Search

The measured 14 C: 12 C isotopic ratio of atmospheric CO 2 (and its associated derived Δ 14 C value) is an ideal tracer for determination of the fossil fuel derived CO 2 enhancement contributing to any atmospheric CO 2 measurement ( C ff ). Given enough such measurements, independent top-down estimation of US fossil fuel-CO 2 emissions should be possible. However, the number of Δ 14 C measurements is presently constrained by cost, available sample volume, and availability of mass spectrometer measurement facilities. Δ 14 C is therefore measured in just a small fraction of samples obtained by ask air sampling networks around the world. Here, we develop a Projection Pursuit Regression (PPR) model to predict C ff as a function of multiple surrogate gases acquired within the NOAA/ESRL Global Greenhouse Gas Reference Network (GGGRN). The surrogates consist of measured enhancements of various anthropogenic trace gases, including CO, SF 6 , and halo- and hydrocarbons acquired in vertical airborne sampling profiles near Cape May, NJ and Portsmouth, NH from 2005 through 2010. Model performance for these sites is quantified based on predicted values corresponding to test data excluded from the model building process. Chi-square hypothesis test analysis indicates that these predictions and corresponding observations are consistent given our uncertainty budget which accounts for random effects and one particular systematic effect. However, quantification of the combined uncertainty of the prediction due to all relevant systematic effects is difficult because of the limited range of the observations and their relatively high fractional uncertainties at the sampling sites considered here. To account for the possibility of additional systematic effects, we incorporate another component of uncertainty into our budget. Expanding the number of Δ 14 C measurements in the NOAA GGGRN and building new PPR models at additional sites would improve our understanding of uncertainties and potentially increase the number of C ff estimates by approximately a factor of three. Provided that these estimates are of comparable quality to Δ 14 C-based estimates, we expect an improved determination of fossil fuel-CO 2 emissions.

Purpose: To conduct post-hoc analysis of National CT Colonography Trial data and compare the sensitivity and specificity of computed tomographic (CT) colonography in participants younger than 65 years with those in participants aged 65 years and older., Materials and Methods: Of 2600 asymptomatic participants recruited at 15 centers for the trial, 497 were 65 years of age or older. Approval of this HIPAA-compliant study was obtained from the institutional review board of each site, and informed consent was obtained from each subject. Radiologists certified in CT colonography reported lesions 5 mm in diameter or larger. Screening detection of large (≥10-mm) histologically confirmed colorectal neoplasia was the primary end point; screening detection of smaller (6-9-mm) colorectal neoplasia was a secondary end point. The differences in sensitivity and specificity of CT colonography in the two age cohorts (age < 65 years and age ≥ 65 years) were estimated with bootstrap confidence intervals (CIs)., Results: Complete data were available for 477 participants 65 years of age or older (among 2531 evaluable participants). Prevalence of adenomas 1 cm or larger for the older participants versus the younger participants was 6.9% (33 of 477) versus 3.7% (76 of 2054) (P < .004). For large neoplasms, mean estimates for CT colonography sensitivity and specificity among the older cohort were 0.82 (95% CI: 0.644, 0.944) and 0.83 (95% CI: 0.779, 0.883), respectively. For large neoplasms in the younger group, CT colonography sensitivity and specificity were 0.92 (95% CI: 0.837, 0.967) and 0.86 (95% CI: 0.816, 0.899), respectively. Per-polyp sensitivity for large neoplasms for the older and younger populations was 0.75 (95% CI: 0.578, 0.869) and 0.84 (95% CI: 0.717, 0.924), respectively. For the older and younger groups, per-participant sensitivity was 0.72 (95% CI: 0.565, 0.854) and 0.81 (95% CI: 0.745, 0.882) for detecting adenomas 6 mm in diameter or larger., Conclusion: For most measures of diagnostic performance and in most subsets, the difference between senior-aged participants and those younger than 65 years was not statistically significant.

Objective: Our objectives are to describe the CT features of angiotensin-converting enzyme (ACE) inhibitor-induced visceral angioedema and to review other conditions that may have similar findings., Conclusion: CT findings in a patient taking an angiotensin-converting enzyme (ACE) inhibitor help in the diagnosis and subsequent treatment of ACE inhibitor-induced visceral angioedema.

Objective: The objective of this article is to describe the experience of the National CT Colonography Trial with radiologist training and qualification testing at CT colonography (CTC) and to correlate this experience with subsequent performance in a prospective screening study., Subjects and Methods: Ten inexperienced radiologists participated in a 1-day educational course, during which partial CTC examinations of 27 cases with neoplasia and full CTC examinations of 15 cases were reviewed using primary 2D and 3D search. Subsequently 15 radiologists took a qualification examination composed of 20 CTC cases. Radiologists who did not pass the first qualification examination attended a second day of focused retraining of 30 cases, which was followed by a second qualification examination. The results of the initial and subsequent qualification tests were compared with reader performance in a large prospective screening trial., Results: All radiologists took and passed the qualification examinations. Seven radiologists passed the qualification examination the first time it was offered, and eight radiologists passed after focused retraining. Significantly better sensitivities were obtained on the second versus the first examination for the retrained radiologists (difference = 16%, p < 0.001). There was no significant difference in sensitivities between the groups who passed the qualification examination the first time versus those who passed the second time in the prospective study (88% vs 92%, respectively; p = 0.612). In the prospective study, the odds of correctly identifying diseased cases increased by 1.5 fold for every 50-case increase in reader experience or formal training (p < 0.025)., Conclusion: A significant difference in performance was observed among radiologists before formalized training, but testing and focused retraining improved radiologist performance, resulting in an overall high sensitivity across radiologists in a subsequent, prospective screening study.