Due to the small diameter cutting tool (<500 μm) and high accuracy requirements, the impact of input parameters in the rotary ultrasonic surface micro-machining (RUSμM) process on tool deformation and cutting quality is extremely different from that in rotary ultrasonic surface machining (RUSM) with relatively large diameter cutting tool (∼10 mm). Therefore, rotary ultrasonic micro-machining (RUμM) is investigated to conduct the surface micro-machining of brittle materials. As one of the nontraditional machining processes, rotary ultrasonic machining is an effective method to reduce the issues generated by traditional machining processes of brittle materials. To reduce and further solve these problems, a new micro-machining process is needed. Traditional ultra-precision micro-machining can lead to workpiece cracking, low machined surface quality, and reduced tool life. ![]() In recent years, there is an increasing demand for high-precision micro-machining of these brittle materials to produce precision functional parts. All rights reserved.Many brittle materials, such as single-crystal materials, amorphous materials, and ceramics, are widely used in many industries such as the energy industry, aerospace industry, and biomedical industry. With the addition of referral recommendations and management plans, this strategy provides optimum investigation and management of LFTs and is cost saving to the NHS.Ībnormal LFTs Automated testing Blood tests Intelligent liver function testing Liver disease Non-invasive diagnosis.Ĭopyright © 2019 European Association for the Study of the Liver. In this study we were able to substantially increase the diagnostic yield of the abnormal LFTs using the automated intelligent LFT system. Checking liver blood tests (LFTs) should be an opportunity to diagnose liver problems, but abnormal results are often incompletely investigated. There is a growing epidemic of advanced liver disease, this could be offset by early detection and management. This can be achieved with minor changes to working practices and exploitation of functionality existing within modern laboratory diagnostics systems. ILFT increases liver disease diagnoses, improves quality of care, and is highly cost-effective. iLFT was cost-effective with a low initial incremental cost-effectiveness ratio of £284 per correct diagnosis, and a saving to the NHS of £3,216 per patient lifetime. Additionally, there were significant increases in the rates of GP visits after diagnosis and the number of referrals to secondary care in the iLFT group. In the iLFT group, the diagnosis of liver disease was increased by 43%. The primary diagnostic outcome was based on the general practitioner diagnosis, which agreed with the iLFT diagnosis in 67% of cases. Of eligible patients with abnormal LFTs, 490 were recruited to the control group and 64 were recruited to the intervention group. Diagnostic outcomes were collated and compared. A stepped-wedged trial design was utilised to compare LFT outcomes in general practices in the 6 months before and after introduction of the iLFT system. This algorithm then generated a diagnosis and/or management plan. We integrated this automated investigation algorithm into the laboratory management system, based on minimal diagnostic criteria, liver fibrosis estimation, and reflex testing for causes of liver disease. We developed an automated system that further investigated abnormal LFTs on initial testing samples to generate a probable diagnosis and management plan. We developed an automated investigation algorithm, intelligent liver function testing (iLFT), with the aim of increasing the early diagnosis of liver disease in a cost-effective manner. ![]() This can lead to missed opportunities to diagnose and treat liver disease at an early stage. LFTs are commonly abnormal, the causes of which can be complex and are frequently under investigated. Liver function tests (LFTs) are frequently requested blood tests which may indicate liver disease.
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