Empirically Understanding Can Make Problems Go Away: The Case of the Chinese Room

ERIC Educational Resources Information Center

Overskeid, Geir

2005-01-01

The many authors debating whether computers can understand often fail to clarify what understanding is, and no agreement exists on this important issue. In his Chinese room argument, Searle (1980) claims that computers running formal programs can never understand. I discuss Searle's claim based on a definition of understanding that is empirical,…

Computed tomography of the anterior mediastinum in myasthemia gravis: a radiologic-pathologic correlative study

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

Fon, G.T.; Bein, M.E.; Mancuso, A.A.

1982-01-01

Chest radiographs and computed tomographic (CT) scans of the mediastinum were correlated with pathologic findings of the thymus following thymectomy in 57 patients with myasthenia gravis. Based on the patient's age and the overall morphology of the anterior mediastinum, CT scans were assigned one of four grades in an attempt to predict thymus pathologic findings. Using this grading, 14 of 16 cases of thymoma were suspected or definitely diagnosed. One of the two cases not diagnosed on CT was a microscopic tumor. There were no false-positive diagnoses in 11 cases graded as definitely thymoma. We conclude that thymoma can bemore » sensitively diagnosed in patients older than 40 years of age. However, thymoma cannot be predicted with a high level of confidence in patients younger than 40 because of the difficulty in differentiating normal thymus or hyperplasia from thymoma. Recommendations for the use of CT in the preoperative evaluation of myasthenic patients are presented.« less

Digital Workflow for Computer-Guided Implant Surgery in Edentulous Patients: A Case Report.

PubMed

Oh, Ji-Hyeon; An, Xueyin; Jeong, Seung-Mi; Choi, Byung-Ho

2017-12-01

The purpose of this article was to describe a fully digital workflow used to perform computer-guided flapless implant placement in an edentulous patient without the use of conventional impressions, models, or a radiographic guide. Digital data for the workflow were acquired using an intraoral scanner and cone-beam computed tomography (CBCT). The image fusion of the intraoral scan data and CBCT data was performed by matching resin markers placed in the patient's mouth. The definitive digital data were used to design a prosthetically driven implant position, surgical template, and computer-aided design and computer-aided manufacturing fabricated fixed dental prosthesis. The authors believe this is the first published case describing such a technique in computer-guided flapless implant surgery for edentulous patients. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

18F-FDG positron emission tomography/computed tomography in infective endocarditis.

PubMed

Salomäki, Soile Pauliina; Saraste, Antti; Kemppainen, Jukka; Bax, Jeroen J; Knuuti, Juhani; Nuutila, Pirjo; Seppänen, Marko; Roivainen, Anne; Airaksinen, Juhani; Pirilä, Laura; Oksi, Jarmo; Hohenthal, Ulla

2017-02-01

The diagnosis of infective endocarditis (IE), especially the diagnosis of prosthetic valve endocarditis (PVE) is challenging since echocardiographic findings are often scarce in the early phase of the disease. We studied the use of 2-[ 18 F]fluoro-2-deoxy-D-glucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) in IE. Sixteen patients with suspected PVE and 7 patients with NVE underwent visual evaluation of 18 F-FDG-PET/CT. 18 F-FDG uptake was measured also semiquantitatively as maximum standardized uptake value (SUV max ) and target-to-background ratio (TBR). The modified Duke criteria were used as a reference. There was strong, focal 18 F-FDG uptake in the area of the affected valve in all 6 cases of definite PVE, in 3 of 5 possible PVE cases, and in 2 of 5 rejected cases. In all patients with definite PVE, SUV max of the affected valve was higher than 4 and TBR higher than 1.8. In contrast to PVE, only 1 of 7 patients with NVE had uptake of 18 F-FDG by PET/CT in the valve area. Embolic infectious foci were detected in 58% of the patients with definite IE. 18 F-FDG-PET/CT appears to be a sensitive method for the detection of paravalvular infection associated with PVE. Instead, the sensitivity of PET/CT is limited in NVE.

GEODYN system description, volume 1. [computer program for estimation of orbit and geodetic parameters

NASA Technical Reports Server (NTRS)

Chin, M. M.; Goad, C. C.; Martin, T. V.

1972-01-01

A computer program for the estimation of orbit and geodetic parameters is presented. The areas in which the program is operational are defined. The specific uses of the program are given as: (1) determination of definitive orbits, (2) tracking instrument calibration, (3) satellite operational predictions, and (4) geodetic parameter estimation. The relationship between the various elements in the solution of the orbit and geodetic parameter estimation problem is analyzed. The solution of the problems corresponds to the orbit generation mode in the first case and to the data reduction mode in the second case.

Simulation study of entropy production in the one-dimensional Vlasov system

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

Dai, Zongliang, E-mail: liangliang1223@gmail.com; Wang, Shaojie

2016-07-15

The coarse-grain averaged distribution function of the one-dimensional Vlasov system is obtained by numerical simulation. The entropy productions in cases of the random field, the linear Landau damping, and the bump-on-tail instability are computed with the coarse-grain averaged distribution function. The computed entropy production is converged with increasing length of coarse-grain average. When the distribution function differs slightly from a Maxwellian distribution, the converged value agrees with the result computed by using the definition of thermodynamic entropy. The length of the coarse-grain average to compute the coarse-grain averaged distribution function is discussed.

Software development for safety-critical medical applications

NASA Technical Reports Server (NTRS)

Knight, John C.

1992-01-01

There are many computer-based medical applications in which safety and not reliability is the overriding concern. Reduced, altered, or no functionality of such systems is acceptable as long as no harm is done. A precise, formal definition of what software safety means is essential, however, before any attempt can be made to achieve it. Without this definition, it is not possible to determine whether a specific software entity is safe. A set of definitions pertaining to software safety will be presented and a case study involving an experimental medical device will be described. Some new techniques aimed at improving software safety will also be discussed.

Computed tomography in cases of coccidioidal meningitis, with clinical correlation

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

Shetter, A.G.; Fischer, D.W.; Flom, R.A.

1985-06-01

Cranial computed tomographic (CT) scans of 22 patients with coccidioidal meningitis were reviewed and their clinical course was analyzed. Abnormalities of the ventricular system or the basilar cisterns or both were present in 16 instances. Although it is not a definitive diagnostic tool, the CT scan is helpful in suggesting a diagnosis of coccidioidal meningitis and in predicting the prognosis of patients affected by the disease. 19 references, 4 figures, 2 tables.

Concordance of clinical diagnosis of T classification among physicians for locally advanced unresectable thoracic esophageal cancer.

PubMed

Yokota, Tomoya; Yasuda, Takushi; Kato, Hiroyuki; Nozaki, Isao; Sato, Hiroshi; Miyata, Yoshinori; Kuroki, Yoshifumi; Kato, Ken; Hamamoto, Yasuo; Tsubosa, Yasuhiro; Ogawa, Hirofumi; Ito, Yoshinori; Kitagawa, Yuko

2018-02-01

We conducted a multicenter phase II trial assessing chemoselection with docetaxel plus 5-fluorouracil and cisplatin induction chemotherapy and subsequent conversion surgery for locally advanced, unresectable esophageal cancer. The aim of this study was to validate the concordance of clinical T diagnosis among physicians in the cases of this trial. Computed tomography scans and esophagoscopic images of 48 patients taken at baseline were centrally reviewed by 6 senior physicians with experience in esophageal oncology. Individual reviewers voted for definitive T4, relative T4, relative T3, or definitive T3. Discordant diagnoses between reviewers were resolved by the majority opinion. The reviewers were blinded to patient clinical outcome data and to the vote of the other reviewers. Ninety percent of cases were diagnosed as clinical T4 by investigators, while 33.3-75.0% (median 70.8%) of cases were judged to be T4 by 6 reviewers. Discordant diagnosis between investigators and reviewers occurred in 33% (16/48) of all cases (Cohen's kappa coefficient 0.0519), including 12 cases where curative resection was considered possible (48%, n = 25) and 4 cases where curative resection was considered impossible (17%, n = 23). Critical discordance (one reviewer voted for definitive T3 but the other voted for definitive T4, and vice versa) between reviewers occurred in 0-12.5% of cases (median 2.1%). There were inter-observer variations in clinical diagnosis of the T category of locally advanced, unresectable esophageal cancer. Accurate clinical diagnosis of T classification is required for determining the optimum treatment for each patient.

Proxy case mix measures for nursing homes.

PubMed

Cyr, A B

1983-01-01

Nursing home case mix measures are needed for the same purposes that spurred the intensive development of case mix measures for hospitals: management and planning decisions, organizational performance research, and reimbursement policy analysis. This paper develops and validates a pair of complementary measures that are simple to compute, are easy to interpret, and use generally available data. They are not, however, definitive. A secondary purpose of this paper is thus to galvanize the development of data bases that will give rise to superior case mix measures for nursing homes.

12 CFR 1235.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... or received on a computer network for transmitting messages electronically, and any attachments which... outside sources by a regulated entity or the Office of Finance, related to the conduct of the business of a regulated entity or the Office of Finance (which business, in the case of the Office of Finance...

MULTIVARIATERESIDUES : A Mathematica package for computing multivariate residues

NASA Astrophysics Data System (ADS)

Larsen, Kasper J.; Rietkerk, Robbert

2018-01-01

Multivariate residues appear in many different contexts in theoretical physics and algebraic geometry. In theoretical physics, they for example give the proper definition of generalized-unitarity cuts, and they play a central role in the Grassmannian formulation of the S-matrix by Arkani-Hamed et al. In realistic cases their evaluation can be non-trivial. In this paper we provide a Mathematica package for efficient evaluation of multivariate residues based on methods from computational algebraic geometry.

Refractory septic shock in children: a European Society of Paediatric and Neonatal Intensive Care definition.

PubMed

Morin, Luc; Ray, Samiran; Wilson, Clare; Remy, Solenn; Benissa, Mohamed Rida; Jansen, Nicolaas J G; Javouhey, Etienne; Peters, Mark J; Kneyber, Martin; De Luca, Daniele; Nadel, Simon; Schlapbach, Luregn Jan; Maclaren, Graeme; Tissieres, Pierre

2016-12-01

Although overall paediatric septic shock mortality is decreasing, refractory septic shock (RSS) is still associated with high mortality. A definition for RSS is urgently needed to facilitate earlier identification and treatment. We aim to establish a European society of paediatric and neonatal intensive care (ESPNIC) experts' definition of paediatric RSS. We conducted a two-round Delphi study followed by an observational multicentre retrospective study. One hundred and fourteen paediatric intensivists answered a clinical case-based, two-round Delphi survey, identifying clinical items consistent with RSS. Multivariate analysis of these items in a development single-centre cohort (70 patients, 30 % mortality) facilitated development of RSS definitions based on either a bedside or computed severity score. Both scores were subsequently tested in a validation cohort (six centres, 424 patients, 11.6 % mortality). From the Delphi process, the draft definition included evidence of myocardial dysfunction and high blood lactate levels despite high vasopressor treatment. When assessed in the development population, each item was independently associated with the need for extracorporeal life support (ECLS) or death. Resultant bedside and computed septic shock scores had high discriminative power against the need for ECLS or death, with areas under the receiver operating characteristics curve of 0.920 (95 % CI 0.89-0.94), and 0.956 (95 % CI 0.93-0.97), respectively. RSS defined by a bedside score equal to or higher than 2 and a computed score equal to or higher than 3.5 was associated with a significant increase in mortality. This ESPNIC definition of RSS accurately identifies children with the most severe form of septic shock.

Acoustic power balance in lined ducts

NASA Technical Reports Server (NTRS)

Eversman, W.

1979-01-01

It is shown that the two common definitions of acoustic energy density and intensity in uniform unlined ducts carrying uniform flow are compatible to the extent that both energy densities can be used in an appropriate variational principle to derive the convected wave equation. When the duct walls are lined both energy densities must be modified to account for the wall energy density. This results in a new energy conservation equation which utilizes a modified definition of axial power and accounts for wall dissipation. Computations in specific cases demonstrate the validity of the modified acoustic energy relation.

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

Miller, P E

Tips and case histories on computer use for idea and outline processing: Productivity software to solve problems of idea hierarchy, transitions, and developments is matched to solutions for communicators. One case is text that ranges from methods and procedures to histories and legal definitions of classification for the US Department of Energy. Applications of value to writers, editors, and managers are for research; calendars; creativity; prioritization; idea discovery and manipulation; file and time management; and contents, indexes, and glossaries. 6 refs., 7 figs.

HPC on Competitive Cloud Resources

NASA Astrophysics Data System (ADS)

Bientinesi, Paolo; Iakymchuk, Roman; Napper, Jeff

Computing as a utility has reached the mainstream. Scientists can now easily rent time on large commercial clusters that can be expanded and reduced on-demand in real-time. However, current commercial cloud computing performance falls short of systems specifically designed for scientific applications. Scientific computing needs are quite different from those of the web applications that have been the focus of cloud computing vendors. In this chapter we demonstrate through empirical evaluation the computational efficiency of high-performance numerical applications in a commercial cloud environment when resources are shared under high contention. Using the Linpack benchmark as a case study, we show that cache utilization becomes highly unpredictable and similarly affects computation time. For some problems, not only is it more efficient to underutilize resources, but the solution can be reached sooner in realtime (wall-time). We also show that the smallest, cheapest (64-bit) instance on the studied environment is the best for price to performance ration. In light of the high-contention we witness, we believe that alternative definitions of efficiency for commercial cloud environments should be introduced where strong performance guarantees do not exist. Concepts like average, expected performance and execution time, expected cost to completion, and variance measures--traditionally ignored in the high-performance computing context--now should complement or even substitute the standard definitions of efficiency.

[A Case of Pancreatic Neuroendocrine Tumor with Necrolytic Migratory Erythema].

PubMed

Hijikawa, Takeshi; Kitade, Hiroaki; Yanagida, Hidesuke; Yamada, Masanori; Yoshioka, Kazuhiko; Shijimaya, Takako; Kiyohara, Takahiro; Uemura, Yoshiko; Kon, Masanori

2017-10-01

A 45-year-old man was admitted because of necrolytic migratory erythema. A computed tomographic scan of the abdomen revealed a 4.5cm mass in the tail of the pancreas. We performed distal pancreatectomy and splenectomy, and a definitive diagnosis of pancreatic neuroendocrine tumor(WHO class grade 2)was made histopathologically.

[Duodenal leiomyosarcoma. Apropos of a case].

PubMed

Galliou, G; Nonent, M; Kergastel, I; Le Guyader, J

1995-01-01

The authors report a new case of leiomyosarcoma of the duodenum. The exoluminal growth and the volume of this tumor explain the difficulties of the imaging methods diagnostic. Computed tomography, magnetic resonance imaging and angiography were not sufficient to determine the origin of the tumor. Surgical exposure itself was not conclusive and only pathology provided the definitive diagnosis. We think that endoscopic ultrasonography should be indicated in these submucosal tumors of the duodenum to differentiate them from pancreatic neoplasms.

Patient specific anatomy: the new area of anatomy based on computer science illustrated on liver.

PubMed

Soler, Luc; Mutter, Didier; Pessaux, Patrick; Marescaux, Jacques

2015-01-01

Over the past century, medical imaging has brought a new revolution: internal anatomy of a patient could be seen without any invasive technique. This revolution has highlighted the two main limits of current anatomy: the anatomical description is physician dependent, and the average anatomy is more and more frequently insufficient to describe anatomical variations. These drawbacks can sometimes be so important that they create mistakes but they can be overcome through the use of 3D patient-specific surgical anatomy. In this article, we propose to illustrate such improvement of standard anatomy on liver. We first propose a general scheme allowing to easily compare the four main liver anatomical descriptions by Takasaki, Goldsmith and Woodburne, Bismuth and Couinaud. From this general scheme we propose four rules to apply in order to correct these initial anatomical definitions. Application of these rules allows to correct usual vascular topological mistakes of standard anatomy. We finally validate such correction on a database of 20 clinical cases compared to the 111 clinical cases of a Couinaud article. Out of the 20 images of the database, we note a revealing difference in 14 cases (70%) on at least one important branch of the portal network. Only six cases (30%) do not present a revealing difference between both labellings. We also show that the right portal fissure location on our 20 cases defined between segment V and VI of our anatomical definition is well correlated with the real position described by Couinaud on 111 cases, knowing that the theoretical position was only found in 46 cases out of 111, i.e., 41.44% of cases with the non-corrected Couinaud definition. We have proposed a new anatomical segmentation of the liver based on four main rules to apply in order to correct topological errors of the four main standard segmentations. Our validation clearly illustrates that this new definition corrects the large amount of mistakes created by the current standard definitions, increased by physician interpretation that can vary from one case to another.

Patient specific anatomy: the new area of anatomy based on computer science illustrated on liver

PubMed Central

Mutter, Didier; Pessaux, Patrick; Marescaux, Jacques

2015-01-01

Background Over the past century, medical imaging has brought a new revolution: internal anatomy of a patient could be seen without any invasive technique. This revolution has highlighted the two main limits of current anatomy: the anatomical description is physician dependent, and the average anatomy is more and more frequently insufficient to describe anatomical variations. These drawbacks can sometimes be so important that they create mistakes but they can be overcome through the use of 3D patient-specific surgical anatomy. Methods In this article, we propose to illustrate such improvement of standard anatomy on liver. We first propose a general scheme allowing to easily compare the four main liver anatomical descriptions by Takasaki, Goldsmith and Woodburne, Bismuth and Couinaud. From this general scheme we propose four rules to apply in order to correct these initial anatomical definitions. Application of these rules allows to correct usual vascular topological mistakes of standard anatomy. We finally validate such correction on a database of 20 clinical cases compared to the 111 clinical cases of a Couinaud article. Results Out of the 20 images of the database, we note a revealing difference in 14 cases (70%) on at least one important branch of the portal network. Only six cases (30%) do not present a revealing difference between both labellings. We also show that the right portal fissure location on our 20 cases defined between segment V and VI of our anatomical definition is well correlated with the real position described by Couinaud on 111 cases, knowing that the theoretical position was only found in 46 cases out of 111, i.e., 41.44% of cases with the non-corrected Couinaud definition. Conclusions We have proposed a new anatomical segmentation of the liver based on four main rules to apply in order to correct topological errors of the four main standard segmentations. Our validation clearly illustrates that this new definition corrects the large amount of mistakes created by the current standard definitions, increased by physician interpretation that can vary from one case to another. PMID:29075611

Enhancing Security by System-Level Virtualization in Cloud Computing Environments

NASA Astrophysics Data System (ADS)

Sun, Dawei; Chang, Guiran; Tan, Chunguang; Wang, Xingwei

Many trends are opening up the era of cloud computing, which will reshape the IT industry. Virtualization techniques have become an indispensable ingredient for almost all cloud computing system. By the virtual environments, cloud provider is able to run varieties of operating systems as needed by each cloud user. Virtualization can improve reliability, security, and availability of applications by using consolidation, isolation, and fault tolerance. In addition, it is possible to balance the workloads by using live migration techniques. In this paper, the definition of cloud computing is given; and then the service and deployment models are introduced. An analysis of security issues and challenges in implementation of cloud computing is identified. Moreover, a system-level virtualization case is established to enhance the security of cloud computing environments.

Computational open-channel hydraulics for movable-bed problems

USGS Publications Warehouse

Lai, Chintu; ,

1990-01-01

As a major branch of computational hydraulics, notable advances have been made in numerical modeling of unsteady open-channel flow since the beginning of the computer age. According to the broader definition and scope of 'computational hydraulics,' the basic concepts and technology of modeling unsteady open-channel flow have been systematically studied previously. As a natural extension, computational open-channel hydraulics for movable-bed problems are addressed in this paper. The introduction of the multimode method of characteristics (MMOC) has made the modeling of this class of unsteady flows both practical and effective. New modeling techniques are developed, thereby shedding light on several aspects of computational hydraulics. Some special features of movable-bed channel-flow simulation are discussed here in the same order as given by the author in the fixed-bed case.

[Acute pancreatitis associated with hypercalcaemia].

PubMed

Tun-Abraham, Mauro Enrique; Obregón-Guerrero, Gabriela; Romero-Espinoza, Larry; Valencia-Jiménez, Javier

2015-01-01

Hypercalcaemia due to primary hyperparathyroidism is a rare cause of acute pancreatitis, with a reported prevalence of 1.5 to 8%. There is no clear pathophysiological basis, but elevated parathyroid hormone and high serum calcium levels could be responsible for calcium deposit in the pancreatic ducts and activation of pancreatic enzymes, which may be the main risk factor for developing acute pancreatitis. The aim of this report is to describe four cases. Four cases are reported of severe pancreatitis associated with hypercalcaemia secondary to primary hyperparathyroidism; three of them with complications (two pseudocysts and one pancreatic necrosis). Cervical ultrasound, computed tomography, and scintigraphy using 99mTc-Sestambi, studies showed the parathyroid adenoma. Surgical resection was the definitive treatment in all four cases. None of the patients had recurrent acute pancreatitis events during follow-up. Acute pancreatitis secondary to hypercalcaemia of primary hyperparathyroidism is rare; however, when it occurs it is associated with severe pancreatitis. It is suspected in patients with elevated serum calcium and high parathyroid hormone levels. Imaging techniques such as cervical ultrasound, computed tomography, and scintigraphy using 99mTc-Sestambi, should be performed, to confirm clinical suspicion. Surgical resection is the definitive treatment with excellent results. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

A large and aggressive fibromatosis in the axilla: a rare case report and review of the literature.

PubMed

Duan, Mingyue; Xing, Hua; Wang, Keren; Niu, Chunbo; Jiang, Chengwei; Zhang, Lijuan; Ezzat, Shereen; Zhang, Le

2018-01-01

Aggressive fibromatosis (AF) is a rare benign tumor, which occurs in the deep part of bone and muscle fibrous tissue. Clinical and pathological features can be challenging for definitive diagnosis. Here, we report a rare case of a large AF in the axilla. Interestingly, 18 F-fluorodeoxyglucose-positron emission tomography/computed tomography showed significant increase in standard uptake value. Surgical resection yielded a spindle cell tumor likely of fibromatosis origin which was positive for β-catenin expression.

An efficient method for computation of the manipulator inertia matrix

NASA Technical Reports Server (NTRS)

Fijany, Amir; Bejczy, Antal K.

1989-01-01

An efficient method of computation of the manipulator inertia matrix is presented. Using spatial notations, the method leads to the definition of the composite rigid-body spatial inertia, which is a spatial representation of the notion of augmented body. The previously proposed methods, the physical interpretations leading to their derivation, and their redundancies are analyzed. The proposed method achieves a greater efficiency by eliminating the redundancy in the intrinsic equations as well as by a better choice of coordinate frame for their projection. In this case, removing the redundancy leads to greater efficiency of the computation in both serial and parallel senses.

Tensor Sparse Coding for Positive Definite Matrices.

PubMed

Sivalingam, Ravishankar; Boley, Daniel; Morellas, Vassilios; Papanikolopoulos, Nikos

2013-08-02

In recent years, there has been extensive research on sparse representation of vector-valued signals. In the matrix case, the data points are merely vectorized and treated as vectors thereafter (for e.g., image patches). However, this approach cannot be used for all matrices, as it may destroy the inherent structure of the data. Symmetric positive definite (SPD) matrices constitute one such class of signals, where their implicit structure of positive eigenvalues is lost upon vectorization. This paper proposes a novel sparse coding technique for positive definite matrices, which respects the structure of the Riemannian manifold and preserves the positivity of their eigenvalues, without resorting to vectorization. Synthetic and real-world computer vision experiments with region covariance descriptors demonstrate the need for and the applicability of the new sparse coding model. This work serves to bridge the gap between the sparse modeling paradigm and the space of positive definite matrices.

Tensor sparse coding for positive definite matrices.

PubMed

Sivalingam, Ravishankar; Boley, Daniel; Morellas, Vassilios; Papanikolopoulos, Nikolaos

2014-03-01

In recent years, there has been extensive research on sparse representation of vector-valued signals. In the matrix case, the data points are merely vectorized and treated as vectors thereafter (for example, image patches). However, this approach cannot be used for all matrices, as it may destroy the inherent structure of the data. Symmetric positive definite (SPD) matrices constitute one such class of signals, where their implicit structure of positive eigenvalues is lost upon vectorization. This paper proposes a novel sparse coding technique for positive definite matrices, which respects the structure of the Riemannian manifold and preserves the positivity of their eigenvalues, without resorting to vectorization. Synthetic and real-world computer vision experiments with region covariance descriptors demonstrate the need for and the applicability of the new sparse coding model. This work serves to bridge the gap between the sparse modeling paradigm and the space of positive definite matrices.

A Computer Program for the Calculation of Three-Dimensional Transonic Nacelle/Inlet Flowfields

NASA Technical Reports Server (NTRS)

Vadyak, J.; Atta, E. H.

1983-01-01

A highly efficient computer analysis was developed for predicting transonic nacelle/inlet flowfields. This algorithm can compute the three dimensional transonic flowfield about axisymmetric (or asymmetric) nacelle/inlet configurations at zero or nonzero incidence. The flowfield is determined by solving the full-potential equation in conservative form on a body-fitted curvilinear computational mesh. The difference equations are solved using the AF2 approximate factorization scheme. This report presents a discussion of the computational methods used to both generate the body-fitted curvilinear mesh and to obtain the inviscid flow solution. Computed results and correlations with existing methods and experiment are presented. Also presented are discussions on the organization of the grid generation (NGRIDA) computer program and the flow solution (NACELLE) computer program, descriptions of the respective subroutines, definitions of the required input parameters for both algorithms, a brief discussion on interpretation of the output, and sample cases to illustrate application of the analysis.

Vectorization of linear discrete filtering algorithms

NASA Technical Reports Server (NTRS)

Schiess, J. R.

1977-01-01

Linear filters, including the conventional Kalman filter and versions of square root filters devised by Potter and Carlson, are studied for potential application on streaming computers. The square root filters are known to maintain a positive definite covariance matrix in cases in which the Kalman filter diverges due to ill-conditioning of the matrix. Vectorization of the filters is discussed, and comparisons are made of the number of operations and storage locations required by each filter. The Carlson filter is shown to be the most efficient of the filters on the Control Data STAR-100 computer.

User's manual for the Shuttle Electric Power System analysis computer program (SEPS), volume 2 of program documentation

NASA Technical Reports Server (NTRS)

Bains, R. W.; Herwig, H. A.; Luedeman, J. K.; Torina, E. M.

1974-01-01

The Shuttle Electric Power System Analysis SEPS computer program which performs detailed load analysis including predicting energy demands and consumables requirements of the shuttle electric power system along with parameteric and special case studies on the shuttle electric power system is described. The functional flow diagram of the SEPS program is presented along with data base requirements and formats, procedure and activity definitions, and mission timeline input formats. Distribution circuit input and fixed data requirements are included. Run procedures and deck setups are described.

A computable expression of closure to efficient causation.

PubMed

Mossio, Matteo; Longo, Giuseppe; Stewart, John

2009-04-07

In this paper, we propose a mathematical expression of closure to efficient causation in terms of lambda-calculus; we argue that this opens up the perspective of developing principled computer simulations of systems closed to efficient causation in an appropriate programming language. An important implication of our formulation is that, by exhibiting an expression in lambda-calculus, which is a paradigmatic formalism for computability and programming, we show that there are no conceptual or principled problems in realizing a computer simulation or model of closure to efficient causation. We conclude with a brief discussion of the question whether closure to efficient causation captures all relevant properties of living systems. We suggest that it might not be the case, and that more complex definitions could indeed create crucial some obstacles to computability.

Computational System For Rapid CFD Analysis In Engineering

NASA Technical Reports Server (NTRS)

Barson, Steven L.; Ascoli, Edward P.; Decroix, Michelle E.; Sindir, Munir M.

1995-01-01

Computational system comprising modular hardware and software sub-systems developed to accelerate and facilitate use of techniques of computational fluid dynamics (CFD) in engineering environment. Addresses integration of all aspects of CFD analysis process, including definition of hardware surfaces, generation of computational grids, CFD flow solution, and postprocessing. Incorporates interfaces for integration of all hardware and software tools needed to perform complete CFD analysis. Includes tools for efficient definition of flow geometry, generation of computational grids, computation of flows on grids, and postprocessing of flow data. System accepts geometric input from any of three basic sources: computer-aided design (CAD), computer-aided engineering (CAE), or definition by user.

Intelligent tutoring systems research in the training systems division: Space applications

NASA Technical Reports Server (NTRS)

Regian, J. Wesley

1988-01-01

Computer-Aided Instruction (CAI) is a mature technology used to teach students in a wide variety of domains. The introduction of Artificial Intelligence (AI) technology of the field of CAI has prompted research and development efforts in an area known as Intelligent Computer-Aided Instruction (ICAI). In some cases, ICAI has been touted as a revolutionary alternative to traditional CAI. With the advent of powerful, inexpensive school computers, ICAI is emerging as a potential rival to CAI. In contrast to this, one may conceive of Computer-Based Training (CBT) systems as lying along a continuum which runs from CAI to ICAI. Although the key difference between the two is intelligence, there is not commonly accepted definition of what constitutes an intelligent instructional system.

Development of simulation computer complex specification

NASA Technical Reports Server (NTRS)

1973-01-01

The Training Simulation Computer Complex Study was one of three studies contracted in support of preparations for procurement of a shuttle mission simulator for shuttle crew training. The subject study was concerned with definition of the software loads to be imposed on the computer complex to be associated with the shuttle mission simulator and the development of procurement specifications based on the resulting computer requirements. These procurement specifications cover the computer hardware and system software as well as the data conversion equipment required to interface the computer to the simulator hardware. The development of the necessary hardware and software specifications required the execution of a number of related tasks which included, (1) simulation software sizing, (2) computer requirements definition, (3) data conversion equipment requirements definition, (4) system software requirements definition, (5) a simulation management plan, (6) a background survey, and (7) preparation of the specifications.

The Relation between Order of Acquisition, Segmental Frequency and Function: The Case of Word-Initial Consonants in Dutch

ERIC Educational Resources Information Center

van Severen, Lieve; Gillis, Joris J. M.; Molemans, Inge; van den Berg, Renate; De Maeyer, Sven; Gillis, Steven

2013-01-01

The impact of input frequency (IF) and functional load (FL) of segments in the ambient language on the acquisition order of word-initial consonants is investigated. Several definitions of IF/FL are compared and implemented. The impact of IF/FL and their components are computed using a longitudinal corpus of interactions between thirty…

Possible artifacts in inferring seismic properties from X-ray data

NASA Astrophysics Data System (ADS)

Bosak, A.; Krisch, M.; Chumakov, A.; Abrikosov, I. A.; Dubrovinsky, L.

2016-11-01

We consider the experimental and computational artifacts relevant for the extraction of aggregate elastic properties of polycrystalline materials with particular emphasis on the derivation of seismic velocities. We use the case of iron as an example, and show that the improper use of definitions and neglecting the crystalline anisotropy can result in unexpectedly large errors up to a few percent.

The GRASP 3: Graphical Reliability Analysis Simulation Program. Version 3: A users' manual and modelling guide

NASA Technical Reports Server (NTRS)

Phillips, D. T.; Manseur, B.; Foster, J. W.

1982-01-01

Alternate definitions of system failure create complex analysis for which analytic solutions are available only for simple, special cases. The GRASP methodology is a computer simulation approach for solving all classes of problems in which both failure and repair events are modeled according to the probability laws of the individual components of the system.

Scarce means with alternative uses: robbins' definition of economics and its extension to the behavioral and neurobiological study of animal decision making.

PubMed

Shizgal, Peter

2012-01-01

Almost 80 years ago, Lionel Robbins proposed a highly influential definition of the subject matter of economics: the allocation of scarce means that have alternative ends. Robbins confined his definition to human behavior, and he strove to separate economics from the natural sciences in general and from psychology in particular. Nonetheless, I extend his definition to the behavior of non-human animals, rooting my account in psychological processes and their neural underpinnings. Some historical developments are reviewed that render such a view more plausible today than would have been the case in Robbins' time. To illustrate a neuroeconomic perspective on decision making in non-human animals, I discuss research on the rewarding effect of electrical brain stimulation. Central to this discussion is an empirically based, functional/computational model of how the subjective intensity of the electrical reward is computed and combined with subjective costs so as to determine the allocation of time to the pursuit of reward. Some successes achieved by applying the model are discussed, along with limitations, and evidence is presented regarding the roles played by several different neural populations in processes posited by the model. I present a rationale for marshaling convergent experimental methods to ground psychological and computational processes in the activity of identified neural populations, and I discuss the strengths, weaknesses, and complementarity of the individual approaches. I then sketch some recent developments that hold great promise for advancing our understanding of structure-function relationships in neuroscience in general and in the neuroeconomic study of decision making in particular.

Scarce Means with Alternative Uses: Robbins’ Definition of Economics and Its Extension to the Behavioral and Neurobiological Study of Animal Decision Making

PubMed Central

Shizgal, Peter

2011-01-01

Almost 80 years ago, Lionel Robbins proposed a highly influential definition of the subject matter of economics: the allocation of scarce means that have alternative ends. Robbins confined his definition to human behavior, and he strove to separate economics from the natural sciences in general and from psychology in particular. Nonetheless, I extend his definition to the behavior of non-human animals, rooting my account in psychological processes and their neural underpinnings. Some historical developments are reviewed that render such a view more plausible today than would have been the case in Robbins’ time. To illustrate a neuroeconomic perspective on decision making in non-human animals, I discuss research on the rewarding effect of electrical brain stimulation. Central to this discussion is an empirically based, functional/computational model of how the subjective intensity of the electrical reward is computed and combined with subjective costs so as to determine the allocation of time to the pursuit of reward. Some successes achieved by applying the model are discussed, along with limitations, and evidence is presented regarding the roles played by several different neural populations in processes posited by the model. I present a rationale for marshaling convergent experimental methods to ground psychological and computational processes in the activity of identified neural populations, and I discuss the strengths, weaknesses, and complementarity of the individual approaches. I then sketch some recent developments that hold great promise for advancing our understanding of structure–function relationships in neuroscience in general and in the neuroeconomic study of decision making in particular. PMID:22363253

Unbiased and automated identification of a circulating tumour cell definition that associates with overall survival.

PubMed

Ligthart, Sjoerd T; Coumans, Frank A W; Attard, Gerhardt; Cassidy, Amy Mulick; de Bono, Johann S; Terstappen, Leon W M M

2011-01-01

Circulating tumour cells (CTC) in patients with metastatic carcinomas are associated with poor survival and can be used to guide therapy. Classification of CTC however remains subjective, as they are morphologically heterogeneous. We acquired digital images, using the CellSearch™ system, from blood of 185 castration resistant prostate cancer (CRPC) patients and 68 healthy subjects to define CTC by computer algorithms. Patient survival data was used as the training parameter for the computer to define CTC. The computer-generated CTC definition was validated on a separate CRPC dataset comprising 100 patients. The optimal definition of the computer defined CTC (aCTC) was stricter as compared to the manual CellSearch CTC (mCTC) definition and as a consequence aCTC were less frequent. The computer-generated CTC definition resulted in hazard ratios (HRs) of 2.8 for baseline and 3.9 for follow-up samples, which is comparable to the mCTC definition (baseline HR 2.9, follow-up HR 4.5). Validation resulted in HRs at baseline/follow-up of 3.9/5.4 for computer and 4.8/5.8 for manual definitions. In conclusion, we have defined and validated CTC by clinical outcome using a perfectly reproducing automated algorithm.

On methods of estimating cosmological bulk flows

NASA Astrophysics Data System (ADS)

Nusser, Adi

2016-01-01

We explore similarities and differences between several estimators of the cosmological bulk flow, B, from the observed radial peculiar velocities of galaxies. A distinction is made between two theoretical definitions of B as a dipole moment of the velocity field weighted by a radial window function. One definition involves the three-dimensional (3D) peculiar velocity, while the other is based on its radial component alone. Different methods attempt at inferring B for either of these definitions which coincide only for the case of a velocity field which is constant in space. We focus on the Wiener Filtering (WF) and the Constrained Minimum Variance (CMV) methodologies. Both methodologies require a prior expressed in terms of the radial velocity correlation function. Hoffman et al. compute B in Top-Hat windows from a WF realization of the 3D peculiar velocity field. Feldman et al. infer B directly from the observed velocities for the second definition of B. The WF methodology could easily be adapted to the second definition, in which case it will be equivalent to the CMV with the exception of the imposed constraint. For a prior with vanishing correlations or very noisy data, CMV reproduces the standard Maximum Likelihood estimation for B of the entire sample independent of the radial weighting function. Therefore, this estimator is likely more susceptible to observational biases that could be present in measurements of distant galaxies. Finally, two additional estimators are proposed.

Validation of an Improved Computer-Assisted Technique for Mining Free-Text Electronic Medical Records.

PubMed

Duz, Marco; Marshall, John F; Parkin, Tim

2017-06-29

The use of electronic medical records (EMRs) offers opportunity for clinical epidemiological research. With large EMR databases, automated analysis processes are necessary but require thorough validation before they can be routinely used. The aim of this study was to validate a computer-assisted technique using commercially available content analysis software (SimStat-WordStat v.6 (SS/WS), Provalis Research) for mining free-text EMRs. The dataset used for the validation process included life-long EMRs from 335 patients (17,563 rows of data), selected at random from a larger dataset (141,543 patients, ~2.6 million rows of data) and obtained from 10 equine veterinary practices in the United Kingdom. The ability of the computer-assisted technique to detect rows of data (cases) of colic, renal failure, right dorsal colitis, and non-steroidal anti-inflammatory drug (NSAID) use in the population was compared with manual classification. The first step of the computer-assisted analysis process was the definition of inclusion dictionaries to identify cases, including terms identifying a condition of interest. Words in inclusion dictionaries were selected from the list of all words in the dataset obtained in SS/WS. The second step consisted of defining an exclusion dictionary, including combinations of words to remove cases erroneously classified by the inclusion dictionary alone. The third step was the definition of a reinclusion dictionary to reinclude cases that had been erroneously classified by the exclusion dictionary. Finally, cases obtained by the exclusion dictionary were removed from cases obtained by the inclusion dictionary, and cases from the reinclusion dictionary were subsequently reincluded using Rv3.0.2 (R Foundation for Statistical Computing, Vienna, Austria). Manual analysis was performed as a separate process by a single experienced clinician reading through the dataset once and classifying each row of data based on the interpretation of the free-text notes. Validation was performed by comparison of the computer-assisted method with manual analysis, which was used as the gold standard. Sensitivity, specificity, negative predictive values (NPVs), positive predictive values (PPVs), and F values of the computer-assisted process were calculated by comparing them with the manual classification. Lowest sensitivity, specificity, PPVs, NPVs, and F values were 99.82% (1128/1130), 99.88% (16410/16429), 94.6% (223/239), 100.00% (16410/16412), and 99.0% (100×2×0.983×0.998/[0.983+0.998]), respectively. The computer-assisted process required few seconds to run, although an estimated 30 h were required for dictionary creation. Manual classification required approximately 80 man-hours. The critical step in this work is the creation of accurate and inclusive dictionaries to ensure that no potential cases are missed. It is significantly easier to remove false positive terms from a SS/WS selected subset of a large database than search that original database for potential false negatives. The benefits of using this method are proportional to the size of the dataset to be analyzed. ©Marco Duz, John F Marshall, Tim Parkin. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 29.06.2017.

Validation of an Improved Computer-Assisted Technique for Mining Free-Text Electronic Medical Records

PubMed Central

Marshall, John F; Parkin, Tim

2017-01-01

Background The use of electronic medical records (EMRs) offers opportunity for clinical epidemiological research. With large EMR databases, automated analysis processes are necessary but require thorough validation before they can be routinely used. Objective The aim of this study was to validate a computer-assisted technique using commercially available content analysis software (SimStat-WordStat v.6 (SS/WS), Provalis Research) for mining free-text EMRs. Methods The dataset used for the validation process included life-long EMRs from 335 patients (17,563 rows of data), selected at random from a larger dataset (141,543 patients, ~2.6 million rows of data) and obtained from 10 equine veterinary practices in the United Kingdom. The ability of the computer-assisted technique to detect rows of data (cases) of colic, renal failure, right dorsal colitis, and non-steroidal anti-inflammatory drug (NSAID) use in the population was compared with manual classification. The first step of the computer-assisted analysis process was the definition of inclusion dictionaries to identify cases, including terms identifying a condition of interest. Words in inclusion dictionaries were selected from the list of all words in the dataset obtained in SS/WS. The second step consisted of defining an exclusion dictionary, including combinations of words to remove cases erroneously classified by the inclusion dictionary alone. The third step was the definition of a reinclusion dictionary to reinclude cases that had been erroneously classified by the exclusion dictionary. Finally, cases obtained by the exclusion dictionary were removed from cases obtained by the inclusion dictionary, and cases from the reinclusion dictionary were subsequently reincluded using Rv3.0.2 (R Foundation for Statistical Computing, Vienna, Austria). Manual analysis was performed as a separate process by a single experienced clinician reading through the dataset once and classifying each row of data based on the interpretation of the free-text notes. Validation was performed by comparison of the computer-assisted method with manual analysis, which was used as the gold standard. Sensitivity, specificity, negative predictive values (NPVs), positive predictive values (PPVs), and F values of the computer-assisted process were calculated by comparing them with the manual classification. Results Lowest sensitivity, specificity, PPVs, NPVs, and F values were 99.82% (1128/1130), 99.88% (16410/16429), 94.6% (223/239), 100.00% (16410/16412), and 99.0% (100×2×0.983×0.998/[0.983+0.998]), respectively. The computer-assisted process required few seconds to run, although an estimated 30 h were required for dictionary creation. Manual classification required approximately 80 man-hours. Conclusions The critical step in this work is the creation of accurate and inclusive dictionaries to ensure that no potential cases are missed. It is significantly easier to remove false positive terms from a SS/WS selected subset of a large database than search that original database for potential false negatives. The benefits of using this method are proportional to the size of the dataset to be analyzed. PMID:28663163

A rare case of recurrent ovarian cancer presenting as a round ligament metastasis.

PubMed

Togami, Shinichi; Kato, Tomoyasu; Oi, Takateru; Ishikawa, Mitsuya; Onda, Takashi; Ikeda, Shun-ichi; Kasamatsu, Takahiro

2011-11-07

We report a rare case of recurrent ovarian cancer presenting as a round ligament metastasis. A 44-year-old woman presented with a lower abdominal mass. Computed tomography showed a pelvic mass. Primary surgery was performed. A histopathological examination showed an ovarian serous adenocarcinoma of Stage IIIb. The patient received 6 cycles of paclitaxel and carboplatin. Almost 2 years after the initial operation, the patient noticed a left inguinal mass. Computed tomography showed a left inguinal mass, 18 mm in size. An excisional biopsy was performed and the tumor was found to originate in the left round ligament. A histopathological examination showed serous adenocarcinoma and there was no evidence of lymph node tissue. Recurrence of ovarian cancer in the round ligament is extremely rare. This unique case suggests, however, that the round ligament in rare cases may be a recurrence site for ovarian cancer, and that accurate differentiation including confirmation by diagnostic imaging and excisional biopsy, is necessary for a definitive pathological diagnosis.

Computer work duration and its dependence on the used pause definition.

PubMed

Richter, Janneke M; Slijper, Harm P; Over, Eelco A B; Frens, Maarten A

2008-11-01

Several ergonomic studies have estimated computer work duration using registration software. In these studies, an arbitrary pause definition (Pd; the minimal time between two computer events to constitute a pause) is chosen and the resulting duration of computer work is estimated. In order to uncover the relationship between the used pause definition and the computer work duration (PWT), we used registration software to record usage patterns of 571 computer users across almost 60,000 working days. For a large range of Pds (1-120 s), we found a shallow, log-linear relationship between PWT and Pds. For keyboard and mouse use, a second-order function fitted the data best. We found that these relationships were dependent on the amount of computer work and subject characteristics. Comparison of exposure duration from studies using different pause definitions should take this into account, since it could lead to misclassification. Software manufacturers and ergonomists assessing computer work duration could use the found relationships for software design and study comparison.

A computing method for spatial accessibility based on grid partition

NASA Astrophysics Data System (ADS)

Ma, Linbing; Zhang, Xinchang

2007-06-01

An accessibility computing method and process based on grid partition was put forward in the paper. As two important factors impacting on traffic, density of road network and relative spatial resistance for difference land use was integrated into computing traffic cost in each grid. A* algorithms was inducted to searching optimum traffic cost of grids path, a detailed searching process and definition of heuristic evaluation function was described in the paper. Therefore, the method can be implemented more simply and its data source is obtained more easily. Moreover, by changing heuristic searching information, more reasonable computing result can be obtained. For confirming our research, a software package was developed with C# language under ArcEngine9 environment. Applying the computing method, a case study on accessibility of business districts in Guangzhou city was carried out.

[Computer game addiction: a psychopathological symptom complex in adolescence].

PubMed

Wölfling, Klaus; Thalemann, Ralf; Grüsser-Sinopoli, Sabine M

2008-07-01

Cases of excessive computer gaming are increasingly reported by practitioners in the psychiatric field. Since there is no standardized definition of this symptom complex, the aim of this study is to access excessive computer gaming in German adolescents as an addictive disorder and its potential negative consequences. Psychopathological computer gaming behavior was diagnosed by applying the adapted diagnostic criteria of substance-related-addictions as defined by the ICD-10. At the same time demographic variables, state of clinical anxiety and underlying cognitive mechanisms were analyzed. 6.3 % of the 221 participating pupils - mostly boys with a low educational background - fulfilled the diagnostic criteria of a behavioral addiction. Clinically diagnosed adolescents exhibited limited cognitive flexibility and were identified to utilize computer gaming as a mood management strategy. These results can be interpreted as a first hint for a prevalence estimation of psychopathological computer gaming in German adolescents.

Spatial patterns in electoral wards with high lymphoma incidence in Yorkshire health region.

PubMed Central

Barnes, N.; Cartwright, R. A.; O'Brien, C.; Roberts, B.; Richards, I. D.; Bird, C. C.

1987-01-01

The possibilities of clustering between those electoral wards which display higher than expected incidences of cases of the lymphomas occurring between 1978 and 1982 are examined. Clusters are defined as being those wards with cases in excess (at a probability of less than 10%) which are geographically adjacent to each other. A separate analysis extends the definition of cluster to include high incidence wards that are adjacent or separated by one other ward. The results indicate that many high incidence lymphoma wards do occur close together and when computer simulations are used to compute expected results, many of the observed results are shown to be highly improbable both in the overall number of clustering wards and in the largest number of wards comprising a 'cluster'. PMID:3663469

Neptune Aerocapture Systems Analysis

NASA Technical Reports Server (NTRS)

Lockwood, Mary Kae

2004-01-01

A Neptune Aerocapture Systems Analysis is completed to determine the feasibility, benefit and risk of an aeroshell aerocapture system for Neptune and to identify technology gaps and technology performance goals. The high fidelity systems analysis is completed by a five center NASA team and includes the following disciplines and analyses: science; mission design; aeroshell configuration screening and definition; interplanetary navigation analyses; atmosphere modeling; computational fluid dynamics for aerodynamic performance and database definition; initial stability analyses; guidance development; atmospheric flight simulation; computational fluid dynamics and radiation analyses for aeroheating environment definition; thermal protection system design, concepts and sizing; mass properties; structures; spacecraft design and packaging; and mass sensitivities. Results show that aerocapture can deliver 1.4 times more mass to Neptune orbit than an all-propulsive system for the same launch vehicle. In addition aerocapture results in a 3-4 year reduction in trip time compared to all-propulsive systems. Aerocapture is feasible and performance is adequate for the Neptune aerocapture mission. Monte Carlo simulation results show 100% successful capture for all cases including conservative assumptions on atmosphere and navigation. Enabling technologies for this mission include TPS manufacturing; and aerothermodynamic methods and validation for determining coupled 3-D convection, radiation and ablation aeroheating rates and loads, and the effects on surface recession.

Tabun

MedlinePlus

... Cyanogen chloride (CK) Digitalis Case Definition: Digitalis Poisoning Ethylene glycol Fentanyls and other opioids Case Definition: Opioids ( ... Thallium Toxic alcohols Case Definition: Toxic Alcohol Poisoning Ethylene glycol Trichothecene Case Definition: Trichothecene Mycotoxin Poisoning Unidentified ...

Sarin

MedlinePlus

... Cyanogen chloride (CK) Digitalis Case Definition: Digitalis Poisoning Ethylene glycol Fentanyls and other opioids Case Definition: Opioids ( ... Thallium Toxic alcohols Case Definition: Toxic Alcohol Poisoning Ethylene glycol Trichothecene Case Definition: Trichothecene Mycotoxin Poisoning Unidentified ...

Arsine

MedlinePlus

... Cyanogen chloride (CK) Digitalis Case Definition: Digitalis Poisoning Ethylene glycol Fentanyls and other opioids Case Definition: Opioids ( ... Thallium Toxic alcohols Case Definition: Toxic Alcohol Poisoning Ethylene glycol Trichothecene Case Definition: Trichothecene Mycotoxin Poisoning Unidentified ...

Strychnine

MedlinePlus

... Cyanogen chloride (CK) Digitalis Case Definition: Digitalis Poisoning Ethylene glycol Fentanyls and other opioids Case Definition: Opioids ( ... Thallium Toxic alcohols Case Definition: Toxic Alcohol Poisoning Ethylene glycol Trichothecene Case Definition: Trichothecene Mycotoxin Poisoning Unidentified ...

Phosgene

MedlinePlus

... Cyanogen chloride (CK) Digitalis Case Definition: Digitalis Poisoning Ethylene glycol Fentanyls and other opioids Case Definition: Opioids ( ... Thallium Toxic alcohols Case Definition: Toxic Alcohol Poisoning Ethylene glycol Trichothecene Case Definition: Trichothecene Mycotoxin Poisoning Unidentified ...

Abrin

MedlinePlus

... Cyanogen chloride (CK) Digitalis Case Definition: Digitalis Poisoning Ethylene glycol Fentanyls and other opioids Case Definition: Opioids ( ... Thallium Toxic alcohols Case Definition: Toxic Alcohol Poisoning Ethylene glycol Trichothecene Case Definition: Trichothecene Mycotoxin Poisoning Unidentified ...

Soman

MedlinePlus

... Cyanogen chloride (CK) Digitalis Case Definition: Digitalis Poisoning Ethylene glycol Fentanyls and other opioids Case Definition: Opioids ( ... Thallium Toxic alcohols Case Definition: Toxic Alcohol Poisoning Ethylene glycol Trichothecene Case Definition: Trichothecene Mycotoxin Poisoning Unidentified ...

Ricin

MedlinePlus

... Cyanogen chloride (CK) Digitalis Case Definition: Digitalis Poisoning Ethylene glycol Fentanyls and other opioids Case Definition: Opioids ( ... Thallium Toxic alcohols Case Definition: Toxic Alcohol Poisoning Ethylene glycol Trichothecene Case Definition: Trichothecene Mycotoxin Poisoning Unidentified ...

7 CFR 3203.3 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... described in paragraph (1) of this definition. Computers or other technical equipment means central... 7 Agriculture 15 2013-01-01 2013-01-01 false Definitions. 3203.3 Section 3203.3 Agriculture..., DEPARTMENT OF AGRICULTURE GUIDELINES FOR THE TRANSFER OF EXCESS COMPUTERS OR OTHER TECHNICAL EQUIPMENT...

48 CFR 23.701 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Definitions. 23.701... DRUG-FREE WORKPLACE Contracting for Environmentally Preferable Products and Services 23.701 Definitions. As used in this subpart— Computer monitor means a video display unit used with a computer. Desktop...

Presentation of idiopathic retroperitoneal fibrosis at a young age: A rare case report.

PubMed

Minocha, Priyanka; Setia, Ankur

2016-11-01

Abdominal pain is a very common symptom in all age groups but retroperitoneal fibrosis is a rare differential diagnosis suspected in young patients presenting with nonspecific abdominal pain and symptoms of obstructive uropathy. Presented here is a case of a 16-year-old boy who presented with symptoms of persistent abdominal pain and a previous history of swelling in the left leg. A computed tomography (CT) scan suggested retroperitoneal fibrosis and an exploratory laparotomy and histopathological examination were performed for definitive diagnosis. This case report is intended to promote awareness of retroperitoneal fibrosis in young patients among health care providers.

Nitrogen Mustards

MedlinePlus

... Cyanogen chloride (CK) Digitalis Case Definition: Digitalis Poisoning Ethylene glycol Fentanyls and other opioids Case Definition: Opioids ( ... Thallium Toxic alcohols Case Definition: Toxic Alcohol Poisoning Ethylene glycol Trichothecene Case Definition: Trichothecene Mycotoxin Poisoning Unidentified ...

Sodium Azide

MedlinePlus

... Cyanogen chloride (CK) Digitalis Case Definition: Digitalis Poisoning Ethylene glycol Fentanyls and other opioids Case Definition: Opioids ( ... Thallium Toxic alcohols Case Definition: Toxic Alcohol Poisoning Ethylene glycol Trichothecene Case Definition: Trichothecene Mycotoxin Poisoning Unidentified ...

Sulfur Mustard

MedlinePlus

... Cyanogen chloride (CK) Digitalis Case Definition: Digitalis Poisoning Ethylene glycol Fentanyls and other opioids Case Definition: Opioids ( ... Thallium Toxic alcohols Case Definition: Toxic Alcohol Poisoning Ethylene glycol Trichothecene Case Definition: Trichothecene Mycotoxin Poisoning Unidentified ...

Pneumonic Plague

MedlinePlus

... Cyanogen chloride (CK) Digitalis Case Definition: Digitalis Poisoning Ethylene glycol Fentanyls and other opioids Case Definition: Opioids ( ... Thallium Toxic alcohols Case Definition: Toxic Alcohol Poisoning Ethylene glycol Trichothecene Case Definition: Trichothecene Mycotoxin Poisoning Unidentified ...

Bioterrorism Agents/Diseases

MedlinePlus

... Cyanogen chloride (CK) Digitalis Case Definition: Digitalis Poisoning Ethylene glycol Fentanyls and other opioids Case Definition: Opioids ( ... Thallium Toxic alcohols Case Definition: Toxic Alcohol Poisoning Ethylene glycol Trichothecene Case Definition: Trichothecene Mycotoxin Poisoning Unidentified ...

Was infectious syphilis being misclassified in remote Australian outbreaks? Evidence that informed modification of the national case definition.

PubMed

Preston-Thomas, Annie; Ryder, Nathan; Harmen, Sonia; Fagan, Patricia

2015-12-31

To assess the ability of the national case definition to identify infectious syphilis during an outbreak affecting predominantly Aboriginal and Torres Strait Islander people in a remote Australian region. A retrospective case series study of all non-congenital syphilis cases in the region notified between 1 January 2009 and 31 December 2012 was performed. The national infectious syphilis case definition was compared with an expanded case definition derived from experienced clinician assessment and the definition proposed in the Interim Guidelines for the Public Health Management of Syphilis Outbreaks in Remote Populations in Australia from the Communicable Diseases Network Australia (CDNA). Two hundred and forty syphilis cases were notified, of which 44 (18.3%) were symptomatic. The national case definition classified 106 (44.2%) cases as infectious, compared with 182 (75.8%) using the clinician-derived expanded case definition and 165 (68.8%) by the interim guidelines case definition. Seven confirmed and 6 probable cases were diagnosed as a result of contact tracing of probable infectious cases identified using the expanded case definition. The national case definition for infectious syphilis applied in this remote Australian outbreak underestimated infectious cases when compared with experienced clinicians' evaluation by up to 76 cases (42%) and was inadequate to monitor the magnitude of a syphilis outbreak in such a setting. This may compromise surveillance and resource allocation decisions, and could reduce the capacity to interrupt transmission and contain an outbreak. A revised national case definition, informed by this analysis, was released by CDNA in July 2015.

Cloud Computing Explained

ERIC Educational Resources Information Center

Metz, Rosalyn

2010-01-01

While many talk about the cloud, few actually understand it. Three organizations' definitions come to the forefront when defining the cloud: Gartner, Forrester, and the National Institutes of Standards and Technology (NIST). Although both Gartner and Forrester provide definitions of cloud computing, the NIST definition is concise and uses…

14 CFR 255.3 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... REGULATIONS AIRLINE COMPUTER RESERVATIONS SYSTEMS § 255.3 Definitions. Availability means information provided... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Definitions. 255.3 Section 255.3... presentation of carrier schedules, fares, rules or availability to a subscriber by means of a computer terminal...

14 CFR 255.3 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... REGULATIONS AIRLINE COMPUTER RESERVATIONS SYSTEMS § 255.3 Definitions. Availability means information provided... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Definitions. 255.3 Section 255.3... presentation of carrier schedules, fares, rules or availability to a subscriber by means of a computer terminal...

14 CFR 255.3 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... REGULATIONS AIRLINE COMPUTER RESERVATIONS SYSTEMS § 255.3 Definitions. Availability means information provided... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false Definitions. 255.3 Section 255.3... presentation of carrier schedules, fares, rules or availability to a subscriber by means of a computer terminal...

14 CFR 255.3 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... REGULATIONS AIRLINE COMPUTER RESERVATIONS SYSTEMS § 255.3 Definitions. Availability means information provided... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Definitions. 255.3 Section 255.3... presentation of carrier schedules, fares, rules or availability to a subscriber by means of a computer terminal...

14 CFR 255.3 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... REGULATIONS AIRLINE COMPUTER RESERVATIONS SYSTEMS § 255.3 Definitions. Availability means information provided... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Definitions. 255.3 Section 255.3... presentation of carrier schedules, fares, rules or availability to a subscriber by means of a computer terminal...

Case-Control Studies of Sporadic Enteric Infections: A Review and Discussion of Studies Conducted Internationally from 1990 to 2009

PubMed Central

Fullerton, Kathleen E.; Scallan, Elaine; Kirk, Martyn D.; Mahon, Barbara E.; Angulo, Frederick J.; de Valk, Henriette; van Pelt, Wilfrid; Gauci, Charmaine; Hauri, Anja M.; Majowicz, Shannon; O’Brien, Sarah J.

2015-01-01

Epidemiologists have used case-control studies to investigate enteric disease outbreaks for many decades. Increasingly, case-control studies are also used to investigate risk factors for sporadic (not outbreak-associated) disease. While the same basic approach is used, there are important differences between outbreak and sporadic disease settings that need to be considered in the design and implementation of the case-control study for sporadic disease. Through the International Collaboration on Enteric Disease “Burden of Illness” Studies (the International Collaboration), we reviewed 79 case-control studies of sporadic enteric infections caused by nine pathogens that were conducted in 22 countries and published from 1990 through to 2009. We highlight important methodological and study design issues (including case definition, control selection, and exposure assessment) and discuss how approaches to the study of sporadic enteric disease have changed over the last 20 years (e.g., making use of more sensitive case definitions, databases of controls, and computer-assisted interviewing). As our understanding of sporadic enteric infections grows, methods and topics for case-control studies are expected to continue to evolve; for example, advances in understanding of the role of immunity can be used to improve control selection, the apparent protective effects of certain foods can be further explored, and case-control studies can be used to provide population-based measures of the burden of disease. PMID:22443481

Frequently Asked Questions (FAQ) about Plague

MedlinePlus

... Cyanogen chloride (CK) Digitalis Case Definition: Digitalis Poisoning Ethylene glycol Fentanyls and other opioids Case Definition: Opioids ( ... Thallium Toxic alcohols Case Definition: Toxic Alcohol Poisoning Ethylene glycol Trichothecene Case Definition: Trichothecene Mycotoxin Poisoning Unidentified ...

48 CFR 227.7201 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... OF DEFENSE GENERAL CONTRACTING REQUIREMENTS PATENTS, DATA, AND COPYRIGHTS Rights in Computer Software and Computer Software Documentation 227.7201 Definitions. (a) As used in this subpart, unless... subpart are defined in the clause at 252.227-7014, Rights in Noncommercial Computer Software and...

48 CFR 227.7201 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... OF DEFENSE GENERAL CONTRACTING REQUIREMENTS PATENTS, DATA, AND COPYRIGHTS Rights in Computer Software and Computer Software Documentation 227.7201 Definitions. (a) As used in this subpart, unless... subpart are defined in the clause at 252.227-7014, Rights in Noncommercial Computer Software and...

48 CFR 227.7201 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... OF DEFENSE GENERAL CONTRACTING REQUIREMENTS PATENTS, DATA, AND COPYRIGHTS Rights in Computer Software and Computer Software Documentation 227.7201 Definitions. (a) As used in this subpart, unless... subpart are defined in the clause at 252.227-7014, Rights in Noncommercial Computer Software and...

48 CFR 227.7201 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... OF DEFENSE GENERAL CONTRACTING REQUIREMENTS PATENTS, DATA, AND COPYRIGHTS Rights in Computer Software and Computer Software Documentation 227.7201 Definitions. (a) As used in this subpart, unless... subpart are defined in the clause at 252.227-7014, Rights in Noncommercial Computer Software and...

48 CFR 227.7201 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... OF DEFENSE GENERAL CONTRACTING REQUIREMENTS PATENTS, DATA, AND COPYRIGHTS Rights in Computer Software and Computer Software Documentation 227.7201 Definitions. (a) As used in this subpart, unless... subpart are defined in the clause at 252.227-7014, Rights in Noncommercial Computer Software and...

Topological T-duality for torus bundles with monodromy

NASA Astrophysics Data System (ADS)

Baraglia, David

2015-05-01

We give a simplified definition of topological T-duality that applies to arbitrary torus bundles. The new definition does not involve Chern classes or spectral sequences, only gerbes and morphisms between them. All the familiar topological conditions for T-duals are shown to follow. We determine necessary and sufficient conditions for existence of a T-dual in the case of affine torus bundles. This is general enough to include all principal torus bundles as well as torus bundles with arbitrary monodromy representations. We show that isomorphisms in twisted cohomology, twisted K-theory and of Courant algebroids persist in this general setting. We also give an example where twisted K-theory groups can be computed by iterating T-duality.

The CMC/3DPNS computer program for prediction of three-dimensional, subsonic, turbulent aerodynamic juncture region flow. Volume 3: Programmers' manual

NASA Technical Reports Server (NTRS)

Orzechowski, J. A.

1982-01-01

The CMC fluid mechanics program system was developed to transmit the theoretical evolution of finite element numerical solution methodology, applied to nonlinear field problems into a versatile computer code for comprehensive flow field analysis. A detailed view of the code from the standpoint of a computer programmer's use is presented. A system macroflow chart and detailed flow charts of several routines necessary to interact with a theoretican/user to modify the operation of this program are presented. All subroutines and details of usage, primarily for input and output routines are described. Integer and real scalars and a cross reference list denoting subroutine usage for these scalars are outlined. Entry points in dynamic storage vector IZ; the lengths of each vector accompanying the scalar definitions are described. A listing of the routines peculiar to the standard test case and a listing of the input deck and printout for this case are included.

Steady, oscillatory, and unsteady subsonic Aerodynamics, production version 1.1 (SOUSSA-P1.1). Volume 2: User/programmer manual

NASA Technical Reports Server (NTRS)

Smolka, S. A.; Preuss, R. D.; Tseng, K.; Morino, L.

1980-01-01

A user/programmer manual for the computer program SOUSSA P 1.1 is presented. The program was designed to provide accurate and efficient evaluation of steady and unsteady loads on aircraft having arbitrary shapes and motions, including structural deformations. These design goals were in part achieved through the incorporation of the data handling capabilities of the SPAR finite element Structural Analysis computer program. As a further result, SOUSSA P possesses an extensive checkpoint/ restart facility. The programmer's portion of this manual includes overlay/subroutine hierarchy, logical flow of control, definition of SOUSSA P 1.1 FORTRAN variables, and definition of SOUSSA P 1.1 subroutines. Purpose of the SOUSSA P 1.1 modules, input data to the program, output of the program, hardware/software requirements, error detection and reporting capabilities, job control statements, a summary of the procedure for running the program and two test cases including input and output and listings are described in the user oriented portion of the manual.

42 CFR 121.2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Definitions. 121.2 Section 121.2 Public Health... PROCUREMENT AND TRANSPLANTATION NETWORK § 121.2 Definitions. As used in this part— Act means the Public Health..., transplant recipient, or organ donor. OPTN computer match program means a set of computer-based instructions...

42 CFR 121.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Definitions. 121.2 Section 121.2 Public Health... PROCUREMENT AND TRANSPLANTATION NETWORK § 121.2 Definitions. As used in this part— Act means the Public Health..., transplant recipient, or organ donor. OPTN computer match program means a set of computer-based instructions...

Computer Generation of Natural Language from a Deep Conceptual Base

DTIC Science & Technology

1974-01-01

It would be useful to have machines which could read scientific documents, newspaper articles , novels, etc., and translate them into other...preparing abstracts :or articles and in headline writing (at least in those cases in which headlines are used as an indication of article content...above), a definite or indefinite article is attached to the noun phrase. The selection of color and size adjectives is made in .. fashion

A computational investigation of fuel mixing in a hypersonic scramjet

NASA Technical Reports Server (NTRS)

Fathauer, Brett W.; Rogers, R. C.

1993-01-01

A parabolized, Navier-Stokes code, SHIP3D, is used to numerically investigate the mixing between air injection and hydrogen injection from a swept ramp injector configuration into either a mainstream low-enthalpy flow or a hypervelocity test flow. The mixing comparisons between air and hydrogen injection reveal the importance of matching injectant-to-mainstream mass flow ratios. In flows with the same injectant-to-mainstream dynamic pressure ratio, the mixing definition was altered for the air injection cases. Comparisons of the computed results indicate that the air injection cases overestimate the mixing performance associated with hydrogen injection simulation. A lifting length parameter, to account for the time a fluid particle transverses through the mixing region, is defined and used to establish a connection of injectant mixing in hypervelocity flows, based on nonreactive, low-enthalpy flows.

Repairing a Facial Cleft by Polyether-Ether-Ketone Implant Combined With Titanium Mesh.

PubMed

Deng, Yuan; Tang, Weiwei; Li, Zhengkang

2018-05-15

The Tessier Number 4 cleft is one of the rarest, most complex craniofacial anomalies that presents difficulties in surgical treatment. In this article, we report a case of simultaneous facial depression, eye displacement, and medial canthus deformity. In this case, the maxillary bony defect was reconstructed using computer-assisted design computer-assisted manufacturing (CAD-CAM) polyether-ether-ketone (PEEK) material, and the orbital floor defect was repaired with AO prefabricated titanium mesh. Additionally, the medial canthus was modified with canthopexy and a single Z-plasty flap. Owing to its relative rarity and varied clinical presentations, no definitive operative methods have been accepted for Tessier No. 4 facial cleft. This study presents the combination of CAD-CAM manufactured PEEK material and titanium mesh as an alternative approach for reconstructing the bony defect of Tessier No. 4 facial clefts.

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

Suh, Uhi Rinn, E-mail: uhrisu1@math.snu.ac.kr

We introduce a classical BRST complex (See Definition 3.2.) and show that one can construct a classical affine W-algebra via the complex. This definition clarifies that classical affine W-algebras can be considered as quasi-classical limits of quantum affine W-algebras. We also give a definition of a classical affine fractional W-algebra as a Poisson vertex algebra. As in the classical affine case, a classical affine fractional W-algebra has two compatible λ-brackets and is isomorphic to an algebra of differential polynomials as a differential algebra. When a classical affine fractional W-algebra is associated to a minimal nilpotent, we describe explicit forms ofmore » free generators and compute λ-brackets between them. Provided some assumptions on a classical affine fractional W-algebra, we find an infinite sequence of integrable systems related to the algebra, using the generalized Drinfel’d and Sokolov reduction.« less

Acute respiratory infection case definitions for young children: a systematic review of community-based epidemiologic studies in South Asia.

PubMed

Roth, Daniel E; Gaffey, Michelle F; Smith-Romero, Evelyn; Fitzpatrick, Tiffany; Morris, Shaun K

2015-12-01

To explore the variability in childhood acute respiratory infection case definitions for research in low-income settings where there is limited access to laboratory or radiologic investigations. We conducted a systematic review of community-based, longitudinal studies in South Asia published from January 1990 to August 2013, in which childhood acute respiratory infection outcomes were reported. Case definitions were classified by their label (e.g. pneumonia, acute lower respiratory infection) and clinical content 'signatures' (array of clinical features that would be always present, conditionally present or always absent among cases). Case definition heterogeneity was primarily assessed by the number of unique case definitions overall and by label. We also compared case definition-specific acute respiratory infection incidence rates for studies reporting incidence rates for multiple case definitions. In 56 eligible studies, we found 124 acute respiratory infection case definitions. Of 90 case definitions for which clinical content was explicitly defined, 66 (73%) were unique. There was a high degree of content heterogeneity among case definitions with the same label, and some content signatures were assigned multiple labels. Within studies for which incidence rates were reported for multiple case definitions, variation in content was always associated with a change in incidence rate, even when the content differed by a single clinical feature. There has been a wide variability in case definition label and content combinations to define acute upper and lower respiratory infections in children in community-based studies in South Asia over the past two decades. These inconsistencies have important implications for the synthesis and translation of knowledge regarding the prevention and treatment of childhood acute respiratory infection. © 2015 John Wiley & Sons Ltd.

Case definitions for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): a systematic review

PubMed Central

Brurberg, Kjetil Gundro; Fønhus, Marita Sporstøl; Larun, Lillebeth; Flottorp, Signe; Malterud, Kirsti

2014-01-01

Objective To identify case definitions for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), and explore how the validity of case definitions can be evaluated in the absence of a reference standard. Design Systematic review. Setting International. Participants A literature search, updated as of November 2013, led to the identification of 20 case definitions and inclusion of 38 validation studies. Primary and secondary outcome measure Validation studies were assessed for risk of bias and categorised according to three validation models: (1) independent application of several case definitions on the same population, (2) sequential application of different case definitions on patients diagnosed with CFS/ME with one set of diagnostic criteria or (3) comparison of prevalence estimates from different case definitions applied on different populations. Results A total of 38 studies contributed data of sufficient quality and consistency for evaluation of validity, with CDC-1994/Fukuda as the most frequently applied case definition. No study rigorously assessed the reproducibility or feasibility of case definitions. Validation studies were small with methodological weaknesses and inconsistent results. No empirical data indicated that any case definition specifically identified patients with a neuroimmunological condition. Conclusions Classification of patients according to severity and symptom patterns, aiming to predict prognosis or effectiveness of therapy, seems useful. Development of further case definitions of CFS/ME should be given a low priority. Consistency in research can be achieved by applying diagnostic criteria that have been subjected to systematic evaluation. PMID:24508851

Analysis of risk factors for schizophrenia with two different case definitions: a nationwide register-based external validation study.

PubMed

Sørensen, Holger J; Larsen, Janne T; Mors, Ole; Nordentoft, Merete; Mortensen, Preben B; Petersen, Liselotte

2015-03-01

Different case definitions of schizophrenia have been used in register based research. However, no previous study has externally validated two different case definitions of schizophrenia against a wide range of risk factors for schizophrenia. We investigated hazard ratios (HRs) for a wide range of risk factors for ICD-10 DCR schizophrenia using a nationwide Danish sample of 2,772,144 residents born in 1955-1997. We compared one contact only (OCO) (the case definition of schizophrenia used in Danish register based studies) with two or more contacts (TMC) (a case definition of at least 2 inpatient contacts with schizophrenia). During the follow-up, the OCO definition included 15,074 and the TMC 7562 cases; i.e. half as many. The TMC case definition appeared to select for a worse illness course. A wide range of risk factors were uniformly associated with both case definitions and only slightly higher risk estimates were found for the TMC definition. Choosing at least 2 inpatient contacts with schizophrenia (TMC) instead of the currently used case definition would result in almost similar risk estimates for many well-established risk factors. However, this would also introduce selection and include considerably fewer cases and reduce power of e.g. genetic studies based on register-diagnosed cases only. Copyright © 2015 Elsevier B.V. All rights reserved.

Acute Kidney Injury Network definition of contrast-induced nephropathy in the critically ill: incidence and outcome.

PubMed

Lakhal, Karim; Ehrmann, Stephan; Chaari, Anis; Laissy, Jean-Pierre; Régnier, Bernard; Wolff, Michel; Pajot, Olivier

2011-12-01

Contrast-induced nephropathy (CIN) has been extensively studied in the ward but only scarcely in intensive care unit (ICU) patients, even if they may be particularly prone to develop or to worsen acute kidney insufficiency. We aimed to measure the incidence of CIN in a large ICU population using the Acute Kidney Injury Network (AKIN) definition and to investigate its impact on patients' outcome. In this 3-year retrospective study, we included all patients undergoing, during their stay in our medical ICU, a contrast media-enhanced computed tomographic scan. Change in serum creatinine between baseline (24 hours before to 12 hours after contrast media injection) and its maximum value over the 96 hours after contrast media injection was recorded. Contrast-induced nephropathy was defined as a 44.2-μmol/L absolute or a 25% relative minimal increase in serum creatinine over 48, 72, or 96 hours and according to the stage 1 of the AKIN classification (at least 26.4 μmol/L or 50% increase over 48 hours). A total of 398 contrast-enhanced computed tomographic scans performed among 299 patients were analyzed. Incidence of CIN was 14% according to the AKIN definition and ranged from 8% (48-hour absolute definition) to 23% (96-hour relative definition). The need for renal replacement therapy and ICU mortality were significantly higher in case of CIN. After adjusting for other variables associated with ICU mortality, the occurrence of at least 1 CIN episode during the ICU stay (AKIN criteria) was independently associated with ICU mortality (odds ratio, 3.85; 95% confidence interval, 1.85-8.00). Even if incidence varied greatly depending on the definition, CIN appeared frequent in our critically ill patients. The AKIN definition, independently associated with ICU mortality, may allow unifying diagnostic criteria to further evaluate this condition that impacts morbidity and mortality. Copyright © 2011 Elsevier Inc. All rights reserved.

Evaluation of the WHO clinical case definition for pediatric HIV infection in Bloemfontein, South Africa.

PubMed

van Gend, Christine L; Haadsma, Maaike L; Sauer, Pieter J J; Schoeman, Cornelius J

2003-06-01

The WHO clinical case definition for pediatric HIV infection has been designed to be used in countries where diagnostic laboratory resources are limited. We evaluated the WHO case definition to determine whether it is a useful instrument to discriminate between HIV-positive and HIV-negative children. In addition, clinical features not included in this case definition were recorded. We recorded clinical data from 300 consecutively admitted children in a state hospital in Bloemfontein, South Africa, and tested these children for HIV infection. A total of 222 children were included in the study; 69 children (31.1 per cent) were HIV positive. The sensitivity of the WHO case definition in this study was 14.5 per cent, the specificity was 98.6 per cent. Apart from weight loss and generalized dermatitis, the signs of the WHO case definition were significantly more often seen in HIV-positive than in HIV-negative children. Of the clinical signs not included in the WHO case definition, marasmus and hepatosplenomegaly especially occurred more frequently in HIV-positive children. Based on these findings we composed a new case definition consisting of four signs: marasmus, hepatosplenomegaly, oropharyngeal candidiasis, and generalized lymphadenopathy. HIV infection is suspected in a child presenting with at least two of these four signs. The sensitivity of this case definition was 63.2 per cent, the specificity was 96.0 per cent. We conclude that in this study the WHO case definition was not a useful instrument to discriminate between HIV-positive and HIV-negative children, mainly because its sensitivity was strikingly low. The simplified case definition we propose, proved to be more sensitive than the WHO case definition (63.2 vs. 14.5 per cent), whilst its specificity remained high.

Monolithic bridges with inCoris TZI and inCoris TZI C.

PubMed

Wiedhahn, Klaus

2015-01-01

Until now, the ability to fabricate definitive Cerec bridges for the posterior region was less a question of the capabilities of the Cerec software than the availability of ceramic materials with sufficient strength for these indications. With the launch of the somewhat translucent inCoris TZI zirconia, Sirona has made possible the computer-assisted design and computer- assisted manufacturing (CAD/CAM) of monolithic bridges using Cerec dental software. In this article, the possibilities and limitations of inCoris TZI, as well as inCoris TZI C (a recently introduced further development from Sirona), will be demonstrated, based on two clinical cases.

Distributed Sensing and Processing Adaptive Collaboration Environment (D-SPACE)

DTIC Science & Technology

2014-07-01

to the query graph, or subgraph permutations with the same mismatch cost (often the case for homogeneous and/or symmetrical data/query). To avoid...decisions are generated in a bottom-up manner using the metric of entropy at the cluster level (Figure 9c). Using the definition of belief messages...for a cluster and a set of data nodes in this cluster , we compute the entropy for forward and backward messages as (,) = −∑ (

Industrial Cloud: Toward Inter-enterprise Integration

NASA Astrophysics Data System (ADS)

Wlodarczyk, Tomasz Wiktor; Rong, Chunming; Thorsen, Kari Anne Haaland

Industrial cloud is introduced as a new inter-enterprise integration concept in cloud computing. The characteristics of an industrial cloud are given by its definition and architecture and compared with other general cloud concepts. The concept is then demonstrated by a practical use case, based on Integrated Operations (IO) in the Norwegian Continental Shelf (NCS), showing how industrial digital information integration platform gives competitive advantage to the companies involved. Further research and development challenges are also discussed.

Clinical case definition for the diagnosis of acute intussusception.

PubMed

Bines, Julie E; Ivanoff, Bernard; Justice, Frances; Mulholland, Kim

2004-11-01

Because of the reported association between intussusception and a rotavirus vaccine, future clinical trials of rotavirus vaccines will need to include intussusception surveillance in the evaluation of vaccine safety. The aim of this study is to develop and validate a clinical case definition for the diagnosis of acute intussusception. A clinical case definition for the diagnosis of acute intussusception was developed by analysis of an extensive literature review that defined the clinical presentation of intussusception in 70 developed and developing countries. The clinical case definition was then assessed for sensitivity and specificity using a retrospective chart review of hospital admissions. Sensitivity of the clinical case definition was assessed in children diagnosed with intussusception over a 6.5-year period. Specificity was assessed in patients aged <2 years admitted with bowel obstruction and in patients aged <19 years presenting with symptoms that may occur in intussusception. The clinical case definition accurately identified 185 of 191 assessable cases as "probable" intussusception and six cases as "possible" intussusception (sensitivity, 97%). No case of radiologic or surgically proven intussusception failed to be identified by the clinical case definition. The specificity of the definition in correctly identifying patients who did not have intussusception ranged from 87% to 91%. The clinical case definition for intussusception may assist in the prompt identification of patients with intussusception and may provide an important tool for the future trials of enteric vaccines.

Techniques and potential capabilities of multi-resolutional information (knowledge) processing

NASA Technical Reports Server (NTRS)

Meystel, A.

1989-01-01

A concept of nested hierarchical (multi-resolutional, pyramidal) information (knowledge) processing is introduced for a variety of systems including data and/or knowledge bases, vision, control, and manufacturing systems, industrial automated robots, and (self-programmed) autonomous intelligent machines. A set of practical recommendations is presented using a case study of a multiresolutional object representation. It is demonstrated here that any intelligent module transforms (sometimes, irreversibly) the knowledge it deals with, and this tranformation affects the subsequent computation processes, e.g., those of decision and control. Several types of knowledge transformation are reviewed. Definite conditions are analyzed, satisfaction of which is required for organization and processing of redundant information (knowledge) in the multi-resolutional systems. Providing a definite degree of redundancy is one of these conditions.

Future Naval Use of COTS Networking Infrastructure

DTIC Science & Technology

2009-07-01

user to benefit from Google’s vast databases and computational resources. Obviously, the ability to harness the full power of the Cloud could be... Computing Impact Findings Action Items Take-Aways Appendices: Pages 54-68 A. Terms of Reference Document B. Sample Definitions of Cloud ...and definition of Cloud Computing . While Cloud Computing is developing in many variations – including Infrastructure as a Service (IaaS), Platform as

Progress in modeling and simulation.

PubMed

Kindler, E

1998-01-01

For the modeling of systems, the computers are more and more used while the other "media" (including the human intellect) carrying the models are abandoned. For the modeling of knowledges, i.e. of more or less general concepts (possibly used to model systems composed of instances of such concepts), the object-oriented programming is nowadays widely used. For the modeling of processes existing and developing in the time, computer simulation is used, the results of which are often presented by means of animation (graphical pictures moving and changing in time). Unfortunately, the object-oriented programming tools are commonly not designed to be of a great use for simulation while the programming tools for simulation do not enable their users to apply the advantages of the object-oriented programming. Nevertheless, there are exclusions enabling to use general concepts represented at a computer, for constructing simulation models and for their easy modification. They are described in the present paper, together with true definitions of modeling, simulation and object-oriented programming (including cases that do not satisfy the definitions but are dangerous to introduce misunderstanding), an outline of their applications and of their further development. In relation to the fact that computing systems are being introduced to be control components into a large spectrum of (technological, social and biological) systems, the attention is oriented to models of systems containing modeling components.

Sensitivity and Specificity of Suspected Case Definition Used during West Africa Ebola Epidemic

PubMed Central

Champaloux, Steven W.; Keïta, Sakoba; Martel, Lise; Bilivogui, Pepe; Knust, Barbara; McCollum, Andrea M.

2018-01-01

Rapid early detection and control of Ebola virus disease (EVD) is contingent on accurate case definitions. Using an epidemic surveillance dataset from Guinea, we analyzed an EVD case definition developed by the World Health Organization (WHO) and used in Guinea. We used the surveillance dataset (March–October 2014; n = 2,847 persons) to identify patients who satisfied or did not satisfy case definition criteria. Laboratory confirmation determined cases from noncases, and we calculated sensitivity, specificity and predictive values. The sensitivity of the defintion was 68.9%, and the specificity of the definition was 49.6%. The presence of epidemiologic risk factors (i.e., recent contact with a known or suspected EVD case-patient) had the highest sensitivity (74.7%), and unexplained deaths had the highest specificity (92.8%). Results for case definition analyses were statistically significant (p<0.05 by χ2 test). Multiple components of the EVD case definition used in Guinea contributed to improved overall sensitivity and specificity. PMID:29260687

Evaluation of the Diagnostic Utility of the Traditional and Revised WHO Dengue Case Definitions

PubMed Central

Gutiérrez, Gamaliel; Gresh, Lionel; Pérez, María Ángeles; Elizondo, Douglas; Avilés, William; Kuan, Guillermina; Balmaseda, Ángel; Harris, Eva

2013-01-01

Dengue, a mosquito-borne viral illness, is a major public health problem worldwide, and its incidence continues to increase. In 2009, the World Health Organization published guidelines that included a revision of the dengue case definition. Compared to the traditional definition, the revised case definition relies more on signs than on symptoms, making it more applicable to young children. We evaluated the diagnostic utility of both case definitions in two studies of pediatric dengue in Managua, Nicaragua. In a community-based cohort study, we included data from 3,407 suspected dengue cases, of which 476 were laboratory-confirmed. In the second study, we collected information from 1,160 participants recruited at the national pediatric reference hospital (723 laboratory-confirmed). In the cohort study, the traditional definition had 89.3% sensitivity and 43.1% specificity, while the revised definition yielded similar sensitivity (86.6%) and higher specificity (55.2%, p<0.001). In the hospital study, the traditional case definition yielded 96.7% sensitivity and 22.0% specificity, whereas the revised case definition had higher sensitivity (99.3%, p<0.001) but lower specificity (8.5%, p<0.001). We then evaluated the performance of two diagnostic models based on the signs/symptoms included in each definition by analyzing the effect of increasing numbers of signs/symptoms on the sensitivity and specificity of case capture. Receiver operating characteristic analysis showed a slightly better performance for the revised model in both studies. Interestingly, despite containing less symptoms that cannot be readily expressed by children aged less than 4 years, the revised definition did not perform better in this age group. Overall, our results indicate that both case definitions have similar capacity to diagnose dengue. Owing to their high sensitivity and low specificity, they should be primarily used for screening purposes. However, in a primary care setting, neither of the case definitions performed well as a screening test in younger children. PMID:23991237

Evaluation of an expanded case definition for vaccine-modified measles in a school outbreak in South Korea in 2010.

PubMed

Choe, Young June; Hu, Jae Kyung; Song, Kyung Min; Cho, Heeyeon; Yoon, Hee Sook; Kim, Seung Tae; Lee, Han Jung; Kim, Kisoon; Bae, Geun-Ryang; Lee, Jong-Koo

2012-01-01

In this study, we have described the clinical characteristics of vaccine-modified measles to assess the performance of an expanded case definition in a school outbreak that occurred in 2010. The sensitivity, specificity, and the positive and negative predictive values were evaluated. Among 74 cases of vaccine-modified measles, 47 (64%) met the original case definition. Fever and rash were observed in 73% (54/74); fever was the most common (96%, 71/74) presenting symptom, and rash was noted in 77% (57/74) of the cases. The original case definition showed an overall sensitivity of 63.5% and a specificity of 100.0%. The expanded case definition combining fever and rash showed a higher sensitivity (72.9%) but a lower specificity (88.2%) than the original. The presence of fever and one or more of cough, coryza, or conjunctivitis scored the highest sensitivity among the combinations of signs and symptoms (77.0%), but scored the lowest specificity (52.9%). The expanded case definition was sensitive in identifying suspected cases of vaccine-modified measles. We suggest using this expanded definition for outbreak investigation in a closed community, and consider further discussions on expanding the case definition of measles for routine surveillance in South Korea.

Highly variable population-based prevalence rates of unilateral hearing loss after the application of common case definitions.

PubMed

Ross, Danielle S; Visser, Susanna N; Holstrum, W June; Qin, Tielin; Kenneson, Aileen

2010-02-01

This study shows how population-based estimates of the prevalence of unilateral hearing loss (UHL) in children aged 6 to 19 yrs can differ considerably with various applications of commonly accepted case definitions. It also examines demographic variables and risk factors related to UHL. The Third National Health and Nutrition Examination Survey, conducted from 1988 to 1994, is a national population-based, cross-sectional survey. This study examined results of audiometric testing at 0.5 to 8 kHz and demographic data from in-person examination interviews. Three definitions of UHL were used: (1) 0.5, 1, and 2 kHz > or = 15 dB pure-tone average (PTA); (2) 0.5, 1, 2, and 4 kHz > or = 15 dB PTA; and (3) 0.5, 1, and 2 kHz > or = 20 dB or PTA >25 dB at two or more frequencies above 2 kHz (3, 4, 6, and 8 kHz). Case definitions 2 and 3 are not merely subsets of case definition 1. Some overlap exists between the groups, but each case definition classifies a proportion of children who fall uniquely under that case definition. Inclusion of participants based on tympanometry results (test of middle ear function) was also examined as were demographic characteristics and risk factors associated with UHL. Overall, the weighted proportion of children with UHL using case definition 1 was 6.3% (approximately 3,213,000 children nationally); using case definition 2, it was 5.8% (approximately 2,958,000 nationally); using case definition 3, it was 3.0% (approximately 1,530,000 nationally). For all three case definitions, children who failed tympanometry were at higher risk for UHL than children who passed. For case definition 2, children from rural areas were at higher risk for UHL than were children from urban areas. This study demonstrates that different applications of well-accepted case definitions of UHL can influence population-based prevalence estimates, in this study by as much as a factor of 2. These findings highlight the importance of controlling for tympanometry status as a risk factor in such estimates. Which demographic characteristics and risk factors are significantly associated with hearing loss seem to vary depending on the case definition. These findings have implications for the interpretation of prevalence rates and risk factors in the literature on hearing loss in general. Prevalence rate estimates require careful consideration of the case definition of hearing loss, tympanometry status, and demographic characteristics.

Case definition for Ebola and Marburg haemorrhagic fevers: a complex challenge for epidemiologists and clinicians.

PubMed

Pittalis, Silvia; Fusco, Francesco Maria; Lanini, Simone; Nisii, Carla; Puro, Vincenzo; Lauria, Francesco Nicola; Ippolito, Giuseppe

2009-10-01

Viral haemorrhagic fevers (VHFs) represent a challenge for public health because of their epidemic potential, and their possible use as bioterrorism agents poses particular concern. In 1999 the World Health Organization (WHO) proposed a case definition for VHFs, subsequently adopted by other international institutions with the aim of early detection of initial cases/outbreaks in western countries. We applied this case definition to reports of Ebola and Marburg virus infections to estimate its sensitivity to detect cases of the disease. We analyzed clinical descriptions of 795 reported cases of Ebola haemorrhagic fever: only 58.5% of patients met the proposed case definition. A similar figure was obtained reviewing 169 cases of Marburg diseases, of which only 64.5% were in accordance with the case definition. In conclusion, the WHO case definition for hemorrhagic fevers is too specific and has poor sensitivity both for case finding during Ebola or Marburg outbreaks, and for early detection of suspected cases in western countries. It can lead to a hazardous number of false negatives and its use should be discouraged for early detection of cases.

Proposed epidemiological case definition for serious skin infection in children.

PubMed

O'Sullivan, Cathryn E; Baker, Michael G

2010-04-01

Researching the rising incidence of serious skin infections in children is limited by the lack of a consistent and valid case definition. We aimed to develop and evaluate a good quality case definition, for use in future research and surveillance of these infections. We tested the validity of the existing case definition, and then of 11 proposed alternative definitions, by assessing their screening performance when applied to a population of paediatric skin infection cases identified by a chart review of 4 years of admissions to a New Zealand hospital. Previous studies have largely used definitions based on the International Classification of Diseases skin infection subchapter. This definition is highly specific (100%) but poorly sensitive (61%); it fails to capture skin infections of atypical anatomical sites, those secondary to primary skin disease and trauma, and those recorded as additional diagnoses. Including these groups produced a new case definition with 98.9% sensitivity and 98.8% specificity. Previous analyses of serious skin infection in children have underestimated the true burden of disease. Using this proposed broader case definition should allow future researchers to produce more valid and comparable estimates of the true burden of these important and increasing infections.

Obturator mononeuropathy caused by lipomatosis of the nerve: a case report.

PubMed

Nardone, Raffaele; Venturi, Alessandro; Ladurner, Gunther; Golaszewski, Stefan; Psenner, Konrad; Tezzon, Frediano

2008-08-01

We report a patient who presented with the clinical features of obturator mononeuropathy. Abdomino-pelvic computed tomography revealed a fusiform mass in the right perivesical space; magnetic resonance imaging (MRI) showed characteristic "coaxial-cable-like" appearance in cross-section and "spaghetti-like" appearance in longitudinal section, pathognomonic of lipomatosis of the nerve. Nerve lipomatosis as the cause of obturator neuropathy has not been previously reported. MRI provides definite and graphic proof of the diagnosis.

Computing on Encrypted Data: Theory and Application

DTIC Science & Technology

2016-01-01

THEORY AND APPLICATION 5a. CONTRACT NUMBER FA8750-11-2-0225 5b. GRANT NUMBER N /A 5c. PROGRAM ELEMENT NUMBER 62303E 6. AUTHOR(S) Shafi...distance decoding assumption, GCD is greatest common divisors, LWE is learning with errors and NTRU is the N -th order truncated ring encryption scheme...that ` = n , but all definitions carry over to the general case). The mini- mum distance between two lattice points is equal to the length of the

[Value of x-ray computed tomography in the study of the inferior vena cava in urologic practice].

PubMed

Barré, C; Vialle, M; Rieux, D; Caron-Poitreau, C; Soret, J Y; Rognon, M

1985-01-01

The CT scan provides a reliable evaluation of the inferior vena cava, especially since the development of second and third generation scanners. It can readily detect congenital malformations and obstructive anomalies complicating renal cancer and it is also able to determine the tumoral or thrombotic nature of the venous obstruction. This excellent definition of the vessel reduces the indications for caval angiography to a few exceptional cases.

Ileal Entrapment within a Paracaecal Hernia Mimicking Acute Appendicitis

PubMed Central

Birchley, David

2009-01-01

Presented is a case of incarcerated paracaecal hernia mimicking acute appendicitis. The clinical scenario highlights the need for a high index of suspicion in the management of patients with localised peritonism even in the absence of obstructive symptoms and the presence of normal laboratory markers of inflammation.Whilst computed tomography might offer a pre-operative diagnosis, in such a low-risk patient laparoscopy offers the combined advantages of immediate diagnosis and definitive treatment of acute pathology. PMID:19317924

False positive computed tomographic angiography for Stanford type A aortic dissection.

PubMed

Bandali, Murad F; Hatem, Muhammed A; Appoo, Jehangir J; Hutchison, Stuart J; Wong, Jason K

2015-12-01

Computed tomographic angiography (CTA) has emerged as the defacto imaging test to rule out acute aortic dissection; however, it is not without flaws. We report a case of a false-positive CTA with respect to Stanford Type A aortic dissection. A 52 year-old male presented with sudden onset shortness of breath. He denied chest pain. Due to severe hypertension and an Emergency Department bedside ultrasound suggesting an intimal flap in the aorta, CTA was requested to better assess the ascending aorta and was interpreted as consistent with Stanford Type A aortic dissection with thrombosis of the false lumen in the ascending aorta. However, intra-operative imaging (TEE and epi-aortic scanning) did not identify an intimal flap or dissection, and neither did definitive surgical inspection of the aorta. The suspected aortic dissection and thrombosed false lumen were not visualized on repeat CTA two days later. False positive diagnosis of Stanford Type A aortic dissection on CTA can be the result of technical factors, streak artifacts, motion artifacts, and periaortic structures. In this case, non-uniform arterial contrast enhancement secondary to unrecognized biventricular dysfunction resulted in the false positive CTA appearance of an intimal flap and mural thrombus. Intra-operative TEE and epi-aortic scanning were proven correct in excluding aortic dissection by the standard of definitive surgical inspection of the aorta.

20 CFR 345.302 - Definition of terms and phrases used in experience-rating.

Code of Federal Regulations, 2010 CFR

2010-04-01

... for the current calendar year. This ratio is computed to four decimal places. (k) Pooled credit ratio... employer for the calendar year involved in the computation. This ratio is computed to four decimal places... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Definition of terms and phrases used in...

Utility of three-dimensional and multiplanar reformatted computed tomography for evaluation of pediatric congenital spine abnormalities.

PubMed

Newton, Peter O; Hahn, Gregory W; Fricka, Kevin B; Wenger, Dennis R

2002-04-15

A retrospective radiographic review of 31 patients with congenital spine abnormalities who underwent conventional radiography and advanced imaging studies was conducted. To analyze the utility of three-dimensional computed tomography with multiplanar reformatted images for congenital spine anomalies, as compared with plain radiographs and axial two-dimensional computed tomography imaging. Conventional radiographic imaging for congenital spine disorders often are difficult to interpret because of the patient's small size, the complexity of the disorder, a deformity not in the plane of the radiographs, superimposed structures, and difficulty in forming a mental three-dimensional image. Multiplanar reformatted and three-dimensional computed tomographic imaging offers many potential advantages for defining congenital spine anomalies including visualization of the deformity in any plane, from any angle, with the overlying structures subtracted. The imaging studies of patients who had undergone a three-dimensional computed tomography for congenital deformities of the spine between 1992 and 1998 were reviewed (31 cases). All plain radiographs and axial two-dimensional computed tomography images performed before the three-dimensional computed tomography were reviewed and the findings documented. This was repeated for the three-dimensional reconstructions and, when available, the multiplanar reformatted images (15 cases). In each case, the utility of the advanced imaging was graded as one of the following: Grade A (substantial new information obtained), Grade B (confirmatory with improved visualization and understanding of the deformity), and Grade C (no added useful information obtained). In 17 of 31 cases, the multiplanar reformatted and three-dimensional images allowed identification of unrecognized malformations. In nine additional cases, the advanced imaging was helpful in better visualizing and understanding previously identified deformities. In five cases, no new information was gained. The standard and curved multiplanar reformatted images were best for defining the occiput-C1-C2 anatomy and the extent of segmentation defects. The curved multiplanar reformatted images were especially helpful in keeping the spine from "coming in" and "going out" of the plane of the image when there was significant spine deformity in the sagittal or coronal plane. The three-dimensional reconstructions proved valuable in defining failures of formation. Advanced computed tomography imaging (three-dimensional computed tomography and curved/standard multiplanar reformatted images) allows better definition of congenital spine anomalies. More than 50% of the cases showed additional abnormalities not appreciated on plain radiographs or axial two-dimensional computed tomography images. Curved multiplanar reformatted images allowed imaging in the coronal and sagittal planes of the entire deformity.

Case definition for progressive multifocal leukoencephalopathy following treatment with monoclonal antibodies.

PubMed

Mentzer, Dirk; Prestel, Jürgen; Adams, Ortwin; Gold, Ralf; Hartung, Hans-Peter; Hengel, Hartmut; Kieseier, Bernd C; Ludwig, Wolf-Dieter; Keller-Stanislawski, Brigitte

2012-09-01

Novel immunosuppressive/modulating therapies with monoclonal antibodies (MABs) have been associated with progressive multifocal leukoencephalopathy (PML), a potentially fatal disease of the brain caused by the JC virus. Taking the complex diagnostic testing and heterogeneous clinical presentation of PML into account, an agreed case definition for PML is a prerequisite for a thorough assessment of PML. A working group was established to develop a standardised case definition for PML which permits data comparability across clinical trials, postauthorisation safety studies and passive postmarketing surveillance. The case definition is designed to define levels of diagnostic certainty of reported PML cases following treatment with MABs. It was subsequently used to categorise retrospectively suspected PML cases from Germany reported to the Paul-Ehrlich-Institute as the responsible national competent authority. The algorithm of the case definition is based on clinical symptoms, PCR for JC virus DNA in cerebrospinal fluid, brain MRI, and brain biopsy/autopsy. The case definition was applied to 119 suspected cases of PML following treatment with MABs and is considered to be helpful for case ascertainment of suspected PML cases for various MABs covering a broad spectrum of indications. Even if the available information is not yet complete, the case definition provides a level of diagnostic certainty. The proposed case definition permits data comparability among different medicinal products and among active as well as passive surveillance settings. It may form a basis for meaningful risk analysis and communication for regulators and healthcare professionals.

Large Reactional Osteogenesis in Maxillary Sinus Associated with Secondary Root Canal Infection Detected Using Cone-beam Computed Tomography.

PubMed

Estrela, Carlos; Porto, Olavo César Lyra; Costa, Nádia Lago; Garrote, Marcel da Silva; Decurcio, Daniel Almeida; Bueno, Mike R; Silva, Brunno Santos de Freitas

2015-12-01

Inflammatory injuries in the maxillary sinus may originate from root canal infections and lead to bone resorption or regeneration. This report describes the radiographic findings of 4 asymptomatic clinical cases of large reactional osteogenesis in the maxillary sinus (MS) associated with secondary root canal infection detected using cone-beam computed tomographic (CBCT) imaging. Apical periodontitis, a consequence of root canal infection, may lead to a periosteal reaction in the MS and osteogenesis seen as a radiopaque structure on imaging scans. The use of a map-reading strategy for the longitudinal and sequential slices of CBCT images may contribute to the definition of diagnoses and treatment plans. Root canal infections may lead to reactional osteogenesis in the MS. High-resolution CBCT images may reveal changes that go unnoticed when using conventional imaging. Findings may help define initial diagnoses and therapeutic plans, but only histopathology provides a definitive diagnosis. Surgical enucleation of the periapical lesion is recommended if nonsurgical root canal treatment fails to control apical periodontitis. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Evaluation of paradoxical TB–associated IRIS with the use of standardized case definitions for resource limited settings

PubMed Central

Eshun-Wilson, Ingrid; Havers, Fiona; Nachega, Jean B; Prozesky, Hans W; Taljaard, Jantjie J; Zeier, Michele D; Cotton, Mark; Simon, Gary; Soentjens, Patrick

2011-01-01

Objective Standardized case definitions have recently been proposed by the International Network for the Study of HIV-associated IRIS (INSHI) for use in resource-limited settings. We evaluated paradoxical TB-associated IRIS in a large cohort from a TB endemic setting with the use of these case definitions. Design A retrospective cohort analysis. Methods We reviewed records from 1250 South African patients who initiated anti-retroviral therapy (ART) over a five-year period. Results 333 (27%) of the patients in the cohort had prevalent TB at the initiation of ART. Of 54 possible paradoxical TB-associated IRIS cases, 35 fulfilled the INSHI case definitions (11% of TB cases). Conclusions INSHI standardised case definitions were used successfully in identifying paradoxical TB-associated IRIS in this cohort and resulted in a similar proportion of TB IRIS cases (11%) as that reported in previous studies from resource-limited settings (8-13%). This case definition should be evaluated prospectively. PMID:20160249

Revision of clinical case definitions: influenza-like illness and severe acute respiratory infection

PubMed Central

Qasmieh, Saba; Mounts, Anthony Wayne; Alexander, Burmaa; Besselaar, Terry; Briand, Sylvie; Brown, Caroline; Clark, Seth; Dueger, Erica; Gross, Diane; Hauge, Siri; Hirve, Siddhivinayak; Jorgensen, Pernille; Katz, Mark A; Mafi, Ali; Malik, Mamunur; McCarron, Margaret; Meerhoff, Tamara; Mori, Yuichiro; Mott, Joshua; Olivera, Maria Teresa da Costa; Ortiz, Justin R; Palekar, Rakhee; Rebelo-de-Andrade, Helena; Soetens, Loes; Yahaya, Ali Ahmed; Zhang, Wenqing; Vandemaele, Katelijn

2018-01-01

Abstract The formulation of accurate clinical case definitions is an integral part of an effective process of public health surveillance. Although such definitions should, ideally, be based on a standardized and fixed collection of defining criteria, they often require revision to reflect new knowledge of the condition involved and improvements in diagnostic testing. Optimal case definitions also need to have a balance of sensitivity and specificity that reflects their intended use. After the 2009–2010 H1N1 influenza pandemic, the World Health Organization (WHO) initiated a technical consultation on global influenza surveillance. This prompted improvements in the sensitivity and specificity of the case definition for influenza – i.e. a respiratory disease that lacks uniquely defining symptomology. The revision process not only modified the definition of influenza-like illness, to include a simplified list of the criteria shown to be most predictive of influenza infection, but also clarified the language used for the definition, to enhance interpretability. To capture severe cases of influenza that required hospitalization, a new case definition was also developed for severe acute respiratory infection in all age groups. The new definitions have been found to capture more cases without compromising specificity. Despite the challenge still posed in the clinical separation of influenza from other respiratory infections, the global use of the new WHO case definitions should help determine global trends in the characteristics and transmission of influenza viruses and the associated disease burden. PMID:29403115

Cayenne aspiration: an unusual type of lower airway foreign-body aspiration

PubMed Central

Lin, Lianjun; Wang, Yuchuan; Zha, Xiankui; Tang, Fei; Lv, Liping; Liu, Xinmin

2014-01-01

Purpose Cayenne aspiration is an unusual type of foreign-body aspiration that is usually misdiagnosed. This article analyzes the clinical features of cayenne aspiration in the lower airway. Patients and methods Clinical data on eight adult patients with cayenne aspiration were retrospectively analyzed. Six were elderly patients. The data were collected from Peking University First Hospital and Anhui Chest Hospital between January 2010 and August 2014. Results The most common symptoms of cayenne aspiration were cough (eight cases, 100%) and sputum (five cases, 62.5%). Only one patient (12.5%) could supply the history of aspiration on his first visit to doctor and was diagnosed definitely without delay. The other seven cases were misdiagnosed as pneumonia and the time to accurate diagnosis was from 1 month to 6 months. The history of aspiration could be recalled after confirmed diagnosis for the other seven cases. The most common presentation shown by chest computed tomography (CT) was pneumonic opacity (eight cases, 100%). The existence of cayenne could not be detected by chest CT in any of the patients. All the patients were diagnosed definitively and managed successfully with flexible bronchoscopy. Cayenne was more often lodged in the right bronchus tree (seven cases, 87.5%), especially the right lower bronchus (four cases, 50%). The segment of cayenne was complete in five cases (62.5%) and scattered in three cases (37.5%). Conclusion The clinical features of cayenne aspiration are usually obscure and nonspecific which may lead to delay in diagnosis. Flexible bronchoscopy is safe and useful for early diagnosis and effective management. PMID:25473273

Geometry definition and grid generation for a complete fighter aircraft

NASA Technical Reports Server (NTRS)

Edwards, T. A.

1986-01-01

Recent advances in computing power and numerical solution procedures have enabled computational fluid dynamicists to attempt increasingly difficult problems. In particular, efforts are focusing on computations of complex three-dimensional flow fields about realistic aerodynamic bodies. To perform such computations, a very accurate and detailed description of the surface geometry must be provided, and a three-dimensional grid must be generated in the space around the body. The geometry must be supplied in a format compatible with the grid generation requirements, and must be verified to be free of inconsistencies. This paper presents a procedure for performing the geometry definition of a fighter aircraft that makes use of a commercial computer-aided design/computer-aided manufacturing system. Furthermore, visual representations of the geometry are generated using a computer graphics system for verification of the body definition. Finally, the three-dimensional grids for fighter-like aircraft are generated by means of an efficient new parabolic grid generation method. This method exhibits good control of grid quality.

Geometry definition and grid generation for a complete fighter aircraft

NASA Technical Reports Server (NTRS)

Edwards, Thomas A.

1986-01-01

Recent advances in computing power and numerical solution procedures have enabled computational fluid dynamicists to attempt increasingly difficult problems. In particular, efforts are focusing on computations of complex three-dimensional flow fields about realistic aerodynamic bodies. To perform such computations, a very accurate and detailed description of the surface geometry must be provided, and a three-dimensional grid must be generated in the space around the body. The geometry must be supplied in a format compatible with the grid generation requirements, and must be verified to be free of inconsistencies. A procedure for performing the geometry definition of a fighter aircraft that makes use of a commercial computer-aided design/computer-aided manufacturing system is presented. Furthermore, visual representations of the geometry are generated using a computer graphics system for verification of the body definition. Finally, the three-dimensional grids for fighter-like aircraft are generated by means of an efficient new parabolic grid generation method. This method exhibits good control of grid quality.

Moving mobile: using an open-sourced framework to enable a web-based health application on touch devices.

PubMed

Lindsay, Joseph; McLean, J Allen; Bains, Amrita; Ying, Tom; Kuo, M H

2013-01-01

Computer devices using touch-enabled technology are becoming more prevalent today. The application of a touch screen high definition surgical monitor could allow not only high definition video from an endoscopic camera to be displayed, but also the display and interaction with relevant patient and health related data. However, this technology has not been quickly embraced by all health care organizations. Although traditional keyboard or mouse-based software programs may function flawlessly on a touch-based device, many are not practical due to the usage of small buttons, fonts and very complex menu systems. This paper describes an approach taken to overcome these problems. A real case study was used to demonstrate the novelty and efficiency of the proposed method.

Effect of dental technician disparities on the 3-dimensional accuracy of definitive casts.

PubMed

Emir, Faruk; Piskin, Bulent; Sipahi, Cumhur

2017-03-01

Studies that evaluated the effect of dental technician disparities on the accuracy of presectioned and postsectioned definitive casts are lacking. The purpose of this in vitro study was to evaluate the accuracy of presectioned and postsectioned definitive casts fabricated by different dental technicians by using a 3-dimensional computer-aided measurement method. An arch-shaped metal master model consisting of 5 abutments resembling prepared mandibular incisors, canines, and first molars and with a 6-degree total angle of convergence was designed and fabricated by computer-aided design and computer-aided manufacturing (CAD-CAM) technology. Complete arch impressions were made (N=110) from the master model, using polyvinyl siloxane (PVS) and delivered to 11 dental technicians. Each technician fabricated 10 definitive casts with dental stone, and the obtained casts were numbered. All casts were sectioned, and removable dies were obtained. The master model and the presectioned and postsectioned definitive casts were digitized with an extraoral scanner, and the virtual master model and virtual presectioned and postsectioned definitive casts were obtained. All definitive casts were compared with the master model by using computer-aided measurements, and the 3-dimensional accuracy of the definitive casts was determined with best fit alignment and represented in color-coded maps. Differences were analyzed using univariate analyses of variance, and the Tukey honest significant differences post hoc tests were used for multiple comparisons (α=.05). The accuracy of presectioned and postsectioned definitive casts was significantly affected by dental technician disparities (P<.001). The largest dimensional changes were detected in the anterior abutments of both of the definitive casts. The changes mostly occurred in the mesiodistal dimension (P<.001). Within the limitations of this in vitro study, the accuracy of presectioned and postsectioned definitive casts is susceptible to dental technician differences. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Multigrid Methods for the Computation of Propagators in Gauge Fields

NASA Astrophysics Data System (ADS)

Kalkreuter, Thomas

Multigrid methods were invented for the solution of discretized partial differential equations in order to overcome the slowness of traditional algorithms by updates on various length scales. In the present work generalizations of multigrid methods for propagators in gauge fields are investigated. Gauge fields are incorporated in algorithms in a covariant way. The kernel C of the restriction operator which averages from one grid to the next coarser grid is defined by projection on the ground-state of a local Hamiltonian. The idea behind this definition is that the appropriate notion of smoothness depends on the dynamics. The ground-state projection choice of C can be used in arbitrary dimension and for arbitrary gauge group. We discuss proper averaging operations for bosons and for staggered fermions. The kernels C can also be used in multigrid Monte Carlo simulations, and for the definition of block spins and blocked gauge fields in Monte Carlo renormalization group studies. Actual numerical computations are performed in four-dimensional SU(2) gauge fields. We prove that our proposals for block spins are “good”, using renormalization group arguments. A central result is that the multigrid method works in arbitrarily disordered gauge fields, in principle. It is proved that computations of propagators in gauge fields without critical slowing down are possible when one uses an ideal interpolation kernel. Unfortunately, the idealized algorithm is not practical, but it was important to answer questions of principle. Practical methods are able to outperform the conjugate gradient algorithm in case of bosons. The case of staggered fermions is harder. Multigrid methods give considerable speed-ups compared to conventional relaxation algorithms, but on lattices up to 184 conjugate gradient is superior.

Stakeholder Perceptions of Cyberbullying Cases: Application of the Uniform Definition of Bullying.

PubMed

Moreno, Megan A; Suthamjariya, Nina; Selkie, Ellen

2018-04-01

The Uniform Definition of Bullying was developed to address bullying and cyberbullying, and to promote consistency in measurement and policy. The purpose of this study was to understand community stakeholder perceptions of typical cyberbullying cases, and to evaluate how these case descriptions align with the Uniform Definition. In this qualitative case analysis we recruited stakeholders commonly involved in cyberbullying. We used purposeful sampling to identify and recruit adolescents and young adults, parents, and professionals representing education and health care. Participants were asked to write a typical case of cyberbullying and descriptors in the context of a group discussion. We applied content analysis to case excerpts using inductive and deductive approaches, and chi-squared tests for mixed methods analyses. A total of 68 participants contributed; participants included 73% adults and 27% adolescents and young adults. A total of 650 excerpts were coded from participants' example cases and 362 (55.6%) were consistent with components of the Uniform Definition. The most frequently mentioned component of the Uniform Definition was Aggressive Behavior (n = 218 excerpts), whereas Repeated was mentioned infrequently (n = 19). Most participants included two to three components of the Uniform Definition within an example case; none of the example cases included all components of the Uniform Definition. We found that most participants described cyberbullying cases using few components of the Uniform Definition. Findings can be applied toward considering refinement of the Uniform Definition to ensure stakeholders find it applicable to cyberbullying. Copyright © 2017 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Fatigue after stroke: the development and evaluation of a case definition.

PubMed

Lynch, Joanna; Mead, Gillian; Greig, Carolyn; Young, Archie; Lewis, Susan; Sharpe, Michael

2007-11-01

While fatigue after stroke is a common problem, it has no generally accepted definition. Our aim was to develop a case definition for post-stroke fatigue and to test its psychometric properties. A case definition with face validity and an associated structured interview was constructed. After initial piloting, the feasibility, reliability (test-retest and inter-rater) and concurrent validity (in relation to four fatigue severity scales) were determined in 55 patients with stroke. All participating patients provided satisfactory answers to all the case definition probe questions demonstrating its feasibility For test-retest reliability, kappa was 0.78 (95% CI, 0.57-0.94, P<.01) and for inter-rater reliability kappa was 0.80 (95% CI, 0.62-0.99, P<.01). Patients fulfilling the case definition also had substantially higher fatigue scores on four fatigue severity scales (P<.001) indicating concurrent validity. The proposed case definition is feasible to administer and reliable in practice, and there is evidence of concurrent validity. It requires further evaluation in different settings.

Integrability of the one dimensional Schrödinger equation

NASA Astrophysics Data System (ADS)

Combot, Thierry

2018-02-01

We present a definition of integrability for the one-dimensional Schrödinger equation, which encompasses all known integrable systems, i.e., systems for which the spectrum can be explicitly computed. For this, we introduce the class of rigid functions, built as Liouvillian functions, but containing all solutions of rigid differential operators in the sense of Katz, and a notion of natural of boundary conditions. We then make a complete classification of rational integrable potentials. Many new integrable cases are found, some of them physically interesting.

Bisimulation equivalence of differential-algebraic systems

NASA Astrophysics Data System (ADS)

Megawati, Noorma Yulia; Schaft, Arjan van der

2018-01-01

In this paper, the notion of bisimulation relation for linear input-state-output systems is extended to general linear differential-algebraic (DAE) systems. Geometric control theory is used to derive a linear-algebraic characterisation of bisimulation relations, and an algorithm for computing the maximal bisimulation relation between two linear DAE systems. The general definition is specialised to the case where the matrix pencil sE - A is regular. Furthermore, by developing a one-sided version of bisimulation, characterisations of simulation and abstraction are obtained.

An Ontology to Improve Transparency in Case Definition and Increase Case Finding of Infectious Intestinal Disease: Database Study in English General Practice

PubMed Central

2017-01-01

Background Infectious intestinal disease (IID) has considerable health impact; there are 2 billion cases worldwide resulting in 1 million deaths and 78.7 million disability-adjusted life years lost. Reported IID incidence rates vary and this is partly because terms such as “diarrheal disease” and “acute infectious gastroenteritis” are used interchangeably. Ontologies provide a method of transparently comparing case definitions and disease incidence rates. Objective This study sought to show how differences in case definition in part account for variation in incidence estimates for IID and how an ontological approach provides greater transparency to IID case finding. Methods We compared three IID case definitions: (1) Royal College of General Practitioners Research and Surveillance Centre (RCGP RSC) definition based on mapping to the Ninth International Classification of Disease (ICD-9), (2) newer ICD-10 definition, and (3) ontological case definition. We calculated incidence rates and examined the contribution of four supporting concepts related to IID: symptoms, investigations, process of care (eg, notification to public health authorities), and therapies. We created a formal ontology using ontology Web language. Results The ontological approach identified 5712 more cases of IID than the ICD-10 definition and 4482 more than the RCGP RSC definition from an initial cohort of 1,120,490. Weekly incidence using the ontological definition was 17.93/100,000 (95% CI 15.63-20.41), whereas for the ICD-10 definition the rate was 8.13/100,000 (95% CI 6.70-9.87), and for the RSC definition the rate was 10.24/100,000 (95% CI 8.55-12.12). Codes from the four supporting concepts were generally consistent across our three IID case definitions: 37.38% (3905/10,448) (95% CI 36.16-38.5) for the ontological definition, 38.33% (2287/5966) (95% CI 36.79-39.93) for the RSC definition, and 40.82% (1933/4736) (95% CI 39.03-42.66) for the ICD-10 definition. The proportion of laboratory results associated with a positive test result was 19.68% (546/2775). Conclusions The standard RCGP RSC definition of IID, and its mapping to ICD-10, underestimates disease incidence. The ontological approach identified a larger proportion of new IID cases; the ontology divides contributory elements and enables transparency and comparison of rates. Results illustrate how improved diagnostic coding of IID combined with an ontological approach to case definition would provide a clearer picture of IID in the community, better inform GPs and public health services about circulating disease, and empower them to respond. We need to improve the Pathology Bounded Code List (PBCL) currently used by laboratories to electronically report results. Given advances in stool microbiology testing with a move to nonculture, PCR-based methods, the way microbiology results are reported and coded via PBCL needs to be reviewed and modernized. PMID:28958989

Evaluation of a surveillance case definition for anogenital warts, Kaiser Permanente northwest.

PubMed

Naleway, Allison L; Weinmann, Sheila; Crane, Brad; Gee, Julianne; Markowitz, Lauri E; Dunne, Eileen F

2014-08-01

Most studies of anogenital wart (AGW) epidemiology have used large clinical or administrative databases and unconfirmed case definitions based on combinations of diagnosis and procedure codes. We developed and validated an AGW case definition using a combination of diagnosis codes and other information available in the electronic medical record (provider type, laboratory testing). We calculated the positive predictive value (PPV) of this case definition compared with manual medical record review in a random sample of 250 cases. Using this case definition, we calculated the annual age- and sex-stratified prevalence of AGW among individuals 11 through 30 years of age from 2000 through 2005. We identified 2730 individuals who met the case definition. The PPV of the case definition was 82%, and the average annual prevalence was 4.16 per 1000. Prevalence of AGW was higher in females compared with males in every age group, with the exception of the 27- to 30-year-olds. Among females, prevalence peaked in the 19- to 22-year-olds, and among males, the peak was observed in 23- to 26-year-olds. The case definition developed in this study is the first to be validated with medical record review and has a good PPV for the detection of AGW. The prevalence rates observed in this study were higher than other published rates, but the age- and sex-specific patterns observed were consistent with previous reports.

The Junior Computer Dictionary. 101 Useful Words and Definitions to Introduce Students to Computer Terminology.

ERIC Educational Resources Information Center

Willing, Kathlene R.; Girard, Suzanne

Suitable for children from grades four to seven, this dictionary is designed to introduce children to computer terminology at a level that they will understand and find useful. It is also suitable as a home resource for parents, for library use, and as a handbook for teachers. For each word, the first sentence of the definition contains the kernel…

Comparison of different criteria for periodontitis case definition in head and neck cancer individuals.

PubMed

Bueno, Audrey Cristina; Ferreira, Raquel Conceição; Cota, Luis Otávio Miranda; Silva, Guilherme Carvalho; Magalhães, Cláudia Silami; Moreira, Allyson Nogueira

2015-09-01

Different periodontitis case definitions have been used in clinical research and epidemiology. The aim of this study was to determine more accurate criterion for the definition of mild and moderate periodontitis case to be applied to head and neck cancer individuals before radiotherapy. The frequency of periodontitis in a sample of 84 individuals was determined according to different diagnostic criteria: (1) Lopez et al. (2002);(2) Hujoel et al. (2006); (3) Beck et al. (1990); (4) Machtei et al. (1992); (5) Tonetti and Claffey (2005); (6) and Page and Eke (2007). All diagnosis were based on the clinical parameters obtained by a single calibrated examiner (Kw = 0.71). The individuals were evaluated before radiotherapy. They received oral hygiene instructions, and the cases diagnosed with periodontitis (Page and Eke 2007) were treated. The gold standard was the definition 6, and the others were compared by means of agreement, sensitivity (SS), specificity (SP), and the area under ROC curve. The kappa test evaluated the agreement between definitions. The frequency of periodontitis at baseline was 53.6 % (definition 1), 81.0 % (definition 2), 40.5 % (definition 3), 26.2 % (definition 4), 13.1 % (definition 5), and 70.2 % (definition 6). The kappa test showed a moderate agreement between definitions 6 and 2 (59.0 %) and definitions 6 and 1 (56.0 %). The criterion with higher SS (0.92) and SP (0.73) was definition 1. Definition 1 was the most accurate criterion to case periodontitis definition to be applied to head and neck cancer individuals.

Computed tomographic findings in 44 dogs and 10 cats with grass seed foreign bodies.

PubMed

Vansteenkiste, D P; Lee, K C L; Lamb, C R

2014-11-01

To supplement recent reports of computed tomographic (CT) findings in dogs and cats with grass seed foreign bodies. Retrospective review of cases that had CT scan and subsequent retrieval of a grass seed during the same period of hospitalisation from a site included in the scan. Records of 44 dogs and 10 cats were reviewed. Most were presented in the months July to December. Median duration of clinical signs was 4 weeks (range 2 days to 2 years). The most frequent clinical signs were soft tissue swelling (30% cases), coughing (28%), sneezing (28%) and discharge (26%). Grass seeds were retrieved from the thorax (35% cases), nasal cavity (31%), ear (7%), other sites in the head and neck (22%), sublumbar muscles (2%) and pelvic limb (2%). The grass seed was visible in CT images in 10 (19%) cases. Secondary lesions were visible in CT images of 52 (96%) cases, including collection of exudate (37%), abscess (24%), enlarged lymph nodes (22%) and pulmonary consolidation (20%). CT images appeared normal in 4% animals. Grass seeds within the respiratory tract are frequently visible in CT images, but in general CT appears to be more useful for localisation of secondary lesions than as a method of definite diagnosis. © 2014 British Small Animal Veterinary Association.

What is biomedical informatics?

PubMed Central

Bernstam, Elmer V.; Smith, Jack W.; Johnson, Todd R.

2009-01-01

Biomedical informatics lacks a clear and theoretically grounded definition. Many proposed definitions focus on data, information, and knowledge, but do not provide an adequate definition of these terms. Leveraging insights from the philosophy of information, we define informatics as the science of information, where information is data plus meaning. Biomedical informatics is the science of information as applied to or studied in the context of biomedicine. Defining the object of study of informatics as data plus meaning clearly distinguishes the field from related fields, such as computer science, statistics and biomedicine, which have different objects of study. The emphasis on data plus meaning also suggests that biomedical informatics problems tend to be difficult when they deal with concepts that are hard to capture using formal, computational definitions. In other words, problems where meaning must be considered are more difficult than problems where manipulating data without regard for meaning is sufficient. Furthermore, the definition implies that informatics research, teaching, and service should focus on biomedical information as data plus meaning rather than only computer applications in biomedicine. PMID:19683067

48 CFR 204.7301 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 204.7301 Definitions. As used in this subpart— Adequate security means protective measures that are... restrictions. Cyber incident means actions taken through the use of computer networks that result in an actual.... Technical information means technical data or computer software, as those terms are defined in the clause at...

Surveillance of paediatric traumatic brain injuries using the NEISS: choosing an appropriate case definition.

PubMed

Thompson, Meghan C; Wheeler, Krista K; Shi, Junxin; Smith, Gary A; Groner, Jonathan I; Haley, Kathryn J; Xiang, Huiyun

2014-01-01

To evaluate the definition of traumatic brain injury (TBI) in the National Electronic Injury Surveillance System (NEISS) and compare TBI case ascertainment using NEISS vs. ICD-9-CM diagnosis coding. Two data samples from a NEISS participating emergency department (ED) in 2008 were compared: (1) NEISS records meeting the recommended NEISS TBI definition and (2) Hospital ED records meeting the ICD-9-CM CDC recommended TBI definition. The sensitivity and positive predictive value were calculated for the NEISS definition using the ICD-9-CM definition as the gold standard. Further analyses were performed to describe cases characterized as TBIs in both datasets and to determine why some cases were not classified as TBIs in both datasets. There were 1834 TBI cases captured by the NEISS and 1836 TBI cases captured by the ICD-9-CM coded ED record, but only 1542 were eligible for inclusion in NEISS. There were 1403 cases classified as TBIs by both the NEISS and ICD-9-CM diagnosis codes. The NEISS TBI definition had a sensitivity of 91.0% (95% CI = 89.6-92.4%) and positive predictive value of 76.5% (95% CI = 74.6-78.4%). Using the NEISS TBI definition presented in this paper would standardize and improve the accuracy of TBI research using the NEISS.

Internet addiction: definition, assessment, epidemiology and clinical management.

PubMed

Shaw, Martha; Black, Donald W

2008-01-01

Internet addiction is characterized by excessive or poorly controlled preoccupations, urges or behaviours regarding computer use and internet access that lead to impairment or distress. The condition has attracted increasing attention in the popular media and among researchers, and this attention has paralleled the growth in computer (and Internet) access. Prevalence estimates vary widely, although a recent random telephone survey of the general US population reported an estimate of 0.3-0.7%. The disorder occurs worldwide, but mainly in countries where computer access and technology are widespread. Clinical samples and a majority of relevant surveys report a male preponderance. Onset is reported to occur in the late 20s or early 30s age group, and there is often a lag of a decade or more from initial to problematic computer usage. Internet addiction has been associated with dimensionally measured depression and indicators of social isolation. Psychiatric co-morbidity is common, particularly mood, anxiety, impulse control and substance use disorders. Aetiology is unknown, but probably involves psychological, neurobiological and cultural factors. There are no evidence-based treatments for internet addiction. Cognitive behavioural approaches may be helpful. There is no proven role for psychotropic medication. Marital and family therapy may help in selected cases, and online self-help books and tapes are available. Lastly, a self-imposed ban on computer use and Internet access may be necessary in some cases.

TOSCA-based orchestration of complex clusters at the IaaS level

NASA Astrophysics Data System (ADS)

Caballer, M.; Donvito, G.; Moltó, G.; Rocha, R.; Velten, M.

2017-10-01

This paper describes the adoption and extension of the TOSCA standard by the INDIGO-DataCloud project for the definition and deployment of complex computing clusters together with the required support in both OpenStack and OpenNebula, carried out in close collaboration with industry partners such as IBM. Two examples of these clusters are described in this paper, the definition of an elastic computing cluster to support the Galaxy bioinformatics application where the nodes are dynamically added and removed from the cluster to adapt to the workload, and the definition of an scalable Apache Mesos cluster for the execution of batch jobs and support for long-running services. The coupling of TOSCA with Ansible Roles to perform automated installation has resulted in the definition of high-level, deterministic templates to provision complex computing clusters across different Cloud sites.

Flexible Description Language for HPC based Processing of Remote Sense Data

NASA Astrophysics Data System (ADS)

Nandra, Constantin; Gorgan, Dorian; Bacu, Victor

2016-04-01

When talking about Big Data, the most challenging aspect lays in processing them in order to gain new insight, find new patterns and gain knowledge from them. This problem is likely most apparent in the case of Earth Observation (EO) data. With ever higher numbers of data sources and increasing data acquisition rates, dealing with EO data is indeed a challenge [1]. Geoscientists should address this challenge by using flexible and efficient tools and platforms. To answer this trend, the BigEarth project [2] aims to combine the advantages of high performance computing solutions with flexible processing description methodologies in order to reduce both task execution times and task definition time and effort. As a component of the BigEarth platform, WorDeL (Workflow Description Language) [3] is intended to offer a flexible, compact and modular approach to the task definition process. WorDeL, unlike other description alternatives such as Python or shell scripts, is oriented towards the description topologies, using them as abstractions for the processing programs. This feature is intended to make it an attractive alternative for users lacking in programming experience. By promoting modular designs, WorDeL not only makes the processing descriptions more user-readable and intuitive, but also helps organizing the processing tasks into independent sub-tasks, which can be executed in parallel on multi-processor platforms in order to improve execution times. As a BigEarth platform [4] component, WorDeL represents the means by which the user interacts with the system, describing processing algorithms in terms of existing operators and workflows [5], which are ultimately translated into sets of executable commands. The WorDeL language has been designed to help in the definition of compute-intensive, batch tasks which can be distributed and executed on high-performance, cloud or grid-based architectures in order to improve the processing time. Main references for further information: [1] Gorgan, D., "Flexible and Adaptive Processing of Earth Observation Data over High Performance Computation Architectures", International Conference and Exhibition Satellite 2015, August 17-19, Houston, Texas, USA. [2] Bigearth project - flexible processing of big earth data over high performance computing architectures. http://cgis.utcluj.ro/bigearth, (2014) [3] Nandra, C., Gorgan, D., "Workflow Description Language for Defining Big Earth Data Processing Tasks", Proceedings of the Intelligent Computer Communication and Processing (ICCP), IEEE-Press, pp. 461-468, (2015). [4] Bacu, V., Stefan, T., Gorgan, D., "Adaptive Processing of Earth Observation Data on Cloud Infrastructures Based on Workflow Description", Proceedings of the Intelligent Computer Communication and Processing (ICCP), IEEE-Press, pp.444-454, (2015). [5] Mihon, D., Bacu, V., Colceriu, V., Gorgan, D., "Modeling of Earth Observation Use Cases through the KEOPS System", Proceedings of the Intelligent Computer Communication and Processing (ICCP), IEEE-Press, pp. 455-460, (2015).

An Ontology to Improve Transparency in Case Definition and Increase Case Finding of Infectious Intestinal Disease: Database Study in English General Practice.

PubMed

de Lusignan, Simon; Shinneman, Stacy; Yonova, Ivelina; van Vlymen, Jeremy; Elliot, Alex J; Bolton, Frederick; Smith, Gillian E; O'Brien, Sarah

2017-09-28

Infectious intestinal disease (IID) has considerable health impact; there are 2 billion cases worldwide resulting in 1 million deaths and 78.7 million disability-adjusted life years lost. Reported IID incidence rates vary and this is partly because terms such as "diarrheal disease" and "acute infectious gastroenteritis" are used interchangeably. Ontologies provide a method of transparently comparing case definitions and disease incidence rates. This study sought to show how differences in case definition in part account for variation in incidence estimates for IID and how an ontological approach provides greater transparency to IID case finding. We compared three IID case definitions: (1) Royal College of General Practitioners Research and Surveillance Centre (RCGP RSC) definition based on mapping to the Ninth International Classification of Disease (ICD-9), (2) newer ICD-10 definition, and (3) ontological case definition. We calculated incidence rates and examined the contribution of four supporting concepts related to IID: symptoms, investigations, process of care (eg, notification to public health authorities), and therapies. We created a formal ontology using ontology Web language. The ontological approach identified 5712 more cases of IID than the ICD-10 definition and 4482 more than the RCGP RSC definition from an initial cohort of 1,120,490. Weekly incidence using the ontological definition was 17.93/100,000 (95% CI 15.63-20.41), whereas for the ICD-10 definition the rate was 8.13/100,000 (95% CI 6.70-9.87), and for the RSC definition the rate was 10.24/100,000 (95% CI 8.55-12.12). Codes from the four supporting concepts were generally consistent across our three IID case definitions: 37.38% (3905/10,448) (95% CI 36.16-38.5) for the ontological definition, 38.33% (2287/5966) (95% CI 36.79-39.93) for the RSC definition, and 40.82% (1933/4736) (95% CI 39.03-42.66) for the ICD-10 definition. The proportion of laboratory results associated with a positive test result was 19.68% (546/2775). The standard RCGP RSC definition of IID, and its mapping to ICD-10, underestimates disease incidence. The ontological approach identified a larger proportion of new IID cases; the ontology divides contributory elements and enables transparency and comparison of rates. Results illustrate how improved diagnostic coding of IID combined with an ontological approach to case definition would provide a clearer picture of IID in the community, better inform GPs and public health services about circulating disease, and empower them to respond. We need to improve the Pathology Bounded Code List (PBCL) currently used by laboratories to electronically report results. Given advances in stool microbiology testing with a move to nonculture, PCR-based methods, the way microbiology results are reported and coded via PBCL needs to be reviewed and modernized. ©Simon de Lusignan, Stacy Shinneman, Ivelina Yonova, Jeremy van Vlymen, Alex J Elliot, Frederick Bolton, Gillian E Smith, Sarah O'Brien. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 28.09.2017.

Helicity amplitudes for QCD with massive quarks

NASA Astrophysics Data System (ADS)

Ochirov, Alexander

2018-04-01

The novel massive spinor-helicity formalism of Arkani-Hamed, Huang and Huang provides an elegant way to calculate scattering amplitudes in quantum chromodynamics for arbitrary quark spin projections. In this note we compute two families of tree-level QCD amplitudes with one massive quark pair and n - 2 gluons. The two cases include all gluons with identical helicity and one opposite-helicity gluon being color-adjacent to one of the quarks. Our results naturally incorporate the previously known amplitudes for both quark spins quantized along one of the gluonic momenta. In the all-multiplicity formulae presented here the spin quantization axes can be tuned at will, which includes the case of the definite-helicity quark states.

Computer program to assess impact of fatigue and fracture criteria on weight and cost of transport aircraft

NASA Technical Reports Server (NTRS)

Tanner, C. J.; Kruse, G. S.; Oman, B. H.

1975-01-01

A preliminary design analysis tool for rapidly performing trade-off studies involving fatigue, fracture, static strength, weight, and cost is presented. Analysis subprograms were developed for fatigue life, crack growth life, and residual strength; and linked to a structural synthesis module which in turn was integrated into a computer program. The part definition module of a cost and weight analysis program was expanded to be compatible with the upgraded structural synthesis capability. The resultant vehicle design and evaluation program is named VDEP-2. It is an accurate and useful tool for estimating purposes at the preliminary design stage of airframe development. A sample case along with an explanation of program applications and input preparation is presented.

Case definition and classification of leukodystrophies and leukoencephalopathies.

PubMed

Vanderver, Adeline; Prust, Morgan; Tonduti, Davide; Mochel, Fanny; Hussey, Heather M; Helman, Guy; Garbern, James; Eichler, Florian; Labauge, Pierre; Aubourg, Patrick; Rodriguez, Diana; Patterson, Marc C; Van Hove, Johan L K; Schmidt, Johanna; Wolf, Nicole I; Boespflug-Tanguy, Odile; Schiffmann, Raphael; van der Knaap, Marjo S

2015-04-01

An approved definition of the term leukodystrophy does not currently exist. The lack of a precise case definition hampers efforts to study the epidemiology and the relevance of genetic white matter disorders to public health. Thirteen experts at multiple institutions participated in iterative consensus building surveys to achieve definition and classification of disorders as leukodystrophies using a modified Delphi approach. A case definition for the leukodystrophies was achieved, and a total of 30 disorders were classified under this definition. In addition, a separate set of disorders with heritable white matter abnormalities but not meeting criteria for leukodystrophy, due to presumed primary neuronal involvement and prominent systemic manifestations, was classified as genetic leukoencephalopathies (gLE). A case definition of leukodystrophies and classification of heritable white matter disorders will permit more detailed epidemiologic studies of these disorders. Copyright © 2015 Elsevier Inc. All rights reserved.

Challenges in congenital syphilis surveillance: how are congenital syphilis investigations classified?

PubMed

Introcaso, Camille E; Gruber, DeAnn; Bradley, Heather; Peterman, Thomas A; Ewell, Joy; Wendell, Debbie; Foxhood, Joseph; Su, John R; Weinstock, Hillard S; Markowitz, Lauri E

2013-09-01

Congenital syphilis is a serious, preventable, and nationally notifiable disease. Despite the existence of a surveillance case definition, congenital syphilis is sometimes classified differently using an algorithm on the Centers for Disease Control and Prevention's case reporting form. We reviewed Louisiana's congenital syphilis electronic reporting system for investigations of infants born from January 2010 to October 2011, abstracted data required for classification, and applied the surveillance definition and the algorithm. We calculated the sensitivities and specificities of the algorithm and Louisiana's classification using the surveillance definition as the surveillance gold standard. Among 349 congenital syphilis investigations, the surveillance definition identified 62 cases. The algorithm had a sensitivity of 91.9% and a specificity of 64.1%. Louisiana's classification had a sensitivity of 50% and a specificity of 91.3% compared with the surveillance definition. The differences between the algorithm and the surveillance definition led to misclassification of congenital syphilis cases. The algorithm should match the surveillance definition. Other state and local health departments should assure that their reported cases meet the surveillance definition.

Epidemiologic evidence of health effects from long-distance transit of chemical weapons fallout from bombing early in the 1991 Persian Gulf War.

PubMed

Haley, Robert W; Tuite, James J

2013-01-01

Military intelligence data published in a companion paper explain how chemical fallout from US and Coalition bombing of Iraqi chemical weapons facilities early in the air campaign transited long distance, triggering nerve agent alarms and exposing US troops. We report the findings of a population-based survey designed to test competing hypotheses on the impact on chronic Gulf War illness of nerve agent from early-war bombing versus post-war demolition. The US Military Health Survey performed computer-assisted telephone interviews of a stratified random sample of Gulf War-era veterans (n = 8,020). Early-war exposure was measured by having heard nerve agent alarms and post-war exposure, by the computer-generated plume from the Khamisiyah demolition. Gulf War illness was measured by two widely published case definitions. The OR (95% CI) for the association of alarms with the Factor case definition was 4.13 (95% CI 2.51-6.80) compared with 1.21 (95% CI 0.86-1.69) for the Khamisiyah plume. There was a dose-related trend for the number of alarms (p(trend) < 0.001) but not for the number of days in the Khamisiyah plume (p(trend) = 0.17). Exposure to low-level sarin nerve agent in fallout from bombing early in the air campaign contributed more to chronic illness than post-war demolition. Copyright © 2012 S. Karger AG, Basel.

41 CFR 105-56.025 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 41 Public Contracts and Property Management 3 2011-01-01 2011-01-01 false Definitions. 105-56.025...-GSA as Paying Agency § 105-56.025 Definitions. The following definitions apply to this subpart: (a... of the Federal Government, including Government corporations. (c) Centralized salary offset computer...

Stress Computed Tomography Myocardial Perfusion Imaging: A New Topic in Cardiology.

PubMed

Seitun, Sara; Castiglione Morelli, Margherita; Budaj, Irilda; Boccalini, Sara; Galletto Pregliasco, Athena; Valbusa, Alberto; Cademartiri, Filippo; Ferro, Carlo

2016-02-01

Since its introduction about 15 years ago, coronary computed tomography angiography has become today the most accurate clinical instrument for noninvasive assessment of coronary atherosclerosis. Important technical developments have led to a continuous stream of new clinical applications together with a significant reduction in radiation dose exposure. Latest generation computed tomography scanners (≥ 64 slices) allow the possibility of performing static or dynamic perfusion imaging during stress by using coronary vasodilator agents (adenosine, dipyridamole, or regadenoson), combining both functional and anatomical information in the same examination. In this article, the emerging role and state-of-the-art of myocardial computed tomography perfusion imaging are reviewed and are illustrated by clinical cases from our experience with a second-generation dual-source 128-slice scanner (Somatom Definition Flash, Siemens; Erlangen, Germany). Technical aspects, data analysis, diagnostic accuracy, radiation dose and future prospects are reviewed. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

A study of upwind schemes on the laminar hypersonic heating predictions for the reusable space vehicle

NASA Astrophysics Data System (ADS)

Qu, Feng; Sun, Di; Zuo, Guang

2018-06-01

With the rapid development of the Computational Fluid Dynamics (CFD), Accurate computing hypersonic heating is in a high demand for the design of the new generation reusable space vehicle to conduct deep space exploration. In the past years, most researchers try to solve this problem by concentrating on the choice of the upwind schemes or the definition of the cell Reynolds number. However, the cell Reynolds number dependencies and limiter dependencies of the upwind schemes, which are of great importance to their performances in hypersonic heating computations, are concerned by few people. In this paper, we conduct a systematic study on these properties respectively. Results in our test cases show that SLAU (Simple Low-dissipation AUSM-family) is with a much higher level of accuracy and robustness in hypersonic heating predictions. Also, it performs much better in terms of the limiter dependency and the cell Reynolds number dependency.

Prevalence and spectrum of residual symptoms in Lyme neuroborreliosis after pharmacological treatment: a systematic review.

PubMed

Dersch, R; Sommer, H; Rauer, S; Meerpohl, J J

2016-01-01

Controversy exists about residual symptoms after pharmacological treatment of Lyme neuroborreliosis. Reports of disabling long-term sequels lead to concerns in patients and health care providers. We systematically reviewed the available evidence from studies reporting treatment of Lyme neuroborreliosis to assess the prevalence and spectrum of residual symptoms after treatment. A literature search was performed in three databases and three clinical trial registers to find eligible studies reporting on residual symptoms in patients after pharmacological treatment of LNB. Diagnosis must have been performed according to consensus-derived case definitions. No restrictions regarding study design or language were set. Symptom prevalence was pooled using a random-effects model. Forty-four eligible clinical trials and studies were found: 8 RCTs, 17 cohort studies, 2 case-control studies, and 17 case series. The follow-up period in the eligible studies ranged from 7 days to 20 years. The weighted mean proportion of residual symptoms was 28 % (95 % CI 23-34 %, n = 34 studies) for the latest reported time point. Prevalence of residual symptoms was statistically significantly higher in studies using the "possible" case definition (p = 0.0048). Cranial neuropathy, pain, paresis, cognitive disturbances, headache, and fatigue were statistically significantly lower in studies using the "probable/definite" case definition. LNB patients may experience residual symptoms after treatment with a prevalence of approximately 28 %. The prevalence and spectrum of residual symptoms differ according to the applied case definition. Symptoms like fatigue are not reported in studies using the "probable/definite" case definition. As the "possible" case definition is more unspecific, patients with other conditions may be included. Reports of debilitating fatigue and cognitive impairment after LNB, a "post-Lyme syndrome", could therefore be an artifact of unspecific case definitions in single studies.

Wind turbines and health: An examination of a proposed case definition.

PubMed

McCunney, Robert J; Morfeld, Peter; Colby, W David; Mundt, Kenneth A

2015-01-01

Renewable energy demands have increased the need for new wind farms. In turn, concerns have been raised about potential adverse health effects on nearby residents. A case definition has been proposed to diagnose "Adverse Health Effects in the Environs of Industrial Wind Turbines" (AHE/IWT); initially in 2011 and then with an update in 2014. The authors invited commentary and in turn, we assessed its scientific merits by quantitatively evaluating its proposed application. We used binomial coefficients to quantitatively assess the potential of obtaining a diagnosis of AHE/IWT. We also reviewed the methodology and process of the development of the case definition by contrasting it with guidelines on case definition criteria of the USA Institute of Medicine. The case definition allows at least 3,264 and up to 400,000 possibilities for meeting second- and third-order criteria, once the limited first-order criteria are met. IOM guidelines for clinical case definitions were not followed. The case definition has virtually no specificity and lacks scientific support from peer-reviewed literature. If applied as proposed, its application will lead to substantial potential for false-positive assessments and missed diagnoses. Virtually any new illness that develops or any prevalent illness that worsens after the installation of wind turbines within 10 km of a residence could be considered AHE/IWT if the patient feels better away from home. The use of this case definition in the absence of a thorough medical evaluation with appropriate diagnostic studies poses risks to patients in that treatable disorders would be overlooked. The case definition has significant potential to mislead patients and its use cannot be recommended for application in any health-care or decision-making setting.

Wind turbines and health: An examination of a proposed case definition

PubMed Central

McCunney, Robert J.; Morfeld, Peter; Colby, W. David; Mundt, Kenneth A.

2015-01-01

Renewable energy demands have increased the need for new wind farms. In turn, concerns have been raised about potential adverse health effects on nearby residents. A case definition has been proposed to diagnose “Adverse Health Effects in the Environs of Industrial Wind Turbines” (AHE/IWT); initially in 2011 and then with an update in 2014. The authors invited commentary and in turn, we assessed its scientific merits by quantitatively evaluating its proposed application. We used binomial coefficients to quantitatively assess the potential of obtaining a diagnosis of AHE/IWT. We also reviewed the methodology and process of the development of the case definition by contrasting it with guidelines on case definition criteria of the USA Institute of Medicine. The case definition allows at least 3,264 and up to 400,000 possibilities for meeting second- and third-order criteria, once the limited first-order criteria are met. IOM guidelines for clinical case definitions were not followed. The case definition has virtually no specificity and lacks scientific support from peer-reviewed literature. If applied as proposed, its application will lead to substantial potential for false-positive assessments and missed diagnoses. Virtually any new illness that develops or any prevalent illness that worsens after the installation of wind turbines within 10 km of a residence could be considered AHE/IWT if the patient feels better away from home. The use of this case definition in the absence of a thorough medical evaluation with appropriate diagnostic studies poses risks to patients in that treatable disorders would be overlooked. The case definition has significant potential to mislead patients and its use cannot be recommended for application in any health-care or decision-making setting. PMID:26168947

Drug substitution associated with a hospital stay in Belgium: a retrospective analysis of a claims database.

PubMed

Simoens, Steven; Dubois, Cécile; Spinewine, Anne; Foulon, Veerle; Paulus, Dominique

2014-04-01

This study measures the extent of drug substitution associated with a hospital stay in Belgium. Data were extracted from the 2006-2007 dataset of the Belgian Agency of Health Insurance Funds on drug use of patients hospitalized in acute hospitals. Reimbursed drugs received in ambulatory care during the 3 months prior to hospitalization were compared with drugs received during the 3 months following hospital discharge. Both a narrow definition and a broad definition were used for drug substitution. Narrow substitution (switches between generic and originator drugs) was computed for 14 drug classes for chronic conditions with the highest public expenditure. Broad substitution (changes between chemical substances within the drug class at ATC level 4, changes in brand name) was calculated for statins and proton-pump inhibitors only. The database included 17 764 patients (mean age 66 ± 17 years; 60% female). In 71% of cases an originator drug was received prior to and following hospitalization. A generic drug was received prior to and following hospitalization in 25% of cases. Some form of narrow substitution occurred in 4% of cases: a generic drug was replaced by an originator drug in 2% of cases and an originator drug was replaced by a generic drug in 2% of cases. Some form of broad substitution occurred in 25% of cases for proton-pump inhibitors and 13% of cases for statins. Hospitalization was not a trigger for changes between originator and generic versions of a drug. Broad substitution associated with a hospital stay was relatively limited for statins and proton-pump inhibitors. © 2013 Royal Pharmaceutical Society.

Anomalous origin of the right coronary artery evaluated with multidetector computed tomography and its clinical relevance.

PubMed

Hirono, Keiichi; Hata, Yukiko; Miyao, Naruaki; Nakaoka, Hideyuki; Saito, Kazuyoshi; Ibuki, Keijiro; Watanabe, Kazuhiro; Ozawa, Sayaka; Higuma, Tomonori; Yoshimura, Naoki; Nishida, Naoki; Ichida, Fukiko

2016-09-01

Anomalous origin of the right coronary artery (AORCA) is a rare congenital anomaly that may cause myocardial ischemia and sudden death. We reviewed the clinicopathological records of three cases of AORCA, and compared these with two cases of sudden cardiac death with AORCA revealed by autopsy. We report three juvenile cases with an AORCA originating above the commissural junction between the left and right aortic sinuses, with interarterial and intramural compression. They presented with exertional symptoms and were diagnosed with an AORCA by multidetector computed tomography (MDCT), which successfully delineated the spatial resolution of the anomalous origin and course of the right coronary artery (RCA), in the operating room. All three underwent successful surgical unroofing of the RCA. Two cases of sudden cardiac death with AORCA revealed by autopsy showed a slit-like orifice, acute-angled take-off, and long intramural course of the RCA, resembling the RCAs of three juvenile cases. It is crucial to be alert to the presentation of exertional symptoms, as sudden death may be the first manifestation of an anomalous coronary artery, such as those observed in these three cases. MDCT provided an excellent definition and spatial resolution of the unusual origin and intramural course of the RCA, facilitating the correct surgical remedy and resulting in a good outcome for the patients. Copyright © 2016 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

17 CFR 145.0 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 17 Commodity and Securities Exchanges 1 2012-04-01 2012-04-01 false Definitions. 145.0 Section 145... INFORMATION § 145.0 Definitions. For the purposes of part 145 the following definitions are applicable..., microfiche, drawing, or computer-stored information or output in the possession of the Commission. The term...

17 CFR 145.0 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Definitions. 145.0 Section 145... INFORMATION § 145.0 Definitions. For the purposes of part 145 the following definitions are applicable..., microfiche, drawing, or computer-stored information or output in the possession of the Commission. The term...

17 CFR 145.0 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 17 Commodity and Securities Exchanges 1 2013-04-01 2013-04-01 false Definitions. 145.0 Section 145... INFORMATION § 145.0 Definitions. For the purposes of part 145 the following definitions are applicable..., microfiche, drawing, or computer-stored information or output in the possession of the Commission. The term...

Quantum computers: Definition and implementations

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

Perez-Delgado, Carlos A.; Kok, Pieter

The DiVincenzo criteria for implementing a quantum computer have been seminal in focusing both experimental and theoretical research in quantum-information processing. These criteria were formulated specifically for the circuit model of quantum computing. However, several new models for quantum computing (paradigms) have been proposed that do not seem to fit the criteria well. Therefore, the question is what are the general criteria for implementing quantum computers. To this end, a formal operational definition of a quantum computer is introduced. It is then shown that, according to this definition, a device is a quantum computer if it obeys the following criteria:more » Any quantum computer must consist of a quantum memory, with an additional structure that (1) facilitates a controlled quantum evolution of the quantum memory; (2) includes a method for information theoretic cooling of the memory; and (3) provides a readout mechanism for subsets of the quantum memory. The criteria are met when the device is scalable and operates fault tolerantly. We discuss various existing quantum computing paradigms and how they fit within this framework. Finally, we present a decision tree for selecting an avenue toward building a quantum computer. This is intended to help experimentalists determine the most natural paradigm given a particular physical implementation.« less

A Rare Cause of Acute Abdomen: Diagnosis and Management of Adult Colonic Intussusception.

PubMed

Sertkaya, Mehmet; Emre, Arif; Pircanoglu, Eyüp Mehmet; Yazar, Fatih Mehmet; Tepe, Murat; Cengiz, Emrah; Isler, Ali; Vicdan, Halit

2016-01-01

Intussusception in adults is very rarely seen, and this cause acute abdomen. A computed tomography (CT) scan, clinical suspicion, history, and a physical examination are important for the diagnosis. We present two cases of colonic intussusceptions induced by lipoma. The cases had similar locations, diagnoses, and management. Both lipomas were located close to the cecum in the ascending colon, and a right segmental colon resection was performed in both cases. The follow-up of both cases was uneventful. Although benign lesions can cause colonic intussusception, the high incidence of malignancy in colonic lesions should always be considered. Therefore, oncologic surgical procedures should be applied. The definitive diagnosis can be made by histopathology. Sertkaya M, Emre A, Pircanoglu EM, Yazar FM, Tepe M, Cengiz E, Isler A, Vicdan H. A Rare cause of Acute Abdomen: Diagnosis and Management of Adult Colonic Intussusception. Euroasian J Hepato-Gastroenterol 2016;6(2):179-182.

Determination of the optimal case definition for the diagnosis of end-stage renal disease from administrative claims data in Manitoba, Canada.

PubMed

Komenda, Paul; Yu, Nancy; Leung, Stella; Bernstein, Keevin; Blanchard, James; Sood, Manish; Rigatto, Claudio; Tangri, Navdeep

2015-01-01

End-stage renal disease (ESRD) is a major public health problem with increasing prevalence and costs. An understanding of the long-term trends in dialysis rates and outcomes can help inform health policy. We determined the optimal case definition for the diagnosis of ESRD using administrative claims data in the province of Manitoba over a 7-year period. We determined the sensitivity, specificity, predictive value and overall accuracy of 4 administrative case definitions for the diagnosis of ESRD requiring chronic dialysis over different time horizons from Jan. 1, 2004, to Mar. 31, 2011. The Manitoba Renal Program Database served as the gold standard for confirming dialysis status. During the study period, 2562 patients were registered as recipients of chronic dialysis in the Manitoba Renal Program Database. Over a 1-year period (2010), the optimal case definition was any 2 claims for outpatient dialysis, and it was 74.6% sensitive (95% confidence interval [CI] 72.3%-76.9%) and 94.4% specific (95% CI 93.6%-95.2%) for the diagnosis of ESRD. In contrast, a case definition of at least 2 claims for dialysis treatment more than 90 days apart was 64.8% sensitive (95% CI 62.2%-67.3%) and 97.1% specific (95% CI 96.5%-97.7%). Extending the period to 5 years greatly improved sensitivity for all case definitions, with minimal change to specificity; for example, for the optimal case definition of any 2 claims for dialysis treatment, sensitivity increased to 86.0% (95% CI 84.7%-87.4%) at 5 years. Accurate case definitions for the diagnosis of ESRD requiring dialysis can be derived from administrative claims data. The optimal definition required any 2 claims for outpatient dialysis. Extending the claims period to 5 years greatly improved sensitivity with minimal effects on specificity for all case definitions.

Expressing clinical data sets with openEHR archetypes: a solid basis for ubiquitous computing.

PubMed

Garde, Sebastian; Hovenga, Evelyn; Buck, Jasmin; Knaup, Petra

2007-12-01

The purpose of this paper is to analyse the feasibility and usefulness of expressing clinical data sets (CDSs) as openEHR archetypes. For this, we present an approach to transform CDS into archetypes, and outline typical problems with CDS and analyse whether some of these problems can be overcome by the use of archetypes. Literature review and analysis of a selection of existing Australian, German, other European and international CDSs; transfer of a CDS for Paediatric Oncology into openEHR archetypes; implementation of CDSs in application systems. To explore the feasibility of expressing CDS as archetypes an approach to transform existing CDSs into archetypes is presented in this paper. In case of the Paediatric Oncology CDS (which consists of 260 data items) this lead to the definition of 48 openEHR archetypes. To analyse the usefulness of expressing CDS as archetypes, we identified nine problems with CDS that currently remain unsolved without a common model underpinning the CDS. Typical problems include incompatible basic data types and overlapping and incompatible definitions of clinical content. A solution to most of these problems based on openEHR archetypes is motivated. With regard to integrity constraints, further research is required. While openEHR cannot overcome all barriers to Ubiquitous Computing, it can provide the common basis for ubiquitous presence of meaningful and computer-processable knowledge and information, which we believe is a basic requirement for Ubiquitous Computing. Expressing CDSs as openEHR archetypes is feasible and advantageous as it fosters semantic interoperability, supports ubiquitous computing, and helps to develop archetypes that are arguably of better quality than the original CDS.

17 CFR 145.0 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 17 Commodity and Securities Exchanges 2 2014-04-01 2014-04-01 false Definitions. 145.0 Section 145... RECORDS AND INFORMATION § 145.0 Definitions. For the purposes of part 145 the following definitions are..., microfiche, drawing, or computer-stored information or output in the possession of the Commission. The term...

Accelerated treatment protocols: full arch treatment with interim and definitive prostheses.

PubMed

Drago, Carl

2012-01-01

With the advent of titanium, root form implants and osseointegration, dental treatment has undergone a metamorphosis in recent years. These new techniques enable dentists to provide anchorage for various kinds of prostheses that improve masticatory function, esthetics, and comfort for patients. Implant treatment protocols have been improved relative to implant macro- and micro-geometries, surgical and prosthetic components, and treatment times. Over the past 20 years, immediate occlusal function (also known as loading) has been established as a predictable treatment modality, provided certain specific criteria are met. In many cases, edentulous patients, crippled by the loss of their teeth, can undergo outpatient surgical and prosthetic procedures and return to a masticatory function that is near normal--sometimes after only one day of surgical and prosthetic treatment. This treatment option is also available for patients with advanced, generalized periodontal disease. Computer-assisted design/Computer-assisted manufacturing (CAD/CAM) has transformed how dental prostheses are made, offering improved accuracy, longevity, and biocompatibility; along with reduced labor costs and fewer complications than casting technologies. This article reviews the principles associated with immediate occlusal loading and illustrates one specific accelerated prosthodontic treatment protocol used to treat edentulous and partially edentulous patients with interim and definitive prostheses.

Algorithmic Mechanism Design of Evolutionary Computation.

PubMed

Pei, Yan

2015-01-01

We consider algorithmic design, enhancement, and improvement of evolutionary computation as a mechanism design problem. All individuals or several groups of individuals can be considered as self-interested agents. The individuals in evolutionary computation can manipulate parameter settings and operations by satisfying their own preferences, which are defined by an evolutionary computation algorithm designer, rather than by following a fixed algorithm rule. Evolutionary computation algorithm designers or self-adaptive methods should construct proper rules and mechanisms for all agents (individuals) to conduct their evolution behaviour correctly in order to definitely achieve the desired and preset objective(s). As a case study, we propose a formal framework on parameter setting, strategy selection, and algorithmic design of evolutionary computation by considering the Nash strategy equilibrium of a mechanism design in the search process. The evaluation results present the efficiency of the framework. This primary principle can be implemented in any evolutionary computation algorithm that needs to consider strategy selection issues in its optimization process. The final objective of our work is to solve evolutionary computation design as an algorithmic mechanism design problem and establish its fundamental aspect by taking this perspective. This paper is the first step towards achieving this objective by implementing a strategy equilibrium solution (such as Nash equilibrium) in evolutionary computation algorithm.

Algorithmic Mechanism Design of Evolutionary Computation

PubMed Central

2015-01-01

We consider algorithmic design, enhancement, and improvement of evolutionary computation as a mechanism design problem. All individuals or several groups of individuals can be considered as self-interested agents. The individuals in evolutionary computation can manipulate parameter settings and operations by satisfying their own preferences, which are defined by an evolutionary computation algorithm designer, rather than by following a fixed algorithm rule. Evolutionary computation algorithm designers or self-adaptive methods should construct proper rules and mechanisms for all agents (individuals) to conduct their evolution behaviour correctly in order to definitely achieve the desired and preset objective(s). As a case study, we propose a formal framework on parameter setting, strategy selection, and algorithmic design of evolutionary computation by considering the Nash strategy equilibrium of a mechanism design in the search process. The evaluation results present the efficiency of the framework. This primary principle can be implemented in any evolutionary computation algorithm that needs to consider strategy selection issues in its optimization process. The final objective of our work is to solve evolutionary computation design as an algorithmic mechanism design problem and establish its fundamental aspect by taking this perspective. This paper is the first step towards achieving this objective by implementing a strategy equilibrium solution (such as Nash equilibrium) in evolutionary computation algorithm. PMID:26257777

45 CFR 1609.2 - Definition.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 4 2014-10-01 2014-10-01 false Definition. 1609.2 Section 1609.2 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION FEE-GENERATING CASES § 1609.2 Definition. (a) Fee-generating case means any case or matter which, if undertaken on behalf of an eligible...

45 CFR 1609.2 - Definition.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false Definition. 1609.2 Section 1609.2 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION FEE-GENERATING CASES § 1609.2 Definition. (a) Fee-generating case means any case or matter which, if undertaken on behalf of an eligible...

45 CFR 1609.2 - Definition.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Definition. 1609.2 Section 1609.2 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION FEE-GENERATING CASES § 1609.2 Definition. (a) Fee-generating case means any case or matter which, if undertaken on behalf of an eligible...

45 CFR 1609.2 - Definition.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 4 2013-10-01 2013-10-01 false Definition. 1609.2 Section 1609.2 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION FEE-GENERATING CASES § 1609.2 Definition. (a) Fee-generating case means any case or matter which, if undertaken on behalf of an eligible...

45 CFR 1609.2 - Definition.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 4 2012-10-01 2012-10-01 false Definition. 1609.2 Section 1609.2 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION FEE-GENERATING CASES § 1609.2 Definition. (a) Fee-generating case means any case or matter which, if undertaken on behalf of an eligible...

The Use of the Medical Dictionary for Regulatory Activities in the Identification of Mitochondrial Dysfunction in HIV-Infected Children.

PubMed

Chernoff, Miriam; Ford-Chatterton, Heather; Crain, Marilyn J

2012-10-01

To demonstrate the utility of a medical terminology-based method for identifying cases of possible mitochondrial dysfunction (MD) in a large cohort of youths with perinatal HIV infection and to describe the scoring algorithms. Medical Dictionary for Regulatory Activities (MedDRA) ® version 6 terminology was used to query clinical criteria for mitochondrial dysfunction by two published classifications, the Enquête Périnatale Française (EPF) and the Mitochondrial Disease Classification (MDC). Data from 2,931 participants with perinatal HIV infection on PACTG 219/219C were analyzed. Data were qualified for severity and persistence, after which clinical reviews of MedDRA-coded and other study data were performed. Of 14,000 data records captured by the EPF MedDRA query, there were 3,331 singular events. Of 18,000 captured by the MDC query, there were 3,841 events. Ten clinicians blindly reviewed non MedDRA-coded supporting data for 15 separate clinical conditions. We used the Statistical Analysis System (SAS) language to code scoring algorithms. 768 participants (26%) met the EPF case definition of possible MD; 694 (24%) met the MDC case definition, and 480 (16%) met both definitions. Subjective application of codes could have affected our results. MedDRA terminology does not include indicators of severity or persistence. Version 6.0 of MedDRA did not include Standard MedDRA Queries, which would have reduced the time needed to map MedDRA terms to EPF and MDC criteria. Together with a computer-coded scoring algorithm, MedDRA terminology enabled identification of potential MD based on clinical data from almost 3000 children with substantially less effort than a case by case review. The article is accessible to readers with a background in statistical hypothesis testing. An exposure to public health issues is useful but not strictly necessary.

The Use of the Medical Dictionary for Regulatory Activities in the Identification of Mitochondrial Dysfunction in HIV-Infected Children

PubMed Central

Chernoff, Miriam; Ford-Chatterton, Heather; Crain, Marilyn J.

2012-01-01

Objective To demonstrate the utility of a medical terminology-based method for identifying cases of possible mitochondrial dysfunction (MD) in a large cohort of youths with perinatal HIV infection and to describe the scoring algorithms. Methods Medical Dictionary for Regulatory Activities (MedDRA)® version 6 terminology was used to query clinical criteria for mitochondrial dysfunction by two published classifications, the Enquête Périnatale Française (EPF) and the Mitochondrial Disease Classification (MDC). Data from 2,931 participants with perinatal HIV infection on PACTG 219/219C were analyzed. Data were qualified for severity and persistence, after which clinical reviews of MedDRA-coded and other study data were performed. Results Of 14,000 data records captured by the EPF MedDRA query, there were 3,331 singular events. Of 18,000 captured by the MDC query, there were 3,841 events. Ten clinicians blindly reviewed non MedDRA-coded supporting data for 15 separate clinical conditions. We used the Statistical Analysis System (SAS) language to code scoring algorithms. 768 participants (26%) met the EPF case definition of possible MD; 694 (24%) met the MDC case definition, and 480 (16%) met both definitions. Limitations Subjective application of codes could have affected our results. MedDRA terminology does not include indicators of severity or persistence. Version 6.0 of MedDRA did not include Standard MedDRA Queries, which would have reduced the time needed to map MedDRA terms to EPF and MDC criteria. Conclusion Together with a computer-coded scoring algorithm, MedDRA terminology enabled identification of potential MD based on clinical data from almost 3000 children with substantially less effort than a case by case review. The article is accessible to readers with a background in statistical hypothesis testing. An exposure to public health issues is useful but not strictly necessary. PMID:23797349

Difficulties in clinical diagnosis of measles: proposal for modified clinical case definition.

PubMed

Ferson, M J; Young, L C; Robertson, P W; Whybin, L R

1995-10-02

To examine the accuracy of clinical diagnosis of measles and to develop an improved measles clinical case definition. Case survey. Eastern Sydney, December 1990 to August 1993. All cases of measles notified to the Eastern Sydney Public Health Unit without or before serological confirmation. Demographic and clinical details, measles- and rubella-specific IgM and measles complement fixation titres in acute and convalescent (when available) sera and epidemiological links with confirmed measles cases. Of 49 subjects reported and with complete follow-up, 24 were confirmed with measles, four with rubella and 21 had no definite diagnosis. Clinical diagnosis of measles had a false positive rate of 51%. Subjects with confirmed measles were significantly more likely to have a cough (23/24) than those with no definite diagnosis (15/21; P = 0.03) and to be febrile on the day of rash onset (23/24 versus 10/21; P = 0.001). The Centers for Disease Control definition had a sensitivity of 92% but specificity of only 24%. A modified case definition of rash, cough and fever present at onset of rash had equal sensitivity but greater specificity (57%). As measles is no longer common in Australia, clinical diagnosis is unreliable. When a public health response is needed, cases should be confirmed by serological tests or, if not available, we propose use of our modified clinical case definition.

Definition Of Touch-Sensitive Zones For Graphical Displays

NASA Technical Reports Server (NTRS)

Monroe, Burt L., III; Jones, Denise R.

1988-01-01

Touch zones defined simply by touching, while editing done automatically. Development of touch-screen interactive computing system, tedious task. Interactive Editor for Definition of Touch-Sensitive Zones computer program increases efficiency of human/machine communications by enabling user to define each zone interactively, minimizing redundancy in programming and eliminating need for manual computation of boundaries of touch areas. Information produced during editing process written to data file, to which access gained when needed by application program.

Computers and Children: Problems and Possibilities.

ERIC Educational Resources Information Center

Siegfried, Pat

1983-01-01

Discusses the use of computers by children, highlighting a definition of computer literacy, computer education in schools, computer software, microcomputers, programming languages, and public library involvement. Seven references and a 40-item bibliography are included. (EJS)

Analysis of an Hp-Non-conforming Discontinuous Galerkin Spectral Element Method for Wave

DTIC Science & Technology

2011-04-01

Scientific Computing, 36 (2008), pp. 351–390. [25] Eleuterio F . Toro , Riemann Solvers and Numerical Methods for Fluid Dynamics, Springer, 1999. [26...denoted by ñ, and the contravariant flux [15] is defined as F̃i = Jeai · F , i = 1, 2, 3, with ai as the contravariant basis vectors. We now describe...wave propagation case by the following definitions, q = ( E v ) ∈ V, Q = ( I 0 0 ρI ) , g = ( 0 f ) ∈ V, with I denoting the fourth-order identity tensor

Computer modeling of fan-exit-splitter spacing effects on F100 response to distortion

NASA Technical Reports Server (NTRS)

Shaw, M.; Murdoch, R. W.

1982-01-01

The distortion response of the F100(3) engine was effected by the fan exit splitter configuration. The sensitivity for a proximate splitter fan is calculated to be slightly greater than a remote splitter configuration with identical airfoils. Predicted response was based upon a multiple segment parallel compressor Model modified to include a bypass ratio representation that effects the performance characteristics of the last rotor and intermediate case struts. The predicted distortion response required an accurate definition of row pre- and post-stall undistorted operation.

Towards a Computational Theory of Definite Anaphora Comprehension in English Discourse.

DTIC Science & Technology

1979-06-01

know what flowers are near others might behave differently. But even special audiences nust sometimes use general techniques. Such is the case in the...2 (The) one is a poodle; 3 the other is a cocker spaniel. 4 The poodle has some weird habits. 5 He eats plastic flowers and likes to sleep in a...paper bag. 6 It’s a real problem keeping him away from plastic flowers . 7 The cocker is pretty normal, 8 and he’s a good watch (log. ( I like having themi

On the maximum off-axis gain of symmetrical pencil-beam antennas

NASA Technical Reports Server (NTRS)

Sawitz, P. H.

1977-01-01

For a general class of symmetrical pencil-beam antennas, the gain at a given off-axis angle can be maximized by choosing the proper antenna size. The maximum gain at the given angle relative to the on-axis gain is independent of the given angle and dependent only on the main-beam pattern. It is computed here for four commonly used gain functions. Its value, in all cases, is close to 4 dB. This result is important in the definition of service areas for communication and broadcast satellites.

Analysis of FET-PET imaging for target volume definition in patients with gliomas treated with conformal radiotherapy.

PubMed

Rieken, Stefan; Habermehl, Daniel; Giesel, Frederik L; Hoffmann, Christoph; Burger, Ute; Rief, Harald; Welzel, Thomas; Haberkorn, Uwe; Debus, Jürgen; Combs, Stephanie E

2013-12-01

Modern radiotherapy (RT) techniques such as stereotactic RT, intensity-modulated RT, or particle irradiation allow local dose escalation with simultaneous sparing of critical organs. Several trials are currently investigating their benefit in glioma reirradiation and boost irradiation. Target volume definition is of critical importance especially when steep dose gradient techniques are employed. In this manuscript we investigate the impact of O-(2-(F-18)fluoroethyl)-l-tyrosine-positron emission tomography/computer tomography (FET-PET/CT) on target volume definition in low and high grade glioma patients undergoing either first or re-irradiation with particles. We investigated volumetric size and uniformity of magnetic resonance imaging (MRI)- vs. FET-PET/CT-derived gross tumor volumes (GTVs) and planning target volumes (PTVs) of 41 glioma patients. Clinical cases are presented to demonstrate potential benefits of integrating FET-PET/CT-planning into daily routine. Integrating FET-uptake into the delineation of GTVs yields larger volumes. Combined modality-derived PTVs are significantly enlarged in high grade glioma patients and in case of primary RT. The congruence of MRI and FET signals for the identification of glioma GTVs is poor with mean uniformity indices of 0.39. MRI-based PTVs miss 17% of FET-PET/CT-based GTVs. Non significant alterations were detected in low grade glioma patients and in those undergoing reirradiation. Target volume definition for malignant gliomas during initial RT may yield significantly differing results depending upon the imaging modality, which the contouring process is based upon. The integration of both MRI and FET-PET/CT may help to improve GTV coverage by avoiding larger incongruences between physical and biological imaging techniques. In low grade gliomas and in cases of reirradiation, more studies are needed in order to investigate a potential benefit of FET-PET/CT for planning of RT. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Perianal nodular hidradenocarcinoma. Case report.

PubMed

Sierra Montenegro, Ernesto; Sierra Luzuriaga, Gastón; Leone Stay, Gaetano; Salazar Menéndez, Vilma; Quiñonez Auria, Carlos

2010-01-01

Eccrine glands (sweat glands) appear in all sites of the skin and are more abundant in hands and feet. Nodular hidradenocarcinoma (NH) is a rare malignant and aggressive tumor of the eccrine glands. The objective of this study is to report a case of perianal hidradenocarcinoma. We present the case of a 75-year-old female with diabetes, hypertension, and hypothyroidism. Physical examination revealed a small perianal tumor that was palpated near the anal canal. Biopsy was done. Pathology report revealed perianal hidradenoma. Rectosigmoidoscopy was normal. Computed tomography showed 1-cm adenopathies in inguinal and right iliac regions. Extensive resection of the tumor was done. Definitive pathology report was malignant eccrine acrospiroma. The patient underwent adjuvant chemotherapy in the Oncology Service and died 1 month later. In patients with a first symptom of metastases in the inguinal region, suspicion must be directed to the anal canal.

Accuracy of clinical diagnosis versus the World Health Organization case definition in the Amoy Garden SARS cohort.

PubMed

Wong, W N; Sek, Antonio C H; Lau, Rick F L; Li, K M; Leung, Joe K S; Tse, M L; Ng, Andy H W; Stenstrom, Robert

2003-11-01

To compare the diagnostic accuracy of emergency department (ED) physicians with the World Health Organization (WHO) case definition in a large community-based SARS (severe acute respiratory syndrome) cohort. This was a cohort study of all patients from Hong Kong's Amoy Garden complex who presented to an ED SARS screening clinic during a 2-month outbreak. Clinical findings and WHO case definition criteria were recorded, along with ED diagnoses. Final diagnoses were established independently based on relevant diagnostic tests performed after the ED visit. Emergency physician diagnostic accuracy was compared with that of the WHO SARS case definition. Sensitivity, specificity, predictive values and likelihood ratios were calculated using standard formulae. During the study period, 818 patients presented with SARS-like symptoms, including 205 confirmed SARS, 35 undetermined SARS and 578 non-SARS. Sensitivity, specificity and accuracy were 91%, 96% and 94% for ED clinical diagnosis, versus 42%, 86% and 75% for the WHO case definition. Positive likelihood ratios (LR+) were 21.1 for physician judgement and 3.1 for the WHO criteria. Negative likelihood ratios (LR-) were 0.10 for physician judgement and 0.67 for the WHO criteria, indicating that clinician judgement was a much more powerful predictor than the WHO criteria. Physician clinical judgement was more accurate than the WHO case definition. Reliance on the WHO case definition as a SARS screening tool may lead to an unacceptable rate of misdiagnosis. The SARS case definition must be revised if it is to be used as a screening tool in emergency departments and primary care settings.

Clinical Case Definitions for Classification of Intrathoracic Tuberculosis in Children: An Update

PubMed Central

Graham, Stephen M.; Cuevas, Luis E.; Jean-Philippe, Patrick; Browning, Renee; Casenghi, Martina; Detjen, Anne K.; Gnanashanmugam, Devasena; Hesseling, Anneke C.; Kampmann, Beate; Mandalakas, Anna; Marais, Ben J.; Schito, Marco; Spiegel, Hans M. L.; Starke, Jeffrey R.; Worrell, Carol; Zar, Heather J.

2015-01-01

Consensus case definitions for childhood tuberculosis have been proposed by an international expert panel, aiming to standardize the reporting of cases in research focusing on the diagnosis of intrathoracic tuberculosis in children. These definitions are intended for tuberculosis diagnostic evaluation studies of symptomatic children with clinical suspicion of intrathoracic tuberculosis, and were not intended to predefine inclusion criteria into such studies. Feedback from researchers suggested that further clarification was required and that these case definitions could be further improved. Particular concerns were the perceived complexity and overlap of some case definitions, as well as the potential exclusion of children with acute onset of symptoms or less severe disease. The updated case definitions proposed here incorporate a number of key changes that aim to reduce complexity and improve research performance, while maintaining the original focus on symptomatic children suspected of having intrathoracic tuberculosis. The changes proposed should enhance harmonized classification for intrathoracic tuberculosis disease in children across studies, resulting in greater comparability and the much-needed ability to pool study results. PMID:26409281

The case of Vipul Bhrigu and the federal definition of research misconduct.

PubMed

Rasmussen, Lisa M

2014-06-01

The Office of Research Integrity found in 2011 that Vipul Bhrigu, a postdoctoral researcher who sabotaged a colleague's research materials, was guilty of misconduct. However, I argue that this judgment is ill-considered and sets a problematic precedent for future cases. I first discuss the current federal definition of research misconduct and representative cases of research misconduct. Then, because this case recalls a debate from the 1990s over what the definition of "research misconduct" ought to be, I briefly recapitulate that history and reconsider the Bhrigu case in light of that history and in comparison to other cases involving tampering. Finally, I consider what the aim of a definition of research misconduct ought to be, and argue that the precedent set by the reasoning in this case is problematic.

31 CFR 359.32 - What definitive Series I savings bonds are excluded from the computation?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false What definitive Series I savings bonds are excluded from the computation? 359.32 Section 359.32 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY BUREAU OF THE PUBLIC...

Avoiding Communication in Dense Linear Algebra

DTIC Science & Technology

2013-08-16

Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 2.1.1 Asymptotic Notation . . . . . . . . . . . . . . . . . . . . . . . . . . . 6...and parallelizing Strassen’s matrix multiplication algorithm (Chapter 11). 6 Chapter 2 Preliminaries 2.1 Notation and Definitions In this section we...between computations and algo- rithms). The following definition is based on [56]: Definition 2.1. A classical algorithm in linear algebra is one that

Standardized Definitions for Code Verification Test Problems

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

Doebling, Scott William

This document contains standardized definitions for several commonly used code verification test problems. These definitions are intended to contain sufficient information to set up the test problem in a computational physics code. These definitions are intended to be used in conjunction with exact solutions to these problems generated using Exact- Pack, www.github.com/lanl/exactpack.

Immediate provisionalization with a CAD/CAM interim abutment and crown: a guided soft tissue healing technique.

PubMed

Proussaefs, Periklis

2015-02-01

A technique is described in which a single interim abutment and crown were fabricated in advance and placed the day of dental implant surgery. The contours of the interim crown were identical to the contours of a tentatively designed definitive prosthesis and allowed the tissue to heal and obtain contours that accommodated the contours of the definitive prosthesis. After osseointegration was established, a definitive impression was made with a custom computer-assisted design and computer-assisted manufacturing impression coping. The definitive prosthesis then was fabricated. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Drug overdose surveillance using hospital discharge data.

PubMed

Slavova, Svetla; Bunn, Terry L; Talbert, Jeffery

2014-01-01

We compared three methods for identifying drug overdose cases in inpatient hospital discharge data on their ability to classify drug overdoses by intent and drug type(s) involved. We compared three International Classification of Diseases, Ninth Revision, Clinical Modification code-based case definitions using Kentucky hospital discharge data for 2000-2011. The first definition (Definition 1) was based on the external-cause-of-injury (E-code) matrix. The other two definitions were based on the Injury Surveillance Workgroup on Poisoning (ISW7) consensus recommendations for national and state poisoning surveillance using the principal diagnosis or first E-code (Definition 2) or any diagnosis/E-code (Definition 3). Definition 3 identified almost 50% more drug overdose cases than did Definition 1. The increase was largely due to cases with a first-listed E-code describing a drug overdose but a principal diagnosis that was different from drug overdose (e.g., mental disorders, or respiratory or circulatory system failure). Regardless of the definition, more than 53% of the hospitalizations were self-inflicted drug overdoses; benzodiazepines were involved in about 30% of the hospitalizations. The 2011 age-adjusted drug overdose hospitalization rate in Kentucky was 146/100,000 population using Definition 3 and 107/100,000 population using Definition 1. The ISW7 drug overdose definition using any drug poisoning diagnosis/E-code (Definition 3) is potentially the highest sensitivity definition for counting drug overdose hospitalizations, including by intent and drug type(s) involved. As the states enact policies and plan for adequate treatment resources, standardized drug overdose definitions are critical for accurate reporting, trend analysis, policy evaluation, and state-to-state comparison.

Pentalogy of Cantrell: report of a case with consanguineous parents.

PubMed

Pachajoa, Harry; Barragán, Arelis; Potes, Angela; Torres, Javier; Isaza, Carolina

2010-01-01

Pentalogy of Cantrell is a syndrome evidencing five anomalies: a midline, upper abdominal wall abnormality; lower sternal defect; anterior diaphragmatic defect; diaphragmatic pericardial defect, and congenital abnormalities of the heart. Its prevalence is one in every 65,000 live births and a survival rate that is low if the fall the five defects are present or the gravity of the cardiac anomalies. It may be diagnosed during the first trimester obstetric ultrasound. For postnatal care, emission-computed tomography and magnetic resonance imaging is recommended for a clear definition of the extent of the defect and to design a course of corrective surgery. Herein, a case of pentology of Cantrell is reported for a child offspring of consanguineous parents.

A subtraction scheme for computing QCD jet cross sections at NNLO: integrating the doubly unresolved subtraction terms

NASA Astrophysics Data System (ADS)

Somogyi, Gábor

2013-04-01

We finish the definition of a subtraction scheme for computing NNLO corrections to QCD jet cross sections. In particular, we perform the integration of the soft-type contributions to the doubly unresolved counterterms via the method of Mellin-Barnes representations. With these final ingredients in place, the definition of the scheme is complete and the computation of fully differential rates for electron-positron annihilation into two and three jets at NNLO accuracy becomes feasible.

Positive predictive value of a case definition for diabetes mellitus using automated administrative health data in children and youth exposed to antipsychotic drugs or control medications: a Tennessee Medicaid study.

PubMed

Bobo, William V; Cooper, William O; Stein, C Michael; Olfson, Mark; Mounsey, Jackie; Daugherty, James; Ray, Wayne A

2012-08-24

We developed and validated an automated database case definition for diabetes in children and youth to facilitate pharmacoepidemiologic investigations of medications and the risk of diabetes. The present study was part of an in-progress retrospective cohort study of antipsychotics and diabetes in Tennessee Medicaid enrollees aged 6-24 years. Diabetes was identified from diabetes-related medical care encounters: hospitalizations, outpatient visits, and filled prescriptions. The definition required either a primary inpatient diagnosis or at least two other encounters of different types, most commonly an outpatient diagnosis with a prescription. Type 1 diabetes was defined by insulin prescriptions with at most one oral hypoglycemic prescription; other cases were considered type 2 diabetes. The definition was validated for cohort members in the 15 county region geographically proximate to the investigators. Medical records were reviewed and adjudicated for cases that met the automated database definition as well as for a sample of persons with other diabetes-related medical care encounters. The study included 64 cases that met the automated database definition. Records were adjudicated for 46 (71.9%), of which 41 (89.1%) met clinical criteria for newly diagnosed diabetes. The positive predictive value for type 1 diabetes was 80.0%. For type 2 and unspecified diabetes combined, the positive predictive value was 83.9%. The estimated sensitivity of the definition, based on adjudication for a sample of 30 cases not meeting the automated database definition, was 64.8%. These results suggest that the automated database case definition for diabetes may be useful for pharmacoepidemiologic studies of medications and diabetes.

Positive predictive value of a case definition for diabetes mellitus using automated administrative health data in children and youth exposed to antipsychotic drugs or control medications: a Tennessee Medicaid study

PubMed Central

2012-01-01

Background We developed and validated an automated database case definition for diabetes in children and youth to facilitate pharmacoepidemiologic investigations of medications and the risk of diabetes. Methods The present study was part of an in-progress retrospective cohort study of antipsychotics and diabetes in Tennessee Medicaid enrollees aged 6–24 years. Diabetes was identified from diabetes-related medical care encounters: hospitalizations, outpatient visits, and filled prescriptions. The definition required either a primary inpatient diagnosis or at least two other encounters of different types, most commonly an outpatient diagnosis with a prescription. Type 1 diabetes was defined by insulin prescriptions with at most one oral hypoglycemic prescription; other cases were considered type 2 diabetes. The definition was validated for cohort members in the 15 county region geographically proximate to the investigators. Medical records were reviewed and adjudicated for cases that met the automated database definition as well as for a sample of persons with other diabetes-related medical care encounters. Results The study included 64 cases that met the automated database definition. Records were adjudicated for 46 (71.9%), of which 41 (89.1%) met clinical criteria for newly diagnosed diabetes. The positive predictive value for type 1 diabetes was 80.0%. For type 2 and unspecified diabetes combined, the positive predictive value was 83.9%. The estimated sensitivity of the definition, based on adjudication for a sample of 30 cases not meeting the automated database definition, was 64.8%. Conclusion These results suggest that the automated database case definition for diabetes may be useful for pharmacoepidemiologic studies of medications and diabetes. PMID:22920280

Validity of calendar day-based definitions for community-onset bloodstream infections.

PubMed

Laupland, Kevin B; Gregson, Daniel B; Church, Deirdre L

2015-04-02

Community-onset (CO) bloodstream infections (BSI) are those BSI where the blood culture is drawn <48 hours from hospital admission. However, exact times of culture draw or hospital admission are not always available. We evaluated the validity of using 2- or 3- calendar day based definitions for CO-BSI by comparing to a "gold standard" 48-hour definition. Among the population-based cohort of 14,106 episodes of BSI studied, 10,543 were classified as CO based on "gold standard" 48-hour criteria. When 2-day and 3-day definitions were applied, 10,396 and 10,707 CO-BSI episodes were ascertained, respectively. All but 147 (1.4%) true CO-BSI cases were included by using the 2-day definition. When the 3-day definition was applied, all cases of CO-BSI were identified but and additional 164 (1.5%) cases of hospital-onset HO-BSI were also included. Thus the sensitivity and specificity of the 2-day definition was 98.6% and 100% and for the 3-day definition was 100% and 98.5%, respectively. Overall, only 311 (2.2%) cases were potentially miss-classifiable using either the 2- or 3-calendar day based definitions. Use of either a 2- or 3-day definition is highly accurate for classifying CO-BSI.

The San Diego definition of SIDS: practical application and comparison with the GeSID classification.

PubMed

Bajanowski, T; Brinkmann, B; Vennemann, M

2006-11-01

The new definition of the term sudden infant death syndrome (SIDS) and the criteria introduced in San Diego for the subclassification of cases have been used to re-classify the first 100 consecutive cases of sudden and unexpected infant deaths that were registered with the German SIDS study (GeSID). Although there are 30 different variables that have to be considered in the general and stratified sections of the San Diego definition, it is practical, in particular, as an international standard to perform scientific studies. The comparison of the San Diego definition and the classification used for GeSID shows similarities in the methods but differences in the criteria used. Nevertheless, the numbers of cases classified as SIDS and borderline SIDS are similar (San Diego n=69, GeSID n=74). The SIDS IA criteria of the San Diego definition were not fulfilled by any case because metabolic screening and vitreous chemistry were not included in the GeSID investigation scheme. An important advantage of the San Diego definition is the introduction of the category of unclassified sudden infant death, which includes cases for which no autopsy was performed. This demonstrates that such cases cannot be classified as SIDS. In conclusion, we recommend the universal acceptance and use of the San Diego SIDS definition.

A multicenter study demonstrating discordant results from electronic prostate-specific antigen biochemical failure calculation systems.

PubMed

Williams, Scott G; Pickles, Tom; Kestin, Larry; Potters, Louis; Fearn, Paul; Smith, Ryan; Pratt, Gary

2006-08-01

To evaluate the interobserver variation of four electronic biochemical failure (bF) calculators using three bF definitions. The data of 1200 men were analyzed using the electronic bF calculators of four institutions. Three bF definitions were examined for their concordance of bF identification across the centers: the American Society for Therapeutic Radiology and Oncology consensus definition (ACD), the lowest prostate-specific antigen (PSA) level to date plus 2 ng/mL (L2), and a threshold of 3 ng/mL (T3). Unanimous agreement regarding bF status using the ACD, L2, and T3 definitions occurred in 87.3%, 96.4%, and 92.7% of cases, respectively. Using the ACD, 63% of the variation was from one institution, which allowed the bF status to be reversed if a PSA decline was seen after bF (PSA "bounce"). A total of 270 men had an ACD bF time variation of >2 months across the calculators, and the 5-year freedom from bF rate was 49.8-60.9%. The L2 definition had a 20.5% rate of calculated bF times; which varied by >2 months (median, 6.4; range, 2.1-75.6) and a corresponding 5-year freedom from bF rate of 55.9-61.0%. The T3 definition had a 2.0% range in the 5-year freedom from bF. Fifteen definition interpretation variations were identified. Reported bF results vary not only because of bF definition differences, but because of variations in how those definitions are written into computer-based calculators, with multiple interpretations most prevalent for the ACD. An algorithm to avoid misinterpretations is proposed for the L2 definition. A verification system to guarantee consistent electronic bF results requires development.

Comparing External Ventricular Drains-Related Ventriculitis Surveillance Definitions.

PubMed

Reyes, Maria M; Munigala, Satish; Church, Emily L; Kulik, Tobias B; Keyrouz, Salah G; Zipfel, Gregory J; Warren, David K

2017-05-01

OBJECTIVE To evaluate the agreement between the current National Healthcare Safety Network (NHSN) definition for ventriculitis and others found in the literature among patients with an external ventricular drain (EVD) DESIGN Retrospective cohort study from January 2009 to December 2014 SETTING Neurology and neurosurgery intensive care unit of a large tertiary-care center PATIENTS Patients with an EVD were included. Patients with an infection prior to EVD placement or a permanent ventricular shunt were excluded. METHODS We reviewed the charts of patients with positive cerebrospinal fluid (CSF) cultures and/or abnormal CSF results while they had an EVD in place and applied various ventriculitis definitions. RESULTS We identified 48 patients with a total of 52 cases of ventriculitis (41 CSF culture-positive cases and 11 cases based on abnormal CSF test results) using the NHSN definition. The most common organisms causing ventriculitis were gram-positive commensals (79.2%); however, 45% showed growth of only 1 colony on 1 piece of media. Approximately 60% of the ventriculitis cases by the NHSN definition met the Honda criteria, approximately 56% met the Gozal criteria, and 23% met Citerio's definition. Cases defined using Honda versus Gozal definitions had a moderate agreement (κ=0.528; P<.05) whereas comparisons of Honda versus Citerio definitions (κ=0.338; P<.05) and Citerio versus Gozal definitions (κ=0.384; P<.05) had only fair agreements. CONCLUSIONS The agreement between published ventriculostomy-associated infection (VAI) definitions in this cohort was moderate to fair. A VAI surveillance definition that better defines contaminants is needed for more homogenous application of surveillance definitions between institutions and better comparison of rates. Infect Control Hosp Epidemiol 2017;38:574-579.

Data-Flow Based Model Analysis

NASA Technical Reports Server (NTRS)

Saad, Christian; Bauer, Bernhard

2010-01-01

The concept of (meta) modeling combines an intuitive way of formalizing the structure of an application domain with a high expressiveness that makes it suitable for a wide variety of use cases and has therefore become an integral part of many areas in computer science. While the definition of modeling languages through the use of meta models, e.g. in Unified Modeling Language (UML), is a well-understood process, their validation and the extraction of behavioral information is still a challenge. In this paper we present a novel approach for dynamic model analysis along with several fields of application. Examining the propagation of information along the edges and nodes of the model graph allows to extend and simplify the definition of semantic constraints in comparison to the capabilities offered by e.g. the Object Constraint Language. Performing a flow-based analysis also enables the simulation of dynamic behavior, thus providing an "abstract interpretation"-like analysis method for the modeling domain.

Rare Disease Terminology and Definitions-A Systematic Global Review: Report of the ISPOR Rare Disease Special Interest Group.

PubMed

Richter, Trevor; Nestler-Parr, Sandra; Babela, Robert; Khan, Zeba M; Tesoro, Theresa; Molsen, Elizabeth; Hughes, Dyfrig A

2015-09-01

At present, there is no universal definition of rare disease. To provide an overview of rare disease definitions currently used globally. We systematically searched for definitions related to rare disease from organizations in 32 international jurisdictions. Descriptive statistics of definitions were generated and prevalence thresholds were calculated. We identified 296 definitions from 1109 organizations. The terms "rare disease(s)" and "orphan drug(s)" were used most frequently (38% and 27% of the definitions, respectively). Qualitative descriptors such as "life-threatening" were used infrequently. A prevalence threshold was specified in at least one definition in 88% of the jurisdictions. The average prevalence threshold across organizations within individual jurisdictions ranged from 5 to 76 cases/100,000 people. Most jurisdictions (66%) had an average prevalence threshold between 40 and 50 cases/100,000 people, with a global average of 40 cases/100,000 people. Prevalence thresholds used by different organizations within individual jurisdictions varied substantially. Across jurisdictions, umbrella patient organizations had the highest (most liberal) average prevalence threshold (47 cases/100,000 people), whereas private payers had the lowest threshold (18 cases/100,000 people). Despite variation in the terminology and prevalence thresholds used to define rare diseases among different jurisdictions and organizations, the terms "rare disease" and "orphan drug" are used most widely and the average prevalence threshold is between 40 and 50 cases/100,000 people. These findings highlight the existing diversity among definitions of rare diseases, but suggest that any attempts to harmonize rare disease definitions should focus on standardizing objective criteria such as prevalence thresholds and avoid qualitative descriptors. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

The impact of Magnetic Resonance Imaging (MRI) on ischemic stroke detection and incidence: minimal impact within a population-based study.

PubMed

Kleindorfer, Dawn; Khoury, Jane; Alwell, Kathleen; Moomaw, Charles J; Woo, Daniel; Flaherty, Matthew L; Adeoye, Opeolu; Ferioli, Simona; Khatri, Pooja; Kissela, Brett M

2015-09-25

There are several situations in which magnetic resonance imaging (MRI) might impact whether an cerebrovascular event is considered a new stroke. These include clinically non-focal events with positive imaging for acute cerebral infarction, and worsening of older symptoms without evidence of new infarction on MRI. We sought to investigate the impact of MRI on stroke detection and stroke incidence, by describing agreement between a strictly clinical definition of stroke and a definition based on physician opinion, including MRI imaging findings. All hospitalized strokes that occurred in five Ohio and Northern Kentucky counties (population 1.3 million) in the calendar year of 2005 were identified using ICD-9 discharge codes 430-436. The two definitions used were: "clinical case definition" which included sudden onset focal neurologic symptoms referable to a vascular territory for >24 h, compared to the "best clinical judgment of the physician definition", which considers all relevant information, including neuroimaging findings. The 95% confidence intervals (CI) for the incidence rates were calculated assuming a Poisson distribution. Rates were standardized to the 2000 U.S. population, adjusting for age, race, and sex, and included all age groups. There were 2403 ischemic stroke events in 2269 patients; 1556 (64%) had MRI performed. Of the events, 2049 (83%) were cases by both definitions, 185 (7.7%) met the clinical case definition but were non-cases in the physician's opinion and 169 (7.0%) were non-cases by clinical definition but were cases in the physician's opinion. There was no significant difference in the incidence rates of first-ever or total ischemic strokes generated by the two different definitions, or when only those with MRI imaging were included. We found that MRI findings do not appear to substantially change stroke incidence estimates, as the strictly clinical definition of stroke did not significantly differ from a definition that included imaging findings. Including MRI in the case definition "rules out" almost the same number of strokes as it "rules in".

Validation of a Syndromic Case Definition for Detecting Emergency Department Visits Potentially Related to Marijuana.

PubMed

DeYoung, Kathryn; Chen, Yushiuan; Beum, Robert; Askenazi, Michele; Zimmerman, Cali; Davidson, Arthur J

Reliable methods are needed to monitor the public health impact of changing laws and perceptions about marijuana. Structured and free-text emergency department (ED) visit data offer an opportunity to monitor the impact of these changes in near-real time. Our objectives were to (1) generate and validate a syndromic case definition for ED visits potentially related to marijuana and (2) describe a method for doing so that was less resource intensive than traditional methods. We developed a syndromic case definition for ED visits potentially related to marijuana, applied it to BioSense 2.0 data from 15 hospitals in the Denver, Colorado, metropolitan area for the period September through October 2015, and manually reviewed each case to determine true positives and false positives. We used the number of visits identified by and the positive predictive value (PPV) for each search term and field to refine the definition for the second round of validation on data from February through March 2016. Of 126 646 ED visits during the first period, terms in 524 ED visit records matched ≥1 search term in the initial case definition (PPV, 92.7%). Of 140 932 ED visits during the second period, terms in 698 ED visit records matched ≥1 search term in the revised case definition (PPV, 95.7%). After another revision, the final case definition contained 6 keywords for marijuana or derivatives and 5 diagnosis codes for cannabis use, abuse, dependence, poisoning, and lung disease. Our syndromic case definition and validation method for ED visits potentially related to marijuana could be used by other public health jurisdictions to monitor local trends and for other emerging concerns.

17 CFR 270.2a-4 - Definition of “current net asset value” for use in computing periodically the current price of...

Code of Federal Regulations, 2010 CFR

2010-04-01

... AND REGULATIONS, INVESTMENT COMPANY ACT OF 1940 § 270.2a-4 Definition of “current net asset value” for... value of any redeemable security issued by a registered investment company used in computing... which reflects calculations, whether or not recorded in the books of account, made substantially in...

Concordance between European and US case definitions of healthcare-associated infections

PubMed Central

2012-01-01

Background Surveillance of healthcare-associated infections (HAI) is a valuable measure to decrease infection rates. Across Europe, inter-country comparisons of HAI rates seem limited because some countries use US definitions from the US Centers for Disease Control and Prevention (CDC/NHSN) while other countries use European definitions from the Hospitals in Europe Link for Infection Control through Surveillance (HELICS/IPSE) project. In this study, we analyzed the concordance between US and European definitions of HAI. Methods An international working group of experts from seven European countries was set up to identify differences between US and European definitions and then conduct surveillance using both sets of definitions during a three-month period (March 1st -May 31st, 2010). Concordance between case definitions was estimated with Cohen’s kappa statistic (κ). Results Differences in HAI definitions were found for bloodstream infection (BSI), pneumonia (PN), urinary tract infection (UTI) and the two key terms “intensive care unit (ICU)-acquired infection” and “mechanical ventilation”. Concordance was analyzed for these definitions and key terms with the exception of UTI. Surveillance was performed in 47 ICUs and 6,506 patients were assessed. One hundred and eighty PN and 123 BSI cases were identified. When all PN cases were considered, concordance for PN was κ = 0.99 [CI 95%: 0.98-1.00]. When PN cases were divided into subgroups, concordance was κ = 0.90 (CI 95%: 0.86-0.94) for clinically defined PN and κ = 0.72 (CI 95%: 0.63-0.82) for microbiologically defined PN. Concordance for BSI was κ = 0.73 [CI 95%: 0.66-0.80]. However, BSI cases secondary to another infection site (42% of all BSI cases) are excluded when using US definitions and concordance for BSI was κ = 1.00 when only primary BSI cases, i.e. Europe-defined BSI with ”catheter” or “unknown” origin and US-defined laboratory-confirmed BSI (LCBI), were considered. Conclusions Our study showed an excellent concordance between US and European definitions of PN and primary BSI. PN and primary BSI rates of countries using either US or European definitions can be compared if the points highlighted in this study are taken into account. PMID:22958646

Spectral Rate Theory for Two-State Kinetics

NASA Astrophysics Data System (ADS)

Prinz, Jan-Hendrik; Chodera, John D.; Noé, Frank

2014-02-01

Classical rate theories often fail in cases where the observable(s) or order parameter(s) used is a poor reaction coordinate or the observed signal is deteriorated by noise, such that no clear separation between reactants and products is possible. Here, we present a general spectral two-state rate theory for ergodic dynamical systems in thermal equilibrium that explicitly takes into account how the system is observed. The theory allows the systematic estimation errors made by standard rate theories to be understood and quantified. We also elucidate the connection of spectral rate theory with the popular Markov state modeling approach for molecular simulation studies. An optimal rate estimator is formulated that gives robust and unbiased results even for poor reaction coordinates and can be applied to both computer simulations and single-molecule experiments. No definition of a dividing surface is required. Another result of the theory is a model-free definition of the reaction coordinate quality. The reaction coordinate quality can be bounded from below by the directly computable observation quality, thus providing a measure allowing the reaction coordinate quality to be optimized by tuning the experimental setup. Additionally, the respective partial probability distributions can be obtained for the reactant and product states along the observed order parameter, even when these strongly overlap. The effects of both filtering (averaging) and uncorrelated noise are also examined. The approach is demonstrated on numerical examples and experimental single-molecule force-probe data of the p5ab RNA hairpin and the apo-myoglobin protein at low pH, focusing here on the case of two-state kinetics.

f1: a code to compute Appell's F1 hypergeometric function

NASA Astrophysics Data System (ADS)

Colavecchia, F. D.; Gasaneo, G.

2004-02-01

In this work we present the FORTRAN code to compute the hypergeometric function F1( α, β1, β2, γ, x, y) of Appell. The program can compute the F1 function for real values of the variables { x, y}, and complex values of the parameters { α, β1, β2, γ}. The code uses different strategies to calculate the function according to the ideas outlined in [F.D. Colavecchia et al., Comput. Phys. Comm. 138 (1) (2001) 29]. Program summaryTitle of the program: f1 Catalogue identifier: ADSJ Program summary URL:http://cpc.cs.qub.ac.uk/summaries/ADSJ Program obtainable from: CPC Program Library, Queen's University of Belfast, N. Ireland Licensing provisions: none Computers: PC compatibles, SGI Origin2∗ Operating system under which the program has been tested: Linux, IRIX Programming language used: Fortran 90 Memory required to execute with typical data: 4 kbytes No. of bits in a word: 32 No. of bytes in distributed program, including test data, etc.: 52 325 Distribution format: tar gzip file External subprograms used: Numerical Recipes hypgeo [W.H. Press et al., Numerical Recipes in Fortran 77, Cambridge Univ. Press, 1996] or chyp routine of R.C. Forrey [J. Comput. Phys. 137 (1997) 79], rkf45 [L.F. Shampine and H.H. Watts, Rep. SAND76-0585, 1976]. Keywords: Numerical methods, special functions, hypergeometric functions, Appell functions, Gauss function Nature of the physical problem: Computing the Appell F1 function is relevant in atomic collisions and elementary particle physics. It is usually the result of multidimensional integrals involving Coulomb continuum states. Method of solution: The F1 function has a convergent-series definition for | x|<1 and | y|<1, and several analytic continuations for other regions of the variable space. The code tests the values of the variables and selects one of the precedent cases. In the convergence region the program uses the series definition near the origin of coordinates, and a numerical integration of the third-order differential parametric equation for the F1 function. Also detects several special cases according to the values of the parameters. Restrictions on the complexity of the problem: The code is restricted to real values of the variables { x, y}. Also, there are some parameter domains that are not covered. These usually imply differences between integer parameters that lead to negative integer arguments of Gamma functions. Typical running time: Depends basically on the variables. The computation of Table 4 of [F.D. Colavecchia et al., Comput. Phys. Comm. 138 (1) (2001) 29] (64 functions) requires approximately 0.33 s in a Athlon 900 MHz processor.

Validation of a surveillance case definition for arthritis.

PubMed

Sacks, Jeffrey J; Harrold, Leslie R; Helmick, Charles G; Gurwitz, Jerry H; Emani, Srinivas; Yood, Robert A

2005-02-01

To assess whether self-reports of chronic joint symptoms or doctor-diagnosed arthritis can validly identify persons with clinically verifiable arthritis. The Behavioral Risk Factor Surveillance System (BRFSS), a telephone health survey, defines a case of arthritis as a self-report of chronic joint symptoms (CJS) and/or doctor-diagnosed arthritis (DDx). A sample of health plan enrollees aged 45-64 years and >/= 65 years with upcoming annual physical examinations were surveyed by telephone using the 2002 BRFSS CJS and DDx questions. Based on responses (CJS+, DDx-; CJS-, DDx+; CJS+, DDx+; CJS-, DDx-), respondents were recruited to undergo a standardized clinical history and physical examination for arthritis (the gold standard for clinical validation). Weighted sensitivities and specificities of the case definition were calculated to adjust for sampling. Of 2180 persons completing the telephone questionnaire, 389 were examined; of these, 258 met the case definition and 131 did not. For those examined and aged 45 to 64 years (n = 179), 96 persons had arthritis confirmed, of whom 76 met the case definition. Among those examined and aged >/= 65 (n = 210), 150 had arthritis confirmed, of whom 124 met the case definition. Among those without clinical arthritis, 45 of 83 of those aged 45 to 64 years and 40 of 60 of those aged >/= 65 did not meet the case definition. For those aged 45 to 64 years, the weighted sensitivity of the case definition in this sample was 77.4% and the weighted specificity was 58.8%; for those aged >/= 65, the sensitivity was 83.6% and specificity 70.6%. CJS+ had higher sensitivity and lower specificity than DDx+ in the younger age group; CJS+ and DDx+ behaved more comparably in the older age group. The case definition based on self-reported CJS and/or DDx appeared to be sensitive in identifying arthritis, but specificity was lower than desirable for those under age 65 years. Better methods of ascertaining arthritis by self-report are needed. Until then, a change in the surveillance case definition for arthritis appears warranted.

Drug Overdose Surveillance Using Hospital Discharge Data

PubMed Central

Bunn, Terry L.; Talbert, Jeffery

2014-01-01

Objectives We compared three methods for identifying drug overdose cases in inpatient hospital discharge data on their ability to classify drug overdoses by intent and drug type(s) involved. Methods We compared three International Classification of Diseases, Ninth Revision, Clinical Modification code-based case definitions using Kentucky hospital discharge data for 2000–2011. The first definition (Definition 1) was based on the external-cause-of-injury (E-code) matrix. The other two definitions were based on the Injury Surveillance Workgroup on Poisoning (ISW7) consensus recommendations for national and state poisoning surveillance using the principal diagnosis or first E-code (Definition 2) or any diagnosis/E-code (Definition 3). Results Definition 3 identified almost 50% more drug overdose cases than did Definition 1. The increase was largely due to cases with a first-listed E-code describing a drug overdose but a principal diagnosis that was different from drug overdose (e.g., mental disorders, or respiratory or circulatory system failure). Regardless of the definition, more than 53% of the hospitalizations were self-inflicted drug overdoses; benzodiazepines were involved in about 30% of the hospitalizations. The 2011 age-adjusted drug overdose hospitalization rate in Kentucky was 146/100,000 population using Definition 3 and 107/100,000 population using Definition 1. Conclusion The ISW7 drug overdose definition using any drug poisoning diagnosis/E-code (Definition 3) is potentially the highest sensitivity definition for counting drug overdose hospitalizations, including by intent and drug type(s) involved. As the states enact policies and plan for adequate treatment resources, standardized drug overdose definitions are critical for accurate reporting, trend analysis, policy evaluation, and state-to-state comparison. PMID:25177055

International Spine Radiosurgery Consortium Consensus Guidelines for Target Volume Definition in Spinal Stereotactic Radiosurgery

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

Cox, Brett W., E-mail: coxb@mskcc.org; Spratt, Daniel E.; Lovelock, Michael

2012-08-01

Purpose: Spinal stereotactic radiosurgery (SRS) is increasingly used to manage spinal metastases. However, target volume definition varies considerably and no consensus target volume guidelines exist. This study proposes consensus target volume definitions using common scenarios in metastatic spine radiosurgery. Methods and Materials: Seven radiation oncologists and 3 neurological surgeons with spinal radiosurgery expertise independently contoured target and critical normal structures for 10 cases representing common scenarios in metastatic spine radiosurgery. Each set of volumes was imported into the Computational Environment for Radiotherapy Research. Quantitative analysis was performed using an expectation maximization algorithm for Simultaneous Truth and Performance Level Estimation (STAPLE)more » with kappa statistics calculating agreement between physicians. Optimized confidence level consensus contours were identified using histogram agreement analysis and characterized to create target volume definition guidelines. Results: Mean STAPLE agreement sensitivity and specificity was 0.76 (range, 0.67-0.84) and 0.97 (range, 0.94-0.99), respectively, for gross tumor volume (GTV) and 0.79 (range, 0.66-0.91) and 0.96 (range, 0.92-0.98), respectively, for clinical target volume (CTV). Mean kappa agreement was 0.65 (range, 0.54-0.79) for GTV and 0.64 (range, 0.54-0.82) for CTV (P<.01 for GTV and CTV in all cases). STAPLE histogram agreement analysis identified optimal consensus contours (80% confidence limit). Consensus recommendations include that the CTV should include abnormal marrow signal suspicious for microscopic invasion and an adjacent normal bony expansion to account for subclinical tumor spread in the marrow space. No epidural CTV expansion is recommended without epidural disease, and circumferential CTVs encircling the cord should be used only when the vertebral body, bilateral pedicles/lamina, and spinous process are all involved or there is extensive metastatic disease along the circumference of the epidural space. Conclusions: This report provides consensus guidelines for target volume definition for spinal metastases receiving upfront SRS in common clinical situations.« less

Validation of asthma recording in electronic health records: a systematic review

PubMed Central

Nissen, Francis; Quint, Jennifer K; Wilkinson, Samantha; Mullerova, Hana; Smeeth, Liam; Douglas, Ian J

2017-01-01

Objective To describe the methods used to validate asthma diagnoses in electronic health records and summarize the results of the validation studies. Background Electronic health records are increasingly being used for research on asthma to inform health services and health policy. Validation of the recording of asthma diagnoses in electronic health records is essential to use these databases for credible epidemiological asthma research. Methods We searched EMBASE and MEDLINE databases for studies that validated asthma diagnoses detected in electronic health records up to October 2016. Two reviewers independently assessed the full text against the predetermined inclusion criteria. Key data including author, year, data source, case definitions, reference standard, and validation statistics (including sensitivity, specificity, positive predictive value [PPV], and negative predictive value [NPV]) were summarized in two tables. Results Thirteen studies met the inclusion criteria. Most studies demonstrated a high validity using at least one case definition (PPV >80%). Ten studies used a manual validation as the reference standard; each had at least one case definition with a PPV of at least 63%, up to 100%. We also found two studies using a second independent database to validate asthma diagnoses. The PPVs of the best performing case definitions ranged from 46% to 58%. We found one study which used a questionnaire as the reference standard to validate a database case definition; the PPV of the case definition algorithm in this study was 89%. Conclusion Attaining high PPVs (>80%) is possible using each of the discussed validation methods. Identifying asthma cases in electronic health records is possible with high sensitivity, specificity or PPV, by combining multiple data sources, or by focusing on specific test measures. Studies testing a range of case definitions show wide variation in the validity of each definition, suggesting this may be important for obtaining asthma definitions with optimal validity. PMID:29238227

Severe versus Moderate Criteria for the New Pediatric Case Definition for ME/CFS

ERIC Educational Resources Information Center

Jason, Leonard; Porter, Nicole; Shelleby, Elizabeth; Till, Lindsay; Bell, David S.; Lapp, Charles W.; Rowe, Kathy; De Meirleir, Kenny

2009-01-01

The new diagnostic criteria for pediatric ME/CFS are structurally based on the Canadian Clinical Adult case definition, and have more required specific symptoms than the (Fukuda et al. Ann Intern Med 121:953-959, 1994) adult case definition. Physicians specializing in pediatric ME/CFS referred thirty-three pediatric patients with ME/CFS and 21…

Tuberculous meningitis: a uniform case definition for use in clinical research.

PubMed

Marais, Suzaan; Thwaites, Guy; Schoeman, Johan F; Török, M Estée; Misra, Usha K; Prasad, Kameshwar; Donald, Peter R; Wilkinson, Robert J; Marais, Ben J

2010-11-01

Tuberculous meningitis causes substantial mortality and morbidity in children and adults. More research is urgently needed to better understand the pathogenesis of disease and to improve its clinical management and outcome. A major stumbling block is the absence of standardised diagnostic criteria. The different case definitions used in various studies makes comparison of research findings difficult, prevents the best use of existing data, and limits the management of disease. To address this problem, a 3-day tuberculous meningitis workshop took place in Cape Town, South Africa, and was attended by 41 international participants experienced in the research or management of tuberculous meningitis. During the meeting, diagnostic criteria were assessed and discussed, after which a writing committee was appointed to finalise a consensus case definition for tuberculous meningitis for use in future clinical research. We present the consensus case definition together with the rationale behind the recommendations. This case definition is applicable irrespective of the patient's age, HIV infection status, or the resources available in the research setting. Consistent use of the proposed case definition will aid comparison of studies, improve scientific communication, and ultimately improve care. Copyright © 2010 Elsevier Ltd. All rights reserved.

48 CFR 239.7101 - Definition.

Code of Federal Regulations, 2011 CFR

2011-10-01

... OF DEFENSE SPECIAL CATEGORIES OF CONTRACTING ACQUISITION OF INFORMATION TECHNOLOGY Security and Privacy for Computer Systems 239.7101 Definition. Information assurance, as used in this subpart, means...

48 CFR 239.7101 - Definition.

Code of Federal Regulations, 2012 CFR

2012-10-01

... OF DEFENSE SPECIAL CATEGORIES OF CONTRACTING ACQUISITION OF INFORMATION TECHNOLOGY Security and Privacy for Computer Systems 239.7101 Definition. Information assurance, as used in this subpart, means...

48 CFR 239.7101 - Definition.

Code of Federal Regulations, 2014 CFR

2014-10-01

... OF DEFENSE SPECIAL CATEGORIES OF CONTRACTING ACQUISITION OF INFORMATION TECHNOLOGY Security and Privacy for Computer Systems 239.7101 Definition. Information assurance, as used in this subpart, means...

48 CFR 239.7101 - Definition.

Code of Federal Regulations, 2013 CFR

2013-10-01

... OF DEFENSE SPECIAL CATEGORIES OF CONTRACTING ACQUISITION OF INFORMATION TECHNOLOGY Security and Privacy for Computer Systems 239.7101 Definition. Information assurance, as used in this subpart, means...

48 CFR 239.7101 - Definition.

Code of Federal Regulations, 2010 CFR

2010-10-01

... OF DEFENSE SPECIAL CATEGORIES OF CONTRACTING ACQUISITION OF INFORMATION TECHNOLOGY Security and Privacy for Computer Systems 239.7101 Definition. Information assurance, as used in this subpart, means...

A New Framework for Effective and Efficient Global Sensitivity Analysis of Earth and Environmental Systems Models

NASA Astrophysics Data System (ADS)

Razavi, Saman; Gupta, Hoshin

2015-04-01

Earth and Environmental Systems (EES) models are essential components of research, development, and decision-making in science and engineering disciplines. With continuous advances in understanding and computing power, such models are becoming more complex with increasingly more factors to be specified (model parameters, forcings, boundary conditions, etc.). To facilitate better understanding of the role and importance of different factors in producing the model responses, the procedure known as 'Sensitivity Analysis' (SA) can be very helpful. Despite the availability of a large body of literature on the development and application of various SA approaches, two issues continue to pose major challenges: (1) Ambiguous Definition of Sensitivity - Different SA methods are based in different philosophies and theoretical definitions of sensitivity, and can result in different, even conflicting, assessments of the underlying sensitivities for a given problem, (2) Computational Cost - The cost of carrying out SA can be large, even excessive, for high-dimensional problems and/or computationally intensive models. In this presentation, we propose a new approach to sensitivity analysis that addresses the dual aspects of 'effectiveness' and 'efficiency'. By effective, we mean achieving an assessment that is both meaningful and clearly reflective of the objective of the analysis (the first challenge above), while by efficiency we mean achieving statistically robust results with minimal computational cost (the second challenge above). Based on this approach, we develop a 'global' sensitivity analysis framework that efficiently generates a newly-defined set of sensitivity indices that characterize a range of important properties of metric 'response surfaces' encountered when performing SA on EES models. Further, we show how this framework embraces, and is consistent with, a spectrum of different concepts regarding 'sensitivity', and that commonly-used SA approaches (e.g., Sobol, Morris, etc.) are actually limiting cases of our approach under specific conditions. Multiple case studies are used to demonstrate the value of the new framework. The results show that the new framework provides a fundamental understanding of the underlying sensitivities for any given problem, while requiring orders of magnitude fewer model runs.

Key Facts about Tularemia

MedlinePlus

... Methyl isocyanate Case Definition: Methyl Isocyanate Poisoning Mustard gas (H) (sulfur mustard) Facts About Sulfur Mustard Case ... choking/lung agents Ricin Riot control agents/tear gas Facts About Riot Control Agents Case Definition: Riot ...

Research Trends in Computational Linguistics. Conference Report.

ERIC Educational Resources Information Center

Center for Applied Linguistics, Washington, DC.

This document contains the reports summarizing the main discussion held during the March 1972 Computational Linguistics Conference. The first report, "Computational Linguistics and Linguistics," helps to establish definitions and an understanding of the scope of computational linguistics. "Integrated Computer Systems for Language" and…

Using administrative databases in the surveillance of depressive disorders--case definitions.

PubMed

Alaghehbandan, Reza; Macdonald, Don; Barrett, Brendan; Collins, Kayla; Chen, Yue

2012-12-01

The objective of this study was to assess the usefulness of provincial administrative databases in carrying out surveillance on depressive disorders. Electronic medical records (EMRs) at 3 family practice clinics in St. John's, NL, Canada, were audited; 253 depressive disorder cases and 257 patients not diagnosed with a depressive disorder were selected. The EMR served as the "gold standard," which then was compared to these same patients investigated through the use of various case definitions applied against the provincial hospital and physician administrative databases. Variables used in the development of the case definitions were depressive disorder diagnoses (either in hospital or physician claims data), date of diagnosis, and service provider type [general practitioner (GP) vs. psychiatrist]. Of the 120 case definitions investigated, 26 were found to have a kappa statistic greater than 0.6, of which 5 case definitions were considered the most appropriate for surveillance of depressive disorders. Of the 5 definitions, the following case definition, with a 77.5% sensitivity and 93% specificity, was found to be the most valid ([ ≥1 hospitalizations OR ≥1 psychiatrist visit related to depressive disorders any time] OR ≥2 GP visits related to depressive disorders within the first 2 years of diagnosis). This study found that provincial administrative databases may be useful for carrying out surveillance on depressive disorders among the adult population. The approach used in this study was simple and resulted in rather reasonable sensitivity and specificity.

A pilot asthma incidence surveillance system and case definition: lessons learned.

PubMed

Trepka, Mary Jo; Martin, Pilar; Mavunda, Kunjana; Rodriguez, Diana; Zhang, Guoyan; Brown, Clive

2009-01-01

Surveillance for incident asthma in the general population could provide timely information about asthma trends and new, emerging etiologic factors. We sought to determine the feasibility of an asthma incidence surveillance system using voluntary reporting of asthma by outpatient clinics and emergency departments (EDs). Voluntary reporting occurred from July 2002 through June 2006. We classified reported asthma based on a case definition adapted from one developed by the Council of State and Territorial Epidemiologists. We validated the case definition by having pulmonologists review data from participant interviews, medical record abstractions, and pulmonary function test (PFT) results. The positive predictive value (PPV) of meeting any of the case definition criteria for asthma was 80% to 82%. The criterion of taking at least one rescue and one controller medication had the highest PPV (97% to 100%). Only 7% of people meeting the incident case definition had a PFT documented in their medical record, limiting the usefulness of PFT results for case classification. Compared with pediatric participants, adult participants were more likely to be uninsured and to obtain asthma care at EDs. The surveillance system cost $5129 per enrolled person meeting the incident case definition and was difficult to implement in participating clinics and EDs because asthma reporting was not mandatory and informed consent was necessary. The project was useful in evaluating the case definition's validity and in describing the participants' characteristics and health-care use patterns. However, without mandatory reporting laws, reporting of incident asthma in the general population by clinicians is not likely to be a feasible method for asthma surveillance.

Functional measures developed for clinical populations identified impairment among active workers with upper extremity disorders

PubMed Central

Gardner, Bethany T.; Dale, Ann Marie; Buckner-Petty, Skye; Rachford, Robert; Strickland, Jaime; Kaskutas, Vicki; Evanoff, Bradley

2017-01-01

Purpose Few studies have explored measures of function across a range of health outcomes in a general working population. Using four upper extremity (UE) case definitions from the scientific literature, we described the performance of functional measures of work, activities of daily living, and overall health. Methods A sample of 573 workers completed several functional measures: modified recall versions of the QuickDASH, Levine Functional Status Scale (FSS), DASH Work module (DASH-W), and standard SF-8 physical component score. We determined case status based on four UE case definitions: 1) UE symptoms, 2) UE musculoskeletal disorders (MSD), 3) carpal tunnel syndrome (CTS), and 4) work limitations due to UE symptoms. We calculated effect sizes for each case definition to show the magnitude of the differences that were detected between cases and non-cases for each case definition on each functional measure. Sensitivity and specificity analyses showed how well each measure identified functional impairments across the UE case definitions. Results All measures discriminated between cases and non-cases for each case definition with the largest effect sizes for CTS and work limitations, particularly for the modified FSS and DASH-W measures. Specificity was high and sensitivity was low for outcomes of UE symptoms and UE MSD in all measures. Sensitivity was high for CTS and work limitations. Conclusions Functional measures developed specifically for use in clinical, treatment-seeking populations may identify mild levels of impairment in relatively healthy, active working populations, but measures performed better among workers with CTS or those reporting limitations at work. PMID:26091980

Defining chaos.

PubMed

Hunt, Brian R; Ott, Edward

2015-09-01

In this paper, we propose, discuss, and illustrate a computationally feasible definition of chaos which can be applied very generally to situations that are commonly encountered, including attractors, repellers, and non-periodically forced systems. This definition is based on an entropy-like quantity, which we call "expansion entropy," and we define chaos as occurring when this quantity is positive. We relate and compare expansion entropy to the well-known concept of topological entropy to which it is equivalent under appropriate conditions. We also present example illustrations, discuss computational implementations, and point out issues arising from attempts at giving definitions of chaos that are not entropy-based.

A robust upscaling of the effective particle deposition rate in porous media

NASA Astrophysics Data System (ADS)

Boccardo, Gianluca; Crevacore, Eleonora; Sethi, Rajandrea; Icardi, Matteo

2018-05-01

In the upscaling from pore to continuum (Darcy) scale, reaction and deposition phenomena at the solid-liquid interface of a porous medium have to be represented by macroscopic reaction source terms. The effective rates can be computed, in the case of periodic media, from three-dimensional microscopic simulations of the periodic cell. Several computational and semi-analytical models have been studied in the field of colloid filtration to describe this problem. They typically rely on effective deposition rates defined by complex fitting procedures, neglecting the advection-diffusion interplay, the pore-scale flow complexity, and assuming slow reactions (or large Péclet numbers). Therefore, when these rates are inserted into general macroscopic transport equations, they can lead to several conceptual inconsistencies and significant errors. To study more accurately the dependence of deposition on the flow parameters, in this work we advocate a clear distinction between the surface processes (that altogether defines the so-called attachment efficiency), and the pore-scale processes. With this approach, valid when colloidal particles are small enough, we study Brownian and gravity-driven deposition on a face-centred cubic (FCC) arrangement of spherical grains, and define a robust upscaling based on a linear effective reaction rate. The case of partial deposition, defined by an attachment probability, is studied and the limit of perfect sink is retrieved as a particular case. We introduce a novel upscaling approach and a particularly convenient computational setup that allows the direct computation of the asymptotic stationary value of effective rates. This allows to drastically reduce the computational domain down to the scale of the single repeating periodic unit. The savings are ever more noticeable in the case of higher Péclet numbers, when larger physical times are needed to reach the asymptotic regime and thus, equivalently, much larger computational domain and simulation time would be needed in a traditional setup. We show how this new definition of deposition rate is more robust and extendable to the whole range of Péclet numbers; it also is consistent with the classical heat and mass transfer literature.

Survival in Nonocclusive Mesenteric Ischemia

PubMed Central

Mitsuyoshi, Akira; Obama, Kazutaka; Shinkura, Nobuhiko; Ito, Takashi; Zaima, Masazumi

2007-01-01

Objectives: The aim of the study was to establish a procedure for early diagnosis and treatment of nonocclusive mesenteric ischemia (NOMI). Background: NOMI has a high mortality rate, and early diagnosis and treatment are important for improving survival in patients with this condition. Methods: The subjects were 22 patients treated at our hospital over 13 years. Diagnostic criteria for NOMI were established based on the first 13 cases. In the 9 more recent cases, we performed abdominal contrast multidetector row computed tomography (MDCT) upon suspicion of NOMI based on these criteria. Imaging allowed definite diagnosis of NOMI, and continuous intravenous high-dose PGE1 administration was initiated immediately after diagnosis (dose, 0.01–0.03 μg/kg per min; mean administration period, 4.8 days). Results: Nine of the first 13 patients died of multiple organ failure associated with multiple intestinal necrosis. These cases suggested that NOMI may develop when 3 of the following 4 criteria are met after cardiovascular surgery or maintenance dialysis in elderly patients: symptoms of the ileus develop slowly from abdominal symptoms, such as an unpleasant abdominal feeling or pain; a requirement for catecholamine treatment; an episode of hypotension; and slow elevation of the serum transaminase level. In the 9 recent cases, definite diagnosis was made from spasm of the principal arteries in arterial volume rendering and curved planar reformation MDCT images. Early treatment with PGE1 prevented acute-stage NOMI in 8 of the 9 cases. Conclusions: Early diagnosis of NOMI is possible using the above criteria and MDCT, and initiation of PGE1 treatment may increase survival in patients with NOMI. PMID:17667501

Inflammatory Pseudotumor-Like Follicular Dendritic Cell Sarcoma of the Spleen: Computed Tomography Imaging Characteristics in 5 Patients.

PubMed

Li, Xiumei; Shi, Zhenshan; You, Ruixiong; Li, Yueming; Cao, Dairong; Lin, Renjie; Huang, Xinming

The purpose of this study was to retrospectively review the computed tomography (CT) and clinicopathological characteristics of inflammatory pseudotumor (IPT)-like follicular dendritic cell sarcoma (FDCS) of the spleen in 5 patients. Clinical, pathologic, and CT imaging findings of 5 patients with IPT-like FDCS of the spleen were reviewed and analyzed. Computed tomography imaging and pathologic features were compared. Abdominal unenhanced CT revealed a well-defined hypodense mass in the spleen with complex internal architecture with focal necrosis and/or speckle-strip calcification. On postcontrast CT, slightly delayed enhancement was observed in 5 cases. Four patients had a normalized spleen. The fourth patient had lung metastasis. The fifth patient had 2 relatively small lesions as well as metastases to the spine. Computed tomography imaging features of IPT-like FDCS of the spleen are distinctly different from other hypovascular splenic neoplasm; however, the definitive diagnosis requires further confirmation with needle biopsy or surgery. Inflammatory pseudotumor-like FDCS of the spleen should be suggested by using the CT imaging features of the splenic mass with evidence of metastatic disease.

Definition of a positive test result in computed tomography screening for lung cancer: a cohort study.

PubMed

Henschke, Claudia I; Yip, Rowena; Yankelevitz, David F; Smith, James P

2013-02-19

Low-dose computed tomography screening for lung cancer can reduce mortality among high-risk persons, but "false-positive" findings may result in unnecessary evaluations with attendant risks. The effect of alternative thresholds for defining a positive result on the rates of positive results and cancer diagnoses is unknown. To assess the frequency of positive results and potential delays in diagnosis in the baseline round of screening by using more restrictive thresholds. Prospective cohort study. Multi-institutional International Early Lung Cancer Action Program. 21 136 participants with baseline computed tomography performed between 2006 and 2010. The frequency of solid and part-solid pulmonary nodules and the rate of lung cancer diagnosis by using current (5 mm) and more restrictive thresholds of nodule diameter. The frequency of positive results in the baseline round by using the current definition of positive result (any parenchymal, solid or part-solid, noncalcified nodule ≥5.0 mm) was 16% (3396/21 136). When alternative threshold values of 6.0, 7.0, 8.0 and 9.0 mm were used, the frequencies of positive results were 10.2% (95% CI, 9.8% to 10.6%), 7.1% (CI, 6.7% to 7.4%), 5.1% (CI, 4.8% to 5.4%), and 4.0% (CI, 3.7% to 4.2%), respectively. Use of these alternative definitions would have reduced the work-up by 36%, 56%, 68%, and 75%, respectively. Concomitantly, lung cancer diagnostics would have been delayed by at most 9 months for 0%, 5.0% (CI, 1.1% to 9.0%), 5.9% (CI, 1.7 to 10.1%), and 6.7% (CI, 2.2% to 11.2%) of the cases of cancer, respectively. This was a retrospective analysis and thus whether delays in diagnosis would have altered outcomes cannot be determined. These findings suggest that using a threshold of 7 or 8 mm to define positive results in the baseline round of computed tomography screening for lung cancer should be prospectively evaluated to determine whether the benefits of decreasing further work-up outweigh the consequent delay in diagnosis in some patients.

A grid-embedding transonic flow analysis computer program for wing/nacelle configurations

NASA Technical Reports Server (NTRS)

Atta, E. H.; Vadyak, J.

1983-01-01

An efficient grid-interfacing zonal algorithm was developed for computing the three-dimensional transonic flow field about wing/nacelle configurations. the algorithm uses the full-potential formulation and the AF2 approximate factorization scheme. The flow field solution is computed using a component-adaptive grid approach in which separate grids are employed for the individual components in the multi-component configuration, where each component grid is optimized for a particular geometry such as the wing or nacelle. The wing and nacelle component grids are allowed to overlap, and flow field information is transmitted from one grid to another through the overlap region using trivariate interpolation. This report represents a discussion of the computational methods used to generate both the wing and nacelle component grids, the technique used to interface the component grids, and the method used to obtain the inviscid flow solution. Computed results and correlations with experiment are presented. also presented are discussions on the organization of the wing grid generation (GRGEN3) and nacelle grid generation (NGRIDA) computer programs, the grid interface (LK) computer program, and the wing/nacelle flow solution (TWN) computer program. Descriptions of the respective subroutines, definitions of the required input parameters, a discussion on interpretation of the output, and the sample cases illustrating application of the analysis are provided for each of the four computer programs.

The Coast Artillery Journal. Volume 68, Number 3, March 1928

DTIC Science & Technology

1928-03-01

therefor. Although the system of observation and computation of hits contemplated by the regulations were devised for the former semi-cubical target-area...so greatly simplifies his observations. It is also a fact that if hits are to he computed , as described below, the range observer must regard only...have been computed , the 3’s and 4’s are divided definitely into s’s and h’s, and the 10-20’s definitely into h’s and outs. It need not be fancied that

A Position on a Computer Literacy Course.

ERIC Educational Resources Information Center

Self, Charles C.

A position is put forth on the appropriate content of a computer literacy course and the role of computer literacy in the community college. First, various definitions of computer literacy are examined, including the programming, computer awareness, and comprehensive approaches. Next, five essential components of a computer literacy course are…

Model-based methods for case definitions from administrative health data: application to rheumatoid arthritis

PubMed Central

Kroeker, Kristine; Widdifield, Jessica; Muthukumarana, Saman; Jiang, Depeng; Lix, Lisa M

2017-01-01

Objective This research proposes a model-based method to facilitate the selection of disease case definitions from validation studies for administrative health data. The method is demonstrated for a rheumatoid arthritis (RA) validation study. Study design and setting Data were from 148 definitions to ascertain cases of RA in hospital, physician and prescription medication administrative data. We considered: (A) separate univariate models for sensitivity and specificity, (B) univariate model for Youden’s summary index and (C) bivariate (ie, joint) mixed-effects model for sensitivity and specificity. Model covariates included the number of diagnoses in physician, hospital and emergency department records, physician diagnosis observation time, duration of time between physician diagnoses and number of RA-related prescription medication records. Results The most common case definition attributes were: 1+ hospital diagnosis (65%), 2+ physician diagnoses (43%), 1+ specialist physician diagnosis (51%) and 2+ years of physician diagnosis observation time (27%). Statistically significant improvements in sensitivity and/or specificity for separate univariate models were associated with (all p values <0.01): 2+ and 3+ physician diagnoses, unlimited physician diagnosis observation time, 1+ specialist physician diagnosis and 1+ RA-related prescription medication records (65+ years only). The bivariate model produced similar results. Youden’s index was associated with these same case definition criteria, except for the length of the physician diagnosis observation time. Conclusion A model-based method provides valuable empirical evidence to aid in selecting a definition(s) for ascertaining diagnosed disease cases from administrative health data. The choice between univariate and bivariate models depends on the goals of the validation study and number of case definitions. PMID:28645978

Automated detection of heuristics and biases among pathologists in a computer-based system.

PubMed

Crowley, Rebecca S; Legowski, Elizabeth; Medvedeva, Olga; Reitmeyer, Kayse; Tseytlin, Eugene; Castine, Melissa; Jukic, Drazen; Mello-Thoms, Claudia

2013-08-01

The purpose of this study is threefold: (1) to develop an automated, computer-based method to detect heuristics and biases as pathologists examine virtual slide cases, (2) to measure the frequency and distribution of heuristics and errors across three levels of training, and (3) to examine relationships of heuristics to biases, and biases to diagnostic errors. The authors conducted the study using a computer-based system to view and diagnose virtual slide cases. The software recorded participant responses throughout the diagnostic process, and automatically classified participant actions based on definitions of eight common heuristics and/or biases. The authors measured frequency of heuristic use and bias across three levels of training. Biases studied were detected at varying frequencies, with availability and search satisficing observed most frequently. There were few significant differences by level of training. For representativeness and anchoring, the heuristic was used appropriately as often or more often than it was used in biased judgment. Approximately half of the diagnostic errors were associated with one or more biases. We conclude that heuristic use and biases were observed among physicians at all levels of training using the virtual slide system, although their frequencies varied. The system can be employed to detect heuristic use and to test methods for decreasing diagnostic errors resulting from cognitive biases.

Assessment of severe malaria in a multicenter, phase III, RTS, S/AS01 malaria candidate vaccine trial: case definition, standardization of data collection and patient care.

PubMed

Vekemans, Johan; Marsh, Kevin; Greenwood, Brian; Leach, Amanda; Kabore, William; Soulanoudjingar, Solange; Asante, Kwaku Poku; Ansong, Daniel; Evans, Jennifer; Sacarlal, Jahit; Bejon, Philip; Kamthunzi, Portia; Salim, Nahya; Njuguna, Patricia; Hamel, Mary J; Otieno, Walter; Gesase, Samwel; Schellenberg, David

2011-08-04

An effective malaria vaccine, deployed in conjunction with other malaria interventions, is likely to substantially reduce the malaria burden. Efficacy against severe malaria will be a key driver for decisions on implementation. An initial study of an RTS, S vaccine candidate showed promising efficacy against severe malaria in children in Mozambique. Further evidence of its protective efficacy will be gained in a pivotal, multi-centre, phase III study. This paper describes the case definitions of severe malaria used in this study and the programme for standardized assessment of severe malaria according to the case definition. Case definitions of severe malaria were developed from a literature review and a consensus meeting of expert consultants and the RTS, S Clinical Trial Partnership Committee, in collaboration with the World Health Organization and the Malaria Clinical Trials Alliance. The same groups, with input from an Independent Data Monitoring Committee, developed and implemented a programme for standardized data collection.The case definitions developed reflect the typical presentations of severe malaria in African hospitals. Markers of disease severity were chosen on the basis of their association with poor outcome, occurrence in a significant proportion of cases and on an ability to standardize their measurement across research centres. For the primary case definition, one or more clinical and/or laboratory markers of disease severity have to be present, four major co-morbidities (pneumonia, meningitis, bacteraemia or gastroenteritis with severe dehydration) are excluded, and a Plasmodium falciparum parasite density threshold is introduced, in order to maximize the specificity of the case definition. Secondary case definitions allow inclusion of co-morbidities and/or allow for the presence of parasitaemia at any density. The programmatic implementation of standardized case assessment included a clinical algorithm for evaluating seriously sick children, improvements to care delivery and a robust training and evaluation programme for clinicians. The case definition developed for the pivotal phase III RTS, S vaccine study is consistent with WHO recommendations, is locally applicable and appropriately balances sensitivity and specificity in the diagnosis of severe malaria. Processes set up to standardize severe malaria data collection will allow robust assessment of the efficacy of the RTS, S vaccine against severe malaria, strengthen local capacity and benefit patient care for subjects in the trial. Clinicaltrials.gov NCT00866619.

Contamination control in HVAC systems for aseptic processing area. Part I: Case study of the airflow velocity in a unidirectional airflow workstation with computational fluid dynamics.

PubMed

Ogawa, M

2000-01-01

A unidirectional airflow workstation for processing a sterile pharmaceutical product is required to be "Grade A," according to EU-GMP and WHO-GMP. These regulations have employed the wording of "laminar airflow" for unidirectional airflow, with an unclear definition given. This seems to have allowed many reports to describe discussion of airflow velocity only. The guidance values as to the velocity are expressed in various words of 90 ft/min, 0.45 m/sec, 0.3 m/sec, +/- 20%, or "homogeneous air speed." It has been also little clarified how variation in airflow velocity gives influences on contamination control of a workstation working with varying key characteristics, such as ceiling height, internal heat load, internal particle generation, etc. The present author has revealed following points from a case study using Computational Fluid Dynamics: the airflow characteristic in Grade A area shows no significant changes with varying the velocity of supplied airflow, and the particles generated from the operator will be exhausted outside Grade A area without contamination.

A case of fetal osteogenesis imperfecta type 2A: longitudinal observation of natural course in utero and pitfalls for prenatal ultrasound diagnosis.

PubMed

Kimura, Ibuki; Araki, Ryota; Yoshizato, Toshiyuki; Miyamoto, Shingo

2015-10-01

We present a case of osteogenesis imperfecta (OI) type 2A in which a natural course in utero was observed from 23 weeks' gestation to term. At 23 weeks' gestation, a sonographic examination showed a cloverleaf skull-like head, a narrow thorax, and marked shortening of the long bones with bowing of the femurs and humeri. Follow-up examinations showed that the cloverleaf skull-like head was not evident at 28 weeks' gestation. Discontinuity of the ribs and femurs was observed at 26 and 30 weeks' gestation, respectively. This finding suggested bone fractures, which were confirmed by three-dimensional computed tomography at 32 weeks' gestation. Ultrasonographic findings of bones, including the long bones and calvarium, changed with advancing gestation during the second trimester. Characteristic features of OI type 2A were evident during the late second to early third trimesters. Repeated ultrasonographic examinations together with three-dimensional computed tomography are necessary for the definitive diagnosis of OI type 2A in the second trimester.

Gold standards and expert panels: a pulmonary nodule case study with challenges and solutions

NASA Astrophysics Data System (ADS)

Miller, Dave P.; O'Shaughnessy, Kathryn F.; Wood, Susan A.; Castellino, Ronald A.

2004-05-01

Comparative evaluations of reader performance using different modalities, e.g. CT with computer-aided detection (CAD) vs. CT without CAD, generally require a "truth" definition based on a gold standard. There are many situations in which a true invariant gold standard is impractical or impossible to obtain. For instance, small pulmonary nodules are generally not assessed by biopsy or resection. In such cases, it is common to use a unanimous consensus or majority agreement from an expert panel as a reference standard for actionability in lieu of the unknown gold standard for disease. Nonetheless, there are three major concerns about expert panel reference standards: (1) actionability is not synonymous with disease (2) it may be possible to obtain different conclusions about which modality is better using different rules (e.g. majority vs. unanimous consensus), and (3) the variability associated with the panelists is not formally captured in the p-values or confidence intervals that are generally produced for estimating the extent to which one modality is superior to the other. A multi-reader-multi-case (MRMC) receiver operating characteristic (ROC) study was performed using 90 cases, 15 readers, and a reference truth based on 3 experienced panelists. The primary analyses were conducted using a reference truth of unanimous consensus regarding actionability (3 out of 3 panelists). To assess the three concerns noted above: (1) additional data from the original radiology reports were compared to the panel (2) the complete analysis was repeated using different definitions of truth, and (3) bootstrap analyses were conducted in which new truth panels were constructed by picking 1, 2, or 3 panelists at random. The definition of the reference truth affected the results for each modality (CT with CAD and CT without CAD) considered by itself, but the effects were similar, so the primary analysis comparing the modalities was robust to the choice of the reference truth.

[State of the art diagnostic criteria of severe periodontitis].

PubMed

Ouyang, X Y

2017-02-09

Periodontitis could be categorized as mild, moderate, and severe according to the severity of the disease. This categorizing system could also be used together with other classification systems. The present article introduced the status about the case definition of severe periodontitis, including the standard of case definitions for surveillance of periodontitis reported by the Centers for Disease Control and Prevention (CDC) in partnership with the American Academy of Periodontology (AAP) and the consensus report on the definition of periodontitis case for use in risk factor research by Europe workshop. A consensus on the state of the art definition of severe periodontitis for use in clinical work was gained base on the expertise of Chinese Society of Periodontology, Chinese Association of Stomatology. The background of this consensus and the significance of the criteria for the case definition were discussed.

Evaluation of Semantic Web Technologies for Storing Computable Definitions of Electronic Health Records Phenotyping Algorithms.

PubMed

Papež, Václav; Denaxas, Spiros; Hemingway, Harry

2017-01-01

Electronic Health Records are electronic data generated during or as a byproduct of routine patient care. Structured, semi-structured and unstructured EHR offer researchers unprecedented phenotypic breadth and depth and have the potential to accelerate the development of precision medicine approaches at scale. A main EHR use-case is defining phenotyping algorithms that identify disease status, onset and severity. Phenotyping algorithms utilize diagnoses, prescriptions, laboratory tests, symptoms and other elements in order to identify patients with or without a specific trait. No common standardized, structured, computable format exists for storing phenotyping algorithms. The majority of algorithms are stored as human-readable descriptive text documents making their translation to code challenging due to their inherent complexity and hinders their sharing and re-use across the community. In this paper, we evaluate the two key Semantic Web Technologies, the Web Ontology Language and the Resource Description Framework, for enabling computable representations of EHR-driven phenotyping algorithms.

Unusual anchor pins placement and protocol deviations during computer-based implant placement in a patient with severe mandibular bone atrophy. A case report.

PubMed

Pozzi, A; Tallarico, M; Barlattani, A

2012-06-01

The aim of the study was to describe an unusual method to stabilize the surgical template during the treatment of a severely resorbed edentulous mandible by means of computer-guided implant surgery. Pre-operative computer-based planning revealed the difficulty to stabilize the surgical template in a 67-year-old healthy woman. A deviation of the original NobelGuide™ protocol was performed to ensure the stability of the surgical template: four anchor pins were used to stabilize the surgical template, two in the buccal side of the anterior template and two unusual pins were placed in the lingual site. Four straight TiUnite® Nobel Biocare™ implants were then placed, according to a modified All-on-4™ concept procedure, to avoid graft procedures and to reduce the cumulative chair-side treatment time and costs. A temporary restoration was placed immediately after implant placement. Three months later a definitive, full acrylic restoration was delivered.

Development of innovative computer software to facilitate the setup and computation of water quality index.

PubMed

Nabizadeh, Ramin; Valadi Amin, Maryam; Alimohammadi, Mahmood; Naddafi, Kazem; Mahvi, Amir Hossein; Yousefzadeh, Samira

2013-04-26

Developing a water quality index which is used to convert the water quality dataset into a single number is the most important task of most water quality monitoring programmes. As the water quality index setup is based on different local obstacles, it is not feasible to introduce a definite water quality index to reveal the water quality level. In this study, an innovative software application, the Iranian Water Quality Index Software (IWQIS), is presented in order to facilitate calculation of a water quality index based on dynamic weight factors, which will help users to compute the water quality index in cases where some parameters are missing from the datasets. A dataset containing 735 water samples of drinking water quality in different parts of the country was used to show the performance of this software using different criteria parameters. The software proved to be an efficient tool to facilitate the setup of water quality indices based on flexible use of variables and water quality databases.

Parallel conjugate gradient algorithms for manipulator dynamic simulation

NASA Technical Reports Server (NTRS)

Fijany, Amir; Scheld, Robert E.

1989-01-01

Parallel conjugate gradient algorithms for the computation of multibody dynamics are developed for the specialized case of a robot manipulator. For an n-dimensional positive-definite linear system, the Classical Conjugate Gradient (CCG) algorithms are guaranteed to converge in n iterations, each with a computation cost of O(n); this leads to a total computational cost of O(n sq) on a serial processor. A conjugate gradient algorithms is presented that provide greater efficiency using a preconditioner, which reduces the number of iterations required, and by exploiting parallelism, which reduces the cost of each iteration. Two Preconditioned Conjugate Gradient (PCG) algorithms are proposed which respectively use a diagonal and a tridiagonal matrix, composed of the diagonal and tridiagonal elements of the mass matrix, as preconditioners. Parallel algorithms are developed to compute the preconditioners and their inversions in O(log sub 2 n) steps using n processors. A parallel algorithm is also presented which, on the same architecture, achieves the computational time of O(log sub 2 n) for each iteration. Simulation results for a seven degree-of-freedom manipulator are presented. Variants of the proposed algorithms are also developed which can be efficiently implemented on the Robot Mathematics Processor (RMP).

Face and construct validity of a computer-based virtual reality simulator for ERCP.

PubMed

Bittner, James G; Mellinger, John D; Imam, Toufic; Schade, Robert R; Macfadyen, Bruce V

2010-02-01

Currently, little evidence supports computer-based simulation for ERCP training. To determine face and construct validity of a computer-based simulator for ERCP and assess its perceived utility as a training tool. Novice and expert endoscopists completed 2 simulated ERCP cases by using the GI Mentor II. Virtual Education and Surgical Simulation Laboratory, Medical College of Georgia. Outcomes included times to complete the procedure, reach the papilla, and use fluoroscopy; attempts to cannulate the papilla, pancreatic duct, and common bile duct; and number of contrast injections and complications. Subjects assessed simulator graphics, procedural accuracy, difficulty, haptics, overall realism, and training potential. Only when performance data from cases A and B were combined did the GI Mentor II differentiate novices and experts based on times to complete the procedure, reach the papilla, and use fluoroscopy. Across skill levels, overall opinions were similar regarding graphics (moderately realistic), accuracy (similar to clinical ERCP), difficulty (similar to clinical ERCP), overall realism (moderately realistic), and haptics. Most participants (92%) claimed that the simulator has definite training potential or should be required for training. Small sample size, single institution. The GI Mentor II demonstrated construct validity for ERCP based on select metrics. Most subjects thought that the simulated graphics, procedural accuracy, and overall realism exhibit face validity. Subjects deemed it a useful training tool. Study repetition involving more participants and cases may help confirm results and establish the simulator's ability to differentiate skill levels based on ERCP-specific metrics.

Principles of Faithful Execution in the implementation of trusted objects.

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

Tarman, Thomas David; Campbell, Philip LaRoche; Pierson, Lyndon George

2003-09-01

We begin with the following definitions: Definition: A trusted volume is the computing machinery (including communication lines) within which data is assumed to be physically protected from an adversary. A trusted volume provides both integrity and privacy. Definition: Program integrity consists of the protection necessary to enable the detection of changes in the bits comprising a program as specified by the developer, for the entire time that the program is outside a trusted volume. For ease of discussion we consider program integrity to be the aggregation of two elements: instruction integrity (detection of changes in the bits within an instructionmore » or block of instructions), and sequence integrity (detection of changes in the locations of instructions within a program). Definition: Faithful Execution (FE) is a type of software protection that begins when the software leaves the control of the developer and ends within the trusted volume of a target processor. That is, FE provides program integrity, even while the program is in execution. (As we will show below, FE schemes are a function of trusted volume size.) FE is a necessary quality for computing. Without it we cannot trust computations. In the early days of computing FE came for free since the software never left a trusted volume. At that time the execution environment was the same as the development environment. In some circles that environment was referred to as a ''closed shop:'' all of the software that was used there was developed there. When an organization bought a large computer from a vendor the organization would run its own operating system on that computer, use only its own editors, only its own compilers, only its own debuggers, and so on. However, with the continuing maturity of computing technology, FE becomes increasingly difficult to achieve« less

Data mining: comparing the empiric CFS to the Canadian ME/CFS case definition.

PubMed

Jason, Leonard A; Skendrovic, Beth; Furst, Jacob; Brown, Abigail; Weng, Angela; Bronikowski, Christine

2012-01-01

This article contrasts two case definitions for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). We compared the empiric CFS case definition (Reeves et al., 2005) and the Canadian ME/CFS clinical case definition (Carruthers et al., 2003) with a sample of individuals with CFS versus those without. Data mining with decision trees was used to identify the best items to identify patients with CFS. Data mining is a statistical technique that was used to help determine which of the survey questions were most effective for accurately classifying cases. The empiric criteria identified about 79% of patients with CFS and the Canadian criteria identified 87% of patients. Items identified by the Canadian criteria had more construct validity. The implications of these findings are discussed. © 2011 Wiley Periodicals, Inc.

Bladder Leiomyoma.

PubMed

Caliskan, Selahattin; Sungur, Mustafa

2017-03-01

Leiomyoma of the bladder is a very rare disorder that accounts for 0.43% of all bladder neoplasms. Although the pathophysiology of the bladder leiomyoma is unknown, there are some theories in it. The patients can be asymptomatic; and clinical symptoms, when present, are associated with the tumor size and location. Imaging techniques such as ultrasonography, intravenous urography, computed tomography, and magnetic resonance imaging are helpful but definitive diagnosis is made by histopathological examination. Surgical resection of tumor with transurethral, open, laparoscopic and robotic approaches is the main treatment. We present a case of leiomyoma of the bladder in an adult male patient.

Fluid Stochastic Petri Nets: Theory, Applications, and Solution

NASA Technical Reports Server (NTRS)

Horton, Graham; Kulkarni, Vidyadhar G.; Nicol, David M.; Trivedi, Kishor S.

1996-01-01

In this paper we introduce a new class of stochastic Petri nets in which one or more places can hold fluid rather than discrete tokens. We define a class of fluid stochastic Petri nets in such a way that the discrete and continuous portions may affect each other. Following this definition we provide equations for their transient and steady-state behavior. We present several examples showing the utility of the construct in communication network modeling and reliability analysis, and discuss important special cases. We then discuss numerical methods for computing the transient behavior of such nets. Finally, some numerical examples are presented.

Algorithmics - Is There Hope for a Unified Theory?

NASA Astrophysics Data System (ADS)

Hromkovič, Juraj

Computer science was born with the formal definition of the notion of an algorithm. This definition provides clear limits of automatization, separating problems into algorithmically solvable problems and algorithmically unsolvable ones. The second big bang of computer science was the development of the concept of computational complexity. People recognized that problems that do not admit efficient algorithms are not solvable in practice. The search for a reasonable, clear and robust definition of the class of practically solvable algorithmic tasks started with the notion of the class {P} and of {NP}-completeness. In spite of the fact that this robust concept is still fundamental for judging the hardness of computational problems, a variety of approaches was developed for solving instances of {NP}-hard problems in many applications. Our 40-years short attempt to fix the fuzzy border between the practically solvable problems and the practically unsolvable ones partially reminds of the never-ending search for the definition of "life" in biology or for the definitions of matter and energy in physics. Can the search for the formal notion of "practical solvability" also become a never-ending story or is there hope for getting a well-accepted, robust definition of it? Hopefully, it is not surprising that we are not able to answer this question in this invited talk. But to deal with this question is of crucial importance, because only due to enormous effort scientists get a better and better feeling of what the fundamental notions of science like life and energy mean. In the flow of numerous technical results, we must not forget the fact that most of the essential revolutionary contributions to science were done by defining new concepts and notions.

The High-Resolution Wave-Propagation Method Applied to Meso- and Micro-Scale Flows

NASA Technical Reports Server (NTRS)

Ahmad, Nashat N.; Proctor, Fred H.

2012-01-01

The high-resolution wave-propagation method for computing the nonhydrostatic atmospheric flows on meso- and micro-scales is described. The design and implementation of the Riemann solver used for computing the Godunov fluxes is discussed in detail. The method uses a flux-based wave decomposition in which the flux differences are written directly as the linear combination of the right eigenvectors of the hyperbolic system. The two advantages of the technique are: 1) the need for an explicit definition of the Roe matrix is eliminated and, 2) the inclusion of source term due to gravity does not result in discretization errors. The resulting flow solver is conservative and able to resolve regions of large gradients without introducing dispersion errors. The methodology is validated against exact analytical solutions and benchmark cases for non-hydrostatic atmospheric flows.

A computer package for the design and eigenproblem solution of damped linear multidegree of freedom systems

NASA Technical Reports Server (NTRS)

Ahmadian, M.; Inman, D. J.

1982-01-01

Systems described by the matrix differental equation are considered. An interactive design routine is presented for positive definite mass, damping, and stiffness matrices. Designing is accomplished by adjusting the mass, damping, and stiffness matrices to obtain a desired oscillation behavior. The algorithm also features interactively modifying the physical structure of the system, obtaining the matrix structure and a number of other system properties. In case of a general system, where the M, C, and K matrices lack any special properties, a routine for the eigenproblem solution of the system is developed. The latent roots are obtained by computing the characteristic polynomial of the system and solving for its roots. The above routines are prepared in FORTRAN IV and prove to be usable for the machines with low core memory.

Extremely high-definition full-parallax computer-generated hologram created by the polygon-based method.

PubMed

Matsushima, Kyoji; Nakahara, Sumio

2009-12-01

A large-scale full-parallax computer-generated hologram (CGH) with four billion (2(16) x 2(16)) pixels is created to reconstruct a fine true 3D image of a scene, with occlusions. The polygon-based method numerically generates the object field of a surface object, whose shape is provided by a set of vertex data of polygonal facets, while the silhouette method makes it possible to reconstruct the occluded scene. A novel technique using the segmented frame buffer is presented for handling and propagating large wave fields even in the case where the whole wave field cannot be stored in memory. We demonstrate that the full-parallax CGH, calculated by the proposed method and fabricated by a laser lithography system, reconstructs a fine 3D image accompanied by a strong sensation of depth.

Endodontic management of supernumerary tooth fused with maxillary first molar by using cone-beam computed tomography.

PubMed

Song, Chang-Kyu; Chang, Hoon-Sang; Min, Kyung-San

2010-11-01

Fusion is a rare occurrence, and its definitive diagnosis is of prime importance for successful root canal treatment. This case report discusses the endodontic management of a supernumerary tooth fused with a right maxillary first molar by using cone-beam computed tomography (CBCT). Nonsurgical endodontic retreatment was performed on the supernumerary tooth. A communication between the maxillary first molar and the supernumerary tooth was repaired by using flowable resin. After 1 year of follow-up, there were no clinical symptoms, and the maxillary first molar remained vital. Recall radiographs and CBCT showed satisfactory healing of the periapical pathosis. Proper diagnosis and treatment planning for endodontic management of fused teeth by using CBCT can ensure predictable and successful results. Copyright © 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Using parallel banded linear system solvers in generalized eigenvalue problems

NASA Technical Reports Server (NTRS)

Zhang, Hong; Moss, William F.

1993-01-01

Subspace iteration is a reliable and cost effective method for solving positive definite banded symmetric generalized eigenproblems, especially in the case of large scale problems. This paper discusses an algorithm that makes use of two parallel banded solvers in subspace iteration. A shift is introduced to decompose the banded linear systems into relatively independent subsystems and to accelerate the iterations. With this shift, an eigenproblem is mapped efficiently into the memories of a multiprocessor and a high speed-up is obtained for parallel implementations. An optimal shift is a shift that balances total computation and communication costs. Under certain conditions, we show how to estimate an optimal shift analytically using the decay rate for the inverse of a banded matrix, and how to improve this estimate. Computational results on iPSC/2 and iPSC/860 multiprocessors are presented.

40 CFR 1611.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Definitions. 1611.2 Section 1611.2... PROCEEDINGS § 1611.2 Definitions. CSB incident report means the report containing the CSB's determinations, including the probable cause of an incident, issued either as a narrative report or in a computer format...

28 CFR 802.4 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Definitions. 802.4 Section 802.4 Judicial... Freedom of Information Act § 802.4 Definitions. As used in this subpart, the following terms have the... proprietary interest in the information. (e) Computer software means tools by which records are created...

40 CFR 1611.2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 34 2012-07-01 2012-07-01 false Definitions. 1611.2 Section 1611.2... PROCEEDINGS § 1611.2 Definitions. CSB incident report means the report containing the CSB's determinations, including the probable cause of an incident, issued either as a narrative report or in a computer format...

40 CFR 1611.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 33 2011-07-01 2011-07-01 false Definitions. 1611.2 Section 1611.2... PROCEEDINGS § 1611.2 Definitions. CSB incident report means the report containing the CSB's determinations, including the probable cause of an incident, issued either as a narrative report or in a computer format...

16 CFR 682.1 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Definitions. 682.1 Section 682.1 Commercial... RECORDS § 682.1 Definitions. (a) In general. Except as modified by this part or unless the context... (2) The sale, donation, or transfer of any medium, including computer equipment, upon which consumer...

40 CFR 1611.2 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 34 2013-07-01 2013-07-01 false Definitions. 1611.2 Section 1611.2... PROCEEDINGS § 1611.2 Definitions. CSB incident report means the report containing the CSB's determinations, including the probable cause of an incident, issued either as a narrative report or in a computer format...

39 CFR 501.1 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false Definitions. 501.1 Section 501.1 Postal Service... EVIDENCING SYSTEMS § 501.1 Definitions. (a) Postage Evidencing Systems regulated by part 501 produce evidence... Evidencing Systems that use a personal computer as an integral part of the system. PC Postage products may...

39 CFR 501.1 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 39 Postal Service 1 2013-07-01 2013-07-01 false Definitions. 501.1 Section 501.1 Postal Service... EVIDENCING SYSTEMS § 501.1 Definitions. (a) Postage Evidencing Systems regulated by part 501 produce evidence... Evidencing Systems that use a personal computer as an integral part of the system. PC Postage products may...

28 CFR 802.4 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Definitions. 802.4 Section 802.4 Judicial... Freedom of Information Act § 802.4 Definitions. As used in this subpart, the following terms have the... proprietary interest in the information. (e) Computer software means tools by which records are created...

39 CFR 501.1 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 39 Postal Service 1 2014-07-01 2014-07-01 false Definitions. 501.1 Section 501.1 Postal Service... EVIDENCING SYSTEMS § 501.1 Definitions. (a) Postage Evidencing Systems regulated by part 501 produce evidence... Evidencing Systems that use a personal computer as an integral part of the system. PC Postage products may...

49 CFR 835.2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 7 2012-10-01 2012-10-01 false Definitions. 835.2 Section 835.2 Transportation... OF BOARD EMPLOYEES § 835.2 Definitions. Accident, for purposes of this part includes “incident... cause of an accident, issued either as a narrative report or in a computer format (“briefs” of accidents...

16 CFR 682.1 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 16 Commercial Practices 1 2014-01-01 2014-01-01 false Definitions. 682.1 Section 682.1 Commercial... RECORDS § 682.1 Definitions. (a) In general. Except as modified by this part or unless the context... (2) The sale, donation, or transfer of any medium, including computer equipment, upon which consumer...

49 CFR 835.2 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 7 2013-10-01 2013-10-01 false Definitions. 835.2 Section 835.2 Transportation... OF BOARD EMPLOYEES § 835.2 Definitions. Accident, for purposes of this part includes “incident... cause of an accident, issued either as a narrative report or in a computer format (“briefs” of accidents...

16 CFR 682.1 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 16 Commercial Practices 1 2012-01-01 2012-01-01 false Definitions. 682.1 Section 682.1 Commercial... RECORDS § 682.1 Definitions. (a) In general. Except as modified by this part or unless the context... (2) The sale, donation, or transfer of any medium, including computer equipment, upon which consumer...

16 CFR 682.1 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 16 Commercial Practices 1 2013-01-01 2013-01-01 false Definitions. 682.1 Section 682.1 Commercial... RECORDS § 682.1 Definitions. (a) In general. Except as modified by this part or unless the context... (2) The sale, donation, or transfer of any medium, including computer equipment, upon which consumer...

49 CFR 835.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 7 2011-10-01 2011-10-01 false Definitions. 835.2 Section 835.2 Transportation... OF BOARD EMPLOYEES § 835.2 Definitions. Accident, for purposes of this part includes “incident... cause of an accident, issued either as a narrative report or in a computer format (“briefs” of accidents...

49 CFR 835.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 7 2014-10-01 2014-10-01 false Definitions. 835.2 Section 835.2 Transportation... OF BOARD EMPLOYEES § 835.2 Definitions. Accident, for purposes of this part includes “incident... cause of an accident, issued either as a narrative report or in a computer format (“briefs” of accidents...

28 CFR 802.4 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Definitions. 802.4 Section 802.4 Judicial... Freedom of Information Act § 802.4 Definitions. As used in this subpart, the following terms have the... proprietary interest in the information. (e) Computer software means tools by which records are created...

40 CFR 1611.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 33 2014-07-01 2014-07-01 false Definitions. 1611.2 Section 1611.2... PROCEEDINGS § 1611.2 Definitions. CSB incident report means the report containing the CSB's determinations, including the probable cause of an incident, issued either as a narrative report or in a computer format...

49 CFR 835.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 7 2010-10-01 2010-10-01 false Definitions. 835.2 Section 835.2 Transportation... OF BOARD EMPLOYEES § 835.2 Definitions. Accident, for purposes of this part includes “incident... cause of an accident, issued either as a narrative report or in a computer format (“briefs” of accidents...

Contribution of brain CT in the diagnosis of tuberculous meningitis: a case report from Djibouti.

PubMed

Garetier, M; Roche, N C; Longin, C; Clapson, P; Benois, A; Rousset, J

2017-08-01

Tuberculous meningitis, a serious disease with high mortality and morbidity, remains frequent in countries with endemic tuberculosis. Its non-specific presentation often delays the introduction of appropriate treatment. Its definitive diagnosis requires isolation of Mycobacterium tuberculosis from cerebrospinal fluid, although this test may be negative without conclusively ruling out this diagnosis. A presumptive diagnosis should be reached as soon as possible through a body of clinical evidence, including the lumbar puncture findings. Brain computed tomography (CT) with and without contrast medium injection is helpful for the diagnosis of tuberculous meningitis and its complications. We discuss the features of CT and their value in relation to a case of tuberculous meningitis in Djibouti, as well as the role of CT in managing this disease.

Generalization of the optical theorem for an arbitrary multipole in the presence of a transparent half-space

NASA Astrophysics Data System (ADS)

Eremin, Yu. A.; Sveshnikov, A. G.

2017-07-01

The optical theorem is generalized to the case of excitation of a local inhomogeneity introduced in a transparent substrate by a multipole of arbitrary order. It is shown that, to calculate the generalized extinction cross section, it is sufficient to calculate the derivatives of the scattered field at a single point by adding a constant and a definite integral. Apart from general scientific interest, the proposed generalization makes it possible to calculate the absorption cross section by subtracting the scattering cross section from the extinction cross section. The latter fact is important, because the scattered field in the far zone contains no Sommerfeld integrals. In addition, the proposed generalization allows one to test computer modules for the case where a lossless inhomogeneity is considered.

14 CFR 1214.801 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... customer's pro rata share of Shuttle services and used to compute the Shuttle charge factor. Means of... compute the customer's pro rata share of each element's services and used to compute the element charge... element charge factor. Parameters used in computation of the customer's flight price. Means of computing...

14 CFR 1214.801 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... customer's pro rata share of Shuttle services and used to compute the Shuttle charge factor. Means of... compute the customer's pro rata share of each element's services and used to compute the element charge... element charge factor. Parameters used in computation of the customer's flight price. Means of computing...

14 CFR 1214.801 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... customer's pro rata share of Shuttle services and used to compute the Shuttle charge factor. Means of... compute the customer's pro rata share of each element's services and used to compute the element charge... element charge factor. Parameters used in computation of the customer's flight price. Means of computing...

14 CFR 1214.801 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... customer's pro rata share of Shuttle services and used to compute the Shuttle charge factor. Means of... compute the customer's pro rata share of each element's services and used to compute the element charge... element charge factor. Parameters used in computation of the customer's flight price. Means of computing...

14 CFR § 1214.801 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... customer's pro rata share of Shuttle services and used to compute the Shuttle charge factor. Means of... compute the customer's pro rata share of each element's services and used to compute the element charge... element charge factor. Parameters used in computation of the customer's flight price. Means of computing...

Computational Fluid Dynamics: Past, Present, And Future

NASA Technical Reports Server (NTRS)

Kutler, Paul

1988-01-01

Paper reviews development of computational fluid dynamics and explores future prospects of technology. Report covers such topics as computer technology, turbulence, development of solution methodology, developemnt of algorithms, definition of flow geometries, generation of computational grids, and pre- and post-data processing.

42 CFR 37.42 - Chest radiograph specifications-digital radiography systems.

Code of Federal Regulations, 2014 CFR

2014-10-01

... resolution, modulation transfer function (MTF), image signal-to-noise and detective quantum efficiency must... Information Object Definitions, sections: Computed Radiography Image Information Object Definition; Digital X...

Mumps: a year of enhanced surveillance in Catalonia, Spain.

PubMed

Dominguez, Angela; Oviedo, Manuel; Torner, Nuria; Carmona, Gloria; Costa, Josep; Caylà, Joan; Sala, M Rosa; Barrabeig, Irene; Camps, Neus; Minguell, Sofia; Alvarez, Josep; Godoy, Pere; Jansà, Josep M

2009-05-26

Mumps is a vaccine-preventable disease candidate for elimination. Positive predictive value (PPV) of clinical case definition was assessed. During 2007, 410 suspected cases were reported in Catalonia: 348 fulfilled clinical case definition and 159 were laboratory confirmed. Incidence rate was 4.8 per 100,000 for cases that fulfilled the clinical definition, and 2.2 for laboratory confirmed cases. Global PPV was 44.5%; 38.5% in <15 years and 50% in > or =15 years (p=0.04). Most laboratory confirmed cases (72.3%) received at least one MMR dose. With sustained high MMR coverage, laboratory confirmation is necessary to control the disease and assess vaccine failure.

Case definition for clinical and subclinical bacterial kidney disease (BKD) in Atlantic Salmon (Salmo salar L.) in New Brunswick, Canada.

PubMed

Boerlage, A S; Stryhn, H; Sanchez, J; Hammell, K L

2017-03-01

Bacterial kidney disease (BKD) is considered an important cause of loss in salmon aquaculture in Atlantic Canada. Causative agent of BKD is the Gram-positive bacteria Renibacterium salmoninarum. Infected salmon are often asymptomatic (subclinical infection), and the disease is considered chronic. One of the challenges in quantifying information from farm production and health records is the application of a standardized case definition. Case definitions for farm-level and cage-level clinical and subclinical BKD were developed using retrospective longitudinal data from aquaculture practices in New Brunswick, Canada, combining (i) industry records of weekly production data including mortalities, (ii) field observations for BKD using reports of veterinarians and/or fish health technicians, (iii) diagnostic submissions and test results and (iv) treatments used to control BKD. Case definitions were evaluated using veterinarians' expert judgements as reference standard. Eighty-nine and 66% of sites and fish groups, respectively, were associated with BKD at least once. For BKD present (subclinical or clinical), sensitivity and specificity of the case definition were 75-100% varying between event, fish group, site cycle and level (site pen). For clinical BKD, sensitivities were 29-64% and specificities 91-100%. Industry data can be used to develop sensitive case definitions. © 2016 John Wiley & Sons Ltd.

New myocardial infarction definition affects incidence, mortality, hospitalization rates and prognosis.

PubMed

Agüero, Fernando; Marrugat, Jaume; Elosua, Roberto; Sala, Joan; Masiá, Rafael; Ramos, Rafel; Grau, María

2015-10-01

To analyse differences in myocardial infarction incidence, mortality and hospitalization rates, 28-day case-fatality and two-year prognosis using two myocardial infarction case definitions: the classical World Health Organization definition (1994) and the European Society of Cardiology/American College of Cardiology definition (2000), which added cardiac troponin as a diagnostic biomarker. Population-based cohort of 4170 consecutive myocardial infarction patients aged 35-74 years from Girona (Spain) recruited between 2002 and 2009. Incidence, mortality rates standardized to the European population and 28-day case-fatality were calculated. To estimate the association between case definition and prognosis, Cox models were fitted. Use of the 2000 European Society of Cardiology/American College of Cardiology definition significantly increased myocardial infarction incidence per 100,000 population (238.3 vs. 274.5 in men and 54.1 vs. 69.7 in women). Applying this definition decreased the 28-day case-fatality rate from 26.9% to 23.4% in men, and from 31.0% to 24.1% in women. In the acute phase, patients diagnosed only by increased troponins were significantly less treated with thrombolysis (34.4% vs. 2.0%), angiotensin-converting enzyme inhibitors (71.7% vs. 65.0%) and percutaneous coronary intervention (41.1% vs. 31.7%). Case-fatality at 28 days was significantly better in cases diagnosed only by troponin increase (0.2 % vs. 9.7%), but two-year cardiovascular mortality was higher (7.5% vs. 3.7%). Inclusion of cardiac troponins in myocardial infarction diagnosis increased annual incidence and decreased case-fatality. Diagnosis based only on increased troponins was associated with worse outcome. This group of patients at high risk of death should receive aggressive secondary prevention therapy. © The European Society of Cardiology 2014.

Does expert opinion match the operational definition of the Lupus Low Disease Activity State (LLDAS)? A case-based construct validity study.

PubMed

Golder, Vera; Huq, Molla; Franklyn, Kate; Calderone, Alicia; Lateef, Aisha; Lau, Chak Sing; Lee, Alfred Lok Hang; Navarra, Sandra Teresa V; Godfrey, Timothy; Oon, Shereen; Hoi, Alberta Yik Bun; Morand, Eric Francis; Nikpour, Mandana

2017-06-01

To evaluate the construct validity of the Lupus Low Disease Activity State (LLDAS), a treatment target in systemic lupus erythematosus (SLE). Fifty SLE case summaries based on real patients were prepared and assessed independently for meeting the operational definition of LLDAS. Fifty international rheumatologists with expertise in SLE, but with no prior involvement in the LLDAS project, responded to a survey in which they were asked to categorize the disease activity state of each case as remission, low, moderate, or high. Agreement between expert opinion and LLDAS was assessed using Cohen's kappa. Overall agreement between expert opinion and the operational definition of LLDAS was 77.96% (95% CI: 76.34-79.58%), with a Cohen's kappa of 0.57 (95% CI: 0.55-0.61). Of the cases (22 of 50) that fulfilled the operational definition of LLDAS, only 5.34% (59 of 22 × 50) of responses classified the cases as moderate/high activity. Of the cases that did not fulfill the operational definition of LLDAS (28 of 50), 35.14% (492 of 28 × 50) of responses classified the cases as remission/low activity. Common reasons for discordance were assignment to remission/low activity of cases with higher corticosteroid doses than defined in LLDAS (prednisolone ≤ 7.5mg) or with SLEDAI-2K >4 due to serological activity (high anti-dsDNA antibody and/or low complement). LLDAS has good construct validity with high overall agreement between the operational definition of LLDAS and expert opinion. Discordance of results suggests that the operational definition of LLDAS is more stringent than expert opinion at defining a low disease activity state. Copyright © 2017 Elsevier Inc. All rights reserved.

A validated case definition for chronic rhinosinusitis in administrative data: a Canadian perspective.

PubMed

Rudmik, Luke; Xu, Yuan; Kukec, Edward; Liu, Mingfu; Dean, Stafford; Quan, Hude

2016-11-01

Pharmacoepidemiological research using administrative databases has become increasingly popular for chronic rhinosinusitis (CRS); however, without a validated case definition the cohort evaluated may be inaccurate resulting in biased and incorrect outcomes. The objective of this study was to develop and validate a generalizable administrative database case definition for CRS using International Classification of Diseases, 9th edition (ICD-9)-coded claims. A random sample of 100 patients with a guideline-based diagnosis of CRS and 100 control patients were selected and then linked to a Canadian physician claims database from March 31, 2010, to March 31, 2015. The proportion of CRS ICD-9-coded claims (473.x and 471.x) for each of these 200 patients were reviewed and the validity of 7 different ICD-9-based coding algorithms was evaluated. The CRS case definition of ≥2 claims with a CRS ICD-9 code (471.x or 473.x) within 2 years of the reference case provides a balanced validity with a sensitivity of 77% and specificity of 79%. Applying this CRS case definition to the claims database produced a CRS cohort of 51,000 patients with characteristics that were consistent with published demographics and rates of comorbid asthma, allergic rhinitis, and depression. This study has validated several coding algorithms; based on the results a case definition of ≥2 physician claims of CRS (ICD-9 of 471.x or 473.x) within 2 years provides an optimal level of validity. Future studies will need to validate this administrative case definition from different health system perspectives and using larger retrospective chart reviews from multiple providers. © 2016 ARS-AAOA, LLC.

Validation of a Case Definition for Pediatric Brain Injury Using Administrative Data.

PubMed

McChesney-Corbeil, Jane; Barlow, Karen; Quan, Hude; Chen, Guanmin; Wiebe, Samuel; Jette, Nathalie

2017-03-01

Health administrative data are a common population-based data source for traumatic brain injury (TBI) surveillance and research; however, before using these data for surveillance, it is important to develop a validated case definition. The objective of this study was to identify the optimal International Classification of Disease , edition 10 (ICD-10), case definition to ascertain children with TBI in emergency room (ER) or hospital administrative data. We tested multiple case definitions. Children who visited the ER were identified from the Regional Emergency Department Information System at Alberta Children's Hospital. Secondary data were collected for children with trauma, musculoskeletal, or central nervous system complaints who visited the ER between October 5, 2005, and June 6, 2007. TBI status was determined based on chart review. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each case definition. Of 6639 patients, 1343 had a TBI. The best case definition was, "1 hospital or 1 ER encounter coded with an ICD-10 code for TBI in 1 year" (sensitivity 69.8% [95% confidence interval (CI), 67.3-72.2], specificity 96.7% [95% CI, 96.2-97.2], PPV 84.2% [95% CI 82.0-86.3], NPV 92.7% [95% CI, 92.0-93.3]). The nonspecific code S09.9 identified >80% of TBI cases in our study. The optimal ICD-10-based case definition for pediatric TBI in this study is valid and should be considered for future pediatric TBI surveillance studies. However, external validation is recommended before use in other jurisdictions, particularly because it is plausible that a larger proportion of patients in our cohort had milder injuries.

Student-Created Definitions of Sequence Convergence: A Case Study

ERIC Educational Resources Information Center

Fisher, Brian

2016-01-01

This paper describes the development of an instructional sequence designed to allow students to reinvent the definition of sequence convergence in an introductory proof course. The sequence follows a heuristic of guided reinvention that encourages students to independently create their own mathematical definitions. This case study reports on how…

Emergent Legal Definitions of Parentage in Assisted Reproductive Technology

ERIC Educational Resources Information Center

Robinson, Cherylon; Miller, Michael V.

2004-01-01

State statutes and court cases involving Assisted Reproductive Technology (ART) are examined to determine legal definitions of father and mother. While traditional definitions are not disturbed overall by statutes and cases involving use of artificial insemination by donor among married couples, complications and disputes between parties involved…

Defining Polio: Closing the Gap in Global Surveillance.

PubMed

Tajaldin, Bachir; Almilaji, Khaled; Langton, Paul; Sparrow, Annie

2015-01-01

By late 2012 the Global Polio Eradication Initiative (GPEI) had nearly eradicated this ancient infectious disease. Successful surveillance programs for acute flaccid paralysis however rely on broad governmental support for implementation. With the onset of conflict, public health breakdown has contributed to the resurgence of polio in a number of regions. The current laboratory based case definition may be a contributory factor in these regions. We sought to compare case definition rates using strict laboratory based criteria to rates obtained using the clinical criteria in modern day Syria. We also sought to examine this distribution of cases by sub-region. We examined the World Health Organization (WHO) reported figures for Syria from 2013-2014 using laboratory based criteria. We compared these with cases obtained when clinical criteria were applied. In addition we sought data from the opposition controlled Assistance Coordination Unit which operates in non-Government controlled areas where WHO data maybe incomplete. Cases were carefully examined for potential overlap to avoid double reporting. Whilst the WHO data clearly confirmed the polio outbreak in Syria, it did so with considerable delay and with under reporting of cases, particularly from non-government controlled areas. In addition, laboratory based case definition led to a substantial underestimate of polio (36 cases) compared with those found with the clinically compatible definition (an additional 46 cases). Rates of adequate diagnostic specimens from suspected cases are well below target, no doubt reflecting the effect of conflict in these areas. We have identified a gap in the surveillance of polio, a global threat. The current laboratory based definition, in the setting of conflict and insecurity, leads to under diagnosis of polio with potential delays and inadequacies in coordinating effective responses to contain outbreaks and eradicate polio. Breakdown in public health measures as a contributing factor is likely to result in a resurgence of previously controlled infectious diseases. The clinical definition should be reinstituted to supplement the lab-based definition. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Revised surveillance case definition for HIV infection--United States, 2014.

PubMed

2014-04-11

Following extensive consultation and peer review, CDC and the Council of State and Territorial Epidemiologists have revised and combined the surveillance case definitions for human immunodeficiency virus (HIV) infection into a single case definition for persons of all ages (i.e., adults and adolescents aged ≥13 years and children aged <13 years). The revisions were made to address multiple issues, the most important of which was the need to adapt to recent changes in diagnostic criteria. Laboratory criteria for defining a confirmed case now accommodate new multitest algorithms, including criteria for differentiating between HIV-1 and HIV-2 infection and for recognizing early HIV infection. A confirmed case can be classified in one of five HIV infection stages (0, 1, 2, 3, or unknown); early infection, recognized by a negative HIV test within 6 months of HIV diagnosis, is classified as stage 0, and acquired immunodeficiency syndrome (AIDS) is classified as stage 3. Criteria for stage 3 have been simplified by eliminating the need to differentiate between definitive and presumptive diagnoses of opportunistic illnesses. Clinical (nonlaboratory) criteria for defining a case for surveillance purposes have been made more practical by eliminating the requirement for information about laboratory tests. The surveillance case definition is intended primarily for monitoring the HIV infection burden and planning for prevention and care on a population level, not as a basis for clinical decisions for individual patients. CDC and the Council of State and Territorial Epidemiologists recommend that all states and territories conduct case surveillance of HIV infection using this revised surveillance case definition.

Application of digital diagnostic impression, virtual planning, and computer-guided implant surgery for a CAD/CAM-fabricated, implant-supported fixed dental prosthesis: a clinical report.

PubMed

Stapleton, Brandon M; Lin, Wei-Shao; Ntounis, Athanasios; Harris, Bryan T; Morton, Dean

2014-09-01

This clinical report demonstrated the use of an implant-supported fixed dental prosthesis fabricated with a contemporary digital approach. The digital diagnostic data acquisition was completed with a digital diagnostic impression with an intraoral scanner and cone-beam computed tomography with a prefabricated universal radiographic template to design a virtual prosthetically driven implant surgical plan. A surgical template fabricated with computer-aided design and computer-aided manufacturing (CAD/CAM) was used to perform computer-guided implant surgery. The definitive digital data were then used to design the definitive CAD/CAM-fabricated fixed dental prosthesis. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Occupational risk factors have to be considered in the definition of high-risk lung cancer populations.

PubMed

Wild, P; Gonzalez, M; Bourgkard, E; Courouble, N; Clément-Duchêne, C; Martinet, Y; Févotte, J; Paris, C

2012-03-27

The aim of this study was to compute attributable fractions (AF) to occupational factors in an area in North-Eastern France with high lung cancer rates and a past of mining and steel industry. A population-based case-control study among males aged 40-79 was conducted, including confirmed primary lung cancer cases from all hospitals of the study region. Controls were stratified by broad age-classes, district and socioeconomic classes. Detailed occupational and personal risk factors were obtained in face-to-face interviews. Cumulative occupational exposure indices were obtained from the questionnaires. Attributable fractions were computed from multiple unconditional logistic regression models. A total of 246 cases and 531 controls were included. The odds ratios (ORs) adjusted on cumulative smoking and family history of lung cancer increased significantly with the cumulative exposure indices to asbestos, polycyclic aromatic hydrocarbons and crystalline silica, and with exposure to diesel motor exhaust. The AF for occupational factors exceeded 50%, the most important contributor being crystalline silica and asbestos. These AFs are higher than most published figures. This can be because of the highly industrialised area or methods for exposure assessments. Occupational factors are important risk factors and should not be forgotten when defining high-risk lung cancer populations.

Introduction to computational aero-acoustics

NASA Technical Reports Server (NTRS)

Hardin, Jay C.

1996-01-01

Computational aeroacoustics (CAA) is introduced, by presenting its definition, advantages, applications, and initial challenges. The effects of Mach number and Reynolds number on CAA are considered. The CAA method combines the methods of aeroacoustics and computational fluid dynamics.

The Epidemiology of Transfusion-related Acute Lung Injury Varies According to the Applied Definition of Lung Injury Onset Time.

PubMed

Vande Vusse, Lisa K; Caldwell, Ellen; Tran, Edward; Hogl, Laurie; Dinwiddie, Steven; López, José A; Maier, Ronald V; Watkins, Timothy R

2015-09-01

Research that applies an unreliable definition for transfusion-related acute lung injury (TRALI) may draw false conclusions about its risk factors and biology. The effectiveness of preventive strategies may decrease as a consequence. However, the reliability of the consensus TRALI definition is unknown. To prospectively study the effect of applying two plausible definitions of acute respiratory distress syndrome onset time on TRALI epidemiology. We studied 316 adults admitted to the intensive care unit and transfused red blood cells within 24 hours of blunt trauma. We identified patients with acute respiratory distress syndrome, and defined acute respiratory distress syndrome onset time two ways: (1) the time at which the first radiographic or oxygenation criterion was met, and (2) the time both criteria were met. We categorized two corresponding groups of TRALI cases transfused in the 6 hours before acute respiratory distress syndrome onset. We used Cohen's kappa to measure agreement between the TRALI cases and implicated blood components identified by the two acute respiratory distress syndrome onset time definitions. In a nested case-control study, we examined potential risk factors for each group of TRALI cases, including demographics, injury severity, and characteristics of blood components transfused in the 6 hours before acute respiratory distress syndrome onset. Forty-two of 113 patients with acute respiratory distress syndrome were TRALI cases per the first acute respiratory distress syndrome onset time definition and 63 per the second definition. There was slight agreement between the two groups of TRALI cases (κ = 0.16; 95% confidence interval, -0.01 to 0.33) and between the implicated blood components (κ = 0.15, 95% confidence interval, 0.11-0.20). Age, Injury Severity Score, high plasma-volume components, and transfused plasma volume were risk factors for TRALI when applying the second acute respiratory distress syndrome onset time definition but not when applying the first definition. The epidemiology of TRALI varies when applying two plausible definitions of acute respiratory distress syndrome onset time to severely injured trauma patients. A TRALI definition that standardizes acute respiratory distress syndrome onset time might improve reliability and align efforts to understand epidemiology, biology, and prevention.

Development and validation of a registry-based definition of eosinophilic esophagitis in Denmark

PubMed Central

Dellon, Evan S; Erichsen, Rune; Pedersen, Lars; Shaheen, Nicholas J; Baron, John A; Sørensen, Henrik T; Vyberg, Mogens

2013-01-01

AIM: To develop and validate a case definition of eosinophilic esophagitis (EoE) in the linked Danish health registries. METHODS: For case definition development, we queried the Danish medical registries from 2006-2007 to identify candidate cases of EoE in Northern Denmark. All International Classification of Diseases-10 (ICD-10) and prescription codes were obtained, and archived pathology slides were obtained and re-reviewed to determine case status. We used an iterative process to select inclusion/exclusion codes, refine the case definition, and optimize sensitivity and specificity. We then re-queried the registries from 2008-2009 to yield a validation set. The case definition algorithm was applied, and sensitivity and specificity were calculated. RESULTS: Of the 51 and 49 candidate cases identified in both the development and validation sets, 21 and 24 had EoE, respectively. Characteristics of EoE cases in the development set [mean age 35 years; 76% male; 86% dysphagia; 103 eosinophils per high-power field (eos/hpf)] were similar to those in the validation set (mean age 42 years; 83% male; 67% dysphagia; 77 eos/hpf). Re-review of archived slides confirmed that the pathology coding for esophageal eosinophilia was correct in greater than 90% of cases. Two registry-based case algorithms based on pathology, ICD-10, and pharmacy codes were successfully generated in the development set, one that was sensitive (90%) and one that was specific (97%). When these algorithms were applied to the validation set, they remained sensitive (88%) and specific (96%). CONCLUSION: Two registry-based definitions, one highly sensitive and one highly specific, were developed and validated for the linked Danish national health databases, making future population-based studies feasible. PMID:23382628

Computed Tomography Angiography in Microsurgery: Indications, Clinical Utility, and Pitfalls

PubMed Central

Lee, Gordon K.; Fox, Paige M.; Riboh, Jonathan; Hsu, Charles; Saber, Sepideh; Rubin, Geoffrey D.; Chang, James

2013-01-01

Objective: Computed tomographic angiography (CTA) can be used to obtain 3-dimensional vascular images and soft-tissue definition. The goal of this study was to evaluate the reliability, usefulness, and pitfalls of CTA in preoperative planning of microvascular reconstructive surgery. Methods: A retrospective review of patients who obtained preoperative CTA in preparation for planned microvascular reconstruction was performed over a 5-year period (2001–2005). The influence of CTA on the original operative plan was assessed for each patient, and CTA results were correlated to the operative findings. Results: Computed tomographic angiography was performed on 94 patients in preparation for microvascular reconstruction. In 48 patients (51%), vascular abnormalities were noted on CTA. Intraoperative findings correlated with CTA results in 97% of cases. In 42 patients (45%), abnormal CTA findings influenced the original operative plan, such as the choice of vessels, side of harvest, or nature of the reconstruction (local flap instead of free tissue transfer). Technical difficulties in performing CTA were encountered in 5 patients (5%) in whom interference from external fixation devices was the main cause. Conclusions: This large study of CTA obtained for preoperative planning of reconstructive microsurgery at both donor and recipient sites study demonstrates that CTA is safe and highly accurate. Computed tomographic angiography can alter the surgeon's reconstructive plan when abnormalities are noted preoperatively and consequently improve results by decreasing vascular complication rates. The use of CTA should be considered for cases of microsurgical reconstruction where the vascular anatomy may be questionable. PMID:24023972

A net reproductive number for periodic matrix models.

PubMed

Cushing, J M; Ackleh, A S

2012-01-01

We give a definition of a net reproductive number R (0) for periodic matrix models of the type used to describe the dynamics of a structured population with periodic parameters. The definition is based on the familiar method of studying a periodic map by means of its (period-length) composite. This composite has an additive decomposition that permits a generalization of the Cushing-Zhou definition of R (0) in the autonomous case. The value of R (0) determines whether the population goes extinct (R (0)<1) or persists (R (0)>1). We discuss the biological interpretation of this definition and derive formulas for R (0) for two cases: scalar periodic maps of arbitrary period and periodic Leslie models of period 2. We illustrate the use of the definition by means of several examples and by applications to case studies found in the literature. We also make some comparisons of this definition of R (0) with another definition given recently by Bacaër.

32 CFR 290.5 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 2 2014-07-01 2014-07-01 false Definitions. 290.5 Section 290.5 National... Definitions. The terms used in this rule with the exception of the following are defined in DCAAP 5410.14. (a... means. This does not include computer software, which is the tool by which to create, store, or retrieve...

Assessment of severe malaria in a multicenter, phase III, RTS, S/AS01 malaria candidate vaccine trial: case definition, standardization of data collection and patient care

PubMed Central

2011-01-01

Background An effective malaria vaccine, deployed in conjunction with other malaria interventions, is likely to substantially reduce the malaria burden. Efficacy against severe malaria will be a key driver for decisions on implementation. An initial study of an RTS, S vaccine candidate showed promising efficacy against severe malaria in children in Mozambique. Further evidence of its protective efficacy will be gained in a pivotal, multi-centre, phase III study. This paper describes the case definitions of severe malaria used in this study and the programme for standardized assessment of severe malaria according to the case definition. Methods Case definitions of severe malaria were developed from a literature review and a consensus meeting of expert consultants and the RTS, S Clinical Trial Partnership Committee, in collaboration with the World Health Organization and the Malaria Clinical Trials Alliance. The same groups, with input from an Independent Data Monitoring Committee, developed and implemented a programme for standardized data collection. The case definitions developed reflect the typical presentations of severe malaria in African hospitals. Markers of disease severity were chosen on the basis of their association with poor outcome, occurrence in a significant proportion of cases and on an ability to standardize their measurement across research centres. For the primary case definition, one or more clinical and/or laboratory markers of disease severity have to be present, four major co-morbidities (pneumonia, meningitis, bacteraemia or gastroenteritis with severe dehydration) are excluded, and a Plasmodium falciparum parasite density threshold is introduced, in order to maximize the specificity of the case definition. Secondary case definitions allow inclusion of co-morbidities and/or allow for the presence of parasitaemia at any density. The programmatic implementation of standardized case assessment included a clinical algorithm for evaluating seriously sick children, improvements to care delivery and a robust training and evaluation programme for clinicians. Conclusions The case definition developed for the pivotal phase III RTS, S vaccine study is consistent with WHO recommendations, is locally applicable and appropriately balances sensitivity and specificity in the diagnosis of severe malaria. Processes set up to standardize severe malaria data collection will allow robust assessment of the efficacy of the RTS, S vaccine against severe malaria, strengthen local capacity and benefit patient care for subjects in the trial. Trial registration Clinicaltrials.gov NCT00866619 PMID:21816031

Research on Key Technologies of Cloud Computing

NASA Astrophysics Data System (ADS)

Zhang, Shufen; Yan, Hongcan; Chen, Xuebin

With the development of multi-core processors, virtualization, distributed storage, broadband Internet and automatic management, a new type of computing mode named cloud computing is produced. It distributes computation task on the resource pool which consists of massive computers, so the application systems can obtain the computing power, the storage space and software service according to its demand. It can concentrate all the computing resources and manage them automatically by the software without intervene. This makes application offers not to annoy for tedious details and more absorbed in his business. It will be advantageous to innovation and reduce cost. It's the ultimate goal of cloud computing to provide calculation, services and applications as a public facility for the public, So that people can use the computer resources just like using water, electricity, gas and telephone. Currently, the understanding of cloud computing is developing and changing constantly, cloud computing still has no unanimous definition. This paper describes three main service forms of cloud computing: SAAS, PAAS, IAAS, compared the definition of cloud computing which is given by Google, Amazon, IBM and other companies, summarized the basic characteristics of cloud computing, and emphasized on the key technologies such as data storage, data management, virtualization and programming model.

45 CFR 1620.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false Definitions. 1620.2 Section 1620.2 Public Welfare... § 1620.2 Definitions. (a) A case is a form of program service in which an attorney or paralegal of a... (PAI) cases. (b) A matter is an action which contributes to the overall delivery of program services...

45 CFR 1620.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Definitions. 1620.2 Section 1620.2 Public Welfare... § 1620.2 Definitions. (a) A case is a form of program service in which an attorney or paralegal of a... (PAI) cases. (b) A matter is an action which contributes to the overall delivery of program services...

45 CFR 1620.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 4 2014-10-01 2014-10-01 false Definitions. 1620.2 Section 1620.2 Public Welfare... § 1620.2 Definitions. (a) A case is a form of program service in which an attorney or paralegal of a... (PAI) cases. (b) A matter is an action which contributes to the overall delivery of program services...

45 CFR 1620.2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 4 2012-10-01 2012-10-01 false Definitions. 1620.2 Section 1620.2 Public Welfare... § 1620.2 Definitions. (a) A case is a form of program service in which an attorney or paralegal of a... (PAI) cases. (b) A matter is an action which contributes to the overall delivery of program services...

Definitions Are Important: The Case of Linear Algebra

ERIC Educational Resources Information Center

Berman, Abraham; Shvartsman, Ludmila

2016-01-01

In this paper we describe an experiment in a linear algebra course. The aim of the experiment was to promote the students' understanding of the studied concepts focusing on their definitions. It seems to be a given that students should understand concepts' definitions before working substantially with them. Unfortunately, in many cases they do…

Structured Hierarchical Ada Presentation Using Pictographs (SHARP) definition, Application and Automation

DTIC Science & Technology

1986-09-01

implement a computer program as a function of the Function Point Total. As shown in Table 9, the software product (referred to as SPQR ) establishes the...language being used. Source code statements are defined in SPQR as consisting of executable statements and data definitions. The factors used to calculate... SPQR is a trademark of Software Productivity Research, Inc, 233 TABLE 9 NUMBER OF COMPUTER PROGRAM SOURCE STATEMENTS PER FUNCTION POINT TOTAL

Topics on data transmission problem in software definition network

NASA Astrophysics Data System (ADS)

Gao, Wei; Liang, Li; Xu, Tianwei; Gan, Jianhou

2017-08-01

In normal computer networks, the data transmission between two sites go through the shortest path between two corresponding vertices. However, in the setting of software definition network (SDN), it should monitor the network traffic flow in each site and channel timely, and the data transmission path between two sites in SDN should consider the congestion in current networks. Hence, the difference of available data transmission theory between normal computer network and software definition network is that we should consider the prohibit graph structures in SDN, and these forbidden subgraphs represent the sites and channels in which data can't be passed by the serious congestion. Inspired by theoretical analysis of an available data transmission in SDN, we consider some computational problems from the perspective of the graph theory. Several results determined in the paper imply the sufficient conditions of data transmission in SDN in the various graph settings.

Teleconnections in the Presence of Climate Change: A Case Study of the Annular Modes

NASA Astrophysics Data System (ADS)

Gerber, Edwin; Baldwin, Mark

2010-05-01

Long model integrations of future and past climates present a problem for defining teleconnection patterns through Empirical Orthogonal Function (EOF) or correlation analysis when trends in the underlying climate begin to dominate the covariance structure. Similar issues may soon appear in observations as the record becomes longer, especially if climate trends accelerate. The Northern and Southern Annular Modes provide a prime example, because the poleward shift of the jet streams strongly projects onto these patterns, particularly in the Southern Hemisphere. Climate forecasts of the 21st century by chemistry climate models provide a case study. Computation of the annular modes in these long data sets with secular trends requires refinement of the standard definition of the annular mode, and a more robust procedure that allows for slowly varying trends is established and verified. The new procedure involves two key changes. First, the global mean geopotential height is removed at each time step before computing anomalies. This is particularly important high in the atmosphere, where seasonal variations in geopotential height become significant, and filters out trends due to changes in the temperature structure of the atmosphere. Pattern definition can be very sensitive near the tropopause, as regions of the atmosphere that used to be more of stratospheric character begin to take on tropospheric characteristics as the tropopause rises. The second change is to define anomalies relative to a slowly evolving seasonal climatology, so that the covariance structure reflects internal variability. Once these changes are accounted for, it is found that the zonal mean variability of the atmosphere stays remarkably constant, despite significant changes in the baseline climate forecast for the rest of the century. This stability of the internal variability makes it possible to relate trends in climate to teleconnections.

Endoscopic ultrasound - fine needle aspiration of 2-deoxy-2-[18F] fluoro-D-glucose avid lymph nodes seen on positron emission tomography- computed tomography -what looks like cancer may not always be so.

PubMed

Malik, Anum Imran; Akhtar, Noreen; Loya, Asif; Yusuf, Muhammed Aasim

2014-07-31

Patients suffering from malignancies often undergo serial positron emission tomography - computed tomography (PET-CT) scans, using 2-deoxy-2-[18F] fluoro-D-glucose (FDG) for diagnosis and follow up. This principle may also be applied to benign conditions as inflammatory cells take up increased amounts of FDG as well. The aim of our study was to retrospectively review the cytological diagnoses made at EUS-FNA of FDG-avid PET-CT lesions in patients with a history of cancer and to determine whether the cause of FDG-avidity was neoplastic or benign. We used the endoscopy database to extract clinical information on all patients with malignancies who underwent EUS-FNA to obtain tissue from FDG-avid nodes seen on PET-CT at our institution from 2009 - 2012. All patients who were referred for EUS-FNA after their scans were included. Those who had contraindications to endoscopic procedures were excluded. The most common location of positive lymph nodes was the subcarinal region (46%). A definitive diagnosis was obtained in 87.8% cases, of which 51.2% had a diagnosis of malignancy confirmed on cytology, while 36.5% were benign. Out of these, 29% had granulomatous inflammation. In 12.2% of cases no definitive diagnosis was obtained. Our results show that great caution should be exercised when evaluating FDG-avid PET-CT nodes in patients with known malignant disease, as a significant proportion of these lesions may be benign, particularly in geographic locations with a high background prevalence of granulomatous inflammation.

Interobserver variability in target definition for hepatocellular carcinoma with and without portal vein thrombus: radiation therapy oncology group consensus guidelines.

PubMed

Hong, Theodore S; Bosch, Walter R; Krishnan, Sunil; Kim, Tae K; Mamon, Harvey J; Shyn, Paul; Ben-Josef, Edgar; Seong, Jinsil; Haddock, Michael G; Cheng, Jason C; Feng, Mary U; Stephans, Kevin L; Roberge, David; Crane, Christopher; Dawson, Laura A

2014-07-15

Defining hepatocellular carcinoma (HCC) gross tumor volume (GTV) requires multimodal imaging, acquired in different perfusion phases. The purposes of this study were to evaluate the variability in contouring and to establish guidelines and educational recommendations for reproducible HCC contouring for treatment planning. Anonymous, multiphasic planning computed tomography scans obtained from 3 patients with HCC were identified and distributed to a panel of 11 gastrointestinal radiation oncologists. Panelists were asked the number of HCC cases they treated in the past year. Case 1 had no vascular involvement, case 2 had extensive portal vein involvement, and case 3 had minor branched portal vein involvement. The agreement between the contoured total GTVs (primary + vascular GTV) was assessed using the generalized kappa statistic. Agreement interpretation was evaluated using Landis and Koch's interpretation of strength of agreement. The S95 contour, defined using the simultaneous truth and performance level estimation (STAPLE) algorithm consensus at the 95% confidence level, was created for each case. Of the 11 panelists, 3 had treated >25 cases in the past year, 2 had treated 10 to 25 cases, 2 had treated 5 to 10 cases, 2 had treated 1 to 5 cases, 1 had treated 0 cases, and 1 did not respond. Near perfect agreement was seen for case 1, and substantial agreement was seen for cases 2 and 3. For case 2, there was significant heterogeneity in the volume identified as tumor thrombus (range 0.58-40.45 cc). For case 3, 2 panelists did not include the branched portal vein thrombus, and 7 panelists contoured thrombus separately from the primary tumor, also showing significant heterogeneity in volume of tumor thrombus (range 4.52-34.27 cc). In a group of experts, excellent agreement was seen in contouring total GTV. Heterogeneity exists in the definition of portal vein thrombus that may impact treatment planning, especially if differential dosing is contemplated. Guidelines for HCC GTV contouring are recommended. Copyright © 2014. Published by Elsevier Inc.

Interobserver Variability in Target Definition for Hepatocellular Carcinoma With and Without Portal Vein Thrombus: Radiation Therapy Oncology Group Consensus Guidelines

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

Hong, Theodore S., E-mail: tshong1@mgh.harvard.edu; Bosch, Walter R.; Krishnan, Sunil

2014-07-15

Purpose: Defining hepatocellular carcinoma (HCC) gross tumor volume (GTV) requires multimodal imaging, acquired in different perfusion phases. The purposes of this study were to evaluate the variability in contouring and to establish guidelines and educational recommendations for reproducible HCC contouring for treatment planning. Methods and Materials: Anonymous, multiphasic planning computed tomography scans obtained from 3 patients with HCC were identified and distributed to a panel of 11 gastrointestinal radiation oncologists. Panelists were asked the number of HCC cases they treated in the past year. Case 1 had no vascular involvement, case 2 had extensive portal vein involvement, and case 3more » had minor branched portal vein involvement. The agreement between the contoured total GTVs (primary + vascular GTV) was assessed using the generalized kappa statistic. Agreement interpretation was evaluated using Landis and Koch's interpretation of strength of agreement. The S95 contour, defined using the simultaneous truth and performance level estimation (STAPLE) algorithm consensus at the 95% confidence level, was created for each case. Results: Of the 11 panelists, 3 had treated >25 cases in the past year, 2 had treated 10 to 25 cases, 2 had treated 5 to 10 cases, 2 had treated 1 to 5 cases, 1 had treated 0 cases, and 1 did not respond. Near perfect agreement was seen for case 1, and substantial agreement was seen for cases 2 and 3. For case 2, there was significant heterogeneity in the volume identified as tumor thrombus (range 0.58-40.45 cc). For case 3, 2 panelists did not include the branched portal vein thrombus, and 7 panelists contoured thrombus separately from the primary tumor, also showing significant heterogeneity in volume of tumor thrombus (range 4.52-34.27 cc). Conclusions: In a group of experts, excellent agreement was seen in contouring total GTV. Heterogeneity exists in the definition of portal vein thrombus that may impact treatment planning, especially if differential dosing is contemplated. Guidelines for HCC GTV contouring are recommended.« less

Real time method and computer system for identifying radioactive materials from HPGe gamma-ray spectroscopy

DOEpatents

Rowland, Mark S.; Howard, Douglas E.; Wong, James L.; Jessup, James L.; Bianchini, Greg M.; Miller, Wayne O.

2007-10-23

A real-time method and computer system for identifying radioactive materials which collects gamma count rates from a HPGe gamma-radiation detector to produce a high-resolution gamma-ray energy spectrum. A library of nuclear material definitions ("library definitions") is provided, with each uniquely associated with a nuclide or isotope material and each comprising at least one logic condition associated with a spectral parameter of a gamma-ray energy spectrum. The method determines whether the spectral parameters of said high-resolution gamma-ray energy spectrum satisfy all the logic conditions of any one of the library definitions, and subsequently uniquely identifies the material type as that nuclide or isotope material associated with the satisfied library definition. The method is iteratively repeated to update the spectrum and identification in real time.

Validation of a published case definition for tuberculosis-associated immune reconstitution inflammatory syndrome.

PubMed

Haddow, Lewis J; Moosa, Mahomed-Yunus S; Easterbrook, Philippa J

2010-01-02

To evaluate the International Network for the Study of HIV-associated IRIS (INSHI) case definitions for tuberculosis (TB)-associated immune reconstitution inflammatory syndrome (IRIS) in a South African cohort. Prospective cohort of 498 adult HIV-infected patients initiating antiretroviral therapy. Patients were followed up for 24 weeks and all clinical events were recorded. Events with TB-IRIS as possible cause were assessed by consensus expert opinion and INSHI case definition. Positive, negative, and chance-corrected agreement (kappa) were calculated, and reasons for disagreement were assessed. One hundred and two (20%) patients were receiving TB therapy at antiretroviral therapy initiation. Three hundred and thirty-three events were evaluated (74 potential paradoxical IRIS, 259 potential unmasking IRIS). Based on expert opinion, there were 18 cases of paradoxical IRIS associated with TB and/or other opportunistic disease. The INSHI criteria for TB-IRIS agreed in 13 paradoxical cases, giving positive agreement of 72.2%, negative agreement in 52/56 non-TB-IRIS events (92.9%), and kappa of 0.66. There were 19 unmasking TB-IRIS cases based on expert opinion, of which 12 were considered IRIS using the INSHI definition (positive agreement 63.2%). There was agreement in all 240 non-TB-IRIS events (negative agreement 100%) and kappa was 0.76. There was good agreement between the INSHI case definition for both paradoxical and unmasking TB-IRIS and consensus expert opinion. These results support the use of this definition in clinical and research practice, with minor caveats in its application.

32 CFR 68.3 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

.... Academic skills. Competencies in English, reading, writing, speaking, mathematics, and computer skills that..., degree competencies (e.g., foreign language, computer literacy), and elective course options that... course requirements, degree competencies (e.g., foreign language, computer literacy), and elective course...

32 CFR 68.3 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

.... Academic skills. Competencies in English, reading, writing, speaking, mathematics, and computer skills that..., degree competencies (e.g., foreign language, computer literacy), and elective course options that... course requirements, degree competencies (e.g., foreign language, computer literacy), and elective course...

Evaluation of surveillance case definition in the diagnosis of leptospirosis, using the Microscopic Agglutination Test: a validation study.

PubMed

Dassanayake, Dinesh L B; Wimalaratna, Harith; Agampodi, Suneth B; Liyanapathirana, Veranja C; Piyarathna, Thibbotumunuwe A C L; Goonapienuwala, Bimba L

2009-04-22

Leptospirosis is endemic in both urban and rural areas of Sri Lanka and there had been many out breaks in the recent past. This study was aimed at validating the leptospirosis surveillance case definition, using the Microscopic Agglutination Test (MAT). The study population consisted of patients with undiagnosed acute febrile illness who were admitted to the medical wards of the Teaching Hospital Kandy, from 1st July 2007 to 31st July 2008. The subjects were screened to diagnose leptospirosis according to the leptospirosis case definition. MAT was performed on blood samples taken from each patient on the 7th day of fever. Leptospirosis case definition was evaluated in regard to sensitivity, specificity and predictive values, using a MAT titre >or= 1:800 for confirming leptospirosis. A total of 123 patients were initially recruited of which 73 had clinical features compatible with the surveillance case definition. Out of the 73 only 57 had a positive MAT result (true positives) leaving 16 as false positives. Out of the 50 who didn't have clinical features compatible with the case definition 45 had a negative MAT as well (true negatives), therefore 5 were false negatives. Total number of MAT positives was 62 out of 123. According to these results the test sensitivity was 91.94%, specificity 73.77%, positive predictive value and negative predictive values were 78.08% and 90% respectively. Diagnostic accuracy of the test was 82.93%. This study confirms that the surveillance case definition has a very high sensitivity and negative predictive value with an average specificity in diagnosing leptospirosis, based on a MAT titre of >or= 1: 800.

Development and validation of an administrative case definition for inflammatory bowel diseases

PubMed Central

Rezaie, Ali; Quan, Hude; Fedorak, Richard N; Panaccione, Remo; Hilsden, Robert J

2012-01-01

BACKGROUND: A population-based database of inflammatory bowel disease (IBD) patients is invaluable to explore and monitor the epidemiology and outcome of the disease. In this context, an accurate and validated population-based case definition for IBD becomes critical for researchers and health care providers. METHODS: IBD and non-IBD individuals were identified through an endoscopy database in a western Canadian health region (Calgary Health Region, Calgary, Alberta). Subsequently, using a novel algorithm, a series of case definitions were developed to capture IBD cases in the administrative databases. In the second stage of the study, the criteria were validated in the Capital Health Region (Edmonton, Alberta). RESULTS: A total of 150 IBD case definitions were developed using 1399 IBD patients and 15,439 controls in the development phase. In the validation phase, 318,382 endoscopic procedures were searched and 5201 IBD patients were identified. After consideration of sensitivity, specificity and temporal stability of each validated case definition, a diagnosis of IBD was assigned to individuals who experienced at least two hospitalizations or had four physician claims, or two medical contacts in the Ambulatory Care Classification System database with an IBD diagnostic code within a two-year period (specificity 99.8%; sensitivity 83.4%; positive predictive value 97.4%; negative predictive value 98.5%). An alternative case definition was developed for regions without access to the Ambulatory Care Classification System database. A novel scoring system was developed that detected Crohn disease and ulcerative colitis patients with a specificity of >99% and a sensitivity of 99.1% and 86.3%, respectively. CONCLUSION: Through a robust methodology, a reproducible set of criteria to capture IBD patients through administrative databases was developed. The methodology may be used to develop similar administrative definitions for chronic diseases. PMID:23061064

Accuracy of Zika virus disease case definition during simultaneous Dengue and Chikungunya epidemics.

PubMed

Braga, José Ueleres; Bressan, Clarisse; Dalvi, Ana Paula Razal; Calvet, Guilherme Amaral; Daumas, Regina Paiva; Rodrigues, Nadia; Wakimoto, Mayumi; Nogueira, Rita Maria Ribeiro; Nielsen-Saines, Karin; Brito, Carlos; Bispo de Filippis, Ana Maria; Brasil, Patrícia

2017-01-01

Zika is a new disease in the American continent and its surveillance is of utmost importance, especially because of its ability to cause neurological manifestations as Guillain-Barré syndrome and serious congenital malformations through vertical transmission. The detection of suspected cases by the surveillance system depends on the case definition adopted. As the laboratory diagnosis of Zika infection still relies on the use of expensive and complex molecular techniques with low sensitivity due to a narrow window of detection, most suspected cases are not confirmed by laboratory tests, mainly reserved for pregnant women and newborns. In this context, an accurate definition of a suspected Zika case is crucial in order for the surveillance system to gauge the magnitude of an epidemic. We evaluated the accuracy of various Zika case definitions in a scenario where Dengue and Chikungunya viruses co-circulate. Signs and symptoms that best discriminated PCR confirmed Zika from other laboratory confirmed febrile or exanthematic diseases were identified to propose and test predictive models for Zika infection based on these clinical features. Our derived score prediction model had the best performance because it demonstrated the highest sensitivity and specificity, 86·6% and 78·3%, respectively. This Zika case definition also had the highest values for auROC (0·903) and R2 (0·417), and the lowest Brier score 0·096. In areas where multiple arboviruses circulate, the presence of rash with pruritus or conjunctival hyperemia, without any other general clinical manifestations such as fever, petechia or anorexia is the best Zika case definition.

Impact of revising the National Nosocomial Infection Surveillance System definition for catheter-related bloodstream infection in ICU: reproducibility of the National Healthcare Safety Network case definition in an Australian cohort of infection control professionals.

PubMed

Worth, Leon J; Brett, Judy; Bull, Ann L; McBryde, Emma S; Russo, Philip L; Richards, Michael J

2009-10-01

Effective and comparable surveillance for central venous catheter-related bloodstream infections (CLABSIs) in the intensive care unit requires a reproducible case definition that can be readily applied by infection control professionals. Using a questionnaire containing clinical cases, reproducibility of the National Nosocomial Infection Surveillance System (NNIS) surveillance definition for CLABSI was assessed in an Australian cohort of infection control professionals participating in the Victorian Hospital Acquired Infection Surveillance System (VICNISS). The same questionnaire was then used to evaluate the reproducibility of the National Healthcare Safety Network (NHSN) surveillance definition for CLABSI. Target hospitals were defined as large metropolitan (1A) or other large hospitals (non-1A), according to the Victorian Department of Human Services. Questionnaire responses of Centers for Disease Control and Prevention NHSN surveillance experts were used as gold standard comparator. Eighteen of 21 eligible VICNISS centers participated in the survey. Overall concordance with the gold standard was 57.1%, and agreement was highest for 1A hospitals (60.6%). The proportion of congruently classified cases varied according to NNIS criteria: criterion 1 (recognized pathogen), 52.8%; criterion 2a (skin contaminant in 2 or more blood cultures), 83.3%; criterion 2b (skin contaminant in 1 blood culture and appropriate antimicrobial therapy instituted), 58.3%; non-CLABSI cases, 51.4%. When survey questions regarding identification of cases of CLABSI criterion 2b were removed (consistent with the current NHSN definition), overall percentage concordance increased to 62.5% (72.2% for 1A centers). Further educational interventions are required to improve the discrimination of primary and secondary causes of bloodstream infection in Victorian intensive care units. Although reproducibility of the CLABSI case definition is relatively poor, adoption of the revised NHSN definition for CLABSI is likely to improve the concordance of Victorian data with international centers.

10 CFR 727.2 - What are the definitions of the terms used in this part?

Code of Federal Regulations, 2012 CFR

2012-01-01

... information. Computer means desktop computers, portable computers, computer networks (including the DOE network and local area networks at or controlled by DOE organizations), network devices, automated.... DOE means the Department of Energy, including the National Nuclear Security Administration. DOE...

10 CFR 727.2 - What are the definitions of the terms used in this part?

Code of Federal Regulations, 2014 CFR

2014-01-01

... information. Computer means desktop computers, portable computers, computer networks (including the DOE network and local area networks at or controlled by DOE organizations), network devices, automated.... DOE means the Department of Energy, including the National Nuclear Security Administration. DOE...

10 CFR 727.2 - What are the definitions of the terms used in this part?

Code of Federal Regulations, 2013 CFR

2013-01-01

... information. Computer means desktop computers, portable computers, computer networks (including the DOE network and local area networks at or controlled by DOE organizations), network devices, automated.... DOE means the Department of Energy, including the National Nuclear Security Administration. DOE...

10 CFR 727.2 - What are the definitions of the terms used in this part?

Code of Federal Regulations, 2011 CFR

2011-01-01

... information. Computer means desktop computers, portable computers, computer networks (including the DOE network and local area networks at or controlled by DOE organizations), network devices, automated.... DOE means the Department of Energy, including the National Nuclear Security Administration. DOE...

10 CFR 727.2 - What are the definitions of the terms used in this part?

Code of Federal Regulations, 2010 CFR

2010-01-01

... information. Computer means desktop computers, portable computers, computer networks (including the DOE network and local area networks at or controlled by DOE organizations), network devices, automated.... DOE means the Department of Energy, including the National Nuclear Security Administration. DOE...

Case definitions for inclusion and analysis of endpoints in clinical trials for nonalcoholic steatohepatitis through the lens of regulatory science.

PubMed

Siddiqui, Mohammad Shadab; Harrison, Stephen A; Abdelmalek, Manal F; Anstee, Quentin M; Bedossa, Pierre; Castera, Laurent; Dimick-Santos, Lara; Friedman, Scott L; Greene, Katherine; Kleiner, David E; Megnien, Sophie; Neuschwander-Tetri, Brent A; Ratziu, Vlad; Schabel, Elmer; Miller, Veronica; Sanyal, Arun J

2018-05-01

Nonalcoholic steatohepatitis (NASH) is an important cause of liver-related morbidity and mortality. There are no approved therapies, and the results of clinical trials have been difficult to compare due to inconsistent definitions of relevant disease parameters in patients with NASH. The natural course of the disease has not been rigorously characterized, particularly with respect to the contributions of underlying obesity, type 2 diabetes, and other comorbidities and the treatments provided for these comorbidities. Efforts to perform analyses of pooled data are limited by heterogeneous case definitions used across studies to define disease states. There remains a major unmet need in the field to develop standardized definitions for populations for interventional trials. Such definitions are expected to impact how endpoints for clinical trials are constructed. The Liver Forum is a multistakeholder effort including US and European regulatory agencies, academic investigators, professional and patient representative organizations, and industry to catalyze therapeutic development for NASH by developing potential solutions to barriers to development. The Case Definitions Working Group was established by The Liver Forum to evaluate the validity of case definitions for populations to be included in clinical trials for NASH from a regulatory science perspective. Based on such analyses, specific recommendations are provided noting the strengths and weaknesses of the case definitions along with knowledge gaps that require additional study. (Hepatology 2018;67:2001-2012). © 2017 The Authors. Hepatology published by Wiley Periodicals, Inc. on behalf of American Association for the Study of Liver Diseases.

The prevalence and overlap of interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome in men: results of the RAND Interstitial Cystitis Epidemiology male study.

PubMed

Suskind, Anne M; Berry, Sandra H; Ewing, Brett A; Elliott, Marc N; Suttorp, Marika J; Clemens, J Quentin

2013-01-01

As part of the RICE (RAND Interstitial Cystitis Epidemiology) study, we developed validated case definitions to identify interstitial cystitis/bladder pain syndrome in women and chronic prostatitis/chronic pelvic pain syndrome in men. Using population based screening methods, we applied these case definitions to determine the prevalence of these conditions in men. A total of 6,072 households were contacted by telephone to screen for men who had symptoms of interstitial cystitis/bladder pain syndrome or chronic prostatitis/chronic pelvic pain syndrome. An initial 296 men screened positive, of whom 149 met the inclusionary criteria and completed the telephone interview. For interstitial cystitis/bladder pain syndrome 2 case definitions were applied (1 with high sensitivity and 1 with high specificity), while for chronic prostatitis/chronic pelvic pain syndrome a single case definition (with high sensitivity and specificity) was used. These case definitions were used to classify subjects into groups based on diagnosis. The interstitial cystitis/bladder pain syndrome weighted prevalence estimates for the high sensitivity and high specificity definitions were 4.2% (3.1-5.3) and 1.9% (1.1-2.7), respectively. The chronic prostatitis/chronic pelvic pain syndrome weighted prevalence estimate was 1.8% (0.9-2.7). These values equate to 1,986,972 (95% CI 966,042-2,996,924) men with chronic prostatitis/chronic pelvic pain syndrome and 2,107,727 (95% CI 1,240,485-2,974,969) men with the high specificity definition of interstitial cystitis/bladder pain syndrome in the United States. The overlap between men who met the high specificity interstitial cystitis/bladder pain syndrome case definition or the chronic prostatitis/chronic pelvic pain syndrome case definition was 17%. Symptoms of interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome are widespread among men in the United States. The prevalence of interstitial cystitis/bladder pain syndrome symptoms in men approaches that in women, suggesting that this condition may be underdiagnosed in the male population. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

32 CFR 290.5 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Definitions. The terms used in this rule with the exception of the following are defined in DCAAP 5410.14. (a... means. This does not include computer software, which is the tool by which to create, store, or retrieve...

32 CFR 290.5 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Definitions. The terms used in this rule with the exception of the following are defined in DCAAP 5410.14. (a... means. This does not include computer software, which is the tool by which to create, store, or retrieve...

32 CFR 290.5 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Definitions. The terms used in this rule with the exception of the following are defined in DCAAP 5410.14. (a... means. This does not include computer software, which is the tool by which to create, store, or retrieve...

32 CFR 290.5 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Definitions. The terms used in this rule with the exception of the following are defined in DCAAP 5410.14. (a... means. This does not include computer software, which is the tool by which to create, store, or retrieve...

TETRA-COM: a comprehensive SPSS program for estimating the tetrachoric correlation.

PubMed

Lorenzo-Seva, Urbano; Ferrando, Pere J

2012-12-01

We provide an SPSS program that implements descriptive and inferential procedures for estimating tetrachoric correlations. These procedures have two main purposes: (1) bivariate estimation in contingency tables and (2) constructing a correlation matrix to be used as input for factor analysis (in particular, the SPSS FACTOR procedure). In both cases, the program computes accurate point estimates, as well as standard errors and confidence intervals that are correct for any population value. For purpose (1), the program computes the contingency table together with five other measures of association. For purpose (2), the program checks the positive definiteness of the matrix, and if it is found not to be Gramian, performs a nonlinear smoothing procedure at the user's request. The SPSS syntax, a short manual, and data files related to this article are available as supplemental materials from brm.psychonomic-journals.org/content/supplemental.

Importance of inlet boundary conditions for numerical simulation of combustor flows

NASA Technical Reports Server (NTRS)

Sturgess, G. J.; Syed, S. A.; Mcmanus, K. R.

1983-01-01

Fluid dynamic computer codes for the mathematical simulation of problems in gas turbine engine combustion systems are required as design and diagnostic tools. To eventually achieve a performance standard with these codes of more than qualitative accuracy it is desirable to use benchmark experiments for validation studies. Typical of the fluid dynamic computer codes being developed for combustor simulations is the TEACH (Teaching Elliptic Axisymmetric Characteristics Heuristically) solution procedure. It is difficult to find suitable experiments which satisfy the present definition of benchmark quality. For the majority of the available experiments there is a lack of information concerning the boundary conditions. A standard TEACH-type numerical technique is applied to a number of test-case experiments. It is found that numerical simulations of gas turbine combustor-relevant flows can be sensitive to the plane at which the calculations start and the spatial distributions of inlet quantities for swirling flows.

Hybrid expert system for decision supporting in the medical area: complexity and cognitive computing.

PubMed

Brasil, L M; de Azevedo, F M; Barreto, J M

2001-09-01

This paper proposes a hybrid expert system (HES) to minimise some complexity problems pervasive to the artificial intelligence such as: the knowledge elicitation process, known as the bottleneck of expert systems; the model choice for knowledge representation to code human reasoning; the number of neurons in the hidden layer and the topology used in the connectionist approach; the difficulty to obtain the explanation on how the network arrived to a conclusion. Two algorithms applied to developing of HES are also suggested. One of them is used to train the fuzzy neural network and the other to obtain explanations on how the fuzzy neural network attained a conclusion. To overcome these difficulties the cognitive computing was integrated to the developed system. A case study is presented (e.g. epileptic crisis) with the problem definition and simulations. Results are also discussed.

Coral disease and health workshop: Coral Histopathology II, July 12-14, 2005

USGS Publications Warehouse

Galloway, S.B.; Woodley, Cheryl M.; McLaughlin, S.M.; Work, Thierry M.; Bochsler, V.S.; Meteyer, Carol U.; Sileo, Louis; Peters, E.C.; Kramarsky-Winters, E.; Morado, J. Frank; Parnell, P.G.; Rotstein, D.S.; Harely, R.A.; Reynolds, T.L.

2005-01-01

An exciting highlight of this meeting was provided by Professor Robert Ogilvie (MUSC Department of Cell Biology and Anatomy) when he introduced participants to a new digital technology that is revolutionizing histology and histopathology in the medical field. The Virtual Slide technology creates digital images of histological tissue sections by computer scanning actual slides in high definition and storing the images for retrieval and viewing. Virtual slides now allow any investigator with access to a computer and the web to view, search, annotate and comment on the same tissue sections in real time. Medical and veterinary slide libraries across the country are being converted into virtual slides to enhance biomedical education, research and diagnosis. The coral health and disease researchers at this workshop deem virtual slides as a significant way to increase capabilities in coral histology and a means for pathology consultations on coral disease cases on a global scale. 

A Computer Program for Drip Irrigation System Design for Small Plots

NASA Astrophysics Data System (ADS)

Philipova, Nina; Nicheva, Olga; Kazandjiev, Valentin; Chilikova-Lubomirova, Mila

2012-12-01

A computer programhas been developed for design of surface drip irrigation system. It could be applied for calculation of small scale fields with an area up to 10 ha. The program includes two main parts: crop water requirements and hydraulic calculations of the system. It has been developed in Graphical User Interface in MATLAB and gives opportunity for selecting some parameters from tables such as: agro- physical soil properties, characteristics of the corresponding crop, climatic data. It allows the user of the program to assume and set a definite value, for example the emitter discharge, plot parameters and etc. Eight cases of system layout according to the water source layout and the number of plots of the system operation are laid into hydraulic section of the program. It includes the design of lateral, manifold, main line and pump calculations. The program has been compiled to work in Windows.

Liquid Water Cloud Properties During the Polarimeter Definition Experiment (PODEX)

NASA Technical Reports Server (NTRS)

Alexandrov, Mikhail D.; Cairns, Brian; Wasilewski, Andrzei P.; Ackerman, Andrew S.; McGill, Matthew J.; Yorks, John E.; Hlavka, Dennis L.; Platnick, Steven; Arnold, George; Van Diedenhoven, Bastiaan;

[Management of acute respiratory distress syndrome in Midi-Pyrnees].

PubMed

Fuzier, R; Mercier-Fuzier, V; Chaminade, B; Georges, B; Decun, J F; Cougot, P; Ducassé, J L; Virenque, C

2000-10-07

To assess management of acute respiratory distress syndrome (ARDS) in Midi-Pyrénées, France. A prospective study using a questionnaire divided into 10 parts, definition, etiology, radiography, computed tomography, management, was conducted in 26 intensive care units in the Midi-Pyrénées. Management of ARDS in Midi-Pyrénées was comparted with management elsewhere as described in the literature. Overall participation rate was 73%. Disparities were found concerning the definition. Four etiologies accounted for 75% of all ARDS cases. Chest x-rays were used for positive diagnosis and thoracic scans for complications. Ventilatory and hemodynamic optimizations were the first line therapy used. Twenty-nine percent and 41% of the intensive care unites used nitric oxide and prone position respectively. There are differences between ARDS management in Midi-Pyrénées and that described in the current literature. Epidemiologic studies such as this one are necessary before publishing guidelines for the management of ARDS.

Medical Surveillance Monthly Report (MSMR). Volume 22, Number 9, September 2015

DTIC Science & Technology

2015-09-01

MEDICAL SURVEILLANCE MONTHLY REPORT PAGE 2 PAGE 6 PAGE 12 Assessment of ICD-9-based case definitions for influenza -like illness surveillance...appropriate when there is a need to maximize specifi city. Assessment of ICD-9-based Case Definitions for Influenza -like Illness Surveillance Angelia A. Eick...matched to the spec- imen; if such a match was not possible, T A 8 L E 1. ICD-9 codes for original influenza -like illness case definition ICD-9 code

Asymptotic density and effective negligibility

NASA Astrophysics Data System (ADS)

Astor, Eric P.

In this thesis, we join the study of asymptotic computability, a project attempting to capture the idea that an algorithm might work correctly in all but a vanishing fraction of cases. In collaboration with Hirschfeldt and Jockusch, broadening the original investigation of Jockusch and Schupp, we introduce dense computation, the weakest notion of asymptotic computability (requiring only that the correct answer is produced on a set of density 1), and effective dense computation, where every computation halts with either the correct answer or (on a set of density 0) a symbol denoting uncertainty. A few results make more precise the relationship between these notions and work already done with Jockusch and Schupp's original definitions of coarse and generic computability. For all four types of asymptotic computation, including generic computation, we demonstrate that non-trivial upper cones have measure 0, building on recent work of Hirschfeldt, Jockusch, Kuyper, and Schupp in which they establish this for coarse computation. Their result transfers to yield a minimal pair for relative coarse computation; we generalize their method and extract a similar result for relative dense computation (and thus for its corresponding reducibility). However, all of these notions of near-computation treat a set as negligible iff it has asymptotic density 0. Noting that this definition is not computably invariant, this produces some failures of intuition and a break with standard expectations in computability theory. For instance, as shown by Hamkins and Miasnikov, the halting problem is (in some formulations) effectively densely computable, even in polynomial time---yet this result appears fragile, as indicated by Rybalov. In independent work, we respond to this by strengthening the approach of Jockusch and Schupp to avoid such phenomena; specifically, we introduce a new notion of intrinsic asymptotic density, invariant under computable permutation, with rich relations to both randomness and classical computability theory. For instance, we prove that the stochasticities corresponding to permutation randomness and injection randomness coincide, and identify said stochasticity as intrinsic density 1/2. We then define sets of intrinsic density 0 to be effectively negligible, and classify this as a new immunity property, determining its position in the standard hierarchy from immune to cohesive for both general and Delta02 sets. We further characterize the Turing degrees of effectively negligible sets as those which are either high (a' ≥T 0") or compute a DNC (diagonally non-computable) function. In fact, this result holds over RCA0, demonstrating the reverse-mathematical equivalence of the principles ID0 and DOM \\sext DNR. . Replacing Jockusch and Schupp's negligibility (density 0) by effective negligibility (intrinsic density 0), we then obtain new notions of intrinsically dense computation. Finally, we generalize Rice's Theorem to all forms of intrinsic dense computation, showing that no set that is 1-equivalent to a non-trivial index set is intrinsically densely computable; in particular, in contrast to ordinary dense computation, we see that the halting problem cannot be intrinsically densely computable.

Update of the Case Definitions for Population-Based Surveillance of Periodontitis

PubMed Central

Eke, Paul I.; Page, Roy C.; Wei, Liang; Thornton-Evans, Gina; Genco, Robert J.

2018-01-01

Background This report adds a new definition for mild periodontitis that allows for better descriptions of the overall prevalence of periodontitis in populations. In 2007, the Centers for Disease Control and Prevention in partnership with the American Academy of Periodontology developed and reported standard case definitions for surveillance of moderate and severe periodontitis based on measurements of probing depth (PD) and clinical attachment loss (AL) at interproximal sites. However, combined cases of moderate and severe periodontitis are insufficient to determine the total prevalence of periodontitis in populations. Methods The authors proposed a definition for mild periodontitis as ≥2 interproximal sites with AL ≥3 mm and ≥2 interproximal sites with PD ≥4 mm (not on the same tooth) or one site with PD ≥5 mm. The effect of the proposed definition on the total burden of periodontitis was assessed in a convenience sample of 456 adults ≥35 years old and compared with other previously reported definitions for similar categories of periodontitis. Results Addition of mild periodontitis increases the total prevalence of periodontitis by ≈31% in this sample when compared with the prevalence of severe and moderate disease. Conclusion Total periodontitis using the case definitions in this study should be based on the sum of mild, moderate, and severe periodontitis. PMID:22420873

High Definition Information Systems. Hearings before the Subcommittee on Technology and Competitiveness of the Committee on Science, Space, and Technology. U.S. House of Representatives, One Hundred Second Congress, First Session (May 14, 21, 1991).

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Committee on Science, Space and Technology.

The report of these two hearings on high definition information systems begins by noting that they are digital, and that they are likely to handle computing, telecommunications, home security, computer imaging, storage, fiber optics networks, multi-dimensional libraries, and many other local, national, and international systems. (It is noted that…

Child Maltreatment Surveillance Improvement Opportunities: A Wake County, North Carolina Pilot Project.

PubMed

Shanahan, Meghan E; Fliss, Mike D; Proescholdbell, Scott K

2018-01-01

BACKGROUND As child maltreatment often occurs in private, child welfare numbers underestimate its true prevalence. Child maltreatment surveillance systems have been used to ascertain more accurate counts of children who experience maltreatment. This manuscript describes the results from a pilot child maltreatment surveillance system in Wake County, North Carolina. METHODS We linked 2010 and 2011 data from 3 sources (Child Protective Services, Raleigh Police Department, and Office of the Chief Medical Examiner) to obtain rates of definite and possible child maltreatment. We separately analyzed emergency department visits from 2010 and 2011 to obtain counts of definite and possible child maltreatment. We then compared the results from the surveillance systems to those obtained from Child Protective Services (CPS) data alone. RESULTS In 2010 and 2011, rates of definite child maltreatment were 11.7 and 11.3 per 1,000 children, respectively, when using the linked data, compared to 10.0 and 9.5 per 1,000 children using CPS data alone. The rates of possible maltreatment were 25.3 and 23.8 per 1,000, respectively. In the 2010 and 2011 emergency department data, there were 68 visits and 84 visits, respectively, that met the case definition for maltreatment. LIMITATIONS While 4 data sources were analyzed, only 3 were linked in the current surveillance system. It is likely that we would have identified more cases of maltreatment had more sources been included. CONCLUSION While the surveillance system identified more children who met the case definition of maltreatment than CPS data alone, the rates of definite child maltreatment were not considerably higher than official reports. Rates of possible child maltreatment were much higher than both the definite case definition and child welfare records. Tracking both definite and possible case definitions and using a variety of data sources provides a more complete picture of child maltreatment in North Carolina. ©2018 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

Enabling the use of hereditary information from pedigree tools in medical knowledge-based systems.

PubMed

Gay, Pablo; López, Beatriz; Plà, Albert; Saperas, Jordi; Pous, Carles

2013-08-01

The use of family information is a key issue to deal with inheritance illnesses. This kind of information use to come in the form of pedigree files, which contain structured information as tree or graphs, which explains the family relationships. Knowledge-based systems should incorporate the information gathered by pedigree tools to assess medical decision making. In this paper, we propose a method to achieve such a goal, which consists on the definition of new indicators, and methods and rules to compute them from family trees. The method is illustrated with several case studies. We provide information about its implementation and integration on a case-based reasoning tool. The method has been experimentally tested with breast cancer diagnosis data. The results show the feasibility of our methodology. Copyright © 2013 Elsevier Inc. All rights reserved.

A pilot prospective feasibility study of organ-at-risk definition using Target Contour Testing/Instructional Computer Software (TaCTICS), a training and evaluation platform for radiotherapy target delineation.

PubMed

Kalpathy-Cramer, Jayashree; Bedrick, Steven D; Boccia, Kelly; Fuller, Clifton D

2011-01-01

Target volume delineation is a critical, but time-consuming step in the creation of radiation therapy plans used in the treatment of many types of cancer. However, variability in target volume definitions can introduce substantial differences in resulting doses to tumors and critical structures. We developed TaCTICS, a web-based educational training software application targeted towards non-expert users. We report on a small, prospective study to evaluate the utility of this online tool in improving conformance of regions-of-interest (ROIs) with a reference set. Eight residents contoured a set of structures for a head-and-neck cancer case. Subsequently, they were provided access to TaCTICS as well as contouring atlases to allow evaluation of their contours in reference to other users as well as reference ROIs. The residents then contoured a second case using these resources. Volume overlap metrics between the users showed a substantial improvement following the intervention. Additionally, 66% of users reported that they found TaCTICS to be a useful educational tool and all participants reported they would like to use TaCTICS to track their contouring skills over the course of their residency.

Survey Definitions of Gout for Epidemiologic Studies: Comparison With Crystal Identification as the Gold Standard.

PubMed

Dalbeth, Nicola; Schumacher, H Ralph; Fransen, Jaap; Neogi, Tuhina; Jansen, Tim L; Brown, Melanie; Louthrenoo, Worawit; Vazquez-Mellado, Janitzia; Eliseev, Maxim; McCarthy, Geraldine; Stamp, Lisa K; Perez-Ruiz, Fernando; Sivera, Francisca; Ea, Hang-Korng; Gerritsen, Martijn; Scire, Carlo A; Cavagna, Lorenzo; Lin, Chingtsai; Chou, Yin-Yi; Tausche, Anne-Kathrin; da Rocha Castelar-Pinheiro, Geraldo; Janssen, Matthijs; Chen, Jiunn-Horng; Cimmino, Marco A; Uhlig, Till; Taylor, William J

2016-12-01

To identify the best-performing survey definition of gout from items commonly available in epidemiologic studies. Survey definitions of gout were identified from 34 epidemiologic studies contributing to the Global Urate Genetics Consortium (GUGC) genome-wide association study. Data from the Study for Updated Gout Classification Criteria (SUGAR) were randomly divided into development and test data sets. A data-driven case definition was formed using logistic regression in the development data set. This definition, along with definitions used in GUGC studies and the 2015 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) gout classification criteria were applied to the test data set, using monosodium urate crystal identification as the gold standard. For all tested GUGC definitions, the simple definition of "self-report of gout or urate-lowering therapy use" had the best test performance characteristics (sensitivity 82%, specificity 72%). The simple definition had similar performance to a SUGAR data-driven case definition with 5 weighted items: self-report, self-report of doctor diagnosis, colchicine use, urate-lowering therapy use, and hyperuricemia (sensitivity 87%, specificity 70%). Both of these definitions performed better than the 1977 American Rheumatism Association survey criteria (sensitivity 82%, specificity 67%). Of all tested definitions, the 2015 ACR/EULAR criteria had the best performance (sensitivity 92%, specificity 89%). A simple definition of "self-report of gout or urate-lowering therapy use" has the best test performance characteristics of existing definitions that use routinely available data. A more complex combination of features is more sensitive, but still lacks good specificity. If a more accurate case definition is required for a particular study, the 2015 ACR/EULAR gout classification criteria should be considered. © 2016, American College of Rheumatology.

Calculus domains modelled using an original bool algebra based on polygons

NASA Astrophysics Data System (ADS)

Oanta, E.; Panait, C.; Raicu, A.; Barhalescu, M.; Axinte, T.

2016-08-01

Analytical and numerical computer based models require analytical definitions of the calculus domains. The paper presents a method to model a calculus domain based on a bool algebra which uses solid and hollow polygons. The general calculus relations of the geometrical characteristics that are widely used in mechanical engineering are tested using several shapes of the calculus domain in order to draw conclusions regarding the most effective methods to discretize the domain. The paper also tests the results of several CAD commercial software applications which are able to compute the geometrical characteristics, being drawn interesting conclusions. The tests were also targeting the accuracy of the results vs. the number of nodes on the curved boundary of the cross section. The study required the development of an original software consisting of more than 1700 computer code lines. In comparison with other calculus methods, the discretization using convex polygons is a simpler approach. Moreover, this method doesn't lead to large numbers as the spline approximation did, in that case being required special software packages in order to offer multiple, arbitrary precision. The knowledge resulted from this study may be used to develop complex computer based models in engineering.

Information management advanced development. Volume 1: Summary

NASA Technical Reports Server (NTRS)

Gerber, C. R.

1972-01-01

The information management systems designed for the modular space station are discussed. Subjects presented are: (1) communications terminal breadboard configuration, (2) digital data bus breadboard configuration, (3) data processing assembly definition, and (4) computer program (software) assembly definition.

The Problem of Defining Intelligence.

ERIC Educational Resources Information Center

Lubar, David

1981-01-01

The major philosophical issues surrounding the concept of intelligence are reviewed with respect to the problems surrounding the process of defining and developing artificial intelligence (AI) in computers. Various current definitions and problems with these definitions are presented. (MP)

Closed Forms for 4-Parameter Families of Integrals

ERIC Educational Resources Information Center

Dana-Picard, Thierry; Zeitoun, David G.

2009-01-01

We compute closed forms for two multiparameter families of definite integrals, thus obtaining combinatorial formulas. As a consequence, a surprising formula is derived between a definite integral and an improper integral for the same parametric function.

32 CFR 241.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... motivated, disciplined employees. Information technology (IT) as defined means use of computers, ancillary... technology, including occupational specialty areas such as systems administration, IT project management... PILOT PROGRAM FOR TEMPORARY EXCHANGE OF INFORMATION TECHNOLOGY PERSONNEL § 241.2 Definitions. In this...

32 CFR 241.2 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... motivated, disciplined employees. Information technology (IT) as defined means use of computers, ancillary... technology, including occupational specialty areas such as systems administration, IT project management... PILOT PROGRAM FOR TEMPORARY EXCHANGE OF INFORMATION TECHNOLOGY PERSONNEL § 241.2 Definitions. In this...

An ICA-based method for the segmentation of pigmented skin lesions in macroscopic images.

PubMed

Cavalcanti, Pablo G; Scharcanski, Jacob; Di Persia, Leandro E; Milone, Diego H

2011-01-01

Segmentation is an important step in computer-aided diagnostic systems for pigmented skin lesions, since that a good definition of the lesion area and its boundary at the image is very important to distinguish benign from malignant cases. In this paper a new skin lesion segmentation method is proposed. This method uses Independent Component Analysis to locate skin lesions in the image, and this location information is further refined by a Level-set segmentation method. Our method was evaluated in 141 images and achieved an average segmentation error of 16.55%, lower than the results for comparable state-of-the-art methods proposed in literature.

Evaluating Options for Measurement of Neighborhood Socioeconomic Context: Evidence from a Myocardial Infarction Case-Control Study

PubMed Central

Lovasi, Gina S.; Moudon, Anne Vernez; Smith, Nicholas L.; Lumley, Thomas; Larson, Eric B.; Sohn, Dong W; Siscovick, David S; Psaty, Bruce M

2008-01-01

We hypothesized that neighborhood socioeconomic context would be most stronly associated with risk of myocardial infarction (MI) for smaller “neighborhood” definitions. We used data on 487 non-fatal, incident MI cases and 1,873 controls from a case-control study in Washington State. Census data on income, home ownership, and education were used to estimate socioeconomic context across four neighborhood definitions: one-kilometer buffer, block group, census tract, and ZIP code. No neighborhood definition led to consistently stronger associations with MI. Although we confirmed the association between neighborhood socioeconomic measures and risk of MI, we did not find these associations sensitive to neighborhood definition. PMID:17950024

Evaluation of the WHO clinical case definition of AIDS among children in India.

PubMed

Gurprit, Grover; Tripti, Pensi; Gadpayle, A K; Tanushree, Banerjee

2008-03-01

The need of a clinical case definition (CCD) for Acquired Immunodeficiency Syndrome (AIDS) was felt by public health agencies to monitor diseases resulting from human immunodeficiency virus (HIV) infection. To test the statistical significance of the existing World Health Organization (WHO) CCD for the diagnosis of AIDS in areas where diagnostic resources are limited in India, a prospective study was conducted in the Paediatrics department at Dr. Ram Manohar Lohia Hospital, New Delhi. 360 cases between 18 months-12 years of age satisfying WHO case definitions of AIDS were included in the study group. Informed consent was taken from the parents. The serum of patients was subjected to ELISA to conform the diagnosis of HIV infection. Our study detected 16.66% (60) of HIV prevalence in children visiting paediatrics outpatient clinic. 20% cases manifested 3 major and 2 minor signs. This definition had a sensitivity of 73.33%, specificity of 90.66%, positive predictive value (PPV) of 61.11% and negative predictive value (NPV) of 94.44%. On using stepwise logistic regression analysis weight loss, chronic fever > 1 month and total lymphocyte count of less than 1500 cells/mm3 emerged as important predictors. Cases showing 2 major and 2 minor signs were 86 (23.89%) with a sensitivity and specificity of 86.66% and 88.66% respectively. Based on these findings, we propose a clinical case definition based on 13 clinical signs and symptoms for paediatric AIDS in India with better sensitivity and PPV than the WHO case definition but with almost similar specificity. Thus multicentric studies are further required to modify these criteria in Indian set up.

Evaluation of the Components of the North Carolina Syndromic Surveillance System Heat Syndrome Case Definition.

PubMed

Harduar Morano, Laurel; Waller, Anna E

To improve heat-related illness surveillance, we evaluated and refined North Carolina's heat syndrome case definition. We analyzed North Carolina emergency department (ED) visits during 2012-2014. We evaluated the current heat syndrome case definition (ie, keywords in chief complaint/triage notes or International Classification of Diseases, Ninth Revision, Clinical Modification [ ICD-9-CM] codes) and additional heat-related inclusion and exclusion keywords. We calculated the positive predictive value and sensitivity of keyword-identified ED visits and manually reviewed ED visits to identify true positives and false positives. The current heat syndrome case definition identified 8928 ED visits; additional inclusion keywords identified another 598 ED visits. Of 4006 keyword-identified ED visits, 3216 (80.3%) were captured by 4 phrases: "heat ex" (n = 1674, 41.8%), "overheat" (n = 646, 16.1%), "too hot" (n = 594, 14.8%), and "heatstroke" (n = 302, 7.5%). Among the 267 ED visits identified by keyword only, a burn diagnosis or the following keywords resulted in a false-positive rate >95%: "burn," "grease," "liquid," "oil," "radiator," "antifreeze," "hot tub," "hot spring," and "sauna." After applying the revised inclusion and exclusion criteria, we identified 9132 heat-related ED visits: 2157 by keyword only, 5493 by ICD-9-CM code only, and 1482 by both (sensitivity = 27.0%, positive predictive value = 40.7%). Cases identified by keywords were strongly correlated with cases identified by ICD-9-CM codes (rho = .94, P < .001). Revising the heat syndrome case definition through the use of additional inclusion and exclusion criteria substantially improved the accuracy of the surveillance system. Other jurisdictions may benefit from refining their heat syndrome case definition.

Performance of gout definitions for genetic epidemiological studies: analysis of UK Biobank.

PubMed

Cadzow, Murray; Merriman, Tony R; Dalbeth, Nicola

2017-08-09

Many different combinations of available data have been used to identify gout cases in large genetic studies. The aim of this study was to determine the performance of case definitions of gout using the limited items available in multipurpose cohorts for population-based genetic studies. This research was conducted using the UK Biobank Resource. Data, including genome-wide genotypes, were available for 105,421 European participants aged 40-69 years without kidney disease. Gout definitions and combinations of these definitions were identified from previous epidemiological studies. These definitions were tested for association with 30 urate-associated single-nucleotide polymorphisms (SNPs) by logistic regression, adjusted for age, sex, waist circumference, and ratio of waist circumference to height. Heritability estimates under an additive model were generated using GCTA version 1.26.0 and PLINK version 1.90b3.32 by partitioning the genome. There were 2066 (1.96%) cases defined by self-report of gout, 1652 (1.57%) defined by urate-lowering therapy (ULT) use, 382 (0.36%) defined by hospital diagnosis, 1861 (1.76%) defined by hospital diagnosis or gout-specific medications and 2295 (2.18%) defined by self-report of gout or ULT use. Association with gout at experiment-wide significance (P < 0.0017) was observed for 13 SNPs with gout using the self-report of gout or ULT use definition, 12 SNPs using the self-report of gout definition, 11 SNPs using the hospital diagnosis or gout-specific medication definition, 10 SNPs using ULT use definition and 3 SNPs using hospital diagnosis definition. Heritability estimates ranged from 0.282 to 0.308 for all definitions except hospital diagnosis (0.236). Of the limited items available in multipurpose cohorts, the case definition of self-report of gout or ULT use has high sensitivity and precision for detecting association in genetic epidemiological studies of gout.

Treatment of Osteomyelitis: A Case for Disruption of the Affected Adjacent Periosteum.

PubMed

Hudson, John W; Daly, Austin P; Foster, Michael

2017-10-01

To evaluate the response of mandibular osteomyelitis treated by surgical decortication with disruption of the affected adjacent periosteum in concert with long-term targeted antibiotic therapy. The hypothesis is that, by removing the buccal cortical plate and disrupting the hypertrophically inflamed adjacent periosteum, the medullary bone will be brought in contact with bleeding tissue and circulating immunologic factors and antibiotics, which will promote definitive resolution. A retrospective review was conducted of 7 patient charts with associated radiographs from November 2010 to August 2016 treated by the first author at the University of Tennessee Medical Center (Knoxville, TN). Patients with chronic suppurative or nonsuppurative osteomyelitis of the mandible without condylar involvement or pathologic fracture were selected and treated with decortication with periosteal disruption in combination with long-term targeted antibiotic therapy. Seven patients (3 women and 4 men; mean age, 60 yr) underwent decortication with periosteal disruption of the affected area and received at least 6 weeks of targeted intravenous antibiotics. Computed tomography was performed preoperatively and a repeat study was performed after completion of antibiotics. In each case, post-treatment imaging showed definitive resolution after treatment with decortication in concert with disruption of the inflamed hypertrophic periosteum and intravenous antibiotics. Debridement of the infected cortical bone with restoration of the blood supply through disruption of the adjacent periosteum provided definitive resolution of mandibular osteomyelitis in the 7 patients treated. The hypothesis is that disruption of the affected adjacent periosteum reintroduces an immune-mediated response in concert with improved antibiotic delivery to and penetrance of the diseased mandible, aiding in definitive resolution. Decortication with periosteal disruption allows for preservation of the inferior alveolar nerve, maintains mandibular integrity, and obviates reconstructive surgery. Decortication with disruption of the adjacent periosteum, when combined with targeted antimicrobial therapy, produced definitive resolution of osteomyelitis as shown by postoperative imaging. It is the authors' assertion that not only decortication, but also disruption of the adjacent periosteum in combination with targeted antibiotic therapy should be considered a valid and principal therapeutic option for the surgical treatment of osteomyelitis of the mandible. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

How should an incident case of atopic dermatitis be defined? A systematic review of primary prevention studies

PubMed Central

Simpson, Eric L.; Keck, Laura E.; Chalmers, Joanne R.; Williams, Hywel C.

2012-01-01

Background Eczema prevention is now an active area of dermatologic and allergic research. Defining an incident case is therefore a prerequisite for such as study. Objective We sought to examine how an incident case of atopic dermatitis was defined in previous atopic dermatitis prevention studies in order to make recommendations on a standard definition of new atopic dermatitis cases for use in future prevention trials. Methods We conducted a systematic review of controlled interventional atopic dermatitis prevention studies using searches of Medline and Cochrane databases from 1980 to the end of January 2011. Studies that included atopic dermatitis as a secondary outcome, such as asthma prevention trials, were included. Results One hundred and two (102) studies were included in the final analysis, of which 27 (26.5%) did not describe any criteria for defining an incident case of atopic dermatitis. Of the remaining 75 studies with reported disease criteria, the Hanifin-Rajka criteria were the most commonly used (28 studies). A disease definition unique to that particular study (21 studies) was the second most commonly used disease definition, although the sources for such novel definitions were not cited. Conclusions The results from this systematic review highlight the need for improved reporting and standardization of the definition used for an incident case in atopic dermatitis prevention studies. Most prevention studies have used disease definitions such as the Hanifin-Rajka criteria that include disease chronicity. While acceptable for cumulative incidence outcomes, inclusion of disease chronicity precludes the precise measurement of disease onset. We propose a definition based on existing scientific studies that could be used in future prospective studies. PMID:22424882

Computational pan-genomics: status, promises and challenges.

PubMed

2018-01-01

Many disciplines, from human genetics and oncology to plant breeding, microbiology and virology, commonly face the challenge of analyzing rapidly increasing numbers of genomes. In case of Homo sapiens, the number of sequenced genomes will approach hundreds of thousands in the next few years. Simply scaling up established bioinformatics pipelines will not be sufficient for leveraging the full potential of such rich genomic data sets. Instead, novel, qualitatively different computational methods and paradigms are needed. We will witness the rapid extension of computational pan-genomics, a new sub-area of research in computational biology. In this article, we generalize existing definitions and understand a pan-genome as any collection of genomic sequences to be analyzed jointly or to be used as a reference. We examine already available approaches to construct and use pan-genomes, discuss the potential benefits of future technologies and methodologies and review open challenges from the vantage point of the above-mentioned biological disciplines. As a prominent example for a computational paradigm shift, we particularly highlight the transition from the representation of reference genomes as strings to representations as graphs. We outline how this and other challenges from different application domains translate into common computational problems, point out relevant bioinformatics techniques and identify open problems in computer science. With this review, we aim to increase awareness that a joint approach to computational pan-genomics can help address many of the problems currently faced in various domains. © The Author 2016. Published by Oxford University Press.

Development of a validated clinical case definition of generalized tonic-clonic seizures for use by community-based health care providers.

PubMed

Anand, Krishnan; Jain, Satish; Paul, Eldho; Srivastava, Achal; Sahariah, Sirazul A; Kapoor, Suresh K

2005-05-01

To develop and test a clinical case definition for identification of generalized tonic-clonic seizures (GTCSs) by community-based health care providers. To identify symptoms that can help identify GTCSs, patients with history of a jerky movements or rigidity in any part of the body ever in life were recruited from three sites: the community, secondary care hospital, and tertiary care hospital. These patients were administered a 14-item structured interview schedule focusing on the circumstances surrounding the seizure. Subsequently, a neurologist examined each patient and, based on available investigations, classified them as GTCS or non-GTCS cases. A logistic regression analysis was performed to select symptoms that were to be used for case definition of GTCSs. Validity parameters for the case definition at different cutoff points were calculated in another set of subjects. In total, 339 patients were enrolled in the first phase of the study. The tertiary care hospital contributed the maximal number of GTCS cases, whereas cases of non-GTCS were mainly from the community. At the end of phase I, the questionnaire was shortened from 14 to eight questions based on statistical association and clinical judgment. After phase II, which was conducted among 170 subjects, three variables were found to be significantly related to the presence of GTCSs by logistic regression: absence of stress (13.1; 4.1-41.3), presence of frothing (13.7; 4.0-47.3), and occurrence in sleep (8.3; 2.0-34.9). As a case definition using only three variables did not provide sufficient specificity, three more variables were added based on univariate analysis of the data (incontinence during the episode and unconsciousness) and review of literature (injury during episode). A case definition consisting of giving one point to an affirmative answer for each of the six questions was tested. At a cutoff point of four, sensitivity was 56.9 (47.4-66.0) and specificity, 96.3 (86.2-99.4). Among the 197 GTCS and 26 new non-GTCS patients recruited from hospitals from select SEAR Member Countries, in phase III, the sensitivity of this clinical case definition was 72% and specificity, 100%. A stratified analysis by gender in all the three phases did not show any differences between the sexes. Based on these criteria, we recommend that all patients with a history of two or more episodes of jerking or rigidity of limbs, having a score of > or =4 in the case definition, be identified as having GTCSs and started on antiepileptic medications. This clinical case definition can be very useful for community-based health care providers to identify and manage cases of GTCSs in the community. This should play a major role in the reduction of treatment gap for epilepsy in developing countries.

26 CFR 1.50B-1 - Definitions of WIN expenses and WIN employees.

Code of Federal Regulations, 2010 CFR

2010-04-01

... employee. (c) Trade or business expenses. The term “WIN expenses” includes only salaries and wages which... 26 Internal Revenue 1 2010-04-01 2010-04-01 true Definitions of WIN expenses and WIN employees. 1... INCOME TAXES Rules for Computing Credit for Expenses of Work Incentive Programs § 1.50B-1 Definitions of...

Testing Pneumonia Vaccines in the Elderly: Determining a Case Definition for Pneumococcal Pneumonia in the Absence of a Gold Standard.

PubMed

Jokinen, Jukka; Snellman, Marja; Palmu, Arto A; Saukkoriipi, Annika; Verlant, Vincent; Pascal, Thierry; Devaster, Jeanne-Marie; Hausdorff, William P; Kilpi, Terhi M

2018-06-01

Clinical assessments of vaccines to prevent pneumococcal community-acquired pneumonia (CAP) require sensitive and specific case definitions, but there is no gold standard diagnostic test. To develop a new case definition suitable for vaccine efficacy studies, we applied latent class analysis (LCA) to the results from 7 diagnostic tests for pneumococcal etiology on clinical specimens from 323 elderly persons with radiologically confirmed pneumonia enrolled in the Finnish Community-Acquired Pneumonia Epidemiology study during 2005-2007. Compared with the conventional use of LCA, which is mainly to determine sensitivities and specificities of different tests, we instead used LCA as an appropriate instrument to predict the probability of pneumococcal etiology for each CAP case based on individual test profiles, and we used the predictions to minimize the sample size that would be needed for a vaccine efficacy trial. When compared with the conventional laboratory criteria of encapsulated pneumococci in culture, in blood culture or high-quality sputum culture, or urine antigen positivity, our optimized case definition for pneumococcal CAP resulted in a trial sample size that was almost 20,000 subjects smaller. We believe that the novel application of LCA detailed here to determine a case definition for pneumococcal CAP could also be similarly applied to other diseases without a gold standard.

A Comparative Assessment of Computer Literacy of Private and Public Secondary School Students in Lagos State, Nigeria

ERIC Educational Resources Information Center

Osunwusi, Adeyinka Olumuyiwa; Abifarin, Michael Segun

2013-01-01

The aim of this study was to conduct a comparative assessment of computer literacy of private and public secondary school students. Although the definition of computer literacy varies widely, this study treated computer literacy in terms of access to, and use of, computers and the internet, basic knowledge and skills required to use computers and…

37 CFR 41.100 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Definitions. 41.100 Section... COMMERCE PRACTICE BEFORE THE BOARD OF PATENT APPEALS AND INTERFERENCES Contested Cases § 41.100 Definitions. In addition to the definitions in § 41.2, the following definitions apply to proceedings under this...

Implications of a quadratic stream definition in radiative transfer theory.

NASA Technical Reports Server (NTRS)

Whitney, C.

1972-01-01

An explicit definition of the radiation-stream concept is stated and applied to approximate the integro-differential equation of radiative transfer with a set of twelve coupled differential equations. Computational efficiency is enhanced by distributing the corresponding streams in three-dimensional space in a totally symmetric way. Polarization is then incorporated in this model. A computer program based on the model is briefly compared with a Monte Carlo program for simulation of horizon scans of the earth's atmosphere. It is found to be considerably faster.

Modern Approaches to the Computation of the Probability of Target Detection in Cluttered Environments

NASA Astrophysics Data System (ADS)

Meitzler, Thomas J.

The field of computer vision interacts with fields such as psychology, vision research, machine vision, psychophysics, mathematics, physics, and computer science. The focus of this thesis is new algorithms and methods for the computation of the probability of detection (Pd) of a target in a cluttered scene. The scene can be either a natural visual scene such as one sees with the naked eye (visual), or, a scene displayed on a monitor with the help of infrared sensors. The relative clutter and the temperature difference between the target and background (DeltaT) are defined and then used to calculate a relative signal -to-clutter ratio (SCR) from which the Pd is calculated for a target in a cluttered scene. It is shown how this definition can include many previous definitions of clutter and (DeltaT). Next, fuzzy and neural -fuzzy techniques are used to calculate the Pd and it is shown how these methods can give results that have a good correlation with experiment. The experimental design for actually measuring the Pd of a target by observers is described. Finally, wavelets are applied to the calculation of clutter and it is shown how this new definition of clutter based on wavelets can be used to compute the Pd of a target.

Computational Modeling to Predict Fatigue Behavior of NiTi Stents: What Do We Need?

PubMed Central

Dordoni, Elena; Petrini, Lorenza; Wu, Wei; Migliavacca, Francesco; Dubini, Gabriele; Pennati, Giancarlo

2015-01-01

NiTi (nickel-titanium) stents are nowadays commonly used for the percutaneous treatment of peripheral arterial disease. However, their effectiveness is still debated in the clinical field. In fact a peculiar cyclic biomechanical environment is created before and after stent implantation, with the risk of device fatigue failure. An accurate study of the device fatigue behavior is of primary importance to ensure a successful stenting procedure. Regulatory authorities recognize the possibility of performing computational analyses instead of experimental tests for the assessment of medical devices. However, confidence in numerical methods is only possible after verification and validation of the models used. For the case of NiTi stents, mechanical properties are strongly dependent on the device dimensions and the whole treatments undergone during manufacturing process. Hence, special attention should be paid to the accuracy of the description of the device geometry and the material properties implementation into the numerical code, as well as to the definition of the fatigue limit. In this paper, a path for setting up an effective numerical model for NiTi stent fatigue assessment is proposed and the results of its application in a specific case study are illustrated. PMID:26011245

APPROXIMATING SYMMETRIC POSITIVE SEMIDEFINITE TENSORS OF EVEN ORDER*

PubMed Central

BARMPOUTIS, ANGELOS; JEFFREY, HO; VEMURI, BABA C.

2012-01-01

Tensors of various orders can be used for modeling physical quantities such as strain and diffusion as well as curvature and other quantities of geometric origin. Depending on the physical properties of the modeled quantity, the estimated tensors are often required to satisfy the positivity constraint, which can be satisfied only with tensors of even order. Although the space P02m of 2mth-order symmetric positive semi-definite tensors is known to be a convex cone, enforcing positivity constraint directly on P02m is usually not straightforward computationally because there is no known analytic description of P02m for m > 1. In this paper, we propose a novel approach for enforcing the positivity constraint on even-order tensors by approximating the cone P02m for the cases 0 < m < 3, and presenting an explicit characterization of the approximation Σ2m ⊂ Ω2m for m ≥ 1, using the subset Ω2m⊂P02m of semi-definite tensors that can be written as a sum of squares of tensors of order m. Furthermore, we show that this approximation leads to a non-negative linear least-squares (NNLS) optimization problem with the complexity that equals the number of generators in Σ2m. Finally, we experimentally validate the proposed approach and we present an application for computing 2mth-order diffusion tensors from Diffusion Weighted Magnetic Resonance Images. PMID:23285313

Non-localization and localization ROC analyses using clinically based scoring

NASA Astrophysics Data System (ADS)

Paquerault, Sophie; Samuelson, Frank W.; Myers, Kyle J.; Smith, Robert C.

2009-02-01

We are investigating the potential for differences in study conclusions when assessing the estimated impact of a computer-aided detection (CAD) system on readers' performance. The data utilized in this investigation were derived from a multi-reader multi-case observer study involving one hundred mammographic background images to which fixed-size and fixed-intensity Gaussian signals were added, generating a low- and high-intensity signal sets. The study setting allowed CAD assessment in two situations: when CAD sensitivity was 1) superior or 2) lower than the average reader. Seven readers were asked to review each set in the unaided and CAD-aided reading modes, mark and rate their findings. Using this data, we studied the effect on study conclusion of three clinically-based receiver operating characteristic (ROC) scoring definitions. These scoring definitions included both location-specific and non-location-specific rules. The results showed agreement in the estimated impact of CAD on the overall reader performance. In the study setting where CAD sensitivity is superior to the average reader, the mean difference in AUC between the CAD-aided read and unaided read was 0.049 (95%CIs: -0.027; 0.130) for the image scoring definition that is based on non-location-specific rules, and 0.104 (95%CIs: 0.036; 0.174) and 0.090 (95%CIs: 0.031; 0.155) for image scoring definitions that are based on location-specific rules. The increases in AUC were statistically significant for the location-specific scoring definitions. It was further observed that the variance on these estimates was reduced when using the location-specific scoring definitions compared to that using a non-location-specific scoring definition. In the study setting where CAD sensitivity is equivalent or lower than the average reader, the mean differences in AUC are slightly above 0.01 for all image scoring definitions. These increases in AUC were not statistical significant for any of the image scoring definitions. The results on the variance analysis differed from those observed in the other study setting. This investigation furthers our understanding of the relationships between non-localization-specific and localization-specific ROC assessment methodologies and their relevance to clinical practice.

On the Equivalence of Formal Grammars and Machines.

ERIC Educational Resources Information Center

Lund, Bruce

1991-01-01

Explores concepts of formal language and automata theory underlying computational linguistics. A computational formalism is described known as a "logic grammar," with which computational systems process linguistic data, with examples in declarative and procedural semantics and definite clause grammars. (13 references) (CB)

Workshop on Aircraft Surface Representation for Aerodynamic Computation

NASA Technical Reports Server (NTRS)

Gregory, T. J. (Editor); Ashbaugh, J. (Editor)

1980-01-01

Papers and discussions on surface representation and its integration with aerodynamics, computers, graphics, wind tunnel model fabrication, and flow field grid generation are presented. Surface definition is emphasized.

36 CFR 79.4 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... or use of man-made or natural materials (such as slag, dumps, cores and debitage); (v) Organic..., laboratory reports, computer cards and tapes, computer disks and diskettes, printouts of computerized data...

36 CFR 79.4 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... or use of man-made or natural materials (such as slag, dumps, cores and debitage); (v) Organic..., laboratory reports, computer cards and tapes, computer disks and diskettes, printouts of computerized data...

36 CFR 79.4 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... or use of man-made or natural materials (such as slag, dumps, cores and debitage); (v) Organic..., laboratory reports, computer cards and tapes, computer disks and diskettes, printouts of computerized data...

36 CFR 79.4 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... or use of man-made or natural materials (such as slag, dumps, cores and debitage); (v) Organic..., laboratory reports, computer cards and tapes, computer disks and diskettes, printouts of computerized data...

36 CFR 79.4 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... or use of man-made or natural materials (such as slag, dumps, cores and debitage); (v) Organic..., laboratory reports, computer cards and tapes, computer disks and diskettes, printouts of computerized data...

Baseline Skills Assessment of the US Army Research Laboratory

DTIC Science & Technology

2015-01-01

level definitions Level Definition 1 Basic understanding, minimal experience 2 More specific understanding, some level of application 3 Expertise...polymers 1 Energy absorbers 2 Computational material modeling 1 Powder metallurgy 1 Tribology 1 Non-destructive inspection 1 Advanced

Validation of two case definitions to identify pressure ulcers using hospital administrative data

PubMed Central

Ho, Chester; Jiang, Jason; Eastwood, Cathy A; Wong, Holly; Weaver, Brittany; Quan, Hude

2017-01-01

Objective Pressure ulcer development is a quality of care indicator, as pressure ulcers are potentially preventable. Yet pressure ulcer is a leading cause of morbidity, discomfort and additional healthcare costs for inpatients. Methods are lacking for accurate surveillance of pressure ulcer in hospitals to track occurrences and evaluate care improvement strategies. The main study aim was to validate hospital discharge abstract database (DAD) in recording pressure ulcers against nursing consult reports, and to calculate prevalence of pressure ulcers in Alberta, Canada in DAD. We hypothesised that a more inclusive case definition for pressure ulcers would enhance validity of cases identified in administrative data for research and quality improvement purposes. Setting A cohort of patients with pressure ulcers were identified from enterostomal (ET) nursing consult documents at a large university hospital in 2011. Participants There were 1217 patients with pressure ulcers in ET nursing documentation that were linked to a corresponding record in DAD to validate DAD for correct and accurate identification of pressure ulcer occurrence, using two case definitions for pressure ulcer. Results Using pressure ulcer definition 1 (7 codes), prevalence was 1.4%, and using definition 2 (29 codes), prevalence was 4.2% after adjusting for misclassifications. The results were lower than expected. Definition 1 sensitivity was 27.7% and specificity was 98.8%, while definition 2 sensitivity was 32.8% and specificity was 95.9%. Pressure ulcer in both DAD and ET consultation increased with age, number of comorbidities and length of stay. Conclusion DAD underestimate pressure ulcer prevalence. Since various codes are used to record pressure ulcers in DAD, the case definition with more codes captures more pressure ulcer cases, and may be useful for monitoring facility trends. However, low sensitivity suggests that this data source may not be accurate for determining overall prevalence, and should be cautiously compared with other prevalence studies. PMID:28851785

CDM: Teaching Discrete Mathematics to Computer Science Majors

ERIC Educational Resources Information Center

Sutner, Klaus

2005-01-01

CDM, for computational discrete mathematics, is a course that attempts to teach a number of topics in discrete mathematics to computer science majors. The course abandons the classical definition-theorem-proof model, and instead relies heavily on computation as a source of motivation and also for experimentation and illustration. The emphasis on…

The Basics of Cloud Computing

ERIC Educational Resources Information Center

Kaestner, Rich

2012-01-01

Most school business officials have heard the term "cloud computing" bandied about and may have some idea of what the term means. In fact, they likely already leverage a cloud-computing solution somewhere within their district. But what does cloud computing really mean? This brief article puts a bit of definition behind the term and helps one…

48 CFR 252.227-7019 - Validation of asserted restrictions-Computer software.

Code of Federal Regulations, 2010 CFR

2010-10-01

... restrictions-Computer software. 252.227-7019 Section 252.227-7019 Federal Acquisition Regulations System...—Computer software. As prescribed in 227.7104(e)(3) or 227.7203-6(c), use the following clause: Validation of Asserted Restrictions—Computer Software (JUN 1995) (a) Definitions. (1) As used in this clause...

48 CFR 252.227-7019 - Validation of asserted restrictions-Computer software.

Code of Federal Regulations, 2011 CFR

2011-10-01

... restrictions-Computer software. 252.227-7019 Section 252.227-7019 Federal Acquisition Regulations System...—Computer software. As prescribed in 227.7104(e)(3) or 227.7203-6(c), use the following clause: Validation of Asserted Restrictions—Computer Software (SEP 2011) (a) Definitions. (1) As used in this clause...

48 CFR 252.227-7019 - Validation of asserted restrictions-Computer software.

Code of Federal Regulations, 2012 CFR

2012-10-01

... restrictions-Computer software. 252.227-7019 Section 252.227-7019 Federal Acquisition Regulations System...—Computer software. As prescribed in 227.7104(e)(3) or 227.7203-6(c), use the following clause: Validation of Asserted Restrictions—Computer Software (SEP 2011) (a) Definitions. (1) As used in this clause...

48 CFR 252.227-7019 - Validation of asserted restrictions-Computer software.

Code of Federal Regulations, 2014 CFR

2014-10-01

... restrictions-Computer software. 252.227-7019 Section 252.227-7019 Federal Acquisition Regulations System...—Computer software. As prescribed in 227.7104(e)(3) or 227.7203-6(c), use the following clause: Validation of Asserted Restrictions—Computer Software (SEP 2011) (a) Definitions. (1) As used in this clause...

48 CFR 252.227-7019 - Validation of asserted restrictions-Computer software.

Code of Federal Regulations, 2013 CFR

2013-10-01

... restrictions-Computer software. 252.227-7019 Section 252.227-7019 Federal Acquisition Regulations System...—Computer software. As prescribed in 227.7104(e)(3) or 227.7203-6(c), use the following clause: Validation of Asserted Restrictions—Computer Software (SEP 2011) (a) Definitions. (1) As used in this clause...

48 CFR 52.223-16 - IEEE 1680 Standard for the Environmental Assessment of Personal Computer Products.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Environmental Assessment of Personal Computer Products. 52.223-16 Section 52.223-16 Federal Acquisition... Assessment of Personal Computer Products. As prescribed in 23.705(b)(1), insert the following clause: IEEE 1680 Standard for the Environmental Assessment of Personal Computer Products (DEC 2007) (a) Definitions...

48 CFR 52.223-16 - IEEE 1680 Standard for the Environmental Assessment of Personal Computer Products.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Environmental Assessment of Personal Computer Products. 52.223-16 Section 52.223-16 Federal Acquisition... Assessment of Personal Computer Products. As prescribed in 23.705(b)(1), insert the following clause: IEEE 1680 Standard for the Environmental Assessment of Personal Computer Products (DEC 2007) (a) Definitions...

48 CFR 52.223-16 - IEEE 1680 Standard for the Environmental Assessment of Personal Computer Products.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Environmental Assessment of Personal Computer Products. 52.223-16 Section 52.223-16 Federal Acquisition... Assessment of Personal Computer Products. As prescribed in 23.705(b)(1), insert the following clause: IEEE 1680 Standard for the Environmental Assessment of Personal Computer Products (DEC 2007) (a) Definitions...

48 CFR 52.223-16 - IEEE 1680 Standard for the Environmental Assessment of Personal Computer Products.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Environmental Assessment of Personal Computer Products. 52.223-16 Section 52.223-16 Federal Acquisition... Assessment of Personal Computer Products. As prescribed in 23.706(b)(1), insert the following clause: IEEE 1680 Standard for the Environmental Assessment of Personal Computer Products (DEC 2007) (a) Definitions...

Verification methodology for fault-tolerant, fail-safe computers applied to maglev control computer systems. Final report, July 1991-May 1993

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

Lala, J.H.; Nagle, G.A.; Harper, R.E.

1993-05-01

The Maglev control computer system should be designed to verifiably possess high reliability and safety as well as high availability to make Maglev a dependable and attractive transportation alternative to the public. A Maglev control computer system has been designed using a design-for-validation methodology developed earlier under NASA and SDIO sponsorship for real-time aerospace applications. The present study starts by defining the maglev mission scenario and ends with the definition of a maglev control computer architecture. Key intermediate steps included definitions of functional and dependability requirements, synthesis of two candidate architectures, development of qualitative and quantitative evaluation criteria, and analyticalmore » modeling of the dependability characteristics of the two architectures. Finally, the applicability of the design-for-validation methodology was also illustrated by applying it to the German Transrapid TR07 maglev control system.« less

Five-Level Posterior Total En Bloc Spondylectomy of Severe Myelomeningocele Kyphosis.

PubMed

Ganjeifar, Babak; Zabihyan, Samira; Baharvahdat, Humain; Baradaran, Aslan

2016-06-01

In this case report we discuss a case of thoracolumbar kyphectomy associated with myelomeningocoele. To our knowledge, no such total spondylectomy and fascinating alignment, with no skin defect on the outcome, has been reported in the literature. A 15-year-old paraplegic girl, suffering from severe kyphosis, was not able to sit in a wheelchair. Her lumbar myelomeningocele was repaired perinatally. Surgery reduced the 137-degree angle deformity to a 30-degree kyphosis. At 12-month follow-up, the fusion consolidated as shown on the computed tomography scans and the instruments were good position with a 5-degree correction loss. In most cases of kyphosis, anterior wedging occurs in the vertebral body where the apex of the deformity is located. In our patient kyphosis had a round curve with no definite apex that could be marked out. These deformities demand special attention regarding the surgical techniques and postoperative course. Copyright © 2016 Elsevier Inc. All rights reserved.

Supercritical wing sections 2, volume 108

NASA Technical Reports Server (NTRS)

Bauer, F.; Garabedian, P.; Korn, D.; Jameson, A.; Beckmann, M. (Editor); Kuenzi, H. P. (Editor)

1975-01-01

A mathematical theory for the design and analysis of supercritical wing sections was previously presented. Examples and computer programs showing how this method works were included. The work on transonics is presented in a more definitive form. For design, a better model of the trailing edge is introduced which should eliminate a loss of fifteen or twenty percent in lift experienced with previous heavily aft loaded models, which is attributed to boundary layer separation. How drag creep can be reduced at off-design conditions is indicated. A rotated finite difference scheme is presented that enables the application of Murman's method of analysis in more or less arbitrary curvilinear coordinate systems. This allows the use of supersonic as well as subsonic free stream Mach numbers and to capture shock waves as far back on an airfoil as desired. Moreover, it leads to an effective three dimensional program for the computation of transonic flow past an oblique wing. In the case of two dimensional flow, the method is extended to take into account the displacement thickness computed by a semi-empirical turbulent boundary layer correction.

Development of innovative computer software to facilitate the setup and computation of water quality index

PubMed Central

2013-01-01

Background Developing a water quality index which is used to convert the water quality dataset into a single number is the most important task of most water quality monitoring programmes. As the water quality index setup is based on different local obstacles, it is not feasible to introduce a definite water quality index to reveal the water quality level. Findings In this study, an innovative software application, the Iranian Water Quality Index Software (IWQIS), is presented in order to facilitate calculation of a water quality index based on dynamic weight factors, which will help users to compute the water quality index in cases where some parameters are missing from the datasets. Conclusion A dataset containing 735 water samples of drinking water quality in different parts of the country was used to show the performance of this software using different criteria parameters. The software proved to be an efficient tool to facilitate the setup of water quality indices based on flexible use of variables and water quality databases. PMID:24499556

Computer Model Used to Help Customize Medicine

NASA Technical Reports Server (NTRS)

Stauber, Laurel J.; Veris, Jenise

2001-01-01

Dr. Radhakrishnan, a researcher at the NASA Glenn Research Center, in collaboration with biomedical researchers at the Case Western Reserve University School of Medicine and Rainbow Babies and Children's Hospital, is developing computational models of human physiology that quantitate metabolism and its regulation, in both healthy and pathological states. These models can help predict the effects of stresses or interventions, such as drug therapies, and contribute to the development of customized medicine. Customized medical treatment protocols can give more comprehensive evaluations and lead to more specific and effective treatments for patients, reducing treatment time and cost. Commercial applications of this research may help the pharmaceutical industry identify therapeutic needs and predict drug-drug interactions. Researchers will be able to study human metabolic reactions to particular treatments while in different environments as well as establish more definite blood metabolite concentration ranges in normal and pathological states. These computational models may help NASA provide the background for developing strategies to monitor and safeguard the health of astronauts and civilians in space stations and colonies. They may also help to develop countermeasures that ameliorate the effects of both acute and chronic space exposure.

Thermal modeling of lesion growth with radiofrequency ablation devices

PubMed Central

Chang, Isaac A; Nguyen, Uyen D

2004-01-01

Background Temperature is a frequently used parameter to describe the predicted size of lesions computed by computational models. In many cases, however, temperature correlates poorly with lesion size. Although many studies have been conducted to characterize the relationship between time-temperature exposure of tissue heating to cell damage, to date these relationships have not been employed in a finite element model. Methods We present an axisymmetric two-dimensional finite element model that calculates cell damage in tissues and compare lesion sizes using common tissue damage and iso-temperature contour definitions. The model accounts for both temperature-dependent changes in the electrical conductivity of tissue as well as tissue damage-dependent changes in local tissue perfusion. The data is validated using excised porcine liver tissues. Results The data demonstrate the size of thermal lesions is grossly overestimated when calculated using traditional temperature isocontours of 42°C and 47°C. The computational model results predicted lesion dimensions that were within 5% of the experimental measurements. Conclusion When modeling radiofrequency ablation problems, temperature isotherms may not be representative of actual tissue damage patterns. PMID:15298708

Enhancing case definitions for surveillance of human monkeypox in the Democratic Republic of Congo.

PubMed

Osadebe, Lynda; Hughes, Christine M; Shongo Lushima, Robert; Kabamba, Joelle; Nguete, Beatrice; Malekani, Jean; Pukuta, Elisabeth; Karhemere, Stomy; Muyembe Tamfum, Jean-Jacques; Wemakoy Okitolonda, Emile; Reynolds, Mary G; McCollum, Andrea M

2017-09-01

Human monkeypox (MPX) occurs at appreciable rates in the Democratic Republic of Congo (DRC). Infection with varicella zoster virus (VZV) has a similar presentation to that of MPX, and in areas where MPX is endemic these two illnesses are commonly mistaken. This study evaluated the diagnostic utility of two surveillance case definitions for MPX and specific clinical characteristics associated with laboratory-confirmed MPX cases. Data from a cohort of suspect MPX cases (identified by surveillance over the course of a 42 month period during 2009-2014) from DRC were used; real-time PCR diagnostic test results were used to establish MPX and VZV diagnoses. A total of 333 laboratory-confirmed MPX cases, 383 laboratory-confirmed VZV cases, and 36 cases that were determined to not be either MPX or VZV were included in the analyses. Significant (p<0.05) differences between laboratory-confirmed MPX and VZV cases were noted for several signs/symptoms including key rash characteristics. Both surveillance case definitions had high sensitivity and low specificities for individuals that had suspected MPX virus infections. Using 12 signs/symptoms with high sensitivity and/or specificity values, a receiver operator characteristic analysis showed that models for MPX cases that had the presence of 'fever before rash' plus at least 7 or 8 of the 12 signs/symptoms demonstrated a more balanced performance between sensitivity and specificity. Laboratory-confirmed MPX and VZV cases presented with many of the same signs and symptoms, and the analysis here emphasized the utility of including 12 specific signs/symptoms when investigating MPX cases. In order to document and detect endemic human MPX cases, a surveillance case definition with more specificity is needed for accurate case detection. In the absence of a more specific case definition, continued emphasis on confirmatory laboratory-based diagnostics is warranted.

Computer system for definition of the quantitative geometry of musculature from CT images.

PubMed

Daniel, Matej; Iglic, Ales; Kralj-Iglic, Veronika; Konvicková, Svatava

2005-02-01

The computer system for quantitative determination of musculoskeletal geometry from computer tomography (CT) images has been developed. The computer system processes series of CT images to obtain three-dimensional (3D) model of bony structures where the effective muscle fibres can be interactively defined. Presented computer system has flexible modular structure and is suitable also for educational purposes.

Correlation between preoperative tomographic staging and definitive histopathologic results in gastric cancer at the Hospital Central Militar.

PubMed

López-Ramírez, M A; Lever-Rosas, C D; Motta-Ramírez, G A; Rebollo-Hurtado, V; Guzmán-Bárcenas, J; Fonseca-Morales, J V; Carreño-Lomeli, M A

In relation to the number of new cases diagnosed, gastric cancer is the fourth most common cancer worldwide, and the second cause of cancer death. The development of multidetector tomography has improved the preoperative staging of gastric cancer. To correlate preoperative tomographic studies with the definitive pathologic results according to the TNM staging system. A retrospective, cross-sectional study within the time frame of January 2009 to December 2013 was conducted that included the case records of 67 patients. They all had upper endoscopy and preoperative multidetector tomography examinations, underwent surgical resection, and had the corresponding histopathology study. Statistical analysis was carried out with the SPSS version 15.0 software and the sensitivity and specificity calculations were made using the Excel 2011 program for Mac. The majority of the patients included in the case series had clinical stage iii and iv disease. When compared with the histopathologic result, the overall accuracy of multidetector CT was 83% (T0 96%, T1 94%, T2 93%, T3 67%, and T4 67%) for tumor size (T) and was 70% (N0 72%, N1 73%, N2 70%, and N3 66%) for lymph node involvement (N). Overall sensitivity was 48% (T0 100%, T1 0%, T2 33%, T3 44%, and T4 65%) for T and was 41% (N0 58%, N1 56%, N2 15%, and N3 35%) for N. A strong association between the multidetector CT results and the pathology results was demonstrated through the Spearman's correlation, especially in T4 and N3. Multidetector computed tomography showed greater congruency in detecting stages T4, N0, and N3 in gastric cancer, when compared with the definitive histopathologic results. Copyright © 2017 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.

Muscular Dystrophy Surveillance Tracking and Research Network (MD STARnet): case definition in surveillance for childhood-onset Duchenne/Becker muscular dystrophy.

PubMed

Mathews, Katherine D; Cunniff, Chris; Kantamneni, Jiji R; Ciafaloni, Emma; Miller, Timothy; Matthews, Dennis; Cwik, Valerie; Druschel, Charlotte; Miller, Lisa; Meaney, F John; Sladky, John; Romitti, Paul A

2010-09-01

The Muscular Dystrophy Surveillance Tracking and Research Network (MD STARnet) is a multisite collaboration to determine the prevalence of childhood-onset Duchenne/Becker muscular dystrophy and to characterize health care and health outcomes in this population. MD STARnet uses medical record abstraction to identify patients with Duchenne/Becker muscular dystrophy born January 1, 1982 or later who resided in 1 of the participating sites. Critical diagnostic elements of each abstracted record are reviewed independently by >4 clinicians and assigned to 1 of 6 case definition categories (definite, probable, possible, asymptomatic, female, not Duchenne/Becker muscular dystrophy) by consensus. As of November 2009, 815 potential cases were reviewed. Of the cases included in analysis, 674 (82%) were either ''definite'' or ''probable'' Duchenne/Becker muscular dystrophy. These data reflect a change in diagnostic testing, as case assignment based on genetic testing increased from 67% in the oldest cohort (born 1982-1987) to 94% in the cohort born 2004 to 2009.

Balamuthia mandrillaris meningoencephalitis: the first case in southeast Asia.

PubMed

Intalapaporn, Poj; Suankratay, Chusana; Shuangshoti, Shanop; Phantumchinda, Kammant; Keelawat, Somboon; Wilde, Henry

2004-06-01

We present a case of 23-year-old man with acute meningoencephalitis, accompanied by inflammation of a nasal ulcer. He had been healthy until six months prior to admission to the hospital when he had a motorcycle accident. A star-shaped wound at his nose was incurred after falling into a swamp. A computed tomogram of the brain showed two nonenhancing hypodense lesions at the left caudate nucleus and the right parietal lobe, ependymitis and leptomeningeal enhancement. A skin biopsy showed chronic noncaseous granulomatous inflammation without demonstrated microorganisms. The patient did not respond to the empirical treatment with cloxacillin, ceftriaxone, and amphotericin B, and eventually died on the thirteenth day of hospitalization. At autopsy, hematoxylin and eosin-stained brain sections showed a chronic necrotizing inflammation with numerous amebic trophozoites and rare cysts. Definitive identification of Balamuthia mandrillaris was made by fluorescent immunohistochemical analysis. There were 10 Naegleria fowleri primary amebic meningoencephalitis, eight Acanthamoeba granulomatous amebic encephalitis, and three Acanthamoeba meningitis in Thailand. To our knowledge, this case is the first reported case of B. mandrillaris in Southeast Asia.

Rare case of tibial hemimelia, preaxial polydactyly, and club foot

PubMed Central

Granite, Guinevere; Herzenberg, John E; Wade, Ronald

2016-01-01

A seven-month old female presented with left tibial hemimelia (or congenital tibial aplasia; Weber type VIIb, Jones et al type 1a), seven-toed preaxial polydactyly, and severe club foot (congenital talipes equinovarus). Definitive amputation surgery disarticulated the lower limb at the knee. This case report describes the anatomical findings of a systematic post-amputation examination of the lower limb’s superficial dissection, X-rays, and computed tomography (CT) scans. From the X-rays and CT scans, we found curved and overlapping preaxial supernumerary toes, hypoplastic first metatarsal, lack of middle and distal phalanges in one supernumerary toe, three tarsal bones, hypoplastic middle phalanx and no distal phalanx for fourth toe, and no middle or distal phalanges for fifth toe. The fibula articulated with the anteromedial calcaneus and the tibia was completely absent. We identified numerous muscles and nerves in the superficial dissection that are described in the results section of the case report. Due to the rarity of this combination of anatomical findings, descriptions of such cases are very infrequent in the literature. PMID:28035313

Rare case of tibial hemimelia, preaxial polydactyly, and club foot.

PubMed

Granite, Guinevere; Herzenberg, John E; Wade, Ronald

2016-12-16

A seven-month old female presented with left tibial hemimelia (or congenital tibial aplasia; Weber type VIIb, Jones et al type 1a), seven-toed preaxial polydactyly, and severe club foot (congenital talipes equinovarus). Definitive amputation surgery disarticulated the lower limb at the knee. This case report describes the anatomical findings of a systematic post-amputation examination of the lower limb's superficial dissection, X-rays, and computed tomography (CT) scans. From the X-rays and CT scans, we found curved and overlapping preaxial supernumerary toes, hypoplastic first metatarsal, lack of middle and distal phalanges in one supernumerary toe, three tarsal bones, hypoplastic middle phalanx and no distal phalanx for fourth toe, and no middle or distal phalanges for fifth toe. The fibula articulated with the anteromedial calcaneus and the tibia was completely absent. We identified numerous muscles and nerves in the superficial dissection that are described in the results section of the case report. Due to the rarity of this combination of anatomical findings, descriptions of such cases are very infrequent in the literature.

Standardized classification unsuitable for spontaneous reporting: the example of osteonecrosis of the jaw.

PubMed

de Boissieu, Paul; Trenque, Thierry

2015-07-01

This study assessed the impact of using a standardized definition of bisphosphonate-related osteonecrosis of the jaw (BRONJ) in the analysis of a spontaneous reporting database. All notifications of osteonecrosis of the jaw (ONJ) in the French National Pharmacovigilance Database as of 31 December 2013 were analyzed. First, we considered all reports of ONJ with bisphosphonates as BRONJ. Second, we applied the 2014 definition of BRONJ from the American Association of Oral and Maxillofacial Surgeons (AAOMS), retaining only bisphosphonates as antiresorptive medication. In the absence of any one of these criteria, or missing data, cases were not considered as BRONJ. The first analysis found 158 cases of ONJ, among which 153 were associated with bisphosphonate use. The second analysis identified only 43 cases of BRONJ (28.1%). The definition of BRONJ as laid down by the AAOMS is not suitable for use in spontaneous reporting database. The use of the AAOMS definition alone should be avoided, as it leads to the exclusion of over 70% of cases. When cases of ONJ are identified, all results should be presented including confirmed and excluded cases.

Network-Physics (NP) BEC DIGITAL(#)-VULNERABILITY; ``Q-Computing"=Simple-Arithmetic;Modular-Congruences=SignalXNoise PRODUCTS=Clock-model;BEC-Factorization;RANDOM-# Definition;P=/=NP TRIVIAL Proof!!!

NASA Astrophysics Data System (ADS)

Pi, E. I.; Siegel, E.

2010-03-01

Siegel[AMS Natl.Mtg.(2002)-Abs.973-60-124] digits logarithmic- law inversion to ONLY BEQS BEC:Quanta/Bosons=#: EMP-like SEVERE VULNERABILITY of ONLY #-networks(VS.ANALOG INvulnerability) via Barabasi NP(VS.dynamics[Not.AMS(5/2009)] critique);(so called)``quantum-computing''(QC) = simple-arithmetic (sansdivision);algorithmiccomplexities:INtractibility/UNdecidabi lity/INefficiency/NONcomputability/HARDNESS(so MIScalled) ``noise''-induced-phase-transition(NIT)ACCELERATION:Cook-Levin theorem Reducibility = RG fixed-points; #-Randomness DEFINITION via WHAT? Query(VS. Goldreich[Not.AMS(2002)] How? mea culpa)= ONLY MBCS hot-plasma v #-clumping NON-random BEC; Modular-Arithmetic Congruences = Signal x Noise PRODUCTS = clock-model; NON-Shor[Physica A,341,586(04)]BEC logarithmic-law inversion factorization: Watkins #-theory U statistical- physics); P=/=NP C-S TRIVIAL Proof: Euclid!!! [(So Miscalled) computational-complexity J-O obviation(3 millennia AGO geometry: NO:CC,``CS'';``Feet of Clay!!!'']; Query WHAT?:Definition: (so MIScalled)``complexity''=UTTER-SIMPLICITY!! v COMPLICATEDNESS MEASURE(S).

Computer-Integrated Manufacturing Technology. Tech Prep Competency Profile.

ERIC Educational Resources Information Center

Lakeland Tech Prep Consortium, Kirtland, OH.

This tech prep competency profile for computer-integrated manufacturing technology begins with definitions for four occupations: manufacturing technician, quality technician, mechanical engineering technician, and computer-assisted design/drafting (CADD) technician. A chart lists competencies by unit and indicates whether entire or partial unit is…

Computer Page: Computer Studies for All--A Wider Approach

ERIC Educational Resources Information Center

Edens, A. J.

1975-01-01

An approach to teaching children aged 12 through 14 a substantial course about computers is described. Topics covered include simple algorithms, information and communication, man-machine communication, the concept of a system, the definition of a system, and the use of files. (SD)

Instructional Variables in Meaningful Learning of Computer Programming.

ERIC Educational Resources Information Center

Mayer, Richard E.

Some 120 undergraduate students participated in experiments to learn how novice computer programers learn to interact with the computer. Two instructional booklets were used: A "rule" booklet consisted of definitions and examples of seven modified FORTRAN statements and appropriate grammar rules; the "model" booklet was…

14 CFR 234.2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

...: Cancelled flight means a flight operation that was not operated, but was listed in a carrier's computer... dropped from a carrier's computer reservation system more than seven calendar days before its scheduled... reporting to computer reservations system vendors, flight also means one-stop or multi-stop single plane...

14 CFR 234.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

...: Cancelled flight means a flight operation that was not operated, but was listed in a carrier's computer... dropped from a carrier's computer reservation system more than seven calendar days before its scheduled... reporting to computer reservations system vendors, flight also means one-stop or multi-stop single plane...

45 CFR 310.1 - What definitions apply to this part?

Code of Federal Regulations, 2010 CFR

2010-10-01

... existing automated data processing computer system through an Intergovernmental Service Agreement; (4...) Office Automation means a generic adjunct component of a computer system that supports the routine... timely and satisfactory; (iv) Assurances that information in the computer system as well as access, use...

45 CFR 310.1 - What definitions apply to this part?

Code of Federal Regulations, 2013 CFR

2013-10-01

... existing automated data processing computer system through an Intergovernmental Service Agreement; (4...) Office Automation means a generic adjunct component of a computer system that supports the routine... timely and satisfactory; (iv) Assurances that information in the computer system as well as access, use...

45 CFR 310.1 - What definitions apply to this part?

Code of Federal Regulations, 2014 CFR

2014-10-01

... existing automated data processing computer system through an Intergovernmental Service Agreement; (4...) Office Automation means a generic adjunct component of a computer system that supports the routine... timely and satisfactory; (iv) Assurances that information in the computer system as well as access, use...

45 CFR 310.1 - What definitions apply to this part?

Code of Federal Regulations, 2011 CFR

2011-10-01

... existing automated data processing computer system through an Intergovernmental Service Agreement; (4...) Office Automation means a generic adjunct component of a computer system that supports the routine... timely and satisfactory; (iv) Assurances that information in the computer system as well as access, use...

14 CFR 234.2 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

...: Cancelled flight means a flight operation that was not operated, but was listed in a carrier's computer... dropped from a carrier's computer reservation system more than seven calendar days before its scheduled... reporting to computer reservations system vendors, flight also means one-stop or multi-stop single plane...

14 CFR 234.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

...: Cancelled flight means a flight operation that was not operated, but was listed in a carrier's computer... dropped from a carrier's computer reservation system more than seven calendar days before its scheduled... reporting to computer reservations system vendors, flight also means one-stop or multi-stop single plane...

45 CFR 310.1 - What definitions apply to this part?

Code of Federal Regulations, 2012 CFR

2012-10-01

... existing automated data processing computer system through an Intergovernmental Service Agreement; (4...) Office Automation means a generic adjunct component of a computer system that supports the routine... timely and satisfactory; (iv) Assurances that information in the computer system as well as access, use...

14 CFR 234.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

...: Cancelled flight means a flight operation that was not operated, but was listed in a carrier's computer... dropped from a carrier's computer reservation system more than seven calendar days before its scheduled... reporting to computer reservations system vendors, flight also means one-stop or multi-stop single plane...

State-Transition Structures in Physics and in Computation

NASA Astrophysics Data System (ADS)

Petri, C. A.

1982-12-01

In order to establish close connections between physical and computational processes, it is assumed that the concepts of “state” and of “transition” are acceptable both to physicists and to computer scientists, at least in an informal way. The aim of this paper is to propose formal definitions of state and transition elements on the basis of very low level physical concepts in such a way that (1) all physically possible computations can be described as embedded in physical processes; (2) the computational aspects of physical processes can be described on a well-defined level of abstraction; (3) the gulf between the continuous models of physics and the discrete models of computer science can be bridged by simple mathematical constructs which may be given a physical interpretation; (4) a combinatorial, nonstatistical definition of “information” can be given on low levels of abstraction which may serve as a basis to derive higher-level concepts of information, e.g., by a statistical or probabilistic approach. Conceivable practical consequences are discussed.

Comparison of severe acute respiratory illness (sari) and clinical pneumonia case definitions for the detection of influenza virus infections among hospitalized patients, western Kenya, 2009-2013.

PubMed

Makokha, Caroline; Mott, Joshua; Njuguna, Henry N; Khagayi, Sammy; Verani, Jennifer R; Nyawanda, Bryan; Otieno, Nancy; Katz, Mark A

2016-07-01

Although the severe acute respiratory illness (SARI) case definition is increasingly used for inpatient influenza surveillance, pneumonia is a more familiar term to clinicians and policymakers. We evaluated WHO case definitions for severe acute respiratory illness (SARI) and pneumonia (Integrated Management of Childhood Illnesses (IMCI) for children aged <5 years and Integrated Management of Adolescent and Adult Illnesses (IMAI) for patients aged ≥13 years) for detecting laboratory-confirmed influenza among hospitalized ARI patients. Sensitivities were 84% for SARI and 69% for IMCI pneumonia in children aged <5 years and 60% for SARI and 57% for IMAI pneumonia in patients aged ≥13 years. Clinical pneumonia case definitions may be a useful complement to SARI for inpatient influenza surveillance. © 2016 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

32 CFR 241.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... PILOT PROGRAM FOR TEMPORARY EXCHANGE OF INFORMATION TECHNOLOGY PERSONNEL § 241.2 Definitions. In this... organizational goals. Information technology (IT) as defined in section 11101 of title 40, U.S.C. includes computers, ancillary equipment (including imaging peripherals, input, output, and storage devices necessary...

Confirmed clinical case of chronic kidney disease of nontraditional causes in agricultural communities in Central America: a case definition for surveillance.

PubMed

Ferreiro, Alejandro; Álvarez-Estévez, Guillermo; Cerdas-Calderón, Manuel; Cruz-Trujillo, Zulma; Mena, Elio; Reyes, Marina; Sandoval-Diaz, Mabel; Sánchez-Polo, Vicente; Valdés, Régulo; Ordúnez, Pedro

2016-11-01

Over the last 20 years, many reports have described an excess of cases of chronic kidney disease (CKD) in the Pacific coastal area of Central America, mainly affecting male farmworkers and signaling a serious public health problem. Most of these cases are not associated with traditional risk factors for CKD, such as aging, diabetes mellitus, and hypertension. This CKD of nontraditional causes (CKDnT) might be linked to environmental and/or occupational exposure or working conditions, limited access to health services, and poverty. In response to a resolution approved by the Directing Council of the Pan American Health Organization (PAHO) in 2013, PAHO, the U.S. Centers for Disease Control and Prevention, and the Latin American Society of Nephrology and Hypertension (SLANH) organized a consultation process in order to expand knowledge on the epidemic of CKDnT and to develop appropriate surveillance instruments. The Clinical Working Group from SLANH was put in charge of finding a consensus definition of a confirmed clinical case of CKDnT. The resulting definition establishes mandatory criteria and exclusion criteria necessary for classifying a case of CKDnT. The definition includes a combination of universally accepted definitions of CKD and the main clinical manifestations of CKDnT. Based on the best available evidence, the Clinical Working Group also formulated general recommendations about clinical management that apply to any patient with CKDnT. Adhering to the definition of a confirmed clinical case of CKDnT and implementing it appropriately is expected to be a powerful instrument for understanding the prevalence of the epidemic, evaluating the results of interventions, and promoting appropriate advocacy and planning efforts.

Applications of multiple-constraint matrix updates to the optimal control of large structures

NASA Technical Reports Server (NTRS)

Smith, S. W.; Walcott, B. L.

1992-01-01

Low-authority control or vibration suppression in large, flexible space structures can be formulated as a linear feedback control problem requiring computation of displacement and velocity feedback gain matrices. To ensure stability in the uncontrolled modes, these gain matrices must be symmetric and positive definite. In this paper, efficient computation of symmetric, positive-definite feedback gain matrices is accomplished through the use of multiple-constraint matrix update techniques originally developed for structural identification applications. Two systems were used to illustrate the application: a simple spring-mass system and a planar truss. From these demonstrations, use of this multiple-constraint technique is seen to provide a straightforward approach for computing the low-authority gains.

Generic project definitions for improvement of health care delivery: a case-based approach.

PubMed

Niemeijer, Gerard C; Does, Ronald J M M; de Mast, Jeroen; Trip, Albert; van den Heuvel, Jaap

2011-01-01

The purpose of this article is to create actionable knowledge, making the definition of process improvement projects in health care delivery more effective. This study is a retrospective analysis of process improvement projects in hospitals, facilitating a case-based reasoning approach to project definition. Data sources were project documentation and hospital-performance statistics of 271 Lean Six Sigma health care projects from 2002 to 2009 of general, teaching, and academic hospitals in the Netherlands and Belgium. Objectives and operational definitions of improvement projects in the sample, analyzed and structured in a uniform format and terminology. Extraction of reusable elements of earlier project definitions, presented in the form of 9 templates called generic project definitions. These templates function as exemplars for future process improvement projects, making the selection, definition, and operationalization of similar projects more efficient. Each template includes an explicated rationale, an operationalization in the form of metrics, and a prototypical example. Thus, a process of incremental and sustained learning based on case-based reasoning is facilitated. The quality of project definitions is a crucial success factor in pursuits to improve health care delivery. We offer 9 tried and tested improvement themes related to patient safety, patient satisfaction, and business-economic performance of hospitals.

Ferrofluids: Modeling, numerical analysis, and scientific computation

NASA Astrophysics Data System (ADS)

Tomas, Ignacio

This dissertation presents some developments in the Numerical Analysis of Partial Differential Equations (PDEs) describing the behavior of ferrofluids. The most widely accepted PDE model for ferrofluids is the Micropolar model proposed by R.E. Rosensweig. The Micropolar Navier-Stokes Equations (MNSE) is a subsystem of PDEs within the Rosensweig model. Being a simplified version of the much bigger system of PDEs proposed by Rosensweig, the MNSE are a natural starting point of this thesis. The MNSE couple linear velocity u, angular velocity w, and pressure p. We propose and analyze a first-order semi-implicit fully-discrete scheme for the MNSE, which decouples the computation of the linear and angular velocities, is unconditionally stable and delivers optimal convergence rates under assumptions analogous to those used for the Navier-Stokes equations. Moving onto the much more complex Rosensweig's model, we provide a definition (approximation) for the effective magnetizing field h, and explain the assumptions behind this definition. Unlike previous definitions available in the literature, this new definition is able to accommodate the effect of external magnetic fields. Using this definition we setup the system of PDEs coupling linear velocity u, pressure p, angular velocity w, magnetization m, and magnetic potential ϕ We show that this system is energy-stable and devise a numerical scheme that mimics the same stability property. We prove that solutions of the numerical scheme always exist and, under certain simplifying assumptions, that the discrete solutions converge. A notable outcome of the analysis of the numerical scheme for the Rosensweig's model is the choice of finite element spaces that allow the construction of an energy-stable scheme. Finally, with the lessons learned from Rosensweig's model, we develop a diffuse-interface model describing the behavior of two-phase ferrofluid flows and present an energy-stable numerical scheme for this model. For a simplified version of this model and the corresponding numerical scheme we prove (in addition to stability) convergence and existence of solutions as by-product . Throughout this dissertation, we will provide numerical experiments, not only to validate mathematical results, but also to help the reader gain a qualitative understanding of the PDE models analyzed in this dissertation (the MNSE, the Rosenweig's model, and the Two-phase model). In addition, we also provide computational experiments to illustrate the potential of these simple models and their ability to capture basic phenomenological features of ferrofluids, such as the Rosensweig instability for the case of the two-phase model. In this respect, we highlight the incisive numerical experiments with the two-phase model illustrating the critical role of the demagnetizing field to reproduce physically realistic behavior of ferrofluids.

Definite (microbiologically confirmed) tuberculous meningitis: predictors and prognostic impact.

PubMed

Jha, Sneh Kumar; Garg, Ravindra Kumar; Jain, Amita; Malhotra, Hardeep Singh; Verma, Rajesh; Sharma, Praveen Kumar

2015-12-01

Microbiological confirmation cannot be obtained in approximately two-third patients with tuberculous meningitis. In this study, we sought to identify epidemiological, clinical, cerebrospinal fluid, and imaging parameters that could indicate the possibility of microbiological confirmation among patients with suspected tuberculous meningitis. In this prospective observational study, patients with tuberculous meningitis were evaluated for clinical, laboratory (cerebrospinal fluid microscopy, culture, and polymerase chain reaction), and neuroimaging parameters. All patients received anti-tuberculosis drugs and corticosteroids. The patients were followed for a period of 6 months. Among 118 cases of tuberculous meningitis, there were 43 (36 %) definite (microbiologically confirmed) cases, 59 (50 %) probable and 16 (14 %) possible cases. Among 43 definite cases, tuberculosis polymerase chain reaction (PCR) was positive in 42 (35 %) patients, culture was positive in 1 case and microscopy, after Ziehl-Neelsen staining, was positive in 3 cases. Three factors, modified Barthel index score at admission ≤12 (p = 0.008), cerebrospinal fluid total cell count >100/mm(3) (p = 0.016), and basal exudates on imaging (p = 0.015), were significantly associated with definite tuberculous meningitis. Among 20 patients who died within 6 months, 13 belonged to definite tuberculous meningitis group (p < 0.001). Stage III tuberculous meningitis (p = 0.004), baseline-modified Barthel index score ≤12 (p = 0.013), and positive tuberculosis PCR (p = 0.007) were independently associated with poor outcome on multivariate analysis. Severe disability, cerebrospinal fluid cells >100 mm(3), and basal exudates are significantly related to the presence of microbiologically confirmed definite tuberculous meningitis. Microbiologically confirmed tuberculous meningitis is associated with poorer outcome.

The Chiari 3 Malformation and a Systemic Review of the Literature.

PubMed

Young, Richard M; Shafa, Justin S; Myseros, John S

2015-01-01

Chiari type 3 is a rare hindbrain malformation that has been reported in the literature primarily as case reports and case series. Radiological, pathophysiological and surgical definitions of the malformation are inconsistent in the literature and subsequently can be confusing, and outcomes have also been uniformly poor. The definition of this rare malformation will be clarified through a case presentation. A retrospective review of prior publications in the PubMed and MEDLINE databases was performed looking for reports of 'Chiari 3 +/- malformation' and 'occipital encephalocele'. Relevant papers were reviewed and compiled into table format with associated descriptions of a Chiari type 3 malformation. A case illustration is presented with radiological and intraoperative imaging to reinforce and clarify the definition. Upon review of the prior publications in the detail of the descriptions and imaging associated with each article, there is a wide range of variability in the description of what is considered a Chiari 3 malformation. Occipital, occipitocervical and high cervical defects have all been described as Chiari 3 malformation. Our case illustration presents a patient with an occipitocervical encephalocele with neural elements, which is the classic and accepted definition of the Chiari 3 malformation. Chiari type 3 is a rare congenital malformation, and prior publications describing this developmental disorder have not demonstrated a consensus in its definition. In addition, outcomes have traditionally been reported as poor. This case illustration of a Chiari type 3 enforces the definition of an occipitocervical encephalocele with hindbrain herniation, and with proper management not all Chiari 3 malformation patients have bad outcomes. © 2015 S. Karger AG, Basel.

Evaluation of a focussed protocol for hand-held echocardiography and computer-assisted auscultation in detecting latent rheumatic heart disease in scholars.

PubMed

Zühlke, Liesl J; Engel, Mark E; Nkepu, Simpiwe; Mayosi, Bongani M

2016-08-01

Introduction Echocardiography is the diagnostic test of choice for latent rheumatic heart disease. The utility of echocardiography for large-scale screening is limited by high cost, complex diagnostic protocols, and time to acquire multiple images. We evaluated the performance of a brief hand-held echocardiography protocol and computer-assisted auscultation in detecting latent rheumatic heart disease with or without pathological murmur. A total of 27 asymptomatic patients with latent rheumatic heart disease based on the World Heart Federation criteria and 66 healthy controls were examined by standard cardiac auscultation to detect pathological murmur. Hand-held echocardiography using a focussed protocol that utilises one view - that is, the parasternal long-axis view - and one measurement - that is, mitral regurgitant jet - and a computer-assisted auscultation utilising an automated decision tool were performed on all patients. The sensitivity and specificity of computer-assisted auscultation in latent rheumatic heart disease were 4% (95% CI 1.0-20.4%) and 93.7% (95% CI 84.5-98.3%), respectively. The sensitivity and specificity of the focussed hand-held echocardiography protocol for definite rheumatic heart disease were 92.3% (95% CI 63.9-99.8%) and 100%, respectively. The test reliability of hand-held echocardiography was 98.7% for definite and 94.7% for borderline disease, and the adjusted diagnostic odds ratios were 1041 and 263.9 for definite and borderline disease, respectively. Computer-assisted auscultation has extremely low sensitivity but high specificity for pathological murmur in latent rheumatic heart disease. Focussed hand-held echocardiography has fair sensitivity but high specificity and diagnostic utility for definite or borderline rheumatic heart disease in asymptomatic patients.

Evaluation of tuberculosis diagnostics in children: 1. Proposed clinical case definitions for classification of intrathoracic tuberculosis disease. Consensus from an expert panel.

PubMed

Graham, Stephen M; Ahmed, Tahmeed; Amanullah, Farhana; Browning, Renee; Cardenas, Vicky; Casenghi, Martina; Cuevas, Luis E; Gale, Marianne; Gie, Robert P; Grzemska, Malgosia; Handelsman, Ed; Hatherill, Mark; Hesseling, Anneke C; Jean-Philippe, Patrick; Kampmann, Beate; Kabra, Sushil Kumar; Lienhardt, Christian; Lighter-Fisher, Jennifer; Madhi, Shabir; Makhene, Mamodikoe; Marais, Ben J; McNeeley, David F; Menzies, Heather; Mitchell, Charles; Modi, Surbhi; Mofenson, Lynne; Musoke, Philippa; Nachman, Sharon; Powell, Clydette; Rigaud, Mona; Rouzier, Vanessa; Starke, Jeffrey R; Swaminathan, Soumya; Wingfield, Claire

2012-05-15

There is a critical need for improved diagnosis of tuberculosis in children, particularly in young children with intrathoracic disease as this represents the most common type of tuberculosis in children and the greatest diagnostic challenge. There is also a need for standardized clinical case definitions for the evaluation of diagnostics in prospective clinical research studies that include children in whom tuberculosis is suspected but not confirmed by culture of Mycobacterium tuberculosis. A panel representing a wide range of expertise and child tuberculosis research experience aimed to develop standardized clinical research case definitions for intrathoracic tuberculosis in children to enable harmonized evaluation of new tuberculosis diagnostic technologies in pediatric populations. Draft definitions and statements were proposed and circulated widely for feedback. An expert panel then considered each of the proposed definitions and statements relating to clinical definitions. Formal group consensus rules were established and consensus was reached for each statement. The definitions presented in this article are intended for use in clinical research to evaluate diagnostic assays and not for individual patient diagnosis or treatment decisions. A complementary article addresses methodological issues to consider for research of diagnostics in children with suspected tuberculosis.

Education for Computers

ERIC Educational Resources Information Center

Heslep, Robert D.

2012-01-01

The computer engineers who refer to the education of computers do not have a definite idea of education and do not bother to justify the fuzzy ones to which they allude. Hence, they logically cannot specify the features a computer must have in order to be educable. This paper puts forth a non-standard, but not arbitrary, concept of education that…

7 CFR 1739.3 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... terrestrial technology having the capacity to provide transmission facilities that enable subscribers of the...) Computer Access Points and wireless access, that is used for the purposes of providing free access to and..., and after normal working hours and on Saturdays or Sunday. Computer Access Point means a new computer...

Fast calculation of the `ILC norm' in iterative learning control

NASA Astrophysics Data System (ADS)

Rice, Justin K.; van Wingerden, Jan-Willem

2013-06-01

In this paper, we discuss and demonstrate a method for the exploitation of matrix structure in computations for iterative learning control (ILC). In Barton, Bristow, and Alleyne [International Journal of Control, 83(2), 1-8 (2010)], a special insight into the structure of the lifted convolution matrices involved in ILC is used along with a modified Lanczos method to achieve very fast computational bounds on the learning convergence, by calculating the 'ILC norm' in ? computational complexity. In this paper, we show how their method is equivalent to a special instance of the sequentially semi-separable (SSS) matrix arithmetic, and thus can be extended to many other computations in ILC, and specialised in some cases to even faster methods. Our SSS-based methodology will be demonstrated on two examples: a linear time-varying example resulting in the same ? complexity as in Barton et al., and a linear time-invariant example where our approach reduces the computational complexity to ?, thus decreasing the computation time, for an example, from the literature by a factor of almost 100. This improvement is achieved by transforming the norm computation via a linear matrix inequality into a check of positive definiteness - which allows us to further exploit the almost-Toeplitz properties of the matrix, and additionally provides explicit upper and lower bounds on the norm of the matrix, instead of the indirect Ritz estimate. These methods are now implemented in a MATLAB toolbox, freely available on the Internet.

Programmable and autonomous computing machine made of biomolecules

PubMed Central

Benenson, Yaakov; Paz-Elizur, Tamar; Adar, Rivka; Keinan, Ehud; Livneh, Zvi; Shapiro, Ehud

2013-01-01

Devices that convert information from one form into another according to a definite procedure are known as automata. One such hypothetical device is the universal Turing machine1, which stimulated work leading to the development of modern computers. The Turing machine and its special cases2, including finite automata3, operate by scanning a data tape, whose striking analogy to information-encoding biopolymers inspired several designs for molecular DNA computers4–8. Laboratory-scale computing using DNA and human-assisted protocols has been demonstrated9–15, but the realization of computing devices operating autonomously on the molecular scale remains rare16–20. Here we describe a programmable finite automaton comprising DNA and DNA-manipulating enzymes that solves computational problems autonomously. The automaton’s hardware consists of a restriction nuclease and ligase, the software and input are encoded by double-stranded DNA, and programming amounts to choosing appropriate software molecules. Upon mixing solutions containing these components, the automaton processes the input molecule via a cascade of restriction, hybridization and ligation cycles, producing a detectable output molecule that encodes the automaton’s final state, and thus the computational result. In our implementation 1012 automata sharing the same software run independently and in parallel on inputs (which could, in principle, be distinct) in 120 μl solution at room temperature at a combined rate of 109 transitions per second with a transition fidelity greater than 99.8%, consuming less than 10−10 W. PMID:11719800

Novel Use of Flu Surveillance Data: Evaluating Potential of Sentinel Populations for Early Detection of Influenza Outbreaks.

PubMed

Daughton, Ashlynn R; Velappan, Nileena; Abeyta, Esteban; Priedhorsky, Reid; Deshpande, Alina

2016-01-01

Influenza causes significant morbidity and mortality each year, with 2-8% of weekly outpatient visits around the United States for influenza-like-illness (ILI) during the peak of the season. Effective use of existing flu surveillance data allows officials to understand and predict current flu outbreaks and can contribute to reductions in influenza morbidity and mortality. Previous work used the 2009-2010 influenza season to investigate the possibility of using existing military and civilian surveillance systems to improve early detection of flu outbreaks. Results suggested that civilian surveillance could help predict outbreak trajectory in local military installations. To further test that hypothesis, we compare pairs of civilian and military outbreaks in seven locations between 2000 and 2013. We find no predictive relationship between outbreak peaks or time series of paired outbreaks. This larger study does not find evidence to support the hypothesis that civilian data can be used as sentinel surveillance for military installations. We additionally investigate the effect of modifying the ILI case definition between the standard Department of Defense definition, a more specific definition proposed in literature, and confirmed Influenza A. We find that case definition heavily impacts results. This study thus highlights the importance of careful selection of case definition, and appropriate consideration of case definition in the interpretation of results.

Definition of drug-resistant epilepsy: is it evidence based?

PubMed

Wiebe, Samuel

2013-05-01

Clinical case definitions are the cornerstone of clinical communication and of clinical and epidemiologic research. The ramifications of establishing a case definition are extensive, including potentially large changes in epidemiologic estimates of frequency, and decisions for clinical management. Yet, defining a condition entails numerous challenges such as defining the scope and purpose, incorporating the strongest evidence base with clinical expertise, accounting for patients' values, and considering impact on care. The clinical case definition of drug-resistant epilepsy, in addition, must address what constitutes an adequate intervention for an individual drug, what are the outcomes of relevance, what period of observation is sufficient to determine success or failure, how many medications should be tried, whether seizure frequency should play a role, and what is the role of side effects and tolerability. On the other hand, the principles of evidence-based medicine (EBM) aim at providing a systematic approach to incorporating the best available evidence into the process of clinical decision for individual patients. The case definition of drug-resistant epilepsy proposed by the the International League Against Epilepsy (ILAE) in 2009 is evaluated in terms of the principles of EBM as well as the stated goals of the authors of the definition. Wiley Periodicals, Inc. © 2013 International League Against Epilepsy.

Cloud Computing for DoD

DTIC Science & Technology

2012-05-01

cloud computing 17 NASA Nebula Platform •  Cloud computing pilot program at NASA Ames •  Integrates open-source components into seamless, self...Mission support •  Education and public outreach (NASA Nebula , 2010) 18 NSF Supported Cloud Research •  Support for Cloud Computing in...Mell, P. & Grance, T. (2011). The NIST Definition of Cloud Computing. NIST Special Publication 800-145 •  NASA Nebula (2010). Retrieved from

45 CFR 160.103 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., the following definitions apply to this subchapter: Act means the Social Security Act. ANSI stands for... required documents. Electronic media means: (1) Electronic storage media including memory devices in computers (hard drives) and any removable/transportable digital memory medium, such as magnetic tape or disk...

45 CFR 160.103 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., the following definitions apply to this subchapter: Act means the Social Security Act. ANSI stands for... required documents. Electronic media means: (1) Electronic storage media including memory devices in computers (hard drives) and any removable/transportable digital memory medium, such as magnetic tape or disk...

45 CFR 160.103 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., the following definitions apply to this subchapter: Act means the Social Security Act. ANSI stands for... required documents. Electronic media means: (1) Electronic storage media including memory devices in computers (hard drives) and any removable/transportable digital memory medium, such as magnetic tape or disk...

Application of grounded theory to content definition: a case study.

PubMed

Audiss, D; Roth, T

1999-02-01

Successful implementation of a clinical information system requires clinician involvement throughout the process of content definition and system development to ensure acceptance of the automated care process. In these times of downsizing, however, clinicians are not always able to participate fully in the dontent definition phase of system development and often become frustrated with their inability to obtain the patient information they need from the system. The qualitative research principles of grounded theory afford clinicians the opportunity to participate in content definition for information systems. This article presents a case study of the application of grounded theory to develop systematically the content definition for a clinical information system in preparation for implementation on four medical-surgical units.

Renal Clear Cell Sarcoma - Anaplastic Variant: A Rare Entity.

PubMed

Walke, Vaishali Atmaram; Shende, Nitin Y; Kumbhalkar, D T

2017-01-01

Clear Cell Sarcoma of Kidney (CCSK) is known for its morphologic diversity, aggressive behaviour, tendency to recur and metastasis to bone. Amongst the various morphologic subtypes, anaplastic CCSK is associated with worse prognosis. Here, we report a case of this rare variant of CCSK. A five-year-old boy presented with history of lump and pain in abdomen since one week. The Computed Tomography (CT) scan revealed a large mass occupying the middle and inferior pole of right kidney. The clinical impression was Wilms tumour. Nephrectomy specimen was received and the diagnosis of CCSK anaplastic variant was offered only after excluding the differentials and after performing ancillary tests such as Immunohistochemistry (IHC). Thus, this case emphasizes the diagnostic challenges on morphology and the essential role of IHC in arriving at a definitive diagnosis, because failure to do so may deprive the child from optimal treatment.

Renal Clear Cell Sarcoma - Anaplastic Variant: A Rare Entity

PubMed Central

Shende, Nitin Y; Kumbhalkar, D T

2017-01-01

Clear Cell Sarcoma of Kidney (CCSK) is known for its morphologic diversity, aggressive behaviour, tendency to recur and metastasis to bone. Amongst the various morphologic subtypes, anaplastic CCSK is associated with worse prognosis. Here, we report a case of this rare variant of CCSK. A five-year-old boy presented with history of lump and pain in abdomen since one week. The Computed Tomography (CT) scan revealed a large mass occupying the middle and inferior pole of right kidney. The clinical impression was Wilms tumour. Nephrectomy specimen was received and the diagnosis of CCSK anaplastic variant was offered only after excluding the differentials and after performing ancillary tests such as Immunohistochemistry (IHC). Thus, this case emphasizes the diagnostic challenges on morphology and the essential role of IHC in arriving at a definitive diagnosis, because failure to do so may deprive the child from optimal treatment. PMID:28273978

45 CFR 303.15 - Agreements to use the Federal Parent Locator Service (PLS) in parental kidnapping and child...

Code of Federal Regulations, 2010 CFR

2010-10-01

... Service (PLS) in parental kidnapping and child custody or visitation cases. 303.15 Section 303.15 Public... parental kidnapping and child custody or visitation cases. (a) Definitions. The following definitions apply... responsibilities require access in connection with child custody and parental kidnapping cases; (ii) Store the...

45 CFR 303.15 - Agreements to use the Federal Parent Locator Service (PLS) in parental kidnapping and child...

Code of Federal Regulations, 2014 CFR

2014-10-01

... Service (PLS) in parental kidnapping and child custody or visitation cases. 303.15 Section 303.15 Public... parental kidnapping and child custody or visitation cases. (a) Definitions. The following definitions apply... responsibilities require access in connection with child custody and parental kidnapping cases; (ii) Store the...

45 CFR 303.15 - Agreements to use the Federal Parent Locator Service (PLS) in parental kidnapping and child...

Code of Federal Regulations, 2011 CFR

2011-10-01

... Service (PLS) in parental kidnapping and child custody or visitation cases. 303.15 Section 303.15 Public... parental kidnapping and child custody or visitation cases. (a) Definitions. The following definitions apply... responsibilities require access in connection with child custody and parental kidnapping cases; (ii) Store the...

45 CFR 303.15 - Agreements to use the Federal Parent Locator Service (PLS) in parental kidnapping and child...

Code of Federal Regulations, 2013 CFR

2013-10-01

... Service (PLS) in parental kidnapping and child custody or visitation cases. 303.15 Section 303.15 Public... parental kidnapping and child custody or visitation cases. (a) Definitions. The following definitions apply... responsibilities require access in connection with child custody and parental kidnapping cases; (ii) Store the...

45 CFR 303.15 - Agreements to use the Federal Parent Locator Service (PLS) in parental kidnapping and child...

Code of Federal Regulations, 2012 CFR

2012-10-01

... Service (PLS) in parental kidnapping and child custody or visitation cases. 303.15 Section 303.15 Public... parental kidnapping and child custody or visitation cases. (a) Definitions. The following definitions apply... responsibilities require access in connection with child custody and parental kidnapping cases; (ii) Store the...

Among the New Worlds.

ERIC Educational Resources Information Center

Algeo, John; Algeo, Adele

1989-01-01

Presents definitions and examples of usage of late-twentieth century American words and terms, including: bite, dramedy, photo op, photo opportunist, safe computer practice, sound bite, teflon, trapdoor, vaccination program, computer virus, and wait state. (CB)

A UALR Computer Literacy Project to Determine Curricular Goals and Objectives.

ERIC Educational Resources Information Center

Teeter, Thomas A.

The results of a study assessing departmental plans for hardware and software acquisitions, faculty development activities, and curricular modifications aimed at increasing student computer literacy at the University of Arkansas at Little Rock (UALR) are reported. The study involved reviewing departmental definitions of computer literacy generated…

Everything You Always Wanted to Know about Computers but Were Afraid to Ask.

ERIC Educational Resources Information Center

DiSpezio, Michael A.

1989-01-01

An overview of the basics of computers is presented. Definitions and discussions of processing, programs, memory, DOS, anatomy and design, central processing unit (CPU), disk drives, floppy disks, and peripherals are included. This article was designed to help teachers to understand basic computer terminology. (CW)

Characteristics of fatal abusive head trauma among children in the USA: 2003-2007: an application of the CDC operational case definition to national vital statistics data.

PubMed

Parks, Sharyn E; Kegler, Scott R; Annest, Joseph L; Mercy, James A

2012-06-01

In March of 2008, an expert panel was convened at the Centers for Disease Control and Prevention to develop code-based case definitions for abusive head trauma (AHT) in children under 5 years of age based on the International Classification of Diseases, 10th Revision (ICD-10) nature and cause of injury codes. This study presents the operational case definition and applies it to US death data. National Center for Health Statistics National Vital Statistics System data on multiple cause-of-death from 2003 to 2007 were examined. Inspection of records with at least one ICD-10 injury/disease code and at least one ICD-10 cause code from the AHT case definition resulted in the identification of 780 fatal AHT cases, with 699 classified as definite/presumptive AHT and 81 classified as probable AHT. The fatal AHT rate was highest among children age <1 year with a peak in incidence that occurred at 1-2 months of age. Fatal AHT incidence rates were higher for men than women and were higher for non-Hispanic African-Americans compared to other racial/ethnic groups. Fatal AHT incidence was relatively constant across seasons. This report demonstrates that the definition can help to identify population subgroups at higher risk for AHT defined by year and month of death, age, sex and race/ethnicity. This type of definition may be useful for various epidemiological applications including research and surveillance. These activities can in turn inform further development of prevention activities, including educating parents about the dangers of shaking and strategies for managing infant crying.

Can the Cancer-related Fatigue Case-definition Criteria Be Applied to Chronic Medical Illness? A Comparison between Breast Cancer and Systemic Sclerosis.

PubMed

Kwakkenbos, Linda; Minton, Ollie; Stone, Patrick C; Alexander, Susanna; Baron, Murray; Hudson, Marie; Thombs, Brett D

2015-07-01

Fatigue is a crucial determinant of quality of life across rheumatic diseases, but the lack of agreed-upon standards for identifying clinically significant fatigue hinders research and clinical management. Case definition criteria for cancer-related fatigue were proposed for inclusion in the International Classification of Diseases. The objective was to evaluate whether the cancer-related fatigue case definition performed equivalently in women with breast cancer and systemic sclerosis (SSc) and could be used to identify patients with chronic illness-related fatigue. The cancer-related fatigue interview (case definition criteria met if ≥ 5 of 9 fatigue-related symptoms present with functional impairment) was completed by 291 women with SSc and 278 women successfully treated for breast cancer. Differential item functioning was assessed with the multiple indicator multiple cause model. Items 3 (concentration) and 10 (short-term memory) were endorsed significantly less often by women with SSc compared with cancer, controlling for responses on other items. Omitting these 2 items from the case definition and requiring 4 out of the 7 remaining symptoms resulted in a similar overall prevalence of cancer-related fatigue in the cancer sample compared with the original criteria (37.4% vs 37.8%, respectively), with 97.5% of patients diagnosed identically with both definitions. Prevalence of chronic illness-related fatigue was 36.1% in SSc using 4 of 7 symptoms. The cancer-related fatigue criteria can be used equivalently to identify patients with chronic illness-related fatigue when 2 cognitive fatigue symptoms are omitted. Harmonized definitions and measurement of clinically significant fatigue will advance research and clinical management of fatigue in rheumatic diseases and other conditions.

High Definition Information Systems. Hearing before the Subcommittee on Technology, Environment and Aviation of the Committee on Science, Space, and Technology. House of Representatives, One Hundred Third Congress, First Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Committee on Science, Space and Technology.

The objectives of this Congressional hearing on high definition information systems were: (1) to receive testimony on standards for systems that permit interoperability between the computer, communications, and broadcasting industries; (2) to examine the implications of the Grand Alliance, an agreement by high definition television (HDTV)…

Performance of nested RT-PCR on CSF for tuberculous meningitis diagnosis in HIV-infected patients.

PubMed

Gualberto, F A S; Gonçalves, M G; Fukasawa, L O; Santos, A M Ramos Dos; Sacchi, C T; Harrison, L H; Boulware, D R; Vidal, J E

2017-10-01

Timely diagnosis of tuberculous meningitis (TBM) in patients with human immunodeficiency virus (HIV) infection remains a challenge. Despite the current scale-up of the Xpert® MTB/RIF assay, other molecular diagnostic tools are necessary, particularly in referral centres in low- and middle-income countries without Xpert testing. To determine the diagnostic performance of nested real-time polymerase chain reaction (nRT-PCR) in HIV-infected TBM patients categorised according to standardised clinical case definitions. Based on clinical, laboratory and imaging data, HIV-infected patients with suspected TBM were prospectively categorised as 'definite TBM', 'probable TBM', 'possible TBM' or 'not TBM'. We evaluated nRT-PCR sensitivity and specificity in diagnosing TBM among definite TBM cases, and among definite + probable TBM cases. Ninety-two participants were enrolled in the study. nRT-PCR sensitivity for definite TBM (n = 8) was 100% (95%CI 67-100) and 86% (95%CI 60-96) for both definite and probable TBM (n = 6). Assuming that 'not TBM' patients (n = 74) were true-negatives, nRT-PCR specificity was 100% (95%CI 95-100). The possible TBM group (n = 4) had no nRT-PCR positives. The nRT-PCR is a useful rule-in test for HIV-infected patients with TBM according to international consensus case definitions. As nRT-PCR cannot exclude TBM, studies comparing and combining nRT-PCR with other assays are necessary for a rule-out test.

24 CFR 570.416 - Hispanic-serving institutions work study program.

Code of Federal Regulations, 2010 CFR

2010-04-01

... to pre-professional careers in these fields. (b) Definitions. The following definitions apply to HSI... such as natural sciences, computer sciences, mathematics, accounting, electronics, engineering, and the... pursuing careers in community building, and make them aware of the availability of assistance opportunities...

5 CFR 850.103 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

...) ELECTRONIC RETIREMENT PROCESSING General Provisions § 850.103 Definitions. In this part— Agency means an... graphical image of a handwritten signature usually created using a special computer input device (such as a... comparison with the characteristics and biometric data of a known or exemplar signature image. Director means...

26 CFR 1.545-1 - Definition.

Code of Federal Regulations, 2010 CFR

2010-04-01

... imposition of the personal holding company tax on a foreign corporation, resident or nonresident, which files..., which files no return, the undistributed personal holding company income shall be computed on the basis... TAXES (CONTINUED) Personal Holding Companies § 1.545-1 Definition. (a) Undistributed personal holding...

26 CFR 1.545-1 - Definition.

Code of Federal Regulations, 2011 CFR

2011-04-01

... imposition of the personal holding company tax on a foreign corporation, resident or nonresident, which files..., which files no return, the undistributed personal holding company income shall be computed on the basis... TAXES (CONTINUED) Personal Holding Companies § 1.545-1 Definition. (a) Undistributed personal holding...

Biological Warfare Improved Response Program (BW-IRP) CDC/DoD Smallpox Workshop

DTIC Science & Technology

2005-01-01

national surveillance effort. Awareness of unique symptoms will need to be raised by training clinicians. For example, adults presenting with chicken pox ...no case definitions but rather visual recognition cards. Presently, the chicken pox definition has been modified to create a smallpox definition. The...the last 2 weeks • Pharmaceuticals prescribed or issued for chicken pox • A number of suspected cases of chicken pox • Reports of rashes, especially a

36 CFR 1236.2 - What definitions apply to this part?

Code of Federal Regulations, 2014 CFR

2014-07-01

... users but does not retain any transmission data), data systems used to collect and process data that have been organized into data files or data bases on either personal computers or mainframe computers...

36 CFR 1236.2 - What definitions apply to this part?

Code of Federal Regulations, 2011 CFR

2011-07-01

... users but does not retain any transmission data), data systems used to collect and process data that have been organized into data files or data bases on either personal computers or mainframe computers...

36 CFR 1236.2 - What definitions apply to this part?

Code of Federal Regulations, 2012 CFR

2012-07-01

... users but does not retain any transmission data), data systems used to collect and process data that have been organized into data files or data bases on either personal computers or mainframe computers...

36 CFR 1236.2 - What definitions apply to this part?

Code of Federal Regulations, 2010 CFR

2010-07-01

... users but does not retain any transmission data), data systems used to collect and process data that have been organized into data files or data bases on either personal computers or mainframe computers...

Investigating AI with Basic and Logo. Teaching Your Computer to Be Intelligent.

ERIC Educational Resources Information Center

Mandell, Alan; Lucking, Robert

1988-01-01

Discusses artificial intelligence, its definitions, and potential applications. Provides listings of Logo and BASIC versions for programs along with REM statements needed to make modifications for use with Apple computers. (RT)

Congenital intrahepatic portosystemic venous shunt presenting with paraparesis as the initial symptom.

PubMed

Torigoe, Masataka; Maeshima, Keisuke; Takeshita, Yasushi

2013-01-01

An 85-year-old woman was hospitalized with rapidly progressive paraparesis without altered consciousness, although she was not definitively diagnosed. She developed acute drowsiness and disorientation several days later. An intrahepatic portosystemic venous shunt (IPSVS) was observed on enhanced computed tomography, and hyperammonemia suggested leakage of neurotoxins from the shunt as the etiology of the patient's symptoms. Her neurological symptoms and hyperammonemia improved following transcatheter shunt embolization. We diagnosed her with hepatic myelopathy, which is a rare complication of liver cirrhosis and portosystemic venous shunts. Hepatic myelopathy resulting from a congenital IPSVS has not been previously reported. A diagnosis of hepatic myelopathy should be ruled out in diagnostically difficult cases of paraparesis.

Man-Computer Symbiosis Through Interactive Graphics: A Survey and Identification of Critical Research Areas.

ERIC Educational Resources Information Center

Knoop, Patricia A.

The purpose of this report was to determine the research areas that appear most critical to achieving man-computer symbiosis. An operational definition of man-computer symbiosis was developed by: (1) reviewing and summarizing what others have said about it, and (2) attempting to distinguish it from other types of man-computer relationships. From…

Sensitivity, Specificity, and Public-Health Utility of Clinical Case Definitions Based on the Signs and Symptoms of Cholera in Africa.

PubMed

Nadri, Johara; Sauvageot, Delphine; Njanpop-Lafourcade, Berthe-Marie; Baltazar, Cynthia S; Banla Kere, Abiba; Bwire, Godfrey; Coulibaly, Daouda; Kacou N'Douba, Adele; Kagirita, Atek; Keita, Sakoba; Koivogui, Lamine; Landoh, Dadja E; Langa, Jose P; Miwanda, Berthe N; Mutombo Ndongala, Guy; Mwakapeje, Elibariki R; Mwambeta, Jacob L; Mengel, Martin A; Gessner, Bradford D

2018-04-01

During 2014, Africa reported more than half of the global suspected cholera cases. Based on the data collected from seven countries in the African Cholera Surveillance Network (Africhol), we assessed the sensitivity, specificity, and positive and negative predictive values of clinical cholera case definitions, including that recommended by the World Health Organization (WHO) using culture confirmation as the gold standard. The study was designed to assess results in real-world field situations in settings with recent cholera outbreaks or endemicity. From June 2011 to July 2015, a total of 5,084 persons with suspected cholera were tested for Vibrio cholerae in seven different countries of which 35.7% had culture confirmation. For all countries combined, the WHO case definition had a sensitivity = 92.7%, specificity = 8.1%, positive predictive value = 36.1%, and negative predictive value = 66.6%. Adding dehydration, vomiting, or rice water stools to the case definition could increase the specificity without a substantial decrease in sensitivity. Future studies could further refine our findings primarily by using more sensitive methods for cholera confirmation.

Acute pesticide poisoning: a proposed classification tool.

PubMed

Thundiyil, Josef G; Stober, Judy; Besbelli, Nida; Pronczuk, Jenny

2008-03-01

Cases of acute pesticide poisoning (APP) account for significant morbidity and mortality worldwide. Developing countries are particularly susceptible due to poorer regulation, lack of surveillance systems, less enforcement, lack of training and inadequate access to information systems. Previous research has demonstrated wide variability in incidence rates for APP. This is possibly due to inconsistent reporting methodology and exclusion of occupational and non-intentional poisonings. The purpose of this document is to create a standard case definition to facilitate the identification and diagnosis of all causes of APP, especially at the field level, rural clinics and primary health-care systems. This document is a synthesis of existing literature and case definitions that have been previously proposed by other authors around the world. It provides a standardized case definition and classification scheme for APP into categories of probable, possible and unlikely/unknown cases. Its use is intended to be applicable worldwide to contribute to identification of the scope of existing problems and thus promote action for improved management and prevention. By enabling a field diagnosis for APP, this standardized case definition may facilitate immediate medical management of pesticide poisoning and aid in estimating its incidence.

Is a rheumatic fever register the best surveillance tool to evaluate rheumatic fever control in the Auckland region?

PubMed

Moxon, Te Aro; Reed, Peter; Jelleyman, Timothy; Anderson, Philippa; Leversha, Alison; Jackson, Catherine; Lennon, Diana

2017-08-11

To determine the most accurate data source for acute rheumatic fever (ARF) epidemiology in the Auckland region. To assess coverage of the Auckland Regional Rheumatic Fever Register (ARRFR), (1998-2010) for children <15 years and resident in Auckland at the time of illness, register, hospitalisation and notification data were compared. A consistent definition was applied to determine definite and probable cases of ARF using clinical records. (www.heartfoundation.org.nz) RESULTS: Of 559 confirmed (definite and probable) RF cases <15 years (median age 10 years), seven were recurrences. Of 552 first episodes, the ARRFR identified 548 (99%), hospitalisations identified 501 (91%) including four not on the register, and public health notifications identified 384 (70%). Of hospitalisation cases, 33% (245/746), and of notifications 20% (94/478) did not meet the case definition and were therefore excluded. Between 1998-2010, eight cases, initially entered as ARF on the ARRFR, were later removed once further clinical detail was available. The ARRFR produced the most accurate information surrounding new cases of ARF (for children <15 years) for the years 1998-2010 in Auckland. This was significantly more accurate than medical officer of health notification and hospitalisation data.

Zinc supplementation for the prevention of acute lower respiratory infection in children in developing countries: meta-analysis and meta-regression of randomized trials.

PubMed

Roth, Daniel E; Richard, Stephanie A; Black, Robert E

2010-06-01

Routine zinc supplementation is a potential intervention for the prevention of acute lower respiratory infection (ALRI) in developing countries. However, discrepant findings from recent randomized trials remain unexplained. Randomized trials of zinc supplementation in young children in developing countries were identified by a systematic literature review. Trials included in the meta-analysis met specific criteria, including participants <5 years of age, daily/weekly zinc and control supplementation for greater than 3 months, active household surveillance for respiratory morbidity and use of a case definition that included at least one sign of lower respiratory tract illness. ALRI case definitions were classified on the basis of specificity/severity. Incidence rate ratios (IRRs) were pooled by random-effects models. Meta-regression and sub-group analysis were performed to assess potential sources of between-study heterogeneity. Ten trials were eligible for inclusion (n = 49 450 children randomized). Zinc reduced the incidence of ALRI defined by specific clinical criteria [IRR 0.65, 95% confidence interval (CI) 0.52-0.82], but had no effect on lower-specificity ALRI case definitions based on caregiver report (IRR 1.01, 95% CI 0.91-1.12) or World Health Organization 'non-severe pneumonia' (0.96, 95% CI 0.86-1.08). By meta-regression, the effect of zinc was associated with ALRI case definition, but not with mean baseline age, geographic location, nutritional status or zinc dose. Routine zinc supplementation reduced the incidence of childhood ALRI defined by relatively specific clinical criteria, but the effect was null if lower specificity case definitions were applied. The choice of ALRI case definition may substantially influence inferences from community trials regarding the efficacy of preventive interventions.

Alternative perspectives of safety in home delivered health care: a sequential exploratory mixed method study.

PubMed

Jones, Sarahjane

2016-10-01

The aim of this study was to discover and describe how patients, carers and case management nurses define safety and compare it to the traditional risk reduction and harm avoidance definition of safety. Care services are increasingly being delivered in the home for patients with complex long-term conditions. However, the concept of safety remains largely unexplored. A sequential, exploratory mixed method design. A qualitative case study of the UK National Health Service case management programme in the English UK National Health Service was deployed during 2012. Thirteen interviews were conducted with patients (n = 9) and carers (n = 6) and three focus groups with nurses (n = 17) from three community care providers. The qualitative element explored the definition of safety. Data were subjected to framework analysis and themes were identified by participant group. Sequentially, a cross-sectional survey was conducted during 2013 in a fourth community care provider (patient n = 35, carer n = 19, nurse n = 26) as a form of triangulation. Patients and carers describe safety differently to case management nurses, choosing to focus on meeting needs. They use more positive language and recognize the role they have in safety in home-delivered health care. In comparison, case management nurses described safety similarly to the definitions found in the literature. However, when offered the patient and carer definition of safety, they preferentially selected this definition to their own or the literature definition. Patients and carers offer an alternative perspective on patient safety in home-delivered health care that identifies their role in ensuring safety and is more closely aligned with the empowerment philosophy of case management. © 2016 John Wiley & Sons Ltd.

Validation of a case definition for leptospirosis diagnosis in patients with acute severe febrile disease admitted in reference hospitals at the State of Pernambuco, Brazil.

PubMed

Albuquerque Filho, Alfredo Pereira Leite de; Araújo, Jéssica Guido de; Souza, Inacelli Queiroz de; Martins, Luciana Cardoso; Oliveira, Marta Iglis de; Silva, Maria Jesuíta Bezerra da; Montarroyos, Ulisses Ramos; Miranda Filho, Demócrito de Barros

2011-01-01

Leptospirosis is often mistaken for other acute febrile illnesses because of its nonspecific presentation. Bacteriologic, serologic, and molecular methods have several limitations for early diagnosis: technical complexity, low availability, low sensitivity in early disease, or high cost. This study aimed to validate a case definition, based on simple clinical and laboratory tests, that is intended for bedside diagnosis of leptospirosis among hospitalized patients. Adult patients, admitted to two reference hospitals in Recife, Brazil, with a febrile illness of less than 21 days and with a clinical suspicion of leptospirosis, were included to test a case definition comprising ten clinical and laboratory criteria. Leptospirosis was confirmed or excluded by a composite reference standard (microscopic agglutination test, ELISA, and blood culture). Test properties were determined for each cutoff number of the criteria from the case definition. Ninety seven patients were included; 75 had confirmed leptospirosis and 22 did not. Mean number of criteria from the case definition that were fulfilled was 7.8±1.2 for confirmed leptospirosis and 5.9±1.5 for non-leptospirosis patients (p<0.0001). Best sensitivity (85.3%) and specificity (68.2%) combination was found with a cutoff of 7 or more criteria, reaching positive and negative predictive values of 90.1% and 57.7%, respectively; accuracy was 81.4%. The case definition, for a cutoff of at least 7 criteria, reached average sensitivity and specificity, but with a high positive predictive value. Its simplicity and low cost make it useful for rapid bedside leptospirosis diagnosis in Brazilian hospitalized patients with acute severe febrile disease.

Bubble Entropy: An Entropy Almost Free of Parameters.

PubMed

Manis, George; Aktaruzzaman, Md; Sassi, Roberto

2017-11-01

Objective : A critical point in any definition of entropy is the selection of the parameters employed to obtain an estimate in practice. We propose a new definition of entropy aiming to reduce the significance of this selection. Methods: We call the new definition Bubble Entropy . Bubble Entropy is based on permutation entropy, where the vectors in the embedding space are ranked. We use the bubble sort algorithm for the ordering procedure and count instead the number of swaps performed for each vector. Doing so, we create a more coarse-grained distribution and then compute the entropy of this distribution. Results: Experimental results with both real and synthetic HRV signals showed that bubble entropy presents remarkable stability and exhibits increased descriptive and discriminating power compared to all other definitions, including the most popular ones. Conclusion: The definition proposed is almost free of parameters. The most common ones are the scale factor r and the embedding dimension m . In our definition, the scale factor is totally eliminated and the importance of m is significantly reduced. The proposed method presents increased stability and discriminating power. Significance: After the extensive use of some entropy measures in physiological signals, typical values for their parameters have been suggested, or at least, widely used. However, the parameters are still there, application and dataset dependent, influencing the computed value and affecting the descriptive power. Reducing their significance or eliminating them alleviates the problem, decoupling the method from the data and the application, and eliminating subjective factors. Objective : A critical point in any definition of entropy is the selection of the parameters employed to obtain an estimate in practice. We propose a new definition of entropy aiming to reduce the significance of this selection. Methods: We call the new definition Bubble Entropy . Bubble Entropy is based on permutation entropy, where the vectors in the embedding space are ranked. We use the bubble sort algorithm for the ordering procedure and count instead the number of swaps performed for each vector. Doing so, we create a more coarse-grained distribution and then compute the entropy of this distribution. Results: Experimental results with both real and synthetic HRV signals showed that bubble entropy presents remarkable stability and exhibits increased descriptive and discriminating power compared to all other definitions, including the most popular ones. Conclusion: The definition proposed is almost free of parameters. The most common ones are the scale factor r and the embedding dimension m . In our definition, the scale factor is totally eliminated and the importance of m is significantly reduced. The proposed method presents increased stability and discriminating power. Significance: After the extensive use of some entropy measures in physiological signals, typical values for their parameters have been suggested, or at least, widely used. However, the parameters are still there, application and dataset dependent, influencing the computed value and affecting the descriptive power. Reducing their significance or eliminating them alleviates the problem, decoupling the method from the data and the application, and eliminating subjective factors.

Automatic segmentation of male pelvic anatomy on computed tomography images: a comparison with multiple observers in the context of a multicentre clinical trial.

PubMed

Geraghty, John P; Grogan, Garry; Ebert, Martin A

2013-04-30

This study investigates the variation in segmentation of several pelvic anatomical structures on computed tomography (CT) between multiple observers and a commercial automatic segmentation method, in the context of quality assurance and evaluation during a multicentre clinical trial. CT scans of two prostate cancer patients ('benchmarking cases'), one high risk (HR) and one intermediate risk (IR), were sent to multiple radiotherapy centres for segmentation of prostate, rectum and bladder structures according to the TROG 03.04 "RADAR" trial protocol definitions. The same structures were automatically segmented using iPlan software for the same two patients, allowing structures defined by automatic segmentation to be quantitatively compared with those defined by multiple observers. A sample of twenty trial patient datasets were also used to automatically generate anatomical structures for quantitative comparison with structures defined by individual observers for the same datasets. There was considerable agreement amongst all observers and automatic segmentation of the benchmarking cases for bladder (mean spatial variations < 0.4 cm across the majority of image slices). Although there was some variation in interpretation of the superior-inferior (cranio-caudal) extent of rectum, human-observer contours were typically within a mean 0.6 cm of automatically-defined contours. Prostate structures were more consistent for the HR case than the IR case with all human observers segmenting a prostate with considerably more volume (mean +113.3%) than that automatically segmented. Similar results were seen across the twenty sample datasets, with disagreement between iPlan and observers dominant at the prostatic apex and superior part of the rectum, which is consistent with observations made during quality assurance reviews during the trial. This study has demonstrated quantitative analysis for comparison of multi-observer segmentation studies. For automatic segmentation algorithms based on image-registration as in iPlan, it is apparent that agreement between observer and automatic segmentation will be a function of patient-specific image characteristics, particularly for anatomy with poor contrast definition. For this reason, it is suggested that automatic registration based on transformation of a single reference dataset adds a significant systematic bias to the resulting volumes and their use in the context of a multicentre trial should be carefully considered.

Biopharming, bananas and bureaucracy: the banana vaccine as a case study for products that straddle the definitional food/drug divide.

PubMed

Birdsall, Margaux

2011-01-01

This paper examines the definition of the terms "food" and "drug" as used in the Food, Drug and Cosmetic Act through the lens of biopharmed products. The paper uses the so-called "banana vaccine" as a case study to highlight the problems that occur when attempting to regulate a product that could be safely used as a food or as a drug. Specifically, the examination of this model illustrates the problems in the current definitional scheme. The paper considers how a product that straddles the definitional line between food and drug could be regulated and proposes a reformation to how the definitions are applied to products to better suit new technology in food and drugs.

Follow-on Low Noise Fan Aerodynamic Study

NASA Technical Reports Server (NTRS)

Heidegger, Nathan J.; Hall, Edward J.; Delaney, Robert A.

1999-01-01

The focus of the project was to investigate the effects of turbulence models on the prediction of rotor wake structures. The Advanced Ducted Propfan Analysis (ADPAC) code was modified through the incorporation of the Spalart-Allmaras one-equation turbulence model. Suitable test cases were solved numerically using ADPAC employing the Spalart-Allmaras turbulence model and another prediction code for comparison. A near-wall spacing study was also completed to determine the adequate spacing of the first computational cell off the wall. Solutions were also collected using two versions of the algebraic Baldwin-Lomax turbulence model in ADPAC. The effects of the turbulence model on the rotor wake definition was examined by obtaining ADPAC solutions for the Low Noise Fan rotor-only steady-flow case using the standard algebraic Baldwin-Lomax turbulence model, a modified version of the Baldwin-Lomax turbulence model and the one-equation Spalart-Allmaras turbulence model. The results from the three different turbulence modeling techniques were compared with each other and the available experimental data. These results include overall rotor performance, spanwise exit profiles, and contours of axial velocity taken along constant axial locations and along blade-to-blade surfaces. Wake characterizations were also performed on the experimental and ADPAC predicted results including the definition of a wake correlation function. Correlations were evaluated for wake width and wake depth. Similarity profiles of the wake shape were also compared between all numerical solutions and experimental data.

Localized primary amyloidosis of the breast: a case report and review of the literature.

PubMed

Tsuji, Wakako; Takeuchi, Eiji; Oka, Satoshi; Yamashita, Taro; Yotsumoto, Fumiaki

2016-09-13

Primary amyloidosis of the breast is an unusual benign disease that mostly occurs in postmenopausal elderly women. Amyloidosis is the deposition of amorphous protein within tissues. Breast biopsy is necessary to make a definite diagnosis in order to avoid unnecessary surgical methods. Localized primary amyloidosis of the breast has a good prognosis. However, secondary amyloidosis is a systemic disease and has a poor prognosis. We report the case of a 77-year-old female with primary amyloidosis of the breast. She noticed a lump in her left breast. Mammographic and ultrasonographic examinations indicated breast cancer. However, core needle biopsy showed amyloidosis, not cancer of the breast. For further examinations, the patient visited the outpatient clinics of the hematology, dermatology, and gastroenterology departments. She underwent bone marrow aspiration, computed tomography, cardiac ultrasonography, random skin biopsy, gastrofiberscopy, and colonofiberscopy. Plasma cell myeloma and systemic amyloidosis were ruled out, and localized breast amyloidosis was highly suspected. Lumpectomy was performed to make a definite diagnosis, and histological evaluations revealed that this patient had localized amyloidosis of the breast, and the deposited amyloid protein was of the amyloid light chain kappa type. Breast biopsy is necessary in order to avoid unnecessary surgical technique. A diagnosis should be achieved only through a histological evaluation. The main treatment of localized primary amyloidosis of the breast is surgical removal.

Defining Usability: How Library Practice Differs from Published Research

ERIC Educational Resources Information Center

Chen, Yu-Hui; Germain, Carol Anne; Rorissa, Abebe

2011-01-01

Library/information science professionals need a clearly articulated definition of usability/Web usability to implement intuitive websites. In this study, the authors analyzed usability definitions provided by the ARL library professionals and those found in the library/information science and computer science-information systems literature.…

31 CFR 29.103 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Definitions. 29.103 Section 29.103 Money and Finance: Treasury Office of the Secretary of the Treasury FEDERAL BENEFIT PAYMENTS UNDER... regulations were properly applied; and/or (2) The mathematical computation of the benefit or liability is...

31 CFR 29.103 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance: Treasury 1 2013-07-01 2013-07-01 false Definitions. 29.103 Section 29.103 Money and Finance: Treasury Office of the Secretary of the Treasury FEDERAL BENEFIT PAYMENTS UNDER... regulations were properly applied; and/or (2) The mathematical computation of the benefit or liability is...

31 CFR 29.103 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance: Treasury 1 2011-07-01 2011-07-01 false Definitions. 29.103 Section 29.103 Money and Finance: Treasury Office of the Secretary of the Treasury FEDERAL BENEFIT PAYMENTS UNDER... regulations were properly applied; and/or (2) The mathematical computation of the benefit or liability is...

31 CFR 29.103 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance: Treasury 1 2014-07-01 2014-07-01 false Definitions. 29.103 Section 29.103 Money and Finance: Treasury Office of the Secretary of the Treasury FEDERAL BENEFIT PAYMENTS UNDER... regulations were properly applied; and/or (2) The mathematical computation of the benefit or liability is...