Science.gov

Sample records for objective structured clinical

  1. Objective structured clinical examination in radiology

    PubMed Central

    Agarwal, Anurag; Batra, Bipin; Sood, AK; Ramakantan, Ravi; Bhargava, Satish K; Chidambaranathan, N; Indrajit, IK

    2010-01-01

    There is a growing need for introducing objective structured clinical examination (OSCE) as a part of radiology practical examinations in India. OSCE is an established, reliable, and effective multistation test for the assessment of practical professional skills in an objective and a transparent manner. In India, it has been successfully initiated and implemented in specialties like pediatrics, ophthalmology, and otolaryngology. Each OSCE station needs to have a pre-agreed “key-list” that contains a list of objective steps prepared for uniformly assessing the tasks given to students. Broadly, OSCE stations are classified as “manned” or “unmanned” stations. These stations may include procedure or pictorial or theory stations with clinical oriented contents. This article is one of a series of measures to initiate OSCE in radiology; it analyzes the attributes of OSCE stations and outlines the steps for implementing OSCE. Furthermore, important issues like the advantages of OSCE, its limitations, a strengths, weaknesses, opportunities, and threats (SWOT) analysis, and the timing of introduction of OSCE in radiology are also covered. The OSCE format in radiology and its stations needs to be validated, certified, and finalized before its use in examinations. This will need active participation and contribution from the academic radiology fraternity and inputs from faculty members of leading teaching institutions. Many workshops/meetings need to be conducted. Indeed, these collaborative measures will effectively sensitize universities, examiners, organizers, faculty, and students across India to OSCE and help successfully usher in this new format in radiology practical examinations. PMID:20607015

  2. Effects of test stress during an objective structured clinical examination

    PubMed Central

    Zhang, Niu; Rabatsky, Ali

    2015-01-01

    Objective The existence of test stress has been widely reported among professional students. To our knowledge, no studies exist that explore student stress response to objective structured clinical examinations. The aim of this study was to evaluate possible correlations between stress and objective structured clinical examination performance in a sample of chiropractic students. Methods A total of 116 students completed a 2-part questionnaire to assess test stress and the physiological symptoms and signs of stress. Heart rate, systolic blood pressure, and diastolic were measured during the physical examination laboratory class within the first 3 weeks and then again just prior to their objective structured clinical examination in week 5. Statistical tests were then performed for questionnaire data, heart rate and blood pressure differences, and correlation between the objective structured clinical examination grade and symptoms and signs. Results Questionnaire results showed that 5.1%–22.4% of students sometimes or often felt a certain degree of stress. More than 50% had 1 or more physiological symptoms and signs of stress. The objective structured clinical examination heart rate (75.23 ± 11.20 vs 68.16 ± 8.82, p < .001), systolic blood pressure (120.43 ± 9.59 vs 114.97 ± 11.83, p < .001), and diastolic blood pressure (73.00 ± 7.93 vs 69.32 ± 7.76, p < .001) were significantly higher than baseline. There were also negative linear correlations between objective structured clinical examination grades and physiological symptoms and signs and between objective structured clinical examination grades and feeling statement score. Conclusion The results support our hypothesis that chiropractic students experience stress when performing the objective structured clinical examination and that high levels of stress had a negative impact on performance. PMID:25806413

  3. Objective structured clinical examination (OSCE) in pharmacy education - a trend

    PubMed Central

    Shirwaikar, Annie

    2015-01-01

    Pharmacy education has undergone a radical change as it evolves towards becoming a more patient oriented profession. With a greater emphasis on problem based teaching and competency, the Objective Structured Clinical Examination (OSCE), supported by its reliability and validity became the gold standard for the evaluation of clinical skills of undergraduate students of medicine and pharmacy worldwide. Core competency evaluation has become a mandatory and critical norm for accountability of educational objectives as the traditional testing tools cannot evaluate clinical competence. Interpersonal and communication skills, professional judgment, skills of resolution etc., may be best assessed through a well- structured OSCE in comparison to oral examinations, multiple choice tests and other methods of assessment. Though OSCEs as an objective method of evaluation offer several advantages to both students and teachers, it also has disadvantages and pitfalls in implementation. This article reviews the OSCE as a trend in pharmacy education. PMID:26759616

  4. Using the objective structured clinical examinations in undergraduate midwifery students

    PubMed Central

    Delavar, MA; Salmalian, H; Faramarzi, M; Pasha, H; Bakhtiari, A; Nikpour, M; Ledari, FM

    2013-01-01

    The Objective Structured Clinical Examination (OSCE) has been considered a modern type of examination for the assessment of clinical skills within nurse education, but it has been rarely applied in the teaching of midwifery. The aim of the present study was to assess the use of the OSCE as a tool to evaluate the abilities of undergraduate midwifery students and to compare the perspectives of the students regarding the OSCE and traditional examination. Fifty-two midwifery students participated in the study. The export trainer evaluated the internal consistency of the OSCE stations and it was tested by using Cronbach’s alpha. Successive groups of students completed a self-administered questionnaire immediately after the final examination. The students’ perspective regarding the traditional final examination ranked as unsatisfactory by more than two thirds of the students, while, the students’ perspective regarding the OSCE system was ranked as very satisfactory to satisfactory by more than half of the students (p=0.001). There was a significant difference in the students’ perspective between the OSCE system and the traditional final examination among the students (49.8±18.3 vs 25.3±18.1) (p=0.001). A significant difference was found in being credible (p=0.0001), consistent/reliable (p=0.001), enhances teaching level (p=0.011), and measures the course category (p=0.008) between two methods of the final examination. Around half of the students expressed their opinion that the OSCE test was a stressful assessment. Overall, students’ evaluation of the OSCE was remarkably encouraging. To this end, we recommend the consideration of the validity and reliability of the process for undergraduate midwifery students. PMID:23599825

  5. Teaching About Substance Abuse with Objective Structured Clinical Exams

    PubMed Central

    Parish, Sharon J; Ramaswamy, Megha; Stein, Melissa R; Kachur, Elizabeth K; Arnsten, Julia H

    2006-01-01

    BACKGROUND Although residents commonly manage substance abuse disorders, optimal approaches to teaching these specialized interviewing and intervention skills are unknown. OBJECTIVE We developed a Substance Abuse Objective Structured Clinical Exam (OSCE) to teach addiction medicine competencies using immediate feedback. In this study we evaluated OSCE performance, examined associations between performance and self-assessed interest and competence in substance abuse, and assessed learning during the OSCE. DESIGN Five-station OSCE, including different substance abuse disorders and readiness to change stages, administered during postgraduate year-3 ambulatory rotations for 2 years. PARTICIPANTS One hundred and thirty-one internal and family medicine residents. MEASUREMENTS Faculty and standardized patients (SPs) assessed residents' general communication, assessment, management, and global skills using 4-point scales. Residents completed a pre-OSCE survey of experience, interest and competence in substance abuse, and a post-OSCE survey evaluating its educational value. Learning during the OSCE was also assessed by measuring performance improvement from the first to the final OSCE station. RESULTS Residents performed better (P<.001) in general communication (mean ± SD across stations = 3.12 ± 0.35) than assessment (2.65 ± 0.32) or management (2.58 ± 0.44), and overall ratings were lowest in the contemplative alcohol abuse station (2.50 ± 0.83). Performance was not associated with residents' self-assessed interest or competence. Perceived educational value of the OSCE was high, and feedback improved subsequent performance. CONCLUSIONS Although internal and family medicine residents require additional training in specialized substance abuse skills, immediate feedback provided during an OSCE helped teach needed skills for assessing and managing substance abuse disorders. PMID:16704387

  6. [HOLDING OBJECTIVE STRUCTURED CLINICAL EXAMINATIONS FOR ANESTHESIOLOGY AND INTENSIVE CARE CLINICAL RESIDENCY IN STATE GRADUATES CERTIFICATION].

    PubMed

    Schegolev, A V; Andreenko, A A; Ershov, E N; Lahin, R E; Makarenko, E P

    2016-01-01

    The modern system of medical education requires objective methods to assess clinical competence of medical specialists. Application of objective structured clinical examination (OSCE) during the final certification of graduates of clinical residency allows to evaluate the theoretical knowledge, manual skills. Enabling simulation scenarios in the program makes it possible to objectively evaluate the important non-technical skills of anesthesiologists, identify gaps in the system of training and modify it. The experience of the objective structured clinical examination as part of the state certification of graduates of clinical residency of the Department ofAnesthesiology and Intensive Care, Military MedicalAcademy after C M Kirov allows us to consider this technique in an objective way a comprehensive assessment of the competence of health professionals. Students confirmed its highly realistic, they have revealed the presence of emotional stress during the simulation sessions, the majority agreed that the simulation session increased the level of their readiness to address these situations in clinical practice. Staff of the department is planning to testing and introduction rating scales into a system of assessment, to improved exam program, increasing the number of clinical scenarios for simulation sessions. PMID:27192861

  7. Psychometric Structure of a Comprehensive Objective Structured Clinical Examination: A Factor Analytic Approach

    ERIC Educational Resources Information Center

    Volkan, Kevin; Simon, Steven R.; Baker, Harley; Todres, I. David

    2004-01-01

    Problem Statement and Background: While the psychometric properties of Objective Structured Clinical Examinations (OSCEs) have been studied, their latent structures have not been well characterized. This study examines a factor analytic model of a comprehensive OSCE and addresses implications for measurement of clinical performance. Methods: An…

  8. Do Clinical Clerks Provide Candidates with Adequate Formative Assessment during Objective Structured Clinical Examinations?

    ERIC Educational Resources Information Center

    Reiter, Harold I.; Rosenfeld, Jack; Nandagopal, Kiruthiga; Eva, Kevin W.

    2004-01-01

    Context: Various research studies have examined the question of whether expert or non-expert raters, faculty or students, evaluators or standardized patients, give more reliable and valid summative assessments of performance on Objective Structured Clinical Examinations (OSCEs). Less studied has been the question of whether or not non-faculty…

  9. Does Objective Structured Clinical Examinations Score Reflect the Clinical Reasoning Ability of Medical Students?

    PubMed Central

    Park, Wan Beom; Kang, Seok Hoon; Lee, Yoon-Seong

    2015-01-01

    Abstract: Background: Clinical reasoning ability is an important factor in a physician's competence and thus should be taught and tested in medical schools. Medical schools generally use objective structured clinical examinations (OSCE) to measure the clinical competency of medical students. However, it is unknown whether OSCE can also evaluate clinical reasoning ability. In this study, the authors investigated whether OSCE scores reflected students' clinical reasoning abilities. Methods: Sixty-five fourth-year medical students participated in this study. Medical students completed the OSCE with 4 cases using standardized patients. For assessment of clinical reasoning, students were asked to list differential diagnoses and the findings that were compatible or not compatible with each diagnosis. The OSCE score (score of patient encounter), diagnostic accuracy score, clinical reasoning score, clinical knowledge score and grade point average (GPA) were obtained for each student, and correlation analysis was performed. Results: Clinical reasoning score was significantly correlated with diagnostic accuracy and GPA (correlation coefficient = 0.258 and 0.380; P = 0.038 and 0.002, respectively) but not with OSCE score or clinical knowledge score (correlation coefficient = 0.137 and 0.242; P = 0.276 and 0.052, respectively). Total OSCE score was not significantly correlated with clinical knowledge test score, clinical reasoning score, diagnostic accuracy score or GPA. Conclusions: OSCE score from patient encounters did not reflect the clinical reasoning abilities of the medical students in this study. The evaluation of medical students' clinical reasoning abilities through OSCE should be strengthened. PMID:25647834

  10. Can disclosure of scoring rubric for basic clinical skills improve objective structured clinical examination?

    PubMed Central

    2016-01-01

    Purpose: To determine whether disclosure of scoring rubric for objective basic clinical skills can improve the scores on the objective structured clinical examination (OSCE) in medical students. Methods: Clinical performance score results of one university medical students (study group, n=345) were compared to those of another university (control group, n=1,847). Both groups took identical OSCE exam. OSCE rubric was not revealed to the study group until they were in the last 2 years of medical school. Results: There was no significant difference between before and after disclosure of rubric. However, history taking and physical examination scores of the study group were lower than those of the control group before the disclosure of rubric. After disclosure of rubric, the scores were either unchanged or slightly increased in the control group. Trend analysis of scores demonstrated that history taking and physical examination scores after the disclosure were significantly increased in the study group for 2 years. Conclusion: This study revealed that disclosure of basic clinical skills rubric to medical students could enhance their clinical performance, particularly in history taking and physical examination scores. PMID:27240891

  11. Construct Validity of an Objective Structured Clinical Examination (OSCE) in Psychiatry: Associations with the Clinical Skills Examination and Other Indicators

    ERIC Educational Resources Information Center

    Park, Robin S.; Chibnall, John T.; Blaskiewicz, Robert J.; Furman, Gail E.; Powell, Jill K.; Mohr, Clinton J.

    2004-01-01

    Objective: The construct validity of checklist and global process scores for an objective structured clinical examination (OSCE) in psychiatry was assessed. Multiple regression analysis was used to predict psychiatry OSCE scores from the clinical skills examination, an obstetrics/gynecology (OB/GYN) OSCE, and the National Board of Medical…

  12. Geriatric Medicine Fellows' Experiences and Attitudes toward an Objective Structured Clinical Examination (OSCE)

    ERIC Educational Resources Information Center

    Bagri, Anita S.; Zaw, Khin M.; Milanez, Marcos N.; Palacios, Juan J.; Qadri, Syeda S.; Bliss, Linda A.; Roos, Bernard A.; Ruiz, Jorge G.

    2009-01-01

    A total of 8 geriatric medicine fellows participated in an objective structured clinical examination (OSCE) assessing communication skills and clinical reasoning in common geriatric syndromes. To determine their perceptions about the experience, we conducted surveys and semistructured interviews. We analyzed the survey data using descriptive…

  13. Evaluating an Objective Structured Clinical Examination (OSCE) Adapted for Social Work

    ERIC Educational Resources Information Center

    Bogo, Marion; Regehr, Cheryl; Katz, Ellen; Logie, Carmen; Tufford, Lea; Litvack, Andrea

    2012-01-01

    Objectives: To evaluate an objective structured clinical examination (OSCE) adapted for social work in a lab course and examine the degree to which it predicts competence in the practicum. Method: 125 Masters students participated in a one-scenario OSCE and wrote responses to standardized reflection questions. OSCE performance and reflections were…

  14. Brief Analysis of Application of Objective Structured Clinical Examination (OSCE) in Graduation Exams of Clinical Medical Students

    ERIC Educational Resources Information Center

    Du, Yihua; Yu, Ke; Li, Xiaohong; Wang, Feng; Wang, Tingting

    2011-01-01

    This article gives a brief introduction to the Objective Structured Clinical Examination (OSCE) and analyzes developmental progress of OSCE at both home and abroad and standardized patients' application in OSCE. Also, this article expounds application of OSCE in graduation exam of clinical medical students. Finally, this article summarizes…

  15. Factors shaping e-feedback utilization following electronic Objective Structured Clinical Examinations.

    PubMed

    Ashby, Samantha E; Snodgrass, Suzanne H; Rivett, Darren A; Russell, Trevor

    2016-09-01

    The development of student-practitioners' practical clinical skills is essential in health professional education. Objective Structured Clinical Examinations are central to the assessment of students performing clinical procedures on simulated patients (actors). While feedback is considered core to learning providing timely, individualised student OSCE feedback is difficult. This study explored the perceptions of students about the multiple factors which shape the utility of e-feedback following an electronic Objective Structured Clinical Examinations, which utilized iPad and specialised software. The e-feedback was trialled in four courses within occupational therapy and physiotherapy pre-professional programs with a cohort of 204 students. Evaluation of student perceptions about feedback was collected using two surveys and eight focus groups. This data showed three factors shaped perceptions of the utility of e- Objective Structured Clinical Examinations feedback: 1) timely accessibility within one day of the assessment, 2) feedback demonstrating examiners' academic literacy and 3) feedback orientated to ways of improving future performance of clinical skills. The study found training in the provision of feedback using IPads and software is needed for examiners to ensure e-feedback meets students' needs for specific, future-oriented e-feedback and institutional requirements for justification of grades. PMID:27029015

  16. Adapting Objective Structured Clinical Examinations to Assess Social Work Students' Performance and Reflections

    ERIC Educational Resources Information Center

    Bogo, Marion; Regehr, Cheryl; Logie, Carmen; Katz, Ellen; Mylopoulos, Maria; Regehr, Glenn

    2011-01-01

    The development of standardized, valid, and reliable methods for assessment of students' practice competence continues to be a challenge for social work educators. In this study, the Objective Structured Clinical Examination (OSCE), originally used in medicine to assess performance through simulated interviews, was adapted for social work to…

  17. Evaluation of Clinical and Communication Skills of Pharmacy Students and Pharmacists with an Objective Structured Clinical Examination

    PubMed Central

    Attridge, Rebecca L.; Tovar, John M.; Witte, Amy P.

    2015-01-01

    Objective. To evaluate how effectively pharmacy students and practicing pharmacists communicate and apply knowledge to simulations of commonly encountered patient scenarios using an objective structured clinical examination (OSCE). Design. Second-, third-, and fourth-year pharmacy students completed an OSCE as part of their required courses in 2012 and 2013. All students in both years completed identical OSCE cases. Licensed pharmacists were recruited to complete the OSCE and serve as controls in 2012. A survey assessed student perception and acceptance of the OSCE as well as student confidence in performance. Assessment. Licensed pharmacists had significantly higher clinical and communication skills scores than did pharmacy students. Student progression in communication and clinical skills improved significantly over time. Survey results indicated that students felt the OSCE was well-structured and assessed clinical skills taught in pharmacy school; 86% of students felt confident they could provide these skills. Conclusion. Objective structured clinical examinations can evaluate clinical competence and communication skills among professional students. Implementation of OSCEs may be an effective tool for assessment of the Center for the Advancement of Pharmacy Education domains. PMID:26690286

  18. An Objective Structured Clinical Examination to Assess Problem-Based Learning

    PubMed Central

    O'Connell, Mary Beth; Garwood, Candice L.; Lehr, Victoria Tutag; Abdallah, Karina

    2012-01-01

    Objectives. To compare pharmacy students’ performance on an objective structured clinical examination (OSCE) to their performance on a written examination for the assessment of problem-based learning (PBL); and to determine students’ and faculty members’ perceptions of OSCEs for PBL evaluations. Design. Four OSCEs were added to the written examination to assess 4 PBL cases in a third-year pharmacotherapy course. OSCE scores were compared to written examination scores. Faculty members evaluated student performance. Assessment. OSCE performance did not correlate with the written-examination scores. Most students (≥ 75%) agreed that OSCEs reflected their learning from PBL and measured knowledge, communication, and clinical skills. A majority of faculty members (≥75%) agreed that OSCEs should be part of PBL assessment. Conclusions. Addition of an OSCE to written examinations was valued and provided a more comprehensive assessment of the PBL experience. PMID:22544961

  19. The reliability, validity, and usefulness of the Objective Structured Clinical Examination (OSCE) in dental education

    NASA Astrophysics Data System (ADS)

    Graham, Roseanna

    This study evaluated the reliability, validity, and educational usefulness of a comprehensive, multidisciplinary Objective Structured Clinical Examination (OSCE) in dental education. The OSCE was administered to dental students at the Columbia University College of Dental Medicine (CDM) before they entered clinical training. Participants in this study included CDM's class of 2010 which consisted of 78 students. The overall reliability of the examination was measured via calculation of Cronbach's alpha. Content validity was examined through evaluation of the OSCE by three experienced clinical faculty members. Predictive validity was evaluated by correlating student grades on the OSCE to future clinical performance as measured by number of clinical points achieved during the third year of training. Student perceptions regarding the educational usefulness of the examination were evaluated through a 12-question Liken-type survey and focus group interviews analyzed using a phenomenological approach. Findings of the study indicated the OSCE was a highly reliable examination (alpha=0.86) with high content validity and a moderately high correlation to future clinical performance (r=.614, p<.0001). Overall, student perceptions of the educational usefulness of the OSCE were positive as based on their responses to a 5-point Likert scale (1=strongly disagree and 5=strongly agree). They reported that the exam required the ability to think critically and problem-solve (4.0 +/- 0.85), assessed clinically relevant skills (4.59 +/- 0.69), helped identify clinical weaknesses (4.16 +/- 0.90), and was a learning experience (4.58 +/- 0.84). Findings from the qualitative portion of the study identified four main themes including the student perception that the OSCE is a unique assessment experience that required integration and application of knowledge. Recommendations for the use of the OSCE to improve clinical teaching and the implications of this study relating to the expanded use of

  20. A Competitive Objective Structured Clinical Examination Event to Generate an Objective Assessment of Anesthesiology Resident Skills Development.

    PubMed

    Rebel, Annette; DiLorenzo, Amy N; Fragneto, Regina Y; Dority, Jeremy S; Rose, Greg; Nguyen, Dung; Hassan, Zaki-Udin; Schell, Randall M

    2016-05-15

    Residency programs are charged with teaching, assessing, and documenting resident competency for a multitude of skills throughout the course of residency training. An innovative, competition-based objective structured clinical examination event was designed in our department to objectively assess the skill level of anesthesiology residents. After conducting the identical event for 2 years in postgraduate year 1 (PGY1) and postgraduate year 2 (PGY2) residents, we tested the hypothesis that the event can provide adequate standardization to appropriately document progression in technical and nontechnical skills. Twenty-one residents participated in both events during their PGY1 and PGY2 years: n = 10, 2012/2013, n = 11, 2013/2014. The PGY1 participants in 2012 were retested in 2013 (as PGY2 residents) during an identical event, and their performance was compared as a group and on an individual level. The PGY1 residents in 2013 did the same in 2014. Four workstations were analyzed to determine whether improvement in performance occurred between the PGY1 and the PGY2 years: (1) preoperative assessment, (2) operating room anesthesia station checkout, (3) peripheral IV and endotracheal tube placement, and (4) transfer of care in the postanesthesia care unit. The performances of PGY1 and PGY2 residents were compared. The assessments were performed by anesthesiology faculty using checklists, time to complete task, and Likert scale ratings. Data analysis showed improved technical anesthesia skills (operating room setup, peripheral IV, and endotracheal tube placement) and more complete anesthesia-related information management in the preoperative assessment and postoperative transition of care in the postanesthesia care unit in PGY2 residents compared with the PGY1 performance of the same residents. The described event is a valuable tool for objective assessment of multiple anesthesia skills and possible milestones during residency. PMID:26752179

  1. The cost of the objective structured clinical examination on an Italian nursing bachelor's degree course.

    PubMed

    Palese, A; Bulfone, G; Venturato, E; Urli, N; Bulfone, T; Zanini, A; Fabris, S; Tomietto, M; Comisso, I; Tosolini, C; Zuliani, S; Dante, A

    2012-05-01

    The OSCE (Objective Structured Clinical Examination) is considered the most valid and reliable method for assessing the clinical skills of students training for health professions, but its use is limited by the related high costs. We analyzed the cost retrospectively of using an OSCE designed for second-year students (2009) in our degree course, adopting the Reznick et al. guidelines (1993), which recommend assessing both high-end costs and low-end costs. The high-end costs adopting the OSCE amounted to € 145.23 per student, while the low-end costs were € 31.51 per student. Considering the economic crisis and the cost-containment measures applied also in nursing education, strategies for further reducing costs are discussed. PMID:21470724

  2. Limited Predictive Utility of Admissions Scores and Objective Structured Clinical Examinations for APPE Performance

    PubMed Central

    McLaughlin, Jacqueline E.; Khanova, Julia; Scolaro, Kelly; Rodgers, Philip T.

    2015-01-01

    Objective. To examine the relationship between admissions, objective structured clinical examination (OSCE), and advanced pharmacy practice experience (APPE) scores. Methods. Admissions, OSCE, and APPE scores were collected for students who graduated from the doctor of pharmacy (PharmD) program in spring of 2012 and spring of 2013 (n=289). Pearson correlation was used to examine relationships between variables, and independent t test was used to compare mean scores between groups. Results. All relationships among admissions data (undergraduate grade point average, composite PCAT scores, and interview scores) and OSCE and APPE scores were weak, with the strongest association found between the final OSCE and ambulatory care APPEs. Students with low scores on the final OSCE performed lower than others on the acute care, ambulatory care, and community APPEs. Conclusion. This study highlights the complexities of assessing student development of noncognitive professional skills over the course of a curriculum. PMID:26430271

  3. Perceptions of postgraduate trainees on the impact of objective structured clinical examinations on their study behavior and clinical practice

    PubMed Central

    Opoka, Robert O; Kiguli, Sarah; Ssemata, Andrew S; Govaerts, Marjan; Driessen, Erik W

    2015-01-01

    Background The objective structured clinical examination (OSCE) is a commonly used method of assessing clinical competence at various levels, including at the postgraduate level. How the OSCE impacts on learning in higher education is poorly described. In this study, we evaluated the perceptions of postgraduate trainees regarding the impact of the OSCE on their study and clinical behavior. Methods We employed an explorative qualitative research design by conducting focus group discussions with 41 pediatric postgraduate trainees at the College of Health Science, Makerere University. A semi-structured tool was used to obtain the views and experiences of the trainees. Transcripts from the discussion were analyzed in an iterative manner using thematic content analysis. Results The trainees reported the OSCEs as a fair and appropriate tool for assessing clinical competency at the postgraduate level. However, they noted that whereas OSCEs assess a broad range of skills and competencies relevant to their training, there were areas that they did not adequately assess. In particular, OSCEs did not adequately assess in-depth clinical knowledge or detailed history-taking skills. Overall, the majority of the trainees reported that the OSCEs inspired them to study widely and improve their procedural and communication skills. Conclusion OSCEs are a useful tool for assessing clinical competencies in postgraduate education. However, the perceived limitations in their ability to assess complex skills raises concerns about their use as a standalone mode of assessment at the postgraduate level. Future studies should evaluate how use of OSCEs in combination with other assessment tools impacts on learning. PMID:26082673

  4. The opinion of post graduate students on objective structured clinical examination in Anaesthesiology: A preliminary report

    PubMed Central

    Jindal, Parul; Khurana, Gurjeet

    2016-01-01

    Background and Aims: The scenario in medical education is changing with objective structured clinical examination (OSCE) being introduced as an assessment tool. Its successful implementation in anaesthesiology postgraduate evaluation process is still limited. We decided to to evaluate the effectiveness of OSCE and compare it to conventional examinations as formative assessment tools in anaesthesiology. Methods: We conducted a cross-sectional comparative study in defined population of anaesthesiology postgraduate students to evaluate the effectiveness of OSCE as compared to conventional examination as formative assessment tool in anaesthesiology. Thirty-five students appeared for the conventional examination on the 1st day and viva voce on the 2nd day and OSCE on the last day. At the conclusion of the assessment, all the students were asked to respond to the perception evaluation questionnaire. We analysed the perception of OSCE among the students. Results: Results showed a positive perception of the objective structured physical examination (OSCE) as well as structured 9 (25.7%), fair 19 (54.2%) and unbiased 13 (37.1%) with more standardised scoring 9 (25.7%). The students perceived OSCE to be less stressful than other examination. Thirty-one (88.5%) students agreed that OSCE is easier to pass than conventional method and 29 (82.5%) commented that the degree of emotional stress is less in OSCE than traditional methods. Conclusion: OSCE is better evaluation tool when compared to conventional examination. PMID:27053779

  5. [Improving the Care Accuracy of Percutaneously Inserted Central Catheters Using Objective Structured Clinical Examination].

    PubMed

    Yang, Pei-Hsin; Hsu, Hsin-Chieh; Chiang, Chia-Chin; Tseng, Yun-Shan

    2016-06-01

    Approximately 9,800 adverse events related to medical tubing are reported in Taiwan every year. Most neonates in critical condition and premature infants acquire fluid, nutrition, and infusion solution using percutaneously inserted central catheters (PICCs). Objective structured clinical examination (OSCE) is an objective evaluative tool that may be used to measure the clinical competence of healthcare professionals. Very little is known about the effects of OSCE in Taiwan in terms of improving the accuracy of use of PICCs in nursing care and of reducing unexpected medical tubing removals. The present project aimed to explore the effects of an OSCE course on these two issues in the realms of standard operating procedures, care protocols, and training equipment at a neonatal intermediate unit in Taiwan. The duration of the present study ran from 2/20/2013 to 10/30/2013. The results showed that nurses' knowledge of PICCs improved from 87% to 91.5%; nurses' skill-care accuracy related to PICCs improved from 59.1% to 97.3%; and incidents of unexpected tube removals declined from 63.6% to 16.7%. This project demonstrated that OSCE courses improve the quality of PICC nursing care. Additionally, the instant feedback mechanism within the OSCE course benefited both teachers and students. PMID:27250965

  6. Evaluation of midwifery students’ competency in providing intrauterine device services using objective structured clinical examination

    PubMed Central

    Erfanian, Fatemeh; Khadivzadeh, Talaat

    2011-01-01

    BACKGROUND: Delivering IUD services is one of the important competencies that midwifery students must obtain during academic period. As Objective Structured Clinical Examination (OSCE) can be reasonably reliable, valid and objective method for clinical skills assessment, this study was conducted to assess midwifery students’ skill in delivering intrauterine device (IUD) services using a clinical examination and their satisfaction from the OSCE. METHODS: All of the 62 eligible Bachelor of Science midwifery students of Mashhad University of Medical Sciences participated in a ten-station OSCE about delivering IUD services for 50 minutes in 2006. Students performed technical skills or interacted with standard patients in 6 stations and in 4 stations they answered to the related questions. Students’ performance in 6 stations was rated by observer or standard patients using validated checklists. Students’ level of satisfaction and also their experience of participating in OSCE examination were gathered. RESULTS: Performance of 98.2% of students was poor. On average, the students gained 49% of total score in counseling and screening, 35.7% in inserting the IUD, 40% in IUD removal and 24.4% in management of IUD side effect. Eighty percent of students rated their satisfaction from the OSCE high and very high. Students reported the OSCE as an enjoying examination experience. CONCLUSIONS: Students’ skill in delivering IUD services was lower than expected level that shows the need to change the current teaching methods. OSCE is a valid evaluation method which provides valuable information which cannot be obtained by more traditional assessment modalities. Based on the finding of this study a workshop program on providing IUD services for midwifery students and family planning providers should be prepared. PMID:22224105

  7. Reliability analysis of the objective structured clinical examination using generalizability theory

    PubMed Central

    Trejo-Mejía, Juan Andrés; Sánchez-Mendiola, Melchor; Méndez-Ramírez, Ignacio; Martínez-González, Adrián

    2016-01-01

    Background The objective structured clinical examination (OSCE) is a widely used method for assessing clinical competence in health sciences education. Studies using this method have shown evidence of validity and reliability. There are no published studies of OSCE reliability measurement with generalizability theory (G-theory) in Latin America. The aims of this study were to assess the reliability of an OSCE in medical students using G-theory and explore its usefulness for quality improvement. Methods An observational cross-sectional study was conducted at National Autonomous University of Mexico (UNAM) Faculty of Medicine in Mexico City. A total of 278 fifth-year medical students were assessed with an 18-station OSCE in a summative end-of-career final examination. There were four exam versions. G-theory with a crossover random effects design was used to identify the main sources of variance. Examiners, standardized patients, and cases were considered as a single facet of analysis. Results The exam was applied to 278 medical students. The OSCE had a generalizability coefficient of 0.93. The major components of variance were stations, students, and residual error. The sites and the versions of the tests had minimum variance. Conclusions Our study achieved a G coefficient similar to that found in other reports, which is acceptable for summative tests. G-theory allows the estimation of the magnitude of multiple sources of error and helps decision makers to determine the number of stations, test versions, and examiners needed to obtain reliable measurements. PMID:27543188

  8. Measuring Professional Behaviour in Canadian Physical Therapy Students' Objective Structured Clinical Examinations: An Environmental Scan

    PubMed Central

    Ellerton, Cindy; Evans, Cathy

    2015-01-01

    ABSTRACT Purpose: To identify professional behaviours measured in objective structured clinical examinations (OSCEs) by Canadian university physical therapy (PT) programs. Method: A cross-sectional telephone survey was conducted to review current practice and determine which OSCE items Canadian PT programs are using to measure PT students' professional behaviours. Telephone interviews using semi-structured questions were conducted with individual instructors responsible for courses that included an OSCE as part of the assessment component. Results: Nine PT programmes agreed to take part in the study, and all reported conducting at least one OSCE. The number and characteristics of OSCEs varied both within and across programs. Participants identified 31 professional behaviour items for use in an OSCE; these items clustered into four categories: communication (n=14), respect (n=10), patient safety (n=4), and physical therapists' characteristics (n=3). Conclusions: All Canadian entry-level PT programmes surveyed assess professional behaviours in OSCE-type examinations; however, the content and style of assessment is variable. The local environment should be considered when determining what professional behaviours are appropriate to assess in the OSCE context in individual programmes. PMID:25931656

  9. Objective structured clinical examination for pharmacy students in Qatar: cultural and contextual barriers to assessment.

    PubMed

    Wilby, K J; Black, E K; Austin, Z; Mukhalalati, B; Aboulsoud, S; Khalifa, S I

    2016-04-01

    This study aimed to evaluate the feasibility and psychometric defensibility of implementing a comprehensive objective structured clinical examination (OSCE) on the complete pharmacy programme for pharmacy students in a Middle Eastern context, and to identify facilitators and barriers to implementation within new settings. Eight cases were developed, validated, and had standards set according to a blueprint, and were assessed with graduating pharmacy students. Assessor reliability was evaluated using inter-class coefficients (ICCs). Concurrent validity was evaluated by comparing OSCE results to professional skills course grades. Field notes were maintained to generate recommendations for implementation in other contexts. The examination pass mark was 424 points out of 700 (60.6%). All 23 participants passed. Mean performance was 74.6%. Low to moderate inter-rater reliability was obtained for analytical and global components (average ICC 0.77 and 0.48, respectively). In conclusion, OSCE was feasible in Qatar but context-related validity and reliability concerns must be addressed prior to future iterations in Qatar and elsewhere. PMID:27432407

  10. The effectiveness of immediate feedback during the objective structured clinical examination.

    PubMed

    Hodder, R V; Rivington, R N; Calcutt, L E; Hart, I R

    1989-03-01

    Using eight different physical examination or technical stations, 400 examinations were conducted to evaluate the effectiveness of immediate feedback during the Objective Structured Clinical Examination (OSCE). The test group comprised 50 medical students who underwent a standard 4-minute examination followed by 2 minutes of feedback. Immediately following feedback the students repeated an identical 4-minute examination scored by the same examiners. The control group consisted of 50 students from the same class who underwent an identical testing sequence, but instead of receiving feedback, they were instructed to continue their examinations for an additional 2 minutes before repeating the stations. Simple repetition of the task did not significantly improve score (mean increase 2.0%, NS). Extending the testing period from 4 to 6 minutes resulted in a small but significant increase in score (mean 6.7%, P less than 0.001). However, there was a much larger increase in the scores obtained following 2 minutes of immediate feedback compared to pre-feedback performance (mean 26.3%, P less than 0.0001). The majority of students and examiners felt that feedback, as administered in this study, was valuable both as a learning and teaching experience. Short periods of immediate feedback during an OSCE are practical and can improve competency in the performance of criterion-based tasks, at least over the short term. In addition, such feedback provides students with valuable self-assessment that may stimulate further learning. PMID:2716557

  11. Assessment of percutaneous renal access skills during Urology Objective Structured Clinical Examinations (OSCE)

    PubMed Central

    Noureldin, Yasser A.; Elkoushy, Mohamed A.; Andonian, Sero

    2015-01-01

    Introduction: The first objective was to assess percutaneous renal access (PCA) skills of urology postgraduate trainees (PGTs) during the Objective Structured Clinical Examinations (OSCEs). The second objective was to determine whether previous experience with percutaneous nephrolithotomy (PCNL) improved performance. Methods: After obtaining ethics approval, we recruited PGTs from two urology programs in Quebec between postgraduate years (PGY-3 to PGY-5). Each trainee was asked to answer a short questionnaire regarding previous experience in endourologic procedures. After a 3-minute orientation on the PERC Mentor simulator (Simbionix, Cleveland, OH), each trainee was asked to perform task 4, where they had to correctly access all of the renal calyces and pop the balloons in a normal left kidney model. We collected and analyzed data from the questionnaire and the performance report generated by the simulator. Results: In total, 13 PGTs participated in this study. PGTs had performed a median of 200 (range: 50–1000) cystoscopies, 50 (range: 10–125) TURBTs, 30 (range: 0–100) TURPs, 5 (range: 0–50) laser prostatectomies, and 50 (range: 2–125) ureteroscopies prior to this OSCE. PGTs with previous PCNL experience (8/13) had performed a mean of 18.6 ± 6.3 PCNLs. PGTs with previous PCNL experience performed significantly better in terms of shorter fluoroscopy time (10 ± 1.5 vs. 5.1 ± 0.7 min; p = 0.04), fewer attempts required for successful puncture of the pelvi-calyceal system (PCS) (21 ± 2.3 vs. 13 ± 1.8; p = 0.02), and had significantly lower complications in terms of fewer infundibular injury (7.4 ± 1.5 vs. 2 ± 0.4; p = 0.004) and fewer PCS perforations (11 ± 1.7 vs. 4.5 ± 1.2; p = 0.01). Conclusion: It is feasible to use the PERC Mentor simulator during OSCEs to assess PCA skills of urology PGTs. PGTs who had previous PCNL experience performed significantly better with fewer complications. PMID:25844094

  12. Assessment of photoselective vaporization of prostate skills during Urology Objective Structured Clinical Examinations (OSCE)

    PubMed Central

    Noureldin, Yasser A.; Elkoushy, Mohamed A.; Fahmy, Nader; Carrier, Serge; Elhilali, Mostafa M.; Andonian, Sero

    2015-01-01

    Introduction: We evaluated the use of the GreenLight Simulator (GL-SIM) (American Medical Systems, Guelph, ON) in the skill assessment of postgraduate trainees (PGTs) in photoselective vaporization of the prostate (PVP). We also sought to determine whether previous PVP experience or GL-SIM practice improved performance. Methods: PGTs in postgraduate years (PGY-3 to PGY-5) from all 4 Quebec urology training programs were recruited during 2 annual Objective Structured Clinical Examinations (OSCEs). During a 20-minute OSCE station, PGTs were asked to perform 2 exercises: (1) identification of endoscopic landmarks and (2) a PVP of a 30-g normal prostate. Grams vaporized, global scores, and number of correct anatomical landmarks were recorded and correlated with PGY level, practice on the GL-SIM, and previous PVP experience. Results: In total, 25 PGTs were recruited at each OSCE, with 13 PGTs participating in both OSCEs. When comparing scores from the first and second OSCEs, there was a significant improvement in the number of grams vaporized (2.9 vs. 4.3 g; p = 0.003) and global score (100 vs. 165; p = 0.03). There was good correlation between the number of previously performed PVPs and the global score (r = 0.4, p = 0.04). Similarly, PGTs with previous practice on the GL-SIM had significantly higher global score (100.6 vs. 162.6; p = 0.04) and grams vaporized (3.1 vs. 4.1 g; p = 0.04) when compared with those who did not practice on GL-SIM. Furthermore, there were significantly more competent PGTs among those who had previously practiced on the GL-SIM (32.7% vs. 10.2%; p = 0.009). PGY level did not significantly affect grams vaporized or global score (p > 0.05). Conclusion: Performance on the GL-SIM at OSCEs significantly correlated with previous practice on the GL-SIM and previous PVP experience rather than PGY level. Furthermore, there were significantly more competent PGTs among those who had previously practiced on the GL-SIM. PMID:25737763

  13. Translating the IHE Teaching File and Clinical Trial Export (TCE) profile document templates into functional DICOM structured report objects.

    PubMed

    Kamauu, Aaron W C; DuVall, Scott L; Liimatta, Andrew P; Wiggins, Richard H; Avrin, David E

    2008-12-01

    The Integrating the Healthcare Enterprise (IHE) Teaching File and Clinical Trial Export (TCE) integration profile describes a standard workflow for exporting key images from an image manager/archive to a teaching file, clinical trial, or electronic publication application. Two specific digital imaging and communication in medicine (DICOM) structured reports (SR) reference the key images and contain associated case information. This paper presents step-by-step instructions for translating the TCE document templates into functional and complete DICOM SR objects. Others will benefit from these instructions in developing TCE compliant applications. PMID:17805930

  14. Identifying strengths and weaknesses in the utilization of Objective Structured Clinical Examination (OSCE) in a nursing program.

    PubMed

    McWilliam, Paula L; Botwinski, Carol A

    2012-01-01

    Objective Structured Clinical Examination (OSCE) is used in nursing to assess students' transfer of classroom and laboratory learning experiences into simulated clinical practice. OSCE is a performance-based exam in which students are observed demonstrating a multitude of clinical behaviors. The purpose of this study was to identify strengths and weaknesses in the utilization of OSCE in this nursing program with 60 full-time students ages 21 to 23. An evaluation methodology was used for this study. Interviews were conducted with two groups: faculty facilitators of OSCE and standardized patients (SPs). Areas of focus were: data collection of students' performance, SP selection and training, and modification of the Nursing Interview Interaction Scale (NIIS). It was found that with appropriate SP selection and training, utilization of appropriate tools, and good data collection, OSCE can offer a valid and reliable means of testing nursing students' clinical competencies. PMID:22416539

  15. Objective Eulerian coherent structures.

    PubMed

    Serra, Mattia; Haller, George

    2016-05-01

    We define objective Eulerian Coherent Structures (OECSs) in two-dimensional, non-autonomous dynamical systems as the instantaneously most influential material curves. Specifically, OECSs are stationary curves of the averaged instantaneous material stretching-rate or material shearing-rate functionals. From these objective (frame-invariant) variational principles, we obtain explicit differential equations for hyperbolic, elliptic, and parabolic OECSs. As an illustration, we compute OECSs in an unsteady ocean velocity data set. In comparison to structures suggested by other common Eulerian diagnostic tools, we find OECSs to be the correct short-term cores of observed trajectory deformation patterns. PMID:27249950

  16. Objective Eulerian coherent structures

    NASA Astrophysics Data System (ADS)

    Serra, Mattia; Haller, George

    2016-05-01

    We define objective Eulerian Coherent Structures (OECSs) in two-dimensional, non-autonomous dynamical systems as the instantaneously most influential material curves. Specifically, OECSs are stationary curves of the averaged instantaneous material stretching-rate or material shearing-rate functionals. From these objective (frame-invariant) variational principles, we obtain explicit differential equations for hyperbolic, elliptic, and parabolic OECSs. As an illustration, we compute OECSs in an unsteady ocean velocity data set. In comparison to structures suggested by other common Eulerian diagnostic tools, we find OECSs to be the correct short-term cores of observed trajectory deformation patterns.

  17. A focus group study of the use of video-recorded simulated objective structured clinical examinations in nurse practitioner education.

    PubMed

    Barratt, Julian

    2010-05-01

    The objective structured clinical examination (OSCE) is a common method of clinical skills assessment used for advanced nurse practitioner students across the United Kingdom. The purpose of an advanced nursing OSCE is to assess a nurse practitioner student's competence and safety in the performance of commonly used advanced clinical practice skills. Students often feel nervous when preparing for and participating in an OSCE. Consideration of these identified anxieties led to the development of an alternative method of meeting students' OSCE learning and preparation needs; namely video-recorded simulated OSCEs. Video-recording was appealing for the following reasons: it provides a flexible usage of staff resources and time; OSCE performance mistakes can be rectified; it is possible to use the same video-recordings with multiple cohorts of students, and the recordings can be made conveniently available for students with video streaming on internet-based video-sharing sites or virtual learning environments. The aim of the study was to explore the value of using such recordings amongst nurse practitioner students, via online and face-to-face focus groups, to see if they are a suitable OSCE educational preparation technique. The study findings indicate that simulated OSCE video-recordings are an effective method for supporting nurse practitioner educational development. PMID:20202909

  18. Implementation of an Electronic Objective Structured Clinical Exam for Assessing Practical Skills in Pre-Professional Physiotherapy and Occupational Therapy Programs: Examiner and Course Coordinator Perspectives

    ERIC Educational Resources Information Center

    Snodgrass, Suzanne J.; Ashby, Samantha E.; Rivett, Darren A.; Russell, Trevor

    2014-01-01

    Assessment of practical clinical skills is essential in the health fields. Objective Structured Clinical Exams (OSCEs), where examiners assess students performing clinical procedures on simulated patients (actors), are central to the evaluation of practical skills. However, traditional OSCEs require considerable time-investment to administer, and…

  19. Experiences in adding multiple-choice questions to an objective structural clinical examination (OSCE) in undergraduate dental education.

    PubMed

    Näpänkangas, R; Harila, V; Lahti, S

    2012-02-01

    In the University of Oulu, the competencies of fourth-year dental students have traditionally been assessed with a written examination before they go to work for the first time as dentists outside the Institute of Dentistry. In 2009, the objective structural clinical examination (OSCE) modified with multiple-choice questions was introduced as a tool for assessing clinical competencies. The aim of the study was to evaluate the validity of the modified OSCE (m-OSCE) by measuring the attitude of examiners (teachers) and dental students towards the m-OSCE and to evaluate whether the OSCE is preferred to the written examination in the assessment of knowledge and clinical skills. Additionally, the aim was to evaluate the reliability of the multiple-choice examination. Altogether 30 students (86%) and 11/12 examiners (92%) responded to the questionnaire. Most of the students considered the multiple-choice questions easy, but complained about the complex formulation of the questions. The test stations were easy for 87% of the students, but the time allocated was too short. Most of the students (73%) and examiners (91%) preferred the m-OSCE to the written examination. All students and examiners found the immediate assessment of the tasks good. Based on the evaluations of m-OSCE, it could be concluded that both students and examiners preferred the m-OSCE to the pure written examination in assessment, which indicate that m-OSCE had good face validity. Combining multiple methods in assessment of knowledge and clinical skills whilst simultaneously taking into account the feasibility and available resources provides more valid results. PMID:22251338

  20. Objective Structured Clinical Examination (OSCE)-based Assessment of the Advanced Trauma Life Support (ATLS) Course in Iran

    PubMed Central

    Abbasi, Hamid Reza; Amini, Mitra; Bolandparvaz, Shahram; Paydar, Shahram; Ali, Jameel; Sefidbakht, Sepideh

    2016-01-01

    Objective: To evaluate the effect of advance trauma life support (ATLS®) training on general surgery residents clinical reasoning skills using the national boards-style objective structured clinical examination (OSCE). Methods: This cross-sectional single-center study was conducted in Shiraz University of Medical Sciences including 51 surgery residents that participated in a mandatory national board style OSCE between May 2014 and May 2015. OSCE scores of two groups of general surgery residents including 23 ATLS® trained and 28 non-ATLS® trained were compared using Mann-Whitney U test. The exam was graded out of 20 points and the passing score was ≥14 including 40% trauma cases. Results: There were 8(15.7%) women and 43(84.3%) men among the participants with mean age of 31.12 ± 2.69 and 33.67 ± 4.39 years in women and men respectively. Overall 7 (87.5%) women and 34 (79.07%) men passed the OSCE. The trauma section OSCE score was significantly higher in the ATLS® trained participants when compared to non-ATLS®(7.79 ± 0.81vs.6.90 ± 1.00; p=0.001). In addition, the total score was also significantly higher in ATLS® trained residents (16.07 ± 1.41 vs. 14.60 ± 1.40; p=0.001). There was no association between gender and ATLS® score (p=0.245) or passing the OSCE (p=0.503). Conclusion: ATLS® training is associated with improved overall OSCE scores of general surgery residents completing the board examinations suggesting a positive transfer of ATLS learned skills to management of simulated surgical patients including trauma cases. PMID:27331063

  1. Assessment of first-year veterinary students' communication skills using an objective structured clinical examination: the importance of context.

    PubMed

    Hecker, Kent G; Adams, Cindy L; Coe, Jason B

    2012-01-01

    Communication skills are considered to be a core clinical skill in veterinary medicine and essential for practice success, including outcomes of care for patients and clients. While veterinary schools include communication skills training in their programs, there is minimal knowledge on how best to assess communication competence throughout the undergraduate program. The purpose of this study was to further our understanding of the reliability, utility, and suitability of a communication skills Objective Structured Clinical Examination (OSCE). Specifically we wanted to (1) identify the greatest source of variability (student, rater, station, and track) within a first-year, four station OSCE using exam scores and scores from videotape review by two trained raters, and (2) determine the effect of different stations on students' communication skills performance. Reliability of the scores from both the exam data and the two expert raters was 0.50 and 0.46 respectively, with the greatest amount of variance attributable to student by station. The percentage of variance due to raters in the exam data was 16.35%, whereas the percentage of variance for the two expert raters was 0%. These results have three important implications. First, the results reinforce the need for communication educators to emphasize that use of communication skills is moderated by the context of the clinical interaction. Second, by increasing rater training the amount of error in the scores due to raters can be reduced and inter-rater reliability increases. Third, the communication assessment method (in this case the OSCE checklist) should be built purposefully, taking into consideration the context of the case. PMID:22951466

  2. Designing the objective structured clinical examination to cover all major areas of physical medicine and rehabilitation over 3 yrs.

    PubMed

    Garstang, Susan; Altschuler, Eric L; Jain, Sheela; Delisa, Joel A

    2012-06-01

    The Accreditation Council for Graduate Medical Education requires that training programs comprehensively evaluate residents in the six core Accreditation Council for Graduate Medical Education competencies. One of the ways we do this in our residency is by administering a nine-station Objective Structured Clinical Examination (OSCE) at the end of each year, which evaluates tasks such as history taking, focused physical examination, communication, professionalism, procedural skills, management, prescription writing, and understanding systems-based practice. We have classified our OSCE stations into what we consider key areas in our field and assessed these on a rotating basis over 3 yrs. This results in the assessment of 27 areas over the 3 yrs of residency. Structuring the OSCE as a series of stations over 3 yrs is an efficient method to evaluate residents' competencies that are required by the Accreditation Council for Graduate Medical Education and certifying boards. An analysis of OSCE scores when compared with American Board of Physical Medicine & Rehabilitation parts 1 and 2 scores and final summative resident evaluation scores reveals that OSCE results correlate with part 1 scores and final evaluation scores but do not show the same strong correlations with part 2 scores. We discuss the way the OSCE can complete other assessment techniques and ways to improve cases in the future. PMID:22469878

  3. Assessing Communication Skills of Medical Students in Objective Structured Clinical Examinations (OSCE) - A Systematic Review of Rating Scales

    PubMed Central

    Cömert, Musa; Zill, Jördis Maria; Christalle, Eva; Dirmaier, Jörg; Härter, Martin; Scholl, Isabelle

    2016-01-01

    Background Teaching and assessment of communication skills have become essential in medical education. The Objective Structured Clinical Examination (OSCE) has been found as an appropriate means to assess communication skills within medical education. Studies have demonstrated the importance of a valid assessment of medical students’ communication skills. Yet, the validity of the performance scores depends fundamentally on the quality of the rating scales used in an OSCE. Thus, this systematic review aimed at providing an overview of existing rating scales, describing their underlying definition of communication skills, determining the methodological quality of psychometric studies and the quality of psychometric properties of the identified rating scales. Methods We conducted a systematic review to identify psychometrically tested rating scales, which have been applied in OSCE settings to assess communication skills of medical students. Our search strategy comprised three databases (EMBASE, PsycINFO, and PubMed), reference tracking and consultation of experts. We included studies that reported psychometric properties of communication skills assessment rating scales used in OSCEs by examiners only. The methodological quality of included studies was assessed using the COnsensus based Standards for the selection of health status Measurement INstruments (COSMIN) checklist. The quality of psychometric properties was evaluated using the quality criteria of Terwee and colleagues. Results Data of twelve studies reporting on eight rating scales on communication skills assessment in OSCEs were included. Five of eight rating scales were explicitly developed based on a specific definition of communication skills. The methodological quality of studies was mainly poor. The psychometric quality of the eight rating scales was mainly intermediate. Discussion Our results reveal that future psychometric evaluation studies focusing on improving the methodological quality are needed

  4. Objective pain diagnostics: clinical neurophysiology.

    PubMed

    Garcia-Larrea, L

    2012-06-01

    Neurophysiological techniques help in diagnosis, prognosis and treatment of chronic pain, and are particularly useful to determine its neuropathic origin. According to current standards, the diagnosis of definite neuropathic pain (NP) needs objective confirmation of a lesion or disease of somatosensory systems, which can be provided by neurophysiological testing. Lesions causing NP mostly concern the pain-temperature pathways, and therefore neurophysiological procedures allowing the specific testing of these pathways (i.e., A-delta and C-fibres, spino-thalamo-cortical tracts) are essential for objective diagnosis. Different techniques to stimulate selectively pain-temperature pathways are discussed. Of these, laser-evoked potentials (LEPs) appear as the easiest and most reliable neurophysiological method of assessing nociceptive function, and their coupling with autonomic responses (e.g., galvanic skin response) and psychophysics (quantitative sensory testing - QST) can still enhance their diagnostic yield. Neurophysiological techniques not exploring specifically nociception, such as standard nerve conduction velocities (NCV) and SEPs to non-noxious stimulation, should be associated to the exploration of nociceptive systems, not only because both may be simultaneously affected to different degrees, but also because some specific painful symptoms, such as paroxysmal discharges, may depend on specific alteration of highly myelinated A-beta fibres. The choice of techniques is determined after anamnesis and clinical exam, and tries to answer a number of questions: (a) is the pain-related to injury of somatosensory pathways?; (b) to what extent are different subsystems affected?; (c) are mechanisms and lesion site in accordance with imaging data?; (d) are results of use for diagnostic or therapeutic follow-up? Neuropathic pain (NP) affects more than 15 million people in Western countries, and its belated diagnosis leads to insufficient or delayed therapy. The use of

  5. Test of Integrated Professional Skills: Objective Structured Clinical Examination/Simulation Hybrid Assessment of Obstetrics-Gynecology Residents' Skill Integration

    PubMed Central

    Winkel, Abigail Ford; Gillespie, Colleen; Hiruma, Marissa T.; Goepfert, Alice R.; Zabar, Sondra; Szyld, Demian

    2014-01-01

    Background Assessment of obstetrics-gynecology residents' ability to integrate clinical judgment, interpersonal skills, and technical ability in a uniform fashion is required to document achievement of benchmarks of competency. An observed structured clinical examination that incorporates simulation and bench models uses direct observation of performance to generate formative feedback and standardized evaluation. Methods The Test of Integrated Professional Skills (TIPS) is a 5-station performance-based assessment that uses standardized patients and complex scenarios involving ultrasonography, procedural skills, and evidence-based medicine. Standardized patients and faculty rated residents by using behaviorally anchored checklists. Mean scores reflecting performance in TIPS were compared across competency domains and by developmental level (using analysis of variance) and then compared to standard faculty clinical evaluations (using Spearman ρ). Participating faculty and residents were also asked to evaluate the usefulness of the TIPS. Results Twenty-four residents participated in the TIPS. Checklist items used to assess competency were sufficiently reliable, with Cronbach α estimates from 0.69 to 0.82. Performance improved with level of training, with wide variation in performance. Standard faculty evaluations did not correlate with TIPS performance. Several residents who were rated as average or above average by faculty performed poorly on the TIPS (> 1 SD below the mean). Both faculty and residents found the TIPS format useful, providing meaningful evaluation and opportunity for feedback. Conclusions A simulation-based observed structured clinical examination facilitates observation of a range of skills, including competencies that are difficult to observe and measure in a standardized way. Debriefing with faculty provides an important interface for identification of performance gaps and individualization of learning plans. PMID:24701321

  6. A new method for the assessment of patient safety competencies during a medical school clerkship using an objective structured clinical examination

    PubMed Central

    Daud-Gallotti, Renata Mahfuz; Morinaga, Christian Valle; Arlindo-Rodrigues, Marcelo; Velasco, Irineu Tadeu; Arruda Martins, Milton; Tiberio, Iolanda Calvo

    2011-01-01

    INTRODUCTION: Patient safety is seldom assessed using objective evaluations during undergraduate medical education. OBJECTIVE: To evaluate the performance of fifth-year medical students using an objective structured clinical examination focused on patient safety after implementation of an interactive program based on adverse events recognition and disclosure. METHODS: In 2007, a patient safety program was implemented in the internal medicine clerkship of our hospital. The program focused on human error theory, epidemiology of incidents, adverse events, and disclosure. Upon completion of the program, students completed an objective structured clinical examination with five stations and standardized patients. One station focused on patient safety issues, including medical error recognition/disclosure, the patient-physician relationship and humanism issues. A standardized checklist was completed by each standardized patient to assess the performance of each student. The student's global performance at each station and performance in the domains of medical error, the patient-physician relationship and humanism were determined. The correlations between the student performances in these three domains were calculated. RESULTS: A total of 95 students participated in the objective structured clinical examination. The mean global score at the patient safety station was 87.59±1.24 points. Students' performance in the medical error domain was significantly lower than their performance on patient-physician relationship and humanistic issues. Less than 60% of students (n = 54) offered the simulated patient an apology after a medical error occurred. A significant correlation was found between scores obtained in the medical error domains and scores related to both the patient-physician relationship and humanistic domains. CONCLUSIONS: An objective structured clinical examination is a useful tool to evaluate patient safety competencies during the medical student clerkship

  7. Learning from the Narrative Comments of Standardized Patients during an Objective Structured Clinical Examination of Fourth-Year Medical Students.

    ERIC Educational Resources Information Center

    Wilkerson, LuAnn; Rose, Mike

    The standardized patient (SP) examination is used in a majority of medical schools to test clinical skills. This exam usually yields both numerical ratings of clinical skill and narrative comments by patients or observers, yet most empirical studies of SP assessment focus on the numerical ratings only. This study analyzes the comments on a recent…

  8. Mental health and learning disability nursing students' perceptions of the usefulness of the objective structured clinical examination to assess their competence in medicine administration.

    PubMed

    Hemingway, Steve; Stephenson, John; Roberts, Bronwyn; McCann, Terence

    2014-08-01

    The aim of this study was to evaluate mental health and learning disability nursing students' perceptions of the usefulness of the objective structured clinical examination (OSCE) in assessing their administration of medicine competence. Learning disability (n = 24) and mental health (n = 46) students from a single cohort were invited to evaluate their experience of the OSCE. A 10-item survey questionnaire was used, comprising open- and closed-response questions. Twelve (50%) learning disability and 32 (69.6%) mental health nursing students participated. The OSCE was rated highly compared to other theoretical assessments; it was also reported as clinically real and as a motivational learning strategy. However, it did not rate as well as clinical practice. Content analysis of written responses identified four themes: (i) benefits of the OSCE; (ii) suggestions to improve the OSCE; (iii) concern about the lack of clinical reality of the OSCE; and (iv) OSCE-induced stress. The themes, although repeating some of the positive statistical findings, showed that participants were critical of the university setting as a place to conduct clinical assessment, highlighted OSCE-related stress, and questioned the validity of the OSCE as a real-world assessment. The OSCE has an important role in the development of student nurses' administration of medicine skills. However, it might hinder their performance as a result of the stress of being assessed in a simulated environment. PMID:25180411

  9. Terminal Behavioral Objectives for Teaching Clinical Toxicology to Clinical Pharmacists

    ERIC Educational Resources Information Center

    Veltri, Joseph C.; And Others

    1976-01-01

    As a first step in the development of a competency-based clinical toxicology clerkship, a set of terminal behavioral objectives were developed that reflect the anticipated role that clinical pharmacists should play as part of the clinical toxicology team. The evaluation approaches used at the University of Utah are presented. (LBH)

  10. The feasibility and acceptability of administering a telemedicine objective structured clinical exam as a solution for providing equivalent education to remote and rural learners

    PubMed Central

    Palmer, RT; Biagioli, FE; Mujcic, J; Schneider, BN; Spires, L; Dodson, LG

    2016-01-01

    Introduction Although many medical schools incorporate distance learning into their curricula, assessing students at a distance can be challenging. While some assessments are relatively simple to administer to remote students, other assessments, such as objective structured clinical exams (OSCEs) are not. This article describes a means to more effectively and efficiently assess distance learners and evaluate the feasibility and acceptability of the assessment. Methods We developed a teleOSCE, administered online in real time, to two cohorts of students on a rural clerkship rotation and assessed the feasibility and acceptability of using such an approach to assess medical students’ clinical skills at rural locations. Project feasibility was defined as having development and implementation costs of less than $5000. Project acceptability was determined by analyzing student interview transcripts. A qualitative case study design framework was chosen due to the novel nature of the activity. Results The implementation cost of the teleOSCE was approximately US$1577.20, making it a feasible educational endeavor. Interview data indicated the teleOSCE was also acceptable to students. Conclusions The teleOSCE format may be useful to other institutions as a method to centrally administer clinical skills exams for assessment of distance medical students. PMID:26632083

  11. E-learning module on chronic low back pain in older adults: evidence of effect on medical student objective structured clinical examination performance.

    PubMed

    Weiner, Debra K; Morone, Natalia E; Spallek, Heiko; Karp, Jordan F; Schneider, Michael; Washburn, Carol; Dziabiak, Michael P; Hennon, John G; Elnicki, D Michael

    2014-06-01

    The Institute of Medicine has highlighted the urgent need to close undergraduate and graduate educational gaps in treating pain. Chronic low back pain (CLBP) is one of the most common pain conditions, and older adults are particularly vulnerable to potential morbidities associated with misinformed treatment. An e-learning case-based interactive module was developed at the University of Pittsburgh Center of Excellence in Pain Education, one of 12 National Institutes of Health-designated centers, to teach students important principles for evaluating and managing CLBP in older adults. A team of six experts in education, information technology, pain management, and geriatrics developed the module. Teaching focused on common errors, interactivity, and expert modeling and feedback. The module mimicked a patient encounter using a standardized patient (the older adult with CLBP) and a pain expert (the patient provider). Twenty-eight medical students were not exposed to the module (Group 1) and 27 were exposed (Group 2). Their clinical skills in evaluating CLBP were assessed using an objective structured clinical examination (OSCE). Mean scores were 62.0 ± 8.6 for Group 1 and 79.5 ± 10.4 for Group 2 (P < .001). Using an OSCE pass-fail cutoff score of 60%, 17 of 28 Group 1 students (60.7%) and 26 of 27 Group 2 students (96.3%) passed. The CLBP OSCE was one of 10 OSCE stations in which students were tested at the end of a Combined Ambulatory Medicine and Pediatrics Clerkship. There were no between-group differences in performance on eight of the other nine OSCE stations. This module significantly improved medical student clinical skills in evaluating CLBP. Additional research is needed to ascertain the effect of e-learning modules on more-advanced learners and on improving the care of older adults with CLBP. PMID:24833496

  12. E-Learning Module on Chronic Low Back Pain in Older Adults: Evidence of Effect on Medical Student Objective Structured Clinical Examination Performance

    PubMed Central

    Weiner, Debra K.; Morone, Natalia E.; Spallek, Heiko; Karp, Jordan F.; Schneider, Michael; Washburn, Carol; Dziabiak, Michael P.; Hennon, John G.; Elnicki, D. Michael

    2015-01-01

    The Institute of Medicine has highlighted the urgent need to close undergraduate and graduate educational gaps in treating pain. Chronic low back pain (CLBP) is one of the most common pain conditions, and older adults are particularly vulnerable to potential morbidities associated with misinformed treatment. An e-learning case-based interactive module was developed at the University of Pittsburgh Center of Excellence in Pain Education, one of 12 National Institutes of Health–designated centers, to teach students important principles for evaluating and managing CLBP in older adults. A team of six experts in education, information technology, pain management, and geriatrics developed the module. Teaching focused on common errors, interactivity, and expert modeling and feedback. The module mimicked a patient encounter using a standardized patient (the older adult with CLBP) and a pain expert (the patient provider). Twenty-eight medical students were not exposed to the module (Group 1) and 27 were exposed (Group 2). Their clinical skills in evaluating CLBP were assessed using an objective structured clinical examination (OSCE). Mean scores were 62.0 ± 8.6 for Group 1 and 79.5 ± 10.4 for Group 2 (P < .001). Using an OSCE pass–fail cutoff score of 60%, 17 of 28 Group 1 students (60.7%) and 26 of 27 Group 2 students (96.3%) passed. The CLBP OSCE was one of 10 OSCE stations in which students were tested at the end of a Combined Ambulatory Medicine and Pediatrics Clerkship. There were no between-group differences in performance on eight of the other nine OSCE stations. This module significantly improved medical student clinical skills in evaluating CLBP. Additional research is needed to ascertain the effect of e-learning modules on more-advanced learners and on improving the care of older adults with CLBP. PMID:24833496

  13. The Implementation and Development of an Objective Structured Clinical Examination in the Community Pharmacy Course of a Select Gulf-Region Academic Institution (Ras Al Khaimah College of Pharmaceutical Sciences): A Pilot Study

    ERIC Educational Resources Information Center

    Al-Azzawi, Amad Mohammed Jamil; Nagavi, B.G.; Hachim, Mahmood Y.; Mossa, Omar H.

    2016-01-01

    Background: Objective Structured Clinical Examinations (OSCEs) were used to assess translational pharmacotherapeutic skills of a Gulf-region representative academic institution. Aim: The aim of the current study was to assess the clinical skills of students enrolled within the third year Bachelor of Pharmacy (BPharm) programme within Ras Al…

  14. Objective Sepsis Surveillance Using Electronic Clinical Data

    PubMed Central

    Rhee, Chanu; Kadri, Sameer; Huang, Susan S.; Murphy, Michael V.; Li, Lingling; Platt, Richard; Klompas, Michael

    2016-01-01

    OBJECTIVE To compare the accuracy of surveillance of severe sepsis using electronic health record clinical data vs claims and to compare incidence and mortality trends using both methods. DESIGN We created an electronic health record–based surveillance definition for severe sepsis using clinical indicators of infection (blood culture and antibiotic orders) and concurrent organ dysfunction (vasopressors, mechanical ventilation, and/or abnormal laboratory values). We reviewed 1,000 randomly selected medical charts to characterize the definition’s accuracy and stability over time compared with a claims-based definition requiring infection and organ dysfunction codes. We compared incidence and mortality trends from 2003–2012 using both methods. SETTING Two US academic hospitals. PATIENTS Adult inpatients. RESULTS The electronic health record–based clinical surveillance definition had stable and high sensitivity over time (77% in 2003–2009 vs 80% in 2012, P=.58) whereas the sensitivity of claims increased (52% in 2003–2009 vs 67% in 2012, P=.02). Positive predictive values for claims and clinical surveillance definitions were comparable (55% vs 53%, P=.65) and stable over time. From 2003 to 2012, severe sepsis incidence imputed from claims rose by 72% (95% CI, 57%–88%) and absolute mortality declined by 5.4% (95% CI, 4.6%–6.7%). In contrast, incidence using the clinical surveillance definition increased by 7.7% (95% CI, −1.1% to 17%) and mortality declined by 1.7% (95% CI, 1.1%–2.3%). CONCLUSIONS Sepsis surveillance using clinical data is more sensitive and more stable over time compared with claims and can be done electronically. This may enable more reliable estimates of sepsis burden and trends. PMID:26526737

  15. Emmetropic eyes: objective performance and clinical reference

    NASA Astrophysics Data System (ADS)

    Tepichín-Rodríguez, Eduardo; Cruz Felix, Angel S.; López-Olazagasti, Estela; Balderas-Mata, Sandra

    2013-11-01

    The application of the wavefront sensors to measuring the monochromatic aberrations of the normal human eyes has given a new insight in the objective understanding of its performance. The resultant wavefront aberration function can be applied to evaluate the image quality on the retina, which includes the analysis of the higher-order aberrations. Among others, and due to their well-known mathematical properties for circular apertures, the wavefront aberration function is most commonly represented in terms of the Zernike polynomials. The main idea is to have a clinical reference of the objective performance of a set of normal human eyes. However, the high-order aberrations in normal human eyes are different for each persoņ that can be interpreted as that there are many possible solutions for the objective performance of emmetropic eyes. When dealing with the Zernike coefficients and excluding the spherical aberration, higher-order aberrations have a tendency to have a zero mean value. Different proposals have been suggested in the literature to deal with this feature. Moreover, it has been also shown that there is an ethnic dependency in the magnitude of the aberrations. We present in this work the objective performance of a set of uncorrected Mexican eyes, and compare them with other ethnic results published in the literature.

  16. Acquistion of Structural versus Object Landmark Knowledge

    ERIC Educational Resources Information Center

    Stankiewicz, Brian J.; Kalia, Amy A.

    2007-01-01

    Three experiments investigated the acquisition and retention of structural and object landmarks in virtual indoor environments. The experiments investigated the rate of acquisition and memory retention for hallway structure (structural landmarks) and pictures (object landmarks). The experiments investigated the rate of acquisition, the role of…

  17. [Revised objectives of postgraduate clinical training in JSCP].

    PubMed

    Kumasaka, K; Fujimaki, M

    1994-05-01

    Japanese medical graduates are recommended to receive clinical training for more than two years after graduation, because undergraduate clinical training is insufficient. In 1979, the educational committee of the Japan Society of Clinical Pathology (JSCP) proposed the objectives of postgraduate training for clinical pathologist, and the minimal training period should be 5 years of which at least 1 year should be completed in internal medicine or anatomic pathology or clinical physiology. The field of clinical pathology seen dramatic development since 1979. Therefore, we here present the revised objectives of basic clinical training in 1993. This training in general internal medicine should be the precondition for further postgraduate training in clinical pathology or laboratory medicine. It is emphasized that clinical trainees should have basic clinical skills which include interviewing techniques, skills in physical examination and communication skills to other doctors and other medical co-workers in POS (Problem Oriented System). PMID:8022079

  18. Evaluating the objective structured long examination record for nurse education.

    PubMed

    Traynor, Marian; Galanouli, Despina; Rice, Billiejoan; Lynn, Fiona

    2016-06-23

    An objective structured long examination record (OSLER) is a modification of the long-case clinical examination and is mainly used in medical education. This study aims to obtain nursing students' views of the OSLER compared with the objective structured clinical examination (OSCE), which is used to assess discrete clinical skills. A sample of third-year undergraduate nursing students (n=21) volunteered to participate from a cohort of 230 students. Participants undertook the OSLER under examination conditions. Pre-and post-test questionnaires gathered the students' views on the assessments and these were analysed from a mainly qualitative perspective. Teachers' and simulated patient views were also used for data triangulation. The findings indicate that the OSLER ensures more holistic assessment of a student's clinical skills and particularly essential skills such as communication, and that the OSLER, together with the OSCE, should be used to supplement the assessment of clinical competence in nursing education. PMID:27345072

  19. Evaluation of a Problem-based Learning Workshop Using Pre- and Post-test Objective Structured Clinical Examinations and Standardized Patients.

    ERIC Educational Resources Information Center

    Davis, Paul; Kvern, Brent; Donen, Neil; Andrews, Elaine; Nixon, Olga

    2000-01-01

    Pre/posttest data on 40 physicians who completed problem-based clinical scenarios on osteoporosis revealed that 39 showed improvement or modest change in postworkshop scores, especially in terms of management of male patients, determination of risk factors, and use and interpretation of bone density tests. (SK)

  20. Object Recognition and Random Image Structure Evolution

    ERIC Educational Resources Information Center

    Sadr, Jvid; Sinha, Pawan

    2004-01-01

    We present a technique called Random Image Structure Evolution (RISE) for use in experimental investigations of high-level visual perception. Potential applications of RISE include the quantitative measurement of perceptual hysteresis and priming, the study of the neural substrates of object perception, and the assessment and detection of subtle…

  1. Structured Course Objects in a Digital Library

    NASA Technical Reports Server (NTRS)

    Maly, K.; Zubair, M.; Liu, X.; Nelson, M.; Zeil, S.

    1999-01-01

    We are developing an Undergraduate Digital Library Framework (UDLF) that will support creation/archiving of courses and reuse of existing course material to evolve courses. UDLF supports the publication of course materials for later instantiation for a specific offering and allows the addition of time-dependent and student-specific information and structures. Instructors and, depending on permissions, students can access the general course materials or the materials for a specific offering. We are building a reference implementation based on NCSTRL+, a digital library derived from NCSTRL. Digital objects in NCSTRL+ are called buckets, self-contained entities that carry their own methods for access and display. Current bucket implementations have a two level structure of packages and elements. This is not a rich enough structure for course objects in UDLF. Typically, courses can only be modeled as a multilevel hierarchy and among different courses, both the syntax and semantics of terms may vary. Therefore, we need a mechanism to define, within a particular library, course models, their constituent objects, and the associated semantics in a flexible, extensible way. In this paper, we describe our approach to define and implement these multilayered course objects. We use XML technology to emulate complex data structures within the NCSTRL+ buckets. We have developed authoring and browsing tools to manipulate these course objects. In our current implementation a user downloading an XML based course bucket also downloads the XML-aware tools: an applet that enables the user to edit or browse the bucket. We claim that XML provides an effective means to represent multi-level structure of a course bucket.

  2. Canadian experience with structured clinical examinations.

    PubMed Central

    Grand'Maison, P; Lescop, J; Brailovsky, C A

    1993-01-01

    The use of structured clinical examinations to improve the evaluation of medical students and graduates has become significantly more common in the past 25 years. Many Canadian medical educators have contributed to the development of this technique. The Canadian experience is reviewed from the introduction of simulated-standardized patients and objective-structured clinical examinations to more recent developments and the use of such examinations for licensure and certification. PMID:8477384

  3. A Primer for Objective Structured Teaching Exercises

    PubMed Central

    Schaivone, Kathryn A.

    2014-01-01

    The objective structured teaching exercise (OSTE) is a high-fidelity training method for advancing the teaching and interpersonal communication skills of faculty members and preceptors. This paper is a primer for implementation of OSTEs as part of a comprehensive faculty development program. This primer addresses teaching and precepting skills that can be most effectively enhanced and assessed by the OSTE method. Development of case scenarios, recruitment and training of standardized students, OSTE session implementation processes, and OSTE evaluation methods are discussed. The experience of the authors as well as recommendations from a review of the literature and discussions with educators with OSTE experience are included. PMID:24954944

  4. Identifying and structuring the objectives of terrorists.

    PubMed

    Keeney, Gregory L; Von Winterfeldt, Detlof

    2010-12-01

    The risk of terrorism is of great concern to many countries and significant resources are spent to counter this threat. A better understanding of the motivation of terrorists and their reasons for selecting certain modes and targets of attack can help improve the decisions to allocate resources in the fight against terrorism. The fundamental question addressed in this article is: "What do terrorists want?" We take the view that terrorists' preferences for actions are based on their values and beliefs. An important missing piece in our knowledge of terrorists' preferences is an understanding of their values. This article uses a novel approach to determine these values and state them as objectives, using principles from decision analysis and value-focused thinking. Instead of interviewing decisionmakers and stakeholders, as would be normal in decision analysis, we extract the values of terrorists by examining their own writings and verbal statements. To illustrate the approach, we extract the values of Al-Qaeda and structure them in terms of strategic, fundamental, and means objectives. These objectives are interrelated through a means-ends network. This information is useful for understanding terrorists' motivations, intent, and likely actions, as well as for developing policies to counter terrorism at its root causes. PMID:20731792

  5. Integrating microarray gene expression object model and clinical document architecture for cancer genomics research.

    PubMed

    Park, Yu Rang; Lee, Hye Won; Kim, Ju Han

    2005-01-01

    Systematic integration of genomic-scale expression profiles with clinical information may facilitate cancer genomics research. MAGE-OM (Microarray Gene Expression Object Model) defines standard objects for genomic but not for clinical data. HL7 CDA (Clinical Document Architecture) is a document model for clinical information, describing syntax (generic structure) but not semantics. We designed a document template in XML Schema with additional constraints for CDA to define content semantics, enabling data model-level integration of MAGE-OM and CDA for cancer genomics research. PMID:16779360

  6. Improving International Research with Clinical Specimens: 5 Achievable Objectives

    PubMed Central

    LaBaer, Joshua

    2012-01-01

    Our increased interest in translational research has created a large demand for blood, tissue and other clinical samples, which find use in a broad variety of research including genomics, proteomics, and metabolomics. Hundreds of millions of dollars have been invested internationally on the collection, storage and distribution of samples. Nevertheless, many researchers complain in frustration about their inability to obtain relevant and/or useful samples for their research. Lack of access to samples, poor condition of samples, and unavailability of appropriate control samples have slowed our progress in the study of diseases and biomarkers. In this editorial, I focus on five major challenges that thwart clinical sample use for translational research and propose near term objectives to address them. They include: (1) defining our biobanking needs; (2) increasing the use of and access to standard operating procedures; (3) mapping inter-observer differences for use in normalizing diagnoses; (4) identifying natural internal protein controls; and (5) redefining the clinical sample paradigm by building partnerships with the public. In each case, I believe that we have the tools at hand required to achieve the objective within 5 years. Potential paths to achieve these objectives are explored. However we solve these problems, the future of proteomics depends on access to high quality clinical samples, collected under standardized conditions, accurately annotated and shared under conditions that promote the research we need to do. PMID:22998582

  7. Towards a smart object network for clinical services.

    PubMed

    Sedlmayr, Martin; Becker, Andreas; Muench, Ulli; Meier, Fritz; Prokosch, Hans-Ulrich; Ganslandt, Thomas

    2009-01-01

    Radio Frequency Identification (RFID) technology has become prevalent in logistics to support and optimize processes and numerous projects investigate its opportunities and challenges in the clinical context. However, most approaches are focused on one specific application using only a few possibilities of the technology. We describe the development of a smart object network to serve as a generic platform for various clinical services. Based on two disparate scenarios - tracking medical devices and transfusion safety - the architecture, implementation issues and prospects of such a platform are discussed. PMID:20351921

  8. DICOM structured reporting: an object model as an implementation boundary

    NASA Astrophysics Data System (ADS)

    Clunie, David A.

    2001-08-01

    DICOM Structured Reporting (SR) provides for encoding and interchanging structured information that may reference images, waveforms or other composite objects, in traditional reporting applications as well as for logs, measurements and CAD results. DICOM SR differs from generic content encoding approaches like XML, in that it supports coded entries, values that are strongly typed, and explicit relationships. DICOM structured reports (like images and waveforms) are composite objects that can be stored, transmitted and queried. The traditional DICOM binary encoding is used to encode structured reports. The structure and content of the SR tree should be accessible regardless of the internal or external representation. XML parsers and XSL-T tree transformation engines that can be used for data entry, presentation (display and printing) and trans-coding (to HL7 2.x and HL7 Clinical Document Architecture (CDA)) need to be interfaced with DICOM tools that support encoding, transmission, storage and retrieval. Issues associated with establishing the appropriate boundaries between tools are discussed, as are how and when to internalize a DICOM SR in an actual or virtual XML representation, the characteristics of such a representation, and the use of SAX events or the Document Object Model (DOM) to drive style-sheet driven tree transformation engines.

  9. Transforming Clinical Imaging Data for Virtual Reality Learning Objects

    ERIC Educational Resources Information Center

    Trelease, Robert B.; Rosset, Antoine

    2008-01-01

    Advances in anatomical informatics, three-dimensional (3D) modeling, and virtual reality (VR) methods have made computer-based structural visualization a practical tool for education. In this article, the authors describe streamlined methods for producing VR "learning objects," standardized interactive software modules for anatomical sciences…

  10. In pursuit of objective dry eye screening clinical techniques.

    PubMed

    Kanellopoulos, Anastasios John; Asimellis, George

    2016-01-01

    Dry eye is a multifactorial, progressive, and chronic disease of the tears and ocular surface. The disease is multi-factorial and has intermittent symptoms. Discomfort, visual disturbance, tear film instability with potential damage to the ocular surface, and increased tear film osmolarity are known associates. Dry eye is a common clinical problem for eye-care providers worldwide and there is a large number of clinical investigative techniques for the evaluation of dry eye. Despite this, however, there is no globally accepted guideline for dry eye diagnosis and none of the available tests may hold the title of the 'gold standard'. The majority of the techniques involved in the diagnosis of the disease, particularly for its early stages, has a large degree of subjectivity. The purpose of this article is to review existing dry eye investigative techniques and to present a new objective dry eye screening technique based on optical coherence tomography. PMID:26783543

  11. Dynamic object management for distributed data structures

    NASA Technical Reports Server (NTRS)

    Totty, Brian K.; Reed, Daniel A.

    1992-01-01

    In distributed-memory multiprocessors, remote memory accesses incur larger delays than local accesses. Hence, insightful allocation and access of distributed data can yield substantial performance gains. The authors argue for the use of dynamic data management policies encapsulated within individual distributed data structures. Distributed data structures offer performance, flexibility, abstraction, and system independence. This approach is supported by data from a trace-driven simulation study of parallel scientific benchmarks. Experimental data on memory locality, message count, message volume, and communication delay suggest that data-structure-specific data management is superior to a single, system-imposed policy.

  12. Formation and structure of neutrino astronomical objects

    NASA Astrophysics Data System (ADS)

    Lu, Tan; Luo, Liao-fu; Yang, Gou-chen

    1981-12-01

    Neutrinos with non-zero mass could gather to form a new kind of astronomical bodies: the Neutrino Astronomical Objects (NAO). We have investigated the mechanism of their formation and the relation of this formation to that of the galaxies, ascertained their e, p, He 4 content, whose presence should produce a series of observable effects. NAOs are a peculiar kind of heavenly bodies with many new properties. They have a linear size of the order of 100 pc, a total neutrino content of the order of 10 14M⊙ and an e, p, He 4 content of the order of 10 9M⊙.

  13. Conflict between object structural and functional affordances in peripersonal space.

    PubMed

    Kalénine, Solène; Wamain, Yannick; Decroix, Jérémy; Coello, Yann

    2016-10-01

    Recent studies indicate that competition between conflicting action representations slows down planning of object-directed actions. The present study aims to assess whether similar conflict effects exist during manipulable object perception. Twenty-six young adults performed reach-to-grasp and semantic judgements on conflictual objects (with competing structural and functional gestures) and non-conflictual objects (with similar structural and functional gestures) presented at difference distances in a 3D virtual environment. Results highlight a space-dependent conflict between structural and functional affordances. Perceptual judgments on conflictual objects were slower that perceptual judgments on non-conflictual objects, but only when objects were presented within reach. Findings demonstrate that competition between structural and functional affordances during object perception induces a processing cost, and further show that object position in space can bias affordance competition. PMID:27327864

  14. Prosthetic heart valves: Objective Performance Criteria versus randomized clinical trial.

    PubMed

    Grunkemeier, Gary L; Jin, Ruyun; Starr, Albert

    2006-09-01

    The current Food and Drug Administration (FDA) heart valve guidance document uses an objective performance criteria (OPC) methodology to evaluate the clinical performance of prosthetic heart valves. OPC are essentially historical controls, but they have turned out to be an adequate, and perhaps optimal, study design in this situation. Heart valves have a simple open-and-close mechanism, device effectiveness is easy to document, and the common complications (thromboembolism, thrombosis, bleeding, leak, and infection) are well known and easily detected. Thus, randomized clinical trials (RCTs) have not been deemed necessary for the regulatory approval of prosthetic heart valves. The OPC are derived from the average complication rates of all approved heart valves. Studies based on OPC have been shown to work well; many different valve models have gained FDA market approval based on this methodology. Although heart valve RCTs are not required by the FDA, they have been done to compare valves or treatment regimens after approval. Recently, the Artificial Valve Endocarditis Reduction Trial (AVERT) was designed to compare a new Silzone sewing ring, designed to reduce infection, with the Standard sewing ring on a St. Jude Medical heart valve. This was the largest heart valve RCT ever proposed (4,400 valve patients, followed for as long as 4 years), but it was stopped prematurely because of a high leak rate associated with the Silzone valve. Examining the results showed that a much smaller, OPC-based study with 800 patient-years would have been sufficient to disclose this complication of the Silzone valve. PMID:16928482

  15. Handling categories properly: a novel objective of clinical research.

    PubMed

    Cleophas, Ton J; Atiqi, Roya; Zwinderman, Aeilko H

    2012-07-01

    A major objective of clinical research is to study outcome effects in subgroups. Such effects generally have stepping functions that are not strictly linear. Analyzing stepping functions in linear models thus raises the risk of underestimating the effects. In the past few years, recoding subgroup properties from continuous variables into categorical ones has been recommended as a solution to the problem. The objectives of this study were to demonstrate from examples how recoding works and to show that stepping functions, if used as continuous variables, do not produce significant effects, whereas they produce very significant effects after recoding. In the first example, the effects on physical strength were assessed in 60 subjects of different races. A linear regression in SPSS with race as the independent and physical strength score as the dependent variable showed that race was not a significant predictor of physical strength. Using the process of recoding, the variable race into categorical dummy variables showed that compared with the presence of Hispanic race, the black and white races were significant positive predictors (P = 0.0001 and 0.004 respectively) and Asian race is a significant negative predictor (P = 0.050). In the second example, the effects of numbers of comedications on admissions to a hospital resulting from adverse drug effects were assessed. A logistic regression in SPSS with numbers of comedications as the independent variable showed that comedications was not a significant predictor of iatrogenic admission. Using again the process of recoding for categorical dummy variables showed that comedication was a very significant predictor of iatrogenic admission with P = 0.004. Categorical variables are currently rarely analyzed in a proper way. Mostly they are analyzed in the form of continuous variables. This approach does not always fit the data patterns causing negative results as demonstrated in the examples of this article. We recommend that

  16. Method for preventing micromechanical structures from adhering to another object

    DOEpatents

    Smith, James H.; Ricco, Antonio J.

    1998-01-01

    A method for preventing micromechanical structures from adhering to another object includes the step of immersing a micromechanical structure and its associated substrate in a chemical species that does not stick to itself. The method can be employed during the manufacture of micromechanical structures to prevent micromechanical parts from sticking or adhering to one another and their associated substrate surface.

  17. Method for preventing micromechanical structures from adhering to another object

    DOEpatents

    Smith, J.H.; Ricco, A.J.

    1998-06-16

    A method for preventing micromechanical structures from adhering to another object includes the step of immersing a micromechanical structure and its associated substrate in a chemical species that does not stick to itself. The method can be employed during the manufacture of micromechanical structures to prevent micromechanical parts from sticking or adhering to one another and their associated substrate surface. 3 figs.

  18. Control system structure design for object positioning system

    NASA Astrophysics Data System (ADS)

    Kurgankin, V.; Zamyatin, V.; Zamyatin, S.

    2016-04-01

    Object positioning system is intended for load transposition. Its main feature is the control method which is based on operator muscle force. One of the most important object position system development problems is a control system design. The article presents the first step of this problem solution that consists of control system structure design.

  19. An object-oriented database for protein structure analysis.

    PubMed

    Gray, P M; Paton, N W; Kemp, G J; Fothergill, J E

    1990-03-01

    An object-oriented database system has been developed which is being used to store protein structure data. The database can be queried using the logic programming language Prolog or the query language Daplex. Queries retrieve information by navigating through a network of objects which represent the primary, secondary and tertiary structures of proteins. Routines written in both Prolog and Daplex can integrate complex calculations with the retrieval of data from the database, and can also be stored in the database for sharing among users. Thus object-oriented databases are better suited to prototyping applications and answering complex queries about protein structure than relational databases. This system has been used to find loops of varying length and anchor positions when modelling homologous protein structures. PMID:2188261

  20. Objective Clinical Assessment of Posture Patterns after Implant Breast Augmentation

    PubMed Central

    Mandrini, Silvia; Finotti, Valentina; Dall’Angelo, Anna; Malovini, Alberto; Chierico, Simona; Faga, Angela; Dalla Toffola, Elena

    2015-01-01

    Background: An increased weight of the breasts causes several spinal postural alterations that reduce the ability to perform dynamic tasks requiring a stable balance. The effects of the increased weight of the breasts on static posture after implant breast augmentation have not been investigated yet. Methods: Forty volunteer healthy women were asked to wear different sized breast implants (800, 400, and 300 g) inside a dedicated sports bra for 6½ consecutive hours during their everyday life activities, 1 day for every implant size. Posture changes were assessed with the association of a physiatric clinical examination with a static force platform analysis. Results: A significant increase in cervical lordosis after the use of 400-g breast implants and upward was demonstrated. This alteration was stable between the 400-g and 800-g breast implants. The 400-g (per breast) implant might therefore be the load threshold that breaks the cervical postural physiologic balance. A significant increase in lumbar lordosis was demonstrated only after the use of the 800-g breast implants. The static force platform assessment demonstrated a worsening of the balance independent from the visual control with the use of 400-g and 800-g implants. Conclusions: Heavy breast implants proved to induce reversible alterations in the spinal curve, and 400 g is the cutoff for functional physiologic compensation in the short term. Such a weight might be considered the safety limit for the use of breast implants for cosmetic purposes. PMID:26218390

  1. Computerization of the Structured-Objective Rorschach Test

    ERIC Educational Resources Information Center

    Ingenohl, Ingo

    1973-01-01

    SORTSCOR performs raw scoring of the Structured-Objective Rorschach Test (SORT) and REPORT subsequently writes a narrative report in easily readable, nonclinical language. Complete documentation is available, at cost, from the author at Quinnipiac College, Hamden, Conn. 06518. (Author/CB)

  2. Object-oriented structures supporting remote sensing databases

    NASA Technical Reports Server (NTRS)

    Wichmann, Keith; Cromp, Robert F.

    1995-01-01

    Object-oriented databases show promise for modeling the complex interrelationships pervasive in scientific domains. To examine the utility of this approach, we have developed an Intelligent Information Fusion System based on this technology, and applied it to the problem of managing an active repository of remotely-sensed satellite scenes. The design and implementation of the system is compared and contrasted with conventional relational database techniques, followed by a presentation of the underlying object-oriented data structures used to enable fast indexing into the data holdings.

  3. Structure light with laser speckle for object contour reconstruction

    NASA Astrophysics Data System (ADS)

    Hua, Ting-Xuan; Chen, Cheng-Huan; Tsai, Augustine; Liu, Wen-Kai

    2012-02-01

    Invisible grid-pattern structure light has often been used for being shined on objects for contour reconstruction based on the distortion of grid pattern, for vehicle collision prevention etc. However, the structure light can be easily disturbed by surrounding nature light even if infra-red (IR) light source is used because natural light contains quite an amount of IR spectrum. In this paper, it is proposed that the structure light is provided from a highly coherent laser source, so that the structure light pattern reflected from the target object will contain not only the distorted irradiance distribution of grid pattern, but also laser speckle associated with it. The laser speckle pattern depends on the surface roughness of the target object, which provides extra information for extracting the distorted grid pattern from the background irradiance of surrounding natural light. The laser speckle pattern therefore helps to improve the immunity for surrounding light disturbance, and hence the robustness and reliability of contour reconstruction system. A binary surface relief phase-type diffractive optical element(DOE) has been proposed for generating desired pattern directly at far field when working together with laser light source. The design process is based on iterative Fourier transform algorithm(IFTA) in scalar diffraction theory.

  4. Motor Performance Assessment in Parkinson’s Disease: Association between Objective In-Clinic, Objective In-Home, and Subjective/Semi-Objective Measures

    PubMed Central

    Toosizadeh, Nima; Mohler, Jane; Lei, Hong; Parvaneh, Saman; Sherman, Scott; Najafi, Bijan

    2015-01-01

    Advances in wearable technology allow for the objective assessment of motor performance in both in-home and in-clinic environments and were used to explore motor impairments in Parkinson’s disease (PD). The aims of this study were to: 1) assess differences between in-clinic and in-home gait speed, and sit-to-stand and stand-to-sit duration in PD patients (in comparison with healthy controls); and 2) determine the objective physical activity measures, including gait, postural balance, instrumented Timed-up-and-go (iTUG), and in-home spontaneous physical activity (SPA), with the highest correlation with subjective/semi-objective measures, including health survey, fall history (fallers vs. non-fallers), fear of falling, pain, Unified Parkinson's Disease Rating Scale, and PD stage (Hoehn and Yahr). Objective assessments of motor performance were made by measuring physical activities in the same sample of PD patients (n = 15, Age: 71.2±6.3 years) and age-matched healthy controls (n = 35, Age: 71.9±3.8 years). The association between in-clinic and in-home parameters, and between objective parameters and subjective/semi-objective evaluations in the PD group was assessed using linear regression-analysis of variance models and reported as Pearson correlations (R). Both in-home SPA and in-clinic assessments demonstrated strong discriminatory power in detecting impaired motor function in PD. However, mean effect size (0.94±0.37) for in-home measures was smaller compared to in-clinic assessments (1.30±0.34) for parameters that were significantly different between PD and healthy groups. No significant correlation was observed between identical in-clinic and in-home parameters in the PD group (R = 0.10–0.25; p>0.40), while the healthy showed stronger correlation in gait speed, sit-to-stand duration, and stand-to-sit duration (R = 0.36–0.56; p<0.03). This suggests a better correlation between supervised and unsupervised motor function assessments in healthy controls

  5. Boundary objects in clinical simulation and design of eHealth.

    PubMed

    Jensen, Sanne; Kushniruk, Andre

    2016-06-01

    Development and implementation of eHealth is challenging due to the complexity of clinical work practices and organizations. Standardizing work processes and documentation procedures is one way of coping with these challenges, and acceptance of these initiatives and acceptance of the clinical information system are vital for success. Clinical simulation may be used as "boundary objects" and help transferring of knowledge between groups of stakeholders and help to better understand needs and requirements in other parts of the organization. This article presents a case study about design of electronic documentation templates for nurses' initial patient assessment, where clinical simulation was used as a boundary object and thereby achieved mutual clinical agreement on the content. Results showed that meetings prior to and in between workshops allowed all communities of practice an opportunity to voice their point of view and affect the final result. Implications of considering clinical simulations as boundary objects are discussed. PMID:25301197

  6. Clinical simulation as a boundary object in design of health IT-systems.

    PubMed

    Rasmussen, Stine Loft; Jensen, Sanne; Lyng, Karen Marie

    2013-01-01

    Healthcare organizations are very complex, holding numerous stakeholders with various approaches and goals towards the design of health IT-systems. Some of these differences may be approached by applying the concept of boundary objects in a participatory IT-design process. Traditionally clinical simulation provides the opportunity to evaluate the design and the usage of clinical IT-systems without endangering the patients and interrupting clinical work. In this paper we present how clinical simulation additionally holds the potential to function as a boundary object in the design process. The case points out that clinical simulation provides an opportunity for discussions and mutual learning among the various stakeholders involved in design of standardized electronic clinical documentation templates. The paper presents and discusses the use of clinical simulation in the translation, transfer and transformation of knowledge between various stakeholders in a large healthcare organization. PMID:23941951

  7. The Development of Clinical Reasoning Skills: A Major Objective of the Anatomy Course

    ERIC Educational Resources Information Center

    Elizondo-Omana, Rodrigo E.; Lopez, Santos Guzman

    2008-01-01

    Traditional medical school curricula have made a clear demarcation between the basic biomedical sciences and the clinical years. It is our view that a comprehensive medical education necessarily involves an increased correlation between basic science knowledge and its clinical applications. A basic anatomy course should have two main objectives:…

  8. Self-perceived versus objectively measured competence in performing clinical practical procedures by final year medical students

    PubMed Central

    Banda, Sekelani

    2016-01-01

    Objectives To determine and compare the self-perceived and objectively measured competence in performing 14 core-clinical practical procedures by Final Year Medical Students of the University of Zambia. Methods The study included 56 out of 60 graduating University of Zambia Medical Students of the 2012/2013 academic year. Self-perceived competence: students rated their competence on 14 core- clinical practical procedures using a self-administered questionnaire on a 5-point Likert scale. Objective competence: it was measured by Objective Structured Clinical Examination (OSCE) by faculty using predetermined rating scales. Rank order correlation test was performed for self-perceived and objectively measured competence. Results Two thirds 36 (66.7%) of the participants perceived themselves as moderately competent, 15 (27.8%) rated themselves as highly competent while 3 (5.6%) had low self-perception. With objective competence, the majority 52 (92.8%) were barely competent while 4 (7.2%) were absolutely competent. When overall self-perception was compared to objectively measured competence, there was a discordance which was demonstrated by a negative correlation (Spearman rho -.123). Conclusions Significant numbers of students reported low self-competence in performing procedures such as endotracheal intubation, gastric lavage and cardiopulmonary resuscitation which most never performed during the clinical years of medical education. In addition, the negative correlation between self-perceived and objectively measured competence demonstrated the inability of students to assess and rate themselves objectively due to fear that others may know their weaknesses and realize that they are not as competent as expected at a specific level of training. PMID:27132255

  9. Objective structured video examination in psychiatric and mental health nursing: a learning and assessment method.

    PubMed

    Selim, Abeer A; Dawood, Eman

    2015-02-01

    In the current study, the Objective Structured Video Examination (OSVE) was conducted to assess undergraduate nursing students' knowledge, observation, and clinical reasoning related to clinical psychiatric nursing competencies. The OSVE showed acceptable reliability and validity (Cronbach's α = 0.714, r = 0.6, respectively). Students highly appraised the OSVE because it covered a wide area of knowledge and clinical skills; the examination instructions were clear, concrete, and easily understood; the sounds and pictures of the videos were clear; and the videos simulated real patients. The examination was fair, well-administered, well-structured, and well-sequenced. The OSVE reflected learned skills, it provided opportunities for learning, grades were clearly identified, and it eliminated personal bias. Overall, the OSVE provided a practical and useful experience. On the other hand, some students negatively perceived the OSVE as being stressful and requiring more time. PMID:25602587

  10. Objective performance of a set of uncorrected 20/20 normal eyes: clinical reference

    NASA Astrophysics Data System (ADS)

    Tepichín, E.; López-Olazagasti, E.; Sánchez-de-La-Llave, D.; Cruz Félix, Angel S.; Ramírez-Zavaleta, G.; Ibarra, J.

    2011-08-01

    In recent years we have been working in the characterization of the objective average performance of a set of uncorrected human eyes with a 20/20 visual acuity, described as the resultant average wavefront aberration function (WA), point-spread function (PSF), modulation transfer function (MTF), and power refractive maps. This objective performance has been used as our clinical reference to analyze the objective pre- and post-operated performance in laser refractive surgery in different situations. We show some of our current results obtained from the application of our clinical reference.

  11. Statistical characterization of complex object structure by dynamic tomography

    NASA Astrophysics Data System (ADS)

    Tillack, Gerd-Rüdiger; Goebbels, Jürgen; Illerhaus, Bernhard; Artemiev, Valentin; Naumov, Alexander

    2002-05-01

    Considering modern materials like reinforced plastics or metal foams the mechanical properties of the component are not determined by every single structural element like a single fiber in a composite. Moreover the ensemble mean and correlation properties of all structural elements form the mechanical properties of the component. Accordingly a statistical description of material properties on a macroscopic scale allow to characterize its mechanical behavior or aging. State of the art tomographic techniques assign a measure of material properties to a volume element. The discretization, i.e., the volume or size of a single element, is limited mainly by the physical mechanisms and the equipment used for the data acquisition. In any case the result of reconstruction yields a statistical average within the considered volume element. To evaluate the integrity of the component the determined measures have to be correlated with the mechanical properties of the component. Special reconstruction algorithms are investigated that allow the statistical description of complex object structures including its dynamics. The algorithm is based on the Kalman filter using statistical prior. The prior includes knowledge about the covariance matrix as well as a prior assumption about the probability density distribution function. The resulting algorithm is recursive yielding a quasi-optimal solution at every reconstruction step. The applicability of the developed algorithm is discussed for the investigation of a specimen made from aluminum foam.

  12. Consensus Recommendations of Pediatric Transfusion Medicine Objectives for Clinical Pathology Residency Training Programs

    PubMed Central

    Sanchez, Rosa; Sloan, Steven R.; Josephson, Cassandra D.; Ambruso, Daniel R.; Hillyer, Christopher D.; O’Sullivan, Patricia

    2010-01-01

    BACKGROUND Pediatric transfusion medicine (PTM) is a subspecialty of transfusion medicine (TM) with no formal training program and few specialists. The Pediatric Transfusion Medicine Academic Awardees (PedsTMAA) group surveyed PTM content experts to identify relevant objectives for the first formal PTM curriculum. STUDY DESIGN AND METHODS Eight North American PTM experts were invited to participate in a two-step consensus process. PTM-related objectives compiled from a review of existing training documents were organized into a survey. Experts were asked to rate each objective for relevancy for a clinical pathology trainee. Content validity indices (CVIs) and asymmetric confidence intervals (ACIs) of expert ratings and analysis of respondents’ comments were used to identify relevant objectives. RESULTS Six experts participated and reviewed 117 objectives. Based on content validity criteria (CVI ≥ 0.83 and lower-limit 95% ACI ≥ 3), a total of 65 objectives were considered relevant. Twenty-three objectives were rated “very relevant” by all the experts while some proposed objectives were determined to be not relevant, out-of-date, or inappropriate for a resident trainee level. CONCLUSION The PedsTMAA group identified 65 objectives for a PTM curriculum. Twenty-three represent a clear core set of objectives and should be considered for clinical pathology training. The next step is to consider the teaching strategies and evaluation methods that will be employed to best deliver this content addressing competency in medical knowledge. PMID:20051052

  13. Structure and Evolution of Kuiper Belt Objects and Dwarf Planets

    NASA Astrophysics Data System (ADS)

    McKinnon, W. B.; Prialnik, D.; Stern, S. A.; Coradini, A.

    Kuiper belt objects (KBOs) accreted from a mélange of volatile ices, carbonaceous matter, and rock of mixed interstellar and solar nebular provenance. The transneptunian region, where this accretion took place, was likely more radially compact than today. This and the influence of gas drag during the solar nebula epoch argue for more rapid KBO accretion than usually considered. Early evolution of KBOs was largely the result of heating due to radioactive decay, the most important potential source being 26Al, whereas long-term evolution of large bodies is controlled by the decay of U, Th, and 40K. Several studies are reviewed dealing with the evolution of KBO models, calculated by means of one-dimensional numerical codes that solve the heat and mass balance equations. It is shown that, depending on parameters (principally rock content and porous conductivity), KBO interiors may have reached relatively high temperatures. The models suggest that KBOs likely lost ices of very volatile species during early evolution, whereas ices of less-volatile species should be retained in cold, less-altered subsurface layers. Initially amorphous ice may have crystallized in KBO interiors, releasing volatiles trapped in the amorphous ice, and some objects may have lost part of these volatiles as well. Generally, the outer layers are far less affected by internal evolution than the inner part, which in the absence of other effects (such as collisions) predicts a stratified composition and altered porosity distribution. Kuiper belt objects are thus unlikely to be "the most pristine objects in the solar system," but they do contain key information as to how the early solar system accreted and dynamically evolved. For large (dwarf planet) KBOs, long-term radiogenic heating alone may lead to differentiated structures -- rock cores, ice mantles, volatile-ice-rich "crusts," and even oceans. Persistence of oceans and (potential) volcanism to the present day depends strongly on body size and

  14. The luminosity structure and objective classification of galaxies

    NASA Technical Reports Server (NTRS)

    Han, Mingshen

    1995-01-01

    The luminosity structure of spiral galaxies is studied using the technique of principal component analysis. It is found that approximately 94% of the variation in the luminosity distribution of galaxies can be accounted for by just two principal components. The principal luminosity components may contain valuable information about star formation history or whatever luminosity-regulating process occurs in galaxies. Practically, these principal components provide a new approach for the investigation of the luminosity structures of galaxies and their dependence on other properties. They also serve as an excellent objective classification system for galaxies. We introduce in this paper such a classification scheme and explore its various properties. The new system shows a number of very impressive characteristics. Most important, it can well segregate virtually all the important galactic properties we tested and does so much better than the conventional morphological classification systems. Of particular interest is that some distance-dependent parameters can also be determined to a surprisingly good accuracy; for example, absolute magnitude may be determined to an accuracy of approximately 0.6 mag (yet further improvement is believed to be highly possible). Second, the system is objective, and the classification procedure can be automated to a large degree; also the new system can apply to much smaller and fainter images than do eye-based clasification systems. These properties make the new system suitable for practical application, especially on very large (and deeper) digital image catalogs. Third, the classification is expressed in dimensionless numbers, yet the simple notation bears significant and easily understandable meaning, making it easy and convenient to use. Finally, the new system has another extremely useful feature: it provides a very powerful and convenient platform not only for classification, but also for easily recording, examining, and studying the

  15. Assessment for learning with Objectively Structured Practical Examination in Biochemistry

    PubMed Central

    Jaswal, Shivani; Chattwal, Jugesh; Kaur, Jasbinder; Gupta, Seema; Singh, Tejinder

    2015-01-01

    Context: Despite a radical shift in assessment methodologies over the last decade, the majority of medical colleges still follow the Traditional Practical Examination (TPE). TPE raises concerns about examiner variability, standardization, and uniformity of assessment. To address these issues and in line with the notion of assessments as motivating what and how students learn, Objectively Structured Practical Examination (OSPE) was introduced, as an assessment modality. Despite its usefulness, awareness and motivation to use the same, still needs to be probed. Aims: To implement OSPE in the assessment of practical skills in biochemistry, and to know student and faculty perspectives regarding OSPE. Settings and Design: OSPE was introduced at the stage of formative assessment of practical skills, for 94 year one MBBS students. Subjects and Methods: Students were divided into two groups; the first group was evaluated by the traditional method and the second by OSPE. Students were crossed over on a second examination. The mean score obtained by both the methods was compared statistically. Students and faculty perspectives regarding OSPE were obtained by a questionnaire. Student performance was compared using “Bland–Altman technique,” and Student's t-test. Results: The mean scores of students was found to be significantly higher (P < 0.0001) when assessed with OSPE as compared to TPE. Number of students achieving >70% marks was also significantly higher with OSPE. Validity was supported by a significant correlation coefficient of comparison of marks by the two methods. Feedback from students and faculty indicated that they endorsed OSPE. Conclusions: This evaluation demonstrated the need for a structured approach to assessment. Going in line with the notion that assessment drives learning, introducing OSPE would help tailoring teaching-learning to optimize student satisfaction and learning. PMID:26380217

  16. Reconstruction of buried objects embedded in circular opaque structures

    NASA Astrophysics Data System (ADS)

    Persico, Raffaele; Gennarelli, Gianluca; Soldovieri, Francesco

    2014-05-01

    This contribution deals with the ground penetrating radar imaging of targets embedded in a visually opaque circular structure. The problem has practical relevance in civil engineering and archeological prospections, where structures of interest such as columns or pillars may have to be inspected in non-invasive way in order to detect the possible presence of anomalies (e.g. cracks, water infiltrations, and so on). In this framework, we investigate the possibility to inspect the circular region of interest thanks to a radar system composed by two antennas that are in contact with the structure and rotate simultaneously around it in order to illuminate and measure the field scattered by buried objects from multiple directions. Two different measurement strategies are examined. The first one is the multimonostatic configuration where the backscattered signal is collected by the transmitting antenna itself, as it moves along the circular observation line. The second acquisition strategy is the multibistatic one, with the transmitting and receiving antennas shifted by a constant angular offset of ninety degrees as they move around the column. From the mathematical viewpoint, the imaging problem is formulated as a linear inverse scattering one holding under Born approximation [1]. Furthermore, the Green's function of a homogeneous medium [2] is used to simplify the evaluation of the kernel of the integral equation. The inverse problem is then solved via the Truncated Singular Value Decomposition algorithm [3] in order to obtain a regularized solution. Tomographic reconstructions based on full-wave synthetic data generated by the Finite Difference Time Domain code GPRmax2D [4] are shown to assess the effectiveness of the reconstruction process. REFERENCES [1] W. C. Chew, Waves and fields in inhomogeneous media, IEEE Press, 1995. [2] R. F. Harrington, Time harmonic electromagnetic waves, McGraw-Hill, New York, USA, 1961. [3] M. Bertero and P. Boccacci, Introduction to

  17. A component-based, distributed object services architecture for a clinical workstation.

    PubMed Central

    Chueh, H. C.; Raila, W. F.; Pappas, J. J.; Ford, M.; Zatsman, P.; Tu, J.; Barnett, G. O.

    1996-01-01

    Attention to an architectural framework in the development of clinical applications can promote reusability of both legacy systems as well as newly designed software. We describe one approach to an architecture for a clinical workstation application which is based on a critical middle tier of distributed object-oriented services. This tier of network-based services provides flexibility in the creation of both the user interface and the database tiers. We developed a clinical workstation for ambulatory care using this architecture, defining a number of core services including those for vocabulary, patient index, documents, charting, security, and encounter management. These services can be implemented through proprietary or more standard distributed object interfaces such as CORBA and OLE. Services are accessed over the network by a collection of user interface components which can be mixed and matched to form a variety of interface styles. These services have also been reused with several applications based on World Wide Web browser interfaces. PMID:8947744

  18. The formation and the structure of the neutrino astronomical objects

    NASA Astrophysics Data System (ADS)

    Lu, T.; Luo, L.-F.; Yang, G.-C.

    1981-06-01

    The neutrinos with non-zero mass could gather to form a new kind of astronomical objects: the neutrino astronomical object (denoted as NAO). This is a peculiar astronomical object, 100 pc in size and 10 to the 14th solar masses, in mass, containing approximately 10 to the 9th solar masses of electrons, protons, and He-4. These matters contained in NAO could produce a lot of observational effects, some are characteristics for identifying NAO.

  19. Structuring Clinical Workflows for Diabetes Care

    PubMed Central

    Lasierra, N.; Oberbichler, S.; Toma, I.; Fensel, A.; Hoerbst, A.

    2014-01-01

    Summary Background Electronic health records (EHRs) play an important role in the treatment of chronic diseases such as diabetes mellitus. Although the interoperability and selected functionality of EHRs are already addressed by a number of standards and best practices, such as IHE or HL7, the majority of these systems are still monolithic from a user-functionality perspective. The purpose of the OntoHealth project is to foster a functionally flexible, standards-based use of EHRs to support clinical routine task execution by means of workflow patterns and to shift the present EHR usage to a more comprehensive integration concerning complete clinical workflows. Objectives The goal of this paper is, first, to introduce the basic architecture of the proposed OntoHealth project and, second, to present selected functional needs and a functional categorization regarding workflow-based interactions with EHRs in the domain of diabetes. Methods A systematic literature review regarding attributes of workflows in the domain of diabetes was conducted. Eligible references were gathered and analyzed using a qualitative content analysis. Subsequently, a functional workflow categorization was derived from diabetes-specific raw data together with existing general workflow patterns. Results This paper presents the design of the architecture as well as a categorization model which makes it possible to describe the components or building blocks within clinical workflows. The results of our study lead us to identify basic building blocks, named as actions, decisions, and data elements, which allow the composition of clinical workflows within five identified contexts. Conclusions The categorization model allows for a description of the components or building blocks of clinical workflows from a functional view. PMID:25024765

  20. Instructional Objectives for a Junior College Course in Art Structure.

    ERIC Educational Resources Information Center

    Starkweather, Ann, Comp.

    These instructional objectives have been selected from materials submitted to the Curriculum Laboratory of the Graduate School of Education at UCLA. Arranged by major course goals, these objectives are offered simply as samples that may be used where they correspond to the skills, abilities, and attitudes instructors want their students to…

  1. The posterior glottis: structural and clinical considerations.

    PubMed

    Kotby, M N; Kamal, E; El-Makhzangy, A; Nabil Khattab, A; Milad, P

    2012-11-01

    Despite the presence of a number of good publications during the past two decades, the posterior glottis (PG) is still not clearly appreciated in clinical laryngological practice. This study focuses on searching the literature to find out the present day awareness of the PG, as well as highlighting some of its clinical features. The investigation proceeds with two main sections: (1) critical analysis of the literature on the PG during the last 50 years (2) describing the clinical appearance and behavior of the PG in 100 normal subjects. Results of section 1 illustrate the limited awareness in the literature of the existence of PG as a distinct part of the human larynx. Results of section 2 illustrate some misconcepts related to the PG as inter-arytenoid pachydermia, change of voice with lesions in the PG. Discussion elaborates on the significance of the findings and attempts to clarify certain misconcepts about the PG, its structure, function, and clinical features. In the light of the data collected from the literature regarding the dimensions of the PG, a set of recommendations were proposed regarding the optimal sizes of the endotracheal tubes in both sexes. PMID:22614807

  2. User-specific interfaces for clinical data-management systems: an object-based approach.

    PubMed Central

    Wilton, R.

    1992-01-01

    Multiple user-specific visual interfaces are desirable in any computer-based clinical data-management system that is used by different people with different jobs to perform. The programming and maintenance problems of supporting multiple user interfaces to a single information system can be addressed by separating user-interface functionality from data-management subsystems, and by building user interfaces from object-based software components whose functionality is bound to an underlying server-client data-management architecture. Experience with this approach in a patient-tracking system suggests that this object-based approach is viable in the design of a user interface for a clinical information system. PMID:1482880

  3. The objectivity of the Autism Diagnostic Observation Schedule (ADOS) in naturalistic clinical settings.

    PubMed

    Zander, Eric; Willfors, Charlotte; Berggren, Steve; Choque-Olsson, Nora; Coco, Christina; Elmund, Anna; Moretti, Åsa Hedfors; Holm, Anette; Jifält, Ida; Kosieradzki, Renata; Linder, Jenny; Nordin, Viviann; Olafsdottir, Karin; Poltrago, Lina; Bölte, Sven

    2016-07-01

    The Autism Diagnostic Observation Schedule (ADOS) is a first-choice diagnostic tool in autism spectrum disorder (ASD). Excellent interpersonal objectivity (interrater reliability) has been demonstrated for the ADOS under optimal conditions, i.e., within groups of highly trained "research reliable" examiners in research setting. We investigated the spontaneous interrater reliability among clinically trained ADOS users across multiple sites in clinical routine. Forty videotaped administrations of the ADOS modules 1-4 were rated by five different raters each from a pool of in total 15 raters affiliated to 13 different clinical sites. G(q,k) coefficients (analogous to intraclass correlations), kappas (ĸ) and percent agreement (PA) were calculated. The median interrater reliability for items across the four modules was G(q,k) = .74-.83, with the single ADOS items ranging from .23 to .94. G(q,k) for total scores was .85-.92. For diagnostic classification (ASD/non-spectrum), PA was 64-82 % and Fleiss' ĸ .19-.55. Objectivity was lower for pervasive developmental disorder not otherwise specified and non-spectrum diagnoses as compared to autism. Interrater reliabilities of the ADOS items and domain totals among clinical users across multiple sites were in the same range as previously reported for research reliable users, while the one for diagnostic classification was lower. Differences in sample characteristics, rater skills and statistics compared with previous studies are discussed. Findings endorse the objectivity of the ADOS in naturalistic clinical settings, but also pinpoint its limitations and the need and value of adequate and continuous rater training. PMID:26584575

  4. What is an Objective Structured Practical Examination in Anatomy?

    ERIC Educational Resources Information Center

    Yaqinuddin, Ahmed; Zafar, Muhammad; Ikram, Muhammad Faisal; Ganguly, Paul

    2013-01-01

    Assessing teaching-learning outcomes in anatomical knowledge is a complex task that requires the evaluation of multiple domains: theoretical, practical, and clinical knowledge. In general, theoretical knowledge is tested by a written examination system constituted by multiple choice questions (MCQs) and/or short answer questions (SAQ). The…

  5. Hopf-algebraic structure of combinatorial objects and differential operators

    NASA Technical Reports Server (NTRS)

    Grossman, Robert; Larson, Richard G.

    1989-01-01

    A Hopf-algebraic structure on a vector space which has as basis a family of trees is described. Some applications of this structure to combinatorics and to differential operators are surveyed. Some possible future directions for this work are indicated.

  6. Optical imaging via biological object internal structure contrasting

    NASA Astrophysics Data System (ADS)

    Podgaetsky, Vitaly M.; Tereshchenko, Sergei A.; Vorobiev, Nikolai S.; Tomilova, Larisa G.; Smirnov, Alexander V.; Ivanov, Andrei V.

    1995-01-01

    For successful application of laser tomography methods for earlier medical diagnostics the signal-to-noise ratio (contrast) must be increased. For this purpose it is possible to use the absorbing dyes. We have theoretically investigated optical imaging conditions in high scattering medium on a model object. In our experiments a YAG:Nd laser generating picosecond pulses was employed. Output radiation has been recorded by a high speed streak camera with 1.5 ps temporal resolution. The high stability of the laser and of measurement scheme characteristics was provided. We looked for the contrasting substances having tropism with pathologically changed tissue of the tumor. For this purpose some dyphthalocyanines were synthesized. The experiments with laboratory animals have demonstrated that saturated dye concentrations were noticeably lower than toxicologic dangerous concentration values. We have demonstrated a possibility of the contrasting for a model object. The experimental temporal profile of scattered radiation can be explained by the nonstationary two-flow theory.

  7. Language structure in the n -object naming game

    NASA Astrophysics Data System (ADS)

    Lipowski, Adam; Lipowska, Dorota

    2009-11-01

    We examine a naming game with two agents trying to establish a common vocabulary for n objects. Such efforts lead to the emergence of language that allows for an efficient communication and exhibits some degree of homonymy and synonymy. Although homonymy reduces the communication efficiency, it seems to be a dynamical trap that persists for a long, and perhaps indefinite, time. On the other hand, synonymy does not reduce the efficiency of communication but appears to be only a transient feature of the language. Thus, in our model the role of synonymy decreases and in the long-time limit it becomes negligible. A similar rareness of synonymy is observed in present natural languages. The role of noise, that distorts the communicated words, is also examined. Although, in general, the noise reduces the communication efficiency, it also regroups the words so that they are more evenly distributed within the available “verbal” space.

  8. WWW-based access to object-oriented clinical databases: the KHOSPAD project.

    PubMed

    Pinciroli, F; Portoni, L; Combi, C; Violante, F F

    1998-09-01

    KHOSPAD is a project aiming at improving the quality of the process of patient care concerning general practitioner-patient-hospital relationships, using current information and networking technologies. The studied application field is a cardiology division, with hemodynamic laboratory and the population of PTCA patients. Data related to PTCA patients are managed by ARCADIA, an object-oriented database management system developed for the considered clinical setting. We defined a remotely accessible view of ARCADIA medical record, suitable for general practitioners (GPs) caring patients after PTCA, during the follow-up period. Using a PC, a modem and Internet, an authorized GP can consult remotely the medical records of his PTCA patients. Main features of the application are related to the management and display of complex data, specifically characterized by multimedia and temporal features, based on an object-oriented temporal data model. PMID:9861510

  9. Clinical risk of stigma and discrimination of mental illnesses: Need for objective assessment and quantification.

    PubMed

    Shrivastava, Amresh; Bureau, Yves; Rewari, Nitika; Johnston, Megan

    2013-04-01

    Stigma and discrimination continue to be a reality in the lives of people suffering from mental illness, particularly schizophrenia, and prove to be one of the greatest barriers to regaining a normal lifestyle and health. Research advances have defined stigma and assessed its implications and have even examined intervention strategies for dealing with stigma. We are of the opinion that stigma is a potential clinical risk factor. It delays treatment seeking, worsens course and outcome, reduces compliance, and increases the risk of relapse; causing further disability, discrimination, and isolation even in persons who have accessed mental health services. The delay in treatment due to stigma causes potential complications like suicide, violence, harm to others, and deterioration in capacity to look after one's physical health. These are preventable clinical complications. In order to deal with the impact of stigma on an individual basis, it needs to be (i) assessed during routine clinical examination, (ii) assessed for quantification in order to obtain measurable objective deliverables, and (iii) examined if treatment can reduce stigma and its impact on individuals. New and innovative anti-stigma programs are required that are clinically driven in order to see the change in life of an individual by removing potential risks. The basic requirement for dealing with an individual's stigma perception/experience is its proper assessment for origin and impact in both a qualitative and quantitative manner. We further argue that quantification would allow for regular assessment and offer more effective intervention for patients. It will also be helpful in identifying modifiable social factors to enhance quality of care planning for management in hospitals and communities. The objective of quantification is to facilitate developing an approach to bring the assessment of stigma into clinical work and formulating customized strategies to deal with stigma at the patient level. It

  10. 30 CFR 77.403 - Mobile equipment; falling object protective structures (FOPS).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Mobile equipment; falling object protective... object protective structures (FOPS). (a) When necessary to protect the operator of the equipment, all... underground coal mines shall be provided with substantial falling object protective structures (FOPS)....

  11. Thermal structure of neutral winds from young stellar objects

    NASA Technical Reports Server (NTRS)

    Ruden, Steven P.; Glassgold, Alfred E.; Shu, Frank H.

    1990-01-01

    The physical processes that control the thermal structure of lightly ionized winds from cool protostars are discussed. Attention is concentrated on the hydrogen gas, and the heating, cooling, and chemical processes that affect the neutral and ionic species of atomic and molecular hydrogen are examined. Warm silicate dust may condense out of the cooling wind and may heat the gas through collisions. Singly ionized sodium atoms, which do not recombine for the mass-loss rates considered, set a lower limit to the ionization fraction in the wind. Magnetic fields, which are presumed to accelerate the wind, couple directly to the ionic component of the gas and transfer momentum and energy to the neutral component through collisions. This process of ambipolar diffusion is found to be the dominant source of heat input to the gas.

  12. Magnetic field structure around cores with very low luminosity objects

    NASA Astrophysics Data System (ADS)

    Soam, A.; Maheswar, G.; Lee, Chang Won; Dib, Sami; Bhatt, H. C.; Tamura, Motohide; Kim, Gwanjeong

    2015-01-01

    Aims: We carried out optical polarimetry of five dense cores, (IRAM 04191, L1521F, L328, L673-7, and L1014) which are found to harbour very low luminosity objects (VeLLOs; Lint ≲ 0.1 L⊙). This study was conducted mainly to understand the role played by the magnetic field in the formation of very low and substellar mass range objects. Methods: Light from the stars, while passing through the dust grains that are aligned with their short axis parallel to an external magnetic field, becomes linearly polarised. The polarisation position angles measured for the stars can provide the plane-of-the sky magnetic field orientation. Because the light in the optical wavelength range is most efficiently polarised by the dust grains typically found at the outer layers of the molecular clouds, optical polarimetry mostly traces the magnetic field orientation of the core envelope. Results: The polarisation observations of stars projected on IRAM 04191, L328, L673-7, and L1014 were obtained in the R-band and those of L1521F were obtained in the V-band. The angular offsets between the envelope magnetic field direction (inferred from optical polarisation measurements) and the outflow position angles from the VeLLOs in IRAM 04191, L1521F, L328, L673-7, and L1014 are found to be 84°, 53°, 24°, 08°, and 15°, respectively. The mean value of the offsets for all the five clouds is ~ 37°. If we exclude IRAM 04191, the mean value reduces to become ~ 25°. In IRAM 04191, the offset between the projected envelope and the inner magnetic field (inferred from the submillimetre data obtained using SCUBA-POL) is found to be ~ 68°. The inner magnetic field, however, is found to be nearly aligned with the projected position angles of the minor axis, the rotation axis of the cloud, and the outflow from the IRAM 04191-IRS. We discuss a possible explanation for the nearly perpendicular orientation between the envelope and core scale magnetic fields in IRAM 04191. The angular offset between the

  13. "Active" and "passive" learning of three-dimensional object structure within an immersive virtual reality environment.

    PubMed

    James, K H; Humphrey, G K; Vilis, T; Corrie, B; Baddour, R; Goodale, M A

    2002-08-01

    We used a fully immersive virtual reality environment to study whether actively interacting with objects would effect subsequent recognition, when compared with passively observing the same objects. We found that when participants learned object structure by actively rotating the objects, the objects were recognized faster during a subsequent recognition task than when object structure was learned through passive observation. We also found that participants focused their study time during active exploration on a limited number of object views, while ignoring other views. Overall, our results suggest that allowing active exploration of an object during initial learning can facilitate recognition of that object, perhaps owing to the control that the participant has over the object views upon which they can focus. The virtual reality environment is ideal for studying such processes, allowing realistic interaction with objects while maintaining experimenter control. PMID:12395554

  14. Organizational and Spatial Dynamics of Attentional Focusing in Hierarchically Structured Objects

    ERIC Educational Resources Information Center

    Yeari, Menahem; Goldsmith, Morris

    2011-01-01

    Is the focusing of visual attention object-based, space-based, both, or neither? Attentional focusing latencies in hierarchically structured compound-letter objects were examined, orthogonally manipulating global size (larger vs. smaller) and organizational complexity (two-level structure vs. three-level structure). In a dynamic focusing task,…

  15. Objective Bayesian fMRI analysis—a pilot study in different clinical environments

    PubMed Central

    Magerkurth, Joerg; Mancini, Laura; Penny, William; Flandin, Guillaume; Ashburner, John; Micallef, Caroline; De Vita, Enrico; Daga, Pankaj; White, Mark J.; Buckley, Craig; Yamamoto, Adam K.; Ourselin, Sebastien; Yousry, Tarek; Thornton, John S.; Weiskopf, Nikolaus

    2015-01-01

    Functional MRI (fMRI) used for neurosurgical planning delineates functionally eloquent brain areas by time-series analysis of task-induced BOLD signal changes. Commonly used frequentist statistics protect against false positive results based on a p-value threshold. In surgical planning, false negative results are equally if not more harmful, potentially masking true brain activity leading to erroneous resection of eloquent regions. Bayesian statistics provides an alternative framework, categorizing areas as activated, deactivated, non-activated or with low statistical confidence. This approach has not yet found wide clinical application partly due to the lack of a method to objectively define an effect size threshold. We implemented a Bayesian analysis framework for neurosurgical planning fMRI. It entails an automated effect-size threshold selection method for posterior probability maps accounting for inter-individual BOLD response differences, which was calibrated based on the frequentist results maps thresholded by two clinical experts. We compared Bayesian and frequentist analysis of passive-motor fMRI data from 10 healthy volunteers measured on a pre-operative 3T and an intra-operative 1.5T MRI scanner. As a clinical case study, we tested passive motor task activation in a brain tumor patient at 3T under clinical conditions. With our novel effect size threshold method, the Bayesian analysis revealed regions of all four categories in the 3T data. Activated region foci and extent were consistent with the frequentist analysis results. In the lower signal-to-noise ratio 1.5T intra-operative scanner data, Bayesian analysis provided improved brain-activation detection sensitivity compared with the frequentist analysis, albeit the spatial extents of the activations were smaller than at 3T. Bayesian analysis of fMRI data using operator-independent effect size threshold selection may improve the sensitivity and certainty of information available to guide neurosurgery

  16. Objective Bayesian fMRI analysis-a pilot study in different clinical environments.

    PubMed

    Magerkurth, Joerg; Mancini, Laura; Penny, William; Flandin, Guillaume; Ashburner, John; Micallef, Caroline; De Vita, Enrico; Daga, Pankaj; White, Mark J; Buckley, Craig; Yamamoto, Adam K; Ourselin, Sebastien; Yousry, Tarek; Thornton, John S; Weiskopf, Nikolaus

    2015-01-01

    Functional MRI (fMRI) used for neurosurgical planning delineates functionally eloquent brain areas by time-series analysis of task-induced BOLD signal changes. Commonly used frequentist statistics protect against false positive results based on a p-value threshold. In surgical planning, false negative results are equally if not more harmful, potentially masking true brain activity leading to erroneous resection of eloquent regions. Bayesian statistics provides an alternative framework, categorizing areas as activated, deactivated, non-activated or with low statistical confidence. This approach has not yet found wide clinical application partly due to the lack of a method to objectively define an effect size threshold. We implemented a Bayesian analysis framework for neurosurgical planning fMRI. It entails an automated effect-size threshold selection method for posterior probability maps accounting for inter-individual BOLD response differences, which was calibrated based on the frequentist results maps thresholded by two clinical experts. We compared Bayesian and frequentist analysis of passive-motor fMRI data from 10 healthy volunteers measured on a pre-operative 3T and an intra-operative 1.5T MRI scanner. As a clinical case study, we tested passive motor task activation in a brain tumor patient at 3T under clinical conditions. With our novel effect size threshold method, the Bayesian analysis revealed regions of all four categories in the 3T data. Activated region foci and extent were consistent with the frequentist analysis results. In the lower signal-to-noise ratio 1.5T intra-operative scanner data, Bayesian analysis provided improved brain-activation detection sensitivity compared with the frequentist analysis, albeit the spatial extents of the activations were smaller than at 3T. Bayesian analysis of fMRI data using operator-independent effect size threshold selection may improve the sensitivity and certainty of information available to guide neurosurgery

  17. Drawing skill is related to the efficiency of encoding object structure

    PubMed Central

    Perdreau, Florian; Cavanagh, Patrick

    2014-01-01

    Accurate drawing calls on many skills beyond simple motor coordination. A good internal representation of the target object's structure is necessary to capture its proportion and shape in the drawing. Here, we assess two aspects of the perception of object structure and relate them to participants' drawing accuracy. First, we assessed drawing accuracy by computing the geometrical dissimilarity of their drawing to the target object. We then used two tasks to evaluate the efficiency of encoding object structure. First, to examine the rate of temporal encoding, we varied presentation duration of a possible versus impossible test object in the fovea using two different test sizes (8° and 28°). More skilled participants were faster at encoding an object's structure, but this difference was not affected by image size. A control experiment showed that participants skilled in drawing did not have a general advantage that might have explained their faster processing for object structure. Second, to measure the critical image size for accurate classification in the periphery, we varied image size with possible versus impossible object tests centered at two different eccentricities (3° and 8°). More skilled participants were able to categorise object structure at smaller sizes, and this advantage did not change with eccentricity. A control experiment showed that the result could not be attributed to differences in visual acuity, leaving attentional resolution as a possible explanation. Overall, we conclude that drawing accuracy is related to faster encoding of object structure and better access to crowded details. PMID:25469216

  18. Drawing skill is related to the efficiency of encoding object structure.

    PubMed

    Perdreau, Florian; Cavanagh, Patrick

    2014-01-01

    Accurate drawing calls on many skills beyond simple motor coordination. A good internal representation of the target object's structure is necessary to capture its proportion and shape in the drawing. Here, we assess two aspects of the perception of object structure and relate them to participants' drawing accuracy. First, we assessed drawing accuracy by computing the geometrical dissimilarity of their drawing to the target object. We then used two tasks to evaluate the efficiency of encoding object structure. First, to examine the rate of temporal encoding, we varied presentation duration of a possible versus impossible test object in the fovea using two different test sizes (8° and 28°). More skilled participants were faster at encoding an object's structure, but this difference was not affected by image size. A control experiment showed that participants skilled in drawing did not have a general advantage that might have explained their faster processing for object structure. Second, to measure the critical image size for accurate classification in the periphery, we varied image size with possible versus impossible object tests centered at two different eccentricities (3° and 8°). More skilled participants were able to categorise object structure at smaller sizes, and this advantage did not change with eccentricity. A control experiment showed that the result could not be attributed to differences in visual acuity, leaving attentional resolution as a possible explanation. Overall, we conclude that drawing accuracy is related to faster encoding of object structure and better access to crowded details. PMID:25469216

  19. 48 CFR 1815.404-471 - NASA structured approach for profit or fee objective.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 6 2011-10-01 2011-10-01 false NASA structured approach for profit or fee objective. 1815.404-471 Section 1815.404-471 Federal Acquisition Regulations System... NEGOTIATION Contract Pricing 1815.404-471 NASA structured approach for profit or fee objective....

  20. 48 CFR 1815.404-471 - NASA structured approach for profit or fee objective.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 6 2013-10-01 2013-10-01 false NASA structured approach for profit or fee objective. 1815.404-471 Section 1815.404-471 Federal Acquisition Regulations System... NEGOTIATION Contract Pricing 1815.404-471 NASA structured approach for profit or fee objective....

  1. Systems and methods for estimating the structure and motion of an object

    SciTech Connect

    Dani, Ashwin P; Dixon, Warren

    2015-11-03

    In one embodiment, the structure and motion of a stationary object are determined using two images and a linear velocity and linear acceleration of a camera. In another embodiment, the structure and motion of a stationary or moving object are determined using an image and linear and angular velocities of a camera.

  2. Understanding BL Lacertae objects. Structural and kinematic mode changes in the BL Lac object PKS 0735+178

    NASA Astrophysics Data System (ADS)

    Britzen, S.; Witzel, A.; Gong, B. P.; Zhang, J. W.; Gopal-Krishna; Goyal, A.; Aller, M. F.; Aller, H. D.; Zensus, J. A.

    2010-06-01

    Context. We present evidence that parsec-scale jets in BL Lac objects may be significantly distinct in kinematics from their counterparts in quasars. We argued this previously for the BL lac sources 1803+784 and 0716+714 and report here a similar pattern for another well-known BL Lac object, PKS 0735+178, whose nuclear jet is found to exhibit kinematics atypical of quasars. Aims: By analyzing the pc-scale jet morphology and its changes in 0735+178 we seek to understand the emission processes in BL Lac objects and to decipher their differences from quasars. A detailed study of the jet components' motion reveals that the standard AGN paradigm of apparent superluminal motion does not always describe the kinematics in BL Lac objects. We study 0735+178 here to augment and improve the understanding of the peculiar motions in the jets of BL Lac objects as a class. Methods: We analyzed 15 GHz VLBA (Very Long Baseline Array) observations (2 cm/MOJAVE survey) performed at 23 epochs between 1995.27 and 2008.91. Multiple Gaussians were fitted to the derived VLBA data, to trace the kinematical and flux density evolution of the individual VLBI (Very Long Baseline Interferometry) components in the nuclear jet. We then compared the jet kinematics with the optical and radio light curves available for this BL Lac object and point out some striking correlations between the properties of the radio knots and the features in the light curves. Results: We found a drastic structural mode change in the VLBI jet of 0735+178, between 2000.4 and 2001.8 when its twice sharply bent trajectory turned into a linear shape. We further found that this jet had undergone a similar transition sometime between December 1981 and June 1983. A mode change, occurring in the reverse direction (between mid-1992 and mid-1995) has already been reported in the literature. These structural mode changes are found to be reflected in changed kinematical behavior of the nuclear jet, manifested as an apparent

  3. Working models of attachment and representations of the object in a clinical sample of sexually abused women.

    PubMed

    Stalker, C A; Davies, F

    1998-01-01

    This study examined internal working models of attachment as assessed by the Adult Attachment Interview (AAI; George, Kaplan, & Main, 1984) and self-other differentiation as assessed by the Description of Significant Other (Marziali & Oleniuk, 1990) in a clinical sample of 40 women reporting a history of childhood sexual abuse. Although there was some relationship between the two measures, the association was not strong. The Cannot Classify category of the AAI, which is increasingly being assigned in clinical samples, needs refinement to increase the usefulness of the AAI for clinical purposes. Integration of concepts from objects relations theory may also enhance the value of the AAI in studies of clinical samples. PMID:9703711

  4. Learning the 3-D structure of objects from 2-D views depends on shape, not format

    PubMed Central

    Tian, Moqian; Yamins, Daniel; Grill-Spector, Kalanit

    2016-01-01

    Humans can learn to recognize new objects just from observing example views. However, it is unknown what structural information enables this learning. To address this question, we manipulated the amount of structural information given to subjects during unsupervised learning by varying the format of the trained views. We then tested how format affected participants' ability to discriminate similar objects across views that were rotated 90° apart. We found that, after training, participants' performance increased and generalized to new views in the same format. Surprisingly, the improvement was similar across line drawings, shape from shading, and shape from shading + stereo even though the latter two formats provide richer depth information compared to line drawings. In contrast, participants' improvement was significantly lower when training used silhouettes, suggesting that silhouettes do not have enough information to generate a robust 3-D structure. To test whether the learned object representations were format-specific or format-invariant, we examined if learning novel objects from example views transfers across formats. We found that learning objects from example line drawings transferred to shape from shading and vice versa. These results have important implications for theories of object recognition because they suggest that (a) learning the 3-D structure of objects does not require rich structural cues during training as long as shape information of internal and external features is provided and (b) learning generates shape-based object representations independent of the training format. PMID:27153196

  5. Learning the 3-D structure of objects from 2-D views depends on shape, not format.

    PubMed

    Tian, Moqian; Yamins, Daniel; Grill-Spector, Kalanit

    2016-05-01

    Humans can learn to recognize new objects just from observing example views. However, it is unknown what structural information enables this learning. To address this question, we manipulated the amount of structural information given to subjects during unsupervised learning by varying the format of the trained views. We then tested how format affected participants' ability to discriminate similar objects across views that were rotated 90° apart. We found that, after training, participants' performance increased and generalized to new views in the same format. Surprisingly, the improvement was similar across line drawings, shape from shading, and shape from shading + stereo even though the latter two formats provide richer depth information compared to line drawings. In contrast, participants' improvement was significantly lower when training used silhouettes, suggesting that silhouettes do not have enough information to generate a robust 3-D structure. To test whether the learned object representations were format-specific or format-invariant, we examined if learning novel objects from example views transfers across formats. We found that learning objects from example line drawings transferred to shape from shading and vice versa. These results have important implications for theories of object recognition because they suggest that (a) learning the 3-D structure of objects does not require rich structural cues during training as long as shape information of internal and external features is provided and (b) learning generates shape-based object representations independent of the training format. PMID:27153196

  6. DICOM Structured Reporting and Cancer Clinical Trials Results

    PubMed Central

    Clunie, David A

    2007-01-01

    The use of biomarkers derived from radiological images as surrogate end-points in therapeutic cancer clinical trials is well established. DICOM is the ubiquitous standard for the interchange of images for both clinical use as well as research. It also has capabilities for the exchange of image-related information, including categorical and quantitative information derived from images. The use of DICOM Structured Reporting for the encoding and interchange of clinical trial results in a standard manner is reviewed. PMID:19390663

  7. Assessment of clinical information: Comparison of the Validity of a Structured Clinical Interview (the SCID) and the Clinical Diagnostic Interview

    PubMed Central

    Drill, Rebecca; Nakash, Ora; DeFife, Jared A.; Westen, Drew

    2015-01-01

    Adaptive functioning is a key aspect of psychiatric diagnosis and assessment in research and practice. This study compared adaptive functioning validity ratings from Structured Clinical Interviews (SCIDs), symptom-focused structured diagnostic interviews, and Clinical Diagnostic Interviews (CDIs), systematic diagnostic interviews modeling naturalistic clinical interactions focusing on relational narratives. Two hundred forty-five patients (interviewed by two independent interviewers) and their interviewers completed the Clinical Data Form which assesses adaptive functioning and clinical information. Both interviews converged strongly with patient-reports, with no significant differences in validity of the interviews in measuring global and specific domains of adaptive functioning variables. Findings suggest that CDIs provide adaptive functioning data comparable to SCIDs (often considered “gold standard” for assessment but difficult to use in practice), and have important implications for bridging the research-practice gap. By incorporating clinicians’ everyday methods, CDIs yield information that is psychometrically sound for empirical investigation, diagnostically practical, and clinically meaningful and valid. PMID:25974055

  8. Development and Initial Testing of a Structured Clinical Observation Tool to Assess Pharmacotherapy Competence

    ERIC Educational Resources Information Center

    Young, John Q.; Lieu, Sandra; O'Sullivan, Patricia; Tong, Lowell

    2011-01-01

    Objective: The authors developed and tested the feasibility and utility of a new direct-observation instrument to assess trainee performance of a medication management session. Methods: The Psychopharmacotherapy-Structured Clinical Observation (P-SCO) instrument was developed based on multiple sources of expertise and then implemented in 4…

  9. A rudimentary database for three-dimensional objects using structural representation

    NASA Technical Reports Server (NTRS)

    Sowers, James P.

    1987-01-01

    A database which enables users to store and share the description of three-dimensional objects in a research environment is presented. The main objective of the design is to make it a compact structure that holds sufficient information to reconstruct the object. The database design is based on an object representation scheme which is information preserving, reasonably efficient, and yet economical in terms of the storage requirement. The determination of the needed data for the reconstruction process is guided by the belief that it is faster to do simple computations to generate needed data/information for construction than to retrieve everything from memory. Some recent techniques of three-dimensional representation that influenced the design of the database are discussed. The schema for the database and the structural definition used to define an object are given. The user manual for the software developed to create and maintain the contents of the database is included.

  10. Determining the 3-D structure and motion of objects using a scanning laser range sensor

    NASA Technical Reports Server (NTRS)

    Nandhakumar, N.; Smith, Philip W.

    1993-01-01

    In order for the EVAHR robot to autonomously track and grasp objects, its vision system must be able to determine the 3-D structure and motion of an object from a sequence of sensory images. This task is accomplished by the use of a laser radar range sensor which provides dense range maps of the scene. Unfortunately, the currently available laser radar range cameras use a sequential scanning approach which complicates image analysis. Although many algorithms have been developed for recognizing objects from range images, none are suited for use with single beam, scanning, time-of-flight sensors because all previous algorithms assume instantaneous acquisition of the entire image. This assumption is invalid since the EVAHR robot is equipped with a sequential scanning laser range sensor. If an object is moving while being imaged by the device, the apparent structure of the object can be significantly distorted due to the significant non-zero delay time between sampling each image pixel. If an estimate of the motion of the object can be determined, this distortion can be eliminated; but, this leads to the motion-structure paradox - most existing algorithms for 3-D motion estimation use the structure of objects to parameterize their motions. The goal of this research is to design a rigid-body motion recovery technique which overcomes this limitation. The method being developed is an iterative, linear, feature-based approach which uses the non-zero image acquisition time constraint to accurately recover the motion parameters from the distorted structure of the 3-D range maps. Once the motion parameters are determined, the structural distortion in the range images is corrected.

  11. Structure and method for controlling the thermal emissivity of a radiating object

    DOEpatents

    DeSteese, John G.; Antoniak, Zenen I.; White, Michael; Peters, Timothy J.

    2004-03-30

    A structure and method for changing or controlling the thermal emissivity of the surface of an object in situ, and thus, changing or controlling the radiative heat transfer between the object and its environment in situ, is disclosed. Changing or controlling the degree of blackbody behavior of the object is accomplished by changing or controlling certain physical characteristics of a cavity structure on the surface of the object. The cavity structure, defining a plurality of cavities, may be formed by selectively removing material(s) from the surface, selectively adding a material(s) to the surface, or adding an engineered article(s) to the surface to form a new radiative surface. The physical characteristics of the cavity structure that are changed or controlled include cavity area aspect ratio, cavity longitudinal axis orientation, and combinations thereof. Controlling the cavity area aspect ratio may be by controlling the size of the cavity surface area, the size of the cavity aperture area, or a combination thereof. The cavity structure may contain a gas, liquid, or solid that further enhances radiative heat transfer control and/or improves other properties of the object while in service.

  12. Clinical vocabulary as a boundary object in multidisciplinary care management of multiple chemical sensitivity, a complex and chronic condition

    PubMed Central

    Sampalli, Tara; Shepherd, Michael; Duffy, Jack

    2011-01-01

    Background: Research has shown that accurate and timely communication between multidisciplinary clinicians involved in the care of complex and chronic health conditions is often challenging. The domain knowledge for these conditions is heterogeneous, with poorly categorized, unstructured, and inconsistent clinical vocabulary. The potential of boundary object as a technique to bridge communication gaps is explored in this study. Methods: A standardized and controlled clinical vocabulary was developed as a boundary object in the domain of a complex and chronic health condition, namely, multiple chemical sensitivity, to improve communication among multidisciplinary clinicians. A convenience sample of 100 patients with a diagnosis of multiple chemical sensitivity, nine multidisciplinary clinicians involved in the care of patients with multiple chemical sensitivity, and 36 clinicians in the community participated in the study. Results: Eighty-two percent of the multidisciplinary and inconsistent vocabulary was standardized using the Systematized Nomenclature of Medicine – Clinical Terms (SNOMED® CT as a reference terminology. Over 80% of the multidisciplinary clinicians agreed on the overall usefulness of having a controlled vocabulary as a boundary object. Over 65% of clinicians in the community agreed on the overall usefulness of the vocabulary. Conclusion: The results from this study are promising and will be further evaluated in the domain of another complex chronic condition, ie, chronic pain. The study was conducted as a preliminary analysis for developing a boundary object in a heterogeneous domain of knowledge. PMID:21594060

  13. Orientation estimation of anatomical structures in medical images for object recognition

    NASA Astrophysics Data System (ADS)

    Bağci, Ulaş; Udupa, Jayaram K.; Chen, Xinjian

    2011-03-01

    Recognition of anatomical structures is an important step in model based medical image segmentation. It provides pose estimation of objects and information about "where" roughly the objects are in the image and distinguishing them from other object-like entities. In,1 we presented a general method of model-based multi-object recognition to assist in segmentation (delineation) tasks. It exploits the pose relationship that can be encoded, via the concept of ball scale (b-scale), between the binary training objects and their associated grey images. The goal was to place the model, in a single shot, close to the right pose (position, orientation, and scale) in a given image so that the model boundaries fall in the close vicinity of object boundaries in the image. Unlike position and scale parameters, we observe that orientation parameters require more attention when estimating the pose of the model as even small differences in orientation parameters can lead to inappropriate recognition. Motivated from the non-Euclidean nature of the pose information, we propose in this paper the use of non-Euclidean metrics to estimate orientation of the anatomical structures for more accurate recognition and segmentation. We statistically analyze and evaluate the following metrics for orientation estimation: Euclidean, Log-Euclidean, Root-Euclidean, Procrustes Size-and-Shape, and mean Hermitian metrics. The results show that mean Hermitian and Cholesky decomposition metrics provide more accurate orientation estimates than other Euclidean and non-Euclidean metrics.

  14. A Trial of the Objective Structured Practical Examination in Physiology at Melaka Manipal Medical College, India

    ERIC Educational Resources Information Center

    Abraham, Reem Rachel; Raghavendra, Rao; Surekha, Kamath; Asha, Kamath

    2009-01-01

    A single examination does not fulfill all the functions of assessment. The present study was undertaken to determine the reliability and student satisfaction regarding the objective structured practical examination (OSPE) as a method of assessment of laboratory exercises in physiology before implementing it in the forthcoming university…

  15. Paying for prevention in clinical practice: Aligning provider remuneration with system objectives

    PubMed Central

    2015-01-01

    Evidence on the efficacy of preventive procedures in oral health care has not been matched by uptake of prevention in clinical practice. Reducing oral disease in the population reduces the size of the future market for treatment. Hence a provider's intention to adopt prevention in clinical practice may be offset by the financial implications of such behaviour. Effective prevention may therefore depend upon prevention-friendly methods of remuneration if providers are to be rewarded appropriately for doing what the system expects them to do. This paper considers whether changing the way providers are paid for delivering care can be expected to change the utilisation of preventive care in the population in terms of the proportion of the population receiving preventive care, the distribution of preventive care in the population and the pattern of preventive care received. A conceptual framework is presented that identifies the determinants of rewards under different approaches to provider remuneration. The framework is applied to develop recommendations for paying for prevention in clinical practice. Literature on provider payment in dental care is reviewed to assess the evidence base for the effects of changing payment methods, identify gaps in the evidence-base and inform the design of future research on dental remuneration. PMID:26390928

  16. A Grading System To Evaluate Objectively the Strength of Pre-Clinical Data of Acute Neuroprotective Therapies for Clinical Translation in Spinal Cord Injury

    PubMed Central

    Okon, Elena B.; Tsai, Eve; Beattie, Michael S.; Bresnahan, Jacqueline C.; Magnuson, David K.; Reier, Paul J.; McTigue, Dana M.; Popovich, Phillip G.; Blight, Andrew R.; Oudega, Martin; Guest, James D.; Weaver, Lynne C.; Fehlings, Michael G.; Tetzlaff, Wolfram

    2011-01-01

    Abstract The past three decades have seen an explosion of research interest in spinal cord injury (SCI) and the development of hundreds of potential therapies that have demonstrated some promise in pre-clinical experimental animal models. A growing number of these treatments are seeking to be translated into human clinical trials. Conducting such a clinical trial, however, is extremely costly, not only for the time and money required to execute it, but also for the limited resources that will then no longer be available to evaluate other promising therapies. The decision about what therapies have sufficient pre-clinical evidence of efficacy to justify testing in humans is therefore of utmost importance. Here, we have developed a scoring system for objectively grading the body of pre-clinical literature on neuroprotective treatments for acute SCI. The components of the system include an evaluation of a number of factors that are thought to be important in considering the “robustness” of a therapy's efficacy, including the animal species and injury models that have been used to test it, the time window of efficacy, the types of functional improvements effected by it, and whether efficacy has been independently replicated. The selection of these factors was based on the results of a questionnaire that was performed within the SCI research community. A modified Delphi consensus-building exercise was then conducted with experts in pre-clinical SCI research to refine the criteria and decide upon how to score them. Finally, the grading system was applied to a series of potential neuroprotective treatments for acute SCI. This represents a systematic approach to developing an objective method of evaluating the extent to which the pre-clinical literature supports the translation of a particular experimental treatment into human trials. PMID:20507235

  17. Differential visualisation of a spectrally selective structure of strongly scattering objects

    SciTech Connect

    Kuratov, A S; Rudenko, V N; Shuvalov, V V

    2014-07-31

    We describe a modification of the algorithm for the fast approximate solution of the diffuse optical tomography inverse problem. In this modification the amount of a priori (auxiliary) information necessary for the visualisation of the internal structure of the object is reduced by using a differential measurement scheme. The experiment is performed at two different wavelengths, and some a priori information, necessary to reconstruct only the spectrally selective component of the internal structure (the difference structure of the spatial distributions of the extinction coefficient at the wavelength employed), is replaced by the data of one of these measurements. (laser biophotonics)

  18. Dynamic structured illumination microscopy: Focused imaging and optical sectioning for moving objects

    NASA Astrophysics Data System (ADS)

    Krzewina, Leo G.; Kim, Myung K.

    2006-02-01

    Structured illumination microscopy (SIM) is a valuable tool for three-dimensional microscopy and has numerous applications in bioscience. Its success has been limited to static objects, though, as three sequential image acquisitions are required per final processed, focused image. To overcome this problem we have developed a multicolored grid which when used in tandem with a color camera is capable of performing SIM with just a single exposure. Images and movies demonstrating optical sectioning of three-dimensional objects are presented, and results of applying color SIM for wide-field focused imaging are compared to those of SIM. From computer modeling and analytical calculations a theoretical estimate of the maximum observable object velocity in both the lateral and axial directions is available, implying that the new method will be capable of imaging a variety of live objects. Sample images of the technique applied to lens paper and a pigeon feather are included to show both advantages and disadvantages of CSIM.

  19. Inpainting for videos with dynamic objects using texture and structure reconstruction

    NASA Astrophysics Data System (ADS)

    Voronin, V. V.; Marchuk, V. I.; Gapon, N. V.; Zhuravlev, A. V.; Maslennikov, S.; Stradanchenko, S.

    2015-05-01

    This paper describes a novel inpainting approach for removing marked dynamic objects from videos captured with a camera, so long as the objects occlude parts of the scene with a static background. Proposed approach allow to remove objects or restore missing or tainted regions present in a video sequence by utilizing spatial and temporal information from neighboring scenes. The algorithm iteratively performs following operations: achieve frame; update the scene model; update positions of moving objects; replace parts of the frame occupied by the objects marked for remove with use of a background model. In this paper, we extend an image inpainting algorithm based texture and structure reconstruction by incorporating an improved strategy for video. An image inpainting approach based on the construction of a composite curve for the restoration of the edges of objects in a frame using the concepts of parametric and geometric continuity is presented. It is shown that this approach allows to restore the curved edges and provide more flexibility for curve design in damaged frame by interpolating the boundaries of objects by cubic splines. After edge restoration stage, a texture reconstruction using patch-based method is carried out. We demonstrate the performance of a new approach via several examples, showing the effectiveness of our algorithm and compared with state-of-the-art video inpainting methods.

  20. Determination of the object surface function by structured light: application to the study of spinal deformities

    NASA Astrophysics Data System (ADS)

    Buendía, M.; Salvador, R.; Cibrián, R.; Laguia, M.; Sotoca, J. M.

    1999-01-01

    The projection of structured light is a technique frequently used to determine the surface shape of an object. In this paper, a new procedure is described that efficiently resolves the correspondence between the knots of the projected grid and those obtained on the object when the projection is made. The method is based on the use of three images of the projected grid. In two of them the grid is projected over a flat surface placed, respectively, before and behind the object; both images are used for calibration. In the third image the grid is projected over the object. It is not reliant on accurate determination of the camera and projector pair relative to the grid and object. Once the method is calibrated, we can obtain the surface function by just analysing the projected grid on the object. The procedure is especially suitable for the study of objects without discontinuities or large depth gradients. It can be employed for determining, in a non-invasive way, the patient's back surface function. Symmetry differences permit a quantitative diagnosis of spinal deformities such as scoliosis.

  1. Structured clinical interview guide for postdeployment psychological screening programs.

    PubMed

    Wright, Kathleen M; Adler, Amy B; Bliese, Paul D; Eckford, Rachel D

    2008-05-01

    Brief structured clinical interviews are a key component of the Department of Defense postdeployment health reassessment program. Such interviews are critical for recommending individuals for follow-up assessment and care. To standardize the interview process, U.S. Army Medical Research Unit-Europe developed a structured interview guide, designed in response to both clinical requirements and research findings. The guide includes sections on depression, suicidality, post-traumatic stress disorder, anger, relationship problems, alcohol problems, and sleep problems. In addition, there is an open-ended section on other problems and a section for case dispositions. Data from a 2005 blinded validation study with soldiers returning from a 1-year-long combat deployment are included to demonstrate the utility of the structured interview. Guidelines and implementation considerations for the use of the structured interview are discussed. PMID:18543560

  2. Efficient electronic integrals and their generalized derivatives for object oriented implementations of electronic structure calculations.

    PubMed

    Flocke, N; Lotrich, V

    2008-12-01

    For the new parallel implementation of electronic structure methods in ACES III (Lotrich et al., in preparation) the present state-of-the-art algorithms for the evaluation of electronic integrals and their generalized derivatives were implemented in new object oriented codes with attention paid to efficient execution on modern processors with a deep hierarchy of data storage including multiple caches and memory banks. Particular attention has been paid to define proper integral blocks as basic building objects. These objects are stand-alone units and are no longer tied to any specific software. They can hence be used by any quantum chemistry code without modification. The integral blocks can be called at any time and in any sequence during the execution of an electronic structure program. Evaluation efficiency of these integral objects has been carefully tested and it compares well with other fast integral programs in the community. Correctness of the objects has been demonstrated by several application runs on real systems using the ACES III program. PMID:18496792

  3. Factor Structure of the WPPSI in Mental Health Clinic Settings.

    ERIC Educational Resources Information Center

    Haynes, Jack P.; Atkinson, David

    1984-01-01

    Factor-analyzed the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) scores of emotionally disturbed children (N=181). The results suggested that the structure of intelligence for emotionally disturbed children is similar to that for normal children. WPPSI profile analysis that uses subtest scores may be invalid in clinical settings.…

  4. Vulnerable plaque detection: an unrealistic quest or a feasible objective with a clinical value?

    PubMed

    Bourantas, Christos V; Garcia-Garcia, Hector M; Torii, Ryo; Zhang, Yao-Jun; Westwood, Mark; Crake, Tom; Serruys, Patrick W

    2016-04-15

    Evidence from the first prospective studies of coronary atherosclerosis demonstrated that intravascular imaging has limited accuracy in detecting lesions that are likely to progress and cause future events, and divided the scientific community into experts who advocate abandoning this quest and others who suggest intensifying our efforts improve and optimise the available imaging techniques. Although the current evidence may not justify the use of invasive or non-invasive imaging in the clinical setting for the detection of vulnerable, high-risk lesions, it is apparent that imaging has provided unique insights about plaque pathophysiology and evolution. Recent evidence indicates that both invasive and non-invasive imaging also provides useful prognostic information in patients with established coronary artery disease and in asymptomatic individuals and is likely to enable more accurate risk stratification. Future studies are anticipated to provide further insights about the value of novel hybrid imaging techniques, which are expected to enable complete assessment of plaque pathophysiology, in detecting vulnerable lesions and identifying high-risk patients that would benefit from new aggressive treatments targeting coronary atherosclerosis. PMID:26783236

  5. Information Object Definition–based Unified Modeling Language Representation of DICOM Structured Reporting

    PubMed Central

    Tirado-Ramos, Alfredo; Hu, Jingkun; Lee, K.P.

    2002-01-01

    Supplement 23 to DICOM (Digital Imaging and Communications for Medicine), Structured Reporting, is a specification that supports a semantically rich representation of image and waveform content, enabling experts to share image and related patient information. DICOM SR supports the representation of textual and coded data linked to images and waveforms. Nevertheless, the medical information technology community needs models that work as bridges between the DICOM relational model and open object-oriented technologies. The authors assert that representations of the DICOM Structured Reporting standard, using object-oriented modeling languages such as the Unified Modeling Language, can provide a high-level reference view of the semantically rich framework of DICOM and its complex structures. They have produced an object-oriented model to represent the DICOM SR standard and have derived XML-exchangeable representations of this model using World Wide Web Consortium specifications. They expect the model to benefit developers and system architects who are interested in developing applications that are compliant with the DICOM SR specification. PMID:11751804

  6. Objective assessment of biomagnetic devices and alternative clinical therapies using infrared thermal imaging

    NASA Astrophysics Data System (ADS)

    Rockley, Graham J.

    2001-03-01

    The overwhelming introduction of magnetic devices and other alternative therapies into the health care market prompts the need for objective evaluation of these techniques through the use of infrared thermal imaging. Many of these therapies are reported to promote the stimulation of blood flow or the relief of pain conditions. Infrared imaging is an efficient tool to assess such changes in the physiological state. Therefore, a thermal imager can help document and substantiate whether these therapies are in fact providing an effective change to the local circulation. Thermal images may also indicate whether the change is temporary or sustained. As a specific case example, preliminary findings will be presented concerning the use of magnets and the effect they have on peripheral circulation. This will include a discussion of the recommended protocols for this type of infrared testing. This test model can be applied to the evaluation of other devices and therapeutic procedures which are reputed to affect circulation such as electro acupuncture, orthopedic footwear and topical ointments designed to relieve pain or inflammation.

  7. Objective Assessment of Joint Stiffness: A Clinically Oriented Hardware and Software Device with an Application to the Shoulder Joint.

    PubMed

    McQuade, Kevin; Price, Robert; Liu, Nelson; Ciol, Marcia A

    2012-08-30

    Examination of articular joints is largely based on subjective assessment of the "end-feel" of the joint in response to manually applied forces at different joint orientations. This technical report aims to describe the development of an objective method to examine joints in general, with specific application to the shoulder, and suitable for clinical use. We adapted existing hardware and developed laptop-based software to objectively record the force/displacement behavior of the glenohumeral joint during three common manual joint examination tests with the arm in six positions. An electromagnetic tracking system recorded three-dimensional positions of sensors attached to a clinician examiner and a patient. A hand-held force transducer recorded manually applied translational forces. The force and joint displacement were time-synchronized and the joint stiffness was calculated as a quantitative representation of the joint "end-feel." A methodology and specific system checks were developed to enhance clinical testing reproducibility and precision. The device and testing protocol were tested on 31 subjects (15 with healthy shoulders, and 16 with a variety of shoulder impairments). Results describe the stiffness responses, and demonstrate the feasibility of using the device and methods in clinical settings. PMID:23641316

  8. Proposal for a new objective method to evaluate low-level laser therapy efficacy in clinical practice

    NASA Astrophysics Data System (ADS)

    Antipa, Ciprian; Nicolescu, Alin; Pascu, Mihail-Lucian; Vlaiculescu, Mihaela; Ionescu, Elena

    2000-06-01

    Until now there is a lack of objective methods to evaluate the clinical efficacy of low level lasers (LLL). The reported results in this paper are showing that the cutaneous ultrasound could be a valuable method to be used in order to objectify the results obtained in low level laser therapy (LLLT). 52 patients with osteoarthritis were divided into three groups: Group A:19 patients treated with IR emitted laser diode, CW, 3mW power, 780 nm wavelengths. Group B: 18 patients treated with the same IR laser diode as above and He-Ne laser, CW, 2mW power. Group C: 14 patients exposed to placebo laser. To every patient was done cutaneous ultrasound before and after LLLT and we followed also the clinical evolution. The positive results meaning significant US favorable changes were found in 73.9 percent for group A and 77.7 percent for group B and 21.4 percent for PLACEBO group. We conclude that cutaneous ultrasound could be an objective method to appreciate the clinical efficacy of low power lasers.

  9. Learning to explore the structure of kinematic objects in a virtual environment

    PubMed Central

    Buckmann, Marcus; Gaschler, Robert; Höfer, Sebastian; Loeben, Dennis; Frensch, Peter A.; Brock, Oliver

    2015-01-01

    The current study tested the quantity and quality of human exploration learning in a virtual environment. Given the everyday experience of humans with physical object exploration, we document substantial practice gains in the time, force, and number of actions needed to classify the structure of virtual chains, marking the joints as revolute, prismatic, or rigid. In line with current work on skill acquisition, participants could generalize the new and efficient psychomotor patterns of object exploration to novel objects. On the one hand, practice gains in exploration performance could be captured by a negative exponential practice function. On the other hand, they could be linked to strategies and strategy change. After quantifying how much was learned in object exploration and identifying the time course of practice-related gains in exploration efficiency (speed), we identified what was learned. First, we identified strategy components that were associated with efficient (fast) exploration performance: sequential processing, simultaneous use of both hands, low use of pulling rather than pushing, and low use of force. Only the latter was beneficial irrespective of the characteristics of the other strategy components. Second, we therefore characterized efficient exploration behavior by strategies that simultaneously take into account the abovementioned strategy components. We observed that participants maintained a high level of flexibility, sampling from a pool of exploration strategies trading the level of psycho-motoric challenges with exploration speed. We discuss the findings pursuing the aim of advancing intelligent object exploration by combining analytic (object exploration in humans) and synthetic work (object exploration in robots) in the same virtual environment. PMID:25904878

  10. Learning to explore the structure of kinematic objects in a virtual environment.

    PubMed

    Buckmann, Marcus; Gaschler, Robert; Höfer, Sebastian; Loeben, Dennis; Frensch, Peter A; Brock, Oliver

    2015-01-01

    The current study tested the quantity and quality of human exploration learning in a virtual environment. Given the everyday experience of humans with physical object exploration, we document substantial practice gains in the time, force, and number of actions needed to classify the structure of virtual chains, marking the joints as revolute, prismatic, or rigid. In line with current work on skill acquisition, participants could generalize the new and efficient psychomotor patterns of object exploration to novel objects. On the one hand, practice gains in exploration performance could be captured by a negative exponential practice function. On the other hand, they could be linked to strategies and strategy change. After quantifying how much was learned in object exploration and identifying the time course of practice-related gains in exploration efficiency (speed), we identified what was learned. First, we identified strategy components that were associated with efficient (fast) exploration performance: sequential processing, simultaneous use of both hands, low use of pulling rather than pushing, and low use of force. Only the latter was beneficial irrespective of the characteristics of the other strategy components. Second, we therefore characterized efficient exploration behavior by strategies that simultaneously take into account the abovementioned strategy components. We observed that participants maintained a high level of flexibility, sampling from a pool of exploration strategies trading the level of psycho-motoric challenges with exploration speed. We discuss the findings pursuing the aim of advancing intelligent object exploration by combining analytic (object exploration in humans) and synthetic work (object exploration in robots) in the same virtual environment. PMID:25904878

  11. Genetic Algorithm Based Objective Functions Comparative Study for Damage Detection and Localization in Beam Structures

    NASA Astrophysics Data System (ADS)

    Khatir, S.; Belaidi, I.; Serra, R.; Benaissa, B.; Ait Saada, A.

    2015-07-01

    The detection techniques based on non-destructive testing (NDT) defects are preferable because of their low cost and operational aspects related to the use of the analyzed structure. In this study, we used the genetic algorithm (GA) for detecting and locating damage. The finite element was used for diagnostic beams. Different structures considered may incur damage to be modelled by a loss of rigidity supposed to represent a defect in the structure element. Identification of damage is formulated as an optimization problem using three objective functions (change of natural frequencies, Modal Assurance Criterion MAC and MAC natural frequency). The results show that the best objective function is based on the natural frequency and MAC while the method of the genetic algorithm present its efficiencies in indicating and quantifying multiple damage with great accuracy. Three defects have been created to enhance damage depending on the elements 2, 5 and 8 with a percentage allocation of 50% in the beam structure which has been discretized into 10 elements. Finally the defect with noise was introduced to test the stability of the method against uncertainty.

  12. The "Bantu Clinic": a genealogy of the African patient as object and effect of South African clinical medicine, 1930-1990.

    PubMed

    Butchart, A

    1997-12-01

    This paper is about power, medicine and the identity of the African as a patient of western medicine. From a conventional perspective and as encoded in the current "quest for wholeness" that characterises South African biomedical discourse, the African patient--like any other patient--has always existed as an authentic and subjectified being, whose true attributes and experiences have been denied by the "mechanistic," "reductionistic" and "ethnocentric" practices of clinical medicine. Against this liberal humanist perspective on the body as ontologically independent of power, this paper offers a Foucaultian reading of the African patient as-like any other patient--contingent upon the force relations immanent within and relayed through the clinical practices of biomedicine. A quintessential form of disciplinary micro-power, these fabricate the most intimate recesses of the human body as manageable objects of medical knowledge and social consciousness to make possible the great control strategies of repression, segmentation and liberation that are the usual focus of conventional investigations into the place and function of medicine in society. Since the 1930s when the African body first emerged as a discrete object of a secular clinical knowledge, these have repeatedly transformed the attributes and identity of the African patient, and the paper traces this archaeology of South African clinical perception from then until the 1990s to show how its "quest for wholeness" is not an end point of "discovery" or "liberation," but merely another ephemeral crystallization of socio-medical knowledge in a constantly changing force field of disciplinary power. PMID:9492973

  13. Large-Scale Structure Formation: From the First Non-linear Objects to Massive Galaxy Clusters

    NASA Astrophysics Data System (ADS)

    Planelles, S.; Schleicher, D. R. G.; Bykov, A. M.

    2015-05-01

    The large-scale structure of the Universe formed from initially small perturbations in the cosmic density field, leading to galaxy clusters with up to 1015 M⊙ at the present day. Here, we review the formation of structures in the Universe, considering the first primordial galaxies and the most massive galaxy clusters as extreme cases of structure formation where fundamental processes such as gravity, turbulence, cooling and feedback are particularly relevant. The first non-linear objects in the Universe formed in dark matter halos with 105-108 M⊙ at redshifts 10-30, leading to the first stars and massive black holes. At later stages, larger scales became non-linear, leading to the formation of galaxy clusters, the most massive objects in the Universe. We describe here their formation via gravitational processes, including the self-similar scaling relations, as well as the observed deviations from such self-similarity and the related non-gravitational physics (cooling, stellar feedback, AGN). While on intermediate cluster scales the self-similar model is in good agreement with the observations, deviations from such self-similarity are apparent in the core regions, where numerical simulations do not reproduce the current observational results. The latter indicates that the interaction of different feedback processes may not be correctly accounted for in current simulations. Both in the most massive clusters of galaxies as well as during the formation of the first objects in the Universe, turbulent structures and shock waves appear to be common, suggesting them to be ubiquitous in the non-linear regime.

  14. Measuring the 3D shape of high temperature objects using blue sinusoidal structured light

    NASA Astrophysics Data System (ADS)

    Zhao, Xianling; Liu, Jiansheng; Zhang, Huayu; Wu, Yingchun

    2015-12-01

    The visible light radiated by some high temperature objects (less than 1200 °C) almost lies in the red and infrared waves. It will interfere with structured light projected on a forging surface if phase measurement profilometry (PMP) is used to measure the shapes of objects. In order to obtain a clear deformed pattern image, a 3D measurement method based on blue sinusoidal structured light is proposed in this present work. Moreover, a method for filtering deformed pattern images is presented for correction of the unwrapping phase. Blue sinusoidal phase-shifting fringe pattern images are projected on the surface by a digital light processing (DLP) projector, and then the deformed patterns are captured by a 3-CCD camera. The deformed pattern images are separated into R, G and B color components by the software. The B color images filtered by a low-pass filter are used to calculate the fringe order. Consequently, the 3D shape of a high temperature object is obtained by the unwrapping phase and the calibration parameter matrixes of the DLP projector and 3-CCD camera. The experimental results show that the unwrapping phase is completely corrected with the filtering method by removing the high frequency noise from the first harmonic of the B color images. The measurement system can complete the measurement in a few seconds with a relative error of less than 1 : 1000.

  15. 3D shape shearography with integrated structured light projection for strain inspection of curved objects

    NASA Astrophysics Data System (ADS)

    Anisimov, Andrei G.; Groves, Roger M.

    2015-05-01

    Shearography (speckle pattern shearing interferometry) is a non-destructive testing technique that provides full-field surface strain characterization. Although real-life objects especially in aerospace, transport or cultural heritage are not flat (e.g. aircraft leading edges or sculptures), their inspection with shearography is of interest for both hidden defect detection and material characterization. Accurate strain measuring of a highly curved or free form surface needs to be performed by combining inline object shape measuring and processing of shearography data in 3D. Previous research has not provided a general solution. This research is devoted to the practical questions of 3D shape shearography system development for surface strain characterization of curved objects. The complete procedure of calibration and data processing of a 3D shape shearography system with integrated structured light projector is presented. This includes an estimation of the actual shear distance and a sensitivity matrix correction within the system field of view. For the experimental part a 3D shape shearography system prototype was developed. It employs three spatially-distributed shearing cameras, with Michelson interferometers acting as the shearing devices, one illumination laser source and a structured light projector. The developed system performance was evaluated with a previously reported cylinder specimen (length 400 mm, external diameter 190 mmm) loaded by internal pressure. Further steps for the 3D shape shearography prototype and the technique development are also proposed.

  16. STRUCTURED JETS IN BL LAC OBJECTS: EFFICIENT PeV NEUTRINO FACTORIES?

    SciTech Connect

    Tavecchio, Fabrizio; Ghisellini, Gabriele; Guetta, Dafne

    2014-09-20

    The origin of high-energy neutrinos (0.1–1 PeV range) detected by IceCube remains a mystery. In this work, we explore the possibility that efficient neutrino production can occur in structured jets of BL Lac objects, characterized by a fast inner spine surrounded by a slower layer. This scenario has been widely discussed in the framework of the high-energy emission models for BL Lac objects and radio galaxies. One of the relevant consequences of a velocity structure is the enhancement of the inverse Compton emission caused by the radiative coupling of the two zones. We show that a similar boosting could occur for the neutrino output of the spine through the photo-meson reaction of high-energy protons scattering off the amplified soft target photon field of the layer. Assuming the local density and the cosmological evolution of γ-ray BL Lac object derived from Fermi Large Area Telescope data, we calculate the expected diffuse neutrino intensity, which can match the IceCube data for a reasonable choice of parameters.

  17. The clinical use of structural MRI in Alzheimer disease

    PubMed Central

    Frisoni, Giovanni B.; Fox, Nick C.; Jack, Clifford R.; Scheltens, Philip; Thompson, Paul M.

    2010-01-01

    Structural imaging based on magnetic resonance is an integral part of the clinical assessment of patients with suspected Alzheimer dementia. Prospective data on the natural history of change in structural markers from preclinical to overt stages of Alzheimer disease are radically changing how the disease is conceptualized, and will influence its future diagnosis and treatment. Atrophy of medial temporal structures is now considered to be a valid diagnostic marker at the mild cognitive impairment stage. Structural imaging is also included in diagnostic criteria for the most prevalent non-Alzheimer dementias, reflecting its value in differential diagnosis. In addition, rates of whole-brain and hippocampal atrophy are sensitive markers of neurodegeneration, and are increasingly used as outcome measures in trials of potentially disease-modifying therapies. Large multicenter studies are currently investigating the value of other imaging and nonimaging markers as adjuncts to clinical assessment in diagnosis and monitoring of progression. The utility of structural imaging and other markers will be increased by standardization of acquisition and analysis methods, and by development of robust algorithms for automated assessment. PMID:20139996

  18. Needle-based fluorescence endomicroscopy via structured illumination with a plastic, achromatic objective

    PubMed Central

    Kyrish, Matthew; Dobbs, Jessica; Jain, Shalini; Wang, Xiao; Yu, Dihua; Richards-Kortum, Rebecca

    2013-01-01

    Abstract. In order to diagnose cancer, a sample must be removed, prepared, and examined under a microscope, which is expensive, invasive, and time consuming. Fiber optic fluorescence endomicroscopy, where an image guide is used to obtain high-resolution images of tissue in vivo, has shown promise as an alternative to conventional biopsies. However, the resolution of standard endomicroscopy is limited by the fiber bundle sampling frequency and out-of-focus light. A system is presented which incorporates a plastic, achromatic objective to increase the sampling and which provides optical sectioning via structured illumination to reject background light. An image is relayed from the sample by a fiber bundle with the custom 2.1-mm outer diameter objective lens integrated to the distal tip. The objective is corrected for the excitation and the emission wavelengths of proflavine (452 and 515 nm). It magnifies the object onto the fiber bundle to improve the system’s lateral resolution by increasing the sampling. The plastic lenses were fabricated via single-point diamond turning and assembled using a zero alignment technique. Ex vivo images of normal and neoplastic murine mammary tissues stained with proflavine are captured. The system achieves higher contrast and resolves smaller features than standard fluorescence endomicroscopy. PMID:24002190

  19. Line-Based Object Recognition using Hausdorff Distance: From Range Images to Molecular Secondary Structure

    SciTech Connect

    Guerra, C; Pascucci, V

    2004-12-13

    Object recognition algorithms are fundamental tools in automatic matching of geometric shapes within a background scene. Many approaches have been proposed in the past to solve the object recognition problem. Two of the key aspects that distinguish them in terms of their practical usability are: (i) the type of input model description and (ii) the comparison criteria used. In this paper we introduce a novel scheme for 3D object recognition based on line segment representation of the input shapes and comparison using the Hausdor distance. This choice of model representation provides the flexibility to apply the scheme in different application areas. We define several variants of the Hausdor distance to compare the models within the framework of well defined metric spaces. We present a matching algorithm that efficiently finds a pattern in a 3D scene. The algorithm approximates a minimization procedure of the Hausdor distance. The output error due to the approximation is guaranteed to be within a known constant bound. Practical results are presented for two classes of objects: (i) polyhedral shapes extracted from segmented range images and (ii) secondary structures of large molecules. In both cases the use of our approximate algorithm allows to match correctly the pattern in the background while achieving the efficiency necessary for practical use of the scheme. In particular the performance is improved substantially with minor degradation of the quality of the matching.

  20. Three dimensional reconstruction of irregular object with indigent texture based on structured light

    NASA Astrophysics Data System (ADS)

    Zheng, Li; Zhang, Jianqing; Zhan, Zongqian

    2005-11-01

    In this paper we describe three dimensional (3D) reconstruction of irregular object lack of texture based on structured light techniques. This system uses a CCD camera synchronized with the DLP projector captures the images, from which the 3D shape of the object is reconstructed. With the characteristic of the right image obtained from the projector and collinearity equations, the spacial point coordinates on the surface of the irregular object are obtained quickly by space intersection. As the grid table is rotating, the projector and the CCD camera are always fixed. Then all the point coordinates of different surfaces are computed in the same reference frame while the interior and exterior orientation elements of the CCD camera and projector are obtained in each different point of view. A CCD camera is also used to capture images for texture mapping. The untouched method based on close-range photogrammetry can be successfully adapted to reconstruct various kinds of shapes and some soft objects in the diverse areas.

  1. Online Deformable Object Tracking Based on Structure-Aware Hyper-Graph.

    PubMed

    Du, Dawei; Qi, Honggang; Li, Wenbo; Wen, Longyin; Huang, Qingming; Lyu, Siwei

    2016-08-01

    Recent advances in online visual tracking focus on designing part-based model to handle the deformation and occlusion challenges. However, previous methods usually consider only the pairwise structural dependences of target parts in two consecutive frames rather than the higher order constraints in multiple frames, making them less effective in handling large deformation and occlusion challenges. This paper describes a new and efficient method for online deformable object tracking. Different from most existing methods, this paper exploits higher order structural dependences of different parts of the tracking target in multiple consecutive frames. We construct a structure-aware hyper-graph to capture such higher order dependences, and solve the tracking problem by searching dense subgraphs on it. Furthermore, we also describe a new evaluating data set for online deformable object tracking (the Deform-SOT data set), which includes 50 challenging sequences with full annotations that represent realistic tracking challenges, such as large deformations and severe occlusions. The experimental result of the proposed method shows considerable improvement in performance over the state-of-the-art tracking methods. PMID:27214901

  2. Creating Shareable Clinical Decision Support Rules for a Pharmacogenomics Clinical Guideline Using Structured Knowledge Representation.

    PubMed

    Linan, Margaret K; Sottara, Davide; Freimuth, Robert R

    2015-01-01

    Pharmacogenomics (PGx) guidelines contain drug-gene relationships, therapeutic and clinical recommendations from which clinical decision support (CDS) rules can be extracted, rendered and then delivered through clinical decision support systems (CDSS) to provide clinicians with just-in-time information at the point of care. Several tools exist that can be used to generate CDS rules that are based on computer interpretable guidelines (CIG), but none have been previously applied to the PGx domain. We utilized the Unified Modeling Language (UML), the Health Level 7 virtual medical record (HL7 vMR) model, and standard terminologies to represent the semantics and decision logic derived from a PGx guideline, which were then mapped to the Health eDecisions (HeD) schema. The modeling and extraction processes developed here demonstrate how structured knowledge representations can be used to support the creation of shareable CDS rules from PGx guidelines. PMID:26958298

  3. Creating Shareable Clinical Decision Support Rules for a Pharmacogenomics Clinical Guideline Using Structured Knowledge Representation

    PubMed Central

    Linan, Margaret K.; Sottara, Davide; Freimuth, Robert R.

    2015-01-01

    Pharmacogenomics (PGx) guidelines contain drug-gene relationships, therapeutic and clinical recommendations from which clinical decision support (CDS) rules can be extracted, rendered and then delivered through clinical decision support systems (CDSS) to provide clinicians with just-in-time information at the point of care. Several tools exist that can be used to generate CDS rules that are based on computer interpretable guidelines (CIG), but none have been previously applied to the PGx domain. We utilized the Unified Modeling Language (UML), the Health Level 7 virtual medical record (HL7 vMR) model, and standard terminologies to represent the semantics and decision logic derived from a PGx guideline, which were then mapped to the Health eDecisions (HeD) schema. The modeling and extraction processes developed here demonstrate how structured knowledge representations can be used to support the creation of shareable CDS rules from PGx guidelines. PMID:26958298

  4. Static-dynamic multi-scale structural damage identification in a multi-objective framework

    NASA Astrophysics Data System (ADS)

    Perera, Ricardo; Marin, Roberto; Ruiz, Antonio

    2013-03-01

    Although either static or dynamic measurements have been used for model updating in a damage identification procedure, when a generally valid and accurate model is sought, different types of measurements should be combined. While modal characteristics give information about the global response of structures, static measurements are more concerned with the local response. Their combination would allow considering different scale levels in the detection through the simultaneous optimization of several objectives. In this work, a damage identification methodology is presented which allows combining static and dynamic measurements within a model updating procedure posed in a multi-objective framework solved by using evolutionary algorithms. Unlike other global-local multi-stage procedures developed in the past, the proposed method is solved as a simplified one-stage procedure.

  5. Objective Sleep Structure and Cardiovascular Risk Factors in the General Population: The HypnoLaus Study

    PubMed Central

    Haba-Rubio, José; Marques-Vidal, Pedro; Andries, Daniela; Tobback, Nadia; Preisig, Martin; Vollenweider, Peter; Waeber, Gérard; Luca, Gianina; Tafti, Mehdi; Heinzer, Raphaël

    2015-01-01

    Study Objectives: To evaluate the association between objective sleep measures and metabolic syndrome (MS), hypertension, diabetes, and obesity. Design: Cross-sectional study. Setting: General population sample. Participants: There were 2,162 patients (51.2% women, mean age 58.4 ± 11.1). Interventions: Patients were evaluated for hypertension, diabetes, overweight/obesity, and MS, and underwent a full polysomnography (PSG). Measurements and Results: PSG measured variables included: total sleep time (TST), percentage and time spent in slow wave sleep (SWS) and in rapid eye movement (REM) sleep, sleep efficiency and arousal index (ArI). In univariate analyses, MS was associated with decreased TST, SWS, REM sleep, and sleep efficiency, and increased ArI. After adjustment for age, sex, smoking, alcohol, physical activity, drugs that affect sleep and depression, the ArI remained significantly higher, but the difference disappeared in patients without significant sleep disordered breathing (SDB). Differences in sleep structure were also found according to the presence or absence of hypertension, diabetes, and overweight/obesity in univariate analysis. However, these differences were attenuated after multivariate adjustment and after excluding subjects with significant SDB. Conclusions: In this population-based sample we found significant associations between sleep structure and metabolic syndrome (MS), hypertension, diabetes, and obesity. However, these associations were cancelled after multivariate adjustment. We conclude that normal variations in sleep contribute little if any to MS and associated disorders. Citation: Haba-Rubio J, Marques-Vidal P, Andries D, Tobback N, Preisig M, Vollenweider P, Waeber G, Luca G, Tafti M, Heinzer R. Objective sleep structure and cardiovascular risk factors in the general population: the HypnoLaus study. SLEEP 2015;38(3):391–400. PMID:25325467

  6. [Agreement between Clinical Evaluation and Structured Clinical Interviews in Psychosomatic Inpatients].

    PubMed

    Reichert, Cornelia; Henniger, Stephan; Jäger, Burkard; de Zwaan, Martina

    2015-05-01

    The goal of this study was to determine the agreement between axis I mental disorders assessed with a structured clinical interview (SCID) and independently obtained non-structured clinical diagnoses in 185 psychosomatic in-patients. Additionally, the study focuses on the detection of potential predictors for the level of agreement. Diagnostic agreement was poor to moderate for the mood, anxiety and somatoform disorder cluster (κ = 0.293-0.444). Only for eating disorders an almost complete concordance could be found (κ = 0.812). The predictor analysis indicated a significant positive association between the comorbidity rate and the agreement in mood disorders. Furthermore, the diagnostic agreement of anxiety disorders was significantly higher for female than for male patients. These results reveal that even a team-based clinical diagnosis, assessed over the period of a hospital stay, shows little agreement with SCID-diagnoses. The predictor analysis as well as the poor correlation in 3 of 4 diagnostic clusters suggest that conceptual differences of the disorder criteria as well as their clinical interpretation might influence the concordance between diagnoses. Further studies focusing on methodical factors might reveal further insights to the cause of the diagnostic discrepancies. PMID:25941987

  7. Transforming clinical imaging and 3D data for virtual reality learning objects: HTML5 and mobile devices implementation.

    PubMed

    Trelease, Robert B; Nieder, Gary L

    2013-01-01

    Web deployable anatomical simulations or "virtual reality learning objects" can easily be produced with QuickTime VR software, but their use for online and mobile learning is being limited by the declining support for web browser plug-ins for personal computers and unavailability on popular mobile devices like Apple iPad and Android tablets. This article describes complementary methods for creating comparable, multiplatform VR learning objects in the new HTML5 standard format, circumventing platform-specific limitations imposed by the QuickTime VR multimedia file format. Multiple types or "dimensions" of anatomical information can be embedded in such learning objects, supporting different kinds of online learning applications, including interactive atlases, examination questions, and complex, multi-structure presentations. Such HTML5 VR learning objects are usable on new mobile devices that do not support QuickTime VR, as well as on personal computers. Furthermore, HTML5 VR learning objects can be embedded in "ebook" document files, supporting the development of new types of electronic textbooks on mobile devices that are increasingly popular and self-adopted for mobile learning. PMID:23212750

  8. An integrated control/structure design method using multi-objective optimization

    NASA Technical Reports Server (NTRS)

    Gupta, Sandeep; Joshi, Suresh M.

    1991-01-01

    The benefits are demonstrated of a multiobjective optimization based control structure integrated design methodology. An application of the proposed CSI methodology to the integrated design of the Spacecraft COntrol Lab Experiment (SCOLE) configuration is presented. Integrated design resulted in reducing both the control performance measure and the mass. Thus, better overall performance is achieved through integrated design optimization. The mutliobjective optimization approach used provides Pareto optimal solutions by unconstrained minimization of a differentiable KS function. Furthermore, adjusting the parameters gives insight into the trade-offs involved between different objectives.

  9. Structural Model Tuning Capability in an Object-Oriented Multidisciplinary Design, Analysis, and Optimization Tool

    NASA Technical Reports Server (NTRS)

    Lung, Shun-fat; Pak, Chan-gi

    2008-01-01

    Updating the finite element model using measured data is a challenging problem in the area of structural dynamics. The model updating process requires not only satisfactory correlations between analytical and experimental results, but also the retention of dynamic properties of structures. Accurate rigid body dynamics are important for flight control system design and aeroelastic trim analysis. Minimizing the difference between analytical and experimental results is a type of optimization problem. In this research, a multidisciplinary design, analysis, and optimization [MDAO] tool is introduced to optimize the objective function and constraints such that the mass properties, the natural frequencies, and the mode shapes are matched to the target data as well as the mass matrix being orthogonalized.

  10. Structural Model Tuning Capability in an Object-Oriented Multidisciplinary Design, Analysis, and Optimization Tool

    NASA Technical Reports Server (NTRS)

    Lung, Shun-fat; Pak, Chan-gi

    2008-01-01

    Updating the finite element model using measured data is a challenging problem in the area of structural dynamics. The model updating process requires not only satisfactory correlations between analytical and experimental results, but also the retention of dynamic properties of structures. Accurate rigid body dynamics are important for flight control system design and aeroelastic trim analysis. Minimizing the difference between analytical and experimental results is a type of optimization problem. In this research, a multidisciplinary design, analysis, and optimization (MDAO) tool is introduced to optimize the objective function and constraints such that the mass properties, the natural frequencies, and the mode shapes are matched to the target data as well as the mass matrix being orthogonalized.

  11. TRENCADIS--a WSRF grid MiddleWare for managing DICOM structured reporting objects.

    PubMed

    Blanquer, Ignacio; Hernandez, Vicente; Segrelles, Damià

    2006-01-01

    The adoption of the digital processing of medical data, especially on radiology, has leaded to the availability of millions of records (images and reports). However, this information is mainly used at patient level, being the extraction of information, organised according to administrative criteria, which make the extraction of knowledge difficult. Moreover, legal constraints make the direct integration of information systems complex or even impossible. On the other side, the widespread of the DICOM format has leaded to the inclusion of other information different from just radiological images. The possibility of coding radiology reports in a structured form, adding semantic information about the data contained in the DICOM objects, eases the process of structuring images according to content. DICOM Structured Reporting (DICOM-SR) is a specification of tags and sections to code and integrate radiology reports, with seamless references to findings and regions of interests of the associated images, movies, waveforms, signals, etc. The work presented in this paper aims at developing of a framework to efficiently and securely share medical images and radiology reports, as well as to provide high throughput processing services. This system is based on a previously developed architecture in the framework of the TRENCADIS project, and uses other components such as the security system and the Grid processing service developed in previous activities. The work presented here introduces a semantic structuring and an ontology framework, to organise medical images considering standard terminology and disease coding formats (SNOMED, ICD9, LOINC..). PMID:16823156

  12. Assessment of clinical outcomes of Roth and MBT bracket prescription using the American Board of Orthodontics Objective Grading System

    PubMed Central

    Jain, Mahesh; Varghese, Joseph; Mascarenhas, Rohan; Mogra, Subraya; Shetty, Siddarth; Dhakar, Nidhi

    2013-01-01

    Background: There is always a need to assess whether small changes in bracket prescription can lead to visually detectable differences in tooth positions. However, with little clinical evidence to show advantages of any of the popularly used bracket systems, orthodontists are forced to make clinical decisions with little scientific guidance. Aim: To compare the orthodontic cases finished with Roth and MBT prescription using American Board of Orthodontics-Objective Grading System (ABO-OGS). Settings and Design: Department of Orthodontics, Post-graduate dental college, retrospective cross-sectional study. Materials and Methods: Forty patients selected were divided into two groups of 20 patients each finished with straight wire appliance using Roth and MBT prescription, respectively. The examiner ability was assessed and calibrated by one of the ABO certified clinician to grade cases using the OGS. Statistical Analysis: Unpaired student t-test was used and P < 0.05 was accepted as significant. Results and Conclusions: MBT bracket group had a lower score of 2.60 points in buccolingual inclination and lower score of 1.10 points in occlusal contact category that was statistically significant when compared with Roth group. The difference in total ABO-OGS score was 2.65 points showing that the outcome for the MBT prescription was better than that of the Roth prescription, which is statistically significant, but with little or no clinical significance. It can be concluded that use of either one of the Roth and MBT bracket prescriptions have no impact to the overall clinical outcome and quality of treatment entirely depends on clinician judgment and experience. PMID:24124295

  13. Clinical joint inactivity predicts structural stability in patients with established rheumatoid arthritis

    PubMed Central

    Gärtner, M; Sigmund, I K; Alasti, F; Supp, G; Radner, H; Machold, K; Smolen, J S; Aletaha, D

    2016-01-01

    Objectives Clinical joint activity is a strong predictor of joint damage in rheumatoid arthritis (RA), but progression of damage might increase despite clinical inactivity of the respective joint (silent progression). The aim of this study was to evaluate the prevalence of silent joint progression, but particularly on the patient level and to investigate the duration of clinical inactivity as a marker for non-progression on the joint level. Methods 279 patients with RA with any radiographic progression over an observational period of 3–5 years were included. We obtained radiographic and clinical data of 22 hand/finger joints over a period of at least 3 years. Prevalence of silent progression and associations of clinical joint activity and radiographic progression were evaluated. Results 120 (43.0%) of the patients showed radiographic progression in at least one of their joints without any signs of clinical activity in that respective joint. In only 7 (5.8%) patients, such silent joint progression would go undetected, as the remainder had other joints with clinical activity, either with (n=84; 70.0%) or without (n=29; 24.2%) accompanying radiographic progression. Also, the risk of silent progression decreases with duration of clinical activity. Conclusions Silent progression of a joint without accompanying apparent clinical activity in any other joint of a patient was very rare, and would therefore be most likely detected by the assessment of the patient. Thus, full clinical remission is an excellent marker of structural stability in patients with RA, and the maintenance of this state reduces the risk of progression even further. PMID:27110386

  14. The sperm chromatin structure assay: a review of clinical applications.

    PubMed

    Love, Charles C

    2005-10-01

    The sperm chromatin structure assay (SCSA) was introduced by as a method to determine the susceptibility of sperm DNA to denaturation and how those results related to fertility. This initial study used human sperm and was followed by studies in bulls and boars . This assay was one of the first to introduce the technique of flow cytometry, which has the ability to evaluate specific sperm compartments of large numbers of sperm in a short time, as a methodology to evaluate sperm quality and further define the relationship of sperm quality to fertility. For any assay to be of use clinically, it must not only be validated and adapted for the species of interest, but guidelines that associate specific levels of fertility with assay results must be defined. This review will describe how our laboratory uses the SCSA for clinical diagnosis of reduced fertility in the stallion. PMID:16140481

  15. SEMCARE: Multilingual Semantic Search in Semi-Structured Clinical Data.

    PubMed

    López-García, Pablo; Kreuzthaler, Markus; Schulz, Stefan; Scherr, Daniel; Daumke, Philipp; Markó, Kornél; Kors, Jan A; van Mulligen, Erik M; Wang, Xinkai; Gonna, Hanney; Behr, Elijah; Honrado, Ángel

    2016-01-01

    The vast amount of clinical data in electronic health records constitutes a great potential for secondary use. However, most of this content consists of unstructured or semi-structured texts, which is difficult to process. Several challenges are still pending: medical language idiosyncrasies in different natural languages, and the large variety of medical terminology systems. In this paper we present SEMCARE, a European initiative designed to minimize these problems by providing a multi-lingual platform (English, German, and Dutch) that allows users to express complex queries and obtain relevant search results from clinical texts. SEMCARE is based on a selection of adapted biomedical terminologies, together with Apache UIMA and Apache Solr as open source state-of-the-art natural language pipeline and indexing technologies. SEMCARE has been deployed and is currently being tested at three medical institutions in the UK, Austria, and the Netherlands, showing promising results in a cardiology use case. PMID:27139390

  16. MBBS Student Perceptions about Physiology Subject Teaching and Objective Structured Practical Examination Based Formative Assessment for Improving Competencies

    ERIC Educational Resources Information Center

    Lakshmipathy, K.

    2015-01-01

    The objectives of the present study were to 1) assess student attitudes to physiology, 2) evaluate student opinions about the influence of an objective structured practical examination (OSPE) on competence, and 3) assess the validity and reliability of an indigenously designed feedback questionnaire. A structured questionnaire containing 16 item…

  17. Characterization of the Interior Density Structure of Near Earth Objects with Muons

    NASA Astrophysics Data System (ADS)

    Prettyman, T. H.; Sykes, M. V.; Miller, R. S.; Pinsky, L. S.; Empl, A.; Nolan, M. C.; Koontz, S. L.; Lawrence, D. J.; Mittlefehldt, D. W.; Reddell, B. D.

    2015-12-01

    Near Earth Objects (NEOs) are a diverse population of short-lived asteroids originating from the main belt and Jupiter family comets. Some have orbits that are easy to access from Earth, making them attractive as targets for science and exploration as well as a potential resource. Some pose a potential impact threat. NEOs have undergone extensive collisional processing, fragmenting and re-accreting to form rubble piles, which may be compositionally heterogeneous (e.g., like 2008 TC3, the precursor to Almahata Sitta). At present, little is known about their interior structure or how these objects are held together. The wide range of inferred NEO macroporosities hint at complex interiors. Information about their density structure would aid in understanding their formation and collisional histories, the risks they pose to human interactions with their surfaces, the constraints on industrial processing of NEO resources, and the selection of hazard mitigation strategies (e.g., kinetic impactor vs nuclear burst). Several methods have been proposed to characterize asteroid interiors, including radar imaging, seismic tomography, and muon imaging (muon radiography and tomography). Of these, only muon imaging has the potential to determine interior density structure, including the relative density of constituent fragments. Muons are produced by galactic cosmic ray showers within the top meter of asteroid surfaces. High-energy muons can traverse large distances through rock with little deflection. Muons transmitted through an Itokawa-sized asteroid can be imaged using a compact hodoscope placed on or near the surface. Challenges include background rejection and correction for variations in muon production with surface density. The former is being addressed by hodoscope design. Surface density variations can be determined via radar or muon limb imaging. The performance of muon imaging is evaluated for prospective NEO interior-mapping missions.

  18. Thorax, Trachea, and Lung Ultrasonography in Emergency and Critical Care Medicine: Assessment of an Objective Structured Training Concept

    PubMed Central

    Breitkreutz, Raoul; Dutiné, Martina; Scheiermann, Patrick; Kujumdshiev, Sandy; Ackermann, Hanns; Seeger, Florian Hartmut; Walcher, Felix; Hirche, Tim Oliver

    2013-01-01

    Background and Study objective. Focused lung ultrasound (LUS) examinations are important tools in critical care medicine. There is evidence that LUS can be used for the detection of acute thoracic lesions. However, no validated training method is available. The goal of this study was to develop and assess an objective structured clinical examination (OSCE) curriculum for focused thorax, trachea, and lung ultrasound in emergency and critical care medicine (THOLUUSE). Methods. 39 trainees underwent a one-day training course in a prospective educational study, including lectures in sonoanatomy and -pathology of the thorax, case presentations, and hands-on training. Trainees' pre- and posttest performances were assessed by multiple choice questionnaires, visual perception tests by interpretation video clips, practical performance of LUS, and identification of specific ultrasound findings. Results. Trainees postcourse scores of correct MCQ answers increased from 56 ± 4% to 82 ± 2% (mean± SD; P < 0.001); visual perception skills increased from 54 ± 5% to 78 ± 3% (P < 0.001); practical ultrasound skills improved, and correct LUS was performed in 94%. Subgroup analysis revealed that learning success was independent from the trainees' previous ultrasound experience. Conclusions. THOLUUSE significantly improves theoretical and practical skills for the diagnosis of acute thoracic lesions. We propose to implement THOLUUSE in emergency medicine training. PMID:24369503

  19. Comparing the Effects of Objective Structured Assessment of Technical Skills (OSATS) and Traditional Method on Learning of Students

    PubMed Central

    Mansoorian, Mohammad Reza; Hosseiny, Marzeih Sadat; Khosravan, Shahla; Alami, Ali; Alaviani, Mehri

    2015-01-01

    Background: Despite the benefits of the objective structured assessment of technical skills (OSATS) and it appropriateness for evaluating clinical abilities of nursing students , few studies are available on the application of this method in nursing education. Objectives: The purpose of this study was to compare the effect of using OSATS and traditional methods on the students’ learning. We also aimed to signify students’ views about these two methods and their views about the scores they received in these methods in a medical emergency course. Patients and Methods: A quasi-experimental study was performed on 45 first semester students in nursing and medical emergencies passing a course on fundamentals of practice. The students were selected by a census method and evaluated by both the OSATS and traditional methods. Data collection was performed using checklists prepared based on the ‘text book of nursing procedures checklists’ published by Iranian nursing organization and a questionnaire containing learning rate and students’ estimation of their received scores. Descriptive statistics as well as paired t-test and independent samples t-test were used in data analysis. Results: The mean of students’ score in OSATS was significantly higher than their mean score in traditional method (P = 0.01). Moreover, the mean of self-evaluation score after the traditional method was relatively the same as the score the students received in the exam. However, the mean of self-evaluation score after the OSATS was relatively lower than the scores the students received in the OSATS exam. Most students believed that OSATS can evaluate a wide range of students’ knowledge and skills compared to traditional method. Conclusions: Results of this study indicated the better effect of OSATS on learning and its relative superiority in precise assessment of clinical skills compared with the traditional evaluation method. Therefore, we recommend using this method in evaluation of

  20. Psychomotor Vigilance Testing of Professional Drivers in the Occupational Health Clinic: a Potential Objective Screen for Daytime Sleepiness

    PubMed Central

    Zhang, Chunbai; Varvarigou, Vasileia; Parks, Philip D.; Gautam, Shiva; Bueno, Antonio Vela; Malhotra, Atul; Kales, Stefanos N.

    2013-01-01

    Objective Psychomotor vigilance testing (PVT) rapidly assesses attention, reaction time (RT) and abnormal vigilance. Thus, PVT may be an adjunct to screening drivers for high risk obstructive sleep apnea (OSA)/excess daytime sleepiness (EDS). Methods Commercial drivers and emergency responders undergoing occupational examinations took a 10-minute PVT and were instructed to achieve their fastest possible RTs. Participants with maximum RT >5 seconds or ≥2 “super lapses” (RT ≥1000ms) were categorized as “microsleepers”. Results Among 193 male participants, the 15 microsleepers (8%) were significantly more obese, but not different on age or Epworth Sleepiness Score. Time of day had no effect on RT. Conclusion PVT is suitable to occupational clinics and can identify otherwise unrecognized, impaired vigilance. Further studies must validate the PVT abnormalities most predictive of OSA/EDS and vehicular crashes, compared to adiposity measures alone. PMID:21826029

  1. The Netherlands XTC Toxicity (NeXT) study: objectives and methods of a study investigating causality, course, and clinical relevance.

    PubMed

    De Win, Maartje M L; Jager, Gerry; Vervaeke, Hylke K E; Schilt, Thelma; Reneman, Liesbeth; Booij, Jan; Verhulst, Frank C; Den Heeten, Gerard J; Ramsey, Nick F; Korf, Dirk J; Van den Brink, Wim

    2005-01-01

    This paper describes the objectives and methods of The Netherlands XTC Toxicity (NeXT) study focussing on the causality, course, and clinical relevance of ecstasy neurotoxicity. Previous studies suggest that ecstasy (3,4 methylene-dioxymethamphetamine, MDMA, XTC) is toxic toward brain serotonin axons, but most of these studies have serious methodological limitations. The current study is a combination of different approaches with three substudies: (1) a crosssectional substudy among heavy ecstasy users and controls with variation in drug use, which will provide information about potential neurotoxic consequences of ecstasy in relation to other drugs; (2) a prospective cohort substudy in ecstasy-naive subjects with high risk for future ecstasy use, which will provide information on the causality and short-term course of ecstasy use and potential neurotoxicity, and (3) a retrospective cohort substudy in lifetime ecstasy users and matched controls of an existing epidemiological sample that will provide information on long-term course and outcome of ecstasy use in the general population. Neurotoxicity is studied using (a) different imaging techniques (beta-CIT SPECT, 1H-MR spectroscopy, diffusion tensor imaging, perfusion weighted imaging and functional magnetic resonance imaging), and (b) neuropsychological and psychiatric assessments of memory, depression, and personality. The combined results will lead to conclusions that can be used in prevention messages, clinical decision making, and the development of an (inter)national ecstasy policy. PMID:16395871

  2. Lightweight Object Oriented Structure analysis: Tools for building Tools to Analyze Molecular Dynamics Simulations

    PubMed Central

    Romo, Tod D.; Leioatts, Nicholas; Grossfield, Alan

    2014-01-01

    LOOS (Lightweight Object-Oriented Structure-analysis) is a C++ library designed to facilitate making novel tools for analyzing molecular dynamics simulations by abstracting out the repetitive tasks, allowing developers to focus on the scientifically relevant part of the problem. LOOS supports input using the native file formats of most common biomolecular simulation packages, including CHARMM, NAMD, Amber, Tinker, and Gromacs. A dynamic atom selection language based on the C expression syntax is included and is easily accessible to the tool-writer. In addition, LOOS is bundled with over 120 pre-built tools, including suites of tools for analyzing simulation convergence, 3D histograms, and elastic network models. Through modern C++ design, LOOS is both simple to develop with (requiring knowledge of only 4 core classes and a few utility functions) and is easily extensible. A python interface to the core classes is also provided, further facilitating tool development. PMID:25327784

  3. Incremental Structured Dictionary Learning for Video Sensor-Based Object Tracking

    PubMed Central

    Xue, Ming; Yang, Hua; Zheng, Shibao; Zhou, Yi; Yu, Zhenghua

    2014-01-01

    To tackle robust object tracking for video sensor-based applications, an online discriminative algorithm based on incremental discriminative structured dictionary learning (IDSDL-VT) is presented. In our framework, a discriminative dictionary combining both positive, negative and trivial patches is designed to sparsely represent the overlapped target patches. Then, a local update (LU) strategy is proposed for sparse coefficient learning. To formulate the training and classification process, a multiple linear classifier group based on a K-combined voting (KCV) function is proposed. As the dictionary evolves, the models are also trained to timely adapt the target appearance variation. Qualitative and quantitative evaluations on challenging image sequences compared with state-of-the-art algorithms demonstrate that the proposed tracking algorithm achieves a more favorable performance. We also illustrate its relay application in visual sensor networks. PMID:24549252

  4. A real options approach to clinical faculty salary structure.

    PubMed

    Kahn, Marc J; Long, Hugh W

    2012-01-01

    One can use the option theory model originally developed to price financial opportunities in security markets to analyze many other economic arrangements such as the salary structures of clinical faculty in an academic medical center practice plan. If one views the underlying asset to be the portion (labeled "salary") of the economic value of the collections made for the care provided patients by the physician, then a salary guarantee can be considered a put option provided the physician, the guarantee having value to the physician only when the actual salary earned is less than the salary guarantee. Similarly, within an incentive plan, a salary cap can be thought of as a call option provided to the practice plan since a salary cap only has value to the practice plan when a physician's earnings exceed the cap. Further, based on analysis of prior earnings, the Black-Scholes options pricing model can be used both to price each option and to determine a financially neutral balance between a salary guarantee and a salary cap by equating the prices of the implied put and call options. We suggest that such analysis is superior to empirical methods for setting clinical faculty salary structure in the academic practice plan setting. PMID:23155746

  5. [Structure, Immunogenicity and Clinical Value of Chlamydiaphage Capsid Protein 3].

    PubMed

    Yao, Weifeng; Li, Yiju; Yuan, Jing; Wang, Lei; Li, Qunyan; Song, Mengmeng; Lu, Guiling; Zhang, Litao

    2015-07-01

    We wished to assess the role of chlamydia micro virus capsid protein Vp3 in recombinant molecules, chart its molecular evolution, screen the wild-type strain, and reveal its value in clinical research. Using a protein BLAST multiple-alignment program, we compared various strains of Chlamydia micro virus capsid protein Vp3 sequences. Using a "distance tree" of those results, we created a phylogenetic tree. We applied the Karplus-Schulz method of flexible-region analyses for highly conserved alignments of amino-acid sequences. Gamier-Robson and Chou-Fasman methods were employed to analyze two-level structures of sequences. The Emini method was used for analyses of the accessibility of surface epitopes. Studies of hydrophilic proteins were undertaken using Kyte-Doolittle and Hopp-Woods methods. Analyses of antigen epitopes helped to reveal the antigen index using the Jameson-Wolf method. All sequences in the six strains of chlamydia micro virus capsid protein Vp3 were highly conserved, with the main differences being between Vp3 protein in Chp1 and the other five strains of the micro virus. The viral strain of Vp3 protein was based mainly on micro-alpha helix structures, and multiple epitopes were noted in highly conserved regions. Vp3 protein was highly conserved structurally, and was an important protein of the chlamydiaphage capsid. Vp3 protein has a complicated molecular structure, highly conserved regions with strong immunogenicity, and has considerable research value. PMID:26524915

  6. Correlating Photoreceptor Mosaic Structure to Clinical Findings in Stargardt Disease

    PubMed Central

    Razeen, Moataz M.; Cooper, Robert F.; Langlo, Christopher S.; Goldberg, Mara R.; Wilk, Melissa A.; Han, Dennis P.; Connor, Thomas B.; Fishman, Gerald A.; Collison, Frederick T.; Sulai, Yusufu N.; Dubra, Alfredo; Carroll, Joseph; Stepien, Kimberly E.

    2016-01-01

    Purpose To demonstrate a method for correlating photoreceptor mosaic structure with optical coherence tomography (OCT) and microperimetry findings in patients with Stargardt disease. Methods A total of 14 patients with clinically diagnosed Stargardt disease were imaged using confocal and split-detection adaptive optics scanning light ophthalmoscopy. Cone photoreceptors were identified manually in a band along the temporal meridian. Resulting values were compared to a normative database (n = 9) to generate cone density deviation (CDD) maps. Manual measurement of outer nuclear layer plus Henle fiber layer (ONL+HFL) thickness was performed, in addition to determination of the presence of ellipsoid zone (EZ) and interdigitation zone (IZ) bands on OCT. These results, along with microperimetry data, were overlaid with the CDD maps. Results Wide variation in foveal structure and CDD maps was seen within this small group. Disruption of ONL+HFL and/or IZ band was seen in all patients, with EZ band preservation in regions with low cone density in 38% of locations analyzed. Normality of retinal lamellar structure on OCT corresponded with cone density and visual function at 50/78 locations analyzed. Outer retinal tubulations containing photoreceptor-like structures were observed in 3 patients. Conclusions The use of CDD color-coded maps enables direct comparison of cone mosaic local density with other measures of retinal structure and function. Larger normative datasets and improved tools for automation of image alignment are needed. Translational Relevance The approach described facilitates comparison of complex multimodal data sets from patients with inherited retinal degeneration, and can be expanded to incorporate other structural imaging or functional testing. PMID:26981328

  7. Origin of Rotating Ring Structures in the Strong Gravity of a Central Object.

    NASA Astrophysics Data System (ADS)

    Coppi, B.

    2006-04-01

    The origin of plasma rotating ring structures forming around a central object whose gravity is prevalent has been identified [1] through the analysis of thin equilibrium configurations that are immersed in a relatively weak external magnetic field and can carry internal toroidal currents. Unlike the case of the ``classical'' gaseous disk, in which the vertical equilibrium is maintained only by gravity, rings are maintained vertically by the Lorentz force and radially by gravity. The differential rotation is the sustaining factor of these ring structures and of the jets that may emerge from them. The rings are connected with the formation of a periodic sequence [2] of Field Reverse Configurations of the poloidal magnetic field, consisting of pairs of counter-streaming toroidal current channels. In magnetic field configurations that have been considered previously for accretion disks the magnetic field diffusion was assumed to be such that the Ferraro isorotation condition was not valid, while in our case it has a primary role. The relevant equilibria are not described by the Grad-Shafranov equation but by two non-linear coupled equations that have been solved analytically. These provide both the plasma pressure function and the magnetic surface function once a consistent plasma density function is chosen within a relatively narrow class. A two-fluid description of the same equilibria is given differentiating the relative roles of electrons and ions.[1] B. Coppi and F. Rousseau, to appear in Ap. J., April (2006). [2] B. Coppi, Phys. of Plasmas, 12, 057302 (2005).

  8. Ne II FINE-STRUCTURE LINE EMISSION FROM THE OUTFLOWS OF YOUNG STELLAR OBJECTS

    SciTech Connect

    Shang, Hsien; Lin, Wei-Chieh; Liu, Chun-Fan J.; Glassgold, Alfred E.

    2010-05-10

    The flux and line shape of the fine-structure transitions of Ne II and Ne III at 12.8 and 15.55 {mu}m and of the forbidden transitions of O I {lambda}6300 are calculated for young stellar objects with a range of mass-loss rates and X-ray luminosities using the X-wind model of jets and the associated wide-angle winds. For moderate and high accretion rates, the calculated Ne II line luminosity is comparable to or much larger than produced in X-ray irradiated disk models. All of the line luminosities correlate well with the main parameter in the X-wind model, the mass-loss rate, and also with the assumed X-ray luminosity-and with one another. The line shapes of an approaching jet are broad and have strong blue-shifted peaks near the effective terminal velocity of the jet. They serve as a characteristic and testable aspect of jet production of the neon fine-structure lines and the O I forbidden transitions.

  9. Saving Lives and Money: A Multi-Objective Optimization Approach to the Selection of Structural Retrofits

    NASA Astrophysics Data System (ADS)

    Franco, G.; Deodatis, G.; Smyth, A.

    2005-12-01

    The existence of large numbers of poorly constructed buildings in earthquake-prone areas has made large scale retrofitting campaigns a desirable strategy for reducing the risk of loss of life and infrastructure. Since the retrofitting operation must be, therefore, carried out for numerous buildings, it has become a necessity to find the most attractive retrofitting solution for a given type of buildings that significantly reduces the risk of loss of life while remaining as economic as possible. Each retrofit solution for an existing building carries a set of potential costs and benefits over a given period of time. Some of these costs and benefits can be taken into account in terms of monetary values, whereas others cannot. The value of lives spared or lives lost that may potentially occur over the lifespan of a building as a consequence of choosing a particular retrofit cannot be easily measured in terms of money. In the absence of better methods to incorporate the value of life into economic analyses, a somewhat arbitrary monetary quantity based on personal insurance or personal productivity is often chosen as a proxy to quantify it. These quantities, however, not only fail to capture the otherwise incalculable cost of life, but are also strongly dependent on the economy under study. In this work, the monetary costs of construction and structural damage are clearly differentiated from the loss of life, which is simply measured as the number of potential casualties in a certain earthquake scenario. Finding the best retrofit then becomes a multi-objective optimization problem, whose purpose is to find the cheapest solution that saves most lives. The conflicting nature of the objectives causes the appearance of not only one optimal solution but of a set of most convenient solutions that capture the different levels of trade-off between costs and lives saved. A large number of possible structural retrofits must be considered in order to find the set of best solutions

  10. Clinical use of echocardiography in structural heart disease.

    PubMed

    Shibayama, Kentaro; Watanabe, Hiroyuki

    2016-07-01

    Recently, a development of devices for transcatheter interventions, such as transcatheter aortic valve implantation for aortic stenosis, percutaneous mitral valve repair for mitral regurgitation, and percutaneous closure of atrial septal defect, has led to a greatly expanded armamentarium of catheter-based approaches for patients with structural heart disease (SHD). Comorbidity and anatomical limitations specific to each procedure are known to influence outcomes during and after the intervention. Therefore, risk stratification of the intervention including anatomical and functional assessments is critically important. Furthermore, echocardiography reveals both physiological and anatomical abnormalities of SHD in real-time even in the operation theater. Consequently, echocardiography plays an essential role in providing not only preoperative assessment of SHD but also intra-procedural monitoring and postoperative follow-up. This document is intended as a reference for cardiac surgeons using echocardiography clinically for patients with SHD, particularly those with valvular heart disease and atrial septal defect. PMID:27138937

  11. Cystathionine γ-lyase: clinical, metabolic, genetic, and structural studies

    PubMed Central

    Kraus, Jan P.; Hašek, Jindrich; Kožich, Viktor; Collard, Renata; Venezia, Sarah; Janošíková, Bohumila; Wang, Jian; Stabler, Sally P.; Allen, Robert H.; Jakobs, Cornelis; Finn, Christine T.; Chien, Yin-Hsiu; Hwu, Wuh-Liang; Hegele, Robert A.; Mudd, S. Harvey

    2009-01-01

    We report studies of six individuals with marked elevations of cystathionine in plasma and/or urine. Studies of CTH, the gene that encodes cystathionine γ-lyase, revealed the presence among these individuals of either homozygous or compound heterozygous forms of a novel large deletion, p.Gly57_Gln196del, two novel missense mutations, c.589C>T (p.Arg197Cys) and c.932C>T (p.Thr311Ile), and one previously reported alteration, c.200C>T (p.Thr67Ile). Another novel missense mutation, c.185G>T (p.Arg62His), was found in heterozygous form in three mildly hypercystathioninemic members of a Taiwanese family. In one severely hypercystathioninemic individual no CTH mutation was found. Brief clinical histories of the cystathioninemic/cystathioninuric patients are presented. Most of the novel mutations were expressed and the CTH activities of the mutant proteins determined. The crystal structure of the human enzyme, hCTH, and the evidence available as to the effects of the mutations in question, as well as those of the previously reported p.Gln240Glu, on protein structure, enzymatic activity, and responsiveness to vitamin B6 administration are discussed. Among healthy Czech controls, 9.3% were homozygous for CTH c.1208G>T (p.Ser403Ile), previously found homozygously in 7.5% of Canadians for whom plasma total homocysteine (tHcy) had been measured. Compared to wild-type homozygotes, among the 55 Czech c.1208G>T (p.Ser403Ile) homozygotes a greater level of plasma cystathionine was found only after methionine loading. Three of the four individuals homozygous or compound heterozygous for inactivating CTH mutations had mild plasma tHcy elevations, perhaps indicating a cause-and-effect relationship. The experience with the present patients provides no evidence that severe loss of CTH activity is accompanied by adverse clinical effects. PMID:19428278

  12. Correlative nanoscale 3D imaging of structure and composition in extended objects.

    PubMed

    Xu, Feng; Helfen, Lukas; Suhonen, Heikki; Elgrabli, Dan; Bayat, Sam; Reischig, Péter; Baumbach, Tilo; Cloetens, Peter

    2012-01-01

    Structure and composition at the nanoscale determine the behavior of biological systems and engineered materials. The drive to understand and control this behavior has placed strong demands on developing methods for high resolution imaging. In general, the improvement of three-dimensional (3D) resolution is accomplished by tightening constraints: reduced manageable specimen sizes, decreasing analyzable volumes, degrading contrasts, and increasing sample preparation efforts. Aiming to overcome these limitations, we present a non-destructive and multiple-contrast imaging technique, using principles of X-ray laminography, thus generalizing tomography towards laterally extended objects. We retain advantages that are usually restricted to 2D microscopic imaging, such as scanning of large areas and subsequent zooming-in towards a region of interest at the highest possible resolution. Our technique permits correlating the 3D structure and the elemental distribution yielding a high sensitivity to variations of the electron density via coherent imaging and to local trace element quantification through X-ray fluorescence. We demonstrate the method by imaging a lithographic nanostructure and an aluminum alloy. Analyzing a biological system, we visualize in lung tissue the subcellular response to toxic stress after exposure to nanotubes. We show that most of the nanotubes are trapped inside alveolar macrophages, while a small portion of the nanotubes has crossed the barrier to the cellular space of the alveolar wall. In general, our method is non-destructive and can be combined with different sample environmental or loading conditions. We therefore anticipate that correlative X-ray nano-laminography will enable a variety of in situ and in operando 3D studies. PMID:23185554

  13. Correlative Nanoscale 3D Imaging of Structure and Composition in Extended Objects

    PubMed Central

    Xu, Feng; Helfen, Lukas; Suhonen, Heikki; Elgrabli, Dan; Bayat, Sam; Reischig, Péter; Baumbach, Tilo; Cloetens, Peter

    2012-01-01

    Structure and composition at the nanoscale determine the behavior of biological systems and engineered materials. The drive to understand and control this behavior has placed strong demands on developing methods for high resolution imaging. In general, the improvement of three-dimensional (3D) resolution is accomplished by tightening constraints: reduced manageable specimen sizes, decreasing analyzable volumes, degrading contrasts, and increasing sample preparation efforts. Aiming to overcome these limitations, we present a non-destructive and multiple-contrast imaging technique, using principles of X-ray laminography, thus generalizing tomography towards laterally extended objects. We retain advantages that are usually restricted to 2D microscopic imaging, such as scanning of large areas and subsequent zooming-in towards a region of interest at the highest possible resolution. Our technique permits correlating the 3D structure and the elemental distribution yielding a high sensitivity to variations of the electron density via coherent imaging and to local trace element quantification through X-ray fluorescence. We demonstrate the method by imaging a lithographic nanostructure and an aluminum alloy. Analyzing a biological system, we visualize in lung tissue the subcellular response to toxic stress after exposure to nanotubes. We show that most of the nanotubes are trapped inside alveolar macrophages, while a small portion of the nanotubes has crossed the barrier to the cellular space of the alveolar wall. In general, our method is non-destructive and can be combined with different sample environmental or loading conditions. We therefore anticipate that correlative X-ray nano-laminography will enable a variety of in situ and in operando 3D studies. PMID:23185554

  14. Clinical Significance of Umami Taste and Umami-Related Gene Expression Analysis for the Objective Assessment of Umami Taste Loss.

    PubMed

    Shoji, Noriaki; Satoh-Ku Riwada, Shizuko; Sasano, Takashi

    2016-01-01

    Loss of umami taste sensation affects quality of life and causes weight loss and health problems, particularly in the elderly. We recently expanded the use of the filter paper disc method to include assessment of umami taste sensitivity, using monosodium glutamate as the test solution. This test showed high diagnostic performance for discriminating between normal taste function and disorders in sensation of the umami taste, according to established cut-off values. The test also revealed: (1) some elderly patients suffered from specific loss of umami taste sensation with preservation of the other four taste sensations (sweet, salty, sour, and bitter); (2) umami taste disorder caused a loss of appetite and decline in weight, resulting in poor health; (3) appetite, weight and overall health improved after appropriate treatment for umami taste disorder. Because of the subjective nature of the test, however, it may not be useful for patients who cannot express which taste sensation is induced by a tastant, such as those with dementia. Most recently, using tissue samples collected from the tongue by scraping the foliate papillae, we showed that evaluation of umami taste receptor gene expression may be clinically useful for the objective genetic diagnosis of umami taste disorders. PMID:26881442

  15. Incidental and Context-Responsive Activation of Structure- and Function-Based Action Features during Object Identification

    ERIC Educational Resources Information Center

    Lee, Chia-lin; Middleton, Erica; Mirman, Daniel; Kalenine, Solene; Buxbaum, Laurel J.

    2013-01-01

    Previous studies suggest that action representations are activated during object processing, even when task-irrelevant. In addition, there is evidence that lexical-semantic context may affect such activation during object processing. Finally, prior work from our laboratory and others indicates that function-based ("use") and structure-based…

  16. Development of the Objective, Structured Communication Assessment of Residents (OSCAR) Tool for Measuring Communication Skills With Patients

    PubMed Central

    Caron, Aleece; Perzynski, Adam; Thomas, Charles; Saade, Jimmy Y.; McFarlane, Michael; Becker, Jeffery

    2013-01-01

    Background Although interpersonal and communication skills are essential to physician practice, there is a dearth of effective tools to meaningfully teach and assess communication skills. Objective The purpose of our study was to create a standardized tool for evaluation of communication skills for residents across specialties. Methods We designed an Objective, Structured Communication Assessment of Residents (OSCAR) tool, consisting of 4 clinical stations, to assess intern communication skills with relationship development, their establishment of case goals, and their organization and time management skills. Interns from 11 training programs completed the stations, with senior residents trained to function as standardized patients. The 4 stations' scenarios were a disruptive patient, handling a phone call for a narcotics refill, disclosing a medical mistake, and delivering bad news. Results Eighty-three interns completed OSCAR during orientation. The assessment took interns about 40 minutes to complete, and participants were given immediate feedback by the standardized patients. The total possible score for each station was 50. Resident performance was highest for disclosing a medical error (94%, 47 of 50), followed by handling a disruptive patient (90%, 45 of 50), disclosing bad news (86%, 43 of 50), and handling the phone call for the narcotics refill (62%, 31 of 50). Multivariate analysis of variance results indicated differences between residents from US and international medical schools, but there were no significant differences across specialties. Interrater reliability was excellent for each station (> 0.80). Conclusions OSCAR is a practical tool for assessing interns' communication skills to provide timely results to program directors. PMID:24455003

  17. Chemistry of massive young stellar objects with a disk-like structure

    NASA Astrophysics Data System (ADS)

    Isokoski, K.; Bottinelli, S.; van Dishoeck, E. F.

    2013-06-01

    Aims: Our goal is to take an inventory of complex molecules in three well-known high-mass protostars for which disks or toroids have been claimed and to study the similarities and differences with a sample of massive young stellar objects (YSOs) without evidence of such flattened disk-like structures. With a disk-like geometry, UV radiation can escape more readily and potentially affect the ice and gas chemistry on hot-core scales. Methods: A partial submillimeter line survey, targeting CH3OH, H2CO, C2H5OH, HCOOCH3, CH3OCH3, CH3CN, HNCO, NH2CHO, C2H5CN, CH2CO, HCOOH, CH3CHO, and CH3CCH, was made toward three massive YSOs with disk-like structures, IRAS 20126+4104, IRAS 18089-1732, and G31.41+0.31. Rotation temperatures and column densities were determined by the rotation diagram method, as well as by independent spectral modeling. The molecular abundances were compared with previous observations of massive YSOs without evidence of any disk structure, targeting the same molecules with the same settings and using the same analysis method. Results: Consistent with previous studies, different complex organic species have different characteristic rotation temperatures and can be classified either as warm (>100 K) or cold (<100 K). The excitation temperatures and abundance ratios are similar from source to source and no significant difference can be established between the two source types. Acetone, CH3COCH3, is detected for the first time in G31.41+0.31 and IRAS 18089-1732. Temperatures and abundances derived from the two analysis methods generally agree within factors of a few. Conclusions: The lack of chemical differentiation between massive YSOs with and without observed disks suggest either that the chemical complexity is already fully established in the ices in the cold prestellar phase or that the material experiences similar physical conditions and UV exposure through outflow cavities during the short embedded lifetime. Appendices are available in electronic form

  18. Method and apparatus for detecting internal structures of bulk objects using acoustic imaging

    DOEpatents

    Deason, Vance A.; Telschow, Kenneth L.

    2002-01-01

    Apparatus for producing an acoustic image of an object according to the present invention may comprise an excitation source for vibrating the object to produce at least one acoustic wave therein. The acoustic wave results in the formation of at least one surface displacement on the surface of the object. A light source produces an optical object wavefront and an optical reference wavefront and directs the optical object wavefront toward the surface of the object to produce a modulated optical object wavefront. A modulator operatively associated with the optical reference wavefront modulates the optical reference wavefront in synchronization with the acoustic wave to produce a modulated optical reference wavefront. A sensing medium positioned to receive the modulated optical object wavefront and the modulated optical reference wavefront combines the modulated optical object and reference wavefronts to produce an image related to the surface displacement on the surface of the object. A detector detects the image related to the surface displacement produced by the sensing medium. A processing system operatively associated with the detector constructs an acoustic image of interior features of the object based on the phase and amplitude of the surface displacement on the surface of the object.

  19. Active member control of a precision structure with an H(infinity) performance objective

    NASA Technical Reports Server (NTRS)

    Fanson, J. L.; Chu, C.-C.; Smith, R. S.; Anderson, E. H.

    1990-01-01

    This paper addresses the noncollocated control of active structures using active structural elements. A top level architecture for active structures is presented, and issues pertaining to robust control of structures are discussed. Controllers optimized for an H sub inf performance specification are implemented on a test structure and the results are compared with analytical predictions. Directions for further research are identified.

  20. Nanoscale Mechanics of Helical and Angular Structures: Exploring and Expanding the Capabilities of Objective Molecular Dynamics

    NASA Astrophysics Data System (ADS)

    Nikiforov, Ilia Andreyevich

    Objective molecular dynamics (OMD) is a recently developed generalization of the traditionally employed periodic boundary conditions (PBC) used in atomistic simulations. OMD allows for helical and/or rotational symmetries to be exploited in addition to translational symmetry. These symmetries are especially prevalent in nanostructures, and OMD enables or facilitates many simulations that were previously dicult or impossible to carry out. This includes simulations of pristine structures that inherently possess helical and/or angular symmetries (such as nanotubes), structures that contain defects (such as screw disclocations) or stuctures that are subjected to deformations (such as bending or torsion). OMD is already a powerful method, having been coupled with the quantum-mechanical density functional-based tight-binding (DFTB) method, as well as with classical potentials. In this work, these capabilities are used to investigate electromechanical properties of silicon nanowires, treating the mechanical simulation results in the context of continuum mechanics. The bending of graphene is studied, and the underlying molecular orbital mechanisms are investigated. The implications of the results on other simulation methods used to study bending of graphene are discussed. OMD is used in an experimental-theoretical collaboration studying the kinking of graphene and boron nitride nanoribbons. The simulations elucidate and quantify the underlying mechanism behind the kinking seen in experiments. Although theoretically, as a generalization, OMD can match or exceed the capabilities of PBC in all cases, OMD is a new method. Thus, practical implementation must be tackled to expand the capabilities of OMD to new simulation methods and simulation types. In this work, OMD is expanded to allow coupling with self-consistent charge (SCC) DFTB, by developing and implementing the required summation formulas for electrostatic and dispersion interactions. SCC-DFTB is an improved form of

  1. The clinical utility of the continuous performance test and objective measures of activity for diagnosing and monitoring ADHD in children: a systematic review.

    PubMed

    Hall, Charlotte L; Valentine, Althea Z; Groom, Madeleine J; Walker, Gemma M; Sayal, Kapil; Daley, David; Hollis, Chris

    2016-07-01

    Attention-deficit hyperactivity disorder (ADHD) is typically diagnosed using clinical observation and subjective informant reports. Once children commence ADHD medication, robust monitoring is required to detect partial or non-responses. The extent to which neuropsychological continuous performance tests (CPTs) and objective measures of activity can clinically aid the assessment and titration process in ADHD is not fully understood. This review describes the current evidence base for the use of CPTs and objectively measured activity to support the diagnostic procedure and medication management for children with ADHD. Four databases (PsycINFO, Medline, Allied and Complementary Medicine (AMED), and PsycARTICLES) were systematically searched to understand the current evidence base for (1) the use of CPTs to aid clinical assessment of ADHD; (2) the use of CPTs to aid medication management; and (3) the clinical utility of objective measures of activity in ADHD. Sixty relevant articles were identified. The search revealed six commercially available CPTs that had been reported on for their clinical use. There were mixed findings with regard to the use of CPTs to assess and manage medication, with contrasting evidence on their ability to support clinical decision-making. There was a strong evidence base for the use of objective measures of activity to aid ADHD/non-ADHD group differentiation, which appears sensitive to medication effects and would also benefit from further research on their clinical utility. The findings suggest that combining CPTs and an objective measure of activity may be particularly useful as a clinical tool and worthy of further pursuit. PMID:26620873

  2. Envelope structure of deeply embedded young stellar objects in the Serpens Molecular Cloud

    NASA Technical Reports Server (NTRS)

    Hogerheijde, M. R.; van Dishoeck, E. F.; Salverda, J. M.; Blake, G. A.

    1999-01-01

    Aperture-synthesis and single-dish (sub-) millimeter molecular-line and continuum observations reveal in great detail the envelope structure of deeply embedded young stellar objects (SMM 1 = FIRS 1, SMM 2, SMM 3, SMM 4) in the densely star-forming Serpens Molecular Cloud. SMM 1, 3, and 4 show partially resolved (>2" = 800 AU) continuum emission in the beam of the Owens Valley Millimeter Array at lambda = 3.4-1.4 mm. The continuum visibilities accurately constrain the density structure in the envelopes, which can be described by a radial power law with slope -2.0 +/- 0.5 on scales of 300 to 8000 AU. Inferred envelope masses within a radius of 8000 AU are 8.7, 3.0, and 5.3 Msolar for SMM 1, 3, and 4, respectively. A point source with 20%-30% of the total flux at 1.1 mm is required to fit the observations on long baselines, corresponding to warm envelope material within approximately 100 AU or a circumstellar disk. No continuum emission is detected interferometrically toward SMM 2, corresponding to an upper limit of 0.2 Msolar assuming Td = 24 K. The lack of any compact dust emission suggests that the SMM 2 core does not contain a central protostar. Aperture-synthesis observations of the 13CO, C18O, HCO+, H13CO+, HCN, H13CN, N2H+ 1-0, SiO 2-1, and SO 2(2)-1(1) transitions reveal compact emission toward SMM 1, 3, and 4. SMM 2 shows only a number of clumps scattered throughout the primary field of view, supporting the conclusion that this core does not contain a central star. The compact molecular emission around SMM 1, 3, and 4 traces 5"-10" (2000-4000 AU) diameter cores that correspond to the densest regions of the envelopes, as well as material directly associated with the molecular outflow. Especially prominent are the optically thick HCN and HCO+ lines that show up brightly along the walls of the outflow cavities. SO and SiO trace shocked material, where their abundances may be enhanced by 1-2 orders of magnitude over dark-cloud values. A total of 31 molecular

  3. Envelope structure of deeply embedded young stellar objects in the Serpens Molecular Cloud.

    PubMed

    Hogerheijde, M R; van Dishoeck, E F; Salverda, J M; Blake, G A

    1999-03-01

    Aperture-synthesis and single-dish (sub-) millimeter molecular-line and continuum observations reveal in great detail the envelope structure of deeply embedded young stellar objects (SMM 1 = FIRS 1, SMM 2, SMM 3, SMM 4) in the densely star-forming Serpens Molecular Cloud. SMM 1, 3, and 4 show partially resolved (>2" = 800 AU) continuum emission in the beam of the Owens Valley Millimeter Array at lambda = 3.4-1.4 mm. The continuum visibilities accurately constrain the density structure in the envelopes, which can be described by a radial power law with slope -2.0 +/- 0.5 on scales of 300 to 8000 AU. Inferred envelope masses within a radius of 8000 AU are 8.7, 3.0, and 5.3 Msolar for SMM 1, 3, and 4, respectively. A point source with 20%-30% of the total flux at 1.1 mm is required to fit the observations on long baselines, corresponding to warm envelope material within approximately 100 AU or a circumstellar disk. No continuum emission is detected interferometrically toward SMM 2, corresponding to an upper limit of 0.2 Msolar assuming Td = 24 K. The lack of any compact dust emission suggests that the SMM 2 core does not contain a central protostar. Aperture-synthesis observations of the 13CO, C18O, HCO+, H13CO+, HCN, H13CN, N2H+ 1-0, SiO 2-1, and SO 2(2)-1(1) transitions reveal compact emission toward SMM 1, 3, and 4. SMM 2 shows only a number of clumps scattered throughout the primary field of view, supporting the conclusion that this core does not contain a central star. The compact molecular emission around SMM 1, 3, and 4 traces 5"-10" (2000-4000 AU) diameter cores that correspond to the densest regions of the envelopes, as well as material directly associated with the molecular outflow. Especially prominent are the optically thick HCN and HCO+ lines that show up brightly along the walls of the outflow cavities. SO and SiO trace shocked material, where their abundances may be enhanced by 1-2 orders of magnitude over dark-cloud values. A total of 31 molecular

  4. The Efficacy of Structural Priming on the Acquisition of Double Object Construction by Chinese EFL Learners

    ERIC Educational Resources Information Center

    Jiang, Lin; Huang, Kang

    2015-01-01

    Structural priming refers to the tendency of speakers to reuse the same structural pattern as one that was previously encountered (Bock, 1986). The effectiveness of structural priming has been an issue of much discussion in the field of second language acquisition over decades. This study aims at investigating the role of structural priming in…

  5. Object reconstruction in multilayer neural network based profilometry using grating structure comprising two regions with different spatial periods

    NASA Astrophysics Data System (ADS)

    Ganotra, Dinesh; Joseph, Joby; Singh, Kehar

    2004-08-01

    Feed-forward backpropagation neural network has been used in fringe projection profilometry for reconstruction of a three-dimensional (3D) object. A grating structure comprising two regions of different spatial periods is projected on the reference surface over which the object is placed. The shorter spatial period part of the grating is projected over the object, whereas the longer spatial period part is projected on the reference surface only. 3D object shape is reconstructed with the help of neural networks using images of the projected grating. During training phase of the network, the shorter spatial period grating along with the longer spatial period grating is used. Experimental results are presented for a diffuse object, showing that the 3D shape of the object is recovered using the above-mentioned method. However, the phases wrapping takes place in Fourier transform profilometry by using only one grating of shorter spatial period.

  6. Assessment of Semi-Structured Clinical Interview for Mobile Phone Addiction Disorder

    PubMed Central

    Alavi, Seyyed Salman; Jannatifard, Fereshteh; Mohammadi Kalhori, Soroush; Sepahbodi, Ghazal; BabaReisi, Mohammad; Sajedi, Sahar; Farshchi, Mojtaba; KhodaKarami, Rasul; Hatami Kasvaee, Vahid

    2016-01-01

    Objective: The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) classified mobile phone addiction disorder under “impulse control disorder not elsewhere classified”. This study surveyed the diagnostic criteria of DSM-IV-TR for the diagnosis of mobile phone addiction in correspondence with Iranian society and culture. Method: Two hundred fifty students of Tehran universities were entered into this descriptive-analytical and cross-sectional study. Quota sampling method was used. At first, semi- structured clinical interview (based on DSM-IV-TR) was performed for all the cases, and another specialist reevaluated the interviews. Data were analyzed using content validity, inter-scorer reliability (Kappa coefficient) and test-retest via SPSS18 software. Results: The content validity of the semi- structured clinical interview matched the DSM–IV-TR criteria for behavioral addiction. Moreover, their content was appropriate, and two items, including “SMS pathological use” and “High monthly cost of using the mobile phone” were added to promote its validity. Internal reliability (Kappa) and test–retest reliability were 0.55 and r = 0.4 (p<0. 01) respectively. Conclusion: The results of this study revealed that semi- structured diagnostic criteria of DSM-IV-TR are valid and reliable for diagnosing mobile phone addiction, and this instrument is an effective tool to diagnose this disorder. PMID:27437008

  7. Local x-ray structure analysis of optically manipulated biological micro-objects

    SciTech Connect

    Cojoc, Dan; Ferrari, Enrico; Santucci, Silvia C.; Amenitsch, Heinz; Sartori, Barbara; Rappolt, Michael; Marmiroli, Benedetta; Burghammer, Manfred; Riekel, Christian

    2010-12-13

    X-ray diffraction using micro- and nanofocused beams is well suited for nanostructure analysis at different sites of a biological micro-object. To conduct in vitro studies without mechanical contact, we developed object manipulation by optical tweezers in a microfluidic cell. Here we report x-ray microdiffraction analysis of a micro-object optically trapped in three dimensions. We revealed the nanostructure of a single starch granule at different points and investigated local radiation damage induced by repeated x-ray exposures at the same position, demonstrating high stability and full control of the granule orientation by multiple optical traps.

  8. THE USE OF THE ANALYST AND THE SENSE OF BEING REAL: THE CLINICAL MEANING OF WINNICOTT'S "THE USE OF AN OBJECT".

    PubMed

    Fabozzi, Paolo

    2016-01-01

    "The Use of an Object and Relating through Identifications" (1968) represents Donald Winnicott's theoretical and clinical legacy. The author develops this concept from a clinical point of view, through the analysis of a woman with psychotic functioning. He reflects upon the dramatic quality of risks inherent in the processes linked to the use of the object with seriously disturbed patients. He explores different meanings of the analyst's survival, linking it to the analyst's response. The processes of the use of the object--that is, the encounter between the patient's potential destructiveness and the analyst's capacity to respond through his own judicious subjectivity--let the patient experience the analyst's capacity to keep his own subjectivity, authenticity, and creativity alive. It is starting from the traces of this live object that patients gradually form their own personal sense of being real. PMID:26784713

  9. 2D virtual texture on 3D real object with coded structured light

    NASA Astrophysics Data System (ADS)

    Molinier, Thierry; Fofi, David; Salvi, Joaquim; Gorria, Patrick

    2008-02-01

    Augmented reality is used to improve color segmentation on human body or on precious no touch artifacts. We propose a technique to project a synthesized texture on real object without contact. Our technique can be used in medical or archaeological application. By projecting a suitable set of light patterns onto the surface of a 3D real object and by capturing images with a camera, a large number of correspondences can be found and the 3D points can be reconstructed. We aim to determine these points of correspondence between cameras and projector from a scene without explicit points and normals. We then project an adjusted texture onto the real object surface. We propose a global and automatic method to virtually texture a 3D real object.

  10. The search for structure - Object classification in large data sets. [for astronomers

    NASA Technical Reports Server (NTRS)

    Kurtz, Michael J.

    1988-01-01

    Research concerning object classifications schemes are reviewed, focusing on large data sets. Classification techniques are discussed, including syntactic, decision theoretic methods, fuzzy techniques, and stochastic and fuzzy grammars. Consideration is given to the automation of MK classification (Morgan and Keenan, 1973) and other problems associated with the classification of spectra. In addition, the classification of galaxies is examined, including the problems of systematic errors, blended objects, galaxy types, and galaxy clusters.

  11. Gist in time: Scene semantics and structure enhance recall of searched objects.

    PubMed

    Josephs, Emilie L; Draschkow, Dejan; Wolfe, Jeremy M; Võ, Melissa L-H

    2016-09-01

    Previous work has shown that recall of objects that are incidentally encountered as targets in visual search is better than recall of objects that have been intentionally memorized (Draschkow, Wolfe, & Võ, 2014). However, this counter-intuitive result is not seen when these tasks are performed with non-scene stimuli. The goal of the current paper is to determine what features of search in a scene contribute to higher recall rates when compared to a memorization task. In each of four experiments, we compare the free recall rate for target objects following a search to the rate following a memorization task. Across the experiments, the stimuli include progressively more scene-related information. Experiment 1 provides the spatial relations between objects. Experiment 2 adds relative size and depth of objects. Experiments 3 and 4 include scene layout and semantic information. We find that search leads to better recall than explicit memorization in cases where scene layout and semantic information are present, as long as the participant has ample time (2500ms) to integrate this information with knowledge about the target object (Exp. 4). These results suggest that the integration of scene and target information not only leads to more efficient search, but can also contribute to stronger memory representations than intentional memorization. PMID:27270227

  12. Dysexecutive Questionnaire (DEX): Unrestricted structural analysis in large clinical and non-clinical samples.

    PubMed

    Pedrero-Pérez, Eduardo J; Ruiz-Sánchez-de-León, José M; Winpenny-Tejedor, Carmen

    2015-01-01

    The factorial structure of the Dysexecutive Questionnaire (DEX) is an unresolved issue in scientific literature. One-to-five-factor solutions have been found in several studies by applying different research methods. Only a few of these studies used appropriate analysis procedures to suit a Likert scale-type of answer or investigated large enough samples to ensure the stability of factorial solutions. The present study examines a sample of 2151 subjects, 1482 from the general population and 669 from a clinical population. An unrestricted factorial analysis was carried out on both samples. The results unequivocally point to a single-factor solution in both samples. This means that only one latent variable is displayed in the DEX, which accounts for symptoms of oversight malfunction in activities of daily living. It is concluded that the diversity of results previously obtained in other studies may be due to using research methods that depict Likert-type scales on a continuum when they are actually ordinal categorical measures. In conclusion, the DEX should be considered a screening test that reports symptoms of prefrontal malfunction, although it is unable to specify what areas or functions have been affected, as previous studies have claimed. PMID:25517980

  13. Superconducting extended objects and applications to the phase structure of quantum chromodynamics

    NASA Astrophysics Data System (ADS)

    Skagerstam, B.-S.; Stern, A.

    1982-03-01

    In a previous work the dynamics of relativistic extended objects (i.e., strings, shells, etc.) coupled to Abelian or non-Abelian gauge fields was developed. The extended objects possessed an electriclike current which was defined in the associated Lie algebra of the gauge group under consideration. In the present paper, the interaction between the extended objects and gauge fields is slightly modified so that the objects behave like superconductors. By this we mean (a) the electrical conductivity is infinite and (b) for objects other than strings, a magnetic shielding or Meissner effect (with zero penetration depth) is present. Both (a) and (b) are features which occur in the classical description of the system. We also develop the dynamics for a system which is dual to the one described above. That is, instead of possessing an electric current, the objects here carry a magnetic current (Abelian or non-Abelian). Furthermore, the magnetic conductivity is infinite, and for objects other than strings an electric shielding or "dual" Meissner effect is present. The systems developed here contain Dirac's extended electron model and the MIT bag model as special cases. The former coincides with the description of an electrically charged shell. In the latter, we verify that the dynamics of a cavity within a (magnetic) superconducting vacuum is identical to that of a glueball in the MIT bag. This agrees with the view that the true quantum-chromodynamic (QCD) vacuum may be in a magnetic superconducting phase, and that the "dual" Meissner effect may be relevant for the confinement question. We also examine the possibility of the QCD vacuum being in an electric (or conventional) superconducting phase and a mixed superconducting phase, and comment on the confinement question for these two cases.

  14. Factor Structure of the Adolescent Clinical Sexual Behavior Inventory

    ERIC Educational Resources Information Center

    Wherry, Jeffrey N.; Berres, Ashley K.; Sim, Leslie; Friedrich, William N.

    2009-01-01

    The primary goal of this study was to determine if the Adolescent Clinical Sexual Behavior Inventory-Self-Report conformed to the five-factor scale format that was initially used with a clinical sample that included adolescents referred for sexual abuse evaluations. Participants were 141 teenagers, ages 12-19 (M = 15.11, SD = 1.4), and their…

  15. The structure of Herbig-Haro object 43 and Orion dark cloud extinction

    NASA Technical Reports Server (NTRS)

    Schwartz, R. D.; Dopita, M. A.; Cohen, M.

    1984-01-01

    New ultraviolet and optical observations of Herbig-Haro Object No. 43 are reported. Continuum and emission line fluxes in the range 1250 A equal to or less than lambda equal to less than 7350A have been measured. The continuum fluxes are best matched by an enhanced H two photon component added to H free bound emission, assuming theta Ori extinction curve with E(B-V) = 0.2, R = 5. The strucutre and dynamics of three components within the object are discussed. The object has a radiative output of equal to or greater than 0.23 infrared luminosity in ultraviolet and optical radiation combined. The energy requirements are discussed in terms of the production of shock waves by a collimated, supersonic mass outflow from a nearby infrared source.

  16. Incidental and context-responsive activation of structure- and function-based action features during object identification.

    PubMed

    Lee, Chia-lin; Middleton, Erica; Mirman, Daniel; Kalénine, Solène; Buxbaum, Laurel J

    2013-02-01

    Previous studies suggest that action representations are activated during object processing, even when task-irrelevant. In addition, there is evidence that lexical-semantic context may affect such activation during object processing. Finally, prior work from our laboratory and others indicates that function-based ("use") and structure-based ("move") action subtypes may differ in their activation characteristics. Most studies assessing such effects, however, have required manual object-relevant motor responses, thereby plausibly influencing the activation of action representations. The present work uses eyetracking and a Visual World Paradigm task without object-relevant actions to assess the time course of activation of action representations, as well as their responsiveness to lexical-semantic context. In two experiments, participants heard a target word and selected its referent from an array of four objects. Gaze fixations on nontarget objects signal activation of features shared between targets and nontargets. The experiments assessed activation of structure-based (Experiment 1) or function-based (Experiment 2) distractors, using neutral sentences ("S/he saw the....") or sentences with a relevant action verb (Experiment 1: "S/he picked up the...."; Experiment 2: "S/he used the...."). We observed task-irrelevant activations of action information in both experiments. In neutral contexts, structure-based activation was relatively faster-rising but more transient than function-based activation. Additionally, action verb contexts reliably modified patterns of activation in both Experiments. These data provide fine-grained information about the dynamics of activation of function-based and structure-based actions in neutral and action-relevant contexts, in support of the "Two Action System" model of object and action processing (e.g., Buxbaum & Kalénine, 2010). PMID:22390294

  17. Distinct Roles for Medial Temporal Lobe Structures in Memory for Objects and Their Locations

    ERIC Educational Resources Information Center

    Buffalo, Elizabeth A.; Bellgowan, Patrick S. F.; Martin, Alex

    2006-01-01

    The ability to learn and retain novel information depends on a system of structures in the medial temporal lobe (MTL) including the hippocampus and the surrounding entorhinal, perirhinal, and parahippocampal cortices. Damage to these structures produces profound memory deficits; however, the unique contribution to memory of each of these…

  18. OPM Scheme Editor 2: A graphical editor for specifying object-protocol structures

    SciTech Connect

    Chen, I-Min A.; Markowitz, V.M.; Pang, F.; Ben-Shachar, O.

    1993-07-01

    This document describes an X-window based Schema Editor for the Object-Protocol Model (OPM). OPM is a data model that supports the specification of complex object and protocol classes. objects and protocols are qualified in OPM by attributes that are defined over (associated with) value classes. Connections of object and protocol classes are expressed in OPM via attributes. OPM supports the specification (expansion) of protocols in terms of alternative and sequences of component (sub) protocols. The OPM Schema Editor allows specifying, displaying, modifying, and browsing through OPM schemas. The OPM Schema Editor generates an output file that can be used as input to an OPM schema translation tool that maps OPM schemas into definitions for relational database management systems. The OPM Schema Editor was implemented using C++ and the X11 based Motif toolkit, on Sun SPARCstation under Sun Unix OS 4.1. This document consists of the following parts: (1) A tutorial consisting of seven introductory lessons for the OPM Schema Editor. (2) A reference manual describing all the windows and functions of the OPM Schema Editor. (3) An appendix with an overview of OPM.

  19. Innovative Language-Based & Object-Oriented Structured AMR Using Fortran 90 and OpenMP

    NASA Technical Reports Server (NTRS)

    Norton, C.; Balsara, D.

    1999-01-01

    Parallel adaptive mesh refinement (AMR) is an important numerical technique that leads to the efficient solution of many physical and engineering problems. In this paper, we describe how AMR programing can be performed in an object-oreinted way using the modern aspects of Fortran 90 combined with the parallelization features of OpenMP.

  20. Effectiveness of structured, hospital-based, nurse-led atrial fibrillation clinics: a comparison between a real-world population and a clinical trial population

    PubMed Central

    Qvist, Ina; Hendriks, Jeroen M L; Møller, Dorthe S; Albertsen, Andi E; Mogensen, Helle M; Oddershede, Gitte D; Odgaard, Annette; Mortensen, Leif Spange; Johnsen, Søren Paaske; Frost, Lars

    2016-01-01

    Objective A previous randomised trial showed that structured, nurse-led atrial fibrillation (AF) care is superior to conventional AF care, although further research is needed to determine the outcomes of such care in a real-world setting. We compared the outcomes of patients in real-world, nurse-led, structured hospital AF clinics with the outcomes of a randomised trial of the efficacy of a nurse-led AF clinic, with respect to a composite outcome of cardiovascular-related hospitalisation and death. Methods All patients were referred to the AF nurse specialist by cardiologists. The AF nurse specialist provided patient education, risk-factor control and stimulated empowerment and compliance. During follow-up, treatment was adjusted according to clinical guidelines. Patient education was repeated, and compliance with medical treatment was controlled. The study size was powered as a non-inferiority study. Outcome measures were adjudicated by the same principles in both cohorts. Results A total of 596 patients from the real world and 356 patients from a clinical trial were included in this study. No significant difference between groups with respect to age, type of AF or CHA2DS2VASc score was found. The composite primary end point occurred with an incidence rate of 8.0 (95% CI 6.1 to 10.4) per 100 person-years in the real-world population and 8.3 (95% CI 6.3 to 10.9) per 100 person-years in the clinical trial, with a crude HR of 0.83 (95% CI 0.56 to 1.23). Conclusions Structured, nurse-led, hospital-based AF care appears to be effective, and patient outcomes in an actual, hospital-based, structured AF care are as least as good as those in trial settings. PMID:26835143

  1. Object Oriented Learning Objects

    ERIC Educational Resources Information Center

    Morris, Ed

    2005-01-01

    We apply the object oriented software engineering (OOSE) design methodology for software objects (SOs) to learning objects (LOs). OOSE extends and refines design principles for authoring dynamic reusable LOs. Our learning object class (LOC) is a template from which individualised LOs can be dynamically created for, or by, students. The properties…

  2. Constructing a Validity Argument for the Objective Structured Assessment of Technical Skills (OSATS): A Systematic Review of Validity Evidence

    ERIC Educational Resources Information Center

    Hatala, Rose; Cook, David A.; Brydges, Ryan; Hawkins, Richard

    2015-01-01

    In order to construct and evaluate the validity argument for the Objective Structured Assessment of Technical Skills (OSATS), based on Kane's framework, we conducted a systematic review. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, Web of Science, Scopus, and selected reference lists through February 2013. Working in duplicate, we selected…

  3. Parallel checksumming of data chunks of a shared data object using a log-structured file system

    DOEpatents

    Bent, John M.; Faibish, Sorin; Grider, Gary

    2016-09-06

    Checksum values are generated and used to verify the data integrity. A client executing in a parallel computing system stores a data chunk to a shared data object on a storage node in the parallel computing system. The client determines a checksum value for the data chunk; and provides the checksum value with the data chunk to the storage node that stores the shared object. The data chunk can be stored on the storage node with the corresponding checksum value as part of the shared object. The storage node may be part of a Parallel Log-Structured File System (PLFS), and the client may comprise, for example, a Log-Structured File System client on a compute node or burst buffer. The checksum value can be evaluated when the data chunk is read from the storage node to verify the integrity of the data that is read.

  4. A stroboscopic structured illumination system used in dynamic 3D visualization of high-speed motion object

    NASA Astrophysics Data System (ADS)

    Su, Xianyu; Zhang, Qican; Li, Yong; Xiang, Liqun; Cao, Yiping; Chen, Wenjing

    2005-04-01

    A stroboscopic structured illumination system, which can be used in measurement for 3D shape and deformation of high-speed motion object, is proposed and verified by experiments. The system, present in this paper, can automatically detect the position of high-speed moving object and synchronously control the flash of LED to project a structured optical field onto surface of motion object and the shoot of imaging system to acquire an image of deformed fringe pattern, also can create a signal, set artificially through software, to synchronously control the LED and imaging system to do their job. We experiment on a civil electric fan, successful acquire a serial of instantaneous, sharp and clear images of rotation blade and reconstruct its 3D shapes in difference revolutions.

  5. Perception of anatomical structures in digitally filtered and conventional panoramic radiographs: a clinical evaluation

    PubMed Central

    Baksi, BG; Alpöz, E; Soğur, E; Mert, A

    2010-01-01

    Objectives The aims of the study were to compare subjective image quality of clinical images obtained with a storage phosphor plate (SPP)-based digital and conventional film-based panoramic system for the visualization of various anatomical structures and to evaluate the effect of various processing algorithms on image interpretation. Methods Panoramic radiographs were taken in 42 patients both with film and with a SPP system. SPP images were treated with shadow, sharpen, negative, greyscale sigma and greyscale exponential filters. Four observers subjectively evaluated films and unfiltered and filtered SPP images for the visibility of anatomical structures with various radiodensities as well as for overall image quality on a three-point rating scale. The statistical methods used were Kruskal–Wallis, odds ratio analysis and Cohen's kappa. Results No statistically significant difference was found between film and unfiltered digital images except for low-contrast structures (P > 0.05). Film images were preferred for the visibility of low-contrast structures (P < 0.05). Best overall image quality was obtained with sharpened images (P < 0.05) followed by films and unfiltered digital images. Among all filtered images, sharpened ones received the highest ratings for the visibility of all anatomical structures (P < 0.05). The intra- and interobserver agreement ranged between moderate and substantial and between fair and moderate, respectively. Conclusions Film and unfiltered SPP-based panoramic images performed equally well in terms of overall quality; however, films were best for the perception of low-contrast structures. The sharpening filter may be recommended for enhancing SPP panoramic images to improve the visual perception of most of the anatomical structures as well as overall quality. PMID:20841460

  6. The realities of implementation of Clinical Context Object Workgroup (CCOW) standards for integration of vendor disparate clinical software in a large medical center.

    PubMed

    Berger, Robert G; Baba, John

    2009-06-01

    CCOW standards have been touted to currently be the best way to integrate disparate clinical applications by passing user identification and passwords as well as patient context between these applications at the desktop. However, nothing has been published in academic journals on the actual realities of implementation of CCOW. In this report, we describe the implementation of CCOW for our three main clinical applications and compare this with the simultaneous development and implementation of a portal session manager for the same purpose. We found the portal session manager much easier to develop and implement than CCOW. The resulting functionality was almost equivalent as judged by our clinical end users who compared both solutions. We now have the portal session manager functional across the institution and have stopped any further work on CCOW. PMID:19157966

  7. Theoretical study of multispectral structured illumination for depth resolved imaging of non-stationary objects: focus on retinal imaging

    PubMed Central

    Gruppetta, Steve; Chetty, Sabah

    2011-01-01

    Current implementations of structured illumination microscopy for depth-resolved (three-dimensional) imaging have limitations that restrict its use; specifically, they are not applicable to non-stationary objects imaged with relatively poor condenser optics and in non-fluorescent mode. This includes in-vivo retinal imaging. A novel implementation of structured illumination microscopy is presented that overcomes these issues. A three-wavelength illumination technique is used to obtain the three sub-images required for structured illumination simultaneously rather than sequentially, enabling use on non-stationary objects. An illumination method is presented that produces an incoherent pattern through interference, bypassing the limitations imposed by the aberrations of the condenser lens and thus enabling axial sectioning in non-fluorescent imaging. The application to retinal imaging can lead to a device with similar sectioning capabilities to confocal microscopy without the optical complexity (and cost) required for scanning systems. PMID:21339871

  8. Damage tolerance of composite sandwich structures subjected to projectile impact. [of low velocity foreign object

    NASA Technical Reports Server (NTRS)

    Sharma, A. V.

    1979-01-01

    An experimental investigation was conducted to evaluate the effect of low velocity projectile impact on the strength carrying ability of secondary aerospace structural components fabricated with graphite/epoxy composite materials. The preload and the impact energy combinations necessary to cause catastrophic failure were determined. Those specimens that survived the projectile impact were evaluated for the residual strength.

  9. Structure and Evolution of Kuiper Belt Objects: The Case for Compositional Classes

    NASA Astrophysics Data System (ADS)

    McKinnon, William B.; Prialnik, D.; Stern, S. A.

    2007-10-01

    Kuiper belt objects (KBOs) accreted from a mélange of ices, carbonaceous matter, and rock of mixed interstellar and solar nebular provenance. The transneptunian region, where this accretion took place, was likely more radially compact than today. This and the influence of gas drag during the solar nebula epoch argue for more rapid KBO accretion than usually considered. Early evolution of KBOs was largely the result of radiogenic heating, with both short-term and long-term contributions being potentially important. Depending on rock content and porous conductivity, KBO interiors may have reached relatively high temperatures. Models suggest that KBOs likely lost very volatile ices during early evolution, whereas less volatile ices should be retained in cold, less altered subsurface layers; initially amorphous ice may have crystallized in the interior as well, releasing trapped volatiles. Generally, KBOs should be stratified in terms of composition and porosity, albeit subject to impact disruption and collisional stripping. KBOs are thus unlikely to be "the most pristine objects in the Solar System.” Large (dwarf planet) KBOs may be fully differentiated. KBO surface color and compositional classes are usually discussed in terms of "nature vs. nurture,” i.e., a generic primordial composition vs. surface processing, but the true nature of KBOs also depends on how they have evolved. The broad range of albedos now found in the Kuiper belt, deep water-ice absorptions on some objects, evidence for differentiation of Pluto and 2003 EL61, and a range of densities incompatible with a single, primordial composition and variable porosity strongly imply significant, intrinsic compositional differences among KBOs. The interplay of formation zone (accretion rate), body size, and dynamical (collisional) history may yield KBO compositional classes (and their spectral correlates) that recall the different classes of asteroids in the inner Solar System, but whose members are

  10. Computing 3-D structure of rigid objects using stereo and motion

    NASA Technical Reports Server (NTRS)

    Nguyen, Thinh V.

    1987-01-01

    Work performed as a step toward an intelligent automatic machine vision system for 3-D imaging is discussed. The problem considered is the quantitative 3-D reconstruction of rigid objects. Motion and stereo are the two clues considered in this system. The system basically consists of three processes: the low level process to extract image features, the middle level process to establish the correspondence in the stereo (spatial) and motion (temporal) modalities, and the high level process to compute the 3-D coordinates of the corner points by integrating the spatial and temporal correspondences.

  11. Integration of multi-objective structural optimization into cementless hip prosthesis design: Improved Austin-Moore model.

    PubMed

    Kharmanda, G

    2016-11-01

    A new strategy of multi-objective structural optimization is integrated into Austin-Moore prosthesis in order to improve its performance. The new resulting model is so-called Improved Austin-Moore. The topology optimization is considered as a conceptual design stage to sketch several kinds of hollow stems according to the daily loading cases. The shape optimization presents the detailed design stage considering several objectives. Here, A new multiplicative formulation is proposed as a performance scale in order to define the best compromise between several requirements. Numerical applications on 2D and 3D problems are carried out to show the advantages of the proposed model. PMID:27028554

  12. Solid-state structure of a degradation product frequently observed on historic metal objects.

    PubMed

    Dinnebier, Robert E; Runčevski, Tomče; Fischer, Andrea; Eggert, Gerhard

    2015-03-16

    In the course of the investigation of glass-induced metal corrosion processes, a microcrystalline sodium copper formate hydroxide oxide hydrate, Cu4Na4O(HCOO)8(H2O)4(OH)2, was detected on a series of antique works of art, and its crystal structure was determined ab initio from high-resolution laboratory X-ray powder diffraction data using the method of charge flipping, simulated annealing, and difference-Fourier analysis (P42/n, a = 8.425 109(97) Å, c = 17.479 62(29) Å, V = 1240.747(35) Å(3), Z = 8). In the crystal structure, the metal cations are interconnected in a two-dimensional metal-organic framework via the oxygen atoms of the formate, hydroxide, and oxide anions. Doublets of face-sharing square pyramidal Cu(2+) polyhedra are linked via a single, central oxide oxygen atom to give a paddle-wheel arrangement, while the Na(+) cations are organized in Na2O11 moieties with highly disordered, edge-sharing octahedral coordination. In addition, hydrogen bonding plays an important role in stabilizing the crystal structure. PMID:25710277

  13. Transforming Clinical Imaging and 3D Data for Virtual Reality Learning Objects: HTML5 and Mobile Devices Implementation

    ERIC Educational Resources Information Center

    Trelease, Robert B.; Nieder, Gary L.

    2013-01-01

    Web deployable anatomical simulations or "virtual reality learning objects" can easily be produced with QuickTime VR software, but their use for online and mobile learning is being limited by the declining support for web browser plug-ins for personal computers and unavailability on popular mobile devices like Apple iPad and Android…

  14. Disks and Ring Structures Around Collapsed Objects Suitable for the Emergence of Jets

    NASA Astrophysics Data System (ADS)

    Coppi, B.

    2005-10-01

    The emergence of jets from plasma accretion disks surrounding for instance a black hole requires that the magnetic energy densities within the disk be significant relative to the plasma pressure. Thus the axisymmetric equilibrium configurations, that can form in the strong gravitational field of a central object and where the currents within differentially rotating disks can produce a ``crystal'' magnetic structureootnotetextB. Coppi, Phys. Plasmas 12, 057302 (2005), are shown to be characterized by strong modulations of the plasma density and pressure when the magnetic energy densities are comparable to the thermal energy densities. Moreover, when the external magnetic field in which the plasma is immersed is relatively weak, the internal currents can produce a configuration consisting of a sequence of plasma ring pairsootnotetextB. Coppi, F. Rousseau, M.I.T. (LNS) Report HEP05/01 (2005), submitted to Ap.J. The processes which can sustain these configurations are discussed.

  15. An object-oriented approach for parallel self adaptive mesh refinement on block structured grids

    NASA Technical Reports Server (NTRS)

    Lemke, Max; Witsch, Kristian; Quinlan, Daniel

    1993-01-01

    Self-adaptive mesh refinement dynamically matches the computational demands of a solver for partial differential equations to the activity in the application's domain. In this paper we present two C++ class libraries, P++ and AMR++, which significantly simplify the development of sophisticated adaptive mesh refinement codes on (massively) parallel distributed memory architectures. The development is based on our previous research in this area. The C++ class libraries provide abstractions to separate the issues of developing parallel adaptive mesh refinement applications into those of parallelism, abstracted by P++, and adaptive mesh refinement, abstracted by AMR++. P++ is a parallel array class library to permit efficient development of architecture independent codes for structured grid applications, and AMR++ provides support for self-adaptive mesh refinement on block-structured grids of rectangular non-overlapping blocks. Using these libraries, the application programmers' work is greatly simplified to primarily specifying the serial single grid application and obtaining the parallel and self-adaptive mesh refinement code with minimal effort. Initial results for simple singular perturbation problems solved by self-adaptive multilevel techniques (FAC, AFAC), being implemented on the basis of prototypes of the P++/AMR++ environment, are presented. Singular perturbation problems frequently arise in large applications, e.g. in the area of computational fluid dynamics. They usually have solutions with layers which require adaptive mesh refinement and fast basic solvers in order to be resolved efficiently.

  16. Observing microscopic structures of a relativistic object using a time-stretch strategy.

    PubMed

    Roussel, E; Evain, C; Le Parquier, M; Szwaj, C; Bielawski, S; Manceron, L; Brubach, J-B; Tordeux, M-A; Ricaud, J-P; Cassinari, L; Labat, M; Couprie, M-E; Roy, P

    2015-01-01

    Emission of light by a single electron moving on a curved trajectory (synchrotron radiation) is one of the most well-known fundamental radiation phenomena. However experimental situations are more complex as they involve many electrons, each being exposed to the radiation of its neighbors. This interaction has dramatic consequences, one of the most spectacular being the spontaneous formation of spatial structures inside electrons bunches. This fundamental effect is actively studied as it represents one of the most fundamental limitations in electron accelerators, and at the same time a source of intense terahertz radiation (Coherent Synchrotron Radiation, or CSR). Here we demonstrate the possibility to directly observe the electron bunch microstructures with subpicosecond resolution, in a storage ring accelerator. The principle is to monitor the terahertz pulses emitted by the structures, using a strategy from photonics, time-stretch, consisting in slowing-down the phenomena before recording. This opens the way to unpreceeded possibilities for analyzing and mastering new generation high power coherent synchrotron sources. PMID:26020859

  17. Observing microscopic structures of a relativistic object using a time-stretch strategy

    NASA Astrophysics Data System (ADS)

    Roussel, E.; Evain, C.; Le Parquier, M.; Szwaj, C.; Bielawski, S.; Manceron, L.; Brubach, J.-B.; Tordeux, M.-A.; Ricaud, J.-P.; Cassinari, L.; Labat, M.; Couprie, M.-E.; Roy, P.

    2015-05-01

    Emission of light by a single electron moving on a curved trajectory (synchrotron radiation) is one of the most well-known fundamental radiation phenomena. However experimental situations are more complex as they involve many electrons, each being exposed to the radiation of its neighbors. This interaction has dramatic consequences, one of the most spectacular being the spontaneous formation of spatial structures inside electrons bunches. This fundamental effect is actively studied as it represents one of the most fundamental limitations in electron accelerators, and at the same time a source of intense terahertz radiation (Coherent Synchrotron Radiation, or CSR). Here we demonstrate the possibility to directly observe the electron bunch microstructures with subpicosecond resolution, in a storage ring accelerator. The principle is to monitor the terahertz pulses emitted by the structures, using a strategy from photonics, time-stretch, consisting in slowing-down the phenomena before recording. This opens the way to unpreceeded possibilities for analyzing and mastering new generation high power coherent synchrotron sources.

  18. Observing microscopic structures of a relativistic object using a time-stretch strategy

    PubMed Central

    Roussel, E.; Evain, C.; Le Parquier, M.; Szwaj, C.; Bielawski, S.; Manceron, L.; Brubach, J.-B.; Tordeux, M.-A.; Ricaud, J.-P.; Cassinari, L.; Labat, M.; Couprie, M.-E; Roy, P.

    2015-01-01

    Emission of light by a single electron moving on a curved trajectory (synchrotron radiation) is one of the most well-known fundamental radiation phenomena. However experimental situations are more complex as they involve many electrons, each being exposed to the radiation of its neighbors. This interaction has dramatic consequences, one of the most spectacular being the spontaneous formation of spatial structures inside electrons bunches. This fundamental effect is actively studied as it represents one of the most fundamental limitations in electron accelerators, and at the same time a source of intense terahertz radiation (Coherent Synchrotron Radiation, or CSR). Here we demonstrate the possibility to directly observe the electron bunch microstructures with subpicosecond resolution, in a storage ring accelerator. The principle is to monitor the terahertz pulses emitted by the structures, using a strategy from photonics, time-stretch, consisting in slowing-down the phenomena before recording. This opens the way to unpreceeded possibilities for analyzing and mastering new generation high power coherent synchrotron sources. PMID:26020859

  19. Multi-objective shape optimization of plate structure under stress criteria based on sub-structured mixed FEM and genetic algorithms

    NASA Astrophysics Data System (ADS)

    Garambois, Pierre; Besset, Sebastien; Jézéquel, Louis

    2015-07-01

    This paper presents a methodology for the multi-objective (MO) shape optimization of plate structure under stress criteria, based on a mixed Finite Element Model (FEM) enhanced with a sub-structuring method. The optimization is performed with a classical Genetic Algorithm (GA) method based on Pareto-optimal solutions and considers thickness distributions parameters and antagonist objectives among them stress criteria. We implement a displacement-stress Dynamic Mixed FEM (DM-FEM) for plate structure vibrations analysis. Such a model gives a privileged access to the stress within the plate structure compared to primal classical FEM, and features a linear dependence to the thickness parameters. A sub-structuring reduction method is also computed in order to reduce the size of the mixed FEM and split the given structure into smaller ones with their own thickness parameters. Those methods combined enable a fast and stress-wise efficient structure analysis, and improve the performance of the repetitive GA. A few cases of minimizing the mass and the maximum Von Mises stress within a plate structure under a dynamic load put forward the relevance of our method with promising results. It is able to satisfy multiple damage criteria with different thickness distributions, and use a smaller FEM.

  20. Clinical and Biochemical Markers of Cardiovascular Structure and Function in Women With the Metabolic Syndrome.

    PubMed

    Velarde, Gladys P; Sherazi, Saadia; Kraemer, Dale F; Bravo-Jaimes, Katia; Butterfield, Ryan; Amico, Tonja; Steinmetz, Sherry D; Guzman, Maricela; Martin, Dale; Dodani, Sunita; Smith, Brian H

    2015-12-01

    The pathobiological impact of individual components of the metabolic syndrome (MS) on cardiac structural and functional parameters in women with isolated MS is not known. The objectives of this study were (1) to compare biochemical (prothrombotic, lipogenic, and inflammatory) and imaging (carotid intima-media thickening and basic cardiac structural measurements) markers in women with and without MS and (2) to examine if any of these markers associated or predicted cardiac structural differences between the 2 groups. This cross-sectional pilot study included 88 women with MS and 35 women without it. MS was defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria. Patients with diagnosis of diabetes were excluded. Compared with healthy subjects, women with MS had higher levels of intercellular adhesion molecule, myeloperoxidase, C-reactive protein, plasminogen activator inhibitor-1, leptin, apolipoprotein-B, and lower levels of apolipoprotein-A1 (p <0.001 for all). They also had higher mean ventricular septum, posterior wall thickness, left ventricular (LV) mass, carotid intima-media thickness (p <0.001 for all), and left atrial diameter (p = 0.015). In multivariable regression models, waist circumference and systolic blood pressure (BP) were significant predictors of: ventricular septum (p = 0.005 and p = 0.001, respectively), posterior wall thickness (p = 0.008 and p = 0.040, respectively), and LV mass (p <0.001 and p = 0.013, respectively). Significant predictors for carotid intima-media thickness were systolic BP, glucose, and leptin (p <0.0001, p = 0.034, and p = 0.002, respectively). In conclusion, there are significant clinical, biochemical, and cardiovascular structural differences in women with isolated MS compared with those without. Waist circumference and systolic BP had the strongest association with cardiac structural differences in this group of women. PMID:26482181

  1. An object-based multisensoral approach for the derivation of urban land use structures in the city of Rostock, Germany

    NASA Astrophysics Data System (ADS)

    Lindner, Martin; Hese, Sören; Berger, Christian; Schmullius, Christiane

    2011-11-01

    The present work is part of the Enviland-2 research project, which investigates the synergism between radar- and optical satellite data for ENVIronment and LAND use applications. The urban work package of Enviland aims at the combined analysis of RapidEye and TerraSAR-X data for the parameterization of different urban land use structures. This study focuses on the development of a transferable, object-based rule set for the derivation of urban land use structures at block level. The data base consists of RapidEye and TerraSAR-X imagery, as well as height information of a LiDAR nDSM (normalized Digital Surface Model) and object boundaries of ATKIS (Official Topographic Cartographic Information System) vector data for a study area in the city of Rostock, Germany. The classification of various land cover units forms the basis of the analysis. Therefore, an object-based land cover classification is implemented that uses feature level fusion to combine the information of all available input data. Besides spectral values also shape and context features are employed to characterize and extract specific land cover objects as indicators for the prevalent land use. The different land use structures are then determined by typical combinations and constellations of the extracted land use indicators and land cover proportions. Accuracy assessment is done by utilizing the available ATKIS information. From this analysis the land use structure classes residential, industrial/commercial, other built-up, allotments, sports facility, forest, grassland, other green spaces, squares/parking areas and water are distinguished with an overall accuracy of 63.2 %.

  2. Differentially Rotating Structures and Angular Momentum Transport in the Prevalent Gravity of a Central Object*

    NASA Astrophysics Data System (ADS)

    Rousseau, F.; Coppi, B.

    2006-10-01

    The presence of angular momentum transport associated with an accretion process in an axisymmetric differentially rotating structure affects the equilibrium configuration that this can take and can introduce a toroidal Lorentz force with the associated poloidal current densities. All three components (vertical, radial and toroidal) of the total momentum conservation equation are considered. A sequence of ring solutions can be found by making use of the inequalities vNJ

  3. Individualized and Clinically Derived Stimuli Activate Limbic Structures in Depression: An fMRI Study

    PubMed Central

    Kessler, Henrik; Taubner, Svenja; Buchheim, Anna; Münte, Thomas F.; Stasch, Michael; Kächele, Horst; Roth, Gerhard; Heinecke, Armin; Erhard, Peter; Cierpka, Manfred; Wiswede, Daniel

    2011-01-01

    Objectives In the search for neurobiological correlates of depression, a major finding is hyperactivity in limbic-paralimbic regions. However, results so far have been inconsistent, and the stimuli used are often unspecific to depression. This study explored hemodynamic responses of the brain in patients with depression while processing individualized and clinically derived stimuli. Methods Eighteen unmedicated patients with recurrent major depressive disorder and 17 never-depressed control subjects took part in standardized clinical interviews from which individualized formulations of core interpersonal dysfunction were derived. In the patient group such formulations reflected core themes relating to the onset and maintenance of depression. In controls, formulations reflected a major source of distress. This material was thereafter presented to subjects during functional magnetic resonance imaging (fMRI) assessment. Results Increased hemodynamic responses in the anterior cingulate cortex, medial frontal gyrus, fusiform gyrus and occipital lobe were observed in both patients and controls when viewing individualized stimuli. Relative to control subjects, patients with depression showed increased hemodynamic responses in limbic-paralimbic and subcortical regions (e.g. amygdala and basal ganglia) but no signal decrease in prefrontal regions. Conclusions This study provides the first evidence that individualized stimuli derived from standardized clinical interviewing can lead to hemodynamic responses in regions associated with self-referential and emotional processing in both groups and limbic-paralimbic and subcortical structures in individuals with depression. Although the regions with increased responses in patients have been previously reported, this study enhances the ecological value of fMRI findings by applying stimuli that are of personal relevance to each individual's depression. PMID:21283580

  4. Structural and diffusion imaging versus clinical assessment to monitor amyotrophic lateral sclerosis.

    PubMed

    Cardenas-Blanco, Arturo; Machts, Judith; Acosta-Cabronero, Julio; Kaufmann, Joern; Abdulla, Susanne; Kollewe, Katja; Petri, Susanne; Schreiber, Stefanie; Heinze, Hans-Jochen; Dengler, Reinhard; Vielhaber, Stefan; Nestor, Peter J

    2016-01-01

    Amyotrophic lateral sclerosis is a progressive neurodegenerative disease that affects upper and lower motor neurons. Observational and intervention studies can be tracked using clinical measures such as the revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R) but for a complete understanding of disease progression, objective in vivo biomarkers of both central and peripheral motor pathway pathology are highly desirable. The aim of this study was to determine the utility of structural and diffusion imaging as central nervous system biomarkers compared to the standard clinical measure, ALSFRS-R, to track longitudinal evolution using three time-point measurements. N = 34 patients with ALS were scanned and clinically assessed three times at a mean of three month time intervals. The MRI biomarkers were structural T1-weighted volumes for cortical thickness measurement as well as deep grey matter volumetry, voxel-based morphometry and diffusion tensor imaging (DTI). Cortical thickness focused specifically on the precentral gyrus while quantitative DTI biomarkers focused on the corticospinal tracts. The evolution of imaging biomarkers and ALSFRS-R scores over time were analysed using a mixed effects model that accounted for the scanning interval as a fixed effect variable, and, the initial measurements and time from onset as random variables. The mixed effects model showed a significant decrease in the ALSFRS-R score, (p < 0.0001, and an annual rate of change (AROC) of - 7.3 points). Similarly, fractional anisotropy of the corticospinal tract showed a significant decrease (p = 0.009, AROC = - 0.0066) that, in turn, was driven by a significant increase in radial diffusivity combined with a trend to decrease in axial diffusivity. No significant change in cortical thickness of the precentral gyrus was found (p > 0.5). In addition, deep grey matter volumetry and voxel-based morphometry also identified no significant changes. Furthermore, the

  5. Structural and diffusion imaging versus clinical assessment to monitor amyotrophic lateral sclerosis

    PubMed Central

    Cardenas-Blanco, Arturo; Machts, Judith; Acosta-Cabronero, Julio; Kaufmann, Joern; Abdulla, Susanne; Kollewe, Katja; Petri, Susanne; Schreiber, Stefanie; Heinze, Hans-Jochen; Dengler, Reinhard; Vielhaber, Stefan; Nestor, Peter J.

    2016-01-01

    Amyotrophic lateral sclerosis is a progressive neurodegenerative disease that affects upper and lower motor neurons. Observational and intervention studies can be tracked using clinical measures such as the revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R) but for a complete understanding of disease progression, objective in vivo biomarkers of both central and peripheral motor pathway pathology are highly desirable. The aim of this study was to determine the utility of structural and diffusion imaging as central nervous system biomarkers compared to the standard clinical measure, ALSFRS-R, to track longitudinal evolution using three time-point measurements. N = 34 patients with ALS were scanned and clinically assessed three times at a mean of three month time intervals. The MRI biomarkers were structural T1-weighted volumes for cortical thickness measurement as well as deep grey matter volumetry, voxel-based morphometry and diffusion tensor imaging (DTI). Cortical thickness focused specifically on the precentral gyrus while quantitative DTI biomarkers focused on the corticospinal tracts. The evolution of imaging biomarkers and ALSFRS-R scores over time were analysed using a mixed effects model that accounted for the scanning interval as a fixed effect variable, and, the initial measurements and time from onset as random variables. The mixed effects model showed a significant decrease in the ALSFRS-R score, (p < 0.0001, and an annual rate of change (AROC) of − 7.3 points). Similarly, fractional anisotropy of the corticospinal tract showed a significant decrease (p = 0.009, AROC = − 0.0066) that, in turn, was driven by a significant increase in radial diffusivity combined with a trend to decrease in axial diffusivity. No significant change in cortical thickness of the precentral gyrus was found (p > 0.5). In addition, deep grey matter volumetry and voxel-based morphometry also identified no significant changes. Furthermore, the

  6. Korean Anxiety Sensitivity Index-3: Its Factor Structure, Reliability, and Validity in Non-Clinical Samples

    PubMed Central

    Lim, Young-Jin

    2012-01-01

    Objective The aim here is to examine the factorial structure, internal consistency, and concurrent validity of the Korean version of the Anxiety Sensitivity Index-3 (K-ASI-3) in student samples in Korea. Also, we investigated the cross-cultural differences in the Social Concerns factor. Methods K-ASI-3 was administered to non clinical samples in Korea. Internal consistency, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA) were undertaken to examine the factorial structure and reliability of the K-ASI-3. Results Results from CFA comparing our data to factor solutions commonly reported as representative of European-American samples indicated an adequate fit. The K-ASI-3 showed good performance on the indices of internal consistency and concurrent validity. In addition, using regression analyses, we found the Social Concerns factor is most strongly related to life satisfaction and worry. However, we found no evidence that Korean college students express more Social Concerns than their European Caucasian counterparts. Conclusion The authors demonstrate that the K-ASI-3 has highly internally consistent and psychometrically sound items, and that it reliably measures three lower-order domains assessing Physical, Social, and Cognitive Concerns. PMID:22396684

  7. An objective biochemical assessment of therapeutic response in metastatic breast cancer: a study with external review of clinical data.

    PubMed Central

    Williams, M. R.; Turkes, A.; Pearson, D.; Griffiths, K.; Blamey, R. W.

    1990-01-01

    A series of tumour related markers have been examined in 179 patients receiving primary endocrine therapy for metastatic breast cancer. Significant correlations between therapeutic response (UICC criteria after 6 months of treatment) and appropriate alterations in serum concentrations of carcinoembryonic antigen, ferritin, c-reactive protein, orosomucoid and the erythrocyte sedimentation rate, have been observed when changes in these markers were examined only at high serum concentrations. By combining these five markers a 'therapeutic index' of response has been devised which can be employed at an early stage of treatment in more than 90% of patients, giving an overall sensitivity/specificity of 90%/78% for therapeutic response or disease stabilisation over a 6-month period. The design of an objective measurement of response, which is easy to perform, has the potential to replace the existing, largely subjective. UICC criteria for retrospective judgement of response, and may also be used to direct systemic endocrine therapy. PMID:2137007

  8. The status of and future research into Myalgic Encephalomyelitis and Chronic Fatigue Syndrome: the need of accurate diagnosis, objective assessment, and acknowledging biological and clinical subgroups

    PubMed Central

    Twisk, Frank N. M.

    2014-01-01

    Although Myalgic Encephalomyelitis (ME) and Chronic Fatigue Syndrome (CFS) are used interchangeably, the diagnostic criteria define two distinct clinical entities. Cognitive impairment, (muscle) weakness, circulatory disturbances, marked variability of symptoms, and, above all, post-exertional malaise: a long-lasting increase of symptoms after a minor exertion, are distinctive symptoms of ME. This latter phenomenon separates ME, a neuro-immune illness, from chronic fatigue (syndrome), other disorders and deconditioning. The introduction of the label, but more importantly the diagnostic criteria for CFS have generated much confusion, mostly because chronic fatigue is a subjective and ambiguous notion. CFS was redefined in 1994 into unexplained (persistent or relapsing) chronic fatigue, accompanied by at least four out of eight symptoms, e.g., headaches and unrefreshing sleep. Most of the research into ME and/or CFS in the last decades was based upon the multivalent CFS criteria, which define a heterogeneous patient group. Due to the fact that fatigue and other symptoms are non-discriminative, subjective experiences, research has been hampered. Various authors have questioned the physiological nature of the symptoms and qualified ME/CFS as somatization. However, various typical symptoms can be assessed objectively using standardized methods. Despite subjective and unclear criteria and measures, research has observed specific abnormalities in ME/CFS repetitively, e.g., immunological abnormalities, oxidative and nitrosative stress, neurological anomalies, circulatory deficits and mitochondrial dysfunction. However, to improve future research standards and patient care, it is crucial that patients with post-exertional malaise (ME) and patients without this odd phenomenon are acknowledged as separate clinical entities that the diagnosis of ME and CFS in research and clinical practice is based upon accurate criteria and an objective assessment of characteristic symptoms

  9. Age structure and mortality of walleyes in Kansas reservoirs: Use of mortality caps to establish realistic management objectives

    USGS Publications Warehouse

    Quist, M.C.; Stephen, J.L.; Guy, C.S.; Schultz, R.D.

    2004-01-01

    Age structure, total annual mortality, and mortality caps (maximum mortality thresholds established by managers) were investigated for walleye Sander vitreus (formerly Stizostedion vitreum) populations sampled from eight Kansas reservoirs during 1991-1999. We assessed age structure by examining the relative frequency of different ages in the population; total annual mortality of age-2 and older walleyes was estimated by use of a weighted catch curve. To evaluate the utility of mortality caps, we modeled threshold values of mortality by varying growth rates and management objectives. Estimated mortality thresholds were then compared with observed growth and mortality rates. The maximum age of walleyes varied from 5 to 11 years across reservoirs. Age structure was dominated (???72%) by walleyes age 3 and younger in all reservoirs, corresponding to ages that were not yet vulnerable to harvest. Total annual mortality rates varied from 40.7% to 59.5% across reservoirs and averaged 51.1% overall (SE = 2.3). Analysis of mortality caps indicated that a management objective of 500 mm for the mean length of walleyes harvested by anglers was realistic for all reservoirs with a 457-mm minimum length limit but not for those with a 381-mm minimum length limit. For a 500-mm mean length objective to be realized for reservoirs with a 381-mm length limit, managers must either reduce mortality rates (e.g., through restrictive harvest regulations) or increase growth of walleyes. When the assumed objective was to maintain the mean length of harvested walleyes at current levels, the observed annual mortality rates were below the mortality cap for all reservoirs except one. Mortality caps also provided insight on management objectives expressed in terms of proportional stock density (PSD). Results indicated that a PSD objective of 20-40 was realistic for most reservoirs. This study provides important walleye mortality information that can be used for monitoring or for inclusion into

  10. [Is the structure of surgical clinics in Germany changing? A current investigation into the structure of surgical clinics in the Federal Republic of Germany].

    PubMed

    Lob, G; Lob, T; Bauer, H; Niethard, F; Polonius, J; Siebert, H

    2009-04-01

    Medical developments have led to extensive specialization in the field of surgery. This has already been reflected for many years in altered structure and organization forms of surgical clinics. Indispensable quality standards, statutory general conditions, increasing competition in service providers and health insurance with transparency of the service procedure all intensify this trend. The aim of this investigation was, therefore, to determine how far this differentiation of service supply in the field of surgery is also reflected in the area and in surgical departments and clinics of basic and routine supply. To achieve this, all available published information on the structure and organization of surgical clinics in the Federal Republic of Germany was classified according to current departmentalization into "undivided" or general/visceral surgery facilities compared to orthopedic/trauma surgery departments. PMID:19290506

  11. X-ray Powder Diffraction in Conservation Science: Towards Routine Crystal Structure Determination of Corrosion Products on Heritage Art Objects.

    PubMed

    Dinnebier, Robert E; Fischer, Andrea; Eggert, Gerhard; Runčevski, Tomče; Wahlberg, Nanna

    2016-01-01

    The crystal structure determination and refinement process of corrosion products on historic art objects using laboratory high-resolution X-ray powder diffraction (XRPD) is presented in detail via two case studies. The first material under investigation was sodium copper formate hydroxide oxide hydrate, Cu4Na4O(HCOO)8(OH)2∙4H2O (sample 1) which forms on soda glass/copper alloy composite historic objects (e.g., enamels) in museum collections, exposed to formaldehyde and formic acid emitted from wooden storage cabinets, adhesives, etc. This degradation phenomenon has recently been characterized as "glass induced metal corrosion". For the second case study, thecotrichite, Ca3(CH3COO)3Cl(NO3)2∙6H2O (sample 2), was chosen, which is an efflorescent salt forming needlelike crystallites on tiles and limestone objects which are stored in wooden cabinets and display cases. In this case, the wood acts as source for acetic acid which reacts with soluble chloride and nitrate salts from the artifact or its environment. The knowledge of the geometrical structure helps conservation science to better understand production and decay reactions and to allow for full quantitative analysis in the frequent case of mixtures. PMID:27341300

  12. Spun-wrapped aligned nanofiber (SWAN) lithography for fabrication of micro/nano-structures on 3D objects.

    PubMed

    Ye, Zhou; Nain, Amrinder S; Behkam, Bahareh

    2016-07-01

    Fabrication of micro/nano-structures on irregularly shaped substrates and three-dimensional (3D) objects is of significant interest in diverse technological fields. However, it remains a formidable challenge thwarted by limited adaptability of the state-of-the-art nanolithography techniques for nanofabrication on non-planar surfaces. In this work, we introduce Spun-Wrapped Aligned Nanofiber (SWAN) lithography, a versatile, scalable, and cost-effective technique for fabrication of multiscale (nano to microscale) structures on 3D objects without restriction on substrate material and geometry. SWAN lithography combines precise deposition of polymeric nanofiber masks, in aligned single or multilayer configurations, with well-controlled solvent vapor treatment and etching processes to enable high throughput (>10(-7) m(2) s(-1)) and large-area fabrication of sub-50 nm to several micron features with high pattern fidelity. Using this technique, we demonstrate whole-surface nanopatterning of bulk and thin film surfaces of cubes, cylinders, and hyperbola-shaped objects that would be difficult, if not impossible to achieve with existing methods. We demonstrate that the fabricated feature size (b) scales with the fiber mask diameter (D) as b(1.5)∝D. This scaling law is in excellent agreement with theoretical predictions using the Johnson, Kendall, and Roberts (JKR) contact theory, thus providing a rational design framework for fabrication of systems and devices that require precisely designed multiscale features. PMID:27283144

  13. A Four- and Five-Factor Structural Model for Wechsler Tests: Does It Really Matter Clinically?

    ERIC Educational Resources Information Center

    Schwartz, David M.

    2013-01-01

    The purpose of this commentary is to focus on the clinical utility of the four- and five-factor structural models for the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) and Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV). It provides a discussion of important considerations when evaluating the clinical utility of the…

  14. A study of the structure and kinematics of the narrow-line region in Seyfert galaxies. III. Individual objects

    SciTech Connect

    Veilleux, S. )

    1991-03-01

    An individual analysis is presented of the narrow-line profiles of 16 Seyfert galaxies. Substructure is observed in all but one of the sample objects. A direct relationship between the radio structure and these emission-line components is proposed in about half of the objects. The emission-line components generally have flux ratios which are quite similar to the rest of the narrow-line gas. These results suggest that the radio-emitting plasma strongly affects the kinematics of the thermal gas of the narrow-line region (NLR), but not its ionization state. Evidence for ionization/density stratification of the gas in the NLR is found in 4(ionization)/5(density) of the 11 objects for which a multispecies analysis is possible. The stronger cases of stratification are found in the objects whose emission lines present a minimum of profile substructure. A multicomponent model of the NLR is proposed to explain the results of this paper and previous ones. 192 refs.

  15. Electron Spectroscopy of Single Quantum Objects To Directly Correlate the Local Structure to Their Electronic Transport and Optical Properties.

    PubMed

    Senga, Ryosuke; Pichler, Thomas; Suenaga, Kazu

    2016-06-01

    Physical property of a single quantum object is governed by its precise atomic arrangement. The direct correlation of localized physical properties with the atomic structures has been therefore strongly desired but still limited in the theoretical studies. Here, we have successfully examined the localized electronic properties of individual carbon nanotubes by means of high-resolution electron energy-loss spectroscopy combined with high-resolution transmission electron microscopy. Well-separated sharp peaks at the carbon K(1s) absorption edge and in the valence-loss spectra are obtained from a single freestanding carbon nanotube with the local chiral index and unambiguously identified as the transitions between the van Hove singularities. The spectra features clearly vary upon the different areas even in the individual carbon nanotube. Variations in interband transitions, plasmonic behaviors, and unoccupied electronic structures are clearly attributed to the local irregular atomic arrangement such as topological defect and/or elastic bond stretching. PMID:27171894

  16. Clinical judgment development using structured classroom reflective practice: a qualitative study.

    PubMed

    Glynn, Donna M

    2012-03-01

    This qualitative study examined the incorporation of "reflection-on-action" in a structured reflective classroom format as defined by Tanner's Clinical Judgment Model on the development of perceived clinical judgment and clinical confidence in Bachelor of Science nursing students. The qualitative results described the students' perceptions of the benefit of the intervention on their development of clinical judgment and clinical confidence. This research was an important contribution to the debate regarding the benefit of structured reflection in a classroom setting. By using reflection in the classroom, nurse educators may influence the education-practice gap and incorporate new pedagogies to strengthen the educational preparedness of nursing students to provide high-quality, competent, compassionate care to patients and their families. PMID:22283156

  17. Psychosocial and demographic correlates of objectively measured physical activity in structured and unstructured after-school recreation sessions.

    PubMed

    Rosenkranz, Richard R; Welk, Gregory J; Hastmann, Tanis J; Dzewaltowski, David A

    2011-07-01

    Most studies of psychosocial and demographic correlates of physical activity (PA) have examined relationships across various types of physical and social environments, rather than within a specific environmental behavior setting. The objective of this study was to investigate correlates of PA in structured and unstructured after-school recreation sessions. This study is cross-sectional. School records, questionnaires, and anthropometry were used to obtain demographic and psychosocial variables. Third and fourth-grade children (n = 230) from seven schools wore Actigraph GT1M accelerometers up to six times per year during after-school programming. Accelerometer data were processed to determine percentage of time in moderate-to-vigorous PA (T scores, reflective of an individual child's PA level relative to group mean, were computed for each session and averaged across sessions). Pearson correlations, point-biserial correlations, and mixed-model analyses were used to determine significant associations with PA for each session type (structured and unstructured). For structured sessions, gender, PA barriers self-efficacy, and PA enjoyment were significantly related to PA. For unstructured sessions, only gender was related to PA. Despite equivalent opportunities to participate in active recreation, boys were more active than girls, and children varied in PA level partly due to psychosocial factors. Our results showed that PA self-efficacy and enjoyment explained variability in structured PA sessions. PMID:21349765

  18. Objective Structured Assessment of Technical Skill in assessing technical competence to carry out caesarean section with increasing seniority.

    PubMed

    Landau, Alex; Reid, Wendy; Watson, Andrew; McKenzie, Clare

    2013-04-01

    Since the incorporation of workplace-based assessment within the specialty training programme in obstetrics and gynaecology, the assessment of technical competence to carry out caesarean section has been undertaken by the Objective Structured Assessment of Technical Skill tool. This requirement has been formalised in the Matrix of Educational Progression, ensuring that the tool must assess trainees' technical competence in caesarean section procedures of varying levels of complexity throughout training. Trainee feedback suggests that the effectiveness of the tool diminishes as the seniority of the trainee increases, with technical competence assessed less effectively in more complex procedures. This seems to be a result of the generic design of the tool and insufficient training on the part of assessors. Both of these are due to be addressed within a division of the Objective Structured Assessment of Technical Skill tool into explicitly formative and summative assessments of technical skill, following a General Medical Council-led consultation on the future of workplace-based assessment. PMID:23062591

  19. Spun-wrapped aligned nanofiber (SWAN) lithography for fabrication of micro/nano-structures on 3D objects

    NASA Astrophysics Data System (ADS)

    Ye, Zhou; Nain, Amrinder S.; Behkam, Bahareh

    2016-06-01

    Fabrication of micro/nano-structures on irregularly shaped substrates and three-dimensional (3D) objects is of significant interest in diverse technological fields. However, it remains a formidable challenge thwarted by limited adaptability of the state-of-the-art nanolithography techniques for nanofabrication on non-planar surfaces. In this work, we introduce Spun-Wrapped Aligned Nanofiber (SWAN) lithography, a versatile, scalable, and cost-effective technique for fabrication of multiscale (nano to microscale) structures on 3D objects without restriction on substrate material and geometry. SWAN lithography combines precise deposition of polymeric nanofiber masks, in aligned single or multilayer configurations, with well-controlled solvent vapor treatment and etching processes to enable high throughput (>10-7 m2 s-1) and large-area fabrication of sub-50 nm to several micron features with high pattern fidelity. Using this technique, we demonstrate whole-surface nanopatterning of bulk and thin film surfaces of cubes, cylinders, and hyperbola-shaped objects that would be difficult, if not impossible to achieve with existing methods. We demonstrate that the fabricated feature size (b) scales with the fiber mask diameter (D) as b1.5 ~ D. This scaling law is in excellent agreement with theoretical predictions using the Johnson, Kendall, and Roberts (JKR) contact theory, thus providing a rational design framework for fabrication of systems and devices that require precisely designed multiscale features.Fabrication of micro/nano-structures on irregularly shaped substrates and three-dimensional (3D) objects is of significant interest in diverse technological fields. However, it remains a formidable challenge thwarted by limited adaptability of the state-of-the-art nanolithography techniques for nanofabrication on non-planar surfaces. In this work, we introduce Spun-Wrapped Aligned Nanofiber (SWAN) lithography, a versatile, scalable, and cost-effective technique for

  20. Development of the clinical learning evaluation questionnaire for undergraduate clinical education: factor structure, validity, and reliability study

    PubMed Central

    2014-01-01

    Background Teaching and learning of clinical skills for undergraduate medical students usually takes place during the clinical clerkship. Therefore, it is of vital importance to ensure the effectiveness of the rotations within this clerkship. The aims of this study were to develop an instrument that measures the effectiveness of the clinical learning environment, to determine its factor structure, and to find first evidence for the reliability and validity of the total scale and the different factors. Methods The Clinical Learning Evaluation Questionnaire (CLEQ) is an instrument, consisting of 40 items, which have been developed after consideration of the results of a qualitative study that investigated the important factors influencing clinical learning, both from the perspective of students, as well as teachers. Results of relevant literature that investigated this issue were also incorporated in the CLEQ. This instrument was administered to a sample of students (N = 182) from three medical colleges in Riyadh city, the capital of Saudi Arabia. The factor structure of the CLEQ (Principal component analysis, Oblimin rotation) and reliability of the factor scales (Cronbach’s α) were determined. Hypotheses concerning the correlations between the different factors were tested to investigate their convergent and divergent validity. Results One hundred and nine questionnaires were returned. The factor analysis yielded six factors: F1 Cases (8 items), F2 Authenticity of clinical experience (8 items), F3 Supervision (8 items), F4 Organization of the doctor-patient encounter (4 items), F5 Motivation to learn (5 items), and F6 Self awareness (4 items). The overall internal consistency (α) of the CLEQ was 0.88, and the reliabilities (Cronbach’s α) of the six factors varied from .60 to .86. Hypotheses concerning the correlations between the different factors were partly confirmed, which supported the convergent validity of the factors, but not their divergent

  1. Structured Interview of Personality Organization (STIPO): preliminary psychometrics in a clinical sample.

    PubMed

    Stern, Barry L; Caligor, Eve; Clarkin, John F; Critchfield, Kenneth L; Horz, Susanne; MacCornack, Verna; Lenzenweger, Mark F; Kernberg, Otto F

    2010-01-01

    In this article, we describe the development and preliminary psychometric properties of the Structured Interview of Personality Organization (STIPO), a semistructured interview designed for the dimensional assessment of identity, primitive defenses, and reality testing, the three primary content domains in the model of personality health and disorder elaborated by Kernberg (1984; Kernberg & Caligor, 2005). Results of this investigation, conducted in a clinical sample representing a broad range of personality pathology, indicate that identity and primitive defenses as operationalized in the STIPO are internally consistent and that interrater reliability for all 3 content domains is adequate. Validity findings suggest that the assessment of one's sense of self and significant others (Identity) is predictive of measures of positive and negative affect, whereas the maladaptive ways in which the subject uses his or her objects for purposes of regulating one's self experience (Primitive Defenses) is predictive of measures of aggression and personality disorder traits associated with cluster B personality disorders. We discuss implications of these findings in terms of the theory-driven and trait-based assessment of personality pathology. PMID:20013454

  2. A Marginal Structural Model Analysis for Loneliness: Implications for Intervention Trials and Clinical Practice

    ERIC Educational Resources Information Center

    VanderWeele, Tyler J.; Hawkley, Louise C.; Thisted, Ronald A.; Cacioppo, John T.

    2011-01-01

    Objective: Clinical scientists, policymakers, and individuals must make decisions concerning effective interventions that address health-related issues. We use longitudinal data on loneliness and depressive symptoms and a new class of causal models to illustrate how empirical evidence can be used to inform intervention trial design and clinical…

  3. Morphology and structure of extremely red objects at z ∼ 1 in the CANDELS-COSMOS field

    NASA Astrophysics Data System (ADS)

    Fang, Guan-Wen; Ma, Zhong-Yang; Chen, Yang; Kong, Xu

    2015-06-01

    Using high-resolution HST/Wide Field Camera 3 F125W imaging from the CANDELS-COSMOS field, we report the structural and morphological properties of extremely red objects (EROs) at z ∼ 1. Based on the UVJ color criteria, we separate EROs into two types: old passive galaxies (OGs) and dusty star-forming galaxies (DGs). For a given stellar mass, we find that the mean size of OGs (DGs) is smaller by a factor of ∼ 2 (1.5) than that of present-day early-type (late-type) galaxies at a rest-frame optical wavelength. We derive the average effective radii of OGs and DGs, corresponding to 2.09 ± 1.13 kpc and 3.27 ± 1.14 kpc, respectively. Generally, the DGs are heterogeneous, with mixed features including bulges, disks and irregular structures, with relatively high M20, large size and low G. By contrast, OGs have elliptical-like compact morphologies with lower M20, smaller size and higher G, indicating a more concentrated and symmetric spatial extent of the stellar population distribution in OGs than DGs. These findings imply that OGs and DGs have different evolutionary processes, and that the minor merger scenario is the most likely mechanism for the structural properties of OGs. However, the size evolution of DGs is possibly due to the secular evolution of galaxies. Supported by the National Natural Science Foundation of China.

  4. Behaviors of the percentage depth dose curves along the beam axis of a phantom filled with different clinical PTO objects, a Monte Carlo Geant4 study

    NASA Astrophysics Data System (ADS)

    EL Bakkali, Jaafar; EL Bardouni, Tarek; Safavi, Seyedmostafa; Mohammed, Maged; Saeed, Mroan

    2016-08-01

    The aim of this work is to assess the capabilities of Monte Carlo Geant4 code to reproduce the real percentage depth dose (PDD) curves generated in phantoms which mimic three important clinical treatment situations that include lung slab, bone slab, bone-lung slab geometries. It is hoped that this work will lead us to a better understanding of dose distributions in an inhomogeneous medium, and to identify any limitations of dose calculation algorithm implemented in the Geant4 code. For this purpose, the PDD dosimetric functions associated to the three clinical situations described above, were compared to one produced in a homogeneous water phantom. Our results show, firstly, that the Geant4 simulation shows potential mistakes on the shape of the calculated PDD curve of the first physical test object (PTO), and it is obviously not able to successfully predict dose values in regions near to the boundaries between two different materials. This is, surely due to the electron transport algorithm and it is well-known as the artifacts at interface phenomenon. To deal with this issue, we have added and optimized the StepMax parameter to the dose calculation program; consequently the artifacts due to the electron transport were quasi disappeared. However, the Geant4 simulation becomes painfully slow when we attempt to completely resolve the electron artifact problems by considering a smaller value of an electron StepMax parameter. After electron transport optimization, our results demonstrate the medium-level capabilities of the Geant4 code to modeling dose distribution in clinical PTO objects.

  5. Comparison of single distance phase retrieval algorithms by considering different object composition and the effect of statistical and structural noise.

    PubMed

    Chen, R C; Rigon, L; Longo, R

    2013-03-25

    Phase retrieval is a technique for extracting quantitative phase information from X-ray propagation-based phase-contrast tomography (PPCT). In this paper, the performance of different single distance phase retrieval algorithms will be investigated. The algorithms are herein called phase-attenuation duality Born Algorithm (PAD-BA), phase-attenuation duality Rytov Algorithm (PAD-RA), phase-attenuation duality Modified Bronnikov Algorithm (PAD-MBA), phase-attenuation duality Paganin algorithm (PAD-PA) and phase-attenuation duality Wu Algorithm (PAD-WA), respectively. They are all based on phase-attenuation duality property and on weak absorption of the sample and they employ only a single distance PPCT data. In this paper, they are investigated via simulated noise-free PPCT data considering the fulfillment of PAD property and weakly absorbing conditions, and with experimental PPCT data of a mixture sample containing absorbing and weakly absorbing materials, and of a polymer sample considering different degrees of statistical and structural noise. The simulation shows all algorithms can quantitatively reconstruct the 3D refractive index of a quasi-homogeneous weakly absorbing object from noise-free PPCT data. When the weakly absorbing condition is violated, the PAD-RA and PAD-PA/WA obtain better result than PAD-BA and PAD-MBA that are shown in both simulation and mixture sample results. When considering the statistical noise, the contrast-to-noise ratio values decreases as the photon number is reduced. The structural noise study shows that the result is progressively corrupted by ring-like artifacts with the increase of structural noise (i.e. phantom thickness). The PAD-RA and PAD-PA/WA gain better density resolution than the PAD-BA and PAD-MBA in both statistical and structural noise study. PMID:23546122

  6. Special Features of the Structure of Secular Resonances in the Dynamics of Near-Earth Space Objects

    NASA Astrophysics Data System (ADS)

    Bordovitsyna, T. V.; Tomilova, I. V.

    2016-07-01

    The special features of the structure of secular resonances in the near-earth orbital space bounded by the following range of orbital parameters: semimajor axis from 8000 to 55 000 km, inclination from 0 to 90°, and eccentricity equal to 0.01, 0.6, and 0.8 are analyzed. The influence of stable and unstable secular resonances on the long-term orbital evolution of near-earth space objects is also considered. It is demonstrated that the joint effect of the stable secular resonances of different spectral classes does not violate the regularity of motion. The chaoticity arises when stable secular resonances of one spectral class are imposed.

  7. Calibration and 3D reconstruction of underwater objects with non-single-view projection model by structured light stereo imaging.

    PubMed

    Wang, Yexin; Negahdaripour, Shahriar; Aykin, Murat D

    2016-08-20

    Establishing the projection model of imaging systems is critical in 3D reconstruction of object shapes from multiple 2D views. When deployed underwater, these are enclosed in waterproof housings with transparent glass ports that generate nonlinear refractions of optical rays at interfaces, leading to invalidation of the commonly assumed single-viewpoint (SVP) model. In this paper, we propose a non-SVP ray tracing model for the calibration of a projector-camera system, employed for 3D reconstruction based on the structured light paradigm. The projector utilizes dot patterns, having established that the contrast loss is less severe than for traditional stripe patterns in highly turbid waters. Experimental results are presented to assess the achieved calibrating accuracy. PMID:27556973

  8. Reducing Patient Clinical Management Errors Using Structured Content and Electronic Nursing Handover.

    PubMed

    Johnson, Maree; Sanchez, Paula; Zheng, Catherine

    2016-01-01

    We examined whether an integrated nursing handover system-structured content and an electronic tool within the patient clinical information system with bedside delivery-would improve the quality of information delivered at nursing handover and reduce adverse patient outcomes. Using a pre/posttest evaluative design, improvements in the transfer of critical patient information and reductions in nursing clinical management incidents were demonstrated. No changes in falls or medication incident rates were identified. PMID:26796972

  9. Evidence-based protocol for structural rehabilitation of the spine and posture: review of clinical biomechanics of posture (CBP®) publications

    PubMed Central

    Oakley, Paul A.; Harrison, Donald D.; Harrison, Deed E.; Haas, Jason W.

    2005-01-01

    BACKGROUND Although practice protocols exist for SMT and functional rehabilitation, no practice protocols exist for structural rehabilitation. Traditional chiropractic practice guidelines have been limited to acute and chronic pain treatment, with limited inclusion of functional and exclusion of structural rehabilitation procedures. OBJECTIVE (1) To derive an evidence-based practice protocol for structural rehabilitation from publications on Clinical Biomechanics of Posture (CBP®) methods, and (2) to compare the evidence for Diversified, SMT, and CBP®. METHODS Clinical control trials utilizing CBP® methods and spinal manipulative therapy (SMT) were obtained from searches in Mantis, CINAHL, and Index Medicus. Using data from SMT review articles, evidence for Diversified Technique (as taught in chiropractic colleges), SMT, and CBP® were rated and compared. RESULTS From the evidence from Clinical Control Trials on SMT and CBP®, there is very little evidence support for Diversified (our rating = 18), as taught in chiropractic colleges, for the treatment of pain subjects, while CBP® (our rating = 46) and SMT for neck pain (rating = 58) and low back pain (our rating = 202) have evidence-based support. CONCLUSIONS While CBP® Technique has approximately as much evidence-based support as SMT for neck pain, CBP® has more evidence to support its methods than the Diversified technique taught in chiropractic colleges, but not as much as SMT for low back pain. The evolution of chiropractic specialization has occurred, and doctors providing structural-based chiropractic care require protocol guidelines for patient quality assurance and standardization. A structural rehabilitation protocol was developed based on evidence from CBP® publications. PMID:17549209

  10. Medical image segmentation using object atlas versus object cloud models

    NASA Astrophysics Data System (ADS)

    Phellan, Renzo; Falcão, Alexandre X.; Udupa, Jayaram K.

    2015-03-01

    Medical image segmentation is crucial for quantitative organ analysis and surgical planning. Since interactive segmentation is not practical in a production-mode clinical setting, automatic methods based on 3D object appearance models have been proposed. Among them, approaches based on object atlas are the most actively investigated. A key drawback of these approaches is that they require a time-costly image registration process to build and deploy the atlas. Object cloud models (OCM) have been introduced to avoid registration, considerably speeding up the whole process, but they have not been compared to object atlas models (OAM). The present paper fills this gap by presenting a comparative analysis of the two approaches in the task of individually segmenting nine anatomical structures of the human body. Our results indicate that OCM achieve a statistically significant better accuracy for seven anatomical structures, in terms of Dice Similarity Coefficient and Average Symmetric Surface Distance.

  11. Objective evaluation of methods to track motion from clinical cardiac-gated tagged MRI without the use of a gold standard

    NASA Astrophysics Data System (ADS)

    Parages, Felipe M.; Denney, Thomas S.; Brankov, Jovan G.

    2015-03-01

    Cardiac-gated MRI is widely used for the task of measuring parameters related to heart motion. More specifically, gated tagged MRI is the preferred modality to estimate local deformation (strain) and rotational motion (twist) of myocardial tissue. Many methods have been proposed to estimate cardiac motion from gated MRI sequences. However, when dealing with clinical data, evaluation of these methods is problematic due to the absence of gold-standards for cardiac motion. To overcome that, a linear regression scheme known as regression-without-truth (RWT) was proposed in the past. RWT uses priors to model the distribution of true values, thus enabling us to assess image-analysis algorithms without knowledge of the ground-truth. Furthermore, it allows one to rank methods by means of an objective figure-of-merit γ (i.e. precision). In this work we apply RWT to compare the performance of several gated MRI motion-tracking methods (e.g. non-rigid registration, feature based, harmonic phase) at the task of estimating myocardial strain and left-ventricle (LV) twist, from a population of 18 clinical human cardiac-gated tagged MRI studies.

  12. Validity of early MRI structural damage end points and potential impact on clinical trial design in rheumatoid arthritis

    PubMed Central

    Baker, Joshua F; Conaghan, Philip G; Emery, Paul; Baker, Daniel G; Østergaard, Mikkel

    2016-01-01

    Objective To evaluate the construct validity of the rheumatoid arthritis MRI score (RAMRIS) erosion evaluation as structural damage end point and to assess the potential impact of incorporation in clinical trials. Methods In a randomised trial of early methotrexate-naïve RA (GO-BEFORE), RAMRIS scores were determined from MRIs and van der Heijde-Sharp (vdHS) scores from radiographs, at baseline, week 12, week 24 and week 52. Progression in damage scores was defined as change >0.5. Associations of X-ray and MRI outcomes with clinical features were evaluated for convergent validity. Iterative Wilcoxon rank sum tests and tests of proportion estimated the sample size required to detect differences between combination therapy (methotrexate+golimumab) and methotrexate-monotherapy arms in (A) change in damage score and (B) proportion of patients progressing. Results Patients with early MRI progression had higher DAS28, C reactive protein (CRP) and vdHS at baseline, and higher 2-year HAQ. Associations were similar to those with 1-year vdHS progression. Differences in change in structural damage between treatment arms achieved significance with fewer subjects when 12-week or 24-week MRI erosion score was the outcome (150 patients; 100 among an enriched sample with baseline-synovitis >5) compared with the 52-week vdHS (275 patients). Differences in the proportion progressing could be detected in 234 total subjects with 12-week MRI in an enriched sample whereas 1-year X-ray required between 468 and 1160 subjects. Conclusions Early MRI erosion progression is a valid measure of structural damage that could substantially decrease sample size and study duration if used as structural damage end point in RA clinical trials. PMID:26091907

  13. Clinical Application of the Mean Babbling Level and Syllable Structure Level

    ERIC Educational Resources Information Center

    Morris, Sherrill R.

    2010-01-01

    Purpose: This clinical exchange reviews two independent phonological assessment measures: mean babbling level (MBL) and syllable structure level (SSL). Both measures summarize phonetic inventory and syllable shape in a calculated average and have been used in research to describe the phonological abilities of children ages 9 to 36 months. An…

  14. Using Case Study Analysis and Case Writing to Structure Clinical Experiences in a Teacher Education Program

    ERIC Educational Resources Information Center

    Floyd, Deborah M.; Bodur, Yasar

    2005-01-01

    This study reports on the design and results of a two-semester study on the use of case study analysis and case writing in clinical experiences in an undergraduate teacher education program. Findings indicated that structured experiences with case studies and case writing increase preservice teachers' informed decision making on educational…

  15. LASER BIOLOGY AND MEDICINE: Visualisation of details of a complicated inner structure of model objects by the method of diffusion optical tomography

    NASA Astrophysics Data System (ADS)

    Tret'yakov, Evgeniy V.; Shuvalov, Vladimir V.; Shutov, I. V.

    2002-11-01

    An approximate algorithm is tested for solving the problem of diffusion optical tomography in experiments on the visualisation of details of the inner structure of strongly scattering model objects containing scattering and semitransparent inclusions, as well as absorbing inclusions located inside other optical inhomogeneities. The stability of the algorithm to errors is demonstrated, which allows its use for a rapid (2 — 3 min) image reconstruction of the details of objects with a complicated inner structure.

  16. [How can institutional structures make clinical research in France more operational?].

    PubMed

    Funck-Brentano, C; Brouard, R

    The laws regulating the practice of clinical research in France, in particular the law of 20 December 1988, the so-called Huriet's law, constitute a major advance for medical progress. However, their implementation by administrative offices generates practical difficulties which impair the development of applied research in human beings. Beyond the laws themselves, it appears that our institutions are unprepared to optimize the conduct of such research. This round table sought to list the existing problems and to propose constructive solutions or objectives to be reached to optimize clinical research in France, with a view to improving French participation in international collaborative programmes, notably European ones. Evaluation of projects and practices, financial support and accounting, and some aspects of existing laws have been identified as the major sources of our difficulties. Harmonization and clarification of our procedures as well as improvement of training should be our primary objectives to achieve a higher level of medical, scientific, financial and administrative quality in the conduct of clinical research. Creation of a referential Web site, designed and updated by a central public organization, is an imperative step towards reaching these objectives. PMID:10667114

  17. A Pilot Clinical Trial to Objectively Assess the Efficacy of Electroacupuncture on Gait in Patients with Parkinson's Disease Using Body Worn Sensors

    PubMed Central

    Lei, Hong

    2016-01-01

    Background Gait disorder, a key contributor to fall and poor quality of life, represents a major therapeutic challenge in Parkinson’s disease (PD). The efficacy of acupuncture for PD remains unclear, largely due to methodological flaws and lack of studies using objective outcome measures. Objective To objectively assess the efficacy of electroacupuncture (EA) for gait disorders using body-worn sensor technology in patients with PD. Methods In this randomized pilot study, both the patients and assessors were masked. Fifteen PD patients were randomly assigned to an experimental group (n = 10) or to a control group (n = 5). Outcomes were assessed at baseline and after completion of three weekly EA treatments. Measurements included gait analysis during single-task habitual walking (STHW), dual-task habitual walking (DTHW), single-task fast walking (STFW), dual-task fast walking (DTFW). In addition, Unified Parkinson's Disease Rating Scale (UPDRS), SF-12 health survey, short Falls Efficacy Scale-International (FES-I), and visual analog scale (VAS) for pain were utilized. Results All gait parameters were improved in the experimental group in response to EA treatment. After adjustment by age and BMI, the improvement achieved statistical significant level for gait speed under STHW, STFW, and DTFW (9%-19%, p<0.05) as well as stride length during DTFW (9%, p = 0.037) and midswing speed during STFW (6%, p = 0.033). No significant changes were observed in the control group (p>0.110). The highest correlation between gait parameters and UPRDS scores at baseline was observed between gait speed during STFW and UPDRS II (r = -0.888, p = 0.004). The change in this gait parameter in response to active intervention was positively correlated with baseline UPDRS (r = 0.595, p = 0.057). Finally, comparison of responses to treatment between groups showed significant improvement, prominently in gait speed (effect size 0.32–1.16, p = 0.001). Conclusions This study provides the objective

  18. Disrupted topological organization of structural and functional brain connectomes in clinically isolated syndrome and multiple sclerosis.

    PubMed

    Shu, Ni; Duan, Yunyun; Xia, Mingrui; Schoonheim, Menno M; Huang, Jing; Ren, Zhuoqiong; Sun, Zheng; Ye, Jing; Dong, Huiqing; Shi, Fu-Dong; Barkhof, Frederik; Li, Kuncheng; Liu, Yaou

    2016-01-01

    The brain connectome of multiple sclerosis (MS) has been investigated by several previous studies; however, it is still unknown how the network changes in clinically isolated syndrome (CIS), the earliest stage of MS, and how network alterations on a functional level relate to the structural level in MS disease. Here, we investigated the topological alterations of both the structural and functional connectomes in 41 CIS and 32 MS patients, compared to 35 healthy controls, by combining diffusion tensor imaging and resting-state functional MRI with graph analysis approaches. We found that the structural connectome showed a deviation from the optimal pattern as early as the CIS stage, while the functional connectome only showed local changes in MS patients, not in CIS. When comparing two patient groups, the changes appear more severe in MS. Importantly, the disruptions of structural and functional connectomes in patients occurred in the same direction and locally correlated in sensorimotor component. Finally, the extent of structural network changes was correlated with several clinical variables in MS patients. Together, the results suggested early disruption of the structural brain connectome in CIS patients and provided a new perspective for investigating the relationship of the structural and functional alterations in MS. PMID:27403924

  19. Disrupted topological organization of structural and functional brain connectomes in clinically isolated syndrome and multiple sclerosis

    PubMed Central

    Shu, Ni; Duan, Yunyun; Xia, Mingrui; Schoonheim, Menno M.; Huang, Jing; Ren, Zhuoqiong; Sun, Zheng; Ye, Jing; Dong, Huiqing; Shi, Fu-Dong; Barkhof, Frederik; Li, Kuncheng; Liu, Yaou

    2016-01-01

    The brain connectome of multiple sclerosis (MS) has been investigated by several previous studies; however, it is still unknown how the network changes in clinically isolated syndrome (CIS), the earliest stage of MS, and how network alterations on a functional level relate to the structural level in MS disease. Here, we investigated the topological alterations of both the structural and functional connectomes in 41 CIS and 32 MS patients, compared to 35 healthy controls, by combining diffusion tensor imaging and resting-state functional MRI with graph analysis approaches. We found that the structural connectome showed a deviation from the optimal pattern as early as the CIS stage, while the functional connectome only showed local changes in MS patients, not in CIS. When comparing two patient groups, the changes appear more severe in MS. Importantly, the disruptions of structural and functional connectomes in patients occurred in the same direction and locally correlated in sensorimotor component. Finally, the extent of structural network changes was correlated with several clinical variables in MS patients. Together, the results suggested early disruption of the structural brain connectome in CIS patients and provided a new perspective for investigating the relationship of the structural and functional alterations in MS. PMID:27403924

  20. The Structure of Clinical Consultation: A Case of Non-Native Speakers of English as Participants

    PubMed Central

    Bagheri, H.; Ibrahim, N. A.; Habil, H.

    2015-01-01

    Background: In many parts of the world, patients may find it difficult to visit doctors who share the same language and culture due to the intermingling of people and international recruitment of doctors among many other reasons. In these multilingual multicultural settings (MMSs), doctor-patient interactions face new communication challenges. This study aims to identify the structure of clinical consultation and its phases in an MMS where both doctors and patients are non-native speakers (NNSs) of English. Method: This study takes on a discourse analytic approach to examine the structure of clinical consultation as an activity type. 25 clinical consultation sessions between non-native speakers of English in a public healthcare centre in Malaysia were audio-recorded. Findings and Discussion: The results show that there are some deviations from the mainstream structure of clinical consultations although, in general, the pattern is compatible with previous studies. Deviations are particularly marked in the opening and closing phases of consultation. Conclusion: In almost all interactions, there is a straightforward manner of beginning medical consultations. The absence of greetings may have naturally reduced the length of talk. Hence, by directly entering medical talks, the doctors voice their concern on the curing aspects of the consultation rather than its caring facets. The preference of curing priority to caring is more goal-oriented and in alignment with the consultation as an activity type. PMID:25560336

  1. The Vital Role of Patient Feedback in the Critical Assessment of a Patient-Centered Care Objective Structured Clinical Examination

    ERIC Educational Resources Information Center

    Rentfro, Allison Carothers

    2011-01-01

    Priorities in medical education have increasingly emphasized teaching skills and fostering attitudes related to patient-centered care (Beckman & Frankel, 2003; Haidet & Paterniti, 2003). The challenge for academic medical centers is to implement these competencies into their curriculum and assess the outcomes. Using a qualitative single…

  2. Instructor and Dental Student Perceptions of Clinical Communication Skills via Structured Assessments.

    PubMed

    McKenzie, Carly T

    2016-05-01

    The aim of this study was to use structured assessments to assess dental students' clinical communication skills exhibited during patient appointments. Fourth-year dental students (n=55) at the University of Alabama at Birmingham evaluated their own interpersonal skills in a clinical setting utilizing the Four Habits Coding Scheme. An instructor also assessed student-patient clinical communication. These assessments were used to identify perceived strengths and weaknesses in students' clinical communication. Both instructor assessments and student self-assessments pinpointed the following clinical communication skills as effective the most often: patient greeting, avoidance of jargon, and non-verbal behavior. There was also relative agreement between instructor assessments and student self-assessments regarding clinical communication skills that were rated as not effective most frequently: ensuring patient comprehension, identification of patient feelings, and exploration of barriers to treatment. These resulted pointed to strengths and weaknesses in the portion of the curriculum designed to prepare students for effective provider-patient communication. These results may suggest a need for the school's current behavioral science curriculum to better address discussion of potential treatment barriers and patient feelings as well as techniques to ensure patient comprehension. PMID:27139207

  3. Envelope structure on 700 AU scales and the molecular outflows of low-mass young stellar objects

    NASA Technical Reports Server (NTRS)

    Hogerheijde, M. R.; van Dishoeck, E. F.; Blake, G. A.; van Langevelde, H. J.

    1998-01-01

    Aperture synthesis observations of HCO+ J = 1-0, 13CO 1-0, and C18O 1-0 obtained with the Owens Valley Millimeter Array are used to probe the small-scale (5" approximately 700 AU) structure of the molecular envelopes of a well-defined sample of nine embedded low-mass young stellar objects in Taurus. The interferometer results can be understood in terms of: (1) a core of radius approximately or less than 1000 AU surrounding the central star, possibly flattened and rotating; (2) condensations scattered throughout the envelope that may be left over from the inhomogeneous structure of the original cloud core or that may have grown during collapse; and (3) material within the outflow or along the walls of the outflow cavity. Masses of the central cores are 0.001-0.1 M (solar), and agree well with dust continuum measurements. Averaged over the central 20" (3000 AU) region, an HCO+ abundance of 4 x 10(-8) is inferred, with a spread of a factor of 3 between the different sources. Reanalysis of previously presented single-dish data yields an HCO+ abundance of (5.0 +/- 1.7) x 10(-9), which may indicate an average increase by a factor of a few on the smaller scales sampled by the interferometer. Part of this apparent abundance variation could be explained by contributions from extended cloud emission to the single-dish C18O lines, and uncertainties in the assumed excitation temperatures and opacities. The properties of the molecular envelopes and outflows are further investigated through single-dish observations of 12CO J = 6-5, 4-3, and 3-2, 13CO 6-5 and 3-2, and C18O 3-2 and 2-1, obtained with the James Clerk Maxwell and IRAM 30 m telescopes, along with the Caltech Submillimeter Observatory. Ratios of the mid-J CO lines are used to estimate the excitation temperature, with values of 25-80 K derived for the gas near line centre. The outflow wings show a similar range, although Tex is enhanced by a factor of 2-3 in at least two sources. In contrast to the well-studied L1551

  4. Superresolution microscope image reconstruction by spatiotemporal object decomposition and association: application in resolving t-tubule structure in skeletal muscle

    PubMed Central

    Sun, Mingzhai; Huang, Jiaqing; Bunyak, Filiz; Gumpper, Kristyn; De, Gejing; Sermersheim, Matthew; Liu, George; Lin, Pei-Hui; Palaniappan, Kannappan; Ma, Jianjie

    2014-01-01

    One key factor that limits resolution of single-molecule superresolution microscopy relates to the localization accuracy of the activated emitters, which is usually deteriorated by two factors. One originates from the background noise due to out-of-focus signals, sample auto-fluorescence, and camera acquisition noise; and the other is due to the low photon count of emitters at a single frame. With fast acquisition rate, the activated emitters can last multiple frames before they transiently switch off or permanently bleach. Effectively incorporating the temporal information of these emitters is critical to improve the spatial resolution. However, majority of the existing reconstruction algorithms locate the emitters frame by frame, discarding or underusing the temporal information. Here we present a new image reconstruction algorithm based on tracklets, short trajectories of the same objects. We improve the localization accuracy by associating the same emitters from multiple frames to form tracklets and by aggregating signals to enhance the signal to noise ratio. We also introduce a weighted mean-shift algorithm (WMS) to automatically detect the number of modes (emitters) in overlapping regions of tracklets so that not only well-separated single emitters but also individual emitters within multi-emitter groups can be identified and tracked. In combination with a maximum likelihood estimator method (MLE), we are able to resolve low to medium density of overlapping emitters with improved localization accuracy. We evaluate the performance of our method with both synthetic and experimental data, and show that the tracklet-based reconstruction is superior in localization accuracy, particularly for weak signals embedded in a strong background. Using this method, for the first time, we resolve the transverse tubule structure of the mammalian skeletal muscle. PMID:24921337

  5. 3D OCT imaging in clinical settings: toward quantitative measurements of retinal structures

    NASA Astrophysics Data System (ADS)

    Zawadzki, Robert J.; Fuller, Alfred R.; Zhao, Mingtao; Wiley, David F.; Choi, Stacey S.; Bower, Bradley A.; Hamann, Bernd; Izatt, Joseph A.; Werner, John S.

    2006-02-01

    The acquisition speed of current FD-OCT (Fourier Domain - Optical Coherence Tomography) instruments allows rapid screening of three-dimensional (3D) volumes of human retinas in clinical settings. To take advantage of this ability requires software used by physicians to be capable of displaying and accessing volumetric data as well as supporting post processing in order to access important quantitative information such as thickness maps and segmented volumes. We describe our clinical FD-OCT system used to acquire 3D data from the human retina over the macula and optic nerve head. B-scans are registered to remove motion artifacts and post-processed with customized 3D visualization and analysis software. Our analysis software includes standard 3D visualization techniques along with a machine learning support vector machine (SVM) algorithm that allows a user to semi-automatically segment different retinal structures and layers. Our program makes possible measurements of the retinal layer thickness as well as volumes of structures of interest, despite the presence of noise and structural deformations associated with retinal pathology. Our software has been tested successfully in clinical settings for its efficacy in assessing 3D retinal structures in healthy as well as diseased cases. Our tool facilitates diagnosis and treatment monitoring of retinal diseases.

  6. E6/E7 mRNA expression analysis: a test for the objective assessment of cervical adenocarcinoma in clinical prognostic procedure.

    PubMed

    Hovland, Siri; Muller, Susanne; Skomedal, Hanne; Mints, Michael; Bergström, Jakob; Wallin, Keng-Ling; Karlsen, Frank; Johansson, Bo; Andersson, Sonia

    2010-06-01

    Detection of E6/E7 mRNA expression using the real-time nucleic acid sequence-based amplification assay (NASBA) PreTect HPV-Proofer was compared with results of human papillomavirus (HPV) DNA detection in 98 paraffin-embedded samples from patients with cervical adenocarcinoma. HR-HPV DNA was detected in 61 (62%), while HR-HPV E6/E7 mRNA was detected in 63 (64%) of the samples. Correlation between results from DNA analyses and the E6/E7 mRNA assay showed consistent results in 87% of samples (47 of 54). The results from these two methods in detecting presence of HPV infection of any type agreed in 77%. Overall agreement between the methods was seen in 82 of the 98 cases (84%). When evaluating change in sensitivity for detection of HPV positives by adding more HPV types to the HPV DNA assay, maximum sensitivity was reached by targeting four HPV types. The coverage of HPV DNA presence was 76.9%, while the E6/E7 mRNA assay achieved a maximum coverage of 80.8% using only three HPV types. Thus, E6/E7 oncogene expression analysis may provide a more objective test for assessment of neoplastic glandular cells. Further studies may reveal whether the clinical performance of the E6/E7 mRNA assay will be of prognostic value in management of cervical adenocarcinoma. PMID:20428778

  7. Learning objects in medical education.

    PubMed

    Ruiz, Jorge G; Mintzer, Michael J; Issenberg, S Barry

    2006-11-01

    A learning object (LO) is a grouping of instructional materials structured to meet a specified educational objective. Digital LOs, which can be stored electronically, allow a new approach to instructional activity, making medical education more efficient, and potentially more cost-effective. They are reusable and can incorporate text, graphics, animations, audio, and video to support and enhance learning. A learning object can stand alone or be aggregated with additional objects to create larger forms of educational content meeting multiple educational objectives. Digital learning objects located in online repositories can be accessed by many computers and are easily handled by an array of learning management systems for delivery to learners at any time. Integrating digital learning objects with traditional educational methods in a blended learning approach assists medical educators in meeting the challenges of competing priorities. Multimedia LOs enable learners to tailor their experience to their preferred learning style. Through the use of learning objects, learners' reactions, their acquisition of knowledge, skills and attitudes, and their behavioral changes become readily measurable. Learning objects provide multiple research opportunities, such as their use in adaptive learning, their added value in preclinical versus clinical education, and their impact as part of a blended learning strategy. PMID:17594550

  8. Recognizing clinical entities in hospital discharge summaries using Structural Support Vector Machines with word representation features

    PubMed Central

    2013-01-01

    Background Named entity recognition (NER) is an important task in clinical natural language processing (NLP) research. Machine learning (ML) based NER methods have shown good performance in recognizing entities in clinical text. Algorithms and features are two important factors that largely affect the performance of ML-based NER systems. Conditional Random Fields (CRFs), a sequential labelling algorithm, and Support Vector Machines (SVMs), which is based on large margin theory, are two typical machine learning algorithms that have been widely applied to clinical NER tasks. For features, syntactic and semantic information of context words has often been used in clinical NER systems. However, Structural Support Vector Machines (SSVMs), an algorithm that combines the advantages of both CRFs and SVMs, and word representation features, which contain word-level back-off information over large unlabelled corpus by unsupervised algorithms, have not been extensively investigated for clinical text processing. Therefore, the primary goal of this study is to evaluate the use of SSVMs and word representation features in clinical NER tasks. Methods In this study, we developed SSVMs-based NER systems to recognize clinical entities in hospital discharge summaries, using the data set from the concept extration task in the 2010 i2b2 NLP challenge. We compared the performance of CRFs and SSVMs-based NER classifiers with the same feature sets. Furthermore, we extracted two different types of word representation features (clustering-based representation features and distributional representation features) and integrated them with the SSVMs-based clinical NER system. We then reported the performance of SSVM-based NER systems with different types of word representation features. Results and discussion Using the same training (N = 27,837) and test (N = 45,009) sets in the challenge, our evaluation showed that the SSVMs-based NER systems achieved better performance than the CRFs

  9. Objectives and Structure of the SWRL Reading Program, Blocks 1-8. Technical Note No. 3-72-42.

    ERIC Educational Resources Information Center

    Scott, Roger O.

    An instructional system designed to implement the objectives of the Southwest Regional Laboratory (SWRL) Reading Program is currently under development. This document defines the program objectives, content, content sequence, and pedagogical strategies for each outcome area. A description of the program's instructional activities, their sequence,…

  10. The Structure of Three-Dimensional Object Representations in Human Vision: Evidence from Whole-Part Matching

    ERIC Educational Resources Information Center

    Leek, E. Charles; Reppa, Irene; Arguin, Martin

    2005-01-01

    This article examines how the human visual system represents the shapes of 3-dimensional (3D) objects. One long-standing hypothesis is that object shapes are represented in terms of volumetric component parts and their spatial configuration. This hypothesis is examined in 3 experiments using a whole-part matching paradigm in which participants…

  11. Differences in the internal structure of hallucinatory experiences between clinical and nonclinical populations.

    PubMed

    Chang, Jae Seung; Kim, Yeni; Kim, Se Hyun; Hwang, Samuel; Kim, Jayoun; Chung, In-Won; Kim, Yong Sik; Jung, Hee-Yeon

    2015-03-30

    We investigated differential patterns of hallucinatory experiences between nonclinical and clinical samples. A total of 223 nonclinical individuals (108 females) and 111 subjects with schizophrenia (54 females) completed the Launay-Slade Hallucination Scale-Revised (LSHS-R) and Perceptual Aberration Scale (PAS). The Minnesota Multiphasic Personality Inventory-2 (MMPI-2) was used for the nonclinical group, and the Positive and Negative Syndrome Scale (PANSS) hallucination item was used for the clinical group. Cronbach's alpha values showed good internal consistency for the LSHS-R. In the two groups, significant associations were found between LSHS-R and PAS scores. Two factors were extracted through a principal component analysis (PCA) in the nonclinical group, and three factors were identified in the clinical group. The results of a hierarchical cluster analysis (HCA) revealed that a perception-cognition dimension was clear cluster discriminating element for the nonclinical group, whereas alterations in perception-cognition dimension were characteristic in cluster structure of the clinical group. Our findings suggest that the nature of hallucinatory experiences may differ qualitatively between a nonclinical population and subjects with schizophrenia. Perceptual or cognitive aberrations may add a psychopathologic dimension to hallucinatory experiences. Exploring the internal structure of hallucinatory experiences may provide explanatory insight into these experiences in the general population. PMID:25619435

  12. Effects of structured written feedback by cards on medical students’ performance at Mini Clinical Evaluation Exercise (Mini-CEX) in an outpatient clinic

    PubMed Central

    HAGHANI, FARIBA; HATEF KHORAMI, MOHAMMAD; FAKHARI, MOHAMMAD

    2016-01-01

    Introduction Feedback cards are recommended as a feasible tool for structured written feedback delivery in clinical education while effectiveness of this tool on the medical students’ performance is still questionable.  The purpose of this study was to compare the effects of structured written feedback by cards as well as verbal feedback versus verbal feedback alone on the clinical performance of medical students at the Mini Clinical Evaluation Exercise (Mini-CEX) test in an outpatient clinic. Methods This is a quasi-experimental study with pre- and post-test comprising four groups in two terms of medical students’ externship. The students’ performance was assessed through the Mini-Clinical Evaluation Exercise (Mini-CEX) as a clinical performance evaluation tool. Structured written feedbacks were given to two experimental groups by designed feedback cards as well as verbal feedback, while in the two control groups feedback was delivered verbally as a routine approach in clinical education. Results By consecutive sampling method, 62 externship students were enrolled in this study and seven students were excluded from the final analysis due to their absence for three days. According to the ANOVA analysis and Post Hoc Tukey test,  no statistically significant difference was observed among the four groups at the pre-test, whereas a statistically significant difference was observed between the experimental and control groups at the post-test  (F = 4.023, p =0.012). The effect size of the structured written feedbacks on clinical performance was 0.19. Conclusion Structured written feedback by cards could improve the performance of medical students in a statistical sense. Further studies must be conducted in other clinical courses with longer durations. PMID:27382581

  13. A Comparison of the Correlational Structures and Elevation Patterns of the MMPI-2 Restructured Clinical (RC) and Clinical Scales

    ERIC Educational Resources Information Center

    Wallace, Amanda; Liljequist, Laura

    2005-01-01

    The relationship between the MMPI-2 restructured clinical scales and the original clinical scales was evaluated using an outpatient clinical sample (N = 150). Similar patterns of correlations to those reported by Tellegen et al. in 2003, such as high correlations between the restructured scales and their original scale counterparts and lower…

  14. OCT imaging of osteoarthritic cartilage: structure, polarization sensitivity, and clinical feasibility

    NASA Astrophysics Data System (ADS)

    Li, Xing D.; Herrmann, Jurgen; Ghanta, Ravi K.; Pitris, Constantinos; Drexler, Wolfgang; Jesser, Christine; Stamper, Debra L.; Golden, David; Martin, Scott; Fujimoto, James G.; Brezinski, Mark E.

    1999-04-01

    This work demonstrates the feasibility of OCT for identifying early osteoarthritic pathology. In addition to structural abnormalities, changes in collagen fiber organization, an indicator of very early osteoarthritis, were assessed with a polarization sensitive OCT system. A portable, real time, modular OCT system, suitable for both laboratory and clinical settings, has been developed. Preliminary in vivo imaging results obtained during partial knee replacement surgery are discussed.

  15. Effectiveness of structured hourly nurse rounding on patient satisfaction and clinical outcomes.

    PubMed

    Brosey, Lisa A; March, Karen S

    2015-01-01

    Structured hourly nurse rounding is an effective method to improve patient satisfaction and clinical outcomes. This program evaluation describes outcomes related to the implementation of hourly nurse rounding in one medical-surgical unit in a large community hospital. Overall Hospital Consumer Assessment of Healthcare Providers and Systems domain scores increased with the exception of responsiveness of staff. Patient falls and hospital-acquired pressure ulcers decreased during the project period. PMID:25237791

  16. Outcomes of Health System Structures, Highly Pertinent Clinical Information, Idea Stimulators, Clinical Reviews, and Prediction Tools: JABFM Exemplified.

    PubMed

    Bowman, Marjorie A; Neale, Anne Victoria; Seehusen, Dean A

    2016-01-01

    This issue exemplifies the types of articles that JABFM publishes to advance family medicine. We have articles on the implications of health system organizational structures. Three of these are international articles at the level of the national health system (1 from China) and systematic local health interventions (1 from Canada and 1 from Netherlands). Inside the United States, where there are more family physicians, there is less obesity, and designation as a Patient Centered Medical Home is related to increased rates of colorectal cancer screening. Review articles on common clinical topics discuss treatments that are changing (acne in pregnancy) or lack consensus (distal radial fractures). We have articles on making life easier in the office, such as for predicting Vitamin D levels, osteoporosis, and pre-diabetes in normal weight adults. There are articles to raise awareness of the "newest" testing or treatments, that is, auditory brainstem implants. "Reminder" articles highlight known entities that need to be reinforced to prevent over-/underdiagnosis or treatment, for example, "cotton fever." Another article discusses the increased risk for postoperative complications with sleep apnea. We also provide "thought" pieces, in this case about the terminology we are using to extend our concept of patient-centered medical homes. PMID:26957371

  17. SeaDataNet : Pan-European infrastructure for marine and ocean data management - Project objectives, structure and components

    NASA Astrophysics Data System (ADS)

    Maudire, G.; Maillard, C.; Fichaut, M.; Manzella, G.; Schaap, D. M. A.

    2009-04-01

    SeaDataNet : Pan-European infrastructure for marine and ocean data management Project objectives, structure and components G. Maudire (1), C. Maillard (1), G. Manzella (2), M. Fichaut (1), D.M.A. Schaap (3), E. Iona (4) and the SeaDataNet consortium. (1) IFREMER, Brest, France (Gilbert.Maudire@ifremer.fr), (2) ENEA, La Spezia, Italy, (3) Mariene Informatie Service 'MARIS', Voorburg, The Netherlands, (4) Hellenic Centre for Marine Research-HCMR, Anavyssos, Greece. Since a large part of the earth population lives near the oceans or carries on activities directly or indirectly linked to the seas (fishery and aquaculture, exploitation of sea bottom resources, international shipping, tourism), knowledge of oceans is of primary importance for security and economy. However, observation and monitoring of the oceans remains difficult and expensive even if real improvements have been achieved using research vessels and submersibles, satellites and automatic observatories like buoys, floats and seafloor observatories transmitting directly to the shore using global transmission systems. More than 600 governmental or private organizations are active in observation of seas bordering Europe, but European oceanographic data are fragmented, not always validated and not always easily accessible. That highlights the need of international collaboration to tend toward a comprehensive view of ocean mechanisms, resources and changes. SeaDataNet is an Integrated research Infrastructure Initiative (I3) in European Union Framework Program 6 (2006 - 2011) to provide the data management system adapted both to the fragmented observation systems and to the users need for an integrated access to data, meta-data, products and services. Its major objectives are to: - encourage long-term archiving at national level to secure ocean data taking into account that all the observations made in the variable oceanic environment can never be remade if they are lost; - promote best practices for data

  18. The Impact of Structured Inter-professional Education on Health Care Professional Students' Perceptions of Collaboration in a Clinical Setting

    PubMed Central

    Lee, Sam; Lombardo, Samantha; Salama, Mariam; Ellis, Sandi; Kay, Theresa; Davies, Robyn; Landry, Michel D.

    2012-01-01

    ABSTRACT Purpose: To examine how a structured inter-professional education (IPE) clinical placement influences health care professional (HCP) students' perceptions of inter-professional collaboration (IPC) relative to that of students in a traditional clinical placement. Methods: This study used a mixed-methods design. The Interdisciplinary Education Perception Scale (IEPS) was administered to HCP students (n=36) in two Toronto hospitals before and after a structured 5-week IPE clinical placement to examine changes in their perceptions of IPC. Students in a traditional clinical placement (n=28) were used as a control group. Focus groups were then conducted with seven students who took part in the structured IPE clinical placement. A coding framework was devised a priori, and the qualitative results were used to explain the quantitative findings. Results: There were no statistically significant differences between groups after the structured IPE clinical placement, but the intervention group showed a greater positive trend in total IEPS scores from baseline to follow-up. Qualitative data suggest that students valued the knowledge and skills gained through the structured IPE clinical placement. Conclusions: Findings suggest that structured IPE clinical placements may provide students with valuable collaborative learning opportunities, enhanced respect for other professionals, and insight into the value of IPC in healthcare delivery. More research is needed to explore other factors that influence specific perceptions among physical therapy students. PMID:23450044

  19. Adaptive Objectness for Object Tracking

    NASA Astrophysics Data System (ADS)

    Liang, Pengpeng; Pang, Yu; Liao, Chunyuan; Mei, Xue; Ling, Haibin

    2016-07-01

    Object tracking is a long standing problem in vision. While great efforts have been spent to improve tracking performance, a simple yet reliable prior knowledge is left unexploited: the target object in tracking must be an object other than non-object. The recently proposed and popularized objectness measure provides a natural way to model such prior in visual tracking. Thus motivated, in this paper we propose to adapt objectness for visual object tracking. Instead of directly applying an existing objectness measure that is generic and handles various objects and environments, we adapt it to be compatible to the specific tracking sequence and object. More specifically, we use the newly proposed BING objectness as the base, and then train an object-adaptive objectness for each tracking task. The training is implemented by using an adaptive support vector machine that integrates information from the specific tracking target into the BING measure. We emphasize that the benefit of the proposed adaptive objectness, named ADOBING, is generic. To show this, we combine ADOBING with seven top performed trackers in recent evaluations. We run the ADOBING-enhanced trackers with their base trackers on two popular benchmarks, the CVPR2013 benchmark (50 sequences) and the Princeton Tracking Benchmark (100 sequences). On both benchmarks, our methods not only consistently improve the base trackers, but also achieve the best known performances. Noting that the way we integrate objectness in visual tracking is generic and straightforward, we expect even more improvement by using tracker-specific objectness.

  20. Validity and reliability of the Structured Clinical Interview for Depersonalization–Derealization Spectrum (SCI-DER)

    PubMed Central

    Mula, Marco; Pini, Stefano; Calugi, Simona; Preve, Matteo; Masini, Matteo; Giovannini, Ilaria; Conversano, Ciro; Rucci, Paola; Cassano, Giovanni B

    2008-01-01

    This study evaluates the validity and reliability of a new instrument developed to assess symptoms of depersonalization: the Structured Clinical Interview for the Depersonalization-Derealization Spectrum (SCI-DER). The instrument is based on a spectrum model that emphasizes soft-signs, sub-threshold syndromes as well as clinical and subsyndromal manifestations. Items of the interview include, in addition to DSM-IV criteria for depersonalization, a number of features derived from clinical experience and from a review of phenomenological descriptions. Study participants included 258 consecutive patients with mood and anxiety disorders, 16.7% bipolar I disorder, 18.6% bipolar II disorder, 32.9% major depression, 22.1% panic disorder, 4.7% obsessive compulsive disorder, and 1.5% generalized anxiety disorder; 2.7% patients were also diagnosed with depersonalization disorder. A comparison group of 42 unselected controls was enrolled at the same site. The SCI-DER showed excellent reliability and good concurrent validity with the Dissociative Experiences Scale. It significantly discriminated subjects with any diagnosis of mood and anxiety disorders from controls and subjects with depersonalization disorder from controls. The hypothesized structure of the instrument was confirmed empirically. PMID:19183789

  1. Towards symbiosis in knowledge representation and natural language processing for structuring clinical practice guidelines.

    PubMed

    Weng, Chunhua; Payne, Philip R O; Velez, Mark; Johnson, Stephen B; Bakken, Suzanne

    2014-01-01

    The successful adoption by clinicians of evidence-based clinical practice guidelines (CPGs) contained in clinical information systems requires efficient translation of free-text guidelines into computable formats. Natural language processing (NLP) has the potential to improve the efficiency of such translation. However, it is laborious to develop NLP to structure free-text CPGs using existing formal knowledge representations (KR). In response to this challenge, this vision paper discusses the value and feasibility of supporting symbiosis in text-based knowledge acquisition (KA) and KR. We compare two ontologies: (1) an ontology manually created by domain experts for CPG eligibility criteria and (2) an upper-level ontology derived from a semantic pattern-based approach for automatic KA from CPG eligibility criteria text. Then we discuss the strengths and limitations of interweaving KA and NLP for KR purposes and important considerations for achieving the symbiosis of KR and NLP for structuring CPGs to achieve evidence-based clinical practice. PMID:24943582

  2. Structural brain MRI studies in eye diseases: are they clinically relevant? A review of current findings.

    PubMed

    Prins, Doety; Hanekamp, Sandra; Cornelissen, Frans W

    2016-03-01

    Many eye diseases reduce visual acuity or are associated with visual field defects. Because of the well-defined retinotopic organization of the connections of the visual pathways, this may affect specific parts of the visual pathways and cortex, as a result of either deprivation or transsynaptic degeneration. For this reason, over the past several years, numerous structural magnetic resonance imaging (MRI) studies have examined the association of eye diseases with pathway and brain changes. Here, we review structural MRI studies performed in human patients with the eye diseases albinism, amblyopia, hereditary retinal dystrophies, age-related macular degeneration (AMD) and glaucoma. We focus on two main questions. First, what have these studies revealed? Second, what is the potential clinical relevance of their findings? We find that all the aforementioned eye diseases are indeed associated with structural changes in the visual pathways and brain. As such changes have been described in very different eye diseases, in our view the most parsimonious explanation is that these are caused by the loss of visual input and the subsequent deprivation of the visual pathways and brain regions, rather than by transsynaptic degeneration. Moreover, and of clinical relevance, for some of the diseases - in particular glaucoma and AMD - present results are compatible with the view that the eye disease is part of a more general neurological or neurodegenerative disorder that also affects the brain. Finally, establishing structural changes of the visual pathways has been relevant in the context of new therapeutic strategies to restore retinal function: it implies that restoring retinal function may not suffice to also effectively restore vision. Future structural MRI studies can contribute to (i) further establish relationships between ocular and neurological neurodegenerative disorders, (ii) investigate whether brain degeneration in eye diseases is reversible, (iii) evaluate the use

  3. Love Objects.

    ERIC Educational Resources Information Center

    Cusack, Lynne

    1998-01-01

    Discusses the role of "security" or "transition" objects, such as a blanket or stuffed toy, in children's development of self-comfort and autonomy. Notes the influence of parents in the child-object relationship, and discusses children's responses to losing a security object, and the developmental point at which a child will give up such an…

  4. Structural and biomechanical aspects of equine sacroiliac joint function and their relationship to clinical disease.

    PubMed

    Goff, L M; Jeffcott, L B; Jasiewicz, J; McGowan, C M

    2008-06-01

    Pain originating from the sacroiliac joint (SIJ) in horses has long been associated with poor performance, yet specific diagnosis of sacroiliac dysfunction (SID) has been difficult to achieve. Clinical presentation of SID appears to fall into two categories. The first, presenting as pain and poor performance, is responsive to local analgesia of periarticular structures with poorly defined pathology. The second presents primarily as poor performance with bony pathological changes as a result of chronic instability. Diagnostic tests based on biomechanics as well as manual provocation for SIJ pain have formed the basis of tests currently used to diagnose SIJ dysfunction in humans. This review summarises the anatomy and biomechanics of the equine SIJ and current biomechanical, innervation and motor control concepts in human SID. The relationship between abnormal SIJ motion and altered neuromotor control with clinical disease of the equine SIJ are discussed. Future utilisation of these principles to develop new diagnostic and management tools for the equine SID is promising. PMID:17493851

  5. Clitics and Object Expression in the L3 Acquisition of Brazilian Portuguese: Structural Similarity Matters for Transfer

    ERIC Educational Resources Information Center

    Montrul, Silvina; Dias, Rejanes; Santos, Helade

    2011-01-01

    This article addresses the role of previously acquired languages in the acquisition of a third language (L3) in two experimental studies on object expression in Brazilian Portuguese (BP). Participants were English-speaking learners of BP as L3 with knowledge of Spanish as a second language (L2) and Spanish-speaking learners of BP with knowledge of…

  6. Population genetic structure of clinical and environmental isolates of Blastomyces dermatitidis, Based on 27 Polymorphic Microsatellite Markers

    USGS Publications Warehouse

    Meece, J.K.; Anderson, J.L.; Fisher, M.C.; Henk, D.A.; Sloss, Brian L.; Reed, K.D.

    2011-01-01

    Blastomyces dermatitidis, a thermally dimorphic fungus, is the etiologic agent of North American blastomycosis. Clinical presentation is varied, ranging from silent infections to fulminant respiratory disease and dissemination to skin and other sites. Exploration of the population genetic structure of B. dermatitidis would improve our knowledge regarding variation in virulence phenotypes, geographic distribution, and difference in host specificity. The objective of this study was to develop and test a panel of microsatellite markers to delineate the population genetic structure within a group of clinical and environmental isolates of B. dermatitidis. We developed 27 microsatellite markers and genotyped B. dermatitidis isolates from various hosts and environmental sources (n = 112). Assembly of a neighbor-joining tree of allele-sharing distance revealed two genetically distinct groups, separated by a deep node. Bayesian admixture analysis showed that two populations were statistically supported. Principal coordinate analysis also reinforced support for two genetic groups, with the primary axis explaining 61.41% of the genetic variability. Group 1 isolates average 1.8 alleles/locus, whereas group 2 isolates are highly polymorphic, averaging 8.2 alleles/locus. In this data set, alleles at three loci are unshared between the two groups and appear diagnostic. The mating type of individual isolates was determined by PCR. Both mating type-specific genes, the HMG and ??-box domains, were represented in each of the genetic groups, with slightly more isolates having the HMG allele. One interpretation of this study is that the species currently designated B. dermatitidis includes a cryptic subspecies or perhaps a separate species. ?? 2011, American Society for Microbiology.

  7. Locating Relevant Patient Information in Electronic Health Record Data Using Representations of Clinical Concepts and Database Structures

    PubMed Central

    Pan, Xuequn; Cimino, James J.

    2014-01-01

    Clinicians and clinical researchers often seek information in electronic health records (EHRs) that are relevant to some concept of interest, such as a disease or finding. The heterogeneous nature of EHRs can complicate retrieval, risking incomplete results. We frame this problem as the presence of two gaps: 1) a gap between clinical concepts and their representations in EHR data and 2) a gap between data representations and their locations within EHR data structures. We bridge these gaps with a knowledge structure that comprises relationships among clinical concepts (including concepts of interest and concepts that may be instantiated in EHR data) and relationships between clinical concepts and the database structures. We make use of available knowledge resources to develop a reproducible, scalable process for creating a knowledge base that can support automated query expansion from a clinical concept to all relevant EHR data. PMID:25954405

  8. An empirical assessment of social structural and cultural change in clinical directorates.

    PubMed

    Braithwaite, Jeffrey

    2006-12-01

    The results of two observational studies of clinical directorates (CDs) are presented. The paper exposes fresh perspectives about the management of hospitals and CDs, and suggests that the most important axis on which hospital decision-making rests continues to be profession rather than the CD, even though CDs are designed at least in part to mitigate professional tribalism and bridge professional divides. In empiricising social structural and cultural theories it seems clear that changes to the prescribed organisational framework, which CDs represent, have had negligible effects on behaviour. This being the case, the paper questions the benefits alleged to have accrued from establishing CDs and calls for more effective, micro-behavioural change strategies than merely altering the structure. PMID:17214253

  9. Structural determination of the polysaccharide isolated from biofilms produced by a clinical strain of Klebsiella pneumoniae.

    PubMed

    Cescutti, Paola; De Benedetto, Gianluigi; Rizzo, Roberto

    2016-07-22

    Klebsiella pneumoniae are Gram negative opportunistic pathogens producing capsular (K) polysaccharides. Seventy-seven different K antigens have been described and they are the basis for K serotyping. Capsular polysaccharides are important virulence factors and have a relevant role for the structure of biofilm communities. Nevertheless, little information is available on the polysaccharides produced in biofilm matrices by Klebsiella spp. In the present study, a clinical isolate of Klebsiella pneumoniae was grown both on cellulose membranes deposited on agar plates, where it formed an adherent biofilm, and in liquid medium, where it formed floating biofilms (flocs). Extraction and purification of the polysaccharide fraction showed that only one main carbohydrate polymer was present in both adherent biofilms and flocs. Composition and linkage analysis, Smith degradation followed by ESI-MS, 1D and 2D NMR spectroscopy revealed that the polysaccharide belong to the type K24 and has the following structure. PMID:27182661

  10. The Structure of Pathological Gambling among Korean Gamblers: A Cluster and Factor Analysis of Clinical and Demographic Characteristics

    ERIC Educational Resources Information Center

    Lee, Tae Kyung; LaBrie, Richard A.; Grant, Jon E.; Kim, Suck Won; Shaffer, Howard J.

    2008-01-01

    This paper reports the underlying structure of the demographic and clinical characteristics of level 3 (i.e., pathological) Korean casino gamblers. The participants reported their gambling behavior and clinical characteristics known to be associated with gambling problems (e.g., alcohol use problems, eating disorders, depression, anxiety, and…

  11. Narrowband Near-Infrared Imaging of Young Planetary Nebulae and Transition Objects: Probing Core and Halo Structures

    NASA Technical Reports Server (NTRS)

    Hora, Joseph L.; Latter, William B.

    1997-01-01

    The new images presented here have high spatial resolution and are very sensitive to low levels of emission. We compare our new data to existing imaging and spectroscopic data to give clues as to the structure and formation of planetary nebulae, the role of shocks, and the evolution of photon-dominated regions.

  12. A Multi-Objective Approach for Protein Structure Prediction Based on an Energy Model and Backbone Angle Preferences

    PubMed Central

    Tsay, Jyh-Jong; Su, Shih-Chieh; Yu, Chin-Sheng

    2015-01-01

    Protein structure prediction (PSP) is concerned with the prediction of protein tertiary structure from primary structure and is a challenging calculation problem. After decades of research effort, numerous solutions have been proposed for optimisation methods based on energy models. However, further investigation and improvement is still needed to increase the accuracy and similarity of structures. This study presents a novel backbone angle preference factor, which is one of the factors inducing protein folding. The proposed multiobjective optimisation approach simultaneously considers energy models and backbone angle preferences to solve the ab initio PSP. To prove the effectiveness of the multiobjective optimisation approach based on the energy models and backbone angle preferences, 75 amino acid sequences with lengths ranging from 22 to 88 amino acids were selected from the CB513 data set to be the benchmarks. The data sets were highly dissimilar, therefore indicating that they are meaningful. The experimental results showed that the root-mean-square deviation (RMSD) of the multiobjective optimization approach based on energy model and backbone angle preferences was superior to those of typical energy models, indicating that the proposed approach can facilitate the ab initio PSP. PMID:26151847

  13. An algorithm to unveil the inner structure of objects concealed by beam divergence in radiographic image acquisition systems

    NASA Astrophysics Data System (ADS)

    Almeida, G. L.; Silvani, M. I.; Lopes, R. T.

    2014-11-01

    Two main parameters rule the performance of an Image Acquisition System, namely, spatial resolution and contrast. For radiographic systems using cone beam arrangements, the farther the source, the better the resolution, but the contrast would diminish due to the lower statistics. A closer source would yield a higher contrast but it would no longer reproduce the attenuation map of the object, as the incoming beam flux would be reduced by unequal large divergences and attenuation factors. This work proposes a procedure to correct these effects when the object is comprised of a hull - or encased in it - possessing a shape capable to be described in analytical geometry terms. Such a description allows the construction of a matrix containing the attenuation factors undergone by the beam from the source until its final destination at each coordinate on the 2D detector. Each matrix element incorporates the attenuation suffered by the beam after its travel through the hull wall, as well as its reduction due to the square of distance to the source and the angle it hits the detector surface. When the pixel intensities of the original image are corrected by these factors, the image contrast, reduced by the overall attenuation in the exposure phase, are recovered, allowing one to see details otherwise concealed due to the low contrast. In order to verify the soundness of this approach, synthetic images of objects of different shapes, such as plates and tubes, incorporating defects and statistical fluctuation, have been generated, recorded for further comparison and afterwards processed to improve their contrast. The developed algorithm which, generates processes and plots the images has been written in Fortran 90 language. As the resulting final images exhibit the expected improvements, it therefore seemed worthwhile to carry out further tests with actual experimental radiographies.

  14. An algorithm to unveil the inner structure of objects concealed by beam divergence in radiographic image acquisition systems

    SciTech Connect

    Almeida, G. L.; Silvani, M. I.; Lopes, R. T.

    2014-11-11

    Two main parameters rule the performance of an Image Acquisition System, namely, spatial resolution and contrast. For radiographic systems using cone beam arrangements, the farther the source, the better the resolution, but the contrast would diminish due to the lower statistics. A closer source would yield a higher contrast but it would no longer reproduce the attenuation map of the object, as the incoming beam flux would be reduced by unequal large divergences and attenuation factors. This work proposes a procedure to correct these effects when the object is comprised of a hull - or encased in it - possessing a shape capable to be described in analytical geometry terms. Such a description allows the construction of a matrix containing the attenuation factors undergone by the beam from the source until its final destination at each coordinate on the 2D detector. Each matrix element incorporates the attenuation suffered by the beam after its travel through the hull wall, as well as its reduction due to the square of distance to the source and the angle it hits the detector surface. When the pixel intensities of the original image are corrected by these factors, the image contrast, reduced by the overall attenuation in the exposure phase, are recovered, allowing one to see details otherwise concealed due to the low contrast. In order to verify the soundness of this approach, synthetic images of objects of different shapes, such as plates and tubes, incorporating defects and statistical fluctuation, have been generated, recorded for further comparison and afterwards processed to improve their contrast. The developed algorithm which, generates processes and plots the images has been written in Fortran 90 language. As the resulting final images exhibit the expected improvements, it therefore seemed worthwhile to carry out further tests with actual experimental radiographies.

  15. Multi-objective genetic algorithms based structural optimization and experimental investigation of the planet carrier in wind turbine gearbox

    NASA Astrophysics Data System (ADS)

    Yi, Pengxing; Dong, Lijian; Shi, Tielin

    2014-12-01

    To improve the dynamic performance and reduce the weight of the planet carrier in wind turbine gearbox, a multi-objective optimization method, which is driven by the maximum deformation, the maximum stress and the minimum mass of the studied part, is proposed by combining the response surface method and genetic algorithms in this paper. Firstly, the design points' distribution for the design variables of the planet carrier is established with the central composite design (CCD) method. Then, based on the computing results of finite element analysis (FEA), the response surface analysis is conducted to find out the proper sets of design variable values. And a multi-objective genetic algorithm (MOGA) is applied to determine the direction of optimization. As well, this method is applied to design and optimize the planet carrier in a 1.5MW wind turbine gearbox, the results of which are validated by an experimental modal test. Compared with the original design, the mass and the stress of the optimized planet carrier are respectively reduced by 9.3% and 40%. Consequently, the cost of planet carrier is greatly reduced and its stability is also improved.

  16. Population Structure of Clinical Vibrio parahaemolyticus from 17 Coastal Countries, Determined through Multilocus Sequence Analysis

    PubMed Central

    Lu, Jun; Wang, Guangzhou; Zhou, Lin; Min, Lingfeng; Han, Chongxu

    2014-01-01

    Vibrio parahaemolyticus is a leading cause of food-borne gastroenteritis worldwide. Although this bacterium has been the subject of much research, the population structure of clinical strains from worldwide collections remains largely undescribed, and the recorded outbreaks of V. parahaemolyticus gastroenteritis highlight the need for the subtyping of this species. We present a broad phylogenetic analysis of 490 clinical V. parahaemolyticus isolates from 17 coastal countries through multilocus sequence analysis (MLST). The 490 tested isolates fell into 161 sequence types (STs). The eBURST algorithm revealed that the 161 clinically relevant STs belonged to 8 clonal complexes, 11 doublets, and 94 singletons, showing a high level of genetic diversity. CC3 was found to be a global epidemic clone of V. parahaemolyticus, and ST-3 was the only ST with an international distribution. recA was observed to be evolving more rapidly, exhibiting the highest degree of nucleotide diversity (0.028) and the largest number of polymorphic nucleotide sites (177). We also found that the high variability of recA was an important cause of differences between the results of the eBURST and ME tree analyses, suggesting that recA has a much greater influence on the apparent evolutionary classification of V. parahaemolyticus based on the current MLST scheme. In conclusion, it is evident that a high degree of genetic diversity within the V. parahaemolyticus population and multiple sequence types are contributing to the burden of disease around the world. MLST, with a fully extractable database, is a powerful system for analysis of the clonal relationships of strains at a global scale. With the addition of more strains, the pubMLST database will provide more detailed and accurate information, which will be conducive to our future research on the population structure of V. parahaemolyticus. PMID:25225911

  17. Shoulder Structure and Function Following the Modified Latarjet Procedure: A Clinical and Radiological Review

    PubMed Central

    Garewal, Devinder; Evans, Mathew; Taylor, David; Hoy, Gregory A.; Barwood, Shane; Connell, David

    2013-01-01

    Background To evaluate the clinical and radiological outcomes of the modified Latarjet procedure for traumatic, antero-inferior glenohumeral joint instability. Methods Case series were used with a mean follow-up of 21.3 months for clinical and radiological review and 47.2 months for recurrent instability. Shoulder function was evaluated by clinical examination and validated shoulder scales: Western Ontario Shoulder Stability Index (WOSI), Melbourne Instability Shoulder Score (MISS) and l'Insalata Shoulder Questionnaire. Shoulder structure was evaluated by computed tomography. Results Thirty-two cases were enrolled (mean age 27.0 years). One patient reported a redislocation during the follow-up period. Clinical examination revealed that the median external rotation (at 0° and 90° abduction) was reduced on the operative side by 7.5° (p < 0.01) and 10° (p < 0.001), respectively. Subjective shoulder function was good. Mean (SD) scores on the WOSI, MISS and l'Insalata scales were 78.0 (19.7), 75.8 (11.5) and 89.3 (9.9), respectively. No loss of subscapularis strength was identified (p > 0.05). Radiological evaluation revealed a mean (SD) pre-operative glenoid surface area loss of 169.5 (48.5) mm2 reconstituted surgically by a bone block of 225.4 (73.8) mm2. Subscapularis muscle bulk was reduced on the operative side, above the level of the muscle split (p < 0.05). Conclusions The Latarjet procedure reliably restores lost glenoid surface area, shoulder stability, strength and function. A small loss of external rotation is expected and related to altered subscapularis anatomy.

  18. Objective lens

    NASA Technical Reports Server (NTRS)

    Olczak, Eugene G. (Inventor)

    2011-01-01

    An objective lens and a method for using same. The objective lens has a first end, a second end, and a plurality of optical elements. The optical elements are positioned between the first end and the second end and are at least substantially symmetric about a plane centered between the first end and the second end.

  19. Dynamic neuronal ensembles: Issues in representing structure change in object-oriented, biologically-based brain models

    SciTech Connect

    Vahie, S.; Zeigler, B.P.; Cho, H.

    1996-12-31

    This paper describes the structure of dynamic neuronal ensembles (DNEs). DNEs represent a new paradigm for learning, based on biological neural networks that use variable structures. We present a computational neural element that demonstrates biological neuron functionality such as neurotransmitter feedback absolute refractory period and multiple output potentials. More specifically, we will develop a network of neural elements that have the ability to dynamically strengthen, weaken, add and remove interconnections. We demonstrate that the DNE is capable of performing dynamic modifications to neuron connections and exhibiting biological neuron functionality. In addition to its applications for learning, DNEs provide an excellent environment for testing and analysis of biological neural systems. An example of habituation and hyper-sensitization in biological systems, using a neural circuit from a snail is presented and discussed. This paper provides an insight into the DNE paradigm using models developed and simulated in DEVS.

  20. Scaling Out and Evaluation of OBSecAn, an Automated Section Annotator for Semi-Structured Clinical Documents, on a Large VA Clinical Corpus

    PubMed Central

    Tran, Le-Thuy T.; Divita, Guy; Redd, Andrew; Carter, Marjorie E.; Samore, Matthew; Gundlapalli, Adi V.

    2015-01-01

    “Identifying and labeling” (annotating) sections improves the effectiveness of extracting information stored in the free text of clinical documents. OBSecAn, an automated ontology-based section annotator, was developed to identify and label sections of semi-structured clinical documents from the Department of Veterans Affairs (VA). In the first step, the algorithm reads and parses the document to obtain and store information regarding sections into a structure that supports the hierarchy of sections. The second stage detects and makes correction to errors in the parsed structure. The third stage produces the section annotation output using the final parsed tree. In this study, we present the OBSecAn method and its scale to a million document corpus and evaluate its performance in identifying family history sections. We identify high yield sections for this use case from note titles such as primary care and demonstrate a median rate of 99% in correctly identifying a family history section. PMID:26958260

  1. Self-imaging of transparent objects and structures in focusing of spatially phase-modulated laser radiation into a weakly absorbing medium

    SciTech Connect

    Bubis, E L

    2011-06-30

    Self-imaging of transparent objects and structures in focusing of a spatially phase-modulated laser beam into an extended weakly absorbing medium is described. The laser power level that is necessary for effective imaging corresponds to the illuminating beam power when thermal self-defocusing starts evolving in the medium. The effect can be described in terms of the ideology of Zernike's classical phase-contrast method. Edge enhancement in visualised images of transparent objects is experimentally demonstrated. Self-imaging of a microscopic object in the form of transparent letters and long-lived refractive-index fluctuations in liquid glycerol is shown. Due to the adaptivity of the process under consideration, unlike the classical case, self-imaging occurs also in the situations where a beam is displaced (undergoes random walk) as a whole in the Fourier plane, for example, in the presence of thermal flows. (image processing)

  2. Trusted Objects

    SciTech Connect

    CAMPBELL,PHILIP L.; PIERSON,LYNDON G.; WITZKE,EDWARD L.

    1999-10-27

    In the world of computers a trusted object is a collection of possibly-sensitive data and programs that can be allowed to reside and execute on a computer, even on an adversary's machine. Beyond the scope of one computer we believe that network-based agents in high-consequence and highly reliable applications will depend on this approach, and that the basis for such objects is what we call ''faithful execution.''

  3. Clinical significance of knowledge about the structure, function, and impairments of working memory

    PubMed Central

    Brodziak, Andrzej; Brewczyński, Adam; Bajor, Grzegorz

    2013-01-01

    A review of contemporary research on the working memory system (WMS) is important, both due to the need to focus the discussion on further necessary investigations on the structure and function of this key part of the human brain, as well as to share this knowledge with clinicians. In our introduction we try to clarify the actual terminology and provide an intuitively understandable model for 3 basic cognitive operations: perception, recognition, imagery, and manipulation of recalled mental images. We emphasize the importance of knowledge of the structure and function of the WMS for the possibility to demonstrate the links between genetic polymorphisms and the prevalence to some mental disorders. We also review current knowledge of working memory dysfunction in the most common diseases and specific clinical situations such as maturation and aging. Finally, we briefly discuss methods for assessment of WMS capacity. This article establishes a kind of compendium of knowledge for clinicians who are not familiar with the structure and operation of the WMS. PMID:23645218

  4. Effects of the SpeechEasy on Objective and Perceived Aspects of Stuttering: A 6-Month, Phase I Clinical Trial in Naturalistic Environments

    ERIC Educational Resources Information Center

    Pollard, Ryan; Ellis, John B.; Finan, Don; Ramig, Peter R.

    2009-01-01

    Purpose: Effects of the SpeechEasy when used under extraclinical conditions over several months were investigated. Primary purposes were to help establish Phase I level information about the therapeutic utility of the SpeechEasy and to compare those results with previous findings obtained in laboratory and clinical settings. Method: Eleven adults…

  5. Relationship Between Foveal Cone Structure and Clinical Measures of Visual Function in Patients With Inherited Retinal Degenerations

    PubMed Central

    Ratnam, Kavitha; Carroll, Joseph; Porco, Travis C.; Duncan, Jacque L.; Roorda, Austin

    2013-01-01

    Purpose. To study the relationship between cone spacing and density and clinical measures of visual function near the fovea. Methods. High-resolution images of the photoreceptor mosaic were obtained with adaptive optics scanning laser ophthalmoscopy from 26 patients with inherited retinal degenerations. Cone spacing measures were made close to or at the foveal center (mean [SD] eccentricity, 0.02 [0.03] degree; maximum eccentricity, 0.13 degree) and were converted to Z-scores, fraction of cones, and percentage-of-cones-below-average compared with normal values for each location (based on 37 age-similar visually normal eyes). Z-scores and percentage of cones below average were compared with best-corrected visual acuity (VA) and foveal sensitivity. Results. Visual acuity was significantly correlated with cone spacing (Spearman rank correlation ρ = −0.60, P = 0.003) and was preserved (≥80 letters), despite cone density measures that were 52% below normal. Foveal sensitivity showed significant correlation with cone spacing (ρ = −0.47, P = 0.017) and remained normal (≥35 decibels), despite density measures that were approximately 52% to 62% below normal. Conclusions. Cone density was reduced by up to 62% below normal at or near the fovea in eyes with VA and sensitivity that remained within normal limits. Despite a significant correlation with foveal cone spacing, VA and sensitivity are insensitive indicators of the integrity of the foveal cone mosaic. Direct, objective measures of cone structure may be more sensitive indicators of disease severity than VA or foveal sensitivity in eyes with inherited retinal degenerations. (ClinicalTrials.gov number, NCT00254605.) PMID:23908179

  6. The management of a sexually charged clinical problem: social structural and psychoanalytic functionalist approaches in a therapeutic community.

    PubMed

    James, O W

    1986-03-01

    An event in a therapeutic community is examined from the perspectives of the structuralism of Durkheim and the functionalism of psychoanalysis. Although these two approaches might appear theoretically contradictory, analysis of the evidence shows them to be clinically complementary. The role of social structure in therapeutic communities requires deliberate conceptualization if such communities are to be demonstrably therapeutic. PMID:3964583

  7. Structural barriers to timely initiation of antiretroviral treatment in Vietnam: findings from six outpatient clinics.

    PubMed

    Tran, Dam Anh; Shakeshaft, Anthony; Ngo, Anh Duc; Rule, John; Wilson, David P; Zhang, Lei; Doran, Christopher

    2012-01-01

    In Vietnam, premature mortality due to AIDS-related conditions is commonly associated with late initiation to antiretroviral therapy (ART). This study explores reasons for late ART initiation among people living with HIV (PLHIV) from the perspectives of health care providers and PLHIV. The study was undertaken in six clinics from five provinces in Vietnam. Baseline CD4 counts were collected from patient records and grouped into three categories: very late initiators (≤100 cells/mm(3) CD4), late initiators (100-200 cells/mm(3)) and timely initiators (200-350 cells/mm(3)). Thirty in-depth interviews with patients who started ART and 15 focus group discussions with HIV service providers were conducted and thematic analysis of the content performed. Of 934 patients, 62% started ART very late and 11% initiated timely treatment. The proportion of patients for whom a CD4 count was obtained within six months of their HIV diagnosis ranged from 22% to 72%. The proportion of patients referred to ART clinics by voluntary testing and counselling centres ranged from 1% to 35%. Structural barriers to timely ART initiation were poor linkage between HIV testing and HIV care and treatment services, lack of patient confidentiality and a shortage of HIV/AIDS specialists. If Vietnam's treatment practice is to align with WHO recommendations then the connection between voluntary counselling and testing service and ART clinics must be improved. Expansion and decentralization of HIV/AIDS services to allow implementation at the community level increased task sharing between doctors and nurses to overcome limited human resources, and improved patient confidentiality are likely to increase timely access to HIV treatment services for more patients. PMID:23240013

  8. The validity and clinical utility of structured diagnoses of antisocial personality disorder with forensic patients.

    PubMed

    Marin-Avellan, Luisa E; McGauley, Gillian A; Campbell, Colin D; Fonagy, Peter

    2014-08-01

    Current DSM-based instruments for personality disorders (PDs) limit the investigation of the course and outcome of treatment of these disorders. This study examined the validity of the Shedler-Westen Assessment Procedure-200 (SWAP-200) and the Structured Clinical Interview for DSM-IV Axis II PD (SCID-II) in a sample of forensic PD patients. Results based on 66 participants indicated that the SWAP-200 Q-factors reduced the frequency of diagnostic comorbidity of PD categories by half compared with the SCID-II. Only the SWAP-200's Antisocial PD category showed good convergent and discriminant validity with respect to other instruments describing aspects of PD. The validity of the cutoff score for severe antisocial PD was confirmed, and this category predicted severe incidents in the hospital at 1 year of follow-up. A violence risk scale was constructed, which differentiated violent and nonviolent offenders. The results support the validity of the SWAP-200 and its potential clinical utility with forensic PD patients. PMID:24511901

  9. Structure Based In Silico Analysis of Quinolone Resistance in Clinical Isolates of Salmonella Typhi from India

    PubMed Central

    Sharma, Priyanka; Sharma, Sujata; Singh, Tej P.; Kapil, Arti; Kaur, Punit

    2015-01-01

    Enteric fever is a major cause of morbidity in several parts of the Indian subcontinent. The treatment for typhoid fever majorly includes the fluoroquinolone group of antibiotics. Excessive and indiscriminate use of these antibiotics has led to development of acquired resistance in the causative organism Salmonella Typhi. The resistance towards fluoroquinolones is associated with mutations in the target gene of DNA Gyrase. We have estimated the Minimum Inhibitory Concentration (MIC) of commonly used fluoroquinolone representatives from three generations, ciprofloxacin, ofloxacin, levofloxacin and moxifloxacin, for 100 clinical isolates of Salmonella Typhi from patients in the Indian subcontinent. The MICs have been found to be in the range of 0.032 to 8 μg/ml. The gene encoding DNA Gyrase was subsequently sequenced and point mutations were observed in DNA Gyrase in the quinolone resistance determining region comprising Ser83Phe/Tyr and Asp87Tyr/Gly. The binding ability of these four fluoroquinolones in the quinolone binding pocket of wild type as well as mutant DNA Gyrase was computationally analyzed by molecular docking to assess their differential binding behaviour. This study has revealed that mutations in DNA Gyrase alter the characteristics of the binding pocket resulting in the loss of crucial molecular interactions and consequently decrease the binding affinity of fluoroquinolones with the target protein. The present study assists in understanding the underlying molecular and structural mechanism for decreased fluoroquinolone susceptibility in clinical isolates as a consequence of mutations in DNA Gyrase. PMID:25962113

  10. Clinical review: Clinical management of new oral anticoagulants: a structured review with emphasis on the reversal of bleeding complications

    PubMed Central

    2013-01-01

    New oral anticoagulants, including dabigatran, rivaroxaban, and apixaban, have been recently approved for primary and secondary prophylaxis of thromboembolic conditions. However, there is no clear strategy for managing and reversing their anticoagulant effects. We aimed to summarize the available evidence for clinical management and reversal of bleeding associated with new oral anticoagulants. Using a systematic review approach, we aimed to identify studies describing reversal strategies for dabigatran, rivaroxaban, and apixaban. The search was conducted using Medline, EMBASE, HealthSTAR, and grey literature. We included laboratory and human studies. We included 23 studies reported in 37 out of 106 potentially relevant references. Four studies were conducted in humans and the rest were in vitro and in vivo studies. The majority of the studies evaluated the use of prothrombinase complex concentrate (PCC), either activated or inactivated, and recombinant activated factor VII (rFVIIa). Other interventions were also identified. Laboratory studies suggest that hemostatic parameters and bleeding might be partially or completely corrected by PCC for rivaroxaban better than dabigatran. Studies in humans suggest that PCC might reverse the effects of rivaroxaban better than dabigatran assessed by hemostatic tests. We were not able to locate studies evaluating the clinical efficacy of these agents. The best available evidence suggests that PCC (activated or inactivated) might be the best option for reversing new anticoagulants. Evidence for rFVIIa is less compelling. There might be differences in the efficacy of reversing agents for different anticoagulants. Studies assessing the clinical efficacy of these reversal agents are urgently needed. PMID:23806169

  11. Mathematical Modeling of Human Glioma Growth Based on Brain Topological Structures: Study of Two Clinical Cases

    PubMed Central

    Suarez, Cecilia; Maglietti, Felipe; Colonna, Mario; Breitburd, Karina; Marshall, Guillermo

    2012-01-01

    Gliomas are the most common primary brain tumors and yet almost incurable due mainly to their great invasion capability. This represents a challenge to present clinical oncology. Here, we introduce a mathematical model aiming to improve tumor spreading capability definition. The model consists in a time dependent reaction-diffusion equation in a three-dimensional spatial domain that distinguishes between different brain topological structures. The model uses a series of digitized images from brain slices covering the whole human brain. The Talairach atlas included in the model describes brain structures at different levels. Also, the inclusion of the Brodmann areas allows prediction of the brain functions affected during tumor evolution and the estimation of correlated symptoms. The model is solved numerically using patient-specific parametrization and finite differences. Simulations consider an initial state with cellular proliferation alone (benign tumor), and an advanced state when infiltration starts (malign tumor). Survival time is estimated on the basis of tumor size and location. The model is used to predict tumor evolution in two clinical cases. In the first case, predictions show that real infiltrative areas are underestimated by current diagnostic imaging. In the second case, tumor spreading predictions were shown to be more accurate than those derived from previous models in the literature. Our results suggest that the inclusion of differential migration in glioma growth models constitutes another step towards a better prediction of tumor infiltration at the moment of surgical or radiosurgical target definition. Also, the addition of physiological/psychological considerations to classical anatomical models will provide a better and integral understanding of the patient disease at the moment of deciding therapeutic options, taking into account not only survival but also life quality. PMID:22761843

  12. Reduced-Order Modeling and Wavelet Analysis of Turbofan Engine Structural Response Due to Foreign Object Damage (FOD) Events

    NASA Technical Reports Server (NTRS)

    Turso, James; Lawrence, Charles; Litt, Jonathan

    2004-01-01

    The development of a wavelet-based feature extraction technique specifically targeting FOD-event induced vibration signal changes in gas turbine engines is described. The technique performs wavelet analysis of accelerometer signals from specified locations on the engine and is shown to be robust in the presence of significant process and sensor noise. It is envisioned that the technique will be combined with Kalman filter thermal/health parameter estimation for FOD-event detection via information fusion from these (and perhaps other) sources. Due to the lack of high-frequency FOD-event test data in the open literature, a reduced-order turbofan structural model (ROM) was synthesized from a finite element model modal analysis to support the investigation. In addition to providing test data for algorithm development, the ROM is used to determine the optimal sensor location for FOD-event detection. In the presence of significant noise, precise location of the FOD event in time was obtained using the developed wavelet-based feature.

  13. Reduced-Order Modeling and Wavelet Analysis of Turbofan Engine Structural Response Due to Foreign Object Damage "FOD" Events

    NASA Technical Reports Server (NTRS)

    Turso, James A.; Lawrence, Charles; Litt, Jonathan S.

    2007-01-01

    The development of a wavelet-based feature extraction technique specifically targeting FOD-event induced vibration signal changes in gas turbine engines is described. The technique performs wavelet analysis of accelerometer signals from specified locations on the engine and is shown to be robust in the presence of significant process and sensor noise. It is envisioned that the technique will be combined with Kalman filter thermal/ health parameter estimation for FOD-event detection via information fusion from these (and perhaps other) sources. Due to the lack of high-frequency FOD-event test data in the open literature, a reduced-order turbofan structural model (ROM) was synthesized from a finite-element model modal analysis to support the investigation. In addition to providing test data for algorithm development, the ROM is used to determine the optimal sensor location for FOD-event detection. In the presence of significant noise, precise location of the FOD event in time was obtained using the developed wavelet-based feature.

  14. Application of CYP3A4 in vitro data to predict clinical drug–drug interactions; predictions of compounds as objects of interaction

    PubMed Central

    Youdim, Kuresh A; Zayed, Aref; Dickins, Maurice; Phipps, Alex; Griffiths, Michelle; Darekar, Amanda; Hyland, Ruth; Fahmi, Odette; Hurst, Susan; Plowchalk, David R; Cook, Jack; Guo, Feng; Obach, R Scott

    2008-01-01

    AIMS The aim of this study was to explore and optimize the in vitro and in silico approaches used for predicting clinical DDIs. A data set containing clinical information on the interaction of 20 Pfizer compounds with ketoconazole was used to assess the success of the techniques. METHODS The study calculated the fraction and the rate of metabolism of 20 Pfizer compounds via each cytochrome P450. Two approaches were used to determine fraction metabolized (fm); 1) by measuring substrate loss in human liver microsomes (HLM) in the presence and absence of specific chemical inhibitors and 2) by measuring substrate loss in individual cDNA expressed P450s (also referred to as recombinant P450s (rhCYP)) The fractions metabolized via each CYP were used to predict the drug–drug interaction due to CYP3A4 inhibition by ketoconazole using the modelling and simulation software SIMCYP®. RESULTS When in vitro data were generated using Gentest supersomes, 85% of predictions were within two-fold of the observed clinical interaction. Using PanVera baculosomes, 70% of predictions were predicted within two-fold. In contrast using chemical inhibitors the accuracy was lower, predicting only 37% of compounds within two-fold of the clinical value. Poorly predicted compounds were found to either be metabolically stable and/or have high microsomal protein binding. The use of equilibrium dialysis to generate accurate protein binding measurements was especially important for highly bound drugs. CONCLUSIONS The current study demonstrated that the use of rhCYPs with SIMCYP® provides a robust in vitro system for predicting the likelihood and magnitude of changes in clinical exposure of compounds as a consequence of CYP3A4 inhibition by a concomitantly administered drug. WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT Numerous retrospective analyses have shown the utility of in vitro systems for predicting potential drug–drug interactions (DDIs). Prediction of DDIs from in vitro data is commonly

  15. Setting Objectives

    ERIC Educational Resources Information Center

    Elkins, Aaron J.

    1977-01-01

    The author questions the extent to which educators have relied on "relevance" and learner participation in objective-setting in the past decade. He describes a useful approach to learner-oriented evaluation in which content relevance was not judged by participants until after they had been exposed to it. (MF)

  16. Paranoid personality has a dimensional latent structure: taxometric analyses of community and clinical samples.

    PubMed

    Edens, John F; Marcus, David K; Morey, Leslie C

    2009-08-01

    Although paranoid personality is one of the most commonly diagnosed personality disorders and is associated with numerous negative life consequences, relatively little is known about the structural properties of this condition. This study examines whether paranoid personality traits represent a latent dimension or a discrete class (i.e., taxon). In Study 1, the authors conducted taxometric analyses of paranoid personality disorder criteria in a sample of 731 patients participating in the Collaborative Longitudinal Study of Personality Disorders project (Gunderson et al., 2000) who had been administered a semistructured diagnostic interview for personality disorders according to criteria of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994). In Study 2, the authors conducted parallel analyses of the Paranoia scale of the Personality Assessment Inventory (PAI; L. C. Morey, 2007), using data from the PAI community and clinical normative databases. Analyses across both self-report and interview-based indicators offered compelling support for a dimensional structure. Additionally, analyses of external correlates in these data sets suggested that dimensional models demonstrated stronger validity coefficients with criterion measures than did dichotomous models. PMID:19685951

  17. CT Lesion Model-Based Structural Allografts: Custom Fabrication and Clinical Experience

    PubMed Central

    Brune, Jan Claas; Hesselbarth, Uwe; Seifert, Philipp; Nowack, Dimitri; von Versen, Rüdiger; Smith, Mark David; Seifert, Dirk

    2012-01-01

    Summary Background Patients requiring knee and hip revision arthroplasty often present with difficult anatomical situations that limit options for surgery. Customised mega-implants may be one of few remaining treatment options. However, extensive damage to residual bone stock may also be present, and in such cases even customised prosthetics may be difficult to implant. Small quantities of lost bone can be replaced with standard allografts or autologous bone. Larger defects may require structural macro-allografts, sometimes in combination with implants (allograft-prosthesis composites). Methods Herein, we describe a process for manufacturing lesion-specific large structural allografts according to a 3D, full-scale, lithographically generated defect model. These macro-allografts deliver the volume and the mechanical stability necessary for certain complex revisions. They are patient-and implant-matched, negate some requirements for additional implants and biomaterials and save time in the operating theatre by eliminating the requirement for intra-operative sizing and shaping of standard allografts. Conclusion While a robust data set from long-term follow-up of patients receiving customised macro-allografts is not yet available, initial clinical experience and results suggest that lesion-matched macro-allografts can be an important component of revision joint surgery. PMID:23800856

  18. Structure-activity relationship studies on clinically relevant HIV-1 NNRTIs.

    PubMed

    Rawal, R K; Murugesan, V; Katti, S B

    2012-01-01

    In addition to the nucleoside reverse transcriptase inhibitors (NRTIs), protease inhibitors (PIs) and integrase inhibitors (INIs), nonnucleoside reverse transcriptase inhibitors (NNRTIs) have contributed significantly in the treatment of HIV-1 infections. More than 60 structurally different classes of compounds have been identified as NNRTIs, which are specifically inhibiting HIV-1 reverse transcriptase (RT). Five NNRTIs (nevirapine, delavirdine, efavirenz, etravirine and rilpivirine) have been approved by US Food and Drug Administration (FDA) for clinical use. The NNRTIs bind with a specific 'pocket' site of HIV-1 RT (allosteric site) that is closely associated with the NRTI binding site. Due to mutations of the amino acid residues surrounding the NNRTI-binding site, NNRTIs are notorious for rapidly eliciting resistance. Though, the emergence of resistant HIV strains can be circumvented if the NNRTIs are used either alone or in combination with NRTIs (AZT, 3TC, ddI, ddC, TVD or d4T) and PIs (Indinavir, nelfinavir, saquinavir, ritonavir and lopinavir etc.) as shown by both a decrease in plasma HIV-1 RNA levels and increased CD4 T-cells. Here we are going to discuss recent advances in structure activity relationship studies on nevirapine, delavirdine, efavirenz, etravirine, rilpivirine and 4-thiazolidinones (privileged scaffold) HIV-1 NNRTIs. PMID:22998569

  19. Brain structural correlates of schizotypy and psychosis proneness in a non-clinical healthy volunteer sample.

    PubMed

    Nenadic, Igor; Lorenz, Carsten; Langbein, Kerstin; Dietzek, Maren; Smesny, Stefan; Schönfeld, Nils; Fañanás, Lourdes; Sauer, Heinrich; Gaser, Christian

    2015-10-01

    Schizotypal traits are phenotypic risk factors for schizophrenia, associated with biological changes across a putative schizophrenia spectrum. In this study, we tested the hypothesis that brain structural changes in key brain areas relevant to this spectrum (esp. medial and lateral prefrontal cortex) would vary across different degrees of schizotypal trait expression and/or phenotypic markers of psychosis proneness in healthy non-clinical volunteers. We analysed high-resolution 3Tesla magnetic resonance images (MRI) of 59 healthy volunteers using voxel-based morphometry (VBM), correlating grey matter values to the positive and negative symptom factors of the schizotypal personality questionnaire (SPQ, German version) and a measure of psychosis proneness (community assessment of psychic experiences, CAPE). We found positive correlations between positive SPQ dimension and bilateral inferior and right superior frontal cortices, and positive CAPE dimension and left inferior frontal cortex, as well as CAPE negative dimension and right supplementary motor area (SMA) and left inferior parietal cortex. However, only the positive correlation of the right precuneus with negative schizotypy scores was significant after FWE correction for multiple comparisons. Our findings confirm an effect of schizotypal traits and psychosis proneness on brain structure in healthy subjects, providing further support to a biological continuum model. PMID:26164819

  20. A distributed, collaborative, structuring model for a clinical-guideline digital-library.

    PubMed

    Shahar, Yuval; Shalom, Erez; Mayaffit, Alon; Young, Ohad; Galperin, Maya; Martins, Susana; Goldstein, Mary

    2003-01-01

    The Digital Electronic Guideline Library (DeGeL) is a Web-based framework and a set of distributed tools that facilitate gradual conversion of clinical guidelines from free text, through semi-structured text, to a fully structured, executable representation. Thus, guidelines exist in a hybrid, multiple-format representation The three formats support increasingly sophisticated computational tasks. The tools perform semantic markup, classification, search, and browsing, and support computational modules that we are developing, for run-time application and retrospective quality assessment. We describe the DeGeL architecture and its collaborative-authoring authorization model, which is based on (1) multiple medical-specialty authoring groups, each including a group manager who controls group authorizations, and (2) a hierarchical authorization model based on the different functions involved in the hybrid guideline-specification process. We have implemented the core modules of the DeGeL architecture and demonstrated distributed markup and retrieval using the knowledge roles of two guidelines ontologies (Asbru and GEM). We are currently evaluating several of the DeGeL tools. PMID:14728241

  1. Diverse clinical compounds alter the quaternary structure and inhibit the activity of an essential enzyme

    PubMed Central

    Lawrence, Sarah H.; Selwood, Trevor; Jaffe, Eileen K.

    2011-01-01

    An in vitro evaluation of the Johns Hopkins Clinical Compound Library demonstrates that certain drugs can alter the quaternary structure of an essential human protein. Human porphobilinogen synthase (HsPBGS) is an essential enzyme involved in heme biosynthesis; it exists as an equilibrium of high activity octamers, low activity hexamers, and alternate dimer configurations that dictate the stoichiometry and architecture of further assembly. Reduced HsPBGS activity is implicated in toxicities associated with lead poisoning and ALAD porphyria, the latter of which involves hexamer-favoring HsPBGS variants. A medium-throughput native PAGE mobility shift screen, coupled with evaluation of hits as HsPBGS inhibitors, revealed twelve drugs that stabilize the HsPBGS hexamer and inhibit HsPBGS activity in vitro. A detailed characterization of these effects is presented. Drug inhibition of HsPBGS in vivo by inducing hexamer formation would constitute an unprecedented mechanism for side effects. We suggest that small molecule perturbation of quaternary structure equilibria be considered as a general mechanism for drug action and side effects. PMID:21506274

  2. Why it is difficult to see the anima as a helpful object: critique and clinical relevance of the theory of archetypes.

    PubMed

    von Raffay, A

    2000-10-01

    This paper is divided into three parts. The first deals briefly with more general aspects of the theory of archetypes (as conceived by Jung); the second examines the anima archetype in rather more detail, because it is, apart from the self, the main archetype in Jung's thought; and the third discusses the clinical repercussions of the anima theory and of the theory of the archetypes in general. The various references to Jung himself and certain circumstances of his life are included here on the assumption that personal problems in his biography contributed decisively to the constitution of his theory, so that deeper insights accure if they are taken into account. PMID:11077760

  3. Quantitative structure-activity relationship models of clinical pharmacokinetics: clearance and volume of distribution.

    PubMed

    Gombar, Vijay K; Hall, Stephen D

    2013-04-22

    Reliable prediction of two fundamental human pharmacokinetic (PK) parameters, systemic clearance (CL) and apparent volume of distribution (Vd), determine the size and frequency of drug dosing and are at the heart of drug discovery and development. Traditionally, estimated CL and Vd are derived from preclinical in vitro and in vivo absorption, distribution, metabolism, and excretion (ADME) measurements. In this paper, we report quantitative structure-activity relationship (QSAR) models for prediction of systemic CL and steady-state Vd (Vdss) from intravenous (iv) dosing in humans. These QSAR models avoid uncertainty associated with preclinical-to-clinical extrapolation and require two-dimensional structure drawing as the sole input. The clean, uniform training sets for these models were derived from the compilation published by Obach et al. (Drug Metab. Disp. 2008, 36, 1385-1405). Models for CL and Vdss were developed using both a support vector regression (SVR) method and a multiple linear regression (MLR) method. The SVR models employ a minimum of 2048-bit fingerprints developed in-house as structure quantifiers. The MLR models, on the other hand, are based on information-rich electro-topological states of two-atom fragments as descriptors and afford reverse QSAR (RQSAR) analysis to help model-guided, in silico modulation of structures for desired CL and Vdss. The capability of the models to predict iv CL and Vdss with acceptable accuracy was established by randomly splitting data into training and test sets. On average, for both CL and Vdss, 75% of test compounds were predicted within 2.5-fold of the value observed and 90% of test compounds were within 5.0-fold of the value observed. The performance of the final models developed from 525 compounds for CL and 569 compounds for Vdss was evaluated on an external set of 56 compounds. The predictions were either better or comparable to those predicted by other in silico models reported in the literature. To

  4. [Achievement of therapeutic objectives].

    PubMed

    Mantilla, Teresa

    2014-07-01

    Therapeutic objectives for patients with atherogenic dyslipidemia are achieved by improving patient compliance and adherence. Clinical practice guidelines address the importance of treatment compliance for achieving objectives. The combination of a fixed dose of pravastatin and fenofibrate increases the adherence by simplifying the drug regimen and reducing the number of daily doses. The good tolerance, the cost of the combination and the possibility of adjusting the administration to the patient's lifestyle helps achieve the objectives for these patients with high cardiovascular risk. PMID:25043543

  5. Beyond Program Objectives.

    PubMed

    Baessler, Matthew; Best, William; Sexton, Martha

    2016-06-01

    Graduate students in eight diverse health care professional programs participated together in a pilot course entitled, "An Interprofessional Approach to Patient Care." Through postcourse discussions with the clinical nurse leader students, faculty discovered that beyond meeting program objectives, the nursing learners gained numerous unexpected insights about interprofessional collaborative practice. J Contin Educ Nurs. 2016;47(6):248-249. PMID:27232220

  6. Clinical prediction from structural brain MRI scans: a large-scale empirical study.

    PubMed

    Sabuncu, Mert R; Konukoglu, Ender

    2015-01-01

    Multivariate pattern analysis (MVPA) methods have become an important tool in neuroimaging, revealing complex associations and yielding powerful prediction models. Despite methodological developments and novel application domains, there has been little effort to compile benchmark results that researchers can reference and compare against. This study takes a significant step in this direction. We employed three classes of state-of-the-art MVPA algorithms and common types of structural measurements from brain Magnetic Resonance Imaging (MRI) scans to predict an array of clinically relevant variables (diagnosis of Alzheimer's, schizophrenia, autism, and attention deficit and hyperactivity disorder; age, cerebrospinal fluid derived amyloid-β levels and mini-mental state exam score). We analyzed data from over 2,800 subjects, compiled from six publicly available datasets. The employed data and computational tools are freely distributed ( https://www.nmr.mgh.harvard.edu/lab/mripredict), making this the largest, most comprehensive, reproducible benchmark image-based prediction experiment to date in structural neuroimaging. Finally, we make several observations regarding the factors that influence prediction performance and point to future research directions. Unsurprisingly, our results suggest that the biological footprint (effect size) has a dramatic influence on prediction performance. Though the choice of image measurement and MVPA algorithm can impact the result, there was no universally optimal selection. Intriguingly, the choice of algorithm seemed to be less critical than the choice of measurement type. Finally, our results showed that cross-validation estimates of performance, while generally optimistic, correlate well with generalization accuracy on a new dataset. PMID:25048627

  7. HIV-1 Protease with 20 Mutations Exhibits Extreme Resistance to Clinical Inhibitors through Coordinated Structural Rearrangements

    SciTech Connect

    Agniswamy, Johnson; Shen, Chen-Hsiang; Aniana, Annie; Sayer, Jane M.; Louis, John M.; Weber, Irene T.

    2012-06-28

    The escape mutant of HIV-1 protease (PR) containing 20 mutations (PR20) undergoes efficient polyprotein processing even in the presence of clinical protease inhibitors (PIs). PR20 shows >3 orders of magnitude decreased affinity for PIs darunavir (DRV) and saquinavir (SQV) relative to PR. Crystal structures of PR20 crystallized with yttrium, substrate analogue p2-NC, DRV, and SQV reveal three distinct conformations of the flexible flaps and diminished interactions with inhibitors through the combination of multiple mutations. PR20 with yttrium at the active site exhibits widely separated flaps lacking the usual intersubunit contacts seen in other inhibitor-free dimers. Mutations of residues 35-37 in the hinge loop eliminate interactions and perturb the flap conformation. Crystals of PR20/p2-NC contain one uninhibited dimer with one very open flap and one closed flap and a second inhibitor-bound dimer in the closed form showing six fewer hydrogen bonds with the substrate analogue relative to wild-type PR. PR20 complexes with PIs exhibit expanded S2/S2' pockets and fewer PI interactions arising from coordinated effects of mutations throughout the structure, in agreement with the strikingly reduced affinity. In particular, insertion of the large aromatic side chains of L10F and L33F alters intersubunit interactions and widens the PI binding site through a network of hydrophobic contacts. The two very open conformations of PR20 as well as the expanded binding site of the inhibitor-bound closed form suggest possible approaches for modifying inhibitors to target extreme drug-resistant HIV.

  8. Quantum origins of objectivity

    NASA Astrophysics Data System (ADS)

    Horodecki, R.; Korbicz, J. K.; Horodecki, P.

    2015-03-01

    In spite of all of its successes, quantum mechanics leaves us with a central problem: How does nature create a bridge from fragile quanta to the objective world of everyday experience? Here we find that a basic structure within quantum mechanics that leads to the perceived objectivity is a so-called spectrum broadcast structure. We uncover this based on minimal assumptions, without referring to any dynamical details or a concrete model. More specifically, working formally within the decoherence theory setting with multiple environments (called quantum Darwinism), we show how a crucial for quantum mechanics notion of nondisturbance due to Bohr [N. Bohr, Phys. Rev. 48, 696 (1935), 10.1103/PhysRev.48.696] and a natural definition of objectivity lead to a canonical structure of a quantum system-environment state, reflecting objective information records about the system stored in the environment.

  9. A clinical and radiological objective tumor response with somatostatin analogs (SSA) in well-differentiated neuroendocrine metastatic tumor of the ileum: a case report

    PubMed Central

    De Divitiis, Chiara; von Arx, Claudia; Carbone, Roberto; Tatangelo, Fabiana; Di Girolamo, Elena; Romano, Giovanni Maria; Ottaiano, Alessandro; de Lutio di Castelguidone, Elisabetta; Iaffaioli, Rosario Vincenzo; Tafuto, Salvatore

    2015-01-01

    Somatostatin analogs (SSAs) are typically used to treat the symptoms caused by neuroendocrine tumors (NETs), but they are not used as the primary treatment to induce tumor shrinkage. We report a case of a 63-year-old woman with a symptomatic metastatic NET of the ileum. Complete symptomatic response was achieved after 1 month of treatment with SSAs. In addition, there was an objective response in the liver, with the disappearance of secondary lesions noted on computed tomography scan after 3 months of octreotide treatment. Our experience suggests that SSAs could be useful for downstaging and/or downsizing well-differentiated NETs, and they could allow surgery to be performed. Such presurgery therapy could be a promising tool in the management of patients with initially inoperable NETs. PMID:25878507

  10. Retinal Structures and Visual Cortex Activity are Impaired Prior to Clinical Vision Loss in Glaucoma.

    PubMed

    Murphy, Matthew C; Conner, Ian P; Teng, Cindy Y; Lawrence, Jesse D; Safiullah, Zaid; Wang, Bo; Bilonick, Richard A; Kim, Seong-Gi; Wollstein, Gadi; Schuman, Joel S; Chan, Kevin C

    2016-01-01

    Glaucoma is the second leading cause of blindness worldwide and its pathogenesis remains unclear. In this study, we measured the structure, metabolism and function of the visual system by optical coherence tomography and multi-modal magnetic resonance imaging in healthy subjects and glaucoma patients with different degrees of vision loss. We found that inner retinal layer thinning, optic nerve cupping and reduced visual cortex activity occurred before patients showed visual field impairment. The primary visual cortex also exhibited more severe functional deficits than higher-order visual brain areas in glaucoma. Within the visual cortex, choline metabolism was perturbed along with increasing disease severity in the eye, optic radiation and visual field. In summary, this study showed evidence that glaucoma deterioration is already present in the eye and the brain before substantial vision loss can be detected clinically using current testing methods. In addition, cortical cholinergic abnormalities are involved during trans-neuronal degeneration and can be detected non-invasively in glaucoma. The current results can be of impact for identifying early glaucoma mechanisms, detecting and monitoring pathophysiological events and eye-brain-behavior relationships, and guiding vision preservation strategies in the visual system, which may help reduce the burden of this irreversible but preventable neurodegenerative disease. PMID:27510406

  11. 'What matters to graduates': An evaluation of a structured clinical support program for newly graduated nurses.

    PubMed

    Henderson, Amanda; Ossenberg, Christine; Tyler, Scott

    2015-05-01

    Effective guidance in practice is necessary for safe practice of clinicians upon entering the workforce. The transition period is recognised as a time of significant stress as newly graduated nurses (novices) endeavour to consolidate their nursing knowledge and gain mastery in a new working environment. This study explored novices perception of a structured clinical support program designed to assist their assimilation and development of good practice in the real world. Surveys and focus groups were conducted twelve months after novices commenced employment in a large tertiary hospital in South-East Queensland, Australia. Survey results from 78 novices (43% response rate), and feedback from a subsequent focus group of the respondents, indicated that the program which provided interactive content days and supervised experience in an environment conducive to learning was successful in transitioning novices. Novices placed considerable importance on largely intangible aspects of the interactive days, such as emotional support and collegiality which contributed to their confidence. These intangible elements of programs are often not measured and therefore their value not visible to those responsible for continuous education. Of particular significance was that novices indicated their thoughts about practice were given limited consideration. This is an important factor for future retention. PMID:25665461

  12. Retinal Structures and Visual Cortex Activity are Impaired Prior to Clinical Vision Loss in Glaucoma

    PubMed Central

    Murphy, Matthew C.; Conner, Ian P.; Teng, Cindy Y.; Lawrence, Jesse D.; Safiullah, Zaid; Wang, Bo; Bilonick, Richard A.; Kim, Seong-Gi; Wollstein, Gadi; Schuman, Joel S.; Chan, Kevin C.

    2016-01-01

    Glaucoma is the second leading cause of blindness worldwide and its pathogenesis remains unclear. In this study, we measured the structure, metabolism and function of the visual system by optical coherence tomography and multi-modal magnetic resonance imaging in healthy subjects and glaucoma patients with different degrees of vision loss. We found that inner retinal layer thinning, optic nerve cupping and reduced visual cortex activity occurred before patients showed visual field impairment. The primary visual cortex also exhibited more severe functional deficits than higher-order visual brain areas in glaucoma. Within the visual cortex, choline metabolism was perturbed along with increasing disease severity in the eye, optic radiation and visual field. In summary, this study showed evidence that glaucoma deterioration is already present in the eye and the brain before substantial vision loss can be detected clinically using current testing methods. In addition, cortical cholinergic abnormalities are involved during trans-neuronal degeneration and can be detected non-invasively in glaucoma. The current results can be of impact for identifying early glaucoma mechanisms, detecting and monitoring pathophysiological events and eye-brain-behavior relationships, and guiding vision preservation strategies in the visual system, which may help reduce the burden of this irreversible but preventable neurodegenerative disease. PMID:27510406

  13. Structured Data Capture from Multiple EMRs: Towards an Architecture for Clinical Research.

    PubMed

    Zaveree, Zaib; Keshavjee, Karim

    2015-01-01

    EMR adoption by primary care physicians in Canada has increased dramatically in recent years. This provides an excellent opportunity for researchers to collaborate with primary care providers to capture structured data at the point of care. This paper describes the feasibility of converting a popular well-baby checklist form into an electronic version for research data collection. Usability and scalability of the instrument to large numbers of physicians was assessed. We developed and tested a standardized, electronic version of the Rourke Baby Record (eRourke) that was embedded into two different EMRs at four primary care clinics in Southern Ontario over a 6-month period. We utilized qualitative and quantitative research techniques, including on-site observation, key informant interviews and administration of pre- and post-questionnaires. Implementation of the eRourke improved the quality of data for research and reporting significantly. Providers also reported a subjective sense of having collected better quality data. Enhancing the usability of the form in 3 specific areas would likely increase the receptivity to the form to larger numbers of providers. Overall, providers were satisfied with the eRourke and felt that it captured higher quality information than previous versions (55% Agree before vs 88% Agree after). PMID:25677002

  14. Real-time object recognition in multidimensional images based on joined extended structural tensor and higher-order tensor decomposition methods

    NASA Astrophysics Data System (ADS)

    Cyganek, Boguslaw; Smolka, Bogdan

    2015-02-01

    In this paper a system for real-time recognition of objects in multidimensional video signals is proposed. Object recognition is done by pattern projection into the tensor subspaces obtained from the factorization of the signal tensors representing the input signal. However, instead of taking only the intensity signal the novelty of this paper is first to build the Extended Structural Tensor representation from the intensity signal that conveys information on signal intensities, as well as on higher-order statistics of the input signals. This way the higher-order input pattern tensors are built from the training samples. Then, the tensor subspaces are built based on the Higher-Order Singular Value Decomposition of the prototype pattern tensors. Finally, recognition relies on measurements of the distance of a test pattern projected into the tensor subspaces obtained from the training tensors. Due to high-dimensionality of the input data, tensor based methods require high memory and computational resources. However, recent achievements in the technology of the multi-core microprocessors and graphic cards allows real-time operation of the multidimensional methods as is shown and analyzed in this paper based on real examples of object detection in digital images.

  15. Are persons with physical disabilities who participate in society healthier and happier? Structural equation modelling of objective participation and subjective well-being.

    PubMed

    van Campen, Cretien; Iedema, Jurjen

    2007-05-01

    In many countries, governments pursue a policy of offering persons with disabilities greater opportunities for participation in society, based on the assumption that this will also improve their subjective well-being. Currently, however, it is not known whether this assumption is valid. In this study we relate the objective participation and the subjective well-being aspects of both disabled and non-disabled persons to an array of social and health-related determinants. Linear structural equation modelling of data of a sample selection of the Dutch population is analysed. The sample size is 5,826, including 642 respondents with physical disabilities. In terms of objective participation, the persons with disabilities are at a greater disadvantage as regards labour participation than is the case for social and cultural participation. When it comes to subjective well-being, we find that the persons with disabilities are more likely to lag behind in perceived physical health than in mental health and happiness. In a multivariate model relating objective participation to subjective health and happiness, correlations are much weaker than expected. It is striking to find that participation, perceived health and happiness are much less closely related than is often assumed. Their determinants differ widely in nature and strength. The empirical model leads to rejection of the hypothesis that higher participation by the persons with disabilities is associated with higher subjective well-being. PMID:17268932

  16. A membranous structure separating the adenohypophysis and neurohypophysis: an anatomical study and its clinical application for craniopharyngioma.

    PubMed

    Lu, Yun-Tao; Qi, Song-Tao; Xu, Jia-Ming; Pan, Jun; Shi, Jin

    2015-06-01

    OBJECT This study aimed to identify the membranous septation between the adeno- and neurohypophysis. The clinical impact of this septation in the surgical removal of infradiaphragmatic craniopharyngioma (Id-CP) is also clarified. METHODS The sellar regions from 8 fetal and 6 adult cadavers were dissected. After staining first with H & E and then with picro-Sirius red, the membranous structures were observed and measured under normal light and polarization microscopy. The pre- and postsurgical images and intraoperative procedures in 28 cases of childhood Id-CP were reviewed and analyzed. RESULTS There is a significant membranous septation (termed the adenoneurohypophysis septation [ANHS]) lying behind the intermediate lobe to separate the adeno- and neurohypophysis. The average thicknesses are 21.9 ± 16.9 μm and 79.1 ± 43.2 μm in fetal and adult heads, respectively. The median segment of the septation is significantly thicker than the upper and lower segments. The ANHS extends from the suprasellar pars tuberalis to the sellar floor, where it is fused with the pituitary capsule. During Id-CP surgery performed via a transcranial approach, the ANHS can be identified to reserve the neurohypophysis. Moreover, by understanding the anatomy of this membrane, the pituitary stalk was preserved in 3 patients (10.7%). CONCLUSIONS There is a significant membrane separating the anterior and posterior lobes of the pituitary gland, which lies behind the intermediate lobe. Understanding the anatomy of this septation is important for identifying and preserving the neurohypophysis and pituitary stalk during Id-CP surgery. PMID:25745951

  17. Proposal for a structured assessment of parenting based on attachment theory: theoretical background, description and initial clinical experience.

    PubMed

    Green, J M

    1996-09-01

    This paper proposes a structured clinical assessment of parenting and illustrates its use within child psychiatry practice. The aim was to develop a structured instrument based on current theoretical knowledge which was simple enough to be clinically viable while being precise and repeatable enough to enable quantification and research. Use is made of inpatient and daypatient resources but the assessment could be modified for outpatient practice. The assessment takes a "diagnostic" approach; concentrating on factors that have been shown in research to be good predictors of parenting dysfunction. These include parental personality, current mental state and degree of current social stress and support (including quality of marital relationship). Additionally, information regarding the adult's representation of early attachment relationships is elicited using the Adult Attachment Interview. Independent assessments of the child and the parent/child interaction are made. Initial clinical experience with this instrument is described and practical and theoretical issues raised by its use are explored. PMID:8908419

  18. Phase I and Phase II Objective Response Rates are Correlated in Pediatric Cancer Trials: An Argument for Better Clinical Trial Efficiency.

    PubMed

    Yeh, Jonathan C; Huang, Peng; Cohen, Kenneth J

    2016-07-01

    Although many phase I trials report tumor response, formal analysis of efficacy is deferred to phase II. We reviewed paired phase I and II pediatric oncology trials to ascertain the relationship between phase I and II objective response rate (OR%). Single-agent phase I trials were paired with corresponding phase II trials (comparable study drug, dosing schedule, and population). Phase I trials without efficacy data or a matching phase II trial were excluded. OR% was tabulated for all trials, and phase II authors' subjective conclusions regarding efficacy were documented; 35 pairs of trials were analyzed. The correlation between phase I and II OR% was 0.93. Between phase II studies with a "positive" conclusion versus a "negative" one, there was a statistically significant difference in mean phase I OR% (32.0% vs. 4.5%, P<0.001). Thirteen phase II studies were undertaken despite phase I OR% of 0%; only 1 had a "positive" conclusion, and none exceeded OR% of 15%. OR% are highly correlated between phase I and II pediatric oncology trials. Although not a formal measure of drug efficacy, phase I OR% may provide an estimate of phase II response, inform phase II study design, and should be given greater consideration. PMID:27164535

  19. Structural Equation Analyses of Clinical Subpopulation Differences and Comparative Treatment Outcomes: Characterizing the Daily Lives of Drug Addicts.

    ERIC Educational Resources Information Center

    Aiken, Leona S.; And Others

    1994-01-01

    Used structural equation modeling for comparative treatment outcome research conducted with heterogeneous clinical subpopulations within large multimodality treatment settings. Evaluated effect of early period of treatment on daily lives of 486 clients in 2 drug abuse treatment modalities (methadone maintenance and outpatient counseling).…

  20. A structured exercise programme during haemodialysis for patients with chronic kidney disease: clinical benefit and long-term adherence

    PubMed Central

    Anding, Kirsten; Bär, Thomas; Trojniak-Hennig, Joanna; Kuchinke, Simone; Krause, Rolfdieter; Rost, Jan M; Halle, Martin

    2015-01-01

    Objective Long-term studies regarding the effect of a structured physical exercise programme (SPEP) during haemodialysis (HD) assessing compliance and clinical benefit are scarce. Study design A single-centre clinical trial, non-randomised, investigating 46 patients with HD (63.2±16.3 years, male/female 24/22, dialysis vintage 4.4 years) performing an SPEP over 5 years. The SPEP (twice/week for 60 min during haemodialysis) consisted of a combined resistance (8 muscle groups) and endurance (supine bicycle ergometry) training. Exercise intensity was continuously adjusted to improvements of performance testing. Changes in endurance and resistance capacity, physical functioning and quality of life (QoL) were analysed over 1 year in addition to long-term adherence and economics of the programme over 5 years. Average power per training session, maximal strength tests (maximal exercise repetitions/min), three performance-based tests for physical function, SF36 for QoL were assessed in the beginning and every 6 months thereafter. Results 78% of the patients completed the programme after 1 year and 43% after 5 years. Participants were divided—according to adherence to the programme—into three groups: (1) high adherence group (HA, >80% of 104 training sessions within 12 months), (2) moderate adherence (MA, 60–80%), and 3. Low adherence group (LA, <60%)) with HA and MA evaluated quantitatively. One-year follow-up data revealed significant (p<0.05) improvement for both groups in all measured parameters: exercise capacity (HA: 55%, MA: 45%), strength (HA: >120%, MA: 40–50%), QoL in three scores of SF36 subscales and physical function in the three tests taken between 11% and 31%. Moreover, a quantitative correlation analysis revealed a close association (r=0.8) between large improvement of endurance capacity and weak physical condition (HA). Conclusions The exercise programme described improves physical function significantly and can be integrated

  1. [The root of the deep and fast ongoing evolution of both structure and methodology of clinical research].

    PubMed

    Tavazzi, Luigi

    2016-03-01

    The growing scientific knowledge and technology development are leading to radical changes in biological and medical research. The prevalent lines of development deal with a pragmatic evolution of controlled clinical trials, a massive diffusion of observational research, which is progressively incorporated in clinical practice, new models and designs of clinical research, the systematic use of information technology to build up vast networks of medical centers producing huge amounts of shared data to be managed through the big data methodology, personalized as well as precision medicine, a reshaped physician-patient relationship based on a co-working principle. All this is leading to profound changes in public health governance, a renewal of clinical epidemiology and prevention, a modified structure of several specific sectors of medical care, hopefully guided by scientific evidences. A few aspects of such an evolving picture are discussed in this article. PMID:27029875

  2. Non-invasive cardiac assessment in high risk patients (The GROUND study): rationale, objectives and design of a multi-center randomized controlled clinical trial

    PubMed Central

    de Vos, Alexander M; Rutten, Annemarieke; van de Zaag-Loonen, Hester J; Bots, Michiel L; Dikkers, Riksta; Buiskool, Robert A; Mali, Willem P; Lubbers, Daniel D; Mosterd, Arend; Prokop, Mathias; Rensing, Benno J; Cramer, Maarten J; van Es, H Wouter; Moll, Frans L; van de Pavoordt, Eric D; Doevendans, Pieter A; Velthuis, Birgitta K; Mackaay, Albert J; Zijlstra, Felix; Oudkerk, Matthijs

    2008-01-01

    Background Peripheral arterial disease (PAD) is a common disease associated with a considerably increased risk of future cardiovascular events and most of these patients will die from coronary artery disease (CAD). Screening for silent CAD has become an option with recent non-invasive developments in CT (computed tomography)-angiography and MR (magnetic resonance) stress testing. Screening in combination with more aggressive treatment may improve prognosis. Therefore we propose to study whether a cardiac imaging algorithm, using non-invasive imaging techniques followed by treatment will reduce the risk of cardiovascular disease in PAD patients free from cardiac symptoms. Design The GROUND study is designed as a prospective, multi-center, randomized clinical trial. Patients with peripheral arterial disease, but without symptomatic cardiac disease will be asked to participate. All patients receive a proper risk factor management before randomization. Half of the recruited patients will enter the 'control group' and only undergo CT calcium scoring. The other half of the recruited patients (index group) will undergo the non invasive cardiac imaging algorithm followed by evidence-based treatment. First, patients are submitted to CT calcium scoring and CT angiography. Patients with a left main (or equivalent) coronary artery stenosis of > 50% on CT will be referred to a cardiologist without further imaging. All other patients in this group will undergo dobutamine stress magnetic resonance (DSMR) testing. Patients with a DSMR positive for ischemia will also be referred to a cardiologist. These patients are candidates for conventional coronary angiography and cardiac interventions (coronary artery bypass grafting (CABG) or percutaneous cardiac interventions (PCI)), if indicated. All participants of the trial will enter a 5 year follow up period for the occurrence of cardiovascular events. Sequential interim analysis will take place. Based on sample size calculations about

  3. White matter structure and clinical characteristics of stroke patients: A diffusion tensor MRI study.

    PubMed

    Ueda, Ryo; Yamada, Naoki; Kakuda, Wataru; Abo, Masahiro; Senoo, Atsushi

    2016-03-15

    Fractional anisotropy has been used in many studies that examined post-stroke changes in white matter. This study was performed to clarify cerebral white matter changes after stroke using generalized fractional anisotropy (GFA). White matter structure was visualized using diffusion tensor imaging in 72 patients with post-stroke arm paralysis. Exercise-related brain regions were examined in cerebral white matter using GFA. The relationship between GFA and clinical characteristics was examined. Overall, the mean GFA of the lesioned hemisphere was significantly lower than that of the non-lesioned hemisphere (P<0.05), the white matter of the lesioned side was severely affected by stroke. A weak negative correlation between GFA and time since stroke onset was found in Brodmann area 5 of the non-lesioned hemisphere. Age correlated negatively with GFA in Brodmann areas 5 and 7 of the lesioned hemisphere. Though these results may be due to a decrease in the frequency of use of the paralyzed limb over time, GFA overall was significantly and negatively affected by the subject's age. The GFA values of patients with paralysis of the dominant hand were significantly different from those of patients with paralysis of the nondominant hand in Brodmann areas 4 and 6 of the non-lesioned hemisphere and Brodmann area 4 of the lesioned hemisphere (P<0.05). The stroke size and location were not associated with GFA differences. Differences between the GFA of the lesioned and non-lesioned hemispheres varied depending on the affected brain region, age at onset of paralysis, and paralysis of the dominant or non-dominant hand. PMID:26783693

  4. Feasibility of multi-site clinical structural neuroimaging studies of aging using legacy data.

    PubMed

    Fennema-Notestine, Christine; Gamst, Anthony C; Quinn, Brian T; Pacheco, Jenni; Jernigan, Terry L; Thal, Leon; Buckner, Randy; Killiany, Ron; Blacker, Deborah; Dale, Anders M; Fischl, Bruce; Dickerson, Brad; Gollub, Randy L

    2007-01-01

    The application of advances in biomedical computing to medical imaging research is enabling scientists to conduct quantitative clinical imaging studies using data collected across multiple sites to test new hypotheses on larger cohorts, increasing the power to detect subtle effects. Given that many research groups have valuable existing (legacy) data, one goal of the Morphometry Biomedical Informatics Research Network (BIRN) Testbed is to assess the feasibility of pooled analyses of legacy structural neuroimaging data in normal aging and Alzheimer's disease. The present study examined whether such data could be meaningfully reanalyzed as a larger combined data set by using rigorous data curation, image analysis, and statistical modeling methods; in this case, to test the hypothesis that hippocampal volume decreases with age and to investigate findings of hippocampal asymmetry. This report describes our work with legacy T1-weighted magnetic resonance (MR) and demographic data related to normal aging that have been shared through the BIRN by three research sites. Results suggest that, in the present application, legacy MR data from multiple sites can be pooled to investigate questions of scientific interest. In particular, statistical analyses suggested that a mixed-effects model employing site as a random effect best fits the data, accounting for site-specific effects while taking advantage of expected comparability of age-related effects. In the combined sample from three sites, significant age-related decline of hippocampal volume and right-dominant hippocampal asymmetry were detected in healthy elderly controls. These expected findings support the feasibility of combining legacy data to investigate novel scientific questions. PMID:17999200

  5. Biofilm Morphotypes and Population Structure among Staphylococcus epidermidis from Commensal and Clinical Samples

    PubMed Central

    Harris, Llinos G.; Murray, Susan; Pascoe, Ben; Bray, James; Meric, Guillaume; Magerios, Leonardos; Wilkinson, Thomas S.; Jeeves, Rose; Rohde, Holger; Schwarz, Stefan; de Lencastre, Herminia; Miragaia, Maria; Rolo, Joana; Bowden, Rory; Jolley, Keith A.; Maiden, Martin C. J.; Mack, Dietrich; Sheppard, Samuel K.

    2016-01-01

    Bacterial species comprise related genotypes that can display divergent phenotypes with important clinical implications. Staphylococcus epidermidis is a common cause of nosocomial infections and, critical to its pathogenesis, is its ability to adhere and form biofilms on surfaces, thereby moderating the effect of the host’s immune response and antibiotics. Commensal S. epidermidis populations are thought to differ from those associated with disease in factors involved in adhesion and biofilm accumulation. We quantified the differences in biofilm formation in 98 S. epidermidis isolates from various sources, and investigated population structure based on ribosomal multilocus typing (rMLST) and the presence/absence of genes involved in adhesion and biofilm formation. All isolates were able to adhere and form biofilms in in vitro growth assays and confocal microscopy allowed classification into 5 biofilm morphotypes based on their thickness, biovolume and roughness. Phylogenetic reconstruction grouped isolates into three separate clades, with the isolates in the main disease associated clade displaying diversity in morphotype. Of the biofilm morphology characteristics, only biofilm thickness had a significant association with clade distribution. The distribution of some known adhesion-associated genes (aap and sesE) among isolates showed a significant association with the species clonal frame. These data challenge the assumption that biofilm-associated genes, such as those on the ica operon, are genetic markers for less invasive S. epidermidis isolates, and suggest that phenotypic characteristics, such as adhesion and biofilm formation, are not fixed by clonal descent but are influenced by the presence of various genes that are mobile among lineages. PMID:26978068

  6. DICOM for quantitative imaging biomarker development: a standards based approach to sharing clinical data and structured PET/CT analysis results in head and neck cancer research.

    PubMed

    Fedorov, Andriy; Clunie, David; Ulrich, Ethan; Bauer, Christian; Wahle, Andreas; Brown, Bartley; Onken, Michael; Riesmeier, Jörg; Pieper, Steve; Kikinis, Ron; Buatti, John; Beichel, Reinhard R

    2016-01-01

    Background. Imaging biomarkers hold tremendous promise for precision medicine clinical applications. Development of such biomarkers relies heavily on image post-processing tools for automated image quantitation. Their deployment in the context of clinical research necessitates interoperability with the clinical systems. Comparison with the established outcomes and evaluation tasks motivate integration of the clinical and imaging data, and the use of standardized approaches to support annotation and sharing of the analysis results and semantics. We developed the methodology and tools to support these tasks in Positron Emission Tomography and Computed Tomography (PET/CT) quantitative imaging (QI) biomarker development applied to head and neck cancer (HNC) treatment response assessment, using the Digital Imaging and Communications in Medicine (DICOM(®)) international standard and free open-source software. Methods. Quantitative analysis of PET/CT imaging data collected on patients undergoing treatment for HNC was conducted. Processing steps included Standardized Uptake Value (SUV) normalization of the images, segmentation of the tumor using manual and semi-automatic approaches, automatic segmentation of the reference regions, and extraction of the volumetric segmentation-based measurements. Suitable components of the DICOM standard were identified to model the various types of data produced by the analysis. A developer toolkit of conversion routines and an Application Programming Interface (API) were contributed and applied to create a standards-based representation of the data. Results. DICOM Real World Value Mapping, Segmentation and Structured Reporting objects were utilized for standards-compliant representation of the PET/CT QI analysis results and relevant clinical data. A number of correction proposals to the standard were developed. The open-source DICOM toolkit (DCMTK) was improved to simplify the task of DICOM encoding by introducing new API abstractions

  7. DICOM for quantitative imaging biomarker development: a standards based approach to sharing clinical data and structured PET/CT analysis results in head and neck cancer research

    PubMed Central

    Clunie, David; Ulrich, Ethan; Bauer, Christian; Wahle, Andreas; Brown, Bartley; Onken, Michael; Riesmeier, Jörg; Pieper, Steve; Kikinis, Ron; Buatti, John; Beichel, Reinhard R.

    2016-01-01

    Background. Imaging biomarkers hold tremendous promise for precision medicine clinical applications. Development of such biomarkers relies heavily on image post-processing tools for automated image quantitation. Their deployment in the context of clinical research necessitates interoperability with the clinical systems. Comparison with the established outcomes and evaluation tasks motivate integration of the clinical and imaging data, and the use of standardized approaches to support annotation and sharing of the analysis results and semantics. We developed the methodology and tools to support these tasks in Positron Emission Tomography and Computed Tomography (PET/CT) quantitative imaging (QI) biomarker development applied to head and neck cancer (HNC) treatment response assessment, using the Digital Imaging and Communications in Medicine (DICOM®) international standard and free open-source software. Methods. Quantitative analysis of PET/CT imaging data collected on patients undergoing treatment for HNC was conducted. Processing steps included Standardized Uptake Value (SUV) normalization of the images, segmentation of the tumor using manual and semi-automatic approaches, automatic segmentation of the reference regions, and extraction of the volumetric segmentation-based measurements. Suitable components of the DICOM standard were identified to model the various types of data produced by the analysis. A developer toolkit of conversion routines and an Application Programming Interface (API) were contributed and applied to create a standards-based representation of the data. Results. DICOM Real World Value Mapping, Segmentation and Structured Reporting objects were utilized for standards-compliant representation of the PET/CT QI analysis results and relevant clinical data. A number of correction proposals to the standard were developed. The open-source DICOM toolkit (DCMTK) was improved to simplify the task of DICOM encoding by introducing new API abstractions

  8. Space, structure and social dynamics within the clinical setting: two case studies of assisted reproduction in Mexico City.

    PubMed

    González-Santos, Sandra P

    2011-01-01

    Drawing on the concept of therapeutic environments and comparing two case studies, this paper explores the interaction between the spatial factors of the clinical setting, the structural elements of the health system, and the specific treatment requirements of assisted reproduction in order to see the type and degree of privacy and accessibility, as well as the particular social dynamics (i.e. patient-physician and among patients) fostered in two Mexico City fertility clinics. Both cases suggest that certain types of therapeutic environments encourage the formation of spontaneous support groups while others favour the patient-physician relationship. PMID:20961798

  9. Structural Competency in the U.S. Healthcare Crisis: Putting Social and Policy Interventions Into Clinical Practice.

    PubMed

    Hansen, H; Metzl, J

    2016-06-01

    This symposium of the Journal of Bioethical Inquiry illustrates structural competency: how clinical practitioners can intervene on social and institutional determinants of health. It will require training clinicians to see and act on structural barriers to health, to adapt imaginative structural approaches from fields outside of medicine, and to collaborate with disciplines and institutions outside of medicine. Case studies of effective work on all of these levels are presented in this volume. The contributors exemplify structural competency from many angles, from the implications of epigenetics for environmental intervention in personalized medicine to the ways clinicians can act on fundamental causes of disease, address abuses of power in clinical training, racially desegregate cities to reduce health disparities, address the systemic causes of torture by police, and implement harm-reduction programs for addiction in the face of punitive drug laws. Together, these contributors demonstrate the unique roles that clinicians can play in breaking systemic barriers to health and the benefit to the U.S. healthcare system of adopting innovations from outside of the United States and outside of clinical medicine. PMID:27178191

  10. Factor structure of the General Health Questionnaire-28 (GHQ-28) from infertile women attending the Yazd Research and Clinical Center for Infertility

    PubMed Central

    Shayan, Zahra; Pourmovahed, Zahra; Najafipour, Fatemeh; Abdoli, Ali Mohammad; Mohebpour, Fatemeh; Najafipour, Sedighe

    2015-01-01

    Background: Nowadays, infertility problems have become a social concern, and are associated with multiple psychological and social problems. Also, it affects the interpersonal communication between the individual, familial, and social characteristics. Since women are exposed to stressors of physical, mental, social factors, and treatment of infertility, providing a psychometric screening tool is necessary for disorders of this group. Objective: The aim of this study was to determine the factor structure of the general health questionnaire-28 to discover mental disorders in infertile women. Materials and Methods: In this study, 220 infertile women undergoing treatment of infertility were selected from the Yazd Research and Clinical Center for Infertility with convenience sampling in 2011. After completing the general health questionnaire by the project manager, validity and, reliability of the questionnaire were calculated by confirmatory factor structure and Cronbach's alpha, respectively. Results: Four factors, including anxiety and insomnia, social dysfunction, depression, and physical symptoms were extracted from the factor structure. 50.12% of the total variance was explained by four factors. The reliability coefficient of the questionnaire was obtained 0.90. Conclusion: Analysis of the factor structure and reliability of General Health Questionnaire-28 showed that it is suitable as a screening instrument for assessing general health of infertile women. PMID:27141541

  11. Data quality objectives summary report for the 105-F and 105-DR Phase III below-grade structure and underlying soils

    SciTech Connect

    J. G. Adler.

    1999-09-29

    The scope of this data quality objective (DQO) summary report involves the characterization of below-grade structures for interim closure and waste designation. The project is Phase 3 of a four-phase Interim Safe Storage (ISS) Project to remove and dispose of the rooms and facilities surrounding the 105-F and 105-DR Reactors. This includes the D and D and interim closure of the 105-DR fuel storage basin (FSB), the underlying soils, and the below-grade rooms and tunnels at the 105-F and 105-DR Reactor buildings. Phase 3 also includes removal and disposal of the on-grade floor slabs that remain after Phase 2. Also included within Phase 3 are those activities needed for clean closure of the 105-DR Large Sodium Fire Facility Resource Conservation and Recovery Act of 1976 2048A)'' treatment, storage, and disposal (TSD) unit. These activities include the removal and disposal of the remaining TSD structures and clean closure of the soils beneath the 105-DR Large Sodium Fire Facility underground exhaust duct. Contaminated demolition rubble will be disposed in the Environmental Restoration Disposal Facility.

  12. Population Structure of Clinical Pseudomonas aeruginosa from West and Central African Countries

    PubMed Central

    Cholley, Pascal; Ka, Roughyatou; Guyeux, Christophe; Thouverez, Michelle; Guessennd, Nathalie; Ghebremedhin, Beniam; Frank, Thierry; Bertrand, Xavier; Hocquet, Didier

    2014-01-01

    Background Pseudomonas aeruginosa (PA) has a non-clonal, epidemic population with a few widely distributed and frequently encountered sequence types (STs) called ‘high-risk clusters’. Clinical P. aeruginosa (clinPA) has been studied in all inhabited continents excepted in Africa, where a very few isolates have been analyzed. Here, we characterized a collection of clinPA isolates from four countries of West and Central Africa. Methodology 184 non-redundant isolates of clinPA from hospitals of Senegal, Ivory Coast, Nigeria, and Central African Republic were genotyped by MLST. We assessed their resistance level to antibiotics by agar diffusion and identified the extended-spectrum β-lactamases (ESBLs) and metallo-β-lactamases (MBLs) by sequencing. The population structure of the species was determined by a nucleotide-based analysis of the entire PA MLST database and further localized on the phylogenetic tree (i) the sequence types (STs) of the present collection, (ii) the STs by continents, (iii) ESBL- and MBL-producing STs from the MLST database. Principal Findings We found 80 distinct STs, of which 24 had no relationship with any known STs. ‘High-risk’ international clonal complexes (CC155, CC244, CC235) were frequently found in West and Central Africa. The five VIM-2-producing isolates belonged to CC233 and CC244. GES-1 and GES-9 enzymes were produced by one CC235 and one ST1469 isolate, respectively. We showed the spread of ‘high-risk’ international clonal complexes, often described as multidrug-resistant on other continents, with a fully susceptible phenotype. The MBL- and ESBL-producing STs were scattered throughout the phylogenetic tree and our data suggest a poor association between a continent and a specific phylogroup. Conclusions ESBL- and MBL-encoding genes are borne by both successful international clonal complexes and distinct local STs in clinPA of West and Central Africa. Furthermore, our data suggest that the spread of a ST could be

  13. The GuideView System for Interactive, Structured, Multi-modal Delivery of Clinical Guidelines

    NASA Technical Reports Server (NTRS)

    Iyengar, Sriram; Florez-Arango, Jose; Garcia, Carlos Andres

    2009-01-01

    GuideView is a computerized clinical guideline system which delivers clinical guidelines in an easy-to-understand and easy-to-use package. It may potentially enhance the quality of medical care or allow non-medical personnel to provide acceptable levels of care in situations where physicians or nurses may not be available. Such a system can be very valuable during space flight missions when a physician is not readily available, or perhaps the designated medical personnel is unable to provide care. Complex clinical guidelines are broken into simple steps. At each step clinical information is presented in multiple modes, including voice,audio, text, pictures, and video. Users can respond via mouse clicks or via voice navigation. GuideView can also interact with medical sensors using wireless or wired connections. The system's interface is illustrated and the results of a usability study are presented.

  14. Unveiling the near-infrared structure of the massive-young stellar object NGC 3603 IRS 9A* with sparse aperture masking and spectroastrometry

    NASA Astrophysics Data System (ADS)

    Sanchez-Bermudez, J.; Hummel, C. A.; Tuthill, P.; Alberdi, A.; Schödel, R.; Lacour, S.; Stanke, T.

    2016-04-01

    Context. Contemporary theory holds that massive stars gather mass during their initial phases via accreting disk-like structures. However, conclusive evidence for disks has remained elusive for most massive young objects. This is mainly due to significant observational challenges: objects are rare and located at great distances within dusty, highly opaque environments. Incisive studies, even targeting individual objects, are therefore relevant to the progression of the field. NGC 3603 IRS 9A* is a young massive stellar object that is still surrounded by an envelope of molecular gas for which previous mid-infrared observations with long-baseline interferometry have provided evidence of a plausible disk of 50 mas diameter at its core. Aims: This work aims at a comprehensive study of the physics and morphology of IRS 9A at near-infrared wavelengths. Methods: New sparse aperture-masking interferometry data, taken with the near-infrared camera NACO of the Very Large Telescope (VLT) at Ks and L' wavelengths, were analyzed together with archival high-resolution H2 and Brγ lines obtained with the cryogenic high-resolution infrared schelle spectrograph (CRIRES). Results: The trends in the calibrated visibilities at Ks and L'-bands suggest the presence of a partially resolved compact object with an angular size of ≤30 mas at the core of IRS 9A, together with the presence of over-resolved flux. The spectroastrometric signal of the H2 line, obtained from the CRIRES spectra, shows that this spectral feature proceeds from the large-scale extended emission (~300 mas), while the Brγ line appears to be formed at the core of the object (~20 mas). To better understand the physics that drive IRS 9A, we have performed continuum radiative transfer modeling. Our best model supports the existence of a compact disk with an angular diameter of 20 mas, together with an outer envelope of 1'' exhibiting a polar cavity with an opening angle of ~30°. This model reproduces the MIR morphology

  15. Automatic recognition of disorders, findings, pharmaceuticals and body structures from clinical text: an annotation and machine learning study.

    PubMed

    Skeppstedt, Maria; Kvist, Maria; Nilsson, Gunnar H; Dalianis, Hercules

    2014-06-01

    Automatic recognition of clinical entities in the narrative text of health records is useful for constructing applications for documentation of patient care, as well as for secondary usage in the form of medical knowledge extraction. There are a number of named entity recognition studies on English clinical text, but less work has been carried out on clinical text in other languages. This study was performed on Swedish health records, and focused on four entities that are highly relevant for constructing a patient overview and for medical hypothesis generation, namely the entities: Disorder, Finding, Pharmaceutical Drug and Body Structure. The study had two aims: to explore how well named entity recognition methods previously applied to English clinical text perform on similar texts written in Swedish; and to evaluate whether it is meaningful to divide the more general category Medical Problem, which has been used in a number of previous studies, into the two more granular entities, Disorder and Finding. Clinical notes from a Swedish internal medicine emergency unit were annotated for the four selected entity categories, and the inter-annotator agreement between two pairs of annotators was measured, resulting in an average F-score of 0.79 for Disorder, 0.66 for Finding, 0.90 for Pharmaceutical Drug and 0.80 for Body Structure. A subset of the developed corpus was thereafter used for finding suitable features for training a conditional random fields model. Finally, a new model was trained on this subset, using the best features and settings, and its ability to generalise to held-out data was evaluated. This final model obtained an F-score of 0.81 for Disorder, 0.69 for Finding, 0.88 for Pharmaceutical Drug, 0.85 for Body Structure and 0.78 for the combined category Disorder+Finding. The obtained results, which are in line with or slightly lower than those for similar studies on English clinical text, many of them conducted using a larger training data set, show that

  16. Evaluating measurement models in clinical research: covariance structure analysis of latent variable models of self-conception.

    PubMed

    Hoyle, R H

    1991-02-01

    Indirect measures of psychological constructs are vital to clinical research. On occasion, however, the meaning of indirect measures of psychological constructs is obfuscated by statistical procedures that do not account for the complex relations between items and latent variables and among latent variables. Covariance structure analysis (CSA) is a statistical procedure for testing hypotheses about the relations among items that indirectly measure a psychological construct and relations among psychological constructs. This article introduces clinical researchers to the strengths and limitations of CSA as a statistical procedure for conceiving and testing structural hypotheses that are not tested adequately with other statistical procedures. The article is organized around two empirical examples that illustrate the use of CSA for evaluating measurement models with correlated error terms, higher-order factors, and measured and latent variables. PMID:2002144

  17. Belt-hierarchic structure of th ring, satellite and planet systems: prediction S/2001 U1 and others objects in Solar system

    NASA Astrophysics Data System (ADS)

    Barkin, Yu. V.

    2003-04-01

    BELT-HIERARCHIC STRUCTURE OF THE RING, SATELLITE AND PLANET SYSTEMS: PREDICTION S/2001 U1 AND OTHERS OBJECTS IN SOLAR SYSTEM Yu.V.Barkin Sternberg Astronomical Institute, Moscow, Russia, barkin@sai.msu.ru Structure regularities of the planet and satellite systems have been studied. Statistic analysis of the distribution of the major semi-axes of the orbits of the planets, comets and centaurs of the Solar system, satellite and ring systems of Jupiter, Saturn, Neptune and Uran, exoplanet systems of the pulsars PSR 1257+12, PSR 1828-11 and of the main consequence star Ups And was fulfilled. The following empirical regularities were described [1]: 1) the bodies of systems are combined into hierarchic groups and main from them combine 5 companions; 2) differences of the major semi-axes of the neighboring orbits for bodies of every group are constant; 4) for main neighboring hierarchic group these distances are distinguished in 6 times increasing to external grope; 5) the filling of the gropes and some present changes in their structure are caused by the past catastrophes in corresponding systems. The special method of reconstruction of the catastrophes which had place in the life of the Solar system (SS) was developed. Suggested method has let us to explain uniformly observed values of the major semi-axes and average values of eccentricities of the planets. In particular the Pancul’s hypothesis about Jupiter formation from two giant protoplanets (Jupiter I and Jupiter II) was confirmed. The new empirical law of the filling of the orbits of the regular groups of the planets or satellites (or rings structures) of the hierarchic ordered systems of celestial bodies was established. It was shown that sum number of bodies is proportional to the value of catastrophic value of the eccentricities which are same for first, second ,.... and fifth orbits of all gropes. The theoretical numbers of bodies for pointed orbits practically coincide with their observed numbers in main

  18. [Dissociation of structural and functional parameters of the retina and optic nerve in a patient with Alzheimer's disease (clinical case)].

    PubMed

    Erichev, V P; Panyushkina, L A; Ronzina, I A

    2015-01-01

    Visual impairment is often one of the earliest sings of Alzheimer's disease. This article reports a clinical case of a female patient diagnosed with mild dementia due to Alzheimer's disease. As revealed by a comprehensive examination, her visual fields and visual evoked potentials were markedly changed, while morphometric parameters of the retina and optic nerve appeared normal. Such a significant dissociation of structural and functional parameters may indicate a more proximal involvement of visual pathways in Alzheimer's disease. PMID:26080589

  19. The content coverage of clinical classifications. For The Computer-Based Patient Record Institute's Work Group on Codes & Structures.

    PubMed Central

    Chute, C G; Cohn, S P; Campbell, K E; Oliver, D E; Campbell, J R

    1996-01-01

    BACKGROUND AND OBJECTIVE: Patient conditions and events are the core of patient record content. Computer-based records will require standard vocabularies to represent these data consistently, thereby facilitating clinical decision support, research, and efficient care delivery. To address whether existing major coding systems can serve this function, the authors evaluated major clinical classifications for their content coverage. METHODS: Clinical text from four medical centers was sampled from inpatient and outpatient settings. The resultant corpus of 14,247 words was parsed into 3,061 distinct concepts. These concepts were grouped into Diagnoses, Modifiers, Findings, Treatments and Procedures, and Other. Each concept was coded into ICD-9-CM, ICD-10, CPT, SNOMED III, Read V2, UMLS 1.3, and NANDA; a secondary reviewer ensured consistency. While coding, the information was scored: 0 = no match, 1 = fair match, 2 = complete match. RESULTS: ICD-9-CM had an overall mean score of 0.77 out of 2; its highest subscore was 1.61 for Diagnoses. ICD-10 scored 1.60 for Diagnoses, and 0.62 overall. The overall score of ICD-9-CM augmented by CPT was not materially improved at 0.82. The SNOMED International system demonstrated the highest score in every category, including Diagnoses (1.90), and had an overall score of 1.74. CONCLUSION: No classification captured all concepts, although SNOMED did notably the most complete job. The systems in major use in the United States, ICD-9-CM and CPT, fail to capture substantial clinical content. ICD-10 does not perform better than ICD-9-CM. The major clinical classifications in use today incompletely cover the clinical content of patient records; thus analytic conclusions that depend on these systems may be suspect. PMID:8723613

  20. Clinical Structural Anatomy of the Inferior Pyramidal Space Reconstructed Within the Cardiac Contour Using Multidetector-Row Computed Tomography.

    PubMed

    Mori, Shumpei; Fukuzawa, Koji; Takaya, Tomofumi; Takamine, Sachiko; Ito, Tatsuro; Fujiwara, Sei; Nishii, Tatsuya; Kono, Atsushi K; Yoshida, Akihiro; Hirata, Ken-Ichi

    2015-07-01

    Although many studies have described the detailed anatomy of the inferior pyramidal space, it may not be easy for cardiologists who have few chances to study cadaveric hearts to understand the correct morphology of the structure. The inferior pyramidal space is the part of extracardiac fibro-adipose tissue wedging between the 4 cardiac chambers from the diaphragmatic surface of the heart. Many cardiologists have interests in pericardial adipose tissue, but the inferior pyramidal space seems to have been neglected. A number of important structures, including the coronary sinus, atrioventricular node, atrioventricular nodal artery, membranous septum, muscular atrioventricular sandwich (previously called the "muscular atrioventricular septum"), atrial septum, ventricular septum, aortic valvar complex, mitral valvar attachment, and tricuspid valvar attachment are associated with the inferior pyramidal space. We previously revealed its 3-dimensional live anatomy using multidetector-row computed tomography. Moreover, the 3-dimensional understanding of the anatomy in association with the cardiac contour is important from the viewpoints of clinical cardiac electrophysiology. The purpose of this article is to demonstrate extended findings regarding the clinical structural anatomy of the inferior pyramidal space, which was reconstructed in combination with the cardiac contour using multidetector-row computed tomography, and discuss the clinical implications of the findings. PMID:25884276

  1. A randomized, double-blind, Phase 2 study to evaluate subjective and objective outcomes in patients with acute bacterial skin and skin structure infections treated with delafloxacin, linezolid or vancomycin

    PubMed Central

    Kingsley, Jeff; Mehra, Purvi; Lawrence, Laura E.; Henry, Eugenia; Duffy, Erin; Cammarata, Sue K.; Pullman, John

    2016-01-01

    Objectives Delafloxacin is an investigational anionic fluoroquinolone being developed to treat infections caused by Gram-positive and -negative organisms. This clinical trial evaluated the efficacy and safety of delafloxacin in the treatment of acute bacterial skin and skin structure infections (ABSSSIs). Methods In a double-blind, Phase 2 trial, 256 patients were randomized (1 : 1 : 1) to 300 mg of delafloxacin, 600 mg of linezolid or 15 mg/kg vancomycin (actual body weight), each administered intravenously twice daily for 5–14 days. Randomization was stratified by infection category. The primary endpoint was the investigator's assessment of cure, defined as complete resolution of baseline signs and symptoms at follow-up. Secondary endpoints included reductions in the total areas of erythema and induration and assessments of bacterial eradication. This trial has been registered at ClinicalTrials.gov under registration number NCT01283581. Results Cure rates were significantly greater with delafloxacin versus vancomycin (mean difference: −16.3%; 95% CI, −30.3% to −2.3%; P = 0.031); differences were significant for obese patients (BMI ≥30 kg/m2; mean difference: −30.0%; 95% CI, −50.7% to −9.3%; P = 0.009), but not for non-obese patients. Cure rates with delafloxacin and linezolid were similar. Using digital measurement, the percentage decrease in total erythema area was significantly greater with delafloxacin versus vancomycin at follow-up (−96.4% versus −84.5%; P = 0.028). There were no differences in bacterial eradication among the treatment groups. The most frequently reported treatment-emergent adverse events were nausea, diarrhoea and vomiting. Conclusions These data show that delafloxacin is effective in the treatment of ABSSSIs and is well tolerated. PMID:26679243

  2. An application of cmaps in the description of clinical information structure and logic in electronic health records.

    PubMed

    Brewer, Allen; Helfgott, Maxwell A; Novak, Joseph; Schanhals, Rick

    2012-09-01

    The development and implementation of competent and cost-effective computerized medical records that profoundly improve physician productivity and knowledge management will require the development of a new paradigm for the representation and analysis of medical knowledge and logic. Medical knowledge is acquired inductively by observing, measuring, and eliciting information from patients in a process that is investigational rather than transactional. Most, if not all, current approaches to health information technology (HIT) rely on a logic and data structure that imposes significant limitations on the ability of physicians to thoroughly and efficiently document and access empiric patient data because the information is almost invariably organized in a way which presumes, rather than makes explicit, the relationships of concepts and their meaning. Cmapping provides a graphical method of capturing and displaying expert content knowledge that is simple to comprehend and modify and provides a foundation for a dynamic, inductive, and inclusive method of clinical documentation and research. The basis of medical decision analysis along with representative samples of medical knowledge modeling in the Cmap format is presented. The knowledge structures that are captured in Cmaps can be expressed directly in propositional logic, enabling the capability to convert Cmapped clinical expressions to be used to define a description logic for clinical evidence documentation and analysis that can in turn be mapped to multiple natural languages. The described description logic approach can be used to formulate digital messages and documents and to automate the process of converting description specifications formulated in propositional logic into operational electronic health record solutions for capture and reporting of clinical encounters. It has also been demonstrated that using Cmaps to elicit content knowledge from physicians to build point-of-care clinical documentation screens

  3. An Application of Cmaps in the Description of Clinical Information Structure and Logic in Electronic Health Records

    PubMed Central

    Helfgott, Maxwell A.; Novak, Joseph; Schanhals, Rick

    2012-01-01

    The development and implementation of competent and cost-effective computerized medical records that profoundly improve physician productivity and knowledge management will require the development of a new paradigm for the representation and analysis of medical knowledge and logic. Medical knowledge is acquired inductively by observing, measuring, and eliciting information from patients in a process that is investigational rather than transactional. Most, if not all, current approaches to health information technology (HIT) rely on a logic and data structure that imposes significant limitations on the ability of physicians to thoroughly and efficiently document and access empiric patient data because the information is almost invariably organized in a way which presumes, rather than makes explicit, the relationships of concepts and their meaning. Cmapping provides a graphical method of capturing and displaying expert content knowledge that is simple to comprehend and modify and provides a foundation for a dynamic, inductive, and inclusive method of clinical documentation and research. The basis of medical decision analysis along with representative samples of medical knowledge modeling in the Cmap format is presented. The knowledge structures that are captured in Cmaps can be expressed directly in propositional logic, enabling the capability to convert Cmapped clinical expressions to be used to define a description logic for clinical evidence documentation and analysis that can in turn be mapped to multiple natural languages. The described description logic approach can be used to formulate digital messages and documents and to automate the process of converting description specifications formulated in propositional logic into operational electronic health record solutions for capture and reporting of clinical encounters. It has also been demonstrated that using Cmaps to elicit content knowledge from physicians to build point-of-care clinical documentation screens

  4. Availability of Structured and Unstructured Clinical Data for Comparative Effectiveness Research and Quality Improvement: A Multisite Assessment

    PubMed Central

    Capurro, Daniel; PhD, Meliha Yetisgen; van Eaton, Erik; Black, Robert; Tarczy-Hornoch, Peter

    2014-01-01

    Introduction: A key attribute of a learning health care system is the ability to collect and analyze routinely collected clinical data in order to quickly generate new clinical evidence, and to monitor the quality of the care provided. To achieve this vision, clinical data must be easy to extract and stored in computer readable formats. We conducted this study across multiple organizations to assess the availability of such data specifically for comparative effectiveness research (CER) and quality improvement (QI) on surgical procedures. Setting: This study was conducted in the context of the data needed for the already established Surgical Care and Outcomes Assessment Program (SCOAP), a clinician-led, performance benchmarking, and QI registry for surgical and interventional procedures in Washington State. Methods: We selected six hospitals, managed by two Health Information Technology (HIT) groups, and assessed the ease of automated extraction of the data required to complete the SCOAP data collection forms. Each data element was classified as easy, moderate, or complex to extract. Results: Overall, a significant proportion of the data required to automatically complete the SCOAP forms was not stored in structured computer-readable formats, with more than 75 percent of all data elements being classified as moderately complex or complex to extract. The distribution differed significantly between the health care systems studied. Conclusions: Although highly desirable, a learning health care system does not automatically emerge from the implementation of electronic health records (EHRs). Innovative methods to improve the structured capture of clinical data are needed to facilitate the use of routinely collected clinical data for patient phenotyping. PMID:25848594

  5. Medical students' perception of the proposal for theme-based integrated multi-disciplinary objective structured practical examination in Saudi Arabia.

    PubMed

    Hassan, Mohammad Saleh; Yacoubi, Amel

    2016-01-01

    This study aimed to find the opinion of preclinical medical students concerning a new suggested approach for practical assessment. Fifty-three female students agreed to participate in this study, out of 87 registered students in years 2 and 3 of the basic science phase of the College of Medicine, Qassim University, Kingdom of Saudi Arabia. Full explanation was made to the students of theme-based integrated objective structured practical examination (TBI-OSPE), followed by distribution of a questionnaire to collect the students' opinions. The study was conducted in January 2015. Results showed that 78% of respondents were accepting of this new approach, and that only 5.7% rejected it. This difference was statistically significant (P<0.05). This study suggested a new model for assessment of preclinical students' competencies using the proposed tool (TBI-OSPE) rather than standard classical OSPE, particularly in curricula involving high levels of integration and theme-based problems. This form of assessment would more positively enhance learning. PMID:27044780

  6. Objective convective updraft identification and tracking: Part 1. Structure and thermodynamics of convection in the rainband regions of two hurricane simulations

    NASA Astrophysics Data System (ADS)

    Terwey, Wesley D.; Rozoff, Christopher M.

    2014-06-01

    To better understand the life cycles of convective elements in numerical model simulations, a convective updraft tracking algorithm, dubbed the Statistical and Programmable Objective Updraft Tracker (SPOUT), is developed. SPOUT identifies updraft cores in horizontal slices through a given model data set, links these cores in three dimensions to form vertically coherent updrafts, and then tracks updrafts in time via estimates of the mean local advection. SPOUT is evaluated in idealized hurricane simulations from both the Regional Atmospheric Modeling System (RAMS) and Weather Research and Forecasting (WRF). In both simulations, SPOUT indicates most updrafts live less than 60 min, but some can persist for over 2 h. Updrafts are typically manifested as shallow cumulus, cumulus congestus, and deep cumulonimbus. Overall, there is reasonable agreement between the vigor of convection and the amount of localized conditional convective instability. Also, the majority of updrafts attain a tilted structure that is in accordance with the localized vertical wind shear. Nonetheless, there are striking differences between models, with the higher-resolution WRF simulation producing around twice as many updrafts as RAMS. Moreover, the WRF updrafts are significantly weaker. This paper highlights the utility of SPOUT for studying convective life cycles in high-resolution numerical simulations and provides some basic features of convection in two hurricane simulations.

  7. Medical students’ perception of the proposal for theme-based integrated multi-disciplinary objective structured practical examination in Saudi Arabia

    PubMed Central

    2016-01-01

    This study aimed to find the opinion of preclinical medical students concerning a new suggested approach for practical assessment. Fifty-three female students agreed to participate in this study, out of 87 registered students in years 2 and 3 of the basic science phase of the College of Medicine, Qassim University, Kingdom of Saudi Arabia. Full explanation was made to the students of theme-based integrated objective structured practical examination (TBI-OSPE), followed by distribution of a questionnaire to collect the students’ opinions. The study was conducted in January 2015. Results showed that 78% of respondents were accepting of this new approach, and that only 5.7% rejected it. This difference was statistically significant (P<0.05). This study suggested a new model for assessment of preclinical students’ competencies using the proposed tool (TBI-OSPE) rather than standard classical OSPE, particularly in curricula involving high levels of integration and theme-based problems. This form of assessment would more positively enhance learning. PMID:27044780

  8. Numerical integration of gravitational field for general three-dimensional objects and its application to gravitational study of grand design spiral arm structure

    NASA Astrophysics Data System (ADS)

    Fukushima, Toshio

    2016-08-01

    We present a method to integrate the gravitational field for general three-dimensional objects. By adopting the spherical polar coordinates centered at the evaluation point as the integration variables, we numerically compute the volume integral representation of the gravitational potential and of the acceleration vector. The variable transformation completely removes the algebraic singularities of the original integrals. The comparison with exact solutions reveals around 15 digits accuracy of the new method. Meanwhile, the 6 digit accuracy of the integrated gravitational field is realized by around 106 evaluations of the integrand per evaluation point, which costs at most a few seconds at a PC with Intel Core i7-4600U CPU running at 2.10 GHz clock. By using the new method, we show the gravitational field of a grand design spiral arm structure as an example. The computed gravitational field shows not only spiral shaped details but also a global feature composed of a thick oblate spheroid and a thin disc. The developed method is directly applicable to the electromagnetic field computation by means of Coulomb's law, the Biot-Savart law, and their retarded extensions. Sample FORTRAN 90 programs and test results are electronically available.

  9. Standardization of Course Plan and Design of Objective Structured Field Examination (OSFE) for the Assessment of Pharm.D. Student’s Community Pharmacy Clerkship Skills

    PubMed Central

    Monajjemzadeh, Farnaz; Shokri, Javad; Mohajel Nayebi, Ali Reza; Nemati, Mahboob; Azarmi, Yadollah; Charkhpour, Mohammad; Najafi, Moslem

    2014-01-01

    Purpose: This study was aimed to design Objective Structured Field Examination (OSFE) and also standardize the course plan of community pharmacy clerkship at Pharmacy Faculty of Tabriz University of Medical Sciences (Iran). Methods: The study was composed of several stages including; evaluation of the old program, standardization and implementation of the new course plan, design and implementation of OSFE, and finally results evaluation. Results: Lack of a fair final assessment protocol and proper organized educating system in various fields of community pharmacy clerkship skills were assigned as the main weaknesses of the old program. Educational priorities were determined and student’s feedback was assessed to design the new curriculum consisting of sessions to fulfill a 60-hour training course. More than 70% of the students were satisfied and successfulness and efficiency of the new clerkship program was significantly greater than the old program (P<0.05). In addition, they believed that OSFE was a suitable testing method. Conclusion: The defined course plan was successfully improved different skills of the students and OSFE was concluded as a proper performance based assessment method. This is easily adoptable by pharmacy faculties to improve the educational outcomes of the clerkship course. PMID:24511477

  10. Use of conditional rule structure to automate clinical decision support: a comparison of artificial intelligence and deterministic programming techniques.

    PubMed

    Friedman, R H; Frank, A D

    1983-08-01

    A rule-based computer system was developed to perform clinical decision-making support within a medical information system, oncology practice, and clinical research. This rule-based system, which has been programmed using deterministic rules, possesses features of generalizability, modularity of structure, convenience in rule acquisition, explanability, and utility for patient care and teaching, features which have been identified as advantages of artificial intelligence (AI) rule-based systems. Formal rules are primarily represented as conditional statements; common conditions and actions are stored in system dictionaries so that they can be recalled at any time to form new decision rules. Important similarities and differences exist in the structure of this system and clinical computer systems utilizing artificial intelligence (AI) production rule techniques. The non-AI rule-based system possesses advantages in cost and ease of implementation. The degree to which significant medical decision problems can be solved by this technique remains uncertain as does whether the more complex AI methodologies will be required. PMID:6352165

  11. Therapist turnover and new program sustainability in mental health clinics as a function of organizational culture, climate, and service structure.

    PubMed

    Glisson, Charles; Schoenwald, Sonja K; Kelleher, Kelly; Landsverk, John; Hoagwood, Kimberly Eaton; Mayberg, Stephen; Green, Philip

    2008-03-01

    The present study incorporates organizational theory and organizational characteristics in examining issues related to the successful implementation of mental health services. Following the theoretical foundations of socio-technical and cultural models of organizational effectiveness, organizational climate, culture, legal and service structures, and workforce characteristics are examined as correlates of therapist turnover and new program sustainability in a nationwide sample of mental health clinics. Results of General Linear Modeling (GLM) with the organization as the unit of analysis revealed that organizations with the best climates as measured by the Organizational Social Context (OSC) profiling system, had annual turnover rates (10%) that were less than half the rates found in organizations with the worst climates (22%). In addition, organizations with the best culture profiles sustained new treatment or service programs over twice as long (50 vs. 24 months) as organizations with the worst cultures. Finally, clinics with separate children's services units had higher turnover rates than clinics that served adults and children within the same unit. The findings suggest that strategies to support the implementation of new mental health treatments and services should attend to organizational culture and climate, and to the compatibility of organizational service structures with the demand characteristics of treatments. PMID:18080741

  12. [Literature of so-called "clinical research": structure and trends, 1991-2010].

    PubMed

    Schubert, András; Somogyi, Anikó

    2014-11-30

    The authors studied trends and patterns in the literature of research labeled as clinical (i.e., having the word "clinical" in their title) in the period between 1991 and 2010. The main findings are: 1. The growth of the literature under study was somewhat stronger than that of the overall medical literature. 2. The dominance of the USA is strong but is challenged by some of the most rapidly developing countries (particularly in the Far-East region: China, Korea) in total production, and by the developed European countries in highly cited publications. The eminence of Italy is remarkable. 3. In comparing the medical fields, the most striking tendencies are the increase of oncology and the attenuation of internal medicine. Surgery is steadily growing in size but decreasing in its citation influence. 4. Word frequency studies support the ever growing weight of oncology and also of genetics. 5. Beyond the thematic changes, word frequency studies also reveal a substantial change in attitude: in the period under study more and more effort was made on emphasizing the usefulness, efficiency and risks of the results in contrast with the more descriptive, investigative approach of the past. The role of therapy is growing, the role of diagnostics is decreasing. The knowledge of these trends and patterns may orient health and science policy makers to cope appropriately with the ever changing world of clinical research. PMID:25417139

  13. Reflective type objective based spectral-domain phase-sensitive optical coherence tomography for high-sensitive structural and functional imaging of cochlear microstructures through intact bone of an excised guinea pig cochlea

    NASA Astrophysics Data System (ADS)

    Subhash, Hrebesh M.; Wang, Ruikang K.; Chen, Fangyi; Nuttall, Alfred L.

    2013-03-01

    Most of the optical coherence tomographic (OCT) systems for high resolution imaging of biological specimens are based on refractive type microscope objectives, which are optimized for specific wave length of the optical source. In this study, we present the feasibility of using commercially available reflective type objective for high sensitive and high resolution structural and functional imaging of cochlear microstructures of an excised guinea pig through intact temporal bone. Unlike conventional refractive type microscopic objective, reflective objective are free from chromatic aberrations due to their all-reflecting nature and can support a broadband of spectrum with very high light collection efficiency.

  14. Solvent interaction analysis as a proteomic approach to structure-based biomarker discovery and clinical diagnostics.

    PubMed

    Zaslavsky, Boris Y; Uversky, Vladimir N; Chait, Arnon

    2016-01-01

    Proteins have several measurable features in biological fluids that may change under pathological conditions. The current disease biomarker discovery is mostly based on protein concentration in the sample as the measurable feature. Changes in protein structures, such as post-translational modifications and in protein-partner interactions are known to accompany pathological processes. Changes in glycosylation profiles are well-established for many plasma proteins in various types of cancer and other diseases. The solvent interaction analysis method is based on protein partitioning in aqueous two-phase systems and is highly sensitive to changes in protein structure and protein-protein- and protein-partner interactions while independent of the protein concentration in the biological sample. It provides quantitative index: partition coefficient representing changes in protein structure and interactions with partners. The fundamentals of the method are presented with multiple examples of applications of the method to discover and monitor structural protein biomarkers as disease-specific diagnostic indicators. PMID:26558960

  15. Characterization of the microbunch time structure of proton pencil beams at a clinical treatment facility.

    PubMed

    Petzoldt, J; Roemer, K E; Enghardt, W; Fiedler, F; Golnik, C; Hueso-González, F; Helmbrecht, S; Kormoll, T; Rohling, H; Smeets, J; Werner, T; Pausch, G

    2016-03-21

    Proton therapy is an advantageous treatment modality compared to conventional radiotherapy. In contrast to photons, charged particles have a finite range and can thus spare organs at risk. Additionally, the increased ionization density in the so-called Bragg peak close to the particle range can be utilized for maximum dose deposition in the tumour volume. Unfortunately, the accuracy of the therapy can be affected by range uncertainties, which have to be covered by additional safety margins around the treatment volume. A real-time range and dose verification is therefore highly desired and would be key to exploit the major advantages of proton therapy. Prompt gamma rays, produced in nuclear reactions between projectile and target nuclei, can be used to measure the proton's range. The prompt gamma-ray timing (PGT) method aims at obtaining this information by determining the gamma-ray emission time along the proton path using a conventional time-of-flight detector setup. First tests at a clinical accelerator have shown the feasibility to observe range shifts of about 5 mm at clinically relevant doses. However, PGT spectra are smeared out by the bunch time spread. Additionally, accelerator related proton bunch drifts against the radio frequency have been detected, preventing a potential range verification. At OncoRay, first experiments using a proton bunch monitor (PBM) at a clinical pencil beam have been conducted. Elastic proton scattering at a hydrogen-containing foil could be utilized to create a coincident proton-proton signal in two identical PBMs. The selection of coincident events helped to suppress uncorrelated background. The PBM setup was used as time reference for a PGT detector to correct for potential bunch drifts. Furthermore, the corrected PGT data were used to image an inhomogeneous phantom. In a further systematic measurement campaign, the bunch time spread and the proton transmission rate were measured for several beam energies between 69 and 225 Me

  16. Characterization of the microbunch time structure of proton pencil beams at a clinical treatment facility

    NASA Astrophysics Data System (ADS)

    Petzoldt, J.; Roemer, K. E.; Enghardt, W.; Fiedler, F.; Golnik, C.; Hueso-González, F.; Helmbrecht, S.; Kormoll, T.; Rohling, H.; Smeets, J.; Werner, T.; Pausch, G.

    2016-03-01

    Proton therapy is an advantageous treatment modality compared to conventional radiotherapy. In contrast to photons, charged particles have a finite range and can thus spare organs at risk. Additionally, the increased ionization density in the so-called Bragg peak close to the particle range can be utilized for maximum dose deposition in the tumour volume. Unfortunately, the accuracy of the therapy can be affected by range uncertainties, which have to be covered by additional safety margins around the treatment volume. A real-time range and dose verification is therefore highly desired and would be key to exploit the major advantages of proton therapy. Prompt gamma rays, produced in nuclear reactions between projectile and target nuclei, can be used to measure the proton’s range. The prompt gamma-ray timing (PGT) method aims at obtaining this information by determining the gamma-ray emission time along the proton path using a conventional time-of-flight detector setup. First tests at a clinical accelerator have shown the feasibility to observe range shifts of about 5 mm at clinically relevant doses. However, PGT spectra are smeared out by the bunch time spread. Additionally, accelerator related proton bunch drifts against the radio frequency have been detected, preventing a potential range verification. At OncoRay, first experiments using a proton bunch monitor (PBM) at a clinical pencil beam have been conducted. Elastic proton scattering at a hydrogen-containing foil could be utilized to create a coincident proton-proton signal in two identical PBMs. The selection of coincident events helped to suppress uncorrelated background. The PBM setup was used as time reference for a PGT detector to correct for potential bunch drifts. Furthermore, the corrected PGT data were used to image an inhomogeneous phantom. In a further systematic measurement campaign, the bunch time spread and the proton transmission rate were measured for several beam energies between 69 and 225

  17. Subcallosal brain structure: correlation with hearing threshold at supra-clinical frequencies (>8 kHz), but not with tinnitus.

    PubMed

    Melcher, Jennifer R; Knudson, Inge M; Levine, Robert A

    2013-01-01

    This study tested for differences in brain structure between tinnitus and control subjects, focusing on a subcallosal brain region where striking differences have been inconsistently found previously. Voxel-based morphometry (VBM) was used to compare structural MRIs of tinnitus subjects and non-tinnitus controls. Audiograms of all subjects were normal or near-normal at standard clinical frequencies (≤8 kHz). Mean threshold through 14 kHz, age, sex and handedness were matched between groups. There were no definitive differences between tinnitus and control groups in modulated or unmodulated maps of gray matter (GM) probability (i.e., GM volume and concentration, respectively). However, when the image data were tested for correlations with parameters that were either not measured or not matched between the tinnitus and control groups of previous studies, a notable correlation was found: Threshold at supra-clinical frequencies (above 8 kHz) was negatively correlated with modulated GM probability in ventral posterior cingulate cortex, dorsomedial prefrontal cortex, and a subcallosal region that included ventromedial prefrontal cortex and coincided with previously-reported differences between tinnitus and control subjects. The results suggest an explanation for the discrepant findings in subcallosal brain: threshold at supra-clinical frequencies may have differed systematically between tinnitus and control groups in some studies but not others. The observed correlation between (1) brain structure in regions engaged in cognitive and attentional processes and (2) hearing sensitivity at frequencies generally considered unnecessary for normal human auditory behavior is surprising and worthy of follow up. PMID:22504034

  18. Early object relations into new objects.

    PubMed

    Downey, T W

    2001-01-01

    Two strands of change are suggested by this review, one maturational, the other therapeutic or developmental (Hartmann and Kris, 1945). By "maturational" I mean to suggest energies that infuse the individual from earliest life in a manner that includes object relations, but for the healthy exercise of which object relations per se need not be of central and crucial importance. Within wide limits such energies may be delayed until growth conditions prevail without significant distortion of certain of the organism's ego functions. Therapeutic change is analogous to developmental change in that both involve the crucial presence of another to release energies. In therapeutic change these are energies that have been repressed beyond the reach of developmental dynamics. In everyday development crisis and synthesis alternate in conjunction with new and emerging objects to add to the psychological structures brought to the fore by maturation. In many instances, as we see with John, over time and in a less focussed manner, developmental changes can approximate therapeutic change and visa versa. Freud-Dann in their "experiment" pursued one line, in which the equipmental delay brought on by extremely adverse living circumstances was redressed by providing an interpersonally enriching, loving, developmentally facilitating milieu. The sketches of individual children and John's subsequent story provide a perspective into what becomes the stuff of growth and what remains the stuff of neurosis. The developmental reserves and ego resilience of these children were impressive but probably not extraordinary. Usual growth ensued as soon as they were provided with the rich soil of Bulldogs Bank instead of the desert sand of the Tereszin concentration camp. However, no one can escape such adverse circumstances without having taken in the stuff of neurosis. Affects and percepts that were not assimilatable or even available to consciousness at the time remain buried in the unconscious

  19. A randomised controlled trial of structured nurse-led outpatient clinic follow-up for dyspeptic patients after direct access gastroscopy

    PubMed Central

    2009-01-01

    Background Dyspepsia is a common disorder in the community, with many patients referred for diagnostic gastroscopy by their General Practitioner (GP). The National Institute of Clinical Excellence (NICE) recommends follow-up after investigation for cost effective management, including lifestyle advice and drug use. An alternative strategy may be the use of a gastro-intestinal nurse practitioner (GNP) instead of the GP. The objective of this study is to compare the effectiveness and costs of systematic GNP led follow-up to usual care by GPs in dyspeptic patients following gastroscopy. Results Direct access adult dyspeptic patients referred for gastroscopy; without serious pathology, were followed-up in a structured nurse-led outpatient clinic. Outcome measurement used to compare the two study cohorts (GNP versus GP) included Glasgow dyspepsia severity (Gladys) score, Health Status Short Form 12 (SF12), ulcer healing drug (UHD) use and costs. One hundred and seventy five patients were eligible after gastroscopy, 89 were randomised to GNP follow-up and 86 to GP follow-up. Follow-up at 6 months was 81/89 (91%) in the GNP arm and 79/86 (92%) in the GP arm. On an intention to treat analysis, adjusted mean differences (95%CI) at follow-up between Nurse and GP follow-up were: Gladys score 2.30 (1.4–3.2) p < 0.001, SF12 140.6 (96.5–184.8) p =< 0.001 and UHD costs £39.60 (£24.20–£55.10) p =< 0.001, all in favour of nurse follow-up. Conclusion A standardised and structured follow-up by one gastrointestinal nurse practitioner was effective and may save drug costs in patients after gastroscopy. These findings need replication in other centres. PMID:19200356

  20. Hypothyroidism Side Effect in Patients Treated with Sunitinib or Sorafenib: Clinical and Structural Analyses.

    PubMed

    Shu, Mao; Zai, Xiaoli; Zhang, Beina; Wang, Rui; Lin, Zhihua

    2016-01-01

    Tyrosine kinase inhibitors (TKIs) provide more effective targeted treatments for cancer, but are subject to a variety of adverse effects, such as hypothyroidism. TKI-induced hypothyroidism is a highly complicated issue, because of not only the unrealized toxicological mechanisms, but also different incidences of individual TKI drugs. While sunitinib is suspected for causing thyroid dysfunction more often than other TKIs, sorafenib is believed to be less risky. Here we integrated clinical data and in silico drug-protein interactions to examine the pharmacological distinction between sunitinib and sorafenib. Statistical analysis on the FDA Adverse Event Reporting System (FAERS) confirmed that sunitinib is more concurrent with hypothyroidism than sorafenib, which was observed in both female and male patients. Then, we used docking method and identified 3 proteins specifically binding to sunitinib but not sorafenib, i.e., retinoid X receptor alpha, retinoic acid receptors beta and gamma. As potential off-targets of sunitinib, these proteins are well known to assemble with thyroid hormone receptors, which can explain the profound impact of sunitinib on thyroid function. Taken together, we established a strategy of integrated analysis on clinical records and drug off-targets, which can be applied to explore the molecular basis of various adverse drug reactions. PMID:26784451

  1. Hypothyroidism Side Effect in Patients Treated with Sunitinib or Sorafenib: Clinical and Structural Analyses

    PubMed Central

    Shu, Mao; Zai, Xiaoli; Zhang, Beina; Wang, Rui; Lin, Zhihua

    2016-01-01

    Tyrosine kinase inhibitors (TKIs) provide more effective targeted treatments for cancer, but are subject to a variety of adverse effects, such as hypothyroidism. TKI-induced hypothyroidism is a highly complicated issue, because of not only the unrealized toxicological mechanisms, but also different incidences of individual TKI drugs. While sunitinib is suspected for causing thyroid dysfunction more often than other TKIs, sorafenib is believed to be less risky. Here we integrated clinical data and in silico drug-protein interactions to examine the pharmacological distinction between sunitinib and sorafenib. Statistical analysis on the FDA Adverse Event Reporting System (FAERS) confirmed that sunitinib is more concurrent with hypothyroidism than sorafenib, which was observed in both female and male patients. Then, we used docking method and identified 3 proteins specifically binding to sunitinib but not sorafenib, i.e., retinoid X receptor alpha, retinoic acid receptors beta and gamma. As potential off-targets of sunitinib, these proteins are well known to assemble with thyroid hormone receptors, which can explain the profound impact of sunitinib on thyroid function. Taken together, we established a strategy of integrated analysis on clinical records and drug off-targets, which can be applied to explore the molecular basis of various adverse drug reactions. PMID:26784451

  2. Structural and incremental validity of the Wechsler Adult Intelligence Scale-Fourth Edition with a clinical sample.

    PubMed

    Nelson, Jason M; Canivez, Gary L; Watkins, Marley W

    2013-06-01

    Structural and incremental validity of the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV; Wechsler, 2008a) was examined with a sample of 300 individuals referred for evaluation at a university-based clinic. Confirmatory factor analysis indicated that the WAIS-IV structure was best represented by 4 first-order factors as well as a general intelligence factor in a direct hierarchical model. The general intelligence factor accounted for the most common and total variance among the subtests. Incremental validity analyses indicated that the Full Scale IQ (FSIQ) generally accounted for medium to large portions of academic achievement variance. For all measures of academic achievement, the first-order factors combined accounted for significant achievement variance beyond that accounted for by the FSIQ, but individual factor index scores contributed trivial amounts of achievement variance. Implications for interpreting WAIS-IV results are discussed. PMID:23544395

  3. Structural basis for effectiveness of siderophore-conjugated monocarbams against clinically relevant strains of Pseudomonas aeruginosa

    SciTech Connect

    Han, Seungil; Zaniewski, Richard P.; Marr, Eric S.; Lacey, Brian M.; Tomaras, Andrew P.; Evdokimov, Artem; Miller, J. Richard; Shanmugasundaram, Veerabahu

    2012-02-08

    Pseudomonas aeruginosa is an opportunistic Gram-negative pathogen that causes nosocomial infections for which there are limited treatment options. Penicillin-binding protein PBP3, a key therapeutic target, is an essential enzyme responsible for the final steps of peptidoglycan synthesis and is covalently inactivated by {beta}-lactam antibiotics. Here we disclose the first high resolution cocrystal structures of the P. aeruginosa PBP3 with both novel and marketed {beta}-lactams. These structures reveal a conformational rearrangement of Tyr532 and Phe533 and a ligand-induced conformational change of Tyr409 and Arg489. The well-known affinity of the monobactam aztreonam for P. aeruginosa PBP3 is due to a distinct hydrophobic aromatic wall composed of Tyr503, Tyr532, and Phe533 interacting with the gem-dimethyl group. The structure of MC-1, a new siderophore-conjugated monocarbam complexed with PBP3 provides molecular insights for lead optimization. Importantly, we have identified a novel conformation that is distinct to the high-molecular-weight class B PBP subfamily, which is identifiable by common features such as a hydrophobic aromatic wall formed by Tyr503, Tyr532, and Phe533 and the structural flexibility of Tyr409 flanked by two glycine residues. This is also the first example of a siderophore-conjugated triazolone-linked monocarbam complexed with any PBP. Energetic analysis of tightly and loosely held computed hydration sites indicates protein desolvation effects contribute significantly to PBP3 binding, and analysis of hydration site energies allows rank ordering of the second-order acylation rate constants. Taken together, these structural, biochemical, and computational studies provide a molecular basis for recognition of P. aeruginosa PBP3 and open avenues for future design of inhibitors of this class of PBPs.

  4. Stable feature selection for clinical prediction: exploiting ICD tree structure using Tree-Lasso.

    PubMed

    Kamkar, Iman; Gupta, Sunil Kumar; Phung, Dinh; Venkatesh, Svetha

    2015-02-01

    Modern healthcare is getting reshaped by growing Electronic Medical Records (EMR). Recently, these records have been shown of great value towards building clinical prediction models. In EMR data, patients' diseases and hospital interventions are captured through a set of diagnoses and procedures codes. These codes are usually represented in a tree form (e.g. ICD-10 tree) and the codes within a tree branch may be highly correlated. These codes can be used as features to build a prediction model and an appropriate feature selection can inform a clinician about important risk factors for a disease. Traditional feature selection methods (e.g. Information Gain, T-test, etc.) consider each variable independently and usually end up having a long feature list. Recently, Lasso and related l1-penalty based feature selection methods have become popular due to their joint feature selection property. However, Lasso is known to have problems of selecting one feature of many correlated features randomly. This hinders the clinicians to arrive at a stable feature set, which is crucial for clinical decision making process. In this paper, we solve this problem by using a recently proposed Tree-Lasso model. Since, the stability behavior of Tree-Lasso is not well understood, we study the stability behavior of Tree-Lasso and compare it with other feature selection methods. Using a synthetic and two real-world datasets (Cancer and Acute Myocardial Infarction), we show that Tree-Lasso based feature selection is significantly more stable than Lasso and comparable to other methods e.g. Information Gain, ReliefF and T-test. We further show that, using different types of classifiers such as logistic regression, naive Bayes, support vector machines, decision trees and Random Forest, the classification performance of Tree-Lasso is comparable to Lasso and better than other methods. Our result has implications in identifying stable risk factors for many healthcare problems and therefore can

  5. Inhibition of Human Aldehyde Oxidase Activity by Diet-Derived Constituents: Structural Influence, Enzyme-Ligand Interactions, and Clinical Relevance

    PubMed Central

    Barr, John T.; Jones, Jeffrey P.; Oberlies, Nicholas H.

    2015-01-01

    The mechanistic understanding of interactions between diet-derived substances and conventional medications in humans is nascent. Most investigations have examined cytochrome P450–mediated interactions. Interactions mediated by other phase I enzymes are understudied. Aldehyde oxidase (AO) is a phase I hydroxylase that is gaining recognition in drug design and development programs. Taken together, a panel of structurally diverse phytoconstituents (n = 24) was screened for inhibitors of the AO-mediated oxidation of the probe substrate O6-benzylguanine. Based on the estimated IC50 (<100 μM), 17 constituents were advanced for Ki determination. Three constituents were described best by a competitive inhibition model, whereas 14 constituents were described best by a mixed-mode model. The latter model consists of two Ki terms, Kis and Kii, which ranged from 0.26–73 and 0.80–120 μM, respectively. Molecular modeling was used to glean mechanistic insight into AO inhibition. Docking studies indicated that the tested constituents bound within the AO active site and elucidated key enzyme-inhibitor interactions. Quantitative structure-activity relationship modeling identified three structural descriptors that correlated with inhibition potency (r2 = 0.85), providing a framework for developing in silico models to predict the AO inhibitory activity of a xenobiotic based solely on chemical structure. Finally, a simple static model was used to assess potential clinically relevant AO-mediated dietary substance–drug interactions. Epicatechin gallate and epigallocatechin gallate, prominent constituents in green tea, were predicted to have moderate to high risk. Further characterization of this uncharted type of interaction is warranted, including dynamic modeling and, potentially, clinical evaluation. PMID:25326286

  6. Inhibition of human aldehyde oxidase activity by diet-derived constituents: structural influence, enzyme-ligand interactions, and clinical relevance.

    PubMed

    Barr, John T; Jones, Jeffrey P; Oberlies, Nicholas H; Paine, Mary F

    2015-01-01

    The mechanistic understanding of interactions between diet-derived substances and conventional medications in humans is nascent. Most investigations have examined cytochrome P450-mediated interactions. Interactions mediated by other phase I enzymes are understudied. Aldehyde oxidase (AO) is a phase I hydroxylase that is gaining recognition in drug design and development programs. Taken together, a panel of structurally diverse phytoconstituents (n = 24) was screened for inhibitors of the AO-mediated oxidation of the probe substrate O(6)-benzylguanine. Based on the estimated IC50 (<100 μM), 17 constituents were advanced for Ki determination. Three constituents were described best by a competitive inhibition model, whereas 14 constituents were described best by a mixed-mode model. The latter model consists of two Ki terms, Kis and Kii, which ranged from 0.26-73 and 0.80-120 μM, respectively. Molecular modeling was used to glean mechanistic insight into AO inhibition. Docking studies indicated that the tested constituents bound within the AO active site and elucidated key enzyme-inhibitor interactions. Quantitative structure-activity relationship modeling identified three structural descriptors that correlated with inhibition potency (r(2) = 0.85), providing a framework for developing in silico models to predict the AO inhibitory activity of a xenobiotic based solely on chemical structure. Finally, a simple static model was used to assess potential clinically relevant AO-mediated dietary substance-drug interactions. Epicatechin gallate and epigallocatechin gallate, prominent constituents in green tea, were predicted to have moderate to high risk. Further characterization of this uncharted type of interaction is warranted, including dynamic modeling and, potentially, clinical evaluation. PMID:25326286

  7. [Rheumatology - Integration into student training (RISA) : Current structure of clinical rheumatology in German universities (RISA III)].

    PubMed

    Riemekasten, G; Aringer, M; Baerwald, C G O; Meyer-Bahlburg, A; Bergner, R; Feuchtenberger, M; Gebhardt, C; Hellmich, B; Keyßer, G; Lorenz, H-M; Kneitz, C; Witte, T; Müller-Ladner, U; Schneider, M; Braun, J; Rautenstrauch, J; Specker, C; Schulze-Koops, H

    2016-06-01

    The German Society of Rheumatology and the Committee for Student Training investigated what effects the structures in university medicine have on student teaching. In February 2014 a questionnaire was sent to the teaching staff and Deans of each of the 37 medical faculties. Of the locations seven were classified as being independent rheumatological university hospitals and nine universities had a W2/W3/C3 grade professor as head of a department of clinical rheumatology but answerable to superiors. In the 37 faculties in Germany the proportion of lecture hours, the proportion of obligatory lecture hours, the number of hours for practical exercises and the number of hours for bedside teaching were distributed very differently and as a rule higher in universities with academic freedom. Not all medical faculties have obligatory teaching in the field of clinical rheumatology. On average medical students see five patients with rheumatological symptoms during their studies. In summary, over the past years it has not been possible to successfully utilize the great importance of rheumatology for society and the innovation potential of this discipline in order to improve the integration of clinical rheumatology into universities. PMID:27193335

  8. NCL Objective #5 - Nanotechnology Characterization Lab (NCL)

    Cancer.gov

    Nanotechnology Characterization Lab (NCL) Objective #5: Engage and Facilitate Academic and Industrial-based Knowledge Sharing of Nanomaterial Performance Data and Behavior Resulting from Pre-Clinical Testing.

  9. Structure and Measurement of Depression in Youth: Applying Item Response Theory to Clinical Data

    PubMed Central

    Cole, David A.; Cai, Li; Martin, Nina C.; Findling, Robert L; Youngstrom, Eric A.; Garber, Judy; Curry, John F.; Hyde, Janet S.; Essex, Marilyn J.; Compas, Bruce E.; Goodyer, Ian M.; Rohde, Paul; Stark, Kevin D.; Slattery, Marcia J.; Forehand, Rex

    2013-01-01

    Goals of the paper were to use item response theory (IRT) to assess the relation of depressive symptoms to the underlying dimension of depression and to demonstrate how IRT-based measurement strategies can yield more reliable data about depression severity than conventional symptom counts. Participants were 3403 clinic and nonclinic children and adolescents from 12 contributing samples, all of whom received the Kiddie Schedule of Affective Disorders and Schizophrenia for school-aged children. Results revealed that some symptoms reflected higher levels of depression and were more discriminating than others. Results further demonstrated that utilization of IRT-based information about symptom severity and discriminability in the measurement of depression severity can reduce measurement error and increase measurement fidelity. PMID:21534696

  10. Associations between CMS's Clinical Performance Measures project benchmarks, profit structure, and mortality in dialysis units.

    PubMed

    Szczech, L A; Klassen, P S; Chua, B; Hedayati, S S; Flanigan, M; McClellan, W M; Reddan, D N; Rettig, R A; Frankenfield, D L; Owen, W F

    2006-06-01

    Prior studies observing greater mortality in for-profit dialysis units have not captured information about benchmarks of care. This study was undertaken to examine the association between profit status and mortality while achieving benchmarks. Utilizing data from the US Renal Data System and the Centers for Medicare & Medicaid Services' end-stage renal disease (ESRD) Clinical Performance Measures project, hemodialysis units were categorized as for-profit or not-for-profit. Associations with mortality at 1 year were estimated using Cox regression. Two thousand six hundred and eighty-five dialysis units (31,515 patients) were designated as for-profit and 1018 (15,085 patients) as not-for-profit. Patients in for-profit facilities were more likely to be older, black, female, diabetic, and have higher urea reduction ratio (URR), hematocrit, serum albumin, and transferrin saturation. Patients (19.4 and 18.6%) in for-profit and not-for-profit units died, respectively. In unadjusted analyses, profit status was not associated with mortality (hazard ratio (HR)=1.04, P=0.09). When added to models with profit status, the following resulted in a significant association between profit status (for-profit vs not-for-profit) and increasing mortality risk: URR, hematocrit, albumin, and ESRD Network. In adjusted models, patients in for-profit facilities had a greater death risk (HR 1.09, P=0.004). More patients in for-profit units met clinical benchmarks. Survival among patients in for-profit units was similar to not-for-profit units. This suggests that in the contemporary era, interventions in for-profit dialysis units have not impaired their ability to deliver performance benchmarks and do not affect survival. PMID:16732194

  11. Breadth versus volume: Neurology outpatient clinic cases in medical education.

    PubMed

    Albert, Dara V; Blood, Angela D; Park, Yoon Soo; Brorson, James R; Lukas, Rimas V

    2016-06-01

    This study examined how volume in certain patient case types and breadth across patient case types in the outpatient clinic setting are related to Neurology Clerkship student performance. Case logs from the outpatient clinic experience of 486 students from The University of Chicago Pritzker School of Medicine, USA, participating in the 4week Neurology Clerkship from July 2008 to June 2013 were reviewed. A total of 12,381 patient encounters were logged and then classified into 13 diagnostic categories. How volume of cases within categories and the breadth of cases across categories relate to the National Board of Medical Examiners Clinical Subject Examination for Neurology and a Neurology Clerkship Objective Structured Clinical Examination was analyzed. Volume of cases was significantly correlated with the National Board of Medical Examiners Clinical Subject Examination for Neurology (r=.290, p<.001), the Objective Structured Clinical Examination physical examination (r=.236, p=.011), and the Objective Structured Clinical Examination patient note (r=.238, p=.010). Breadth of cases was significantly correlated with the National Board of Medical Examiners Clinical Subject Examination for Neurology (r=.231, p=.017), however was not significantly correlated with any component of the Objective Structured Clinical Examination. Volume of cases correlated with higher performance on measures of specialty knowledge and clinical skill. Fewer relationships emerged correlating breadth of cases and performance on the same measures. This study provides guidance to educators who must decide how much emphasis to place on volume versus breadth of cases in outpatient clinic learning experiences. PMID:26896906

  12. HIGHER ORDER FACTOR STRUCTURE OF THE WISC-IV IN A CLINICAL NEUROPSYCHOLOGICAL SAMPLE

    PubMed Central

    Bodin, Doug; Pardini, Dustin A.; Burns, Thomas G.; Stevens, Abigail B.

    2010-01-01

    A confirmatory factor analysis was conducted examining the higher order factor structure of the WISC-IV scores for 344 children who participated in neuropsychological evaluations at a large children’s hospital. The WISC-IV factor structure mirrored that of the standardization sample. The second order general intelligence factor (g) accounted for the largest proportion of variance in the first-order latent factors and in the individual subtests, especially for the working memory index. The first-order processing speed factor exhibited the most unique variance beyond the influence of g. The results suggest that clinicians should not ignore the contribution of g when interpreting the first-order factors. PMID:19132580

  13. ARTEMIS Science Objectives

    NASA Technical Reports Server (NTRS)

    Sibeck, D. G.; Angelopoulos, V.; Brain, D. A.; Delory, G. T.; Eastwood, J. P.; Farrell, W. M.; Grimm, R. E.; Halekas, J. S.; Hasegawa, H.; Hellinger, P.; Khurana, K. K.; Lillis, R. J.; Oieroset, M.; Phan, T.-D.; Raeder, J.; Russell, C. T.; Schriver, D.; Slavin, J. A.; Travnicel, P. M.; Weygand, J. M.

    2011-01-01

    NASA's two spacecraft ARTEMIS mission will address both heliospheric and planetary research questions, first while in orbit about the Earth with the Moon and subsequently while in orbit about the Moon. Heliospheric topics include the structure of the Earth's magnetotail; reconnection, particle acceleration, and turbulence in the Earth's magnetosphere, at the bow shock, and in the solar wind; and the formation and structure of the lunar wake. Planetary topics include the lunar exosphere and its relationship to the composition of the lunar surface, the effects of electric fields on dust in the exosphere, internal structure of the Moon, and the lunar crustal magnetic field. This paper describes the expected contributions of ARTEMIS to these baseline scientific objectives.

  14. Comparative Evaluation for Brain Structural Connectivity Approaches: Towards Integrative Neuroinformatics Tool for Epilepsy Clinical Research.

    PubMed

    Yang, Sheng; Tatsuoka, Curtis; Ghosh, Kaushik; Lacuey-Lecumberri, Nuria; Lhatoo, Samden D; Sahoo, Satya S

    2016-01-01

    Recent advances in brain fiber tractography algorithms and diffusion Magnetic Resonance Imaging (MRI) data collection techniques are providing new approaches to study brain white matter connectivity, which play an important role in complex neurological disorders such as epilepsy. Epilepsy affects approximately 50 million persons worldwide and it is often described as a disorder of the cortical network organization. There is growing recognition of the need to better understand the role of brain structural networks in the onset and propagation of seizures in epilepsy using high resolution non-invasive imaging technologies. In this paper, we perform a comparative evaluation of two techniques to compute structural connectivity, namely probabilistic fiber tractography and statistics derived from fractional anisotropy (FA), using diffusion MRI data from a patient with rare case of medically intractable insular epilepsy. The results of our evaluation demonstrate that probabilistic fiber tractography provides a more accurate map of structural connectivity and may help address inherent complexities of neural fiber layout in the brain, such as fiber crossings. This work provides an initial result towards building an integrative informatics tool for neuroscience that can be used to accurately characterize the role of fiber tract connectivity in neurological disorders such as epilepsy. PMID:27570685

  15. Comparative Evaluation for Brain Structural Connectivity Approaches: Towards Integrative Neuroinformatics Tool for Epilepsy Clinical Research

    PubMed Central

    Yang, Sheng; Tatsuoka, Curtis; Ghosh, Kaushik; Lacuey-Lecumberri, Nuria; Lhatoo, Samden D.; Sahoo, Satya S.

    2016-01-01

    Recent advances in brain fiber tractography algorithms and diffusion Magnetic Resonance Imaging (MRI) data collection techniques are providing new approaches to study brain white matter connectivity, which play an important role in complex neurological disorders such as epilepsy. Epilepsy affects approximately 50 million persons worldwide and it is often described as a disorder of the cortical network organization. There is growing recognition of the need to better understand the role of brain structural networks in the onset and propagation of seizures in epilepsy using high resolution non-invasive imaging technologies. In this paper, we perform a comparative evaluation of two techniques to compute structural connectivity, namely probabilistic fiber tractography and statistics derived from fractional anisotropy (FA), using diffusion MRI data from a patient with rare case of medically intractable insular epilepsy. The results of our evaluation demonstrate that probabilistic fiber tractography provides a more accurate map of structural connectivity and may help address inherent complexities of neural fiber layout in the brain, such as fiber crossings. This work provides an initial result towards building an integrative informatics tool for neuroscience that can be used to accurately characterize the role of fiber tract connectivity in neurological disorders such as epilepsy. PMID:27570685

  16. Structural basis for heterogeneous phenotype of ERG11 dependent Azole resistance in C.albicans clinical isolates.

    PubMed

    Debnath, Surajit; Addya, Soma

    2014-01-01

    Correlating antifungal Azole drug resistance and mis-sense mutations of ERG11 has been paradoxical in pathogenic yeast Candida albicans. Amino acid substitutions (single or multiple) are frequent on ERG11, a membrane bound enzyme of Ergosterol biosynthesis pathway. Presence or absence of mutations can not sufficiently predict susceptibility. To analyze role of mis-sense mutations on Azole resistance energetically optimized, structurally validated homology model of wild C.albicans ERG11 using eukaryotic template was generated. A Composite Search Approach is proposed to identify vital residues for interaction at 3D active site. Structural analysis of catalytic groove, dynamics of substrate access channels and proximity of Heme prosthetic group characterized ERG11 active site. Several mis-sense mutations of ERG11 reported in C.albicans clinical isolates were selected through a stringent criterion and modeled. ERG11 mutants subsequently subjected to a four tier comparative biophysical analysis. This study indicates (i) critical interactions occur with residues at anterior part of 3D catalytic groove and substitution of these vital residues alters local geometry causing considerable change in catalytic pocket dimension. (ii) Substitutions of vital residues lead to confirmed resistance in clinical isolates that may be resultant to changed geometry of catalytic pocket. (iii)These substitutions also impart significant energetic changes on C.albicans ERG11 and (iv) include detectable dynamic fluctuations on the mutants. (v)Mis-sense mutations on the vital residues of the active site and at the vicinity of Heme prosthetic group are less frequent compared to rest of the enzyme. This large scale mutational study can aid to characterize the mutants in clinical isolates. PMID:25512882

  17. Structural Mechanics Predictions Relating to Clinical Coronary Stent Fracture in a 5 Year Period in FDA MAUDE Database.

    PubMed

    Everett, Kay D; Conway, Claire; Desany, Gerard J; Baker, Brian L; Choi, Gilwoo; Taylor, Charles A; Edelman, Elazer R

    2016-02-01

    Endovascular stents are the mainstay of interventional cardiovascular medicine. Technological advances have reduced biological and clinical complications but not mechanical failure. Stent strut fracture is increasingly recognized as of paramount clinical importance. Though consensus reigns that fractures can result from material fatigue, how fracture is induced and the mechanisms underlying its clinical sequelae remain ill-defined. In this study, strut fractures were identified in the prospectively maintained Food and Drug Administration's (FDA) Manufacturer and User Facility Device Experience Database (MAUDE), covering years 2006-2011, and differentiated based on specific coronary artery implantation site and device configuration. These data, and knowledge of the extent of dynamic arterial deformations obtained from patient CT images and published data, were used to define boundary conditions for 3D finite element models incorporating multimodal, multi-cycle deformation. The structural response for a range of stent designs and configurations was predicted by computational models and included estimation of maximum principal, minimum principal and equivalent plastic strains. Fatigue assessment was performed with Goodman diagrams and safe/unsafe regions defined for different stent designs. Von Mises stress and maximum principal strain increased with multimodal, fully reversed deformation. Spatial maps of unsafe locations corresponded to the identified locations of fracture in different coronary arteries in the clinical database. These findings, for the first time, provide insight into a potential link between patient adverse events and computational modeling of stent deformation. Understanding of the mechanical forces imposed under different implantation conditions may assist in rational design and optimal placement of these devices. PMID:26467552

  18. Review of tissue penetration and clinical efficacy of enoxacin in skin and skin structure infections and in osteomyelitis.

    PubMed

    Pankey, G A

    1989-01-01

    Enoxacin achieves a high penetration into skin tissue and blister fluid, reaching a maximum serum concentration (Cmax) of 3.7 mg/L at a time to reach maximum concentration (tmax) of 1.9 hours and a blister-fluid Cmax of 2.9 mg/L at a tmax of 3.7 hours after an oral dose of 600 mg. The half-life of enoxacin is 6.2 hours in serum and 7.2 hours in blister fluid. In a multicentre, open, non-comparative trial, clinical cure or improvement in skin or skin structure infections was achieved after oral administration of enoxacin 200 to 600 mg twice daily in 88% of 196 evaluable patients. Overall satisfactory bacteriological response was obtained in 76% of patients. In a multicentre, randomised, double-blind trial comparing oral enoxacin 400 mg twice daily with cephalexin 500 mg twice daily, satisfactory clinical outcome was achieved in 92% of 73 evaluable patients receiving enoxacin and in 99% of 72 evaluable patients receiving cephalexin. Furthermore, there was no statistically significant difference between the bacteriological efficacy of the 2 agents. In 3 single-centre trials, satisfactory clinical results were achieved in 75 to 100% of patients, and satisfactory bacteriological results occurred in 47 to 76% of patients after administration of oral enoxacin 400 mg twice daily for 7 to 14 days. In vitro uptake of enoxacin in bone leads to a concentration of 300 micrograms/g, with 83% being retained by bone after 3 washings with saline at pH 7.2. Clinical trials involving oral enoxacin in osteomyelitis are currently under way. PMID:2653695

  19. A Structured Protocol Model of Depression Care versus Clinical Acumen: A Cluster Randomized Trial of the Effects on Depression Screening, Diagnostic Evaluation, and Treatment Uptake in Ugandan HIV Clinics

    PubMed Central

    Wagner, Glenn J.; Ngo, Victoria; Goutam, Prodyumna; Glick, Peter; Musisi, Seggane; Akena, Dickens

    2016-01-01

    Depression is common among people living with HIV, and it has consequences for both HIV prevention and treatment response, yet depression treatment is rarely integrated into HIV care in sub-Saharan Africa, partly due to the paucity of mental health professionals. We conducted a cluster randomized controlled trial of two task-shifting models to facilitating depression care delivered by medical providers: one that utilized a structured protocol, and one that relied on clinical acumen, in 10 HIV clinics in Uganda. Both models started with routine depression screening of all clients at triage using the 2-item Patient Health Questionnaire (PHQ-2), from which we enrolled 1252 clients (640 at structured protocol clinics, 612 at clinical acumen clinics) who had screened positive over 12 months. We compared the two models on (1) proportion of all client participants, and those clinically depressed (based on survey-administered 9-item PHQ-9>9), who received post-screening evaluation for depression using the PHQ-9; and (2) proportion of clinically depressed who were prescribed antidepressant therapy. Linear probability regression analyses were conducted using a wild cluster bootstrap to control for clustering; patient characteristics, clinic size and time fixed effects were included as covariates. Among all client participants, those in the structured protocol arm were far more likely to have received further evaluation by a medical provider using the PHQ-9 (84% vs. 49%; beta = .33; p = .01). Among the clinically depressed clients (n = 369), the advantage of the structured protocol model over clinical acumen was not statistically significant with regard to PHQ-9 depression evaluation (93% vs. 68%; beta = .21; p = .14) or prescription of antidepressants (69% vs. 58%; beta = .10; p = .50), in part because only 30% of clients who screened positive were clinically depressed. These findings reveal that in both models depression care practices were widely adopted by providers, and

  20. Development of a clinical data architecture.

    PubMed Central

    Beeler, G. W.; Gibbons, P. S.; Chute, C. G.

    1992-01-01

    This paper presents a methodology for developing a data architecture for clinical medicine. The methodology uses an object-oriented analysis approach that takes advantage of the domain expertise of practicing physicians. The resulting high-level data model combines a structured, event-based model of clinical information with the process-oriented structures usually associated with problem lists and practice protocols. PMID:1482875

  1. [Structural and dynamic characteristics of patients with oligophrenia at a forensic-psychiatric clinic].

    PubMed

    Gorinov, V V

    1989-01-01

    In a comparative structure-dynamic investigation of 250 oligophrenic patients at the debility stage the results of forensic-psychiatric evaluation of responsibility depended on the dynamic shifts. The complexes of symptoms of psychogenic decompensation and reactive states were singled out that were observable in debile patients. The criteria are given for the forensic evaluation of these states. A group of mentally retarded patients with considerable volitional-emotional disorders was studied which did not achieve the age-related compensation. In these, social dysadaptation was of a steady nature with persisting incapability of organizing and critically assessing their own behavior. PMID:2728747

  2. Development of a formal structure for clinical management decisions: a mathematical analysis.

    PubMed

    Card, W I

    1975-01-01

    Decision theory and the calculating power of the computer now enables us to contemplate the development of formal methods for making decisions about clinical management. In the simplest model, it is first necessary to define all treatment decisions as an exhaustive and mutually exclusive set and similarly to define the set of consequences or outcomes of treatment. The probability of each outcome conditional on treatment has to be estimated and this consequent state of health has to be quantified as a utility. Possible methods of estimating utilities of states of health are discussed and the construction of a unidimensional utility function based on a sequence of wagers. The states of health consequent on severe brain damage can only be described multidimensionally and the model has to be extended to include this case. While such a model would allow simple treatment decisions to be formalized, it could not decide whether the cost of treatment was worth while nor whether it would pay to carry out further investigative tests and thus buy more evidence. If these additional variables are to be included in the model, it is necessary to introduce the motion of an equivalence between monetary values and utilities. This implies attaching a monetary value to any given state of health. PMID:1045996

  3. Abnormal hippocampal structure and function in clinical anxiety and comorbid depression.

    PubMed

    Cha, Jiook; Greenberg, Tsafrir; Song, Inkyung; Blair Simpson, Helen; Posner, Jonathan; Mujica-Parodi, Lilianne R

    2016-05-01

    Given the high prevalence rates of comorbidity of anxiety and depressive disorders, identifying a common neural pathway to both disorders is important not only for better diagnosis and treatment, but also for a more complete conceptualization of each disease. Hippocampal abnormalities have been implicated in anxiety and depression, separately; however, it remains unknown whether these abnormalities are also implicated in their comorbidity. Here we address this question by testing 32 adults with generalized anxiety disorder (15 GAD only and 17 comorbid MDD) and 25 healthy controls (HC) using multimodal MRI (structure, diffusion and functional) and automated hippocampal segmentation. We demonstrate that (i) abnormal microstructure of the CA1 and CA2-3 is associated with GAD/MDD comorbidity and (ii) decreased anterior hippocampal reactivity in response to repetition of the threat cue is associated with GAD (with or without MDD comorbidity). In addition, mediation-structural equation modeling (SEM) reveals that our hippocampal and dimensional symptom data are best explained by a model describing a significant influence of abnormal hippocampal microstructure on both anxiety and depression-mediated through its impact on abnormal hippocampal threat processing. Collectively, our findings show a strong association between changes in hippocampal microstructure and threat processing, which together may present a common neural pathway to comorbidity of anxiety and depression. © 2016 Wiley Periodicals, Inc. PMID:26743454

  4. Clinical Scenarios in Chronic Kidney Disease: Kidneys' Structural Changes in End-Stage Renal Disease.

    PubMed

    Meola, Mario; Samoni, Sara; Petrucci, Ilaria

    2016-01-01

    Acquired cystic kidney disease (ACKD) and renal cell carcinoma (RCC) are the most important manifestations of end-stage kidneys' structural changes. ACKD is caused by kidney damage or scarring and it is characterized by the presence of small, multiple cortical and medullary cysts filled with a fluid similar to preurine. ACKD prevalence varies according to predialysis and dialysis age and its pathogenesis is unknown, although it is stated that progressive destruction of renal tissue induces hypertrophy/compensatory hyperplasia of residual nephrons and may trigger the degenerative process. ACKD is almost asymptomatic, but it can lead to several complications (bleeding, rupture, infections, RCC). Ultrasound (US) is the first level imaging technique in ACKD, because of its sensitivity and reliability. The most serious complication of ACKD is RCC, which is stimulated by the same growth factors and proto-oncogenes that lead to the genesis of cysts. Two different histological types of RCC have been identified: (1) RCC associated with ACKD and (2) papillary renal clear cell carcinoma. Tumors in end-stage kidneys are mainly small, multifocal and bilateral, with a papillary structure and a low degree of malignancy. At US, RCC appears as a small inhomogeneous nodule (<3 cm), clearly outlined from the renal profile and hypoechoic if compared with sclerotic parenchyma. In some cases, tumor appears as a homogeneous and hyperechoic multifocal mass. The most specific US sign of a small tumor in end-stage kidney is the important arterial vascularization, in contrast with renal parenchymal vascular sclerosis. PMID:27169876

  5. Shape Similarity, Better than Semantic Membership, Accounts for the Structure of Visual Object Representations in a Population of Monkey Inferotemporal Neurons

    PubMed Central

    DiCarlo, James J.; Zecchina, Riccardo; Zoccolan, Davide

    2013-01-01

    The anterior inferotemporal cortex (IT) is the highest stage along the hierarchy of visual areas that, in primates, processes visual objects. Although several lines of evidence suggest that IT primarily represents visual shape information, some recent studies have argued that neuronal ensembles in IT code the semantic membership of visual objects (i.e., represent conceptual classes such as animate and inanimate objects). In this study, we investigated to what extent semantic, rather than purely visual information, is represented in IT by performing a multivariate analysis of IT responses to a set of visual objects. By relying on a variety of machine-learning approaches (including a cutting-edge clustering algorithm that has been recently developed in the domain of statistical physics), we found that, in most instances, IT representation of visual objects is accounted for by their similarity at the level of shape or, more surprisingly, low-level visual properties. Only in a few cases we observed IT representations of semantic classes that were not explainable by the visual similarity of their members. Overall, these findings reassert the primary function of IT as a conveyor of explicit visual shape information, and reveal that low-level visual properties are represented in IT to a greater extent than previously appreciated. In addition, our work demonstrates how combining a variety of state-of-the-art multivariate approaches, and carefully estimating the contribution of shape similarity to the representation of object categories, can substantially advance our understanding of neuronal coding of visual objects in cortex. PMID:23950700

  6. Development of a metacognitive effort construct of empathy during clinical training: a longitudinal study of the factor structure of the Jefferson Scale of Empathy.

    PubMed

    Stansfield, R Brent; Schwartz, Alan; O'Brien, Celia Laird; Dekhtyar, Michael; Dunham, Lisette; Quirk, Mark

    2016-03-01

    Empathy is crucial for effective clinical care but appears to decline during undergraduate medical training. Understanding the nature of this decline is necessary for addressing it. The Jefferson Scale of Empathy (JSE) is used to measure medical students' clinical empathy attitudes. One recent study described a 3-factor model of the JSE. This model was found in responses from matriculating medical students, but little is known about how the factor structure of the scale changes during clinical training. The Learning Environment Study is a longitudinal prospective study of two cohorts from 28 medical schools. At matriculation and at the end of each subsequent year, students self-reported clinical empathy attitudes using the JSE. Data from 4,797 students were randomly partitioned for exploratory (EFA) and confirmatory factor analyses using responses from preclinical and clinical years of medical school. Five models were compared for confirmatory factor analysis: two null models for control, the recent 3-factor model, and the two models resulting from the EFAs of preclinical and clinical year responses. Preclinical year responses yielded a 3-factor model similar to the recent 3-factor model. Clinical year responses yielded a 4-factor model ("feelings," "importance," "ease," and "metacognitive effort") suggesting changes in the structure of clinical empathy attitudes over time. Metacognitive effort showed the largest decline over time. The model is a better fit for both preclinical and clinical responses and may provide more insight into medical students' clinical empathy attitudes than other models. The emergence of metacognitive effort in the clinical years suggests empathy may become more nuanced for students after clinical exposure and may account for much of the observed decline in clinical empathy attitudes. PMID:25828541

  7. Contact sport-related chronic traumatic encephalopathy in the elderly: clinical expression and structural substrates

    PubMed Central

    Costanza, Alessandra; Weber, Kerstin; Gandy, Samuel; Bouras, Constantin; Hof, Patrick R.; Canuto, Alessandra

    2011-01-01

    Professional boxers and other contact sport athletes are exposed to repetitive brain trauma that may affect motor functions, cognitive performance, emotional regulation and social awareness. The term of chronic traumatic encephalopathy (CTE) was recently introduced to regroup a wide spectrum of symptoms such as cerebellar, pyramidal, and extrapyramidal syndromes, impairments in orientation, memory, language, attention, information processing and frontal executive functions, as well as personality changes and behavioural and psychiatric symptoms. Magnetic resonance imaging (MRI) usually reveals hippocampal and vermis atrophy, a cavum septum pellucidum (CSP), signs of diffuse axonal injury, pituitary gland atrophy, dilated perivascular spaces, and periventricular white matter disease. Given the partial overlapping of the clinical expression, epidemiology, and pathogenesis of CTE and Alzheimer’s disease (AD), as well as the close association between traumatic brain injuries (TBIs) and neurofibrillary tangle formation, a mixed pathology promoted by pathogenetic cascades resulting in either CTE or AD has been postulated. Molecular studies suggested that TBIs increase the neurotoxicity of the TAR DNA-binding protein 43 (TDP-43) that is a key pathological marker of ubiquitin-positive forms of frontotemporal dementia (FTLD-TDP) associated or not with motor neuron disease/amyotrophic lateral sclerosis (MND/ALS). Similar patterns of immunoreactivity for TDP-43 in CTE, FTLD-TDP, and ALS as well as epidemiological correlations support the presence of common pathogenetic mechanisms. The present review provides a critical update of the evolution of the concept of CTE with reference to its neuropathological definition together with an in depth discussion of the differential diagnosis between this entity, AD and frontotemporal dementia. PMID:21696410

  8. Structural Validation of the Abridged Autism Spectrum Quotient-Short Form in a Clinical Sample of People with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Kuenssberg, Renate; Murray, Aja L.; Booth, Tom; McKenzie, Karen

    2014-01-01

    The primary aim of this article was to provide a structural validation of the 28-item Autism Spectrum Quotient-Short Form questionnaire in a sample of adults with clinically diagnosed autism spectrum disorders ("n" = 148). Confirmatory factor analysis demonstrated that the proposed structure, comprising a second-order Social Skills…

  9. Clinical efficacy of dalbavancin for the treatment of acute bacterial skin and skin structure infections (ABSSSI)

    PubMed Central

    Leuthner, Kimberly D; Buechler, Kristin A; Kogan, David; Saguros, Agafe; Lee, H Stephen

    2016-01-01

    Acute bacterial skin and skin structure infections (ABSSSI) are a common disease causing patients to seek treatment through the health care system. With the continued increase of drug-resistant bacterial pathogens, these infections are becoming more difficult to successfully cure. Lipoglycopeptides have unique properties that allow the drug to remain active toward both common and challenging pathogens at the infected site for lengthy periods of time. Dalbavancin, a new lipoglycopeptide, provides two unique dosing regimens for the treatment of ABSSSI. The original regimen of 1,000 mg intravenous infusion followed by a 500 mg intravenous infusion after a week has been shown as safe and effective in multiple, randomized noninferiority trials. These studies also demonstrated that dalbavancin was similar to standard regimens in terms of both safety and tolerability. Recently a single 1,500 mg dose was demonstrated to be equivalent to the dalbavancin two-dose regimen for treating ABSSSI. With the introduction of dalbavancin, clinicians have the option to provide an intravenous antimicrobial agent shown to be as effective as traditional therapies, without requiring admission into the hospitals or prescribing a medication which may not be utilized optimally. Further understanding of dalbavancin and its unusual properties can provide unique treatment situations with potential benefits for both the patient and the overall health care system, which should be further explored. PMID:27354809

  10. Different mutations at V363 MAPT codon are associated with atypical clinical phenotypes and show unusual structural and functional features.

    PubMed

    Rossi, Giacomina; Bastone, Antonio; Piccoli, Elena; Morbin, Michela; Mazzoleni, Giulia; Fugnanesi, Valeria; Beeg, Marten; Del Favero, Elena; Cantù, Laura; Motta, Simona; Salsano, Ettore; Pareyson, Davide; Erbetta, Alessandra; Elia, Antonio Emanuele; Del Sorbo, Francesca; Silani, Vincenzo; Morelli, Claudia; Salmona, Mario; Tagliavini, Fabrizio

    2014-02-01

    Microtubule-associated protein tau gene (MAPT) is one of the major genes linked to frontotemporal lobar degeneration, a group of neurodegenerative diseases clinically, pathologically, and genetically heterogeneous. In particular, MAPT mutations give rise to the subgroup of tauopathies. The pathogenetic mechanisms underlying the MAPT mutations so far described are the decreased ability of tau protein to promote microtubule polymerization (missense mutations) or the altered ratio of tau isoforms (splicing mutations), both leading to accumulation of hyperphosphorylated filamentous tau protein. Following a genetic screening of patients affected by frontotemporal lobar degeneration, we identified 2 MAPT mutations, V363I and V363A, leading to atypical clinical phenotypes, such as posterior cortical atrophy. We investigated in vitro features of the recombinant mutated tau isoforms and revealed unusual functional and structural characteristics such as an increased ability to promote microtubule polymerization and a tendency to form oligomeric instead of filamentous aggregates. Thus, we disclosed a greater than expected complexity of abnormal features of mutated tau isoforms. Overall our findings suggest a high probability that these mutations are pathogenic. PMID:24018212

  11. How do students with dyslexia perform in extended matching questions, short answer questions and observed structured clinical examinations?

    PubMed

    Gibson, Sandra; Leinster, Samuel

    2011-08-01

    There are an increasing number of students with learning difficulties attending university, and currently much debate about the suitability and ability of students with dyslexia at both medical school and once they graduate into clinical practice. In this study we describe the performance of students with dyslexia compared to fellow students in extended matching questions (EMQ), short answer question (SAQ) and observed structured clinical examinations (OSCE) and discuss the implications of differences identified. End of year assessment results for 5 cohorts of medical students were analysed. Students with dyslexia did less well overall in all assessment types in year 1 but this difference was not evident in later years. Dyslexic students who were allowed extra time in written assessments did better than dyslexic students who did not have their assessment concessions in place. When station type within OSCE assessments was analysed students with dyslexia did less well in both examination skills and data interpretation stations in years 1, 2 & 3. In conclusion, differences in performance in written assessments are only evident early in training and may be partly due to delayed adjustment to medical school or implementation of assessment concessions. Performance in individual OSCE stations is dependent on station type. Why students with specific learning difficulties (SpLDs) perform less well in examination skills and data analysis OSCE stations requires further investigation. PMID:21249518

  12. Learning Object Repositories

    ERIC Educational Resources Information Center

    Lehman, Rosemary

    2007-01-01

    This chapter looks at the development and nature of learning objects, meta-tagging standards and taxonomies, learning object repositories, learning object repository characteristics, and types of learning object repositories, with type examples. (Contains 1 table.)

  13. Object locating system

    DOEpatents

    Novak, J.L.; Petterson, B.

    1998-06-09

    A sensing system locates an object by sensing the object`s effect on electric fields. The object`s effect on the mutual capacitance of electrode pairs varies according to the distance between the object and the electrodes. A single electrode pair can sense the distance from the object to the electrodes. Multiple electrode pairs can more precisely locate the object in one or more dimensions. 12 figs.

  14. Evaluation of Clinical Results and Complications of Structural Allograft Reconstruction after Bone Tumor Surgery

    PubMed Central

    Gharedaghi, Mohammad; Peivandi, Mohammad Taghi; Mazloomi, Mehdi; Shoorin, Hasan Rahimi; Hasani, Mohammad; Seyf, Parham; Khazaee, Fatemeh

    2016-01-01

    occurred in the adjuvant chemotherapy plus radiation therapy group. Allograft fracture occurred in six patients and prevalence was the same in all groups. Only in six cases of radio-chemotherapy nonunion occurred, so we used autogenous bone graft for union. Local recurrence was observed in six patients: three belonged to the adjuvant chemotherapy group and the other three were in the chemo-radiotherapy group; no significant difference was observed between these two groups. However, there was a significant difference between these two and the group that received no adjuvant therapy. Also, there were 11 cases of metastases and Restriction of knee joint motion occurred in 48 cases of osteo-cartilaginous grafts of the distal femur and proximal tibia. Conclusion: Although structural allograft is an appropriate choice in limb reconstruction after massive resection of involved tissues in malignant and invasive bone tumors, the risk of complications such as nonunion and infection in massive allograft increases in cases of adjuvant (chemotherapy and radiotherapy) modalities of treatment. Whereas the rate of tumor recurrence, metastasis, and restrictions in range of motion during a short term follow up after implantation showed no significant difference among the evaluated groups. Consequently, further attention and constant periodic visits of the patients and checking for local recurrence and distant metastasis should be done after surgery. PMID:27517069

  15. Object locating system

    DOEpatents

    Novak, James L.; Petterson, Ben

    1998-06-09

    A sensing system locates an object by sensing the object's effect on electric fields. The object's effect on the mutual capacitance of electrode pairs varies according to the distance between the object and the electrodes. A single electrode pair can sense the distance from the object to the electrodes. Multiple electrode pairs can more precisely locate the object in one or more dimensions.

  16. Whole genome sequencing of multiple Leishmania donovani clinical isolates provides insights into population structure and mechanisms of drug resistance.

    PubMed

    Downing, Tim; Imamura, Hideo; Decuypere, Saskia; Clark, Taane G; Coombs, Graham H; Cotton, James A; Hilley, James D; de Doncker, Simonne; Maes, Ilse; Mottram, Jeremy C; Quail, Mike A; Rijal, Suman; Sanders, Mandy; Schönian, Gabriele; Stark, Olivia; Sundar, Shyam; Vanaerschot, Manu; Hertz-Fowler, Christiane; Dujardin, Jean-Claude; Berriman, Matthew

    2011-12-01

    Visceral leishmaniasis is a potentially fatal disease endemic to large parts of Asia and Africa, primarily caused by the protozoan parasite Leishmania donovani. Here, we report a high-quality reference genome sequence for a strain of L. donovani from Nepal, and use this sequence to study variation in a set of 16 related clinical lines, isolated from visceral leishmaniasis patients from the same region, which also differ in their response to in vitro drug susceptibility. We show that whole-genome sequence data reveals genetic structure within these lines not shown by multilocus typing, and suggests that drug resistance has emerged multiple times in this closely related set of lines. Sequence comparisons with other Leishmania species and analysis of single-nucleotide diversity within our sample showed evidence of selection acting in a range of surface- and transport-related genes, including genes associated with drug resistance. Against a background of relative genetic homogeneity, we found extensive variation in chromosome copy number between our lines. Other forms of structural variation were significantly associated with drug resistance, notably including gene dosage and the copy number of an experimentally verified circular episome present in all lines and described here for the first time. This study provides a basis for more powerful molecular profiling of visceral leishmaniasis, providing additional power to track the drug resistance and epidemiology of an important human pathogen. PMID:22038251

  17. Integrating population variation and protein structural analysis to improve clinical interpretation of missense variation: application to the WD40 domain.

    PubMed

    Laskowski, Roman A; Tyagi, Nidhi; Johnson, Diana; Joss, Shelagh; Kinning, Esther; McWilliam, Catherine; Splitt, Miranda; Thornton, Janet M; Firth, Helen V; Wright, Caroline F

    2016-03-01

    We present a generic, multidisciplinary approach for improving our understanding of novel missense variants in recently discovered disease genes exhibiting genetic heterogeneity, by combining clinical and population genetics with protein structural analysis. Using six new de novo missense diagnoses in TBL1XR1 from the Deciphering Developmental Disorders study, together with population variation data, we show that the β-propeller structure of the ubiquitous WD40 domain provides a convincing way to discriminate between pathogenic and benign variation. Children with likely pathogenic mutations in this gene have severely delayed language development, often accompanied by intellectual disability, autism, dysmorphology and gastrointestinal problems. Amino acids affected by likely pathogenic missense mutations are either crucial for the stability of the fold, forming part of a highly conserved symmetrically repeating hydrogen-bonded tetrad, or located at the top face of the β-propeller, where 'hotspot' residues affect the binding of β-catenin to the TBLR1 protein. In contrast, those altered by population variation are significantly less likely to be spatially clustered towards the top face or to be at buried or highly conserved residues. This result is useful not only for interpreting benign and pathogenic missense variants in this gene, but also in other WD40 domains, many of which are associated with disease. PMID:26740553

  18. Do gender and age moderate the symptom structure of PTSD? Findings from a national clinical sample of children and adolescents.

    PubMed

    Contractor, Ateka A; Layne, Christopher M; Steinberg, Alan M; Ostrowski, Sarah A; Ford, Julian D; Elhai, Jon D

    2013-12-30

    A substantial body of evidence documents that the frequency and intensity of posttraumatic stress disorder (PTSD) symptoms are linked to such demographic variables as female sex (e.g., Kaplow et al., 2005) and age (e.g., Meiser-Stedman et al., 2008). Considerably less is known about relations between biological sex and age with PTSD's latent factor structure. This study systematically examined the roles that sex and age may play as candidate moderators of the full range of factor structure parameters of an empirically supported five-factor PTSD model (Elhai et al., 2011). The sample included 6591 trauma-exposed children and adolescents selected from the National Child Traumatic Stress Network's Core Data Set. Confirmatory factor analysis using invariance testing (Gregorich, 2006) and comparative fit index difference values (Cheung and Rensvold, 2002) reflected a mixed pattern of test item intercepts across age groups. The adolescent subsample produced lower residual error variances, reflecting less measurement error than the child subsample. Sex did not show a robust moderating effect. We conclude by discussing implications for clinical assessment, theory building, and future research. PMID:24103907

  19. COGNITION, ACTION, AND OBJECT MANIPULATION

    PubMed Central

    Rosenbaum, David A.; Chapman, Kate M.; Weigelt, Matthias; Weiss, Daniel J.; van der Wel, Robrecht

    2012-01-01

    Although psychology is the science of mental life and behavior, it has paid little attention to the means by which mental life is translated into behavior. One domain where links between cognition and action have been explored is the manipulation of objects. This article reviews psychological research on this topic, with special emphasis on the tendency to grasp objects differently depending on what one plans to do with the objects. Such differential grasping has been demonstrated in a wide range of object manipulation tasks, including grasping an object in a way that reveals anticipation of the object's future orientation, height, and required placement precision. Differential grasping has also been demonstrated in a wide range of behaviors, including one-hand grasps, two-hand grasps, walking, and transferring objects from place to place as well as from person to person. The populations in whom the tendency has been shown are also diverse, including nonhuman primates as well as human adults, children, and babies. Meanwhile, the tendency is compromised in a variety of clinical populations and in children of a surprisingly advanced age. Verbal working memory is compromised as well if words are memorized while object manipulation tasks are performed; the recency portion of the serial position curve is reduced in this circumstance. In general, the research reviewed here points to rich connections between cognition and action as revealed through the study of object manipulation. Other implications concern affordances, Donders' Law, and naturalistic observation and the teaching of psychology. PMID:22448912

  20. Research directions in object-oriented programming

    SciTech Connect

    Shriver, B.; Wegner, P.

    1987-01-01

    The contributions in this book provide the most complete survey available in programming languages, databases, and programming semantics. The contents include: The Beta Programming Language: Common Objects: An Object-Oriented Programming Language with Encapsulation and Inheritance: Actors: A Conceptual Foundation for Object-Oriented Programmming: Vulcan; A model for Object-Based Inheritance; Definition Groups; Block-Structure and Object-Oriented Languages; A Mechanism for Specifying the Structure of Large Layered Programs; Classification in Object-Oriented Systems; Extensions and Foundations of Object-Oriented Programming; Object-Oriented Specification; Object-Oriented Databases; Development and Implementation of an Object-Oriented Database Management System; Maintaining Consistency in Databases with Changing Types; Object-Oriented Environments; An Object-Oriented Framework for Graphical Programming; A Substrate for Object-Oriented Interface Design.

  1. A National Content Analysis of PhD Program Objectives, Structures, and Curricula: Do Programs Address the Full Range of Social Work's Needs?

    ERIC Educational Resources Information Center

    Drisko, James; Hunnicutt, Christie; Berenson, Laura

    2015-01-01

    The Group for the Advancement of Doctoral Education (GADE) promotes excellence in PhD education in Social Work. GADE's 2013 Quality Guidelines for PhD Programs heavily emphasize preparation for research. Little is known, however, about the details of the contemporary social work PhD program structure and curriculum. Several prior surveys have…

  2. Glycan analysis of Fonsecaea monophora from clinical and environmental origins reveals different structural profile and human antigenic response.

    PubMed

    Burjack, Juliana R; Santana-Filho, Arquimedes P; Ruthes, Andrea C; Riter, Daniel S; Vicente, Vania A; Alvarenga, Larissa M; Sassaki, Guilherme L

    2014-01-01

    Dematiaceous fungi constitute a large and heterogeneous group, characterized by having a dark pigment, the dihydroxynaftalen melanin-DHN, inside their cell walls. In nature they are found mainly as soil microbiota or decomposing organic matter, and are spread in tropical and subtropical regions. The fungus Fonsecaea monophora causes chromoblastomycosis in humans, and possesses essential mechanisms that may enhance pathogenicity, proliferation and dissemination inside the host. Glycoconjugates confer important properties to these pathogenic microorganisms. In this work, structural characterization of glycan structures present in two different strains of F. monophora MMHC82 and FE5p4, from clinical and environmental origins, respectively, was performed. Each one were grown on Minimal Medium (MM) and Czapeck-Dox (CD) medium, and the water soluble cell wall glycoconjugates and exopolysaccharides (EPS) were evaluated by NMR, methylation and principal component analysis (PCA). By combining the methylation and 2D NMR analyses, it was possible to visualize the glycosidic profiles of the complex carbohydrate mixtures. Significant differences were observed in β-D-Galf-(1→5) and (1→6) linkages, α- and β-D-Glcp-(1→3), (1→4), and (1→6) units, as well as in α-D-Manp. PCA from (1)H-NMR data showed that MMHC82 from CD medium showed a higher variation in the cell wall carbohydrates, mainly related to O-2 substituted β-D-Galf (δ 106.0/5.23 and δ 105.3/5.23) units. In order to investigate the antigenic response of the glycoconjugates, these were screened against serum from chromoblastomycosis patients. The antigen which contained the cell wall of MMHC82 grown in MM had β-D-Manp units that promoted higher antigenic response. The distribution of these fungal species in nature and the knowledge of how cell wall polysaccharides and glycoconjugates structure vary, may contribute to the better understanding and the elucidation of the pathology caused by this fungus. PMID

  3. Glycan analysis of Fonsecaea monophora from clinical and environmental origins reveals different structural profile and human antigenic response

    PubMed Central

    Burjack, Juliana R.; Santana-Filho, Arquimedes P.; Ruthes, Andrea C.; Riter, Daniel S.; Vicente, Vania A.; Alvarenga, Larissa M.; Sassaki, Guilherme L.

    2014-01-01

    Dematiaceous fungi constitute a large and heterogeneous group, characterized by having a dark pigment, the dihydroxynaftalen melanin—DHN, inside their cell walls. In nature they are found mainly as soil microbiota or decomposing organic matter, and are spread in tropical and subtropical regions. The fungus Fonsecaea monophora causes chromoblastomycosis in humans, and possesses essential mechanisms that may enhance pathogenicity, proliferation and dissemination inside the host. Glycoconjugates confer important properties to these pathogenic microorganisms. In this work, structural characterization of glycan structures present in two different strains of F. monophora MMHC82 and FE5p4, from clinical and environmental origins, respectively, was performed. Each one were grown on Minimal Medium (MM) and Czapeck-Dox (CD) medium, and the water soluble cell wall glycoconjugates and exopolysaccharides (EPS) were evaluated by NMR, methylation and principal component analysis (PCA). By combining the methylation and 2D NMR analyses, it was possible to visualize the glycosidic profiles of the complex carbohydrate mixtures. Significant differences were observed in β-D-Galf-(1→5) and (1→6) linkages, α- and β-D-Glcp-(1→3), (1→4), and (1→6) units, as well as in α-D-Manp. PCA from 1H-NMR data showed that MMHC82 from CD medium showed a higher variation in the cell wall carbohydrates, mainly related to O-2 substituted β-D-Galf (δ 106.0/5.23 and δ 105.3/5.23) units. In order to investigate the antigenic response of the glycoconjugates, these were screened against serum from chromoblastomycosis patients. The antigen which contained the cell wall of MMHC82 grown in MM had β-D-Manp units that promoted higher antigenic response. The distribution of these fungal species in nature and the knowledge of how cell wall polysaccharides and glycoconjugates structure vary, may contribute to the better understanding and the elucidation of the pathology caused by this fungus. PMID

  4. Object links in the repository

    NASA Technical Reports Server (NTRS)

    Beck, Jon; Eichmann, David

    1991-01-01

    Some of the architectural ramifications of extending the Eichmann/Atkins lattice-based classification scheme to encompass the assets of the full life-cycle of software development are explored. In particular, we wish to consider a model which provides explicit links between objects in addition to the edges connecting classification vertices in the standard lattice. The model we consider uses object-oriented terminology. Thus, the lattice is viewed as a data structure which contains class objects which exhibit inheritance. A description of the types of objects in the repository is presented, followed by a discussion of how they interrelate. We discuss features of the object-oriented model which support these objects and their links, and consider behavior which an implementation of the model should exhibit. Finally, we indicate some thoughts on implementing a prototype of this repository architecture.

  5. Setting and Achieving Objectives.

    ERIC Educational Resources Information Center

    Knoop, Robert

    1986-01-01

    Provides basic guidelines which school officials and school boards may find helpful in negotiating, establishing, and managing objectives. Discusses characteristics of good objectives, specific and directional objectives, multiple objectives, participation in setting objectives, feedback on goal process and achievement, and managing a school…

  6. Picturing Objects in Infancy

    ERIC Educational Resources Information Center

    Shinskey, Jeanne L.; Jachens, Liza J.

    2014-01-01

    Infants' transfer of information from pictures to objects was tested by familiarizing 9-month-olds (N = 31) with either a color or black-and-white photograph of an object and observing their preferential reaching for the real target object versus a distractor. One condition tested object recognition by keeping both objects visible, and the…

  7. Selecting a Reference Object

    ERIC Educational Resources Information Center

    Miller, Jared E.; Carlson, Laura A.; Hill, Patrick L.

    2011-01-01

    One way to describe the location of an object is to relate it to another object. Often there are many nearby objects, each of which could serve as a candidate to be the reference object. A common theoretical assumption is that features that make a given object salient relative to the candidate set are instrumental in determining which is selected.…

  8. Behavioral Objectives?-No!

    ERIC Educational Resources Information Center

    Ferguson, Bill L.

    1971-01-01

    Discusses his reasons for objecting to the use of behavioral objectives in education. Article is in response to Robert Blake's article on Behavioral Objectives and the Teaching of English" in English Education, Winter 1971. (RB)

  9. Do Clinical Evaluations in a Psychiatry Clerkship Favor Students with Positive Personality Characteristics?

    ERIC Educational Resources Information Center

    Chibnall, John T.; Blaskiewicz, Robert J.

    2008-01-01

    Objective: The authors examine associations of personality characteristics, National Board of Medical Examiners subject examination performance, and Objective Structured Clinical Examination performance with clinical evaluations of third-year medical students in a psychiatry clerkship. Methods: Students completed the Revised NEO Personality…

  10. Comparison of structural allograft and traditional autograft technique in occipitocervical fusion: radiological and clinical outcomes from a single institution.

    PubMed

    Godzik, Jakub; Ravindra, Vijay M; Ray, Wilson Z; Schmidt, Meic H; Bisson, Erica F; Dailey, Andrew T

    2015-08-01

    OBJECT The authors' objectives were to compare the rate of fusion after occipitoatlantoaxial arthrodesis using structural allograft with the fusion rate from using autograft, to evaluate correction of radiographic parameters, and to describe symptom relief with each graft technique. METHODS The authors assessed radiological fusion at 6 and 12 months after surgery and obtained radiographic measurements of C1-2 and C2-7 lordotic angles, C2-7 sagittal vertical alignments, and posterior occipitocervical angles at preoperative, postoperative, and final follow-up examinations. Demographic data, intraoperative details, adverse events, and functional outcomes were collected from hospitalization records. Radiological fusion was defined as the presence of bone trabeculation and no movement between the graft and the occiput or C-2 on routine flexion-extension cervical radiographs. Radiographic measurements were obtained from lateral standing radiographs with patients in the neutral position. RESULTS At the University of Utah, 28 adult patients underwent occipitoatlantoaxial arthrodesis between 2003 and 2010 using bicortical allograft, and 11 patients were treated using iliac crest autograft. Mean follow-up for all patients was 20 months (range 1-108 months). Of the 27 patients with a minimum of 12 months of follow-up, 18 (95%) of 19 in the allograft group and 8 (100%) of 8 in the autograft group demonstrated evidence of bony fusion shown by imaging. Patients in both groups demonstrated minimal deterioration of sagittal vertical alignment at final follow-up. Operative times were comparable, but patients undergoing occipitocervical fusion with autograft demonstrated greater blood loss (316 ml vs 195 ml). One (9%) of 11 patients suffered a significant complication related to autograft harvesting. CONCLUSIONS The use of allograft in occipitocervical fusion allows a high rate of successful arthrodesis yet avoids the potentially significant morbidity and pain associated with

  11. Comparison of structural allograft and traditional autograft technique in occipitocervical fusion: radiological and clinical outcomes from a single institution

    PubMed Central

    Godzik, Jakub; Ravindra, Vijay M.; Ray, Wilson Z.; Schmidt, Meic H.; Bisson, Erica F.; Dailey, Andrew T.

    2016-01-01

    Object The authors' objectives were to compare the rate of fusion after occipitoatlantoaxial arthrodesis using structural allograft with the fusion rate from using autograft, to evaluate correction of radiographic parameters, and to describe symptom relief with each graft technique. Methods The authors assessed radiological fusion at 6 and 12 months after surgery and obtained radiographic measurements of C1–2 and C2–7 lordotic angles, C2–7 sagittal vertical alignments, and posterior occipitocervical angles at preoperative, postoperative, and final follow-up examinations. Demographic data, intraoperative details, adverse events, and functional outcomes were collected from hospitalization records. Radiological fusion was defined as the presence of bone trabeculation and no movement between the graft and the occiput or C-2 on routine flexion-extension cervical radiographs. Radiographic measurements were obtained from lateral standing radiographs with patients in the neutral position. Results At the University of Utah, 28 adult patients underwent occipitoatlantoaxial arthrodesis between 2003 and 2010 using bicortical allograft, and 11 patients were treated using iliac crest autograft. Mean follow-up for all patients was 20 months (range 1–108 months). Of the 27 patients with a minimum of 12 months of follow-up, 18 (95%) of 19 in the allograft group and 8 (100%) of 8 in the autograft group demonstrated evidence of bony fusion shown by imaging. Patients in both groups demonstrated minimal deterioration of sagittal vertical alignment at final follow-up. Operative times were comparable, but patients undergoing occipitocervical fusion with autograft demonstrated greater blood loss (316 ml vs 195 ml). One (9%) of 11 patients suffered a significant complication related to autograft harvesting. Conclusions The use of allograft in occipitocervical fusion allows a high rate of successful arthrodesis yet avoids the potentially significant morbidity and pain associated

  12. Relations among early object recognition skills: Objects and letters

    PubMed Central

    Augustine, Elaine; Jones, Susan S.; Smith, Linda B.; Longfield, Erica

    2014-01-01

    Human visual object recognition is multifaceted, with several domains of expertise. Developmental relations between young children's letter recognition and their 3-dimensional object recognition abilities are implicated on several grounds but have received little research attention. Here, we ask how preschoolers’ success in recognizing letters relates to their ability to recognize 3-dimensional objects from sparse shape information alone. A relation is predicted because perception of the spatial relations is critical in both domains. Seventy-three 2 ½- to 4-year-old children completed a Letter Recognition task, measuring the ability to identify a named letter among 3 letters with similar shapes, and a “Shape Caricature Recognition” task, measuring recognition of familiar objects from sparse, abstract information about their part shapes and the spatial relations among those parts. Children also completed a control “Shape Bias” task, in which success depends on recognition of overall object shape but not of relational structure. Children's success in letter recognition was positively related to their shape caricature recognition scores, but not to their shape bias scores. The results suggest that letter recognition builds upon developing skills in attending to and representing the relational structure of object shape, and that these skills are common to both 2-dimensional and 3-dimensional object perception. PMID:25969673

  13. Understanding N-Acetyl-L-Glutamate Synthase Deficiency: Mutational Spectrum, Impact of Clinical Mutations on Enzyme Functionality, and Structural Considerations.

    PubMed

    Sancho-Vaello, Enea; Marco-Marín, Clara; Gougeard, Nadine; Fernández-Murga, Leonor; Rüfenacht, Véronique; Mustedanagic, Merima; Rubio, Vicente; Häberle, Johannes

    2016-07-01

    N-acetyl-L-glutamate synthase (NAGS) deficiency (NAGSD), the rarest urea cycle defect, is clinically indistinguishable from carbamoyl phosphate synthetase 1 deficiency, rendering the identification of NAGS gene mutations key for differentiation, which is crucial, as only NAGSD has substitutive therapy. Over the last 13 years, we have identified 43 patients from 33 families with NAGS mutations, of which 14 were novel. Overall, 36 NAGS mutations have been found so far in 56 patients from 42 families, of which 76% are homozygous for the mutant allele. 61% of mutations are missense changes. Lack or decrease of NAGS protein is predicted for ∼1/3 of mutations. Missense mutations frequency is inhomogeneous along NAGS: null for exon 1, but six in exon 6, which reflects the paramount substrate binding/catalytic role of the C-terminal domain (GNAT domain). Correspondingly, phenotypes associated with missense mutations mapping in the GNAT domain are more severe than phenotypes of amino acid kinase domain-mapping missense mutations. Enzyme activity and stability assays with 12 mutations introduced into pure recombinant Pseudomonas aeruginosa NAGS, together with in silico structural analysis, support the pathogenic role of most NAGSD-associated mutations found. The disease-causing mechanisms appear to be, from higher to lower frequency, decreased solubility/stability, aberrant kinetics/catalysis, and altered arginine modulation. PMID:27037498

  14. Structural Integration as an Adjunct to Outpatient Rehabilitation for Chronic Nonspecific Low Back Pain: A Randomized Pilot Clinical Trial

    PubMed Central

    Jacobson, Eric E.; Meleger, Alec L.; Bonato, Paolo; Wayne, Peter M.; Langevin, Helene M.; Kaptchuk, Ted J.; Davis, Roger B.

    2015-01-01

    Structural Integration (SI) is an alternative method of manipulation and movement education. To obtain preliminary data on feasibility, effectiveness, and adverse events (AE), 46 outpatients from Boston area with chronic nonspecific low back pain (CNSLBP) were randomized to parallel treatment groups of SI plus outpatient rehabilitation (OR) versus OR alone. Feasibility data were acceptable except for low compliance with OR and lengthy recruitment time. Intent-to-treat data on effectiveness were analyzed by Wilcoxon rank sum, n = 23 per group. Median reductions in VAS Pain, the primary outcome, of −26 mm in SI + OR versus 0 in OR alone were not significantly different (P = 0.075). Median reductions in RMDQ, the secondary outcome, of −2 points in SI + OR versus 0 in OR alone were significantly different (P = 0.007). Neither the proportions of participants with nor the seriousness of AE were significantly different. SI as an adjunct to OR for CNSLBP is not likely to provide additional reductions in pain but is likely to augment short term improvements in disability with a low additional burden of AE. A more definitive trial is feasible, but OR compliance and recruitment might be challenging. This trial is registered with ClinicalTrials.gov (NCT01322399). PMID:25945112

  15. Clinical governance and external audit.

    PubMed

    Glazebrook, S G; Buchanan, J G

    2001-01-01

    This paper describes a model of clinical governance that was developed at South Auckland Health during the period 1995 to 2000. Clinical quality and safety are core objectives. A multidisciplinary Clinical Board is responsible for the development and publicising of sound clinical policies together with monitoring the effects of their implementation on quality and safety. The Clinical Board has several committees, including an organization-wide Continuous Quality Improvement Committee to enhance the explicit nature of the quality system in terms of structure, staff awareness and involvement, and to develop the internal audit system. The second stream stems from the Chief Medical Officer and clinical directors in a clinical management sense. The Audit Committee of the Board of Directors covers both clinical and financial audit. The reporting lines back to that committee are described and the role of the external auditor of clinical standards is explained. The aim has been to create a supportive culture where quality initiatives and innovation can flourish, and where the emphasis is not on censure but improvement. PMID:11422717

  16. A First Look at the Structured Clinical Interview for "DSM-IV" Personality Disorders Screening Questionnaire: More Than Just a Screener?

    ERIC Educational Resources Information Center

    Piedmont, Ralph L.; Sherman, Martin F.; Sherman, Nancy C.; Williams, Joseph E. G.

    2003-01-01

    This study examined the psychometrics of the Structured Clinical Interview for DSM-IV Personality Disorders Personality Questionnaire (SCID-IIP) self-report personality questionnaire. The responses to the instrument were found reliable and evidenced good self-other convergence. Correlations with external criteria showed the SCID-IIP to contain…

  17. Automatic object recognition

    NASA Technical Reports Server (NTRS)

    Ranganath, H. S.; Mcingvale, Pat; Sage, Heinz

    1988-01-01

    Geometric and intensity features are very useful in object recognition. An intensity feature is a measure of contrast between object pixels and background pixels. Geometric features provide shape and size information. A model based approach is presented for computing geometric features. Knowledge about objects and imaging system is used to estimate orientation of objects with respect to the line of sight.

  18. Early object rule acquisition.

    PubMed

    Pierce, D E

    1991-05-01

    The purpose of this study was to generate a grounded theory of early object rule acquisition. The grounded theory approach and computer coding were used to analyze videotaped samples of an infant's and a toddler's independent object play, which produced the categories descriptive of three primary types of object rules; rules of object properties, rules of object action, and rules of object affect. This occupational science theory offers potential for understanding the role of objects in human occupations, for development of instruments, and for applications in occupational therapy early intervention. PMID:2048625

  19. The analyst's subjectivity and the analyst's objectivity.

    PubMed

    Renik, O

    1998-06-01

    The author suggests that, increasingly, contemporary psychoanalysts have been acknowledging and examining the intersubjectivity of the clinical encounter and that this trend has sometimes been misunderstood as necessitating the conclusion that objectivity is impossible to achieve in clinical psychoanalysis. In contrast to this, the author proposes a pragmatic definition of the analyst's objectivity that is entirely consistent with acceptance of the analyst's irreducible subjectivity, and illustrates his view by means of a clinical example. He suggests that objectivity concerns both objects and objectives, and indicates that a pragmatic conception of objectivity is employed throughout modern science. He explains why he regards psychoanalysis as a science, rather than as a hermeneutic discipline. He takes up the way in which implicit positivist assumptions can disadvantageously influence our thinking about the relation between an analyst's subjectivity and an analyst's objectivity. Finally, he discusses the important role of consensus in objectivity generally and in psychoanalytic objectivity particularly, as well as some of the differences that exist among analysts with regard to the specific objectives that take priority in clinical work. PMID:9717097

  20. Development and implementation of an automatic integration system for fibre optic sensors in the braiding process with the objective of online-monitoring of composite structures

    NASA Astrophysics Data System (ADS)

    Hufenbach, W.; Gude, M.; Czulak, A.; Kretschmann, Martin

    2014-04-01

    Increasing economic, political and ecological pressure leads to steadily rising percentage of modern processing and manufacturing processes for fibre reinforced polymers in industrial batch production. Component weights beneath a level achievable by classic construction materials, which lead to a reduced energy and cost balance during product lifetime, justify the higher fabrication costs. However, complex quality control and failure prediction slow down the substitution by composite materials. High-resolution fibre-optic sensors (FOS), due their low diameter, high measuring point density and simple handling, show a high applicability potential for an automated sensor-integration in manufacturing processes, and therefore the online monitoring of composite products manufactured in industrial scale. Integrated sensors can be used to monitor manufacturing processes, part tests as well as the component structure during product life cycle, which simplifies allows quality control during production and the optimization of single manufacturing processes.[1;2] Furthermore, detailed failure analyses lead to a enhanced understanding of failure processes appearing in composite materials. This leads to a lower wastrel number and products of a higher value and longer product life cycle, whereby costs, material and energy are saved. This work shows an automation approach for FOS-integration in the braiding process. For that purpose a braiding wheel has been supplemented with an appliance for automatic sensor application, which has been used to manufacture preforms of high-pressure composite vessels with FOS-networks integrated between the fibre layers. All following manufacturing processes (vacuum infiltration, curing) and component tests (quasi-static pressure test, programmed delamination) were monitored with the help of the integrated sensor networks. Keywords: SHM, high-pressure composite vessel, braiding, automated sensor integration, pressure test, quality control, optic

  1. [Clinical documentation in obstetrics and collection of relevant data with reference to the structural reform law. Results of a survey of 72 clinics].

    PubMed

    Butterwegge, M; Pluta, M

    1993-11-01

    This study was conducted on the spread and usage of computer-aided software programme (GDS) in 72 obstetric departments. Standardised questionnaires were sent to universities and hospitals to ask for information on registered perinatal data. The record with the hand-written delivery book cannot record all data needed for quality protection as the PC is able to list. 89% of the obstetricians evaluate their clinical data regularly by statistical survey and classification. By analysing the general trend they can critically assess their actual obstetrical management. The PC is established in 83%, functions without technical problems in 92% and is optimal in the sequence of operation in 57% of all departments questioned. Overtime hours for the staff could be reduced in 11%, if a computer was used, and in 13% the nurses could take more care of mother and child because of less official red tape. Independent of the size of the department and the data processing knowledge of the staff, the software programme runs efficiently. The comprehensive basis data documentation with all perinatal and neonatal data is used to its full extent in 100% of the cases and documents the clinical effectivity. With regard to the standardised hospital quality control process by the modified requirements in the public health legislation, the directors of the hospital departments are able to assess the quality control and show economic independence. PMID:8293945

  2. Objective Measures for Longitudinal Assessment of Robotic Surgery Training

    PubMed Central

    Kumar, Rajesh; Jog, Amod; Vagvolgyi, Balazs; Nguyen, Hiep; Hager, Gregory; Chen, Chi Chiung Grace; Yuh, David

    2011-01-01

    Objectives Current robotic training approaches lack criteria for automatically assessing and tracking (over time) technical skills separately from clinical proficiency. We describe the development and validation of a novel automated and objective framework for assessment of training. Methods We are able to record all system variables (stereo instrument video, hand and instrument motion, buttons and pedal events) from the da Vinci surgical systems using a portable archival system integrated with the robotic surgical system. Data can be collected unsupervised, and the archival system does not change system operation in any way. Our open-ended multi-center protocol is collecting surgical skill benchmarking data from 24 trainees to surgical proficiency, subject only to their continued availability. Two independent experts performed structured (OSATS) assessments on longitudinal data from 8 novice and 4 expert surgeons to generate ground truth for training and to validate our computerized statistical analysis methods in identifying ranges of operational and clinical skill measures. Results Objective differences in operational and technical skill between known experts and other subjects were quantified. Longitudinal learning curves and statistical analysis for trainee performance measures are reported. Graphical representations of skills developed for feedback to the trainees are also included. Conclusions We describe an open-ended longitudinal study and automated motion recognition system capable of objectively differentiating between clinical and technical operational skills in robotic surgery. Our results demonstrate a convergence of trainee skill parameters towards those derived from expert robotic surgeons over the course of our training protocol. PMID:22172215

  3. Effect of structured physical activity on prevention of serious fall injuries in adults aged 70-89: randomized clinical trial (LIFE Study)

    PubMed Central

    Pahor, Marco; Guralnik, Jack M; McDermott, Mary M; King, Abby C; Buford, Thomas W; Strotmeyer, Elsa S; Nelson, Miriam E; Sink, Kaycee M; Demons, Jamehl L; Kashaf, Susan S; Walkup, Michael P; Miller, Michael E

    2016-01-01

    Objective To test whether a long term, structured physical activity program compared with a health education program reduces the risk of serious fall injuries among sedentary older people with functional limitations. Design Multicenter, single blinded randomized trial (Lifestyle Interventions and Independence for Elders (LIFE) study). Setting Eight centers across the United States, February 2010 to December 2011. Participants 1635 sedentary adults aged 70-89 years with functional limitations, defined as a short physical performance battery score ≤9, but who were able to walk 400 m. Interventions A permuted block algorithm stratified by field center and sex was used to allocate interventions. Participants were randomized to a structured, moderate intensity physical activity program (n=818) conducted in a center (twice a week) and at home (3-4 times a week) that included aerobic, strength, flexibility, and balance training activities, or to a health education program (n=817) consisting of workshops on topics relevant to older people and upper extremity stretching exercises. Main outcome measures Serious fall injuries, defined as a fall that resulted in a clinical, non-vertebral fracture or that led to a hospital admission for another serious injury, was a prespecified secondary outcome in the LIFE Study. Outcomes were assessed every six months for up to 42 months by staff masked to intervention assignment. All participants were included in the analysis. Results Over a median follow-up of 2.6 years, a serious fall injury was experienced by 75 (9.2%) participants in the physical activity group and 84 (10.3%) in the health education group (hazard ratio 0.90, 95% confidence interval 0.66 to 1.23; P=0.52). These results were consistent across several subgroups, including sex. However, in analyses that were not prespecified, sex specific differences were observed for rates of all serious fall injuries (rate ratio 0.54, 95% confidence interval 0.31 to 0.95 in men

  4. NCL Objective #4 - Nanotechnology Characterization Lab (NCL)

    Cancer.gov

    The Nanotechnology Characterization Lab (NCL) Objective #4: Examine the Biological and Functional Characteristics of MultiComponent/Combinatorial Aspects of Nanoscaled Therapeutic, Molecular and Clinical Diagnostics, and Detection Platforms.

  5. Zero-Copy Objects System

    NASA Technical Reports Server (NTRS)

    Burleigh, Scott C.

    2011-01-01

    Zero-Copy Objects System software enables application data to be encapsulated in layers of communication protocol without being copied. Indirect referencing enables application source data, either in memory or in a file, to be encapsulated in place within an unlimited number of protocol headers and/or trailers. Zero-copy objects (ZCOs) are abstract data access representations designed to minimize I/O (input/output) in the encapsulation of application source data within one or more layers of communication protocol structure. They are constructed within the heap space of a Simple Data Recorder (SDR) data store to which all participating layers of the stack must have access. Each ZCO contains general information enabling access to the core source data object (an item of application data), together with (a) a linked list of zero or more specific extents that reference portions of this source data object, and (b) linked lists of protocol header and trailer capsules. The concatenation of the headers (in ascending stack sequence), the source data object extents, and the trailers (in descending stack sequence) constitute the transmitted data object constructed from the ZCO. This scheme enables a source data object to be encapsulated in a succession of protocol layers without ever having to be copied from a buffer at one layer of the protocol stack to an encapsulating buffer at a lower layer of the stack. For large source data objects, the savings in copy time and reduction in memory consumption may be considerable.

  6. Preceptors’ Self-Assessment of Their Ability to Perform the Learning Objectives of an Experiential Program

    PubMed Central

    2012-01-01

    Objective. To evaluate preceptors’ perception of their ability to perform the Structured Practical Experiences in Pharmacy (SPEP) learning objectives through a self-assessment activity. Methods. A self-assessment instrument consisting of 28 learning objectives associated with clinic, community, and hospital pharmacy practice experiences were developed. Preceptors rated their performance ability for each of the learning objectives using a 3-point Likert scale. Results. Of the 116 preceptors, 89 (77%) completed the self-assessment survey instrument. The overall preceptor responses to the items on performance of the 28 SPEP learning objectives ranged from good to excellent. Years of experience, practice experience setting, and involvement as a SPEP or SPEP and PharmD preceptor had no influence on their self-reported capabilities. Conclusion. Most preceptors rated their ability to perform the learning objectives for the structured practical experiences in pharmacy as high. Competency areas requiring further preceptor development were identified. PMID:23193333

  7. Teaching Spanish Direct Object Pronouns.

    ERIC Educational Resources Information Center

    Moody, Raymond

    1972-01-01

    An innovative approach to facilitate student mastery of Spanish linguistic structures requiring manipulation of the direct object is described in this article. The method, derived originally from William Bull's "Spanish for Teachers," also enables students to apply the transformational method to sentences containing nominalized adjectives,…

  8. Classical psychoanalysis and object relations theory in the analysis of character.

    PubMed

    Gill, H S

    1990-01-01

    The analysis of character begins with repeated interpretation of its defensive structure and later moves into the analysis of object relations. What appears at first to be a patient's defenses against instinctual impulses may subsequently be recognized as defenses against emotional reactions to early objects. Nevertheless, at the beginning, interpretations should be directed toward the clinical material already available, and not at what may eventually emerge according to the analyst's theory. The author presents a case report to illustrate this viewpoint. PMID:2268755

  9. Objectives and Preparing Tests.

    ERIC Educational Resources Information Center

    Purohit, Anal A.; Bober, Kenneth F.

    1984-01-01

    The concepts behind, and construction of, specific behavioral objectives are examined as steps that are preliminary to evaluating student performance through tests. A taxonomy of educational objectives and guidelines in preparing them are outlined in detail. (MSE)

  10. Eye - foreign object in

    MedlinePlus

    ... medlineplus.gov/ency/article/002084.htm Eye - foreign object in To use the sharing features on this ... Blinking The eye will often flush out small objects, like eyelashes and sand, through blinking and tearing. ...

  11. Feature engineering combined with machine learning and rule-based methods for structured information extraction from narrative clinical discharge summaries

    PubMed Central

    Xu, Yan; Hong, Kai; Tsujii, Junichi

    2012-01-01

    Objective A system that translates narrative text in the medical domain into structured representation is in great demand. The system performs three sub-tasks: concept extraction, assertion classification, and relation identification. Design The overall system consists of five steps: (1) pre-processing sentences, (2) marking noun phrases (NPs) and adjective phrases (APs), (3) extracting concepts that use a dosage-unit dictionary to dynamically switch two models based on Conditional Random Fields (CRF), (4) classifying assertions based on voting of five classifiers, and (5) identifying relations using normalized sentences with a set of effective discriminating features. Measurements Macro-averaged and micro-averaged precision, recall and F-measure were used to evaluate results. Results The performance is competitive with the state-of-the-art systems with micro-averaged F-measure of 0.8489 for concept extraction, 0.9392 for assertion classification and 0.7326 for relation identification. Conclusions The system exploits an array of common features and achieves state-of-the-art performance. Prudent feature engineering sets the foundation of our systems. In concept extraction, we demonstrated that switching models, one of which is especially designed for telegraphic sentences, improved extraction of the treatment concept significantly. In assertion classification, a set of features derived from a rule-based classifier were proven to be effective for the classes such as conditional and possible. These classes would suffer from data scarcity in conventional machine-learning methods. In relation identification, we use two-staged architecture, the second of which applies pairwise classifiers to possible candidate classes. This architecture significantly improves performance. PMID:22586067

  12. [GSG (Structured Health Regulation)-conforming documentation of surgical interventions in a university clinic--3 years clinical experiences 1994-1996].

    PubMed

    Huber, F X; Schall, R; Stern, J; Gleim, U; Krieglstein, C; Mieth, M; Herfarth, C

    1998-01-01

    The cost increase in the public health sector is steadily mounting and hence politicians are forced to redefine the economic conditions for regulations. As a new quality in the area of inpatient hospital care the new German law of structural health care (GSG), valid as of January 1, 1993 replaces the principle of covering full costs. The GSG law required in our hospital an adjustment of existing EDP structures with integrated automatic remuneration estimate and the installation of a medical structure of the organisation for complete and correct documentation. Weakpoints of the prescribed obligatory ICPM codes and inadequate legal regulations result in a lack of separation or wrong integration of the lump sum payment in individual cases (FP) and special compensation (SE). The summary analysis of the compensation system with a subsequent medical control system showed a primarily inaccurate classification by 12%. There is as yet no proof for the usefulness of a lump sum payment system resulting in a selection of risks. PMID:9522560

  13. Objects in Motion

    ERIC Educational Resources Information Center

    Damonte, Kathleen

    2004-01-01

    One thing scientists study is how objects move. A famous scientist named Sir Isaac Newton (1642-1727) spent a lot of time observing objects in motion and came up with three laws that describe how things move. This explanation only deals with the first of his three laws of motion. Newton's First Law of Motion says that moving objects will continue…

  14. Presentation on Instructional Objectives

    ERIC Educational Resources Information Center

    Naz, Bibi Asia

    2009-01-01

    "Learning can be defined as change in a student's capacity for performance as a result of experience" (Kenneth D. Moore). The intended changes should be specified in instructional objectives. Viewed in this context, an objective can be defined as a clear and unambiguous description of your instructional intent. An objective is not a statement of…

  15. Behavioral Objectives for English

    ERIC Educational Resources Information Center

    Zoellner, Robert

    1972-01-01

    A review-critique of On Writing Behavioral Objectives for English, by John Maxwell and Anthony Lovat, in which behavioral objectives theory is dominated by a stimulus-response rather than a stimulus-response-reinforcement psychology. The reviewer questions whether behavioral objectives can be applied accurately and without distortion of meanings,…

  16. Survivability via Control Objectives

    SciTech Connect

    CAMPBELL,PHILIP L.

    2000-08-11

    Control objectives open an additional front in the survivability battle. A given set of control objectives is valuable if it represents good practices, it is complete (it covers all the necessary areas), and it is auditable. CobiT and BS 7799 are two examples of control objective sets.

  17. Learning Objects and Gerontology

    ERIC Educational Resources Information Center

    Weinreich, Donna M.; Tompkins, Catherine J.

    2006-01-01

    Virtual AGE (vAGE) is an asynchronous educational environment that utilizes learning objects focused on gerontology and a learning anytime/anywhere philosophy. This paper discusses the benefits of asynchronous instruction and the process of creating learning objects. Learning objects are "small, reusable chunks of instructional media" Wiley…

  18. Music Objectives: Second Assessment.

    ERIC Educational Resources Information Center

    Education Commission of the States, Denver, CO. National Assessment of Educational Progress.

    The document describes the development of objectives and presents objectives formulated by music educators, lay individuals, and the National Assessment of Educational Progress (NAEP) staff in 1973. Objectives from the first music assessment were reappraised, reviewed, and revised to include greater breadth of application, greater emphasis on the…

  19. Ownership and Object History

    ERIC Educational Resources Information Center

    Friedman, Ori; Neary, Karen R.; Defeyter, Margaret A.; Malcolm, Sarah L.

    2011-01-01

    Appropriate behavior in relation to an object often requires judging whether it is owned and, if so, by whom. The authors propose accounts of how people make these judgments. Our central claim is that both judgments often involve making inferences about object history. In judging whether objects are owned, people may assume that artifacts (e.g.,…

  20. Data-Driven Objectness.

    PubMed

    Hongwen Kang; Hebert, Martial; Efros, Alexei A; Kanade, Takeo

    2015-01-01

    We propose a data-driven approach to estimate the likelihood that an image segment corresponds to a scene object (its "objectness") by comparing it to a large collection of example object regions. We demonstrate that when the application domain is known, for example, in our case activity of daily living (ADL), we can capture the regularity of the domain specific objects using millions of exemplar object regions. Our approach to estimating the objectness of an image region proceeds in two steps: 1) finding the exemplar regions that are the most similar to the input image segment; 2) calculating the objectness of the image segment by combining segment properties, mutual consistency across the nearest exemplar regions, and the prior probability of each exemplar region. In previous work, parametric objectness models were built from a small number of manually annotated objects regions, instead, our data-driven approach uses 5 million object regions along with their metadata information. Results on multiple data sets demonstrates our data-driven approach compared to the existing model based techniques. We also show the application of our approach in improving the performance of object discovery algorithms. PMID:26353218

  1. Auditory object cognition in dementia.

    PubMed

    Goll, Johanna C; Kim, Lois G; Hailstone, Julia C; Lehmann, Manja; Buckley, Aisling; Crutch, Sebastian J; Warren, Jason D

    2011-07-01

    The cognition of nonverbal sounds in dementia has been relatively little explored. Here we undertook a systematic study of nonverbal sound processing in patient groups with canonical dementia syndromes comprising clinically diagnosed typical amnestic Alzheimer's disease (AD; n=21), progressive nonfluent aphasia (PNFA; n=5), logopenic progressive aphasia (LPA; n=7) and aphasia in association with a progranulin gene mutation (GAA; n=1), and in healthy age-matched controls (n=20). Based on a cognitive framework treating complex sounds as 'auditory objects', we designed a novel neuropsychological battery to probe auditory object cognition at early perceptual (sub-object), object representational (apperceptive) and semantic levels. All patients had assessments of peripheral hearing and general neuropsychological functions in addition to the experimental auditory battery. While a number of aspects of auditory object analysis were impaired across patient groups and were influenced by general executive (working memory) capacity, certain auditory deficits had some specificity for particular dementia syndromes. Patients with AD had a disproportionate deficit of auditory apperception but preserved timbre processing. Patients with PNFA had salient deficits of timbre and auditory semantic processing, but intact auditory size and apperceptive processing. Patients with LPA had a generalised auditory deficit that was influenced by working memory function. In contrast, the patient with GAA showed substantial preservation of auditory function, but a mild deficit of pitch direction processing and a more severe deficit of auditory apperception. The findings provide evidence for separable stages of auditory object analysis and separable profiles of impaired auditory object cognition in different dementia syndromes. PMID:21689671

  2. Reasoning about Function Objects

    NASA Astrophysics Data System (ADS)

    Nordio, Martin; Calcagno, Cristiano; Meyer, Bertrand; Müller, Peter; Tschannen, Julian

    Modern object-oriented languages support higher-order implementations through function objects such as delegates in C#, agents in Eiffel, or closures in Scala. Function objects bring a new level of abstraction to the object-oriented programming model, and require a comparable extension to specification and verification techniques. We introduce a verification methodology that extends function objects with auxiliary side-effect free (pure) methods to model logical artifacts: preconditions, postconditions and modifies clauses. These pure methods can be used to specify client code abstractly, that is, independently from specific instantiations of the function objects. To demonstrate the feasibility of our approach, we have implemented an automatic prover, which verifies several non-trivial examples.

  3. Herbig-Haro objects

    NASA Technical Reports Server (NTRS)

    Boehm, K. H.

    1990-01-01

    The IUE (International Ultraviolet Explorer) spectra of Herbig-Haro (HH) objects and their relation to the very detailed optical spectra available for these objects are studied. Useful information about the physics of HH objects in general and especially about their hydrodynamic models which are contained in these IUE observations is outlined. The merged spectra of high excitation, low excitation HH objects (like HH43 and HH47), and peculiar HH objects are discussed. Results of the spatial variation of lines and continua in HH objects are discussed. Their compatibility with predictions for aerodynamic and especially bow shock models is discussed. The problems arising in the interpretation of the continuous energy distribution in the short wavelength range are discussed. They require the presence of other emission mechanisms in addition to the collisionally enhanced two photon continuum. In HH43 the fluorescent H2 line emission comes from a surprisingly small spatial region. Implications of these results are discussed.

  4. Ultrathin zoom telescopic objective.

    PubMed

    Li, Lei; Wang, Di; Liu, Chao; Wang, Qiong-Hua

    2016-08-01

    We report an ultrathin zoom telescopic objective that can achieve continuous zoom change and has reduced compact volume. The objective consists of an annular folded lens and three electrowetting liquid lenses. The annular folded lens undertakes the main part of the focal power of the lens system. Due to a multiple-fold design, the optical path is folded in a lens with the thickness of ~1.98mm. The electrowetting liquid lenses constitute a zoom part. Based on the proposed objective, an ultrathin zoom telescopic camera is demonstrated. We analyze the properties of the proposed objective. The aperture of the proposed objective is ~15mm. The total length of the system is ~18mm with a tunable focal length ~48mm to ~65mm. Compared with the conventional zoom telescopic objective, the total length has been largely reduced. PMID:27505830

  5. Propelling Extended Objects

    ERIC Educational Resources Information Center

    Humbert, Richard

    2010-01-01

    A force acting on just part of an extended object (either a solid or a volume of a liquid) can cause all of it to move. That motion is due to the transmission of the force through the object by its material. This paper discusses how the force is distributed to all of the object by a gradient of stress or pressure in it, which creates the local…

  6. Robot Grasps Rotating Object

    NASA Technical Reports Server (NTRS)

    Wilcox, Brian H.; Tso, Kam S.; Litwin, Todd E.; Hayati, Samad A.; Bon, Bruce B.

    1991-01-01

    Experimental robotic system semiautomatically grasps rotating object, stops rotation, and pulls object to rest in fixture. Based on combination of advanced techniques for sensing and control, constructed to test concepts for robotic recapture of spinning artificial satellites. Potential terrestrial applications for technology developed with help of system includes tracking and grasping of industrial parts on conveyor belts, tracking of vehicles and animals, and soft grasping of moving objects in general.

  7. Moving Object Control System

    NASA Technical Reports Server (NTRS)

    Arndt, G. Dickey (Inventor); Carl, James R. (Inventor)

    2001-01-01

    A method is provided for controlling two objects relatively moveable with respect to each other. A plurality of receivers are provided for detecting a distinctive microwave signal from each of the objects and measuring the phase thereof with respect to a reference signal. The measured phase signal is used to determine a distance between each of the objects and each of the plurality of receivers. Control signals produced in response to the relative distances are used to control the position of the two objects.

  8. Perceptual objects capture attention.

    PubMed

    Yeshurun, Yaffa; Kimchi, Ruth; Sha'shoua, Guy; Carmel, Tomer

    2009-06-01

    A recent study has demonstrated that the mere organization of some elements in the visual field into an object attracts attention automatically [Kimchi, R., Yeshurun, Y., & Cohen-Savransky, A. (2007). Automatic, stimulus-driven attentional capture by objecthood. Psychonomic Bulletin & Review, 14(1), 166-172]. We tested whether similar results will emerge when the target is not a part of the object and with simplified task demands. A matrix of 16 black L elements in various orientations preceded the presentation of a Vernier target. The target was either added to the matrix (Experiment 1), or appeared after its offset (Experiment 2). On some trials four elements formed a square-like object, and on some of these trials the target appeared in the center of the object. No featural uniqueness or abrupt onset was associated with the object and it did not predict the target location or the direction of the target's horizontal offset. Performance was better when the target appeared in the center of the object than in a different location than the object, even when the target appeared after the matrix offset. These findings support the hypothesis that a perceptual object captures attention (Kimchi et al., 2007), and demonstrate that this automatic deployment of attention to the object is robust and involves a spatial component. PMID:18299141

  9. Objects of Maximum Electromagnetic Chirality

    NASA Astrophysics Data System (ADS)

    Fernandez-Corbaton, Ivan; Fruhnert, Martin; Rockstuhl, Carsten

    2016-07-01

    We introduce a definition of the electromagnetic chirality of an object and show that it has an upper bound. Reciprocal objects attain the upper bound if and only if they are transparent for all the fields of one polarization handedness (helicity). Additionally, electromagnetic duality symmetry, i.e., helicity preservation upon interaction, turns out to be a necessary condition for reciprocal objects to attain the upper bound. We use these results to provide requirements for the design of such extremal objects. The requirements can be formulated as constraints on the polarizability tensors for dipolar objects or on the material constitutive relations for continuous media. We also outline two applications for objects of maximum electromagnetic chirality: a twofold resonantly enhanced and background-free circular dichroism measurement setup, and angle-independent helicity filtering glasses. Finally, we use the theoretically obtained requirements to guide the design of a specific structure, which we then analyze numerically and discuss its performance with respect to maximal electromagnetic chirality.

  10. Carpentry Performance Objectives.

    ERIC Educational Resources Information Center

    Day, Gerald F.; Tucker, John

    The guidelines for carpentry performance objectives were written for vocational educators in order to insure that their programs are fulfilling the training requirements of today's job market. The document outlines eight uses of performance objectives and provides sample employability profiles, training achievement records, and a carpentry…

  11. Science Objectives. 1990 Assessment.

    ERIC Educational Resources Information Center

    National Assessment of Educational Progress, Princeton, NJ.

    This booklet describes the assessment objectives of the sixth national assessment of science by the National Assessment of Educational Progress (NAEP). Chapters included are: (1) "Introduction" (describing the development process for the objectives and the purpose and elements of school science); (2) "The Assessment Framework" (discussing major…

  12. Manipulator for hollow objects

    DOEpatents

    Cawley, William E.; Frantz, Charles E.

    1977-01-01

    A device for gripping the interior of a tubular object to pull it out of a body in which it has become stuck includes an expandable rubber tube having a plurality of metal cables lodged in the exterior of the rubber tube so as to protrude slightly therefrom, means for inflating the tube and means for pulling the tube longitudinally of the tubular object.

  13. Images of Axial Objects

    ERIC Educational Resources Information Center

    Rabal, Hector; Cap, Nelly; Trivi, Marcelo

    2011-01-01

    Imaging of three-dimensional objects by lenses and mirrors is sometimes poorly indicated in textbooks and can be incorrectly drawn. We stress a need to clarify the concept of longitudinal magnification, with simulated images illustrating distortions introduced along the optical axis. We consider all possible positions of the object for both a…

  14. The Effective Clinical Conference.

    ERIC Educational Resources Information Center

    Wink, Diane M.

    1995-01-01

    Examines the common problems with clinical conferences and suggests approaches to maximize student learning. Suggests that an effective clinical conference has three characteristics: (1) it is a group event; (2) it contributes to the achievement of course and clinical objectives; and (3) it provides a setting for students to explore personal…

  15. Moving Objects Updating

    NASA Astrophysics Data System (ADS)

    Chen, Jidong; Meng, Xiaofeng

    In moving objects applications, large numbers of locations can be sampled by sensors or GPS periodically, then sent from moving clients to the server and stored in a database. Therefore, continuously maintaining in a database the current locations of moving objects by using a tracking technique becomes very important. The key issue is minimizing the number of updates, while providing precise locations for query results. In this chapter, we will introduce some underlying location update methods. Then, we describe two location update strategies in detail, which can improve the performance. One is the proactive location update strategy, which predicts the movement of moving objects to lower the update frequency; the other is the group location update strategy, which groups the objects to minimize the total number of objects reporting their locations.

  16. Acoustic Characterization of Mesoscale Objects

    SciTech Connect

    Chinn, D; Huber, R; Chambers, D; Cole, G; Balogun, O; Spicer, J; Murray, T

    2007-03-13

    This report describes the science and engineering performed to provide state-of-the-art acoustic capabilities for nondestructively characterizing mesoscale (millimeter-sized) objects--allowing micrometer resolution over the objects entire volume. Materials and structures used in mesoscale objects necessitate the use of (1) GHz acoustic frequencies and (2) non-contacting laser generation and detection of acoustic waves. This effort demonstrated that acoustic methods at gigahertz frequencies have the necessary penetration depth and spatial resolution to effectively detect density discontinuities, gaps, and delaminations. A prototype laser-based ultrasonic system was designed and built. The system uses a micro-chip laser for excitation of broadband ultrasonic waves with frequency components reaching 1.0 GHz, and a path-stabilized Michelson interferometer for detection. The proof-of-concept for mesoscale characterization is demonstrated by imaging a micro-fabricated etched pattern in a 70 {micro}m thick silicon wafer.

  17. Methods and strategies of object localization

    NASA Technical Reports Server (NTRS)

    Shao, Lejun; Volz, Richard A.

    1989-01-01

    An important property of an intelligent robot is to be able to determine the location of an object in 3-D space. A general object localization system structure is proposed, some important issues on localization discussed, and an overview given for current available object localization algorithms and systems. The algorithms reviewed are characterized by their feature extracting and matching strategies; the range finding methods; the types of locatable objects; and the mathematical formulating methods.

  18. Treatment of Adolescent Marijuana Abuse: A Randomized Clinical Trial. Presentation 1: Structure of the Cannabis Youth Treatment Study.

    ERIC Educational Resources Information Center

    Titus, Janet C.; Dennis, Michael L.; Diamond, Guy; Godley, Susan H.; Babor, Thomas; Donaldson, Jean; Herrell, James; Tims, Frank; Webb, Charles

    The Cannabis Youth Treatment (CYT) study is a multi-site randomized field experiment examining five outpatient treatment protocols for adolescents who abuse or are dependent on marijuana. The purpose of the CYT project is twofold: (a) to test the relative clinical effectiveness and cost-effectiveness of five promising interventions targeted at…

  19. The Asperger Syndrome (and High-Functioning Autism) Diagnostic Interview (ASDI): A Preliminary Study of a New Structured Clinical Interview.

    ERIC Educational Resources Information Center

    Gillberg, Christopher; Gillberg, Carina; Rastam, Maria; Wentz, Elisabeth

    2001-01-01

    The development of the Asperger Syndrome (and high-functioning autism) Diagnostic Interview (ASDI) is described. Preliminary data from a clinical study of 20 individuals (ages 6-55) suggest that interrater reliability and test-retest stability may be excellent, with kappas exceeding 0.90 in both instances. The validity appears to be relatively…

  20. How Do Students with Dyslexia Perform in Extended Matching Questions, Short Answer Questions and Observed Structured Clinical Examinations?

    ERIC Educational Resources Information Center

    Gibson, Sandra; Leinster, Samuel

    2011-01-01

    There are an increasing number of students with learning difficulties attending university, and currently much debate about the suitability and ability of students with dyslexia at both medical school and once they graduate into clinical practice. In this study we describe the performance of students with dyslexia compared to fellow students in…