An experimental evaluation of the understanding of safety compliance needs with models

Proceedings of: 36th International Conference on Conceptual Modeling, ER 2017, Valencia, Spain, November 6–9, 2017Context: Most safety-critical systems have to fulfil compliance needs specified in safety standards. These needs can be difficult to understand from the text of the standards, and the use of conceptual models has been proposed as a solution. Goal: We aim to evaluate the understanding of safety compliance needs with models. Method: We have conducted an experiment to study the effectiveness, efficiency, and perceived benefits in understanding these needs, with text of safety standards and with UML object diagrams. Results: Sixteen Bachelor students participated in the experiment. Their average effectiveness in understanding compliance needs and their average efficiency were higher with models (17% and 15%, respectively). However, the difference is not statistically significant. The students found benefits in using models, but on average they are undecided about their ease of understanding. Conclusions: Although the results are not conclusive enough, they suggest that the use of models could improve the understanding of safety compliance needs.The research leading to this paper has received funding from the AMASS project (H2020-ECSEL grant agreement no 692474; Spain’s MINECO ref. PCIN-2015-262) and the AMoDDI project (Ref. 11130583). We also thank the subjects that participated in the experiment

Diagnostic accuracy of different ultrasound signs for detecting adnexal torsion: systematic review and meta-analysis

Objective. To evaluate the diagnostic accuracy of different ultrasound signs for diagnosing adnexal torsion (AT), using surgery as the reference standard. Methods. A search was performed in PubMed/MEDLINE, CINAHL, Scopus, Cochrane, ClinicalTrials.gov and Web of Science databases (January 1990 to November 2021) for studies evaluating the presence of ovarian edema, an adnexal mass, Doppler flow findings and the whirlpool sign as ultrasound signs (index tests) for detecting AT, using surgical findings as reference standard. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was used to evaluate the quality of the studies. Pooled sensitivity, specificity, positive and negative likelihood ratios were calculated separately, and the post-test probability of AT following a positive or negative test also was determined. Results. The search identified 1267 citations after excluding duplicates. Twenty studies were ultimately included in the qualitative and quantitative syntheses. Ten studies, comprising 983 patients, analyzed ovarian edema. Eleven studies, comprising 1295 patients, analyzed the presence of adnexal mass. Fifteen studies, comprising 2212 patients, analyzed the Doppler flow. Finally, seven studies, comprising 654 patients, analyzed whirlpool sign. Overall, quality was considered as moderate or good for most studies. However, there is a high risk of bias in Patient Selection and Index text (except for whirlpool sign) in a significant proportion of studies. Pooled sensitivity, specificity and positive and negative likelihood ratios of each ultrasound sign were 58%, 86%,4.0 and 0.49 for ovarian edema, 69%, 43%, 1.3 and 0.67 for adnexal mass, 65%, 92%, 8.0 and 0.38 for whirlpool sign, 53%, 95%, 11.0 and 0.49 for Doppler findings and 55%, 69%, 1.7 and 0.66 for pelvic fluid. Heterogeneity was high for all them. Conclusion. Diagnostic accuracy of the presence of an adnexal mass or pelvic fluid as ultrasound signs for suspecting an adnexal torsion is moderate, while the presence of ovarian edema, whirlpool sign and decreased or absent Doppler flow show good specificit

EFFECT OF DIETARY SUPPLEMENTATION OF TULASI (OCIMUM SANCTUM) AND SELENIUM ON ALANINE TRANSAMINASE (ALT) AND ASPARTATE TRANSAMINASE (AST) LEVELS IN BROILERS

ABSTRAC

Leveraging PET to image folate receptor α therapy of an antibody-drug conjugate

Background: The folate receptor α (FRα)-targeting antibody-drug conjugate (ADC), IMGN853, shows great antitumor activity against FRα-expressing tumors in vivo, but patient selection and consequently therapy outcome are based on immunohistochemistry. The aim of this study is to develop an antibody-derived immuno-PET imaging agent strategy for targeting FRα in ovarian cancer as a predictor of treatment success. Methods: We developed [89Zr]Zr-DFO-M9346A, a humanized antibody-based radiotracer targeting tumorassociated FRα in the preclinical setting. [89Zr]Zr-DFO-M9346A’s binding ability was tested in an in vitro uptake assay using cell lines with varying FRα expression levels. The diagnostic potential of [89Zr]Zr-M9346A was evaluated in KB and OV90 subcutaneous xenografts. Following intravenous injection of [89Zr]Zr-DFO-M9346A (~90 μCi, 50 μg), PET imaging and biodistribution studies were performed. We determined the blood half-life of [89Zr]Zr-DFO-M9346A and compared it to the therapeutic, radioiodinated ADC [131I]-IMGN853. Finally, in vivo studies using IMG853 as a therapeutic, paired with [89Zr]Zr-DFO-M9346A as a companion diagnostic were performed using OV90 xenografts. Results: DFO-M9346A was labeled with Zr-89 at 37 °C within 60 min and isolated in labeling yields of 85.7 ± 5.7%, radiochemical purities of 98.0 ± 0.7%, and specific activities of 3.08 ± 0.43 mCi/mg. We observed high specificity for binding FRα positive cells in vitro. For PET and biodistribution studies, [89Zr]Zr-M9346A displayed remarkable in vivo performance in terms of excellent tumor uptake for KB and OV xenografts (45.8 ± 29.0 %IA/g and 26.1 ± 7.2 %IA/g), with low non-target tissue uptake in other organs such as kidneys (4.5 ± 1.2 %IA/g and 4.3 ± 0.7 %IA/g). A direct comparison of the blood half life of [89Zr]Zr-M9346A and [131I]-IMGN853 corroborated the equivalency of the radiopharmaceutical and the ADC, paving the way for a companion PET imaging study. Conclusions: We developed a new folate receptor-targeted 89Zr-labeled PET imaging agent with excellent pharmacokinetics in vivo. Good tumor uptake in subcutaneous KB and OV90 xenografts were obtained, and ADC therapy studies were performed with the precision predictor

Human, All Too Human? An All-Around Appraisal of the “Artificial Intelligence Revolution” in Medical Imaging

Artificial intelligence (AI) has seen dramatic growth over the past decade, evolving from a niche super specialty computer application into a powerful tool which has revolutionized many areas of our professional and daily lives, and the potential of which seems to be still largely untapped. The field of medicine and medical imaging, as one of its various specialties, has gained considerable benefit from AI, including improved diagnostic accuracy and the possibility of predicting individual patient outcomes and options of more personalized treatment. It should be noted that this process can actively support the ongoing development of advanced, highly specific treatment strategies (e.g., target therapies for cancer patients) while enabling faster workflow and more efficient use of healthcare resources. The potential advantages of AI over conventional methods have made it attractive for physicians and other healthcare stakeholders, raising much interest in both the research and the industry communities. However, the fast development of AI has unveiled its potential for disrupting the work of healthcare professionals, spawning concerns among radiologists that, in the future, AI may outperform them, thus damaging their reputations or putting their jobs at risk. Furthermore, this development has raised relevant psychological, ethical, and medico-legal issues which need to be addressed for AI to be considered fully capable of patient management. The aim of this review is to provide a brief, hopefully exhaustive, overview of the state of the art of AI systems regarding medical imaging, with a special focus on how AI and the entire healthcare environment should be prepared to accomplish the goal of a more advanced human-centered world

Diagnostic accuracy of ultrasound signs for detecting adnexal torsion: systematic review and meta-analysis

Objective: To evaluate the diagnostic accuracy of different ultrasound signs for diagnosing adnexal torsion, using surgery as the reference standard. Methods: This was a systematic review and meta-analysis of studies published between January 1990 and November 2021 evaluating ovarian edema, adnexal mass, ovarian Doppler flow findings, the whirlpool sign and pelvic fluid as ultrasound signs (index tests) for detecting adnexal torsion, using surgical findings as the reference standard. The search for studies was performed in PubMed/MEDLINE, CINAHL, Scopus, The Cochrane Library, ClinicalTrials.gov and Web of Science databases. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was used to evaluate the quality of the studies. Pooled sensitivity, specificity, and positive and negative likelihood ratios were calculated separately, and the post-test probability of adnexal torsion following a positive or negative test was also determined. Results: The search identified 1267 citations after excluding duplicates. Eighteen studies were ultimately included in the qualitative and quantitative syntheses. Eight studies (809 patients) analyzed the presence of ovarian edema, eight studies (1044 patients) analyzed the presence of an adnexal mass, 14 studies (1742 patients) analyzed ovarian Doppler flow, six studies (545 patients) analyzed the whirlpool sign and seven studies (981 patients) analyzed the presence of pelvic fluid as ultrasound signs of adnexal torsion. Overall, the quality of most studies was considered to be moderate or good. However, there was a high risk of bias in the patient-selection and index-text domains (with the exception of the whirlpool sign) in a significant proportion of studies. Pooled sensitivity, specificity, and positive and negative likelihood ratios of each ultrasound sign were 58%, 86%, 4.0 and 0.49 for ovarian edema, 69%, 46%, 1.3 and 0.67 for adnexal mass, 65%, 91%, 7.6 and 0.38 for the whirlpool sign, 53%, 95%, 11.0 and 0.49 for ovarian Doppler findings and 55%, 69%, 1.7 and 0.66 for pelvic fluid. Heterogeneity was high for all analyses. Conclusions: The presence of an adnexal mass or pelvic fluid have poor diagnostic accuracy as ultrasound signs of adnexal torsion, while the presence of ovarian edema, the whirlpool sign and decreased or absent ovarian Doppler flow have good specificity but moderate sensitivity for detecting adnexal torsion. © 2022 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.Objetivo.Evaluar la precision diagnostica de diferentes indicios ecograficos para el diagnostico de la torsion anexial,utilizando la cirugia como patron de referencia. Metodos. Se trata de una revision sistematica y un metaanalisis de los estudios publicados entre enero de 1990 y noviembre de 2021 que evaluaron el edema ovarico, la masa anexial, los resultados del flujo Doppler ovarico, el ‘‘signo del remolino’’ (torsion ovarica) y el liquido pelvico como indicios ecograficos (pruebas de referencia) para detectar la torsion anexial, utilizando los resultados quirurgicos como patron de referencia. La busqueda de estudios se realizo en las bases de datos PubMed/MEDLINE, CINAHL, Scopus, The Cochrane Library, ClinicalTrials.gov y Web of Science.Para evaluar la calidad de los estudios se utilizo la herramienta de Evaluacion de Calidad de los Estudios de Precision Diagnostica-2 (QUADAS-2, por sus siglas en ingles). Se calcularon por separado los valores combinados de sensibilidad,especificidad y cocientes de verosimilitud positivos y negativos, y se determino tambien la probabilidad posterior a la prueba de la torsion anexial tras una prueba positiva o negativa. Resultados. La busqueda identifico 1267 citas, una vez excluidas las duplicadas. Se incluyeron dieciocho estudios en las sıntesis cualitativa y cuantitativa. Ocho estudios (809 pacientes) analizaron la presencia de edema ovarico, ocho estudios(1044 pacientes) analizaron la presencia de una masa anexial, 14 estudios (1742 pacientes) analizaron el flujo Doppler ovarico, seis estudios (545 pacientes) analizaron el ‘‘signo del remolino’’ y siete estudios (981 pacientes) analizaron la presencia de lıquido pelvico como indicios ecograficos de torsion anexial. En general, la calidad de la mayorıa de los estudios se considero moderada o buena. Sin embargo, hubo un alto riesgo de sesgo en una proporcion significativa de estudios en las areas de seleccion de pacientes y texto de referencia (con la excepcion del ‘‘signo del remolino’’). Los valores combinados de la sensibilidad, la especificidad y los cocientes de probabilidad positivos y negativos de cada indicio ecografico fueron del 58%, 86%, 4,0 y 0,49 para el edema ovarico, del 69%, 46%, 1,3 y 0,67 para la masa anexial, del 65%, 91%, 7,6 y 0,38 para el ‘‘signo del remolino’’, del 53%, 95%, 11,0 y 0,49 para los resultados del Doppler ovarico y del 55%, 69%, 1,7 y 0,66 para el liquido pelvico. La heterogeneidad fue elevada en todos los analisis. Conclusion. La presencia de una masa anexial o de liquido pelvico apenas tienen precision diagnostica como indicios ecograficos de torsion anexial, mientras que la presencia de edema ovarico, el ‘‘signo del remolino’’ y la disminucion o ausencia de flujo Doppler ovarico tienen una buena especificidad, pero una sensibilidad moderada para detectar la torsion anexial