In recent years, dataanalysis systems that combine natural language generation and visualization are increasing. The medium of text is superior to visualization in that it does not require special knowledge for users...
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To better understand how model resolution affects the formation of Arctic boundary layer clouds,we investigated the influence of grid spacing on simulating cloud streets that occurred near Utqiaġvik(formerly Barrow),A...
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To better understand how model resolution affects the formation of Arctic boundary layer clouds,we investigated the influence of grid spacing on simulating cloud streets that occurred near Utqiaġvik(formerly Barrow),Alaska,on 2 May 2013 and were observed by MODIS(the Moderate Resolution Imaging Spectroradiometer).The Weather Research and Forecasting model was used to simulate the clouds using nested domains with increasingly fine resolution ranging from a horizontal grid spacing of 27 km in the boundary-layer-parameterized mesoscale domain to a grid spacing of 0.111 km in the large-eddy-permitting *** investigated the model-simulated mesoscale environment,horizontal and vertical cloud structures,boundary layer stability,and cloud properties,all of which were subsequently used to interpret the observed roll-cloud *** model resolution led to a transition from a more buoyant boundary layer to a more shear-driven turbulent boundary *** clouds were stratiform-like in the mesoscale domain,but as the model resolution increased,roll-like structures,aligned along the wind field,appeared with ever smaller wavelengths.A stronger vertical water vapor gradient occurred above the cloud layers with decreasing grid *** fixed model grid spacing at 0.333 km,changing the model configuration from a boundary layer parameterization to a large-eddy-permitting scheme produced a more shear-driven and less unstable environment,a stronger vertical water vapor gradient below the cloud layers,and the wavelengths of the rolls decreased *** this study,only the large-eddy-permitting simulation with gird spacing of 0.111 km was sufficient to model the observed roll clouds.
ObjectivesThe aim of this study was to assess the performance and optimal cut-off points of UDFF for the non-invasive assessment of liver steatosis, using transient elastography (TE) with CAP as a reference method. Ma...
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ObjectivesThe aim of this study was to assess the performance and optimal cut-off points of UDFF for the non-invasive assessment of liver steatosis, using transient elastography (TE) with CAP as a reference method. MaterialsWe included 271 consecutive patients, with or without chronic liver disease (43.7% female, mean age 53.3 ± 13.05 years). Liver steatosis was evaluated in the same session by two techniques: UDFF - using a Siemens ACUSON Sequoia system (Deep Abdominal Transducer-DAX) and by CAP – using a FibroScan Compact M 530 device (M and XL probes). The following CAP cut-off values were used to differentiate among different grades of steatosis: 248dB/m for mild steatosis (S1), 268 dB/m for moderate steatosis (S2) and 280 dB/m for severe steatosis (S3). ResultsAccording to BMI, from the 271 patients 41% were obese, 34% were overweight and 25% normal weight. The correlation between UDFF and CAP was good, r=0.75, p<0.0001. We calculated the following UDFF optimal cut-off values to differentiate among steatosis grades: for S1->5% [(with 88.4% Se, 77.5% Sp,73.8% NPV, 90.3% PPV and an AUC of 0.92 (0.89-0.95), p< 0.0001];for S2 >10% [(with 69.3% Se, 99% Sp, 99.1% NPV, 67.9% PPV and an AUC of 0.95 (0.92-0.97), p< 0.0001]; and for S3 >15% [(with46.9% Se, 100% Sp, 100% NPV, 60.5% PPV and an AUC of 0.93 (0.89-0.96), p<0.0001]. ConclusionsUDFF is a good method for classifying steatosis severity with the following cut-offs:> 5% for mild steatosis,> 10% for moderate steatosis and > 15% for severe steatosis,the specificity increasing with steatosis severity.
ObjectivesLiver steatosis can progress to nonalcoholic steatohepatitis and liver cirrhosis, becoming one of the leading indications for liver transplantation. Therefore, early detection and staging of steatosis is ver...
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ObjectivesLiver steatosis can progress to nonalcoholic steatohepatitis and liver cirrhosis, becoming one of the leading indications for liver transplantation. Therefore, early detection and staging of steatosis is very important. In addition to Transient Elastography (TE) with Controlled Attenuation Parameter (CAP), several methods were developed for steatosis assessment. The aim of our study was to evaluate the feasibility of two new quantitative ultrasound (QUS) parameters, TSI (tissue scatter-distribution imaging) and TAI (tissue attenuation imaging) for steatosis diagnosis considering CAP as reference. MaterialsA prospective study was conducted in which liver steatosis was assessed in 67 patients (65.7% men, mean age 55.6 ± 13.2 years), evaluated in the same session by QUS and CAP implemented on the following systems: Samsung Medison RS85 (CA1-7A probe) and FibroScan Compact M 530 (M and XL probes), respectively. For CAP, reliable measurements were defined as the median value of 10 measurements with IQR/M<0.3. For QUS, five consecutive measurements of TAI and TSI were acquired by a color-coded map overlaid on B-mode ultrasound. Attenuation coefficient and scatter-distribution coefficient were automatically calculated and reliable measurements were defined as an reliability index, R2 over 0.6. The cut-off value by CAP for identifying the presence of at least mild steatosis was 248 dB/m [1]. ResultsReliable measurements by CAP and TAI/TSI were obtained in 100% of cases. Moderate correlations between steatosis assessment methods were observed: TAI vs. CAP r=0.67, TSI vs. CAP r=0.53, TSI vs. TAI, r=0.63. The best cut-off value for TAI to identify at least mild steatosis was > 0.66 (AUROC=0.87, p<0.0001, Se=81.2%, Sp=84.2%, PPV=92.9%, NPV=64%). The best cut-off value for TSI for identifying at least mild steatosis was > 96.2 (AUROC=0.81, p<0.0001, Se=81.2%, Sp=84.2%, PPV=88.6%, NPV=64%). ConclusionsTAI and TSI are feasible methods for assessing liver steatosis, whic
ObjectivesNon-invasive ultrasound-based techniques for liver stiffness assessment (LS) were developed as an alternative to liver biopsy. Transient Elastography (TE) is the first method validated by several guidelines ...
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ObjectivesNon-invasive ultrasound-based techniques for liver stiffness assessment (LS) were developed as an alternative to liver biopsy. Transient Elastography (TE) is the first method validated by several guidelines and other new methods were developed recently. The aim of this study was to evaluate the performance of two point Shear Waves Elastography (pSWE) techniques implemented in the same ultrasound system for liver stiffness assessment, using TE as reference. MaterialsA prospective study was conducted, in which 271 consecutive patients with or without previously diagnosed liver disease were included. LS was evaluated by point Shear Wave Elastography (pSWE and Auto pSWE) implemented on Siemens ACUSON Sequoia system (Deep Abdominal Transducer-DAX) and by TE using FibroScan Compact M 530 system (M and XL probes).For Auto pSWE, 15 measurements/values are automatically obtained in a single evaluation and the median and IQR are calculated. For p-SWE and TE, reliable measurements were defined as the median value of 10 measurements with IQR/M<0.3 for all probes. For significant fibrosis, a cut-off value by TE of 7 kPa was used, and for liver cirrhosis 12 kPa [1]. ResultsValid LSM were obtained in all 271 (100%) patients using both elastographic methods. A very good positive correlation was found between the LS values obtained by TE and both Auto pSWE and pSWE: r=0.78, p< 0.0001; and between Auto pSWE and p-SWE: r=0.92, p<0.0001. The best pSWE and Auto pSWE cut-off value for significant fibrosis (F≥2) was 5.1 kPa (p-SWE: AUC- 0.81; Se-58.3%; Sp-94.6%; PPV-83.1%; NPV-83.5%; Auto pSWE: AUC- 0.82; Se-63.1%; Sp-90.4%; PPV-76.8%; NPV-84.4%) and for liver cirrhosis (F4) was 6.7 kPa (p-SWE: AUC- 0.92; Se-73.8%; Sp-94.3%; PPV-83.8%; NPV-95.3%; Auto pSWE: AUC- 0.93; Se-78.5%; Sp-97.8%; PPV-86.8%; NPV-96.1%). ConclusionsThe two techniques, pSWE and Auto pSWE have very good correlations with TE and similar performance for predicting significant fibrosis and liver cirrhosis in a
ObjectivesLiver fibrosis is a progressive process leading to liver cirrhosis. Several non-invasive elastography techniques were developed in order to perform liver stiffness measurements (LS). The aim of this stu...
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ObjectivesLiver fibrosis is a progressive process leading to liver cirrhosis. Several non-invasive elastography techniques were developed in order to perform liver stiffness measurements (LS). The aim of this study was to evaluate the performance and feasibility of 2D-Shear Wave Elastography (2D-SWE) for liver fibrosis (LF) assessment using Transient Elastography (TE) as the reference method. Materials67 subjects were included, 65% (44/67) male, mean age 55.6 ± 13.2, in which LS was evaluated in the same session by TE (FibroScan Compact M 530) and 2D-SWE (Samsung-Medison RS85). Reliable LS measurements were defined for TE the median value of 10 measurements with an IQR/M≤30%, while for 2D-SWE the median value of 10 measurements, with a reliability measurement index (RMI)≥ 0.5 and IQR/M ≤30%. For classification of LF severity we used TE as reference method with cut-off value ≥ 7 kPa for at least significant liver fibrosis [1]. ResultsReliable measurements by TE and 2D-SWE were obtained in all 67 cases. A strong correlation was found between 2D-SWE and TE, r=0.83. The best cut-off value for 2D-SWE in identifying at least significant fibrosis (F≥2) was >7 kPa [AUROC=0.91, 95% CI (0.82;0.97), p<0.0001, Se=81.8%, Sp=80.0%, PPV=66.7%, NPV=90.0%]. Conclusions2D-SWE is a feasible method for assessing liver fibrosis, that strongly correlates with TE results.
ObjectivesThe aim of this study was to assess the performance and optimal cut-off points for p-SWE and 2D-SWE for the non-invasive assessment of advanced liver fibrosis, using transient elastography as a reference met...
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ObjectivesThe aim of this study was to assess the performance and optimal cut-off points for p-SWE and 2D-SWE for the non-invasive assessment of advanced liver fibrosis, using transient elastography as a reference method. MaterialsSiemens ACUSON Sequoia (5C-1 convex transducer and Deep Abdominal Transducer-DAX) and FibroScan Compact M 530 (M and XL probes) were used. We included 198 consecutive patients with or without chronic liver disease that had all five LS values available. LS was evaluated in the same session by 3 elastographic techniques: TE, p-SWE and 2D-SWE. Reliable measurements were defined as the median value of 10 measurements and an IQR/M<0.3. For cACLD, the transient elastography cut-off point of 9.5 kPa was used [1]. ResultsFrom the 198 patients, 41.5% were women and 58.5% were men, mean age 54.8 ±13.8 years. The best cut-off values cACLD were: for 2D-SWE- 5C1 probe:>8.8 kPa, Se=97.7%, Sp=38.6%, AUC=0.84, p< 0.0001;DAX probe:>7.6 kPa, Se= 40.9%, Sp=99.9%, AUC=0.84, p< 0.0001; ForpSWE- 5C1 probe: >9.1 kPa, Se=54.5%, Sp=97.7%, AUC=0.86, p< 0.0001; DAXprobe: > 8.8 kPa, Se=50%, Sp=98.5%, AUC=0.88, p<0.0001. ConclusionsThe best cut-off value for predicting cACLD in pSWE range between 8.8 kPa and 9.1 kPa and for 2D-SWE raged between 7.6 kPa and 8.8 kPa.
ObjectivesSeveral noninvasive biological scores were developed to predict liver fibrosis (LF) in patients with non-alcoholic fatty liver disease (NAFLD). We aimed to assess the correlation between AST to Platelet Rati...
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ObjectivesSeveral noninvasive biological scores were developed to predict liver fibrosis (LF) in patients with non-alcoholic fatty liver disease (NAFLD). We aimed to assess the correlation between AST to Platelet Ratio Index (APRI), Fibrosis 4 (FIB-4) Index and BARD score vs. Transient Elastography (TE), in a group of NAFLD patients. MaterialsWe conducted a prospective study, which included 74 patients with NAFLD, (mean age 54.5 ± 11.6 years, 49.4% female). All patients were evaluated clinically (Body mass index- BMI, waist circumference), by serum markers (aspartate transaminase-AST, alanine aminotransferase -ALT, platelets count, gamma glutamyl transferases- GGT, triglycerides), as well as by TE (FibroScan Compact M 530). Based on specific formulas, we calculated APRI, FIB-4 index and, BARD, scores [1]. To discriminate advanced fibrosis (F≥3) by means of TE, we used the cut-off value of 9.7 kPa [2]. ResultsOut of 74 patients with NAFLD, 10.8% (8/74) patients had advanced fibrosis based on TE measurements. Using APRI cut-off <2 (100% patients) to rule out advanced fibrosis, we found a NPV of 91.7%. A weak, but significant correlation between liver stiffness (LS) assessed by TE and APRI score was found (r=0.31, p<0.0001). Using FIB-4 cut-off <2.6 to rule out advanced fibrosis (91.2% - 68/74 patients), we found out a NPV of 92.8%. FIB-4 score was weakly correlated to TE measurements, but statistically significant (r=0.20 , p=0.006). Regarding BARD score, 36.4% (27/74) of patients had a BARD score <2, used to rule out advanced fibrosis, with a NPV of 100%. ConclusionsAPRI, BARD and FIB-4 can rule out advanced fibrosis. These simple scores could be the basis for evaluation on LF in order to evaluate the need for further investigations
ObjectivesUltrasound-based liver elastography techniques are non-invasive methods used for the assessment of liver stiffness (LS). In addition to Transient Elastography (TE), new methods were developed. Aimto compare ...
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ObjectivesUltrasound-based liver elastography techniques are non-invasive methods used for the assessment of liver stiffness (LS). In addition to Transient Elastography (TE), new methods were developed. Aimto compare the performance of 2D-SWE technique implemented on two different ultrasound probes from different vendors for the assessment of liver stiffness measurements (LSM) using transient elastography (TE) as reference method. MaterialsA prospective study was conducted in which LSM were performed in 201 consecutive patients with or without chronic liver disease, evaluated in the same session by 2D-SWE and TE implemented on the following systems: Siemens ACUSON Sequoia (5C-1 convex transducer and Deep Abdominal Transducer-DAX), Aixplorer Mach 30 (C2-1X convex transducer) and FibroScan Compact M 530 (M and XL probes). Reliable measurements were defined as the median value of 10 measurements and an IQR/M<0.3. For significant fibrosis a cut-off value for TE of 7 kPa was used, for advanced fibrosis 9.5 kPa and for liver cirrhosis 12 kPa [1] ResultsFrom 201 patients, 198 patients had reliable measurements in all techniques and were included in the final analysis, mean age 54.8±13.3 years, mean BMI28.8 ± 5.0, 58% (116/198)men. 58.5% were without or with mild fibrosis, 14.1% had significant fibrosis, 6.2% had advanced fibrosis and 21.2% had liver cirrhosis. For significant fibrosis the performance was slightly better for *** (AUROC=0.89, p<0.0001, >7.3 kPa, Se=85.1%, Sp=87.9%) followed by 2D-SWE.5C1 (AUROC=0.79, p<0.0001, >6.9 kPa, Se=33.7%, Sp=96.7%) and *** (AUROC=0.78, p<0.0001, >6.3 kPa, Se= 36.4%, Sp=96.7%), p=0.01. For advanced fibrosis the best performance was slightly better by *** (AUROC=0.92, p<0.0001, >8.8 kPa, Se=92.5%, Sp=91.9%), and by *** (AUROC=0.86, p<0.0001, >7.6 kPa, Se= 38.8%, Sp=99.3%), followed by 2D-SWE.5C1 (AUROC=0.84, p<0.0001, >8.6 kPa, Se=38.8%, Sp=96.5%), p=0.02. For liver cirrhosis the performances were similar: 2
ObjectivesAlcoholic liver disease (ALD) and Non-alcoholic fatty liver disease (NAFLD) are becoming the most common causes of chronic liver diseases and the leading causes of liver transplantation. Developing non-invas...
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ObjectivesAlcoholic liver disease (ALD) and Non-alcoholic fatty liver disease (NAFLD) are becoming the most common causes of chronic liver diseases and the leading causes of liver transplantation. Developing non-invasive methods for liver fibrosis and steatosis assessment are needed in these patients. In addition to Transient Elastography (TE), new methods were developed. Aimto evaluate and compare the performance of two point shear wave elastography techniques (pSWE and Auto pSWE) for the assessment of fibrosis and of Ultrasound Derived Fat Fraction (UDFF) for the assessment of steatosis, in patients with NAFLD and ALD using TE with Controlled Attenuation Parameter (CAP) as a reference methods. MaterialsA prospective study was conducted in which 166 consecutive patients with previously diagnosed ALD and NAFLD were included. All were evaluated in the same session by pSWE, Auto pSWE and UDFF, implemented in a Siemens ACUSON Sequoia system, using a Deep Abdominal Transducer (DAX), and by TE with CAP, implemented in a FibroScan Compact M 530 system (M and XL probes). Reliable measurements were defined as the median value of 10 measurements with an IQR/M<0.3. The following TE cut-off values were used: for significant fibrosis (F≥2) - 9 kPa for ALD and 8.2 kPa for NAFLD [1,2]. For mild (S1) steatosis, the following CAP cut-off values were used: 268 dB/m for ALD and 294 dB/m for NAFLD [3]. ResultsFibrosis distribution was the following: in the ALD group F≥2 -10% (5/48) patients and F4 -25% (12/48) patients; in the NAFLD group, F≥2 -4.2% (5/118) patients and F4- 6% (7/118) patients. In the ALD group 50% (24/48) had severe steatosis and in the NAFLD- 39% (46/118), with no significant differences between the two groups, p-values >0.05. The best cut-off values for identifying significant fibrosis (F≥2) with p-SWE and Auto pSWE in ALD patients were: >7 kPa, with AUCs (0.94 and 0.90), Se (83.3% and 41.6%), Sp (83.3% and 100%); in NAFLD patients: >5.2 kPa, AUCs (0.71 and 0.75)
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