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PubMed2000

Accuracy of target detection in new-object and old-object displays.

In 4 experiments, the authors investigated accuracy of detecting a target among nontargets. In some experiments, the target was a second-order square of stationary lines on a background of downward-moving lines, and nontargets were second-order squares of upward-moving lines. In other experiments, target and nontarget squares and background were shades of gray. The principal comparison was between "new" and "old" object displays. In new-object displays, search items appeared abruptly and one might be a target. In old-object displays, search items appeared abruptly, and after a delay one might become a target. Search displays in both conditions terminated shortly after target onset. Except when target onset was associated with the sole luminance change in a display, targets were much better detected in new- than in old-object displays. It is suggested that object onsets elicit a brief stimulus-driven enhancement of attention to the new objects.

Attention↗

PubMed2002

The effect of stimulus blanking on the detection of intrasaccadic displacements of translating objects.

In a display with a stationary and a translating object, subjects made a saccade towards one of the objects and had to detect intrasaccadic changes in the position of either the saccade target or the saccade flanker. Sensitivity for displacements of the stationary and moving objects was measured in conditions with (60 and 220 ms) and without blanking. In the conditions without blanking, displacement detection for translating objects was better than detection for stationary objects, which confirmed previous results (Vis. Res. 42 (2002) 379). This pattern was reversed in the blanking conditions: Sensitivity for intrasaccadic displacements of the translating object decreased drastically in comparison to conditions without a blank and was even lower than sensitivity for the stationary object. The results suggest differences in the transsaccadic spatial representation of translating and stationary objects. While a change in the spatial position of a stationary object can be detected after a blank period of 60 and 220 ms, this seems impossible for a translating object, indicating timing differences in postsaccadic spatial localization processes. Accounts in terms of a fast and accurate motion processing mechanism that possibly makes use of gain control are discussed.

Analysis of Variance↗

PubMed1997

An economic analysis of developmental detection methods.

OBJECTIVE: To assess the costs and benefits of various approaches to early detection of developmental disabilities. DESIGN: Cost-benefit analyses based on data from previously published studies of developmental screening tests. SETTING: General pediatric practices and day care centers. PATIENTS AND OTHER PARTICIPANTS: A total of 247 parents and their 0- to 6-year-old children-103 from day care centers and 144 from pediatric practices. MAIN OUTCOME MEASURES: Licensed psychological examiners administered a screening test of parents' concerns about children's development and one or two direct screening tests: the Denver-II and/or the Battelle Developmental Inventory Screening Test. For the day care sample, examiners also administered to each child measures of intelligence, adaptive behavior, and language. In the pediatric sample, children were administered additional assessments. At the same time, diagnostic measures were administered to a randomly selected subsample to make determinations about developmental status. Each screening method was evaluated for its short-term costs (administration, interpretation, diagnosis, and treatment) and long-term benefits (impact of early intervention on adult functioning as inferred from longitudinal studies by other researchers). RESULTS: When the long-term costs and benefits were considered, none of the approaches emerged as markedly superior to another. When viewing the short-term costs, the various screening approaches differed markedly. The use of parents' concerns was by far the least costly for physicians to administer and interpret. CONCLUSION: Physicians can incur tremendous expenses when attempting to detect children with developmental problems. Although the benefits of early detection and intervention are substantial, physicians are not well-compensated for providing a critical service to society. Health policymakers and third-party payers must reconsider their minimal investment in early detection by health care providers. Nevertheless, our findings have encouraging implications for practice, because the use of parents' concerns as a screening technique offers substantial savings over and above other methods.

Child↗

PubMed2003

Stereotactic histologic biopsy with patients prone: technical feasibility in 98% of mammographically detected lesions.

OBJECTIVE: The purpose of this retrospective study was to determine which mammographically detected lesions in need of imaging-guided biopsy could undergo prone, stereotactic biopsy. MATERIALS AND METHODS: From July 1991 through June 2001, 1687 consecutive patients (age range, 29-94 years; median age, 58 years) with 1894 lesions were referred by clinicians in a multispecialty clinic. The patients underwent stereotactic, prone, histologic biopsy of 1851 lesions (98%) and needle-localized breast biopsy of 43 lesions (2%). We performed stereotactic biopsies successively with 14-gauge automated large-core devices and 14- or 11-gauge vacuum-assisted devices. We evaluated lesions by patient, breast, lesion, and procedural variables to determine why stereotactic biopsy was not performed. RESULTS: Of 1851 lesions referred for stereotactic biopsy, biopsies were canceled in 42 lesions (2%) not considered suspicious enough to warrant biopsy. Of 1809 lesions in which stereotactic biopsy was considered to be warranted, stereotactic biopsy was canceled for technical reasons in 29 lesions (2%). Of 43 lesions referred for surgical biopsy, stereotactic biopsy was thought to be technically problematic in five (12%). Inability to accomplish a stereotactic biopsy in 34 (2%) of 1852 lesions needing a biopsy was due to proximity to the chest wall (n = 10, 29%), inadequate lesion visualization unrelated to lesion depth (n = 19, 56%), and patient factors (n = 5, 15%). CONCLUSION: Stereotactic biopsy had a technical success rate of 98% (1780/1809) and was used for histologic diagnosis in 96% (1780/1852) of mammographically detected lesions. Inadequate lesion visualization accounted for 85% (29/34) of stereotactic biopsy failures.

Adult↗

PubMed2006

[Study on colloidal gold labeled anti-buprenorphine monoclonal antibody for rapid test kit to detect buprenorphine].

OBJECTIVE: To develope an easy to use, rapid and accurate test for detecting buprenorphine based on the principle of competitive immunoassay. METHODS: Monoclonal antibody against buprenorphine was conjugated with colloidal gold and dispensed on the glass fiber. The complete antigen Buprenorphine-BSA and the goat anti-mouse IgG polyclonal antibody were separately sprayed on the nitrocellulose membrane as the test line (T line) and the control line (C line). The rapid test kit was the final assembled product of test strip with the plastic cover. RESULTS: A total of 100 urine samples were tested for buprenorphine by immunochromatographic and GC/ MS methods. The accuracy was 99.0%. It is found the test kit can only detect by cross reaction with other 45 kind drugs. CONCLUSION: Rapid test kit can detect buprenorphine in the samples in 5 minutes. The cut-off value of the test is 100 ng/mL.

Analgesics, Opioid↗

PubMed1996

Comparison of upright inspiratory and expiratory chest radiographs for detecting pneumothoraces.

OBJECTIVE: Expiratory films are regarded as being superior to inspiratory films for pneumothorax detection, yet this has not been proved. In the current study, we compared inspiratory versus expiratory chest radiographs for pneumothorax detection. MATERIALS AND METHODS: Eighty-five paired inspiratory and expiratory radiographs with pneumothoraces and 93 pairs without pneumothoraces were randomly arranged and reviewed independently by three radiologists. A score of 1-5 was assigned for each hemithorax (5 = definite pneumothorax, 1 = definitely no pneumothorax). Results were compared for inspiration and expiration using receiver operating characteristic (ROC) analysis. RESULTS: The average area under the ROC curves for all readers was .973 for inspiration and .972 for expiration (nonsignificant). McNemar's test and an alpha level of .05 also yielded no significant difference in sensitivity and specificity. Four of the 85 cases were scored as definite pneumothorax on inspiration and as definitely not on expiration by all readers, and three of the 85 cases were scored as definite pneumothorax on expiration and as definitely not on inspiration. CONCLUSION: Inspiratory and expiratory upright films are equally sensitive for pneumothorax detection. Given the limitations of expiratory films, inspiratory films are recommended as the initial examination of choice for pneumothorax detection.

Female↗

PubMed1989

Automated detection and recognition of live cells in tissue culture using image cytometry.

An automated image cytometry device, the Cell Analyzer, was used to locate live V79 cells plated at low densities in a tissue culture flask. Cells and other objects were detected by moving the flask in steps across a linear solid-state image sensor. The step size was selected to be small enough to allow detection of all the cells in the area being scanned but sufficiently large so that most cells would be detected on only one image line. To distinguish cells from other detected objects, a recognition algorithm utilizing 18 characteristic cell signal features was developed. The algorithm first tests whether a set of feature values falls within specified upper and lower bounds, and then applies a linear discriminant function to the remaining data to further discriminate cells from debris. False-positive errors of 5% or less were achieved with this method, whereas 15-35% of cells were misclassified as debris.

Algorithms↗

PubMed2005

Effect of using 2 throat swabs vs 1 throat swab on detection of group A streptococcus by a rapid antigen detection test.

OBJECTIVE: To assess the effect of using 2 throat swabs vs 1 on rapid detection of group A streptococcus by the STREP A OIA MAX (hereafter, OIA MAX) test. METHODS: Children aged 5 to 18 years with acute pharyngitis were randomized to 1 of 2 study groups. In group 1, one throat swab was obtained, streaked first on sheep blood agar, and then used for OIA MAX testing. In group 2, two throat swabs were obtained simultaneously. One swab was streaked first on sheep blood agar and then joined with the other swab for OIA MAX testing. In both groups, the pledgets in the collection-transport tube were incubated in Todd-Hewitt broth. A positive group A streptococcus culture either by sheep blood agar or Todd-Hewitt broth was confirmed by a latex agglutination test. RESULTS: Three hundred sixty-three patients were enrolled, 177 in group 1 and 186 in group 2. Cultures were positive for group A streptococcus in 154 (42.4%) of 363 patients. The sensitivity and specificity of OIA MAX testing were 94.7% and 100.0%, respectively, in group 1, and 92.4% and 96.3%, respectively, in group 2. There was no statistical difference between the sensitivity, the specificity, and the predictive values of the OIA MAX test performed with 1 swab compared with those performed with 2 swabs (P>.10). There was no association between OIA MAX test sensitivity and the severity of pharyngitis as measured by the modified Centor criterion (history of fever, absence of cough, presence of pharyngeal or tonsillar exudates, and presence of cervical lymphadenopathy) scores. CONCLUSIONS: The OIA MAX test yielded comparable sensitivity and specificity in both study groups. The use of 2 throat swabs instead of 1 swab did not increase the sensitivity of the OIA MAX test. The performance of the OIA MAX test did not depend on the severity of pharyngitis.

Adolescent↗

PubMed1992

Sexual abuse of children. The detection of semen on skin.

OBJECTIVE: The detection of semen on the skin of children who present within 72 hours of an episode of sexual assault is critical to medical, forensic, and legal personnel. The Wood's Lamp, a UV light that causes semen to fluoresce, and four forensic laboratory techniques were compared to determine their sensitivity and decline in sensitivity over time. DESIGN: A descriptive study. PARTICIPANTS: Eleven adult female volunteers. MEASUREMENTS/MAIN RESULTS: Semen was placed on the skin of the volunteers. Samples of the dried semen were assessed during a 28-hour period with the Wood's Lamp, microscopy, the acid phosphatase assay, and two assays for the prostatic protein p30 (counterimmunoelectrophoresis and enzyme-linked immunosorbent assay). The intensity of the Wood's Lamp fluorescence of semen diminished dramatically by 28 hours; in contrast, the fluorescence of urine persisted up to 80 hours. Over time, the p30-enzyme-linked immunosorbent assay technique was more sensitive than microscopy, the acid phosphatase assay, and p30-counterimmunoelectrophoresis in detecting semen on skin. CONCLUSIONS: The Wood's Lamp is not a sensitive screening tool and should be used with caution. To improve the detection of sexual abuse in children, we recommend that the p30-enzyme-linked immunosorbent assay be used because of its potential as a more sensitive assay than those in current clinical use.

Acid Phosphatase↗

PubMed1999

Strength assessment in postpolio syndrome: validity of a hand-held dynamometer in detecting change.

OBJECTIVES: To investigate the validity, the intraexaminer and interexaminer reproducibility, and the ability to detect change of a hand-held dynamometer (HHD) in strength measurements in former polio subjects. DESIGN: HHD measurement of knee extensor strength was compared with the criterion standard of a chair dynamometer measurement in 49 subjects. The "break" method was used for HHD measurements. Reproducibility was studied for six lower extremity muscle groups in 28 subjects. The measurements were performed by one experienced and one inexperienced examiner on two separate occasions, with an interval of 1 week. The examiners were blinded to each other's and to previous results. SETTING: University hospital. SUBJECTS: Volunteer sample of former polio subjects. RESULTS: For knee extension, the forces that could be measured with the HHD were limited to approximately 200N. Although the intraclass correlation coefficients were high (.75 to .98), the 95% limits of agreement between measurements showed large intervals for differences between two measurements (ratio intervals ranging from .76-1.52 to .52-2.77). The intraexaminer reproducibility for the experienced examiner was superior to that of the inexperienced examiner. The reproducibility of the inexperienced examiner showed systematic bias, with significantly higher strength values for the second session measurement of three muscle groups. CONCLUSION: The device has good validity in the lower force range. However, because the agreement between measurements was poor, it has limited ability to detect a change in muscle strength. Therefore, this method is unable to detect small changes in lower extremity muscle strength in former polio patients.

Clinical Competence↗

PubMed2001

Dementia in primary care: why the low detection rate?

OBJECTIVE: The aim of the present study was to find reasons for the low detection rate of dementia in primary care. Another aim was to investigate the attitudes and knowledge on dementia among Swedish general practitioners (GPs). DESIGN: Two-hundred-and-twenty-eight postal questionnaires were distributed to GPs in the county of Ostergötland. SETTING: Primary care in Sweden. MAIN OUTCOME MEASURES: The opinions of GPs on dementia management in primary care. RESULTS: The response rate was 67%. GPs showed a good knowledge of dementia diseases but underestimated the occurrence of dementia. They presented a positive attitude towards managing patients with dementia and considered that existing drug therapy justified an active search for patients with dementia in primary care, but they believed the efficacy of the drugs to be limited. Assessing the social environment of patients and organising social support were regarded as the most difficult tasks in the management of demented patients. CONCLUSION: The study indicates that the main obstacles are a lack of resources and a sceptical attitude to the benefits of drug treatment. Co-operation between the community services, specialist clinics and the primary care team should be improved.

Attitude of Health Personnel↗

PubMed1995

UV-induced photoproducts in human skin explants analysed by TLC and HPLC-radioactivity detection.

The objective of this study was to apply the 32P-postlabelling method for the detection of UV-induced dipyrimidine photoadducts in human skin explants. [32P]TLC and [32P]HPLC analysis were used. These techniques allow detection of different combinations of cyclobutane dimers and 6-4 photoproducts in human skin at low doses of irradiation. Detection limit of the present method for some dinucleotide adducts is < 1 adduct per 10(7) normal nucleotides. Reaction of photochemical reversion of the cyclobutane dimers was performed to confirm the nature of the products detected in human skin explants.

Chromatography, High Pressure Liquid↗

PubMedDate not supplied

Medical inpatients at risk of extended hospital stay and poor discharge health status: detection with COMPRI and INTERMED.

OBJECTIVE: To detect the patients in medical wards at risk of extended LOS and poor discharge health status with the use of complexity prediction instrument (COMPRI) and interdisciplinary medicine (INTERMED) instruments. METHODS: STUDY 1: In a sample of 275 consecutively admitted medical inpatients, a hierarchical cluster analysis on INTERMED variables was performed. The clusters were compared on length of hospital stay (LOS) and Short Form 36 (SF-36) at discharge. STUDY 2: Receiver operating characteristic (ROC) analysis was used to optimal cut-off points for the COMPRI and INTERMED. Patients detected with COMPRI and INTERMED were then compared with undetected patients on LOS and SF-36. RESULTS: STUDY 1: In concordance with previous findings, a cluster of patients with high biopsychosocial vulnerability was identified with significantly higher scores on LOS (p <.05) and lower scores on SF-36 (p <.001) than patients in other clusters. STUDY 2: A cut-off point for the COMPRI of 5/6 was found to detect patients at risk of long LOS. A cut off score for the INTERMED of 20/21 was found to detect patients at risk of poor discharge health status. Patients detected with COMPRI and INTERMED had a significantly longer LOS (p <.001) and a poorer discharge health status (SF-36 MCS: p <.001; SF-36 PCS: p =.05) than nondetected patients. Of the detected patients, 37% had an extended hospital stay and poor discharge health status; of the nondetected patients, this was only 7%. CONCLUSIONS: The COMPRI-INTERMED can help to detect complex patients admitted to medical wards within the first days of admission, and rule out those with a small chance of poor outcomes.

Case Management↗

PubMed1994

Chlamydia trachomatis-specific antibodies in patients with pelvic inflammatory disease: comparison with isolation in tissue culture or detection with polymerase chain reaction.

OBJECTIVE: The detection of acute phase antibodies against C trachomatis and its comparison with tissue culture or polymerase chain reaction (PCR) on samples of cervix and urethra obtained from patients with pelvic inflammatory disease (PID). METHODS: In the academic hospital Dijkzigt, Rotterdam, The Netherlands, prospective investigations were performed on 49 consecutive patients who were admitted with the diagnosis of PID. Infections with C trachomatis were traced using tissue culture, PCR or by determining acute phase IgG and IgM antibodies. Differences between the sensitivities of serology and tissue culture or PCR were calculated using the Fisher exact test. RESULTS: C trachomatis infection was detected more often in PID patients using serology in comparison with PCR (p < 0.05) or tissue culture (p < 0.05). All patients who were positive in tissue culture also had acute phase antibodies. CONCLUSION: The establishing of acute C trachomatis infections in PID patients on the basis of serology was superior to either tissue culture or PCR on samples obtained from cervix and urethra.

Antibodies, Bacterial↗

PubMed2004

Simplified detection of dynamic hyperinflation.

STUDY OBJECTIVE: To detect dynamic hyperinflation by comparing reduction in inspiratory capacity (IC) during both paced hyperventilation and cycle ergometry in patients with moderate-to-severe COPD, studied before and after acute bronchodilation. METHODS: IC and FEV(1) were measured before and after metronome-paced hyperventilation at twice the resting respiratory rate for 20 s in 16 patients with COPD before and after 54 microg aerosolized ipratropium bromide (IB). We also studied the same 16 patients before and after administration of 54 microg aerosolized IB during symptom-limited incremental cycle ergometry when the final respiratory rate was also twice the resting rate. RESULTS: Resting IC was 2.23 +/- 0.53 L (mean +/- SD), and the mean decrease in IC from baseline was 0.36 +/- 0.25 L after exercise (p < 0.001), and not significantly different (p = 0.64) from mean decrease in IC of 0.40 +/- 0.29 L following hyperventilation. Results following hyperventilation and exercise were similar after bronchodilator. The mean difference for decrease of IC between hyperventilation and exercise was 0.138 L (95% confidence interval, - 0.347 to 0.622; r = 0.66, p = 0.006). The decrease in FEV(1) was 0.01 +/- 0.13 L after exercise and 0.06 +/- 0.18 L after hyperventilation. Separately, baseline and peak end-expiratory and end-inspiratory lung volumes were similar with hyperventilation vs exercise both before and after bronchodilator. CONCLUSION: Both metronome-paced hyperventilation and incremental cycle ergometry, when resting respiratory rate was doubled, provoked similar significant decrease in IC, even after administration of 54 microg aerosolized IB. The noninvasive simplicity of hyperventilation for 20 s provides a clinically useful screening surrogate to monitor changes in IC following exercise.

Administration, Inhalation↗

PubMed2004

Using metabolic syndrome traits for efficient detection of impaired glucose tolerance.

OBJECTIVE: Efficient detection of impaired glucose tolerance (IGT) is needed to implement type 2 diabetes prevention interventions. RESEARCH DESIGN AND METHODS: We assessed the capacity of the metabolic syndrome (MetS) to identify IGT in a cross-sectional analysis of 3,326 Caucasian Framingham Offspring Study (FOS), 1,168 Caucasian and 1,812 Mexican-American San Antonio Heart Study (SAHS), 1,983 Mexico City Diabetes Study (MCDS), and 452 Caucasian, 407 Mexican-American, and 290 African-American Insulin Resistance Atherosclerosis Study (IRAS) men and women aged 30-79 years who had a clinical examination and an oral glucose tolerance test (OGTT) during 1987-1996. Those with diabetes treatment or fasting plasma glucose > or =7.0 mmol/l were excluded (MetS was defined by Third Report of the National Cholesterol Education Program's Adult Treatment Panel criteria and IGT as 2-h postchallenge glucose [2hPG] > or =7.8 mmol/l). We calculated positive (PPV) and negative predictive values (NPV), population attributable risk percentages (PAR%), age- and sex-adjusted odds ratios (ORs), and areas under the receiver operating characteristic curve (AROCs) associated with MetS traits. RESULTS: Among FOS, SAHS, and MCDS subjects, 24-43% had MetS and 15-23% had IGT (including 2-5% with 2hPG > or =11.1 mmol/l). Among those with MetS, OR for IGT were 3-4, PPV were 0.24-0.41, NPV were 0.84-0.91, and PAR% were 30-40%. Among subjects with MetS defined by impaired fasting glucose (IFG) and any two other traits, OR for IGT were 9-24, PPV were 0.62-0.89, NPV were 0.78-0.87, and PAR% were 3-12%. Among IRAS subjects, 24-34% had MetS and 37-41% had IGT. Among those with MetS, ORs for IGT were 3-6, PPVs were 0.57-0.73, and NPVs were 0.67-0.72. In logistic regression models, IFG, large waist, and high triglycerides were independently associated with IGT (AROC 0.71-0.83) in all study populations. CONCLUSIONS: The MetS, especially defined by IFG, large waist, and high triglycerides, efficiently identifies subjects likely to have IGT on OGTT and thus be eligible for diabetes prevention interventions.

Cross-Sectional Studies↗

PubMed1999

[Alternatives to population screening for breast cancer. Is the chance detection useful?].

OBJECTIVES: 1. To evaluate the characteristics of the demand, coverage and acceptability of random detection of breast cancer at a health centre (HC) between January 1995 and December 1996. 2. To describe the cases of breast cancer diagnosed since the setting up in 1988 of random demands for screening mammographies. DESIGN: Crossover study. SETTING: La Mina Primary Care Centre, Barcelona. PATIENTS: A sample of 340 women of a population of 2796 women between 45 and 75 with a clinical history at the HC were studied. MEASUREMENTS AND MAIN RESULTS: The profile of women with neoplasms was: aged 59 +/- 8.5; 279 women attended, 273 medicine, 132 medicine and gynaecology, and 6 gynaecology. Mammographies requested were: 143 (118 through gynaecology, 12 medicine and 13 outside the centre), which was 51% of women who attended and 42% of the sample. The reason for mammography was screening (129) and symptoms (14). Screening mammographies actually done (acceptance) were 116 out of 129 (90%). Sample coverage was 34% (116/340); and 42% of the women who attended (116/279). Most studied age-group was 50-64 (coverage 45%, n = 176). 11 cases of breast cancer were diagnosed: age 54.3 +/- 9.1; 1 in situ, 3 < 10 mm, 2 between 10 and 20 mm, 4 > 20 mm, 1 without data. Diagnosis to treatment delay: 33.7 +/- 0 days. At time of writing 8 women were free of illness. CONCLUSIONS: Through random detection 34% coverage was achieved with good acceptance. Most neoplasms are diagnosed in their early stages. The general practitioner should be more attentive to periodic requests for mammographies.

Aged↗

PubMed2005

[Influence of mannitol on cerebral blood flow of post-resuscitation children as detected by transcranial Doppler ultrasound].

OBJECTIVE: To detect the influence of mannitol on cerebral blood flow of post-resuscitation children by transcranial Doppler (TCD). METHODS: The blood flow changes of left side middle cerebral artery (MCA) and extracranial internal carotid artery (EICA) were monitored by TCD in 21 post-resuscitation children. TCD waveforms, peak velocity (Vp), diastolic velocity (Vd), mean velocity (Vm) and pulsitility index (PI) of MCA and EICA were monitored daily and 30 minutes before and after the first dose of mannitol. Glasgow scores were estimated in the meantime. The patients were divided into 2 groups according to the patterns of diastolic flow. Patients in group I showed no diastolic flow or retrograde diastolic flow (n = 9), and patients in group II had positive diastolic flow (n = 12). RESULTS: Vp, Vd, Vm, PI of MCA and EICA in group I patients had no significant change after the administration of mannitol and the Glasgow scores were much lower than that of group II patients (P < 0.05). TCD waveforms showed no improvement in group I patients and their outcomes were poor. Vd, Vm and Vp of MCA and Vd of EICA in group II patients increased, PI of MCA decreased (P < 0.05), while Vp, Vm, PI of EICA had no significant change. TCD waveforms recovered within one week. All the patients in this group survived. CONCLUSIONS: The results suggested that mannitol could improve cerebral perfusion in patients with mild brain damage. These patients usually had increased diastolic blood flow in the early stage. Lack of or retrograde diastolic flow of TCD waveforms might be associated with severe brain damage with poor outcome. Mannitol had no effect on improving cerebral blood flow in these patients.

Adolescent↗