Accuracy of diagnostic testing in primary ciliary dyskinesia.

Diagnosis of primary ciliary dyskinesia (PCD) lacks a "gold standard" test and is therefore based on combinations of tests including nasal nitric oxide (nNO), high-speed video microscopy analysis (HSVMA), genotyping and transmission electron microscopy (TEM). There are few published data on the accuracy of this approach.Using prospectively collected data from 654 consecutive patients referred for PCD diagnostics we calculated sensitivity and specificity for individual and combination testing strategies. Not all patients underwent all tests.HSVMA had excellent sensitivity and specificity (100% and 93%, respectively). TEM was 100% specific, but 21% of PCD patients had normal ultrastructure. nNO (30 nL·min(-1) cut-off) had good sensitivity and specificity (91% and 96%, respectively). Simultaneous testing using HSVMA and TEM was 100% sensitive and 92% specific.In conclusion, combination testing was found to be a highly accurate approach for diagnosing PCD. HSVMA alone has excellent accuracy, but requires significant expertise, and repeated sampling or cell culture is often needed. TEM alone is specific but misses 21% of cases. nNO (≤30 nL·min(-1)) contributes well to the diagnostic process. In isolation nNO screening at this cut-off would miss ∼10% of cases, but in combination with HSVMA could reduce unnecessary further testing. Standardisation of testing between centres is a future priority.

Improving Surveying Accuracy and Efficiency in Connecticut: An Accuracy Assessment of GEOID03 and GEOID09

Comparing published NAVD 88 Helmert orthometric heights of First-Order bench marks against GPS-determined orthometric heights showed that GEOID03 and GEOID09 perform at their reported accuracy in Connecticut. GPS-determined orthometric heights were determined by subtracting geoid undulations from ellipsoid heights obtained from a network least-squares adjustment of GPS occupations in 2007 and 2008. A total of 73 markers were occupied in these stability classes: 25 class A, 11 class B, 12 class C, 2 class D bench marks, and 23 temporary marks with transferred elevations. Adjusted ellipsoid heights were compared against OPUS as a check. We found that: the GPS-determined orthometric heights of stability class A markers and the transfers are statistically lower than their published values but just barely; stability class B, C and D markers are also statistically lower in a manner consistent with subsidence or settling; GEOID09 does not exhibit a statistically significant residual trend across Connecticut; and GEOID09 out-performed GEOID03. A "correction surface" is not recommended in spite of the geoid models being statistically different than the NAVD 88 heights because the uncertainties involved dominate the discrepancies. Instead, it is recommended that the vertical control network be re-observed.

ACCURACY OF THE BRCAPRO RISK ASSESSMENT MODEL IN MALES PRESENTING TO MD ANDERSON FOR BRCA TESTING

ACCURACY OF THE BRCAPRO RISK ASSESSMENT MODEL IN MALES PRESENTING TO MD ANDERSON FOR BRCA TESTING Publication No. _______ Carolyn A. Garby, B.S. Supervisory Professor: Banu Arun, M.D. Hereditary Breast and Ovarian Cancer (HBOC) syndrome is due to mutations in BRCA1 and BRCA2 genes. Women with HBOC have high risks to develop breast and ovarian cancers. Males with HBOC are commonly overlooked because male breast cancer is rare and other male cancer risks such as prostate and pancreatic cancers are relatively low. BRCA genetic testing is indicated for men as it is currently estimated that 4-40% of male breast cancers result from a BRCA1 or BRCA2 mutation (Ottini, 2010) and management recommendations can be made based on genetic test results. Risk assessment models are available to provide the individualized likelihood to have a BRCA mutation. Only one study has been conducted to date to evaluate the accuracy of BRCAPro in males and was based on a cohort of Italian males and utilized an older version of BRCAPro. The objective of this study is to determine if BRCAPro5.1 is a valid risk assessment model for males who present to MD Anderson Cancer Center for BRCA genetic testing. BRCAPro has been previously validated for determining the probability of carrying a BRCA mutation, however has not been further examined particularly in males. The total cohort consisted of 152 males who had undergone BRCA genetic testing. The cohort was stratified by indication for genetic counseling. Indications included having a known familial BRCA mutation, having a personal diagnosis of a BRCA-related cancer, or having a family history suggestive of HBOC. Overall there were 22 (14.47%) BRCA1+ males and 25 (16.45%) BRCA2+ males. Receiver operating characteristic curves were constructed for the cohort overall, for each particular indication, as well as for each cancer subtype. Our findings revealed that the BRCAPro5.1 model had perfect discriminating ability at a threshold of 56.2 for males with breast cancer, however only 2 (4.35%) of 46 were found to have BRCA2 mutations. These results are significantly lower than the high approximation (40%) reported in previous literature. BRCAPro does perform well in certain situations for men. Future investigation of male breast cancer and men at risk for BRCA mutations is necessary to provide a more accurate risk assessment.

Data Accuracy in Medical Record Abstraction

Clinical Research Data Quality Literature Review and Pooled Analysis We present a literature review and secondary analysis of data accuracy in clinical research and related secondary data uses. A total of 93 papers meeting our inclusion criteria were categorized according to the data processing methods. Quantitative data accuracy information was abstracted from the articles and pooled. Our analysis demonstrates that the accuracy associated with data processing methods varies widely, with error rates ranging from 2 errors per 10,000 files to 5019 errors per 10,000 fields. Medical record abstraction was associated with the highest error rates (70–5019 errors per 10,000 fields). Data entered and processed at healthcare facilities had comparable error rates to data processed at central data processing centers. Error rates for data processed with single entry in the presence of on-screen checks were comparable to double entered data. While data processing and cleaning methods may explain a significant amount of the variability in data accuracy, additional factors not resolvable here likely exist. Defining Data Quality for Clinical Research: A Concept Analysis Despite notable previous attempts by experts to define data quality, the concept remains ambiguous and subject to the vagaries of natural language. This current lack of clarity continues to hamper research related to data quality issues. We present a formal concept analysis of data quality, which builds on and synthesizes previously published work. We further posit that discipline-level specificity may be required to achieve the desired definitional clarity. To this end, we combine work from the clinical research domain with findings from the general data quality literature to produce a discipline-specific definition and operationalization for data quality in clinical research. While the results are helpful to clinical research, the methodology of concept analysis may be useful in other fields to clarify data quality attributes and to achieve operational definitions. Medical Record Abstractor’s Perceptions of Factors Impacting the Accuracy of Abstracted Data Medical record abstraction (MRA) is known to be a significant source of data errors in secondary data uses. Factors impacting the accuracy of abstracted data are not reported consistently in the literature. Two Delphi processes were conducted with experienced medical record abstractors to assess abstractor’s perceptions about the factors. The Delphi process identified 9 factors that were not found in the literature, and differed with the literature by 5 factors in the top 25%. The Delphi results refuted seven factors reported in the literature as impacting the quality of abstracted data. The results provide insight into and indicate content validity of a significant number of the factors reported in the literature. Further, the results indicate general consistency between the perceptions of clinical research medical record abstractors and registry and quality improvement abstractors. Distributed Cognition Artifacts on Clinical Research Data Collection Forms Medical record abstraction, a primary mode of data collection in secondary data use, is associated with high error rates. Distributed cognition in medical record abstraction has not been studied as a possible explanation for abstraction errors. We employed the theory of distributed representation and representational analysis to systematically evaluate cognitive demands in medical record abstraction and the extent of external cognitive support employed in a sample of clinical research data collection forms. We show that the cognitive load required for abstraction in 61% of the sampled data elements was high, exceedingly so in 9%. Further, the data collection forms did not support external cognition for the most complex data elements. High working memory demands are a possible explanation for the association of data errors with data elements requiring abstractor interpretation, comparison, mapping or calculation. The representational analysis used here can be used to identify data elements with high cognitive demands.

No insulation : politics and technocracy's troubled trajectory

Technocracy often holds out the promise of rational, disinterested decision-making. Yet states look to technocracy not just for expert inputs and calculated outcomes but to embed the exercise of power in many agendas, policies and programs. Thus, technocracy operates as an appendage of politically constructed structures and configurations of power, and highly placed technocrats cannot be 'mere' backroom experts who supply disinterested rational-technical solutions in economic planning, resource allocation and social distribution, which are inherently political. This paper traces the trajectories of technocracy in conditions of rapid social transformation, severe economic restructuring, or political crises - when the technocratic was unavoidably political.

Improving target localization accuracy of wireless visual sensor networks

This paper discusses the target localization problem of wireless visual sensor networks. Specifically, each node with a low-resolution camera extracts multiple feature points to represent the target at the sensor node level. A statistical method of merging the position information of different sensor nodes to select the most correlated feature point pair at the base station is presented. This method releases the influence of the accuracy of target extraction on the accuracy of target localization in universal coordinate system. Simulations show that, compared with other relative approach, our proposed method can generate more desirable target localization's accuracy, and it has a better trade-off between camera node usage and localization accuracy.

GIS analysis of the accuracy of Tomas Lopez's historical cartography in the Canary Islands (1742 - 1746)

The accuracy of Tomás López´s historical cartography of the Canary Islands included in the “Atlas Particular” of the Kingdoms of Spain, Portugal and Adjacent Islands” is analyzed. For this purpose, we propose a methodology based on Geographic Information Systems (GIS), a comparison of digitized historical cartography population centres with current ones. This study shows that the lineal error value is small for the smaller islands: Lanzarote, El Hierro, La Palma and La Gomera. In the large islands of Tenerife, Fuerteventura and Gran Canaria, the error is smaller in central zones but increases towards the coast. This indicates that Tomás López began his cartography starting from central island zones, accumulating errors due to lack of geodetic references as he moved toward the coast.

Aircraft trajectory simulator using a three degrees of freedom aircraft point mass model

Aircraft Operators Companies (AOCs) are always willing to keep the cost of a flight as low as possible. These costs could be modelled using a function of the fuel consumption, time of flight and fixed cost (over flight cost, maintenance, etc.). These are strongly dependant on the atmospheric conditions, the presence of winds and the aircraft performance. For this reason, much research effort is being put in the development of numerical and graphical techniques for defining the optimal trajectory. This paper presents a different approach to accommodate AOCs preferences, adding value to their activities, through the development of a tool, called aircraft trajectory simulator. This tool is able to simulate the actual flight of an aircraft with the constraints imposed. The simulator is based on a point mass model of the aircraft. The aim of this paper is to evaluate 3DoF aircraft model errors with BADA data through real data from Flight Data Recorder FDR. Therefore, to validate the proposed simulation tool a comparative analysis of the state variables vector is made between an actual flight and the same flight using the simulator. Finally, an example of a cruise phase is presented, where a conventional levelled flight is compared with a continuous climb flight. The comparison results show the potential benefits of following user-preferred routes for commercial flights.

Automatic-dependent surveillance-broadcast experimental deployment using system wide information management

This paper describes an automatic-dependent surveillance-broadcast (ADS-B) implementation for air-to-air and ground-based experimental surveillance within a prototype of a fully automated air traffic management (ATM) system, under a trajectory-based-operations paradigm. The system is built using an air-inclusive implementation of system wide information management (SWIM). This work describes the relations between airborne and ground surveillance (SURGND), the prototype surveillance systems, and their algorithms. System's performance is analyzed with simulated and real data. Results show that the proposed ADS-B implementation can fulfill the most demanding surveillance accuracy requirements.

Analysis of the geometric altimetry to support aircraft optimal profiles within future 4D trajectory management

The use of barometric altimetry is to some extent a limiting factor on safety, predictability and efficiency of aircraft operations, and reduces the potential of the trajectory based operations capabilities. However, geometric altimetry could be used to improve all of these aspects. Nowadays aircraft altitude is estimated by applying the International Standard Atmosphere which differs from real altitude. At different temperatures for an assigned barometric altitude, aerodynamic forces are different and this has a direct relationship with time, fuel consumption and range of the flight. The study explores the feasibility of using sensors providing geometric reference altitude, in particular, to supply capabilities for the optimization of vertical profiles and also, their impact on the vertical Air Traffic Management separation assurance processes. One of the aims of the thesis is to assess if geometric altitude fulfils the aeronautical requirements through existing sensors. Also the thesis will elaborate on the advantages of geometric altitude over the barometric altitude in terms of efficiency for vertical navigation. The evidence that geometric altitude is the best choice to improve the efficiency in vertical profile and aircraft capacity by reducing vertical uncertainties will also be shown. In this paper, an atmospheric study is presented, as well as the impact of temperature deviation from International Standard Atmosphere model is analyzed in order to obtain relationship between geometric and barometric altitude. Furthermore, an aircraft model to study aircraft vertical profile is provided to analyse trajectories based on geometric altitudes.

Effect of positioning on the accuracy of decision making of association football top-class referees and assistant referees during competitive matches

The aim of this study was to examine the effect of positioning on the correctness of decision making of top-class referees and assistant referees during international games. Match analyses were carried out during the Fe´de´ration Internationale de Football Association (FIFA) Confederations Cup 2009 and 380 foul play incidents and 165 offside situations were examined. The error percentage for the referees when indicating the incidents averaged 14%. The lowest error percentage occurred in the central area of the field, where the collaboration of the assistant referee is limited, and was achieved when indicating the incidents from a distance of 11–15 m, whereas this percentage peaked (23%) in the last 15-min match period. The error rate for the assistant referees was 13%. Distance of the assistant referee to the offside line did not have an impact on the quality of the offside decision. The risk of making incorrect decisions was reduced when the assistant referees viewed the offside situations from an angle between 46 and 608. Incorrect offside decisions occurred twice as often in the second as in the first half of the games. Perceptual-cognitive training sessions specific to the requirements of the game should be implemented in the weekly schedule of football officials to reduce the overall error rate.

Performance of pressure control valves and flow meters precision in operational irrigation-water balance accuracy

In pressure irrigation-water distribution networks, pressure regulating devices for controlling the discharged flow rate by irrigation units are needed due to the variability of flow rate. In addition, applied water volume is used controlled operating the valve during a calculated time interval, and assuming constant flow rate. In general, a pressure regulating valve PRV is the commonly used pressure regulating device in a hydrant, which, also, executes the open and close function. A hydrant feeds several irrigation units, requiring a wide range in flow rate. In addition, some flow meters are also available, one as a component of the hydrant and the rest are placed downstream. Every land owner has one flow meter for each group of field plots downstream the hydrant. Its lecture could be used for refining the water balance but its accuracy must be taken into account. Ideal PRV performance would maintain a constant downstream pressure. However, the true performance depends on both upstream pressure and the discharged flow rate. The objective of this work is to asses the influence of the performance on the applied volume during the whole irrigation events in a year. The results of the study have been obtained introducing the flow rate into a PRV model. Variations on flow rate are simulated by taking into account the consequences of variations on climate conditions and also decisions in irrigation operation, such us duration and frequency application. The model comprises continuity, dynamic and energy equations of the components of the PRV.

Aircraft flight trajectory deviation in the standard instrument departures. Operators penalties.

In the recent years many problems are emerging due to the aircraft noise on the airport surrounding areas. The solution to this problem is not easy considering that the neighbourhood asks for the reduction of the number of aircraft operations and the airlines ask for a growing demand in the number of operations in the major airports. So the airport and regulatory authorities try to get a solution imposing a fine to the aircraft which its actual trajectory differs from the nominal one more than a lateral deviation. But, which is the value of this deviation?. The current situation is that many operators have to pay a lot of money for exceeding a deviation which has been established without operational criteria. This paper presents the results of a research program which is being carried out by the authors which aims to determine the "delta" deviation to be used for this purpose. In addition it is proposed a customized method per SID and per airport to be used for determining the maximum allowed lateral deviation by which if the aircraft is within it, then none fine will be imposed.

AUTOFLY-Aid: Flight Deck Automation Support with Dynamic 4D Trajectory Management for Responsive and Adaptive Airborne Collision Avoidance

AUTOFLY-Aid Project aims to develop and demonstrate novel automation support algorithms and tools to the flight crew for flight critical collision avoidance using “dynamic 4D trajectory management”. The automation support system is envisioned to improve the primary shortcomings of TCAS, and to aid the pilot through add-on avionics/head-up displays and reality augmentation devices in dynamically evolving collision avoidance scenarios. The main theoretical innovative and novel concepts to be developed by AUTOFLY-Aid project are a) design and development of the mathematical models of the full composite airspace picture from the flight deck’s perspective, as seen/measured/informed by the aircraft flying in SESAR 2020, b) design and development of a dynamic trajectory planning algorithm that can generate at real-time (on the order of seconds) flyable (i.e. dynamically and performance-wise feasible) alternative trajectories across the evolving stochastic composite airspace picture (which includes new conflicts, blunder risks, terrain and weather limitations) and c) development and testing of the Collision Avoidance Automation Support System on a Boeing 737 NG FNPT II Flight Simulator with synthetic vision and reality augmentation while providing the flight crew with quantified and visual understanding of collision risks in terms of time and directions and countermeasures.

An integrated framework for assessing the accuracy of geobia landcover products.

Se establece un metodología para evaluar la cartografía de capas GIS