The influence of experience and training in a group of novice observers: a jackknife alternative free-response receiver operating characteristic analysis

Purpose - The study evaluates the pre- and post-training lesion localisation ability of a group of novice observers. Parallels are drawn with the performance of inexperienced radiographers taking part in preliminary clinical evaluation (PCE) and ‘red-dot’ systems, operating within radiography practice. Materials and methods - Thirty-four novice observers searched 92 images for simulated lesions. Pre-training and post-training evaluations were completed following the free-response the receiver operating characteristic (FROC) method. Training consisted of observer performance methodology, the characteristics of the simulated lesions and information on lesion frequency. Jackknife alternative FROC (JAFROC) and highest rating inferred ROC analyses were performed to evaluate performance difference on lesion-based and case-based decisions. The significance level of the test was set at 0.05 to control the probability of Type I error. Results - JAFROC analysis (F(3,33) = 26.34, p < 0.0001) and highest-rating inferred ROC analysis (F(3,33) = 10.65, p = 0.0026) revealed a statistically significant difference in lesion detection performance. The JAFROC figure-of-merit was 0.563 (95% CI 0.512,0.614) pre-training and 0.677 (95% CI 0.639,0.715) post-training. Highest rating inferred ROC figure-of-merit was 0.728 (95% CI 0.701,0.755) pre-training and 0.772 (95% CI 0.750,0.793) post-training. Conclusions - This study has demonstrated that novice observer performance can improve significantly. This study design may have relevance in the assessment of inexperienced radiographers taking part in PCE or commenting scheme for trauma.

Monitorização da insuficiência cardíaca por parâmetros fisiológicos em portadores de cardioversor-desfibrilhador implantável e/ou sistema de ressincronização cardíaca: HF-PREDICT

Mestrado em Tecnologia de Diagnóstico e Intervenção Cardiovascular. Área de especialização: Intervenção Cardiovascular.

Arrow Plot: a new graphical tool for selecting up and down regulated genes and genes differentially expressed on samples subgroups

Background: A common task in analyzing microarray data is to determine which genes are differentially expressed across two (or more) kind of tissue samples or samples submitted under experimental conditions. Several statistical methods have been proposed to accomplish this goal, generally based on measures of distance between classes. It is well known that biological samples are heterogeneous because of factors such as molecular subtypes or genetic background that are often unknown to the experimenter. For instance, in experiments which involve molecular classification of tumors it is important to identify significant subtypes of cancer. Bimodal or multimodal distributions often reflect the presence of subsamples mixtures. Consequently, there can be genes differentially expressed on sample subgroups which are missed if usual statistical approaches are used. In this paper we propose a new graphical tool which not only identifies genes with up and down regulations, but also genes with differential expression in different subclasses, that are usually missed if current statistical methods are used. This tool is based on two measures of distance between samples, namely the overlapping coefficient (OVL) between two densities and the area under the receiver operating characteristic (ROC) curve. The methodology proposed here was implemented in the open-source R software. Results: This method was applied to a publicly available dataset, as well as to a simulated dataset. We compared our results with the ones obtained using some of the standard methods for detecting differentially expressed genes, namely Welch t-statistic, fold change (FC), rank products (RP), average difference (AD), weighted average difference (WAD), moderated t-statistic (modT), intensity-based moderated t-statistic (ibmT), significance analysis of microarrays (samT) and area under the ROC curve (AUC). On both datasets all differentially expressed genes with bimodal or multimodal distributions were not selected by all standard selection procedures. We also compared our results with (i) area between ROC curve and rising area (ABCR) and (ii) the test for not proper ROC curves (TNRC). We found our methodology more comprehensive, because it detects both bimodal and multimodal distributions and different variances can be considered on both samples. Another advantage of our method is that we can analyze graphically the behavior of different kinds of differentially expressed genes. Conclusion: Our results indicate that the arrow plot represents a new flexible and useful tool for the analysis of gene expression profiles from microarrays.

Acuidade de eletrocardiograma no diagnóstico de hipertrofia ventricular esquerda em indivíduos hipertensos no distrito de Portalegre

Mestrado em Gestão e Avaliação de Tecnologias em Saúde.

Assessment of the quality of brain regions and neuroimaging metrics as biomarkers of Alzheimer’s disease

Alzheimer Disease (AD) is characterized by progressive cognitive decline and dementia. Earlier diagnosis and classification of different stages of the disease are currently the main challenges and can be assessed by neuroimaging. With this work we aim to evaluate the quality of brain regions and neuroimaging metrics as biomarkers of AD. Multimodal Imaging Brain Connectivity Analysis (MIBCA) toolbox functionalities were used to study AD by T1weighted, Diffusion Tensor Imaging and 18FAV45 PET, with data obtained from the AD Neuroimaging Initiative database, specifically 12 healthy controls (CTRL) and 33 patients with early mild cognitive impairment (EMCI), late MCI (LMCI) and AD (11 patients/group). The metrics evaluated were gray-matter volume (GMV), cortical thickness (CThk), mean diffusivity (MD), fractional anisotropy (FA), fiber count (FiberConn), node degree (Deg), cluster coefficient (ClusC) and relative standard-uptake-values (rSUV). Receiver Operating Characteristic (ROC) curves were used to evaluate and compare the diagnostic accuracy of the most significant metrics and brain regions and expressed as area under the curve (AUC). Comparisons were performed between groups. The RH-Accumbens/Deg demonstrated the highest AUC when differentiating between CTRLEMCI (82%), whether rSUV presented it in several brain regions when distinguishing CTRL-LMCI (99%). Regarding CTRL-AD, highest AUC were found with LH-STG/FiberConn and RH-FP/FiberConn (~100%). A larger number of neuroimaging metrics related with cortical atrophy with AUC>70% was found in CTRL-AD in both hemispheres, while in earlier stages, cortical metrics showed in more confined areas of the temporal region and mainly in LH, indicating an increasing of the spread of cortical atrophy that is characteristic of disease progression. In CTRL-EMCI several brain regions and neuroimaging metrics presented AUC>70% with a worst result in later stages suggesting these indicators as biomarkers for an earlier stage of MCI, although further research is necessary.

Lesion detection performance: comparative analysis of low-dose CT data of the chest on two hybrid imaging systems

Incidental findings on low-dose CT images obtained during hybrid imaging are an increasing phenomenon as CT technology advances. Understanding the diagnostic value of incidental findings along with the technical limitations is important when reporting image results and recommending follow-up, which may result in an additional radiation dose from further diagnostic imaging and an increase in patient anxiety. This study assessed lesions incidentally detected on CT images acquired for attenuation correction on two SPECT/CT systems. Methods: An anthropomorphic chest phantom containing simulated lesions of varying size and density was imaged on an Infinia Hawkeye 4 and a Symbia T6 using the low-dose CT settings applied for attenuation correction acquisitions in myocardial perfusion imaging. Twenty-two interpreters assessed 46 images from each SPECT/CT system (15 normal images and 31 abnormal images; 41 lesions). Data were evaluated using a jackknife alternative free-response receiver-operating-characteristic analysis (JAFROC). Results: JAFROC analysis showed a significant difference (P < 0.0001) in lesion detection, with the figures of merit being 0.599 (95% confidence interval, 0.568, 0.631) and 0.810 (95% confidence interval, 0.781, 0.839) for the Infinia Hawkeye 4 and Symbia T6, respectively. Lesion detection on the Infinia Hawkeye 4 was generally limited to larger, higher-density lesions. The Symbia T6 allowed improved detection rates for midsized lesions and some lower-density lesions. However, interpreters struggled to detect small (5 mm) lesions on both image sets, irrespective of density. Conclusion: Lesion detection is more reliable on low-dose CT images from the Symbia T6 than from the Infinia Hawkeye 4. This phantom-based study gives an indication of potential lesion detection in the clinical context as shown by two commonly used SPECT/CT systems, which may assist the clinician in determining whether further diagnostic imaging is justified.

Avaliação da tonopaquimetria como exame de rastreio de glaucoma primário de ângulo aberto

Mestrado em Gestão e Avaliação de Tecnologias em Saúde

Diagnostic performance of visual screening tests in the elderly

This study aimed to determine and evaluate the diagnostic accuracy of visual screening tests for detecting vision loss in elderly. This study is defined as study of diagnostic performance. The diagnostic accuracy of 5 visual tests -near convergence point, near accommodation point, stereopsis, contrast sensibility and amsler grid—was evaluated by means of the ROC method (receiver operating characteristics curves), sensitivity, specificity, positive and negative likelihood ratios (LR+/LR−). Visual acuity was used as the reference standard. A sample of 44 elderly aged 76.7 years (±9.32), who were institutionalized, was collected. The curves of contrast sensitivity and stereopsis are the most accurate (area under the curves were 0.814−p = 0.001, C.I.95%[0.653;0.975]— and 0.713−p = 0.027, C.I.95%[0,540;0,887], respectively). The scores with the best diagnostic validity for the stereopsis test were 0.605 (sensitivity 0.87, specificity 0.54; LR+ 1.89, LR−0.24) and 0.610 (sensitivity 0.81, specificity 0.54; LR+1.75, LR−0.36). The scores with higher diagnostic validity for the contrast sensibility test were 0.530 (sensitivity 0.94, specificity 0.69; LR+ 3.04, LR−0.09). The contrast sensitivity and stereopsis test's proved to be clinically useful in detecting vision loss in the elderly.

Stratification of the earth beneath the Azores from P and S receiver functions

Seismic recordings of IRIS/IDA/GSN station CMLA and of several temporary stations in the Azores archipelago are processed with P and S receiver function (PRF and SRF) techniques. Contrary to regional seismic tomography these methods provide estimates of the absolute velocities and of the Vp/Vs ratio up to a depth of similar to 300 km. Joint inversion of PRFs and SRFs for a few data sets consistently reveals a division of the subsurface medium into four zones with a distinctly different Vp/Vs ratio: the crust similar to 20 km thick with a ratio of similar to 1.9 in the lower crust, the high-Vs mantle lid with a strongly reduced VpNs velocity ratio relative to the standard 1.8, the low-velocity zone (LVZ) with a velocity ratio of similar to 2.0, and the underlying upper-mantle layer with a standard velocity ratio. Our estimates of crustal thickness greatly exceed previous estimates (similar to 10 km). The base of the high-Vs lid (the Gutenberg discontinuity) is at a depth of-SO km. The LVZ with a reduction of S velocity of similar to 15% relative to the standard (IASP91) model is terminated at a depth of similar to 200 km. The average thickness of the mantle transition zone (TZ) is evaluated from the time difference between the S410p and SKS660p, seismic phases that are robustly detected in the S and SKS receiver functions. This thickness is practically similar to the standard IASP91 value of 250 km. and is characteristic of a large region of the North Atlantic outside the Azores plateau. Our data are indicative of a reduction of the S-wave velocity of several percent relative to the standard velocity in a depth interval from 460 to 500 km. This reduction is found in the nearest vicinities of the Azores, in the region sampled by the PRFs, but, as evidenced by SRFs, it is missing at a distance of a few hundred kilometers from the islands. We speculate that this anomaly may correspond to the source of a plume which generated the Azores hotspot. Previously, a low S velocity in this depth range was found with SRF techniques beneath a few other hotspots.

Reversible Photorheology in Solutions of Cetyltrimethylammonium Bromide, Salicylic Acid, and trans-2,4,4 '-Trihydroxychalcone

We show photorheology in aqueous solutions of weakly entangled wormlike micelles prepared with cetyltrimethylammonium bromide (CTAB), salicylic acid (HSal), and dilute amounts of the photochromic multistate compound trans-2,4,4'-trihydroxychalcone (Ct). Different chemical species of Ct are associated with different colorations and propensities to reside within or outside CTAB micelles. A light-induced transfer between the intra- and intermicellar space is used to alter the mean length of wormlike micelles and hence the rheological properties of the fluid, studied in steady-state shear Bow and in dynamic rheological measurements. Light-induced changes of fluid rheology are reversible by a the relaxation process. at relaxation rates which depend on pH and which are consistent with photochromic reversion rates measured by UV-vis absorption spectroscopy. Parameterizing viscoelostic rheological states by their effective relaxation time tau(c) and corresponding response modulus G(c), we find the light and dark states of the system to fall onto a characteristic state curve defined by comparable experiments conducted without photosensitive components. These reference experiments were prepared with the same concentration of CTAB, but different concentrations of HSal or sodium salicylote (NaSal), and tested at different temperatures.

RF Receiver Front End for 28.5 GHz Applications on a 70 GHz F-T SiGe BiCMOS Process

This article presents the design and test of a receiver front end aimed at LMDS applications at 28.5 GHz. It presents a system-level design after which the receiver was designed. The receiver comprises an LNA, quadrature mixer and quadrature local oscillator. Experimental results at 24 GHz center frequency show a conversion voltage gain of 15 dB and conversion noise figure of 14 5 dB. The receiver operates from a 2 5 V power supply with a total current consumption of 31 mA.

Optical demultiplexer device operating in the visible spectrum

In this paper, we present results on the use of multilayered a-SiC:H heterostructures as a device for wavelength-division demultiplexing of optical signals. These devices are useful in optical communications applications that use the wavelength division multiplexing technique to encode multiple signals into the same transmission medium. The device is composed of two stacked p-i-n photodiodes, both optimized for the selective collection of photo generated carriers. Band gap engineering was used to adjust the photogeneration and recombination rate profiles of the intrinsic absorber regions of each photodiode to short and long wavelength absorption in the visible spectrum. The photocurrent signal using different input optical channels was analyzed at reverse and forward bias and under steady state illumination. A demux algorithm based on the voltage controlled sensitivity of the device was proposed and tested. An electrical model of the WDM device is presented and supported by the solution of the respective circuit equations.

Design of a Multiband Full-Rate Ultra-Wideband Receiver in FPGA

MultiBand OFDM (MB-OFDM) UWB [1] is a short-range promising wireless technology for high data rate communications up to 480 Mbps. In this paper, we have designed and implemented in an Virtex-6 FPGA an MB-OFDM UWB receiver for the highest data rate of 480 Mbps. To test the system, we have also implemented an MB-OFDM transmitter and an AWGN generator in VHDL and determined the bit error rates at the receiver running in an FPGA.

A 5GHz1.8V Low Power CMOS Low-Noise Amplifier

Wireless local-area networks (WLANs) have been deployed as office and home communications infrastructures worldwide. The diversification of the standards, such as IEEE 802.11 series demands the design of RF front-ends. Low power consumption is one of the most important design concerns in the application of those technologies. To maintain competitive hardware costs, CMOS has been used since it is the best solution for low cost and high integration processing, allowing analog circuits to be mixed with digital ones. In the receiver chain, the low noise amplifier (LNA) is one of the most critical blocks in a transceiver design. The sensitivity is mainly determined by the LNA noise figure and gain. It interfaces with the pre-select filter and the mixer. Furthermore, since it is the first gain stage, care must be taken to provide accurate input match, low-noise figure, good linearity and a sufficient gain over a wide band of operation. Several CMOS LNAs have been reported during the last decade, showing that the most research has been done at 802.11/b and GSM standards (900-2400MHz spectrum) and more recently at 802.11/a (5GHz band). One of the more significant disadvantages of 802.11/b is that the frequency band is crowded and subject to interference from other technologies, as is 2.4GHz cordless phones and Bluetooth. As the demand for radio-frequency integrated circuits, operating at higher frequency bands, increases, the IEEE 802.11/a standard becomes a very attractive option to wireless communication system developers. This paper presents the design and implementation of a low power, low noise amplifier aimed at IEEE 802.11a for WLAN applications. It was designed to be integrated with an active balun and mixer, representing the first step toward a fully integrated monolithic WLAN receiver. All the required circuits are integrated at the same die and are powered by 1.8V supply source. Preliminary experimental results (S-parameters) are shown and promise excellent results. The LNA circuit design details are illustrated in Section 2. Spectre simulation results focused at gain, noise figure (NF) and input/output matching are presented in Section 3. Finally, conclusions and comparison with other recently reported LNAs are made in Section 4, followed by future work.

Lighting conditions at an operating room in a Portuguese maternity

Lighting is one of the most important factors in human interaction with the environment. Poor lighting may increase the risk of accidents and could also cause a variety of symptoms including: rapid fatigue, headaches, eyestrain, tired eyes, dry eyes, ocular surface symptoms (watery and irritated eyes), decreased concentration and stress. Specific disorders: degeneration of the sharpness of vision (blurred and double vision) and slowness in changing focus. Apart from the advantages in the health and welfare for the workers, good lighting also leads to better job performance (faster), less errors, better safety, fewer accidents and less absenteeism. The overall effect is: better productivity. Good lighting includes quantity and quality requirements, and should necessarily be appropriate to the activity/task being carried out, bearing in mind the comfort and visual efficiency of the worker.