Barbara Szymanik

Validation of the BARD scoring system in Polish patients with nonalcoholic fatty liver disease (NAFLD)

AbtractBackgroundNonalcoholic fatty liver disease (NAFLD) includes a wide spectrum of liver diseases, ranging from pure steatosis to nonalcoholic steatohepatitis (NASH), and eventually to liver cirrhosis with its complications. Identifying advanced fibrosis in patients is crucial to evaluating prognosis and possible therapeutic intervention. A novel, simple, and highly accurate scoring system called BARD, which identifies patients with NAFLD and without significant fibrosis, has been recently introduced and validated in North America..The aim of this study is to validate the BARD scoring system in a Polish cohort with NAFLD.MethodsA group of 104 Caucasians with biopsy-proven NAFLD were included in this study. Fibrosis in liver biopsies was evaluated according to the Histological Scoring System for Nonalcoholic Fatty Liver Disease. The BARD scoring system was assessed according to Harrison et al.: BMI ≥ 28 = 1 point, AST/ALT ratio (AAR) ≥ 0.8 = 2 points, type 2 diabetes mellitus = 1point.ResultsAge over 50 and AAR over 0.8 showed, respectively, a moderate and strong association with advanced fibrosis. A BARD score of 2-4 points was associated with F3 or F4 stages of fibrosis with an odds ratio of 17.333 (95% Cl; 3,639 - 82.558) and negative predictive value of 97%.ConclusionOur results demonstrate that the BARD scoring system has value in the non-invasive diagnosis of advanced fibrosis in NAFLD patients. The vast majority of patients with NAFLD would avoid liver biopsy if BARD was broadly introduced into the clinic.

Minimal hepatic encephalopathy does not impair health-related quality of life in patients with cirrhosis: a prospective study.

Background: Minimal hepatic encephalopathy (HE) is a serious complication of cirrhosis; however, the impact of minimal HE on health‐related quality of life (HRQoL) remains controversial. The Psychometric Hepatic Encephalopathy Score (PHES) remains a ‘gold standard’ for the assessment of minimal HE, but its results clearly differ between studied populations.

Terahertz and Thermal Testing of Glass-Fiber Reinforced Composites with Impact Damages

The studies on glass-fiber reinforced composites, due to their growing popularity and high diversity of industrial applications, are becoming an increasingly popular branch of the nondestructive testing. Mentioned composites are used, among other applications, in wind turbine blades and are exposed to various kinds of damages. The equipment reliability requirements force the development of accurate methods of their health monitoring. In this paper we present the study of composite samples with impact damages, using three methods: terahertz time domain inspection, active thermography with convective excitation, and active thermography with microwave excitation. The results of discrete Fourier transform of obtained time sequences of signals will be presented as well as some image processing of resulting amplitude and phase images. Proposed experimental methods combined with harmonic analysis are efficient tool of defects detection and allowed to detect flaws in examined specimens. Reader may find it interesting that in spite of differences in nature of applied experimental methods, one technique of signal processing (harmonic analysis) gave adequate and comparable results in each case.

Assessment of a Modified Child-Pugh-Turcotte Score to Predict Early Mortality After Liver Transplantation

OBJECTIVE The Model for End-Stage Liver Disease (MELD) predicts mortality on the transplant list; however, it has not been of much use to predict posttransplant outcomes. Several prognostic models have been tested among patients with cirrhosis; nevertheless, their predictive value has not been established in the posttransplant setting. We recently modified the Child-Pugh-Turcotte (CPT) score by adding creatinine levels (CPT + Cr), which has proven useful for patients with alcoholic cirrhosis. This retrospective analysis sought to predict early (1 month) mortality using CPT + Cr versus 5 other prognostic models in patients who underwent orthotopic liver transplantation (OLT) at our center. MATERIALS AND METHODS We included 48 consecutive patients (30 males, 18 females, median age 51 years). The predictive values of CPT + Cr were compared with CPT scores without or with the Huo modification, CPT + Na, MELD, and MESO, which is the MELD to serum Na ratio. Pearson correlations and ROC curves as evidenced by the area under the curve (AUC) were determined for each index. P < .05 was considered to be significant. RESULTS CPT + Cr showed the highest correlation with the risk of death (r = .368, P = .01); MELD and MESO were the lowest (r = .204, P = NS; and r = .254, P = NS, respectively). ROC analysis showed the best predictive value of CPT and CPT-Crea with AUC of 0.758 (P = .010) and 0.748 (P = .011) respectively, as compared to 0.689 for MESO and 0.659 for MELD (both NS). CONCLUSIONS A modified CPT score with creatinine levels may be of value to predict early death after OLT. Its usefulness must be validated in a prospective study of a large patient cohort.

Detection and Inspection of Steel Bars in Reinforced Concrete Structures Using Active Infrared Thermography with Microwave Excitation and Eddy Current Sensors

The purpose of this paper is to present a multi-sensor approach to the detection and inspection of steel bars in reinforced concrete structures. In connection with our past experience related to non-destructive testing of different materials, we propose using two potentially effective methods: active infrared thermography with microwave excitation and the eddy current technique. In this article active infrared thermography with microwave excitation is analyzed both by numerical modeling and experiments. This method, based on thermal imaging, due to its characteriatics should be considered as a preliminary method for the assessment of relatively shallowly located steel bar reinforcements. The eddy current technique, on the other hand, allows for more detailed evaluation and detection of deeply located rebars. In this paper a series of measurement results, together with the initial identification of certain features of steel reinforcement bars will be presented.

Feasibility studies on microwave heating for nondestructive evaluation of glass fibre reinforced plastic composites

Recent developments in non-destructive evaluation (NDE) have concentrated in two directions: 1) sensors and arrays for local material/defect detection at both macro and/or micro levels; 2) large-scale component imaging and monitoring such as thermography. In this paper, microwave heating is proposed for defect detection of glass fibre reinforced plastic (GFRP) composite material in far field. Such system using rectangular waveguide as illumination device is implemented and compared via both numerical simulation and experiment. In experiment, a GFRP wind turbine blade is chosen as test sample. Results for GFRP blade from simulation and experiment show that heat is accumulated at defect edge regions. This phenomenon enables defect detection using microwave heating. To achieve better contract of heat patterns at defect and non-defect region, a high power heating system is proposed. Simulation and experimental results show the feasibility of the system for defect detection with enough heat generation.

Critical flicker frequency fails to disclose brain dysfunction in patients with primary biliary cirrhosis

BACKGROUND Recent studies suggest that stage-independent symptoms of primary biliary cirrhosis (PBC) such as chronic fatigue are a consequence of structural and functional abnormalities of the brain. Critical flicker frequency (CFF) is a psychophysiological modality analysing function of cerebral cortex. AIM To analyse the usefulness of CFF in detection of brain dysfunction in patients with PBC. METHODS Fifty-one (37 non-cirrhotic/14 cirrhotic) patients with PBC were included. Control group consisted of 31 matched healthy individuals. Fatigue and health-related quality of life (HRQoL) were assessed using Fatigue Impact Scale (FIS) and questionnaire PBC-40. CFF was analysed with HEPAtonorm Analyzer(®). RESULTS When compared to healthy controls all patients with PBC showed significantly impaired HRQoL in majority of PBC-40 domains and increased fatigue level in physical domain of FIS. No differences in HRQoL and PBC-40 domains were seen, when patients with and without cirrhosis where compared. CFF analysis showed no difference between healthy controls and patients with PBC. CFF did not correlate with PBC-40 and FIS domains. CONCLUSION CFF fails to determine brain dysfunction in non-encephalopatic patients with PBC, suggesting that functional efficiency of their cerebral cortex remains unaffected and other central mechanisms are responsible for chronic fatigue in these patients.

Multisource system for NDT of welded elements exploited in aircraft industry

Purpose – The purpose of this paper is to describe a multisource system for nondestructive inspection of welded elements exploited in aircraft industry developed in West Pomeranian University of Technology, Szczecin in the frame of CASELOT project. The system task is to support the operator in flaws identification of welded aircraft elements using data obtained from X-ray inspection and 3D triangulation laser scanners. Design/methodology/approach – For proper defects detection a set of special processing algorithms were developed. For easier system exploitation and integration of all components a user friendly interface in LabVIEW environment was designed. Findings – It is possible to create the fully independent, intelligent system for welds’ flaws detection. This kind of technology might be crucial in further development of aircraft industry. Originality/value – In this paper a number of innovative solutions (new algorithms, algorithms’ combinations) for defects’ detection in welds are presented. All of...

Nondestructive Inspection of Thin Basalt Fiber Reinforced Composites Using Combined Terahertz Imaging and Infrared Thermography

The inspection of thin basalt fiber reinforced composite materials was carried out using two nondestructive methods: terahertz time domain imaging and infrared thermography. In order to combine the information about the defects arising in examined materials the inspection results were parametrized. In order to acquire more information content, new approximation based features are proposed. Then, a knowledge extraction based multivariate analysis of preselected features’ vector was carried out. Finally, in order to integrate features distributions of representing different dynamic level of information, a multiresolution wavelet based data fusion algorithm was applied. The results are presented and discussed.

Inspection of reinforcement concrete structures with active infrared thermography

In this article the reinforced concrete non-destructive evaluation using active thermography is discussed. There are several aspects of possible non-destructive testing of mentioned structures. One of them is the detection and assessment of the reinforcement itself. In case of active thermography, the external energy source has to be used to induce the thermal response of the inspected specimen. Here, authors propose two different techniques: microwave heating and induction heating. In this article authors will present several experimental results which will allow to compare mentioned two techniques of heating. suitability of each one to assess the reinforced concrete by using the active thermography will be discussed.