Performance Of Visual Inspection Research Articles

Performance and applications of bedside visual inspection of airway pressure-time curve profiles for estimating stress index in patients with acute respiratory distress syndrome.

To determine the performance of bedside visual inspection of airway pressure-time (Paw-t) curve profiles(VI) for estimating stress index (SI) in patients with acute respiratory distress syndrome (ARDS). A prospective study in 30 subjects with ARDS receiving mechanical ventilation at two peak inspiratory flow (PIF) settings: 60 or 40L/min. For each study session, two physicians inspected real-time Paw-t waveforms from mechanical ventilator's monitoring screens at bedside for 30s and interpreted which of the three patterns (tidal recruitment, noninjurious ventilation or tidal overdistension) the Paw-t curve profile was compatible with. Subsequently, the study was repeated again at the second PIF setting. SI was derived from a standardized dedicated software program and categorized into three groups: SI < 0.9, or tidal recruitment; SI = 0.9-1.05, or noninjurious ventilation; and SI > 1.05, or tidal overdistension. The lower PIF setting increased the sensitivity of VI to correctly estimate SI (75% vs. 50%; p = 0.005). At PIF 40L/min, the likelihood ratio of a positive test was 3.6, 5.4 or 7 if the Paw-t curve profile was interpreted as noninjurious ventilation, tidal recruitment or tidal overdistension, respectively. The likelihood ratio of a negative test ranged from 0.55 for tidal recruitment to 0.32 and 0.19 for noninjurious ventilation and tidal overdistension, respectively. Experience in mechanical ventilation did not influence the accuracy. Bedside VI is moderately accurate for estimating SI and may be used to monitor injurious ventilation in patients with ARDS, in addition to plateau airway pressure.

Deep learning based image recognition for crack and leakage defects of metro shield tunnel

The performance of traditional visual inspection by handcrafted features for crack and leakage defects of metro shield tunnel is hardly satisfactory nowadays because it is low-efficient to distinguish defects from some interference such as segmental joints, bolt holes, cables and manual marks. Based on deep learning (DL), this paper proposes a novel image recognition algorithm for semantic segmentation of crack and leakage defects of metro shield tunnel using hierarchies of features extracted by fully convolutional network (FCN). The defect images in training dataset and testing dataset are captured via a self-developed image acquisition equipment named Moving Tunnel Inspection (MTI-200a). After the establishment of image datasets, FCN models of crack and leakage are separately trained through several iterations of forward inference and backward learning. Semantic segmentation of defect images is implemented via the corresponding FCN models using two-stream algorithm, i.e. one stream is used to recognize the crack by sliding-window-assembling operation and the other is adopted for the leakage by resizing-interpolation operation. Compared with two frequently-used traditional methods, i.e. region growing algorithm (RGA) and adaptive thresholding algorithm (ATA), great superiority of the proposed method in terms of recognition results, inference time and error rates is shown based on four typical types of defect images which are crack-only image, leakage-only image, two-defect-nonoverlapping (TDN) image, two-defect-overlapping (TDO) image. The proposed method using DL can be employed to rapidly and accurately recognize defects for structure health monitoring and maintenance of metro shield tunnels.

The Influence of Cognitive Bias on Caries Lesion Detection in Preschool Children

We aimed to evaluate whether children’s caries experience exerts an influence on the performance of visual and radiographic methods in detecting nonevident proximal caries lesions in primary molars. Eighty children (3–6 years old) were selected and classified as having a lower (≤3 decayed, missing, or filled surfaces; dmf-s) or higher (> 3 dmf-s) caries experience. Two calibrated examiners then assessed 526 proximal surfaces for caries lesions using visual and radiographic methods. As a reference standard, 2 other examiners checked the surfaces after temporary separation. Noncavitated and cavitated lesion thresholds were considered and Poisson multilevel regression analyses were conducted to evaluate the influence of caries experience on the performance of diagnostic strategies. Accuracy parameters stratified by caries experience were also derived. A statistically significant influence of caries experience was observed only for visual inspection, with more false-positive results in children with a higher caries experience at the noncavitated lesion threshold, and more false results at the cavitated threshold. The detection of noncavitated caries lesions in children with a higher caries experience was overestimated (specificity = 0.696), compared to children with a lower caries experience (specificity = 0.918), probably due to confirmation bias. However, the examiners underestimated the detection of cavitated lesions in children with a higher caries experience (sensitivity = 0.143) compared to lower-caries-experience children (sensitivity = 0.222), possibly because of representativeness bias. The radiographic method was not influenced by children’s caries experience. In conclusion, children’s caries experience influences the performance of visual inspection in detecting proximal caries lesions in primary teeth, evidencing the occurrence of cognitive biases.

Performance of Different Methods for Detection of Incipient Occlusal Caries Lesions: An In Vitro Study.

The aim of this in vitro study was to evaluate the diagnostic performance of visual inspection (VI), laser fluorescence (LF pen), fluorescence camera (FC), and alternating current impedance spectroscopy technique (ACIST) for detection of incipient occlusal caries lesions. Histology was used as the gold standard to determine the interexaminer reliability of the methods, among three examiners with different levels of experiences (Examiner 1: 5 years; examiner 2: 10 years; and examiner 3: 25 years). One hundred two molar teeth were selected. The occlusal surfaces of teeth were evaluated with VI, LF pen, FC, and ACIST devices independently by three examiners. Diagnostic performances of methods were evaluated with binormal receiver-operating characteristics analysis. Interexaminer agreement of detection methods was assessed using Cohen's kappa coefficient values (p < 0.001). Incipient enamel lesions were determined more successfully with VI by all examiners. All detection methods were presented with statistically acceptable interexaminer agreement (p < 0.001). For D2 and D3 thresholds, FC for examiner 1, VI for examiner 2, and both VI and FC for examiner 3 demonstrated statistically high sensitivity and specificity (p < 0.05). It can be concluded that diagnostic performance of the methods was insufficient for detecting incipient occlusal caries lesions by itself. Performance can be improved by using them with VI as a traditional caries detection method.

Accuracy of Cervical Visual Inspection with Acetic Acid Guide for 4-Quadrant Random Cervical Biopsies by General Practitioners in Women with Abnormal Pap Smears

Objective:To study the performance of visual inspection with acetic acid plus 4-quadrant cervical biopsy (V4B) by general practitioners in detecting high grade cervical lesion, compared to highest histopathologic grade from the American Society for Colposcopy and Cervical Pathology American Society for Colposcopy and Cervical Pathology (ASCCP) 2013 work up guidelines.Materials and methods:Patients with abnormal cervical cytologic screening results suggesting low grade lesions underwent V4B by general practitioners followed by colposcopy on the same day bases on ASCCP 2013 guidelines. Those with Pap smears indicative of high grade lesions or cervical cancer were sent to V4B before confirmed diagnosis and and therapeutic excisional procedures. Predictive performance of V4B was evaluated against the reference diagnosis.Results:Compared with the reference diagnosis in 100 of patients, V4B by general practitioners had sensitivity, specificity, PPV, and NPV of 67.9%, 100%, 100%, and 88.9%, respectively. There were 11.1% false negatives with no false positives. No complications were observed following this technique.Conclusion:Overall, V4B by general practitioners demonstrates moderate accuracy when compared with definite diagnosis by colposcopy and/or LEEP. This novel strategy performed better in those with low grade lesions on cervical cytological screening.

A Real-World Feasibility Study of CareHPV assay, VIA/VILI and Pap Smear as Primary Screening in Rural China

Background: To compare the real-world performance of visual inspection with acetic acid and with Lugol’s iodine (VIA/VILI), cytology and careHPV DNA assay in rural China performed by local health providers. Methods: Eligible women living in rural areas in Xinmi County, Henan Province were invited to participate in cervical cancer screening program. Enrolled women were randomized into 3 intervention arms, screened by VIA/ VILI, pap smears, and careHPV assay respectively. Women had positive primary screening results were referred to colposcopy and/or biopsy. All the clinical and lab work was performed by local health providers. The final diagnoses of histopathology were based on the diagnosing of a senior histopathology expert from Cancer Hospital, Chinese Academy of Medical Sciences. Questionnaires about the knowledge and attitudes towards the HPV and the screening program of the health providers at village clinics were collected. Results: 894 women had careHPV DNA test, 552 underwent VIA/VILI and 547 had Pap smears. The positive rates for careHPV assay, VIA/VILI and Pap smears were 10.6%, 18.1%, and 4.9% respectively (χ2=48.647, P<0.001). The overall CIN2+ detection rate was 0.5%, the CIN2+ detection rate for the three arms were not significantly different (0.7% for careHPV assay, 0.5% for VIA/VILI, 0.2% for pap smear, χ2=1.648, P=0.439). The knowledge of the health providers about HPV, HPV assay in screening was unsatisfactory. However, their attitudes about implementing HPV assay into the national program were positive. Conclusion: Implementing careHPV assay in low resource settings and performed by simply trained lab personnel is feasible. For large population screening program, extensive training and good quality control are needed to improve the quality. Education for implementing HPV assay in local health providers are needed.

Clinical Performance Validation of 4 Point-of-Care Cervical Cancer Screening Tests in HIV-Infected Women in Zambia

We sought to determine the clinical performance of visual inspection with acetic acid (VIA), digital cervicography (DC), Xpert human papillomavirus (HPV), and OncoE6 for cervical cancer screening in an HIV-infected population. HIV-infected women 18 years or older were included in this cross-sectional validation study conducted in Lusaka, Zambia. The screening tests were compared against a histological gold standard. We calculated sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios, and odds ratios using cervical intraepithelial neoplasia grade 2 or worse (CIN 2+) and grade 3 or worse (CIN 3+) thresholds. Between January and June 2015, a total of 200 women were enrolled. Fifteen percent were screen positive by VIA, 20% by DC, 47% by Xpert HPV, and 6% by OncoE6. Using a CIN 2+ threshold, the sensitivity and specificity of VIA were 48% (95% CI = 30%-67%) and 92% (95% CI = 86%-95%), respectively. Similarly, the sensitivity and specificity of DC were 59% (95% CI = 41%-76%) and 88% (95% CI = 82%-93%), respectively. The sensitivity and specificity of Xpert HPV were 88% (95% CI = 71%-97%) and 60% (95% CI = 52%-68%), respectively. Finally, the sensitivity and specificity of OncoE6 were 31% (95% CI = 16%-50%) and 99% (95% CI = 97%-100%), respectively. VIA and DC displayed moderate sensitivity and high specificity. Xpert HPV performed equivalently to currently approved HPV DNA tests, with high sensitivity and moderate specificity. OncoE6 displayed excellent specificity but low sensitivity. These results confirm an important role for VIA, DC, and Xpert HPV in screen-and-treat cervical cancer prevention in low- and middle-income countries, such as Zambia.

Toward a better visual inspection of products

Purpose – Visual inspection is used to assess a product’s quantitative characteristics (physical inspection) and/or to assess a product’s qualitative characteristics (sensory inspection). Due to the complexity of the product, inspection tasks are often performed by humans and are therefore prone to errors. It is particularly the case when controllers have to detect aesthetic anomalies, to evaluate them and decide if a product must be rejected or not. The purpose of this paper is to detail how to improve visual inspection. Design/methodology/approach – This paper details how the performance of visual inspection can be measured. It then lists the actions which can be carried out to improve the detection and the evaluation of aesthetic anomalies. Finally, it describes how can be made the knowledge about visual inspection more explicit in order to be shared by controllers. The methods the authors propose are illustrated with a concrete example detailed throughout the paper. Findings – The gage R2 & E2 the aut...

Accuracy of Combined Visual Inspection with Acetic Acid and Cervical Cytology Testing as a Primary Screening Tool for Cervical Cancer: a Systematic Review and Meta-Analysis.

The performance of combined testing visual inspection with acetic acid (VIA) and cervical cytology tests might differ from one setting to another. The average estimate of the testing accuracy across studies is informative, but no meta-analysis has been carried out to assess this combined method. The objective of this study was to estimate the average sensitivity and specificity of the combined VIA and cervical cytology tests for the detection of cervical precancerous lesions. We conducted a systematic review and a meta-analysis, according to the Cochrane Handbook for Systematic Review of Diagnostic Test Accuracy. We considered two cases. In the either-positive result case, a positive result implies positivity in at least one of the tests. A negative result implies negativity in both tests. In the both-positive case, a positive result implies having both tests positive. Eligible studies were identified using Pubmed, Embase, Website of Science, CINHAL and COCRANE databases. True positive, false positive, false negative and true negative values were extracted. Estimates of sensitivity and specificity, positive and negative likelihood (LR) and diagnostic odds ratios (DOR) were pooled using a hierarchical random effect model. Hierarchical summary receiver operating characteristics (HSROC) were generated and heterogeneity was verified through covariates potentially influencing the diagnostic odds ratio. Nine studies fulfilled inclusion criteria and were included in the analysis. Pooled estimates of the sensitivities of the combined tests in either-positive and both-positive cases were 0.87 (95% CI: 0.83-0.90) and 0.38 (95% CI: 0.29-0.48), respectively. Corresponding specificities were 0.79 (95% CI: 0.63-0.89) and 0.98 (95% CI: 0.96-0.99) respectively. The DORs of the combined tests in either-positive or both-positive result cases were 27.7 (95% CI: 12.5-61.5) and 52 (95% CI: 22.1-122.2), respectively. When including only articles without partial verification bias and also a high-grade cervical intraepithelial neoplasia as a threshold of the disease, DOR of combined test in both-positive result cases remained the highest. However, DORs decreased to 12.1 (95% CI: 6.05-24.1) and 13.8 (95% CI: 7.92-23.9) in studies without partial verification bias for the combined tests in the either-positive and both-positive result cases, respectively. The screener, the place of study and the size of the population significantly influenced the DOR of combined tests in the both-positive result case in restriction analyses that considered only articles with CIN2+ as disease threshold. The combined test in the either-positive result case has a high sensitivity, but a low specificity. These results suggest that the combined test should be considered in developing countries as a primary screening test if facilities exist to confirm, through colposcopy and biopsy, a positive result.

Evaluation of several screening approaches for detection of cervical lesions in rural Shandong, China.

The study was designed to: (1) investigate the prevalence of high-risk human papillomavirus (HR- HPV) infection and cervical neoplasia; and (2) evaluate clinical performance of visual inspection with acetic acid/ Lugol's iodine (VIA /VILI), Pap smear, high-risk human papillomavirus (HR-HPV) DNA test for detecting cervical intraepithelial neoplasia grade 2 or worse (CIN2+) and (3) explore appropriate screening approach in rural areas of Shandong Province. A total of 3,763 eligible women from Yiyuan County in Yimeng mountainous areas of rural Shandong, China, were enrolled and underwent Pap smear, HR-HPV DNA testing by Hybrid Capture 2 (HC2), and VIA /VILI tests. Women positive in any test were referred to colposcopy and biopsy as indicated. The prevalence of HR-HPV infection among all enrolled women was 11.1% and that in healthy women was 9.9%. In total 33 cases of CIN1, 16 cases of CIN2, 6 cases of CIN3 but none of cervical cancer were detected and the crude prevalence of CIN2+ was 0.58%. For detecting CIN2+, the sensitivity of HR-HPV DNA testing, VIA/VILI, Pap smear was 90.9%, 77.3%, 81.8%, respectively. Pap smear had the best specificity of 98.2%, followed by HR-HPV DNA testing with specificity of 89.4%, VIA/VILI had the lowest specificity of 81.2%. Colposcopy referral rate of HR-HPV DNA testing, VIA/VILI, Pap smear was 11.1%, 18.5%, 2.3%, respectively. Our results suggest that HR-HPV DNA testing alone might be appropriate for primary cervical cancer screening in rural low-resource areas of Shandong Province, China.

Effects of Auditory Cues for Linear and Differential Magnification Methods on Visual Inspection Performance

AbstractThe unfavorable consequence of biased attention to peripheral objects was reported with the use of a newly proposed differential magnification method by the authors. Given the favorable influence of auditory cueing on attention orientation, this study investigated the effectiveness of auditory cues in directing participants’ attention from the peripheral to foveal areas of the differential magnifying lens for improving inspection performance. Thirty‐nine Chinese undergraduates performed a simulated inspection task using a particular magnification method (between‐participant factor). Three within‐participant factors of auditory cue interval, target difficulty, and magnification power were tested. Objective performance measures of speed and accuracy and subjective evaluation using NASA task load index were collected and analyzed. The results showed that positive effects of auditory cues were found for the differential magnification methods but not for the traditional linear magnification method. Significant effects of target difficulty and magnification power were also found. It was concluded that the aid of auditory cues, which did not share the same attentional resource with the visual inspection task, proved to be an appropriate reminder for the differential magnification methods to improve participants’ visual inspection performance. Attention should also be paid to selecting an appropriate auditory cue interval for search tasks of different target difficulties. The findings of this study have implications for the design of video magnifiers in the context of multimodal human–machine interfaces.

Performance of visual inspection with acetic acid and human papillomavirus testing for detection of high‐grade cervical lesions in HIV positive and HIV negative Tanzanian women

The aim of this cross sectional study was to assess type distribution of human papillomavirus (HPV) among HIV positive and HIV negative women who underwent cervical cancer screening, and to examine the ability of visual inspection with acetic acid (VIA), the standard detection method in Tanzania, and HPV-testing to detect cytologically diagnosed high grade lesions or cancer (HSIL+). Women from different areas in Tanzania were invited by public announcement to cervical cancer screening organized by Ocean Road Cancer Institute (Dar-es-Salaam). A total of 3,767 women were enrolled. Women underwent gynecological examination with collection of cervical cells for conventional cytological examination, and swab for HPV-DNA detection (Hybrid-Capture2) and genotyping (LiPAv2 test). Subsequently VIA was performed. The participants were also tested for HIV. HPV16, HPV52 and HPV18 were the three most common HR HPV types among women with HSIL+ cytology with prevalences of 42.9, 35.7 and 28.6%, respectively, in HIV positive women which was higher than among HIV negative women (30.2, 21.9 and 16.7%). A total of 4.5% of the women were VIA positive, and VIA showed a low sensitivity compared to HPV-testing for detection of HSIL+. The sensitivity of VIA varied with staff VIA experience, HIV status and age. Vaccines including HPV16, HPV52 and HPV18 will likely reduce the number of HSIL+ cases independently of HIV status. The frequency of HSIL+ was high among HIV positive women, emphasizing the importance of establishing a screening program which also reaches HIV positive women. Our results highlight the importance of continuous training of staff performing VIA, and also point to the need for other screening methods such as HPV-testing at low cost.

Human Reliability Analysis for Visual Inspection in Aviation Maintenance by a Bayesian Network Approach

Visual inspection plays an important role in aviation maintenance. Human reliability analysis (HRA) in this field is necessary and can bring benefits to better human error management. Because of the lack of safety data, the present paper aims to introduce the Bayesian network (BN) approach to perform HRA in visual inspection, which permits the utilization of multi-disciplinary sources of objective and subjective information. In this paper, significant influence factors of visual inspection are identified according to the Human Factors Analysis and Classification System–Maintenance Extension. Then a network representing the visual inspection performance model is constructed. Expert opinions, data fusion from accident reports, and related literature are utilized in the step of obtaining parameters. Two canonical models used in probabilistic network model building, the Noisy-OR gates and the Recursive Noisy-OR rule, are applied to generate conditional probabilities from parameters obtained by the absolute probability judgment technique. Through the BN inference, the inspection reliability can be assessed, and some conclusions and recommendations are drawn that could provide theoretical base and data support to make interventions for safety management of visual inspection.

Influence of Examiner Experience on Clinical Performance of Visual Inspection in Detecting and Assessing the Activity Status of Caries Lesions

Our hypothesis was that a method of caries activity evaluation based on the clinical features of the lesions would be less time consuming but more influenced by the examiner's experience than the scoring system used in association with the International Caries Detection and Assessment System (ICDAS). Thus, the aim of this study was to evaluate the performance of three groups of examiners with different levels of experience using two different methods to assess the activity status of caries lesions by visual inspection. A cross-sectional study in a dental office setting was performed selecting 18 children, aged three to eight years, who had sought dental treatment at a dental school. Examinations to detect caries lesions were performed using visual inspection by six examiners with different levels of experience: two undergraduate dental students, two specialists in pediatric dentistry, and two graduate students. The examiners used ICDAS and two different methods to assess caries activity: using an additional score system or considering the examination of clinical features. Two benchmark examiners examined the children in a joint session, and their consensus was considered to be the reference standard. The sensitivity, specificity, and reproducibility were calculated for different thresholds: all, cavitated, and active caries lesions. Multilevel analyses were performed to compare the different methods and examiners. No differences were observed among the examiners, either in detecting all lesions and cavitated lesions or regarding the activity assessment. The methods of assessing activity status performed similarly, but the time spent on examinations was shorter for the method evaluating clinical features. In conclusion, the experience of examiners does not significantly influence the performance of visual inspection, and both methods of assessing activity status result in similar diagnostic accuracy.

Visual Inspection with Acetic Acid (VIA) Vs Cervical Cytology as Cervical Cancer Screening Tools in South India

Context: With a quarter of all cervical cancers occurring in India, the risk for women to contract this condition is high. The burden remains high because cervical screening programs of adequate scale are lacking. Aims: To compare the performance of visual inspection with acetic acid and cervical cytology in south India. Setting and Design: A cross-sectional study was performed in three villages in one of the south Indian district by recruiting 668 healthy women to undergo VIA and conventional Pap smear examination. Method and Material: Women who had a positive result from any of these tests were subjected to colposcopy and biopsies (if necessary), and women with high-grade cervical intraepithelial neoplasia (CIN) were properly treated. Statistical Analysis: Data was analyzed using statistical software from www.OpenEpi.com Results: Overall test positivity was 21.4% for VIA and 2.24% for Pap smear (LSIL threshold), 1.04% for Pap smear (HSIL threshold). VIA was positive in 70% of the women with CIN 1, 75% of those with CIN 2, 66.66% of women with CIN 3 and in two of two (100%) of women with cancer. Approximately 10% of women with no detectable disease had an abnormal VIA. Conclusions: A combined use of VIA with the Pap test allowed specific detection of cervical abnormalities.

Prevalence of high‐risk human papillomavirus and cervical intraepithelial neoplasias in a previously unscreened population—A pooled analysis from three studies

Population prevalence of human papillomavirus (HPV) and cervical intraepithelial neoplasias (CIN) is an important indicator to judge the disease burden in the community, to monitor the performance of cervical cancer screening program and to assess the impact of HPV vaccination program. India being a country without any cervical cancer screening program has no published data on the population prevalence of CIN and only a few large community-based studies to report the high-risk HPV prevalence. The objective of our study was to study HPV and CIN prevalence in a previously unscreened population. We pooled together the results of three research studies originally designed to assess the performance of visual inspection after acetic acid application and Hybrid Capture 2 (HC 2). Nearly 60% of the screened women had colposcopy irrespective of their screening test results. The diagnosis and grading of cervical neoplasias were based on histology. The age standardized prevalence of HPV by HC 2 test was 6.0%. Age-adjusted prevalence of CIN1 and CIN2 was 2.3% and 0.5%, respectively. The age-adjusted prevalence of CIN3 was 0.4% and that of invasive cancer was 0.2%. The prevalence of high-risk HPV was relatively low in the population we studied, which is reflected in the low prevalence of high-grade CIN. The prevalence of CIN3 remained constant across age groups due to absence of screening.

Radiographic and Laser Fluorescence Methods Have No Benefits for Detecting Caries in Primary Teeth

Clinical guidelines advise that dentists take radiographs in children to detect caries lesions missed by visual inspection; however, due to the current low caries prevalence in most countries, we hypothesized that the adjunct methods of caries detection would not significantly improve the detection of primary molar lesions in comparison to visual inspection alone. We evaluated the performance of visual inspection, alone or in combination with radiographic and laser fluorescence pen (LFpen) methods, in detecting occlusal and approximal caries lesions in primary molars. Two examiners evaluated children who had sought dental treatment with these diagnostic strategies. The reference standard involved the temporary separation of approximal and operative interventions for occlusal surfaces. The sensitivity, specificity, accuracy and utility of diagnostic strategies were calculated. Simultaneous combined strategies increased sensitivities but decreased specificities. Furthermore, no differences were observed in accuracy and utility, parameters more influenced by caries prevalence. In conclusion, adjunct radiographic and laser fluorescence methods offer no benefits to the detection of caries in primary teeth in comparison to visual inspection alone; hence, present clinical guidelines should be re-evaluated.

Review of inspection and quality control techniques for composite wind turbine blades

One of the main global engineering challenges for the wind energy sector is to develop efficient wind turbines with high fatigue life. Large wind turbine blades made out of polymer composites elevate specific stiffness, strength and good fatigue performance. However, large composite structures are prone to defects such as delamination and adhesive failure, which can lead to crack initiation and propagation under cyclic stress. The presented study covers an overview of the manufacturing defects of wind turbine blades, in-service damages and the available inspection techniques that are used to identify defects in wind turbine blades. In this paper, the detection capabilities and performance of visual inspection, acoustic emissions, ultrasonic testing and X-ray inspection have been reviewed. The paper describes the importance of developing quality control guidelines for wind turbine manufacturing sectors based on standard inspection methods.

Adjunctive testing for cervical cancer screening in low resource settings

Cervical cancer screening using cytology is expensive and requires repeat testing with loss to follow-up for triage. Adjunctive testing using two tests in a parallel or sequential combination can improve diagnostic accuracy, decrease costs and minimise referral rates. To evaluate the performance of visual inspection with acetic acid (VIA), human papillomavirus (HPV) DNA and cervical cytology in sequential and parallel combinations, to determine the optimum screening strategy. A total of 548 symptomatic women presenting to a gynaecology clinic were screened using conventional cytology; HPV testing of self- and physician-collected samples using HC2 assay; and VIA. All women underwent colposcopy with biopsy from all lesions as the reference standard. Test characteristics were calculated individually, and then applied jointly in parallel and sequential combinations. Biopsy-proven CIN2+ was present in 40 (7.8%) women. The sensitivity and specificity, respectively, of the various tests were as follows - VIA 82.5, 66.9%, Pap (≥ASCUS) 77.5, 86.8%, HPV-Physician (HPV(P)) 90.0, 91.5%, HPV-Self (HPV(S)) 80.0, 88.1%. Among the adjunctive testing scenarios, sequential testing performed better than parallel. VIA followed by HPV test had the highest specificity (90.4%) and diagnostic accuracy (90.5%), comparable to HPV-P followed by Pap. Sequential testing combination of VIA and HPV, followed by colposcopy and directed biopsy for diagnosis, combines economic viability with high scientific fidelity. The high specificity and negative predictive value reduce referral and treatment rates, as well as number of visits required for diagnosis. HPV (P) followed by reflex Pap is a suitable option for high resource situations with access to liquid-based cytology.

Clinical Performance of Two Fluorescence-Based Methods in Detecting Occlusal Caries Lesions in Primary Teeth

This in vivo study aimed to evaluate the performance of 2 fluorescence-based methods in detecting occlusal caries lesions in primary teeth, compared with the performance of visual inspection and radiographic methods, and to propose a mathematic correction of the diagnostic parameters due to the imperfect reference standard method used in the study. Two examiners assessed the occlusal surfaces of 407 primary teeth (62 children) using visual inspection (ICDAS), radiographic, DIAGNOdent pen (pen type laser fluorescence; LFpen), and fluorescence camera (FC) methods. At the noncavitated threshold (NC) the reference standard method was the results of ICDAS, and at the dentine caries threshold (D3) teeth diagnosed with dentine caries by ICDAS or radiographic methods were subjected to operative treatment to confirm the presence of lesion. Reproducibility, sensitivity, specificity, accuracy, and the area under the ROC curve were calculated for the methods at both thresholds. At the NC threshold, LFpen had a slightly better performance compared to the FC and radiographic methods. However, at the D3 threshold, both fluorescence-based methods performed similarly. Visual inspection and radiographic methods presented higher specificities but lower sensitivities than fluorescence methods. After corrections, there was a significant decrease in some parameters. In conclusion, both fluorescence-based methods presented similar performance in detecting occlusal dentine caries lesions in primary teeth, but they usually gave more false-positive results than did the visual and radiographic methods. The correction proposed shows that the performance of the methods can be overestimated, and the correction should be validated and considered in further studies that use an imprecise reference standard method.