Forensic comparison of fired cartridge cases: Feature-extraction methods for feature-based calculation of likelihood ratios

We describe and validate a feature-based system for calculation of likelihood ratios from 3D digital images of fired cartridge cases. The system includes a database of 3D digital images of the bases of 10 cartridges fired per firearm from approximately 300 firearms of the same class (semi-automatic pistols that fire 9 mm diameter centre-fire Luger-type ammunition, and that have hemispherical firing pins and parallel breech-face marks). The images were captured using Evofinder®, an imaging system that is commonly used by operational forensic laboratories. A key component of the research reported is the comparison of different feature-extraction methods. Feature sets compared include those previously proposed in the literature, plus Zernike-moment based features. Comparisons are also made of using feature sets extracted from the firing-pin impression, from the breech-face region, and from the whole region of interest (firing-pin impression + breech-face region + flowback if present). Likelihood ratios are calculated using a statistical modelling pipeline that is standard in forensic voice comparison. Validation is conducted and results are assessed using validation procedures and validation metrics and graphics that are standard in forensic voice comparison

Pancreatic lipase immunoreactivity in serum of dogs with diabetic ketoacidosis

BACKGROUND : Diabetic ketoacidosis (DKA) is a relatively common endocrine disorder in dogs and is routinely associated with concurrent pancreatic injury. OBJECTIVES : The aims of this study were to determine the prevalence of pancreatic injury in dogs with DKA based on measurement of pancreatic lipase immunoreactivity in serum (PLI); compare demographic, clinicopathologic, and ultrasonographic findings in dogs with and without evidence of concurrent pancreatic injury; determine the impact of pancreatic injury on duration of hospitalization and short-term outcome. ANIMALS : One hundred and nineteen dogs with DKA with or without concurrent pancreatic injury. METHODS : Retrospective study. Dogs with DKA were divided into three groups on the basis of PLI results: positive for pancreatic injury (PLIpos), negative for pancreatic injury (PLIneg), and not tested (PLIna). Demographics, clinicopathologic test results, findings on abdominal ultrasonography (AUS), duration of hospitalization, and short-term outcome were compared between the three groups. RESULTS : Based on serum PLI activity, 45 dogs (73%) with DKA had evidence of concurrent pancreatic injury. Median total carbon dioxide was significantly lower in the PLIpos dogs compared to the PLIneg dogs. There was fair agreement (j = 0.26) between serum PLI activity and AUS. Evidence of pancreatic injury was not associated with significantly longer periods of hospitalization (PLIpos median 6 days, range 4–7 days, PLIneg median 4 days, range 3–6 days) and did not influence short-term outcome (PLIpos failure to survive to discharge 11/45, 24%, PLIneg failure to survive to discharge 2/17, 12%). CLINICAL IMPORTANCE : Concurrent pancreatic injury is common in dogs with DKA, but did not affect prognosis in this population of dogs.http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1939-1676hb2017Production Animal Studie

Forensic comparison of fired cartridge cases: Feature-extraction methods for feature-based calculation of likelihood ratios

We describe and validate a feature-based system for calculation of likelihood ratios from 3D digital images of fired cartridge cases. The system includes a database of 3D digital images of the bases of 10 cartridges fired per firearm from approximately 300 firearms of the same class (semi-automatic pistols that fire 9 mm diameter centre-fire Luger-type ammunition, and that have hemispherical firing pins and parallel breech-face marks). The images were captured using Evofinder®, an imaging system that is commonly used by operational forensic laboratories. A key component of the research reported is the comparison of different feature-extraction methods. Feature sets compared include those previously proposed in the literature, plus Zernike-moment based features. Comparisons are also made of using feature sets extracted from the firing-pin impression, from the breech-face region, and from the whole region of interest (firing-pin impression + breech-face region + flowback if present). Likelihood ratios are calculated using a statistical modelling pipeline that is standard in forensic voice comparison. Validation is conducted and results are assessed using validation procedures and validation metrics and graphics that are standard in forensic voice comparison

Patterns of pharmacotherapies used to treat alcohol use disorders: A population-based administrative data study

Introduction Alcohol use disorders (AUDs) – mental and/or physical health diagnoses due to harmful alcohol consumption – are associated with compromised quality of life for the individual. Over the past two decades, pharmacotherapies have been developed to treat alcohol addiction and may help mitigate the harmful outcomes linked with excessive alcohol. Objectives and Approach The objectives were to examine the pharmacotherapy dispensation patterns among individuals with an AUD and their mental health comorbidities. We used ICD codes from medical claims and hospital discharge data to identify anyone with a physical / mental health diagnosis due to harmful alcohol consumption – AUD, April 1, 1996-March 31, 2015. We identified mental health comorbidities using administrative health records. Drug dispensation data were used to identify all first-time prescriptions for acamprosate, naltrexone, or disulfiram occurring after an initial AUD diagnosis. Generalized linear models tested for predictors of receiving a prescription and to identify differences in mental health comorbidities. Results We identified 53,556 treatment niave individuals with an AUD who were eligible to receive one of these three prescriptions. 493 of these received a prescription for acamprosate, naltrexone, or disulfiram. The majority of prescriptions came from general practitioners from urban centers. Those with a prescription were significantly more likely to have a comorbid mood or anxiety diagnosis. Those with a prescription were more likely to have a physician visit for a mental health issue a year to two years before diagnosis compared with those who did not have a prescription; and, they were more likely to be dispensed a selective serotonin, a sedative, and an anti-anxiety medication prior to receiving an AUD diagnosis. Conclusion/Implications Drug therapies to aid in the recovery from AUD are being underutilized. Diagnosis of and treatment for mental health disorders is more common among those dispensed these medications. Programs that study clinicians’ use of AUD-targeted drug therapies should be considered, while psychiatric services in addiction care require significant improvement

International EANM-SNMMI-ISMRM consensus recommendation for PET/MRI in oncology

The Society of Nuclear Medicine and Molecular Imaging (SNMMI) is an international scientific and professional organization founded in 1954 to promote the science, technology, and practical application of nuclear medicine. The European Association of Nuclear Medicine (EANM) is a professional non-profit medical association that facilitates communication worldwide between individuals pursuing clinical and research excellence in nuclear medicine. The EANM was founded in 1985. The merged International Society for Magnetic Resonance in Medicine (ISMRM) is an international, nonprofit, scientific association whose purpose is to promote communication, research, development, and applications in the field of magnetic resonance in medicine and biology and other related topics and to develop and provide channels and facilities for continuing education in the field.The ISMRM was founded in 1994 through the merger of the Society of Magnetic Resonance in Medicine and the Society of Magnetic Resonance Imaging. SNMMI, ISMRM, and EANM members are physicians, technologists, and scientists specializing in the research and practice of nuclear medicine and/or magnetic resonance imaging. The SNMMI, ISMRM, and EANM will periodically define new guidelines for nuclear medicine practice to help advance the science of nuclear medicine and/or magnetic resonance imaging and to improve the quality of service to patients throughout the world. Existing practice guidelines will be reviewed for revision or renewal, as appropriate, on their fifth anniversary or sooner, if indicated. Each practice guideline, representing a policy statement by the SNMMI/EANM/ISMRM, has undergone a thorough consensus process in which it has been subjected to extensive review. The SNMMI, ISMRM, and EANM recognize that the safe and effective use of diagnostic nuclear medicine imaging and magnetic resonance imaging requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guideline by those entities not providing these services is not authorized. These guidelines are an educational tool designed to assist practitioners in providing appropriate care for patients. They are not inflexible rules or requirements of practice and are not intended, nor should they be used, to establish a legal standard of care. For these reasons and those set forth below, the SNMMI, the ISMRM, and the EANM caution against the use of these guidelines in litigation in which the clinical decisions of a practitioner are called into question. The ultimate judgment regarding the propriety of any specific procedure or course of action must be made by the physician or medical physicist in light of all the circumstances presented. Thus, there is no implication that an approach differing from the guidelines, standing alone, is below the standard of care. To the contrary, a conscientious practitioner may responsibly adopt a course of action different from that set forth in the guidelines when, in the reasonable judgment of the practitioner, such course of action is indicated by the condition of the patient, limitations of available resources, or advances in knowledge or technology subsequent to publication of the guidelines. The practice of medicine includes both the art and the science of the prevention, diagnosis, alleviation, and treatment of disease. The variety and complexity of human conditions make it impossible to always reach the most appropriate diagnosis or to predict with certainty a particular response to treatment. Therefore, it should be recognized that adherence to these guidelines will not ensure an accurate diagnosis or a successful outcome. All that should be expected is that the practitioner will follow a reasonable course of action based on current knowledge, available resources, and the needs of the patient to deliver effective and safe medical care. The sole purpose of these guidelines is to assist practitioners in achieving this objective

ECCO essential requirements for quality cancer care : Oesophageal and gastric cancer

Background: ECCO essential requirements for quality cancer care (ERQCC) are checklists and explanations of organisation and actions that are necessary to give high-quality care to patients who have a specific type of cancer. They are written by European experts representing all disciplines involved in cancer care. ERQCC papers give oncology teams, patients, policymakers and managers an overview of the elements needed in any healthcare system to provide high quality of care throughout the patient journey. References are made to clinical guidelines and other resources where appropriate, and the focus is on care in Europe. Oesophageal and gastric: essential requirements for quality care: Oesophageal and gastric (OG) cancers are a challenging tumour group with a poor prognosis and wide variation in outcomes among European countries. Increasing numbers of older people are contracting the diseases, and treatments and care pathways are becoming more complex in both curative and palliative settings. High-quality care can only be a carried out in specialised OG cancer units or centres which have both a core multidisciplinary team and an extended team of allied professionals, and which are subject to quality and audit procedures. Such units or centres are far from universal in all European countries. It is essential that, to meet European aspirations for comprehensive cancer control, healthcare organisations implement the essential requirements in this paper, paying particular attention to multidisciplinarity and patient-centred pathways from diagnosis, to treatment, to survivorship. Conclusion: Taken together, the information presented in this paper provides a comprehensive description of the essential requirements for establishing a high-quality OG cancer service. The ERQCC expert group is aware that it is not possible to propose a one size fits all' system for all countries, but urges that access to multidisciplinary units or centres must be guaranteed for all those with OG cancer.Peer reviewe

ECCO Essential Requirements for Quality Cancer Care : Colorectal Cancer. A critical review

Background: ECCO essential requirements for quality cancer care (ERQCC) are checklists and explanations of organisation and actions that are necessary to give high-quality care to patients who have a specific tumour type. They are written by European experts representing all disciplines involved in cancer care. ERQCC papers give oncology teams, patients, policymakers and managers an overview of the elements needed in any healthcare system to provide high quality of care throughout the patient journey. References are made to clinical guidelines and other resources where appropriate, and the focus is on care in Europe. Colorectal cancer: essential requirements for quality care Colorectal cancer (CRC) is the second most common cause of cancer death in Europe and has wide variation in outcomes among countries. Increasing numbers of older people are contracting the disease, and treatments for advanced stages are becoming more complex. A growing number of survivors also require specialist support. High-quality care can only be a carried out in specialised CRC units or centres which have both a core multidisciplinary team and an extended team of allied professionals, and which are subject to quality and audit procedures. Such units or centres are far from universal in all European countries. It is essential that, to meet European aspirations for comprehensive cancer control, healthcare organisations implement the essential requirements in this paper, paying particular attention to multidisciplinarity and patient-centred pathways from diagnosis, to treatment, to survivorship. Conclusion: Taken together, the information presented in this paper provides a comprehensive description of the essential requirements for establishing a high-quality CRC service. The ECCO expert group is aware that it is not possible to propose a 'one size fits all' system for all countries, but urges that access to multidisciplinary units or centres must be guaranteed for all those with CRC. (C) 2016 The Authors. Published by Elsevier Ireland Ltd.Peer reviewe

Dressings and securements for the prevention of peripheral intravenous catheter failure in adults (SAVE): a pragmatic, randomised controlled, superiority trial

Background: Two billion peripheral intravenous catheters (PIVCs) are used globally each year, but optimal dressing and securement methods are not well established. We aimed to compare the efficacy and costs of three alternative approaches to standard non-bordered polyurethane dressings. Methods: We did a pragmatic, randomised controlled, parallel-group superiority trial at two hospitals in Queensland, Australia. Eligible patients were aged 18 years or older and required PIVC insertion for clinical treatment, which was expected to be required for longer than 24 h. Patients were randomly assigned (1:1:1:1) via a centralised web-based randomisation service using random block sizes, stratified by hospital, to receive tissue adhesive with polyurethane dressing, bordered polyurethane dressing, a securement device with polyurethane dressing, or polyurethane dressing (control). Randomisation was concealed before allocation. Patients, clinicians, and research staff were not masked because of the nature of the intervention, but infections were adjudicated by a physician who was masked to treatment allocation. The primary outcome was all-cause PIVC failure (as a composite of complete dislodgement, occlusion, phlebitis, and infection [primary bloodstream infection or local infection]). Analysis was by modified intention to treat. This trial is registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12611000769987. Findings: Between March 18, 2013, and Sept 9, 2014, we randomly assigned 1807 patients to receive tissue adhesive with polyurethane (n=446), bordered polyurethane (n=454), securement device with polyurethane (n=453), or polyurethane (n=454); 1697 patients comprised the modified intention-to-treat population. 163 (38%) of 427 patients in the tissue adhesive with polyurethane group (absolute risk difference −4·5% [95% CI −11·1 to 2·1%], p=0·19), 169 (40%) of 423 of patients in the bordered polyurethane group (–2·7% [–9·3 to 3·9%] p=0·44), 176 (41%) of 425 patients in the securement device with poplyurethane group (–1·2% [–7·9% to 5·4%], p=0·73), and 180 (43%) of 422 patients in the polyurethane group had PIVC failure. 17 patients in the tissue adhesive with polyurethane group, two patients in the bordered polyurethane group, eight patients in the securement device with polyurethane group, and seven patients in the polyurethane group had skin adverse events. Total costs of the trial interventions did not differ significantly between groups. Interpretation: Current dressing and securement methods are commonly associated with PIVC failure and poor durability, with simultaneous use of multiple products commonly required. Cost is currently the main factor that determines product choice. Innovations to achieve effective, durable dressings and securements, and randomised controlled trials assessing their effectiveness are urgently needed

Challenges of the transition to a low carbon, more electric future:From here to 2050

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