA mutations, structural alterations, and fusion events. Results are aligned with the reference neuropathological diagnosis, and discrepant findings are discussed in a multi-disciplinary tumor board including reference neuroradiological evaluation. Ten FFPE sections as input material are sufficient to establish a molecular diagnosis in >95% of tumors. Alignment with reference pathology results in four broad categories: a) concordant classification (~77%), b) discrepant classification resolvable by tumor board discussion and/or additional data (~5%), c) discrepant classification without currently available options to resolve (~8%), and d) cases currently unclassifiable by molecular diagnostics (~10%). Discrepancies are enriched in certain histopathological entities, such as histological high grade gliomas with a molecularly low grade profile. Gene panel sequencing reveals predisposing germline events in ~10% of patients. Genome wide (epi-)genetic analyses add a valuable layer of information to routine neuropathological diagnostics. Our study provides insight into CNS tumors with divergent histopathological and molecular classification, opening new avenues for research discoveries and facilitating optimization of clinical management for affected patients in the future.

Philosophy of science and the diagnostic process.

PubMed

Willis, Brian H; Beebee, Helen; Lasserson, Daniel S

2013-10-01

This is an overview of the principles that underpin philosophy of science and how they may provide a framework for the diagnostic process. Although philosophy dates back to antiquity, it is only more recently that philosophers have begun to enunciate the scientific method. Since Aristotle formulated deduction, other modes of reasoning including induction, inference to best explanation, falsificationism, theory-laden observations and Bayesian inference have emerged. Thus, rather than representing a single overriding dogma, the scientific method is a toolkit of ideas and principles of reasoning. Here we demonstrate that the diagnostic process is an example of science in action and is therefore subject to the principles encompassed by the scientific method. Although a number of the different forms of reasoning are used readily by clinicians in practice, without a clear understanding of their pitfalls and the assumptions on which they are based, it leaves doctors open to diagnostic error. We conclude by providing a case example from the medico-legal literature in which diagnostic errors were made, to illustrate how applying the scientific method may mitigate the chance for diagnostic error.

Gene and genetic diagnostic method patent claims: a comparison under current European and US patent law

PubMed Central

Huys, Isabelle; Van Overwalle, Geertrui; Matthijs, Gert

2011-01-01

The paper focuses on the fundamental debate that is going on in Europe and the United States about whether genes and genetic diagnostic methods are to be regarded as inventions or subject matter eligible for patent protection, or whether they are discoveries or principles of nature and thus excluded from patentability. The study further explores some possible scenarios of American influences on European patent applications with respect to genetic diagnostic methods. Our analysis points out that patent eligibility for genes and genetic diagnostic methods, as discussed in the United States in the Association of Molecular Pathology versus US Patent and Trademark Office decision, is based on a different reasoning compared with the European Patent Convention. PMID:21654725

Gene and genetic diagnostic method patent claims: a comparison under current European and US patent law.

PubMed

Huys, Isabelle; Van Overwalle, Geertrui; Matthijs, Gert

2011-10-01

The paper focuses on the fundamental debate that is going on in Europe and the United States about whether genes and genetic diagnostic methods are to be regarded as inventions or subject matter eligible for patent protection, or whether they are discoveries or principles of nature and thus excluded from patentability. The study further explores some possible scenarios of American influences on European patent applications with respect to genetic diagnostic methods. Our analysis points out that patent eligibility for genes and genetic diagnostic methods, as discussed in the United States in the Association of Molecular Pathology versus US Patent and Trademark Office decision, is based on a different reasoning compared with the European Patent Convention.

Decision support in psychiatry – a comparison between the diagnostic outcomes using a computerized decision support system versus manual diagnosis

PubMed Central

Bergman, Lars G; Fors, Uno GH

2008-01-01

Background Correct diagnosis in psychiatry may be improved by novel diagnostic procedures. Computerized Decision Support Systems (CDSS) are suggested to be able to improve diagnostic procedures, but some studies indicate possible problems. Therefore, it could be important to investigate CDSS systems with regard to their feasibility to improve diagnostic procedures as well as to save time. Methods This study was undertaken to compare the traditional 'paper and pencil' diagnostic method SCID1 with the computer-aided diagnostic system CB-SCID1 to ascertain processing time and accuracy of diagnoses suggested. 63 clinicians volunteered to participate in the study and to solve two paper-based cases using either a CDSS or manually. Results No major difference between paper and pencil and computer-supported diagnosis was found. Where a difference was found it was in favour of paper and pencil. For example, a significantly shorter time was found for paper and pencil for the difficult case, as compared to computer support. A significantly higher number of correct diagnoses were found in the diffilt case for the diagnosis 'Depression' using the paper and pencil method. Although a majority of the clinicians found the computer method supportive and easy to use, it took a longer time and yielded fewer correct diagnoses than with paper and pencil. Conclusion This study could not detect any major difference in diagnostic outcome between traditional paper and pencil methods and computer support for psychiatric diagnosis. Where there were significant differences, traditional paper and pencil methods were better than the tested CDSS and thus we conclude that CDSS for diagnostic procedures may interfere with diagnosis accuracy. A limitation was that most clinicians had not previously used the CDSS system under study. The results of this study, however, confirm that CDSS development for diagnostic purposes in psychiatry has much to deal with before it can be used for routine clinical purposes. PMID:18261222

Identifying EGFR-Expressed Cells and Detecting EGFR Multi-Mutations at Single-Cell Level by Microfluidic Chip

NASA Astrophysics Data System (ADS)

Li, Ren; Zhou, Mingxing; Li, Jine; Wang, Zihua; Zhang, Weikai; Yue, Chunyan; Ma, Yan; Peng, Hailin; Wei, Zewen; Hu, Zhiyuan

2018-03-01

EGFR mutations companion diagnostics have been proved to be crucial for the efficacy of tyrosine kinase inhibitor targeted cancer therapies. To uncover multiple mutations occurred in minority of EGFR-mutated cells, which may be covered by the noises from majority of un-mutated cells, is currently becoming an urgent clinical requirement. Here we present the validation of a microfluidic-chip-based method for detecting EGFR multi-mutations at single-cell level. By trapping and immunofluorescently imaging single cells in specifically designed silicon microwells, the EGFR-expressed cells were easily identified. By in situ lysing single cells, the cell lysates of EGFR-expressed cells were retrieved without cross-contamination. Benefited from excluding the noise from cells without EGFR expression, the simple and cost-effective Sanger's sequencing, but not the expensive deep sequencing of the whole cell population, was used to discover multi-mutations. We verified the new method with precisely discovering three most important EGFR drug-related mutations from a sample in which EGFR-mutated cells only account for a small percentage of whole cell population. The microfluidic chip is capable of discovering not only the existence of specific EGFR multi-mutations, but also other valuable single-cell-level information: on which specific cells the mutations occurred, or whether different mutations coexist on the same cells. This microfluidic chip constitutes a promising method to promote simple and cost-effective Sanger's sequencing to be a routine test before performing targeted cancer therapy.[Figure not available: see fulltext.

Next Generation Flow for highly sensitive and standardized detection of minimal residual disease in multiple myeloma.

PubMed

Flores-Montero, J; Sanoja-Flores, L; Paiva, B; Puig, N; García-Sánchez, O; Böttcher, S; van der Velden, V H J; Pérez-Morán, J-J; Vidriales, M-B; García-Sanz, R; Jimenez, C; González, M; Martínez-López, J; Corral-Mateos, A; Grigore, G-E; Fluxá, R; Pontes, R; Caetano, J; Sedek, L; Del Cañizo, M-C; Bladé, J; Lahuerta, J-J; Aguilar, C; Bárez, A; García-Mateo, A; Labrador, J; Leoz, P; Aguilera-Sanz, C; San-Miguel, J; Mateos, M-V; Durie, B; van Dongen, J J M; Orfao, A

2017-10-01

Flow cytometry has become a highly valuable method to monitor minimal residual disease (MRD) and evaluate the depth of complete response (CR) in bone marrow (BM) of multiple myeloma (MM) after therapy. However, current flow-MRD has lower sensitivity than molecular methods and lacks standardization. Here we report on a novel next generation flow (NGF) approach for highly sensitive and standardized MRD detection in MM. An optimized 2-tube 8-color antibody panel was constructed in five cycles of design-evaluation-redesign. In addition, a bulk-lysis procedure was established for acquisition of ⩾10 7 cells/sample, and novel software tools were constructed for automatic plasma cell gating. Multicenter evaluation of 110 follow-up BM from MM patients in very good partial response (VGPR) or CR showed a higher sensitivity for NGF-MRD vs conventional 8-color flow-MRD -MRD-positive rate of 47 vs 34% (P=0.003)-. Thus, 25% of patients classified as MRD-negative by conventional 8-color flow were MRD-positive by NGF, translating into a significantly longer progression-free survival for MRD-negative vs MRD-positive CR patients by NGF (75% progression-free survival not reached vs 7 months; P=0.02). This study establishes EuroFlow-based NGF as a highly sensitive, fully standardized approach for MRD detection in MM which overcomes the major limitations of conventional flow-MRD methods and is ready for implementation in routine diagnostics.

Use of Occult Blood Detection Cards for Real-Time PCR-Based Diagnosis of Schistosoma Mansoni Infection

PubMed Central

Schunk, Mirjam; Kebede Mekonnen, Seleshi; Wondafrash, Beyene; Mengele, Carolin; Fleischmann, Erna; Herbinger, Karl-Heinz; Verweij, Jaco J.; Geldmacher, Christof; Bretzel, Gisela; Löscher, Thomas; Zeynudin, Ahmed

2015-01-01

Background In Schistosoma mansoni infection, diagnosis and control after treatment mainly rely on parasitological stool investigations which are laborious and have limited sensitivity. PCR methods have shown equal or superior sensitivity but preservation and storage methods limit their use in the field. Therefore, the use of occult blood detection cards (fecal cards) for easy sampling and storage of fecal samples for further PCR testing was evaluated in a pilot study. Methodology Stool specimens were collected in a highly endemic area for S. mansoni in Ethiopia and submitted in an investigator-blinded fashion to microscopic examination by Kato-Katz thick smear as well as to real-time PCR using either fresh frozen stool samples or stool smears on fecal cards which have been stored at ambient temperature for up to ten months. Principal Findings Out of 55 stool samples, 35 were positive by microscopy, 33 and 32 were positive by PCR of frozen samples and of fecal card samples, respectively. When microscopy was used as diagnostic “gold standard”, the sensitivity of PCR on fresh stool was 94.3% (95%-CI: 86.6; 100) and on fecal cards 91.4% (95%-CI: 82.2; 100). Conclusions The use of fecal cards proved to be a simple and useful method for stool collection and prolonged storage prior to PCR based diagnosis of S. mansoni infection. This technique may be a valuable approach for large scale surveillance and post treatment assessments PMID:26360049

Use of Occult Blood Detection Cards for Real-Time PCR-Based Diagnosis of Schistosoma Mansoni Infection.

PubMed

Schunk, Mirjam; Kebede Mekonnen, Seleshi; Wondafrash, Beyene; Mengele, Carolin; Fleischmann, Erna; Herbinger, Karl-Heinz; Verweij, Jaco J; Geldmacher, Christof; Bretzel, Gisela; Löscher, Thomas; Zeynudin, Ahmed

2015-01-01

In Schistosoma mansoni infection, diagnosis and control after treatment mainly rely on parasitological stool investigations which are laborious and have limited sensitivity. PCR methods have shown equal or superior sensitivity but preservation and storage methods limit their use in the field. Therefore, the use of occult blood detection cards (fecal cards) for easy sampling and storage of fecal samples for further PCR testing was evaluated in a pilot study. Stool specimens were collected in a highly endemic area for S. mansoni in Ethiopia and submitted in an investigator-blinded fashion to microscopic examination by Kato-Katz thick smear as well as to real-time PCR using either fresh frozen stool samples or stool smears on fecal cards which have been stored at ambient temperature for up to ten months. Out of 55 stool samples, 35 were positive by microscopy, 33 and 32 were positive by PCR of frozen samples and of fecal card samples, respectively. When microscopy was used as diagnostic "gold standard", the sensitivity of PCR on fresh stool was 94.3% (95%-CI: 86.6; 100) and on fecal cards 91.4% (95%-CI: 82.2; 100). The use of fecal cards proved to be a simple and useful method for stool collection and prolonged storage prior to PCR based diagnosis of S. mansoni infection. This technique may be a valuable approach for large scale surveillance and post treatment assessments.

Danish study of Non-Invasive testing in Coronary Artery Disease (Dan-NICAD): study protocol for a randomised controlled trial.

PubMed

Nissen, Louise; Winther, Simon; Isaksen, Christin; Ejlersen, June Anita; Brix, Lau; Urbonaviciene, Grazina; Frost, Lars; Madsen, Lene Helleskov; Knudsen, Lars Lyhne; Schmidt, Samuel Emil; Holm, Niels Ramsing; Maeng, Michael; Nyegaard, Mette; Bøtker, Hans Erik; Bøttcher, Morten

2016-05-26

Coronary computed tomography angiography (CCTA) is an established method for ruling out coronary artery disease (CAD). Most patients referred for CCTA do not have CAD and only approximately 20-30 % of patients are subsequently referred to further testing by invasive coronary angiography (ICA) or non-invasive perfusion evaluation due to suspected obstructive CAD. In cases with severe calcifications, a discrepancy between CCTA and ICA often occurs, leading to the well-described, low-diagnostic specificity of CCTA. As ICA is cost consuming and involves a risk of complications, an optimized algorithm would be valuable and could decrease the number of ICAs that do not lead to revascularization. The primary objective of the Dan-NICAD study is to determine the diagnostic accuracy of cardiac magnetic resonance imaging (CMRI) and myocardial perfusion scintigraphy (MPS) as secondary tests after a primary CCTA where CAD could not be ruled out. The secondary objective includes an evaluation of the diagnostic precision of an acoustic technology that analyses the sound of coronary blood flow. It may potentially provide better stratification prior to CCTA than clinical risk stratification scores alone. Dan-NICAD is a multi-centre, randomised, cross-sectional trial, which will include approximately 2,000 patients without known CAD, who were referred to CCTA due to a history of symptoms suggestive of CAD and a low-risk to intermediate-risk profile, as evaluated by a cardiologist. Patient interview, sound recordings, and blood samples are obtained in connection with the CCTA. All patients with suspected obstructive CAD by CCTA are randomised to either stress CMRI or stress MPS, followed by ICA with fractional flow reserve (FFR) measurements. Obstructive CAD is defined as an FFR below 0.80 or as high-grade stenosis (>90 % diameter stenosis) by visual assessment. Diagnostic performance is evaluated as sensitivity, specificity, predictive values, likelihood ratios, and C statistics. Enrolment commenced in September 2014 and is expected to be complete in May 2016. Dan-NICAD is designed to assess whether a secondary perfusion examination after CCTA could safely reduce the number of ICAs where revascularization is not required. The results are expected to add knowledge about the optimal algorithm for diagnosing CAD. Clinicaltrials.gov identifier, NCT02264717 . Registered on 26 September 2014.

What Workshop or Inservice Activity Has Been Most Valuable to You in Your Teaching?

ERIC Educational Resources Information Center

Johnson, Laurel Eury; Quatroke, Rosanne; Simpson, Amy J.; Easterling, Victoria J.; Felps, Maryann; McAloon, Noreen Watson; Danforth, Kathleen M.

2001-01-01

Offers brief descriptions from seven secondary school teachers describing a workshop or inservice activity that has been particularly valuable for their teaching, including a Shakespeare seminar, a Socratic teaching seminar, English-as-a-second language courses, a new teacher induction program, a program on the "Brody paragraph" method, and the…

Diagnostic Accuracy Assessment of Sensititre and Agar Disk Diffusion for Determining Antimicrobial Resistance Profiles of Bovine Clinical Mastitis Pathogens▿

PubMed Central

Saini, V.; Riekerink, R. G. M. Olde; McClure, J. T.; Barkema, H. W.

2011-01-01

Determining the accuracy and precision of a measuring instrument is pertinent in antimicrobial susceptibility testing. This study was conducted to predict the diagnostic accuracy of the Sensititre MIC mastitis panel (Sensititre) and agar disk diffusion (ADD) method with reference to the manual broth microdilution test method for antimicrobial resistance profiling of Escherichia coli (n = 156), Staphylococcus aureus (n = 154), streptococcal (n = 116), and enterococcal (n = 31) bovine clinical mastitis isolates. The activities of ampicillin, ceftiofur, cephalothin, erythromycin, oxacillin, penicillin, the penicillin-novobiocin combination, pirlimycin, and tetracycline were tested against the isolates. Diagnostic accuracy was determined by estimating the area under the receiver operating characteristic curve; intertest essential and categorical agreements were determined as well. Sensititre and the ADD method demonstrated moderate to highly accurate (71 to 99%) and moderate to perfect (71 to 100%) predictive accuracies for 74 and 76% of the isolate-antimicrobial MIC combinations, respectively. However, the diagnostic accuracy was low for S. aureus-ceftiofur/oxacillin combinations and other streptococcus-ampicillin combinations by either testing method. Essential agreement between Sensititre automatic MIC readings and MIC readings obtained by the broth microdilution test method was 87%. Essential agreement between Sensititre automatic and manual MIC reading methods was 97%. Furthermore, the ADD test method and Sensititre MIC method exhibited 92 and 91% categorical agreement (sensitive, intermediate, resistant) of results, respectively, compared with the reference method. However, both methods demonstrated lower agreement for E. coli-ampicillin/cephalothin combinations than for Gram-positive isolates. In conclusion, the Sensititre and ADD methods had moderate to high diagnostic accuracy and very good essential and categorical agreement for most udder pathogen-antimicrobial combinations and can be readily employed in veterinary diagnostic laboratories. PMID:21270215

A New Method with General Diagnostic Utility for the Calculation of Immunoglobulin G Avidity

PubMed Central

Korhonen, Maria H.; Brunstein, John; Haario, Heikki; Katnikov, Alexei; Rescaldani, Roberto; Hedman, Klaus

1999-01-01

The reference method for immunoglobulin G (IgG) avidity determination includes reagent-consuming serum titration. Aiming at better IgG avidity diagnostics, we applied a logistic model for the reproduction of antibody titration curves. This method was tested with well-characterized serum panels for cytomegalovirus, Epstein-Barr virus, rubella virus, parvovirus B19, and Toxoplasma gondii. This approach for IgG avidity calculation is generally applicable and attains the diagnostic performance of the reference method while being less laborious and twice as cost-effective. PMID:10473525

Born to yawn? Cortisol linked to yawning: a new hypothesis.

PubMed

Thompson, Simon B N

2011-11-01

Yawning has become an interesting and curious scientific conundrum. Links between several neurological disorders can be found through the commonality of yawning episodes and contagious yawning. However, the reasons why we yawn are uncertain. Cortisol levels are known to rise during stress and fatigue; yawning may occur when we are under stress or tired. We do not know whether cortisol levels fluctuate during yawning. Potentially, yawning and cortisol levels may provide a valuable diagnostic tool and warning of untoward underlying neurological problems. A new hypothesis is proposed that links cortisol levels with yawning episodes. Copyright © 2011 Elsevier Ltd. All rights reserved.

Shock Waves in Supernova Ejecta

NASA Astrophysics Data System (ADS)

Raymond, J. C.

2018-02-01

Astrophysical shock waves are a major mechanism for dissipating energy, and by heating and ionizing the gas they produce emission spectra that provide valuable diagnostics for the shock parameters, for the physics of collisionless shocks, and for the composition of the shocked material. Shocks in SN ejecta in which H and He have been burned to heavier elements behave differently than shocks in ordinary astrophysical gas because of their very large radiative cooling rates. In particular, extreme departures from thermal equilibrium among ions and electrons and from ionization equilibrium may arise. This paper discusses the consequences of the enhanced metal abundances for the structure and emission spectra of those shocks.

Development of Loop-Mediated Isothermal Amplification Assay for Detection of Entamoeba histolytica▿

PubMed Central

Liang, Shih-Yu; Chan, Yun-Hsien; Hsia, Kan-Tai; Lee, Jing-Lun; Kuo, Ming-Chu; Hwa, Kuo-Yuan; Chan, Chi-Wen; Chiang, Ting-Yi; Chen, Jung-Sheng; Wu, Fang-Tzy; Ji, Dar-Der

2009-01-01

A novel one-step, closed-tube, loop-mediated isothermal amplification (LAMP) assay for detecting Entamoeba histolytica, one of the leading causes of morbidity in developing countries, was developed. The sensitivity of the LAMP assay is 1 parasite per reaction. A total of 130 clinical samples were analyzed, and the results compared with those of conventional nested PCR to validate the practicability of this assay. No DNA was amplified from other diarrheal pathogens, such as other Entamoeba species, bacteria, and viruses. These results indicate that LAMP is a rapid, simple, and valuable diagnostic tool for epidemiological studies of amebiasis. PMID:19321720

Application of special diagnostic techniques in the management of nodular goitre.

PubMed Central

Walfish, P. G.; Miskin, M.; Rosen, I. B.; Strawbridge, H. T.

1976-01-01

The primary challenge in the management of nodular goitre is to establish which thyroid nodules are malignant. Since selection of patients for operation on the basis of palpation of nodules alone gives a low yield of malignant disease, physicians have sought criteria for selection that combine the information obtained from special laboratory procedures with thoughtful clinical appraisal. Such special procedures, which include radioisotope scintiscanning, echography by B-mode ultrasonography, and either large- or fine-needle aspiration and cytologic examination of the aspirate, are considered valuable in a proposed clinical approach to the management of thyroid nodules. Images FIG. 1 FIG. 2 FIG. 3 PMID:1277058

[Caffeine dependence].

PubMed

Ogawa, Naoshi; Ueki, Hirofumi

2010-08-01

Caffeine is the most widely consumed psychoactive substance in the world and is a legal stimulant that is readily available to children. The potential for dependence on caffeine has been debated. Presently, due to a paucity of clinical evidence on caffeine dependence, no such diagnosis is included in the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition, Text Revision (DSM-IV-TR). Although in recent studies, a subset of the general population was found to demonstrate caffeine dependence. It is valuable for psychiatrists and primary care physicians to recognize caffeine dependence as a clinical syndrome, since some people are distressed by their caffeine use and feel they can not control or stop their problematic use.

Shear-wave elastography in breast ultrasonography: the state of the art

PubMed Central

2017-01-01

Shear-wave elastography (SWE) is a recently developed ultrasound technique that can visualize and measure tissue elasticity. In breast ultrasonography, SWE has been shown to be useful for differentiating benign breast lesions from malignant breast lesions, and it has been suggested that SWE enhances the diagnostic performance of ultrasonography, potentially improving the specificity of conventional ultrasonography using the Breast Imaging Reporting and Data System criteria. More recently, not only has SWE been proven useful for the diagnosis of breast cancer, but has also been shown to provide valuable information that can be used as a preoperative predictor of the prognosis or response to chemotherapy. PMID:28513127

Respiratory Acid-Base Disorders in the Critical Care Unit.

PubMed

Hopper, Kate

2017-03-01

The incidence of respiratory acid-base abnormalities in the critical care unit (CCU) is unknown, although respiratory alkalosis is suspected to be common in this population. Abnormal carbon dioxide tension can have many physiologic effects, and changes in Pco 2 may have a significant impact on outcome. Monitoring Pco 2 in CCU patients is an important aspect of critical patient assessment, and identification of respiratory acid-base abnormalities can be valuable as a diagnostic tool. Treatment of respiratory acid-base disorders is largely focused on resolution of the primary disease, although mechanical ventilation may be indicated in cases with severe respiratory acidosis. Published by Elsevier Inc.

Magnetic resonance imaging of the pediatric neck: an overview.

PubMed

Shekdar, Karuna V; Mirsky, David M; Kazahaya, Ken; Bilaniuk, Larissa T

2012-08-01

Evaluation of neck lesions in the pediatric population can be a diagnostic challenge, for which magnetic resonance (MR) imaging is extremely valuable. This article provides an overview of the value and utility of MR imaging in the evaluation of pediatric neck lesions, addressing what the referring clinician requires from the radiologist. Concise descriptions and illustrations of MR imaging findings of commonly encountered pathologic entities in the pediatric neck, including abnormalities of the branchial apparatus, thyroglossal duct anomalies, and neoplastic processes, are given. An approach to establishing a differential diagnosis is provided, and critical points of information are summarized. Copyright © 2012 Elsevier Inc. All rights reserved.

The emerging role of obesity, diet and lipid metabolism in prostate cancer.

PubMed

Ferro, Matteo; Terracciano, Daniela; Buonerba, Carlo; Lucarelli, Giuseppe; Bottero, Danilo; Perdonà, Sisto; Autorino, Riccardo; Serino, Alessandro; Cantiello, Francesco; Damiano, Rocco; Andras, Iulia; De Placido, Sabino; Di Lorenzo, Giuseppe; Battaglia, Michele; Jereczek-Fossa, Barbara A; Mirone, Vincenzo; De Cobelli, Ottavio

2017-02-01

Obesity is associated with an increased risk of a number of serious medical conditions, including cancer. As far as prostate cancer is concerned, obesity is associated with an increased risk of high-grade tumors, which is possibly related to lower androgen levels. Diet may also affect prostate cancer risk since countries with a higher dietary fat intake also present higher prostate cancer mortality rates. Interestingly, prostate cancer is associated with a number of metabolic alterations that may provide valuable diagnostic and therapeutic targets. This review explores the available clinical as well as biological evidence supporting the relationship between obesity, diet, alteration in metabolic pathways and prostate cancer.

Diagnosis before treatment: Identifying dairy farmers' determinants for the adoption of sustainable practices in gastrointestinal nematode control.

PubMed

Vande Velde, F; Claerebout, E; Cauberghe, V; Hudders, L; Van Loo, H; Vercruysse, J; Charlier, J

2015-09-15

Anthelmintic resistance is emerging in dairy cattle and this can result in a lack of effective control and production losses. Therefore, sustainable control strategies, such as targeted treatments (TT) and targeted selected treatments (TST), should be adopted by the industry. TT and TST approaches require the use of diagnostic methods to take informed treatment decisions. To understand the factors affecting the farmers' intention to adopt diagnostic methods before implementing anthelmintic drugs ('adoption intention'), a cross-sectional survey was carried out in dairy farms in Belgium (Flanders). A framework was constructed to predict adoption intentions based on two fundamental theories in the field of behavioural psychology and health psychology: the Theory of Planned Behaviour and the Health Belief Model. In the tested model, adoption intentions were predicted based on attitudes towards anthelminthics, attitudes towards diagnostic methods, subjective norms, behavioural control and perceived risk. Structural equation modelling was used for analyses. The model fitted the data well and explained 46% of the variance in adoption intention of diagnostics. The factors 'attitude towards diagnostic methods' and 'subjective norm'; i.e. the influence of significant others, had the strongest, positive influence on adoption intention of diagnostic methods. 'Perceived behavioural control' had a weak, positive effect on intention. Further, 'attitude towards the use of anthelmintic drugs' had a negative effect on adoption intention of the diagnostic methods. This implicates an effect of current behaviour on future adoption, which should be considered in future research. Factors measuring risk perception of anthelmintic resistance; perceived severity and perceived susceptibility, had no effect on the adoption intention of diagnostic methods. The threat of anthelmintic resistance is perceived to be low for dairy herds. The study further did not find any differences in the effects of the predictors for young stock and adult dairy cows. The results of this study can be used to develop communication strategies to advertise sustainable nematode control on dairy farms. Copyright © 2015 Elsevier B.V. All rights reserved.

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

PubMed

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

2017-07-01

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

A New Dual-purpose Quality Control Dosimetry Protocol for Diagnostic Reference-level Determination in Computed Tomography.

PubMed

Sohrabi, Mehdi; Parsi, Masoumeh; Sina, Sedigheh

2018-05-17

A diagnostic reference level is an advisory dose level set by a regulatory authority in a country as an efficient criterion for protection of patients from unwanted medical exposure. In computed tomography, the direct dose measurement and data collection methods are commonly applied for determination of diagnostic reference levels. Recently, a new quality-control-based dose survey method was proposed by the authors to simplify the diagnostic reference-level determination using a retrospective quality control database usually available at a regulatory authority in a country. In line with such a development, a prospective dual-purpose quality control dosimetry protocol is proposed for determination of diagnostic reference levels in a country, which can be simply applied by quality control service providers. This new proposed method was applied to five computed tomography scanners in Shiraz, Iran, and diagnostic reference levels for head, abdomen/pelvis, sinus, chest, and lumbar spine examinations were determined. The results were compared to those obtained by the data collection and quality-control-based dose survey methods, carried out in parallel in this study, and were found to agree well within approximately 6%. This is highly acceptable for quality-control-based methods according to International Atomic Energy Agency tolerance levels (±20%).

Evolution of the Preliminary Clinical Year and the Case for a Categorical Diagnostic Radiology Residency.

PubMed

Pfeifer, Cory M

2016-07-01

While other specialties traditionally utilizing a segregated clinical internship year have slowly progressed toward integrated training curricula, diagnostic radiology has been slow to adopt this path. The aim of this study was to analyze the trends in stand-alone preliminary clinical years as well as the shift toward categorical residencies currently being undertaken in other specialties. Advantages of mimicking the trends of other specialties and current integrated radiology programs are discussed. The perception of diagnostic radiology as a competitive specialty is explored, and the prospect of change as a recruiting tool is examined. Data assimilated by the NRMP from 1994 through 2016 were processed and analyzed. The total number of postgraduate year (PGY) 1 preliminary year programs has remained relatively constant over the past 10 years despite a gradual increase in overall NRMP applicants. The proportion of these programs offered as a transitional year declined from 31% in 1994 to 20% in 2016. The proportion of categorical anesthesiology positions gradually rose from 43% in 2007 to 70% in 2016. The fraction of categorical neurology positions increased from 30% in 2007 to 59% in 2016. The percentage of diagnostic radiology programs beginning at the PGY 1 level has been relatively constant at 12% to 14% since 2007. Dermatology has increased advanced (PGY 2) positions while decreasing categorical (PGY 1) positions. Those matching in diagnostic radiology have performed at a high level compared with the composite NRMP average since 2007. In the 2015 match, there were 65 diagnostic radiology programs that did not fill all of their offered positions. Of the institutions housing these programs, only 22% of them had preliminary internal medicine or transitional year positions available after the match. In response to the evolving nature of health care and graduate medical education, other specialties are gradually shifting toward curricular structures that begin at the PGY 1 level. By considering such a transition, diagnostic radiology would be well served to position itself as a valuable clinical specialty while maintaining a lesser dependence on other specialties to train its physicians. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

A new diagnostic method for separating airborne and structureborne noise radiated by plates with applications for propeller driven aircraft

NASA Technical Reports Server (NTRS)

Mcgary, Michael C.

1988-01-01

The anticipated application of advanced turboprop propulsion systems is expected to increase the interior noise of future aircraft to unacceptably high levels. The absence of technically and economically feasible noise source-path diagnostic tools has been a prime obstacle in the development of efficient noise control treatments for propeller-driven aircraft. A new diagnostic method that permits the separation and prediction of the fully coherent airborne and structureborne components of the sound radiated by plates or thin shells has been developed. Analytical and experimental studies of the proposed method were performed on an aluminum plate. The results of the study indicate that the proposed method could be used in flight, and has fewer encumbrances than the other diagnostic tools currently available.

Mapping the different methods adopted for diagnostic imaging instruction at medical schools in Brazil

PubMed Central

Chojniak, Rubens; Carneiro, Dominique Piacenti; Moterani, Gustavo Simonetto Peres; Duarte, Ivone da Silva; Bitencourt, Almir Galvão Vieira; Muglia, Valdair Francisco; D'Ippolito, Giuseppe

2017-01-01

Objective To map the different methods for diagnostic imaging instruction at medical schools in Brazil. Materials and Methods In this cross-sectional study, a questionnaire was sent to each of the coordinators of 178 Brazilian medical schools. The following characteristics were assessed: teaching model; total course hours; infrastructure; numbers of students and professionals involved; themes addressed; diagnostic imaging modalities covered; and education policies related to diagnostic imaging. Results Of the 178 questionnaires sent, 45 (25.3%) were completed and returned. Of those 45 responses, 17 (37.8%) were from public medical schools, whereas 28 (62.2%) were from private medical schools. Among the 45 medical schools evaluated, the method of diagnostic imaging instruction was modular at 21 (46.7%), classic (independent discipline) at 13 (28.9%), hybrid (classical and modular) at 9 (20.0%), and none of the preceding at 3 (6.7%). Diagnostic imaging is part of the formal curriculum at 36 (80.0%) of the schools, an elective course at 3 (6.7%), and included within another modality at 6 (13.3%). Professors involved in diagnostic imaging teaching are radiologists at 43 (95.5%) of the institutions. Conclusion The survey showed that medical courses in Brazil tend to offer diagnostic imaging instruction in courses that include other content and at different time points during the course. Radiologists are extensively involved in undergraduate medical education, regardless of the teaching methodology employed at the institution. PMID:28298730

[Stress-ECG is adequate to detect myocardial ischemia: when are additional diagnostic tests needed?].

PubMed

Baer, F M

2007-09-01

The stress-ECG is the most often adopted and most cost effective initial diagnostic test for the assessment of myocardial ischemia in patients with suspected coronary artery disease (CAD). Prerequisites for the diagnostic usefullness of stress-ECG are a clearly interpretable ST-segment, ability to reach the predicted work load, an intermediate pretest probability for CAD ranging between 10% and 90% and the absence of any contraindications for dynamic exercise. Because of the limited diagnostic sensitivity of about 70%, and a high percentage of patients, who are unable to exercise, a negative stress ECG can definitely not exclude hemodynamically significant CAD. Therefore, stress imaging techniques like myocardial scintigraphy, stress-echocardiography and stress magnetic resonance imaging play a major role in the stepwise diagnostic work-up of patients with suspected CAD. These stress imaging techniques are basically interchangeable since no method is definitely superior to one of the others. However, each method has its specific pros and cons and inherent contraindications. Therefore the choice of the stress imaging method and the form of stress applied should be based on the individual patients characteristics to gain optimal image quality and diagnostic accuracy. Moreover, the decision for one method should take the local availability and institutional expertise of diagnostic centers into account. Although partly substituted by stress imaging techniques the stress-ECG still remains the workhorse for a stepwise diagnostic work-up of patients with suspected CAD.

Use of information on disease diagnoses from databases for animal health economic, welfare and food safety purposes: strengths and limitations of recordings.

PubMed

Houe, Hans; Gardner, Ian Andrew; Nielsen, Liza Rosenbaum

2011-01-01

Many animal health, welfare and food safety databases include data on clinical and test-based disease diagnoses. However, the circumstances and constraints for establishing the diagnoses vary considerably among databases. Therefore results based on different databases are difficult to compare and compilation of data in order to perform meta-analysis is almost impossible. Nevertheless, diagnostic information collected either routinely or in research projects is valuable in cross comparisons between databases, but there is a need for improved transparency and documentation of the data and the performance characteristics of tests used to establish diagnoses. The objective of this paper is to outline the circumstances and constraints for recording of disease diagnoses in different types of databases, and to discuss these in the context of disease diagnoses when using them for additional purposes, including research. Finally some limitations and recommendations for use of data and for recording of diagnostic information in the future are given. It is concluded that many research questions have such a specific objective that investigators need to collect their own data. However, there are also examples, where a minimal amount of extra information or continued validation could make sufficient improvement of secondary data to be used for other purposes. Regardless, researchers should always carefully evaluate the opportunities and constraints when they decide to use secondary data. If the data in the existing databases are not sufficiently valid, researchers may have to collect their own data, but improved recording of diagnostic data may improve the usefulness of secondary diagnostic data in the future.

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.

Contrast-enhanced ultrasound in diagnosis of gallbladder adenoma.

PubMed

Yuan, Hai-Xia; Cao, Jia-Ying; Kong, Wen-Tao; Xia, Han-Sheng; Wang, Xi; Wang, Wen-Ping

2015-04-01

Gallbladder adenoma is a pre-cancerous neoplasm and needs surgical resection. It is difficult to differentiate adenoma from other gallbladder polyps using imaging examinations. The study aimed to illustrate characteristics of contrast-enhanced ultrasound (CEUS) and its diagnostic value in gallbladder adenoma. Thirty-seven patients with 39 gallbladder adenomatoid lesions (maximal diameter ≥10 mm and without metastasis) were enrolled in this study. Lesion appearances in conventional ultrasound and CEUS were documented. The imaging features were compared individually among gallbladder cholesterol polyp, gallbladder adenoma and malignant lesion. Adenoma lesions showed iso-echogenicity in ultrasound, and an eccentric enhancement pattern, "fast-in and synchronous-out" contrast enhancement pattern and homogeneous at peak-time enhancement in CEUS. The homogenicity at peak-time enhancement showed the highest diagnostic ability in differentiating gallbladder adenoma from cholesterol polyps. The sensitivity, specificity, positive predictive value, negative predictive value, accuracy and Youden index were 100%, 90.9%, 92.9%, 100%, 95.8% and 0.91, respectively. The characteristic of continuous gallbladder wall shown by CEUS had the highest diagnostic ability in differentiating adenoma from malignant lesion (100%, 86.7%, 86.7%, 100%, 92.9% and 0.87, respectively). The characteristic of the eccentric enhancement pattern had the highest diagnostic ability in differentiating adenoma from cholesterol polyp and malignant lesion, with corresponding indices of 69.2%, 88.5%, 75.0%, 85.2%, 82.1% and 0.58, respectively. CEUS is valuable in differentiating gallbladder adenoma from other gallbladder polyps (≥10 mm in diameter). Homogeneous echogenicity on peak-time enhancement, a continuous gallbladder wall, and the eccentric enhancement pattern are important indicators of gallbladder adenoma on CEUS.

Clinical bacteriology in low-resource settings: today's solutions.

PubMed

Ombelet, Sien; Ronat, Jean-Baptiste; Walsh, Timothy; Yansouni, Cedric P; Cox, Janneke; Vlieghe, Erika; Martiny, Delphine; Semret, Makeda; Vandenberg, Olivier; Jacobs, Jan

2018-03-05

Low-resource settings are disproportionately burdened by infectious diseases and antimicrobial resistance. Good quality clinical bacteriology through a well functioning reference laboratory network is necessary for effective resistance control, but low-resource settings face infrastructural, technical, and behavioural challenges in the implementation of clinical bacteriology. In this Personal View, we explore what constitutes successful implementation of clinical bacteriology in low-resource settings and describe a framework for implementation that is suitable for general referral hospitals in low-income and middle-income countries with a moderate infrastructure. Most microbiological techniques and equipment are not developed for the specific needs of such settings. Pending the arrival of a new generation diagnostics for these settings, we suggest focus on improving, adapting, and implementing conventional, culture-based techniques. Priorities in low-resource settings include harmonised, quality assured, and tropicalised equipment, consumables, and techniques, and rationalised bacterial identification and testing for antimicrobial resistance. Diagnostics should be integrated into clinical care and patient management; clinically relevant specimens must be appropriately selected and prioritised. Open-access training materials and information management tools should be developed. Also important is the need for onsite validation and field adoption of diagnostics in low-resource settings, with considerable shortening of the time between development and implementation of diagnostics. We argue that the implementation of clinical bacteriology in low-resource settings improves patient management, provides valuable surveillance for local antibiotic treatment guidelines and national policies, and supports containment of antimicrobial resistance and the prevention and control of hospital-acquired infections. Copyright © 2018 Elsevier Ltd. All rights reserved.

Investigating the cross-cultural validity of DSM-5 autism spectrum disorder: evidence from Finnish and UK samples.

PubMed

Mandy, William; Charman, Tony; Puura, Kaija; Skuse, David

2014-01-01

The recent Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) reformulation of autism spectrum disorder has received empirical support from North American and UK samples. Autism spectrum disorder is an increasingly global diagnosis, and research is needed to discover how well it generalises beyond North America and the United Kingdom. We tested the applicability of the DSM-5 model to a sample of Finnish young people with autism spectrum disorder (n = 130) or the broader autism phenotype (n = 110). Confirmatory factor analysis tested the DSM-5 model in Finland and compared the fit of this model between Finnish and UK participants (autism spectrum disorder, n = 488; broader autism phenotype, n = 220). In both countries, autistic symptoms were measured using the Developmental, Diagnostic and Dimensional Interview. Replicating findings from English-speaking samples, the DSM-5 model fitted well in Finnish autism spectrum disorder participants, outperforming a Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) model. The DSM-5 model fitted equally well in Finnish and UK autism spectrum disorder samples. Among broader autism phenotype participants, this model fitted well in the United Kingdom but poorly in Finland, suggesting that cross-cultural variability may be greatest for milder autistic characteristics. We encourage researchers with data from other cultures to emulate our methodological approach, to map any cultural variability in the manifestation of autism spectrum disorder and the broader autism phenotype. This would be especially valuable given the ongoing revision of the International Classification of Diseases-11th Edition, the most global of the diagnostic manuals.

Gene Expression (mRNA) Markers for Differentiating between Malignant and Benign Follicular Thyroid Tumours

PubMed Central

Wojtas, Bartosz; Pfeifer, Aleksandra; Oczko-Wojciechowska, Malgorzata; Krajewska, Jolanta; Czarniecka, Agnieszka; Kukulska, Aleksandra; Eszlinger, Markus; Musholt, Thomas; Stokowy, Tomasz; Swierniak, Michal; Stobiecka, Ewa; Chmielik, Ewa; Rusinek, Dagmara; Tyszkiewicz, Tomasz; Halczok, Monika; Hauptmann, Steffen; Lange, Dariusz; Jarzab, Michal; Paschke, Ralf; Jarzab, Barbara

2017-01-01

Distinguishing between follicular thyroid cancer (FTC) and follicular thyroid adenoma (FTA) constitutes a long-standing diagnostic problem resulting in equivocal histopathological diagnoses. There is therefore a need for additional molecular markers. To identify molecular differences between FTC and FTA, we analyzed the gene expression microarray data of 52 follicular neoplasms. We also performed a meta-analysis involving 14 studies employing high throughput methods (365 follicular neoplasms analyzed). Based on these two analyses, we selected 18 genes differentially expressed between FTA and FTC. We validated them by quantitative real-time polymerase chain reaction (qRT-PCR) in an independent set of 71 follicular neoplasms from formaldehyde-fixed paraffin embedded (FFPE) tissue material. We confirmed differential expression for 7 genes (CPQ, PLVAP, TFF3, ACVRL1, ZFYVE21, FAM189A2, and CLEC3B). Finally, we created a classifier that distinguished between FTC and FTA with an accuracy of 78%, sensitivity of 76%, and specificity of 80%, based on the expression of 4 genes (CPQ, PLVAP, TFF3, ACVRL1). In our study, we have demonstrated that meta-analysis is a valuable method for selecting possible molecular markers. Based on our results, we conclude that there might exist a plausible limit of gene classifier accuracy of approximately 80%, when follicular tumors are discriminated based on formalin-fixed postoperative material. PMID:28574441