Sample records for classification system iii

  1. Teaching DSM-III to clinicians. Some problems of the DSM-III system reducing reliability, using the diagnosis and classification of depressive disorders as an example.

    PubMed

    Malt, U F

    1986-01-01

    Experiences from teaching DSM-III to more than three hundred Norwegian psychiatrists and clinical psychologists suggest that reliable DSM-III diagnoses can be achieved within a few hours training with reference to the decision trees and the diagnostic criteria only. The diagnoses provided are more reliable than the corresponding ICD diagnoses which the participants were more familiar with. The three main sources of reduced reliability of the DSM-III diagnoses are related to: poor knowledge of the criteria which often is connected with failure of obtaining diagnostic key information during the clinical interview; unfamiliar concepts and vague or ambiguous criteria. The two first issues are related to the quality of the teaching of DSM-III. The third source of reduced reliability reflects unsolved validity issues. By using the classification of five affective case stories as examples, these sources of diagnostic pitfalls, reducing reliability and ways to overcome these problems when teaching the DSM-III system, are discussed. It is concluded that the DSM-III system of classification is easy to teach and that the system is superior to other classification systems available from a reliability point of view. The current version of the DSM-III system, however, partly owes a high degree of reliability to broad and heterogeneous diagnostic categories like the concept major depression, which may have questionable validity. Thus, the future revisions of the DSM-III system should, above all, address the issue of validity.

  2. Effects of gross motor function and manual function levels on performance-based ADL motor skills of children with spastic cerebral palsy.

    PubMed

    Park, Myoung-Ok

    2017-02-01

    [Purpose] The purpose of this study was to determine effects of Gross Motor Function Classification System and Manual Ability Classification System levels on performance-based motor skills of children with spastic cerebral palsy. [Subjects and Methods] Twenty-three children with cerebral palsy were included. The Assessment of Motor and Process Skills was used to evaluate performance-based motor skills in daily life. Gross motor function was assessed using Gross Motor Function Classification Systems, and manual function was measured using the Manual Ability Classification System. [Results] Motor skills in daily activities were significantly different on Gross Motor Function Classification System level and Manual Ability Classification System level. According to the results of multiple regression analysis, children categorized as Gross Motor Function Classification System level III scored lower in terms of performance based motor skills than Gross Motor Function Classification System level I children. Also, when analyzed with respect to Manual Ability Classification System level, level II was lower than level I, and level III was lower than level II in terms of performance based motor skills. [Conclusion] The results of this study indicate that performance-based motor skills differ among children categorized based on Gross Motor Function Classification System and Manual Ability Classification System levels of cerebral palsy.

  3. DSM-III as a research tool.

    PubMed

    Treece, C

    1982-05-01

    The author describes the use of the DSM-III's diagnostic criteria and classification system as a research instrument and discusses some of the advantages and drawbacks of DMS-III for a specific type of study. A rearrangement of the hierarchical order of the DSM-III diagnostic classes is suggested. This rearrangement provides for levels of certainty in analyzing interrater reliability and offers a simplified framework for summarizing group data. When this approach is combined with a structured interview and response format, it provides a flexible way of managing a large classification system for a smaller study without sacrificing standardization.

  4. Three Diagnostic Systems for Autism: DSM-III, DSM-III-R, and ICD-10.

    ERIC Educational Resources Information Center

    Volkmar, Fred R.; And Others

    1992-01-01

    This paper compared clinicians' diagnosis and DSM-III (Diagnostic and Statistical Manual), DSM-III-R (Revised), and ICD-10 (International Classification of Diseases) diagnoses of 52 individuals with autism and 62 nonautistic, developmentally disordered individuals. The DSM-III-R system overdiagnosed the presence of autism, and ICD-10 closely…

  5. Diagnosis and Classification in Autism.

    ERIC Educational Resources Information Center

    Waterhouse, Lynn; And Others

    1996-01-01

    This study compared four systems for diagnosis of autism (Diagnostic and Statistical Manuals of Mental Disorders III, III-R, and IV, and the International Classification of Disabilities-10) with 2 empirically derived taxa and 3 social subgroups (aloof, passive, and active but odd) in 194 preschool children with social impairment. Findings support…

  6. Using the RUG-III classification system for understanding the resource intensity of persons with intellectual disability residing in nursing homes.

    PubMed

    Martin, Lynn; Fries, Brant E; Hirdes, John P; James, Mary

    2011-06-01

    Since 1991, the Minimum Data Set 2.0 (MDS 2.0) has been the mandated assessment in US nursing homes. The Resource Utilization Groups III (RUG-III) case-mix system provides person-specific means of allocating resources based on the variable costs of caring for persons with different needs. Retrospective analyses of data collected on a sample of 9707 nursing home residents (2.4% had an intellectual disability) were used to examine the fit of the RUG-III case-mix system for determining the cost of supporting persons with intellectual disability (intellectual disability). The RUG-III system explained 33.3% of the variance in age-weighted nursing time among persons with intellectual disability compared to 29.6% among other residents, making it a good fit among persons with intellectual disability in nursing homes. The RUG-III may also serve as the basis for the development of a classification system that describes the resource intensity of persons with intellectual disability in other settings that provide similar types of support.

  7. 40 CFR 52.221 - Classification of regions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS California § 52.221 Classification of regions. The California plan was evaluated on the basis of the following classifications: Air quality control... III III III Southeast Desert Intrastate I III III III I San Diego Intrastate II III III I I Lake...

  8. 40 CFR 52.221 - Classification of regions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS California § 52.221 Classification of regions. The California plan was evaluated on the basis of the following classifications: Air quality control... III III III Southeast Desert Intrastate I III III III I San Diego Intrastate II III III I I Lake...

  9. 40 CFR 52.221 - Classification of regions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS California § 52.221 Classification of regions. The California plan was evaluated on the basis of the following classifications: Air quality control... III III III Southeast Desert Intrastate I III III III I San Diego Intrastate II III III I I Lake...

  10. 40 CFR 52.1521 - Classification of regions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) New Hampshire § 52.1521 Classification of regions. The New Hampshire plan was evaluated on the basis of the following classifications... Ozone Androscoggin Valley Interstate IA IA III III III Central New Hampshire Intrastate III III III III...

  11. 40 CFR 52.1521 - Classification of regions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) New Hampshire § 52.1521 Classification of regions. The New Hampshire plan was evaluated on the basis of the following classifications... Ozone Androscoggin Valley Interstate IA IA III III III Central New Hampshire Intrastate III III III III...

  12. 40 CFR 52.1521 - Classification of regions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) New Hampshire § 52.1521 Classification of regions. The New Hampshire plan was evaluated on the basis of the following classifications... Ozone Androscoggin Valley Interstate IA IA III III III Central New Hampshire Intrastate III III III III...

  13. 40 CFR 52.1971 - Classification of regions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Oregon § 52.1971 Classification of regions. The Oregon plan was evaluated on the basis of the following classifications: Air quality control... Interstate I IA III I I Southwest Oregon Intrastate II III III III III Northwest Oregon Intrastate III III...

  14. 40 CFR 52.1971 - Classification of regions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Oregon § 52.1971 Classification of regions. The Oregon plan was evaluated on the basis of the following classifications: Air quality control... Interstate I IA III I I Southwest Oregon Intrastate II III III III III Northwest Oregon Intrastate III III...

  15. 42 CFR 413.333 - Definitions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... relative difference in resource intensity among different groups in the resident classification system... goods and services included in covered skilled nursing services. Resident classification system means a... 1, 2005, an area as defined in § 412.62(f)(1)(iii) of this chapter. For services provided on or...

  16. 40 CFR 52.1671 - Classification of regions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) New York § 52.1671 Classification of regions. The New York plans were evaluated on the basis of the following classifications: Air... II III III III Central New York Intrastate I II III I I Genesee-Finger Lakes Intrastate II II III III...

  17. Nursing home case-mix instruments: validation of the RUG-III system in Italy.

    PubMed

    Brizioli, Enrico; Bernabei, Roberto; Grechi, Francesca; Masera, Filippo; Landi, Francesco; Bandinelli, Stefania; Cavazzini, Chiara; Gangemi, Salvatore; Ferrucci, Luigi

    2003-06-01

    The current Italian reimbursement system for long-term care does not adequately consider the great variability in the health and functional status of older persons who are admitted to long-term care institutions. Furthermore, no procedure is implemented to monitor the quality of care provided to older residents. We conducted this study to verify whether the RUG-III (Resource Utilization Groups-version III), a tool for assessing the case-mix of nursing home residents, which is widely used in the United States and in many European countries, can be effectively used in the Italian health care system. We administered an Italian version of the RUG-III to 1000 older residents of 11 intermediate- and long-term care institutions. We also collected objective information on the amount of care provided directly or indirectly to each resident by nurses, physical therapists, and other health professionals. The RUG-III 44 group classification system explained 61 and 44% of the variance in rehabilitative and nursing wage-adjusted care time, respectively. Our findings provide strong evidence that the RUG-III classification, applied to Italian intermediate- and long-term care institutions, provides a robust estimate of the amount of nursing and rehabilitation resources consumed by older residents.

  18. Classifying diseases and remedies in ethnomedicine and ethnopharmacology.

    PubMed

    Staub, Peter O; Geck, Matthias S; Weckerle, Caroline S; Casu, Laura; Leonti, Marco

    2015-11-04

    Ethnopharmacology focuses on the understanding of local and indigenous use of medicines and therefore an emic approach is inevitable. Often, however, standard biomedical disease classifications are used to describe and analyse local diseases and remedies. Standard classifications might be a valid tool for cross-cultural comparisons and bioprospecting purposes but are not suitable to understand the local perception of disease and use of remedies. Different standard disease classification systems exist but their suitability for cross-cultural comparisons of ethnomedical data has never been assessed. Depending on the research focus, (I) ethnomedical, (II) cross-cultural, and (III) bioprospecting, we provide suggestions for the use of specific classification systems. We analyse three different standard biomedical classification systems (the International Classification of Diseases (ICD); the Economic Botany Data Collection Standard (EBDCS); and the International Classification of Primary Care (ICPC)), and discuss their value for categorizing diseases of ethnomedical systems and their suitability for cross-cultural research in ethnopharmacology. Moreover, based on the biomedical uses of all approved plant derived biomedical drugs, we propose a biomedical therapy-based classification system as a guide for the discovery of drugs from ethnopharmacological sources. Widely used standards, such as the International Classification of Diseases (ICD) by the WHO and the Economic Botany Data Collection Standard (EBDCS) are either technically challenging due to a categorisation system based on clinical examinations, which are usually not possible during field research (ICD) or lack clear biomedical criteria combining disorders and medical effects in an imprecise and confusing way (EBDCS). The International Classification of Primary Care (ICPC), also accepted by the WHO, has more in common with ethnomedical reality than the ICD or the EBDCS, as the categories are designed according to patient's perceptions and are less influenced by clinical medicine. Since diagnostic tools are not required, medical ethnobotanists and ethnopharmacologists can easily classify reported symptoms and complaints with the ICPC in one of the "chapters" based on 17 body systems, psychological and social problems. Also the biomedical uses of plant-derived drugs are classifiable into 17 broad organ- and therapy-based use-categories but can easily be divided into more specific subcategories. Depending on the research focus (I-III) we propose the following classification systems: I. Ethnomedicine: Ethnomedicine is culture-bound and local classifications have to be understood from an emic perspective. Consequently, the application of prefabricated, "one-size fits all" biomedical classification schemes is of limited value. II. Cross-cultural analysis: The ICPC is a suitable standard that can be applied but modified as required. III. Bioprospecting: We suggest a biomedical therapy-driven classification system with currently 17 use-categories based on biomedical uses of all approved plant derived natural product drugs. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  19. Does the Modified Gartland Classification Clarify Decision Making?

    PubMed

    Leung, Sophia; Paryavi, Ebrahim; Herman, Martin J; Sponseller, Paul D; Abzug, Joshua M

    2018-01-01

    The modified Gartland classification system for pediatric supracondylar fractures is often utilized as a communication tool to aid in determining whether or not a fracture warrants operative intervention. This study sought to determine the interobserver and intraobserver reliability of the Gartland classification system, as well as to determine whether there was agreement that a fracture warranted operative intervention regardless of the classification system. A total of 200 anteroposterior and lateral radiographs of pediatric supracondylar humerus fractures were retrospectively reviewed by 3 fellowship-trained pediatric orthopaedic surgeons and 2 orthopaedic residents and then classified as type I, IIa, IIb, or III. The surgeons then recorded whether they would treat the fracture nonoperatively or operatively. The κ coefficients were calculated to determine interobserver and intraobserver reliability. Overall, the Wilkins-modified Gartland classification has low-moderate interobserver reliability (κ=0.475) and high intraobserver reliability (κ=0.777). A low interobserver reliability was found when differentiating between type IIa and IIb (κ=0.240) among attendings. There was moderate-high interobserver reliability for the decision to operate (κ=0.691) and high intraobserver reliability (κ=0.760). Decreased interobserver reliability was present for decision to operate among residents. For fractures classified as type I, the decision to operate was made 3% of the time and 27% for type IIa. The decision was made to operate 99% of the time for type IIb and 100% for type III. There is almost full agreement for the nonoperative treatment of Type I fractures and operative treatment for type III fractures. There is agreement that type IIb fractures should be treated operatively and that the majority of type IIa fractures should be treated nonoperatively. However, the interobserver reliability for differentiating between type IIa and IIb fractures is low. Our results validate the Gartland classfication system as a method to help direct treatment of pediatric supracondylar humerus fractures, although the modification of the system, IIa versus IIb, seems to have limited reliability and utility. Terminology based on decision to treat may lead to a more clinically useful classification system in the evaluation and treatment of pediatric supracondylar humerus fractures. Level III-diagnostic studies.

  20. Validation of Resource Utilization Groups version III for Home Care (RUG-III/HC): evidence from a Canadian home care jurisdiction.

    PubMed

    Poss, Jeffrey W; Hirdes, John P; Fries, Brant E; McKillop, Ian; Chase, Mary

    2008-04-01

    The case-mix system Resource Utilization Groups version III for Home Care (RUG-III/HC) was derived using a modest data sample from Michigan, but to date no comprehensive large scale validation has been done. This work examines the performance of the RUG-III/HC classification using a large sample from Ontario, Canada. Cost episodes over a 13-week period were aggregated from individual level client billing records and matched to assessment information collected using the Resident Assessment Instrument for Home Care, from which classification rules for RUG-III/HC are drawn. The dependent variable, service cost, was constructed using formal services plus informal care valued at approximately one-half that of a replacement worker. An analytic dataset of 29,921 episodes showed a skewed distribution with over 56% of cases falling into the lowest hierarchical level, reduced physical functions. Case-mix index values for formal and informal cost showed very close similarities to those found in the Michigan derivation. Explained variance for a function of combined formal and informal cost was 37.3% (20.5% for formal cost alone), with personal support services as well as informal care showing the strongest fit to the RUG-III/HC classification. RUG-III/HC validates well compared with the Michigan derivation work. Potential enhancements to the present classification should consider the large numbers of undifferentiated cases in the reduced physical function group, and the low explained variance for professional disciplines.

  1. 40 CFR 52.1221 - Classification of regions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Minnesota § 52.1221 Classification of regions. The Minnesota plan was evaluated on the basis of the following classifications: Air... Photochemical oxidants (hydrocarbons) Central Minnesota Intrastate II III III III III Southeast Minnesota-La...

  2. 40 CFR 52.1221 - Classification of regions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Minnesota § 52.1221 Classification of regions. The Minnesota plan was evaluated on the basis of the following classifications: Air... Photochemical oxidants (hydrocarbons) Central Minnesota Intrastate II III III III III Southeast Minnesota-La...

  3. 40 CFR 52.1221 - Classification of regions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Minnesota § 52.1221 Classification of regions. The Minnesota plan was evaluated on the basis of the following classifications: Air... Photochemical oxidants (hydrocarbons) Central Minnesota Intrastate II III III III III Southeast Minnesota-La...

  4. 40 CFR 52.1771 - Classification of regions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 4 2013-07-01 2013-07-01 false Classification of regions. 52.1771 Section 52.1771 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... III III III III Eastern Piedmont Intrastate I III III III III Northern Coastal Intrastate I III III...

  5. 40 CFR 52.1771 - Classification of regions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 4 2014-07-01 2014-07-01 false Classification of regions. 52.1771 Section 52.1771 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... III III III III Eastern Piedmont Intrastate I III III III III Northern Coastal Intrastate I III III...

  6. 40 CFR 52.1771 - Classification of regions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 4 2011-07-01 2011-07-01 false Classification of regions. 52.1771 Section 52.1771 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... III III III III Eastern Piedmont Intrastate I III III III III Northern Coastal Intrastate I III III...

  7. 40 CFR 52.1771 - Classification of regions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Classification of regions. 52.1771 Section 52.1771 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... III III III III Eastern Piedmont Intrastate I III III III III Northern Coastal Intrastate I III III...

  8. 40 CFR 52.1771 - Classification of regions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 4 2012-07-01 2012-07-01 false Classification of regions. 52.1771 Section 52.1771 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... III III III III Eastern Piedmont Intrastate I III III III III Northern Coastal Intrastate I III III...

  9. 40 CFR 52.621 - Classification of regions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Hawaii § 52.621 Classification of regions. The Hawaii plan was evaluated on the basis of the following classifications: Air quality control region... (hydrocarbons) State of Hawaii II III III III III [37 FR 10860, May 31, 1972] ...

  10. 78 FR 37998 - Electronic One Touch Bingo System

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-25

    ... decision regarding the classification of server based electronic bingo system games that can be played... Class II or Class III game. DATES: The agency must receive comments on or before August 26, 2013... from the regulated community regarding the status of one touch bingo as a Class II or a Class III game...

  11. Bosniak Classification for Complex Renal Cysts Reevaluated: A Systematic Review.

    PubMed

    Schoots, Ivo G; Zaccai, Keren; Hunink, Myriam G; Verhagen, Paul C M S

    2017-07-01

    We systematically evaluated the Bosniak classification system with malignancy rates of each Bosniak category, and assessed the effectiveness related to surgical treatment and oncologic outcome based on recurrence and/or metastasis. In a systematic review according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement and the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies) criteria, we selected 39 publications for inclusion in this analysis and categorized them into 1) surgical cohorts-all cysts treated surgically and 2) radiological cohorts-cysts with surgical treatment or radiological followup. A total of 3,036 complex renal cysts were categorized into Bosniak II, IIF, III and IV. In surgical and radiological cohorts pooled estimates showed a malignancy prevalence of 0.51 (0.44, 0.58) in Bosniak III and 0.89 (0.83, 0.92) in Bosniak IV cysts, respectively. Stable Bosniak IIF cysts showed a malignancy rate of less than 1% during radiological followup (surveillance). Bosniak IIF cysts, which showed reclassification to the Bosniak III/IV category during radiological followup (12%), showed malignancy in 85%, comparable to Bosniak IV cysts. The estimated surgical number needed to treat to avoid metastatic disease of Bosniak III and IV cysts was 140 and 40, respectively. The effectiveness of the Bosniak classification system for complex renal cysts was high in categories II, IIF and IV, but low in category III, and 49% of Bosniak III cysts was overtreated because of a benign outcome. This surgical overtreatment combined with the excellent outcome for Bosniak III cysts may suggest that surveillance is a rational alternative to surgery. This will require further study to assess whether surveillance of Bosniak III cysts will prove safe. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  12. 40 CFR 52.2571 - Classification of regions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Wisconsin § 52.2571 Classification of regions. The Wisconsin plan was evaluated on the basis of the following classifications: Air... Duluth (Minnesota)-Superior (Wisconsin) Interstate I II III III III North Central Wisconsin Intrastate II...

  13. 40 CFR 52.2571 - Classification of regions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Wisconsin § 52.2571 Classification of regions. The Wisconsin plan was evaluated on the basis of the following classifications: Air... Duluth (Minnesota)-Superior (Wisconsin) Interstate I II III III III North Central Wisconsin Intrastate II...

  14. 40 CFR 52.2571 - Classification of regions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Wisconsin § 52.2571 Classification of regions. The Wisconsin plan was evaluated on the basis of the following classifications: Air... Duluth (Minnesota)-Superior (Wisconsin) Interstate I II III III III North Central Wisconsin Intrastate II...

  15. 40 CFR 52.2721 - Classification of regions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Puerto Rico § 52.2721 Classification of regions. The Puerto Rico plan was evaluated on the basis of the following classifications. Air... Photochemical oxidants (hydrocarbons) Puerto Rico IA IA III III III [37 FR 10905, May 31, 1972] ...

  16. Comparisons of severity classification systems for oropharyngeal dysfunction in children with cerebral palsy: Relations with other functional profiles.

    PubMed

    Goh, Yu-Ra; Choi, Ja Young; Kim, Seon Ah; Park, Jieun; Park, Eun Sook

    2018-01-01

    This study aimed to investigate the relationships between various classification systems assessing the severity of oropharyngeal dysphagia and communication function and other functional profiles in children with cerebral palsy (CP). This is a prospective, cross-sectional, study in a university-affiliated, tertiary-care hospital. We recruited 151 children with CP (mean age 6.11 years, SD 3.42, range 3-18yr). The Eating and Drinking Ability Classification System (EDACS) and the dysphagia scales of Functional Oral Intake Scale (FOIS), Swallow Function Scales (SFS), and Food Intake Level Scale (FILS) were used. The Communication Function Classification System (CFCS) and Viking Speech Scale (VSS) were employed to classify communication function and speech intelligibility, respectively. The Pediatric Evaluation of Disability Inventory (PEDI) with the Gross Motor Function Classification System (GFMCS) and the Manual Ability Classification System (MACS) level were also assessed. Spearman correlation analysis to investigate the associations between measures and univariate and multivariate logistic regression models to identify significant factors were used. Median GMFCS level of participants was III (interquartile range II-IV). Significant dysphagia based on EDACS level III-V was noted in 23 children (15.2%). There were strong to very strong relationships between the EDACS level with the dysphagia scales. The EDACS presented strong associations with MACS, CFCS, and VSS, a moderate association with GMFCS level, and a moderate to strong association with each domain of the PEDI. In multivariate analysis, poor functioning in EDACS were associated with poor functioning in gross motor and communication functions. Copyright © 2017. Published by Elsevier Ltd.

  17. Human Factors Engineering. Student Supplement,

    DTIC Science & Technology

    1981-08-01

    a job TASK TAXONOMY A classification scheme for the different levels of activities in a system, i.e., job - task - sub-task, etc. TASK-AN~ALYSIS...with the classification of learning objectives by learning category so as to identify learningPhas III guidelines necessary for optimum learning to...correct. .4... .the sequencing of all dependent tasks. .1.. .the classification of learning objectives by learning category and the Identification of

  18. Intellectual Classification of Black and White Children in Special Education Programs Using the WISC-III and the Cognitive Assessment System.

    ERIC Educational Resources Information Center

    Naglieri, Jack A.; Rojahn, Johannes

    2001-01-01

    Comparison of the Wechsler Intelligence Scale for Children (Third Edition) and the Cognitive Assessment System (CAS) with 78 special education students found that the WISC-III identified more children, especially more black children, as having mental retardation. Results imply that the problem of disproportionate identification of black children…

  19. 41 CFR 105-54.303 - Fiscal and administrative provisions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... support, arranges with the Office of Finance, Office of the Comptroller, for maintaining all financial... Schedule classification and pay system in Chapter 51 and Subchapter III of Chapter 53 of Title 5, U.S.C. (e... under the General Schedule, General Management Schedule, or Senior Executive Service classification...

  20. Site classification for National Strong Motion Observation Network System (NSMONS) stations in China using an empirical H/V spectral ratio method

    NASA Astrophysics Data System (ADS)

    Ji, Kun; Ren, Yefei; Wen, Ruizhi

    2017-10-01

    Reliable site classification of the stations of the China National Strong Motion Observation Network System (NSMONS) has not yet been assigned because of lacking borehole data. This study used an empirical horizontal-to-vertical (H/V) spectral ratio (hereafter, HVSR) site classification method to overcome this problem. First, according to their borehole data, stations selected from KiK-net in Japan were individually assigned a site class (CL-I, CL-II, or CL-III), which is defined in the Chinese seismic code. Then, the mean HVSR curve for each site class was computed using strong motion recordings captured during the period 1996-2012. These curves were compared with those proposed by Zhao et al. (2006a) for four types of site classes (SC-I, SC-II, SC-III, and SC-IV) defined in the Japanese seismic code (JRA, 1980). It was found that an approximate range of the predominant period Tg could be identified by the predominant peak of the HVSR curve for the CL-I and SC-I sites, CL-II and SC-II sites, and CL-III and SC-III + SC-IV sites. Second, an empirical site classification method was proposed based on comprehensive consideration of peak period, amplitude, and shape of the HVSR curve. The selected stations from KiK-net were classified using the proposed method. The results showed that the success rates of the proposed method in identifying CL-I, CL-II, and CL-III sites were 63%, 64%, and 58% respectively. Finally, the HVSRs of 178 NSMONS stations were computed based on recordings from 2007 to 2015 and the sites classified using the proposed method. The mean HVSR curves were re-calculated for three site classes and compared with those from KiK-net data. It was found that both the peak period and the amplitude were similar for the mean HVSR curves derived from NSMONS classification results and KiK-net borehole data, implying the effectiveness of the proposed method in identifying different site classes. The classification results have good agreement with site classes based on borehole data of 81 stations in China, which indicates that our site classification results are acceptable and that the proposed method is practicable.

  1. Computer Recognition of Facial Profiles

    DTIC Science & Technology

    1974-08-01

    facial recognition 20. ABSTRACT (Continue on reverse side It necessary and Identify by block number) A system for the recognition of human faces from...21 2.6 Classification Algorithms ........... ... 32 III FACIAL RECOGNITION AND AUTOMATIC TRAINING . . . 37 3.1 Facial Profile Recognition...provide a fair test of the classification system. The work of Goldstein, Harmon, and Lesk [81 indicates, however, that for facial recognition , a ten class

  2. Intellectual classification of Black and White children in special education programs using the WISC-III and the Cognitive Assessment System.

    PubMed

    Naglieri, J A; Rojahn, J

    2001-07-01

    The Wechsler Intelligence Scale for Children--Third Edition and the Cognitive Assessment System were compared for a sample of 78 White and Black students in special education programs for children with mental retardation. Results showed that the WISC-III identified more children as having mental retardation than did the Cognitive Assessment System. More important, however, the WISC-III classified disproportionately more Blacks than Whites as having mental retardation as compared to the Cognitive Assessment System. Results imply that the problem of disproportionate representation of Black children in special education classes for children with mental retardation may be addressed if the Cognitive Assessment System were used instead of the WISC-III.

  3. A comparison of DSM-II and DSM-III in the diagnosis of childhood psychiatric disorders. II. Interrater agreement.

    PubMed

    Mattison, R; Cantwell, D P; Russell, A T; Will, L

    1979-10-01

    A case-history format was utilized to compare interrater agreement on childhood and adolescent psychiatric disorders, using DSM-II and DSM-III. The average interrater agreement was 57% for DSM-II and 54% for axis I (clinical psychiatric syndrome) of DSM-III. There was high agreement in both systems on cases of psychosis, conduct disorder, hyperactivity, and mental retardation, with DSM-III appearing slightly better. There was noteworthy interrater disagreement in both systems for "anxiety" disorders, complex cases, and in the subtyping of depression. Overall, the reliability of DSM-III appears to be good and is comparable with that of DSM-II and other classification systems of childhood psychiatric disorders.

  4. Classification of mood disorders in DSM-V and DSM-VI.

    PubMed

    Joyce, Peter R

    2008-10-01

    For any diagnostic system to be clinically useful, and go beyond description, it must provide an understanding that informs about aetiology and/or outcome. DSM-III and DSM-IV have provided reliability; the challenge for DSM-V and DSM-VI will be to provide validity. For DSM-V this will not be achieved. Believers in DSM-III and DSM-IV have impeded progress towards a valid classification system, so DSM-V needs to retain continuity with its predecessors to retain reliability and enhance research, but position itself to inform a valid diagnostic system by DSM-VI. This review examines the features of a diagnostic system and summarizes what is really known about mood disorders. The review also questions whether what are called mood disorders are primarily disorders of mood. Finally, it provides suggestions for DSM-VI.

  5. Comparison of severity classification in Japanese patients with antineutrophil cytoplasmic antibody-associated vasculitis in a nationwide, prospective, inception cohort study.

    PubMed

    Sada, Ken-Ei; Harigai, Masayoshi; Amano, Koichi; Atsumi, Tatsuya; Fujimoto, Shouichi; Yuzawa, Yukio; Takasaki, Yoshinari; Banno, Shogo; Sugihara, Takahiko; Kobayashi, Masaki; Usui, Joichi; Yamagata, Kunihiro; Homma, Sakae; Dobashi, Hiroaki; Tsuboi, Naotake; Ishizu, Akihiro; Sugiyama, Hitoshi; Okada, Yasunori; Arimura, Yoshihiro; Matsuo, Seiichi; Makino, Hirofumi

    2016-09-01

    To compare disease severity classification systems for six-month outcome prediction in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Patients with newly diagnosed AAV from 53 tertiary institutions were enrolled. Six-month remission, overall survival, and end-stage renal disease (ESRD)-free survival were evaluated. According to the European Vasculitis Study Group (EUVAS)-defined disease severity, the 321 enrolled patients were classified as follows: 14, localized; 71, early systemic; 170, generalized; and 66, severe disease. According to the rapidly progressive glomerulonephritis (RPGN) clinical grading system, the patients were divided as follows: 60, grade I; 178, grade II; 66, grade III; and 12, grade IV. According to the Five-Factor Score (FFS) 2009, 103, 109, and 109 patients had ≤1, 2, and ≥3 points, respectively. No significant difference in remission rates was found in any severity classification. The overall and ESRD-free survival rates significantly differed between grades I/II, III, and IV, regardless of renal involvement. Severe disease was a good predictor of six-month overall and ESRD-free survival. The FFS 2009 was useful to predict six-month ESRD-free survival but not overall survival. The RPGN grading system was more useful to predict six-month overall and ESRD-free survival than the EUVAS-defined severity or FFS 2009.

  6. A Hybrid Classification System for Heart Disease Diagnosis Based on the RFRS Method.

    PubMed

    Liu, Xiao; Wang, Xiaoli; Su, Qiang; Zhang, Mo; Zhu, Yanhong; Wang, Qiugen; Wang, Qian

    2017-01-01

    Heart disease is one of the most common diseases in the world. The objective of this study is to aid the diagnosis of heart disease using a hybrid classification system based on the ReliefF and Rough Set (RFRS) method. The proposed system contains two subsystems: the RFRS feature selection system and a classification system with an ensemble classifier. The first system includes three stages: (i) data discretization, (ii) feature extraction using the ReliefF algorithm, and (iii) feature reduction using the heuristic Rough Set reduction algorithm that we developed. In the second system, an ensemble classifier is proposed based on the C4.5 classifier. The Statlog (Heart) dataset, obtained from the UCI database, was used for experiments. A maximum classification accuracy of 92.59% was achieved according to a jackknife cross-validation scheme. The results demonstrate that the performance of the proposed system is superior to the performances of previously reported classification techniques.

  7. Change in mobility function and its causes in adults with cerebral palsy by Gross Motor Function Classification System level: A cross-sectional questionnaire study.

    PubMed

    Himuro, Nobuaki; Mishima, Reiko; Seshimo, Takashi; Morishima, Toshibumi; Kosaki, Keisuke; Ibe, Shigeharu; Asagai, Yoshimi; Minematsu, Koji; Kurita, Kazuhiro; Okayasu, Tsutomu; Shimura, Tsukasa; Hoshino, Kotaro; Suzuki, Toshiro; Yanagizono, Taiichiro

    2018-04-07

    The prognosis for mobility function by Gross Motor Function Classification System (GMFCS) level is vital as a guide to rehabilitation for people with cerebral palsy. This study sought to investigate change in mobility function and its causes in adults with cerebral palsy by GMFCS level. We conducted a cross-sectional questionnaire study. A total of 386 participants (26 y 8 m, SD 5 y 10 m) with cerebral palsy were analyzed. Participant numbers by GMFCS level were: I (53), II (139), III (74) and IV (120). The median age of participants with peak mobility function in GMFCS level III was younger than that in the other levels. 48% had experienced a decline in mobility. A Kaplan-Meier plot showed the risk of mobility decline increased in GMFCS level III; the hazard ratio was 1.97 (95% CI, 1.20-3.23) compared with level I. The frequently reported causes of mobility decline were changes in environment, and illness and injury in GMFCS level III, stiffness and deformity in level IV, and reduced physical activity in level II and III. Peak mobility function and mobility decline occurred at a younger age in GMFCS level III, with the cause of mobility decline differing by GMFCS level.

  8. Post-treatment glenoid classification system for total shoulder arthroplasty.

    PubMed

    Churchill, R Sean

    2012-04-01

    Over the past 10 years, numerous advancements in glenoid preparation and resurfacing have occurred. Current glenoid classification systems are either focused solely on the patient's preoperative glenoid bone configuration or on the available glenoid bone stock in revision arthroplasty cases. While these systems provide value in preoperative planning, they fail to properly classify the surgical reconstruction completed. A literature review of common bone preparation methods and sources of glenoid prosthetic failure was performed. Based upon this review, a classification system for grading the status of the glenoid after prosthetic implantation was developed. A 6 category, post-treatment, glenoid classification system is proposed: type 0: no reaming; type I: glenoid reaming into but not through the subchondral bone; type II: glenoid reaming which perforates through <50% of the subchondral bone surface area; type III: glenoid reaming which perforates through >50% of the subchondral bone surface area; type IV: use of structural bone graft; and type V: use of a posterior augmented glenoid prosthesis. Types I-III are further subdivided into subtype A which have 100% bone support of the prosthesis, and subtype B which have a region of unsupported prosthesis. The classification system proposed addresses the surgical management of the glenoid during prosthetic replacement. This unique approach to classifying the glenoid following surgical intervention will allow direct follow-up comparison of similarly treated glenoid replacements. Future multicenter studies, possibly through joint registry databases, could then determine the long-term efficacy of the various glenoid preparation methods. Copyright © 2012 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  9. Perforator chimerism for the reconstruction of complex defects: A new chimeric free flap classification system.

    PubMed

    Kim, Jeong Tae; Kim, Youn Hwan; Ghanem, Ali M

    2015-11-01

    Complex defects present structural and functional challenges to reconstructive surgeons. When compared to multiple free flaps or staged reconstruction, the use of chimeric flaps to reconstruct such defects have many advantages such as reduced number of operative procedures and donor site morbidity as well as preservation of recipient vessels. With increased popularity of perforator flaps, chimeric flaps' harvest and design has benefited from 'perforator concept' towards more versatile and better reconstruction solutions. This article discusses perforator based chimeric flaps and presents a practice based classification system that incorporates the perforator flap concept into "Perforator Chimerism". The authors analyzed a variety of chimeric patterns used in 31 consecutive cases to present illustrative case series and their new classification system. Accordingly, chimeric flaps are classified into four types. Type I: Classical Chimerism, Type II: Anastomotic Chimerism, Type III: Perforator Chimerism and Type IV Mixed Chimerism. Types I on specific source vessel anatomy whilst Type II requires microvascular anastomosis to create the chimeric reconstructive solution. Type III chimeric flaps utilizes the perforator concept to raise two components of tissues without microvascular anastomosis between them. Type IV chimeric flaps are mixed type flaps comprising any combination of Types I to III. Incorporation of the perforator concept in planning and designing chimeric flaps has allowed safe, effective and aesthetically superior reconstruction of complex defects. The new classification system aids reconstructive surgeons and trainees to understand chimeric flaps design, facilitating effective incorporation of this important reconstructive technique into the armamentarium of the reconstruction toolbox. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  10. Modified Angle's Classification for Primary Dentition.

    PubMed

    Chandranee, Kaushik Narendra; Chandranee, Narendra Jayantilal; Nagpal, Devendra; Lamba, Gagandeep; Choudhari, Purva; Hotwani, Kavita

    2017-01-01

    This study aims to propose a modification of Angle's classification for primary dentition and to assess its applicability in children from Central India, Nagpur. Modification in Angle's classification has been proposed for application in primary dentition. Small roman numbers i/ii/iii are used for primary dentition notation to represent Angle's Class I/II/III molar relationships as in permanent dentition, respectively. To assess applicability of modified Angle's classification a cross-sectional preschool 2000 children population from central India; 3-6 years of age residing in Nagpur metropolitan city of Maharashtra state were selected randomly as per the inclusion and exclusion criteria. Majority 93.35% children were found to have bilateral Class i followed by 2.5% bilateral Class ii and 0.2% bilateral half cusp Class iii molar relationships as per the modified Angle's classification for primary dentition. About 3.75% children had various combinations of Class ii relationships and 0.2% children were having Class iii subdivision relationship. Modification of Angle's classification for application in primary dentition has been proposed. A cross-sectional investigation using new classification revealed various 6.25% Class ii and 0.4% Class iii molar relationships cases in preschool children population in a metropolitan city of Nagpur. Application of the modified Angle's classification to other population groups is warranted to validate its routine application in clinical pediatric dentistry.

  11. Six of one, half a dozen of the other: A measure of multidisciplinary inter/intra-rater reliability of the society for fetal urology and urinary tract dilation grading systems for hydronephrosis.

    PubMed

    Rickard, Mandy; Easterbrook, Bethany; Kim, Soojin; Farrokhyar, Forough; Stein, Nina; Arora, Steven; Belostotsky, Vladamir; DeMaria, Jorge; Lorenzo, Armando J; Braga, Luis H

    2017-02-01

    The urinary tract dilation (UTD) classification system was introduced to standardize terminology in the reporting of hydronephrosis (HN), and bridge a gap between pre- and postnatal classification such as the Society for Fetal Urology (SFU) grading system. Herein we compare the intra/inter-rater reliability of both grading systems. SFU (I-IV) and UTD (I-III) grades were independently assigned by 13 raters (9 pediatric urology staff, 2 nephrologists, 2 radiologists), twice, 3 weeks apart, to 50 sagittal postnatal ultrasonographic views of hydronephrotic kidneys. Data regarding ureteral measurements and bladder abnormalities were included to allow proper UTD categorization. Ten images were repeated to assess intra-rater reliability. Krippendorff's alpha coefficient was used to measure overall and by grade intra/inter-rater reliability. Reliability between specialties and training levels were also analyzed. Overall inter-rater reliability was slightly higher for SFU (α = 0.842, 95% CI 0.812-0.879, in session 1; and α = 0.808, 95% CI 0.775-0.839, in session 2) than for UTD (α = 0.774, 95% CI 0.715-0.827, in session 1; and α = 0.679, 95% CI 0.605-0.750, in session 2). Reliability for intermediate grades (SFU II/III and UTD 2) of HN was poor regardless of the system. Reliabilities for SFU and UTD classifications among Urology, Nephrology, and Radiology, as well as between training levels were not significantly different. Despite the introduction of HN grading systems to standardize the interpretation and reporting of renal ultrasound in infants with HN, none have been proven superior in allowing clinicians to distinguish between "moderate" grades. While this study demonstrated high reliability in distinguishing between "mild" (SFU I/II and UTD 1) and "severe" (SFU IV and UTD 3) grades of HN, the overall reliability between specialties was poor. This is in keeping with a previous report of modest inter-rater reliability of the SFU system. This drawback is likely explained by the subjective interpretation required to assign grades, which can be impacted by experience, image quality, and scanning technique. As shown in the figure, which demonstrates SFU II (a) and SFU III (b), as assigned by a radiologist, it is possible to make an argument that either of these images can be classified into both categories that were observed during the grading sessions of this study. Although both systems have acceptable reliability, the SFU grading system showed higher overall intra/inter-rater reliability regardless of rater specialty than the UTD classification. Inter-rater reliability for SFU grades II/III and UTD 2 was low, highlighting the limitations of both classifications in regards to properly segregating moderate HN grades. Copyright © 2016 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  12. Performance of the Delirium Rating Scale-Revised-98 Against Different Delirium Diagnostic Criteria in a Population With a High Prevalence of Dementia.

    PubMed

    Sepulveda, Esteban; Franco, José G; Trzepacz, Paula T; Gaviria, Ana M; Viñuelas, Eva; Palma, José; Ferré, Gisela; Grau, Imma; Vilella, Elisabet

    2015-01-01

    Delirium diagnosis in elderly is often complicated by underlying dementia. We evaluated performance of the Delirium Rating Scale-Revised-98 (DRS-R98) in patients with high dementia prevalence and also assessed concordance among past and current diagnostic criteria for delirium. Cross-sectional analysis of newly admitted patients to a skilled nursing facility over 6 months, who were rated within 24-48 hours after admission. Interview for Diagnostic and Statistical Manual of Mental Disorders, 3rd edition-R (DSM)-III-R, DSM-IV, DSM-5, and International Classification of Diseases 10th edition delirium ratings, administration of the DRS-R98, and assessment of dementia using the Informant Questionnaire on Cognitive Decline in the Elderly were independently performed by 3 researchers. Discriminant analyses (receiver operating characteristics curves) were used to study DRS-R98 accuracy against different diagnostic criteria. Hanley and McNeil test compared the area under the curve for DRS-R98's discriminant performance for all diagnostic criteria. Dementia was present in 85/125 (68.0%) subjects, and 36/125 (28.8%) met criteria for delirium by at least 1 classification system, whereas only 19/36 (52.8%) did by all. DSM-III-R diagnosed the most as delirious (27.2%), followed by DSM-5 (24.8%), DSM-IV-TR (22.4%), and International Classification of Diseases 10th edition (16%). DRS-R98 had the highest AUC when discriminating DSM-III-R delirium (92.9%), followed by DSM-IV (92.4%), DSM-5 (91%), and International Classification of Diseases 10th edition (90.5%), without statistical differences among them. The best DRS-R98 cutoff score was ≥14.5 for all diagnostic systems except International Classification of Diseases 10th edition (≥15.5). There is a low concordance across diagnostic systems for identification of delirium. The DRS-R98 performs well despite differences across classification systems perhaps because it broadly assesses phenomenology, even in this population with a high prevalence of dementia. Copyright © 2015 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  13. Deep mural injury and perforation after colonic endoscopic mucosal resection: a new classification and analysis of risk factors.

    PubMed

    Burgess, Nicholas G; Bassan, Milan S; McLeod, Duncan; Williams, Stephen J; Byth, Karen; Bourke, Michael J

    2017-10-01

    Perforation is the most serious complication associated with endoscopic mucosal resection (EMR). We propose a new classification for the appearance and integrity of the muscularis propria (MP) after EMR including various extents of deep mural injury (DMI). Risk factors for these injuries were analysed. Endoscopic images and histological specimens of consecutive patients undergoing EMR of colonic laterally spreading lesions ≥20 mm at a large Australian tertiary referral endoscopy unit were retrospectively analysed using our new DMI classification system. DMI was graded according to MP injury (I/II intact MP without/with fibrosis, III target sign, IV/V obvious transmural perforation without/with contamination). Histological specimens were examined for included MP and patient outcomes were recorded. All type III-V DMI signs were clipped if possible, types I and II DMI were clipped at the endoscopists' discretion. EMR was performed in 911 lesions (mean size 37 mm) in 802 patients (male sex 51.4%, mean age 67 years). DMI signs were identified in 83 patients (10.3%). Type III-V DMI was identified in 24 patients (3.0%); clipping was successfully performed in all patients. A clinically significant perforation occurred in two patients (0.2%). Only one of the 59 type I/II cases experienced a delayed perforation. 85.5% of patients with DMI were discharged on the same day, all without sequelae. On multivariable analysis, type III-V DMI was associated with transverse colon location (OR 3.55, p=0.028), en bloc resection (OR 3.84, p=0.005) and high-grade dysplasia or submucosal invasive cancer (OR 2.97, p 0.014). In this retrospective analysis, use of the new classification and management with clips appeared to be a safe approach. Advanced DMI types (III-V) occurred in 3.0% of patients and were associated with identifiable risk factors. Further prospective clinical studies should use this new classification. NCT01368289; results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  14. Classification for congenital anomalies of the hand: the IFSSH classification and the JSSH modification.

    PubMed

    De Smet, L

    2002-01-01

    The purpose of a classification for clinical problems which, except for a few specialized centers, occur only sporadically is to provide a system where these cases can be stored. This should allow all involved investigators to speak the same language; so-doing syndromes can be delinated, frequencies of occurence established and results of--different--treatments compared. A classification system should be simple to use, reliable and uniformly accepted. It should allow space for adaptations and/or extensions. The IFSSH proposed a 7 categories classification based on the proposed classification of Swanson et al. in 1976. This classification, was based on, which was thought in the seventies, etiopathogenic pathways. These 7 groups are: I. Failure of formation; transverse (A), or longitudinal (B) II. Failure of differentiation III. Polydactyly IV. Overgrowth V. Undergrowth VI. Amniotic band syndrome VII. Generalized skeletal syndromes. The extended classification proposed by IFSSH was used to classify 1013 hand differences in 925 hands of 650 patients. We found associated anomalies in 26.7%. The classification was straightforward in 86%, difficult in 6.6% and not possible in 7.8%. Group II was the most numerous group including 513 anomalies. We propose to include in this group the Madelung deformity, the Kirner deformity and congenital trigger fingers and trigger thumbs. In group I the radial and ulnar deficiencies, limited to the hand without forearm deficlencies should be Included. Triphalangeal thumbs are a problem, we suggest it to be listed in group III and consider it as a duplication in length. It is not always possible to evaluate the (transverse) absence of the fingers or hand. Longitudinal deficiencies (group IIB), symbrachydactyly (group V), and amniotic bands (group IV) occasionally develop a phenotype similar to the genuine transverse deficiency (group IA). Recently, the Japanese Society for Surgery of the Hand (JSSH) (16) proposed an extension/modification of the IFSSH classification. Based on newer knowledge on teratology, symbrachydactyly in all stages were transfered to group I. Two new groups were introduced. A group "failure of finger ray induction" including typical cleft hand (IC), central polydactyly (III) and (bony) syndactyly (II)--was included. Also a group of "unclassifiable" cases was added. This Japanese proposed classification is a real improvement and most clinicians and surgeons tend to use it in the future.

  15. Modified Angle's Classification for Primary Dentition

    PubMed Central

    Chandranee, Kaushik Narendra; Chandranee, Narendra Jayantilal; Nagpal, Devendra; Lamba, Gagandeep; Choudhari, Purva; Hotwani, Kavita

    2017-01-01

    Aim: This study aims to propose a modification of Angle's classification for primary dentition and to assess its applicability in children from Central India, Nagpur. Methods: Modification in Angle's classification has been proposed for application in primary dentition. Small roman numbers i/ii/iii are used for primary dentition notation to represent Angle's Class I/II/III molar relationships as in permanent dentition, respectively. To assess applicability of modified Angle's classification a cross-sectional preschool 2000 children population from central India; 3–6 years of age residing in Nagpur metropolitan city of Maharashtra state were selected randomly as per the inclusion and exclusion criteria. Results: Majority 93.35% children were found to have bilateral Class i followed by 2.5% bilateral Class ii and 0.2% bilateral half cusp Class iii molar relationships as per the modified Angle's classification for primary dentition. About 3.75% children had various combinations of Class ii relationships and 0.2% children were having Class iii subdivision relationship. Conclusions: Modification of Angle's classification for application in primary dentition has been proposed. A cross-sectional investigation using new classification revealed various 6.25% Class ii and 0.4% Class iii molar relationships cases in preschool children population in a metropolitan city of Nagpur. Application of the modified Angle's classification to other population groups is warranted to validate its routine application in clinical pediatric dentistry. PMID:29326514

  16. Classification of parotidectomies: a proposal of the European Salivary Gland Society.

    PubMed

    Quer, M; Guntinas-Lichius, O; Marchal, F; Vander Poorten, V; Chevalier, D; León, X; Eisele, D; Dulguerov, P

    2016-10-01

    The objective of this study is to provide a comprehensive classification system for parotidectomy operations. Data sources include Medline publications, author's experience, and consensus round table at the Third European Salivary Gland Society (ESGS) Meeting. The Medline database was searched with the term "parotidectomy" and "definition". The various definitions of parotidectomy procedures and parotid gland subdivisions extracted. Previous classification systems re-examined and a new classification proposed by a consensus. The ESGS proposes to subdivide the parotid parenchyma in five levels: I (lateral superior), II (lateral inferior), III (deep inferior), IV (deep superior), V (accessory). A new classification is proposed where the type of resection is divided into formal parotidectomy with facial nerve dissection and extracapsular dissection. Parotidectomies are further classified according to the levels removed, as well as the extra-parotid structures ablated. A new classification of parotidectomy procedures is proposed.

  17. 40 CFR 52.1021 - Classification of regions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Portland Intrastate I II III III III Androscoggin Valley Interstate IA IA III III III Down East Intrastate IA IA III III III Aroostook Intrastate III III III III III Northwest Maine Intrastate III III III III...

  18. 40 CFR 52.1021 - Classification of regions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Portland Intrastate I II III III III Androscoggin Valley Interstate IA IA III III III Down East Intrastate IA IA III III III Aroostook Intrastate III III III III III Northwest Maine Intrastate III III III III...

  19. Surgical scheduling categorization system (SSCS): A novel classification system to improve coordination and scheduling of operative cases in a tertiary pediatric medical system.

    PubMed

    Gantwerker, Eric A; Bannos, Cassandra; Cunningham, Michael J; Rahbar, Reza

    2017-01-01

    To describe a surgical categorization system to create a universal nomenclature, delineating patient complexity as a first step toward developing a true risk stratification system. Retrospective database review of all otolaryngology surgical procedures performed in a tertiary pediatric hospital system over one academic year (July 2012-June 2013). All otolaryngology surgical procedures were reviewed, encompassing 8478 procedures on 5711 patients. The attending otolaryngologist assigned surgical scheduling category (SSCS) at the time of case booking based on an institution specific guidelines. The guidelines are as follow: Category I was assigned to American Society of Anesthesiologists physical status classification (ASA) I/II patients, designating them appropriate for institution's suburban ambulatory surgery centers; Category II was ASA I/II patients with social or transportation issues; Category III was ASA I/II patients who required case coordination with other medical or surgical departments; Category IV was reserved for patients of any ASA class whom the surgeon designated to be of a higher complexity. 8478 total procedures analyzed with 7198 having complete records. 48% were Category I, 13.6% were Category II, 1.9% were Category III and 36.5% were Category IV. The ASA were 34.7% ASA I, 50% ASA II, 13.39% ASA III, and 1.9% ASA IV. Although the largest proportion of patients were ASA II (50%), 39.6% of all ASA II were Category IV. Category IV was split into 54.2% ASA II and 34% ASA III and shows that peri-operative surgical concerns were not encompassed by the ASA system. This surgical categorization system streamlines surgical scheduling in a tertiary pediatric hospital system, particularly with respect to the designation of cases as ambulatory surgery center or main operating room appropriate. The case mix complexity is also readily apparent, enhancing recognition of the coordination and attention required for the perioperative management of high complexity patients. The SSCS helps convey concerns not addressed by ASA physical status alone. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. 21 CFR 876.1735 - Electrogastrography system.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... accessories. (b) Classification. Class II (Special Controls). The special controls are as follows: (1) The... describe how background data should be gathered and used to eliminate artifact in the data signal; (iii) To...

  1. 21 CFR 876.1735 - Electrogastrography system.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... accessories. (b) Classification. Class II (Special Controls). The special controls are as follows: (1) The... describe how background data should be gathered and used to eliminate artifact in the data signal; (iii) To...

  2. 21 CFR 876.1735 - Electrogastrography system.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... accessories. (b) Classification. Class II (Special Controls). The special controls are as follows: (1) The... describe how background data should be gathered and used to eliminate artifact in the data signal; (iii) To...

  3. 21 CFR 876.1735 - Electrogastrography system.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... accessories. (b) Classification. Class II (Special Controls). The special controls are as follows: (1) The... describe how background data should be gathered and used to eliminate artifact in the data signal; (iii) To...

  4. Data Needs in Vocational Education. "The Development of a Minimal Information System to Satisfy the Needs of Selected User Groups." Final Report. Volume III. Project EDNEED Lexicon.

    ERIC Educational Resources Information Center

    Nerden, J. T.; And Others

    Designed for the exclusive purpose of accompanying the Project EDNEED (Empirical Determination of Nationally Essential Educational Data) classification document, this volume comprises the third of a five-volume final report. It provides uniform definitions for vocational education terms found in the EDNEED classification document, and aids in…

  5. 40 CFR 52.2171 - Classification of regions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quality control region Pollutant Particulate matter Sulfur oxides Nitrogen dioxide Carbon monoxide... Falls Interstate II III III III III Black Hills—Rapid City Intrastate III III III III III South Dakota...

  6. 40 CFR 52.2171 - Classification of regions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... quality control region Pollutant Particulate matter Sulfur oxides Nitrogen dioxide Carbon monoxide... Falls Interstate II III III III III Black Hills—Rapid City Intrastate III III III III III South Dakota...

  7. 40 CFR 52.2171 - Classification of regions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quality control region Pollutant Particulate matter Sulfur oxides Nitrogen dioxide Carbon monoxide... Falls Interstate II III III III III Black Hills—Rapid City Intrastate III III III III III South Dakota...

  8. 40 CFR 52.721 - Classification of regions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... III I I North Central Illinois Intrastate II IA III III III Paducah (Kentucky)-Cairo (Illinois... Southeast Illinois Intrastate III II III III III West Central Illinois Intrastate I IA III III III [37 FR...

  9. 40 CFR 52.721 - Classification of regions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... III I I North Central Illinois Intrastate II IA III III III Paducah (Kentucky)-Cairo (Illinois... Southeast Illinois Intrastate III II III III III West Central Illinois Intrastate I IA III III III [37 FR...

  10. 40 CFR 52.121 - Classification of regions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Intrastate (Mohave, Yuma) I III III III III Central Arizona Intrastate (Gila, Pinal) I IA III III III Southeast Arizona Intrastate (Cochise, Graham, Greenlee, Santa Cruz) I IA III III III [45 FR 67345, Oct. 10...

  11. 40 CFR 52.121 - Classification of regions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Intrastate (Mohave, Yuma) I III III III III Central Arizona Intrastate (Gila, Pinal) I IA III III III Southeast Arizona Intrastate (Cochise, Graham, Greenlee, Santa Cruz) I IA III III III [45 FR 67345, Oct. 10...

  12. A Global Classification System for Catchment Hydrology

    NASA Astrophysics Data System (ADS)

    Woods, R. A.

    2004-05-01

    It is a shocking state of affairs - there is no underpinning scientific taxonomy of catchments. There are widely used global classification systems for climate, river morphology, lakes and wetlands, but for river catchments there exists only a plethora of inconsistent, incomplete regional schemes. By proceeding without a common taxonomy for catchments, freshwater science has missed one of its key developmental stages, and has leapt from definition of phenomena to experiments, theories and models, without the theoretical framework of a classification. I propose the development of a global hierarchical classification system for physical aspects of river catchments, to help underpin physical science in the freshwater environment and provide a solid foundation for classification of river ecosystems. Such a classification scheme can open completely new vistas in hydrology: for example it will be possible to (i) rationally transfer experimental knowledge of hydrological processes between basins anywhere in the world, provided they belong to the same class; (ii) perform meaningful meta-analyses in order to reconcile studies that show inconsistent results (iii) generate new testable hypotheses which involve locations worldwide.

  13. 40 CFR 52.1121 - Classification of regions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Ozone Metropolitan Boston Intrastate I I III I I Merrimack Valley-Southern New Hampshire Interstate I I... III III III Hartford-New Haven-Springfield Interstate I I III I I Berkshire Intrastate II III III III...

  14. 40 CFR 52.1121 - Classification of regions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Ozone Metropolitan Boston Intrastate I I III I I Merrimack Valley-Southern New Hampshire Interstate I I... III III III Hartford-New Haven-Springfield Interstate I I III I I Berkshire Intrastate II III III III...

  15. 40 CFR 52.1121 - Classification of regions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Ozone Metropolitan Boston Intrastate I I III I I Merrimack Valley-Southern New Hampshire Interstate I I... III III III Hartford-New Haven-Springfield Interstate I I III I I Berkshire Intrastate II III III III...

  16. [Generalized anxiety disorder, now and the future: a perspective to the DSM-5].

    PubMed

    Otsubo, Tempei

    2012-01-01

    Generalized, persistent, and free-floating anxiety was first described by Freud in 1894. The diagnostic term generalized anxiety disorder (GAD) was not in classification systems until the publication of the diagnostic and statistical manual for mental disorders, third edition (DSM-III) in 1980. Initially considered as a residual category to be used when no other diagnosis could be made, it is not accepted that GAD represents a distinct diagnostic category yet. Since 1980, revisions to the diagnostic criteria for GAD in the DSM-III-R, DSM-IV and DSM-5 classifications have slightly redefined this disorder. The classification is fluid. The duration criterion has increased to 6 months in DSM-IV, but decreased to 3 months in DSM-5. This article reviews the development of diagnostic criteria for defining GAD from Freud to DSM-5 and compares the DSM-5 criterion with DSM-IV and the tenth revision of the International Classification of Disease. The impact of the changes in diagnostic criteria on research into GAD, and on diagnosis, differential diagnosis, will be discussed.

  17. A comparison of outcomes according to different diagnostic systems for delirium (DSM-5, DSM-IV, CAM, and DRS-R98).

    PubMed

    Adamis, Dimitrios; Meagher, David; Rooney, Siobhan; Mulligan, Owen; McCarthy, Geraldine

    2018-04-01

    ABSTRACTStudies indicate that DSM-5 criteria for delirium are relatively restrictive, and identify different cases of delirium compared with previous systems. We evaluate four outcomes of delirium (mortality, length of hospital stay, institutionalization, and cognitive improvement) in relation to delirium defined by different DSM classification systems.Prospective, longitudinal study of patients aged 70+ admitted to medical wards of a general hospital. Participants were assessed up to a maximum of four times during two weeks, using DSM-5 and DSM-IV criteria, DRS-R98 and CAM scales as proxies for DSM III-R and DSM III.Of the 200 assessed patients (mean age 81.1, SD = 6.5; and 50% female) during hospitalization, delirium was identified in 41 (20.5%) using DSM-5, 45 (22.5%) according to DSM-IV, 46 (23%) with CAM positive, and 37 (18.5%) with DRS-R98 severity score >15. Mortality was significantly associated with delirium according to any classification system, but those identified with DSM-5 were at greater risk. Length of stay was significantly longer for those with DSM-IV delirium. Discharge to a care home was associated only with DRS-R98 defined delirium. Cognitive improvement was only associated with CAM and DSM-IV. Different classification systems for delirium identify populations with different outcomes.

  18. 40 CFR 52.51 - Classification of regions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... (hydrocarbons) Alabama & Tombigbee Rivers Intrastate II III III III III Columbus (Georgia)-Phenix City (Alabama... II III I I Mobile (Alabama)-Pensacola-Panama City (Florida)-Southern Mississippi Interstate I I III III I Southeast Alabama Intrastate II III III III III Tennessee River Valley (Alabama)-Cumberland...

  19. Effects of pressure ulcer classification system education programme on knowledge and visual differential diagnostic ability of pressure ulcer classification and incontinence-associated dermatitis for clinical nurses in Korea.

    PubMed

    Lee, Yun Jin; Kim, Jung Yoon

    2016-03-01

    The objective of this study was to evaluate the effect of pressure ulcer classification system education on clinical nurses' knowledge and visual differential diagnostic ability of pressure ulcer (PU) classification and incontinence-associated dermatitis (IAD). One group pre and post-test was used. A convenience sample of 407 nurses, participating in PU classification education programme of continuing education, were enrolled. The education programme was composed of a 50-minute lecture on PU classification and case-studies. The PU Classification system and IAD knowledge test (PUCS-KT) and visual differential diagnostic ability tool (VDDAT), consisting of 21 photographs including clinical information were used. Paired t-test was performed using SPSS/WIN 20.0. The overall mean difference of PUCS-KT (t = -11·437, P<0·001) and VDDAT (t = -21·113, P<0·001) was significantly increased after PU classification education. Overall understanding of six PU classification and IAD after education programme was increased, but lacked visual differential diagnostic ability regarding Stage III PU, suspected deep tissue injury (SDTI), and Unstageable. Continuous differentiated education based on clinical practice is needed to improve knowledge and visual differential diagnostic ability for PU classification, and comparison experiment study is required to examine effects of education programmes. © 2016 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  20. Verification of the Robin and Graham classification system of hip disease in cerebral palsy using three-dimensional computed tomography.

    PubMed

    Gose, Shinichi; Sakai, Takashi; Shibata, Toru; Akiyama, Keisuke; Yoshikawa, Hideki; Sugamoto, Kazuomi

    2011-12-01

    We evaluated the validity of the Robin and Graham classification system of hip disease in cerebral palsy (CP) using three-dimensional computed tomography in young people with CP. A total of 91 hips in 91 consecutive children with bilateral spastic CP (57 males, 34 females; nine classified at Gross Motor Function Classification System level II, 42 at level III, 32 at level IV, and eight at level V; mean age 5 y 2 mo, SD 11 mo; range 2-6 y) were investigated retrospectively using anteroposterior plain radiographs and three-dimensional computed tomography (3D-CT) of the hip. The migration percentage was calculated on plain radiographs and all participants were classified into four groups according to migration percentage: grade II, migration percentage ≥ 10% but ≤ 15%, (four hips), grade III, migration percentage >15% but ≤ 30%, (20 hips); grade IV, migration percentage >30% but <100%, (63 hips); and grade V, migration percentage ≥ 100%, (four hips). The lateral opening angle and the sagittal inclination angle of the acetabulum, the neck-shaft angle, and the femoral anteversion of the femur were measured on 3D-CT. The three-dimensional quantitative evaluation indicated that there were significant differences in the lateral opening angle and the neck-shaft angle between the four groups (Kruskal-Wallis test, p ≤ 0.001). This three-dimensional evaluation supports the validation of the Robin and Graham classification system for hip disease in 2- to 7-year-olds with CP. © The Authors. Developmental Medicine & Child Neurology © 2011 Mac Keith Press.

  1. A support vector machine for spectral classification of emission-line galaxies from the Sloan Digital Sky Survey

    NASA Astrophysics Data System (ADS)

    Shi, Fei; Liu, Yu-Yan; Sun, Guang-Lan; Li, Pei-Yu; Lei, Yu-Ming; Wang, Jian

    2015-10-01

    The emission-lines of galaxies originate from massive young stars or supermassive blackholes. As a result, spectral classification of emission-line galaxies into star-forming galaxies, active galactic nucleus (AGN) hosts, or compositions of both relates closely to formation and evolution of galaxy. To find efficient and automatic spectral classification method, especially in large surveys and huge data bases, a support vector machine (SVM) supervised learning algorithm is applied to a sample of emission-line galaxies from the Sloan Digital Sky Survey (SDSS) data release 9 (DR9) provided by the Max Planck Institute and the Johns Hopkins University (MPA/JHU). A two-step approach is adopted. (i) The SVM must be trained with a subset of objects that are known to be AGN hosts, composites or star-forming galaxies, treating the strong emission-line flux measurements as input feature vectors in an n-dimensional space, where n is the number of strong emission-line flux ratios. (ii) After training on a sample of emission-line galaxies, the remaining galaxies are automatically classified. In the classification process, we use a 10-fold cross-validation technique. We show that the classification diagrams based on the [N II]/Hα versus other emission-line ratio, such as [O III]/Hβ, [Ne III]/[O II], ([O III]λ4959+[O III]λ5007)/[O III]λ4363, [O II]/Hβ, [Ar III]/[O III], [S II]/Hα, and [O I]/Hα, plus colour, allows us to separate unambiguously AGN hosts, composites or star-forming galaxies. Among them, the diagram of [N II]/Hα versus [O III]/Hβ achieved an accuracy of 99 per cent to separate the three classes of objects. The other diagrams above give an accuracy of ˜91 per cent.

  2. 40 CFR 52.2471 - Classification of regions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Eastern Washington-Northern Idaho Interstate I IA III I III Northern Washington Intrastate II III III III III Olympic-Northwest Washington Intrastate II II III III III Portland Interstate I IA III I I Puget Sound Intrastate I IA III I I South Central Washington Intrastate I III III III III [37 FR 10900, May 31...

  3. 40 CFR 52.2471 - Classification of regions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Eastern Washington-Northern Idaho Interstate I IA III I III Northern Washington Intrastate II III III III III Olympic-Northwest Washington Intrastate II II III III III Portland Interstate I IA III I I Puget Sound Intrastate I IA III I I South Central Washington Intrastate I III III III III [37 FR 10900, May 31...

  4. New Classification of Focal Cortical Dysplasia: Application to Practical Diagnosis

    PubMed Central

    Bae, Yoon-Sung; Kang, Hoon-Chul; Kim, Heung Dong; Kim, Se Hoon

    2012-01-01

    Background and Purpose: Malformation of cortical development (MCD) is a well-known cause of drug-resistant epilepsy and focal cortical dysplasia (FCD) is the most common neuropathological finding in surgical specimens from drug-resistant epilepsy patients. Palmini’s classification proposed in 2004 is now widely used to categorize FCD. Recently, however, Blumcke et al. recommended a new system for classifying FCD in 2011. Methods: We applied the new classification system in practical diagnosis of a sample of 117 patients who underwent neurosurgical operations due to drug-resistant epilepsy at Severance Hospital in Seoul, Korea. Results: Among 117 cases, a total of 16 cases were shifted to other FCD subtypes under the new classification system. Five cases were reclassified to type IIIa and five cases were categorized as dual pathology. The other six cases were changed within the type I category. Conclusions: The most remarkable changes in the new classification system are the advent of dual pathology and FCD type III. Thus, it will be very important for pathologists and clinicians to discriminate between these new categories. More large-scale research needs to be conducted to elucidate the clinical influence of the alterations within the classification of type I disease. Although the new FCD classification system has several advantages compared to the former, the correlation with clinical characteristics is not yet clear. PMID:24649461

  5. Analysis of A Drug Target-based Classification System using Molecular Descriptors.

    PubMed

    Lu, Jing; Zhang, Pin; Bi, Yi; Luo, Xiaomin

    2016-01-01

    Drug-target interaction is an important topic in drug discovery and drug repositioning. KEGG database offers a drug annotation and classification using a target-based classification system. In this study, we gave an investigation on five target-based classes: (I) G protein-coupled receptors; (II) Nuclear receptors; (III) Ion channels; (IV) Enzymes; (V) Pathogens, using molecular descriptors to represent each drug compound. Two popular feature selection methods, maximum relevance minimum redundancy and incremental feature selection, were adopted to extract the important descriptors. Meanwhile, an optimal prediction model based on nearest neighbor algorithm was constructed, which got the best result in identifying drug target-based classes. Finally, some key descriptors were discussed to uncover their important roles in the identification of drug-target classes.

  6. Comparison of diagnostic classification systems for delirium with new research criteria that incorporate the three core domains.

    PubMed

    Trzepacz, Paula T; Meagher, David J; Franco, José G

    2016-05-01

    Diagnostic classification systems do not incorporate phenomenological research findings about the three core symptom domains of delirium (Attentional/Cognitive, Circadian, Higher Level Thinking). We evaluated classification performances of novel Trzepacz, Meagher, and Franco research diagnostic criteria (TMF) that incorporate those domains and ICD-10, DSM-III-R, DSM-IV, and DSM-5. Primary data analysis of 641 patients with mixed neuropsychiatric profiles. Delirium (n=429) and nondelirium (n=212) reference standard groups were identified using cluster analysis of symptoms assessed using the Delirium Rating Scale-Revised-98. Accuracy, sensitivity, specificity, positive and negative predictive values (PPV, NPV), and likelihood ratios (LR+, LR-) are reported. TMF criteria had high sensitivity and specificity (87.4% and 89.2%), more balanced than DSM-III-R (100% and 31.6%), DSM-IV (97.7% and 74.1%), DSM-5 (97.7% and 72.6%), and ICD-10 (66.2% and 100%). PPV of DSM-III-R, DSM-IV, and DSM-5 were <90.0%, while PPV for ICD-10 and TMF were >90%. ICD-10 had the lowest NPV (59.4%). TMF had the highest LR+ (8.06) and DSM-III-R the lowest LR- (0.0). Overall, values for DSM-IV and DSM-5 were similar, whereas for ICD-10 and DSM-III-R were inverse of each other. In the pre-existing cognitive impairment/dementia subsample (n=128), TMF retained its highest LR+ though specificity (58.3%) became less well balanced with sensitivity (87.9%), which still exceeded that of DSM. TMF research diagnostic criteria performed well, with more balanced sensitivity and specificity and the highest likelihood ratio for delirium identification. Reflecting the three core domains of delirium, TMF criteria may have advantages in biological research where delineation of this syndrome is important. Copyright © 2016. Published by Elsevier Inc.

  7. 78 FR 42910 - Community Right-to-Know; Adoption of 2012 North American Industry Classification System (NAICS...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-18

    ... www.regulations.gov or email. The www.regulations.gov Web site is an ``anonymous access'' system...-7672, http://www.epa.gov/epaoswer/hotline/ . SUPPLEMENTARY INFORMATION: I. Why is EPA issuing this... entity, consult the person listed in the FOR FURTHER INFORMATION CONTACT section. III. What should I...

  8. A Functional-Phylogenetic Classification System for Transmembrane Solute Transporters

    PubMed Central

    Saier, Milton H.

    2000-01-01

    A comprehensive classification system for transmembrane molecular transporters has been developed and recently approved by the transport panel of the nomenclature committee of the International Union of Biochemistry and Molecular Biology. This system is based on (i) transporter class and subclass (mode of transport and energy coupling mechanism), (ii) protein phylogenetic family and subfamily, and (iii) substrate specificity. Almost all of the more than 250 identified families of transporters include members that function exclusively in transport. Channels (115 families), secondary active transporters (uniporters, symporters, and antiporters) (78 families), primary active transporters (23 families), group translocators (6 families), and transport proteins of ill-defined function or of unknown mechanism (51 families) constitute distinct categories. Transport mode and energy coupling prove to be relatively immutable characteristics and therefore provide primary bases for classification. Phylogenetic grouping reflects structure, function, mechanism, and often substrate specificity and therefore provides a reliable secondary basis for classification. Substrate specificity and polarity of transport prove to be more readily altered during evolutionary history and therefore provide a tertiary basis for classification. With very few exceptions, a phylogenetic family of transporters includes members that function by a single transport mode and energy coupling mechanism, although a variety of substrates may be transported, sometimes with either inwardly or outwardly directed polarity. In this review, I provide cross-referencing of well-characterized constituent transporters according to (i) transport mode, (ii) energy coupling mechanism, (iii) phylogenetic grouping, and (iv) substrates transported. The structural features and distribution of recognized family members throughout the living world are also evaluated. The tabulations should facilitate familial and functional assignments of newly sequenced transport proteins that will result from future genome sequencing projects. PMID:10839820

  9. Early tumor shrinkage served as a prognostic factor for patients with stage III non-small cell lung cancer treated with concurrent chemoradiotherapy.

    PubMed

    Wei, Min; Ye, Qingqing; Wang, Xuan; Wang, Men; Hu, Yan; Yang, Yonghua; Yang, Jiyuan; Cai, Jun

    2018-05-01

    Lung cancer is the most common cause of cancer death. About 80% of patients are diagnosed at stage III in the non-small cell lung cancer (NSCLC). It is extremely important to understand the progression of this disease which has low survival times despite the advancing treatment modalities. We aimed to investigate the relationship between early tumor shrinkage (ETS) after initial concurrent chemoradiotherapy (C-CRT) and survival outcome in patients with stage III (NSCLC). A retrospective review of 103 patients with stage III NSCLC who had received C-CRT from January 2006 to October 2011 was performed. Patients were treated with systemic chemotherapy regimen of Cisplatin/Vp-16 and concurrent thoracic radiotherapy at a median dose of 66 Gy (range 60-70 Gy). All patients received a computed tomography (CT) examination before treatment. Also subsequently, chest CT scans were performed with the same imaging parameters at approximately 5 weeks after the initiation of treatment. ETS is here stratified by a decrease in tumor size ≥30% and <30% in the longest dimension of the target lesion within 5 weeks. Of the 103 patients, 59 ones showed a 30% decrease in tumor size, and the rest displayed a decrease of <30%. ETS showed no significant correlation with age, T classification, N classification, histological classification, smoking status, G classification, EGFR status, or acute pulmonary toxicity. In the current retrospective clinical study, Kaplan-Meier curves showed that patients with ETS ≥ 30% had a better progression-free survival and overall survival. The univariate and multivariate Cox regression analyses indicated that ETS < 30% was associated with a significantly increased risk of cancer-related death (P < .05) in stage IIINSCLC. ETS may be served as a useful prognostic factor to predict the outcome of stage III NSCLC patients treated with CCRT.

  10. What is generalized anxiety disorder?

    PubMed

    Rickels, K; Rynn, M A

    2001-01-01

    Generalized, persistent, and free-floating anxiety was first described by Freud in 1894, although the diagnostic term generalized anxiety disorder (GAD) was not included in classification systems until 1980 (Diagnostic and Statistical Manual for Mental Disorders, Third Edition [DSM-III]). Initially considered a residual category to be used when no other diagnosis could be made, it is now widely accepted that GAD represents a distinct diagnostic category. Since 1980, revisions to the diagnostic criteria for GAD in the DSM-III-R and DSM-IV classifications have markedly redefined this disorder, increasing the duration criterion to 6 months and increasing the emphasis on worry and psychic symptoms. This article reviews the development of the diagnostic criteria for defining GAD from Freud to DSM-IV and compares the DSM-IV criteria with the criteria set forth in the tenth revision of the International Classification of Diseases. The impact of the changes in diagnostic criteria on research into GAD, and on diagnosis, differential diagnosis, and treatment of GAD, will be discussed.

  11. Stellar C III Emissions as a New Classification Parameter for (WC) Central Stars

    NASA Technical Reports Server (NTRS)

    Feibelman, W. A.

    1999-01-01

    We report detection of stellar C III lambda 1909 emission in International Ultraviolet Explorer (IUE) echelle spectra of early-type [WC] planetary nebula central stars (CSPNs). Additionally, stellar C III emission at lambda 2297 is observed in early- and late-type [WC) CSPNS. Inclusion of these C III features for abundance determinations may resolve a conflict of underabundance of C/O for early type [WC2] - [WC4] CSPNS. A linear dependence on stellar C III lambda 2297 equivalent widths can be used to indicate a new classification of type [WCUV] central stars.

  12. Resource utilization groups (RUGs): defining chronic care, rehabilitation and nursing home case mix in Canada.

    PubMed

    Botz, C K; Bestard, S; Demaray, M; Molloy, G

    1993-01-01

    The two major purposes of this study were: (1) to evaluate Resource Utilization Groups (RUGs III) as a unified method for classifying all residential, chronic care and rehabilitation patients at the St. Joseph's Health Centre, London, and (2) to compare the potential funding implications of RUGs and other patient/resident classification systems. RUGs were used to classify a total of 336 patients/residents in residential, extended care, chronic care and rehabilitation beds at the Health Centre. Patients were also concurrently classified according to the Alberta Long Term Care Classification System and the Medicus Long Term Care System. Results show that RUGs provide relatively more credit for higher acuity patients than do the Alberta or Medicus systems. If used as a basis for funding, chronic care and rehabilitation hospitals would be entitled to more funding (relative to residential/nursing homes) under RUGs than under the other two patient classification mechanisms.

  13. Early warning, warning or alarm systems for natural hazards? A generic classification.

    NASA Astrophysics Data System (ADS)

    Sättele, Martina; Bründl, Michael; Straub, Daniel

    2013-04-01

    Early warning, warning and alarm systems have gained popularity in recent years as cost-efficient measures for dangerous natural hazard processes such as floods, storms, rock and snow avalanches, debris flows, rock and ice falls, landslides, flash floods, glacier lake outburst floods, forest fires and even earthquakes. These systems can generate information before an event causes loss of property and life. In this way, they mainly mitigate the overall risk by reducing the presence probability of endangered objects. These systems are typically prototypes tailored to specific project needs. Despite their importance there is no recognised system classification. This contribution classifies warning and alarm systems into three classes: i) threshold systems, ii) expert systems and iii) model-based expert systems. The result is a generic classification, which takes the characteristics of the natural hazard process itself and the related monitoring possibilities into account. The choice of the monitoring parameters directly determines the system's lead time. The classification of 52 active systems moreover revealed typical system characteristics for each system class. i) Threshold systems monitor dynamic process parameters of ongoing events (e.g. water level of a debris flow) and incorporate minor lead times. They have a local geographical coverage and a predefined threshold determines if an alarm is automatically activated to warn endangered objects, authorities and system operators. ii) Expert systems monitor direct changes in the variable disposition (e.g crack opening before a rock avalanche) or trigger events (e.g. heavy rain) at a local scale before the main event starts and thus offer extended lead times. The final alarm decision incorporates human, model and organisational related factors. iii) Model-based expert systems monitor indirect changes in the variable disposition (e.g. snow temperature, height or solar radiation that influence the occurrence probability of snow avalanches) or trigger events (e.g. heavy snow fall) to predict spontaneous hazard events in advance. They encompass regional or national measuring networks and satisfy additional demands such as the standardisation of the measuring stations. The developed classification and the characteristics, which were revealed for each class, yield a valuable input to quantifying the reliability of warning and alarm systems. Importantly, this will facilitate to compare them with well-established standard mitigation measures such as dams, nets and galleries within an integrated risk management approach.

  14. Three-column classification and Schatzker classification: a three- and two-dimensional computed tomography characterisation and analysis of tibial plateau fractures.

    PubMed

    Patange Subba Rao, Sheethal Prasad; Lewis, James; Haddad, Ziad; Paringe, Vishal; Mohanty, Khitish

    2014-10-01

    The aim of the study was to evaluate inter-observer reliability and intra-observer reproducibility between the three-column classification and Schatzker classification systems using 2D and 3D CT models. Fifty-two consecutive patients with tibial plateau fractures were evaluated by five orthopaedic surgeons. All patients were classified into Schatzker and three-column classification systems using x-rays and 2D and 3D CT images. The inter-observer reliability was evaluated in the first round and the intra-observer reliability was determined during the second round 2 weeks later. The average intra-observer reproducibility for the three-column classification was from substantial to excellent in all sub classifications, as compared with Schatzker classification. The inter-observer kappa values increased from substantial to excellent in three-column classification and to moderate in Schatzker classification The average values for three-column classification for all the categories are as follows: (I-III) k2D = 0.718, 95% CI 0.554-0.864, p < 0.0001 and average 3D = 0.874, 95% CI 0.754-0.890, p < 0.0001. For Schatzker classification system, the average values for all six categories are as follows: (I-VI) k2D = 0.536, 95% CI 0.365-0.685, p < 0.0001 and average k3D = 0.552 95% CI 0.405-0.700, p < 0.0001. The values are statistically significant. Statistically significant inter-observer values in both rounds were noted with the three-column classification, making it statistically an excellent agreement. The intra-observer reproducibility for the three-column classification improved as compared with the Schatzker classification. The three-column classification seems to be an effective way to characterise and classify fractures of tibial plateau.

  15. Experiences with the DSM-III in a psychiatric consultation/liaison service.

    PubMed

    Larsen, F

    1986-01-01

    375 patients referred to consultation/liaison service at a general hospital from the neurological and internal medical department were diagnosed according to the DSM-III criteria for axis I and II. The sample represents all the patients referred from the two departments in a two year period. The phenomenological approach of the DSM-III and its reliability, is an advantage over older classification systems in the psychiatric consultation/liaison work. The system was easily applicable in this setting, leaving only 4 percent with "Diagnoses deferred" on both axes. From the consultation/liaison psychiatrist's point of view, special problems seemed to exist concerning the categories "Somatoform disorders" and "Psychological factors affecting physical condition", and the concepts of the axis II.

  16. Spatial-temporal discriminant analysis for ERP-based brain-computer interface.

    PubMed

    Zhang, Yu; Zhou, Guoxu; Zhao, Qibin; Jin, Jing; Wang, Xingyu; Cichocki, Andrzej

    2013-03-01

    Linear discriminant analysis (LDA) has been widely adopted to classify event-related potential (ERP) in brain-computer interface (BCI). Good classification performance of the ERP-based BCI usually requires sufficient data recordings for effective training of the LDA classifier, and hence a long system calibration time which however may depress the system practicability and cause the users resistance to the BCI system. In this study, we introduce a spatial-temporal discriminant analysis (STDA) to ERP classification. As a multiway extension of the LDA, the STDA method tries to maximize the discriminant information between target and nontarget classes through finding two projection matrices from spatial and temporal dimensions collaboratively, which reduces effectively the feature dimensionality in the discriminant analysis, and hence decreases significantly the number of required training samples. The proposed STDA method was validated with dataset II of the BCI Competition III and dataset recorded from our own experiments, and compared to the state-of-the-art algorithms for ERP classification. Online experiments were additionally implemented for the validation. The superior classification performance in using few training samples shows that the STDA is effective to reduce the system calibration time and improve the classification accuracy, thereby enhancing the practicability of ERP-based BCI.

  17. The 2016 revision of the WHO Classification of Central Nervous System Tumours: retrospective application to a cohort of diffuse gliomas.

    PubMed

    Rogers, Te Whiti; Toor, Gurvinder; Drummond, Katharine; Love, Craig; Field, Kathryn; Asher, Rebecca; Tsui, Alpha; Buckland, Michael; Gonzales, Michael

    2018-03-01

    The classification of central nervous system tumours has more recently been shaped by a focus on molecular pathology rather than histopathology. We re-classified 82 glial tumours according to the molecular-genetic criteria of the 2016 revision of the World Health Organization (WHO) Classification of Tumours of the Central Nervous System. Initial diagnoses and grading were based on the morphological criteria of the 2007 WHO scheme. Because of the impression of an oligodendroglial component on initial histological assessment, each tumour was tested for co-deletion of chromosomes 1p and 19q and mutations of isocitrate dehydrogenase (IDH-1 and 2) genes. Additionally, expression of proteins encoded by alpha-thalassemia X-linked mental retardation (ATRX) and TP53 genes was assessed by immunohistochemistry. We found that all but two tumours could be assigned to a specific category in the 2016 revision. The most common change in diagnosis was from oligoastrocytoma to specifically astrocytoma or oligodendroglioma. Analysis of progression free survival (PFS) for WHO grade II and III tumours showed that the objective criteria of the 2016 revision separated diffuse gliomas into three distinct molecular categories: chromosome 1p/19q co-deleted/IDH mutant, intact 1p/19q/IDH mutant and IDH wild type. No significant difference in PFS was found when comparing IDH mutant grade II and III tumours suggesting that IDH status is more informative than tumour grade. The segregation into distinct molecular sub-types that is achieved by the 2016 revision provides an objective evidence base for managing patients with grade II and III diffuse gliomas based on prognosis.

  18. Preprocessing and meta-classification for brain-computer interfaces.

    PubMed

    Hammon, Paul S; de Sa, Virginia R

    2007-03-01

    A brain-computer interface (BCI) is a system which allows direct translation of brain states into actions, bypassing the usual muscular pathways. A BCI system works by extracting user brain signals, applying machine learning algorithms to classify the user's brain state, and performing a computer-controlled action. Our goal is to improve brain state classification. Perhaps the most obvious way to improve classification performance is the selection of an advanced learning algorithm. However, it is now well known in the BCI community that careful selection of preprocessing steps is crucial to the success of any classification scheme. Furthermore, recent work indicates that combining the output of multiple classifiers (meta-classification) leads to improved classification rates relative to single classifiers (Dornhege et al., 2004). In this paper, we develop an automated approach which systematically analyzes the relative contributions of different preprocessing and meta-classification approaches. We apply this procedure to three data sets drawn from BCI Competition 2003 (Blankertz et al., 2004) and BCI Competition III (Blankertz et al., 2006), each of which exhibit very different characteristics. Our final classification results compare favorably with those from past BCI competitions. Additionally, we analyze the relative contributions of individual preprocessing and meta-classification choices and discuss which types of BCI data benefit most from specific algorithms.

  19. Comparison of Rai and Binet Classifications in Chronic Lymphocytic Leukemia.

    PubMed

    Zengin, N; Kars, A; Kansu, E; Özdemir, O; Barişta, İ; Güllü, İ; Güler, N; Özişik, Y; Dündar, S; Firat, D

    1997-01-01

    Staging systems are essential for understanding disease, in predicting the outcome, and therapeutic decision making in any tumor as well as chronic lymphocytic leukemia (CLL). In this study, we compared the clinical correlation of the Rai and Binet classification systems in 133 CLL patients. The distribution of 133 patients according to the Rai system was as follows, stage 0:17, I:13, II:45, III:30, IV:28, and in the Binet system stage A:35, B:40, C:58 patients. Median survival of patients according to the Rai staging system was >67.0, >91.0, 63.8, 20.9 and 9.8 months, and >91.0, 63.4, 16.0 months according to Binet, respectively. Although no difference was found between Rai stages 0, I, II (p > 0.05) in terms of median survival, the difference between these stages and stages III and IV was statistically significant (p < 0.05). In the Binet staging system statistically significant survival difference was found between all stages (p < 0.05). We concluded that although both systems are comparable in terms of staging and predicting the outcome of patients with CLL, the Rai staging system appears to have an advantage over the Binet system by defining a subset of patients with excellent prognosis (stage 0) which is included within stage A of the latter.

  20. Variation in the shape of the tibial insertion site of the anterior cruciate ligament: classification is required.

    PubMed

    Guenther, Daniel; Irarrázaval, Sebastian; Nishizawa, Yuichiro; Vernacchia, Cara; Thorhauer, Eric; Musahl, Volker; Irrgang, James J; Fu, Freddie H

    2017-08-01

    To propose a classification system for the shape of the tibial insertion site (TIS) of the anterior cruciate ligament (ACL) and to demonstrate the intra- and inter-rater agreement of this system. Due to variation in shape and size, different surgical approaches may be feasible to improve reconstruction of the TIS. One hundred patients with a mean age of 26 ± 11 years were included. The ACL was cut arthroscopically at the base of the tibial insertion site. Arthroscopic images were taken from the lateral and medial portal. Images were de-identified and duplicated. Two blinded observers classified the tibial insertion site according to a classification system. The tibial insertion site was classified as type I (elliptical) in 51 knees (51 %), type II (triangular) in 33 knees (33 %) and type III (C-shaped) in 16 knees (16 %). There was good agreement between raters when viewing the insertion site from the lateral portal (κ = 0.65) as well as from the medial portal (κ = 0.66). Intra-rater reliability was good to excellent. Agreement in the description of the insertion site between the medial and lateral portals was good for rater 1 and good for rater 2 (κ = 0.74 and 0.77, respectively). There is variation in the shape of the ACL TIS. The classification system is a repeatable and reliable tool to summarize the shape of the TIS using three common patterns. For clinical relevance, different shapes may require different types of reconstruction to ensure proper footprint restoration. Consideration of the individual TIS shape is required to prevent iatrogenic damage of adjacent structures like the menisci. III.

  1. Detection of interaction articles and experimental methods in biomedical literature.

    PubMed

    Schneider, Gerold; Clematide, Simon; Rinaldi, Fabio

    2011-10-03

    This article describes the approaches taken by the OntoGene group at the University of Zurich in dealing with two tasks of the BioCreative III competition: classification of articles which contain curatable protein-protein interactions (PPI-ACT) and extraction of experimental methods (PPI-IMT). Two main achievements are described in this paper: (a) a system for document classification which crucially relies on the results of an advanced pipeline of natural language processing tools; (b) a system which is capable of detecting all experimental methods mentioned in scientific literature, and listing them with a competitive ranking (AUC iP/R > 0.5). The results of the BioCreative III shared evaluation clearly demonstrate that significant progress has been achieved in the domain of biomedical text mining in the past few years. Our own contribution, together with the results of other participants, provides evidence that natural language processing techniques have become by now an integral part of advanced text mining approaches.

  2. Portable Multispectral Colorimeter for Metallic Ion Detection and Classification

    PubMed Central

    Jaimes, Ruth F. V. V.; Borysow, Walter; Gomes, Osmar F.; Salcedo, Walter J.

    2017-01-01

    This work deals with a portable device system applied to detect and classify different metallic ions as proposed and developed, aiming its application for hydrological monitoring systems such as rivers, lakes and groundwater. Considering the system features, a portable colorimetric system was developed by using a multispectral optoelectronic sensor. All the technology of quantification and classification of metallic ions using optoelectronic multispectral sensors was fully integrated in the embedded hardware FPGA ( Field Programmable Gate Array) technology and software based on virtual instrumentation (NI LabView®). The system draws on an indicative colorimeter by using the chromogen reagent of 1-(2-pyridylazo)-2-naphthol (PAN). The results obtained with the signal processing and pattern analysis using the method of the linear discriminant analysis, allows excellent results during detection and classification of Pb(II), Cd(II), Zn(II), Cu(II), Fe(III) and Ni(II) ions, with almost the same level of performance as for those obtained from the Ultravioled and visible (UV-VIS) spectrophotometers of high spectral resolution. PMID:28788082

  3. Portable Multispectral Colorimeter for Metallic Ion Detection and Classification.

    PubMed

    Braga, Mauro S; Jaimes, Ruth F V V; Borysow, Walter; Gomes, Osmar F; Salcedo, Walter J

    2017-07-28

    This work deals with a portable device system applied to detect and classify different metallic ions as proposed and developed, aiming its application for hydrological monitoring systems such as rivers, lakes and groundwater. Considering the system features, a portable colorimetric system was developed by using a multispectral optoelectronic sensor. All the technology of quantification and classification of metallic ions using optoelectronic multispectral sensors was fully integrated in the embedded hardware FPGA ( Field Programmable Gate Array) technology and software based on virtual instrumentation (NI LabView ® ). The system draws on an indicative colorimeter by using the chromogen reagent of 1-(2-pyridylazo)-2-naphthol (PAN). The results obtained with the signal processing and pattern analysis using the method of the linear discriminant analysis, allows excellent results during detection and classification of Pb(II), Cd(II), Zn(II), Cu(II), Fe(III) and Ni(II) ions, with almost the same level of performance as for those obtained from the Ultravioled and visible (UV-VIS) spectrophotometers of high spectral resolution.

  4. Surgical management of morbidity due to lymphatic filariasis: the usefulness of a standardized international clinical classification of hydroceles.

    PubMed

    Capuano, G P; Capuano, C

    2012-03-01

    The objective of this work is to evaluate the usefulness of a standardized clinical classification of hydroceles in lymphatic filariasis endemic countries to guide their surgical management. 64 patients with hydroceles were operated in 2009-2010, in Level II hospitals (WHO classification), during two visits to Fiji, by the same mobile surgical team. The number of hydroceles treated was 83. We developed and evaluated a much needed clinical classification of hydroceles based on four criteria: Type (uni/bilateral); Side (left/right); Stage of enlargement of the scrotum rated from I to VI; Grade of burial of the penis rated from 0 to 4. It lead to the conclusion that 1) A Stage I or II hydrocele, associated with Grade 0 or 1 penis burial could be considered a "Simple Hydrocele". The surgical treatment is simple with no anticipated early complication. WHO Level II of health care structure seems adapted. 2) A Stage III or IV hydrocele associated with Grade 2, 3 or 4 penis burial could be considered a "Complicated Hydrocele". The operation is longer, more complicated and the possibility of occurrence of complications seems greater. A level III health care facility would be more adapted under the normal functioning of the health system. We conclude that a standardized clinical classification of hydroceles based on the Stage of enlargement of the scrotum and the Grade of burial of the penis appears to be a useful tool to guide the decision about the level of care and the surgical technique required. We use the same classification for penoscrotal lymphoedema. A decision tree is presented for the management of hydroceles in lymphatic filariasis endemic countries which could usefully complement the "Algorithm for management of scrotal swelling" proposed by WHO in 2002. An international classification system of hydroceles would also allow standardization and facilitate study design and comparisons of their results.

  5. 78 FR 42875 - Community Right-to-Know; Adoption of 2012 North American Industry Classification System (NAICS...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-18

    ....regulations.gov or email. The www.regulations.gov Web site is an ``anonymous access'' system, which means EPA.../ . SUPPLEMENTARY INFORMATION: I. Why is EPA using a direct final rule? EPA is publishing this rule without a prior... entity, consult the person listed in the FOR FURTHER INFORMATION CONTACT section. III. What should I...

  6. Property Accounting for Local and State School Systems. State Educational Records and Reports Series--Handbook III.

    ERIC Educational Resources Information Center

    Reason, Paul L.; Tankard, George G., Jr.

    This handbook serves as a basic guide to property accounting for local and state school systems in the U.S. Information and guidelines are presented regarding--(1) classification of property accounts, (2) definitions of property accounts, (3) measures of school property, (4) supplies and equipment, (5) individual property records, and (6) summary…

  7. Values and assumptions in the development of DSM-III and DSM-III-R: an insider's perspective and a belated response to Sadler, Hulgus, and Agich's "On values in recent American psychiatric classification".

    PubMed

    Spitzer, R L

    2001-06-01

    It is widely acknowledged that the approach taken in the development of a classification of mental disorders is guided by various values and assumptions. The author, who played a central role in the development of DSM-III (American Psychiatric Association [1980] Diagnostic and statistical manual of mental disorders, 3rd ed. Washington, DC:Author) and DSM-III-R (American Psychiatric Association [1987] Diagnostic and statistical manual of mental disorders, 3rd ed, rev. Washington, DC:Author) will explicate the basic values and assumptions that guided the development of these two diagnostic manuals. In so doing, the author will respond to the critique of DSM-III and DSM-III-R made by Sadler et al. in their 1994 paper (Sadler JZ, Hulgus YF, Agich GJ [1994] On values in recent American psychiatric classification. JMed Phil 19:261-277). The author will attempt to demonstrate that the stated goals of DSM-III and DSM-III-R are not inherently in conflict and are easily explicated by appealing to widely held values and assumptions, most of which appeared in the literature during the development of the manuals. Furthermore, we will demonstrate that it is not true that DSM-III places greater emphasis on reliability over validity and is covertly committed to a biological approach to explaining psychiatric disturbance.

  8. Measurement Properties and Classification Accuracy of Two Spanish Parent Surveys of Language Development for Preschool-Age Children

    ERIC Educational Resources Information Center

    Guiberson, Mark; Rodriguez, Barbara L.

    2010-01-01

    Purpose: To describe the concurrent validity and classification accuracy of 2 Spanish parent surveys of language development, the Spanish Ages and Stages Questionnaire (ASQ; Squires, Potter, & Bricker, 1999) and the Pilot Inventario-III (Pilot INV-III; Guiberson, 2008a). Method: Forty-eight Spanish-speaking parents of preschool-age children…

  9. Cataract prevalence varies substantially with assessment systems: comparison of clinical and photographic grading in a population-based study.

    PubMed

    Tan, Anna C S; Wang, Jie Jin; Lamoureux, Ecosse L; Wong, Wanling; Mitchell, Paul; Li, Jialiang; Tan, Ava Grace; Wong, Tien Y

    2011-08-01

    Cataract is the major cause of blindness worldwide yet there is no consensus on its assessment and definition. This study compares age-related cataract prevalence derived from two commonly used methods: clinical assessment using the Lens Opacity Classification System (LOCS III) and photographic grading using the Wisconsin Cataract Grading System (Wisconsin System). The Singapore Malay Eye Study is a population-based study of 3,280 Singapore Malays aged 40-80 years. Presence of nuclear, cortical and posterior sub-capsular cataract was assessed clinically during slit-lamp examination using LOCS III, and via slit-lamp and retro-illumination photographic grading using the Wisconsin System. Analyses were conducted to determine agreement in cataract prevalence estimates between the two grading Systems and approaches. Poor agreement was found between severity levels of the two grading scales for all three cataract types. Using currently accepted cut-offs to define nuclear (≥ 4 on both LOCS III and Wisconsin System), cortical (≥ 2 in LOCS III, ≥ 25% in Wisconsin) and PSC (≥ 2 in LOCS III, ≥ 5 % in Wisconsin) cataract, the LOCS III overestimated the prevalence of significant cataract as compared to the Wisconsin System, with nuclear cataract prevalence, 27.5% (LOCS III) versus 17.0% (Wisconsin System), cortical cataract prevalence, 27.9% versus 7.0% and posterior sub-capsular cataract prevalence, 7.8% versus 5.1%. The prevalence of cataract in a population varies substantially by measurement methods, with systematically different estimates found using the two most frequent cataract grading systems. This study re-emphasizes the need for global standards to assess and define cataract for epidemiologic and clinical studies.

  10. Bilateral weighted radiographs are required for accurate classification of acromioclavicular separation: an observational study of 59 cases.

    PubMed

    Ibrahim, E F; Forrest, N P; Forester, A

    2015-10-01

    Misinterpretation of the Rockwood classification system for acromioclavicular joint (ACJ) separations has resulted in a trend towards using unilateral radiographs for grading. Further, the use of weighted views to 'unmask' a grade III injury has fallen out of favour. Recent evidence suggests that many radiographic grade III injuries represent only a partial injury to the stabilising ligaments. This study aimed to determine (1) whether accurate classification is possible on unilateral radiographs and (2) the efficacy of weighted bilateral radiographs in unmasking higher-grade injuries. Complete bilateral non-weighted and weighted sets of radiographs for patients presenting with an acromioclavicular separation over a 10-year period were analysed retrospectively, and they were graded I-VI according to Rockwood's criteria. Comparison was made between grading based on (1) a single antero-posterior (AP) view of the injured side, (2) bilateral non-weighted views and (3) bilateral weighted views. Radiographic measurements for cases that changed grade after weighted views were statistically compared to see if this could have been predicted beforehand. Fifty-nine sets of radiographs on 59 patients (48 male, mean age of 33 years) were included. Compared with unilateral radiographs, non-weighted bilateral comparison films resulted in a grade change for 44 patients (74.5%). Twenty-eight of 56 patients initially graded as I, II or III were upgraded to grade V and two of three initial grade V patients were downgraded to grade III. The addition of a weighted view further upgraded 10 patients to grade V. No grade II injury was changed to grade III and no injury of any severity was downgraded by a weighted view. Grade III injuries upgraded on weighted views had a significantly greater baseline median percentage coracoclavicular distance increase than those that were not upgraded (80.7% vs. 55.4%, p=0.015). However, no cut-off point for this value could be identified to predict an upgrade. The accurate classification of ACJ separation requires weighted bilateral comparative views. Attempts to predict grade on a single AP radiograph result in a gross underestimation of severity. The value of bilateral weighted views is to 'unmask' a grade V injury, and it is recommended as a first-line investigation. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Refining a case-mix measure for nursing homes: Resource Utilization Groups (RUG-III).

    PubMed

    Fries, B E; Schneider, D P; Foley, W J; Gavazzi, M; Burke, R; Cornelius, E

    1994-07-01

    A case-mix classification system for nursing home residents is developed, based on a sample of 7,658 residents in seven states. Data included a broad assessment of resident characteristics, corresponding to items of the Minimum Data Set, and detailed measurement of nursing staff care time over a 24-hour period and therapy staff time over a 1-week period. The Resource Utilization Groups, Version III (RUG-III) system, with 44 distinct groups, achieves 55.5% variance explanation of total (nursing and therapy) per diem cost and meets goals of clinical validity and payment incentives. The mean resource use (case-mix index) of groups spans a nine-fold range. The RUG-III system improves on an earlier version not only by increasing the variance explanation (from 43%), but, more importantly, by identifying residents with "high tech" procedures (e.g., ventilators, respirators, and parenteral feeding) and those with cognitive impairments; by using better multiple activities of daily living; and by providing explicit qualifications for the Medicare nursing home benefit. RUG-III is being implemented for nursing home payment in 11 states (six as part of a federal multistate demonstration) and can be used in management, staffing level determination, and quality assurance.

  12. The use of the decision tree technique and image cytometry to characterize aggressiveness in World Health Organization (WHO) grade II superficial transitional cell carcinomas of the bladder.

    PubMed

    Decaestecker, C; van Velthoven, R; Petein, M; Janssen, T; Salmon, I; Pasteels, J L; van Ham, P; Schulman, C; Kiss, R

    1996-03-01

    The aggressiveness of human bladder tumours can be assessed by means of various classification systems, including the one proposed by the World Health Organization (WHO). According to the WHO classification, three levels of malignancy are identified as grades I (low), II (intermediate), and III (high). This classification system operates satisfactorily for two of the three grades in forecasting clinical progression, most grade I tumours being associated with good prognoses and most grade III with bad. In contrast, the grade II group is very heterogeneous in terms of their clinical behaviour. The present study used two computer-assisted methods to investigate whether it is possible to sub-classify grade II tumours: computer-assisted microscope analysis (image cytometry) of Feulgen-stained nuclei and the Decision Tree Technique. This latter technique belongs to the Supervised Learning Algorithm and enables an objective assessment to be made of the diagnostic value associated with a given parameter. The combined use of these two methods in a series of 292 superficial transitional cell carcinomas shows that it is possible to identify one subgroup of grade II tumours which behave clinically like grade I tumours and a second subgroup which behaves clinically like grade III tumours. Of the nine ploidy-related parameters computed by means of image cytometry [the DNA index (DI), DNA histogram type (DHT), and the percentages of diploid, hyperdiploid, triploid, hypertriploid, tetraploid, hypertetraploid, and polyploid cell nuclei], it was the percentage of hyperdiploid and hypertetraploid cell nuclei which enabled identification, rather than conventional parameters such as the DI or the DHT.

  13. Detecting experimental techniques and selecting relevant documents for protein-protein interactions from biomedical literature.

    PubMed

    Wang, Xinglong; Rak, Rafal; Restificar, Angelo; Nobata, Chikashi; Rupp, C J; Batista-Navarro, Riza Theresa B; Nawaz, Raheel; Ananiadou, Sophia

    2011-10-03

    The selection of relevant articles for curation, and linking those articles to experimental techniques confirming the findings became one of the primary subjects of the recent BioCreative III contest. The contest's Protein-Protein Interaction (PPI) task consisted of two sub-tasks: Article Classification Task (ACT) and Interaction Method Task (IMT). ACT aimed to automatically select relevant documents for PPI curation, whereas the goal of IMT was to recognise the methods used in experiments for identifying the interactions in full-text articles. We proposed and compared several classification-based methods for both tasks, employing rich contextual features as well as features extracted from external knowledge sources. For IMT, a new method that classifies pair-wise relations between every text phrase and candidate interaction method obtained promising results with an F1 score of 64.49%, as tested on the task's development dataset. We also explored ways to combine this new approach and more conventional, multi-label document classification methods. For ACT, our classifiers exploited automatically detected named entities and other linguistic information. The evaluation results on the BioCreative III PPI test datasets showed that our systems were very competitive: one of our IMT methods yielded the best performance among all participants, as measured by F1 score, Matthew's Correlation Coefficient and AUC iP/R; whereas for ACT, our best classifier was ranked second as measured by AUC iP/R, and also competitive according to other metrics. Our novel approach that converts the multi-class, multi-label classification problem to a binary classification problem showed much promise in IMT. Nevertheless, on the test dataset the best performance was achieved by taking the union of the output of this method and that of a multi-class, multi-label document classifier, which indicates that the two types of systems complement each other in terms of recall. For ACT, our system exploited a rich set of features and also obtained encouraging results. We examined the features with respect to their contributions to the classification results, and concluded that contextual words surrounding named entities, as well as the MeSH headings associated with the documents were among the main contributors to the performance.

  14. 14 CFR Section 21 - Introduction to System of Reports

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... classification of large certificated air carriers into Group I, Group II, and Group III with the form and content differentiated as between groups. (d) Each schedule of the prescribed BTS Form 41 Report has been assigned a... U.S. Virgin Islands, and shall also include Canadian transborder operations. The reports to be...

  15. Position Between Trunk and Pelvis During Gait Depending on the Gross Motor Function Classification System.

    PubMed

    Sanz-Mengibar, Jose Manuel; Altschuck, Natalie; Sanchez-de-Muniain, Paloma; Bauer, Christian; Santonja-Medina, Fernando

    2017-04-01

    To understand whether there is a trunk postural control threshold in the sagittal plane for the transition between the Gross Motor Function Classification System (GMFCS) levels measured with 3-dimensional gait analysis. Kinematics from 97 children with spastic bilateral cerebral palsy from spine angles according to Plug-In Gait model (Vicon) were plotted relative to their GMFCS level. Only average and minimum values of the lumbar spine segment correlated with GMFCS levels. Maximal values at loading response correlated independently with age at all functional levels. Average and minimum values were significant when analyzing age in combination with GMFCS level. There are specific postural control patterns in the average and minimum values for the position between trunk and pelvis in the sagittal plane during gait, for the transition among GMFCS I-III levels. Higher classifications of gross motor skills correlate with more extended spine angles.

  16. Management of colorectal trauma: a review.

    PubMed

    Cheong, Ju Yong; Keshava, Anil

    2017-07-01

    Traumatic colorectal injuries are common during times of military conflict, and major improvements in their care have arisen in such periods. Since World War II, many classification systems for colorectal trauma have been proposed, including (i) Flint Grading System; (ii) Penetrating Abdominal Trauma Index; (iii) Colonic/Rectal Injury Scale; and (iv) destructive/non-destructive colonic injuries. The primary goal of these classifications was to aid surgical management and, more particularly, to determine whether a primary repair or faecal diversion should be performed. Primary repair is now the preferred surgical option. Patients who have been identified as having destructive injuries have been found to have higher anastomotic leak rates after a primary repair. Damage control principles need to be adhered to in surgical decision-making. In this review, we discuss the mechanisms of injury, classifications, clinical presentation and current recommendations for the management of colorectal trauma. © 2017 Royal Australasian College of Surgeons.

  17. Five years of experience with the DSM-III system in clinical work and research: some concluding remarks.

    PubMed

    Malt, U

    1986-01-01

    The reliability of the DSM-III is superior to other classification systems available in psychiatry. However, reliability depends on proper knowledge of the system. Some pitfalls reducing reliability of axis 1 diagnosis which commonly are overlooked are discussed. Secondly, some problems of validity of axis 1 and 2 are considered. This is done by discussing the differential diagnosis of organic mental disorders and other psychiatric disorders with concomittant physical dysfunction, and the diagnoses of post-traumatic stress disorders and adjustment disorders among others. The emphasis on health care seeking behaviour as a diagnostic criteria in the DSM-III system, may cause a social, racial and sexual bias in DSM-III diagnoses. The present discussion of the DSM-III system from a clinical point of view indicates the need for validation studies based on clinical experience with the DSM-III. These studies should include more out-patients and patients with psychopathology who do not seek psychiatric treatment. Such studies must also apply alternative diagnostic standards like the ICD-9 and not only rely on structured psychiatric interviews constructed for DSM-III diagnoses. The discussion of axis 4 points to the problem of wanting to combine reliable rating with clinically meaningful information. It is concluded that the most important issue to be settled regarding axis 4 in the future revisions is the aim of including this axis. The discussion of axis 5 concludes that axis 5 is biased toward poor functioning and thus may be less usefull when applied on patients seen outside hospitals. Despite these problems of the DSM-III, our experiences indicate that the use of the DSM-III is fruitful both for the patient, the clinician and the researcher. Thus, the cost of time and effort needed to learn to use the DSM-III properly are small compared to the benefits achieved by using the system.

  18. 32 CFR 2001.12 - Duration of classification.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... classification authority shall follow the sequence listed in paragraphs (a)(1)(i), (ii), and (iii) of this... to the sequence in paragraph (a)(1) of this section are as follows: (i) If an original classification... and shall be designated with the following marking, “50X1-HUM;” or (ii) If an original classification...

  19. 32 CFR 2001.12 - Duration of classification.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... classification authority shall follow the sequence listed in paragraphs (a)(1)(i), (ii), and (iii) of this... to the sequence in paragraph (a)(1) of this section are as follows: (i) If an original classification... and shall be designated with the following marking, “50X1-HUM;” or (ii) If an original classification...

  20. [Classification of enuresis/encopresis according to DSM-5].

    PubMed

    von Gontard, Alexander

    2014-03-01

    Elimination disorders are common in childhood and adolescence. Enuresis is traditionally defined as wetting from the age of 5 years and encopresis as soiling from 4 years onwards - after all organic causes have been excluded. In the past decades, many subtypes of elimination disorders have been identified with different symptoms, etiologies, and specific treatment options. Unfortunately, the DSM-5 criteria did not integrate these new approaches. In contrast, classification systems of the International Children's Incontinence Society (ICCS) for enuresis and urinary incontinence as well as the ROME-III criteria for fecal incontinence offer new and relevant suggestions for both clinical and research purposes.

  1. Application of Classification Methods for Forecasting Mid-Term Power Load Patterns

    NASA Astrophysics Data System (ADS)

    Piao, Minghao; Lee, Heon Gyu; Park, Jin Hyoung; Ryu, Keun Ho

    Currently an automated methodology based on data mining techniques is presented for the prediction of customer load patterns in long duration load profiles. The proposed approach in this paper consists of three stages: (i) data preprocessing: noise or outlier is removed and the continuous attribute-valued features are transformed to discrete values, (ii) cluster analysis: k-means clustering is used to create load pattern classes and the representative load profiles for each class and (iii) classification: we evaluated several supervised learning methods in order to select a suitable prediction method. According to the proposed methodology, power load measured from AMR (automatic meter reading) system, as well as customer indexes, were used as inputs for clustering. The output of clustering was the classification of representative load profiles (or classes). In order to evaluate the result of forecasting load patterns, the several classification methods were applied on a set of high voltage customers of the Korea power system and derived class labels from clustering and other features are used as input to produce classifiers. Lastly, the result of our experiments was presented.

  2. Motor Control of the Lower Extremity Musculature in Children with Cerebral Palsy

    ERIC Educational Resources Information Center

    Arpin, David J.; Stuberg, Wayne; Stergiou, Nicholas; Kurz, Max J.

    2013-01-01

    The aim of this investigation was to quantify the differences in torque steadiness and variability of the muscular control in children with cerebral palsy (CP) and typically developing (TD) children. Fifteen children with CP (age = 14.2 [plus or minus] 0.7 years) that had a Gross Motor Function Classification System (GMFCS) score of I-III and 15…

  3. Rational Rationing: Impossible or Inevitable?

    DTIC Science & Technology

    1993-04-01

    AD-A276 769 1993 Executive Research Project S45 Rational Rationing : Impossible or Inevitable? Commander Albert Benjamin Long, III Medical Service...used until exhausted. SECURITY CLASSIFICATION OF THIS PAGE All other editions are obsolete. UNCLASSIFIED Rational Rationing : Inevitable or Inpossible...dilemma requires that we--as individuals and as a Nation--consciously and rationally decide what we expect from our future health care delivery system and

  4. Classification of patients with low back-related leg pain: a systematic review.

    PubMed

    Stynes, Siobhán; Konstantinou, Kika; Dunn, Kate M

    2016-05-23

    The identification of clinically relevant subgroups of low back pain (LBP) is considered the number one LBP research priority in primary care. One subgroup of LBP patients are those with back related leg pain. Leg pain frequently accompanies LBP and is associated with increased levels of disability and higher health costs than simple low back pain. Distinguishing between different types of low back-related leg pain (LBLP) is important for clinical management and research applications, but there is currently no clear agreement on how to define and identify LBLP due to nerve root involvement. The aim of this systematic review was to identify, describe and appraise papers that classify or subgroup populations with LBLP, and summarise how leg pain due to nerve root involvement is described and diagnosed in the various systems. The search strategy involved nine electronic databases including Medline and Embase, reference lists of eligible studies and relevant reviews. Selected papers were appraised independently by two reviewers using a standardised scoring tool. Of 13,358 initial potential eligible citations, 50 relevant papers were identified that reported on 22 classification systems. Papers were grouped according to purpose and criteria of the classification systems. Five themes emerged: (i) clinical features (ii) pathoanatomy (iii) treatment-based approach (iv) screening tools and prediction rules and (v) pain mechanisms. Three of the twenty two systems focused specifically on LBLP populations. Systems that scored highest following quality appraisal were ones where authors generally included statistical methods to develop their classifications, and supporting work had been published on the systems' validity, reliability and generalisability. There was lack of consistency in how LBLP due to nerve root involvement was described and diagnosed within the systems. Numerous classification systems exist that include patients with leg pain, a minority of them focus specifically on distinguishing between different presentations of leg pain. Further work is needed to identify clinically meaningful subgroups of LBLP patients, ideally based on large primary care cohort populations and using recommended methods for classification system development.

  5. Essential core of the Hawking–Ellis types

    NASA Astrophysics Data System (ADS)

    Martín-Moruno, Prado; Visser, Matt

    2018-06-01

    The Hawking–Ellis (Segre–Plebański) classification of possible stress–energy tensors is an essential tool in analyzing the implications of the Einstein field equations in a more-or-less model-independent manner. In the current article the basic idea is to simplify the Hawking–Ellis type I, II, III, and IV classification by isolating the ‘essential core’ of the type II, type III, and type IV stress–energy tensors; this being done by subtracting (special cases of) type I to simplify the (Lorentz invariant) eigenvalue structure as much as possible without disturbing the eigenvector structure. We will denote these ‘simplified cores’ type II0, type III0, and type IV0. These ‘simplified cores’ have very nice and simple algebraic properties. Furthermore, types I and II0 have very simple classical interpretations, while type IV0 is known to arise semi-classically (in renormalized expectation values of standard stress–energy tensors). In contrast type III0 stands out in that it has neither a simple classical interpretation, nor even a simple semi-classical interpretation. We will also consider the robustness of this classification considering the stability of the different Hawking–Ellis types under perturbations. We argue that types II and III are definitively unstable, whereas types I and IV are stable.

  6. Occlusal Classification in Relation to Original Cleft Width in Patients With Unilateral Cleft Lip and Palate.

    PubMed

    Huang, Andrew H; Patel, Kamlesh B; Maschhoff, Clayton W; Huebener, Donald V; Skolnick, Gary B; Naidoo, Sybill D; Woo, Albert S

    2015-09-01

    To determine a correlation between the width of the cleft palate measured at the time of lip adhesion, definitive lip repair, and palatoplasty and the subsequent occlusal classification of patients born with unilateral cleft lip and palate. Retrospective, observational study. Referral, urban, children's hospital Participants : Dental models and records of 270 patients were analyzed. None. Angle occlusion classification. The mean age at which occlusal classification was determined was 11 ± 0.3 years. Of the children studies, 84 were diagnosed with Class I or II occlusion, 67 were diagnosed with Class III occlusion, and 119 were lost to follow up or transferred care. Mean cleft widths were significantly larger in subjects with Class III occlusion for all measures at time of lip adhesion and definitive lip repair (P < .02). At time of palatoplasty, cleft widths were significantly greater at the alveolus (P = .025) but not at the midportion of the hard palate (P = .35) or posterior hard palate (P = .10). Cleft widths from the lip through to the posterior hard palate are generally greater in children who are diagnosed with Class III occlusion later in life. Notably, the alveolar cleft width is significantly greater at each time point for patients who went on to develop Class III occlusion. There were no significant differences in cleft widths between patients diagnosed later with Class I and Class II occlusions.

  7. Detecting experimental techniques and selecting relevant documents for protein-protein interactions from biomedical literature

    PubMed Central

    2011-01-01

    Background The selection of relevant articles for curation, and linking those articles to experimental techniques confirming the findings became one of the primary subjects of the recent BioCreative III contest. The contest’s Protein-Protein Interaction (PPI) task consisted of two sub-tasks: Article Classification Task (ACT) and Interaction Method Task (IMT). ACT aimed to automatically select relevant documents for PPI curation, whereas the goal of IMT was to recognise the methods used in experiments for identifying the interactions in full-text articles. Results We proposed and compared several classification-based methods for both tasks, employing rich contextual features as well as features extracted from external knowledge sources. For IMT, a new method that classifies pair-wise relations between every text phrase and candidate interaction method obtained promising results with an F1 score of 64.49%, as tested on the task’s development dataset. We also explored ways to combine this new approach and more conventional, multi-label document classification methods. For ACT, our classifiers exploited automatically detected named entities and other linguistic information. The evaluation results on the BioCreative III PPI test datasets showed that our systems were very competitive: one of our IMT methods yielded the best performance among all participants, as measured by F1 score, Matthew’s Correlation Coefficient and AUC iP/R; whereas for ACT, our best classifier was ranked second as measured by AUC iP/R, and also competitive according to other metrics. Conclusions Our novel approach that converts the multi-class, multi-label classification problem to a binary classification problem showed much promise in IMT. Nevertheless, on the test dataset the best performance was achieved by taking the union of the output of this method and that of a multi-class, multi-label document classifier, which indicates that the two types of systems complement each other in terms of recall. For ACT, our system exploited a rich set of features and also obtained encouraging results. We examined the features with respect to their contributions to the classification results, and concluded that contextual words surrounding named entities, as well as the MeSH headings associated with the documents were among the main contributors to the performance. PMID:22151769

  8. Suggestions for Lymph Node Classification of UICC/AJCC Staging System: A Retrospective Study Based on 1197 Nasopharyngeal Carcinoma Patients Treated With Intensity-Modulated Radiation Therapy

    PubMed Central

    Guo, Qiaojuan; Pan, Jianji; Zong, Jingfeng; Zheng, Wei; Zhang, Chun; Tang, Linbo; Chen, Bijuan; Cui, Xiaofei; Xiao, Youping; Chen, Yunbin; Lin, Shaojun

    2015-01-01

    Abstract This article provides suggestions for N classification of Union for International Cancer Control/American Joint Committee on Cancer (UICC/AJCC) staging system of nasopharyngeal carcinoma (NPC), purely based on magnetic resonance imaging (MRI) in intensity-modulated radiation therapy (IMRT) era. A total of 1197 nonmetastatic NPC patients treated with IMRT were enrolled, and all were scanned by MRI at nasopharynx and neck before treatment. MRI-based nodal variables including level, laterality, maximal axial diameter (MAD), extracapsular spread (ECS), and necrosis were analyzed as potential prognostic factors. Modifications of N classification were then proposed and verified. Only nodal level and laterality were considered to be significant variables affecting the treatment outcome. N classification was thus proposed accordingly: N0, no regional lymph node (LN) metastasis; N1, retropharyngeal LNs involvement (regardless of laterality), and/or unilateral levels I, II, III, and/or Va involvement; N2, bilateral levels I, II, III, and/or Va involvement; and N3, levels IV, Vb, and Vc involvement. This proposal showed significant predicting value in multivariate analysis. N3 patients indicated relatively inferior overall survival (OS) and distant metastasis-free survival (DMFS) than N2 patients; however, the difference showed no statistical significance (P = 0.673 and 0.265 for OS and DMFS, respectively), and this was considered to be correlated with the small sample sizes of N3 patients (79 patients, 6.6%). Nodal level and laterality, but not MAD, ECS, and necrosis, were considered to be significant predicting factors for NPC. The proposed N classification was proved to be powerfully predictive in our cohort; however, treatment outcome of the proposed N2 and N3 patients could not differ significantly from each other. This insignificance may be because of the small sample sizes of N3 patients. Our results are based on a single-center data, to develop a new N classification that is universally acceptable; further verification by data from multicenter is warranted. PMID:25997052

  9. Health information management: an introduction to disease classification and coding.

    PubMed

    Mony, Prem Kumar; Nagaraj, C

    2007-01-01

    Morbidity and mortality data constitute an important component of a health information system and their coding enables uniform data collation and analysis as well as meaningful comparisons between regions or countries. Strengthening the recording and reporting systems for health monitoring is a basic requirement for an efficient health information management system. Increased advocacy for and awareness of a uniform coding system together with adequate capacity building of physicians, coders and other allied health and information technology personnel would pave the way for a valid and reliable health information management system in India. The core requirements for the implementation of disease coding are: (i) support from national/institutional health administrators, (ii) widespread availability of the ICD-10 material for morbidity and mortality coding; (iii) enhanced human and financial resources; and (iv) optimal use of informatics. We describe the methodology of a disease classification and codification system as also its applications for developing and maintaining an effective health information management system for India.

  10. Sexual orientation and gender identity: review of concepts, controversies and their relation to psychopathology classification systems

    PubMed Central

    Moleiro, Carla; Pinto, Nuno

    2015-01-01

    Numerous controversies and debates have taken place throughout the history of psychopathology (and its main classification systems) with regards to sexual orientation and gender identity. These are still reflected on present reformulations of gender dysphoria in both the Diagnostic and Statistical Manual and the International Classification of Diseases, and in more or less subtle micro-aggressions experienced by lesbian, gay, bisexual and trans patients in mental health care. The present paper critically reviews this history and current controversies. It reveals that this deeply complex field contributes (i) to the reflection on the very concept of mental illness; (ii) to the focus on subjective distress and person-centered experience of psychopathology; and (iii) to the recognition of stigma and discrimination as significant intervening variables. Finally, it argues that sexual orientation and gender identity have been viewed, in the history of the field of psychopathology, between two poles: gender transgression and gender variance/fluidity. PMID:26483748

  11. The role of identity in the DSM-5 classification of personality disorders

    PubMed Central

    2013-01-01

    In the revised Diagnostic and Statistical Manual DSM-5 the definition of personality disorder diagnoses has not been changed from that in the DSM-IV-TR. However, an alternative model for diagnosing personality disorders where the construct “identity” has been integrated as a central diagnostic criterion for personality disorders has been placed in section III of the manual. The alternative model’s hybrid nature leads to the simultaneous use of diagnoses and the newly developed “Level of Personality Functioning-Scale” (a dimensional tool to define the severity of the disorder). Pathological personality traits are assessed in five broad domains which are divided into 25 trait facets. With this dimensional approach, the new classification system gives, both clinicians and researchers, the opportunity to describe the patient in much more detail than previously possible. The relevance of identity problems in assessing and understanding personality pathology is illustrated using the new classification system applied in two case examples of adolescents with a severe personality disorder. PMID:23902698

  12. The role of identity in the DSM-5 classification of personality disorders.

    PubMed

    Schmeck, Klaus; Schlüter-Müller, Susanne; Foelsch, Pamela A; Doering, Stephan

    2013-07-31

    In the revised Diagnostic and Statistical Manual DSM-5 the definition of personality disorder diagnoses has not been changed from that in the DSM-IV-TR. However, an alternative model for diagnosing personality disorders where the construct "identity" has been integrated as a central diagnostic criterion for personality disorders has been placed in section III of the manual. The alternative model's hybrid nature leads to the simultaneous use of diagnoses and the newly developed "Level of Personality Functioning-Scale" (a dimensional tool to define the severity of the disorder). Pathological personality traits are assessed in five broad domains which are divided into 25 trait facets. With this dimensional approach, the new classification system gives, both clinicians and researchers, the opportunity to describe the patient in much more detail than previously possible. The relevance of identity problems in assessing and understanding personality pathology is illustrated using the new classification system applied in two case examples of adolescents with a severe personality disorder.

  13. Sexual orientation and gender identity: review of concepts, controversies and their relation to psychopathology classification systems.

    PubMed

    Moleiro, Carla; Pinto, Nuno

    2015-01-01

    Numerous controversies and debates have taken place throughout the history of psychopathology (and its main classification systems) with regards to sexual orientation and gender identity. These are still reflected on present reformulations of gender dysphoria in both the Diagnostic and Statistical Manual and the International Classification of Diseases, and in more or less subtle micro-aggressions experienced by lesbian, gay, bisexual and trans patients in mental health care. The present paper critically reviews this history and current controversies. It reveals that this deeply complex field contributes (i) to the reflection on the very concept of mental illness; (ii) to the focus on subjective distress and person-centered experience of psychopathology; and (iii) to the recognition of stigma and discrimination as significant intervening variables. Finally, it argues that sexual orientation and gender identity have been viewed, in the history of the field of psychopathology, between two poles: gender transgression and gender variance/fluidity.

  14. Prognostic value of computed tomography classification systems for intra-articular calcaneus fractures.

    PubMed

    Swords, Michael P; Alton, Timothy B; Holt, Sarah; Sangeorzan, Bruce J; Shank, John R; Benirschke, Stephen K

    2014-10-01

    There are several published computed tomography (CT) classification systems for calcaneus fractures, each validated by a different standard. The goal of this study was to measure which system would best predict clinical outcomes as measured by a widely used and validated musculoskeletal health status questionnaire. Forty-nine patients with isolated intra-articular joint depression calcaneus fractures more than 2 years after treatment were identified. All had preoperative CT studies and were treated with open reduction and plate fixation using a lateral extensile approach. Four different blinded reviewers classified injuries according to the CT classification systems of Crosby and Fitzgibbons, Eastwood, and Sanders. Functional outcomes evaluated with a Musculoskeletal Functional Assessment (MFA). The mean follow-up was 4.3 years. The mean MFA score was 15.7 (SD = 11.6), which is not significantly different from published values for midfoot injuries, hindfoot injuries, or both, 1 year after injury (mean = 22.1, SD = 18.4). The classification systems of Crosby and Fitzgibbons, Eastwood, and Sanders, the number of fragments of the posterior facet, and payer status were not significantly associated with outcome as determined by the MFA. The Sanders classification trended toward significance. Anterior process comminution and surgeon's overall impression of severity were significantly associated with functional outcome. The amount of anterior process comminution was an important determinant of functional outcome with increasing anterior process comminution significantly associated with worsened functional outcome (P = .04). In addition, the surgeon's overall impression of severity of injury was predictive of functional outcome (P = .02), as determined by MFA. Level III, comparative series. © The Author(s) 2014.

  15. A developmental and genetic classification for midbrain-hindbrain malformations

    PubMed Central

    Millen, Kathleen J.; Dobyns, William B.

    2009-01-01

    Advances in neuroimaging, developmental biology and molecular genetics have increased the understanding of developmental disorders affecting the midbrain and hindbrain, both as isolated anomalies and as part of larger malformation syndromes. However, the understanding of these malformations and their relationships with other malformations, within the central nervous system and in the rest of the body, remains limited. A new classification system is proposed, based wherever possible, upon embryology and genetics. Proposed categories include: (i) malformations secondary to early anteroposterior and dorsoventral patterning defects, or to misspecification of mid-hindbrain germinal zones; (ii) malformations associated with later generalized developmental disorders that significantly affect the brainstem and cerebellum (and have a pathogenesis that is at least partly understood); (iii) localized brain malformations that significantly affect the brain stem and cerebellum (pathogenesis partly or largely understood, includes local proliferation, cell specification, migration and axonal guidance); and (iv) combined hypoplasia and atrophy of putative prenatal onset degenerative disorders. Pertinent embryology is discussed and the classification is justified. This classification will prove useful for both physicians who diagnose and treat patients with these disorders and for clinical scientists who wish to understand better the perturbations of developmental processes that produce them. Importantly, both the classification and its framework remain flexible enough to be easily modified when new embryologic processes are described or new malformations discovered. PMID:19933510

  16. Correlation of the New York Heart Association Classification and the 6-Minute Walk Distance: A Systematic Review.

    PubMed

    Yap, Jonathan; Lim, Fang Yi; Gao, Fei; Teo, Ling Li; Lam, Carolyn Su Ping; Yeo, Khung Keong

    2015-10-01

    Functional status assessment is the cornerstone of heart failure management and trials. The New York Heart Association (NYHA) classification and 6-minute walk distance (6MWD) are commonly used tools; however, the correlation between them is not well understood. We hypothesised that the relationship between the NYHA classification and 6MWD might vary across studies. A systematic literature search was performed to identify all studies reporting both NYHA class and 6MWD. Two reviewers independently assessed study eligibility and extracted data. Thirty-seven studies involving 5678 patients were included. There was significant heterogeneity across studies in 6MWD within all NYHA classes: I (n = 16, Q = 934.2; P < 0.001), II (n = 25, Q = 1658.3; P < 0.001), III (n = 30, Q = 1020.1; P < 0.001), and IV (n = 6, Q = 335.5; P < 0.001). There was no significant difference in average 6MWD between NYHA I and II (420 m vs 393 m; P = 0.416). There was a significant difference in average 6MWD between NYHA II and III (393 m vs 321 m; P = 0.014) and III and IV (321 m vs 224 m; P = 0.027). This remained significant after adjusting for region of study, age, and sex. Although there is an inverse correlation between NYHA II-IV and 6MWD, there is significant heterogeneity across studies in 6MWD within each NYHA class and overlap in 6MWD between NYHA I and II. The NYHA classification performs well in more symptomatic patients (NYHA III/IV) but less so in asymptomatic/mildly symptomatic patients (NYHA I/II). Nonetheless, the NYHA classification is an easily applied first-line tool in everyday clinical practice, but its potential subjectivity should be considered when performing comparisons across studies. © 2015 Wiley Periodicals, Inc.

  17. Diagnostic depressive symptoms of the mixed bipolar episode.

    PubMed

    Cassidy, F; Ahearn, E; Murry, E; Forest, K; Carroll, B J

    2000-03-01

    There is not yet consensus on the best diagnostic definition of mixed bipolar episodes. Many have suggested the DSM-III-R/-IV definition is too rigid. We propose alternative criteria using data from a large patient cohort. We evaluated 237 manic in-patients using DSM-III-R criteria and the Scale for Manic States (SMS). A bimodally distributed factor of dysphoric mood has been reported from the SMS data. We used both the factor and the DSM-III-R classifications to identify candidate depressive symptoms and then developed three candidate depressive symptom sets. Using ROC analysis we determined the optimal threshold number of symptoms in each set and compared the three ROC solutions. The optimal solution was tested against the DSM-III-R classification for crossvalidation. The optimal ROC solution was a set, derived from both the DSM-III-R and the SMS, and the optimal threshold for diagnosis was two or more symptoms. Applying this set iteratively to the DSM-III-R classification produced the identical ROC solution. The prevalence of mixed episodes in the cohort was 13.9% by DSM-III-R, 20.2% by the dysphoria factor and 27.4% by the new ROC solution. A diagnostic set of six dysphoric symptoms (depressed mood, anhedonia, guilt, suicide, fatigue and anxiety), with a threshold of two symptoms, is proposed for a mixed episode. This new definition has a foundation in clinical data, in the proved diagnostic performance of the qualifying symptoms, and in ROC validation against two previous definitions that each have face validity.

  18. Determination of Classification Accuracy for Land Use/cover Types Using Landsat-Tm Spot-Mss and Multipolarized and Multi-Channel Synthetic Aperture Radar

    NASA Astrophysics Data System (ADS)

    Dondurur, Mehmet

    The primary objective of this study was to determine the degree to which modern SAR systems can be used to obtain information about the Earth's vegetative resources. Information obtainable from microwave synthetic aperture radar (SAR) data was compared with that obtainable from LANDSAT-TM and SPOT data. Three hypotheses were tested: (a) Classification of land cover/use from SAR data can be accomplished on a pixel-by-pixel basis with the same overall accuracy as from LANDSAT-TM and SPOT data. (b) Classification accuracy for individual land cover/use classes will differ between sensors. (c) Combining information derived from optical and SAR data into an integrated monitoring system will improve overall and individual land cover/use class accuracies. The study was conducted with three data sets for the Sleeping Bear Dunes test site in the northwestern part of Michigan's lower peninsula, including an October 1982 LANDSAT-TM scene, a June 1989 SPOT scene and C-, L- and P-Band radar data from the Jet Propulsion Laboratory AIRSAR. Reference data were derived from the Michigan Resource Information System (MIRIS) and available color infrared aerial photos. Classification and rectification of data sets were done using ERDAS Image Processing Programs. Classification algorithms included Maximum Likelihood, Mahalanobis Distance, Minimum Spectral Distance, ISODATA, Parallelepiped, and Sequential Cluster Analysis. Classified images were rectified as necessary so that all were at the same scale and oriented north-up. Results were analyzed with contingency tables and percent correctly classified (PCC) and Cohen's Kappa (CK) as accuracy indices using CSLANT and ImagePro programs developed for this study. Accuracy analyses were based upon a 1.4 by 6.5 km area with its long axis east-west. Reference data for this subscene total 55,770 15 by 15 m pixels with sixteen cover types, including seven level III forest classes, three level III urban classes, two level II range classes, two water classes, one wetland class and one agriculture class. An initial analysis was made without correcting the 1978 MIRIS reference data to the different dates of the TM, SPOT and SAR data sets. In this analysis, highest overall classification accuracy (PCC) was 87% with the TM data set, with both SPOT and C-Band SAR at 85%, a difference statistically significant at the 0.05 level. When the reference data were corrected for land cover change between 1978 and 1991, classification accuracy with the C-Band SAR data increased to 87%. Classification accuracy differed from sensor to sensor for individual land cover classes, Combining sensors into hypothetical multi-sensor systems resulted in higher accuracies than for any single sensor. Combining LANDSAT -TM and C-Band SAR yielded an overall classification accuracy (PCC) of 92%. The results of this study indicate that C-Band SAR data provide an acceptable substitute for LANDSAT-TM or SPOT data when land cover information is desired of areas where cloud cover obscures the terrain. Even better results can be obtained by integrating TM and C-Band SAR data into a multi-sensor system.

  19. A Biochar Classification System and Associated Test Methods

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Camps-Arbestain, Marta; Amonette, James E.; Singh, Balwant

    2015-02-18

    In this chapter, a biochar classification system related to its use as soil amendment is proposed. This document builds upon previous work and constrains its scope to materials with properties that satisfy the criteria for biochar as defined by either the International Biochar Initiative (IBI) Biochar Standards or the European Biochar Community (EBC) Standards, and it is intended to minimise the need for testing in addition to those required according to the above-mentioned standards. The classification system envisions enabling stakeholders and commercial entities to (i) identify the most suitable biochar to fulfil the requirements for a particular soil and/or land-use,more » and (ii) distinguish the application of biochar for specific niches (e.g., soilless agriculture). It is based on the best current knowledge and the intention is to periodically review and update the document based on new data and knowledge that become available in the scientific literature. The main thrust of this classification system is based on the direct or indirect beneficial effects that biochar provides from its application to soil. We have classified the potential beneficial effects of biochar application to soils into five categories with their corresponding classes, where applicable: (i) carbon (C) storage value, (ii) fertiliser value, (iii) liming value, (iv) particle-size, and (v) use in soil-less agriculture. A summary of recommended test methods is provided at the end of the chapter.« less

  20. How Well Do Molecular and Pedigree Relatedness Correspond, in Populations with Diverse Mating Systems, and Various Types and Quantities of Molecular and Demographic Data?

    PubMed

    Kopps, Anna M; Kang, Jungkoo; Sherwin, William B; Palsbøll, Per J

    2015-06-30

    Kinship analyses are important pillars of ecological and conservation genetic studies with potentially far-reaching implications. There is a need for power analyses that address a range of possible relationships. Nevertheless, such analyses are rarely applied, and studies that use genetic-data-based-kinship inference often ignore the influence of intrinsic population characteristics. We investigated 11 questions regarding the correct classification rate of dyads to relatedness categories (relatedness category assignments; RCA) using an individual-based model with realistic life history parameters. We investigated the effects of the number of genetic markers; marker type (microsatellite, single nucleotide polymorphism SNP, or both); minor allele frequency; typing error; mating system; and the number of overlapping generations under different demographic conditions. We found that (i) an increasing number of genetic markers increased the correct classification rate of the RCA so that up to >80% first cousins can be correctly assigned; (ii) the minimum number of genetic markers required for assignments with 80 and 95% correct classifications differed between relatedness categories, mating systems, and the number of overlapping generations; (iii) the correct classification rate was improved by adding additional relatedness categories and age and mitochondrial DNA data; and (iv) a combination of microsatellite and single-nucleotide polymorphism data increased the correct classification rate if <800 SNP loci were available. This study shows how intrinsic population characteristics, such as mating system and the number of overlapping generations, life history traits, and genetic marker characteristics, can influence the correct classification rate of an RCA study. Therefore, species-specific power analyses are essential for empirical studies. Copyright © 2015 Kopps et al.

  1. Validation of the Japanese disease severity classification and the GAP model in Japanese patients with idiopathic pulmonary fibrosis.

    PubMed

    Kondoh, Shun; Chiba, Hirofumi; Nishikiori, Hirotaka; Umeda, Yasuaki; Kuronuma, Koji; Otsuka, Mitsuo; Yamada, Gen; Ohnishi, Hirofumi; Mori, Mitsuru; Kondoh, Yasuhiro; Taniguchi, Hiroyuki; Homma, Sakae; Takahashi, Hiroki

    2016-09-01

    The clinical course of idiopathic pulmonary fibrosis (IPF) shows great inter-individual differences. It is important to standardize the severity classification to accurately evaluate each patient׳s prognosis. In Japan, an original severity classification (the Japanese disease severity classification, JSC) is used. In the United States, the new multidimensional index and staging system (the GAP model) has been proposed. The objective of this study was to evaluate the model performance for the prediction of mortality risk of the JSC and GAP models using a large cohort of Japanese patients with IPF. This is a retrospective cohort study including 326 patients with IPF in the Hokkaido prefecture from 2003 to 2007. We obtained the survival curves of each stage of the GAP and JSC models to perform a comparison. In the GAP model, the prognostic value for mortality risk of Japanese patients was also evaluated. In the JSC, patient prognoses were roughly divided into two groups, mild cases (Stages I and II) and severe cases (Stages III and IV). In the GAP model, there was no significant difference in survival between Stages II and III, and the mortality rates in the patients classified into the GAP Stages I and II were underestimated. It is difficult to predict accurate prognosis of IPF using the JSC and the GAP models. A re-examination of the variables from the two models is required, as well as an evaluation of the prognostic value to revise the severity classification for Japanese patients with IPF. Copyright © 2016 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

  2. Ambulatory Activity of Children with Cerebral Palsy: Which Characteristics Are Important?

    ERIC Educational Resources Information Center

    van Wely, Leontien; Becher, Jules G.; Balemans, Astrid C. J.; Dallmeijer, Annet J.

    2012-01-01

    Aim: To assess ambulatory activity of children with cerebral palsy (CP), aged 7 to 13 years, and identify associated characteristics. Method: Sixty-two children with spastic CP (39 males, 23 females; mean age 10y 1mo, SD 1y 8mo; age range 7-13y), classified as Gross Motor Function Classification System (GMFCS) levels I to III, participated.…

  3. Diagnosis and treatment of dyspeptic patients in Japan.

    PubMed

    Manabe, Noriaki; Haruma, Ken

    2011-04-01

    Although functional gastrointestinal (GI) disorders has been paid more attention recently in Japan, similar to Western countries, the clinical characteristics of dyspeptic patients, current diagnostic approach to dyspeptic patients and current standard treatments for dyspeptic patients are not well known in Japan. This review, in the most part, summarizes two topics about Japanese dyspeptic patients. The first topic is the pros and cons of the diagnosis of Japanese dyspeptic patients using Rome III classification on the basis of our data and the second topic deals with standard treatments for dyspeptic patients-especially by primary care doctors in Japan. We conducted a PubMed search using the following key words alone or in combination: functional dyspepsia (FD), medical treatment, Rome III classification and Japanese. The Rome III classification for FD does not adequately identify a large proportion of Japanese dyspeptic patients, primarily due to their earlier presentation for medical evaluation. There are many kinds of options for the treatment of FD in Japan: proton-pump inhibitors, histamine H(2) receptor antagonists, mucoprotective agents, Japanese traditional herbal medicines, Helicobacter pylori eradication therapy and prokinetics. Under the current situation, Japanese primary care doctors choose drugs according to each subtype of FD, which means that they prescribe medicine according to the pathogenesis of each patient. While the Rome III classification seems logical, some aspects need further evaluation for Japanese dyspeptic patients. Japanese primary care doctors choose drugs appropriately based on the pathogenesis of FD. However, efforts to further elucidate underlying pathophysiologic mechanisms and identify the appropriate patient population using modified Rome classification will be required. © 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.

  4. User’s Guide for SHIPINT - A Computer Program to Compute Two Ship Interaction in Waves

    DTIC Science & Technology

    1996-08-01

    P500693.PDF [Page: 1 of 84] Image Cover Sheet CLASSIFICATION SYSTEM NUMBER 500693 UNCLASSIFIED I llllll 111111111111111111111111111111111 TITLE...Halifax, Nova Scotia, Canada B3J 2X4 1 ---------· CONTRACTOR REPORT I I I I I iii;,"’: · 1 Defence Research Establishment Atlantic Canada...SUMMARY 1 Introduction 2 Coordinate Systems and Two Ship Motions 3 Flow Chart 4 Input Data File Description 4.1 shipint.in ........ . 4.2 paneLa.in

  5. Spinal Cord Injury Impairs Cardiovascular Capacity in Elite Wheelchair Rugby Athletes.

    PubMed

    Gee, Cameron M; Currie, Katharine D; Phillips, Aaron A; Squair, Jordan W; Krassioukov, Andrei V

    2017-12-19

    To examine differences in heart rate (HR) responses during international wheelchair rugby competition between athletes with and without a cervical spinal cord injury (SCI) and across standardized sport classifications. Observational study. The 2015 Parapan American Games wheelchair rugby competition. Forty-three male athletes (31 ± 8 years) with a cervical SCI (n = 32) or tetraequivalent impairment (non-SCI, n = 11). Average and peak HR (HRavg and HRpeak, respectively). To characterize HR responses in accordance with an athletes' International Wheelchair Rugby Federation (IWRF) classification, we separated athletes into 3 groups: group I (IWRF classification 0.5-1.5, n = 15); group II (IWRF classification 2.0, n = 15); and group III (IWRF classification 2.5-3.5, n = 13). Athletes with SCI had lower HRavg (111 ± 14 bpm vs 155 ± 13 bpm) and HRpeak (133 ± 12 bpm vs 178 ± 13 bpm) compared with non-SCI (both P < 0.001). Average HR was higher in group III than in I (136 ± 25 bpm vs 115 ± 20 bpm, P = 0.045); however, SCI athletes showed no difference in HRavg or HRpeak between groups. Within group III, SCI athletes had lower HRavg (115 ± 6 bpm vs 160 ± 8 bpm) and HRpeak (135 ± 11 bpm vs 183 ± 11 bpm) than non-SCI athletes (both P < 0.001). This study is the first to demonstrate attenuated HR responses during competition in SCI compared with non-SCI athletes, likely due to injury to spinal autonomic pathways. Among athletes with SCI, IWRF classification was not related to differences in HR. Specific assessment of autonomic function after SCI may be able to predict HR during competition and consideration of autonomic impairments may improve the classification process.

  6. 76 FR 68767 - Draft Guidance for Industry and Food and Drug Administration Staff; De Novo Classification...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-07

    ... and Radiological Health (CDRH) guidance documents is available at http://www.fda.gov/MedicalDevices... ``De Novo Classification Process (Evaluation of Automatic Class III Designation)'' from CDRH you may...

  7. Incremental Validity of the DSM-5 Section III Personality Disorder Traits With Respect to Psychosocial Impairment.

    PubMed

    Simms, Leonard J; Calabrese, William R

    2016-02-01

    Traditional personality disorders (PDs) are associated with significant psychosocial impairment. DSM-5 Section III includes an alternative hybrid personality disorder (PD) classification approach, with both type and trait elements, but relatively little is known about the impairments associated with Section III traits. Our objective was to study the incremental validity of Section III traits--compared to normal-range traits, traditional PD criterion counts, and common psychiatric symptomatology--in predicting psychosocial impairment. To that end, 628 current/recent psychiatric patients completed measures of PD traits, normal-range traits, traditional PD criteria, psychiatric symptomatology, and psychosocial impairments. Hierarchical regressions revealed that Section III PD traits incrementally predicted psychosocial impairment over normal-range personality traits, PD criterion counts, and common psychiatric symptomatology. In contrast, the incremental effects for normal-range traits, PD symptom counts, and common psychiatric symptomatology were substantially smaller than for PD traits. These findings have implications for PD classification and the impairment literature more generally.

  8. Classification of upper limb disability levels of children with spastic unilateral cerebral palsy using K-means algorithm.

    PubMed

    Raouafi, Sana; Achiche, Sofiane; Begon, Mickael; Sarcher, Aurélie; Raison, Maxime

    2018-01-01

    Treatment for cerebral palsy depends upon the severity of the child's condition and requires knowledge about upper limb disability. The aim of this study was to develop a systematic quantitative classification method of the upper limb disability levels for children with spastic unilateral cerebral palsy based on upper limb movements and muscle activation. Thirteen children with spastic unilateral cerebral palsy and six typically developing children participated in this study. Patients were matched on age and manual ability classification system levels I to III. Twenty-three kinematic and electromyographic variables were collected from two tasks. Discriminative analysis and K-means clustering algorithm were applied using 23 kinematic and EMG variables of each participant. Among the 23 kinematic and electromyographic variables, only two variables containing the most relevant information for the prediction of the four levels of severity of spastic unilateral cerebral palsy, which are fixed by manual ability classification system, were identified by discriminant analysis: (1) the Falconer index (CAI E ) which represents the ratio of biceps to triceps brachii activity during extension and (2) the maximal angle extension (θ Extension,max ). A good correlation (Kendall Rank correlation coefficient = -0.53, p = 0.01) was found between levels fixed by manual ability classification system and the obtained classes. These findings suggest that the cost and effort needed to assess and characterize the disability level of a child can be further reduced.

  9. Relationships between aerodynamic roughness and land use and land cover in Baltimore, Maryland

    USGS Publications Warehouse

    Nicholas, F.W.; Lewis, J.E.

    1980-01-01

    Urbanization changes the radiative, thermal, hydrologic, and aerodynamic properties of the Earth's surface. Knowledge of these surface characteristics, therefore, is essential to urban climate analysis. Aerodynamic or surface roughness of urban areas is not well documented, however, because of practical constraints in measuring the wind profile in the presence of large buildings. Using an empirical method designed by Lettau, and an analysis of variance of surface roughness values calculated for 324 samples averaging 0.8 hectare (ha) of land use and land cover sample in Baltimore, Md., a strong statistical relation was found between aerodynamic roughness and urban land use and land cover types. Assessment of three land use and land cover systems indicates that some of these types have significantly different surface roughness characteristics. The tests further indicate that statistically significant differences exist in estimated surface roughness values when categories (classes) from different land use and land cover classification systems are used as surrogates. A Level III extension of the U.S. Geological Survey Level II land use and land cover classification system provided the most reliable results. An evaluation of the physical association between the aerodynamic properties of land use and land cover and the surface climate by numerical simulation of the surface energy balance indicates that changes in surface roughness within the range of values typical of the Level III categories induce important changes in the surface climate.

  10. The ESHRE/ESGE consensus on the classification of female genital tract congenital anomalies.

    PubMed

    Grimbizis, Grigoris F; Gordts, Stephan; Di Spiezio Sardo, Attilio; Brucker, Sara; De Angelis, Carlo; Gergolet, Marco; Li, Tin-Chiu; Tanos, Vasilios; Brölmann, Hans; Gianaroli, Luca; Campo, Rudi

    2013-08-01

    What classification system is more suitable for the accurate, clear, simple and related to the clinical management categorization of female genital anomalies? The new ESHRE/ESGE classification system of female genital anomalies is presented. Congenital malformations of the female genital tract are common miscellaneous deviations from normal anatomy with health and reproductive consequences. Until now, three systems have been proposed for their categorization but all of them are associated with serious limitations. The European Society of Human Reproduction and Embryology (ESHRE) and the European Society for Gynaecological Endoscopy (ESGE) have established a common Working Group, under the name CONUTA (CONgenital UTerine Anomalies), with the goal of developing a new updated classification system. A scientific committee (SC) has been appointed to run the project, looking also for consensus within the scientists working in the field. The new system is designed and developed based on (i) scientific research through critical review of current proposals and preparation of an initial proposal for discussion between the experts, (ii) consensus measurement among the experts through the use of the DELPHI procedure and (iii) consensus development by the SC, taking into account the results of the DELPHI procedure and the comments of the experts. Almost 90 participants took part in the process of development of the ESHRE/ESGE classification system, contributing with their structured answers and comments. The ESHRE/ESGE classification system is based on anatomy. Anomalies are classified into the following main classes, expressing uterine anatomical deviations deriving from the same embryological origin: U0, normal uterus; U1, dysmorphic uterus; U2, septate uterus; U3, bicorporeal uterus; U4, hemi-uterus; U5, aplastic uterus; U6, for still unclassified cases. Main classes have been divided into sub-classes expressing anatomical varieties with clinical significance. Cervical and vaginal anomalies are classified independently into sub-classes having clinical significance. The ESHRE/ESGE classification of female genital anomalies seems to fulfill the expectations and the needs of the experts in the field, but its clinical value needs to be proved in everyday practice. The ESHRE/ESGE classification system of female genital anomalies could be used as a starting point for the development of guidelines for their diagnosis and treatment. None.

  11. Terrain Perception for DEMO III

    NASA Technical Reports Server (NTRS)

    Manduchi, R.; Bellutta, P.; Matthies, L.; Owens, K.; Rankin, A.

    2000-01-01

    The Demo III program has as its primary focus the development of autonomous mobility for a small rugged cross country vehicle. In this paper we report recent progress on both stereo-based obstacle detection and terrain cover color-based classification.

  12. A comparison of DSM-III-R and ICD-10 personality disorder criteria in an out-patient population.

    PubMed

    Sara, G; Raven, P; Mann, A

    1996-01-01

    This study reports the results of a comparison of DSM-III-R and ICD-10 personality disorder criteria by application of both sets of criteria to the same group of patients. Despite the clinical relevance of these disorders and the need for reliable diagnostic criteria, such a comparison has not previously been reported. DSM-III-R and ICD-10 have converged in their classification of personality disorders, but some important differences between the two systems remain. Personality disorder diagnoses from both systems were obtained in 52 out-patients, using the Standardized Assessment of Personality (SAP), a brief, informant-based interview which yields diagnoses in both DSM-III-R and ICD-10. For individual personality disorder diagnoses, agreement between systems was limited. Thirty-four subjects received a personality disorder diagnosis that had an equivalent form in both systems, but only 10 subjects (29%) received the same primary diagnosis in each system. There was a difference in rate of diagnosis, with ICD-10 making significantly more personality disorder diagnoses. The lower diagnostic threshold of the ICD-10 contributed most of this effect. Further modifications in ICD-10 Diagnostic Criteria for Research (DCR) and DSM-IV to the personality disorder category have been considered. The omission in DSM-IV of three categories unique to that system and the raising of the threshold in ICD-10 DCR, do seem to have been helpful in promoting convergence.

  13. Improving Generalization Based on l1-Norm Regularization for EEG-Based Motor Imagery Classification

    PubMed Central

    Zhao, Yuwei; Han, Jiuqi; Chen, Yushu; Sun, Hongji; Chen, Jiayun; Ke, Ang; Han, Yao; Zhang, Peng; Zhang, Yi; Zhou, Jin; Wang, Changyong

    2018-01-01

    Multichannel electroencephalography (EEG) is widely used in typical brain-computer interface (BCI) systems. In general, a number of parameters are essential for a EEG classification algorithm due to redundant features involved in EEG signals. However, the generalization of the EEG method is often adversely affected by the model complexity, considerably coherent with its number of undetermined parameters, further leading to heavy overfitting. To decrease the complexity and improve the generalization of EEG method, we present a novel l1-norm-based approach to combine the decision value obtained from each EEG channel directly. By extracting the information from different channels on independent frequency bands (FB) with l1-norm regularization, the method proposed fits the training data with much less parameters compared to common spatial pattern (CSP) methods in order to reduce overfitting. Moreover, an effective and efficient solution to minimize the optimization object is proposed. The experimental results on dataset IVa of BCI competition III and dataset I of BCI competition IV show that, the proposed method contributes to high classification accuracy and increases generalization performance for the classification of MI EEG. As the training set ratio decreases from 80 to 20%, the average classification accuracy on the two datasets changes from 85.86 and 86.13% to 84.81 and 76.59%, respectively. The classification performance and generalization of the proposed method contribute to the practical application of MI based BCI systems. PMID:29867307

  14. Cognitive context detection in UAS operators using eye-gaze patterns on computer screens

    NASA Astrophysics Data System (ADS)

    Mannaru, Pujitha; Balasingam, Balakumar; Pattipati, Krishna; Sibley, Ciara; Coyne, Joseph

    2016-05-01

    In this paper, we demonstrate the use of eye-gaze metrics of unmanned aerial systems (UAS) operators as effective indices of their cognitive workload. Our analyses are based on an experiment where twenty participants performed pre-scripted UAS missions of three different difficulty levels by interacting with two custom designed graphical user interfaces (GUIs) that are displayed side by side. First, we compute several eye-gaze metrics, traditional eye movement metrics as well as newly proposed ones, and analyze their effectiveness as cognitive classifiers. Most of the eye-gaze metrics are computed by dividing the computer screen into "cells". Then, we perform several analyses in order to select metrics for effective cognitive context classification related to our specific application; the objective of these analyses are to (i) identify appropriate ways to divide the screen into cells; (ii) select appropriate metrics for training and classification of cognitive features; and (iii) identify a suitable classification method.

  15. Quality of Life and Health-Related Quality of Life of Adolescents with Cerebral Palsy

    ERIC Educational Resources Information Center

    Rosenbaum, Peter L.; Livingston, Michael H.; Palisano, Robert J.; Galuppi, Barbara E.; Russell, Dianne J.

    2007-01-01

    This study assessed quality of life (QOL) and health-related quality of life (HRQOL) of 203 adolescents with cerebral palsy (111 males, 92 females; mean age 16y [SD 1y 9mo]). Participants were classified using the Gross Motor Function Classification System (GMFCS), as Level I (n=60), Level II (n=33), Level III (n=28), Level IV (n=50), or Level V…

  16. Acromioclavicular joint dislocations: radiological correlation between Rockwood classification system and injury patterns in human cadaver species.

    PubMed

    Eschler, Anica; Rösler, Klaus; Rotter, Robert; Gradl, Georg; Mittlmeier, Thomas; Gierer, Philip

    2014-09-01

    The classification system of Rockwood and Young is a commonly used classification for acromioclavicular joint separations subdividing types I-VI. This classification hypothesizes specific lesions to anatomical structures (acromioclavicular and coracoclavicular ligaments, capsule, attached muscles) leading to the injury. In recent literature, our understanding for anatomical correlates leading to the radiological-based Rockwood classification is questioned. The goal of this experimental-based investigation was to approve the correlation between the anatomical injury pattern and the Rockwood classification. In four human cadavers (seven shoulders), the acromioclavicular and coracoclavicular ligaments were transected stepwise. Radiological correlates were recorded (Zanca view) with 15-kg longitudinal tension applied at the wrist. The resulting acromio- and coracoclavicular distances were measured. Radiographs after acromioclavicular ligament transection showed joint space enlargement (8.6 ± 0.3 vs. 3.1 ± 0.5 mm, p < 0.05) and no significant change in coracoclavicular distance (10.4 ± 0.9 vs. 10.0 ± 0.8 mm). According to the Rockwood classification only type I and II lesions occurred. After additional coracoclavicular ligament cut, the acromioclavicular joint space width increased to 16.7 ± 2.7 vs. 8.6 ± 0.3 mm, p < 0.05. The mean coracoclavicular distance increased to 20.6 ± 2.1 mm resulting in type III-V lesions concerning the Rockwood classification. Trauma with intact coracoclavicular ligaments did not result in acromioclavicular joint lesions higher than Rockwood type I and II. The clinical consequence for reconstruction of low-grade injuries might be a solely surgical approach for the acromioclavicular ligaments or conservative treatment. High-grade injuries were always based on additional structural damage to the coracoclavicular ligaments. Rockwood type V lesions occurred while muscle attachments were intact.

  17. New Sources of Active Duty Military Personnel: The Prior Service Accessions Pool.

    DTIC Science & Technology

    1981-10-01

    Age Group Classification 20...level. -30- Table 15 E.IPLOYMENT STATUS BY AGE AN[) RACE (Iii thotisands) Age Group Classification 20-23 24-29 30-34 35-39 40-49 50-60 Total White...alternative job than for full time workers. Table 17 NUMBER OF VETERANS WORKING LESS THAN 35 HOURS (In thousands) Age Group Classification 20-23

  18. An innovative cycling exergame to promote cardiovascular fitness in youth with cerebral palsy.

    PubMed

    Knights, Shannon; Graham, Nicholas; Switzer, Lauren; Hernandez, Hamilton; Ye, Zi; Findlay, Briar; Xie, Wen Yan; Wright, Virginia; Fehlings, Darcy

    2016-01-01

    To evaluate the effects of an internet-platform exergame cycling programme on cardiovascular fitness of youth with cerebral palsy (CP). In this pilot prospective case series, eight youth with bilateral spastic CP, Gross Motor Functional Classification System (GMFCS) level III, completed a six-week exergame programme. Outcomes were obtained at baseline and post-intervention. The primary outcome measure was the GMFCS III-specific shuttle run test (SRT-III). Secondary outcomes included health-related quality of life (HQL) as measured by the KIDSCREEN-52 questionnaire, six-minute walk test, Wingate arm cranking test and anthropomorphic measurements. There were significant improvements in the SRT-III (t = -2.5, p = 0.04, d = 0.88) post-intervention. There were no significant changes in secondary outcomes. An exergame cycling programme may lead to improvement in cardiovascular fitness in youth with CP. This study was limited by small sample size and lack of a comparison group. Future research is warranted.

  19. Genetic and environmental contributions to age of onset of alcohol dependence symptoms in male twins.

    PubMed

    Liu, I-Chao; Blacker, Deborah L; Xu, Ronghui; Fitzmaurice, Garrett; Tsuang, Ming T; Lyons, Michael J

    2004-11-01

    To investigate genetic and environmental influences on the development of specific alcohol dependence symptoms. A classical twin study of 3372 male-male twin pairs in the Vietnam Era Twin (VET) Registry based on telephone interviews about alcohol use. The nine diagnostic symptoms according to the Diagnostic and Statistical Manual of Mental Disorder, version III (revised) (DSM-III-R) definition of alcohol dependence. Symptoms were grouped into those based on impaired control, biological effects and social consequences (Beresford's classification) or early versus late symptoms (Nelson's classification). Survival models with random effects were used to examine the age of onset of each symptom. Approximately 38% of the variation in age of onset of each symptom group based on Beresford's classification is due to additive genetic factors. The age of onset of late symptoms from Nelson's classification appears to be most affected by genetic factors. Estimates of genetic effects for impaired control symptoms are greatly decreased when twins with comorbid psychiatric disorders are excluded. Our results support the heritability of age of onset of DSM-III-R-defined symptoms for alcohol dependence. However, no symptom group in Beresford's classification could be identified as more heritable than other symptom groups. A strong association between genetic vulnerability and co-occurring diseases for symptoms indicative of impaired control could be found. In addition, our findings show that the late symptom group could be a good candidate for subsequent genetic research.

  20. Chronic shin splints. Classification and management of medial tibial stress syndrome.

    PubMed

    Detmer, D E

    1986-01-01

    A clinical classification and treatment programme has been developed for chronic medial tibial stress syndrome. Medial tibial stress syndrome has been reported to be either tibial stress fracture or microfracture, tibial periostitis, or distal deep posterior chronic compartment syndrome. Three chronic types exist and may coexist: Type I (tibial microfracture, bone stress reaction or cortical fracture); type II (periostalgia from chronic avulsion of the periosteum at the periosteal-fascial junction); and type III (chronic compartment syndrome syndrome). Type I disease is treated nonoperatively. Operations for resistant types II and III medial tibial stress syndrome were performed in 41 patients. Bilaterality was common (type II, 50% type III, 88%). Seven had coexistent type II/III; one had type I/II. Preoperative symptoms averaged 24 months in type II, 6 months in type III, and 33 months in types II/III. Mean age was 22 years (15 to 51). Resting compartment pressures were normal in type II (mean 12 mm Hg) and elevated in type III and type II/III (mean 23 mm Hg). Type II and type II/III patients received fasciotomy plus periosteal cauterisation. Type III patients had fasciotomy only. All procedures were performed on an outpatient basis using local anaesthesia. Follow up was complete and averaged 6 months (2 to 14 months). Improved performance was as follows: type II, 93%, type III, 100%; type II/III, 86%. Complete cures were as follows: type II, 78%; type III, 75%; and type II/III, 57%. This experience suggests that with precise diagnosis and treatment involving minimal risk and cost the athlete has a reasonable chance of return to full activity.

  1. Rule-guided human classification of Volunteered Geographic Information

    NASA Astrophysics Data System (ADS)

    Ali, Ahmed Loai; Falomir, Zoe; Schmid, Falko; Freksa, Christian

    2017-05-01

    During the last decade, web technologies and location sensing devices have evolved generating a form of crowdsourcing known as Volunteered Geographic Information (VGI). VGI acted as a platform of spatial data collection, in particular, when a group of public participants are involved in collaborative mapping activities: they work together to collect, share, and use information about geographic features. VGI exploits participants' local knowledge to produce rich data sources. However, the resulting data inherits problematic data classification. In VGI projects, the challenges of data classification are due to the following: (i) data is likely prone to subjective classification, (ii) remote contributions and flexible contribution mechanisms in most projects, and (iii) the uncertainty of spatial data and non-strict definitions of geographic features. These factors lead to various forms of problematic classification: inconsistent, incomplete, and imprecise data classification. This research addresses classification appropriateness. Whether the classification of an entity is appropriate or inappropriate is related to quantitative and/or qualitative observations. Small differences between observations may be not recognizable particularly for non-expert participants. Hence, in this paper, the problem is tackled by developing a rule-guided classification approach. This approach exploits data mining techniques of Association Classification (AC) to extract descriptive (qualitative) rules of specific geographic features. The rules are extracted based on the investigation of qualitative topological relations between target features and their context. Afterwards, the extracted rules are used to develop a recommendation system able to guide participants to the most appropriate classification. The approach proposes two scenarios to guide participants towards enhancing the quality of data classification. An empirical study is conducted to investigate the classification of grass-related features like forest, garden, park, and meadow. The findings of this study indicate the feasibility of the proposed approach.

  2. Classification of oxidative stress based on its intensity

    PubMed Central

    Lushchak, Volodymyr I.

    2014-01-01

    In living organisms production of reactive oxygen species (ROS) is counterbalanced by their elimination and/or prevention of formation which in concert can typically maintain a steady-state (stationary) ROS level. However, this balance may be disturbed and lead to elevated ROS levels called oxidative stress. To our best knowledge, there is no broadly acceptable system of classification of oxidative stress based on its intensity due to which proposed here system may be helpful for interpretation of experimental data. Oxidative stress field is the hot topic in biology and, to date, many details related to ROS-induced damage to cellular components, ROS-based signaling, cellular responses and adaptation have been disclosed. However, it is common situation when researchers experience substantial difficulties in the correct interpretation of oxidative stress development especially when there is a need to characterize its intensity. Careful selection of specific biomarkers (ROS-modified targets) and some system may be helpful here. A classification of oxidative stress based on its intensity is proposed here. According to this classification there are four zones of function in the relationship between “Dose/concentration of inducer” and the measured “Endpoint”: I – basal oxidative stress (BOS); II – low intensity oxidative stress (LOS); III – intermediate intensity oxidative stress (IOS); IV – high intensity oxidative stress (HOS). The proposed classification will be helpful to describe experimental data where oxidative stress is induced and systematize it based on its intensity, but further studies will be in need to clear discriminate between stress of different intensity. PMID:26417312

  3. Flood Damage Analysis Within the Readiness Management System

    DTIC Science & Technology

    1992-11-01

    criteria as nearly as possible while maintaining the economic detail desired for analysis. After the damage reach boundaries have been chosen, they are...1) Economic data for Urban Areas Economic input data generated using the GIS is shown in Appendix B Section 1. The original data file generated by...statted in section III, it is essential that the landuse classification, including all of the necessary economic data, be verified by a qualified

  4. Ling classification describes endoscopic progressive process of achalasia and successful peroral endoscopy myotomy prevents endoscopic progression of achalasia.

    PubMed

    Zhang, Wen-Gang; Linghu, En-Qiang; Chai, Ning-Li; Li, Hui-Kai

    2017-05-14

    To verify the hypothesis that the Ling classification describes the endoscopic progressive process of achalasia and determine the ability of successful peroral endoscopic myotomy (POEM) to prevent endoscopic progression of achalasia. We retrospectively reviewed the endoscopic findings, symptom duration, and manometric data in patients with achalasia. A total of 359 patients (197 women, 162 men) with a mean age of 42.1 years (range, 12-75 years) were evaluated. Symptom duration ranged from 2 to 360 mo, with a median of 36 mo. Patients were classified with Ling type I ( n = 119), IIa ( n = 106), IIb ( n = 60), IIc ( n = 60), or III ( n = 14), according to the Ling classification. Of the 359 patients, 349 underwent POEM, among whom 21 had an endoscopic follow-up for more than 2 years. Pre-treatment and post-treatment Ling classifications of these 21 patients were compared. Symptom duration increased significantly with increasing Ling classification (from I to III) ( P < 0.05), whereas lower esophageal sphincter pressure decreased with increasing Ling type (from I to III) ( P < 0.05). There was no difference in sex ratio or onset age among the Ling types, although the age at time of diagnosis was higher in Ling types IIc and III than in Ling types I, IIa, and IIb. Of the 21 patients, 19 underwent high-resolution manometry both before and after treatment. The mean preoperative and postoperative lower esophageal sphincter pressure were 34.6 mmHg (range, 15.3-59.4 mmHg) and 15.0 mmHg (range, 2.1-21.6 mmHg), respectively, indicating a statistically significant decrease after POEM. All of the 21 patients were treated successfully by POEM (postoperative Eckardt score ≤ 3) and still had the same Ling type during a mean follow-up period of 37.8 mo (range, 24-51 mo). The Ling classification represents the endoscopic progressive process of achalasia and may be able to serve as an endoscopic assessment criterion for achalasia. Successful POEM (Eckardt score ≤ 3) seems to have the ability to prevent endoscopic evolvement of achalasia. However, studies with larger populations are warranted to confirm our findings.

  5. Establishing the pharmaceutical quality of Chinese herbal medicine: a provisional BCS classification.

    PubMed

    Fong, Sophia Y K; Liu, Mary; Wei, Hai; Löbenberg, Raimar; Kanfer, Isadore; Lee, Vincent H L; Amidon, Gordon L; Zuo, Zhong

    2013-05-06

    The Biopharmaceutical Classification System (BCS), which is a scientific approach to categorize active drug ingredient based on its solubility and intestinal permeability into one of the four classes, has been used to set the pharmaceutical quality standards for drug products in western society. However, it has received little attention in the area of Chinese herbal medicine (CHM). This is likely, in part, due to the presence of multiple active components as well as lack of standardization of CHM. In this report, we apply BCS classification to CHMs provisionally as a basis for establishing improved in vitro quality standards. Based on a top-200 drugs selling list in China, a total of 31 CHM products comprising 50 official active marker compounds (AMCs) were provisionally classified according to BCS. Information on AMC content and doses of these CHM products were retrieved from the Chinese Pharmacopoeia. BCS parameters including solubility and permeability of the AMCs were predicted in silico (ACD/Laboratories). A BCS classification of CHMs according to biopharmaceutical properties of their AMCs is demonstrated to be feasible in the current study and can be used to provide a minimum set of quality standards. Our provisional results showed that 44% of the included AMCs were classified as Class III (high solubility, low permeability), followed by Class II (26%), Class I (18%), and Class IV (12%). A similar trend was observed when CHMs were classified in accordance with the BCS class of AMCs. Most (45%) of the included CHMs were classified as Class III, followed by Class II (16%), Class I (10%), and Class IV (6%); whereas 23% of the CHMs were of mixed class due to the presence of multiple individual AMCs with different BCS classifications. Moreover, about 60% of the AMCs were classified as high-solubility compounds (Class I and Class III), suggesting an important role for an in vitro dissolution test in setting quality control standards ensuring consistent biopharmaceutical quality for the commercially available CHM products. That is, provisionally, more than half of the AMCs of the top-selling CHMs included in this study would be candidates for a bioequivalence (BE) biowaiver, based on WHO recommendations and EMEA guidelines. Thus a dissolution requirement on these AMCs would represent a significant advance in the pharmaceutical quality of CHM today.

  6. Evaluation of new antiemetic agents and definition of antineoplastic agent emetogenicity--an update.

    PubMed

    Grunberg, Steven M; Osoba, David; Hesketh, Paul J; Gralla, Richard J; Borjeson, Sussanne; Rapoport, Bernardo L; du Bois, Andreas; Tonato, Maurizio

    2005-02-01

    Development of effective antiemetic therapy depends upon an understanding of both the antiemetic agents and the emetogenic challenges these agents are designed to address. New potential antiemetic agents should be studied in an orderly manner, proceeding from phase I to phase II open-label trials and then to randomized double-blind phase III trials comparing new agents and regimens to best standard therapy. Use of placebos in place of antiemetic therapy against highly or moderately emetogenic chemotherapy is unacceptable. Nausea and vomiting should be evaluated separately and for both the acute and delayed periods. Defining the emetogenicity of new antineoplastic agents is a challenge, since such data are often not reliably recorded during early drug development. A four-level classification system is proposed for emetogenicity of intravenous antineoplastic agents. A separate four-level classification system for emetogenicity of oral antineoplastic agents, which are often given over an extended period of time, is also proposed.

  7. Evaluation of the membrane permeability (PAMPA and skin) of benzimidazoles with potential cannabinoid activity and their relation with the Biopharmaceutics Classification System (BCS).

    PubMed

    Alvarez-Figueroa, M Javiera; Pessoa-Mahana, C David; Palavecino-González, M Elisa; Mella-Raipán, Jaime; Espinosa-Bustos, Cristián; Lagos-Muñoz, Manuel E

    2011-06-01

    The permeability of five benzimidazole derivates with potential cannabinoid activity was determined in two models of membranes, parallel artificial membrane permeability assay (PAMPA) and skin, in order to study the relationship of the physicochemical properties of the molecules and characteristics of the membranes with the permeability defined by the Biopharmaceutics Classification System. It was established that the PAMPA intestinal absorption method is a good predictor for classifying these molecules as very permeable, independent of their thermodynamic solubility, if and only if these have a Log P(oct) value <3.0. In contrast, transdermal permeability is conditioned on the solubility of the molecule so that it can only serve as a model for classifying the permeability of molecules that possess high solubility (class I: high solubility, high permeability; class III: high solubility, low permeability).

  8. [Rome III classification of functional gastrointestinal disorders in children with chronic abdominal pain].

    PubMed

    Plocek, Anna; Wasowska-Królikowska, Krystyna; Toporowska-Kowalska, Ewa

    2010-01-01

    The updated Rome III Classification of paediatric functional gastrointestinal disorders (FGIDs) associated with abdominal pain comprises: functional dyspepsia (FD), irritable bowel syndrome (IBS), abdominal migraine, functional abdominal pain (FAP), functional abdominal pain syndrome (FAPS). To assess the value of the Rome criteria in identifying FGIDs in children with chronic abdominal pain. The study group consisted of 439 consecutive paediatric patients (192 boys and 247 girls) aged 4-18 years (mean age was 11.95 +/- 3.89 years) referred to the Paediatric Gastroenterology Department at Medical University of Lodz from January 2008 to June 2009 for evaluation of abdominal pain of at least 2 months' duration. After exclusion of organic disease children suspected of functional chronic abdominal pain were categorized with the use of Rome III criteria of FGIDs associated with abdominal pain (H2a-H2d1) and the Questionnaire on Paediatric Gastrointestinal Symptoms (with the permission of doctor L. S. Walker). The patients with known nonabdominal organic disease, chronic illness or handicap were excluded. In 161 patients (36.58%) organic etiology was confirmed. Of the 278 children (63.42%) with functional chronic abdominal pain, 228 (82.02%) met the Rome III criteria for FGIDs associated with abdominal pain (FD, 15.5%; IBS, 21.6%; abdominal migraine, 5%; FAP 24.5%; FAPS, 15.9%). Fifty cases (17.98%) did not fulfill the criteria for subtypes of abdominal pain-related FGIDs--mainly due to different as defined by Rome III criteria (at least once per week) frequency of symptom presentation. (1) In the authors'investigations FGIDs was the most frequent cause of chronic abdominal pain in children. (2) The significant number of children with nonclassified FGIDs implies the need to modify the diagnostic criteria of Rome III classification concerning the prevalence of symptoms.

  9. Proposal of a Classification System for the Assessment and Treatment of Prominent Ear Deformity.

    PubMed

    Lee, Youngdae; Kim, Young Seok; Lee, Won Jai; Rha, Dong Kyun; Kim, Jiye

    2018-06-01

    Prominent ear is the most common external ear deformity. To comprehensively treat prominent ear deformity, adequate comprehension of its pathophysiology is crucial. In this article, we analyze cases of prominent ear and suggest a simple classification system and treatment algorithm according to pathophysiology. We retrospectively reviewed a total of 205 Northeast Asian patients' clinical data who underwent an operation for prominent ear deformity. Follow-up assessments were conducted 3, 6, and 12 months after surgery. Prominent ear deformities were classified by diagnostic checkpoints. Class I (simple prominent ear) includes prominent ear that developed with the absence of the antihelix without conchal hypertrophy. Class II (mixed-type prominent ear) is defined as having not only a flat antihelix, but also conchal excess. Class III (conchal-type prominent ear) has an enlarged conchal bowl with a well-developed antihelix. Among the three types of prominent ear, class I was most frequent (162 patients, 81.6%). Class II was observed in 28 patients (13.6%) and class III in 10 patients (4.8%). We used the scaphomastoid suture method for correction of antihelical effacement, the anterior approach conchal resection for correction of conchal hypertrophy, and Bauer's squid incision for lobule prominence. The complication rate was 9.2% including early hematoma, hypersensitivity, and suture extrusion. Unfavorable results occurred in 4% including partial recurrence, overcorrection, and undercorrection. To reduce unfavorable results and avoid recurrence, we propose the use of a classification and treatment algorithm in preoperative evaluation of prominent ear. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  10. Towards brain-activity-controlled information retrieval: Decoding image relevance from MEG signals.

    PubMed

    Kauppi, Jukka-Pekka; Kandemir, Melih; Saarinen, Veli-Matti; Hirvenkari, Lotta; Parkkonen, Lauri; Klami, Arto; Hari, Riitta; Kaski, Samuel

    2015-05-15

    We hypothesize that brain activity can be used to control future information retrieval systems. To this end, we conducted a feasibility study on predicting the relevance of visual objects from brain activity. We analyze both magnetoencephalographic (MEG) and gaze signals from nine subjects who were viewing image collages, a subset of which was relevant to a predetermined task. We report three findings: i) the relevance of an image a subject looks at can be decoded from MEG signals with performance significantly better than chance, ii) fusion of gaze-based and MEG-based classifiers significantly improves the prediction performance compared to using either signal alone, and iii) non-linear classification of the MEG signals using Gaussian process classifiers outperforms linear classification. These findings break new ground for building brain-activity-based interactive image retrieval systems, as well as for systems utilizing feedback both from brain activity and eye movements. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Digital classification of Landsat data for vegetation and land-cover mapping in the Blackfoot River watershed, southeastern Idaho

    USGS Publications Warehouse

    Pettinger, L.R.

    1982-01-01

    This paper documents the procedures, results, and final products of a digital analysis of Landsat data used to produce a vegetation and landcover map of the Blackfoot River watershed in southeastern Idaho. Resource classes were identified at two levels of detail: generalized Level I classes (for example, forest land and wetland) and detailed Levels II and III classes (for example, conifer forest, aspen, wet meadow, and riparian hardwoods). Training set statistics were derived using a modified clustering approach. Environmental stratification that separated uplands from lowlands improved discrimination between resource classes having similar spectral signatures. Digital classification was performed using a maximum likelihood algorithm. Classification accuracy was determined on a single-pixel basis from a random sample of 25-pixel blocks. These blocks were transferred to small-scale color-infrared aerial photographs, and the image area corresponding to each pixel was interpreted. Classification accuracy, expressed as percent agreement of digital classification and photo-interpretation results, was 83.0:t 2.1 percent (0.95 probability level) for generalized (Level I) classes and 52.2:t 2.8 percent (0.95 probability level) for detailed (Levels II and III) classes. After the classified images were geometrically corrected, two types of maps were produced of Level I and Levels II and III resource classes: color-coded maps at a 1:250,000 scale, and flatbed-plotter overlays at a 1:24,000 scale. The overlays are more useful because of their larger scale, familiar format to users, and compatibility with other types of topographic and thematic maps of the same scale.

  12. The ESHRE/ESGE consensus on the classification of female genital tract congenital anomalies†,‡

    PubMed Central

    Grimbizis, Grigoris F.; Gordts, Stephan; Di Spiezio Sardo, Attilio; Brucker, Sara; De Angelis, Carlo; Gergolet, Marco; Li, Tin-Chiu; Tanos, Vasilios; Brölmann, Hans; Gianaroli, Luca; Campo, Rudi

    2013-01-01

    STUDY QUESTION What classification system is more suitable for the accurate, clear, simple and related to the clinical management categorization of female genital anomalies? SUMMARY ANSWER The new ESHRE/ESGE classification system of female genital anomalies is presented. WHAT IS KNOWN ALREADY Congenital malformations of the female genital tract are common miscellaneous deviations from normal anatomy with health and reproductive consequences. Until now, three systems have been proposed for their categorization but all of them are associated with serious limitations. STUDY DESIGN, SIZE AND DURATION The European Society of Human Reproduction and Embryology (ESHRE) and the European Society for Gynaecological Endoscopy (ESGE) have established a common Working Group, under the name CONUTA (CONgenital UTerine Anomalies), with the goal of developing a new updated classification system. A scientific committee (SC) has been appointed to run the project, looking also for consensus within the scientists working in the field. PARTICIPANTS/MATERIALS, SETTING, METHODS The new system is designed and developed based on (i) scientific research through critical review of current proposals and preparation of an initial proposal for discussion between the experts, (ii) consensus measurement among the experts through the use of the DELPHI procedure and (iii) consensus development by the SC, taking into account the results of the DELPHI procedure and the comments of the experts. Almost 90 participants took part in the process of development of the ESHRE/ESGE classification system, contributing with their structured answers and comments. MAIN RESULTS AND THE ROLE OF CHANCE The ESHRE/ESGE classification system is based on anatomy. Anomalies are classified into the following main classes, expressing uterine anatomical deviations deriving from the same embryological origin: U0, normal uterus; U1, dysmorphic uterus; U2, septate uterus; U3, bicorporeal uterus; U4, hemi-uterus; U5, aplastic uterus; U6, for still unclassified cases. Main classes have been divided into sub-classes expressing anatomical varieties with clinical significance. Cervical and vaginal anomalies are classified independently into sub-classes having clinical significance. LIMITATIONS, REASONS FOR CAUTION The ESHRE/ESGE classification of female genital anomalies seems to fulfill the expectations and the needs of the experts in the field, but its clinical value needs to be proved in everyday practice. WIDER IMPLICATIONS OF THE FINDINGS The ESHRE/ESGE classification system of female genital anomalies could be used as a starting point for the development of guidelines for their diagnosis and treatment. STUDY FUNDING/COMPETING INTEREST(S) None. PMID:23771171

  13. Clinically orientated classification incorporating shoulder balance for the surgical treatment of adolescent idiopathic scoliosis.

    PubMed

    Elsebaie, H B; Dannawi, Z; Altaf, F; Zaidan, A; Al Mukhtar, M; Shaw, M J; Gibson, A; Noordeen, H

    2016-02-01

    The achievement of shoulder balance is an important measure of successful scoliosis surgery. No previously described classification system has taken shoulder balance into account. We propose a simple classification system for AIS based on two components which include the curve type and shoulder level. Altogether, three curve types have been defined according to the size and location of the curves, each curve pattern is subdivided into type A or B depending on the shoulder level. This classification was tested for interobserver reproducibility and intraobserver reliability. A retrospective analysis of the radiographs of 232 consecutive cases of AIS patients treated surgically between 2005 and 2009 was also performed. Three major types and six subtypes were identified. Type I accounted for 30 %, type II 28 % and type III 42 %. The retrospective analysis showed three patients developed a decompensation that required extension of the fusion. One case developed worsening of shoulder balance requiring further surgery. This classification was tested for interobserver and intraobserver reliability. The mean kappa coefficients for interobserver reproducibility ranged from 0.89 to 0.952, while the mean kappa value for intraobserver reliability was 0.964 indicating a good-to-excellent reliability. The treatment algorithm guides the spinal surgeon to achieve optimal curve correction and postoperative shoulder balance whilst fusing the smallest number of spinal segments. The high interobserver reproducibility and intraobserver reliability makes it an invaluable tool to describe scoliosis curves in everyday clinical practice.

  14. The utility of rat jejunal permeability for biopharmaceutics classification system.

    PubMed

    Zakeri-Milani, Parvin; Valizadeh, Hadi; Tajerzadeh, Hosnieh; Islambulchilar, Ziba

    2009-12-01

    The biopharmaceutical classification system has been developed to provide a scientific approach for classifying drug compounds based on their dose/solubility ratio and human intestinal permeability. Therefore in this study a new classification is presented, which is based on a correlation between rat and human intestinal permeability values. In situ technique in rat jejunum was used to determine the effective intestinal permeability of tested drugs. Then three dimensionless parameters--dose number, absorption number, and dissolution number (D(o), A(n), and D(n))--were calculated for each drug. Four classes of drugs were defined, that is, class I, D(0) < 0.5, P(eff(rat)) > 5.09 x 10(-5) cm/s; class II, D(o) > 1, P(eff(rat)) > 5.09 x 10( -5) cm/s; class III, D(0) < 0.5, P(eff(rat)) < 4.2 x 10(-5) cm/s; and class IV, D(o) > 1, P(eff(rat)) < 4.2 x 10(-5) cm/s. A region of borderline drugs (0.5 < D(o) < 1, 4.2 x 10(-5) < P(eff(rat)) < 5.09 x 10(-5) cm/s) was also defined. According to obtained results and proposed classification for drugs, it is concluded that drugs could be categorized correctly based on dose number and their intestinal permeability values in rat model using single-pass intestinal perfusion technique. This classification enables us to remark defined characteristics for intestinal absorption of all four classes using suitable cutoff points for both dose number and rat effective intestinal permeability values.

  15. Chemical Preparation Laboratory for IND Candidate Compounds

    DTIC Science & Technology

    1990-02-08

    CLASSIFICATION lb. RESTRICTIVE MARKINGS Unclassified 2a. SECURITY CLASSIFICATION AUTHORITY 3 . DISTRIBUTION /AVAILABILITY OF REPORT 2b. DECLASSIFICATION... 3 III. Cumulative list of Compounds Delivered to U.S. Army Medical Research and Development (USAMRIID) from January 17, 1989 to...AVS 52) ............................................ 7 2. Selenazole (AVS 253) ............................................... 9 3 . Methyl-l,2,4

  16. Comparison of LSS-IV and LISS-III+LISS-IV merged data for classification of crops

    NASA Astrophysics Data System (ADS)

    Hebbar, R.; Sesha Sai, M. V. R.

    2014-11-01

    Resourcesat-1 satellite with its unique capability of simultaneous acquisition of multispectral images at different spatial resolutions (AWiFS, LISS-III and LISS-IV MX / Mono) has immense potential for crop inventory. The present study was carried for selection of suitable LISS-IV MX band for data fusion and its evaluation for delineation different crops in a multi-cropped area. Image fusion techniques namely intensity hue saturation (IHS), principal component analysis (PCA), brovey, high pass filter (HPF) and wavelet methods were used for merging LISS-III and LISS-IV Mono data. The merged products were evaluated visually and through universal image quality index, ERGAS and classification accuracy. The study revealed that red band of LISS-IV MX data was found to be optimal band for merging with LISS-III data in terms of maintaining both spectral and spatial information and thus, closely matching with multispectral LISS-IVMX data. Among the five data fusion techniques, wavelet method was found to be superior in retaining image quality and higher classification accuracy compared to commonly used methods of IHS, PCA and Brovey. The study indicated that LISS-IV data in mono mode with wider swath of 70 km could be exploited in place of 24km LISS-IVMX data by selection of appropriate fusion techniques by acquiring monochromatic data in the red band.

  17. Remodeling characteristics and collagen distribution in synthetic mesh materials explanted from human subjects after abdominal wall reconstruction: an analysis of remodeling characteristics by patient risk factors and surgical site classifications

    PubMed Central

    Cavallo, Jaime A.; Roma, Andres A.; Jasielec, Mateusz S.; Ousley, Jenny; Creamer, Jennifer; Pichert, Matthew D.; Baalman, Sara; Frisella, Margaret M.; Matthews, Brent D.

    2014-01-01

    Background The purpose of this study was to evaluate the associations between patient characteristics or surgical site classifications and the histologic remodeling scores of synthetic meshes biopsied from their abdominal wall repair sites in the first attempt to generate a multivariable risk prediction model of non-constructive remodeling. Methods Biopsies of the synthetic meshes were obtained from the abdominal wall repair sites of 51 patients during a subsequent abdominal re-exploration. Biopsies were stained with hematoxylin and eosin, and evaluated according to a semi-quantitative scoring system for remodeling characteristics (cell infiltration, cell types, extracellular matrix deposition, inflammation, fibrous encapsulation, and neovascularization) and a mean composite score (CR). Biopsies were also stained with Sirius Red and Fast Green, and analyzed to determine the collagen I:III ratio. Based on univariate analyses between subject clinical characteristics or surgical site classification and the histologic remodeling scores, cohort variables were selected for multivariable regression models using a threshold p value of ≤0.200. Results The model selection process for the extracellular matrix score yielded two variables: subject age at time of mesh implantation, and mesh classification (c-statistic = 0.842). For CR score, the model selection process yielded two variables: subject age at time of mesh implantation and mesh classification (r2 = 0.464). The model selection process for the collagen III area yielded a model with two variables: subject body mass index at time of mesh explantation and pack-year history (r2 = 0.244). Conclusion Host characteristics and surgical site assessments may predict degree of remodeling for synthetic meshes used to reinforce abdominal wall repair sites. These preliminary results constitute the first steps in generating a risk prediction model that predicts the patients and clinical circumstances for which non-constructive remodeling of an abdominal wall repair site with synthetic mesh reinforcement is most likely to occur. PMID:24442681

  18. A geometric reappraisal of proximal landing zones for thoracic endovascular aortic repair according to aortic arch types.

    PubMed

    Marrocco-Trischitta, Massimiliano M; de Beaufort, Hector W; Secchi, Francesco; van Bakel, Theodorus M; Ranucci, Marco; van Herwaarden, Joost A; Moll, Frans L; Trimarchi, Santi

    2017-06-01

    This study assessed whether the additional use of the aortic arch classification in type I, II, and III may complement Ishimaru's aortic arch map and provide valuable information on the geometry and suitability of proximal landing zones for thoracic endovascular aortic repair. Anonymized thoracic computed tomography scans of healthy aortas were reviewed and stratified according to the aortic arch classification, and 20 of each type of arch were selected. Further processing allowed calculation of angulation and tortuosity of each proximal landing zone. Data were described indicating both proximal landing zone and type of arch (eg, 0/I). Angulation was severe (>60°) in 2/III and in 3/III. Comparisons among the types of arch showed an increase in proximal landing zones angulation (P < .001) and tortuosity (P = .009) depending on the type of arch. Comparisons within type of arch showed no change in angulation and tortuosity across proximal landing zones within type I arch (P = .349 and P = .409), and increases in angulation and tortuosity toward more distal proximal landing zones within type II (P = .003 and P = .043) and type III (P < .001 in both). The aortic arch classification is associated with a consistent geometric pattern of the aortic arch map, which identifies specific proximal landing zones with suboptimal angulation for stent graft deployment. Arches II and III also appear to have progressively less favorable anatomy for thoracic endovascular aortic repair compared with arch I. Copyright © 2016 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  19. The use of old and recent DSM definitions of premature ejaculation in observational studies: a contribution to the present debate for a new classification of PE in the DSM-V.

    PubMed

    Waldinger, Marcel D; Schweitzer, Dave H

    2008-05-01

    The DSM-III definition of premature ejaculation (PE) contains the criterion "control" but not that of "ejaculation time." In contrast, the Diagnostic and Statistical Manual of Mental Disorders (4th edition, Text Revision) (DSM-IV-TR) contains the criterion "short ejaculation time," while it lacks "control." To review the adequacy and consequent use of all criteria of the DSM-IV-TR definition in previously published PE Internet surveys. Reviewing all published cohort studies on PE from 2004 to 2007. MEDLINE and EMBASE computer bibliographies were used. Definitions of DSM-III, DSM-IV-TR, and International Classification of Diseases. Five papers, of which three are original studies, reported inclusion of men with PE according to DSM-IV-TR definition but omitted to apply the required "short ejaculation time" criterion. These studies, which have defined PE according to subjective criteria such as control, actually referred to the DSM-III definition. Using DSM-III-like definitions in three different studies revealed a highly variable prevalence of PE (32.5%, 27.6%, and 13.0%). In contrast, based on studies using a 1-minute cutoff point, being the time that is required to call ejaculation time "short" or using the criterion "persistent occurrence," PE revealed to be far less prevalent (5-6%). Unacceptable discrepancies of PE definitions according to DSM-III (abandoned but still used) and DSM-IV-TR argue strongly in favor of a multidimensional new classification of PE for the DSM-V.

  20. Test-Retest Reliability of the 10-Metre Fast Walk Test and 6-Minute Walk Test in Ambulatory School-Aged Children with Cerebral Palsy

    ERIC Educational Resources Information Center

    Thompson, Patricia; Beath, Tricia; Bell, Jacqueline; Jacobson, Gabrielle; Phair, Tegan; Salbach, Nancy M.; Wright, F. Virginia

    2008-01-01

    Short-term test-retest reliability of the 10-metre fast walk test (10mFWT) and 6-minute walk test (6MWT) was evaluated in 31 ambulatory children with cerebral palsy (CP), with subgroup analyses in Gross Motor Function Classification System (GMFCS) Levels I (n=9), II (n=8), and III (n=14). Sixteen females and 15 males participated, mean age 9 years…

  1. Comparison of torsional and longitudinal modes using phacoemulsification parameters.

    PubMed

    Rekas, Marek; Montés-Micó, Robert; Krix-Jachym, Karolina; Kluś, Adam; Stankiewicz, Andrzej; Ferrer-Blasco, Teresa

    2009-10-01

    To compare phacoemulsification parameters of torsional and longitudinal ultrasound modes. Ophthalmology Department, Military Health Service Institute, Warsaw, Poland. This prospective study evaluated eyes 1, 7, and 30 days after phacoemulsification with an Infiniti Vision System using the torsional or longitudinal ultrasound (US) mode. Cataract classification was according to the Lens Opacities Classification System II. Nucleus fragmentation was by the phaco-chop and quick-chop methods. Primary outcome measures were phaco time, mean phaco power, mean torsional amplitude, and aspiration time. Total energy, defined as cumulative dissipated energy (CDE) x aspiration time, and the effective coefficient, defined as aspiration time/phaco time, were also calculated. Four hundred eyes were evaluated. The CDE was statistically significantly lower in the torsional mode for nucleus grades I, II, and III (P<.001) but not for grade IV (P>.05). Aspiration time was statistically significantly shorter in the torsional mode than in the longitudinal mode for nucleus grades III and IV (P<.05). Total energy was significantly lower in the torsional mode for all nucleus densities (P<.05). The effective coefficient was significantly lower in the longitudinal mode except for nucleus grade I (P<.05). Torsional phacoemulsification was more effective than longitudinal phacoemulsification in the amount of applied fluid and the quantity of US energy expended. With the torsional method, it was possible to maintain a constant ratio of amount of fluid flow to quantity of US energy used, regardless of nucleus density.

  2. Prediction of type III secretion signals in genomes of gram-negative bacteria.

    PubMed

    Löwer, Martin; Schneider, Gisbert

    2009-06-15

    Pathogenic bacteria infecting both animals as well as plants use various mechanisms to transport virulence factors across their cell membranes and channel these proteins into the infected host cell. The type III secretion system represents such a mechanism. Proteins transported via this pathway ("effector proteins") have to be distinguished from all other proteins that are not exported from the bacterial cell. Although a special targeting signal at the N-terminal end of effector proteins has been proposed in literature its exact characteristics remain unknown. In this study, we demonstrate that the signals encoded in the sequences of type III secretion system effectors can be consistently recognized and predicted by machine learning techniques. Known protein effectors were compiled from the literature and sequence databases, and served as training data for artificial neural networks and support vector machine classifiers. Common sequence features were most pronounced in the first 30 amino acids of the effector sequences. Classification accuracy yielded a cross-validated Matthews correlation of 0.63 and allowed for genome-wide prediction of potential type III secretion system effectors in 705 proteobacterial genomes (12% predicted candidates protein), their chromosomes (11%) and plasmids (13%), as well as 213 Firmicute genomes (7%). We present a signal prediction method together with comprehensive survey of potential type III secretion system effectors extracted from 918 published bacterial genomes. Our study demonstrates that the analyzed signal features are common across a wide range of species, and provides a substantial basis for the identification of exported pathogenic proteins as targets for future therapeutic intervention. The prediction software is publicly accessible from our web server (www.modlab.org).

  3. Measurement properties and classification accuracy of two spanish parent surveys of language development for preschool-age children.

    PubMed

    Guiberson, Mark; Rodríguez, Barbara L

    2010-08-01

    To describe the concurrent validity and classification accuracy of 2 Spanish parent surveys of language development, the Spanish Ages and Stages Questionnaire (ASQ; Squires, Potter, & Bricker, 1999) and the Pilot Inventario-III (Pilot INV-III; Guiberson, 2008a). Forty-eight Spanish-speaking parents of preschool-age children participated. Twenty-two children had expressive language delays, and 26 had typical language development. The parents completed the Spanish ASQ and the Pilot INV-III at home, and the Preschool Language Scale, Fourth Edition: Spanish Edition (PLS-4 Spanish; Zimmerman, Steiner, & Pond, 2002) was administered to the children at preschool centers. The Spanish ASQ and Pilot INV-III were significantly correlated with the PLS-4 Spanish, establishing concurrent validity. On both surveys, children with expressive language delays scored significantly lower than children with typical development. The Spanish ASQ demonstrated unacceptably low sensitivity (59%) and good specificity (92%), while the Pilot INV-III demonstrated fair sensitivity (82%) and specificity (81%). Likelihood ratios and posttest probability revealed that the Pilot INV-III may assist in detection of expressive language delays, but viewed alone it is insufficient to make an unconditional screening determination. Results suggest that Spanish parent surveys hold promise for screening language delay in Spanish-speaking preschool children; however, further refinement of these tools is needed.

  4. Late Presentation of a Type III Axis Fracture with Spondyloptosis

    PubMed Central

    Jayakumar, Prakash; Choi, David; Casey, Adrian

    2008-01-01

    A 58-year-old man presented with an undiagnosed Effendi type III classification fracture and spondyloptosis of the axis with remarkably normal neurology. We discuss his surgery 4 years since the initial injury, and the presentation, features and management of fractures of the axis. PMID:18430325

  5. Validation of Accelerometer Cut-Points in Children With Cerebral Palsy Aged 4 to 5 Years.

    PubMed

    Keawutan, Piyapa; Bell, Kristie L; Oftedal, Stina; Davies, Peter S W; Boyd, Roslyn N

    2016-01-01

    To derive and validate triaxial accelerometer cut-points in children with cerebral palsy (CP) and compare these with previously established cut-points in children with typical development. Eighty-four children with CP aged 4 to 5 years wore the ActiGraph during a play-based gross motor function measure assessment that was video-taped for direct observation. Receiver operating characteristic and Bland-Altman plots were used for analyses. The ActiGraph had good classification accuracy in Gross Motor Function Classification System (GMFCS) levels III and V and fair classification accuracy in GMFCS levels I, II, and IV. These results support the use of the previously established cut-points for sedentary time of 820 counts per minute in children with CP aged 4 to 5 years across all functional abilities. The cut-point provides an objective measure of sedentary and active time in children with CP. The cut-point is applicable to group data but not for individual children.

  6. Using Fractal and Local Binary Pattern Features for Classification of ECOG Motor Imagery Tasks Obtained from the Right Brain Hemisphere.

    PubMed

    Xu, Fangzhou; Zhou, Weidong; Zhen, Yilin; Yuan, Qi; Wu, Qi

    2016-09-01

    The feature extraction and classification of brain signal is very significant in brain-computer interface (BCI). In this study, we describe an algorithm for motor imagery (MI) classification of electrocorticogram (ECoG)-based BCI. The proposed approach employs multi-resolution fractal measures and local binary pattern (LBP) operators to form a combined feature for characterizing an ECoG epoch recording from the right hemisphere of the brain. A classifier is trained by using the gradient boosting in conjunction with ordinary least squares (OLS) method. The fractal intercept, lacunarity and LBP features are extracted to classify imagined movements of either the left small finger or the tongue. Experimental results on dataset I of BCI competition III demonstrate the superior performance of our method. The cross-validation accuracy and accuracy is 90.6% and 95%, respectively. Furthermore, the low computational burden of this method makes it a promising candidate for real-time BCI systems.

  7. Normal Lung Quantification in Usual Interstitial Pneumonia Pattern: The Impact of Threshold-based Volumetric CT Analysis for the Staging of Idiopathic Pulmonary Fibrosis.

    PubMed

    Ohkubo, Hirotsugu; Kanemitsu, Yoshihiro; Uemura, Takehiro; Takakuwa, Osamu; Takemura, Masaya; Maeno, Ken; Ito, Yutaka; Oguri, Tetsuya; Kazawa, Nobutaka; Mikami, Ryuji; Niimi, Akio

    2016-01-01

    Although several computer-aided computed tomography (CT) analysis methods have been reported to objectively assess the disease severity and progression of idiopathic pulmonary fibrosis (IPF), it is unclear which method is most practical. A universal severity classification system has not yet been adopted for IPF. The purpose of this study was to test the correlation between quantitative-CT indices and lung physiology variables and to determine the ability of such indices to predict disease severity in IPF. A total of 27 IPF patients showing radiological UIP pattern on high-resolution (HR) CT were retrospectively enrolled. Staging of IPF was performed according to two classification systems: the Japanese and GAP (gender, age, and physiology) staging systems. CT images were assessed using a commercially available CT imaging analysis workstation, and the whole-lung mean CT value (MCT), the normally attenuated lung volume as defined from -950 HU to -701 Hounsfield unit (NL), the volume of the whole lung (WL), and the percentage of NL to WL (NL%), were calculated. CT indices (MCT, WL, and NL) closely correlated with lung physiology variables. Among them, NL strongly correlated with forced vital capacity (FVC) (r = 0.92, P <0.0001). NL% showed a large area under the receiver operating characteristic curve for detecting patients in the moderate or advanced stages of IPF. Multivariable logistic regression analyses showed that NL% is significantly more useful than the percentages of predicted FVC and predicted diffusing capacity of the lungs for carbon monoxide (Japanese stage II/III/IV [odds ratio, 0.73; 95% confidence intervals (CI), 0.48 to 0.92; P < 0.01]; III/IV [odds ratio. 0.80; 95% CI 0.59 to 0.96; P < 0.01]; GAP stage II/III [odds ratio, 0.79; 95% CI, 0.56 to 0.97; P < 0.05]). The measurement of NL% by threshold-based volumetric CT analysis may help improve IPF staging.

  8. Local soil classification and crop suitability: Implications for the historical land use and soil management in Monti di Trapani (Sicily)

    NASA Astrophysics Data System (ADS)

    Garcia-Vila, Margarita; Corselli, Rocco; Bonet, María Teresa; Lopapa, Giuseppe; Pillitteri, Valentina; Fereres, Elias

    2017-04-01

    In the past, the lack of technologies (e.g. synthetic fertilizers) to overcome biophysical limitations has played a central role in land use planning. Thus, landscape management and agronomic practices are reactions to local knowledge and perceptions on natural resources, particularly soil. In the framework of the European research project MEMOLA (FP7), the role of local farmers knowledge and perceptions on soil for the historical land use through the spatial distribution of crops and the various management practices have been assessed in three different areas of Monti di Trapani region (Sicily). The identification of the soil classification systems of farmers and the criteria on which it is based, linked to the evaluation of the farmers' ability to identify and map the different soil types, was a key step. Nevertheless, beyond the comparison of the ethnopedological classification approach versus standard soil classification systems, the study also aims at understanding local soil management and land use decisions. The applied methodology was based on an interdisciplinary approach, combining soil science methods and participatory appraisal tools, particularly: i) semi-structured interviews; ii) soil sampling and analysis; iii) discussion groups; and iv) a workshop with local edafologists and agronomists. A rich local glossary of terms associated with the soil conditions and an own soil classification system have been identified in the region. Also, a detailed soil map, including process of soil degradation and soil capability, has been generated. This traditional soil knowledge has conditioned the management and the spatial distribution of the crops, and therefore the configuration of the landscape, until the 1990s. Acknowledgements This work has been funded by the European Union project MEMOLA (Grant agreement no: 613265).

  9. Phylogeny and classification of bacteria in the genera Clavibacter and Rathayibacter on the basis of 16s rRNA gene sequence analyses.

    PubMed

    Lee, I M; Bartoszyk, I M; Gundersen-Rindal, D E; Davis, R E

    1997-07-01

    A phylogenetic analysis by parsimony of 16S rRNA gene sequences (16S rDNA) revealed that species and subspecies of Clavibacter and Rathayibacter form a discrete monophyletic clade, paraphyletic to Corynebacterium species. Within the Clavibacter-Rathayibacter clade, four major phylogenetic groups (subclades) with a total of 10 distinct taxa were recognized: (I) species C. michiganensis; (II) species C. xyli; (III) species R. iranicus and R. tritici; and (IV) species R. rathayi. The first three groups form a monophyletic cluster, paraphyletic to R. rathayi. On the basis of the phylogeny inferred, reclassification of members of Clavibacter-Rathayibacter group is proposed. A system for classification of taxa in Clavibacter and Rathayibacter was developed based on restriction fragment length polymorphism (RFLP) analysis of the PCR-amplified 16S rDNA sequences. The groups delineated on the basis of RFLP patterns of 16S rDNA coincided well with the subclades delineated on the basis of phylogeny. In contrast to previous classification systems, which are based primarily on phenotypic properties and are laborious, the RFLP analyses allow for rapid differentiation among species and subspecies in the two genera.

  10. A systematic review of the management and outcome of ERCP related duodenal perforations using a standardized classification system.

    PubMed

    Cirocchi, Roberto; Kelly, Michael Denis; Griffiths, Ewen A; Tabola, Renata; Sartelli, Massimo; Carlini, Luigi; Ghersi, Stefania; Di Saverio, Salomone

    2017-12-01

    The incidence of duodenal perforation after ERCP ranges from 0.09% to 1.67% and mortality up to 8%. This systematic review was registered in Prospective Register of Systematic Reviews, PROSPERO. Stapfer classification of ERCP-related duodenal perforations was used. The systematic search yielded 259 articles. Most frequent post-ERCP perforation was Stapfer type II (58.4%), type I second most frequent perforation (17.8%) followed by Stapfer type III in 13.2% and type IV in 10.6%. Rate of NOM was lowest in Stapfer type I perforations (13%), moderate in type III lesions (58.1%) and high in other types of perforations (84.2% in type II and 84.6% in IV). In patients underwent early surgical treatment (<24 h from ERCP) the most frequent operation was simple duodenal suture with or without omentopexy (93.7%). In patients undergoing late surgical treatment (>24 h from ERCP) interventions performed were more complex. In type I lesions post-operative mortality rate was higher in patients underwent late operation (>24 h). In type I lesions, failure of NOM occurred in 42.8% of patients. In type II failure of NOM occurred in 28.9% of patients and in type III there was failure of NOM in only 11.1%, none in type IV. Postoperative mortality after NOM failure was 75% in type I, 22.5% in type II and none died after surgical treatment for failure of NOM in type III perforations. This systematic review showed that in patients with Stapfer type I lesions, early surgical treatment gives better results, however the opposite seems true in Stapfer III and IV lesions. Copyright © 2017 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  11. High-resolution manometry classifications for idiopathic achalasia in patients with Chagas' disease esophagopathy.

    PubMed

    Vicentine, Fernando P P; Herbella, Fernando A M; Allaix, Marco E; Silva, Luciana C; Patti, Marco G

    2014-02-01

    Idiopathic achalasia (IA) and Chagas' disease esophagopathy (CDE) share several similarities. The comparison between IA and CDE is important to evaluate whether treatment options and their results can be accepted universally. High-resolution manometry (HRM) has proved a better diagnostic tool compared to conventional manometry. This study aims to evaluate HRM classifications for idiopathic achalasia in patients with CDE. We studied 98 patients: 52 patients with CDE (52 % females, mean age, 57 ± 14 years) and 46 patients with IA (54 % females; mean age 48 ± 19 years). All patients underwent a HRM and barium esophagogram. The Chicago classification was distributed in IA as Chicago I, 35 %; Chicago II, 63 %; and Chicago III, 2 %, and in CDE as Chicago I, 52 %; Chicago II, 48 %; and Chicago III, 0 % (p = 0.1, 0.1, and 0.5, respectively). All patients had the classic Rochester type. CDE patients had more pronounced degrees of esophageal dilatation (p < 0.002). The degree of esophageal dilatation did not correlate with Chicago classification (p = 0.08). In nine (9 %) patients, the HRM pattern changed during the test from Chicago I to II. Our results show that (a) HRM classifications for IA can be applied in patients with CDE and (b) HRM classifications did not correlate with the degree of esophageal dilatation. HRM classifications may reflect esophageal repletion and pressurization instead of muscular contraction. The correlation between manometric findings and treatment outcomes for CDE needs to be answered in the near future.

  12. Comparative analysis of pharmaceuticals versus industrial chemicals acute aquatic toxicity classification according to the United Nations classification system for chemicals. Assessment of the (Q)SAR predictability of pharmaceuticals acute aquatic toxicity and their predominant acute toxic mode-of-action.

    PubMed

    Sanderson, Hans; Thomsen, Marianne

    2009-06-01

    Pharmaceuticals have been reported to be ubiquitously present in surface waters prompting concerns of effects of these bioactive substances. Meanwhile, there is a general scarcity of publicly available ecotoxicological data concerning pharmaceuticals. The aim of this paper was to compile a comprehensive database based on OECD's standardized measured ecotoxicological data and to evaluate if there is generally cause of greater concern with regards to pharmaceutical aquatic toxicological profiles relative to industrial chemicals. Comparisons were based upon aquatic ecotoxicity classification under the United Nations Global Harmonized System for classification and labeling of chemicals (GHS). Moreover, we statistically explored whether the predominant mode-of-action (MOA) for pharmaceuticals is narcosis. We found 275 pharmaceuticals with 569 acute aquatic effect data; 23 pharmaceuticals had chronic data. Pharmaceuticals were found to be more frequent than industrial chemicals in GHS category III. Acute toxicity was predictable (>92%) using a generic (Q)SAR ((Quantitative) Structure Activity Relationship) suggesting a narcotic MOA. Analysis of model prediction error suggests that 68% of the pharmaceuticals have a non-specific MOA. Additionally, the acute-to-chronic ratio (ACR) for 70% of the analyzed pharmaceuticals was below 25 further suggesting a non-specific MOA. Sub-lethal receptor-mediated effects may however have a more specific MOA.

  13. Intra- and interobserver agreement in the classification and treatment of distal third clavicle fractures.

    PubMed

    Bishop, Julie Y; Jones, Grant L; Lewis, Brian; Pedroza, Angela

    2015-04-01

    In treatment of distal third clavicle fractures, the Neer classification system, based on the location of the fracture in relation to the coracoclavicular ligaments, has traditionally been used to determine fracture pattern stability. To determine the intra- and interobserver reliability in the classification of distal third clavicle fractures via standard plain radiographs and the intra- and interobserver agreement in the preferred treatment of these fractures. Cohort study (Diagnosis); Level of evidence, 3. Thirty radiographs of distal clavicle fractures were randomly selected from patients treated for distal clavicle fractures between 2006 and 2011. The radiographs were distributed to 22 shoulder/sports medicine fellowship-trained orthopaedic surgeons. Fourteen surgeons responded and took part in the study. The evaluators were asked to measure the size of the distal fragment, classify the fracture pattern as stable or unstable, assign the Neer classification, and recommend operative versus nonoperative treatment. The radiographs were reordered and redistributed 3 months later. Inter- and intrarater agreement was determined for the distal fragment size, stability of the fracture, Neer classification, and decision to operate. Single variable logistic regression was performed to determine what factors could most accurately predict the decision for surgery. Interrater agreement was fair for distal fragment size, moderate for stability, fair for Neer classification, slight for type IIB and III fractures, and moderate for treatment approach. Intrarater agreement was moderate for distal fragment size categories (κ = 0.50, P < .001) and Neer classification (κ = 0.42, P < .001) and substantial for stable fracture (κ = 0.65, P < .001) and decision to operate (κ = 0.65, P < .001). Fracture stability was the best predictor of treatment, with 89% accuracy (P < .001). Fracture stability determination and the decision to operate had the highest interobserver agreement. Fracture stability was the key determinant of treatment, rather than the Neer classification system or the size of the distal fragment. © 2015 The Author(s).

  14. Non-target adjacent stimuli classification improves performance of classical ERP-based brain computer interface

    NASA Astrophysics Data System (ADS)

    Ceballos, G. A.; Hernández, L. F.

    2015-04-01

    Objective. The classical ERP-based speller, or P300 Speller, is one of the most commonly used paradigms in the field of Brain Computer Interfaces (BCI). Several alterations to the visual stimuli presentation system have been developed to avoid unfavorable effects elicited by adjacent stimuli. However, there has been little, if any, regard to useful information contained in responses to adjacent stimuli about spatial location of target symbols. This paper aims to demonstrate that combining the classification of non-target adjacent stimuli with standard classification (target versus non-target) significantly improves classical ERP-based speller efficiency. Approach. Four SWLDA classifiers were trained and combined with the standard classifier: the lower row, upper row, right column and left column classifiers. This new feature extraction procedure and the classification method were carried out on three open databases: the UAM P300 database (Universidad Autonoma Metropolitana, Mexico), BCI competition II (dataset IIb) and BCI competition III (dataset II). Main results. The inclusion of the classification of non-target adjacent stimuli improves target classification in the classical row/column paradigm. A gain in mean single trial classification of 9.6% and an overall improvement of 25% in simulated spelling speed was achieved. Significance. We have provided further evidence that the ERPs produced by adjacent stimuli present discriminable features, which could provide additional information about the spatial location of intended symbols. This work promotes the searching of information on the peripheral stimulation responses to improve the performance of emerging visual ERP-based spellers.

  15. Comparison of citrus orchard inventory using LISS-III and LISS-IV data

    NASA Astrophysics Data System (ADS)

    Singh, Niti; Chaudhari, K. N.; Manjunath, K. R.

    2016-04-01

    In India, in terms of area under cultivation, citrus is the third most cultivated fruit crop after Banana and Mango. Among citrus group, lime is one of the most important horticultural crops in India as the demand for its consumption is very high. Hence, preparing citrus crop inventories using remote sensing techniques would help in maintaining a record of its area and production statistics. This study shows how accurately citrus orchard can be classified using both IRS Resourcesat-2 LISS-III and LISS-IV data and depicts the optimum bio-widow for procuring satellite data to achieve high classification accuracy required for maintaining inventory of crop. Findings of the study show classification accuracy increased from 55% (using LISS-III) to 77% (using LISS-IV). Also, according to classified outputs and NDVI values obtained, April and May months were identified as optimum bio-window for citrus crop identification.

  16. Prognostic value of somatosensory-evoked potentials in the surgical management of cervical spondylotic myelopathy.

    PubMed

    Hu, Yong; Ding, Yu; Ruan, Dike; Wong, Y W; Cheung, Kenneth M C; Luk, Keith D K

    2008-05-01

    Preoperative somatosensory-evoked potentials (SEPs) were retrospectively analyzed and classified, and compared with surgical outcome. To evaluate the value of the preoperative SEP waveform in predicting the clinical outcome after surgical management of cervical spondylotic myelopathy (CSM). SEPs have played an important role in spinal surgery. However, the value of SEPs in predicting the outcome of surgery for CSM remains controversial. This study enrolled 76 CSM patients who underwent surgical intervention. Median nerve SEPs were recorded before surgery. The Japanese Orthopedic Association (JOA) scoring system was used to evaluate the neurologic function before surgery and at postoperative follow-up at 1, 3, 6, 12, and 24 months. Patients were divided into 5 groups according to the classification of their preoperative SEP waveforms. Group I patients had normal SEPs, group IIa had normal latency and abnormal amplitude, group IIb had abnormal latency and normal amplitude, group III had abnormal latency and amplitude, and group IV had immeasurable waveforms. The myelopathic disability scores and surgical outcomes in different groups were compared by the Kruskal-Wallis test. The SEP classification was found to be significantly associated with the JOA score (Pearson's chi test, chi = 53.9, P < 0.05). There were no significant differences in JOA score recovery at different follow-up times within any SEP group. At 24 months after surgery, there was no significant difference in the recovery ratio between groups I and IIa, or between groups IIb and III (Kruskal-Wallis test, P > 0.05). However, the recovery ratio was significantly higher in groups I and IIa than in all the other groups (Kruskal-Wallis test, P < 0.05), and in groups IIb and III than in group IV (Kruskal-Wallis test, P < 0.05). SEP classification correlates well with CSM disability and postoperative recovery ratio. Median nerve SEP recordings would be a valuable and practical tool for the diagnosis and prognosis of myelopathy.

  17. Seeking order amidst chaos: a systematic review of classification systems for causes of stillbirth and neonatal death, 2009-2014.

    PubMed

    Leisher, Susannah Hopkins; Teoh, Zheyi; Reinebrant, Hanna; Allanson, Emma; Blencowe, Hannah; Erwich, Jan Jaap; Frøen, J Frederik; Gardosi, Jason; Gordijn, Sanne; Gülmezoglu, A Metin; Heazell, Alexander E P; Korteweg, Fleurisca; Lawn, Joy; McClure, Elizabeth M; Pattinson, Robert; Smith, Gordon C S; Tunçalp, Ӧzge; Wojcieszek, Aleena M; Flenady, Vicki

    2016-10-05

    Each year, about 5.3 million babies die in the perinatal period. Understanding of causes of death is critical for prevention, yet there is no globally acceptable classification system. Instead, many disparate systems have been developed and used. We aimed to identify all systems used or created between 2009 and 2014, with their key features, including extent of alignment with the International Classification of Diseases (ICD) and variation in features by region, to inform the World Health Organization's development of a new global approach to classifying perinatal deaths. A systematic literature review (CINAHL, EMBASE, Medline, Global Health, and PubMed) identified published and unpublished studies and national reports describing new classification systems or modifications of existing systems for causes of perinatal death, or that used or tested such systems, between 2009 and 2014. Studies reporting ICD use only were excluded. Data were independently double-extracted (except from non-English publications). Subgroup analyses explored variation by extent and region. Eighty-one systems were identified as new, modifications of existing systems, or having been used between 2009 and 2014, with an average of ten systems created/modified each year. Systems had widely varying characteristics: (i) comprehensiveness (40 systems classified both stillbirths and neonatal deaths); (ii) extent of use (systems were created in 28 countries and used in 40; 17 were created for national use; 27 were widely used); (iii) accessibility (three systems available in e-format); (iv) underlying cause of death (64 systems required a single cause of death); (v) reliability (10 systems tested for reliability, with overall Kappa scores ranging from .35-.93); and (vi) ICD alignment (17 systems used ICD codes). Regional databases were not searched, so system numbers may be underestimated. Some non-differential misclassification of systems was possible. The plethora of systems in use, and continuing system development, hamper international efforts to improve understanding of causes of death. Recognition of the features of currently used systems, combined with a better understanding of the drivers of continued system creation, may help the development of a truly effective global system.

  18. Statewide land cover derived from multiseasonal Landsat TM data: A retrospective of the WISCLAND project

    USGS Publications Warehouse

    Reese, H.M.; Lillesand, T.M.; Nagel, D.E.; Stewart, J.S.; Goldmann, R.A.; Simmons, T.E.; Chipman, J.W.; Tessar, P.A.

    2002-01-01

    Landsat Thematic Mapper (TM) data were the basis in production of a statewide land cover data set for Wisconsin, undertaken in partnership with U.S. Geological Survey's (USGS) Gap Analysis Program (GAP). The data set contained seven classes comparable to Anderson Level I and 24 classes comparable to Anderson Level II/III. Twelve scenes of dual-date TM data were processed with methods that included principal components analysis, stratification into spectrally consistent units, separate classification of upland, wetland, and urban areas, and a hybrid supervised/unsupervised classification called "guided clustering." The final data had overall accuracies of 94% for Anderson Level I upland classes, 77% for Level II/III upland classes, and 84% for Level II/III wetland classes. Classification accuracies for deciduous and coniferous forest were 95% and 93%, respectively, and forest species' overall accuracies ranged from 70% to 84%. Limited availability of acceptable imagery necessitated use of an early May date in a majority of scene pairs, perhaps contributing to lower accuracy for upland deciduous forest species. The mixed deciduous/coniferous forest class had the lowest accuracy, most likely due to distinctly classifying a purely mixed class. Mixed forest signatures containing oak were often confused with pure oak. Guided clustering was seen as an efficient classification method, especially at the tree species level, although its success relied in part on image dates, accurate ground troth, and some analyst intervention. ?? 2002 Elsevier Science Inc. All rights reserved.

  19. A classification scheme for edge-localized modes based on their probability distributions

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Shabbir, A., E-mail: aqsa.shabbir@ugent.be; Max Planck Institute for Plasma Physics, D-85748 Garching; Hornung, G.

    We present here an automated classification scheme which is particularly well suited to scenarios where the parameters have significant uncertainties or are stochastic quantities. To this end, the parameters are modeled with probability distributions in a metric space and classification is conducted using the notion of nearest neighbors. The presented framework is then applied to the classification of type I and type III edge-localized modes (ELMs) from a set of carbon-wall plasmas at JET. This provides a fast, standardized classification of ELM types which is expected to significantly reduce the effort of ELM experts in identifying ELM types. Further, themore » classification scheme is general and can be applied to various other plasma phenomena as well.« less

  20. The Effect of Excipients on the Permeability of BCS Class III Compounds and Implications for Biowaivers.

    PubMed

    Parr, Alan; Hidalgo, Ismael J; Bode, Chris; Brown, William; Yazdanian, Mehran; Gonzalez, Mario A; Sagawa, Kazuko; Miller, Kevin; Jiang, Wenlei; Stippler, Erika S

    2016-01-01

    Currently, the FDA allows biowaivers for Class I (high solubility and high permeability) and Class III (high solubility and low permeability) compounds of the Biopharmaceutics Classification System (BCS). Scientific evidence should be provided to support biowaivers for BCS Class I and Class III (high solubility and low permeability) compounds. Data on the effects of excipients on drug permeability are needed to demonstrate that commonly used excipients do not affect the permeability of BCS Class III compounds, which would support the application of biowaivers to Class III compounds. This study was designed to generate such data by assessing the permeability of four BCS Class III compounds and one Class I compound in the presence and absence of five commonly used excipients. The permeability of each of the compounds was assessed, at three to five concentrations, with each excipient in two different models: Caco-2 cell monolayers, and in situ rat intestinal perfusion. No substantial increases in the permeability of any of the compounds were observed in the presence of any of the tested excipients in either of the models, with the exception of disruption of Caco-2 cell monolayer integrity by sodium lauryl sulfate at 0.1 mg/ml and higher. The results suggest that the absorption of these four BCS Class III compounds would not be greatly affected by the tested excipients. This may have implications in supporting biowaivers for BCS Class III compounds in general.

  1. Relationship between foot posture and dental malocclusions in children aged 6 to 9 years

    PubMed Central

    Marchena-Rodríguez, Ana; Moreno-Morales, Noelia; Ramírez-Parga, Edith; Labajo-Manzanares, María Teresa; Luque-Suárez, Alejandro; Gijon-Nogueron, Gabriel

    2018-01-01

    Abstract The aim of this study was to determine the association, if any, between foot posture and dental malocclusions in the anteroposterior plane, in children. The study population consisted of 189 children (95 boys and 94 girls) aged 6 to 9 years. In every case, previous informed consent was requested and obtained from the parent/guardian and the study was approved by the Ethics Committee of the University of Málaga (CEUMA 26/2015H). This observational, descriptive, cross-sectional analysis is based on a study population (STROBE). Qualified personnel conducted a podiatric and dental examination of each child, recording the Clarke angle and the foot posture index (FPI) as an outcomes measure in the feet, and also dental malocclusions, according to Angle classification. A significant correlation was observed for the FPI scores (for right foot) as well as the Clarke angle (for right foot), in relation to dental malocclusions as determined by Angle classification (P < .001). Of all the supinated feet analyzed, 38.46% were Class II according to Angle classification, and none were Class III. Of the pronated feet, 48.57% were Class III, 42.85% were Class I, and 8.57% were Class II. The Clarke angle decreases with the progression from Class I to III, whereas the FPI increases with that from Class I to III. These findings suggest there is a relation between the Clarke angle and FPI, on the one hand, and dental malocclusion on the other. PMID:29742725

  2. Relationship between foot posture and dental malocclusions in children aged 6 to 9 years: A cross-sectional study.

    PubMed

    Marchena-Rodríguez, Ana; Moreno-Morales, Noelia; Ramírez-Parga, Edith; Labajo-Manzanares, María Teresa; Luque-Suárez, Alejandro; Gijon-Nogueron, Gabriel

    2018-05-01

    The aim of this study was to determine the association, if any, between foot posture and dental malocclusions in the anteroposterior plane, in children.The study population consisted of 189 children (95 boys and 94 girls) aged 6 to 9 years. In every case, previous informed consent was requested and obtained from the parent/guardian and the study was approved by the Ethics Committee of the University of Málaga (CEUMA 26/2015H).This observational, descriptive, cross-sectional analysis is based on a study population (STROBE). Qualified personnel conducted a podiatric and dental examination of each child, recording the Clarke angle and the foot posture index (FPI) as an outcomes measure in the feet, and also dental malocclusions, according to Angle classification.A significant correlation was observed for the FPI scores (for right foot) as well as the Clarke angle (for right foot), in relation to dental malocclusions as determined by Angle classification (P < .001). Of all the supinated feet analyzed, 38.46% were Class II according to Angle classification, and none were Class III. Of the pronated feet, 48.57% were Class III, 42.85% were Class I, and 8.57% were Class II.The Clarke angle decreases with the progression from Class I to III, whereas the FPI increases with that from Class I to III. These findings suggest there is a relation between the Clarke angle and FPI, on the one hand, and dental malocclusion on the other.

  3. Equine endometrial fibrosis correlates with 11beta-HSD2, TGF-beta1 and ACE activities.

    PubMed

    Ganjam, V K; Evans, T J

    2006-03-27

    Endometrial periglandular fibrosis (EPF) contributes to embryonic and fetal loss in mares. Equine EPF correlates inversely with conception and successful gestation. In the modified Kenney endometrial biopsy classification system, EPF categories I, IIA, IIB, and III correspond to minimal, mild, moderate, and severe fibrosis (+/-inflammation), respectively. Paraffin sections of biopsy specimens were stained with H&E, and picrosirius red (specific for fibrillar collagens types I and III), to determine %EPCVF. Endometrial ACE-binding activity, TGF-beta1 and 11beta-HSD2 activities were also measured. Ultrastructural changes in EPF categories IIB and III endometria strongly suggested myofibroblastic transformation. ACE-binding activity was highest in EPF category IIB; however, endometrial TGF-beta1 and 11beta-HSD2 activities were significantly correlated to the severity of EPF (P<0.05). We conclude that, locally generated angiotensin II initiates the expression of TGF-beta1 resulting in myofibroblastic transformation. 11Beta-HSD2 in concert appears to modulate the severity of endometrial fibrosis.

  4. Current and evolving approaches for improving the oral permeability of BCS Class III or analogous molecules.

    PubMed

    Dave, Vivek S; Gupta, Deepak; Yu, Monica; Nguyen, Phuong; Varghese Gupta, Sheeba

    2017-02-01

    The Biopharmaceutics Classification System (BCS) classifies pharmaceutical compounds based on their aqueous solubility and intestinal permeability. The BCS Class III compounds are hydrophilic molecules (high aqueous solubility) with low permeability across the biological membranes. While these compounds are pharmacologically effective, poor absorption due to low permeability becomes the rate-limiting step in achieving adequate bioavailability. Several approaches have been explored and utilized for improving the permeability profiles of these compounds. The approaches include traditional methods such as prodrugs, permeation enhancers, ion-pairing, etc., as well as relatively modern approaches such as nanoencapsulation and nanosizing. The most recent approaches include a combination/hybridization of one or more traditional approaches to improve drug permeability. While some of these approaches have been extremely successful, i.e. drug products utilizing the approach have progressed through the USFDA approval for marketing; others require further investigation to be applicable. This article discusses the commonly studied approaches for improving the permeability of BCS Class III compounds.

  5. [Differentiation between moisture lesions and pressure ulcers using photographs in a critical area].

    PubMed

    Valls-Matarín, Josefa; Del Cotillo-Fuente, Mercedes; Pujol-Vila, María; Ribal-Prior, Rosa; Sandalinas-Mulero, Inmaculada

    2016-01-01

    To identify difficulties for nurses in differentiating between moisture lesions and pressure ulcers, proper classification of pressure ulcers to assess the adequate classification of the Grupo Nacional para el Estudio y Asesoramiento de Úlceras por Presión y Heridas Crónicas (GNEAUPP) and the degree of agreement in the correct assessment by type and category of injury. Cross-sectional study in a critical area during 2014. All nurses who agreed to participate were included. They performed a questionnaire with 14 photographs validated by experts of moisture lesions or pressure ulcers in the sacral area and buttocks, with 6 possible answers: Pressure ulcer category I, II, III, IV, moisture lesions and unknown. Demographics and knowledge of the classification system of the pressure ulcers were collected according to GNEAUPP. It involved 98% of the population (n=56); 98.2% knew the classification system of the GNEAUPP; 35.2% of moisture lesions were considered as pressure ulcers, most of them as a category II (18.9%). The 14.8% of the pressure ulcers photographs were identified as moisture lesions and 16.1% were classified in another category. The agreement between nurses earned a global Kappa index of .38 (95% CI: .29-.57). There are difficulties differentiating between pressure ulcers and moisture lesions, especially within initial categories. Nurses have the perception they know the pressure ulcers classification, but they do not classify them correctly. The degree of concordance in the diagnosis of skin lesions was low. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  6. Measurement of the center edge angle and determination of the Severin classification using digital radiography, computer-assisted measurement tools, and a Severin algorithm: intraobserver and interobserver reliability revisited.

    PubMed

    Carroll, Kristen L; Murray, Kathleen A; MacLeod, Lynne M; Hennessey, Theresa A; Woiczik, Marcella R; Roach, James W

    2011-06-01

    Numerous studies underscore the poor intraobserver and interobserver reliability of both the center edge angle (CEA) and the Severin classification using plain film measurements. In this study, experienced observers applied a computer-assisted measurement program to determine the CEA in digital pelvic radiographs of adults who had been previously treated for dysplasia of the hip (DDH). Using a teaching aid/algorithm of the Severin classification, the observers then assigned a Severin rating to these hips. Intraobserver and interobserver errors were then calculated on both the CEA measurements and the Severin classifications. Four pediatric orthopaedic surgeons and 1 pediatric radiologist calculated the CEAs using the OrthoView TM planning system and then determined the Severin classification on 41 blinded digital pelvic radiographs. The radiographs were evaluated by each examiner twice, with evaluations separated by 2 months. All examiners reviewed a Severin classification algorithm before making their Severin assignments. The intraobserver and interobserver reliability for both the CEA and the Severin classification were calculated using the interclass correlation coefficients and Cohen and Fleiss κ scores, respectively. The intraobserver and interobserver reliability for CEA measurement was moderate to almost perfect. When we separated the Severin classification into 3 clinically relevant groups of good (Severin I and II), dysplastic (Severin III), and poor (Severin IV and above), our interobserver reliability neared almost perfect. The Severin classification is an extremely useful and oft-used radiographic measure for the success of DDH treatment. Our research found digital radiography, computer-aided measurement tools, the use of a Severin algorithm, and separating the Severin classification into 3 clinically relevant groups significantly increased the intraobserver and interobserver reliability of both the CEA and Severin classification. This finding will assist future studies using the CEA and Severin classification in the radiographic assessment of DDH treatment outcomes.

  7. Implementing the Biopharmaceutics Classification System in Drug Development: Reconciling Similarities, Differences, and Shared Challenges in the EMA and US-FDA-Recommended Approaches.

    PubMed

    Cardot, J-M; Garcia Arieta, A; Paixao, P; Tasevska, I; Davit, B

    2016-07-01

    The US-FDA recently posted a draft guideline for industry recommending procedures necessary to obtain a biowaiver for immediate-release oral dosage forms based on the Biopharmaceutics Classification System (BCS). This review compares the present FDA BCS biowaiver approach, with the existing European Medicines Agency (EMA) approach, with an emphasis on similarities, difficulties, and shared challenges. Some specifics of the current EMA BCS guideline are compared with those in the recently published draft US-FDA BCS guideline. In particular, similarities and differences in the EMA versus US-FDA approaches to establishing drug solubility, permeability, dissolution, and formulation suitability for BCS biowaiver are critically reviewed. Several case studies are presented to illustrate the (i) challenges of applying for BCS biowaivers for global registration in the face of differences in the EMA and US-FDA BCS biowaiver criteria, as well as (ii) challenges inherent in applying for BCS class I or III designation and common to both jurisdictions.

  8. Using EUNIS habitat classification for benthic mapping in European seas: present concerns and future needs.

    PubMed

    Galparsoro, Ibon; Connor, David W; Borja, Angel; Aish, Annabelle; Amorim, Patricia; Bajjouk, Touria; Chambers, Caroline; Coggan, Roger; Dirberg, Guillaume; Ellwood, Helen; Evans, Douglas; Goodin, Kathleen L; Grehan, Anthony; Haldin, Jannica; Howell, Kerry; Jenkins, Chris; Michez, Noëmie; Mo, Giulia; Buhl-Mortensen, Pål; Pearce, Bryony; Populus, Jacques; Salomidi, Maria; Sánchez, Francisco; Serrano, Alberto; Shumchenia, Emily; Tempera, Fernando; Vasquez, Mickaël

    2012-12-01

    The EUNIS (European Union Nature Information System) habitat classification system aims to provide a common European reference set of habitat types within a hierarchical classification, and to cover all terrestrial, freshwater and marine habitats of Europe. The classification facilitates reporting of habitat data in a comparable manner, for use in nature conservation (e.g. inventories, monitoring and assessments), habitat mapping and environmental management. For the marine environment the importance of a univocal habitat classification system is confirmed by the fact that many European initiatives, aimed at marine mapping, assessment and reporting, are increasingly using EUNIS habitat categories and respective codes. For this reason substantial efforts have been made to include information on marine benthic habitats from different regions, aiming to provide a comprehensive geographical coverage of European seas. However, there still remain many concerns on its applicability as only a small fraction of Europe's seas are fully mapped and increasing knowledge and application raise further issues to be resolved. This paper presents an overview of the main discussion and conclusions of a workshop, organised by the MeshAtlantic project, focusing upon the experience in using the EUNIS habitats classification across different countries and seas, together with case studies. The aims of the meeting were to: (i) bring together scientists with experience in the use of the EUNIS marine classification and representatives from the European Environment Agency (EEA); (ii) agree on enhancements to EUNIS that ensure an improved representation of the European marine habitats; and (iii) establish practices that make marine habitat maps produced by scientists more consistent with the needs of managers and decision-makers. During the workshop challenges for the future development of EUNIS were identified, which have been classified into five categories: (1) structure and hierarchy; (2) biology; (3) terminology; (4) mapping; and (5) future development. The workshop ended with a declaration from the attendees, with recommendations to the EEA and European Topic Centre on Biological Diversity, to take into account the outputs of the workshop, which identify weaknesses in the current classification and include proposals for its modification, and to devise a process to further develop the marine component of the EUNIS habitat classification. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. The applicability of new TNM classification for humanpapilloma virus-related oropharyngeal cancer in the 8th edition of the AJCC/UICC TNM staging system in Japan: A single-centre study.

    PubMed

    Sano, Daisuke; Yabuki, Kenichiro; Arai, Yasuhiro; Tanabe, Teruhiko; Chiba, Yoshihiro; Nishimura, Goshi; Takahashi, Hideaki; Yamanaka, Shoji; Oridate, Nobuhiko

    2018-06-01

    The purpose of this study is to validate the applicability of new TNM classification for human papillomavirus (HPV)-related oropharyngeal cancer (OPC) in the 8th edition of the American Joint Committee on Cancer (AJCC)/Union for International Cancer Control (UICC) TNM staging system in Japan. A total of 91 OPC patients treated with radiation-based therapy between November 2001 and July 2015 were analyzed retrospectively in this study. HPV infection status was evaluated using tumor p16 expression. 40 OPC patients (44.0%) had HPV-positive disease in this study. The distribution of disease stage of HPV-positive OPC patients dramatically changed from the 7th edition to the 8th edition of AJCC/UICC TNM classification. However, neither the 8th edition nor the 7th edition of the AJCC/UICC TNM staging system could adequately predict outcomes of HPV-positive OPC patients in our patient series. On the other hand, our multivariate analysis indicated that matted nodes and age ≥63 were independent prognostic factors for progression-free survival. In addition, HPV-positive OPC patients with stage I without matted nodes showed significantly better overall and progression-free survival compared with those with stage I with matted nodes and stages II and III in the 8th edition of the AJCC/UICC TNM staging system (P=0.008, and P=0.043, respectively). Our results suggested that matted nodes of HPV-positive OPC patients might be additionally examined to apply the 8th edition of AJCC/UICC TNM classification for more adequate predicting outcomes of HPV-positive OPC patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Extensions to the Speech Disorders Classification System (SDCS)

    PubMed Central

    Shriberg, Lawrence D.; Fourakis, Marios; Hall, Sheryl D.; Karlsson, Heather B.; Lohmeier, Heather L.; McSweeny, Jane L.; Potter, Nancy L.; Scheer-Cohen, Alison R.; Strand, Edythe A.; Tilkens, Christie M.; Wilson, David L.

    2010-01-01

    This report describes three extensions to a classification system for pediatric speech sound disorders termed the Speech Disorders Classification System (SDCS). Part I describes a classification extension to the SDCS to differentiate motor speech disorders from speech delay and to differentiate among three subtypes of motor speech disorders. Part II describes the Madison Speech Assessment Protocol (MSAP), an approximately two-hour battery of 25 measures that includes 15 speech tests and tasks. Part III describes the Competence, Precision, and Stability Analytics (CPSA) framework, a current set of approximately 90 perceptual- and acoustic-based indices of speech, prosody, and voice used to quantify and classify subtypes of Speech Sound Disorders (SSD). A companion paper, Shriberg, Fourakis, et al. (2010) provides reliability estimates for the perceptual and acoustic data reduction methods used in the SDCS. The agreement estimates in the companion paper support the reliability of SDCS methods and illustrate the complementary roles of perceptual and acoustic methods in diagnostic analyses of SSD of unknown origin. Examples of research using the extensions to the SDCS described in the present report include diagnostic findings for a sample of youth with motor speech disorders associated with galactosemia (Shriberg, Potter, & Strand, 2010) and a test of the hypothesis of apraxia of speech in a group of children with autism spectrum disorders (Shriberg, Paul, Black, & van Santen, 2010). All SDCS methods and reference databases running in the PEPPER (Programs to Examine Phonetic and Phonologic Evaluation Records; [Shriberg, Allen, McSweeny, & Wilson, 2001]) environment will be disseminated without cost when complete. PMID:20831378

  11. Applying a food processing-based classification system to a food guide: a qualitative analysis of the Brazilian experience.

    PubMed

    Davies, Vanessa Fernandes; Moubarac, Jean-Claude; Medeiros, Kharla Janinny; Jaime, Patricia Constante

    2018-01-01

    The present paper aimed to identify the stakeholders, as well as their arguments and recommendations, in the debate on the application of a food processing-based classification system to the new Brazilian Food Guide. Qualitative approach; an analysis was made of documents resulting from the consultation conducted for the development of the new Brazilian Food Guide, which uses the NOVA classification for its dietary recommendations. A thematic matrix was constructed and the resulting themes represented the main points for discussion raised during the consultation. Brazil. Actors from academia, government and associations/unions/professional bodies/organizations related to the area of nutrition and food security; non-profit institutions linked to consumer interests and civil society organizations; organizations, associations and food unions linked to the food industry; and individuals. Four themes were identified: (i) conflicting paradigms; (ii) different perceptions about the role and need of individuals; (iii) we want more from the new food guide; and (iv) a sustainable guide. There was extensive participation from different sectors of society. The debate generated by the consultation revealed two main conflicting opinions: a view aligned with the interests of the food industry and a view of healthy eating which serves the interests of the population. The first group was against the adoption of a food processing-based classification system in a public policy such as the new Brazilian Food Guide. The second group, although mostly agreeing with the new food guide, argued that it failed to address some important issues related to the food and nutrition agenda in Brazil.

  12. Design and update of a classification system: the UCSD map of science.

    PubMed

    Börner, Katy; Klavans, Richard; Patek, Michael; Zoss, Angela M; Biberstine, Joseph R; Light, Robert P; Larivière, Vincent; Boyack, Kevin W

    2012-01-01

    Global maps of science can be used as a reference system to chart career trajectories, the location of emerging research frontiers, or the expertise profiles of institutes or nations. This paper details data preparation, analysis, and layout performed when designing and subsequently updating the UCSD map of science and classification system. The original classification and map use 7.2 million papers and their references from Elsevier's Scopus (about 15,000 source titles, 2001-2005) and Thomson Reuters' Web of Science (WoS) Science, Social Science, Arts & Humanities Citation Indexes (about 9,000 source titles, 2001-2004)-about 16,000 unique source titles. The updated map and classification adds six years (2005-2010) of WoS data and three years (2006-2008) from Scopus to the existing category structure-increasing the number of source titles to about 25,000. To our knowledge, this is the first time that a widely used map of science was updated. A comparison of the original 5-year and the new 10-year maps and classification system show (i) an increase in the total number of journals that can be mapped by 9,409 journals (social sciences had a 80% increase, humanities a 119% increase, medical (32%) and natural science (74%)), (ii) a simplification of the map by assigning all but five highly interdisciplinary journals to exactly one discipline, (iii) a more even distribution of journals over the 554 subdisciplines and 13 disciplines when calculating the coefficient of variation, and (iv) a better reflection of journal clusters when compared with paper-level citation data. When evaluating the map with a listing of desirable features for maps of science, the updated map is shown to have higher mapping accuracy, easier understandability as fewer journals are multiply classified, and higher usability for the generation of data overlays, among others.

  13. Design and Update of a Classification System: The UCSD Map of Science

    PubMed Central

    Börner, Katy; Klavans, Richard; Patek, Michael; Zoss, Angela M.; Biberstine, Joseph R.; Light, Robert P.; Larivière, Vincent; Boyack, Kevin W.

    2012-01-01

    Global maps of science can be used as a reference system to chart career trajectories, the location of emerging research frontiers, or the expertise profiles of institutes or nations. This paper details data preparation, analysis, and layout performed when designing and subsequently updating the UCSD map of science and classification system. The original classification and map use 7.2 million papers and their references from Elsevier’s Scopus (about 15,000 source titles, 2001–2005) and Thomson Reuters’ Web of Science (WoS) Science, Social Science, Arts & Humanities Citation Indexes (about 9,000 source titles, 2001–2004)–about 16,000 unique source titles. The updated map and classification adds six years (2005–2010) of WoS data and three years (2006–2008) from Scopus to the existing category structure–increasing the number of source titles to about 25,000. To our knowledge, this is the first time that a widely used map of science was updated. A comparison of the original 5-year and the new 10-year maps and classification system show (i) an increase in the total number of journals that can be mapped by 9,409 journals (social sciences had a 80% increase, humanities a 119% increase, medical (32%) and natural science (74%)), (ii) a simplification of the map by assigning all but five highly interdisciplinary journals to exactly one discipline, (iii) a more even distribution of journals over the 554 subdisciplines and 13 disciplines when calculating the coefficient of variation, and (iv) a better reflection of journal clusters when compared with paper-level citation data. When evaluating the map with a listing of desirable features for maps of science, the updated map is shown to have higher mapping accuracy, easier understandability as fewer journals are multiply classified, and higher usability for the generation of data overlays, among others. PMID:22808037

  14. A 3-tier classification of cerebral arteriovenous malformations. Clinical article.

    PubMed

    Spetzler, Robert F; Ponce, Francisco A

    2011-03-01

    The authors propose a 3-tier classification for cerebral arteriovenous malformations (AVMs). The classification is based on the original 5-tier Spetzler-Martin grading system, and reflects the treatment paradigm for these lesions. The implications of this modification in the literature are explored. Class A combines Grades I and II AVMs, Class B are Grade III AVMs, and Class C combines Grades IV and V AVMs. Recommended management is surgery for Class A AVMs, multimodality treatment for Class B, and observation for Class C, with exceptions to the latter including recurrent hemorrhages and progressive neurological deficits. To evaluate whether combining grades is warranted from the perspective of surgical outcomes, the 3-tier system was applied to 1476 patients from 7 surgical series in which results were stratified according to Spetzler-Martin grades. Pairwise comparisons of individual Spetzler-Martin grades in the series analyzed showed the fewest significant differences (p < 0.05) in outcomes between Grades I and II AVMs and between Grades IV and V AVMs. In the pooled data analysis, significant differences in outcomes were found between all grades except IV and V (p = 0.38), and the lowest relative risks were found between Grades I and II (1.066) and between Grades IV and V (1.095). Using the pooled data, the predictive accuracies for surgical outcomes of the 5-tier and 3-tier systems were equivalent (receiver operating characteristic curve area 0.711 and 0.713, respectively). Combining Grades I and II AVMs and combining Grades IV and V AVMs is justified in part because the differences in surgical results between these respective pairs are small. The proposed 3-tier classification of AVMs offers simplification of the Spetzler-Martin system, provides a guide to treatment, and is predictive of outcome. The revised classification not only simplifies treatment recommendations; by placing patients into 3 as opposed to 5 groups, statistical power is markedly increased for series comparisons.

  15. Associations of Initial Society for Fetal Urology Grades and Urinary Tract Dilatation Risk Groups with Clinical Outcomes in Patients with Isolated Prenatal Hydronephrosis.

    PubMed

    Braga, Luis H; McGrath, Melissa; Farrokhyar, Forough; Jegatheeswaran, Kizanee; Lorenzo, Armando J

    2017-03-01

    There are limited comparative data on the predictive value of the 2 most commonly used classification systems, that is SFU (Society for Fetal Urology) hydronephrosis grades and urinary tract dilatation risk groups, in regard to the future risk of surgical intervention and the development of febrile urinary tract infection. We explored this topic in infants with isolated hydronephrosis. After screening 938 patients with prenatal hydronephrosis from 2009 to 2016 we selected 322 patients with ureteropelvic junction obstruction-like hydronephrosis for study. Hydronephrosis grades were prospectively collected at baseline, surgery and last followup. Gender, circumcision status, antibiotic prophylaxis and renal pelvis anteroposterior diameter were captured. The primary outcome was pyeloplasty and the development of febrile urinary tract infection. Comparative analyses between SFU grades/urinary tract dilatation groups and the primary outcome were performed with the Fisher exact and log rank tests. Mean ± SD age at presentation was 3.3 ± 2.6 months and mean followup was 22 ± 19 months. Pyeloplasty was performed in 32% of patients with SFU III/IV vs 31% with urinary tract dilatation 2/3. The rate of febrile urinary tract infection in patients with SFU III/IV was similar to that in those with urinary tract dilatation group 2/3 (8% vs 10%). Children with SFU III/IV showed a significantly higher rate of surgery than those with SFU I/II (32% vs 2%, p <0.01). Similar findings were seen when using urinary tract dilatation groups to compare patients at low risk (1) vs moderate/high risk (2/3). Both grading systems equally allowed for proper risk stratification and prediction of clinical outcomes based on baseline ultrasound. They correctly separated most infants who underwent surgery or in whom febrile urinary tract infection developed from those who could be treated nonsurgically. Use of the new urinary tract dilatation classification should not affect how families of children with isolated hydronephrosis are counseled regarding surgical intervention and the risk of febrile urinary tract infection. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  16. Osteodysplastic primordial dwarfism: report of a further patient with manifestations similar to those seen in patients with types I and III.

    PubMed

    Winter, R M; Wigglesworth, J; Harding, B N

    1985-07-01

    We describe a female infant with low birthweight osteodysplastic microcephalic dwarfism. The child has many manifestations in common with those seen in osteodysplastic primordial dwarfism types I and III. The classification of this heterogeneous group of disorders is discussed in the light of the above case.

  17. Classification and Realizations of Type III Factor Representations of Cuntz-Krieger Algebras Associated with Quasi-Free States

    NASA Astrophysics Data System (ADS)

    Kawamura, Katsunori

    2009-03-01

    We completely classify type III factor representations of Cuntz-Krieger algebras associated with quasi-free states up to unitary equivalence. Furthermore, we realize these representations on concrete Hilbert spaces without using GNS construction. Free groups and their type II1 factor representations are used in these realizations.

  18. Classification and virtual screening of androgen receptor antagonists.

    PubMed

    Li, Jiazhong; Gramatica, Paola

    2010-05-24

    Computational tools, such as quantitative structure-activity relationship (QSAR), are highly useful as screening support for prioritization of substances of very high concern (SVHC). From the practical point of view, QSAR models should be effective to pick out more active rather than inactive compounds, expressed as sensitivity in classification works. This research investigates the classification of a big data set of endocrine-disrupting chemicals (EDCs)-androgen receptor (AR) antagonists, mainly aiming to improve the external sensitivity and to screen for potential AR binders. The kNN, lazy IB1, and ADTree methods and the consensus approach were used to build different models, which improve the sensitivity on external chemicals from 57.1% (literature) to 76.4%. Additionally, the models' predictive abilities were further validated on a blind collected data set (sensitivity: 85.7%). Then the proposed classifiers were used: (i) to distinguish a set of AR binders into antagonists and agonists; (ii) to screen a combined estrogen receptor binder database to find out possible chemicals that can bind to both AR and ER; and (iii) to virtually screen our in-house environmental chemical database. The in silico screening results suggest: (i) that some compounds can affect the normal endocrine system through a complex mechanism binding both to ER and AR; (ii) new EDCs, which are nonER binders, but can in silico bind to AR, are recognized; and (iii) about 20% of compounds in a big data set of environmental chemicals are predicted as new AR antagonists. The priority should be given to them to experimentally test the binding activities with AR.

  19. [Clinical observation on the different treatments targeted at different types of radial head fracture and radial neck fracture].

    PubMed

    Zhang, Ying-Ze; Guo, Ming-Ke; Zheng, Zhan-le; Zhang, Qi; Chen, Wei

    2009-06-15

    To assess the effect of the different treatments targeted at different types of radial head fracture and radial neck fracture. A retrospective study was performed in 87 patients from February 2006 to March 2007. Fifty-four patients with radial head fractures included 36 males and 18 females, aged from 18 to 65 years (the average age was 33); Forty of them resulted from crashing, 8 from traffic injury and 6 from falling injury. According to Mason classification system, there were 15 type I, 23 type II and 16 type III. Thirty-three patients with radial neck fractures included 21 males and 12 females, aged from 9 to 17 years (the average age was 13), 29 of them resulted from crashing, 1 from traffic injury and 3 from falling injury. According to O'Brien classification system, there were 8 type I, 14 type II and 11 type III. Type I of radial head fractures and radial neck fractures were immobilization with cast, the patients with type II of radial head fractures were treated with open reduction and micro-screw or T-trapezoid and bridge-shaped plate fixation and type III had operations to fix with bridge-shaped locked plate and repair the broken annular ligament, or replace heads with prosthesis. All patients with type II and type III of radial neck fractures were treated with closed reduction by leverage and percutaneous intra-medullary nailing. The patients were followed up for 4-12 months (mean 7.2 months). The functional recovery degrees were evaluated with Wheeler's evaluation system. In group of radial head fractures, the results were excellent in 26 patients, good in 20, fair in 6 and poor in 2, the excellent and good rate was 85.2%. In group of radial neck fractures, the results were excellent in 20 patients, good in 9, fair in 4 and poor in no patient, and the excellent and good rate was 87.9%. Different types of fractures should choose different surgical methods according to their characters. The excellent functional recovery depend on anatomical reduction, retaining the head of radius, early repairing and protecting the broken annular ligament of radius, and early functional training.

  20. Proposal of a novel system for the staging of thymic epithelial tumors.

    PubMed

    Bedini, Amedeo Vittorio; Andreani, Stefano Michele; Tavecchio, Luca; Fabbri, Alessandra; Giardini, Roberto; Camerini, Tiziana; Bufalino, Rosaria; Morabito, Alberto; Rosai, Juan

    2005-12-01

    We designed and assessed a new TNM staging system (herein called the INT [Istituto Nazionale Tumori] system) for thymic epithelial tumors in order to overcome the perceived drawbacks of Masaoka's system, which represents the current standard. In all, 123 cases were evaluated. The histologic types according to the World Health Organization (WHO) classification were as follows: subtype A: 5 cases; AB: 40; B1: 16; B2: 29; B3: 16; and C: 17 cases. There were 45 Masaoka's stage I, 33 stage II, 26 stage III, and 19 stage IV cases. A total of 11 INT definitions were grouped into three stages: locally restricted disease (75 cases), which included Masaoka's stage I and selected stage II cases (no pleural invasion); locally advanced disease (37 cases), which included Masaoka's stage III cases plus those staged II owing to pleural invasion and those staged IV owing to intrathoracic nodal or limited pleuropericardial involvement; and systemic disease (11 cases), which included the remaining Masaoka's stage IV cases. Completeness of resection, WHO types, and both staging systems were significant prognostic factors (p < 0.0001) on univariate analysis. The 95-month progression-free survival rates according to Masaoka's system were stage I: 100%; II: 93.6%; III: 46.3%; and IV: 23.2%. The INT system corresponding figures were as follows: locally restricted disease: 98.6%; locally advanced disease: 46.9%; and systemic disease: 11.7%. The INT system was the prognostic factor with the greatest impact (p = 0.0218) on multivariate analysis (Masaoka's system: p = 0.2012; completeness of resection: p = 0.6855; histology: p = 0.9386). The INT system allows finer disease descriptions than Masaoka's system, resulting in a stage grouping with higher prognostic distinctiveness.

  1. Assessment of the variation in American Society of Anesthesiologists [corrected] Physical Status Classification assignment in small animal anaesthesia.

    PubMed

    McMillan, Matthew; Brearley, Jacqueline

    2013-05-01

    To evaluate the interobserver variability in the assignment of the American Society of Anesthesiologists Physical Status Classification (ASA-PSC) to compromised small animal patients amongst a group of veterinary anaesthetists. Anonymous internet survey. Hypothetical case presentations. Sixteen hypothetical small animal cases with differing degrees of physiological or patho-physiological compromise were presented as part of an internet survey. Respondents were asked to assign a single ASA-PSC to each case and also to answer a number of demographic questions. ASA-PSC scores were considered separately and then grouped as scores of I-II and III-V. Agreement was analysed using the modified kappa statistic for multiple observers. Data were then sorted into various demographic groups for further analysis. There were 144 respondents of which 60 (~42%) were anaesthesia diplomates, 24 (~17%) were post-residency (nondiploma holders), 24 (~17%) were current anaesthesia residents, 21 (~15%) were general practitioners, 12 (~8%) were veterinary nurses or technicians, and 3 (~2%) were interns. Although there was a majority agreement (>50% in a single category) in 15 of the 16 cases, ASA-PSC were spread over at least three ASA-PS classifications for every case. Overall agreement was considered only fair (κ = 0.24, mean ± SD agreement 46 ± 7%). When comparing grouped data (ASA-PSC I-II versus III-V) overall agreement remained fair (κ = 0.36, mean ± SD agreement 69 ± 19%). There was no difference in ASA-PSC assignment between any of the demographic groups investigated. This study suggests major discrepancies can occur between observers given identical information when using the ASA-PSC to categorise health status in compromised small animal patients. The significant potential for interobserver variability in classification allocation should be borne in mind when the ASA-PSC is used for clinical, scientific and statistical purposes. © 2013 The Authors. Veterinary Anaesthesia and Analgesia © 2013 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.

  2. Single-Dose Oritavancin Treatment of Acute Bacterial Skin and Skin Structure Infections: SOLO Trial Efficacy by Eron Severity and Management Setting.

    PubMed

    Deck, Daniel H; Jordan, Jennifer M; Holland, Thomas L; Fan, Weihong; Wikler, Matthew A; Sulham, Katherine A; Ralph Corey, G

    2016-09-01

    Introduction of new antibiotics enabling single-dose administration, such as oritavancin may significantly impact site of care decisions for patients with acute bacterial skin and skin structure infections (ABSSSI). This analysis compared the efficacy of single-dose oritavancin with multiple-dose vancomycin in patients categorized according to disease severity via modified Eron classification and management setting. SOLO I and II were phase 3 studies evaluating single-dose oritavancin versus 7-10 days of vancomycin for treatment of ABSSSI. Patient characteristics were collected at baseline and retrospectively analyzed. Study protocols were amended, allowing outpatient management at the discretion of investigators. In this post hoc analysis, patients were categorized according to a modified Eron severity classification and management setting (outpatient vs. inpatient) and the efficacy compared. Overall, 1910 patients in the SOLO trials were categorized into Class I (520, 26.5%), II (790, 40.3%), and III (600, 30.6%). Of the 767 patients (40%) in the SOLO trials who were managed entirely in the outpatient setting 40.3% were categorized as Class II and 30.6% were Class III. Clinical efficacy was similar between oritavancin and vancomycin treatment groups, regardless of severity classification and across inpatient and outpatient settings. Class III patients had lower response rates (oritavancin 73.3%, vancomycin 76.6%) at early clinical evaluation when compared to patients in Class I (82.6%) or II (86.1%); however, clinical cure rates at the post-therapy evaluation were similar for Class III patients (oritavancin 79.8%, vancomycin 79.9%) when compared to Class I and II patients (79.1-85.7%). Single-dose oritavancin therapy results in efficacy comparable to multiple-dose vancomycin in patients categorized according to modified Eron disease severity classification regardless of whether management occurred in the inpatient or outpatient setting. The Medicines Company, Parsippany, NJ, USA. ClinicalTrials.gov identifiers, NCT01252719 (SOLO I) and NCT01252732 (SOLO II).

  3. Lesson Plans for Teaching Basic Vocational Agriculture. Section III. Introduction to Soil Management and Classification.

    ERIC Educational Resources Information Center

    McCully, James S., Jr., Comp.

    This publication, one of five sections, was developed for use in first and second year basic agriculture courses in secondary schools in Mississippi. The five lessons focus on the measurement and description of property and the classification of land. The purposes of the lessons are to (1) introduce the units and methods used to measure distance…

  4. Evaluating the Generality and Limits of Blind Return-Oriented Programming Attacks

    DTIC Science & Technology

    2015-12-01

    consider a recently proposed information disclosure vulnerability called blind return-oriented programming (BROP). Under certain conditions, this...implementation disclosure attacks 15. NUMBER OF PAGES 75 16. PRICE CODE 17. SECURITY CLASSIFICATION OF REPORT Unclassified 18. SECURITY CLASSIFICATION OF...Science iii THIS PAGE INTENTIONALLY LEFT BLANK iv ABSTRACT We consider a recently proposed information disclosure vulnerability called blind return

  5. Evaluation of the Sensitivity and Specificity of the New Clinical Diagnostic and Classification Criteria for Kashin-Beck Disease, an Endemic Osteoarthritis, in China.

    PubMed

    Yu, Fang Fang; Ping, Zhi Guang; Yao, Chong; Wang, Zhi Wen; Wang, Fu Qi; Guo, Xiong

    2017-02-01

    This study aimed to evaluate the sensitivity and specificity of the new clinical diagnostic and classification criteria for Kashin-Beck disease (KBD) using six clinical markers: flexion of the distal part of fingers, deformed fingers, enlarged finger joints, shortened fingers, squat down, and dwarfism. One-third of the total population in Linyou County was sampled by stratified random sampling. The survey included baseline characteristics and clinical diagnoses, and the sensitivity and specificity of the new criteria was evaluated. We identified 3,459 KBD patients, of which 69 had early stage KBD, 1,952 had stage I, 1,132 had stage II, and 306 had stage III. A screening test classified enlarged finger joints as stage I KBD, with a sensitivity and specificity of 0.978 and 0.045, respectively. Shortened fingers were classified as stage II KBD, with a sensitivity and specificity of 0.969 and 0.844, respectively, and dwarfism was classified as stage III KBD with a sensitivity and specificity of 0.951 and 0.992, respectively. Serial screening test revealed that the new clinical classification of KBD classified stages I, II, and III KBD with sensitivities of 0.949, 0.945, and 0.925 and specificities of 0.967, 0.970, and 0.993, respectively. The screening tests revealed that enlarged finger joints, shortened fingers, and dwarfism were appropriate markers for the clinical diagnosis and classification of KBD with high sensitivity and specificity. Copyright © 2017 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

  6. Generalized Rainich conditions, generalized stress-energy conditions, and the Hawking-Ellis classification

    NASA Astrophysics Data System (ADS)

    Martín–Moruno, Prado; Visser, Matt

    2017-11-01

    The (generalized) Rainich conditions are algebraic conditions which are polynomial in the (mixed-component) stress-energy tensor. As such they are logically distinct from the usual classical energy conditions (NEC, WEC, SEC, DEC), and logically distinct from the usual Hawking-Ellis (Segré-Plebański) classification of stress-energy tensors (type I, type II, type III, type IV). There will of course be significant inter-connections between these classification schemes, which we explore in the current article. Overall, we shall argue that it is best to view the (generalized) Rainich conditions as a refinement of the classical energy conditions and the usual Hawking-Ellis classification.

  7. Grey zones in the diagnosis of adult migraine without aura based on the International Classification of Headache Disorders-III beta: exploring the covariates of possible migraine without aura.

    PubMed

    Ozge, Aynur; Aydinlar, Elif; Tasdelen, Bahar

    2015-01-01

    Exploring clinical characteristics and migraine covariates may be useful in the diagnosis of migraine without aura. To evaluate the diagnostic value of the International Classification of Headache Disorders (ICHD)-III beta-based diagnosis of migraine without aura; to explore the covariates of possible migraine without aura using an analysis of grey zones in this area; and, finally, to make suggestions for the final version of the ICHD-III. A total of 1365 patients (mean [± SD] age 38.5±10.4 years, 82.8% female) diagnosed with migraine without aura according to the criteria of the ICHD-III beta were included in the present tertiary care-based retrospective study. Patients meeting all of the criteria of the ICHD-III beta were classified as having full migraine without aura, while those who did not meet one, two or ≥3 of the diagnostic criteria were classified as zones I, II and III, respectively. The diagnostic value of the clinical characteristics and covariates of migraine were determined. Full migraine without aura was evident in 25.7% of the migraineurs. A higher likelihood of zone I classification was shown for an attack lasting 4 h to 72 h (OR 1.560; P=0.002), with pulsating quality (OR 4.096; P<0.001), concomitant nausea⁄vomiting (OR 2.300; P<0.001) and photophobia⁄phonophobia (OR 4.865; P<0.001). The first-rank determinants for full migraine without aura were sleep irregularities (OR 1.596; P=0.005) and periodic vomiting (OR 1.464; P=0.026). However, even if not mentioned in ICHD-III beta, the authors determined that motion sickness, abdominal pain or infantile colic attacks in childhood, associated dizziness and osmophobia have important diagnostic value. In cases that do not fulfill all of the diagnostic criteria although they are largely consistent with the characteristics of migraine in clinical terms, the authors believe that a history of infantile colic; periodic vomiting (but not periodic vomiting syndrome); recurrent abdominal pain; the presence of motion sickness or vertigo, dizziness or osmophobia accompanying the pain; and comorbid atopic disorder are characteristics that should to be discussed and considered as additional diagnostic criteria (covariates) in the preparation of the final version of ICHD-III.

  8. Fascia: a morphological description and classification system based on a literature review

    PubMed Central

    Kumka, Myroslava; Bonar, Jason

    2012-01-01

    Fascia is virtually inseparable from all structures in the body and acts to create continuity amongst tissues to enhance function and support. In the past fascia has been difficult to study leading to ambiguities in nomenclature, which have only recently been addressed. Through review of the available literature, advances in fascia research were compiled, and issues related to terminology, descriptions, and clinical relevance of fascia were addressed. Our multimodal search strategy was conducted in Medline and PubMed databases, with other targeted searches in Google Scholar and by hand, utilizing reference lists and conference proceedings. In an effort to organize nomenclature for fascial structures provided by the Federative International Committee on Anatomical Terminology (FICAT), we developed a functional classification system which includes four categories of fascia: i) linking, ii) fascicular, iii) compression, and iv) separating fasciae. Each category was developed from descriptions in the literature on gross anatomy, histology, and biomechanics; the category names reflect the function of the fascia. An up-to-date definition of fascia is provided, as well as descriptions of its function and clinical features. Our classification demonstrates the use of internationally accepted terminology in an ontology which can improve understanding of major terms in each category of fascia. PMID:22997468

  9. Health systems strengthening: a common classification and framework for investment analysis

    PubMed Central

    Shakarishvili, George; Lansang, Mary Ann; Mitta, Vinod; Bornemisza, Olga; Blakley, Matthew; Kley, Nicole; Burgess, Craig; Atun, Rifat

    2011-01-01

    Significant scale-up of donors’ investments in health systems strengthening (HSS), and the increased application of harmonization mechanisms for jointly channelling donor resources in countries, necessitate the development of a common framework for tracking donors’ HSS expenditures. Such a framework would make it possible to comparatively analyse donors’ contributions to strengthening specific aspects of countries’ health systems in multi-donor-supported HSS environments. Four pre-requisite factors are required for developing such a framework: (i) harmonization of conceptual and operational understanding of what constitutes HSS; (ii) development of a common set of criteria to define health expenditures as contributors to HSS; (iii) development of a common HSS classification system; and (iv) harmonization of HSS programmatic and financial data to allow for inter-agency comparative analyses. Building on the analysis of these aspects, the paper proposes a framework for tracking donors’ investments in HSS, as a departure point for further discussions aimed at developing a commonly agreed approach. Comparative analysis of financial allocations by the Global Fund to Fight AIDS, Tuberculosis and Malaria and the GAVI Alliance for HSS, as an illustrative example of applying the proposed framework in practice, is also presented. PMID:20952397

  10. Tools and Functions of Reconfigurable Colloidal Assembly.

    PubMed

    Solomon, Michael J

    2018-02-19

    We review work in reconfigurable colloidal assembly, a field in which rapid, back-and-forth transitions between the equilibrium states of colloidal self-assembly are accomplished by dynamic manipulation of the size, shape, and interaction potential of colloids, as well as the magnitude and direction of the fields applied to them. It is distinguished from the study of colloidal phase transitions by the centrality of thermodynamic variables and colloidal properties that are time switchable; by the applicability of these changes to generate transitions in assembled colloids that may be spatially localized; and by its incorporation of the effects of generalized potentials due to, for example, applied electric and magnetic fields. By drawing upon current progress in the field, we propose a matrix classification of reconfigurable colloidal systems based on the tool used and function performed by reconfiguration. The classification distinguishes between the multiple means by which reconfigurable assembly can be accomplished (i.e., the tools of reconfiguration) and the different kinds of structural transitions that can be achieved by it (i.e., the functions of reconfiguration). In the first case, the tools of reconfiguration can be broadly classed as (i) those that control the colloidal contribution to the system entropy-as through volumetric and/or shape changes of the particles; (ii) those that control the internal energy of the colloids-as through manipulation of colloidal interaction potentials; and (iii) those that control the spatially resolved potential energy that is imposed on the colloids-as through the introduction of field-induced phoretic mechanisms that yield colloidal displacement and accumulation. In the second case, the functions of reconfiguration include reversible: (i) transformation between different phases-including fluid, cluster, gel, and crystal structures; (ii) manipulation of the spacing between colloids in crystals and clusters; and (iii) translation, rotation, or shape-change of finite-size objects self-assembled from colloids. With this classification in hand, we correlate the current limits on the spatiotemporal scales for reconfigurable colloidal assembly and identify a set of future research challenges.

  11. Biowaiver extension potential to BCS Class III high solubility-low permeability drugs: bridging evidence for metformin immediate-release tablet.

    PubMed

    Cheng, Ching-Ling; Yu, Lawrence X; Lee, Hwei-Ling; Yang, Chyun-Yu; Lue, Chang-Sha; Chou, Chen-Hsi

    2004-07-01

    The biopharmaceutics classification system (BCS) allows biowaiver for rapid dissolving immediate-release (IR) products of Class I drugs (high solubility and high permeability). The possibility of extending biowaivers to Class III high solubility and low permeability drugs is currently under scrutiny. In vivo bioequivalence data of different formulations of Class III drugs would support such an extension. The objective of this work was to demonstrate the bioequivalence of two marketed IR tablet products of a Class III drug, metformin hydrochloride, that are rapidly dissolving and have similar in vitro dissolution profiles. The effect of race on the systemic exposure of metformin was also explored. A randomized, open-label, two-period crossover study was conducted in 12 healthy Chinese male volunteers. Each subject received a single-dose of 500 mg of each product after an overnight fasting. The plasma concentrations of metformin were followed for 24 h. No significant formulation effect was found for the bioequivalence metrics: areas under concentration-time curve (AUC0-t, AUC0-infinity) and maximal concentration (Cmax). The 90% confidence intervals for the ratio of means were found within the acceptance range of 80-125% for the log-transformed data. Based on these results, it was concluded that the two IR products are bioequivalent. The pharmacokinetic parameters of metformin in Chinese for both products were similar and were in good agreement with those reported for metformin IR tablets in other ethnic populations. This study serves as an example for supporting biowaiver for BCS Class III drugs.

  12. [Injuries of the acromioclavicular joint].

    PubMed

    Meeder, P J; Dannöhl, C

    1988-07-01

    The injuries of the acromio-clavicular joint require a differentiated diagnosis and treatment. The classification of the acromio-clavicular dislocations from grade I to grade III according to Tossy is proved. The diagnosis of a complete acromio-clavicular dislocation (Tossy III) is an indication for a surgical repair. Many and different methods are reported in the literature. 178 patients with a fresh acromio-clavicular dislocation (Typ Tossy II and III) were treated at the BG-Unfallklinik Tübingen from 1970 to 1987 by suturing the ligaments, inserting pins across the joint and tension wire bending. In old cases with Tossy III dislocation of the acromio-clavicular joint an oblique osteotomy combined with the reduction of the clavicle is recommended as a method of choice. The results of these procedures and there possible intra- and postoperative complications are reported. The incision along the clavicle quite often gives scar problems. Therefore the advantages of an arched incision across the acromio-clavicular joint is pointed out. Because of there biomechanical relationship fractures in the lateral third of the clavicle are similar to dislocations of the acromio-clavicular joint. The classification of these fractures according to Jäger, Buschle and Breitner allows a differentiated management of these lesions.

  13. Validation of accelerometer cut points in toddlers with and without cerebral palsy.

    PubMed

    Oftedal, Stina; Bell, Kristie L; Davies, Peter S W; Ware, Robert S; Boyd, Roslyn N

    2014-09-01

    The purpose of this study was to validate uni- and triaxial ActiGraph cut points for sedentary time in toddlers with cerebral palsy (CP) and typically developing children (TDC). Children (n = 103, 61 boys, mean age = 2 yr, SD = 6 months, range = 1 yr 6 months-3 yr) were divided into calibration (n = 65) and validation (n = 38) samples with separate analyses for TDC (n = 28) and ambulant (Gross Motor Function Classification System I-III, n = 51) and nonambulant (Gross Motor Function Classification System IV-V, n = 25) children with CP. An ActiGraph was worn during a videotaped assessment. Behavior was coded as sedentary or nonsedentary. Receiver operating characteristic-area under the curve analysis determined the classification accuracy of accelerometer data. Predictive validity was determined using the Bland-Altman analysis. Classification accuracy for uniaxial data was fair for the ambulatory CP and TDC group but poor for the nonambulatory CP group. Triaxial data showed good classification accuracy for all groups. The uniaxial ambulatory CP and TDC cut points significantly overestimated sedentary time (bias = -10.5%, 95% limits of agreement [LoA] = -30.2% to 9.1%; bias = -17.3%, 95% LoA = -44.3% to 8.3%). The triaxial ambulatory and nonambulatory CP and TDC cut points provided accurate group-level measures of sedentary time (bias = -1.5%, 95% LoA = -20% to 16.8%; bias = 2.1%, 95% LoA = -17.3% to 21.5%; bias = -5.1%, 95% LoA = -27.5% to 16.1%). Triaxial accelerometers provide useful group-level measures of sedentary time in children with CP across the spectrum of functional abilities and TDC. Uniaxial cut points are not recommended.

  14. How do we understand the disagreement in the frequency of surgical site infection between the CDC and Clavien-Dindo classifications?

    PubMed

    Yamamoto, Takanobu; Takahashi, Satoshi; Ichihara, Koji; Hiyama, Yoshiki; Uehara, Teruhisa; Hashimoto, Jiro; Hirobe, Megumi; Masumori, Naoya

    2015-02-01

    To clarify the discrepancy in the incidence and severity of surgical site infections (SSI) for radical cystectomy between reports based on the CDC guideline and those using the Clavien-Dindo classification we evaluated 449 consecutive patients who underwent radical cystectomy for bladder cancer between 1990 and 2012. Of the 115 (25.6%) patients with SSI defined by the CDC guideline, 89 could be analyzed. We compared the SSI rates and severity defined by the CDC guideline and Clavien-Dindo classifications. There were 58 patients with superficial SSI, 16 with deep SSI, and 15 with organ/space SSI according to the CDC guideline. All patients with organ/space SSI were judged as "not having SSI" by the Clavien-Dindo classification. They were classified as having "intestinal prolapse", "intestinal fistula", "abdominal abscess" and "pelvic abscess." There was a significant association between the treatment duration and depth of SSI based on the CDC guideline by Spearman's rank-correlation coefficient (p < 0.001, r = 0.614) and with the grade of complications (p < 0.001, r = 0.632) in the Clavien-Dindo classification. Multivariate analysis showed that patients with grade III SSI in the Clavien-Dindo classification needed a significantly longer treatment duration. It is necessary to be aware that a discrepancy can occur automatically due to the different natures of the definitions. Using the CDC guideline, we can effectively estimate the future treatment period when SSI occurs. With the Clavien-Dindo classification, grade III SSI requires a longer treatment duration. Copyright © 2014 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  15. Diagnostic discrepancies in retinopathy of prematurity classification

    PubMed Central

    Campbell, J. Peter; Ryan, Michael C.; Lore, Emily; Tian, Peng; Ostmo, Susan; Jonas, Karyn; Chan, R.V. Paul; Chiang, Michael F.

    2016-01-01

    Objective To identify the most common areas for discrepancy in retinopathy of prematurity (ROP) classification between experts. Design Prospective cohort study. Subjects, Participants, and/or Controls 281 infants were identified as part of a multi-center, prospective, ROP cohort study from 7 participating centers. Each site had participating ophthalmologists who provided the clinical classification after routine examination using binocular indirect ophthalmoscopy (BIO), and obtained wide-angle retinal images, which were independently classified by two study experts. Methods Wide-angle retinal images (RetCam; Clarity Medical Systems, Pleasanton, CA) were obtained from study subjects, and two experts evaluated each image using a secure web-based module. Image-based classifications for zone, stage, plus disease, overall disease category (no ROP, mild ROP, Type II or pre-plus, and Type I) were compared between the two experts, and to the clinical classification obtained by BIO. Main Outcome Measures Inter-expert image-based agreement and image-based vs. ophthalmoscopic diagnostic agreement using absolute agreement and weighted kappa statistic. Results 1553 study eye examinations from 281 infants were included in the study. Experts disagreed on the stage classification in 620/1553 (40%) of comparisons, plus disease classification (including pre-plus) in 287/1553 (18%), zone in 117/1553 (8%), and overall ROP category in 618/1553 (40%). However, agreement for presence vs. absence of type 1 disease was >95%. There were no differences between image-based and clinical classification except for zone III disease. Conclusions The most common area of discrepancy in ROP classification is stage, although inter-expert agreement for clinically-significant disease such as presence vs. absence of type 1 and type 2 disease is high. There were no differences between image-based grading and the clinical exam in the ability to detect clinically-significant disease. This study provides additional evidence that image-based classification of ROP reliably detects clinically significant levels of ROP with high accuracy compared to the clinical exam. PMID:27238376

  16. Random forest wetland classification using ALOS-2 L-band, RADARSAT-2 C-band, and TerraSAR-X imagery

    NASA Astrophysics Data System (ADS)

    Mahdianpari, Masoud; Salehi, Bahram; Mohammadimanesh, Fariba; Motagh, Mahdi

    2017-08-01

    Wetlands are important ecosystems around the world, although they are degraded due both to anthropogenic and natural process. Newfoundland is among the richest Canadian province in terms of different wetland classes. Herbaceous wetlands cover extensive areas of the Avalon Peninsula, which are the habitat of a number of animal and plant species. In this study, a novel hierarchical object-based Random Forest (RF) classification approach is proposed for discriminating between different wetland classes in a sub-region located in the north eastern portion of the Avalon Peninsula. Particularly, multi-polarization and multi-frequency SAR data, including X-band TerraSAR-X single polarized (HH), L-band ALOS-2 dual polarized (HH/HV), and C-band RADARSAT-2 fully polarized images, were applied in different classification levels. First, a SAR backscatter analysis of different land cover types was performed by training data and used in Level-I classification to separate water from non-water classes. This was followed by Level-II classification, wherein the water class was further divided into shallow- and deep-water classes, and the non-water class was partitioned into herbaceous and non-herbaceous classes. In Level-III classification, the herbaceous class was further divided into bog, fen, and marsh classes, while the non-herbaceous class was subsequently partitioned into urban, upland, and swamp classes. In Level-II and -III classifications, different polarimetric decomposition approaches, including Cloude-Pottier, Freeman-Durden, Yamaguchi decompositions, and Kennaugh matrix elements were extracted to aid the RF classifier. The overall accuracy and kappa coefficient were determined in each classification level for evaluating the classification results. The importance of input features was also determined using the variable importance obtained by RF. It was found that the Kennaugh matrix elements, Yamaguchi, and Freeman-Durden decompositions were the most important parameters for wetland classification in this study. Using this new hierarchical RF classification approach, an overall accuracy of up to 94% was obtained for classifying different land cover types in the study area.

  17. Proposal for a bariatric mortality risk classification system for patients undergoing bariatric surgery.

    PubMed

    Nguyen, Ninh T; Nguyen, Brian; Smith, Brian; Reavis, Kevin M; Elliott, Christian; Hohmann, Samuel

    2013-01-01

    An obesity surgery mortality risk score derived from a single clinical series can be used to stratify the mortality risk of patients undergoing gastric bypass. However, such a scoring system does not take into account 2 important factors in contemporary bariatric surgery--increased use of the laparoscopic approach and laparoscopic adjustable gastric banding. The present study analyzed the preoperative factors that might predict in-hospital mortality after bariatric surgery using data from academic medical centers and proposes a classification system for predicting mortality. Using the "International Classification of Diseases, 9th revision," diagnosis and procedural codes, the data for all patients who underwent bariatric surgery for the treatment of morbid obesity from 2002 to 2009 were obtained from the University HealthSystem Consortium database. The limitations of this database included the lack of the body mass index and the underestimation of some co-morbidities, such as sleep apnea. Multiple regression analyses were performed to determine the factors predictive of greater in-hospital mortality. The factors examined included race, gender, age, co-morbidities, surgical technique (laparoscopic versus open), bariatric operation (gastric bypass versus nongastric bypass), and payer type. A scoring system was devised by assigning 1 point for each major factor (those with an adjusted odds ratio [AOR] of ≥2.0) and .5 point for each minor factor (those with an AOR <2.0). Using contemporary data from 2007 to 2009, the in-hospital mortality was analyzed according to the classification: class I, 0-0.5 point; class II, 1.0-1.5 points; class III, 2.0-3.0 points; and class IV, ≥3.5 points. During the 8-year period, 105,287 patients underwent bariatric surgery. The operations included laparoscopic gastric bypass (45%), open gastric bypass (41%), and laparoscopic gastric banding or gastroplasty (14%). The overall in-hospital mortality rate was .17%. The number of deaths per 1000 bariatric operations decreased from 4.0 in 2002 to .6 in 2009. Using regression analyses, the factors predictive of greater in-hospital mortality were male gender (AOR 3.2), gastric bypass procedure (AOR 5.8), open surgical technique (AOR 4.8), Medicare payer (AOR 3.0), diabetes (AOR 1.6), and age >60 years (AOR 1.9). The mortality rate was .10% for class I patients, .15% for class II, .33% for class III, and .70% for class IV (P < .05 among all classes). Within the context of academic centers, the mortality after bariatric surgery has decreased substantially since 2002, with an increase in the use of the laparoscopic technique and laparoscopic gastric banding. A bariatric mortality risk classification system was developed to stratify mortality, given the limits of this database, which does not include the body mass index and underestimates the incidence of sleep apnea. It might be useful to aid surgeons in surgical decision-making, to inform patients of their risks, and for quality improvement reporting purposes. Copyright © 2013 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  18. EXhype: A tool for mineral classification using hyperspectral data

    NASA Astrophysics Data System (ADS)

    Adep, Ramesh Nityanand; shetty, Amba; Ramesh, H.

    2017-02-01

    Various supervised classification algorithms have been developed to classify earth surface features using hyperspectral data. Each algorithm is modelled based on different human expertises. However, the performance of conventional algorithms is not satisfactory to map especially the minerals in view of their typical spectral responses. This study introduces a new expert system named 'EXhype (Expert system for hyperspectral data classification)' to map minerals. The system incorporates human expertise at several stages of it's implementation: (i) to deal with intra-class variation; (ii) to identify absorption features; (iii) to discriminate spectra by considering absorption features, non-absorption features and by full spectra comparison; and (iv) finally takes a decision based on learning and by emphasizing most important features. It is developed using a knowledge base consisting of an Optimal Spectral Library, Segmented Upper Hull method, Spectral Angle Mapper (SAM) and Artificial Neural Network. The performance of the EXhype is compared with a traditional, most commonly used SAM algorithm using Airborne Visible/Infrared Imaging Spectrometer (AVIRIS) data acquired over Cuprite, Nevada, USA. A virtual verification method is used to collect samples information for accuracy assessment. Further, a modified accuracy assessment method is used to get a real users accuracies in cases where only limited or desired classes are considered for classification. With the modified accuracy assessment method, SAM and EXhype yields an overall accuracy of 60.35% and 90.75% and the kappa coefficient of 0.51 and 0.89 respectively. It was also found that the virtual verification method allows to use most desired stratified random sampling method and eliminates all the difficulties associated with it. The experimental results show that EXhype is not only producing better accuracy compared to traditional SAM but, can also rightly classify the minerals. It is proficient in avoiding misclassification between target classes when applied on minerals.

  19. Modified CC-LR algorithm with three diverse feature sets for motor imagery tasks classification in EEG based brain-computer interface.

    PubMed

    Siuly; Li, Yan; Paul Wen, Peng

    2014-03-01

    Motor imagery (MI) tasks classification provides an important basis for designing brain-computer interface (BCI) systems. If the MI tasks are reliably distinguished through identifying typical patterns in electroencephalography (EEG) data, a motor disabled people could communicate with a device by composing sequences of these mental states. In our earlier study, we developed a cross-correlation based logistic regression (CC-LR) algorithm for the classification of MI tasks for BCI applications, but its performance was not satisfactory. This study develops a modified version of the CC-LR algorithm exploring a suitable feature set that can improve the performance. The modified CC-LR algorithm uses the C3 electrode channel (in the international 10-20 system) as a reference channel for the cross-correlation (CC) technique and applies three diverse feature sets separately, as the input to the logistic regression (LR) classifier. The present algorithm investigates which feature set is the best to characterize the distribution of MI tasks based EEG data. This study also provides an insight into how to select a reference channel for the CC technique with EEG signals considering the anatomical structure of the human brain. The proposed algorithm is compared with eight of the most recently reported well-known methods including the BCI III Winner algorithm. The findings of this study indicate that the modified CC-LR algorithm has potential to improve the identification performance of MI tasks in BCI systems. The results demonstrate that the proposed technique provides a classification improvement over the existing methods tested. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  20. Recursive partitioning analysis (RPA) classification predicts survival in patients with brain metastases from sarcoma.

    PubMed

    Grossman, Rachel; Ram, Zvi

    2014-12-01

    Sarcoma rarely metastasizes to the brain, and there are no specific treatment guidelines for these tumors. The recursive partitioning analysis (RPA) classification is a well-established prognostic scale used in many malignancies. In this study we assessed the clinical characteristics of metastatic sarcoma to the brain and the validity of the RPA classification system in a subset of 21 patients who underwent surgical resection of metastatic sarcoma to the brain We retrospectively analyzed the medical, radiological, surgical, pathological, and follow-up clinical records of 21 patients who were operated for metastatic sarcoma to the brain between 1996 and 2012. Gliosarcomas, sarcomas of the head and neck with local extension into the brain, and metastatic sarcomas to the spine were excluded from this reported series. The patients' mean age was 49.6 ± 14.2 years (range, 25-75 years) at the time of diagnosis. Sixteen patients had a known history of systemic sarcoma, mostly in the extremities, and had previously received systemic chemotherapy and radiation therapy for their primary tumor. The mean maximal tumor diameter in the brain was 4.9 ± 1.7 cm (range 1.7-7.2 cm). The group's median preoperative Karnofsky Performance Scale was 80, with 14 patients presenting with Karnofsky Performance Scale of 70 or greater. The median overall survival was 7 months (range 0.2-204 months). The median survival time stratified by the Radiation Therapy Oncology Group RPA classes were 31, 7, and 2 months for RPA class I, II, and III, respectively (P = 0.0001). This analysis is the first to support the prognostic utility of the Radiation Therapy Oncology Group RPA classification for sarcoma brain metastases and may be used as a treatment guideline tool in this rare disease. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. CT imaging-based determination and classification of anatomic variations of left gastric vein.

    PubMed

    Wu, Yongyou; Chen, Guangqiang; Wu, Pengfei; Zhu, Jianbin; Peng, Wei; Xing, Chungen

    2017-03-01

    Precise determination and classification of left gastric vein (LGV) anatomy are helpful in planning for gastric surgery, in particular, for resection of gastric cancer. However, the anatomy of LGV is highly variable. A systematic classification of its variations is still to be proposed. We aimed to investigate the anatomical variations in LGV using CT imaging and develop a new nomenclature system. We reviewed CT images and tracked the course of LGV in 825 adults. The frequencies of common and variable LGV anatomical courses were recorded. Anatomic variations of LGV were proposed and classified into different types mainly based on its courses. The inflow sites of LGV into the portal system were also considered if common hepatic artery (CHA) or splenic artery (SA) could not be used as a frame of reference due to variations. Detailed anatomy and courses of LGV were depicted on CT images. Using CHA and SA as the frames of reference, the routes of LGV were divided into six types (i.e., PreS, RetroS, Mid, PreCH, RetroCH, and Supra). The inflow sites were classified into four types (i.e., PV, SV, PSV, and LPV). The new classification was mainly based on the courses of LGV, which was validated with MDCT in the 805 cases with an identifiable LGV, namely type I, RetroCH, 49.8 % (401/805); type II, PreS, 20.6 % (166/805); type III, Mid, 20.0 % (161/805); type IV, RetroS, 7.3 % (59/805); type V, Supra, 1.5 % (12/805); and type VI, PreCH, 0.7 % (6/805). Type VII, designated to the cases in which SA and CHA could not be used as frames of reference, was not observed in this series. Detailed depiction of the anatomy and courses of LGV on CT images allowed us to evaluate and develop a new classification and nomenclature system for the anatomical variations of LGV.

  2. Classification of human coronary atherosclerotic plaques using ex vivo high-resolution multicontrast-weighted MRI compared with histopathology.

    PubMed

    Li, Tao; Li, Xin; Zhao, Xihai; Zhou, Weihua; Cai, Zulong; Yang, Li; Guo, Aitao; Zhao, Shaohong

    2012-05-01

    The objective of our study was to evaluate the feasibility of ex vivo high-resolution multicontrast-weighted MRI to accurately classify human coronary atherosclerotic plaques according to the American Heart Association classification. Thirteen human cadaver heart specimens were imaged using high-resolution multicontrast-weighted MR technique (T1-weighted, proton density-weighted, and T2-weighted). All MR images were matched with histopathologic sections according to the landmark of the bifurcation of the left main coronary artery. The sensitivity and specificity of MRI for the classification of plaques were determined, and Cohen's kappa analysis was applied to evaluate the agreement between MRI and histopathology in the classification of atherosclerotic plaques. One hundred eleven MR cross-sectional images obtained perpendicular to the long axis of the proximal left anterior descending artery were successfully matched with the histopathologic sections. For the classification of plaques, the sensitivity and specificity of MRI were as follows: type I-II (near normal), 60% and 100%; type III (focal lipid pool), 80% and 100%; type IV-V (lipid, necrosis, fibrosis), 96.2% and 88.2%; type VI (hemorrhage), 100% and 99.0%; type VII (calcification), 93% and 100%; and type VIII (fibrosis without lipid core), 100% and 99.1%, respectively. Isointensity, which indicates lipid composition on histopathology, was detected on MRI in 48.8% of calcified plaques. Agreement between MRI and histopathology for plaque classification was 0.86 (p < 0.001). Ex vivo high-resolution multicontrast-weighted MRI can accurately classify advanced atherosclerotic plaques in human coronary arteries.

  3. A neural network approach for enhancing information extraction from multispectral image data

    USGS Publications Warehouse

    Liu, J.; Shao, G.; Zhu, H.; Liu, S.

    2005-01-01

    A back-propagation artificial neural network (ANN) was applied to classify multispectral remote sensing imagery data. The classification procedure included four steps: (i) noisy training that adds minor random variations to the sampling data to make the data more representative and to reduce the training sample size; (ii) iterative or multi-tier classification that reclassifies the unclassified pixels by making a subset of training samples from the original training set, which means the neural model can focus on fewer classes; (iii) spectral channel selection based on neural network weights that can distinguish the relative importance of each channel in the classification process to simplify the ANN model; and (iv) voting rules that adjust the accuracy of classification and produce outputs of different confidence levels. The Purdue Forest, located west of Purdue University, West Lafayette, Indiana, was chosen as the test site. The 1992 Landsat thematic mapper imagery was used as the input data. High-quality airborne photographs of the same Lime period were used for the ground truth. A total of 11 land use and land cover classes were defined, including water, broadleaved forest, coniferous forest, young forest, urban and road, and six types of cropland-grassland. The experiment, indicated that the back-propagation neural network application was satisfactory in distinguishing different land cover types at US Geological Survey levels II-III. The single-tier classification reached an overall accuracy of 85%. and the multi-tier classification an overall accuracy of 95%. For the whole test, region, the final output of this study reached an overall accuracy of 87%. ?? 2005 CASI.

  4. Mössbauer investigations to characterize Fe lattice sites in sheet silicates and Peru Basin deep-sea sediments

    NASA Astrophysics Data System (ADS)

    Lougear, André; König, Iris; Trautwein, Alfred X.; Suess, Erwin

    A procedure to classify different Fe lattice sites, i.e., OH-group geometries, in the clay mineral content of deep-sea sediments was developed using Mössbauer spectroscopy at low temperature (77 K). This speciation is of interest with regard to the redox behavior, reactivity and color of marine sediments, since substantial iron redox transitions (associated with sediment color change) have been documented for the structural sheet silicate iron. Lattice site classification was achieved for the Fe(II) fraction, all of which is structural clay Fe(II) in the sediments under investigation. Whereas the major part of the Fe(III) is structural clay iron as well, there is a small Fe(III) fraction in oxide minerals. Therefore, further elaboration of the procedure would be required to also achieve lattice site classification for the Fe(III) fraction. Analysis of the Mössbauer spectra is based on computer fits, the input parameters of which were derived from a separate study of Fe(II)-rich pure chlorites. The procedure of classification is qualified to investigate, e.g., in laboratory experiments, the site-specific reaction rates and the effects on sediment color of iron redox transitions in the sheet silicate content of sediments. The new skills were successfully applied in environmental impact studies on the mining of polymetallic nodules from the Peru Basin deep-sea floor.

  5. Ensemble of random forests One vs. Rest classifiers for MCI and AD prediction using ANOVA cortical and subcortical feature selection and partial least squares.

    PubMed

    Ramírez, J; Górriz, J M; Ortiz, A; Martínez-Murcia, F J; Segovia, F; Salas-Gonzalez, D; Castillo-Barnes, D; Illán, I A; Puntonet, C G

    2018-05-15

    Alzheimer's disease (AD) is the most common cause of dementia in the elderly and affects approximately 30 million individuals worldwide. Mild cognitive impairment (MCI) is very frequently a prodromal phase of AD, and existing studies have suggested that people with MCI tend to progress to AD at a rate of about 10-15% per year. However, the ability of clinicians and machine learning systems to predict AD based on MRI biomarkers at an early stage is still a challenging problem that can have a great impact in improving treatments. The proposed system, developed by the SiPBA-UGR team for this challenge, is based on feature standardization, ANOVA feature selection, partial least squares feature dimension reduction and an ensemble of One vs. Rest random forest classifiers. With the aim of improving its performance when discriminating healthy controls (HC) from MCI, a second binary classification level was introduced that reconsiders the HC and MCI predictions of the first level. The system was trained and evaluated on an ADNI datasets that consist of T1-weighted MRI morphological measurements from HC, stable MCI, converter MCI and AD subjects. The proposed system yields a 56.25% classification score on the test subset which consists of 160 real subjects. The classifier yielded the best performance when compared to: (i) One vs. One (OvO), One vs. Rest (OvR) and error correcting output codes (ECOC) as strategies for reducing the multiclass classification task to multiple binary classification problems, (ii) support vector machines, gradient boosting classifier and random forest as base binary classifiers, and (iii) bagging ensemble learning. A robust method has been proposed for the international challenge on MCI prediction based on MRI data. The system yielded the second best performance during the competition with an accuracy rate of 56.25% when evaluated on the real subjects of the test set. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. PSIDD3: Post-Scan Ultrasonic Data Display System for the Windows-Based PC Including Fuzzy Logic Analysis

    NASA Technical Reports Server (NTRS)

    Lovelace, Jeffrey J.; Cios, Krzysztof J.; Roth, Don J.; Cao, Wei

    2000-01-01

    Post-Scan Interactive Data Display (PSIDD) III is a user-oriented Windows-based system that facilitates the display and comparison of ultrasonic contact data. The system is optimized to compare ultrasonic measurements made at different locations within a material or at different stages of material degradation. PSIDD III provides complete analysis of the primary wave forms in the time and frequency domains along with the calculation of several frequency dependent properties including Phase Velocity and Attenuation Coefficient and several frequency independent properties, like the Cross Correlation Velocity. The system allows image generation on all of the frequency dependent properties at any available frequency (limited by the bandwidth used in the scans) and on any of the frequency independent properties. From ultrasonic contact scans, areas of interest on an image can be studied with regard to underlying raw waveforms and derived ultrasonic properties by simply selecting the point on the image. The system offers various modes of in-depth comparison between scan points. Up to five scan points can be selected for comparative analysis at once. The system was developed with Borland Delphi software (Visual Pascal) and is based on a SQL database. It is ideal for classification of material properties, or location of microstructure variations in materials.

  7. Technical Operations Support III (TOPS III). Task Order 0018: Nanostructured Graphene-Like Polymers

    DTIC Science & Technology

    2010-06-01

    diverse response by a large class of materials: viscoelastic fluids, inelasticity, crystallization of polymers, twinning, shape memory alloys , single...crystal super alloys , and viscoelastic solids. 15. SUBJECT TERMS 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT: SAR 18. NUMBER...twinning (Rajagopal and Srinivasa (1997)), Kannan et al. (2002)), shape memory alloys (Rajagopal and Srinivasa (1999)), single crystal super alloys

  8. Malingering in Toxic Exposure. Classification Accuracy of Reliable Digit Span and WAIS-III Digit Span Scaled Scores

    ERIC Educational Resources Information Center

    Greve, Kevin W.; Springer, Steven; Bianchini, Kevin J.; Black, F. William; Heinly, Matthew T.; Love, Jeffrey M.; Swift, Douglas A.; Ciota, Megan A.

    2007-01-01

    This study examined the sensitivity and false-positive error rate of reliable digit span (RDS) and the WAIS-III Digit Span (DS) scaled score in persons alleging toxic exposure and determined whether error rates differed from published rates in traumatic brain injury (TBI) and chronic pain (CP). Data were obtained from the files of 123 persons…

  9. CLARIPED: a new tool for risk classification in pediatric emergencies.

    PubMed

    Magalhães-Barbosa, Maria Clara de; Prata-Barbosa, Arnaldo; Alves da Cunha, Antonio José Ledo; Lopes, Cláudia de Souza

    2016-09-01

    To present a new pediatric risk classification tool, CLARIPED, and describe its development steps. Development steps: (i) first round of discussion among experts, first prototype; (ii) pre-test of reliability, 36 hypothetical cases; (iii) second round of discussion to perform adjustments; (iv) team training; (v) pre-test with patients in real time; (vi) third round of discussion to perform new adjustments; (vii) final pre-test of validity (20% of medical treatments in five days). CLARIPED features five urgency categories: Red (Emergency), Orange (very urgent), Yellow (urgent), Green (little urgent) and Blue (not urgent). The first classification step includes the measurement of four vital signs (Vipe score); the second step consists in the urgency discrimination assessment. Each step results in assigning a color, selecting the most urgent one for the final classification. Each color corresponds to a maximum waiting time for medical care and referral to the most appropriate physical area for the patient's clinical condition. The interobserver agreement was substantial (kappa=0.79) and the final pre-test, with 82 medical treatments, showed good correlation between the proportion of patients in each urgency category and the number of used resources (p<0.001). CLARIPED is an objective and easy-to-use tool for simple risk classification, of which pre-tests suggest good reliability and validity. Larger-scale studies on its validity and reliability in different health contexts are ongoing and can contribute to the implementation of a nationwide pediatric risk classification system. Copyright © 2016 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  10. Adenocarcinoma of the lung with scattered consolidation: radiological-pathological correlation and prognosis.

    PubMed

    Jiang, Binghu; Takashima, Shodayu; Hakucho, Tomoaki; Hodaka, Numasaki; Yasuhiko, Tomita; Masahiko, Higashiyama

    2013-10-01

    To investigate the clinicopathological features and prognosis in patients with adenocarcinoma of the lung with scattered consolidation (ALSC). Between January 2006 and March 2010, 139 consecutive patients with lung adenocarcinoma of ≤3 cm, who underwent pulmonary resection for lung cancer, were investigated retrospectively. Radiologic classification was based on the findings of thin-section CT such as the presence of consolidation or ground-glass opacity (GGO). Type I (n=15) and Type II (n=14), showed a pure GGO and a mixed GGO with consolidation <50%, respectively. Type IV (n=38) and Type V (n=52) showed a mixed GGO with consolidation ≥50% and a pure consolidation, respectively. Type III (n=20) was the adenocarcinoma of the lung with scattered consolidation (ALSC). The clinicopathological features and prognosis of ALSC was investigated with comparative analysis and survival analysis. Because of the similar recurrence rate for Type I and Type II (P=1.000), Type IV and Type V (P=0.343), we merged Type I and Type II as Type I+II, Type IV and Type V as Type IV+V, respectively. In the 20 (14.4%) patients with ALSC, lymph node metastasis was not observed, and it was rare in lymphatic invasion and vascular invasion. On the basis of IASLC/ATS/ERS 2011 classification, 80% of the ALSC were preinvasive lesions. In Noguchi classification, there was no significant difference between Type I+II and ALSC (P=0.260). The prognosis of ALSC was similar to Type I+II (P=0.408), but better than Type IV+V (P=0.040). Adenocarcinoma of the lung with scattered consolidation (ALSC) on thin-section CT was a relatively favorable prognostic factor. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  11. The Fracturing of China? Ethnic Separatism and Political Violence in the Xinjiang Uyghur Autonomous Region

    DTIC Science & Technology

    2007-09-01

    deprivation, rational choice 16. PRICE CODE 17. SECURITY CLASSIFICATION OF REPORT Unclassified 18 . SECURITY CLASSIFICATION OF THIS PAGE...Prescribed by ANSI Std. 239- 18 ii THIS PAGE INTENTIONALLY LEFT BLANK iii Approved for public release; distribution is unlimited. THE...psychological, or erotic in nature.10 This argument purports that when individuals participate within a group for the advancement of collective good, they

  12. Bioinformatics analyses of Shigella CRISPR structure and spacer classification.

    PubMed

    Wang, Pengfei; Zhang, Bing; Duan, Guangcai; Wang, Yingfang; Hong, Lijuan; Wang, Linlin; Guo, Xiangjiao; Xi, Yuanlin; Yang, Haiyan

    2016-03-01

    Clustered regularly interspaced short palindromic repeats (CRISPR) are inheritable genetic elements of a variety of archaea and bacteria and indicative of the bacterial ecological adaptation, conferring acquired immunity against invading foreign nucleic acids. Shigella is an important pathogen for anthroponosis. This study aimed to analyze the features of Shigella CRISPR structure and classify the spacers through bioinformatics approach. Among 107 Shigella, 434 CRISPR structure loci were identified with two to seven loci in different strains. CRISPR-Q1, CRISPR-Q4 and CRISPR-Q5 were widely distributed in Shigella strains. Comparison of the first and last repeats of CRISPR1, CRISPR2 and CRISPR3 revealed several base variants and different stem-loop structures. A total of 259 cas genes were found among these 107 Shigella strains. The cas gene deletions were discovered in 88 strains. However, there is one strain that does not contain cas gene. Intact clusters of cas genes were found in 19 strains. From comprehensive analysis of sequence signature and BLAST and CRISPRTarget score, the 708 spacers were classified into three subtypes: Type I, Type II and Type III. Of them, Type I spacer referred to those linked with one gene segment, Type II spacer linked with two or more different gene segments, and Type III spacer undefined. This study examined the diversity of CRISPR/cas system in Shigella strains, demonstrated the main features of CRISPR structure and spacer classification, which provided critical information for elucidation of the mechanisms of spacer formation and exploration of the role the spacers play in the function of the CRISPR/cas system.

  13. Morphology of Mesiobuccal Root Canals of Maxillary First Molars: a comparison of CBCT scanning and Cross-sectioning.

    PubMed

    Lyra, Carina Maria; Delai, Débora; Pereira, Keila Cristina Rausch; Pereira, Guy Martins; Pasternak Júnior, Bráulio; Oliveira, César Augusto Pereira

    2015-10-01

    The aim of this study was to evaluate the mesiobuccal root of maxillary first molars, according to the root canal configuration, prevalence and location of isthmuses at 3 and 6 mm from the apex, comparing cone-beam computed tomography (CBCT) analysis and cross sectioning of roots by thirds. Images of the mesiobuccal root of 100 maxillary first molars were acquired by CBCT and then roots were cross-sectioned into two parts, starting at 3 mm from the apex. Data were recorded and analyzed according to Weine's classification for root canal configuration, and Hsu and Kim's classification for isthmuses. In the analysis of CBCT images, 8 root canals were classified as type I, 57 as type II, 35 as type III. In the cross-sectioning technique, 19 root canals were classified as type I, 60 as type II, 20 as type III and 1 as type IV. The classification of isthmuses was predominantly type I in both CBCT and cross-sectioning evaluations for sections at 3 mm from the apex, while for sections at 6 mm from the apex, the classification of isthmuses was predominantly types V and II in CBCT and cross-sectioning evaluations, respectively. The cross-sectioning technique showed better results in detection of the internal morphology of root canals than CBCT scanning.

  14. Biological attachment devices: exploring nature's diversity for biomimetics.

    PubMed

    Gorb, Stanislav N

    2008-05-13

    Many species of animals and plants are supplied with diverse attachment devices, in which morphology depends on the species biology and the particular function in which the attachment device is involved. Many functional solutions have evolved independently in different lineages of animals and plants. Since the diversity of such biological structures is huge, there is a need for their classification. This paper, based on the original and literature data, proposes ordering of biological attachment systems according to several principles: (i) fundamental physical mechanism, according to which the system operates, (ii) biological function of the attachment device, and (iii) duration of the contact. Finally, we show a biomimetic potential of studies on biological attachment devices.

  15. GPCRdb: an information system for G protein-coupled receptors

    PubMed Central

    Isberg, Vignir; Mordalski, Stefan; Munk, Christian; Rataj, Krzysztof; Harpsøe, Kasper; Hauser, Alexander S.; Vroling, Bas; Bojarski, Andrzej J.; Vriend, Gert; Gloriam, David E.

    2016-01-01

    Recent developments in G protein-coupled receptor (GPCR) structural biology and pharmacology have greatly enhanced our knowledge of receptor structure-function relations, and have helped improve the scientific foundation for drug design studies. The GPCR database, GPCRdb, serves a dual role in disseminating and enabling new scientific developments by providing reference data, analysis tools and interactive diagrams. This paper highlights new features in the fifth major GPCRdb release: (i) GPCR crystal structure browsing, superposition and display of ligand interactions; (ii) direct deposition by users of point mutations and their effects on ligand binding; (iii) refined snake and helix box residue diagram looks; and (iii) phylogenetic trees with receptor classification colour schemes. Under the hood, the entire GPCRdb front- and back-ends have been re-coded within one infrastructure, ensuring a smooth browsing experience and development. GPCRdb is available at http://www.gpcrdb.org/ and it's open source code at https://bitbucket.org/gpcr/protwis. PMID:26582914

  16. Branched-chain amino acids to tyrosine ratio (BTR) predicts intrahepatic distant recurrence and survival for early hepatocellular carcinoma.

    PubMed

    Ishikawa, Toru; Kubota, Tomoyuki; Horigome, Ryoko; Kimura, Naruhiro; Honda, Hiroki; Iwanaga, Akito; Seki, Keiichi; Honma, Terasu; Yoshida, Toshiaki

    2013-01-01

    The Child-Pugh classification system is the most widely used system for assessing hepatic functional reserve in HCC treatment. In the Child-Pugh classification system, serum albumin levels are used to accurately assess the status of protein metabolism and nutrition. To date, a lack of attention has been given to amino acid metabolism. In the present study, we investigated whether the branched-chain amino acids to tyrosine ratio (BTR) as an indicator of amino acid metabolism can serve as both a prognostic factor for early HCC and a predictive factor for recurrence. We conducted a cohort study of 50 patients with stage I/II HCC enrolled between May 2002 and December 2010. It was investigated whether BTR can serve as both a prognostic factor and a predictive factor for HCC recurrence. Overall survival rates were significantly higher in patients with high baseline BTR than in those with low BTR. Multivariate analysis showed that both BTR and serum albumin were prognostic factors, and that BTR was the best predictive factor for recurrence. BTR was a prognostic factor for early HCC and the most predictive factor for intrahepatic distant recurrence and contributing factors for survival.

  17. Low-Rank Linear Dynamical Systems for Motor Imagery EEG.

    PubMed

    Zhang, Wenchang; Sun, Fuchun; Tan, Chuanqi; Liu, Shaobo

    2016-01-01

    The common spatial pattern (CSP) and other spatiospectral feature extraction methods have become the most effective and successful approaches to solve the problem of motor imagery electroencephalography (MI-EEG) pattern recognition from multichannel neural activity in recent years. However, these methods need a lot of preprocessing and postprocessing such as filtering, demean, and spatiospectral feature fusion, which influence the classification accuracy easily. In this paper, we utilize linear dynamical systems (LDSs) for EEG signals feature extraction and classification. LDSs model has lots of advantages such as simultaneous spatial and temporal feature matrix generation, free of preprocessing or postprocessing, and low cost. Furthermore, a low-rank matrix decomposition approach is introduced to get rid of noise and resting state component in order to improve the robustness of the system. Then, we propose a low-rank LDSs algorithm to decompose feature subspace of LDSs on finite Grassmannian and obtain a better performance. Extensive experiments are carried out on public dataset from "BCI Competition III Dataset IVa" and "BCI Competition IV Database 2a." The results show that our proposed three methods yield higher accuracies compared with prevailing approaches such as CSP and CSSP.

  18. Configuration of electro-optic fire source detection system

    NASA Astrophysics Data System (ADS)

    Fabian, Ram Z.; Steiner, Zeev; Hofman, Nir

    2007-04-01

    The recent fighting activities in various parts of the world have highlighted the need for accurate fire source detection on one hand and fast "sensor to shooter cycle" capabilities on the other. Both needs can be met by the SPOTLITE system which dramatically enhances the capability to rapidly engage hostile fire source with a minimum of casualties to friendly force and to innocent bystanders. Modular system design enable to meet each customer specific requirements and enable excellent future growth and upgrade potential. The design and built of a fire source detection system is governed by sets of requirements issued by the operators. This can be translated into the following design criteria: I) Long range, fast and accurate fire source detection capability. II) Different threat detection and classification capability. III) Threat investigation capability. IV) Fire source data distribution capability (Location, direction, video image, voice). V) Men portability. ) In order to meet these design criteria, an optimized concept was presented and exercised for the SPOTLITE system. Three major modular components were defined: I) Electro Optical Unit -Including FLIR camera, CCD camera, Laser Range Finder and Marker II) Electronic Unit -including system computer and electronic. III) Controller Station Unit - Including the HMI of the system. This article discusses the system's components definition and optimization processes, and also show how SPOTLITE designers successfully managed to introduce excellent solutions for other system parameters.

  19. Nearest neighbor: The low-mass Milky Way satellite Tucana III

    DOE PAGES

    Simon, J. D.; Li, T. S.; Drlica-Wagner, A.; ...

    2017-03-17

    Here, we present Magellan/IMACS spectroscopy of the recently discovered Milky Way satellite Tucana III (Tuc III). We identify 26 member stars in Tuc III from which we measure a mean radial velocity of v hel = -102.3 ± 0.4 (stat.) ± 2.0 (sys.)more » $$\\mathrm{km}\\,{{\\rm{s}}}^{-1}$$, a velocity dispersion of $${0.1}_{-0.1}^{+0.7}$$ $$\\mathrm{km}\\,{{\\rm{s}}}^{-1}$$, and a mean metallicity of $${\\rm{[Fe/H]}}=-{2.42}_{-0.08}^{+0.07}$$. The upper limit on the velocity dispersion is σ < 1.5 $$\\mathrm{km}\\,{{\\rm{s}}}^{-1}$$ at 95.5% confidence, and the corresponding upper limit on the mass within the half-light radius of Tuc III is 9.0 × 10 4 M ⊙. We cannot rule out mass-to-light ratios as large as 240 M ⊙/L ⊙ for Tuc III, but much lower mass-to-light ratios that would leave the system baryon-dominated are also allowed. We measure an upper limit on the metallicity spread of the stars in Tuc III of 0.19 dex at 95.5% confidence. Tuc III has a smaller metallicity dispersion and likely a smaller velocity dispersion than any known dwarf galaxy, but a larger size and lower surface brightness than any known globular cluster. Its metallicity is also much lower than those of the clusters with similar luminosity. We therefore tentatively suggest that Tuc III is the tidally stripped remnant of a dark matter-dominated dwarf galaxy, but additional precise velocity and metallicity measurements will be necessary for a definitive classification. If Tuc III is indeed a dwarf galaxy, it is one of the closest external galaxies to the Sun. Because of its proximity, the most luminous stars in Tuc III are quite bright, including one star at V = 15.7 that is the brightest known member star of an ultra-faint satellite.« less

  20. Comparison of 2 Orthotic Approaches in Children With Cerebral Palsy.

    PubMed

    Wren, Tishya A L; Dryden, James W; Mueske, Nicole M; Dennis, Sandra W; Healy, Bitte S; Rethlefsen, Susan A

    2015-01-01

    To compare dynamic ankle-foot orthoses (DAFOs) and adjustable dynamic response (ADR) ankle-foot orthoses (AFOs) in children with cerebral palsy. A total of 10 children with cerebral palsy (4-12 years; 6 at Gross Motor Function Classification System level I, 4 at Gross Motor Function Classification System level III) and crouch and/or equinus gait wore DAFOs and ADR-AFOs, each for 4 weeks, in randomized order. Laboratory-based gait analysis, walking activity monitor, and parent-reported questionnaire outcomes were compared among braces and barefoot conditions. Children demonstrated better stride length (11-12 cm), hip extension (2°-4°), and swing-phase dorsiflexion (9°-17°) in both braces versus barefoot. Push-off power (0.3 W/kg) and knee extension (5°) were better in ADR-AFOs than in DAFOs. Parent satisfaction and walking activity (742 steps per day, 43 minutes per day) were higher for DAFOs. ADR-AFOs produce better knee extension and push-off power; DAFOs produce more normal ankle motion, greater parent satisfaction, and walking activity. Both braces provide improvements over barefoot.

  1. IDH mutation is paradoxically associated with higher 18F-FDOPA PET uptake in diffuse grade II and grade III gliomas.

    PubMed

    Verger, A; Metellus, Ph; Sala, Q; Colin, C; Bialecki, E; Taieb, D; Chinot, O; Figarella-Branger, D; Guedj, E

    2017-08-01

    The World Health Organization Classification of Tumors of the Central Nervous System has recently been updated by the integration of diagnostic and prognostic molecular parameters, giving pivotal attention to IDH mutation as a favourable factor. Amino acid PET is increasingly used in the management of gliomas, but its prognostic value is a matter of debate. The aim of this study was to assess the relationship between IDH mutation and 18 F-FDOPA uptake on PET in newly diagnosed gliomas. A total of 43 patients, presenting with diffuse astrocytic and oligodendroglial grade II and III gliomas, reclassified according to the 2016 WHO classification of tumours of the CNS, were retrospectively included. They had all undergone 18 F-FDOPA PET at an initial stage before surgery and histological diagnosis. 18 F-FDOPA uptake values were compared between patients with and without IDH mutation in terms of maximum standardized uptake value (SUVmax) ratios between tumour and normal contralateral brain (T/N), and between tumour and striatum (T/S). Patients with IDH mutation showed higher 18 F-FDOPA T/N SUVmax ratios (1.6 vs. 1.2) and T/S SUVmax ratios (0.9 vs. 0.6) than patients without IDH mutation (p < 0.05). This study showed paradoxically higher 18 F-FDOPA uptake in diffuse grade II and III gliomas with IDH mutation. Despite evident interest in the management of gliomas, and especially in relation to posttherapy evaluation, our findings raise the question of the prognostic value of 18 F-FDOPA uptake on PET uptake in this group of patients. This may be related to differences in amino acid integration, metabolism, or cell differentiation.

  2. Systemic treatment after whole-brain radiotherapy may improve survival in RPA class II/III breast cancer patients with brain metastasis.

    PubMed

    Zhang, Qian; Chen, Jian; Yu, Xiaoli; Ma, Jinli; Cai, Gang; Yang, Zhaozhi; Cao, Lu; Chen, Xingxing; Guo, Xiaomao; Chen, Jiayi

    2013-09-01

    Whole brain radiotherapy (WBRT) is the most widely used treatment for brain metastasis (BM), especially for patients with multiple intracranial lesions. The purpose of this study was to examine the efficacy of systemic treatments following WBRT in breast cancer patients with BM who had different clinical characteristics, based on the classification of the Radiation Therapy Oncology Group recursive partitioning analysis (RPA) and the breast cancer-specific Graded Prognostic Assessment (Breast-GPA). One hundred and one breast cancer patients with BM treated between 2006 and 2010 were analyzed. The median interval between breast cancer diagnosis and identification of BM in the triple-negative patients was shorter than in the luminal A subtype (26 vs. 36 months, respectively; P = 0.021). Univariate analysis indicated that age at BM diagnosis, Karnofsky performance status/recursive partitioning analysis (KPS/RPA) classes, number of BMs, primary tumor control, extracranial metastases and systemic treatment following WBRT were significant prognostic factors for overall survival (OS) (P < 0.05). Multivariate analysis revealed that KPS/RPA classes and systemic treatments following WBRT remained the significant prognostic factors for OS. For RPA class I, the median survival with and without systemic treatments following WBRT was 25 and 22 months, respectively (P = 0.819), while for RPA class II/III systemic treatments significantly improved OS from 7 and 2 months to 11 and 5 months, respectively (P < 0.05). Our results suggested that triple-negative patients had a shorter interval between initial diagnosis and the development of BM than luminal A patients. Systemic treatments following WBRT improved the survival of RPA class II/III patients.

  3. Transoral oropharyngeal resection classification: Proposal of the SCORL working group.

    PubMed

    Virós Porcuna, David; Avilés Jurado, Francisco; Pollán Guisasola, Carlos; Ramírez Ruiz, Rosa Delia; García Lorenzo, Jacinto; Tobed Secall, Marc; Vilaseca González, Isabel; Costa González, José Miguel; Soteras Olle, Josep; Casamitjana Claramunt, Francesc; Sumarroca Trouboul, Anna; Hijano Esqué, Rafael; Viscasillas Pallàs, Guillem; Mañós Pujol, Manel; Quer Agustí, Miquel

    There has been a very significant increase in the use of minimally invasive surgery has in the last decade. In order to provide a common language after transoral surgery of the oropharynx, a system for classifying resections has been created in this area, regardless of the instrumentation used. From the Oncology Working Group of the Catalan Society of Otorhinolaryngology, a proposal for classification based on a topographical division of the different areas of the oropharynx is presented, as also based on the invasion of the related structures according to the anatomical routes of extension of these tumours. The classification starts using the letter D or I according to laterality either right (D) or left (I). The number of the resected area is then placed. This numbering defines the zones beginning at the cranial level where area I would be the soft palate, lateral area II in the tonsillar area, area III in the tongue base, area IV in the glossoepiglottic folds, epiglottis and pharyngoepiglottic folds, area V posterior oropharyngeal wall and VI the retromolar trigone. The suffix p is added if the resection deeply affects the submucosal plane of the compromised area. The different proposed areas would, in theory, have different functional implications. Proposal for a system of classification by area to definedifferent types of transoral surgery of the oropharynx, and enable as sharing of results and helps in teaching this type of technique. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  4. Reliability of a novel, semi-quantitative scale for classification of structural brain magnetic resonance imaging in children with cerebral palsy.

    PubMed

    Fiori, Simona; Cioni, Giovanni; Klingels, Katrjin; Ortibus, Els; Van Gestel, Leen; Rose, Stephen; Boyd, Roslyn N; Feys, Hilde; Guzzetta, Andrea

    2014-09-01

    To describe the development of a novel rating scale for classification of brain structural magnetic resonance imaging (MRI) in children with cerebral palsy (CP) and to assess its interrater and intrarater reliability. The scale consists of three sections. Section 1 contains descriptive information about the patient and MRI. Section 2 contains the graphical template of brain hemispheres onto which the lesion is transposed. Section 3 contains the scoring system for the quantitative analysis of the lesion characteristics, grouped into different global scores and subscores that assess separately side, regions, and depth. A larger interrater and intrarater reliability study was performed in 34 children with CP (22 males, 12 females; mean age at scan of 9 y 5 mo [SD 3 y 3 mo], range 4 y-16 y 11 mo; Gross Motor Function Classification System level I, [n=22], II [n=10], and level III [n=2]). Very high interrater and intrarater reliability of the total score was found with indices above 0.87. Reliability coefficients of the lobar and hemispheric subscores ranged between 0.53 and 0.95. Global scores for hemispheres, basal ganglia, brain stem, and corpus callosum showed reliability coefficients above 0.65. This study presents the first visual, semi-quantitative scale for classification of brain structural MRI in children with CP. The high degree of reliability of the scale supports its potential application for investigating the relationship between brain structure and function and examining treatment response according to brain lesion severity in children with CP. © 2014 Mac Keith Press.

  5. Neural network-based systems for handprint OCR applications.

    PubMed

    Ganis, M D; Wilson, C L; Blue, J L

    1998-01-01

    Over the last five years or so, neural network (NN)-based approaches have been steadily gaining performance and popularity for a wide range of optical character recognition (OCR) problems, from isolated digit recognition to handprint recognition. We present an NN classification scheme based on an enhanced multilayer perceptron (MLP) and describe an end-to-end system for form-based handprint OCR applications designed by the National Institute of Standards and Technology (NIST) Visual Image Processing Group. The enhancements to the MLP are based on (i) neuron activations functions that reduce the occurrences of singular Jacobians; (ii) successive regularization to constrain the volume of the weight space; and (iii) Boltzmann pruning to constrain the dimension of the weight space. Performance characterization studies of NN systems evaluated at the first OCR systems conference and the NIST form-based handprint recognition system are also summarized.

  6. 21 CFR 884.1185 - Endometrial washer.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... with negative pressure. This device is used to study endometrial cytology (cells). (b) Classification... a recent cesarean section, and (iii) Warning: Do not attach to a wall or any external suction, and...

  7. Osteodysplastic primordial dwarfism: report of a further case with manifestations similar to those of types I and III.

    PubMed

    Haan, E A; Furness, M E; Knowles, S; Morris, L L; Scott, G; Svigos, J M; Vigneswaren, R

    1989-06-01

    We describe a male infant with microcephalic osteodysplastic primordial dwarfism. The clinical and radiological manifestations most closely resemble those of the patient described by Winter et al. to have manifestations overlapping with both osteodysplastic primordial dwarfism types I and III. The classification of the patient within the spectrum of osteodysplastic primordial dwarfism is discussed and the distinctive neuropathology documented.

  8. Effects of severity of gross motor disability on anticipatory postural adjustments while standing in individuals with bilateral spastic cerebral palsy.

    PubMed

    Tomita, Hidehito; Fukaya, Yoshiki; Takagi, Yukina; Yokozawa, Asami

    2016-10-01

    Although individuals with bilateral spastic cerebral palsy (BSCP) exhibit several deficits in anticipatory postural adjustments (APAs) while standing, effects of severity of motor disability on their APAs are unclear. To determine whether individuals with BSCP exhibit severity-dependent deficits in APAs. Seven individuals with level II BSCP (BSCP-II group) and seven with level III BSCP (BSCP-III group) according to the Gross Motor Function Classification System and seven healthy controls lifted a load under two different load conditions. Anticipatory activities of the erector spinae (ES), medial hamstring (MH), and gastrocnemius (GCM) were smaller in the two BSCP groups than in the control group. Although the anticipatory GCM activity was similar between the BSCP groups, the ES and MH activities were larger in the BSCP-II group than in the BSCP-III group. In the BSCP-II group, an increase in anticipatory activity with an increase in load was observed in the MH, but not in the GCM. In the BSCP-III group, load-related modulation was not found in the MH or GCM. The present findings suggest that in individuals with BSCP with severe motor disability, APA deficits extend to more proximal parts of the body. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Assessing Angle's malocclusion among cleft lip and/or palate patients in Jammu.

    PubMed

    Gupta, Akshay; Gupta, Anur; Bhardwaj, Amit; Vikram, S; Gomathi, Ajeetha; Singh, Karanprakash

    2016-04-01

    The study was conducted to examine the patients with abnormalities of cleft lip and/or palate and its association with different types of malocclusion. This descriptive study was done among 168 patients with abnormalities of cleft lip and/or palate. Angle's classification of malocclusion was applied for assessment of occlusion as Class I, Class II, and Class III. The types of oral clefts classification such as cleft lip unilateral and cleft lip bilateral, cleft palate (CP), unilateral cleft lip with palate (UCLP) and bilateral cleft lip with palate (BCLP) was considered. Chi-square test was applied to analyze the data at P < 0.05. The study showed different categories of clefts patients as cleft lip (81), CP (31), and both cleft lip and palate (53). The occurrence of unilateral cleft lip (44) was maximum among the sample followed by UCLP (39), and bilateral cleft lip (31). Maximum subjects with Class II (10.7%) and Class III (4.9%) malocclusion were seen with unilateral cleft lip deformities. None of the patients with UCLP had Class III malocclusion. Cleft lip was the most commonly observed deformity and high frequency of Class II and III malocclusion was evident. Therefore, patients with such abnormalities should be screened timely.

  10. [Discussion of new classification of epididymal malformation in cryptorchidism of children].

    PubMed

    Zhang, Dian-Liang; Li, Zhen; Xie, Jia-Lun

    2002-12-01

    To discuss the new classification of epididymal malformation in cryptorchidism. One hundred and fifty-three boys who were two to four year old underwent orchidopexy for cryptorchidism and 144 hydroceles who were two to eight year old were enrolled into control. Based on the observation of the status between testis and epididymia, the length of epididymis and the configuration of epididymis as well as spermaduct, we divided epididymal malformations in cryptorchidism into three types. Type I: obstruction of sperm transport, including I A, I B and I C; Type II: possible obstruction of sperm transport, defined by II A and II B; Type III: no obstruction of sperm transport, classified into III A and III B. There were 47 (23.4%) out of 201 undescended testes with malformation of epididymides and 16 (10.3%) out of 155 testes in the control(P < 0.05). 11 of 48 cases of bilateral cryptorchidism had the same malformations, with 2 cases of type IB, 2 of IC, 1 of II A, 4 of III A and 2 of IV B underwent orchidopexy or orchiectomy. These data showed that the incidence of epididymal abnormalities in cryptorchidism was higher than that in the hydroceles and it's not essential to have orchiectomy unlimitedly to serious epididymal abnormalities.

  11. Evaluating data mining algorithms using molecular dynamics trajectories.

    PubMed

    Tatsis, Vasileios A; Tjortjis, Christos; Tzirakis, Panagiotis

    2013-01-01

    Molecular dynamics simulations provide a sample of a molecule's conformational space. Experiments on the mus time scale, resulting in large amounts of data, are nowadays routine. Data mining techniques such as classification provide a way to analyse such data. In this work, we evaluate and compare several classification algorithms using three data sets which resulted from computer simulations, of a potential enzyme mimetic biomolecule. We evaluated 65 classifiers available in the well-known data mining toolkit Weka, using 'classification' errors to assess algorithmic performance. Results suggest that: (i) 'meta' classifiers perform better than the other groups, when applied to molecular dynamics data sets; (ii) Random Forest and Rotation Forest are the best classifiers for all three data sets; and (iii) classification via clustering yields the highest classification error. Our findings are consistent with bibliographic evidence, suggesting a 'roadmap' for dealing with such data.

  12. [Impact of the labour market on vocational retraining centre participants' return to work: a study on employment agencies level].

    PubMed

    Hetzel, C; Flach, T; Schmidt, C

    2012-08-01

    This paper is aimed at identifying labour market factors impacting vocational retraining centre participants' return to work on Employment Agencies level and at comparing results to unemployed people's return to work (Social Code Book III). Databases are regional return to work rates of 2006 graduates, selected labour market indicators 2007, and the 2007 labour market classification of the Institute for Employment Research (IAB). The n = 75 Employment Agency districts where 74.5 % of the participants followed-up lived were analyzed using analyses of variance and multiple loglinear regression. Compared to the unemployment context (Social Code Book III), the impact of the labour market is much lower and less complex. In the multiple model, the regional unemployment rate and the regional tertiarization rate (size of the service sector) are found to be significant and superior to the IAB-classification. Hence, participants' return to work is less dependent on labour market conditions than unemployed people's return to work (Social Code Book III). © Georg Thieme Verlag KG Stuttgart · New York.

  13. Somatoform disorders and recent diagnostic controversies.

    PubMed

    Kroenke, Kurt

    2007-12-01

    Classification is not a trivial matter. In Burmese Days, George Orwell writes, "It is devilish to suffer from a pain that is all but nameless. Blessed are they who are stricken only with classifiable diseases! Blessed are the poor, the sick, the crossed in love, for at least other people know what is the matter with them and will listen to their belly-achings with sympathy." Patients who have somatoform disorders are particularly susceptible to this Orwellian lamentation. They are afflicted by symptoms that defy simple explanations. As detailed in this article, there is a spectrum of medical and psychiatric factors that can cause or contribute to somatic symptom burden. Research is continuing to reveal the central mechanisms that may provide a common pathway for physical and psychologic symptoms. The dualism that places some somatic symptom disorders on Axis I and others on Axis III gradually may fade in the coming decades as what the unifying causes are among common symptoms and the multicausal nature of many symptoms are discovered. Meanwhile, the classification systems should continue to operate on pragmatic principles where mechanistic explanations are lacking. This will allow grouping patients into categories that inform research, scientific and patient communication, prognostication, and clinical management. Coupling a heuristic classification system with evidence-based measures for assessing severity and monitoring treatment outcomes are important steps in the optimal care of symptomatic patients.

  14. Systemic classification for a new diagnostic approach to acute abdominal pain in children.

    PubMed

    Kim, Ji Hoi; Kang, Hyun Sik; Han, Kyung Hee; Kim, Seung Hyo; Shin, Kyung-Sue; Lee, Mu Suk; Jeong, In Ho; Kim, Young Sil; Kang, Ki-Soo

    2014-12-01

    With previous methods based on only age and location, there are many difficulties in identifying the etiology of acute abdominal pain in children. We sought to develop a new systematic classification of acute abdominal pain and to give some helps to physicians encountering difficulties in diagnoses. From March 2005 to May 2010, clinical data were collected retrospectively from 442 children hospitalized due to acute abdominal pain with no apparent underlying disease. According to the final diagnoses, diseases that caused acute abdominal pain were classified into nine groups. The nine groups were group I "catastrophic surgical abdomen" (7 patients, 1.6%), group II "acute appendicitis and mesenteric lymphadenitis" (56 patients, 12.7%), group III "intestinal obstruction" (57 patients, 12.9%), group IV "viral and bacterial acute gastroenteritis" (90 patients, 20.4%), group V "peptic ulcer and gastroduodenitis" (66 patients, 14.9%), group VI "hepatobiliary and pancreatic disease" (14 patients, 3.2%), group VII "febrile viral illness and extraintestinal infection" (69 patients, 15.6%), group VIII "functional gastrointestinal disorder (acute manifestation)" (20 patients, 4.5%), and group IX "unclassified acute abdominal pain" (63 patients, 14.3%). Four patients were enrolled in two disease groups each. Patients were distributed unevenly across the nine groups of acute abdominal pain. In particular, the "unclassified abdominal pain" only group was not uncommon. Considering a systemic classification for acute abdominal pain may be helpful in the diagnostic approach in children.

  15. 7 CFR 52.3760 - Color.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... be given. Canned ripe olives that fall into this classification shall not be graded above U.S. Grade... and typical of these styles prepared from olives of fairly good color. (iii) Broken pitted. The...

  16. 7 CFR 52.3760 - Color.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... be given. Canned ripe olives that fall into this classification shall not be graded above U.S. Grade... and typical of these styles prepared from olives of fairly good color. (iii) Broken pitted. The...

  17. Projectile Measurements and Instrumentation Laboratory Mass Property Measurements

    DTIC Science & Technology

    1974-09-01

    STATEMENT (ol III* abalrael anlarad In Block 20, II dlllaranl Irom Rmpotl) 11. SUPPLEMENTARY NOTES Available in DDC . 1». KEY WORDS fConllnu* on...FORM I JAN 73 1473 EDITION OF I NOV SB IS OBSOLETE UNCLASSIFIED SECURITY CLASSIFICATION OF THIS PAGE (Whmn Dmlm Enlmrmd) ■auHHaUi^L^u^. ^^-..-^-i... CLASSIFICATION Of THIS PAQE(Whm> Dmlm Knltrmd) Item 19 (Continued): Top Loading Balance Center of Gravity Balance Moment of Inertia Instrument

  18. A novel Brain Computer Interface for classification of social joint attention in autism and comparison of 3 experimental setups: A feasibility study.

    PubMed

    Amaral, Carlos P; Simões, Marco A; Mouga, Susana; Andrade, João; Castelo-Branco, Miguel

    2017-10-01

    We present a novel virtual-reality P300-based Brain Computer Interface (BCI) paradigm using social cues to direct the focus of attention. We combined interactive immersive virtual-reality (VR) technology with the properties of P300 signals in a training tool which can be used in social attention disorders such as autism spectrum disorder (ASD). We tested the novel social attention training paradigm (P300-based BCI paradigm for rehabilitation of joint-attention skills) in 13 healthy participants, in 3 EEG systems. The more suitable setup was tested online with 4 ASD subjects. Statistical accuracy was assessed based on the detection of P300, using spatial filtering and a Naïve-Bayes classifier. We compared: 1 - g.Mobilab+ (active dry-electrodes, wireless transmission); 2 - g.Nautilus (active electrodes, wireless transmission); 3 - V-Amp with actiCAP Xpress dry-electrodes. Significant statistical classification was achieved in all systems. g.Nautilus proved to be the best performing system in terms of accuracy in the detection of P300, preparation time, speed and reported comfort. Proof of concept tests in ASD participants proved that this setup is feasible for training joint attention skills in ASD. This work provides a unique combination of 'easy-to-use' BCI systems with new technologies such as VR to train joint-attention skills in autism. Our P300 BCI paradigm is feasible for future Phase I/II clinical trials to train joint-attention skills, with successful classification within few trials, online in ASD participants. The g.Nautilus system is the best performing one to use with the developed BCI setup. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Electroencephalography (EEG) Based Control in Assistive Mobile Robots: A Review

    NASA Astrophysics Data System (ADS)

    Krishnan, N. Murali; Mariappan, Muralindran; Muthukaruppan, Karthigayan; Hijazi, Mohd Hanafi Ahmad; Kitt, Wong Wei

    2016-03-01

    Recently, EEG based control in assistive robot usage has been gradually increasing in the area of biomedical field for giving quality and stress free life for disabled and elderly people. This study reviews the deployment of EGG based control in assistive robots, especially for those who in need and neurologically disabled. The main objective of this paper is to describe the methods used for (i) EEG data acquisition and signal preprocessing, (ii) feature extraction and (iii) signal classification methods. Besides that, this study presents the specific research challenges in the designing of these control systems and future research directions.

  20. Nursing Care Hour Standards Study. Part 1. Section B. Patient Classification System Model Development

    DTIC Science & Technology

    1981-09-01

    Measurement/Adult El FI~ [El 1:11] II PIES Form 326e (OT) 1 Novembeti 1978 A-3 sfti= 237 Saline IrrigatioD (Gastric)W uli il 111 Enema: Cleansing Mi...U lIED Dilatation and -Curettage/Assisting Physician ii) El Do~ EI M.1 L or Evacuation Vaginal /Pelvic Examinrations/Assisting Physician ElU L. IE l2...ADMINISTRATION: Oral -QB E ED EE ElE Suppositories Rectal/ Vaginal 1E El El El I ElD Topical MI~II iE Sublingual III ol El El El DIAGNOSTIC TESTS: Bone

  1. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Simon, J. D.; Li, T. S.; Drlica-Wagner, A.

    Here, we present Magellan/IMACS spectroscopy of the recently discovered Milky Way satellite Tucana III (Tuc III). We identify 26 member stars in Tuc III from which we measure a mean radial velocity of v hel = -102.3 ± 0.4 (stat.) ± 2.0 (sys.)more » $$\\mathrm{km}\\,{{\\rm{s}}}^{-1}$$, a velocity dispersion of $${0.1}_{-0.1}^{+0.7}$$ $$\\mathrm{km}\\,{{\\rm{s}}}^{-1}$$, and a mean metallicity of $${\\rm{[Fe/H]}}=-{2.42}_{-0.08}^{+0.07}$$. The upper limit on the velocity dispersion is σ < 1.5 $$\\mathrm{km}\\,{{\\rm{s}}}^{-1}$$ at 95.5% confidence, and the corresponding upper limit on the mass within the half-light radius of Tuc III is 9.0 × 10 4 M ⊙. We cannot rule out mass-to-light ratios as large as 240 M ⊙/L ⊙ for Tuc III, but much lower mass-to-light ratios that would leave the system baryon-dominated are also allowed. We measure an upper limit on the metallicity spread of the stars in Tuc III of 0.19 dex at 95.5% confidence. Tuc III has a smaller metallicity dispersion and likely a smaller velocity dispersion than any known dwarf galaxy, but a larger size and lower surface brightness than any known globular cluster. Its metallicity is also much lower than those of the clusters with similar luminosity. We therefore tentatively suggest that Tuc III is the tidally stripped remnant of a dark matter-dominated dwarf galaxy, but additional precise velocity and metallicity measurements will be necessary for a definitive classification. If Tuc III is indeed a dwarf galaxy, it is one of the closest external galaxies to the Sun. Because of its proximity, the most luminous stars in Tuc III are quite bright, including one star at V = 15.7 that is the brightest known member star of an ultra-faint satellite.« less

  2. Descriptive and dynamic psychiatry: a perspective on DSM-III.

    PubMed

    Frances, A; Cooper, A M

    1981-09-01

    The APA Task Force on Nomenclature and Statistics attempted to make DSM-III a descriptive nosology that is atheoretical in regard to etiology. The authors believe that a sharp polarity between morphological classification and explanatory formulation is artificial and misleading, and they critically review DSM-III from a psychodynamic perspective. They compare and contrast the descriptive orientation in psychiatry with the psychodynamic orientation and conclude that the two approaches overlap, that they are complementary and necessary to each other, and that there is a descriptive data base underlying dynamic psychiatry which may be usefully included in future nomenclatures.

  3. The DSM-III concept of organic brain syndrome.

    PubMed

    Fox, H A

    1983-04-01

    The shortcomings of the DSM-II classification of organic brain syndrome are described, including the limitation of the concept to the global brain disorders; the idiosyncratic use of the terms acute and chronic; and the unsatisfactory categories psychotic and nonpsychotic. Organic brain syndrome is defined according to DSM-III and the 10 separate brain syndrome categories are outlined. The diagnostic criteria for each category are listed and the general principles underlying the criteria are described. Finally, the goals of the authors' of DSM-III to enhance diagnostic reliability and validity are discussed and the impact of the new nomenclature is assessed.

  4. Classroom Demonstrations of Polymer Principles. Part III. Physical States and Transitions.

    ERIC Educational Resources Information Center

    Rodriguez, F.; And Others

    1988-01-01

    Presented is a classification of polymers according to physical condition. Considered are molecular structure and arrangements. Described are demonstrations using polarized light and the mechanical properties of polymers. (CW)

  5. The Protein-Protein Interaction tasks of BioCreative III: classification/ranking of articles and linking bio-ontology concepts to full text.

    PubMed

    Krallinger, Martin; Vazquez, Miguel; Leitner, Florian; Salgado, David; Chatr-Aryamontri, Andrew; Winter, Andrew; Perfetto, Livia; Briganti, Leonardo; Licata, Luana; Iannuccelli, Marta; Castagnoli, Luisa; Cesareni, Gianni; Tyers, Mike; Schneider, Gerold; Rinaldi, Fabio; Leaman, Robert; Gonzalez, Graciela; Matos, Sergio; Kim, Sun; Wilbur, W John; Rocha, Luis; Shatkay, Hagit; Tendulkar, Ashish V; Agarwal, Shashank; Liu, Feifan; Wang, Xinglong; Rak, Rafal; Noto, Keith; Elkan, Charles; Lu, Zhiyong; Dogan, Rezarta Islamaj; Fontaine, Jean-Fred; Andrade-Navarro, Miguel A; Valencia, Alfonso

    2011-10-03

    Determining usefulness of biomedical text mining systems requires realistic task definition and data selection criteria without artificial constraints, measuring performance aspects that go beyond traditional metrics. The BioCreative III Protein-Protein Interaction (PPI) tasks were motivated by such considerations, trying to address aspects including how the end user would oversee the generated output, for instance by providing ranked results, textual evidence for human interpretation or measuring time savings by using automated systems. Detecting articles describing complex biological events like PPIs was addressed in the Article Classification Task (ACT), where participants were asked to implement tools for detecting PPI-describing abstracts. Therefore the BCIII-ACT corpus was provided, which includes a training, development and test set of over 12,000 PPI relevant and non-relevant PubMed abstracts labeled manually by domain experts and recording also the human classification times. The Interaction Method Task (IMT) went beyond abstracts and required mining for associations between more than 3,500 full text articles and interaction detection method ontology concepts that had been applied to detect the PPIs reported in them. A total of 11 teams participated in at least one of the two PPI tasks (10 in ACT and 8 in the IMT) and a total of 62 persons were involved either as participants or in preparing data sets/evaluating these tasks. Per task, each team was allowed to submit five runs offline and another five online via the BioCreative Meta-Server. From the 52 runs submitted for the ACT, the highest Matthew's Correlation Coefficient (MCC) score measured was 0.55 at an accuracy of 89% and the best AUC iP/R was 68%. Most ACT teams explored machine learning methods, some of them also used lexical resources like MeSH terms, PSI-MI concepts or particular lists of verbs and nouns, some integrated NER approaches. For the IMT, a total of 42 runs were evaluated by comparing systems against manually generated annotations done by curators from the BioGRID and MINT databases. The highest AUC iP/R achieved by any run was 53%, the best MCC score 0.55. In case of competitive systems with an acceptable recall (above 35%) the macro-averaged precision ranged between 50% and 80%, with a maximum F-Score of 55%. The results of the ACT task of BioCreative III indicate that classification of large unbalanced article collections reflecting the real class imbalance is still challenging. Nevertheless, text-mining tools that report ranked lists of relevant articles for manual selection can potentially reduce the time needed to identify half of the relevant articles to less than 1/4 of the time when compared to unranked results. Detecting associations between full text articles and interaction detection method PSI-MI terms (IMT) is more difficult than might be anticipated. This is due to the variability of method term mentions, errors resulting from pre-processing of articles provided as PDF files, and the heterogeneity and different granularity of method term concepts encountered in the ontology. However, combining the sophisticated techniques developed by the participants with supporting evidence strings derived from the articles for human interpretation could result in practical modules for biological annotation workflows.

  6. The Protein-Protein Interaction tasks of BioCreative III: classification/ranking of articles and linking bio-ontology concepts to full text

    PubMed Central

    2011-01-01

    Background Determining usefulness of biomedical text mining systems requires realistic task definition and data selection criteria without artificial constraints, measuring performance aspects that go beyond traditional metrics. The BioCreative III Protein-Protein Interaction (PPI) tasks were motivated by such considerations, trying to address aspects including how the end user would oversee the generated output, for instance by providing ranked results, textual evidence for human interpretation or measuring time savings by using automated systems. Detecting articles describing complex biological events like PPIs was addressed in the Article Classification Task (ACT), where participants were asked to implement tools for detecting PPI-describing abstracts. Therefore the BCIII-ACT corpus was provided, which includes a training, development and test set of over 12,000 PPI relevant and non-relevant PubMed abstracts labeled manually by domain experts and recording also the human classification times. The Interaction Method Task (IMT) went beyond abstracts and required mining for associations between more than 3,500 full text articles and interaction detection method ontology concepts that had been applied to detect the PPIs reported in them. Results A total of 11 teams participated in at least one of the two PPI tasks (10 in ACT and 8 in the IMT) and a total of 62 persons were involved either as participants or in preparing data sets/evaluating these tasks. Per task, each team was allowed to submit five runs offline and another five online via the BioCreative Meta-Server. From the 52 runs submitted for the ACT, the highest Matthew's Correlation Coefficient (MCC) score measured was 0.55 at an accuracy of 89% and the best AUC iP/R was 68%. Most ACT teams explored machine learning methods, some of them also used lexical resources like MeSH terms, PSI-MI concepts or particular lists of verbs and nouns, some integrated NER approaches. For the IMT, a total of 42 runs were evaluated by comparing systems against manually generated annotations done by curators from the BioGRID and MINT databases. The highest AUC iP/R achieved by any run was 53%, the best MCC score 0.55. In case of competitive systems with an acceptable recall (above 35%) the macro-averaged precision ranged between 50% and 80%, with a maximum F-Score of 55%. Conclusions The results of the ACT task of BioCreative III indicate that classification of large unbalanced article collections reflecting the real class imbalance is still challenging. Nevertheless, text-mining tools that report ranked lists of relevant articles for manual selection can potentially reduce the time needed to identify half of the relevant articles to less than 1/4 of the time when compared to unranked results. Detecting associations between full text articles and interaction detection method PSI-MI terms (IMT) is more difficult than might be anticipated. This is due to the variability of method term mentions, errors resulting from pre-processing of articles provided as PDF files, and the heterogeneity and different granularity of method term concepts encountered in the ontology. However, combining the sophisticated techniques developed by the participants with supporting evidence strings derived from the articles for human interpretation could result in practical modules for biological annotation workflows. PMID:22151929

  7. CRISPRCasFinder, an update of CRISRFinder, includes a portable version, enhanced performance and integrates search for Cas proteins.

    PubMed

    Couvin, David; Bernheim, Aude; Toffano-Nioche, Claire; Touchon, Marie; Michalik, Juraj; Néron, Bertrand; C Rocha, Eduardo P; Vergnaud, Gilles; Gautheret, Daniel; Pourcel, Christine

    2018-05-22

    CRISPR (clustered regularly interspaced short palindromic repeats) arrays and their associated (Cas) proteins confer bacteria and archaea adaptive immunity against exogenous mobile genetic elements, such as phages or plasmids. CRISPRCasFinder allows the identification of both CRISPR arrays and Cas proteins. The program includes: (i) an improved CRISPR array detection tool facilitating expert validation based on a rating system, (ii) prediction of CRISPR orientation and (iii) a Cas protein detection and typing tool updated to match the latest classification scheme of these systems. CRISPRCasFinder can either be used online or as a standalone tool compatible with Linux operating system. All third-party software packages employed by the program are freely available. CRISPRCasFinder is available at https://crisprcas.i2bc.paris-saclay.fr.

  8. Studies of Phlebotomine Sand Flies.

    DTIC Science & Technology

    1982-06-30

    CLASSIFICATION OF THIS PAQE(W,. Date St.4- 20 ain subgenera of Lutzomyia were reviewed; a large work on the phlebotomines of Colombia , representing... Lutzomyia cirrita n. sp. from Colombia with a new synonym in the genus (Diptera: Psychodidae). Fla. Ent. 57:321-325. 8. Young, D.G. and D.J. Lewis. 1977...Report) * III. SUPPLEMENTARY NOTES III. KEY WORDS (Continue on reverse side if necesary and Identify by block number) Sand Fly Phlebotomus Lutzomyia

  9. Small Independent Action Force (SIAF), Vegetation Classification Study

    DTIC Science & Technology

    1976-03-01

    CONTENTS I. INTRODUCTION 8 II. BACKGBCUND and PORPOSE 10 III. METHOD 16 A. EXPERIMENTAL DESIGN 16 B. SUBJECTS .’ 17 C. APPARATUS 17 D. STIMULUS...reliability of subjects will be obtained. 15 III. METHOD A. EXPERIMENTAL DESIGN . The experiment involved a continous stream of stimuli. Phase 1 stimuli...the attribute to be scaled. The subjecr must designate one of the pair as greater. No equality judgments are permitted. In order to obtain data from

  10. Reliability and Construct Validity of the 6-Minute Racerunner Test in Children and Youth with Cerebral Palsy, GMFCS Levels III and IV.

    PubMed

    Bolster, Eline A M; Dallmeijer, Annet J; de Wolf, G Sander; Versteegt, Marieke; Schie, Petra E M van

    2017-05-01

    To determine the test-retest reliability and construct validity of a novel 6-Minute Racerunner Test (6MRT) in children and youth with cerebral palsy (CP) classified as Gross Motor Function Classification System (GMFCS) levels III and IV. The racerunner is a step-propelled tricycle. The participants were 38 children and youth with CP (mean age 11 y 2 m, SD 3 y 7 m; GMFCS III, n = 19; IV, n = 19). Racerunner capability was determined as the distance covered during the 6MRT on three occasions. The intraclass correlation coefficient (ICC), standard error of measurement (SEM), and smallest detectable differences (SDD) were calculated to assess test-retest reliability. The ICC for tests 2 and 3 were 0.89 (SDD 37%; 147 m) for children in level III and 0.91 for children in level IV (SDD 52%; 118 m). When the average of two separate test occasions was used, the SDDs were reduced to 26% (104 m; level III) and 37% (118 m; level IV). For tests 1 to 3, the mean distance covered increased from 345 m (SD 148 m) to 413 m (SD 137 m) for children in level III, and from 193 m (SD 100 m) to 239 m (SD 148 m) for children in level IV. Results suggest high test-retest reliability. However, large SDDs indicate that a single 6MRT measurement is only useful for individual evaluation when large improvements are expected, or when taking the average of two tests. The 6MRT discriminated the distance covered between children and youth in levels III and IV, supporting construct validity.

  11. Explaining direct care resource use of nursing home residents: findings from time studies in four states.

    PubMed

    Arling, Greg; Kane, Robert L; Mueller, Christine; Lewis, Teresa

    2007-04-01

    To explain variation in direct care resource use (RU) of nursing home residents based on the Resource Utilization Groups III (RUG-III) classification system and other resident- and unit-level explanatory variables. Primary data were collected on 5,314 nursing home residents in 156 nursing units in 105 facilities from four states (CO, IN, MN, MS) from 1998 to 2004. Study Design. Nurses and other direct care staff recorded resident-specific and other time caring for all residents on sampled nursing units. Care time was linked to resident data from the Minimum Data Set assessment instrument. Major variables were: RUG-III group (34-group), other health and functional conditions, licensed and other professional minutes per day, unlicensed minutes per day, and direct care RU (wage-weighted minutes). Resident- and unit-level relationships were examined through hierarchical linear modeling. Time study data were recorded with hand-held computers, verified for accuracy by project staff at the data collection sites and then merged into resident and unit-level data sets. Resident care time and RU varied between and within nursing units. RUG-III group was related to RU; variables such as length of stay and unit percentage of high acuity residents also were significantly related. Case-mix indices (CMIs) constructed from study data displayed much less variation across RUG-III groups than CMIs from earlier time studies. Results from earlier time studies may not be representative of care patterns of Medicaid and private pay residents. New RUG-III CMIs should be developed to better reflect the relative costs of caring for these residents.

  12. Alignment of classification paradigms for communication abilities in children with cerebral palsy.

    PubMed

    Hustad, Katherine C; Oakes, Ashley; McFadd, Emily; Allison, Kristen M

    2016-06-01

    We examined three communication ability classification paradigms for children with cerebral palsy (CP): the Communication Function Classification System (CFCS), the Viking Speech Scale (VSS), and the Speech Language Profile Groups (SLPG). Questions addressed interjudge reliability, whether the VSS and the CFCS captured impairments in speech and language, and whether there were differences in speech intelligibility among levels within each classification paradigm. Eighty children (42 males, 38 females) with a range of types and severity levels of CP participated (mean age 60mo, range 50-72mo [SD 5mo]). Two speech-language pathologists classified each child via parent-child interaction samples and previous experience with the children for the CFCS and VSS, and using quantitative speech and language assessment data for the SLPG. Intelligibility scores were obtained using standard clinical intelligibility measurement. Kappa values were 0.67 (95% confidence interval [CI] 0.55-0.79) for the CFCS, 0.82 (95% CI 0.72-0.92) for the VSS, and 0.95 (95% CI 0.72-0.92) for the SLPG. Descriptively, reliability within levels of each paradigm varied, with the lowest agreement occurring within the CFCS at levels II (42%), III (40%), and IV (61%). Neither the CFCS nor the VSS were sensitive to language impairments captured by the SLPG. Significant differences in speech intelligibility were found among levels for all classification paradigms. Multiple tools are necessary to understand speech, language, and communication profiles in children with CP. Characterization of abilities at all levels of the International Classification of Functioning, Disability and Health will advance our understanding of the ways that speech, language, and communication abilities present in children with CP. © 2015 Mac Keith Press.

  13. Grading nuclear, cortical and posterior subcapsular cataracts using an objective scatter index measured with a double-pass system.

    PubMed

    Vilaseca, Meritxell; Romero, Maria José; Arjona, Montserrat; Luque, Sergio Oscar; Ondategui, Juan Carlos; Salvador, Antoni; Güell, José L; Artal, Pablo; Pujol, Jaume

    2012-09-01

    To evaluate objectively intraocular scattering in eyes with nuclear, cortical and posterior subcapsular cataracts by means of an objective scatter index (OSI) obtained from double-pass images. To compare the results with those obtained using clinical conventional procedures. In this prospective, observational, cross-sectional, non-consecutive case series study, 188 eyes with cataracts of 136 patients were analysed (123 eyes had nuclear, 41 eyes had cortical and 24 eyes had posterior subcapsular cataracts). The control group consisted of 117 eyes of 68 healthy patients. Patient examination included subjective refraction, best spectacle-corrected visual acuity (BSCVA), cataract grade using the lens opacities classification system III (LOCS III) and OSI. We found a decrease in the BSCVA and an increase in the OSI with increasing cataract grade. Statistically significant differences were observed when the OSI of eyes without cataracts and those with different LOCS III were compared. The comparison between the OSI and LOCS III reported good percentages of agreement regarding the number of eyes classified in equivalent levels: 72.4% (nuclear cataracts), 86.6% (cortical cataracts) and 84.3% (posterior subcapsular cataracts). A non-linear regression model was applied between OSI and BSCVA, which resulted in the following multiple correlation coefficients: r=0.878 (nuclear), r=0.843 (cortical) and r=0.844 (posterior subcapsular). The results of the study showed that OSI is a useful parameter for evaluating large amounts of intraocular scattering that can be used, in combination with other conventional procedures, as a valuable tool in clinical practice to grade cataracts objectively.

  14. Meta-Analysis of Human Factors Engineering Studies Comparing Individual Differences, Practice Effects and Equipment Design Variations.

    DTIC Science & Technology

    1985-02-21

    Approvoid foT public 90Ieleol, 2* . tJni7nited " - . - o . - ’--. * . -... . 1 UNCLASSIFIED S, E CURITY CLASSIFICATION OF THIS PAGE-" REPORT DOCUMENTATION...ACCESSION NO. 11. TITLE (Include Security Classification) . Veta -Analysis of Human Factors Engineering Studies Comparing Individual Differences, Practice...Background C Opportunity D Significance E History III. PHASE I FINAL REPORT A Literature Review B Formal Analysis C Results D Implications for Phase II IV

  15. [Clinical forms of major depressive states observed in the Ivory Coast. Classification trial].

    PubMed

    Megglé, D; Série, E; Veillon, F; Delafosse, J; Hazera, M

    1989-12-01

    After a previous analysis of African depressions in studies based on the use of D.S.M. III as a preliminary tool, the authors are now seeking to understand more directly the different ways for depressed Ivorians to express the lowering of self-esteem, as well as the various meanings of agitation observed among them. An attempt of nosographic classification, closely linked with local reality, has been extracted from this material by the authors.

  16. Trainer Engineering Report (Final) for MILES. Volume 2. Revision

    DTIC Science & Technology

    1981-04-22

    formerly a separate document, Data Item AOOX. iii/iv 1A , SECURITY CLASSIFICATION OF THIS PAGE (Uhen Deaa Enterecd) ... __ . ....... REPORT DOCUMENTATION...NAVTRAEQUIPCEN, Orlando, FL 32813 3 14. MON’TORING AGENCY NAME & ADDRESS(II dilletent from CoftrollIn OGlue*) IS. SECURITY CLASS. (of thie twoot...OBSOLETE UNCLASSIFIED S/N 0102蓞-6601 I SECURITY CL.ASSIFICATION OF THIS iPAGE fUlses Data EaieteE i • CONTENTS .I * INTRODUCTION 1-1 1.1 1980 MILES 1-1

  17. 21 CFR 870.5225 - External counter-pulsating device.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... used to assist the heart by applying positive or negative pressure to one or more of the body's limbs in synchrony with the heart cycle. (b) Classification. Class III (premarket approval). (c) Date PMA...

  18. Railroad Classification Yard Technology Manual. Volume III. Freight Car Rollability

    DOT National Transportation Integrated Search

    1981-07-01

    The report presents a survey of rolling resistance research, histograms of rolling resistance from five yards, a statistical regression analysis of causal factors affecting rolling resistance, procedures for constructing a rolling resistance histogra...

  19. 7 CFR 52.3760 - Color.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... this classification shall not be graded above U.S. Grade C regardless of the total score for the... color. (iii) Broken pitted. The general color impression of the olives as a mass is normal and may be...

  20. 7 CFR 52.3760 - Color.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... this classification shall not be graded above U.S. Grade C regardless of the total score for the... color. (iii) Broken pitted. The general color impression of the olives as a mass is normal and may be...

  1. 32 CFR Appendix C to Part 290 - For Official Use Only

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... the top and bottom with the highest security classification of information appearing on the page. (iii... the additional expense balanced against the degree of sensitivity of the type of FOUO information...

  2. 21 CFR 870.5225 - External counter-pulsating device.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... used to assist the heart by applying positive or negative pressure to one or more of the body's limbs in synchrony with the heart cycle. (b) Classification. Class III (premarket approval). (c) Date PMA...

  3. 21 CFR 870.5225 - External counter-pulsating device.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... used to assist the heart by applying positive or negative pressure to one or more of the body's limbs in synchrony with the heart cycle. (b) Classification. Class III (premarket approval). (c) Date PMA...

  4. 21 CFR 870.5225 - External counter-pulsating device.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... used to assist the heart by applying positive or negative pressure to one or more of the body's limbs in synchrony with the heart cycle. (b) Classification. Class III (premarket approval). (c) Date PMA...

  5. Development and assessment of Memorial Sloan Kettering Cancer Center's Surgical Secondary Events grading system.

    PubMed

    Strong, Vivian E; Selby, Luke V; Sovel, Mindy; Disa, Joseph J; Hoskins, William; Dematteo, Ronald; Scardino, Peter; Jaques, David P

    2015-04-01

    Studying surgical secondary events is an evolving effort with no current established system for database design, standard reporting, or definitions. Using the Clavien-Dindo classification as a guide, in 2001 we developed a Surgical Secondary Events database based on grade of event and required intervention to begin prospectively recording and analyzing all surgical secondary events (SSE). Events are prospectively entered into the database by attending surgeons, house staff, and research staff. In 2008 we performed a blinded external audit of 1,498 operations that were randomly selected to examine the quality and reliability of the data. Of 4,284 operations, 1,498 were audited during the third quarter of 2008. Of these operations, 79 % (N = 1,180) did not have a secondary event while 21 % (N = 318) had an identified event; 91 % of operations (1,365) were correctly entered into the SSE database. Also 97 % (129 of 133) of missed secondary events were grades I and II. There were 3 grade III (2 %) and 1 grade IV (1 %) secondary event that were missed. There were no missed grade 5 secondary events. Grade III-IV events are more accurately collected than grade I-II events. Robust and accurate secondary events data can be collected by clinicians and research staff, and these data can safely be used for quality improvement projects and research.

  6. Heterogeneity in Positive Predictive Value of RAS Mutations in Cytologically Indeterminate Thyroid Nodules.

    PubMed

    Nabhan, Fadi; Porter, Kyle; Lupo, Mark A; Randolph, Gregory W; Patel, Kepal N; Kloos, Richard T

    2018-06-01

    RAS mutations are common in the available mutational analysis of cytologically indeterminate (Cyto-I) thyroid nodules. However, their reported positive predictive value (PPV) for cancer is widely variable. The reason for this variability is unknown, and it causes clinical management uncertainty. A systematic review was performed, evaluating the PPV for cancer in RAS mutation positive Cyto-I nodules, and variables that might affect residual heterogeneity across the different studies were considered. PubMed was searched through February 22, 2017, including studies that evaluated at least one type of RAS mutation in Cyto-I nodules, including any (or all) of the Bethesda III/IV/V categories or their equivalents and where the histological diagnosis was available. The PPV residual heterogeneity was investigated after accounting for Bethesda classification, blindedness of the histopathologist to the RAS mutational status, Bethesda category-specific cancer prevalence for each study, and which RAS genes and codons were tested. This was studied using five meta-regression models fit to different sets of Bethesda classification categories: Bethesda III, IV, or V (III/IV/V); Bethesda III or IV (III/IV); Bethesda III only; Bethesda IV only; and Bethesda V only. Of 1831 studies, 23 were eligible for data inclusion. Wide ranges of PPV were found at 0-100%, 28-100%, and 0-100% in Bethesda III, IV, and V, respectively. Residual heterogeneity remained moderately high for PPV after accounting for the above moderators for Bethesda III/IV/V (21 studies; I 2  = 59.5%) and Bethesda III/IV (19 studies; I 2  = 66.0%), with significant Cochran's Q-test for residual heterogeneity (p < 0.001). Among individual Bethesda categories, residual heterogeneity was: Bethesda III (eight studies; I 2  = 89.0%), IV (12 studies; I 2  = 53.5%), and V (10 studies; I 2  = 34.4%), with significant Cochran's Q-test for Bethesda III (p < 0.001) and IV (p = 0.04). The PPV of RAS mutations in Bethesda III and IV categories is quite heterogeneous across different studies, creating low confidence in the accuracy of a single estimate of PPV. Clinicians must appreciate this wide variability when managing a RAS-mutated Cyto-I nodule. Future studies should seek to resolve this unexplained variability.

  7. The Biopharmaceutics Classification System: subclasses for in vivo predictive dissolution (IPD) methodology and IVIVC.

    PubMed

    Tsume, Yasuhiro; Mudie, Deanna M; Langguth, Peter; Amidon, Greg E; Amidon, Gordon L

    2014-06-16

    The Biopharmaceutics Classification System (BCS) has found widespread utility in drug discovery, product development and drug product regulatory sciences. The classification scheme captures the two most significant factors influencing oral drug absorption; solubility and intestinal permeability and it has proven to be a very useful and a widely accepted starting point for drug product development and drug product regulation. The mechanistic base of the BCS approach has, no doubt, contributed to its wide spread acceptance and utility. Nevertheless, underneath the simplicity of BCS are many detailed complexities, both in vitro and in vivo which must be evaluated and investigated for any given drug and drug product. In this manuscript we propose a simple extension of the BCS classes to include sub-specification of acid (a), base (b) and neutral (c) for classes II and IV. Sub-classification for Classes I and III (high solubility drugs as currently defined) is generally not needed except perhaps in border line solubility cases. It is well known that the , pKa physical property of a drug (API) has a significant impact on the aqueous solubility dissolution of drug from the drug product both in vitro and in vivo for BCS Class II and IV acids and bases, and is the basis, we propose for a sub-classification extension of the original BCS classification. This BCS sub-classification is particularly important for in vivo predictive dissolution methodology development due to the complex and variable in vivo environment in the gastrointestinal tract, with its changing pH, buffer capacity, luminal volume, surfactant luminal conditions, permeability profile along the gastrointestinal tract and variable transit and fasted and fed states. We believe this sub-classification is a step toward developing a more science-based mechanistic in vivo predictive dissolution (IPD) methodology. Such a dissolution methodology can be used by development scientists to assess the likelihood of a formulation and dosage form functioning as desired in humans, can be optimized along with parallel human pharmacokinetic studies to set a dissolution methodology for Quality by Design (QbD) and in vitro-in vivo correlations (IVIVC) and ultimately can be used as a basis for a dissolution standard that will ensure continued in vivo product performance. Copyright © 2014 Elsevier B.V. All rights reserved.

  8. The Biopharmaceutics Classification System: Subclasses for in vivo predictive dissolution (IPD) methodology and IVIVC

    PubMed Central

    Tsume, Yasuhiro; Mudie, Deanna M.; Langguth, Peter; Amidon, Greg E.; Amidon, Gordon L.

    2014-01-01

    The Biopharmaceutics Classification System (BCS) has found widespread utility in drug discovery, product development and drug product regulatory sciences. The classification scheme captures the two most significant factors influencing oral drug absorption; solubility and intestinal permeability and it has proven to be a very useful and a widely accepted starting point for drug product development and drug product regulation. The mechanistic base of the BCS approach has, no doubt, contributed to its wide spread acceptance and utility. Nevertheless, underneath the simplicity of BCS are many detailed complexities, both in vitro and in vivo which must be evaluated and investigated for any given drug and drug product. In this manuscript we propose a simple extension of the BCS classes to include subspecification of acid (a), base (b) and neutral (c) for classes II and IV. Sub-classification for Classes I and III (high solubility drugs as currently defined) is generally not needed except perhaps in border line solubility cases. It is well known that the , pKa physical property of a drug (API) has a significant impact on the aqueous solubility dissolution of drug from the drug product both in vitro and in vivo for BCS Class II and IV acids and bases, and is the basis, we propose for a sub-classification extension of the original BCS classification. This BCS sub-classification is particularly important for in vivo predictive dissolution methodology development due to the complex and variable in vivo environment in the gastrointestinal tract, with its changing pH, buffer capacity, luminal volume, surfactant luminal conditions, permeability profile along the gastrointestinal tract and variable transit and fasted and fed states. We believe this sub-classification is a step toward developing a more science-based mechanistic in vivo predictive dissolution (IPD) methodology. Such a dissolution methodology can be used by development scientists to assess the likelihood of a formulation and dosage form functioning as desired in humans, can be optimized along with parallel human pharmacokinetic studies to set a dissolution methodology for Quality by Design (QbD) and in vitro–in vivo correlations (IVIVC) and ultimately can be used as a basis for a dissolution standard that will ensure continued in vivo product performance. PMID:24486482

  9. Predicting functional communication ability in children with cerebral palsy at school entry.

    PubMed

    Coleman, Andrea; Weir, Kelly; Ware, Robert S; Boyd, Roslyn

    2015-03-01

    To explore the value of demographic, environmental, and early clinical characteristics in predicting functional communication in children with cerebral palsy (CP) at school entry. Data are from an Australian prospective longitudinal study of children with CP. Children assessed at 18 to 24 and 48 to 60 months corrected age were included in the study. Functional communication was classified at 48 to 60 months using the Communication Function Classification System (CFCS). Predictive variables included communication skills at 18 to 24 months, evaluated using the Communication and Symbolic Behavioural Scales Developmental Profile (CSBS-DP) Infant-Toddler Checklist. Early Gross Motor Function Classification System (GMFCS), Manual Ability Classification System, and motor type and distribution were evaluated by two physiotherapists. Demographic and comorbid variables were obtained through parent interview with a paediatrician or rehabilitation specialist. A total of 114 children (76 males, 38 females) were included in the study. At 18 to 24 months the mean CSBS-DP was 84.9 (SD 19.0). The CFCS distribution at 48 to 60 months was I=36(32%), II=25(22%), III=20(18%), IV=19(17%), and V=14(12%). In multivariable regression analysis, only CSBS-DP (p<0.01) and GMFCS (p<0.01) at 18 to 24 months were predictors of functional communication at school entry. Body structure and function and not environmental factors impact functional communication at school entry in children with CP. This provides valuable guidance for early screening, parent education, and future planning of intervention programs to improve functional communication. © 2014 Mac Keith Press.

  10. Crystallization tendency of active pharmaceutical ingredients following rapid solvent evaporation--classification and comparison with crystallization tendency from undercooled melts.

    PubMed

    Van Eerdenbrugh, Bernard; Baird, Jared A; Taylor, Lynne S

    2010-09-01

    In this study, the crystallization behavior of a variety of compounds was studied following rapid solvent evaporation using spin coating. Initial screening to determine model compound suitability was performed using a structurally diverse set of 51 compounds in three different solvent systems [dichloromethane (DCM), a 1:1 (w/w) dichloromethane/ethanol mixture (MIX), and ethanol (EtOH)]. Of this starting set of 153 drug-solvent combinations, 93 (40 compounds) were selected for further evaluation based on solubility, chemical solution stability, and processability criteria. These systems were spin coated and their crystallization was monitored using polarized light microscopy (7 days, dry conditions). The crystallization behavior of the samples could be classified as rapid (Class I: 39 cases), intermediate (Class II: 23 cases), or slow (Class III: 31 cases). The solvent system employed influenced the classification outcome for only four of the compounds. The various compounds showed very diverse crystallization behavior. Upon comparison of classification results with those of a previous study, where cooling from the melt was used as a preparation technique, a good similarity was found whereby 68% of the cases were identically classified. Multivariate analysis was performed using a set of relevant physicochemical compound characteristics. It was found that a number of these parameters tended to differ between the different classes. These could be further interpreted in terms of the nature of the crystallization process. Additional multivariate analysis on the separate classes of compounds indicated some potential in predicting the crystallization tendency of a given compound.

  11. Characteristics of dysphagia in children with cerebral palsy, related to gross motor function.

    PubMed

    Kim, Joon-Sung; Han, Zee-A; Song, Dae Heon; Oh, Hyun-Mi; Chung, Myung Eun

    2013-10-01

    The aim of this study was to report the characteristics of dysphagia in children with cerebral palsy (CP), related to gross motor function. Videofluoroscopic swallow study was performed in 29 children with CP, according to the manual of Logemann. Five questions about oromotor dysfunction were answered. Gross motor function level was classified by the Gross Motor Function Classification System Expanded and Revised. The results of the videofluoroscopic swallowing studies showed that reduced lip closure, inadequate bolus formation, residue in the oral cavity, delayed triggering of pharyngeal swallow, reduced larynx elevation, coating on the pharyngeal wall, delayed pharyngeal transit time, multiple swallow, and aspiration were significantly more common in the severe group (Gross Motor Function Classification System Expanded and Revised IV or V). As for aspiration, 50% of the children with severe CP had problems, but only 14.3% of them with moderate (Gross Motor Function Classification System Expanded and Revised III) CP and none of them with mild CP had abnormalities. In addition, five of the seven aspiration cases occurred silently. This study shows that dysphagia is closely related to gross motor function in children with CP. Silent aspiration was observed in the moderate to severe CP groups. Aspiration is an important cause of medical problems such as acute and chronic lung disease, and associated respiratory complications contribute significantly in increasing morbidity and mortality in these patient groups. Therefore, the authors suggest that early dysphagia evaluation including videofluoroscopic swallow study is necessary in managing feeding problems and may prevent chronic aspiration, malnutrition, and infections.

  12. Alignment of classification paradigms for communication abilities in children with cerebral palsy

    PubMed Central

    Hustad, Katherine C.; Oakes, Ashley; McFadd, Emily; Allison, Kristen M.

    2015-01-01

    Aim We examined three communication ability classification paradigms for children with cerebral palsy (CP): the Communication Function Classification System (CFCS), the Viking Speech Scale (VSS), and the Speech Language Profile Groups (SLPG). Questions addressed inter-judge reliability, whether the VSS and the CFCS captured impairments in speech and language, and whether there were differences in speech intelligibility among levels within each classification paradigm. Method 80 children (42 males) with a range of types and severity levels of CP participated (mean age, 60 months; SD 4.8 months). Two speech-language pathologists classified each child via parent-child interaction samples and previous experience with the children for the CFCS and VSS, and uisng quantitative speech and language assessment data for the SLPG. Intelligibility scores were obtained using standard clinical intelligibility measurement. Results Kappa values were .67 (95% CI [.55, .79]) for the CFCS, .82 (95% CI [.72, .92]), for the VSS, .95 (95% CI [.72, .92]) for the SLPG. Descriptively, reliability within levels of each paradigm varied, with the lowest agreement occurring within the CFCS at levels II (42%), III (40%), and IV (61%). Neither the CFCS nor the VSS were sensitive to language impairments captured by the SLPG. Significant differences in speech intelligibility were found among levels for all classification paradigms. Interpretation Multiple tools are necessary to understand speech, language, and communication profiles in children with CP. Characterization of abilities at all levels of the ICF will advance our understanding of the ways that speech, language, and communication abilities present in children with CP. PMID:26521844

  13. Female genital mutilation reversal: a general approach.

    PubMed

    Anand, Mallika; Stanhope, Todd J; Occhino, John A

    2014-07-01

    Female genital mutilation (FGM) is a violation of human rights; yet, more than 100 million females are estimated to have undergone the procedure worldwide. There is an increased need for physician education in treating FGM. Female pelvic surgeons have a unique opportunity to treat this population of patients. Here, we depict the classification of FGM and a general approach to FGM reversal. We specifically address the procedure of type III FGM reversal, or defibulation. In this video, we first highlight the importance of the problem of FGM. Next, we present the classification of FGM using an original, simple, schematic diagram highlighting they key anatomic structures involved in the four types of FGM. We then present a simple case of reversal of type III FGM, a procedure also known as defibulation. After depicting the surgical procedure, we discuss clinical results and summarize key principles of the defibulation procedure. Our patient was a 25-year-old woman who had undergone type III FGM as a child in Somalia. She desired restoration of vaginal function. We performed a reversal, and her postoperative course was uncomplicated. By 6 weeks postoperatively, she was able to engage in sexual intercourse without dyspareunia. FGM is a problem at the doorsteps of female pelvic medicine and reconstructive surgery. Our video demonstrates a basic surgical approach that can be applied to simple cases of type III FGM presenting to the female pelvic surgeon.

  14. Contemporary survival of patients with pulmonary arterial hypertension and congenital systemic to pulmonary shunts

    PubMed Central

    Chungsomprasong, Paweena; Bositthipichet, Densiri; Ketsara, Salisa; Titaram, Yuttapon; Chanthong, Prakul; Kanjanauthai, Supaluck

    2018-01-01

    Objective To compare survival of patients with newly diagnosed pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD) according to various clinical classifications with classifications of anatomical-pathophysiological systemic to pulmonary shunts in a single-center cohort. Methods All prevalent cases of PAH-CHD with hemodynamic confirmation by cardiac catheterization in 1995–2015 were retrospectively reviewed. Patients who were younger than three months of age, or with single ventricle following surgery were excluded. Baseline characteristics and clinical outcomes were retrieved from the database. The survival analysis was performed at the end of 2016. Prognostic factors were identified using multivariate analysis. Results A total of 366 consecutive patients (24.5 ± 17.6 years of age, 40% male) with PAH-CHD were analyzed. Most had simple shunts (85 pre-tricuspid, 105 post-tricuspid, 102 combined shunts). Patients with pre-tricuspid shunts were significantly older at diagnosis in comparison to post-tricuspid, combined, and complex shunts. Clinical classifications identified patients as having Eisenmenger syndrome (ES, 26.8%), prevalent left to right shunt (66.7%), PAH with small defect (3%), or PAH following defect correction (3.5%). At follow-up (median = 5.9 years; 0.1–20.7 years), no statistically significant differences in survival rate were seen among the anatomical-pathophysiological shunts (p = 0.1). Conversely, the clinical classifications revealed that patients with PAH-small defect had inferior survival compared to patients with ES, PAH post-corrective surgery, or PAH with prevalent left to right shunt (p = 0.01). Significant mortality risks were functional class III, age < 10 years, PAH-small defect, elevated right atrial pressure > 15 mmHg, and baseline PVR > 8 WU•m.2 Conclusion Patients with PAH-CHD had a modest long-term survival. Different anatomical-pathophysiological shunts affect the natural presentation, while clinical classifications indicate treatment strategies and survival. Contemporary therapy improves survival in deliberately selected patients. PMID:29664959

  15. 76 FR 72355 - Classification of Two Steroids, Prostanozol and Methasterone, as Schedule III Anabolic Steroids...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-23

    ... positive nitrogen balance and protein metabolism, resulting in increases in protein synthesis and lean body... nitrogen balance and androgenic activity based on weight changes of the ventral prostrate of prostanozol...

  16. 21 CFR 7.41 - Health hazard evaluation and recall classification.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... exposed to the product being considered, with particular attention paid to the hazard to those individuals....e., Class I, Class II, or Class III, to indicate the relative degree of health hazard of the product...

  17. 21 CFR 878.4480 - Absorbable powder for lubricating a surgeon's glove.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878... degradation. (b) Classification. Class III. (c) Date PMA or notice of completion of a PDP is required. As of...

  18. 20 CFR 627.440 - Classification of costs.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... to: (A) Salaries, fringe benefits, equipment, supplies, space, staff training, transportation, and... participants; (iii) Equipment and materials used in providing training to participants; (iv) Classroom space... work experience, vocational exploration, limited internships, and entry employment. (2) Direct training...

  19. 20 CFR 627.440 - Classification of costs.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... to: (A) Salaries, fringe benefits, equipment, supplies, space, staff training, transportation, and... participants; (iii) Equipment and materials used in providing training to participants; (iv) Classroom space... work experience, vocational exploration, limited internships, and entry employment. (2) Direct training...

  20. 20 CFR 627.440 - Classification of costs.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... to: (A) Salaries, fringe benefits, equipment, supplies, space, staff training, transportation, and... participants; (iii) Equipment and materials used in providing training to participants; (iv) Classroom space... work experience, vocational exploration, limited internships, and entry employment. (2) Direct training...

  1. Implementing disability evaluation and welfare services based on the framework of the international classification of functioning, disability and health: experiences in Taiwan

    PubMed Central

    2013-01-01

    Background Before 2007, the disability evaluation was based on the medical model in Taiwan. According to the People with Disabilities Rights Protection Act, from 2012 the assessment of a person’s eligibility for disability benefits has to be determined based on the International Classification of Functioning, Disability, and Health (ICF) framework nationwide. The purposes of this study were to: 1) design the evaluation tools for disability eligibility system based on the ICF/ICF-Children and Youth; 2) compare the differences of grades of disability between the old and new evaluation systems; 3) analyse the outcome of the new disability evaluation system. Methods To develop evaluation tools and procedure for disability determination, we formed an implementation taskforce, including 199 professional experts, and conducted a small-scale field trial to examine the feasibility of evaluation tools in Phase I. To refine the evaluation tools and process and to compare the difference of the grades of disability between new and old systems, 7,329 persons with disabilities were randomly recruited in a national population-based study in Phase II. To implement the new system smoothly and understand the impact of the new system, the collaboration mechanism was established and data of 168,052 persons who applied for the disability benefits was extracted from the information system and analysed in Phase III. Results The measures of the 43 categories for body function/structure components, the Functioning Scale of Disability Evaluation System for activities/participation components, and the needs assessment have been developed and used in the field after several revisions. In Phase II, there was 49.7% agreement of disability grades between the old and new systems. In Phase III, 110,667 persons with a disability received their welfare services through the new system. Among them, 77% received basic social welfare support, 89% financial support, 24% allowance for assistive technology, 7% caregiver support, 8% nursing care and rehabilitation services at home, and 47% were issued parking permits for persons with disability. Conclusion This study demonstrated that disability evaluation system based on the ICF could provide a common language between disability assessment, needs assessment and welfare services. However, the proposed assessment protocol and tools require additional testing and validation. PMID:24125482

  2. [Proposal for the classification of the periprosthetic membrane from loosened hip and knee endoprostheses].

    PubMed

    Morawietz, L; Gehrke, Th; Classen, R-A; Barden, B; Otto, M; Hansen, T; Aigner, Th; Stiehl, P; Neidel, J; Schröder, J H; Frommelt, L; Schubert, Th; Meyer-Scholten, C; König, A; Ströbel, Ph; Rader, Ch P; Kirschner, S; Lintner, F; Rüther, W; Skwara, A; Bos, I; Kriegsmann, J; Krenn, V

    2004-09-01

    After 10 years, loosening of total joint endoprostheses occurs in about 3 to 10 percent of all patients, requiring elaborate revision surgery. A periprosthetic membrane is routinely found between bone and loosened prosthesis. Further histomorphological examination allows determination of the etiology of the loosening process. Aim of this study is the introduction of clearly defined histopathological criteria for a standardized evaluation of the periprosthetic membrane. Based on histomorphological criteria and polarized light microscopy, four types of the periprosthetic membrane were defined: periprosthetic membrane of wear particle type (type I), periprosthetic membrane of infectious type (type II), periprosthetic membrane of combined type (type III), periprosthetic membrane of indifferent type (type IV). Periprosthetic membranes of 268 patients were analyzed according to the defined criteria. The correlation between histopathological and microbiological diagnosis was high (89%, p<0,001), the inter-observer reproducibility was sufficient (95%). This classification system enables a standardized diagnostic procedure and therefore is a basis for further studies concerning the etiology of and pathogenesis of prosthesis loosening.

  3. Intrahepatic biliary anatomy derived from right graft adult live donor liver transplantation.

    PubMed

    Radtke, A; Sgourakis, G; Sotiropoulos, G C; Molmenti, E P; Nadalin, S; Fouzas, I; Schroeder, T; Saner, F; Schenk, A; Cincinnati, V R; Malagó, M; Lang, H

    2008-11-01

    The successful management of the bile duct in right graft adult live donor liver transplantation requires knowledge of both its central (hilar) and distal (sectorial) anatomy. The purpose of this study was to provide a systematic classification of its branching patterns to enhance clinical decision-making. We analyzed three-dimensional computed tomography (3-D CT) imaging reconstructions of 139 potential live liver donors evaluated at our institution between January 2003 and June 2007. Fifty-four (n = 54 or 38.8%) donor candidates had a normal (classic) hilar and sectorial right bile duct anatomy (type I). Seventy-eight (n = 78 or 56.1%) cases had either hilar or sectorial branching abnormalities (types II or III). Seven (n = 7 or 5.1%) livers had a mixed type (IV) of a rare and complex central and distal anatomy. We believe that the classification proposed herein can aid in the better organization and categorization of the variants encountered within the right-sided intrahepatic biliary system.

  4. Analysis of composition-based metagenomic classification.

    PubMed

    Higashi, Susan; Barreto, André da Motta Salles; Cantão, Maurício Egidio; de Vasconcelos, Ana Tereza Ribeiro

    2012-01-01

    An essential step of a metagenomic study is the taxonomic classification, that is, the identification of the taxonomic lineage of the organisms in a given sample. The taxonomic classification process involves a series of decisions. Currently, in the context of metagenomics, such decisions are usually based on empirical studies that consider one specific type of classifier. In this study we propose a general framework for analyzing the impact that several decisions can have on the classification problem. Instead of focusing on any specific classifier, we define a generic score function that provides a measure of the difficulty of the classification task. Using this framework, we analyze the impact of the following parameters on the taxonomic classification problem: (i) the length of n-mers used to encode the metagenomic sequences, (ii) the similarity measure used to compare sequences, and (iii) the type of taxonomic classification, which can be conventional or hierarchical, depending on whether the classification process occurs in a single shot or in several steps according to the taxonomic tree. We defined a score function that measures the degree of separability of the taxonomic classes under a given configuration induced by the parameters above. We conducted an extensive computational experiment and found out that reasonable values for the parameters of interest could be (i) intermediate values of n, the length of the n-mers; (ii) any similarity measure, because all of them resulted in similar scores; and (iii) the hierarchical strategy, which performed better in all of the cases. As expected, short n-mers generate lower configuration scores because they give rise to frequency vectors that represent distinct sequences in a similar way. On the other hand, large values for n result in sparse frequency vectors that represent differently metagenomic fragments that are in fact similar, also leading to low configuration scores. Regarding the similarity measure, in contrast to our expectations, the variation of the measures did not change the configuration scores significantly. Finally, the hierarchical strategy was more effective than the conventional strategy, which suggests that, instead of using a single classifier, one should adopt multiple classifiers organized as a hierarchy.

  5. Repair-oriented classification of aortic insufficiency: impact on surgical techniques and clinical outcomes.

    PubMed

    Boodhwani, Munir; de Kerchove, Laurent; Glineur, David; Poncelet, Alain; Rubay, Jean; Astarci, Parla; Verhelst, Robert; Noirhomme, Philippe; El Khoury, Gébrine

    2009-02-01

    Valve repair for aortic insufficiency requires a tailored surgical approach determined by the leaflet and aortic disease. Over the past decade, we have developed a functional classification of AI, which guides repair strategy and can predict outcome. In this study, we analyze our experience with a systematic approach to aortic valve repair. From 1996 to 2007, 264 patients underwent elective aortic valve repair for aortic insufficiency (mean age - 54 +/- 16 years; 79% male). AV was tricuspid in 171 patients bicuspid in 90 and quadricuspid in 3. One hundred fifty three patients had type I dysfunction (aortic dilatation), 134 had type II (cusp prolapse), and 40 had type III (restrictive). Thirty six percent (96/264) of the patients had more than one identified mechanism. In-hospital mortality was 1.1% (3/264). Six patients experienced early repair failure; 3 underwent re-repair. Functional classification predicted the necessary repair techniques in 82-100% of patients, with adjunctive techniques being employed in up to 35% of patients. Mid-term follow up (median [interquartile range]: 47 [29-73] months) revealed a late mortality rate of 4.2% (11/261, 10 cardiac). Five year overall survival was 95 +/- 3%. Ten patients underwent aortic valve reoperation (1 re-repair). Freedoms from recurrent Al (>2+) and from AV reoperation at 5 years was 88 +/- 3% and 92 +/- 4% respectively and patients with type I (82 +/- 9%; 93 +/- 5%) or II (95 +/- 5%; 94 +/- 6%) had better outcomes compared to type III (76 +/- 17%; 84 +/- 13%). Aortic valve repair is an acceptable therapeutic option for patients with aortic insufficiency. This functional classification allows a systematic approach to the repair of Al and can help to predict the surgical techniques required as well as the durability of repair. Restrictive cusp motion (type III), due to fibrosis or calcification, is an important predictor for recurrent Al following AV repair.

  6. Seven-Color Photometry and Classification of Stars in the Direction of Open Cluster M29 (NGC 6913) in Cygnus

    DTIC Science & Technology

    2013-01-01

    Spitzer, 2MASS , VVISE and IPHAS databases is acknowledged. The project is partly supported by the Research Council of Lithuania, grant No. MIP-061/2013...1304. YSO [WISE, IPHAS]; 1305. HD 19򒵺 (A), B5V [5], B8III [6]; 1306. G5III [5[; 1307. WDS 20243+3811 (sep ~ 1.9"); 1313. YSO [ 2MASS , Spitze... 2MASS , IPHAS); 1387. Fl III [!6[; 1391. HD 229261 (B9), BS [5,8], B6II [16], B5IV-V [17[; 1407. F2 [5[; 1408. B3 V [16[; 1419. A2IV [16[; 1427

  7. A New Diagnostic Diagram of Ionization Sources for High-redshift Emission Line Galaxies

    NASA Astrophysics Data System (ADS)

    Zhang, Kai; Hao, Lei

    2018-04-01

    We propose a new diagram, the kinematics–excitation (KEx) diagram, which uses the [O III] λ5007/Hβ line ratio and the [O III] λ5007 emission line width (σ [O III]) to diagnose the ionization source and physical properties of active galactic nuclei (AGNs) and star-forming galaxies (SFGs). The KEx diagram is a suitable tool to classify emission line galaxies at intermediate redshift because it uses only the [O III] λ5007 and Hβ emission lines. We use the main galaxy sample of SDSS DR7 and the Baldwin‑Phillips‑Terlevich (BPT) diagnostic to calibrate the diagram at low redshift. The diagram can be divided into three regions: the KEx-AGN region, which consists mainly of pure AGNs, the KEx-composite region, which is dominated by composite galaxies, and the KEx-SFG region, which contains mostly SFGs. LINERs strongly overlap with the composite and AGN regions. AGNs are separated from SFGs in this diagram mainly because they preferentially reside in luminous and massive galaxies and have higher [O III]/Hβ than SFGs. The separation between AGNs and SFGs is even cleaner thanks to the additional 0.15/0.12 dex offset in σ [O III] at fixed luminosity/stellar mass. We apply the KEx diagram to 7866 galaxies at 0.3 < z < 1 in the DEEP2 Galaxy Redshift Survey, and compare it to an independent X-ray classification scheme using Chandra observations. X-ray AGNs are mostly located in the KEx-AGN region, while X-ray SFGs are mostly located in the KEx-SFG region. Almost all Type 1 AGNs lie in the KEx-AGN region. These tests support the reliability of this classification diagram for emission line galaxies at intermediate redshift. At z ∼ 2, the demarcation line between SFGs and AGNs is shifted by ∼0.3 dex toward higher values of σ [O III] due to evolution effects.

  8. Classification of residents in nursing homes in Tuscany (Italy) using Resource Utilization Groups Version III (RUG-III).

    PubMed

    Francesconi, Paolo; Cantini, Elisabetta; Bavazzano, Emanuela; Lauretani, Fabrizio; Bandinelli, Stefania; Buiatti, Eva; Ferrucci, Luigi

    2006-04-01

    Samples of nursing homes in Tuscany (Italy) classify their residents and determine their case-mix according to the Resource Utilization Groups System, Version III (RUG-III). A large sample of nursing homes was selected, based on willingness to participate, representation of both public and private institutions, and wide geographic representation. Two registered nurses assessed all residents using the RUG questionnaire. The information collected was then used to group residents into 44 RUGs, and facility-specific case-mix indices were calculated using the RUG-specific weights previously validated in Italy. A total of 3981 residents from 93 nursing homes were assessed. Most residents were over 75 years old (87.4%) and women (68.6%). A large percentage was classified into RUGs within the following primary categories: reduced physical function (33.6%), impaired cognition (17.6%) and clinically complex (17.6%). The resulting nursing home case-mix indices ranged from 0.627 to 1.108 (mean 0.807+/-0.110). No significant association was found between type of facility, level of fees, or extent of staff in the nursing homes and their case-mix indices. RUGIII can provide information on types of nursing home residents and their care needs. This is useful for monitoring and evaluating long-term care services for the elderly, and allows for more effective planning and allocation of staffing and financial resources.

  9. Do DSM-5 Section II personality disorders and Section III personality trait domains reflect the same genetic and environmental risk factors?

    PubMed

    Reichborn-Kjennerud, T; Krueger, R F; Ystrom, E; Torvik, F A; Rosenström, T H; Aggen, S H; South, S C; Neale, M C; Knudsen, G P; Kendler, K S; Czajkowski, N O

    2017-09-01

    DSM-5 includes two conceptualizations of personality disorders (PDs). The classification in Section II is identical to the one found in DSM-IV, and includes 10 categorical PDs. The Alternative Model (Section III) includes criteria for dimensional measures of maladaptive personality traits organized into five domains. The degree to which the two conceptualizations reflect the same etiological factors is not known. We use data from a large population-based sample of adult twins from the Norwegian Institute of Public Health Twin Panel on interview-based DSM-IV PDs and a short self-report inventory that indexes the five domains of the DSM-5 Alternative Model plus a domain explicitly targeting compulsivity. Schizotypal, Paranoid, Antisocial, Borderline, Avoidant, and Obsessive-compulsive PDs were assessed at the same time as the maladaptive personality traits and 10 years previously. Schizoid, Histrionic, Narcissistic, and Dependent PDs were only assessed at the first interview. Biometric models were used to estimate overlap in genetic and environmental risk factors. When measured concurrently, there was 100% genetic overlap between the maladaptive trait domains and Paranoid, Schizotypal, Antisocial, Borderline, and Avoidant PDs. For OCPD, 43% of the genetic variance was shared with the domains. Genetic correlations between the individual domains and PDs ranged from +0.21 to +0.91. The pathological personality trait domains, which are part of the Alternative Model for classification of PDs in DSM-5 Section III, appears to tap, at an aggregate level, the same genetic risk factors as the DSM-5 Section II classification for most of the PDs.

  10. Concurrent chemoradiotherapy with S-1 in patients with stage III-IV oral squamous cell carcinoma: A retrospective analysis of nodal classification based on the neck node level.

    PubMed

    Murakami, Ryuji; Semba, Akiko; Kawahara, Kenta; Matsuyama, Keiya; Hiraki, Akimitsu; Nagata, Masashi; Toya, Ryo; Yamashita, Yasuyuki; Oya, Natsuo; Nakayama, Hideki

    2017-07-01

    The aim of the present study was to retrospectively evaluate the treatment outcomes of concurrent chemoradiotherapy (CCRT) with S-1, an oral fluoropyrimidine anticancer agent, for advanced oral squamous cell carcinoma (SCC). The study population consisted of 47 patients with clinical stage III or IV oral SCC, who underwent CCRT with S-1. Pretreatment variables, including patient age, clinical stage, T classification, midline involvement of the primary tumor and nodal status, were analyzed as predictors of survival. In addition to the N classification (node-positive, multiple and contralateral), the prognostic impact of the level of nodal involvement was assessed. Nodal involvement was mainly observed at levels Ib and II; involvement at levels Ia and III-V was considered to be anterior and inferior extension, respectively, and was recorded as extensive nodal involvement (ENI). The 3-year overall survival (OS) and progression-free survival (PFS) rates were 37 and 27%, respectively. A finding of ENI was a significant factor for OS [hazard ratio (HR)=2.16; 95% confidence interval (CI): 1.03-4.55; P=0.038] and PFS (HR=2.65; 95% CI: 1.32-5.33; P=0.005); the 3-year OS and PFS rates in patients with vs. those without ENI were 23 vs. 50% and 9 vs. 43%, respectively. The other variables were not significant. Therefore, CCRT with S-1 may be an alternative treatment for advanced oral SCC; favorable outcomes are expected in patients without ENI.

  11. A new look at the International Duration Evaluation of Adjuvant therapy (IDEA) classification-Defining novel predictive and prognostic markers in stage III colon cancer.

    PubMed

    Margalit, Ofer; Mamtani, Ronac; Yang, Yu-Xiao; Reiss, Kim A; Golan, Talia; Halpern, Naama; Aderka, Dan; Giantonio, Bruce; Shacham-Shmueli, Einat; Boursi, Ben

    2018-04-23

    The International Duration Evaluation of Adjuvant therapy (IDEA) pooled analysis compared 3 to 6 months of adjuvant chemotherapy for stage III colon cancer. The overarching goal was to reduce chemotherapy-related toxicity, mainly oxaliplatin-induced neuropathy. Patients were classified into low-risk and high-risk groups, suggesting that low-risk patients may be offered only 3 months of treatment. We aimed to evaluate the benefit of monotherapy versus doublet chemotherapy in low and high IDEA risk groups. Using the National Cancer Database (2004-2014), we identified 56,728 low-risk and 47,557 high-risk individuals with stage III colon cancer, according to the IDEA classification. We used multivariate Cox regression to evaluate the magnitude of survival differences between IDEA risk groups, according to treatment intensity (doublet versus monotherapy). In a secondary analysis, we examined the prognostic and predictive value of subgroups of age, tumour sidedness and lymph node ratio (LNR). Low and high IDEA risk groups derived similar benefit from doublet adjuvant chemotherapy as compared with monotherapy, with hazard ratios (HRs) of 0.83 (95% confidence interval [CI] 0.79-0.86) and 0.80 (95% CI 0.78-0.83), respectively. The only subpopulations that did not benefit from doublet chemotherapy were low-risk patients older than 72 years (HR = 0.95, 95% CI 0.90-1.01) and high-risk patients older than 85 years (HR = 0.90, 95% CI 0.77-1.05). LNR and tumour sidedness were shown as additional prognostic, but not predictive, factors within the IDEA risk groups. IDEA risk classification per se does not predict for treatment benefit from doublet chemotherapy in stage III colon cancer. However, omission of oxaliplatin can be considered in IDEA low-risk patients older than 72 years. Copyright © 2018 Elsevier Ltd. All rights reserved.

  12. Evaluation of a Smartphone-based Human Activity Recognition System in a Daily Living Environment.

    PubMed

    Lemaire, Edward D; Tundo, Marco D; Baddour, Natalie

    2015-12-11

    An evaluation method that includes continuous activities in a daily-living environment was developed for Wearable Mobility Monitoring Systems (WMMS) that attempt to recognize user activities. Participants performed a pre-determined set of daily living actions within a continuous test circuit that included mobility activities (walking, standing, sitting, lying, ascending/descending stairs), daily living tasks (combing hair, brushing teeth, preparing food, eating, washing dishes), and subtle environment changes (opening doors, using an elevator, walking on inclines, traversing staircase landings, walking outdoors). To evaluate WMMS performance on this circuit, fifteen able-bodied participants completed the tasks while wearing a smartphone at their right front pelvis. The WMMS application used smartphone accelerometer and gyroscope signals to classify activity states. A gold standard comparison data set was created by video-recording each trial and manually logging activity onset times. Gold standard and WMMS data were analyzed offline. Three classification sets were calculated for each circuit: (i) mobility or immobility, ii) sit, stand, lie, or walking, and (iii) sit, stand, lie, walking, climbing stairs, or small standing movement. Sensitivities, specificities, and F-Scores for activity categorization and changes-of-state were calculated. The mobile versus immobile classification set had a sensitivity of 86.30% ± 7.2% and specificity of 98.96% ± 0.6%, while the second prediction set had a sensitivity of 88.35% ± 7.80% and specificity of 98.51% ± 0.62%. For the third classification set, sensitivity was 84.92% ± 6.38% and specificity was 98.17 ± 0.62. F1 scores for the first, second and third classification sets were 86.17 ± 6.3, 80.19 ± 6.36, and 78.42 ± 5.96, respectively. This demonstrates that WMMS performance depends on the evaluation protocol in addition to the algorithms. The demonstrated protocol can be used and tailored for evaluating human activity recognition systems in rehabilitation medicine where mobility monitoring may be beneficial in clinical decision-making.

  13. Factors affecting the causality assessment of adverse events following immunisation in paediatric clinical trials: An online survey.

    PubMed

    Voysey, Merryn; Tavana, Rahele; Farooq, Yama; Heath, Paul T; Bonhoeffer, Jan; Snape, Matthew D

    2015-12-16

    Serious adverse events (SAEs) in clinical trials require reporting within 24h, including a judgment of whether the SAE was related to the investigational product(s). Such assessments are an important component of pharmacovigilance, however classification systems for assigning relatedness vary across study protocols. This on-line survey evaluated the consistency of SAE causality assessment among professionals with vaccine clinical trial experience. Members of the clinical advisory forum of experts (CAFÉ), a Brighton Collaboration online-forum, were emailed a survey containing SAEs from hypothetical vaccine trials which they were asked to classify. Participants were randomised to either two classification options (related/not related to study immunisation) or three options (possibly/probably/unrelated). The clinical scenarios, were (i) leukaemia diagnosed 5 months post-immunisation with a live RSV vaccine, (ii) juvenile idiopathic arthritis (JIA) 3 months post-immunisation with a group A streptococcal vaccine, (iii) developmental delay diagnosed at age 10 months after infant capsular group B meningococcal vaccine, (iv) developmental delay diagnosed at age 10 months after maternal immunisation with a group B streptococcal vaccine. There were 140 respondents (72 two options, 68 three options). Across all respondents, SAEs were considered related to study immunisation by 28% (leukaemia), 74% (JIA), 29% (developmental delay after infant immunisation) and 42% (developmental delay after maternal immunisation). Having only two options made respondents significantly less likely to classify the SAE as immunisation-related for two scenarios (JIA p=0.0075; and maternal immunisation p=0.045). Amongst study investigators (n=43) this phenomenon was observed for three of the four scenarios: (JIA p=0.0236; developmental delay following infant immunisation p=0.0266; and developmental delay after maternal immunisation p=0.0495). SAE causality assessment is inconsistent amongst study investigators and can be influenced by the classification systems available to them. There is a pressing need for SAE classification systems to be standardised across study protocols. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Systemic Classification for a New Diagnostic Approach to Acute Abdominal Pain in Children

    PubMed Central

    Kim, Ji Hoi; Kang, Hyun Sik; Han, Kyung Hee; Kim, Seung Hyo; Shin, Kyung-Sue; Lee, Mu Suk; Jeong, In Ho; Kim, Young Sil

    2014-01-01

    Purpose With previous methods based on only age and location, there are many difficulties in identifying the etiology of acute abdominal pain in children. We sought to develop a new systematic classification of acute abdominal pain and to give some helps to physicians encountering difficulties in diagnoses. Methods From March 2005 to May 2010, clinical data were collected retrospectively from 442 children hospitalized due to acute abdominal pain with no apparent underlying disease. According to the final diagnoses, diseases that caused acute abdominal pain were classified into nine groups. Results The nine groups were group I "catastrophic surgical abdomen" (7 patients, 1.6%), group II "acute appendicitis and mesenteric lymphadenitis" (56 patients, 12.7%), group III "intestinal obstruction" (57 patients, 12.9%), group IV "viral and bacterial acute gastroenteritis" (90 patients, 20.4%), group V "peptic ulcer and gastroduodenitis" (66 patients, 14.9%), group VI "hepatobiliary and pancreatic disease" (14 patients, 3.2%), group VII "febrile viral illness and extraintestinal infection" (69 patients, 15.6%), group VIII "functional gastrointestinal disorder (acute manifestation)" (20 patients, 4.5%), and group IX "unclassified acute abdominal pain" (63 patients, 14.3%). Four patients were enrolled in two disease groups each. Conclusion Patients were distributed unevenly across the nine groups of acute abdominal pain. In particular, the "unclassified abdominal pain" only group was not uncommon. Considering a systemic classification for acute abdominal pain may be helpful in the diagnostic approach in children. PMID:25587522

  15. A dynamical classification of the cosmic web

    NASA Astrophysics Data System (ADS)

    Forero-Romero, J. E.; Hoffman, Y.; Gottlöber, S.; Klypin, A.; Yepes, G.

    2009-07-01

    In this paper, we propose a new dynamical classification of the cosmic web. Each point in space is classified in one of four possible web types: voids, sheets, filaments and knots. The classification is based on the evaluation of the deformation tensor (i.e. the Hessian of the gravitational potential) on a grid. The classification is based on counting the number of eigenvalues above a certain threshold, λth, at each grid point, where the case of zero, one, two or three such eigenvalues corresponds to void, sheet, filament or a knot grid point. The collection of neighbouring grid points, friends of friends, of the same web type constitutes voids, sheets, filaments and knots as extended web objects. A simple dynamical consideration of the emergence of the web suggests that the threshold should not be null, as in previous implementations of the algorithm. A detailed dynamical analysis would have found different threshold values for the collapse of sheets, filaments and knots. Short of such an analysis a phenomenological approach has been opted for, looking for a single threshold to be determined by analysing numerical simulations. Our cosmic web classification has been applied and tested against a suite of large (dark matter only) cosmological N-body simulations. In particular, the dependence of the volume and mass filling fractions on λth and on the resolution has been calculated for the four web types. We also study the percolation properties of voids and filaments. Our main findings are as follows. (i) Already at λth = 0.1 the resulting web classification reproduces the visual impression of the cosmic web. (ii) Between 0.2 <~ λth <~ 0.4, a system of percolated voids coexists with a net of interconnected filaments. This suggests a reasonable choice for λth as the parameter that defines the cosmic web. (iii) The dynamical nature of the suggested classification provides a robust framework for incorporating environmental information into galaxy formation models, and in particular to semi-analytical models.

  16. Does semi-automatic bone-fragment segmentation improve the reproducibility of the Letournel acetabular fracture classification?

    PubMed

    Boudissa, M; Orfeuvre, B; Chabanas, M; Tonetti, J

    2017-09-01

    The Letournel classification of acetabular fracture shows poor reproducibility in inexperienced observers, despite the introduction of 3D imaging. We therefore developed a method of semi-automatic segmentation based on CT data. The present prospective study aimed to assess: (1) whether semi-automatic bone-fragment segmentation increased the rate of correct classification; (2) if so, in which fracture types; and (3) feasibility using the open-source itksnap 3.0 software package without incurring extra cost for users. Semi-automatic segmentation of acetabular fractures significantly increases the rate of correct classification by orthopedic surgery residents. Twelve orthopedic surgery residents classified 23 acetabular fractures. Six used conventional 3D reconstructions provided by the center's radiology department (conventional group) and 6 others used reconstructions obtained by semi-automatic segmentation using the open-source itksnap 3.0 software package (segmentation group). Bone fragments were identified by specific colors. Correct classification rates were compared between groups on Chi 2 test. Assessment was repeated 2 weeks later, to determine intra-observer reproducibility. Correct classification rates were significantly higher in the "segmentation" group: 114/138 (83%) versus 71/138 (52%); P<0.0001. The difference was greater for simple (36/36 (100%) versus 17/36 (47%); P<0.0001) than complex fractures (79/102 (77%) versus 54/102 (53%); P=0.0004). Mean segmentation time per fracture was 27±3min [range, 21-35min]. The segmentation group showed excellent intra-observer correlation coefficients, overall (ICC=0.88), and for simple (ICC=0.92) and complex fractures (ICC=0.84). Semi-automatic segmentation, identifying the various bone fragments, was effective in increasing the rate of correct acetabular fracture classification on the Letournel system by orthopedic surgery residents. It may be considered for routine use in education and training. III: prospective case-control study of a diagnostic procedure. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  17. Differences in the molecular biology of adenocarcinoma of the esophagus, gastric cardia, and upper gastric third.

    PubMed

    Lehmann, Kuno; Schneider, Paul M

    2010-01-01

    Adenocarcinoma of the distal esophagus, gastric cardia, and upper gastric third are grouped in type I-III by the Siewert classification. This classification is based on the endoscopic localisation of the tumor center, and is the most important diagnostic tool to group these tumors. On a molecular level, there is currently no marker that would allow to differentiate the three different types. Furthermore, the Siewert classification was not uniformly used in the recent literature, making interpretation and generalization of these results difficult. However, several potential targets have been identified that may help to separate these tumors by molecular markers, and are summarized in this chapter.

  18. Classification of hydrocephalus: critical analysis of classification categories and advantages of "Multi-categorical Hydrocephalus Classification" (Mc HC).

    PubMed

    Oi, Shizuo

    2011-10-01

    Hydrocephalus is a complex pathophysiology with disturbed cerebrospinal fluid (CSF) circulation. There are numerous numbers of classification trials published focusing on various criteria, such as associated anomalies/underlying lesions, CSF circulation/intracranial pressure patterns, clinical features, and other categories. However, no definitive classification exists comprehensively to cover the variety of these aspects. The new classification of hydrocephalus, "Multi-categorical Hydrocephalus Classification" (Mc HC), was invented and developed to cover the entire aspects of hydrocephalus with all considerable classification items and categories. Ten categories include "Mc HC" category I: onset (age, phase), II: cause, III: underlying lesion, IV: symptomatology, V: pathophysiology 1-CSF circulation, VI: pathophysiology 2-ICP dynamics, VII: chronology, VII: post-shunt, VIII: post-endoscopic third ventriculostomy, and X: others. From a 100-year search of publication related to the classification of hydrocephalus, 14 representative publications were reviewed and divided into the 10 categories. The Baumkuchen classification graph made from the round o'clock classification demonstrated the historical tendency of deviation to the categories in pathophysiology, either CSF or ICP dynamics. In the preliminary clinical application, it was concluded that "Mc HC" is extremely effective in expressing the individual state with various categories in the past and present condition or among the compatible cases of hydrocephalus along with the possible chronological change in the future.

  19. [Neurosurgical treatment of complications of intra-disk injections of triamcinolone hexacetonide. Value of a radio-clinical classification].

    PubMed

    Privat, J M; Finiels, P J

    1997-01-01

    Epidural granulomas following intra-discal injection of triamcinolone hexacetonide are a well-known complication of this procedure, which is still encountered, even if its utilization was discontinued several years ago. According to the results of their experience, the authors propose a new radio-clinical grading system: grade I: disc calcification with aspect of "sub-ligamentar hernia" on CT scan; grade II: ascendant or descendant retrosomatic migration of distal content; grade III: pseudotumoral epidural infiltrate producing progressive narrowing of the spinal canal with neurological disturbance. Surgical indications in these cases can be drawn from their evolution: posterior approach can be used, with or without laminectomy, for excision as complete as possible of the involved disc (grades I and II); anterior approach should be preferred in cases of multiples recurrences after medical treatment and failure of classical posterior approach, or in case of necrotico-inflammatory proliferation with narrowing of the spinal canal (grade III).

  20. Carl Sagan's Cosmic Connection

    NASA Astrophysics Data System (ADS)

    Sagan, Carl; Agel, Jerome

    2000-08-01

    Foreword Freeman Dyson; Personal reflections Ann Druyan; Preface; Part I. Cosmic Perspective: 1. A transitional animal; 2. The Unicorn of Cetus; 3. A message from earth; 4. A message to earth; 5. Experiments in utopias; 6. Chauvinism; 7. Space exploration as a human enterprise I. The scientific interest; 8. Space exploration as a human enterprise II. The public interest; 9. Space exploration as a human enterprise III. The historical interest; Part II. The Solar System: 10. On teaching the first grade; 11. 'The ancient and legendary Gods of old'; 12. The Venus detective story; 13. Venus is hell; 14. Science and 'intelligence'; 15. The moons of Barsoom; 16. The mountains of Mars I. Observations from earth; 17. The mountains of Mars II. Observations from space; 18. The canals of Mars; 19. The lost pictures of Mars; 20. The Ice Age and the cauldron; 21. Beginnings and ends of the Earth; 22. Terraforming the plants; 23. The exploration and utlization of the solar system; Part III. Beyond the Solar System: 24. Some of my best friends are dolphins; 25. 'Hello, central casting? Send me twenty extraterrestrials'; 26. The cosmic connection; 27. Extraterrestrial life: an idea whose time has come; 28. Has the Earth been visited?; 29. A search strategy for detecting extraterrestrial intelligence; 30. If we succeed 31. Cables, drums, and seashells; 32. The night freight to the stars; 33. Astroengineering; 34. Twenty questions: a classification of cosmic civilisations; 35. Galactic cultural exchanges; 36. A passage to elsewhere; 37. Starfolk I. A Fable; 38. Starfolk II. A future; 39. Starfolk III. The cosmic Cheshire cats; Epilog David Morrison; Index.

  1. Software OT&E Guidelines. Volume 3. Software Maintainability Evaluator’s Handbook

    DTIC Science & Technology

    1980-04-01

    SOFTWARE OT&E " 1 GUIDELINES . VOLUME III SOFTWARE MAINTAINABILITY EVALUATOR’S HANDBOOK APRIL 1980 AIR FORCE TEST AND EVALUATION CENTER KIRTLAND AIR...FORCE BASE NEW MEXICO 87117 C-, -j AfTECP 800-3 AF’r...........3 ...... UNCLASSIFIED SECURITY CLASSIFICATION OF THIS PAGE (When D.. Entered) RE:PORT...c -. 5 TY!aJ0. PERIOD COVERED SOFTWARE OT& . GUIDELINES, Volume III .of five). -1 softare-R.aintainability Evaluator’s P-IEFnook’ 4ina. i 1980

  2. Episodic Syndromes That May Be Associated With Migraine: A.K.A. "the Childhood Periodic Syndromes".

    PubMed

    Gelfand, Amy A

    2015-01-01

    Previously called "childhood periodic syndromes that are commonly precursors of migraine" in International Headache Classification of Headache Disorders (ICHD)-II, these disorders were renamed "episodic syndromes that may be associated with migraine" in ICHD-III beta. The specific disorders reviewed in this article include: benign paroxysmal torticollis, benign paroxysmal vertigo, abdominal migraine, and cyclical vomiting syndrome, as well as infantile colic, which was recently added under the appendix section in ICHD-III beta. © 2015 American Headache Society.

  3. Postoperative complications of contemporary open and robot-assisted laparoscopic radical prostatectomy using standardized reporting systems.

    PubMed

    Pompe, Raisa S; Beyer, Burkhard; Haese, Alexander; Preisser, Felix; Michl, Uwe; Steuber, Thomas; Graefen, Markus; Huland, Hartwig; Karakiewicz, Pierre I; Tilki, Derya

    2018-05-04

    To analyze time trends and contemporary rates of postoperative complications after RP and to compare the complication profile of ORP and RALP using standardized reporting systems. Retrospective analysis of 13,924 RP patients in a single institution (2005 to 2015). Complications were collected during hospital stay and via standardized questionnaire 3 months after and grouped into eight schemes. Since 2013, the revised Clavien-Dindo classification was used (n = 4,379). Annual incidence rates of different complications were graphically displayed. Multivariable logistic regression analyses compared complications between ORP and RALP after inverse probability of treatment weighting (IPTW). After introduction of standardized classification systems, complication rates have increased with a contemporary rate of 20.6% (2013 - 2015). While minor Clavien-Dindo grades represented the majority (I: 10.6%; II: 7.9%), severe complications (grades IV-V) were rare (<1%). In logistic regression analyses after IPTW, RALP was associated with less blood loss, shorter catheterization time and lower risk for Clavien-Dindo grade II and III complications. Our results emphasize the importance of standardized reporting systems for quality control and comparison across approaches or institutions. Contemporary complication rates in a high volume center remain low and are most frequently minor Clavien-Dindo grades. RALP had a slightly better complication profile compared to ORP. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  4. Orbit classification in an equal-mass non-spinning binary black hole pseudo-Newtonian system

    NASA Astrophysics Data System (ADS)

    Zotos, Euaggelos E.; Dubeibe, Fredy L.; González, Guillermo A.

    2018-07-01

    The dynamics of a test particle in a non-spinning binary black hole system of equal masses is numerically investigated. The binary system is modelled in the context of the pseudo-Newtonian circular restricted three-body problem, such that the primaries are separated by a fixed distance and move in a circular orbit around each other. In particular, the Paczyński-Wiita potential is used for describing the gravitational field of the two non-Newtonian primaries. The orbital properties of the test particle are determined through the classification of the initial conditions of the orbits, using several values of the Jacobi constant, in the Hill's regions of possible motion. The initial conditions are classified into three main categories: (i) bounded, (ii) escaping, and (iii) displaying close encounters. Using the smaller alignment index chaos indicator, we further classify bounded orbits into regular, sticky, or chaotic. To gain a complete view of the dynamics of the system, we define grids of initial conditions on different types of two-dimensional planes. The orbital structure of the configuration plane, along with the corresponding distributions of the escape and collision/close encounter times, allow us to observe the transition from the classical Newtonian to the pseudo-Newtonian regime. Our numerical results reveal a strong dependence of the properties of the considered basins with the Jacobi constant as well as with the Schwarzschild radius of the black holes.

  5. C-reactive protein and serum creatinine, but not haemoglobin A1c, are independent predictors of coronary heart disease risk in non-diabetic Chinese.

    PubMed

    Salim, Agus; Tai, E Shyong; Tan, Vincent Y; Welsh, Alan H; Liew, Reginald; Naidoo, Nasheen; Wu, Yi; Yuan, Jian-Min; Koh, Woon P; van Dam, Rob M

    2016-08-01

    In western populations, high-sensitivity C-reactive protein (hsCRP), and to a lesser degree serum creatinine and haemoglobin A1c, predict risk of coronary heart disease (CHD). However, data on Asian populations that are increasingly affected by CHD are sparse and it is not clear whether these biomarkers can be used to improve CHD risk classification. We conducted a nested case-control study within the Singapore Chinese Health Study cohort, with incident 'hard' CHD (myocardial infarction or CHD death) as an outcome. We used data from 965 men (298 cases, 667 controls) and 528 women (143 cases, 385 controls) to examine the utility of hsCRP, serum creatinine and haemoglobin A1c in improving the prediction of CHD risk over and above traditional risk factors for CHD included in the ATP III model. For each sex, the performance of models with only traditional risk factors used in the ATP III model was compared with models with the biomarkers added using weighted Cox proportional hazards analysis. The impact of adding these biomarkers was assessed using the net reclassification improvement index. For men, loge hsCRP (hazard ratio 1.25, 95% confidence interval: 1.05; 1.49) and loge serum creatinine (hazard ratio 4.82, 95% confidence interval: 2.10; 11.04) showed statistically significantly associations with CHD risk when added to the ATP III model. We did not observe a significant association between loge haemoglobin A1c and CHD risk (hazard ratio 1.83, 95% confidence interval: 0.21; 16.06). Adding hsCRP and serum creatinine to the ATP III model improved risk classification in men with a net gain of 6.3% of cases (p-value = 0.001) being reclassified to a higher risk category, while it did not significantly reduce the accuracy of classification for non-cases. For women, squared hsCRP was borderline significantly (hazard ratio 1.01, 95% confidence interval: 1.00; 1.03) and squared serum creatinine was significantly (hazard ratio 1.81, 95% confidence interval: 1.49; 2.21) associated with CHD risk. However, the association between squared haemoglobin A1c and CHD risk was not significant (hazard ratio 1.05, 95% confidence interval: 0.99; 1.12). The addition of hsCRP and serum creatinine to the ATP III model resulted in 3.7% of future cases being reclassified to a higher risk category (p-value = 0.025), while it did not significantly reduce the accuracy of classification for non-cases. Adding hsCRP and serum creatinine, but not haemoglobin A1c, to traditional risk factors improved CHD risk prediction among non-diabetic Singaporean Chinese. The improved risk estimates will allow better identification of individuals at high risk of CHD than existing risk calculators such as the ATP III model. © The European Society of Cardiology 2016.

  6. Ultrasonic Data Display and Analysis System Developed (Including Fuzzy Logic Analysis) for the Windows-Based PC

    NASA Technical Reports Server (NTRS)

    Lovelace, Jeffrey J.; Cios, Kryzsztof J.; Roth, Don J.; cAO, wEI n.

    2001-01-01

    Post-Scan Interactive Data Display (PSIDD) III is a user-oriented Windows-based system that facilitates the display and comparison of ultrasonic contact measurement data obtained at NASA Glenn Research Center's Ultrasonic Nondestructive Evaluation measurement facility. The system is optimized to compare ultrasonic measurements made at different locations within a material or at different stages of material degradation. PSIDD III provides complete analysis of the primary waveforms in the time and frequency domains along with the calculation of several frequency-dependent properties including phase velocity and attenuation coefficient and several frequency-independent properties, like the cross correlation velocity. The system allows image generation on all the frequency-dependent properties at any available frequency (limited by the bandwidth used in the scans) and on any of the frequency-independent properties. From ultrasonic contact scans, areas of interest on an image can be studied with regard to underlying raw waveforms and derived ultrasonic properties by simply selecting the point on the image. The system offers various modes of indepth comparison between scan points. Up to five scan points can be selected for comparative analysis at once. The system was developed with Borland Delphi software (Visual Pascal) and is based on an SQL data base. It is ideal for the classification of material properties or the location of microstructure variations in materials. Along with the ultrasonic contact measurement software that it is partnered with, this system is technology ready and can be transferred to users worldwide.

  7. Explaining Direct Care Resource Use of Nursing Home Residents: Findings from Time Studies in Four States

    PubMed Central

    Arling, Greg; Kane, Robert L; Mueller, Christine; Lewis, Teresa

    2007-01-01

    Objective To explain variation in direct care resource use (RU) of nursing home residents based on the Resource Utilization Groups III (RUG-III) classification system and other resident- and unit-level explanatory variables. Data Sources/Study Setting Primary data were collected on 5,314 nursing home residents in 156 nursing units in 105 facilities from four states (CO, IN, MN, MS) from 1998 to 2004. Study Design Nurses and other direct care staff recorded resident-specific and other time caring for all residents on sampled nursing units. Care time was linked to resident data from the Minimum Data Set assessment instrument. Major variables were: RUG-III group (34-group), other health and functional conditions, licensed and other professional minutes per day, unlicensed minutes per day, and direct care RU (wage-weighted minutes). Resident- and unit-level relationships were examined through hierarchical linear modeling. Data Collection/Extraction Methods Time study data were recorded with hand-held computers, verified for accuracy by project staff at the data collection sites and then merged into resident and unit-level data sets. Principal Findings Resident care time and RU varied between and within nursing units. RUG-III group was related to RU; variables such as length of stay and unit percentage of high acuity residents also were significantly related. Case-mix indices (CMIs) constructed from study data displayed much less variation across RUG-III groups than CMIs from earlier time studies. Conclusions Results from earlier time studies may not be representative of care patterns of Medicaid and private pay residents. New RUG-III CMIs should be developed to better reflect the relative costs of caring for these residents. PMID:17362220

  8. Automated Grading of Gliomas using Deep Learning in Digital Pathology Images: A modular approach with ensemble of convolutional neural networks.

    PubMed

    Ertosun, Mehmet Günhan; Rubin, Daniel L

    2015-01-01

    Brain glioma is the most common primary malignant brain tumors in adults with different pathologic subtypes: Lower Grade Glioma (LGG) Grade II, Lower Grade Glioma (LGG) Grade III, and Glioblastoma Multiforme (GBM) Grade IV. The survival and treatment options are highly dependent of this glioma grade. We propose a deep learning-based, modular classification pipeline for automated grading of gliomas using digital pathology images. Whole tissue digitized images of pathology slides obtained from The Cancer Genome Atlas (TCGA) were used to train our deep learning modules. Our modular pipeline provides diagnostic quality statistics, such as precision, sensitivity and specificity, of the individual deep learning modules, and (1) facilitates training given the limited data in this domain, (2) enables exploration of different deep learning structures for each module, (3) leads to developing less complex modules that are simpler to analyze, and (4) provides flexibility, permitting use of single modules within the framework or use of other modeling or machine learning applications, such as probabilistic graphical models or support vector machines. Our modular approach helps us meet the requirements of minimum accuracy levels that are demanded by the context of different decision points within a multi-class classification scheme. Convolutional Neural Networks are trained for each module for each sub-task with more than 90% classification accuracies on validation data set, and achieved classification accuracy of 96% for the task of GBM vs LGG classification, 71% for further identifying the grade of LGG into Grade II or Grade III on independent data set coming from new patients from the multi-institutional repository.

  9. Automated Grading of Gliomas using Deep Learning in Digital Pathology Images: A modular approach with ensemble of convolutional neural networks

    PubMed Central

    Ertosun, Mehmet Günhan; Rubin, Daniel L.

    2015-01-01

    Brain glioma is the most common primary malignant brain tumors in adults with different pathologic subtypes: Lower Grade Glioma (LGG) Grade II, Lower Grade Glioma (LGG) Grade III, and Glioblastoma Multiforme (GBM) Grade IV. The survival and treatment options are highly dependent of this glioma grade. We propose a deep learning-based, modular classification pipeline for automated grading of gliomas using digital pathology images. Whole tissue digitized images of pathology slides obtained from The Cancer Genome Atlas (TCGA) were used to train our deep learning modules. Our modular pipeline provides diagnostic quality statistics, such as precision, sensitivity and specificity, of the individual deep learning modules, and (1) facilitates training given the limited data in this domain, (2) enables exploration of different deep learning structures for each module, (3) leads to developing less complex modules that are simpler to analyze, and (4) provides flexibility, permitting use of single modules within the framework or use of other modeling or machine learning applications, such as probabilistic graphical models or support vector machines. Our modular approach helps us meet the requirements of minimum accuracy levels that are demanded by the context of different decision points within a multi-class classification scheme. Convolutional Neural Networks are trained for each module for each sub-task with more than 90% classification accuracies on validation data set, and achieved classification accuracy of 96% for the task of GBM vs LGG classification, 71% for further identifying the grade of LGG into Grade II or Grade III on independent data set coming from new patients from the multi-institutional repository. PMID:26958289

  10. [A family with progressive myoclonus epilepsy (author's transl)].

    PubMed

    Ammann, F; Schweingruber, R; Paro, M

    1978-01-01

    To begin, a survey of the literature concerning the group of progressive myoclonic epilepsies is presented, from the initial descriptions of Unverricht (1891) and Lundborg (1903) to the present. Recently several subforms of this nosologic entity have been delineated according to the mode of inheritance, time of manifestation, severity of course, and biochemical characteristics (i.e, eventual demonstration of mucopolysaccharide storage in Lafora bodies or diffuse in the central nervous system and other organs). The most useful classification stems from Diebold (1972): early (I) and late (II) forms of the Lafora type having autosomal recessive inheritance; an autosomal recessive early form (III) and an autosomal dominant late form (IV) with degenerative changes in the central nervous system without biochemical disturbances. The authors describe 3 young siblings from Southern Tyrol, who clinically manifested the cardinal symptoms of the disease in addition to extrapyramidal cerebellar disturbances. In spite of extensive bioptic and biochemical examinations, neither Lafora bodies nor diffuse deposits or excretion of mucopolysaccharides could be demonstrated. The distant blood relationship between the parents of these patients supports the assumption of an autosomal recessive mode of transmission. The relatively early manifestation of the disease and the demonstration of degenerative changes within the central nervous system suggest assignment of these patients to Diebold's subgroup III of the progressive myoclonic epilepsy.

  11. Femtosecond laser-assisted compared with standard cataract surgery for removal of advanced cataracts.

    PubMed

    Hatch, Kathryn M; Schultz, Tim; Talamo, Jonathan H; Dick, H Burkhard

    2015-09-01

    To compare effective phacoemulsification time (EPT) for the removal of brunescent cataracts treated with femtosecond laser-assisted cataract surgery with standard cataract phacoemulsification techniques. Ruhr University Eye Hospital, Bochum, Germany. Comparative prospective case study. The Lens Opacities Classification System III (LOCS III) grading system was used to measure eyes divided into 4 groups having cataract surgery. Groups 1 and 2 contained eyes with LOCS III grade nuclear opalescence (NO) 3 cataracts treated with standard cataract surgery and femtosecond laser-assisted cataract surgery, respectively. Groups 3 and 4 contained brunescent cataracts, LOCS III grades NO5, treated with standard cataract surgery and femtosecond laser-assisted cataract surgery, respectively. There were 240 eyes, with 60 eyes in each group. The EPT in Group 1 ranged from 0.46 to 3.10 (mean 1.38); the EPT in all eyes in Group 2 was 0 (P < .001). The EPT in Groups 3 and 4 was 2.12 to 19.29 (mean 6.85) and 0 to 6.75 (mean 1.35), respectively (P < .001). A comparison between EPT in Groups 1 and 4 showed that EPT in Group 4 was also lower than in Group 1 (P = .013). Groups 4 and 1 were the most statistically similar of all groups compared, suggesting that EPT for a femtosecond laser-treated grade 5 cataract was most similar to that of a standard-treated grade 3 cataract. Femtosecond laser pretreatment for brunescent cataracts allowed for a significant reduction in EPT compared with manual standard phacoemulsification techniques. Drs. Hatch, Talamo, and Dick are consultants to Abbott Medical Optics, Inc. Dr. Schultz has no financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  12. Prognostic value of the 8th edition of the tumor-node-metastasis classification for patients with papillary thyroid carcinoma: a single-institution study at a high-volume center in Japan.

    PubMed

    Ito, Yasuhiro; Miyauchi, Akira; Hirokawa, Mitsuyoshi; Yamamoto, Masatoshi; Oda, Hitomi; Masuoka, Hiroo; Sasai, Hisanori; Fukushima, Mitsuhiro; Higashiyama, Takuya; Kihara, Minoru; Miya, Akihiro

    2018-04-20

    The tumor-node-metastasis (TNM) staging system is most commonly adopted to evaluate the prognosis of patients with thyroid carcinoma. The 8 th edition of the TNM staging system, an extensively revised version of the 7 th edition, was recently released. We aimed to investigate whether and how well the 8 th edition reflects the cause-specific survival (CSS) of patients with papillary thyroid carcinoma by analyzing the cases in 5,892 patients who underwent initial surgery at Kuma Hospital between 1987 and 2005. The median postoperative follow-up duration was 178 months (range: 6-357 months). One patient with T4b disease was excluded from the analysis. Overall, 116 (2.0%) patients died of thyroid carcinoma. The proportion of variance explained (PVE) for CSS in the 7 th and 8 th editions was 10.69 and 10.97, respectively. Using the 7 th edition, CSS of patients with stage IVA and stage III disease was similar (p = 0.32). In contrast, using the 8 th edition, CSS was poorer in stage II than in stage I (p < 0.001), in stage III than in stage II (p < 0.001), and in stage IVB than in stage III (p < 0.001). Similar results were observed for disease-free survival. Although we could not establish any objective evidence that the 8 th edition is superior to the 7 th edition, the 8 th edition is simpler and more convenient, as it includes fewer stages and addresses the issue of the 7 th edition where stage IVA and III patients had similar prognoses.

  13. Changing scene highlights III. [Iowa State University

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Fassel, V. A.; Harl, Neil E.; Legvold, Sam

    1979-01-01

    The research programs in progress at Ames Laboratory, Iowa State University, are reviewed: hydrogen (storage), materials, catalysts, TRISTAN (their laboratory isotope separator), coal preparation, coal classification, land reclamation (after surface mining, nitinol, neutron radiography, grain dust explosions, biomass conversion, etc). (LTC)

  14. Relating DSM-5 section II and section III personality disorder diagnostic classification systems to treatment planning.

    PubMed

    Morey, Leslie C; Benson, Kathryn T

    2016-07-01

    Beginning with DSM-III, the inclusion of a "personality" axis was designed to encourage awareness of personality disorders and the treatment-related implications of individual differences, but since that time there is little accumulated evidence that the personality disorder categories provide substantial treatment-related guidance. The DSM-5 Personality and Personality Disorders Work Group sought to develop an Alternative Model for personality disorder, and this study examined whether this model is more closely related to clinicians' decision-making processes than the traditional categorical personality disorder diagnoses. A national sample of 337 clinicians provided complete personality disorder diagnostic information and several treatment-related clinical judgments about one of their patients. The dimensional concepts of the DSM-5 Alternative Model for personality disorders demonstrated stronger relationships than categorical DSM-IV/DSM-5 Section II diagnoses to 10 of 11 clinical judgments regarding differential treatment planning, optimal treatment intensity, and long-term prognosis. The constructs of the DSM-5 Alternative Model for personality disorders may provide more clinically useful information for treatment planning than the official categorical personality disorder diagnostic system retained in DSM-5 Section II. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Surface-active agents from the group of polyoxyethylated glycerol esters of fatty acids. Part III. Surface activity and solubilizing properties of the products of oxyethylation of lard (Adeps suillus, F.P. VIII) in the equilibrium system in relation to lipophilic therapeutic agents (class II and III of BCS).

    PubMed

    Nachajski, Michał J; Piotrowska, Jowita B; Kołodziejczyk, Michał K; Lukosek, Marek; Zgoda, Marian M

    2013-01-01

    Research was conducted into the solubilization processes of diclofenac, ibuprofen, ketoprofen and naproxen in equilibrium conditions in the environment of aqueous solutions of oxyethylated lard's fractions (Adeps suillus, Polish Pharmacopoeia VIII). The determined thermodynamic (cmc, deltaGm(0)) and hydrodynamic (R0, R(obs), omega, M(eta)) parameters characterizing the micelle of the solubilizer and the adduct demonstrate that lipophilic therapeutic agents are adsorbed in a palisade structure of the micelle due to a topologically created so-called "lipophilic adsorption pocket". This shows that the hydrophilicity of the micelle and the adsorption layer decreases at the phase boundary, which is confirmed by the calculated values of coefficients A(m) and r x (a). The results obtained indicate the possibility of making use of the class of non-ionic surfactants which are not ksenobiotics for the modification of the profile of solid oral dosage forms with lipophilic therapeutic agents from the II class of Biopharmaceutics Classification System (BCS).

  16. Classification of ductal carcinoma in situ by gene expression profiling.

    PubMed

    Hannemann, Juliane; Velds, Arno; Halfwerk, Johannes B G; Kreike, Bas; Peterse, Johannes L; van de Vijver, Marc J

    2006-01-01

    Ductal carcinoma in situ (DCIS) is characterised by the intraductal proliferation of malignant epithelial cells. Several histological classification systems have been developed, but assessing the histological type/grade of DCIS lesions is still challenging, making treatment decisions based on these features difficult. To obtain insight in the molecular basis of the development of different types of DCIS and its progression to invasive breast cancer, we have studied differences in gene expression between different types of DCIS and between DCIS and invasive breast carcinomas. Gene expression profiling using microarray analysis has been performed on 40 in situ and 40 invasive breast cancer cases. DCIS cases were classified as well- (n = 6), intermediately (n = 18), and poorly (n = 14) differentiated type. Of the 40 invasive breast cancer samples, five samples were grade I, 11 samples were grade II, and 24 samples were grade III. Using two-dimensional hierarchical clustering, the basal-like type, ERB-B2 type, and the luminal-type tumours originally described for invasive breast cancer could also be identified in DCIS. Using supervised classification, we identified a gene expression classifier of 35 genes, which differed between DCIS and invasive breast cancer; a classifier of 43 genes could be identified separating between well- and poorly differentiated DCIS samples.

  17. Classification of ductal carcinoma in situ by gene expression profiling

    PubMed Central

    Hannemann, Juliane; Velds, Arno; Halfwerk, Johannes BG; Kreike, Bas; Peterse, Johannes L; van de Vijver, Marc J

    2006-01-01

    Introduction Ductal carcinoma in situ (DCIS) is characterised by the intraductal proliferation of malignant epithelial cells. Several histological classification systems have been developed, but assessing the histological type/grade of DCIS lesions is still challenging, making treatment decisions based on these features difficult. To obtain insight in the molecular basis of the development of different types of DCIS and its progression to invasive breast cancer, we have studied differences in gene expression between different types of DCIS and between DCIS and invasive breast carcinomas. Methods Gene expression profiling using microarray analysis has been performed on 40 in situ and 40 invasive breast cancer cases. Results DCIS cases were classified as well- (n = 6), intermediately (n = 18), and poorly (n = 14) differentiated type. Of the 40 invasive breast cancer samples, five samples were grade I, 11 samples were grade II, and 24 samples were grade III. Using two-dimensional hierarchical clustering, the basal-like type, ERB-B2 type, and the luminal-type tumours originally described for invasive breast cancer could also be identified in DCIS. Conclusion Using supervised classification, we identified a gene expression classifier of 35 genes, which differed between DCIS and invasive breast cancer; a classifier of 43 genes could be identified separating between well- and poorly differentiated DCIS samples. PMID:17069663

  18. AO Distal Radius Fracture Classification: Global Perspective on Observer Agreement.

    PubMed

    Jayakumar, Prakash; Teunis, Teun; Giménez, Beatriz Bravo; Verstreken, Frederik; Di Mascio, Livio; Jupiter, Jesse B

    2017-02-01

    Background  The primary objective of this study was to test interobserver reliability when classifying fractures by consensus by AO types and groups among a large international group of surgeons. Secondarily, we assessed the difference in inter- and intraobserver agreement of the AO classification in relation to geographical location, level of training, and subspecialty. Methods  A randomized set of radiographic and computed tomographic images from a consecutive series of 96 distal radius fractures (DRFs), treated between October 2010 and April 2013, was classified using an electronic web-based portal by an invited group of participants on two occasions. Results  Interobserver reliability was substantial when classifying AO type A fractures but fair and moderate for type B and C fractures, respectively. No difference was observed by location, except for an apparent difference between participants from India and Australia classifying type B fractures. No statistically significant associations were observed comparing interobserver agreement by level of training and no differences were shown comparing subspecialties. Intra-rater reproducibility was "substantial" for fracture types and "fair" for fracture groups with no difference accounting for location, training level, or specialty. Conclusion  Improved definition of reliability and reproducibility of this classification may be achieved using large international groups of raters, empowering decision making on which system to utilize. Level of Evidence  Level III.

  19. AO Distal Radius Fracture Classification: Global Perspective on Observer Agreement

    PubMed Central

    Jayakumar, Prakash; Teunis, Teun; Giménez, Beatriz Bravo; Verstreken, Frederik; Di Mascio, Livio; Jupiter, Jesse B.

    2016-01-01

    Background The primary objective of this study was to test interobserver reliability when classifying fractures by consensus by AO types and groups among a large international group of surgeons. Secondarily, we assessed the difference in inter- and intraobserver agreement of the AO classification in relation to geographical location, level of training, and subspecialty. Methods A randomized set of radiographic and computed tomographic images from a consecutive series of 96 distal radius fractures (DRFs), treated between October 2010 and April 2013, was classified using an electronic web-based portal by an invited group of participants on two occasions. Results Interobserver reliability was substantial when classifying AO type A fractures but fair and moderate for type B and C fractures, respectively. No difference was observed by location, except for an apparent difference between participants from India and Australia classifying type B fractures. No statistically significant associations were observed comparing interobserver agreement by level of training and no differences were shown comparing subspecialties. Intra-rater reproducibility was “substantial” for fracture types and “fair” for fracture groups with no difference accounting for location, training level, or specialty. Conclusion Improved definition of reliability and reproducibility of this classification may be achieved using large international groups of raters, empowering decision making on which system to utilize. Level of Evidence Level III PMID:28119795

  20. VizieR Online Data Catalog: Spectral Classes in Kapteyn areas 68-91 (Chargeishvili+, 2000)

    NASA Astrophysics Data System (ADS)

    Chargeishvili, K. B.; Bartaya, R. A.; Kharadze, E. K.

    2013-11-01

    The present catalogue is the third one of the four catalogues published according to programme of Abastumani Astrophysical Observatory of a massive two-dimensional MK classification of stars in 115 kapteyn Select Areas (KA) of Northen Sky (Bartaya, 1983, Cat. III/112; Bartaya, Kharadze, 1992, Cat. III/270). The catalogue lists the spectral types and luminosity classes for 3914 stars in 24 Kapteyn areas 68-91 through the declination circle of 0°. The catalogue is compiled on the basis of the spectral data obtained with the 70-cm meniscus telescope of Abastumani Astrophysical Observatory using the 8° objective prism (dispersion 166Å/mm near Hγ; in the short-wave region, the spectrum extends up to 3500Å). The field of the meniscus telescope is 4.5°x 4.5°. The photo material is taken on Kodak IIa-O, hyper-sensitized Kodak IIIa-J and in order to detect also Hα emission stars and M, S, C type stars in the surveyed KA's, hyper-sensitized Kodak IIIa-F plates were also taken. A limiting apparent magnitude in V for stars in question is 12.5 photographic mag. and for M ones - 15.0 mag. The data for all KA's are uniform not only in the sense of classification accuracy (the whole classification is done by one person - the author of the present catalogue), but also in the sense of penetration. The errors of our determinations are: +/-0.6 for spectral subtype and +/-0.5 for luminosity class. The stars in the KA's are arranged in the Catalogue by increasing right ascension. The stars are numbered according to zones of 1° in declination. The printed catalogue is provided with suitable stellar charts for separate KA's reproduced from the Lick Catalogue. The reference system on the charts refers to 1950 epoch and it is plotted according to the Smithsonian Astrophysical Observatory (SAO) catalogue. (1 data file).

  1. Quantum Cascade Laser-Based Infrared Microscopy for Label-Free and Automated Cancer Classification in Tissue Sections.

    PubMed

    Kuepper, Claus; Kallenbach-Thieltges, Angela; Juette, Hendrik; Tannapfel, Andrea; Großerueschkamp, Frederik; Gerwert, Klaus

    2018-05-16

    A feasibility study using a quantum cascade laser-based infrared microscope for the rapid and label-free classification of colorectal cancer tissues is presented. Infrared imaging is a reliable, robust, automated, and operator-independent tissue classification method that has been used for differential classification of tissue thin sections identifying tumorous regions. However, long acquisition time by the so far used FT-IR-based microscopes hampered the clinical translation of this technique. Here, the used quantum cascade laser-based microscope provides now infrared images for precise tissue classification within few minutes. We analyzed 110 patients with UICC-Stage II and III colorectal cancer, showing 96% sensitivity and 100% specificity of this label-free method as compared to histopathology, the gold standard in routine clinical diagnostics. The main hurdle for the clinical translation of IR-Imaging is overcome now by the short acquisition time for high quality diagnostic images, which is in the same time range as frozen sections by pathologists.

  2. Efficacy of the Kyoto Classification of Gastritis in Identifying Patients at High Risk for Gastric Cancer.

    PubMed

    Sugimoto, Mitsushige; Ban, Hiromitsu; Ichikawa, Hitomi; Sahara, Shu; Otsuka, Taketo; Inatomi, Osamu; Bamba, Shigeki; Furuta, Takahisa; Andoh, Akira

    2017-01-01

    Objective The Kyoto gastritis classification categorizes the endoscopic characteristics of Helicobacter pylori (H. pylori) infection-associated gastritis and identifies patterns associated with a high risk of gastric cancer. We investigated its efficacy, comparing scores in patients with H. pylori-associated gastritis and with gastric cancer. Methods A total of 1,200 patients with H. pylori-positive gastritis alone (n=932), early-stage H. pylori-positive gastric cancer (n=189), and successfully treated H. pylori-negative cancer (n=79) were endoscopically graded according to the Kyoto gastritis classification for atrophy, intestinal metaplasia, fold hypertrophy, nodularity, and diffuse redness. Results The prevalence of O-II/O-III-type atrophy according to the Kimura-Takemoto classification in early-stage H. pylori-positive gastric cancer and successfully treated H. pylori-negative cancer groups was 45.1%, which was significantly higher than in subjects with gastritis alone (12.7%, p<0.001). Kyoto gastritis scores of atrophy and intestinal metaplasia in the H. pylori-positive cancer group were significantly higher than in subjects with gastritis alone (all p<0.001). No significant differences were noted in the rates of gastric fold hypertrophy or diffuse redness between the two groups. In a multivariate analysis, the risks for H. pylori-positive gastric cancer increased with intestinal metaplasia (odds ratio: 4.453, 95% confidence interval: 3.332-5.950, <0.001) and male sex (1.737, 1.102-2.739, p=0.017). Conclusion Making an appropriate diagnosis and detecting patients at high risk is crucial for achieving total eradication of gastric cancer. The scores of intestinal metaplasia and atrophy of the scoring system in the Kyoto gastritis classification may thus be useful for detecting these patients.

  3. Efficacy of the Kyoto Classification of Gastritis in Identifying Patients at High Risk for Gastric Cancer

    PubMed Central

    Sugimoto, Mitsushige; Ban, Hiromitsu; Ichikawa, Hitomi; Sahara, Shu; Otsuka, Taketo; Inatomi, Osamu; Bamba, Shigeki; Furuta, Takahisa; Andoh, Akira

    2017-01-01

    Objective The Kyoto gastritis classification categorizes the endoscopic characteristics of Helicobacter pylori (H. pylori) infection-associated gastritis and identifies patterns associated with a high risk of gastric cancer. We investigated its efficacy, comparing scores in patients with H. pylori-associated gastritis and with gastric cancer. Methods A total of 1,200 patients with H. pylori-positive gastritis alone (n=932), early-stage H. pylori-positive gastric cancer (n=189), and successfully treated H. pylori-negative cancer (n=79) were endoscopically graded according to the Kyoto gastritis classification for atrophy, intestinal metaplasia, fold hypertrophy, nodularity, and diffuse redness. Results The prevalence of O-II/O-III-type atrophy according to the Kimura-Takemoto classification in early-stage H. pylori-positive gastric cancer and successfully treated H. pylori-negative cancer groups was 45.1%, which was significantly higher than in subjects with gastritis alone (12.7%, p<0.001). Kyoto gastritis scores of atrophy and intestinal metaplasia in the H. pylori-positive cancer group were significantly higher than in subjects with gastritis alone (all p<0.001). No significant differences were noted in the rates of gastric fold hypertrophy or diffuse redness between the two groups. In a multivariate analysis, the risks for H. pylori-positive gastric cancer increased with intestinal metaplasia (odds ratio: 4.453, 95% confidence interval: 3.332-5.950, <0.001) and male sex (1.737, 1.102-2.739, p=0.017). Conclusion Making an appropriate diagnosis and detecting patients at high risk is crucial for achieving total eradication of gastric cancer. The scores of intestinal metaplasia and atrophy of the scoring system in the Kyoto gastritis classification may thus be useful for detecting these patients. PMID:28321054

  4. Computer-aided diagnosis of pulmonary diseases using x-ray darkfield radiography

    NASA Astrophysics Data System (ADS)

    Einarsdóttir, Hildur; Yaroshenko, Andre; Velroyen, Astrid; Bech, Martin; Hellbach, Katharina; Auweter, Sigrid; Yildirim, Önder; Meinel, Felix G.; Eickelberg, Oliver; Reiser, Maximilian; Larsen, Rasmus; Kjær Ersbøll, Bjarne; Pfeiffer, Franz

    2015-12-01

    In this work we develop a computer-aided diagnosis (CAD) scheme for classification of pulmonary disease for grating-based x-ray radiography. In addition to conventional transmission radiography, the grating-based technique provides a dark-field imaging modality, which utilizes the scattering properties of the x-rays. This modality has shown great potential for diagnosing early stage emphysema and fibrosis in mouse lungs in vivo. The CAD scheme is developed to assist radiologists and other medical experts to develop new diagnostic methods when evaluating grating-based images. The scheme consists of three stages: (i) automatic lung segmentation; (ii) feature extraction from lung shape and dark-field image intensities; (iii) classification between healthy, emphysema and fibrosis lungs. A study of 102 mice was conducted with 34 healthy, 52 emphysema and 16 fibrosis subjects. Each image was manually annotated to build an experimental dataset. System performance was assessed by: (i) determining the quality of the segmentations; (ii) validating emphysema and fibrosis recognition by a linear support vector machine using leave-one-out cross-validation. In terms of segmentation quality, we obtained an overlap percentage (Ω) 92.63  ±  3.65%, Dice Similarity Coefficient (DSC) 89.74  ±  8.84% and Jaccard Similarity Coefficient 82.39  ±  12.62%. For classification, the accuracy, sensitivity and specificity of diseased lung recognition was 100%. Classification between emphysema and fibrosis resulted in an accuracy of 93%, whilst the sensitivity was 94% and specificity 88%. In addition to the automatic classification of lungs, deviation maps created by the CAD scheme provide a visual aid for medical experts to further assess the severity of pulmonary disease in the lung, and highlights regions affected.

  5. CSP-TSM: Optimizing the performance of Riemannian tangent space mapping using common spatial pattern for MI-BCI.

    PubMed

    Kumar, Shiu; Mamun, Kabir; Sharma, Alok

    2017-12-01

    Classification of electroencephalography (EEG) signals for motor imagery based brain computer interface (MI-BCI) is an exigent task and common spatial pattern (CSP) has been extensively explored for this purpose. In this work, we focused on developing a new framework for classification of EEG signals for MI-BCI. We propose a single band CSP framework for MI-BCI that utilizes the concept of tangent space mapping (TSM) in the manifold of covariance matrices. The proposed method is named CSP-TSM. Spatial filtering is performed on the bandpass filtered MI EEG signal. Riemannian tangent space is utilized for extracting features from the spatial filtered signal. The TSM features are then fused with the CSP variance based features and feature selection is performed using Lasso. Linear discriminant analysis (LDA) is then applied to the selected features and finally classification is done using support vector machine (SVM) classifier. The proposed framework gives improved performance for MI EEG signal classification in comparison with several competing methods. Experiments conducted shows that the proposed framework reduces the overall classification error rate for MI-BCI by 3.16%, 5.10% and 1.70% (for BCI Competition III dataset IVa, BCI Competition IV Dataset I and BCI Competition IV Dataset IIb, respectively) compared to the conventional CSP method under the same experimental settings. The proposed CSP-TSM method produces promising results when compared with several competing methods in this paper. In addition, the computational complexity is less compared to that of TSM method. Our proposed CSP-TSM framework can be potentially used for developing improved MI-BCI systems. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Machine learning methods for the classification of gliomas: Initial results using features extracted from MR spectroscopy.

    PubMed

    Ranjith, G; Parvathy, R; Vikas, V; Chandrasekharan, Kesavadas; Nair, Suresh

    2015-04-01

    With the advent of new imaging modalities, radiologists are faced with handling increasing volumes of data for diagnosis and treatment planning. The use of automated and intelligent systems is becoming essential in such a scenario. Machine learning, a branch of artificial intelligence, is increasingly being used in medical image analysis applications such as image segmentation, registration and computer-aided diagnosis and detection. Histopathological analysis is currently the gold standard for classification of brain tumors. The use of machine learning algorithms along with extraction of relevant features from magnetic resonance imaging (MRI) holds promise of replacing conventional invasive methods of tumor classification. The aim of the study is to classify gliomas into benign and malignant types using MRI data. Retrospective data from 28 patients who were diagnosed with glioma were used for the analysis. WHO Grade II (low-grade astrocytoma) was classified as benign while Grade III (anaplastic astrocytoma) and Grade IV (glioblastoma multiforme) were classified as malignant. Features were extracted from MR spectroscopy. The classification was done using four machine learning algorithms: multilayer perceptrons, support vector machine, random forest and locally weighted learning. Three of the four machine learning algorithms gave an area under ROC curve in excess of 0.80. Random forest gave the best performance in terms of AUC (0.911) while sensitivity was best for locally weighted learning (86.1%). The performance of different machine learning algorithms in the classification of gliomas is promising. An even better performance may be expected by integrating features extracted from other MR sequences. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  7. 21 CFR 868.1120 - Indwelling blood oxyhemoglobin concentration analyzer.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Indwelling blood oxyhemoglobin concentration... Indwelling blood oxyhemoglobin concentration analyzer. (a) Identification. An indwelling blood oxyhemoglobin... hemoglobin in blood to aid in determining the patient's physiological status. (b) Classification. Class III...

  8. 21 CFR 868.1120 - Indwelling blood oxyhemoglobin concentration analyzer.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Indwelling blood oxyhemoglobin concentration... Indwelling blood oxyhemoglobin concentration analyzer. (a) Identification. An indwelling blood oxyhemoglobin... hemoglobin in blood to aid in determining the patient's physiological status. (b) Classification. Class III...

  9. 21 CFR 868.1120 - Indwelling blood oxyhemoglobin concentration analyzer.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Indwelling blood oxyhemoglobin concentration... Indwelling blood oxyhemoglobin concentration analyzer. (a) Identification. An indwelling blood oxyhemoglobin... hemoglobin in blood to aid in determining the patient's physiological status. (b) Classification. Class III...

  10. 21 CFR 868.1120 - Indwelling blood oxyhemoglobin concentration analyzer.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Indwelling blood oxyhemoglobin concentration... Indwelling blood oxyhemoglobin concentration analyzer. (a) Identification. An indwelling blood oxyhemoglobin... hemoglobin in blood to aid in determining the patient's physiological status. (b) Classification. Class III...

  11. 21 CFR 868.1120 - Indwelling blood oxyhemoglobin concentration analyzer.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Indwelling blood oxyhemoglobin concentration... Indwelling blood oxyhemoglobin concentration analyzer. (a) Identification. An indwelling blood oxyhemoglobin... hemoglobin in blood to aid in determining the patient's physiological status. (b) Classification. Class III...

  12. Grading of meningeal solitary fibrous tumors/hemangiopericytomas: analysis of the prognostic value of the Marseille Grading System in a cohort of 132 patients.

    PubMed

    Macagno, Nicolas; Vogels, Rob; Appay, Romain; Colin, Carole; Mokhtari, Karima; Küsters, Benno; Wesseling, Pieter; Figarella-Branger, Dominique; Flucke, Uta; Bouvier, Corinne

    2018-03-30

    The finding that meningeal solitary fibrous tumors (SFTs) and meningeal hemangiopericytomas (HPCs) are both characterized by NAB2-STAT6 gene fusion has pushed their inclusion in the WHO 2016 Classification of tumors of the central nervous system (CNS) as different manifestations of the same entity. Given that the clinical behavior of the CNS SFT/HPC spectrum ranges from benign to malignant, it is presently unclear whether the grading criteria are still adequate. Here, we present the results of a study that analyzed the prognostic value of an updated version of the Marseille Grading System (MGS) in a retrospectively assembled cohort of 132 primary meningeal SFTs/HPCs with nuclear overexpression of STAT6. The median patient follow-up was 64 months (range 4-274 months); 73 cases (55%) were MGS I, 50 cases (38%) MGS II and 9 cases (7%) were MGS III. Progression-free survival (PFS) and disease-specific survival (DSS) were investigated using univariate analysis: the prognostic factors for PFS included MGS, extent of surgery, radiotherapy, chemotherapy and mitotic activity ≥5/10 high-power field (HPF). Moreover, MGS, radiotherapy, mitotic activity ≥5/10 HPF, and necrosis were the prognostic factors measured for DSS. In multivariate analysis, extent of surgery, mitotic activity ≥5/10 HPF, MGS I and MGS III were the independent prognostic factors measured for PFS while necrosis, MGS III and radiotherapy were the independent prognostic factors for DSS. In conclusion, our results show that assessing the malignancy risk of SFT/HPC should not rely on one single criterion like mitotic activity. Therefore, MGS is useful as it combines the value of different criteria. In particular, the combination of a high mitotic activity and necrosis (MGS III) indicates a particularly poor prognosis. © 2018 International Society of Neuropathology.

  13. Cumulated UDC Supplement, 1965-1975. Volume III: Classes 6/62 (61 Medical Sciences, 62 Engineering and Technology Generally, 621 Mechanical and Electrical Engineering, 622 Mining, 623 Military and Naval Engineering, 624 Civil and Structural Engineering, 625 Railway and Highway Engineering, 626/627 Hydraulic Engineering Works, 628 Public Health Engineering, 629 Transport (Vehicle) Engineering).

    ERIC Educational Resources Information Center

    International Federation for Documentation, The Hague (Netherlands). Committee on Classification Research.

    In continuation of the "Cumulated UDC Supplement - 1964" published by the International Federation for Documentation, this document provides a cumulative supplement to the Universal Decimal Classification for 1965-1975. This third of five volumes lists new classification subdivisions in the following subject areas: (1) medical sciences; (2)…

  14. Santa Ana River Design Memorandum Number 1. Phase 2. GDM on the Santa Ana River Mainstem, Including Santiago Creek. Volume 6. Santiago Creek

    DTIC Science & Technology

    1988-08-01

    requirements of ASTM C 150. 8-10 The Kaiser Cement Company plant in the Lucerne Valley , located approximately 100 miles from the project, produces Type II...land classification of the greater Los Angeles area; Part III Classification of sand and gravel resource areas, Orange County-Temescal Valley Production...Memorandum No. i 4. TITLE (eod Subtitle) 5. TYPE OF REPORT a P ERIOD COVERED Phase II GDM on the Santa Ana River MainstemIncluding Santiago Creek Final

  15. On the Measure and the Structure of the Free Boundary of the Lower Dimensional Obstacle Problem

    NASA Astrophysics Data System (ADS)

    Focardi, Matteo; Spadaro, Emanuele

    2018-04-01

    We provide a thorough description of the free boundary for the lower dimensional obstacle problem in R^{n+1} up to sets of null H^{n-1} measure. In particular, we prove (i) local finiteness of the (n-1)-dimensional Hausdorff measure of the free boundary, (ii) H^{n-1}-rectifiability of the free boundary, (iii) classification of the frequencies up to a set of Hausdorff dimension at most (n-2) and classification of the blow-ups at H^{n-1} almost every free boundary point.

  16. BET, thermal degradation, and FTIR spectras of triazine polyamine polymers.

    PubMed

    Can, Mustafa

    2017-04-01

    Here we show effect of the polyamine polymer chain length to BET isotherms. According to IUPAC classification [1], all three polymers are fitting type 1 physical adsorption isotherm with H3 hysteresis (except for EDA having H2 hysteresis). Moreover, TG and TGA analysis of polymers triazine-ethylenediamine (EDA) and triazine-triethylenetetramine (TETA) are provided. Due to the similarities of the structure, main decomposition temperatures are close to each other (between 593 K and 873 K). In order to understand change of FTIR spectra with adsorption and stripping Au(III), fresh, Au(III) adsorbed and recycled spectras of polymers measured. For further discussions about the effect of chain length to adsorption of Au(III) onto triazine polyamine polymer particles "Au (III) Uptake by Triazine Polyamine Polymers: Mechanism, Kinetic and Equilibrium Studies" Can et al. [2] (article in press).

  17. Transcranial direct current stimulation combined with upper limb functional training in children with spastic, hemiparetic cerebral palsy: study protocol for a randomized controlled trial.

    PubMed

    Moura, Renata Calhes Franco; Santos, Cibele Almeida; Grecco, Luanda André Collange; Lazzari, Roberta Delasta; Dumont, Arislander Jonathan Lopes; Duarte, Natalia Carvalho de Almeida; Braun, Luiz Alfredo; Lopes, Jamile Benite Palma; Santos, Ligia Abram Dos; Rodrigues, Eliane Lopes Souza; Albertini, Giorgio; Cimolin, Veronica; Galli, Manuela; Oliveira, Claudia Santos

    2016-08-17

    The aim of the proposed study is to perform a comparative analysis of functional training effects for the paretic upper limb with and without transcranial direct current stimulation over the primary motor cortex in children with spastic hemiparetic cerebral palsy. The sample will comprise 34 individuals with spastic hemiparetic cerebral palsy, 6 to 16 years old, classified at level I, II, or III of the Manual Ability Classification System. Participants will be randomly allocated to two groups: (1) functional training of the paretic upper limb combined with anodic transcranial stimulation; (2) functional training of the paretic upper limb combined with sham transcranial stimulation. Evaluation will involve three-dimensional movement analysis and electromyography using the SMART-D 140® system (BTS Engineering) and the FREEEMG® system (BTS Engineering), the Quality of Upper Extremity Skills Test, to assess functional mobility, the Portable Device and Ashworth Scale, to measure movement resistance and spasticity, and the Pediatric Evaluation of Disability Inventory, to evaluate performance. Functional reach training of the paretic upper limb will include a range of manual activities using educational toys associated with an induced constraint of the non-paretic limb during the training. Training will be performed in five weekly 20-minute sessions for two weeks. Transcranial stimulation over the primary motor cortex will be performed during the training sessions at an intensity of 1 mA. Findings will be analyzed statistically considering a 5 % significance level (P ≤ 0.05). This paper presents a detailed description of a prospective, randomized, controlled, double-blind, clinical trial designed to demonstrate the effects of combining transcranial direct current stimulation over the primary motor cortex and functional training of the paretic limb in children with cerebral palsy classified at level I, II, or III of the Manual Ability Classification System. The results will be published and evidence found may contribute to the use of transcranial stimulation for this population. ReBEC RBR-6V4Y3K . Registered on 11 February 2015.

  18. Application of the BCS biowaiver approach to assessing bioequivalence of orally disintegrating tablets with immediate release formulations.

    PubMed

    Ono, Asami; Sugano, Kiyohiko

    2014-11-20

    The aim of this study was to compare the dissolution profiles of oral disintegrating tablets (ODTs) and immediate release (IR) formulations in order to experimentally validate the regulatory biowaiver scheme (BWS) for biopharmaceutical classification system (BCS) class III drugs. We examined six drugs that show clinical bioequivalence between the ODTs and IR formulations: taltirelin, olopatadine, droxidopa, famotidine, fexofenadine, and hydrochlorothiazide. The dissolution profiles of these drugs were evaluated using the compendium paddle apparatus at pH 1.2 and 6.8. Taltirelin and olopatadine showed very rapid dissolution and met the dissolution criteria in the BWS, whereas droxidopa, famotidine, fexofenadine, and hydrochlorothiazide did not. Furthermore, in the case of famotidine, fexofenadine, and hydrochlorothiazide, the ODTs and IR formulations showed dissimilar dissolution profiles. The dose-to-solubility ratio (D:S) of these drugs was larger than that of the other drugs. The results of this study suggest that extension of the BCS-BWS to ODTs and IR formulations of BCS class III drugs is appropriate. Furthermore, for BCS class III drugs with relatively high D:S, clinical bioequivalence would be achievable even when two formulations showed different dissolution profiles in vitro. Copyright © 2014 Elsevier B.V. All rights reserved.

  19. Identifying the Risk of Swallowing-Related Pulmonary Complications in Older Patients With Hip Fracture.

    PubMed

    Meals, Clifton; Roy, Siddharth; Medvedev, Gleb; Wallace, Matthew; Neviaser, Robert J; O'Brien, Joseph

    2016-01-01

    To identify and potentially modify the risk of pulmonary complications in a group of older patients with hip fracture, the authors obtained speech and language pathology consultations for these patients. Then they performed a retrospective chart review of all patients 65 years and older who were admitted to their institution between June 2011 and July 2013 with acute hip fracture, were treated surgically, and had a speech and language pathology evaluation in the immediate perioperative period. The authors identified 52 patients who met the study criteria. According to the American Society of Anesthesiologists (ASA) classification system, at the time of surgery, 1 patient (2%) was classified as ASA I, 12 patients (23%) were ASA II, 26 (50%) were ASA III, and 12 (23%) were ASA IV. Based on a speech and language pathology evaluation, 22 patients (42%) were diagnosed with dysphagia. Statistical analysis showed that ASA III status and ASA IV status were meaningful predictors of dysphagia and that dysphagia itself was a strong risk factor for pulmonary aspiration, pneumonia, and aspiration pneumonitis. Evaluation by a speech and language pathologist, particularly of patients classified as ASA III or ASA IV, may be an efficient means of averting pulmonary morbidity that is common in older patients with hip fracture. Copyright 2016, SLACK Incorporated.

  20. Creating a Canonical Scientific and Technical Information Classification System for NCSTRL+

    NASA Technical Reports Server (NTRS)

    Tiffany, Melissa E.; Nelson, Michael L.

    1998-01-01

    The purpose of this paper is to describe the new subject classification system for the NCSTRL+ project. NCSTRL+ is a canonical digital library (DL) based on the Networked Computer Science Technical Report Library (NCSTRL). The current NCSTRL+ classification system uses the NASA Scientific and Technical (STI) subject classifications, which has a bias towards the aerospace, aeronautics, and engineering disciplines. Examination of other scientific and technical information classification systems showed similar discipline-centric weaknesses. Traditional, library-oriented classification systems represented all disciplines, but were too generalized to serve the needs of a scientific and technically oriented digital library. Lack of a suitable existing classification system led to the creation of a lightweight, balanced, general classification system that allows the mapping of more specialized classification schemes into the new framework. We have developed the following classification system to give equal weight to all STI disciplines, while being compact and lightweight.

  1. 21 CFR 884.5320 - Glans sheath.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... the entire shaft of the penis. It is indicated only for the prevention of pregnancy and not for the prevention of sexually-transmitted diseases. (b) Classification. Class III (premarket approval). (c) Date premarket approval application (PMA) or notice of completion of a product development protocol (PDP) is...

  2. 21 CFR 888.3330 - Hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... component is intended to be fixed with bone cement. The acetabular component is intended for use without bone cement (§ 888.3027). (b) Classification. Class III. (c) Date PMA or notice of completion of a PDP...

  3. 21 CFR 888.3330 - Hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... component is intended to be fixed with bone cement. The acetabular component is intended for use without bone cement (§ 888.3027). (b) Classification. Class III. (c) Date PMA or notice of completion of a PDP...

  4. 21 CFR 888.3330 - Hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... component is intended to be fixed with bone cement. The acetabular component is intended for use without bone cement (§ 888.3027). (b) Classification. Class III. (c) Date PMA or notice of completion of a PDP...

  5. 21 CFR 888.3330 - Hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... component is intended to be fixed with bone cement. The acetabular component is intended for use without bone cement (§ 888.3027). (b) Classification. Class III. (c) Date PMA or notice of completion of a PDP...

  6. 21 CFR 888.3330 - Hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... component is intended to be fixed with bone cement. The acetabular component is intended for use without bone cement (§ 888.3027). (b) Classification. Class III. (c) Date PMA or notice of completion of a PDP...

  7. RhoGTPase Involvement in Breast Cancer Migration and Invasion

    DTIC Science & Technology

    2008-03-01

    wound healing 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME OF RESPONSIBLE PERSON USAMRMC a...high confidence, MC= moderate confidence, indicated in absolute numbers. i) ii) iii) 10 Figure 2: Top signalling netowrk of direct relationships for

  8. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bostwick, J.; Stevenson, T.R.; Nahai, F.

    Major complications of radiation directed to the breast, axilla, and mediastinum were treated in 54 patients from 1974 to 1983. A classification of these complications facilitates both an understanding of the pattern of injury and the development of a treatment plan. Classification: I. Breast necrosis; II. Radionecrosis and Chest Wall Ulceration; III. Accelerated Coronary Atherosclerosis with Median Sternotomy Wound Failure After Coronary Revascularization; IV. Brachial Plexus Pain and Paresis; V. Lymphedema and Axillary Cicatrix; VI. Radiation-induced Neoplasia. The treatment has evolved during the 10-year study period to excision of the necrotic wound, including any tumor, and closure with a transposedmore » muscle or musculocutaneous flap of latissimus dorsi (II, III, V) or rectus abdominis (I, II, VI). This strategy reflects a change from primary use of the omentum during the first years of the study. The vascularity, oxygen and antibiotic delivery of these muscle and musculocutaneous flaps promote wound healing, usually with one operation. The transfer of these muscles has not caused significant functional deficits.« less

  9. Descriptive epidemiology of childhood central nervous system tumours in Tunisia. experience of a single institution over a 15-year period (1990-2004).

    PubMed

    Bellil, Salma; Limaiem, Faten; Mahfoudhi, Houaïda; Bellil, Khadija; Chelly, Inès; Mekni, Amina; Jemel, Hafedh; Khaldi, Moncef; Haouet, Slim; Zitouna, Moncef; Kchir, Nidhameddine

    2008-01-01

    Central nervous system tumours represent 20% of all childhood cancers, and are the second most common group of neoplasms after leukaemias. To describe epidemiological characteristics of central nervous system tumours in a paediatric Tunisian population. A retrospective study of 492 childhood central nervous system tumours operated between 1990 and 2004 was undertaken. We investigated the age-related location, gender distribution and the histology of all tumours, and adopted the latest WHO classification (2007) in grouping all the tumours. There were 488 primary and 4 secondary tumours; 426 (86.6%) were intracranial and 66 (13.4%) were intraspinal. Of the 426 intracranial tumours, 214 (50.24%) were supratentorial and 212 (49.76%) were infratentorial. The median age at diagnosis was 8 years, with a male:female ratio of 1.14:1. Low-grade tumours (WHO I/II) constituted 67.3% of all lesions and the rest (32.7%) were high-grade tumours (WHO III/IV). The most common tumour found in our series was astrocytoma (38%), followed by medulloblastoma (16.2%), then ependymoma (6.9%), cystic tumours (6.3%) and craniopharyngioma (5.3%). The overall 5-year survival rate was 45% with a mean follow-up period of 36 months. In our patient population, the incidence and distribution of central nervous system tumours were similar to those reported in literature. Overall survival rates varied according to tumour location and histopathology. (c) 2008 S. Karger AG, Basel.

  10. Genetic burden associated with varying degrees of disease severity in endometriosis

    PubMed Central

    Sapkota, Yadav; Attia, John; Gordon, Scott D.; Henders, Anjali K.; Holliday, Elizabeth G.; Rahmioglu, Nilufer; MacGregor, Stuart; Martin, Nicholas G.; McEvoy, Mark; Morris, Andrew P.; Scott, Rodney J.; Zondervan, Krina T.; Montgomery, Grant W.; Nyholt, Dale R.

    2015-01-01

    Endometriosis is primarily characterized by the presence of tissue resembling endometrium outside the uterine cavity and is usually diagnosed by laparoscopy. The most commonly used classification of disease, the revised American Fertility Society (rAFS) system to grade endometriosis into different stages based on disease severity (I to IV), has been questioned as it does not correlate well with underlying symptoms, posing issues in diagnosis and choice of treatment. Using two independent European genome-wide association (GWA) datasets and top-level classification of the endometriosis cases based on rAFS [minimal or mild (Stage A) and moderate-to-severe (Stage B) disease], we previously showed that Stage B endometriosis has greater contribution of common genetic variation to its aetiology than Stage A disease. Herein, we extend our previous analysis to four endometriosis stages [minimal (Stage I), mild (Stage II), moderate (Stage III) and severe (Stage IV) disease] based on the rAFS classification system and compared the genetic burden across stages. Our results indicate that genetic burden increases from minimal to severe endometriosis. For the minimal disease, genetic factors may contribute to a lesser extent than other disease categories. Mild and moderate endometriosis appeared genetically similar, making it difficult to tease them apart. Consistent with our previous reports, moderate and severe endometriosis showed greater genetic burden than minimal or mild disease. Overall, our results provide new insights into the genetic architecture of endometriosis and further investigation in larger samples may help to understand better the aetiology of varying degrees of endometriosis, enabling improved diagnostic and treatment modalities. PMID:25882541

  11. Mechanisms, biology and inhibitors of deubiquitinating enzymes.

    PubMed

    Love, Kerry Routenberg; Catic, André; Schlieker, Christian; Ploegh, Hidde L

    2007-11-01

    The addition of ubiquitin (Ub) and ubiquitin-like (Ubl) modifiers to proteins serves to modulate function and is a key step in protein degradation, epigenetic modification and intracellular localization. Deubiquitinating enzymes and Ubl-specific proteases, the proteins responsible for the removal of Ub and Ubls, act as an additional level of control over the ubiquitin-proteasome system. Their conservation and widespread occurrence in eukaryotes, prokaryotes and viruses shows that these proteases constitute an essential class of enzymes. Here, we discuss how chemical tools, including activity-based probes and suicide inhibitors, have enabled (i) discovery of deubiquitinating enzymes, (ii) their functional profiling, crystallographic characterization and mechanistic classification and (iii) development of molecules for therapeutic purposes.

  12. Acute acromioclavicular dislocation: a cheaper, easier and all-arthroscopic system. Is it effective in nowadays economical crisis?

    PubMed

    Sastre, Sergi; Dada, Michelle; Santos, Simon; Lozano, Lluis; Alemany, Xavier; Peidro, Lluis

    2015-03-01

    The objective of this manuscript is to show an effective, easier and cheaper way to reduce acute acromioclavicular (AC) dislocation type III and V (Rockwood classification). Numerous procedures have been described for surgical management of acromioclavicular joint disruption. Newest devices involve an arthroscopic technique that allows nonrigid anatomic fixation of the acromioclavicular joint. Arthroscopically assisted treatment of acute AC joint dislocation is advantageous because it provides good clinical results and few complications. It also allows reviewing glenohumeral associated lesions. This surgical technique requires no specific implants to achieve a correct AC reduction. Actually, economical advantages are very important factors to decide the use of determinate surgical techniques.

  13. Robotic astrobiology - prospects for enhancing scientific productivity of mars rover missions

    NASA Astrophysics Data System (ADS)

    Ellery, A. A.

    2018-07-01

    Robotic astrobiology involves the remote projection of intelligent capabilities to planetary missions in the search for life, preferably with human-level intelligence. Planetary rovers would be true human surrogates capable of sophisticated decision-making to enhance their scientific productivity. We explore several key aspects of this capability: (i) visual texture analysis of rocks to enable their geological classification and so, astrobiological potential; (ii) serendipitous target acquisition whilst on the move; (iii) continuous extraction of regolith properties, including water ice whilst on the move; and (iv) deep learning-capable Bayesian net expert systems. Individually, these capabilities will provide enhanced scientific return for astrobiology missions, but together, they will provide full autonomous science capability.

  14. Alzheimer's Disease Diagnosis in Individual Subjects using Structural MR Images: Validation Studies

    PubMed Central

    Vemuri, Prashanthi; Gunter, Jeffrey L.; Senjem, Matthew L.; Whitwell, Jennifer L.; Kantarci, Kejal; Knopman, David S.; Boeve, Bradley F.; Petersen, Ronald C.; Jack, Clifford R.

    2008-01-01

    OBJECTIVE To develop and validate a tool for Alzheimer's disease (AD) diagnosis in individual subjects using support vector machine (SVM) based classification of structural MR (sMR) images. BACKGROUND Libraries of sMR scans of clinically well characterized subjects can be harnessed for the purpose of diagnosing new incoming subjects. METHODS 190 patients with probable AD were age- and gender-matched with 190 cognitively normal (CN) subjects. Three different classification models were implemented: Model I uses tissue densities obtained from sMR scans to give STructural Abnormality iNDex (STAND)-score; and Models II and III use tissue densities as well as covariates (demographics and Apolipoprotein E genotype) to give adjusted-STAND (aSTAND)-score. Data from 140 AD and 140 CN were used for training. The SVM parameter optimization and training was done by four-fold cross validation. The remaining independent sample of 50 AD and 50 CN were used to obtain a minimally biased estimate of the generalization error of the algorithm. RESULTS The CV accuracy of Model II and Model III aSTAND-scores was 88.5% and 89.3% respectively and the developed models generalized well on the independent test datasets. Anatomic patterns best differentiating the groups were consistent with the known distribution of neurofibrillary AD pathology. CONCLUSIONS This paper presents preliminary evidence that application of SVM-based classification of an individual sMR scan relative to a library of scans can provide useful information in individual subjects for diagnosis of AD. Including demographic and genetic information in the classification algorithm slightly improves diagnostic accuracy. PMID:18054253

  15. Changes in the classification of carcinogenic chemicals in the work area. (Section III of the German List of MAK and BAT values).

    PubMed

    Neumann, H G; Thielmann, H W; Filser, J G; Gelbke, H P; Greim, H; Kappus, H; Norpoth, K H; Reuter, U; Vamvakas, S; Wardenbach, P; Wichmann, H E

    1998-01-01

    Carcinogenic chemicals in the work area were previously classified into three categories in section III of the German List of MAK and BAT values (the list of values on maximum workplace concentrations and biological tolerance for occupational exposures). This classification was based on qualitative criteria and reflected essentially the weight of evidence available for judging the carcinogenic potential of the chemicals. In the new classification scheme the former sections IIIA1, IIIA2, and IIIB are retained as categories 1, 2, and 3, to correspond with European Union regulations. On the basis of our advancing knowledge of reaction mechanisms and the potency of carcinogens, these three categories are supplemented with two additional categories. The essential feature of substances classified in the new categories is that exposure to these chemicals does not contribute significantly to the risk of cancer to man, provided that an appropriate exposure limit (MAK value) is observed. Chemicals known to act typically by non-genotoxic mechanisms, and for which information is available that allows evaluation of the effects of low-dose exposures, are classified in category 4. Genotoxic chemicals for which low carcinogenic potency can be expected on the basis of dose/response relationships and toxicokinetics and for which risk at low doses can be assessed are classified in category 5. The basis for a better differentiation of carcinogens is discussed, the new categories are defined, and possible criteria for classification are described. Examples for category 4 (1,4-dioxane) and category 5 (styrene) are presented.

  16. Rabi cropped area forecasting of parts of Banaskatha District,Gujarat using MRS RISAT-1 SAR data

    NASA Astrophysics Data System (ADS)

    Parekh, R. A.; Mehta, R. L.; Vyas, A.

    2016-10-01

    Radar sensors can be used for large-scale vegetation mapping and monitoring using backscatter coefficients in different polarisations and wavelength bands. Due to cloud and haze interference, optical images are not always available at all phonological stages important for crop discrimination. Moreover, in cloud prone areas, exclusively SAR approach would provide operational solution. This paper presents the results of classifying the cropped and non cropped areas using multi-temporal SAR images. Dual polarised C- band RISAT MRS (Medium Resolution ScanSAR mode) data were acquired on 9thDec. 2012, 28thJan. 2013 and 22nd Feb. 2013 at 18m spatial resolution. Intensity images of two polarisations (HH, HV) were extracted and converted into backscattering coefficient images. Cross polarisation ratio (CPR) images and Radar fractional vegetation density index (RFDI) were created from the temporal data and integrated with the multi-temporal images. Signatures of cropped and un-cropped areas were used for maximum likelihood supervised classification. Separability in cropped and umcropped classes using different polarisation combinations and classification accuracy analysis was carried out. FCC (False Color Composite) prepared using best three SAR polarisations in the data set was compared with LISS-III (Linear Imaging Self-Scanning System-III) image. The acreage under rabi crops was estimated. The methodology developed was for rabi cropped area, due to availability of SAR data of rabi season. Though, the approach is more relevant for acreage estimation of kharif crops when frequent cloud cover condition prevails during monsoon season and optical sensors fail to deliver good quality images.

  17. Glomeruloid Microvascular Proliferation, Desmoplasia, and High Proliferative Index as Potential Indicators of High Grade Canine Choroid Plexus Tumors.

    PubMed

    Muscatello, Luisa Vera; Avallone, Giancarlo; Serra, Fabienne; Seuberlich, Torsten; Mandara, Maria Teresa; Sisó, Silvia; Brunetti, Barbara; Oevermann, Anna

    2018-05-01

    Choroid plexus tumors (CPT) are intraventricular neoplasms accounting for 10% of all primary central nervous system tumors in dogs. They are frequently classified according to the human WHO classification into choroid plexus papilloma (CPP, grade I), atypical CPP (aCPP, grade II), and choroid plexus carcinoma (CPC, grade III). Histological features observed in canine CPT such as increased vascular density (IVD) and glomeruloid microvascular proliferation (GMVP) are not part of the WHO classification. This multi-centric study aimed to investigate tumor-associated vascular hyperplasia in dogs by determining the prevalence of GMVP and IVD in 52 canine CPT and their association with tumor grade. In addition, the expression of angiogenic factors was assessed by immunohistochemistry in 25 tumors to investigate the pathogenesis of tumor-associated vascular hyperplasia. Based on the classical histological hallmarks, this study of 52 CPT identified 22 (42%) CPP (grade I) and 30 of (58%) CPC (grade III). GMVP was more prevalent in CPC (13/30; 43%) than CPP (1/22; 4%), whereas IVD occurred to a similar extent in CPP and CPC. Desmoplasia was more common in CPC (19/30; 63%) than CPP (2/22; 9%), and similarly, the proliferative index (PI) of neoplastic epithelium was significantly higher in CPC (5.14%) than CPP (0.94%). The majority of CPT expressed platelet-derived growth factor (PDGF), PDGFRα, PDGFRβ, and vascular endothelial growth factor (VEGF) irrespective of tumor grade or tumor-associated vascular hyperplasia. These results suggest that tumor-associated GMVP, desmoplasia, and PI may serve as histological indicators of malignancy in CPT.

  18. Current status and perspectives of interventional clinical trials for glioblastoma - analysis of ClinicalTrials.gov.

    PubMed

    Cihoric, Nikola; Tsikkinis, Alexandros; Minniti, Giuseppe; Lagerwaard, Frank J; Herrlinger, Ulrich; Mathier, Etienne; Soldatovic, Ivan; Jeremic, Branislav; Ghadjar, Pirus; Elicin, Olgun; Lössl, Kristina; Aebersold, Daniel M; Belka, Claus; Herrmann, Evelyn; Niyazi, Maximilian

    2017-01-03

    The records of 208.777 (100%) clinical trials registered at ClinicalTrials.gov were downloaded on the 19th of February 2016. Phase II and III trials including patients with glioblastoma were selected for further classification and analysis. Based on the disease settings, trials were classified into three groups: newly diagnosed glioblastoma, recurrent disease and trials with no differentiation according to disease setting. Furthermore, we categorized trials according to the experimental interventions, the primary sponsor, the source of financial support and trial design elements. Trends were evaluated using the autoregressive integrated moving average model. Two hundred sixteen (0.1%) trials were selected for further analysis. Academic centers (investigator initiated trials) were recorded as primary sponsors in 56.9% of trials, followed by industry 25.9%. Industry was the leading source of monetary support for the selected trials in 44.4%, followed by 25% of trials with primarily academic financial support. The number of newly initiated trials between 2005 and 2015 shows a positive trend, mainly through an increase in phase II trials, whereas phase III trials show a negative trend. The vast majority of trials evaluate forms of different systemic treatments (91.2%). In total, one hundred different molecular entities or biologicals were identified. Of those, 60% were involving drugs specifically designed for central nervous system malignancies. Trials that specifically address radiotherapy, surgery, imaging and other therapeutic or diagnostic methods appear to be rare. Current research in glioblastoma is mainly driven or sponsored by industry, academic medical oncologists and neuro-oncologists, with the majority of trials evaluating forms of systemic therapies. Few trials reach phase III. Imaging, radiation therapy and surgical procedures are underrepresented in current trials portfolios. Optimization in research portfolio for glioblastoma is needed.

  19. Mapping ecological states in a complex environment

    NASA Astrophysics Data System (ADS)

    Steele, C. M.; Bestelmeyer, B.; Burkett, L. M.; Ayers, E.; Romig, K.; Slaughter, A.

    2013-12-01

    The vegetation of northern Chihuahuan Desert rangelands is sparse, heterogeneous and for most of the year, consists of a large proportion of non-photosynthetic material. The soils in this area are spectrally bright and variable in their reflectance properties. Both factors provide challenges to the application of remote sensing for estimating canopy variables (e.g., leaf area index, biomass, percentage canopy cover, primary production). Additionally, with reference to current paradigms of rangeland health assessment, remotely-sensed estimates of canopy variables have limited practical use to the rangeland manager if they are not placed in the context of ecological site and ecological state. To address these challenges, we created a multifactor classification system based on the USDA-NRCS ecological site schema and associated state-and-transition models to map ecological states on desert rangelands in southern New Mexico. Applying this system using per-pixel image processing techniques and multispectral, remotely sensed imagery raised other challenges. Per-pixel image classification relies upon the spectral information in each pixel alone, there is no reference to the spatial context of the pixel and its relationship with its neighbors. Ecological state classes may have direct relevance to managers but the non-unique spectral properties of different ecological state classes in our study area means that per-pixel classification of multispectral data performs poorly in discriminating between different ecological states. We found that image interpreters who are familiar with the landscape and its associated ecological site descriptions perform better than per-pixel classification techniques in assigning ecological states. However, two important issues affect manual classification methods: subjectivity of interpretation and reproducibility of results. An alternative to per-pixel classification and manual interpretation is object-based image analysis. Object-based image analysis provides a platform for classification that more closely resembles human recognition of objects within a remotely sensed image. The analysis presented here compares multiple thematic maps created for test locations on the USDA-ARS Jornada Experimental Range ranch. Three study sites in different pastures, each 300 ha in size, were selected for comparison on the basis of their ecological site type (';Clayey', ';Sandy' and a combination of both) and the degree of complexity of vegetation cover. Thematic maps were produced for each study site using (i) manual interpretation of digital aerial photography (by five independent interpreters); (ii) object-oriented, decision-tree classification of fine and moderate spatial resolution imagery (Quickbird; Landsat Thematic Mapper) and (iii) ground survey. To identify areas of uncertainty, we compared agreement in location, areal extent and class assignation between 5 independently produced, manually-digitized ecological state maps and with the map created from ground survey. Location, areal extent and class assignation of the map produced by object-oriented classification was also assessed with reference to the ground survey map.

  20. Predictive mapping of soil organic carbon in wet cultivated lands using classification-tree based models: the case study of Denmark.

    PubMed

    Bou Kheir, Rania; Greve, Mogens H; Bøcher, Peder K; Greve, Mette B; Larsen, René; McCloy, Keith

    2010-05-01

    Soil organic carbon (SOC) is one of the most important carbon stocks globally and has large potential to affect global climate. Distribution patterns of SOC in Denmark constitute a nation-wide baseline for studies on soil carbon changes (with respect to Kyoto protocol). This paper predicts and maps the geographic distribution of SOC across Denmark using remote sensing (RS), geographic information systems (GISs) and decision-tree modeling (un-pruned and pruned classification trees). Seventeen parameters, i.e. parent material, soil type, landscape type, elevation, slope gradient, slope aspect, mean curvature, plan curvature, profile curvature, flow accumulation, specific catchment area, tangent slope, tangent curvature, steady-state wetness index, Normalized Difference Vegetation Index (NDVI), Normalized Difference Wetness Index (NDWI) and Soil Color Index (SCI) were generated to statistically explain SOC field measurements in the area of interest (Denmark). A large number of tree-based classification models (588) were developed using (i) all of the parameters, (ii) all Digital Elevation Model (DEM) parameters only, (iii) the primary DEM parameters only, (iv), the remote sensing (RS) indices only, (v) selected pairs of parameters, (vi) soil type, parent material and landscape type only, and (vii) the parameters having a high impact on SOC distribution in built pruned trees. The best constructed classification tree models (in the number of three) with the lowest misclassification error (ME) and the lowest number of nodes (N) as well are: (i) the tree (T1) combining all of the parameters (ME=29.5%; N=54); (ii) the tree (T2) based on the parent material, soil type and landscape type (ME=31.5%; N=14); and (iii) the tree (T3) constructed using parent material, soil type, landscape type, elevation, tangent slope and SCI (ME=30%; N=39). The produced SOC maps at 1:50,000 cartographic scale using these trees are highly matching with coincidence values equal to 90.5% (Map T1/Map T2), 95% (Map T1/Map T3) and 91% (Map T2/Map T3). The overall accuracies of these maps once compared with field observations were estimated to be 69.54% (Map T1), 68.87% (Map T2) and 69.41% (Map T3). The proposed tree models are relatively simple, and may be also applied to other areas. Copyright 2010 Elsevier Ltd. All rights reserved.

  1. A web-based land cover classification system based on ontology model of different classification systems

    NASA Astrophysics Data System (ADS)

    Lin, Y.; Chen, X.

    2016-12-01

    Land cover classification systems used in remote sensing image data have been developed to meet the needs for depicting land covers in scientific investigations and policy decisions. However, accuracy assessments of a spate of data sets demonstrate that compared with the real physiognomy, each of the thematic map of specific land cover classification system contains some unavoidable flaws and unintended deviation. This work proposes a web-based land cover classification system, an integrated prototype, based on an ontology model of various classification systems, each of which is assigned the same weight in the final determination of land cover type. Ontology, a formal explication of specific concepts and relations, is employed in this prototype to build up the connections among different systems to resolve the naming conflicts. The process is initialized by measuring semantic similarity between terminologies in the systems and the search key to produce certain set of satisfied classifications, and carries on through searching the predefined relations in concepts of all classification systems to generate classification maps with user-specified land cover type highlighted, based on probability calculated by votes from data sets with different classification system adopted. The present system is verified and validated by comparing the classification results with those most common systems. Due to full consideration and meaningful expression of each classification system using ontology and the convenience that the web brings with itself, this system, as a preliminary model, proposes a flexible and extensible architecture for classification system integration and data fusion, thereby providing a strong foundation for the future work.

  2. Correlation of the New York Heart Association classification and the cardiopulmonary exercise test: A systematic review.

    PubMed

    Lim, Fang Yi; Yap, Jonathan; Gao, Fei; Teo, Ling Li; Lam, Carolyn S P; Yeo, Khung Keong

    2018-07-15

    The New York Heart Association (NYHA) classification is frequently used in the management of heart failure but may be limited by patient and physician subjectivity. Cardiopulmonary exercise testing (CPET) provides a potentially more objective measurement of functional status. We aim to study the correlation between NYHA classification and peak oxygen consumption (pVO 2 ) on Cardiopulmonary Exercise Testing (CPET) within and across published studies. A systematic literature review on all studies reporting both NYHA class and CPET data was performed, and pVO 2 from CPET was correlated to reported NYHA class within and across eligible studies. 38 studies involving 2645 patients were eligible. Heterogenity was assessed by the Q statistic, which is a χ2 test and marker of systematic differences between studies. Within each NYHA class, significant heterogeneity in pVO 2 was seen across studies: NYHA I (n = 17, Q = 486.7, p < 0.0001), II (n = 24, Q = 381.0, p < 0.0001), III (n = 32, Q = 761.3, p < 0.0001) and IV (n = 5, Q = 12.8, p = 0.012). Significant differences in mean pVO 2 were observed between NYHA I and II (23.8 vs 17.6 mL/(kg·min), p < 0.0001) and II and III (17.6 vs 13.3 mL/(kg·min), p < 0.0001); but not between NYHA III and IV (13.3 vs 12.5 mL/(kg·min), p = 0.45). These differences remained significant after adjusting for age, gender, ejection fraction and region of study. There was a general inverse correlation between NYHA class and pVO 2. However, significant heterogeneity in pVO 2 exists across studies within each NYHA class. While the NYHA classification holds clinical value in heart failure management, direct comparison across studies may have its limitations. Copyright © 2018 Elsevier B.V. All rights reserved.

  3. DSM-III field trials: I. Initial interrater diagnostic reliability.

    PubMed

    Spitzer, R L; Forman, J B; Nee, J

    1979-06-01

    The interrater agreement for major diagnostic categories in studies using DSM-I and DSM-II was usually only fair or poor. In phase one of the DSM-III field trials the overall kappa coefficient of agreement for axis I diagnoses of 281 adult patients was .78 for joint interviews and .66 for diagnoses made after separate interviews; for axis II--personality disorders and specific developmental disorders--the coefficients of agreement were .61 and .54. The interrater reliability of DSM--III is, in general, higher than that previously achieved and may be due to changes in the classification itself, the separation of axis I from axis II conditions, the systematic description of the various disorders, and the inclusion of diagnostic criteria.

  4. The diagnostic status of homosexuality in DSM-III: a reformulation of the issues.

    PubMed

    Spitzer, R L

    1981-02-01

    In 1973 homosexuality per se was removed from the DSM-II classification of mental disorders and replaced by the category Sexual Orientation Disturbance. This represented a compromise between the view that preferential homosexuality is invariably a mental disorder and the view that it is merely a normal sexual variant. While the 1973 DSM-II controversy was highly public, more recently a related but less public controversy involved what became the DSM-III category of Ego-dystonic Homosexuality. The author presents the DSM-III controversy and a reformulation of the issues involved in the diagnostic status of homosexuality. He argues that what is at issue is a value judgment about heterosexuality, rather than a factual dispute about homosexuality.

  5. Impact of using the new GOLD classification on the distribution of COPD severity in clinical practice.

    PubMed

    Hernández, Marcos; García, Gabriel; Falco, Jimena; García, Agustín R; Martín, Vanina; Ibarrola, Manuel; Quadrelli, Silvia

    2018-01-01

    The objective of this study was to examine how COPD patients were classified by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) spirometry-based severity system and the distribution of COPD severity using the new GOLD 2011 assessment framework. This was an observational, retrospective cohort study conducted in a single tertiary center on a prospective database, which aimed to evaluate the prevalence, incidence, severity, and comorbidities of COPD. Inclusion criteria were age ≥40 years and COPD diagnosis according to GOLD 2007 classification. Clinical factors were compared between the categories in GOLD 2007 and 2011 groups by using the χ 2 test for categorical data and the analysis of variance for continuous data. In total, 420 COPD patients were included in the analysis. The distribution of patients into GOLD 2007 categories was as follows: 6.4% (n=27) of them were classified into subgroup I, 42.1% (n=177) into subgroup II, 37.9% (n=159) into subgroup III, and 13.6% (n=57) into subgroup IV. The distribution of patients into GOLD 2011 categories was as follows: 16.4% (n=69) of them were classified into subgroup A (low risk and fewer symptoms), 32.1% (n=135) into subgroup B (low risk and more symptoms), 21.6% (n=91) into subgroup C (high risk and fewer symptoms), and 29.7% (n=125) into subgroup D (high risk and more symptoms). After the application of the new GOLD 2011 (modified Medical Research Council [mMRC] system), 22% (n=94) of patients were upgraded to a higher level than their spirometry level, and 16.2% (n=68) of them were downgraded in their severity category, meaning that almost 40% of patients changed their severity assessment category. In total, 22% of patients in stage I were allocated to group B, and 35% of patients in stage IV were allocated to group C. Patients in stage III were the most frequently upgraded to a higher risk group (D), taking into account mMRC and exacerbation history. Classifying patients using the new GOLD 2011 criteria reallocated a relevant proportion of patients to a different risk category and identified larger proportions of patients in the mildest and more severe groups compared with GOLD 2007 classification.

  6. Survival Analysis of Papillary Thyroid Carcinoma in Relation to Stage and Recurrence Risk: A 20-Year Experience in Pakistan.

    PubMed

    Hassan, Aamna; Razi, Mairah; Riaz, Saima; Khalid, Madeeha; Nawaz, M Khalid; Syed, Aamir Ali; Bashir, Humayun

    2016-08-01

    The aim of this study was to evaluate the overall and progression-free survival of papillary thyroid carcinoma (PTC), comparing the American Thyroid Association (ATA) guideline for risk of recurrence with the TNM staging system with dynamic assessment at 2 years. This study is a retrospective analysis of 689 PTC patients over a 20-year period at a single center. Disease-free survival based on the TNM staging and ATA recurrence risk was calculated using Kaplan-Meier curves. Dynamic response assessment during the first 2 years was compared for both systems. Survival was calculated based on age, baseline resectability, and postthyroidectomy serum tumor marker levels. Six hundred eighty-nine (72.2%) of the total thyroid cancer patients had PTC. Four hundred sixty-nine patients were females, and 220 patients were males. The age range was 6 to 87 years. Five hundred thirty-five patients were resectable, and 56 patients were unresectable. One hundred fifty-one patients were excluded due to insufficient information on recurrence risk. By ATA categorization, 39% had low risk, no disease-related mortality; 44% had intermediate risk, 3 died; and 17% had high risk, 32 died. The 5-year disease-free survival was 54%, 26%, and 5% in low-, intermediate-, and high-risk groups, respectively. The log-rank test showed a significant difference in the percent survival (P < 0.01). TNM stage wise, in terms of survival, 1.3% in stage I, 2.2% in stage II, 0% in stage III, and 37.5% in stage IV died. The 20-year disease-free survival showed the following: stage I, 43%; stage II, 28%; stage III, 18%; and stage IV, 2%. There is significant difference in survival rate (P < 0.01). Both ATA risk classification and TNM staging were significant predictors of disease-free survival. On bivariate analysis, ATA classification (hazards ratio, 2.1; 95% confidence interval, 1.64-2.67; P = 0.001) was better predictive of overall survival versus TNM classification (hazards ratio, 1.3; 95% confidence interval, 1.11-1.43; P = 0.063). The ATA risk stratification and continuous reassessment during the first 2 years predicts disease-free survival better than the TNM staging. Age older than 45 years, unresectable disease, and elevated postthyroidectomy thyroglobulin levels dictate a poorer prognosis.

  7. The clinical diagnosis and misdiagnosis of senile dementia of Lewy body type (SDLT).

    PubMed

    McKeith, I G; Fairbairn, A F; Perry, R H; Thompson, P

    1994-09-01

    Current clinical classifications do not contain specific diagnostic categories for patients with senile dementia of the Lewy body type (SDLT), recently proposed as the second commonest neuropathological cause of dementia in the elderly. This study determines how existing clinical diagnosis systems label SDLT patients and suggests how such patients may be identified. A range of clinical diagnostic criteria for dementia were applied to case notes of autopsy-confirmed SDLT (n = 20), dementia of Alzheimer type (DAT; n = 21) and multi-infarct dementia (MID; n = 9) patients who had received psychogeriatric assessment. The predictive validity of each set of clinical criteria was calculated against the external criterion of neuropathological diagnosis. Many SDLT patients erroneously met criteria for MID (35% with Hachinski scores > or = 7) or for DAT (15% by NINCDS 'probable AD', 35% by DSM-III-R DAT and 50% by NINCDS 'possible AD'). Up to 85% of SDLT cases could be correctly identified using recently published specific criteria. SDLT usually has a discernible clinical syndrome and existing clinical classifications may need revision to diagnose correctly such patients.

  8. 78 FR 2647 - Dental Devices; Reclassification of Blade-Form Endosseous Dental Implant

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-14

    .... FDA-2012-N-0677] Dental Devices; Reclassification of Blade-Form Endosseous Dental Implant AGENCY: Food...) is proposing to reclassify the blade- form endosseous dental implant, a preamendments class III... proposing to revise the classification of blade-form endosseous dental implants. DATES: Submit either...

  9. 40 CFR 63.1561 - Am I subject to this subpart?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... American Industry Classification (NAIC) code 32411, and used mainly for: (i) Producing transportation fuels (such as gasoline, diesel fuels, and jet fuels), heating fuels (such as kerosene, fuel gas distillate, and fuel oils), or lubricants; (ii) Separating petroleum; or (iii) Separating, cracking, reacting, or...

  10. 40 CFR 63.1561 - Am I subject to this subpart?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... American Industry Classification (NAIC) code 32411, and used mainly for: (i) Producing transportation fuels (such as gasoline, diesel fuels, and jet fuels), heating fuels (such as kerosene, fuel gas distillate, and fuel oils), or lubricants; (ii) Separating petroleum; or (iii) Separating, cracking, reacting, or...

  11. 40 CFR 63.1561 - Am I subject to this subpart?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... American Industry Classification (NAIC) code 32411, and used mainly for: (i) Producing transportation fuels (such as gasoline, diesel fuels, and jet fuels), heating fuels (such as kerosene, fuel gas distillate, and fuel oils), or lubricants; (ii) Separating petroleum; or (iii) Separating, cracking, reacting, or...

  12. 49 CFR 225.3 - Applicability.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... TRANSPORTATION RAILROAD ACCIDENTS/INCIDENTS: REPORTS CLASSIFICATION, AND INVESTIGATIONS § 225.3 Applicability. (a... is in use; (iii) A bridge over a public road or waters used for commercial navigation; or (iv) A... injuries and illnesses and accountable rail equipment accidents/incidents found in § 225.25(a) through (g...

  13. 21 CFR 884.5225 - Abdominal decompression chamber.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Abdominal decompression chamber. 884.5225 Section 884.5225 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... abdominal pain during pregnancy or labor. (b) Classification. Class III (premarket approval). (c) Date PMA...

  14. Magnetic STAR technology for real-time localization and classification of unexploded ordnance and buried mines

    NASA Astrophysics Data System (ADS)

    Wiegert, R. F.

    2009-05-01

    A man-portable Magnetic Scalar Triangulation and Ranging ("MagSTAR") technology for Detection, Localization and Classification (DLC) of unexploded ordnance (UXO) has been developed by Naval Surface Warfare Center Panama City Division (NSWC PCD) with support from the Strategic Environmental Research and Development Program (SERDP). Proof of principle of the MagSTAR concept and its unique advantages for real-time, high-mobility magnetic sensing applications have been demonstrated by field tests of a prototype man-portable MagSTAR sensor. The prototype comprises: a) An array of fluxgate magnetometers configured as a multi-tensor gradiometer, b) A GPS-synchronized signal processing system. c) Unique STAR algorithms for point-by-point, standoff DLC of magnetic targets. This paper outlines details of: i) MagSTAR theory, ii) Design and construction of the prototype sensor, iii) Signal processing algorithms recently developed to improve the technology's target-discrimination accuracy, iv) Results of field tests of the portable gradiometer system against magnetic dipole targets. The results demonstrate that the MagSTAR technology is capable of very accurate, high-speed localization of magnetic targets at standoff distances of several meters. These advantages could readily be transitioned to a wide range of defense, security and sensing applications to provide faster and more effective DLC of UXO and buried mines.

  15. Orbit classification in an equal-mass non-spinning binary black hole pseudo-Newtonian system

    NASA Astrophysics Data System (ADS)

    Zotos, Euaggelos E.; Dubeibe, F. L.; González, Guillermo A.

    2018-04-01

    The dynamics of a test particle in a non-spinning binary black hole system of equal masses is numerically investigated. The binary system is modeled in the context of the pseudo-Newtonian circular restricted three-body problem, such that the primaries are separated by a fixed distance and move in a circular orbit around each other. In particular, the Paczyński-Wiita potential is used for describing the gravitational field of the two non-Newtonian primaries. The orbital properties of the test particle are determined through the classification of the initial conditions of the orbits, using several values of the Jacobi constant, in the Hill's regions of possible motion. The initial conditions are classified into three main categories: (i) bounded, (ii) escaping and (iii) displaying close encounters. Using the smaller alignment index (SALI) chaos indicator, we further classify bounded orbits into regular, sticky or chaotic. To gain a complete view of the dynamics of the system, we define grids of initial conditions on different types of two-dimensional planes. The orbital structure of the configuration plane, along with the corresponding distributions of the escape and collision/close encounter times, allow us to observe the transition from the classical Newtonian to the pseudo-Newtonian regime. Our numerical results reveal a strong dependence of the properties of the considered basins with the Jacobi constant as well as with the Schwarzschild radius of the black holes.

  16. 42 CFR 412.620 - Patient classification system.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Patient classification system. 412.620 Section 412... Inpatient Rehabilitation Hospitals and Rehabilitation Units § 412.620 Patient classification system. (a) Classification methodology. (1) A patient classification system is used to classify patients in inpatient...

  17. 42 CFR 412.620 - Patient classification system.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Patient classification system. 412.620 Section 412... Inpatient Rehabilitation Hospitals and Rehabilitation Units § 412.620 Patient classification system. (a) Classification methodology. (1) A patient classification system is used to classify patients in inpatient...

  18. Intra- and Interobserver Reliability of Three Classification Systems for Hallux Rigidus.

    PubMed

    Dillard, Sarita; Schilero, Christina; Chiang, Sharon; Pham, Peter

    2018-04-18

    There are over ten classification systems currently used in the staging of hallux rigidus. This results in confusion and inconsistency with radiographic interpretation and treatment. The reliability of hallux rigidus classification systems has not yet been tested. The purpose of this study was to evaluate intra- and interobserver reliability using three commonly used classifications for hallux rigidus. Twenty-one plain radiograph sets were presented to ten ACFAS board-certified foot and ankle surgeons. Each physician classified each radiograph based on clinical experience and knowledge according to the Regnauld, Roukis, and Hattrup and Johnson classification systems. The two-way mixed single-measure consistency intraclass correlation was used to calculate intra- and interrater reliability. The intrarater reliability of individual sets for the Roukis and Hattrup and Johnson classification systems was "fair to good" (Roukis, 0.62±0.19; Hattrup and Johnson, 0.62±0.28), whereas the intrarater reliability of individual sets for the Regnauld system bordered between "fair to good" and "poor" (0.43±0.24). The interrater reliability of the mean classification was "excellent" for all three classification systems. Conclusions Reliable and reproducible classification systems are essential for treatment and prognostic implications in hallux rigidus. In our study, Roukis classification system had the best intrarater reliability. Although there are various classification systems for hallux rigidus, our results indicate that all three of these classification systems show reliability and reproducibility.

  19. The Revisited Classification of GN in SLE at 10 Years: Time to Re-Evaluate Histopathologic Lesions

    PubMed Central

    Alpers, Charles E.; Cook, H. Terence; Ferrario, Franco; Fogo, Agnes B.; Haas, Mark; Joh, Kensuke; Noël, Laure-Hélène; Seshan, Surya V.; Bruijn, Jan A.; Bajema, Ingeborg M.

    2015-01-01

    Over 10 years have passed since the latest revision of the histopathologic classification of lupus nephritis. This revision was a significant improvement compared with the previous version, mainly because of clearer and more concise definitions and the elimination of mixed subclasses. Despite these improvements, there are still some difficulties in the classification for lupus nephritis, many of which are in the definitions provided. In this review, we focus on the difficulties surrounding the evaluation of classes III and IV lesions, particularly the definitions of endocapillary and extracapillary proliferation, the use of the terms endocapillary proliferation and hypercellularity, the clinical relevance of segmental and global subdivision in class IV, and the value of distinguishing lesions that indicate activity and chronicity. Vascular and tubulointerstitial lesions are also discussed. Furthermore, we give an overview of the history of the classification to provide background on the origin and development of the definitions in lupus nephritis. The issues raised in this review as well as the suggestions for improvements may assist with a revision of the lupus nephritis classification in the near future. PMID:26152271

  20. Hyperspectral Image Enhancement and Mixture Deep-Learning Classification of Corneal Epithelium Injuries.

    PubMed

    Noor, Siti Salwa Md; Michael, Kaleena; Marshall, Stephen; Ren, Jinchang

    2017-11-16

    In our preliminary study, the reflectance signatures obtained from hyperspectral imaging (HSI) of normal and abnormal corneal epithelium tissues of porcine show similar morphology with subtle differences. Here we present image enhancement algorithms that can be used to improve the interpretability of data into clinically relevant information to facilitate diagnostics. A total of 25 corneal epithelium images without the application of eye staining were used. Three image feature extraction approaches were applied for image classification: (i) image feature classification from histogram using a support vector machine with a Gaussian radial basis function (SVM-GRBF); (ii) physical image feature classification using deep-learning Convolutional Neural Networks (CNNs) only; and (iii) the combined classification of CNNs and SVM-Linear. The performance results indicate that our chosen image features from the histogram and length-scale parameter were able to classify with up to 100% accuracy; particularly, at CNNs and CNNs-SVM, by employing 80% of the data sample for training and 20% for testing. Thus, in the assessment of corneal epithelium injuries, HSI has high potential as a method that could surpass current technologies regarding speed, objectivity, and reliability.

  1. Influence of Texture and Colour in Breast TMA Classification

    PubMed Central

    Fernández-Carrobles, M. Milagro; Bueno, Gloria; Déniz, Oscar; Salido, Jesús; García-Rojo, Marcial; González-López, Lucía

    2015-01-01

    Breast cancer diagnosis is still done by observation of biopsies under the microscope. The development of automated methods for breast TMA classification would reduce diagnostic time. This paper is a step towards the solution for this problem and shows a complete study of breast TMA classification based on colour models and texture descriptors. The TMA images were divided into four classes: i) benign stromal tissue with cellularity, ii) adipose tissue, iii) benign and benign anomalous structures, and iv) ductal and lobular carcinomas. A relevant set of features was obtained on eight different colour models from first and second order Haralick statistical descriptors obtained from the intensity image, Fourier, Wavelets, Multiresolution Gabor, M-LBP and textons descriptors. Furthermore, four types of classification experiments were performed using six different classifiers: (1) classification per colour model individually, (2) classification by combination of colour models, (3) classification by combination of colour models and descriptors, and (4) classification by combination of colour models and descriptors with a previous feature set reduction. The best result shows an average of 99.05% accuracy and 98.34% positive predictive value. These results have been obtained by means of a bagging tree classifier with combination of six colour models and the use of 1719 non-correlated (correlation threshold of 97%) textural features based on Statistical, M-LBP, Gabor and Spatial textons descriptors. PMID:26513238

  2. 78 FR 18252 - Prevailing Rate Systems; North American Industry Classification System Based Federal Wage System...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-26

    ...-AM78 Prevailing Rate Systems; North American Industry Classification System Based Federal Wage System... 2007 North American Industry Classification System (NAICS) codes currently used in Federal Wage System... (OPM) issued a final rule (73 FR 45853) to update the 2002 North American Industry Classification...

  3. The Location of Anterior Cruciate Ligament Tears: A Prevalence Study Using Magnetic Resonance Imaging

    PubMed Central

    van der List, Jelle P.; Mintz, Douglas N.; DiFelice, Gregory S.

    2017-01-01

    Background: Over the past decade, there has been a resurgence of interest in anterior cruciate ligament (ACL) preservation. Proximal and distal avulsion tears have been treated with arthroscopic primary repair, while augmented repair, remnant tensioning, primary repair with biological scaffold, and remnant preservation have been proposed for different types of midsubstance tears. Currently, the incidence of these different tear types is unknown. Purpose: To propose a magnetic resonance imaging (MRI) classification system for different tear types based on clinical relevance and to assess the distribution of these different ACL tear types. Study Design: Case series; Level of evidence, 4. Methods: A retrospective search in an institutional radiographic database was performed for patients who underwent knee MRI at our institution between June 2014 and June 2016. Patients younger than 18 years and those with reports of chronic tears, partial tears, multiligamentous injuries, were excluded. Tear types were graded as proximal avulsion (distal remnant length >90% of total ligament length, type I), proximal (75%-90%, type II), midsubstance (25%-75%, type III), distal (10%-25%, type IV), and distal avulsion (<10%, type V). An orthopaedic surgeon, a radiologist, and a research fellow graded the tear type on 30 MRIs to determine reliability, and the research fellow graded all MRIs. Inter- and intraobserver reliability were measured using kappa statistics. Results: A total of 353 patients (57% male; mean age, 37.1 years; range, 18.1-81.2 years) were included. Interobserver reliability was 0.670 (95% confidence interval, 0.505-0.836), and intraobserver reliability ranged from 0.741 to 0.934. Incidence of type I tears was 16%, type II tears 27%, type III tears 52%, type IV tears 1%, and type V tears 3% (2.5% with bony avulsion). Type I tears were more common in patients older than 35 years compared with those younger than 35 years (23% vs 8%; P < .001). Conclusion: This classification system was reliable in assessing tear location in acute ACL injuries. Type I tears were seen in 16%, type II in 27%, and type III in 52% of patients in our cohort. These data suggest that there may be greater potential application for ACL preservation techniques. PMID:28680889

  4. Self-care and mobility skills in children with cerebral palsy, related to their manual ability and gross motor function classifications.

    PubMed

    Öhrvall, Ann-Marie; Eliasson, Ann-Christin; Löwing, Kristina; Ödman, Pia; Krumlinde-Sundholm, Lena

    2010-11-01

    The aim of this study was to investigate the acquisition of self-care and mobility skills in children with cerebral palsy (CP) in relation to their manual ability and gross motor function. Data from the Pediatric Evaluation of Disability Inventory (PEDI) self-care and mobility functional skill scales, the Manual Ability Classification System (MACS), and the Gross Motor Function Classification System (GMFCS) were collected from 195 children with CP (73 females, 122 males; mean age 8 y 1 mo; SD 3 y 11 mo; range 3-15 y); 51% had spastic bilateral CP, 36% spastic unilateral CP, 8% dyskinetic CP, and 3% ataxic CP. The percentage of children classified as MACS levels I to V was 28%, 34%, 17%, 7%, and 14% respectively, and classified as GMFCS levels I to V was 46%, 16%, 15%, 11%, and 12% respectively. Children classified as MACS and GMFCS levels I or II scored higher than children in MACS and GMFCS levels III to V on both the self-care and mobility domains of the PEDI, with significant differences between all classification levels (p<0.001). The stepwise multiple regression analysis verified that MACS was the strongest predictor of self-care skills (66%) and that GMFCS was the strongest predictor of mobility skills (76%). A strong correlation between age and self-care ability was found among children classified as MACS level I or II and between age and mobility among children classified as GMFCS level I. Many of these children achieved independence, but at a later age than typically developing children. Children at other MACS and GMFCS levels demonstrated minimal progress with age. Knowledge of a child's MACS and GMFCS level can be useful when discussing expectations of, and goals for, the development of functional skills. © The Authors. Journal compilation © Mac Keith Press 2010.

  5. Systemic mastocytosis: CT and US features of abdominal manifestations.

    PubMed

    Avila, N A; Ling, A; Worobec, A S; Mican, J M; Metcalfe, D D

    1997-02-01

    To study the imaging findings in patients with systemic mastocytosis and to correlate the findings with the severity of disease on the basis of an established classification system. Pathologic findings, when available, were correlated with imaging findings. Computed tomographic (CT) and ultrasound (US) scans and corresponding pathologic findings, when available, were retrospectively reviewed in 27 patients with systemic mastocytosis. Only five (19%) of the patients in our series had normal abdominal CT and/or US examination results. Common abdominal imaging findings associated with systemic mastocytosis were hepatosplenomegaly, retroperitoneal adenopathy, periportal adenopathy, mesenteric adenopathy, thickening of the omentum and the mesentery, and ascites. Less common findings included hepatofugal portal venous flow, Budd-Chiari syndrome, cavernous transformation of the portal vein, ovarian mass, and complications such as chloroma. The findings were more common in patients with category II and those with category III disease. Abdominal findings at CT and US are common in patients with systemic mastocytosis. Although the findings in patients with systemic mastocytosis are not specific to the disease, they are useful in directing further studies for diagnostic confirmation and in estimating the extent of systemic involvement.

  6. A 16-Gene Signature Distinguishes Anaplastic Astrocytoma from Glioblastoma

    PubMed Central

    Rao, Soumya Alige Mahabala; Srinivasan, Sujaya; Patric, Irene Rosita Pia; Hegde, Alangar Sathyaranjandas; Chandramouli, Bangalore Ashwathnarayanara; Arimappamagan, Arivazhagan; Santosh, Vani; Kondaiah, Paturu; Rao, Manchanahalli R. Sathyanarayana; Somasundaram, Kumaravel

    2014-01-01

    Anaplastic astrocytoma (AA; Grade III) and glioblastoma (GBM; Grade IV) are diffusely infiltrating tumors and are called malignant astrocytomas. The treatment regimen and prognosis are distinctly different between anaplastic astrocytoma and glioblastoma patients. Although histopathology based current grading system is well accepted and largely reproducible, intratumoral histologic variations often lead to difficulties in classification of malignant astrocytoma samples. In order to obtain a more robust molecular classifier, we analysed RT-qPCR expression data of 175 differentially regulated genes across astrocytoma using Prediction Analysis of Microarrays (PAM) and found the most discriminatory 16-gene expression signature for the classification of anaplastic astrocytoma and glioblastoma. The 16-gene signature obtained in the training set was validated in the test set with diagnostic accuracy of 89%. Additionally, validation of the 16-gene signature in multiple independent cohorts revealed that the signature predicted anaplastic astrocytoma and glioblastoma samples with accuracy rates of 99%, 88%, and 92% in TCGA, GSE1993 and GSE4422 datasets, respectively. The protein-protein interaction network and pathway analysis suggested that the 16-genes of the signature identified epithelial-mesenchymal transition (EMT) pathway as the most differentially regulated pathway in glioblastoma compared to anaplastic astrocytoma. In addition to identifying 16 gene classification signature, we also demonstrated that genes involved in epithelial-mesenchymal transition may play an important role in distinguishing glioblastoma from anaplastic astrocytoma. PMID:24475040

  7. Diabetic foot surgery: classifying patients to predict complications.

    PubMed

    Bevilacqua, Nicholas J; Rogers, Lee C; Armstrong, David G

    2008-01-01

    The purpose of this article is to describe a classification of diabetic foot surgery performed in the absence of critical limb ischaemia. The basis of this classification is centred on three fundamental variables that are present in the assessment of risk and indication: (1) presence or absence of neuropathy (the loss of protective sensation); (2) presence or absence of an open wound; (3) presence or absence of acute limb-threatening infection. The conceptual framework for this classification is to define distinct classes of surgery in an order of theoretically increasing risk for high-level amputation. These include: Class I: elective diabetic foot surgery (procedures performed to treat a painful deformity in a patient without the loss of protective sensation); Class II: prophylactic (procedure performed to reduce the risk of ulceration or reulceration in a person with the loss of protective sensation but without an open wound); Class III: curative (procedure performed to assist in healing an open wound); and Class IV: emergency (procedure performed to limit the progression of acute infection). The presence of critical ischaemia in any of these classes of surgery should prompt a vascular evaluation to consider (1) the urgency of the procedure being considered and (2) possible revascularization prior to or temporally concomitant with the procedure. It is our hope that this system begins a dialogue amongst physicians and surgeons which can ultimately facilitate communication, enhance perspective, and improve care.

  8. [Nomenclature of squamous cell precursor lesions of the lower female genital tract : Current aspects].

    PubMed

    Horn, L-C; Brambs, C E; Handzel, R; Mehlhorn, G; Schmidt, D; Schierle, K

    2016-11-01

    The majority of precancerous lesions of the lower female genital tract (intraepithelial neoplasia, IN) are caused by human papillomavirus (HPV) infections resulting in cellular atypia and in turn an altered tissue architecture. Depending on the pathogenesis, a distinction is made between vulvar intraepithelial neoplasia (VIN) classified as classical VIN associated with high-risk HPV infections (u-VIN) and differentiated VIN (d-VIN), which is associated with lichen sclerosus et atrophicus and p53 alterations. In the current World Health Organization (WHO) classification a novel grading system for squamous cell precancerous lesions of the lower female genital tract has been proposed, differentiating low grade squamous intraepithelial lesions (L-SIL) including condyloma and HPV-associated alterations plus VIN 1, vaginal intraepithelial neoplasia (VaIN 1) and cervical intraepithelial neoplasia (CIN 1) from high grade squamous intraepithelial lesions (H-SIL) with VIN 2 and 3, VaIN 2 and 3 as well as CIN 2 and 3. The use of p16 immunohistochemistry can assist the differentiation. The new binary classification, however, contradicts the German cytological nomenclature (Munich nomenclature III), which differentiated three grades of dysplasia in order to avoid overtreatment of patients with moderate IN. The individual nomenclatures are compared to each other. It is recommended to report the grade of precancerous lesions in addition to the SIL classification of the WHO.

  9. Voluntary organ donation system adapted to Chinese cultural values and social reality.

    PubMed

    Huang, Jiefu; Millis, J Michael; Mao, Yilei; Millis, M Andrew; Sang, Xinting; Zhong, Shouxian

    2015-04-01

    Organ donation and transplant systems have unique characteristics based on the local culture and socioeconomic context. China's transplant and organ donation systems developed without regulatory oversight until 2006 when regulation and policy were developed and then implemented over the next several years. Most recently, the pilot project of establishing a voluntary citizen-based deceased donor program was established. The pilot program addressed the legal, financial, and cultural barriers to organ donation in China. The pilot program has evolved into a national program. Significantly, it established a uniquely Chinese donor classification system. The Chinese donor classification system recognizes donation after brain death (category I), donation after circulatory death (category II), and donation after brain death followed by circulatory death (category III). Through August 2014, the system has identified 2326 donors and provided 6416 organs that have been allocated though a transparent organ allocation system. The estimated number of donors in 2014 is 1147. As China's attitudes toward organ donation have matured and evolved and as China, as a nation, is taking its place on the world stage, it is recognizing that its past practice of using organs from executed prisoners is not sustainable. It is time to recognize that the efforts to regulate transplantation and provide voluntary citizen-based deceased organ donation have been successful and that China should use this system to provide organs for all transplants in every province and hospital in China. At the national organ transplant congress on October 30, 2014, the Chairman of the China's national organ donation and transplantation committee, Jeifu Huang required all hospitals to stop using organs from executed prisoners immediately and the civilian organ donation will be sole source for organ transplant in China starting January 2015. © 2015 American Association for the Study of Liver Diseases.

  10. 21 CFR 886.3600 - Intraocular lens.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Intraocular lens. 886.3600 Section 886.3600 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL... the natural lens of an eye. (b) Classification. Class III. (c) Date PMA or notice of completion of a...

  11. 9 CFR 145.23 - Terminology and classification; flocks and products.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... the following terms and the corresponding designs illustrated in § 145.10: (a) [Reserved] (b) U.S... from flocks that met equivalent requirements under official supervision; and (iii) The flock is located... from U.S. Pullorum-Typhoid Clean breeding flocks or from flocks that met equivalent requirements under...

  12. 21 CFR 878.4010 - Tissue adhesive.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ..., is a device used for adhesion of internal tissues and vessels. (2) Classification. Class III... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Tissue adhesive. 878.4010 Section 878.4010 Food... DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4010 Tissue adhesive. (a) Tissue...

  13. 21 CFR 878.4010 - Tissue adhesive.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ..., is a device used for adhesion of internal tissues and vessels. (2) Classification. Class III... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Tissue adhesive. 878.4010 Section 878.4010 Food... DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4010 Tissue adhesive. (a) Tissue...

  14. Scenario Analysis: An Integrative Study and Guide to Implementation in the United States Air Force

    DTIC Science & Technology

    1994-09-01

    Environmental Analysis ................................ 3-3 Classifications of Environments ......................... 3-5 Characteristics of... Environments ........................ 3-8 iii Page Components of the Environmental Analysis Process ........... 3-12 Forecasting... Environmental Analysis ...................... 3-4 3-2 Model of the Industry Environment ......................... 3-6 3-3 Model of Macroenvironment

  15. 21 CFR 870.3610 - Implantable pacemaker pulse generator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... asynchronous devices implanted in the human body. (b) Classification. Class III (premarket approval). (c) Date... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Implantable pacemaker pulse generator. 870.3610 Section 870.3610 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES...

  16. 21 CFR 870.3610 - Implantable pacemaker pulse generator.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... asynchronous devices implanted in the human body. (b) Classification. Class III (premarket approval). (c) Date... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Implantable pacemaker pulse generator. 870.3610 Section 870.3610 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES...

  17. 78 FR 5327 - Medical Devices; Ophthalmic Devices; Classification of the Scleral Plug

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-25

    ... Agency) is proposing to classify the scleral plug into class II (special controls), and proposing to... controls needed to provide reasonable assurance of their safety and effectiveness. The three categories of devices are class I (general controls), class II (special controls), and class III (premarket approval...

  18. A New Classification System for IgG4 Autoantibodies

    PubMed Central

    Koneczny, Inga

    2018-01-01

    IgG4 autoimmune diseases are characterized by the presence of antigen-specific autoantibodies of the IgG4 subclass and contain well-characterized diseases such as muscle-specific kinase myasthenia gravis, pemphigus, and thrombotic thrombocytopenic purpura. In recent years, several new diseases were identified, and by now 14 antigens targeted by IgG4 autoantibodies have been described. The IgG4 subclass is considered immunologically inert and functionally monovalent due to structural differences compared to other IgG subclasses. IgG4 usually arises after chronic exposure to antigen and competes with other antibody species, thus “blocking” their pathogenic effector mechanisms. Accordingly, in the context of IgG4 autoimmunity, the pathogenicity of IgG4 is associated with blocking of enzymatic activity or protein–protein interactions of the target antigen. Pathogenicity of IgG4 autoantibodies has not yet been systematically analyzed in IgG4 autoimmune diseases. Here, we establish a modified classification system based on Witebsky’s postulates to determine IgG4 pathogenicity in IgG4 autoimmune diseases, review characteristics and pathogenic mechanisms of IgG4 in these disorders, and also investigate the contribution of other antibody entities to pathophysiology by additional mechanisms. As a result, three classes of IgG4 autoimmune diseases emerge: class I where IgG4 pathogenicity is validated by the use of subclass-specific autoantibodies in animal models and/or in vitro models of pathogenicity; class II where IgG4 pathogenicity is highly suspected but lack validation by the use of subclass specific antibodies in in vitro models of pathogenicity or animal models; and class III with insufficient data or a pathogenic mechanism associated with multivalent antigen binding. Five out of the 14 IgG4 antigens were validated as class I, five as class II, and four as class III. Antibodies of other IgG subclasses or immunoglobulin classes were present in several diseases and could contribute additional pathogenic mechanisms. PMID:29483905

  19. Responsiveness of the ACTIVLIM-CP questionnaire measuring global activity performance in children with cerebral palsy.

    PubMed

    Paradis, Julie; Arnould, Carlyne; Thonnard, Jean-Louis; Houx, Laëtitia; Pons-Becmeur, Christelle; Renders, Anne; Brochard, Sylvain; Bleyenheuft, Yannick

    2018-06-04

    To investigate the responsiveness of the ACTIVLIM-CP questionnaire after two evidence-based interventions for children with cerebral palsy (CP). Seventy-five children with CP either participated in an intensive motor-skill learning intervention (hand-arm bimanual intensive therapy including lower extremities [HABIT-ILE], n=47) or received botulinum neurotoxin-A (BoNT-A) injection(s) into lower extremities combined with conventional physical therapy (n=28). All children were assessed three times: at baseline (T 0 ; before HABIT-ILE/the day of BoNT-A injection), at T 1 (last day of HABIT-ILE/6wks after BoNT-A injection), and at follow-up (T 2 ; 3-4mo after the beginning of intervention). Parents completed ACTIVLIM-CP and three other activity questionnaires. Responsiveness was analysed using group (based on intervention), subgroup (based on gross motor function level), and individual approaches. For the HABIT-ILE group, significant improvements in ACTIVLIM-CP were observed for the T 0 -T 1 period (p<0.001) but not for the T 1 -T 2 period. No significant changes were found in the BoNT-A group during assessments (p=0.84). In the subgroup analysis for the HABIT-ILE group (T 0 -T 1 ), greater changes were demonstrated for children in Gross Motor Function Classification System levels III and IV (p<0.001, effect size=1.36). The individual approach was congruent with the group approach. ACTIVLIM-CP demonstrated high responsiveness after HABIT-ILE, showing that this scale may be used to investigate global activity performance in clinical trials focusing on improving daily life activities. Good responsiveness of ACTIVLIM-CP questionnaire during intensive motor-skill learning intervention. Higher responsiveness for children in Gross Motor Function Classification System (GMFCS) levels III and IV versus I and II after intensive intervention. ACTIVLIM-CP is useful to identify children improving their performance after botulinum neurotoxin-A injection. © 2018 Mac Keith Press.

  20. Gastrocnemius operating length with ankle foot orthoses in cerebral palsy.

    PubMed

    Choi, Hwan; Wren, Tishya Anne Leong; Steele, Katherine Muterspaugh

    2017-06-01

    Many individuals with cerebral palsy wear ankle foot orthoses during daily life. Orthoses influence joint motion, but how they impact muscle remains unclear. In particular, the gastrocnemius is commonly stiff in cerebral palsy. Understanding whether orthoses stretch or shorten this muscle during daily life may inform orthosis design and rehabilitation. This study investigated the impact of different ankle foot orthoses on gastrocnemius operating length during walking in children with cerebral palsy. Case series, within subject comparison of gastrocnemius operating length while walking barefoot and with two types of ankle foot orthoses. We performed gait analyses for 11 children with cerebral palsy. Each child was fit with two types of orthoses: a dynamic ankle foot orthosis (Cascade dynamic ankle foot orthosis) and an adjustable dynamic response ankle foot orthosis (Ultraflex ankle foot orthosis). Musculoskeletal modeling was used to quantify gastrocnemius musculotendon operating length and velocity with each orthosis. Walking with ankle foot orthoses could stretch the gastrocnemius more than barefoot walking for some individuals; however, there was significant variability between participants and orthoses. At least one type of orthosis stretched the gastrocnemius during walking for 4/6 and 3/5 of the Gross Motor Functional Classification System Level I and III participants, respectively. AFOs also reduced peak gastrocnemius lengthening velocity compared to barefoot walking for some participants, with greater reductions among the Gross Motor Functional Classification System Level III participants. Changes in gastrocnemius operating length and lengthening velocity were related to changes in ankle and knee kinematics during gait. Ankle foot orthoses impact gastrocnemius operating length during walking and, with proper design, may assist with stretching tight muscles in daily life. Clinical relevance Determining whether ankle foot orthoses stretch tight muscles can inform future orthotic design and potentially provide a platform for integrating therapy into daily life. However, stretching tight muscles must be balanced with other goals of orthoses such as improving gait and preventing bone deformities.

  1. MeMoVolc report on classification and dynamics of volcanic explosive eruptions

    NASA Astrophysics Data System (ADS)

    Bonadonna, C.; Cioni, R.; Costa, A.; Druitt, T.; Phillips, J.; Pioli, L.; Andronico, D.; Harris, A.; Scollo, S.; Bachmann, O.; Bagheri, G.; Biass, S.; Brogi, F.; Cashman, K.; Dominguez, L.; Dürig, T.; Galland, O.; Giordano, G.; Gudmundsson, M.; Hort, M.; Höskuldsson, A.; Houghton, B.; Komorowski, J. C.; Küppers, U.; Lacanna, G.; Le Pennec, J. L.; Macedonio, G.; Manga, M.; Manzella, I.; Vitturi, M. de'Michieli; Neri, A.; Pistolesi, M.; Polacci, M.; Ripepe, M.; Rossi, E.; Scheu, B.; Sulpizio, R.; Tripoli, B.; Valade, S.; Valentine, G.; Vidal, C.; Wallenstein, N.

    2016-11-01

    Classifications of volcanic eruptions were first introduced in the early twentieth century mostly based on qualitative observations of eruptive activity, and over time, they have gradually been developed to incorporate more quantitative descriptions of the eruptive products from both deposits and observations of active volcanoes. Progress in physical volcanology, and increased capability in monitoring, measuring and modelling of explosive eruptions, has highlighted shortcomings in the way we classify eruptions and triggered a debate around the need for eruption classification and the advantages and disadvantages of existing classification schemes. Here, we (i) review and assess existing classification schemes, focussing on subaerial eruptions; (ii) summarize the fundamental processes that drive and parameters that characterize explosive volcanism; (iii) identify and prioritize the main research that will improve the understanding, characterization and classification of volcanic eruptions and (iv) provide a roadmap for producing a rational and comprehensive classification scheme. In particular, classification schemes need to be objective-driven and simple enough to permit scientific exchange and promote transfer of knowledge beyond the scientific community. Schemes should be comprehensive and encompass a variety of products, eruptive styles and processes, including for example, lava flows, pyroclastic density currents, gas emissions and cinder cone or caldera formation. Open questions, processes and parameters that need to be addressed and better characterized in order to develop more comprehensive classification schemes and to advance our understanding of volcanic eruptions include conduit processes and dynamics, abrupt transitions in eruption regime, unsteadiness, eruption energy and energy balance.

  2. Increased auditory startle reflex in children with functional abdominal pain.

    PubMed

    Bakker, Mirte J; Boer, Frits; Benninga, Marc A; Koelman, Johannes H T M; Tijssen, Marina A J

    2010-02-01

    To test the hypothesis that children with abdominal pain-related functional gastrointestinal disorders have a general hypersensitivity for sensory stimuli. Auditory startle reflexes were assessed in 20 children classified according to Rome III classifications of abdominal pain-related functional gastrointestinal disorders (13 irritable bowel syndrome [IBS], 7 functional abdominal pain syndrome; mean age, 12.4 years; 15 girls) and 23 control subjects (14 girls; mean age, 12.3 years) using a case-control design. The activity of 6 left-sided muscles and the sympathetic skin response were obtained by an electromyogram. We presented sudden loud noises to the subjects through headphones. Both the combined response of 6 muscles and the blink response proved to be significantly increased in patients with abdominal pain compared with control subjects. A significant increase of the sympathetic skin response was not found. Comorbid anxiety disorders (8 patients with abdominal pain) or Rome III subclassification did not significantly affect these results. This study demonstrates an objective hyperresponsivity to nongastrointestinal stimuli. Children with abdominal pain-related functional gastrointestinal disorders may have a generalized hypersensitivity of the central nervous system. Copyright 2010 Mosby, Inc. All rights reserved.

  3. AUTOCLASS III - AUTOMATIC CLASS DISCOVERY FROM DATA

    NASA Technical Reports Server (NTRS)

    Cheeseman, P. C.

    1994-01-01

    The program AUTOCLASS III, Automatic Class Discovery from Data, uses Bayesian probability theory to provide a simple and extensible approach to problems such as classification and general mixture separation. Its theoretical basis is free from ad hoc quantities, and in particular free of any measures which alter the data to suit the needs of the program. As a result, the elementary classification model used lends itself easily to extensions. The standard approach to classification in much of artificial intelligence and statistical pattern recognition research involves partitioning of the data into separate subsets, known as classes. AUTOCLASS III uses the Bayesian approach in which classes are described by probability distributions over the attributes of the objects, specified by a model function and its parameters. The calculation of the probability of each object's membership in each class provides a more intuitive classification than absolute partitioning techniques. AUTOCLASS III is applicable to most data sets consisting of independent instances, each described by a fixed length vector of attribute values. An attribute value may be a number, one of a set of attribute specific symbols, or omitted. The user specifies a class probability distribution function by associating attribute sets with supplied likelihood function terms. AUTOCLASS then searches in the space of class numbers and parameters for the maximally probable combination. It returns the set of class probability function parameters, and the class membership probabilities for each data instance. AUTOCLASS III is written in Common Lisp, and is designed to be platform independent. This program has been successfully run on Symbolics and Explorer Lisp machines. It has been successfully used with the following implementations of Common LISP on the Sun: Franz Allegro CL, Lucid Common Lisp, and Austin Kyoto Common Lisp and similar UNIX platforms; under the Lucid Common Lisp implementations on VAX/VMS v5.4, VAX/Ultrix v4.1, and MIPS/Ultrix v4, rev. 179; and on the Macintosh personal computer. The minimum Macintosh required is the IIci. This program will not run under CMU Common Lisp or VAX/VMS DEC Common Lisp. A minimum of 8Mb of RAM is required for Macintosh platforms and 16Mb for workstations. The standard distribution medium for this program is a .25 inch streaming magnetic tape cartridge in UNIX tar format. It is also available on a 3.5 inch diskette in UNIX tar format and a 3.5 inch diskette in Macintosh format. An electronic copy of the documentation is included on the distribution medium. AUTOCLASS was developed between March 1988 and March 1992. It was initially released in May 1991. Sun is a trademark of Sun Microsystems, Inc. UNIX is a registered trademark of AT&T Bell Laboratories. DEC, VAX, VMS, and ULTRIX are trademarks of Digital Equipment Corporation. Macintosh is a trademark of Apple Computer, Inc. Allegro CL is a registered trademark of Franz, Inc.

  4. Expression analysis of URI/RMP gene in endometrioid adenocarcinoma by tissue microarray immunohistochemistry.

    PubMed

    Gu, Junxia; Liang, Yuting; Qiao, Longwei; Li, Xiaoyun; Li, Xingang; Lu, Yaojuan; Zheng, Qiping

    2013-01-01

    Multiple studies have recently demonstrated the oncogenic property of URI (or RMP, a member of the prefoldin family of molecular chaperones) during progression of hepatocellular carcinoma, ovarian cancer, and possibly prostate cancer. Most recently, we have shown that URI/RMP is up-regulated in cervical cancer, another reproductive system tumor beside ovarian and prostate cancers. To investigate if URI/RMP also plays a role in other reproductive system tumors, especially in endometrioid adenocarcinoma, we analyzed URI/RMP expression in a TMA (tissue microarray) containing tissues from 30 cases of endometrioid adenocarcinoma (which covers tumor tissues from Grade I through Grade III) and adjacent endometrium by immunohistochemistry (IHC) and densitometry analysis using image-pro plus 6.0 software. Our results showed that the mean density of URI/RMP expression in cancerous tissue is slightly higher than that of the adjacent endometrial tissue, though not statistically significant (p>0.05). There is no significant difference either between the mean density of Grade III cancerous tissue and that of Grade I and II cancers. Notably, we detected significantly higher signal intensity in cancerous tissue of all 7 Grade III cases than that of their adjacent endometrial tissue (p<0.05), suggesting a correlation of URI/RMP expression with the differentiation and pathological classification of endometrioid adenocarcinoma. Together, our results demonstrate the heterogeneous expression of URI/RMP in endometrioid adenocarcinoma. The higher level of URI/RMP expression in high-grade endometrioid adenocarcinomas compared to tissues of adjacent endometrium or gland suggests a diagnostic and possibly, a prognostic value of URI/RMP in endometrioid adenocarcinoma.

  5. Expression analysis of URI/RMP gene in endometrioid adenocarcinoma by tissue microarray immunohistochemistry

    PubMed Central

    Gu, Junxia; Liang, Yuting; Qiao, Longwei; Li, Xiaoyun; Li, Xingang; Lu, Yaojuan; Zheng, Qiping

    2013-01-01

    Multiple studies have recently demonstrated the oncogenic property of URI (or RMP, a member of the prefoldin family of molecular chaperones) during progression of hepatocellular carcinoma, ovarian cancer, and possibly prostate cancer. Most recently, we have shown that URI/RMP is up-regulated in cervical cancer, another reproductive system tumor beside ovarian and prostate cancers. To investigate if URI/RMP also plays a role in other reproductive system tumors, especially in endometrioid adenocarcinoma, we analyzed URI/RMP expression in a TMA (tissue microarray) containing tissues from 30 cases of endometrioid adenocarcinoma (which covers tumor tissues from Grade I through Grade III) and adjacent endometrium by immunohistochemistry (IHC) and densitometry analysis using image-pro plus 6.0 software. Our results showed that the mean density of URI/RMP expression in cancerous tissue is slightly higher than that of the adjacent endometrial tissue, though not statistically significant (p>0.05). There is no significant difference either between the mean density of Grade III cancerous tissue and that of Grade I and II cancers. Notably, we detected significantly higher signal intensity in cancerous tissue of all 7 Grade III cases than that of their adjacent endometrial tissue (p<0.05), suggesting a correlation of URI/RMP expression with the differentiation and pathological classification of endometrioid adenocarcinoma. Together, our results demonstrate the heterogeneous expression of URI/RMP in endometrioid adenocarcinoma. The higher level of URI/RMP expression in high-grade endometrioid adenocarcinomas compared to tissues of adjacent endometrium or gland suggests a diagnostic and possibly, a prognostic value of URI/RMP in endometrioid adenocarcinoma. PMID:24228101

  6. Correlation between patients' reasons for encounters/health problems and population density in Japan: a systematic review of observational studies coded by the International Classification of Health Problems in Primary Care (ICHPPC) and the International Classification of Primary care (ICPC).

    PubMed

    Kaneko, Makoto; Ohta, Ryuichi; Nago, Naoki; Fukushi, Motoharu; Matsushima, Masato

    2017-09-13

    The Japanese health care system has yet to establish structured training for primary care physicians; therefore, physicians who received an internal medicine based training program continue to play a principal role in the primary care setting. To promote the development of a more efficient primary health care system, the assessment of its current status in regard to the spectrum of patients' reasons for encounters (RFEs) and health problems is an important step. Recognizing the proportions of patients' RFEs and health problems, which are not generally covered by an internist, can provide valuable information to promote the development of a primary care physician-centered system. We conducted a systematic review in which we searched six databases (PubMed, the Cochrane Library, Google Scholar, Ichushi-Web, JDreamIII and CiNii) for observational studies in Japan coded by International Classification of Health Problems in Primary Care (ICHPPC) and International Classification of Primary Care (ICPC) up to March 2015. We employed population density as index of accessibility. We calculated Spearman's rank correlation coefficient to examine the correlation between the proportion of "non-internal medicine-related" RFEs and health problems in each study area in consideration of the population density. We found 17 studies with diverse designs and settings. Among these studies, "non-internal medicine-related" RFEs, which was not thought to be covered by internists, ranged from about 4% to 40%. In addition, "non-internal medicine-related" health problems ranged from about 10% to 40%. However, no significant correlation was found between population density and the proportion of "non-internal medicine-related" RFEs and health problems. This is the first systematic review on RFEs and health problems coded by ICHPPC and ICPC undertaken to reveal the diversity of health problems in Japanese primary care. These results suggest that primary care physicians in some rural areas of Japan need to be able to deal with "non-internal-medicine-related" RFEs and health problems, and that curriculum including practical non-internal medicine-related training is likely to be important.

  7. Children exposed to disaster: I. Epidemiology of post-traumatic symptoms and symptom profiles.

    PubMed

    Shannon, M P; Lonigan, C J; Finch, A J; Taylor, C M

    1994-01-01

    To determine the range and severity of post-traumatic stress disorder (PTSD) symptoms exhibited by children after exposure to a natural disaster. Three months after Hurricane Hugo struck Berkeley County, South Carolina, 5,687 school-aged children were surveyed about their experiences and reactions related to the storm. Self-reports of PTSD symptoms were obtained by use of a PTSD Reaction Index. Significant variation in the prevalence of PTSD symptoms was found across race, gender, and age groups. Self-reported symptoms were used to derive a post-traumatic stress syndrome classification according to DSM-III-R guidelines for the diagnosis of PTSD. More than 5% of the sample reported sufficient symptoms to be classified as exhibiting this post-traumatic stress syndrome. Females and younger children were more likely to receive this classification. At the symptom level, females reported more symptoms associated with emotional processing and emotional reaction to the trauma. Males were more likely to report symptoms related to cognitive and behavioral factors. Younger children were more likely to report symptoms overall. Children exposed to a high magnitude natural disaster report sufficient symptoms to establish a DSM-III-R derived classification of a PTSD syndrome. Differences between gender, age, and race groups appear to be related to differential risk of exposure, reporting biases, as well as a differential risk for developing post-traumatic symptoms.

  8. CDX2 prognostic value in stage II/III resected colon cancer is related to CMS classification.

    PubMed

    Pilati, C; Taieb, J; Balogoun, R; Marisa, L; de Reyniès, A; Laurent-Puig, P

    2017-05-01

    Caudal-type homeobox transcription factor 2 (CDX2) is involved in colon cancer (CC) oncogenesis and has been proposed as a prognostic biomarker in patients with stage II or III CC. We analyzed CDX2 expression in a series of 469 CC typed for the new international consensus molecular subtype (CMS) classification, and we confirmed results in a series of 90 CC. Here, we show that lack of CDX2 expression is only present in the mesenchymal subgroup (CMS4) and in MSI-immune tumors (CMS1) and not in CMS2 and CMS3 colon cancer. Although CDX2 expression was a globally independent prognostic factor, loss of CDX2 expression is not associated with a worse prognosis in the CMS1 group, but is highly prognostic in CMS4 patients for both relapse free and overall survival. Similarly, lack of CDX2 expression was a bad prognostic factor in MSS patients, but not in MSI. Our work suggests that combination of the consensual CMS classification and lack of CDX2 expression could be a useful marker to identify CMS4/CDX2-negative patients with a very poor prognosis. © The Author 2017. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  9. Development and feasibility of the misuse, abuse, and diversion drug event reporting system (MADDERS®).

    PubMed

    Treister, Roi; Trudeau, Jeremiah J; Van Inwegen, Richard; Jones, Judith K; Katz, Nathaniel P

    2016-12-01

    Inappropriate use of analgesic drugs has become increasingly pervasive over the past decade. Currently, drug abuse potential is primarily assessed post-marketing; no validated tools are available to assess this potential in phase II and III clinical trials. This paper describes the development and feasibility testing of a Misuse, Abuse, and Diversion Drug Event Reporting System (MADDERS), which aims to identify potentially abuse-related events and classify them according to a recently developed classification scheme, allowing the quantification of these events in clinical trials. The system was initially conceived and designed with input from experts and patients, followed by field-testing to assess its feasibility and content validity in both completed and ongoing clinical trials. The results suggest that MADDERS is a feasible system with initial validity. It showed higher rates of the triggering events in subjects taking medications with known abuse potential than in patients taking medications without abuse potential. Additionally, experts agreed on the classification of most abuse-related events in MADDERS. MADDERS is a new systematic approach to collect information on potentially abuse-related events in clinical trials and classify them. The system has demonstrated feasibility for implementation. Additional research is ongoing to further evaluate its validity. Currently, there are no validated tools to assess drug abuse potential during clinical trials. Because of its ease of implementation, its systematic approach, and its preliminary validation results, MADDERS could provide such a tool for clinical trials. (Am J Addict 2016;25:641-651). © 2016 American Academy of Addiction Psychiatry.

  10. Understanding the use of standardized nursing terminology and classification systems in published research: A case study using the International Classification for Nursing Practice(®).

    PubMed

    Strudwick, Gillian; Hardiker, Nicholas R

    2016-10-01

    In the era of evidenced based healthcare, nursing is required to demonstrate that care provided by nurses is associated with optimal patient outcomes, and a high degree of quality and safety. The use of standardized nursing terminologies and classification systems are a way that nursing documentation can be leveraged to generate evidence related to nursing practice. Several widely-reported nursing specific terminologies and classifications systems currently exist including the Clinical Care Classification System, International Classification for Nursing Practice(®), Nursing Intervention Classification, Nursing Outcome Classification, Omaha System, Perioperative Nursing Data Set and NANDA International. However, the influence of these systems on demonstrating the value of nursing and the professions' impact on quality, safety and patient outcomes in published research is relatively unknown. This paper seeks to understand the use of standardized nursing terminology and classification systems in published research, using the International Classification for Nursing Practice(®) as a case study. A systematic review of international published empirical studies on, or using, the International Classification for Nursing Practice(®) were completed using Medline and the Cumulative Index for Nursing and Allied Health Literature. Since 2006, 38 studies have been published on the International Classification for Nursing Practice(®). The main objectives of the published studies have been to validate the appropriateness of the classification system for particular care areas or populations, further develop the classification system, or utilize it to support the generation of new nursing knowledge. To date, most studies have focused on the classification system itself, and a lesser number of studies have used the system to generate information about the outcomes of nursing practice. Based on the published literature that features the International Classification for Nursing Practice, standardized nursing terminology and classification systems appear to be well developed for various populations, settings and to harmonize with other health-related terminology systems. However, the use of the systems to generate new nursing knowledge, and to validate nursing practice is still in its infancy. There is an opportunity now to utilize the well-developed systems in their current state to further what is know about nursing practice, and how best to demonstrate improvements in patient outcomes through nursing care. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Controlling protected designation of origin of wine by Raman spectroscopy.

    PubMed

    Mandrile, Luisa; Zeppa, Giuseppe; Giovannozzi, Andrea Mario; Rossi, Andrea Mario

    2016-11-15

    In this paper, a Fourier Transform Raman spectroscopy method, to authenticate the provenience of wine, for food traceability applications was developed. In particular, due to the specific chemical fingerprint of the Raman spectrum, it was possible to discriminate different wines produced in the Piedmont area (North West Italy) in accordance with i) grape varieties, ii) production area and iii) ageing time. In order to create a consistent training set, more than 300 samples from tens of different producers were analyzed, and a chemometric treatment of raw spectra was applied. A discriminant analysis method was employed in the classification procedures, providing a classification capability (percentage of correct answers) of 90% for validation of grape analysis and geographical area provenance, and a classification capability of 84% for ageing time classification. The present methodology was applied successfully to raw materials without any preliminary treatment of the sample, providing a response in a very short time. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Rapid identification and classification of bacteria by 16S rDNA restriction fragment melting curve analyses (RFMCA).

    PubMed

    Rudi, Knut; Kleiberg, Gro H; Heiberg, Ragnhild; Rosnes, Jan T

    2007-08-01

    The aim of this work was to evaluate restriction fragment melting curve analyses (RFMCA) as a novel approach for rapid classification of bacteria during food production. RFMCA was evaluated for bacteria isolated from sous vide food products, and raw materials used for sous vide production. We identified four major bacterial groups in the material analysed (cluster I-Streptococcus, cluster II-Carnobacterium/Bacillus, cluster III-Staphylococcus and cluster IV-Actinomycetales). The accuracy of RFMCA was evaluated by comparison with 16S rDNA sequencing. The strains satisfying the RFMCA quality filtering criteria (73%, n=57), with both 16S rDNA sequence information and RFMCA data (n=45) gave identical group assignments with the two methods. RFMCA enabled rapid and accurate classification of bacteria that is database compatible. Potential application of RFMCA in the food or pharmaceutical industry will include development of classification models for the bacteria expected in a given product, and then to build an RFMCA database as a part of the product quality control.

  13. Arthroscopic study of injuries in articular fractures of distal radius extremity

    PubMed Central

    Araf, Marcelo; Mattar, Rames

    2014-01-01

    OBJECTIVE: To analyze the incidence of wrist ligament and cartilage associated fractures of the distal radius, through arthroscopy, correlating with AO/ASIF classification. METHODS: Thirty patients aged between 20 and 50 years old, with closed fracture from groups B and C according to AO/ASIF classification were selected. All of them were submitted to wrist arthroscopy to address intra-articular injuries and reduction and osteosynthesis of the fracture. RESULTS: A high incidence of intra-articular injuries was noticed, and 76.6% of them presented injury of the triangular fibrocartilage complex, 36.6% of the intrinsic scapholunate ligament, 6.6% of the intrinsic triquetrolunate ligament, and 33% articular cartilage injury larger than three millimeters. Patients with fractures from type C according to AO/ASIF classification presented a higher incidence of ligament injuries. CONCLUSION: There is no relationship between the presence of chondral injury and the AO/ASIF classification of the fractures in the cases reported in this study. Level of Evidence III, Non Randomized Controlled Trial. PMID:25061421

  14. Ecological Land Classification: Applications to Identify the Productive Potential of Southern Forests

    Treesearch

    Dennis L. Mengel; D. Thompson Tew; [Editors

    1991-01-01

    Eighteen papers representing four categories-Regional Overviews; Classification System Development; Classification System Interpretation; Mapping/GIS Applications in Classification Systems-present the state of the art in forest-land classification and evaluation in the South. In addition, nine poster papers are presented.

  15. Viability of NLCD Products From IRS-P6, And From Landsat 7 Scan-gap Data

    NASA Technical Reports Server (NTRS)

    Coan, Michael

    2007-01-01

    Landcover test on Salt Lake test site illustrates potential issues with AWiFS/LISS-III for classification of certain land cover classes (evergreen, shrub/scrub, woody wetlands, emergent wetlands). Canopy and impervious graphs of product differences from source indicate slightly lower overall accuracies (shorter peaks, wider bases) for AWiFS/LISS-III, compared to L5/L7. Inspection of individual products from canopy and impervious estimate tests revealed issues with combining AWifs quadrants, and similar but less severe effects with combining multiple dates of L7 scan gap data.

  16. Classification of Newborn Ear Malformations and their Treatment with the EarWell Infant Ear Correction System.

    PubMed

    Daniali, Lily N; Rezzadeh, Kameron; Shell, Cheryl; Trovato, Matthew; Ha, Richard; Byrd, H Steve

    2017-03-01

    A single practice's treatment protocol and outcomes following molding therapy on newborn ear deformations and malformations with the EarWell Infant Ear Correction System were reviewed. A classification system for grading the severity of constricted ear malformations was created on the basis of anatomical findings. A retrospective chart/photograph review of a consecutive series of infants treated with the EarWell System from 2011 to 2014 was undertaken. The infants were placed in either deformation or malformation groups. Three classes of malformation were identified. Data regarding treatment induction, duration of treatment, and quality of outcome were collected for all study patients. One hundred seventy-five infant ear malformations and 303 infant ear deformities were treated with the EarWell System. The average age at initiation of treatment was 12 days; the mean duration of treatment was 37 days. An average of six office visits was required. Treated malformations included constricted ears [172 ears (98 percent)] and cryptotia [three ears (2 percent)]. Cup ear (34 ears) was considered a constricted malformation, in contrast to the prominent ear deformity. Constricted ears were assigned to one of three classes, with each subsequent class indicating increasing severity: class I, 77 ears (45 percent); class II, 81 ears (47 percent); and class III, 14 ears (8 percent). Molding therapy with the EarWell System reduced the severity by an average of 1.2 points (p < 0.01). Complications included minor superficial excoriations and abrasions. The EarWell System was shown to be effective in eliminating or reducing the need for surgery in all but the most severe malformations. Therapeutic, IV.

  17. A novel summary report of colonoscopy: timeline visualization providing meaningful colonoscopy video information.

    PubMed

    Cho, Minwoo; Kim, Jee Hyun; Kong, Hyoun Joong; Hong, Kyoung Sup; Kim, Sungwan

    2018-05-01

    The colonoscopy adenoma detection rate depends largely on physician experience and skill, and overlooked colorectal adenomas could develop into cancer. This study assessed a system that detects polyps and summarizes meaningful information from colonoscopy videos. One hundred thirteen consecutive patients had colonoscopy videos prospectively recorded at the Seoul National University Hospital. Informative video frames were extracted using a MATLAB support vector machine (SVM) model and classified as bleeding, polypectomy, tool, residue, thin wrinkle, folded wrinkle, or common. Thin wrinkle, folded wrinkle, and common frames were reanalyzed using SVM for polyp detection. The SVM model was applied hierarchically for effective classification and optimization of the SVM. The mean classification accuracy according to type was over 93%; sensitivity was over 87%. The mean sensitivity for polyp detection was 82.1%, and the positive predicted value (PPV) was 39.3%. Polyps detected using the system were larger (6.3 ± 6.4 vs. 4.9 ± 2.5 mm; P = 0.003) with a more pedunculated morphology (Yamada type III, 10.2 vs. 0%; P < 0.001; Yamada type IV, 2.8 vs. 0%; P < 0.001) than polyps missed by the system. There were no statistically significant differences in polyp distribution or histology between the groups. Informative frames and suspected polyps were presented on a timeline. This summary was evaluated using the system usability scale questionnaire; 89.3% of participants expressed positive opinions. We developed and verified a system to extract meaningful information from colonoscopy videos. Although further improvement and validation of the system is needed, the proposed system is useful for physicians and patients.

  18. [Guidelines for adult diffuse gliomas WHO grade II, III and IV: pathology and biology. Société franc¸aise de neuropathologie . Réseau de neuro-oncologie pathologique].

    PubMed

    Figarella-Branger, Dominique; Labrousse, François; Mohktari, Karima

    2012-10-01

    Pathological diagnosis plays a major role in the therapeutic management of adult diffuse gliomas. It is based on the histopathological analysis of a representative specimen. Therefore pathologists might be aware of the neuroradiological features of the lesions. Pathologists play a major role in the management of biological resources. Pathologists should classify adult gliomas according to WHO 2007 classification (histological subtype and grade). In addition, in order to provide the histomolecular classification of adult gliomas, search for molecular markers of diagnostic, prognostic or predictive of therapeutic responses must be performed by appropriate and validated immunohistochemical and molecular techniques. In all diffuse gliomas, whatever their grade, search for IDH1 R132H and P53 expression is required. Search for IDH1 minor mutations and IDH2 mutations is required in grade II and III IDH1 R132H negative gliomas whereas 1p19q codeletion should be searched for in grade II and III gliomas with an oligodendroglial component. Search for EGFR amplification and MGMT promoter methylation is recommended. It is strongly recommended to fill the standardized form for pathology and molecular features (validated by the French Society of Neuropathology) in all adult diffuse gliomas. Copyright © 2012. Published by Elsevier Masson SAS.

  19. Buried penis: classification surgical approach.

    PubMed

    Hadidi, Ahmed T

    2014-02-01

    The purpose of this study was to describe morphological classification of congenital buried penis (BP) and present a versatile surgical approach for correction. Sixty-one patients referred with BP were classified into 3 grades according to morphological findings: Grade 1-29 patients with Longer Inner Prepuce (LIP) only, Grade II-20 patients who presented with LIP associated with indrawn penis that required division of the fundiform and suspensory ligaments, and Grade III-12 patients who had in addition to the above, excess supra-pubic fat. A ventral midline penile incision extending from the tip of prepuce down to the penoscrotal junction was used in all patients. The operation was tailored according to the BP Grade. All patients underwent circumcision. Mean follow up was 3 years (range 1 to 10). All 61 patients had an abnormally long inner prepuce (LIP). Forty-seven patients had a short penile shaft. Early improvement was noted in all cases. Satisfactory results were achieved in all 29 patients in grade I and in 27 patients in grades II and III. Five children (Grades II and III) required further surgery (9%). Congenital buried penis is a spectrum characterized by LIP and may include in addition; short penile shaft, abnormal attachment of fundiform, and suspensory ligaments and excess supra-pubic fat. Congenital Mega Prepuce (CMP) is a variant of Grade I BP, with LIP characterized by intermittent ballooning of the genital area. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Chemical compositional study of 35 iron meteorites and its application in taxonomy

    NASA Technical Reports Server (NTRS)

    Wang, D.; Malvin, D. J.; Wasson, J. T.

    1985-01-01

    Structural and compositional data are reported as a guide to the classification of 35 iron meteorites. The Xinjiang iron meteorite, previously classified as III AB, is reclassified as III E on the basis of its lower Ga/Ni and Ge/Ni ratios, its wider, swollen kamacite bands, and the ubiquitous presence of haxonite, (Fe,Ni)22C. The Dongling (III CD) appears not to be a new meteorite, but to be paired with the Nantan. Four Antarctic iron meteorites, IAB Allan Hills A77250, A77263, A77289, and A77290, are classified as a paired meteorite because of their similarities in structure and in concentrations of various elements. It is shown that Cu shares certain properties with Ga and Ge, which makes them excellent taxonomic parameters.

  1. Control of Walking Speed in Children With Cerebral Palsy.

    PubMed

    Davids, Jon R; Cung, Nina Q; Chen, Suzy; Sison-Williamson, Mitell; Bagley, Anita M

    2017-03-21

    Children's ability to control the speed of gait is important for a wide range of activities. It is thought that the ability to increase the speed of gait for children with cerebral palsy (CP) is common. This study considered 3 hypotheses: (1) most ambulatory children with CP can increase gait speed, (2) the characteristics of free (self-selected) and fast walking are related to motor impairment level, and (3) the strategies used to increase gait speed are distinct among these levels. A retrospective review of time-distance parameters (TDPs) for 212 subjects with CP and 34 typically developing subjects walking at free and fast speeds was performed. Only children who could increase their gait speed above the minimal clinically important difference were defined as having a fast walk. Analysis of variance was used to compare TDPs of children with CP, among Gross Motor Function Classification System (GMFCS) levels, and children in typically developing group. Eight-five percent of the CP group (GMFCS I, II, III; 96%, 99%, and 34%, respectively) could increase gait speed on demand. At free speed, children at GMFCS I and II were significantly faster than children at GMFCS level III. At free speed, children at GMFCS I and II had significantly greater stride length than those at GMFCS levels III. At free speed, children at GMFCS level III had significantly lower cadence than those at GMFCS I and II. There were no significant differences in cadence among GMFCS levels at fast speeds. There were no significant differences among GMFCS levels for percent change in any TDP between free and fast walking. Almost all children with CP at GMFCS levels I and II can control the speed of gait, however, only one-third at GMFCS III level have this ability. This study suggests that children at GMFCS III level can be divided into 2 groups based on their ability to control gait speed; however, the prognostic significance of such categorization remains to be determined. Diagnostic level II.

  2. [Cannulated lag screw combined with lateral supporting plate for treatment of Hoffa fracture of Letenneur type I and type III].

    PubMed

    Lin, Tao; Yang, Shuhua; Xiao, Baojun; Fu, Dehao

    2013-09-01

    To investigate the effectiveness of cannulated lag screws combined with lateral supporting plates in the treatment of Hoffa fracture of Letenneur type I and type III. Between May 2004 and April 2011, 11 patients with Hoffa fracture of Letenneur type I and type III were treated, including 6 males and 5 females with an average age of 36 years (range, 25-47 years). Factures were caused by traffic accident in 8 cases, by falling in 2 cases, and by the other in 1 case. Fracture involved the left knee in 7 patients and the right knee in 4 patients. According Letenneur's classification criteria, there were 7 type I fractures (6 lateral condyle fractures and 1 medial condyle fracture) and 4 type III fractures (3 lateral condyle fractures and 1 medial condyle fracture). Of 11 fractures, 9 were fresh fractures and 2 were old fractures. Two 6.5 mm cannulated lag screws combined with lateral supporting plates were used to fix fractures by anterolateral or anteromedial incision. All incisions achieved primary healing with no early complication. All patients were followed up 12-26 months (mean, 15 months). X-ray films showed bone healing with an average healing time of 15 weeks (range, 10-18 weeks). No loosening or breaking of internal fixator was observed; the removal time of internal fixation was 9-15 months (mean, 12 months). Accoding to Letenneur's functional assessment system, the results were excellent in 7 cases, good in 3 cases, and poor in 1 case at last follow-up. Cannulated lag screws combined with lateral supporting plates fixation is effective in treatment of Hoffa fracture of Letenneur type I and type III with a high union rate; anterolateral or anteromedial approach is the first choice for Hoffa fracture of type I and type III, especially for complicating by tibial plateau fracture or patella fracture.

  3. 42 CFR 412.513 - Patient classification system.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Patient classification system. 412.513 Section 412... Long-Term Care Hospitals § 412.513 Patient classification system. (a) Classification methodology. CMS...-DRGs. (1) The classification of a particular discharge is based, as appropriate, on the patient's age...

  4. 42 CFR 412.513 - Patient classification system.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Patient classification system. 412.513 Section 412... Long-Term Care Hospitals § 412.513 Patient classification system. (a) Classification methodology. CMS...-DRGs. (1) The classification of a particular discharge is based, as appropriate, on the patient's age...

  5. Therapeutic Outcome of Achalasia Based on High-Resolution Manometry: A Korean Multicenter Study.

    PubMed

    Lee, Hyuk; Chung, Hyunsoo; Lee, Tae Hee; Hong, Kyoung Sup; Youn, Young Hoon; Park, Jung Ho; Park, Hyung Seok; Park, Hyojin

    2017-09-11

    Because achalasia subtype is associated with therapeutic response, it is possible that regional differences in subtype distribution could lead to differences in therapeutic outcomes. We aimed to evaluate and compare high-resolution manometry (HRM) profiles among the different subtypes of achalasia and to elucidate predictive factors associated with treatment outcomes. Patients who were diagnosed with achalasia using HRM at 4 Korean university hospitals were retrospectively identified and analyzed. Sixty-four patients with untreated achalasia were divided into 3 subtypes using the Chicago classification system. Clinical characteristics, manometric features, and treatment outcomes were compared. Among 64 patients diagnosed with achalasia, 31 patients were classified as type I, 27 as type II, and 6 as type III. Regarding HRM parameters, there were statistically significant differences in basal lower esophageal sphincter pressure, 4-second-integrated relaxation pressure, residual upper esophageal sphincter pressure, body amplitude, and maximal intrabolus pressure between subtypes. Regarding therapeutic outcome, type II patients (overall success rate of 80.0%) were more likely to respond than type I (55.2%) or type III (33.2%) patients. Multivariate analysis demonstrated that achalasia subtype (type I vs. III, P = 0.072; type II vs. III, P = 0.005), therapeutic modality (dilation vs. pharmacologic, P = 0.013; laparoscopic Heller's myotomy vs. pharmacologic, P = 0.006), and HRM-measured esophageal length (<27.5 vs. ≥27.5 cm, P = 0.014) are independent predictive factors for therapeutic failure. Patients with type II achalasia had better treatment outcomes than patients with other achalasia subtypes. Achalasia subtype, therapeutic modality, and esophageal length are independent predictive factors of therapeutic outcome.

  6. Bayesian Network Structure Learning for Urban Land Use Classification from Landsat ETM+ and Ancillary Data

    NASA Astrophysics Data System (ADS)

    Park, M.; Stenstrom, M. K.

    2004-12-01

    Recognizing urban information from the satellite imagery is problematic due to the diverse features and dynamic changes of urban landuse. The use of Landsat imagery for urban land use classification involves inherent uncertainty due to its spatial resolution and the low separability among land uses. To resolve the uncertainty problem, we investigated the performance of Bayesian networks to classify urban land use since Bayesian networks provide a quantitative way of handling uncertainty and have been successfully used in many areas. In this study, we developed the optimized networks for urban land use classification from Landsat ETM+ images of Marina del Rey area based on USGS land cover/use classification level III. The networks started from a tree structure based on mutual information between variables and added the links to improve accuracy. This methodology offers several advantages: (1) The network structure shows the dependency relationships between variables. The class node value can be predicted even with particular band information missing due to sensor system error. The missing information can be inferred from other dependent bands. (2) The network structure provides information of variables that are important for the classification, which is not available from conventional classification methods such as neural networks and maximum likelihood classification. In our case, for example, bands 1, 5 and 6 are the most important inputs in determining the land use of each pixel. (3) The networks can be reduced with those input variables important for classification. This minimizes the problem without considering all possible variables. We also examined the effect of incorporating ancillary data: geospatial information such as X and Y coordinate values of each pixel and DEM data, and vegetation indices such as NDVI and Tasseled Cap transformation. The results showed that the locational information improved overall accuracy (81%) and kappa coefficient (76%), and lowered the omission and commission errors compared with using only spectral data (accuracy 71%, kappa coefficient 62%). Incorporating DEM data did not significantly improve overall accuracy (74%) and kappa coefficient (66%) but lowered the omission and commission errors. Incorporating NDVI did not much improve the overall accuracy (72%) and k coefficient (65%). Including Tasseled Cap transformation reduced the accuracy (accuracy 70%, kappa 61%). Therefore, additional information from the DEM and vegetation indices was not useful as locational ancillary data.

  7. Psychological Assessment with the DSM-5 Alternative Model for Personality Disorders: Tradition and Innovation

    PubMed Central

    Waugh, Mark H.; Hopwood, Christopher J.; Krueger, Robert F.; Morey, Leslie C.; Pincus, Aaron L.; Wright, Aidan G. C.

    2016-01-01

    The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) Section III Alternative Model for Personality Disorders (AMPD; APA, 2013) represents an innovative system for simultaneous psychiatric classification and psychological assessment of personality disorders (PD). The AMPD combines major paradigms of personality assessment and provides an original, heuristic, flexible, and practical framework that enriches clinical thinking and practice. Origins, emerging research, and clinical application of the AMPD for diagnosis and psychological assessment are reviewed. The AMPD integrates assessment and research traditions, facilitates case conceptualization, is easy to learn and use, and assists in providing patient feedback. New as well as existing tests and psychometric methods may be used to operationalize the AMPD for clinical assessments. PMID:28450760

  8. Psychological Assessment with the DSM-5 Alternative Model for Personality Disorders: Tradition and Innovation.

    PubMed

    Waugh, Mark H; Hopwood, Christopher J; Krueger, Robert F; Morey, Leslie C; Pincus, Aaron L; Wright, Aidan G C

    2017-04-01

    The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) Section III Alternative Model for Personality Disorders (AMPD; APA, 2013) represents an innovative system for simultaneous psychiatric classification and psychological assessment of personality disorders (PD). The AMPD combines major paradigms of personality assessment and provides an original, heuristic, flexible, and practical framework that enriches clinical thinking and practice. Origins, emerging research, and clinical application of the AMPD for diagnosis and psychological assessment are reviewed. The AMPD integrates assessment and research traditions, facilitates case conceptualization, is easy to learn and use, and assists in providing patient feedback. New as well as existing tests and psychometric methods may be used to operationalize the AMPD for clinical assessments.

  9. Pathohistological classification systems in gastric cancer: Diagnostic relevance and prognostic value

    PubMed Central

    Berlth, Felix; Bollschweiler, Elfriede; Drebber, Uta; Hoelscher, Arnulf H; Moenig, Stefan

    2014-01-01

    Several pathohistological classification systems exist for the diagnosis of gastric cancer. Many studies have investigated the correlation between the pathohistological characteristics in gastric cancer and patient characteristics, disease specific criteria and overall outcome. It is still controversial as to which classification system imparts the most reliable information, and therefore, the choice of system may vary in clinical routine. In addition to the most common classification systems, such as the Laurén and the World Health Organization (WHO) classifications, other authors have tried to characterize and classify gastric cancer based on the microscopic morphology and in reference to the clinical outcome of the patients. In more than 50 years of systematic classification of the pathohistological characteristics of gastric cancer, there is no sole classification system that is consistently used worldwide in diagnostics and research. However, several national guidelines for the treatment of gastric cancer refer to the Laurén or the WHO classifications regarding therapeutic decision-making, which underlines the importance of a reliable classification system for gastric cancer. The latest results from gastric cancer studies indicate that it might be useful to integrate DNA- and RNA-based features of gastric cancer into the classification systems to establish prognostic relevance. This article reviews the diagnostic relevance and the prognostic value of different pathohistological classification systems in gastric cancer. PMID:24914328

  10. Proposal for a new risk stratification classification for meningioma based on patient age, WHO tumor grade, size, localization, and karyotype

    PubMed Central

    Domingues, Patrícia Henriques; Sousa, Pablo; Otero, Álvaro; Gonçalves, Jesus Maria; Ruiz, Laura; de Oliveira, Catarina; Lopes, Maria Celeste; Orfao, Alberto; Tabernero, Maria Dolores

    2014-01-01

    Background Tumor recurrence remains the major clinical complication of meningiomas, the majority of recurrences occurring among WHO grade I/benign tumors. In the present study, we propose a new scoring system for the prognostic stratification of meningioma patients based on analysis of a large series of meningiomas followed for a median of >5 years. Methods Tumor cytogenetics were systematically investigated by interphase fluorescence in situ hybridization in 302 meningioma samples, and the proposed classification was further validated in an independent series of cases (n = 132) analyzed by high-density (500K) single-nucleotide polymorphism (SNP) arrays. Results Overall, we found an adverse impact on patient relapse-free survival (RFS) for males, presence of brain edema, younger patients (<55 years), tumor size >50 mm, tumor localization at intraventricular and anterior cranial base areas, WHO grade II/III meningiomas, and complex karyotypes; the latter 5 variables showed an independent predictive value in multivariate analysis. Based on these parameters, a prognostic score was established for each individual case, and patients were stratified into 4 risk categories with significantly different (P < .001) outcomes. These included a good prognosis group, consisting of approximately 20% of cases, that showed a RFS of 100% ± 0% at 10 years and a very poor-prognosis group with a RFS rate of 0% ± 0% at 10 years. The prognostic impact of the scoring system proposed here was also retained when WHO grade I cases were considered separately (P < .001). Conclusions Based on this risk-stratification classification, different strategies may be adopted for follow-up, and eventually also for treatment, of meningioma patients at different risks for relapse. PMID:24536048

  11. Agricultural conservation planning framework: 2. Classification of riparian buffer design types with application to assess and map stream corridors.

    PubMed

    Tomer, M D; Boomer, K M B; Porter, S A; Gelder, B K; James, D E; McLellan, E

    2015-05-01

    A watershed's riparian corridor presents opportunities to stabilize streambanks, intercept runoff, and influence shallow groundwater with riparian buffers. This paper presents a system to classify these riparian opportunities and apply them toward riparian management planning in hydrologic unit code 12 watersheds. In two headwater watersheds from each of three landform regions found in Iowa and Illinois, high-resolution (3-m grid) digital elevation models were analyzed to identify spatial distributions of surface runoff contributions and zones with shallow water tables (SWTs) (within 1.5 m of the channel elevation) along the riparian corridors. Results were tabulated, and a cross classification was applied. Classes of buffers include those primarily placed to (i) trap runoff and sediment, (ii) influence shallow groundwater, (iii) address both runoff and shallow groundwater, and (iv) maintain/improve stream bank stability. Riparian buffers occupying about 2.5% of these six watersheds could effectively intercept runoff contributions from 81 to 94% of the watersheds' contributing areas. However, extents of riparian zones where a narrow buffer (<10 m wide) would adequately intercept runoff but where >25 m width of buffer vegetation could root to a SWT varied according to landform region ( < 0.10). Yet, these wide-SWT riparian zones were widespread and occupied 23 to 53% of the lengths of stream banks among the six watersheds. The wide-SWT setting provides opportunities to reduce dissolved nutrients (particularly NO-N) carried via groundwater. This riparian classification and mapping system is part of a ArcGIS toolbox and could provide a consistent basis to identify riparian management opportunities in Midwestern headwater catchments wherever high-resolution elevation data are available. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

  12. Inter-observer agreement for diagnostic classification of esophageal motility disorders defined in high-resolution manometry.

    PubMed

    Fox, M R; Pandolfino, J E; Sweis, R; Sauter, M; Abreu Y Abreu, A T; Anggiansah, A; Bogte, A; Bredenoord, A J; Dengler, W; Elvevi, A; Fruehauf, H; Gellersen, S; Ghosh, S; Gyawali, C P; Heinrich, H; Hemmink, M; Jafari, J; Kaufman, E; Kessing, K; Kwiatek, M; Lubomyr, B; Banasiuk, M; Mion, F; Pérez-de-la-Serna, J; Remes-Troche, J M; Rohof, W; Roman, S; Ruiz-de-León, A; Tutuian, R; Uscinowicz, M; Valdovinos, M A; Vardar, R; Velosa, M; Waśko-Czopnik, D; Weijenborg, P; Wilshire, C; Wright, J; Zerbib, F; Menne, D

    2015-01-01

    High-resolution esophageal manometry (HRM) is a recent development used in the evaluation of esophageal function. Our aim was to assess the inter-observer agreement for diagnosis of esophageal motility disorders using this technology. Practitioners registered on the HRM Working Group website were invited to review and classify (i) 147 individual water swallows and (ii) 40 diagnostic studies comprising 10 swallows using a drop-down menu that followed the Chicago Classification system. Data were presented using a standardized format with pressure contours without a summary of HRM metrics. The sequence of swallows was fixed for each user but randomized between users to avoid sequence bias. Participants were blinded to other entries. (i) Individual swallows were assessed by 18 practitioners (13 institutions). Consensus agreement (≤ 2/18 dissenters) was present for most cases of normal peristalsis and achalasia but not for cases of peristaltic dysmotility. (ii) Diagnostic studies were assessed by 36 practitioners (28 institutions). Overall inter-observer agreement was 'moderate' (kappa 0.51) being 'substantial' (kappa > 0.7) for achalasia type I/II and no lower than 'fair-moderate' (kappa >0.34) for any diagnosis. Overall agreement was somewhat higher among those that had performed >400 studies (n = 9; kappa 0.55) and 'substantial' among experts involved in development of the Chicago Classification system (n = 4; kappa 0.66). This prospective, randomized, and blinded study reports an acceptable level of inter-observer agreement for HRM diagnoses across the full spectrum of esophageal motility disorders for a large group of clinicians working in a range of medical institutions. Suboptimal agreement for diagnosis of peristaltic motility disorders highlights contribution of objective HRM metrics. © 2014 International Society for Diseases of the Esophagus.

  13. High glucose variability is associated with poor neurodevelopmental outcomes in neonatal hypoxic ischemic encephalopathy.

    PubMed

    Al Shafouri, N; Narvey, M; Srinivasan, G; Vallance, J; Hansen, G

    2015-01-01

    In neonatal hypoxic ischemic encephalopathy (HIE), hypo- and hyperglycemia have been associated with poor outcomes. However, glucose variability has not been reported in this population. To examine the association between serum glucose variability within the first 24 hours and two-year neurodevelopmental outcomes in neonates cooled for HIE. In this retrospective cohort study, glucose, clinical and demographic data were documented from 23 term newborns treated with whole body therapeutic hypothermia. Severe neurodevelopmental outcomes from planned two-year assessments were defined as the presence of any one of the following: Gross Motor Function Classification System levels 3 to 5, Bayley III Motor Standard Score <70, Bayley III Language Score <70 and Bayley III Cognitive Standard Score <70. The neurodevelopmental outcomes from 8 of 23 patients were considered severe, and this group demonstrated a significant increase of mean absolute glucose (MAG) change (-0.28 to -0.03, 95% CI, p = 0.032). There were no significant differences between outcome groups with regards to number of patients with hyperglycemic means, one or multiple hypo- or hyperglycemic measurement(s). There were also no differences between both groups with mean glucose, although mean glucose standard deviation was approaching significance. Poor neurodevelopmental outcomes in whole body cooled HIE neonates are significantly associated with MAG changes. This information may be relevant for prognostication and potential management strategies.

  14. 33 CFR 401.80 - Reporting dangerous cargo.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Reporting dangerous cargo. 401.80... dangerous cargo. (a) The master of any explosive vessel or hazardous cargo vessel shall report to a Seaway station, as set out in Schedule III, the nature, quantity, and IMO classification of the dangerous cargo...

  15. 33 CFR 401.80 - Reporting dangerous cargo.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Reporting dangerous cargo. 401.80... dangerous cargo. (a) The master of any explosive vessel or hazardous cargo vessel shall report to a Seaway station, as set out in Schedule III, the nature, quantity, and IMO classification of the dangerous cargo...

  16. 33 CFR 401.80 - Reporting dangerous cargo.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Reporting dangerous cargo. 401.80... dangerous cargo. (a) The master of any explosive vessel or hazardous cargo vessel shall report to a Seaway station, as set out in Schedule III, the nature, quantity, and IMO classification of the dangerous cargo...

  17. 33 CFR 401.80 - Reporting dangerous cargo.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Reporting dangerous cargo. 401.80... dangerous cargo. (a) The master of any explosive vessel or hazardous cargo vessel shall report to a Seaway station, as set out in Schedule III, the nature, quantity, and IMO classification of the dangerous cargo...

  18. 33 CFR 401.80 - Reporting dangerous cargo.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Reporting dangerous cargo. 401.80... dangerous cargo. (a) The master of any explosive vessel or hazardous cargo vessel shall report to a Seaway station, as set out in Schedule III, the nature, quantity, and IMO classification of the dangerous cargo...

  19. Bibliography of Soviet Laser Developments, Number 58, March-April 1982.

    DTIC Science & Technology

    1983-05-01

    generation and diagnostics . DD IA7 1473 EOITION OF I NOV A OSOLETE UNCLASSIFIED SECURITY CLASSIFICATION OF THIS PAGE (When Does Entered) Introduction...10 C. He-Kr............................................. 10 iv 2. Molecular Beam and lIon a. C02...104 K. Plasma Generation and Diagnostics ....................... 105 III. MONOGRAPHS, BOOKS, CONFERENCE PROCEEDINGS................... 113

  20. 33 CFR Schedule III to Subpart A... - Calling-in Table

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 1. Name of vessel.2. Location. 3. ETA Cape Vincent or River Port. 15. Whale back Shoal—Con ......do... transiting from the Lower St. Lawrence River Seaway Beauharnois, channel 14 1. Name of vessel.2. Location. 3... classification; location where dangerous cargo is stowed. 7. Pilot requirement—Lake Ontario. 8. Confirm pilot...

  1. 33 CFR Schedule III to Subpart A... - Calling-in Table

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 1. Name of vessel.2. Location. 3. ETA Cape Vincent or River Port. 15. Whale back Shoal—Con ......do... transiting from the Lower St. Lawrence River Seaway Beauharnois, channel 14 1. Name of vessel.2. Location. 3... classification; location where dangerous cargo is stowed. 7. Pilot requirement—Lake Ontario. 8. Confirm pilot...

  2. 33 CFR Schedule III to Subpart A... - Calling-in Table

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 1. Name of vessel.2. Location. 3. ETA Cape Vincent or River Port. 15. Whale back Shoal—Con ......do... transiting from the Lower St. Lawrence River Seaway Beauharnois, channel 14 1. Name of vessel.2. Location. 3... classification; location where dangerous cargo is stowed. 7. Pilot requirement—Lake Ontario. 8. Confirm pilot...

  3. 33 CFR Schedule III to Subpart A... - Calling-in Table

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 1. Name of vessel.2. Location. 3. ETA Cape Vincent or River Port. 15. Whale back Shoal—Con ......do... transiting from the Lower St. Lawrence River Seaway Beauharnois, channel 14 1. Name of vessel.2. Location. 3... classification; location where dangerous cargo is stowed. 7. Pilot requirement—Lake Ontario. 8. Confirm pilot...

  4. 14 CFR Section 11 - Functional Classification-Operating Expenses of Group II and Group III Air Carriers

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...) This function shall include expenses incurred directly in the in-flight operation of aircraft and... assignment to an in-flight status. (b) This function shall not include expenses incurred in repairing, servicing or storing aircraft, expenses incurred on the ground in protecting and controlling the in-flight...

  5. 14 CFR Section 11 - Functional Classification-Operating Expenses of Group II and Group III Air Carriers

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...) This function shall include expenses incurred directly in the in-flight operation of aircraft and... assignment to an in-flight status. (b) This function shall not include expenses incurred in repairing, servicing or storing aircraft, expenses incurred on the ground in protecting and controlling the in-flight...

  6. 14 CFR 11 - Functional Classification-Operating Expenses of Group II and Group III Air Carriers

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Operations. (a) This function shall include expenses incurred directly in the in-flight operation of aircraft... assignment to an in-flight status. (b) This function shall not include expenses incurred in repairing, servicing or storing aircraft, expenses incurred on the ground in protecting and controlling the in-flight...

  7. 14 CFR Section 11 - Functional Classification-Operating Expenses of Group II and Group III Air Carriers

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...) This function shall include expenses incurred directly in the in-flight operation of aircraft and... assignment to an in-flight status. (b) This function shall not include expenses incurred in repairing, servicing or storing aircraft, expenses incurred on the ground in protecting and controlling the in-flight...

  8. 14 CFR Section 11 - Functional Classification-Operating Expenses of Group II and Group III Air Carriers

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ...) This function shall include expenses incurred directly in the in-flight operation of aircraft and... assignment to an in-flight status. (b) This function shall not include expenses incurred in repairing, servicing or storing aircraft, expenses incurred on the ground in protecting and controlling the in-flight...

  9. 9 CFR 145.83 - Terminology and classification; flocks and products.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... manufacturing process; (B) Mash feed may contain animal protein if the finished feed is treated with a salmonella control product approved by the U.S. Food and Drug Administration. (C) All feed is stored and transported in such a manner as to prevent possible contamination. (iii) The flock is maintained in compliance...

  10. 77 FR 40261 - The Interagency Security Classification Appeals Panel (ISCAP) Bylaws, Rules, and Appeal Procedures

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-09

    ... in order to fulfill the Panel's functions. (d) Member vacancies. Vacancies among the primary members... (Article I). 2003.2 Authority (Article II). 2003.3 Functions (Article III). 2003.4 Membership (Article IV... section 3.5 of the Order. 2003.14 Dissemination of ISCAP decisions. 2003.15 Additional functions...

  11. NCCN Guidelines Insights: Central Nervous System Cancers, Version 1.2017.

    PubMed

    Nabors, Louis Burt; Portnow, Jana; Ammirati, Mario; Baehring, Joachim; Brem, Henry; Butowski, Nicholas; Fenstermaker, Robert A; Forsyth, Peter; Hattangadi-Gluth, Jona; Holdhoff, Matthias; Howard, Steven; Junck, Larry; Kaley, Thomas; Kumthekar, Priya; Loeffler, Jay S; Moots, Paul L; Mrugala, Maciej M; Nagpal, Seema; Pandey, Manjari; Parney, Ian; Peters, Katherine; Puduvalli, Vinay K; Ragsdale, John; Rockhill, Jason; Rogers, Lisa; Rusthoven, Chad; Shonka, Nicole; Shrieve, Dennis C; Sills, Allen K; Swinnen, Lode J; Tsien, Christina; Weiss, Stephanie; Wen, Patrick Yung; Willmarth, Nicole; Bergman, Mary Anne; Engh, Anita

    2017-11-01

    For many years, the diagnosis and classification of gliomas have been based on histology. Although studies including large populations of patients demonstrated the prognostic value of histologic phenotype, variability in outcomes within histologic groups limited the utility of this system. Nonetheless, histology was the only proven and widely accessible tool available at the time, thus it was used for clinical trial entry criteria, and therefore determined the recommended treatment options. Research to identify molecular changes that underlie glioma progression has led to the discovery of molecular features that have greater diagnostic and prognostic value than histology. Analyses of these molecular markers across populations from randomized clinical trials have shown that some of these markers are also predictive of response to specific types of treatment, which has prompted significant changes to the recommended treatment options for grade III (anaplastic) gliomas. Copyright © 2017 by the National Comprehensive Cancer Network.

  12. [Tossy III injuries of the acromioclavicular joint. In what circumstances is surgery still justified? Personal results and literature review].

    PubMed

    Prokop, A; Helling, H J; Andermahr, J; Mönig, S; Rehm, K E

    2003-05-01

    In Germany AC-joint-dislocations type Tossy III are treated in most of the cases operatively. Over two times of period we treated AC-joint-dislocations type Tossy III with biodegradable PDS-cords. 54 patients were operated between 1989 and 1997 and followed up after 39 months. 87.5% of patients are satisfied with results and have 10.2 points at Taftscore. In this period we couldn't differentiated the results by Rockwood classification. 12 patients with Rockwood V were operated between 1998 and 2002 and followed up after 14 months. Excellent and good results were seen in 92% of cases. At Taftscore we seen 10.7 points. 3 patients with Rockwood III were treated conservative with 10.3 points and 3 patients were operated with 10.7 points at Taftscore. AC-joint dislocations should be classified to Rockwood. No differences were seen between operation and conservative treatment in Rockwood III in literature. We recommend operation with PDS cords with good results in Rockwood V.

  13. PubMed

    Di Mare, Valerio; Garramone, Gaetano; Rubbiani, Maristella; Moretto, Angelo

    2017-02-15

    Hazard classification of chemicals can be defined as a logic-mathematical operation aimed at identifying the type and severity of the inherent hazards of a substance or a mixture. The purpose of this study was to evaluate, in 134 safety data sheets (SDSs): i) the hazard classification and ii) its coherence with sections 9 (physical-chemical properties), 11 (toxicological properties) and 12 (ecological properties) of the SDSs. Hazard classification and the information provided in sections 9, 11 and 12 of the SDSs have been evaluated against the criteria provided in annexes VI of the Dangerous Substance Directive, II and III of the Dangerous Preparations Directive, I and VI of the Regulation (EC) n. 1272/2008. Most of the analyzed SDSs of substances (62%) was associated to non-classified chemicals (61.4%), although 19.6% of them should have been classified. By contrast, 59.4% of classified substances (representing 38.6% of analyzed ones) were wrongly classified. Fifty-four %, 54% and 67% of suggested substances hazard classification were in line with sections 9 (physical-chemical properties), 11 (toxicological properties) and 12 (ecological properties). The proportion of hazard classification mistakes in SDS was significant, suggesting the need of more qualified experts to derive classification. The introduction of an ad hoc evaluation team, managed by a single, qualified specialist, could represent a solution to ensure the needed improvement of SDSs quality.

  14. Contextual Classification of Point Cloud Data by Exploiting Individual 3d Neigbourhoods

    NASA Astrophysics Data System (ADS)

    Weinmann, M.; Schmidt, A.; Mallet, C.; Hinz, S.; Rottensteiner, F.; Jutzi, B.

    2015-03-01

    The fully automated analysis of 3D point clouds is of great importance in photogrammetry, remote sensing and computer vision. For reliably extracting objects such as buildings, road inventory or vegetation, many approaches rely on the results of a point cloud classification, where each 3D point is assigned a respective semantic class label. Such an assignment, in turn, typically involves statistical methods for feature extraction and machine learning. Whereas the different components in the processing workflow have extensively, but separately been investigated in recent years, the respective connection by sharing the results of crucial tasks across all components has not yet been addressed. This connection not only encapsulates the interrelated issues of neighborhood selection and feature extraction, but also the issue of how to involve spatial context in the classification step. In this paper, we present a novel and generic approach for 3D scene analysis which relies on (i) individually optimized 3D neighborhoods for (ii) the extraction of distinctive geometric features and (iii) the contextual classification of point cloud data. For a labeled benchmark dataset, we demonstrate the beneficial impact of involving contextual information in the classification process and that using individual 3D neighborhoods of optimal size significantly increases the quality of the results for both pointwise and contextual classification.

  15. Towards affordable biomarkers of frontotemporal dementia: A classification study via network's information sharing.

    PubMed

    Dottori, Martin; Sedeño, Lucas; Martorell Caro, Miguel; Alifano, Florencia; Hesse, Eugenia; Mikulan, Ezequiel; García, Adolfo M; Ruiz-Tagle, Amparo; Lillo, Patricia; Slachevsky, Andrea; Serrano, Cecilia; Fraiman, Daniel; Ibanez, Agustin

    2017-06-19

    Developing effective and affordable biomarkers for dementias is critical given the difficulty to achieve early diagnosis. In this sense, electroencephalographic (EEG) methods offer promising alternatives due to their low cost, portability, and growing robustness. Here, we relied on EEG signals and a novel information-sharing method to study resting-state connectivity in patients with behavioral variant frontotemporal dementia (bvFTD) and controls. To evaluate the specificity of our results, we also tested Alzheimer's disease (AD) patients. The classification power of the ensuing connectivity patterns was evaluated through a supervised classification algorithm (support vector machine). In addition, we compared the classification power yielded by (i) functional connectivity, (ii) relevant neuropsychological tests, and (iii) a combination of both. BvFTD patients exhibited a specific pattern of hypoconnectivity in mid-range frontotemporal links, which showed no alterations in AD patients. These functional connectivity alterations in bvFTD were replicated with a low-density EEG setting (20 electrodes). Moreover, while neuropsychological tests yielded acceptable discrimination between bvFTD and controls, the addition of connectivity results improved classification power. Finally, classification between bvFTD and AD patients was better when based on connectivity than on neuropsychological measures. Taken together, such findings underscore the relevance of EEG measures as potential biomarker signatures for clinical settings.

  16. Outer-disk reddening and gas-phase metallicities: The CALIFA connection

    NASA Astrophysics Data System (ADS)

    Marino, R. A.; Gil de Paz, A.; Sánchez, S. F.; Sánchez-Blázquez, P.; Cardiel, N.; Castillo-Morales, A.; Pascual, S.; Vílchez, J.; Kehrig, C.; Mollá, M.; Mendez-Abreu, J.; Catalán-Torrecilla, C.; Florido, E.; Perez, I.; Ruiz-Lara, T.; Ellis, S.; López-Sánchez, A. R.; González Delgado, R. M.; de Lorenzo-Cáceres, A.; García-Benito, R.; Galbany, L.; Zibetti, S.; Cortijo, C.; Kalinova, V.; Mast, D.; Iglesias-Páramo, J.; Papaderos, P.; Walcher, C. J.; Bland-Hawthorn, J.

    2016-01-01

    We study, for the first time in a statistically significant and well-defined sample, the relation between the outer-disk ionized-gas metallicity gradients and the presence of breaks in the surface brightness profiles of disk galaxies. Sloan Digital Sky Survey (SDSS) g'- and r'-band surface brightness, (g' - r') color, and ionized-gasoxygen abundance profiles for 324 galaxies within the Calar Alto Legacy Integral Field Area (CALIFA) survey are used for this purpose. We perform a detailed light-profile classification, finding that 84% of our disks show down- or up-bending profiles (Type II and Type III, respectively), while the remaining 16% are well fitted by one single exponential (Type I). The analysis of the color gradients at both sides of this break shows a U-shaped profile for most Type II galaxies with an average minimum (g' - r') color of ~0.5 mag and an ionized-gas metallicity flattening associated with it only in the case of low-mass galaxies. Comparatively, more massive systems show a rather uniform negative metallicity gradient. The correlation between metallicity flattening and stellar mass for these systems results in p-values as low as 0.01. Independent of the mechanism having shaped the outer light profiles of these galaxies, stellar migration or a previous episode of star formation in a shrinking star-forming disk, it is clear that the imprint in their ionized-gas metallicity was different for low- and high-mass Type II galaxies. In the case of Type III disks, a positive correlation between the change in color and abundance gradient is found (the null hypothesis is ruled out with a p-value of 0.02), with the outer disks of Type III galaxies with masses ≤1010 M⊙ showing a weak color reddening or even a bluing. This is interpreted as primarily due to a mass downsizing effect on the population of Type III galaxies that recently experienced an enhanced inside-out growth.

  17. How should children with speech sound disorders be classified? A review and critical evaluation of current classification systems.

    PubMed

    Waring, R; Knight, R

    2013-01-01

    Children with speech sound disorders (SSD) form a heterogeneous group who differ in terms of the severity of their condition, underlying cause, speech errors, involvement of other aspects of the linguistic system and treatment response. To date there is no universal and agreed-upon classification system. Instead, a number of theoretically differing classification systems have been proposed based on either an aetiological (medical) approach, a descriptive-linguistic approach or a processing approach. To describe and review the supporting evidence, and to provide a critical evaluation of the current childhood SSD classification systems. Descriptions of the major specific approaches to classification are reviewed and research papers supporting the reliability and validity of the systems are evaluated. Three specific paediatric SSD classification systems; the aetiologic-based Speech Disorders Classification System, the descriptive-linguistic Differential Diagnosis system, and the processing-based Psycholinguistic Framework are identified as potentially useful in classifying children with SSD into homogeneous subgroups. The Differential Diagnosis system has a growing body of empirical support from clinical population studies, across language error pattern studies and treatment efficacy studies. The Speech Disorders Classification System is currently a research tool with eight proposed subgroups. The Psycholinguistic Framework is a potential bridge to linking cause and surface level speech errors. There is a need for a universally agreed-upon classification system that is useful to clinicians and researchers. The resulting classification system needs to be robust, reliable and valid. A universal classification system would allow for improved tailoring of treatments to subgroups of SSD which may, in turn, lead to improved treatment efficacy. © 2012 Royal College of Speech and Language Therapists.

  18. FICE in Predicting Colorectal Flat Lesion Histology.

    PubMed

    Akarsu, Cevher; Sahbaz, Nuri A; Dural, Ahmet C; Kones, Osman; Binboga, Sinan; Kabuli, Hamit A; Gumusoglu, Alpen Y; Alis, Halil

    2017-01-01

    Colonoscopy is the gold standard for detection of polyps and is preventive against colorectal cancers. Flat adenomas are small, superficial lesions and have a high rate of going undetected during conventional white-light endoscopy. This article adds to the scant body of literature in English regarding in vivo detection and diagnosis of flat adenomas using Fujinon intelligent color enhancement (FICE) system. In this study, we investigated the diagnosis of flat lesions via the FICE endoscopy system and in vivo histologic diagnostic estimations of flat lesions. This prospective study was conducted in patients who underwent colonoscopy that found flat adenomas. Lesions were classified morphologically with regard to the Paris Classification and sent for histopathologic examination after in vivo histologic diagnostic estimations were made according to Kudo's pit pattern classification. The positive predictive value (PPV), negative predictive value (NPV), specificity, sensitivity, and accuracy of in vivo endoscopic diagnostic estimations of flat lesions with the FICE system were analyzed. A total of 217 flat lesions were identified in 137 patients. Of the lesions, 85.7% were Paris type 0-IIa, and 59.4% were Kudo pit pattern type III. When the FICE diagnostic estimations of flat lesions and final pathology results were considered, PPV was 68.5%, NPV value was 89.6%, sensitivity was 94.7%, specificity was 50.9%, and accuracy was 74.2%. Biologic importance of flat lesions is obscure, as they are usually missed during colonoscopy. The use of novel endoscopic techniques may improve their detection and diagnosis rates.

  19. 5 CFR 9701.231 - Conversion of positions and employees to the DHS classification system.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... the DHS classification system. 9701.231 Section 9701.231 Administrative Personnel DEPARTMENT OF... MANAGEMENT) DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM Classification Transitional Provisions § 9701.231 Conversion of positions and employees to the DHS classification system. (a) This...

  20. Molecular Diagnostics of Gliomas Using Next Generation Sequencing of a Glioma-Tailored Gene Panel.

    PubMed

    Zacher, Angela; Kaulich, Kerstin; Stepanow, Stefanie; Wolter, Marietta; Köhrer, Karl; Felsberg, Jörg; Malzkorn, Bastian; Reifenberger, Guido

    2017-03-01

    Current classification of gliomas is based on histological criteria according to the World Health Organization (WHO) classification of tumors of the central nervous system. Over the past years, characteristic genetic profiles have been identified in various glioma types. These can refine tumor diagnostics and provide important prognostic and predictive information. We report on the establishment and validation of gene panel next generation sequencing (NGS) for the molecular diagnostics of gliomas. We designed a glioma-tailored gene panel covering 660 amplicons derived from 20 genes frequently aberrant in different glioma types. Sensitivity and specificity of glioma gene panel NGS for detection of DNA sequence variants and copy number changes were validated by single gene analyses. NGS-based mutation detection was optimized for application on formalin-fixed paraffin-embedded tissue specimens including small stereotactic biopsy samples. NGS data obtained in a retrospective analysis of 121 gliomas allowed for their molecular classification into distinct biological groups, including (i) isocitrate dehydrogenase gene (IDH) 1 or 2 mutant astrocytic gliomas with frequent α-thalassemia/mental retardation syndrome X-linked (ATRX) and tumor protein p53 (TP53) gene mutations, (ii) IDH mutant oligodendroglial tumors with 1p/19q codeletion, telomerase reverse transcriptase (TERT) promoter mutation and frequent Drosophila homolog of capicua (CIC) gene mutation, as well as (iii) IDH wildtype glioblastomas with frequent TERT promoter mutation, phosphatase and tensin homolog (PTEN) mutation and/or epidermal growth factor receptor (EGFR) amplification. Oligoastrocytic gliomas were genetically assigned to either of these groups. Our findings implicate gene panel NGS as a promising diagnostic technique that may facilitate integrated histological and molecular glioma classification. © 2016 International Society of Neuropathology.

Top