Testing of the assisting software for radiologists analysing head CT images: lessons learned.

BACKGROUND: Assessing a plan for user testing and evaluation of the assisting software developed for radiologists. METHODS: Test plan was assessed in experimental testing, where users performed reporting on head computed tomography studies with the aid of the software developed. The user testing included usability tests, questionnaires, and interviews. In addition, search relevance was assessed on the basis of user opinions. RESULTS: The testing demonstrated weaknesses in the initial plan and enabled improvements. Results showed that the software has acceptable usability level but some minor fixes are needed before larger-scale pilot testing. The research also proved that it is possible even for radiologists with under a year's experience to perform reporting of non-obvious cases when assisted by the software developed. Due to the small number of test users, it was impossible to assess effects on diagnosis quality. CONCLUSIONS: The results of the tests performed showed that the test plan designed is useful, and answers to the key research questions should be forthcoming after testing with more radiologists. The preliminary testing revealed opportunities to improve test plan and flow, thereby illustrating that arranging preliminary test sessions prior to any complex scenarios is beneficial.

Unacylated ghrelin is associated with changes in insulin sensitivity and lipid profile during an exercise intervention.

OBJECTIVE: Ghrelin has been implicated in energy homeostasis, body weight regulation and glucose metabolism. Level of unacylated ghrelin (UAG), but not acylated ghrelin (AG), has been suggested to increase during long-term exercise. However, the association of the level of UAG with exercise-induced changes of insulin sensitivity and lipid metabolism has not been previously investigated. We hypothesized that an increase in UAG level in response to a long-term exercise programme improves insulin sensitivity and associated lipid profile, independently of weight loss. DESIGN, PATIENTS AND MEASUREMENTS: A prospective study of 552 young men (mean age 19·3 and range 19-28 years) undergoing military service with structured 6-month exercise training programme. Exercise performance, clinical and biochemical measurements were obtained at baseline and follow-up. Association between UAG level and fasting glucose, insulin, insulin sensitivity and lipid levels were evaluated. RESULTS: An overall increase in the level of UAG was observed during the 6-month follow-up (P < 0·001), which was largest among those with weight loss ≥ 2·5% or among those whose reduction in waist circumference was largest (P = 0·007 and P < 0·001, respectively). A change in UAG level correlated inversely with a change in fasting glucose and insulin levels, HOMA-IR, total cholesterol and total triglyceride levels (P < 0·001 for all). The association between change in the UAG level and the change in insulin sensitivity was independent of weight loss or reduction in waist circumference. CONCLUSIONS: Increase in UAG level was associated with improved insulin sensitivity via mechanisms independent of weight loss during an intensive, long-term exercise intervention in young healthy men.

Unacylated ghrelin is associated with changes in body composition and body fat distribution during long-term exercise intervention.

OBJECTIVE: Ghrelin, a gut-brain peptide involved in energy homeostasis, circulates predominantly (>90%) in unacylated form. Previous studies, however, have focused on total and acylated ghrelin, and the role of unacylated ghrelin (UAG) is not well understood. Particularly, the association of UAG with weight loss and changes in body composition in adults remains unclear. We hypothesized that exercise-associated increase in UAG level is associated with weight loss, favorable changes in body composition, and body fat distribution. DESIGN AND METHODS: A prospective study of 552 young men (mean age 19.3 and range 19-28 years) undergoing military service with structured 6-month exercise training program. Exercise performance, body composition, and biochemical measurements were obtained at baseline and follow-up. Association between changes in UAG levels and body composition and body fat distribution were evaluated. RESULTS: An increase in UAG level during the exercise intervention was associated with reduced weight, fat mass (FM), fat percentage (fat %), and waist circumference, but not with fat-free mass. Inverse associations of changes in UAG level with changes in waist circumference and fat % were independent of weight at baseline, and changes in weight and exercise performance. Associations of changes in UAG level with waist circumference were significantly stronger than with fat % after the adjustment for confounding variables. CONCLUSION: UAG is associated with changes in body weight and body composition during an intensive long-term exercise intervention in young men. The association of UAG levels with changes in central obesity was stronger than with total FM.