Rapid on-site evaluation of endoscopic-ultrasound-guided fine-needle aspiration diagnosis of pancreatic masses

Endoscopic ultrasound (EUS) has become an essential tool for the study of pancreatic diseases. Specifically, EUS plays a pivotal role evaluating patients with a known or suspected pancreatic mass. In this setting, differential diagnosis remains a clinical challenge. EUS-guided fine-needle aspiration (FNA) and fine-needle biopsy (FNB) have been proven to be safe and useful tools in this setting. EUS-guided FNA and FNB, by obtaining cytological and/or histological samples, are able to diagnose pancreatic lesions with high sensitivity and specificity. In this context, several methodological features, trying to increase the diagnostic yield of EUS-guided FNA and FNB, have been evaluated. In this review, we focus on the role of rapid on-site evaluation (ROSE). From data reported in the literature, ROSE may increase diagnostic yield of EUS-FNA specimens by 10%-30%, and thus, diagnostic accuracy. However, we should point out that many recent studies have reported adequacy rates of > 90% without ROSE, indicating that, perhaps, at high-volume centers, ROSE may not be indispensable to achieve excellent results. The use of ROSE can be considered important during the learning curve of EUS-FNA, and also in hospital with diagnostic accuracy rates < 90%.

Role of macroscopic on-site evaluation of endoscopic ultrasoundguided fine-needle aspiration/biopsy:Results of a multicentric prospective study

BACKGROUND The concept of macroscopic on-site evaluation(MOSE)was introduced in 2015 when the endoscopist observed better diagnostic yield when the macroscopically visible core on MOSE was superior to 4 mm.Recent studies suggest that MOSE by the endoscopist may be an excellent alternative to rapid on-site evaluation,and some classi-fications have been published.Few studies have assessed the adequacy of histologic cores in MOSE during endoscopic ultrasound-guided fine-needle aspiration/biopsy(EUS-FNA/FNB).AIM To evaluate the performance of MOSE during EUS-FNA/FNB.METHODS This multicentric prospective study was conducted in 16 centers in 3 countries(Egypt,Iraq,and Morocco)and included 1108 patients with pancreatic,biliary,or gastrointestinal pathology who were referred for EUS examination.We prospectively analyzed the MOSE in 1008 patients with available histopathological reports according to 2 classifications to determine the adequacy of the histological core samples.Data management and analysis were performed using a Statistical Package for Social Sciences(SPSS)version 27.RESULTS A total of 1074 solid lesions were biopsied in 1008 patients with available cytopathological reports.Mean age was 59 years,and 509 patients(50.5%)were male.The mean lesion size was 38 mm.The most frequently utilized needles were FNB-Franseen(74.5%)and 22 G(93.4%),with a median of 2 passes.According to 2 classifications,618 non-bloody cores(61.3%)and 964 good samples(95.6%)were adequate for histological evaluation.The overall diagnostic yield of cytopathology was 95.5%.The cytological examination confirmed the diagnosis of malignancy in 861 patients(85.4%),while 45 samples(4.5%)were inconclusive.Post-procedural adverse events occurred in 33 patients(3.3%).Statistical analysis showed a difference between needle types(P=0.035)with a high sensitivity of FNB(97%).The analysis of the relationship between the MOSE-score and the final diagnosis showed a significant difference between the different scores of the MOSE(P<0.001).CONCLUSION MOSE is a simple method that allows endoscopists to increase needle passes to improve sample quality.There is significantly higher FNB sensitivity and cytopathology diagnostic yield with good MOSE cores.

Evaluation of a Rapid Diagnostic Test, Boson Biotech SARS CoV-2 Ag, for the Detection of SARS-CoV-2 in Gabon

1) Background: Rapid and acurate diagnostic testing for case identification, quarantine, and contact tracing is essential for managing the COVID 19 pandemic. Rapid antigen detection tests are available, however, it is important to evaluate their performances before use. We tested a rapid antigen detection of SARS-CoV-2, based on the immunochromatography (Boson Biotech SARS-CoV-2 Ag Test (Xiamen Boson Biotech Co., Ltd., China)) and the results were compared with the real time reverse transcriptase-Polymerase chain reaction (RT-PCR) (Gold standard) results;2) Methods: From November 2021 to December 2021, samples were collected from symptomatic patients and asymptomatic individuals referred for testing in a hospital during the second pandemic wave in Gabon. All these participants attending “CTA Angondjé”, a field hospital set up as part of the management of COVID-19 in Gabon. Two nasopharyngeal swabs were collected in all the patients, one for Ag test and the other for RT-PCR;3) Results: A total of 300 samples were collected from 189 symptomatic and 111 asymptomatic individuals. The sensitivity and specificity of the antigen test were 82.5% [95%CI 73.8 - 89.3] and 97.9 % [95%CI 92.2 - 98.2] respectively, and the diagnostic accuracy was 84.4% (95% CI: 79.8 - 88.3%). The antigen test was more likely to be positive for samples with RT-PCR Ct values ≤ 32, with a sensitivity of 89.8%;4) Conclusions: The Boson Biotech SARS-CoV-2 Ag Test has good sensitivity and can detect SARS-CoV-2 infection, especially among symptomatic individuals with low viral load. This test could be incorporated into efficient testing algorithms as an alternative to PCR to decrease diagnostic delays and curb viral transmission.

Analysis of the Application of Bridge Rapid Inspection and Evaluation Technology

Rapid bridge inspection and evaluation mainly uses information technology to test the quality of bridge infrastructure and structures,integrates the test results with the existing management system,completes the bridge status assessment,establishes information management files to provide bridge disease problem inspection and analysis,and provides support for the application of disposal measures.This paper briefly discusses the necessity of applying rapid inspection and evaluation technology and analyzes the bridge’s rapid inspection and evaluation content,inspection system,and application process.We look forward to the future application prospects of this technology and supporting those in this field.

The efficacy of rapid on-site evaluation during endoscopic ultrasound-guided fine needle aspiration of pancreatic masses

Background:Endoscopic ultrasound(EUS)-guided fine needle aspiration(FNA)has become the preferred method to diagnose pancreatic masses due to its minimally invasive approach and diagnostic accuracy.Many studies have shown that rapid on-site evaluation(ROSE)improves diagnostic yield by 10–30%;however,more recent studies have demonstrated effective diagnostic accuracy rates without ROSE.Our study aims to examine whether the current standard of performing ROSE after each FNA pass adds diagnostic value during EUS-guided FNA of pancreatic masses.Methods:We conducted a retrospective case series on patients who underwent EUS-guided FNA of pancreatic masses between February 2011 and October 2014.All cases were performed by one of three endoscopists at Emory University Hospital.Patient demographics,radiologic details of pancreatic masses and pathology reports of the biopsied pancreatic masses were examined.Results:A total of 184 procedures performed in 171 patients were reviewed.The final pathology reports of the biopsied pancreatic masses showed 128(70%)with confirmed malignancy.Only 64(50%)of these 128 cases initially showed malignant cells during ROSE.Among these 64 cases,23%required 5 or more FNA passes to first detect malignant cells.Conclusions:The use of ROSE during EUS-guided FNA of pancreatic masses may increase the diagnostic yield,since malignant cells were often detected during later FNA passes that would otherwise be missed if tissue sampling stopped prematurely.In addition,sample preparation for ROSE may be suboptimal,since malignant cells were only detected in 50%of cases.

Cheesy material on macroscopic on-site evaluation after endoscopic ultrasound-guided fine-needle biopsy:Don't miss the tuberculosis

Endoscopic ultrasound-guided fine-needle biopsy(EUS-FNB)is an excellent investigation to diagnose pancreatic lesions and has shown high accuracy for its use in pathologic diagnosis.Recently,macroscopic on-site evaluation(MOSE)performed by an endoscopist was introduced as an alternative to rapid on-site cytologic evaluation to increase the diagnostic yield of EUS-FNB.The MOSE of the biopsy can estimate the adequacy of the sample directly by the macroscopic evaluation of the core tissue obtained from EUS-FNB.Isolated pancreatic tuberculosis is extremely rare and difficult to diagnose because of its non-specific signs and symptoms.Therefore,this challenging diagnosis is based on endoscopy,imaging,and the bacteriological and histological examination of tissue biopsies.This uncommon presentation of tuberculosis can be revealed as pancreatic mass mimicking cancer.EUS-FNB can be very useful in providing a valuable histopathological diagnosis.A calcified lesion with a cheesy core in MOSE must be suggestive of tuberculosis,leading to the request of the GeneXpert,which can detect Mycobacterium tuberculosis deoxyribonucleic acid and resistance to rifampicin.A decent diagnostic strategy is crucial to prevent unnecessary surgical resection and to supply conservative management with antitubercular therapy.

Failure evaluation and control factor analysis of slope block instability along traffic corridor in Southeastern Tibet

The instability of slope blocks occurred frequently along traffic corridor in Southeastern Tibet(TCST),which was primarily controlled by the rock mass structures.A rapid method evaluating the control effects of rock mass structures was proposed through field statistics of the slopes and rock mass structures along TCST,which combined the stereographic projection method,modified M-JCS model,and limit equilibrium theory.The instabilities of slope blocks along TCST were then evaluated rapidly,and the different control factors of instability were analyzed.Results showed that the probabilities of toppling(5.31%),planar(16.15%),and wedge(35.37%)failure of slope blocks along TCST increased sequentially.These instability modes were respectively controlled by the anti-dip joint,the joint parallel to slope surface with a dip angle smaller than the slope angle(singlejoint),and two groups of joints inclined out of the slope(double-joints).Regarding the control effects on slope block instability,the stabilization ability of doublejoints(72.7%),anti-dip joint(67.4%),and single-joint(57.6%)decreased sequentially,resulting in different probabilities of slope block instability.Additionally,nearby regional faults significantly influenced the joints,leading to spatial heterogeneity and segmental clustering in the stabilization ability provided by joints to the slope blocks.Consequently,the stability of slope blocks gradually weakened as they approached the fault zones.This paper can provide guidance and assistance for investigating the development characteristics of rock mass structures and the stability of slope blocks.

Recent Advances in the Rapid Detection and Performance Evaluation Methods of Detergent Additives for Gasoline

Although detergent additives for gasoline have been widely commercialized,their formulas are often kept confidential and there is still no standardized method for quickly detecting the main active ingredients and evaluating their effectiveness,which makes their regulation difficult.An overview of the current state of the development and application of detergent additives for gasoline in China and other regions,as well as a review of the rapid detection and performance evaluation methods available for analyzing detergent additives are given herein.The review focuses on the convenience,cost,efficiency,and feasibility of on-site detection and the evaluation of various methods,and also looks into future research directions,such as detecting and evaluating detergent additives in ethanol gasoline and with advanced engine technologies.

Rapid digitalization and panoramic evaluation of weld X-ray film

The computer evaluation of weld X-ray film is an attractive technique for weld seam NDT （ nondestructive testing）. To achieve this target, digitalization of film is the first step and automatic defect identification is another key technique. In this paper, a weld X-ray film digitalizing system has been established with linear array CCD and highlight LED light source. Its space resolution can reach 0. 04 mm/pixel and scanning speed can reach 100 mm/s for an industrial film. The transfer function curves of the system have been measured and the results indicate that its image gray resolution can reach 88 G/D at 4. 5D, and its dynamic range can be wider than 2. OD. In order to facilitate the evaluation of large welded structure, a panoramic evaluation algorithm is developed also. The algorithm includes image matching, image fusion and panoramic evaluation of the long linked film image.

A Computerized Evaluation of Sensory Memory and Short-term Memory Impairment After Rapid Ascent to 4280 m

To evaluate the effect of acute high-altitude exposure on sensory and short-term memory using interactive software,we transported 30 volunteers in a sport utility vehicle to a 4280 m plateau within3 h.We measured their memory performance on the plain（initial arrival）and 3 h after arrival on the plateau using six measures.

Establishment of Quick Testing Efficiency Evaluation Model and Analysis of Related Factors

Objective: “Rapid screening, targeted sampling, objective test” is an efficient test model. The factors affecting the efficiency include false screening rate, missing rate and rapid screening time. However, only missing rate and accuracy have been used as technical requirements to evaluate rapid screening method. In this study, efficiency was regarded as evaluation index of quick testing method. Method: The evaluation model of quick testing efficiency was established by comparing time of routine testing and quick testing. By simulation calculation, the effect factors such as rapid screening time, false screening rate, missing rate and defective rate were analyzed. Results: The calculation formula of efficiency was derived. Simulation results showed that the lower defective rate, the higher efficiency;the smaller missing rate, false screening rate, or screening time, the higher efficiency and the degree of improving efficiency is related to defective rate;sometimes, the screening time is the most important factor affecting the efficiency. In certain cases, if the false screening rate or missing rate is 50%, the efficiency can be increased by more than 10 times. Conclusions: Taken together, this study highlighted a role of efficiency which functioned as an index to evaluate rapid screening. Quick testing efficiency evaluation model can be used for the calculation efficiency, and can be used to analysis the relationship between efficiency and the influence factors, and can provide the theoretical foundation for rapid screening method development and evaluation.

Multispectral Imaging for Authenticity Identification and Quality Evaluation of <i>Flos carthami</i>

The identification and quality evaluation of Flos carthami were studied using tunable liquid spectral imaging instrument, to discuss the application range and advantages of spectral imaging technology in Chinese medicine identification and quality control field. The Flos carthami was indentified by extracting the normalized characteristic spectral curves of Flos carthami, Crocus sativus and Dendranthema morifolium, which were standard samples supplied by National Institute for Drug Control. The qualities of Flos carthamies collecting from different pharmacies were evaluated by extracting their normalized characteristic spectral curves. The imaging spectrum testing system was designed independently. The spectral resolution was 5 nm, and the spectral range was from 400 nm to 680 nm. The results showed that the normalized characteristic spectral curve of Flos carthami was significantly different from those of Crocus sativus’ and Dendranthema morifolium’s, and the fluorescence intensity of Flos carthami from different commercial sources were different. Spectral imaging technology could be used to identify and evaluate Flos carthami, and operation method was rapid, convenient and non-destructive.

Establishment and Clinical Application of Multidisciplinary Collaborative Rapid Rehabilitation Nursing Pathway in Perioperative Period of Brucellosis Spondylitis

Objective: To study the establishment and clinical application of multidisciplinary collaborative rapid rehabilitation nursing model in patients with brucellosis spondylitis during the perioperative period. Method: From January 2009 to January 2013, 39 patients diagnosed with brucellosis spondylitis were treated with focal clearance combined with posterior pedicle internal fixation. Nursing was randomly divided into 2 groups: 19 cases of routine nursing as the control group (group A);20 cases of implementation of the nursing path as the intervention group (group B). In the intervention group, analgesic nursing plan, daily activity ability training path, medication compliance and health education path were used to effectively intervene on the evaluation parameters affecting rapid recovery and clinical efficacy (VAS score, daily activity ability mastery, Oswestry disability index and medication Morisky-Green index). The nursing effect and clinical evaluation of the two groups were compared. Results: As time went by, VAS pain score, mastery of daily activity ability, Oswestry disability index and medication compliance between the two groups at the same time point were significantly different (P Conclusions: The nursing path of brucellosis spondylitis is positively correlated with rapid recovery and clinical efficacy. Compared with routine nursing, it has a significant effect on accelerating postoperative rehabilitation and clinical efficacy.

国内外食品快速检测方法评价技术研究

相比于国外成熟的快速检测方法评价技术体系,我国的评价技术体系发展滞后且有较多问题,严重制约了快检行业的发展。本文主要从验证方法、性能指标、测试要求等方面对各个评价技术体系做了对比分析。同时梳理了国内不同监管部门的评价技术体系发展与侧重,以期为我国食品快速检测方法确认政策和技术研究提供良好的借鉴,引导食品快速检测方法及产品的评价标准进一步规范,形成完善的科学评价方法和评价技术体系,促进我国食品安全及快速检测行业的健康发展。

近红外光谱技术在乳及乳制品质量检测中的应用

随着生活水平的提升,人们对食品质量的关注日益增加,快速获取产品质量信息已成为热点问题之一。近红外光谱技术作为一种快速、无损、定量的检测手段,能够在短时间内获取食品的质量信息,该技术已逐渐在食品质量评价中得到广泛应用。本文综述了近红外光谱技术在乳及乳制品质量检测方面的应用,旨在为该技术在乳制品行业中的进一步应用提供参考。

乌司他丁治疗急性胰腺炎的快速卫生技术评估

目的本文通过对乌司他丁(UTI)进行快速卫生技术评估(HTA),评价UTI治疗急性胰腺炎(AP)的有效性、安全性及经济性。方法计算机检索PubMed、Embase、the Cochrane Library、中国知网、万方数据库、中国生物医学文献数据库和HTA机构官方网站,收集UTI在AP方面的系统评价(SR)/Meta分析、经济学评价及HTA报告,检索时限为建库至2024年4月。由2名研究者根据纳排标准独立进行筛选、质量评价和数据提取,采取描述性分析方式对数据进行分析汇总。结果共纳入19篇研究,包括15篇SR/Meta分析和4篇经济学研究,未检索到HTA报告。UTI联合治疗AP较单独常规治疗在提高总有效率、缩短淀粉酶恢复时间、减少腹痛腹胀缓解时间、降低病死率及缩短平均住院天数等方面均具有明显优势,和其他阳性药物(甲磺酸加贝酯、奥曲肽、生长抑素)相比疗效相当或基本一致,安全性良好。就目前纳入的研究而言,UTI对比其他阳性药物具有明显经济学优势。结论UTI在治疗AP方面安全有效,具有经济学优势。

BAL联合M-ROSE在潜在供肺维护中的作用

目的探讨BAL联合M-ROSE在潜在供肺维护中的作用。方法选取昆明医科大学附属甘美医院重症医学科2020年09月至2022年12月收治的符合纳入标准的脑死亡患者行BAL,留取灌洗液行M-ROSE比较病原菌检出率及初步诊断时间。根据M-ROSE结果阳性的患者采用经验性抗感染治疗,评估抗感染治疗48 h前后的氧合指数、胸部X线评分、感染指标(WBC、CRP、PCT)变化。结果(1)病原菌检出率比较:MROSE对细菌感染初步诊断结果与检验科报告的结果表现出高度一致性(Kappa=0.921,P<0.001);(2)诊断时效性比较:M-ROSE初步诊断时间与常规涂片报告时间、微生物培养时间比较,差异有统计学意义(P<0.001);(3)抗感染治疗48 h的疗效比较:抗感染治疗前后氧合指数,白细胞,超敏C反应蛋白差异无统计学意义(P>0.05);抗感染治疗前后胸部X线,降钙素原差异有统计学意义(P<0.05)。结论BAL联合M-ROSE在潜在供肺肺部感染中的诊断时效性高,可以为供肺维护早期抗感染治疗提供初步的依据。

快速现场评价联合支气管内超声引导下经支气管镜肺活检对肺外周恶性肿瘤的诊断价值

目的:探讨快速现场评价(ROSE)联合支气管内超声引导下经支气管镜肺活检(EBUS-TBLB)在诊断肺外周恶性肿瘤中的临床价值。方法:回顾性分析2021年1月至2022年6月在广州医科大学附属第一医院国家呼吸医学中心行EBUS-TBLB检查的肺外周病灶直径≤30 mm的患者190例,根据是否进行ROSE检查,分为ROSE组(50例)和非ROSE组(140例),比较两组的总体诊断率,并分析病灶所在肺叶位置、病灶直径、超声探头在病灶中的位置以及病灶距胸膜的距离等因素对两组患者诊断率的影响。结果:ROSE联合EBUS-TBLB可提高肺外周恶性肿瘤的诊断率(84.00%比60.71%,P=0.003)。在直径21~30 mm的病灶中,ROSE组的诊断率显著高于非ROSE组(85.29%比64.13%,P=0.022)。ROSE可明显提高超声图像显示病变包绕超声探头的肿瘤病灶的诊断率(90.32%比62.34%,P=0.004)。在距离胸膜≤15 mm的病灶中,ROSE组的诊断率明显高于非ROSE组(95.24%比60.76%,P=0.003)。结论:ROSE可显著提高EBUS-TBLB对肺外周恶性肿瘤的诊断率,在直径21~30 mm、超声影像中间型以及距离胸膜≤15mm的病灶中有更明显的优势。

滑坡位移预测模型补充评价方法

针对目前滑坡位移预测模型评价方法中总体性指标区分能力不足,以及对滑坡高风险期预测效果评价不准确等问题,设计滑坡位移预测模型快速位移期综合误差(CERDP)和峰值预测误差(PPE)两个补充评价指标以及对应的补充评价技术流程。基于滑坡监测数据的实例研究表明,所提补充评价指标和应用流程合理可行,可以有效地应对均方根误差(RMSE)等指标差异不显著带来的评价不准确问题,遴选出总体性能可靠,在风险时段和最高风险时点表现更好的模型,为滑坡风险管理工作提供有效的技术支持。

复杂环境下DWA与RRT算法融合的AUV局部路径规划

针对复杂水下环境下的自主水下航行器(autonomous underwater vehicle,AUV)局部路径规划问题,传统动态窗口法(dynamic window approach,DWA)存在复杂障碍物中陷入局部停滞,动态避障性能不佳等问题,本文提出了一种基于DWA与快速随机搜索树(rapid-exploration random tree,RRT)算法融合的路径规划算法。改进的DWA算法速度空间根据整个动态窗口的周期生成,重设了评价函数并结合AUV任务环境引入洋流能耗评价函数;改进的RRT算法在局部已知空间内规划导引点,帮助DWA脱离局部停滞状态并实现更安全的动态避障。将2种算法融合,实现了AUV在复杂水下环境中的局部路径规划。仿真表明,该融合算法能够降低AUV在洋流中的能耗代价,解决了DWA在复杂障碍物中陷入局部停滞的问题,能够安全有效地躲避动态避障物。