Biasing Influence of ‘Mental Shortcuts’ on Diagnostic Decision-Making: Radiologists Can Overlook Breast Cancer in Mammograms When Prior Diagnostic Information Is Available

When making decisions under uncertainty, people in all walks of life, including highly trained medical professionals, tend to resort to using ‘mental shortcuts’, or heuristics. Anchoring-and-adjustment (AAA) is a well-known heuristic in which subjects reach a judgment by starting from an initial internal judgment (‘anchored position’) based on available external information (‘anchoring information’) and adjusting it until they are satisfied. We studied the effects of the AAA heuristic during diagnostic decision-making in mammography. We provided practicing radiologists (N = 27 across two studies) a random number that we told them was the estimate of a previous radiologist of the probability that a mammogram they were about to see was positive for breast cancer. We then showed them the actual mammogram. We found that the radiologists’ own estimates of cancer in the mammogram reflected the random information they were provided and ignored the actual evidence in the mammogram. However, when the heuristic information was not provided, the same radiologists detected breast cancer in the same set of mammograms highly accurately, indicating that the effect was solely attributable to the availability of heuristic information. Thus, the effects of the AAA heuristic can sometimes be so strong as to override the actual clinical evidence in diagnostic tasks.

Biochemical markers of connective tissue metabolism in the diagnostics of respiratory diseases in human and animals: retrospective analysis (1984–2010)

The aim: to analyze the literature data for the period from 1984 to 2010 on the use of biochemical markers of disorders of connective tissue metabolism in diseases of the respiratory system in humans and animals. Materials and methods. The research was conducted by the method of scientific literature open source analysis: PubMed, Elsevier, electronic resources of the National Library named after V.I. Vernadsky (1984–2010). Results. In the case of diseases of the respiratory system in humans, the pathogenesis of pneumonia is the development of inflammation in the interstitial, peribronchial, perivascular and perilobular connective tissue, lymphatic vessels of the lungs, followed by involvement of alveoli and bronchioles in the inflammation. The morphological basis of these changes may be pneumofibrosis and pneumosclerotic changes. In the chronic course of pneumonia, chronic obstructive pulmonary disease develops. This pathology is closely related to the action of inflammatory cytokines that regulate connective tissue proliferation. Similar studies were performed on eosinophilic bronchopneumonia in dogs, but the material for the study was bronchoalveolar lavage. The current method of diagnosing respiratory diseases using cytokines (interleukin-4, interferon-γ) and bronchoalveolar lavage has no diagnostic information in chronic bronchitis and bronchial asthma in cats. Fundamental studies of connective tissue biopolymers in clinically healthy and bronchopneumonia piglets have recently been conducted in veterinary medicine. Conclusions. Recently, in medicine of particular interest to researchers is the determination of the content in biological fluids of indicators of connective tissue metabolism (hydroxyproline, glycosaminoglycans, glycoproteins, sialic acids) to diagnose diseases of the respiratory system. To diagnose connective tissue disorders in lung diseases in medical practice use indicators of oxyproline in serum and urine. Oxyproline is one of the most important components of lung collagen. An increase in the content of free oxyproline in the blood indicates an increased rate of collagen breakdown in the lung tissue. Analysis of oxyproline fractions, as indicators of the direction of collagen metabolism, allows to assess the condition of the connective tissue of the lungs and can serve as a prognostic criterion for the course of the disease. Thus, the indicators of connective tissue metabolism showed significant diagnostic information, which allowed to recommend them for use in the practice of veterinary medicine.

MRI for paediatric flatfoot: Is it necessary?

Objective: To determine the additional benefit of MRI for children with flatfoot deformity assessed with weight-bearing radiographs in a specialist paediatric orthopaedic unit. Methods and materials: Patient cohort was obtained by searching the Radiology Information System for children referred for investigation of flatfoot. All patients with flatfoot on weight bearing radiographs who had undergone MRI were included. Radiographs were classified by a consultant musculoskeletal radiologist as showing no underlying abnormality, talo-calcaneal coalition, calcaneo-navicular coalition, accessory navicular or other abnormality. MRI studies were classified similarly by a different consultant musculoskeletal radiologist blinded to the radiographic findings. Results: 33 males and 24 females were included (mean age 12.5 years; range 3–18 years). Twenty-four had bilateral abnormality, so 81 feet were assessed. Radiographs showed no specific abnormality (n = 51), talo-calcaneal coalition (n = 6), calcaneo-navicular coalition (n = 3), os naviculare (n = 12) or other abnormality (n = 9). MRI showed no specific abnormality (n = 40), talo-calcaneal coalition (n = 10), calcaneo-navicular coalition (n = 5), os naviculare (n = 12) or other abnormality (n = 14). Assuming MRI as the diagnostic gold standard, additional relevant diagnostic information was identified in 19 (23.5%) cases, while in the 51 cases for which radiographs provided no specific diagnosis MRI confirmed no underlying abnormality in 31 (60.8%). Conclusion: MRI is a valuable adjunct to weight bearing radiography for investigating paediatric flatfoot deformity. Advances in knowledge: MRI is of value in the assessment of paediatric flatfoot, additional diagnostic information to radiography being identified in 23.5% cases, while in 60.8% of cases for which radiographs provided no specific diagnosis MRI confirmed no underlying abnormality.

An effort to enhance the threshold contrast index of gas Cherenkov detectors

Because of being capable of excluding the most of secondary gamma rays interference, gas Cherenkov detectors have been the primary candidate for fusion gamma rays detection. It is a goal worthy of long-term efforts to enhance the threshold contrast index used for evaluating the ability of GCD to exclude below-threshold interference. The paper presents the way of enhancing the index through ultraviolet reflection selective suppression of scintillation signal in the detectors. Both theoretical estimation and experimental verification demonstrate that the threshold contrast index can be enhanced by 5.5 times after applying this method. This provides possibilities of obtaining better fusion gamma rays detection waveforms and higher confidence diagnostic information.

Extensive Intramyocardial Calcifications: Value of Multimodality Imaging

Massive myocardial calcification is a very rare finding. Accurate identification and characterization may help the clinicians to determine the etiology and clinical significance. In this case, the diagnostic pathway excluded previous myocardial infarction, myocarditis and calcium-phosphate disorders. A possible dystrophic etiology was considered. There are no standardized imaging features available to classify specific subtypes of intramyocardial calcifications. The relative merits of cardiac computed tomography and magnetic resonance in providing complimentary diagnostic information for calcific myocardial lesions is shown. Knowledge of the potential etiology and their imaging patterns are important to provide a concise and accurate differential diagnosis.

The Condition of Photovoltaic Modules under Random Operation Parameters

The paper presents an original method underlying an efficient tool for assessing the condition of photovoltaic (PV) modules, in particular, those made of amorphous cells. Significantly random changes in operational parameters characterize amorphous cell operation and cause them to be challenging to test, especially in working conditions. To develop the method, the authors modified the residual method with incorporated histograms. The proposed method has been verified through experiments that show the usefulness of the proposed approach. It significantly minimizes the risk of false diagnostic information in assessing the condition of photovoltaic modules. Based on the proposed methods, the inference results confirm the effectiveness of the concept for evaluating the degree of failure of the photovoltaic module described in the paper.

Light detection and ranging (LIDAR) laser altimeter for the Martian Moons Exploration (MMX) spacecraft

An altimeter is a critical instrument in planetary missions, for both safe operations and science activities. We present required specifications and link budget calculations for light detection and ranging (LIDAR) onboard the Martian Moons Exploration (MMX) spacecraft. During the mission phase, this LIDAR will continuously measure the distance between the spacecraft and its target. The time-series distance provides important diagnostic information for safe spacecraft operations and important information for geomorphological studies. Because MMX is a sample return mission, its LIDAR must accommodate physical disturbances on the Martian satellite surface. This resulted in changes to the optical system design. Graphical abstract

Diagnostic Information Analysis of Quickly Changing Temperature of Exhaust Gas from Marine Diesel Engine Part I Single Factor Analysis

In this paper, attention was paid to the problem of low controllability of marine medium- and high-speed engines during operation, which significantly limits the parametric diagnosis. The measurement of quickly changing temperature of engine exhaust gas was proposed, the courses of which can be a source of diagnostic information. The F statistic of the Fisher-Snedecor distribution was chosen as a statistical tool. Laboratory tests were carried out on the bench of a Farymann Diesel engine. The tests consisted of introducing the real changes in the constructional structure of the considered functional systems of the engine. Three changed parameters for the structure were reviewed: the active cross-sectional area of the inlet air channel, injector opening pressure and compression ratio. Based on the recorded plots of the quick-changing temperatures of the exhaust gases, three diagnostic measures were defined and subjected to statistical tests. The following data were averaged over one cycle for a 4-stroke piston engine operation, (1) the peak-to-peak value of the exhaust gas temperature, (2) the specific enthalpy of the exhaust gas, and (3) the rate of increase and decrease in the values for the quick-changing exhaust gas temperature. In this paper will present results of the first stage of the elimination study: the one-factor statistical analysis (randomised complete plan). The next part will present the results of the second stage of studies: two-factor analysis (block randomised plan), where the significance of the effect of changing the values of the structure parameters on the diagnostic measures was analysed in the background of a variable engine load.