AIM： To evaluate accuracy of in vivo diagnosis of ad- enomatous vs non-adenomatous polyps using/-SCAN digital chromoendoscopy compared with high-definition white light. METHODS： This is a single-center comparative e...AIM： To evaluate accuracy of in vivo diagnosis of ad- enomatous vs non-adenomatous polyps using/-SCAN digital chromoendoscopy compared with high-definition white light. METHODS： This is a single-center comparative effec- tiveness pilot study. Polyps （n = 103） from 75 average- risk adult outpatients undergoing screening or surveil- lance colonoscopy between December 1, 2010 and April 1, 2011 were evaluated by two participating en- doscopists in an academic outpatient endoscopy center. Polyps were evaluated both with high-definition white light and with/-SCAN to make an/n vivo prediction of adenomatous vs non-adenomatous pathology. We de- termined diagnostic characteristics of/-SCAN and high- definition white light, including sensitivity, specificity, and accuracy, with regards to identifying adenomatous vs non-adenomatous polyps. Histopathologic diagnosis was the gold standard comparison. RESULTS： One hundred and three small polyps, de- tected from forty-three patients, were included in the analysis. The average size of the polyps evaluated in the analysis was 3.7 mm （SD 1.3 mm, range 2 mm to 8 mm）. Formal histopathology revealed that 54/103 （52.4%） were adenomas, 26/103 （25.2%） were hyper- plastic, and 23/103 （22.3%） were other diagnoses in- clude ＂lymphoid aggregates＂, ＂non-specific colitis,＂ and ＂no pathologic diagnosis.＂ Overall, the combined accu- racy of endoscopists for predicting adenomas was iden- tical between/-SCAN （71.8%, 95%CI： 62.1%-80.3%） and high-definition white light （71.8%, 95%CI： 62.1%-80.3%）. However, the accuracy of each endosco- pist differed substantially, where endoscopist A demon- strated 63.0% overall accuracy （95%CI： 50.9%-74.0%） as compared with endoscopist B demonstrating 93.3% overall accuracy （95%CI： 77.9%-99.2%）, irrespective of imaging modality. Neither endoscopist demonstrated a significant learning effect with i-SCAN during the study. Though endoscopist A increased accuracy using/-SCAN from 59% （95%CI： 42.1%-74.4%） in the first half to 67.6% （95%CI： 49.5%-82.6%） in the second half, and endoscopist B decreased accuracy usingi-SCAN from 100% （95%CI： 80.5%-100.0%） in the first half to 84.6% （95%CI： 54.6%-98.1%） in the second half, nei- ther of these differences were statistically significant. CONCLUSION：i-SCAN and high-definition white light had similar efficacy predicting polyp histology. Endosco- pist training likely plays a critical role in diagnostic test characteristics and deserves further study.展开更多
The response surface methodology （Box-behnken design） was acknowledged for the production of optimized protein enriched pasta. Studied responses （protein, overall acceptability, hue angle and hardness） resulted to...The response surface methodology （Box-behnken design） was acknowledged for the production of optimized protein enriched pasta. Studied responses （protein, overall acceptability, hue angle and hardness） resulted to high protein pasta. The optima were at 12.5%,5 mung bean, 10% whey protein concentrate and 6% egg albumen in combination. Best combination of protein source and their respective level for high protein pasta on the quality evaluation basis were mung bean （15%） ＋ whey protein concentrate （10%）; mung bean （15%） ＋ egg albumen （6%）; mung bean （15%） ＋ whey protein concentrate （10%） ＋ egg albumen （6%）. Hue angle and Hardness remained within acceptable range. Model adequacy was supported with lack of fit test. Enriched protein pasta had excellent cooking and sensory quality during storage period of 4 months. ERH value ranged from 34-36 per cent had supported the results. Rheological properties and good storage behaviour （4 months） had also enhanced the quality of optimized protein enriched pasta. Enriched pasta was rated excellent by 70 per cent of the consumers in mass acceptability trials.展开更多
基金Supported by An Unrestricted Educational Grant from PENTAX Medical CompanyA Career Development Research Awardfrom the American Society for Gastrointestinal Endoscopy,to Dr.Gellad
文摘AIM： To evaluate accuracy of in vivo diagnosis of ad- enomatous vs non-adenomatous polyps using/-SCAN digital chromoendoscopy compared with high-definition white light. METHODS： This is a single-center comparative effec- tiveness pilot study. Polyps （n = 103） from 75 average- risk adult outpatients undergoing screening or surveil- lance colonoscopy between December 1, 2010 and April 1, 2011 were evaluated by two participating en- doscopists in an academic outpatient endoscopy center. Polyps were evaluated both with high-definition white light and with/-SCAN to make an/n vivo prediction of adenomatous vs non-adenomatous pathology. We de- termined diagnostic characteristics of/-SCAN and high- definition white light, including sensitivity, specificity, and accuracy, with regards to identifying adenomatous vs non-adenomatous polyps. Histopathologic diagnosis was the gold standard comparison. RESULTS： One hundred and three small polyps, de- tected from forty-three patients, were included in the analysis. The average size of the polyps evaluated in the analysis was 3.7 mm （SD 1.3 mm, range 2 mm to 8 mm）. Formal histopathology revealed that 54/103 （52.4%） were adenomas, 26/103 （25.2%） were hyper- plastic, and 23/103 （22.3%） were other diagnoses in- clude ＂lymphoid aggregates＂, ＂non-specific colitis,＂ and ＂no pathologic diagnosis.＂ Overall, the combined accu- racy of endoscopists for predicting adenomas was iden- tical between/-SCAN （71.8%, 95%CI： 62.1%-80.3%） and high-definition white light （71.8%, 95%CI： 62.1%-80.3%）. However, the accuracy of each endosco- pist differed substantially, where endoscopist A demon- strated 63.0% overall accuracy （95%CI： 50.9%-74.0%） as compared with endoscopist B demonstrating 93.3% overall accuracy （95%CI： 77.9%-99.2%）, irrespective of imaging modality. Neither endoscopist demonstrated a significant learning effect with i-SCAN during the study. Though endoscopist A increased accuracy using/-SCAN from 59% （95%CI： 42.1%-74.4%） in the first half to 67.6% （95%CI： 49.5%-82.6%） in the second half, and endoscopist B decreased accuracy usingi-SCAN from 100% （95%CI： 80.5%-100.0%） in the first half to 84.6% （95%CI： 54.6%-98.1%） in the second half, nei- ther of these differences were statistically significant. CONCLUSION：i-SCAN and high-definition white light had similar efficacy predicting polyp histology. Endosco- pist training likely plays a critical role in diagnostic test characteristics and deserves further study.
文摘The response surface methodology （Box-behnken design） was acknowledged for the production of optimized protein enriched pasta. Studied responses （protein, overall acceptability, hue angle and hardness） resulted to high protein pasta. The optima were at 12.5%,5 mung bean, 10% whey protein concentrate and 6% egg albumen in combination. Best combination of protein source and their respective level for high protein pasta on the quality evaluation basis were mung bean （15%） ＋ whey protein concentrate （10%）; mung bean （15%） ＋ egg albumen （6%）; mung bean （15%） ＋ whey protein concentrate （10%） ＋ egg albumen （6%）. Hue angle and Hardness remained within acceptable range. Model adequacy was supported with lack of fit test. Enriched protein pasta had excellent cooking and sensory quality during storage period of 4 months. ERH value ranged from 34-36 per cent had supported the results. Rheological properties and good storage behaviour （4 months） had also enhanced the quality of optimized protein enriched pasta. Enriched pasta was rated excellent by 70 per cent of the consumers in mass acceptability trials.
