Sensitivity of diagnosis of spontaneous bacterial peritonitis is higher with the automated cell count method

BACKGROUND Spontaneous bacterial peritonitis(SBP)is one of the most important complications of patients with liver cirrhosis entailing high morbidity and mortality.Making an accurate early diagnosis of this infection is key in the outcome of these patients.The current definition of SBP is based on studies performed more than 40 years ago using a manual technique to count the number of polymorphs in ascitic fluid(AF).There is a lack of data comparing the traditional cell count method with a current automated cell counter.Moreover,current international guidelines do not mention the type of cell count method to be employed and around half of the centers still rely on the traditional manual method.AIM To compare the accuracy of polymorph count on AF to diagnose SBP between the traditional manual cell count method and a modern automated cell counter against SBP cases fulfilling gold standard criteria:Positive AF culture and signs/symptoms of peritonitis.METHODS Retrospective analysis including two cohorts:Cross-sectional(cohort 1)and case-control(cohort 2),of patients with decompensated cirrhosis and ascites.Both cell count methods were conducted simultaneously.Positive SBP cases had a pathogenic bacteria isolated on AF and signs/symptoms of peritonitis.RESULTS A total of 137 cases with 5 positive-SBP,and 85 cases with 33 positive-SBP were included in cohort 1 and 2,respectively.Positive-SBP cases had worse liver function in both cohorts.The automated method showed higher sensitivity than the manual cell count:80%vs 52%,P=0.02,in cohort 2.Both methods showed very good specificity(>95%).The best cutoff using the automated cell counter was polymorph≥0.2 cells×10^(9)/L(equivalent to 200 cells/mm^(3))in AF as it has the higher sensitivity keeping a good specificity.CONCLUSION The automated cell count method should be preferred over the manual method to diagnose SBP because of its higher sensitivity.SBP definition,using the automated method,as polymorph cell count≥0.2 cells×10^(9)/L in AF would need to be considered in patients admitted with decompensated cirrhosis.

Delayed diagnosis in inflammatory bowel disease:Time to consider solutions

In this editorial,we discuss a recently published manuscript by Blüthner et al in the World Journal of Gastroenterology,with a specific focus on the delayed diagnosis of inflammatory bowel disease(IBD).IBD,which includes Crohn's disease and ulcerative colitis,is a chronic intestinal disorder.A time lag may exist between the onset of inflammation and the appearance of signs and symptoms,potentially leading to an incorrect or delayed diagnosis,a situation referred to as the delayed diagnosis of IBD.Early diagnosis is crucial for effective patient treatment and prognosis,yet delayed diagnosis remains common.The reasons for delayed diagnosis of IBD are numerous and not yet fully understood.One key factor is the nonspecific nature of IBD symptoms,which can easily be mistaken for other conditions.Additionally,the lack of specific diagnostic methods for IBD contributes to these delays.Delayed diagnosis of IBD can result in numerous adverse consequences,including increased intestinal damage,fibrosis,a higher risk of colorectal cancer,and a decrease in the quality of life of the patient.Therefore,it is essential to diagnose IBD promptly by raising physician awareness,enhancing patient education,and developing new diagnostic methods.

Research on Gear-box Fault Diagnosis Method Based on Adjusting-learning-rate PSO Neural Network

Based on the research of Particle Swarm Optimization (PSO) learning rate, two learning rates are changed linearly with velocity-formula evolving in order to adjust the proportion of social part and cognitional part; then the methods are applied to BP neural network training, the convergence rate is heavily accelerated and locally optional solution is avoided. According to actual data of two levels compound-box in vibration lab, signals are analyzed and their characteristic values are abstracted. By applying the trained BP neural networks to compound-box fault diagnosis, it is indicated that the methods are sound effective.

A Method for Gear Fault Diagnosis Based on the Empirical Mode Decomposition

According to the characteristics of gear fault vibration signals, a methodfor gear fault diagnosis based upon the empirical mode decomposition (EMD) is proposed in thispaper. By using EMD, any complicated signal can be decomposed into a finite and often small numberof intrinsic mode functions (IMFs) , which are based upon the local characteristic time scale of thesignal. Thus, EMD is perfectly suitable for non-stationary signal processing and faultcharacteristics extracting. It is well known that a gear vibration signal consists of a number offrequency family components, each of which is a modulated signal. Thus, we can use EMD to decomposea gear fault vibration signal into a number of IMF components, some of which correspond to thefrequency families, and the others are noises. Therefore, the frequency families can be separatedand the noise can be decreased at the same time. The proposed method has been applied to gear faultdiagnosis. The results show that both the sensitivity and the reliability of this method aresatisfactory.

A reasoning diagram based method for fault diagnosis of railway point system

Railway Point System(RPS)is an important infrastructure in railway industry and its faults may have significant impacts on the safety and efficiency of train operations.For the fault diagnosis of RPS,most existing methods assume that sufficient samples of each failure mode are available,which may be unrealistic,especially for those modes of low occurrence frequency but with high risk.To address this issue,this work proposes a novel fault diagnosis method that only requires the power signals generated under normal RPS operations in the training stage.Specifically,the failure modes of RPS are distinguished through constructing a reasoning diagram,whose nodes are either binary logic problems or those that can be decomposed into the problems of the binary logic.Then,an unsupervised method for the signal segmentation and a fault detection method are combined to make decisions for each binary logic problem.Based on the results of decisions,the diagnostic rules are established to identify the failure modes.Finally,the data collected from multiple real-world RPSs are used for validation and the results demonstrate that the proposed method outperforms the benchmark in identifying the faults of RPSs.

A case of 9p deletion syndrome with congenital infantile glaucoma,effective method of diagnosis,and treatment

Dear Editor,I am Dr.Jia X from the Department of Ophthalmology,Second Xiangya Hospital,Central South University,Changsha,China.I write to present a rare case report of 9p deletion syndrome with congenital infantile glaucoma in an infant,accompanying with an effective method of both diagnosis and treatment.

Application of local wave ti me-frequency method in reciprocating mechanical fault diagnosis

To diagnosethe reciprocating mechanical fault.We utilizedlocal waveti me-frequency approach.Firstly,we gave the principle.Secondly,the application of local wave ti me-frequency was given.Finally,we discusseditsvirtue in reciprocating mechanical fault diagnosis.

Fault Diagnosis Method Based on Xgboost and LR Fusion Model under Data Imbalance

Diagnosis methods based on machine learning and deep learning are widely used in the field of motor fault diagnosis.However,due to the fact that the data imbalance caused by the high cost of obtaining fault data will lead to insufficient generalization performance of the diagnosis method.In response to this problem,a motor fault monitoring system is proposed,which includes a fault diagnosis method(Xgb_LR)based on the optimized gradient boosting decision tree(Xgboost)and logistic regression(LR)fusion model and a data augmentation method named data simulation neighborhood interpolation(DSNI).The Xgb_LR method combines the advantages of the two models and has positive adaptability to imbalanced data.Simultaneously,the DSNI method can be used as an auxiliary method of the diagnosis method to reduce the impact of data imbalance by expanding the original data(signal).Simulation experiments verify the effectiveness of the proposed methods.

Vibration Diagnosis and Optimization of Industrial Robot Based on TPA and EMD Methods

This paper proposedmethod that combined transmission path analysis(TPA)and empirical mode decomposition(EMD)envelope analysis to solve the vibration problemof an industrial robot.Firstly,the deconvolution filter timedomain TPA method is proposed to trace the source along with the time variation.Secondly,the TPA method positioned themain source of robotic vibration under typically different working conditions.Thirdly,independent vibration testing of the Rotate Vector(RV)reducer is conducted under different loads and speeds,which are key components of an industrial robot.The method of EMD and Hilbert envelope was used to extract the fault feature of the RV reducer.Finally,the structural problems of the RV reducer were summarized.The vibration performance of industrial robots was improved through the RV reducer optimization.From the whole industrial robot to the local RV Reducer and then to the internal microstructure of the reducer,the source of defect information is traced accurately.Experimental results showed that the TPA and EMD hybrid methods were more accurate and efficient than traditional time-frequency analysis methods to solve industrial robot vibration problems.

Structural modal parameter identifi cation and damage diagnosis based on Hilbert-Huang transform

Traditional modal parameter identifi cation methods have many disadvantages,especially when used for processing nonlinear and non-stationary signals.In addition,they are usually not able to accurately identify the damping ratio and damage.In this study,methods based on the Hilbert-Huang transform(HHT) are investigated for structural modal parameter identifi cation and damage diagnosis.First,mirror extension and prediction via a radial basis function(RBF) neural network are used to restrain the troublesome end-effect issue in empirical mode decomposition(EMD),which is a crucial part of HHT.Then,the approaches based on HHT combined with other techniques,such as the random decrement technique(RDT),natural excitation technique(NExT) and stochastic subspace identifi cation(SSI),are proposed to identify modal parameters of structures.Furthermore,a damage diagnosis method based on the HHT is also proposed.Time-varying instantaneous frequency and instantaneous energy are used to identify the damage evolution of the structure.The relative amplitude of the Hilbert marginal spectrum is used to identify the damage location of the structure.Finally,acceleration records at gauge points from shaking table testing of a 12-story reinforced concrete frame model are taken to validate the proposed approaches.The results show that the proposed approaches based on HHT for modal parameter identifi cation and damage diagnosis are reliable and practical.

Improved CICA Algorithm Used for Single Channel Compound Fault Diagnosis of Rolling Bearings

A Compound fault signal usually contains multiple characteristic signals and strong confusion noise, which makes it difficult to separate week fault signals from them through conventional ways, such as FFT-based envelope detection, wavelet transform or empirical mode decomposition individually. In order to realize single channel compound fault diagnosis of bearings and improve the diagnosis accuracy, an improved CICA algorithm named constrained independent component analysis based on the energy method （E-CICA） is proposed. With the approach, the single channel vibration signal is firstly decomposed into several wavelet coefficients by discrete wavelet transform（DWT） method for the purpose of obtaining multichannel signals. Then the envelope signals of the reconstructed wavelet coefficients are selected as the input of E-CICA algorithm, which fulfills the requirements that the number of sensors is greater than or equal to that of the source signals and makes it more suitable to be processed by CICA strategy. The frequency energy ratio（ER） of each wavelet reconstructed signal to the total energy of the given synchronous signal is calculated, and then the synchronous signal with maximum ER value is set as the reference signal accordingly. By this way, the reference signal contains a priori knowledge of fault source signal and the influence on fault signal extraction accuracy which is caused by the initial phase angle and the duty ratio of the reference signal in the traditional CICA algorithm is avoided. Experimental results show that E-CICA algorithm can effectively separate out the outer-race defect and the rollers defect from the single channel compound fault and fulfill the needs of compound fault diagnosis of rolling bearings, and the running time is 0.12% of that of the traditional CICA algorithm and the extraction accuracy is 1.4 times of that of CICA as well. The proposed research provides a new method to separate single channel compound fault signals.

Fault diagnosis using noise modeling and a new artificial immune system based algorithm

A new fault classification/diagnosis method based on artificial immune system (AIS) algorithms for the structural systems is proposed. In order to improve the accuracy of the proposed method, i.e., higher success rate, Gaussian and non-Gaussian noise generating models are applied to simulate environmental noise. The identification of noise model, known as training process, is based on the estimation of the noise model parameters by genetic algorithms (GA) utilizing real experimental features. The proposed fault classification/diagnosis algorithm is applied to the noise contaminated features. Then, the results are compared to that obtained without noise modeling. The performance of the proposed method is examined using three laboratory case studies in two healthy and damaged conditions. Finally three different types of noise models are studied and it is shown experimentally that the proposed algorithm with non-Gaussian noise modeling leads to more accurate clustering of memory cells as the major part of the fault classification procedure.

Screening and early diagnosis of osteoporosis through X-ray and ultrasound based techniques

Effective prevention and management of osteoporosis would require suitable methods for population screenings and early diagnosis. Current clinicallyavailable diagnostic methods are mainly based on the use of either X-rays or ultrasound(US). All X-ray based methods provide a measure of bone mineral density(BMD), but it has been demonstrated that other structural aspects of the bone are important in determining fracture risk, such as mechanical features and elastic properties, which cannot be assessed using densitometric techniques. Among the most commonly used techniques, dual X-ray absorptiometry(DXA) is considered the current 'gold standard' for osteoporosis diagnosis and fracture risk prediction. Unfortunately, as other X-ray based techniques, DXA has specific limitations(e.g., use of ionizing radiation, large size of the equipment, high costs, limited availability) that hinder its application for population screenings and primary care diagnosis. This has resulted in an increasing interest in developing reliable pre-screening tools for osteoporosis such as quantitative ultrasound(QUS) scanners, which do not involve ionizing radiation exposure and represent a cheaper solution exploiting portable and widely available devices. Furthermore, the usefulness of QUS techniques in fracture risk prediction has been proven and, with the last developments, they are also becoming a more and more reliable approach for assessing bone quality. However, the US assessment of osteoporosis is currently used only as a pre-screening tool, requiring a subsequent diagnosis confirmation by means of a DXA evaluation. Here we illustrate the state of art in the early diagnosis of this 'silent disease' and show up recent advances for its prevention and improved management through early diagnosis.

Helicobacter pylori infection- recent developments in diagnosis

Considering the recommended indications for Helicobacter pylori(H.pylori)eradication therapy and the broad spectrum of available diagnostic methods,a reliable diagnosis is mandatory both before and after eradication therapy.Only highly accurate tests should be used in clinical practice,and the sensitivity and specificity of an adequate test should exceed 90%.The choice of tests should take into account clinical circumstances,the likelihood ratio of positive and negative tests,the cost-effectiveness of the testing strategy and the availability of the tests.This review concerns some of the most recent developments in diagnostic methods of H.pylori infection,namely the contribution of novel endoscopic evaluation methodologies for the diagnosis of H.pylori infection,such as magnifying endoscopy techniques and chromoendoscopy.In addition,the diagnostic contribution of histology and the urea breath test was explored recently in specific clinical settings and patient groups.Recent studies recommend enhancing the number of biopsy fragments for the rapid urease test.Bacterial culture from the gastric biopsy is the gold standard technique,and is recommended for antibiotic susceptibility test.Serology is used for initial screening and the stool antigen test is particularly used when the urea breath test is not available,while molecular methods have gained attention mostly for detecting antibiotic resistance.

A Neural-based L1-Norm Optimization Approach for Fault Diagnosis of Nonlinear Resistive Circuits

This paper deals with fault isolation in nonlinear analog circuits with tolerance under an insufficient number of independent voltage measurements.A neural network-based L1-norm optimization approach is proposed and utilized in locating the most likely faulty elements in nonlinear circuits.The validity of the proposed method is verified by both extensive computer simulations and practical examples.One simulation example is presented in the paper.

Diagnosis of boundary in early gastric cancer

Endoscopic submucosal dissection (ESD) is an advanced therapeutic endoscopic technique,which allowsresection of larger superficial tumors in the esophagus,stomach,and colon.Precise diagnosis of the boundary between tumor and the non-tumorous surrounding portion is especially important before starting ESD,because too much resection can potentially take more time and can induce a higher complication rate,while too little resection can result in a non-curative resection.The boundary diagnosis is often difficult for early gastric cancer,mainly because of the underlying condition of chronic gastritis.Due to recent developments in endoscopy,including magnified endoscopy and narrow band endoscopy,the boundary diagnosis is becoming easy and more accurate.We have also applied magnified endoscopy combined with narrow band imaging to fresh specimens immediately after resection using thetiling method and XY stage.

On-Line Broken-Bar Fault Diagnosis System of Induction Motor

Induction motor faults including mechanical and electrical faults are reviewed.The fault diagnosis methods are summarized.To analyze the influence of stator current,torque,speed and rotor current on faulted bars,a time-stepping transient finite element(FE)model of induction motor with bars faulted is created in this paper.With wavelet package analysis method and FFT method, the simulation result of finite element is analyzed.Based on the simulation analysis,the on-line fault diagnosis system of induction motor with bars faulted is developed.With the speed of broken bars motor changed from 1 478 r/min to 1 445 r/min,the FFT power spectra and the wavelet package decoupling factors are given.The comparison result shows that the on-line diagnosis system can detect broken-bar fault efficiently.

Static-deformation based fault diagnosis for damping spring of large vibrating screen

Based on the statics theory, a novel and feasible twice-suspended-mass method(TSMM) was proposed to deal with the seldom-studied issue of fault diagnosis for damping springs of large vibrating screen(LVS). With the static balance characteristic of the screen body/surface as well as the deformation compatibility relation of springs considered, static model of the screen surface under a certain load was established to calculate compression deformation of each spring. Accuracy of the model was validated by both an experiment based on the suspended mass method and the properties of the 3D deformation space in a numerical simulation. Furthermore, by adopting the Taylor formula and the control variate method, quantitative relationship between the change of damping spring deformation and the change of spring stiffness, defined as the deformation sensitive coefficient(DSC), was derived mathematically, from which principle of the TSMM for spring fault diagnosis is clarified. In the end, an experiment was carried out and results show that the TSMM is applicable for diagnosing the fault of single spring in a LVS.

Clinical Intelligent Diagnosis Path Based on the Chief Complaint

Goals of traditional Chinese medicine(TCM)include precision,accuracy,and recognition by clinical practice.Establishment of a diagnosis and treatment system that closely conforms to the principle-method-recipe-medicines system and derivation of an accurate diagnosis and treatment plan should be considerations of TCM.Artificial intelligence research based on computer technology is one of the effective ways to solve this problem.In the research of intelligent diagnosis path,reflecting the characteristics of the overall view and dialectical treatment of TCM such as"Combination of four diagnostic methods""overall examination""combination of disease and syndrome"and"treatment individualized to patient,season and locality"are key for successful research of artificial intelligence in TCM diagnosis or recognition by clinical practice.

Fault Diagnosis and Separation for a Distributed Rotary-laser Scanning System

The wMPS is a laser-based measurement system used for large scale metrology.However,it is susceptible to external factors such as vibrations,which can lead to unreliable measurements.This paper presents a fault diagnosis and separation method which can counter this problem.To begin with,the paper uses simple models to explain the fault diagnosis and separation methods.These methods are then mathematically derived using statistical analysis and the principles of the wMPS.A comprehensive solution for fault diagnosis and separation is proposed,considering the characteristics of the wMPS.The effectiveness of this solution is verified through experimental observations.It can be concluded that this approach can detect and separate false observations,thereby enhancing the reliability of the wMPS.