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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. 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

  3. 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

  4. 3-dimensional current collection model. [Of Tethered Satellite System 1

    SciTech Connect

    Hwang, Kai-Shen; Shiah, A.; Wu, S.T.; Stone, N. Alabama, University, Huntsvilll NASA, Marshall Space Flight Center, Huntsville, Ae )

    1992-07-01

    A three-dimensional, time dependent current collection model of a satellite has been developed for the TSS-1 system. The system has been simulated particularly for the Research of Plasma Electrodynamics (ROPE) experiment. The Maxwellian distributed particles with the geomagnetic field effects are applied in this numerical simulation. The preliminary results indicate that a ring current is observed surrounding the satellite in the equatorial plane. This ring current is found between the plasma sheath and the satellite surface and is oscillating with a time scale of approximately 1 microsec. This is equivalent to the electron plasma frequency. An hour glass shape of electron distribution was observed when the viewing direction is perpendicular to the equatorial plane. This result is consistent with previous findings from Linson (1969) and Antoniades et al. (1990). Electrons that are absorbed by the satellite are limited from the background ionosphere as indicated by Parker and Murphy (1967). 6 refs.

  5. 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.

  6. Finite element modelling of a 3 dimensional dielectrophoretic flow separator device for optimal bioprocessing conditions.

    PubMed

    Fatoyinbo, H O; Hughes, M P

    2004-01-01

    Planar 2-dimensional dielectrophoresis electrode geometries are limited in only being capable of handling fluid volumes ranging from picolitres to hundreds of microliters per hour. A 3-dimensional electrode system has been developed capable of handling significantly larger volumes of fluid. Using finite element modeling the electric field distribution within various bore sizes was realized. From these simulations it is possible to optimize bioprocessing factors influencing the performance of a dielectrophoretic separator. Process calculations have shown that flow-rates of 25ml hr/sup -1/ or more can be attained for the separation of heterogeneous populations of bio-particles based on their dielectric properties.

  7. 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

  8. Investigation of Asymmetries in Inductively Coupled Plasma Etching Reactors Using a 3-Dimensional Hybrid Model

    NASA Astrophysics Data System (ADS)

    Kushner, Mark J.; Grapperhaus, Michael J.

    1996-10-01

    Inductively Coupled Plasma (ICP) reactors have the potential for scaling to large area substrates while maintaining azimuthal symmetry or side-to-side uniformity across the wafer. Asymmetric etch properties in these devices have been attributed to transmission line properties of the coil, internal structures (such as wafer clamps) and non-uniform gas injection or pumping. To investigate the origins of asymmetric etch properties, a 3-dimensional hybrid model has been developed. The hybrid model contains electromagnetic, electric circuit, electron energy equation, and fluid modules. Continuity and momentum equations are solved in the fluid module along with Poisson's equation. We will discuss results for ion and radical flux uniformity to the substrate while varying the transmission line characteristics of the coil, symmetry of gas inlets/pumping, and internal structures. Comparisons will be made to expermental measurements of etch rates. ^*Work supported by SRC, NSF, ARPA/AFOSR and LAM Research.

  9. Using 3-dimensional printing to create presurgical models for endodontic surgery.

    PubMed

    Bahcall, James K

    2014-09-01

    Advances in endodontic surgery--from both a technological and procedural perspective-have been significant over the last 18 years. Although these technologies and procedural enhancements have significantly improved endodontic surgical treatment outcomes, there is still an ongoing challenge of overcoming the limitations of interpreting preoperative 2-dimensional (2-D) radiographic representation of a 3-dimensional (3-D) in vivo surgical field. Cone-beam Computed Tomography (CBCT) has helped to address this issue by providing a 3-D enhancement of the 2-D radiograph. The next logical step to further improve a presurgical case 3-D assessment is to create a surgical model from the CBCT scan. The purpose of this article is to introduce 3-D printing of CBCT scans for creating presurgical models for endodontic surgery. PMID:25197746

  10. 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.

  11. 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.

  12. A 3-dimensional DTI MRI-based model of GBM growth and response to radiation therapy.

    PubMed

    Hathout, Leith; Patel, Vishal; Wen, Patrick

    2016-09-01

    Glioblastoma (GBM) is both the most common and the most aggressive intra-axial brain tumor, with a notoriously poor prognosis. To improve this prognosis, it is necessary to understand the dynamics of GBM growth, response to treatment and recurrence. The present study presents a mathematical diffusion-proliferation model of GBM growth and response to radiation therapy based on diffusion tensor (DTI) MRI imaging. This represents an important advance because it allows 3-dimensional tumor modeling in the anatomical context of the brain. Specifically, tumor infiltration is guided by the direction of the white matter tracts along which glioma cells infiltrate. This provides the potential to model different tumor growth patterns based on location within the brain, and to simulate the tumor's response to different radiation therapy regimens. Tumor infiltration across the corpus callosum is simulated in biologically accurate time frames. The response to radiation therapy, including changes in cell density gradients and how these compare across different radiation fractionation protocols, can be rendered. Also, the model can estimate the amount of subthreshold tumor which has extended beyond the visible MR imaging margins. When combined with the ability of being able to estimate the biological parameters of invasiveness and proliferation of a particular GBM from serial MRI scans, it is shown that the model has potential to simulate realistic tumor growth, response and recurrence patterns in individual patients. To the best of our knowledge, this is the first presentation of a DTI-based GBM growth and radiation therapy treatment model. PMID:27572745

  13. 3-Dimensional Modeling of Capacitively and Inductively Coupled Plasma Etching Systems

    NASA Astrophysics Data System (ADS)

    Rauf, Shahid

    2008-10-01

    Low temperature plasmas are widely used for thin film etching during micro and nano-electronic device fabrication. Fluid and hybrid plasma models were developed 15-20 years ago to understand the fundamentals of these plasmas and plasma etching. These models have significantly evolved since then, and are now a major tool used for new plasma hardware design and problem resolution. Plasma etching is a complex physical phenomenon, where inter-coupled plasma, electromagnetic, fluid dynamics, and thermal effects all have a major influence. The next frontier in the evolution of fluid-based plasma models is where these models are able to self-consistently treat the inter-coupling of plasma physics with fluid dynamics, electromagnetics, heat transfer and magnetostatics. We describe one such model in this paper and illustrate its use in solving engineering problems of interest for next generation plasma etcher design. Our 3-dimensional plasma model includes the full set of Maxwell equations, transport equations for all charged and neutral species in the plasma, the Navier-Stokes equation for fluid flow, and Kirchhoff's equations for the lumped external circuit. This model also includes Monte Carlo based kinetic models for secondary electrons and stochastic heating, and can take account of plasma chemistry. This modeling formalism allows us to self-consistently treat the dynamics in commercial inductively and capacitively coupled plasma etching reactors with realistic plasma chemistries, magnetic fields, and reactor geometries. We are also able to investigate the influence of the distributed electromagnetic circuit at very high frequencies (VHF) on the plasma dynamics. The model is used to assess the impact of azimuthal asymmetries in plasma reactor design (e.g., off-center pump, 3D magnetic field, slit valve, flow restrictor) on plasma characteristics at frequencies from 2 -- 180 MHz. With Jason Kenney, Ankur Agarwal, Ajit Balakrishna, Kallol Bera, and Ken Collins.

  14. An Explicit 3-Dimensional Model for Reactive Transport of Nitrogen in Tile Drained Fields

    NASA Astrophysics Data System (ADS)

    Hill, D. J.; Valocchi, A. J.; Hudson, R. J.

    2001-12-01

    Recently, there has been increased interest in nitrate contamination of groundwater in the Midwest because of its link to surface water eutrophication, especially in the Gulf of Mexico. The vast majority of this nitrate is the product of biologically mediated transformation of fertilizers containing ammonia in the vadose zone of agricultural fields. For this reason, it is imperative that mathematical models, which can serve as useful tools to evaluate both the impact of agricultural fertilizer applications and nutrient-reducing management practices, are able to specifically address transport in the vadose zone. The development of a 3-dimensional explicit numerical model to simulate the movement and transformation of nitrogen species through the subsurface on the scale of an individual farm plot will be presented. At this scale, nitrogen fate and transport is controlled by a complex coupling among hydrologic, agricultural and biogeochemical processes. The nitrogen model is a component of a larger modeling effort that focuses upon conditions typical of those found in agricultural fields in Illinois. These conditions include non-uniform, multi-dimensional, transient flow in both saturated and unsaturated zones, geometrically complex networks of tile drains, coupled surface-subsurface-tile flow, and dynamic levels of dissolved oxygen in the soil profile. The advection-dispersion-reaction equation is solved using an operator-splitting approach, which is a flexible and straightforward strategy. Advection is modeled using a total variation diminishing scheme, dispersion is modeled using an alternating direction explicit method, and reactions are modeled using rate law equations. The model's stability and accuracy will be discussed, and test problems will be presented.

  15. 3-Dimensional modeling of large diameter wire array high intensity K-shell radiation sources.

    SciTech Connect

    Giuliani, J. L.; Waisman, Eduardo Mario; Chittenden, Jeremy Paul; Jennings, Christopher A.; Ampleford, David J.; Yu, Edmund P.; Thornhill, Joseph W.; Cuneo, Michael Edward; Coverdale, Christine Anne; Jones, Brent Manley; Hansen, Stephanie B.

    2010-06-01

    Large diameter nested wire array z-pinches imploded on the Z-generator at Sandia National Laboratories have been used extensively to generate high intensity K-shell radiation. Large initial radii are required to obtain the high implosion velocities needed to efficiently radiate in the K-shell. This necessitates low wire numbers and large inter-wire gaps which introduce large azimuthal non-uniformities. Furthermore, the development of magneto-Rayleigh-Taylor instabilities during the implosion are known to generate large axial non-uniformity These effects motivate the complete, full circumference 3-dimensional modeling of these systems. Such high velocity implosions also generate large voltages, which increase current losses in the power feed and limit the current delivery to these loads. Accurate representation of the generator coupling is therefore required to reliably represent the energy delivered to, and the power radiated from these sources. We present 3D-resistive MHD calculations of the implosion and stagnation of a variety of large diameter stainless steel wire arrays (hv {approx} 6.7 keV), imploded on the Z-generator both before and after its refurbishment. Use of a tabulated K-shell emission model allows us to compare total and K-shell radiated powers to available experimental measurements. Further comparison to electrical voltage and current measurements allows us to accurately assess the power delivered to these loads. These data allow us to begin to constrain and validate our 3D MHD calculations, providing insight into ways in which these sources may be further optimized.

  16. Contributions of the Musculus Uvulae to Velopharyngeal Closure Quantified With a 3-Dimensional Multimuscle Computational Model.

    PubMed

    Inouye, Joshua M; Lin, Kant Y; Perry, Jamie L; Blemker, Silvia S

    2016-02-01

    The convexity of the dorsal surface of the velum is critical for normal velopharyngeal (VP) function and is largely attributed to the levator veli palatini (LVP) and musculus uvulae (MU). Studies have correlated a concave or flat nasal velar surface to symptoms of VP dysfunction including hypernasality and nasal air emission. In the context of surgical repair of cleft palates, the MU has been given relatively little attention in the literature compared with the larger LVP. A greater understanding of the mechanics of the MU will provide insight into understanding the influence of a dysmorphic MU, as seen in cleft palate, as it relates to VP function. The purpose of this study was to quantify the contributions of the MU to VP closure in a computational model. We created a novel 3-dimensional (3D) finite element model of the VP mechanism from magnetic resonance imaging data collected from an individual with healthy noncleft VP anatomy. The model components included the velum, posterior pharyngeal wall (PPW), LVP, and MU. Simulations were based on the muscle and soft tissue mechanical properties from the literature. We found that, similar to previous hypotheses, the MU acts as (i) a space-occupying structure and (ii) a velar extensor. As a space-occupying structure, the MU helps to nearly triple the midline VP contact length. As a velar extensor, the MU acting alone without the LVP decreases the VP distance 62%. Furthermore, activation of the MU decreases the LVP activation required for closure almost 3-fold, from 20% (without MU) to 8% (with MU). Our study suggests that any possible salvaging and anatomical reconstruction of viable MU tissue in a cleft patient may improve VP closure due to its mechanical function. In the absence or dysfunction of MU tissue, implantation of autologous or engineered tissues at the velar midline, as a possible substitute for the MU, may produce a geometric convexity more favorable to VP closure. In the future, more complex models will

  17. 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

  18. Virtual model surgery and wafer fabrication using 2-dimensional cephalograms, 3-dimensional virtual dental models, and stereolithographic technology.

    PubMed

    Choi, Jin-Young; Hwang, Jong-Min; Baek, Seung-Hak

    2012-02-01

    Although several 3-dimensional virtual model surgery (3D-VMS) programs have been introduced to reduce time-consuming manual laboratory steps and potential errors, these programs still require 3D-computed tomography (3D-CT) data and involve complex computerized maneuvers. Because it is difficult to take 3D-CTs for all cases, a new VMS program using 2D lateral and posteroanterior cephalograms and 3D virtual dental models (2.5D-VMS program; 3Txer version 2.5, Orapix, Seoul, Korea) has recently been introduced. The purposes of this article were to present the methodology of the 2.5D-VMS program and to verify the accuracy of intermediate surgical wafers fabricated with the stereolithographic technique. Two cases successfully treated using the 2.5D-VMS program are presented. There was no significant difference in the position of upper dentition after surgical movement between 2.5D-VMS and 3D-VMS in 18 samples (less than 0.10 mm, P > .05, Wilcoxon-signed rank test). The 2.5D-VMS can be regarded as an effective alternative for 3D-VMS for cases in which 3D-CT data are not available.

  19. 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.

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

    NASA Astrophysics Data System (ADS)

    Joubert, Pierre

    2008-10-01

    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 H2-N2 mixtures with high pressure and high temperature are presented. The effects of collisional relaxation on the spectral line shapes are discussed.

  1. Application of 3-Dimensional Printing Technology to Construct an Eye Model for Fundus Viewing Study

    PubMed Central

    Li, Xinhua; Gao, Zhishan; Yuan, Dongqing; Liu, Qinghuai

    2014-01-01

    Objective To construct a life-sized eye model using the three-dimensional (3D) printing technology for fundus viewing study of the viewing system. Methods We devised our schematic model eye based on Navarro's eye and redesigned some parameters because of the change of the corneal material and the implantation of intraocular lenses (IOLs). Optical performance of our schematic model eye was compared with Navarro's schematic eye and other two reported physical model eyes using the ZEMAX optical design software. With computer aided design (CAD) software, we designed the 3D digital model of the main structure of the physical model eye, which was used for three-dimensional (3D) printing. Together with the main printed structure, polymethyl methacrylate(PMMA) aspherical cornea, variable iris, and IOLs were assembled to a physical eye model. Angle scale bars were glued from posterior to periphery of the retina. Then we fabricated other three physical models with different states of ammetropia. Optical parameters of these physical eye models were measured to verify the 3D printing accuracy. Results In on-axis calculations, our schematic model eye possessed similar size of spot diagram compared with Navarro's and Bakaraju's model eye, much smaller than Arianpour's model eye. Moreover, the spherical aberration of our schematic eye was much less than other three model eyes. While in off- axis simulation, it possessed a bit higher coma and similar astigmatism, field curvature and distortion. The MTF curves showed that all the model eyes diminished in resolution with increasing field of view, and the diminished tendency of resolution of our physical eye model was similar to the Navarro's eye. The measured parameters of our eye models with different status of ametropia were in line with the theoretical value. Conclusions The schematic eye model we designed can well simulate the optical performance of the human eye, and the fabricated physical one can be used as a tool in fundus

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

    DOE PAGESBeta

    Lund, Tina; Wongwathanarat, Annop; Janka, Hans -Thomas; Muller, Ewald; Raffelt, Georg

    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.

  3. 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.

  4. [Rapid 3-Dimensional Models of Cerebral Aneurysm for Emergency Surgical Clipping].

    PubMed

    Konno, Takehiko; Mashiko, Toshihiro; Oguma, Hirofumi; Kaneko, Naoki; Otani, Keisuke; Watanabe, Eiju

    2016-08-01

    We developed a method for manufacturing solid models of cerebral aneurysms, with a shorter printing time than that involved in conventional methods, using a compact 3D printer with acrylonitrile-butadiene-styrene(ABS)resin. We further investigated the application and utility of this printing system in emergency clipping surgery. A total of 16 patients diagnosed with acute subarachnoid hemorrhage resulting from cerebral aneurysm rupture were enrolled in the present study. Emergency clipping was performed on the day of hospitalization. Digital Imaging and Communication in Medicine(DICOM)data obtained from computed tomography angiography(CTA)scans were edited and converted to stereolithography(STL)file formats, followed by the production of 3D models of the cerebral aneurysm by using the 3D printer. The mean time from hospitalization to the commencement of surgery was 242 min, whereas the mean time required for manufacturing the 3D model was 67 min. The average cost of each 3D model was 194 Japanese Yen. The time required for manufacturing the 3D models shortened to approximately 1 hour with increasing experience of producing 3D models. Favorable impressions for the use of the 3D models in clipping were reported by almost all neurosurgeons included in this study. Although 3D printing is often considered to involve huge costs and long manufacturing time, the method used in the present study requires shorter time and lower costs than conventional methods for manufacturing 3D cerebral aneurysm models, thus making it suitable for use in emergency clipping. PMID:27506842

  5. High fidelity 3-dimensional models of beam-electron cloud interactions in circular accelerators

    NASA Astrophysics Data System (ADS)

    Feiz Zarrin Ghalam, Ali

    Electron cloud is a low-density electron profile created inside the vacuum chamber of circular machines with positively charged beams. Electron cloud limits the peak current of the beam and degrades the beams' quality through luminosity degradation, emittance growth and head to tail or bunch to bunch instability. The adverse effects of electron cloud on long-term beam dynamics becomes more and more important as the beams go to higher and higher energies. This problem has become a major concern in many future circular machines design like the Large Hadron Collider (LHC) under construction at European Center for Nuclear Research (CERN). Due to the importance of the problem several simulation models have been developed to model long-term beam-electron cloud interaction. These models are based on "single kick approximation" where the electron cloud is assumed to be concentrated at one thin slab around the ring. While this model is efficient in terms of computational costs, it does not reflect the real physical situation as the forces from electron cloud to the beam are non-linear contrary to this model's assumption. To address the existing codes limitation, in this thesis a new model is developed to continuously model the beam-electron cloud interaction. The code is derived from a 3-D parallel Particle-In-Cell (PIC) model (QuickPIC) originally used for plasma wakefield acceleration research. To make the original model fit into circular machines environment, betatron and synchrotron equations of motions have been added to the code, also the effect of chromaticity, lattice structure have been included. QuickPIC is then benchmarked against one of the codes developed based on single kick approximation (HEAD-TAIL) for the transverse spot size of the beam in CERN-LHC. The growth predicted by QuickPIC is less than the one predicted by HEAD-TAIL. The code is then used to investigate the effect of electron cloud image charges on the long-term beam dynamics, particularly on the

  6. 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.

  7. 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

  8. 3-DIMENSIONAL Geological Mapping and Modeling Activities at the Geological Survey of Norway

    NASA Astrophysics Data System (ADS)

    Jarna, A.; Bang-Kittilsen, A.; Haase, C.; Henderson, I. H. C.; Høgaas, F.; Iversen, S.; Seither, A.

    2015-10-01

    Geology and all geological structures are three-dimensional in space. Geology can be easily shown as four-dimensional when time is considered. Therefore GIS, databases, and 3D visualization software are common tools used by geoscientists to view, analyse, create models, interpret and communicate geological data. The NGU (Geological Survey of Norway) is the national institution for the study of bedrock, mineral resources, surficial deposits and groundwater and marine geology. The interest in 3D mapping and modelling has been reflected by the increase of number of groups and researches dealing with 3D in geology within NGU. This paper highlights 3D geological modelling techniques and the usage of these tools in bedrock, geophysics, urban and groundwater studies at NGU, same as visualisation of 3D online. The examples show use of a wide range of data, methods, software and an increased focus on interpretation and communication of geology in 3D. The goal is to gradually expand the geospatial data infrastructure to include 3D data at the same level as 2D.

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

    DOE PAGESBeta

    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

  10. 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.

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

    PubMed Central

    2015-01-01

    Summary 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. PMID:26734515

  13. 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

  14. A 3-dimensional in vitro model of epithelioid granulomas induced by high aspect ratio nanomaterials

    PubMed Central

    2011-01-01

    Background The most common causes of granulomatous inflammation are persistent pathogens and poorly-degradable irritating materials. A characteristic pathological reaction to intratracheal instillation, pharyngeal aspiration, or inhalation of carbon nanotubes is formation of epithelioid granulomas accompanied by interstitial fibrosis in the lungs. In the mesothelium, a similar response is induced by high aspect ratio nanomaterials, including asbestos fibers, following intraperitoneal injection. This asbestos-like behaviour of some engineered nanomaterials is a concern for their potential adverse health effects in the lungs and mesothelium. We hypothesize that high aspect ratio nanomaterials will induce epithelioid granulomas in nonadherent macrophages in 3D cultures. Results Carbon black particles (Printex 90) and crocidolite asbestos fibers were used as well-characterized reference materials and compared with three commercial samples of multiwalled carbon nanotubes (MWCNTs). Doses were identified in 2D and 3D cultures in order to minimize acute toxicity and to reflect realistic occupational exposures in humans and in previous inhalation studies in rodents. Under serum-free conditions, exposure of nonadherent primary murine bone marrow-derived macrophages to 0.5 μg/ml (0.38 μg/cm2) of crocidolite asbestos fibers or MWCNTs, but not carbon black, induced macrophage differentiation into epithelioid cells and formation of stable aggregates with the characteristic morphology of granulomas. Formation of multinucleated giant cells was also induced by asbestos fibers or MWCNTs in this 3D in vitro model. After 7-14 days, macrophages exposed to high aspect ratio nanomaterials co-expressed proinflammatory (M1) as well as profibrotic (M2) phenotypic markers. Conclusions Induction of epithelioid granulomas appears to correlate with high aspect ratio and complex 3D structure of carbon nanotubes, not with their iron content or surface area. This model offers a time- and cost

  15. 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.

  16. 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.

  17. Effect of Heat-Inactivated Clostridium sporogenes and Its Conditioned Media on 3-Dimensional Colorectal Cancer Cell Models

    PubMed Central

    Bhave, Madhura Satish; Hassanbhai, Ammar Mansoor; Anand, Padmaja; Luo, Kathy Qian; Teoh, Swee Hin

    2015-01-01

    Traditional cancer treatments, such as chemotherapy and radiation therapy continue to have limited efficacy due to tumor hypoxia. While bacterial cancer therapy has the potential to overcome this problem, it comes with the risk of toxicity and infection. To circumvent these issues, this paper investigates the anti-tumor effects of non-viable bacterial derivatives of Clostridium sporogenes. These non-viable derivatives are heat-inactivated C. sporogenes bacteria (IB) and the secreted bacterial proteins in culture media, known as conditioned media (CM). In this project, the effects of IB and CM on CT26 and HCT116 colorectal cancer cells were examined on a 2-Dimensional (2D) and 3-Dimensional (3D) platform. IB significantly inhibited cell proliferation of CT26 to 6.3% of the control in 72 hours for the 2D monolayer culture. In the 3D spheroid culture, cell proliferation of HCT116 spheroids notably dropped to 26.2%. Similarly the CM also remarkably reduced the cell-proliferation of the CT26 cells to 2.4% and 20% in the 2D and 3D models, respectively. Interestingly the effect of boiled conditioned media (BCM) on the cells in the 3D model was less inhibitory than that of CM. Thus, the inhibitive effect of inactivated C. sporogenes and its conditioned media on colorectal cancer cells is established. PMID:26507312

  18. 3-dimensional Modeling of Electromagnetic and Physical Sources of Aziumuthal Nonuniformities in Inductively Coupled Plasmas for Deposition

    NASA Astrophysics Data System (ADS)

    Lu, Junqing; Keiter, Eric R.; Kushner, Mark J.

    1998-10-01

    Inductively Coupled Plasmas (ICPs) are being used for a variety of deposition processes for microelectronics fabrication. Of particular concern in scaling these devices to large areas is maintaining azimuthal symmetry of the reactant fluxes. Sources of nonuniformity may be physical (e.g., gas injection and side pumping) or electromagnetic (e.g., transmission line effects in the antennas). In this paper, a 3-dimensional plasma equipment model, HPEM-3D,(M. J. Kushner, J. Appl. Phys. v.82, 5312 (1997).) is used to investigate physical and electromagentic sources of azimuthal nonuniformities in deposition tools. An ionized metal physical vapor deposition (IMPVD) system will be investigated where transmission line effects in the coils produce an asymmetric plasma density. Long mean free path transport for sputtered neutrals and tensor conducitivities have been added to HPEM-3D to address this system. Since the coil generated ion flux drifts back to the target to sputter low ionization potential metal atoms, the asymmetry is reinforced by rapid ionization of the metal atoms.

  19. Molecular profiling of the invasive tumor microenvironment in a 3-dimensional model of colorectal cancer cells and ex vivo fibroblasts.

    PubMed

    Bullock, Marc D; Mellone, Max; Pickard, Karen M; Sayan, Abdulkadir Emre; Mitter, Richard; Primrose, John N; Packham, Graham K; Thomas, Gareth; Mirnezami, Alexander H

    2014-01-01

    Invading colorectal cancer (CRC) cells have acquired the capacity to break free from their sister cells, infiltrate the stroma, and remodel the extracellular matrix (ECM). Characterizing the biology of this phenotypically distinct group of cells could substantially improve our understanding of early events during the metastatic cascade. Tumor invasion is a dynamic process facilitated by bidirectional interactions between malignant epithelium and the cancer associated stroma. In order to examine cell-specific responses at the tumor stroma-interface we have combined organotypic co-culture and laser micro-dissection techniques. Organotypic models, in which key stromal constituents such as fibroblasts are 3-dimensionally co-cultured with cancer epithelial cells, are highly manipulatable experimental tools which enable invasion and cancer-stroma interactions to be studied in near-physiological conditions. Laser microdissection (LMD) is a technique which entails the surgical dissection and extraction of the various strata within tumor tissue, with micron level precision. By combining these techniques with genomic, transcriptomic and epigenetic profiling we aim to develop a deeper understanding of the molecular characteristics of invading tumor cells and surrounding stromal tissue, and in doing so potentially reveal novel biomarkers and opportunities for drug development in CRC. PMID:24836208

  20. Development of a high-throughput screening assay based on the 3-dimensional pannus model for rheumatoid arthritis.

    PubMed

    Ibold, Yvonne; Frauenschuh, Simone; Kaps, Christian; Sittinger, Michael; Ringe, Jochen; Goetz, Peter M

    2007-10-01

    The 3-dimensional (3-D) pannus model for rheumatoid arthritis (RA) is based on the interactive co-culture of cartilage and synovial fibroblasts (SFs). Besides the investigation of the pathogenesis of RA, it can be used to analyze the active profiles of antirheumatic pharmaceuticals and other bioactive substances under in vitro conditions. For a potential application in the industrial drug-screening process as a transitional step between 2-dimensional (2-D) cell-based assays and in vivo animal studies, the pannus model was developed into an in vitro high-throughput screening (HTS) assay. Using the CyBitrade mark-Disk workstation for parallel liquid handling, the main cell culture steps of cell seeding and cultivation were automated. Chondrocytes were isolated from articular cartilage and seeded directly into 96-well microplates in high-density pellets to ensure formation of cartilage-specific extracellular matrix (ECM). Cell seeding was performed automatically and manually to compare both processes regarding accuracy, reproducibility, consistency, and handling time. For automated cultivation of the chondrocyte pellet cultures, a sequential program was developed using the CyBio Control software to minimize shear forces and handling time. After 14 days of cultivation, the pannus model was completed by coating the cartilage pellets with a layer of human SFs. The effects due to automation in comparison to manual handling were analyzed by optical analysis of the pellets, histological and immunohistochemical staining, and real-time PCR. Automation of this in vitro model was successfully achieved and resulted in an improved quality of the generated pannus cultures by enhancing the formation of cartilage-specific ECM. In addition, automated cell seeding and media exchange increased the efficiency due to a reduction of labor intensity and handling time.

  1. 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

  2. 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

  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. Three-Dimensional Radiobiologic Dosimetry: Application of Radiobiologic Modeling to Patient-Specific 3-Dimensional Imaging–Based Internal Dosimetry

    PubMed Central

    Prideaux, Andrew R.; Song, Hong; Hobbs, Robert F.; He, Bin; Frey, Eric C.; Ladenson, Paul W.; Wahl, Richard L.; Sgouros, George

    2010-01-01

    Phantom-based and patient-specific imaging-based dosimetry methodologies have traditionally yielded mean organ-absorbed doses or spatial dose distributions over tumors and normal organs. In this work, radiobiologic modeling is introduced to convert the spatial distribution of absorbed dose into biologically effective dose and equivalent uniform dose parameters. The methodology is illustrated using data from a thyroid cancer patient treated with radioiodine. Methods Three registered SPECT/CT scans were used to generate 3-dimensional images of radionuclide kinetics (clearance rate) and cumulated activity. The cumulated activity image and corresponding CT scan were provided as input into an EGSnrc-based Monte Carlo calculation: The cumulated activity image was used to define the distribution of decays, and an attenuation image derived from CT was used to define the corresponding spatial tissue density and composition distribution. The rate images were used to convert the spatial absorbed dose distribution to a biologically effective dose distribution, which was then used to estimate a single equivalent uniform dose for segmented volumes of interest. Equivalent uniform dose was also calculated from the absorbed dose distribution directly. Results We validate the method using simple models; compare the dose-volume histogram with a previously analyzed clinical case; and give the mean absorbed dose, mean biologically effective dose, and equivalent uniform dose for an illustrative case of a pediatric thyroid cancer patient with diffuse lung metastases. The mean absorbed dose, mean biologically effective dose, and equivalent uniform dose for the tumor were 57.7, 58.5, and 25.0 Gy, respectively. Corresponding values for normal lung tissue were 9.5, 9.8, and 8.3 Gy, respectively. Conclusion The analysis demonstrates the impact of radiobiologic modeling on response prediction. The 57% reduction in the equivalent dose value for the tumor reflects a high level of dose

  5. 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. PMID:27065461

  6. 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

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

    PubMed

    Ferrario, V F; Sforza, C; Schmitz, J H; Ciusa, V; Colombo, A

    2000-04-01

    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

  8. 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.

  9. 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.

  10. 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

  11. 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.

  12. 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.

  13. 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...

  14. 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.

  15. The use of TOUGH2 for the LBL/USGS 3-dimensional site-scale model of Yucca Mountain, Nevada

    SciTech Connect

    Bodvarsson, G.; Chen, G.; Haukwa, C.; Kwicklis, E.

    1995-12-31

    The three-dimensional site-scale numerical model o the unsaturated zone at Yucca Mountain is under continuous development and calibration through a collaborative effort between Lawrence Berkeley Laboratory (LBL) and the United States Geological Survey (USGS). The site-scale model covers an area of about 30 km{sup 2} and is bounded by major fault zones to the west (Solitario Canyon Fault), east (Bow Ridge Fault) and perhaps to the north by an unconfirmed fault (Yucca Wash Fault). The model consists of about 5,000 grid blocks (elements) with nearly 20,000 connections between them; the grid was designed to represent the most prevalent geological and hydro-geological features of the site including major faults, and layering and bedding of the hydro-geological units. Submodels are used to investigate specific hypotheses and their importance before incorporation into the three-dimensional site-scale model. The primary objectives of the three-dimensional site-scale model are to: (1) quantify moisture, gas and heat flows in the ambient conditions at Yucca Mountain, (2) help in guiding the site-characterization effort (primarily by USGS) in terms of additional data needs and to identify regions of the mountain where sufficient data have been collected, and (3) provide a reliable model of Yucca Mountain that is validated by repeated predictions of conditions in new boreboles and the ESF and has therefore the confidence of the public and scientific community. The computer code TOUGH2 developed by K. Pruess at LBL was used along with the three-dimensional site-scale model to generate these results. In this paper, we also describe the three-dimensional site-scale model emphasizing the numerical grid development, and then show some results in terms of moisture, gas and heat flow.

  16. 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

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

    PubMed

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

    2015-10-01

    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

  18. 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.

  19. Application of 3-dimensional printing in hand surgery for production of a novel bone reduction clamp.

    PubMed

    Fuller, Sam M; Butz, Daniel R; Vevang, Curt B; Makhlouf, Mansour V

    2014-09-01

    Three-dimensional printing is being rapidly incorporated in the medical field to produce external prosthetics for improved cosmesis and fabricated molds to aid in presurgical planning. Biomedically engineered products from 3-dimensional printers are also utilized as implantable devices for knee arthroplasty, airway orthoses, and other surgical procedures. Although at first expensive and conceptually difficult to construct, 3-dimensional printing is now becoming more affordable and widely accessible. In hand surgery, like many other specialties, new or customized instruments would be desirable; however, the overall production cost restricts their development. We are presenting our step-by-step experience in creating a bone reduction clamp for finger fractures using 3-dimensional printing technology. Using free, downloadable software, a 3-dimensional model of a bone reduction clamp for hand fractures was created based on the senior author's (M.V.M.) specific design, previous experience, and preferences for fracture fixation. Once deemed satisfactory, the computer files were sent to a 3-dimensional printing company for the production of the prototypes. Multiple plastic prototypes were made and adjusted, affording a fast, low-cost working model of the proposed clamp. Once a workable design was obtained, a printing company produced the surgical clamp prototype directly from the 3-dimensional model represented in the computer files. This prototype was used in the operating room, meeting the expectations of the surgeon. Three-dimensional printing is affordable and offers the benefits of reducing production time and nurturing innovations in hand surgery. This article presents a step-by-step description of our design process using online software programs and 3-dimensional printing services. As medical technology advances, it is important that hand surgeons remain aware of available resources, are knowledgeable about how the process works, and are able to take advantage of

  20. 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.

  1. Noninvasive 3-dimensional imaging of liver regeneration in a mouse model of hereditary tyrosinemia type 1 using the sodium iodide symporter gene.

    PubMed

    Hickey, Raymond D; Mao, Shennen A; Amiot, Bruce; Suksanpaisan, Lukkana; Miller, Amber; Nace, Rebecca; Glorioso, Jaime; O'Connor, Michael K; Peng, Kah Whye; Ikeda, Yasuhiro; Russell, Stephen J; Nyberg, Scott L

    2015-04-01

    Cell transplantation is a potential treatment for the many liver disorders that are currently only curable by organ transplantation. However, one of the major limitations of hepatocyte (HC) transplantation is an inability to monitor cells longitudinally after injection. We hypothesized that the thyroidal sodium iodide symporter (NIS) gene could be used to visualize transplanted HCs in a rodent model of inherited liver disease: hereditary tyrosinemia type 1. Wild-type C57Bl/6J mouse HCs were transduced ex vivo with a lentiviral vector containing the mouse Slc5a5 (NIS) gene controlled by the thyroxine-binding globulin promoter. NIS-transduced cells could robustly concentrate radiolabeled iodine in vitro, with lentiviral transduction efficiencies greater than 80% achieved in the presence of dexamethasone. Next, NIS-transduced HCs were transplanted into congenic fumarylacetoacetate hydrolase knockout mice, and this resulted in the prevention of liver failure. NIS-transduced HCs were readily imaged in vivo by single-photon emission computed tomography, and this demonstrated for the first time noninvasive 3-dimensional imaging of regenerating tissue in individual animals over time. We also tested the efficacy of primary HC spheroids engrafted in the liver. With the NIS reporter, robust spheroid engraftment and survival could be detected longitudinally after direct parenchymal injection, and this thereby demonstrated a novel strategy for HC transplantation. This work is the first to demonstrate the efficacy of NIS imaging in the field of HC transplantation. We anticipate that NIS labeling will allow noninvasive and longitudinal identification of HCs and stem cells in future studies related to liver regeneration in small and large preclinical animal models.

  2. 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?

  3. 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

  4. Models for medical practice integration.

    PubMed

    Harris, R M

    1994-08-01

    Decreased physician income, increased administrative burdens, and interference with the compassionate delivery of high-quality medical care are threatening the independent practice of medicine in solo and small group practices. Many established physicians, and the hospitals with which they relate, are searching for organizational models that, by integrating some or all aspects of their practices, will preserve incomes and reduce regulatory and administrative burdens. This article will describe several "practice integration models," pointing out advantages and disadvantages to physicians in established practices. (Many of the same arguments could be made for physicians new to practice, with different emphasis). The continuum of integration models is shown in figure 1, page 19. The group practice without walls and its two submodels, the independent group practice without walls (IGWW) and the affiliated medical practice corporation (AMPC) are more recent and more effective models and will be covered in depth in the article.

  5. 3-dimensional bioprinting for tissue engineering applications.

    PubMed

    Gu, Bon Kang; Choi, Dong Jin; Park, Sang Jun; Kim, Min Sup; Kang, Chang Mo; Kim, Chun-Ho

    2016-01-01

    The 3-dimensional (3D) printing technologies, referred to as additive manufacturing (AM) or rapid prototyping (RP), have acquired reputation over the past few years for art, architectural modeling, lightweight machines, and tissue engineering applications. Among these applications, tissue engineering field using 3D printing has attracted the attention from many researchers. 3D bioprinting has an advantage in the manufacture of a scaffold for tissue engineering applications, because of rapid-fabrication, high-precision, and customized-production, etc. In this review, we will introduce the principles and the current state of the 3D bioprinting methods. Focusing on some of studies that are being current application for biomedical and tissue engineering fields using printed 3D scaffolds.

  6. 3-dimensional bioprinting for tissue engineering applications.

    PubMed

    Gu, Bon Kang; Choi, Dong Jin; Park, Sang Jun; Kim, Min Sup; Kang, Chang Mo; Kim, Chun-Ho

    2016-01-01

    The 3-dimensional (3D) printing technologies, referred to as additive manufacturing (AM) or rapid prototyping (RP), have acquired reputation over the past few years for art, architectural modeling, lightweight machines, and tissue engineering applications. Among these applications, tissue engineering field using 3D printing has attracted the attention from many researchers. 3D bioprinting has an advantage in the manufacture of a scaffold for tissue engineering applications, because of rapid-fabrication, high-precision, and customized-production, etc. In this review, we will introduce the principles and the current state of the 3D bioprinting methods. Focusing on some of studies that are being current application for biomedical and tissue engineering fields using printed 3D scaffolds. PMID:27114828

  7. On AGV's navigation in 3-dimensional space

    NASA Astrophysics Data System (ADS)

    Kusche, Jürgen

    1996-01-01

    This paper deals with position estimation and path control for Autonomous Guided Vehicles (AGV). To enable a vehicle or a mobile robot in following a continuous “virtual” path without human control, these techniques play an important role. The relationship between the vehicle's motion in 3-dimensional space and the shape of a curved surface is described. In particular, the introduction of a digital terrain model in dead reckoning is considered. Moreover, a possible nonlinear control is developed based on curvilinear path coordinates, and the proof for global stability is given. To achieve general validity, these topics are treated here independently of the cart's special mechanization (the configuration of steered wheels and driven wheels). Simulation studies are presented to illustrate the investigations.

  8. Teleportation of a 3-dimensional GHZ State

    NASA Astrophysics Data System (ADS)

    Cao, Hai-Jing; Wang, Huai-Sheng; Li, Peng-Fei; Song, He-Shan

    2012-05-01

    The process of teleportation of a completely unknown 3-dimensional GHZ state is considered. Three maximally entangled 3-dimensional Bell states function as quantum channel in the scheme. This teleportation scheme can be directly generalized to teleport an unknown d-dimensional GHZ state.

  9. [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.

  10. 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 ...

  11. 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.

  12. [Posterior glass fiber-reinforced composite resin-bonded fixed partial dentures: A 3-dimensional modeling and finite element numerical analysis].

    PubMed

    Han, Jingyun; Fei, Renyuan; Li, Yansheng; Zhang, Lei

    2006-08-01

    The method of modeling and mesh generation about 3-unit tooth/restoration complex were established. The three-dimensional finite element models were subjected to four types of occlusal load applied to pontic element to evaluate 3 fiber framework designs and 3 cavities preparation configurations. By comparing the difference of stress distribution, following conclusions were obtained: the principal stress under buccal-lingual cusp load in traditional fiber framework pontic increased by 6.22% compared to that in pure composite resin pontic; optimized fiber framework obviously reduced stress level under any load; modified cavities exhibited better stress transfer and decreased share stress at adhesive interface than traditional cavities. PMID:17002101

  13. 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

  14. The 3-Dimensional Structure of Galaxy Clusters

    NASA Astrophysics Data System (ADS)

    King, Lindsay

    NASA's Hubble Space Telescope Multi-Cycle Treasury Program CLASH (PI Postman) has provided the community with the most detailed views ever of the central regions of massive galaxy clusters. These galaxy clusters have also been observed with NASA's Chandra X-Ray Observatory, with the ground-based Subaru telescope, and with other ground- and space-based facilities, resulting in unprecedented multi-wavelength data sets of the most massive bound structures in the universe. Fitting 3-Dimensional mass models is crucial to understanding how mass is distributed in individual clusters, investigating the properties of dark matter, and testing our cosmological model. With the exquisite data available, the time is now ideal to undertake this analysis. We propose to use algorithms that we have developed and obtain mass models for the clusters from the CLASH sample. The project would use archival gravitational lensing data, X-ray data of the cluster's hot gas and additional constraints from Sunyaev-Zel'dovich (SZ) data. Specifically, we would model the 23 clusters for which both HST and Subaru data (or in one case WFI data) are publicly available, since the exquisite imaging of HST in the clusters' central regions is beautifully augmented by the wide field coverage of Subaru imaging. If the true 3-D shapes of clusters are not properly accounted for when analysing data, this can lead to inaccuracies in the mass density profiles of individual clusters - up to 50% bias in mass for the most highly triaxial systems. Our proposed project represents an independent analysis of the CLASH sample, complementary to that of the CLASH team, probing the triaxial shapes and orientations of the cluster dark matter halos and hot gas. Our findings will be relevant to the analysis of data from future missions such as JWST and Euclid, and also to ground-based surveys to be made with telescopes such as LSST.

  15. 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

  16. 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…

  17. Wear Particles Derived from Metal Hip Implants Induce the Generation of Multinucleated Giant Cells in a 3-Dimensional Peripheral Tissue-Equivalent Model

    PubMed Central

    Dutta, Debargh K.; Potnis, Pushya A.; Rhodes, Kelly; Wood, Steven C.

    2015-01-01

    Multinucleate giant cells (MGCs) are formed by the fusion of 5 to 15 monocytes or macrophages. MGCs can be generated by hip implants at the site where the metal surface of the device is in close contact with tissue. MGCs play a critical role in the inflammatory processes associated with adverse events such as aseptic loosening of the prosthetic joints and bone degeneration process called osteolysis. Upon interaction with metal wear particles, endothelial cells upregulate pro-inflammatory cytokines and other factors that enhance a localized immune response. However, the role of endothelial cells in the generation of MGCs has not been completely investigated. We developed a three-dimensional peripheral tissue-equivalent model (PTE) consisting of collagen gel, supporting a monolayer of endothelial cells and human peripheral blood mononuclear cells (PBMCs) on top, which mimics peripheral tissue under normal physiological conditions. The cultures were incubated for 14 days with Cobalt chromium alloy (CoCr ASTM F75, 1–5 micron) wear particles. PBMC were allowed to transit the endothelium and harvested cells were analyzed for MGC generation via flow cytometry. An increase in forward scatter (cell size) and in the propidium iodide (PI) uptake (DNA intercalating dye) was used to identify MGCs. Our results show that endothelial cells induce the generation of MGCs to a level 4 fold higher in 3-dimentional PTE system as compared to traditional 2-dimensional culture plates. Further characterization of MGCs showed upregulated expression of tartrate resistant alkaline phosphatase (TRAP) and dendritic cell specific transmembrane protein, (DC-STAMP), which are markers of bone degrading cells called osteoclasts. In sum, we have established a robust and relevant model to examine MGC and osteoclast formation in a tissue like environment using flow cytometry and RT-PCR. With endothelial cells help, we observed a consistent generation of metal wear particle- induced MGCs, which

  18. Medical futility: a conceptual model

    PubMed Central

    Mohindra, R K

    2007-01-01

    This paper introduces the medical factual matrix as a new and potentially valuable tool in medical ethical analysis. Using this tool it demonstrates the idea that a defined medical intervention can only be meaningfully declared futile in relation to a defined goal(s) of treatment. It argues that a declaration of futility made solely in relation to a defined medical intervention is inchoate. It recasts the definition of goal futility as an intervention that cannot alter the probability of the existence of the important outcome states that might flow from a defined intervention. The idea of value futility and the extent of physician obligations in futile situations are also addressed. It also examines the source of substantive conflicts which commonly arise within the doctor‐patient relationship and the ensuing power relations that operate between doctor and patient when questions of futility arise. PMID:17264191

  19. 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

  20. 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.

  1. 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!

  2. 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.

  3. 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.

  4. Biochemical Applications Of 3-Dimensional Fluorescence Spectrometry

    NASA Astrophysics Data System (ADS)

    Leiner, Marc J.; Wolfbeis, Otto S.

    1988-06-01

    We investigated the 3-dimensional fluorescence of complex mixtures of bioloquids such as human serum, serum ultrafiltrate, human urine, and human plasma low density lipoproteins. The total fluorescence of human serum can be divided into a few peaks. When comparing fluorescence topograms of sera, from normal and cancerous subjects, we found significant differences in tryptophan fluorescence. Although the total fluorescence of human urine can be resolved into 3-5 distinct peaks, some of them. do not result from single fluorescent urinary metabolites, but rather from. several species having similar spectral properties. Human plasma, low density lipoproteins possess a native fluorescence that changes when submitted to in-vitro autoxidation. The 3-dimensional fluorescence demonstrated the presence of 7 fluorophores in the lipid domain, and 6 fluorophores in the protein. dovain- The above results demonstrated that 3-dimensional fluorescence can resolve the spectral properties of complex ,lxtures much better than other methods. Moreover, other parameters than excitation and emission wavelength and intensity (for instance fluorescence lifetime, polarization, or quenchability) may be exploited to give a multidl,ensio,a1 matrix, that is unique for each sample. Consequently, 3-dimensio:Hhal fluorescence as such, or in combination with separation techniques is therefore considered to have the potential of becoming a useful new H.ethod in clinical chemistry and analytical biochemistry.

  5. 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

  6. 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.

  7. [3-dimensional documentation of wound-healing].

    PubMed

    Körber, A; Grabbe, S; Dissemond, J

    2006-04-01

    The objective evaluation of the course of wound-healing represents a substantial parameter for the quality assurance of a modern wound management in chronic wounds. Established procedures exclusively based on a two-dimensional measurement of the wound surface with planimetry or digital photo documentation in combination with a metric statement of size. Thus so far an objective method is missing for the evaluation of the volumes of chronic wounds. By the linkage of digital photography, optical grid by means of digital scanner and an image processing software in co-operation with the company RSI we were able to do an accurate 3-dimensional documentation of chronic wounds (DigiSkin). The generated scatter-plots allow a visual, computer-assisted 3-dimensional measurement and documentation of chronic wounds. In comparison with available systems it is now possible for the first time to objectify the volume changes of a chronic wound. On the basis of a case report of a female patient with an venous leg ulcer, which has been treated with a vacuum closure therapy before and after performing a mesh-graft transplantation, we would like to describe the advantages and the resulting scientific use of this new, objective wound documentation system in the clinical employment. PMID:16575675

  8. Fabrication of 3-dimensional multicellular microvascular structures

    PubMed Central

    Barreto-Ortiz, Sebastian F.; Fradkin, Jamie; Eoh, Joon; Trivero, Jacqueline; Davenport, Matthew; Ginn, Brian; Mao, Hai-Quan; Gerecht, Sharon

    2015-01-01

    Despite current advances in engineering blood vessels over 1 mm in diameter and the existing wealth of knowledge regarding capillary bed formation, studies for the development of microvasculature, the connecting bridge between them, have been extremely limited so far. Here, we evaluate the use of 3-dimensional (3D) microfibers fabricated by hydrogel electrospinning as templates for microvascular structure formation. We hypothesize that 3D microfibers improve extracellular matrix (ECM) deposition from vascular cells, enabling the formation of freestanding luminal multicellular microvasculature. Compared to 2-dimensional cultures, we demonstrate with confocal microscopy and RT-PCR that fibrin microfibers induce an increased ECM protein deposition by vascular cells, specifically endothelial colony-forming cells, pericytes, and vascular smooth muscle cells. These ECM proteins comprise different layers of the vascular wall including collagen types I, III, and IV, as well as elastin, fibronectin, and laminin. We further demonstrate the achievement of multicellular microvascular structures with an organized endothelium and a robust multicellular perivascular tunica media. This, along with the increased ECM deposition, allowed for the creation of self-supporting multilayered microvasculature with a distinct circular lumen following fibrin microfiber core removal. This approach presents an advancement toward the development of human microvasculature for basic and translational studies.—Barreto-Ortiz, S. F., Fradkin, J., Eoh, J., Trivero, J., Davenport, M., Ginn, B., Mao, H.-Q., Gerecht, S. Fabrication of 3-dimensional multicellular microvascular structures. PMID:25900808

  9. 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)…

  10. Triage in medical practices: an unacceptable model?

    PubMed

    Bell, Nora K

    1981-12-01

    Two basic presuppositions of triage are challenged: the utilitarian notion that it is morally preferable to save the greater number, and the extension of the salvageability concept as a model for macroallocation of scarce medical resources. The 'more is better' principle lacks the status of a universal moral obligation and leads to an impersonal view of the valuing of life. In the allocation of scarce resources, triage is suspect since life-saving decisions involve medical, social, economic, and political criteria. Triage thus perpetuates existing injustices.

  11. [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.

  12. [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. PMID:23985238

  13. 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

  14. 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

  15. 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.

  16. The medical model versus the just deserts model.

    PubMed

    Wolfgang, M E

    1988-01-01

    This paper traces the history of two models that have been influential in shaping modern views toward criminals. One of these two--the medical model--is based on the concept of rehabilitation, that is, treatment predicated on the attributes of the offender. The second of these two--the just deserts model--centers on retribution, that is, punishment deserved for the seriousness of the crime. Each model has been dominant in various periods of history.

  17. 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. PMID:23433685

  18. 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

  19. 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.

  20. A medical model for criminalistics education.

    PubMed

    Stoney, D A

    1988-07-01

    The history of medical education during the period of 1870 to 1926 is examined in the context of current issues confronting education in the forensic laboratory sciences. Medical education was radically altered during this period, changing from a rudimentary lecture/apprenticeship system into its modern form. Although the motivating forces had developed over some time, the actual change was quite rapid. By examining how this change occurred, we gain insight into how changes in our own profession might be initiated. Parallels between our current situation and that in medical education 117 years ago include: (1) the primary burden of professional education is borne outside the university in an apprenticeship system, (2) the apprenticeship system is overburdened by a dramatic expansion in the knowledge and skills needed for professional practice, (3) there is no standardized curriculum or accreditation process for educational programs, and (4) there is no educational program that incorporates formal clinical education. Based on this historical analysis, three major goals are proposed: (1) active entreprenurial promotion of professional educational programs by academics, (2) creation of a committee within the American Academy of Forensic Sciences to critique and rate university programs, and (3) the development of a well-defined clinical education program. A model for formalized clinical education in the forensic laboratory sciences is proposed, incorporating clinical professors, student clerkships, and university control over instruction within an operational forensic science laboratory. Benefits from this arrangement include: efficient combination of physical plants, added personnel resources in the laboratory, rapid introduction of research into the laboratory, enhanced prestige for both academics and practitioners, and relief of the laboratory's in-house training burden.

  1. Improving Perceptual Skills with 3-Dimensional Animations.

    ERIC Educational Resources Information Center

    Johns, Janet Faye; Brander, Julianne Marie

    1998-01-01

    Describes three-dimensional computer aided design (CAD) models for every component in a representative mechanical system; the CAD models made it easy to generate 3-D animations that are ideal for teaching perceptual skills in multimedia computer-based technical training. Fifteen illustrations are provided. (AEF)

  2. 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.

  3. 3-Dimensional simulation of the grain formation in investment castings

    SciTech Connect

    Gandin, C.A.; Rappaz, M. ); Tintillier, R. . Dept. Materiaux et Procedes-Direction Technique)

    1994-03-01

    A 3-dimensional (3-D) probabilistic model which has been developed previously for the prediction of grain structure formation during solidification is applied to thin superalloy plates produced using the investment-casting process. This model considers the random nucleation and orientation of nuclei formed at the mold surface and in the bulk of the liquid, the growth kinetics of the dendrite tips, and the preferential growth directions of the dendrite trunks and arms. In the present study, the grains are assumed to nucleate at the surface of the mold only. The computed grain structures, as observed in 2-dimensional (2-D) sections made parallel to the mold surface, are compared with experimental micrographs. The grain densities are then deduced as a function of the distance from the mold surface for both the experiment and the simulation. It is shown that these values are in good agreement, thus, providing validation of the grain formation mechanisms built into the 3-D probabilistic model. Finally, this model is further extended to more complex geometries and the 3-D computed grain structure of an equiaxed turbine-blade airfoil is compared with the experimental transverse section micrograph.

  4. 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

  5. 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.

  6. 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

  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. 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

  9. A model for selecting assessment methods for evaluating medical students in African medical schools.

    PubMed

    Walubo, Andrew; Burch, Vanessa; Parmar, Paresh; Raidoo, Deshandra; Cassimjee, Mariam; Onia, Rudy; Ofei, Francis

    2003-09-01

    Introduction of more effective and standardized assessment methods for testing students' performance in Africa's medical institutions has been hampered by severe financial and personnel shortages. Nevertheless, some African institutions have recognized the problem and are now revising their medical curricula, and, therefore, their assessment methods. These institutions, and those yet to come, need guidance on selecting assessment methods so as to adopt models that can be sustained locally. The authors provide a model for selecting assessment methods for testing medical students' performance in African medical institutions. The model systematically evaluates factors that influence implementation of an assessment method. Six commonly used methods (the essay examinations, short-answer questions, multiple-choice questions, patient-based clinical examination, problem-based oral examination [POE], and objective structured clinical examination) are evaluated by scoring and weighting against performance, cost, suitability, and safety factors. In the model, the highest score identifies the most appropriate method. Selection of an assessment method is illustrated using two institutional models, one depicting an ideal situation in which the objective structured clinical examination was preferred, and a second depicting the typical African scenario in which the essay and short-answer-question examinations were best. The POE method received the highest score and could be recommended as the most appropriate for Africa's medical institutions, but POE assessments require changing the medical curricula to a problem-based learning approach. The authors' model is easy to understand and promotes change in the medical curriculum and method of student assessment.

  10. Development of a change model for a controlled medical vocabulary.

    PubMed Central

    Oliver, D. E.; Shahar, Y.

    1997-01-01

    Managing change in controlled medical vocabularies is labor intensive and costly, but change is inevitable if vocabularies are to be kept up to date. The changes that are appropriate for a controlled medical vocabulary depend on the data stored for that vocabulary, and those data in turn depend on the needs of users. The set of change operations is the change model; the data stored about concepts comprise the concept model. Because the change model depends directly on the concept model, a discussion of the former necessitates a discussion of the latter. In this paper, we first present a set of tasks that we believe controlled medical vocabularies should handle. Next, we describe our concept model for a controlled medical vocabulary. Then, we review the literature on changes in existing vocabulary systems. Finally, we present our change model. We call our system, which incorporates the concept model and change model, the General Online Dictionary of Medicine (GOLDMINE). PMID:9357697

  11. New Models of CKD Care Including Pharmacists: Improving Medication Reconciliation and Medication Management

    PubMed Central

    St Peter, Wendy L.; Wazny, Lori D.; Patel, Uptal D.

    2014-01-01

    Purpose of review Chronic kidney disease patients are complex, have many medication-related problems (MRPs) and high rates of medication nonadherence, and are less adherent to some medications than patients with higher levels of kidney function. Nonadherence in CKD patients increases the odds of uncontrolled hypertension, which can increase the risk of CKD progression. This review discusses reasons for gaps in medication-related care for CKD patients, pharmacy services to reduce these gaps, and successful models that incorporate pharmacist care. Recent findings Pharmacists are currently being trained to deliver patient-centered care, including identification and management of MRPs and helping patients overcome barriers to improve medication adherence. A growing body of evidence indicates that pharmacist services for CKD patients, including medication reconciliation and medication therapy management, positively affect clinical and cost outcomes including lower rates of decline in glomerular filtration rates, reduced mortality, and fewer hospitalizations and hospital days, but more robust research is needed. Team-based models including pharmacists exist today and are being studied in a wide range of innovative care and reimbursement models. Summary Opportunities are growing to include pharmacists as integral members of CKD and dialysis healthcare teams to reduce MRPs, increase medication adherence, and improve patient outcomes. PMID:24076556

  12. Application of word-formation models in medical terms fixation.

    PubMed

    Bujalkova, M; Jureckova, A

    2003-01-01

    In their article the authors present goals of Latin teaching at medical faculties in Slovakia. They analyze in more details word-formation and structure of one-word medical terms from the point of view of their model teaching/learning and fixation. Presentation of the medical terms in models proved to be very effective for adult learners because they provide exact and easy-to-memorize scheme mechanisms that can be analogically applied in the production/manipulation and fixation of a whole range of medical terms. In conclusion several examples--excercises are presented to illustrate their use in teaching practice. (Fig. 1, Ref. 7.). PMID:15055735

  13. Commentary: discovering a different model of medical student education.

    PubMed

    Watson, Robert T

    2012-12-01

    Traditional medical schools in modern academic health centers make discoveries, create new knowledge and technology, provide innovative care to the sickest patients, and educate future academic and practicing physicians. Unfortunately, the growth of the research and clinical care missions has sometimes resulted in a loss of emphasis on the general professional education of medical students. The author concludes that it may not be practical for many established medical schools to functionally return to the reason they were created: for the education of medical students.He had the opportunity to discover a different model of medical student education at the first new MD-granting medical school created in the United States in 25 years (in 2000), the Florida State University College of Medicine. He was initially skeptical about how its distributed regional campuses model, using practicing primary care physicians to help medical students learn in mainly ambulatory settings, could be effective. But his experience as a faculty member at the school convinced him that the model works very well.He proposes a better alignment of form and function for many established medical schools and an extension of the regional community-based model to the formation of community-based primary care graduate medical education programs determined by physician workforce needs and available resources.

  14. Portal of medical data models: information infrastructure for medical research and healthcare

    PubMed Central

    Dugas, Martin; Neuhaus, Philipp; Meidt, Alexandra; Doods, Justin; Storck, Michael; Bruland, Philipp; Varghese, Julian

    2016-01-01

    Introduction: Information systems are a key success factor for medical research and healthcare. Currently, most of these systems apply heterogeneous and proprietary data models, which impede data exchange and integrated data analysis for scientific purposes. Due to the complexity of medical terminology, the overall number of medical data models is very high. At present, the vast majority of these models are not available to the scientific community. The objective of the Portal of Medical Data Models (MDM, https://medical-data-models.org) is to foster sharing of medical data models. Methods: MDM is a registered European information infrastructure. It provides a multilingual platform for exchange and discussion of data models in medicine, both for medical research and healthcare. The system is developed in collaboration with the University Library of Münster to ensure sustainability. A web front-end enables users to search, view, download and discuss data models. Eleven different export formats are available (ODM, PDF, CDA, CSV, MACRO-XML, REDCap, SQL, SPSS, ADL, R, XLSX). MDM contents were analysed with descriptive statistics. Results: MDM contains 4387 current versions of data models (in total 10 963 versions). 2475 of these models belong to oncology trials. The most common keyword (n = 3826) is ‘Clinical Trial’; most frequent diseases are breast cancer, leukemia, lung and colorectal neoplasms. Most common languages of data elements are English (n = 328 557) and German (n = 68 738). Semantic annotations (UMLS codes) are available for 108 412 data items, 2453 item groups and 35 361 code list items. Overall 335 087 UMLS codes are assigned with 21 847 unique codes. Few UMLS codes are used several thousand times, but there is a long tail of rarely used codes in the frequency distribution. Discussion: Expected benefits of the MDM portal are improved and accelerated design of medical data models by sharing best practice, more standardised data models

  15. Defending the Counseling Model and Its Eventual Synthesis with the Medical Model.

    ERIC Educational Resources Information Center

    Farrell, Madison, III

    This paper explores the strengths and weaknesses of the medical model in an effort to promote a counseling perspective that embraces some of the medical models strengths. Through inclusion, rather than exclusion, it is believed that the counseling model will eventually infiltrate the medical model by way of its own documentation system. With its…

  16. The medical director in integrated clinical care models.

    PubMed

    Parker, Thomas F; Aronoff, George R

    2015-07-01

    Integrated clinical care models, like Accountable Care Organizations and ESRD Seamless Care Organizations, present new opportunities for dialysis facility medical directors to affect changes in care that result in improved patient outcomes. Currently, there is little scholarly information on what role the medical director should play. In this opinion-based review, it is predicted that dialysis providers, the hospitals in which the medical director and staff physicians practice, and the payers with which they contract are going to insist that, as care becomes more integrated, dialysis facility medical directors participate in new ways to improve quality and decrease the costs of care. Six broad areas are proposed where dialysis unit medical directors can have the greatest effect on shifting the quality-care paradigm where integrated care models are used. The medical director will need to develop an awareness of the regional medical care delivery system, collect and analyze actionable data, determine patient outcomes to be targeted that are mutually agreed on by participating physicians and institutions, develop processes of care that result in improved patient outcomes, and lead and inform the medical staff. Three practical examples of patient-centered, quality-focused programs developed and implemented by dialysis unit medical directors and their practice partners that targeted dialysis access, modality choice, and fluid volume management are presented. Medical directors are encouraged to move beyond traditional roles and embrace responsibilities associated with integrated care.

  17. 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.

  18. A 3-Dimensional Anatomic Study of the Distal Biceps Tendon

    PubMed Central

    Walton, Christine; Li, Zhi; Pennings, Amanda; Agur, Anne; Elmaraghy, Amr

    2015-01-01

    Background Complete rupture of the distal biceps tendon from its osseous attachment is most often treated with operative intervention. Knowledge of the overall tendon morphology as well as the orientation of the collagenous fibers throughout the musculotendinous junction are key to intraoperative decision making and surgical technique in both the acute and chronic setting. Unfortunately, there is little information available in the literature. Purpose To comprehensively describe the morphology of the distal biceps tendon. Study Design Descriptive laboratory study. Methods The distal biceps terminal musculature, musculotendinous junction, and tendon were digitized in 10 cadaveric specimens and data reconstructed using 3-dimensional modeling. Results The average length, width, and thickness of the external distal biceps tendon were found to be 63.0, 6.0, and 3.0 mm, respectively. A unique expansion of the tendon fibers within the distal muscle was characterized, creating a thick collagenous network along the central component between the long and short heads. Conclusion This study documents the morphologic parameters of the native distal biceps tendon. Reconstruction may be necessary, especially in chronic distal biceps tendon ruptures, if the remaining tendon morphology is significantly compromised compared with the native distal biceps tendon. Knowledge of normal anatomical distal biceps tendon parameters may also guide the selection of a substitute graft with similar morphological characteristics. Clinical Relevance A thorough description of distal biceps tendon morphology is important to guide intraoperative decision making between primary repair and reconstruction and to better select the most appropriate graft. The detailed description of the tendinous expansion into the muscle may provide insight into better graft-weaving and suture-grasping techniques to maximize proximal graft incorporation. PMID:26665092

  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. 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.…

  1. 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…

  2. 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.

  3. Controlled teleportation of a 3-dimensional bipartite quantum state

    NASA Astrophysics Data System (ADS)

    Cao, Hai-Jing; Chen, Zhong-Hua; Song, He-Shan

    2008-07-01

    A controlled teleportation scheme of an unknown 3-dimensional (3D) two-particle quantum state is proposed, where a 3D Bell state and 3D GHZ state function as the quantum channel. This teleportation scheme can be directly generalized to teleport an unknown d-dimensional bipartite quantum state.

  4. 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

  5. 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.

    PubMed

    Joosten, A; Bochud, F; Moeckli, R

    2014-08-21

    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

  6. A 3-dimensional Analysis of the Cassiopeia A Supernova Remnant

    NASA Astrophysics Data System (ADS)

    Isensee, Karl

    We present a multi-wavelength study of the nearby supernova remnant Cassiopeia A (Cas A). Easily resolvable supernova remnants such as Cas A provide a unique opportunity to test supernova explosion models. Additionally, we can observe key processes in the interstellar medium as the ejecta from the initial explosion encounter Cas A's powerful shocks. In order to accomplish these science goals, we used the Spitzer Space Telescope's Infrared Spectrograph to create a high resolution spectral map of select regions of Cas A, allowing us to make a Doppler reconstruction of its 3-dimensional structure structure. In the center of the remnant, we find relatively pristine ejecta that have not yet reached Cas A's reverse shock or interacted with the circumstellar environment. We observe O, Si, and S emission. These ejecta can form both sheet-like structures as well as filaments. Si and O, which come from different nucleosynthetic layers of the star, are observed to be coincident in some regions, and separated by >500 km s -1 in others. Observed ejecta traveling toward us are, on average, ˜800 km s -1 slower than the material traveling away from us. We compare our observations to recent supernova explosion models and find that no single model can simultaneously reproduce all the observed features. However, models of different supernova explosions can collectively produce the observed geometries and structures of the emission interior to Cas A's reverse shock. We use the results from the models to address the conditions during the supernova explosion, concentrating on asymmetries in the shock structure. We also predict that the back surface of Cassiopeia A will begin brightening in ∼30 years, and the front surface in ˜100 years. We then used similar observations from 3 regions on Cas A's reverse shock in order to create more 3-dimensional maps. In these regions, we observe supernova ejecta both immediately before and during the shock-ejecta interaction. We determine that the

  7. 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

  8. 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

  9. 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

    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.

  10. A hypergraphic model of medical informatics: curriculum development guide.

    PubMed Central

    Chi, X.; Pavilcek, K.

    1999-01-01

    Medical informatics, as a descriptive, scientific study, must be mathematically or theoretically described. Is it important to define a model for medical informatics? The answer is worth pursuing. The medical informatics profession stands to benefit three-fold: first, by clarifying the vagueness of the definition of medical informatics, secondly, by identifying the scope and content for educational programs, and, thirdly, by defining career opportunities for its graduates. Existing medical informatics curricula are not comparable. Consequently, the knowledge and skills of graduates from these programs are difficult to assess. The challenge is to promote academics that develops graduates for prospective employers to fulfill the criteria of the health care industry and, simultaneously, compete with computer science programs that produce information technology graduates. In order to meet this challenge, medical informatics programs must have unique curricula that distinguishes its graduates. The solution is to educate students in a comparable manner across the domain of medical informatics. This paper discusses a theoretical model for medical informatics. Images Figure PMID:10566316

  11. 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…

  12. Morphological analysis and preoperative simulation of a double-chambered right ventricle using 3-dimensional printing technology.

    PubMed

    Shirakawa, Takashi; Koyama, Yasushi; Mizoguchi, Hiroki; Yoshitatsu, Masao

    2016-05-01

    We present a case of a double-chambered right ventricle in adulthood, in which we tried a detailed morphological assessment and preoperative simulation using 3-dimensional (3D) heart models for improved surgical planning. Polygonal object data for the heart were constructed from computed tomography images of this patient, and transferred to a desktop 3D printer to print out models in actual size. Medical staff completed all of the work processes. Because the 3D heart models were examined by hand, observed from various viewpoints and measured by callipers with ease, we were able to create an image of the complete form of the heart. The anatomical structure of an anomalous bundle was clearly observed, and surgical approaches to the lesion were simulated accurately. During surgery, we used an incision on the pulmonary infundibulum and resected three muscular components of the stenosis. The similarity between the models and the actual heart was excellent. As a result, the operation for this rare defect was performed safely and successfully. We concluded that the custom-made model was useful for morphological analysis and preoperative simulation. PMID:26860990

  13. Morphological analysis and preoperative simulation of a double-chambered right ventricle using 3-dimensional printing technology.

    PubMed

    Shirakawa, Takashi; Koyama, Yasushi; Mizoguchi, Hiroki; Yoshitatsu, Masao

    2016-05-01

    We present a case of a double-chambered right ventricle in adulthood, in which we tried a detailed morphological assessment and preoperative simulation using 3-dimensional (3D) heart models for improved surgical planning. Polygonal object data for the heart were constructed from computed tomography images of this patient, and transferred to a desktop 3D printer to print out models in actual size. Medical staff completed all of the work processes. Because the 3D heart models were examined by hand, observed from various viewpoints and measured by callipers with ease, we were able to create an image of the complete form of the heart. The anatomical structure of an anomalous bundle was clearly observed, and surgical approaches to the lesion were simulated accurately. During surgery, we used an incision on the pulmonary infundibulum and resected three muscular components of the stenosis. The similarity between the models and the actual heart was excellent. As a result, the operation for this rare defect was performed safely and successfully. We concluded that the custom-made model was useful for morphological analysis and preoperative simulation.

  14. 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.

  15. Noncommutative 3 Dimensional Soliton from Multi-instantons

    NASA Astrophysics Data System (ADS)

    Correa, D. H.; Forgacs, P.; Moreno, E. F.; Schaposnik, F. A.; Silva, G. A.

    2004-07-01

    We extend the relation between instanton and monopole solutions of the selfduality equations in SU(2) gauge theory to noncommutative space-times. Using this approach and starting from a noncommutative multi-instanton solution we construct a U(2) monopole configuration which lives in 3 dimensional ordinary space. This configuration resembles the Wu-Yang monopole and satisfies the selfduality (Bogomol'nyi) equations for a U(2) Yang-Mills-Higgs system.

  16. Multimodality 3-Dimensional Image Integration for Congenital Cardiac Catheterization

    PubMed Central

    2014-01-01

    Cardiac catheterization procedures for patients with congenital and structural heart disease are becoming more complex. New imaging strategies involving integration of 3-dimensional images from rotational angiography, magnetic resonance imaging (MRI), computerized tomography (CT), and transesophageal echocardiography (TEE) are employed to facilitate these procedures. We discuss the current use of these new 3D imaging technologies and their advantages and challenges when used to guide complex diagnostic and interventional catheterization procedures in patients with congenital heart disease. PMID:25114757

  17. 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.

  18. 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...

  19. [A medical image semantic modeling based on hierarchical Bayesian networks].

    PubMed

    Lin, Chunyi; Ma, Lihong; Yin, Junxun; Chen, Jianyu

    2009-04-01

    A semantic modeling approach for medical image semantic retrieval based on hierarchical Bayesian networks was proposed, in allusion to characters of medical images. It used GMM (Gaussian mixture models) to map low-level image features into object semantics with probabilities, then it captured high-level semantics through fusing these object semantics using a Bayesian network, so that it built a multi-layer medical image semantic model, aiming to enable automatic image annotation and semantic retrieval by using various keywords at different semantic levels. As for the validity of this method, we have built a multi-level semantic model from a small set of astrocytoma MRI (magnetic resonance imaging) samples, in order to extract semantics of astrocytoma in malignant degree. Experiment results show that this is a superior approach.

  20. 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…

  1. 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…

  2. Discrepancy Analysis in Continuing Medical Education: A Conceptual Model.

    ERIC Educational Resources Information Center

    Fox, Robert D.

    1983-01-01

    Presents a conceptual model of discrepancy analysis evaluation for planning, evaluating, and assessing the impact of continuing medical education (CME). Describes the model in terms of its value as a means of diagnosing errors in the development and implementation of CME. (JOW)

  3. 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

  4. 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

  5. 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

  6. 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.

  7. Flexner's model and the future of medical education.

    PubMed

    Ebert, R H

    1992-11-01

    Less attention has been paid to Flexner's educational philosophy as compared with the recommendations he made to reform American medical education in Bulletin No. 4 of the Carnegie Foundation, the so-called "Flexner Report." His philosophy begins with the education of the child, having much in common with the educational theories of John Dewey, and is based on learning by observing and doing. Flexner believed that all education should be utilitarian and should prepare the individual for the responsibilities of citizenship and for an occupation or a profession. He also believed that general education lasted too long in this country. Based on Flexner's educational philosophy rather than the four-year medical school model that bears his name, the education of the physician is reexamined. Recommendations are made concerning the interface between the last two years of college and the first two years of medical school that would better equip the future physician to face the complexities of medical practice in the next century. Further, if medical schools were given responsibility for graduate medical education, as has been recommended by prestigious committees in the past, it would be possible to integrate the medical school clinical years with those of residency training and thereby improve the educational experience. A consideration of the education of the physician as a continuum, beginning in the third year of college and ending with the conclusion of residency training, also would be entirely consistent with Flexner's educational views.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. 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. PMID:26689300

  9. Dialect Topic Modeling for Improved Consumer Medical Search

    SciTech Connect

    Crain, Steven P.; Yang, Shuang-Hong; Zha, Hongyuan; Jiao, Yu

    2010-01-01

    Access to health information by consumers is ham- pered by a fundamental language gap. Current attempts to close the gap leverage consumer oriented health information, which does not, however, have good coverage of slang medical terminology. In this paper, we present a Bayesian model to automatically align documents with different dialects (slang, com- mon and technical) while extracting their semantic topics. The proposed diaTM model enables effective information retrieval, even when the query contains slang words, by explicitly modeling the mixtures of dialects in documents and the joint influence of dialects and topics on word selection. Simulations us- ing consumer questions to retrieve medical information from a corpus of medical documents show that diaTM achieves a 25% improvement in information retrieval relevance by nDCG@5 over an LDA baseline.

  10. Dialect topic modeling for improved consumer medical search.

    PubMed

    Crain, Steven P; Yang, Shuang-Hong; Zha, Hongyuan; Jiao, Yu

    2010-11-13

    Access to health information by consumers is hampered by a fundamental language gap. Current attempts to close the gap leverage consumer oriented health information, which does not, however, have good coverage of slang medical terminology. In this paper, we present a Bayesian model to automatically align documents with different dialects (slang, common and technical) while extracting their semantic topics. The proposed diaTM model enables effective information retrieval, even when the query contains slang words, by explicitly modeling the mixtures of dialects in documents and the joint influence of dialects and topics on word selection. Simulations using consumer questions to retrieve medical information from a corpus of medical documents show that diaTM achieves a 25% improvement in information retrieval relevance by nDCG@5 over an LDA baseline.

  11. Semantic models in medical record data-bases.

    PubMed

    Cerutti, S

    1980-01-01

    A great effort has been recently made in the area of data-base design in a number of application fields (banking, insurance, travel, etc.). Yet, it is the current experience of computer scientists in the medical field that medical record information-processing requires less rigid and more complete definition of data-base specifications for a much more heterogeneous set of data, for different users who have different aims. Hence, it is important to state that the data-base in the medical field ought to be a model of the environment for which it was created, rather than just a collection of data. New more powerful and more flexible data-base models are being now designed, particularly in the USA, where the current trend in medicine is to implement, in the same structure, the connection among more different and specific users and the data-base (for administrative aims, medical care control, treatments, statistical and epidemiological results, etc.). In such a way the single users are able to talk with the data-base without interfering with one another. The present paper outlines that this multi-purpose flexibility can be achieved by improving mainly the capabilities of the data-base model. This concept allows the creation of procedures of semantic integrity control which will certainly have in the future a dramatic impact on important management features, starting from data-quality checking and non-physiological state detections, as far as more medical-oriented procedures like drug interactions, record surveillance and medical care review. That is especially true when a large amount of data are to be processed and the classical hierarchical and network data models are no longer sufficient for developing satisfactory and reliable automatic procedures. In this regard, particular emphasis will be dedicated to the relational model and, at the highest level, to the same semantic data model.

  12. Prenatal diagnosis of holoprosencephaly with ethmocephaly via 3-dimensional sonography.

    PubMed

    Lee, Gui-Se-Ra; Hur, Soo Young; Shin, Jong-Chul; Kim, Soo-Pyung; Kim, Sa Jin

    2006-01-01

    We present the prenatal 3-dimensional (3D) sonographic findings in a case of holoprosencephaly with ethmocephaly at 32 weeks' gestation. The sonographic diagnosis was based on the intracranial findings of a single ventricle and bulb-shaped appearance of the thalami and facial abnormalities, including hypotelorism with proboscis. Chromosome study of the fetus revealed a normal female karyotype (46,XX). Postmortem examination confirmed the 3D sonographic findings. This case demonstrates that the use of 3D sonography improves the imaging and the understanding of the condition of the intracranial abnormalities and the facial anomalies. PMID:16788963

  13. Meta-modelling the Medical Record: Design and Application

    PubMed Central

    Huet, Bernard; Lesueur, Bruno; Lebeux, Pierre; Blain, Gilles

    2000-01-01

    This project is based on a user-oriented design for medical record, thanks to a meta-model able to generate various models for an application domain. The meta-model is constituted of basic concepts: User Semantic Group, sentence-type, variable, graph. A beginning of implementation is in echocardiography report; The advantages are a very thorough personalization of the document for the user, and a greater independence of the design diagram from the technological platform.

  14. 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.

  15. 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.

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

    PubMed

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

    2014-03-01

    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

  17. 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

  18. Medical informatics: a model developed for diabetes education via telemedicine.

    PubMed

    Ubeyli, Elif Derya

    2009-04-01

    Fast developments in information and communication technology (ICT) have made it possible to develop new services for people. One of the most interesting areas is health care. Medical informatics is the discipline concerned with the systematic processing of data, information and knowledge in medicine and health care. Information services, medical decision support systems and telemedicine are becoming important tools for medical professionals and also people who are interested in health related information. Medical decision support aims at providing health care professionals with therapy guidelines directly at the point of care. Telemedicine is the use of modern telecommunications and information technologies (IT) for the provision of clinical care to individuals at a distance and transmission of information to provide that care. In the present study, usage of IT in medicine, medical decision support systems, computerized medical measurements, patient education and network connectivity were described. A model for risk evaluation, data collection and education of undiagnosed diabetes using the world wide web (www) was presented. PMID:19397096

  19. 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.

  20. 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. PMID:27222318

  1. 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.

  2. Medical preparedness: Chernobyl as a model for southeastern Michigan

    SciTech Connect

    Rogers, F.J.; Apsey, D.; Kantor, K.; Hann, E.; Dienst, S.

    1987-08-07

    The Detroit Chapter of Physicians for Social Responsibility developed a project to evaluate the potential response of the local medical community to a small nuclear disaster involving radiation injuries. The model was patterned after the Chernobyl nuclear power plant disaster of April 26, 1986. They surveyed the potential response to a hypothetical disaster at the Enrico Fermi II nuclear reactor located south of Detroit.

  3. 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

  4. 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

  5. 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

  6. Assessment of Medical Risks and Optimization of their Management using Integrated Medical Model

    NASA Technical Reports Server (NTRS)

    Fitts, Mary A.; Madurai, Siram; Butler, Doug; Kerstman, Eric; Risin, Diana

    2008-01-01

    The Integrated Medical Model (IMM) Project is a software-based technique that will identify and quantify the medical needs and health risks of exploration crew members during space flight and evaluate the effectiveness of potential mitigation strategies. The IMM Project employs an evidence-based approach that will quantify probability and consequences of defined in-flight medical risks, mitigation strategies, and tactics to optimize crew member health. Using stochastic techniques, the IMM will ultimately inform decision makers at both programmatic and institutional levels and will enable objective assessment of crew health and optimization of mission success using data from relevant cohort populations and from the astronaut population. The objectives of the project include: 1) identification and documentation of conditions that may occur during exploration missions (Baseline Medical Conditions List [BMCL), 2) assessment of the likelihood of conditions in the BMCL occurring during exploration missions (incidence rate), 3) determination of the risk associated with these conditions and quantify in terms of end states (Loss of Crew, Loss of Mission, Evacuation), 4) optimization of in-flight hardware mass, volume, power, bandwidth and cost for a given level of risk or uncertainty, and .. validation of the methodologies used.

  7. 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. PMID:21811148

  8. 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.

  9. 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.

  10. Military medical modeling and simulation in the 21st century.

    PubMed

    Moses, G; Magee, J H; Bauer, J J; Leitch, R

    2001-01-01

    As we enter the 21st century, military medicine struggles with critical issues. One of the most important issues is how to train medical personnel in peace for the realities of war. In April, 1998, The General Accounting Office (GAO) reported, "Military medical personnel have almost no chance during peacetime to practice battlefield trauma care skills. As a result, physicians both within and outside the Department of Defense (DOD) believe that military medical personnel are not prepared to provide trauma care to the severely injured soldiers in wartime. With some of today's training methods disappearing, the challenge of providing both initial; and sustainment training for almost 100,000 military medical personnel is becoming insurmountable. The "training gap" is huge and impediments to training are mounting. For example, restrictions on animal use are increasing and the cost of conducting live mass casualty exercises is prohibitive. Many medical simulation visionaries believe that four categories of medical simulation are emerging to address these challenges. These categories include PC-based multimedia, digital mannequins, virtual workbenches, and total immersion virtual reality (TIVR). The use of simulation training can provide a risk = free realistic learning environment for the spectrum of medical skills training, from buddy-aid to trauma surgery procedures. This will, in turn, enhance limited hands on training opportunities and revolutionize the way we train in peace to deliver medicine in war. High-fidelity modeling will permit manufacturers to prototype new devices before manufacture. Also, engineers will be able to test a device for themselves in a variety of simulated anatomical representations, permitting them to "practice medicine".

  11. Medical simulation: Overview, and application to wound modelling and management

    PubMed Central

    Pai, Dinker R.; Singh, Simerjit

    2012-01-01

    Simulation in medical education is progressing in leaps and bounds. The need for simulation in medical education and training is increasing because of a) overall increase in the number of medical students vis-à-vis the availability of patients; b) increasing awareness among patients of their rights and consequent increase in litigations and c) tremendous improvement in simulation technology which makes simulation more and more realistic. Simulation in wound care can be divided into use of simulation in wound modelling (to test the effect of projectiles on the body) and simulation for training in wound management. Though this science is still in its infancy, more and more researchers are now devising both low-technology and high-technology (virtual reality) simulators in this field. It is believed that simulator training will eventually translate into better wound care in real patients, though this will be the subject of further research. PMID:23162218

  12. Business models for academic medical center cyclotron operations.

    PubMed

    LeGarde, Caroline; Bledsoe, Martin L; Wahl, Richard L

    2005-06-01

    A cyclotron facility may provide a significant strategic advantage for an academic medical center that desires to build a strong research program in nuclear medicine. Such a facility may provide an advantage in obtaining support from the National Institutes of Health. A nuclear medicine research program often requires the production of short-lived radioisotopes for clinical patients. Combining the research program with a commercial production and distribution program can increase the synergies and efficiencies of an organization. This article describes various business models that combine research, clinical, and commercial operations to align an academic medical center's cyclotron program operation to its goals and resources. By coordinating these three functions, an academic medical center may be able to support extensive research capabilities that would otherwise be unattainable.

  13. 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. PMID:23949724

  14. Role Modeling in the First 2 Years of Medical School.

    PubMed

    Obadia, Sharon J

    2015-08-01

    Role modeling opportunities for osteopathic physician teachers during a student's first 2 years of medical school are emerging as more colleges of osteopathic medicine strive to connect basic science didactics with clinically based learning activities. Examples of positive modeling by physician teachers during the first years of medical school are illustrated by 10 vignettes that can be incorporated into faculty development programs to increase awareness of such opportunities. The physician teacher in each vignette interacts with the student demonstrating desired professional behaviors. These vignettes also illustrate the effect of a positive "hidden curriculum" on a student's professional development. By recognizing these valuable teachable moments, teachers can incorporate role modeling into their daily practice. PMID:26214824

  15. Medical Students’ Perceptions of Clinical Teachers as Role Model

    PubMed Central

    Haider, Sonia Ijaz; Snead, David R. J.; Bari, Muhammad Furqan

    2016-01-01

    Introduction Role models facilitate student learning and assists in the development of professional identity. However, social organization and cultural values influence the choice of role models. Considering that the social organization and cultural values in South East Asia are different from other countries, it is important to know whether this affects the characteristics medical students look for in their role models in these societies. Methods A 32 item questionnaire was developed and self-administered to undergraduate medical students. Participants rated the characteristics on a three point scale (0 = not important, 1 = mildly important, 2 = very important). One way ANOVA and student's t-test were used to compare the groups. Results A total of 349 (65.23%) distributed questionnaires were returned. The highest ranked themes were teaching and facilitating learning, patient care and continuing professional development followed by communication and professionalism. Safe environment and guiding personal and professional development was indicated least important. Differences were also observed between scores obtained by males and females. Conclusion Globally there are attributes which are perceived as essential for role models, while others are considered desirable. An understanding of the attributes which are essential and desirable for role models can help medical educators devise strategies which can reinforce those attributes within their institutions. PMID:26959364

  16. Design of 3-dimensional complex airplane configurations with specified pressure distribution via optimization

    NASA Technical Reports Server (NTRS)

    Kubrynski, Krzysztof

    1991-01-01

    A subcritical panel method applied to flow analysis and aerodynamic design of complex aircraft configurations is presented. The analysis method is based on linearized, compressible, subsonic flow equations and indirect Dirichlet boundary conditions. Quadratic dipol and linear source distribution on flat panels are applied. In the case of aerodynamic design, the geometry which minimizes differences between design and actual pressure distribution is found iteratively, using numerical optimization technique. Geometry modifications are modeled by surface transpiration concept. Constraints in respect to resulting geometry can be specified. A number of complex 3-dimensional design examples are presented. The software is adopted to personal computers, and as result an unexpected low cost of computations is obtained.

  17. The collaborative autonomy model of medical decision-making.

    PubMed

    Rubin, Michael A

    2014-04-01

    While the bioethical principle of beneficence originated in antiquity, the ascension of autonomy, or "self-rule," has redefined the physician-patient relationship to the extent that autonomy often dominates medical decision-making. Philosophical and social movements, medical research atrocities, consumerism, and case law have all had their influence on this paradigm shift. Consequently, the contemporary physician encounters an uncertainty in medical practice on how to resolve conflicts that arise in the pursuit of valuing both autonomy and beneficence. This is especially true in the practice of neurologic critical care where physicians may be advising comfort care measures for neurologically devastated patients while surrogates request physiologically futile interventions. This conundrum has been an important subject of the bioethics and social science literature but often this discourse is not disseminated to the clinicians confronting these issues. The purpose of this essay is to present a history of the principles of autonomy and beneficence and then present a shared medical decision-making model, collaborative autonomy, to provide guidance to neurologic critical care providers in how to resolve such dilemmas. Clinical vignettes will help illustrate the model. PMID:24233814

  18. Structured spreadsheet modeling in medical decision making and research.

    PubMed

    Kokol, P

    1990-06-01

    The construction, evaluation, implementation, and use of models representing various algorithms, strategies, methods, theories etc. based on the analysis of great amounts of data are necessary in both Medical Research and Decision Making (MR/DM). Performing such tasks manually is not only time consuming and tedious, but also very error-prone. The appearance of a computer with its ability to store and process information has opened an opportunity to facilitate enormously and improve activities. However, the effective use of computers is limited by difficulties accompanying noncomputer specialists like doctors, nurses, and other medical staff in learning and using conventional programming languages, tools, and techniques. In this paper we present Structured Spreadsheet Modeling as a possible solution, and show that it is applicable in the MR/DM field on a concrete basis.

  19. 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.

  20. Modeling of bubble dynamics in relation to medical applications

    SciTech Connect

    Amendt, P.A.; London, R.A.; Strauss, M. |

    1997-03-12

    In various pulsed-laser medical applications, strong stress transients can be generated in advance of vapor bubble formation. To better understand the evolution of stress transients and subsequent formation of vapor bubbles, two-dimensional simulations are presented in channel or cylindrical geometry with the LATIS (LAser TISsue) computer code. Differences with one-dimensional modeling are explored, and simulated experimental conditions for vapor bubble generation are presented and compared with data. 22 refs., 8 figs.

  1. Medical staff privileges for ethics consultants: an institutional model.

    PubMed

    La Puma, J; Priest, E R

    1992-01-01

    On January 1, 1991, the Joint Commission required hospitals to be equipped for resolving moral dilemmas that arise in the care of a patient. Regulation of those professing expertise in clinical ethics is new and untested yet must be evaluated and further developed to protect patients from practitioners who lack expertise in clinical ethics but may promote themselves as qualified. The authors report the development of standard criteria for clinical ethics consultation privileges as one model to protect patients. An institutional medical staff model utilizing approved credentialing mechanisms is a generous umbrella under which patients may be protected, qualified clinical ethicists may practice, and continuous quality improvement may be sought.

  2. 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

    2015-01-01

    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

  3. A Novel 3-Dimensional Approach for Cardiac Regeneration

    PubMed Central

    Munarin, F.; Coulombe, K.L.K.

    2016-01-01

    Ischemic heart diseases, such as coronary artery disease and microvascular disease, are cardiovascular pathologies that cause reduced blood supply to the heart muscle. Acute and chronic ischemia cause cardiomyocytes to die, and these cells are not naturally replaced as part of the wound healing process in the heart. To promote neovascularization in the wound bed and in implanted engineered tissues, we have developed a collagen–alginate microspheres scaffold intended for local release of drugs and growth factors in order to recruit host endothelial cells to the area and provide them with geometrical cues to form new vessels. Optimization of alginate microspheres included modulation of nitrogen pressure, alginate and CaCl2 concentrations, nozzle size, and velocity of extrusion to achieve monodisperse populations of 100 μm diameter microspheres with protein release over 3 days. In vitro incorporation of fibroblasts in the bulk collagen demonstrated cellular compatibility with embedded alginate microspheres. An in vitro vessel formation assay, performed with human umbilical vein endothelial cells (HUVECs) immobilized in the collagen phase of the collagen–alginate microspheres scaffolds, showed that HUVECs formed networks following the 3-dimensional pattern of the microspheres even in the absence of growth factor. Implantation of acellular collagen–alginate microspheres scaffolds onto healthy rat hearts confirmed the invasion of host cells at one week. Together, these results suggest that the collagen–alginate microspheres scaffold is a viable, tunable therapeutic approach for directing neovascularization in engineered tissues and in the heart after ischemic events. PMID:26736614

  4. 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.

  5. 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

  6. Chromosome Conformation of Human Fibroblasts Grown in 3-Dimensional Spheroids

    PubMed Central

    Chen, Haiming; Comment, Nicholas; Chen, Jie; Ronquist, Scott; Hero, Alfred; Ried, Thomas; Rajapakse, Indika

    2015-01-01

    In the study of interphase chromosome organization, genome-wide chromosome conformation capture (Hi-C) maps are often generated using 2-dimensional (2D) monolayer cultures. These 2D cells have morphological deviations from cells that exist in 3-dimensional (3D) tissues in vivo, and may not maintain the same chromosome conformation. We used Hi-C maps to test the extent of differences in chromosome conformation between human fibroblasts grown in 2D cultures and those grown in 3D spheroids. Significant differences in chromosome conformation were found between 2D cells and those grown in spheroids. Intra-chromosomal interactions were generally increased in spheroid cells, with a few exceptions, while inter-chromosomal interactions were generally decreased. Overall, chromosomes located closer to the nuclear periphery had increased intra-chromosomal contacts in spheroid cells, while those located more centrally had decreased interactions. This study highlights the necessity to conduct studies on the topography of the interphase nucleus under conditions that mimic an in vivo environment. PMID:25738643

  7. Medicalization in psychiatry: the medical model, descriptive diagnosis, and lost knowledge.

    PubMed

    Sedler, Mark J

    2016-06-01

    Medicalization was the theme of the 29th European Conference on Philosophy of Medicine and Health Care that included a panel session on the DSM and mental health. Philosophical critiques of the medical model in psychiatry suffer from endemic assumptions that fail to acknowledge the real world challenges of psychiatric nosology. The descriptive model of classification of the DSM 3-5 serves a valid purpose in the absence of known etiologies for the majority of psychiatric conditions. However, a consequence of the "atheoretical" approach of the DSM is rampant epistemological confusion, a shortcoming that can be ameliorated by importing perspectives from the work of Jaspers and McHugh. Finally, contemporary psychiatry's over-reliance on neuroscience and pharmacotherapy has led to a reductionist agenda that is antagonistic to the inherently pluralistic nature of psychiatry.  As a result,  the field has suffered a loss of knowledge that may be difficult to recover. PMID:26602907

  8. 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.

  9. 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.

  10. 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).

  11. 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.

  12. Modeling past, current, and future time in medical databases.

    PubMed Central

    Kouramajian, V.; Fowler, J.

    1994-01-01

    Recent research has focused on increasing the power of medical information systems by incorporating time into the database system. A problem with much of this research is that it fails to differentiate between historical time and future time. The concept of bitemporal lifespan presented in this paper overcomes this deficiency. Bitemporal lifespan supports the concepts of valid time and transaction time and allows the integration of past, current, and future information in a unified model. The concept of bitemporal lifespan is presented within the framework of the Extended Entity-Relationship model. This model permits the characterization of temporal properties of entities, relationships, and attributes. Bitemporal constraints are defined that must hold between entities forming "isa" hierarchies and between entities and relationships. Finally, bitemporal extensions are presented for database query languages in order to provide natural high-level operators for bitemporal query expressions. PMID:7949941

  13. 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.

  14. Conceptual Modeling for the Unified Medical Language System

    PubMed Central

    Barr, Charles E.; Komorowski, Henryk Jan; Pattison-Gordon, Edward; Greenes, Robert A.

    1988-01-01

    The Unified Medical Language System was proposed by the National Library of Medicine to facilitate the exchange and utilization of information from multiple sources. We are using semantic networks as the knowledge representation scheme in a prototype system to explore how to accomplish these goals. Conceptual modeling helps define a complete and consistent set of objects and relationships to include in the semantic net. Both top-down and bottom-up approaches were found useful in the seven step process of building the semantic network. Theoretical and practical issues are discussed as well as future extensions to the current prototype.

  15. 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.

  16. The method of geometrical comparison of 3-dimensional objects created from DICOM images.

    PubMed

    Gaweł, Dominik; Danielewicz, Kamil; Nowak, Michał

    2012-01-01

    This work presents a method of geometrical comparison of 3-dimensional objects created from DICOM images. The reconstruction of biological objects is realized with use of Simpleware commercial software. Then the 3D geometries are registered and the recognized shape differences are visualized using color map, indicating the change of the 3D geometry. Than the last, but most important step of the presented technology is performed. The model including the information about changes in compared geometries is translated into the PDF format. Such approach allows to present the final result on every desktop computer equipped with Adobe Reader. This PDF browser is free to use and gives the possibility to freely rotate, move and zoom the model. PMID:22744507

  17. 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

  18. 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

  19. 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

  20. 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.

  1. Analysis of errors in medical rapid prototyping models.

    PubMed

    Choi, J Y; Choi, J H; Kim, N K; Kim, Y; Lee, J K; Kim, M K; Lee, J H; Kim, M J

    2002-02-01

    Rapid prototyping (RP) is a relatively new technology that produces physical models by selectively solidifying UV-sensitive liquid resin using a laser beam. The technology has gained a great amount of attention, particularly in oral and maxillofacial surgery. An important issue in RP applications in this field is how to obtain RP models of the required accuracy. We investigated errors generated during the production of medical RP models, and identified the factors that caused dimensional errors in each production phase. The errors were mainly due to the volume-averaging effect, threshold value, and difficulty in the exact replication of landmark locations. We made 16 linear measurements on a dry skull, a replicated three-dimensional (3-D) visual (STL) model, and an RP model. The results showed that the absolute mean deviation between the original dry skull and the RP model over the 16 linear measurements was 0.62 +/- 0.35 mm (0.56 +/- 0.39%), which is smaller than values reported in previous studies. A major emphasis is placed on the dumb-bell effect. Classifying measurements as internal and external measurements, we observed that the effect of an inadequate threshold value differs with the type of measurement.

  2. 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).

  3. 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

  4. 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.

  5. The adaptive FEM elastic model for medical image registration.

    PubMed

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

    2014-01-01

    This paper proposes an adaptive mesh refinement strategy for the finite element method (FEM) based elastic registration model. The signature matrix for mesh refinement takes into account the regional intensity variance and the local deformation displacement. The regional intensity variance reflects detailed information for improving registration accuracy and the deformation displacement fine-tunes the mesh refinement for a more efficient algorithm. The gradient flows of two different similarity metrics, the sum of the squared difference and the spatially encoded mutual information for the mono-modal and multi-modal registrations, are used to derive external forces to drive the model to the equilibrium state. We compared our approach to three other models: (1) the conventional multi-resolution FEM registration algorithm; (2) the FEM elastic method that uses variation information for mesh refinement; and (3) the robust block matching based registration. Comparisons among different methods in a dataset with 20 CT image pairs upon artificial deformation demonstrate that our registration method achieved significant improvement in accuracies. Experimental results in another dataset of 40 real medical image pairs for both mono-modal and multi-modal registrations also show that our model outperforms the other three models in its accuracy.

  6. Pseudoexponential and Semi-Pseudoexponential Models in Medical Prognostics

    NASA Astrophysics Data System (ADS)

    Filus, Jerzy K.; Filus, Lidia Z.

    2010-09-01

    We investigate some aspects of bio-medical problems of estimation of residual life time T of a person subjected to a variety of circumstances such as illness with possible some additional stresses. As the model of that (random) life time we use some exponential conditional probability distributions, given random values X1,X2…,Xm. In the stochastic model we construct, these measures (of the stresses) are considered to serve as explanatory variables for the variable of main interest (the life time) T. The first stochastic model, we choose, is associated with the pseudoexponential joint pdf of the m+1 dimensional random vectors (T,X1,X2,…,Xm) but in this case we restrict our attention only to the conditional densities of the time T, given observed values X1,X2…,Xm. of the stresses. This density is exponential with respect to t. If the latter model is pseudoexponential then the density of the random vector (X1,X2…,Xm) is pseudoexponential as well. We then relax this assumption by admitting the probability distribution of the random vector (X1,X2,…,Xm) to be arbitrary and the marginals are not necessary from the same class of distributions. The so extended model we consider a `semi-pseudoexponential' and postulate to use it in the similar to the above biomedical (or reliability) problems in order to increase flexibility.

  7. 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.

  8. 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. PMID:25178271

  9. 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…

  10. 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.

  11. Method and apparatus for imaging through 3-dimensional tracking of protons

    NASA Technical Reports Server (NTRS)

    Ryan, James M. (Inventor); Macri, John R. (Inventor); McConnell, Mark L. (Inventor)

    2001-01-01

    A method and apparatus for creating density images of an object through the 3-dimensional tracking of protons that have passed through the object are provided. More specifically, the 3-dimensional tracking of the protons is accomplished by gathering and analyzing images of the ionization tracks of the protons in a closely packed stack of scintillating fibers.

  12. 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.

  13. 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…

  14. 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…

  15. 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

  16. [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.

  17. Unification of color postprocessing techniques for 3-dimensional computational mechanics

    NASA Technical Reports Server (NTRS)

    Bailey, Bruce Charles

    1985-01-01

    To facilitate the understanding of complex three-dimensional numerical models, advanced interactive color postprocessing techniques are introduced. These techniques are sufficiently flexible so that postprocessing difficulties arising from model size, geometric complexity, response variation, and analysis type can be adequately overcome. Finite element, finite difference, and boundary element models may be evaluated with the prototype postprocessor. Elements may be removed from parent models to be studied as independent subobjects. Discontinuous responses may be contoured including responses which become singular, and nonlinear color scales may be input by the user for the enhancement of the contouring operation. Hit testing can be performed to extract precise geometric, response, mesh, or material information from the database. In addition, stress intensity factors may be contoured along the crack front of a fracture model. Stepwise analyses can be studied, and the user can recontour responses repeatedly, as if he were paging through the response sets. As a system, these tools allow effective interpretation of complex analysis results.

  18. Sparse principal component analysis in medical shape modeling

    NASA Astrophysics Data System (ADS)

    Sjöstrand, Karl; Stegmann, Mikkel B.; Larsen, Rasmus

    2006-03-01

    Principal component analysis (PCA) is a widely used tool in medical image analysis for data reduction, model building, and data understanding and exploration. While PCA is a holistic approach where each new variable is a linear combination of all original variables, sparse PCA (SPCA) aims at producing easily interpreted models through sparse loadings, i.e. each new variable is a linear combination of a subset of the original variables. One of the aims of using SPCA is the possible separation of the results into isolated and easily identifiable effects. This article introduces SPCA for shape analysis in medicine. Results for three different data sets are given in relation to standard PCA and sparse PCA by simple thresholding of small loadings. Focus is on a recent algorithm for computing sparse principal components, but a review of other approaches is supplied as well. The SPCA algorithm has been implemented using Matlab and is available for download. The general behavior of the algorithm is investigated, and strengths and weaknesses are discussed. The original report on the SPCA algorithm argues that the ordering of modes is not an issue. We disagree on this point and propose several approaches to establish sensible orderings. A method that orders modes by decreasing variance and maximizes the sum of variances for all modes is presented and investigated in detail.

  19. 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,…

  20. 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.

  1. 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.

  2. 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. PMID:23920835

  3. 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.

  4. Medical foundations: one model for hospital-physician alignment.

    PubMed

    Feldman, Joan W

    2012-05-01

    Some states that enforce a corporate practice of medicine prohibition have created medical foundation statutes allowing hospitals or health systems to own corporations providing physician services. Medical foundations may be useful in the coordination of care through employed or contracted physicians. Medical foundations that qualify as a tax-exempt entities have lower risks associated with tax-exempt rules as long as payments to physicians are reasonable and don't result in private inurement. PMID:22616507

  5. Medical foundations: one model for hospital-physician alignment.

    PubMed

    Feldman, Joan W

    2012-05-01

    Some states that enforce a corporate practice of medicine prohibition have created medical foundation statutes allowing hospitals or health systems to own corporations providing physician services. Medical foundations may be useful in the coordination of care through employed or contracted physicians. Medical foundations that qualify as a tax-exempt entities have lower risks associated with tax-exempt rules as long as payments to physicians are reasonable and don't result in private inurement.

  6. Biomechanical 3-Dimensional Finite Element Analysis of Obturator Protheses Retained with Zygomatic and Dental Implants in Maxillary Defects

    PubMed Central

    Akay, Canan; Yaluğ, Suat

    2015-01-01

    Background The objective of this study was to investigate the stress distribution in the bone around zygomatic and dental implants for 3 different implant-retained obturator prostheses designs in a Aramany class IV maxillary defect using 3-dimensional finite element analysis (FEA). Material\\Methods A 3-dimensional finite element model of an Aramany class IV defect was created. Three different implant-retained obturator prostheses were modeled: model 1 with 1 zygomatic implant and 1 dental implant, model 2 with 1 zygomatic implant and 2 dental implants, and model 3 with 2 zygomatic implants. Locator attachments were used as a superstructure. A 150-N load was applied 3 different ways. Qualitative analysis was based on the scale of maximum principal stress; values obtained through quantitative analysis are expressed in MPa. Results In all loading conditions, model 3 (when compared models 1 and 2) showed the lowest maximum principal stress value. Model 3 is the most appropirate reconstruction in Aramany class IV maxillary defects. Two zygomatic implants can reduce the stresses in model 3. The distribution of stresses on prostheses were more rational with the help of zygoma implants, which can distribute the stresses on each part of the maxilla. Conclusions Aramany class IV obturator prosthesis placement of 2 zygomatic implants in each side of the maxilla is more advantageous than placement of dental implants. In the non-defective side, increasing the number of dental implants is not as suitable as zygomatic implants. PMID:25714086

  7. 3-dimensional wells and tunnels for finite element grids

    SciTech Connect

    Cherry, T.A.; Gable, C.W.; Trease, H.

    1996-12-31

    Modeling fluid, vapor, and air injection and extraction from wells poses a number of problems. The length scale of well bores is centimeters, the region of high pressure gradient may be tens of meters and the reservoir may be tens of kilometers. Furthermore, accurate representation of the path of a deviated well can be difficult. Incorporating the physics of injection and extraction can be made easier and more accurate with automated grid generation tools that incorporate wells as part of a background mesh that represents the reservoir. GEOMESH is a modeling tool developed for automating finite element grid generation. This tool maintains the geometric integrity of the geologic framework and produces optimal (Delaunay) tetrahedral grids. GEOMESH creates a 3D well as hexagonal segments formed along the path of the well. This well structure is tetrahedralized into a Delaunay mesh and then embedded into a background mesh. The well structure can be radially or vertically refined and each well layer is assigned a material property or can take on the material properties of the surrounding stratigraphy. The resulting embedded well can then be used by unstructured finite element models for gas and fluid flow in the vicinity of wells or tunnels. This 3D well representation allows the study of the free-surface of the well and surrounding stratigraphy. It reduces possible grid orientation effects, and allows better correlation between well sample data and the geologic model. The well grids also allow improved visualization for well and tunnel model analysis. 3D observation of the grids helps qualitative interpretation and can reveal features not apparent in fewer dimensions.

  8. 3-dimensional wells and tunnels for finite element grids

    SciTech Connect

    Cherry, T.A.; Gable, C.W.; Trease, H.

    1996-04-01

    Modeling fluid, vapor, and air injection and extraction from wells poses a number of problems. The length scale of well bores is centimeters, the region of high pressure gradient may be tens of meters and the reservoir may be tens of kilometers. Furthermore, accurate representation of the path of a deviated well can be difficult. Incorporating the physics of injection and extraction can be made easier and more accurate with automated grid generation tools that incorporate wells as part of a background mesh that represents the reservoir. GEOMESH is a modeling tool developed for automating finite element grid generation. This tool maintains the geometric integrity of the geologic framework and produces optimal (Delaunay) tetrahedral grids. GEOMESH creates a 3D well as hexagonal segments formed along the path of the well. This well structure is tetrahedralized into a Delaunay mesh and then embedded into a background mesh. The well structure can be radially or vertically refined and each well layer is assigned a material property or can take on the material properties of the surrounding stratigraphy. The resulting embedded well can then be used by unstructured finite element models for gas and fluid flow in the vicinity of wells or tunnels. This 3D well representation allows the study of the free- surface of the well and surrounding stratigraphy. It reduces possible grid orientation effects, and allows better correlation between well sample data and the geologic model. The well grids also allow improved visualization for well and tunnel model analysis. 3D observation of the grids helps qualitative interpretation and can reveal features not apparent in fewer dimensions.

  9. Addiction medicine: a model osteopathic medical school curriculum.

    PubMed

    Lande, R Gregory; Wyatt, Stephen A; Przekop, Peter R

    2010-03-01

    The World Health Organization has identified nicotine, alcohol, and illicit drugs as among the top 10 contributors of morbidity and mortality in the world. Substance use disorders are preventable conditions that are major contributors to poor health, family dysfunction, and various social problems in the United States-problems that have a profound economic impact. The American Osteopathic Academy of Addiction Medicine seeks to promote teaching of addiction medicine at colleges of osteopathic medicine (COMs), which-honoring the osteopathic concepts of holistic medicine and disease prevention-are well poised to develop a model addiction medicine curriculum. Educators and students at COMs can use guidelines from Project MAINSTREAM, a core addiction medicine curriculum designed to improve education of health professionals in substance abuse, for developing addiction medicine curricula and for gauging their professional growth. These guidelines should be incorporated into the first 2 years of osteopathic medical students' basic science didactics. The authors encourage the development of addiction medicine courses and curricula at all COMs. PMID:20386021

  10. 3-dimensional simulation of the tangential YORP effect

    NASA Astrophysics Data System (ADS)

    Golubov, O.; Scheeres, D. J.; Krugly, Y. N.

    2013-12-01

    YORP effect is a torque created by recoil forces of the light reflected or re-emitted by the surface of an asteroid. This torque has been demonstrated to be a major factor of evolution of kilometer-sized asteroids, largely responsible for their distribution over rotation rates and obliquities. YORP used to be considered predominantly in the model of locally flat surface. It resulted in the recoil force normal to the surface, and the overall torque being non-zero only due to slight non-symmetries of the asteroid's shape. But recently it has been shown that presence of decimeter-sized stones on the surface of an asteroid can substantially change this picture (Golubov & Krugly 2012, ApJL 752: L11). Under certain conditions, the western sides of stones appear to be on average slightly warmer than their eastern sides, thus experiencing a stronger recoil force and dragging the surface of the asteroid eastward. This force parallel to the overall surface of the asteroid is called the tangential YORP, or TYORP. It operates in concert with the normal YORP force, or NYORP, which acts normally to the overall surface. Even though the TYORP force is much smaller than the NYORP force, it has a bigger lever arm with respect to the rotation axis of the asteroid, and its torques tend to add up for opposite points on the asteroid's surface rather than to subtract, therefore the effects of TYORP and NYORP on the rotation rate of the asteroid can be comparable, and the standard treatment of the effect considering NYORP only is insufficient. In the talk we are going to review the results from Golubov & Krugly (2012), which give a rough estimate of the effect in a 1-dimensional model, approximating the stones by high long walls. Then we shall go beyond this model and present simulations of the effect for a surface covered with spherical stones. Our model incorporates 3-dimentional heat conductivity in stones and ray tracing of incoming and emitted light. We shall present the strength of

  11. Accuracy of medical models made by consumer-grade fused deposition modelling printers

    PubMed Central

    Petropolis, Christian; Kozan, Daniel; Sigurdson, Leif

    2015-01-01

    BACKGROUND: Additive manufacturing using fused deposition modelling (FDM) has become widely available with the development of consumer-grade three-dimensional printers. To be useful in maxillofacial surgery, models created by these printers must accurately reproduce the craniofacial skeleton. OBJECTIVE: To determine the accuracy of consumer-grade FDM printers in the production of medical models compared with industrial selective laser sintering (SLS) printers. METHODS: Computed tomography images of a dry skull were manipulated using OsiriX (OsiriX, Switzerland) and ZBrush (Pixologic, USA) software. Models were fabricated using a consumer-grade FDM printer at 100 μm, 250 μm and 500 μm layer heights and an industrial SLS printer. Seven linear measurements were made on the models and compared with the corresponding dry skull measurements using an electronic caliper. RESULTS: A dimensional error of 0.30% was observed for the SLS models and 0.44%, 0.52% and 1.1% for the 100 μm, 250 μm and 500 μm FDM models, respectively. CONCLUSION: Consumer-grade FDM printers can produce medical models with sufficient dimensional accuracy for use in maxillofacial surgery. With this technology, surgeons can independently produce low-cost maxillofacial models in an office setting. PMID:26090349

  12. 3-Dimensional simulations of storm dynamics on Saturn

    NASA Astrophysics Data System (ADS)

    Hueso, R.; Sanchez-Lavega, A.

    2000-10-01

    The formation and evolution of convective clouds in the atmosphere of Saturn is investigated using an anelastic three-dimensional time-dependent model with parameterized microphysics. The model is designed to study the development of moist convection on any of the four giant planets and has been previously used to investigate the formation of water convective storms in the jovian atmosphere. The role of water and ammonia in moist convection is investigated with varying deep concentrations. Results imply that most of the convective activity observed at Saturn may occur at the ammonia cloud deck while the formation of water moist convection may happen only when very strong constraints on the lower troposphere are met. Ammonia storms can ascend to the 300 mb level with vertical velocities around 30 ms-1. The seasonal effect on the thermal profile at the upper troposphere may have important effects on the development of ammonia storms. In the cases where water storms can develop they span many scale heights with peak vertical velocities around 160 ms-1 and cloud particles can be transported up to the 150 mb level. These predicted characteristics are similar to the Great White Spots observed in Saturn which, therefore, could be originated at the water cloud base level. This work has been supported by Gobierno Vasco PI 1997-34. R. Hueso acknowledges a PhD fellowship from Gobierno Vasco.

  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. 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.

  15. 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

  16. Cleft posterior mitral valve leaflet in an adult with Turner syndrome diagnosed with the use of 3-dimensional transesophageal echocardiography.

    PubMed

    Negrea, Stefania Luminita; Alexandrescu, Clara; Sabatier, Michel; Dreyfus, Gilles D

    2012-01-01

    Turner syndrome is a monosomy (45,X karyotype) in which the prevalence of cardiovascular anomalies is high. However, this aspect of Turner syndrome has received little attention outside of the pediatric medical literature, and the entire spectrum of cardiovascular conditions in adults remains unknown. We present the case of a 34-year-old woman who had Turner syndrome. When she was a teenager, her native bicuspid aortic valve was replaced with a mechanical prosthesis. Fifteen years later, during preoperative examination for prosthesis-patient mismatch, severe mitral regurgitation was detected, and a congenital cleft in the posterior leaflet of the mitral valve was diagnosed with use of 3-dimensional transesophageal echocardiography. The patient underwent concurrent mitral valve repair and aortic valve replacement. To our knowledge, this is the first report of a cleft in the posterior mitral valve leaflet as a cardiovascular defect observed in Turner syndrome, and the first such instance to have been diagnosed with the use of 3-dimensional echocardiography.

  17. 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. PMID:23106040

  18. Regulation and 3 dimensional culture of tertiary follicle growth

    PubMed Central

    2012-01-01

    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. PMID:23106040

  19. 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.

  20. 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.

  1. 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…

  2. 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)

  3. 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.

  4. Biphasic response of cell invasion to matrix stiffness in 3-dimensional biopolymer networks

    PubMed Central

    Lang, Nadine R.; Skodzek, Kai; Hurst, Sebastian; Mainka, Astrid; Steinwachs, Julian; Schneider, Julia; Aifantis, Katerina E.; Fabry, Ben

    2015-01-01

    When cells come in contact with an adhesive matrix, they begin to spread and migrate with a speed that depends on the stiffness of the extracellular matrix. On a flat surface, migration speed decreases with matrix stiffness mainly due to an increased stability of focal adhesions. In a 3-dimensional (3D) environment, cell migration is thought to be additionally impaired by the steric hindrance imposed by the surrounding matrix. For porous 3D biopolymer networks such as collagen gels, however, the effect of matrix stiffness on cell migration is difficult to separate from effects of matrix pore size and adhesive ligand density, and is therefore unknown. Here we used glutaraldehyde as a crosslinker to increase the stiffness of self-assembled collagen biopolymer networks independently of collagen concentration or pore size. Breast carcinoma cells were seeded onto the surface of 3D collagen gels, and the invasion depth was measured after 3 days of culture. Cell invasion in gels with pore sizes larger than 5 μm increased with higher gel stiffness, whereas invasion in gels with smaller pores decreased with higher gel stiffness. These data show that 3D cell invasion is enhanced by higher matrix stiffness, opposite to cell behavior in 2D, as long as the pore size does not fall below a critical value where it causes excessive steric hindrance. These findings may be important for optimizing the recellularization of soft tissue implants or for the design of 3D invasion models in cancer research. PMID:25462839

  5. 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.

  6. 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. PMID:27137437

  7. 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.

  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. 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.

  10. Problem-solving model in radiology for medical students.

    PubMed

    Blane, C E; Vydareny, K H; Ten Haken, J D; Calhoun, J G

    1989-05-01

    Current undergraduate medical education is criticized for not preparing physicians to be independent thinkers. The rapid development of new imaging techniques and the problem of escalating medical costs call for efficient patient management. The development of algorithms in imaging work-up of patient problems is an excellent example of problem solving or medical decision making. The senior elective in radiology at our institution incorporates this type of problem-solving session. Small groups (15-25 students) with faculty guidance discuss 5-6 common patient problems to develop an investigative plan in imaging. Algorithms are thus developed by the group, but not presented for memorization. Small changes are then made in the case history so that the students are forced to make new hypotheses and generate a modified algorithm. Correlative costs are included. Flexibility and initiative in development of patient management algorithms are stressed.

  11. A model for statement of privileges of medical students within the AHEC systems.

    PubMed

    Berens, L; Nicholson, R M

    1980-01-01

    A combination of factors has resulted in medical students being placed in hospitals not accustomed to their presence. These factors include expansion of the number of medical students in United States schools, an increasing emphasis on primary care education, and the strengthening of medical education programs in hospitals and area health education centers (AHEC) not previously utilized as medical education facilities. The introduction of the students has caused some confusion in these hospitals which may contribute to less than optimal medical education. Some of the confusion is attributable to the lack of a clearly defined role for the medical student and the lack of delineation of the responsibility of other personnel in providing and permitting student access to the system. Presented here is a model of privileges and responsibilities which has been introduced in an AHEC with positive effects on the quality of medical education and improvement of interdisciplinary relations.

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

    PubMed

    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.

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

    PubMed

    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

  15. Developing a medication communication framework across continuums of care using the Circle of Care Modeling approach

    PubMed Central

    2013-01-01

    Background Medication errors are a common type of preventable errors in health care causing unnecessary patient harm, hospitalization, and even fatality. Improving communication between providers and between providers and patients is a key aspect of decreasing medication errors and improving patient safety. Medication management requires extensive collaboration and communication across roles and care settings, which can reduce (or contribute to) medication-related errors. Medication management involves key recurrent activities (determine need, prescribe, dispense, administer, and monitor/evaluate) with information communicated within and between each. Despite its importance, there is a lack of conceptual models that explore medication communication specifically across roles and settings. This research seeks to address that gap. Methods The Circle of Care Modeling (CCM) approach was used to build a model of medication communication activities across the circle of care. CCM positions the patient in the centre of his or her own healthcare system; providers and other roles are then modeled around the patient as a web of relationships. Recurrent medication communication activities were mapped to the medication management framework. The research occurred in three iterations, to test and revise the model: Iteration 1 consisted of a literature review and internal team discussion, Iteration 2 consisted of interviews, observation, and a discussion group at a Community Health Centre, and Iteration 3 consisted of interviews and a discussion group in the larger community. Results Each iteration provided further detail to the Circle of Care medication communication model. Specific medication communication activities were mapped along each communication pathway between roles and to the medication management framework. We could not map all medication communication activities to the medication management framework; we added Coordinate as a separate and distinct recurrent activity

  16. 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)

  17. 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…

  18. 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

  19. 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.

  20. 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. PMID:22550398

  1. Estimating the costs of intensity-modulated and 3-dimensional conformal radiotherapy in Ontario

    PubMed Central

    Yong, J.H.E.; McGowan, T.; Redmond-Misner, R.; Beca, J.; Warde, P.; Gutierrez, E.; Hoch, J.S.

    2016-01-01

    Background Radiotherapy is a common treatment for many cancers, but up-to-date estimates of the costs of radiotherapy are lacking. In the present study, we estimated the unit costs of intensity-modulated radiotherapy (imrt) and 3-dimensional conformal radiotherapy (3D-crt) in Ontario. Methods An activity-based costing model was developed to estimate the costs of imrt and 3D-crt in prostate cancer. It included the costs of equipment, staff, and supporting infrastructure. The framework was subsequently adapted to estimate the costs of radiotherapy in breast cancer and head-and-neck cancer. We also tested various scenarios by varying the program maturity and the use of volumetric modulated arc therapy (vmat) alongside imrt. Results From the perspective of the health care system, treating prostate cancer with imrt and 3D-crt respectively cost $12,834 and $12,453 per patient. The cost of radiotherapy ranged from $5,270 to $14,155 and was sensitive to analytic perspective, radiation technique, and disease site. Cases of head-and-neck cancer were the most costly, being driven by treatment complexity and fractions per treatment. Although imrt was more costly than 3D-crt, its cost will likely decline over time as programs mature and vmat is incorporated. Conclusions Our costing model can be modified to estimate the costs of 3D-crt and imrt for various disease sites and settings. The results demonstrate the important role of capital costs in studies of radiotherapy cost from a health system perspective, which our model can accommodate. In addition, our study established the need for future analyses of imrt cost to consider how vmat affects time consumption. PMID:27330359

  2. Statistical models of the demand for emergency medical services in an urban area.

    PubMed Central

    Kvålseth, T O; Deems, J M

    1979-01-01

    First- and second-order statistical regression models are presented for the Emergency Medical Services (EMS) demand in an urban area as it relates to various socioeconomic, demographic, and other characteristics of the area. Individual models are formulated for different types of medical emergencies with the city of Atlanta, GA, serving as the data base. These models are generally shown to provide excellent fits to the empirical data. PMID:420371

  3. An Introductory Pharmacy Practice Experience Based on a Medication Therapy Management Service Model

    PubMed Central

    Huynh, Donna; Brandt, Nicole

    2011-01-01

    Objective. To implement and evaluate an introductory pharmacy practice experience (IPPE) based on the medication therapy management (MTM) service model. Design. Patient Care 2 is an IPPE that introduces third-year pharmacy students to the MTM service model. Students interacted with older adults to identify medication-related problems and develop recommendations using core MTM elements. Course outcome evaluations were based on number of documented medication-related problems, recommendations, and student reviews. Assessment. Fifty-seven older adults participated in the course. Students identified 52 medication-related problems and 66 medical problems, and documented 233 recommendations relating to health maintenance and wellness, pharmacotherapy, referrals, and education. Students reported having adequate experience performing core MTM elements. Conclusion. Patient Care 2 may serve as an experiential learning model for pharmacy schools to teach the core elements of MTM and provide patient care services to the community. PMID:21829256

  4. Computer-based learning materials for medical education: a model production.

    PubMed

    Mooney, G A; Bligh, J G

    1997-05-01

    Computer-based learning materials (CBL or courseware) have the potential to be valuable learning resources for medical education. However, CBL has failed to realize its potential primarily because of unstructured approaches towards design and development. This paper describes the courseware development model (CDM), a conceptual model produced and used by the Medical Education Unit at The University of Liverpool. The model describes a structured multi-disciplinary approach to the design and production of CBL materials. It promotes meticulous planning, communication and organization. The CDM draws on three areas of expertise: (1) education; (2) computer science; and (3) medical content. PMID:9231139

  5. 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…

  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. 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…

  8. Editorial: metabolic modeling in biotechnology and medical research.

    PubMed

    Mattanovich, Diethard; Hatzimanikatis, Vassily

    2013-09-01

    Metabolic Modeling and Simulation: This special issue of Biotechnology Journal is edited by Diethard Mattanovich and Vassily Hatzimanikatis and covers the state-of-the-art in metabolic modeling, including the major themes of methods in metabolic modeling, modeling of human and microbial metabolism, and modeling of bioprocesses.

  9. 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.

  10. 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

  11. Construction of 3-Dimensional Printed Ultrasound Phantoms With Wall-less Vessels.

    PubMed

    Nikitichev, Daniil I; Barburas, Anamaria; McPherson, Kirstie; Mari, Jean-Martial; West, Simeon J; Desjardins, Adrien E

    2016-06-01

    Ultrasound phantoms are invaluable as training tools for vascular access procedures. We developed ultrasound phantoms with wall-less vessels using 3-dimensional printed chambers. Agar was used as a soft tissue-mimicking material, and the wall-less vessels were created with rods that were retracted after the agar was set. The chambers had integrated luer connectors to allow for fluid injections with clinical syringes. Several variations on this design are presented, which include branched and stenotic vessels. The results show that 3-dimensional printing can be well suited to the construction of wall-less ultrasound phantoms, with designs that can be readily customized and shared electronically. PMID:27162278

  12. 3-Dimensional Multiwaveguide Probe Array for Light Delivery to Distributed Brain Circuits

    PubMed Central

    Zorzos, Anthony N.; Scholvin, Jorg; Boyden, Edward S.; Fonstad, Clifton G.

    2013-01-01

    To deliver light to the brain for neuroscientific and neuroengineering applications like optogenetics, in which light is used to activate or silence neurons expressing specific photosensitive proteins, optical fibers are commonly used. However, an optical fiber is limited to delivering light to a single target within the three-dimensional structure of the brain. We here describe the design and fabrication of an array of thin microwaveguides which terminate at a 3-dimensionally distributed set of points, appropriate for delivering light to targets distributed in a 3-dimensional pattern throughout the brain. PMID:23202064

  13. Magnetic topologies of coronal mass ejection events: Effects of 3-dimensional reconnection

    SciTech Connect

    Gosling, J.T.

    1995-09-01

    New magnetic loops formed in the corona following coronal mass ejection, CME, liftoffs provide strong evidence that magnetic reconnection commonly occurs within the magnetic ``legs`` of the departing CMEs. Such reconnection is inherently 3-dimensional and naturally produces CMEs having magnetic flux rope topologies. Sustained reconnection behind CMEs can produce a mixture of open and disconnected field lines threading the CMES. In contrast to the results of 2-dimensional reconnection. the disconnected field lines are attached to the outer heliosphere at both ends. A variety of solar and solar wind observations are consistent with the concept of sustained 3-dimensional reconnection within the magnetic legs of CMEs close to the Sun.

  14. Medical mitigation model: quantifying the benefits of the public health response to a chemical terrorism attack.

    PubMed

    Good, Kevin; Winkel, David; VonNiederhausern, Michael; Hawkins, Brian; Cox, Jessica; Gooding, Rachel; Whitmire, Mark

    2013-06-01

    The Chemical Terrorism Risk Assessment (CTRA) and Chemical Infrastructure Risk Assessment (CIRA) are programs that estimate the risk of chemical terrorism attacks to help inform and improve the US defense posture against such events. One aspect of these programs is the development and advancement of a Medical Mitigation Model-a mathematical model that simulates the medical response to a chemical terrorism attack and estimates the resulting number of saved or benefited victims. At the foundation of the CTRA/CIRA Medical Mitigation Model is the concept of stock-and-flow modeling; "stocks" are states that individuals progress through during the event, while "flows" permit and govern movement from one stock to another. Using this approach, the model is able to simulate and track individual victims as they progress from exposure to an end state. Some of the considerations in the model include chemical used, type of attack, route and severity of exposure, response-related delays, detailed treatment regimens with efficacy defined as a function of time, medical system capacity, the influx of worried well individuals, and medical countermeasure availability. As will be demonstrated, the output of the CTRA/CIRA Medical Mitigation Model makes it possible to assess the effectiveness of the existing public health response system and develop and examine potential improvement strategies. Such a modeling and analysis capability can be used to inform first-responder actions/training, guide policy decisions, justify resource allocation, and direct knowledge-gap studies.

  15. Medical mitigation model: quantifying the benefits of the public health response to a chemical terrorism attack.

    PubMed

    Good, Kevin; Winkel, David; VonNiederhausern, Michael; Hawkins, Brian; Cox, Jessica; Gooding, Rachel; Whitmire, Mark

    2013-06-01

    The Chemical Terrorism Risk Assessment (CTRA) and Chemical Infrastructure Risk Assessment (CIRA) are programs that estimate the risk of chemical terrorism attacks to help inform and improve the US defense posture against such events. One aspect of these programs is the development and advancement of a Medical Mitigation Model-a mathematical model that simulates the medical response to a chemical terrorism attack and estimates the resulting number of saved or benefited victims. At the foundation of the CTRA/CIRA Medical Mitigation Model is the concept of stock-and-flow modeling; "stocks" are states that individuals progress through during the event, while "flows" permit and govern movement from one stock to another. Using this approach, the model is able to simulate and track individual victims as they progress from exposure to an end state. Some of the considerations in the model include chemical used, type of attack, route and severity of exposure, response-related delays, detailed treatment regimens with efficacy defined as a function of time, medical system capacity, the influx of worried well individuals, and medical countermeasure availability. As will be demonstrated, the output of the CTRA/CIRA Medical Mitigation Model makes it possible to assess the effectiveness of the existing public health response system and develop and examine potential improvement strategies. Such a modeling and analysis capability can be used to inform first-responder actions/training, guide policy decisions, justify resource allocation, and direct knowledge-gap studies. PMID:22744439

  16. 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.

  17. 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. PMID:23095918

  18. 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.

  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. PMID:26411928

  20. 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.

  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. 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.

  3. The Arabian Gulf University College of Medicine and Medical Sciences: a successful model of a multinational medical school.

    PubMed

    Hamdy, Hossam; Anderson, M Brownell

    2006-12-01

    In the late 1970s, leaders of the Arabian [corrected] Gulf countries proposed a novel idea of a joint educational and cultural venture: establishing a new regional university based in the Kingdom of Bahrain that would be managed as a multinational consortium of Gulf countries including Saudi Arabia, United Arab Emirates, Kuwait, Oman, Qatar, and Bahrain. It was intended to promote higher education and research in the Gulf region; to serve the development needs of the region; to reflect the unique economic, social, and cultural attributes of the Gulf communities and their environments; and to respond to the health care needs of the member countries. Since its inception in 1982, the College of Medicine and Medical Sciences (CMMS) at Arabian Gulf University (AGU) has adopted the educational philosophy of problem-based learning (PBL) and self-directed, student-centered education. The curriculum is integrated, with early introduction of education to foster clinical skills and professional competencies. The strategic alliance with the health care systems in Bahrain and other Gulf regions has created a successful model of efficient and effective initialization of health care resources in the community. The experience that has accumulated at the AGU-CMMS from introducing innovative medical education has allowed it to take a leadership position in medical education in the Gulf region. The original goals of this unique experiment have been realized along with unanticipated outcomes of spearheading changes in medical education in the Gulf region. Old and new medical schools have adopted several characteristics of the AGU educational program. Several elements contributed to its success: a clear vision of providing quality medical education and realizing and sustaining this vision by a supportive leadership at the university and college levels; an alliance with the regional health care systems; a dedicated faculty who have been able to work as a team while continually

  4. The Arabian Gulf University College of Medicine and Medical Sciences: a successful model of a multinational medical school.

    PubMed

    Hamdy, Hossam; Anderson, M Brownell

    2006-12-01

    In the late 1970s, leaders of the Arabian [corrected] Gulf countries proposed a novel idea of a joint educational and cultural venture: establishing a new regional university based in the Kingdom of Bahrain that would be managed as a multinational consortium of Gulf countries including Saudi Arabia, United Arab Emirates, Kuwait, Oman, Qatar, and Bahrain. It was intended to promote higher education and research in the Gulf region; to serve the development needs of the region; to reflect the unique economic, social, and cultural attributes of the Gulf communities and their environments; and to respond to the health care needs of the member countries. Since its inception in 1982, the College of Medicine and Medical Sciences (CMMS) at Arabian Gulf University (AGU) has adopted the educational philosophy of problem-based learning (PBL) and self-directed, student-centered education. The curriculum is integrated, with early introduction of education to foster clinical skills and professional competencies. The strategic alliance with the health care systems in Bahrain and other Gulf regions has created a successful model of efficient and effective initialization of health care resources in the community. The experience that has accumulated at the AGU-CMMS from introducing innovative medical education has allowed it to take a leadership position in medical education in the Gulf region. The original goals of this unique experiment have been realized along with unanticipated outcomes of spearheading changes in medical education in the Gulf region. Old and new medical schools have adopted several characteristics of the AGU educational program. Several elements contributed to its success: a clear vision of providing quality medical education and realizing and sustaining this vision by a supportive leadership at the university and college levels; an alliance with the regional health care systems; a dedicated faculty who have been able to work as a team while continually

  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. 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…

  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. 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.

  10. Testing a Mediational Model of Communication Among Medical Staff and Families of Cancer Patients

    ERIC Educational Resources Information Center

    Gionta, Dana A.; Harlow, Lisa L.; Loitman, Jane E.; Leeman, Joanne M.

    2005-01-01

    Three structural equation models of communication between family members and medical staff were examined to understand relations among staff accessibility, inhibitory family attitudes, getting communication needs met, perceived stress, and satisfaction with communication. Compared to full and direct models, a mediational model fit best in which…

  11. 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.

  12. 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. PMID:21097152

  13. 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.

  14. Water uptake by a maize root system - An explicit numerical 3-dimensional simulation.

    NASA Astrophysics Data System (ADS)

    Leitner, Daniel; Schnepf, Andrea; Klepsch, Sabine; Roose, Tiina

    2010-05-01

    Water is one of the most important resources for plant growth and function. An accurate modelling of the unsaturated flow is not only substantial to predict water uptake but also important to describe nutrient movement regarding water saturation and transport. In this work we present a model for water uptake. The model includes the simultaneous flow of water inside the soil and inside the root network. Water saturation in the soil volume is described by the Richards equation. Water flow inside the roots' xylem is calculated using the Poiseuille law for water flow in a cylindrical tube. The water saturation in the soil as well as water uptake of the root system is calculated numerically in three dimensions. We study water uptake of a maize plant in a confined pot under different supply scenarios. The main improvement of our approach is that the root surfaces act as spatial boundaries of the soil volume. Therefore water influx into the root is described by a surface flux instead of a volume flux, which is commonly given by an effective sink term. For the numerical computation we use the following software: The 3-dimensional maize root architecture is created by a root growth model based on L-Systems (Leitner et al 2009). A mesh of the surrounding soil volume is created using the meshing software DistMesh (Persson & Strang 2004). Using this mesh the partial differential equations are solved with the finite element method using Comsol Multiphysics 3.5a. Modelling results are related to accepted water uptake models from literature (Clausnitzer & Hopmans 1994, Roose & Fowler 2004, Javaux et al 2007). This new approach has several advantages. By considering the individual roots it is possible to analyse the influence of overlapping depletion zones due to inter root competition. Furthermore, such simulations can be used to estimate the influence of simplifying assumptions that are made in the development of effective models. The model can be easily combined with a nutrient

  15. 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.

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

    PubMed Central

    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. PMID:26146512

  17. 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.

  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. PMID:23367069

  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. Model-based segmentation of medical x-ray images

    NASA Astrophysics Data System (ADS)

    Hoare, Frederick; de Jager, Gerhard

    1994-03-01

    This paper discusses the methods used to model the structure of x-ray images of the human body and the individual organs within the body. A generic model of a region is built up from x-ray images to aid in automatic segmentation. By using the ribs from a chest x-ray image as an example, it is shown how models of the different organs can be generated. The generic model of the chest region is built up by using a priori knowledge of the physical structure of the human body. The models of the individual organs are built up by using knowledge of the structure of the organs as well as other information contained within each image. Each image is unique and therefore information from the region surrounding the organs in the image has to be taken into account when adapting the generic model to individual images. Results showing the application of these techniques to x-ray images of the chest region, the labelling of individual organs, and the generation of models of the ribs are presented.

  1. Models for treating depression in specialty medical settings: a narrative review☆,☆☆

    PubMed Central

    Breland, Jessica Y.; Mignogna, Joseph; Kiefer, Lea; Marsh, Laura

    2015-01-01

    Objective This review answered two questions: (a) what types of specialty medical settings are implementing models for treating depression, and (b) do models for treating depression in specialty medical settings effectively treat depression symptoms? Method We searched Medline/Pubmed to identify articles, published between January 1990 and May 2013, reporting on models for treating depression in specialty medical settings. Included studies had to have adult participants with comorbid medical conditions recruited from outpatient, nonstandard primary care settings. Studies also had to report specific, validated depression measures. Results Search methods identified nine studies (six randomized controlled trials, one nonrandomized controlled trial and two uncontrolled trials), all representing integrated care for depression, in three specialty settings (oncology, infectious disease, neurology). Most studies (N=7) reported greater reductions in depression among patients receiving integrated care compared to usual care, particularly in oncology clinics. Conclusions Integrated care for depression in specialty medical settings can improve depression outcomes. Additional research is needed to understand the effectiveness of incorporating behavioral and/or psychological treatments into existing methods. When developing or selecting a model for treating depression in specialty medical settings, clinicians and researchers will benefit from choosing specific components and measures most relevant to their target populations. PMID:25956666

  2. Modeling relationships between traditional preadmission measures and clinical skills performance on a medical licensure examination.

    PubMed

    Roberts, William L; Pugliano, Gina; Langenau, Erik; Boulet, John R

    2012-08-01

    Medical schools employ a variety of preadmission measures to select students most likely to succeed in the program. The Medical College Admission Test (MCAT) and the undergraduate college grade point average (uGPA) are two academic measures typically used to select students in medical school. The assumption that presently used preadmission measures can predict clinical skill performance on a medical licensure examination was evaluated within a validity argument framework (Kane 1992). A hierarchical generalized linear model tested relationships between the log-odds of failing a high-stakes medical licensure performance examination and matriculant academic and non-academic preadmission measures, controlling for student-and school-variables. Data includes 3,189 matriculants from 22 osteopathic medical schools tested in 2009-2010. Unconditional unit-specific model expected average log-odds of failing the examination across medical schools is -3.05 (se = 0.11) or 5%. Student-level estimated coefficients for MCAT Verbal Reasoning scores (0.03), Physical Sciences scores (0.05), Biological Sciences scores (0.04), uGPA(science) (0.07), and uGPA(non-science) (0.26) lacked association with the log-odds of failing the COMLEX-USA Level 2-PE, controlling for all other predictors in the model. Evidence from this study shows that present preadmission measures of academic ability are not related to later clinical skill performance. Given that clinical skill performance is an important part of medical practice, selection measures should be developed to identify students who will be successful in communication and be able to demonstrate the ability to systematically collect a medical history, perform a physical examination, and synthesize this information to diagnose and manage patient conditions.

  3. 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

  4. Rethinking adherence: a health literacy-informed model of medication self-management.

    PubMed

    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

  5. 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

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

    PubMed

    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.

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

    PubMed

    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

  8. How to Teach Psychiatry to Medical Undergraduates in India?: A Model

    PubMed Central

    Manohari, S. M.; Johnson, Pradeep R.; Galgali, Ravindra Baburao

    2013-01-01

    Psychiatry is not considered important by most medical students. But knowledge of psychiatry is essential for all doctors as psychiatric problems are prevalent in the population either as part of other physical illnesses or independently. All medical practitioners need skills in communication and forming empathy and the ability to counsel that are learnt in psychiatry. Nearly all medical students feel psychiatry is not scientific enough and psychiatrists are peculiar. We need to make psychiatry interesting, and impart skills and techniques to practice psychiatry at the primary care level and in the process change the misconceptions students have of psychiatry. We present a model to accomplish this. PMID:23833338

  9. A unified timeline model and user interface for multimedia medical databases.

    PubMed

    Dionisio, J D; Cárdenas, A F; Taira, R K; Aberle, D R; Chu, W W; McNitt-Gray, M F; Goldin, J; Lufkin, R B

    1996-01-01

    A multimedia medical database model and prototype is described for supporting a timeline-based presentation of information. The database links image and text data in a way that permits users to look at medical information in a single unified view. Various visualization programs permit the user to view data in various ways, including full image views, graphs, and tables. Our technology is applied for proof-of-concept to two areas: thoracic oncology and thermal tumor ablation therapy of the brain. This effort is part of the multidisciplinary KMeD project in collaboration with medical research and clinical treatment projects at UCLA.

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

    PubMed Central

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

    2013-01-01

    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. PMID:24177176

  11. 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. PMID:24177176

  12. A collaborative model for developing and maintaining virtual patients for medical education.

    PubMed

    Berman, Norman B; Fall, Leslie H; Chessman, Alexander W; Dell, Michael R; Lang, Valerie J; Leong, Shou Ling; Nixon, L James; Smith, Sherilyn

    2011-01-01

    There is great interest in using computer-assisted instruction in medical education, but getting computer-assisted instruction materials used broadly is difficult to achieve. We describe a successful model for the development and maintenance of a specific type of computer-assisted instruction - virtual patients - in medical education. The collaborative model's seven key components are described and compared to other models of diffusion of innovation and curriculum development. The collaborative development model that began in one medical discipline is now extended to two additional disciplines, through partnerships with their respective clerkship director organizations. We believe that the ability to achieve broad use of virtual patients, and to transition the programs from successfully relying on grant funding to financially self-sustaining, resulted directly from the collaborative development and maintenance process. This process can be used in other learning environments and for the development of other types of computer-assisted instruction programs.

  13. 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.

  14. 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. PMID:26940870

  15. 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

  16. 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)

  17. 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…

  18. Theoretical Biology and Medical Modelling: ensuring continued growth and future leadership.

    PubMed

    Nishiura, Hiroshi; Rietman, Edward A; Wu, Rongling

    2013-07-11

    Theoretical biology encompasses a broad range of biological disciplines ranging from mathematical biology and biomathematics to philosophy of biology. Adopting a broad definition of "biology", Theoretical Biology and Medical Modelling, an open access journal, considers original research studies that focus on theoretical ideas and models associated with developments in biology and medicine.

  19. Equations for a 3 dimensional transient flow of a multicomponent gas mixutre with chemical reactions. Publication No. 2

    SciTech Connect

    Vos, J.B.

    1982-11-01

    This report gives a general description of the basic equations for the 3-dimensional transient flow of a multicomponent gas mixture with chemical reactions. The number of assumption made is small. Next to the equation of momentum, the equation of angular momentum is introduced. It could in the future be advantageous to use the latter equation instead of the first because the flow may possess vortices which introduce an angular momentum. In the first chapter of this report, the conservation equations are introduced. In the next chapters, the processes which occur on microscale are described. In the last chapter, the conservation equations are modelled for turbulence. This is done with Reynolds' decomposition and time-averaging of the subsequent equations.

  20. 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.

  1. 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.

  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. 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. PMID:22363636

  4. 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

  5. The Neural Representation of 3-Dimensional Objects in Rodent Memory Circuits

    PubMed Central

    Burke, Sara N.; Barnes, Carol A.

    2014-01-01

    Three-dimensional objects are common stimuli that rodents and other animals encounter in the natural world that contribute to the associations that are the hallmark of explicit memory. Thus, the use of 3-dimensional objects for investigating the circuits that support associative and episodic memories has a long history. In rodents, the neural representation of these types of stimuli is a polymodal process and lesion data suggest that the perirhinal cortex, an area of the medial temporal lobe that receives afferent input from all sensory modalities, is particularly important for integrating sensory information across modalities to support object recognition. Not surprisingly, recent data from in vivo electrophysiological recordings have shown that principal cells within the perirhinal cortex are activated at locations of an environment that contain 3-dimensional objects. Interestingly, it appears that neural activity patterns related to object stimuli are ubiquitous across memory circuits and have now been observed in many medial temporal lobe structures as well as in the anterior cingulate cortex. This review summarizes behavioral and neurophysiological data that examine the representation of 3-dimensional objects across brain regions that are involved in memory. PMID:25205370

  6. The neural representation of 3-dimensional objects in rodent memory circuits.

    PubMed

    Burke, Sara N; Barnes, Carol A

    2015-05-15

    Three-dimensional objects are common stimuli that rodents and other animals encounter in the natural world that contribute to the associations that are the hallmark of explicit memory. Thus, the use of 3-dimensional objects for investigating the circuits that support associative and episodic memories has a long history. In rodents, the neural representation of these types of stimuli is a polymodal process and lesion data suggest that the perirhinal cortex, an area of the medial temporal lobe that receives afferent input from all sensory modalities, is particularly important for integrating sensory information across modalities to support object recognition. Not surprisingly, recent data from in vivo electrophysiological recordings have shown that principal cells within the perirhinal cortex are activated at locations of an environment that contain 3-dimensional objects. Interestingly, it appears that neural activity patterns related to object stimuli are ubiquitous across memory circuits and have now been observed in many medial temporal lobe structures as well as in the anterior cingulate cortex. This review summarizes behavioral and neurophysiological data that examine the representation of 3-dimensional objects across brain regions that are involved in memory. PMID:25205370

  7. The Preoperative Evaluation of Infective Endocarditis via 3-Dimensional Transesophageal Echocardiography.

    PubMed

    Yong, Matthew S; Saxena, Pankaj; Killu, Ammar M; Coffey, Sean; Burkhart, Harold M; Wan, Siu-Hin; Malouf, Joseph F

    2015-08-01

    Transesophageal echocardiography continues to have a central role in the diagnosis of infective endocarditis and its sequelae. Recent technological advances offer the option of 3-dimensional imaging in the evaluation of patients with infective endocarditis. We present an illustrative case and review the literature regarding the potential advantages and limitations of 3-dimensional transesophageal echocardiography in the diagnosis of complicated infective endocarditis. A 51-year-old man, an intravenous drug user who had undergone bioprosthetic aortic valve replacement 5 months earlier, presented with prosthetic valve endocarditis. Preoperative transesophageal echocardiography with 3D rendition revealed a large abscess involving the mitral aortic intervalvular fibrosa, together with a mycotic aneurysm that had ruptured into the left atrium, resulting in a left ventricle-to-left atrium fistula. Three-dimensional transesophageal echocardiography enabled superior preoperative anatomic delineation and surgical planning. We conclude that 3-dimensional transesophageal echocardiography can be a useful adjunct to traditional 2-dimensional transesophageal echocardiography as a tool in the diagnosis of infective endocarditis.

  8. 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

  9. 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

  10. 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

  11. 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

  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. PMID:27298619

  13. 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

  14. 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.

  15. 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.

  16. 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.

  17. The Vascular Model Repository: A Public Resource of Medical Imaging Data and Blood Flow Simulation Results.

    PubMed

    Wilson, Nathan M; Ortiz, Ana K; Johnson, Allison B

    2013-12-01

    Patient-specific blood flow simulations may provide insight into disease progression, treatment options, and medical device design that would be difficult or impossible to obtain experimentally. However, publicly available image data and computer models for researchers and device designers are extremely limited. The National Heart, Lung, and Blood Institute sponsored Open Source Medical Software Corporation (contract nos. HHSN268200800008C and HHSN268201100035C) and its university collaborators to build a repository (www.vascularmodel.org) including realistic, image-based anatomic models and related hemodynamic simulation results to address this unmet need.

  18. A maturity model to deliver a national shared medications system, options, practice, and pitfalls.

    PubMed

    Bainbridge, Michael; Pearce, Christopher; Taggart, Richard

    2013-01-01

    In July 2012 Australia launched the Personally Controlled electronic Health Record (PCEHR). This structured record allows health related information to be shared between providers as well as between providers and consumers. The next big challenge in delivering value for consumers is to use the medicines information distributed throughout the record in a way that allows better medications management at all levels. This poster points to the design and usability challenges being dealt with in that process during a national roll out and proposes a maturity model to accelerate the delivery of shared medication records. It is suggested that this model will have relevance in other jurisdictions. PMID:23920844

  19. A maturity model to deliver a national shared medications system, options, practice, and pitfalls.

    PubMed

    Bainbridge, Michael; Pearce, Christopher; Taggart, Richard

    2013-01-01

    In July 2012 Australia launched the Personally Controlled electronic Health Record (PCEHR). This structured record allows health related information to be shared between providers as well as between providers and consumers. The next big challenge in delivering value for consumers is to use the medicines information distributed throughout the record in a way that allows better medications management at all levels. This poster points to the design and usability challenges being dealt with in that process during a national roll out and proposes a maturity model to accelerate the delivery of shared medication records. It is suggested that this model will have relevance in other jurisdictions.

  20. A model for offering an International Medicine Seminar Course for US medical students: the 13-year experience of the New Jersey Medical School.

    PubMed Central

    Reza Najem, G.

    1999-01-01

    An International Medicine Elective Seminar Course at the New Jersey Medical School (NJMS) was designed in 1985 to present a description of medical education, medical care systems, major global health problems, and intervention programs in other countries. Seminars are scheduled for nine weeks in the fall semester. At the end of each course, the medical students complete evaluations. Almost all (97%) students in 1997-1998 evaluated the course as either good (55%) or excellent (45%). Enrollment in the International Medicine Seminar Course increased from 12 medical students in 1985-1986 to 62 students in 1997-1998. An increasing number of students have applied for a fourth-year overseas International Medicine Elective. This and students' evaluations indicated that they have been motivated toward international medicine. The atmosphere of informal seminars and faculty interaction with students has characterized the course. It has made this model of teaching an ideal forum for medical students' professional growth. This course offers students the opportunity and insight to explore facets of their professional role not explicitly covered in the formal medical curriculum. The International Medicine Seminar Course is a self-supported model and can be adopted readily by other medical schools. PMID:10599189

  1. 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

  2. A latent growth model suggests that empathy of medical students does not decline over time.

    PubMed

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

    2013-08-01

    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, final of pre-clinical phase and at the beginning of clinical training. Data collected with the adaptation to Portuguese of the Jefferson Scale of Physician Empathy (student version) were analysed with latent growth modelling, conditioned by gender, openness and agreeableness. Empathy scores at all times were higher for females than for males, but only significantly at the end of the preclinical phase. The model showed a satisfactory fit level and the primary finding was that undergraduate medical student's empathy did not decline over time. Empathy scores were significantly and positively related with Openness to Experience and Agreeableness at admission, but the empathy rate of change across time was not significant. The stability of empathy revealed by a longitudinal methodology applied for the first time to empathy studying, contradicts previous results of decline and contributes to the understanding of the empathy development of medical students.

  3. 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. PMID:27055620

  4. 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

  5. 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

  6. 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

  7. Gender perspective in medicine: a vital part of medical scientific rationality. A useful model for comprehending structures and hierarchies within medical science

    PubMed Central

    Risberg, Gunilla; Hamberg, Katarina; Johansson, Eva E

    2006-01-01

    Background During the past few decades, research has reported gender bias in various areas of clinical and academic medicine. To prevent such bias, a gender perspective in medicine has been requested, but difficulties and resistance have been reported from implementation attempts. Our study aimed at analysing this resistance in relation to what is considered good medical research. Method We used a theoretical model, based on scientific competition, to understand the structures of scientific medicine and how they might influence the resistance to a gender perspective in medicine. The model was originally introduced to discuss how pluralism improves rationality in the social sciences. Results The model provided a way to conceptualise different fields of research in medicine: basic research, applied research, medical philosophy, and 'empowering' research. It clarified how various research approaches within medicine relate to each other, and how they differ and compete. It also indicated why there might be conflicts between them: basic and applied research performed within the biomedical framework have higher status than gender research and other research approaches that are performed within divergent research paradigms. Conclusion This hierarchy within medical research contributes to the resistance to a gender perspective, causing gender bias and making medical scientific rationality suboptimal. We recommend that the theoretical model can be applied in a wider medical context when different and hierarchically arranged research traditions are in conflict. In this way, the model might contribute to shape a medical community where scientific pluralism is acknowledged to enlarge, not to disturb, the scientific rationality of medicine. PMID:16928283

  8. 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.

  9. 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. PMID:25072575

  10. 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.

  11. 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

  12. 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

  13. 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

  14. A Model-Based Approach to Support Validation of Medical Cyber-Physical Systems.

    PubMed

    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

  15. 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.

  16. 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

  17. 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.

  18. 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. PMID:26262111

  19. A novel resource model for underprivileged health support: Community Medical Outreach.

    PubMed

    Heravi, M; Bertram, J E A

    2007-01-01

    Community Medical Outreach is a student-run organization that provides healthcare access to medically underprivileged farm workers. The program exploits the substantial energy, enthusiasm and organizational capacity of pre-medical students as they prepare to apply for medical school. All of the partners benefit from the interchange. The students gain from a unique first-hand medical experience that demonstrates their leadership, management skills, commitment to a healthcare team, and focus on care at the community level. Those in most need gain healthcare access. Volunteer staff and physicians are inspired by the students and are energized by caring for those most in need of health care. The companies, agencies, and organizations donating supplies, drugs, expertise, and sponsorship benefit from enhanced public relations. The article describes the initiation, the lessons learned, the critical importance of linkages, and the essential components such as individual and institutional liability. Community Medical Outreach is an important vehicle for shaping students in the process of becoming physicians, shaping those involved with the process of admitting students, shaping training experiences, and shaping new models of health care. PMID:17313302

  20. Assessment of the interns’ ability based on Dundee model in Shiraz University of Medical Sciences

    PubMed Central

    AMINI, MITRA; ABIRI, SAMANEH; NABEIEI, PARISA; GHANAVATI, SHIRIN; HAYAT, ALI ASGHAR; KOJURI, JAVAD

    2015-01-01

    Introduction The importance of medical profession and the role of the physician in society is no secret to anyone. Skills and competencies in clinical practice are necessary for the medical profession. In fact, in patient care, doctors require practical skills in addition to scientific knowledge. This study examines the potentials of medical school students in three areas of doing the right thing, doing the right thing in an intermediate range, and doing the right thing by the right person. Methods This study was done in a descriptive-analytical and sectional model. The population of this study was all interns of Shiraz University of Medical Sciences who were passing internship at Internal Medicine, Surgery, Pediatrics, Obstetrics and Emergency wards. About 100 persons were selected by simple randomization. In order to collect data, a questionnaire with 12 questions was designed in two parts. The questionnaire was approved by 7 Faculty members of Clinical Medicine and Medical Education, and its reliability was approved by test-retest method on 20 medical students in the form of a pilot study and through Cronbach's alpha (82%). Collected data were analyzed by SPSS software version 14 using descriptive statistical methods. Results Results showed that within the inner circle, interns evaluated their skills in surgery, internal medicine, and gynecology wards, intermediate and at other wards as weak. Also within the center circle, interns evaluated adequate educational evidence-based training in the field of medicine, and sufficiency of educational training in the field of clinical decision making and clinical care as suitable. Conclusion According to the results, it seems that medical interns' skills in performing most medical skills are moderate. So teaching students by new educational methods and workshop techniques, using experienced teachers will be effective. The use of clinical skills training centers and objective assessment methods for the students' skills

  1. Modeling determinants of medication attitudes and poor adherence in early nonaffective psychosis: implications for intervention.

    PubMed

    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

    2015-05-01

    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

  2. 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

  3. 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…

  4. Strategic outsourcing of clinical services: a model for volume-stressed academic medical centers.

    PubMed

    Billi, John E; Pai, Chih-Wen; Spahlinger, David A

    2004-01-01

    Many academic medical centers have significant capacity constraints and limited ability to expand services to meet demand. Health care management should employ strategic thinking to deal with service demands. This article uses three organizational models to develop a theoretical framework to guide the selection of clinical services for outsourcing.

  5. 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…

  6. "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.…

  7. 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…

  8. 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…

  9. Caveat Emptor: Considerations before Buying In to the "New" Medical Model.

    ERIC Educational Resources Information Center

    Gresham, Frank M.

    2002-01-01

    In response to Forness and Kavale's (2001) argument that the field of emotional and behavioral disorders (E/BD) should adopt a "new" medical model, this commentary argues that the benefit of psychiatric diagnoses and pharmacologic treatments have not been established. It advocates a resistance-to-intervention approach to E/BD eligibility…

  10. The way assisted suicide is legalised: balancing a medical framework against a demedicalised model.

    PubMed

    Delbeke, Evelien

    2011-03-01

    To date, in three European countries and three American states--i.e., The Netherlands, Luxemburg, Switzerland, and the states of Oregon, Washington and Montana--it is permitted by law for one person to assist in the suicide of another person. When comparing the legislations of these countries/states, it becomes apparent that The Netherlands, Luxemburg, Oregon, Washington and Montana have chosen a medical approach (the so-called medical model), whereas the Swiss legal framework for assisted suicide is clearly a non-medical one (the demedicalised model). The differences between these two models mainly concern two aspects: the requirement as to the capacity of the person providing assistance in suicide and the condition regarding the state of health of the person committing suicide. A closer view on the practice of assisted suicide in the depenalising countries shows that the differences are smaller than initially thought. Nevertheless, important distinctions still remain. When analysing which model is most preferable, it is concluded that an involvement of a physician is inevitable and necessary and that the requirement of a certain medical condition is needed to set a clear and objective limit.

  11. 3-Dimensional Scene Perception during Active Electrolocation in a Weakly Electric Pulse Fish

    PubMed Central

    von der Emde, Gerhard; Behr, Katharina; Bouton, Béatrice; Engelmann, Jacob; Fetz, Steffen; Folde, Caroline

    2010-01-01

    Weakly electric fish use active electrolocation for object detection and orientation in their environment even in complete darkness. The African mormyrid Gnathonemus petersii can detect object parameters, such as material, size, shape, and distance. Here, we tested whether individuals of this species can learn to identify 3-dimensional objects independently of the training conditions and independently of the object's position in space (rotation-invariance; size-constancy). Individual G. petersii were trained in a two-alternative forced-choice procedure to electrically discriminate between a 3-dimensional object (S+) and several alternative objects (S−). Fish were then tested whether they could identify the S+ among novel objects and whether single components of S+ were sufficient for recognition. Size-constancy was investigated by presenting the S+ together with a larger version at different distances. Rotation-invariance was tested by rotating S+ and/or S− in 3D. Our results show that electrolocating G. petersii could (1) recognize an object independently of the S− used during training. When only single components of a complex S+ were offered, recognition of S+ was more or less affected depending on which part was used. (2) Object-size was detected independently of object distance, i.e. fish showed size-constancy. (3) The majority of the fishes tested recognized their S+ even if it was rotated in space, i.e. these fishes showed rotation-invariance. (4) Object recognition was restricted to the near field around the fish and failed when objects were moved more than about 4 cm away from the animals. Our results indicate that even in complete darkness our G. petersii were capable of complex 3-dimensional scene perception using active electrolocation. PMID:20577635

  12. 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.

  13. 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. PMID:25607941

  14. Patterned 3-dimensional metal grid electrodes as alternative electron collectors in dye-sensitized solar cells.

    PubMed

    Chua, Julianto; Mathews, Nripan; Jennings, James R; Yang, Guangwu; Wang, Qing; Mhaisalkar, Subodh G

    2011-11-21

    We describe the application of 3-dimensional metal grid electrodes (3D-MGEs) as electron collectors in dye-sensitized solar cells (DSCs) as a replacement for fluorinated tin oxide (FTO) electrodes. Requirements, structure, advantages, and limitations of the metal grid electrodes are discussed. Solar conversion efficiencies of 6.2% have been achieved in 3D-MGE based solar cells, comparable to that fabricated on FTO (7.1%). The charge transport properties and collection efficiencies in these novel solar cells have been studied using electrochemical impedance spectroscopy.

  15. High-speed 3-dimensional imaging in robot-assisted thoracic surgical procedures.

    PubMed

    Kajiwara, Naohiro; Akata, Soichi; Hagiwara, Masaru; Yoshida, Koichi; Kato, Yasufumi; Kakihana, Masatoshi; Ohira, Tatsuo; Kawate, Norihiko; Ikeda, Norihiko

    2014-06-01

    We used a high-speed 3-dimensional (3D) image analysis system (SYNAPSE VINCENT, Fujifilm Corp, Tokyo, Japan) to determine the best positioning of robotic arms and instruments preoperatively. The da Vinci S (Intuitive Surgical Inc, Sunnyvale, CA) was easily set up accurately and rapidly for this operation. Preoperative simulation and intraoperative navigation using the SYNAPSE VINCENT for robot-assisted thoracic operations enabled efficient planning of the operation settings. The SYNAPSE VINCENT can detect the tumor location and depict surrounding tissues quickly, accurately, and safely. This system is also excellent for navigational and educational use. PMID:24882302

  16. High-speed 3-dimensional imaging in robot-assisted thoracic surgical procedures.

    PubMed

    Kajiwara, Naohiro; Akata, Soichi; Hagiwara, Masaru; Yoshida, Koichi; Kato, Yasufumi; Kakihana, Masatoshi; Ohira, Tatsuo; Kawate, Norihiko; Ikeda, Norihiko

    2014-06-01

    We used a high-speed 3-dimensional (3D) image analysis system (SYNAPSE VINCENT, Fujifilm Corp, Tokyo, Japan) to determine the best positioning of robotic arms and instruments preoperatively. The da Vinci S (Intuitive Surgical Inc, Sunnyvale, CA) was easily set up accurately and rapidly for this operation. Preoperative simulation and intraoperative navigation using the SYNAPSE VINCENT for robot-assisted thoracic operations enabled efficient planning of the operation settings. The SYNAPSE VINCENT can detect the tumor location and depict surrounding tissues quickly, accurately, and safely. This system is also excellent for navigational and educational use.

  17. 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

  18. Topic modeling for cluster analysis of large biological and medical datasets

    PubMed Central

    2014-01-01

    Background The big data moniker is nowhere better deserved than to describe the ever-increasing prodigiousness and complexity of biological and medical datasets. New methods are needed to generate and test hypotheses, foster biological interpretation, and build validated predictors. Although multivariate techniques such as cluster analysis may allow researchers to identify groups, or clusters, of related variables, the accuracies and effectiveness of traditional clustering methods diminish for large and hyper dimensional datasets. Topic modeling is an active research field in machine learning and has been mainly used as an analytical tool to structure large textual corpora for data mining. Its ability to reduce high dimensionality to a small number of latent variables makes it suitable as a means for clustering or overcoming clustering difficulties in large biological and medical datasets. Results In this study, three topic model-derived clustering methods, highest probable topic assignment, feature selection and feature extraction, are proposed and tested on the cluster analysis of three large datasets: Salmonella pulsed-field gel electrophoresis (PFGE) dataset, lung cancer dataset, and breast cancer dataset, which represent various types of large biological or medical datasets. All three various methods are shown to improve the efficacy/effectiveness of clustering results on the three datasets in comparison to traditional methods. A preferable cluster analysis method emerged for each of the three datasets on the basis of replicating known biological truths. Conclusion Topic modeling could be advantageously applied to the large datasets of biological or medical research. The three proposed topic model-derived clustering methods, highest probable topic assignment, feature selection and feature extraction, yield clustering improvements for the three different data types. Clusters more efficaciously represent truthful groupings and subgroupings in the data than

  19. Measuring product meaning for prescribed medication using a means-end chain model.

    PubMed

    Doucette, W R; Wiederholt, J B

    1992-03-01

    On the basis of a means-end chain model, the product attribute and consequence levels of consumers' product meaning for prescribed medication were measured for a sample of 550 consumers. Using exploratory factor analysis on a 30-item scale, the authors identified five product attribute dimensions and three consequence dimensions. The means-end chain model can help marketers of health care learn more about how consumers categorize product meanings, which in turn can be used in the development of marketing strategies.

  20. 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.

  1. 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.

  2. Medical Image Segmentation Based on a Hybrid Region-Based Active Contour Model

    PubMed Central

    Liu, Tingting; Xu, Haiyong; Liu, Zhen; Zhao, Yiming; Tian, Wenzhe

    2014-01-01

    A novel hybrid region-based active contour model is presented to segment medical images with intensity inhomogeneity. The energy functional for the proposed model consists of three weighted terms: global term, local term, and regularization term. The total energy is incorporated into a level set formulation with a level set regularization term, from which a curve evolution equation is derived for energy minimization. Experiments on some synthetic and real images demonstrate that our model is more efficient compared with the localizing region-based active contours (LRBAC) method, proposed by Lankton, and more robust compared with the Chan-Vese (C-V) active contour model. PMID:25028593

  3. 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.

  4. 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.

  5. Determining the full costs of medical education in Thai Binh, Vietnam: a generalizable model.

    PubMed

    Bicknell, W J; Beggs, A C; Tham, P V

    2001-12-01

    We summarize a model for determining the full cost of educating a medical student at Thai Binh Medical School in Vietnam. This is the first full-cost analysis of medical education in a low-income country in over 20 years. We emphasize policy implications and the importance of looking at the educational costs and service roles of the major health professions. In Vietnam fully subsidized medical education has given way to a system combining student-paid tuition and fees with decreased government subsidies. Full cost information facilitates resource management, setting tuition charges at a school and adjusting budget allocations between medical schools, teaching hospitals, and health centres. When linked to quality indicators, trends within and useful comparisons between schools are possible. Cost comparisons between different types of providers can assist policy-makers in judging the appropriateness of expenditures per graduate for nursing and allied health education versus physician education. If privatization of medical education is considered, cost analysis allows policy-makers to know the full costs of educating physicians including the subsidies required in clinical settings. Our approach is intuitively simple and provides useful, understandable new information to managers and policy-makers. The full cost per medical graduate in 1997 was 111 462 989 Vietnamese Dong (US$9527). The relative expenditure per Vietnamese physician educated was 2.8 times the expenditure in the United States when adjusted for GNP per capita. Preliminary findings suggest that, within Vietnam, the cost to educate a physician is 14 times the cost of educating a nurse. Given the direct costs of physician education, the lifetime earnings of physicians and the costs that physicians generate for the use of health services and supplies, it is remarkable that so little attention is paid to the costs of educating physicians. Studies of this type can provide the quantitative basis for vital human

  6. 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. PMID:10168485

  7. 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.

  8. 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.

  9. 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.

  10. 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

  11. 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. PMID:27642588

  12. Formal representation of a conceptual data model for the patient-based medical record.

    PubMed

    Gouveia-Oliveira, A; Lopes, L

    1993-01-01

    We present a general architecture for the patient-based medical record as it is being developed for the SAMS, a private social security system. The conceptual data model is described in a convenient formal notation, the entity-relationship diagram. Although following the original formulation of the problem-oriented medical record (POMR), the data model was designed with a level of generalization that, functionally, makes structural differences between conventional and POMR no longer apparent. The main features of this model are its adaptability to individual work practices and its problem-oriented structure, including the representation of problems' evolution. This structure will enable physicians to organize the data, mostly collected elsewhere, by explicitly relating the facts that constitute a particular patient record, which is a simple way to store context information and clinical knowledge that is not part of patient data.

  13. A Low-Cost Teaching Model of Inguinal Canal: A Useful Method to Teach Surgical Concepts in Hernia Repair

    ERIC Educational Resources Information Center

    Ansaloni, Luca; Catena, Fausto; Coccolini, Frederico; Ceresoli, Marco; Pinna, Antonio Daniele

    2014-01-01

    Objectives: Inguinal canal anatomy and hernia repair is difficult for medical students and surgical residents to comprehend. Methods: Using low-cost material, a 3-dimensional inexpensive model of the inguinal canal was created to allow students to learn anatomical details and landmarks and to perform their own simulated hernia repair. In order to…

  14. 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. PMID:26983961

  15. 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.

  16. A new model for providing prehospital medical care in large stadiums.

    PubMed

    Spaite, D W; Criss, E A; Valenzuela, T D; Meislin, H W; Smith, R; Nelson, A

    1988-08-01

    To determine proper priorities for the provision of health care in large stadiums, we studied the medical incident patterns occurring in a major college facility and combined this with previously reported information from four other large stadiums. Medical incidents were an uncommon occurrence (1.20 to 5.23 per 10,000 people) with true medical emergencies being even more unusual (0.09 to 0.31 per 10,000 people). Cardiac arrest was rare (0.01 to 0.04 events per 10,000 people). However, the rates of successful resuscitation in three studies were 85% or higher. The previous studies were descriptive in nature and failed to provide specific recommendations for medical aid system configuration or response times. A model is proposed to provide rapid response of advanced life support care to victims of cardiac arrest. We believe that the use of this model in large stadiums throughout the United States could save as many as 100 lives during each football season. PMID:3394987

  17. Investigation on the governance model and effect of medical schools merged with comprehensive universities in China.

    PubMed

    Bai, Ge; Luo, Li

    2013-08-01

    This investigation analyzes the management of medical schools merged with comprehensive universities through internet search and research review to reveal management model and effect of the merger. The conclusion is safely reached that governance models are divided into two different patterns: centralized management and decentralized management. Eight universities, representing the two models, were selected and evaluated comprehensively. Among them, the universities that carried out decentralized management have greater development after the merger based on a quality comparison concerning freshmen, faculty, teaching, and research between the two patterns.

  18. 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.

  19. A Social Problem-Solving Model of Adherence to HIV Medications

    PubMed Central

    Johnson, Mallory O.; Elliott, Timothy R.; Neilands, Torsten B.; Morin, Stephen F.; Chesney, Margaret A.

    2008-01-01

    HIV medication adherence remains a challenge and limits the degree to which treatment benefit can be maximized. The purpose of this paper is to test 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 (ART) medication adherence. Structural equation modeling (SEM) techniques were employed 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 non-adherent. 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. PMID:16719607

  20. 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.

  1. How students experience and navigate transitions in undergraduate medical education: an application of Bourdieu's theoretical model.

    PubMed

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

    2015-10-01

    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 this longitudinal case study. Students had similar preclinical and post-MCY experiences but different MCY experiences (rotational vs. longitudinal tracks). We interviewed students every 6 months in the preclinical phase, mid-way through MCY, and 7-8 months before graduation (101 total interviews). We inductively created codes, iteratively revised codes to best-fit the data, and thematically clustered codes into Bourdieu-informed categories: field (social structures), capital (resources) and habitus (dispositions). We found that students acclimated to shifts in the UME field as they moved through medical school: from medical school itself to the health system and back. To successfully navigate transitions, students learned to secure capital as medical knowledge and social connections in the preclinical and preparation for residency phases, and as reputable patient care and being noticed in the clinical phase. To obtain capital, and be well-positioned for the next phase of training, students consistently relied on dispositions of initiative and flexibility. In summary, students experience the complex context of medical school through a series of transitions. Efforts to improve UME would be well-served by greater awareness of the social structures (field) that students encounter, the resources to which they afford value (capital), and the dispositions which aid acquisition of these resources (habitus). PMID:25633168

  2. How students experience and navigate transitions in undergraduate medical education: an application of Bourdieu's theoretical model.

    PubMed

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

    2015-10-01

    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 this longitudinal case study. Students had similar preclinical and post-MCY experiences but different MCY experiences (rotational vs. longitudinal tracks). We interviewed students every 6 months in the preclinical phase, mid-way through MCY, and 7-8 months before graduation (101 total interviews). We inductively created codes, iteratively revised codes to best-fit the data, and thematically clustered codes into Bourdieu-informed categories: field (social structures), capital (resources) and habitus (dispositions). We found that students acclimated to shifts in the UME field as they moved through medical school: from medical school itself to the health system and back. To successfully navigate transitions, students learned to secure capital as medical knowledge and social connections in the preclinical and preparation for residency phases, and as reputable patient care and being noticed in the clinical phase. To obtain capital, and be well-positioned for the next phase of training, students consistently relied on dispositions of initiative and flexibility. In summary, students experience the complex context of medical school through a series of transitions. Efforts to improve UME would be well-served by greater awareness of the social structures (field) that students encounter, the resources to which they afford value (capital), and the dispositions which aid acquisition of these resources (habitus).

  3. Pathology service line: a model for accountable care organizations at an academic medical center.

    PubMed

    Sussman, Ira; Prystowsky, Michael B

    2012-05-01

    Accountable care is designed to manage the health of patients using a capitated cost model rather than fee for service. Pay for performance is an attempt to use quality and not service reduction as the way to decrease costs. Pathologists will have to demonstrate value to the system. This value will include (1) working with clinical colleagues to optimize testing protocols, (2) reducing unnecessary testing in both clinical and anatomic pathology, (3) guiding treatment by helping to personalize therapy, (4) designing laboratory information technology solutions that will promote and facilitate accurate, complete data mining, and (5) administering efficient cost-effective laboratories. The pathology service line was established to improve the efficiency of delivering pathology services and to provide more effective support of medical center programs. We have used this model effectively at the Montefiore Medical Center for the past 14 years. PMID:22333926

  4. Jackson Community Medical Record: a model for provider collaboration in a RHIO.

    PubMed

    Hayward, Mary K; Warren, Richard D; Sykes, Jonathan

    2007-01-01

    Foote Health System serves more than 247,000 individuals throughout six Michigan counties. In January 2005, FHS and Jackson Physicians Alliance, a 160-member physician contracting group, joined together to champion a community electronic health record by forming Jackson Community Medical Record LLC. JCMR selected and implemented of a fully integrated HIPAA-compliant EHR hosted on an application service provider. The shared database enables providers to leverage the work of each other. The community is already experiencing the benefits of the HER, including increased accuracy of medications, patient satisfaction, efficiency and reimbursement. The JCMR business model provides low entry costs and economies of scale. Software licenses and services are negotiated and held by JCMR. The interfaces between hospital systems and providers are maximized. JCMR is successfully bringing isolated islands of patient data together and serves a model for other communities. PMID:19195291

  5. [Behavior of microorganisms in wastes from medical practice and household refuse deposited in a model landfill].

    PubMed

    Trost, M; Filip, Z

    1985-06-01

    Refuse from medical consulting rooms, a mixture of those refuse with municipal refuse (1:10), and municipal refuse were disposed aerobically and roughly anaerobically for over six months in a model landfill. Survival, proliferation, and transportation of microorganisms were estimated at different periods of time. Concentrations of aerobic bacteria and hyphomycetes decreased during the first weeks of deposition but remained later almost unchanged. Concentrations of nonsporeforming indicator bacteria (Escherichia coli, feacal streptococci) decreased more strongly, and E. coli could not be found at latest after 23 weeks. In municipal refuse alone and mixed with refuse from medical consulting rooms, Pseudomonas aeruginosa proliferated temporarily. Leaching of microorganisms from the model landfill was observed in the whole course of the disposal period.

  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. 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.

  8. 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.

  9. 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.

  10. [Conditional discrimination using 3-dimensional objects by a chimpanzee (Pan troglodytes): tests for derived stimulus relations].

    PubMed

    Tomonaga, Masaki; Fushimi, Takao

    2002-06-01

    A female chimpanzee (Pan troglodytes) was trained on the conditional-discrimination task using 3-dimensional objects under a face-to-face experimental setting. In Experiment 1, the subject was required to pick up the correct comparison object, take it to the sample object, and construct a new paired-object with a specific action. After acquisition of the task, derived stimulus relations (associative symmetry) were tested. The subject showed a significant emergence of symmetry only when the spatial arrangements of stimuli were changed between the baseline and test trials. In Experiment 2, the subject was tested under the condition where the action to constructed paired-object was common to all stimuli. The subject showed significant above-chance performance in the transitivity test, but not in the symmetry tests. The present results are generally consistent with previous studies in chimpanzees that show weak evidence for the emergence of symmetry.

  11. S2PLOT: a Straightforward Library for Advanced 3-dimensional Scientific Visualisation

    NASA Astrophysics Data System (ADS)

    Barnes, D. G.; Fluke, C. J.

    2008-08-01

    S2PLOT is a user-oriented programming library for generating and exploring 3-dimensional (3-d) scientific plots and diagrams. It provides a lightweight interface---inspired by the simple yet widely-used PGPLOT---to produce hardware-accelerated visualisations of point, line, image and volumetric data. S2PLOT provides C and FORTRAN interfaces, and supports monoscopic, stereoscopic and curved (eg. dome) display devices. PGPLOT-savvy astronomers can usually write their first S2PLOT program in less than ten minutes. In this paper, we introduce the latest S2PLOT version and highlight major new additions to the library, including volume rendering and isosurfacing of astronomical data. We describe a simple extension that enables the embedding of large-area FITS images directly into S2PLOT programs using standard World Coordinate Systems, and we introduce the Python interface to S2PLOT.

  12. Lateral characteristic analysis of PMLSM considering overhang effect by 3 dimensional equivalent magnetic circuit network method

    SciTech Connect

    Hur, J.; Jung, I.S.; Hyun, D.S.

    1998-09-01

    PMLSM is used for propulsion device of high speed ground transportation or contactless carrier in factory automation and office automation. This paper represents lateral characteristics of Permanent Magnet Linear Synchronous Motor (PMLSM) according to change of overhang length. In order to analyze overhang effect of PMLSM with large airgap and finite width considering lateral displacement, new 3 dimensional equivalent magnetic circuit network method (3-D EMCN) taking into account movement of the secondary in lateral direction is introduced, which supplements magnetic equivalent circuit by using numerical technique. 3-D EMCN can consider secondary movement without remesh the element because it uses the initial mesh continuously. The authors analyzed characteristics for overhang three type case which must be problems in 3-D. The results are compared with experimental data and shown a reasonable agreement.

  13. Theory of relativistic Brownian motion: the (1+3) -dimensional case.

    PubMed

    Dunkel, Jörn; Hänggi, Peter

    2005-09-01

    A theory for (1+3) -dimensional relativistic Brownian motion under the influence of external force fields is put forward. Starting out from a set of relativistically covariant, but multiplicative Langevin equations we describe the relativistic stochastic dynamics of a forced Brownian particle. The corresponding Fokker-Planck equations are studied in the laboratory frame coordinates. In particular, the stochastic integration prescription--i.e., the discretization rule dilemma--is elucidated (prepoint discretization rule versus midpoint discretization rule versus postpoint discretization rule). Remarkably, within our relativistic scheme we find that the postpoint rule (or the transport form) yields the only Fokker-Planck dynamics from which the relativistic Maxwell-Boltzmann statistics is recovered as the stationary solution. The relativistic velocity effects become distinctly more pronounced by going from one to three spatial dimensions. Moreover, we present numerical results for the asymptotic mean-square displacement of a free relativistic Brownian particle moving in 1+3 dimensions.

  14. PROMALS3D: multiple protein sequence alignment enhanced with evolutionary and 3-dimensional structural information

    PubMed Central

    Pei, Jimin; Grishin, Nick V.

    2015-01-01

    SUMMARY Multiple sequence alignment (MSA) is an essential tool with many applications in bioinformatics and computational biology. Accurate MSA construction for divergent proteins remains a difficult computational task. The constantly increasing protein sequences and structures in public databases could be used to improve alignment quality. PROMALS3D is a tool for protein MSA construction enhanced with additional evolutionary and structural information from database searches. PROMALS3D automatically identifies homologs from sequence and structure databases for input proteins, derives structure-based constraints from alignments of 3-dimensional structures, and combines them with sequence-based constraints of profile-profile alignments in a consistency-based framework to construct high-quality multiple sequence alignments. PROMALS3D output is a consensus alignment enriched with sequence and structural information about input proteins and their homologs. PROMALS3D web server and package are available at http://prodata.swmed.edu/PROMALS3D. PMID:24170408

  15. 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

  16. 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.

  17. The SHEL model: a useful tool for analyzing and teaching the contribution of Human Factors to medical error.

    PubMed

    Molloy, Gerard J; O'Boyle, Ciarán A

    2005-02-01

    Recent reports on the problem of medical error pointed to a discipline that has been until recently, largely disregarded by the medical profession. The interdisciplinary science of Human Factors, the reports argue, provides a pragmatic framework for analyzing and assessing risk and reducing error in health care. The argument for applying Human Factors analysis to health care is increasingly accepted, and the application of Human Factors systems models for understanding medical error in particular have proved to be especially illuminating. The authors present a conceptual model of Human Factors--the SHEL model (named after the initial letters of its components' names, Software, Hardware, Environment, and Liveware)--that has been used in investigations of error in aviation. The authors use this simple model to examine and elucidate the Human Factors issues in a specific real-life example of medical error. The SHEL model is particularly useful in examining Human Factors issues in microsystems in health care such as the emergency room or the operating theatre; it argues that mismatches at the interface between the components in these health care microsystems are often conducive to medical errors. The authors propose that the SHEL model may have some unexploited potential in analyzing error and in training medical professionals about the science of Human Factors and its application to medical error. Empirical studies are needed, however, to ascertain the optimal amount of training needed to make clinically significant reductions in the occurrence of medical error.

  18. 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

  19. 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

  20. The pig as a model for translational research: overview of porcine animal models at Jichi Medical University.

    PubMed

    Kobayashi, Eiji; Hishikawa, Shuji; Teratani, Takumi; Lefor, Alan T

    2012-01-01

    To improve the welfare of experimental animals, investigators seek to respect the 3R principle (Replacement, Reduction, and Refinement). Even when large animal studies are essential before moving to clinical trials, it is important to look for ways to reduce the number of experimental animals used. At the Center for the Development of Advanced Medical Technology, we consider 'medical' pigs to be ideal preclinical model systems.We have been using both wild-type and genetically modified pigs. We began using this approach about 10 years ago with a 'total pig system' to model human health and disease for the purposes of both medical skill education and the development of new devices and therapeutic strategies.At our Center, medical students and residents use pigs to gain experience with surgical skills and train for emergency procedures after appropriate simulation training. Senior clinicians have also used these models to advance the development of innovative tools for endo- and laparoscopic procedures. The Center focuses on translational research for organ transplantation and stem cell therapy. Several pig models have been established for liver, intestine, kidney, pancreas, and lung transplantation. Mesenchymal stromal cells have been established in green fluorescent protein- and red fluorescent protein-transgenic pigs and tested to trans-differentiate organogenesis. A program to establish induced pluripotent stem cells in the pig is ongoing at our Center.Here, we review our 10 years of activity in this field. Based on our experience in surgical education and research, experimental pigs are valuable models in translational research.

  1. 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.

  2. The social structure of the medical model of madness and the physician's role.

    PubMed

    Fernandez, G

    1981-08-01

    In this paper the origins of the medical model of madness are traced in the sociohistorical context of institutional and professional development. The paper establishes the emergence of the three primary conditions necessary for the medical model to exist: (a) the view that madness is a separate ontological reality which can be differentiated from the insane person; (b) the concept that insane people do not have a completely free will and therefore cannot be held responsible for their actions; and (c) the creation of specific criteria to classify the disease into empirically derived nosologies. These conditions and their acceptance as an explanatory paradigm of insanity result from the political economy of the late Middle Ages and are reflected in the institutional arrangement for insane persons of the 17th and 18th centuries. Finally, the role of the physician-psychiatrist is explained in terms of an ability to (a) serve as a technician for the new political forces, and (b) dislodge the moral entrepreneurs and become the only profession able to offer a proper scientific and secular treatment of madness. The psychiatrist is presented as a by-product of the dominance of the medical model rather than as the agent who created it.

  3. 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.

  4. 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.

  5. "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.

  6. Shape-model-based adaptation of 3D deformable meshes for segmentation of medical images

    NASA Astrophysics Data System (ADS)

    Pekar, Vladimir; Kaus, Michael R.; Lorenz, Cristian; Lobregt, Steven; Truyen, Roel; Weese, Juergen

    2001-07-01

    Segmentation methods based on adaptation of deformable models have found numerous applications in medical image analysis. Many efforts have been made in the recent years to improve their robustness and reliability. In particular, increasingly more methods use a priori information about the shape of the anatomical structure to be segmented. This reduces the risk of the model being attracted to false features in the image and, as a consequence, makes the need of close initialization, which remains the principal limitation of elastically deformable models, less crucial for the segmentation quality. In this paper, we present a novel segmentation approach which uses a 3D anatomical statistical shape model to initialize the adaptation process of a deformable model represented by a triangular mesh. As the first step, the anatomical shape model is parametrically fitted to the structure of interest in the image. The result of this global adaptation is used to initialize the local mesh refinement based on an energy minimization. We applied our approach to segment spine vertebrae in CT datasets. The segmentation quality was quantitatively assessed for 6 vertebrae, from 2 datasets, by computing the mean and maximum distance between the adapted mesh and a manually segmented reference shape. The results of the study show that the presented method is a promising approach for segmentation of complex anatomical structures in medical images.

  7. Useful measures and models for analytical quality management in medical laboratories.

    PubMed

    Westgard, James O

    2016-02-01

    The 2014 Milan Conference "Defining analytical performance goals 15 years after the Stockholm Conference" initiated a new discussion of issues concerning goals for precision, trueness or bias, total analytical error (TAE), and measurement uncertainty (MU). Goal-setting models are critical for analytical quality management, along with error models, quality-assessment models, quality-planning models, as well as comprehensive models for quality management systems. There are also critical underlying issues, such as an emphasis on MU to the possible exclusion of TAE and a corresponding preference for separate precision and bias goals instead of a combined total error goal. This opinion recommends careful consideration of the differences in the concepts of accuracy and traceability and the appropriateness of different measures, particularly TAE as a measure of accuracy and MU as a measure of traceability. TAE is essential to manage quality within a medical laboratory and MU and trueness are essential to achieve comparability of results across laboratories. With this perspective, laboratory scientists can better understand the many measures and models needed for analytical quality management and assess their usefulness for practical applications in medical laboratories.

  8. 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

  9. 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

  10. OntoVIP: an ontology for the annotation of object models used for medical image simulation.

    PubMed

    Gibaud, Bernard; Forestier, Germain; Benoit-Cattin, Hugues; Cervenansky, Frédéric; Clarysse, Patrick; Friboulet, Denis; Gaignard, Alban; Hugonnard, Patrick; Lartizien, Carole; Liebgott, Hervé; Montagnat, Johan; Tabary, Joachim; Glatard, Tristan

    2014-12-01

    This paper describes the creation of a comprehensive conceptualization of object models used in medical image simulation, suitable for major imaging modalities and simulators. The goal is to create an application ontology that can be used to annotate the models in a repository integrated in the Virtual Imaging Platform (VIP), to facilitate their sharing and reuse. Annotations make the anatomical, physiological and pathophysiological content of the object models explicit. In such an interdisciplinary context we chose to rely on a common integration framework provided by a foundational ontology, that facilitates the consistent integration of the various modules extracted from several existing ontologies, i.e. FMA, PATO, MPATH, RadLex and ChEBI. Emphasis is put on methodology for achieving this extraction and integration. The most salient aspects of the ontology are presented, especially the organization in model layers, as well as its use to browse and query the model repository.

  11. OntoVIP: an ontology for the annotation of object models used for medical image simulation.

    PubMed

    Gibaud, Bernard; Forestier, Germain; Benoit-Cattin, Hugues; Cervenansky, Frédéric; Clarysse, Patrick; Friboulet, Denis; Gaignard, Alban; Hugonnard, Patrick; Lartizien, Carole; Liebgott, Hervé; Montagnat, Johan; Tabary, Joachim; Glatard, Tristan

    2014-12-01

    This paper describes the creation of a comprehensive conceptualization of object models used in medical image simulation, suitable for major imaging modalities and simulators. The goal is to create an application ontology that can be used to annotate the models in a repository integrated in the Virtual Imaging Platform (VIP), to facilitate their sharing and reuse. Annotations make the anatomical, physiological and pathophysiological content of the object models explicit. In such an interdisciplinary context we chose to rely on a common integration framework provided by a foundational ontology, that facilitates the consistent integration of the various modules extracted from several existing ontologies, i.e. FMA, PATO, MPATH, RadLex and ChEBI. Emphasis is put on methodology for achieving this extraction and integration. The most salient aspects of the ontology are presented, especially the organization in model layers, as well as its use to browse and query the model repository. PMID:25038553

  12. Adventitial Cells and Perictyes Support Chondrogenesis Through Different Mechanisms in 3-Dimensional Cultures With or Without Nanoscaffolds.

    PubMed

    Zhang, Shu; Ba, Kai; Wu, Ling; Lee, Siyong; Peault, Bruno; Petrigliano, Frank A; McAllister, David R; Adams, John S; Evseenko, Denis; Lin, Yunfeng

    2015-10-01

    In previous studies, mesenchymal stromal cells (MSCs) derived from bone marrow and fat tissues were shown to increase proliferation and matrix production of chondrocytes (CH) in co-culture. The aim of this study was to investigate the roles of pericytes (CD31(neg)CD45(neg)CD146+CD34(neg)) and adventitial cells (CD31(neg)CD45(neg)CD146(neg)CD34+) sub-populations of MSCs in supporting proliferation and matrix deposition of CH. The MSCs were derived from synovial membrane and attaching fat tissue. Then, the pericytes and adventitial cells were sorted from total MSCs and co-cultured with articular CH respectively. In pellet co-culture model, the pericytes showed more prominent effects on glycosaminoglycans (GAGs) production and Collagen II synthesis than the adventitial cells which had stronger effects on promoting CH proliferation. In addition, quantitative polymerase chain reaction (qPCR) was performed to examine the expression of a group of secreted growth factors and co-culture performed on electrospun scaffolds based on Poly(3-hydroxybutyrate-co-4-hydroxybutyrate) (P3HB4HB), to verify the trophic effects of different MSC sub-populations in 3-Dimensional (3D) environment. In conclusion, it was found that the pericytes and adventitial cells support CH in different ways; the adventitial cells more supporting the proliferation of CH, while pericytes are better in stimulating GAGs and collagen production of CH. PMID:26502642

  13. [Segmentation of medical images based on dyadic wavelet transform and active contour model].

    PubMed

    Li, Hong; Wang, Huinan; Chang, Linfeng; Shao, Xiaoli

    2008-12-01

    The interference of noise and the weak edge characteristic of symptom information on medical images prevent the traditional methods of segmentation from having good effects. In this paper is proposed a boundary detection method of focus which is based on dyadic wavelet transform and active contour model. In this method, the true edge points are detected by dyadic wavelet transform and linked by improved fast active contour model algorithm. The result of experiment on MRI of brain shows that the method can remove the influence of noise effective and detect the contour of brain tumor actually. PMID:19166191

  14. Research on an Improved Medical Image Enhancement Algorithm Based on P-M Model.

    PubMed

    Dong, Beibei; Yang, Jingjing; Hao, Shangfu; Zhang, Xiao

    2015-01-01

    Image enhancement can improve the detail of the image and so as to achieve the purpose of the identification of the image. At present, the image enhancement is widely used in medical images, which can help doctor's diagnosis. IEABPM (Image Enhancement Algorithm Based on P-M Model) is one of the most common image enhancement algorithms. However, it may cause the lost of the texture details and other features. To solve the problems, this paper proposes an IIEABPM (Improved Image Enhancement Algorithm Based on P-M Model). Simulation demonstrates that IIEABPM can effectively solve the problems of IEABPM, and improve image clarity, image contrast, and image brightness. PMID:26628929

  15. 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.

  16. The medical decision model and decision maker tools for management of radiological and nuclear incidents.

    PubMed

    Koerner, John F; Coleman, C Norman; Murrain-Hill, Paula; FitzGerald, Denis J; Sullivan, Julie M

    2014-06-01

    Effective decision making during a rapidly evolving emergency such as a radiological or nuclear incident requires timely interim decisions and communications from onsite decision makers while further data processing, consultation, and review are ongoing by reachback experts. The authors have recently proposed a medical decision model for use during a radiological or nuclear disaster, which is similar in concept to that used in medical care, especially when delay in action can have disastrous effects. For decision makers to function most effectively during a complex response, they require access to onsite subject matter experts who can provide information, recommendations, and participate in public communication efforts. However, in the time before this expertise is available or during the planning phase, just-in-time tools are essential that provide critical overview of the subject matter written specifically for the decision makers. Recognizing the complexity of the science, risk assessment, and multitude of potential response assets that will be required after a nuclear incident, the Office of the Assistant Secretary for Preparedness and Response, in collaboration with other government and non-government experts, has prepared a practical guide for decision makers. This paper illustrates how the medical decision model process could facilitate onsite decision making that includes using the deliberative reachback process from science and policy experts and describes the tools now available to facilitate timely and effective incident management. PMID:24776895

  17. 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

  18. 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. PMID:25108980

  19. Functional and Dysfunctional Characteristics of the Prevailing Model of Clinical Evaluation Systems in North American Medical Schools.

    ERIC Educational Resources Information Center

    Hunt, D. Daniel

    1992-01-01

    Drawing from survey data (n=138 medical schools in the United States and Canada), a study analyzed medical schools' systems for evaluating student progress in clinical experiences. The 4-stage model used by most schools, common and unique characteristics, and 17 symptoms of system errors, signaling a need for system review, are outlined.…

  20. A New Model for the Organizational Structure of Medical Record Departments in Hospitals in Iran

    PubMed Central

    Moghaddasi, Hamid; Hosseini, Azamossadat; Sheikhtaheri, Abbas

    2006-01-01

    The organizational structure of medical record departments in Iran is not appropriate for the efficient management of healthcare information. In addition, there is no strong information management division to provide comprehensive information management services in hospitals in Iran. Therefore, a suggested model was designed based on four main axes: 1) specifications of a Health Information Management Division, 2) specifications of a Healthcare Information Management Department, 3) the functions of the Healthcare Information Management Department, and 4) the units of the Healthcare Information Management Department. The validity of the model was determined through use of the Delphi technique. The results of the validation process show that the majority of experts agree with the model and consider it to be appropriate and applicable for hospitals in Iran. The model is therefore recommended for hospitals in Iran. PMID:18066362

  1. 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

  2. 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.

  3. Comparison Of Image Display Techniques For Solid Models In Medical Imaging

    NASA Astrophysics Data System (ADS)

    Wood, Sally L.; Fellingham, Linda L.; Massicotte, Jean B.; Dev, Parvati

    1985-09-01

    Presenting three-dimensional information in the form of 3D solid models rather than as a sequence of two-dimensional intensity images provides many benefits in presurgical planning and diagnostic radiography. Although the model generation process does not add information to the sequential slice data, it does present images of organs and bony structures in a form more like the expected view of solid objects in natural scenes. Surface shapes and details of surface variations, which would require practiced observation of two-dimensional intensity data, are readily visible in the solid model displays making this information immediately available to a broad cross section of medical personnel. After a year of experience with a commercially available system, a Contour Medical Systems CEMAX-l000, which accepts input from several CT or MR scanner models and provides basic solid model displays, additional types of solid model viewing have been made available to clinical personnel for preliminary evaluation. The advantages and disadvantages in terms of subjective display quality, information content, and computational cost of several display methods have been investigated. Display of solid models by range encoding, heuristic mappings of intensity levels, and complete reflectance models have been compared for black-and-white and monochromatic color images. The option of displaying multiple objects in contrasting colors both as opaque and transparent objects has also been tested. Methods of surface acquisition from the two-dimensional data have been varied to match the material of interest and the characteristics of the original intensity data allowing improved representation of soft tissue. Finally, the utility of several types of time varying imagery is discussed, including the advantages of viewing rotating solid objects compared to viewing a collage of still pictures in many orientations. Some clinical examples of these experimental image display techniques are presented

  4. Modeled occupational exposures to gas-phase medical laser-generated air contaminants.

    PubMed

    Lippert, Julia F; Lacey, Steven E; Jones, Rachael M

    2014-01-01

    Exposure monitoring data indicate the potential for substantive exposure to laser-generated air contaminants (LGAC); however the diversity of medical lasers and their applications limit generalization from direct workplace monitoring. Emission rates of seven previously reported gas-phase constituents of medical laser-generated air contaminants (LGAC) were determined experimentally and used in a semi-empirical two-zone model to estimate a range of plausible occupational exposures to health care staff. Single-source emission rates were generated in an emission chamber as a one-compartment mass balance model at steady-state. Clinical facility parameters such as room size and ventilation rate were based on standard ventilation and environmental conditions required for a laser surgical facility in compliance with regulatory agencies. All input variables in the model including point source emission rates were varied over an appropriate distribution in a Monte Carlo simulation to generate a range of time-weighted average (TWA) concentrations in the near and far field zones of the room in a conservative approach inclusive of all contributing factors to inform future predictive models. The concentrations were assessed for risk and the highest values were shown to be at least three orders of magnitude lower than the relevant occupational exposure limits (OELs). Estimated values do not appear to present a significant exposure hazard within the conditions of our emission rate estimates. PMID:24762065

  5. 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. PMID:16752110

  6. Acute care nurse practitioners: creating and implementing a model of care for an inpatient general medical service.

    PubMed

    Howie, Jill N; Erickson, Mitchel

    2002-09-01

    Changes in medical education and healthcare reimbursement are recent threats to most academic medical centers' dual mission of patient care and education. Financial pressures stem from reduced insurance reimbursement, capitation, and changes in public funding for medical residency education. Pressures for innovation result from increasing numbers of patients, higher acuity of patients, an aging population of patients with complex problems, and restrictions on residency workloads. A framework for addressing the need for innovation in the medical service at a large academic medical center is presented. The framework enables acute care nurse practitioners to provide inpatient medical management in collaboration with a hospitalist. The model's development, acceptance, successes, pitfalls, and evaluation are described. The literature describing the use of nurse practitioners in acute care settings is reviewed.

  7. Successful Parenchyma-Sparing Anatomical Surgery by 3-Dimensional Reconstruction of Hilar Cholangiocarcinoma Combined with Anatomic Variation.

    PubMed

    Ni, Qihong; Wang, Haolu; Liang, Xiaowen; Zhang, Yunhe; Chen, Wei; Wang, Jian

    2016-06-01

    The combination of hilar cholangiocarcinoma and anatomic variation constitutes a rare and complicated condition. Precise understanding of 3-dimensional position of tumor in the intrahepatic structure in such cases is important for operation planning and navigation. We report a case of a 61-year woman presenting with hilar cholangiocarcinoma. Anatomic variation and tumor location were well depicted on preoperative multidetector computed tomography (MDCT) combined with 3-dimensional reconstruction as the right posterior segmental duct drained to left hepatic duct. The common hepatic duct, biliary confluence, right anterior segmental duct, and right anterior branch of portal vein were involved by the tumor (Bismuth IIIa). After carefully operation planning, we successfully performed a radical parenchyma-sparing anatomical surgery of hilar cholangiocarcinoma: Liver segmentectomy (segments 5 and 8) and caudate lobectomy. MDCTcombined with 3-dimensional reconstruction is a reliable non-invasive modality for preoperative evaluation of hilar cholangiocarcinoma. PMID:27376205

  8. 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.

  9. Identifying the Basal Ganglia Network Model Markers for Medication-Induced Impulsivity in Parkinson's Disease Patients

    PubMed Central

    Balasubramani, Pragathi Priyadharsini; Chakravarthy, V. Srinivasa; Ali, Manal; Ravindran, Balaraman; Moustafa, Ahmed A.

    2015-01-01

    Impulsivity, i.e. irresistibility in the execution of actions, may be prominent in Parkinson's disease (PD) patients who are treated with dopamine precursors or dopamine receptor agonists. In this study, we combine clinical investigations with computational modeling to explore whether impulsivity in PD patients on medication may arise as a result of abnormalities in risk, reward and punishment learning. In order to empirically assess learning outcomes involving risk, reward and punishment, four subject groups were examined: healthy controls, ON medication PD patients with impulse control disorder (PD-ON ICD) or without ICD (PD-ON non-ICD), and OFF medication PD patients (PD-OFF). A neural network model of the Basal Ganglia (BG) that has the capacity to predict the dysfunction of both the dopaminergic (DA) and the serotonergic (5HT) neuromodulator systems was developed and used to facilitate the interpretation of experimental results. In the model, the BG action selection dynamics were mimicked using a utility function based decision making framework, with DA controlling reward prediction and 5HT controlling punishment and risk predictions. The striatal model included three pools of Medium Spiny Neurons (MSNs), with D1 receptor (R) alone, D2R alone and co-expressing D1R-D2R. Empirical studies showed that reward optimality was increased in PD-ON ICD patients while punishment optimality was increased in PD-OFF patients. Empirical studies also revealed that PD-ON ICD subjects had lower reaction times (RT) compared to that of the PD-ON non-ICD patients. Computational modeling suggested that PD-OFF patients have higher punishment sensitivity, while healthy controls showed comparatively higher risk sensitivity. A significant decrease in sensitivity to punishment and risk was crucial for explaining behavioral changes observed in PD-ON ICD patients. Our results highlight the power of computational modelling for identifying neuronal circuitry implicated in learning, and its

  10. 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.

  11. Challenging the focus on technology: a critique of the medical model in a changing health care system.

    PubMed

    Allan, J D; Hall, B A

    1988-04-01

    The medical model and medical technology have had a pervasive effect on society. Their importance to nursing and to nursing's clients cannot be overstated. This article explores the belief system of medicine and challenges its "germ theory" conceptual underpinnings. Other issues explored are the lack of established efficacy of practice stemming from the medical model; the attendant but unaddressed ethical and iatrogenic questions; the model's destructive effect on health and well-being; and, finally, the economic consequences of the medical model for consumers and the practice of other professional groups. Nurses are urged to consider paradigms that derive from ecological and process orientations to support nursing's concern with health and quality of life.

  12. 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

  13. Automatic fabrication of 3-dimensional tissues using cell sheet manipulator technique.

    PubMed

    Kikuchi, Tetsutaro; Shimizu, Tatsuya; Wada, Masanori; Yamato, Masayuki; Okano, Teruo

    2014-03-01

    Automated manufacturing is a key for tissue-engineered therapeutic products to become common-place and economical. Here, we developed an automatic cell sheet stacking apparatus to fabricate 3-dimensional tissue-engineered constructs exploiting our cell sheet manipulator technique, where cell sheets harvested from temperature-responsive culture dishes are stacked into a multilayered cell sheet. By optimizing the stacking conditions and cell seeding conditions, the apparatus was eventually capable of reproducibly making five-layer human skeletal muscle myoblast (HSMM) sheets with a thickness of approximately 70-80 μm within 100 min. Histological sections and confocal topographies of the five-layer HSMM sheets revealed a stratified structure with no delamination. In cell counts using trypsinization, the live cell numbers in one-, three- and five-layer HSMM sheets were equivalent to the seeded cell numbers at 1 h after the stacking processes; however, after subsequent 5-day static cultures, the live cell numbers of the five-layered HSMM sheets decreased slightly, while one- and three-layer HSMM sheets maintained their live cell numbers. This suggests that there are thickness limitations in maintaining tissues in a static culture. We concluded that by combining our cell sheet manipulator technique and industrial robot technology we can create a secure, cost-effective manufacturing system able to produce tissue-engineered products from cell sheets. PMID:24370007

  14. A 60GHz-Band 3-Dimensional System-in-Package Transmitter Module with Integrated Antenna

    NASA Astrophysics Data System (ADS)

    Suematsu, Noriharu; Yoshida, Satoshi; Tanifuji, Shoichi; Kameda, Suguru; Takagi, Tadashi; Tsubouchi, Kazuo

    A low cost, ultra small Radio Frequency (RF) transceiver module with integrated antenna is one of the key technologies for short range millimeter-wave wireless communication. This paper describes a 60GHz-band transmitter module with integrated dipole antenna. The module consists of three pieces of low-cost organic resin substrate. These substrates are vertically stacked by employing Cu ball bonding 3-dimensional (3-D) system-in-package (SiP) technology and the MMIC's are mounted on each organic substrates by using Au-stud bump bonding (SBB) technique. The planer dipole antenna is fabricated on the top of the stacked organic substrate to avoid the influence of the grounding metal on the base substrate. At 63GHz, maximum actual gain of 6.0dBi is obtained for fabricated planar dipole antenna. The measured radiation patterns are agreed with the electro-magnetic (EM) simulated result, therefore the other RF portion of the 3-D front-end module, such as flip chip mounted IC's on the top surface of the module, does not affect the antenna characteristics. The results show the feasibility of millimeter-wave low cost, ultra small antenna integrated module using stacked organic substrates.

  15. 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

  16. 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). PMID:24086243

  17. 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

  18. 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. PMID:26344279

  19. 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.

  20. 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.

  1. Automatic fabrication of 3-dimensional tissues using cell sheet manipulator technique.

    PubMed

    Kikuchi, Tetsutaro; Shimizu, Tatsuya; Wada, Masanori; Yamato, Masayuki; Okano, Teruo

    2014-03-01

    Automated manufacturing is a key for tissue-engineered therapeutic products to become common-place and economical. Here, we developed an automatic cell sheet stacking apparatus to fabricate 3-dimensional tissue-engineered constructs exploiting our cell sheet manipulator technique, where cell sheets harvested from temperature-responsive culture dishes are stacked into a multilayered cell sheet. By optimizing the stacking conditions and cell seeding conditions, the apparatus was eventually capable of reproducibly making five-layer human skeletal muscle myoblast (HSMM) sheets with a thickness of approximately 70-80 μm within 100 min. Histological sections and confocal topographies of the five-layer HSMM sheets revealed a stratified structure with no delamination. In cell counts using trypsinization, the live cell numbers in one-, three- and five-layer HSMM sheets were equivalent to the seeded cell numbers at 1 h after the stacking processes; however, after subsequent 5-day static cultures, the live cell numbers of the five-layered HSMM sheets decreased slightly, while one- and three-layer HSMM sheets maintained their live cell numbers. This suggests that there are thickness limitations in maintaining tissues in a static culture. We concluded that by combining our cell sheet manipulator technique and industrial robot technology we can create a secure, cost-effective manufacturing system able to produce tissue-engineered products from cell sheets.

  2. 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.

  3. Craniofacial muscle engineering using a 3-dimensional phosphate glass fibre construct.

    PubMed

    Shah, R; Sinanan, A C M; Knowles, J C; Hunt, N P; Lewis, M P

    2005-05-01

    The current technique to replace missing craniofacial skeletal muscle is the surgical transfer of local or free flaps. This is associated with donor site morbidity, possible tissue rejection and limited supply. The alternative is to engineer autologous skeletal muscle in vitro, which can then be re-implanted into the patient. A variety of biomaterials have been used to engineer skeletal muscle with limited success. This study investigated the use of phosphate-based glass fibres as a potential scaffold material for the in vitro engineering of craniofacial skeletal muscle. Human masseter (one of the muscles of mastication)--derived cell cultures were used to seed the glass fibres, which were arranged into various configurations. Growth factors and matrix components were to used to manipulate the in vitro environment. Outcome was determined with the aid of microscopy, time-lapse footage, immunofluorescence imaging and CyQUANT proliferation, creatine kinase and protein assays. A 3-dimensional mesh arrangement of the glass fibres was the best at encouraging cell attachment and proliferation. In addition, increasing the density of the seeded cells and using Matrigel and insulin-like growth factor I enhanced the formation of prototypic muscle fibres. In conclusion, phosphate-based glass fibres can support the in vitro engineering of human craniofacial muscle.

  4. 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

  5. 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

  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. Nurses and Psychologists Advancing the Patient-Centered Medical Home Model.

    PubMed

    Corso, Kent A; Gage, Donna

    2016-01-01

    As America experiences the largest health care revolution of the past 50 years, clinicians and administrators are refocusing their attention on the goals of the Quadruple Aim. Motivation and capabilities among stakeholders vary as practical tools and an adequate workforce remain elusive. At the same time, the patient-centered medical home (PCMH) model is spreading rapidly but demonstrating variable results. Positive PCMH outcomes seem to reflect high-quality teamwork. A primary care physician shortage is looming, and increasing numbers of health professionals are being pushed into the PCMH, mandated to provide "integrated" care. Even now, the majority of our Graduate Medical Education programs do not train clinicians in team-based workflow models and interaction skills. Consequently, PCMH teams will only optimize and realize the model's true potential if they learn to coordinate, communicate, and collaborate effectively. This means all PCMH staff members achieve solid teamwork skills and work at the top of their license. The authors discuss resources for improving coordination, communication, and collaboration among members of PCMH teams, and strategies for including other professionals.

  8. 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.

  9. Medical image segmentation using minimal path deformable models with implicit shape priors.

    PubMed

    Yan, Pingkun; Kassim, Ashraf A

    2006-10-01

    This paper presents a new method for segmentation of medical images by extracting organ contours, using minimal path deformable models incorporated with statistical shape priors. In our approach, boundaries of structures are considered as minimal paths, i.e., paths associated with the minimal energy, on weighted graphs. Starting from the theory of minimal path deformable models, an intelligent "worm" algorithm is proposed for segmentation, which is used to evaluate the paths and finally find the minimal path. Prior shape knowledge is incorporated into the segmentation process to achieve more robust segmentation. The shape priors are implicitly represented and the estimated shapes of the structures can be conveniently obtained. The worm evolves under the joint influence of the image features, its internal energy, and the shape priors. The contour of the structure is then extracted as the worm trail. The proposed segmentation framework overcomes the short-comings of existing deformable models and has been successfully applied to segmenting various medical images. PMID:17044401

  10. Nurses and Psychologists Advancing the Patient-Centered Medical Home Model.

    PubMed

    Corso, Kent A; Gage, Donna

    2016-01-01

    As America experiences the largest health care revolution of the past 50 years, clinicians and administrators are refocusing their attention on the goals of the Quadruple Aim. Motivation and capabilities among stakeholders vary as practical tools and an adequate workforce remain elusive. At the same time, the patient-centered medical home (PCMH) model is spreading rapidly but demonstrating variable results. Positive PCMH outcomes seem to reflect high-quality teamwork. A primary care physician shortage is looming, and increasing numbers of health professionals are being pushed into the PCMH, mandated to provide "integrated" care. Even now, the majority of our Graduate Medical Education programs do not train clinicians in team-based workflow models and interaction skills. Consequently, PCMH teams will only optimize and realize the model's true potential if they learn to coordinate, communicate, and collaborate effectively. This means all PCMH staff members achieve solid teamwork skills and work at the top of their license. The authors discuss resources for improving coordination, communication, and collaboration among members of PCMH teams, and strategies for including other professionals. PMID:27259123

  11. 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

  12. 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

  13. 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.

  14. 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.

  15. Development of antipsychotic medications with novel mechanisms of action based on computational modeling of hippocampal neuropathology.

    PubMed

    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

  16. [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

  17. [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

  18. Mutual information in coupled multi-shape model for medical image segmentation.

    PubMed

    Tsai, A; Wells, W; Tempany, C; Grimson, E; Willsky, A

    2004-12-01

    This paper presents extensions which improve the performance of the shape-based deformable active contour model presented earlier in [IEEE Conf. Comput. Vision Pattern Recog. 1 (2001) 463] for medical image segmentation. In contrast to that previous work, the segmentation framework that we present in this paper allows multiple shapes to be segmented simultaneously in a seamless fashion. To achieve this, multiple signed distance functions are employed as the implicit representations of the multiple shape classes within the image. A parametric model for this new representation is derived by applying principal component analysis to the collection of these multiple signed distance functions. By deriving a parametric model in this manner, we obtain a coupling between the multiple shapes within the image and hence effectively capture the co-variations among the different shapes. The parameters of the multi-shape model are then calculated to minimize a single mutual information-based cost criterion for image segmentation. The use of a single cost criterion further enhances the coupling between the multiple shapes as the deformation of any given shape depends, at all times, upon every other shape, regardless of their proximity. We found that this resulting algorithm is able to effectively utilize the co-dependencies among the different shapes to aid in the segmentation process. It is able to capture a wide range of shape variability despite being a parametric shape-model. And finally, the algorithm is robust to large amounts of additive noise. We demonstrate the utility of this segmentation framework by applying it to a medical application: the segmentation of the prostate gland, the rectum, and the internal obturator muscles for MR-guided prostate brachytherapy.

  19. 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).

  20. Pharmacist-Led Model to Reduce Hospital Readmissions in Medically Complex Children

    PubMed Central

    DaCosta, Alison M.; Garavaglia, Lisa R.; Casey, Francis L.; Lancaster, Jeffrey D.

    2016-01-01

    OBJECTIVES: This pilot study investigated the feasibility and effect on health care utilization of medically complex children participating in a pharmacist-led model for care coordination. Quality of life and satisfaction with care were secondarily assessed for each patient. METHODS: Four medically complex children were enrolled and contacted by the pharmacist weekly for 5 consecutive months. Time for each encounter with a patient was collected. Each patient's hospital admissions, days of stay, emergency department visits, and clinic visits were recorded. At enrollment and at the end of the study, each caregiver completed the PedsQL 4.0 questionnaire to evaluate the child's quality of life and the Patient Assessment of Care for Chronic Conditions questionnaire to assess satisfaction with care. Patients aged 5 years and older completed an age-appropriate version of the PedsQL 4.0 as well. RESULTS: The pharmacist spent on average 60 to 80 minutes per patient per week. Hospital admissions and days of stay decreased for 3 patients and increased for 1 patient during this study. Quality of life increased for 2 patients and decreased for 2 patients and satisfaction with care increased for all 4 caregivers. CONCLUSIONS: This model was feasible for a pharmacist to coordinate and required frequent physician involvement. Health care utilization varied between patients, but overall decreased for the 4 patients pooled. Changes in quality of life varied and may be attributed to using a survey that was not specific to medically complex children. Overall, caregivers were highly satisfied with this service and the health care their child received. PMID:27713675

  1. 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…

  2. Dog model with implanted pump to test boosters for antiretroviral medication.

    PubMed

    Schueller, Laurent; Baert, Lieven; Lachau-Durand, Sophie; Borghys, Herman; Clessens, Ellen; Van Den Mooter, Guy; Van Gyseghem, Elke; Jonckers, Tim H M; Van Remoortere, Pieter; Wigerinck, Piet; Rosier, Jan

    2008-05-01

    A dog model was developed to test the capacity of boosters for antiretroviral medication. Two dogs were implanted with a modified constant-flow Codman 3000 infusion pump, adapted to release viscous solutions of darunavir (TMC114) at a constant rate of 25mg/dog/day in the venous blood stream. Booster candidates were given by oral gavage for at least 4 days up to maximum 7 days in cross-over fashion, separated by a wash-out period of minimum 1 week. The booster candidates were tested at doses of 20 and/or 40mg/kg/day: blood sampling for determination of the boosting effect was performed on the last day of booster administration. The model allowed to (1) compare the boosting ratio of these booster candidates based on the exposure (determination of the area under the curve (AUC) of darunavir in presence versus absence of the booster candidate), (2) detect delay in boosting activity by evaluation of the shift of Cmax of darunavir following booster administration versus the Cmax of the booster candidate) and (3) calculate the intrinsic booster capacity, by correcting for the systemic exposure of booster candidate by normalizing the booster ratio for the booster's AUC. The latter parameter (intrinsic booster capacity) allows to determine the booster's metabolic contribution in inhibiting the metabolism of antiretroviral medication (most likely via inhibition of CYP3A4), minimizing the impact of potential effects of the booster at the level of the gastro-intestinal tract.

  3. 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.

  4. 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. PMID:24369867

  5. On the ontological assumptions of the medical model of psychiatry: philosophical considerations and pragmatic tasks

    PubMed Central

    2010-01-01

    A common theme in the contemporary medical model of psychiatry is that pathophysiological processes are centrally involved in the explanation, evaluation, and treatment of mental illnesses. Implied in this perspective is that clinical descriptors of these pathophysiological processes are sufficient to distinguish underlying etiologies. Psychiatric classification requires differentiation between what counts as normality (i.e.- order), and what counts as abnormality (i.e.- disorder). The distinction(s) between normality and pathology entail assumptions that are often deeply presupposed, manifesting themselves in statements about what mental disorders are. In this paper, we explicate that realism, naturalism, reductionism, and essentialism are core ontological assumptions of the medical model of psychiatry. We argue that while naturalism, realism, and reductionism can be reconciled with advances in contemporary neuroscience, essentialism - as defined to date - may be conceptually problematic, and we pose an eidetic construct of bio-psychosocial order and disorder based upon complex systems' dynamics. However we also caution against the overuse of any theory, and claim that practical distinctions are important to the establishment of clinical thresholds. We opine that as we move ahead toward both a new edition of the Diagnostic and Statistical Manual, and a proposed Decade of the Mind, the task at hand is to re-visit nosologic and ontologic assumptions pursuant to a re-formulation of diagnostic criteria and practice. PMID:20109176

  6. 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. PMID:23943068

  7. 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. PMID:17001529

  8. 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 >180,000 people in the last 90 years. According to the current plan in 2007, the disaster management system of Iran is composed of three main work groups: (1) Prevention and risk management, (2) Education, and (3) Operation. This organizational separation has resulted in lack of necessary training programs for experts of specialized organizations, e.g., the Ministry of Health and Medical Education (MOHME).The National Board of MOHME arranged a training program in the field of medical disaster management. A qualified training team was chosen to conduct this program in each collaborating center, based on a predefined schedule. All collaborating centers were asked to recall 5-7 experts from each member university. Working in medical disaster management field for greater than or equal to 2 years was an inclusion criterion. The training programs lasted three days, consisted of all relevant aspects of medical disaster management, and were conducted over a six-month period (November 2007-April 2008). Pre-test and post-tests were used to examine the participants' knowledge regarding disaster management; the mean score on the pretest was 67.1 +/-11.6 and 88.1 +/-6.2, respectively. All participants were asked to hold the same training course for their organizations in order to enhance knowledge of related managers, stakeholders, and workers, and build capacity at the local and provincial levels. The next step was supposed to be developing a comprehensive medical disaster management plan for the entire country. Establishing nine disaster management regional collaborating centers in the health system of Iran has provided an appropriate base for related programs to be rapidly and easily accomplished throughout the country. This tree-shaped model is

  9. Development of an Electrophysiology (EP)-Enabled Intracardiac Ultrasound Catheter Integrated With NavX 3-Dimensional Electrofield Mapping for Guiding Cardiac EP Interventions

    PubMed Central

    Li, Xiao Kui; Pemberton, James; Thomenius, Kai; Dentinger, Aaron; Lowe, Robert I.; Ashraf, Muhammad; Shung, K. Kirk; Chia, Raymond; Stephens, Douglas N.; O'Donnell, Matthew; Mahajan, Aman; Balaji, Seshadri; Shivkumar, Kalyanam; Sahn, David J.

    2015-01-01

    Objective We have developed an integrated high-resolution intracardiac echocardiography (ICE) catheter for electrophysiology (EP) testing, which can be coregistered in 3-dimensional space with EP testing and ablation catheters using electrofield sensing. Methods Twelve open-chest pigs (34–55 kg) and 3 closed-chest pigs were studied. After introduction from the jugular or femoral venous locations, the 9F side-looking, highly steerable (0°–180°), 64-element array catheters could be manipulated easily throughout the right side of the heart. Multisite cardiac pacing was performed for assessing left ventricular (LV) synchrony using tissue Doppler methods. Also, in the open-chest pigs, right atrial (RA) and right ventricular (RV) ablations were performed with a separate radio frequency catheter under fluoroscopic guidance and visualized with ICE to characterize the changes. In the 3 closed-chest pigs, electrofield NavX 3-dimensional coregistration (St Jude Medical Corp, Minneapolis, MN) allowed us to test whether this additional feature could shorten the time necessary to perform 4 targeted ablations in each animal while imaging the ablation catheter and the adjacent region by ICE. Results Intracardiac anatomy, tricuspid, aortic, pulmonary, and mitral valve function, and pulmonary vein flow were all imaged reproducibly from scanning locations in the RA or RV in all animals, along with assessment of cardiac motion and the effects of multisite pacing. Three-dimensional electrofield displays detailed the spatial relationship between the ICE catheter and ablation catheters such that the time to visualize and ablate 4 sites in each of the 3 closed-chest animals was reduced. Conclusions This new technology is a first step in the integration of ICE with EP procedures. PMID:17957051

  10. Evaluating Osteoarthritic Chondrocytes through a Novel 3-Dimensional In Vitro System for Cartilage Tissue Engineering and Regeneration

    PubMed Central

    Li, Hanwei; Davison, Noel; Moroni, Lorenzo; Feng, Felicia; Crist, Joshua; Salter, Erin; Bingham, Clifton O.

    2012-01-01

    Objective: To characterize and evaluate osteoarthritic (OA) chondrocytes, in comparison to normal chondrocytes, through a novel 3-dimensional (3-D) culture system, poly(ethylene-glycol) diacrylate (PEGDA). The cytokine interleukin 1β (IL-1β) was also used to simulate an in vitro OA model. Methods: Normal and OA chondrocytes were cultured in monolayer and analyzed for changes in cartilage-specific gene expressions due to passage number. Then, cells were encapsulated in PEGDA to evaluate phenotype and matrix production capabilities through the in vitro culture system. Characterization was conducted with polymerase chain reaction (PCR), biochemical analyses, and histological staining. 3-D encapsulated chondrocytes (human and bovine) were also treated with IL-1β to characterize how the cytokine affects gene transcription and extracellular matrix (ECM) content. Results: In 2-dimensional monolayer, anabolic genes were down-regulated significantly in both normal and OA chondrocytes. In 3-D culture, OA chondrocytes demonstrated significantly higher expressions of catabolic genes when compared to normal cells. Differentiation medium resulted in significantly more matrix production than growth medium from OA chondrocytes, indicated through histological staining. In addition, normal chondrocytes responded more significantly to exogenous administration of IL-1β than OA chondrocytes. Temporary initial stimulation of IL-1β to OA chondrocytes resulted in comparable gene expressions to untreated cells after 3 weeks of in vitro culture. Conclusions: Our findings demonstrate the use of OA chondrocytes in tissue engineering and their significance for potential future cartilage regeneration research through their matrix production capabilities and the use of a hydrogel culture system. PMID:26069626

  11. Comparison of 3-dimensional dose reconstruction system between fluence-based system and dose measurement-guided system.

    PubMed

    Nakaguchi, Yuji; Ono, Takeshi; Onitsuka, Ryota; Maruyama, Masato; Shimohigashi, Yoshinobu; Kai, Yudai

    2016-01-01

    COMPASS system (IBA Dosimetry, Schwarzenbruck, Germany) and ArcCHECK with 3DVH software (Sun Nuclear Corp., Melbourne, FL) are commercial quasi-3-dimensional (3D) dosimetry arrays. Cross-validation to compare them under the same conditions, such as a treatment plan, allows for clear evaluation of such measurement devices. In this study, we evaluated the accuracy of reconstructed dose distributions from the COMPASS system and ArcCHECK with 3DVH software using Monte Carlo simulation (MC) for multi-leaf collimator (MLC) test patterns and clinical VMAT plans. In a phantom study, ArcCHECK 3DVH showed clear differences from COMPASS, measurement and MC due to the detector resolution and the dose reconstruction method. Especially, ArcCHECK 3DVH showed 7% difference from MC for the heterogeneous phantom. ArcCHECK 3DVH only corrects the 3D dose distribution of treatment planning system (TPS) using ArcCHECK measurement, and therefore the accuracy of ArcCHECK 3DVH depends on TPS. In contrast, COMPASS showed good agreement with MC for all cases. However, the COMPASS system requires many complicated installation procedures such as beam modeling, and appropriate commissioning is needed. In terms of clinical cases, there were no large differences for each QA device. The accuracy of the compass and ArcCHECK 3DVH systems for phantoms and clinical cases was compared. Both systems have advantages and disadvantages for clinical use, and consideration of the operating environment is important. The QA system selection is depending on the purpose and workflow in each hospital. PMID:27179708

  12. An integrated occupational health consultation model for the medical supply manufacturing industry.

    PubMed

    Lin, Yi-Kuei; Lee, Lien-Hsiung; Sheu, Shey-Huei

    2010-01-01

    In this research, we designed a three-stage consultation procedure and eight major consultation items in order to construct an integrated occupational health consultation model that emphasizes both inspection and consultation. The main characteristics of the proposed model include cooperation among governmental departments, combining non-governmental professional consulting organizations, and establishing partnerships with industrial associations. This model has clear active and passive performance indicators and includes technical guidance during consultation as well as the exit mechanism after consultation. This consultation model enables small- and medium-sized enterprises to achieve environmental improvements with minimum investment. Companies that improved after consultation have a mean ethylene oxide exposure concentration, for the time weighted average, that dropped from 7.36 ± 16.88 ppm to 0.76 ± 1.35 ppm (p<0.01). In addition, the overall company compliant item ratio for regulations increased from 34.1% to 89.7%. The above results demonstrate the integrated occupational health consultation model assists small- and medium-sized enterprises in reducing exposure concentrations at operational sites. Our results further demonstrate the feasibility of successfully implementing the proposed consultation model within Taiwan's medical supply manufacturing industry.

  13. An integrated occupational health consultation model for the medical supply manufacturing industry.

    PubMed

    Lin, Yi-Kuei; Lee, Lien-Hsiung; Sheu, Shey-Huei

    2010-01-01

    In this research, we designed a three-stage consultation procedure and eight major consultation items in order to construct an integrated occupational health consultation model that emphasizes both inspection and consultation. The main characteristics of the proposed model include cooperation among governmental departments, combining non-governmental professional consulting organizations, and establishing partnerships with industrial associations. This model has clear active and passive performance indicators and includes technical guidance during consultation as well as the exit mechanism after consultation. This consultation model enables small- and medium-sized enterprises to achieve environmental improvements with minimum investment. Companies that improved after consultation have a mean ethylene oxide exposure concentration, for the time weighted average, that dropped from 7.36 ± 16.88 ppm to 0.76 ± 1.35 ppm (p<0.01). In addition, the overall company compliant item ratio for regulations increased from 34.1% to 89.7%. The above results demonstrate the integrated occupational health consultation model assists small- and medium-sized enterprises in reducing exposure concentrations at operational sites. Our results further demonstrate the feasibility of successfully implementing the proposed consultation model within Taiwan's medical supply manufacturing industry. PMID:20616473

  14. Multisite geriatrics clerkship for fourth-year medical students: a successful model for teaching the Association of American Medical Colleges' core competencies.

    PubMed

    Oates, Daniel J; Norton, Lisa E; Russell, Matthew L; Chao, Serena H; Hardt, Eric J; Brett, Belle; Kimball, Patricia; Levine, Sharon A

    2009-10-01

    As the population ages, it is important that graduating medical students be properly prepared to treat older adults, regardless of their chosen specialty. To this end, the Association of American Medical Colleges (AAMC) and the John A. Hartford Foundation convened a consensus conference to establish core competencies in geriatrics for all graduating medical students. An ambulatory geriatric clerkship for fourth-year medical students that successfully teaches 24 of the 26 AAMC core competencies using an interdisciplinary, team-based approach is reported here. Graduating students (N=158) reported that the clerkship was successful at teaching the core competencies, as evidenced by positive responses on the AAMC Graduation Questionnaire (GQ). More than three-quarters (80-93%) of students agreed or strongly agreed that they learned the seven geriatrics concepts asked about on the GQ, which cover 14 of the 26 core competencies. This successful model for a geriatrics clerkship can be used in many institutions to teach the core competencies and in any constellation of geriatric ambulatory care sites that are already available to the faculty.

  15. Growth and development in higher plants under simulated microgravity conditions on a 3-dimensional clinostat

    NASA Astrophysics Data System (ADS)

    Shimazu, T.; Yuda, T.; Miyamoto, K.; Yamashita, M.; Ueda, J.

    Growth and development of etiolated pea (Pisum sativum L. cv. Alaska) and maize (Zea mays L. cv. Golden Cross Bantam) seedlings grown under simulated microgravity conditions were intensively studied using a 3-dimensional clinostat as a simulator of weightlessness. Epicotyls of etiolated pea seedlings grown on the clinostat were the most oriented toward the direction far from cotyledons. Mesocotyls of etiolated maize seedlings grew at random and coleoptiles curved slightly during clinostat rotation. Clinostat rotation promoted the emergence of the 3rd internodes in etiolated pea seedlings, while it significantly inhibited the growth of the 1st internodes. In maize seedlings, the growth of coleoptiles was little affected by clinostat rotation, but that of mesocotyls was suppressed, and therefore, the emergence of the leaf out of coleoptile was promoted. Clinostat rotation reduced the osmotic concentration in the 1st internodes of pea seedlings, although it has little effect on the 2nd and the 3rd internodes. Clinostat rotation also reduced the osmotic concentrations in both coleoptiles and mesocotyls of maize seedlings. Cell-wall extensibilities of the 1st and the 3rd internodes of pea seedlings grown on the clinostat were significantly lower and higher as compared with those on 1 g conditions, respectively. Cell-wall extensibility of mesocotyls in seedlings grown on the clinostat also decreased. Changes in cell wall properties seem to be well correlated to the growth of each organ in pea and maize seedlings. These results suggest that the growth and development of plants is controlled under gravity on earth, and that the growth responses of higher plants to microgravity conditions are regulated by both cell-wall mechanical properties and osmotic properties of stem cells.

  16. Using a clinical protocol for orthognathic surgery and assessing a 3-dimensional virtual approach: current therapy.

    PubMed

    Quevedo, Luis A; Ruiz, Jessica V; Quevedo, Cristobal A

    2011-03-01

    Oral and maxillofacial surgeons who perform orthognathic surgery face major changes in their practices, and these challenges will increase in the near future, because the extraordinary advances in technology applied to our profession are not only amazing but are becoming the standard of care as they promote improved outcomes for our patients. Orthognathic surgery is one of the favorite areas of practicing within the scope of practice of an oral and maxillofacial surgeon. Our own practice in orthognathic surgery has completed over 1,000 surgeries of this type. Success is directly related to the consistency and capability of the surgical-orthodontic team to achieve predictable, stable results, and our hypothesis is that a successful result is directly related to the way we take our records and perform diagnosis and treatment planning following basic general principles. Now that we have the opportunity to plan and treat 3-dimensional (3D) problems with 3D technology, we should enter into this new era with appropriate standards to ensure better results, instead of simply enjoying these new tools, which will clearly show not only us but everyone what we do when we perform orthognathic surgery. Appropriate principles need to be taken into account when implementing this new technology. In other words, new technology is welcome, but we do not have to reinvent the wheel. The purpose of this article is to review the current protocol that we use for orthognathic surgery and compare it with published protocols that incorporate new 3D and virtual technology. This report also describes our approach to this new technology.

  17. Surgical Classification of the Mandibular Deformity in Craniofacial Microsomia Using 3-Dimensional Computed Tomography

    PubMed Central

    Swanson, Jordan W.; Mitchell, Brianne T.; Wink, Jason A.; Taylor, Jesse A.

    2016-01-01

    Background: Grading systems of the mandibular deformity in craniofacial microsomia (CFM) based on conventional radiographs have shown low interrater reproducibility among craniofacial surgeons. We sought to design and validate a classification based on 3-dimensional CT (3dCT) that correlates features of the deformity with surgical treatment. Methods: CFM mandibular deformities were classified as normal (T0), mild (hypoplastic, likely treated with orthodontics or orthognathic surgery; T1), moderate (vertically deficient ramus, likely treated with distraction osteogenesis; T2), or severe (ramus rudimentary or absent, with either adequate or inadequate mandibular body bone stock; T3 and T4, likely treated with costochondral graft or free fibular flap, respectively). The 3dCT face scans of CFM patients were randomized and then classified by craniofacial surgeons. Pairwise agreement and Fleiss' κ were used to assess interrater reliability. Results: The 3dCT images of 43 patients with CFM (aged 0.1–15.8 years) were reviewed by 15 craniofacial surgeons, representing an average 15.2 years of experience. Reviewers demonstrated fair interrater reliability with average pairwise agreement of 50.4 ± 9.9% (Fleiss' κ = 0.34). This represents significant improvement over the Pruzansky–Kaban classification (pairwise agreement, 39.2%; P = 0.0033.) Reviewers demonstrated substantial interrater reliability with average pairwise agreement of 83.0 ± 7.6% (κ = 0.64) distinguishing deformities requiring graft or flap reconstruction (T3 and T4) from others. Conclusion: The proposed classification, designed for the era of 3dCT, shows improved consensus with respect to stratifying the severity of mandibular deformity and type of operative management. PMID:27104097

  18. Reproducibility of a 3-dimensional gyroscope in measuring shoulder anteflexion and abduction

    PubMed Central

    2012-01-01

    Background Few studies have investigated the use of a 3-dimensional gyroscope for measuring the range of motion (ROM) in the impaired shoulder. Reproducibility of digital inclinometer and visual estimation is poor. This study aims to investigate the reproducibility of a tri axial gyroscope in measurement of anteflexion, abduction and related rotations in the impaired shoulder. Methods Fifty-eight patients with either subacromial impingement (27) or osteoarthritis of the shoulder (31) participated. Active anteflexion, abduction and related rotations were measured with a tri axial gyroscope according to a test retest protocol. Severity of shoulder impairment and patient perceived pain were assessed by the Disability of Arm Shoulder and Hand score (DASH) and the Visual Analogue Scale (VAS). VAS scores were recorded before and after testing. Results In two out of three hospitals patients with osteoarthritis (n = 31) were measured, in the third hospital patients with subacromial impingement (n = 27). There were significant differences among hospitals for the VAS and DASH scores measured before and after testing. The mean differences between the test and retest means for anteflexion were −6 degrees (affected side), 9 (contralateral side) and for abduction 15 degrees (affected side) and 10 degrees (contralateral side). Bland & Altman plots showed that the confidence intervals for the mean differences fall within −6 up to 15 degrees, individual test - retest differences could exceed these limits. A simulation according to ‘Generalizability Theory’ produces very good coefficients for anteflexion and related rotation as a comprehensive measure of reproducibility. Optimal reproducibility is achieved with 2 repetitions for anteflexion. Conclusions Measurements were influenced by patient perceived pain. Differences in VAS and DASH might be explained by different underlying pathology. These differences in shoulder pathology however did not alter the

  19. Role of biplane and biplane echocardiographically guided 3-dimensional echocardiography during dobutamine stress echocardiography.

    PubMed

    Yang, Hyun Suk; Pellikka, Patricia A; McCully, Robert B; Oh, Jae K; Kukuzke, Joyce A; Khandheria, Bijoy K; Chandrasekaran, Krishnaswamy

    2006-09-01

    Image acquisition time and wall-motion score of conventional 2-dimensional (2D) dobutamine stress echocardiography (DSE) were compared with those of biplane and 3-dimensional (3D) DSE in 50 patients (age 67 +/- 13 years) with regular rhythms during clinically indicated DSE. Commercially available systems were used for the study. We used a conventional transducer for 2D and a matrix-array transducer (x4 or x3-1) for two biplane (60- and 120-degree) images and one 3D full-volume image. Image quality was scored as 1 = good; 2 = adequate; and 3 = inadequate. Segmental wall-motion scores for each method were analyzed in blinded fashion. Acquisition times of biplane (9.3 +/- 2.8 seconds) and biplane-guided 3D (additional 2.6 +/- 1.0 seconds) echocardiography were significantly shorter than those of conventional 2D DSE (60.0 +/- 26.7 seconds) (P < .001). Image quality was adequate or good in 94% for biplane and 96% for 3D echocardiography. Agreement of segmental wall-motion score was present in 87.6% of segments for 2D versus biplane and 85.9% for 2D versus 3D at baseline and in 88.0% for 2D versus biplane and 87.4% for 2D versus 3D at peak stress. Acquisition of biplane or biplane-guided 3D volumetric data during DSE with use of a new matrix-array transducer was feasible and shortened image acquisition time without affecting the diagnostic yield compared with conventional 2D imaging.

  20. Immediate 3-dimensional ridge augmentation after extraction of periodontally hopeless tooth using chinblock graft

    PubMed Central

    Desai, Ankit; Thomas, Raison; A. Baron, Tarunkumar; Shah, Rucha; Mehta, Dhoom-Singh

    2015-01-01

    Background The aim of the present study was to evaluate clinically and radiographically, the efficacy of immediate ridge augmentation to reconstruct the vertical and horizontal dimensions at extraction sites of periodontally hopeless tooth using an autogenous chin block graft. Material and Methods A total of 11 patients (7 male & 4 female) with localized advanced bone loss around single rooted teeth having hopeless prognosis and indicated for extraction were selected for the study. The teeth were atraumatically extracted and deficient sites were augmented using autogenous chin block graft. Parameters like clinically soft tissue height - width and also radiographic ridge height -width were measured before and 6 months after augmentation. Obtained results were tabulated and analysed statistically. Results After 6 months of immediate ridge augmentation, the mean gain in radiographic vertical height and horizontal width was 7.64 + 1.47 mm (P = 0.005) and 5.28 + 0.46 mm (P = 0.007) respectively which was found to be statistically significant (P < 0.05). Mean change of width gain of 0.40mm and height loss of 0.40mm of soft tissue parameters, from the baseline till completion of the study at 6 months was observed. Conclusions The present study showed predictable immediate ridge augmentation with autogenous chin block graft at periodontally compromised extraction site. It can provide adequate hard and soft tissue foundation for perfect 3-Dimensional prosthetic positioning of implant in severely deficient ridges. Key words:Immediate ridge augmentation, periondontally hopeless tooth, autogenous chin graft, dental implant. PMID:26644832