Utilising allelic dropout probabilities estimated by logistic regression in casework

Some advanced methods for DNA profile interpretation require a probability for the event of dropout. Methods have been suggested based on logistic regression. Two of these respectively use a proxy for template that is constant across loci and one that is modelled using an exponential curve. Both of these methods allow different modelling constants from each locus. A variant of the model using an exponential curve is discussed. This variant constrains the constants to be the same for every locus. We test these two methods and the variant by developing the constants (training) on one set of data and testing them on another. This mimics the likely use in casework. We find that the new variant appears to be the most useful in that it performs better than the other two options when trained on one data set and used on another. The hypothesised reason for this is that locus to locus variation in amplification efficiency varies with time, multimix batch, or from sample to sample.     

《FIGO 2018癌症报告》——子宫肉瘤诊治指南解读

正子宫肉瘤约占所有女性生殖道恶性肿瘤的1%,子宫体恶性肿瘤的3%～7%。因其罕见和组织病理学的多样性,目前仍缺乏最佳治疗方案和与不良预后相关的危险因素的共识。子宫肉瘤的亚型有平滑肌肉瘤、子宫内膜间质肉瘤(ESS)和子宫腺肉瘤。目前,癌肉瘤被认为     

美国妇产科医师学会“妊娠期恶心呕吐指南2015版”要点解读

正妊娠期恶心、呕吐是一种影响孕妇及其胎儿健康的常见疾病。早孕期轻度的恶心、呕吐是一种生理性反应;中度(和)或重度或病情迁延(和)或加重的妊娠期恶心、呕吐,会严重影响孕妇的生活质量,乃至危及母胎生命安全,需及时诊治。美国妇产科医师学会(ACOG)近年来针对妊娠期呕吐,颁布了一系列指南,并提出一些与妊娠期恶心、呕吐诊治有关的新观念及循证医学证据。本文对2015年颁布的第153号《妊娠期恶心     

《中国胰腺神经内分泌肿瘤诊疗指南（2020）》解读

胰腺神经内分泌肿瘤的临床决策路径复杂、诊疗难度较大，病人管理依赖多学科协调参与。为此，中华医学会外科学分会胰腺外科学组联合多领域专家，基于循证医学证据及我国现阶段医疗特点，联合制定了《中国胰腺神经内分泌肿瘤诊疗指南（2020）》，以进一步改进中国胰腺神经内分泌肿瘤病人的诊疗流程。该指南的推荐多基于临床证据充分、专家共识度高的观点。在学习现有指南的同时，应积极开展针对胰腺神经内分泌肿瘤的临床和基础研究，共同推动疾病标准化诊疗体系的建立。     

The importance of evaluating findings given activity level propositions in order to avoid misleading evidence

ABSTRACT

The advancement of DNA technology comes with the increased sensitivity of amplification systems, where DNA traces are routinely detected without a known biological source. These systems also have increased discriminating capacity, providing larger likelihood ratios (LRs) when a corresponding DNA profile is observed. Questions in court are shifting from identity to transfer mechanism, where the presence of an individual’s DNA is conceded by both parties, but the activities that led to its deposition is in dispute. One way of handling propositions developed at the activity level is with the use of graphical structures known as Bayesian Networks (BNs). The following is an evaluation of a case, given activity level propositions, through the application of BNs. Alternative case findings will be explored for the given scenario to show the potential value of the DNA evidence for different outcomes within the broader case context.     

Volume and Coverage of Secondary Imaging Interpretation Under Medicare, 2003 to 2016

PurposeThe aim of this study was to assess changing Medicare volumes of, and coverage for, secondary interpretations of diagnostic imaging examinations stratified by modality and body region service families.MethodsMedicare Physician/Supplier Procedure Summary Master Files for 2003 to 2016 were obtained. Aggregate Part B fee-for-service claims frequency and payment data were isolated for noninvasive diagnostic imaging and stratified by service family. Using published Medicare payment rules, secondary interpretations were identified as studies billed using both modifiers 26 and 77. Billed and denied services volumes were calculated and compared across modality and body region service families.ResultsSeven service families showed a compound annual growth rate from 2003 to 2016 of >20% (an additional 12 service families, >10% growth). For select high-volume service families (chest radiography and fluoroscopy [R&F], brain MRI, and abdominal and pelvic CT), relative growth in billed secondary interpretation services exceeded that for primary interpretations. In 2016, body region and modality service families with the most billed secondary interpretations were chest R&F (674,124), abdominal and pelvic R&F (65,566), brain CT (45,642), extremity R&F (34,560), abdominal and pelvic CT (14,269), and chest CT (10,914). All service families had secondary interpretation denial rates <25% in 2016 (15 service families, <10%).ConclusionsAmong Medicare beneficiaries, the frequency of billed secondary interpretation services for diagnostic imaging services increased from 2003 to 2016 across a broad range of modalities and body regions, often dramatically. Payment denial rates were consistently low across service families. As CMS continues to seek input on appropriate coverage for these services, these findings suggest increasing clinical demand for and payer acceptance of these value-added radiologist services.     

Breast Density Analysis Using an Automatic Density Segmentation Algorithm

Breast density is a strong risk factor for breast cancer. In this paper, we present an automated approach for breast density segmentation in mammographic images based on a supervised pixel-based classification and using textural and morphological features. The objective of the paper is not only to show the feasibility of an automatic algorithm for breast density segmentation but also to prove its potential application to the study of breast density evolution in longitudinal studies. The database used here contains three complete screening examinations, acquired 2 years apart, of 130 different patients. The approach was validated by comparing manual expert annotations with automatically obtained estimations. Transversal analysis of the breast density analysis of craniocaudal (CC) and mediolateral oblique (MLO) views of both breasts acquired in the same study showed a correlation coefficient of ρ = 0.96 between the mammographic density percentage for left and right breasts, whereas a comparison of both mammographic views showed a correlation of ρ = 0.95. A longitudinal study of breast density confirmed the trend that dense tissue percentage decreases over time, although we noticed that the decrease in the ratio depends on the initial amount of breast density.     

2009—2020年合肥市肺结核空间特征分析

目的: 分析2009—2020年合肥市肺结核疫情特征及空间聚集性。方法: 通过收集“中国疾病预防控制信息系统”的子系统“结核病管理信息系统”中合肥市2009—2020年肺结核数据,筛选出肺结核患者42681例,利用GeoDa和Arcgis 10.8空间分析软件进行分析,在街道/乡镇水平上绘制空间分布地图,探索空间分布规律及肺结核发病冷热点地区。结果: 2009—2020年合肥市肺结核共报告42681例,报告发病率从2009年57.96/10万(4195/7237966)下降到2020年31.04/10万(2908/9369881),整体呈现波动下降趋势($\chi _{趋势}^{2}$=12.531,P<0.001);全局空间自相关结果显示2009—2014年合肥市肺结核发病呈现空间自相关性(Moran’s I值均>0,P值均<0.05);2015—2020年空间分布偏向随机性。局部自相关分析显示高-高聚集发病街道/乡镇主要集中在长丰县、肥东县;低-低聚集区主要集中在老城区(庐阳区、包河区)。冷热点分析发现,热点区域有2个,分布在长丰县义井乡和肥西县严店乡。结论: 合肥市肺结核疫情存在一定的聚集性,后续应针对不同的县(区)街道/乡镇特点采取不同的防控措施,加大高-高聚集区的街道和热点区域的防控力度。