Purpose: This study aimed to determine new criteria for detecting independent factors with high sensitivity in cases of cervical spine injury. We compared the sensitivity, the specificity, and the false negative predictive value (NPV) of plain radiographs with those of computed tomography for cervical spine injury in patients with minor head injury. Methods: We retrospectively reviewed the cases of 357 patients who underwent both cervical plain radiographs and computer tomography from January 2006, to September 2008. Patients were divided into two groups: the cervical spine injury group and the no cervical spine injury group. New criteria were organized based on variables that had significant differences in the logistic regression test. Results: Among the 357 patients, 78 patients had cervical spine injuries. The average age was $43.9{\pm}15.2$ yrs old, and the male-to-female ratio was 1.90. The most common mechanism of injury was motor vehicle accidents. There was a significant difference in loss of consciousness, Glasgow Coma Scale (GCS)=14, neurologic deficit, posterior neck tenderness, and abnormality of the cervical plain radiographs between the two groups on the logistic regression test. New criteria included the above five variables. If a patient has at least variable, the area under the ROC curve of the new criteria was 0.850, and the sensitivity and the false NPV were 87.2% and 5.2%, respectively. Conclusion: New criteria included loss of consciousness, GCS=14, neurologic deficit, posterior neck tenderness, and abnormality of the cervical plain radiographs. If the patient had at least 1 variable, he or she could have a of cervical spine injury with a sensitivity of 87.2% and a false NPV of 5.2%.
Purpose: Catheter urine (CATH-U) and suprapubic aspiration (SPA) are reliable urine collection methods for confirming urinary tract infections (UTI) in infants. However, noninvasive and easily accessible collecting bag urine (CBU) is widely used, despite its high contamination rate. This study investigated the validity of CBU cultures for diagnosing UTIs, using CATH-U culture results as the gold standard. Methods: We retrospectively analyzed 210 infants, 2- to 24-month-old, who presented to a tertiary care hospital's pediatrics department between September 2008 and August 2013. We reviewed the results of CBU and CATH-U cultures from the same infants. Results: CBU results, relative to CATH-U culture results (${\geq}10^4$ colony-forming units [CFU]/mL) were widely variable, ranging from no growth to ${\geq}10^5CFU/mL$. A CBU cutoff value of ${\geq}10^5CFU/mL$ resulted in false-positive and false-negative rates of 18% and 24%, respectively. The probability of a UTI increased when the CBU bacterial count was ${\geq}10^5/mL$ for all infants, both uncircumcised male infants and female infants (likelihood ratios [LRs], 4.16, 4.11, and 4.11, respectively). UTIs could not be excluded for female infants with a CBU bacterial density of $10^4-10^5$ (LR, 1.40). The LRs for predicting UTIs based on a positive dipstick test and a positive urinalysis were 4.19 and 3.11, respectively. Conclusion: The validity of obtaining urine sample from a sterile bag remains questionable. Inconclusive culture results from CBU should be confirmed with a more reliable method.
Jeon, Min-Cheol;Kim, Ju Ock;Jung, Sung Soo;Park, Hee Sun;Lee, Jeong Eun;Moon, Jae Young;Chung, Chae Uk;Kang, Da Hyun;Park, Dong Il
Tuberculosis and Respiratory Diseases
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제81권4호
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pp.330-338
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2018
Background: We developed an additional laser guidance system to improve the efficacy and safety of conventional computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB), and we conducted this study to evaluate the efficacy and safety of our system. Methods: We retrospectively analyzed the medical records of 244 patients who underwent CT-guided PTNB using our additional laser guidance system from July 1, 2015, to January 20, 2016. Results: There were nine false-negative results among the 238 total cases. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of our system for diagnosing malignancy were 94.4% (152/161), 100% (77/77), 100% (152/152), 89.5% (77/86), and 96.2% (229/238), respectively. The results of univariate analysis showed that the risk factors for a false-negative result were male sex (p=0.029), a final diagnosis of malignancy (p=0.033), a lesion in the lower lobe (p=0.035), shorter distance from the skin to the target lesion (p=0.003), and shorter distance from the pleura to the target lesion (p=0.006). The overall complication rate was 30.5% (74/243). Pneumothorax, hemoptysis, and hemothorax occurred in 21.8% (53/243), 9.1% (22/243), and 1.6% (4/243) of cases, respectively. Conclusion: The additional laser guidance system might be a highly economical and efficient method to improve the diagnostic efficacy and safety of conventional CT-guided PTNB even if performed by inexperienced pulmonologists.
Asian Dust is a meteorological phenomenon that sand particles are raised from the arid and semi-arid regions-Taklamakan Desert, Gobi Desert and Inner Mongolia in China-and transported by westerlies and deposited on the surface. Asian dust results in a negative effect on human health as well as environmental, social and economic aspects. For monitoring of Asian Dust, Korea Meteorological Administration operates 29 stations using a continuous ambient particulate monitor. Kim et al. (2016) developed an automatic quality check (AQC) algorithm for objective and systematic quality check of observed PM10 concentration and evaluated AQC with results of a manual quality check (MQC). The results showed the AQC algorithm could detect abnormal observations efficiently but it also presented a large number of false alarms which result from valid error check. To complement the deficiency of AQC and to develop an AQC system which can be applied in real-time, AQC has been modulated. Based on the analysis of instrument status codes, valid error check process was revised and 6 status codes were further considered as normal. Also, time continuity check and spike check were modified so that posterior data was not referred at inspection time. Two-year observed PM10 concentration data and corresponding MQC results were used to evaluate the modulated AQC compared to the original AQC algorithm. The results showed a false alarm ratio decreased from 0.44 to 0.09 and the accuracy and the probability of detection were conserved well in spite of the exclusion of posterior data at inspection time.
KSII Transactions on Internet and Information Systems (TIIS)
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제16권12호
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pp.4008-4023
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2022
Since machine learning was introduced into cross-site scripting (XSS) attack detection, many researchers have conducted related studies and achieved significant results, such as saving time and labor costs by not maintaining a rule database, which is required by traditional XSS attack detection methods. However, this topic came across some problems, such as poor generalization ability, significant false negative rate (FNR) and false positive rate (FPR). Moreover, the automatic clustering property of graph convolutional networks (GCN) has attracted the attention of researchers. In the field of natural language process (NLP), the results of graph embedding based on GCN are automatically clustered in space without any training, which means that text data can be classified just by the embedding process based on GCN. Previously, other methods required training with the help of labeled data after embedding to complete data classification. With the help of the GCN auto-clustering feature and labeled data, this research proposes an approach to detect XSS attacks (called GCNXSS) to mine the dependencies between the units that constitute an XSS payload. First, GCNXSS transforms a URL into a word homogeneous graph based on word co-occurrence relationships. Then, GCNXSS inputs the graph into the GCN model for graph embedding and gets the classification results. Experimental results show that GCNXSS achieved successful results with accuracy, precision, recall, F1-score, FNR, FPR, and predicted time scores of 99.97%, 99.75%, 99.97%, 99.86%, 0.03%, 0.03%, and 0.0461ms. Compared with existing methods, GCNXSS has a lower FNR and FPR with stronger generalization ability.
To protect aquatic animal health of importing countries from the potential risks associated with exotic diseases introduced through international trade of live aquatic animals, inspection of designated commodities at ports of entry is a critical component of the safeguarding system. The only way to be 100% confident that no fishes in a shipment are infected with a specific agent is to test every fish in the commodity imported with a perfect diagnostic test. For the majority of cases, this is unrealistic since the group of interest may very large particularly for aquatic animals, or imperfect tests are often available. It is, therefore, more common to test a fixed proportion of a group by preplanned sampling schemes. However, decision making based on results of testing the sample can provide quite a chance that infected groups may be misclassified as uninfected, depending on sampling strategy employed. The objective of this study was to determine the possibility that one or more fishes in the group imported being infected but tests negative after inspecting samples. This question is critical to government authorities to examine whether sampling plan is sufficient to achieve the purpose intended for. At fixed population size, the maximum number of infected fishes when all tests negative was decreased as the sampling fraction increased. The probability of including at least one undetected but infected fish in a group for negative tests increased with the number of fish tested or true prevalence. The risk was much lesser where high sensitivity test was assumed; when increasing test sensitivity from 0.9 to 0.99, this risk was dramatically reduced to about a tenth or a fourth for prevalence ranges from 2 to 10%, given sample size ranges from 10 to 200. Based on the preliminary analysis, the author concluded that current sampling plan testing 4-8% of the import proposal for human consumption still can yield high false negative results. Therefore, from the quarantine inspection point of view, an enforced commodity-specific sampling design that accounts for the cost of testing with an imperfect test at the specified design prevalence is urgent.
Chanthavilay, Phetsavanh;Mayxay, Mayfong;Phongsavan, Keokedthong;Marsden, Donald E;White, Lisa J;Moore, Lynne;Reinharz, Daniel
Asian Pacific Journal of Cancer Prevention
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제16권14호
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pp.5889-5897
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2015
Background: The performance of combined testing visual inspection with acetic acid (VIA) and cervical cytology tests might differ from one setting to another. The average estimate of the testing accuracy across studies is informative, but no meta-analysis has been carried out to assess this combined method. Objective: The objective of this study was to estimate the average sensitivity and specificity of the combined VIA and cervical cytology tests for the detection of cervical precancerous lesions. Materials and Methods: We conducted a systematic review and a meta-analysis, according to the Cochrane Handbook for Systematic Review of Diagnostic Test Accuracy. We considered two cases. In the either-positive result case, a positive result implies positivity in at least one of the tests. A negative result implies negativity in both tests. In the both-positive case, a positive result implies having both tests positive. Eligible studies were identified using Pubmed, Embase, Website of Science, CINHAL and COCRANE databases. True positive, false positive, false negative and true negative values were extracted. Estimates of sensitivity and specificity, positive and negative likelihood (LR) and diagnostic odds ratios (DOR) were pooled using a hierarchical random effect model. Hierarchical summary receiver operating characteristics (HSROC) were generated and heterogeneity was verified through covariates potentially influencing the diagnostic odds ratio. Findings: Nine studies fulfilled inclusion criteria and were included in the analysis. Pooled estimates of the sensitivities of the combined tests in either-positive and both-positive cases were 0.87 (95% CI: 0.83-0.90) and 0.38 (95% CI: 0.29-0.48), respectively. Corresponding specificities were 0.79 (95% CI: 0.63-0.89) and 0.98 (95% CI: 0.96-0.99) respectively. The DORs of the combined tests in either-positive or both-positive result cases were 27.7 (95% CI: 12.5-61.5) and 52 (95% CI: 22.1-122.2), respectively. When including only articles without partial verification bias and also a high-grade cervical intraepithelial neoplasia as a threshold of the disease, DOR of combined test in both-positive result cases remained the highest. However, DORs decreased to 12.1 (95% CI: 6.05-24.1) and 13.8 (95% CI: 7.92-23.9) in studies without partial verification bias for the combined tests in the either-positive and both-positive result cases, respectively. The screener, the place of study and the size of the population significantly influenced the DOR of combined tests in the both-positive result case in restriction analyses that considered only articles with CIN2+ as disease threshold. Conclusions: The combined test in the either-positive result case has a high sensitivity, but a low specificity. These results suggest that the combined test should be considered in developing countries as a primary screening test if facilities exist to confirm, through colposcopy and biopsy, a positive result.
Malignant catarrhal fever (MCF) is a systemic disease of ruminants caused by ovine herpesvirus 2 (OvHV-2). OvHV-2 is a gamma herpesvirus, which induces frequent latent infection and often difficult to detect its antigens and even specific nucleic acids because of its low viral copies in the infected tissues. Histopathology, serology and polymerase chain reaction (PCR) were compared for the diagnosis of MCF using 10 bison infected with OvHV-2. Histopathological diagnosis was performed using the criteria which was based upon the pathognomic lesions. Serological diagnosis was conducted using its serum with competitive ELISA for the detection of antibodies of OvHV-2. Also, the nest PCR was performed with peripheral blood leukocytes for the detection of OvHV-2-specific DNAs. Primers 556 and 775 were used for the primary amplification, and primers 556 and 555 were used for the secondary amplification. As the results, positive cases were 6 by histopahology, 9 by serology and 10 by PCR. As comparing with other diagnostic methods, PCR was found to be more sensitive than histopathology and serology. The recent development of molecular diagnostic assays has provided powerful tools for investigating how viruses survive in nature. Development of PCR specific for viruses has dramatically improved the accuracy of diagnosis of viruses in clinically infected animals. Furthermore, amplification of viral genomic material by nest PCR represents the most sensitive method for the detection of viruses and might be detected successfully even though very low viral DNA copies. So, it could be used as the first choice for the detection of viral DNAs with low copies such as the status of latent infection. However, it has also some limitation of application like as false negative results by PCR inhibitors and false positive results by contamination. The results of this study suggest that the use of molecular biological methods like PCR may increase the accuracy for the diagnosis of infectious diseases. However, in diagnostic laboratory, it is recommended that PCR assay must be conducted with other diagnostic methods for more reliable diagnosis.
This study was performed in order to evaluate the accuracy and the usefulness of the fine needle aspiration cytology (FNAC) on the breast lesions, to compare the FNAC findings between fibroadenoma and fibrocystic disease, and to determine the accuracy of cytologic Black's nuclear grading. The subjects in this study were 110 cases of FNAC, later confirmed by biopsy, between January 1988 and December 1991. The results are as follows ; 1 Comparison between the results of the FNAC and the histologic findings revealed that FNAC had a sensitivity of 96.6%, a specificity of 100%, a false negative rate of 3.4% a false positive rate of 0.0%, and an overall diagnostic accuracy of 98.2%. 2 Semi-quantitative evaluation of epithelial celluarity, stroma, and naked nuclei in the smears of aspirate showed high celluarity in 56.7% of the aspirates from fibroadenoma and in 0% of those from fibrocystic disease. Abundant stroma was found in 46.7% of the fibroadenoma and none of fibrocystic disease. Numerous naked nuclei were found in 60% of the fibroadenoma and 4.5% of the fibrocystic disease. The overall diagnostic accuracy was 98% 3. In order to determine the accuracy of Black's nuclear grading of FNAC on breast carcinoma, we retrospectively studied 38 cases of ductal carcinomas diagnosed by FNAC with subsequent histologic confirmation. The concordance rate with histology was 94.7%. These results suggest that FNAC of breast is a diagnostically accurate method, and provide for the preoperative differential diagnosis between fibroadenoma and fibrocystic disease. Our results also suggest that the evaluation of nuclear grading of FNAC can predict clinical outcome and decide the way of management of breast cancer.
Background: Cervical cancer is the second most common cancer among women in many populations. While the Pap smear is a well established screening test it suffers from both false-positive and false-negative results in diagnosis of cancers and precancerous states. In this study, immunocytochemistry of the P16 biomarker and HPV-PCR were compared for their diagnostic potential. Materials and methods: In the study, we obtained pairs of specimens from 45 women with cervical dysplasia. One sample was placed in a liquid-based solution, and processed for staining of sections with antibodies to P16. HPV-PCR was performed on the other and the results obtained were analyzed by T-test using SPSS v. 15. Results: Using HPV-PCR 71% of the samples were found to be infected with either HPV 16 or HPV 18, and the rate of infection did not have a statistically significant relationship with higher grades of dysplasia (p= 0.253). In contrast, with immunocytochemistry evaluation of P16, 64% of the specimens were positive, but the percentage of positive results significantly increased with higher grades of dysplasia (p= 0.0001). Conclusion: Employment of the P16 marker as an optional test might be preferable over HPV-PCR for cervical dysplasia in our geographical region.
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