CEUS LI-RADS: a pictorial review

Contrast-enhanced ultrasound (CEUS) greatly improved the diagnostic accuracy of US in the detection and characterization of focal liver lesions (FLLs), and it is suggested and often included in many international guidelines as an important diagnostic tool in the imaging work-up of cirrhotic patients at risk for developing hepatocellular carcinoma (HCC). In particular, CEUS Liver Imaging Reporting and Data System (LI-RADS) provides standardized terminology, interpretation, and reporting for the diagnosis of HCC. The aim of this pictorial essay is to illustrate CEUS features of nodules discovered at US in cirrhotic liver according to LI-RADS categorization

Standardized EEG interpretation accurately predicts prognosis after cardiac arrest.

OBJECTIVE: To identify reliable predictors of outcome in comatose patients after cardiac arrest using a single routine EEG and standardized interpretation according to the terminology proposed by the American Clinical Neurophysiology Society. METHODS: In this cohort study, 4 EEG specialists, blinded to outcome, evaluated prospectively recorded EEGs in the Target Temperature Management trial (TTM trial) that randomized patients to 33°C vs 36°C. Routine EEG was performed in patients still comatose after rewarming. EEGs were classified into highly malignant (suppression, suppression with periodic discharges, burst-suppression), malignant (periodic or rhythmic patterns, pathological or nonreactive background), and benign EEG (absence of malignant features). Poor outcome was defined as best Cerebral Performance Category score 3-5 until 180 days. RESULTS: Eight TTM sites randomized 202 patients. EEGs were recorded in 103 patients at a median 77 hours after cardiac arrest; 37% had a highly malignant EEG and all had a poor outcome (specificity 100%, sensitivity 50%). Any malignant EEG feature had a low specificity to predict poor prognosis (48%) but if 2 malignant EEG features were present specificity increased to 96% (p < 0.001). Specificity and sensitivity were not significantly affected by targeted temperature or sedation. A benign EEG was found in 1% of the patients with a poor outcome. CONCLUSIONS: Highly malignant EEG after rewarming reliably predicted poor outcome in half of patients without false predictions. An isolated finding of a single malignant feature did not predict poor outcome whereas a benign EEG was highly predictive of a good outcome

On systematic approaches for interpreted information transfer of inspection data from bridge models to structural analysis

In conjunction with the improved methods of monitoring damage and degradation processes, the interest in reliability assessment of reinforced concrete bridges is increasing in recent years. Automated imagebased inspections of the structural surface provide valuable data to extract quantitative information about deteriorations, such as crack patterns. However, the knowledge gain results from processing this information in a structural context, i.e. relating the damage artifacts to building components. This way, transformation to structural analysis is enabled. This approach sets two further requirements: availability of structural bridge information and a standardized storage for interoperability with subsequent analysis tools. Since the involved large datasets are only efficiently processed in an automated manner, the implementation of the complete workflow from damage and building data to structural analysis is targeted in this work. First, domain concepts are derived from the back-end tasks: structural analysis, damage modeling, and life-cycle assessment. The common interoperability format, the Industry Foundation Class (IFC), and processes in these domains are further assessed. The need for usercontrolled interpretation steps is identified and the developed prototype thus allows interaction at subsequent model stages. The latter has the advantage that interpretation steps can be individually separated into either a structural analysis or a damage information model or a combination of both. This approach to damage information processing from the perspective of structural analysis is then validated in different case studies

Electrical-power-system data base for consumables analysis. Volume 1: Electrical equipment list, activity blocks, and time lines

A standardized data base is described which consists of a space shuttle electrical equipment list, activity blocks defining electrical equipment utilization, and activity-block time lines for specific mission analyses. Information is presented to facilitate utilization of the data base, to provide the basis for the electrical equipment utilization to enable interpretation of analyses based on the data contained herein

Design of a (mini) wide plate specimen for strain-based weld integrity assessment

Wide plate tension tests are commonly executed to investigate the integrity of defective welds under a uniaxial load. The specimen can be flat or curved, depending on the geometry from which it has been extracted (plate or pipe). Despite its usefulness, the design of the (curved) wide plate test is still not standardized up-to-date. This paper compares two specimen designs with a different length-to-width ratio through finite element analysis, using a design-of-experiments approach to account for different influential factors. The results reveal significant differences between the interpretation of tests with net section collapse and gross section collapse, promoted by weld strength overmatch. Further, both investigated designs tend to provide similar estimates of failure mode, strain capacity and crack driving force. Hence, the shorter specimen is considered an acceptable alternative to the slightly more representative longer specimen

Bank Accounting Standards in Mexico. A layman’s guide to changes 10 years after the 1995 bank crisis

After the 1995 crisis, the Mexican banking system experienced significant changes in bank accounting standards. Most of these changes took place between 1996 and 2001, and had a significant impact in the structure and interpretation of financial information of banks. This document explains the major changes on bank accounting, their purpose and structure, and discusses their impact on financial information reported by Mexican banks. It also provides the English equivalent of the major accounting terms used by Mexican banks. The main purpose of this document is to provide a standardized guide to better understand financial information produced before and after the crisis, within the current context of internationalization of Mexican banks' ownership.

Technical pre-analytical effects on the clinical biochemistry of Atlantic salmon (Salmo salar L.)

Clinical biochemistry has long been utilized in human and veterinary medicine as a vital diagnostic tool, but despite occasional studies showing its usefulness in monitoring health status in Atlantic salmon (Salmo salar L.), it has not yet been widely utilized within the aquaculture industry. This is due, in part, to a lack of an agreed protocol for collection and processing of blood prior to analysis. Moreover, while the analytical phase of clinical biochemistry is well controlled, there is a growing understanding that technical pre-analytical variables can influence analyte concentrations or activities. In addition, post-analytical interpretation of treatment effects is variable in the literature, thus making the true effect of sample treatment hard to evaluate. Therefore, a number of pre-analytical treatments have been investigated to examine their effect on analyte concentrations and activities. In addition, reference ranges for salmon plasma biochemical analytes have been established to inform veterinary practitioners and the aquaculture industry of the importance of clinical biochemistry in health and disease monitoring. Furthermore, a standardized protocol for blood collection has been proposed

Radiographers supporting radiologists in the interpretation of screening mammography: a viable strategy to meet the shortage in the number of radiologists.

BackgroundAn alternative approach to the traditional model of radiologists interpreting screening mammography is necessary due to the shortage of radiologists to interpret screening mammograms in many countries.MethodsWe evaluated the performance of 15 Mexican radiographers, also known as radiologic technologists, in the interpretation of screening mammography after a 6 months training period in a screening setting. Fifteen radiographers received 6 months standardized training with radiologists in the interpretation of screening mammography using the Breast Imaging Reporting and Data System (BI-RADS) system. A challenging test set of 110 cases developed by the Breast Cancer Surveillance Consortium was used to evaluate their performance. We estimated sensitivity, specificity, false positive rates, likelihood ratio of a positive test (LR+) and the area under the subject-specific Receiver Operating Characteristic (ROC) curve (AUC) for diagnostic accuracy. A mathematical model simulating the consequences in costs and performance of two hypothetical scenarios compared to the status quo in which a radiologist reads all screening mammograms was also performed.ResultsRadiographer's sensitivity was comparable to the sensitivity scores achieved by U.S. radiologists who took the test but their false-positive rate was higher. Median sensitivity was 73.3 % (Interquartile range, IQR: 46.7-86.7 %) and the median false positive rate was 49.5 % (IQR: 34.7-57.9 %). The median LR+ was 1.4 (IQR: 1.3-1.7 %) and the median AUC was 0.6 (IQR: 0.6-0.7). A scenario in which a radiographer reads all mammograms first, and a radiologist reads only those that were difficult for the radiographer, was more cost-effective than a scenario in which either the radiographer or radiologist reads all mammograms.ConclusionsGiven the comparable sensitivity achieved by Mexican radiographers and U.S. radiologists on a test set, screening mammography interpretation by radiographers appears to be a possible adjunct to radiologists in countries with shortages of radiologists. Further studies are required to assess the effectiveness of different training programs in order to obtain acceptable screening accuracy, as well as the best approaches for the use of non-physician readers to interpret screening mammography

Mapping standard for sprint orienteering: standardized competition maps for urban, park and forest areas

Orienteering maps are one of the map products where the symbol set is standardized, no national deviations are allowed. Orienteering has developed a new form of competition which was originally held in parks or urban areas. This competition form is a very short and fast event where good media coverage is possible. The use of parks and urban areas has a significant advantage: it brings the sport into the midst of people and offers opportunities for increasing public and media awareness of orienteering. The international specification for traditional orienteering maps contains symbols for man-made features. However, the symbol set needed revision and extension in order to provide a clear and unambiguous interpretation of urban terrain required for fair competition in sprint orienteering. There are a number of reasons why the mapping of urban areas needs a modified approach compared to that used for the depiction of the 'classic' forested terrain