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Sample records for 3-dimensional medical model

  1. The Effectiveness of an Interactive 3-Dimensional Computer Graphics Model for Medical Education

    PubMed Central

    Konishi, Takeshi; Tamura, Yoko; Moriguchi, Hiroki

    2012-01-01

    Background Medical students often have difficulty achieving a conceptual understanding of 3-dimensional (3D) anatomy, such as bone alignment, muscles, and complex movements, from 2-dimensional (2D) images. To this end, animated and interactive 3-dimensional computer graphics (3DCG) can provide better visual information to users. In medical fields, research on the advantages of 3DCG in medical education is relatively new. Objective To determine the educational effectiveness of interactive 3DCG. Methods We divided 100 participants (27 men, mean (SD) age 17.9 (0.6) years, and 73 women, mean (SD) age 18.1 (1.1) years) from the Health Sciences University of Mongolia (HSUM) into 3DCG (n = 50) and textbook-only (control) (n = 50) groups. The control group used a textbook and 2D images, while the 3DCG group was trained to use the interactive 3DCG shoulder model in addition to a textbook. We conducted a questionnaire survey via an encrypted satellite network between HSUM and Tokushima University. The questionnaire was scored on a 5-point Likert scale from strongly disagree (score 1) to strongly agree (score 5). Results Interactive 3DCG was effective in undergraduate medical education. Specifically, there was a significant difference in mean (SD) scores between the 3DCG and control groups in their response to questionnaire items regarding content (4.26 (0.69) vs 3.85 (0.68), P = .001) and teaching methods (4.33 (0.65) vs 3.74 (0.79), P < .001), but no significant difference in the Web category. Participants also provided meaningful comments on the advantages of interactive 3DCG. Conclusions Interactive 3DCG materials have positive effects on medical education when properly integrated into conventional education. In particular, our results suggest that interactive 3DCG is more efficient than textbooks alone in medical education and can motivate students to understand complex anatomical structures. PMID:23611759

  2. 3-Dimensional Topographic Models for the Classroom

    NASA Technical Reports Server (NTRS)

    Keller, J. W.; Roark, J. H.; Sakimoto, S. E. H.; Stockman, S.; Frey, H. V.

    2003-01-01

    We have recently undertaken a program to develop educational tools using 3-dimensional solid models of digital elevation data acquired by the Mars Orbital Laser Altimeter (MOLA) for Mars as well as a variety of sources for elevation data of the Earth. This work is made possible by the use of rapid prototyping technology to construct solid 3-Dimensional models of science data. We recently acquired rapid prototyping machine that builds 3-dimensional models in extruded plastic. While the machine was acquired to assist in the design and development of scientific instruments and hardware, it is also fully capable of producing models of spacecraft remote sensing data. We have demonstrated this by using Mars Orbiter Laser Altimeter (MOLA) topographic data and Earth based topographic data to produce extruded plastic topographic models which are visually appealing and instantly engage those who handle them.

  3. Incorporating 3-dimensional models in online articles

    PubMed Central

    Cevidanes, Lucia H. S.; Ruellasa, Antonio C. O.; Jomier, Julien; Nguyen, Tung; Pieper, Steve; Budin, Francois; Styner, Martin; Paniagua, Beatriz

    2015-01-01

    Introduction The aims of this article were to introduce the capability to view and interact with 3-dimensional (3D) surface models in online publications, and to describe how to prepare surface models for such online 3D visualizations. Methods Three-dimensional image analysis methods include image acquisition, construction of surface models, registration in a common coordinate system, visualization of overlays, and quantification of changes. Cone-beam computed tomography scans were acquired as volumetric images that can be visualized as 3D projected images or used to construct polygonal meshes or surfaces of specific anatomic structures of interest. The anatomic structures of interest in the scans can be labeled with color (3D volumetric label maps), and then the scans are registered in a common coordinate system using a target region as the reference. The registered 3D volumetric label maps can be saved in .obj, .ply, .stl, or .vtk file formats and used for overlays, quantification of differences in each of the 3 planes of space, or color-coded graphic displays of 3D surface distances. Results All registered 3D surface models in this study were saved in .vtk file format and loaded in the Elsevier 3D viewer. In this study, we describe possible ways to visualize the surface models constructed from cone-beam computed tomography images using 2D and 3D figures. The 3D surface models are available in the article’s online version for viewing and downloading using the reader’s software of choice. These 3D graphic displays are represented in the print version as 2D snapshots. Overlays and color-coded distance maps can be displayed using the reader’s software of choice, allowing graphic assessment of the location and direction of changes or morphologic differences relative to the structure of reference. The interpretation of 3D overlays and quantitative color-coded maps requires basic knowledge of 3D image analysis. Conclusions When submitting manuscripts, authors can

  4. Mandibular reconstruction using stereolithographic 3-dimensional printing modeling technology.

    PubMed

    Cohen, Adir; Laviv, Amir; Berman, Phillip; Nashef, Rizan; Abu-Tair, Jawad

    2009-11-01

    Mandibular reconstruction can be challenging for the surgeon wishing to restore its unique geometry. Reconstruction can be achieved with titanium bone plates followed by autogenous bone grafting. Incorporation of the bone graft into the mandible provides continuity and strength required for proper esthetics and function and permitting dental implant rehabilitation at a later stage. Precious time in the operating room is invested in plate contouring to reconstruct the mandible. Rapid prototyping technologies can construct physical models from computer-aided design via 3-dimensional (3D) printers. A prefabricated 3D model is achieved, which assists in accurate contouring of plates and/or planning of bone graft harvest geometry before surgery. The 2 most commonly used rapid prototyping technologies are stereolithography and 3D printing (3DP). Three-dimensional printing is advantageous to stereolithography for better accuracy, quicker printing time, and lower cost. We present 3 clinical cases based on 3DP modeling technology. Models were fabricated before the resection of mandibular ameloblastoma and were used to prepare bridging plates before the first stage of reconstruction. In 1 case, another model was fabricated and used as a template for iliac crest bone graft in the second stage of reconstruction. The 3DP technology provided a precise, fast, and cheap mandibular reconstruction, which aids in shortened operation time (and therefore decreased exposure time to general anesthesia, decreased blood loss, and shorter wound exposure time) and easier surgical procedure.

  5. Development and Validation of a 3-Dimensional CFB Furnace Model

    NASA Astrophysics Data System (ADS)

    Vepsäläinen, Arl; Myöhänen, Karl; Hyppäneni, Timo; Leino, Timo; Tourunen, Antti

    At Foster Wheeler, a three-dimensional CFB furnace model is essential part of knowledge development of CFB furnace process regarding solid mixing, combustion, emission formation and heat transfer. Results of laboratory and pilot scale phenomenon research are utilized in development of sub-models. Analyses of field-test results in industrial-scale CFB boilers including furnace profile measurements are simultaneously carried out with development of 3-dimensional process modeling, which provides a chain of knowledge that is utilized as feedback for phenomenon research. Knowledge gathered by model validation studies and up-to-date parameter databases are utilized in performance prediction and design development of CFB boiler furnaces. This paper reports recent development steps related to modeling of combustion and formation of char and volatiles of various fuel types in CFB conditions. Also a new model for predicting the formation of nitrogen oxides is presented. Validation of mixing and combustion parameters for solids and gases are based on test balances at several large-scale CFB boilers combusting coal, peat and bio-fuels. Field-tests including lateral and vertical furnace profile measurements and characterization of solid materials provides a window for characterization of fuel specific mixing and combustion behavior in CFB furnace at different loads and operation conditions. Measured horizontal gas profiles are projection of balance between fuel mixing and reactions at lower part of furnace and are used together with both lateral temperature profiles at bed and upper parts of furnace for determination of solid mixing and combustion model parameters. Modeling of char and volatile based formation of NO profiles is followed by analysis of oxidizing and reducing regions formed due lower furnace design and mixing characteristics of fuel and combustion airs effecting to formation ofNO furnace profile by reduction and volatile-nitrogen reactions. This paper presents

  6. A 3-dimensional model for teaching local flaps using porcine skin.

    PubMed

    Hassan, Zahid; Hogg, Fiona; Graham, Ken

    2014-10-01

    The European Working Time Directive and streamlined training has led to reduced training time. Surgery, as an experience-dependent craft specialty is affected more than other medical specialties. Trainees want to maximize all training opportunities in the clinical setting, and having predeveloped basic skills acquired on a simulated model can facilitate this.Here we describe the use of a novel model to design and raise local flaps in the face and scalp regions. The model consists of mannequin heads draped with porcine skin which is skewered with pins at strategic points to give a 3-dimensional model which closely resembles a cadaveric head.The advantages of this model are that it is life size and incorporates all the relevant anatomical features, which can be drawn on if required.This model was used on a recent course, Intermediate Skills in Plastic Surgery: Flaps Around the Face, at the Royal College of Surgeons England. The trainees found that practicing on the porcine skin gave them an opportunity to master the basics of flap design and implementation.In summary, this innovative 3-dimensional training model has received high levels of satisfaction and is currently as close as we can get to cadaveric dissection without the constraints and cost of using human tissue.

  7. 3-dimensional modeling of transcranial magnetic stimulation: Design and application

    NASA Astrophysics Data System (ADS)

    Salinas, Felipe Santiago

    Over the past three decades, transcranial magnetic stimulation (TMS) has emerged as an effective tool for many research, diagnostic and therapeutic applications in humans. TMS delivers highly localized brain stimulations via non-invasive externally applied magnetic fields. This non-invasive, painless technique provides researchers and clinicians a unique tool capable of stimulating both the central and peripheral nervous systems. However, a complete analysis of the macroscopic electric fields produced by TMS has not yet been performed. In this dissertation, we present a thorough examination of the total electric field induced by TMS in air and a realistic head model with clinically relevant coil poses. In the first chapter, a detailed account of TMS coil wiring geometry was shown to provide significant improvements in the accuracy of primary E-field calculations. Three-dimensional models which accounted for the TMS coil's wire width, height, shape and number of turns clearly improved the fit of calculated-to-measured E-fields near the coil body. Detailed primary E-field models were accurate up to the surface of the coil body (within 0.5% of measured values) whereas simple models were often inadequate (up to 32% different from measured). In the second chapter, we addressed the importance of the secondary E-field created by surface charge accumulation during TMS using the boundary element method (BEM). 3-D models were developed using simple head geometries in order to test the model and compare it with measured values. The effects of tissue geometry, size and conductivity were also investigated. Finally, a realistic head model was used to assess the effect of multiple surfaces on the total E-field. We found that secondary E-fields have the greatest impact at areas in close proximity to each tissue layer. Throughout the head, the secondary E-field magnitudes were predominantly between 25% and 45% of the primary E-fields magnitude. The direction of the secondary E

  8. Simple parameter estimation for complex models — Testing evolutionary techniques on 3-dimensional biogeochemical ocean models

    NASA Astrophysics Data System (ADS)

    Mattern, Jann Paul; Edwards, Christopher A.

    2017-01-01

    Parameter estimation is an important part of numerical modeling and often required when a coupled physical-biogeochemical ocean model is first deployed. However, 3-dimensional ocean model simulations are computationally expensive and models typically contain upwards of 10 parameters suitable for estimation. Hence, manual parameter tuning can be lengthy and cumbersome. Here, we present four easy to implement and flexible parameter estimation techniques and apply them to two 3-dimensional biogeochemical models of different complexities. Based on a Monte Carlo experiment, we first develop a cost function measuring the model-observation misfit based on multiple data types. The parameter estimation techniques are then applied and yield a substantial cost reduction over ∼ 100 simulations. Based on the outcome of multiple replicate experiments, they perform on average better than random, uninformed parameter search but performance declines when more than 40 parameters are estimated together. Our results emphasize the complex cost function structure for biogeochemical parameters and highlight dependencies between different parameters as well as different cost function formulations.

  9. 3-dimensional orthodontics visualization system with dental study models and orthopantomograms

    NASA Astrophysics Data System (ADS)

    Zhang, Hua; Ong, S. H.; Foong, K. W. C.; Dhar, T.

    2005-04-01

    The aim of this study is to develop a system that provides 3-dimensional visualization of orthodontic treatments. Dental plaster models and corresponding orthopantomogram (dental panoramic tomogram) are first digitized and fed into the system. A semi-auto segmentation technique is applied to the plaster models to detect the dental arches, tooth interstices and gum margins, which are used to extract individual crown models. 3-dimensional representation of roots, generated by deforming generic tooth models with orthopantomogram using radial basis functions, is attached to corresponding crowns to enable visualization of complete teeth. An optional algorithm to close the gaps between deformed roots and actual crowns by using multi-quadratic radial basis functions is also presented, which is capable of generating smooth mesh representation of complete 3-dimensional teeth. User interface is carefully designed to achieve a flexible system with as much user friendliness as possible. Manual calibration and correction is possible throughout the data processing steps to compensate occasional misbehaviors of automatic procedures. By allowing the users to move and re-arrange individual teeth (with their roots) on a full dentition, this orthodontic visualization system provides an easy and accurate way of simulation and planning of orthodontic treatment. Its capability of presenting 3-dimensional root information with only study models and orthopantomogram is especially useful for patients who do not undergo CT scanning, which is not a routine procedure in most orthodontic cases.

  10. A Novel Medical Image Protection Scheme Using a 3-Dimensional Chaotic System

    PubMed Central

    Fu, Chong; Zhang, Gao-yuan; Bian, Ou; Lei, Wei-min; Ma, Hong-feng

    2014-01-01

    Recently, great concerns have been raised regarding the issue of medical image protection due to the increasing demand for telemedicine services, especially the teleradiology service. To meet this challenge, a novel chaos-based approach is suggested in this paper. To address the security and efficiency problems encountered by many existing permutation-diffusion type image ciphers, the new scheme utilizes a single 3D chaotic system, Chen's chaotic system, for both permutation and diffusion. In the permutation stage, we introduce a novel shuffling mechanism, which shuffles each pixel in the plain image by swapping it with another pixel chosen by two of the three state variables of Chen's chaotic system. The remaining variable is used for quantification of pseudorandom keystream for diffusion. Moreover, the selection of state variables is controlled by plain pixel, which enhances the security against known/chosen-plaintext attack. Thorough experimental tests are carried out and the results indicate that the proposed scheme provides an effective and efficient way for real-time secure medical image transmission over public networks. PMID:25541941

  11. Experimental Validation of Plastic Mandible Models Produced by a “Low-Cost” 3-Dimensional Fused Deposition Modeling Printer

    PubMed Central

    Maschio, Federico; Pandya, Mirali; Olszewski, Raphael

    2016-01-01

    Background The objective of this study was to investigate the accuracy of 3-dimensional (3D) plastic (ABS) models generated using a low-cost 3D fused deposition modelling printer. Material/Methods Two human dry mandibles were scanned with a cone beam computed tomography (CBCT) Accuitomo device. Preprocessing consisted of 3D reconstruction with Maxilim software and STL file repair with Netfabb software. Then, the data were used to print 2 plastic replicas with a low-cost 3D fused deposition modeling printer (Up plus 2®). Two independent observers performed the identification of 26 anatomic landmarks on the 4 mandibles (2 dry and 2 replicas) with a 3D measuring arm. Each observer repeated the identifications 20 times. The comparison between the dry and plastic mandibles was based on 13 distances: 8 distances less than 12 mm and 5 distances greater than 12 mm. Results The mean absolute difference (MAD) was 0.37 mm, and the mean dimensional error (MDE) was 3.76%. The MDE decreased to 0.93% for distances greater than 12 mm. Conclusions Plastic models generated using the low-cost 3D printer UPplus2® provide dimensional accuracies comparable to other well-established rapid prototyping technologies. Validated low-cost 3D printers could represent a step toward the better accessibility of rapid prototyping technologies in the medical field. PMID:27003456

  12. 3-Dimensional Geologic Modeling Applied to the Structural Characterization of Geothermal Systems: Astor Pass, Nevada, USA

    SciTech Connect

    Siler, Drew L; Faulds, James E; Mayhew, Brett

    2013-04-16

    Geothermal systems in the Great Basin, USA, are controlled by a variety of fault intersection and fault interaction areas. Understanding the specific geometry of the structures most conducive to broad-scale geothermal circulation is crucial to both the mitigation of the costs of geothermal exploration (especially drilling) and to the identification of geothermal systems that have no surface expression (blind systems). 3-dimensional geologic modeling is a tool that can elucidate the specific stratigraphic intervals and structural geometries that host geothermal reservoirs. Astor Pass, NV USA lies just beyond the northern extent of the dextral Pyramid Lake fault zone near the boundary between two distinct structural domains, the Walker Lane and the Basin and Range, and exhibits characteristics of each setting. Both northwest-striking, left-stepping dextral faults of the Walker Lane and kinematically linked northerly striking normal faults associated with the Basin and Range are present. Previous studies at Astor Pass identified a blind geothermal system controlled by the intersection of west-northwest and north-northwest striking dextral-normal faults. Wells drilled into the southwestern quadrant of the fault intersection yielded 94°C fluids, with geothermometers suggesting a maximum reservoir temperature of 130°C. A 3-dimensional model was constructed based on detailed geologic maps and cross-sections, 2-dimensional seismic data, and petrologic analysis of the cuttings from three wells in order to further constrain the structural setting. The model reveals the specific geometry of the fault interaction area at a level of detail beyond what geologic maps and cross-sections can provide.

  13. Photoprotection by pistachio bioactives in a 3-dimensional human skin equivalent tissue model.

    PubMed

    Chen, C-Y Oliver; Smith, Avi; Liu, Yuntao; Du, Peng; Blumberg, Jeffrey B; Garlick, Jonathan

    2017-01-25

    Reactive oxygen species (ROS) generated during ultraviolet (UV) light exposure can induce skin damage and aging. Antioxidants can provide protection against oxidative injury to skin via "quenching" ROS. Using a validated 3-dimensional (3D) human skin equivalent (HSE) tissue model that closely mimics human skin, we examined whether pistachio antioxidants could protect HSE against UVA-induced damage. Lutein and γ-tocopherol are the predominant lipophilic antioxidants in pistachios; treatment with these compounds prior to UVA exposure protected against morphological changes to the epithelial and connective tissue compartments of HSE. Pistachio antioxidants preserved overall skin thickness and organization, as well as fibroblast morphology, in HSE exposed to UVA irradiation. However, this protection was not substantiated by the analysis of the proliferation of keratinocytes and apoptosis of fibroblasts. Additional studies are warranted to elucidate the basis of these discordant results and extend research into the potential role of pistachio bioactives promoting skin health.

  14. Assessment and Planning for a Pediatric Bilateral Hand Transplant Using 3-Dimensional Modeling: Case Report.

    PubMed

    Gálvez, Jorge A; Gralewski, Kevin; McAndrew, Christine; Rehman, Mohamed A; Chang, Benjamin; Levin, L Scott

    2016-03-01

    Children are not typically considered for hand transplantation for various reasons, including the difficulty of finding an appropriate donor. Matching donor-recipient hands and forearms based on size is critically important. If the donor's hands are too large, the recipient may not be able to move the fingers effectively. Conversely, if the donor's hands are too small, the appearance may not be appropriate. We present an 8-year-old child evaluated for a bilateral hand transplant following bilateral amputation. The recipient forearms and model hands were modeled from computed tomography imaging studies and replicated as anatomic models with a 3-dimensional printer. We modified the scale of the printed hand to produce 3 proportions, 80%, 100% and 120%. The transplant team used the anatomical models during evaluation of a donor for appropriate match based on size. The donor's hand size matched the 100%-scale anatomical model hand and the transplant team was activated. In addition to assisting in appropriate donor selection by the transplant team, the 100%-scale anatomical model hand was used to create molds for prosthetic hands for the donor.

  15. Using Interior Point Method Optimization Techniques to Improve 2- and 3-Dimensional Models of Earth Structures

    NASA Astrophysics Data System (ADS)

    Zamora, A.; Gutierrez, A. E.; Velasco, A. A.

    2014-12-01

    2- and 3-Dimensional models obtained from the inversion of geophysical data are widely used to represent the structural composition of the Earth and to constrain independent models obtained from other geological data (e.g. core samples, seismic surveys, etc.). However, inverse modeling of gravity data presents a very unstable and ill-posed mathematical problem, given that solutions are non-unique and small changes in parameters (position and density contrast of an anomalous body) can highly impact the resulting model. Through the implementation of an interior-point method constrained optimization technique, we improve the 2-D and 3-D models of Earth structures representing known density contrasts mapping anomalous bodies in uniform regions and boundaries between layers in layered environments. The proposed techniques are applied to synthetic data and gravitational data obtained from the Rio Grande Rift and the Cooper Flat Mine region located in Sierra County, New Mexico. Specifically, we improve the 2- and 3-D Earth models by getting rid of unacceptable solutions (those that do not satisfy the required constraints or are geologically unfeasible) given the reduction of the solution space.

  16. Superimposition of 3-dimensional cone-beam computed tomography models of growing patients

    PubMed Central

    Cevidanes, Lucia H. C.; Heymann, Gavin; Cornelis, Marie A.; DeClerck, Hugo J.; Tulloch, J. F. Camilla

    2009-01-01

    Introduction The objective of this study was to evaluate a new method for superimposition of 3-dimensional (3D) models of growing subjects. Methods Cone-beam computed tomography scans were taken before and after Class III malocclusion orthopedic treatment with miniplates. Three observers independently constructed 18 3D virtual surface models from cone-beam computed tomography scans of 3 patients. Separate 3D models were constructed for soft-tissue, cranial base, maxillary, and mandibular surfaces. The anterior cranial fossa was used to register the 3D models of before and after treatment (about 1 year of follow-up). Results Three-dimensional overlays of superimposed models and 3D color-coded displacement maps allowed visual and quantitative assessment of growth and treatment changes. The range of interobserver errors for each anatomic region was 0.4 mm for the zygomatic process of maxilla, chin, condyles, posterior border of the rami, and lower border of the mandible, and 0.5 mm for the anterior maxilla soft-tissue upper lip. Conclusions Our results suggest that this method is a valid and reproducible assessment of treatment outcomes for growing subjects. This technique can be used to identify maxillary and mandibular positional changes and bone remodeling relative to the anterior cranial fossa. PMID:19577154

  17. An integrated 3-Dimensional Genome Modeling Engine for data-driven simulation of spatial genome organization.

    PubMed

    Szałaj, Przemysław; Tang, Zhonghui; Michalski, Paul; Pietal, Michal J; Luo, Oscar J; Sadowski, Michał; Li, Xingwang; Radew, Kamen; Ruan, Yijun; Plewczynski, Dariusz

    2016-12-01

    ChIA-PET is a high-throughput mapping technology that reveals long-range chromatin interactions and provides insights into the basic principles of spatial genome organization and gene regulation mediated by specific protein factors. Recently, we showed that a single ChIA-PET experiment provides information at all genomic scales of interest, from the high-resolution locations of binding sites and enriched chromatin interactions mediated by specific protein factors, to the low resolution of nonenriched interactions that reflect topological neighborhoods of higher-order chromosome folding. This multilevel nature of ChIA-PET data offers an opportunity to use multiscale 3D models to study structural-functional relationships at multiple length scales, but doing so requires a structural modeling platform. Here, we report the development of 3D-GNOME (3-Dimensional Genome Modeling Engine), a complete computational pipeline for 3D simulation using ChIA-PET data. 3D-GNOME consists of three integrated components: a graph-distance-based heat map normalization tool, a 3D modeling platform, and an interactive 3D visualization tool. Using ChIA-PET and Hi-C data derived from human B-lymphocytes, we demonstrate the effectiveness of 3D-GNOME in building 3D genome models at multiple levels, including the entire genome, individual chromosomes, and specific segments at megabase (Mb) and kilobase (kb) resolutions of single average and ensemble structures. Further incorporation of CTCF-motif orientation and high-resolution looping patterns in 3D simulation provided additional reliability of potential biologically plausible topological structures.

  18. First Results from a Forward, 3-Dimensional Regional Model of a Transpressional San Andreas Fault System

    NASA Astrophysics Data System (ADS)

    Fitzenz, D. D.; Miller, S. A.

    2001-12-01

    We present preliminary results from a 3-dimensional fault interaction model, with the fault system specified by the geometry and tectonics of the San Andreas Fault (SAF) system. We use the forward model for earthquake generation on interacting faults of Fitzenz and Miller [2001] that incorporates the analytical solutions of Okada [85,92], GPS-constrained tectonic loading, creep compaction and frictional dilatancy [Sleep and Blanpied, 1994, Sleep, 1995], and undrained poro-elasticity. The model fault system is centered at the Big Bend, and includes three large strike-slip faults (each discretized into multiple subfaults); 1) a 300km, right-lateral segment of the SAF to the North, 2) a 200km-long left-lateral segment of the Garlock fault to the East, and 3) a 100km-long right-lateral segment of the SAF to the South. In the initial configuration, three shallow-dipping faults are also included that correspond to the thrust belt sub-parallel to the SAF. Tectonic loading is decomposed into basal shear drag parallel to the plate boundary with a 35mm yr-1 plate velocity, and East-West compression approximated by a vertical dislocation surface applied at the far-field boundary resulting in fault-normal compression rates in the model space about 4mm yr-1. Our aim is to study the long-term seismicity characteristics, tectonic evolution, and fault interaction of this system. We find that overpressured faults through creep compaction are a necessary consequence of the tectonic loading, specifically where high normal stress acts on long straight fault segments. The optimal orientation of thrust faults is a function of the strike-slip behavior, and therefore results in a complex stress state in the elastic body. This stress state is then used to generate new fault surfaces, and preliminary results of dynamically generated faults will also be presented. Our long-term aim is to target measurable properties in or around fault zones, (e.g. pore pressures, hydrofractures, seismicity

  19. 3-Dimensional Marine CSEM Modeling by Employing TDFEM with Parallel Solvers

    NASA Astrophysics Data System (ADS)

    Wu, X.; Yang, T.

    2013-12-01

    In this paper, parallel fulfillment is developed for forward modeling of the 3-Dimensional controlled source electromagnetic (CSEM) by using time-domain finite element method (TDFEM). Recently, a greater attention rises on research of hydrocarbon (HC) reservoir detection mechanism in the seabed. Since China has vast ocean resources, seeking hydrocarbon reservoirs become significant in the national economy. However, traditional methods of seismic exploration shown a crucial obstacle to detect hydrocarbon reservoirs in the seabed with a complex structure, due to relatively high acquisition costs and high-risking exploration. In addition, the development of EM simulations typically requires both a deep knowledge of the computational electromagnetics (CEM) and a proper use of sophisticated techniques and tools from computer science. However, the complexity of large-scale EM simulations often requires large memory because of a large amount of data, or solution time to address problems concerning matrix solvers, function transforms, optimization, etc. The objective of this paper is to present parallelized implementation of the time-domain finite element method for analysis of three-dimensional (3D) marine controlled source electromagnetic problems. Firstly, we established a three-dimensional basic background model according to the seismic data, then electromagnetic simulation of marine CSEM was carried out by using time-domain finite element method, which works on a MPI (Message Passing Interface) platform with exact orientation to allow fast detecting of hydrocarbons targets in ocean environment. To speed up the calculation process, SuperLU of an MPI (Message Passing Interface) version called SuperLU_DIST is employed in this approach. Regarding the representation of three-dimension seabed terrain with sense of reality, the region is discretized into an unstructured mesh rather than a uniform one in order to reduce the number of unknowns. Moreover, high-order Whitney

  20. Dissection of the host-pathogen interaction in human tuberculosis using a bioengineered 3-dimensional model

    PubMed Central

    Tezera, Liku B; Bielecka, Magdalena K; Chancellor, Andrew; Reichmann, Michaela T; Shammari, Basim Al; Brace, Patience; Batty, Alex; Tocheva, Annie; Jogai, Sanjay; Marshall, Ben G; Tebruegge, Marc; Jayasinghe, Suwan N; Mansour, Salah; Elkington, Paul T

    2017-01-01

    Cell biology differs between traditional cell culture and 3-dimensional (3-D) systems, and is modulated by the extracellular matrix. Experimentation in 3-D presents challenges, especially with virulent pathogens. Mycobacterium tuberculosis (Mtb) kills more humans than any other infection and is characterised by a spatially organised immune response and extracellular matrix remodelling. We developed a 3-D system incorporating virulent mycobacteria, primary human blood mononuclear cells and collagen–alginate matrix to dissect the host-pathogen interaction. Infection in 3-D led to greater cellular survival and permitted longitudinal analysis over 21 days. Key features of human tuberculosis develop, and extracellular matrix integrity favours the host over the pathogen. We optimised multiparameter readouts to study emerging therapeutic interventions: cytokine supplementation, host-directed therapy and immunoaugmentation. Each intervention modulates the host-pathogen interaction, but has both beneficial and harmful effects. This methodology has wide applicability to investigate infectious, inflammatory and neoplastic diseases and develop novel drug regimes and vaccination approaches. DOI: http://dx.doi.org/10.7554/eLife.21283.001 PMID:28063256

  1. In vitro 3-dimensional tumor model for radiosensitivity of HPV positive OSCC cell lines.

    PubMed

    Zhang, Mei; Rose, Barbara; Lee, C Soon; Hong, Angela M

    2015-01-01

    The incidence of oropharyngeal squamous cell carcinoma (OSCC) is increasing due to the rising prevalence of human papillomavirus (HPV) positive OSCC. HPV positive OSCC is associated with better outcomes than HPV negative OSCC. Our aim was to explore the possibility that this favorable prognosis is due to the enhanced radiosensitivity of HPV positive OSCC. HPV positive OSCC cell lines were generated from the primary OSCCs of 2 patients, and corresponding HPV positive cell lines generated from nodal metastases following xenografting in nude mice. Monolayer and 3 dimensional (3D) culture techniques were used to compare the radiosensitivity of HPV positive lines with that of 2 HPV negative OSCC lines. Clonogenic and protein assays were used to measure survival post radiation. Radiation induced cell cycle changes were studied using flow cytometry. In both monolayer and 3D culture, HPV positive cells exhibited a heterogeneous appearance whereas HPV negative cells tended to be homogeneous. After irradiation, HPV positive cells had a lower survival in clonogenic assays and lower total protein levels in 3D cultures than HPV negative cells. Irradiated HPV positive cells showed a high proportion of cells in G1/S phase, increased apoptosis, an increased proliferation rate, and an inability to form 3D tumor clumps. In conclusion, HPV positive OSCC cells are more radiosensitive than HPV negative OSCC cells in vitro, supporting a more radiosensitive nature of HPV positive OSCC.

  2. The Keilson and Storer 3-dimensional (KS-3D) line shape model: applications to optical diagnostic in combustion media

    SciTech Connect

    Joubert, Pierre

    2008-10-22

    High-resolution infrared and Raman spectroscopies require refine spectral line shape model to account for all observed features. For instance, for gaseous mixtures of light molecules with heavy perturbers, drastic changes arise particularly in the collision regime, resulting from the inhomogeneous effects due to the radiator speed-dependence of the collisional line broadening and line shifting parameters. Following our previous work concerning the collision regime, we have developed a new line shape modelization called the Keilson and Storer 3-dimensional line shape model to lower densities, when the Doppler contribution, and the collisional confinement narrowing can be no longer neglected. The consequences for optical diagnostics, particularly for H{sub 2}-N{sub 2} mixtures with high pressure and high temperature are presented. The effects of collisional relaxation on the spectral line shapes are discussed.

  3. Fast time variations of supernova neutrino signals from 3-dimensional models

    DOE PAGES

    Lund, Tina; Wongwathanarat, Annop; Janka, Hans -Thomas; ...

    2012-11-19

    Here, we study supernova neutrino flux variations in the IceCube detector, using 3D models based on a simplified neutrino transport scheme. The hemispherically integrated neutrino emission shows significantly smaller variations compared with our previous study of 2D models, largely because of the reduced activity of the standing accretion shock instability in this set of 3D models which we interpret as a pessimistic extreme. For the studied cases, intrinsic flux variations up to about 100 Hz frequencies could still be detected in a supernova closer than about 2 kpc.

  4. Visualization of the 3-dimensional flow around a model with the aid of a laser knife

    NASA Technical Reports Server (NTRS)

    Borovoy, V. Y.; Ivanov, V. V.; Orlov, A. A.; Kharchenko, V. N.

    1984-01-01

    A method for visualizing the three-dimensional flow around models of various shapes in a wind tunnel at a Mach number of 5 is described. A laser provides a planar light flux such that any plane through the model can be selectively illuminated. The shape of shock waves and separation regions is then determined by the intensity of light scattered by soot particles in the flow.

  5. Remanent magnetization and 3-dimensional density model of the Kentucky anomaly region

    NASA Technical Reports Server (NTRS)

    Mayhew, M. A.; Estes, R. H.; Myers, D. M.

    1984-01-01

    A three-dimensional model of the Kentucky body was developed to fit surface gravity and long wavelength aeromagnetic data. Magnetization and density parameters for the model are much like those of Mayhew et al (1982). The magnetic anomaly due to the model at satellite altitude is shown to be much too small by itself to account for the anomaly measured by Magsat. It is demonstrated that the source region for the satellite anomaly is considerably more extensive than the Kentucky body sensu stricto. The extended source region is modeled first using prismatic model sources and then using dipole array sources. Magnetization directions for the source region found by inversion of various combinations of scalar and vector data are found to be close to the main field direction, implying the lack of a strong remanent component. It is shown by simulation that in a case (such as this) where the geometry of the source is known, if a strong remanent component is present its direction is readily detectable, but by scalar data as readily as vector data.

  6. Accretion Onto Supermassive Black Holes: Observational Signals from 3-Dimensional Disk Models

    NASA Technical Reports Server (NTRS)

    Bromley, Benjamin C.; Miller, Warner A.

    2003-01-01

    Our project was to model accretion flows onto supermassive black holes which reside in the centers of many galaxies. In this report we summarize the results which we obtained with the support of our NASA ATP grant. The scientific results associated with the grant are given in approximately chronological order. We also provide a list of references which acknowledge funding from this grant.

  7. A simple, analytic 3-dimensional downburst model based on boundary layer stagnation flow

    NASA Technical Reports Server (NTRS)

    Oseguera, Rosa M.; Bowles, Roland L.

    1988-01-01

    A simple downburst model is developed for use in batch and real-time piloted simulation studies of guidance strategies for terminal area transport aircraft operations in wind shear conditions. The model represents an axisymmetric stagnation point flow, based on velocity profiles from the Terminal Area Simulation System (TASS) model developed by Proctor and satisfies the mass continuity equation in cylindrical coordinates. Altitude dependence, including boundary layer effects near the ground, closely matches real-world measurements, as do the increase, peak, and decay of outflow and downflow with increasing distance from the downburst center. Equations for horizontal and vertical winds were derived, and found to be infinitely differentiable, with no singular points existent in the flow field. In addition, a simple relationship exists among the ratio of maximum horizontal to vertical velocities, the downdraft radius, depth of outflow, and altitude of maximum outflow. In use, a microburst can be modeled by specifying four characteristic parameters, velocity components in the x, y and z directions, and the corresponding nine partial derivatives are obtained easily from the velocity equations.

  8. Estimation of Nasal Tip Support Using Computer-Aided Design and 3-Dimensional Printed Models

    PubMed Central

    Gray, Eric; Maducdoc, Marlon; Manuel, Cyrus; Wong, Brian J. F.

    2016-01-01

    IMPORTANCE Palpation of the nasal tip is an essential component of the preoperative rhinoplasty examination. Measuring tip support is challenging, and the forces that correspond to ideal tip support are unknown. OBJECTIVE To identify the integrated reaction force and the minimum and ideal mechanical properties associated with nasal tip support. DESIGN, SETTING, AND PARTICIPANTS Three-dimensional (3-D) printed anatomic silicone nasal models were created using a computed tomographic scan and computer-aided design software. From this model, 3-D printing and casting methods were used to create 5 anatomically correct nasal models of varying constitutive Young moduli (0.042, 0.086, 0.098, 0.252, and 0.302 MPa) from silicone. Thirty rhinoplasty surgeons who attended a regional rhinoplasty course evaluated the reaction force (nasal tip recoil) of each model by palpation and selected the model that satisfied their requirements for minimum and ideal tip support. Data were collected from May 3 to 4, 2014. RESULTS Of the 30 respondents, 4 surgeons had been in practice for 1 to 5 years; 9 surgeons, 6 to 15 years; 7 surgeons, 16 to 25 years; and 10 surgeons, 26 or more years. Seventeen surgeons considered themselves in the advanced to expert skill competency levels. Logistic regression estimated the minimum threshold for the Young moduli for adequate and ideal tip support to be 0.096 and 0.154 MPa, respectively. Logistic regression estimated the thresholds for the reaction force associated with the absolute minimum and ideal requirements for good tip recoil to be 0.26 to 4.74 N and 0.37 to 7.19 N during 1- to 8-mm displacement, respectively. CONCLUSIONS AND RELEVANCE This study presents a method to estimate clinically relevant nasal tip reaction forces, which serve as a proxy for nasal tip support. This information will become increasingly important in computational modeling of nasal tip mechanics and ultimately will enhance surgical planning for rhinoplasty. LEVEL OF EVIDENCE

  9. A simple and efficient quasi 3-dimensional viscoelastic model and software for simulation of tapping-mode atomic force microscopy

    SciTech Connect

    Solares, Santiago D.

    2015-11-26

    This study introduces a quasi-3-dimensional (Q3D) viscoelastic model and software tool for use in atomic force microscopy (AFM) simulations. The model is based on a 2-dimensional array of standard linear solid (SLS) model elements. The well-known 1-dimensional SLS model is a textbook example in viscoelastic theory but is relatively new in AFM simulation. It is the simplest model that offers a qualitatively correct description of the most fundamental viscoelastic behaviors, namely stress relaxation and creep. However, this simple model does not reflect the correct curvature in the repulsive portion of the force curve, so its application in the quantitative interpretation of AFM experiments is relatively limited. In the proposed Q3D model the use of an array of SLS elements leads to force curves that have the typical upward curvature in the repulsive region, while still offering a very low computational cost. Furthermore, the use of a multidimensional model allows for the study of AFM tips having non-ideal geometries, which can be extremely useful in practice. Examples of typical force curves are provided for single- and multifrequency tappingmode imaging, for both of which the force curves exhibit the expected features. Lastly, a software tool to simulate amplitude and phase spectroscopy curves is provided, which can be easily modified to implement other controls schemes in order to aid in the interpretation of AFM experiments.

  10. A simple and efficient quasi 3-dimensional viscoelastic model and software for simulation of tapping-mode atomic force microscopy

    DOE PAGES

    Solares, Santiago D.

    2015-11-26

    This study introduces a quasi-3-dimensional (Q3D) viscoelastic model and software tool for use in atomic force microscopy (AFM) simulations. The model is based on a 2-dimensional array of standard linear solid (SLS) model elements. The well-known 1-dimensional SLS model is a textbook example in viscoelastic theory but is relatively new in AFM simulation. It is the simplest model that offers a qualitatively correct description of the most fundamental viscoelastic behaviors, namely stress relaxation and creep. However, this simple model does not reflect the correct curvature in the repulsive portion of the force curve, so its application in the quantitative interpretationmore » of AFM experiments is relatively limited. In the proposed Q3D model the use of an array of SLS elements leads to force curves that have the typical upward curvature in the repulsive region, while still offering a very low computational cost. Furthermore, the use of a multidimensional model allows for the study of AFM tips having non-ideal geometries, which can be extremely useful in practice. Examples of typical force curves are provided for single- and multifrequency tappingmode imaging, for both of which the force curves exhibit the expected features. Lastly, a software tool to simulate amplitude and phase spectroscopy curves is provided, which can be easily modified to implement other controls schemes in order to aid in the interpretation of AFM experiments.« less

  11. A simple and efficient quasi 3-dimensional viscoelastic model and software for simulation of tapping-mode atomic force microscopy.

    PubMed

    Solares, Santiago D

    2015-01-01

    This paper introduces a quasi-3-dimensional (Q3D) viscoelastic model and software tool for use in atomic force microscopy (AFM) simulations. The model is based on a 2-dimensional array of standard linear solid (SLS) model elements. The well-known 1-dimensional SLS model is a textbook example in viscoelastic theory but is relatively new in AFM simulation. It is the simplest model that offers a qualitatively correct description of the most fundamental viscoelastic behaviors, namely stress relaxation and creep. However, this simple model does not reflect the correct curvature in the repulsive portion of the force curve, so its application in the quantitative interpretation of AFM experiments is relatively limited. In the proposed Q3D model the use of an array of SLS elements leads to force curves that have the typical upward curvature in the repulsive region, while still offering a very low computational cost. Furthermore, the use of a multidimensional model allows for the study of AFM tips having non-ideal geometries, which can be extremely useful in practice. Examples of typical force curves are provided for single- and multifrequency tapping-mode imaging, for both of which the force curves exhibit the expected features. Finally, a software tool to simulate amplitude and phase spectroscopy curves is provided, which can be easily modified to implement other controls schemes in order to aid in the interpretation of AFM experiments.

  12. 3-dimensional spatially organized PEG-based hydrogels for an aortic valve co-culture model

    PubMed Central

    Puperi, Daniel S.; Balaoing, Liezl R.; O’Connell, Ronan W.; West, Jennifer L.; Grande-Allen, K. Jane

    2015-01-01

    Physiologically relevant in vitro models are needed to study disease progression and to develop and screen potential therapeutic interventions for disease. Heart valve disease, in particular, has no early intervention or non-invasive treatment because there is a lack of understanding the cellular mechanisms which lead to disease. Here, we establish a novel, customizable synthetic hydrogel platform that can be used to study cell-cell interactions and the factors which contribute to valve disease. Spatially localized cell adhesive ligands bound in the scaffold promote cell growth and organization of valve interstitial cells and valve endothelial cells in 3D co-culture. Both cell types maintained phenotypes, homeostatic functions, and produced zonally localized extracellular matrix. This model extends the capabilities of in vitro research by providing a platform to perform direct contact co-culture with cells in their physiologically relevant spatial arrangement. PMID:26241755

  13. 3-dimensional numerical modeling of an industrial radio frequency heating system using finite elements.

    PubMed

    Chan, T V Chow Ting; Tang, J; Younce, F

    2004-01-01

    This paper presents a new, yet simple and effective approach to modeling industrial Radio Frequency heating systems, using the wave equation applied in three dimensions instead of the conventional electrostatics method. The central idea is that the tank oscillatory circuit is excited using an external source. This then excites the applicator circuit which is then used to heat or dry the processed load. Good agreement was obtained between the experimental and numerical data, namely the S11-parameter, phase, and heating patterns for different sized loads and positions.

  14. 3-DIMENSIONAL Geometric Survey and Structural Modelling of the Dome of Pisa Cathedral

    NASA Astrophysics Data System (ADS)

    Aita, D.; Barsotti, R.; Bennati, S.; Caroti, G.; Piemonte, A.

    2017-02-01

    This paper aims to illustrate the preliminary results of a research project on the dome of Pisa Cathedral (Italy). The final objective of the present research is to achieve a deep understanding of the structural behaviour of the dome, through a detailed knowledge of its geometry and constituent materials, and by taking into account historical and architectural aspects as well. A reliable survey of the dome is the essential starting point for any further investigation and adequate structural modelling. Examination of the status quo on the surveys of the Cathedral dome shows that a detailed survey suitable for structural analysis is in fact lacking. For this reason, high-density and high-precision surveys have been planned, by considering that a different survey output is needed, according both to the type of structural model chosen and purposes to be achieved. Thus, both range-based (laser scanning) and image-based (3D Photogrammetry) survey methodologies have been used. This contribution introduces the first results concerning the shape of the dome derived from surveys. Furthermore, a comparison is made between such survey outputs and those available in the literature.

  15. Evaluation of 3-Dimensional Superimposition Techniques on Various Skeletal Structures of the Head Using Surface Models

    PubMed Central

    Pazera, Pawel; Zorkun, Berna; Katsaros, Christos; Ludwig, Björn

    2015-01-01

    Objectives To test the applicability, accuracy, precision, and reproducibility of various 3D superimposition techniques for radiographic data, transformed to triangulated surface data. Methods Five superimposition techniques (3P: three-point registration; AC: anterior cranial base; AC + F: anterior cranial base + foramen magnum; BZ: both zygomatic arches; 1Z: one zygomatic arch) were tested using eight pairs of pre-existing CT data (pre- and post-treatment). These were obtained from non-growing orthodontic patients treated with rapid maxillary expansion. All datasets were superimposed by three operators independently, who repeated the whole procedure one month later. Accuracy was assessed by the distance (D) between superimposed datasets on three form-stable anatomical areas, located on the anterior cranial base and the foramen magnum. Precision and reproducibility were assessed using the distances between models at four specific landmarks. Non parametric multivariate models and Bland-Altman difference plots were used for analyses. Results There was no difference among operators or between time points on the accuracy of each superimposition technique (p>0.05). The AC + F technique was the most accurate (D<0.17 mm), as expected, followed by AC and BZ superimpositions that presented similar level of accuracy (D<0.5 mm). 3P and 1Z were the least accurate superimpositions (0.790.05), the detected structural changes differed significantly between different techniques (p<0.05). Bland-Altman difference plots showed that BZ superimposition was comparable to AC, though it presented slightly higher random error. Conclusions Superimposition of 3D datasets using surface models created from voxel data can provide accurate, precise, and reproducible results, offering also high efficiency and increased post-processing capabilities. In

  16. Global simulation of canopy scale sun-induced chlorophyll fluorescence with a 3 dimensional radiative transfer model

    NASA Astrophysics Data System (ADS)

    Kobayashi, H.; Yang, W.; Ichii, K.

    2015-12-01

    Global simulation of canopy scale sun-induced chlorophyll fluorescence with a 3 dimensional radiative transfer modelHideki Kobayashi, Wei Yang, and Kazuhito IchiiDepartment of Environmental Geochemical Cycle Research, Japan Agency for Marine-Earth Science and Technology3173-25, Showa-machi, Kanazawa-ku, Yokohama, Japan.Plant canopy scale sun-induced chlorophyll fluorescence (SIF) can be observed from satellites, such as Greenhouse gases Observation Satellite (GOSAT), Orbiting Carbon Observatory-2 (OCO-2), and Global Ozone Monitoring Experiment-2 (GOME-2), using Fraunhofer lines in the near infrared spectral domain [1]. SIF is used to infer photosynthetic capacity of plant canopy [2]. However, it is not well understoond how the leaf-level SIF emission contributes to the top of canopy directional SIF because SIFs observed by the satellites use the near infrared spectral domain where the multiple scatterings among leaves are not negligible. It is necessary to quantify the fraction of emission for each satellite observation angle. Absorbed photosynthetically active radiation of sunlit leaves are 100 times higher than that of shaded leaves. Thus, contribution of sunlit and shaded leaves to canopy scale directional SIF emission should also be quantified. Here, we show the results of global simulation of SIF using a 3 dimensional radiative transfer simulation with MODIS atmospheric (aerosol optical thickness) and land (land cover and leaf area index) products and a forest landscape data sets prepared for each land cover category. The results are compared with satellite-based SIF (e.g. GOME-2) and the gross primary production empirically estimated by FLUXNET and remote sensing data.

  17. Is a 3-Dimensional Stress Balance Ice-Stream Model Really Better Than a 2-Dimensional "Reduced Order" Ice-Stream Model?

    NASA Astrophysics Data System (ADS)

    Sergienko, O.; Macayeal, D. R.

    2007-12-01

    With growing observational awareness of numerous ice-stream processes occurring on short time and spatial scales, e.g., sub-ice-stream lake volume changes and grounding-line sediment wedge build-up, the question of how well models based on "reduced-order" dynamics can simulate ice-stream behavior becomes paramount. Reduced-order models of ice-streams are typically 2-dimensional, and capture only the largest-magnitude terms in the stress tensor (with other terms being constrained by various assumptions). In predicting the overall magnitude and large-scale pattern of ice-stream flow, the reduced-order models appear to be adequate. Efforts underway in the Glaciological Community to create 3-dimensional models of the "full" ice-stream stress balance, which relax the assumptions associated with reduced-order models, suggest that a cost/benefit analysis should be done to determine how likely these efforts will be fruitful. To assess the overall benefits of full 3-dimensional models in relation to the simpler 2-dimensional counterparts, we present model solutions of the full Stokes equations for ice-stream flow over a variety of basal perturbations (e.g., a sticky spot, a subglacial lake, a grounding line). We also present the solutions derived from reduced 2-dimensional models, and compare the two solutions to estimate effects of simplifications and neglected terms, as well as to advise on what circumstances 3-dimensional models are preferable to 2-dimensional models.

  18. A 3-dimensional human embryonic stem cell (hESC)-derived model to detect developmental neurotoxicity of nanoparticles.

    PubMed

    Hoelting, Lisa; Scheinhardt, Benjamin; Bondarenko, Olesja; Schildknecht, Stefan; Kapitza, Marion; Tanavde, Vivek; Tan, Betty; Lee, Qian Yi; Mecking, Stefan; Leist, Marcel; Kadereit, Suzanne

    2013-04-01

    Nanoparticles (NPs) have been shown to accumulate in organs, cross the blood-brain barrier and placenta, and have the potential to elicit developmental neurotoxicity (DNT). Here, we developed a human embryonic stem cell (hESC)-derived 3-dimensional (3-D) in vitro model that allows for testing of potential developmental neurotoxicants. Early central nervous system PAX6(+) precursor cells were generated from hESCs and differentiated further within 3-D structures. The 3-D model was characterized for neural marker expression revealing robust differentiation toward neuronal precursor cells, and gene expression profiling suggested a predominantly forebrain-like development. Altered neural gene expression due to exposure to non-cytotoxic concentrations of the known developmental neurotoxicant, methylmercury, indicated that the 3-D model could detect DNT. To test for specific toxicity of NPs, chemically inert polyethylene NPs (PE-NPs) were chosen. They penetrated deep into the 3-D structures and impacted gene expression at non-cytotoxic concentrations. NOTCH pathway genes such as HES5 and NOTCH1 were reduced in expression, as well as downstream neuronal precursor genes such as NEUROD1 and ASCL1. FOXG1, a patterning marker, was also reduced. As loss of function of these genes results in severe nervous system impairments in mice, our data suggest that the 3-D hESC-derived model could be used to test for Nano-DNT.

  19. A Novel 3 Dimensional Stromal-based Model for In Vitro Chemotherapy Sensitivity Testing of Leukemia Cells

    PubMed Central

    Aljitawi, Omar S.; Li, Dandan; Xiao, Yinghua; Zhang, Da; Ramachandran, Karthik; Stehno-Bittel, Lisa; Van Veldhuizen, Peter; Lin, Tara L.; Kambhampati, Suman; Garimella, Rama

    2014-01-01

    The disparate responses of leukemia cells to chemotherapy in vivo, compared to in vitro, is partly related to the interactions of leukemic cells and the 3 dimensional (3D) bone marrow stromal microenvironment. We investigated the effects of chemotherapy agents on leukemic cell lines co-cultured with human bone marrow mesenchymal stem cell (hu-BM-MSC) in 3D. Comparison was made to leukemic cells treated in suspension, or grown on a hu-BM-MSC monolayer (2D conditions). We demonstrated that leukemic cells cultured in 3D were more resistant to drug-induced apoptosis compared to cells cultured in 2D or in suspension. We also demonstrated significant differences in leukemic cell response to chemotherapy using different leukemic cell lines cultured in 3D. We suggest that the differential responses to chemotherapy in 3D may be related to the expression of N-cadherin in the co-culture system. This unique model provides an opportunity to study leukemic cell responses to chemotherapy in 3D. PMID:23566162

  20. A Geometric Modelling Approach to Determining the Best Sensing Coverage for 3-Dimensional Acoustic Target Tracking in Wireless Sensor Networks

    PubMed Central

    Pashazadeh, Saeid; Sharifi, Mohsen

    2009-01-01

    Existing 3-dimensional acoustic target tracking methods that use wired/wireless networked sensor nodes to track targets based on four sensing coverage do not always compute the feasible spatio-temporal information of target objects. To investigate this discrepancy in a formal setting, we propose a geometric model of the target tracking problem alongside its equivalent geometric dual model that is easier to solve. We then study and prove some properties of dual model by exploiting its relationship with algebra. Based on these properties, we propose a four coverage axis line method based on four sensing coverage and prove that four sensing coverage always yields two dual correct answers; usually one of them is infeasible. By showing that the feasible answer can be only sometimes identified by using a simple time test method such as the one proposed by ourselves, we prove that four sensing coverage fails to always yield the feasible spatio-temporal information of a target object. We further prove that five sensing coverage always gives the feasible position of a target object under certain conditions that are discussed in this paper. We propose three extensions to four coverage axis line method, namely, five coverage extent point method, five coverage extended axis lines method, and five coverage redundant axis lines method. Computation and time complexities of all four proposed methods are equal in the worst cases as well as on average being equal to Θ(1) each. Proposed methods and proved facts about capabilities of sensing coverage degree in this paper can be used in all other methods of acoustic target tracking like Bayesian filtering methods. PMID:22423198

  1. A 3-Dimensional Model of Water-Bearing Sequences in the Dominguez Gap Region, Long Beach, California

    USGS Publications Warehouse

    Ponti, Daniel J.; Ehman, Kenneth D.; Edwards, Brian D.; Tinsley, John C.; Hildenbrand, Thomas; Hillhouse, John W.; Hanson, Randall T.; McDougall, Kristen; Powell, Charles L.; Wan, Elmira; Land, Michael; Mahan, Shannon; Sarna-Wojcicki, Andrei M.

    2007-01-01

    A 3-dimensional computer model of the Quaternary sequence stratigraphy in the Dominguez gap region of Long Beach, California has been developed to provide a robust chronostratigraphic framework for hydrologic and tectonic studies. The model consists of 13 layers within a 16.5 by 16.1 km (10.25 by 10 mile) square area and extends downward to an altitude of -900 meters (-2952.76 feet). Ten sequences of late Pliocene to Holocene age are identified and correlated within the model. Primary data to build the model comes from five reference core holes, extensive high-resolution seismic data obtained in San Pedro Bay, and logs from several hundred water and oil wells drilled in the region. The model is best constrained in the vicinity of the Dominguez gap seawater intrusion barrier where a dense network of subsurface data exist. The resultant stratigraphic framework and geologic structure differs significantly from what has been proposed in earlier studies. An important new discovery from this approach is the recognition of ongoing tectonic deformation throughout nearly all of Quaternary time that has impacted the geometry and character of the sequences. Anticlinal folding along a NW-SE trend, probably associated with Quaternary reactivation of the Wilmington anticline, has uplifted and thinned deposits along the fold crest, which intersects the Dominguez gap seawater barrier near Pacific Coast Highway. A W-NW trending fault system that approximately parallels the fold crest has also been identified. This fault progressively displaces all but the youngest sequences down to the north and serves as the southern termination of the classic Silverado aquifer. Uplift and erosion of fining-upward paralic sequences along the crest of the young fold has removed or thinned many of the fine-grained beds that serve to protect the underlying Silverado aquifer from seawater contaminated shallow groundwater. As a result of this process, the potential exists for vertical migration of

  2. Development and Application of a 3-Dimensional Finite Element Model for Remediation Wellfield Management at Lawrence Livermore National Laboratory

    NASA Astrophysics Data System (ADS)

    Mansoor, K.; Maley, M. P.; Demir, Z.; Noyes, C.

    2001-12-01

    Lawrence Livermore National Laboratory (LLNL), which is on the Superfund National Priorities List, is implementing an extensive ground water remediation program. The environmental investigation covers an area of about 2 square miles, and is underlain by a thick sequence of heterogeneous alluvial sediments. These sediments have been subdivided into hydrostratigraphic units (HSUs) bounded by thin confining layers that were identified using a deterministic approach. LLNL currently operates a large ground water extraction system that includes 80 ground water extraction wells connected to 25 separate treatment facilities. These combined facilities treated about 308 million gallons of ground water at an average combined flow rate of 600 gpm, and removed about 270 kg of volatile organic compounds (VOC's). To better manage this large complex remediation system, a 3-dimensional, finite-element numerical model was developed using FEFLOW. The model simulated a 7 square-mile portion of the large Livermore Valley ground water basin. The quality of the input data varied from highly detailed, in the environmental investigation areas, to sparse, near some of the model domain boundaries. These different data sets had to be integrated to obtain the necessary boundary conditions and input parameters for the model. Hydraulic conductivities were averaged from measured lithologic descriptions and hydraulic test data. Boundary conditions were based on a local and regional assessment of groundwater elevation data representative of observed inflow/outflow boundaries. The model was initially calibrated to a set of 8 distinct hydrologic stress periods over 12 years. Initial flow calibration for the model was achieved using the parameter estimation tool PEST. Through successive data analysis and calibration, optimal parameters were established for each HSU and expanded to 35 hydrologic stress periods covering the entire recorded hydrologic history. VOC transport was calibrated to 9 years of

  3. The Integrated Medical Model

    NASA Technical Reports Server (NTRS)

    Butler, Douglas J.; Kerstman, Eric

    2010-01-01

    This slide presentation reviews the goals and approach for the Integrated Medical Model (IMM). The IMM is a software decision support tool that forecasts medical events during spaceflight and optimizes medical systems during simulations. It includes information on the software capabilities, program stakeholders, use history, and the software logic.

  4. Use of 3-Dimensional Volumetric Modeling of Adrenal Gland Size in Patients with Primary Pigmented Nodular Adrenocortical Disease.

    PubMed

    Chrysostomou, P P; Lodish, M B; Turkbey, E B; Papadakis, G Z; Stratakis, C A

    2016-04-01

    Primary pigmented nodular adrenocortical disease (PPNAD) is a rare type of bilateral adrenal hyperplasia leading to hypercortisolemia. Adrenal nodularity is often appreciable with computed tomography (CT); however, accurate radiologic characterization of adrenal size in PPNAD has not been studied well. We used 3-dimensional (3D) volumetric analysis to characterize and compare adrenal size in PPNAD patients, with and without Cushing's syndrome (CS). Patients diagnosed with PPNAD and their family members with known mutations in PRKAR1A were screened. CT scans were used to create 3D models of each adrenal. Criteria for biochemical diagnosis of CS included loss of diurnal variation and/or elevated midnight cortisol levels, and paradoxical increase in urinary free cortisol and/or urinary 17-hydroxysteroids after dexamethasone administration. Forty-five patients with PPNAD (24 females, 27.8±17.6 years) and 8 controls (19±3 years) were evaluated. 3D volumetric modeling of adrenal glands was performed in all. Thirty-eight patients out of 45 (84.4%) had CS. Their mean adrenal volume was 8.1 cc±4.1, 7.2 cc±4.5 (p=0.643) for non-CS, and 8.0cc±1.6 for controls. Mean values were corrected for body surface area; 4.7 cc/kg/m(2)±2.2 for CS, and 3.9 cc/kg/m(2)±1.3 for non-CS (p=0.189). Adrenal volume and midnight cortisol in both groups was positively correlated, r=0.35, p=0.03. We conclude that adrenal volume measured by 3D CT in patients with PPNAD and CS was similar to those without CS, confirming empirical CT imaging-based observations. However, the association between adrenal volume and midnight cortisol levels may be used as a marker of who among patients with PPNAD may develop CS, something that routine CT cannot do.

  5. Normal growth and development of the lips: a 3-dimensional study from 6 years to adulthood using a geometric model

    PubMed Central

    FERRARIO, VIRGILIO F.; SFORZA, CHIARELLA; SCHMITZ, JOHANNES H.; CIUSA, VERONICA; COLOMBO, ANNA

    2000-01-01

    A 3-dimensional computerised system with landmark representation of the soft-tissue facial surface allows noninvasive and fast quantitative study of facial growth. The aims of the present investigation were (1) to provide reference data for selected dimensions of lips (linear distances and ratios, vermilion area, volume); (2) to quantify the relevant growth changes; and (3) to evaluate sex differences in growth patterns. The 3-dimensional coordinates of 6 soft-tissue landmarks on the lips were obtained by an optoelectronic instrument in a mixed longitudinal and cross-sectional study (2023 examinations in 1348 healthy subjects between 6 y of age and young adulthood). From the landmarks, several linear distances (mouth width, total vermilion height, total lip height, upper lip height), the vermilion height-to-mouth width ratio, some areas (vermilion of the upper lip, vermilion of the lower lip, total vermilion) and volumes (upper lip volume, lower lip volume, total lip volume) were calculated and averaged for age and sex. Male values were compared with female values by means of Student's t test. Within each age group all lip dimensions (distances, areas, volumes) were significantly larger in boys than in girls (P < 0.05), with some exceptions in the first age groups and coinciding with the earlier female growth spurt, whereas the vermilion height-to-mouth width ratio did not show a corresponding sexual dimorphism. Linear distances in girls had almost reached adult dimensions in the 13–14 y age group, while in boys a large increase was still to occur. The attainment of adult dimensions was faster in the upper than in the lower lip, especially in girls. The method used in the present investigation allowed the noninvasive evaluation of a large sample of nonpatient subjects, leading to the definition of 3-dimensional normative data. Data collected in the present study could represent a data base for the quantitative description of human lip morphology from childhood to

  6. Verification and transfer of thermal pollution model. Volume 3: Verification of 3-dimensional rigid-lid model

    NASA Technical Reports Server (NTRS)

    Lee, S. S.; Sengupta, S.; Nwadike, E. V.; Sinha, S. K.

    1982-01-01

    The six-volume report: describes the theory of a three dimensional (3-D) mathematical thermal discharge model and a related one dimensional (1-D) model, includes model verification at two sites, and provides a separate user's manual for each model. The 3-D model has two forms: free surface and rigid lid. The former, verified at Anclote Anchorage (FL), allows a free air/water interface and is suited for significant surface wave heights compared to mean water depth; e.g., estuaries and coastal regions. The latter, verified at Lake Keowee (SC), is suited for small surface wave heights compared to depth (e.g., natural or man-made inland lakes) because surface elevation has been removed as a parameter. These models allow computation of time-dependent velocity and temperature fields for given initial conditions and time-varying boundary conditions. The free-surface model also provides surface height variations with time.

  7. Verification and transfer of thermal pollution model. Volume 2: User's manual for 3-dimensional free-surface model

    NASA Technical Reports Server (NTRS)

    Lee, S. S.; Sengupta, S.; Tuann, S. Y.; Lee, C. R.

    1982-01-01

    The six-volume report: describes the theory of a three-dimensional (3-D) mathematical thermal discharge model and a related one-dimensional (1-D) model, includes model verification at two sites, and provides a separate user's manual for each model. The 3-D model has two forms: free surface and rigid lid. The former, verified at Anclote Anchorage (FL), allows a free air/water interface and is suited for significant surface wave heights compared to mean water depth; e.g., estuaries and coastal regions. The latter, verified at Lake Keowee (SC), is suited for small surface wave heights compared to depth. These models allow computation of time-dependent velocity and temperature fields for given initial conditions and time-varying boundary conditions.

  8. ABSTRACTION OF INFORMATION FROM 2- AND 3-DIMENSIONAL PORFLOW MODELS INTO A 1-D GOLDSIM MODEL - 11404

    SciTech Connect

    Taylor, G.; Hiergesell, R.

    2010-11-16

    The Savannah River National Laboratory has developed a 'hybrid' approach to Performance Assessment modeling which has been used for a number of Performance Assessments. This hybrid approach uses a multi-dimensional modeling platform (PorFlow) to develop deterministic flow fields and perform contaminant transport. The GoldSim modeling platform is used to develop the Sensitivity and Uncertainty analyses. Because these codes are performing complementary tasks, it is incumbent upon them that for the deterministic cases they produce very similar results. This paper discusses two very different waste forms, one with no engineered barriers and one with engineered barriers, each of which present different challenges to the abstraction of data. The hybrid approach to Performance Assessment modeling used at the SRNL uses a 2-D unsaturated zone (UZ) and a 3-D saturated zone (SZ) model in the PorFlow modeling platform. The UZ model consists of the waste zone and the unsaturated zoned between the waste zone and the water table. The SZ model consists of source cells beneath the waste form to the points of interest. Both models contain 'buffer' cells so that modeling domain boundaries do not adversely affect the calculation. The information pipeline between the two models is the contaminant flux. The domain contaminant flux, typically in units of moles (or Curies) per year from the UZ model is used as a boundary condition for the source cells in the SZ. The GoldSim modeling component of the hybrid approach is an integrated UZ-SZ model. The model is a 1-D representation of the SZ, typically 1-D in the UZ, but as discussed below, depending on the waste form being analyzed may contain pseudo-2-D elements. A waste form at the Savannah River Site (SRS) which has no engineered barriers is commonly referred to as a slit trench. A slit trench, as its name implies, is an unlined trench, typically 6 m deep, 6 m wide, and 200 m long. Low level waste consisting of soil, debris, rubble, wood

  9. The Integrated Medical Model

    NASA Technical Reports Server (NTRS)

    Kerstman, Eric; Minard, Charles; Saile, Lynn; Freiere deCarvalho, Mary; Myers, Jerry; Walton, Marlei; Butler, Douglas; Iyengar, Sriram; Johnson-Throop, Kathy; Baumann, David

    2010-01-01

    The goals of the Integrated Medical Model (IMM) are to develop an integrated, quantified, evidence-based decision support tool useful to crew health and mission planners and to help align science, technology, and operational activities intended to optimize crew health, safety, and mission success. Presentation slides address scope and approach, beneficiaries of IMM capabilities, history, risk components, conceptual models, development steps, and the evidence base. Space adaptation syndrome is used to demonstrate the model's capabilities.

  10. Integrated Medical Model Overview

    NASA Technical Reports Server (NTRS)

    Myers, J.; Boley, L.; Foy, M.; Goodenow, D.; Griffin, D.; Keenan, A.; Kerstman, E.; Melton, S.; McGuire, K.; Saile, L.; Shah, R.; Garcia, Y.; Sirmons. B.; Walton, M.; Reyes, D.

    2015-01-01

    The Integrated Medical Model (IMM) Project represents one aspect of NASA's Human Research Program (HRP) to quantitatively assess medical risks to astronauts for existing operational missions as well as missions associated with future exploration and commercial space flight ventures. The IMM takes a probabilistic approach to assessing the likelihood and specific outcomes of one hundred medical conditions within the envelope of accepted space flight standards of care over a selectable range of mission capabilities. A specially developed Integrated Medical Evidence Database (iMED) maintains evidence-based, organizational knowledge across a variety of data sources. Since becoming operational in 2011, version 3.0 of the IMM, the supporting iMED, and the expertise of the IMM project team have contributed to a wide range of decision and informational processes for the space medical and human research community. This presentation provides an overview of the IMM conceptual architecture and range of application through examples of actual space flight community questions posed to the IMM project.

  11. 3DHYDROGEOCHEM: A 3-DIMENSIONAL MODEL OF DENSITY-DEPENDENT SUBSURFACE FLOW AND THERMAL MULTISPECIES-MULTICOMPONENT HYDROGEOCHEMICAL TRANSPORT

    EPA Science Inventory

    This report presents a three-dimensional finite-element numerical model designed to simulate chemical transport in subsurface systems with temperature effect taken into account. The three-dimensional model is developed to provide (1) a tool of application, with which one is able...

  12. User's manual for master: Modeling of aerodynamic surfaces by 3-dimensional explicit representation. [input to three dimensional computational fluid dynamics

    NASA Technical Reports Server (NTRS)

    Gibson, S. G.

    1983-01-01

    A system of computer programs was developed to model general three dimensional surfaces. Surfaces are modeled as sets of parametric bicubic patches. There are also capabilities to transform coordinates, to compute mesh/surface intersection normals, and to format input data for a transonic potential flow analysis. A graphical display of surface models and intersection normals is available. There are additional capabilities to regulate point spacing on input curves and to compute surface/surface intersection curves. Input and output data formats are described; detailed suggestions are given for user input. Instructions for execution are given, and examples are shown.

  13. Next Generation, Waveform Based 3-Dimensional Models & Metrics to Improve Nuclear Explosion Monitoring in the Middle East

    DTIC Science & Technology

    2012-04-20

    Indian tectonic plates . Without knowing the true lateral changes in anisotropy and including large continental provinces within the model it is...also significantly increase anomaly strength while sharpening the anomaly edges to create stronger and more pronounced tectonic structures. The

  14. Direct measurement of the 3-dimensional DNA lesion distribution induced by energetic charged particles in a mouse model tissue

    PubMed Central

    Mirsch, Johanna; Tommasino, Francesco; Frohns, Antonia; Conrad, Sandro; Durante, Marco; Scholz, Michael; Friedrich, Thomas; Löbrich, Markus

    2015-01-01

    Charged particles are increasingly used in cancer radiotherapy and contribute significantly to the natural radiation risk. The difference in the biological effects of high-energy charged particles compared with X-rays or γ-rays is determined largely by the spatial distribution of their energy deposition events. Part of the energy is deposited in a densely ionizing manner in the inner part of the track, with the remainder spread out more sparsely over the outer track region. Our knowledge about the dose distribution is derived solely from modeling approaches and physical measurements in inorganic material. Here we exploited the exceptional sensitivity of γH2AX foci technology and quantified the spatial distribution of DNA lesions induced by charged particles in a mouse model tissue. We observed that charged particles damage tissue nonhomogenously, with single cells receiving high doses and many other cells exposed to isolated damage resulting from high-energy secondary electrons. Using calibration experiments, we transformed the 3D lesion distribution into a dose distribution and compared it with predictions from modeling approaches. We obtained a radial dose distribution with sub-micrometer resolution that decreased with increasing distance to the particle path following a 1/r2 dependency. The analysis further revealed the existence of a background dose at larger distances from the particle path arising from overlapping dose deposition events from independent particles. Our study provides, to our knowledge, the first quantification of the spatial dose distribution of charged particles in biologically relevant material, and will serve as a benchmark for biophysical models that predict the biological effects of these particles. PMID:26392532

  15. New 3-dimensional CFD modeling of CO2 and H2S simultaneous stripping from water within PVDF hollow fiber membrane contactor

    NASA Astrophysics Data System (ADS)

    Bahlake, Ahmad; Farivar, Foad; Dabir, Bahram

    2016-07-01

    In this paper a 3-dimensional modeling of simultaneous stripping of carbon dioxide (CO2) and hydrogen sulfide (H2S) from water using hollow fiber membrane made of polyvinylidene fluoride is developed. The water, containing CO2 and H2S enters to the membrane as feed. At the same time, pure nitrogen flow in the shell side of a shell and tube hollow fiber as the solvent. In the previous methods of modeling hollow fiber membranes just one of the membranes was modeled and the results expand to whole shell and tube system. In this research the whole hollow fiber shell and tube module is modeled to reduce the errors. Simulation results showed that increasing the velocity of solvent flow and decreasing the velocity of the feed are leads to increase in the system yield. However the effect of the feed velocity on the process is likely more than the influence of changing the velocity of the gaseous solvent. In addition H2S stripping has higher yield in comparison with CO2 stripping. This model is compared to the previous modeling methods and shows that the new model is more accurate. Finally, the effect of feed temperature is studied using response surface method and the operating conditions of feed temperature, feed velocity, and solvent velocity is optimized according to synergistic effects. Simulation results show that, in the optimum operating conditions the removal percentage of H2S and CO2 are 27 and 21 % respectively.

  16. Cardiothoracic Applications of 3-dimensional Printing.

    PubMed

    Giannopoulos, Andreas A; Steigner, Michael L; George, Elizabeth; Barile, Maria; Hunsaker, Andetta R; Rybicki, Frank J; Mitsouras, Dimitris

    2016-09-01

    Medical 3-dimensional (3D) printing is emerging as a clinically relevant imaging tool in directing preoperative and intraoperative planning in many surgical specialties and will therefore likely lead to interdisciplinary collaboration between engineers, radiologists, and surgeons. Data from standard imaging modalities such as computed tomography, magnetic resonance imaging, echocardiography, and rotational angiography can be used to fabricate life-sized models of human anatomy and pathology, as well as patient-specific implants and surgical guides. Cardiovascular 3D-printed models can improve diagnosis and allow for advanced preoperative planning. The majority of applications reported involve congenital heart diseases and valvular and great vessels pathologies. Printed models are suitable for planning both surgical and minimally invasive procedures. Added value has been reported toward improving outcomes, minimizing perioperative risk, and developing new procedures such as transcatheter mitral valve replacements. Similarly, thoracic surgeons are using 3D printing to assess invasion of vital structures by tumors and to assist in diagnosis and treatment of upper and lower airway diseases. Anatomic models enable surgeons to assimilate information more quickly than image review, choose the optimal surgical approach, and achieve surgery in a shorter time. Patient-specific 3D-printed implants are beginning to appear and may have significant impact on cosmetic and life-saving procedures in the future. In summary, cardiothoracic 3D printing is rapidly evolving and may be a potential game-changer for surgeons. The imager who is equipped with the tools to apply this new imaging science to cardiothoracic care is thus ideally positioned to innovate in this new emerging imaging modality.

  17. A Validation Study of a Novel 3-Dimensional MRI Modeling Technique to Identify the Anatomic Insertions of the Anterior Cruciate Ligament

    PubMed Central

    Hui, Catherine; Pi, Yeli; Swami, Vimarsha; Mabee, Myles; Jaremko, Jacob L.

    2016-01-01

    Background: Anatomic single bundle anterior cruciate ligament (ACL) reconstruction is the current gold standard in ACL reconstructive surgery. However, placement of femoral and tibial tunnels at the anatomic center of the ACL insertion sites can be difficult intraoperatively. We developed a “virtual arthroscopy” program that allows users to identify ACL insertions on preoperative knee magnetic resonance images (MRIs) and generates a 3-dimensional (3D) bone model that matches the arthroscopic view to help guide intraoperative tunnel placement. Purpose: To test the validity of the ACL insertion sites identified using our 3D modeling program and to determine the accuracy of arthroscopic ACL reconstruction guided by our “virtual arthroscopic” model. Study Design: Descriptive laboratory study. Methods: Sixteen cadaveric knees were prescanned using routine MRI sequences. A trained, blinded observer then identified the center of the ACL insertions using our program. Eight knees were dissected, and the centers of the ACL footprints were marked with a screw. In the remaining 8 knees, arthroscopic ACL tunnels were drilled into the center of the ACL footprints based on landmarks identified using our virtual arthroscopic model. Postprocedural MRI was performed on all 16 knees. The 3D distance between pre- and postoperative 3D centers of the ACL were calculated by 2 trained, blinded observers and a musculoskeletal radiologist. Results: With 2 outliers removed, the postoperative femoral and tibial tunnel placements in the open specimens differed by 2.5 ± 0.9 mm and 2.9 ± 0.7 mm from preoperative centers identified on MRI. Postoperative femoral and tibial tunnel centers in the arthroscopic specimens differed by 3.2 ± 0.9 mm and 2.9 ± 0.7 mm, respectively. Conclusion: Our results show that MRI-based 3D localization of the ACL and our virtual arthroscopic modeling program is feasible and does not show a statistically significant difference to an open arthrotomy approach

  18. With the advent of domestic 3-dimensional (3D) printers and their associated reduced cost, is it now time for every medical school to have their own 3D printer?

    PubMed

    Balestrini, Christopher; Campo-Celaya, Tatiana

    2016-01-01

    Anatomy is the backbone of medical education and new techniques to improve learning are frequently explored. With the introduction of 3D printers specifically for the home market, the price of this technology has reached affordable levels. Using patient scan data, accurate 3D models can be printed that represent real human variation in anatomy to provide an innovative, inexpensive and valuable adjunct to anatomical teaching. Is it now time for every medical school to have their own 3D printer?

  19. Hydroelectric structures studies using 3-dimensional methods

    SciTech Connect

    Harrell, T.R.; Jones, G.V.; Toner, C.K. )

    1989-01-01

    Deterioration and degradation of aged, hydroelectric project structures can significantly affect the operation and safety of a project. In many cases, hydroelectric headworks (in particular) have complicated geometrical configurations, loading patterns and hence, stress conditions. An accurate study of such structures can be performed using 3-dimensional computer models. 3-D computer models can be used for both stability evaluation and for finite element stress analysis. Computer aided engineering processes facilitate the use of 3-D methods in both pre-processing and post-processing of data. Two actual project examples are used to emphasize the authors' points.

  20. A thermodynamic and mechanical model for formation of the Solar System via 3-dimensional collapse of the dusty pre-solar nebula

    NASA Astrophysics Data System (ADS)

    Hofmeister, Anne M.; Criss, Robert E.

    2012-03-01

    The fundamental and shared rotational characteristics of the Solar System (nearly circular, co-planar orbits and mostly upright axial spins of the planets) record conditions of origin, yet are not explained by prevailing 2-dimensional disk models. Current planetary spin and orbital rotational energies (R.E.) each nearly equal and linearly depend on gravitational self-potential of formation (Ug), revealing mechanical energy conservation. We derive -ΔUg≅Δ.R.E. and stability criteria from thermodynamic principles, and parlay these relationships into a detailed model of simultaneous accretion of the protoSun and planets from the dust-bearing 3-d pre-solar nebula (PSN). Gravitational heating is insignificant because Ug is negative, the 2nd law of thermodynamics must be fulfilled, and ideal gas conditions pertain to the rarified PSN until the objects were nearly fully formed. Combined conservation of angular momentum and mechanical energy during 3-dimensional collapse of spheroidal dust shells in a contracting nebula provides ΔR.E.≅R.E. for the central body, whereas for formation of orbiting bodies, ΔR.E.≅R.E.f(1-If/Ii), where I is the moment of inertia. Orbital data for the inner planets follow 0.04×R.E.f≅-Ug which confirms conservation of angular momentum. Significant loss of spin, attributed to viscous dissipation during differential rotation, masks the initial spin of the un-ignited protoSun predicted by R.E.=-Ug. Heat production occurs after nearly final sizes are reached via mechanisms such as shear during differential rotation and radioactivity. We focus on the dilute stage, showing that the PSN was compositionally graded due to light molecules diffusing preferentially, providing the observed planetary chemistry, and set limits on PSN mass, density, and temperature. From measured planetary masses and orbital characteristics, accounting for dissipation of spin, we deduce mechanisms and the sequence of converting a 3-d dusty cloud to the present 2-d

  1. Requirements for Medical Modeling Languages

    PubMed Central

    van der Maas, Arnoud A.F.; Ter Hofstede, Arthur H.M.; Ten Hoopen, A. Johannes

    2001-01-01

    Objective: The development of tailor-made domain-specific modeling languages is sometimes desirable in medical informatics. Naturally, the development of such languages should be guided. The purpose of this article is to introduce a set of requirements for such languages and show their application in analyzing and comparing existing modeling languages. Design: The requirements arise from the practical experience of the authors and others in the development of modeling languages in both general informatics and medical informatics. The requirements initially emerged from the analysis of information modeling techniques. The requirements are designed to be orthogonal, i.e., one requirement can be violated without violation of the others. Results: The proposed requirements for any modeling language are that it be “formal” with regard to syntax and semantics, “conceptual,” “expressive,” “comprehensible,” “suitable,” and “executable.” The requirements are illustrated using both the medical logic modules of the Arden Syntax as a running example and selected examples from other modeling languages. Conclusion: Activity diagrams of the Unified Modeling Language, task structures for work flows, and Petri nets are discussed with regard to the list of requirements, and various tradeoffs are thus made explicit. It is concluded that this set of requirements has the potential to play a vital role in both the evaluation of existing domain-specific languages and the development of new ones. PMID:11230383

  2. 3-dimensional Oil Drift Simulations

    NASA Astrophysics Data System (ADS)

    Wettre, C.; Reistad, M.; Hjøllo, B.Å.

    Simulation of oil drift has been an ongoing activity at the Norwegian Meteorological Institute since the 1970's. The Marine Forecasting Centre provides a 24-hour service for the Norwegian Pollution Control Authority and the oil companies operating in the Norwegian sector. The response time is 30 minutes. From 2002 the service is extended to simulation of oil drift from oil spills in deep water, using the DeepBlow model developed by SINTEF Applied Chemistry. The oil drift model can be applied both for instantaneous and continuous releases. The changes in the mass of oil and emulsion as a result of evaporation and emulsion are computed. For oil spill at deep water, hydrate formation and gas dissolution are taken into account. The properties of the oil depend on the oil type, and in the present version 64 different types of oil can be simulated. For accurate oil drift simulations it is important to have the best possible data on the atmospheric and oceanic conditions. The oil drift simulations at the Norwegian Meteorological Institute are always based on the most updated data from numerical models of the atmosphere and the ocean. The drift of the surface oil is computed from the vectorial sum of the surface current from the ocean model and the wave induced Stokes drift computed from wave energy spectra from the wave prediction model. In the new model the current distribution with depth is taken into account when calculating the drift of the dispersed oil droplets. Salinity and temperature profiles from the ocean model are needed in the DeepBlow model. The result of the oil drift simulations can be plotted on sea charts used for navigation, either as trajectory plots or particle plots showing the situation at a given time. The results can also be sent as data files to be included in the user's own GIS system.

  3. [Publishing models in medical journals].

    PubMed

    Reyes, Humberto B

    2012-02-01

    Medical journals are published by scientific societies, universities, publishing agencies and other for-profit or non-profit organizations. The traditional way to cover the expenses in printed journals has been a "subscribers pay" model. The rise of electronic versions in the internet, either together with the printed version or replacing it entirely, plus a progressive adherence to an "open access" for electronic versions, has created financial difficulties. Therefore, the "authors pay" model has been added. Both models can be subsidized by commercial or institutional advertising, but still a main source for financing relies either in subscriptions or in authors' payments. A small source of income that helps to cover publishing costs is a "charge for manuscript reception", currently applied by several journals. Those authors whose work has institutional or external support can use their grants to cover any charges, but the situation is more difficult for those who do not have such support. Since 1872, Sociedad Médica de Santiago-Chilean Society of Internal Medicine, owner and publisher of Revista Médica de Chile, has employed the "subscribers pay" model, subsidized by commercial advertising and temporary sponsors (Chilean government and others). The printed journal is reproduced in an open access electronic version, in www.scielo.cl. The increasing cost of both publications systems demands a time for reflection.

  4. 3DHYDROGEOCHEM: A 3-DIMENSIONAL MODEL OF DENSITY-DEPENDENT SUBSURFACE FLOW AND THERMAL MULTISPECIES-MULTICOMPONENT HYDROGEOCHEMICAL TRANSPORT (EPA/600/SR-98/159)

    EPA Science Inventory

    This report presents a three-dimensional finite-element numerical model designed to simulate chemical transport in subsurface systems with temperature effect taken into account. The three-dimensional model is developed to provide (1) a tool of application, with which one is able ...

  5. Phase diagram of quark-antiquark and diquark condensates in the 3-dimensional Gross-Neveu model with the 4-component spinor representation

    SciTech Connect

    Kohyama, Hiroaki

    2008-07-01

    We construct the phase diagram of the quark-antiquark and diquark condensates at finite temperature and density in the 2+1 dimensional (3D) two flavor massless Gross-Neveu (GN) model with the 4-component quarks. In contrast to the case of the 2-component quarks, there appears the coexisting phase of the quark-antiquark and diquark condensates. This is the crucial difference between the 2-component and 4-component quark cases in the 3D GN model. The coexisting phase is also seen in the 4D Nambu Jona-Lasinio model. Then we see that the 3D GN model with the 4-component quarks bears closer resemblance to the 4D Nambu Jona-Lasinio model.

  6. Utility of a 3-dimensional full-scale NaCl model for rib strut grafting for anterior fusion for cervicothoracic kyphosis

    PubMed Central

    Kobayashi, Kazuyoshi; Imagama, Shiro; Muramoto, Akio; Ito, Zenya; Ando, Kei; Yagi, Hideki; Hida, Tetsuro; Ito, Kenyu; Ishikawa, Yoshimoto; Tsushima, Mikito; Ishiguro, Naoki

    2015-01-01

    ABSTRACT In severe spinal deformity, pain and neurological disorder may be caused by spinal cord compression. Surgery for spinal reconstruction is desirable, but may be difficult in a case with severe deformity. Here, we show the utility of a 3D NaCl (salt) model in preoperative planning of anterior reconstruction using a rib strut in a 49-year-old male patient with cervicothoracic degenerative spondylosis. We performed surgery in two stages: a posterior approach with decompression and posterior instrumentation with a pedicle screw; followed by a second operation using an anterior approach, for which we created a 3D NaCl model including the cervicothoracic lesion, spinal deformity, and ribs for anterior reconstruction. The 3D NaCl model was easily scraped compared with a conventional plaster model and was useful for planning of resection and identification of a suitable rib for grafting in a preoperative simulation. Surgery was performed successfully with reference to the 3D NaCl model. We conclude that preoperative simulation with a 3D NaCl model contributes to performance of anterior reconstruction using a rib strut in a case of cervicothoracic deformity. PMID:26412901

  7. A 3-dimensional trimeric β-barrel model for Chlamydia MOMP contains conserved and novel elements of Gram-negative bacterial porins.

    PubMed

    Feher, Victoria A; Randall, Arlo; Baldi, Pierre; Bush, Robin M; de la Maza, Luis M; Amaro, Rommie E

    2013-01-01

    Chlamydia trachomatis is the most prevalent cause of bacterial sexually transmitted diseases and the leading cause of preventable blindness worldwide. Global control of Chlamydia will best be achieved with a vaccine, a primary target for which is the major outer membrane protein, MOMP, which comprises ~60% of the outer membrane protein mass of this bacterium. In the absence of experimental structural information on MOMP, three previously published topology models presumed a16-stranded barrel architecture. Here, we use the latest β-barrel prediction algorithms, previous 2D topology modeling results, and comparative modeling methodology to build a 3D model based on the 16-stranded, trimeric assumption. We find that while a 3D MOMP model captures many structural hallmarks of a trimeric 16-stranded β-barrel porin, and is consistent with most of the experimental evidence for MOMP, MOMP residues 320-334 cannot be modeled as β-strands that span the entire membrane, as is consistently observed in published 16-stranded β-barrel crystal structures. Given the ambiguous results for β-strand delineation found in this study, recent publications of membrane β-barrel structures breaking with the canonical rule for an even number of β-strands, findings of β-barrels with strand-exchanged oligomeric conformations, and alternate folds dependent upon the lifecycle of the bacterium, we suggest that although the MOMP porin structure incorporates canonical 16-stranded conformations, it may have novel oligomeric or dynamic structural changes accounting for the discrepancies observed.

  8. A 3-dimensional micro- and nanoparticle transport and filtration model (MNM3D) applied to the migration of carbon-based nanomaterials in porous media

    NASA Astrophysics Data System (ADS)

    Bianco, Carlo; Tosco, Tiziana; Sethi, Rajandrea

    2016-10-01

    Engineered nanoparticles (NPs) in the environment can act both as contaminants, when they are unintentionally released, and as remediation agents when injected on purpose at contaminated sites. In this work two carbon-based NPs are considered, namely CARBO-IRON®, a new material developed for contaminated site remediation, and single layer graphene oxide (SLGO), a potential contaminant of the next future. Understanding and modeling the transport and deposition of such NPs in aquifer systems is a key aspect in both cases, and numerical models capable to simulate NP transport in groundwater in complex 3D scenarios are necessary. To this aim, this work proposes a modeling approach based on modified advection-dispersion-deposition equations accounting for the coupled influence of flow velocity and ionic strength on particle transport. A new modeling tool (MNM3D - Micro and Nanoparticle transport Model in 3D geometries) is presented for the simulation of NPs injection and transport in 3D scenarios. MNM3D is the result of the integration of the numerical code MNMs (Micro and Nanoparticle transport, filtration and clogging Model - Suite) in the well-known transport model RT3D (Clement et al., 1998). The injection in field-like conditions of CARBO-IRON® (20 g/l) amended by CMC (4 g/l) in a 2D vertical tank (0.7 × 1.0 × 0.12 m) was simulated using MNM3D, and compared to experimental results under the same conditions. Column transport tests of SLGO at a concentration (10 mg/l) representative of a possible spill of SLGO-containing waste water were performed at different values of ionic strength (0.1 to 35 mM), evidencing a strong dependence of SLGO transport on IS, and a reversible blocking deposition. The experimental data were fitted using the numerical code MNMs and the ionic strength-dependent transport was up-scaled for a full scale 3D simulation of SLGO release and long-term transport in a heterogeneous aquifer. MNM3D showed to potentially represent a valid tool for

  9. The Spatiotemporal Stability of Dominant Frequency Sites in In-Silico Modeling of 3-Dimensional Left Atrial Mapping of Atrial Fibrillation

    PubMed Central

    Hwang, Minki; Song, Jun-Seop; Lee, Young-Seon; Joung, Boyoung; Pak, Hui-Nam

    2016-01-01

    Background We previously reported that stable rotors were observed in in-silico human atrial fibrillation (AF) models, and were well represented by dominant frequency (DF). We explored the spatiotemporal stability of DF sites in 3D-AF models imported from patient CT images of the left atrium (LA). Methods We integrated 3-D CT images of the LA obtained from ten patients with persistent AF (male 80%, 61.8 ± 13.5 years old) into an in-silico AF model. After induction, we obtained 6 seconds of AF simulation data for DF analyses in 30 second intervals (T1–T9). The LA was divided into ten sections. Spatiotemporal changes and variations in the temporal consistency of DF were evaluated at each section of the LA. The high DF area was defined as the area with the highest 10% DF. Results 1. There was no spatial consistency in the high DF distribution at each LA section during T1–T9 except in one patient (p = 0.027). 2. Coefficients of variation for the high DF area were highly different among the ten LA sections (p < 0.001), and they were significantly higher in the four pulmonary vein (PV) areas, the LA appendage, and the peri-mitral area than in the other LA sections (p < 0.001). 3. When we conducted virtual ablation of 10%, 15%, and 20% of the highest DF areas (n = 270 cases), AF was changed to atrial tachycardia (AT) or terminated at a rate of 40%, 57%, and 76%, respectively. Conclusions Spatiotemporal consistency of the DF area was observed in 10% of AF patients, and high DF areas were temporally variable. Virtual ablation of DF is moderately effective in AF termination and AF changing into AT. PMID:27459377

  10. Modeling Manipulation in Medical Education

    ERIC Educational Resources Information Center

    Dailey, Jason I.

    2010-01-01

    As residents and medical students progress through their medical training, they are presented with multiple instances in which they feel they must manipulate the healthcare system and deceive others in order to efficiently treat their patients. This, however, creates a culture of manipulation resulting in untoward effects on trainees' ethical and…

  11. Optimization of 3-dimensional imaging of the breast region with 3-dimensional laser scanners.

    PubMed

    Kovacs, Laszlo; Yassouridis, Alexander; Zimmermann, Alexander; Brockmann, Gernot; Wöhnl, Antonia; Blaschke, Matthias; Eder, Maximilian; Schwenzer-Zimmerer, Katja; Rosenberg, Robert; Papadopulos, Nikolaos A; Biemer, Edgar

    2006-03-01

    The anatomic conditions of the female breast require imaging the breast region 3-dimensionally in a normal standing position for quality assurance and for surgery planning or surgery simulation. The goal of this work was to optimize the imaging technology for the mammary region with a 3-dimensional (3D) laser scanner, to evaluate the precision and accuracy of the method, and to allow optimum data reproducibility. Avoiding the influence of biotic factors, such as mobility, we tested the most favorable imaging technology on dummy models for scanner-related factors such as the scanner position in comparison with the torso and the number of scanners and single shots. The influence of different factors of the breast region, such as different breast shapes or premarking of anatomic landmarks, was also first investigated on dummies. The findings from the dummy models were then compared with investigations on test persons, and the accuracy of measurements on the virtual models was compared with a coincidence analysis of the manually measured values. The best precision and accuracy of breast region measurements were achieved when landmarks were marked before taking the shots and when shots at 30 degrees left and 30 degrees right, relative to the sagittal line, were taken with 2 connected scanners mounted with a +10-degree upward angle. However, the precision of the measurements on test persons was significantly lower than those measured on dummies. Our findings show that the correct settings for 3D imaging of the breast region with a laser scanner can achieve an acceptable degree of accuracy and reproducibility.

  12. A Probabilistic Model for Reducing Medication Errors

    PubMed Central

    Nguyen, Phung Anh; Syed-Abdul, Shabbir; Iqbal, Usman; Hsu, Min-Huei; Huang, Chen-Ling; Li, Hsien-Chang; Clinciu, Daniel Livius; Jian, Wen-Shan; Li, Yu-Chuan Jack

    2013-01-01

    Background Medication errors are common, life threatening, costly but preventable. Information technology and automated systems are highly efficient for preventing medication errors and therefore widely employed in hospital settings. The aim of this study was to construct a probabilistic model that can reduce medication errors by identifying uncommon or rare associations between medications and diseases. Methods and Finding(s) Association rules of mining techniques are utilized for 103.5 million prescriptions from Taiwan’s National Health Insurance database. The dataset included 204.5 million diagnoses with ICD9-CM codes and 347.7 million medications by using ATC codes. Disease-Medication (DM) and Medication-Medication (MM) associations were computed by their co-occurrence and associations’ strength were measured by the interestingness or lift values which were being referred as Q values. The DMQs and MMQs were used to develop the AOP model to predict the appropriateness of a given prescription. Validation of this model was done by comparing the results of evaluation performed by the AOP model and verified by human experts. The results showed 96% accuracy for appropriate and 45% accuracy for inappropriate prescriptions, with a sensitivity and specificity of 75.9% and 89.5%, respectively. Conclusions We successfully developed the AOP model as an efficient tool for automatic identification of uncommon or rare associations between disease-medication and medication-medication in prescriptions. The AOP model helps to reduce medication errors by alerting physicians, improving the patients’ safety and the overall quality of care. PMID:24312659

  13. 3-dimensional imaging at nanometer resolutions

    DOEpatents

    Werner, James H.; Goodwin, Peter M.; Shreve, Andrew P.

    2010-03-09

    An apparatus and method for enabling precise, 3-dimensional, photoactivation localization microscopy (PALM) using selective, two-photon activation of fluorophores in a single z-slice of a sample in cooperation with time-gated imaging for reducing the background radiation from other image planes to levels suitable for single-molecule detection and spatial location, are described.

  14. Fingernail Injuries and NASA's Integrated Medical Model

    NASA Technical Reports Server (NTRS)

    Kerstman, Eric; Butler, Doug

    2008-01-01

    The goal of space medicine is to optimize both crew health and performance. Currently, expert opinion is primarily relied upon for decision-making regarding medical equipment and supplies flown in space. Evidence-based decisions are preferred due to mass and volume limitations and the expense of space flight. The Integrated Medical Model (IMM) is an attempt to move us in that direction!

  15. The 3-dimensional cellular automata for HIV infection

    NASA Astrophysics Data System (ADS)

    Mo, Youbin; Ren, Bin; Yang, Wencao; Shuai, Jianwei

    2014-04-01

    The HIV infection dynamics is discussed in detail with a 3-dimensional cellular automata model in this paper. The model can reproduce the three-phase development, i.e., the acute period, the asymptotic period and the AIDS period, observed in the HIV-infected patients in a clinic. We show that the 3D HIV model performs a better robustness on the model parameters than the 2D cellular automata. Furthermore, we reveal that the occurrence of a perpetual source to successively generate infectious waves to spread to the whole system drives the model from the asymptotic state to the AIDS state.

  16. 3-dimensional fabrication of soft energy harvesters

    NASA Astrophysics Data System (ADS)

    McKay, Thomas; Walters, Peter; Rossiter, Jonathan; O'Brien, Benjamin; Anderson, Iain

    2013-04-01

    Dielectric elastomer generators (DEG) provide an opportunity to harvest energy from low frequency and aperiodic sources. Because DEG are soft, deformable, high energy density generators, they can be coupled to complex structures such as the human body to harvest excess mechanical energy. However, DEG are typically constrained by a rigid frame and manufactured in a simple planar structure. This planar arrangement is unlikely to be optimal for harvesting from compliant and/or complex structures. In this paper we present a soft generator which is fabricated into a 3 Dimensional geometry. This capability will enable the 3-dimensional structure of a dielectric elastomer to be customised to the energy source, allowing efficient and/or non-invasive coupling. This paper demonstrates our first 3 dimensional generator which includes a diaphragm with a soft elastomer frame. When the generator was connected to a self-priming circuit and cyclically inflated, energy was accumulated in the system, demonstrated by an increased voltage. Our 3D generator promises a bright future for dielectric elastomers that will be customised for integration with complex and soft structures. In addition to customisable geometries, the 3D printing process may lend itself to fabricating large arrays of small generator units and for fabricating truly soft generators with excellent impedance matching to biological tissue. Thus comfortable, wearable energy harvesters are one step closer to reality.

  17. Wetting characteristics of 3-dimensional nanostructured fractal surfaces

    NASA Astrophysics Data System (ADS)

    Davis, Ethan; Liu, Ying; Jiang, Lijia; Lu, Yongfeng; Ndao, Sidy

    2017-01-01

    This article reports the fabrication and wetting characteristics of 3-dimensional nanostructured fractal surfaces (3DNFS). Three distinct 3DNFS surfaces, namely cubic, Romanesco broccoli, and sphereflake were fabricated using two-photon direct laser writing. Contact angle measurements were performed on the multiscale fractal surfaces to characterize their wetting properties. Average contact angles ranged from 66.8° for the smooth control surface to 0° for one of the fractal surfaces. The change in wetting behavior was attributed to modification of the interfacial surface properties due to the inclusion of 3-dimensional hierarchical fractal nanostructures. However, this behavior does not exactly obey existing surface wetting models in the literature. Potential applications for these types of surfaces in physical and biological sciences are also discussed.

  18. Multilingual Medical Data Models in ODM Format

    PubMed Central

    Breil, B.; Kenneweg, J.; Fritz, F.; Bruland, P.; Doods, D.; Trinczek, B.; Dugas, M.

    2012-01-01

    Background Semantic interoperability between routine healthcare and clinical research is an unsolved issue, as information systems in the healthcare domain still use proprietary and site-specific data models. However, information exchange and data harmonization are essential for physicians and scientists if they want to collect and analyze data from different hospitals in order to build up registries and perform multicenter clinical trials. Consequently, there is a need for a standardized metadata exchange based on common data models. Currently this is mainly done by informatics experts instead of medical experts. Objectives We propose to enable physicians to exchange, rate, comment and discuss their own medical data models in a collaborative web-based repository of medical forms in a standardized format. Methods Based on a comprehensive requirement analysis, a web-based portal for medical data models was specified. In this context, a data model is the technical specification (attributes, data types, value lists) of a medical form without any layout information. The CDISC Operational Data Model (ODM) was chosen as the appropriate format for the standardized representation of data models. The system was implemented with Ruby on Rails and applies web 2.0 technologies to provide a community based solution. Forms from different source systems – both routine care and clinical research – were converted into ODM format and uploaded into the portal. Results A portal for medical data models based on ODM-files was implemented (http://www.medical-data-models.org). Physicians are able to upload, comment, rate and download medical data models. More than 250 forms with approximately 8000 items are provided in different views (overview and detailed presentation) and in multiple languages. For instance, the portal contains forms from clinical and research information systems. Conclusion The portal provides a system-independent repository for multilingual data models in ODM

  19. Modelling empathy in medical and nursing education.

    PubMed

    Malpas, Phillipa J; Corbett, Andrea

    2012-03-30

    Medical and nursing student numbers are expected to increase significantly in NZ over the next few years. The ethical, and professional and clinical skills' training of trainee health practitioners is a central and crucial component in medical and nursing education and is underpinned by a strong commitment to improve patient health and well being. In this discussion we reflect on the virtue of empathy and the importance of role modelling in the education of nurses and doctors. We endorse the claim that as medical educators, how and what we teach matters.

  20. An event model of medical information representation.

    PubMed Central

    Huff, S M; Rocha, R A; Bray, B E; Warner, H R; Haug, P J

    1995-01-01

    OBJECTIVE: Develop a model for structured and encoded representation of medical information that supports human review, decision support applications, ad hoc queries, statistical analysis, and natural-language processing. DESIGN: A medical information representation model was developed from manual and semiautomated analysis of patient data. The key assumption of the model is that medical information can be represented as a series of linked events. The event representation has two main components. The first component is a frame or template definition that specifies the attributes of the event. The second component is a structured vocabulary, the terms of which are taken as the values of the slots in the event template structure. Individual event instances are linked by specific named relationships. RESULTS: The proposed model was used to represent a chest-radiograph report. CONCLUSIONS: The event model of medical information representation provides a mechanism for formal definition of the logical structure of medical data and allows explicit time-oriented and associative relationships between event instances. PMID:7743315

  1. Crime, criminals, and cures: medical model revisited.

    PubMed

    Sampson, R J

    2000-06-01

    David Lykken's target article assesses the causes of crime and advocates a controversial "cure"--parental licensure. Although Lykken gets many of the facts about criminals right, ultimately the disease metaphor breaks down. Crime requires three things--motivated offenders ("criminals"), suitable targets or victims, and the absence of capable guardians to prevent the act. Typical of medical model approaches, failure to consider the convergence in time and space of the three necessary elements for crime results in a misdiagnosis. In this invited commentary, I briefly note three reasons why Lykken's cure, along with the medical model in general, is unlikely to bear fruit.

  2. Visualization and model building in medical imaging.

    PubMed

    McDonald, J P; Siebert, J P; Fryer, R J; Urquhart, C W

    1994-01-01

    We present technologies and ideas, developed from the JFIT 'Active Stereo Probe Project', which are applicable to problems within medical measurement and monitoring. Two related areas are considered. The first concerns patient body surface modelling. During the project two state-of-the-art non-contact surface measurement techniques have been developed which are applicable to medical situations requiring dense and accurate body surface modelling. Such applications include, for example, prosthetic appliance fabrication, presurgical planning and non-invasive deformity analysis. The second is concerned with overlay projection. Using this enabling technology the information content of a scene can be enhanced as an aid to medical personnel. Results and illustrative applications of the newly developed technology are presented.

  3. Model observers in medical imaging research.

    PubMed

    He, Xin; Park, Subok

    2013-10-04

    Model observers play an important role in the optimization and assessment of imaging devices. In this review paper, we first discuss the basic concepts of model observers, which include the mathematical foundations and psychophysical considerations in designing both optimal observers for optimizing imaging systems and anthropomorphic observers for modeling human observers. Second, we survey a few state-of-the-art computational techniques for estimating model observers and the principles of implementing these techniques. Finally, we review a few applications of model observers in medical imaging research.

  4. A Database Model for Medical Consultation.

    ERIC Educational Resources Information Center

    Anvari, Morteza

    1991-01-01

    Describes a relational data model that can be used for knowledge representation and manipulation in rule-based medical consultation systems. Fuzzy queries or attribute values and fuzzy set theory are discussed, functional dependencies are described, and an example is presented of a system for diagnosing causes of eye inflammation. (15 references)…

  5. The Medical Research Model: No Magic Formula

    ERIC Educational Resources Information Center

    Kingsbury, G. Gage

    2006-01-01

    In the No Child Left Behind Act and the What Works Clearinghouse, the federal government has attempted to establish guidelines for the type of education research that U.S. schools should consider in selecting instructional programs and resources. The government's clear preference for the medical model--a powerful research design in such fields as…

  6. Medical image segmentation by MDP model

    NASA Astrophysics Data System (ADS)

    Lu, Yisu; Chen, Wufan

    2011-11-01

    MDP (Dirichlet Process Mixtures) model is applied to segment medical images in this paper. Segmentation can been automatically done without initializing segmentation class numbers. The MDP model segmentation algorithm is used to segment natural images and MR (Magnetic Resonance) images in the paper. To demonstrate the accuracy of the MDP model segmentation algorithm, many compared experiments, such as EM (Expectation Maximization) image segmentation algorithm, K-means image segmentation algorithm and MRF (Markov Field) image segmentation algorithm, have been done to segment medical MR images. All the methods are also analyzed quantitatively by using DSC (Dice Similarity Coefficients). The experiments results show that DSC of MDP model segmentation algorithm of all slices exceed 90%, which show that the proposed method is robust and accurate.

  7. Control of Grasp and Manipulation by Soft Fingers with 3-Dimensional Deformation

    NASA Astrophysics Data System (ADS)

    Nakashima, Akira; Shibata, Takeshi; Hayakawa, Yoshikazu

    In this paper, we consider control of grasp and manipulation of an object in a 3-dimensional space by a 3-fingered hand robot with soft finger tips. We firstly propose a 3-dimensional deformation model of a hemispherical soft finger tip and verify its relevance by experimental data. Second, we consider the contact kinematics and derive the dynamical equations of the fingers and the object where the 3-dimensional deformation is considered. For the system, we thirdly propose a method to regulate the object and the internal force with the information of the hand, the object and the deformation. A simulation result is presented to show the effectiveness of the control method.

  8. [New business model for medical specialists].

    PubMed

    Houwen, L G H J Louis

    2013-01-01

    The reforms in the field of medical specialist care have important implications for the professional practice of medical specialists and their working relationship with the hospital. This leads to a considerable amount of pressure placed upon the way physicians have traditionally practiced their liberal professions, which is by forming partnerships and practicing from within the hospitals based on an admission agreement. As of 2015, the tax benefits for entrepreneurs will be abolished and the formation of regional partnerships will be discouraged. These developments not only pose threats but also offer opportunities for both the entrepreneurial medical specialist and the innovative hospital. In this article, the prospect of a future business model for specialist medical care will be outlined and explored by proposing three new organizational forms. The central vision of this model is that physicians who wish to retain their status of liberal professional practitioners in the twenty-first century should be more involved in the ownership structure of hospitals. The social importance of responsible patient care remains paramount.

  9. Medical Countermeasure Models. Volume 4. Francisella tularensis

    DTIC Science & Technology

    2013-04-12

    outcome in terms of morbidity, mortality and loss of work due to both the agent itself, and any adverse medical countermeasure side effects . The...MCM Model Inputs Input Category Explanation of Input Dose of Agent Inhaled dose Designates the number of inhaled organisms. Vaccination Inputs...The length of the incubation period is dose dependent; therefore, individuals that inhale large doses of agent have a shorter average incubation

  10. The Integrated Medical Model: A Probabilistic Simulation Model for Predicting In-Flight Medical Risks

    NASA Technical Reports Server (NTRS)

    Keenan, Alexandra; Young, Millennia; Saile, Lynn; Boley, Lynn; Walton, Marlei; Kerstman, Eric; Shah, Ronak; Goodenow, Debra A.; Myers, Jerry G.

    2015-01-01

    The Integrated Medical Model (IMM) is a probabilistic model that uses simulation to predict mission medical risk. Given a specific mission and crew scenario, medical events are simulated using Monte Carlo methodology to provide estimates of resource utilization, probability of evacuation, probability of loss of crew, and the amount of mission time lost due to illness. Mission and crew scenarios are defined by mission length, extravehicular activity (EVA) schedule, and crew characteristics including: sex, coronary artery calcium score, contacts, dental crowns, history of abdominal surgery, and EVA eligibility. The Integrated Medical Evidence Database (iMED) houses the model inputs for one hundred medical conditions using in-flight, analog, and terrestrial medical data. Inputs include incidence, event durations, resource utilization, and crew functional impairment. Severity of conditions is addressed by defining statistical distributions on the dichotomized best and worst-case scenarios for each condition. The outcome distributions for conditions are bounded by the treatment extremes of the fully treated scenario in which all required resources are available and the untreated scenario in which no required resources are available. Upon occurrence of a simulated medical event, treatment availability is assessed, and outcomes are generated depending on the status of the affected crewmember at the time of onset, including any pre-existing functional impairments or ongoing treatment of concurrent conditions. The main IMM outcomes, including probability of evacuation and loss of crew life, time lost due to medical events, and resource utilization, are useful in informing mission planning decisions. To date, the IMM has been used to assess mission-specific risks with and without certain crewmember characteristics, to determine the impact of eliminating certain resources from the mission medical kit, and to design medical kits that maximally benefit crew health while meeting

  11. The Integrated Medical Model: A Probabilistic Simulation Model Predicting In-Flight Medical Risks

    NASA Technical Reports Server (NTRS)

    Keenan, Alexandra; Young, Millennia; Saile, Lynn; Boley, Lynn; Walton, Marlei; Kerstman, Eric; Shah, Ronak; Goodenow, Debra A.; Myers, Jerry G., Jr.

    2015-01-01

    The Integrated Medical Model (IMM) is a probabilistic model that uses simulation to predict mission medical risk. Given a specific mission and crew scenario, medical events are simulated using Monte Carlo methodology to provide estimates of resource utilization, probability of evacuation, probability of loss of crew, and the amount of mission time lost due to illness. Mission and crew scenarios are defined by mission length, extravehicular activity (EVA) schedule, and crew characteristics including: sex, coronary artery calcium score, contacts, dental crowns, history of abdominal surgery, and EVA eligibility. The Integrated Medical Evidence Database (iMED) houses the model inputs for one hundred medical conditions using in-flight, analog, and terrestrial medical data. Inputs include incidence, event durations, resource utilization, and crew functional impairment. Severity of conditions is addressed by defining statistical distributions on the dichotomized best and worst-case scenarios for each condition. The outcome distributions for conditions are bounded by the treatment extremes of the fully treated scenario in which all required resources are available and the untreated scenario in which no required resources are available. Upon occurrence of a simulated medical event, treatment availability is assessed, and outcomes are generated depending on the status of the affected crewmember at the time of onset, including any pre-existing functional impairments or ongoing treatment of concurrent conditions. The main IMM outcomes, including probability of evacuation and loss of crew life, time lost due to medical events, and resource utilization, are useful in informing mission planning decisions. To date, the IMM has been used to assess mission-specific risks with and without certain crewmember characteristics, to determine the impact of eliminating certain resources from the mission medical kit, and to design medical kits that maximally benefit crew health while meeting

  12. Automated feature extraction for 3-dimensional point clouds

    NASA Astrophysics Data System (ADS)

    Magruder, Lori A.; Leigh, Holly W.; Soderlund, Alexander; Clymer, Bradley; Baer, Jessica; Neuenschwander, Amy L.

    2016-05-01

    Light detection and ranging (LIDAR) technology offers the capability to rapidly capture high-resolution, 3-dimensional surface data with centimeter-level accuracy for a large variety of applications. Due to the foliage-penetrating properties of LIDAR systems, these geospatial data sets can detect ground surfaces beneath trees, enabling the production of highfidelity bare earth elevation models. Precise characterization of the ground surface allows for identification of terrain and non-terrain points within the point cloud, and facilitates further discernment between natural and man-made objects based solely on structural aspects and relative neighboring parameterizations. A framework is presented here for automated extraction of natural and man-made features that does not rely on coincident ortho-imagery or point RGB attributes. The TEXAS (Terrain EXtraction And Segmentation) algorithm is used first to generate a bare earth surface from a lidar survey, which is then used to classify points as terrain or non-terrain. Further classifications are assigned at the point level by leveraging local spatial information. Similarly classed points are then clustered together into regions to identify individual features. Descriptions of the spatial attributes of each region are generated, resulting in the identification of individual tree locations, forest extents, building footprints, and 3-dimensional building shapes, among others. Results of the fully-automated feature extraction algorithm are then compared to ground truth to assess completeness and accuracy of the methodology.

  13. Collaborative practice model: Madigan Army Medical Center.

    PubMed

    Nielsen, Peter E; Munroe, Michelle; Foglia, Lisa; Piecek, Roxanne I; Backman, Mary Paul; Cypher, Rebecca; Smith, Denise C

    2012-09-01

    In 2007, Madigan Army Medical Center implemented a new maternity care delivery model, integrating obstetricians and certified nurse-midwives (CNMs) in a collaborative practice. The change was driven by multiple factors, including patient preference, changes in the resident workweek, and low provider satisfaction. This article describes the elements of successful collaboration, including the structure, effective teamwork principles, role of the CNM in resident education, and preliminary data on mode of delivery, the number of CNM-supervised resident births, and procedures, such as episiotomy and epidural use.

  14. Modelling medical care usage under medical insurance scheme for urban non-working residents.

    PubMed

    Xiong, Linping; Tian, Wenhua; Tang, Weidong

    2013-06-01

    This research investigates and evaluates China's urban medical care usage for non-working residents using microsimulation techniques. It focuses on modelling medical services usage and simulating medical expenses on hospitalization treatments as well as clinic services for serious illness in an urban area for the period of 2008-2010. A static microsimulation model was created to project the impact of the medical insurance scheme. Four kinds of achievements have been made. For three different scenarios, the model predicted the hospitalization services costs and payments, as well as the balance of the social pool fund and the medical burden on families.

  15. Integrated Medical Model Verification, Validation, and Credibility

    NASA Technical Reports Server (NTRS)

    Walton, Marlei; Kerstman, Eric; Foy, Millennia; Shah, Ronak; Saile, Lynn; Boley, Lynn; Butler, Doug; Myers, Jerry

    2014-01-01

    The Integrated Medical Model (IMM) was designed to forecast relative changes for a specified set of crew health and mission success risk metrics by using a probabilistic (stochastic process) model based on historical data, cohort data, and subject matter expert opinion. A probabilistic approach is taken since exact (deterministic) results would not appropriately reflect the uncertainty in the IMM inputs. Once the IMM was conceptualized, a plan was needed to rigorously assess input information, framework and code, and output results of the IMM, and ensure that end user requests and requirements were considered during all stages of model development and implementation. METHODS: In 2008, the IMM team developed a comprehensive verification and validation (VV) plan, which specified internal and external review criteria encompassing 1) verification of data and IMM structure to ensure proper implementation of the IMM, 2) several validation techniques to confirm that the simulation capability of the IMM appropriately represents occurrences and consequences of medical conditions during space missions, and 3) credibility processes to develop user confidence in the information derived from the IMM. When the NASA-STD-7009 (7009) was published, the IMM team updated their verification, validation, and credibility (VVC) project plan to meet 7009 requirements and include 7009 tools in reporting VVC status of the IMM. RESULTS: IMM VVC updates are compiled recurrently and include 7009 Compliance and Credibility matrices, IMM VV Plan status, and a synopsis of any changes or updates to the IMM during the reporting period. Reporting tools have evolved over the lifetime of the IMM project to better communicate VVC status. This has included refining original 7009 methodology with augmentation from the NASA-STD-7009 Guidance Document. End user requests and requirements are being satisfied as evidenced by ISS Program acceptance of IMM risk forecasts, transition to an operational model and

  16. [3-dimensional photogrammetry assessment of facial contours].

    PubMed

    Kakoschke, D; Gäbel, H; Schettler, D

    1997-02-01

    In Germany, three-dimensional non-invasive measurement techniques are not in routine use for medical purposes. Completely integrated applications of photogrammetric technology are lacking. The results of clinical examination, X-rays and pre- and postoperative photographs from different angles have been used for medical analysis. In an interdisciplinary research project we tested the general applicability of photogrammetric measurement systems. We examined patients with malformations of the mandible-maxilla complex by taking pictures of the face. In order to assess the surface structure we projected regular patterns onto the surface. We calculated about 500 points on the surface with accuracy better than 0.2 mm. Graphical analyses of measurement results are presented in clinically relevant form. We produce representations of the faces in auto-CAD by means of regular meshes which allow views from any perspective, longitudinal and lateral sections. In addition to calculating angles, distances, surfaces and volumes, visualisation of shape is a useful aid in documentation and quantification of changes of soft tissue of the human face under surgery treatment.

  17. Chaotic Advection in a Bounded 3-Dimensional Potential Flow

    NASA Astrophysics Data System (ADS)

    Metcalfe, Guy; Smith, Lachlan; Lester, Daniel

    2012-11-01

    3-dimensional potential, or Darcy flows, are central to understanding and designing laminar transport in porous media; however, chaotic advection in 3-dimensional, volume-preserving flows is still not well understood. We show results of advecting passive scalars in a transient 3-dimensional potential flow that consists of a steady dipole flow and periodic reorientation. Even for the most symmetric reorientation protocol, neither of the two invarients of the motion are conserved; however, one invarient is closely shadowed by a surface of revolution constructed from particle paths of the steady flow, creating in practice an adiabatic surface. A consequence is that chaotic regions cover 3-dimensional space, though tubular regular regions are still transport barriers. This appears to be a new mechanism generating 3-dimensional chaotic orbits. These results contast with the experimental and theoretical results for chaotic scalar transport in 2-dimensional Darcy flows. Wiggins, J. Fluid Mech. 654 (2010).

  18. The Integrated Medical Model: A Risk Assessment and Decision Support Tool for Space Flight Medical Systems

    NASA Technical Reports Server (NTRS)

    Kerstman, Eric; Minard, Charles; Saile, Lynn; deCarvalho, Mary Freire; Myers, Jerry; Walton, Marlei; Butler, Douglas; Iyengar, Sriram; Johnson-Throop, Kathy; Baumann, David

    2009-01-01

    The Integrated Medical Model (IMM) is a decision support tool that is useful to mission planners and medical system designers in assessing risks and designing medical systems for space flight missions. The IMM provides an evidence based approach for optimizing medical resources and minimizing risks within space flight operational constraints. The mathematical relationships among mission and crew profiles, medical condition incidence data, in-flight medical resources, potential crew functional impairments, and clinical end-states are established to determine probable mission outcomes. Stochastic computational methods are used to forecast probability distributions of crew health and medical resource utilization, as well as estimates of medical evacuation and loss of crew life. The IMM has been used in support of the International Space Station (ISS) medical kit redesign, the medical component of the ISS Probabilistic Risk Assessment, and the development of the Constellation Medical Conditions List. The IMM also will be used to refine medical requirements for the Constellation program. The IMM outputs for ISS and Constellation design reference missions will be presented to demonstrate the potential of the IMM in assessing risks, planning missions, and designing medical systems. The implementation of the IMM verification and validation plan will be reviewed. Additional planned capabilities of the IMM, including optimization techniques and the inclusion of a mission timeline, will be discussed. Given the space flight constraints of mass, volume, and crew medical training, the IMM is a valuable risk assessment and decision support tool for medical system design and mission planning.

  19. 3DIVS: 3-Dimensional Immersive Virtual Sculpting

    SciTech Connect

    Kuester, F; Duchaineau, M A; Hamann, B; Joy, K I; Uva, A E

    2001-10-03

    Virtual Environments (VEs) have the potential to revolutionize traditional product design by enabling the transition from conventional CAD to fully digital product development. The presented prototype system targets closing the ''digital gap'' as introduced by the need for physical models such as clay models or mockups in the traditional product design and evaluation cycle. We describe a design environment that provides an intuitive human-machine interface for the creation and manipulation of three-dimensional (3D) models in a semi-immersive design space, focusing on ease of use and increased productivity for both designer and CAD engineers.

  20. Medical Surveillance System & Medical Effect Modeling Thrust Areas

    DTIC Science & Technology

    2007-06-01

    Equations ( PFE ) developed for this project model physiological systems in biological organisms as 1D liquid or gas flows. Special attention is given...in the model to capturing 2D viscous effects and branching effects. Multiple PFE representations of physiological systems (e.g. the respiratory and

  1. Casualty modeling for real-time medical training.

    PubMed

    Chi, D M; Clarke, J R; Webber, B L; Badler, N I

    1996-01-01

    We present a model for simulating casualties in virtual environments for real-time medical training. It allows a user to choose diagnostic and therapeutic actions to carry out on a simulated casualty who will manifest appropriate physiological, behavioral, and physical responses. Currently, the user or a "stealth instructor" can specify one or more injuries that the casualty has sustained. The model responds by continuously determining the state of the casualty, responding appropriately to medical assessment and treatment procedures. So far, we have modeled four medical conditions and over 20 procedures. The model has been designed to handle the addition of other injuries and medical procedures.

  2. A Flexible Model for Correlated Medical Costs, with Application to Medical Expenditure Panel Survey Data

    PubMed Central

    Chen, Jinsong; Liu, Lei; Shih, Ya-Chen T.; Zhang, Daowen; Severini, Thomas A.

    2016-01-01

    We propose a flexible model for correlated medical cost data with several appealing features. First, the mean function is partially linear. Second, the distributional form for the response is not specified. Third, the covariance structure of correlated medical costs has a semiparametric form. We use extended generalized estimating equations to simultaneously estimate all parameters of interest. B-splines is used to estimate unknown functions, and a modification to Akaike Information Criterion is proposed for selecting knots in spline bases. We apply the model to correlated medical costs in the Medical Expenditure Panel Survey (MEPS) dataset. Simulation studies are conducted to assess the performance of our method. PMID:26403805

  3. A flexible model for correlated medical costs, with application to medical expenditure panel survey data.

    PubMed

    Chen, Jinsong; Liu, Lei; Shih, Ya-Chen T; Zhang, Daowen; Severini, Thomas A

    2016-03-15

    We propose a flexible model for correlated medical cost data with several appealing features. First, the mean function is partially linear. Second, the distributional form for the response is not specified. Third, the covariance structure of correlated medical costs has a semiparametric form. We use extended generalized estimating equations to simultaneously estimate all parameters of interest. B-splines are used to estimate unknown functions, and a modification to Akaike information criterion is proposed for selecting knots in spline bases. We apply the model to correlated medical costs in the Medical Expenditure Panel Survey dataset. Simulation studies are conducted to assess the performance of our method.

  4. Invasive 3-Dimensional Organotypic Neoplasia from Multiple Normal Human Epithelia

    PubMed Central

    Ridky, Todd W.; Chow, Jennifer M.; Wong, David J.; Khavari, Paul A.

    2013-01-01

    Refined cancer models are required to assess the burgeoning number of potential targets for cancer therapeutics within a rapid and clinically relevant context. Here we utilize tumor-associated genetic pathways to transform primary human epithelial cells from epidermis, oropharynx, esophagus, and cervix into genetically defined tumors within a human 3-dimensional (3-D) tissue environment incorporating cell-populated stroma and intact basement membrane. These engineered organotypic tissues recapitulated natural features of tumor progression, including epithelial invasion through basement membrane, a complex process critically required for biologic malignancy in 90% of human cancers. Invasion was rapid, and potentiated by stromal cells. Oncogenic signals in 3-D tissue, but not 2-D culture, resembled gene expression profiles from spontaneous human cancers. Screening well-characterized signaling pathway inhibitors in 3-D organotypic neoplasia helped distil a clinically faithful cancer gene signature. Multi-tissue 3-D human tissue cancer models may provide an efficient and relevant complement to current approaches to characterize cancer progression. PMID:21102459

  5. Development of a career coaching model for medical students

    PubMed Central

    Hur, Yera

    2016-01-01

    Purpose: Deciding on a future career path or choosing a career specialty is an important academic decision for medical students. The purpose of this study is to develop a career coaching model for medical students. Methods: This research was carried out in three steps. The first step was systematic review of previous studies. The second step was a need assessment of medical students. The third step was a career coaching model using the results acquired from the researched literature and the survey. Results: The career coaching stages were defined as three big phases: The career coaching stages were defined as the “crystallization” period (Pre-medical year 1 and 2), “specification” period (medical year 1 and 2), and “implementation” period (medical year 3 and 4). Conclusion: The career coaching model for medical students can be used in programming career coaching contents and also in identifying the outcomes of career coaching programs at an institutional level. PMID:26867586

  6. A Model for Enhancing Internet Medical Document Retrieval with “Medical Core Metadata”

    PubMed Central

    Malet, Gary; Munoz, Felix; Appleyard, Richard; Hersh, William

    1999-01-01

    Objective: Finding documents on the World Wide Web relevant to a specific medical information need can be difficult. The goal of this work is to define a set of document content description tags, or metadata encodings, that can be used to promote disciplined search access to Internet medical documents. Design: The authors based their approach on a proposed metadata standard, the Dublin Core Metadata Element Set, which has recently been submitted to the Internet Engineering Task Force. Their model also incorporates the National Library of Medicine's Medical Subject Headings (MeSH) vocabulary and Medline-type content descriptions. Results: The model defines a medical core metadata set that can be used to describe the metadata for a wide variety of Internet documents. Conclusions: The authors propose that their medical core metadata set be used to assign metadata to medical documents to facilitate document retrieval by Internet search engines. PMID:10094069

  7. A Seafloor Benchmark for 3-dimensional Geodesy

    NASA Astrophysics Data System (ADS)

    Chadwell, C. D.; Webb, S. C.; Nooner, S. L.

    2014-12-01

    We have developed an inexpensive, permanent seafloor benchmark to increase the longevity of seafloor geodetic measurements. The benchmark provides a physical tie to the sea floor lasting for decades (perhaps longer) on which geodetic sensors can be repeatedly placed and removed with millimeter resolution. Global coordinates estimated with seafloor geodetic techniques will remain attached to the benchmark allowing for the interchange of sensors as they fail or become obsolete, or for the sensors to be removed and used elsewhere, all the while maintaining a coherent series of positions referenced to the benchmark. The benchmark has been designed to free fall from the sea surface with transponders attached. The transponder can be recalled via an acoustic command sent from the surface to release from the benchmark and freely float to the sea surface for recovery. The duration of the sensor attachment to the benchmark will last from a few days to a few years depending on the specific needs of the experiment. The recovered sensors are then available to be reused at other locations, or again at the same site in the future. Three pins on the sensor frame mate precisely and unambiguously with three grooves on the benchmark. To reoccupy a benchmark a Remotely Operated Vehicle (ROV) uses its manipulator arm to place the sensor pins into the benchmark grooves. In June 2014 we deployed four benchmarks offshore central Oregon. We used the ROV Jason to successfully demonstrate the removal and replacement of packages onto the benchmark. We will show the benchmark design and its operational capabilities. Presently models of megathrust slip within the Cascadia Subduction Zone (CSZ) are mostly constrained by the sub-aerial GPS vectors from the Plate Boundary Observatory, a part of Earthscope. More long-lived seafloor geodetic measures are needed to better understand the earthquake and tsunami risk associated with a large rupture of the thrust fault within the Cascadia subduction zone

  8. Preventable Medical Errors Driven Modeling of Medical Best Practice Guidance Systems.

    PubMed

    Ou, Andrew Y-Z; Jiang, Yu; Wu, Po-Liang; Sha, Lui; Berlin, Richard B

    2017-01-01

    In a medical environment such as Intensive Care Unit, there are many possible reasons to cause errors, and one important reason is the effect of human intellectual tasks. When designing an interactive healthcare system such as medical Cyber-Physical-Human Systems (CPHSystems), it is important to consider whether the system design can mitigate the errors caused by these tasks or not. In this paper, we first introduce five categories of generic intellectual tasks of humans, where tasks among each category may lead to potential medical errors. Then, we present an integrated modeling framework to model a medical CPHSystem and use UPPAAL as the foundation to integrate and verify the whole medical CPHSystem design models. With a verified and comprehensive model capturing the human intellectual tasks effects, we can design a more accurate and acceptable system. We use a cardiac arrest resuscitation guidance and navigation system (CAR-GNSystem) for such medical CPHSystem modeling. Experimental results show that the CPHSystem models help determine system design flaws and can mitigate the potential medical errors caused by the human intellectual tasks.

  9. Medical Models for Teachers' Learning: Asking for a Second Opinion

    ERIC Educational Resources Information Center

    Philpott, Carey

    2017-01-01

    Recently there has been renewed interest in basing teachers' professional learning on medically derived models. This interest has included clinical practice models and evidence-based teaching as well as the use of various forms of "Rounds" which claim to derive from medical rounds. However, many arguing for these approaches may well not…

  10. Medical record review conduction model for improving interrater reliability of abstracting medical-related information.

    PubMed

    Engel, Lisa; Henderson, Courtney; Fergenbaum, Jennifer; Colantonio, Angela

    2009-09-01

    Medical record review (MRR) is often used in clinical research and evaluation, yet there is limited literature regarding best practices in conducting a MRR, and there are few studies reporting interrater reliability (IRR) from MRR data. The aim of this research was twofold: (a) to develop a MRR abstraction tool and standardize the MRR process and (b) to examine the IRR from MRR data. This study introduces the MRR-Conduction Model, which was used to implement a MRR, and examines the IRR between two abstractors who collected preinjury medical and psychiatric, incident-related medical and postinjury head symptom information from the medical records of 47 neurologically injured workers. Results showed that the percentage agreement was > or =85% and the unweighted kappa statistic was > or =.60 for most variables, indicating substantial IRR. An effective and reliable MRR to abstract medical-related information requires planning and time. The MRR-Conduction Model is proposed to guide the process of creating a MRR.

  11. 3-Dimensional wireless sensor network localization: A review

    NASA Astrophysics Data System (ADS)

    Najib, Yasmeen Nadhirah Ahmad; Daud, Hanita; Aziz, Azrina Abd; Razali, Radzuan

    2016-11-01

    The proliferation of wireless sensor network (WSN) has shifted the focus to 3-Dimensional geometry rather than 2-Dimensional geometry. Since exact location of sensors has been the fundamental issue in wireless sensor network, node localization is essential for any wireless sensor network applications. Most algorithms mainly focus on 2-Dimensional geometry, where the application of this algorithm will decrease the accuracy on 3-Dimensional geometry. The low rank attribute in WSN's node estimation makes the application of nuclear norm minimization as a viable solution for dimensionality reduction problems. This research proposes a novel localization algorithm for 3-Dimensional WSN which is nuclear norm minimization. The node localization is formulated via Euclidean Distance Matrix (EDM) and is then optimized using Nuclear-Norm Minimization (NNM).

  12. Analyses of medical data models - identifying common concepts and items in a repository of medical forms.

    PubMed

    Breil, Bernhard; Dugas, Martin

    2013-01-01

    One year ago the portal of Medical Data Models (http://medical-data-models.org) was presented as a resource for the scientific community. As of November 2012 there are approximately 3,300 forms with 102,000 items available in the CDISC ODM format. First descriptive analyses regarding form metadata demonstrate the capability of such a repository to identify commonly used medical concepts. Most common items are administrative attributes which indicates that more clinical information are needed to increase the secondary use of data documented within these forms.

  13. Modelling Medications for Public Health Research

    PubMed Central

    van Gaans, D.; Ahmed, S.; D’Onise, K.; Moyon, J.; Caughey, G.; McDermott, R.

    2016-01-01

    Most patients with chronic disease are prescribed multiple medications, which are recorded in their personal health records. This is rich information for clinical public health researchers but also a challenge to analyse. This paper describes the method that was undertaken within the Public Health Research Data Management System (PHReDMS) to map medication data retrieved from individual patient health records for population health researcher’s use. The PHReDMS manages clinical, health service, community and survey research data within a secure web environment that allows for data sharing amongst researchers. The PHReDMS is currently used by researchers to answer a broad range of questions, including monitoring of prescription patterns in different population groups and geographic areas with high incidence/prevalence of chronic renal, cardiovascular, metabolic and mental health issues. In this paper, we present the general notion of abstraction network, a higher level network that sits above a terminology and offers compact and more easily understandable view of its content. We demonstrate the utilisation of abstraction network methodology to examine medication data from electronic medical records to allow a compact and more easily understandable view of its content. PMID:28149446

  14. The 3-dimensional construction of the Rae craton, central Canada

    NASA Astrophysics Data System (ADS)

    Snyder, David B.; Craven, James A.; Pilkington, Mark; Hillier, Michael J.

    2015-10-01

    Reconstruction of the 3-dimensional tectonic assembly of early continents, first as Archean cratons and then Proterozoic shields, remains poorly understood. In this paper, all readily available geophysical and geochemical data are assembled in a 3-D model with the most accurate bedrock geology in order to understand better the geometry of major structures within the Rae craton of central Canada. Analysis of geophysical observations of gravity and seismic wave speed variations revealed several lithospheric-scale discontinuities in physical properties. Where these discontinuities project upward to correlate with mapped upper crustal geological structures, the discontinuities can be interpreted as shear zones. Radiometric dating of xenoliths provides estimates of rock types and ages at depth beneath sparse kimberlite occurrences. These ages can also be correlated to surface rocks. The 3.6-2.6 Ga Rae craton comprises at least three smaller continental terranes, which "cratonized" during a granitic bloom. Cratonization probably represents final differentiation of early crust into a relatively homogeneous, uniformly thin (35-42 km), tonalite-trondhjemite-granodiorite crust with pyroxenite layers near the Moho. The peak thermotectonic event at 1.86-1.7 Ga was associated with the Hudsonian orogeny that assembled several cratons and lesser continental blocks into the Canadian Shield using a number of southeast-dipping megathrusts. This orogeny metasomatized, mineralized, and recrystallized mantle and lower crustal rocks, apparently making them more conductive by introducing or concentrating sulfides or graphite. Little evidence exists of thin slabs similar to modern oceanic lithosphere in this Precambrian construction history whereas underthrusting and wedging of continental lithosphere is inferred from multiple dipping discontinuities.

  15. Micmac medical student becomes role model for his community.

    PubMed

    Robb, N

    1997-01-01

    When Robert Johnson graduates from medical school in 1998, he will become Canada's first Micmac physician. For him, going to medical school is a major responsibility because he is a role model for an entire community. He hopes he is only the first of many Micmacs to make this career choice.

  16. Micmac medical student becomes role model for his community

    PubMed Central

    Robb, N

    1997-01-01

    When Robert Johnson graduates from medical school in 1998, he will become Canada's first Micmac physician. For him, going to medical school is a major responsibility because he is a role model for an entire community. He hopes he is only the first of many Micmacs to make this career choice. PMID:9006570

  17. Expanded Medical Home Model Works for Children in Foster Care

    ERIC Educational Resources Information Center

    Jaudes, Paula Kienberger; Champagne, Vince; Harden, Allen; Masterson, James; Bilaver, Lucy A.

    2012-01-01

    The Illinois Child Welfare Department implemented a statewide health care system to ensure that children in foster care obtain quality health care by providing each child with a medical home. This study demonstrates that the Medical Home model works for children in foster care providing better health outcomes in higher immunization rates. These…

  18. Medical Specialty Decision Model: Utilizing Social Cognitive Career Theory

    ERIC Educational Resources Information Center

    Gibson, Denise D.; Borges, Nicole J.

    2004-01-01

    Objectives: The purpose of this study was to develop a working model to explain medical specialty decision-making. Using Social Cognitive Career Theory, we examined personality, medical specialty preferences, job satisfaction, and expectations about specialty choice to create a conceptual framework to guide specialty choice decision-making.…

  19. Four Models of Medical Education about Elder Mistreatment.

    ERIC Educational Resources Information Center

    Heath, John M.; Dyer, Carmel B.; Kerzner, Lawrence J.; Mosqueda, Laura; Murphy, Carole

    2002-01-01

    Describe four models of incorporating elder-mistreatment curriculum and collaboration with adult protective services into geriatrics medical education. Draws on efforts at the University of Medicine and Dentistry of New Jersey--Robert Wood Johnson Medical School; the University of California, Irvine College of Medicine; Hennepin County Medical…

  20. Differential Cross Section Kinematics for 3-dimensional Transport Codes

    NASA Technical Reports Server (NTRS)

    Norbury, John W.; Dick, Frank

    2008-01-01

    In support of the development of 3-dimensional transport codes, this paper derives the relevant relativistic particle kinematic theory. Formulas are given for invariant, spectral and angular distributions in both the lab (spacecraft) and center of momentum frames, for collisions involving 2, 3 and n - body final states.

  1. A Medication Safety Model: A Case Study in Thai Hospital

    PubMed Central

    Rattanarojsakul, Phichai; Thawesaengskulthai, Natcha

    2013-01-01

    Reaching zero defects is vital in medication service. Medication error can be reduced if the causes are recognized. The purpose of this study is to search for a conceptual framework of the causes of medication error in Thailand and to examine relationship between these factors and its importance. The study was carried out upon an in-depth case study and survey of hospital personals who were involved in the drug use process. The structured survey was based on Emergency Care Research Institute (ECRI) (2008) questionnaires focusing on the important factors that affect the medication safety. Additional questionnaires included content to the context of Thailand's private hospital, validated by five-hospital qualified experts. By correlation Pearson analysis, the result revealed 14 important factors showing a linear relationship with drug administration error except the medication reconciliation. By independent sample t-test, the administration error in the hospital was significantly related to external impact. The multiple regression analysis of the detail of medication administration also indicated the patient identification before administration of medication, detection of the risk of medication adverse effects and assurance of medication administration at the right time, dosage and route were statistically significant at 0.05 level. The major implication of the study is to propose a medication safety model in a Thai private hospital. PMID:23985110

  2. [Models and practical games in training the medical service officers to control the medical care quality].

    PubMed

    Kartashov, V T; Romanovskiĭ, V V

    2006-02-01

    The 3-component structure of the model of medical service quality (MSQ) control is proposed. The model reflects the functional dependence of qualitative parameters of military treatment-and-prophylactic institutions' (TPI) activities: Qn = f(Rn, Mn), where the independent variables are the following: Rn is the provision of n-TPI with resources, Mn is the level of administrative activities and Qn function is MSQ. It allows transferring to information-and-analytical modeling of TPI as the triad of indices that reflect the resource quality (cadre, financial, material and technical), management and medical-and-statistical indices of medical service quality. For each of the model's component the information-and-analytical indices and criteria of their assessment are proposed. The scenario of practical games is based on abovementioned peculiarities of the model and consists of logically interconnected and successively solved situational problems. The methods and problems described can be used during medical service officers' training, for studying TPI physicians, in educational process of some departments of military medical higher schools. The specific feature of proposed models and methods is their applicability both in educational process and in practical work.

  3. A critical evaluation of secondary cancer risk models applied to Monte Carlo dose distributions of 2-dimensional, 3-dimensional conformal and hybrid intensity-modulated radiation therapy for breast cancer

    NASA Astrophysics Data System (ADS)

    Joosten, A.; Bochud, F.; Moeckli, R.

    2014-08-01

    The comparison of radiotherapy techniques regarding secondary cancer risk has yielded contradictory results possibly stemming from the many different approaches used to estimate risk. The purpose of this study was to make a comprehensive evaluation of different available risk models applied to detailed whole-body dose distributions computed by Monte Carlo for various breast radiotherapy techniques including conventional open tangents, 3D conformal wedged tangents and hybrid intensity modulated radiation therapy (IMRT). First, organ-specific linear risk models developed by the International Commission on Radiological Protection (ICRP) and the Biological Effects of Ionizing Radiation (BEIR) VII committee were applied to mean doses for remote organs only and all solid organs. Then, different general non-linear risk models were applied to the whole body dose distribution. Finally, organ-specific non-linear risk models for the lung and breast were used to assess the secondary cancer risk for these two specific organs. A total of 32 different calculated absolute risks resulted in a broad range of values (between 0.1% and 48.5%) underlying the large uncertainties in absolute risk calculation. The ratio of risk between two techniques has often been proposed as a more robust assessment of risk than the absolute risk. We found that the ratio of risk between two techniques could also vary substantially considering the different approaches to risk estimation. Sometimes the ratio of risk between two techniques would range between values smaller and larger than one, which then translates into inconsistent results on the potential higher risk of one technique compared to another. We found however that the hybrid IMRT technique resulted in a systematic reduction of risk compared to the other techniques investigated even though the magnitude of this reduction varied substantially with the different approaches investigated. Based on the epidemiological data available, a reasonable

  4. Students are not customers: a better model for medical education.

    PubMed

    Albanese, M

    1999-11-01

    The author argues that the student-as-customer model of medical education has many failings that result in interactions that are educationally dysfunctional. Ten "pathologies" resulting from the adoption of this model are presented (e.g., "The student-customer model seduces students into believing that they know what is best for them"). Part of the reason for the unprofessional conduct often demonstrated by students and faculty alike may be a result of the influence of this model on medical education and the consequent inappropriate empowerment of students in the role of customers, the diminishment of faculty in the role of workers who provide instruction, and the view that instruction is the service or product of medical education. The author proposes a new model of medical education in which faculty are managers of instruction, students are learning workers, the product is successful learning, and the customers are faculty, residency supervisors, patients, managed care organizations, and society. The implications of this new model are profound and are described in terms of Deming's 14 principles for achieving quality in business. The author maintains that the proposed model is the critical first step in clarifying and identifying the proper roles of all those involved in the medical education process, which in turn will diminish or eliminate the pathologies that currently plague medical education and lead to the achievement of real quality.

  5. Medical Countermeasure Models. Volume 8. Botulinum Neurotoxin

    DTIC Science & Technology

    2013-04-12

    were treated with antibiotics , 5,000 would be entered as identical treated individuals and 5,000 would be entered as identical untreated individuals...toxin as a biological weapon.” Journal of the American Medical Association. 285(1059). 2001. 24 Tacket CO et al. “ Equine Antitoxin Use and Other...antitoxin available for non-infant cases of botulism in the United States.69,70 HBAT, an equine antitoxin, targets BoNT serotypes A, B, C, D, E, F and G

  6. FMEA: a model for reducing medical errors.

    PubMed

    Chiozza, Maria Laura; Ponzetti, Clemente

    2009-06-01

    Patient safety is a management issue, in view of the fact that clinical risk management has become an important part of hospital management. Failure Mode and Effect Analysis (FMEA) is a proactive technique for error detection and reduction, firstly introduced within the aerospace industry in the 1960s. Early applications in the health care industry dating back to the 1990s included critical systems in the development and manufacture of drugs and in the prevention of medication errors in hospitals. In 2008, the Technical Committee of the International Organization for Standardization (ISO), licensed a technical specification for medical laboratories suggesting FMEA as a method for prospective risk analysis of high-risk processes. Here we describe the main steps of the FMEA process and review data available on the application of this technique to laboratory medicine. A significant reduction of the risk priority number (RPN) was obtained when applying FMEA to blood cross-matching, to clinical chemistry analytes, as well as to point-of-care testing (POCT).

  7. A Model of Medical Countermeasures for Organophosphates

    DTIC Science & Technology

    2015-10-01

    Animal Data ................................................................. 51 6.2.1. Verifying AChE Activity...28 Table 5-2. Rate Constants for Three OPs Considered in the Animal Injury Model ..................... 29 Table 5...model OP injury and to be able to compare output to available animal data, we modeled the route of exposure for the OP. We account for three different

  8. Molecular Signatures in the Prevention of Radiation Damage by the Synergistic Effect of N-Acetyl Cysteine and Qingre Liyan Decoction, a Traditional Chinese Medicine, Using a 3-Dimensional Cell Culture Model of Oral Mucositis

    PubMed Central

    Lambros, Maria P.; Kondapalli, Lavanya; Parsa, Cyrus; Mulamalla, Hari Chandana; Orlando, Robert; Pon, Doreen; Huang, Ying; Chow, Moses S. S.

    2015-01-01

    Qingre Liyan decoction (QYD), a Traditional Chinese medicine, and N-acetyl cysteine (NAC) have been used to prevent radiation induced mucositis. This work evaluates the protective mechanisms of QYD, NAC, and their combination (NAC-QYD) at the cellular and transcriptional level. A validated organotypic model of oral mucosal consisting of a three-dimensional (3D) cell tissue-culture of primary human keratinocytes exposed to X-ray irradiation was used. Six hours after the irradiation, the tissues were evaluated by hematoxylin and eosin (H and E) and a TUNEL assay to assess histopathology and apoptosis, respectively. Total RNA was extracted and used for microarray gene expression profiling. The tissue-cultures treated with NAC-QYD preserved their integrity and showed no apoptosis. Microarray results revealed that the NAC-QYD caused the upregulation of genes encoding metallothioneins, HMOX1, and other components of the Nrf2 pathway, which protects against oxidative stress. DNA repair genes (XCP, GADD45G, RAD9, and XRCC1), protective genes (EGFR and PPARD), and genes of the NFκB pathway were upregulated. Finally, tissue-cultures treated prophylactically with NAC-QYD showed significant downregulation of apoptosis, cytokines and chemokines genes, and constrained damage-associated molecular patterns (DAMPs). NAC-QYD treatment involves the protective effect of Nrf2, NFκB, and DNA repair factors. PMID:25705238

  9. Contribution of seismic processing to put up the scaffolding for the 3-dimensional study of deep sedimentary basins: the fundaments of trans-national 3D modelling in the project GeoMol

    NASA Astrophysics Data System (ADS)

    Capar, Laure

    2013-04-01

    Within the framework of the transnational project GeoMol geophysical and geological information on the entire Molasse Basin and on the Po Basin are gathered to build consistent cross-border 3D geological models based on borehole evidence and seismic data. Benefiting from important progress in seismic processing, these new models will provide some answers to various questions regarding the usage of subsurface resources, as there are geothermal energy, CO2 and gas storage, oil and gas production, and support decisions-making to national and local administrations as well as to industries. More than 28 000 km of 2D seismic lines are compiled reprocessed and harmonized. This work faces various problems like the vertical drop of more than 700 meters between West and East of the Molasse Basin and to al lesser extent in the Po Plain, the heterogeneities of the substratum, the large disparities between the period and parameters of seismic acquisition, and depending of their availability, the use of two types of seismic data, raw and processed seismic data. The main challenge is to harmonize all lines at the same reference level, amplitude and step of signal processing from France to Austria, spanning more than 1000 km, to avoid misfits at crossing points between seismic lines and artifacts at the country borders, facilitating the interpretation of the various geological layers in the Molasse Basin and Po Basin. A generalized stratigraphic column for the two basins is set up, representing all geological layers relevant to subsurface usage. This stratigraphy constitutes the harmonized framework for seismic reprocessing. In general, processed seismic data is available on paper at stack stage and the mandatory information to take these seismic lines to the final stage of processing, the migration step, are datum plane and replacement velocity. However several datum planes and replacement velocities were used during previous processing projects. Our processing sequence is to

  10. Organizational Models of Medical School Relationships to the Clinical Enterprise.

    ERIC Educational Resources Information Center

    Culbertson, Richard A.; And Others

    1996-01-01

    Analyzed existing relationships between medical schools and clinical enterprises to develop models of these relationships. Four conceptual models were identified: (1) "single ownership, owned integrated system"; (2) "general partner"; (3) "limited partner"; and (4) "wholly owned, subsidiary." The advantages and disadvantages of each model are…

  11. Sleep Disruption Medical Intervention Forecasting (SDMIF) Module for the Integrated Medical Model

    NASA Technical Reports Server (NTRS)

    Lewandowski, Beth; Brooker, John; Mallis, Melissa; Hursh, Steve; Caldwell, Lynn; Myers, Jerry

    2011-01-01

    The NASA Integrated Medical Model (IMM) assesses the risk, including likelihood and impact of occurrence, of all credible in-flight medical conditions. Fatigue due to sleep disruption is a condition that could lead to operational errors, potentially resulting in loss of mission or crew. Pharmacological consumables are mitigation strategies used to manage the risks associated with sleep deficits. The likelihood of medical intervention due to sleep disruption was estimated with a well validated sleep model and a Monte Carlo computer simulation in an effort to optimize the quantity of consumables. METHODS: The key components of the model are the mission parameter program, the calculation of sleep intensity and the diagnosis and decision module. The mission parameter program was used to create simulated daily sleep/wake schedules for an ISS increment. The hypothetical schedules included critical events such as dockings and extravehicular activities and included actual sleep time and sleep quality. The schedules were used as inputs to the Sleep, Activity, Fatigue and Task Effectiveness (SAFTE) Model (IBR Inc., Baltimore MD), which calculated sleep intensity. Sleep data from an ISS study was used to relate calculated sleep intensity to the probability of sleep medication use, using a generalized linear model for binomial regression. A human yes/no decision process using a binomial random number was also factored into sleep medication use probability. RESULTS: These probability calculations were repeated 5000 times resulting in an estimate of the most likely amount of sleep aids used during an ISS mission and a 95% confidence interval. CONCLUSIONS: These results were transferred to the parent IMM for further weighting and integration with other medical conditions, to help inform operational decisions. This model is a potential planning tool for ensuring adequate sleep during sleep disrupted periods of a mission.

  12. 3-dimensional (3D) fabricated polymer based drug delivery systems.

    PubMed

    Moulton, Simon E; Wallace, Gordon G

    2014-11-10

    Drug delivery from 3-dimensional (3D) structures is a rapidly growing area of research. It is essential to achieve structures wherein drug stability is ensured, the drug loading capacity is appropriate and the desired controlled release profile can be attained. Attention must also be paid to the development of appropriate fabrication machinery that allows 3D drug delivery systems (DDS) to be produced in a simple, reliable and reproducible manner. The range of fabrication methods currently being used to form 3D DDSs include electrospinning (solution and melt), wet-spinning and printing (3-dimensional). The use of these techniques enables production of DDSs from the macro-scale down to the nano-scale. This article reviews progress in these fabrication techniques to form DDSs that possess desirable drug delivery kinetics for a wide range of applications.

  13. Modeling Medical Ethics through Intelligent Agents

    NASA Astrophysics Data System (ADS)

    Machado, José; Miranda, Miguel; Abelha, António; Neves, José; Neves, João

    The amount of research using health information has increased dramatically over the last past years. Indeed, a significative number of healthcare institutions have extensive Electronic Health Records (EHR), collected over several years for clinical and teaching purposes, but are uncertain as to the proper circumstances in which to use them to improve the delivery of care to the ones in need. Research Ethics Boards in Portugal and elsewhere in the world are grappling with these issues, but lack clear guidance regarding their role in the creation of and access to EHRs. However, we feel we have an effective way to handle Medical Ethics if we look to the problem under a structured and more rational way. Indeed, we felt that physicians were not aware of the relevance of the subject in their pre-clinical years, but their interest increase when they were exposed to patients. On the other hand, once EHRs are stored in machines, we also felt that we had to find a way to ensure that the behavior of machines toward human users, and perhaps other machines as well, is ethically acceptable. Therefore, in this article we discuss the importance of machine ethics and the need for machines that represent ethical principles explicitly. It is also shown how a machine may abstract an ethical principle from a logical representation of ethical judgments and use that principle to guide its own behavior.

  14. 3-Dimensional modeling of protein structures distinguishes closely related phytoplasmas

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Phytoplasmas (formerly mycoplasmalike organisms, MLOs) are cell wall-less bacteria that inhabit phloem tissue of plants and are transmitted from plant-to-plant by phloem-feeding insects. Numerous diseases affecting hundreds of plant species in many botanical families are attributed to infections by...

  15. [Medical product designing model for the "BOP" in China].

    PubMed

    Jiang, Xie-hui; Yan, Zhuang-zhi; Shi, Jun; Wanigasekara, N R

    2006-01-01

    China has a large population under the average economy. This group of people is often referred to those at the Bottom of the Pyramid (BOP). In order to meet their special medical needs, this paper is to discuss a topic on how to create medical products for the "BOP" in China, especially under sustainable developments based on the investigation and analysis in Shanghai. Also, a new possible development model including the government's support, knowledge exchange and communication is introduced.

  16. Using Modeling to Predict Medical Requirements for Special Operations Missions

    DTIC Science & Technology

    2008-07-30

    military force. Information operations involve adversely affecting the information systems of an adversary.1 Many of these missions are joint...Medical System . In 2007, the Air Force asked NHRC to conduct another proof-of-concept study to demonstrate the benefits of modeling medical supply...are used for this purpose. (NHRC is currently in the process of matching these patient conditions to International Classification of Diseases codes

  17. Optimization Routine for Generating Medical Kits for Spaceflight Using the Integrated Medical Model

    NASA Technical Reports Server (NTRS)

    Graham, Kimberli; Myers, Jerry; Goodenow, Deb

    2017-01-01

    The Integrated Medical Model (IMM) is a MATLAB model that provides probabilistic assessment of the medical risk associated with human spaceflight missions.Different simulations or profiles can be run in which input conditions regarding both mission characteristics and crew characteristics may vary. For each simulation, the IMM records the total medical events that occur and “treats” each event with resources drawn from import scripts. IMM outputs include Total Medical Events (TME), Crew Health Index (CHI), probability of Evacuation (pEVAC), and probability of Loss of Crew Life (pLOCL).The Crew Health Index is determined by the amount of quality time lost (QTL). Previously, an optimization code was implemented in order to efficiently generate medical kits. The kits were optimized to have the greatest benefit possible, given amass and/or volume constraint. A 6-crew, 14-day lunar mission was chosen for the simulation and run through the IMM for 100,000 trials. A built-in MATLAB solver, mixed-integer linear programming, was used for the optimization routine. Kits were generated in 10% increments ranging from 10%-100% of the benefit constraints. Conditions wheremass alone was minimized, volume alone was minimized, and where mass and volume were minimizedjointly were tested.

  18. Revisiting "Discrepancy Analysis in Continuing Medical Education: A Conceptual Model"

    ERIC Educational Resources Information Center

    Fox, Robert D.

    2011-01-01

    Based upon a review and analysis of selected literature, the author presents a conceptual model of discrepancy analysis evaluation for planning, implementing, and assessing the impact of continuing medical education (CME). The model is described in terms of its value as a means of diagnosing errors in the development and implementation of CME. The…

  19. Students Are Not Customers: A Better Model for Medical Education.

    ERIC Educational Resources Information Center

    Albanese, Mark

    1999-01-01

    Argues that the student-as-customer model of medical education has many failings that result in educationally dysfunctional interactions. Proposes a new model (based on Deming's 14 principles for quality in business) in which faculty are managers of instruction, students are learning workers, the product is successful learning, and the customers…

  20. Medical Device Integration Model Based on the Internet of Things

    PubMed Central

    Hao, Aiyu; Wang, Ling

    2015-01-01

    At present, hospitals in our country have basically established the HIS system, which manages registration, treatment, and charge, among many others, of patients. During treatment, patients need to use medical devices repeatedly to acquire all sorts of inspection data. Currently, the output data of the medical devices are often manually input into information system, which is easy to get wrong or easy to cause mismatches between inspection reports and patients. For some small hospitals of which information construction is still relatively weak, the information generated by the devices is still presented in the form of paper reports. When doctors or patients want to have access to the data at a given time again, they can only look at the paper files. Data integration between medical devices has long been a difficult problem for the medical information system, because the data from medical devices are lack of mandatory unified global standards and have outstanding heterogeneity of devices. In order to protect their own interests, manufacturers use special protocols, etc., thus causing medical decices to still be the "lonely island" of hospital information system. Besides, unfocused application of the data will lead to failure to achieve a reasonable distribution of medical resources. With the deepening of IT construction in hospitals, medical information systems will be bound to develop towards mobile applications, intelligent analysis, and interconnection and interworking, on the premise that there is an effective medical device integration (MDI) technology. To this end, this paper presents a MDI model based on the Internet of Things (IoT). Through abstract classification, this model is able to extract the common characteristics of the devices, resolve the heterogeneous differences between them, and employ a unified protocol to integrate data between devices. And by the IoT technology, it realizes interconnection network of devices and conducts associate matching

  1. Medical Device Integration Model Based on the Internet of Things.

    PubMed

    Hao, Aiyu; Wang, Ling

    2015-01-01

    At present, hospitals in our country have basically established the HIS system, which manages registration, treatment, and charge, among many others, of patients. During treatment, patients need to use medical devices repeatedly to acquire all sorts of inspection data. Currently, the output data of the medical devices are often manually input into information system, which is easy to get wrong or easy to cause mismatches between inspection reports and patients. For some small hospitals of which information construction is still relatively weak, the information generated by the devices is still presented in the form of paper reports. When doctors or patients want to have access to the data at a given time again, they can only look at the paper files. Data integration between medical devices has long been a difficult problem for the medical information system, because the data from medical devices are lack of mandatory unified global standards and have outstanding heterogeneity of devices. In order to protect their own interests, manufacturers use special protocols, etc., thus causing medical decices to still be the "lonely island" of hospital information system. Besides, unfocused application of the data will lead to failure to achieve a reasonable distribution of medical resources. With the deepening of IT construction in hospitals, medical information systems will be bound to develop towards mobile applications, intelligent analysis, and interconnection and interworking, on the premise that there is an effective medical device integration (MDI) technology. To this end, this paper presents a MDI model based on the Internet of Things (IoT). Through abstract classification, this model is able to extract the common characteristics of the devices, resolve the heterogeneous differences between them, and employ a unified protocol to integrate data between devices. And by the IoT technology, it realizes interconnection network of devices and conducts associate matching

  2. Medical Updates Number 5 to the International Space Station Probability Risk Assessment (PRA) Model Using the Integrated Medical Model

    NASA Technical Reports Server (NTRS)

    Butler, Doug; Bauman, David; Johnson-Throop, Kathy

    2011-01-01

    The Integrated Medical Model (IMM) Project has been developing a probabilistic risk assessment tool, the IMM, to help evaluate in-flight crew health needs and impacts to the mission due to medical events. This package is a follow-up to a data package provided in June 2009. The IMM currently represents 83 medical conditions and associated ISS resources required to mitigate medical events. IMM end state forecasts relevant to the ISS PRA model include evacuation (EVAC) and loss of crew life (LOCL). The current version of the IMM provides the basis for the operational version of IMM expected in the January 2011 timeframe. The objectives of this data package are: 1. To provide a preliminary understanding of medical risk data used to update the ISS PRA Model. The IMM has had limited validation and an initial characterization of maturity has been completed using NASA STD 7009 Standard for Models and Simulation. The IMM has been internally validated by IMM personnel but has not been validated by an independent body external to the IMM Project. 2. To support a continued dialogue between the ISS PRA and IMM teams. To ensure accurate data interpretation, and that IMM output format and content meets the needs of the ISS Risk Management Office and ISS PRA Model, periodic discussions are anticipated between the risk teams. 3. To help assess the differences between the current ISS PRA and IMM medical risk forecasts of EVAC and LOCL. Follow-on activities are anticipated based on the differences between the current ISS PRA medical risk data and the latest medical risk data produced by IMM.

  3. Four models of medical education about elder mistreatment.

    PubMed

    Heath, John M; Dyer, Carmel B; Kerzner, Lawrence J; Mosqueda, Laura; Murphy, Carole

    2002-11-01

    The authors describe four models of incorporating elder-mistreatment curricular content and collaboration with adult protective service (APS) community service agencies into geriatrics medical education. Geriatrics education programs at four academic health centers-the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School; the University of California, Irvine College of Medicine; Hennepin County Medical Center, Minneapolis, Minnesota; and Baylor College of Medicine Geriatrics Program at the Harris County Hospital District, Houston, Texas-were surveyed and information collated. All programs incorporated direct interactions between learners and APS workers into their teaching programs. Learners were fellows, residents, and medical students. While two programs provided direct patient care, two others restricted learners to consultant roles, supporting the APS service providers with medical input. In addition to directly meeting curricular training needs of elder abuse and neglect, clinical cases provided valued learning experiences in applied clinical ethics, the role of physicians with community-based programs, the interaction between the medical and legal professions in cases of financial exploitation, and assessment of elder individuals' decision-making capacity. In two programs APS workers also contribute to the assessment of trainees' humanistic competencies. The authors conclude that APS community service agencies can successfully be incorporated into medical training programs to address a wide range of curricular goals.

  4. Model selection and inference for censored lifetime medical expenditures.

    PubMed

    Johnson, Brent A; Long, Qi; Huang, Yijian; Chansky, Kari; Redman, Mary

    2016-09-01

    Identifying factors associated with increased medical cost is important for many micro- and macro-institutions, including the national economy and public health, insurers and the insured. However, assembling comprehensive national databases that include both the cost and individual-level predictors can prove challenging. Alternatively, one can use data from smaller studies with the understanding that conclusions drawn from such analyses may be limited to the participant population. At the same time, smaller clinical studies have limited follow-up and lifetime medical cost may not be fully observed for all study participants. In this context, we develop new model selection methods and inference procedures for secondary analyses of clinical trial data when lifetime medical cost is subject to induced censoring. Our model selection methods extend a theory of penalized estimating function to a calibration regression estimator tailored for this data type. Next, we develop a novel inference procedure for the unpenalized regression estimator using perturbation and resampling theory. Then, we extend this resampling plan to accommodate regularized coefficient estimation of censored lifetime medical cost and develop postselection inference procedures for the final model. Our methods are motivated by data from Southwest Oncology Group Protocol 9509, a clinical trial of patients with advanced nonsmall cell lung cancer, and our models of lifetime medical cost are specific to this population. But the methods presented in this article are built on rather general techniques and could be applied to larger databases as those data become available.

  5. Medical problem and document model for natural language understanding.

    PubMed

    Meystre, Stephanie; Haug, Peter J

    2003-01-01

    We are developing tools to help maintain a complete, accurate and timely problem list within a general purpose Electronic Medical Record system. As a part of this project, we have designed a system to automatically retrieve medical problems from free-text documents. Here we describe an information model based on XML (eXtensible Markup Language) and compliant with the CDA (Clinical Document Architecture). This model is used to ease the exchange of clinical data between the Natural Language Understanding application that retrieves potential problems from narrative document, and the problem list management application.

  6. Model-based engineering for medical-device software.

    PubMed

    Ray, Arnab; Jetley, Raoul; Jones, Paul L; Zhang, Yi

    2010-01-01

    This paper demonstrates the benefits of adopting model-based design techniques for engineering medical device software. By using a patient-controlled analgesic (PCA) infusion pump as a candidate medical device, the authors show how using models to capture design information allows for i) fast and efficient construction of executable device prototypes ii) creation of a standard, reusable baseline software architecture for a particular device family, iii) formal verification of the design against safety requirements, and iv) creation of a safety framework that reduces verification costs for future versions of the device software. 1.

  7. 3-dimensional electronic structures of CaC6

    NASA Astrophysics Data System (ADS)

    Kyung, Wonshik; Kim, Yeongkwan; Han, Garam; Leem, Choonshik; Kim, Junsung; Kim, Yeongwook; Kim, Keunsu; Rotenberg, Eli; Kim, Changyoung; Postech Collaboration; Advanced Light Source Collaboration; Yonsei University Team

    2014-03-01

    There is still remaining issues on origin of superconductivity in graphite intercalation compounds, especially CaC6 because of its relatively high transition temperature than other GICs. There are two competing theories on where the superconductivity occurs in this material; intercalant metal or charge doped graphene layer. To elucidate this issue, it is necessary to confirm existence of intercalant driven band. Therefore, we performed 3 dimensional electronic structure studies with ARPES to find out 3d dispersive intercalant band. However, we could not observe it, instead observed 3d dispersive carbon band. This support the aspect of charge doped graphene superconductivity more than intercalant driving aspect.

  8. Integrated Medical Model (IMM) 4.0 Enhanced Functionalities

    NASA Technical Reports Server (NTRS)

    Young, M.; Keenan, A. B.; Saile, L.; Boley, L. A.; Walton, M. E.; Shah, R. V.; Kerstman, E. L.; Myers, J. G.

    2015-01-01

    The Integrated Medical Model is a probabilistic simulation model that uses input data on 100 medical conditions to simulate expected medical events, the resources required to treat, and the resulting impact to the mission for specific crew and mission characteristics. The newest development version of IMM, IMM v4.0, adds capabilities that remove some of the conservative assumptions that underlie the current operational version, IMM v3. While IMM v3 provides the framework to simulate whether a medical event occurred, IMMv4 also simulates when the event occurred during a mission timeline. This allows for more accurate estimation of mission time lost and resource utilization. In addition to the mission timeline, IMMv4.0 features two enhancements that address IMM v3 assumptions regarding medical event treatment. Medical events in IMMv3 are assigned the untreated outcome if any resource required to treat the event was unavailable. IMMv4 allows for partially treated outcomes that are proportional to the amount of required resources available, thus removing the dichotomous treatment assumption. An additional capability IMMv4 is to use an alternative medical resource when the primary resource assigned to the condition is depleted, more accurately reflecting the real-world system. The additional capabilities defining IMM v4.0the mission timeline, partial treatment, and alternate drug result in more realistic predicted mission outcomes. The primary model outcomes of IMM v4.0 for the ISS6 mission, including mission time lost, probability of evacuation, and probability of loss of crew life, are be compared to those produced by the current operational version of IMM to showcase enhanced prediction capabilities.

  9. Visual computing model for immune system and medical system.

    PubMed

    Gong, Tao; Cao, Xinxue; Xiong, Qin

    2015-01-01

    Natural immune system is an intelligent self-organizing and adaptive system, which has a variety of immune cells with different types of immune mechanisms. The mutual cooperation between the immune cells shows the intelligence of this immune system, and modeling this immune system has an important significance in medical science and engineering. In order to build a comprehensible model of this immune system for better understanding with the visualization method than the traditional mathematic model, a visual computing model of this immune system was proposed and also used to design a medical system with the immune system, in this paper. Some visual simulations of the immune system were made to test the visual effect. The experimental results of the simulations show that the visual modeling approach can provide a more effective way for analyzing this immune system than only the traditional mathematic equations.

  10. The regulation of cognitive enhancement devices: extending the medical model

    PubMed Central

    Maslen, Hannah; Douglas, Thomas; Cohen Kadosh, Roi; Levy, Neil; Savulescu, Julian

    2014-01-01

    This article presents a model for regulating cognitive enhancement devices (CEDs). Recently, it has become very easy for individuals to purchase devices which directly modulate brain function. For example, transcranial direct current stimulators are increasingly being produced and marketed online as devices for cognitive enhancement. Despite posing risks in a similar way to medical devices, devices that do not make any therapeutic claims do not have to meet anything more than basic product safety standards. We present the case for extending existing medical device legislation to cover CEDs. Medical devices and CEDs operate by the same or similar mechanisms and pose the same or similar risks. This fact coupled with the arbitrariness of the line between treatment and enhancement count in favour of regulating these devices in the same way. In arguing for this regulatory model, the paper highlights potential challenges to its implementation, and suggests solutions. PMID:25243073

  11. Object-oriented modeling of patients in a medical federation.

    PubMed

    Proctor, M D; Creech, G S

    2001-09-01

    This research explores the development of an object-oriented model to support inter-operation of simulations within a federation for the purpose of conducting medical analysis and training over a distributed infrastructure. The medical federation is referred to as the combat trauma patient simulation system and is composed using high level architecture. The infrastructure contains components that were separately developed and are heterogeneous in nature. This includes a general anatomical computer database capable of generating human injuries, referred to as operational requirements-based casualty assessment, an animated mannequin called the human patient simulator, and other components. The research develops an object model that enables bodily injury data to be shared across the simulation, conducts analysis on that data, and considers possible applications of the technique in expanded medical infrastructures.

  12. Incorporating a 3-dimensional printer into the management of early-stage cervical cancer.

    PubMed

    Baek, Min-Hyun; Kim, Dae-Yeon; Kim, Namkug; Rhim, Chae Chun; Kim, Jong-Hyeok; Nam, Joo-Hyun

    2016-08-01

    We used a 3-dimensional (3D) printer to create anatomical replicas of real lesions and tested its application in cervical cancer. Our study patient decided to undergo radical hysterectomy after seeing her 3D model which was then used to plan and simulate this surgery. Using 3D printers to create patient-specific 3D tumor models may aid cervical cancer patients make treatment decisions. This technology will lead to better surgical and oncological outcomes for cervical cancer patients. J. Surg. Oncol. 2016;114:150-152. © 2016 Wiley Periodicals, Inc.

  13. Performance analysis of a medical record exchanges model.

    PubMed

    Huang, Ean-Wen; Liou, Der-Ming

    2007-03-01

    Electronic medical record exchange among hospitals can provide more information for physician diagnosis and reduce costs from duplicate examinations. In this paper, we proposed and implemented a medical record exchange model. According to our study, exchange interface servers (EISs) are designed for hospitals to manage the information communication through the intra and interhospital networks linked with a medical records database. An index service center can be given responsibility for managing the EIS and publishing the addresses and public keys. The prototype system has been implemented to generate, parse, and transfer the health level seven query messages. Moreover, the system can encrypt and decrypt a message using the public-key encryption algorithm. The queuing theory is applied to evaluate the performance of our proposed model. We estimated the service time for each queue of the CPU, database, and network, and measured the response time and possible bottlenecks of the model. The capacity of the model is estimated to process the medical records of about 4000 patients/h in the 1-MB network backbone environments, which comprises about the 4% of the total outpatients in Taiwan.

  14. Implications of the Hospitalist Model for Medical Students' Education.

    ERIC Educational Resources Information Center

    Hauer, Karen E.; Wachter, Robert M.

    2001-01-01

    Proposes a research agenda to investigate the educational impact for medical students of the hospitalist model, suggests strategies to mitigate the limitations in students' exposures to subspecialty faculty, and recommends professional development in teaching for hospitalists to ensure that student education thrives in this new environment of…

  15. Integrated Medical Model Project - Overview and Summary of Historical Application

    NASA Technical Reports Server (NTRS)

    Myers, J.; Boley, L.; Butler, D.; Foy, M.; Goodenow, D.; Griffin, D.; Keenan, A.; Kerstman, E.; Melton, S.; McGuire, K.; Saile, L.; Shah, R.; Garcia, Y.; Sirmons, B.; Walton, M.

    2015-01-01

    Introduction: The Integrated Medical Model (IMM) Project represents one aspect of NASA's Human Research Program (HRP) to quantitatively assess medical risks to astronauts for existing operational missions as well as missions associated with future exploration and commercial space flight ventures. The IMM takes a probabilistic approach to assessing the likelihood and specific outcomes of one hundred medical conditions within the envelope of accepted space flight standards of care over a selectable range of mission capabilities. A specially developed Integrated Medical Evidence Database (iMED) maintains evidence-based, organizational knowledge across a variety of data sources. Since becoming operational in 2011, version 3.0 of the IMM, the supporting iMED, and the expertise of the IMM project team have contributed to a wide range of decision and informational processes for the space medical and human research community. This presentation provides an overview of the IMM conceptual architecture and range of application through examples of actual space flight community questions posed to the IMM project. Methods: Figure 1 [see document] illustrates the IMM modeling system and scenario process. As illustrated, the IMM computational architecture is based on Probabilistic Risk Assessment techniques. Nineteen assumptions and limitations define the IMM application domain. Scenario definitions include crew medical attributes and mission specific details. The IMM forecasts probabilities of loss of crew life (LOCL), evacuation (EVAC), quality time lost during the mission, number of medical resources utilized and the number and type of medical events by combining scenario information with in-flight, analog, and terrestrial medical information stored in the iMED. In addition, the metrics provide the integrated information necessary to estimate optimized in-flight medical kit contents under constraints of mass and volume or acceptable level of mission risk. Results and Conclusions

  16. The Use of the Integrated Medical Model for Forecasting and Mitigating Medical Risks for a Near-Earth Asteroid Mission

    NASA Technical Reports Server (NTRS)

    Kerstman, Eric; Saile, Lynn; Freire de Carvalho, Mary; Myers, Jerry; Walton, Marlei; Butler, Douglas; Lopez, Vilma

    2011-01-01

    Introduction The Integrated Medical Model (IMM) is a decision support tool that is useful to space flight mission managers and medical system designers in assessing risks and optimizing medical systems. The IMM employs an evidence-based, probabilistic risk assessment (PRA) approach within the operational constraints of space flight. Methods Stochastic computational methods are used to forecast probability distributions of medical events, crew health metrics, medical resource utilization, and probability estimates of medical evacuation and loss of crew life. The IMM can also optimize medical kits within the constraints of mass and volume for specified missions. The IMM was used to forecast medical evacuation and loss of crew life probabilities, as well as crew health metrics for a near-earth asteroid (NEA) mission. An optimized medical kit for this mission was proposed based on the IMM simulation. Discussion The IMM can provide information to the space program regarding medical risks, including crew medical impairment, medical evacuation and loss of crew life. This information is valuable to mission managers and the space medicine community in assessing risk and developing mitigation strategies. Exploration missions such as NEA missions will have significant mass and volume constraints applied to the medical system. Appropriate allocation of medical resources will be critical to mission success. The IMM capability of optimizing medical systems based on specific crew and mission profiles will be advantageous to medical system designers. Conclusion The IMM is a decision support tool that can provide estimates of the impact of medical events on human space flight missions, such as crew impairment, evacuation, and loss of crew life. It can be used to support the development of mitigation strategies and to propose optimized medical systems for specified space flight missions. Learning Objectives The audience will learn how an evidence-based decision support tool can be

  17. Use of animal models to develop antiaddiction medications.

    PubMed

    Gardner, Eliot L

    2008-10-01

    Although addiction is a uniquely human phenomenon, some of its pathognomonic features can be modeled at the animal level. Such features include the euphoric "high" produced by acute administration of addictive drugs; the dysphoric "crash" produced by acute withdrawal; drug-seeking and drug-taking behaviors; and relapse to drug-seeking behavior after achieving successful abstinence. Animal models exist for each of these features. In this review, I focus on various animal models of addiction and how they can be used to search for clinically effective antiaddiction medications. I conclude by noting some of the new and novel medications that have been developed preclinically using such models and the hope for further developments along such lines.

  18. Use of Animal Models to Develop Antiaddiction Medications

    PubMed Central

    Gardner, Eliot L.

    2008-01-01

    Although addiction is a uniquely human phenomenon, some of its pathognomonic features can be modeled at the animal level. Such features include the euphoric “high” produced by acute administration of addictive drugs; the dysphoric “crash” produced by acute withdrawal, drug-seeking, and drug-taking behaviors; and relapse to drug-seeking behavior after achieving successful abstinence. Animal models exist for each of these features. In this review, I focus on various animal models of addiction and how they can be used to search for clinically effective antiaddiction medications. I conclude by noting some of the new and novel medications that have been developed preclinically using such models and the hope for further developments along such lines. PMID:18803910

  19. 3-Dimensional quantitative detection of nanoparticle content in biological tissue samples after local cancer treatment

    NASA Astrophysics Data System (ADS)

    Rahn, Helene; Alexiou, Christoph; Trahms, Lutz; Odenbach, Stefan

    2014-06-01

    X-ray computed tomography is nowadays used for a wide range of applications in medicine, science and technology. X-ray microcomputed tomography (XμCT) follows the same principles used for conventional medical CT scanners, but improves the spatial resolution to a few micrometers. We present an example of an application of X-ray microtomography, a study of 3-dimensional biodistribution, as along with the quantification of nanoparticle content in tumoral tissue after minimally invasive cancer therapy. One of these minimal invasive cancer treatments is magnetic drug targeting, where the magnetic nanoparticles are used as controllable drug carriers. The quantification is based on a calibration of the XμCT-equipment. The developed calibration procedure of the X-ray-μCT-equipment is based on a phantom system which allows the discrimination between the various gray values of the data set. These phantoms consist of a biological tissue substitute and magnetic nanoparticles. The phantoms have been studied with XμCT and have been examined magnetically. The obtained gray values and nanoparticle concentration lead to a calibration curve. This curve can be applied to tomographic data sets. Accordingly, this calibration enables a voxel-wise assignment of gray values in the digital tomographic data set to nanoparticle content. Thus, the calibration procedure enables a 3-dimensional study of nanoparticle distribution as well as concentration.

  20. Medical Modeling of Particle Size Effects for CB Inhalation Hazards

    DTIC Science & Technology

    2015-09-01

    typical city. As has been described , many of the parameters in the model are hard-coded due to limitations in data transfer with SCIPUFF. When fully... describes the resulting medical impact. Many current models assume that only the 1 to 5 micron “respirable” particles capable of reaching the pulmonary...well. Inhalation mechanics , FXCODA, DARRT, bioagent, aerosol, particle size, particle deposition, biological agents, ricin, tularemia Unclassified

  1. Scene-of-crime analysis by a 3-dimensional optical digitizer: a useful perspective for forensic science.

    PubMed

    Sansoni, Giovanna; Cattaneo, Cristina; Trebeschi, Marco; Gibelli, Daniele; Poppa, Pasquale; Porta, Davide; Maldarella, Monica; Picozzi, Massimo

    2011-09-01

    Analysis and detailed registration of the crime scene are of the utmost importance during investigations. However, this phase of activity is often affected by the risk of loss of evidence due to the limits of traditional scene of crime registration methods (ie, photos and videos). This technical note shows the utility of the application of a 3-dimensional optical digitizer on different crime scenes. This study aims in fact at verifying the importance and feasibility of contactless 3-dimensional reconstruction and modeling by optical digitization to achieve an optimal registration of the crime scene.

  2. Expanded medical home model works for children in foster care.

    PubMed

    Jaudes, Kienberger Paula; Champagne, Vince; Harden, Allen; Masterson, James; Bilaver, Lucy A

    2012-01-01

    The Illinois Child Welfare Department implemented a statewide health care system to ensure that children in foster care obtain quality health care by providing each child with a medical home. This study demonstrates that the Medical Home model works for children in foster care providing better health outcomes in higher immunization rates.These children used the health care system more effectively and cost-effective as reflected in the higher utilization rates of primary care and well-child visits and lower utilization of emergency room care for children with chronic conditions.

  3. Ranking Medical Subject Headings using a factor graph model.

    PubMed

    Wei, Wei; Demner-Fushman, Dina; Wang, Shuang; Jiang, Xiaoqian; Ohno-Machado, Lucila

    2015-01-01

    Automatically assigning MeSH (Medical Subject Headings) to articles is an active research topic. Recent work demonstrated the feasibility of improving the existing automated Medical Text Indexer (MTI) system, developed at the National Library of Medicine (NLM). Encouraged by this work, we propose a novel data-driven approach that uses semantic distances in the MeSH ontology for automated MeSH assignment. Specifically, we developed a graphical model to propagate belief through a citation network to provide robust MeSH main heading (MH) recommendation. Our preliminary results indicate that this approach can reach high Mean Average Precision (MAP) in some scenarios.

  4. A Cellular Automata Model of Infection Control on Medical Implants.

    PubMed

    Prieto-Langarica, Alicia; Kojouharov, Hristo; Chen-Charpentier, Benito; Tang, Liping

    2011-06-01

    S. epidermidis infections on medically implanted devices are a common problem in modern medicine due to the abundance of the bacteria. Once inside the body, S. epidermidis gather in communities called biofilms and can become extremely hard to eradicate, causing the patient serious complications. We simulate the complex S. epidermidis-Neutrophils interactions in order to determine the optimum conditions for the immune system to be able to contain the infection and avoid implant rejection. Our cellular automata model can also be used as a tool for determining the optimal amount of antibiotics for combating biofilm formation on medical implants.

  5. Leasing vs. owning a medical office: an analytical model.

    PubMed

    Tolbert, Samuel H; Wood, Carol P

    2007-01-01

    Physicians often face a major financial dilemma: To lease or own their medical office. This article takes a set of typical assumptions for a real estate market and analyzes the capital costs, cash flow, and investment implications of the option of leasing a medical office versus owning a similar property. The paper analyzes the financial aspects of each option and the impact on net physician income and potential return-on-investment. A model for analysis is presented that can be used by practitioners who advise physicians in such decision-making.

  6. Curriculum inventory: Modeling, sharing and comparing medical education programs.

    PubMed

    Ellaway, Rachel H; Albright, Susan; Smothers, Valerie; Cameron, Terri; Willett, Timothy

    2014-03-01

    Abstract descriptions of how curricula are structured and run. The American National Standards Institute (ANSI) MedBiquitous Curriculum Inventory Standard provides a technical syntax through which a wide range of different curricula can be expressed and subsequently compared and analyzed. This standard has the potential to shift curriculum mapping and reporting from a somewhat disjointed and institution-specific undertaking to something that is shared among multiple medical schools and across whole medical education systems. Given the current explosion of different models of curricula (time-free, competency-based, socially accountable, distributed, accelerated, etc.), the ability to consider this diversity using a common model has particular value in medical education management and scholarship. This article describes the development and structure of the Curriculum Inventory Standard as a way of standardizing the modeling of different curricula for audit, evaluation and research purposes. It also considers the strengths and limitations of the current standard and the implications for a medical education world in which this level of commonality, precision, and accountability for curricular practice is the norm rather than the exception.

  7. A model for critiquing based on automated medical records.

    PubMed

    van der Lei, J; Musen, M A

    1991-08-01

    We describe the design of a critiquing system, HyperCritic, that relies on automated medical records for its data input. The purpose of the system is to advise general practitioners who are treating patients who have hypertension. HyperCritic has access to the data stored in a primary-care information system that supports a fully automated medical record. Hyper-Critic relies on data in the automated medical record to critique the management of hypertensive patients, avoiding a consultation-style interaction with the user. The first step in the critiquing process involves the interpretation of the medical record in an attempt to discover the physician's actions and decisions. After detecting the relevant events in the medical record, HyperCritic views the task of critiquing as the assignment of critiquing statements to these patient-specific events. Critiquing statements are defined as recommendations involving one or more suggestions for possible modifications in the actions of the physician. The core of the model underlying HyperCritic is that the process of generating the critiquing statements is viewed as the application of a limited set of abstract critiquing tasks. We distinguish four categories of critiquing tasks: preparation tasks, selection tasks, monitoring tasks, and responding tasks. The execution of these critiquing tasks requires specific medical factual knowledge. This factual knowledge is separated from the critiquing tasks and is stored in a medical fact base. The principal advantage demonstrated by HyperCritic is the adaption of a domain-independent critiquing structure. We show how this domain-independent critiquing structure can be used to facilitate knowledge acquisition and maintenance of the system.

  8. Scientific visualization of 3-dimensional optimized stellarator configurations

    SciTech Connect

    Spong, D.A.

    1998-01-01

    The design techniques and physics analysis of modern stellarator configurations for magnetic fusion research rely heavily on high performance computing and simulation. Stellarators, which are fundamentally 3-dimensional in nature, offer significantly more design flexibility than more symmetric devices such as the tokamak. By varying the outer boundary shape of the plasma, a variety of physics features, such as transport, stability, and heating efficiency can be optimized. Scientific visualization techniques are an important adjunct to this effort as they provide a necessary ergonomic link between the numerical results and the intuition of the human researcher. The authors have developed a variety of visualization techniques for stellarators which both facilitate the design optimization process and allow the physics simulations to be more readily understood.

  9. Medical students' emotional development in early clinical experience: a model.

    PubMed

    Helmich, Esther; Bolhuis, Sanneke; Laan, Roland; Dornan, Tim; Koopmans, Raymond

    2014-08-01

    Dealing with emotions is a critical feature of professional behaviour. There are no comprehensive theoretical models, however, explaining how medical students learn about emotions. We aimed to explore factors affecting their emotions and how they learn to deal with emotions in themselves and others. During a first-year nursing attachment in hospitals and nursing homes, students wrote daily about their most impressive experiences, explicitly reporting what they felt, thought, and did. In a subsequent interview, they discussed those experiences in greater detail. Following a grounded theory approach, we conducted a constant comparative analysis, collecting and then interpreting data, and allowing the interpretation to inform subsequent data collection. Impressive experiences set up tensions, which gave rise to strong emotions. We identified four 'axes' along which tensions were experienced: 'idealism versus reality', 'critical distance versus adaptation', 'involvement versus detachment' and 'feeling versus displaying'. We found many factors, which influenced how respondents relieved those tensions. Their personal attributes and social relationships both inside and outside the medical community were important ones. Respondents' positions along the different dimensions, as determined by the balance between attributes and tensions, shaped their learning outcomes. Medical students' emotional development occurs through active participation in medical practice and having impressive experiences within relationships with patients and others on wards. Tensions along four dimensions give rise to strong emotions. Gaining insight into the many conditions that influence students' learning about emotions might support educators and supervisors in fostering medical students' emotional and professional development.

  10. A 3-dimensional finite-difference method for calculating the dynamic coefficients of seals

    NASA Technical Reports Server (NTRS)

    Dietzen, F. J.; Nordmann, R.

    1989-01-01

    A method to calculate the dynamic coefficients of seals with arbitrary geometry is presented. The Navier-Stokes equations are used in conjunction with the k-e turbulence model to describe the turbulent flow. These equations are solved by a full 3-dimensional finite-difference procedure instead of the normally used perturbation analysis. The time dependence of the equations is introduced by working with a coordinate system rotating with the precession frequency of the shaft. The results of this theory are compared with coefficients calculated by a perturbation analysis and with experimental results.

  11. Modeling of medical care with stochastic Petri Nets.

    PubMed

    Leite, Cicilia R M; Martin, Daniel L; Sizilio, Glaucia R A; Dos Santos, Keylly E A; de Araujo, Bruno G; Valentim, Ricardo A M; Neto, Adriao D D; de Melo, Jorge D; Guerreiro, Ana M G

    2010-01-01

    Due to the need for management, control, and monitoring of information in an effient way. The hospital automation has been the object of a number of studies owing to constantly evolving technologies. However, many hospital processes are still manual in private and public hospitals. Thus, the aim of this study is to model and simulate of medical care provided to patients in the Intensive Care Unit (ICU), using stochastic Petri Nets and their possible use in a number of automation processes.

  12. Medical applications of model-based dynamic thermography

    NASA Astrophysics Data System (ADS)

    Nowakowski, Antoni; Kaczmarek, Mariusz; Ruminski, Jacek; Hryciuk, Marcin; Renkielska, Alicja; Grudzinski, Jacek; Siebert, Janusz; Jagielak, Dariusz; Rogowski, Jan; Roszak, Krzysztof; Stojek, Wojciech

    2001-03-01

    The proposal to use active thermography in medical diagnostics is promising in some applications concerning investigation of directly accessible parts of the human body. The combination of dynamic thermograms with thermal models of investigated structures gives attractive possibility to make internal structure reconstruction basing on different thermal properties of biological tissues. Measurements of temperature distribution synchronized with external light excitation allow registration of dynamic changes of local temperature dependent on heat exchange conditions. Preliminary results of active thermography applications in medicine are discussed. For skin and under- skin tissues an equivalent thermal model may be determined. For the assumed model its effective parameters may be reconstructed basing on the results of transient thermal processes. For known thermal diffusivity and conductivity of specific tissues the local thickness of a two or three layer structure may be calculated. Results of some medical cases as well as reference data of in vivo study on animals are presented. The method was also applied to evaluate the state of the human heart during the open chest cardio-surgical interventions. Reference studies of evoked heart infarct in pigs are referred, too. We see the proposed new in medical applications technique as a promising diagnostic tool. It is a fully non-invasive, clean, handy, fast and affordable method giving not only qualitative view of investigated surfaces but also an objective quantitative measurement result, accurate enough for many applications including fast screening of affected tissues.

  13. A complementary model for medical subspecialty training in South Africa.

    PubMed

    Dalmeyer, J Paul F; Struwig, Miemie; Kruger, Thinus F

    2016-04-19

    The shortage of healthcare workers and doctors in the developing world compared with the developed world is problematic, and will continue to be so owing to the ongoing migration of qualified professionals and the inability of the state to remedy the shortfalls. This will seriously hamper the government's National Health Insurance plan and the sustainability of South Africa (SA)'s healthcare sector. Furthermore, it is well known that the duration of medical training in SA is exceptionally long, which discourages trainees. Medical corporates have taken a limited initiative to fund education projects in collaboration with academic institutions. These projects have been unstructured, mostly ad hoc, and poorly co-ordinated. The private corporate medical sector has expressed a desire to become involved on a much larger scale by means of more formalised structures. Given this background, the primary objective of our research was to develop a business model to complement the current academic medical subspecialty training.

  14. [Design and application of medical knowledge model on SAGE].

    PubMed

    Yang, Yan; Wu, Bin-fei; Ye, Feng; Lv, Xu-dong

    2009-01-01

    As an methodology for promoting the quality and efficiency of health care, clinical decision support systems (CDSSs) have gained much improvement. The knowledge base (KB) plays an important role in DSS. For CDSSs, the construction of KB means modeling the medical knowledge based on a suitable model. This study analyzes the SAGE model, then implements it on knowledge of diagnosis and treatment of Metabolic Syndrome (MS), and improves the SAGE to enhance its expression ability. The model is constructed as the KB in CDSS, and be applied in hospital. The evaluation result of CDSS reveals that the SAGE model should be useful in clinical application. Finally, this study propounds some points yet to be improved in the SAGE.

  15. Model-based segmentation of medical imagery by matching distributions.

    PubMed

    Freedman, Daniel; Radke, Richard J; Zhang, Tao; Jeong, Yongwon; Lovelock, D Michael; Chen, George T Y

    2005-03-01

    The segmentation of deformable objects from three-dimensional (3-D) images is an important and challenging problem, especially in the context of medical imagery. We present a new segmentation algorithm based on matching probability distributions of photometric variables that incorporates learned shape and appearance models for the objects of interest. The main innovation over similar approaches is that there is no need to compute a pixelwise correspondence between the model and the image. This allows for a fast, principled algorithm. We present promising results on difficult imagery for 3-D computed tomography images of the male pelvis for the purpose of image-guided radiotherapy of the prostate.

  16. Thermal crosstalk in 3-dimensional RRAM crossbar array

    NASA Astrophysics Data System (ADS)

    Sun, Pengxiao; Lu, Nianduan; Li, Ling; Li, Yingtao; Wang, Hong; Lv, Hangbing; Liu, Qi; Long, Shibing; Liu, Su; Liu, Ming

    2015-08-01

    High density 3-dimensional (3D) crossbar resistive random access memory (RRAM) is one of the major focus of the new age technologies. To compete with the ultra-high density NAND and NOR memories, understanding of reliability mechanisms and scaling potential of 3D RRAM crossbar array is needed. Thermal crosstalk is one of the most critical effects that should be considered in 3D crossbar array application. The Joule heat generated inside the RRAM device will determine the switching behavior itself, and for dense memory arrays, the temperature surrounding may lead to a consequent resistance degradation of neighboring devices. In this work, thermal crosstalk effect and scaling potential under thermal effect in 3D RRAM crossbar array are systematically investigated. It is revealed that the reset process is dominated by transient thermal effect in 3D RRAM array. More importantly, thermal crosstalk phenomena could deteriorate device retention performance and even lead to data storage state failure from LRS (low resistance state) to HRS (high resistance state) of the disturbed RRAM cell. In addition, the resistance state degradation will be more serious with continuously scaling down the feature size. Possible methods for alleviating thermal crosstalk effect while further advancing the scaling potential are also provided and verified by numerical simulation.

  17. The first 3-dimensional assemblies of organotin-functionalized polyanions.

    PubMed

    Piedra-Garza, Luis Fernando; Reinoso, Santiago; Dickman, Michael H; Sanguineti, Michael M; Kortz, Ulrich

    2009-08-21

    Reaction of the (CH(3))(2)Sn(2+) electrophile toward trilacunary [A-alpha-XW(9)O(34)](n-) Keggin polytungstates (X = P(V), As(V), Si(IV)) with guanidinium as templating-cation resulted in the isostructural compounds Na[C(NH(2))(3)](2)[{(CH(3))(2)Sn(H(2)O)}(3)(A-alpha-PW(9)O(34))] x 9 H(2)O (1), Na[C(NH(2))(3)](2)[{(CH(3))(2)Sn(H(2)O)}(3)(A-alpha-AsW(9)O(34))] x 8 H(2)O (2) and Na(2)[C(NH(2))(3)](2)[{(CH(3))(2)Sn(H(2)O)}(3)(A-alpha-SiW(9)O(34))] x 10 H(2)O (3). Compounds 1-3 constitute the first 3-dimensional assemblies of organotin-functionalized polyanions, as well as the first example of a dimethyltin-containing tungstosilicate in the case of 3, and they show a similar chiral architecture based on tetrahedrally-arranged {(CH(3))(2)Sn}(3)(A-alpha-XW(9)O(34)) monomeric building-blocks connected via intermolecular Sn-O=W bridges regardless of the size and/or charge of the heteroatom.

  18. Thermal crosstalk in 3-dimensional RRAM crossbar array

    PubMed Central

    Sun, Pengxiao; Lu, Nianduan; Li, Ling; Li, Yingtao; Wang, Hong; Lv, Hangbing; Liu, Qi; Long, Shibing; Liu, Su; Liu, Ming

    2015-01-01

    High density 3-dimensional (3D) crossbar resistive random access memory (RRAM) is one of the major focus of the new age technologies. To compete with the ultra-high density NAND and NOR memories, understanding of reliability mechanisms and scaling potential of 3D RRAM crossbar array is needed. Thermal crosstalk is one of the most critical effects that should be considered in 3D crossbar array application. The Joule heat generated inside the RRAM device will determine the switching behavior itself, and for dense memory arrays, the temperature surrounding may lead to a consequent resistance degradation of neighboring devices. In this work, thermal crosstalk effect and scaling potential under thermal effect in 3D RRAM crossbar array are systematically investigated. It is revealed that the reset process is dominated by transient thermal effect in 3D RRAM array. More importantly, thermal crosstalk phenomena could deteriorate device retention performance and even lead to data storage state failure from LRS (low resistance state) to HRS (high resistance state) of the disturbed RRAM cell. In addition, the resistance state degradation will be more serious with continuously scaling down the feature size. Possible methods for alleviating thermal crosstalk effect while further advancing the scaling potential are also provided and verified by numerical simulation. PMID:26310537

  19. Thermal crosstalk in 3-dimensional RRAM crossbar array.

    PubMed

    Sun, Pengxiao; Lu, Nianduan; Li, Ling; Li, Yingtao; Wang, Hong; Lv, Hangbing; Liu, Qi; Long, Shibing; Liu, Su; Liu, Ming

    2015-08-27

    High density 3-dimensional (3D) crossbar resistive random access memory (RRAM) is one of the major focus of the new age technologies. To compete with the ultra-high density NAND and NOR memories, understanding of reliability mechanisms and scaling potential of 3D RRAM crossbar array is needed. Thermal crosstalk is one of the most critical effects that should be considered in 3D crossbar array application. The Joule heat generated inside the RRAM device will determine the switching behavior itself, and for dense memory arrays, the temperature surrounding may lead to a consequent resistance degradation of neighboring devices. In this work, thermal crosstalk effect and scaling potential under thermal effect in 3D RRAM crossbar array are systematically investigated. It is revealed that the reset process is dominated by transient thermal effect in 3D RRAM array. More importantly, thermal crosstalk phenomena could deteriorate device retention performance and even lead to data storage state failure from LRS (low resistance state) to HRS (high resistance state) of the disturbed RRAM cell. In addition, the resistance state degradation will be more serious with continuously scaling down the feature size. Possible methods for alleviating thermal crosstalk effect while further advancing the scaling potential are also provided and verified by numerical simulation.

  20. In vitro measurement of muscle volume with 3-dimensional ultrasound.

    PubMed

    Delcker, A; Walker, F; Caress, J; Hunt, C; Tegeler, C

    1999-05-01

    The aim was to test the accuracy of muscle volume measurements with a new 3-dimensional (3-D) ultrasound system, which allows a freehand scanning of the transducer with an improved quality of the ultrasound images and therefore the outlines of the muscles. Five resected cadaveric hand muscles were insonated and the muscle volumes calculated by 3-D reconstructions of the acquired 2-D ultrasound sections. Intra-reader, inter-reader and follow-up variability were calculated, as well as the volume of the muscle tissue measured by water displacement. In the results, 3-D ultrasound and water displacement measurements showed an average deviation of 10.1%; Data of 3-D ultrasound measurements were: intra-reader variability 2.8%; inter-reader variability 2.4% and follow-up variability 2.3%. 3-D measurements of muscle volume are valid and reliable. Serial sonographic measurements of muscle may be able to quantitate changes in muscle volume that occur in disease and recovery.

  1. Dental caries: an updated medical model of risk assessment.

    PubMed

    Kutsch, V Kim

    2014-04-01

    Dental caries is a transmissible, complex biofilm disease that creates prolonged periods of low pH in the mouth, resulting in a net mineral loss from the teeth. Historically, the disease model for dental caries consisted of mutans streptococci and Lactobacillus species, and the dental profession focused on restoring the lesions/damage from the disease by using a surgical model. The current recommendation is to implement a risk-assessment-based medical model called CAMBRA (caries management by risk assessment) to diagnose and treat dental caries. Unfortunately, many of the suggestions of CAMBRA have been overly complicated and confusing for clinicians. The risk of caries, however, is usually related to just a few common factors, and these factors result in common patterns of disease. This article examines the biofilm model of dental caries, identifies the common disease patterns, and discusses their targeted therapeutic strategies to make CAMBRA more easily adaptable for the privately practicing professional.

  2. Architecture for Integrated Medical Model Dynamic Probabilistic Risk Assessment

    NASA Technical Reports Server (NTRS)

    Jaworske, D. A.; Myers, J. G.; Goodenow, D.; Young, M.; Arellano, J. D.

    2016-01-01

    Probabilistic Risk Assessment (PRA) is a modeling tool used to predict potential outcomes of a complex system based on a statistical understanding of many initiating events. Utilizing a Monte Carlo method, thousands of instances of the model are considered and outcomes are collected. PRA is considered static, utilizing probabilities alone to calculate outcomes. Dynamic Probabilistic Risk Assessment (dPRA) is an advanced concept where modeling predicts the outcomes of a complex system based not only on the probabilities of many initiating events, but also on a progression of dependencies brought about by progressing down a time line. Events are placed in a single time line, adding each event to a queue, as managed by a planner. Progression down the time line is guided by rules, as managed by a scheduler. The recently developed Integrated Medical Model (IMM) summarizes astronaut health as governed by the probabilities of medical events and mitigation strategies. Managing the software architecture process provides a systematic means of creating, documenting, and communicating a software design early in the development process. The software architecture process begins with establishing requirements and the design is then derived from the requirements.

  3. Crossover from 2-dimensional to 3-dimensional aggregations of clusters on square lattice substrates

    NASA Astrophysics Data System (ADS)

    Cheng, Yi; Zhu, Yu-Hong; Pan, Qi-Fa; Yang, Bo; Tao, Xiang-Ming; Ye, Gao-Xiang

    2015-11-01

    A Monte Carlo study on the crossover from 2-dimensional to 3-dimensional aggregations of clusters is presented. Based on the traditional cluster-cluster aggregation (CCA) simulation, a modified growth model is proposed. The clusters (including single particles and their aggregates) diffuse with diffusion step length l (1 ≤ l ≤ 7) and aggregate on a square lattice substrate. If the number of particles contained in a cluster is larger than a critical size sc, the particles at the edge of the cluster have a possibility to jump onto the upper layer, which results in the crossover from 2-dimensional to 3-dimensional aggregations. Our simulation results are in good agreement with the experimental findings. Project supported by the National Natural Science Foundation of China (Grant Nos. 11374082 and 11074215), the Science Foundation of Zhejiang Province Department of Education, China (Grant No. Y201018280), the Fundamental Research Funds for Central Universities, China (Grant No. 2012QNA3010), and the Specialized Research Fund for the Doctoral Program of Higher Education of China (Grant No. 20100101110005).

  4. Endothelial cells assemble into a 3-dimensional prevascular network in a bone tissue engineering construct.

    PubMed

    Rouwkema, Jeroen; de Boer, Jan; Van Blitterswijk, Clemens A

    2006-09-01

    To engineer tissues with clinically relevant dimensions, one must overcome the challenge of rapidly creating functional blood vessels to supply cells with oxygen and nutrients and to remove waste products. We tested the hypothesis that endothelial cells, cocultured with osteoprogenitor cells, can organize into a prevascular network in vitro. When cultured in a spheroid coculture model with human mesenchymal stem cells, human umbilical vein endothelial cells (HUVECs) form a 3-dimensional prevascular network within 10 days of in vitro culture. The formation of the prevascular network was promoted by seeding 2% or fewer HUVECs. Moreover, the addition of endothelial cells resulted in a 4-fold upregulation of the osteogenic marker alkaline phosphatase. The addition of mouse embryonic fibroblasts did not result in stabilization of the prevascular network. Upon implantation, the prevascular network developed further and structures including lumen could be seen regularly. However, anastomosis with the host vasculature was limited. We conclude that endothelial cells are able to form a 3-dimensional (3D) prevascular network in vitro in a bone tissue engineering setting. This finding is a strong indication that in vitro prevascularization is a promising strategy to improve implant vascularization in bone tissue engineering.

  5. 3-Dimensional shear wave elastography of breast lesions

    PubMed Central

    Chen, Ya-ling; Chang, Cai; Zeng, Wei; Wang, Fen; Chen, Jia-jian; Qu, Ning

    2016-01-01

    Abstract Color patterns of 3-dimensional (3D) shear wave elastography (SWE) is a promising method in differentiating tumoral nodules recently. This study was to evaluate the diagnostic accuracy of color patterns of 3D SWE in breast lesions, with special emphasis on coronal planes. A total of 198 consecutive women with 198 breast lesions (125 malignant and 73 benign) were included, who underwent conventional ultrasound (US), 3D B-mode, and 3D SWE before surgical excision. SWE color patterns of Views A (transverse), T (sagittal), and C (coronal) were determined. Sensitivity, specificity, and the area under the receiver operating characteristic curve (AUC) were calculated. Distribution of SWE color patterns was significantly different between malignant and benign lesions (P = 0.001). In malignant lesions, “Stiff Rim” was significantly more frequent in View C (crater sign, 60.8%) than in View A (51.2%, P = 0.013) and View T (54.1%, P = 0.035). AUC for combination of “Crater Sign” and conventional US was significantly higher than View A (0.929 vs 0.902, P = 0.004) and View T (0.929 vs 0.907, P = 0.009), and specificity significantly increased (90.4% vs 78.1%, P = 0.013) without significant change in sensitivity (85.6% vs 88.0%, P = 0.664) as compared with conventional US. In conclusion, combination of conventional US with 3D SWE color patterns significantly increased diagnostic accuracy, with “Crater Sign” in coronal plane of the highest value. PMID:27684820

  6. A new preclinical 3-dimensional agarose colony formation assay.

    PubMed

    Kajiwara, Yoshinori; Panchabhai, Sonali; Levin, Victor A

    2008-08-01

    The evaluation of new drug treatments and combination treatments for gliomas and other cancers requires a robust means to interrogate wide dose ranges and varying times of drug exposure without stain-inactivation of the cells (colonies). To this end, we developed a 3-dimensional (3D) colony formation assay that makes use of GelCount technology, a new cell colony counter for gels and soft agars. We used U251MG, SNB19, and LNZ308 glioma cell lines and MiaPaCa pancreas adenocarcinoma and SW480 colon adenocarcinoma cell lines. Colonies were grown in a two-tiered agarose that had 0.7% agarose on the bottom and 0.3% agarose on top. We then studied the effects of DFMO, carboplatin, and SAHA over a 3-log dose range and over multiple days of drug exposure. Using GelCount we approximated the area under the curve (AUC) of colony volumes as the sum of colony volumes (microm2xOD) in each plate to calculate IC50 values. Adenocarcinoma colonies were recognized by GelCount scanning at 3-4 days, while it took 6-7 days to detect glioma colonies. The growth rate of MiaPaCa and SW480 cells was rapid, with 100 colonies counted in 5-6 days; glioma cells grew more slowly, with 100 colonies counted in 9-10 days. Reliable log dose versus AUC curves were observed for all drugs studied. In conclusion, the GelCount method that we describe is more quantitative than traditional colony assays and allows precise study of drug effects with respect to both dose and time of exposure using fewer culture plates.

  7. SimITK: model driven engineering for medical imaging

    NASA Astrophysics Data System (ADS)

    Trezise, Melissa; Gobbi, David; Cordy, James; Abolmaesumi, Purang; Mousavi, Parvin

    2014-03-01

    The Insight Segmentation and Registration Toolkit (ITK) is a highly utilized open source medical imaging library providing chiefly the functionality to register, segment, and filter medical images. Although extremely powerful, ITK has a steep learning curve for users with little or no background in programming. It was for this reason that SimITK was developed. SimITK wraps ITK into the model driven engineering environment Simulink, a part of the Matlab development suite. The first released version of SimITK was a proof of concept, and demonstrated that ITK could be wrapped successfully in Simulink. In this paper a new version of SimITK is presented where ITK classes are wrapped using a fully automated process. In addition, SimITK is transitioned to successfully support ITK version 4, in order to remain current with the ITK project. SimITK includes thirty-seven image filters, twelve optimizers, and nineteen transform classes from ITK version 4 which are successfully wrapped and tested, and can be quickly and easily combined to perform medical imaging tasks. These classes were chosen to represent a broad range of usability, and to allow for greater flexibility when creating registration pipelines. SimITK has the potential to reduce the learning curve for ITK and allow the user to focus on developing workflows and algorithms. A release of SimITK along with tutorials and videos is available at www.simitkvtk.com.

  8. The medical simulation markup language - simplifying the biomechanical modeling workflow.

    PubMed

    Suwelack, Stefan; Stoll, Markus; Schalck, Sebastian; Schoch, Nicolai; Dillmann, Rüdiger; Bendl, Rolf; Heuveline, Vincent; Speidel, Stefanie

    2014-01-01

    Modeling and simulation of the human body by means of continuum mechanics has become an important tool in diagnostics, computer-assisted interventions and training. This modeling approach seeks to construct patient-specific biomechanical models from tomographic data. Usually many different tools such as segmentation and meshing algorithms are involved in this workflow. In this paper we present a generalized and flexible description for biomechanical models. The unique feature of the new modeling language is that it not only describes the final biomechanical simulation, but also the workflow how the biomechanical model is constructed from tomographic data. In this way, the MSML can act as a middleware between all tools used in the modeling pipeline. The MSML thus greatly facilitates the prototyping of medical simulation workflows for clinical and research purposes. In this paper, we not only detail the XML-based modeling scheme, but also present a concrete implementation. Different examples highlight the flexibility, robustness and ease-of-use of the approach.

  9. 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.

  10. Can We Trust Computational Modeling for Medical Applications?

    NASA Technical Reports Server (NTRS)

    Mulugeta, Lealem; Walton, Marlei; Nelson, Emily; Myers, Jerry

    2015-01-01

    Operations in extreme environments such as spaceflight pose human health risks that are currently not well understood and potentially unanticipated. In addition, there are limited clinical and research data to inform development and implementation of therapeutics for these unique health risks. In this light, NASA's Human Research Program (HRP) is leveraging biomedical computational models and simulations (M&S) to help inform, predict, assess and mitigate spaceflight health and performance risks, and enhance countermeasure development. To ensure that these M&S can be applied with confidence to the space environment, it is imperative to incorporate a rigorous verification, validation and credibility assessment (VV&C) processes to ensure that the computational tools are sufficiently reliable to answer questions within their intended use domain. In this presentation, we will discuss how NASA's Integrated Medical Model (IMM) and Digital Astronaut Project (DAP) have successfully adapted NASA's Standard for Models and Simulations, NASA-STD-7009 (7009) to achieve this goal. These VV&C methods are also being leveraged by organization such as the Food and Drug Administration (FDA), National Institute of Health (NIH) and the American Society of Mechanical Engineers (ASME) to establish new M&S VV&C standards and guidelines for healthcare applications. Similarly, we hope to provide some insight to the greater aerospace medicine community on how to develop and implement M&S with sufficient confidence to augment medical research and operations.

  11. Additive Manufacturing of Medical Models--Applications in Rhinology.

    PubMed

    Raos, Pero; Klapan, Ivica; Galeta, Tomislav

    2015-09-01

    In the paper we are introducing guidelines and suggestions for use of 3D image processing SW in head pathology diagnostic and procedures for obtaining physical medical model by additive manufacturing/rapid prototyping techniques, bearing in mind the improvement of surgery performance, its maximum security and faster postoperative recovery of patients. This approach has been verified in two case reports. In the treatment we used intelligent classifier-schemes for abnormal patterns using computer-based system for 3D-virtual and endoscopic assistance in rhinology, with appropriate visualization of anatomy and pathology within the nose, paranasal sinuses, and scull base area.

  12. Use of 3-Dimensional Printing for Preoperative Planning in the Treatment of Recurrent Anterior Shoulder Instability

    PubMed Central

    Sheth, Ujash; Theodoropoulos, John; Abouali, Jihad

    2015-01-01

    Recurrent anterior shoulder instability often results from large bony Bankart or Hill-Sachs lesions. Preoperative imaging is essential in guiding our surgical management of patients with these conditions. However, we are often limited to making an attempt to interpret a 3-dimensional (3D) structure using conventional 2-dimensional imaging. In cases in which complex anatomy or bony defects are encountered, this type of imaging is often inadequate. We used 3D printing to produce a solid 3D model of a glenohumeral joint from a young patient with recurrent anterior shoulder instability and complex Bankart and Hill-Sachs lesions. The 3D model from our patient was used in the preoperative planning stages of an arthroscopic Bankart repair and remplissage to determine the depth of the Hill-Sachs lesion and the degree of abduction and external rotation at which the Hill-Sachs lesion engaged. PMID:26759768

  13. Sensitivity Analysis of the Integrated Medical Model for ISS Programs

    NASA Technical Reports Server (NTRS)

    Goodenow, D. A.; Myers, J. G.; Arellano, J.; Boley, L.; Garcia, Y.; Saile, L.; Walton, M.; Kerstman, E.; Reyes, D.; Young, M.

    2016-01-01

    Sensitivity analysis estimates the relative contribution of the uncertainty in input values to the uncertainty of model outputs. Partial Rank Correlation Coefficient (PRCC) and Standardized Rank Regression Coefficient (SRRC) are methods of conducting sensitivity analysis on nonlinear simulation models like the Integrated Medical Model (IMM). The PRCC method estimates the sensitivity using partial correlation of the ranks of the generated input values to each generated output value. The partial part is so named because adjustments are made for the linear effects of all the other input values in the calculation of correlation between a particular input and each output. In SRRC, standardized regression-based coefficients measure the sensitivity of each input, adjusted for all the other inputs, on each output. Because the relative ranking of each of the inputs and outputs is used, as opposed to the values themselves, both methods accommodate the nonlinear relationship of the underlying model. As part of the IMM v4.0 validation study, simulations are available that predict 33 person-missions on ISS and 111 person-missions on STS. These simulated data predictions feed the sensitivity analysis procedures. The inputs to the sensitivity procedures include the number occurrences of each of the one hundred IMM medical conditions generated over the simulations and the associated IMM outputs: total quality time lost (QTL), number of evacuations (EVAC), and number of loss of crew lives (LOCL). The IMM team will report the results of using PRCC and SRRC on IMM v4.0 predictions of the ISS and STS missions created as part of the external validation study. Tornado plots will assist in the visualization of the condition-related input sensitivities to each of the main outcomes. The outcomes of this sensitivity analysis will drive review focus by identifying conditions where changes in uncertainty could drive changes in overall model output uncertainty. These efforts are an integral

  14. Medical Inpatient Journey Modeling and Clustering: A Bayesian Hidden Markov Model Based Approach

    PubMed Central

    Huang, Zhengxing; Dong, Wei; Wang, Fei; Duan, Huilong

    2015-01-01

    Modeling and clustering medical inpatient journeys is useful to healthcare organizations for a number of reasons including inpatient journey reorganization in a more convenient way for understanding and browsing, etc. In this study, we present a probabilistic model-based approach to model and cluster medical inpatient journeys. Specifically, we exploit a Bayesian Hidden Markov Model based approach to transform medical inpatient journeys into a probabilistic space, which can be seen as a richer representation of inpatient journeys to be clustered. Then, using hierarchical clustering on the matrix of similarities, inpatient journeys can be clustered into different categories w.r.t their clinical and temporal characteristics. We evaluated the proposed approach on a real clinical data set pertaining to the unstable angina treatment process. The experimental results reveal that our method can identify and model latent treatment topics underlying in personalized inpatient journeys, and yield impressive clustering quality. PMID:26958200

  15. Modelling and enforcing privacy for medical data disclosure across Europe.

    PubMed

    Boussi Rahmouni, Hanene; Solomonides, Tony; Casassa Mont, Marco; Shiu, Simon

    2009-01-01

    The harmonization of data protection legislation in Europe has been theoretically achieved by means of the EU directive on data protection. In practice the harmonization is not absolute and conflicts and inconsistencies continue to exist in the way Member States are implementing the directive. The integration of different European medical systems by means of grid technologies will continue to be challenging if technology does not intervene to enhance interoperability between national regulatory frameworks on data protection. In this paper we present an approach to automate privacy requirements for the sharing of patient data across Europe on a healthgrid domain and ensure its enforcement internally and within external domains where the data might travel. This approach is based on the semantic modelling of privacy obligations that are of legal, ethical or cultural nature. These requirements are for the sharing of personal data between different European Member States. Our model reflects both similarities and conflicts, if any, between the different Member States. This allows us to reason on the safeguards a data controller should ask from an organization belonging to another Member State before disclosing medical data to them. The system will also generate the relevant set of policies to be enforced at the process level of the grid to ensure privacy compliance before allowing access to the data.

  16. [Implementation of a telementoring model of medical education in psoriasis].

    PubMed

    Mazzuoccolo, Luis D; Marciano, Sebastián; Echeverría, Cristina M

    2016-01-01

    The ECHO® (Extension for Community Healthcare Outcomes) project is a model of distance medical education. Its mission is to expand knowledge and evaluate the results of this action, both in the training of human resources in healthcare and in the accomplishment of the best medical practices in the community target. It is developed through case presentation videoconferencing, between experts in chronic and complex diseases and physicians, with the aim of reducing the healthcare asymmetries between large urban centers and peripherals areas. We have implemented this telementoring for dermatologists and residents who treat patients with psoriasis. After 10 sessions, a survey was conducted to evaluate the educational attainment of the participants. A significant improvement was found in their abilities to determine the severity of psoriasis, screening for arthritis, assessment of the patient before beginning systemic treatment and appropriate follow-up under different systemic therapies. ECHO replication model helped improve the skills of the participants in the management of this disease, and reduced professional isolation.

  17. Evaluation of Medical Education virtual Program: P3 model

    PubMed Central

    REZAEE, RITA; SHOKRPOUR, NASRIN; BOROUMAND, MARYAM

    2016-01-01

    Introduction: In e-learning, people get involved in a process and create the content (product) and make it available for virtual learners. The present study was carried out in order to evaluate the first virtual master program in medical education at Shiraz University of Medical Sciences according to P3 Model. Methods: This is an evaluation research study with post single group design used to determine how effective this program was. All students 60 who participated more than one year in this virtual program and 21 experts including teachers and directors participated in this evaluation project. Based on the P3 e-learning model, an evaluation tool with 5-point Likert rating scale was designed and applied to collect the descriptive data. Results: Students reported storyboard and course design as the most desirable element of learning environment (2.30±0.76), but they declared technical support as the less desirable part (1.17±1.23). Conclusion: Presence of such framework in this regard and using it within the format of appropriate tools for evaluation of e-learning in universities and higher education institutes, which present e-learning curricula in the country, may contribute to implementation of the present and future e-learning curricula efficiently and guarantee its implementation in an appropriate way. PMID:27795971

  18. Stress analysis in platform-switching implants: a 3-dimensional finite element study.

    PubMed

    Pellizzer, Eduardo Piza; Verri, Fellippo Ramos; Falcón-Antenucci, Rosse Mary; Júnior, Joel Ferreira Santiago; de Carvalho, Paulo Sérgio Perri; de Moraes, Sandra Lúcia Dantas; Noritomi, Pedro Yoshito

    2012-10-01

    The aim of this study was to evaluate the influence of the platform-switching technique on stress distribution in implant, abutment, and peri-implant tissues, through a 3-dimensional finite element study. Three 3-dimensional mandibular models were fabricated using the SolidWorks 2006 and InVesalius software. Each model was composed of a bone block with one implant 10 mm long and of different diameters (3.75 and 5.00 mm). The UCLA abutments also ranged in diameter from 5.00 mm to 4.1 mm. After obtaining the geometries, the models were transferred to the software FEMAP 10.0 for pre- and postprocessing of finite elements to generate the mesh, loading, and boundary conditions. A total load of 200 N was applied in axial (0°), oblique (45°), and lateral (90°) directions. The models were solved by the software NeiNastran 9.0 and transferred to the software FEMAP 10.0 to obtain the results that were visualized through von Mises and maximum principal stress maps. Model A (implants with 3.75 mm/abutment with 4.1 mm) exhibited the highest area of stress concentration with all loadings (axial, oblique, and lateral) for the implant and the abutment. All models presented the stress areas at the abutment level and at the implant/abutment interface. Models B (implant with 5.0 mm/abutment with 5.0 mm) and C (implant with 5.0 mm/abutment with 4.1 mm) presented minor areas of stress concentration and similar distribution pattern. For the cortical bone, low stress concentration was observed in the peri-implant region for models B and C in comparison to model A. The trabecular bone exhibited low stress that was well distributed in models B and C. Model A presented the highest stress concentration. Model B exhibited better stress distribution. There was no significant difference between the large-diameter implants (models B and C).

  19. The Integrated Medical Model - Optimizing In-flight Space Medical Systems to Reduce Crew Health Risk and Mission Impacts

    NASA Technical Reports Server (NTRS)

    Kerstman, Eric; Walton, Marlei; Minard, Charles; Saile, Lynn; Myers, Jerry; Butler, Doug; Lyengar, Sriram; Fitts, Mary; Johnson-Throop, Kathy

    2009-01-01

    The Integrated Medical Model (IMM) is a decision support tool used by medical system planners and designers as they prepare for exploration planning activities of the Constellation program (CxP). IMM provides an evidence-based approach to help optimize the allocation of in-flight medical resources for a specified level of risk within spacecraft operational constraints. Eighty medical conditions and associated resources are represented in IMM. Nine conditions are due to Space Adaptation Syndrome. The IMM helps answer fundamental medical mission planning questions such as What medical conditions can be expected? What type and quantity of medical resources are most likely to be used?", and "What is the probability of crew death or evacuation due to medical events?" For a specified mission and crew profile, the IMM effectively characterizes the sequence of events that could potentially occur should a medical condition happen. The mathematical relationships among mission and crew attributes, medical conditions and incidence data, in-flight medical resources, potential clinical and crew health end states are established to generate end state probabilities. A Monte Carlo computational method is used to determine the probable outcomes and requires up to 25,000 mission trials to reach convergence. For each mission trial, the pharmaceuticals and supplies required to diagnose and treat prevalent medical conditions are tracked and decremented. The uncertainty of patient response to treatment is bounded via a best-case, worst-case, untreated case algorithm. A Crew Health Index (CHI) metric, developed to account for functional impairment due to a medical condition, provides a quantified measure of risk and enables risk comparisons across mission scenarios. The use of historical in-flight medical data, terrestrial surrogate data as appropriate, and space medicine subject matter expertise has enabled the development of a probabilistic, stochastic decision support tool capable of

  20. Sensitivity analysis of geometric errors in additive manufacturing medical models.

    PubMed

    Pinto, Jose Miguel; Arrieta, Cristobal; Andia, Marcelo E; Uribe, Sergio; Ramos-Grez, Jorge; Vargas, Alex; Irarrazaval, Pablo; Tejos, Cristian

    2015-03-01

    Additive manufacturing (AM) models are used in medical applications for surgical planning, prosthesis design and teaching. For these applications, the accuracy of the AM models is essential. Unfortunately, this accuracy is compromised due to errors introduced by each of the building steps: image acquisition, segmentation, triangulation, printing and infiltration. However, the contribution of each step to the final error remains unclear. We performed a sensitivity analysis comparing errors obtained from a reference with those obtained modifying parameters of each building step. Our analysis considered global indexes to evaluate the overall error, and local indexes to show how this error is distributed along the surface of the AM models. Our results show that the standard building process tends to overestimate the AM models, i.e. models are larger than the original structures. They also show that the triangulation resolution and the segmentation threshold are critical factors, and that the errors are concentrated at regions with high curvatures. Errors could be reduced choosing better triangulation and printing resolutions, but there is an important need for modifying some of the standard building processes, particularly the segmentation algorithms.

  1. Developing a semantic web model for medical differential diagnosis recommendation.

    PubMed

    Mohammed, Osama; Benlamri, Rachid

    2014-10-01

    In this paper we describe a novel model for differential diagnosis designed to make recommendations by utilizing semantic web technologies. The model is a response to a number of requirements, ranging from incorporating essential clinical diagnostic semantics to the integration of data mining for the process of identifying candidate diseases that best explain a set of clinical features. We introduce two major components, which we find essential to the construction of an integral differential diagnosis recommendation model: the evidence-based recommender component and the proximity-based recommender component. Both approaches are driven by disease diagnosis ontologies designed specifically to enable the process of generating diagnostic recommendations. These ontologies are the disease symptom ontology and the patient ontology. The evidence-based diagnosis process develops dynamic rules based on standardized clinical pathways. The proximity-based component employs data mining to provide clinicians with diagnosis predictions, as well as generates new diagnosis rules from provided training datasets. This article describes the integration between these two components along with the developed diagnosis ontologies to form a novel medical differential diagnosis recommendation model. This article also provides test cases from the implementation of the overall model, which shows quite promising diagnostic recommendation results.

  2. Revising Medical Consent Forms: An Empirical Model and Test. CDC Technical Report No. 2.

    ERIC Educational Resources Information Center

    Kaufer, David S.; And Others

    1983-01-01

    Noting that medical consent forms traditionally have been so full of medical and legal jargon that they have been impossible for even the educated layperson to understand, this paper presents a model for revising medical consent forms to make them more comprehensible. After describing the model, the paper explains each step involved in using it,…

  3. A Conceptual Model of Medical Student Well-Being: Promoting Resilience and Preventing Burnout

    ERIC Educational Resources Information Center

    Dunn, Laura B.; Iglewicz, Alana; Moutier, Christine

    2008-01-01

    Objective: This article proposes and illustrates a conceptual model of medical student well-being. Method: The authors reviewed the literature on medical student stress, coping, and well-being and developed a model of medical student coping termed the "coping reservoir." Results: The reservoir can be replenished or drained by various aspects of…

  4. Bayesian Analysis for Risk Assessment of Selected Medical Events in Support of the Integrated Medical Model Effort

    NASA Technical Reports Server (NTRS)

    Gilkey, Kelly M.; Myers, Jerry G.; McRae, Michael P.; Griffin, Elise A.; Kallrui, Aditya S.

    2012-01-01

    The Exploration Medical Capability project is creating a catalog of risk assessments using the Integrated Medical Model (IMM). The IMM is a software-based system intended to assist mission planners in preparing for spaceflight missions by helping them to make informed decisions about medical preparations and supplies needed for combating and treating various medical events using Probabilistic Risk Assessment. The objective is to use statistical analyses to inform the IMM decision tool with estimated probabilities of medical events occurring during an exploration mission. Because data regarding astronaut health are limited, Bayesian statistical analysis is used. Bayesian inference combines prior knowledge, such as data from the general U.S. population, the U.S. Submarine Force, or the analog astronaut population located at the NASA Johnson Space Center, with observed data for the medical condition of interest. The posterior results reflect the best evidence for specific medical events occurring in flight. Bayes theorem provides a formal mechanism for combining available observed data with data from similar studies to support the quantification process. The IMM team performed Bayesian updates on the following medical events: angina, appendicitis, atrial fibrillation, atrial flutter, dental abscess, dental caries, dental periodontal disease, gallstone disease, herpes zoster, renal stones, seizure, and stroke.

  5. A trial model for medical subspecialty training in South Africa

    PubMed Central

    DALMEYER, P; STRUWIG, M; KRUGER, T

    2016-01-01

    Abstract This article outlines the trial model in reproductive medicine that was created as a first step in the development of a business model for medical subspecialty training to complement the current academic subspecialty training in South Africa. A two-tiered training model was developed over time. The hurdles that had to be overcome were the development of a curriculum and academic capacity, acquisition of appropriate funding, acceptance and accreditation of the decentralised training facility, and lastly, registration of the fellowship with the Health Professions Council of South Africa. The end result of the trial programme was a two-year full-time training with supportive funding, or a four-year programme, where the subspecialists would spend three weeks of the month in their home practice environment, attached to an accredited unit, and the last week in an academic institution. Due to the trial program’s success for the South African context and the potential of such model for the developing world, it was evident that the trial programme had to be tested to determine whether and how it can be implemented on a wider basis. PMID:27822351

  6. Genetically engineered livestock: ethical use for food and medical models.

    PubMed

    Garas, Lydia C; Murray, James D; Maga, Elizabeth A

    2015-01-01

    Recent advances in the production of genetically engineered (GE) livestock have resulted in a variety of new transgenic animals with desirable production and composition changes. GE animals have been generated to improve growth efficiency, food composition, and disease resistance in domesticated livestock species. GE animals are also used to produce pharmaceuticals and as medical models for human diseases. The potential use of these food animals for human consumption has prompted an intense debate about food safety and animal welfare concerns with the GE approach. Additionally, public perception and ethical concerns about their use have caused delays in establishing a clear and efficient regulatory approval process. Ethically, there are far-reaching implications of not using genetically engineered livestock, at a detriment to both producers and consumers, as use of this technology can improve both human and animal health and welfare.

  7. Simulation and optimization models for emergency medical systems planning.

    PubMed

    Bettinelli, Andrea; Cordone, Roberto; Ficarelli, Federico; Righini, Giovanni

    2014-01-01

    The authors address strategic planning problems for emergency medical systems (EMS). In particular, the three following critical decisions are considered: i) how many ambulances to deploy in a given territory at any given point in time, to meet the forecasted demand, yielding an appropriate response time; ii) when ambulances should be used for serving nonurgent requests and when they should better be kept idle for possible incoming urgent requests; iii) how to define an optimal mix of contracts for renting ambulances from private associations to meet the forecasted demand at minimum cost. In particular, analytical models for decision support, based on queuing theory, discrete-event simulation, and integer linear programming were presented. Computational experiments have been done on real data from the city of Milan, Italy.

  8. Expanding the Biomedical Model: Case Studies of Five Medical Schools.

    ERIC Educational Resources Information Center

    Tresolini, Carol P.; And Others

    This study examined five representative medical schools for approaches to teaching integrated approaches to health care. Traditionally medical schools have taught from a biomedical, technological approach. The study used a qualitative, multiple case study design to explore which medical schools were attempting integrated health care education. On…

  9. Students Teaching Students: A Model for Medical Education

    ERIC Educational Resources Information Center

    Flax, Jim; Garrard, Judith

    1974-01-01

    At the University of Minnesota Medical School a course, Introduction to Clinical Medicine, introduces communication skills; develops interview skills consistent with students' personality, their role as medical students, and the patients' needs; assists students in becoming comfortable as medical students in the hospital setting; and teaches them…

  10. A new mouse model of ADHD for medication development

    PubMed Central

    Majdak, Petra; Ossyra, John R.; Ossyra, Jessica M.; Cobert, Adam J.; Hofmann, Gabrielle C.; Tse, Stephen; Panozzo, Brent; Grogan, Elizabeth L.; Sorokina, Anastassia; Rhodes, Justin S.

    2016-01-01

    ADHD is a major societal problem with increasing incidence and a stagnant track record for treatment advances. A lack of appropriate animal models has partly contributed to the incremental advance of this field. Hence, our goal was to generate a novel mouse model that could be useful for ADHD medication development. We reasoned that hyperactivity is a core feature of ADHD that could easily be bred into a population, but to what extent other hallmark features of ADHD would appear as correlated responses was unknown. Hence, starting from a heterogeneous population, we applied within-family selection over 16 generations to produce a High-Active line, while simultaneously maintaining an unselected line to serve as the Control. We discovered that the High-Active line demonstrated motor impulsivity in two different versions of the Go/No-go test, which was ameliorated with a low dose of amphetamine, and further displayed hypoactivation of the prefrontal cortex and dysregulated cerebellar vermal activation as indexed by c-Fos immunohistochemical staining. We conclude that the High-Active line represents a valid model for the Hyperactive-Impulsive subtype of ADHD and therefore may be used in future studies to advance our understanding of the etiology of ADHD and screen novel compounds for its treatment. PMID:27996970

  11. Animal Models for Medical Countermeasures to Radiation Exposure

    PubMed Central

    Williams, Jacqueline P.; Brown, Stephen L.; Georges, George E.; Hauer-Jensen, Martin; Hill, Richard P.; Huser, Amy K.; Kirsch, David G.; MacVittie, Thomas J.; Mason, Kathy A.; Medhora, Meetha M.; Moulder, John E.; Okunieff, Paul; Otterson, Mary F.; Robbins, Michael E.; Smathers, James B.; McBride, William H.

    2011-01-01

    Since September 11, 2001, there has been the recognition of a plausible threat from acts of terrorism, including radiological or nuclear attacks. A network of Centers for Medical Countermeasures against Radiation (CMCRs) has been established across the U.S.; one of the missions of this network is to identify and develop mitigating agents that can be used to treat the civilian population after a radiological event. The development of such agents requires comparison of data from many sources and accumulation of information consistent with the “Animal Rule” from the Food and Drug Administration (FDA). Given the necessity for a consensus on appropriate animal model use across the network to allow for comparative studies to be performed across institutions, and to identify pivotal studies and facilitate FDA approval, in early 2008, investigators from each of the CMCRs organized and met for an Animal Models Workshop. Working groups deliberated and discussed the wide range of animal models available for assessing agent efficacy in a number of relevant tissues and organs, including the immune and hematopoietic systems, gastrointestinal tract, lung, kidney and skin. Discussions covered the most appropriate species and strains available as well as other factors that may affect differential findings between groups and institutions. This report provides the workshop findings. PMID:20334528

  12. 3-dimensionally integrated photo-detector for neutrino physics and beyond

    NASA Astrophysics Data System (ADS)

    Retiere, Fabrice

    2016-09-01

    Silicon photo-multipliers (SiPMs) are a promising solution for the detection of scintillation light of liquid Xenon and Argon in applications requiring minimum radioactivity content such as neutrinoless double beta decay. The nEXO experiment in particular is planning to use SiPM planes covering 5 m2 for the detection of the light emitted within 5tons of liquid Xenon. The 3-dimensionally digital integrated SiPMs (3DdSiPMs) is an emerging technology that if successful would challenge the analog SiPM technology. Indeed, by combining separate photo-detector and electronics chips within a single package, 3DdSiPM achieve excellent performances for photon counting and time stamping, while dissipating minimum power. Being mostly based on high purity silicon chips, 3DdSiPMs are also expected to achieve excellent radiopurity.The development of 3DdSiPMs for applications in liquid Xenon is expected to progress rapidly by altering the design of the first successful chip assembly developed for medical imaging, focusing on minimizing power dissipation and large area (> cm2) scaling. In this talk we will describe the 3DdSiPM concept a solution for ``light to bit conversion'' within a single package and show how it may revolutionize light detection in noble-gas liquids and beyond.

  13. [On hi-tech cardiologic care model in medical support of train operation safety].

    PubMed

    Pfaf, V F; Gorokhova, S G; Kotenko, V A

    2015-01-01

    The article covers hi-tech cardiologic care model in system of medical support of train operation safety, with definition of structure blocks in this model. Discussion covers peculiarities of the model functioning in comparison with the governmental system of hi-tech medical care, including its closed cycle principle characteristics, wide patients selection among railway workers, continuous and close cooperation between various medical speicalities, with active involvement of occupational fitness specialists (medical examination committees of various levels, including Central Medical Examination Committee), major extent of interventional rentgenosurgical technologies applied in diseases without significant functional failure.

  14. Faculty development in medical education research: a cooperative model.

    PubMed

    Coates, Wendy C; Love, Jeffrey N; Santen, Sally A; Hobgood, Cherri D; Mavis, Brian E; Maggio, Lauren A; Farrell, Susan E

    2010-05-01

    As the definition of scholarship is clarified, each specialty should develop a cadre of medical education researchers who can design, test, and optimize educational interventions. In 2004, the Association for American Medical Colleges' Group on Educational Affairs developed the Medical Education Research Certificate (MERC) program to provide a curriculum to help medical educators acquire or enhance skills in medical education research, to promote effective collaboration with seasoned researchers, and to create better consumers of medical education scholarship. MERC courses are offered to individuals during educational meetings. Educational leaders in emergency medicine (EM) identified a disparity between the "scholarship of teaching" and medical education research skills, and they collaborated with the MERC steering committee to develop a mentored faculty development program in medical education research. A planning committee comprising experienced medical education researchers who are also board-certified, full-time EM faculty members designed a novel approach to the MERC curriculum: a mentored team approach to learning, grounded in collaborative medical education research projects. The planning committee identified areas of research interest among participants and formed working groups to collaborate on research projects during standard MERC workshops. Rather than focusing on individual questions during the course, each mentored group identified a single study hypothesis. After completing the first three workshops, group members worked under their mentors' guidance on their multiinstitutional research projects. The expected benefits of this approach to MERC include establishing a research community network, creating projects whose enrollments offer a multiinstitutional dimension, and developing a cadre of trained education researchers in EM.

  15. Evaluation of Medical Cystine Stone Prevention in an Animal Model

    NASA Astrophysics Data System (ADS)

    Sagi, Sreedhar; Wendt-Nordahl, Gunnar; Alken, Peter; Knoll, Thomas

    2007-04-01

    Medical treatment for cystinuria aims to decrease the concentration of cystine in the urine, increase its solubility and therefore prevent stone formation. Ascorbic acid and captopril have been recommended as alternatives to thiol drugs, though conflicting data undermining their efficacy has been widely reported, too. The aim of this study was to verify the effects of ascorbic acid and captopril on cystine stone formation in the cystinuria mouse model. A total of 28 male homozygous pebbles mice were used for characterizing the mice on normal diet, ascorbic acid and captopril supplemented diets. The baseline physiological parameters of the mice were determined initially. The normal diet was then replaced with the supplemented diet (ascorbic acid/captopril) for the next 48 weeks and various biochemical parameters in urine and plasma were analyzed. All homozygous mice developed urinary cystine stones during the first year of life. No reduction in the urinary cystine concentration was seen with either of the supplemented diets. The stone mass varied widely in the study and a beneficial effect of ascorbic acid in some of the animals was possible though an overall statistical significance was not seen. Conclusions: The cystinuria mouse model provides an ideal tool for evaluation of stone preventive measures in a standardized environment. This study confirms that ascorbic acid and captopril are not effective in cystinuria.

  16. A Latent Growth Model Suggests that Empathy of Medical Students Does Not Decline over Time

    ERIC Educational Resources Information Center

    Costa, Patrício; Magalhães, Eunice; Costa, Manuel João

    2013-01-01

    Empathy is a relevant attribute in the context of patient care. However, a decline in empathy throughout medical education has been reported in North-American medical schools, particularly, in the transition to clinical training. The present study aims to longitudinally model empathy during medical school at three time points: at the entrance,…

  17. The Integrated Medical Model - A Risk Assessment and Decision Support Tool for Human Space Flight Missions

    NASA Technical Reports Server (NTRS)

    Kerstman, Eric; Minard, Charles G.; Saile, Lynn; FreiredeCarvalho, Mary; Myers, Jerry; Walton, Marlei; Butler, Douglas; Lopez, Vilma

    2010-01-01

    The Integrated Medical Model (IMM) is a decision support tool that is useful to space flight mission planners and medical system designers in assessing risks and optimizing medical systems. The IMM employs an evidence-based, probabilistic risk assessment (PRA) approach within the operational constraints of space flight.

  18. Model medication management process in Australian nursing homes using business process modeling.

    PubMed

    Qian, Siyu; Yu, Ping

    2013-01-01

    One of the reasons for end user avoidance or rejection to use health information systems is poor alignment of the system with healthcare workflow, likely causing by system designers' lack of thorough understanding about healthcare process. Therefore, understanding the healthcare workflow is the essential first step for the design of optimal technologies that will enable care staff to complete the intended tasks faster and better. The often use of multiple or "high risk" medicines by older people in nursing homes has the potential to increase medication error rate. To facilitate the design of information systems with most potential to improve patient safety, this study aims to understand medication management process in nursing homes using business process modeling method. The paper presents study design and preliminary findings from interviewing two registered nurses, who were team leaders in two nursing homes. Although there were subtle differences in medication management between the two homes, major medication management activities were similar. Further field observation will be conducted. Based on the data collected from observations, an as-is process model for medication management will be developed.

  19. Air Force Medical Modeling and Simulation: Bringing Virtual Reality to Reality

    DTIC Science & Technology

    2011-01-26

    Modeling and Simulation 26 January 2011 Colonel Deborah N. Burgess, MD, FACP 1 Military Health System Conference Medical Modernization Division...Medical Modeling and Simulation: Bringing Virtual Reality to Reality 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d...Coordinating Group-1 Modeling & Simulation subgroup • USAF SG designated SPO vs MEFPAK for medical simulation E&T *Current Jan 2011 2011 MHS

  20. A 3-dimensional theory of free electron lasers

    SciTech Connect

    Webb, S.D.; Wang, G.; Litvinenko, V.N.

    2010-08-23

    In this paper, we present an analytical three-dimensional theory of free electron lasers. Under several assumptions, we arrive at an integral equation similar to earlier work carried out by Ching, Kim and Xie, but using a formulation better suited for the initial value problem of Coherent Electron Cooling. We use this model in later papers to obtain analytical results for gain guiding, as well as to develop a complete model of Coherent Electron Cooling.

  1. Social Work Education on Mental Health: Postmodern Discourse and the Medical Model

    ERIC Educational Resources Information Center

    Casstevens, W. J.

    2010-01-01

    This article provides a pedagogical approach to presenting alternatives along with the traditional medical model in the context of mental health treatment and service provision. Given the current influence of the medical model in community mental health, this article outlines a rationale for challenging the model and considering alternative models…

  2. The distribution of particles in the plane dispersed by a simple 3-dimensional diffusion process.

    PubMed

    Stockmarr, Anders

    2002-11-01

    Populations of particles dispersed in the 2-dimensional plane from a single point-source may be grouped as focus expansion patterns, with an exponentially decreasing density, and more diffuse patterns with thicker tails. Exponentially decreasing distributions are often modelled as the result of 2-dimensional diffusion processes acting to disperse the particles, while thick-tailed distributions tend to be modelled by purely descriptive distributions. Models based on the Cauchy distribution have been suggested, but these have not been related to diffusion modelling. However, the distribution of particles dispersed from a point source by a 3-dimensional Brownian motion that incorporates a constant drift, under the condition that the particle starts at a given height and is stopped when it reaches the xy plane (zero height) may be shown to result in both slim-tailed exponentially decreasing densities, and thick-tailed polynomially decreasing densities with infinite mean travel distance from the source, depending on parameter values. The drift in the third coordinate represents gravitation, while the drift in the first and second represents a (constant) wind. Conditions for the density having exponentially decreasing tails is derived in terms of gravitation and wind, with a special emphasis on applications to light-weighted particles such as fungal spores.

  3. Professionalism Deficits among Medical Students: Models of Identification and Intervention

    ERIC Educational Resources Information Center

    Bennett, Aurora J.; Roman, Brenda; Arnold, Lesley M.; Kay, Jerald; Goldenhar, Linda M.

    2005-01-01

    Objective: This study compares the instruments and interventions utilized to identify and remediate unprofessional behaviors in medical students across U.S. psychiatry clerkships. Methods: A 20-item questionnaire was distributed to 120 psychiatry clerkship directors and directors of medical student education, in the U.S., inquiring into the…

  4. 3-Dimensional Immersive Visualization For Regional Water Planning

    NASA Astrophysics Data System (ADS)

    Block, J.; Razdan, A.; Shangraw, R.; Arrowsmith, R.

    2005-12-01

    As the population in the southwestern US grows, water planning requires increasingly creative solutions to manage valuable water resources at the local and regional level. The East Valley Water Forum (EVWF) is a regional cooperative of water providers east of Phoenix, Arizona, designing their water management plan for the next 25 years. Water resources in this region come from the Colorado River, the Salt River Project, groundwater, and other local and regional sources which provide resources that are subject to climatic variability. In order to best understand the physical and political relationships between water resources and their management, the Arizona Department of Water Resources (ADWR) analyzes hydrologic data in the region using USGS's MODFLOW software, which computes the status of groundwater resources in the region. However, in order to improve policy decision making using MODFLOW outputs, a comprehensive scientific understanding of the inputs, outputs and their uncertainties is needed. These uncertainties include intrinsic hydrologic uncertainty as well uncertainties in external controls such as drought and urban growth. The Decision Theater (DT) is a new facility at Arizona State University (ASU) that specializes in high resolution 3D immersive visualization of scientific data and models. The facility includes a room with a seven-paneled screen surrounding the viewers by 260 degrees for an immersive experience. It is an innovative tool for visualization of datasets from disparate sources for synthesis of complex spatial problems, and its staff is collaborating with the EVWF and the Bureau of Reclamation to better visualize their modeled water supply and demand scenarios under various drought conditions. The space provides a neutral setting for a workflow of data and model integration in which groups can iteratively assess, interact with, and gain intuition about the relevant data and models. This data integration results in visualizations that

  5. Live streaming video for medical education: a laboratory model.

    PubMed

    Gandsas, Alejandro; McIntire, Katherine; Palli, Guillermo; Park, Adrian

    2002-10-01

    At the University of Kentucky (UK), we applied streaming video technology to develop a webcast model that will allow institutions to broadcast live and prerecorded surgeries, conferences, and courses in real time over networks (the Internet or an intranet). We successfully broadcast a prerecorded laparoscopic paraesophageal hernia repair to domestic and international clients by using desktop computers equipped with off-the-shelf, streaming-enabled software and standard hardware and operating systems. A web-based user interface made accessing the educational material as simple as a mouse click and allowed clients to participate in the broadcast event via an embedded e-mail/chat module. Three client computers (two connected to the Internet and a third connected to the UK intranet) requested and displayed the surgical film by means of seven common network connection configurations. Significantly, no difference in image resolution was detected with the use of a connection speed faster than 128 kilobytes per second (kbps). At this connection speed, an average bandwidth of 32.7 kbps was used, and although a 15-second delay was experienced from the time of data request to data display, the surgical film streamed continuously from beginning to end at a mean rate of 14.4 frames per second (fps). The clients easily identified all anatomic structures in full color motion, clearly followed all steps of the surgical procedure, and successfully asked questions and made comments by using the e-mail/chat module while viewing the surgery. With minimal financial investment, we have created an interactive virtual classroom with the potential to attract a global audience. Our webcast model represents a simple and practical method for institutions to supplement undergraduate and graduate surgical education and offer continuing medical education credits in a way that is convenient for clients (surgeons, students, residents, others). In the future, physicians may access streaming webcast

  6. Physical Constraint Finite Element Model for Medical Image Registration

    PubMed Central

    Zhang, Jingya; Wang, Jiajun; Wang, Xiuying; Gao, Xin; Feng, Dagan

    2015-01-01

    Due to being derived from linear assumption, most elastic body based non-rigid image registration algorithms are facing challenges for soft tissues with complex nonlinear behavior and with large deformations. To take into account the geometric nonlinearity of soft tissues, we propose a registration algorithm on the basis of Newtonian differential equation. The material behavior of soft tissues is modeled as St. Venant-Kirchhoff elasticity, and the nonlinearity of the continuum represents the quadratic term of the deformation gradient under the Green- St.Venant strain. In our algorithm, the elastic force is formulated as the derivative of the deformation energy with respect to the nodal displacement vectors of the finite element; the external force is determined by the registration similarity gradient flow which drives the floating image deforming to the equilibrium condition. We compared our approach to three other models: 1) the conventional linear elastic finite element model (FEM); 2) the dynamic elastic FEM; 3) the robust block matching (RBM) method. The registration accuracy was measured using three similarities: MSD (Mean Square Difference), NC (Normalized Correlation) and NMI (Normalized Mutual Information), and was also measured using the mean and max distance between the ground seeds and corresponding ones after registration. We validated our method on 60 image pairs including 30 medical image pairs with artificial deformation and 30 clinical image pairs for both the chest chemotherapy treatment in different periods and brain MRI normalization. Our method achieved a distance error of 0.320±0.138 mm in x direction and 0.326±0.111 mm in y direction, MSD of 41.96±13.74, NC of 0.9958±0.0019, NMI of 1.2962±0.0114 for images with large artificial deformations; and average NC of 0.9622±0.008 and NMI of 1.2764±0.0089 for the real clinical cases. Student’s t-test demonstrated that our model statistically outperformed the other methods in comparison (p

  7. Development of a structural model explaining medication compliance of persons with schizophrenia.

    PubMed

    Seo, Mi A; Min, Sung Kil

    2005-06-30

    The purpose of this study was to develop and test a structural model explaining medication compliance of schizophrenia. From a review of the literature, a hypothetical model was developed based on the conceptual framework of the Health Belief Model with medication knowledge, symptom severity and social support as the exogenous variables, and perceived benefits, perceived barriers, substance use and medication compliance as the endogenous variables. Data was collected at various mental health facilities, including psychiatric outpatient clinics of general hospitals and community mental health centers, between March and May, 2001. A structured questionnaire was used by one- on- one interviews to collect data on 208 schizophrenic patients. Well established measurement instruments, with confirmed reliability, were used to assess each method variable. As a result of covariance structural analysis, the hypothetical model was found not to fit the empirical data well, so a parsimonious model was adopted after modifying the model. The final model was able to explain the 33 % medication compliance. Medication knowledge, social support and perceived benefits had significant effects on medication compliance. The findings of this study address the importance of medication education and social support to promote medication compliance. It is also suggested that various education programs and support groups are needed to enhance medication compliance.

  8. Constructing an urban population model for medical insurance scheme using microsimulation techniques.

    PubMed

    Xiong, Linping; Zhang, Lulu; Tang, Weidong; Ma, Yuqin

    2012-01-01

    China launched a pilot project of medical insurance reform in 79 cities in 2007 to cover urban nonworking residents. An urban population model was created in this paper for China's medical insurance scheme using microsimulation model techniques. The model made it clear for the policy makers the population distributions of different groups of people, the potential urban residents entering the medical insurance scheme. The income trends of units of individuals and families were also obtained. These factors are essential in making the challenging policy decisions when considering to balance the long-term financial sustainability of the medical insurance scheme.

  9. The approach of Bayesian model indicates media awareness of medical errors

    NASA Astrophysics Data System (ADS)

    Ravichandran, K.; Arulchelvan, S.

    2016-06-01

    This research study brings out the factors behind the increase in medical malpractices in the Indian subcontinent in the present day environment and impacts of television media awareness towards it. Increased media reporting of medical malpractices and errors lead to hospitals taking corrective action and improve the quality of medical services that they provide. The model of Cultivation Theory can be used to measure the influence of media in creating awareness of medical errors. The patient's perceptions of various errors rendered by the medical industry from different parts of India were taken up for this study. Bayesian method was used for data analysis and it gives absolute values to indicate satisfaction of the recommended values. To find out the impact of maintaining medical records of a family online by the family doctor in reducing medical malpractices which creates the importance of service quality in medical industry through the ICT.

  10. Magnetic flux ropes in 3-dimensional MHD simulations

    NASA Technical Reports Server (NTRS)

    Ogino, Tatsuki; Walker, Raymond J.; Ashour-Abdalla, Maha

    1990-01-01

    The interaction of the solar wind and the earth's magnetosphere is presently simulated by a 3D, time-dependent, global MHD method in order to model the magnetopause and magnetotail generation of magnetic flux ropes. It is noted that strongly twisted and localized magnetic flux tubes simular to magnetic flux ropes appear at the subpolar magnetopause when the IMF has a large azimuthal component, as well as a southward component. Plasmoids are generated in the magnetotail after the formation of a near-earth magnetic neutral line; the magnetic field lines have a helical structure that is connected from dawn to dusk.

  11. Continuing education for medical students: a library model

    PubMed Central

    Swanberg, Stephanie M.; Engwall, Keith; Mi, Misa

    2015-01-01

    Purpose The research assessed a three-year continuing medical education–style program for medical students in a Midwestern academic medical library. Methods A mixed methods approach of a survey and two focus groups comparing attendees versus non-attendees assessed the program. Results Eleven students participated in the focus groups. Attendance was driven by topic interest and lunch. Barriers included lack of interest, scheduling, location, and convenience. Conclusions Although attendance was a challenge, students valued opportunities to learn new skills. This study showcases a reproducible method to engage students outside the curriculum. PMID:26512222

  12. Interfacial magnetic anisotropy from a 3-dimensional Rashba substrate.

    PubMed

    Li, Junwen; Haney, Paul M

    2016-07-18

    We study the magnetic anisotropy which arises at the interface between a thin film ferromagnet and a 3-d Rashba material. We use a tight-binding model to describe the bilayer, and the 3-d Rashba material characterized by the spin-orbit strength α and the direction of broken bulk inversion symmetry n̂. We find an in-plane uniaxial anisotropy in the ẑ × n̂ direction, where ẑ is the interface normal. For realistic values of α, the uniaxial anisotropy is of a similar order of magnitude as the bulk magnetocrystalline anisotropy. Evaluating the uniaxial anisotropy for a simplified model in 1-d shows that for small band filling, the in-plane easy axis anisotropy scales as α(4) and results from a twisted exchange interaction between the spins in the 3-d Rashba material and the ferromagnet. For a ferroelectric 3-d Rashba material, n̂ can be controlled with an electric field, and we propose that the interfacial magnetic anisotropy could provide a mechanism for electrical control of the magnetic orientation.

  13. Regulation and 3 dimensional culture of tertiary follicle growth.

    PubMed

    Cheon, Yong-Pil

    2012-09-01

    It has been revealed that multiple cohorts of tertiary follicles develop during some animal estrous cycle and the human menstrual cycle. To reach developmental competence, oocytes need the support of somatic cells. During embryogenesis, the primordial germ cells appear, travel to the gonadal rudiments, and form follicles. The female germ cells develop within the somatic cells of the ovary, granulosa cells, and theca cells. How the oocyte and follicle cells support each other has been seriously studied. The latest technologies in genes and proteins and genetic engineering have allowed us to collect a great deal of information about folliculogenesis. For example, a few web pages (http://www.ncbi.nlm.nih.gov; http://mrg.genetics.washington.edu) provide access to databases of genomes, sequences of transcriptomes, and various tools for analyzing and discovering genes important in ovarian development. Formation of the antrum (tertiary follicle) is the final phase of folliculogenesis and the transition from intraovarian to extraovian regulation. This final step coordinates with the hypothalamic-pituitary-ovarian axis. On the other hand, currently, follicle physiology is under intense investigation, as little is known about how to overcome women's ovarian problems or how to develop competent oocytes from in vitro follicle culture or transplantation. In this review, some of the known roles of hormones and some of the genes involved in tertiary follicle growth and the general characteristics of tertiary follicles are summarized. In addition, in vitro culture of tertiary follicles is also discussed as a study model and an assisted reproductive technology model.

  14. Influence of the implant diameter with different sizes of hexagon: analysis by 3-dimensional finite element method.

    PubMed

    Pellizzer, Eduardo Piza; Verri, Fellippo Ramos; de Moraes, Sandra Lúcia Dantas; Falcón-Antenucci, Rosse Mary; de Carvalho, Paulo Sérgio Perri; Noritomi, Pedro Yoshito

    2013-08-01

    The aim of this study was to evaluate the stress distribution in implants of regular platforms and of wide diameter with different sizes of hexagon by the 3-dimensional finite element method. We used simulated 3-dimensional models with the aid of Solidworks 2006 and Rhinoceros 4.0 software for the design of the implant and abutment and the InVesalius software for the design of the bone. Each model represented a block of bone from the mandibular molar region with an implant 10 mm in length and different diameters. Model A was an implant 3.75 mm/regular hexagon, model B was an implant 5.00 mm/regular hexagon, and model C was an implant 5.00 mm/expanded hexagon. A load of 200 N was applied in the axial, lateral, and oblique directions. At implant, applying the load (axial, lateral, and oblique), the 3 models presented stress concentration at the threads in the cervical and middle regions, and the stress was higher for model A. At the abutment, models A and B showed a similar stress distribution, concentrated at the cervical and middle third; model C showed the highest stresses. On the cortical bone, the stress was concentrated at the cervical region for the 3 models and was higher for model A. In the trabecular bone, the stresses were less intense and concentrated around the implant body, and were more intense for model A. Among the models of wide diameter (models B and C), model B (implant 5.00 mm/regular hexagon) was more favorable with regard to distribution of stresses. Model A (implant 3.75 mm/regular hexagon) showed the largest areas and the most intense stress, and model B (implant 5.00 mm/regular hexagon) showed a more favorable stress distribution. The highest stresses were observed in the application of lateral load.

  15. Scaffold Free Bio-orthogonal Assembly of 3-Dimensional Cardiac Tissue via Cell Surface Engineering

    PubMed Central

    Rogozhnikov, Dmitry; O’Brien, Paul J.; Elahipanah, Sina; Yousaf , Muhammad N.

    2016-01-01

    There has been tremendous interest in constructing in vitro cardiac tissue for a range of fundamental studies of cardiac development and disease and as a commercial system to evaluate therapeutic drug discovery prioritization and toxicity. Although there has been progress towards studying 2-dimensional cardiac function in vitro, there remain challenging obstacles to generate rapid and efficient scaffold-free 3-dimensional multiple cell type co-culture cardiac tissue models. Herein, we develop a programmed rapid self-assembly strategy to induce specific and stable cell-cell contacts among multiple cell types found in heart tissue to generate 3D tissues through cell-surface engineering based on liposome delivery and fusion to display bio-orthogonal functional groups from cell membranes. We generate, for the first time, a scaffold free and stable self assembled 3 cell line co-culture 3D cardiac tissue model by assembling cardiomyocytes, endothelial cells and cardiac fibroblast cells via a rapid inter-cell click ligation process. We compare and analyze the function of the 3D cardiac tissue chips with 2D co-culture monolayers by assessing cardiac specific markers, electromechanical cell coupling, beating rates and evaluating drug toxicity. PMID:28008983

  16. A 3-Dimensional discrete fracture network generator to examine fracture-matrix interaction using TOUGH2

    SciTech Connect

    Ito, Kazumasa; Yongkoo, Seol

    2003-04-09

    Water fluxes in unsaturated, fractured rock involve the physical processes occurring at fracture-matrix interfaces within fracture networks. Modeling these water fluxes using a discrete fracture network model is a complicated effort. Existing preprocessors for TOUGH2 are not suitable to generate grids for fracture networks with various orientations and inclinations. There are several 3-D discrete-fracture-network simulators for flow and transport, but most of them do not capture fracture-matrix interaction. We have developed a new 3-D discrete-fracture-network mesh generator, FRACMESH, to provide TOUGH2 with information about the fracture network configuration and fracture-matrix interactions. FRACMESH transforms a discrete fracture network into a 3 dimensional uniform mesh, in which fractures are considered as elements with unique rock material properties and connected to surrounding matrix elements. Using FRACMESH, individual fractures may have uniform or random aperture distributions to consider heterogeneity. Fracture element volumes and interfacial areas are calculated from fracture geometry within individual elements. By using FRACMESH and TOUGH2, fractures with various inclinations and orientations, and fracture-matrix interaction, can be incorporated. In this paper, results of flow and transport simulations in a fractured rock block utilizing FRACMESH are presented.

  17. MAPAG: a computer program to construct 2- and 3-dimensional antigenic maps.

    PubMed

    Aguilar, R C; Retegui, L A; Roguin, L P

    1994-01-01

    The contact area between an antibody (Ab) and the antigen (Ag) is called antigenic determinant or epitope. The first step in the characterization of an Ag by using monoclonal antibodies (MAb) is to map the relative distribution of the corresponding epitopes on the Ag surface. The computer program MAPAG has been devised to automatically construct antigenic maps. MAPAG is fed with a binary matrix of experimental data indicating the ability of paired MAb to bind or not simultaneously to the Ag. The program is interactive menu-driven and allows the user an easy data handling. MAPAG utilizes iterative processes to construct and to adjust the final map, which is graphically shown as a 2- or a 3-dimensional model. Additionally, the antigenic map obtained can be optionally modified by the user or readjusted by the program. The suitability of MAPAG was illustrated by running experimental data from literature and comparing antigenic maps constructed by the program with those elaborated by the investigators without the assistance of a computer. Furthermore, since some MAb could present negative allosteric effects leading to misinterpretation of data, MAPAG has been provided with an approximate reasoning module to solve such anomalous situations. Results indicated that the program can be successfully employed as a simple, fast and reliable antigenic model-builder.

  18. Scaffold Free Bio-orthogonal Assembly of 3-Dimensional Cardiac Tissue via Cell Surface Engineering

    NASA Astrophysics Data System (ADS)

    Rogozhnikov, Dmitry; O’Brien, Paul J.; Elahipanah, Sina; Yousaf, Muhammad N.

    2016-12-01

    There has been tremendous interest in constructing in vitro cardiac tissue for a range of fundamental studies of cardiac development and disease and as a commercial system to evaluate therapeutic drug discovery prioritization and toxicity. Although there has been progress towards studying 2-dimensional cardiac function in vitro, there remain challenging obstacles to generate rapid and efficient scaffold-free 3-dimensional multiple cell type co-culture cardiac tissue models. Herein, we develop a programmed rapid self-assembly strategy to induce specific and stable cell-cell contacts among multiple cell types found in heart tissue to generate 3D tissues through cell-surface engineering based on liposome delivery and fusion to display bio-orthogonal functional groups from cell membranes. We generate, for the first time, a scaffold free and stable self assembled 3 cell line co-culture 3D cardiac tissue model by assembling cardiomyocytes, endothelial cells and cardiac fibroblast cells via a rapid inter-cell click ligation process. We compare and analyze the function of the 3D cardiac tissue chips with 2D co-culture monolayers by assessing cardiac specific markers, electromechanical cell coupling, beating rates and evaluating drug toxicity.

  19. Novel Radiobiological Gamma Index for Evaluation of 3-Dimensional Predicted Dose Distribution

    SciTech Connect

    Sumida, Iori; Yamaguchi, Hajime; Kizaki, Hisao; Aboshi, Keiko; Tsujii, Mari; Yoshikawa, Nobuhiko; Yamada, Yuji; Suzuki, Osamu; Seo, Yuji; Isohashi, Fumiaki; Yoshioka, Yasuo; Ogawa, Kazuhiko

    2015-07-15

    Purpose: To propose a gamma index-based dose evaluation index that integrates the radiobiological parameters of tumor control (TCP) and normal tissue complication probabilities (NTCP). Methods and Materials: Fifteen prostate and head and neck (H&N) cancer patients received intensity modulated radiation therapy. Before treatment, patient-specific quality assurance was conducted via beam-by-beam analysis, and beam-specific dose error distributions were generated. The predicted 3-dimensional (3D) dose distribution was calculated by back-projection of relative dose error distribution per beam. A 3D gamma analysis of different organs (prostate: clinical [CTV] and planned target volumes [PTV], rectum, bladder, femoral heads; H&N: gross tumor volume [GTV], CTV, spinal cord, brain stem, both parotids) was performed using predicted and planned dose distributions under 2%/2 mm tolerance and physical gamma passing rate was calculated. TCP and NTCP values were calculated for voxels with physical gamma indices (PGI) >1. We propose a new radiobiological gamma index (RGI) to quantify the radiobiological effects of TCP and NTCP and calculate radiobiological gamma passing rates. Results: The mean RGI gamma passing rates for prostate cases were significantly different compared with those of PGI (P<.03–.001). The mean RGI gamma passing rates for H&N cases (except for GTV) were significantly different compared with those of PGI (P<.001). Differences in gamma passing rates between PGI and RGI were due to dose differences between the planned and predicted dose distributions. Radiobiological gamma distribution was visualized to identify areas where the dose was radiobiologically important. Conclusions: RGI was proposed to integrate radiobiological effects into PGI. This index would assist physicians and medical physicists not only in physical evaluations of treatment delivery accuracy, but also in clinical evaluations of predicted dose distribution.

  20. Ecological Psychology: Replacing the Medical Model Paradigm for School-Based Psychological and Psychoeducational Services

    ERIC Educational Resources Information Center

    Gutkin, Terry B.

    2012-01-01

    Traditional medical model service delivery systems have facilitated the creation of nationwide mental health and education pandemics for children and youth. The characteristics and shortcomings of medical model approaches leading to these problems are explicated, including the focus of services on individuals rather than populations, relying…

  1. It's All in Your Head: Feminist and Medical Models of Menopause (Strange Bedfellows).

    ERIC Educational Resources Information Center

    Posner, Judith

    1979-01-01

    This article describes the medical model of menopause as it exists in contemporary gynecological textbooks and some popular books written by gynecologists for the general public. The feminist position on menopause is then compared and contrasted with the medical model. (Author/EB)

  2. Analysis of 3-dimensional finite element after reconstruction of impaired ankle deltoid ligament

    PubMed Central

    Ji, Yunhan; Tang, Xianzhong; Li, Yifan; Xu, Wei; Qiu, Wenjun

    2016-01-01

    We compared four repair techniques for impaired ankle ligament deltoideum, namely Wiltberger, Deland, Kitaoka and Hintermann using a 3-dimensional finite element. We built an ankle ligament deltoideum model, including six pieces of bone structures, gristles and main ligaments around the ankle. After testing the model, we built an impaired ligament deltoideum model plus four reconstruction models. Subsequently, different levels of force on ankles with different flexion were imposed and ankle biomechanics were compared. In the course of bending, from plantar flexion 20° to back flexion 20°, the extortion of talus decreased while the eversion increased. Four reconstruction models failed to bring back the impaired ankle to normal, with an obvious increase of extortion and eversion. The Kitaoka technique was useful to reduce the extortion angle in a consequential manner. Compared with the other three techniques, the Kitaoka technique produced better results for extortion angle and the difference was statistically significant. However, in case of eversion, there was no significant difference among the four techniques (P>0.05). Lateral ligament's stress in all the four models was different from the normal one. When the ankle was imposed with extortion moment of force, stress of anterior talofibular ligament with the Kitaoka reconstruction method was close to that of the complete deltoid ligament. When ankle was imposed with eversion moment of force, stress of anterior talofibular ligament with Kitaoka and Deland reconstruction methods were close to that of the complete deltoid ligament. We concluded that Kitaoka and Deland tendon reconstruction technique could recover impaired ankle deltoid ligament and re-established its normal biomechanics characteristics. PMID:28105122

  3. Analysis of 3-dimensional finite element after reconstruction of impaired ankle deltoid ligament.

    PubMed

    Ji, Yunhan; Tang, Xianzhong; Li, Yifan; Xu, Wei; Qiu, Wenjun

    2016-12-01

    We compared four repair techniques for impaired ankle ligament deltoideum, namely Wiltberger, Deland, Kitaoka and Hintermann using a 3-dimensional finite element. We built an ankle ligament deltoideum model, including six pieces of bone structures, gristles and main ligaments around the ankle. After testing the model, we built an impaired ligament deltoideum model plus four reconstruction models. Subsequently, different levels of force on ankles with different flexion were imposed and ankle biomechanics were compared. In the course of bending, from plantar flexion 20° to back flexion 20°, the extortion of talus decreased while the eversion increased. Four reconstruction models failed to bring back the impaired ankle to normal, with an obvious increase of extortion and eversion. The Kitaoka technique was useful to reduce the extortion angle in a consequential manner. Compared with the other three techniques, the Kitaoka technique produced better results for extortion angle and the difference was statistically significant. However, in case of eversion, there was no significant difference among the four techniques (P>0.05). Lateral ligament's stress in all the four models was different from the normal one. When the ankle was imposed with extortion moment of force, stress of anterior talofibular ligament with the Kitaoka reconstruction method was close to that of the complete deltoid ligament. When ankle was imposed with eversion moment of force, stress of anterior talofibular ligament with Kitaoka and Deland reconstruction methods were close to that of the complete deltoid ligament. We concluded that Kitaoka and Deland tendon reconstruction technique could recover impaired ankle deltoid ligament and re-established its normal biomechanics characteristics.

  4. Race-based medical mistrust, medication beliefs and HIV treatment adherence: test of a mediation model in people living with HIV/AIDS.

    PubMed

    Kalichman, Seth C; Eaton, Lisa; Kalichman, Moira O; Grebler, Tama; Merely, Cynthia; Welles, Brandi

    2016-12-01

    Race-based medical mistrust significantly predicts non-adherence to antiretroviral therapy (ART) in people living with HIV. The current study builds on previous research that shows beliefs about medication necessity (i.e., "My medicines protect me from becoming worse") and concerns (i.e., "Having to take my medicines worries me") mediate the association between race-based medical mistrust and medication adherence. Racial and ethnic minority men and women living with HIV and receiving ART (N = 178) in a southern US city completed computerized measures of demographic and health characteristics, telephone interviews of race-based medical mistrust and medication beliefs, and unannounced phone-based pill counts for ART adherence. Multiple mediation modeling showed that medical mistrust is related to medication necessity and concerns beliefs and ART adherence. Furthermore, medication necessity beliefs predicted ART adherence. The indirect effect of medical mistrust on adherence through medication necessity beliefs was also significant. Results confirm that medication necessity beliefs, although not concerns beliefs, mediate the association between medical mistrust and ART adherence. Medication necessity beliefs offer a viable target for interventions to improve ART adherence in the context of mistrust that patients may have for medical providers and health care systems.

  5. Modeling the acceptance of clinical information systems among hospital medical staff: an extended TAM model.

    PubMed

    Melas, Christos D; Zampetakis, Leonidas A; Dimopoulou, Anastasia; Moustakis, Vassilis

    2011-08-01

    Recent empirical research has utilized the Technology Acceptance Model (TAM) to advance the understanding of doctors' and nurses' technology acceptance in the workplace. However, the majority of the reported studies are either qualitative in nature or use small convenience samples of medical staff. Additionally, in very few studies moderators are either used or assessed despite their importance in TAM based research. The present study focuses on the application of TAM in order to explain the intention to use clinical information systems, in a random sample of 604 medical staff (534 physicians) working in 14 hospitals in Greece. We introduce physicians' specialty as a moderator in TAM and test medical staff's information and communication technology (ICT) knowledge and ICT feature demands, as external variables. The results show that TAM predicts a substantial proportion of the intention to use clinical information systems. Findings make a contribution to the literature by replicating, explaining and advancing the TAM, whereas theory is benefited by the addition of external variables and medical specialty as a moderator. Recommendations for further research are discussed.

  6. Preoperative 3-dimensional Magnetic Resonance Imaging of Uterine Myoma and Endometrium Before Myomectomy.

    PubMed

    Kim, Young Jae; Kim, Kwang Gi; Lee, Sa Ra; Lee, Seung Hyun; Kang, Byung Chul

    2017-02-01

    Uterine myomas are the most common gynecologic benign tumor affecting women of childbearing age, and myomectomy is the main surgical option to preserve the uterus and fertility. During myomectomy for women with multiple myomas, it is advisable to identify and remove as many as possible to decrease the risk of future myomectomies. With deficient preoperative imaging, gynecologists are challenged to identify the location and size of myomas and the endometrium, which, in turn, can lead to uterine rupture during future pregnancies. Current conventional 2-dimensional imaging has limitations in identifying precise locations of multiple myomas and the endometrium. In our experience, we preferred to use 3-dimensional imaging to delineate the myomas, endometrium, or blood vessels, which we were able to successfully reconstruct by using the following imaging method. To achieve 3-dimensional imaging, we matched T2 turbo spin echo images to detect uterine myomas and endometria with T1 high-resolution isotropic volume excitation-post images used to detect blood vessels by using an algorithm based on the 3-dimensional region growing method. Then, we produced images of the uterine myomas, endometria, and blood vessels using a 3-dimensional surface rendering method and successfully reconstructed selective 3-dimensional imaging for uterine myomas, endometria, and adjacent blood vessels. A Web-based survey was sent to 66 gynecologists concerning imaging techniques used before myomectomy. Twenty-eight of 36 responding gynecologists answered that the 3-dimensional image produced in the current study is preferred to conventional 2-dimensional magnetic resonance imaging in identifying precise locations of uterine myomas and endometria. The proposed 3-dimensional magnetic resonance imaging method successfully reconstructed uterine myomas, endometria, and adjacent vessels. We propose that this will be a helpful adjunct to uterine myomectomy as a preoperative imaging technique in future

  7. Fusion of radar data to extract 3-dimensional objects LDRD final report

    SciTech Connect

    Fellerhoff, R.; Hensley, B.; Carande, R.; Burkhart, G.; Ledner, R.

    1997-03-01

    Interferometric Synthetic Aperture Radar (IFSAR) is a very promising technology for remote mapping of 3-Dimensional objects. In particular, 3-D maps of urban areas are extremely important to a wide variety of users, both civilian and military. However, 3-D maps produced by traditional optical stereo (stereogrammetry) techniques can be quite expensive to obtain, and accurate urban maps can only be obtained with a large amount of human-intensive interpretation work. IFSAR has evolved over the last decade as a mapping technology that promises to eliminate much of the human-intensive work in producing elevation maps. However, IFSAR systems have only been robustly demonstrated in non-urban areas, and have not traditionally been able to produce data with enough detail to be of general use in urban areas. Sandia Laboratories Twin Otter IFSAR was the first mapping radar system with the proper parameter set to provide sufficiently detailed information in a large number of urban areas. The goal of this LDRD was to fuse previously unused information derived from IFSAR data in urban areas that can be used to extract accurate digital elevation models (DEMs) over wide areas without intensive human interaction.

  8. A Novel Method of Orbital Floor Reconstruction Using Virtual Planning, 3-Dimensional Printing, and Autologous Bone.

    PubMed

    Vehmeijer, Maarten; van Eijnatten, Maureen; Liberton, Niels; Wolff, Jan

    2016-08-01

    Fractures of the orbital floor are often a result of traffic accidents or interpersonal violence. To date, numerous materials and methods have been used to reconstruct the orbital floor. However, simple and cost-effective 3-dimensional (3D) printing technologies for the treatment of orbital floor fractures are still sought. This study describes a simple, precise, cost-effective method of treating orbital fractures using 3D printing technologies in combination with autologous bone. Enophthalmos and diplopia developed in a 64-year-old female patient with an orbital floor fracture. A virtual 3D model of the fracture site was generated from computed tomography images of the patient. The fracture was virtually closed using spline interpolation. Furthermore, a virtual individualized mold of the defect site was created, which was manufactured using an inkjet printer. The tangible mold was subsequently used during surgery to sculpture an individualized autologous orbital floor implant. Virtual reconstruction of the orbital floor and the resulting mold enhanced the overall accuracy and efficiency of the surgical procedure. The sculptured autologous orbital floor implant showed an excellent fit in vivo. The combination of virtual planning and 3D printing offers an accurate and cost-effective treatment method for orbital floor fractures.

  9. Cell sheet-based tissue engineering for fabricating 3-dimensional heart tissues.

    PubMed

    Shimizu, Tatsuya

    2014-01-01

    In addition to stem cell biology, tissue engineering is an essential research field for regenerative medicine. In contrast to cell injection, bioengineered tissue transplantation minimizes cell loss and has the potential to repair tissue defects. A popular approach is scaffold-based tissue engineering, which utilizes a biodegradable polymer scaffold for seeding cells; however, new techniques of cell sheet-based tissue engineering have been developed. Cell sheets are harvested from temperature-responsive culture dishes by simply lowering the temperature. Monolayer or stacked cell sheets are transplantable directly onto damaged tissues and cell sheet transplantation has already been clinically applied. Cardiac cell sheet stacking produces pulsatile heart tissue; however, lack of vasculature limits the viable tissue thickness to 3 layers. Multistep transplantation of triple-layer cardiac cell sheets cocultured with endothelial cells has been used to form thick vascularized cardiac tissue in vivo. Furthermore, in vitro functional blood vessel formation within 3-dimensional (3D) tissues has been realized by successfully imitating in vivo conditions. Triple-layer cardiac cell sheets containing endothelial cells were layered on vascular beds and the constructs were media-perfused using novel bioreactor systems. Interestingly, cocultured endothelial cells migrate into the vascular beds and form perfusable blood vessels. An in vitro multistep procedure has also enabled the fabrication of thick, vascularized heart tissues. Cell sheet-based tissue engineering has revealed great potential to fabricate 3D cardiac tissues and should contribute to future treatment of severe heart diseases and human tissue model production.

  10. Medical image segmentation based on SLIC superpixels model

    NASA Astrophysics Data System (ADS)

    Chen, Xiang-ting; Zhang, Fan; Zhang, Ruo-ya

    2017-01-01

    Medical imaging has been widely used in clinical practice. It is an important basis for medical experts to diagnose the disease. However, medical images have many unstable factors such as complex imaging mechanism, the target displacement will cause constructed defect and the partial volume effect will lead to error and equipment wear, which increases the complexity of subsequent image processing greatly. The segmentation algorithm which based on SLIC (Simple Linear Iterative Clustering, SLIC) superpixels is used to eliminate the influence of constructed defect and noise by means of the feature similarity in the preprocessing stage. At the same time, excellent clustering effect can reduce the complexity of the algorithm extremely, which provides an effective basis for the rapid diagnosis of experts.

  11. Evaluating an interprofessional disease state and medication management review model.

    PubMed

    Hoti, Kreshnik; Forman, Dawn; Hughes, Jeffery

    2014-03-01

    There is lack of literature data reporting an incorporation of medication management reviews in students' interprofessional education (IPE) and practice programs in aged care settings. This pilot study reports how an interprofessional disease state and medication management review program (DSMMR) was established in a residential aged care facility in Perth, Western Australia. Students from the professions of nursing, pharmacy and physiotherapy focused on a wellness check in the areas of cognition, falls and continence while integrating a medication management review. Students' attitudes were explored using a pre- and post-placement questionnaire. Students indicated positive experience with the IPE DSMMR program which also resulted in their positive attitudinal shift towards IPE and practice. These findings indicated that aged care can be a suitable setting for student interprofessional programs focusing on DSMMR.

  12. Medical staff involvement in nursing homes: development of a conceptual model and research agenda.

    PubMed

    Shield, Renée; Rosenthal, Marsha; Wetle, Terrie; Tyler, Denise; Clark, Melissa; Intrator, Orna

    2014-02-01

    Medical staff (physicians, nurse practitioners, physicians' assistants) involvement in nursing homes (NH) is limited by professional guidelines, government policies, regulations, and reimbursements, creating bureaucratic burden. The conceptual NH Medical Staff Involvement Model, based on our mixed-methods research, applies the Donabedian "structure-process-outcomes" framework to the NH, identifying measures for a coordinated research agenda. Quantitative surveys and qualitative interviews conducted with medical directors, administrators and directors of nursing, other experts, residents and family members and Minimum Data Set, the Online Certification and Reporting System and Medicare Part B claims data related to NH structure, process, and outcomes were analyzed. NH control of medical staff, or structure, affects medical staff involvement in care processes and is associated with better outcomes (e.g., symptom management, appropriate transitions, satisfaction). The model identifies measures clarifying the impact of NH medical staff involvement on care processes and resident outcomes and has strong potential to inform regulatory policies.

  13. A Dual Hesitant Fuzzy Multigranulation Rough Set over Two-Universe Model for Medical Diagnoses

    PubMed Central

    Zhang, Chao; Li, Deyu; Yan, Yan

    2015-01-01

    In medical science, disease diagnosis is one of the difficult tasks for medical experts who are confronted with challenges in dealing with a lot of uncertain medical information. And different medical experts might express their own thought about the medical knowledge base which slightly differs from other medical experts. Thus, to solve the problems of uncertain data analysis and group decision making in disease diagnoses, we propose a new rough set model called dual hesitant fuzzy multigranulation rough set over two universes by combining the dual hesitant fuzzy set and multigranulation rough set theories. In the framework of our study, both the definition and some basic properties of the proposed model are presented. Finally, we give a general approach which is applied to a decision making problem in disease diagnoses, and the effectiveness of the approach is demonstrated by a numerical example. PMID:26858772

  14. A structural equation modeling of the factors affecting student nurses' medication errors.

    PubMed

    Valdez, Les Paul; de Guzman, Allan; Escolar-Chua, Rowena

    2013-03-01

    Across medication error literature, much attention has been given to incidence, types, causes and prevention of medication errors. Despite these efforts, medication errors continue to occur among registered and student nurses. Considering the numerous studies on medication errors committed by registered nurses, little is known on the nature of student nurses' medication error. This study employed factor analysis and structural equation modeling to explore the factors affecting medication errors by student nurses. With the participation of 329 junior and senior student nurses recruited from a comprehensive university in the Philippines, five factor dimensions of the causes of student nurses' medication error were identified, namely: In-violation, In-writing, In-excess, In-experience and In-tension. Results of path analysis showed an interaction among these variables. Additionally, poor adherence to the "five rights" was identified as an important mediator between In-violation, In-writing, In-excess, In-experience and In-tension and student nurses' medication error. By developing a model to explain how student nurses' medication errors occur, this study sheds light on the nature of student nurses' medication error and provides a basis for error prevention strategies.

  15. A Model for Medical Care in Underserved Areas.

    ERIC Educational Resources Information Center

    Mufson, Maurice A.; Melnick, Donald E.

    1981-01-01

    Marshall University School of Medicine, a new community-based medical school in Huntington, West Virginia which aims to improve the number and distribution of physicians in West Virginia through active involvement of its faculty and residents in primary care delivery, is described. (Author/MLW)

  16. Psychological Mechanisms of Medically Unexplained Symptoms: An Integrative Conceptual Model

    ERIC Educational Resources Information Center

    Brown, Richard J.

    2004-01-01

    Theories of medically unexplained illness based on the concepts of dissociation, conversion, and somatization are summarized. Evidence cited in support of these theories is described and the conceptual strengths and shortcomings of each approach are considered. It is argued that each of these approaches adds to the understanding of unexplained…

  17. Using Medical History Embedded in Biometrics Medical Card for User Identity Authentication: Privacy Preserving Authentication Model by Features Matching

    PubMed Central

    Fong, Simon; Zhuang, Yan

    2012-01-01

    Many forms of biometrics have been proposed and studied for biometrics authentication. Recently researchers are looking into longitudinal pattern matching that based on more than just a singular biometrics; data from user's activities are used to characterise the identity of a user. In this paper we advocate a novel type of authentication by using a user's medical history which can be electronically stored in a biometric security card. This is a sequel paper from our previous work about defining abstract format of medical data to be queried and tested upon authentication. The challenge to overcome is preserving the user's privacy by choosing only the useful features from the medical data for use in authentication. The features should contain less sensitive elements and they are implicitly related to the target illness. Therefore exchanging questions and answers about a few carefully chosen features in an open channel would not easily or directly expose the illness, but yet it can verify by inference whether the user has a record of it stored in his smart card. The design of a privacy preserving model by backward inference is introduced in this paper. Some live medical data are used in experiments for validation and demonstration. PMID:22550398

  18. Using medical history embedded in biometrics medical card for user identity authentication: privacy preserving authentication model by features matching.

    PubMed

    Fong, Simon; Zhuang, Yan

    2012-01-01

    Many forms of biometrics have been proposed and studied for biometrics authentication. Recently researchers are looking into longitudinal pattern matching that based on more than just a singular biometrics; data from user's activities are used to characterise the identity of a user. In this paper we advocate a novel type of authentication by using a user's medical history which can be electronically stored in a biometric security card. This is a sequel paper from our previous work about defining abstract format of medical data to be queried and tested upon authentication. The challenge to overcome is preserving the user's privacy by choosing only the useful features from the medical data for use in authentication. The features should contain less sensitive elements and they are implicitly related to the target illness. Therefore exchanging questions and answers about a few carefully chosen features in an open channel would not easily or directly expose the illness, but yet it can verify by inference whether the user has a record of it stored in his smart card. The design of a privacy preserving model by backward inference is introduced in this paper. Some live medical data are used in experiments for validation and demonstration.

  19. Description of a practice model for pharmacist medication review in a general practice setting

    PubMed Central

    Brandt, Mette; Hallas, Jesper; Graabæk, Trine; Pottegård, Anton

    2014-01-01

    Background Practical descriptions of procedures used for pharmacists’ medication reviews are sparse. Objective To describe a model for medication review by pharmacists tailored to a general practice setting. Methods A stepwise model is described. The model is based on data from the medical chart and clinical or laboratory data. The medication review focuses on the diagnoses of the patient instead of the individual drugs. Patient interviews are not part of the model. The model was tested in a pilot study by conducting medical reviews on 50 polypharmacy patients (i.e. receiving 7 or more drugs for regular use). Results The model contained seven main steps. Information about the patient and current treatment was collected in the first three steps, followed by identification of possible interventions related to either diagnoses or drugs in the fourth and fifth step. The sixth and seventh step concerned the reporting of interventions and the considerations of the GPs. 208 interventions were proposed among the 50 patients. The acceptance rate among the GPs was 82%. The most common interventions were lack of clinical or laboratory data (n=57, 27%) and drugs that should be discontinued as they had no indication (n=47, 23%). Most interventions were aimed at cardiovascular drugs. Conclusion We have provided a detailed description of a practical approach to pharmacists’ medication review in a GP setting. The model was tested and found to be usable, and to deliver a medication review with high acceptance rates. PMID:25243030

  20. Developing human laboratory models of smoking lapse behavior for medication screening.

    PubMed

    McKee, Sherry A

    2009-01-01

    Use of human laboratory analogues of smoking behavior can provide an efficient, cost-effective mechanistic evaluation of a medication signal on smoking behavior, with the result of facilitating translational work in medications development. Although a number of human laboratory models exist to investigate various aspects of smoking behavior and nicotine dependence phenomena, none have yet modeled smoking lapse behavior. The first instance of smoking during a quit attempt (i.e. smoking lapse) is highly predictive of relapse and represents an important target for medications development. Focusing on an abstinence outcome is critical for medication screening as the US Food and Drug Administration approval for cessation medications is contingent on demonstrating effects on smoking abstinence. This paper outlines a three-stage process for the development of a smoking lapse model for the purpose of medication screening. The smoking lapse paradigm models two critical features of lapse behavior: the ability to resist the first cigarette and subsequent ad libitum smoking. Within the context of the model, smokers are first exposed to known precipitants of smoking relapse (e.g. nicotine deprivation, alcohol, stress), and then presented their preferred brand of cigarettes. Their ability to resist smoking is then modeled and once smokers 'give in' and decide to smoke, they participate in a tobacco self-administration session. Ongoing and completed work developing and validating these models for the purpose of medication screening is discussed.

  1. Predicting diffusive transport of cationic liposomes in 3-dimensional tumor spheroids.

    PubMed

    Wientjes, Michael G; Yeung, Bertrand Z; Lu, Ze; Wientjes, M Guillaume; Au, Jessie L S

    2014-10-28

    Nanotechnology is widely used in cancer research. Models that predict nanoparticle transport and delivery in tumors (including subcellular compartments) would be useful tools. This study tested the hypothesis that diffusive transport of cationic liposomes in 3-dimensional (3D) systems can be predicted based on liposome-cell biointerface parameters (binding, uptake, retention) and liposome diffusivity. Liposomes comprising different amounts of cationic and fusogenic lipids (10-30mol% DOTAP or 1,2-dioleoyl-sn-glycero-3-phosphoethanolamine, 1-20mol% DOPE or 1,2-dioleoyl-3-trimethylammonium-propane, +25 to +44mV zeta potential) were studied. We (a) measured liposome-cell biointerface parameters in monolayer cultures, and (b) calculated effective diffusivity based on liposome size and spheroid composition. The resulting parameters were used to simulate the liposome concentration-depth profiles in 3D spheroids. The simulated results agreed with the experimental results for liposomes comprising 10-30mol% DOTAP and ≤10mol% DOPE, but not for liposomes with higher DOPE content. For the latter, model modifications to account for time-dependent extracellular concentration decrease and liposome size increase did not improve the predictions. The difference among low- and high-DOPE liposomes suggests concentration-dependent DOPE properties in 3D systems that were not captured in monolayers. Taken together, our earlier and present studies indicate the diffusive transport of neutral, anionic and cationic nanoparticles (polystyrene beads and liposomes, 20-135nm diameter, -49 to +44mV) in 3D spheroids, with the exception of liposomes comprising >10mol% DOPE, can be predicted based on the nanoparticle-cell biointerface and nanoparticle diffusivity. Applying the model to low-DOPE liposomes showed that changes in surface charge affected the liposome localization in intratumoral subcompartments within spheroids.

  2. Modeling Dynamic Casualty Mortality Curves in the Tactical Medical Logistics (TML+) Planning Tool

    DTIC Science & Technology

    2007-11-02

    NAVAL HEALTH RESEARCH CENTER Modeling Dynamic Casualty Mortality Curves in the Tactical Medical Logistics (TML+) Planning Tool...WASHINGTON , DC 20372-5300 Modeling Dynamic Casualty Mortality Curves in the Tactical Medical Logistics (TML+) Planning Tool Ray Mitchell, Ph.D...Sciences Model to Describe the SME Mortality Estimates …………………………………….. 17 Conclusions and Plans

  3. Medication errors in the intensive care unit: literature review using the SEIPS model.

    PubMed

    Frith, Karen H

    2013-01-01

    Medication errors in intensive care units put patients at risk for injury or death every day. Safety requires an organized and systematic approach to improving the tasks, technology, environment, and organizational culture associated with medication systems. The Systems Engineering Initiative for Patient Safety model can help leaders and health care providers understand the complicated and high-risk work associated with critical care. Using this model, the author combines a human factors approach with the well-known structure-process-outcome model of quality improvement to examine research literature. The literature review reveals that human factors, including stress, high workloads, knowledge deficits, and performance deficits, are associated with medication errors. Factors contributing to medication errors are frequent interruptions, communication problems, and poor fit of health information technology to the workflow of providers. Multifaceted medication safety interventions are needed so that human factors and system problems can be addressed simultaneously.

  4. Automating the segmentation of medical images for the production of voxel tomographic computational models.

    PubMed

    Caon, M; Mohyla, J

    2001-12-01

    Radiation dosimetry for the diagnostic medical imaging procedures performed on humans requires anatomically accurate, computational models. These may be constructed from medical images as voxel-based tomographic models. However, they are time consuming to produce and as a consequence, there are few available. This paper discusses the emergence of semi-automatic segmentation techniques and describes an application (iRAD) written in Microsoft Visual Basic that allows the bitmap of a medical image to be segmented interactively and semi-automatically while displayed in Microsoft Excel. iRAD will decrease the time required to construct voxel models.

  5. A Predictive Model for Medical Events Based on Contextual Embedding of Temporal Sequences

    PubMed Central

    Wang, Zhimu; Huang, Yingxiang; Wang, Shuang; Wang, Fei; Jiang, Xiaoqian

    2016-01-01

    Background Medical concepts are inherently ambiguous and error-prone due to human fallibility, which makes it hard for them to be fully used by classical machine learning methods (eg, for tasks like early stage disease prediction). Objective Our work was to create a new machine-friendly representation that resembles the semantics of medical concepts. We then developed a sequential predictive model for medical events based on this new representation. Methods We developed novel contextual embedding techniques to combine different medical events (eg, diagnoses, prescriptions, and labs tests). Each medical event is converted into a numerical vector that resembles its “semantics,” via which the similarity between medical events can be easily measured. We developed simple and effective predictive models based on these vectors to predict novel diagnoses. Results We evaluated our sequential prediction model (and standard learning methods) in estimating the risk of potential diseases based on our contextual embedding representation. Our model achieved an area under the receiver operating characteristic (ROC) curve (AUC) of 0.79 on chronic systolic heart failure and an average AUC of 0.67 (over the 80 most common diagnoses) using the Medical Information Mart for Intensive Care III (MIMIC-III) dataset. Conclusions We propose a general early prognosis predictor for 80 different diagnoses. Our method computes numeric representation for each medical event to uncover the potential meaning of those events. Our results demonstrate the efficiency of the proposed method, which will benefit patients and physicians by offering more accurate diagnosis. PMID:27888170

  6. How Students Experience and Navigate Transitions in Undergraduate Medical Education: An Application of Bourdieu's Theoretical Model

    ERIC Educational Resources Information Center

    Balmer, Dorene F.; Richards, Boyd F.; Varpio, Lara

    2015-01-01

    Using Bourdieu's theoretical model as a lens for analysis, we sought to understand how students experience the undergraduate medical education (UME) milieu, focusing on how they navigate transitions from the preclinical phase, to the major clinical year (MCY), and to the preparation for residency phase. Twenty-two medical students participated in…

  7. Increasing the Educational Value of Medical Care Evaluation: A Model Program.

    ERIC Educational Resources Information Center

    Bashook, P. G.; And Others

    1982-01-01

    A model medical care evaluation (MCE) program was implemented at the Michael Reese Hospital and Medical Center. The program was evaluated by quantitative and qualitative observational techniques, questionnaires, and interviews, and by comparing committees for which the implementation was highly successful with those less successful. (Author/MLW)

  8. An Actuarial Model for Selecting Participants for a Special Medical Education Program.

    ERIC Educational Resources Information Center

    Walker-Bartnick, Leslie; And Others

    An actuarial model applied to the selection process of a special medical school program at the University of Maryland School of Medicine was tested. The 77 students in the study sample were admitted to the university's Fifth Pathway Program, which is designed for U.S. citizens who completed their medical school training, except for internship and…

  9. Health Insurance, Medical Care, and Health Outcomes: A Model of Elderly Health Dynamics

    ERIC Educational Resources Information Center

    Yang, Zhou; Gilleskie, Donna B.; Norton, Edward C.

    2009-01-01

    Prescription drug coverage creates a change in medical care consumption, beyond standard moral hazard, arising both from the differential cost-sharing and the relative effectiveness of different types of care. We model the dynamic supplemental health insurance decisions of Medicare beneficiaries, their medical care demand, and subsequent health…

  10. Analyzing Traditional Medical Practitioners' Information-Seeking Behaviour Using Taylor's Information-Use Environment Model

    ERIC Educational Resources Information Center

    Olatokun, Wole Michael; Ajagbe, Enitan

    2010-01-01

    This survey-based study examined the information-seeking behaviour of traditional medical practitioners using Taylor's information use model. Respondents comprised all 160 traditional medical practitioners that treat sickle cell anaemia. Data were collected using an interviewer-administered, structured questionnaire. Frequency and percentage…

  11. Emergency Medical Science (T-139). Curriculum Models, Guidelines, and Outcome-Competencies.

    ERIC Educational Resources Information Center

    Lovin, Barbara Keelor

    Developed for use by curriculum planners in Emergency Medical Science (EMS) programs throughout the North Carolina Community College System (NCCCS), and by evaluators in their reviews of existing programs, this manual provides a model set of guidelines for the education and training of the Emergency Medical Technician-Paramedic (EMT-P) in…

  12. A Proposed Conceptual Model of Military Medical Readiness

    DTIC Science & Technology

    2007-05-01

    al. reported, "Historically, up to half of the force identified for deployment at any given time were not medically qualified " (p. 1065). The second...essential components and therefore, fail to qualify as a theory when the proposed criteria are applied. To ensure only qualified expressions are labeled as...theory and the relationships between components. Rationally, a theory lacking one of these components fails to qualify as a theory by description alone

  13. Continuing education for medical professionals: a reflective model.

    PubMed Central

    Brigley, S.; Young, Y.; Littlejohns, P.; McEwen, J.

    1997-01-01

    The Royal Colleges and their Faculties have moved continuing professional development up the agenda of doctors in the UK. The low educational value and failure to change professional practice of much continuing medical education has led to criticism of its emphasis on formal, didactic teaching and academic knowledge. The ubiquitous scientific or technical bias in medical education makes questionable assumptions about the nature of professional knowledge, how professionals learn, and the linkage of theory and practice in professional work. Given its narrow conception of professional knowledge, it is hardly surprising that the effectiveness of continuing medical education has proven difficult to evaluate. These points of criticism suggest that a more systematic and coherent approach to continuing education is required. The adoption of the concept of continuing professional development, which draws on learning by reflective practice, marks an important step in this direction. Continuing professional development emphasises self-directed learning, professional self-awareness, learning developed in context, multidisciplinary and multilevel collaboration, the learning needs of individuals and their organisations, and an inquiry-based concept of professionalism. It also involves a widening of accountability to patients, the community, managers and policymakers, and a form of evaluation which is internal, participatory and collaborative rather than external and scientific in character. PMID:9039405

  14. Studies of Cosmic Ray Modulation and Energetic Particle Propagation in Time-Dependent 3-Dimensional Heliospheric Magnetic Fields

    NASA Technical Reports Server (NTRS)

    Zhang, Ming

    2005-01-01

    The primary goal of this project was to perform theoretical calculations of propagation of cosmic rays and energetic particles in 3-dimensional heliospheric magnetic fields. We used Markov stochastic process simulation to achieve to this goal. We developed computation software that can be used to study particle propagation in, as two examples of heliospheric magnetic fields that have to be treated in 3 dimensions, a heliospheric magnetic field suggested by Fisk (1996) and a global heliosphere including the region beyond the termination shock. The results from our model calculations were compared with particle measurements from Ulysses, Earth-based spacecraft such as IMP-8, WIND and ACE, Voyagers and Pioneers in outer heliosphere for tests of the magnetic field models. We particularly looked for features of particle variations that can allow us to significantly distinguish the Fisk magnetic field from the conventional Parker spiral field. The computer code will eventually lead to a new generation of integrated software for solving complicated problems of particle acceleration, propagation and modulation in realistic 3-dimensional heliosphere of realistic magnetic fields and the solar wind with a single computation approach.

  15. Perspective: follow the money: the implications of medical schools' funds flow models.

    PubMed

    Miller, Jeffrey C; Andersson, George E; Cohen, Marcia; Cohen, Stephen M; Gibson, Scott; Hindery, Michael A; Hooven, Martha; Krakower, Jack; Browdy, David H

    2012-12-01

    Medical schools conduct research, provide clinical care, and educate future physicians and scientists. Each school has its own unique mix of revenue sources and expense sharing among the medical school, faculty practice plan(s), parent university, and affiliated hospital(s). Despite these differences, revenues from clinical care subsidize the money-losing research and education missions at every medical school.In this perspective, the authors discuss the flow of funds among a medical school, its faculty practice plan(s), parent university, and affiliated hospital(s). They summarize where medical school revenues come from, how revenues and expenses flow within a medical school and between a medical school and its partners, and why understanding this process is crucial to leading and managing such an enterprise. They conclude with recommendations for medical schools to consider in developing funds flow models that meet their individual needs and circumstances: (1) understand economic drivers, (2) reward desired behaviors, (3) enable every unit to generate a positive margin, (4) communicate budget priorities, financial performance, and the use of institutional resources, and (5) establish principles for sharing resources and allocating expenses among entities within the institution.Medical schools should develop funds flow models that are transparent, aligned with their strategic priorities, and reward the behaviors necessary to produce effective collaboration within and across mission areas.

  16. Dosimetric Comparison Between 3-Dimensional Conformal and Robotic SBRT Treatment Plans for Accelerated Partial Breast Radiotherapy.

    PubMed

    Goggin, L M; Descovich, M; McGuinness, C; Shiao, S; Pouliot, J; Park, C

    2016-06-01

    Accelerated partial breast irradiation is an attractive alternative to conventional whole breast radiotherapy for selected patients. Recently, CyberKnife has emerged as a possible alternative to conventional techniques for accelerated partial breast irradiation. In this retrospective study, we present a dosimetric comparison between 3-dimensional conformal radiotherapy plans and CyberKnife plans using circular (Iris) and multi-leaf collimators. Nine patients who had undergone breast-conserving surgery followed by whole breast radiation were included in this retrospective study. The CyberKnife planning target volume (PTV) was defined as the lumpectomy cavity + 10 mm + 2 mm with prescription dose of 30 Gy in 5 fractions. Two sets of 3-dimensional conformal radiotherapy plans were created, one used the same definitions as described for CyberKnife and the second used the RTOG-0413 definition of the PTV: lumpectomy cavity + 15 mm + 10 mm with prescription dose of 38.5 Gy in 10 fractions. Using both PTV definitions allowed us to compare the dose delivery capabilities of each technology and to evaluate the advantage of CyberKnife tracking. For the dosimetric comparison using the same PTV margins, CyberKnife and 3-dimensional plans resulted in similar tumor coverage and dose to critical structures, with the exception of the lung V5%, which was significantly smaller for 3-dimensional conformal radiotherapy, 6.2% when compared to 39.4% for CyberKnife-Iris and 17.9% for CyberKnife-multi-leaf collimator. When the inability of 3-dimensional conformal radiotherapy to track motion is considered, the result increased to 25.6%. Both CyberKnife-Iris and CyberKnife-multi-leaf collimator plans demonstrated significantly lower average ipsilateral breast V50% (25.5% and 24.2%, respectively) than 3-dimensional conformal radiotherapy (56.2%). The CyberKnife plans were more conformal but less homogeneous than the 3-dimensional conformal radiotherapy plans. Approximately 50% shorter

  17. Autonomous, In-Flight Crew Health Risk Management for Exploration-Class Missions: Leveraging the Integrated Medical Model for the Exploration Medical System Demonstration Project

    NASA Technical Reports Server (NTRS)

    Butler, D. J.; Kerstman, E.; Saile, L.; Myers, J.; Walton, M.; Lopez, V.; McGrath, T.

    2011-01-01

    The Integrated Medical Model (IMM) captures organizational knowledge across the space medicine, training, operations, engineering, and research domains. IMM uses this knowledge in the context of a mission and crew profile to forecast risks to crew health and mission success. The IMM establishes a quantified, statistical relationship among medical conditions, risk factors, available medical resources, and crew health and mission outcomes. These relationships may provide an appropriate foundation for developing an in-flight medical decision support tool that helps optimize the use of medical resources and assists in overall crew health management by an autonomous crew with extremely limited interactions with ground support personnel and no chance of resupply.

  18. A basket two-part model to analyze medical expenditure on interdependent multiple sectors.

    PubMed

    Sugawara, Shinya; Wu, Tianyi; Yamanishi, Kenji

    2016-09-01

    This study proposes a novel statistical methodology to analyze expenditure on multiple medical sectors using consumer data. Conventionally, medical expenditure has been analyzed by two-part models, which separately consider purchase decision and amount of expenditure. We extend the traditional two-part models by adding the step of basket analysis for dimension reduction. This new step enables us to analyze complicated interdependence between multiple sectors without an identification problem. As an empirical application for the proposed method, we analyze data of 13 medical sectors from the Medical Expenditure Panel Survey. In comparison with the results of previous studies that analyzed the multiple sector independently, our method provides more detailed implications of the impacts of individual socioeconomic status on the composition of joint purchases from multiple medical sectors; our method has a better prediction performance.

  19. An Empirical Assessment of a Technology Acceptance Model for Apps in Medical Education.

    PubMed

    Briz-Ponce, Laura; García-Peñalvo, Francisco José

    2015-11-01

    The evolution and the growth of mobile applications ("apps") in our society is a reality. This general trend is still upward and the app use has also penetrated the medical education community. However, there is a lot of unawareness of the students' and professionals' point of view about introducing "apps" within Medical School curriculum. The aim of this research is to design, implement and verify that the Technology Acceptance Model (TAM) can be employed to measure and explain the acceptance of mobile technology and "apps" within Medical Education. The methodology was based on a survey distributed to students and medical professionals from University of Salamanca. This model explains 46.7% of behavioral intention to use mobile devise or "apps" for learning and will help us to justify and understand the current situation of introducing "apps" into the Medical School curriculum.

  20. Validation of the Integrated Medical Model Using Historical Space Flight Data

    NASA Technical Reports Server (NTRS)

    Kerstman, Eric L.; Minard, Charles G.; FreiredeCarvalho, Mary H.; Walton, Marlei E.; Myers, Jerry G., Jr.; Saile, Lynn G.; Lopez, Vilma; Butler, Douglas J.; Johnson-Throop, Kathy A.

    2010-01-01

    The Integrated Medical Model (IMM) utilizes Monte Carlo methodologies to predict the occurrence of medical events, utilization of resources, and clinical outcomes during space flight. Real-world data may be used to demonstrate the accuracy of the model. For this analysis, IMM predictions were compared to data from historical shuttle missions, not yet included as model source input. Initial goodness of fit test-ing on International Space Station data suggests that the IMM may overestimate the number of occurrences for three of the 83 medical conditions in the model. The IMM did not underestimate the occurrence of any medical condition. Initial comparisons with shuttle data demonstrate the importance of understanding crew preference (i.e., preferred analgesic) for accurately predicting the utilization of re-sources. The initial analysis demonstrates the validity of the IMM for its intended use and highlights areas for improvement.

  1. The Integrated Medical Model: A Decision Support Tool for In-flight Crew Health Care

    NASA Technical Reports Server (NTRS)

    Butler, Doug

    2009-01-01

    This viewgraph presentation reviews the development of an Integrated Medical Model (IMM) decision support tool for in-flight crew health care safety. Clinical methods, resources, and case scenarios are also addressed.

  2. Explaining attitudes and adherence to antipsychotic medication: the development of a process model.

    PubMed

    Wiesjahn, Martin; Jung, Esther; Lamster, Fabian; Rief, Winfried; Lincoln, Tania M

    2014-01-01

    Although nonadherence to antipsychotic medication poses a threat to outcome of medical treatment, the processes preceding the intake behavior have not been investigated sufficiently. This study tests a process model of medication adherence derived from the Health Belief Model which is based on cost-benefit considerations. The model includes an extensive set of potential predictors for medication attitudes and uses these attitudes as a predictor for medication adherence. We conducted an online study of 84 participants with a self-reported psychotic disorder and performed a path analysis. More insight into the need for treatment, a higher attribution of the symptoms to a mental disorder, experience of less negative side effects, presence of biological causal beliefs, and less endorsement of psychological causal beliefs were significant predictors of more positive attitudes towards medication. The results largely supported the postulated process model. Mental health professionals should consider attitudes towards medication and the identified predictors when they address adherence problems with the patient in a shared and informed decision process.

  3. Explaining Attitudes and Adherence to Antipsychotic Medication: The Development of a Process Model

    PubMed Central

    Rief, Winfried; Lincoln, Tania M.

    2014-01-01

    Although nonadherence to antipsychotic medication poses a threat to outcome of medical treatment, the processes preceding the intake behavior have not been investigated sufficiently. This study tests a process model of medication adherence derived from the Health Belief Model which is based on cost-benefit considerations. The model includes an extensive set of potential predictors for medication attitudes and uses these attitudes as a predictor for medication adherence. We conducted an online study of 84 participants with a self-reported psychotic disorder and performed a path analysis. More insight into the need for treatment, a higher attribution of the symptoms to a mental disorder, experience of less negative side effects, presence of biological causal beliefs, and less endorsement of psychological causal beliefs were significant predictors of more positive attitudes towards medication. The results largely supported the postulated process model. Mental health professionals should consider attitudes towards medication and the identified predictors when they address adherence problems with the patient in a shared and informed decision process. PMID:24693426

  4. Oxidation behavior of ammonium in a 3-dimensional biofilm-electrode reactor.

    PubMed

    Tang, Jinjing; Guo, Jinsong; Fang, Fang; Chen, Youpeng; Lei, Lijing; Yang, Lin

    2013-12-01

    Excess nitrogenous compounds are detrimental to natural water systems and to human health. To completely realize autohydrogenotrophic nitrogen removal, a novel 3-dimensional biofilm-electrode reactor was designed. Titanium was electroplated with ruthenium and used as the anode. Activated carbon fiber felt was used as the cathode. The reactor was separated into two chambers by a permeable membrane. The cathode chamber was filled with granular graphite and glass beads. The cathode and cathode chamber were inhabited with domesticated biofilm. In the absence of organic substances, a nitrogen removal efficiency of up to 91% was achieved at DO levels of 3.42 +/- 0.37 mg/L when the applied current density was only 0.02 mA/cm2. The oxidation of ammonium in biofilm-electrode reactors was also investigated. It was found that ammonium could be oxidized not only on the anode but also on particle electrodes in the cathode chamber of the biofilm-electrode reactor. Oxidation rates of ammonium and nitrogen removal efficiency were found to be affected by the electric current loading on the biofilm-electrode reactor. The kinetic model of ammonium at different electric currents was analyzed by a first-order reaction kinetics equation. The regression analysis implied that when the current density was less than 0.02 mA/cm2, ammonium removal was positively correlated to the current density. However, when the current density was more than 0.02 mA/cm2, the electric current became a limiting factor for the oxidation rate of ammonium and nitrogen removal efficiency.

  5. Realization of masticatory movement by 3-dimensional simulation of the temporomandibular joint and the masticatory muscles.

    PubMed

    Park, Jong-Tae; Lee, Jae-Gi; Won, Sung-Yoon; Lee, Sang-Hee; Cha, Jung-Yul; Kim, Hee-Jin

    2013-07-01

    Masticatory muscles are closely involved in mastication, pronunciation, and swallowing, and it is therefore important to study the specific functions and dynamics of the mandibular and masticatory muscles. However, the shortness of muscle fibers and the diversity of movement directions make it difficult to study and simplify the dynamics of mastication. The purpose of this study was to use 3-dimensional (3D) simulation to observe the functions and movements of each of the masticatory muscles and the mandible while chewing. To simulate the masticatory movement, computed tomographic images were taken from a single Korean volunteer (30-year-old man), and skull image data were reconstructed in 3D (Mimics; Materialise, Leuven, Belgium). The 3D-reconstructed masticatory muscles were then attached to the 3D skull model. The masticatory movements were animated using Maya (Autodesk, San Rafael, CA) based on the mandibular motion path. During unilateral chewing, the mandible was found to move laterally toward the functional side by contracting the contralateral lateral pterygoid and ipsilateral temporalis muscles. During the initial mouth opening, only hinge movement was observed at the temporomandibular joint. During this period, the entire mandible rotated approximately 13 degrees toward the bicondylar horizontal plane. Continued movement of the mandible to full mouth opening occurred simultaneously with sliding and hinge movements, and the mandible rotated approximately 17 degrees toward the center of the mandibular ramus. The described approach can yield data for use in face animation and other simulation systems and for elucidating the functional components related to contraction and relaxation of muscles during mastication.

  6. [Psychiatric advance directives--medical models into psychiatric medicine].

    PubMed

    Mautner, Sigal; Lachman, Max; Kaplan, Zeev; Shalev, Anat

    2014-01-01

    Since the year 2005, in the field of general medicine, the legislature in Israel determined ways to implement medically advanced directives according to the power of the law. Different states in the world had implemented parallel legislation for patients who suffer from mental illness. Psychiatric Advance Directives is a legitimate document which is valid in Australia, New Zealand, Scotland, England and in 25 countries in the U.S.A. Psychiatric advance directives (PAD's) allow competent persons, through advance instructions, to state their preferences for future mental health treatment in the event of an incapacitating psychiatric crisis. Self Determination Theory, Self Care and Autonomy are dominant supportive approaches in the creation of Psychiatric Advance Directives. Research conducted on psychiatric advance directives shows positive potential benefits for mental health clients, therapists and psychiatrists. More research in that area must be conducted. Psychiatric advance directives are currently developed and implemented with the cooperation of the Tauber Foundation and the Beer Sheva Mental Health Center. This is the first step in learning of effective ways to use this intervention in Israel and change perceptions toward a positive connection between medical efficiency and client preferences.

  7. LADCP Observations of the 3-Dimensional Velocity Field Associated with Internal Waves and Boundary-Layer Flows

    NASA Astrophysics Data System (ADS)

    Thurnherr, A.; St Laurent, L.; Jacobs, S. S.; Kanzow, T.; Naveira Garabato, A. C.; Ledwell, J. R.

    2012-12-01

    While low-frequency processes in the ocean are primarily associated with (quasi-)horizontal, i.e. 2-dimensional, flows energetic high-frequency finescale processes, such as internal waves, hydraulic and other boundary-layer currents, are much more 3-dimensional. Due to recent advances in LADCP processing, it is now possible to derive full-depth snapshots of the 3-dimensional velocity field from standard CTD/LADCP casts. Applying the new method to data obtained in energetic regions of the ocean reveals velocity fields associated with vertical speeds ranging from a few cm/s to more than 20cm/s. Outside boundary layers, the vertical velocities are dominated by high-frequency (near-N) internal waves associated with small horizontal scales and the shapes of the corresponding vertical-velocity spectra in the finescale band are consistent with the Garrett-Munk model. In individual data sets the vertical-velocity spectral levels are correlated with coincident dissipation measurements derived from velocity microstructure, suggesting that a new finescale parameterization method for oceanic turbulence and diapycnal mixing based on LADCP-derived vertical velocities is possible. Near boundaries, there is evidence for large vertical velocities associated not just with waves, but also with seawater upwelling from beneath a fast-melting Antarctic ice shelf, with hydraulic overflow processes of the Mid-Atlantic Ridge, and even with very large "overturns" over the flank of a ridge in Luzon strait.;

  8. A Diverging View of Role Modeling in Medical Education

    ERIC Educational Resources Information Center

    Sandhu, Gurjit; Rich, Jessica V.; Magas, Christopher; Walker, G. Ross

    2015-01-01

    Research in the area of role modeling has primarily focused on the qualities and attributes of exceptional role models, and less attention has been given to the act of role modeling itself (Elzubeir & Rizk, 2001; Jochemsen-van der Leeuw, van Dijk, van Etten-Jamaludin, & Wieringa-de Waard, 2013; Wright, 1996; Wright, Wong, & Newill,…

  9. 3-Dimensional and Interactive Istanbul University Virtual Laboratory Based on Active Learning Methods

    ERIC Educational Resources Information Center

    Ince, Elif; Kirbaslar, Fatma Gulay; Yolcu, Ergun; Aslan, Ayse Esra; Kayacan, Zeynep Cigdem; Alkan Olsson, Johanna; Akbasli, Ayse Ceylan; Aytekin, Mesut; Bauer, Thomas; Charalambis, Dimitris; Gunes, Zeliha Ozsoy; Kandemir, Ceyhan; Sari, Umit; Turkoglu, Suleyman; Yaman, Yavuz; Yolcu, Ozgu

    2014-01-01

    The purpose of this study is to develop a 3-dimensional interactive multi-user and multi-admin IUVIRLAB featuring active learning methods and techniques for university students and to introduce the Virtual Laboratory of Istanbul University and to show effects of IUVIRLAB on students' attitudes on communication skills and IUVIRLAB. Although there…

  10. Reconstruction 3-dimensional image from 2-dimensional image of status optical coherence tomography (OCT) for analysis of changes in retinal thickness

    SciTech Connect

    Arinilhaq,; Widita, Rena

    2014-09-30

    Optical Coherence Tomography is often used in medical image acquisition to diagnose that change due easy to use and low price. Unfortunately, this type of examination produces a two-dimensional retinal image of the point of acquisition. Therefore, this study developed a method that combines and reconstruct 2-dimensional retinal images into three-dimensional images to display volumetric macular accurately. The system is built with three main stages: data acquisition, data extraction and 3-dimensional reconstruction. At data acquisition step, Optical Coherence Tomography produced six *.jpg images of each patient were further extracted with MATLAB 2010a software into six one-dimensional arrays. The six arrays are combined into a 3-dimensional matrix using a kriging interpolation method with SURFER9 resulting 3-dimensional graphics of macula. Finally, system provides three-dimensional color graphs based on the data distribution normal macula. The reconstruction system which has been designed produces three-dimensional images with size of 481 × 481 × h (retinal thickness) pixels.

  11. Integrating the Chronic Care Model into a Novel Medical Student Course

    ERIC Educational Resources Information Center

    Block, Robert C.; Tran, Bill; McIntosh, Scott

    2011-01-01

    Objective: To determine whether integration of the Chronic Care Model into undergraduate medical education is associated with anticipated use of the Model and whether student perceptions match actual integration of the Model into their community projects. Design: This was a cross-sectional study using qualitative and quantitative data. Setting: A…

  12. The professional medical ethics model of decision making under conditions of clinical uncertainty.

    PubMed

    McCullough, Laurence B

    2013-02-01

    The professional medical ethics model of decision making may be applied to decisions clinicians and patients make under the conditions of clinical uncertainty that exist when evidence is low or very low. This model uses the ethical concepts of medicine as a profession, the professional virtues of integrity and candor and the patient's virtue of prudence, the moral management of medical uncertainty, and trial of intervention. These features combine to justifiably constrain clinicians' and patients' autonomy with the goal of preventing nondeliberative decisions of patients and clinicians. To prevent biased recommendations by the clinician that promote such nondeliberative decisions, medically reasonable alternatives supported by low or very low evidence should be offered but not recommended. The professional medical ethics model of decision making aims to improve the quality of decisions by reducing the unacceptable variation that can result from nondeliberative decision making by patients and clinicians when evidence is low or very low.

  13. Compression-based aggregation model for medical web services.

    PubMed

    Al-Shammary, Dhiah; Khalil, Ibrahim

    2010-01-01

    Many organizations such as hospitals have adopted Cloud Web services in applying their network services to avoid investing heavily computing infrastructure. SOAP (Simple Object Access Protocol) is the basic communication protocol of Cloud Web services that is XML based protocol. Generally,Web services often suffer congestions and bottlenecks as a result of the high network traffic that is caused by the large XML overhead size. At the same time, the massive load on Cloud Web services in terms of the large demand of client requests has resulted in the same problem. In this paper, two XML-aware aggregation techniques that are based on exploiting the compression concepts are proposed in order to aggregate the medical Web messages and achieve higher message size reduction.

  14. Prairie Voles as a Model to Screen Medications for the Treatment of Alcoholism and Addictions.

    PubMed

    Ryabinin, A E; Hostetler, C M

    2016-01-01

    Most preclinical studies of medications to treat addictions are performed in mice and rats. These two rodent species belong to one phylogenetic subfamily, which narrows the likelihood of identifying potential mechanisms regulating addictions in other species, ie, humans. Expanding the genetic diversity of organisms modeling alcohol and drug abuse enhances our ability to screen for medications to treat addiction. Recently, research laboratories adapted the prairie vole model to study mechanisms of alcohol and drugs of abuse. This development not only expanded the diversity of genotypes used to screen medications, but also enhanced capabilities of such screens. Prairie voles belong to 3-5% of mammalian species exhibiting social monogamy. This unusual trait is reflected in their ability to form lasting long-term affiliations between adult individuals. The prairie vole animal model has high predictive validity for mechanisms regulating human social behaviors. In addition, these animals exhibit high alcohol intake and preference. In laboratory settings, prairie voles are used to model social influences on drug reward and alcohol consumption as well as effects of addictive substances on social bonding. As a result, this species can be adapted to screen medications whose effectiveness could be (a) resistant to social influences promoting excessive drug taking, (b) dependent on the presence of social support, and (c) medications affecting harmful social consequences of alcohol and drug abuse. This report reviews the literature on studies of alcohol and psychostimulants in prairie voles and discusses capabilities of this animal model as a screen for novel medications to treat alcoholism and addictions.

  15. Development of a time-oriented data warehouse based on a medical information event model.

    PubMed

    Yamamoto, Yuichiro; Namikawa, Hirokazu; Inamura, Kiyonari

    2002-01-01

    We designed a new medical information event model and developed a time-oriented data warehouse based on the model. Here, the medical information event in a basic data unit is handled by a medical information system. The timing of decision making and treatment for a patient in the processing of his medical information is sometimes very critical. The time-oriented data warehouse was developed, to provide a search feature on the time axis. Our medical information event model has a unique simple data structure. PC-ORDERING2000 developed by NEC, which used Oracle, had about 600 pages of tables. However, we reduced these 600 complicated data structures to one unique and simple event model. By means of shifting clinical data from the old type order entry system into the new order entry system of the medical information event model, we produced a simple and flexible system, and the easy secondary use of clinical data of patients was realized. Evaluation of our system revealed heightened data retrieval efficiency and shortened response time 1:600 at a terminal, owing to the 1:600 reduction of the number of tables as mentioned above.

  16. Performance analysis of distributed and centralized models for electronic medical record exchanges.

    PubMed

    Huang, Ean-Wen; Lee, Chiung-San; Jiang, Wey-Wen; Chiou, Shwu-Fen; Liu, Fei-Ying; Liou, Der-Ming

    2007-01-01

    Electronic medical record exchanges can save time and reduce cost by eliminating redundant data and typing errors. The major steps of record exchange consist of querying information from database, encoding data into messages, and sending and decoding messages. Three medical-record-exchange models were proposed in the past, including the distributed, centralized, and indexed models. In this paper, the queuing theory is applied to evaluate the performance of the three models. We estimate the service time for each queue of the CPU, database and network, and predict the response time, probable bottlenecks and system capacities of each model.

  17. Medical Image Fusion Based on Rolling Guidance Filter and Spiking Cortical Model.

    PubMed

    Shuaiqi, Liu; Jie, Zhao; Mingzhu, Shi

    2015-01-01

    Medical image fusion plays an important role in diagnosis and treatment of diseases such as image-guided radiotherapy and surgery. Although numerous medical image fusion methods have been proposed, most of these approaches are sensitive to the noise and usually lead to fusion image distortion, and image information loss. Furthermore, they lack universality when dealing with different kinds of medical images. In this paper, we propose a new medical image fusion to overcome the aforementioned issues of the existing methods. It is achieved by combining with rolling guidance filter (RGF) and spiking cortical model (SCM). Firstly, saliency of medical images can be captured by RGF. Secondly, a self-adaptive threshold of SCM is gained by utilizing the mean and variance of the source images. Finally, fused image can be gotten by SCM motivated by RGF coefficients. Experimental results show that the proposed method is superior to other current popular ones in both subjectively visual performance and objective criteria.

  18. Medical imaging education in biomedical engineering curriculum: courseware development and application through a hybrid teaching model.

    PubMed

    Zhao, Weizhao; Li, Xiping; Chen, Hairong; Manns, Fabrice

    2012-01-01

    Medical Imaging is a key training component in Biomedical Engineering programs. Medical imaging education is interdisciplinary training, involving physics, mathematics, chemistry, electrical engineering, computer engineering, and applications in biology and medicine. Seeking an efficient teaching method for instructors and an effective learning environment for students has long been a goal for medical imaging education. By the support of NSF grants, we developed the medical imaging teaching software (MITS) and associated dynamic assessment tracking system (DATS). The MITS/DATS system has been applied to junior and senior medical imaging classes through a hybrid teaching model. The results show that student's learning gain improved, particularly in concept understanding and simulation project completion. The results also indicate disparities in subjective perception between junior and senior classes. Three institutions are collaborating to expand the courseware system and plan to apply it to different class settings.

  19. Combined Psychotherapy/Medication Treatment: The Valpo Model

    ERIC Educational Resources Information Center

    Cooper, Stewart E.

    2007-01-01

    This article presents how the Valparaiso University Student Counseling and Development Center (SCDC) developed and delivers a combined service treatment model integrating pharmacotherapy with psychotherapy for a subset of the center's clients evidencing significant psychiatric concerns. To explicate the model, several documents that may be of…

  20. A sequential decision-theoretic model for medical diagnostic system.

    PubMed

    Li, Aiping; Jin, Songchang; Zhang, Lumin; Jia, Yan

    2015-01-01

    Although diagnostic expert systems using a knowledge base which models decision-making of traditional experts can provide important information to non-experts, they tend to duplicate the errors made by experts. Decision-Theoretic Model (DTM) is therefore very useful in expert system since they prevent experts from incorrect reasoning under uncertainty. For the diagnostic expert system, corresponding DTM and arithmetic are studied and a sequential diagnostic decision-theoretic model based on Bayesian Network is given. In the model, the alternative features are categorized into two classes (including diseases features and test features), then an arithmetic for prior of test is provided. The different features affect other features weights are also discussed. Bayesian Network is adopted to solve uncertainty presentation and propagation. The model can help knowledge engineers model the knowledge involved in sequential diagnosis and decide evidence alternative priority. A practical example of the models is also presented: at any time of the diagnostic process the expert is provided with a dynamically updated list of suggested tests in order to support him in the decision-making problem about which test to execute next. The results show it is better than the traditional diagnostic model which is based on experience.

  1. Cadaver-based abscess model for medical training

    PubMed Central

    Ellis, Michael Stanley; Nelson, Joseph T; Kartchner, Jeffrey Zane; Yousef, Karl Andrew; Adamas-Rappaport, William J; Amini, Richard

    2017-01-01

    Ultrasound imaging is a rapid and noninvasive tool ideal for the imaging of soft tissue infections and is associated with a change of clinician management plans in 50% of cases. We developed a realistic skin abscess diagnostic and therapeutic training model using fresh frozen cadavers and common, affordable materials. Details for construction of the model and suggested variations are presented. This cadaver-based abscess model produces high-quality sonographic images with internal echogenicity similar to a true clinical abscess, and is ideal for teaching sonographic diagnostic skills in addition to the technical skills of incision and drainage or needle aspiration. PMID:28176889

  2. Specialty choice preference of medical students according to personality traits by Five-Factor Model

    PubMed Central

    Kwon, Oh Young; Park, So Youn

    2016-01-01

    Purpose: The purpose of this study was to determine the relationship between personality traits, using the Five-Factor Model, and characteristics and motivational factors affecting specialty choice in Korean medical students. Methods: A questionnaire survey of Year 4 medical students (n=110) in July 2015 was administered. We evaluated the personality traits of Extraversion, Agreeableness, Conscientiousness, Neuroticism, and Openness by using the Korean version of Big Five Inventory. Questions about general characteristics, medical specialties most preferred as a career, motivational factors in determining specialty choice were included. Data between five personality traits and general characteristics and motivational factors affecting specialty choice were analyzed using Student t-test, Mann-Whitney test and analysis of variance. Results: Of the 110 eligible medical students, 105 (95.4% response rate) completed the questionnaire. More Agreeableness students preferred clinical medicine to basic medicine (p=0.010) and more Openness students preferred medical departments to others (p=0.031). Personal interest was the significant motivational factors in more Openness students (p=0.003) and Conscientiousness students (p=0.003). Conclusion: Medical students with more Agreeableness were more likely to prefer clinical medicine and those with more Openness preferred medical departments. Personal interest was a significant influential factor determining specialty choice in more Openness and Conscientiousness students. These findings may be helpful to medical educators or career counselors in the specialty choice process. PMID:26838573

  3. Medical Evacuation and Treatment Capabilities Optimization Model (METCOM)

    DTIC Science & Technology

    2005-09-01

    1 B . HEALTH SERVICE SUPPORT (HSS) SYSTEM...A. MULTIPERIOD/INTER-TEMPORAL NETWORKS..............................25 B . EVACUATION...29 A. OBJECTIVES OF THE MODEL ................................................................29 B . STRUCTURE OF THE GENERAL

  4. Multilevel Modeling and Policy Development: Guidelines and Applications to Medical Travel

    PubMed Central

    Garcia-Garzon, Eduardo; Zhukovsky, Peter; Haller, Elisa; Plakolm, Sara; Fink, David; Petrova, Dafina; Mahalingam, Vaishali; Menezes, Igor G.; Ruggeri, Kai

    2016-01-01

    Medical travel has expanded rapidly in recent years, resulting in new markets and increased access to medical care. Whereas several studies investigated the motives of individuals seeking healthcare abroad, the conventional analytical approach is limited by substantial caveats. Classical techniques as found in the literature cannot provide sufficient insight due to the nested nature of data generated. The application of adequate analytical techniques, specifically multilevel modeling, is scarce to non-existent in the context of medical travel. This study introduces the guidelines for application of multilevel techniques in public health research by presenting an application of multilevel modeling in analyzing the decision-making patterns of potential medical travelers. Benefits and potential limitations are discussed. PMID:27252672

  5. Rethinking Adherence: A Health Literacy–Informed Model of Medication Self-Management

    PubMed Central

    Bailey, Stacy C.; Oramasionwu, Christine U.; Wolf, Michael S.

    2013-01-01

    Medication adherence has received a great deal of attention over the past several decades; however, its definition and measurement remain elusive. The authors propose a new definition of medication self-management that is guided by evidence from the field of health literacy. Specifically, a new conceptual model is introduced that deconstructs the tasks associated with taking prescription drugs; including the knowledge, skills and behaviors necessary for patients to correctly take medications and sustain use over time in ambulatory care. This model is then used to review and criticize current adherence measures as well as to offer guidance to future interventions promoting medication self-management, especially among patients with low literacy skills. PMID:24093342

  6. [A novel model of the medical instrumentation--an overview of wearable sensors and systems].

    PubMed

    Deng, Qin-kai

    2006-09-01

    The traditional medical instrumentation is now not suited for the transformation of the present healthcare model. It's an attempt to make a breakthrough on traditions to develop wearable sensors/systems. Five articles about wearable technology are selected by this special topic. And our aim is to inspire the designers of medical devices to grasp the chance and to take a vigorous action on innovatory developments, so as to satisfy the huge requirements of the healthcare market, and to open a new era of the medical device industry.

  7. The Yes We Can Urban Asthma Partnership: a medical/social model for childhood asthma management.

    PubMed

    Thyne, Shannon M; Rising, Joshua P; Legion, Vicki; Love, Mary Beth

    2006-11-01

    Pediatric asthma programs have struggled to integrate children's medical and social needs. We developed and piloted an integrated team model for asthma care for low-income children through the Yes We Can Urban Asthma Partnership. Program evaluation demonstrated increases in prescribing controller medications (p <0.05), use of action plans (p<0.001), and the use of mattress covers (p<0.001); and decrease in asthma symptoms (p<0.01). Additional changes occurred within the local system of asthma care to support ongoing efforts to improve asthma management. We conclude that pediatric asthma programs can effectively target the social and medical needs of children in a sustainable manner.

  8. Developing Vibrant State Defense Forces: A Successful Medical and Health Service Model

    DTIC Science & Technology

    2006-01-01

    MEDICAL AND HEALTH SERVICE MODEL Colonel (MD) H. Wayne Nelson, Ph.D. Colonel (MD) Robert Barish, M.D. Brigadier General (MD) Frederic Smalkin, J.D...Its Deputy Commander and MRC project action officer was (one of the authors, Nelson), a professor in the Health Science Department in Towson ...Director COL Wayne Nelson, to select “medically-qualified soldiers” who would accept assignment to “participate in humanitarian missions in response and

  9. Active shape models incorporating isolated landmarks for medical image annotation

    NASA Astrophysics Data System (ADS)

    Norajitra, Tobias; Meinzer, Hans-Peter; Stieltjes, Bram; Maier-Hein, Klaus H.

    2014-03-01

    Apart from their robustness in anatomic surface segmentation, purely surface based 3D Active Shape Models lack the ability to automatically detect and annotate non-surface key points of interest. However, annotation of anatomic landmarks is desirable, as it yields additional anatomic and functional information. Moreover, landmark detection might help to further improve accuracy during ASM segmentation. We present an extension of surface-based 3D Active Shape Models incorporating isolated non-surface landmarks. Positions of isolated and surface landmarks are modeled conjoint within a point distribution model (PDM). Isolated landmark appearance is described by a set of haar-like features, supporting local landmark detection on the PDM estimates using a kNN-Classi er. Landmark detection was evaluated in a leave-one-out cross validation on a reference dataset comprising 45 CT volumes of the human liver after shape space projection. Depending on the anatomical landmark to be detected, our experiments have shown in about 1/4 up to more than 1/2 of all test cases a signi cant improvement in detection accuracy compared to the position estimates delivered by the PDM. Our results encourage further research with regard to the combination of shape priors and machine learning for landmark detection within the Active Shape Model Framework.

  10. Model-Driven Safety Analysis of Closed-Loop Medical Systems.

    PubMed

    Pajic, Miroslav; Mangharam, Rahul; Sokolsky, Oleg; Arney, David; Goldman, Julian; Lee, Insup

    2012-10-26

    In modern hospitals, patients are treated using a wide array of medical devices that are increasingly interacting with each other over the network, thus offering a perfect example of a cyber-physical system. We study the safety of a medical device system for the physiologic closed-loop control of drug infusion. The main contribution of the paper is the verification approach for the safety properties of closed-loop medical device systems. We demonstrate, using a case study, that the approach can be applied to a system of clinical importance. Our method combines simulation-based analysis of a detailed model of the system that contains continuous patient dynamics with model checking of a more abstract timed automata model. We show that the relationship between the two models preserves the crucial aspect of the timing behavior that ensures the conservativeness of the safety analysis. We also describe system design that can provide open-loop safety under network failure.

  11. A Comparison of different learning models used in Data Mining for Medical Data

    NASA Astrophysics Data System (ADS)

    Srimani, P. K.; Koti, Manjula Sanjay

    2011-12-01

    The present study aims at investigating the different Data mining learning models for different medical data sets and to give practical guidelines to select the most appropriate algorithm for a specific medical data set. In practical situations, it is absolutely necessary to take decisions with regard to the appropriate models and parameters for diagnosis and prediction problems. Learning models and algorithms are widely implemented for rule extraction and the prediction of system behavior. In this paper, some of the well-known Machine Learning(ML) systems are investigated for different methods and are tested on five medical data sets. The practical criteria for evaluating different learning models are presented and the potential benefits of the proposed methodology for diagnosis and learning are suggested.

  12. Predicting medical complications after spine surgery: a validated model using a prospective surgical registry

    PubMed Central

    Lee, Michael J.; Cizik, Amy M.; Hamilton, Deven; Chapman, Jens R.

    2014-01-01

    BACKGROUND CONTEXT The possibility and likelihood of a postoperative medical complication after spine surgery undoubtedly play a major role in the decision making of the surgeon and patient alike. Although prior study has determined relative risk and odds ratio values to quantify risk factors, these values may be difficult to translate to the patient during counseling of surgical options. Ideally, a model that predicts absolute risk of medical complication, rather than relative risk or odds ratio values, would greatly enhance the discussion of safety of spine surgery. To date, there is no risk stratification model that specifically predicts the risk of medical complication. PURPOSE The purpose of this study was to create and validate a predictive model for the risk of medical complication during and after spine surgery. STUDY DESIGN/SETTING Statistical analysis using a prospective surgical spine registry that recorded extensive demographic, surgical, and complication data. Outcomes examined are medical complications that were specifically defined a priori. This analysis is a continuation of statistical analysis of our previously published report. METHODS Using a prospectively collected surgical registry of more than 1,476 patients with extensive demographic, comorbidity, surgical, and complication detail recorded for 2 years after surgery, we previously identified several risk factor for medical complications. Using the beta coefficients from those log binomial regression analyses, we created a model to predict the occurrence of medical complication after spine surgery. We split our data into two subsets for internal and cross-validation of our model. We created two predictive models: one predicting the occurrence of any medical complication and the other predicting the occurrence of a major medical complication. RESULTS The final predictive model for any medical complications had a receiver operator curve characteristic of 0.76, considered to be a fair measure

  13. Medical image denoising using one-dimensional singularity function model.

    PubMed

    Luo, Jianhua; Zhu, Yuemin; Hiba, Bassem

    2010-03-01

    A novel denoising approach is proposed that is based on a spectral data substitution mechanism through using a mathematical model of one-dimensional singularity function analysis (1-D SFA). The method consists in dividing the complete spectral domain of the noisy signal into two subsets: the preserved set where the spectral data are kept unchanged, and the substitution set where the original spectral data having lower signal-to-noise ratio (SNR) are replaced by those reconstructed using the 1-D SFA model. The preserved set containing original spectral data is determined according to the SNR of the spectrum. The singular points and singularity degrees in the 1-D SFA model are obtained through calculating finite difference of the noisy signal. The theoretical formulation and experimental results demonstrated that the proposed method allows more efficient denoising while introducing less distortion, and presents significant improvement over conventional denoising methods.

  14. Quantitative modeling of Cerenkov light production efficiency from medical radionuclides.

    PubMed

    Beattie, Bradley J; Thorek, Daniel L J; Schmidtlein, Charles R; Pentlow, Keith S; Humm, John L; Hielscher, Andreas H

    2012-01-01

    There has been recent and growing interest in applying Cerenkov radiation (CR) for biological applications. Knowledge of the production efficiency and other characteristics of the CR produced by various radionuclides would help in accessing the feasibility of proposed applications and guide the choice of radionuclides. To generate this information we developed models of CR production efficiency based on the Frank-Tamm equation and models of CR distribution based on Monte-Carlo simulations of photon and β particle transport. All models were validated against direct measurements using multiple radionuclides and then applied to a number of radionuclides commonly used in biomedical applications. We show that two radionuclides, Ac-225 and In-111, which have been reported to produce CR in water, do not in fact produce CR directly. We also propose a simple means of using this information to calibrate high sensitivity luminescence imaging systems and show evidence suggesting that this calibration may be more accurate than methods in routine current use.

  15. Two Models of Integrating Buprenorphine Treatment and Medical Staff within Formerly "Drug-Free" Outpatient Programs.

    PubMed

    Monico, Laura; Schwartz, Robert P; Gryczynski, Jan; O'Grady, Kevin E; Mitchell, Shannon Gwin

    2016-01-01

    "Drug-free" outpatient programs deliver treatment to the largest number of patients of all treatment modalities in the U.S., providing a significant opportunity to expand access to medication treatments for substance use disorders. This analysis examined staff perceptions of organizational dynamics associated with the delivery of buprenorphine maintenance within three formerly "drug-free" outpatient treatment programs. Semi-structured interviews (N = 15) were conducted with counseling and medical staff, and respondents were predominantly African American (n = 11) and female (n = 12). Themes and concepts related to medical staff integration emerged through an inductive and iterative coding process using Atlas.ti qualitative analysis software. Two treatment clinics incorporated buprenorphine maintenance into their programs using a co-located model of care. Their staff generally reported greater intra-organizational discord regarding the best ways to combine medication and counseling compared to the clinic using an integrated model of care. Co-located program staff reported less communication between medical and clinical staff, which contributed to some uncertainty about proper dosing and concerns about the potential for medication diversion. Clinics that shift from "drug-free" to incorporating buprenorphine maintenance should consider which model of care they wish to adapt and how to train staff and structure staff communication.

  16. A model for training medical student innovators: the Harvard Medical School Center for Primary Care Abundance Agents of Change program.

    PubMed

    Duong, David B; Sullivan, Erin E; Minter-Jordan, Myechia; Giesen, Lindsay; Ellner, Andrew L

    2016-01-01

    Background In 2013, the Harvard Medical School Center for Primary Care established the Abundance Agents of Change (AoC) program to promote interprofessional learning and innovation, increase partnership between 15 academic and community health centers (CHCs) in Boston's most under-served communities, and increase medical student interest in primary care careers. Methods The AoC is modeled in the form of a 'grants challenge', offering $20,000 to interprofessional student teams to develop an innovative solution that addresses a healthcare delivery need identified by CHCs. The program's initial two years were characterized by a four-stage process which included working with CHCs and crafting a request for proposals, forming interprofessional 20 student teams comprising students from across and outside of Harvard University, training students using a systems-based innovation curriculum, and performing program evaluation. Results Our evaluation data from cohorts 1 and 2 of the AoC program demonstrate that we succeeded in training students as innovators and members of interprofessional teams. We also learned valuable lessons regarding creating better alignment with CHC priorities, extending the program cycle from 12 to 18 months, and changing the way funding is disbursed to 25 students, which will be incorporated in later versions of the program. Conclusions Based on our experience and evaluation data, we believe that this program is a replicable way to train students as innovators and members of interprofessional teams to address the current complex healthcare environment.

  17. A model for training medical student innovators: the Harvard Medical School Center for Primary Care Abundance Agents of Change program

    PubMed Central

    Duong, David B.; Sullivan, Erin E.; Minter-Jordan, Myechia; Giesen, Lindsay; Ellner, Andrew L.

    2016-01-01

    Background In 2013, the Harvard Medical School Center for Primary Care established the Abundance Agents of Change (AoC) program to promote interprofessional learning and innovation, increase partnership between 15 academic and community health centers (CHCs) in Boston's most under-served communities, and increase medical student interest in primary care careers. Methods The AoC is modeled in the form of a ‘grants challenge’, offering $20,000 to interprofessional student teams to develop an innovative solution that addresses a healthcare delivery need identified by CHCs. The program's initial two years were characterized by a four-stage process which included working with CHCs and crafting a request for proposals, forming interprofessional 20 student teams comprising students from across and outside of Harvard University, training students using a systems-based innovation curriculum, and performing program evaluation. Results Our evaluation data from cohorts 1 and 2 of the AoC program demonstrate that we succeeded in training students as innovators and members of interprofessional teams. We also learned valuable lessons regarding creating better alignment with CHC priorities, extending the program cycle from 12 to 18 months, and changing the way funding is disbursed to 25 students, which will be incorporated in later versions of the program. Conclusions Based on our experience and evaluation data, we believe that this program is a replicable way to train students as innovators and members of interprofessional teams to address the current complex healthcare environment. PMID:27306994

  18. Applying the International Medical Graduate Program Model to Alleviate the Supply Shortage of Accounting Doctoral Faculty

    ERIC Educational Resources Information Center

    HassabElnaby, Hassan R.; Dobrzykowski, David D.; Tran, Oanh Thikie

    2012-01-01

    Accounting has been faced with a severe shortage in the supply of qualified doctoral faculty. Drawing upon the international mobility of foreign scholars and the spirit of the international medical graduate program, this article suggests a model to fill the demand in accounting doctoral faculty. The underlying assumption of the suggested model is…

  19. The Rasch Model: Its Use by the National Board of Medical Examiners.

    ERIC Educational Resources Information Center

    Kelley, Paul R.; Schumacher, Charles F.

    1984-01-01

    The National Board of Medical Examiners uses the Rasch model to calibrate test items, maintain item banks, equate scores, and monitor the consistency of examiner item response patterns. The model is also being used in the study of patient management problems examinations, standard-setting, and computer-based examinations. (Author/BS)

  20. MO-DE-BRA-05: Developing Effective Medical Physics Knowledge Structures: Models and Methods

    SciTech Connect

    Sprawls, P

    2015-06-15

    Purpose: Develop a method and supporting online resources to be used by medical physics educators for teaching medical imaging professionals and trainees so they develop highly-effective physics knowledge structures that can contribute to improved diagnostic image quality on a global basis. Methods: The different types of mental knowledge structures were analyzed and modeled with respect to both the learning and teaching process for their development and the functions or tasks that can be performed with the knowledge. While symbolic verbal and mathematical knowledge structures are very important in medical physics for many purposes, the tasks of applying physics in clinical imaging--especially to optimize image quality and diagnostic accuracy--requires a sensory conceptual knowledge structure, specifically, an interconnected network of visually based concepts. This type of knowledge supports tasks such as analysis, evaluation, problem solving, interacting, and creating solutions. Traditional educational methods including lectures, online modules, and many texts are serial procedures and limited with respect to developing interconnected conceptual networks. A method consisting of the synergistic combination of on-site medical physics teachers and the online resource, CONET (Concept network developer), has been developed and made available for the topic Radiographic Image Quality. This was selected as the inaugural topic, others to follow, because it can be used by medical physicists teaching the large population of medical imaging professionals, such as radiology residents, who can apply the knowledge. Results: Tutorials for medical physics educators on developing effective knowledge structures are being presented and published and CONET is available with open access for all to use. Conclusion: An adjunct to traditional medical physics educational methods with the added focus on sensory concept development provides opportunities for medical physics teachers to share

  1. A 3-dimensional digital atlas of the ascending sensory and the descending motor systems in the pigeon brain.

    PubMed

    Güntürkün, Onur; Verhoye, Marleen; De Groof, Geert; Van der Linden, Annemie

    2013-01-01

    Pigeons are classic animal models for learning, memory, and cognition. The majority of the current understanding about avian neurobiology outside of the domain of the song system has been established using pigeons. Since MRI represents an increasingly relevant tool for comparative neuroscience, a 3-dimensional MRI-based atlas of the pigeon brain becomes essential. Using multiple imaging protocols, we delineated diverse ascending sensory and descending motor systems as well as the hippocampal formation. This pigeon brain atlas can easily be used to determine the stereotactic location of identified neural structures at any angle of the head. In addition, the atlas is useful to find the optimal angle of sectioning for slice experiments, stereotactic injections and electrophysiological recordings. This pigeon brain atlas is freely available for the scientific community.

  2. Energy Sources of the Dominant Frequency Dependent 3-dimensional Atmospheric Modes

    NASA Technical Reports Server (NTRS)

    Schubert, S.

    1985-01-01

    The energy sources and sinks associated with the zonally asymmetric winter mean flow are investigated as part of an on-going study of atmospheric variability. Distinctly different horizontal structures for the long, intermediate and short time scale atmospheric variations were noted. In previous observations, the 3-dimensional structure of the fluctuations is investigated and the relative roles of barotropic and baroclinic terms are assessed.

  3. DETECTORS AND EXPERIMENTAL METHODS: Decay vertex reconstruction and 3-dimensional lifetime determination at BESIII

    NASA Astrophysics Data System (ADS)

    Xu, Min; He, Kang-Lin; Zhang, Zi-Ping; Wang, Yi-Fang; Bian, Jian-Ming; Cao, Guo-Fu; Cao, Xue-Xiang; Chen, Shen-Jian; Deng, Zi-Yan; Fu, Cheng-Dong; Gao, Yuan-Ning; Han, Lei; Han, Shao-Qing; He, Miao; Hu, Ji-Feng; Hu, Xiao-Wei; Huang, Bin; Huang, Xing-Tao; Jia, Lu-Kui; Ji, Xiao-Bin; Li, Hai-Bo; Li, Wei-Dong; Liang, Yu-Tie; Liu, Chun-Xiu; Liu, Huai-Min; Liu, Ying; Liu, Yong; Luo, Tao; Lü, Qi-Wen; Ma, Qiu-Mei; Ma, Xiang; Mao, Ya-Jun; Mao, Ze-Pu; Mo, Xiao-Hu; Ning, Fei-Peng; Ping, Rong-Gang; Qiu, Jin-Fa; Song, Wen-Bo; Sun, Sheng-Sen; Sun, Xiao-Dong; Sun, Yong-Zhao; Tian, Hao-Lai; Wang, Ji-Ke; Wang, Liang-Liang; Wen, Shuo-Pin; Wu, Ling-Hui; Wu, Zhi; Xie, Yu-Guang; Yan, Jie; Yan, Liang; Yao, Jian; Yuan, Chang-Zheng; Yuan, Ye; Zhang, Chang-Chun; Zhang, Jian-Yong; Zhang, Lei; Zhang, Xue-Yao; Zhang, Yao; Zheng, Yang-Heng; Zhu, Yong-Sheng; Zou, Jia-Heng

    2009-06-01

    This paper focuses mainly on the vertex reconstruction of resonance particles with a relatively long lifetime such as K0S, Λ, as well as on lifetime measurements using a 3-dimensional fit. The kinematic constraints between the production and decay vertices and the decay vertex fitting algorithm based on the least squares method are both presented. Reconstruction efficiencies including experimental resolutions are discussed. The results and systematic errors are calculated based on a Monte Carlo simulation.

  4. Model-based semantic dictionaries for medical language understanding.

    PubMed Central

    Rassinoux, A. M.; Baud, R. H.; Ruch, P.; Trombert-Paviot, B.; Rodrigues, J. M.

    1999-01-01

    Semantic dictionaries are emerging as a major cornerstone towards achieving sound natural language understanding. Indeed, they constitute the main bridge between words and conceptual entities that reflect their meanings. Nowadays, more and more wide-coverage lexical dictionaries are electronically available in the public domain. However, associating a semantic content with lexical entries is not a straightforward task as it is subordinate to the existence of a fine-grained concept model of the treated domain. This paper presents the benefits and pitfalls in building and maintaining multilingual dictionaries, the semantics of which is directly established on an existing concept model. Concrete cases, handled through the GALEN-IN-USE project, illustrate the use of such semantic dictionaries for the analysis and generation of multilingual surgical procedures. PMID:10566333

  5. "Open Access" Requires Clarification: Medical Journal Publication Models Evolve.

    PubMed

    Lubowitz, James H; Brand, Jefferson C; Rossi, Michael J; Provencher, Matthew T

    2017-03-01

    While Arthroscopy journal is a traditional subscription model journal, our companion journal Arthroscopy Techniques is "open access." We used to believe open access simply meant online and free of charge. However, while open-access journals are free to readers, in 2017 authors must make a greater sacrifice in the form of an article-processing charge (APC). Again, while this does not apply to Arthroscopy, the APC will apply to Arthroscopy Techniques.

  6. Quantitative Modeling of Cerenkov Light Production Efficiency from Medical Radionuclides

    PubMed Central

    Beattie, Bradley J.; Thorek, Daniel L. J.; Schmidtlein, Charles R.; Pentlow, Keith S.; Humm, John L.; Hielscher, Andreas H.

    2012-01-01

    There has been recent and growing interest in applying Cerenkov radiation (CR) for biological applications. Knowledge of the production efficiency and other characteristics of the CR produced by various radionuclides would help in accessing the feasibility of proposed applications and guide the choice of radionuclides. To generate this information we developed models of CR production efficiency based on the Frank-Tamm equation and models of CR distribution based on Monte-Carlo simulations of photon and β particle transport. All models were validated against direct measurements using multiple radionuclides and then applied to a number of radionuclides commonly used in biomedical applications. We show that two radionuclides, Ac-225 and In-111, which have been reported to produce CR in water, do not in fact produce CR directly. We also propose a simple means of using this information to calibrate high sensitivity luminescence imaging systems and show evidence suggesting that this calibration may be more accurate than methods in routine current use. PMID:22363636

  7. Fast Apriori-based Graph Mining Algorithm and application to 3-dimensional Structure Analysis

    NASA Astrophysics Data System (ADS)

    Nishimura, Yoshio; Washio, Takashi; Yoshida, Tetsuya; Motoda, Hiroshi; Inokuchi, Akihiro; Okada, Takashi

    Apriori-based Graph Mining (AGM) algorithm efficiently extracts all the subgraph patterns which frequently appear in graph structured data. The algorithm can deal with general graph structured data with multiple labels of vartices and edges, and is capable of analyzing the topological structure of graphs. In this paper, we propose a new method to analyze graph structured data for a 3-dimensional coordinate by AGM. In this method the distance between each vertex of a graph is calculated and added to the edge label so that AGM can handle 3-dimensional graph structured data. One problem in our approach is that the number of edge labels increases, which results in the increase of computational time to extract subgraph patterns. To alleviate this problem, we also propose a faster algorithm of AGM by adding an extra constraint to reduce the number of generated candidates for seeking frequent subgraphs. Chemical compounds with dopamine antagonist in MDDR database were analyzed by AGM to characterize their 3-dimensional chemical structure and correlation with physiological activity.

  8. Reconstructing a 3-dimensional image of the results of antinuclear antibody testing by indirect immunofluorescence.

    PubMed

    Murai, Ryosei; Yamada, Koji; Tanaka, Maki; Kuribayashi, Kageaki; Kobayashi, Daisuke; Tsuji, Naoki; Watanabe, Naoki

    2013-01-31

    Indirect immunofluorescence anti-nuclear antibody testing (IIF-ANAT) is an essential screening tool in the diagnosis of various autoimmune disorders. ANA titer quantification and interpretation of immunofluorescence patterns are determined subjectively, which is problematic. First, we determined the examination conditions under which IIF-ANAT fluorescence intensities are quantified. Next, IIF-ANAT was performed using homogeneous, discrete speckled, and mixed serum samples. Images were obtained using Bio Zero BZ-8000, and 3-dimensional images were reconstructed using the BZ analyzer software. In the 2-dimensional analysis, homogeneous ANAs hid the discrete speckled pattern, resulting in a diagnosis of homogeneous immunofluorescence. However, 3-dimensional analysis of the same sample showed discrete speckled-type ANA in the homogeneous background. This study strengthened the current IIF-ANAT method by providing a new approach to quantify the fluorescence intensity and enhance the resolution of IIF-ANAT fluorescence patterns. Reconstructed 3-dimensional imaging of IIF-ANAT can be a powerful tool for routine laboratory examination.

  9. Acromiohumeral Distance and 3-Dimensional Scapular Position Change After Overhead Muscle Fatigue

    PubMed Central

    Maenhout, Annelies; Dhooge, Famke; Van Herzeele, Maarten; Palmans, Tanneke; Cools, Ann

    2015-01-01

    Context: Muscle fatigue due to repetitive and prolonged overhead sports activity is considered an important factor contributing to impingement-related rotator cuff pathologic conditions in overhead athletes. The evidence on scapular and glenohumeral kinematic changes after fatigue is contradicting and prohibits conclusions about how shoulder muscle fatigue affects acromiohumeral distance. Objective: To investigate the effect of a fatigue protocol resembling overhead sports activity on acromiohumeral distance and 3-dimensional scapular position in overhead athletes. Design: Cross-sectional study. Setting: Institutional laboratory. Patients or Other Participants: A total of 29 healthy recreational overhead athletes (14 men, 15 women; age = 22.23 ± 2.82 years, height = 178.3 ± 7.8 cm, mass = 71.6 ± 9.5 kg). Intervention(s) The athletes were tested before and after a shoulder muscle-fatiguing protocol. Main Outcome Measure(s) Acromiohumeral distance was measured using ultrasound, and scapular position was determined with an electromagnetic motion-tracking system. Both measurements were performed at 3 elevation positions (0°, 45°, and 60° of abduction). We used a 3-factor mixed model for data analysis. Results: After fatigue, the acromiohumeral distance increased when the upper extremity was actively positioned at 45° (Δ = 0.78 ± 0.24 mm, P = .002) or 60° (Δ = 0.58 ± 0.23 mm, P = .02) of abduction. Scapular position changed after fatigue to a more externally rotated position at 45° (Δ = 4.97° ± 1.13°, P < .001) and 60° (Δ = 4.61° ± 1.90°, P = .001) of abduction, a more upwardly rotated position at 45° (Δ = 6.10° ± 1.30°, P < .001) and 60° (Δ = 7.20° ± 1.65°, P < .001) of abduction, and a more posteriorly tilted position at 0°, 45°, and 60° of abduction (Δ = 1.98° ± 0.41°, P < .001). Conclusions: After a fatiguing protocol, we found changes in acromiohumeral distance and scapular position that corresponded with an impingement

  10. Development of automatic body condition scoring using a low-cost 3-dimensional Kinect camera.

    PubMed

    Spoliansky, Roii; Edan, Yael; Parmet, Yisrael; Halachmi, Ilan

    2016-09-01

    Body condition scoring (BCS) is a farm-management tool for estimating dairy cows' energy reserves. Today, BCS is performed manually by experts. This paper presents a 3-dimensional algorithm that provides a topographical understanding of the cow's body to estimate BCS. An automatic BCS system consisting of a Kinect camera (Microsoft Corp., Redmond, WA) triggered by a passive infrared motion detector was designed and implemented. Image processing and regression algorithms were developed and included the following steps: (1) image restoration, the removal of noise; (2) object recognition and separation, identification and separation of the cows; (3) movie and image selection, selection of movies and frames that include the relevant data; (4) image rotation, alignment of the cow parallel to the x-axis; and (5) image cropping and normalization, removal of irrelevant data, setting the image size to 150×200 pixels, and normalizing image values. All steps were performed automatically, including image selection and classification. Fourteen individual features per cow, derived from the cows' topography, were automatically extracted from the movies and from the farm's herd-management records. These features appear to be measurable in a commercial farm. Manual BCS was performed by a trained expert and compared with the output of the training set. A regression model was developed, correlating the features with the manual BCS references. Data were acquired for 4 d, resulting in a database of 422 movies of 101 cows. Movies containing cows' back ends were automatically selected (389 movies). The data were divided into a training set of 81 cows and a test set of 20 cows; both sets included the identical full range of BCS classes. Accuracy tests gave a mean absolute error of 0.26, median absolute error of 0.19, and coefficient of determination of 0.75, with 100% correct classification within 1 step and 91% correct classification within a half step for BCS classes. Results indicated

  11. Supervised variational model with statistical inference and its application in medical image segmentation.

    PubMed

    Li, Changyang; Wang, Xiuying; Eberl, Stefan; Fulham, Michael; Yin, Yong; Dagan Feng, David

    2015-01-01

    Automated and general medical image segmentation can be challenging because the foreground and the background may have complicated and overlapping density distributions in medical imaging. Conventional region-based level set algorithms often assume piecewise constant or piecewise smooth for segments, which are implausible for general medical image segmentation. Furthermore, low contrast and noise make identification of the boundaries between foreground and background difficult for edge-based level set algorithms. Thus, to address these problems, we suggest a supervised variational level set segmentation model to harness the statistical region energy functional with a weighted probability approximation. Our approach models the region density distributions by using the mixture-of-mixtures Gaussian model to better approximate real intensity distributions and distinguish statistical intensity differences between foreground and background. The region-based statistical model in our algorithm can intuitively provide better performance on noisy images. We constructed a weighted probability map on graphs to incorporate spatial indications from user input with a contextual constraint based on the minimization of contextual graphs energy functional. We measured the performance of our approach on ten noisy synthetic images and 58 medical datasets with heterogeneous intensities and ill-defined boundaries and compared our technique to the Chan-Vese region-based level set model, the geodesic active contour model with distance regularization, and the random walker model. Our method consistently achieved the highest Dice similarity coefficient when compared to the other methods.

  12. A General Fuzzy Cerebellar Model Neural Network Multidimensional Classifier Using Intuitionistic Fuzzy Sets for Medical Identification.

    PubMed

    Zhao, Jing; Lin, Lo-Yi; Lin, Chih-Min

    2016-01-01

    The diversity of medical factors makes the analysis and judgment of uncertainty one of the challenges of medical diagnosis. A well-designed classification and judgment system for medical uncertainty can increase the rate of correct medical diagnosis. In this paper, a new multidimensional classifier is proposed by using an intelligent algorithm, which is the general fuzzy cerebellar model neural network (GFCMNN). To obtain more information about uncertainty, an intuitionistic fuzzy linguistic term is employed to describe medical features. The solution of classification is obtained by a similarity measurement. The advantages of the novel classifier proposed here are drawn out by comparing the same medical example under the methods of intuitionistic fuzzy sets (IFSs) and intuitionistic fuzzy cross-entropy (IFCE) with different score functions. Cross verification experiments are also taken to further test the classification ability of the GFCMNN multidimensional classifier. All of these experimental results show the effectiveness of the proposed GFCMNN multidimensional classifier and point out that it can assist in supporting for correct medical diagnoses associated with multiple categories.

  13. A General Fuzzy Cerebellar Model Neural Network Multidimensional Classifier Using Intuitionistic Fuzzy Sets for Medical Identification

    PubMed Central

    Zhao, Jing; Lin, Lo-Yi

    2016-01-01

    The diversity of medical factors makes the analysis and judgment of uncertainty one of the challenges of medical diagnosis. A well-designed classification and judgment system for medical uncertainty can increase the rate of correct medical diagnosis. In this paper, a new multidimensional classifier is proposed by using an intelligent algorithm, which is the general fuzzy cerebellar model neural network (GFCMNN). To obtain more information about uncertainty, an intuitionistic fuzzy linguistic term is employed to describe medical features. The solution of classification is obtained by a similarity measurement. The advantages of the novel classifier proposed here are drawn out by comparing the same medical example under the methods of intuitionistic fuzzy sets (IFSs) and intuitionistic fuzzy cross-entropy (IFCE) with different score functions. Cross verification experiments are also taken to further test the classification ability of the GFCMNN multidimensional classifier. All of these experimental results show the effectiveness of the proposed GFCMNN multidimensional classifier and point out that it can assist in supporting for correct medical diagnoses associated with multiple categories. PMID:27298619

  14. Progress of Ontario's Family Health Team model: a patient-centered medical home.

    PubMed

    Rosser, Walter W; Colwill, Jack M; Kasperski, Jan; Wilson, Lynn

    2011-01-01

    Ontario's Family Health Team (FHT) model, implemented in 2005, may be North America's largest example of a patient-centered medical home. The model, based on multidisciplinary teams and an innovative incentive-based funding system, has been developed primarily from fee-for-service primary care practices. Nearly 2 million Ontarians are served by 170 FHTs. Preliminary observations suggest high satisfaction among patients, higher income and more gratification for family physicians, and trends for more medical students to select careers in family medicine. Popular demand is resulting in expansion to 200 FHTs. We describe the development, implementation, reimbursement plan, and current status of this multidisciplinary model, relating it to the principles of the patient-centered medical home. We also identify its potential to provide an understanding of many aspects of primary care.

  15. A Review of 21st Century Utility of a Biopsychosocial Model in United States Medical School Education

    PubMed Central

    Jaini, Paresh Atu; Lee, Jenny Seung-Hyun

    2015-01-01

    Background Current medical practice is grounded in a biomedical model that fails to effectively address multifaceted lifestyle and morbidogenic environmental components that are the root causes of contemporary chronic diseases. Utilizing the biopsychosocial (BPS) model in medical school training may produce competent healthcare providers to meet the challenge of rising chronic illnesses that are a result of these factors. This study explored the current trend of research on the utility of the BPS model in medical education and examined medical school curricula that have explicitly adopted the BPS model. Methods A systematic review of peer-reviewed literature was conducted on the BPS model and medical education since the 1970s using multiple databases. Descriptive analysis was used to illustrate findings regarding the trends of the BPS model in medical education and its utility in specific medical schools in the United States. Results Major findings illustrated a growing trend in research on the BPS model in medical education since the 1970s with literature in this area most visible since 2000. The same trend was established for the incorporation of psychosocial or behavioral and social science components in medical education. From our peer-reviewed literature search, only 5 medical schools featured utility of the BPS model in their curricula utilizing variable educational processes. Conclusion Although literature regarding the BPS model in medical education is growing, the explicit utility of the BPS model in medical school is limited. Our findings can stimulate educational processes and research endeavors to advance medical education and medical practice to ensure that future doctors can meet the challenge of rising lifestyle and environmental associated illnesses. PMID:26770891

  16. A statewide system to track medical students' careers: the Pennsylvania model.

    PubMed

    Rabinowitz, H K; Veloski, J J; Aber, R C; Adler, S; Ferretti, S M; Kelliher, G J; Mochen, E; Morrison, G; Rattner, S L; Sterling, G; Robeson, M R; Hojat, M; Xu, G

    1999-01-01

    In 1994 the Commonwealth of Pennsylvania announced a statewide Generalist Physician Initiative (GPI) modeled after The Robert Wood Johnson Foundation's GPI. Three-year grants totaling more than $9 million were awarded to seven of Pennsylvania's medical schools, including two that had already received GPI grants from the foundation. Stimulated by these initiatives, the state's six allopathic and two osteopathic medical schools decided to work together to develop a collaborative longitudinal tracking system to follow the careers of all their students from matriculation into their professional careers. This statewide data system, which includes information for more than 18,000 students and graduates beginning with the entering class of 1982, can be used to evaluate the impact of the Pennsylvania GPI, and it also yielded a local longitudinal tracking system for each medical school. This paper outlines the concept of the system, its technical implementation, and the corresponding implications for other medical schools considering the development of similar outcomes assessment systems.

  17. Developing Physiologic Models for Emergency Medical Procedures Under Microgravity

    NASA Technical Reports Server (NTRS)

    Parker, Nigel; OQuinn, Veronica

    2012-01-01

    Several technological enhancements have been made to METI's commercial Emergency Care Simulator (ECS) with regard to how microgravity affects human physiology. The ECS uses both a software-only lung simulation, and an integrated mannequin lung that uses a physical lung bag for creating chest excursions, and a digital simulation of lung mechanics and gas exchange. METI's patient simulators incorporate models of human physiology that simulate lung and chest wall mechanics, as well as pulmonary gas exchange. Microgravity affects how O2 and CO2 are exchanged in the lungs. Procedures were also developed to take into affect the Glasgow Coma Scale for determining levels of consciousness by varying the ECS eye-blinking function to partially indicate the level of consciousness of the patient. In addition, the ECS was modified to provide various levels of pulses from weak and thready to hyper-dynamic to assist in assessing patient conditions from the femoral, carotid, brachial, and pedal pulse locations.

  18. BOLOGNA MODEL OF MEDICAL EDUCATION-UTOPIA OR REALITY.

    PubMed

    Zunic, Lejla; Donev, Doncho

    2016-07-24

    Higher education in Europe and in the Balkan's countries is undergoing major reforms. The Bologna Process was a major reform created with the claimed goal of providing responses to issues such as the public responsibility for higher education and research, higher education governance, the social dimension of higher education and research, and the values and roles of higher education and research in modern, globalized, and increasingly complex societies with the most demanding qualification needs. Changes in the curricula, modernization of facilities and their alignment with the programs of other European universities, employment of a larger number of assistants, especially in the clinical courses at our universities are necessary. Also, it is necessary to continue to conduct further detailed analysis and evaluation of teaching content and outcomes in the future. In this review authors expressed their views and experience of using Bologna model of education in the Balkan's countries with emphasis on Bosnia and Herzegovina and the Republic of Macedonia.

  19. Developing Physiologic Models for Emergency Medical Procedures Under Microgravity

    NASA Technical Reports Server (NTRS)

    Parker, Nigel; O'Quinn, Veronica

    2012-01-01

    Several technological enhancements have been made to METI's commercial Emergency Care Simulator (ECS) with regard to how microgravity affects human physiology. The ECS uses both a software-only lung simulation, and an integrated mannequin lung that uses a physical lung bag for creating chest excursions, and a digital simulation of lung mechanics and gas exchange. METI s patient simulators incorporate models of human physiology that simulate lung and chest wall mechanics, as well as pulmonary gas exchange. Microgravity affects how O2 and CO2 are exchanged in the lungs. Procedures were also developed to take into affect the Glasgow Coma Scale for determining levels of consciousness by varying the ECS eye-blinking function to partially indicate the level of consciousness of the patient. In addition, the ECS was modified to provide various levels of pulses from weak and thready to hyper-dynamic to assist in assessing patient conditions from the femoral, carotid, brachial, and pedal pulse locations.

  20. A Pathophysiological Model-Driven Communication for Dynamic Distributed Medical Best Practice Guidance Systems.

    PubMed

    Hosseini, Mohammad; Jiang, Yu; Wu, Poliang; Berlin, Richard B; Ren, Shangping; Sha, Lui

    2016-11-01

    There is a great divide between rural and urban areas, particularly in medical emergency care. Although medical best practice guidelines exist and are in hospital handbooks, they are often lengthy and difficult to apply clinically. The challenges are exaggerated for doctors in rural areas and emergency medical technicians (EMT) during patient transport. In this paper, we propose the concept of distributed executable medical best practice guidance systems to assist adherence to best practice from the time that a patient first presents at a rural hospital, through diagnosis and ambulance transfer to arrival and treatment at a regional tertiary hospital center. We codify complex medical knowledge in the form of simplified distributed executable disease automata, from the thin automata at rural hospitals to the rich automata in the regional center hospitals. However, a main challenge is how to efficiently and safely synchronize distributed best practice models as the communication among medical facilities, devices, and professionals generates a large number of messages. This complex problem of patient diagnosis and transport from rural to center facility is also fraught with many uncertainties and changes resulting in a high degree of dynamism. A critically ill patient's medical conditions can change abruptly in addition to changes in the wireless bandwidth during the ambulance transfer. Such dynamics have yet to be addressed in existing literature on telemedicine. To address this situation, we propose a pathophysiological model-driven message exchange communication architecture that ensures the real-time and dynamic requirements of synchronization among distributed emergency best practice models are met in a reliable and safe manner. Taking the signs, symptoms, and progress of stroke patients transported across a geographically distributed healthcare network as the motivating use case, we implement our communication system and apply it to our developed best practice

  1. The Integrated Medical Model: Statistical Forecasting of Risks to Crew Health and Mission Success

    NASA Technical Reports Server (NTRS)

    Fitts, M. A.; Kerstman, E.; Butler, D. J.; Walton, M. E.; Minard, C. G.; Saile, L. G.; Toy, S.; Myers, J.

    2008-01-01

    The Integrated Medical Model (IMM) helps capture and use organizational knowledge across the space medicine, training, operations, engineering, and research domains. The IMM uses this domain knowledge in the context of a mission and crew profile to forecast crew health and mission success risks. The IMM is most helpful in comparing the risk of two or more mission profiles, not as a tool for predicting absolute risk. The process of building the IMM adheres to Probability Risk Assessment (PRA) techniques described in NASA Procedural Requirement (NPR) 8705.5, and uses current evidence-based information to establish a defensible position for making decisions that help ensure crew health and mission success. The IMM quantitatively describes the following input parameters: 1) medical conditions and likelihood, 2) mission duration, 3) vehicle environment, 4) crew attributes (e.g. age, sex), 5) crew activities (e.g. EVA's, Lunar excursions), 6) diagnosis and treatment protocols (e.g. medical equipment, consumables pharmaceuticals), and 7) Crew Medical Officer (CMO) training effectiveness. It is worth reiterating that the IMM uses the data sets above as inputs. Many other risk management efforts stop at determining only likelihood. The IMM is unique in that it models not only likelihood, but risk mitigations, as well as subsequent clinical outcomes based on those mitigations. Once the mathematical relationships among the above parameters are established, the IMM uses a Monte Carlo simulation technique (a random sampling of the inputs as described by their statistical distribution) to determine the probable outcomes. Because the IMM is a stochastic model (i.e. the input parameters are represented by various statistical distributions depending on the data type), when the mission is simulated 10-50,000 times with a given set of medical capabilities (risk mitigations), a prediction of the most probable outcomes can be generated. For each mission, the IMM tracks which conditions

  2. BOLOGNA MODEL OF MEDICAL EDUCATION–UTOPIA OR REALITY

    PubMed Central

    Zunic, Lejla; Donev, Doncho

    2016-01-01

    Higher education in Europe and in the Balkan’s countries is undergoing major reforms. The Bologna Process was a major reform created with the claimed goal of providing responses to issues such as the public responsibility for higher education and research, higher education governance, the social dimension of higher education and research, and the values and roles of higher education and research in modern, globalized, and increasingly complex societies with the most demanding qualification needs. Changes in the curricula, modernization of facilities and their alignment with the programs of other European universities, employment of a larger number of assistants, especially in the clinical courses at our universities are necessary. Also, it is necessary to continue to conduct further detailed analysis and evaluation of teaching content and outcomes in the future. In this review authors expressed their views and experience of using Bologna model of education in the Balkan’s countries with emphasis on Bosnia and Herzegovina and the Republic of Macedonia. PMID:27698610

  3. Expanding clinical medical training opportunities at the University of Nairobi: adapting a regional medical education model from the WWAMI program at the University of Washington.

    PubMed

    Child, Mara J; Kiarie, James N; Allen, Suzanne M; Nduati, Ruth; Wasserheit, Judith N; Kibore, Minnie W; John-Stewart, Grace; Njiri, Francis J; O'Malley, Gabrielle; Kinuthia, Raphael; Norris, Tom E; Farquhar, Carey

    2014-08-01

    A major medical education need in Sub-Saharan Africa includes expanding clinical training opportunities to develop health professionals. Medical education expansion is a complicated process that requires significant investment of financial and human resources, but it can also provide opportunities for innovative approaches and partnerships. In 2010, the U.S. President's Emergency Plan for AIDS Relief launched the Medical Education Partnership Initiative to invest in medical education and health system strengthening in Africa. Building on a 30-year collaborative clinical and research training partnership, the University of Nairobi in Kenya developed a pilot regional medical education program modeled on the WWAMI (Washington, Wyoming, Alaska, Montana, and Idaho) medical education program at the University of Washington in the United States. The University of Nairobi adapted key elements of the WWAMI model to expand clinical training opportunities without requiring major capital construction of new buildings or campuses. The pilot program provides short-term clinical training opportunities for undergraduate students and recruits and trains clinical faculty at 14 decentralized training sites. The adaptation of a model from the Northwestern United States to address medical education needs in Kenya is a successful transfer of knowledge and practices that can be scaled up and replicated across Sub-Saharan Africa.

  4. Airway Wall Area Derived from 3-Dimensional Computed Tomography Analysis Differs among Lung Lobes in Male Smokers

    PubMed Central

    Tho, Nguyen Van; Trang, Le Thi Huyen; Murakami, Yoshitaka; Ogawa, Emiko; Ryujin, Yasushi; Kanda, Rie; Nakagawa, Hiroaki; Goto, Kenichi; Fukunaga, Kentaro; Higami, Yuichi; Seto, Ruriko; Nagao, Taishi; Oguma, Tetsuya; Yamaguchi, Masafumi; Lan, Le Thi Tuyet; Nakano, Yasutaka

    2014-01-01

    Background It is time-consuming to obtain the square root of airway wall area of the hypothetical airway with an internal perimeter of 10 mm (√Aaw at Pi10), a comparable index of airway dimensions in chronic obstructive pulmonary disease (COPD), from all airways of the whole lungs using 3-dimensional computed tomography (CT) analysis. We hypothesized that √Aaw at Pi10 differs among the five lung lobes and √Aaw at Pi10 derived from one certain lung lobe has a high level of agreement with that derived from the whole lungs in smokers. Methods Pulmonary function tests and chest volumetric CTs were performed in 157 male smokers (102 COPD, 55 non-COPD). All visible bronchial segments from the 3rd to 5th generations were segmented and measured using commercially available 3-dimensional CT analysis software. √Aaw at Pi10 of each lung lobe was estimated from all measurable bronchial segments of that lobe. Results Using a mixed-effects model, √Aaw at Pi10 differed significantly among the five lung lobes (R2 = 0.78, P<0.0001). The Bland-Altman plots show that √Aaw at Pi10 derived from the right or left upper lobe had a high level of agreement with that derived from the whole lungs, while √Aaw at Pi10 derived from the right or left lower lobe did not. Conclusion In male smokers, CT-derived airway wall area differs among the five lung lobes, and airway wall area derived from the right or left upper lobe is representative of the whole lungs. PMID:24865661

  5. Forecasting the need for medical specialists in Spain: application of a system dynamics model

    PubMed Central

    2010-01-01

    Background Spain has gone from a surplus to a shortage of medical doctors in very few years. Medium and long-term planning for health professionals has become a high priority for health authorities. Methods We created a supply and demand/need simulation model for 43 medical specialties using system dynamics. The model includes demographic, education and labour market variables. Several scenarios were defined. Variables controllable by health planners can be set as parameters to simulate different scenarios. The model calculates the supply and the deficit or surplus. Experts set the ratio of specialists needed per 1000 inhabitants with a Delphi method. Results In the scenario of the baseline model with moderate population growth, the deficit of medical specialists will grow from 2% at present (2800 specialists) to 14.3% in 2025 (almost 21 000). The specialties with the greatest medium-term shortages are Anesthesiology, Orthopedic and Traumatic Surgery, Pediatric Surgery, Plastic Aesthetic and Reparatory Surgery, Family and Community Medicine, Pediatrics, Radiology, and Urology. Conclusions The model suggests the need to increase the number of students admitted to medical school. Training itineraries should be redesigned to facilitate mobility among specialties. In the meantime, the need to make more flexible the supply in the short term is being filled by the immigration of physicians from new members of the European Union and from Latin America. PMID:21034458

  6. SPD-based Logistics Management Model of Medical Consumables in Hospitals

    PubMed Central

    LIU, Tongzhu; SHEN, Aizong; HU, Xiaojian; TONG, Guixian; GU, Wei; YANG, Shanlin

    2016-01-01

    Background: With the rapid development of health services, the progress of medical science and technology, and the improvement of materials research, the consumption of medical consumables (MCs) in medical activities has increased in recent years. However, owing to the lack of effective management methods and the complexity of MCs, there are several management problems including MC waste, low management efficiency, high management difficulty, and frequent medical accidents. Therefore, there is urgent need for an effective logistics management model to handle these problems and challenges in hospitals. Methods: We reviewed books and scientific literature (by searching the articles published from 2010 to 2015 in Engineering Village database) to understand supply chain related theories and methods and performed field investigations in hospitals across many cities to determine the actual state of MC logistics management of hospitals in China. Results: We describe the definition, physical model, construction, and logistics operation processes of the supply, processing, and distribution (SPD) of MC logistics because of the traditional SPD model. With the establishment of a supply-procurement platform and a logistics lean management system, we applied the model to the MC logistics management of Anhui Provincial Hospital with good effects. Conclusion: The SPD model plays a critical role in optimizing the logistics procedures of MCs, improving the management efficiency of logistics, and reducing the costs of logistics of hospitals in China. PMID:27957435

  7. The application of use case modeling in designing medical imaging information systems.

    PubMed

    Safdari, Reza; Farzi, Jebraeil; Ghazisaeidi, Marjan; Mirzaee, Mahboobeh; Goodini, Azadeh

    2013-01-01

    Introduction. The essay at hand is aimed at examining the application of use case modeling in analyzing and designing information systems to support Medical Imaging services. Methods. The application of use case modeling in analyzing and designing health information systems was examined using electronic databases (Pubmed, Google scholar) resources and the characteristics of the modeling system and its effect on the development and design of the health information systems were analyzed. Results. Analyzing the subject indicated that Provident modeling of health information systems should provide for quick access to many health data resources in a way that patients' data can be used in order to expand distant services and comprehensive Medical Imaging advices. Also these experiences show that progress in the infrastructure development stages through gradual and repeated evolution process of user requirements is stronger and this can lead to a decline in the cycle of requirements engineering process in the design of Medical Imaging information systems. Conclusion. Use case modeling approach can be effective in directing the problems of health and Medical Imaging information systems towards understanding, focusing on the start and analysis, better planning, repetition, and control.

  8. The Application of Use Case Modeling in Designing Medical Imaging Information Systems

    PubMed Central

    Safdari, Reza; Farzi, Jebraeil; Ghazisaeidi, Marjan; Mirzaee, Mahboobeh; Goodini, Azadeh

    2013-01-01

    Introduction. The essay at hand is aimed at examining the application of use case modeling in analyzing and designing information systems to support Medical Imaging services. Methods. The application of use case modeling in analyzing and designing health information systems was examined using electronic databases (Pubmed, Google scholar) resources and the characteristics of the modeling system and its effect on the development and design of the health information systems were analyzed. Results. Analyzing the subject indicated that Provident modeling of health information systems should provide for quick access to many health data resources in a way that patients' data can be used in order to expand distant services and comprehensive Medical Imaging advices. Also these experiences show that progress in the infrastructure development stages through gradual and repeated evolution process of user requirements is stronger and this can lead to a decline in the cycle of requirements engineering process in the design of Medical Imaging information systems. Conclusion. Use case modeling approach can be effective in directing the problems of health and Medical Imaging information systems towards understanding, focusing on the start and analysis, better planning, repetition, and control. PMID:24967283

  9. A Model-Based Approach to Support Validation of Medical Cyber-Physical Systems.

    PubMed

    Silva, Lenardo C; Almeida, Hyggo O; Perkusich, Angelo; Perkusich, Mirko

    2015-10-30

    Medical Cyber-Physical Systems (MCPS) are context-aware, life-critical systems with patient safety as the main concern, demanding rigorous processes for validation to guarantee user requirement compliance and specification-oriented correctness. In this article, we propose a model-based approach for early validation of MCPS, focusing on promoting reusability and productivity. It enables system developers to build MCPS formal models based on a library of patient and medical device models, and simulate the MCPS to identify undesirable behaviors at design time. Our approach has been applied to three different clinical scenarios to evaluate its reusability potential for different contexts. We have also validated our approach through an empirical evaluation with developers to assess productivity and reusability. Finally, our models have been formally verified considering functional and safety requirements and model coverage.

  10. A Model-Based Approach to Support Validation of Medical Cyber-Physical Systems

    PubMed Central

    Silva, Lenardo C.; Almeida, Hyggo O.; Perkusich, Angelo; Perkusich, Mirko

    2015-01-01

    Medical Cyber-Physical Systems (MCPS) are context-aware, life-critical systems with patient safety as the main concern, demanding rigorous processes for validation to guarantee user requirement compliance and specification-oriented correctness. In this article, we propose a model-based approach for early validation of MCPS, focusing on promoting reusability and productivity. It enables system developers to build MCPS formal models based on a library of patient and medical device models, and simulate the MCPS to identify undesirable behaviors at design time. Our approach has been applied to three different clinical scenarios to evaluate its reusability potential for different contexts. We have also validated our approach through an empirical evaluation with developers to assess productivity and reusability. Finally, our models have been formally verified considering functional and safety requirements and model coverage. PMID:26528982

  11. Clinical Prediction Models for Sleep Apnea: The Importance of Medical History over Symptoms

    PubMed Central

    Ustun, Berk; Westover, M. Brandon; Rudin, Cynthia; Bianchi, Matt T.

    2016-01-01

    Study Objective: Obstructive sleep apnea (OSA) is a treatable contributor to morbidity and mortality. However, most patients with OSA remain undiagnosed. We used a new machine learning method known as SLIM (Supersparse Linear Integer Models) to test the hypothesis that a diagnostic screening tool based on routinely available medical information would be superior to one based solely on patient-reported sleep-related symptoms. Methods: We analyzed polysomnography (PSG) and self-reported clinical information from 1,922 patients tested in our clinical sleep laboratory. We used SLIM and 7 state-of-the-art classification methods to produce predictive models for OSA screening using features from: (i) self-reported symptoms; (ii) self-reported medical information that could, in principle, be extracted from electronic health records (demographics, comorbidities), or (iii) both. Results: For diagnosing OSA, we found that model performance using only medical history features was superior to model performance using symptoms alone, and similar to model performance using all features. Performance was similar to that reported for other widely used tools: sensitivity 64.2% and specificity 77%. SLIM accuracy was similar to state-of-the-art classification models applied to this dataset, but with the benefit of full transparency, allowing for hands-on prediction using yes/no answers to a small number of clinical queries. Conclusion: To predict OSA, variables such as age, sex, BMI, and medical history are superior to the symptom variables we examined for predicting OSA. SLIM produces an actionable clinical tool that can be applied to data that is routinely available in modern electronic health records, which may facilitate automated, rather than manual, OSA screening. Commentary: A commentary on this article appears in this issue on page 159. Citation: Ustun B, Westover MB, Rudin C, Bianchi MT. Clinical prediction models for sleep apnea: the importance of medical history over symptoms

  12. A professional development model for medical laboratory scientists working in the Core Laboratory.

    PubMed

    Ali, Faheem A; Pulido, Lila A; Garza, Melinda N; Amerson, Megan H; Greenhill, Brandy; Brown, Krystyna N; Lim, Shari K; Manyam, Venkatesara R; Nguyen, Hannah N; Prudhomme, Carrie C; Regan, Laura E; Sims, Willie R; Umeh, Afamefuna U; Williams, Rosemary; Tillman, Patricia K; Hu, Peter C

    2012-01-01

    The Division of Pathology and Laboratory Medicine at The University of Texas MD Anderson Cancer Center has implemented a professional development model designed to further the education, expertise, and experiences of medical laboratory scientists in the core laboratory. The professional development model (PDM) has four competency levels: Discovery, Application, Maturation and Expert. All levels require the medical laboratory scientist to learn new skill sets, complete task and projects, and meet continuing education and certification requirements. Each level encourages personal development, recognizes increased competencies, and sets high standards for all services provided. Upon completion of a level within a given timeframe, the medical laboratory scientist receives a salary adjustment based on the competency level completed.

  13. A Baseline Patient Model to Support Testing of Medical Cyber-Physical Systems.

    PubMed

    Silva, Lenardo C; Perkusich, Mirko; Almeida, Hyggo O; Perkusich, Angelo; Lima, Mateus A M; Gorgônio, Kyller C

    2015-01-01

    Medical Cyber-Physical Systems (MCPS) are currently a trending topic of research. The main challenges are related to the integration and interoperability of connected medical devices, patient safety, physiologic closed-loop control, and the verification and validation of these systems. In this paper, we focus on patient safety and MCPS validation. We present a formal patient model to be used in health care systems validation without jeopardizing the patient's health. To determine the basic patient conditions, our model considers the four main vital signs: heart rate, respiratory rate, blood pressure and body temperature. To generate the vital signs we used regression models based on statistical analysis of a clinical database. Our solution should be used as a starting point for a behavioral patient model and adapted to specific clinical scenarios. We present the modeling process of the baseline patient model and show its evaluation. The conception process may be used to build different patient models. The results show the feasibility of the proposed model as an alternative to the immediate need for clinical trials to test these medical systems.

  14. Modeling Determinants of Medication Attitudes and Poor Adherence in Early Nonaffective Psychosis: Implications for Intervention

    PubMed Central

    Drake, Richard J.; Nordentoft, Merete; Haddock, Gillian; Arango, Celso; Fleischhacker, W. Wolfgang; Glenthøj, Birte; Leboyer, Marion; Leucht, Stefan; Leweke, Markus; McGuire, Phillip; Meyer-Lindenberg, Andreas; Rujescu, Dan; Sommer, Iris E.; Kahn, René S.; Lewis, Shon W.

    2015-01-01

    We aimed to design a multimodal intervention to improve adherence following first episode psychosis, consistent with current evidence. Existing literature identified medication attitudes, insight, and characteristics of support as important determinants of adherence to medication: we examined medication attitudes, self-esteem, and insight in an early psychosis cohort better to understand their relationships. Existing longitudinal data from 309 patients with early Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, nonaffective psychosis (83% first episode) were analyzed to test the hypothesis that medication attitudes, while meaningfully different from “insight,” correlated with insight and self-esteem, and change in each influenced the others. Rosenberg Self-Esteem Scale, Birchwood Insight Scale, and Positive and Negative Syndrome Scale insight were assessed at presentation, after 6 weeks and 3 and 18 months. Drug Attitudes Inventory (DAI) and treatment satisfaction were rated from 6 weeks onward. Structural equation models of their relationships were compared. Insight measures’ and DAI’s predictive validity were compared against relapse, readmission, and remission. Analysis found five latent constructs best fitted the data: medication attitudes, self-esteem, accepting need for treatment, self-rated insight, and objective insight. All were related and each affected the others as it changed, except self-esteem and medication attitudes. Low self-reported insight at presentation predicted readmission. Good 6-week insight (unlike drug attitudes) predicted remission. Literature review and data modeling indicated that a multimodal intervention using motivational interviewing, online psychoeducation, and SMS text medication reminders to enhance adherence without damaging self-concept was feasible and appropriate. PMID:25750247

  15. Factors influencing adherence to psychopharmacological medications in psychiatric patients: a structural equation modeling approach

    PubMed Central

    De las Cuevas, Carlos; de Leon, Jose; Peñate, Wenceslao; Betancort, Moisés

    2017-01-01

    Purpose To evaluate pathways through which sociodemographic, clinical, attitudinal, and perceived health control variables impact psychiatric patients’ adherence to psychopharmacological medications. Method A sample of 966 consecutive psychiatric outpatients was studied. The variables were sociodemographic (age, gender, and education), clinical (diagnoses, drug treatment, and treatment duration), attitudinal (attitudes toward psychopharmacological medication and preferences regarding participation in decision-making), perception of control over health (health locus of control, self-efficacy, and psychological reactance), and level of adherence to psychopharmacological medications. Structural equation modeling was applied to examine the nonstraightforward relationships and the interactive effects among the analyzed variables. Results Structural equation modeling demonstrated that psychiatric patients’ treatment adherence was associated: 1) negatively with cognitive psychological reactance (adherence decreased as cognitive psychological reactance increased), 2) positively with patients’ trust in their psychiatrists (doctors’ subscale), 3) negatively with patients’ belief that they are in control of their mental health and that their mental health depends on their own actions (internal subscale), and 4) positively (although weakly) with age. Self-efficacy indirectly influenced treatment adherence through internal health locus of control. Conclusion This study provides support for the hypothesis that perceived health control variables play a relevant role in psychiatric patients’ adherence to psychopharmacological medications. The findings highlight the importance of considering prospective studies of patients’ psychological reactance and health locus of control as they may be clinically relevant factors contributing to adherence to psychopharmacological medications.

  16. Curriculum Change in a Baccalaureate Nursing Program: From the Medical Model to the Integrated Approach.

    ERIC Educational Resources Information Center

    Kroll, Claudia

    Nursing curricula have been revised numerous times over the years in response to changes in the health care arena, as well as societal demands and political and economic forces. One of the most dynamic shifts in nursing education in the last 25 years is the shift in focus from the medical model to an integrated approach. Faculty in university…

  17. Partnerships in Medical Education: An Exploration of Library Service Models for Postgraduate Medicine at Macquarie University

    ERIC Educational Resources Information Center

    Simons, Mary

    2008-01-01

    Macquarie University's new medical school, The Australian School of Advanced Medicine (ASAM), is developing a postgraduate program that incorporates a partnership with Macquarie University Library. The curriculum encompasses contemporary models of competency-based assessment, teamwork and lifelong learning that are integrated with research and…

  18. Medical Students' Emotional Development in Early Clinical Experience: A Model

    ERIC Educational Resources Information Center

    Helmich, Esther; Bolhuis, Sanneke; Laan, Roland; Dornan, Tim; Koopmans, Raymond

    2014-01-01

    Dealing with emotions is a critical feature of professional behaviour. There are no comprehensive theoretical models, however, explaining how medical students learn about emotions. We aimed to explore factors affecting their emotions and how they learn to deal with emotions in themselves and others. During a first-year nursing attachment in…

  19. Predictive Modeling of Student Performances for Retention and Academic Support in a Diagnostic Medical Sonography Program

    ERIC Educational Resources Information Center

    Borghese, Peter; Lacey, Sandi

    2014-01-01

    As part of a retention and academic support program, data was collected to develop a predictive model of student performances in core classes in a Diagnostic Medical Sonography (DMS) program. The research goal was to identify students likely to have difficulty with coursework and provide supplemental tutorial support. The focus was on the…

  20. Is the Medical Model Making Our Children Sick--of Reading?

    ERIC Educational Resources Information Center

    Heller, Marvin; Hornby, Joyce

    The skills-based method of remedial reading instruction is based on a medical model, in that it focuses instructional efforts solely on "curing" what is "wrong" with a reader. Such attention to students' shortcomings and the labeling of their lack of instant success as a problem causes healthy learners to begin to doubt their own abilities, often…

  1. Balancing the Imbalance: Integrating a Strength-Based Approach with a Medical Model

    ERIC Educational Resources Information Center

    Foltz, Robert

    2006-01-01

    There are major differences in perspective between the traditional medical model of treatment for troubled children and more recent strength-based approaches. This is particularly evident when widespread use of psychoactive drugs becomes a substitute for interpersonal therapeutic interventions. Drugs and relationships both impact the brain, but in…

  2. "Comments on Slavin": Through the Looking Glass--Experiments, Quasi-Experiments, and the Medical Model

    ERIC Educational Resources Information Center

    Sloane, Finbarr

    2008-01-01

    Slavin (2008) has called for changing the criteria used for the inclusion of basic research in national research synthesis clearinghouses. The author of this article examines a number of the assumptions made by Slavin, provides critique with alternatives, and asks what it means to fully implement the medical model in educational settings.…

  3. What makes a top research medical school? A call for a new model to evaluate academic physicians and medical school performance.

    PubMed

    Goldstein, Matthew J; Lunn, Mitchell R; Peng, Lily

    2015-05-01

    Since the publication of the Flexner Report in 1910, the medical education enterprise has undergone many changes to ensure that medical schools meet a minimum standard for the curricula and clinical training they offer students. Although the efforts of the licensing and accrediting bodies have raised the quality of medical education, the educational processes that produce the physicians who provide the best patient care and conduct the best biomedical research have not been identified. Comparative analyses are powerful tools to understand the differences between institutions, but they are challenging to carry out. As a result, the analysis performed by U.S. News & World Report (USN&WR) has become the default tool to compare U.S. medical schools. Medical educators must explore more rigorous and equitable approaches to analyze and understand the performance of medical schools. In particular, a better understanding and more thorough evaluation of the most successful institutions in producing academic physicians with biomedical research careers are needed. In this Perspective, the authors present a new model to evaluate medical schools' production of academic physicians who advance medicine through basic, clinical, translational, and implementation science research. This model is based on relevant and accessible objective criteria that should replace the subjective criteria used in the current USN&WR rankings system. By fostering a national discussion about the most meaningful criteria that should be measured and reported, the authors hope to increase transparency of assessment standards and ultimately improve educational quality.

  4. Preliminary 3-Dimensional Geologic Map of the Santa Rosa Plain, Northern California

    NASA Astrophysics Data System (ADS)

    McCabe, C. A.; McPhee, D. K.; Valin, Z. C.; McLaughlin, R. J.; Jachens, R. C.; Langenheim, V. E.; Wentworth, C. M.

    2004-12-01

    We have constructed a preliminary 3-dimensional geologic map of the Santa Rosa Plain as a tool to address earthquake hazard and groundwater issues. The map allows integration of diverse datasets to produce a stratigraphic and structural architecture for the region. This framework can then be used to predict pathways of ground water flow and potential areas of enhanced or focused seismic shaking beneath the Santa Rosa Plain. The 3D map also allows us to identify relations which will require further refinement to develop a coherent 3D image of the crust. The 3D map, built using EarthVision 3D geologic mapping software, consists of three bounding components: fault surfaces, stratigraphic surfaces, and a basement upper surface. Fault surfaces are derived from geologic mapping, subsurface projection of fault dips from the surface geology and earthquake hypocenters. Stratigraphic surfaces are derived from the mapped geology, a digital elevation model and stratigraphic information from wells. A basement surface, predominantly composed of Mesozoic rocks of the Franciscan Complex, the mafic Coast Range Ophiolite and strata of the Great Valley Sequence, is derived from inversion of regional gravity measurements and constrained by well data. The preliminary 3D map of the Santa Rosa Plain area highlights two large basins (>2 km deep): the Windsor and Cotati basins. These basins are divided by a structural high associated with the W-NW-trending, NE-dipping Trenton thrust fault. The Cotati basin is further subdivided by a deeper basement ridge subparallel to the Trenton fault, which separates the basin beneath Cotati from the basin of Petaluma Valley to the southeast. Neither of the basement ridges breaks the surface, yet faults associated with the ridges could displace or truncate aquifers, provide channelways for groundwater flow between aquifers, or create zones of impermeability that disrupt the vertical and lateral continuity of groundwater flow. The complex configuration

  5. Multimodality imaging of intrauterine devices with an emphasis on the emerging role of 3-dimensional ultrasound.

    PubMed

    Reiner, Jeffrey S; Brindle, Kathleen A; Khati, Nadia Juliet

    2012-12-01

    The intrauterine contraceptive device (IUD) is one of the most widely used reversible contraception methods throughout the world. With advancing technology, it has rapidly gained acceptance through its increased effectiveness and practicality compared with more invasive means such as laparoscopic tubal ligation. This pictorial essay will present the IUDs most commonly used today. It will illustrate both normal and abnormal positions of IUDs across all cross-sectional imaging modalities including 2-dimensional ultrasound, computed tomography, and magnetic resonance imaging, with a focus on the emerging role of 3-dimensional ultrasound as the modality of choice.

  6. Introducing a well-ordered volume porosity in 3-dimensional gold microcantilevers

    NASA Astrophysics Data System (ADS)

    Ayela, Cédric; Lalo, Hélène; Kuhn, Alexander

    2013-02-01

    The purpose of the present work is the introduction of a combined bottom-up and top-down approach to generate 3-dimensional gold microcantilevers, where the porosity in the volume of the free-standing microstructure is well-controlled. By combining the elaboration of a colloidal crystal, followed by electrodeposition, with a sacrificial layer process, free-standing macroporous gold cantilevers are fabricated collectively. In order to validate the proposed concept, a simple application to humidity sensing is evaluated using the devices as mass sensors. A large sensitivity of -529 ppm/%RH and low discrepancy are obtained experimentally, confirming the promising application potential of this original architecture.

  7. Brief communications: visualization of coronary arteries in rats by 3-dimensional real-time contrast echocardiography.

    PubMed

    Ishikura, Fuminobu; Hirayama, Hideo; Iwata, Akiko; Toshida, Tsutomu; Masuda, Kasumi; Otani, Kentaro; Asanuma, Toshihiko; Beppu, Shintaro

    2008-05-01

    Angiogenesis is under intense investigation to advance the treatment of various ischemic diseases. Small animals, such as mice and rats, are often used for this purpose. However, evaluating the structure of coronary arteries in small animals in situ is not easy. We succeeded in visualizing the coronary artery in rats on 3-dimensional real-time contrast echocardiography using a high-frequency transducer. These methods will be applied for more convenient assessment in a new study, examining issues such as angiogenesis using rats in situ.

  8. Evaluation of Temperature and Stress Distribution on 2 Different Post Systems Using 3-Dimensional Finite Element Analysis

    PubMed Central

    Değer, Yalçın; Adigüzel, Özkan; Özer, Senem Yiğit; Kaya, Sadullah; Polat, Zelal Seyfioğlu; Bozyel, Bejna

    2015-01-01

    Background The mouth is exposed to thermal irritation from hot and cold food and drinks. Thermal changes in the oral cavity produce expansions and contractions in tooth structures and restorative materials. The aim of this study was to investigate the effect of temperature and stress distribution on 2 different post systems using the 3-dimensional (3D) finite element method. Material/Methods The 3D finite element model shows a labio-lingual cross-sectional view of the endodontically treated upper right central incisor and supporting periodontal ligament with bone structures. Stainless steel and glass fiber post systems with different physical and thermal properties were modelled in the tooth restored with composite core and ceramic crown. We placed 100 N static vertical occlusal loading onto the center of the incisal surface of the tooth. Thermal loads of 0°C and 65°C were applied on the model for 5 s. Temperature and thermal stresses were determined on the labio-lingual section of the model at 6 different points. Results The distribution of stress, including thermal stress values, was calculated using 3D finite element analysis. The stainless steel post system produced more temperature and thermal stresses on the restorative materials, tooth structures, and posts than did the glass fiber reinforced composite posts. Conclusions Thermal changes generated stresses in the restorative materials, tooth, and supporting structures. PMID:26615495

  9. Mentoring for junior medical faculty: Existing models and suggestions for low-resource settings.

    PubMed

    Menon, Vikas; Muraleedharan, Aparna; Bhat, Ballambhattu Vishnu

    2016-02-01

    Globally, there is increasing recognition about the positive benefits and impact of mentoring on faculty retention rates, career satisfaction and scholarly output. However, emphasis on research and practice of mentoring is comparatively meagre in low and middle income countries. In this commentary, we critically examine two existing models of mentorship for medical faculty and offer few suggestions for an integrated hybrid model that can be adapted for use in low resource settings.

  10. Three-Dimensional Printing and Medical Imaging: A Review of the Methods and Applications.

    PubMed

    Marro, Alessandro; Bandukwala, Taha; Mak, Walter

    2016-01-01

    The purpose of this article is to review recent innovations on the process and application of 3-dimensional (3D) printed objects from medical imaging data. Data for 3D printed medical models can be obtained from computed tomography, magnetic resonance imaging, and ultrasound using the Data Imaging and Communications in Medicine (DICOM) software. The data images are processed using segmentation and mesh generation tools and converted to a standard tessellation language (STL) file for printing. 3D printing technologies include stereolithography, selective laser sintering, inkjet, and fused-deposition modeling . 3D printed models have been used for preoperative planning of complex surgeries, the creation of custom prosthesis, and in the education and training of physicians. The application of medical imaging and 3D printers has been successful in providing solutions to many complex medical problems. As technology advances, its applications continue to grow in the future.

  11. A conceptual model of public medical service system based-on cell phone mobile platform

    NASA Astrophysics Data System (ADS)

    Fu, Hongjiao; Zhao, Yue

    In recent years, cell phones have played an increasingly important role in rapidly-developing global telecommunication services. At present, mobile business develops very fast. However, the development in other mobile service fields, such as public service, mobile medical service, etc, is still in its infant stage. Drawing on the experience of the 'doctor workstation project' which is cooperated by Renmin University of China and Norway Fredskorps Corporation, this paper discusses the research and implementation of the Doctor Workstation System based on cell phone mobile platform. From the practice of the Doctor Workstation System, the paper advances a conceptual model of public medical service system based-on cell phone mobile platform.

  12. Toward a patient-centric medical information model: issues and challenges for US adoption.

    PubMed

    Lorence, Daniel; Monatesti, Sabatini; Margenthaler, Robert; Hoadley, Ellen

    2005-01-01

    As the USA moves, incrementally, toward evidence-based medicine, there is growing awareness of the importance of innovation in information management. Mandates for change include improved use of resources, accelerated diffusion of knowledge and an advanced consumer role. Key among these requirements is the need for a fundamentally different patient information recording system. Within the challenges identified in the most recent national health information technology initiative, we propose a model for an electronic, patient-centric medical information infrastructure, highlighting a transportable, scalable and integrated resource. We identify resources available for technology transfer, promoting consumers as integral parts of the collaborative medical decision-making process.

  13. Development of a model of information security requirements for enterprise-wide medical information systems.

    PubMed Central

    Orr, G. A.; Brantley, B. A.

    1992-01-01

    Information security methods developed within the narrow frameworks of operating system design, specific database models, and military security methods all concentrate on representation of the objects of access control, rather than on the information needs of the subjects. This approach does not adequately support the needs of the varied users of medical information systems, who must have access to information in support of multiple organizational roles. A new conceptual approach to access control in medical settings based on user requirements is discussed. PMID:1482882

  14. Creation of Anatomically Accurate Computer-Aided Design (CAD) Solid Models from Medical Images

    NASA Technical Reports Server (NTRS)

    Stewart, John E.; Graham, R. Scott; Samareh, Jamshid A.; Oberlander, Eric J.; Broaddus, William C.

    1999-01-01

    Most surgical instrumentation and implants used in the world today are designed with sophisticated Computer-Aided Design (CAD)/Computer-Aided Manufacturing (CAM) software. This software automates the mechanical development of a product from its conceptual design through manufacturing. CAD software also provides a means of manipulating solid models prior to Finite Element Modeling (FEM). Few surgical products are designed in conjunction with accurate CAD models of human anatomy because of the difficulty with which these models are created. We have developed a novel technique that creates anatomically accurate, patient specific CAD solids from medical images in a matter of minutes.

  15. Sparse Codebook Model of Local Structures for Retrieval of Focal Liver Lesions Using Multiphase Medical Images

    PubMed Central

    Han, Xian-Hua; Xu, Yingying; Lin, Lanfen; Hu, Hongjie; Jin, Chongwu

    2017-01-01

    Characterization and individual trait analysis of the focal liver lesions (FLL) is a challenging task in medical image processing and clinical site. The character analysis of a unconfirmed FLL case would be expected to benefit greatly from the accumulated FLL cases with experts' analysis, which can be achieved by content-based medical image retrieval (CBMIR). CBMIR mainly includes discriminated feature extraction and similarity calculation procedures. Bag-of-Visual-Words (BoVW) (codebook-based model) has been proven to be effective for different classification and retrieval tasks. This study investigates an improved codebook model for the fined-grained medical image representation with the following three advantages: (1) instead of SIFT, we exploit the local patch (structure) as the local descriptor, which can retain all detailed information and is more suitable for the fine-grained medical image applications; (2) in order to more accurately approximate any local descriptor in coding procedure, the sparse coding method, instead of K-means algorithm, is employed for codebook learning and coded vector calculation; (3) we evaluate retrieval performance of focal liver lesions (FLL) using multiphase computed tomography (CT) scans, in which the proposed codebook model is separately learned for each phase. The effectiveness of the proposed method is confirmed by our experiments on FLL retrieval. PMID:28293255

  16. Limitations of Western Medicine and Models of Integration Between Medical Systems.

    PubMed

    Attena, Francesco

    2016-05-01

    This article analyzes two major limitations of Western medicine: maturity and incompleteness. From this viewpoint, Western medicine is considered an incomplete system for the explanation of living matter. Therefore, through appropriate integration with other medical systems, in particular nonconventional approaches, its knowledge base and interpretations may be widened. This article presents possible models of integration of Western medicine with homeopathy, the latter being viewed as representative of all complementary and alternative medicine. To compare the two, a medical system was classified into three levels through which it is possible to distinguish between different medical systems: epistemological (first level), theoretical (second level), and operational (third level). These levels are based on the characterization of any medical system according to, respectively, a reference paradigm, a theory on the functioning of living matter, and clinical practice. The three levels are consistent and closely consequential in the sense that from epistemology derives theory, and from theory derives clinical practice. Within operational integration, four models were identified: contemporary, alternative, sequential, and opportunistic. Theoretical integration involves an explanation of living systems covering simultaneously the molecular and physical mechanisms of functioning living matter. Epistemological integration provides a more thorough and comprehensive explanation of the epistemic concepts of indeterminism, holism, and vitalism to complement the reductionist approach of Western medicine; concepts much discussed by Western medicine while lacking the epistemologic basis for their emplacement. Epistemologic integration could be reached with or without a true paradigm shift and, in the latter, through a model of fusion or subsumption.

  17. Mass medication modeling in response to public health emergencies: outcomes of a drive-thru exercise.

    PubMed

    Zerwekh, Tyler; McKnight, Jason; Hupert, Nathaniel; Wattson, Daniel; Hendrickson, Lisa; Lane, David

    2007-01-01

    This article presents the outcomes of a full-scale training exercise utilizing a drive-thru clinic model for dispensing of Strategic National Stockpile medication. The Hawaii Department of Health developed a clinic design for vehicles based on previous exercises and research on sample throughput rates. The streamlined model selected includes a triage area near the entrance and consecutive stations for the public to register, have an evaluation for drug contradictions, and receive the medication. During the 2-hour exercise held in April 2005, a total of 622 patients were processed in their vehicles for an overall rate of 5.2 persons per minute. Although patient services were reduced in comparison to current walk-in clinic models, the public was able to receive prophylactic medication in a timely manner with a high rate of accuracy and minimal human-to-human contact. These results demonstrate that local health departments, particularly in rural areas, can provide essential medications, vaccinations, or rations through a drive-thru clinic, thus limiting morbidity and mortality during a public health emergency.

  18. Systems modeling of space medical support architecture: topological mapping of high level characteristics and constraints.

    PubMed

    Musson, David M; Doyle, Thomas E; Saary, Joan

    2012-01-01

    The challenges associated with providing medical support to astronauts on long duration lunar or planetary missions are significant. Experience to date in space has included short duration missions to the lunar surface and both short and long duration stays on board spacecraft and space stations in low Earth orbit. Live actor, terrestrial analogue setting simulation provides a means of studying multiple aspects of the medical challenges of exploration class space missions, though few if any published models exist upon which to construct systems-simulation test beds. Current proposed and projected moon mission scenarios were analyzed from a systems perspective to construct such a model. A resulting topological mapping of high-level architecture for a reference lunar mission with presumed EVA excursion and international mission partners is presented. High-level descriptions of crew operational autonomy, medical support related to crew-member status, and communication characteristics within and between multiple teams are presented. It is hoped this modeling will help guide future efforts to simulate medical support operations for research purposes, such as in the use of live actor simulations in terrestrial analogue environments.

  19. A professional development model for medical laboratory scientists working in the immunohematology laboratory.

    PubMed

    Garza, Melinda N; Pulido, Lila A; Amerson, Megan; Ali, Faheem A; Greenhill, Brandy A; Griffin, Gary; Alvarez, Enrique; Whatley, Marsha; Hu, Peter C

    2012-01-01

    Transfusion medicine, a section of the Department of Laboratory Medicine at The University of Texas MD Anderson Cancer Center is committed to the education and advancement of its health care professionals. It is our belief that giving medical laboratory professionals a path for advancement leads to excellence and increases overall professionalism in the Immunohematology Laboratory. As a result of this strong commitment to excellence and professionalism, the Immunohematology laboratory has instituted a Professional Development Model (PDM) that aims to create Medical Laboratory Scientists (MLS) that are not only more knowledgeable, but are continually striving for excellence. In addition, these MLS are poised for advancement in their careers. The professional development model consists of four levels: Discovery, Application, Maturation, and Expert. The model was formulated to serve as a detailed path to the mastery of all process and methods in the Immunohematology Laboratory. Each level in the professional development model consists of tasks that optimize the laboratory workflow and allow for concurrent training. Completion of a level in the PDM is rewarded with financial incentive and further advancement in the field. The PDM for Medical Laboratory Scientists in the Immunohematology Laboratory fosters personal development, rewards growth and competency, and sets high standards for all services and skills provided. This model is a vital component of the Immunohematology Laboratory and aims to ensure the highest quality of care and standards in their testing. It is because of the success of this model and the robustness of its content that we hope other medical laboratories aim to reach the same level of excellence and professionalism, and adapt this model into their own environment.

  20. An investigative model evaluating how consumers process pictorial information on nonprescription medication labels.

    PubMed

    Sansgiry, S S; Cady, P S

    1997-01-01

    Currently, marketed over-the-counter (OTC) medication labels were simulated and tested in a controlled environment to understand consumer evaluation of OTC label information. Two factors, consumers' age (younger and older adults) and label designs (picture-only, verbal-only, congruent picture-verbal, and noncongruent picture-verbal) were controlled and tested to evaluate consumer information processing. The effects exerted by the independent variables, namely, comprehension of label information (understanding) and product evaluations (satisfaction, certainty, and perceived confusion) were evaluated on the dependent variable purchase intention. Intention measured as purchase recommendation was significantly related to product evaluations and affected by the factor label design. Participants' level of perceived confusion was more important than actual understanding of information on OTC medication labels. A Label Evaluation Process Model was developed which could be used for future testing of OTC medication labels.

  1. Medication Reconciliation: Work Domain Ontology, prototype development, and a predictive model.

    PubMed

    Markowitz, Eliz; Bernstam, Elmer V; Herskovic, Jorge; Zhang, Jiajie; Shneiderman, Ben; Plaisant, Catherine; Johnson, Todd R

    2011-01-01

    Medication errors can result from administration inaccuracies at any point of care and are a major cause for concern. To develop a successful Medication Reconciliation (MR) tool, we believe it necessary to build a Work Domain Ontology (WDO) for the MR process. A WDO defines the explicit, abstract, implementation-independent description of the task by separating the task from work context, application technology, and cognitive architecture. We developed a prototype based upon the WDO and designed to adhere to standard principles of interface design. The prototype was compared to Legacy Health System's and Pre-Admission Medication List Builder MR tools via a Keystroke-Level Model analysis for three MR tasks. The analysis found the prototype requires the fewest mental operations, completes tasks in the fewest steps, and completes tasks in the least amount of time. Accordingly, we believe that developing a MR tool, based upon the WDO and user interface guidelines, improves user efficiency and reduces cognitive load.

  2. Comparison of nonnavigated and 3-dimensional image-based computer navigated balloon kyphoplasty.

    PubMed

    Sembrano, Jonathan N; Yson, Sharon C; Polly, David W; Ledonio, Charles Gerald T; Nuckley, David J; Santos, Edward R G

    2015-01-01

    Balloon kyphoplasty is a common treatment for osteoporotic and pathologic compression fractures. Advantages include minimal tissue disruption, quick recovery, pain relief, and in some cases prevention of progressive sagittal deformity. The benefit of image-based navigation in kyphoplasty has not been established. The goal of this study was to determine whether there is a difference between fluoroscopy-guided balloon kyphoplasty and 3-dimensional image-based navigation in terms of needle malposition rate, cement leakage rate, and radiation exposure time. The authors compared navigated and nonnavigated needle placement in 30 balloon kyphoplasty procedures (47 levels). Intraoperative 3-dimensional image-based navigation was used for needle placement in 21 cases (36 levels); conventional 2-dimensional fluoroscopy was used in the other 9 cases (11 levels). The 2 groups were compared for rates of needle malposition and cement leakage as well as radiation exposure time. Three of 11 (27%) nonnavigated cases were complicated by a malpositioned needle, and 2 of these had to be repositioned. The navigated group had a significantly lower malposition rate (1 of 36; 3%; P=.04). The overall rate of cement leakage was also similar in both groups (P=.29). Radiation exposure time was similar in both groups (navigated, 98 s/level; nonnavigated, 125 s/level; P=.10). Navigated kyphoplasty procedures did not differ significantly from nonnavigated procedures except in terms of needle malposition rate, where navigation may have decreased the need for needle repositioning.

  3. Grain boundary segregation in boron added interstitial free steels studied by 3-dimensional atom probe

    SciTech Connect

    Seto, K.; Larson, D.J.; Warren, P.J.; Smith, G.D.W.

    1999-04-09

    The development of deep-drawable sheet steels is of particular significance for the automotive industry. Titanium and/or niobium added extra-low carbon interstitial free (IF) steels are key materials. The virtually complete removal of carbon and nitrogen should lead to superior forming properties. However, the lack of solute carbon at grain boundaries significantly decreases the bonding force at the interfaces, which often causes intergranular brittle fracture when deeply drawn steel sheets are subjected to impact deformation at low temperature. This phenomenon is called secondary working embrittlement (SWE), and is a major problem when solute atoms such as phosphorus, manganese or silicon are added to increase the tensile strength of the steels. Small amounts of boron, which does not affect the formability of the steels significantly, are usually added as a remedial measure in such cases. The 3-dimensional atom probe (3DAP) combined with field ion microscopy (FIM) has the ability to produce 3-dimensional images from regions approximately 20nm*20nm*100nm in size, and identify each atomic species and the relative location of each atom with nearly lattice resolution. In this study, a combination of these methods was applied to produce FIM tips of IF steel containing grain boundaries. The authors report here the first observations of the segregation of boron in IF steels using 3DAP.

  4. Automated 3-Dimensional Brain Atlas Fitting to Microelectrode Recordings from Deep Brain Stimulation Surgeries

    PubMed Central

    Luján, J. Luis; Noecker, Angela M.; Butson, Christopher R.; Cooper, Scott E.; Walter, Benjamin L.; Vitek, Jerrold L.; McIntyre, Cameron C.

    2009-01-01

    Objective Deep brain stimulation (DBS) surgeries commonly rely on brain atlases and microelectrode recordings (MER) to help identify the target location for electrode implantation. We present an automated method for optimally fitting a 3-dimensional brain atlas to intraoperative MER and predicting a target DBS electrode location in stereotactic coordinates for the patient. Methods We retrospectively fit a 3-dimensional brain atlas to MER points from 10 DBS surgeries targeting the subthalamic nucleus (STN). We used a constrained optimization algorithm to maximize the MER points correctly fitted (i.e., contained) within the appropriate atlas nuclei. We compared our optimization approach to conventional anterior commissure-posterior commissure (AC/PC) scaling, and to manual fits performed by four experts. A theoretical DBS electrode target location in the dorsal STN was customized to each patient as part of the fitting process and compared to the location of the clinically defined therapeutic stimulation contact. Results The human expert and computer optimization fits achieved significantly better fits than the AC/PC scaling (80, 81, and 41% of correctly fitted MER, respectively). However, the optimization fits were performed in less time than the expert fits and converged to a single solution for each patient, eliminating interexpert variance. Conclusions and Significance DBS therapeutic outcomes are directly related to electrode implantation accuracy. Our automated fitting techniques may aid in the surgical decision-making process by optimally integrating brain atlas and intraoperative neurophysiological data to provide a visual guide for target identification. PMID:19556832

  5. Particle trajectory computation on a 3-dimensional engine inlet. Final Report Ph.D. Thesis

    NASA Technical Reports Server (NTRS)

    Kim, J. J.

    1986-01-01

    A 3-dimensional particle trajectory computer code was developed to compute the distribution of water droplet impingement efficiency on a 3-dimensional engine inlet. The computed results provide the essential droplet impingement data required for the engine inlet anti-icing system design and analysis. The droplet trajectories are obtained by solving the trajectory equation using the fourth order Runge-Kutta and Adams predictor-corrector schemes. A compressible 3-D full potential flow code is employed to obtain a cylindrical grid definition of the flowfield on and about the engine inlet. The inlet surface is defined mathematically through a system of bi-cubic parametric patches in order to compute the droplet impingement points accurately. Analysis results of the 3-D trajectory code obtained for an axisymmetric droplet impingement problem are in good agreement with NACA experimental data. Experimental data are not yet available for the engine inlet impingement problem analyzed. Applicability of the method to solid particle impingement problems, such as engine sand ingestion, is also demonstrated.

  6. Response to depression treatment in the Aging Brain Care Medical Home model

    PubMed Central

    LaMantia, Michael A; Perkins, Anthony J; Gao, Sujuan; Austrom, Mary G; Alder, Cathy A; French, Dustin D; Litzelman, Debra K; Cottingham, Ann H; Boustani, Malaz A

    2016-01-01

    Objective To evaluate the effect of the Aging Brain Care (ABC) Medical Home program’s depression module on patients’ depression severity measurement over time. Design Retrospective chart review. Setting Public hospital system. Participants Patients enrolled in the ABC Medical Home program between October 1, 2012 and March 31, 2014. Methods The response of 773 enrolled patients who had multiple patient health questionnaire-9 (PHQ-9) scores recorded in the ABC Medical Home program’s depression care protocol was evaluated. Repeatedly measured PHQ-9 change scores were the dependent variables in the mixed effects models, and demographic and comorbid medical conditions were tested as potential independent variables while including random effects for time and intercept. Results Among those patients with baseline PHQ-9 scores >10, there was a significant decrease in PHQ-9 scores over time (P<0.001); however, the effect differed by gender (P=0.015). On average, women’s scores (4.5 point drop at 1 month) improved faster than men’s scores (1 point drop at 1 month). Moreover, both men and women had a predicted drop of 7 points (>50% decline from baseline) on the PHQ-9 at 6 months. Conclusion These analyses demonstrate evidence for the sustained effectiveness of the ABC Medical Home program at inducing depression remission outcomes while employing clinical staff who required less formal training than earlier clinical trials. PMID:27826188

  7. Complementarity of Clinician Judgment and Evidence Based Models in Medical Decision Making: Antecedents, Prospects, and Challenges

    PubMed Central

    Asante Antwi, Henry

    2016-01-01

    Early accounts of the development of modern medicine suggest that the clinical skills, scientific competence, and doctors' judgment were the main impetus for treatment decision, diagnosis, prognosis, therapy assessment, and medical progress. Yet, clinician judgment has its own critics and is sometimes harshly described as notoriously fallacious and an irrational and unfathomable black box with little transparency. With the rise of contemporary medical research, the reputation of clinician judgment has undergone significant reformation in the last century as its fallacious aspects are increasingly emphasized relative to the evidence based options. Within the last decade, however, medical forecasting literature has seen tremendous change and new understanding is emerging on best ways of sharing medical information to complement the evidence based medicine practices. This review revisits and highlights the core debate on clinical judgments and its interrelations with evidence based medicine. It outlines the key empirical results of clinician judgments relative to evidence based models and identifies its key strengths and prospects, the key limitations and conditions for the effective use of clinician judgment, and the extent to which it can be optimized and professionalized for medical use. PMID:27642588

  8. Complementarity of Clinician Judgment and Evidence Based Models in Medical Decision Making: Antecedents, Prospects, and Challenges.

    PubMed

    Lulin, Zhou; Yiranbon, Ethel; Asante Antwi, Henry

    2016-01-01

    Early accounts of the development of modern medicine suggest that the clinical skills, scientific competence, and doctors' judgment were the main impetus for treatment decision, diagnosis, prognosis, therapy assessment, and medical progress. Yet, clinician judgment has its own critics and is sometimes harshly described as notoriously fallacious and an irrational and unfathomable black box with little transparency. With the rise of contemporary medical research, the reputation of clinician judgment has undergone significant reformation in the last century as its fallacious aspects are increasingly emphasized relative to the evidence based options. Within the last decade, however, medical forecasting literature has seen tremendous change and new understanding is emerging on best ways of sharing medical information to complement the evidence based medicine practices. This review revisits and highlights the core debate on clinical judgments and its interrelations with evidence based medicine. It outlines the key empirical results of clinician judgments relative to evidence based models and identifies its key strengths and prospects, the key limitations and conditions for the effective use of clinician judgment, and the extent to which it can be optimized and professionalized for medical use.

  9. Data-driven interactive 3D medical image segmentation based on structured patch model.

    PubMed

    Park, Sang Hyun; Yun, Il Dong; Lee, Sang Uk

    2013-01-01

    In this paper, we present a novel three dimensional interactive medical image segmentation method based on high level knowledge of training set. Since the interactive system should provide intermediate results to an user quickly, insufficient low level models are used for most of previous methods. To exploit the high level knowledge within a short time, we construct a structured patch model that consists of multiple corresponding patch sets. The structured patch model includes the spatial relationships between neighboring patch sets and the prior knowledge of the corresponding patch set on each local region. The spatial relationships accelerate the search of corresponding patch in test time, while the prior knowledge improves the segmentation accuracy. The proposed framework provides not only fast editing tool, but the incremental learning system through adding the segmentation result to the training set. Experiments demonstrate that the proposed method is useful for fast and accurate segmentation of target objects from the multiple medical images.

  10. A novel level set model with automated initialization and controlling parameters for medical image segmentation.

    PubMed

    Liu, Qingyi; Jiang, Mingyan; Bai, Peirui; Yang, Guang

    2016-03-01

    In this paper, a level set model without the need of generating initial contour and setting controlling parameters manually is proposed for medical image segmentation. The contribution of this paper is mainly manifested in three points. First, we propose a novel adaptive mean shift clustering method based on global image information to guide the evolution of level set. By simple threshold processing, the results of mean shift clustering can automatically and speedily generate an initial contour of level set evolution. Second, we devise several new functions to estimate the controlling parameters of the level set evolution based on the clustering results and image characteristics. Third, the reaction diffusion method is adopted to supersede the distance regularization term of RSF-level set model, which can improve the accuracy and speed of segmentation effectively with less manual intervention. Experimental results demonstrate the performance and efficiency of the proposed model for medical image segmentation.

  11. Prosthesis-guided implant restoration of an auricular defect using computed tomography and 3-dimensional photographic imaging technologies: a clinical report.

    PubMed

    Wang, Shuming; Leng, Xu; Zheng, Yaqi; Zhang, Dapeng; Wu, Guofeng

    2015-02-01

    The concept of prosthesis-guided implantation has been widely accepted for intraoral implant placement, although clinicians do not fully appreciate its use for facial defect restoration. In this clinical report, multiple digital technologies were used to restore a facial defect with prosthesis-guided implantation. A simulation surgery was performed to remove the residual auricular tissue and to ensure the correct position of the mirrored contralateral ear model. The combined application of computed tomography and 3-dimensional photography preserved the position of the mirrored model and facilitated the definitive implant-retained auricular prosthesis.

  12. Explanatory Models and Medication Adherence in Patients with Depression in South India

    PubMed Central

    Siddappa, Adarsh Lakkur; Raman, Rajesh; Hattur, Basavana Gowdappa

    2017-01-01

    Introduction Conceptualization of depression may have bearing on treatment seeking. It may affect adherence behaviour of the patients. Aim To find out the explanatory models and their relationship with socio-demographic variables and medication adherence in patients with depression. Materials and Methods Fifty-eight consecutive patients with depression in remission were recruited as per selection criteria. Socio-demographic details were collected. Patients were assessed using Mental Distress Explanatory Model Questionnaire (MDEMQ) and Morisky Medication Adherence Scale (MMAS). Results Significant scores were observed in all dimensions of explanatory models. In the Mann-Whitney U test the patient’s marital status (MU=113.500, p=0.05, sig≤0.05, 2-tailed), and family history of mental illness (MU=165.5, p=0.03, sig≤0.05, 2-tailed) had a statistically significant group difference in the score of MDEMQ. In linear regression analysis, four predictors (MDEMQ subscales Stress, Western physiology, Non-Western physiology and Supernatural) had significantly predicted the value of MMAS (R2=0.937, f=153.558, p<0.001). Conclusion Findings of this study suggested that patients with depression harbor multidimensional explanatory model. The levels of explanatory models are inversely associated with levels of medication adherence. PMID:28274025

  13. Evaluation of the Effectiveness of 3D Vascular Stereoscopic Models in Anatomy Instruction for First Year Medical Students

    ERIC Educational Resources Information Center

    Cui, Dongmei; Wilson, Timothy D.; Rockhold, Robin W.; Lehman, Michael N.; Lynch, James C.

    2017-01-01

    The head and neck region is one of the most complex areas featured in the medical gross anatomy curriculum. The effectiveness of using three-dimensional (3D) models to teach anatomy is a topic of much discussion in medical education research. However, the use of 3D stereoscopic models of the head and neck circulation in anatomy education has not…

  14. A nonhuman primate model of the hematopoietic acute radiation syndrome plus medical management.

    PubMed

    Farese, Ann M; Cohen, Melanie V; Katz, Barry P; Smith, Cassandra P; Jackson, William; Cohen, Daniel M; MacVittie, Thomas J

    2012-10-01

    The development of medical countermeasures against the hematopoietic subsyndrome of the acute radiation syndrome requires well characterized and validated animal models. The model must define the radiation dose- and time-dependent relationships for mortality and major signs of morbidity to include other organ damage that may contribute to morbidity and mortality. Herein, the authors define these parameters for a nonhuman primate exposed to total body radiation and administered medical management. A blinded, randomized study (n = 48 rhesus macaques) determined the lethal dose-response relationship using bilateral 6 MV linear accelerator photon radiation to doses in the range of 7.20 to 8.90 Gy at 0.80 Gy min(-1). Following irradiation, animals were monitored for complete bloodcounts, body weight, temperature, diarrhea, and hydration status for 60 d. Animals were administered medical management consisting of intravenous fluids, prophylactic antibiotics, blood transfusions, anti-diarrheals, analgesics, and nutrition. The primary endpoint was survival at 60 d post-irradiation; secondary endpoints included hematopoietic-related parameters, number of transfusions, incidence of documented infection, febrile neutropenia, severity of diarrhea, mean survival time of decedents, and tissue histology. The study defined an LD30/60 of 7.06 Gy, LD50/60 of 7.52 Gy, and an LD70/60 of 7.99 Gy with a relatively steep slope of 1.13 probits per linear dose. This study establishes a rhesus macaque model of the hematopoietic acute radiation syndrome and shows the marked effect of medical management on increased survival and overall mean survival time for decedents. Furthermore, following a nuclear terrorist event, medical management may be the only treatment administered at its optimal schedule.

  15. A Nonhuman Primate Model of the Hematopoietic Acute Radiation Syndrome Plus Medical Management

    PubMed Central

    Farese, A.M.; Cohen, M.V.; Katz, B. P.; Smith, C. P.; Jackson, W.; Cohen, D. M.; MacVittie, T.J.

    2012-01-01

    The development of medical countermeasures against the hematopoietic sub-syndrome of the acute radiation syndrome requires well characterized and validated animal models. The model must define the radiation dose- and time-dependent relationships for mortality and major signs of morbidity to include other organ damage that may contribute to the morbidity and mortality. Herein, we define these parameters for the nonhuman primate exposed to total-body radiation and administered medical management. A blinded, randomized study (n=48 rhesus macaques) determined the lethal dose response relationship using bilateral, 6 MV linear accelerator photon radiation to doses in the range of 7.20 to 8.90Gy at 0.80Gy minute−1. Following irradiation animals were monitored for complete blood counts, body weight, temperature, diarrhea, and hydration status for 60 days. Animals were administered medical management consisting of intravenous fluids, prophylactic antibiotics, blood transfusions, anti-diarrheals, analgesics and nutrition. The primary endpoint was survival at 60 days post irradiation; secondary endpoints included hematopoietic-related parameters, number of transfusions, incidence of documented infection, febrile neutropenia, severity of diarrhea, mean survival time of decedents and tissue histology. The study defined an LD30/60 of 7.06Gy, LD50/60 of 7.52Gy, and an LD70/60 of 7.99Gy with a relatively steep slope of 1.13 probits per linear dose. This study establishes a rhesus macaque model of the hematopoietic acute radiation syndrome and shows the marked effect of medical management on increased survival and overall mean survival time for decedents. Furthermore, following a nuclear terrorist event, medical management may be the only treatment administered at its optimal schedule. PMID:22929469

  16. 3-Dimensional Computational Fluid Dynamics Modeling of Solid Oxide Fuel Cell Using Different Fuels

    DTIC Science & Technology

    2011-01-01

    Material Operating Temperature (oC) Efficiency (%) PEMFC H2, Methanol, Formic Acid Hydrated Organic Polymer < 90 40-50 AFC Pure H2 Aqueous...major types of fuel cells in practice are listed below: Polymer Electrolyte Membrane Fuel Cell (PEMFC) Alkaline Fuel cell (AFC) Phosphoric Acid ...potassium hydroxide 60 – 250 50 PAFC Pure H2 Phosphoric Acid 180 - 210 40 MCFC H2, CH4, CH3OH Molten Alkali Carbonate 600 – 700 45-55

  17. Image analysis and superimposition of 3-dimensional cone-beam computed tomography models

    PubMed Central

    Cevidanes, Lucia H. S.; Styner, Martin A.; Proffit, William R.

    2013-01-01

    Three-dimensional (3D) imaging techniques can provide valuable information to clinicians and researchers. But as we move from traditional 2-dimensional (2D) cephalometric analysis to new 3D techniques, it is often necessary to compare 2D with 3D data. Cone-beam computed tomography (CBCT) provides simulation tools that can help bridge the gap between image types. CBCT acquisitions can be made to simulate panoramic, lateral, and posteroanterior cephalometric radioagraphs so that they can be compared with preexisting cephalometric databases. Applications of 3D imaging in orthodontics include initial diagnosis and superimpositions for assessing growth, treatment changes, and stability. Three-dimensional CBCT images show dental root inclination and torque, impacted and supernumerary tooth positions, thickness and morphology of bone at sites of mini-implants for anchorage, and osteotomy sites in surgical planning. Findings such as resorption, hyperplasic growth, displacement, shape anomalies of mandibular condyles, and morphological differences between the right and left sides emphasize the diagnostic value of computed tomography acquisitions. Furthermore, relationships of soft tissues and the airway can be assessed in 3 dimensions. PMID:16679201

  18. Numerical model of electromagnetic scattering off a subterranean 3-dimensional dielectric

    SciTech Connect

    Dease, C.G.; Didwall, E.M.

    1983-08-01

    As part of the effort to develop On-Site Inspection (OSI) techniques for verification of compliance to a Comprehensive Test Ban Treaty (CTBT), a computer code was developed to predict the interaction of an electromagnetic (EM) wave with an underground cavity. Results from the code were used to evaluate the use of surface electromagnetic exploration techniques for detection of underground cavities or rubble-filled regions characteristic of underground nuclear explosions.

  19. A High Performance Pulsatile Pump for Aortic Flow Experiments in 3-Dimensional Models.

    PubMed

    Chaudhury, Rafeed A; Atlasman, Victor; Pathangey, Girish; Pracht, Nicholas; Adrian, Ronald J; Frakes, David H

    2016-06-01

    Aortic pathologies such as coarctation, dissection, and aneurysm represent a particularly emergent class of cardiovascular diseases. Computational simulations of aortic flows are growing increasingly important as tools for gaining understanding of these pathologies, as well as for planning their surgical repair. In vitro experiments are required to validate the simulations against real world data, and the experiments require a pulsatile flow pump system that can provide physiologic flow conditions characteristic of the aorta. We designed a newly capable piston-based pulsatile flow pump system that can generate high volume flow rates (850 mL/s), replicate physiologic waveforms, and pump high viscosity fluids against large impedances. The system is also compatible with a broad range of fluid types, and is operable in magnetic resonance imaging environments. Performance of the system was validated using image processing-based analysis of piston motion as well as particle image velocimetry. The new system represents a more capable pumping solution for aortic flow experiments than other available designs, and can be manufactured at a relatively low cost.

  20. How Can We Link General Medical and Behavioral Health Care? International Models for Practice and Policy.

    PubMed

    Pincus, Harold Alan; Jun, Miraya; Franx, Gerdien; van der Feltz-Cornelis, Christina; Ito, Hiroto; Mossialos, Elias

    2015-08-01

    A range of integration models for providing effective care to individuals with comorbid general medical and behavioral health conditions have been described and tested in varied settings internationally for several subsets of this population. This column examines models in three countries selected to showcase implementation in a variety of health systems: the national health system in England, nationally regulated individual insurance market in the Netherlands, and a mixture of employer-sponsored and government-funded health insurance plans in Japan. The authors describe a set of key practices for and challenges to the successful implementation of these models.

  1. Model of medical supply and astronaut health for long-duration human space flight

    NASA Astrophysics Data System (ADS)

    Assad, Albert; de Weck, Olivier L.

    2015-01-01

    Planning a safe and productive human space exploration mission involves a dual approach addressing both the health of the vehicle and the crew. The goal of this study was to develop a quantitative model of astronaut health during long-duration space flight and a medical supply demand model in support of such missions. The model provides two outputs, Alphah and Mass of Medical Consumables (MMC), for each set of input parameters. Alphah is an estimate of total crew health and is displayed as a percentage. MMC is a measure of medical consumables expended during the mission and is displayed in units of kilograms. We have demonstrated that Alphah is a function of three scaling parameters, the type of mission, duration of mission, and gender mix of the crew. The type of mission and gender of crew are linked to radiation fatality data published by NASA. Mission duration is incorporated into the model with predicted incidence of illness and injury data published on US Navy submarine crews. MMC increases non-linearly with the number of crew, the duration of the mission and the distance of the mission away from Earth. This article describes the relationships between these parameters and discusses implications for future crewed space missions.

  2. A Social Problem-Solving Model of Adherence to HIV Medications.

    PubMed

    Johnson, Mallory O; Elliott, Timothy R; Neilands, Torsten B; Morin, Stephen F; Chesney, Margaret A

    2006-05-01

    HIV medication adherence remains a challenge and limits the degree to which treatment benefit can be maximized. This study tested an explanatory model of HIV medication adherence using a social problem-solving (SPS) framework. Associations of SPS with adherence are hypothesized to be direct and/or indirect via psychological health. HIV+ adults were interviewed using validated measures of SPS, psychological health, and antiretroviral therapy (ART) medication adherence. Structural equation modeling (SEM) techniques were used to test hypothesized relationships and to evaluate overall fit of the model to the data. SEM supported an indirect association (but not direct) of SPS on adherence via psychological health among the 545 HIV+ adults included in the analyses. Overall, the findings resulted in a model of adherence that offered very good fit to the data and correctly classified 97% of the cases as adherent versus nonadherent. Results support the use of SPS as a conceptual framework for understanding adherence to ART. Findings offer rationale and direction for SPS interventions to enhance adherence by improving psychological health. Such approaches, if effective, have the potential to positively impact psychological well being and adherence, thereby maximizing clinical benefit from treatment, which is linked to lower mortality from AIDS.

  3. Reflection of solar wind protons on the Martian bow shock: Investigations by means of 3-dimensional simulations

    NASA Astrophysics Data System (ADS)

    Richer, E.; Chanteur, G. M.; Modolo, R.; Dubinin, E.

    2012-09-01

    The reflection of solar wind protons on the Martian bow shock (BS) is investigated by means of three-dimensional simulation models. A two steps approach is adopted to allow a detailed analysis of the reflected population. Firstly, the 3-dimensional hybrid model of Modolo et al. (2005) is used to compute a stationary state of the interaction of the solar wind (SW) with Mars. Secondly, the motion of test particles is followed in the electromagnetic field computed by the hybrid simulation meanwhile detection criteria defined to identify reflected protons are applied. This study demonstrates some effects of the large curvature of a planetary BS on the structure of the foreshock. Reflected protons encounter the BS in a region encompassing parts of the quasi-perpendicular and quasi-parallel shocks, and exit the shock mainly from the quasi-parallel region. The energy spectrum of all reflected protons extends from 0 to almost 15keV. A virtual omnidirectional detector (VOD) is used to compute the local omnidirectional flux of reflected protons at various locations upstream of the BS. Spatial variations of this omnidirectional flux indicate the location and spatial extent of the proton foreshock and demonstrate its shift, increasing with the distance downstream, in the direction opposite to the motional electric field of the SW. Local energy spectra computed from the VOD observations demonstrate the existence of an energy gradient along the direction of the convection electric field.

  4. Risk assessment models for venous thromboembolism in acutely ill medical patients. A systematic review.

    PubMed

    Stuck, Anna K; Spirk, David; Schaudt, Jil; Kucher, Nils

    2017-04-03

    Although the use of thromboprophylaxis is recommended for acutely ill medical patients at increased risk of venous thromboembolism (VTE), it remains unclear which risk assessment model (RAM) should be routinely used to identify at-risk patients requiring thromboprophylaxis. We therefore aimed to describe existing RAMs, and to compare these tools in terms of validity and applicability for clinical decision-making. We performed a comprehensive systematic search in MEDLINE from the date of initiation until May 2016 for studies in acutely ill medical patients investigating validity of RAMs for VTE. Two reviewers independently screened the title, abstract, and full text, and evaluated the characteristics of studies, and the composition, evidence of validation, and results on validity of the RAMs. We included 11 studies assessing eight RAMs: 4-Element RAM, Caprini RAM, a full logistic model, Geneva risk score, IMPROVE-RAM, Kucher Model, a "Multivariable Model", and Padua Prediction Score. The 4-Element RAM, IMPROVE-RAM, Multivariable Model, and full logistic model had derivation by identifying factors with predictive power. The other four RAMs were empirically generated based on consensus guidelines, published data, and clinical expertise. The Kucher Model, the Padua Prediction Score, the Geneva Risk Score and the IMPROVE-RAM underwent multicenter external validation. The Kucher Model, the Padua Prediction Score, and the Geneva Risk Score improved rates of thromboprophylaxis or clinical outcomes. In conclusion, existing RAMs to evaluate the need of thromboprophylaxis in acutely ill medical patients are difficult to compare and none fulfills the criteria of an ideal RAM. Nevertheless, the adequacy of thromboprophylaxis may be improved by implementing one of the validated RAMs.

  5. Candidate gene analyses of 3-dimensional dentoalveolar phenotypes in subjects with malocclusion

    PubMed Central

    Weaver, Cole A.; Miller, Steven F.; da Fontoura, Clarissa S. G.; Wehby, George L.; Amendt, Brad A.; Holton, Nathan E.; Allareddy, Veeratrishul; Southard, Thomas E.; Moreno Uribe, Lina M.

    2017-01-01

    Introduction Genetic studies of malocclusion etiology have identified 4 deleterious mutations in genes, DUSP6, ARHGAP21, FGF23, and ADAMTS1 in familial Class III cases. Although these variants may have large impacts on Class III phenotypic expression, their low frequency (<1%) makes them unlikely to explain most malocclusions. Thus, much of the genetic variation underlying the dentofacial phenotypic variation associated with malocclusion remains unknown. In this study, we evaluated associations between common genetic variations in craniofacial candidate genes and 3-dimensional dentoalveolar phenotypes in patients with malocclusion. Methods Pretreatment dental casts or cone-beam computed tomographic images from 300 healthy subjects were digitized with 48 landmarks. The 3-dimensional coordinate data were submitted to a geometric morphometric approach along with principal component analysis to generate continuous phenotypes including symmetric and asymmetric components of dentoalveolar shape variation, fluctuating asymmetry, and size. The subjects were genotyped for 222 single-nucleotide polymorphisms in 82 genes/loci, and phenotpye-genotype associations were tested via multivariate linear regression. Results Principal component analysis of symmetric variation identified 4 components that explained 68% of the total variance and depicted anteroposterior, vertical, and transverse dentoalveolar discrepancies. Suggestive associations (P < 0.05) were identified with PITX2, SNAI3, 11q22.2-q22.3, 4p16.1, ISL1, and FGF8. Principal component analysis for asymmetric variations identified 4 components that explained 51% of the total variations and captured left-to-right discrepancies resulting in midline deviations, unilateral crossbites, and ectopic eruptions. Suggestive associations were found with TBX1 AJUBA, SNAI3 SATB2, TP63, and 1p22.1. Fluctuating asymmetry was associated with BMP3 and LATS1. Associations for SATB2 and BMP3 with asymmetric variations remained significant

  6. A flexible model for the mean and variance functions, with application to medical cost data.

    PubMed

    Chen, Jinsong; Liu, Lei; Zhang, Daowen; Shih, Ya-Chen T

    2013-10-30

    Medical cost data are often skewed to the right and heteroscedastic, having a nonlinear relation with covariates. To tackle these issues, we consider an extension to generalized linear models by assuming nonlinear associations of covariates in the mean function and allowing the variance to be an unknown but smooth function of the mean. We make no further assumption on the distributional form. The unknown functions are described by penalized splines, and the estimation is carried out using nonparametric quasi-likelihood. Simulation studies show the flexibility and advantages of our approach. We apply the model to the annual medical costs of heart failure patients in the clinical data repository at the University of Virginia Hospital System.

  7. Patient-specific modelling of pulmonary airflow using GPU cluster for the application in medical practice.

    PubMed

    Miki, T; Wang, X; Aoki, T; Imai, Y; Ishikawa, T; Takase, K; Yamaguchi, T

    2012-01-01

    In this paper, we propose a novel patient-specific method of modelling pulmonary airflow using graphics processing unit (GPU) computation that can be applied in medical practice. To overcome the barriers imposed by computation speed, installation price and footprint to the application of computational fluid dynamics, we focused on GPU computation and the lattice Boltzmann method (LBM). The GPU computation and LBM are compatible due to the characteristics of the GPU. As the optimisation of data access is essential for the performance of the GPU computation, we developed an adaptive meshing method, in which an airway model is covered by isotropic subdomains consisting of a uniform Cartesian mesh. We found that 4(3) size subdomains gave the best performance. The code was also tested on a small GPU cluster to confirm its performance and applicability, as the price and footprint are reasonable for medical applications.

  8. Increasing the educational value of medical care evaluation: a model program.

    PubMed

    Bashook, P G; Maxwell, J A; Sandlow, L J

    1982-09-01

    A model medical care evaluation (MCE) program, designed to increase the educational value of MCE activities, was implemented in three clinical departments at the Michael Reese Hospital and Medical Center. The program was evaluated by means of quantitative and qualitative observational techniques, questionnaires, and interviews and by comparing committees for which the implementation was highly successful with those for which it was less successful. The results confirmed the educational value of the following features of the model program: (a) a focus on the process of care rather than standards of care, (b) prior review of records and their presentation as case problems, (c) educational emphasis by the committee chairperson, and (d) attendance by at least four physicians. Implications for other types of hospital quality assurance or educational activities are discussed.

  9. Model-based formalization of medical knowledge for context-aware assistance in laparoscopic surgery

    NASA Astrophysics Data System (ADS)

    Katić, Darko; Wekerle, Anna-Laura; Gärtner, Fabian; Kenngott, Hannes G.; Müller-Stich, Beat P.; Dillmann, Rüdiger; Speidel, Stefanie

    2014-03-01

    The increase of technological complexity in surgery has created a need for novel man-machine interaction techniques. Specifically, context-aware systems which automatically adapt themselves to the current circumstances in the OR have great potential in this regard. To create such systems, models of surgical procedures are vital, as they allow analyzing the current situation and assessing the context. For this purpose, we have developed a Surgical Process Model based on Description Logics. It incorporates general medical background knowledge as well as intraoperatively observed situational knowledge. The representation consists of three parts: the Background Knowledge Model, the Preoperative Process Model and the Integrated Intraoperative Process Model. All models depend on each other and create a concise view on the surgery. As a proof of concept, we applied the system to a specific intervention, the laparoscopic distal pancreatectomy.

  10. Accomplishments in genome-scale in silico modeling for industrial and medical biotechnology

    PubMed Central

    Milne, Caroline B.; Kim, Pan-Jun; Eddy, James A.; Price, Nathan D.

    2011-01-01

    Driven by advancements in high-throughput biological technologies and the growing number of sequenced genomes, the construction of in silico models at the genome scale has provided powerful tools to investigate a vast array of biological systems and applications. Here, we review comprehensively the uses of such models in industrial and medical biotechnology, including biofuel generation, food production, and drug development. While the use of in silico models is still in its early stages for delivering to industry, significant initial successes have been achieved. For the cases presented here, genome-scale models predict engineering strategies to enhance properties of interest in an organism or to inhibit harmful mechanisms of pathogens or in disease. Going forward, genome-scale in silico models promise to extend their application and analysis scope to become a transformative tool in biotechnology. As such, genome-scale models can provide a basis for rational genome-scale engineering and synthetic biology. PMID:19946878

  11. Postdependent state in rats as a model for medication development in alcoholism.

    PubMed

    Meinhardt, Marcus W; Sommer, Wolfgang H

    2015-01-01

    Rational development of novel therapeutic strategies for alcoholism requires understanding of its underlying neurobiology and pathophysiology. Obtaining this knowledge largely relies on animal studies. Thus, choosing the appropriate animal model is one of the most critical steps in pre-clinical medication development. Among the range of animal models that have been used to investigate excessive alcohol consumption in rodents, the postdependent model stands out. It was specifically developed to test the role of negative affect as a key driving force in a perpetuating addiction cycle for alcoholism. Here, we will describe our approach to make rats dependent via chronic intermittent exposure to alcohol, discuss the validity of this model, and compare it with other commonly used animal models of alcoholism. We will summarize evidence that postdependent rats fulfill several criteria of a 'Diagnostic and Statistical Manual of Mental Disorders IV/V-like' diagnostic system. Importantly, these animals show long-lasting excessive consumption of and increased motivation for alcohol, and evidence for loss of control over alcohol intake. Our conclusion that postdependent rats are an excellent model for medication development for alcoholism is underscored by a summary of more than two dozen pharmacological tests aimed at reversing these abnormal alcohol responses. We will end with open questions on the use of this model. In the tradition of the Sanchis-Segura and Spanagel review, we provide comic strips that illustrate the postdependent procedure and relevant phenotypes in this review.

  12. Creating a Common Data Model for Comparative Effectiveness with the Observational Medical Outcomes Partnership

    PubMed Central

    Resnic, F.S.; Robbins, S.L.; Denton, J.; Nookala, L.; Meeker, D.; Ohno-Machado, L.; Matheny, M.E.

    2015-01-01

    Summary Background Adoption of a common data model across health systems is a key infrastructure requirement to allow large scale distributed comparative effectiveness analyses. There are a growing number of common data models (CDM), such as Mini-Sentinel, and the Observational Medical Outcomes Partnership (OMOP) CDMs. Objectives In this case study, we describe the challenges and opportunities of a study specific use of the OMOP CDM by two health systems and describe three comparative effectiveness use cases developed from the CDM. Methods The project transformed two health system databases (using crosswalks provided) into the OMOP CDM. Cohorts were developed from the transformed CDMs for three comparative effectiveness use case examples. Administrative/billing, demographic, order history, medication, and laboratory were included in the CDM transformation and cohort development rules. Results Record counts per person month are presented for the eligible cohorts, highlighting differences between the civilian and federal datasets, e.g. the federal data set had more outpatient visits per person month (6.44 vs. 2.05 per person month). The count of medications per person month reflected the fact that one system’s medications were extracted from orders while the other system had pharmacy fills and medication administration records. The federal system also had a higher prevalence of the conditions in all three use cases. Both systems required manual coding of some types of data to convert to the CDM. Conclusions The data transformation to the CDM was time consuming and resources required were substantial, beyond requirements for collecting native source data. The need to manually code subsets of data limited the conversion. However, once the native data was converted to the CDM, both systems were then able to use the same queries to identify cohorts. Thus, the CDM minimized the effort to develop cohorts and analyze the results across the sites. PMID:26448797

  13. [Biochemical genetics in St. Petersburg university: from the gene-enzyme model to medical biotechnology].

    PubMed

    Padkina, M V; Sambuk, E V

    2007-10-01

    The history of biochemical genetic research in St. Petersburg (Leningrad) State University is described. The main research projects and achievements of the Laboratory of Biochemical Genetics in studies on the mechanisms of gene expression control, coordinated regulation of metabolism, and the relationship of the physiological state of yeast cells with the maintenance of genetic stability are discussed. The fundamental importance of studies on the acid phosphatase model for the formation and development of medical biotechnology in St. Petersburg University is demonstrated.

  14. Hospital adoption of medical technology: an empirical test of alternative models.

    PubMed Central

    Teplensky, J. D.; Pauly, M. V.; Kimberly, J. R.; Hillman, A. L.; Schwartz, J. S.

    1995-01-01

    OBJECTIVE. This study examines hospital motivations to acquire new medical technology, an issue of considerable policy relevance: in this case, whether, when, and why hospitals acquire a new capital-intensive medical technology, magnetic resonance imaging equipment (MRI). STUDY DESIGN. We review three common explanations for medical technology adoption: profit maximization, technological preeminence, and clinical excellence, and incorporate them into a composite model, controlling for regulatory differences, market structures, and organizational characteristics. All four models are then tested using Cox regressions. DATA SOURCES. The study is based on an initial sample of 637 hospitals in the continental United States that owned or leased an MRI unit as of 31 December 1988, plus nonadopters. Due to missing data the final sample consisted of 507 hospitals. The data, drawn from two telephone surveys, are supplemented by the AHA Survey, census data, and industry and academic sources. PRINCIPAL FINDING. Statistically, the three individual models account for roughly comparable amounts of variance in past adoption behavior. On the basis of explanatory power and parsimony, however, the technology model is "best." Although the composite model is statistically better than any of the individual models, it does not add much more explanatory power adjusting for the number of variables added. CONCLUSIONS. The composite model identified the importance a hospital attached to being a technological leader, its clinical requirements, and the change in revenues it associated with the adoption of MRI as the major determinants of adoption behavior. We conclude that a hospital's adoption behavior is strongly linked to its strategic orientation. PMID:7649751

  15. Use of three-dimensional medical modeling methods for precise planning of orthognathic surgery.

    PubMed

    Mavili, Mehmet Emin; Canter, Halil Ibrahim; Saglam-Aydinatay, Banu; Kamaci, Soner; Kocadereli, Ilken

    2007-07-01

    Stereolithographic (medical rapid prototyping) biomodeling allows three-dimensional computed tomography to be used to generate solid plastic replicas of anatomic structures. Reports in the literature suggest that such biomodels may have a use in maxillofacial surgery, craniofacial surgery, orthopedics, neurosurgery, otology, vascular, and nasal research. A prospective trial to assess the usefulness of biomodeling in orthognathic surgery has been performed. In 12 patients with mandibular prognathism and/or maxillary retrusion, in addition to routine preoperative cephalometric analysis, preoperative high-resolution (cutting slice thickness of 1 mm) three-dimensional computed tomography scan of the patients was obtained. Raw data obtained from computed tomography scanning was processed with a Mimics 9.22 Software (Materialise's Interactive Medical Image Control System, Belgium). Fabrication of three-dimensional medical models was obtained through a process called powder depositional modeling by use of a Spectrum Z 510 3D Color Printer (Z Corporation, Burlington, MA). Alveolar arches of the maxilla and mandibula of the models were replaced with orthodontic dental cast models. Temporomandibular joints of the models were fixed with Kirschner wire. Maxillary and mandibular bony segments were mobilized according to preoperative orthodontic planning done by analysis of cephalometric plain radiographs. The relation between proximal and distal mandibular segments after bilateral sagittal split osteotomies were evaluated on models preoperatively. The same surgeon had a role in both model cutting preoperatively and as an instructor preoperatively. The same bony relation was observed both in preoperative modelsand in the perioperative surgical field in all patients. Condylar malpositioning was not observed in any of the patients. Studying preoperative planned movements of osteotomized bone segments and observing relations of osteotomized segments of mandibula and maxilla in

  16. 3-Dimensional Analysis of Dynamic Behavior of Bearing of Nielsen Bridge

    NASA Astrophysics Data System (ADS)

    Tanimura, Shinji; Heya, Hiroyuki; Umeda, Tsutomu; Mimura, Koji; Yoshikawa, Osamu

    In 1995, the great Hanshin-Awaji earthquake caused a large amount of destruction and structural failures. One example, whose mechanism is not fully clear, is the fracture of a bridge bearing of a Nielsen type bridge that does not occur under the ordinary static or dynamic loading conditions. The fracture probably resulted from very high stress due to an unexpected dynamic mechanism. In this paper, the 3-dimensional dynamic behavior of a Nielsen type bridge was analyzed by assuming a collision between the upper and the lower parts of the bearing, which might have occurred in the great Hanshin-Awaji earthquake. The numerical results show that an impact due to a relative velocity of 5˜6m/s between the upper and the lower parts of the bearing generates a stress sufficient to cause a fracture in the upper bearing. The observed features of the actual fracture surface was also simulated fairly closely.

  17. Investigation of 3-dimensional structural morphology for enhancing light trapping with control of surface haze

    NASA Astrophysics Data System (ADS)

    Park, Hyeongsik; Shin, Myunghun; Kim, Hyeongseok; Kim, Sunbo; Le, Anh Huy Tuan; Kang, Junyoung; Kim, Yongjun; Pham, Duy Phong; Jung, Junhee; Yi, Junsin

    2017-04-01

    A comparative study of 3-dimensional textured glass morphologies with variable haze value and chemical texturing of the glass substrates was conducted to enhance light trapping in silicon (Si) thin film solar cells (TFSCs). The light trapping characteristics of periodic honeycomb structures show enhanced transmittance and haze ratio in numerical and experimental approaches. The periodic honeycomb structure of notched textures is better than a random or periodic carved structure. It has high transmittance of ∼95%, and haze ratio of ∼52.8%, and the haze property of the angular distribution function of transmittance shows wide scattering angles in the long wavelength region because of the wide spacing and aspect ratio of the texture. The numerical and experimental approaches of the 3-D texture structures in this work will be useful in developing high-performance Si TFSCs with light trapping.

  18. The program FANS-3D (finite analytic numerical simulation 3-dimensional) and its applications

    NASA Technical Reports Server (NTRS)

    Bravo, Ramiro H.; Chen, Ching-Jen

    1992-01-01

    In this study, the program named FANS-3D (Finite Analytic Numerical Simulation-3 Dimensional) is presented. FANS-3D was designed to solve problems of incompressible fluid flow and combined modes of heat transfer. It solves problems with conduction and convection modes of heat transfer in laminar flow, with provisions for radiation and turbulent flows. It can solve singular or conjugate modes of heat transfer. It also solves problems in natural convection, using the Boussinesq approximation. FANS-3D was designed to solve heat transfer problems inside one, two and three dimensional geometries that can be represented by orthogonal planes in a Cartesian coordinate system. It can solve internal and external flows using appropriate boundary conditions such as symmetric, periodic and user specified.

  19. Experimental determination of thermal profiles during laser spike annealing with quantitative comparison to 3-dimensional simulations

    SciTech Connect

    Iyengar, Krishna; Jung, Byungki; Willemann, Michael; Thompson, Michael O.; Clancy, Paulette

    2012-05-21

    Thin film platinum resistors were used to directly measure temperature profiles during laser spike annealing (LSA) with high spatial and temporal resolution. Observed resistance changes were calibrated to absolute temperatures using the melting points of the substrate silicon and thin gold films. Both the time-dependent temperature experienced by the sample during passage of the focussed laser beam and profiles across the spatially dependent laser intensity were obtained with sub-millisecond time resolution and 50 {mu}m spatial resolution. Full 3-dimensional simulations incorporating both optical and thermal variations of material parameters were compared with these results. Accounting properly for the specific material parameters, good agreement between experiments and simulations was achieved. Future temperature measurements in complex environments will permit critical evaluation of LSA simulations methodologies.

  20. Carbohydrate Cluster Microarrays Fabricated on 3-Dimensional Dendrimeric Platforms for Functional Glycomics Exploration

    PubMed Central

    Zhou, Xichun; Turchi, Craig; Wang, Denong

    2009-01-01

    We reported here a novel, ready-to-use bioarray platform and methodology for construction of sensitive carbohydrate cluster microarrays. This technology utilizes a 3-dimensional (3-D) poly(amidoamine) starburst dendrimer monolayer assembled on glass surface, which is functionalized with terminal aminooxy and hydrazide groups for site-specific coupling of carbohydrates. A wide range of saccharides, including monosaccharides, oligosaccharides and polysaccharides of diverse structures, are applicable for the 3-D bioarray platform without prior chemical derivatization. The process of carbohydrate coupling is effectively accelerated by microwave radiation energy. The carbohydrate concentration required for microarray fabrication is substantially reduced using this technology. Importantly, this bioarray platform presents sugar chains in defined orientation and cluster configurations. It is, thus, uniquely useful for exploration of the structural and conformational diversities of glyco-epitope and their functional properties. PMID:19791771

  1. Surface compositional heterogeneity of (4) Vesta from Dawn FC using a 3 dimensional spectral approach

    NASA Astrophysics Data System (ADS)

    Thangjam, G.; Nathues, A.; Mengel, K.; Hoffmann, M.; Schäfer, M.; Mann, P.; Cloutis, E. A.; Behrens, H.; Platz, T.; Schäfer, T.; Sierks, H.; Christensen, U.; Russell, C. T.

    2015-10-01

    The historic journey of the Dawn spacecraft in 2011- 2012 was a turning point in understanding asteroid (4) Vesta. The surface composition and lithology were analysed and mapped in earlier studies using Dawn imageries [1], [2]. We introduce here a 3 dimensional spectral approach to analyze and map the surface composition using Dawn Framing Camera (FC) color data. Various laboratory spectra of available HEDs and their mixtures, including new spectra measured in this work, were used. Band parameters were reviewed and modified wherever necessary to make the best use of the data. We particularly focused on carbonaceous-chondrite-bearing and olivine-bearing lithologies. An attempt has been made to distinguish glass/impact-melt lithologies.

  2. A 3-Dimensional Cockpit Display with Traffic and Terrain Information for the Small Aircraft Transportation System

    NASA Technical Reports Server (NTRS)

    UijtdeHaag, Maarten; Thomas, Robert; Rankin, James R.

    2004-01-01

    The report discusses the architecture and the flight test results of a 3-Dimensional Cockpit Display of Traffic and terrain Information (3D-CDTI). The presented 3D-CDTI is a perspective display format that combines existing Synthetic Vision System (SVS) research and Automatic Dependent Surveillance-Broadcast (ADS-B) technology to improve the pilot's situational awareness. The goal of the 3D-CDTI is to contribute to the development of new display concepts for NASA's Small Aircraft Transportation System research program. Papers were presented at the PLANS 2002 meeting and the ION-GPS 2002 meeting. The contents of this report are derived from the results discussed in those papers.

  3. Epigenetic and 3-dimensional regulation of V(D)J rearrangement of immunoglobulin genes.

    PubMed

    Degner-Leisso, Stephanie C; Feeney, Ann J

    2010-12-01

    V(D)J recombination is a crucial component of the adaptive immune response, allowing for the production of a diverse antigen receptor repertoire (Ig and TCR). This review will focus on how epigenetic regulation and 3-dimensional (3D) interactions may control V(D)J recombination at Ig loci. The interplay between transcription factors and post-translational modifications at the Igh, Igκ, and Igλ loci will be highlighted. Furthermore, we propose that the spatial organization and epigenetic boundaries of each Ig loci before and during V(D)J recombination may be influenced in part by the CTCF/cohesin complex. Taken together, the many epigenetic and 3D layers of control ensure that Ig loci are only rearranged at appropriate stages of B cell development.

  4. Using GOMS models and hypertext to create representations of medical procedures for online display

    NASA Technical Reports Server (NTRS)

    Gugerty, Leo; Halgren, Shannon; Gosbee, John; Rudisill, Marianne

    1991-01-01

    This study investigated two methods to improve organization and presentation of computer-based medical procedures. A literature review suggested that the GOMS (goals, operators, methods, and selecton rules) model can assist in rigorous task analysis, which can then help generate initial design ideas for the human-computer interface. GOMS model are hierarchical in nature, so this study also investigated the effect of hierarchical, hypertext interfaces. We used a 2 x 2 between subjects design, including the following independent variables: procedure organization - GOMS model based vs. medical-textbook based; navigation type - hierarchical vs. linear (booklike). After naive subjects studies the online procedures, measures were taken of their memory for the content and the organization of the procedures. This design was repeated for two medical procedures. For one procedure, subjects who studied GOMS-based and hierarchical procedures remembered more about the procedures than other subjects. The results for the other procedure were less clear. However, data for both procedures showed a 'GOMSification effect'. That is, when asked to do a free recall of a procedure, subjects who had studies a textbook procedure often recalled key information in a location inconsistent with the procedure they actually studied, but consistent with the GOMS-based procedure.

  5. Inference With Collaborative Model for Interactive Tumor Segmentation in Medical Image Sequences.

    PubMed

    Lin, Liang; Yang, Wei; Li, Chenglong; Tang, Jin; Cao, Xiaochun

    2015-10-29

    Segmenting organisms or tumors from medical data (e.g., computed tomography volumetric images, ultrasound, or magnetic resonance imaging images/image sequences) is one of the fundamental tasks in medical image analysis and diagnosis, and has received long-term attentions. This paper studies a novel computational framework of interactive segmentation for extracting liver tumors from image sequences, and it is suitable for different types of medical data. The main contributions are twofold. First, we propose a collaborative model to jointly formulate the tumor segmentation from two aspects: 1) region partition and 2) boundary presence. The two terms are complementary but simultaneously competing: the former extracts the tumor based on its appearance/texture information, while the latter searches for the palpable tumor boundary. Moreover, in order to adapt the data variations, we allow the model to be discriminatively trained based on both the seed pixels traced by the Lucas-Kanade algorithm and the scribbles placed by the user. Second, we present an effective inference algorithm that iterates to: 1) solve tumor segmentation using the augmented Lagrangian method and 2) propagate the segmentation across the image sequence by searching for distinctive matches between images. We keep the collaborative model updated during the inference in order to well capture the tumor variations over time. We have verified our system for segmenting liver tumors from a number of clinical data, and have achieved very promising results. The software developed with this paper can be found at http://vision.sysu.edu.cn/projects/med-interactive-seg/.

  6. Addressing the Shortage of Geriatricians: What Medical Educators Can Learn From the Nurse Practitioner Training Model.

    PubMed

    Golden, Adam G; Silverman, Michael A; Issenberg, S Barry

    2015-09-01

    Physicians' career interest in geriatric medicine continues to wane at a time when the health care needs of older adults are increasing. Nurse practitioners have helped fill the U.S. physician gap by delivering outpatient care to older adults and can practice with full autonomy in many states. Nursing graduate school programs are preparing adult-gerontology primary care nurse practitioners to successfully deliver outpatient care services using a model of training with fewer requirements that is more flexible and of shorter duration compared with the training model for geriatricians. Nurse practitioners can also obtain initial certification and recertification with less time commitment and at lower cost than geriatricians. Whether the outpatient care provided by nurse practitioners is comparable to the care provided by physicians remains a subject of debate. However, as nurse practitioners' scope of practice expands, the perception exists that the outpatient clinical roles of adult-gerontology primary care nurse practitioners and geriatricians are similar. This raises questions about whether there are too many educational and certification requirements for geriatricians. The authors encourage medical educators to learn from the success of the nurse practitioner education model for training large numbers of primary care providers. They propose decreasing the duration of medical school and graduate medical education training for geriatricians and providing educational debt repayment programs as potential incentives to stimulate career interest in geriatric medicine.

  7. Lossloss encoding of medical images: hybrid modification of statistical modelling-based conception

    NASA Astrophysics Data System (ADS)

    Przelaskowski, Artur

    2001-10-01

    Methods of lossless compression of medical image data are considered. Selected class of efficient algorithms have been constructed, examined, and optimized to conclude the most useful tools for medical image archiving and transmission. Image data scanning, 2D context-based prediction and interpolation, and statistical models of entropy coder have been optimized to compress effectively ultrasound (US), magnetic resonance (MR), and computed tomography (CT) images. The SSM technique of suitable data decomposing scanning method followed by probabilistic modeling of the context in arithmetic encoding have occurred the most useful in our experiments. Context order, shape, and alphabet have been fitted to local data characteristics to decrease image data correlation and dilution of statistical model. Average bit rate value over test images is equal to 2.53 bpp for SSM coder and significantly overcomes 2.92 bpp of CALIC bit rate. Moreover, optimization of lossless wavelet coder by thinking of efficient subband decomposition schemes, and integer-to-integer transforms is reported. Efficient hybrid coding method (SHEC) as a complete tool for medical image archiving and transmission is proposed. SHEC develops SSM by including CALIC-like coder to compress the highest quality images and JPEG2000 wavelet coder for progressive delivering of high and middle quality images in telemedicine systems.

  8. Can Abdominal Hypopressive Technique Change Levator Hiatus Area?: A 3-Dimensional Ultrasound Study.

    PubMed

    Resende, Ana Paula Magalhães; Torelli, Luiza; Zanetti, Miriam Raquel Diniz; Petricelli, Carla Dellabarba; Jármy-Di Bella, Zsuzsanna IIona Katalin; Nakamura, Mary Uchiyama; Araujo Júnior, E; Moron, Antonio Fernandes; Girão, Manoel João Batista Castello; Sartori, Marair Gracio Ferreira

    2016-06-01

    This study aimed to evaluate the levator hiatus area (LHA) at rest and during the performance of maximal pelvic floor muscle (PFM) contractions, during the abdominal hypopressive technique (AHT), and during the combination of PFM contractions (PFMCs) and the AHT. The study included 17 healthy nulliparous women who had no history of pelvic floor disorders. The LHA was evaluated with the patients in the lithotomy position. After a physiotherapist instructed the patients on the proper performance of the PFM and AHT exercises, 1 gynecologist performed the 3-dimensional translabial ultrasound examinations. The LHA was measured with the patients at rest. The PFMC alone, the AHT alone or the AHT in combination with a PFMC with 30 seconds of rest between the evaluations were performed. Each measurement was performed 2 times, and the mean value was used for statistical analysis. The Wilcoxon test was used to test the differences between the 2 maneuvers. Similar values were observed when comparing the LHA of the PFM at rest (12.2 ± 2.4) cm and during the AHT (11.7 ± 2.6) cm (P = 0.227). The AHT+ PFMC (10.2 ± 1.9) cm demonstrated lower values compared with AHT alone (11.7 ± 2.6) cm (P = 0.002). When comparing the PFMC (10.4 ± 2.1) cm with the AHT + PFMC (10.2 ± 1.9) cm, no significant difference (P = 0.551) was observed. During PFMC, the constriction was 1.8 cm; during the AHT, the constriction was 0.5 cm; and during the AHT + PFMC, it was 2 cm. The LHA assessed by 3-dimensional ultrasound did not significantly change with AHT. These results support the theory that AHT does not strengthen PFM.

  9. Selection of massive bone allografts using shape-matching 3-dimensional registration

    PubMed Central

    Docquier, Pierre-Louis; Cartiaux, Olivier; Cornu, Olivier; Delloye, Christian; Banse, Xavier

    2010-01-01

    Background and purpose Massive bone allografts are used when surgery causes large segmental defects. Shape-matching is the primary criterion for selection of an allograft. The current selection method, based on 2-dimensional template comparison, is inefficient for 3-dimensional complex bones. We have analyzed a 3-dimensional (3-D) registration method to match the anatomy of the allograft with that of the recipient. Methods 3-D CT-based registration was performed to match the shapes of both bones. We used the registration to align the allograft volume onto the recipient's bone. Hemipelvic allograft selection was tested in 10 virtual recipients with a panel of 10 potential allografts, including one from the recipient himself (trap graft). 4 observers were asked to visually inspect the superposition of allograft over the recipient, to classify the allografts into 4 categories according to the matching of anatomic zones, and to select the 3 best matching allografts. The results obtained using the registration method were compared with those from a previous study on the template method. Results Using the registration method, the observers systematically detected the trap graft. Selections of the 3 best matching allografts performed using registration and template methods were different. Selection of the 3 best matching allografts was improved by the registration method. Finally, reproducibility of the selection was improved when using the registration method. Interpretation 3-D CT registration provides more useful information than the template method but the final decision lies with the surgeon, who should select the optimal allograft according to his or her own preferences and the needs of the recipient. PMID:20175643

  10. Efficacy of 3-Dimensional plates over Champys miniplates in mandibular anterior fractures

    PubMed Central

    Barde, Dhananjay H; Mudhol, Anupama; Ali, Fareedi Mukram; Madan, R S; Kar, Sanjay; Ustaad, Farheen

    2014-01-01

    Background: Mandibular fractures are treated surgically by either rigid or semi-rigid fixation, two techniques that reflect almost opposite concept of craniomaxillofacial osteosynthesis. The shortcomings of these fixations led to the development of 3 dimensional (3D) miniplates. This study was designed with the aim of evaluating the efficiency of 3D miniplate over Champys miniplate in anterior mandibular fractures. Materials & Methods: This study was done in 40 patients with anterior mandibular fractures. Group I consisting of 20 patients in whom 3D plates were used for fixation while in Group II consisting of other 20 patients, 4 holes straight plates were used. The efficacy of 3D miniplate over Champy’s miniplate was evaluated in terms of operating time, average pain, post operative infection, occlusion, wound dehiscence, post operative mobility and neurological deficit. Results: The mean operation time for Group II was more compared to Group I (statistically significant).There was significantly greater pain on day of surgery and at 2nd week for Group II patients but there was no significant difference between the two groups at 4th week. The post operative infection, occlusal disturbance, wound dehiscence, post operative mobility at facture site, neurological deficit was statistically insignificant (chi square test). Conclusion: The results of this study suggest that fixation of anterior mandibular fractures with 3D plates provides three dimensional stability and carries low morbidity and infection rates. The only probable limitation of these 3D plates may be excessive implant material, but they seem to be easy alternative to champys miniplate. How to cite the article: Barde DH, Mudhol A, Ali FM, Madan RS, Kar S, Ustaad F. Efficacy of 3-Dimensional plates over Champys miniplates in mandibular anterior fractures. J Int Oral Health 2014;6(1):20-6. PMID:24653598

  11. A Comparison of Expedition Medical Condition List Treatment Directives with Integrated Medical Model Simulation Data Presentation and Briefing Report

    NASA Technical Reports Server (NTRS)

    Lewis, Robert

    2013-01-01

    This aerospace medicine clerkship project is under the direction of Dr. Sharmila Watkins and is in cooperation with Dr. Eric Kerstman and Dr. Ronak Shah. The questions of the research project are: 1. What are the main drivers of evacuation and loss of crew life (LOCL) on three Design Reference Missions (DRMs): Near Earth Asteroid (NEA), Lunar Sortie and Lunar Outpost using an inexhaustible International Space Station medical kit 2. What are the treatment designations for these driving medical conditions as listed in Expedition Medical Condition List (EMCL) 3. Do the drivers make sense in the context of the given Design Reference Mission (DRM) 4. Do any EMCL treatment designations need re-assessing.

  12. A grid-based model for integration of distributed medical databases.

    PubMed

    Luo, Yongxing; Jiang, Lijun; Zhuang, Tian-ge

    2009-12-01

    Grid has emerged recently as an integration infrastructure for sharing and coordinated use of diverse resources in dynamic, distributed environment. In this paper, we present a prototype system for integration of heterogeneous medical databases based on Grid technology, which can provide a uniform access interface and efficient query mechanism to different medical databases. After presenting the architecture of the prototype system that employs corresponding Grid services and middleware technologies, we make an analysis on its basic functional components including OGSA-DAI, metadata model, transaction management, and query processing in detail, which cooperate with each other to enable uniform accessing and seamless integration of the underlying heterogeneous medical databases. Then, we test effectiveness and performance of the system through a query instance, analyze the experiment result, and make a discussion on some issues relating to practical medical applications. Although the prototype system has been carried out and tested in a simulated hospital information environment at present, the underlying principles are applicable to practical applications.

  13. "Med-X": a medical examiner surveillance model for bioterrorism and infectious disease mortality.

    PubMed

    Nolte, Kurt B; Lathrop, Sarah L; Nashelsky, Marcus B; Nine, Jeffrey S; Gallaher, Margaret M; Umland, Edith T; McLemore, Jerri L; Reichard, R Ross; Irvine, Rebecca A; McFeeley, Patricia J; Zumwalt, Ross E

    2007-05-01

    We created a model surveillance system (Med-X) designed to enable medical examiners and coroners to recognize fatal infections of public health importance and deaths due to bioterrorism. All individuals who died in New Mexico and fell under medical examiner jurisdiction between November 23, 2000, and November 22, 2002, were prospectively evaluated using sets of surveillance symptoms and autopsy-based pathologic syndromes. All infectious disease deaths were evaluated to identify the specific causative agent. Of 6104 jurisdictional cases, 250 (4.1%) met Med-X criteria, of which 141 (56.4%) had a target pathologic syndrome. Ultimately, 127 (51%) of the 250 cases were due to infections. The causative organism was identified for 103 (81%) of the infectious disease deaths, of which 60 (58.3%) were notifiable conditions in New Mexico. Flu-like symptoms, fever and respiratory symptoms, and encephalopathy or new-onset seizures had predictive values positive for fatal infections of 65%, 72%, and 50%, respectively, and are useful as autopsy performance criteria. Before the development of surveillance criteria, 37 (14.8%) of the cases ordinarily would not have been autopsied resulting in a 1% increase in autopsy workload. Med-X is an effective method of detecting infectious disease deaths among medical examiner cases. Uniform criteria for performing medical examiner autopsies and reporting cases to public health authorities enhance surveillance for notifiable infectious diseases and increase the likelihood of recognizing deaths related to bioterrorism.

  14. Using a Cost-Construction Model To Assess the Cost of Educating Undergraduate Medical Students at the University of Texas-Houston Medical School.

    ERIC Educational Resources Information Center

    Franzini, Luisa; And Others

    1997-01-01

    Using a cost-construction model, cost of the University of Texas-Houston Medical School program, instructional costs, educational costs, and milieu costs were calculated. Sensitivity analysis revealed the financial effects of various factors, some of which increased and some of which decreased cost. Despite inherent complexities of the method and…

  15. Multi-object segmentation framework using deformable models for medical imaging analysis.

    PubMed

    Namías, Rafael; D'Amato, Juan Pablo; Del Fresno, Mariana; Vénere, Marcelo; Pirró, Nicola; Bellemare, Marc-Emmanuel

    2016-08-01

    Segmenting structures of interest in medical images is an important step in different tasks such as visualization, quantitative analysis, simulation, and image-guided surgery, among several other clinical applications. Numerous segmentation methods have been developed in the past three decades for extraction of anatomical or functional structures on medical imaging. Deformable models, which include the active contour models or snakes, are among the most popular methods for image segmentation combining several desirable features such as inherent connectivity and smoothness. Even though different approaches have been proposed and significant work has been dedicated to the improvement of such algorithms, there are still challenging research directions as the simultaneous extraction of multiple objects and the integration of individual techniques. This paper presents a novel open-source framework called deformable model array (DMA) for the segmentation of multiple and complex structures of interest in different imaging modalities. While most active contour algorithms can extract one region at a time, DMA allows integrating several deformable models to deal with multiple segmentation scenarios. Moreover, it is possible to consider any existing explicit deformable model formulation and even to incorporate new active contour methods, allowing to select a suitable combination in different conditions. The framework also introduces a control module that coordinates the cooperative evolution of the snakes and is able to solve interaction issues toward the segmentation goal. Thus, DMA can implement complex object and multi-object segmentations in both 2D and 3D using the contextual information derived from the model interaction. These are important features for several medical image analysis tasks in which different but related objects need to be simultaneously extracted. Experimental results on both computed tomography and magnetic resonance imaging show that the proposed

  16. Accomplishments in genome-scale in silico modeling for industrial and medical biotechnology.

    PubMed

    Milne, Caroline B; Kim, Pan-Jun; Eddy, James A; Price, Nathan D

    2009-12-01

    Driven by advancements in high-throughput biological technologies and the growing number of sequenced genomes, the construction of in silico models at the genome scale has provided powerful tools to investigate a vast array of biological systems and applications. Here, we review comprehensively the uses of such models in industrial and medical biotechnology, including biofuel generation, food production, and drug development. While the use of in silico models is still in its early stages for delivering to industry, significant initial successes have been achieved. For the cases presented here, genome-scale models predict engineering strategies to enhance properties of interest in an organism or to inhibit harmful mechanisms of pathogens. Going forward, genome-scale in silico models promise to extend their application and analysis scope to become a trans-formative tool in biotechnology.

  17. Efforts to improve patient safety in large, capitated medical groups: description and conceptual model.

    PubMed

    Miller, Robert H; Bovbjerg, Randall R

    2002-06-01

    Medical care should be safer. Inpatient problems and solutions have received the most attention; this outpatient qualitative case study addresses a gap in knowledge. We describe safety improvements among large physician groups, model the key influences on their behavior, and identify beneficial public and private policies. All groups were trying to reduce medical injury, which was part of the sample design. The most commonly targeted problems are those that are similar across groups: shortcomings in diagnosis, abnormal tests follow-up, scope of practice and referral patterns, and continuity of care. Medical group innovators vary greatly, however, in implementation of improvements, that is, in the extent to which they implement process changes that identify events/problems, analyze and track incidents, decide how to change clinical and administrative practices, and monitor impacts of the changes. Our conceptual model identifies key determinants: (1) demand for safety comes from external factors: legal, market, and professional; (2) organizational responses depend on internal factors: group size, scope, and integration; leadership and governance; professional culture; information-system assets; and financial and intellectual capital. Further, safety is an aspect of quality (the same tools, decision making, interventions, and monitoring apply), and safety management benefits from prior efficiency management (similar skills and culture of innovation). Observed variation in even simple safeguards shows that existing safety incentives are too weak. Our model suggests that the biggest improvement would come from boosting the demand for quality and safety from both private and public larger group purchasers. Current policy relies too much on litigation and discipline, which have sometimes helped, but not solved, problems because they are inefficient, tend to drive needed information underground, and complicate needed cultural change. Patients' safety demand is also weak

  18. Quality improvement in healthcare delivery utilizing the patient-centered medical home model.

    PubMed

    Akinci, Fevzi; Patel, Poonam M

    2014-01-01

    Despite the fact that the United States dedicates so much of its resources to healthcare, the current healthcare delivery system still faces significant quality challenges. The lack of effective communication and coordination of care services across the continuum of care poses disadvantages for those requiring long-term management of their chronic conditions. This is why the new transformation in healthcare known as the patient-centered medical home (PCMH) can help restore confidence in our population that the healthcare services they receive is of the utmost quality and will effectively enhance their quality of life. Healthcare using the PCMH model is delivered with the patient at the center of the transformation and by reinvigorating primary care. The PCMH model strives to deliver effective quality care while attempting to reduce costs. In order to relieve some of our healthcare system distresses, organizations can modify their delivery of care to be patient centered. Enhanced coordination of services, better provider access, self-management, and a team-based approach to care represent some of the key principles of the PCMH model. Patients that can most benefit are those that require long-term management of their conditions such as chronic disease and behavioral health patient populations. The PCMH is a feasible option for delivery reform as pilot studies have documented successful outcomes. Controversy about the lack of a medical neighborhood has created concern about the overall sustainability of the medical home. The medical home can stand independently and continuously provide enhanced care services as a movement toward higher quality care while organizations and government policy assess what types of incentives to put into place for the full collaboration and coordination of care in the healthcare system.

  19. The house of gastrointestinal medicine: how academic medical centers can build a sustainable economic clinical model.

    PubMed

    Rustgi, Anil K; Allen, John I

    2013-11-01

    Academic Medical Centers (AMCs) have been given unique responsibilities to care for patients, educate future clinicians, and bring innovative research to the bedside. Over the last few decades, this tripartite mission has served the United States well, and payers (Federal, State, and commercial) have been willing to underwrite these missions with overt and covert financial subsidies. As cost containment efforts have escalated, the traditional business model of AMCs has been challenged. In this issue, Dr Anil Rustgi and I offer some insights into how AMCs must alter their business model to be sustainable in our new world of accountable care, cost containment, and clinical integration.

  20. Using case studies based on a nursing conceptual model to teach medical-surgical nursing.

    PubMed

    DeSanto-Madeya, Susan

    2007-10-01

    Nurse educators are continually challenged to develop teaching strategies that enhance students' critical thinking, problem-solving, and decision-making skills. Case studies are a creative learning strategy that fosters these skills through the use of in-depth descriptions of realistic clinical situations. Conceptual models of nursing provide a unique body of knowledge that can be used to guide construction of case studies and enhance application of didactic course content to nursing practice. In this column, the author discusses the use of case studies constructed within the context of the Roy adaptation model for a senior level medical-surgical nursing course.

  1. Culture of murine aortic explants in 3-dimensional extracellular matrix: a novel, miniaturized assay of angiogenesis in vitro.

    PubMed

    Reed, May J; Karres, Nathan; Eyman, Daniel; Vernon, Robert B

    2007-05-01

    Assays of angiogenesis in vitro are critical to the study of vascular morphogenesis and to the evaluation of therapeutic compounds that promote or inhibit vascular growth. Culture of explanted aortic segments from rats or mice in a 3-dimensional extracellular matrix (ECM) is one of the most effective ways to generate capillary-like endothelial sprouts in vitro. We have modified the classic aortic explant model by placing the aortic segments from mice within small (5.6 mm diameter, 30 microl volume) lenticular hydrogels of type I collagen supported at the edge by nylon mesh rings. This method of culture, referred to as the "miniature ring-supported gel" (MRSG) assay, optimizes handling, cytological staining, and conventional imaging of the specimen and permits use of minimal volumes of reagents in a 96-well tissue culture format. We have used the MRSG assay to quantify the impaired angiogenic response of aged mice relative to young mice and to show that aged mice have significantly decreased sprout formation, but have similar levels of invasion of vascular smooth muscle cells into the supportive ECM. The MRSG assay, which combines low volume, physically robust gels in conjunction with mouse aortic segments, may prove to be a highly useful tool in studies of the process and control of vascular growth.

  2. Examining whether the information-motivation-behavioral skills model predicts medication adherence for patients with a rare disease.

    PubMed

    Alexander, Dayna S; Hogan, Susan L; Jordan, Joanne M; DeVellis, Robert F; Carpenter, Delesha M

    2017-01-01

    The information-motivation-behavioral skills (IMB) model has been used to explain and promote medication adherence among patients with diabetes and HIV. The objective of this study was to examine whether the IMB model predicted medication adherence among vasculitis patients. Adult vasculitis patients (n=228) completed online questionnaires at baseline and 3-month follow-up. Linear regressions were calculated to determine the direct effects of information and motivation on medication adherence (P<0.05). A mediation analysis using a bootstrapping approach was used to test whether behavioral skills significantly mediated the effect of information and motivation on medication adherence. Participants reported high levels of information (M=4.0; standard deviation [SD]=0.68), moderate levels of motivation (M=2.7; SD=1.00), and high levels of behavioral skills (M=4.1; SD=0.74). In the regression model, only behavioral skills (B=0.38; P<0.001) were significantly associated with medication adherence; however, mediation analysis revealed that behavioral skills significantly mediated the effects of information and motivation on medication adherence. The results support the IMB-hypothesized relationships between information, motivation, behavioral skills, and medication adherence in our sample. Findings suggest that providers should work with vasculitis patients to increase their medication-related skills to improve medication adherence.

  3. Examining whether the information–motivation–behavioral skills model predicts medication adherence for patients with a rare disease

    PubMed Central

    Alexander, Dayna S; Hogan, Susan L; Jordan, Joanne M; DeVellis, Robert F; Carpenter, Delesha M

    2017-01-01

    The information–motivation–behavioral skills (IMB) model has been used to explain and promote medication adherence among patients with diabetes and HIV. The objective of this study was to examine whether the IMB model predicted medication adherence among vasculitis patients. Adult vasculitis patients (n=228) completed online questionnaires at baseline and 3-month follow-up. Linear regressions were calculated to determine the direct effects of information and motivation on medication adherence (P<0.05). A mediation analysis using a bootstrapping approach was used to test whether behavioral skills significantly mediated the effect of information and motivation on medication adherence. Participants reported high levels of information (M=4.0; standard deviation [SD]=0.68), moderate levels of motivation (M=2.7; SD=1.00), and high levels of behavioral skills (M=4.1; SD=0.74). In the regression model, only behavioral skills (B=0.38; P<0.001) were significantly associated with medication adherence; however, mediation analysis revealed that behavioral skills significantly mediated the effects of information and motivation on medication adherence. The results support the IMB-hypothesized relationships between information, motivation, behavioral skills, and medication adherence in our sample. Findings suggest that providers should work with vasculitis patients to increase their medication-related skills to improve medication adherence. PMID:28138225

  4. The REEME project: a cooperative model for sharing international medical education materials.

    PubMed

    Iserson, Kenneth V

    2008-07-01

    Although the Internet has become an excellent source of medical education materials, in many specialties, including Emergency Medicine (EM), most of the information is in English. Few international EM practitioners can attend costly specialty conferences, importing foreign experts to teach at these conferences is costly and, even then, these experts are available for a limited time to relatively few people. Countries with minimal health care or medical education budgets find providing even basic materials for professional medical education difficult. An exciting international project now freely distributes Spanish language educational programs to health care professionals on topics relating to EM. The Recursos Educacionales en Español para Medicina de Emergencia (REEME; Educational Resources in Spanish for EM) Project (www.reeme.arizona.edu) was developed to overcome some of these problems by providing language-specific specialty information and widespread international availability, and by promoting international cooperation among professional health care educators. It also provides a ready source of Spanish medical vocabulary for those trying to learn the language. With computer support from the University of Arizona's Learning and Technology Center, REEME first went "live" on November 1, 2004. Three years later, as of November 1, 2007, the site had 575 programs from 411 donors representing 19 countries and the United Nations. There are currently about 645 downloads per month to users in 73 countries. The REEME Project demonstrates the power of the Internet as a means to achieve international cooperation in medical education, and can serve as a model for similar projects in other specialties and languages.

  5. A Structural Equation Model of HIV-related Symptoms, Depressive Symptoms, and Medication Adherence

    PubMed Central

    Yoo-Jeong, Moka; Waldrop-Valverde, Drenna; McCoy, Katryna; Ownby, Raymond L

    2016-01-01

    Adherence to combined antiretroviral therapy (cART) remains critical in management of HIV infection. This study evaluated depression as a potential mechanism by which HIV-related symptoms affect medication adherence and explored if particular clusters of HIV symptoms are susceptible to this mechanism. Baseline data from a multi-visit intervention study were analyzed among 124 persons living with HIV (PLWH). A bifactor model showed two clusters of HIV-related symptom distress: general HIV-related symptoms and gastrointestinal (GI) symptoms. Structural equation modeling showed that both general HIV-related symptoms and GI symptoms were related to higher levels of depressive symptoms, and higher levels of depressive symptoms were related to lower levels of medication adherence. Although general HIV-related symptoms and GI symptoms were not directly related to adherence, they were indirectly associated with adherence via depression. The findings highlight the importance of early recognition and evaluation of symptoms of depression, as well as the underlying physical symptoms that might cause depression, to improve medication adherence. PMID:27695710

  6. An extended protocol for usability validation of medical devices: research design and reference model.

    PubMed

    Schmettow, Martin; Schnittker, Raphaela; Schraagen, Jan Maarten

    2017-03-21

    This paper proposes and demonstrates an extended protocol for usability validation testing of medical devices. A review of currently used methods for the usability evaluation of medical devices revealed two main shortcomings. Firstly, the lack of methods to closely trace the interaction sequences and derive performance measures. Secondly, a prevailing focus on cross-sectional validation studies, ignoring the issues of learnability and training. The U.S. Federal Drug and Food Administration's recent proposal for a validation testing protocol for medical devices is then extended to address these shortcomings: (1) a novel process measure 'normative path deviations' is introduced that is useful for both quantitative and qualitative usability studies and (2) a longitudinal, completely within-subject study design is presented that assesses learnability, training effects and allows analysis of diversity of users. A reference regression model is introduced to analyze data from this and similar studies, drawing upon generalized linear mixed-effects models and a Bayesian estimation approach. The extended protocol is implemented and demonstrated in a study comparing a novel syringe infusion pump prototype to an existing design with a sample of 25 healthcare professionals. Strong performance differences between designs were observed with a variety of usability measures, as well as varying training-on-the-job effects. We discuss our findings with regard to validation testing guidelines, reflect on the extensions and discuss the perspectives they add to the validation process.

  7. Attachment in medical care: A review of the interpersonal model in chronic disease management.

    PubMed

    Jimenez, Xavier F

    2017-03-01

    Objective Patient-physician interaction is continually examined in an era prioritizing patient-centered approaches, yet elaboration beyond aspects of communication and empathy is lacking. Major chronic conditions would benefit tremendously from understanding interpersonal aspects of patient-physician encounters. This review intends to provide a concise introduction to the interpersonal model of attachment theory and how it informs both the patient-physician interaction and medical outcomes in chronic care. Methods A narrative review of the theoretical, neurobiological, epidemiological, investigational, and clinical literature on attachment theory and its impact on medical outcomes was conducted, utilizing a variety of key words as searched on PubMed database. Studies and reviews included were of a variety of sources, including textbooks and peer-reviewed journals. Reports in languages other than English were excluded. Results Measurable, discrete attachment styles and behavioral patterns correlate with poor medical outcomes, including nonadherence in insecure dismissing attachment and care overutilization in insecure preoccupied attachment. Furthermore, insecure dismissing attachment is associated with significant mortality. These variables can be easily assessed, and their effects are reversible, as evidenced by collaborative care outcome data. Discussion Attachment theory is useful a model with application in clinical and investigational aspects of chronic illness care. Implications and guidelines are explored.

  8. Improving Education in Medical Statistics: Implementing a Blended Learning Model in the Existing Curriculum

    PubMed Central

    Milic, Natasa M.; Trajkovic, Goran Z.; Bukumiric, Zoran M.; Cirkovic, Andja; Nikolic, Ivan M.; Milin, Jelena S.; Milic, Nikola V.; Savic, Marko D.; Corac, Aleksandar M.; Marinkovic, Jelena M.; Stanisavljevic, Dejana M.

    2016-01-01

    Background Although recent studies report on the benefits of blended learning in improving medical student education, there is still no empirical evidence on the relative effectiveness of blended over traditional learning approaches in medical statistics. We implemented blended along with on-site (i.e. face-to-face) learning to further assess the potential value of web-based learning in medical statistics. Methods This was a prospective study conducted with third year medical undergraduate students attending the Faculty of Medicine, University of Belgrade, who passed (440 of 545) the final exam of the obligatory introductory statistics course during 2013–14. Student statistics achievements were stratified based on the two methods of education delivery: blended learning and on-site learning. Blended learning included a combination of face-to-face and distance learning methodologies integrated into a single course. Results Mean exam scores for the blended learning student group were higher than for the on-site student group for both final statistics score (89.36±6.60 vs. 86.06±8.48; p = 0.001) and knowledge test score (7.88±1.30 vs. 7.51±1.36; p = 0.023) with a medium effect size. There were no differences in sex or study duration between the groups. Current grade point average (GPA) was higher in the blended group. In a multivariable regression model, current GPA and knowledge test scores were associated with the final statistics score after adjusting for study duration and learning modality (p<0.001). Conclusion This study provides empirical evidence to support educator decisions to implement different learning environments for teaching medical statistics to undergraduate medical students. Blended and on-site training formats led to similar knowledge acquisition; however, students with higher GPA preferred the technology assisted learning format. Implementation of blended learning approaches can be considered an attractive, cost-effective, and efficient

  9. 77 FR 18251 - Development of Animal Models of Pregnancy To Address Medical Countermeasures for Influenza in the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-27

    ... Countermeasures for Influenza in the ``At Risk'' Population of Pregnant Women: Influenza as a Case Study; Public... Address Medical Countermeasures for Influenza in the `At Risk' Population of Pregnant Women: Influenza as... issues related to selecting animal models for use in evaluating medical influenza countermeasures...

  10. Using PICO to align medical evidence with MDs decision making models.

    PubMed

    O'Sullivan, Dympna; Wilk, Szymon; Michalowski, Wojtek; Farion, Ken

    2013-01-01

    Modern medicine is characterized by an "explosion" in clinical research information making practical application of Evidence-Based Medicine (EBM), problematic for many clinicians. We have developed a PICO-(evidence based search strategy focusing on Patient/Population, Intervention, Comparison and Outcome)-based framework for (indexing and retrieving medical evidence and we posit that the use of PICO allows for organizing evidence that is aligned with an MD's decision making model. We describe a study where medical students evaluated our PICO-based approach and results show that students are eager to apply EBM but are hindered by a lack of specialist skills. Students reported that the PICO-based framework for organizing evidence provided an intuitive way of accessing and evaluating evidence and would be useful for their clinical tasks.

  11. An Engagement Model for Medication Management: From Prescription to Description and Conscription.

    PubMed

    Diemert, Simon; Weber, Jens; Price, Morgan

    2017-01-01

    Medication non-adherence is a global problem that has been studied over the past 40 years. Despite the large number of studies there is not an agreed upon definition of "adherence" in the literature. The lack of a consistent definition has resulted in issues in adherence research, clinical implementation, and HIT system development. In this paper a critical review of adherence literature is conducted. Based on this review, a new Adherence Interaction Model (AIM) is proposed and described in detail. AIM considers provider recommendations, the patient's interpretation of the recommendations, and the patient's behavior and provides the foundation for building a more objective view of adherence. AIM provides a foundation for future formalization of medication adherence concepts.

  12. Customer satisfaction and consumer responsibility: toward an alternative model of medical service quality.

    PubMed

    Pinto, M B; Barber, J C

    1999-01-01

    In the increasingly competitive environment of medical services and patient care, physicians feel a strong pressure for increasing efforts to improve patient satisfaction with the goal of creating a loyal patient base. These steps to promote patient satisfaction have typically involved developing new programs and services, as medical offices seek to attract and keep their patients by continually enhancing service features. While patient satisfaction is a worthy goal, this paper argues that we often make mistakes and incur expensive costs in pursuing satisfaction as an end unto itself. This paper proposes an alternative model, based on creating a doctor-patient therapeutic alliance which has the dual benefits of enhancing patient satisfaction while improving the critical personal relationship between doctors and their patients, so necessary for the delivery of optimal care.

  13. Putting patients first: a novel patient-centered model for medical enterprise success.

    PubMed

    Dhawan, Naveen

    2014-01-01

    This article introduces a new way of viewing patient-customers. It encourages a greater emphasis on patients' needs and the importance of considering dimensions of the patient experience to better serve them. It also draws from examples in the general business world as they can be applied to medical enterprises. The author introduces a model that directs all business activities toward the end consumer with an underlying guidance by patient needs. A business is advised to understand its customer, design a patient-directed vision, and focus on creating a unique customer experience. The article delineates key action items for physicians and administrators that will allow them to better meet their patient-customers' needs and develop loyalty. By practicing a patient-centered approach and following these guidelines, one may ensure greater success of the medical enterprise.

  14. Models of the medical consultation: opportunities and limitations of a game theory perspective.

    PubMed

    Tarrant, C; Stokes, T; Colman, A M

    2004-12-01

    The medical consultation is best understood as a two-way social interaction involving interactive decision making. Game theory--a theory based on assumptions of rational choice and focusing on interactive decision making--has the potential to provide models of the consultation that can be used to generate empirically testable predictions about the factors that promote quality of care. Three different game structures--the Prisoner's Dilemma game, the Assurance game, and the Centipede game--all provide insights into the possible underlying dynamics of the doctor-patient interaction. Further empirical work is needed to uncover the underlying game structures that occur most commonly in medical consultations. Game theory has the potential to provide a new conceptual and theoretical basis for future empirical work on the interaction between doctors and their patients.

  15. Role Modeling in Medical Education: The Importance of a Reflective Imitation

    PubMed Central

    2014-01-01

    The medical literature almost uniformly addresses the positive aspects of role modeling. Still, some authors have questioned its educational value, a disagreement that is probably due to differing definitions of role modeling. If defined as demonstration of skills, provision of feedback, and emulation of specific professional behaviors, then role modeling is an important component of clinical training. However, if it is defined as a learner’s unselective imitation of role models and uncritical adoption of the messages of the learning environment, then the benefits of role modeling should be weighed against its unintended harm. In this Perspective, the author argues that imitation of role models may initially help students adapt to the clinical environment. However, if sustained, imitation may perpetuate undesirable practices, such as doctor-centered patient interviewing, and unintended institutional norms, such as discrimination between private and public patients. The author suggests that the value of role modeling can be advanced not only by targeting role models and improving faculty performance but also by enhancing students’ reflective assessment of their preceptors’ behaviors, especially so that they can better discern those that are worth imitating. This student-centered approach may be accomplished by first, warning students against uncritically imitating preceptors who are perceived as role models; second, showing students that their preceptors share their doubts and uncertainties; third, gaining an insight into possible undesirable messages of the learning environment; and finally, developing policies for faculty recruitment and promotion that consider whether a clinical preceptor is a role model. PMID:24556777

  16. Development of a decision support model for scheduling clinical studies and assigning medical personnel.

    PubMed

    Grunow, Martin; Günther, Hans-Otto; Yang, Gang

    2004-11-01

    Clinical studies for the development of new drugs in the pharmaceutical industry consist of a number of individual tasks which have to be carried out in a pre-defined chronological order. Each task requires certain types of medical personnel. This paper investigates the scheduling of clinical studies to be performed during a short-term planning horizon, the allocation of workforce between the studies, and the assignment of individual employees to tasks. Instead of developing a complex monolithic decision model, a hierarchical modelling approach is suggested. In the first stage, a compact integer optimization model is solved in order to determine the start-off times of the studies and the required staffing while taking the limited availability of personnel into account. The objective is to minimize total staffing costs. The assignment of individual employees to tasks is then made in the second stage of the procedure using a binary optimization model.

  17. Identification of a potential fibromyalgia diagnosis using random forest modeling applied to electronic medical records

    PubMed Central

    Emir, Birol; Masters, Elizabeth T; Mardekian, Jack; Clair, Andrew; Kuhn, Max; Silverman, Stuart L

    2015-01-01

    Background Diagnosis of fibromyalgia (FM), a chronic musculoskeletal condition characterized by widespread pain and a constellation of symptoms, remains challenging and is often delayed. Methods Random forest modeling of electronic medical records was used to identify variables that may facilitate earlier FM identification and diagnosis. Subjects aged ≥18 years with two or more listings of the International Classification of Diseases, Ninth Revision, (ICD-9) code for FM (ICD-9 729.1) ≥30 days apart during the 2012 calendar year were defined as cases among subjects associated with an integrated delivery network and who had one or more health care provider encounter in the Humedica database in calendar years 2011 and 2012. Controls were without the FM ICD-9 codes. Seventy-two demographic, clinical, and health care resource utilization variables were entered into a random forest model with downsampling to account for cohort imbalances (<1% subjects had FM). Importance of the top ten variables was ranked based on normalization to 100% for the variable with the largest loss in predicting performance by its omission from the model. Since random forest is a complex prediction method, a set of simple rules was derived to help understand what factors drive individual predictions. Results The ten variables identified by the model were: number of visits where laboratory/non-imaging diagnostic tests were ordered; number of outpatient visits excluding office visits; age; number of office visits; number of opioid prescriptions; number of medications prescribed; number of pain medications excluding opioids; number of medications administered/ordered; number of emergency room visits; and number of musculoskeletal conditions. A receiver operating characteristic curve confirmed the model’s predictive accuracy using an independent test set (area under the curve, 0.810). To enhance interpretability, nine rules were developed that could be used with good predictive probability of

  18. Cost-Effectiveness Analysis of Intensity Modulated Radiation Therapy Versus 3-Dimensional Conformal Radiation Therapy for Anal Cancer

    SciTech Connect

    Hodges, Joseph C.; Beg, Muhammad S.; Das, Prajnan; Meyer, Jeffrey

    2014-07-15

    Purpose: To compare the cost-effectiveness of intensity modulated radiation therapy (IMRT) and 3-dimensional conformal radiation therapy (3D-CRT) for anal cancer and determine disease, patient, and treatment parameters that influence the result. Methods and Materials: A Markov decision model was designed with the various disease states for the base case of a 65-year-old patient with anal cancer treated with either IMRT or 3D-CRT and concurrent chemotherapy. Health states accounting for rates of local failure, colostomy failure, treatment breaks, patient prognosis, acute and late toxicities, and the utility of toxicities were informed by existing literature and analyzed with deterministic and probabilistic sensitivity analysis. Results: In the base case, mean costs and quality-adjusted life expectancy in years (QALY) for IMRT and 3D-CRT were $32,291 (4.81) and $28,444 (4.78), respectively, resulting in an incremental cost-effectiveness ratio of $128,233/QALY for IMRT compared with 3D-CRT. Probabilistic sensitivity analysis found that IMRT was cost-effective in 22%, 47%, and 65% of iterations at willingness-to-pay thresholds of $50,000, $100,000, and $150,000 per QALY, respectively. Conclusions: In our base model, IMRT was a cost-ineffective strategy despite the reduced acute treatment toxicities and their associated costs of management. The model outcome was sensitive to variations in local and colostomy failure rates, as well as patient-reported utilities relating to acute toxicities.

  19. Medical cost-offset following treatment referral for alcohol and other drug use disorders in a group model HMO.

    PubMed

    Polen, Michael R; Freeborn, Donald K; Lynch, Frances L; Mullooly, John P; Dickinson, Daniel M

    2006-07-01

    The purpose of this study was to determine whether specialty alcohol and other drug (AOD) treatment is associated with reduced subsequent medical care costs. AOD treatment costs and medical costs in a group model health maintenance organization (HMO) were collected for up to 6 years on 1,472 HMO members who were recommended for specialty AOD treatment, and on 738 members without AOD diagnoses or treatment. Addiction Severity Index measures were also obtained from a sample of 293 of those recommended for treatment. Changes in medical costs did not differ between treatment and comparison groups. Nor did individuals with improved treatment outcomes have greater reductions in medical costs. AOD treatment costs were not inversely related to subsequent medical costs, except for a subgroup with recent AOD treatment. In the interviewed sample, better treatment outcomes did not predict lower subsequent medical costs. Multiple treatment episodes may hold promise for producing cost-offsets.

  20. Analysis of the technology acceptance model in examining hospital nurses' behavioral intentions toward the use of bar code medication administration.

    PubMed

    Song, Lunar; Park, Byeonghwa; Oh, Kyeung Mi

    2015-04-01

    Serious medication errors continue to exist in hospitals, even though there is technology that could potentially eliminate them such as bar code medication administration. Little is known about the degree to which the culture of patient safety is associated with behavioral intention to use bar code medication administration. Based on the Technology Acceptance Model, this study evaluated the relationships among patient safety culture and perceived usefulness and perceived ease of use, and behavioral intention to use bar code medication administration technology among nurses in hospitals. Cross-sectional surveys with a convenience sample of 163 nurses using bar code medication administration were conducted. Feedback and communication about errors had a positive impact in predicting perceived usefulness (β=.26, P<.01) and perceived ease of use (β=.22, P<.05). In a multiple regression model predicting for behavioral intention, age had a negative impact (β=-.17, P<.05); however, teamwork within hospital units (β=.20, P<.05) and perceived usefulness (β=.35, P<.01) both had a positive impact on behavioral intention. The overall bar code medication administration behavioral intention model explained 24% (P<.001) of the variance. Identified factors influencing bar code medication administration behavioral intention can help inform hospitals to develop tailored interventions for RNs to reduce medication administration errors and increase patient safety by using this technology.

  1. How to interpret the results of medical time series data analysis: Classical statistical approaches versus dynamic Bayesian network modeling

    PubMed Central

    Onisko, Agnieszka; Druzdzel, Marek J.; Austin, R. Marshall

    2016-01-01

    Background: Classical statistics is a well-established approach in the analysis of medical data. While the medical community seems to be familiar with the concept of a statistical analysis and its interpretation, the Bayesian approach, argued by many of its proponents to be superior to the classical frequentist approach, is still not well-recognized in the analysis of medical data. Aim: The goal of this study is to encourage data analysts to use the Bayesian approach, such as modeling with graphical probabilistic networks, as an insightful alternative to classical statistical analysis of medical data. Materials and Methods: This paper offers a comparison of two approaches to analysis of medical time series data: (1) classical statistical approach, such as the Kaplan–Meier estimator and the Cox proportional hazards regression model, and (2) dynamic Bayesian network modeling. Our comparison is based on time series cervical cancer screening data collected at Magee-Womens Hospital, University of Pittsburgh Medical Center over 10 years. Results: The main outcomes of our comparison are cervical cancer risk assessments produced by the three approaches. However, our analysis discusses also several aspects of the comparison, such as modeling assumptions, model building, dealing with incomplete data, individualized risk assessment, results interpretation, and model validation. Conclusion: Our study shows that the Bayesian approach is (1) much more flexible in terms of modeling effort, and (2) it offers an individualized risk assessment, which is more cumbersome for classical statistical approaches. PMID:28163973

  2. The Integrated Medical Model: A Risk Assessment and Decision Support Tool for Human Space Flight Missions

    NASA Technical Reports Server (NTRS)

    Kerstman, Eric L.; Minard, Charles; FreiredeCarvalho, Mary H.; Walton, Marlei E.; Myers, Jerry G., Jr.; Saile, Lynn G.; Lopez, Vilma; Butler, Douglas J.; Johnson-Throop, Kathy A.

    2011-01-01

    This slide presentation reviews the Integrated Medical Model (IMM) and its use as a risk assessment and decision support tool for human space flight missions. The IMM is an integrated, quantified, evidence-based decision support tool useful to NASA crew health and mission planners. It is intended to assist in optimizing crew health, safety and mission success within the constraints of the space flight environment for in-flight operations. It uses ISS data to assist in planning for the Exploration Program and it is not intended to assist in post flight research. The IMM was used to update Probability Risk Assessment (PRA) for the purpose of updating forecasts for the conditions requiring evacuation (EVAC) or Loss of Crew Life (LOC) for the ISS. The IMM validation approach includes comparison with actual events and involves both qualitative and quantitaive approaches. The results of these comparisons are reviewed. Another use of the IMM is to optimize the medical kits taking into consideration the specific mission and the crew profile. An example of the use of the IMM to optimize the medical kits is reviewed.

  3. MO-C-9A-01: Effective Medical Physics Educational Activities: Models and Methods

    SciTech Connect

    Sprawls, P

    2014-06-15

    Medical physics is learned in a combination of activities including classroom sessions, individual study, small-group collaborative problem solving, and direct experience in the laboratory or clinical environment. Each type of learning activity is characterized by its effectiveness in producing the desired knowledge for the learner and the cost in terms of resources and human effort required providing it. While learning and teaching is a human activity, modern technology provides a variety of tools that can be used to enhance human performance. The class or conference room is the common setting for educational sessions in both academic institutions and continuing education conferences and programs such as those sponsored by the AAPM. A major value of a class/conference room program is efficiency by bringing a group of learners together to share in a common learning experience under the guidance of one or more experienced learning facilitators (lecturers or presenters). A major challenge is that the class/conference room is separated from the real world of medical physics. The design of an educational activity needs to take into consideration the desired outcomes with respect to what the learners should be able to do. The distinction is that of being able to apply the knowledge to perform specific physics functions rather than just knowing and being able to recall facts, and perhaps do well on written examinations. These are different types of knowledge structures within the human brain and distinctly different learning activities to develop each. Much of medical physics education, especially at the post-graduate and continuing education level, is for the purpose of enhancing the ability of physicists and other related professionals to perform applied procedures and tasks and requires specific types of knowledge.In this session we will analyze various learning activity models, the values and limitations of each, and how they can be used in medical physics education

  4. Designing a model for critical thinking development in AJA University of Medical Sciences

    PubMed Central

    MAFAKHERI LALEH, MAHYAR; MOHAMMADIMEHR, MOJGAN; ZARGAR BALAYE JAME, SANAZ

    2016-01-01

    Introduction: In the new concept of medical education, creativity development is an important goal. The aim of this research was to identify a model for developing critical thinking among students with the special focus on learning environment and learning style. Methods: This applied and cross-sectional study was conducted among all students studying in undergraduate and professional doctorate programs in Fall Semester 2013-2014 in AJA University of Medical Sciences (N=777). The sample consisted of 257 students selected based on the proportional stratified random sampling method. To collect data, three questionnaires including Critical Thinking, Perception of Learning Environment and Learning Style were employed. The data were analyzed using Pearson's correlation statistical test, and one-sample t-test. The Structural Equation Model (SEM) was used to test the research model. SPSS software, version 14 and the LISREL software were used for data analysis. Results: The results showed that students had significantly assessed the teaching-learning environment and two components of "perception of teachers" and "perception of emotional-psychological climate" at the desirable level (p<0.05). Also learning style and two components of "the study method" and "motivation for studying" were considered significantly desirable (p<0.05). The level of critical thinking among students in terms of components of "commitment", "creativity" and "cognitive maturity" was at the relatively desirable level (p<0.05). In addition, perception of the learning environment can impact the critical thinking through learning style. Conclusion: One of the factors which can significantly impact the quality improvement of the teaching and learning process in AJA University of Medical Sciences is to develop critical thinking among learners. This issue requires providing the proper situation for teaching and learning critical thinking in the educational environment. PMID:27795968

  5. Effects of Non-Uniform Wall Heating on Thermal and Momentum Fields in a 3-Dimensional Urban Environment

    NASA Astrophysics Data System (ADS)

    Nazarian, N.; Kleissl, J. P.

    2014-12-01

    As urbanization progresses, microclimate modifications are also aggravated and the increasing environmental concerns call for more sophisticated methods of urban microclimate analysis. Comprehensive numerical simulations for a clear summer day in southern California are performed in a compact low-rise urban environment. The effect of realistic unsteady, non-uniform thermal forcing, that is caused by solar insolation and inter-building shadowing on thermal and flow conditions are analyzed based on Algebraic Wall-Modeled Large Eddy Simulation (LES) model. The urban thermal field is influenced by urban density, material properties and local weather conditions, as well as urban canyon flow. Urban canyon conditions are translated into vertical and horizontal bulk Richardson numbers indicating atmospheric instability and solar tilt with respect to the momentum forcing of the canyon vortex, respectively. The effect of roof heating is found to be critical on the vortex formation between buildings when the vertical bulk Richardson number is low. Variations of Convective Heat Transfer Coefficients (CHTCs) along building walls are studied and the street canyon ventilation performance is characterized by the mean of air exchange rate (ACH). It is found that volumetric air exchange from street canyons, as well as the distribution of heat transfer along the wall depends strongly on the three-dimensional orientation of the heated wall in relation to wind direction. For example, air removal increases by surface heating and is larger when the leeward wall is heated. In summary, we demonstrate the importance of considering complex realistic conditions on 3-dimensional thermal and momentum fields in Urban Environments.

  6. Modeling and Encoding Clinical Causal Relationships in a Medical Knowledge Base

    PubMed Central

    Blum, Robert L.

    1983-01-01

    This paper presents a method for the computer modeling and encoding of clinical causal relationships (CR's). This method draws on the theory of multivariate linear models and path analysis. The representation was used to encode medical CR's derived empirically from a clinical database by the RX computer project described in SCAMC82. The emphasis in the representation is on capturing the intensities of effects and the variation in the effects across a patient population. This information is used by RX in determining the validity of other CR's. The representation uses a directed graph formalism in which the nodes are frames and the arcs contain seven descriptive features of individual CR's: intensity, distribution, direction, mathematical form, setting, validity, and evidence. Because natural systems (such as the human body) are inherently probabilistic, linear models are useful in representing causal flow in them.

  7. Heterogeneous modeling of medical image data using B-spline functions.

    PubMed

    Grove, Olya; Rajab, Khairan; Les Piegl, A

    2012-10-01

    Biomedical data visualization and modeling rely predominately on manual processing and utilization of voxel- and facet-based homogeneous models. Biological structures are naturally heterogeneous and it is important to incorporate properties, such as material composition, size and shape, into the modeling process. A method to approximate image density data with a continuous B-spline surface is presented. The proposed approach generates a density point cloud, based on medical image data to reproduce heterogeneity across the image, through point densities. The density point cloud is ordered and approximated with a set of B-spline curves. A B-spline surface is lofted through the cross-sectional B-spline curves preserving the heterogeneity of the point cloud dataset. Preliminary results indicate that the proposed methodology produces a mathematical representation capable of capturing and preserving density variations with high fidelity.

  8. Automated image analysis reveals the dynamic 3-dimensional organization of multi-ciliary arrays.

    PubMed

    Galati, Domenico F; Abuin, David S; Tauber, Gabriel A; Pham, Andrew T; Pearson, Chad G

    2015-12-23

    Multi-ciliated cells (MCCs) use polarized fields of undulating cilia (ciliary array) to produce fluid flow that is essential for many biological processes. Cilia are positioned by microtubule scaffolds called basal bodies (BBs) that are arranged within a spatially complex 3-dimensional geometry (3D). Here, we develop a robust and automated computational image analysis routine to quantify 3D BB organization in the ciliate, Tetrahymena thermophila. Using this routine, we generate the first morphologically constrained 3D reconstructions of Tetrahymena cells and elucidate rules that govern the kinetics of MCC organization. We demonstrate the interplay between BB duplication and cell size expansion through the cell cycle. In mutant cells, we identify a potential BB surveillance mechanism that balances large gaps in BB spacing by increasing the frequency of closely spaced BBs in other regions of the cell. Finally, by taking advantage of a mutant predisposed to BB disorganization, we locate the spatial domains that are most prone to disorganization by environmental stimuli. Collectively, our analyses reveal the importance of quantitative image analysis to understand the principles that guide the 3D organization of MCCs.

  9. The Effect of Asymmetric flow on the 3-Dimensional Symmetric Bogus Vortex

    NASA Astrophysics Data System (ADS)

    LEE, J.; Cheong, H.; Hwang, J.

    2013-12-01

    The effect of asymmetric flow on the 3-dimensional symmetric bogus vortex called as Structure Adjustable Balanced Vortex (SABV) is investigated for 9 tropical cyclones (TCs) observed in Northwest Pacific. NCEP global reanalysis data were used as initial condition, and the high order spectral filter (HSF) were employed to separate asymmetric flow from disturbance flow as following: The first step is that the global field is decomposed into environment and disturbance field. And secondly, the disturbance field is transformed into cylindrical coordinates, and the Fourier transform is applied to the transformed data along the azimuth. Lastly, the inverse Fourier transform is carried out except for wavenumber (WN) 0 component, and it is added to SABV. To investigate the effect of asymmetric flow on the SABV, the Weather Research and Forecasting (WRF) V3.2.1 was employed, which was set to have a single domain with 12 km resolution and YSU, WSM 6 and Kain-Fritsch schemes are used. With these methods, it was found that the track error at 48 h and 72 h was improved by about 13% and 16%, respectively, implying the asymmetric flow should be added to SABV for better performance.

  10. Vaginal High Pressure Zone Assessed by Dynamic 3-Dimensional Ultrasound Images of the Pelvic Floor

    PubMed Central

    JUNG, Sung-Ae; PRETORIUS, Dolores H.; PADDA, Bikram S.; WEINSTEIN, Milena M.; NAGER, Charles W.; den BOER, Derkina J.; MITTAL, Ravinder K.

    2009-01-01

    Objective To study the shape and characteristics of the vaginal high pressure zone (HPZ) by imaging a compliant fluid-filled bag placed in the vaginal HPZ with the 3-dimensional ultrasound (3D US) system. Study Design Nine nulliparous asymptomatic women underwent 3D US imaging and vaginal pressure measurements. A compliant bag was placed in the vagina and filled with various volumes of water. 3D US volumes of the pelvic floor were obtained at each bag volume while the subjects were at rest and during pelvic floor contraction. Results At low volumes, the bag was collapsed for a longitudinal extent of approximately 3.3 ± 0.2 cm (length of vaginal HPZ). With increasing bag volume, there was opening of the vaginal HPZ in the lateral dimension before the anterior-posterior (AP) dimension. Pelvic floor contraction produced a decrease in the AP dimension but not the lateral dimension of the bag in the region of the vaginal HPZ. Conclusion We propose that the shape and characteristics of the vaginal HPZ are consistent with the hypothesis that the puborectalis muscle is responsible for the genesis of the vaginal HPZ. PMID:17618755

  11. Inter-surface interactions in a 3-dimensional topological insulator : Bi2Se3 thin film

    NASA Astrophysics Data System (ADS)

    Jin, Hosub; Song, Jung-Hwan; Freeman, Arthur

    2010-03-01

    Recently much attention has focused on 3-dimensional strong topological insulators as a new quantum state of matter, such as Bi2Se3 and Bi2Te3. One of their intriguing features is a topologically protected surface state whose quasiparticle dispersion shows a Dirac cone. Due to lack of backscattering and robustness against disorder and interaction, surface states have the potential to be perfect conducting channels which carry not only charge but also spin currents. Here, we present a theoretical study of electronic structures and surfaces of thin film Bi2Se3 using the highly precise FLAPW methodfootnotetext Wimmer, Krakauer, Weinert, Freeman, Phys. Rev. B, 24, 864 (1981). Our calculated results focus on the interaction between surface states on opposing sides of the slab. The gap opening from the inter-surface interaction can be easily explained by simple symmetry arguments considering both time-reversal and spatial inversion. For a 6 quintuple layer slab (˜6 nm), a 1.06 meV gap at the γ point survives due to the inter-surface interactions, and we discuss how to preserve the massless excitations despite this inter-surface interaction.

  12. Polarization-independent efficiency enhancement of organic solar cells by using 3-dimensional plasmonic electrode

    NASA Astrophysics Data System (ADS)

    Li, Xuanhua; Choy, Wallace C. H.; Ren, Xingang; Xin, Jianzhuo; Lin, Peng; Leung, Dennis C. W.

    2013-04-01

    Plasmonic back reflectors have recently become a promising strategy for realizing efficient organic solar cell (OSCs). Since plasmonic effects are strongly sensitive to light polarization, it is highly desirable to simultaneously achieve polarization-independent response and enhanced power conversion efficiency (PCE) by designing the nanostructured geometry of plasmonic reflector electrode. Here, through a strategic analysis of 2-dimensional grating (2D) and 3-dimensional patterns (3D), with similar periodicity as a plasmonic back reflector, we find that the OSCs with 3D pattern achieve the best PCE enhancement by 24.6%, while the OSCs with 2D pattern can offer 17.5% PCE enhancement compared to the optimized control OSCs. Importantly, compared with the 2D pattern, the 3D pattern shows a polarization independent plasmonic response, which will greatly extend its uses in photovoltaic applications. This work shows the significances of carefully selecting and designing geometry of plasmonic nanostructures in achieving high-efficient, polarization-independent plasmonic OSCs.

  13. Embedding and publishing interactive, 3-dimensional, scientific figures in Portable Document Format (PDF) files.

    PubMed

    Barnes, David G; Vidiassov, Michail; Ruthensteiner, Bernhard; Fluke, Christopher J; Quayle, Michelle R; McHenry, Colin R

    2013-01-01

    With the latest release of the S2PLOT graphics library, embedding interactive, 3-dimensional (3-d) scientific figures in Adobe Portable Document Format (PDF) files is simple, and can be accomplished without commercial software. In this paper, we motivate the need for embedding 3-d figures in scholarly articles. We explain how 3-d figures can be created using the S2PLOT graphics library, exported to Product Representation Compact (PRC) format, and included as fully interactive, 3-d figures in PDF files using the movie15 LaTeX package. We present new examples of 3-d PDF figures, explain how they have been made, validate them, and comment on their advantages over traditional, static 2-dimensional (2-d) figures. With the judicious use of 3-d rather than 2-d figures, scientists can now publish, share and archive more useful, flexible and faithful representations of their study outcomes. The article you are reading does not have embedded 3-d figures. The full paper, with embedded 3-d figures, is recommended and is available as a supplementary download from PLoS ONE (File S2).

  14. Automated image analysis reveals the dynamic 3-dimensional organization of multi-ciliary arrays

    PubMed Central

    Galati, Domenico F.; Abuin, David S.; Tauber, Gabriel A.; Pham, Andrew T.; Pearson, Chad G.

    2016-01-01

    ABSTRACT Multi-ciliated cells (MCCs) use polarized fields of undulating cilia (ciliary array) to produce fluid flow that is essential for many biological processes. Cilia are positioned by microtubule scaffolds called basal bodies (BBs) that are arranged within a spatially complex 3-dimensional geometry (3D). Here, we develop a robust and automated computational image analysis routine to quantify 3D BB organization in the ciliate, Tetrahymena thermophila. Using this routine, we generate the first morphologically constrained 3D reconstructions of Tetrahymena cells and elucidate rules that govern the kinetics of MCC organization. We demonstrate the interplay between BB duplication and cell size expansion through the cell cycle. In mutant cells, we identify a potential BB surveillance mechanism that balances large gaps in BB spacing by increasing the frequency of closely spaced BBs in other regions of the cell. Finally, by taking advantage of a mutant predisposed to BB disorganization, we locate the spatial domains that are most prone to disorganization by environmental stimuli. Collectively, our analyses reveal the importance of quantitative image analysis to understand the principles that guide the 3D organization of MCCs. PMID:26700722

  15. Cerebral Degeneration in Amyotrophic Lateral Sclerosis Revealed by 3-Dimensional Texture Analysis

    PubMed Central

    Maani, Rouzbeh; Yang, Yee-Hong; Emery, Derek; Kalra, Sanjay

    2016-01-01

    Introduction: Routine MR images do not consistently reveal pathological changes in the brain in ALS. Texture analysis, a method to quantitate voxel intensities and their patterns and interrelationships, can detect changes in images not apparent to the naked eye. Our objective was to evaluate cerebral degeneration in ALS using 3-dimensional texture analysis of MR images of the brain. Methods: In a case-control design, voxel-based texture analysis was performed on T1-weighted MR images of 20 healthy subjects and 19 patients with ALS. Four texture features, namely, autocorrelation, sum of squares variance, sum average, and sum variance were computed. Texture features were compared between the groups by statistical parametric mapping and correlated with clinical measures of disability and upper motor neuron dysfunction. Results: Texture features were different in ALS in motor regions including the precentral gyrus and corticospinal tracts. To a lesser extent, changes were also found in the thalamus, cingulate gyrus, and temporal lobe. Texture features in the precentral gyrus correlated with disease duration, and in the corticospinal tract they correlated with finger tapping speed. Conclusions: Changes in MR image textures are present in motor and non-motor regions in ALS and correlate with clinical features. Whole brain texture analysis has potential in providing biomarkers of cerebral degeneration in ALS. PMID:27064416

  16. Embedding and Publishing Interactive, 3-Dimensional, Scientific Figures in Portable Document Format (PDF) Files

    PubMed Central

    Barnes, David G.; Vidiassov, Michail; Ruthensteiner, Bernhard; Fluke, Christopher J.; Quayle, Michelle R.; McHenry, Colin R.

    2013-01-01

    With the latest release of the S2PLOT graphics library, embedding interactive, 3-dimensional (3-d) scientific figures in Adobe Portable Document Format (PDF) files is simple, and can be accomplished without commercial software. In this paper, we motivate the need for embedding 3-d figures in scholarly articles. We explain how 3-d figures can be created using the S2PLOT graphics library, exported to Product Representation Compact (PRC) format, and included as fully interactive, 3-d figures in PDF files using the movie15 LaTeX package. We present new examples of 3-d PDF figures, explain how they have been made, validate them, and comment on their advantages over traditional, static 2-dimensional (2-d) figures. With the judicious use of 3-d rather than 2-d figures, scientists can now publish, share and archive more useful, flexible and faithful representations of their study outcomes. The article you are reading does not have embedded 3-d figures. The full paper, with embedded 3-d figures, is recommended and is available as a supplementary download from PLoS ONE (File S2). PMID:24086243

  17. 3-Dimensional analysis for class III malocclusion patients with facial asymmetry

    PubMed Central

    Ki, Eun-Jung; Cheon, Hae-Myung; Choi, Eun-Joo; Kwon, Kyung-Hwan

    2013-01-01

    Objectives The aim of this study is to investigate the correlation between 2-dimensional (2D) cephalometric measurement and 3-dimensional (3D) cone beam computed tomography (CBCT) measurement, and to evaluate the availability of 3D analysis for asymmetry patients. Materials and Methods A total of Twenty-seven patients were evaluated for facial asymmetry by photograph and cephalometric radiograph, and CBCT. The 14 measurements values were evaluated and those for 2D and 3D were compared. The patients were classified into two groups. Patients in group 1 were evaluated for symmetry in the middle 1/3 of the face and asymmetry in the lower 1/3 of the face, and those in group 2 for asymmetry of both the middle and lower 1/3 of the face. Results In group 1, significant differences were observed in nine values out of 14 values. Values included three from anteroposterior cephalometric radiograph measurement values (cant and both body height) and six from lateral cephalometric radiographs (both ramus length, both lateral ramal inclination, and both gonial angles). In group 2, comparison between 2D and 3D showed significant difference in 10 factors. Values included four from anteroposterior cephalometric radiograph measurement values (both maxillary height, both body height) and six from lateral cephalometric radiographs (both ramus length, both lateral ramal inclination, and both gonial angles). Conclusion Information from 2D analysis was inaccurate in several measurements. Therefore, in asymmetry patients, 3D analysis is useful in diagnosis of asymmetry. PMID:24471038

  18. Casting of 3-dimensional footwear prints in snow with foam blocks.

    PubMed

    Petraco, Nicholas; Sherman, Hal; Dumitra, Aurora; Roberts, Marcel

    2016-06-01

    Commercially available foam blocks are presented as an alternative material for the casting and preservation of 3-dimensional footwear impressions located in snow. The method generates highly detailed foam casts of questioned footwear impressions. These casts can be compared to the known outsole standards made from the suspects' footwear. Modification of the commercially available foam casting blocks is simple and fast. The foam block is removed and a piece of cardboard is secured to one side of the block with painter's masking tape. The prepared foam block is then placed back into its original box, marked appropriately, closed and stored until needed. When required the foam block is carefully removed from its storage box and gently placed, foam side down, over the questioned footwear impression. Next, the crime scene technician's hands are placed on top of the cardboard and pressure is gently applied by firmly pressing down onto the impression. The foam cast is removed, dried and placed back into its original container and sealed. The resulting 3D impressions can be directly compared to the outsole of known suspected item(s) of footwear.

  19. 3-dimensional (orthogonal) structural complexity of time-series data using low-order moment analysis

    NASA Astrophysics Data System (ADS)

    Law, Victor J.; O'Neill, Feidhlim T.; Dowling, Denis P.

    2012-09-01

    The recording of atmospheric pressure plasmas (APP) electro-acoustic emission data has been developed as a plasma metrology tool in the last couple of years. The industrial applications include automotive and aerospace industry for surface activation of polymers prior to bonding [1, 2, and 3]. It has been shown that as the APP jets proceeds over a treatment surface, at a various fixed heights, two contrasting acoustic signatures are produced which correspond to two very different plasma-surface entropy states (blow arc ˜ 1700 ± 100 K; and; afterglow ˜ 300-400 K) [4]. The metrology challenge is now to capture deterministic data points within data clusters. For this to be achieved new real-time data cluster measurement techniques needs to be developed [5]. The cluster information must be extracted within the allotted process time period if real-time process control is to be achieved. This abstract describes a theoretical structural complexity analysis (in terms crossing points) of 2 and 3-dimentional line-graphs that contain time-series data. In addition LabVIEW implementation of the 3-dimensional data analysis is performed. It is also shown the cluster analysis technique can be transfer to other (non-acoustic) datasets.

  20. Cellulose acetate based 3-dimensional electrospun scaffolds for skin tissue engineering applications.

    PubMed

    Atila, Deniz; Keskin, Dilek; Tezcaner, Ayşen

    2015-11-20

    Skin defects that are not able to regenerate by themselves are among the major problems faced. Tissue engineering approach holds promise for treating such defects. Development of tissue-mimicking-scaffolds that can promote healing process receives an increasing interest in recent years. In this study, 3-dimensional electrospun cellulose acetate (CA) pullulan (PULL) scaffolds were developed for the first time. PULL was intentionally used to obtain 3D structures with adjustable height. It was removed from the electrospun mesh to increase the porosity and biostability. Different ratios of the polymers were electrospun and analyzed with respect to degradation, porosity, and mechanical properties. It has been observed that fiber diameter, thickness and porosity of scaffolds increased with increased PULL content, on the other hand this resulted with higher degradation of scaffolds. Mechanical strength of scaffolds was improved after PULL removal suggesting their suitability as cell carriers. Cell culture studies were performed with the selected scaffold group (CA/PULL: 50/50) using mouse fibroblastic cell line (L929). In vitro cell culture tests showed that cells adhered, proliferated and populated CA/PULL (50/50) scaffolds showing that they are cytocompatible. Results suggest that uncrosslinked CA/PULL (50/50) electrospun scaffolds hold potential for skin tissue engineering applications.

  1. Model-based labeling, analysis, and three-dimensional visualization from two-dimensional medical images

    NASA Astrophysics Data System (ADS)

    Arata, Louis K.; Dhawan, Atam P.; Thomas, Stephen R.

    1991-07-01

    The computerized analysis and interpretation of three-dimensional medical images is of significant interest for diagnosis as well as for studying pathological processes. Knowledge-based image analysis and interpretation of radiological images can provide a tool for identifying and labeling each part of the image. The authors have developed a knowledge-based biomedical image analysis system for interpreting medical images using an anatomical knowledge base of the appropriate organs. In this paper, the structure of the biomedical image analysis system, along with results from the analysis of images of the human chest cavity, are presented. This approach utilizes an image analysis system with the capability of analyzing the data in both bottom-up (or data driven) and top-down (or model driven) modes to improve the recognition process. After an initial identification is achieved, segmented regions are aggregated and features for these aggregates are recomputed and matched to the model. This process continues until a 'best' match is found for the subject model region. Initial results are encouraging; however, much work remains to be done.

  2. Technologies in the patient-centered medical home: examining the model from an enterprise perspective.

    PubMed

    Hughes, Cortney L; Marshall, Capt Robert; Murphy, Edward; Mun, Seong K

    2011-01-01

    Fee-for-service reimbursement has fragmented the healthcare system. Providers are paid based on the number of services rendered instead of quality, leading to the cost of care rising at a faster rate than its value. One approach to counter this is the Patient-Centered Medical Home (PCMH), a primary care model that emphasizes team-based medicine, a partnership between patients and providers, and expanded access and communication. The transition to PCMH is facilitated by innovative technologies, such as telemedicine for additional services, electronic medical records to document patients' health needs, and online portals for electronic visits and communication between patients and providers. Implementing these technologies involves tremendous investment of funds and time from practices and healthcare organizations. Although PCMH does not require such technologies, they facilitate its success, as care coordination and population management necessitated by the model are difficult to do without. This article argues that there is a paradox in PCMH and technology is at its center. Although PCMH intends to be cost effective by reducing hospital admissions and ER visits through providing better preventative services, it is actually a financial risk due to the very real upfront costs of implementing and sustaining technologies needed to carry out the intent of the PCMH model, which may not be made up immediately, if ever. This article delves into the rationale behind why payers, providers, and patients have adopted PCMH regardless of this risk and in doing so, maps out the roles that innovative technologies play in the conversion to PCMH.

  3. Migration of plasticizers from PVC medical devices: Development of an infusion model.

    PubMed

    Bernard, L; Cueff, R; Chagnon, Mc; Abdoulouhab, F; Décaudin, B; Breysse, C; Kauffmann, S; Cosserant, B; Souweine, B; Sautou, V

    2015-10-15

    Alternatives to DEHP plasticizers are used in various PVC medical devices (MD) for infusion. As they are able to migrate from these MDs into infused solutions, they may come into contact with patient. Different and specific clinical parameters influence their migration in at-risk situations such as infusion. In contrast to the regulations for Food Contact Materials (MCDA), there is currently no acceptable migration limits for the use of these plasticizers in clinical situations. In order to assess their migration, and thus control the risks linked to these MDs, we developed a migration model for the plasticizers in MDs. To this end, we applied a cross-disciplinary methodological process similar to that used in the food-processing industry, taking into account the MDs' conditions of use in clinical practice. The simulation model is simple and includes the following conditions: MD should be tested with a dynamic method that respects our established clinical assumption (2 L of infused solutions via 13 dm(2) of plasticized PVC), at a temperature of 25 °C and during 24 h of contact, using a 50/50 (v/v) ethanol/water simulant. This model could be proposed as a tool for the safety evaluation of the patients' exposure risk to plasticizers from PVC medical devices for infusions.

  4. Regoaling: a conceptual model of how parents of children with serious illness change medical care goals

    PubMed Central

    2014-01-01

    Background Parents of seriously ill children participate in making difficult medical decisions for their child. In some cases, parents face situations where their initial goals, such as curing the condition, may have become exceedingly unlikely. While some parents continue to pursue these goals, others relinquish their initial goals and generate new goals such as maintaining the child’s quality of life. We call this process of transitioning from one set of goals to another regoaling. Discussion Regoaling involves factors that either promote or inhibit the regoaling process, including disengagement from goals, reengagement in new goals, positive and negative affect, and hopeful thinking. We examine these factors in the context of parental decision making for a seriously ill child, presenting a dynamic conceptual model of regoaling. This model highlights four research questions that will be empirically tested in an ongoing longitudinal study of medical decision making among parents of children with serious illness. Additionally, we consider potential clinical implications of regoaling for the practice of pediatric palliative care. Summary The psychosocial model of regoaling by parents of children with a serious illness predicts that parents who experience both positive and negative affect and hopeful patterns of thought will be more likely to relinquish one set of goals and pursue a new set of goals. A greater understanding of how parents undergo this transition may enable clinicians to better support them through this difficult process. PMID:24625345

  5. Integration of soft tissue model and open haptic device for medical training simulator

    NASA Astrophysics Data System (ADS)

    Akasum, G. F.; Ramdhania, L. N.; Suprijanto; Widyotriatmo, A.

    2016-03-01

    Minimally Invasive Surgery (MIS) has been widely used to perform any surgical procedures nowadays. Currently, MIS has been applied in some cases in Indonesia. Needle insertion is one of simple MIS procedure that can be used for some purposes. Before the needle insertion technique used in the real situation, it essential to train this type of medical student skills. The research has developed an open platform of needle insertion simulator with haptic feedback that providing the medical student a realistic feel encountered during the actual procedures. There are three main steps in build the training simulator, which are configure hardware system, develop a program to create soft tissue model and the integration of hardware and software. For evaluating its performance, haptic simulator was tested by 24 volunteers on a scenario of soft tissue model. Each volunteer must insert the needle on simulator until rearch the target point with visual feedback that visualized on the monitor. From the result it can concluded that the soft tissue model can bring the sensation of touch through the perceived force feedback on haptic actuator by looking at the different force in accordance with different stiffness in each layer.

  6. Future Directions in Medical Physics: Models, Technology, and Translation to Medicine

    NASA Astrophysics Data System (ADS)

    Siewerdsen, Jeffrey

    The application of physics in medicine has been integral to major advances in diagnostic and therapeutic medicine. Two primary areas represent the mainstay of medical physics research in the last century: in radiation therapy, physicists have propelled advances in conformal radiation treatment and high-precision image guidance; and in diagnostic imaging, physicists have advanced an arsenal of multi-modality imaging that includes CT, MRI, ultrasound, and PET as indispensible tools for noninvasive screening, diagnosis, and assessment of treatment response. In addition to their role in building such technologically rich fields of medicine, physicists have also become integral to daily clinical practice in these areas. The future suggests new opportunities for multi-disciplinary research bridging physics, biology, engineering, and computer science, and collaboration in medical physics carries a strong capacity for identification of significant clinical needs, access to clinical data, and translation of technologies to clinical studies. In radiation therapy, for example, the extraction of knowledge from large datasets on treatment delivery, image-based phenotypes, genomic profile, and treatment outcome will require innovation in computational modeling and connection with medical physics for the curation of large datasets. Similarly in imaging physics, the demand for new imaging technology capable of measuring physical and biological processes over orders of magnitude in scale (from molecules to whole organ systems) and exploiting new contrast mechanisms for greater sensitivity to molecular agents and subtle functional / morphological change will benefit from multi-disciplinary collaboration in physics, biology, and engineering. Also in surgery and interventional radiology, where needs for increased precision and patient safety meet constraints in cost and workflow, development of new technologies for imaging, image registration, and robotic assistance can leverage

  7. Integrated Medical Model (IMM) Optimization Version 4.0 Functional Improvements

    NASA Technical Reports Server (NTRS)

    Arellano, John; Young, M.; Boley, L.; Garcia, Y.; Saile, L.; Walton, M.; Kerstman, E.; Reyes, D.; Goodenow, D. A.; Myers, J. G.

    2016-01-01

    The IMMs ability to assess mission outcome risk levels relative to available resources provides a unique capability to provide guidance on optimal operational medical kit and vehicle resources. Post-processing optimization allows IMM to optimize essential resources to improve a specific model outcome such as maximization of the Crew Health Index (CHI), or minimization of the probability of evacuation (EVAC) or the loss of crew life (LOCL). Mass and or volume constrain the optimized resource set. The IMMs probabilistic simulation uses input data on one hundred medical conditions to simulate medical events that may occur in spaceflight, the resources required to treat those events, and the resulting impact to the mission based on specific crew and mission characteristics. Because IMM version 4.0 provides for partial treatment for medical events, IMM Optimization 4.0 scores resources at the individual resource unit increment level as opposed to the full condition-specific treatment set level, as done in version 3.0. This allows the inclusion of as many resources as possible in the event that an entire set of resources called out for treatment cannot satisfy the constraints. IMM Optimization version 4.0 adds capabilities that increase efficiency by creating multiple resource sets based on differing constraints and priorities, CHI, EVAC, or LOCL. It also provides sets of resources that improve mission-related IMM v4.0 outputs with improved performance compared to the prior optimization. The new optimization represents much improved fidelity that will improve the utility of the IMM 4.0 for decision support.

  8. Modelling Estimates of Norovirus Disease in Patients with Chronic Medical Conditions

    PubMed Central

    Verstraeten, Thomas; Jiang, Baoguo; Weil, John G.; Lin, Jennifer H.

    2016-01-01

    Background The burden of disease due to norovirus infection has been well described in the general United States population, but studies of norovirus occurrence among persons with chronic medical conditions have been limited mostly to the immunocompromised. We assessed the impact of norovirus gastroenteritis on health care utilization in US subjects with a range of chronic medical conditions. Methods We performed a retrospective cohort study using MarketScan data from July 2002 to December 2013, comparing the rates of emergency department visits, outpatient visits and hospitalizations among patients with chronic conditions (renal, cardiovascular, respiratory, immunocompromising, gastrointestinal, hepatic/pancreatic and neurological conditions and diabetes) with those in a healthy population. We estimated the rates of these outcomes due to norovirus gastroenteritis using an indirect modelling approach whereby cases of gastroenteritis of unknown cause and not attributed to a range of other causes were assumed to be due to norovirus. Results Hospitalization rates for norovirus gastroenteritis were higher in all of the risk groups analyzed compared with data in otherwise healthy subjects, ranging from 3.2 per 10,000 person-years in persons with chronic respiratory conditions, to 23.1 per 10,000 person-years in persons with chronic renal conditions, compared to 2.1 per 10,000 among persons without chronic conditions. Over 51% of all norovirus hospitalizations occurred in the 37% of the population with some form of chronic medical condition. Outpatient visits for norovirus gastroenteritis were also increased in persons with chronic gastrointestinal or immunocompromising conditions. Conclusion Norovirus gastroenteritis leads to significantly higher rates of healthcare utilization in patients with a chronic medical condition compared to patients without any such condition. PMID:27438335

  9. Medical anthropology and Ebola in Congo: cultural models and humanistic care.

    PubMed

    Hewlett, B S; Epelboin, A; Hewlett, B L; Formenty, P

    2005-09-01

    Seldom have medical anthropologists been involved in efforts to control high mortality diseases such as Ebola hemorrhagic fever (EHF) This paper describes the results of two distinct but complementary interventions during the first phases of an outbreak in the Republic of Congo in 2003. The first approach emphasized understanding local peoples cultural models and political-economic explanations for the disease while the second approach focused on providing more humanitarian care of patients by identifying and incorporating local beliefs and practices into patient care and response efforts.

  10. Intelligent Physiologic Modeling: An Application of Knowledge Based Systems Technology to Medical Education

    PubMed Central

    Kunstaetter, Robert

    1986-01-01

    This presentation describes the design and implementation of a knowledge based physiologic modeling system (KBPMS) and a preliminary evaluation of its use as a learning resource within the context of an experimental medical curriculum -- the Harvard New Pathway. KBPMS possesses combined numeric and qualitative simulation capabilities and can provide explanations of its knowledge and behaviour. It has been implemented on a microcomputer with a user interface incorporating interactive graphics. The preliminary evaluation of KBPMS is based on anecdotal data which suggests that the system might have pedagogic potential. Much work remains to be done in enhancing and further evaluating KBPMS.

  11. Development of Antipsychotic Medications with Novel Mechanisms of Action Based on Computational Modeling of Hippocampal Neuropathology

    PubMed Central

    Siekmeier, Peter J.; vanMaanen, David P.

    2013-01-01

    A large number of cellular level abnormalities have been identified in the hippocampus of schizophrenic subjects. Nonetheless, it remains uncertain how these pathologies interact at a system level to create clinical symptoms, and this has hindered the development of more effective antipsychotic medications. Using a 72-processor supercomputer, we created a tissue level hippocampal simulation, featuring multicompartmental neuron models with multiple ion channel subtypes and synaptic channels with realistic temporal dynamics. As an index of the schizophrenic phenotype, we used the specific inability of the model to attune to 40 Hz (gamma band) stimulation, a well-characterized abnormality in schizophrenia. We examined several possible combinations of putatively schizophrenogenic cellular lesions by systematically varying model parameters representing NMDA channel function, dendritic spine density, and GABA system integrity, conducting 910 trials in total. Two discrete “clusters” of neuropathological changes were identified. The most robust was characterized by co-occurring modest reductions in NMDA system function (-30%) and dendritic spine density (-30%). Another set of lesions had greater NMDA hypofunction along with low level GABA system dysregulation. To the schizophrenic model, we applied the effects of 1,500 virtual medications, which were implemented by varying five model parameters, independently, in a graded manner; the effects of known drugs were also applied. The simulation accurately distinguished agents that are known to lack clinical efficacy, and identified novel mechanisms (e.g., decrease in AMPA conductance decay time constant, increase in projection strength of calretinin-positive interneurons) and combinations of mechanisms that could re-equilibrate model behavior. These findings shed light on the mechanistic links between schizophrenic neuropathology and the gamma band oscillatory abnormalities observed in the illness. As such, they generate

  12. Complete optical stack modeling for CMOS-based medical x-ray detectors

    NASA Astrophysics Data System (ADS)

    Zyazin, Alexander S.; Peters, Inge M.

    2015-03-01

    We have developed a simulation tool for modeling the performance of CMOS-based medical x-ray detectors, based on the Monte Carlo toolkit GEANT4. Following the Fujita-Lubberts-Swank approach recently reported by Star-Lack et al., we calculate modulation transfer function MTF(f), noise power spectrum NPS(f) and detective quantum efficiency DQE(f) curves. The complete optical stack is modeled, including scintillator, fiber optic plate (FOP), optical adhesive and CMOS image sensor. For critical parts of the stack, detailed models have been developed, taking into account their respective microstructure. This includes two different scintillator types: Gd2O2S:Tb (GOS) and CsI:Tl. The granular structure of the former is modeled using anisotropic Mie scattering. The columnar structure of the latter is introduced into calculations directly, using the parameterization capabilities of GEANT4. The underlying homogeneous CsI layer is also incorporated into the model as well as the optional reflective layer on top of the scintillator screen or the protective polymer top coat. The FOP is modeled as an array of hexagonal bundles of fibers. The simulated CMOS stack consists of layers of Si3N4 and SiO2 on top of a silicon pixel array. The model is validated against measurements of various test detector structures, using different x-ray spectra (RQA5 and RQA-M2), showing good match between calculated and measured MTF(f) and DQE(f) curves.

  13. [Usability first. Model-based approach for the use-oriented risk analysis of medical devices].

    PubMed

    Janß, A; Radermacher, K

    2014-12-01

    Due to increasing automation, the number and complexity of technical components have increased in the medical context (e.g., in the clinic or in the home care sector) in recent years. Besides new effective and efficient therapeutic and diagnostic options, these devices entail a wide range of functions and very complex (often computer-based) user interfaces that may lead to human-induced risk potential. A systematic and early human risk analysis and a usability evaluation allow medical device manufacturers to identify and control risks within the human-machine interaction very efficiently. At the Department of Medical Engineering in the Helmholtz Institute for Biomedical Engineering at the RWTH Aachen University, a formal-analytical methodology and a corresponding software tool for prospective human-risk analysis and model-based usability evaluation has been developed. Based on a twofold approach, user interactive process sequences and their potential impacts on the overall process are identified and the resulting use-related risks are assessed. For this, the tasks are categorized (in system and user tasks) and modeled and temporally related within the framework of a high-level task analysis. Within a subsequent cognitive low-level task analysis, potentially critical parallel process sequences are then tested in order to detect a potential resource overload of the user. The subsequent corresponding human-risk analysis is developed according to a knowledge base (checklist) of taxonomies related to human error. The HiFEM (human-function effect modeling) methodology is universally applicable and can be used for the evaluation of human-computer interfaces as well as for the analysis of purely mechanical control interfaces and simple hand-held instruments (such as a scalpel and implant). In a comparative study, the HiFEM method clearly outperforms the classic FMEA (failure modes and effects analysis) process with regard to effectiveness, efficiency, learnability, and

  14. Evolving models for medical physics education and training: a global perspective.

    PubMed

    Sprawls, P

    2008-01-01

    There is a significant need for high-quality medical physics education and training in all countries to support effective and safe use of modern medical technology for both diagnostic and treatment purposes. This is, and will continue to be, achieved using appropriate technology to increase both the effectiveness and efficiency of educational activities everywhere in the world. While the applications of technology to education and training are relatively new, the successful applications are based on theories and principles of the learning process developed by two pioneers in the field, Robert Gagne and Edgar Dale.The work of Gagne defines the different levels of learning that can occur and is used to show the types and levels of learning that are required for the application of physics and engineering principles to achieve appropriate diagnostic and therapeutic results from modern technology. The learning outcomes are determined by the effectiveness of the learning activity or experience. The extensive work of Dale as formulated in his Cone of Experience relates the effectiveness to the efficiency of educational activities. A major challenge in education is the development and conduction of learning activities (classroom discussions, laboratory and applied experiences, individual study, etc) that provide an optimum balance between effectiveness and efficiency. New and evolving models of the educational process use technology as the infrastructure to support education that is both more effective and efficient.The goal is to use technology to enhance human performance for both learners (students) and learning facilitators (teachers). A major contribution to global education is the trend in the development of shared educational resources. Two models of programs to support this effort with open and free shared resources are Physical Principles of Medical Imaging Online (http://www.sprawls.org/resources) and AAPM Continuing Education Courses (http://www.aapm.org/international).

  15. Constructing a Measure for Longitudinal Medical Achievement Studies by the Rasch Model One-Step Equating.

    ERIC Educational Resources Information Center

    Shen, Linjun

    As part of a longitudinal study of the growth of general medical knowledge among osteopathic medical students, a simple, convenient, and accurate vertical equating method was developed for constructing a scale for medical achievement. It was believed that Parts 1, 2, and 3 of the National Board of Osteopathic Medical Examiners' (NBOME) examination…

  16. Adopting epidemic model to optimize medication and surgical intervention of excess weight

    NASA Astrophysics Data System (ADS)

    Sun, Ruoyan

    2017-01-01

    We combined an epidemic model with an objective function to minimize the weighted sum of people with excess weight and the cost of a medication and surgical intervention in the population. The epidemic model is consisted of ordinary differential equations to describe three subpopulation groups based on weight. We introduced an intervention using medication and surgery to deal with excess weight. An objective function is constructed taking into consideration the cost of the intervention as well as the weight distribution of the population. Using empirical data, we show that fixed participation rate reduces the size of obese population but increases the size for overweight. An optimal participation rate exists and decreases with respect to time. Both theoretical analysis and empirical example confirm the existence of an optimal participation rate, u*. Under u*, the weighted sum of overweight (S) and obese (O) population as well as the cost of the program is minimized. This article highlights the existence of an optimal participation rate that minimizes the number of people with excess weight and the cost of the intervention. The time-varying optimal participation rate could contribute to designing future public health interventions of excess weight.

  17. Words and wards: a model of reflective writing and its uses in medical education.

    PubMed

    Shapiro, Johanna; Kasman, Deborah; Shafer, Audrey

    2006-01-01

    Personal, creative writing as a process for reflection on patient care and socialization into medicine ("reflective writing") has important potential uses in educating medical students and residents. Based on the authors' experiences with a range of writing activities in academic medical settings, this article sets forth a conceptual model for considering the processes and effects of such writing. The first phase (writing) is individual and solitary, consisting of personal reflection and creation. Here, introspection and imagination guide learners from loss of certainty to reclaiming a personal voice; identifying the patient's voice; acknowledging simultaneously valid yet often conflicting perspectives; and recognizing and responding to the range of emotions triggered in patient care. The next phase (small-group reading and discussion) is public and communal, where sharing one's writing results in acknowledging vulnerability, risk-taking, and self-disclosure. Listening to others' writing becomes an exercise in mindfulness and presence, including witnessing suffering and confusion experienced by others. Specific pedagogical goals in three arenas-professional development, patient care and practitioner well-being - are linked to the writing/reading/listening process. The intent of presenting this model is to help frame future intellectual inquiry and investigation into this innovative pedagogical modality.

  18. A new model for graduate education and innovation in medical technology.

    PubMed

    Yazdi, Youseph; Acharya, Soumyadipta

    2013-09-01

    We describe a new model of graduate education in bioengineering innovation and design- a year long Master's degree program that educates engineers in the process of healthcare technology innovation for both advanced and low-resource global markets. Students are trained in an iterative "Spiral Innovation" approach that ensures early, staged, and repeated examination of all key elements of a successful medical device. This includes clinical immersion based problem identification and assessment (at Johns Hopkins Medicine and abroad), team based concept and business model development, and project planning based on iterative technical and business plan de-risking. The experiential, project based learning process is closely supported by several core courses in business, design, and engineering. Students in the program work on two team based projects, one focused on addressing healthcare needs in advanced markets and a second focused on low-resource settings. The program recently completed its fourth year of existence, and has graduated 61 students, who have continued on to industry or startups (one half), additional graduate education, or medical school (one third), or our own Global Health Innovation Fellowships. Over the 4 years, the program has sponsored 10 global health teams and 14 domestic/advanced market medtech teams, and launched 5 startups, of which 4 are still active. Projects have attracted over US$2.5M in follow-on awards and grants, that are supporting the continued development of over a dozen projects.

  19. A comprehensive model to build improvement capability in a pediatric academic medical center.

    PubMed

    Kaminski, Gerry M; Schoettker, Pamela J; Alessandrini, Evaline A; Luzader, Carolyn; Kotagal, Uma

    2014-01-01

    Cincinnati Children's Hospital Medical Center developed a comprehensive model to build quality improvement (QI) capability to support its goal to transform its delivery system through a series of training courses. Two online modules orient staff to basic concepts and terminology and prepare them to participate more effectively in QI teams. The basic program (Rapid Cycle Improvement Collaborative, RCIC) is focused on developing the capability to use basic QI tools and complete a narrow-scoped project in approximately 120 days. The Intermediate Improvement Science Series (I(2)S(2)) program is a leadership course focusing on improvement skills and developing a broader and deeper understanding of QI in the context of the organization and external environment. The Advanced Improvement Methods (AIM) course and Quality Scholars Program stimulate the use of more sophisticated methods and prepare Cincinnati Children's Hospital Medical Center (CCHMC) and external faculty to undertake QI research. The Advanced Improvement Leadership Systems (AILS) sessions enable interprofessional care delivery system leadership teams to effectively lead a system of care, manage a portfolio of projects, and to deliver on CCHMC's strategic plan. Implementing these programs has shown us that 1) a multilevel curricular approach to building improvement capability is pragmatic and effective, 2) an interprofessional learning environment is critical to shifting mental models, 3) repetition of project experience with coaching and feedback solidifies critical skills, knowledge and behaviors, and 4) focusing first on developing capable interprofessional improvement leaders, versus engaging in broad general QI training across the whole organization, is effective.

  20. A fundamental, national, medical disaster management plan: an education-based model.

    PubMed

    Djalali, Ahmadreza; Hosseinijenab, Vahid; Hasani, Azadeh; Shirmardi, Kianoush; Castrén, Maaret; Ohlén, Gunnar; Panahi, Farzad

    2009-01-01

    During disasters, especially following earthquakes, health systems are expected to play an essential role in reducing mortality and morbidity. The most significant naturally occurring disaster in Iran is earthquakes; they have killed >