Abstract gepubliceerd in Elsevier: Introduction: Recent research has identified the issue of ‘dose creep’ in diagnostic radiography and claims it is due to the introduction of CR and DR technology. More recently radiographers have reported that they do not regularly manipulate exposure factors for different sized patients and rely on pre-set exposures. The aim of the study was to identify any variation in knowledge and radiographic practice across Europe when imaging the chest, abdomen and pelvis using digital imaging. Methods: A random selection of 50% of educational institutes (n ¼ 17) which were affiliated members of the European Federation of Radiographer Societies (EFRS) were contacted via their contact details supplied on the EFRS website. Each of these institutes identified appropriate radiographic staff in their clinical network to complete an online survey via SurveyMonkey. Data was collected on exposures used for 3 common x-ray examinations using CR/DR, range of equipment in use, staff educational training and awareness of DRL. Descriptive statistics were performed with the aid of Excel and SPSS version 21. Results: A response rate of 70% was achieved from the affiliated educational members of EFRS and a rate of 55% from the individual hospitals in 12 countries across Europe. Variation was identified in practice when imaging the chest, abdomen and pelvis using both CR and DR digital systems. There is wide variation in radiographer training/education across countries.
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The purpose of this article is the presentation of a multidimensional guideline for the diagnosis of anxiety and anxiety-related behavior problems in people with intellectual disability (ID), with a substantial role for the nurse in this diagnostic process. DESIGN AND METHODS: The guideline is illustrated by a case report of a woman with ID with severe problems. FINDINGS: It appears that a multidimensional diagnostic approach involving multidisciplinary team efforts can result in a more accurate diagnosis and improved subsequent treatment. PRACTICE IMPLICATIONS: Nurses should be engaged in the diagnostic process because of their ability to make direct observations and to actively participate in carrying out all parts of the guideline.
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This report presents the highlights of the 7th European Meeting on Molecular Diagnostics held in Scheveningen, The Hague, The Netherlands, 12-14 October 2011. The areas covered included molecular diagnostics applications in medical microbiology, virology, pathology, hemato-oncology,clinical genetics and forensics. Novel real-time amplification approaches, novel diagnostic applications and new technologies, such as next-generation sequencing, PCR lectrospray-ionization TOF mass spectrometry and techniques based on the detection of proteins or other molecules, were discussed. Furthermore, diagnostic companies presented their future visions for molecular diagnostics in human healthcare.
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Production processes can be made ‘smarter’ by exploiting the data streams that are generated by the machines that are used in production. In particular these data streams can be mined to build a model of the production process as it was really executed – as opposed to how it was envisioned. This model can subsequently be analyzed and stress-tested to explore possible causes of production prob-lems and to analyze what-if scenarios, without disrupting the production process itself. It has been shown that such models can successfully be used to diagnose possible causes of production problems, including scrap products and machine defects. Ideally, they can even be used to model and analyze production processes that have not been implemented yet, based on data from existing production pro-cesses and techniques from artificial intelligence that can predict how the new process is likely to be-have in practice in terms of data that its machines generate. This is especially important in mass cus-tomization processes, where the process to create each product may be unique, and can only feasibly be tested using model- and data-driven techniques like the one proposed in this project. Against this background, the goal of this project is to develop a method and toolkit for mining, mod-elling and analyzing production processes, using the time series data that is generated by machines, to: (i) analyze the performance of an existing production process; (ii) diagnose causes of production prob-lems; and (iii) certify that a new – not yet implemented – production process leads to high-quality products. The method is developed by researching and combining techniques from the area of Artificial Intelli-gence with techniques from Operations Research. In particular, it uses: process mining to relate time series data to production processes; queueing networks to determine likely paths through the produc-tion processes and detect anomalies that may be the cause of production problems; and generative adversarial networks to generate likely future production scenarios and sample scenarios of production problems for diagnostic purposes. The techniques will be evaluated and adapted in implementations at the partners from industry, using a design science approach. In particular, implementations of the method are made for: explaining production problems; explaining machine defects; and certifying the correct operation of new production processes.
Routine neuropathology diagnostic methods are limited to histological staining techniques or directed PCR for pathogen detection and microbial cultures of brain abscesses are negative in one-third of the cases. Fortunately, due to improvements in technology, metagenomic sequencing of a conserved bacterial gene could provide an alternative diagnostic method. For histopathological work up, formalin-fixed paraffin-embedded (FFPE) tissue with highly degraded nucleic acids is the only material being available. Innovative amplicon-specific next-generation sequencing (NGS) technology has the capability to identify pathogens based on the degraded DNA within a few hours. This approach significantly accelerates diagnostics and is particularly valuable to identify challenging pathogens. This ensures optimal treatment for the patient, minimizing unnecessary health damage. Within this project, highly conserved primers in a universal PCR will be used, followed by determining the nucleotide sequence. Based on the obtained data, it is then precisely determined which microorganism(s) is/are responsible for the infection, even in cases of co-infection with multiple pathogens. This project will focus to answer the following research question; how can a new form of rapid molecular diagnostics contribute to the identification of microbial pathogens in CNS infections? The SME partner Molecular Biology Systems B.V. (MBS) develops and sells equipment for extremely rapid execution of the commonly used PCR. In this project, the lectorate Analysis Techniques in the Life Sciences (Avans) will, in collaboration with MBS, Westerdijk Institute (WI-KNAW) and the Institute of Neuropathology (Münster, DE) establish a new molecular approach for fast diagnosis within CNS infections using this MBS technology. This enables the monitoring of infectious diseases in a fast and user-friendly manner, resulting in an improved treatment plan.
New innovative methods to determine the DNA sequences of different bacterial species are rising. In the field of microbiology, these methods are very important since it is now possible to determine all the genetic characteristics of the bacterium in one step! This enables to define e.g. the species family, drug resistance or relatedness to other bacteria in outbreak evaluations which is necessary to efficiently treat the bacteria or target potential outbreaks. For many years, PCR-based methods have been the technique of choice to determine DNA sequences (including next-generation sequencing techniques). Recently, a new technique has been introduced to the market that is based on single molecule real-time sequencing (SMRT) with the possibility to determine the DNA sequence of a bacterium. This SMRT MinION sequencing technique is housed on an USB stick and is known for its user-friendliness and huge data output. However, before such a new technique can be implemented and presented in laboratories and used for educational purposes, methods should be harmonized and evaluated to proof its applicability. Harmonisation of the methodology regarding new laboratory techniques is very important to be able to compare results generated by different laboratories. A single consistent protocol, applied in each lab, is essential to obtain the best results in interlaboratory comparisons. During this KIEM-hbo project, we – i.e. Avans UAS, Maastricht University Medical Center and the company IS-diagnostics – will determine the DNA sequence of bacterial species and mixes thereof with a harmonized protocol for an interlaboratory comparison. We will compare this technique to the IS-PRO, an existing technology. Finally a workshop will be organized for medical technicians and other SMRT sequencing users to evaluate the protocols. This will, generate an up-to-date and harmonized sequencing protocol which can be expanded to future research and diagnostics in the different areas.
