Retrospective Analysis of Emergency Department Ultrasound for Acute Appendicitis

OBJECTIVES: To determine whether emergency physicians (EPs) who have skills in the other applications of ultrasound can apply these in appendicitis diagnosis. METHODS: EPs did not have focused training in bedside ultrasound for appendicitis. We identified patients receiving an ED bedside ultrasound evaluation for appendicitis from our ultrasound log. Criterion reference was radiology ultrasound (RUS), CT scan, or pathology report. RESULTS: We performed 155 ED ultrasounds for appendicitis. There were 27/155 cases where the ED ultrasound was true positive and agreed with pathology (sensitivity = 39%, 95% CI 28 – 52%). In 42/155 (27%) the ED ultrasound was non-diagnostic (false negative) with pathology positive. In 77 cases the ED ultrasound was true negative with non-visualization of the appendix in concert with non-visualization by RUS or CT scan (specificity = 90%, 95% CI 81-95%). In nine cases (6%), ED ultrasound was falsely positive, compared to CT scan with surgical consult. CONCLUSION: ED ultrasound by EPs prior to focused appendicitis ultrasound training is insufficiently accurate

Clinical Characteristics and Major Adverse Cardiovascular Events in Diabetic and Non-Diabetic Patients with Vasospastic Angina [Response to Letter]

Hiroki Teragawa, Yuko Uchimura, Chikage Oshita, Yu Hashimoto, Shuichi Nomura Department of Cardiovascular Medicine, JR Hiroshima Hospital, Hiroshima, JapanCorrespondence: Hiroki Teragawa, Department of Cardiovascular Medicine, JR Hiroshima Hospital, 3-1-36 Futabanosato, Higashi-ku, Hiroshima, 732-0057, Japan, Tel +81 82 262 1171, Fax +81 82 262 1499, Email [email protected]

Vision based referee sign language recognition system for the RoboCup MSL league

In RoboCup Middle Size league (MSL) the main referee uses assisting technology, controlled by a second referee, to support him, in particular for conveying referee decisions for robot players with the help of a wireless communication system. In this paper a vision-based system is introduced, able to interpret dynamic and static gestures of the referee, thus eliminating the need for a second one. The referee's gestures are interpreted by the system and sent directly to the Referee Box, which sends the proper commands to the robots. The system is divided into four modules: a real time hand tracking and feature extraction, a SVM (Support Vector Machine) for static hand posture identification, an HMM (Hidden Markov Model) for dynamic unistroke hand gesture recognition, and a FSM (Finite State Machine) to control the various system states transitions. The experimental results showed that the system works very reliably, being able to recognize the combination of gestures and hand postures in real-time. For the hand posture recognition, with the SVM model trained with the selected features, an accuracy of 98,2% was achieved. Also, the system has many advantages over the current implemented one, like avoiding the necessity of a second referee, working on noisy environments, working on wireless jammed situations. This system is easy to implement and train and may be an inexpensive solution

Vision-based portuguese sign language recognition system

Vision-based hand gesture recognition is an area of active current research in computer vision and machine learning. Being a natural way of human interaction, it is an area where many researchers are working on, with the goal of making human computer interaction (HCI) easier and natural, without the need for any extra devices. So, the primary goal of gesture recognition research is to create systems, which can identify specific human gestures and use them, for example, to convey information. For that, vision-based hand gesture interfaces require fast and extremely robust hand detection, and gesture recognition in real time. Hand gestures are a powerful human communication modality with lots of potential applications and in this context we have sign language recognition, the communication method of deaf people. Sign lan- guages are not standard and universal and the grammars differ from country to coun- try. In this paper, a real-time system able to interpret the Portuguese Sign Language is presented and described. Experiments showed that the system was able to reliably recognize the vowels in real-time, with an accuracy of 99.4% with one dataset of fea- tures and an accuracy of 99.6% with a second dataset of features. Although the im- plemented solution was only trained to recognize the vowels, it is easily extended to recognize the rest of the alphabet, being a solid foundation for the development of any vision-based sign language recognition user interface system

A web server for interactive and zoomable Chaos Game Representation images

Chaos Game Representation (CGR) is a generalized scale-independent Markov transition table, which is useful for the visualization and comparative study of genomic signature, or for the study of characteristic sequence motifs. However, in order to fully utilize the scale-independent properties of CGR, it should be accessible through scale-independent user interface instead of static images. Here we describe a web server and Perl library for generating zoomable CGR images utilizing Google Maps API, which is also easily searchable for specific motifs. The web server is freely accessible at , and the Perl library as well as the source code is distributed with the G-language Genome Analysis Environment under GNU General Public License

The First Result of Global Commissioning of the ATLAS Endcap Muon Trigger System in ATLAS Cavern

We report on the ATLAS commissioning run from the view point of the Thin Gap Chamber (TGC), which is the ATLAS end cap muon trigger detector. All the TGC sectors with on-detector electronics are going to be installed to the ATLAS cavern by the end of September 2007. To integrate all sub-detectors before the physics run starting from early 2008, the global commissioning run together with other sub-detectors has been performed from June 2007. We have evaluated the performance of the complete trigger chain of the TGC electronics and provide the trigger signal using cosmic-ray to the sub-systems in the global run environment

Final Test at the Surface of the ATLAS Endcap Muon Trigger Chamber Electronics

For the detector commissioning planned in 2007, sector assembly of the ATLAS muon-endcap trigger chambers and final test at the surface for the assembled electronics are being done in CERN and almost completed. For the test, we built up the Data Acquisition (DAQ) system using test pulse of two types and cosmic rays in order to check functionality of the various aspects of the electronics mounted on a sector. So far, 99% of all 320,000 channels have been tested and most of them were installed into the ATLAS cavern. In this presentation, we will describe the DAQ systems and mass-test procedure in detail, and report the result of electronics test with some actual experience

Ultrasound in Emergency Medicine EMERGENCY BILIARY SONOGRAPHY: UTILITY OF COMMON BILE DUCT MEASUREMENT IN THE DIAGNOSIS OF CHOLECYSTITIS AND CHOLEDOCHOLITHIASIS

, Abstract-Background: Measurement of the common bile duct (CBD) has traditionally been considered an integral part of gallbladder sonography, but accurate identification of the CBD can be difficult for novice sonographers. Objective: To determine the prevalence of isolated sonographic CBD dilation in emergency department (ED) patients with cholecystitis or choledocholithiasis without laboratory abnormalities or other pathologic findings on biliary ultrasound. Methods: We conducted a retrospective chart review on two separate ED patient cohorts between June 2000 and June 2010. The first cohort comprised all ED patients undergoing a biliary ultrasound and subsequent cholecystectomy for presumed cholecystitis. The second cohort consisted of all ED patients receiving a biliary ultrasound who were ultimately diagnosed with choledocholithiasis. Ultrasound data and contemporaneous laboratory values were collected. Postoperative gallbladder pathology reports and endoscopic retrograde cholangiopancreatography (ERCP) reports were used as the criterion standard for final diagnosis. Results: Of 666 cases of cholecystitis, there were 251 (37.7%) with a dilated CBD > 6 mm and only 2 cases (0.3%; 95% confidence interval [CI] 0.0-0.7%) of isolated CBD dilation with an otherwise negative ultrasound and normal laboratory values. Of 111 cases of choledocholithiasis, there were 80 (72.0%) with a dilated CBD and only 1 case (0.9%; 95% CI 0.0-2.7%) with an otherwise negative ultrasound and normal laboratory values. Conclusion: The prevalence of isolated sonographic CBD dilation in cholecystitis and choledocholithiasis is <1%. Omission of CBD measurement is unlikely to result in missed cholecystitis or choledocholithiasis in the setting of a routine ED evaluation with an otherwise normal ultrasound and normal laboratory values. Ó 2013 Elsevier Inc