[Role and management of cancer clinical database in the application of gastric cancer precision medicine].

PubMed

Li, Yuanfang; Zhou, Zhiwei

2016-02-01

Precision medicine is a new medical concept and medical model, which is based on personalized medicine, rapid progress of genome sequencing technology and cross application of biological information and big data science. Precision medicine improves the diagnosis and treatment of gastric cancer to provide more convenience through more profound analyses of characteristics, pathogenesis and other core issues in gastric cancer. Cancer clinical database is important to promote the development of precision medicine. Therefore, it is necessary to pay close attention to the construction and management of the database. The clinical database of Sun Yat-sen University Cancer Center is composed of medical record database, blood specimen bank, tissue bank and medical imaging database. In order to ensure the good quality of the database, the design and management of the database should follow the strict standard operation procedure(SOP) model. Data sharing is an important way to improve medical research in the era of medical big data. The construction and management of clinical database must also be strengthened and innovated.

Guidelines for Teaching Cross-Cultural Clinical Ethics: Critiquing Ideology and Confronting Power in the Service of a Principles-Based Pedagogy.

PubMed

Brunger, Fern

2016-03-01

This paper presents a pedagogical framework for teaching cross-cultural clinical ethics. The approach, offered at the intersection of anthropology and bioethics, is innovative in that it takes on the "social sciences versus bioethics" debate that has been ongoing in North America for three decades. The argument is made that this debate is flawed on both sides and, moreover, that the application of cross-cultural thinking to clinical ethics requires using the tools of the social sciences (such as the critique of the universality of the Euro-American construct of "autonomy") within (rather than in opposition to) a principles-based framework for clinical ethics. This paper introduces the curriculum and provides guidelines for how to teach cross-cultural clinical ethics. The learning points that are introduced emphasize culture in its relation to power and underscore the importance of viewing both biomedicine and bioethics as culturally constructed.

Transplantation of Bioprinted Tissues and Organs: Technical and Clinical Challenges and Future Perspectives.

PubMed

Ravnic, Dino J; Leberfinger, Ashley N; Koduru, Srinivas V; Hospodiuk, Monika; Moncal, Kazim K; Datta, Pallab; Dey, Madhuri; Rizk, Elias; Ozbolat, Ibrahim T

2017-07-01

: Three-dimensional (3D) bioprinting is a revolutionary technology in building living tissues and organs with precise anatomic control and cellular composition. Despite the great progress in bioprinting research, there has yet to be any clinical translation due to current limitations in building human-scale constructs, which are vascularized and readily implantable. In this article, we review the current limitations and challenges in 3D bioprinting, including in situ techniques, which are one of several clinical translational models to facilitate the application of this technology from bench to bedside. A detailed discussion is made on the technical barriers in the fabrication of scalable constructs that are vascularized, autologous, functional, implantable, cost-effective, and ethically feasible. Clinical considerations for implantable bioprinted tissues are further expounded toward the correction of end-stage organ dysfunction and composite tissue deficits.

[Up-to-date methods of cell therapy in treatment of burns].

PubMed

Smirnov, S V; Kiselev, I V; Vasil'ev, A V; Terskikh, V V

2003-01-01

Complex of methods for repair of wounded and burned skin with transplantation of keratinocytes and fibroblasts grown in vitro is proposed. Five different tissue constructions may be used. Original method of skin recovery based on use of alive equivalent of skin is developed. Results of its clinical application are presented. It is concluded that cell constructions may be used in combined treatment of wounds and burns.

Tissue Engineered Constructs: Perspectives on Clinical Translation

PubMed Central

Lu, Lichun; Arbit, Harvey M.; Herrick, James L.; Segovis, Suzanne Glass; Maran, Avudaiappan; Yaszemski, Michael J.

2015-01-01

In this article, a “bedside to bench and back” approach for developing tissue engineered medical products (TEMPs) for clinical applications is reviewed. The driving force behind this approach is unmet clinical needs. Preclinical research, both in vitro and in vivo using small and large animal models, will help find solutions to key research questions. In clinical research, ethical issues regarding the use of cells and tissues, their sources, donor consent, as well as clinical trials are important considerations. Regulatory issues, at both institutional and government levels, must be addressed prior to the translation of TEMPs to clinical practice. TEMPs are regulated as drugs, biologics, devices, or combination products by the US Food and Drug Administration (FDA). Depending on the mode of regulation, applications for TEMP introduction must be filed with the FDA to demonstrate safety and effectiveness in premarket clinical studies, followed by 510(k) premarket clearance or premarket approval (for medical devices), biologics license application approval (for biologics), or New Drug Application approval (for drugs). A case study on nerve cuffs is presented to illustrate the regulatory process. Finally, perspectives on commercialization such as finding a company partner and funding issues, as well as physician culture change, are presented. PMID:25711151

Tissue engineered constructs: perspectives on clinical translation.

PubMed

Lu, Lichun; Arbit, Harvey M; Herrick, James L; Segovis, Suzanne Glass; Maran, Avudaiappan; Yaszemski, Michael J

2015-03-01

In this article, a "bedside to bench and back" approach for developing tissue engineered medical products (TEMPs) for clinical applications is reviewed. The driving force behind this approach is unmet clinical needs. Preclinical research, both in vitro and in vivo using small and large animal models, will help find solutions to key research questions. In clinical research, ethical issues regarding the use of cells and tissues, their sources, donor consent, as well as clinical trials are important considerations. Regulatory issues, at both institutional and government levels, must be addressed prior to the translation of TEMPs to clinical practice. TEMPs are regulated as drugs, biologics, devices, or combination products by the U.S. Food and Drug Administration (FDA). Depending on the mode of regulation, applications for TEMP introduction must be filed with the FDA to demonstrate safety and effectiveness in premarket clinical studies, followed by 510(k) premarket clearance or premarket approval (for medical devices), biologics license application approval (for biologics), or new drug application approval (for drugs). A case study on nerve cuffs is presented to illustrate the regulatory process. Finally, perspectives on commercialization such as finding a company partner and funding issues, as well as physician culture change, are presented.

Ideal discrimination of discrete clinical endpoints using multilocus genotypes.

PubMed

Hahn, Lance W; Moore, Jason H

2004-01-01

Multifactor Dimensionality Reduction (MDR) is a method for the classification and prediction of discrete clinical endpoints using attributes constructed from multilocus genotype data. Empirical studies with both real and simulated data suggest that MDR has good power for detecting gene-gene interactions in the absence of independent main effects. The purpose of this study is to develop an objective, theory-driven approach to evaluate the strengths and limitations of MDR. To accomplish this goal, we borrow concepts from ideal observer analysis used in visual perception to evaluate the theoretical limits of classifying and predicting discrete clinical endpoints using multilocus genotype data. We conclude that MDR ideally discriminates between low risk and high risk subjects using attributes constructed from multilocus genotype data. We also how that the classification approach used once a multilocus attribute is constructed is similar to that of a naive Bayes classifier. This study provides a theoretical foundation for the continued development, evaluation, and application of the MDR as a data mining tool in the domain of statistical genetics and genetic epidemiology.

A construct-network approach to bridging diagnostic and physiological domains: application to assessment of externalizing psychopathology.

PubMed

Patrick, Christopher J; Venables, Noah C; Yancey, James R; Hicks, Brian M; Nelson, Lindsay D; Kramer, Mark D

2013-08-01

A crucial challenge in efforts to link psychological disorders to neural systems, with the aim of developing biologically informed conceptions of such disorders, is the problem of method variance (Campbell & Fiske, 1959). Since even measures of the same construct in differing domains correlate only moderately, it is unsurprising that large sample studies of diagnostic biomarkers yield only modest associations. To address this challenge, a construct-network approach is proposed in which psychometric operationalizations of key neurobehavioral constructs serve as anchors for identifying neural indicators of psychopathology-relevant dispositions, and as vehicles for bridging between domains of clinical problems and neurophysiology. An empirical illustration is provided for the construct of inhibition-disinhibition, which is of central relevance to problems entailing deficient impulse control. Findings demonstrate that: (1) a well-designed psychometric index of trait disinhibition effectively predicts externalizing problems of multiple types, (2) this psychometric measure of disinhibition shows reliable brain response correlates, and (3) psychometric and brain-response indicators can be combined to form a joint psychoneurometric factor that predicts effectively across clinical and physiological domains. As a methodology for bridging between clinical problems and neural systems, the construct-network approach provides a concrete means by which existing conceptions of psychological disorders can accommodate and be reshaped by neurobiological insights. PsycINFO Database Record (c) 2013 APA, all rights reserved.

A 3D bioprinting system to produce human-scale tissue constructs with structural integrity.

PubMed

Kang, Hyun-Wook; Lee, Sang Jin; Ko, In Kap; Kengla, Carlos; Yoo, James J; Atala, Anthony

2016-03-01

A challenge for tissue engineering is producing three-dimensional (3D), vascularized cellular constructs of clinically relevant size, shape and structural integrity. We present an integrated tissue-organ printer (ITOP) that can fabricate stable, human-scale tissue constructs of any shape. Mechanical stability is achieved by printing cell-laden hydrogels together with biodegradable polymers in integrated patterns and anchored on sacrificial hydrogels. The correct shape of the tissue construct is achieved by representing clinical imaging data as a computer model of the anatomical defect and translating the model into a program that controls the motions of the printer nozzles, which dispense cells to discrete locations. The incorporation of microchannels into the tissue constructs facilitates diffusion of nutrients to printed cells, thereby overcoming the diffusion limit of 100-200 μm for cell survival in engineered tissues. We demonstrate capabilities of the ITOP by fabricating mandible and calvarial bone, cartilage and skeletal muscle. Future development of the ITOP is being directed to the production of tissues for human applications and to the building of more complex tissues and solid organs.

Integrating statistical and clinical research elements in intervention-related grant applications: summary from an NIMH workshop.

PubMed

Sherrill, Joel T; Sommers, David I; Nierenberg, Andrew A; Leon, Andrew C; Arndt, Stephan; Bandeen-Roche, Karen; Greenhouse, Joel; Guthrie, Donald; Normand, Sharon-Lise; Phillips, Katharine A; Shear, M Katherine; Woolson, Robert

2009-01-01

The authors summarize points for consideration generated in a National Institute of Mental Health (NIMH) workshop convened to provide an opportunity for reviewers from different disciplines-specifically clinical researchers and statisticians-to discuss how their differing and complementary expertise can be well integrated in the review of intervention-related grant applications. A 1-day workshop was convened in October, 2004. The workshop featured panel presentations on key topics followed by interactive discussion. This article summarizes the workshop and subsequent discussions, which centered on topics including weighting the statistics/data analysis elements of an application in the assessment of the application's overall merit; the level of statistical sophistication appropriate to different stages of research and for different funding mechanisms; some key considerations in the design and analysis portions of applications; appropriate statistical methods for addressing essential questions posed by an application; and the role of the statistician in the application's development, study conduct, and interpretation and dissemination of results. A number of key elements crucial to the construction and review of grant applications were identified. It was acknowledged that intervention-related studies unavoidably involve trade-offs. Reviewers are helped when applications acknowledge such trade-offs and provide good rationale for their choices. Clear linkage among the design, aims, hypotheses, and data analysis plan and avoidance of disconnections among these elements also strengthens applications. The authors identify multiple points to consider when constructing intervention-related grant applications. The points are presented here as questions and do not reflect institute policy or comprise a list of best practices, but rather represent points for consideration.

Construction of databases: advances and significance in clinical research.

PubMed

Long, Erping; Huang, Bingjie; Wang, Liming; Lin, Xiaoyu; Lin, Haotian

2015-12-01

Widely used in clinical research, the database is a new type of data management automation technology and the most efficient tool for data management. In this article, we first explain some basic concepts, such as the definition, classification, and establishment of databases. Afterward, the workflow for establishing databases, inputting data, verifying data, and managing databases is presented. Meanwhile, by discussing the application of databases in clinical research, we illuminate the important role of databases in clinical research practice. Lastly, we introduce the reanalysis of randomized controlled trials (RCTs) and cloud computing techniques, showing the most recent advancements of databases in clinical research.

Deriving the expected utility of a predictive model when the utilities are uncertain.

PubMed

Cooper, Gregory F; Visweswaran, Shyam

2005-01-01

Predictive models are often constructed from clinical databases with the goal of eventually helping make better clinical decisions. Evaluating models using decision theory is therefore natural. When constructing a model using statistical and machine learning methods, however, we are often uncertain about precisely how the model will be used. Thus, decision-independent measures of classification performance, such as the area under an ROC curve, are popular. As a complementary method of evaluation, we investigate techniques for deriving the expected utility of a model under uncertainty about the model's utilities. We demonstrate an example of the application of this approach to the evaluation of two models that diagnose coronary artery disease.

A hospital-wide clinical findings dictionary based on an extension of the International Classification of Diseases (ICD).

PubMed

Bréant, C; Borst, F; Campi, D; Griesser, V; Momjian, S

1999-01-01

The use of a controlled vocabulary set in a hospital-wide clinical information system is of crucial importance for many departmental database systems to communicate and exchange information. In the absence of an internationally recognized clinical controlled vocabulary set, a new extension of the International statistical Classification of Diseases (ICD) is proposed. It expands the scope of the standard ICD beyond diagnosis and procedures to clinical terminology. In addition, the common Clinical Findings Dictionary (CFD) further records the definition of clinical entities. The construction of the vocabulary set and the CFD is incremental and manual. Tools have been implemented to facilitate the tasks of defining/maintaining/publishing dictionary versions. The design of database applications in the integrated clinical information system is driven by the CFD which is part of the Medical Questionnaire Designer tool. Several integrated clinical database applications in the field of diabetes and neuro-surgery have been developed at the HUG.

A hospital-wide clinical findings dictionary based on an extension of the International Classification of Diseases (ICD).

PubMed Central

Bréant, C.; Borst, F.; Campi, D.; Griesser, V.; Momjian, S.

1999-01-01

The use of a controlled vocabulary set in a hospital-wide clinical information system is of crucial importance for many departmental database systems to communicate and exchange information. In the absence of an internationally recognized clinical controlled vocabulary set, a new extension of the International statistical Classification of Diseases (ICD) is proposed. It expands the scope of the standard ICD beyond diagnosis and procedures to clinical terminology. In addition, the common Clinical Findings Dictionary (CFD) further records the definition of clinical entities. The construction of the vocabulary set and the CFD is incremental and manual. Tools have been implemented to facilitate the tasks of defining/maintaining/publishing dictionary versions. The design of database applications in the integrated clinical information system is driven by the CFD which is part of the Medical Questionnaire Designer tool. Several integrated clinical database applications in the field of diabetes and neuro-surgery have been developed at the HUG. Images Figure 1 PMID:10566451

An exploration of the biomedical optics course construction of undergraduate biomedical engineering program in medical colleges

NASA Astrophysics Data System (ADS)

Guo, Shijun; Lyu, Jie; Zhang, Peiming

2017-08-01

In this paper, the teaching goals, teaching contents and teaching methods in biomedical optics course construction are discussed. From the dimension of teaching goals, students should master the principle of optical inspection on the human body, diagnosis and treatment of methodology and instruments, through the study of the theory and practice of this course, and can utilize biomedical optics methods to solve practical problems in the clinical medical engineering practice. From the dimension of teaching contents, based on the characteristics of biomedical engineering in medical colleges, the organic integration of engineering aspects, medical optical instruments, and biomedical aspects dispersed in human anatomy, human physiology, clinical medicine fundamental related to the biomedical optics is build. Noninvasive measurement of the human body composition and noninvasive optical imaging of the human body were taken as actual problems in biomedical optics fields. Typical medical applications such as eye optics and laser medicine were also integrated into the theory and practice teaching. From the dimension of teaching methods, referencing to organ-system based medical teaching mode, optical principle and instrument principle were taught by teachers from school of medical instruments, and the histological characteristics and clinical actual need in areas such as digestive diseases and urinary surgery were taught by teachers from school of basic medicine or clinical medicine of medical colleges. Furthermore, clinical application guidance would be provided by physician and surgeons in hospitals.

Actinium-225 in targeted alpha-particle therapeutic applications

PubMed Central

Scheinberg, David A.; McDevit, Michael R.

2017-01-01

Alpha particle-emitting isotopes are being investigated in radioimmunotherapeutic applications because of their unparalleled cytotoxicity when targeted to cancer and their relative lack of toxicity towards untargeted normal tissue. Actinium-225 has been developed into potent targeting drug constructs and is in clinical use against acute myelogenous leukemia. The key properties of the alpha particles generated by 225Ac are the following: i) limited range in tissue of a few cell diameters; ii) high linear energy transfer leading to dense radiation damage along each alpha track; iii) a 10 day half-life; and iv) four net alpha particles emitted per decay. Targeting 225Ac-drug constructs have potential in the treatment of cancer. PMID:22202153

The Role of Platelet Rich Plasma (PRP) and Other Biologics for Rotator Cuff Repair.

PubMed

Greenspoon, Joshua A; Moulton, Samuel G; Millett, Peter J; Petri, Maximilian

2016-01-01

Surgical treatment of rotator cuff tears has consistently demonstrated good clinical and functional outcomes. However, in some cases, the rotator cuff fails to heal. While improvements in rotator cuff constructs and biomechanics have been made, the role of biologics to aid healing is currently being investigated. A selective literature search was performed and personal surgical experiences are reported. Biologic augmentation of rotator cuff repairs can for example be performed wtableith platelet-rich plasma (PRP) and mesenchymal stem cells (MSCs). Clinical results on PRP application have been controversial. Application of MSCs has shown promise in animal studies, but clinical data on its effectiveness is presently lacking. The role of Matrix Metalloproteinase (MMP) inhibitors is another interesting field for potential targeted drug therapy after rotator cuff repair. Large randomized clinical studies need to confirm the benefit of these approaches, in order to eventually lower retear rates and improve clinical outcomes after rotator cuff repair.

A MEMS-based super fast dew point hygrometer—construction and medical applications

NASA Astrophysics Data System (ADS)

Jachowicz, Ryszard S.; Weremczuk, Jerzy; Paczesny, Daniel; Tarapata, Grzegorz

2009-12-01

The paper shows how MEMS (micro-electro-mechanical system) technology and a modified principle of fast temperature control (by heat injection instead of careful control of cooling) can considerably improve the dynamic parameters of dew point hygrometers. Some aspects of MEMS-type integrated sensor construction and technology, whole measurement system design, the control algorithm to run the system as well as empirical dynamic parameters from the tests are discussed too. The hygrometer can easily obtain five to six measurements per second with an uncertainty of less than 0.3 K. The meter range is between -10 °C and 40 °C dew point. In the second part of the paper (section 2), two different successful applications in medicine based on fast humidity measurements have been discussed. Some specific constructions of these super fast dew point hygrometers based on a MEMS sensor as well as limited empirical results from clinical tests have been reported too.

Discovering Related Clinical Concepts Using Large Amounts of Clinical Notes

PubMed Central

Ganesan, Kavita; Lloyd, Shane; Sarkar, Vikren

2016-01-01

The ability to find highly related clinical concepts is essential for many applications such as for hypothesis generation, query expansion for medical literature search, search results filtering, ICD-10 code filtering and many other applications. While manually constructed medical terminologies such as SNOMED CT can surface certain related concepts, these terminologies are inadequate as they depend on expertise of several subject matter experts making the terminology curation process open to geographic and language bias. In addition, these terminologies also provide no quantifiable evidence on how related the concepts are. In this work, we explore an unsupervised graphical approach to mine related concepts by leveraging the volume within large amounts of clinical notes. Our evaluation shows that we are able to use a data driven approach to discovering highly related concepts for various search terms including medications, symptoms and diseases. PMID:27656096

Human fibroblast-derived extracellular matrix constructs for bone tissue engineering applications.

PubMed

Tour, Gregory; Wendel, Mikael; Tcacencu, Ion

2013-10-01

We exploited the biomimetic approach to generate constructs composed of synthetic biphasic calcium phosphate ceramic and extracellular matrix (SBC-ECM) derived from adult human dermal fibroblasts in complete xeno-free culture conditions. The construct morphology and composition were assessed by scanning electron microscopy, histology, immunohistochemistry, Western blot, glycosaminoglycan, and hydroxyproline assays. Residual DNA quantification, endotoxin testing, and local inflammatory response after implantation in a rat critical-sized calvarial defect were used to access the construct biocompatibility. Moreover, in vitro interaction of human mesenchymal stem cells (hMSCs) with the constructs was studied. The bone marrow- and adipose tissue-derived mesenchymal stem cells were characterized by flow cytometry and tested for osteogenic differentiation capacity prior seeding onto SBC-ECM, followed by alkaline phosphatase, 3-(4,5-dimethythiazol-2-yl)-2,5-diphenyl tetrazolium bromide assay, and real-time quantitative polymerase chain reaction to assess the osteogenic differentiation of hMSCs after seeding onto the constructs at different time intervals. The SBC-ECM constructs enhanced osteogenic differentiation of hMSCs in vitro and exhibited excellent handling properties and high biocompatibility in vivo. Our results highlight the ability to generate in vitro fibroblast-derived ECM constructs in complete xeno-free conditions as a step toward clinical translation, and the potential use of SBC-ECM in craniofacial bone tissue engineering applications. Copyright © 2013 Wiley Periodicals, Inc., a Wiley Company.

A model for translating ethnography and theory into culturally constructed clinical practices.

PubMed

Nastasi, Bonnie Kaul; Schensul, Jean J; Schensul, Stephen L; Mekki-Berrada, Abelwahed; Pelto, Pertti J; Maitra, Shubhada; Verma, Ravi; Saggurti, Niranjan

2015-03-01

This article describes the development of a dynamic culturally constructed clinical practice model for HIV/STI prevention, the Narrative Intervention Model (NIM), and illustrates its application in practice, within the context of a 6-year transdisciplinary research program in Mumbai, India. Theory and research from anthropology, psychology, and public health, and mixed-method ethnographic research with practitioners, patients, and community members, contributed to the articulation of the NIM for HIV/STI risk reduction and prevention among married men living in low-income communities. The NIM involves a process of negotiation of patient narratives regarding their sexual health problems and related risk factors to facilitate risk reduction. The goal of the NIM is to facilitate cognitive-behavioral change through a three-stage process of co-construction (eliciting patient narrative), deconstruction (articulating discrepancies between current and desired narrative), and reconstruction (proposing alternative narratives that facilitate risk reduction). The NIM process extends the traditional clinical approach through the integration of biological, psychological, interpersonal, and cultural factors as depicted in the patient narrative. Our work demonstrates the use of a recursive integration of research and practice to address limitations of current evidence-based intervention approaches that fail to address the diversity of cultural constructions across populations and contexts.

A Model for Translating Ethnography and Theory into Culturally Constructed Clinical Practices

PubMed Central

Schensul, Jean J.; Schensul, Stephen L.; Mekki-Berrada, Abelwahed; Pelto, Pertti J.; Maitra, Shubhada; Verma, Ravi; Saggurti, Niranjan

2015-01-01

This article describes the development of a dynamic culturally constructed clinical practice model for HIV/STI prevention, the Narrative Intervention Model (NIM), and illustrates its application in practice, within the context of a 6-year transdisciplinary research program in Mumbai, India. Theory and research from anthropology, psychology, and public health, and mixed-method ethnographic research with practitioners, patients, and community members, contributed to the articulation of the NIM for HIV/STI risk reduction and prevention among married men living in low-income communities. The NIM involves a process of negotiation of patient narratives regarding their sexual health problems and related risk factors to facilitate risk reduction. The goal of the NIM is to facilitate cognitive-behavioral change through a three-stage process of co-construction (eliciting patient narrative), deconstruction (articulating discrepancies between current and desired narrative), and reconstruction (proposing alternative narratives that facilitate risk reduction). The NIM process extends the traditional clinical approach through the integration of biological, psychological, interpersonal, and cultural factors as depicted in the patient narrative. Our work demonstrates the use of a recursive integration of research and practice to address limitations of current evidence-based intervention approaches that fail to address the diversity of cultural constructions across populations and contexts. PMID:25292448

[Construction of platform on the three-dimensional finite element model of the dentulous mandibular body of a normal person].

PubMed

Gong, Lu-Lu; Zhu, Jing; Ding, Zu-Quan; Li, Guo-Qiang; Wang, Li-Ming; Yan, Bo-Yong

2008-04-01

To develop a method to construct a three-dimensional finite element model of the dentulous mandibular body of a normal person. A series of pictures with the interval of 0.1 mm were taken by CT scanning. After extracting the coordinates of key points of some pictures by the procedure, we used a C program to process the useful data, and constructed a platform of the three-dimensional finite element model of the dentulous mandibular body with the Ansys software for finite element analysis. The experimental results showed that the platform of the three-dimensional finite element model of the dentulous mandibular body was more accurate and applicable. The exact three-dimensional shape of model was well constructed, and each part of this model, such as one single tooth, can be deleted, which can be used to emulate various tooth-loss clinical cases. The three-dimensional finite element model is constructed with life-like shapes of dental cusps. Each part of this model can be easily removed. In conclusion, this experiment provides a good platform of biomechanical analysis on various tooth-loss clinical cases.

Imaging Strategies for Tissue Engineering Applications

PubMed Central

Nam, Seung Yun; Ricles, Laura M.; Suggs, Laura J.

2015-01-01

Tissue engineering has evolved with multifaceted research being conducted using advanced technologies, and it is progressing toward clinical applications. As tissue engineering technology significantly advances, it proceeds toward increasing sophistication, including nanoscale strategies for material construction and synergetic methods for combining with cells, growth factors, or other macromolecules. Therefore, to assess advanced tissue-engineered constructs, tissue engineers need versatile imaging methods capable of monitoring not only morphological but also functional and molecular information. However, there is no single imaging modality that is suitable for all tissue-engineered constructs. Each imaging method has its own range of applications and provides information based on the specific properties of the imaging technique. Therefore, according to the requirements of the tissue engineering studies, the most appropriate tool should be selected among a variety of imaging modalities. The goal of this review article is to describe available biomedical imaging methods to assess tissue engineering applications and to provide tissue engineers with criteria and insights for determining the best imaging strategies. Commonly used biomedical imaging modalities, including X-ray and computed tomography, positron emission tomography and single photon emission computed tomography, magnetic resonance imaging, ultrasound imaging, optical imaging, and emerging techniques and multimodal imaging, will be discussed, focusing on the latest trends of their applications in recent tissue engineering studies. PMID:25012069

Multimodal nanoparticle imaging agents: design and applications

NASA Astrophysics Data System (ADS)

Burke, Benjamin P.; Cawthorne, Christopher; Archibald, Stephen J.

2017-10-01

Molecular imaging, where the location of molecules or nanoscale constructs can be tracked in the body to report on disease or biochemical processes, is rapidly expanding to include combined modality or multimodal imaging. No single imaging technique can offer the optimum combination of properties (e.g. resolution, sensitivity, cost, availability). The rapid technological advances in hardware to scan patients, and software to process and fuse images, are pushing the boundaries of novel medical imaging approaches, and hand-in-hand with this is the requirement for advanced and specific multimodal imaging agents. These agents can be detected using a selection from radioisotope, magnetic resonance and optical imaging, among others. Nanoparticles offer great scope in this area as they lend themselves, via facile modification procedures, to act as multifunctional constructs. They have relevance as therapeutics and drug delivery agents that can be tracked by molecular imaging techniques with the particular development of applications in optically guided surgery and as radiosensitizers. There has been a huge amount of research work to produce nanoconstructs for imaging, and the parameters for successful clinical translation and validation of therapeutic applications are now becoming much better understood. It is an exciting time of progress for these agents as their potential is closer to being realized with translation into the clinic. The coming 5-10 years will be critical, as we will see if the predicted improvement in clinical outcomes becomes a reality. Some of the latest advances in combination modality agents are selected and the progression pathway to clinical trials analysed. This article is part of the themed issue 'Challenges for chemistry in molecular imaging'.

Application of technology to social communication impairment in childhood and adolescence.

PubMed

Wieckowski, Andrea Trubanova; White, Susan W

2017-03-01

Social communication impairment has been implicated in various mental health disorders. The primary aim of this review paper is to summarize the extant research on the development and application of technologies to address social communication deficits, conceptualized according to the four constructs outlined by the NIMH's Research Domain Criteria (RDoC), transdiagnostically in children and adolescents. An exhaustive and systematic search yielded 69 peer-reviewed articles meeting all inclusion criteria (i.e., used technology, applied the technology to target impairment in at least one of four constructs of social communication, included a child or adolescent samples). We found limited use of technology for exploration of impairment in reception of non-facial communication, compared to the other social communication constructs. In addition, there has been an overwhelming focus on social communication impairment in children and adolescents with Autism Spectrum Disorder (ASD), with relatively few studies evaluating technology application in other clinical populations. Implications for future directions for technological interventions to treat social communication impairments transdiagnostically are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Construction Strategy for an Internal Amplification Control for Real-Time Diagnostic Assays Using Nucleic Acid Sequence-Based Amplification: Development and Clinical Application

PubMed Central

Rodríguez-Lázaro, David; D'Agostino, Martin; Pla, Maria; Cook, Nigel

2004-01-01

An important analytical control in molecular amplification-based methods is an internal amplification control (IAC), which should be included in each reaction mixture. An IAC is a nontarget nucleic acid sequence which is coamplified simultaneously with the target sequence. With negative results for the target nucleic acid, the absence of an IAC signal indicates that amplification has failed. A general strategy for the construction of an IAC for inclusion in molecular beacon-based real-time nucleic acid sequence-based amplification (NASBA) assays is presented. Construction proceeds in two phases. In the first phase, a double-stranded DNA molecule that contains nontarget sequences flanked by target sequences complementary to the NASBA primers is produced. At the 5′ end of this DNA molecule is a T7 RNA polymerase binding sequence. In the second phase of construction, RNA transcripts are produced from the DNA by T7 RNA polymerase. This RNA is the IAC; it is amplified by the target NASBA primers and is detected by a molecular beacon probe complementary to the internal nontarget sequences. As a practical example, an IAC for use in an assay for the detection of Mycobacterium avium subsp. paratuberculosis is described, its incorporation and optimization within the assay are detailed, and its application to spiked and natural clinical samples is shown to illustrate the correct interpretation of the diagnostic results. PMID:15583319

Warning Signs for Suicide: Theory, Research, and Clinical Applications

ERIC Educational Resources Information Center

Rudd, M. David; Berman, Alan L.; Joiner, Thomas E., Jr.; Nock, Matthew K.; Silverman, Morton M.; Mandrusiak, Michael; Van Orden, Kimberly; Witte, Tracy

2006-01-01

The current article addresses the issue of warning signs for suicide, attempting to differentiate the construct from risk factors. In accordance with the characteristic features discussed, a consensus set of warning signs identified by the American Association of Suicidology working group are presented, along with a discussion of relevant clinical…

Nanotechnology-based Cryopreservation of Cell-Scaffold Constructs: A New Breakthrough to Clinical Application.

PubMed

Chen, G; Lv, Y

The developments of "off-the-shelf" cell-scaffold constructs received an increasing interest in tissue engineering and regenerative medicine. Although the direct cryopreservation of a single-cell suspension in the tube is a relative mature technology, the cryopreservation of cell-scaffold constructs remains a challenge. Nanotechnology shows tremendous potential for cryopreservation in regulating of freezing and thawing processes. For example, nanoparticles have been reported to modify the cryoprotective agent (CPA), adjust the process of cooling and warming cycles. In this review, we provide an overview of cryopreservation of cell-scaffold constructs firstly. The review further focuses on the effects of nanotechnology on cryopreservation of cell-scaffold constructs, including the nanostructure of scaffold, nanoparticles in cooling and warming process in cryopreservation. The perspectives on future challenges in this filed are also pointed out.

Symptom Dimensions of the Psychotic Symptom Rating Scales in Psychosis: A Multisite Study

PubMed Central

Woodward, Todd S.; Jung, Kwanghee; Hwang, Heungsun; Yin, John; Taylor, Laura; Menon, Mahesh; Peters, Emmanuelle; Kuipers, Elizabeth; Waters, Flavie; Lecomte, Tania; Sommer, Iris E.; Daalman, Kirstin; van Lutterveld, Remko; Hubl, Daniela; Kindler, Jochen; Homan, Philipp; Badcock, Johanna C.; Chhabra, Saruchi; Cella, Matteo; Keedy, Sarah; Allen, Paul; Mechelli, Andrea; Preti, Antonio; Siddi, Sara; Erickson, David

2014-01-01

The Psychotic Symptom Rating Scales (PSYRATS) is an instrument designed to quantify the severity of delusions and hallucinations and is typically used in research studies and clinical settings focusing on people with psychosis and schizophrenia. It is comprised of the auditory hallucinations (AHS) and delusions subscales (DS), but these subscales do not necessarily reflect the psychological constructs causing intercorrelation between clusters of scale items. Identification of these constructs is important in some clinical and research contexts because item clustering may be caused by underlying etiological processes of interest. Previous attempts to identify these constructs have produced conflicting results. In this study, we compiled PSYRATS data from 12 sites in 7 countries, comprising 711 participants for AHS and 520 for DS. We compared previously proposed and novel models of underlying constructs using structural equation modeling. For the AHS, a novel 4-dimensional model provided the best fit, with latent variables labeled Distress (negative content, distress, and control), Frequency (frequency, duration, and disruption), Attribution (location and origin of voices), and Loudness (loudness item only). For the DS, a 2-dimensional solution was confirmed, with latent variables labeled Distress (amount/intensity) and Frequency (preoccupation, conviction, and disruption). The within-AHS and within-DS dimension intercorrelations were higher than those between subscales, with the exception of the AHS and DS Distress dimensions, which produced a correlation that approached the range of the within-scale correlations. Recommendations are provided for integrating these underlying constructs into research and clinical applications of the PSYRATS. PMID:24936086

Just tell me what you want!: the promise and perils of rapid prototyping with the World Wide Web.

PubMed

Cimino, J J; Socratous, S A

1996-01-01

Construction of applications using the World Wide Web architecture and Hypertext Markup Language (HTML) documents is relatively simple. We are exploring this approach with an application, called PolyMed now in use by surgical residents for one year. We monitored use and obtained user feedback to develop new features and eliminate undesirable ones. The system has been used to keep track of over 4,200 patients. We predicted, several advantages and disadvantages to this approach to prototyping clinical applications. Our experience confirms some advantages (ease of development and customization, ability to exploit non-Web system components, and simplified user interface design) and disadvantages (lack of database management services). Some predicted disadvantages failed to materialize (difficulty modeling a clinical application with hypertext and inconveniences associated with the "connectionless" nature of the Web). We were disappointed to find that while integration of external Web applications (such as Medline) into our application was easy, our users did not find it useful.

Just tell me what you want!: the promise and perils of rapid prototyping with the World Wide Web.

PubMed Central

Cimino, J. J.; Socratous, S. A.

1996-01-01

Construction of applications using the World Wide Web architecture and Hypertext Markup Language (HTML) documents is relatively simple. We are exploring this approach with an application, called PolyMed now in use by surgical residents for one year. We monitored use and obtained user feedback to develop new features and eliminate undesirable ones. The system has been used to keep track of over 4,200 patients. We predicted, several advantages and disadvantages to this approach to prototyping clinical applications. Our experience confirms some advantages (ease of development and customization, ability to exploit non-Web system components, and simplified user interface design) and disadvantages (lack of database management services). Some predicted disadvantages failed to materialize (difficulty modeling a clinical application with hypertext and inconveniences associated with the "connectionless" nature of the Web). We were disappointed to find that while integration of external Web applications (such as Medline) into our application was easy, our users did not find it useful. PMID:8947759

Bringing DNA vaccines closer to commercial use.

PubMed

Carvalho, Joana A; Prazeres, Duarte M F; Monteiro, Gabriel A

2009-10-01

Progress in the application of DNA vaccines as an immunization protocol is evident from the increasing number of such vaccines under evaluation in clinical trials and by the recent approval of several DNA vaccine products for veterinary applications. DNA vaccine technology offers important therapeutic and commercial advantages compared with conventional approaches, including the opportunity to target pathogens characterized by significant genetic diversity using a safe immunization platform, and the ability to use a simple, rapid and well-characterized production method. However, further optimization of DNA vaccine technology through the use of improved constructs, delivery systems and immunization protocols is necessary to clinically achieve the promising results that have been demonstrated in preclinical models.

Applications of magnetic resonance image segmentation in neurology

NASA Astrophysics Data System (ADS)

Heinonen, Tomi; Lahtinen, Antti J.; Dastidar, Prasun; Ryymin, Pertti; Laarne, Paeivi; Malmivuo, Jaakko; Laasonen, Erkki; Frey, Harry; Eskola, Hannu

1999-05-01

After the introduction of digital imagin devices in medicine computerized tissue recognition and classification have become important in research and clinical applications. Segmented data can be applied among numerous research fields including volumetric analysis of particular tissues and structures, construction of anatomical modes, 3D visualization, and multimodal visualization, hence making segmentation essential in modern image analysis. In this research project several PC based software were developed in order to segment medical images, to visualize raw and segmented images in 3D, and to produce EEG brain maps in which MR images and EEG signals were integrated. The software package was tested and validated in numerous clinical research projects in hospital environment.

Biothermal Model of Patient for Brain Hypothermia Treatment

NASA Astrophysics Data System (ADS)

Wakamatsu, Hidetoshi; Gaohua, Lu

A biothermal model of patient is proposed and verified for the brain hypothermia treatment, since the conventionally applied biothermal models are inappropriate for their unprecedented application. The model is constructed on the basis of the clinical practice of the pertinent therapy and characterized by the mathematical relation with variable ambient temperatures, in consideration of the clinical treatments such as the vital cardiopulmonary regulation. It has geometrically clear representation of multi-segmental core-shell structure, database of physiological and physical parameters with a systemic state equation setting the initial temperature of each compartment. Its step response gives the time constant about 3 hours in agreement with clinical knowledge. As for the essential property of the model, the dynamic temperature of its face-core compartment is realized, which corresponds to the tympanic membrane temperature measured under the practical anesthesia. From the various simulations consistent with the phenomena of clinical practice, it is concluded that the proposed model is appropriate for the theoretical analysis and clinical application to the brain hypothermia treatment.

Computational models of the pulmonary circulation: Insights and the move towards clinically directed studies

PubMed Central

Tawhai, Merryn H.; Clark, Alys R.; Burrowes, Kelly S.

2011-01-01

Biophysically-based computational models provide a tool for integrating and explaining experimental data, observations, and hypotheses. Computational models of the pulmonary circulation have evolved from minimal and efficient constructs that have been used to study individual mechanisms that contribute to lung perfusion, to sophisticated multi-scale and -physics structure-based models that predict integrated structure-function relationships within a heterogeneous organ. This review considers the utility of computational models in providing new insights into the function of the pulmonary circulation, and their application in clinically motivated studies. We review mathematical and computational models of the pulmonary circulation based on their application; we begin with models that seek to answer questions in basic science and physiology and progress to models that aim to have clinical application. In looking forward, we discuss the relative merits and clinical relevance of computational models: what important features are still lacking; and how these models may ultimately be applied to further increasing our understanding of the mechanisms occurring in disease of the pulmonary circulation. PMID:22034608

Partner Enabling of Substance Use Disorders: Critical Review and Future Directions.

ERIC Educational Resources Information Center

Rotunda, Rob J.; Doman, Kathy

2001-01-01

Substance use disorders affect not only the identified client but significant others as well. This article contrasts the enabling and codependency constructs, reviews empirical studies of enabling, and offers a conceptualization of partner responses to addiction that could enhance future research efforts and clinical applications in this area. (BF)

Developing a Workflow Composite Score to Measure Clinical Information Logistics. A Top-down Approach.

PubMed

Liebe, J D; Hübner, U; Straede, M C; Thye, J

2015-01-01

Availability and usage of individual IT applications have been studied intensively in the past years. Recently, IT support of clinical processes is attaining increasing attention. The underlying construct that describes the IT support of clinical workflows is clinical information logistics. This construct needs to be better understood, operationalised and measured. It is therefore the aim of this study to propose and develop a workflow composite score (WCS) for measuring clinical information logistics and to examine its quality based on reliability and validity analyses. We largely followed the procedural model of MacKenzie and colleagues (2011) for defining and conceptualising the construct domain, for developing the measurement instrument, assessing the content validity, pretesting the instrument, specifying the model, capturing the data and computing the WCS and testing the reliability and validity. Clinical information logistics was decomposed into the descriptors data and information, function, integration and distribution, which embraced the framework validated by an analysis of the international literature. This framework was refined selecting representative clinical processes. We chose ward rounds, pre- and post-surgery processes and discharge as sample processes that served as concrete instances for the measurements. They are sufficiently complex, represent core clinical processes and involve different professions, departments and settings. The score was computed on the basis of data from 183 hospitals of different size, ownership, location and teaching status. Testing the reliability and validity yielded encouraging results: the reliability was high with r(split-half) = 0.89, the WCS discriminated between groups; the WCS correlated significantly and moderately with two EHR models and the WCS received good evaluation results by a sample of chief information officers (n = 67). These findings suggest the further utilisation of the WCS. As the WCS does not assume ideal workflows as a gold standard but measures IT support of clinical workflows according to validated descriptors a high portability of the WCS to other hospitals in other countries is very likely. The WCS will contribute to a better understanding of the construct clinical information logistics.

Development of a Model for the Representation of Nanotechnology-Specific Terminology

PubMed Central

Bailey, LeeAnn O.; Kennedy, Christopher H.; Fritts, Martin J.; Hartel, Francis W.

2006-01-01

Nanotechnology is an important, rapidly-evolving, multidisciplinary field [1]. The tremendous growth in this area necessitates the establishment of a common, open-source terminology to support the diverse biomedical applications of nanotechnology. Currently, the consensus process to define and categorize conceptual entities pertaining to nanotechnology is in a rudimentary stage. We have constructed a nanotechnology-specific conceptual hierarchy that can be utilized by end users to retrieve accurate, controlled terminology regarding emerging nanotechnology and corresponding clinical applications. PMID:17238469

Biomaterial-mesenchymal stem cell constructs for immunomodulation in composite tissue engineering.

PubMed

Hanson, Summer; D'Souza, Rena N; Hematti, Peiman

2014-08-01

Cell-based treatments are being developed as a novel approach for the treatment of many diseases in an effort to repair injured tissues and regenerate lost tissues. Interest in the potential use of multipotent progenitor or stem cells has grown significantly in recent years, specifically the use of mesenchymal stem cells (MSCs), for tissue engineering in combination with extracellular matrix-based scaffolds. An area that warrants further attention is the local or systemic host responses toward the implanted cell-biomaterial constructs. Such immunological responses could play a major role in determining the clinical efficacy of the therapeutic device or biomaterials used. MSCs, due to their unique immunomodulatory properties, hold great promise in tissue engineering as they not only directly participate in tissue repair and regeneration but also modulate the host foreign body response toward the engineered constructs. The purpose of this review was to summarize the current state of knowledge and applications of MSC-biomaterial constructs as a potential immunoregulatory tool in tissue engineering. Better understanding of the interactions between biomaterials and cells could translate to the development of clinically relevant and novel cell-based therapeutics for tissue reconstruction and regenerative medicine.

Clinical translation of handheld optical coherence tomography: practical considerations and recent advancements

NASA Astrophysics Data System (ADS)

Monroy, Guillermo L.; Won, Jungeun; Spillman, Darold R.; Dsouza, Roshan; Boppart, Stephen A.

2017-12-01

Since the inception of optical coherence tomography (OCT), advancements in imaging system design and handheld probes have allowed for numerous advancements in disease diagnostics and characterization of the structural and optical properties of tissue. OCT system developers continue to reduce form factor and cost, while improving imaging performance (speed, resolution, etc.) and flexibility for applicability in a broad range of fields, and nearly every clinical specialty. An extensive array of components to construct customized systems has also become available, with a range of commercial entities that produce high-quality products, from single components to full systems, for clinical and research use. Many advancements in the development of these miniaturized and portable systems can be linked back to a specific challenge in academic research, or a clinical need in medicine or surgery. Handheld OCT systems are discussed and explored for various applications. Handheld systems are discussed in terms of their relative level of portability and form factor, with mention of the supporting technologies and surrounding ecosystem that bolstered their development. Additional insight from our efforts to implement systems in several clinical environments is provided. The trend toward well-designed, efficient, and compact handheld systems paves the way for more widespread adoption of OCT into point-of-care or point-of-procedure applications in both clinical and commercial settings.

Measuring quality of life in evaluating clinical interventions: an overview.

PubMed

Kind, P

2001-07-01

Health professionals provide care with some purpose in mind. It is reasonable to assume that they are therefore interested in observing and measuring health outcomes. In the recent past, it has become fashionable to describe health outcomes in terms of their impact on 'quality of life', a widely used term that is usually left undefined. Measures of health-related quality of life (HRQoL) are now in common usage in clinical studies. The construction of both generic and condition-specific measures of HRQoL relies heavily on the choice of descriptive domains, a process that often reflects the personal values of the developer of the instrument. Subjective valuation is a recurring phenomenon in the construction and application of HRQoL measures. These values should not be restricted to the private judgement of the clinician alone. The challenge for those evaluating clinical interventions is to make such values explicit and to extend the franchise to society as a whole.

Whole kidney engineering for clinical translation.

PubMed

Kim, Ick-Hee; Ko, In Kap; Atala, Anthony; Yoo, James J

2015-04-01

Renal transplantation is currently the only definitive treatment for end-stage renal disease; however, this treatment is severely limited by the shortage of implantable kidneys. To address this shortcoming, development of an engineered, transplantable kidney has been proposed. Although current advances in engineering kidneys based on decellularization and recellularization techniques have offered great promises for the generation of functional kidney constructs, most studies have been conducted using rodent kidney constructs and short-term in-vivo evaluation. Toward clinical translations of this technique, several limitations need to be addressed. Human-sized renal scaffolds are desirable for clinical application, and the fabrication is currently feasible using native porcine and discarded human kidneys. Current progress in stem cell biology and cell culture methods have demonstrated feasibility of the use of embryonic stem cells, induced pluripotent stem cells, and primary renal cells as clinically relevant cell sources for the recellularization of renal scaffolds. Finally, approaches to long-term implantation of engineered kidneys are under investigation using antithrombogenic strategies such as functional reendothelialization of acellular kidney matrices. In the field of bioengineering, whole kidneys have taken a number of important initial steps toward clinical translations, but many challenges must be addressed to achieve a successful treatment for the patient with end-stage renal disease.

Longitudinal construct validity: establishment of clinical meaning in patient evaluative instruments.

PubMed

Liang, M H

2000-09-01

Although widely used and reported in research for the evaluation of groups, measures of health status and health-related quality of life have had little application in clinical practice for the assessment of individual patients. One of the principal barriers is the demonstration that these measures add clinically significant information to measures of function or symptoms alone. Here, we review the methods for evaluation of construct validity in longitudinal studies and make recommendations for nomenclature, reporting of study results, and future research agenda. Analytical review. The terms "sensitivity" and "responsiveness" have been used interchangeably, and there are few studies that evaluate the extent to which health status or health-related quality-of life measures capture clinically important changes ("responsiveness"). Current methods of evaluating responsiveness are not standardized or evaluated. Approaches for the assessment of a clinically significant or meaningful change are described; rather than normative information, however, standardized transition questions are proposed. They would be reported routinely and as separate axes of description to capture individual perceptions. Research in methods to assess the subject's evaluation of the importance and magnitude of a measured change are critical if health status and health-related quality-of-life measures are to have an impact on patient care.

Concise Review: The Clinical Application of Mesenchymal Stem Cells for Musculoskeletal Regeneration: Current Status and Perspectives

PubMed Central

Steinert, Andre F.; Rackwitz, Lars; Gilbert, Fabian; Nöth, Ulrich

2012-01-01

Regenerative therapies in the musculoskeletal system are based on the suitable application of cells, biomaterials, and/or factors. For an effective approach, numerous aspects have to be taken into consideration, including age, disease, target tissue, and several environmental factors. Significant research efforts have been undertaken in the last decade to develop specific cell-based therapies, and in particular adult multipotent mesenchymal stem cells hold great promise for such regenerative strategies. Clinical translation of such therapies, however, remains a work in progress. In the clinical arena, autologous cells have been harvested, processed, and readministered according to protocols distinct for the target application. As outlined in this review, such applications range from simple single-step approaches, such as direct injection of unprocessed or concentrated blood or bone marrow aspirates, to fabrication of engineered constructs by seeding of natural or synthetic scaffolds with cells, which were released from autologous tissues and propagated under good manufacturing practice conditions (for example, autologous chondrocyte implantation). However, only relatively few of these cell-based approaches have entered the clinic, and none of these treatments has become a “standard of care” treatment for an orthopaedic disease to date. The multifaceted reasons for the current status from the medical, research, and regulatory perspectives are discussed here. In summary, this review presents the scientific background, current state, and implications of clinical mesenchymal stem cell application in the musculoskeletal system and provides perspectives for future developments. PMID:23197783

Hydrogel Encapsulation Facilitates Rapid-Cooling Cryopreservation of Stem Cell-Laden Core-Shell Microcapsules as Cell-Biomaterial Constructs.

PubMed

Zhao, Gang; Liu, Xiaoli; Zhu, Kaixuan; He, Xiaoming

2017-12-01

Core-shell structured stem cell microencapsulation in hydrogel has wide applications in tissue engineering, regenerative medicine, and cell-based therapies because it offers an ideal immunoisolative microenvironment for cell delivery and 3D culture. Long-term storage of such microcapsules as cell-biomaterial constructs by cryopreservation is an enabling technology for their wide distribution and ready availability for clinical transplantation. However, most of the existing studies focus on cryopreservation of single cells or cells in microcapsules without a core-shell structure (i.e., hydrogel beads). The goal of this study is to achieve cryopreservation of stem cells encapsulated in core-shell microcapsules as cell-biomaterial constructs or biocomposites. To this end, a capillary microfluidics-based core-shell alginate hydrogel encapsulation technology is developed to produce porcine adipose-derived stem cell-laden microcapsules for vitreous cryopreservation with very low concentration (2 mol L -1 ) of cell membrane penetrating cryoprotective agents (CPAs) by suppressing ice formation. This may provide a low-CPA and cost-effective approach for vitreous cryopreservation of "ready-to-use" stem cell-biomaterial constructs, facilitating their off-the-shelf availability and widespread applications. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Allergic effects of the residual monomer used in denture base acrylic resins

PubMed Central

Rashid, Haroon; Sheikh, Zeeshan; Vohra, Fahim

2015-01-01

Denture base resins are extensively used in dentistry for a variety of purposes. These materials can be classified as chemical, heat, light, and microwave polymerization materials depending upon the factor which starts the polymerization reaction. Their applications include use during denture base construction, relining existing dentures, and for fabrication of orthodontic removable appliances. There have been increased concerns regarding the safe clinical application of these materials as their biodegradation in the oral environment leads to harmful effects. Along with local side effects, the materials have certain occupational hazards, and numerous studies can be found in the literature mentioning those. The purpose of this article is to outline the cytotoxic consequences of denture base acrylic resins and clinical recommendations for their use. PMID:26929705

Future role of MR elastography in tissue engineering and regenerative medicine.

PubMed

Othman, Shadi F; Xu, Huihui; Mao, Jeremy J

2015-05-01

Tissue engineering (TE) has been introduced for more than 25 years without a boom in clinical trials. More than 70 TE-related start-up companies spent more than $600 million/year, with only two FDA-approved tissue-engineered products. Given the modest performance in clinically approved organs, TE is a tenaciously promising field. The TE community is advocating the application of clinically driven methodologies in large animal models enabling clinical translation. This challenge is hindered by the scarcity of tissue biopsies and the absence of standardized evaluation tools, but can be negated through non-invasive assessment of growth and integration, with reduced sample size and low cost. Solving this issue will speed the transition to cost-efficient clinical studies. In this paper we: (a) introduce magnetic resonance elastography to the tissue-engineering and regenerative medicine (TERM) community; (b) review recent MRE applications in TERM; and (c) discuss future directions of MRE in TERM. We have used MRE to study engineered tissues both in vitro and in vivo, where the mechanical properties of mesenchymally derived constructs were progressively monitored before and after tissues were implanted in mouse models. This study represents a stepping stone toward the applications of MRE in directing clinical trials with low cost and likely expediting the translation to more relevantly large animal models and clinical trials. Copyright © 2013 John Wiley & Sons, Ltd.

Use of the experience sampling method in the context of clinical trials

PubMed Central

Verhagen, Simone J W; Hasmi, Laila; Drukker, Marjan; van Os, J; Delespaul, Philippe A E G

2016-01-01

Objective The experience sampling method (ESM) is a structured diary technique to appraise subjective experiences in daily life. It is applied in psychiatric patients, as well as in patients with somatic illness. Despite the potential of ESM assessment, the improved logistics and its increased administration in research, its use in clinical trials remains limited. This paper introduces ESM for clinical trials in psychiatry and beyond. Methods ESM is an ecologically valid method that yields a comprehensive view of an individual's daily life. It allows the assessment of various constructs (eg, quality of life, psychopathology) and psychological mechanisms (eg, stress-sensitivity, coping). These constructs are difficult to assess using cross-sectional questionnaires. ESM can be applied in treatment monitoring, as an ecological momentary intervention, in clinical trials, or in single case clinical trials. Technological advances (eg, smartphone applications) make its implementation easier. Results Advantages of ESM are highlighted and disadvantages are discussed. Furthermore, the ecological nature of ESM data and its consequences are explored, including the potential pitfalls of ambiguously formulated research questions and the specificities of ESM in statistical analyses. The last section focuses on ESM in relation to clinical trials and discusses its future use in optimising clinical decision-making. Conclusions ESM can be a valuable asset in clinical trial research and should be used more often to study the benefits of treatment in psychiatry and somatic health. PMID:27443678

Observation of Couple Conflicts: Clinical Assessment Applications, Stubborn Truths, and Shaky Foundations

PubMed Central

Heyman, Richard E.

2006-01-01

The purpose of this review is to provide a balanced examination of the published research involving the observation of couples, with special attention toward the use of observation for clinical assessment. All published articles that (a) used an observational coding system and (b) relate to the validity of the coding system are summarized in a table. The psychometric properties of observational systems and the use of observation in clinical practice are discussed. Although advances have been made in understanding couple conflict through the use of observation, the review concludes with an appeal to the field to develop constructs in a psychometrically and theoretically sound manner. PMID:11281039

Design and implementation of a film dosimetry audit tool for comparison of planned and delivered dose distributions in high dose rate (HDR) brachytherapy

NASA Astrophysics Data System (ADS)

Palmer, Antony L.; Lee, Chris; Ratcliffe, Ailsa J.; Bradley, David; Nisbet, Andrew

2013-10-01

A novel phantom is presented for ‘full system’ dosimetric audit comparing planned and delivered dose distributions in HDR gynaecological brachytherapy, using clinical treatment applicators. The brachytherapy applicator dosimetry test object consists of a near full-scatter water tank with applicator and film supports constructed of Solid Water, accommodating any typical cervix applicator. Film dosimeters are precisely held in four orthogonal planes bisecting the intrauterine tube, sampling dose distributions in the high risk clinical target volume, points A and B, bladder, rectum and sigmoid. The applicator position is fixed prior to CT scanning and through treatment planning and irradiation. The CT data is acquired with the applicator in a near clinical orientation to include applicator reconstruction in the system test. Gamma analysis is used to compare treatment planning system exported RTDose grid with measured multi-channel film dose maps. Results from two pilot audits are presented, using Ir-192 and Co-60 HDR sources, with a mean gamma passing rate of 98.6% using criteria of 3% local normalization and 3 mm distance to agreement (DTA). The mean DTA between prescribed dose and measured film dose at point A was 1.2 mm. The phantom was funded by IPEM and will be used for a UK national brachytherapy dosimetry audit.

Design and implementation of a film dosimetry audit tool for comparison of planned and delivered dose distributions in high dose rate (HDR) brachytherapy.

PubMed

Palmer, Antony L; Lee, Chris; Ratcliffe, Ailsa J; Bradley, David; Nisbet, Andrew

2013-10-07

A novel phantom is presented for 'full system' dosimetric audit comparing planned and delivered dose distributions in HDR gynaecological brachytherapy, using clinical treatment applicators. The brachytherapy applicator dosimetry test object consists of a near full-scatter water tank with applicator and film supports constructed of Solid Water, accommodating any typical cervix applicator. Film dosimeters are precisely held in four orthogonal planes bisecting the intrauterine tube, sampling dose distributions in the high risk clinical target volume, points A and B, bladder, rectum and sigmoid. The applicator position is fixed prior to CT scanning and through treatment planning and irradiation. The CT data is acquired with the applicator in a near clinical orientation to include applicator reconstruction in the system test. Gamma analysis is used to compare treatment planning system exported RTDose grid with measured multi-channel film dose maps. Results from two pilot audits are presented, using Ir-192 and Co-60 HDR sources, with a mean gamma passing rate of 98.6% using criteria of 3% local normalization and 3 mm distance to agreement (DTA). The mean DTA between prescribed dose and measured film dose at point A was 1.2 mm. The phantom was funded by IPEM and will be used for a UK national brachytherapy dosimetry audit.

[Stem cell-based cardiac regeneration after myocardial infarction].

PubMed

Reinsch, M; Weinberger, F

2018-03-01

Myocardial infarction leads to an irreversible loss of vital myocardial cells. The transplantation of new cardiomyocytes into the heart was first described over 20 years ago and represents a straightforward approach to remuscularize a damaged heart. Due to the lack of human cells a clinical application seemed ambitious; however, dramatic progress in stem cell biology over the last two decades has paved the way towards a clinical application. This is especially important as the prognosis for patients with terminal heart failure is still poor. The transplantation of either cardiomyocytes or engineered heart tissue derived from pluripotent stem cells (either embryonic stem cells or induced pluripotent stem cells) might represent a new regenerative approach. Transplantation of either cells or tissue constructs has now been evaluated in several preclinical models, which have demonstrated that an injured heart can be (partially) remuscularized; however, major hurdles towards a clinical application are the transplantation-related occurrence of arrhythmia, the potential tumorigenicity of pluripotent cells and the required immunosuppression. Several groups are working hard to solve these problems and we are optimistic that the first clinical studies will take place within the next few years.

The NIMH Research Domain Criteria Initiative: Background, Issues, and Pragmatics.

PubMed

Kozak, Michael J; Cuthbert, Bruce N

2016-03-01

This article describes the National Institute of Mental Health's Research Domain Criteria (RDoC) initiative. The description includes background, rationale, goals, and the way the initiative has been developed and organized. The central RDoC concepts are summarized and the current matrix of constructs that have been vetted by workshops of extramural scientists is depicted. A number of theoretical and methodological issues that can arise in connection with the nature of RDoC constructs are highlighted: subjectivism and heterophenomenology, desynchrony and theoretical neutrality among units of analysis, theoretical reductionism, endophenotypes, biomarkers, neural circuits, construct "grain size," and analytic challenges. The importance of linking RDoC constructs to psychiatric clinical problems is discussed. Some pragmatics of incorporating RDoC concepts into applications for NIMH research funding are considered, including sampling design. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

Utilization of the Tablet Application Proband in Pedigree Construction and Assessment.

PubMed

McCarty, Andrew Joseph; Miller, Jeffrey M; Fecteau, Heather; Pennington, Jeffrey W; Kessler, Lisa

2018-04-01

Many medical institutions have converted to a digital model for record keeping due to the Health Information Technology for Economic and Clinical Health Act. This Act provides incentives to health care systems to accelerate and encourage the adoption of electronic health record (EHR) systems. The pedigree as a tool in medicine provides an efficient method to assess and represent an individual's health and family health risks that may otherwise not be apparent in the medical record in a clearly identifiable way (Schuette, J. L., & Bennett 2009). Many clinicians continue to construct pedigrees using pen and paper method despite findings of improved identification of at risk patients with similar electronic intake tools (Arar et al. in Personalized Medicine 2011 8:523-32). The goal of this study was to explore the patient and practitioner experience with electronic pedigree programs using Proband, an application developed at The Children's Hospital of Philadelphia for genetic counselors to construct pedigrees during genetic counseling sessions directly on iPads. The first part of this study looked at the patient experience and assessed time to take the pedigree and the impact of using an electronic pedigree tool on the relationship between participant and genetic counselor. This involved 50 participants and was compared with the traditional paper method of taking a pedigree. There was no statistical significance found between the two different mediums in accuracy, speed, and rapport with provider. The second part of the study assessed the usability of Proband by ten genetic counselors. Overall, the application received a system usability score of 90/100 with a majority (7/10) of counselors agreeing that they would use this application in their clinic. The positive outcome of this study encourages future work to assess the impact and usability of programs on a larger scale as they continue to integrate into current electronic health records.

The use of total human bone marrow fraction in a direct three-dimensional expansion approach for bone tissue engineering applications: focus on angiogenesis and osteogenesis.

PubMed

Guerrero, Julien; Oliveira, Hugo; Catros, Sylvain; Siadous, Robin; Derkaoui, Sidi-Mohammed; Bareille, Reine; Letourneur, Didier; Amédée, Joëlle

2015-03-01

Current approaches in bone tissue engineering have shown limited success, mostly owing to insufficient vascularization of the construct. A common approach consists of co-culture of endothelial cells and osteoblastic cells. This strategy uses cells from different sources and differentiation states, thus increasing the complexity upstream of a clinical application. The source of reparative cells is paramount for the success of bone tissue engineering applications. In this context, stem cells obtained from human bone marrow hold much promise. Here, we analyzed the potential of human whole bone marrow cells directly expanded in a three-dimensional (3D) polymer matrix and focused on the further characterization of this heterogeneous population and on their ability to promote angiogenesis and osteogenesis, both in vitro and in vivo, in a subcutaneous model. Cellular aggregates were formed within 24 h and over the 12-day culture period expressed endothelial and bone-specific markers and a specific junctional protein. Ectopic implantation of the tissue-engineered constructs revealed osteoid tissue and vessel formation both at the periphery and within the implant. This work sheds light on the potential clinical use of human whole bone marrow for bone regeneration strategies, focusing on a simplified approach to develop a direct 3D culture without two-dimensional isolation or expansion.

[The application progress of 3D printing technology in ophthalmology].

PubMed

Ji, Z K; Zhao, Y; Yu, S S; Zhao, H

2018-01-11

3D printing is a kind of technology that makes 3D models from computer-aided designs through additive manufacturing, in which successive layers of the material are deposited onto underlying layers to construct 3D objects. In recent years, 3D printing is gradually applied in the field of ophthalmology, such as the cornea, retina, orbital operation, ocular tumor radiotherapy, ocular implants and ophthalmology teaching. This article reviews the application status of 3D printing technology in the basic research and clinical treatment in ophthalmology. (Chin J Ophthalmol, 2018, 54: 72-76) .

Depression Anxiety and Stress Scales (DASS-21): psychometric analysis across four racial groups.

PubMed

Norton, Peter J

2007-09-01

Growing cross-cultural awareness has led researchers to examine frequently used research instruments and assessment tools in racially diverse populations. The present study was conducted to assess the psychometric characteristics of the 21-item version of the Depression, Anxiety, and Stress Scales (DASS-21) among different racial groups. The DASS-21 was chosen because it appears to be a reliable and easy to administer measure, ideal for both clinical and research purposes. Results suggest that the internal consistency, and convergent and divergent validity of the DASS-21 are similar across racial groups. Multigroup CFA, however, indicated that item loadings were invariant, while scale covariances were not invariant. This suggests that, although the items may load similarly on the depression, anxiety and stress constructs, these constructs may be differentially inter-related across groups. Implications for application in clinical practice are discussed.

Application of artificial intelligence using a convolutional neural network for detecting gastric cancer in endoscopic images.

PubMed

Hirasawa, Toshiaki; Aoyama, Kazuharu; Tanimoto, Tetsuya; Ishihara, Soichiro; Shichijo, Satoki; Ozawa, Tsuyoshi; Ohnishi, Tatsuya; Fujishiro, Mitsuhiro; Matsuo, Keigo; Fujisaki, Junko; Tada, Tomohiro

2018-07-01

Image recognition using artificial intelligence with deep learning through convolutional neural networks (CNNs) has dramatically improved and been increasingly applied to medical fields for diagnostic imaging. We developed a CNN that can automatically detect gastric cancer in endoscopic images. A CNN-based diagnostic system was constructed based on Single Shot MultiBox Detector architecture and trained using 13,584 endoscopic images of gastric cancer. To evaluate the diagnostic accuracy, an independent test set of 2296 stomach images collected from 69 consecutive patients with 77 gastric cancer lesions was applied to the constructed CNN. The CNN required 47 s to analyze 2296 test images. The CNN correctly diagnosed 71 of 77 gastric cancer lesions with an overall sensitivity of 92.2%, and 161 non-cancerous lesions were detected as gastric cancer, resulting in a positive predictive value of 30.6%. Seventy of the 71 lesions (98.6%) with a diameter of 6 mm or more as well as all invasive cancers were correctly detected. All missed lesions were superficially depressed and differentiated-type intramucosal cancers that were difficult to distinguish from gastritis even for experienced endoscopists. Nearly half of the false-positive lesions were gastritis with changes in color tone or an irregular mucosal surface. The constructed CNN system for detecting gastric cancer could process numerous stored endoscopic images in a very short time with a clinically relevant diagnostic ability. It may be well applicable to daily clinical practice to reduce the burden of endoscopists.

3D printing for clinical application in otorhinolaryngology.

PubMed

Zhong, Nongping; Zhao, Xia

2017-12-01

Three-dimensional (3D) printing is a promising technology that can use a patient's image data to create complex and personalized constructs precisely. It has made great progress over the past few decades and has been widely used in medicine including medical modeling, surgical planning, medical education and training, prosthesis and implants. Three-dimensional (3D) bioprinting is a powerful tool that has the potential to fabricate bioengineered constructs of the desired shape layer-by-layer using computer-aided deposition of living cells and biomaterials. Advances in 3D printed implants and future tissue-engineered constructs will bring great progress to the field of otolaryngology. By integrating 3D printing into tissue engineering and materials, it may be possible for otolaryngologists to implant 3D printed functional grafts into patients for reconstruction of a variety of tissue defects in the foreseeable future. In this review, we will introduce the current state of 3D printing technology and highlight the applications of 3D printed prosthesis and implants, 3D printing technology combined with tissue engineering and future directions of bioprinting in the field of otolaryngology.

An Independent Construct for Conditional Expression of Atonal Homolog-1

PubMed Central

Cheng, Yen-fu; Kinouchi, Hikaru; Bieber, Rebecca; Edge, Albert S.B.

2014-01-01

Abstract The mammalian homolog of the basic helix-loop-helix transcription factor atonal-1 (Atoh1 or Math1) is required for development of cochlear hair cells that function as the mechanosensory cells required for audition. Forced expression of Atoh1 in cochlear-supporting cells may provide a way to regenerate hair cells and provide for a therapy for hearing loss. Additionally, Atoh1 is an inhibitor of proliferation and has further clinical applications in anticancer therapies. The goal of these experiments was to improve the method for Atoh1 expression by engineering a genetic construct that may be used in future translational applications. To address the poor control of Atoh1 expression in standard gene expression systems where Atoh1 is expressed constitutively at abnormally elevated levels, our aim was to engineer an inducible system whereby Atoh1 was upregulated by an inducer and downregulated once the inducer was removed. A further aim was to engineer a single genetic construct that allowed for conditional expression of Atoh1 independent of secondary regulatory elements. Here we describe a stand-alone genetic construct that utilizes the tamoxifen sensitivity of a mutated estrogen receptor (ER) ligand-binding domain for the conditional expression of Atoh1. The Atoh1-ER-DsRed construct is translated into an ATOH1-ER-DSRED fusion protein that remains sequestered in the cytoplasm and therefore rendered inactive because it cannot enter the nucleus to activate Atoh1 signaling pathways. However, application of 4-hydroxytamoxifen results in translocation of the fusion protein to the nucleus, where it binds to the Atoh1 enhancer, upregulates transcription and translation of endogenous ATOH1 and activates downstream Atoh1 signaling such as upregulation of the hair cell protein MYOSIN 7A. Removal of tamoxifen reverses the upregulation of endogenous Atoh1 signaling. This construct serves as an independent genetic construct that allows for the conditional upregulation and downregulation of Atoh1, and may prove useful for manipulating Atoh1 expression in vivo. PMID:24066662

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

Koren, S; Bragilovski, D; Tafo, A Guemnie

Purpose: To evaluate the clinical feasibility of IntraBeam intra operative kV irradiation beam device for ocular conjunctiva treatments. The Intra-Beam system offers a 4.4 mm diameter needle applicator, that is not suitable for treatment of a large surface with limits access. We propose an adaptor that will answer to this clinical need and provide initial dosimetry. Methods: The dose distribution of the needle applicator is non uniform and hence not suitable for treatment of relatively large surfaces. We designed an adapter to the needle applicator that will filter the X-rays and produce a conformal dose distribution over the treatment areamore » while shielding surfaces to be spared. Dose distributions were simulated using FLUKA is a fully integrated particle physics Monte Carlo simulation package. Results: We designed a wedge applicator made of Polythermide window and stainless steel for collimating. We compare the dose distribution to that of the known needle and surface applicators. Conclusion: Initial dosimetry shows feasibility of this approach. While further refinements to the design may be warranted, the results support construction of a prototype and confirmation of the Monte Carlo dosimetry with measured data.« less

The Expanding World of Tissue Engineering: The Building Blocks and New Applications of Tissue Engineered Constructs

PubMed Central

Zorlutuna, Pinar; Vrana, Nihal Engin; Khademhosseini, Ali

2013-01-01

The field of tissue engineering has been growing in the recent years as more products have made it to the market and as new uses for the engineered tissues have emerged, motivating many researchers to engage in this multidisciplinary field of research. Engineered tissues are now not only considered as end products for regenerative medicine, but also have emerged as enabling technologies for other fields of research ranging from drug discovery to biorobotics. This widespread use necessitates a variety of methodologies for production of tissue engineered constructs. In this review, these methods together with their non-clinical applications will be described. First, we will focus on novel materials used in tissue engineering scaffolds; such as recombinant proteins and synthetic, self assembling polypeptides. The recent advances in the modular tissue engineering area will be discussed. Then scaffold-free production methods, based on either cell sheets or cell aggregates will be described. Cell sources used in tissue engineering and new methods that provide improved control over cell behavior such as pathway engineering and biomimetic microenvironments for directing cell differentiation will be discussed. Finally, we will summarize the emerging uses of engineered constructs such as model tissues for drug discovery, cancer research and biorobotics applications. PMID:23268388

Modular Laboratories—Cost-Effective and Sustainable Infrastructure for Resource-Limited Settings

PubMed Central

Bridges, Daniel J.; Colborn, James; Chan, Adeline S. T.; Winters, Anna M.; Dengala, Dereje; Fornadel, Christen M.; Kosloff, Barry

2014-01-01

High-quality laboratory space to support basic science, clinical research projects, or health services is often severely lacking in the developing world. Moreover, the construction of suitable facilities using traditional methods is time-consuming, expensive, and challenging to implement. Three real world examples showing how shipping containers can be converted into modern laboratories are highlighted. These include use as an insectary, a molecular laboratory, and a BSL-3 containment laboratory. These modular conversions have a number of advantages over brick and mortar construction and provide a cost-effective and timely solution to offer high-quality, user-friendly laboratory space applicable within the developing world. PMID:25223943

The use and limitations of attachment theory in child psychotherapy.

PubMed

Zilberstein, Karen

2014-03-01

Attachment theory and research has proliferated in recent years, spawning new ideas and applications to child therapy. Some of those interventions are creative and useful and rest on solid theory and research, whereas others derive from tenuous assumptions. As an important developmental construct, attachment plays a role in every therapy, but defining that role can be difficult. Therapists must recognize the significance of attachment in treatment but not at the expense of recognizing and treating other issues. This article provides an overview of attachment theory and attachment-based interventions and discusses how to apply those constructs to therapeutic work with children. It reviews attachment theory, assessment, and treatments, and discusses how attachment-focused interventions can be combined with other therapeutic needs and methods. It also considers limitations in the current clinical application of attachment and makes recommendations for further research. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

The Importance of Considering Clinical Utility in the Construction of a Diagnostic Manual.

PubMed

Mullins-Sweatt, Stephanie N; Lengel, Gregory J; DeShong, Hilary L

2016-01-01

The development of major diagnostic manuals primarily has been guided by construct validity rather than clinical utility. The purpose of this article is to summarize recent research and theory examining the importance of clinical utility when constructing and evaluating a diagnostic manual. We suggest that construct validity is a necessary but not sufficient criterion for diagnostic constructs. This article discusses components of clinical utility and how these have applied to the current and forthcoming diagnostic manuals. Implications and suggestions for future research are provided.

Developing an instrument to measure effective factors on Clinical Learning.

PubMed

Dadgaran, Ideh; Shirazi, Mandana; Mohammadi, Aeen; Ravari, Ali

2016-07-01

Although nursing students spend a large part of their learning period in the clinical environment, clinical learning has not been perceived by its nature yet. To develop an instrument to measure effective factors on clinical learning in nursing students. This is a mixed methods study performed in 2 steps. First, the researchers defined "clinical learning" in nursing students through qualitative content analysis and designed items of the questionnaire based on semi-structured individual interviews with nursing students. Then, as the second step, psychometric properties of the questionnaire were evaluated using the face validity, content validity, construct validity, and internal consistency evaluated on 227 students from fourth or higher semesters. All the interviews were recorded and transcribed, and then, they were analyzed using Max Qualitative Data Analysis and all of qualitative data were analyzed using SPSS 14. To do the study, we constructed the preliminary questionnaire containing 102 expressions. After determination of face and content validities by qualitative and quantitative approaches, the expressions of the questionnaire were reduced to 45. To determine the construct validity, exploratory factor analysis was applied. The results indicated that the maximum variance percentage (40.55%) was defined by the first 3 factors while the rest of the total variance percentage (59.45%) was determined by the other 42 factors. Results of exploratory factor analysis of this questionnaire indicated the presence of 3 instructor-staff, students, and educational related factors. Finally, 41 expressions were kept in 3 factor groups. The α-Cronbach coefficient (0.93) confirmed the high internal consistency of the questionnaire. Results indicated that the prepared questionnaire was an efficient instrument in the study of the effective factors on clinical learning as viewed by nursing students since it involves 41 expressions and properties such as instrument design based on perception and experiences of the nursing students about effective factors on clinical learning, definition of facilitator and preventive factors of the clinical learning, simple scoring, suitable validity and reliability, and applicability in different occasions.

Application of the OMERACT filter to measures of core outcome domains in recent clinical studies of acute gout.

PubMed

Taylor, William J; Redden, David; Dalbeth, Nicola; Schumacher, H Ralph; Edwards, N Lawrence; Simon, Lee S; John, Markus R; Essex, Margaret N; Watson, Douglas J; Evans, Robert; Rome, Keith; Singh, Jasvinder A

2014-03-01

To determine the extent to which instruments that measure core outcome domains in acute gout fulfill the Outcome Measures in Rheumatology (OMERACT) filter requirements of truth, discrimination, and feasibility. Patient-level data from 4 randomized controlled trials of agents designed to treat acute gout and 1 observational study of acute gout were analyzed. For each available measure, construct validity, test-retest reliability, within-group change using effect size, between-group change using the Kruskall-Wallis statistic, and repeated measures generalized estimating equations were assessed. Floor and ceiling effects were also assessed and minimal clinically important difference was estimated. These analyses were presented to participants at OMERACT 11 to help inform voting for possible endorsement. There was evidence for construct validity and discriminative ability for 3 measures of pain [0 to 4 Likert, 0 to 10 numeric rating scale (NRS), 0 to 100 mm visual analog scale (VAS)]. Likewise, there appears to be sufficient evidence for a 4-point Likert scale to possess construct validity and discriminative ability for physician assessment of joint swelling and joint tenderness. There was some evidence for construct validity and within-group discriminative ability for the Health Assessment Questionnaire as a measure of activity limitations, but not for discrimination between groups allocated to different treatment. There is sufficient evidence to support measures of pain (using Likert, NRS, or VAS), joint tenderness, and swelling (using Likert scale) as fulfilling the requirements of the OMERACT filter. Further research on a measure of activity limitations in acute gout clinical trials is required.

[Application of decision curve on evaluation of MRI predictive model for early assessing pathological complete response to neoadjuvant therapy in breast cancer].

PubMed

He, Y J; Li, X T; Fan, Z Q; Li, Y L; Cao, K; Sun, Y S; Ouyang, T

2018-01-23

Objective: To construct a dynamic enhanced MR based predictive model for early assessing pathological complete response (pCR) to neoadjuvant therapy in breast cancer, and to evaluate the clinical benefit of the model by using decision curve. Methods: From December 2005 to December 2007, 170 patients with breast cancer treated with neoadjuvant therapy were identified and their MR images before neoadjuvant therapy and at the end of the first cycle of neoadjuvant therapy were collected. Logistic regression model was used to detect independent factors for predicting pCR and construct the predictive model accordingly, then receiver operating characteristic (ROC) curve and decision curve were used to evaluate the predictive model. Results: ΔArea(max) and Δslope(max) were independent predictive factors for pCR, OR =0.942 (95% CI : 0.918-0.967) and 0.961 (95% CI : 0.940-0.987), respectively. The area under ROC curve (AUC) for the constructed model was 0.886 (95% CI : 0.820-0.951). Decision curve showed that in the range of the threshold probability above 0.4, the predictive model presented increased net benefit as the threshold probability increased. Conclusions: The constructed predictive model for pCR is of potential clinical value, with an AUC>0.85. Meanwhile, decision curve analysis indicates the constructed predictive model has net benefit from 3 to 8 percent in the likely range of probability threshold from 80% to 90%.

Bridging semantics and syntax with graph algorithms—state-of-the-art of extracting biomedical relations

PubMed Central

Uzuner, Özlem; Szolovits, Peter

2017-01-01

Research on extracting biomedical relations has received growing attention recently, with numerous biological and clinical applications including those in pharmacogenomics, clinical trial screening and adverse drug reaction detection. The ability to accurately capture both semantic and syntactic structures in text expressing these relations becomes increasingly critical to enable deep understanding of scientific papers and clinical narratives. Shared task challenges have been organized by both bioinformatics and clinical informatics communities to assess and advance the state-of-the-art research. Significant progress has been made in algorithm development and resource construction. In particular, graph-based approaches bridge semantics and syntax, often achieving the best performance in shared tasks. However, a number of problems at the frontiers of biomedical relation extraction continue to pose interesting challenges and present opportunities for great improvement and fruitful research. In this article, we place biomedical relation extraction against the backdrop of its versatile applications, present a gentle introduction to its general pipeline and shared resources, review the current state-of-the-art in methodology advancement, discuss limitations and point out several promising future directions. PMID:26851224

ERPs and Psychopathology. I. Behavioral process issues.

PubMed

Roth, W T; Tecce, J J; Pfefferbaum, A; Rosenbloom, M; Callaway, E

1984-01-01

The clinical study of ERPs has an inherent defect--a self-selection of clinical populations that hampers equating of clinically defined groups on factors extraneous to the independent variables. Such ex post facto studies increase the likelihood of confounding variables in the interpretation of findings. Hence, the development of lawful relationships between clinical variables and ERPs is impeded and the fulfillment of description, explanation, prediction, and control in brain science is thwarted. Proper methodologies and theory development can increase the likelihood of establishing these lawful relationships. One methodology of potential value in the clinical application of ERPs, particularly in studies of aging, is that of divided attention. Two promising theoretical developments in the understanding of brain functioning and aging are the distraction-arousal hypothesis and the controlled-automatic attention model. The evaluation of ERPs in the study of brain-behavior relations in clinical populations might be facilitated by the differentiation of concurrent, predictive, content, and construct validities.

A web access script language to support clinical application development.

PubMed

O'Kane, K C; McColligan, E E

1998-02-01

This paper describes the development of a script language to support the implementation of decentralized, clinical information applications on the World Wide Web (Web). The goal of this work is to facilitate construction of low overhead, fully functional clinical information systems that can be accessed anywhere by low cost Web browsers to search, retrieve and analyze stored patient data. The Web provides a model of network access to data bases on a global scale. Although it was originally conceived as a means to exchange scientific documents, Web browsers and servers currently support access to a wide variety of audio, video, graphical and text based data to a rapidly growing community. Access to these services is via inexpensive client software browsers that connect to servers by means of the open architecture of the Internet. In this paper, the design and implementation of a script language that supports the development of low cost, Web-based, distributed clinical information systems for both Inter- and Intra-Net use is presented. The language is based on the Mumps language and, consequently, supports many legacy applications with few modifications. Several enhancements, however, have been made to support modern programming practices and the Web interface. The interpreter for the language also supports standalone program execution on Unix, MS-Windows, OS/2 and other operating systems.

Advanced functional polymers for regenerative and therapeutic dentistry.

PubMed

Lai, W-F; Oka, K; Jung, H-S

2015-07-01

Use of ceramics and polymers continues to dominate clinical procedures in modern dentistry. Polymers have provided the basis for adhesives, tissue void fillers, and artificial replacements for whole teeth. They have been remarkably effective in the clinic at restoration of major dental functions after damage or loss of teeth. With the rapid development of polymer science, dental materials science has significantly lagged behind in harnessing these advanced polymer products. What they offer is new and unique properties superior to traditional polymers and crucially a range of properties that more closely match natural biomaterials. Therefore, we should pursue more vigorously the benefits of advanced polymers in dentistry. In this review, we highlight how the latest generation of advanced polymers will enhance the application of materials in the dental clinic using numerous promising examples. Polymers have a broad range of applications in modern dentistry. Some major applications are to construct frameworks that mimic the precise structure of tissues, to restore tooth organ function, and to deliver bioactive agents to influence cell behavior from the inside. The future of polymers in dentistry must include all these new enhancements to increase biological and clinical effectiveness beyond what can be achieved with traditional biomaterials. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

EON: a component-based approach to automation of protocol-directed therapy.

PubMed Central

Musen, M A; Tu, S W; Das, A K; Shahar, Y

1996-01-01

Provision of automated support for planning protocol-directed therapy requires a computer program to take as input clinical data stored in an electronic patient-record system and to generate as output recommendations for therapeutic interventions and laboratory testing that are defined by applicable protocols. This paper presents a synthesis of research carried out at Stanford University to model the therapy-planning task and to demonstrate a component-based architecture for building protocol-based decision-support systems. We have constructed general-purpose software components that (1) interpret abstract protocol specifications to construct appropriate patient-specific treatment plans; (2) infer from time-stamped patient data higher-level, interval-based, abstract concepts; (3) perform time-oriented queries on a time-oriented patient database; and (4) allow acquisition and maintenance of protocol knowledge in a manner that facilitates efficient processing both by humans and by computers. We have implemented these components in a computer system known as EON. Each of the components has been developed, evaluated, and reported independently. We have evaluated the integration of the components as a composite architecture by implementing T-HELPER, a computer-based patient-record system that uses EON to offer advice regarding the management of patients who are following clinical trial protocols for AIDS or HIV infection. A test of the reuse of the software components in a different clinical domain demonstrated rapid development of a prototype application to support protocol-based care of patients who have breast cancer. PMID:8930854

Reliability Stress-Strength Models for Dependent Observations with Applications in Clinical Trials

NASA Technical Reports Server (NTRS)

Kushary, Debashis; Kulkarni, Pandurang M.

1995-01-01

We consider the applications of stress-strength models in studies involving clinical trials. When studying the effects and side effects of certain procedures (treatments), it is often the case that observations are correlated due to subject effect, repeated measurements and observing many characteristics simultaneously. We develop maximum likelihood estimator (MLE) and uniform minimum variance unbiased estimator (UMVUE) of the reliability which in clinical trial studies could be considered as the chances of increased side effects due to a particular procedure compared to another. The results developed apply to both univariate and multivariate situations. Also, for the univariate situations we develop simple to use lower confidence bounds for the reliability. Further, we consider the cases when both stress and strength constitute time dependent processes. We define the future reliability and obtain methods of constructing lower confidence bounds for this reliability. Finally, we conduct simulation studies to evaluate all the procedures developed and also to compare the MLE and the UMVUE.

[Tissue printing; the potential application of 3D printing in medicine].

PubMed

Visser, Jetze; Melchels, Ferry P W; Dhert, Wouter J A; Malda, Jos

2013-01-01

Complex structures based on a digital blueprint can be created using a 3D printer. As this blueprint can be created using patient imaging data, there are many potential patient-specific applications of 3D printing in medicine. Individually printed metal implants and synthetic devices are currently being used on a limited scale in clinical practice. Researchers in the field of regenerative medicine are now going a step further by printing a combination of cells, growth factors and biomaterials. This process is known as 'bioprinting'. It can be used to copy the complex organization of natural tissue required to repair or replace damaged tissues or organs. The technique needs to be optimized, however, and more knowledge is required regarding the development of printed living constructs into functional tissues before 'tissue from the printer' can be clinically applied.

General error analysis in the relationship between free thyroxine and thyrotropin and its clinical relevance.

PubMed

Goede, Simon L; Leow, Melvin Khee-Shing

2013-01-01

This treatise investigates error sources in measurements applicable to the hypothalamus-pituitary-thyroid (HPT) system of analysis for homeostatic set point computation. The hypothalamus-pituitary transfer characteristic (HP curve) describes the relationship between plasma free thyroxine [FT4] and thyrotropin [TSH]. We define the origin, types, causes, and effects of errors that are commonly encountered in TFT measurements and examine how we can interpret these to construct a reliable HP function for set point establishment. The error sources in the clinical measurement procedures are identified and analyzed in relation to the constructed HP model. The main sources of measurement and interpretation uncertainties are (1) diurnal variations in [TSH], (2) TFT measurement variations influenced by timing of thyroid medications, (3) error sensitivity in ranges of [TSH] and [FT4] (laboratory assay dependent), (4) rounding/truncation of decimals in [FT4] which in turn amplify curve fitting errors in the [TSH] domain in the lower [FT4] range, (5) memory effects (rate-independent hysteresis effect). When the main uncertainties in thyroid function tests (TFT) are identified and analyzed, we can find the most acceptable model space with which we can construct the best HP function and the related set point area.

Constructing core competency indicators for clinical teachers in Taiwan: a qualitative analysis and an analytic hierarchy process

PubMed Central

2014-01-01

Background The objective of this study was to construct a framework of core competency indicators of medical doctors who teach in the clinical setting in Taiwan and to evaluate the relative importance of the indicators among these clinical teachers. Methods The preliminary framework of the indicators was developed from an in-depth interview conducted with 12 clinical teachers who had previously been recognized and awarded for their teaching excellence in university hospitals. The framework was categorized into 4 dimensions: 1) Expertise (i.e., professional knowledge and skill); 2) Teaching Ability; 3) Attitudes and Traits; and 4) Beliefs and Values. These areas were further divided into 11 sub-dimensions and 40 indicators. Subsequently, a questionnaire built upon this qualitative analysis was distributed to another group of 17 clinical teachers. Saaty’s eigenvector approach, or the so-called analytic hierarchy process (AHP), was applied to perform the pairwise comparisons between indicators and to determine the ranking and relative importance of the indicators. Results Fourteen questionnaires were deemed valid for AHP assessment due to completeness of data input. The relative contribution of the four main dimensions was 31% for Attitudes and Traits, 30% for Beliefs and Values, 22% for Expertise, and 17% for Teaching Ability. Specifically, 9 out of the 10 top-ranked indicators belonged to the “Attitudes and Traits” or “Beliefs and Values” dimensions, indicating that inner characteristics (i.e., attitudes, traits, beliefs, and values) were perceived as more important than surface ones (i.e., professional knowledge, skills, and teaching competency). Conclusion We performed a qualitative analysis and developed a questionnaire based upon an interview with experienced clinical teachers in Taiwan, and used this tool to construct the key features for the role model. The application has also demonstrated the relative importance in the dimensions of the core competencies for clinical teachers in Taiwan. PMID:24726054

Constructing core competency indicators for clinical teachers in Taiwan: a qualitative analysis and an analytic hierarchy process.

PubMed

Li, Ai-Tzu; Lin, Jou-Wei

2014-04-11

The objective of this study was to construct a framework of core competency indicators of medical doctors who teach in the clinical setting in Taiwan and to evaluate the relative importance of the indicators among these clinical teachers. The preliminary framework of the indicators was developed from an in-depth interview conducted with 12 clinical teachers who had previously been recognized and awarded for their teaching excellence in university hospitals. The framework was categorized into 4 dimensions: 1) Expertise (i.e., professional knowledge and skill); 2) Teaching Ability; 3) Attitudes and Traits; and 4) Beliefs and Values. These areas were further divided into 11 sub-dimensions and 40 indicators. Subsequently, a questionnaire built upon this qualitative analysis was distributed to another group of 17 clinical teachers. Saaty's eigenvector approach, or the so-called analytic hierarchy process (AHP), was applied to perform the pairwise comparisons between indicators and to determine the ranking and relative importance of the indicators. Fourteen questionnaires were deemed valid for AHP assessment due to completeness of data input. The relative contribution of the four main dimensions was 31% for Attitudes and Traits, 30% for Beliefs and Values, 22% for Expertise, and 17% for Teaching Ability. Specifically, 9 out of the 10 top-ranked indicators belonged to the "Attitudes and Traits" or "Beliefs and Values" dimensions, indicating that inner characteristics (i.e., attitudes, traits, beliefs, and values) were perceived as more important than surface ones (i.e., professional knowledge, skills, and teaching competency). We performed a qualitative analysis and developed a questionnaire based upon an interview with experienced clinical teachers in Taiwan, and used this tool to construct the key features for the role model. The application has also demonstrated the relative importance in the dimensions of the core competencies for clinical teachers in Taiwan.

Applicability of central auditory processing disorder models.

PubMed

Jutras, Benoît; Loubert, Monique; Dupuis, Jean-Luc; Marcoux, Caroline; Dumont, Véronique; Baril, Michèle

2007-12-01

Central auditory processing disorder ([C]APD) is a relatively recent construct that has given rise to 2 theoretical models: the Buffalo Model and the Bellis/Ferre Model. These models describe 4 and 5 (C)APD categories, respectively. The present study examines the applicability of these models to clinical practice. Neither of these models was based on data from peer-reviewed sources. This is a retrospective study that reviewed 178 records of children diagnosed with (C)APD, of which 48 were retained for analysis. More than 80% of the children could be classified into one of the Buffalo Model categories, while more than 90% remained unclassified under the Bellis/Ferre Model. This discrepancy can be explained by the fact that the classification of the Buffalo Model is based primarily on a single central auditory test (Staggered Spondaic Word), whereas the Bellis/Ferre Model classification uses a combination of auditory test results. The 2 models provide a conceptual framework for (C)APD, but they must be further refined to be fully applicable in clinical settings.

Tissue engineering for clinical applications.

PubMed

Bhatia, Sujata K

2010-12-01

Tissue engineering is increasingly being recognized as a beneficial means for lessening the global disease burden. One strategy of tissue engineering is to replace lost tissues or organs with polymeric scaffolds that contain specialized populations of living cells, with the goal of regenerating tissues to restore normal function. Typical constructs for tissue engineering employ biocompatible and degradable polymers, along with organ-specific and tissue-specific cells. Once implanted, the construct guides the growth and development of new tissues; the polymer scaffold degrades away to be replaced by healthy functioning tissue. The ideal biomaterial for tissue engineering not only defends against disease and supports weakened tissues or organs, it also provides the elements required for healing and repair, stimulates the body's intrinsic immunological and regenerative capacities, and seamlessly interacts with the living body. Tissue engineering has been investigated for virtually every organ system in the human body. This review describes the potential of tissue engineering to alleviate disease, as well as the latest advances in tissue regeneration. The discussion focuses on three specific clinical applications of tissue engineering: cardiac tissue regeneration for treatment of heart failure; nerve regeneration for treatment of stroke; and lung regeneration for treatment of chronic obstructive pulmonary disease. Copyright © 2010 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Anti-MUC1 nanobody can redirect T-body cytotoxic effector function.

PubMed

Bakhtiari, Seyed Hamid Aghaee; Rahbarizadeh, Fatemeh; Hasannia, Sadegh; Ahmadvand, Davoud; Iri-Sofla, Farnoush Jafari; Rasaee, Mohammad Javad

2009-04-01

Chimeric antigen T cell receptors provide a good approach for adoptive immunotherapy of cancer, especially in the context of cancerous cells that fail to express major histocompatibility complex antigen and co-stimulatory molecules. Clinical applications of these receptors are limited, mostly due to the xenogenic origin of the antibodies, which cause immunogenic reactions. Nanobodies are the smallest fragments of antibodies that have great homology to human VH and low immunogenic potential. MUC1 is a highly attractive immunotherapeutic target owing to increased expression, altered glycosylation, and loss of polarity in more than 80% of human malignancies. We used anti-MUC1 nanobody as an antigen binding domain, CD28 and CD3zeta as signaling domains, and IgG3 as a spacer in a chimeric receptor construct. This construct was transfected to Jurkat cells. The transfected Jurkat cells were exposed to MUC1-positive MCF7 cells. Then we analyzed the secretion of IL2, proliferation of Jurkat cells, and death of MCF7 cells. These data revealed that the nanobody chimeric receptor can target tumor-associated antigen-positive cells. Regarding the efficient and specific function of nanobody chimeric receptor and non-immunogenic nature of nanobodies, these chimeric receptors might be used as promising candidates for clinical applications.

Raman fiberoptic probe for monitoring human tissue engineered oral mucosa constructs

NASA Astrophysics Data System (ADS)

Khmaladze, Alexander; Kuo, Shiuhyang; Okagbare, Paul; Marcelo, Cynthia L.; Feinberg, Stephen E.; Morris, Michael D.

2013-02-01

In oral and maxillofacial surgery, there is a need for tissue engineered constructs for dental implants, reconstructions due to trauma, oral cancer or congenital defects. A non-invasive quality monitoring of the fabrication of tissue engineered constructs during their production and implantation is a required component of any successful tissue engineering technique. We demonstrate the design and application of a Raman spectroscopic probe for rapid and noninvasive monitoring of Ex Vivo Produced Oral Mucosa Equivalent constructs (EVPOMEs). We conducted in vivo studies to identify Raman spectroscopic failure indicators for EVPOMEs (already developed in vitro), and found that Raman spectra of EVPOMEs exposed to thermal stress showed correlation of the band height ratio of CH2 deformation to phenylalanine ring breathing modes, providing a Raman metric to distinguish between viable and nonviable constructs. This is the first step towards the ultimate goal to design a stand-alone system, which will be usable in a clinical setting, as the data processing and analysis will be performed with minimal user intervention, based on already established and tested Raman spectroscopic indicators for EVPOMEs.

Creating an outcomes framework.

PubMed

Doerge, J B

2000-01-01

Four constructs used to build a framework for outcomes management for a large midwestern tertiary hospital are described in this article. A system framework outlining a model of clinical integration and population management based in Steven Shortell's work is discussed. This framework includes key definitions of high-risk patients, target groups, populations and community. Roles for each level of population management and how they were implemented in the health care system are described. A point of service framework centered on seven dimensions of care is the next construct applied on each nursing unit. The third construct outlines the framework for role development. Three roles for nursing were created to implement strategies for target groups that are strategic disease categories; two of those roles are described in depth. The philosophy of nursing practice is centered on caring and existential advocacy. The final construct is the modification of the Dartmouth model as a common framework for outcomes. System applications of the scorecard and lessons learned in the 2-year process of implementation are shared

Analytic Models of Oxygen and Nutrient Diffusion, Metabolism Dynamics, and Architecture Optimization in Three-Dimensional Tissue Constructs with Applications and Insights in Cerebral Organoids

PubMed Central

2016-01-01

Diffusion models are important in tissue engineering as they enable an understanding of gas, nutrient, and signaling molecule delivery to cells in cell cultures and tissue constructs. As three-dimensional (3D) tissue constructs become larger, more intricate, and more clinically applicable, it will be essential to understand internal dynamics and signaling molecule concentrations throughout the tissue and whether cells are receiving appropriate nutrient delivery. Diffusion characteristics present a significant limitation in many engineered tissues, particularly for avascular tissues and for cells whose viability, differentiation, or function are affected by concentrations of oxygen and nutrients. This article seeks to provide novel analytic solutions for certain cases of steady-state and nonsteady-state diffusion and metabolism in basic 3D construct designs (planar, cylindrical, and spherical forms), solutions that would otherwise require mathematical approximations achieved through numerical methods. This model is applied to cerebral organoids, where it is shown that limitations in diffusion and organoid size can be partially overcome by localizing metabolically active cells to an outer layer in a sphere, a regionalization process that is known to occur through neuroglial precursor migration both in organoids and in early brain development. The given prototypical solutions include a review of metabolic information for many cell types and can be broadly applied to many forms of tissue constructs. This work enables researchers to model oxygen and nutrient delivery to cells, predict cell viability, study dynamics of mass transport in 3D tissue constructs, design constructs with improved diffusion capabilities, and accurately control molecular concentrations in tissue constructs that may be used in studying models of development and disease or for conditioning cells to enhance survival after insults like ischemia or implantation into the body, thereby providing a framework for better understanding and exploring the characteristics and behaviors of engineered tissue constructs. PMID:26650970

Modular laboratories--cost-effective and sustainable infrastructure for resource-limited settings.

PubMed

Bridges, Daniel J; Colborn, James; Chan, Adeline S T; Winters, Anna M; Dengala, Dereje; Fornadel, Christen M; Kosloff, Barry

2014-12-01

High-quality laboratory space to support basic science, clinical research projects, or health services is often severely lacking in the developing world. Moreover, the construction of suitable facilities using traditional methods is time-consuming, expensive, and challenging to implement. Three real world examples showing how shipping containers can be converted into modern laboratories are highlighted. These include use as an insectary, a molecular laboratory, and a BSL-3 containment laboratory. These modular conversions have a number of advantages over brick and mortar construction and provide a cost-effective and timely solution to offer high-quality, user-friendly laboratory space applicable within the developing world. © The American Society of Tropical Medicine and Hygiene.

Structuring of Hydrogels across Multiple Length Scales for Biomedical Applications.

PubMed

Cooke, Megan E; Jones, Simon W; Ter Horst, Britt; Moiemen, Naiem; Snow, Martyn; Chouhan, Gurpreet; Hill, Lisa J; Esmaeli, Maryam; Moakes, Richard J A; Holton, James; Nandra, Rajpal; Williams, Richard L; Smith, Alan M; Grover, Liam M

2018-04-01

The development of new materials for clinical use is limited by an onerous regulatory framework, which means that taking a completely new material into the clinic can make translation economically unfeasible. One way to get around this issue is to structure materials that are already approved by the regulator, such that they exhibit very distinct physical properties and can be used in a broader range of clinical applications. Here, the focus is on the structuring of soft materials at multiple length scales by modifying processing conditions. By applying shear to newly forming materials, it is possible to trigger molecular reorganization of polymer chains, such that they aggregate to form particles and ribbon-like structures. These structures then weakly interact at zero shear forming a solid-like material. The resulting self-healing network is of particular use for a range of different biomedical applications. How these materials are used to allow the delivery of therapeutic entities (cells and proteins) and as a support for additive layer manufacturing of larger-scale tissue constructs is discussed. This technology enables the development of a range of novel materials and structures for tissue augmentation and regeneration. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

45 CFR 1309.10 - Applications for the purchase, construction and major renovation of facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false Applications for the purchase, construction and... RENOVATION AND CONSTRUCTION Application Procedures § 1309.10 Applications for the purchase, construction and... description of the rooms, and the lot on which the building is located or will be located (including the space...

45 CFR 1309.10 - Applications for the purchase, construction and major renovation of facilities.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 4 2012-10-01 2012-10-01 false Applications for the purchase, construction and... RENOVATION AND CONSTRUCTION Application Procedures § 1309.10 Applications for the purchase, construction and... description of the rooms, and the lot on which the building is located or will be located (including the space...

45 CFR 1309.10 - Applications for the purchase, construction and major renovation of facilities.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 4 2013-10-01 2013-10-01 false Applications for the purchase, construction and... RENOVATION AND CONSTRUCTION Application Procedures § 1309.10 Applications for the purchase, construction and... description of the rooms, and the lot on which the building is located or will be located (including the space...

45 CFR 1309.10 - Applications for the purchase, construction and major renovation of facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Applications for the purchase, construction and... RENOVATION AND CONSTRUCTION Application Procedures § 1309.10 Applications for the purchase, construction and... description of the rooms, and the lot on which the building is located or will be located (including the space...

45 CFR 1309.10 - Applications for the purchase, construction and major renovation of facilities.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 4 2014-10-01 2014-10-01 false Applications for the purchase, construction and... RENOVATION AND CONSTRUCTION Application Procedures § 1309.10 Applications for the purchase, construction and... description of the rooms, and the lot on which the building is located or will be located (including the space...

Application of BIM technology in construction bidding

NASA Astrophysics Data System (ADS)

wei, Li

2017-12-01

bidding is a very important step of construction project. For the owners, bidding is the key link of selecting the best construction plan and saving the project cost to the maximum extent. For Construction Corporation, it is the key to show their construction technology which can improve the probability of winning the bid. this paper researches on the application of BIM technology in bidding process of construction project in detail, and discussesthe application of BIM technology in construction field comprehensively.

Differentiating intolerance of uncertainty from three related but distinct constructs.

PubMed

Rosen, Natalie O; Ivanova, Elena; Knäuper, Bärbel

2014-01-01

Individual differences in uncertainty have been associated with heightened anxiety, stress and approach-oriented coping. Intolerance of uncertainty (IU) is a trait characteristic that arises from negative beliefs about uncertainty and its consequences. Researchers have established the central role of IU in the development of problematic worry and maladaptive coping, highlighting the importance of this construct to anxiety disorders. However, there is a need to improve our understanding of the phenomenology of IU. The goal of this paper was to present hypotheses regarding the similarities and differences between IU and three related constructs--intolerance of ambiguity, uncertainty orientation, and need for cognitive closure--and to call for future empirical studies to substantiate these hypotheses. To assist with achieving this goal, we conducted a systematic review of the literature, which also served to identify current gaps in knowledge. This paper differentiates these constructs by outlining each definition and general approaches to assessment, reviewing the existing empirical relations, and proposing theoretical similarities and distinctions. Findings may assist researchers in selecting the appropriate construct to address their research questions. Future research directions for the application of these constructs, particularly within the field of clinical and health psychology, are discussed.

Chaos as a psychological construct: historical roots, principal findings, and current growth directions.

PubMed

Guastello, Stephen J

2009-07-01

The landmarks in the use of chaos and related constructs in psychology were entwined with the growing use of other nonlinear dynamical constructs, especially catastrophes and self-organization. The growth in substantive applications of chaos in psychology is partially related to the development of methodologies that work within the constraints of psychological data. The psychological literature includes rigorous theory with testable propositions, lighter-weight metaphorical uses of the construct, and colloquial uses of "chaos" with no particular theoretical intent. The current state of the chaos construct and supporting empirical research in psychological theory is summarized in neuroscience, psychophysics, psychomotor skill and other learning phenomena, clinical and abnormal psychology, and group dynamics and organizational behavior. Trends indicate that human systems do not remain chaotic indefinitely; they eventually self-organize, and the concept of the complex adaptive system has become prominent. Chaotic turbulence is generally higher in healthy systems compared to unhealthy systems, although opposite appears true in mood disorders. Group dynamics research shows trends consistent with the complex adaptive system, whereas organizational behavior lags behind in empirical studies relative to the quantity of its theory. Future directions for research involving the chaos construct and other nonlinear dynamics are outlined.

29 CFR 1926.700 - Scope, application, and definitions applicable to this subpart.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Concrete and Masonry Construction § 1926.700 Scope, application, and definitions applicable to this subpart... from the hazards associated with concrete and masonry construction operations performed in workplaces... parts 1910 and 1926 apply to concrete and masonry construction operations. (b) Definitions applicable to...

29 CFR 1926.700 - Scope, application, and definitions applicable to this subpart.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Concrete and Masonry Construction § 1926.700 Scope, application, and definitions applicable to this subpart... from the hazards associated with concrete and masonry construction operations performed in workplaces... parts 1910 and 1926 apply to concrete and masonry construction operations. (b) Definitions applicable to...

29 CFR 1926.700 - Scope, application, and definitions applicable to this subpart.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Concrete and Masonry Construction § 1926.700 Scope, application, and definitions applicable to this subpart... from the hazards associated with concrete and masonry construction operations performed in workplaces... parts 1910 and 1926 apply to concrete and masonry construction operations. (b) Definitions applicable to...

29 CFR 1926.700 - Scope, application, and definitions applicable to this subpart.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Concrete and Masonry Construction § 1926.700 Scope, application, and definitions applicable to this subpart... from the hazards associated with concrete and masonry construction operations performed in workplaces... parts 1910 and 1926 apply to concrete and masonry construction operations. (b) Definitions applicable to...

29 CFR 1926.700 - Scope, application, and definitions applicable to this subpart.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Concrete and Masonry Construction § 1926.700 Scope, application, and definitions applicable to this subpart... from the hazards associated with concrete and masonry construction operations performed in workplaces... parts 1910 and 1926 apply to concrete and masonry construction operations. (b) Definitions applicable to...

[Quantitative Prediction of Drug-Drug Interaction Caused by CYP Inhibition and Induction from In Vivo Data and Its Application in Daily Clinical Practices-Proposal for the Pharmacokinetic Interaction Significance Classification System (PISCS)].

PubMed

Ohno, Yoshiyuki

2018-01-01

　Drug-drug interactions (DDIs) can affect the clearance of various drugs from the body; however, these effects are difficult to sufficiently evaluate in clinical studies. This article outlines our approach to improving methods for evaluating and providing drug information relative to the effects of DDIs. In a previous study, total exposure changes to many substrate drugs of CYP caused by the co-administration of inhibitor or inducer drugs were successfully predicted using in vivo data. There are two parameters for the prediction: the contribution ratio of the enzyme to oral clearance for substrates (CR), and either the inhibition ratio for inhibitors (IR) or the increase in clearance of substrates produced by induction (IC). To apply these predictions in daily pharmacotherapy, the clinical significance of any pharmacokinetic changes must be carefully evaluated. We constructed a pharmacokinetic interaction significance classification system (PISCS) in which the clinical significance of DDIs was considered in a systematic manner, according to pharmacokinetic changes. The PISCS suggests that many current 'alert' classifications are potentially inappropriate, especially for drug combinations in which pharmacokinetics have not yet been evaluated. It is expected that PISCS would contribute to constructing a reliable system to alert pharmacists, physicians and consumers of a broad range of pharmacokinetic DDIs in order to more safely manage daily clinical practices.

Examining construct validity of a new naturalistic observational assessment of hand skills for preschool- and school-age children.

PubMed

Chien, Chi-Wen; Brown, Ted; McDonald, Rachael

2012-04-01

The Assessment of Children's Hand Skills is a new assessment that utilises a naturalistic observational method to capture children's real-life hand skill performance when engaged at various types of daily activities in everyday living contexts. The Assessment of Children's Hand Skills is designed for use with 2- to 12-year-old children with a range of disabilities or health conditions. The study aimed to investigate construct validity of the Assessment of Children's Hand Skills in Australian children. Rasch analysis was used to examine internal construct validity of the Assessment of Children's Hand Skills in a mixed sample of 53 children with disabilities (including autism spectrum disorder, developmental/genetic disorders and physical disabilities) and 85 typically developing children. External construct validity was examined by correlating with three questionnaires evaluating daily living skills and hand skills. Rasch goodness-of-fit analysis suggested that all 22 activity items and 19 of 20 hand skill items in the Assessment of Children's Hand Skills measured a single construct. The Assessment of Children's Hand Skills items were placed in a clinically meaningful hierarchy from easy to hard, and the difficulty range of the items also matched the majority of children with disabilities and typically developing preschool-aged children. Moderate to high correlations (0.59 ≤ Spearman's ρ coefficients ≤ 0.89, P < 0.01) were found with the assessments of daily living and fine motor skills. This study provided preliminary evidence supporting the construct validity of the Assessment of Children's Hand Skills for its clinical application in assessing children's real-life hand skill performance in Australian contexts. © 2012 The Authors Australian Occupational Therapy Journal © 2012 Occupational Therapy Australia.

Initial psychometric evaluation of the Moral Injury Questionnaire--Military version.

PubMed

Currier, Joseph M; Holland, Jason M; Drescher, Kent; Foy, David

2015-01-01

Moral injury is an emerging construct related to negative consequences associated with war-zone stressors that transgress military veterans' deeply held values/beliefs. Given the newness of the construct, there is a need for instrumentation that might assess morally injurious experiences (MIEs) in this population. Drawing on a community sample of 131 Iraq and/or Afghanistan Veterans and clinical sample of 82 returning Veterans, we conducted an initial psychometric evaluation of the newly developed Moral Injury Questionnaire-Military version (MIQ-M)-a 20-item self-report measure for assessing MIEs. Possibly due to low rates of reporting, an item assessing sexual trauma did not yield favourable psychometric properties and was excluded from analyses. Veterans in the clinical sample endorsed significantly higher scores across MIQ-M items. Factor analytic results for the final 19 items supported a unidimensional structure, and convergent validity analyses revealed that higher scores (indicative of more MIEs) were correlated with greater general combat exposure, impairments in work/social functioning, posttraumatic stress and depression in the community sample. In addition, when controlling for demographics, deployment-related factors and exposure to life threat stressors associated with combat, tests of incremental validity indicated that MIQ-M scores were also uniquely linked with suicide risk and other mental health outcomes. These findings provide preliminary evidence for the validity of the MIQ-M and support the applicability of this measure for further research and clinical work with Veterans. Military service can confront service members with experiences that undermine their core sense of humanity and violate global values and beliefs. These types of experiences increase the risk for posttraumatic maladjustment in this population, even when accounting for rates of exposure to life threat traumas. Moral injury is an emerging construct to more fully capture the many possible psychological, ethical, and spiritual/existential challenges among persons who served in modern wars and other trauma-exposed professional groups. There is currently a need for psychometrically sound instrumentation for assessing morally injurious experiences (MIEs). The Moral Injury Questionnaire - Military Version (MIQ-M) was developed to provide a tool for assessing possible MIEs among military populations. This study provides preliminary evidence of the validity - including factorial, concurrent, and incremental - and clinical utility of the MIQ-M for further applications in clinical and research contexts. Copyright © 2013 John Wiley & Sons, Ltd.

Development and Validation of a Measure of Maladaptive Social-Evaluative Beliefs Characteristic of Social Anxiety Disorder in Youth: The Report of Youth Social Cognitions (RYSC).

PubMed

Wong, Quincy J J; Certoma, Sarah P; McLellan, Lauren F; Halldorsson, Brynjar; Reyes, Natasha; Boulton, Kelsie; Hudson, Jennifer L; Rapee, Ronald M

2017-12-28

Recent research has started to examine the applicability of influential adult models of the maintenance of social anxiety disorder (SAD) to youth. This research is limited by the lack of psychometrically validated measures of underlying constructs that are developmentally appropriate for youth. One key construct in adult models of SAD is maladaptive social-evaluative beliefs. The current study aimed to develop and validate a measure of these beliefs in youth, known as the Report of Youth Social Cognitions (RYSC). The RYSC was developed with a clinical sample of youth with anxiety disorders (N = 180) and cross-validated in a community sample of youth (N = 305). In the clinical sample, the RYSC exhibited a 3-factor structure (negative evaluation, revealing self, and positive impression factors), good internal consistency, and construct validity. In the community sample, the 3-factor structure and the internal consistency of the RYSC were replicated, but the test of construct validity showed that the RYSC had similarly strong associations with social anxiety and depressed affect. The RYSC had good test-retest reliability overall, although the revealing self subscale showed lower temporal stability which improved when only older participants were considered (age ≥9 years). The RYSC in general was also shown to discriminate between youth with and without SAD although the revealing self subscale again performed suboptimally but improved when only older participants were considered. These findings provide psychometric support for the RYSC and justifies its use with youth in research and clinical settings requiring the assessment of maladaptive social-evaluative beliefs. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Negative Mood and Obsessive-Compulsive Related Clinical Constructs: An Examination of Underlying Factors

PubMed Central

Britton, Gary I.; Davey, Graham C. L.

2017-01-01

Emerging evidence suggests that many of the clinical constructs used to help understand and explain obsessive-compulsive (OC) symptoms, and negative mood, may be causally interrelated. One approach to understanding this interrelatedness is a motivational systems approach. This approach suggests that rather than considering clinical constructs and negative affect as separable entities, they are all features of an integrated threat management system, and as such are highly coordinated and interdependent. The aim of the present study was to examine if clinical constructs related to OC symptoms and negative mood are best treated as separable or, alternatively, if these clinical constructs and negative mood are best seen as indicators of an underlying superordinate variable, as would be predicted by a motivational systems approach. A sample of 370 student participants completed measures of mood and the clinical constructs of inflated responsibility, intolerance of uncertainty, not just right experiences, and checking stop rules. An exploratory factor analysis suggested two plausible factor structures, one where all construct items and negative mood items loaded onto one underlying superordinate variable, and a second structure comprising of five factors, where each item loaded onto a factor representative of what the item was originally intended to measure. A confirmatory factor analysis showed that the five factor model was preferential to the one factor model, suggesting the four constructs and negative mood are best conceptualized as separate variables. Given the predictions of a motivational systems approach were not supported in the current study, other possible explanations for the causal interrelatedness between clinical constructs and negative mood are discussed. PMID:28959224

Tissue engineering strategies in spinal arthrodesis: the clinical imperative and challenges to clinical translation.

PubMed

Evans, Nick R; Davies, Evan M; Dare, Chris J; Oreffo, Richard Oc

2013-01-01

Skeletal disorders requiring the regeneration or de novo production of bone present considerable reconstructive challenges and are one of the main driving forces for the development of skeletal tissue engineering strategies. The skeletal or mesenchymal stem cell is a fundamental requirement for osteogenesis and plays a pivotal role in the design and application of these strategies. Research activity has focused on incorporating the biological role of the mesenchymal stem cell with the developing fields of material science and gene therapy in order to create a construct that is not only capable of inducing host osteoblasts to produce bone, but is also osteogenic in its own right. This review explores the clinical need for reparative approaches in spinal arthrodesis, identifying recent tissue engineering strategies employed to promote spinal fusion, and considers the ongoing challenges to successful clinical translation.

Applications of Composite Materials in Helicopter Construction (Les Applications des Materiaux Composite dans la Construction des Helicopteres),

DTIC Science & Technology

1983-11-21

TRANSLATION TITLE: APPLICATIONS OF COMPOSITE MATERIALS IN HELICOPTER CONSTRUCTION LES APPLICATIONS DES MATERTAUX COMWSITE DANS LA CONSTRUCTION DES...International Symposium on Design and Use of Kevlar in Aircraft, Geneva, 12 October 1982 [Beziac, Gilbert;* Les applications des mat6riaux composite...the pilot’s orders to the engine and the rotors. --Rear rotor Conventional or "faired propeller" type with its overall pitch control --Vibration

Self-efficacy: a means of identifying problems in nursing education and career progress.

PubMed

Harvey, V; McMurray, N

1994-10-01

Two nursing self-efficacy scales (academic and clinical) were developed and refined for use in identifying problems in progress in undergraduate nurses. Emergent factors within each scale contained items representing important aspects of nursing education. Both measures showed good internal consistency, test-retest reliability, and construct validity. Sensitivity to content and focus of tuition at time of completion was shown with some changes in factor structure over samples of first year nursing students. Academic self-efficacy (but not clinical self-efficacy) was predictive of course withdrawal. Applications to nursing education, progress in pursuing a nursing career and attrition are discussed.

Evaluation of an injectable rhGDF-5/PLGA construct for minimally invasive periodontal regenerative procedures: a histological study in the dog.

PubMed

Kwon, David H; Bennett, William; Herberg, Samuel; Bastone, Patrizia; Pippig, Susanne; Rodriguez, Nancy A; Susin, Cristiano; Wikesjö, Ulf M E

2010-04-01

To evaluate the injectability, biocompatibility, safety, and periodontal wound healing/regeneration following application of a novel bioresorbable recombinant human growth/differentiation factor-5 (rhGDF-5)/poly(lactic-co-glycolic acid) (PLGA) construct. Periodontal pockets (3 x 6 mm, width x depth) were surgically created over the buccal roots of the second and fourth mandibular pre-molars in eight adult Hound Labrador mongrel dogs. Surgeries including injection of the rhGDF-5/PLGA construct into the pockets were sequenced that four animals provided 2-/4-week and four animals 6-/8-week observations of sites receiving rhGDF-5/PLGA or serving as sham-surgery control. The rhGDF-5/PLGA construct was easy to prepare and apply. Approximately 0.2 ml (93 microg rhGDF-5)/tooth was used. Clinical and radiographic healing was exemplary without adverse events. Healing was characterized by a non-specific connective tissue attachment, acellular/cellular cementum, periodontal ligament (PDL), bone regeneration, and a junctional epithelium. PLGA fragments were observed in 4/7, 2/8, and 1/8 sites at 2, 4, and 6 weeks, respectively. Associated inflammatory reactions exhibited no limiting effect on periodontal wound healing/regeneration. Root resorption/ankylosis was not observed. Bone formation showed apparent increased maturity (lamellar bone) at 6 weeks in sites receiving rhGDF-5/PLGA compared with the control. Both protocols exhibited significant increases in PDL, cementum, and bone regeneration over time, without significant differences between treatments. In time, PDL and cementum regeneration was twofold greater for the control at 4 weeks (p=0.04) while increased bone formation was observed at sites receiving rhGDF-5/PLGA (p<0.01). In conclusion, the rhGDF-5/PLGA construct appears to be a safe technology for injectable, ease-of-use application of rhGDF-5-stimulated periodontal wound healing/regeneration. Additional work to optimize the polymer carrier and rhGDF-5 release kinetics/dose might be required before evaluating the efficacy of this technology in clinical settings using minimally invasive approaches.

[Discipline construction is the theme of the development of burn surgery].

PubMed

Jia, C Y

2018-03-20

Discipline construction is the core element of department development, including discipline structure setting, scale, equipment, medical workers structure, clinical feature and advantage, talent training, teaching level, scientific research level, management system, and cultural construction of department. As leader and engine of discipline construction, directors' ability is an important factor for discipline construction. Clinical characteristic is the basis of discipline construction; innovation actuation is the essence of discipline construction; talents training is the guarantee of discipline construction; scientific research is the wing of discipline construction; cultural construction is the hot spring of discipline construction. Discipline construction is the theme of the development of burn surgery.

A machine learning based approach to identify protected health information in Chinese clinical text.

PubMed

Du, Liting; Xia, Chenxi; Deng, Zhaohua; Lu, Gary; Xia, Shuxu; Ma, Jingdong

2018-08-01

With the increasing application of electronic health records (EHRs) in the world, protecting private information in clinical text has drawn extensive attention from healthcare providers to researchers. De-identification, the process of identifying and removing protected health information (PHI) from clinical text, has been central to the discourse on medical privacy since 2006. While de-identification is becoming the global norm for handling medical records, there is a paucity of studies on its application on Chinese clinical text. Without efficient and effective privacy protection algorithms in place, the use of indispensable clinical information would be confined. We aimed to (i) describe the current process for PHI in China, (ii) propose a machine learning based approach to identify PHI in Chinese clinical text, and (iii) validate the effectiveness of the machine learning algorithm for de-identification in Chinese clinical text. Based on 14,719 discharge summaries from regional health centers in Ya'an City, Sichuan province, China, we built a conditional random fields (CRF) model to identify PHI in clinical text, and then used the regular expressions to optimize the recognition results of the PHI categories with fewer samples. We constructed a Chinese clinical text corpus with PHI tags through substantial manual annotation, wherein the descriptive statistics of PHI manifested its wide range and diverse categories. The evaluation showed with a high F-measure of 0.9878 that our CRF-based model had a good performance for identifying PHI in Chinese clinical text. The rapid adoption of EHR in the health sector has created an urgent need for tools that can parse patient specific information from Chinese clinical text. Our application of CRF algorithms for de-identification has shown the potential to meet this need by offering a highly accurate and flexible solution to analyzing Chinese clinical text. Copyright © 2018 Elsevier B.V. All rights reserved.

Regenerative medicine for the respiratory system: distant future or tomorrow's treatment?

PubMed

Brouwer, Katrien M; Hoogenkamp, Henk R; Daamen, Willeke F; van Kuppevelt, Toin H

2013-03-01

Regenerative medicine (RM) is a new field of biomedical science that focuses on the regeneration of tissues and organs and the restoration of organ function. Although regeneration of organ systems such as bone, cartilage, and heart has attracted intense scientific research over recent decades, RM research regarding the respiratory system, including the trachea, the lung proper, and the diaphragm, has lagged behind. However, the last 5 years have witnessed novel approaches and initial clinical applications of tissue-engineered constructs to restore organ structure and function. In this regard, this article briefly addresses the basics of RM and introduces the key elements necessary for tissue regeneration, including (stem) cells, biomaterials, and extracellular matrices. In addition, the current status of the (clinical) application of RM to the respiratory system is discussed, and bottlenecks and recent approaches are identified. For the trachea, several initial clinical studies have been reported and have used various combinations of cells and scaffolds. Although promising, the methods used in these studies require optimization and standardization. For the lung proper, only (stem) cell-based approaches have been probed clinically, but it is becoming apparent that combinations of cells and scaffolds are required to successfully restore the lung's architecture and function. In the case of the diaphragm, clinical applications have focused on the use of decellularized scaffolds, but novel scaffolds, with or without cells, are clearly needed for true regeneration of diaphragmatic tissue. We conclude that respiratory treatment with RM will not be realized tomorrow, but its future looks promising.

Construct validation of an interactive digital algorithm for ostomy care.

PubMed

Beitz, Janice M; Gerlach, Mary A; Schafer, Vickie

2014-01-01

The purpose of this study was to evaluate construct validity for a previously face and content validated Ostomy Algorithm using digital real-life clinical scenarios. A cross-sectional, mixed-methods Web-based survey design study was conducted. Two hundred ninety-seven English-speaking RNs completed the study; participants practiced in both acute care and postacute settings, with 1 expert ostomy nurse (WOC nurse) and 2 nonexpert nurses. Following written consent, respondents answered demographic questions and completed a brief algorithm tutorial. Participants were then presented with 7 ostomy-related digital scenarios consisting of real-life photos and pertinent clinical information. Respondents used the 11 assessment components of the digital algorithm to choose management options. Participant written comments about the scenarios and the research process were collected. The mean overall percentage of correct responses was 84.23%. Mean percentage of correct responses for respondents with a self-reported basic ostomy knowledge was 87.7%; for those with a self-reported intermediate ostomy knowledge was 85.88% and those who were self-reported experts in ostomy care achieved 82.77% correct response rate. Five respondents reported having no prior ostomy care knowledge at screening and achieved an overall 45.71% correct response rate. No negative comments regarding the algorithm were recorded by participants. The new standardized Ostomy Algorithm remains the only face, content, and construct validated digital clinical decision instrument currently available. Further research on application at the bedside while tracking patient outcomes is warranted.

Clinical trials needed to evaluate compression therapy in breast cancer related lymphedema (BCRL). Proposals from an expert group.

PubMed

Partsch, H; Stout, N; Forner-Cordero, I; Flour, M; Moffatt, C; Szuba, A; Milic, D; Szolnoky, G; Brorson, H; Abel, M; Schuren, J; Schingale, F; Vignes, S; Piller, N; Döller, W

2010-10-01

A mainstay of lymphedema management involves the use of compression therapy. Compression therapy application is variable at different levels of disease severity. Evidence is scant to direct clinicians in best practice regarding compression therapy use. Further, compression clinical trials are fragmented and poorly extrapolable to the greater population. An ideal construct for conducting clinical trials in regards to compression therapy will promote parallel global initiatives based on a standard research agenda. The purpose of this article is to review current evidence in practice regarding compression therapy for BCRL management and based on this evidence, offer an expert consensus recommendation for a research agenda and prescriptive trials. Recommendations herein focus solely on compression interventions. This document represents the proceedings of a session organized by the International Compression Club (ICC) in June 2009 in Ponzano (Veneto, Italy). The purpose of the meeting was to enable a group of experts to discuss the existing evidence for compression treatment in breast cancer related lymphedema (BCRL) concentrating on areas where randomized controlled trials (RCTs) are lacking. The current body of research suggests efficacy of compression interventions in the treatment and management of lymphedema. However, studies to date have failed to adequately address various forms of compression therapy and their optimal application in BCRL. We offer recommendations for standardized compression research trials for prophylaxis of arm lymphedema and for the management of chronic BCRL. Suggestions are also made regarding; inclusion and exclusion criteria, measurement methodology and additional variables of interest for researchers to capture. This document should inform future research trials in compression therapy and serve as a guide to clinical researchers, industry researchers and lymphologists regarding the strengths, weaknesses and shortcomings of the current literature. By providing this construct for research trials, the authors aim to support evidence-based therapy interventions, promote a cohesive, standardized and informative body of literature to enhance clinical outcomes, improve the quality of future research trials, inform industry innovation and guide policy related to BCRL.

Whyever bladder tissue engineering clinical applications still remain unusual even though many intriguing technological advances have been reached?

PubMed

Alberti, C

2016-01-01

To prevent problematic outcomes of bowel-based bladder reconstructive surgery, such as prosthetic tumors and systemic metabolic complications, research works, to either regenerate and strengthen failing organ or build organ replacement biosubstitute, have been turned, from 90s of the last century, to both regenerative medicine and tissue engineering.Various types of acellular matrices, naturally-derived materials, synthetic polymers have been used for either "unseeded" (cell free) or autologous "cell seeded" tissue engineering scaffolds. Different categories of cell sources - from autologous differentiated urothelial and smooth muscle cells to natural or laboratory procedure-derived stem cells - have been taken into consideration to reach the construction of suitable "cell seeded" templates. Current clinically validated bladder tissue engineering approaches essentially consist of augmentation cystoplasty in patients suffering from poorly compliant neuropathic bladder. No clinical applications of wholly tissue engineered neobladder have been carried out to radical-reconstructive surgical treatment of bladder malignancies or chronic inflammation-due vesical coarctation. Reliable reasons why bladder tissue engineering clinical applications so far remain unusual, particularly imply the risk of graft ischemia, hence its both fibrous contraction and even worse perforation. Therefore, the achievement of graft vascular network (vasculogenesis) could allow, together with the promotion of host surrounding vessel sprouting (angiogenesis), an effective graft blood supply, so avoiding the ischemia-related serious complications.

Integrating clinical and biological information in a shanghai biobank: an introduction to the sample repository and information sharing platform project.

PubMed

Cui, Wenbin; Zheng, Peiyong; Yang, Jiahong; Zhao, Rong; Gao, Jiechun; Yu, Guangjun

2015-02-01

Biobanks are important resources and central tools for translational medicine, which brings scientific research outcomes to clinical practice. The key purpose of biobanking in translational medicine and other medical research is to provide biological samples that are integrated with clinical information. In 2008, the Shanghai Municipal Government launched the "Shanghai Tissue Bank" in an effort to promote research in translational medicine. Now a sharing service platform has been constructed to integrate clinical practice and biological information that can be used in diverse medical and pharmaceutical research studies. The platform collects two kinds of data: sample data and clinical data. The sample data are obtained from the hospital biobank management system, and mainly include the donors' age, gender, marital status, sample source, sample type, collection time, deposit time, and storage method. The clinical data are collected from the "Hospital-Link" system (a medical information sharing system that connects 23 tertiary hospitals in Shanghai). The main contents include donors' corresponding medication information, test reports, inspection reports, and hospital information. As of the end of September 2014, the project has a collection of 16,020 donors and 148,282 samples, which were obtained from 12 medical institutions, and automatically acquired donors' corresponding clinical data from the "Hospital-Link" system for 6830 occurrences. This project will contribute to scientific research at medical institutions in Shanghai, and will also support the development of the biopharmaceutical industry. In this article, we will describe the significance, the construction phases, the application prospects, and benefits of the sample repository and information sharing service platform.

The Script Concordance Test: a new tool assessing clinical judgement in neurology.

PubMed

Lubarsky, Stuart; Chalk, Colin; Kazitani, Driss; Gagnon, Robert; Charlin, Bernard

2009-05-01

Clinical judgment, the ability to make appropriate decisions in uncertain situations, is central to neurological practice, but objective measures of clinical judgment in neurology trainees are lacking. The Script Concordance Test (SCT), based on script theory from cognitive psychology, uses authentic clinical scenarios to compare a trainee's judgment skills with those of experts. The SCT has been validated in several medical disciplines, but has not been investigated in neurology. We developed an Internet-based neurology SCT (NSCT) comprising 24 clinical scenarios with three to four questions each. The scenarios were designed to reflect the uncertainty of real-life clinical encounters in adult neurology. The questions explored aspects of the scenario in which several responses might be acceptable; trainees were asked to judge which response they considered to be best. Forty-one PGY1-PGY5 neurology residents and eight medical students from three North American neurology programs (McGill, Calgary, and Mayo Clinic) completed the NSCT. The responses of trainees to each question were compared with the aggregate responses of an expert panel of 16 attending neurologists. The NSCT demonstrated good reliability (Cronbach alpha = 0.79). Neurology residents scored higher than medical students and lower than attending neurologists, supporting the test's construct validity. Furthermore, NSCT scores discriminated between senior (PGY3-5) and junior residents (PGY1-2). Our NSCT is a practical and reliable instrument, and our findings support its construct validity for assessing judgment in neurology trainees. The NSCT has potentially widespread applications as an evaluation tool, both in neurology training and for licensing examinations.

47 CFR 1.2113 - Construction prior to grant of application.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Competitive Bidding Proceedings General Procedures § 1.2113 Construction prior to grant of application. Subject to the provisions of this section, applicants for licenses awarded by competitive bidding may..., applicants must not begin to construct facilities for licenses subject to competitive bidding. (a) When...

47 CFR 1.2113 - Construction prior to grant of application.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Competitive Bidding Proceedings General Procedures § 1.2113 Construction prior to grant of application. Subject to the provisions of this section, applicants for licenses awarded by competitive bidding may..., applicants must not begin to construct facilities for licenses subject to competitive bidding. (a) When...

Developing an instrument to measure effective factors on Clinical Learning

PubMed Central

DADGARAN, IDEH; SHIRAZI, MANDANA; MOHAMMADI, AEEN; RAVARI, ALI

2016-01-01

Introduction Although nursing students spend a large part of their learning period in the clinical environment, clinical learning has not been perceived by its nature yet. To develop an instrument to measure effective factors on clinical learning in nursing students. Methods This is a mixed methods study performed in 2 steps. First, the researchers defined “clinical learning” in nursing students through qualitative content analysis and designed items of the questionnaire based on semi-structured individual interviews with nursing students. Then, as the second step, psychometric properties of the questionnaire were evaluated using the face validity, content validity, construct validity, and internal consistency evaluated on 227 students from fourth or higher semesters. All the interviews were recorded and transcribed, and then, they were analyzed using Max Qualitative Data Analysis and all of qualitative data were analyzed using SPSS 14. Results To do the study, we constructed the preliminary questionnaire containing 102 expressions. After determination of face and content validities by qualitative and quantitative approaches, the expressions of the questionnaire were reduced to 45. To determine the construct validity, exploratory factor analysis was applied. The results indicated that the maximum variance percentage (40.55%) was defined by the first 3 factors while the rest of the total variance percentage (59.45%) was determined by the other 42 factors. Results of exploratory factor analysis of this questionnaire indicated the presence of 3 instructor-staff, students, and educational related factors. Finally, 41 expressions were kept in 3 factor groups. The α-Cronbach coefficient (0.93) confirmed the high internal consistency of the questionnaire. Conclusion Results indicated that the prepared questionnaire was an efficient instrument in the study of the effective factors on clinical learning as viewed by nursing students since it involves 41 expressions and properties such as instrument design based on perception and experiences of the nursing students about effective factors on clinical learning, definition of facilitator and preventive factors of the clinical learning, simple scoring, suitable validity and reliability, and applicability in different occasions. PMID:27382579

Construction and Potential Applications of Biosensors for Proteins in Clinical Laboratory Diagnosis

PubMed Central

Liu, Xuan

2017-01-01

Biosensors for proteins have shown attractive advantages compared to traditional techniques in clinical laboratory diagnosis. In virtue of modern fabrication modes and detection techniques, various immunosensing platforms have been reported on basis of the specific recognition between antigen-antibody pairs. In addition to profit from the development of nanotechnology and molecular biology, diverse fabrication and signal amplification strategies have been designed for detection of protein antigens, which has led to great achievements in fast quantitative and simultaneous testing with extremely high sensitivity and specificity. Besides antigens, determination of antibodies also possesses great significance for clinical laboratory diagnosis. In this review, we will categorize recent immunosensors for proteins by different detection techniques. The basic conception of detection techniques, sensing mechanisms, and the relevant signal amplification strategies are introduced. Since antibodies and antigens have an equal position to each other in immunosensing, all biosensing strategies for antigens can be extended to antibodies under appropriate optimizations. Biosensors for antibodies are summarized, focusing on potential applications in clinical laboratory diagnosis, such as a series of biomarkers for infectious diseases and autoimmune diseases, and an evaluation of vaccine immunity. The excellent performances of these biosensors provide a prospective space for future antibody-detection-based disease serodiagnosis. PMID:29207528

Construction and Potential Applications of Biosensors for Proteins in Clinical Laboratory Diagnosis.

PubMed

Liu, Xuan; Jiang, Hui

2017-12-04

Biosensors for proteins have shown attractive advantages compared to traditional techniques in clinical laboratory diagnosis. In virtue of modern fabrication modes and detection techniques, various immunosensing platforms have been reported on basis of the specific recognition between antigen-antibody pairs. In addition to profit from the development of nanotechnology and molecular biology, diverse fabrication and signal amplification strategies have been designed for detection of protein antigens, which has led to great achievements in fast quantitative and simultaneous testing with extremely high sensitivity and specificity. Besides antigens, determination of antibodies also possesses great significance for clinical laboratory diagnosis. In this review, we will categorize recent immunosensors for proteins by different detection techniques. The basic conception of detection techniques, sensing mechanisms, and the relevant signal amplification strategies are introduced. Since antibodies and antigens have an equal position to each other in immunosensing, all biosensing strategies for antigens can be extended to antibodies under appropriate optimizations. Biosensors for antibodies are summarized, focusing on potential applications in clinical laboratory diagnosis, such as a series of biomarkers for infectious diseases and autoimmune diseases, and an evaluation of vaccine immunity. The excellent performances of these biosensors provide a prospective space for future antibody-detection-based disease serodiagnosis.

29 CFR 2700.1 - Scope; applicability of other rules; construction.

Code of Federal Regulations, 2010 CFR

2010-07-01

... work injustice, in which event the former rules of procedure would continue to apply. (b) Applicability... 29 Labor 9 2010-07-01 2010-07-01 false Scope; applicability of other rules; construction. 2700.1... COMMISSION PROCEDURAL RULES General Provisions § 2700.1 Scope; applicability of other rules; construction. (a...

Human embryonic stem cell-derived mesodermal progenitors display substantially increased tissue formation compared to human mesenchymal stem cells under dynamic culture conditions in a packed bed/column bioreactor.

PubMed

de Peppo, Giuseppe Maria; Sladkova, Martina; Sjövall, Peter; Palmquist, Anders; Oudina, Karim; Hyllner, Johan; Thomsen, Peter; Petite, Hervé; Karlsson, Camilla

2013-01-01

Bone tissue engineering represents a promising strategy to obviate bone deficiencies, allowing the ex vivo construction of bone substitutes with unprecedented potential in the clinical practice. Considering that in the human body cells are constantly stimulated by chemical and mechanical stimuli, the use of bioreactor is emerging as an essential factor for providing the proper environment for the reproducible and large-scale production of the engineered substitutes. Human mesenchymal stem cells (hMSCs) are experimentally relevant cells but, regardless the encouraging results reported after culture under dynamic conditions in bioreactors, show important limitations for tissue engineering applications, especially considering their limited proliferative potential, loss of functionality following protracted expansion, and decline in cellular fitness associated with aging. On the other hand, we previously demonstrated that human embryonic stem cell-derived mesodermal progenitors (hES-MPs) hold great potential to provide a homogenous and unlimited source of cells for bone engineering applications. Based on prior scientific evidence using different types of stem cells, in the present study we hypothesized that dynamic culture of hES-MPs in a packed bed/column bioreactor had the potential to affect proliferation, expression of genes involved in osteogenic differentiation, and matrix mineralization, therefore resulting in increased bone-like tissue formation. The reported findings suggest that hES-MPs constitute a suitable alternative cell source to hMSCs and hold great potential for the construction of bone substitutes for tissue engineering applications in clinical settings.

The potential of 3D printing in urological research and patient care.

PubMed

Colaco, Marc; Igel, Daniel A; Atala, Anthony

2018-04-01

3D printing is an evolving technology that enables the creation of unique organic and inorganic structures with high precision. In urology, the technology has demonstrated potential uses in both patient and clinician education as well as in clinical practice. The four major techniques used for 3D printing are inkjet printing, extrusion printing, laser sintering, and stereolithography. Each of these techniques can be applied to the production of models for education and surgical planning, prosthetic construction, and tissue bioengineering. Bioengineering is potentially the most important application of 3D printing, as the ability to produce functional organic constructs might, in the future, enable urologists to replicate and replace abnormal tissues with neo-organs, improving patient survival and quality of life.

The Average Hazard Ratio - A Good Effect Measure for Time-to-event Endpoints when the Proportional Hazard Assumption is Violated?

PubMed

Rauch, Geraldine; Brannath, Werner; Brückner, Matthias; Kieser, Meinhard

2018-05-01

In many clinical trial applications, the endpoint of interest corresponds to a time-to-event endpoint. In this case, group differences are usually expressed by the hazard ratio. Group differences are commonly assessed by the logrank test, which is optimal under the proportional hazard assumption. However, there are many situations in which this assumption is violated. Especially in applications were a full population and several subgroups or a composite time-to-first-event endpoint and several components are considered, the proportional hazard assumption usually does not simultaneously hold true for all test problems under investigation. As an alternative effect measure, Kalbfleisch and Prentice proposed the so-called 'average hazard ratio'. The average hazard ratio is based on a flexible weighting function to modify the influence of time and has a meaningful interpretation even in the case of non-proportional hazards. Despite this favorable property, it is hardly ever used in practice, whereas the standard hazard ratio is commonly reported in clinical trials regardless of whether the proportional hazard assumption holds true or not. There exist two main approaches to construct corresponding estimators and tests for the average hazard ratio where the first relies on weighted Cox regression and the second on a simple plug-in estimator. The aim of this work is to give a systematic comparison of these two approaches and the standard logrank test for different time-toevent settings with proportional and nonproportional hazards and to illustrate the pros and cons in application. We conduct a systematic comparative study based on Monte-Carlo simulations and by a real clinical trial example. Our results suggest that the properties of the average hazard ratio depend on the underlying weighting function. The two approaches to construct estimators and related tests show very similar performance for adequately chosen weights. In general, the average hazard ratio defines a more valid effect measure than the standard hazard ratio under non-proportional hazards and the corresponding tests provide a power advantage over the common logrank test. As non-proportional hazards are often met in clinical practice and the average hazard ratio tests often outperform the common logrank test, this approach should be used more routinely in applications. Schattauer GmbH.

Reshaping clinical science: Introduction to the Special Issue on Psychophysiology and the NIMH Research Domain Criteria (RDoC) initiative.

PubMed

Patrick, Christopher J; Hajcak, Greg

2016-03-01

The National Institute of Mental Health's (NIMH) Research Domain Criteria (RDoC) initiative seeks to establish new dimensional conceptions of mental health problems, through the investigation of clinically relevant "process" constructs that have neurobiological as well as psychological referents. This special issue provides a detailed overview of the RDoC framework by NIMH officials Michael Kozak and Bruce Cuthbert, and spotlights RDoC-oriented investigative efforts by leading psychophysiological research groups as examples of how clinical science might be reshaped through application of RDoC principles. Accompanying commentaries highlight key aspects of the work by each group, and discuss reported methods/findings in relation to promises and challenges of the RDoC initiative more broadly. © 2016 Society for Psychophysiological Research.

Supercritical carbon dioxide-processed resorbable polymer nanocomposites for bone graft substitute applications

NASA Astrophysics Data System (ADS)

Baker, Kevin C.

Numerous clinical situations necessitate the use of bone graft materials to enhance bone formation. While autologous and allogenic materials are considered the gold standards in the setting of fracture healing and spine fusion, their disadvantages, which include donor site morbidity and finite supply have stimulated research and development of novel bone graft substitute materials. Among the most promising candidate materials are resorbable polymers, composed of lactic and/or glycolic acid. While the characteristics of these materials, such as predictable degradation kinetics and biocompatibility, make them an excellent choice for bone graft substitute applications, they lack mechanical strength when synthesized with the requisite porous morphology. As such, porous resorbable polymers are often reinforced with filler materials. In the presented work, we describe the use of supercritical carbon dioxide (scCO2) processing to create porous resorbable polymeric constructs reinforced by nanostructured, organically modified Montmorillonite clay (nanoclay). scCO2 processing simultaneously disperses the nanoclay throughout the polymeric matrix, while imparting a porous morphology to the construct conducive to facilitating cellular infiltration and neoangiogenesis, which are necessary components of bone growth. With the addition of as little as 2.5wt% of nanoclay, the compressive strength of the constructs nearly doubles putting them on par with human cortico-cancellous bone. Rheological measurements indicate that the dominant mode of reinforcement of the nanocomposite constructs is the restriction of polymer chain mobility. This restriction is a function of the positive interaction between polymer chains and the nanoclay. In vivo inflammation studies indicate biocompatibility of the constructs. Ectopic osteogenesis assays have determined that the scCO2-processed nanocomposites are capable of supporting growth-factor induced bone formation. scCO 2-processed resorbable polymer nanocomposites composed of resorbable polymers and nanocaly exhibit physical, mechanical and biologic properties that make them excellent candidate materials for structural bone graft substitute applications.

Development and Validation of MMPI-2-RF Scales for Indexing Triarchic Psychopathy Constructs.

PubMed

Sellbom, Martin; Drislane, Laura E; Johnson, Alexandria K; Goodwin, Brandee E; Phillips, Tasha R; Patrick, Christopher J

2016-10-01

The triarchic model characterizes psychopathy in terms of three distinct dispositional constructs of boldness, meanness, and disinhibition. The model can be operationalized through scales designed specifically to index these domains or by using items from other inventories that provide coverage of related constructs. The present study sought to develop and validate scales for assessing the triarchic model domains using items from the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF). A consensus rating approach was used to identify items relevant to each triarchic domain, and following psychometric refinement, the resulting MMPI-2-RF-based triarchic scales were evaluated for convergent and discriminant validity in relation to multiple psychopathy-relevant criterion variables in offender and nonoffender samples. Expected convergent and discriminant associations were evident very clearly for the Boldness and Disinhibition scales and somewhat less clearly for the Meanness scale. Moreover, hierarchical regression analyses indicated that all MMPI-2-RF triarchic scales incremented standard MMPI-2-RF scale scores in predicting extant triarchic model scale scores. The widespread use of MMPI-2-RF in clinical and forensic settings provides avenues for both clinical and research applications in contexts where traditional psychopathy measures are less likely to be administered. © The Author(s) 2015.

Tailor-made fibroblast-specific and antibiotic-free interleukin 12 plasmid for gene electrotransfer-mediated cancer immunotherapy.

PubMed

Kamensek, Urska; Tesic, Natasa; Sersa, Gregor; Kos, Spela; Cemazar, Maja

2017-01-01

Electrotransfer mediated delivery of interleukin-12 (IL-12) gene, encoded on a plasmid vector, has already been demonstrated to have a potent antitumor efficacy and great potential for clinical application. In the present study, our aim was to construct an optimized IL-12-encoding plasmid that is safe from the regulatory point of view. In light of previous studies demonstrating that IL-12 should be released in a tumor localized manner for optimal efficacy, the strong ubiquitous promoter was replaced with a weak endogenous promoter of the collagen 2 gene, which is specific for fibroblasts. Next, to comply with increasing regulatory demands for clinically used plasmids, the expression cassette was cloned in a plasmid lacking the antibiotic resistance gene. The constructed fibroblast-specific and antibiotic-free IL-12 plasmid was demonstrated to support low IL-12 expression after gene electrotransfer in selected cell lines. Furthermore, the removal of antibiotic resistance did not affect the plasmid expression profile and lowered its cytotoxicity. With optimal IL-12 expression and minimal transgene non-specific effects, i.e., low cytotoxicity, the constructed plasmid could be especially valuable for different modern immunological approaches to achieve localized boosting of the host's immune system. Copyright © 2016 Elsevier Inc. All rights reserved.

Application of Multilabel Learning Using the Relevant Feature for Each Label in Chronic Gastritis Syndrome Diagnosis

PubMed Central

Liu, Guo-Ping; Yan, Jian-Jun; Wang, Yi-Qin; Fu, Jing-Jing; Xu, Zhao-Xia; Guo, Rui; Qian, Peng

2012-01-01

Background. In Traditional Chinese Medicine (TCM), most of the algorithms are used to solve problems of syndrome diagnosis that only focus on one syndrome, that is, single label learning. However, in clinical practice, patients may simultaneously have more than one syndrome, which has its own symptoms (signs). Methods. We employed a multilabel learning using the relevant feature for each label (REAL) algorithm to construct a syndrome diagnostic model for chronic gastritis (CG) in TCM. REAL combines feature selection methods to select the significant symptoms (signs) of CG. The method was tested on 919 patients using the standard scale. Results. The highest prediction accuracy was achieved when 20 features were selected. The features selected with the information gain were more consistent with the TCM theory. The lowest average accuracy was 54% using multi-label neural networks (BP-MLL), whereas the highest was 82% using REAL for constructing the diagnostic model. For coverage, hamming loss, and ranking loss, the values obtained using the REAL algorithm were the lowest at 0.160, 0.142, and 0.177, respectively. Conclusion. REAL extracts the relevant symptoms (signs) for each syndrome and improves its recognition accuracy. Moreover, the studies will provide a reference for constructing syndrome diagnostic models and guide clinical practice. PMID:22719781

Optical nano-biosensing interface via nucleic acid amplification strategy: construction and application.

PubMed

Zhou, Hong; Liu, Jing; Xu, Jing-Juan; Zhang, Shu-Sheng; Chen, Hong-Yuan

2018-03-21

Modern optical detection technology plays a critical role in current clinical detection due to its high sensitivity and accuracy. However, higher requirements such as extremely high detection sensitivity have been put forward due to the clinical needs for the early finding and diagnosing of malignant tumors which are significant for tumor therapy. The technology of isothermal amplification with nucleic acids opens up avenues for meeting this requirement. Recent reports have shown that a nucleic acid amplification-assisted modern optical sensing interface has achieved satisfactory sensitivity and accuracy, high speed and specificity. Compared with isothermal amplification technology designed to work completely in a solution system, solid biosensing interfaces demonstrated better performances in stability and sensitivity due to their ease of separation from the reaction mixture and the better signal transduction on these optical nano-biosensing interfaces. Also the flexibility and designability during the construction of these nano-biosensing interfaces provided a promising research topic for the ultrasensitive detection of cancer diseases. In this review, we describe the construction of the burgeoning number of optical nano-biosensing interfaces assisted by a nucleic acid amplification strategy, and provide insightful views on: (1) approaches to the smart fabrication of an optical nano-biosensing interface, (2) biosensing mechanisms via the nucleic acid amplification method, (3) the newest strategies and future perspectives.

Rasch Measurement Analysis of the Mayo-Portland Adaptability Inventory (MPAI-4) in a Community-Based Rehabilitation Sample

PubMed Central

Malec, James F.; Altman, Irwin M.; Swick, Shannon

2011-01-01

Abstract The precise measurement of patient outcomes depends upon clearly articulated constructs and refined clinical assessment instruments that work equally well for all subgroups within a population. This is a challenging task in those with acquired brain injury (ABI) because of the marked heterogeneity of the disorder and subsequent outcomes. Alhough essential, the iterative process of instrument refinement is often neglected. This present study was undertaken to examine validity, reliability, dimensionality and item estimate invariance of the Mayo-Portland Adaptability Inventory – 4 (MPAI-4), an outcome measure for persons with ABI. The sampled population included 603 persons with traumatic ABI participating in a home- and community-based rehabilitation program. Results indicated that the MPAI-4 is a valid, reliable measure of outcome following traumatic ABI, which measures a broad but unitary core construct of outcome after ABI. Further, the MPAI-4 is composed of items that are unbiased toward selected subgroups except where differences could be expected [e.g., more chronic traumatic brain injury (TBI) patients are better able to negotiate demands of transportation than more acute TBI patients]. We address the trade-offs between strict unidimensionality and clinical applicability in measuring outcome, and illustrate the advantages and disadvantages of applying single-parameter measurement models to broad constructs. PMID:21332409

Rasch measurement analysis of the Mayo-Portland Adaptability Inventory (MPAI-4) in a community-based rehabilitation sample.

PubMed

Kean, Jacob; Malec, James F; Altman, Irwin M; Swick, Shannon

2011-05-01

The precise measurement of patient outcomes depends upon clearly articulated constructs and refined clinical assessment instruments that work equally well for all subgroups within a population. This is a challenging task in those with acquired brain injury (ABI) because of the marked heterogeneity of the disorder and subsequent outcomes. Although essential, the iterative process of instrument refinement is often neglected. This present study was undertaken to examine validity, reliability, dimensionality and item estimate invariance of the Mayo-Portland Adaptability Inventory - 4 (MPAI-4), an outcome measure for persons with ABI. The sampled population included 603 persons with traumatic ABI participating in a home- and community-based rehabilitation program. Results indicated that the MPAI-4 is a valid, reliable measure of outcome following traumatic ABI, which measures a broad but unitary core construct of outcome after ABI. Further, the MPAI-4 is composed of items that are unbiased toward selected subgroups except where differences could be expected [e.g., more chronic traumatic brain injury (TBI) patients are better able to negotiate demands of transportation than more acute TBI patients]. We address the trade-offs between strict unidimensionality and clinical applicability in measuring outcome, and illustrate the advantages and disadvantages of applying single-parameter measurement models to broad constructs.

Clinical Functional Capacity Testing in Patients With Facioscapulohumeral Muscular Dystrophy: Construct Validity and Interrater Reliability of Antigravity Tests.

PubMed

Rijken, Noortje H; van Engelen, Baziel G; Weerdesteyn, Vivian; Geurts, Alexander C

2015-12-01

To evaluate the construct validity and interrater reliability of 4 simple antigravity tests in a small group of patients with facioscapulohumeral muscular dystrophy (FSHD). Case-control study. University medical center. Patients with various severity levels of FSHD (n=9) and healthy control subjects (n=10) were included (N=19). Not applicable. A 4-point ordinal scale was designed to grade performance on the following 4 antigravity tests: sit to stance, stance to sit, step up, and step down. In addition, the 6-minute walk test, 10-m walking test, Berg Balance Scale, and timed Up and Go test were administered as conventional tests. Construct validity was determined by linear regression analysis using the Clinical Severity Score (CSS) as the dependent variable. Interrater agreement was tested using a κ analysis. Patients with FSHD performed worse on all 4 antigravity tests compared with the controls. Stronger correlations were found within than between test categories (antigravity vs conventional). The antigravity tests revealed the highest explained variance with regard to the CSS (R(2)=.86, P=.014). Interrater agreement was generally good. The results of this exploratory study support the construct validity and interrater reliability of the proposed antigravity tests for the assessment of functional capacity in patients with FSHD taking into account the use of compensatory strategies. Future research should further validate these results in a larger sample of patients with FSHD. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Cloud GPU-based simulations for SQUAREMR.

PubMed

Kantasis, George; Xanthis, Christos G; Haris, Kostas; Heiberg, Einar; Aletras, Anthony H

2017-01-01

Quantitative Magnetic Resonance Imaging (MRI) is a research tool, used more and more in clinical practice, as it provides objective information with respect to the tissues being imaged. Pixel-wise T 1 quantification (T 1 mapping) of the myocardium is one such application with diagnostic significance. A number of mapping sequences have been developed for myocardial T 1 mapping with a wide range in terms of measurement accuracy and precision. Furthermore, measurement results obtained with these pulse sequences are affected by errors introduced by the particular acquisition parameters used. SQUAREMR is a new method which has the potential of improving the accuracy of these mapping sequences through the use of massively parallel simulations on Graphical Processing Units (GPUs) by taking into account different acquisition parameter sets. This method has been shown to be effective in myocardial T 1 mapping; however, execution times may exceed 30min which is prohibitively long for clinical applications. The purpose of this study was to accelerate the construction of SQUAREMR's multi-parametric database to more clinically acceptable levels. The aim of this study was to develop a cloud-based cluster in order to distribute the computational load to several GPU-enabled nodes and accelerate SQUAREMR. This would accommodate high demands for computational resources without the need for major upfront equipment investment. Moreover, the parameter space explored by the simulations was optimized in order to reduce the computational load without compromising the T 1 estimates compared to a non-optimized parameter space approach. A cloud-based cluster with 16 nodes resulted in a speedup of up to 13.5 times compared to a single-node execution. Finally, the optimized parameter set approach allowed for an execution time of 28s using the 16-node cluster, without compromising the T 1 estimates by more than 10ms. The developed cloud-based cluster and optimization of the parameter set reduced the execution time of the simulations involved in constructing the SQUAREMR multi-parametric database thus bringing SQUAREMR's applicability within time frames that would be likely acceptable in the clinic. Copyright © 2016 Elsevier Inc. All rights reserved.

The Power Prior: Theory and Applications

PubMed Central

Ibrahim, Joseph G.; Chen, Ming-Hui; Gwon, Yeongjin; Chen, Fang

2015-01-01

The power prior has been widely used in many applications covering a large number of disciplines. The power prior is intended to be an informative prior constructed from historical data. It has been used in clinical trials, genetics, health care, psychology, environmental health, engineering, economics, and business. It has also been applied for a wide variety of models and settings, both in the experimental design and analysis contexts. In this review article, we give an A to Z exposition of the power prior and its applications to date. We review its theoretical properties, variations in its formulation, statistical contexts for which it has been used, applications, and its advantages over other informative priors. We review models for which it has been used, including generalized linear models, survival models, and random effects models. Statistical areas where the power prior has been used include model selection, experimental design, hierarchical modeling, and conjugate priors. Prequentist properties of power priors in posterior inference are established and a simulation study is conducted to further examine the empirical performance of the posterior estimates with power priors. Real data analyses are given illustrating the power prior as well as the use of the power prior in the Bayesian design of clinical trials. PMID:26346180

Current Status of Messenger RNA Delivery Systems.

PubMed

Stanton, Matthew G

2018-06-01

Messenger RNA is emerging as a highly versatile biological construct for creation of impactful medicines. mRNA vaccines directed toward infectious disease and cancer are in clinical development with encouraging early reads on tolerability and efficacy. The use of mRNA to direct intense but transient expression of paracrine factors is finding utility in reprogramming progenitor cells for wound healing and cardiac regeneration and for stimulation of antitumor immune responses, at least preclinically as we await clinical results. The use of mRNA for prolonged and repeated expression of proteins and enzymes to treat rare, typically monogenic disease is nearing clinical entry. These uses of mRNA require delivery solutions, and the application of and improvement to existing nanoparticle nucleic acid delivery systems have jump started the pace of development and reenergized the field of particle based nucleic acid delivery. The current status of mRNA delivery is reviewed in this article with an eye toward clinical tractability.

Precision medicine: In need of guidance and surveillance.

PubMed

Lin, Jian-Zhen; Long, Jun-Yu; Wang, An-Qiang; Zheng, Ying; Zhao, Hai-Tao

2017-07-28

Precision medicine, currently a hotspot in mainstream medicine, has been strongly promoted in recent years. With rapid technological development, such as next-generation sequencing, and fierce competition in molecular targeted drug exploitation, precision medicine represents an advance in science and technology; it also fulfills needs in public health care. The clinical translation and application of precision medicine - especially in the prevention and treatment of tumors - is far from satisfactory; however, the aims of precision medicine deserve approval. Thus, this medical approach is currently in its infancy; it has promising prospects, but it needs to overcome numbers of problems and deficiencies. It is expected that in addition to conventional symptoms and signs, precision medicine will define disease in terms of the underlying molecular characteristics and other environmental susceptibility factors. Those expectations should be realized by constructing a novel data network, integrating clinical data from individual patients and personal genomic background with existing research on the molecular makeup of diseases. In addition, multi-omics analysis and multi-discipline collaboration will become crucial elements in precision medicine. Precision medicine deserves strong support, and its development demands directed momentum. We propose three kinds of impetus (research, application and collaboration impetus) for such directed momentum toward promoting precision medicine and accelerating its clinical translation and application.

Precision medicine: In need of guidance and surveillance

PubMed Central

Lin, Jian-Zhen; Long, Jun-Yu; Wang, An-Qiang; Zheng, Ying; Zhao, Hai-Tao

2017-01-01

Precision medicine, currently a hotspot in mainstream medicine, has been strongly promoted in recent years. With rapid technological development, such as next-generation sequencing, and fierce competition in molecular targeted drug exploitation, precision medicine represents an advance in science and technology; it also fulfills needs in public health care. The clinical translation and application of precision medicine - especially in the prevention and treatment of tumors - is far from satisfactory; however, the aims of precision medicine deserve approval. Thus, this medical approach is currently in its infancy; it has promising prospects, but it needs to overcome numbers of problems and deficiencies. It is expected that in addition to conventional symptoms and signs, precision medicine will define disease in terms of the underlying molecular characteristics and other environmental susceptibility factors. Those expectations should be realized by constructing a novel data network, integrating clinical data from individual patients and personal genomic background with existing research on the molecular makeup of diseases. In addition, multi-omics analysis and multi-discipline collaboration will become crucial elements in precision medicine. Precision medicine deserves strong support, and its development demands directed momentum. We propose three kinds of impetus (research, application and collaboration impetus) for such directed momentum toward promoting precision medicine and accelerating its clinical translation and application. PMID:28811702

Unmasking feigned sanity: a neurobiological model of emotion processing in primary psychopathy.

PubMed

van Honk, Jack; Schutter, Dennis J L G

2006-05-01

The neurobiological basis of primary psychopathy, an emotional disorder characterised by a lack of fear and empathy, on the one hand, and extremely violent, antisocial tendencies, on the other, is relatively unknown. Nevertheless, theoretical models that emphasise the role of fearlessness, imbalanced motivation, defective somatic markers, and dysfunctional violence inhibition mechanisms have complementary proposals regarding motivations and brain mechanisms involved. Presently, incorporating the heuristic value of these models and further theorising on the basis of recent data from neuropsychology, neuroendocrinology, neuroimaging, and repetitive transcranial magnetic stimulation (rTMS), an attempt is made to construct a neurobiological framework of emotion processing in primary psychopathy with clinical applicability. According to this framework, defective emotional processing in primary psychopathy results from bottom-up hormone-mediated imbalances at: (1) the subcortical level; (2) in subcortico-cortical "cross-talk"; that end up in an instrumental stance at the cortical level (3). An endocrine dual-system approach for the fine-tuned restoration of these hormone-mediated imbalances is proposed as a possible clinical application. This application may be capable of laying a neurobiological foundation for more successful sociotherapeutic interventions in primary psychopathy.

Identifying and applying psychological theory to setting and achieving rehabilitation goals.

PubMed

Scobbie, Lesley; Wyke, Sally; Dixon, Diane

2009-04-01

Goal setting is considered to be a fundamental part of rehabilitation; however, theories of behaviour change relevant to goal-setting practice have not been comprehensively reviewed. (i) To identify and discuss specific theories of behaviour change relevant to goal-setting practice in the rehabilitation setting. (ii) To identify 'candidate' theories that that offer most potential to inform clinical practice. The rehabilitation and self-management literature was systematically searched to identify review papers or empirical studies that proposed a specific theory of behaviour change relevant to setting and/or achieving goals in a clinical context. Data from included papers were extracted under the headings of: key constructs, clinical application and empirical support. Twenty-four papers were included in the review which proposed a total of five theories: (i) social cognitive theory, (ii) goal setting theory, (iii) health action process approach, (iv) proactive coping theory, and (v) the self-regulatory model of illness behaviour. The first three of these theories demonstrated most potential to inform clinical practice, on the basis of their capacity to inform interventions that resulted in improved patient outcomes. Social cognitive theory, goal setting theory and the health action process approach are theories of behaviour change that can inform clinicians in the process of setting and achieving goals in the rehabilitation setting. Overlapping constructs within these theories have been identified, and can be applied in clinical practice through the development and evaluation of a goal-setting practice framework.

Studies in the extensively automatic construction of large odds-based inference networks from structured data. Examples from medical, bioinformatics, and health insurance claims data.

PubMed

Robson, B; Boray, S

2018-04-01

Theoretical and methodological principles are presented for the construction of very large inference nets for odds calculations, composed of hundreds or many thousands or more of elements, in this paper generated by structured data mining. It is argued that the usual small inference nets can sometimes represent rather simple, arbitrary estimates. Examples of applications in clinical and public health data analysis, medical claims data and detection of irregular entries, and bioinformatics data, are presented. Construction of large nets benefits from application of a theory of expected information for sparse data and the Dirac notation and algebra. The extent to which these are important here is briefly discussed. Purposes of the study include (a) exploration of the properties of large inference nets and a perturbation and tacit conditionality models, (b) using these to propose simpler models including one that a physician could use routinely, analogous to a "risk score", (c) examination of the merit of describing optimal performance in a single measure that combines accuracy, specificity, and sensitivity in place of a ROC curve, and (d) relationship to methods for detecting anomalous and potentially fraudulent data. Copyright © 2018 Elsevier Ltd. All rights reserved.

Application of a framework to assess the usefulness of alternative sepsis criteria

PubMed Central

Seymour, Christopher W.; Coopersmith, Craig M.; Deutschman, Clifford S; Gesten, Foster; Klompas, Michael; Levy, Mitchell; Martin, Gregory S.; Osborn, Tiffany M.; Rhee, Chanu; Warren, David; Watson, R. Scott; Angus, Derek C.

2016-01-01

The current definition for sepsis is life-threatening, acute organ dysfunction secondary to a dysregulated host response to infection. Criteria to operationalize this definition can be judged by 6 domains of usefulness (reliability; content, construct and criterion validity, measurement burden, and timeliness). The relative importance of these 6 domains depends on the intended purpose for the criteria (clinical care, basic and clinical research, surveillance, or quality improvement (QI) and audit). For example, criteria for clinical care should have high content and construct validity, timeliness, and low measurement burden to facilitate prompt care. Criteria for surveillance or QI/audit place greater emphasis on reliability across individuals and sites and lower emphasis on timeliness. Criteria for clinical trials require timeliness to ensure prompt enrollment and reasonable reliability but can tolerate high measurement burden. Basic research also tolerates high measurement burden and may not need stability over time. In an illustrative case study, we compared examples of criteria designed for clinical care, surveillance and QI/audit among 396,241 patients admitted to 12 academic and community hospitals in an integrated health system. Case rates differed 4-fold and mortality 3-fold. Predictably, clinical care criteria, which emphasized timeliness and low burden and therefore used vital signs and routine laboratory tests, had the highest case identification with lowest mortality. QI /audit criteria, which emphasized reliability and criterion validity, used discharge information and had the lowest case identification with highest mortality. Using this framework to identify the purpose and apply domains of usefulness can help with the evaluation of existing sepsis diagnostic criteria and provide a roadmap for future work. PMID:26901560

Application of a Framework to Assess the Usefulness of Alternative Sepsis Criteria.

PubMed

Seymour, Christopher W; Coopersmith, Craig M; Deutschman, Clifford S; Gesten, Foster; Klompas, Michael; Levy, Mitchell; Martin, Gregory S; Osborn, Tiffany M; Rhee, Chanu; Warren, David K; Watson, R Scott; Angus, Derek C

2016-03-01

The current definition of sepsis is life-threatening, acute organ dysfunction secondary to a dysregulated host response to infection. Criteria to operationalize this definition can be judged by six domains of usefulness (reliability, content, construct and criterion validity, measurement burden, and timeliness). The relative importance of these six domains depends on the intended purpose for the criteria (clinical care, basic and clinical research, surveillance, or quality improvement [QI] and audit). For example, criteria for clinical care should have high content and construct validity, timeliness, and low measurement burden to facilitate prompt care. Criteria for surveillance or QI/audit place greater emphasis on reliability across individuals and sites and lower emphasis on timeliness. Criteria for clinical trials require timeliness to ensure prompt enrollment and reasonable reliability but can tolerate high measurement burden. Basic research also tolerates high measurement burden and may not need stability over time. In an illustrative case study, we compared examples of criteria designed for clinical care, surveillance and QI/audit among 396,241 patients admitted to 12 academic and community hospitals in an integrated health system. Case rates differed four-fold and mortality three-fold. Predictably, clinical care criteria, which emphasized timeliness and low burden and therefore used vital signs and routine laboratory tests, had the greater case identification with lowest mortality. QI/audit criteria, which emphasized reliability and criterion validity, used discharge information and had the lowest case identification with highest mortality. Using this framework to identify the purpose and apply domains of usefulness can help with the evaluation of existing sepsis diagnostic criteria and provide a roadmap for future work.

Analysis of the safety evaluation for premarketing clinical trials of hemodialyzer and of postmarketing safety reports of hemodialyzer in Japan and the US: insights into the construction of a sophisticated premarketing evaluation.

PubMed

Saito, Masami; Iwasaki, Kiyotaka

2017-03-01

Our aim was to conduct a scoping review of the regulations for hemodialyzers in the safety evaluation in Japan and the United States, and to evaluate the criteria for premarketing clinical trials and postmarketing safety reports to inform the development of a sophisticated premarketing evaluation in Japan. Regulations for approval of hemodialyzers were identified from the databases of the Ministry of Health, Labor and Welfare in Japan and the Federal Drug Agency (FDA) in the United States (US). The criteria for premarket clinical trials and postmarketing safety reports were evaluated for both countries. Standards in Japan required evaluation of blood compatibility and reporting of acute adverse effects by a premarketing clinical trial in 6 of 86 applications with semipermeable membrane materials deemed to be different to those of previously approved devices from 1983 to 31 August 2015. By comparison, the clinical trial was required in one of 545 approvals in the US from 1976 to 29 January 2016, but blood compatibility was not the point. All postmarketing adverse effects identified in Japan were included in the set of 'warnings'. The more stringent requirements for evaluation of blood compatibility and acute adverse effects in Japan seemed to be related to differences in the history of quality management systems for medical devices between the two countries. This study revealed that there were differences between Japan and the US in requiring the premarketing clinical trials for the hemodialyzers. Our findings could be useful for constructing sophisticated premarketing safety evaluation.

Novel imaging analysis system to measure the spatial dimension of engineered tissue construct.

PubMed

Choi, Kyoung-Hwan; Yoo, Byung-Su; Park, So Ra; Choi, Byung Hyune; Min, Byoung-Hyun

2010-02-01

The measurement of the spatial dimensions of tissue-engineered constructs is very important for their clinical applications. In this study, a novel method to measure the volume of tissue-engineered constructs was developed using iterative mathematical computations. The method measures and analyzes three-dimensional (3D) parameters of a construct to estimate its actual volume using a sequence of software-based mathematical algorithms. The mathematical algorithm is composed of two stages: the shape extraction and the determination of volume. The shape extraction utilized 3D images of a construct: length, width, and thickness, captured by a high-quality camera with charge coupled device. The surface of the 3D images was then divided into fine sections. The area of each section was measured and combined to obtain the total surface area. The 3D volume of the target construct was then mathematically obtained using its total surface area and thickness. The accuracy of the measurement method was verified by comparing the results with those obtained from the hydrostatic weighing method (Korea Research Institute of Standards and Science [KRISS], Korea). The mean difference in volume between two methods was 0.0313 +/- 0.0003% (n = 5, P = 0.523) with no significant statistical difference. In conclusion, our image-based spatial measurement system is a reliable and easy method to obtain an accurate 3D volume of a tissue-engineered construct.

Size matters: gold nanoparticles in targeted cancer drug delivery

PubMed Central

Dreaden, Erik C; Austin, Lauren A; Mackey, Megan A; El-Sayed, Mostafa A

2013-01-01

Cancer is the current leading cause of death worldwide, responsible for approximately one quarter of all deaths in the USA and UK. Nanotechnologies provide tremendous opportunities for multimodal, site-specific drug delivery to these disease sites and Au nanoparticles further offer a particularly unique set of physical, chemical and photonic properties with which to do so. This review will highlight some recent advances, by our laboratory and others, in the use of Au nanoparticles for systemic drug delivery to these malignancies and will also provide insights into their rational design, synthesis, physiological properties and clinical/preclinical applications, as well as strategies and challenges toward the clinical implementation of these constructs moving forward. PMID:22834077

Targeting Strategies for Multifunctional Nanoparticles in Cancer Imaging and Therapy

PubMed Central

Yu, Mi Kyung; Park, Jinho; Jon, Sangyong

2012-01-01

Nanomaterials offer new opportunities for cancer diagnosis and treatment. Multifunctional nanoparticles harboring various functions including targeting, imaging, therapy, and etc have been intensively studied aiming to overcome limitations associated with conventional cancer diagnosis and therapy. Of various nanoparticles, magnetic iron oxide nanoparticles with superparamagnetic property have shown potential as multifunctional nanoparticles for clinical translation because they have been used asmagnetic resonance imaging (MRI) constrast agents in clinic and their features could be easily tailored by including targeting moieties, fluorescence dyes, or therapeutic agents. This review summarizes targeting strategies for construction of multifunctional nanoparticles including magnetic nanoparticles-based theranostic systems, and the various surface engineering strategies of nanoparticles for in vivo applications. PMID:22272217

Clinically applied medical ethnography: relevance to cultural competence in patient care.

PubMed

Engebretson, Joan

2011-06-01

Medical anthropology provides an excellent resource for nursing research that is relevant to clinical nursing. By expanding the understanding of ethnographic research beyond ethnicity, nurses can conduct research that explores patient's constructions and explanatory models of health and healing and how they make meaning out of chronic conditions and negotiate daily life. These findings can have applicability to culturally competent care at both the organizational or systems level, as well as in the patient/provider encounter. Individual patient care can be improved by applying ethnographic research findings to build provider expertise and then using a cultural negotiation process for individualized patient care. Copyright © 2011. Published by Elsevier Inc.

Quantitative versus semiquantitative MR imaging of cartilage in blood-induced arthritic ankles: preliminary findings.

PubMed

Doria, Andrea S; Zhang, Ningning; Lundin, Bjorn; Hilliard, Pamela; Man, Carina; Weiss, Ruth; Detzler, Gary; Blanchette, Victor; Moineddin, Rahim; Eckstein, Felix; Sussman, Marshall S

2014-05-01

Recent advances in hemophilia prophylaxis have raised the need for accurate noninvasive methods for assessment of early cartilage damage in maturing joints to guide initiation of prophylaxis. Such methods can either be semiquantitative or quantitative. Whereas semiquantitative scores are less time-consuming to be performed than quantitative methods, they are prone to subjective interpretation. To test the feasibility of a manual segmentation and a quantitative methodology for cross-sectional evaluation of articular cartilage status in growing ankles of children with blood-induced arthritis, as compared with a semiquantitative scoring system and clinical-radiographic constructs. Twelve boys, 11 with hemophilia (A, n = 9; B, n = 2) and 1 with von Willebrand disease (median age: 13; range: 6-17), underwent physical examination and MRI at 1.5 T. Two radiologists semiquantitatively scored the MRIs for cartilage pathology (surface erosions, cartilage loss) with blinding to clinical information. An experienced operator applied a validated quantitative 3-D MRI method to determine the percentage area of denuded bone (dAB) and the cartilage thickness (ThCtAB) in the joints' MRIs. Quantitative and semiquantitative MRI methods and clinical-radiographic constructs (Hemophilia Joint Health Score [HJHS], Pettersson radiograph scores) were compared. Moderate correlations were noted between erosions and dAB (r = 0.62, P = 0.03) in the talus but not in the distal tibia (P > 0.05). Whereas substantial to high correlations (r range: 0.70-0.94, P < 0.05) were observed between erosions, cartilage loss, HJHS and Pettersson scores both at the distal tibia and talus levels, moderate/borderline substantial (r range: 0.55-0.61, P < 0.05) correlations were noted between dAB/ThCtAB and clinical-radiographic constructs. Whereas the semiquantitative method of assessing cartilage status is closely associated with clinical-radiographic scores in cross-sectional studies of blood-induced arthropathy, quantitative measures provide independent information and are therefore less applicable for that research design.

Online quantitative monitoring of live cell engineered cartilage growth using diffuse fiber-optic Raman spectroscopy.

PubMed

Bergholt, Mads S; Albro, Michael B; Stevens, Molly M

2017-09-01

Tissue engineering (TE) has the potential to improve the outcome for patients with osteoarthritis (OA). The successful clinical translation of this technique as part of a therapy requires the ability to measure extracellular matrix (ECM) production of engineered tissues in vitro, in order to ensure quality control and improve the likelihood of tissue survival upon implantation. Conventional techniques for assessing the ECM content of engineered cartilage, such as biochemical assays and histological staining are inherently destructive. Raman spectroscopy, on the other hand, represents a non-invasive technique for in situ biochemical characterization. Here, we outline current roadblocks in translational Raman spectroscopy in TE and introduce a comprehensive workflow designed to non-destructively monitor and quantify ECM biomolecules in large (>3 mm), live cell TE constructs online. Diffuse near-infrared fiber-optic Raman spectra were measured from live cell cartilaginous TE constructs over a 56-day culturing period. We developed a multivariate curve resolution model that enabled quantitative biochemical analysis of the TE constructs. Raman spectroscopy was able to non-invasively quantify the ECM components and showed an excellent correlation with biochemical assays for measurement of collagen (R 2  = 0.84) and glycosaminoglycans (GAGs) (R 2  = 0.86). We further demonstrated the robustness of this technique for online prospective analysis of live cell TE constructs. The fiber-optic Raman spectroscopy strategy developed in this work offers the ability to non-destructively monitor construct growth online and can be adapted to a broad range of TE applications in regenerative medicine toward controlled clinical translation. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Multi-Center Retrospective Evaluation of Screw and Polymethylmethacrylate Constructs for Atlantoaxial Fixation in Dogs.

PubMed

Stout Steele, Megan W; Hodshon, Amy W; Hopkins, Andrew L; Tracy, Gaemia M; Cohen, Noah D; Kerwin, Sharon C; Boudreau, C Elizabeth; Thomas, William B; Mankin, Joseph M; Levine, Jonathan M

2016-10-01

To evaluate outcome and adverse events following ventral stabilization of the atlantoaxial (AA) joint in dogs with clinical AA subluxation using screw/polymethymethacrylate (PMMA) constructs in a retrospective, multi-center cohort study. Historical cohort study. 35 client-owned dogs. Medical records from 3 institutions were reviewed to identify dogs with AA subluxation treated with ventral screw and PMMA constructs. Data on signalment, pre- and postoperative neurologic status, imaging performed, and adverse events were retrieved. Neurologic examination data were abstracted to generate a modified Frankel score at admission, discharge, and re-examination. Telephone interview of owners >180 days postoperative was conducted. Thirty-five dogs with AA subluxation treated with ventral screw/PMMA constructs were included. Most dogs were young (median age 1 year), small breed dogs with acute onset of neurologic signs (median duration 22.5 hours). Most dogs were non-ambulatory at the time of admission (median modified Frankel score 3). Adverse events were identified in 15/35 dogs including 9 dogs with major adverse events. Four dogs required a second surgery due to vertebral canal violation (n = 2) or implant failure (n = 2). Re-examination at 4-6 weeks postoperative reported 15/28 dogs with improved neurologic status and 19/28 dogs were ambulatory. Telephone follow-up was available for 23/35 dogs with 23/23 reported as ambulatory (median follow-up 390 days). Ventral application of screw and PMMA constructs for AA subluxation, as described here, is associated with clinical improvement in the majority of dog. Major adverse events are infrequent and the technique is considered relatively safe. © Copyright 2016 by The American College of Veterinary Surgeons.

7 CFR 1924.271 - Processing applications.

Code of Federal Regulations, 2010 CFR

2010-01-01

... REGULATIONS CONSTRUCTION AND REPAIR Complaints and Compensation for Construction Defects § 1924.271 Processing applications. An application for compensation for construction defects shall be submitted by the claimant to Fm... entirety. All structural defects and claims for which compensation is sought will be listed. Borrowers will...

7 CFR 1924.271 - Processing applications.

Code of Federal Regulations, 2013 CFR

2013-01-01

... REGULATIONS CONSTRUCTION AND REPAIR Complaints and Compensation for Construction Defects § 1924.271 Processing applications. An application for compensation for construction defects shall be submitted by the claimant to Fm... entirety. All structural defects and claims for which compensation is sought will be listed. Borrowers will...

7 CFR 1924.271 - Processing applications.

Code of Federal Regulations, 2012 CFR

2012-01-01

... REGULATIONS CONSTRUCTION AND REPAIR Complaints and Compensation for Construction Defects § 1924.271 Processing applications. An application for compensation for construction defects shall be submitted by the claimant to Fm... entirety. All structural defects and claims for which compensation is sought will be listed. Borrowers will...

7 CFR 1924.271 - Processing applications.

Code of Federal Regulations, 2014 CFR

2014-01-01

... REGULATIONS CONSTRUCTION AND REPAIR Complaints and Compensation for Construction Defects § 1924.271 Processing applications. An application for compensation for construction defects shall be submitted by the claimant to Fm... entirety. All structural defects and claims for which compensation is sought will be listed. Borrowers will...

7 CFR 1924.271 - Processing applications.

Code of Federal Regulations, 2011 CFR

2011-01-01

... REGULATIONS CONSTRUCTION AND REPAIR Complaints and Compensation for Construction Defects § 1924.271 Processing applications. An application for compensation for construction defects shall be submitted by the claimant to Fm... entirety. All structural defects and claims for which compensation is sought will be listed. Borrowers will...

Relating the Components of the Clinical Reasoning Process to the Construction of Patient Management Problems

PubMed Central

Skakun, Ernest N.

1982-01-01

Patient Management Problems (PMPs) are frequently used to test a physician's ability in conducting a medical work-up. The construction of PMPs has been inhibited because the clinical reasoning process with which these simulations deal has not been described until recently. The clinical reasoning process is reviewed and broad guidelines for constructing PMPs to reflect the components of the process are presented.

Understanding Medical Students' Experience with Stress and Its Related Constructs: A Focus Group Study from Singapore.

PubMed

Farquhar, Julia; Lie, Desiree; Chan, Angelique; Ow, Mandy; Vidyarthi, Arpana

2018-02-01

In order to protect medical students from burnout and its untoward psychiatric effects, it is imperative to understand their stress, burnout, coping, and resilience experiences. This study aimed to derive collective definitions from the medical student perspective, to identify common themes of students' experiences, and to distinguish pre-clinical and clinical year students' experiences relating to these four constructs. The authors conducted focus groups of medical students in Singapore across 4 years using a semi-structured question guide. Participants shared their understanding, experiences, and the relationships between stress, burnout, coping, and resilience. Coders independently evaluated construct definitions and derived common themes through an iterative process, and compared transcripts of pre-clinical and clinical year students to determine differences in experience over time. Nine focus groups (54 students, 28 females, mean age 24.3) were conducted. Students identified common definitions for each construct. Nine themes emerged within three domains: (1) relating constructs to personal experience, (2) interrelating stress, burnout, coping, and resilience, and (3) understanding the necessity of stress. Compared to clinical students, pre-clinical students reported theory-based rather than reality-based experiences and exam-induced stress, defined constructs using present rather than future situations, and described constructs as independent rather than interrelated. This sample of medical students in Singapore shares a common understanding of stress, burnout, coping, and resilience, but experiences these uniquely. They perceive a positive role for stress. These findings build upon prior literature, suggesting an interrelationship between stress and its related constructs and adding the novel perspective of students from an Asian country.

33 CFR 115.60 - Procedures for handling applications for bridge construction permits.

Code of Federal Regulations, 2011 CFR

2011-07-01

... applications for bridge construction permits. 115.60 Section 115.60 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES BRIDGE LOCATIONS AND CLEARANCES; ADMINISTRATIVE PROCEDURES § 115.60 Procedures for handling applications for bridge construction permits. The following procedures will be...

33 CFR 115.60 - Procedures for handling applications for bridge construction permits.

Code of Federal Regulations, 2010 CFR

2010-07-01

... applications for bridge construction permits. 115.60 Section 115.60 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES BRIDGE LOCATIONS AND CLEARANCES; ADMINISTRATIVE PROCEDURES § 115.60 Procedures for handling applications for bridge construction permits. The following procedures will be...

Building Data-Driven Pathways From Routinely Collected Hospital Data: A Case Study on Prostate Cancer

PubMed Central

Clark, Jeremy; Cooper, Colin S; Mills, Robert; Rayward-Smith, Victor J; de la Iglesia, Beatriz

2015-01-01

Background Routinely collected data in hospitals is complex, typically heterogeneous, and scattered across multiple Hospital Information Systems (HIS). This big data, created as a byproduct of health care activities, has the potential to provide a better understanding of diseases, unearth hidden patterns, and improve services and cost. The extent and uses of such data rely on its quality, which is not consistently checked, nor fully understood. Nevertheless, using routine data for the construction of data-driven clinical pathways, describing processes and trends, is a key topic receiving increasing attention in the literature. Traditional algorithms do not cope well with unstructured processes or data, and do not produce clinically meaningful visualizations. Supporting systems that provide additional information, context, and quality assurance inspection are needed. Objective The objective of the study is to explore how routine hospital data can be used to develop data-driven pathways that describe the journeys that patients take through care, and their potential uses in biomedical research; it proposes a framework for the construction, quality assessment, and visualization of patient pathways for clinical studies and decision support using a case study on prostate cancer. Methods Data pertaining to prostate cancer patients were extracted from a large UK hospital from eight different HIS, validated, and complemented with information from the local cancer registry. Data-driven pathways were built for each of the 1904 patients and an expert knowledge base, containing rules on the prostate cancer biomarker, was used to assess the completeness and utility of the pathways for a specific clinical study. Software components were built to provide meaningful visualizations for the constructed pathways. Results The proposed framework and pathway formalism enable the summarization, visualization, and querying of complex patient-centric clinical information, as well as the computation of quality indicators and dimensions. A novel graphical representation of the pathways allows the synthesis of such information. Conclusions Clinical pathways built from routinely collected hospital data can unearth information about patients and diseases that may otherwise be unavailable or overlooked in hospitals. Data-driven clinical pathways allow for heterogeneous data (ie, semistructured and unstructured data) to be collated over a unified data model and for data quality dimensions to be assessed. This work has enabled further research on prostate cancer and its biomarkers, and on the development and application of methods to mine, compare, analyze, and visualize pathways constructed from routine data. This is an important development for the reuse of big data in hospitals. PMID:26162314

Mediators of the Relation between Childhood Sexual Abuse and Women’s Sexual Risk Behavior: A Comparison of Two Theoretical Frameworks

PubMed Central

Senn, Theresa E.; Carey, Michael P.; Coury-Doniger, Patricia

2012-01-01

Childhood sexual abuse (CSA) is associated with sexual risk behavior in adulthood, but little research has investigated processes that might mediate this relation. The purpose of this study was to investigate whether constructs suggested by the traumagenic dynamics (TD) model (a theory of the effects of CSA) or constructs suggested by the Information-Motivation-Behavioral skills (IMB) model (a theory of the antecedents of sexual risk behavior) better mediated the relation between CSA and sexual risk behavior in adulthood. Participants were 481 women attending an STI clinic (66% African American) who completed a computerized survey as well as behavioral simulations assessing condom application and sexual assertiveness skills. Forty-five percent of the sample met criteria for CSA and CSA was associated with sexual risk behavior in adulthood. In multiple mediator models, the TD constructs mediated the relation between CSA and the number of sexual partners whereas the IMB constructs mediated the relation between CSA and unprotected sex. In addition, the TD constructs better mediated the relation between CSA and the number of sexual partners; the TD and IMB constructs did not differ in their ability to mediate the relation between CSA and unprotected sex. Sexual risk reduction interventions for women who were sexually abused should target not only the constructs from health behavior models (e.g., motivation and skills to reduce sexual risk), but also constructs that are specific to sexual abuse (e.g., traumatic sexualization and guilt). PMID:22282323

Laparoscopic radical prostatectomy in the canine model.

PubMed

Price, D T; Chari, R S; Neighbors, J D; Eubanks, S; Schuessler, W W; Preminger, G M

1996-12-01

The purpose of this study was to determine the feasibility of performing laparoscopic radical prostatectomy in a canine model. Laparoscopic radical prostatectomy was performed on six adult male canines. A new endoscopic needle driver was used to construct a secure vesicourethral anastomosis. Average operative time required to complete the procedure was 304 min (range 270-345 min). Dissection of the prostate gland took an average of 67 min (range 35-90 min), and construction of the vesicourethral anastomosis took 154 min (rage 80-240 min). There were no intraoperative complications and only one postoperative complication (anastomotic leak). Five of the six animals recovered uneventfully from the procedure, and their foley catheters were removed 10-14 days postoperatively after a retrograde cystourethrogram demonstrated an intact vesicourethral anastomosis. Four (80%) of the surviving animals were clinically continent within 10 days after catheter removal. Post mortem examination confirmed that the vesicourethral anastomosis was intact with no evidence of urine extravasation. These data demonstrate the feasibility of laparoscopic radical prostatectomy in a canine model, and suggest that additional work with this technique should be continued to develop its potential clinical application.

The Montana State University Conceptual Model of Complementary and Alternative Medicine Health Literacy

PubMed Central

Shreffler-Grant, Jean; Nichols, Elizabeth; Weinert, Clarann; Ide, Bette

2016-01-01

This article aims to present and describe a model of complementary and alternative medicine (CAM) health literacy. The model is the conceptual basis for CAM health literacy, which is operationally defined as the information about CAM needed to make informed self-management decisions regarding health. Improving health literacy is a national priority, and widespread use of CAM has added to the complexity of this task. There are no currently available models or measures of health literacy regarding CAM. The authors developed the model using an iterative process of deriving concepts, constructs, and empirical indicators from the literature and the author’s prior work, review and critique by experts, and revision. The model of CAM health literacy can serve as the basis for future research on the use and efficacy of CAM and the constructs and concepts within it can be used to identify points of intervention for research or for clinical practice. It is anticipated that the model will have scientific and clinical application for assessing health literacy in other self care decision-making situations. PMID:23889542

An Inexpensive Biophysics Laboratory Apparatus for Acquiring Pulmonary Function Data with Clinical Applications

NASA Astrophysics Data System (ADS)

Harkay, Gregory

2001-11-01

Interest on the part of the Physics Department at KSC in developing a computer interfaced lab with appeal to biology majors and a need to perform a clinical pulmonological study to fulfill a biology requirement led to the author's undergraduate research project in which a recording spirometer (typical cost: $15K) was constructed from readily available materials and a typical undergraduate lab computer interface. Simple components, including a basic photogate circuit, CPU fan, and PVC couplings were used to construct an instrument for measuring flow rates as a function of time. Pasco software was used to build an experiment in which data was collected and integration performed such that one could obtain accurate values for FEV1 (forced expiratory volume for one second) and FVC (forced vital capacity) and their ratio for a large sample of subjects. Results were compared to published norms and subjects with impaired respiratory mechanisms identified. This laboratory exercise is one with which biology students can clearly identify and would be a robust addition to the repertoire for a HS or college physics or biology teaching laboratory.

The Montana State University conceptual model of complementary and alternative medicine health literacy.

PubMed

Shreffler-Grant, Jean; Nichols, Elizabeth; Weinert, Clarann; Ide, Bette

2013-01-01

This article aims to present and describe a model of complementary and alternative medicine (CAM) health literacy. The model is the conceptual basis for CAM health literacy, which is operationally defined as the information about CAM needed to make informed self-management decisions regarding health. Improving health literacy is a national priority, and widespread use of CAM has added to the complexity of this task. There are no currently available models or measures of health literacy regarding CAM. The authors developed the model using an iterative process of deriving concepts, constructs, and empirical indicators from the literature and the author's prior work, review and critique by experts, and revision. The model of CAM health literacy can serve as the basis for future research on the use and efficacy of CAM and the constructs and concepts within it can be used to identify points of intervention for research or for clinical practice. It is anticipated that the model will have scientific and clinical application for assessing health literacy in other self care decision-making situations.

Robotics in cardiac surgery.

PubMed

Vassiliades, Thomas A

2006-03-01

The current status of surgical telemanipulators in the field of cardiac surgery is best described as a device in search of applications, as its role has not been clearly defined. Basic robotic technological research and development needs to focus on two key areas: (a) developing methods for modeling patient and surgical procedures with the ability to employ that customized information in the successful completion of a minimally invasive operation; and (b) developing novel human machine interactions that can overcome the barriers we currently face in performing surgical tasks using telemanipulators. Significant breakthroughs in these areas will then facilitate the construction and employment of enabling robotic systems, each with its specific clinical application. Copyright 2006 John Wiley & Sons, Ltd.

[Research progress of mammalian synthetic biology in biomedical field].

PubMed

Yang, Linfeng; Yin, Jianli; Wang, Meiyan; Ye, Haifeng

2017-03-25

Although still in its infant stage, synthetic biology has achieved remarkable development and progress during the past decade. Synthetic biology applies engineering principles to design and construct gene circuits uploaded into living cells or organisms to perform novel or improved functions, and it has been widely used in many fields. In this review, we describe the recent advances of mammalian synthetic biology for the treatment of diseases. We introduce common tools and design principles of synthetic gene circuits, and then we demonstrate open-loop gene circuits induced by different trigger molecules used in disease diagnosis and close-loop gene circuits used for biomedical applications. Finally, we discuss the perspectives and potential challenges of synthetic biology for clinical applications.

Powder-based 3D printing for bone tissue engineering.

PubMed

Brunello, G; Sivolella, S; Meneghello, R; Ferroni, L; Gardin, C; Piattelli, A; Zavan, B; Bressan, E

2016-01-01

Bone tissue engineered 3-D constructs customized to patient-specific needs are emerging as attractive biomimetic scaffolds to enhance bone cell and tissue growth and differentiation. The article outlines the features of the most common additive manufacturing technologies (3D printing, stereolithography, fused deposition modeling, and selective laser sintering) used to fabricate bone tissue engineering scaffolds. It concentrates, in particular, on the current state of knowledge concerning powder-based 3D printing, including a description of the properties of powders and binder solutions, the critical phases of scaffold manufacturing, and its applications in bone tissue engineering. Clinical aspects and future applications are also discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

Host-guest supramolecular nanosystems for cancer diagnostics and therapeutics.

PubMed

Wang, Lei; Li, Li-li; Fan, Yun-shan; Wang, Hao

2013-07-26

Extensive efforts have been devoted to the construction of functional supramolecular nanosystems for applications in catalysis, energy conversion, sensing and biomedicine. The applications of supramolecular nanosystems such as liposomes, micelles, inorganic nanoparticles, carbon materials for cancer diagnostics and therapeutics have been reviewed by other groups. Here, we will focus on the recent momentous advances in the implementation of typical supramolecular hosts (i.e., cyclodextrins, calixarenes, cucurbiturils and metallo-hosts) and their nanosystems in cancer diagnostics and therapeutics. We discuss the evolutive process of supramolecular nanosystems from the structural control and characterization to their diagnostic and therapeutic function exploitation and even the future potentials for clinical translation. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Immunization With Fc-Based Recombinant Epstein–Barr Virus gp350 Elicits Potent Neutralizing Humoral Immune Response in a BALB/c Mice Model

PubMed Central

Zhao, Bingchun; Zhang, Xiao; Krummenacher, Claude; Song, Shuo; Gao, Ling; Zhang, Haojiong; Xu, Miao; Feng, Lin; Feng, Qisheng; Zeng, Musheng; Xu, Yuting; Zeng, Yixin

2018-01-01

Epstein–Barr virus (EBV) was the first human virus proved to be closely associated with tumor development, such as lymphoma, nasopharyngeal carcinoma, and EBV-associated gastric carcinoma. Despite many efforts to develop prophylactic vaccines against EBV infection and diseases, no candidates have succeeded in effectively blocking EBV infection in clinical trials. Previous investigations showed that EBV gp350 plays a pivotal role in the infection of B-lymphocytes. Nevertheless, using monomeric gp350 proteins as antigens has not been effective in preventing infection. Multimeric forms of the antigen are more potently immunogenic than monomers; however, the multimerization elements used in previous constructs are not approved for human clinical trials. To prepare a much-needed EBV prophylactic vaccine that is potent, safe, and applicable, we constructed an Fc-based form of gp350 to serve as a dimeric antigen. Here, we show that the Fc-based gp350 antigen exhibits dramatically enhanced immunogenicity compared with wild-type gp350 protein. The complete or partial gp350 ectodomain was fused with the mouse IgG2a Fc domain. Fusion with the Fc domain did not impair gp350 folding, binding to a conformation-dependent neutralizing antibody (nAb) and binding to its receptor by enzyme-linked immunosorbent assay and surface plasmon resonance. Specific antibody titers against gp350 were notably enhanced by immunization with gp350-Fc dimers compared with gp350 monomers. Furthermore, immunization with gp350-Fc fusion proteins elicited potent nAbs against EBV. Our data strongly suggest that an EBV gp350 vaccine based on Fc fusion proteins may be an efficient candidate to prevent EBV infection in clinical applications. PMID:29765376

Design, construction, and technical implementation of a web-based interdisciplinary symptom evaluation (WISE) - a heuristic proposal for orofacial pain and temporomandibular disorders.

PubMed

Ettlin, Dominik A; Sommer, Isabelle; Brönnimann, Ben; Maffioletti, Sergio; Scheidt, Jörg; Hou, Mei-Yin; Lukic, Nenad; Steiger, Beat

2016-12-01

Medical symptoms independent of body location burden individuals to varying degrees and may require care by more than one expert. Various paper and computer-based tools exist that aim to comprehensively capture data for optimal clinical management and research. A web-based interdisciplinary symptom evaluation (WISE) was newly designed, constructed, and technically implemented. For worldwide applicability and to avoid copyright infringements, open source software tools and free validated questionnaires available in multiple languages were used. Highly secure data storage limits access strictly to those who use the tool for collecting, storing, and evaluating their data. Concept and implementation is illustrated by a WISE sample tailored for the requirements of a single center in Switzerland providing interdisciplinary care to orofacial pain and temporomandibular disorder patients. By combining a symptom- burden checklist with in-depth questionnaires serving as case-finding instruments, an algorithm was developed that assists in clarifying case complexity and need for targeted expert evaluation. This novel modular approach provides a personalized, response-tailored instrument for the time- and cost-effective collection of symptom-burden focused quantitative data. The tool includes body drawing options and instructional videos. It is applicable for biopsychosocial evaluation in a variety of clinical settings and offers direct feedback by a case report summary. In clinical practice, the new instrument assists in clarifying case complexity and referral need, based on symptom burden and response -tailored case finding. It provides single-case summary reports from a biopsychosocial perspective and includes graphical symptom maps. Secure, centrally stored data collection of anonymous data is possible. The tool enables personalized medicine, facilitates interprofessional education and collaboration, and allows for multicenter patient-reported outcomes research.

Design Optimization of Vena Cava Filters: An application to dual filtration devices

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

Singer, M A; Wang, S L; Diachin, D P

Pulmonary embolism (PE) is a significant medical problem that results in over 300,000 fatalities per year. A common preventative treatment for PE is the insertion of a metallic filter into the inferior vena cava that traps thrombi before they reach the lungs. The goal of this work is to use methods of mathematical modeling and design optimization to determine the configuration of trapped thrombi that minimizes the hemodynamic disruption. The resulting configuration has implications for constructing an optimally designed vena cava filter. Computational fluid dynamics is coupled with a nonlinear optimization algorithm to determine the optimal configuration of trapped modelmore » thrombus in the inferior vena cava. The location and shape of the thrombus are parameterized, and an objective function, based on wall shear stresses, determines the worthiness of a given configuration. The methods are fully automated and demonstrate the capabilities of a design optimization framework that is broadly applicable. Changes to thrombus location and shape alter the velocity contours and wall shear stress profiles significantly. For vena cava filters that trap two thrombi simultaneously, the undesirable flow dynamics past one thrombus can be mitigated by leveraging the flow past the other thrombus. Streamlining the shape of thrombus trapped along the cava wall reduces the disruption to the flow, but increases the area exposed to abnormal wall shear stress. Computer-based design optimization is a useful tool for developing vena cava filters. Characterizing and parameterizing the design requirements and constraints is essential for constructing devices that address clinical complications. In addition, formulating a well-defined objective function that quantifies clinical risks and benefits is needed for designing devices that are clinically viable.« less

47 CFR 73.4015 - Applications for AM and FM construction permits, incomplete or defective.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 4 2010-10-01 2010-10-01 false Applications for AM and FM construction permits, incomplete or defective. 73.4015 Section 73.4015 Telecommunication FEDERAL COMMUNICATIONS COMMISSION....4015 Applications for AM and FM construction permits, incomplete or defective. See Public Notice, FCC...

47 CFR 73.4015 - Applications for AM and FM construction permits, incomplete or defective.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 4 2011-10-01 2011-10-01 false Applications for AM and FM construction permits, incomplete or defective. 73.4015 Section 73.4015 Telecommunication FEDERAL COMMUNICATIONS COMMISSION....4015 Applications for AM and FM construction permits, incomplete or defective. See Public Notice, FCC...

77 FR 12355 - Hours of Service of Drivers: Underwater Construction Corporation Application for Exemption

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-29

...-0376] Hours of Service of Drivers: Underwater Construction Corporation Application for Exemption AGENCY...; request for comments. SUMMARY: FMCSA has received an application from the Underwater Construction... duty status for each 24 hour period using methods prescribed in that section. UCC claims that...

Transfer of knowledge and skills: some implications for nursing and nurse education.

PubMed

Lauder, W; Reynolds, W; Angus, N

1999-08-01

The construct of transfer has enormous importance to nursing as it begins to highlight potential problems in the transfer of knowledge and skills from the campus to the clinical area, from one part of the clinical area to another (e.g. surgical to medical), and from community to the clinical area. Thus, any adequate conceptualization of transfer must account for problems of practice-practice transfer as well as theory-practice transfer. These potential problems are the concern of educators, students and managers who have a responsibility for agency nurses and bank nurses who may find themselves in different specialities on a regular basis. Transfer has relevance to a whole raft of other issues ranging from the application of theories to nursing practice, through to the validity of claims that courses which develop intellectual skills prepare nurses for lifelong learning.

Clinical field follow-up of high density polyethylene (HDPE)-Jaipur prosthetic technology for trans-femoral amputees.

PubMed

Jensen, J S; Craig, J G; Mtalo, L B; Zelaya, C M

2004-08-01

The purpose of this study was to examine the outcome of the application of the high density polyethylene (HDPE)-Jaipur prosthetic construction in fitting trans-femoral amputees in a number of projects throughout the developing world. Projects in Honduras, Uganda and India were included. One hundred and fifty eight (158) patients had been provided with the HDPE-Jaipur prosthesis and of these 72 were seen for a clinical and technical follow-up after a median of 32 months. More than half the amputees seen had amputation due to trauma and the remainder due to disease. Fabrication and fitting in the three projects was carried out by individuals who had undertaken a three week training course provided by Bhagwan Mahaveer Viklang Sahayata Samiti limb centre in Jaipur. The individuals involved had limited background training in prosthetics. Craftsmanship and fit were assessed as being poor in 86% of cases. Failure requiring replacement of components was observed in 50% of cases. There was low patient satisfaction (58%) and patient compliance (65%). The outcome was considered unsatisfactory both technically and clinically. This was a reflection of the inadequacies of the prosthetic construction, particularly the knee joint, and the inadequate training of those involved in fitting and fabrication of the devices.

48 CFR 922.804-2 - Construction.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false Construction. 922.804-2... APPLICATION OF LABOR LAWS TO GOVERNMENT ACQUISITION Equal Employment Opportunity 922.804-2 Construction. (a) Construction contracts, including cost-sharing contracts, are subject to OFCCP orders applicable in particular...

48 CFR 922.804-2 - Construction.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 5 2013-10-01 2013-10-01 false Construction. 922.804-2... APPLICATION OF LABOR LAWS TO GOVERNMENT ACQUISITION Equal Employment Opportunity 922.804-2 Construction. (a) Construction contracts, including cost-sharing contracts, are subject to OFCCP orders applicable in particular...

48 CFR 922.804-2 - Construction.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 5 2012-10-01 2012-10-01 false Construction. 922.804-2... APPLICATION OF LABOR LAWS TO GOVERNMENT ACQUISITION Equal Employment Opportunity 922.804-2 Construction. (a) Construction contracts, including cost-sharing contracts, are subject to OFCCP orders applicable in particular...

Construction of a functional silk-based biomaterial complex with immortalized chondrocytes in vivo.

PubMed

Ni, Yusu; Jiang, Yi; Wen, Jianchuan; Shao, Zhenzhong; Chen, Xin; Sun, Shan; Yu, Huiqian; Li, Wen

2014-04-01

To explore the feasibility of constructing a functional biomaterial complex with regenerated silk fibroin membrane and immortalized chondrocytes in vivo. Rat auricular chondrocytes (RACs) were transfected with the lentivirus vector pGC-FU-hTERT-3FLAG or pGC-FU-GFP-3FLAG, encoding the human telomerase reverse transcriptase (hTERT) or GFP gene. The effects of regenerated silk fibroin film on the adhesion, growth of immortalized chondrocytes and expression of collagen II in vitro were analyzed with immunofluorescent histochemistry. Immortalized RACs were transformed. Induction by nutrient medium promoted higher expression levels of collagen II in transformed chondrocytes. The regenerated silk fibroin film was not cytotoxic to immortalized chondrocytes and had no adverse influence on their adhesion. Collagen II expression was good in the immortalized chondrocytes in vivo. The construction of a silk-based biomaterial complex with immortalized chondrocytes may provide a feasible kind of functional biomaterial for the repair of cartilage defects in clinical applications. Copyright © 2013 Wiley Periodicals, Inc.

Research on the application of BIM technology in the whole life cycle of construction projects

NASA Astrophysics Data System (ADS)

Chang-liu, CHEN; Wei-wei, KOU; Shuai-hua, YE

2018-05-01

BIM technology can realize information sharing, and good BIM application will reduce the whole life cycle cost of construction projects. The popularization of BIM technology challenges the application of BIM technology at all stages of the whole life cycle of the construction project. It will give full play to the value of BIM, if developing a reasonable BIM project execution plan, defining BIM requirements, specifying Level of Development, determining the BIM quality control plan and clearing BIM application content of each stage, and will provide a unified method for project stakeholders, realize the whole life cycle of construction projects, and achieve the desired information sharing in construction project.

Design criteria for a high energy Compton Camera and possible application to targeted cancer therapy

NASA Astrophysics Data System (ADS)

Conka Nurdan, T.; Nurdan, K.; Brill, A. B.; Walenta, A. H.

2015-07-01

The proposed research focuses on the design criteria for a Compton Camera with high spatial resolution and sensitivity, operating at high gamma energies and its possible application for molecular imaging. This application is mainly on the detection and visualization of the pharmacokinetics of tumor targeting substances specific for particular cancer sites. Expected high resolution (< 0.5 mm) permits monitoring the pharmacokinetics of labeled gene constructs in vivo in small animals with a human tumor xenograft which is one of the first steps in evaluating the potential utility of a candidate gene. The additional benefit of high sensitivity detection will be improved cancer treatment strategies in patients based on the use of specific molecules binding to cancer sites for early detection of tumors and identifying metastasis, monitoring drug delivery and radionuclide therapy for optimum cell killing at the tumor site. This new technology can provide high resolution, high sensitivity imaging of a wide range of gamma energies and will significantly extend the range of radiotracers that can be investigated and used clinically. The small and compact construction of the proposed camera system allows flexible application which will be particularly useful for monitoring residual tumor around the resection site during surgery. It is also envisaged as able to test the performance of new drug/gene-based therapies in vitro and in vivo for tumor targeting efficacy using automatic large scale screening methods.

A generic minimization random allocation and blinding system on web.

PubMed

Cai, Hongwei; Xia, Jielai; Xu, Dezhong; Gao, Donghuai; Yan, Yongping

2006-12-01

Minimization is a dynamic randomization method for clinical trials. Although recommended by many researchers, the utilization of minimization has been seldom reported in randomized trials mainly because of the controversy surrounding the validity of conventional analyses and its complexity in implementation. However, both the statistical and clinical validity of minimization were demonstrated in recent studies. Minimization random allocation system integrated with blinding function that could facilitate the implementation of this method in general clinical trials has not been reported. SYSTEM OVERVIEW: The system is a web-based random allocation system using Pocock and Simon minimization method. It also supports multiple treatment arms within a trial, multiple simultaneous trials, and blinding without further programming. This system was constructed with generic database schema design method, Pocock and Simon minimization method and blinding method. It was coded with Microsoft Visual Basic and Active Server Pages (ASP) programming languages. And all dataset were managed with a Microsoft SQL Server database. Some critical programming codes were also provided. SIMULATIONS AND RESULTS: Two clinical trials were simulated simultaneously to test the system's applicability. Not only balanced groups but also blinded allocation results were achieved in both trials. Practical considerations for minimization method, the benefits, general applicability and drawbacks of the technique implemented in this system are discussed. Promising features of the proposed system are also summarized.

Extracellular matrix hydrogels from decellularized tissues: Structure and function.

PubMed

Saldin, Lindsey T; Cramer, Madeline C; Velankar, Sachin S; White, Lisa J; Badylak, Stephen F

2017-02-01

Extracellular matrix (ECM) bioscaffolds prepared from decellularized tissues have been used to facilitate constructive and functional tissue remodeling in a variety of clinical applications. The discovery that these ECM materials could be solubilized and subsequently manipulated to form hydrogels expanded their potential in vitro and in vivo utility; i.e. as culture substrates comparable to collagen or Matrigel, and as injectable materials that fill irregularly-shaped defects. The mechanisms by which ECM hydrogels direct cell behavior and influence remodeling outcomes are only partially understood, but likely include structural and biological signals retained from the native source tissue. The present review describes the utility, formation, and physical and biological characterization of ECM hydrogels. Two examples of clinical application are presented to demonstrate in vivo utility of ECM hydrogels in different organ systems. Finally, new research directions and clinical translation of ECM hydrogels are discussed. More than 70 papers have been published on extracellular matrix (ECM) hydrogels created from source tissue in almost every organ system. The present manuscript represents a review of ECM hydrogels and attempts to identify structure-function relationships that influence the tissue remodeling outcomes and gaps in the understanding thereof. There is a Phase 1 clinical trial now in progress for an ECM hydrogel. Copyright © 2016 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

High-speed polarization sensitive optical coherence tomography for retinal diagnostics

NASA Astrophysics Data System (ADS)

Yin, Biwei; Wang, Bingqing; Vemishetty, Kalyanramu; Nagle, Jim; Liu, Shuang; Wang, Tianyi; Rylander, Henry G., III; Milner, Thomas E.

2012-01-01

We report design and construction of an FPGA-based high-speed swept-source polarization-sensitive optical coherence tomography (SS-PS-OCT) system for clinical retinal imaging. Clinical application of the SS-PS-OCT system is accurate measurement and display of thickness, phase retardation and birefringence maps of the retinal nerve fiber layer (RNFL) in human subjects for early detection of glaucoma. The FPGA-based SS-PS-OCT system provides three incident polarization states on the eye and uses a bulk-optic polarization sensitive balanced detection module to record two orthogonal interference fringe signals. Interference fringe signals and relative phase retardation between two orthogonal polarization states are used to obtain Stokes vectors of light returning from each RNFL depth. We implement a Levenberg-Marquardt algorithm on a Field Programmable Gate Array (FPGA) to compute accurate phase retardation and birefringence maps. For each retinal scan, a three-state Levenberg-Marquardt nonlinear algorithm is applied to 360 clusters each consisting of 100 A-scans to determine accurate maps of phase retardation and birefringence in less than 1 second after patient measurement allowing real-time clinical imaging-a speedup of more than 300 times over previous implementations. We report application of the FPGA-based SS-PS-OCT system for real-time clinical imaging of patients enrolled in a clinical study at the Eye Institute of Austin and Duke Eye Center.

The Imaging and Medical Beam Line at the Australian Synchrotron

NASA Astrophysics Data System (ADS)

Hausermann, Daniel; Hall, Chris; Maksimenko, Anton; Campbell, Colin

2010-07-01

As a result of the enthusiastic support from the Australian biomedical, medical and clinical communities, the Australian Synchrotron is constructing a world-class facility for medical research, the `Imaging and Medical Beamline'. The IMBL began phased commissioning in late 2008 and is scheduled to commence the first clinical research programs with patients in 2011. It will provide unrivalled x-ray facilities for imaging and radiotherapy for a wide range of research applications in diseases, treatments and understanding of physiological processes. The main clinical research drivers are currently high resolution and sensitivity cardiac and breast imaging, cell tracking applied to regenerative and stem cell medicine and cancer therapies. The beam line has a maximum source to sample distance of 136 m and will deliver a 60 cm by 4 cm x-ray beam1—monochromatic and white—to a three storey satellite building fully equipped for pre-clinical and clinical research. Currently operating with a 1.4 Tesla multi-pole wiggler, it will upgrade to a 4.2 Tesla device which requires the ability to handle up to 21 kW of x-ray power at any point along the beam line. The applications envisaged for this facility include imaging thick objects encompassing materials, humans and animals. Imaging can be performed in the range 15-150 keV. Radiotherapy research typically requires energies between 30 and 120 keV, for both monochromatic and broad beam.

Novice to expert practice via postprofessional athletic training education: a grounded theory.

PubMed

Neibert, Peter J

2009-01-01

To discover the theoretic constructs that confirm, disconfirm, or extend the principles and their applications appropriate for National Athletic Trainers' Association (NATA)-accredited postprofessional athletic training education programs. Interviews at the 2003 NATA Annual Meeting & Clinical Symposia. Qualitative study using grounded theory procedures. Thirteen interviews were conducted with postprofessional graduates. Participants were purposefully selected based on theoretic sampling and availability. The transcribed interviews were analyzed using open coding, axial coding, and selective coding procedures. Member checks, reflective journaling, and triangulation were used to ensure trustworthiness. The participants' comments confirmed and extended the current principles of postprofessional athletic training education programs and offered additional suggestions for more effective practical applications. The emergence of this central category of novice to expert practice is a paramount finding. The tightly woven fabric of the 10 processes, when interlaced with one another, provides a strong tapestry supporting novice to expert practice via postprofessional athletic training education. The emergence of this theoretic position pushes postprofessional graduate athletic training education forward to the future for further investigation into the theoretic constructs of novice to expert practice.

A comprehensive review on droplet-based bioprinting: Past, present and future.

PubMed

Gudapati, Hemanth; Dey, Madhuri; Ozbolat, Ibrahim

2016-09-01

Droplet-based bioprinting (DBB) offers greater advantages due to its simplicity and agility with precise control on deposition of biologics including cells, growth factors, genes, drugs and biomaterials, and has been a prominent technology in the bioprinting community. Due to its immense versatility, DBB technology has been adopted by various application areas, including but not limited to, tissue engineering and regenerative medicine, transplantation and clinics, pharmaceutics and high-throughput screening, and cancer research. Despite the great benefits, the technology currently faces several challenges such as a narrow range of available bioink materials, bioprinting-induced cell damage at substantial levels, limited mechanical and structural integrity of bioprinted constructs, and restrictions on the size of constructs due to lack of vascularization and porosity. This paper presents a first-time review of DBB and comprehensively covers the existing DBB modalities including inkjet, electrohydrodynamic, acoustic, and micro-valve bioprinting. The recent notable studies are highlighted, the relevant bioink biomaterials and bioprinters are expounded, the application areas are presented, and the future prospects are provided to the reader. Copyright © 2016 Elsevier Ltd. All rights reserved.

46 CFR 287.4 - Application to establish fund.

Code of Federal Regulations, 2014 CFR

2014-10-01

... vessel built to specifications, or (b) to acquire a vessel already constructed or under construction. If... OPERATORS ESTABLISHMENT OF CONSTRUCTION RESERVE FUNDS § 287.4 Application to establish fund. (a) Any person claiming to be entitled to the benefits of section 511 of the Act may make application, in writing, to the...

46 CFR 287.4 - Application to establish fund.

Code of Federal Regulations, 2012 CFR

2012-10-01

... vessel built to specifications, or (b) to acquire a vessel already constructed or under construction. If... OPERATORS ESTABLISHMENT OF CONSTRUCTION RESERVE FUNDS § 287.4 Application to establish fund. (a) Any person claiming to be entitled to the benefits of section 511 of the Act may make application, in writing, to the...

46 CFR 287.4 - Application to establish fund.

Code of Federal Regulations, 2011 CFR

2011-10-01

... vessel built to specifications, or (b) to acquire a vessel already constructed or under construction. If... OPERATORS ESTABLISHMENT OF CONSTRUCTION RESERVE FUNDS § 287.4 Application to establish fund. (a) Any person claiming to be entitled to the benefits of section 511 of the Act may make application, in writing, to the...

46 CFR 287.4 - Application to establish fund.

Code of Federal Regulations, 2010 CFR

2010-10-01

... vessel built to specifications, or (b) to acquire a vessel already constructed or under construction. If... OPERATORS ESTABLISHMENT OF CONSTRUCTION RESERVE FUNDS § 287.4 Application to establish fund. (a) Any person claiming to be entitled to the benefits of section 511 of the Act may make application, in writing, to the...

A study on specialist or special disease clinics based on big data.

PubMed

Fang, Zhuyuan; Fan, Xiaowei; Chen, Gong

2014-09-01

Correlation analysis and processing of massive medical information can be implemented through big data technology to find the relevance of different factors in the life cycle of a disease and to provide the basis for scientific research and clinical practice. This paper explores the concept of constructing a big medical data platform and introduces the clinical model construction. Medical data can be collected and consolidated by distributed computing technology. Through analysis technology, such as artificial neural network and grey model, a medical model can be built. Big data analysis, such as Hadoop, can be used to construct early prediction and intervention models as well as clinical decision-making model for specialist and special disease clinics. It establishes a new model for common clinical research for specialist and special disease clinics.

A business planning model to identify new safety net clinic locations.

PubMed

Langabeer, James; Helton, Jeffrey; DelliFraine, Jami; Dotson, Ebbin; Watts, Carolyn; Love, Karen

2014-01-01

Community health clinics serving the poor and underserved are geographically expanding due to changes in U.S. health care policy. This paper describes the experience of a collaborative alliance of health care providers in a large metropolitan area who develop a conceptual and mathematical decision model to guide decisions on expanding its network of community health clinics. Community stakeholders participated in a collaborative process that defined constructs they deemed important in guiding decisions on the location of community health clinics. This collaboration also defined key variables within each construct. Scores for variables within each construct were then totaled and weighted into a community-specific optimal space planning equation. This analysis relied entirely on secondary data available from published sources. The model built from this collaboration revolved around the constructs of demand, sustainability, and competition. It used publicly available data defining variables within each construct to arrive at an optimal location that maximized demand and sustainability and minimized competition. This is a model that safety net clinic planners and community stakeholders can use to analyze demographic and utilization data to optimize capacity expansion to serve uninsured and Medicaid populations. Communities can use this innovative model to develop a locally relevant clinic location-planning framework.

Application of the OMERACT filter to measures of core outcome domains in recent clinical studies of acute gout

PubMed Central

Taylor, William J; Redden, David; Dalbeth, Nicola; Schumacher, H Ralph; Edwards, N Lawrence; Simon, Lee S; John, Markus R; Essex, Margaret N; Watson, Douglas J; Evans, Robert; Rome, Keith; Singh, Jasvinder A

2014-01-01

Objective To determine the extent to which instruments that measure core outcome domains in acute gout fulfil the OMERACT filter requirements of truth, discrimination and feasibility. Methods Patient-level data from four randomised controlled trials of agents designed to treat acute gout and one observational study of acute gout were analysed. For each available measure construct validity, test-retest reliability, within-group change using effect size, between-group change using the Kruskall-Wallis statistic and repeated measures generalised estimating equations were assessed. Floor and ceiling effects were also assessed and MCID was estimated. These analyses were presented to participants at OMERACT 11 to help inform voting for possible endorsement. Results There was evidence for construct validity and discriminative ability for 3 measures of pain (0 to 4 Likert, 0 to 10 numeric rating scale, 0 to 100 mm visual analogue scale). Likewise, there appears to be sufficient evidence for a 4-point Likert scale to possess construct validity and discriminative ability for physician assessment of joint swelling and joint tenderness. There was some evidence for construct validity and within-group discriminative ability for the Health Assessment Questionnaire as a measure of activity limitations, but not for discrimination between groups allocated to different treatment. Conclusions There is sufficient evidence to support measures of pain (using Likert, numeric rating scale or visual analogue scales), joint tenderness and swelling (using Likert scale) as fulfilling the requirements of the OMERACT filter. Further research on a measure of activity limitations in acute gout clinical trials is required. PMID:24429178

Subjective Experience, Heterophenomenology, or Neuroimaging? A Perspective on the Meaning and Application of Mental Disorder Terms, in Particular Major Depressive Disorder.

PubMed

Schleim, Stephan

2018-01-01

Increasing research efforts try to identify biological markers in order to support or eventually replace current practices of diagnosing mental disorders. Inasmuch as these disorders refer to subjective mental states, such efforts amount to their objectification. This gives rise to conceptual as well as empirical challenges: What kind of things are mental disorders? And how to deal with situations where subjective reports, clinical decisions, and brain scans contradict each other? The present paper starts out with a discussion of recent efforts to objectify beauty. Such attempts to quantify and localize psychological constructs in the brain are compared to earlier examples from the history of psychology. The paper then discusses personal and social implications of the objectification of subjective mental states, including mental disorders. The construct of Major Depressive Disorder, one of the most prevalent mental disorders, is then analyzed in more detail. It turns out that this is a very complex construct probably associated with highly heterogeneous actual instances of the disorder. It is then shown that it is unlikely to replace these symptoms' descriptions with patterns of brain activations, at least in the near future, given these patterns' empirical lack of specificity. The paper then discusses which of the disorder's core symptoms are more or less amenable to behavioral or neuroscientific investigation and analyses whether the heterophenomenological method can solve the problem. The conclusion is that the disorder construct is neither entirely subjective, nor completely objectifiable, and that clinical experts do well by continuing to take a pragmatical stance.

Subjective Experience, Heterophenomenology, or Neuroimaging? A Perspective on the Meaning and Application of Mental Disorder Terms, in Particular Major Depressive Disorder

PubMed Central

Schleim, Stephan

2018-01-01

Increasing research efforts try to identify biological markers in order to support or eventually replace current practices of diagnosing mental disorders. Inasmuch as these disorders refer to subjective mental states, such efforts amount to their objectification. This gives rise to conceptual as well as empirical challenges: What kind of things are mental disorders? And how to deal with situations where subjective reports, clinical decisions, and brain scans contradict each other? The present paper starts out with a discussion of recent efforts to objectify beauty. Such attempts to quantify and localize psychological constructs in the brain are compared to earlier examples from the history of psychology. The paper then discusses personal and social implications of the objectification of subjective mental states, including mental disorders. The construct of Major Depressive Disorder, one of the most prevalent mental disorders, is then analyzed in more detail. It turns out that this is a very complex construct probably associated with highly heterogeneous actual instances of the disorder. It is then shown that it is unlikely to replace these symptoms’ descriptions with patterns of brain activations, at least in the near future, given these patterns’ empirical lack of specificity. The paper then discusses which of the disorder’s core symptoms are more or less amenable to behavioral or neuroscientific investigation and analyses whether the heterophenomenological method can solve the problem. The conclusion is that the disorder construct is neither entirely subjective, nor completely objectifiable, and that clinical experts do well by continuing to take a pragmatical stance. PMID:29867668

The Control Attitudes Scale-Revised: psychometric evaluation in three groups of patients with cardiac illness.

PubMed

Moser, Debra K; Riegel, Barbara; McKinley, Sharon; Doering, Lynn V; Meischke, Hendrika; Heo, Seongkum; Lennie, Terry A; Dracup, Kathleen

2009-01-01

Perceived control is a construct with important theoretical and clinical implications for healthcare providers, yet practical application of the construct in research and clinical practice awaits development of an easily administered instrument to measure perceived control with evidence of reliability and validity. To test the psychometric properties of the Control Attitudes Scale-Revised (CAS-R) using a sample of 3,396 individuals with coronary heart disease, 513 patients with acute myocardial infarction, and 146 patients with heart failure. Analyses were done separately in each patient group. Reliability was assessed using Cronbach's alpha to determine internal consistency, and item homogeneity was assessed using item-total and interitem correlations. Validity was examined using principal component analysis and testing hypotheses about known associations. Cronbach's alpha values for the CAS-R in patients with coronary heart disease, acute myocardial infarction, and heart failure were all greater than .70. Item-total and interitem correlation coefficients for all items were acceptable in the groups. In factor analyses, the same single factor was extracted in all groups, and all items were loaded moderately or strongly to the factor in each group. As hypothesized in the final construct validity test, in all groups, patients with higher levels of perceived control had less depression and less anxiety compared with those of patients who had lower levels of perceived control. This study provides evidence of the reliability and validity of the 8-item CAS-R as a measure of perceived control in patients with cardiac illness and provides important insight into a key patient construct.

[Intraoperative augmented reality visualization. Current state of development and initial experiences with the CamC].

PubMed

Weidert, S; Wang, L; von der Heide, A; Navab, N; Euler, E

2012-03-01

The intraoperative application of augmented reality (AR) has so far mainly taken place in the field of endoscopy. Here, the camera image of the endoscope was augmented by computer graphics derived mostly from preoperative imaging. Due to the complex setup and operation of the devices, they have not yet become part of routine clinical practice. The Camera Augmented Mobile C-arm (CamC) that extends a classic C-arm by a video camera and mirror construction is characterized by its uncomplicated handling. It combines its video live stream geometrically correct with the acquired X-ray. The clinical application of the device in 43 cases showed the strengths of the device in positioning for X-ray acquisition, incision placement, K-wire placement, and instrument guidance. With its new function and the easy integration into the OR workflow of any procedure that requires X-ray imaging, the CamC has the potential to become the first widely used AR technology for orthopedic and trauma surgery.

Engineering organs.

PubMed

Atala, Anthony

2009-10-01

Applications of regenerative medicine technology may offer novel therapies for patients with injuries, end-stage organ failure, or other clinical problems. Currently, patients suffering from diseased and injured organs can be treated with transplanted organs. However, there is a severe shortage of donor organs that is worsening yearly as the population ages and new cases of organ failure increase. Scientists in the field of regenerative medicine and tissue engineering are now applying the principles of cell transplantation, material science, and bioengineering to construct biological substitutes that will restore and maintain normal function in diseased and injured tissues. The stem cell field is also advancing rapidly, opening new avenues for this type of therapy. For example, therapeutic cloning and cellular reprogramming may one day provide a potentially limitless source of cells for tissue engineering applications. Although stem cells are still in the research phase, some therapies arising from tissue engineering endeavors have already entered the clinical setting successfully, indicating the promise regenerative medicine holds for the future.

Adipose-Derived Stem Cell Delivery for Adipose Tissue Engineering: Current Status and Potential Applications in a Tissue Engineering Chamber Model.

PubMed

Zhan, Weiqing; Tan, Shaun S; Lu, Feng

2016-08-01

In reconstructive surgery, there is a clinical need for adequate implants to repair soft tissue defects caused by traumatic injury, tumor resection, or congenital abnormalities. Adipose tissue engineering may provide answers to this increasing demand. This study comprehensively reviews current approaches to adipose tissue engineering, detailing different cell carriers under investigation, with a special focus on the application of adipose-derived stem cells (ASCs). ASCs act as building blocks for new tissue growth and as modulators of the host response. Recent studies have also demonstrated that the implantation of a hollow protected chamber, combined with a vascular pedicle within the fat flaps provides blood supply and enables the growth of large-volume of engineered soft tissue. Conceptually, it would be of value to co-regulate this unique chamber model with adipose-derived stem cells to obtain a greater volume of soft tissue constructs for clinical use. Our review provides a cogent update on these advances and details the generation of possible fat substitutes.

Design and application of BIM based digital sand table for construction management

NASA Astrophysics Data System (ADS)

Fuquan, JI; Jianqiang, LI; Weijia, LIU

2018-05-01

This paper explores the design and application of BIM based digital sand table for construction management. Aiming at the demands and features of construction management plan for bridge and tunnel engineering, the key functional features of digital sand table should include three-dimensional GIS, model navigation, virtual simulation, information layers, and data exchange, etc. That involving the technology of 3D visualization and 4D virtual simulation of BIM, breakdown structure of BIM model and project data, multi-dimensional information layers, and multi-source data acquisition and interaction. Totally, the digital sand table is a visual and virtual engineering information integrated terminal, under the unified data standard system. Also, the applications shall contain visual constructing scheme, virtual constructing schedule, and monitoring of construction, etc. Finally, the applicability of several basic software to the digital sand table is analyzed.

48 CFR 22.402 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Construction 22.402 Applicability. (a) Contracts for construction work. (1) The requirements of this subpart apply— (i) Only if the construction work is, or reasonably can be foreseen to be, performed at a particular site so that wage rates can be determined for the locality, and only to construction work that is...

Comparing Parent-Child Interactions in the Clinic and at Home: An Exploration of the Validity of Clinical Behavior Observations Using Sequential Analysis

ERIC Educational Resources Information Center

Shriver, Mark D.; Frerichs, Lynae J.; Williams, Melissa; Lancaster, Blake M.

2013-01-01

Direct observation is often considered the "gold standard" for assessing the function, frequency, and intensity of problem behavior. Currently, the literature investigating the construct validity of direct observation conducted in the clinic setting reveals conflicting results. Previous studies on the construct validity of clinic-based…

SU-E-T-04: 3D Printed Patient-Specific Surface Mould Applicators for Brachytherapy Treatment of Superficial Lesions

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

Cumming, I; Lasso, A; Rankin, A

2014-06-01

Purpose: Evaluate the feasibility of constructing 3D-printed patient-specific surface mould applicators for HDR brachytherapy treatment of superficial lesions. Methods: We propose using computer-aided design software to create 3D printed surface mould applicators for brachytherapy. A mould generation module was developed in the open-source 3D Slicer ( http://www.slicer.org ) medical image analysis platform. The system extracts the skin surface from CT images, and generates smooth catheter paths over the region of interest based on user-defined start and end points at a specified stand-off distance from the skin surface. The catheter paths are radially extended to create catheter channels that are sufficientlymore » wide to ensure smooth insertion of catheters for a safe source travel. An outer mould surface is generated to encompass the channels. The mould is also equipped with fiducial markers to ensure its reproducible placement. A surface mould applicator with eight parallel catheter channels of 4mm diameters was fabricated for the nose region of a head phantom; flexible plastic catheters of 2mm diameter were threaded through these channels maintaining 10mm catheter separations and a 5mm stand-off distance from the skin surface. The apparatus yielded 3mm thickness of mould material between channels and the skin. The mould design was exported as a stereolithography file to a Dimension SST1200es 3D printer and printed using ABS Plus plastic material. Results: The applicator closely matched its design and was found to be sufficiently rigid without deformation during repeated application on the head phantom. Catheters were easily threaded into channels carved along catheter paths. Further tests are required to evaluate feasibility of channel diameters smaller than 4mm. Conclusion: Construction of 3D-printed mould applicators show promise for use in patient specific brachytherapy of superficial lesions. Further evaluation of 3D printing techniques and materials is required for constructing sufficiently thin, rigid and durable surface moulds suitable for clinical deployment.« less

Laparoscopic radical cystectomy with intracorporeal orthotopic ileal neobladder: technique and clinical outcomes.

PubMed

Shao, Pengfei; Li, Pu; Ju, Xiaobing; Qin, Chao; Li, Jie; Lv, Qiang; Meng, Xiaoxin; Yin, Changjun

2015-02-01

To study the feasibility and safety of laparoscopic radical cystectomy with intracorporeal orthotopic ileal neobladder and to evaluate the role of endoscopic stapling in neobladder construction. Fifty-five patients with bladder cancer who underwent laparoscopic radical cystectomy were retrospectively examined. Extended pelvic lymph node dissection was performed before cystectomy. An ileal segment of 50 cm was harvested to construct a U-shaped reservoir. The bottom of the reservoir was anastomosed with the posterior urethra. Twenty-five patients underwent neobladder construction by manual suturing and 30 patients by endoscopic stapler suturing. The mean operative time was 346 minutes, and mean neobladder construction time was 230 minutes. The median estimated blood loss was 500 mL, and 17 patients received intraoperative transfusion. Postoperative complications included 2 cases of urine leakage, 7 cases of pyelonephritis, 4 cases of incomplete bowel obstruction, 1 case of anastomotic stricture, and 1 case of death. Endoscopic stapler suturing for neobladder construction took significantly less time than manual suturing. However, neobladder stones were found in 2 patients who underwent operation using endoscopic suturing, and the stones were removed cystoscopically. The functional outcomes of the 2 constructive methods were comparable. Laparoscopic radical cystectomy with intracorporeal orthotopic neobladder is safe and feasible for experienced laparoscopic surgeons. Application of endoscopic stapler simplifies the surgical procedure while increasing the risk of neobladder stone formation. Copyright © 2015 Elsevier Inc. All rights reserved.

Bioprinting technology and its applications.

PubMed

Seol, Young-Joon; Kang, Hyun-Wook; Lee, Sang Jin; Atala, Anthony; Yoo, James J

2014-09-01

Bioprinting technology has emerged as a powerful tool for building tissue and organ structures in the field of tissue engineering. This technology allows precise placement of cells, biomaterials and biomolecules in spatially predefined locations within confined three-dimensional (3D) structures. Various bioprinting technologies have been developed and utilized for applications in life sciences, ranging from studying cellular mechanisms to constructing tissues and organs for implantation, including heart valve, myocardial tissue, trachea and blood vessels. In this article, we introduce the general principles and limitations of the most widely used bioprinting technologies, including jetting- and extrusion-based systems. Application-based research focused on tissue regeneration is presented, as well as the current challenges that hamper clinical utility of bioprinting technology. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Construct Validity of the Anxiety Sensitivity Index-3 in Clinical Samples

ERIC Educational Resources Information Center

Kemper, Christoph J.; Lutz, Johannes; Bahr, Tobias; Ruddel, Heinz; Hock, Michael

2012-01-01

Using two clinical samples of patients, the presented studies examined the construct validity of the recently revised Anxiety Sensitivity Index-3 (ASI-3). Confirmatory factor analyses established a clear three-factor structure that corresponds to the postulated subdivision of the construct into correlated somatic, social, and cognitive components.…

New insulation constructions for aerospace wiring applications

NASA Technical Reports Server (NTRS)

Slenski, George

1994-01-01

Outlined in this presentation is the background to insulation constructions for aerospace wiring applications, the Air Force wiring policy, the purpose and contract requirements of new insulation constructions, the test plan, and the test results.

Three methods to construct predictive models using logistic regression and likelihood ratios to facilitate adjustment for pretest probability give similar results.

PubMed

Chan, Siew Foong; Deeks, Jonathan J; Macaskill, Petra; Irwig, Les

2008-01-01

To compare three predictive models based on logistic regression to estimate adjusted likelihood ratios allowing for interdependency between diagnostic variables (tests). This study was a review of the theoretical basis, assumptions, and limitations of published models; and a statistical extension of methods and application to a case study of the diagnosis of obstructive airways disease based on history and clinical examination. Albert's method includes an offset term to estimate an adjusted likelihood ratio for combinations of tests. Spiegelhalter and Knill-Jones method uses the unadjusted likelihood ratio for each test as a predictor and computes shrinkage factors to allow for interdependence. Knottnerus' method differs from the other methods because it requires sequencing of tests, which limits its application to situations where there are few tests and substantial data. Although parameter estimates differed between the models, predicted "posttest" probabilities were generally similar. Construction of predictive models using logistic regression is preferred to the independence Bayes' approach when it is important to adjust for dependency of tests errors. Methods to estimate adjusted likelihood ratios from predictive models should be considered in preference to a standard logistic regression model to facilitate ease of interpretation and application. Albert's method provides the most straightforward approach.

Open Source 3D Multipurpose Measurement System with Submillimetre Fidelity and First Application in Magnetic Resonance.

PubMed

Han, Haopeng; Moritz, Raphael; Oberacker, Eva; Waiczies, Helmar; Niendorf, Thoralf; Winter, Lukas

2017-10-18

Magnetic resonance imaging (MRI) is the mainstay of diagnostic imaging, a versatile instrument for clinical science and the subject of intense research interest. Advancing clinical science, research and technology of MRI requires high fidelity measurements in quantity, location and time of the given physical property. To meet this goal a broad spectrum of commercial measurement systems has been made available. These instruments frequently share in common that they are costly and typically employ closed proprietary hardware and software. This shortcoming makes any adjustment for a specified application difficult if not prohibitive. Recognizing this limitation this work presents COSI Measure, an automated open source measurement system that provides submillimetre resolution, robust configuration and a large working volume to support a versatile range of applications. The submillimetre fidelity and reproducibility/backlash performance were evaluated experimentally. Magnetic field mapping of a single ring Halbach magnet, a 3.0 T and a 7.0 T MR scanner as well as temperature mapping of a radio frequency coil were successfully conducted. Due to its open source nature and versatile construction, the system can be easily modified for other applications. In a resource limited research setting, COSI Measure makes efficient use of laboratory space, financial resources and collaborative efforts.

The power prior: theory and applications.

PubMed

Ibrahim, Joseph G; Chen, Ming-Hui; Gwon, Yeongjin; Chen, Fang

2015-12-10

The power prior has been widely used in many applications covering a large number of disciplines. The power prior is intended to be an informative prior constructed from historical data. It has been used in clinical trials, genetics, health care, psychology, environmental health, engineering, economics, and business. It has also been applied for a wide variety of models and settings, both in the experimental design and analysis contexts. In this review article, we give an A-to-Z exposition of the power prior and its applications to date. We review its theoretical properties, variations in its formulation, statistical contexts for which it has been used, applications, and its advantages over other informative priors. We review models for which it has been used, including generalized linear models, survival models, and random effects models. Statistical areas where the power prior has been used include model selection, experimental design, hierarchical modeling, and conjugate priors. Frequentist properties of power priors in posterior inference are established, and a simulation study is conducted to further examine the empirical performance of the posterior estimates with power priors. Real data analyses are given illustrating the power prior as well as the use of the power prior in the Bayesian design of clinical trials. Copyright © 2015 John Wiley & Sons, Ltd.

46 CFR 251.1 - Applications for construction-differential subsidy under Title V, Merchant Marine Act, 1936, as...

Code of Federal Regulations, 2010 CFR

2010-10-01

... Title V, Merchant Marine Act, 1936, as amended. 251.1 Section 251.1 Shipping MARITIME ADMINISTRATION... AND OTHER DIRECT FINANCIAL AID § 251.1 Applications for construction-differential subsidy under Title... Board applicants for construction-differential subsidy (CDS) under Title V of the Merchant Marine Act of...

46 CFR 251.1 - Applications for construction-differential subsidy under Title V, Merchant Marine Act, 1936, as...

Code of Federal Regulations, 2011 CFR

2011-10-01

... Title V, Merchant Marine Act, 1936, as amended. 251.1 Section 251.1 Shipping MARITIME ADMINISTRATION... AND OTHER DIRECT FINANCIAL AID § 251.1 Applications for construction-differential subsidy under Title... Board applicants for construction-differential subsidy (CDS) under Title V of the Merchant Marine Act of...

The effect of cyclic hydrostatic pressure on the functional development of cartilaginous tissues engineered using bone marrow derived mesenchymal stem cells.

PubMed

Meyer, E G; Buckley, C T; Steward, A J; Kelly, D J

2011-10-01

Mechanical signals can play a key role in regulating the chondrogenic differentiation of mesenchymal stem cells (MSCs). The objective of this study was to determine if the long-term application of cyclic hydrostatic pressure could be used to improve the functional properties of cartilaginous tissues engineered using bone marrow derived MSCs. MSCs were isolated from the femora of two porcine donors, expanded separately under identical conditions, and then suspended in cylindrical agarose hydrogels. Constructs from both donors were maintained in a chemically defined media supplemented with TGF-β3 for 42 days. TGF-β3 was removed from a subset of constructs from day 21 to 42. Loaded groups were subjected to 10 MPa of cyclic hydrostatic pressurisation at 1 Hz for one hour/day, five days/week. Loading consisted either of continuous hydrostatic pressure (CHP) initiated at day 0, or delayed hydrostatic pressure (DHP) initiated at day 21. Free swelling (FS) constructs were cultured in parallel as controls. Constructs were assessed at days 0, 21 and 42. MSCs isolated from both donors were morphologically similar, demonstrated comparable colony forming unit-fibroblast (CFU-F) numbers, and accumulated near identical levels of collagen and GAG following 42 days of free swelling culture. Somewhat unexpectedly the two donors displayed a differential response to hydrostatic pressure. For one donor the application of CHP resulted in increased collagen and GAG accumulation by day 42, resulting in an increased dynamic modulus compared to FS controls. In contrast, CHP had no effect on matrix accumulation for the other donor. The application of DHP had no effect on either matrix accumulation or construct mechanical properties for both donors. Variability in the response to hydrostatic pressure was also observed for three further donors. In conclusion, this study demonstrates that the application of long-term hydrostatic pressure can be used to improve the functional properties of cartilaginous tissues engineered using bone marrow derived MSCs by enhancing collagen and GAG accumulation. The response to such loading however is donor dependent, which has implications for the clinical utilisation of such a stimulus when engineering cartilaginous grafts using autologous MSCs. Copyright © 2011 Elsevier Ltd. All rights reserved.

Using a terminology server and consumer search phrases to help patients find physicians with particular expertise.

PubMed

Cole, Curtis L; Kanter, Andrew S; Cummens, Michael; Vostinar, Sean; Naeymi-Rad, Frank

2004-01-01

To design and implement a real world application using a terminology server to assist patients and physicians who use common language search terms to find specialist physicians with a particular clinical expertise. Terminology servers have been developed to help users encoding of information using complicated structured vocabulary during data entry tasks, such as recording clinical information. We describe a methodology using Personal Health Terminology trade mark and a SNOMED CT-based hierarchical concept server. Construction of a pilot mediated-search engine to assist users who use vernacular speech in querying data which is more technical than vernacular. This approach, which combines theoretical and practical requirements, provides a useful example of concept-based searching for physician referrals.

Development of a method for measuring femoral torsion using real-time ultrasound.

PubMed

Hafiz, Eliza; Hiller, Claire E; Nicholson, Leslie L; Nightingale, E Jean; Clarke, Jillian L; Grimaldi, Alison; Eisenhuth, John P; Refshauge, Kathryn M

2014-07-01

Excessive femoral torsion has been associated with various musculoskeletal and neurological problems. To explore this relationship, it is essential to be able to measure femoral torsion in the clinic accurately. Computerized tomography (CT) and magnetic resonance imaging (MRI) are thought to provide the most accurate measurements but CT involves significant radiation exposure and MRI is expensive. The aim of this study was to design a method for measuring femoral torsion in the clinic, and to determine the reliability of this method. Details of design process, including construction of a jig, the protocol developed and the reliability of the method are presented. The protocol developed used ultrasound to image a ridge on the greater trochanter, and a customized jig placed on the femoral condyles as reference points. An inclinometer attached to the customized jig allowed quantification of the degree of femoral torsion. Measurements taken with this protocol had excellent intra- and inter-rater reliability (ICC2,1 = 0.98 and 0.97, respectively). This method of measuring femoral torsion also permitted measurement of femoral torsion with a high degree of accuracy. This method is applicable to the research setting and, with minor adjustments, will be applicable to the clinical setting.

Electromagnetic redesign of the HYPERcollar applicator: toward improved deep local head-and-neck hyperthermia.

PubMed

Togni, P; Rijnen, Z; Numan, W C M; Verhaart, R F; Bakker, J F; van Rhoon, G C; Paulides, M M

2013-09-07

Accumulating evidence shows that hyperthermia improves head-and-neck cancer treatment. Over the last decade, we introduced a radiofrequency applicator, named HYPERcollar, which enables local heating also of deep locations in this region. Based on clinical experience, we redesigned the HYPERcollar for improved comfort, reproducibility and operator handling. In the current study, we analyze the redesign from an electromagnetic point of view. We show that a higher number of antennas and their repositioning allow for a substantially improved treatment quality. Combined with the much better reproducibility of the water bolus, this will substantially minimize the risk of underexposure. All improvements combined enable a reduction of hot-spot prominence (hot-spot to target SAR quotient) by 32% at an average of 981 W, which drastically reduces the probability for system power to become a treatment limiting source. Moreover, the power deposited in the target selectively can be increased by more than twofold. Hence, we expect that the HYPERcollar redesign currently under construction allows us to double the clinically applied power to the target while reducing the hot-spots, resulting in higher temperatures and, consequently, better clinical outcome.

Lymph node segmentation on CT images by a shape model guided deformable surface methodh

NASA Astrophysics Data System (ADS)

Maleike, Daniel; Fabel, Michael; Tetzlaff, Ralf; von Tengg-Kobligk, Hendrik; Heimann, Tobias; Meinzer, Hans-Peter; Wolf, Ivo

2008-03-01

With many tumor entities, quantitative assessment of lymph node growth over time is important to make therapy choices or to evaluate new therapies. The clinical standard is to document diameters on transversal slices, which is not the best measure for a volume. We present a new algorithm to segment (metastatic) lymph nodes and evaluate the algorithm with 29 lymph nodes in clinical CT images. The algorithm is based on a deformable surface search, which uses statistical shape models to restrict free deformation. To model lymph nodes, we construct an ellipsoid shape model, which strives for a surface with strong gradients and user-defined gray values. The algorithm is integrated into an application, which also allows interactive correction of the segmentation results. The evaluation shows that the algorithm gives good results in the majority of cases and is comparable to time-consuming manual segmentation. The median volume error was 10.1% of the reference volume before and 6.1% after manual correction. Integrated into an application, it is possible to perform lymph node volumetry for a whole patient within the 10 to 15 minutes time limit imposed by clinical routine.

Applications of Kelly's Personal Construct Theory to Vocational Guidance

ERIC Educational Resources Information Center

Paszkowska-Rogacz, Anna; Kabzinska, Zofia

2012-01-01

This paper outlines selected applications of Kelly's Personal Construct Theory to vocational guidance. The authors elicited personal constructs using the Rep Test (Role Construct Repertory Test) and compared them with Holland's occupational typology. The sample (N = 136, F = 85, M = 51, average age of 21.97) was composed of students of various…

Cancer Research Center Indiana University School of Medicine

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

Not Available

1994-08-01

The Department of Energy (DOE) proposes to authorize the Indiana School of Medicine to proceed with the detailed design, construction and equipping of the proposed Cancer Research Center (CRC). A grant was executed with the University on April 21, 1992. A four-story building with basement would be constructed on the proposed site over a 24-month period. The proposed project would bring together, in one building, three existing hematology/oncology basic research programs, with improved cost-effectiveness through the sharing of common resources. The proposed site is currently covered with asphaltic pavement and is used as a campus parking lot. The surrounding areamore » is developed campus, characterized by buildings, walkways, with minimal lawns and plantings. The proposed site has no history of prior structures and no evidence of potential sources of prior contamination of the soil. Environmental impacts of construction would be limited to minor increases in traffic, and the typical noises associated with standard building construction. The proposed CRC project operation would involve the use radionuclides and various hazardous materials in conducting clinical studies. Storage, removal and disposal of hazardous wastes would be managed under existing University programs that comply with federal and state requirements. Radiological safety programs would be governed by Nuclear Regulatory Commission (NRC) license and applicable Environmental Protection Agency (EPA) regulations. There are no other NEPA reviews currently active which are in relationship to this proposed site. The proposed project is part of a Medical Campus master plan and is consistent with applicable local zoning and land use requirements.« less

Biomimetic perfusion and electrical stimulation applied in concert improved the assembly of engineered cardiac tissue

PubMed Central

Lee, Eun Jung; Luo, Jianwen; Duan, Yi; Yeager, Keith; Konofagou, Elisa; Vunjak-Novakovic, Gordana

2012-01-01

Maintenance of normal myocardial function depends intimately on synchronous tissue contraction driven by electrical activation and on adequate nutrient perfusion in support thereof. Bioreactors have been used to mimic aspects of these factors in vitro to engineer cardiac tissue, but due to design limitations, previous bioreactor systems have yet to simultaneously support nutrient perfusion, electrical stimulation, and unconstrained (i.e., not isometric) tissue contraction. To the best of our knowledge, the bioreactor system described herein is the first to integrate in concert these three key factors. We present the design of our bioreactor and characterize its capability in integrated experimental and mathematical modeling studies. We then culture cardiac cells obtained from neonatal rats in porous, channeled elastomer scaffolds with the simultaneous application of perfusion and electrical stimulation, with controls excluding either one or both of these two conditions. After eight days of culture, constructs grown with the simultaneous perfusion and electrical stimulation exhibited substantially improved functional properties, as evidenced by a significant increase in contraction amplitude (0.23±0.10% vs. 0.14±0.05, 0.13±0.08, or 0.09±0.02% in control constructs grown without stimulation, without perfusion, or either stimulation or perfusion, respectively). Consistently, these constructs had significantly improved DNA contents, cell distribution throughout the scaffold thickness, cardiac protein expression, cell morphology and overall tissue organization than either control group. Thus, the simultaneous application of medium perfusion and electrical conditioning enabled by the use of the novel bioreactor system may accelerate the generation of fully functional, clinically sized cardiac tissue constructs. PMID:22170772

Construction and Validation of the Clinical Judgment Skill Inventory: Clinical Judgment Skill Competencies That Measure Counselor Debiasing Techniques

ERIC Educational Resources Information Center

Austin, Bryan S.; Leahy, Michael J.

2015-01-01

Purpose: To construct and validate a new self-report instrument, the Clinical Judgment Skill Inventory (CJSI), inclusive of clinical judgment skill competencies that address counselor biases and evidence-based strategies. Method: An Internet-based survey design was used and an exploratory factor analysis was performed on a sample of rehabilitation…

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

ERIC Educational Resources Information Center

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

2004-01-01

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

Clinical Utility and "DSM-V"

ERIC Educational Resources Information Center

Mullins-Sweatt, Stephanie N.; Widiger, Thomas A.

2009-01-01

The construction of the American Psychiatric Association's diagnostic manual has been guided primarily by concerns of construct validity rather than of clinical utility, despite claims by its authors that the highest priority has in fact been clinical utility. The purpose of this article was to further articulate the concept and importance of…

In vitro physical stimulation of tissue-engineered and native cartilage.

PubMed

Li, Kelvin W; Klein, Travis J; Chawla, Kanika; Nugent, Gayle E; Bae, Won C; Sah, Robert L

2004-01-01

Because of the limited availability of donor cartilage for resurfacing defects in articular surfaces, there is tremendous interest in the in vitro bioengineering of cartilage replacements for clinical applications. However, attaining mechanical properties in engineered cartilaginous constructs that approach those of native cartilage has not been previously achieved when constructs are cultured under free-swelling conditions. One approach toward stimulating the development of constructs that are mechanically more robust is to expose them to physical environments that are similar, in certain ways, to those encountered by native cartilage. This is a strategy motivated by observations in numerous short-term experiments that certain mechanical signals are potent stimulators of cartilage metabolism. On the other hand, excess mechanical loading can have a deleterious effect on cartilage. Culture conditions that include a physical stimulation component are made possible by the use of specialized bioreactors. This chapter addresses some of the issues involved in using bioreactors as integral components of cartilage tissue engineering and in studying the physical regulation of cartilage. We first consider the generation of cartilaginous constructs in vitro. Next we describe the rationale and design of bioreactors that can impart either mechanical deformation or fluid-induced mechanical signals.

Construction of quality-assured infant feeding process of care data repositories: definition and design (Part 1).

PubMed

Garcí A-de-León-Chocano, Ricardo; Sáez, Carlos; Muñoz-Soler, Verónica; Garcí A-de-León-González, Ricardo; García-Gómez, Juan M

2015-12-01

This is the first paper of a series of two regarding the construction of data quality (DQ) assured repositories for the reuse of information on infant feeding from birth until two years old. This first paper justifies the need for such repositories and describes the design of a process to construct them from Electronic Health Records (EHR). As a result, Part 1 proposes a computational process to obtain quality-assured datasets represented by a canonical structure extracted from raw data from multiple EHR. For this, 13 steps were defined to ensure the harmonization, standardization, completion, de-duplication, and consistency of the dataset content. Moreover, the quality of the input and output data for each of these steps is controlled according to eight DQ dimensions: predictive value, correctness, duplication, consistency, completeness, contextualization, temporal-stability and spatial-stability. The second paper of the series will describe the application of this computational process to construct the first quality-assured repository for the reuse of information on infant feeding in the perinatal period aimed at the monitoring of clinical activities and research. Copyright © 2015 Elsevier Ltd. All rights reserved.

Development and validation of an automated delirium risk assessment system (Auto-DelRAS) implemented in the electronic health record system.

PubMed

Moon, Kyoung-Ja; Jin, Yinji; Jin, Taixian; Lee, Sun-Mi

2018-01-01

A key component of the delirium management is prevention and early detection. To develop an automated delirium risk assessment system (Auto-DelRAS) that automatically alerts health care providers of an intensive care unit (ICU) patient's delirium risk based only on data collected in an electronic health record (EHR) system, and to evaluate the clinical validity of this system. Cohort and system development designs were used. Medical and surgical ICUs in two university hospitals in Seoul, Korea. A total of 3284 patients for the development of Auto-DelRAS, 325 for external validation, 694 for validation after clinical applications. The 4211 data items were extracted from the EHR system and delirium was measured using CAM-ICU (Confusion Assessment Method for Intensive Care Unit). The potential predictors were selected and a logistic regression model was established to create a delirium risk scoring algorithm to construct the Auto-DelRAS. The Auto-DelRAS was evaluated at three months and one year after its application to clinical practice to establish the predictive validity of the system. Eleven predictors were finally included in the logistic regression model. The results of the Auto-DelRAS risk assessment were shown as high/moderate/low risk on a Kardex screen. The predictive validity, analyzed after the clinical application of Auto-DelRAS after one year, showed a sensitivity of 0.88, specificity of 0.72, positive predictive value of 0.53, negative predictive value of 0.94, and a Youden index of 0.59. A relatively high level of predictive validity was maintained with the Auto-DelRAS system, even one year after it was applied to clinical practice. Copyright © 2017. Published by Elsevier Ltd.

Verticality and containment in song and improvisation: an application of schema theory to Nordoff-Robbins music therapy.

PubMed

Aigen, Kenneth

2009-01-01

This study illustrates the use of a new musicological method for analyzing music in music therapy. It examines two pieces of clinical music through the constructs of schema theory. It begins with an argument for enhanced musical analysis in music therapy as a means of elevating the status of explanation in music therapy. Schema theory is introduced as a means of integrating musical with clinical concerns. Some basic ideas in schema theory are explained and the schemas of VERTICALITY and CONTAINER are presented as central ones in the analysis of music. Two transcriptions-one of a composed song and one of an improvisation-are examined in detail to illustrate how decisions in the temporal, melodic, and harmonic dimensions of the music are linked to specific clinical goals. The article concludes with a discussion of the implications of this type of musicological analysis for explanatory theory in music therapy.

AEG-1 promoter-mediated imaging of prostate cancer

PubMed Central

Bhatnagar, Akrita; Wang, Yuchuan; Mease, Ronnie C.; Gabrielson, Matthew; Sysa, Polina; Minn, Il; Green, Gilbert; Simmons, Brian; Gabrielson, Kathleen; Sarkar, Siddik; Fisher, Paul B.; Pomper, Martin G.

2014-01-01

We describe a new imaging method for detecting prostate cancer, whether localized or disseminated and metastatic to soft tissues and bone. The method relies on the use of imaging reporter genes under the control of the promoter of AEG-1 (MTDH), which is selectively active only in malignant cells. Through systemic, nanoparticle-based delivery of the imaging construct, lesions can be identified through bioluminescence imaging and single photon emission-computed tomography in the PC3-ML murine model of prostate cancer at high sensitivity. This approach is applicable for the detection of prostate cancer metastases, including bone lesions for which there is no current reliable agent for non-invasive clinical imaging. Further, the approach compares favorably to accepted and emerging clinical standards, including positron emission tomography with [18F]fluorodeoxyglucose and [18F]sodium fluoride. Our results offer a preclinical proof of concept that rationalizes clinical evaluation in patients with advanced prostate cancer. PMID:25145668

Reconciling pairs of concurrently used clinical practice guidelines using Constraint Logic Programming.

PubMed

Wilk, Szymon; Michalowski, Martin; Michalowski, Wojtek; Hing, Marisela Mainegra; Farion, Ken

2011-01-01

This paper describes a new methodological approach to reconciling adverse and contradictory activities (called points of contention) occurring when a patient is managed according to two or more concurrently used clinical practice guidelines (CPGs). The need to address these inconsistencies occurs when a patient with more than one disease, each of which is a comorbid condition, has to be managed according to different treatment regimens. We propose an automatic procedure that constructs a mathematical guideline model using the Constraint Logic Programming (CLP) methodology, uses this model to identify and mitigate encountered points of contention, and revises the considered CPGs accordingly. The proposed procedure is used as an alerting mechanism and coupled with a guideline execution engine warns the physician about potential problems with the concurrent application of two or more guidelines. We illustrate the operation of our procedure in a clinical scenario describing simultaneous use of CPGs for duodenal ulcer and transient ischemic attack.

Illness severity and self-efficacy as course predictors of DSM-IV alcohol dependence in a multisite clinical sample.

PubMed

Langenbucher, J; Sulesund, D; Chung, T; Morgenstern, J

1996-01-01

Illness severity and self-efficacy are two constructs of growing interest as predictors of clinical response in alcoholism. Using alternative measures of illness severity (DSM-IV symptom count, Alcohol Dependence Scale, and Addiction Severity Index) and self-efficacy (brief version of the Situational Confidence Questionnaire) rigorously controlled for theoretically important background variables, we studied their unique contribution to multiple indices of relapse, relapse latency, and use of alternative coping behaviors in a large, heterogeneous clinical sample. The Alcohol Dependence Scale contributed to the prediction of 4 of 5 relapse indicators. The SCQ failed to predict relapse behavior or its precursor, coping response. The findings emphasize the predictive validity of severity of dependence as a course specifier and underline the need for more sensitive and externally valid measures of cognitive processes such as self-efficacy for application in future studies of posttreatment behavior.

In Vivo Chondrogenesis in 3D Bioprinted Human Cell-laden Hydrogel Constructs

PubMed Central

Möller, Thomas; Hägg, Daniel; Brantsing, Camilla; Rotter, Nicole; Apelgren, Peter; Lindahl, Anders; Kölby, Lars; Gatenholm, Paul

2017-01-01

Background: The three-dimensional (3D) bioprinting technology allows creation of 3D constructs in a layer-by-layer fashion utilizing biologically relevant materials such as biopolymers and cells. The aim of this study is to investigate the use of 3D bioprinting in a clinically relevant setting to evaluate the potential of this technique for in vivo chondrogenesis. Methods: Thirty-six nude mice (Balb-C, female) received a 5- × 5- × 1-mm piece of bioprinted cell-laden nanofibrillated cellulose/alginate construct in a subcutaneous pocket. Four groups of printed constructs were used: (1) human (male) nasal chondrocytes (hNCs), (2) human (female) bone marrow–derived mesenchymal stem cells (hBMSCs), (3) coculture of hNCs and hBMSCs in a 20/80 ratio, and (4) Cell-free scaffolds (blank). After 14, 30, and 60 days, the scaffolds were harvested for histological, immunohistochemical, and mechanical analysis. Results: The constructs had good mechanical properties and keep their structural integrity after 60 days of implantation. For both the hNC constructs and the cocultured constructs, a gradual increase of glycosaminoglycan production and hNC proliferation was observed. However, the cocultured group showed a more pronounced cell proliferation and enhanced deposition of human collagen II demonstrated by immunohistochemical analysis. Conclusions: In vivo chondrogenesis in a 3D bioprinted human cell-laden hydrogel construct has been demonstrated. The trophic role of the hBMSCs in stimulating hNC proliferation and matrix deposition in the coculture group suggests the potential of 3D bioprinting of human cartilage for future application in reconstructive surgery. PMID:28280669

In Vivo Chondrogenesis in 3D Bioprinted Human Cell-laden Hydrogel Constructs.

PubMed

Möller, Thomas; Amoroso, Matteo; Hägg, Daniel; Brantsing, Camilla; Rotter, Nicole; Apelgren, Peter; Lindahl, Anders; Kölby, Lars; Gatenholm, Paul

2017-02-01

The three-dimensional (3D) bioprinting technology allows creation of 3D constructs in a layer-by-layer fashion utilizing biologically relevant materials such as biopolymers and cells. The aim of this study is to investigate the use of 3D bioprinting in a clinically relevant setting to evaluate the potential of this technique for in vivo chondrogenesis. Thirty-six nude mice (Balb-C, female) received a 5- × 5- × 1-mm piece of bioprinted cell-laden nanofibrillated cellulose/alginate construct in a subcutaneous pocket. Four groups of printed constructs were used: (1) human (male) nasal chondrocytes (hNCs), (2) human (female) bone marrow-derived mesenchymal stem cells (hBMSCs), (3) coculture of hNCs and hBMSCs in a 20/80 ratio, and (4) Cell-free scaffolds (blank). After 14, 30, and 60 days, the scaffolds were harvested for histological, immunohistochemical, and mechanical analysis. The constructs had good mechanical properties and keep their structural integrity after 60 days of implantation. For both the hNC constructs and the cocultured constructs, a gradual increase of glycosaminoglycan production and hNC proliferation was observed. However, the cocultured group showed a more pronounced cell proliferation and enhanced deposition of human collagen II demonstrated by immunohistochemical analysis. In vivo chondrogenesis in a 3D bioprinted human cell-laden hydrogel construct has been demonstrated. The trophic role of the hBMSCs in stimulating hNC proliferation and matrix deposition in the coculture group suggests the potential of 3D bioprinting of human cartilage for future application in reconstructive surgery.

Chimeric antigen receptor (CAR)-directed adoptive immunotherapy: a new era in targeted cancer therapy.

PubMed

Chen, Yamei; Liu, Delong

2014-01-01

As a result of the recent advances in molecular immunology, virology, genetics, and cell processing, chimeric antigen receptor (CAR)-directed cancer therapy has finally arrived for clinical application. CAR-directed adoptive immunotherapy represents a novel form of gene therapy, cellular therapy, and immunotherapy, a combination of three in one. Early phase clinical trial was reported in patients with refractory chronic lymphoid leukemia with 17p deletion. Accompanying the cytokine storm and tumor lysis syndrome was the shocking disappearance of the leukemia cells refractory to chemotherapy and monoclonal antibodies. CAR therapy was reproduced in both children and adults with refractory acute lymphoid leukemia. The CAR technology is being explored for solid tumor therapy, such as glioma. Close to 30 clinical trials are underway in the related fields (www.clinicaltrials.gov). Further improvement in gene targeting, cell expansion, delivery constructs (such as using Sleeping Beauty or Piggyback transposons) will undoubtedly enhance clinical utility. It is foreseeable that CAR-engineered T cell therapy will bring targeted cancer therapy into a new era.

Advanced Engineering Strategies for Periodontal Complex Regeneration.

PubMed

Park, Chan Ho; Kim, Kyoung-Hwa; Lee, Yong-Moo; Seol, Yang-Jo

2016-01-18

The regeneration and integration of multiple tissue types is critical for efforts to restore the function of musculoskeletal complex. In particular, the neogenesis of periodontal constructs for systematic tooth-supporting functions is a current challenge due to micron-scaled tissue compartmentalization, oblique/perpendicular orientations of fibrous connective tissues to the tooth root surface and the orchestration of multiple regenerated tissues. Although there have been various biological and biochemical achievements, periodontal tissue regeneration remains limited and unpredictable. The purpose of this paper is to discuss current advanced engineering approaches for periodontal complex formations; computer-designed, customized scaffolding architectures; cell sheet technology-based multi-phasic approaches; and patient-specific constructs using bioresorbable polymeric material and 3-D printing technology for clinical application. The review covers various advanced technologies for periodontal complex regeneration and state-of-the-art therapeutic avenues in periodontal tissue engineering.

Registered nurses' constructed meaning of concepts of solution and their use in clinical practice

NASA Astrophysics Data System (ADS)

Wilkes, Lesley M.; Batts, Judith E.

1991-12-01

Since the introduction of nursing into tertiary institutions in Australia in 1975, there has been increasing interest in the teaching of physical science to nurses. Various courses in physical science for nurse students have been developed. They vary in length and content but there is agreement that concepts taught should be closely related to nursing applications. The choice of relevant concepts tends to be made by individual curriculum developers. This paper reports an examination of the use of physical science concepts and their relevance from the perspective of registered nurses practising in general ward areas. Inherent in this study is the premise that for registered nurses to have ideas of the physical science underlying their practice they must have constructed meaning first for these concepts. Specific chemical concepts related to solutions are discussed in these terms.

Construction and validation of forms: systematization of the care of people under hemodialysis.

PubMed

Arreguy-Sena, Cristina; Marques, Tais de Oliveira; Souza, Luciene Carnevale de; Alvarenga-Martins, Nathália; Krempser, Paula; Braga, Luciene Muniz; Parreira, Pedro Miguel Dos Santos Dinis

2018-01-01

create and validate forms to subsidize the systematization of nursing care with people on hemodialysis. institutional case study to support the systematization of assistance from the construction of forms for data collection, diagnoses, interventions and nursing results, using cross-mapping, Risner's reasoning, Neuman's theory, taxonomies of diagnoses, interventions and nursing results with application in clinical practice and validation by focal group with specialist nurses. 18 people on hemodialysis and 7 nurses participated. Consensus content of form matter with specialist nurses in the area (Crombach 0.86). The papers captured 43 diagnoses, 26 interventions and 78 nursing results depicting human responses in their singularities. the validated forms fill a gap by enabling the capture of human responses from people on hemodialysis and by subsidizing the planning of nursing care on a scientific basis.

Rolling the Human Amnion to Engineer Laminated Vascular Tissues

PubMed Central

Amensag, Salma

2012-01-01

The prevalence of cardiovascular disease and the limited availability of suitable autologous transplant vessels for coronary and peripheral bypass surgeries is a significant clinical problem. A great deal of progress has been made over recent years to develop biodegradable materials with the potential to remodel and regenerate vascular tissues. However, the creation of functional biological scaffolds capable of withstanding vascular stress within a clinically relevant time frame has proved to be a challenging proposition. As an alternative approach, we report the use of a multilaminate rolling approach using the human amnion to generate a tubular construct for blood vessel regeneration. The human amniotic membrane was decellularized by agitation in 0.03% (w/v) sodium dodecyl sulfate to generate an immune compliant material. The adhesion of human umbilical vein endothelial cells (EC) and human vascular smooth muscle cells (SMC) was assessed to determine initial binding and biocompatibility (monocultures). Extended cultures were either assessed as flat membranes, or rolled to form concentric multilayered conduits. Results showed positive EC adhesion and a progressive repopulation by SMC. Functional changes in SMC gene expression and the constructs' bulk mechanical properties were concomitant with vessel remodeling as assessed over a 40-day culture period. A significant advantage with this approach is the ability to rapidly produce a cell-dense construct with an extracellular matrix similar in architecture and composition to natural vessels. The capacity to control physical parameters such as vessel diameter, wall thickness, shape, and length are critical to match vessel compliance and tailor vessel specifications to distinct anatomical locations. As such, this approach opens new avenues in a range of tissue regenerative applications that may have a much wider clinical impact. PMID:22616610

Design and construction of functional AAV vectors.

PubMed

Gray, John T; Zolotukhin, Serge

2011-01-01

Using the basic principles of molecular biology and laboratory techniques presented in this chapter, researchers should be able to create a wide variety of AAV vectors for both clinical and basic research applications. Basic vector design concepts are covered for both protein coding gene expression and small non-coding RNA gene expression cassettes. AAV plasmid vector backbones (available via AddGene) are described, along with critical sequence details for a variety of modular expression components that can be inserted as needed for specific applications. Protocols are provided for assembling the various DNA components into AAV vector plasmids in Escherichia coli, as well as for transferring these vector sequences into baculovirus genomes for large-scale production of AAV in the insect cell production system.

Developing Mobile Clinical Decision Support for Nursing Home Staff Assessment of Urinary Tract Infection using Goal-Directed Design.

PubMed

Jones, Wallace; Drake, Cynthia; Mack, David; Reeder, Blaine; Trautner, Barbara; Wald, Heidi

2017-06-20

Unique characteristics of nursing homes (NHs) contribute to high rates of inappropriate antibiotic use for asymptomatic bacteriuria (ASB), a benign condition. A mobile clinical decision support system (CDSS) may support NH staff in differentiating urinary tract infections (UTI) from ASB and reducing antibiotic days. We used Goal-Directed Design to: 1) Characterize information needs for UTI identification and management in NHs; 2) Develop UTI Decide, a mobile CDSS prototype informed by personas and scenarios of use constructed from Aim 1 findings; 3) Evaluate the UTI Decide prototype with NH staff. Focus groups were conducted with providers and nurses in NHs in Denver, Colorado (n= 24). Qualitative descriptive analysis was applied to focus group transcripts to identify information needs and themes related to mobile clinical decision support for UTI identification and management. Personas representing typical end users were developed; typical clinical context scenarios were constructed using information needs as goals. Usability testing was performed using cognitive walk-throughs and a think-aloud protocol. Four information needs were identified including guidance regarding resident assessment; communication with providers; care planning; and urine culture interpretation. Design of a web-based application incorporating a published decision support algorithm for evidence-based UTI diagnoses proceeded with a focus on nursing information needs during resident assessment and communication with providers. Certified nursing assistant (CNA) and registered nurse (RN) personas were constructed in 4 context scenarios with associated key path scenarios. After field testing, a high fidelity prototype of UTI Decide was completed and evaluated by potential end users. Design recommendations and content recommendations were elicited. Goal-Directed Design informed the development of a mobile CDSS supporting participant-identified information needs for UTI assessment and communication in NHs. Future work will include iterative deployment and evaluation of UTI Decide in NHs to decrease inappropriate use of antibiotics for suspected UTI.

Immediate occlusal loading of NanoTite PREVAIL implants: a prospective 1-year clinical and radiographic study.

PubMed

Ostman, Pär-Olov; Wennerberg, Ann; Albrektsson, Tomas

2010-03-01

Recently, a new implant surface texture, featuring application of nanometer-scale calcium phosphate has been shown to enhance early bone fixation and formation in preclinical studies and in human histomorphometric studies, which may be beneficial in immediate loading situations. The purpose of the present prospective clinical study was to, during 1 year, clinically and radiographically evaluate a nanometer scale surface modified implant placed for immediate loading of fixed prostheses in both maxillary and mandibular regions. Thirty-five out of 38 patients who needed implant treatment and met inclusion criteria agreed to participate in the study and were consecutively enrolled. Surgical implant placement requirements consisted of a final torque of a least 25 Ncm prior to final seating and an implant stability quotient above 55. A total of 102 NanoTite PREVAIL (NTP) implants (BIOMET 3i, Palm Beach Gardens, FL, USA) (66 maxillary and 36 mandibular) were placed by one investigator, and the majority of these were placed in posterior regions (65%) and in soft bone (69%). A total of 44 prosthetic constructions were evaluated consisting of 14 single-tooth restorations, 26 fixed partial dentures, and four complete fixed restorations. All provisional constructions were delivered within 1 hour, and the final constructions placed after 4 months. Implants were monitored for clinical and radiographic outcomes at follow-up examinations scheduled for 3, 6, and 12 months. Of the 102 study implants, one implant failed. The simple cumulative survival rate value at 1 year was 99.2%. The average marginal bone resorption was 0.37 mm (SD 0.39) during the first year in function. According to the success criteria of Albrektsson and Zarb, success grade 1 was found with 93% of the implants. Although limited to the short follow-up, immediate loading of NanoTite Prevail implants seems to be a viable option in implant rehabilitation, at least when a good initial fixation is achieved.

Longitudinal construct validity of the minimum data set health status index.

PubMed

Jones, Aaron; Feeny, David; Costa, Andrew P

2018-05-24

The Minimum Data Set Health Status Index (MDS-HSI) is a generic, preference-based health-related quality of life (HRQOL) measure derived by mapping items from the Resident Assessment Instrument - Minimum Data Set (RAI-MDS) assessment onto the Health Utilities Index Mark 2 classification system. While the validity of the MDS-HSI has been examined in cross-sectional settings, the longitudinal validity has not been explored. The objective of this study was to investigate the longitudinal construct validity of the MDS-HSI in a home care population. This study utilized a retrospective cohort of home care patients in the Hamilton-Niagara-Haldimand-Brant health region of Ontario, Canada with at least two RAI-MDS Home Care assessments between January 2010 and December 2014. Convergent validity was assessed by calculating Spearman rank correlations between the change in MDS-HSI and changes in six validated indices of health domains that can be calculated from the RAI-MDS assessment. Known-groups validity was investigated by fitting multivariable linear regression models to estimate the mean change in MDS-HSI associated with clinically important changes in the six health domain indices and 15 disease symptoms from the RAI-MDS Home Care assessment, controlling for age and sex. The cohort contained 25,182 patients with two RAI-MDS Home Care assessments. Spearman correlations between the MDS-HSI change and changes in the health domain indices were all statistically significant and in the hypothesized small to moderate range [0.1 < ρ < 0.5]. Clinically important changes in all of the health domain indices and 13 of the 15 disease symptoms were significantly associated with clinically important changes in the MDS-HSI. The findings of this study support the longitudinal construct validity of the MDS-HSI in home care populations. In addition to evaluating changes in HRQOL among home care patients in clinical research, economic evaluation, and health technology assessment, the MDS-HSI may be used in system-level applications using routinely collected population-level data.

Advanced devices for photoacoustic imaging to improve cancer and cerebrovascular medicine

NASA Astrophysics Data System (ADS)

Montilla Marien, Leonardo Gabriel

Recent clinical studies have demonstrated that photoacoustic imaging (PAI) provides important diagnostic information for breast cancer staging. Despite these promising studies, PAI remains an unfeasible option for clinics due to the cost to implement, the required large modification in user conduct and the inflexibility of the hardware to accommodate other applications for the incremental enhancement in diagnostic information. The research described in this dissertation addresses these issues by designing attachments to clinical ultrasound probes and incorporating custom detectors into commercial ultrasound scanners. The ultimate benefit of these handheld devices is to expand the capability of current ultrasound systems and facilitate the translation of PAI to enhance cancer diagnostics and neurosurgical outcomes. Photoacoustic enabling devices (PEDs) were designed as attachments to two clinical ultrasound probes optimized for breast cancer diagnostics. PAI uses pulsed laser excitation to create transient heating (<1°C) and thermoelastic expansion that is detected as an ultrasonic emission. These ultrasonic emissions are remotely sensed to construct noninvasive images with optical contrast at depths much greater than other optical modalities. The PEDs are feasible in terms of cost, user familiarity and flexibility for various applications. Another possible application for PAI is in assisting neurosurgeons treating aneurysms. Aneurysms are often treated by placing a clip to prevent blood flow into the aneurysm. However, this procedure has risks associated with damaging nearby vessels. One of the developed PEDs demonstrated the feasibility to three-dimensionally image tiny microvasculature (<0.3mm) beyond large blood occlusions (>2.4mm) in a phantom model. The capability to use this during surgery would suggest decreasing the risks associated with these treatments. However, clinical ultrasound arrays are not clinically feasible for microsurgical applications due to their bulky size and linear scanning requirements for 3D. Therefore, capacitive micromachined ultrasound transducer (CMUT) two-dimensional arrays compatible with standard ultrasound scanners were used to generate real-time 3D photoacoustic images. Future probes, designed incorporating CMUT arrays, would be relatively simple to fabricate and a convenient upgrade to existing clinical ultrasound equipment. Eventually, a handheld tool with the ability to visualize, in real-time 3D, the desired microvasculature, would assist surgical procedures. The potential implications of PAI devices compatible with standard ultrasound equipment would be a streamlined cost efficient solution for translating photoacoustics into clinical practice. The practitioner could then explore the benefits of the enhanced contrast adjunctive to current ultrasound applications. Clinical availability of PAI could enhance breast cancer diagnostics and cerebrovascular surgical outcomes.

38 CFR 17.255 - Applications for grants for programs which include construction projects.

Code of Federal Regulations, 2011 CFR

2011-07-01

... evidence required by § 17.254, any application for a grant for the construction of any facility, structure... that the rates of pay for laborers and mechanics engaged in construction activities will not be less...

38 CFR 17.255 - Applications for grants for programs which include construction projects.

Code of Federal Regulations, 2012 CFR

2012-07-01

... evidence required by § 17.254, any application for a grant for the construction of any facility, structure... that the rates of pay for laborers and mechanics engaged in construction activities will not be less...

38 CFR 17.255 - Applications for grants for programs which include construction projects.

Code of Federal Regulations, 2013 CFR

2013-07-01

... evidence required by § 17.254, any application for a grant for the construction of any facility, structure... that the rates of pay for laborers and mechanics engaged in construction activities will not be less...

38 CFR 17.255 - Applications for grants for programs which include construction projects.

Code of Federal Regulations, 2010 CFR

2010-07-01

... evidence required by § 17.254, any application for a grant for the construction of any facility, structure... that the rates of pay for laborers and mechanics engaged in construction activities will not be less...

38 CFR 17.255 - Applications for grants for programs which include construction projects.

Code of Federal Regulations, 2014 CFR

2014-07-01

... evidence required by § 17.254, any application for a grant for the construction of any facility, structure... that the rates of pay for laborers and mechanics engaged in construction activities will not be less...

A Construct Validity Study of Clinical Competence: A Multitrait Multimethod Matrix Approach

ERIC Educational Resources Information Center

Baig, Lubna; Violato, Claudio; Crutcher, Rodney

2010-01-01

Introduction: The purpose of the study was to adduce evidence for estimating the construct validity of clinical competence measured through assessment instruments used for high-stakes examinations. Methods: Thirty-nine international physicians (mean age = 41 + 6.5 y) participated in high-stakes examination and 3-month supervised clinical practice…

Fluorometric biosniffer (biochemical gas sensor) for breath acetone as a volatile indicator of lipid metabolism

NASA Astrophysics Data System (ADS)

Mitsubayashi, Kohji; Chien, Po-Jen; Ye, Ming; Suzuki, Takuma; Toma, Koji; Arakawa, Takahiro

2016-11-01

A fluorometric acetone biosniffer (biochemical gas sensor) for assessment of lipid metabolism utilizing reverse reaction of secondary alcohol dehydrogenase was constructed and evaluated. The biosniffer showed highly sensitivity and selectivity for continuous monitoring of gaseous acetone. The measurement of breath acetone concentration during fasting and aerobic exercise were also investigated. The acetone biosniffer provides a novel analytical tool for noninvasive evaluation of human lipid metabolism and it is also expected to use for the clinical and physiological applications such as monitoring the progression of diabetes.

Directional interstitial brachytherapy from simulation to application

NASA Astrophysics Data System (ADS)

Lin, Liyong

Organs at risk (OAR) are sometimes adjacent to or embedded in or overlap with the clinical target volume (CTV) to be treated. The purpose of this PhD study is to develop directionally low energy gamma-emitting interstitial brachytherapy sources. These sources can be applied between OAR to selectively reduce hot spots in the OARs and normal tissues. The reduction of dose over undesired regions can expand patient eligibility or reduce toxicities for the treatment by conventional interstitial brachytherapy. This study covers the development of a directional source from design optimization to construction of the first prototype source. The Monte Carlo code MCNP was used to simulate the radiation transport for the designs of directional sources. We have made a special construction kit to assemble radioactive and gold-shield components precisely into D-shaped titanium containers of the first directional source. Directional sources have a similar dose distribution as conventional sources on the treated side but greatly reduced dose on the shielded side, with a sharp dose gradient between them. A three-dimensional dose deposition kernel for the 125I directional source has been calculated. Treatment plans can use both directional and conventional 125I sources at the same source strength for low-dose-rate (LDR) implants to optimize the dose distributions. For prostate tumors, directional 125I LDR brachytherapy can potentially reduce genitourinary and gastrointestinal toxicities and improve potency preservation for low risk patients. The combination of better dose distribution of directional implants and better therapeutic ratio between tumor response and late reactions enables a novel temporary LDR treatment, as opposed to permanent or high-dose-rate (HDR) brachytherapy for the intermediate risk T2b and high risk T2c tumors. Supplemental external-beam treatments can be shortened with a better brachytherapy boost for T3 tumors. In conclusion, we have successfully finished the design optimization and construction of the first prototype directional source. Potential clinical applications and potential benefits of directional sources have been shown for prostate and breast tumors.

Directly auto-transplanted mesenchymal stem cells induce bone formation in a ceramic bone substitute in an ectopic sheep model

PubMed Central

Boos, Anja M; Loew, Johanna S; Deschler, Gloria; Arkudas, Andreas; Bleiziffer, Oliver; Gulle, Heinz; Dragu, Adrian; Kneser, Ulrich; Horch, Raymund E; Beier, Justus P

2011-01-01

Abstract Bone tissue engineering approaches increasingly focus on the use of mesenchymal stem cells (MSC). In most animal transplantation models MSC are isolated and expanded before auto cell transplantation which might be critical for clinical application in the future. Hence this study compares the potential of directly auto-transplanted versus in vitro expanded MSC with or without bone morphogenetic protein-2 (BMP-2) to induce bone formation in a large volume ceramic bone substitute in the sheep model. MSC were isolated from bone marrow aspirates and directly auto-transplanted or expanded in vitro and characterized using fluorescence activated cell sorting (FACS) and RT-PCR analysis before subcutaneous implantation in combination with BMP-2 and β-tricalcium phosphate/hydroxyapatite (β-TCP/HA) granules. Constructs were explanted after 1 to 12 weeks followed by histological and RT-PCR evaluation. Sheep MSC were CD29+, CD44+ and CD166+ after selection by Ficoll gradient centrifugation, while directly auto-transplanted MSC-populations expressed CD29 and CD166 at lower levels. Both, directly auto-transplanted and expanded MSC, were constantly proliferating and had a decreasing apoptosis over time in vivo. Directly auto-transplanted MSC led to de novo bone formation in a heterotopic sheep model using a β-TCP/HA matrix comparable to the application of 60 μg/ml BMP-2 only or implantation of expanded MSC. Bone matrix proteins were up-regulated in constructs following direct auto-transplantation and in expanded MSC as well as in BMP-2 constructs. Up-regulation was detected using immunohistology methods and RT-PCR. Dense vascularization was demonstrated by CD31 immunohistology staining in all three groups. Ectopic bone could be generated using directly auto-transplanted or expanded MSC with β-TCP/HA granules alone. Hence BMP-2 stimulation might become dispensable in the future, thus providing an attractive, clinically feasible approach to bone tissue engineering. PMID:20636333

10 CFR 2.401 - Notice of hearing on construction permit or combined license applications pursuant to appendix N...

Code of Federal Regulations, 2010 CFR

2010-01-01

... pursuant to appendix N of part 50 of this chapter for construction permits for nuclear power reactors of... Procedures Applicable to Proceedings for the Issuance of Licenses To Construct and/or Operate Nuclear Power... license applications pursuant to appendix N of 10 CFR parts 50 or 52. 2.401 Section 2.401 Energy NUCLEAR...

Clinical social networking--a new revolution in provider communication and delivery of clinical information across providers of care?

PubMed

Kolowitz, Brian J; Lauro, Gonzalo Romero; Venturella, James; Georgiev, Veliyan; Barone, Michael; Deible, Christopher; Shrestha, Rasu

2014-04-01

The adoption of social media technologies appears to enhance clinical outcomes through improved communications as reported by Bacigalupe (Fam Syst Heal 29(1):1-14, 2011). The ability of providers to more effectively, directly, and rapidly communicate among themselves as well as with patients should strengthen collaboration and treatment as reported by Bacigalupe (Fam Syst Heal 29(1):1-14, 2011). This paper is a case study in one organization's development of an internally designed and developed social technology solution termed "Unite." The Unite system combines social technologies' features including push notifications, messaging, community groups, and user lists with clinical workflow and applications to construct dynamic provider networks, simplify communications, and facilitate clinical workflow optimization. Modeling Unite as a social technology may ease adoption barriers. Developing a social network that is integrated with healthcare information systems in the clinical space opens the doors to capturing and studying the way in which providers communicate. The Unite system appears to have the potential to breaking down existing communication paradigms. With Unite, a rich set of usage data tied to clinical events may unravel alternative networks that can be leveraged to advance patient care.

Shifting attention from objective risk factors to patients' self-assessed health resources: a clinical model for general practice.

PubMed

Hollnagel, H; Malterud, K

1995-12-01

The study was designed to present and apply theoretical and empirical knowledge for the construction of a clinical model intended to shift the attention of the general practitioner from objective risk factors to self-assessed health resources in male and female patients. Review, discussion and analysis of selected theoretical models about personal health resources involving assessing existing theories according to their emphasis concerning self-assessed vs. doctor-assessed health resources, specific health resources vs. life and coping in general, abstract vs. clinically applicable theory, gender perspective explicitly included or not. Relevant theoretical models on health and coping (salutogenesis, coping and social support, control/demand, locus of control, health belief model, quality of life), and the perspective of the underprivileged Other (critical theory, feminist standpoint theory, the patient-centred clinical method) were presented and assessed. Components from Antonovsky's salutogenetic perspective and McWhinney's patient-centred clinical method, supported by gender perspectives, were integrated to a clinical model which is presented. General practitioners are recommended to shift their attention from objective risk factors to self-assessed health resources by means of the clinical model. The relevance and feasibility of the model should be explored in empirical research.

26 CFR 2.1-4 - Application to establish fund.

Code of Federal Regulations, 2011 CFR

2011-04-01

... (CONTINUED) MARITIME CONSTRUCTION RESERVE FUND § 2.1-4 Application to establish fund. Any person claiming to... Administration for permission to establish a construction reserve fund. The application shall be in such form and...

26 CFR 2.1-4 - Application to establish fund.

Code of Federal Regulations, 2012 CFR

2012-04-01

... (CONTINUED) MARITIME CONSTRUCTION RESERVE FUND § 2.1-4 Application to establish fund. Any person claiming to... Administration for permission to establish a construction reserve fund. The application shall be in such form and...

26 CFR 2.1-4 - Application to establish fund.

Code of Federal Regulations, 2013 CFR

2013-04-01

... (CONTINUED) MARITIME CONSTRUCTION RESERVE FUND § 2.1-4 Application to establish fund. Any person claiming to... Administration for permission to establish a construction reserve fund. The application shall be in such form and...

26 CFR 2.1-4 - Application to establish fund.

Code of Federal Regulations, 2014 CFR

2014-04-01

... (CONTINUED) MARITIME CONSTRUCTION RESERVE FUND § 2.1-4 Application to establish fund. Any person claiming to... Administration for permission to establish a construction reserve fund. The application shall be in such form and...

26 CFR 2.1-4 - Application to establish fund.

Code of Federal Regulations, 2010 CFR

2010-04-01

... (CONTINUED) MARITIME CONSTRUCTION RESERVE FUND § 2.1-4 Application to establish fund. Any person claiming to... Administration for permission to establish a construction reserve fund. The application shall be in such form and...

A Philosophical Perspective on Construct Validation: Application of Inductive Logic to the Analysis of Experimental Episode Construct Validity.

ERIC Educational Resources Information Center

Rossi, Robert Joseph

Methods drawn from four logical theories associated with studies of inductive processes are applied to the assessment and evaluation of experimental episode construct validity. It is shown that this application provides for estimates of episode informativeness with respect to the person examined in terms of the construct and to the construct…

Towards computerizing intensive care sedation guidelines: design of a rule-based architecture for automated execution of clinical guidelines

PubMed Central

2010-01-01

Background Computerized ICUs rely on software services to convey the medical condition of their patients as well as assisting the staff in taking treatment decisions. Such services are useful for following clinical guidelines quickly and accurately. However, the development of services is often time-consuming and error-prone. Consequently, many care-related activities are still conducted based on manually constructed guidelines. These are often ambiguous, which leads to unnecessary variations in treatments and costs. The goal of this paper is to present a semi-automatic verification and translation framework capable of turning manually constructed diagrams into ready-to-use programs. This framework combines the strengths of the manual and service-oriented approaches while decreasing their disadvantages. The aim is to close the gap in communication between the IT and the medical domain. This leads to a less time-consuming and error-prone development phase and a shorter clinical evaluation phase. Methods A framework is proposed that semi-automatically translates a clinical guideline, expressed as an XML-based flow chart, into a Drools Rule Flow by employing semantic technologies such as ontologies and SWRL. An overview of the architecture is given and all the technology choices are thoroughly motivated. Finally, it is shown how this framework can be integrated into a service-oriented architecture (SOA). Results The applicability of the Drools Rule language to express clinical guidelines is evaluated by translating an example guideline, namely the sedation protocol used for the anaesthetization of patients, to a Drools Rule Flow and executing and deploying this Rule-based application as a part of a SOA. The results show that the performance of Drools is comparable to other technologies such as Web Services and increases with the number of decision nodes present in the Rule Flow. Most delays are introduced by loading the Rule Flows. Conclusions The framework is an effective solution for computerizing clinical guidelines as it allows for quick development, evaluation and human-readable visualization of the Rules and has a good performance. By monitoring the parameters of the patient to automatically detect exceptional situations and problems and by notifying the medical staff of tasks that need to be performed, the computerized sedation guideline improves the execution of the guideline. PMID:20082700

Towards computerizing intensive care sedation guidelines: design of a rule-based architecture for automated execution of clinical guidelines.

PubMed

Ongenae, Femke; De Backere, Femke; Steurbaut, Kristof; Colpaert, Kirsten; Kerckhove, Wannes; Decruyenaere, Johan; De Turck, Filip

2010-01-18

Computerized ICUs rely on software services to convey the medical condition of their patients as well as assisting the staff in taking treatment decisions. Such services are useful for following clinical guidelines quickly and accurately. However, the development of services is often time-consuming and error-prone. Consequently, many care-related activities are still conducted based on manually constructed guidelines. These are often ambiguous, which leads to unnecessary variations in treatments and costs.The goal of this paper is to present a semi-automatic verification and translation framework capable of turning manually constructed diagrams into ready-to-use programs. This framework combines the strengths of the manual and service-oriented approaches while decreasing their disadvantages. The aim is to close the gap in communication between the IT and the medical domain. This leads to a less time-consuming and error-prone development phase and a shorter clinical evaluation phase. A framework is proposed that semi-automatically translates a clinical guideline, expressed as an XML-based flow chart, into a Drools Rule Flow by employing semantic technologies such as ontologies and SWRL. An overview of the architecture is given and all the technology choices are thoroughly motivated. Finally, it is shown how this framework can be integrated into a service-oriented architecture (SOA). The applicability of the Drools Rule language to express clinical guidelines is evaluated by translating an example guideline, namely the sedation protocol used for the anaesthetization of patients, to a Drools Rule Flow and executing and deploying this Rule-based application as a part of a SOA. The results show that the performance of Drools is comparable to other technologies such as Web Services and increases with the number of decision nodes present in the Rule Flow. Most delays are introduced by loading the Rule Flows. The framework is an effective solution for computerizing clinical guidelines as it allows for quick development, evaluation and human-readable visualization of the Rules and has a good performance. By monitoring the parameters of the patient to automatically detect exceptional situations and problems and by notifying the medical staff of tasks that need to be performed, the computerized sedation guideline improves the execution of the guideline.

Biological augmentation and tissue engineering approaches in meniscus surgery.

PubMed

Moran, Cathal J; Busilacchi, Alberto; Lee, Cassandra A; Athanasiou, Kyriacos A; Verdonk, Peter C

2015-05-01

The purpose of this review was to evaluate the role of biological augmentation and tissue engineering strategies in meniscus surgery. Although clinical (human), preclinical (animal), and in vitro tissue engineering studies are included here, we have placed additional focus on addressing preclinical and clinical studies reported during the 5-year period used in this review in a systematic fashion while also providing a summary review of some important in vitro tissue engineering findings in the field over the past decade. A search was performed on PubMed for original works published from 2009 to March 31, 2014 using the term "meniscus" with all the following terms: "scaffolds," "constructs," "cells," "growth factors," "implant," "tissue engineering," and "regenerative medicine." Inclusion criteria were the following: English-language articles and original clinical, preclinical (in vivo), and in vitro studies of tissue engineering and regenerative medicine application in knee meniscus lesions published from 2009 to March 31, 2014. Three clinical studies and 18 preclinical studies were identified along with 68 tissue engineering in vitro studies. These reports show the increasing promise of biological augmentation and tissue engineering strategies in meniscus surgery. The role of stem cell and growth factor therapy appears to be particularly useful. A review of in vitro tissue engineering studies found a large number of scaffold types to be of promise for meniscus replacement. Limitations include a relatively low number of clinical or preclinical in vivo studies, in addition to the fact there is as yet no report in the literature of a tissue-engineered meniscus construct used clinically. Neither does the literature provide clarity on the optimal meniscus scaffold type or biological augmentation with which meniscus repair or replacement would be best addressed in the future. There is increasing focus on the role of mechanobiology and biomechanical and biochemical cues in this process, however, and it is hoped that this may lead to improvements in this strategy. There appears to be significant potential for biological augmentation and tissue engineering strategies in meniscus surgery to enhance options for repair and replacement. However, there are still relatively few clinical studies being reported in this regard. There is a strong need for improved translational activities and infrastructure to link the large amounts of in vitro and preclinical biological and tissue engineering data to clinical application. Level IV, systematic review of Level I-IV studies. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Nanotechnology in Urology

PubMed Central

Jayasimha, Sudhindra

2017-01-01

Introduction: Nanotechnology has revolutionized our approach to medical diagnostics as well as therapeutics and has spanned an entirely new branch of research. This review addresses the potential applications of Nanotechnology in Urology. This article is based on the Dr. Sitharaman Best Essay award of the Urological Society of India for 2016. Methods: A PubMed search was performed for all relevant articles using the terms, “nanotechnology, nanoparticles, nanoshells, nanoscaffolds, and nanofibers.” Results: The developments in diagnostics include novel techniques of imaging of genitourinary malignancies, prostate-specific antigen measurement, early detection of mutations that are diagnostic for polycystic kidney disease. The potential applications of nanotechnology are in the targeted therapy of genitourinary malignancies, erectile dysfunction, overactive bladder, bladder reconstruction, construction of artificial kidneys and biodegradable stents as well as in robotic surgery. Conclusions: Nanotechnology is a rapidly emerging branch of research in urology with diverse and clinically significant applications in diagnostics as well as therapeutics. PMID:28197024

Tissue engineering and regenerative medicine: concepts for clinical application.

PubMed

Atala, Anthony

2004-01-01

Patients suffering from diseased and injured organs may be treated with transplanted organs. However, there is a severe shortage of donor organs that is worsening yearly given the aging population. Scientists in the field of regenerative medicine and tissue engineering apply the principles of cell transplantation, material science, and bioengineering to construct biological substitutes that will restore and maintain normal function in diseased and injured tissues. Therapeutic cloning, where the nucleus from a donor cell is transferred into an enucleated oocyte in order to extract pluripotent embryonic stem cells, offers a potentially limitless source of cells for tissue engineering applications. The stem cell field is also advancing rapidly, opening new options for therapy. This paper reviews recent advances that have occurred in regenerative medicine and describes applications of these new technologies that may offer novel therapies for patients with end-stage organ failure.

Infrared Imaging Tools for Diagnostic Applications in Dermatology.

PubMed

Gurjarpadhye, Abhijit Achyut; Parekh, Mansi Bharat; Dubnika, Arita; Rajadas, Jayakumar; Inayathullah, Mohammed

Infrared (IR) imaging is a collection of non-invasive imaging techniques that utilize the IR domain of the electromagnetic spectrum for tissue assessment. A subset of these techniques construct images using back-reflected light, while other techniques rely on detection of IR radiation emitted by the tissue as a result of its temperature. Modern IR detectors sense thermal emissions and produce a heat map of surface temperature distribution in tissues. Thus, the IR spectrum offers a variety of imaging applications particularly useful in clinical diagnostic area, ranging from high-resolution, depth-resolved visualization of tissue to temperature variation assessment. These techniques have been helpful in the diagnosis of many medical conditions including skin/breast cancer, arthritis, allergy, burns, and others. In this review, we discuss current roles of IR-imaging techniques for diagnostic applications in dermatology with an emphasis on skin cancer, allergies, blisters, burns and wounds.

Validation of the Narrowing Beam Walking Test in Lower Limb Prosthesis Users.

PubMed

Sawers, Andrew; Hafner, Brian

2018-04-11

To evaluate the content, construct, and discriminant validity of the Narrowing Beam Walking Test (NBWT), a performance-based balance test for lower limb prosthesis users. Cross-sectional study. Research laboratory and prosthetics clinic. Unilateral transtibial and transfemoral prosthesis users (N=40). Not applicable. Content validity was examined by quantifying the percentage of participants receiving maximum or minimum scores (ie, ceiling and floor effects). Convergent construct validity was examined using correlations between participants' NBWT scores and scores or times on existing clinical balance tests regularly administered to lower limb prosthesis users. Known-groups construct validity was examined by comparing NBWT scores between groups of participants with different fall histories, amputation levels, amputation etiologies, and functional levels. Discriminant validity was evaluated by analyzing the area under each test's receiver operating characteristic (ROC) curve. No minimum or maximum scores were recorded on the NBWT. NBWT scores demonstrated strong correlations (ρ=.70‒.85) with scores/times on performance-based balance tests (timed Up and Go test, Four Square Step Test, and Berg Balance Scale) and a moderate correlation (ρ=.49) with the self-report Activities-specific Balance Confidence scale. NBWT performance was significantly lower among participants with a history of falls (P=.003), transfemoral amputation (P=.011), and a lower mobility level (P<.001). The NBWT also had the largest area under the ROC curve (.81) and was the only test to exhibit an area that was statistically significantly >.50 (ie, chance). The results provide strong evidence of content, construct, and discriminant validity for the NBWT as a performance-based test of balance ability. The evidence supports its use to assess balance impairments and fall risk in unilateral transtibial and transfemoral prosthesis users. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

47 CFR 73.3533 - Application for construction permit or modification of construction permit.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Changes in a Low Power TV, TV Translator or TV Booster Station.” (6) FCC Form 349, “Application for Authority to Construct or Make Changes in an FM Translator or FM Booster Station.” (7) FCC Form 318...

47 CFR 73.3533 - Application for construction permit or modification of construction permit.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Changes in a Low Power TV, TV Translator or TV Booster Station.” (6) FCC Form 349, “Application for Authority to Construct or Make Changes in an FM Translator or FM Booster Station.” (7) FCC Form 318...

47 CFR 73.3533 - Application for construction permit or modification of construction permit.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Changes in a Low Power TV, TV Translator or TV Booster Station.” (6) FCC Form 349, “Application for Authority to Construct or Make Changes in an FM Translator or FM Booster Station.” (7) FCC Form 318...

15 CFR 270.1 - Description of rule; purpose; applicability.

Code of Federal Regulations, 2013 CFR

2013-01-01

... NATIONAL INSTITUTE OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE NATIONAL CONSTRUCTION SAFETY TEAMS NATIONAL CONSTRUCTION SAFETY TEAMS General § 270.1 Description of rule; purpose; applicability. (a) The National Construction Safety Team Act (the Act) (Pub. L. 107-231) provides for the establishment of...

15 CFR 270.1 - Description of rule; purpose; applicability.

Code of Federal Regulations, 2012 CFR

2012-01-01

... NATIONAL INSTITUTE OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE NATIONAL CONSTRUCTION SAFETY TEAMS NATIONAL CONSTRUCTION SAFETY TEAMS General § 270.1 Description of rule; purpose; applicability. (a) The National Construction Safety Team Act (the Act) (Pub. L. 107-231) provides for the establishment of...

15 CFR 270.1 - Description of rule; purpose; applicability.

Code of Federal Regulations, 2014 CFR

2014-01-01

... NATIONAL INSTITUTE OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE NATIONAL CONSTRUCTION SAFETY TEAMS NATIONAL CONSTRUCTION SAFETY TEAMS General § 270.1 Description of rule; purpose; applicability. (a) The National Construction Safety Team Act (the Act) (Pub. L. 107-231) provides for the establishment of...

15 CFR 270.1 - Description of rule; purpose; applicability.

Code of Federal Regulations, 2010 CFR

2010-01-01

... NATIONAL INSTITUTE OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE NATIONAL CONSTRUCTION SAFETY TEAMS NATIONAL CONSTRUCTION SAFETY TEAMS General § 270.1 Description of rule; purpose; applicability. (a) The National Construction Safety Team Act (the Act) (Pub. L. 107-231) provides for the establishment of...

15 CFR 270.1 - Description of rule; purpose; applicability.

Code of Federal Regulations, 2011 CFR

2011-01-01

... NATIONAL INSTITUTE OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE NATIONAL CONSTRUCTION SAFETY TEAMS NATIONAL CONSTRUCTION SAFETY TEAMS General § 270.1 Description of rule; purpose; applicability. (a) The National Construction Safety Team Act (the Act) (Pub. L. 107-231) provides for the establishment of...

Organization and integration of biomedical knowledge with concept maps for key peroxisomal pathways.

PubMed

Willemsen, A M; Jansen, G A; Komen, J C; van Hooff, S; Waterham, H R; Brites, P M T; Wanders, R J A; van Kampen, A H C

2008-08-15

One important area of clinical genomics research involves the elucidation of molecular mechanisms underlying (complex) disorders which eventually may lead to new diagnostic or drug targets. To further advance this area of clinical genomics one of the main challenges is the acquisition and integration of data, information and expert knowledge for specific biomedical domains and diseases. Currently the required information is not very well organized but scattered over biological and biomedical databases, basic text books, scientific literature and experts' minds and may be highly specific, heterogeneous, complex and voluminous. We present a new framework to construct knowledge bases with concept maps for presentation of information and the web ontology language OWL for the representation of information. We demonstrate this framework through the construction of a peroxisomal knowledge base, which focuses on four key peroxisomal pathways and several related genetic disorders. All 155 concept maps in our knowledge base are linked to at least one other concept map, which allows the visualization of one big network of related pieces of information. The peroxisome knowledge base is available from www.bioinformaticslaboratory.nl (Support-->Web applications). Supplementary data is available from www.bioinformaticslaboratory.nl (Research-->Output--> Publications--> KB_SuppInfo)

Genetic-based prediction of disease traits: prediction is very difficult, especially about the future†

PubMed Central

Schrodi, Steven J.; Mukherjee, Shubhabrata; Shan, Ying; Tromp, Gerard; Sninsky, John J.; Callear, Amy P.; Carter, Tonia C.; Ye, Zhan; Haines, Jonathan L.; Brilliant, Murray H.; Crane, Paul K.; Smelser, Diane T.; Elston, Robert C.; Weeks, Daniel E.

2014-01-01

Translation of results from genetic findings to inform medical practice is a highly anticipated goal of human genetics. The aim of this paper is to review and discuss the role of genetics in medically-relevant prediction. Germline genetics presages disease onset and therefore can contribute prognostic signals that augment laboratory tests and clinical features. As such, the impact of genetic-based predictive models on clinical decisions and therapy choice could be profound. However, given that (i) medical traits result from a complex interplay between genetic and environmental factors, (ii) the underlying genetic architectures for susceptibility to common diseases are not well-understood, and (iii) replicable susceptibility alleles, in combination, account for only a moderate amount of disease heritability, there are substantial challenges to constructing and implementing genetic risk prediction models with high utility. In spite of these challenges, concerted progress has continued in this area with an ongoing accumulation of studies that identify disease predisposing genotypes. Several statistical approaches with the aim of predicting disease have been published. Here we summarize the current state of disease susceptibility mapping and pharmacogenetics efforts for risk prediction, describe methods used to construct and evaluate genetic-based predictive models, and discuss applications. PMID:24917882

Scaffolds for peripheral nerve repair and reconstruction.

PubMed

Yi, Sheng; Xu, Lai; Gu, Xiaosong

2018-06-02

Trauma-associated peripheral nerve defect is a widespread clinical problem. Autologous nerve grafting, the current gold standard technique for the treatment of peripheral nerve injury, has many internal disadvantages. Emerging studies showed that tissue engineered nerve graft is an effective substitute to autologous nerves. Tissue engineered nerve graft is generally composed of neural scaffolds and incorporating cells and molecules. A variety of biomaterials have been used to construct neural scaffolds, the main component of tissue engineered nerve graft. Synthetic polymers (e.g. silicone, polyglycolic acid, and poly(lactic-co-glycolic acid)) and natural materials (e.g. chitosan, silk fibroin, and extracellular matrix components) are commonly used along or together to build neural scaffolds. Many other materials, including the extracellular matrix, glass fabrics, ceramics, and metallic materials, have also been used to construct neural scaffolds. These biomaterials are fabricated to create specific structures and surface features. Seeding supporting cells and/or incorporating neurotrophic factors to neural scaffolds further improve restoration effects. Preliminary studies demonstrate that clinical applications of these neural scaffolds achieve satisfactory functional recovery. Therefore, tissue engineered nerve graft provides a good alternative to autologous nerve graft and represents a promising frontier in neural tissue engineering. Copyright © 2018 Elsevier Inc. All rights reserved.

The Imaging and Medical Beam Line at the Australian Synchrotron

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

Hausermann, Daniel; Hall, Chris; Maksimenko, Anton

2010-07-23

As a result of the enthusiastic support from the Australian biomedical, medical and clinical communities, the Australian Synchrotron is constructing a world-class facility for medical research, the 'Imaging and Medical Beamline'. The IMBL began phased commissioning in late 2008 and is scheduled to commence the first clinical research programs with patients in 2011. It will provide unrivalled x-ray facilities for imaging and radiotherapy for a wide range of research applications in diseases, treatments and understanding of physiological processes. The main clinical research drivers are currently high resolution and sensitivity cardiac and breast imaging, cell tracking applied to regenerative and stemmore » cell medicine and cancer therapies. The beam line has a maximum source to sample distance of 136 m and will deliver a 60 cm by 4 cm x-ray beam1 - monochromatic and white - to a three storey satellite building fully equipped for pre-clinical and clinical research. Currently operating with a 1.4 Tesla multi-pole wiggler, it will upgrade to a 4.2 Tesla device which requires the ability to handle up to 21 kW of x-ray power at any point along the beam line. The applications envisaged for this facility include imaging thick objects encompassing materials, humans and animals. Imaging can be performed in the range 15-150 keV. Radiotherapy research typically requires energies between 30 and 120 keV, for both monochromatic and broad beam.« less

47 CFR 22.143 - Construction prior to grant of application.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES PUBLIC MOBILE SERVICES Licensing Requirements and Procedures Applications and Notifications § 22... Mobile services prior to grant of their applications, subject to the provisions of this section, but must... 47 Telecommunication 2 2010-10-01 2010-10-01 false Construction prior to grant of application. 22...

7 CFR 1783.7 - What is the grant application process?

Code of Federal Regulations, 2012 CFR

2012-01-01

...) Application for Federal Assistance: Standard Form 424; (2) Budget Information—Non-Construction Programs: Standard Form 424A; (3) Assurances—Non-Construction Programs: Standard Form 424B; (4) Evidence of applicant... of this part. (c) The applicant should submit a narrative establishing the basis for any claims that...

7 CFR 1783.7 - What is the grant application process?

Code of Federal Regulations, 2013 CFR

2013-01-01

...) Application for Federal Assistance: Standard Form 424; (2) Budget Information—Non-Construction Programs: Standard Form 424A; (3) Assurances—Non-Construction Programs: Standard Form 424B; (4) Evidence of applicant... of this part. (c) The applicant should submit a narrative establishing the basis for any claims that...

7 CFR 1783.7 - What is the grant application process?

Code of Federal Regulations, 2010 CFR

2010-01-01

...) Application for Federal Assistance: Standard Form 424; (2) Budget Information—Non-Construction Programs: Standard Form 424A; (3) Assurances—Non-Construction Programs: Standard Form 424B; (4) Evidence of applicant... of this part. (c) The applicant should submit a narrative establishing the basis for any claims that...

In vivo assessment of a new multifunctional coating architecture for improved Mg alloy biocompatibility.

PubMed

Gomes, Pedro S; Zomorodian, Amir; Kwiatkowski, Lech; Lutze, Rafal; Balkowiec, Alicja; Colaço, Bruno; Pinheiro, Vitor; Fernandes, João C S; Montemor, Maria F; Fernandes, Maria H

2016-08-10

Magnesium alloys are regarded as potential biodegradable load-bearing biomaterials for orthopedic applications due to their physico-chemical and biomechanical properties. However, their clinical applicability is restricted by their high degradation rate, which limits the physiological reconstruction of the neighbouring tissues. In this work, a multifunctional coating architecture was developed on an AZ31 alloy by conjoining an anodization process with the deposition of a polymeric-based layer consisting of polyether imine reinforced with hydroxyapatite nanoparticles, aiming at improved control of the corrosion activity and biological performance of the Mg substrate. Anodization and coating protocols were evaluated either independently or combined for corrosion resistance and biological behaviour, i.e. the irritation potential and angiogenic capability within a chicken chorioallantoic membrane assay, and bone tissue response following tibia implantation within a rabbit model. Electrochemical impedance spectroscopy (EIS) analysis showed that coated Mg constructs, particularly anodized plus coated with AZ31, exhibited excellent stability compared to the anodized alloy and, particularly, to the bare AZ31. Microtomographic evaluation of the implanted samples correlated with these degradation results. Mg constructs displayed a non-irritating behaviour, and were associated with high levels of vascular ingrowth. Bone ingrowth neighbouring the implanted constructs was observed for all samples, with coated and anodized plus coated samples presenting the highest bone formation. Gene expression analysis suggested that the enhanced bone tissue formation was associated with the boost in osteogenic activity through Runx2 upregulation, following the activation of PGC-1α/ERRα signaling. Overall, the developed multifunctional coatings appear to be a promising strategy to obtain safe and bioactive biodegradable Mg-based implants with potential applications within bone tissue.

Content Analysis of the Construction of Self and Others in Women with Bulimia Nervosa

PubMed Central

Dada, Gloria; Izu, Sheila; Montebruno, Claudia; Grau, Antoni; Feixas, Guillem

2017-01-01

The purpose of this study was to explore the content of personal constructs in people diagnosed with bulimia nervosa (BN). We expected to find differences in the predominant content of the construct systems between women with and without BN. We analyzed the constructs elicited using the repertory grid technique from 120 women aged between 18 to 45 years, divided into two groups: a clinical group of women diagnosed with bulimia (n = 62) and a control group of university students (n = 58). The constructs were categorized using the Classification System for Personal Constructs (CSPC), composed of six themes which are broken down into 45 categories. For this study, a new area called “Physical” was included, and it consists of three categories. The results indicated that women diagnosed with bulimia used significantly more constructs related to the body, while the control group used more constructs from the personal area. In addition, the congruent constructs from the clinical sample were predominantly moral, or related to values and interests, while discrepant constructs were personal and physical. The findings provide evidence for the clinical use of the CSPC as an instrument for exploring the content of personal meaning systems. Understanding the patient’s personal constructions about herself and others is useful for treatment. Moreover, it is important for clinicians to explore the content of constructs related to symptomatic areas, which could be hindering change, and focus on them to facilitate improvement. PMID:28428765

Content Analysis of the Construction of Self and Others in Women with Bulimia Nervosa.

PubMed

Dada, Gloria; Izu, Sheila; Montebruno, Claudia; Grau, Antoni; Feixas, Guillem

2017-01-01

The purpose of this study was to explore the content of personal constructs in people diagnosed with bulimia nervosa (BN). We expected to find differences in the predominant content of the construct systems between women with and without BN. We analyzed the constructs elicited using the repertory grid technique from 120 women aged between 18 to 45 years, divided into two groups: a clinical group of women diagnosed with bulimia ( n = 62) and a control group of university students ( n = 58). The constructs were categorized using the Classification System for Personal Constructs (CSPC), composed of six themes which are broken down into 45 categories. For this study, a new area called "Physical" was included, and it consists of three categories. The results indicated that women diagnosed with bulimia used significantly more constructs related to the body, while the control group used more constructs from the personal area. In addition, the congruent constructs from the clinical sample were predominantly moral, or related to values and interests, while discrepant constructs were personal and physical. The findings provide evidence for the clinical use of the CSPC as an instrument for exploring the content of personal meaning systems. Understanding the patient's personal constructions about herself and others is useful for treatment. Moreover, it is important for clinicians to explore the content of constructs related to symptomatic areas, which could be hindering change, and focus on them to facilitate improvement.

14 CFR 33.31 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-01-01

... STANDARDS: AIRCRAFT ENGINES Design and Construction; Reciprocating Aircraft Engines § 33.31 Applicability. This subpart prescribes additional design and construction requirements for reciprocating aircraft engines. ...

14 CFR 33.31 - Applicability.

Code of Federal Regulations, 2011 CFR

2011-01-01

... STANDARDS: AIRCRAFT ENGINES Design and Construction; Reciprocating Aircraft Engines § 33.31 Applicability. This subpart prescribes additional design and construction requirements for reciprocating aircraft engines. ...

14 CFR 33.61 - Applicability.

Code of Federal Regulations, 2013 CFR

2013-01-01

... STANDARDS: AIRCRAFT ENGINES Design and Construction; Turbine Aircraft Engines § 33.61 Applicability. This subpart prescribes additional design and construction requirements for turbine aircraft engines. ...

14 CFR 33.61 - Applicability.

Code of Federal Regulations, 2012 CFR

2012-01-01

... STANDARDS: AIRCRAFT ENGINES Design and Construction; Turbine Aircraft Engines § 33.61 Applicability. This subpart prescribes additional design and construction requirements for turbine aircraft engines. ...

14 CFR 33.61 - Applicability.

Code of Federal Regulations, 2014 CFR

2014-01-01

... STANDARDS: AIRCRAFT ENGINES Design and Construction; Turbine Aircraft Engines § 33.61 Applicability. This subpart prescribes additional design and construction requirements for turbine aircraft engines. ...

23 CFR 625.3 - Application.

Code of Federal Regulations, 2010 CFR

2010-04-01

... HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS DESIGN STANDARDS FOR HIGHWAYS § 625.3 Application. (a) Applicable Standards. (1) Design and construction standards for...) Federal-aid projects not on the NHS are to be designed, constructed, operated, and maintained in...

23 CFR 625.3 - Application.

Code of Federal Regulations, 2012 CFR

2012-04-01

... HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS DESIGN STANDARDS FOR HIGHWAYS § 625.3 Application. (a) Applicable Standards. (1) Design and construction standards for...) Federal-aid projects not on the NHS are to be designed, constructed, operated, and maintained in...

23 CFR 625.3 - Application.

Code of Federal Regulations, 2013 CFR

2013-04-01

... HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS DESIGN STANDARDS FOR HIGHWAYS § 625.3 Application. (a) Applicable Standards. (1) Design and construction standards for...) Federal-aid projects not on the NHS are to be designed, constructed, operated, and maintained in...

23 CFR 625.3 - Application.

Code of Federal Regulations, 2014 CFR

2014-04-01

... HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS DESIGN STANDARDS FOR HIGHWAYS § 625.3 Application. (a) Applicable Standards. (1) Design and construction standards for...) Federal-aid projects not on the NHS are to be designed, constructed, operated, and maintained in...

47 CFR 90.169 - Construction prior to grant of application.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 5 2010-10-01 2010-10-01 false Construction prior to grant of application. 90.169 Section 90.169 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL... Governing Facilities Used to Provide Commercial Mobile Radio Services § 90.169 Construction prior to grant...

24 CFR 200.1520 - Termination of MAP privileges.

Code of Federal Regulations, 2011 CFR

2011-04-01

...-application, the firm application, the mortgage insurance commitment, or the insured construction loan back to... construction or substantial rehabilitation must be immediately transferred to a new MAP lender. At no time can the new MAP lender assign the firm mortgage insurance commitment, or the insured construction loan...

Effects of nanoencapsulation and PEGylation on biodistribution of indocyanine green in healthy mice: quantitative fluorescence imaging and analysis of organs

PubMed Central

Bahmani, Baharak; Lytle, Christian Y; Walker, Ameae M; Gupta, Sharad; Vullev, Valentine I; Anvari, Bahman

2013-01-01

Near-infrared nanoconstructs present a potentially effective platform for site-specific and deep tissue optical imaging and phototherapy. We have engineered a polymeric nanocapsule composed of polyallylamine hydrochloride (PAH) chains cross-linked with sodium phosphate and doped with indocyanine green (ICG) toward such endeavors. The ICG-doped nanocapsules were coated covalently with polyethylene glycol (5000 daltons) through reductive amination. We administrated the constructs by tail vein injection to healthy mice. To characterize the biodistribution of the constructs, we performed in vivo quantitative fluorescence imaging and subsequently analyzed the various extracted organs. Our results suggest that encapsulation of ICG in these PEGylated constructs is an effective approach to prolong the circulation time of ICG and delay its hepatic accumulation. Increased bioavailability of ICG, due to encapsulation, offers the potential of extending the clinical applications of ICG, which are currently limited due to rapid elimination of ICG from the vasculature. Our results also indicate that PAH and ICG-doped nanocapsules (ICG-NCs) are not cytotoxic at the levels used in this study. PMID:23637530

[Psychometric properties of the Escala de Autoeficacia para el Afrontamiento del Estrés (EAEAE)].

PubMed

Godoy Izquierdo, Débora; Godoy García, Juan F; López-Chicheri García, Isabel; Martínez Delgado, Antonio; Gutiérrez Jiménez, Susana; Vázquez Vázquez, Luisa

2008-02-01

This paper presents the theoretical construct of and an instrument for its assessment, the Escala de Autoeficacia para el Afrontamiento del Estrés (EAEAE; in English, Coping with Stress Self-Efficacy Scale), as well as the results obtained concerning its psychometric properties from an adult population. 812 individuals, aged 18 to 64 years old ( M = 26.46, SD = 9.93, 62.6% females and 37.4% males), recruited from various contexts, participated in this study. Participants completed the EAEAE along with other measures of constructs theoretically related to this specific self-efficacy. The EAEAE shows appropriate reliability in its complete form as well as in its two subscales of Efficacy Expectations and Outcome Expectations, and adequate factorial construct validity (which reveals the bi-dimensionality of the instrument), and convergent validity with the remaining measures. The characteristics of brevity and ease of application of the scale, in addition to its adequate psychometric properties, indicate that the EAEAE is an appropriate tool to assess and investigate coping with stress self-efficacy in research as well as clinical settings.

Autologous temporomandibular joint reconstruction independent of exogenous additives: a proof-of-concept study for guided self-generation.

PubMed

Wei, Jiao; Herrler, Tanja; Han, Dong; Liu, Kai; Huang, Rulin; Guba, Markus; Dai, Chuanchang; Li, Qingfeng

2016-11-28

Joint defects are complex and difficult to reconstruct. By exploiting the body's own regenerative capacity, we aimed to individually generate anatomically precise neo-tissue constructs for autologous joint reconstruction without using any exogenous additives. In a goat model, CT scans of the mandibular condyle including articular surface and a large portion of the ascending ramus were processed using computer-aided design and manufacturing. A corresponding hydroxylapatite negative mold was printed in 3D and temporarily embedded into the transition zone of costal periosteum and perichondrium. A demineralized bone matrix scaffold implanted on the contralateral side served as control. Neo-tissue constructs obtained by guided self-generation exhibited accurate configuration, robust vascularization, biomechanical stability, and function. After autologous replacement surgery, the constructs showed stable results with similar anatomical, histological, and functional findings compared to native controls. Further studies are required to assess long-term outcome and possible extensions to other further applications. The absence of exogenous cells, growth factors, and scaffolds may facilitate clinical translation of this approach.

Autologous temporomandibular joint reconstruction independent of exogenous additives: a proof-of-concept study for guided self-generation

PubMed Central

Wei, Jiao; Herrler, Tanja; Han, Dong; Liu, Kai; Huang, Rulin; Guba, Markus; Dai, Chuanchang; Li, Qingfeng

2016-01-01

Joint defects are complex and difficult to reconstruct. By exploiting the body’s own regenerative capacity, we aimed to individually generate anatomically precise neo-tissue constructs for autologous joint reconstruction without using any exogenous additives. In a goat model, CT scans of the mandibular condyle including articular surface and a large portion of the ascending ramus were processed using computer-aided design and manufacturing. A corresponding hydroxylapatite negative mold was printed in 3D and temporarily embedded into the transition zone of costal periosteum and perichondrium. A demineralized bone matrix scaffold implanted on the contralateral side served as control. Neo-tissue constructs obtained by guided self-generation exhibited accurate configuration, robust vascularization, biomechanical stability, and function. After autologous replacement surgery, the constructs showed stable results with similar anatomical, histological, and functional findings compared to native controls. Further studies are required to assess long-term outcome and possible extensions to other further applications. The absence of exogenous cells, growth factors, and scaffolds may facilitate clinical translation of this approach. PMID:27892493

Nanoparticles for Radiation Therapy Enhancement: the Key Parameters

PubMed Central

Retif, Paul; Pinel, Sophie; Toussaint, Magali; Frochot, Céline; Chouikrat, Rima; Bastogne, Thierry; Barberi-Heyob, Muriel

2015-01-01

This review focuses on the radiosensitization strategies that use high-Z nanoparticles. It does not establish an exhaustive list of the works in this field but rather propose constructive criticisms pointing out critical factors that could improve the nano-radiation therapy. Whereas most reviews show the chemists and/or biologists points of view, the present analysis is also seen through the prism of the medical physicist. In particular, we described and evaluated the influence of X-rays energy spectra using a numerical analysis. We observed a lack of standardization in preclinical studies that could partially explain the low number of translation to clinical applications for this innovative therapeutic strategy. Pointing out the critical parameters of high-Z nanoparticles radiosensitization, this review is expected to contribute to a larger preclinical and clinical development. PMID:26155318

Degradable Organically-Derivatized Polyoxometalate with Enhanced Activity against Glioblastoma Cell Line

NASA Astrophysics Data System (ADS)

She, Shan; Bian, Shengtai; Huo, Ruichao; Chen, Kun; Huang, Zehuan; Zhang, Jiangwei; Hao, Jian; Wei, Yongge

2016-09-01

High efficacy and low toxicity are critical for cancer treatment. Polyoxometalates (POMs) have been reported as potential candidates for cancer therapy. On accounts of the slow clearance of POMs, leading to long-term toxicity, the clinical application of POMs in cancer treatment is restricted. To address this problem, a degradable organoimido derivative of hexamolybdate is developed by modifying it with a cleavable organic group, leading to its degradation. Of note, this derivative exhibits favourable pharmacodynamics towards human malignant glioma cell (U251), the ability to penetrate across blood brain barrier and low toxicity towards rat pheochromocytoma cell (PC12). This line of research develops an effective POM-based agent for glioblastoma inhibition and will pave a new way to construct degradable anticancer agents for clinical cancer therapy.

Feminist poststructuralism: a methodological paradigm for examining clinical decision-making.

PubMed

Arslanian-Engoren, Cynthia

2002-03-01

To present the philosophical framework of feminist poststructuralism, discuss its use as an innovative research approach and its implications for nursing knowledge development and practice. This perspective examines the construction of meaning, power relationships, and the importance of language as it affects contemporary healthcare decisions. It seeks to identify and expose biases that marginalize the healthcare needs of women and contribute to healthcare disparities for this population. Additionally, a feminist poststructuralist perspective seeks to develop new knowledge for understanding gender differences. A feminist poststructuralist perspective represents an alternative paradigm for studying the phenomenon of clinical decision-making. An empirical application example of a feminist poststructuralist perspective is provided. This exemplar investigated emergency department registered nurses' triage decisions for men and women with symptoms suggestive of coronary heart disease.

The Physics and Mathematics of MRI

NASA Astrophysics Data System (ADS)

Ansorge, Richard; Graves, Martin

2016-10-01

Magnetic Resonance Imaging is a very important clinical imaging tool. It combines different fields of physics and engineering in a uniquely complex way. MRI is also surprisingly versatile, `pulse sequences' can be designed to yield many different types of contrast. This versatility is unique to MRI. This short book gives both an in depth account of the methods used for the operation and construction of modern MRI systems and also the principles of sequence design and many examples of applications. An important additional feature of this book is the detailed discussion of the mathematical principles used in building optimal MRI systems and for sequence design. The mathematical discussion is very suitable for undergraduates attending medical physics courses. It is also more complete than usually found in alternative books for physical scientists or more clinically orientated works.

Nanoparticles for Radiation Therapy Enhancement: the Key Parameters.

PubMed

Retif, Paul; Pinel, Sophie; Toussaint, Magali; Frochot, Céline; Chouikrat, Rima; Bastogne, Thierry; Barberi-Heyob, Muriel

2015-01-01

This review focuses on the radiosensitization strategies that use high-Z nanoparticles. It does not establish an exhaustive list of the works in this field but rather propose constructive criticisms pointing out critical factors that could improve the nano-radiation therapy. Whereas most reviews show the chemists and/or biologists points of view, the present analysis is also seen through the prism of the medical physicist. In particular, we described and evaluated the influence of X-rays energy spectra using a numerical analysis. We observed a lack of standardization in preclinical studies that could partially explain the low number of translation to clinical applications for this innovative therapeutic strategy. Pointing out the critical parameters of high-Z nanoparticles radiosensitization, this review is expected to contribute to a larger preclinical and clinical development.

Combining neural and behavioral indicators in the assessment of internalizing psychopathology in children and adolescents.

PubMed

Moser, Jason S; Durbin, C Emily; Patrick, Christopher J; Schmidt, Norman B

2015-01-01

Anxiety and mood disorders are among the most prevalent mental health problems affecting our youth. We propose that assessment and treatment efforts in this area can benefit from a focus on developmentally sensitive neurobehavioral trait constructs, that is, individual difference constructs with direct referents in both neurobiology and behavior across the lifespan. This approach dovetails with the National Institute of Mental Health's Research Domain Criteria initiative, which aims to improve classification and treatment of psychopathology by delineating dimensions of functioning that transcend measurement domains and traditional diagnostic categories. We highlight two neurobehavioral dimensions with clear relevance for understanding internalizing problems at differing ages: (a) defensive reactivity and (b) cognitive control. Individual differences in defensive reactivity are posited to reflect variations in sensitivity of the brain's negative valence systems, whereas differences in cognitive control are theorized to reflect variations in neural systems dedicated to regulating behavior and affect. Focusing on these target constructs, we illustrate a psychoneurometric approach to assessment of internalizing psychopathology entailing use of neural, self-report, and behavioral indicators. We address the feasibility of the psychoneurometric approach for clinical application and present results from a pilot study demonstrating expected associations for neural, parent-report, and behavioral measures of defensive reactivity and cognitive control with internalizing symptoms in preschoolers. Together, our conceptual and empirical analyses highlight the promise of multimethod, dimensional assessment of internalizing psychopathology in the lab and in the clinic.

Behavior-based multi-robot collaboration for autonomous construction tasks

NASA Technical Reports Server (NTRS)

Stroupe, Ashley; Huntsberger, Terry; Okon, Avi; Aghazarian, Hrand; Robinson, Matthew

2005-01-01

The Robot Construction Crew (RCC) is a heterogeneous multi-robot system for autonomous construction of a structure through assembly of Long components. The two robot team demonstrates component placement into an existing structure in a realistic environment. The task requires component acquisition, cooperative transport, and cooperative precision manipulation. A behavior-based architecture provides adaptability. The RCC approach minimizes computation, power, communication, and sensing for applicability to space-related construction efforts, but the techniques are applicable to terrestrial construction tasks.

14 CFR 33.11 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-01-01

... STANDARDS: AIRCRAFT ENGINES Design and Construction; General § 33.11 Applicability. This subpart prescribes the general design and construction requirements for reciprocating and turbine aircraft engines. ...

14 CFR 33.11 - Applicability.

Code of Federal Regulations, 2011 CFR

2011-01-01

... STANDARDS: AIRCRAFT ENGINES Design and Construction; General § 33.11 Applicability. This subpart prescribes the general design and construction requirements for reciprocating and turbine aircraft engines. ...

47 CFR 73.3500 - Application and report forms.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Wireless Telecommunications Bureau Application for Assignments of Authorization and Transfers of Control... Station Construction Permit or License. 315 Application for Consent to Transfer of Control of Corporation... Broadcast Station Construction Permit or License or Transfer of Control of Corporation Holding Broadcast...

Biomimetic perfusion and electrical stimulation applied in concert improved the assembly of engineered cardiac tissue.

PubMed

Maidhof, Robert; Tandon, Nina; Lee, Eun Jung; Luo, Jianwen; Duan, Yi; Yeager, Keith; Konofagou, Elisa; Vunjak-Novakovic, Gordana

2012-11-01

Maintenance of normal myocardial function depends intimately on synchronous tissue contraction, driven by electrical activation and on adequate nutrient perfusion in support thereof. Bioreactors have been used to mimic aspects of these factors in vitro to engineer cardiac tissue but, due to design limitations, previous bioreactor systems have yet to simultaneously support nutrient perfusion, electrical stimulation and unconstrained (i.e. not isometric) tissue contraction. To the best of our knowledge, the bioreactor system described herein is the first to integrate these three key factors in concert. We present the design of our bioreactor and characterize its capability in integrated experimental and mathematical modelling studies. We then cultured cardiac cells obtained from neonatal rats in porous, channelled elastomer scaffolds with the simultaneous application of perfusion and electrical stimulation, with controls excluding either one or both of these two conditions. After 8 days of culture, constructs grown with simultaneous perfusion and electrical stimulation exhibited substantially improved functional properties, as evidenced by a significant increase in contraction amplitude (0.23 ± 0.10% vs 0.14 ± 0.05%, 0.13 ± 0.08% or 0.09 ± 0.02% in control constructs grown without stimulation, without perfusion, or either stimulation or perfusion, respectively). Consistently, these constructs had significantly improved DNA contents, cell distribution throughout the scaffold thickness, cardiac protein expression, cell morphology and overall tissue organization compared to control groups. Thus, the simultaneous application of medium perfusion and electrical conditioning enabled by the use of the novel bioreactor system may accelerate the generation of fully functional, clinically sized cardiac tissue constructs. Copyright © 2011 John Wiley & Sons, Ltd.

77 FR 18990 - Approval and Promulgation of Implementation Plans; New Mexico; Construction Permit Fees

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-29

... reviewing and acting on specific air quality construction permit applications received by the New Mexico... Promulgation of Implementation Plans; New Mexico; Construction Permit Fees AGENCY: Environmental Protection... replace existing rules, and revisions to the applicable State Implementation Plan (SIP) for New Mexico...

Establishment of a database of fetal congenital heart malformations and preliminary investigation of its clinical application.

PubMed

Gao, Jun-Xue; Pei, Qiu-Yan; Li, Yun-Tao; Yang, Zhen-Juan

2015-06-01

The aim of this study was to create a database of anatomical ultrathin cross-sectional images of fetal hearts with different congenital heart diseases (CHDs) and preliminarily to investigate its clinical application. Forty Chinese fetal heart samples from induced labor due to different CHDs were cut transversely at 60-μm thickness. All thoracic organs were removed from the thoracic cavity after formalin fixation, embedded in optimum cutting temperature compound, and then frozen at -25°C for 2 hours. Subsequently, macro shots of the frozen serial sections were obtained using a digital camera in order to build a database of anatomical ultrathin cross-sectional images. Images in the database clearly displayed the fetal heart structures. After importing the images into three-dimensional software, the following functions could be realized: (1) based on the original database of transverse sections, databases of sagittal and coronal sections could be constructed; and (2) the original and constructed databases could be displayed continuously and dynamically, and rotated in arbitrary angles. They could also be displayed synchronically. The aforementioned functions of the database allowed for the retrieval of images and three-dimensional anatomy characteristics of the different fetal CHDs, and virtualization of fetal echocardiography findings. A database of 40 different cross-sectional fetal CHDs was established. An extensive database library of fetal CHDs, from which sonographers and students can study the anatomical features of fetal CHDs and virtualize fetal echocardiography findings via either centralized training or distance education, can be established in the future by accumulating further cases. Copyright © 2015. Published by Elsevier B.V.

Novice to Expert Practice via Postprofessional Athletic Training Education: A Grounded Theory

PubMed Central

Neibert, Peter J

2009-01-01

Objective: To discover the theoretic constructs that confirm, disconfirm, or extend the principles and their applications appropriate for National Athletic Trainers' Association (NATA)–accredited postprofessional athletic training education programs. Design: Interviews at the 2003 NATA Annual Meeting & Clinical Symposia. Setting: Qualitative study using grounded theory procedures. Patients and Other Participants: Thirteen interviews were conducted with postprofessional graduates. Participants were purposefully selected based on theoretic sampling and availability. Data Collection and Analysis: The transcribed interviews were analyzed using open coding, axial coding, and selective coding procedures. Member checks, reflective journaling, and triangulation were used to ensure trustworthiness. Results: The participants' comments confirmed and extended the current principles of postprofessional athletic training education programs and offered additional suggestions for more effective practical applications. Conclusions: The emergence of this central category of novice to expert practice is a paramount finding. The tightly woven fabric of the 10 processes, when interlaced with one another, provides a strong tapestry supporting novice to expert practice via postprofessional athletic training education. The emergence of this theoretic position pushes postprofessional graduate athletic training education forward to the future for further investigation into the theoretic constructs of novice to expert practice. PMID:19593420

Revised Hammersmith Scale for spinal muscular atrophy: A SMA specific clinical outcome assessment tool.

PubMed

Ramsey, Danielle; Scoto, Mariacristina; Mayhew, Anna; Main, Marion; Mazzone, Elena S; Montes, Jacqueline; de Sanctis, Roberto; Dunaway Young, Sally; Salazar, Rachel; Glanzman, Allan M; Pasternak, Amy; Quigley, Janet; Mirek, Elizabeth; Duong, Tina; Gee, Richard; Civitello, Matthew; Tennekoon, Gihan; Pane, Marika; Pera, Maria Carmela; Bushby, Kate; Day, John; Darras, Basil T; De Vivo, Darryl; Finkel, Richard; Mercuri, Eugenio; Muntoni, Francesco

2017-01-01

Recent translational research developments in Spinal Muscular Atrophy (SMA), outcome measure design and demands from regulatory authorities require that clinical outcome assessments are 'fit for purpose'. An international collaboration (SMA REACH UK, Italian SMA Network and PNCRN USA) undertook an iterative process to address discontinuity in the recorded performance of the Hammersmith Functional Motor Scale Expanded and developed a revised functional scale using Rasch analysis, traditional psychometric techniques and the application of clinical sensibility via expert panels. Specifically, we intended to develop a psychometrically and clinically robust functional clinician rated outcome measure to assess physical abilities in weak SMA type 2 through to strong ambulant SMA type 3 patients. The final scale, the Revised Hammersmith Scale (RHS) for SMA, consisting of 36 items and two timed tests, was piloted in 138 patients with type 2 and 3 SMA in an observational cross-sectional multi-centre study across the three national networks. Rasch analysis demonstrated very good fit of all 36 items to the construct of motor performance, good reliability with a high Person Separation Index PSI 0.98, logical and hierarchical scoring in 27/36 items and excellent targeting with minimal ceiling. The RHS differentiated between clinically different groups: SMA type, World Health Organisation (WHO) categories, ambulatory status, and SMA type combined with ambulatory status (all p < 0.001). Construct and concurrent validity was also confirmed with a strong significant positive correlation with the WHO motor milestones rs = 0.860, p < 0.001. We conclude that the RHS is a psychometrically sound and versatile clinical outcome assessment to test the broad range of physical abilities of patients with type 2 and 3 SMA. Further longitudinal testing of the scale with regards change in scores over 6 and 12 months are required prior to its adoption in clinical trials.

75 FR 29420 - Revision of LNG and LHG Waterfront Facility General Requirements

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-26

... exclusive authority to approve or deny an application for the siting, construction, expansion, or operation... a Follow-on WSA will be submitted to the U.S. Coast Guard no later than the filing of an application... least 180 days before the applicant files an application for authorization to construct the facility...

40 CFR 61.96 - Applications to construct or modify.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 8 2010-07-01 2010-07-01 false Applications to construct or modify. 61... Emissions of Radionuclides Other Than Radon From Department of Energy Facilities § 61.96 Applications to...) An application for approval under § 61.07 or notification of startup under § 61.09 does not need to...

40 CFR 61.96 - Applications to construct or modify.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 9 2013-07-01 2013-07-01 false Applications to construct or modify. 61... Emissions of Radionuclides Other Than Radon From Department of Energy Facilities § 61.96 Applications to...) An application for approval under § 61.07 or notification of startup under § 61.09 does not need to...

40 CFR 61.96 - Applications to construct or modify.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 8 2011-07-01 2011-07-01 false Applications to construct or modify. 61... Emissions of Radionuclides Other Than Radon From Department of Energy Facilities § 61.96 Applications to...) An application for approval under § 61.07 or notification of startup under § 61.09 does not need to...

40 CFR 61.96 - Applications to construct or modify.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 9 2012-07-01 2012-07-01 false Applications to construct or modify. 61... Emissions of Radionuclides Other Than Radon From Department of Energy Facilities § 61.96 Applications to...) An application for approval under § 61.07 or notification of startup under § 61.09 does not need to...

40 CFR 61.96 - Applications to construct or modify.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 9 2014-07-01 2014-07-01 false Applications to construct or modify. 61... Emissions of Radionuclides Other Than Radon From Department of Energy Facilities § 61.96 Applications to...) An application for approval under § 61.07 or notification of startup under § 61.09 does not need to...

The stabilizing potential of anterior, posterior and combined techniques for the reconstruction of a 2-level cervical corpectomy model: biomechanical study and first results of ATPS prototyping.

PubMed

Koller, Heiko; Schmidt, Rene; Mayer, Michael; Hitzl, Wolfgang; Zenner, Juliane; Midderhoff, Stefan; Middendorf, Stefan; Graf, Nicolaus; Gräf, Nicolaus; Resch, H; Wilke, Hans-Joachim; Willke, Hans-Joachim

2010-12-01

Clinical studies reported frequent failure with anterior instrumented multilevel cervical corpectomies. Hence, posterior augmentation was recommended but necessitates a second approach. Thus, an author group evaluated the feasibility, pull-out characteristics, and accuracy of anterior transpedicular screw (ATPS) fixation. Although first success with clinical application of ATPS has already been reported, no data exist on biomechanical characteristics of an ATPS-plate system enabling transpedicular end-level fixation in advanced instabilities. Therefore, we evaluated biomechanical qualities of an ATPS prototype C4-C7 for reduction of range of motion (ROM) and primary stability in a non-destructive setup among five constructs: anterior plate, posterior all-lateral mass screw construct, posterior construct with lateral mass screws C5 + C6 and end-level fixation using pedicle screws unilaterally or bilaterally, and a 360° construct. 12 human spines C3-T1 were divided into two groups. Four constructs were tested in group 1 and three in group 2; the ATPS prototypes were tested in both groups. Specimens were subjected to flexibility test in a spine motion tester at intact state and after 2-level corpectomy C5-C6 with subsequent reconstruction using a distractable cage and one of the osteosynthesis mentioned above. ROM in flexion-extension, axial rotation, and lateral bending was reported as normalized values. All instrumentations but the anterior plate showed significant reduction of ROM for all directions compared to the intact state. The 360° construct outperformed all others in terms of reducing ROM. While there were no significant differences between the 360° and posterior constructs in flexion-extension and lateral bending, the 360° constructs were significantly more stable in axial rotation. Concerning primary stability of ATPS prototypes, there were no significant differences compared to posterior-only constructs in flexion-extension and axial rotation. The 360° construct showed significant differences to the ATPS prototypes in flexion-extension, while no significant differences existed in axial rotation. But in lateral bending, the ATPS prototype and the anterior plate performed significantly worse than the posterior constructs. ATPS was shown to confer increased primary stability compared to the anterior plate in flexion-extension and axial rotation with the latter yielding significance. We showed that primary stability after 2-level corpectomy reconstruction using ATPS prototypes compared favorably to posterior systems and superior to anterior plates. From the biomechanical point, the 360° instrumentation was shown the most efficient for reconstruction of 2-level corpectomies. Further studies will elucidate whether fatigue testing will enhance the benefit of transpedicular anchorage with posterior constructs and ATPS.

Mkit: A Cell Migration Assay Based on Microfluidic Device and Smartphone

PubMed Central

Yang, Ke; Wu, Jiandong; Peretz-Soroka, Hagit; Zhu, Ling; Li, Zhigang; Sang, Yaoshuo; Hipolito, Jolly; Zhang, Michael; Santos, Susy; Hillier, Craig; de Faria, Ricardo Lobato; Liu, Yong; Lin, Francis

2017-01-01

Mobile sensing based on the integration of microfluidic device and smartphone, so-called MS2 technology, has enabled many applications over recent years, and continues to stimulate growing interest in both research communities and industries. In particular, it has been envisioned that MS2 technology can be developed for various cell functional assays to enable basic research and clinical applications. Toward this direction, in this paper, we describe the development of a MS2-based cell functional assay for testing cell migration (the Mkit). The system is constructed as an integrated test kit, which includes microfluidic chips, a smartphone-based imaging platform, the phone apps for image capturing and data analysis, and a set of reagent and accessories for performing the cell migration assay. We demonstrated that the Mkit can effectively measure purified neutrophil and cancer cell chemotaxis. Furthermore, neutrophil chemotaxis can be tested from a drop of whole blood using the Mkit with red blood cell (RBC) lysis. The effects of chemoattractant dose and gradient profile on neutrophil chemotaxis were also tested using the Mkit. In addition to research applications, we demonstrated the effective use of the Mkit for on-site test at the hospital and for testing clinical samples from chronic obstructive pulmonary disease patient. Thus, this developed Mkit provides an easy and integrated experimental platform for cell migration related research and potential medical diagnostic applications. PMID:28772229

How can we teach EBM in clinical practice? An analysis of barriers to implementation of on-the-job EBM teaching and learning.

PubMed

Oude Rengerink, Katrien; Thangaratinam, Shakila; Barnfield, Gemma; Suter, Katja; Horvath, Andrea R; Walczak, Jacek; Wełmińska, Anna; Weinbrenner, Susanne; Meyerrose, Berit; Arvanitis, Theodoros N; Onody, Rita; Zanrei, Gianni; Kunz, Regina; Arditi, Chantal; Burnand, Bernard; Gee, Harry; Khan, Khalid S; Mol, Ben W J

2011-01-01

Evidence-based medicine (EBM) improves the quality of health care. Courses on how to teach EBM in practice are available, but knowledge does not automatically imply its application in teaching. We aimed to identify and compare barriers and facilitators for teaching EBM in clinical practice in various European countries. A questionnaire was constructed listing potential barriers and facilitators for EBM teaching in clinical practice. Answers were reported on a 7-point Likert scale ranging from not at all being a barrier to being an insurmountable barrier. The questionnaire was completed by 120 clinical EBM teachers from 11 countries. Lack of time was the strongest barrier for teaching EBM in practice (median 5). Moderate barriers were the lack of requirements for EBM skills and a pyramid hierarchy in health care management structure (median 4). In Germany, Hungary and Poland, reading and understanding articles in English was a higher barrier than in the other countries. Incorporation of teaching EBM in practice faces several barriers to implementation. Teaching EBM in clinical settings is most successful where EBM principles are culturally embedded and form part and parcel of everyday clinical decisions and medical practice.

SeCD electronic folder: CADMIO's application for the medical folder of a service for the care of drug addicts.

PubMed

Della Valle, R M; Baldoni, A; De Rossi, M; Ferri, F

1998-01-01

In this paper we will describe the SeCD (Service for the Care of Drug addicts) electronic folder, a specific application of CADMIO [1] (Computer Aided Design for Medical Information Objects) system. CADMIO is a system for the definition, construction and management of multimedia clinical folders. The Ser.T. (Servizio per la Tossicodipendenza/Service for Drug Addicts) has earned a very special place within the Italian clinical structures as well as any service for drug addicts has done in the rest of the world. Such a structure has special needs and the characteristics of its medical folders are very different from any other folder. Actually, a Ser.T. has to keep updated the patient situation either from the clinical point of view as well as the psychiatric one. Moreover, it must keep track of the clinician subjective considerations about the patient psychic state and his situation in regard of the law. So, we had to redesign some of the features of the existing CADMIO application, to accommodate such highly not structured data into objects easily manipulated by an informative system. The objectives we hope to achieve were mainly two: To show that a well designed adaptive system can be easily exploited to support even very complex and poorly structured data types and actions To design data structures able to accommodate medical, psychiatric and administrative data in an homogeneous manner.

Preventing plane-assisted suicides through the lessons of research on homicide and suicide-homicide.

PubMed

Rice, Timothy R; Sher, Leo

2016-08-01

The Germanwings 9525 incident drew significant attention to the 'plane-assisted suicide' construct, yet little scientific literature exists on this topic. This paper reviews the available literature and applies lessons from the suicide-homicide and men's mental health literature to better understand this construct from a scientific perspective. A systematic review of the relevant clinical literature was undertaken. Multiple lines of evidence suggests the applicability and relevance of suicide-homicide research and men's mental health to the plane-assisted suicide phenomenon. Plane-assisted suicides occur within an overwhelmingly male, middle aged population who, in addition to suicide, commit large scale acts of murder. Issues of divorce, separation, and threats to masculinity appear integral to an effective prevention program. Further research in the understanding of plane-assisted suicide as a product of neuropsychiatric disorder may advance such prevention efforts and have the opportunity to reduce the loss of life in future tragedies.

Construction of human antibody gene libraries and selection of antibodies by phage display.

PubMed

Schirrmann, Thomas; Hust, Michael

2010-01-01

Recombinant antibodies as therapeutics offer new opportunities for the treatment of many tumor diseases. To date, 18 antibody-based drugs are approved for cancer treatment and hundreds of anti-tumor antibodies are under development. The first clinically approved antibodies were of murine origin or human-mouse chimeric. However, since murine antibody domains are immunogenic in human patients and could result in human anti-mouse antibody (HAMA) responses, currently mainly humanized and fully human antibodies are developed for therapeutic applications.Here, in vitro antibody selection technologies directly allow the selection of human antibodies and the corresponding genes from human antibody gene libraries. Antibody phage display is the most common way to generate human antibodies and has already yielded thousands of recombinant antibodies for research, diagnostics and therapy. Here, we describe methods for the construction of human scFv gene libraries and the antibody selection.

An online hybrid brain-computer interface combining multiple physiological signals for webpage browse.

PubMed

Long Chen; Zhongpeng Wang; Feng He; Jiajia Yang; Hongzhi Qi; Peng Zhou; Baikun Wan; Dong Ming

2015-08-01

The hybrid brain computer interface (hBCI) could provide higher information transfer rate than did the classical BCIs. It included more than one brain-computer or human-machine interact paradigms, such as the combination of the P300 and SSVEP paradigms. Research firstly constructed independent subsystems of three different paradigms and tested each of them with online experiments. Then we constructed a serial hybrid BCI system which combined these paradigms to achieve the functions of typing letters, moving and clicking cursor, and switching among them for the purpose of browsing webpages. Five subjects were involved in this study. They all successfully realized these functions in the online tests. The subjects could achieve an accuracy above 90% after training, which met the requirement in operating the system efficiently. The results demonstrated that it was an efficient system capable of robustness, which provided an approach for the clinic application.

Automated novel high-accuracy miniaturized positioning system for use in analytical instrumentation

NASA Astrophysics Data System (ADS)

Siomos, Konstadinos; Kaliakatsos, John; Apostolakis, Manolis; Lianakis, John; Duenow, Peter

1996-01-01

The development of three-dimensional automotive devices (micro-robots) for applications in analytical instrumentation, clinical chemical diagnostics and advanced laser optics, depends strongly on the ability of such a device: firstly to be positioned with high accuracy, reliability, and automatically, by means of user friendly interface techniques; secondly to be compact; and thirdly to operate under vacuum conditions, free of most of the problems connected with conventional micropositioners using stepping-motor gear techniques. The objective of this paper is to develop and construct a mechanically compact computer-based micropositioning system for coordinated motion in the X-Y-Z directions with: (1) a positioning accuracy of less than 1 micrometer, (the accuracy of the end-position of the system is controlled by a hard/software assembly using a self-constructed optical encoder); (2) a heat-free propulsion mechanism for vacuum operation; and (3) synchronized X-Y motion.

A Multitrait-Multimethod Analysis of the Construct Validity of Child Anxiety Disorders in a Clinical Sample

ERIC Educational Resources Information Center

Langer, David A.; Wood, Jeffrey J.; Bergman, R. Lindsey; Piacentini, John C.

2010-01-01

The present study examines the construct validity of separation anxiety disorder (SAD), social phobia (SoP), panic disorder (PD), and generalized anxiety disorder (GAD) in a clinical sample of children. Participants were 174 children, 6 to 17 years old (94 boys) who had undergone a diagnostic evaluation at a university hospital based clinic.…

Accuracy of dengue clinical diagnosis with and without NS1 antigen rapid test: Comparison between human and Bayesian network model decision.

PubMed

Sa-Ngamuang, Chaitawat; Haddawy, Peter; Luvira, Viravarn; Piyaphanee, Watcharapong; Iamsirithaworn, Sopon; Lawpoolsri, Saranath

2018-06-18

Differentiating dengue patients from other acute febrile illness patients is a great challenge among physicians. Several dengue diagnosis methods are recommended by WHO. The application of specific laboratory tests is still limited due to high cost, lack of equipment, and uncertain validity. Therefore, clinical diagnosis remains a common practice especially in resource limited settings. Bayesian networks have been shown to be a useful tool for diagnostic decision support. This study aimed to construct Bayesian network models using basic demographic, clinical, and laboratory profiles of acute febrile illness patients to diagnose dengue. Data of 397 acute undifferentiated febrile illness patients who visited the fever clinic of the Bangkok Hospital for Tropical Diseases, Thailand, were used for model construction and validation. The two best final models were selected: one with and one without NS1 rapid test result. The diagnostic accuracy of the models was compared with that of physicians on the same set of patients. The Bayesian network models provided good diagnostic accuracy of dengue infection, with ROC AUC of 0.80 and 0.75 for models with and without NS1 rapid test result, respectively. The models had approximately 80% specificity and 70% sensitivity, similar to the diagnostic accuracy of the hospital's fellows in infectious disease. Including information on NS1 rapid test improved the specificity, but reduced the sensitivity, both in model and physician diagnoses. The Bayesian network model developed in this study could be useful to assist physicians in diagnosing dengue, particularly in regions where experienced physicians and laboratory confirmation tests are limited.

Photoluminescence Architectures for Disease Diagnosis: From Graphene to Thin-Layer Transition Metal Dichalcogenides and Oxides.

PubMed

He, Xiao-Peng; Tian, He

2016-01-13

Ever since the discovery of graphene, increasing efforts have been devoted to the use of this stellar material as well as the development of other graphene-like materials such as thin-layer transition metal dichalcogenides and oxides (TMD/Os) for a variety of applications. Because of their large surface area and unique optical properties, these two-dimensional materials with a size ranging from the micro- to the nanoscale have been employed as the substrate to construct photoluminescence architectures for disease diagnosis as well as theranostics. These architectures are built through the simple self-assembly of labeled biomolecular probes with the substrate material, leading to signal quenching. Upon the specific interaction of the architecture with a target biomarker, the signal can be spontaneously restored in a reversible manner. Meanwhile, by co-loading therapeutic agents and employing the inherent photo-thermal properties of the material substrates, a combined disease imaging and therapy (theranostics) can be achieved. This review highlights the latest advances in the construction and application of graphene and TMD/O based thin-layer material composites for single-target and multiplexed detection of a variety of biomarkers and theranostics. These versatile material architectures, owing to their ease in preparation, low cost and flexibility in functionalization, provide promising tools for both basic biochemical research and clinical applications. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Checklist to operationalize measurement characteristics of patient-reported outcome measures.

PubMed

Francis, David O; McPheeters, Melissa L; Noud, Meaghan; Penson, David F; Feurer, Irene D

2016-08-02

The purpose of this study was to advance a checklist of evaluative criteria designed to assess patient-reported outcome (PRO) measures' developmental measurement properties and applicability, which can be used by systematic reviewers, researchers, and clinicians with a varied range of expertise in psychometric measure development methodology. A directed literature search was performed to identify original studies, textbooks, consensus guidelines, and published reports that propose criteria for assessing the quality of PRO measures. Recommendations from these sources were iteratively distilled into a checklist of key attributes. Preliminary items underwent evaluation through 24 cognitive interviews with clinicians and quantitative researchers. Six measurement theory methodological novices independently applied the final checklist to assess six PRO measures encompassing a variety of methods, applications, and clinical constructs. Agreement between novice and expert scores was assessed. The distillation process yielded an 18-item checklist with six domains: (1) conceptual model, (2) content validity, (3) reliability, (4) construct validity, (5) scoring and interpretation, and (6) respondent burden and presentation. With minimal instruction, good agreement in checklist item ratings was achieved between quantitative researchers with expertise in measurement theory and less experienced clinicians (mean kappa 0.70; range 0.66-0.87). We present a simplified checklist that can help guide systematic reviewers, researchers, and clinicians with varied measurement theory expertise to evaluate the strengths and weakness of candidate PRO measures' developmental properties and the appropriateness for specific applications.

Statistical identification of gene association by CID in application of constructing ER regulatory network

PubMed Central

Liu, Li-Yu D; Chen, Chien-Yu; Chen, Mei-Ju M; Tsai, Ming-Shian; Lee, Cho-Han S; Phang, Tzu L; Chang, Li-Yun; Kuo, Wen-Hung; Hwa, Hsiao-Lin; Lien, Huang-Chun; Jung, Shih-Ming; Lin, Yi-Shing; Chang, King-Jen; Hsieh, Fon-Jou

2009-01-01

Background A variety of high-throughput techniques are now available for constructing comprehensive gene regulatory networks in systems biology. In this study, we report a new statistical approach for facilitating in silico inference of regulatory network structure. The new measure of association, coefficient of intrinsic dependence (CID), is model-free and can be applied to both continuous and categorical distributions. When given two variables X and Y, CID answers whether Y is dependent on X by examining the conditional distribution of Y given X. In this paper, we apply CID to analyze the regulatory relationships between transcription factors (TFs) (X) and their downstream genes (Y) based on clinical data. More specifically, we use estrogen receptor α (ERα) as the variable X, and the analyses are based on 48 clinical breast cancer gene expression arrays (48A). Results The analytical utility of CID was evaluated in comparison with four commonly used statistical methods, Galton-Pearson's correlation coefficient (GPCC), Student's t-test (STT), coefficient of determination (CoD), and mutual information (MI). When being compared to GPCC, CoD, and MI, CID reveals its preferential ability to discover the regulatory association where distribution of the mRNA expression levels on X and Y does not fit linear models. On the other hand, when CID is used to measure the association of a continuous variable (Y) against a discrete variable (X), it shows similar performance as compared to STT, and appears to outperform CoD and MI. In addition, this study established a two-layer transcriptional regulatory network to exemplify the usage of CID, in combination with GPCC, in deciphering gene networks based on gene expression profiles from patient arrays. Conclusion CID is shown to provide useful information for identifying associations between genes and transcription factors of interest in patient arrays. When coupled with the relationships detected by GPCC, the association predicted by CID are applicable to the construction of transcriptional regulatory networks. This study shows how information from different data sources and learning algorithms can be integrated to investigate whether relevant regulatory mechanisms identified in cell models can also be partially re-identified in clinical samples of breast cancers. Availability the implementation of CID in R codes can be freely downloaded from . PMID:19292896

Promising Biomolecules.

PubMed

Oliveira, Isabel; Carvalho, Ana L; Radhouani, Hajer; Gonçalves, Cristiana; Oliveira, J Miguel; Reis, Rui L

2018-01-01

The osteochondral defect (OD) comprises the articular cartilage and its subchondral bone. The treatment of these lesions remains as one of the most problematic clinical issues, since these defects include different tissues, requiring distinct healing approaches. Among the growing applications of regenerative medicine, clinical articular cartilage repair has been used for two decades, and it is an effective example of translational medicine; one of the most used cell-based repair strategies includes implantation of autologous cells in degradable scaffolds such as alginate, agarose, collagen, chitosan, chondroitin sulfate, cellulose, silk fibroin, hyaluronic acid, and gelatin, among others. Concerning the repair of osteochondral defects, tissue engineering and regenerative medicine started to design single- or bi-phased scaffold constructs, often containing hydroxyapatite-collagen composites, usually used as a bone substitute. Biomolecules such as natural and synthetic have been explored to recreate the cartilage-bone interface through multilayered biomimetic scaffolds. In this chapter, a succinct description about the most relevant natural and synthetic biomolecules used on cartilage and bone repair, describing the procedures to obtain these biomolecules, their chemical structure, common modifications to improve its characteristics, and also their application in the biomedical fields, is given.

Bayesian additive decision trees of biomarker by treatment interactions for predictive biomarker detection and subgroup identification.

PubMed

Zhao, Yang; Zheng, Wei; Zhuo, Daisy Y; Lu, Yuefeng; Ma, Xiwen; Liu, Hengchang; Zeng, Zhen; Laird, Glen

2017-10-11

Personalized medicine, or tailored therapy, has been an active and important topic in recent medical research. Many methods have been proposed in the literature for predictive biomarker detection and subgroup identification. In this article, we propose a novel decision tree-based approach applicable in randomized clinical trials. We model the prognostic effects of the biomarkers using additive regression trees and the biomarker-by-treatment effect using a single regression tree. Bayesian approach is utilized to periodically revise the split variables and the split rules of the decision trees, which provides a better overall fitting. Gibbs sampler is implemented in the MCMC procedure, which updates the prognostic trees and the interaction tree separately. We use the posterior distribution of the interaction tree to construct the predictive scores of the biomarkers and to identify the subgroup where the treatment is superior to the control. Numerical simulations show that our proposed method performs well under various settings comparing to existing methods. We also demonstrate an application of our method in a real clinical trial.

Noncontact blood perfusion mapping in clinical applications

NASA Astrophysics Data System (ADS)

Iakovlev, Dmitry; Dwyer, Vincent; Hu, Sijung; Silberschmidt, Vadim

2016-04-01

Non-contact imaging photoplethysmography (iPPG) to detect pulsatile blood microcirculation in tissue has been selected as a successor to low spatial resolution and slow scanning blood perfusion techniques currently employed by clinicians. The proposed iPPG system employs a novel illumination source constructed of multiple high power LEDs with narrow spectral emission, which are temporally modulated and synchronised with a high performance sCMOS sensor. To ensure spectrum stability and prevent thermal wavelength drift due to junction temperature variations, each LED features a custom-designed thermal management system to effectively dissipate generated heat and auto-adjust current flow. The use of a multi-wavelength approach has resulted in simultaneous microvascular perfusion monitoring at various tissue depths, which is an added benefit for specific clinical applications. A synchronous detection algorithm to extract weak photoplethysmographic pulse-waveforms demonstrated robustness and high efficiency when applied to even small regions of 5 mm2. The experimental results showed evidences that the proposed system could achieve noticeable accuracy in blood perfusion monitoring by creating complex amplitude and phase maps for the tissue under examination.

Molecular Imaging in Synthetic Biology, and Synthetic Biology in Molecular Imaging.

PubMed

Gilad, Assaf A; Shapiro, Mikhail G

2017-06-01

Biomedical synthetic biology is an emerging field in which cells are engineered at the genetic level to carry out novel functions with relevance to biomedical and industrial applications. This approach promises new treatments, imaging tools, and diagnostics for diseases ranging from gastrointestinal inflammatory syndromes to cancer, diabetes, and neurodegeneration. As these cellular technologies undergo pre-clinical and clinical development, it is becoming essential to monitor their location and function in vivo, necessitating appropriate molecular imaging strategies, and therefore, we have created an interest group within the World Molecular Imaging Society focusing on synthetic biology and reporter gene technologies. Here, we highlight recent advances in biomedical synthetic biology, including bacterial therapy, immunotherapy, and regenerative medicine. We then discuss emerging molecular imaging approaches to facilitate in vivo applications, focusing on reporter genes for noninvasive modalities such as magnetic resonance, ultrasound, photoacoustic imaging, bioluminescence, and radionuclear imaging. Because reporter genes can be incorporated directly into engineered genetic circuits, they are particularly well suited to imaging synthetic biological constructs, and developing them provides opportunities for creative molecular and genetic engineering.

Esophageal tissue engineering: Current status and perspectives.

PubMed

Poghosyan, T; Catry, J; Luong-Nguyen, M; Bruneval, P; Domet, T; Arakelian, L; Sfeir, R; Michaud, L; Vanneaux, V; Gottrand, F; Larghero, J; Cattan, P

2016-02-01

Tissue engineering, which consists of the combination and in vivo implantation of elements required for tissue remodeling toward a specific organ phenotype, could be an alternative for classical techniques of esophageal replacement. The current hybrid approach entails creation of an esophageal substitute composed of an acellular matrix and autologous epithelial and muscle cells provides the most successful results. Current research is based on the use of mesenchymal stem cells, whose potential for differentiation and proangioogenic, immune-modulator and anti-inflammatory properties are important assets. In the near future, esophageal substitutes could be constructed from acellular "intelligent matrices" that contain the molecules necessary for tissue regeneration; this should allow circumvention of the implantation step and still obtain standardized in vivo biological responses. At present, tissue engineering applications to esophageal replacement are limited to enlargement plasties with absorbable, non-cellular matrices. Nevertheless, the application of existing clinical techniques for replacement of other organs by tissue engineering in combination with a multiplication of translational research protocols for esophageal replacement in large animals should soon pave the way for health agencies to authorize clinical trials. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

What variables can influence clinical reasoning?

PubMed

Ashoorion, Vahid; Liaghatdar, Mohammad Javad; Adibi, Peyman

2012-12-01

Clinical reasoning is one of the most important competencies that a physician should achieve. Many medical schools and licensing bodies try to predict it based on some general measures such as critical thinking, personality, and emotional intelligence. This study aimed at providing a model to design the relationship between the constructs. Sixty-nine medical students participated in this study. A battery test devised that consist four parts: Clinical reasoning measures, personality NEO inventory, Bar-On EQ inventory, and California critical thinking questionnaire. All participants completed the tests. Correlation and multiple regression analysis consumed for data analysis. There is low to moderate correlations between clinical reasoning and other variables. Emotional intelligence is the only variable that contributes clinical reasoning construct (r=0.17-0.34) (R(2) chnage = 0.46, P Value = 0.000). Although, clinical reasoning can be considered as a kind of thinking, no significant correlation detected between it and other constructs. Emotional intelligence (and its subscales) is the only variable that can be used for clinical reasoning prediction.

30 CFR 75.335 - Seal strengths, design applications, and installation.

Code of Federal Regulations, 2013 CFR

2013-07-01

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30 CFR 75.335 - Seal strengths, design applications, and installation.

Code of Federal Regulations, 2010 CFR

2010-07-01

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30 CFR 75.335 - Seal strengths, design applications, and installation.

Code of Federal Regulations, 2014 CFR

2014-07-01

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30 CFR 75.335 - Seal strengths, design applications, and installation.

Code of Federal Regulations, 2012 CFR

2012-07-01

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30 CFR 75.335 - Seal strengths, design applications, and installation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... properties, construction specifications, quality control, design references, and other information related to... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Seal strengths, design applications, and... Seal strengths, design applications, and installation. (a) Seal strengths. Seals constructed on or...

23 CFR 635.202 - Applicability.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 23 Highways 1 2011-04-01 2011-04-01 false Applicability. 635.202 Section 635.202 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS CONSTRUCTION AND MAINTENANCE Force Account Construction § 635.202 Applicability. This subpart applies to all Federal-aid and...

23 CFR 635.202 - Applicability.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 23 Highways 1 2012-04-01 2012-04-01 false Applicability. 635.202 Section 635.202 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS CONSTRUCTION AND MAINTENANCE Force Account Construction § 635.202 Applicability. This subpart applies to all Federal-aid and...

23 CFR 635.202 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 23 Highways 1 2010-04-01 2010-04-01 false Applicability. 635.202 Section 635.202 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS CONSTRUCTION AND MAINTENANCE Force Account Construction § 635.202 Applicability. This subpart applies to all Federal-aid and...

23 CFR 635.202 - Applicability.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 23 Highways 1 2013-04-01 2013-04-01 false Applicability. 635.202 Section 635.202 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS CONSTRUCTION AND MAINTENANCE Force Account Construction § 635.202 Applicability. This subpart applies to all Federal-aid and...

23 CFR 635.202 - Applicability.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 23 Highways 1 2014-04-01 2014-04-01 false Applicability. 635.202 Section 635.202 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS CONSTRUCTION AND MAINTENANCE Force Account Construction § 635.202 Applicability. This subpart applies to all Federal-aid and...

[Research on the Application of Lean Management in Medical Consumables Material Logistics Management].

PubMed

Yang, Chai; Zhang, Wei; Gu, Wei; Shen, Aizong

2016-11-01

Solve the problems of high cost, low utilization rate of resources, low medical care quality problem in medical consumables material logistics management for scientific of medical consumables management. Analysis of the problems existing in the domestic medical consumables material logistics management in hospital, based on lean management method, SPD(Supply, Processing, Distribution) for specific applications, combined HBOS(Hospital Business Operation System), HIS (Hospital Information System) system for medical consumables material management. Achieve the lean management in medical consumables material purchase, warehouse construction, push, clinical use and retrospect. Lean management in medical consumables material can effectively control the cost in logistics management, optimize the alocation of resources, liberate unnecessary time of medical staff, improve the quality of medical care. It is a scientific management method.

Peptide and protein nanoparticle conjugates: versatile platforms for biomedical applications.

PubMed

Spicer, Christopher D; Jumeaux, Coline; Gupta, Bakul; Stevens, Molly M

2018-05-21

Peptide- and protein-nanoparticle conjugates have emerged as powerful tools for biomedical applications, enabling the treatment, diagnosis, and prevention of disease. In this review, we focus on the key roles played by peptides and proteins in improving, controlling, and defining the performance of nanotechnologies. Within this framework, we provide a comprehensive overview of the key sequences and structures utilised to provide biological and physical stability to nano-constructs, direct particles to their target and influence their cellular and tissue distribution, induce and control biological responses, and form polypeptide self-assembled nanoparticles. In doing so, we highlight the great advances made by the field, as well as the challenges still faced in achieving the clinical translation of peptide- and protein-functionalised nano-drug delivery vehicles, imaging species, and active therapeutics.

Growth factors and chronic wound healing: past, present, and future.

PubMed

Goldman, Robert

2004-01-01

Growth substances (cytokines and growth factors) are soluble signaling proteins affecting the process of normal wound healing. Cytokines govern the inflammatory phase that clears cellular and extracellular matrix debris. Wound repair is controlled by growth factors (platelet-derived growth factor [PDGF], keratinocyte growth factor, and transforming growth factor beta). Endogenous growth factors communicate across the dermal-epidermal interface. PDGF is important for most phases of wound healing. Becaplermin (PDGF-BB), the only growth factor approved by the Food and Drug Administration, requires daily application for neuropathic wound healing. Gene therapy is under development for more efficient growth factor delivery; a single application will induce constitutive growth factor expression for weeks. Based on dramatic preclinical animal studies, a phase 1 clinical trial planned on a PDGF genetic construct appears promising.

Soft bioelectronics using nanomaterials

NASA Astrophysics Data System (ADS)

Lee, Hyunjae; Kim, Dae-Hyeong

2016-09-01

Recently, soft bioelectronics has attracted significant attention because of its potential applications in biointegrated healthcare devices and minimally invasive surgical tools. Mechanical mismatch between conventional electronic/optoelectronic devices and soft human tissues/organs, however, causes many challenges in materials and device designs of bio-integrated devices. Intrinsically soft hybrid materials comprising twodimensional nanomaterials are utilized to solve these issues. In this paper, we describe soft bioelectronic devices based on graphene synthesized by a chemical vapor deposition process. These devices have unique advantages over rigid electronics, particularly in biomedical applications. The functionalized graphene is hybridized with other nanomaterials and fabricated into high-performance sensors and actuators toward wearable and minimally invasive healthcare devices. Integrated bioelectronic systems constructed using these devices solve pending issues in clinical medicine while providing new opportunities in personalized healthcare.

Protecting privacy in a clinical data warehouse.

PubMed

Kong, Guilan; Xiao, Zhichun

2015-06-01

Peking University has several prestigious teaching hospitals in China. To make secondary use of massive medical data for research purposes, construction of a clinical data warehouse is imperative in Peking University. However, a big concern for clinical data warehouse construction is how to protect patient privacy. In this project, we propose to use a combination of symmetric block ciphers, asymmetric ciphers, and cryptographic hashing algorithms to protect patient privacy information. The novelty of our privacy protection approach lies in message-level data encryption, the key caching system, and the cryptographic key management system. The proposed privacy protection approach is scalable to clinical data warehouse construction with any size of medical data. With the composite privacy protection approach, the clinical data warehouse can be secure enough to keep the confidential data from leaking to the outside world. © The Author(s) 2014.

Cartilage engineering using chondrocyte cell sheets and its application in reconstruction of microtia.

PubMed

Zhou, Libin; Ding, Ruiying; Li, Baowei; Han, Haolun; Wang, Hongnan; Wang, Gang; Xu, Bingxin; Zhai, Suoqiang; Wu, Wei

2015-01-01

The imperfections of scaffold materials have hindered the clinical application of cartilage tissue engineering. The recently developed cell-sheet technique is adopted to engineer tissues without scaffold materials, thus is considered being potentially able to overcome the problems concerning the scaffold imperfections. This study constructed monolayer and bilayer chondrocyte cell sheets and harvested the sheets with cell scraper instead of temperature-responsive culture dishes. The properties of the cultured chondrocyte cell sheets and the feasibility of cartilage engineering using the chondrocyte cell sheets was further investigated via in vitro and in vivo study. Primary extracellular matrix (ECM) formation and type II collagen expression was detected in the cell sheets during in vitro culture. After implanted into nude mice for 8 weeks, mature cartilage discs were harvested. The morphology of newly formed cartilage was similar in the constructs originated from monolayer and bilayer chondrocyte cell sheet. The chondrocytes were located within evenly distributed ovoid lacunae. Robust ECM formation and intense expression of type II collagen was observed surrounding the evenly distributed chondrocytes in the neocartilages. Biochemical analysis showed that the DNA contents of the neocartilages were higher than native human costal cartilage; while the contents of the main component of ECM, glycosaminoglycan and hydroxyproline, were similar to native human costal cartilage. In conclusion, the chondrocyte cell sheet constructed using the simple and low-cost technique is basically the same with the cell sheet cultured and harvested in temperature-responsive culture dishes, and can be used for cartilage tissue engineering.

Application of 4G wireless network-based system for remote diagnosis and nursing of stomal complications

PubMed Central

Xu, Xiulian; Cao, Yingjuan; Luan, Xiaorong

2014-01-01

Background: This study aims to apply 4G wireless network in the remote diagnosis of stoma complications for the first time. Background: Remote diagnosis and nursing care for a variety of illnesses are urgently needed in clinical settings. Objectives: Combining with relevant clinical manifestations, an Android phone-based intelligent diagnosis system was designed to construct a universe, easy access to exploitation and human-computer interaction database and exploitation environment for applications and programs. Methods: “Production rule” and forward reasoning method were utilized to design arborescence structures and logic reasoner associated with stoma complications. Stoma physicians were responsible for delivering evaluation scores on patients’ health status using analytic hierarchy process. The emphasis of this study is to exploit an “Android phone-based system for remote diagnosis of stoma”, which is of certain universe usage. Results: Such system was tested in the Medicine Information Center of Qilu Hospital of Shandong University and initially applied in the city of De Zhou, Shandong province, China. Conclusions: These results collectively demonstrated that the system is easy to carry, of high utility and free from the limitations of wire network environment, etc. It provides clinical evidence for establishing a novel type model for the exchange between patients and physicians. PMID:25550986

Patient-specific finite element modeling of bones.

PubMed

Poelert, Sander; Valstar, Edward; Weinans, Harrie; Zadpoor, Amir A

2013-04-01

Finite element modeling is an engineering tool for structural analysis that has been used for many years to assess the relationship between load transfer and bone morphology and to optimize the design and fixation of orthopedic implants. Due to recent developments in finite element model generation, for example, improved computed tomography imaging quality, improved segmentation algorithms, and faster computers, the accuracy of finite element modeling has increased vastly and finite element models simulating the anatomy and properties of an individual patient can be constructed. Such so-called patient-specific finite element models are potentially valuable tools for orthopedic surgeons in fracture risk assessment or pre- and intraoperative planning of implant placement. The aim of this article is to provide a critical overview of current themes in patient-specific finite element modeling of bones. In addition, the state-of-the-art in patient-specific modeling of bones is compared with the requirements for a clinically applicable patient-specific finite element method, and judgment is passed on the feasibility of application of patient-specific finite element modeling as a part of clinical orthopedic routine. It is concluded that further development in certain aspects of patient-specific finite element modeling are needed before finite element modeling can be used as a routine clinical tool.

Initial Construction and Validation of the Pathological Narcissism Inventory

ERIC Educational Resources Information Center

Pincus, Aaron L.; Ansell, Emily B.; Pimentel, Claudia A.; Cain, Nicole M.; Wright, Aidan G. C.; Levy, Kenneth N.

2009-01-01

The construct of narcissism is inconsistently defined across clinical theory, social-personality psychology, and psychiatric diagnosis. Two problems were identified that impede integration of research and clinical findings regarding narcissistic personality pathology: (a) ambiguity regarding the assessment of pathological narcissism vs. normal…

Implementation of an Enterprise Information Portal (EIP) in the Loyola University Health System

PubMed Central

Price, Ronald N.; Hernandez, Kim

2001-01-01

Loyola University Chicago Stritch School of Medicine and Loyola University Medical Center have long histories in the development of applications to support the institutions' missions of education, research and clinical care. In late 1998, the institutions' application development group undertook an ambitious program to re-architecture more than 10 years of legacy application development (30+ core applications) into a unified World Wide Web (WWW) environment. The primary project objectives were to construct an environment that would support the rapid development of n-tier, web-based applications while providing standard methods for user authentication/validation, security/access control and definition of a user's organizational context. The project's efforts resulted in Loyola's Enterprise Information Portal (EIP), which meets the aforementioned objectives. This environment: 1) allows access to other vertical Intranet portals (e.g., electronic medical record, patient satisfaction information and faculty effort); 2) supports end-user desktop customization; and 3) provides a means for standardized application “look and feel.” The portal was constructed utilizing readily available hardware and software. Server hardware consists of multiprocessor (Intel Pentium 500Mhz) Compaq 6500 servers with one gigabyte of random access memory and 75 gigabytes of hard disk storage. Microsoft SQL Server was selected to house the portal's internal or security data structures. Netscape Enterprise Server was selected for the web server component of the environment and Allaire's ColdFusion was chosen for access and application tiers. Total costs for the portal environment was less than $40,000. User data storage is accomplished through two Microsoft SQL Servers and an existing SUN Microsystems enterprise server with eight processors, 750 gigabytes of disk storage operating Sybase relational database manager. Total storage capacity for all system exceeds one terabyte. In the past 12 months, the EIP has supported development of more than 88 applications and is utilized by more than 2,200 users.

Acceleration of vascularized bone tissue-engineered constructs in a large animal model combining intrinsic and extrinsic vascularization.

PubMed

Weigand, Annika; Beier, Justus P; Hess, Andreas; Gerber, Thomas; Arkudas, Andreas; Horch, Raymund E; Boos, Anja M

2015-05-01

During the last decades, a range of excellent and promising strategies in Bone Tissue Engineering have been developed. However, the remaining major problem is the lack of vascularization. In this study, extrinsic and intrinsic vascularization strategies were combined for acceleration of vascularization. For optimal biomechanical stability of the defect site and simplifying future transition into clinical application, a primary stable and approved nanostructured bone substitute in clinically relevant size was used. An arteriovenous (AV) loop was microsurgically created in sheep and implanted, together with the bone substitute, in either perforated titanium chambers (intrinsic/extrinsic) for different time intervals of up to 18 weeks or isolated Teflon(®) chambers (intrinsic) for 18 weeks. Over time, magnetic resonance imaging and micro-computed tomography (CT) analyses illustrate the dense vascularization arising from the AV loop. The bone substitute was completely interspersed with newly formed tissue after 12 weeks of intrinsic/extrinsic vascularization and after 18 weeks of intrinsic/extrinsic and intrinsic vascularization. Successful matrix change from an inorganic to an organic scaffold could be demonstrated in vascularized areas with scanning electron microscopy and energy dispersive X-ray spectroscopy. Using the intrinsic vascularization method only, the degradation of the scaffold and osteoclastic activity was significantly lower after 18 weeks, compared with 12 and 18 weeks in the combined intrinsic-extrinsic model. Immunohistochemical staining revealed an increase in bone tissue formation over time, without a difference between intrinsic/extrinsic and intrinsic vascularization after 18 weeks. This study presents the combination of extrinsic and intrinsic vascularization strategies for the generation of an axially vascularized bone substitute in clinically relevant size using a large animal model. The additional extrinsic vascularization promotes tissue ingrowth and remodeling processes of the bone substitute. Extrinsic vessels contribute to faster vascularization and finally anastomose with intrinsic vasculature, allowing microvascular transplantation of the bone substitute after a shorter prevascularization time than using the intrinsic method only. It can be reasonably assumed that the usage of perforated chambers can significantly reduce the time until transplantation of bone constructs. Finally, this study paves the way for further preclinical testing for proof of the concept as a basis for early clinical applicability.

Vibration response imaging: protocol for a systematic review.

PubMed

Berry, Marc P; Camporota, Luigi; Ntoumenopoulos, George

2013-09-25

The concept of lung sounds conveying information regarding lung physiology has been used extensively in clinical practice, particularly with physical auscultation using a stethoscope. Advances in computer technology have facilitated the construction of dynamic visual images derived from recorded lung sounds. Arguably, the most significant progress in this field was the development of the commercially available vibration response imaging (VRI) (Deep Breeze Ltd, Or-Akiva, Israel). This device provides a non-invasive, dynamic image of both lungs constructed from sounds detected from the lungs using surface sensors. In the literature, VRI has been utilized in a multitude of clinical and research settings. This systematic review aims to address three study questions relating to whether VRI can be used as an evaluative device, whether the images generated can be characterized, and which tools and measures have been used to assess these images. This systematic review will involve implementing search strategies in five online journal databases in order to extract articles relating to the application of VRI. Appropriate articles will be identified against a set of pre-determined eligibility criteria and assessed for methodological quality using a standardized scale. Included articles will have data extracted by the reviewers using a standardized evidence table. A narrative synthesis based on a standardized framework will be conducted, clustering evidence into three main groups; one for each of the study questions. A meta-analysis will be conducted if two or more research articles meet pre-determined criteria that allow quantitative synthesis to take place. This systematic review aims to provide a complete overview of the scope of VRI in the clinical and research settings, as well as to discuss methods to interpret the data obtained from VRI. The systematic review intends to help clinicians to make informed decisions on the clinical applicability of the device, to allow researchers to identify further potential avenues of investigation, and to provide methods for the evaluation and interpretation of dynamic and static images. The publication and registration of this review with PROSPERO provides transparency and accountability, and facilitates the appraisal of the proposed systematic review against the original design. PROSPERO registration number: CRD42013003751.

10 CFR 50.90 - Application for amendment of license, construction permit, or early site permit.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., or early site permit. 50.90 Section 50.90 Energy NUCLEAR REGULATORY COMMISSION DOMESTIC LICENSING OF....90 Application for amendment of license, construction permit, or early site permit. Whenever a holder of a license, including a construction permit and operating license under this part, and an early...

10 CFR 50.90 - Application for amendment of license, construction permit, or early site permit.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., or early site permit. 50.90 Section 50.90 Energy NUCLEAR REGULATORY COMMISSION DOMESTIC LICENSING OF....90 Application for amendment of license, construction permit, or early site permit. Whenever a holder of a license, including a construction permit and operating license under this part, and an early...

The Use of Constructive Modeling and Virtual Simulation in Large-Scale Team Training: A Military Case Study.

ERIC Educational Resources Information Center

Andrews, Dee H.; Dineen, Toni; Bell, Herbert H.

1999-01-01

Discusses the use of constructive modeling and virtual simulation in team training; describes a military application of constructive modeling, including technology issues and communication protocols; considers possible improvements; and discusses applications in team-learning environments other than military, including industry and education. (LRW)

76 FR 58537 - In the Matter of Certain Personal Data and Mobile Communications Devices and Related Software...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-21

... subsystems. (HTC Pet. 30-35). (4) Whether the final ID's applications of the claim constructions for... below: (1) Whether the final ID's applications of the claim constructions for ``linking actions to the... has determined to review certain claim constructions, as well as the final ID's determinations...

Construction Project Performance Improvement through Radio Frequency Identification Technology Application on a Project Supply Chain

ERIC Educational Resources Information Center

Wang, Heng

2017-01-01

Construction project productivity typically lags other industries and it has been the focus of numerous studies in order to improve the project performance. This research investigated the application of Radio Frequency Identification (RFID) technology on construction projects' supply chain and determined that RFID technology can improve the…

The construction of power in family medicine bedside teaching: a video observation study.

PubMed

Rees, Charlotte E; Ajjawi, Rola; Monrouxe, Lynn V

2013-02-01

Bedside teaching is essential for helping students develop skills, reasoning and professionalism, and involves the learning triad of student, patient and clinical teacher. Although current rhetoric espouses the sharing of power, the medical workplace is imbued with power asymmetries. Power is context-specific and although previous research has explored some elements of the enactment and resistance of power within bedside teaching, this exploration has been conducted within hospital rather than general practice settings. Furthermore, previous research has employed audio-recorded rather than video-recorded observation and has therefore focused on language and para-language at the expense of non-verbal communication and human-material interaction. A qualitative design was adopted employing video- and audio-recorded observations of seven bedside teaching encounters (BTEs), followed by short individual interviews with students, patients and clinical teachers. Thematic and discourse analyses of BTEs were conducted. Power is constructed by students, patients and clinical teachers throughout different BTE activities through the use of linguistic, para-linguistic and non-verbal communication. In terms of language, participants construct power through the use of questions, orders, advice, pronouns and medical/health belief talk. With reference to para-language, participants construct power through the use of interruption and laughter. In terms of non-verbal communication, participants construct power through physical positioning and the possession or control of medical materials such as the stethoscope. Using this paper as a trigger for discussion, we encourage students and clinical teachers to reflect critically on how their verbal and non-verbal communication constructs power in bedside teaching. Students and clinical teachers need to develop their awareness of what power is, how it can be constructed and shared, and what it means for the student-patient-doctor relationship within bedside teaching. © Blackwell Publishing Ltd 2013.

MetaKTSP: a meta-analytic top scoring pair method for robust cross-study validation of omics prediction analysis.

PubMed

Kim, SungHwan; Lin, Chien-Wei; Tseng, George C

2016-07-01

Supervised machine learning is widely applied to transcriptomic data to predict disease diagnosis, prognosis or survival. Robust and interpretable classifiers with high accuracy are usually favored for their clinical and translational potential. The top scoring pair (TSP) algorithm is an example that applies a simple rank-based algorithm to identify rank-altered gene pairs for classifier construction. Although many classification methods perform well in cross-validation of single expression profile, the performance usually greatly reduces in cross-study validation (i.e. the prediction model is established in the training study and applied to an independent test study) for all machine learning methods, including TSP. The failure of cross-study validation has largely diminished the potential translational and clinical values of the models. The purpose of this article is to develop a meta-analytic top scoring pair (MetaKTSP) framework that combines multiple transcriptomic studies and generates a robust prediction model applicable to independent test studies. We proposed two frameworks, by averaging TSP scores or by combining P-values from individual studies, to select the top gene pairs for model construction. We applied the proposed methods in simulated data sets and three large-scale real applications in breast cancer, idiopathic pulmonary fibrosis and pan-cancer methylation. The result showed superior performance of cross-study validation accuracy and biomarker selection for the new meta-analytic framework. In conclusion, combining multiple omics data sets in the public domain increases robustness and accuracy of the classification model that will ultimately improve disease understanding and clinical treatment decisions to benefit patients. An R package MetaKTSP is available online. (http://tsenglab.biostat.pitt.edu/software.htm). ctseng@pitt.edu Supplementary data are available at Bioinformatics online. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

46 CFR 163.002-3 - Applicable technical regulations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Applicable technical regulations. 163.002-3 Section 163.002-3 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL CONSTRUCTION Pilot Hoist § 163.002-3 Applicable technical regulations...

Nanomaterials in the construction industry: a review of their applications and environmental health and safety considerations.

PubMed

Lee, Jaesang; Mahendra, Shaily; Alvarez, Pedro J J

2010-07-27

The extraordinary chemical and physical properties of materials at the nanometer scale enable novel applications ranging from structural strength enhancement and energy conservation to antimicrobial properties and self-cleaning surfaces. Consequently, manufactured nanomaterials (MNMs) and nanocomposites are being considered for various uses in the construction and related infrastructure industries. To achieve environmentally responsible nanotechnology in construction, it is important to consider the lifecycle impacts of MNMs on the health of construction workers and dwellers, as well as unintended environmental effects at all stages of manufacturing, construction, use, demolition, and disposal. Here, we review state-of-the-art applications of MNMs that improve conventional construction materials, suggest likely environmental release scenarios, and summarize potential adverse biological and toxicological effects and their mitigation. Aligned with multidisciplinary assessment of the environmental implications of emerging technologies, this review seeks to promote awareness of potential benefits of MNMs in construction and stimulate the development of guidelines to regulate their use and disposal to mitigate potential adverse effects on human and environmental health.

Value engineering awareness study for sustainable construction in Malaysia

NASA Astrophysics Data System (ADS)

U, Fathoni; M, Zakaria C.; O, Rohayu C.

2013-06-01

Construction process has often been described as a highly complex process because of the number of disciplines involved during the conceptual, design and construction stage. With the emergence of latest technology and concern for environment, increasing attention in construction industry is given on sustainability. Balance in quality and sustainability has become a major challenge to the construction industry. This paper presents a study that has conducted to determine the acceptance and application of Value Engineering (VE) and Life Cycle Cost Analysis (LCCA) in Malaysia construction industry. A set of questionnaire have distributed to different practitioners in construction industry and the result has reflect the fact that the application of VE and LCCA are still very low.

GPR application on construction foundation study

NASA Astrophysics Data System (ADS)

Amran, T. S. T.; Ismail, M. P.; Ismail, M. A.; Amin, M. S. M.; Ahmad, M. R.; Basri, N. S. M.

2017-11-01

Extensive researches and studies have been carried on radar system for commercialisation of ground penetrating radar (GPR) technology pioneered in construction, and thus claimed its rightful place in the vision of future. The application of ground penetrating radar in construction study is briefly reviewed. Based on previous experimentation and studies, this paper is focus on reinforcement bar (rebar) investigation on construction. The various data through previous references used to discuss and analyse the capability of ground penetrating radar for further improvement in construction projects especially in rebar placement in works.

Nanoscale platforms for messenger RNA delivery.

PubMed

Li, Bin; Zhang, Xinfu; Dong, Yizhou

2018-05-04

Messenger RNA (mRNA) has become a promising class of drugs for diverse therapeutic applications in the past few years. A series of clinical trials are ongoing or will be initiated in the near future for the treatment of a variety of diseases. Currently, mRNA-based therapeutics mainly focuses on ex vivo transfection and local administration in clinical studies. Efficient and safe delivery of therapeutically relevant mRNAs remains one of the major challenges for their broad applications in humans. Thus, effective delivery systems are urgently needed to overcome this limitation. In recent years, numerous nanoscale biomaterials have been constructed for mRNA delivery in order to protect mRNA from extracellular degradation and facilitate endosomal escape after cellular uptake. Nanoscale platforms have expanded the feasibility of mRNA-based therapeutics, and enabled its potential applications to protein replacement therapy, cancer immunotherapy, therapeutic vaccines, regenerative medicine, and genome editing. This review focuses on recent advances, challenges, and future directions in nanoscale platforms designed for mRNA delivery, including lipid and lipid-derived nanoparticles, polymer-based nanoparticles, protein derivatives mRNA complexes, and other types of nanomaterials. This article is categorized under: Nanotechnology Approaches to Biology > Nanoscale Systems in Biology Biology-Inspired Nanomaterials > Lipid-Based Structures Biology-Inspired Nanomaterials > Nucleic Acid-Based Structures. © 2018 Wiley Periodicals, Inc.

Translational Application of Microfluidics and Bioprinting for Stem Cell-Based Cartilage Repair

PubMed Central

Mondadori, Carlotta; Mainardi, Valerio Luca; Talò, Giuseppe; Candrian, Christian; Święszkowski, Wojciech

2018-01-01

Cartilage defects can impair the most elementary daily activities and, if not properly treated, can lead to the complete loss of articular function. The limitations of standard treatments for cartilage repair have triggered the development of stem cell-based therapies. In this scenario, the development of efficient cell differentiation protocols and the design of proper biomaterial-based supports to deliver cells to the injury site need to be addressed through basic and applied research to fully exploit the potential of stem cells. Here, we discuss the use of microfluidics and bioprinting approaches for the translation of stem cell-based therapy for cartilage repair in clinics. In particular, we will focus on the optimization of hydrogel-based materials to mimic the articular cartilage triggered by their use as bioinks in 3D bioprinting applications, on the screening of biochemical and biophysical factors through microfluidic devices to enhance stem cell chondrogenesis, and on the use of microfluidic technology to generate implantable constructs with a complex geometry. Finally, we will describe some new bioprinting applications that pave the way to the clinical use of stem cell-based therapies, such as scaffold-free bioprinting and the development of a 3D handheld device for the in situ repair of cartilage defects. PMID:29535776

Purpose-driven biomaterials research in liver-tissue engineering.

PubMed

Ananthanarayanan, Abhishek; Narmada, Balakrishnan Chakrapani; Mo, Xuejun; McMillian, Michael; Yu, Hanry

2011-03-01

Bottom-up engineering of microscale tissue ("microtissue") constructs to recapitulate partially the complex structure-function relationships of liver parenchyma has been realized through the development of sophisticated biomaterial scaffolds, liver-cell sources, and in vitro culture techniques. With regard to in vivo applications, the long-lived stem/progenitor cell constructs can improve cell engraftment, whereas the short-lived, but highly functional hepatocyte constructs stimulate host liver regeneration. With regard to in vitro applications, microtissue constructs are being adapted or custom-engineered into cell-based assays for testing acute, chronic and idiosyncratic toxicities of drugs or pathogens. Systems-level methods and computational models that represent quantitative relationships between biomaterial scaffolds, cells and microtissue constructs will further enable their rational design for optimal integration into specific biomedical applications. Copyright © 2010 Elsevier Ltd. All rights reserved.

41 CFR 60-250.1 - Purpose, applicability and construction.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Purpose, applicability and construction. 60-250.1 Section 60-250.1 Public Contracts and Property Management Other Provisions... OTHER PROTECTED VETERANS Preliminary Matters, Equal Opportunity Clause § 60-250.1 Purpose, applicability...

41 CFR 60-250.1 - Purpose, applicability and construction.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 41 Public Contracts and Property Management 1 2011-07-01 2009-07-01 true Purpose, applicability and construction. 60-250.1 Section 60-250.1 Public Contracts and Property Management Other Provisions... OTHER PROTECTED VETERANS Preliminary Matters, Equal Opportunity Clause § 60-250.1 Purpose, applicability...

41 CFR 60-250.1 - Purpose, applicability and construction.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 41 Public Contracts and Property Management 1 2013-07-01 2013-07-01 false Purpose, applicability and construction. 60-250.1 Section 60-250.1 Public Contracts and Property Management Other Provisions... OTHER PROTECTED VETERANS Preliminary Matters, Equal Opportunity Clause § 60-250.1 Purpose, applicability...

41 CFR 60-250.1 - Purpose, applicability and construction.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 41 Public Contracts and Property Management 1 2012-07-01 2009-07-01 true Purpose, applicability and construction. 60-250.1 Section 60-250.1 Public Contracts and Property Management Other Provisions... OTHER PROTECTED VETERANS Preliminary Matters, Equal Opportunity Clause § 60-250.1 Purpose, applicability...

Construction Biotechnology: a new area of biotechnological research and applications.

PubMed

Stabnikov, Viktor; Ivanov, Volodymyr; Chu, Jian

2015-09-01

A new scientific and engineering discipline, Construction Biotechnology, is developing exponentially during the last decade. The major directions of this discipline are selection of microorganisms and development of the microbially-mediated construction processes and biotechnologies for the production of construction biomaterials. The products of construction biotechnologies are low cost, sustainable, and environmentally friendly microbial biocements and biogrouts for the construction ground improvement. The microbial polysaccharides are used as admixtures for cement. Microbially produced biodegradable bioplastics can be used for the temporarily constructions. The bioagents that are used in construction biotechnologies are either pure or enrichment cultures of microorganisms or activated indigenous microorganisms of soil. The applications of microorganisms in the construction processes are bioaggregation, biocementation, bioclogging, and biodesaturation of soil. The biotechnologically produced construction materials and the microbially-mediated construction technologies have a lot of advantages in comparison with the conventional construction materials and processes. Proper practical implementations of construction biotechnologies could give significant economic and environmental benefits.

[Data Mining-revealed Characteristics of Clinical Application of Scalp Acupuncture].

PubMed

Wang, Qiong; Xing, Hai-Jiao; Bao, Na; Kong, Ling-Juan; Jia, Ye-Juan; Yang, Ke; Sun, Yan-Hui; Wang, Jian-Ling; Shi, Jing; Li, Xiao-Feng; Xu, Jing; Zhang, Xuan-Ping; Zhang, Xin; Jia, Chun-Sheng; Li, Ren-Ling

2018-03-25

To explore the regularity and characteristics of clinical application of scalp acupuncture therapy for different types of clinical conditions so as to provide a reference for clinical practice. In the present study, "head acupuncture" and"scalp acupuncture" were used as the keywords to search papers and academic dissertations having definite standards for diagnosis and therapeutic effect assessment and published in journals and academic conferences collected in database China National Knowledge Internet(CNKI) from January 1 of 1959 to December 31 of 2016, followed by constructing a database after sorting, screening, recording, extracting, and statistical analysis by using a computer. Then, the data mining was conducted for summarizing the indications of disease categories, involved medical departments, needle-insertion methods, needle manipulation techniques, academic schools, and clinical efficacy of scalp acupuncture therapy. As a result, a total of 587 papers met our including criteria were analyzed. The scalp acupuncture therapy was widely employed in the treatment of various clinical conditions of different departments, with the application frequency being the internal medicine (438 times), surgery (75 times), pediatrics (44 times), etc. Of the indicated 102 types of clinical problems, 55 belong to the internal medicine, constituting of 53.92%, particularly the cerebral apoplexy and its sequelae with the top application frequency being 102 and 115 times, respectively. In terms of needle inserting methods mentioned in partial papers (most papers do not mention), fingernail-pressing-aided needle insertion, needle-twirling insertion, fingers-squeezed-needle insertion, particularly the swiftly rotating needle insertion and rapid needle-propelling insertion were most commonly used.Regarding the needle manipulation method, rapid needle twirling technique was frequently employed, usually at a frequency of approximately 200 times per min. In regard to the academic schools, JIAO Shun-fa's scalp acupuncture system was most frequently used, followed by the international standardized scalp acupuncture. The therapeutic effect of scalp acupuncture is effective in the treatment of different conditions of various departments, especially those of the dermatology and gynecology. Scalp acupuncture has superiority in the treatment disorders of the internal medicine and has been demonstrated to have positive effects for many types of problems, particularly for apoplexy and its sequelae. Rapid needle-propelling insertion and rapid needle-twirling technique are often employed.

Prefabrication of 3D Cartilage Contructs: Towards a Tissue Engineered Auricle – A Model Tested in Rabbits

PubMed Central

von Bomhard, Achim; Veit, Johannes; Bermueller, Christian; Rotter, Nicole; Staudenmaier, Rainer; Storck, Katharina; The, Hoang Nguyen

2013-01-01

The reconstruction of an auricle for congenital deformity or following trauma remains one of the greatest challenges in reconstructive surgery. Tissue-engineered (TE) three-dimensional (3D) cartilage constructs have proven to be a promising option, but problems remain with regard to cell vitality in large cell constructs. The supply of nutrients and oxygen is limited because cultured cartilage is not vascular integrated due to missing perichondrium. The consequence is necrosis and thus a loss of form stability. The micro-surgical implantation of an arteriovenous loop represents a reliable technology for neovascularization, and thus vascular integration, of three-dimensional (3D) cultivated cell constructs. Auricular cartilage biopsies were obtained from 15 rabbits and seeded in 3D scaffolds made from polycaprolactone-based polyurethane in the shape and size of a human auricle. These cartilage cell constructs were implanted subcutaneously into a skin flap (15×8 cm) and neovascularized by means of vascular loops implanted micro-surgically. They were then totally enhanced as 3D tissue and freely re-implanted in-situ through microsurgery. Neovascularization in the prefabricated flap and cultured cartilage construct was analyzed by microangiography. After explantation, the specimens were examined by histological and immunohistochemical methods. Cultivated 3D cartilage cell constructs with implanted vascular pedicle promoted the formation of engineered cartilaginous tissue within the scaffold in vivo. The auricles contained cartilage-specific extracellular matrix (ECM) components, such as GAGs and collagen even in the center oft the constructs. In contrast, in cultivated 3D cartilage cell constructs without vascular pedicle, ECM distribution was only detectable on the surface compared to constructs with vascular pedicle. We demonstrated, that the 3D flaps could be freely transplanted. On a microangiographic level it was evident that all the skin flaps and the implanted cultivated constructs were well neovascularized. The presented method is suggested as a promising alternative towards clinical application of engineered cartilaginous tissue for plastic and reconstructive surgery. PMID:23951215

Prefabrication of 3D cartilage contructs: towards a tissue engineered auricle--a model tested in rabbits.

PubMed

von Bomhard, Achim; Veit, Johannes; Bermueller, Christian; Rotter, Nicole; Staudenmaier, Rainer; Storck, Katharina; The, Hoang Nguyen

2013-01-01

The reconstruction of an auricle for congenital deformity or following trauma remains one of the greatest challenges in reconstructive surgery. Tissue-engineered (TE) three-dimensional (3D) cartilage constructs have proven to be a promising option, but problems remain with regard to cell vitality in large cell constructs. The supply of nutrients and oxygen is limited because cultured cartilage is not vascular integrated due to missing perichondrium. The consequence is necrosis and thus a loss of form stability. The micro-surgical implantation of an arteriovenous loop represents a reliable technology for neovascularization, and thus vascular integration, of three-dimensional (3D) cultivated cell constructs. Auricular cartilage biopsies were obtained from 15 rabbits and seeded in 3D scaffolds made from polycaprolactone-based polyurethane in the shape and size of a human auricle. These cartilage cell constructs were implanted subcutaneously into a skin flap (15 × 8 cm) and neovascularized by means of vascular loops implanted micro-surgically. They were then totally enhanced as 3D tissue and freely re-implanted in-situ through microsurgery. Neovascularization in the prefabricated flap and cultured cartilage construct was analyzed by microangiography. After explantation, the specimens were examined by histological and immunohistochemical methods. Cultivated 3D cartilage cell constructs with implanted vascular pedicle promoted the formation of engineered cartilaginous tissue within the scaffold in vivo. The auricles contained cartilage-specific extracellular matrix (ECM) components, such as GAGs and collagen even in the center oft the constructs. In contrast, in cultivated 3D cartilage cell constructs without vascular pedicle, ECM distribution was only detectable on the surface compared to constructs with vascular pedicle. We demonstrated, that the 3D flaps could be freely transplanted. On a microangiographic level it was evident that all the skin flaps and the implanted cultivated constructs were well neovascularized. The presented method is suggested as a promising alternative towards clinical application of engineered cartilaginous tissue for plastic and reconstructive surgery.

Assessment of the five-factor model of personality.

PubMed

Widiger, T A; Trull, T J

1997-04-01

The five-factor model (FFM) of personality is obtaining construct validation, recognition, and practical consideration across a broad domain of fields, including clinical psychology, industrial-organizational psychology, and health psychology. As a result, an array of instruments have been developed and existing instruments are being modified to assess the FFM. In this article, we present an overview and critique of five such instruments (the Goldberg Big Five Markers, the revised NEO Personality Inventory, the Interpersonal Adjective Scales-Big Five, the Personality Psychopathology-Five, and the Hogan Personality Inventory), focusing in particular on their representation of the lexical FFM and their practical application.

Markov Analysis of Sleep Dynamics

NASA Astrophysics Data System (ADS)

Kim, J. W.; Lee, J.-S.; Robinson, P. A.; Jeong, D.-U.

2009-05-01

A new approach, based on a Markov transition matrix, is proposed to explain frequent sleep and wake transitions during sleep. The matrix is determined by analyzing hypnograms of 113 obstructive sleep apnea patients. Our approach shows that the statistics of sleep can be constructed via a single Markov process and that durations of all states have modified exponential distributions, in contrast to recent reports of a scale-free form for the wake stage and an exponential form for the sleep stage. Hypnograms of the same subjects, but treated with Continuous Positive Airway Pressure, are analyzed and compared quantitatively with the pretreatment ones, suggesting potential clinical applications.

Human Factors Simulation in Construction Management Education

ERIC Educational Resources Information Center

Jaeger, M.; Adair, D.

2010-01-01

Successful construction management depends primarily on the representatives of the involved construction project parties. In addition to effective application of construction management tools and concepts, human factors impact significantly on the processes of any construction management endeavour. How can human factors in construction management…

A unified procedure for meta-analytic evaluation of surrogate end points in randomized clinical trials

PubMed Central

Dai, James Y.; Hughes, James P.

2012-01-01

The meta-analytic approach to evaluating surrogate end points assesses the predictiveness of treatment effect on the surrogate toward treatment effect on the clinical end point based on multiple clinical trials. Definition and estimation of the correlation of treatment effects were developed in linear mixed models and later extended to binary or failure time outcomes on a case-by-case basis. In a general regression setting that covers nonnormal outcomes, we discuss in this paper several metrics that are useful in the meta-analytic evaluation of surrogacy. We propose a unified 3-step procedure to assess these metrics in settings with binary end points, time-to-event outcomes, or repeated measures. First, the joint distribution of estimated treatment effects is ascertained by an estimating equation approach; second, the restricted maximum likelihood method is used to estimate the means and the variance components of the random treatment effects; finally, confidence intervals are constructed by a parametric bootstrap procedure. The proposed method is evaluated by simulations and applications to 2 clinical trials. PMID:22394448

[Application of portfolio in teaching dermatology clinic: an experience in teaching of medicine].

PubMed

de Cabalier, M E; Chalub, D M

2009-01-01

We present a learning experience conducted in the Chair of Dermatology Clinic of the Faculty of Medical Sciences, National University of Cordoba in the context of curriculum change. For comprehension,present a theoretical framework and practical from the conceptualization of the "portfolio" teaching and its role teaching and learning paradigms sustained constructivist medical education. The portfolio Teach-ing is not a collection of papers, but a coherent set of experiences led thoughtful learning between teachers and students. This resource allows to account for the "qualitative achievements" of students from their work produced, sorted and evaluated in a carefully planned sequence of experiences and case Dermatology Clinic. To introduce the teaching portfolio, the planned new student grouping shapes and a sequence of learning experiences for the construction of this resource, namely: "The development of theoretical material iconographic resources and working guidelines for students. "The clinical reasoning on a case or laboratory experience-Clinical case Discussion and bibliography. -The development of records to from observation of patients. "The study of clinical cases: diagnosis and evolution of clinical cases. Interconsultations-Registration and referrals. "The magazine room and sharing experiences. In each of these, production, tutorial feedback Team teaching and assessment tasks allowed assessment approach to learning and improving he achievements of the students to the approval of the subject.

76 FR 6811 - Endangered and Threatened Wildlife and Plants; Permit; Construction and Operation of Kaheawa II...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-08

...] Endangered and Threatened Wildlife and Plants; Permit; Construction and Operation of Kaheawa II Wind Energy... application from Kaheawa Wind Power II, LLC (KWP II) for an incidental take permit (permit) under the... construction and operation of the KWP II wind energy facility on the island of Maui. The permit application...

40 CFR 60.1090 - What must I do with my revised materials separation plan?

Code of Federal Regulations, 2014 CFR

2014-07-01

... Performance for Small Municipal Waste Combustion Units for Which Construction is Commenced After August 30... Administrator by the date you submit the application for a construction permit under 40 CFR part 51, subpart I, or part 52. (If you are not required to submit an application for a construction permit under 40 CFR...

40 CFR 60.1090 - What must I do with my revised materials separation plan?

Code of Federal Regulations, 2012 CFR

2012-07-01

... Performance for Small Municipal Waste Combustion Units for Which Construction is Commenced After August 30... Administrator by the date you submit the application for a construction permit under 40 CFR part 51, subpart I, or part 52. (If you are not required to submit an application for a construction permit under 40 CFR...

Internalizing and Externalizing Personality Dimensions and Clinical Problems in Adolescents

ERIC Educational Resources Information Center

Hopwood, Christopher J.; Grilo, Carlos M.

2010-01-01

Ostensible psychiatric comorbidity can sometimes be explained by shared relations between diagnostic constructs and higher order internalizing and externalizing dimensions. However, this possibility has not been explored with regard to comorbidity between personality pathology and other clinical constructs in adolescents. In this study,…

10 CFR 2.604 - Notice of hearing on application for early review of site suitability issues in construction...

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Notice of hearing on application for early review of site... AGENCY RULES OF PRACTICE AND PROCEDURE Additional Procedures Applicable to Early Partial Decisions on... Early Partial Decisions on Site Suitability-Construction Permit § 2.604 Notice of hearing on application...

10 CFR 2.604 - Notice of hearing on application for early review of site suitability issues in construction...

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 1 2012-01-01 2012-01-01 false Notice of hearing on application for early review of site... Applicable to Early Partial Decisions on Site Suitability Issues in Connection With an Application for a... Limited Work Authorizations Early Partial Decisions on Site Suitability-Construction Permit § 2.604 Notice...

10 CFR 2.604 - Notice of hearing on application for early review of site suitability issues in construction...

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 1 2014-01-01 2014-01-01 false Notice of hearing on application for early review of site... AGENCY RULES OF PRACTICE AND PROCEDURE Additional Procedures Applicable to Early Partial Decisions on... Early Partial Decisions on Site Suitability-Construction Permit § 2.604 Notice of hearing on application...

10 CFR 2.604 - Notice of hearing on application for early review of site suitability issues in construction...

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Notice of hearing on application for early review of site... Applicable to Early Partial Decisions on Site Suitability Issues in Connection With an Application for a... Limited Work Authorizations Early Partial Decisions on Site Suitability-Construction Permit § 2.604 Notice...

10 CFR 2.604 - Notice of hearing on application for early review of site suitability issues in construction...

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Notice of hearing on application for early review of site... Applicable to Early Partial Decisions on Site Suitability Issues in Connection With an Application for a... Limited Work Authorizations Early Partial Decisions on Site Suitability-Construction Permit § 2.604 Notice...

46 CFR 388.3 - Application and fee.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., including geographic region of intended operation and trade. (iv) Date and place of construction and (if applicable) rebuilding. (If applicant is unable to document the origin of the vessel, foreign construction will be assumed). (v) Name, address, and telephone number of the vessel owner. (vi) A statement on the...

76 FR 19121 - Notice of Submission of Proposed Information Collection to OMB Multifamily Project Applications...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-06

... Proposed Information Collection to OMB Multifamily Project Applications and Construction Prior to Initial... facilities is also required as part of the application for firm commitment for mortgage insurance. Project owners/sponsors may apply for permission to commence construction prior to initial endorsement. DATES...

46 CFR 194.10-1 - Application.

Code of Federal Regulations, 2010 CFR

2010-10-01

... CONTROL OF EXPLOSIVES AND OTHER HAZARDOUS MATERIALS Magazines § 194.10-1 Application. (a) The provisions of this subpart apply to the construction of integral magazines, magazine vans, and magazine chests... construction of magazines shall be in accordance with the applicable provisions of 49 CFR parts 173 and 176 and...

Construct Validity: Advances in Theory and Methodology

PubMed Central

Strauss, Milton E.; Smith, Gregory T.

2008-01-01

Measures of psychological constructs are validated by testing whether they relate to measures of other constructs as specified by theory. Each test of relations between measures reflects on the validity of both the measures and the theory driving the test. Construct validation concerns the simultaneous process of measure and theory validation. In this chapter, we review the recent history of validation efforts in clinical psychological science that has led to this perspective, and we review five recent advances in validation theory and methodology of importance for clinical researchers. These are: the emergence of nonjustificationist philosophy of science; an increasing appreciation for theory and the need for informative tests of construct validity; valid construct representation in experimental psychopathology; the need to avoid representing multidimensional constructs with a single score; and the emergence of effective new statistical tools for the evaluation of convergent and discriminant validity. PMID:19086835

Evaluating measurement models in clinical research: covariance structure analysis of latent variable models of self-conception.

PubMed

Hoyle, R H

1991-02-01

Indirect measures of psychological constructs are vital to clinical research. On occasion, however, the meaning of indirect measures of psychological constructs is obfuscated by statistical procedures that do not account for the complex relations between items and latent variables and among latent variables. Covariance structure analysis (CSA) is a statistical procedure for testing hypotheses about the relations among items that indirectly measure a psychological construct and relations among psychological constructs. This article introduces clinical researchers to the strengths and limitations of CSA as a statistical procedure for conceiving and testing structural hypotheses that are not tested adequately with other statistical procedures. The article is organized around two empirical examples that illustrate the use of CSA for evaluating measurement models with correlated error terms, higher-order factors, and measured and latent variables.

Feedback in a clinical setting: A way forward to enhance student's learning through constructive feedback.

PubMed

Sultan, Amber Shamim; Mateen Khan, Muhammad Arif

2017-07-01

Feedback is considered as a dynamic process in which information about the observed performance is used to promote the desirable behaviour and correct the negative ones. The importance of feedback is widely acknowledged, but still there seems to be inconsistency in the amount, type and timing of feedback received from the clinical faculty. No significant effort has been put forward from the educator end to empower the learners with the skills of receiving and using the feedback effectively. Some institutions conduct faculty development workshops and courses to facilitate the clinicians on how best to deliver constructive feedback to the learners. Despite of all these struggles learners are not fully satisfied with the quality of feedback received from their busy clinicians. The aim of this paper is to highlight what actually feedback is, type and structure of feedback, the essential components of a constructive feedback, benefits of providing feedback, barriers affecting the provision of timely feedback and different models used for providing feedback. The ultimate purpose of this paper is to provide sufficient information to the clinical directors that there is a need to establish a robust system for giving feedback to learners and to inform all the clinical educators with the skills required to provide constructive feedback to their learners. For the literature review, we had used the key words glossary as: Feedback, constructive feedback, barriers to feedback, principles of constructive feedback, Models of feedback, reflection, self-assessment and clinical practice etc. The data bases for the search include: Cardiff University library catalogue, Pub Med, Google Scholar, Web of Knowledge and Science direct.

Reconciling Pairs of Concurrently Used Clinical Practice Guidelines Using Constraint Logic Programming

PubMed Central

Wilk, Szymon; Michalowski, Martin; Michalowski, Wojtek; Hing, Marisela Mainegra; Farion, Ken

2011-01-01

This paper describes a new methodological approach to reconciling adverse and contradictory activities (called points of contention) occurring when a patient is managed according to two or more concurrently used clinical practice guidelines (CPGs). The need to address these inconsistencies occurs when a patient with more than one disease, each of which is a comorbid condition, has to be managed according to different treatment regimens. We propose an automatic procedure that constructs a mathematical guideline model using the Constraint Logic Programming (CLP) methodology, uses this model to identify and mitigate encountered points of contention, and revises the considered CPGs accordingly. The proposed procedure is used as an alerting mechanism and coupled with a guideline execution engine warns the physician about potential problems with the concurrent application of two or more guidelines. We illustrate the operation of our procedure in a clinical scenario describing simultaneous use of CPGs for duodenal ulcer and transient ischemic attack. PMID:22195153

Easily configured real-time CPOE Pick Off Tool supporting focused clinical research and quality improvement.

PubMed

Rosenbaum, Benjamin P; Silkin, Nikolay; Miller, Randolph A

2014-01-01

Real-time alerting systems typically warn providers about abnormal laboratory results or medication interactions. For more complex tasks, institutions create site-wide 'data warehouses' to support quality audits and longitudinal research. Sophisticated systems like i2b2 or Stanford's STRIDE utilize data warehouses to identify cohorts for research and quality monitoring. However, substantial resources are required to install and maintain such systems. For more modest goals, an organization desiring merely to identify patients with 'isolation' orders, or to determine patients' eligibility for clinical trials, may adopt a simpler, limited approach based on processing the output of one clinical system, and not a data warehouse. We describe a limited, order-entry-based, real-time 'pick off' tool, utilizing public domain software (PHP, MySQL). Through a web interface the tool assists users in constructing complex order-related queries and auto-generates corresponding database queries that can be executed at recurring intervals. We describe successful application of the tool for research and quality monitoring.

Comparison of performance of computer display monitors for radiological diagnosis; "diagnostic" high brightness monochrome LCD, 3MP vs "clinical review" colour LCD, 2MP.

PubMed

Sim, L; Manthey, K; Stuckey, S

2007-06-01

A study to compare performance of the following display monitors for application as PACS CR diagnostic workstations is described. 1. Diagnostic quality, 3 Mega Pixel, 21 inch monochrome LCD monitors--Planar C3i. 2. Clinical review quality, 2 Mega Pixel, 21 inch colour LCD monitors--Planar PX212. Two sets of seventy radiological studies were presented to four senior radiologists on two occasions, using different displays on each occasion. The clinical condition used for this investigation was to query for the presence of a solitary pulmonary nodule. Receiver Operating Characteristic (ROC) curves were constructed for diagnostic performance for each presentation. Areas under the ROC curves (AUC) for diagnosis using different monitors were compared and the following results obtained: Monochrome AUC = 0.813 +/- 0.02, Colour AUC = 0.801 +/- 0.021. These results indicate that there is no statistically significant difference in the performance of these monitor types at a 95% confidence level.

Treatment selection in a randomized clinical trial via covariate-specific treatment effect curves.

PubMed

Ma, Yunbei; Zhou, Xiao-Hua

2017-02-01

For time-to-event data in a randomized clinical trial, we proposed two new methods for selecting an optimal treatment for a patient based on the covariate-specific treatment effect curve, which is used to represent the clinical utility of a predictive biomarker. To select an optimal treatment for a patient with a specific biomarker value, we proposed pointwise confidence intervals for each covariate-specific treatment effect curve and the difference between covariate-specific treatment effect curves of two treatments. Furthermore, to select an optimal treatment for a future biomarker-defined subpopulation of patients, we proposed confidence bands for each covariate-specific treatment effect curve and the difference between each pair of covariate-specific treatment effect curve over a fixed interval of biomarker values. We constructed the confidence bands based on a resampling technique. We also conducted simulation studies to evaluate finite-sample properties of the proposed estimation methods. Finally, we illustrated the application of the proposed method in a real-world data set.

The Mini Alcohol Craving Experience Questionnaire: Development and Clinical Application.

PubMed

Coates, Jason M; Gullo, Matthew J; Feeney, Gerald F X; Kavanagh, David J; Young, Ross McD; Dingle, Genevieve A; May, Jon; Andrade, Jackie; Statham, Dixie J; Connor, Jason P

2017-01-01

Standardized alcohol craving scales are rarely used outside of research environments despite recognized clinical utility. Scale length is a key barrier to more widespread application. A brief measure of alcohol craving is needed to improve research and treatment of alcohol use disorders (AUDs). Grounded in the Elaborated Intrusion Theory of Desire, the Alcohol Craving Experience (ACE) Questionnaire comprises two 11-item self-report scales that assess past-week frequency and maximum strength of alcohol craving. This study aimed to create a brief version of the ACE while maintaining psychometric integrity and clinical utility. Patients attending a university hospital alcohol and drug outpatient service for the treatment of AUD completed the ACE as part of a questionnaire battery. Three patient samples were utilized: 519 patients with pretreatment and outcome data, 228 patients with pretreatment data, and 66 patients who completed the ACE at treatment sessions 1 and 2. The Frequency scale of the ACE possessed greater clinical utility and predictive validity than the Strength scale. Revision of the Frequency measure produced a 5-item "Mini Alcohol Craving Experience" (MACE) Questionnaire. Satisfactory validity (construct, predictive, concurrent, convergent, and incremental) and reliability (internal and test-retest) were maintained. A 1 standard deviation increase in pretreatment MACE score was associated with a 54 percentage increase in the odds of patient lapse or dropout. The MACE provides a brief, theoretically, and psychometrically robust measure of alcohol craving suitable for use with AUD populations in time-limited clinical and research settings. Copyright © 2016 by the Research Society on Alcoholism.

Clinical Decision Support in Electronic Prescribing: Recommendations and an Action Plan

PubMed Central

Teich, Jonathan M.; Osheroff, Jerome A.; Pifer, Eric A.; Sittig, Dean F.; Jenders, Robert A.

2005-01-01

Clinical decision support (CDS) in electronic prescribing (eRx) systems can improve the safety, quality, efficiency, and cost-effectiveness of care. However, at present, these potential benefits have not been fully realized. In this consensus white paper, we set forth recommendations and action plans in three critical domains: (1) advances in system capabilities, including basic and advanced sets of CDS interventions and knowledge, supporting database elements, operational features to improve usability and measure performance, and management and governance structures; (2) uniform standards, vocabularies, and centralized knowledge structures and services that could reduce rework by vendors and care providers, improve dissemination of well-constructed CDS interventions, promote generally applicable research in CDS methods, and accelerate the movement of new medical knowledge from research to practice; and (3) appropriate financial and legal incentives to promote adoption. PMID:15802474

[Organic and psychogenic causes of psychopathology: co-construction between the brain and culture].

PubMed

Kanba, Shigenobu

2014-01-01

Rather than attempting to reduce findings to fit a particular standard of explanation, understanding into mental diseases should abandon the dichotomy between organic and psychogenic causes and instead investigate what can be explained at each level from genes, materials, cells and circuits across the spheres of psychology, society and culture, and focus on how findings can be clinically applied. Using this "pluralistic" approach, the author attempts herein to deepen understanding of mental disorders as diseases of mentality. The author depicts the process and significance of mental disorders and introduces the concept of "cultural affordance" while touching on a pathogenic framework comprising both organic and psychogenic causes, namely "culture" and "the brain". This approach has been little considered to date during psychopathological research when attempting to understand disease state and implement clinical application.

B-ALL minimal residual disease flow cytometry: an application of a novel method for optimization of a single-tube model.

PubMed

Shaver, Aaron C; Greig, Bruce W; Mosse, Claudio A; Seegmiller, Adam C

2015-05-01

Optimizing a clinical flow cytometry panel can be a subjective process dependent on experience. We develop a quantitative method to make this process more rigorous and apply it to B lymphoblastic leukemia/lymphoma (B-ALL) minimal residual disease (MRD) testing. We retrospectively analyzed our existing three-tube, seven-color B-ALL MRD panel and used our novel method to develop an optimized one-tube, eight-color panel, which was tested prospectively. The optimized one-tube, eight-color panel resulted in greater efficiency of time and resources with no loss in diagnostic power. Constructing a flow cytometry panel using a rigorous, objective, quantitative method permits optimization and avoids problems of interdependence and redundancy in a large, multiantigen panel. Copyright© by the American Society for Clinical Pathology.

The Positive and Negative Syndrome Scale (PANSS): A Three-Factor Model of Psychopathology in Marginally Housed Persons with Substance Dependence and Psychiatric Illness.

PubMed

Giesbrecht, Chantelle J; O'Rourke, Norm; Leonova, Olga; Strehlau, Verena; Paquet, Karine; Vila-Rodriguez, Fidel; Panenka, William J; MacEwan, G William; Smith, Geoffrey N; Thornton, Allen E; Honer, William G

2016-01-01

Rates of psychopathology are elevated in marginalized and unstably housed persons, underscoring the need for applicable clinical measures for these populations. The Positive and Negative Syndrome Scale (PANSS) is a clinical instrument principally developed for use in schizophrenia to identify the presence and severity of psychopathology symptoms. The current study investigates whether a reliable and valid PANSS factor structure emerges in a marginally housed, heterogeneous sample recruited from the Downtown Eastside of Vancouver where substance use disorders and psychiatric illness are pervasive. Participants (n = 270) underwent structured clinical assessments including the PANSS and then were randomly assigned to either exploratory (EFA) or confirmatory factor analytic (CFA) subsamples. EFA pointed to a novel three factor PANSS. This solution was supported by CFA. All retained items (28 out of 30) load significantly upon hypothesized factors and model goodness of fit analyses are in the acceptable to good range. Each of the three first-order factor constructs, labeled Psychosis/Disorganized, Negative Symptoms/Hostility, and Insight/Awareness, contributed significantly to measurement of a higher-order psychopathology construct. Further, the latent structure of this 3-factor solution appears temporally consistent over one-year. This PANSS factor structure appears valid and reliable for use in persons with multimorbidity, including substance use disorders. The structure is somewhat distinct from existing solutions likely due to the unique characteristics of this marginally housed sample.

The Positive and Negative Syndrome Scale (PANSS): A Three-Factor Model of Psychopathology in Marginally Housed Persons with Substance Dependence and Psychiatric Illness

PubMed Central

Giesbrecht, Chantelle J.; O’Rourke, Norm; Leonova, Olga; Strehlau, Verena; Paquet, Karine; Vila-Rodriguez, Fidel; Panenka, William J.; MacEwan, G. William; Smith, Geoffrey N.; Thornton, Allen E.; Honer, William G.

2016-01-01

Rates of psychopathology are elevated in marginalized and unstably housed persons, underscoring the need for applicable clinical measures for these populations. The Positive and Negative Syndrome Scale (PANSS) is a clinical instrument principally developed for use in schizophrenia to identify the presence and severity of psychopathology symptoms. The current study investigates whether a reliable and valid PANSS factor structure emerges in a marginally housed, heterogeneous sample recruited from the Downtown Eastside of Vancouver where substance use disorders and psychiatric illness are pervasive. Participants (n = 270) underwent structured clinical assessments including the PANSS and then were randomly assigned to either exploratory (EFA) or confirmatory factor analytic (CFA) subsamples. EFA pointed to a novel three factor PANSS. This solution was supported by CFA. All retained items (28 out of 30) load significantly upon hypothesized factors and model goodness of fit analyses are in the acceptable to good range. Each of the three first-order factor constructs, labeled Psychosis/Disorganized, Negative Symptoms/Hostility, and Insight/Awareness, contributed significantly to measurement of a higher-order psychopathology construct. Further, the latent structure of this 3-factor solution appears temporally consistent over one-year. This PANSS factor structure appears valid and reliable for use in persons with multimorbidity, including substance use disorders. The structure is somewhat distinct from existing solutions likely due to the unique characteristics of this marginally housed sample. PMID:26999280

Modification and identification of a vector for making a large phage antibody library.

PubMed

Zhang, Guo-min; Chen, Yü-ping; Guan, Yuan-zhi; Wang, Yan; An, Yun-qing

2007-11-20

The large phage antibody library is used to obtain high-affinity human antibody, and the Loxp/cre site-specific recombination system is a potential method for constructing a large phage antibody library. In the present study, a phage antibody library vector pDF was reconstructed to construct diabody more quickly and conveniently without injury to homologous recombination and the expression function of the vector and thus to integrate construction of the large phage antibody library with the preparation of diabodies. scFv was obtained by overlap polymerase chain reaction (PCR) amplification with the newly designed VL and VH extension primers. loxp511 was flanked by VL and VH and the endonuclease ACC III encoding sequences were introduced on both sides of loxp511. scFv was cloned into the vector pDF to obtain the vector pDscFv. The vector expression function was identified and the feasibility of diabody preparation was evaluated. A large phage antibody library was constructed in pDscFv. Several antigens were used to screen the antibody library and the quality of the antibody library was evaluated. The phage antibody library expression vector pDscFv was successfully constructed and confirmed to express functional scFv. The large phage antibody library constructed using this vector was of high diversity. Screening of the library on 6 antigens confirmed the generation of specific antibodies to these antigens. Two antibodies were subjected to enzymatic digestion and were prepared into diabody with functional expression. The reconstructed vector pDscFv retains its recombination capability and expression function and can be used to construct large phage antibody libraries. It can be used as a convenient and quick method for preparing diabodies after simple enzymatic digestion, which facilitates clinical trials and application of antibody therapy.

[Construction and practice on rational medication model of Chinese patent medicine for orthopedics based on ″symdrome-dosage-toxicity differentiation″ theory].

PubMed

Wang, Yu-Guang; Jin, Rui; Qiang, Si-Si; Lin, Zhi-Jian; Li, Hong-Yan; Lu, Shu; Kong, Xiang-Wen

2016-01-01

Chinese patent medicines for orthopedics are among the hotspot and difficulty in the rational medication of traditional Chinese medicine (TCM), because they mostly contain toxic medicinal herbs and oriented to special patients. According to the hospital pharmacy practices and the therapeutic theories of TCM, this paper focused on a novel model of rational drug use of Chinese patent medicine for orthopedics based on the principles of ″syndrome-dosage-toxicity differentiation″. We also proposed relevant specifications for guiding their clinical use. Firstly, we proposed a list of the primary clinical application characteristics for rational drug use of orthopedic TCMs, including the syndromes of patient, the dosage of medicine and the toxic ingredients in medicine. Secondly, a database was established for recording the package inserts of all of the 81 orthopedic patent medicines in our hospital, and 2 000 retrospective recipes were analyzed for looking for the high-frequency medicines and common irrational factors. Then clinical case reports involving the adverse reactions and side effects of related drugs were searched from CNKI, VIP and WanFang databases. Then the key information for rational application of each medicine was extracted from these resources and some survey questionnaires. Finally, we established a guide named instructions for clinical use of orthopedic Chinese patient medicines (ICUOCPM) after the discusstion with experts. According to the effect after the practice in hospital for 2 months, the proposed principles of ″syndrome-dosage-toxicity differentiation″ in this paper were believed to be the core elements and the most important clinical monitoring points in TCM for orthopedic patents. It would provide innovative ideas, theoretical guarantee and data support for the development of TCM clinical pharmacy. Copyright© by the Chinese Pharmaceutical Association.

Constructing diagnostic likelihood: clinical decisions using subjective versus statistical probability.

PubMed

Kinnear, John; Jackson, Ruth

2017-07-01

Although physicians are highly trained in the application of evidence-based medicine, and are assumed to make rational decisions, there is evidence that their decision making is prone to biases. One of the biases that has been shown to affect accuracy of judgements is that of representativeness and base-rate neglect, where the saliency of a person's features leads to overestimation of their likelihood of belonging to a group. This results in the substitution of 'subjective' probability for statistical probability. This study examines clinicians' propensity to make estimations of subjective probability when presented with clinical information that is considered typical of a medical condition. The strength of the representativeness bias is tested by presenting choices in textual and graphic form. Understanding of statistical probability is also tested by omitting all clinical information. For the questions that included clinical information, 46.7% and 45.5% of clinicians made judgements of statistical probability, respectively. Where the question omitted clinical information, 79.9% of clinicians made a judgement consistent with statistical probability. There was a statistically significant difference in responses to the questions with and without representativeness information (χ2 (1, n=254)=54.45, p<0.0001). Physicians are strongly influenced by a representativeness bias, leading to base-rate neglect, even though they understand the application of statistical probability. One of the causes for this representativeness bias may be the way clinical medicine is taught where stereotypic presentations are emphasised in diagnostic decision making. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Extended turn construction and test question sequences in the conversations of three speakers with agrammatic aphasia

PubMed Central

Beckley, Firle; Best, Wendy; Johnson, Fiona; Edwards, Susan; Maxim, Jane

2013-01-01

The application of Conversation Analysis (CA) to the investigation of agrammatic aphasia reveals that utterances produced by speakers with agrammatism engaged in everyday conversation differ significantly from utterances produced in response to decontextualised assessment and therapy tasks. Early studies have demonstrated that speakers with agrammatism construct turns from sequences of nouns, adjectives, discourse markers and conjunctions, packaged by a distinct pattern of prosody. This article presents examples of turn construction methods deployed by three people with agrammatism as they take an extended turn, in order to recount a past event, initiate a discussion or have a disagreement. This is followed by examples of sequences occurring in the talk of two of these speakers that result in different, and more limited, turn construction opportunities, namely “test” questions asked in order to initiate a new topic of talk, despite the conversation partner knowing the answer. The contrast between extended turns and test question sequences illustrates the effect of interactional context on aphasic turn construction practices, and the potential of less than optimal sequences to mask turn construction skills. It is suggested that the interactional motivation for test question sequences in these data are to invite people with aphasia to contribute to conversation, rather than to practise saying words in an attempt to improve language skills. The idea that test question sequences may have their origins in early attempts to deal with acute aphasia, and the potential for conversation partnerships to become “stuck” in such interactional patterns after they may have outlived their usefulness, are discussed with a view to clinical implications. PMID:23848370

Minor New Source Review Permit Application: Fluidic, Inc.

EPA Pesticide Factsheets

Federal Minor New Source Review New Construction Application for proposed construction of new equipment at an existing source at Fluidic's facility located at 8425 N. 9th Street, Suite #4, Scottsdale, Arizona 48258.

14 CFR 33.61 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: AIRCRAFT ENGINES Design and Construction; Turbine Aircraft Engines § 33.61 Applicability. This subpart prescribes additional design and construction requirements for turbine aircraft engines. ...

14 CFR 33.61 - Applicability.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: AIRCRAFT ENGINES Design and Construction; Turbine Aircraft Engines § 33.61 Applicability. This subpart prescribes additional design and construction requirements for turbine aircraft engines. ...

Automated Construction of Node Software Using Attributes in a Ubiquitous Sensor Network Environment

PubMed Central

Lee, Woojin; Kim, Juil; Kang, JangMook

2010-01-01

In sensor networks, nodes must often operate in a demanding environment facing restrictions such as restricted computing resources, unreliable wireless communication and power shortages. Such factors make the development of ubiquitous sensor network (USN) applications challenging. To help developers construct a large amount of node software for sensor network applications easily and rapidly, this paper proposes an approach to the automated construction of node software for USN applications using attributes. In the proposed technique, application construction proceeds by first developing a model for the sensor network and then designing node software by setting the values of the predefined attributes. After that, the sensor network model and the design of node software are verified. The final source codes of the node software are automatically generated from the sensor network model. We illustrate the efficiency of the proposed technique by using a gas/light monitoring application through a case study of a Gas and Light Monitoring System based on the Nano-Qplus operating system. We evaluate the technique using a quantitative metric—the memory size of execution code for node software. Using the proposed approach, developers are able to easily construct sensor network applications and rapidly generate a large number of node softwares at a time in a ubiquitous sensor network environment. PMID:22163678

Automated construction of node software using attributes in a ubiquitous sensor network environment.

PubMed

Lee, Woojin; Kim, Juil; Kang, JangMook

2010-01-01

In sensor networks, nodes must often operate in a demanding environment facing restrictions such as restricted computing resources, unreliable wireless communication and power shortages. Such factors make the development of ubiquitous sensor network (USN) applications challenging. To help developers construct a large amount of node software for sensor network applications easily and rapidly, this paper proposes an approach to the automated construction of node software for USN applications using attributes. In the proposed technique, application construction proceeds by first developing a model for the sensor network and then designing node software by setting the values of the predefined attributes. After that, the sensor network model and the design of node software are verified. The final source codes of the node software are automatically generated from the sensor network model. We illustrate the efficiency of the proposed technique by using a gas/light monitoring application through a case study of a Gas and Light Monitoring System based on the Nano-Qplus operating system. We evaluate the technique using a quantitative metric-the memory size of execution code for node software. Using the proposed approach, developers are able to easily construct sensor network applications and rapidly generate a large number of node softwares at a time in a ubiquitous sensor network environment.

Social Construction: Vistas in Clinical Child and Adolescent Psychology

ERIC Educational Resources Information Center

Gergen, Kenneth J.; Lightfoot, Cynthia; Sydow, Lisa

2004-01-01

We explore here the potentials of a social constructionist orientation to knowledge for research and clinical practice. Dialogues on social construction emphasize the communal origins of knowledge. They stress the cultural basis of knowledge claims, the significance of language, the value saturation of all knowledge, and the significance of…

What variables can influence clinical reasoning?

PubMed Central

Ashoorion, Vahid; Liaghatdar, Mohammad Javad; Adibi, Peyman

2012-01-01

Background: Clinical reasoning is one of the most important competencies that a physician should achieve. Many medical schools and licensing bodies try to predict it based on some general measures such as critical thinking, personality, and emotional intelligence. This study aimed at providing a model to design the relationship between the constructs. Materials and Methods: Sixty-nine medical students participated in this study. A battery test devised that consist four parts: Clinical reasoning measures, personality NEO inventory, Bar-On EQ inventory, and California critical thinking questionnaire. All participants completed the tests. Correlation and multiple regression analysis consumed for data analysis. Results: There is low to moderate correlations between clinical reasoning and other variables. Emotional intelligence is the only variable that contributes clinical reasoning construct (r=0.17-0.34) (R2 chnage = 0.46, P Value = 0.000). Conclusion: Although, clinical reasoning can be considered as a kind of thinking, no significant correlation detected between it and other constructs. Emotional intelligence (and its subscales) is the only variable that can be used for clinical reasoning prediction. PMID:23853636

Behavior-Based Multi-Robot Collaboration for Autonomous Construction Tasks

NASA Technical Reports Server (NTRS)

Stroupe, Ashley; Huntsberger, Terry; Okon, Avi; Aghazarian, Hrand; Robinson, Matthew

2005-01-01

We present a heterogeneous multi-robot system for autonomous construction of a structure through assembly of long components. Placement of a component within an existing structure in a realistic environment is demonstrated on a two-robot team. The task requires component acquisition, cooperative transport, and cooperative precision manipulation. Far adaptability, the system is designed as a behavior-based architecture. Far applicability to space-related construction efforts, computation, power, communication, and sensing are minimized, though the techniques developed are also applicable to terrestrial construction tasks.

Complementary construction of ideal nonimaging concentrators and its applications.

PubMed

Gordon, J M

1996-10-01

A construction principle for ideal nonimaging concentrators based on the complementary edge rays outside the nominal field of view is presented, with illustrations for the trumpet, compound parabolic concentrator, and compound hyperbolic concentrator. A simple string construction for the trumpet concentrator is shown to follow from this observation-the trumpet having been the one ideal concentrator for which no string-construction method had previously been noted. An application of these observations for solar concentrator design when nonisothermal receivers are advantageous is also presented.

[SIMBO: a Screening Instrument for Identification of Work-Related Disabilities--analyses of construct and prognostic validity].

PubMed

Streibelt, M; Gerwinn, H; Hansmeier, T; Thren, K; Müller-Fahrnow, W

2007-10-01

For a number of years, work-related interventions in medical rehabilitation (MBO) have been developed. Basically, these interventions concentrate on vocational problems of rehabilitees whose health disorders are strongly associated with contextual factors of the environment as well as personal factors. Previous studies showed a close relationship between the success of an intervention and identification of a specific demand. In fact there are several clinical concepts regarding specific demand. But there still is a lack of appropriate instruments for use in identification of occupational challenges. Therefore SIMBO (Screening Instrument for Identification of a Demand for Medical-Vocational Oriented Rehabilitation) has been developed recently. By using a scale for the intensity of work-related problems as well as a cut-off point, SIMBO is able to identify patients with and without a demand for work-related interventions. Analyses relative to construct validity and predictive validity were carried out on two different samples--a multi-clinic sample (patients with musculoskeletal disorders) and a sample from the German statutory pension insurance agency DRV Westfalen (successful applications for medical rehabilitation). In this context the cut-off level discussion is very important. By means of the multi-clinic sample--irrespective of cut-off definition--the SIMBO-decision and the clinical identification of MBO-demand were found to agree in 74-78% of the cases. This corresponds to a maximum adjusted correlation of r=0.59 (phi coefficient). Compared to the external ratings of vocational problems given by DRV staff in handling the applications, however, only little agreement is found (64%, r=0.25). In fact, SIMBO had in 77% (r=0.50) of the cases been able to correctly predict work-related problems to be expected. So the result obtained using this instrument is far better than prediction of these problems in the external ratings by DRV staff (54%, r=0,21). Also, return to work (RTW) in good health after six months can be predicted correctly by SIMBO in 77% of the cases. This means that the probability of RTW in good health is reduced by 90% (Odds Ratio=0.1) if work-related problems had been identified by SIMBO. Concerning its clinical as well as predictive quality, the validity of SIMBO-based ratings of work-related problems has been proven. Further, it has become obvious that SIMBO is suitable as an easy-to-handle tool for identification of a need for vocationally-focused interventions for use by the social insurance agencies which finance rehabilitation. Further interesting questions arise relative to application in different indications as well as potential uses as an outcome instrument.

A Neo-Piagetian Theory of Constructive Operators: Applications to Perceptual-Motor Development and Learning.

ERIC Educational Resources Information Center

Todor, John I.

The author presents an overview of Pascual-Leone's Theory of Constructive Operators, a process-structural theory based upon Piagetian constructs which has evolved to both explain and predict the temporal unfolding of behavior. An application is made of the theory to the demands of a discrete motor task and prediction of (a) the minimal age…

Assessment of the Lunar Surface Layer and in Situ Materials to Sustain Construction-related Applications

NASA Technical Reports Server (NTRS)

Johnson, Stewart W.; Chua, Koon Meng

1992-01-01

Present and future technologies to facilitate lunar composition and resource assessment with applications to lunar surface construction are presented. We are particularly interested in the construction activity associated with lunar-based astronomy. We address, as an example, the use of ground-probing radar to help assess subsurface conditions at sites for observatories and other facilities.

A modular approach to creating large engineered cartilage surfaces.

PubMed

Ford, Audrey C; Chui, Wan Fung; Zeng, Anne Y; Nandy, Aditya; Liebenberg, Ellen; Carraro, Carlo; Kazakia, Galateia; Alliston, Tamara; O'Connell, Grace D

2018-01-23

Native articular cartilage has limited capacity to repair itself from focal defects or osteoarthritis. Tissue engineering has provided a promising biological treatment strategy that is currently being evaluated in clinical trials. However, current approaches in translating these techniques to developing large engineered tissues remains a significant challenge. In this study, we present a method for developing large-scale engineered cartilage surfaces through modular fabrication. Modular Engineered Tissue Surfaces (METS) uses the well-known, but largely under-utilized self-adhesion properties of de novo tissue to create large scaffolds with nutrient channels. Compressive mechanical properties were evaluated throughout METS specimens, and the tensile mechanical strength of the bonds between attached constructs was evaluated over time. Raman spectroscopy, biochemical assays, and histology were performed to investigate matrix distribution. Results showed that by Day 14, stable connections had formed between the constructs in the METS samples. By Day 21, bonds were robust enough to form a rigid sheet and continued to increase in size and strength over time. Compressive mechanical properties and glycosaminoglycan (GAG) content of METS and individual constructs increased significantly over time. The METS technique builds on established tissue engineering accomplishments of developing constructs with GAG composition and compressive properties approaching native cartilage. This study demonstrated that modular fabrication is a viable technique for creating large-scale engineered cartilage, which can be broadly applied to many tissue engineering applications and construct geometries. Copyright © 2017 Elsevier Ltd. All rights reserved.

Exploring depressive personality traits in youth: origins, correlates, and developmental consequences.

PubMed

Rudolph, Karen D; Klein, Daniel N

2009-01-01

Research suggests that depressive personality (DP) disorder may represent a persistent, trait-based form of depression that lies along an affective spectrum ranging from personality traits to diagnosable clinical disorders. A significant gap in this area of research concerns the development of DP and its applicability to youth. The present research explored the construct of DP traits in youth. Specifically, this study examined the reliability, stability, and validity of the construct, potential origins of DP traits, and the developmental consequences of DP traits. A sample of 143 youth (mean age = 12.37 years, SD = 1.26) and their caregivers completed semistructured interviews and questionnaires on two occasions, separated by a 12-month interval. The measure of DP traits was reliable and moderately stable over time. Providing evidence of construct validity, DP traits were associated with a network of constructs, including a negative self-focus, high-negative and low-positive emotionality, and heightened stress reactivity. Moreover, several potential origins of DP traits were identified, including a history of family adversity, maternal DP traits, and maternal depression. Consistent with hypotheses regarding their developmental significance, DP traits predicted the generation of stress and the emergence of depression (but not nondepressive psychopathology) during the pubertal transition. Finally, depression predicted subsequent DP traits, suggesting a reciprocal process whereby DP traits heighten risk for depression, which then exacerbates these traits. These findings support the construct of DP traits in youth, and suggest that these traits may be a useful addition to developmental models of risk for youth depression.

Application and Mechanics Analysis of Multi-Function Construction Platforms in Prefabricated-Concrete Construction

NASA Astrophysics Data System (ADS)

Wang, Meihua; Li, Rongshuai; Zhang, Wenze

2017-11-01

Multi-function construction platforms (MCPs) as an “old construction technology, new application” of the building facade construction equipment, its efforts to reduce labour intensity, improve labour productivity, ensure construction safety, shorten the duration of construction and other aspects of the effect are significant. In this study, the functional analysis of the multi-function construction platforms is carried out in the construction of the assembly building. Based on the general finite element software ANSYS, the static calculation and dynamic characteristics analysis of the MCPs structure are analysed, the simplified finite element model is constructed, and the selection of the unit, the processing and solution of boundary are under discussion and research. The maximum deformation value, the maximum stress value and the structural dynamic characteristic model are obtained. The dangerous parts of the platform structure are analysed, too. Multiple types of MCPs under engineering construction conditions are calculated, so as to put forward the rationalization suggestions for engineering application of the MCPs.

Highly efficient local delivery of endothelial progenitor cells significantly potentiates angiogenesis and full-thickness wound healing.

PubMed

Wang, Chenggui; Wang, Qingqing; Gao, Wendong; Zhang, Zengjie; Lou, Yiting; Jin, Haiming; Chen, Xiaofeng; Lei, Bo; Xu, Huazi; Mao, Cong

2018-03-15

Wound therapy with a rapid healing performance remains a critical clinical challenge. Cellular delivery is considered to be a promising approach to improve the efficiency of healing, yet problems such as compromised cell viability and functionality arise due to the inefficient delivery. Here, we report the efficient delivery of endothelial progenitor cells (EPCs) with a bioactive nanofibrous scaffold (composed of collagen and polycaprolactone and bioactive glass nanoparticles, CPB) for enhancing wound healing. Under the stimulation of CPB nanofibrous system, the viability and angiogenic ability of EPCs were significantly enhanced through the activation of Hif-1α/VEGF/SDF-1α signaling. In vivo, CPB/EPC constructs significantly enhanced the formation of high-density blood vessels by greatly upregulating the expressions of Hif-1α, VEGF, and SDF-1α. Moreover, owing to the increased local delivery of cells and fast neovascularization within the wound site, cell proliferative activity, granulation tissue formation, and collagen synthesis and deposition were greatly promoted by CPB/EPC constructs resulting in rapid re-epithelialization and regeneration of skin appendages. As a result, the synergistic enhancement of wound healing was observed from CPB/EPC constructs, which suggests the highly efficient delivery of EPCs. CPB/EPC constructs may become highly competitive cell-based therapeutic products for efficient impaired wound healing application. This study may also provide a novel strategy to develop bioactive cell therapy constructs for angiogenesis-related regenerative medicine. This paper reported a highly efficient local delivery of EPCs using bioactive glass-based CPB nanofibrous scaffold for enhancing angiogenesis and wound regeneration. In vitro study showed that CPB can promote the proliferation, migration, and tube formation of EPCs through upregulation of the Hif-1α/VEGF/SDF-1α signaling pathway, indicating that the bioactivity and angiogenic ability of EPCs can be highly maintained and promoted by the CPB scaffold. Moreover, CPB/EPC constructs effectively stimulated the regeneration of diabetic wounds with satisfactory vascularization and better healing outcomes in a full-thickness wound model, suggesting that the highly efficient delivery of EPCs to wound site facilitates angiogenesis and further leads to wound healing. The high angiogenic capacity and excellent healing ability make CPB/EPC constructs highly competitive in cell-based therapeutic products for efficient wound repair application. Copyright © 2018 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

10 CFR 50.33 - Contents of applications; general information.

Code of Federal Regulations, 2010 CFR

2010-01-01

.... (e) The class of license applied for, the use to which the facility will be put, the period of time... applicable, the following should be provided: (1) If the application is for a construction permit, the... assurance of obtaining the funds necessary to cover estimated construction costs and related fuel cycle...

29 CFR 2200.2 - Scope of rules; applicability of Federal Rules of Civil Procedure; construction.

Code of Federal Regulations, 2010 CFR

2010-07-01

...; applicability of Federal Rules of Civil Procedure; construction. (a) Scope. These rules shall govern all proceedings before the Commission and its Judges. (b) Applicability of Federal Rules of Civil Procedure. In the absence of a specific provision, procedure shall be in accordance with the Federal Rules of Civil...

29 CFR 2200.2 - Scope of rules; applicability of Federal Rules of Civil Procedure; construction.

Code of Federal Regulations, 2011 CFR

2011-07-01

...; applicability of Federal Rules of Civil Procedure; construction. (a) Scope. These rules shall govern all proceedings before the Commission and its Judges. (b) Applicability of Federal Rules of Civil Procedure. In the absence of a specific provision, procedure shall be in accordance with the Federal Rules of Civil...

Bantu Applicative Construction Types Involving *-Id: Form, Functions and Diachrony

ERIC Educational Resources Information Center

Pacchiarotti, Sara

2016-01-01

This dissertation first addresses various shortcomings in definitions of "applicative" when compared to what is actually found across languages. It then proposes a four-way distinction among applicative constructions, relevant at least to Bantu, a large family of languages spoken in Sub-Saharan Africa. Because of the gradual nature of…

47 CFR 74.112 - Supplementary statement with application for construction permit.

Code of Federal Regulations, 2010 CFR

2010-10-01

... construction permit for any experimental broadcast station confirming the applicant's understanding: (a) That... notice or hearing. (e) That any authorization issued pursuant to the application may be cancelled at any time without notice or hearing, and will expire as a matter of law if the station fails to transmit...

Development of item bank to measure deliberate self-harm behaviours: facilitating tailored scales and computer adaptive testing for specific research and clinical purposes.

PubMed

Latimer, Shane; Meade, Tanya; Tennant, Alan

2014-07-30

The purpose of this study was to investigate the application of item banking to questionnaire items intended to measure Deliberate Self-Harm (DSH) behaviours. The Rasch measurement model was used to evaluate behavioural items extracted from seven published DSH scales administered to 568 Australians aged 18-30 years (62% university students, 21% mental health patients, and 17% community members). Ninety four items were calibrated in the item bank (including 12 items with differential item functioning for gender and age). Tailored scale construction was demonstrated by extracting scales covering different combinations of DSH methods but with the same raw score for each person location on the latent DSH construct. A simulated computer adaptive test (starting with common self-harm methods to minimise presentation of extreme behaviours) demonstrated that 11 items (on average) were needed to achieve a standard error of measurement of 0.387 (corresponding to a Cronbach׳s Alpha of 0.85). This study lays the groundwork for advancing DSH measurement to an item bank approach with the flexibility to measure a specific definitional orientation (e.g., non-suicidal self-injury) or a broad continuum of self-harmful acts, as appropriate to a particular research/clinical purpose. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Archetype Model-Driven Development Framework for EHR Web System.

PubMed

Kobayashi, Shinji; Kimura, Eizen; Ishihara, Ken

2013-12-01

This article describes the Web application framework for Electronic Health Records (EHRs) we have developed to reduce construction costs for EHR sytems. The openEHR project has developed clinical model driven architecture for future-proof interoperable EHR systems. This project provides the specifications to standardize clinical domain model implementations, upon which the ISO/CEN 13606 standards are based. The reference implementation has been formally described in Eiffel. Moreover C# and Java implementations have been developed as reference. While scripting languages had been more popular because of their higher efficiency and faster development in recent years, they had not been involved in the openEHR implementations. From 2007, we have used the Ruby language and Ruby on Rails (RoR) as an agile development platform to implement EHR systems, which is in conformity with the openEHR specifications. We implemented almost all of the specifications, the Archetype Definition Language parser, and RoR scaffold generator from archetype. Although some problems have emerged, most of them have been resolved. We have provided an agile EHR Web framework, which can build up Web systems from archetype models using RoR. The feasibility of the archetype model to provide semantic interoperability of EHRs has been demonstrated and we have verified that that it is suitable for the construction of EHR systems.

Three-Dimensional Bioprinting and Its Potential in the Field of Articular Cartilage Regeneration

PubMed Central

Mouser, Vivian H. M.; Levato, Riccardo; Bonassar, Lawrence J.; D’Lima, Darryl D.; Grande, Daniel A.; Klein, Travis J.; Saris, Daniel B. F.; Zenobi-Wong, Marcy; Gawlitta, Debby; Malda, Jos

2016-01-01

Three-dimensional (3D) bioprinting techniques can be used for the fabrication of personalized, regenerative constructs for tissue repair. The current article provides insight into the potential and opportunities of 3D bioprinting for the fabrication of cartilage regenerative constructs. Although 3D printing is already used in the orthopedic clinic, the shift toward 3D bioprinting has not yet occurred. We believe that this shift will provide an important step forward in the field of cartilage regeneration. Three-dimensional bioprinting techniques allow incorporation of cells and biological cues during the manufacturing process, to generate biologically active implants. The outer shape of the construct can be personalized based on clinical images of the patient’s defect. Additionally, by printing with multiple bio-inks, osteochondral or zonally organized constructs can be generated. Relevant mechanical properties can be obtained by hybrid printing with thermoplastic polymers and hydrogels, as well as by the incorporation of electrospun meshes in hydrogels. Finally, bioprinting techniques contribute to the automation of the implant production process, reducing the infection risk. To prompt the shift from nonliving implants toward living 3D bioprinted cartilage constructs in the clinic, some challenges need to be addressed. The bio-inks and required cartilage construct architecture need to be further optimized. The bio-ink and printing process need to meet the sterility requirements for implantation. Finally, standards are essential to ensure a reproducible quality of the 3D printed constructs. Once these challenges are addressed, 3D bioprinted living articular cartilage implants may find their way into daily clinical practice. PMID:28934880

[Innovation drive is the original motive force of discipline construction: the developing road of Department of Burns and Plastic Surgery in the 309th Hospital of PLA].

PubMed

Jia, C Y

2018-03-20

Discipline construction is a systematic project, covering clinic, teaching, scientific research, management, and humanity. Based on the perspective of innovation drive, from the aspects of discipline structure setting, specialized laboratory construction, sub-specialty formation, clinical characteristic and advantage formation, and management concept update, this article summarizes the growth process of Department of Burns and Plastic Surgery in the 309th Hospital of PLA.

50 CFR 29.21-5 - Construction.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false Construction. 29.21-5 Section 29.21-5... Construction. (a) If construction is not commenced within two (2) years after date of right-of-way grant, the...) Proof of construction: Upon completion of construction, the applicant shall file a certification of...

50 CFR 29.21-5 - Construction.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 50 Wildlife and Fisheries 9 2013-10-01 2013-10-01 false Construction. 29.21-5 Section 29.21-5... Construction. (a) If construction is not commenced within two (2) years after date of right-of-way grant, the...) Proof of construction: Upon completion of construction, the applicant shall file a certification of...

50 CFR 29.21-5 - Construction.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 50 Wildlife and Fisheries 9 2012-10-01 2012-10-01 false Construction. 29.21-5 Section 29.21-5... Construction. (a) If construction is not commenced within two (2) years after date of right-of-way grant, the...) Proof of construction: Upon completion of construction, the applicant shall file a certification of...

50 CFR 29.21-5 - Construction.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 50 Wildlife and Fisheries 8 2011-10-01 2011-10-01 false Construction. 29.21-5 Section 29.21-5... Construction. (a) If construction is not commenced within two (2) years after date of right-of-way grant, the...) Proof of construction: Upon completion of construction, the applicant shall file a certification of...

50 CFR 29.21-5 - Construction.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 50 Wildlife and Fisheries 9 2014-10-01 2014-10-01 false Construction. 29.21-5 Section 29.21-5... Construction. (a) If construction is not commenced within two (2) years after date of right-of-way grant, the...) Proof of construction: Upon completion of construction, the applicant shall file a certification of...

Developing a questionnaire to identify perceived barriers for implementing the Dutch physical therapy COPD clinical practice guideline.

PubMed

van der Wees, Philip J; Zagers, Cor A M; de Die, Sara E; Hendriks, Erik J M; Nijhuis-van der Sanden, Maria W G; de Bie, Rob A

2013-05-01

Clinical practice guidelines have been developed to assist healthcare practitioners in clinical decision making. Publication of clinical practice guidelines does not automatically lead to their uptake and barrier identification has been recognized as an important step in implementation planning. This study aimed at developing a questionnaire to identify perceived barriers for implementing the Dutch COPD guideline for physical therapists and its recommended measurement instruments. An overall questionnaire, based on two existing questionnaires, was constructed to identify barriers and facilitators for implementing the COPD guideline. The construct of the questionnaire was assessed in a cross-sectional study among 246 chest physical therapists. Factor analysis was conducted to explore underlying dimensions. Psychometric properties were analyzed using Cronbach's alpha. Barriers and facilitators were assessed using descriptive statistics. Some 139 physical therapists (57%) responded. Factor analysis revealed 4-factor and 5-factor solutions with an explained variance of 36% and 39% respectively. Cronbach's alpha of the overall questionnaire was 0.90, and varied from 0.66 to 0.92 for the different factors. Underlying domains of the 5-factor solution were characterized as: attitude towards using measurement instruments, knowledge and skills of the physical therapist, applicability of the COPD guideline, required investment of time & money, and patient characteristics. Physical therapists showed a positive attitude toward using the COPD guideline. Main barriers for implementation were required time investment and financial constraints. The construct of the questionnaire revealed relevant underlying domains for the identification of barriers and facilitators for implementing the COPD guideline. The questionnaire allowed for tailoring to the target group and may be used across health care professionals as basis for in-depth analysis of barriers to specific recommendations in guidelines. The results of the questionnaire alone do not provide sufficient information to inform the development of an implementation strategy. The infrastructure for developing the guideline can be used for addressing key barriers by the guideline development group, using the questionnaire as well as in-depth analysis such as focus group interviews. Further development of methods for prospective identification of barriers and consequent tailoring of implementation interventions is required.

Developing a questionnaire to identify perceived barriers for implementing the Dutch physical therapy COPD clinical practice guideline

PubMed Central

2013-01-01

Background Clinical practice guidelines have been developed to assist healthcare practitioners in clinical decision making. Publication of clinical practice guidelines does not automatically lead to their uptake and barrier identification has been recognized as an important step in implementation planning. This study aimed at developing a questionnaire to identify perceived barriers for implementing the Dutch COPD guideline for physical therapists and its recommended measurement instruments. Methods An overall questionnaire, based on two existing questionnaires, was constructed to identify barriers and facilitators for implementing the COPD guideline. The construct of the questionnaire was assessed in a cross-sectional study among 246 chest physical therapists. Factor analysis was conducted to explore underlying dimensions. Psychometric properties were analyzed using Cronbach’s alpha. Barriers and facilitators were assessed using descriptive statistics. Results Some 139 physical therapists (57%) responded. Factor analysis revealed 4-factor and 5-factor solutions with an explained variance of 36% and 39% respectively. Cronbach’s alpha of the overall questionnaire was 0.90, and varied from 0.66 to 0.92 for the different factors. Underlying domains of the 5-factor solution were characterized as: attitude towards using measurement instruments, knowledge and skills of the physical therapist, applicability of the COPD guideline, required investment of time & money, and patient characteristics. Physical therapists showed a positive attitude toward using the COPD guideline. Main barriers for implementation were required time investment and financial constraints. Conclusions The construct of the questionnaire revealed relevant underlying domains for the identification of barriers and facilitators for implementing the COPD guideline. The questionnaire allowed for tailoring to the target group and may be used across health care professionals as basis for in-depth analysis of barriers to specific recommendations in guidelines. The results of the questionnaire alone do not provide sufficient information to inform the development of an implementation strategy. The infrastructure for developing the guideline can be used for addressing key barriers by the guideline development group, using the questionnaire as well as in-depth analysis such as focus group interviews. Further development of methods for prospective identification of barriers and consequent tailoring of implementation interventions is required. PMID:23631555

Adipose and mammary epithelial tissue engineering.

PubMed

Zhu, Wenting; Nelson, Celeste M

2013-01-01

Breast reconstruction is a type of surgery for women who have had a mastectomy, and involves using autologous tissue or prosthetic material to construct a natural-looking breast. Adipose tissue is the major contributor to the volume of the breast, whereas epithelial cells comprise the functional unit of the mammary gland. Adipose-derived stem cells (ASCs) can differentiate into both adipocytes and epithelial cells and can be acquired from autologous sources. ASCs are therefore an attractive candidate for clinical applications to repair or regenerate the breast. Here we review the current state of adipose tissue engineering methods, including the biomaterials used for adipose tissue engineering and the application of these techniques for mammary epithelial tissue engineering. Adipose tissue engineering combined with microfabrication approaches to engineer the epithelium represents a promising avenue to replicate the native structure of the breast.

Adipose and mammary epithelial tissue engineering

PubMed Central

Zhu, Wenting; Nelson, Celeste M.

2013-01-01

Breast reconstruction is a type of surgery for women who have had a mastectomy, and involves using autologous tissue or prosthetic material to construct a natural-looking breast. Adipose tissue is the major contributor to the volume of the breast, whereas epithelial cells comprise the functional unit of the mammary gland. Adipose-derived stem cells (ASCs) can differentiate into both adipocytes and epithelial cells and can be acquired from autologous sources. ASCs are therefore an attractive candidate for clinical applications to repair or regenerate the breast. Here we review the current state of adipose tissue engineering methods, including the biomaterials used for adipose tissue engineering and the application of these techniques for mammary epithelial tissue engineering. Adipose tissue engineering combined with microfabrication approaches to engineer the epithelium represents a promising avenue to replicate the native structure of the breast. PMID:23628872

Modelling Framework and Assistive Device for Peripheral Intravenous Injections

NASA Astrophysics Data System (ADS)

Kam, Kin F.; Robinson, Martin P.; Gilbert, Mathew A.; Pelah, Adar

2016-02-01

Intravenous access for blood sampling or drug administration that requires peripheral venepuncture is perhaps the most common invasive procedure practiced in hospitals, clinics and general practice surgeries.We describe an idealised mathematical framework for modelling the dynamics of the peripheral venepuncture process. Basic assumptions of the model are confirmed through motion analysis of needle trajectories during venepuncture, taken from video recordings of a skilled practitioner injecting into a practice kit. The framework is also applied to the design and construction of a proposed device for accurate needle guidance during venepuncture administration, assessed as consistent and repeatable in application and does not lead to over puncture. The study provides insights into the ubiquitous peripheral venepuncture process and may contribute to applications in training and in the design of new devices, including for use in robotic automation.

Medical subdomain classification of clinical notes using a machine learning-based natural language processing approach.

PubMed

Weng, Wei-Hung; Wagholikar, Kavishwar B; McCray, Alexa T; Szolovits, Peter; Chueh, Henry C

2017-12-01

The medical subdomain of a clinical note, such as cardiology or neurology, is useful content-derived metadata for developing machine learning downstream applications. To classify the medical subdomain of a note accurately, we have constructed a machine learning-based natural language processing (NLP) pipeline and developed medical subdomain classifiers based on the content of the note. We constructed the pipeline using the clinical NLP system, clinical Text Analysis and Knowledge Extraction System (cTAKES), the Unified Medical Language System (UMLS) Metathesaurus, Semantic Network, and learning algorithms to extract features from two datasets - clinical notes from Integrating Data for Analysis, Anonymization, and Sharing (iDASH) data repository (n = 431) and Massachusetts General Hospital (MGH) (n = 91,237), and built medical subdomain classifiers with different combinations of data representation methods and supervised learning algorithms. We evaluated the performance of classifiers and their portability across the two datasets. The convolutional recurrent neural network with neural word embeddings trained-medical subdomain classifier yielded the best performance measurement on iDASH and MGH datasets with area under receiver operating characteristic curve (AUC) of 0.975 and 0.991, and F1 scores of 0.845 and 0.870, respectively. Considering better clinical interpretability, linear support vector machine-trained medical subdomain classifier using hybrid bag-of-words and clinically relevant UMLS concepts as the feature representation, with term frequency-inverse document frequency (tf-idf)-weighting, outperformed other shallow learning classifiers on iDASH and MGH datasets with AUC of 0.957 and 0.964, and F1 scores of 0.932 and 0.934 respectively. We trained classifiers on one dataset, applied to the other dataset and yielded the threshold of F1 score of 0.7 in classifiers for half of the medical subdomains we studied. Our study shows that a supervised learning-based NLP approach is useful to develop medical subdomain classifiers. The deep learning algorithm with distributed word representation yields better performance yet shallow learning algorithms with the word and concept representation achieves comparable performance with better clinical interpretability. Portable classifiers may also be used across datasets from different institutions.

Psychometric properties of the Activities-specific Balance Confidence Scale among individuals with a lower-limb amputation.

PubMed

Miller, William C; Deathe, A Barry; Speechley, Mark

2003-05-01

To evaluate the internal consistency, test-retest reliability, and construct validity of the Activities-specific Balance Confidence (ABC) Scale among people who have a lower-limb amputation. Retest design. A university-affiliated outpatient amputee clinic in Ontario. Two samples of individuals who have unilateral transtibial and transfemoral amputation. Sample 1 (n=54) was a consecutive and sample 2 (n=329) a convenience sample of all members of the clinic population. Not applicable. Repeated application of the ABC Scale, a 16-item questionnaire that assesses confidence in performing various mobility-related tasks. Correlation to test hypothesized relationships between the ABC Scale and the 2-minute walk (2MWT) and the timed up-and-go (TUG) tests; and assessment of the ability of the ABC Scale to discriminate among groups based on amputation cause, amputation level, mobility device use, automatic stepping ability, wearing time, stair climbing ability, and walking distance. Test-retest reliability (intraclass correlation coefficient) of the ABC Scale was .91 (95% confidence interval [CI], .84-.95) with individual item test-retest coefficients ranging from .53 to .87. Internal consistency, measured by Cronbach alpha, was .95. Hypothesized associations with the 2MWT and TUG test were observed with correlations of .72 (95% CI, .56-.84) and -.70 (95% CI, -.82 to -.53), respectively. The ABC Scale discriminated between all groups except those based on amputation level. Balance confidence, as measured by the ABC Scale, is a construct that provides unique information potentially useful to clinicians who provide amputee rehabilitation. The ABC Scale is reliable, with strong support for validity. Study of the scale's responsiveness is recommended.

Emerging trends and new developments in regenerative medicine: a scientometric update (2000 - 2014).

PubMed

Chen, Chaomei; Dubin, Rachael; Kim, Meen Chul

2014-09-01

Our previous scientometric review of regenerative medicine provides a snapshot of the fast-growing field up to the end of 2011. The new review identifies emerging trends and new developments appearing in the literature of regenerative medicine based on relevant articles and reviews published between 2000 and the first month of 2014. Multiple datasets of publications relevant to regenerative medicine are constructed through topic search and citation expansion to ensure adequate coverage of the field. Networks of co-cited references representing the literature of regenerative medicine are constructed and visualized based on a combined dataset of 71,393 articles published between 2000 and 2014. Structural and temporal dynamics are identified in terms of most active topical areas and cited references. New developments are identified in terms of newly emerged clusters and research areas. Disciplinary-level patterns are visualized in dual-map overlays. While research in induced pluripotent stem cells remains the most prominent area in the field of regenerative medicine, research related to clinical and therapeutic applications in regenerative medicine has experienced a considerable growth. In addition, clinical and therapeutic developments in regenerative medicine have demonstrated profound connections with the induced pluripotent stem cell research and stem cell research in general. A rapid adaptation of graphene-based nanomaterials in regenerative medicine is evident. Both basic research represented by stem cell research and application-oriented research typically found in tissue engineering are now increasingly integrated in the scientometric landscape of regenerative medicine. Tissue engineering is an interdisciplinary field in its own right. Advances in multiple disciplines such as stem cell research and graphene research have strengthened the connections between tissue engineering and regenerative medicine.

A Review of Application Building Information Modeling (BIM) During Pre-Construction Stage: Retrospective and Future Directions

NASA Astrophysics Data System (ADS)

Edra Nisa Lau, Santi; Zakaria, Rozana; Aminudin, Eeydzah; Saar, Chai Chang; Yusof, Aswadi; Fatihi Hafifi Che Wahid, Che Muhammad

2018-04-01

Pre-construction is one of the biggest areas of risk and uncertainty in construction project as it deals with subsurface ground conditions information. The amount of detail data needed in pre-construction especially for existing data modelling and site analysis should be sufficient enough to ensure that significant risks could not reasonably be anticipated. Current practicing method in interpreting data during this stage tasks reveal limitation. Construction industry faced many obstacles due to the depends on the traditional practice; paper-based document which missing and redundant data always happened. In recent years, there has been a shift in construction where people move to BIM application because of its potential to reduce the problem faced by infrastructure world. BIM has become a successful technology and widely popular in the construction world especially in developed countries because of its potential. Nowadays, people are moving one step ahead in BIM which is adoption of BIM during pre-construction stage. Thus, this paper review studies centered on BIM-integrated modelling during preconstruction stage. But there is lack of practical researches have been made during this stage. Although a large number of studies on BIM have been conducted in the past decade, a lack of consensus remains among researchers and practitioners regarding the applications of BIM during pre-construction stage, the availability of subsequent data integration tool for geotechnical activity. A comprehensive literature review was conducted for data collection and analysis. After in-depth review of journal articles widely cover the application of BIM, this study summarizes an overview and critical reflection of geotechnical data integration using BIM during pre-construction stage. The results are useful for the identification of research clusters and topics in the BIM community.

A low-cost bioprosthetic semilunar valve for research, disease modelling and surgical training applications.

PubMed

Rosa, Benoit; Machaidze, Zurab; Shin, Borami; Manjila, Sunil; Brown, David W; Baird, Christopher W; Mayer, John E; Dupont, Pierre E

2017-11-01

This paper provides detailed instructions for constructing low-cost bioprosthetic semilunar valves for animal research and clinical training. This work fills an important gap between existing simulator training valves and clinical valves by providing fully functioning designs that can be employed in ex vivo and in vivo experiments and can also be modified to model valvular disease. Valves are constructed in 4 steps consisting of creating a metal frame, covering it with fabric and attaching a suture ring and leaflets. Computer-aided design files are provided for making the frame from wire or by metal 3D printing. The covering fabric and suturing ring are made from materials readily available in a surgical lab, while the leaflets are made from pericardium. The entire fabrication process is described in figures and in a video. To demonstrate disease modelling, design modifications are described for producing paravalvular leaks, and these valves were evaluated in porcine ex vivo (n = 3) and in vivo (n = 6) experiments. Porcine ex vivo and acute in vivo experiments demonstrate that the valves can replicate the performance of clinical valves for research and training purposes. Surgical implantation is similar, and echocardiograms are comparable to clinical valves. Furthermore, valve leaflet function was satisfactory during acute in vivo tests with little central regurgitation, while the paravalvular leak modifications consistently produced leaks in the desired locations. The detailed design procedure presented here, which includes a tutorial video and computer-aided design files, should be of substantial benefit to researchers developing valve disease models and to clinicians developing realistic valve training systems. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

NASA wiring for space applications program

NASA Technical Reports Server (NTRS)

Schulze, Norman

1995-01-01

An overview of the NASA Wiring for Space Applications Program and its relationship to NASA's space technology enterprise is given in viewgraph format. The mission of the space technology enterprise is to pioneer, with industry, the development and use of space technology to secure national economic competitiveness, promote industrial growth, and to support space missions. The objectives of the NASA Wiring for Space Applications Program is to improve the safety, performance, and reliability of wiring systems for space applications and to develop improved wiring technologies for NASA flight programs and commercial applications. Wiring system failures in space and commercial applications have shown the need for arc track resistant wiring constructions. A matrix of tests performed versus wiring constructions is presented. Preliminary data indicate the performance of the Tensolite and Filotex hybrid constructions are the best of the various candidates.

Construction of estimated flow- and load-duration curves for Kentucky using the Water Availability Tool for Environmental Resources (WATER)

USGS Publications Warehouse

Unthank, Michael D.; Newson, Jeremy K.; Williamson, Tanja N.; Nelson, Hugh L.

2012-01-01

Flow- and load-duration curves were constructed from the model outputs of the U.S. Geological Survey's Water Availability Tool for Environmental Resources (WATER) application for streams in Kentucky. The WATER application was designed to access multiple geospatial datasets to generate more than 60 years of statistically based streamflow data for Kentucky. The WATER application enables a user to graphically select a site on a stream and generate an estimated hydrograph and flow-duration curve for the watershed upstream of that point. The flow-duration curves are constructed by calculating the exceedance probability of the modeled daily streamflows. User-defined water-quality criteria and (or) sampling results can be loaded into the WATER application to construct load-duration curves that are based on the modeled streamflow results. Estimates of flow and streamflow statistics were derived from TOPographically Based Hydrological MODEL (TOPMODEL) simulations in the WATER application. A modified TOPMODEL code, SDP-TOPMODEL (Sinkhole Drainage Process-TOPMODEL) was used to simulate daily mean discharges over the period of record for 5 karst and 5 non-karst watersheds in Kentucky in order to verify the calibrated model. A statistical evaluation of the model's verification simulations show that calibration criteria, established by previous WATER application reports, were met thus insuring the model's ability to provide acceptably accurate estimates of discharge at gaged and ungaged sites throughout Kentucky. Flow-duration curves are constructed in the WATER application by calculating the exceedence probability of the modeled daily flow values. The flow-duration intervals are expressed as a percentage, with zero corresponding to the highest stream discharge in the streamflow record. Load-duration curves are constructed by applying the loading equation (Load = Flow*Water-quality criterion) at each flow interval.

Mkit: A cell migration assay based on microfluidic device and smartphone.

PubMed

Yang, Ke; Wu, Jiandong; Peretz-Soroka, Hagit; Zhu, Ling; Li, Zhigang; Sang, Yaoshuo; Hipolito, Jolly; Zhang, Michael; Santos, Susy; Hillier, Craig; de Faria, Ricardo Lobato; Liu, Yong; Lin, Francis

2018-01-15

Mobile sensing based on the integration of microfluidic device and smartphone, so-called MS 2 technology, has enabled many applications over recent years, and continues to stimulate growing interest in both research communities and industries. In particular, it has been envisioned that MS 2 technology can be developed for various cell functional assays to enable basic research and clinical applications. Toward this direction, in this paper, we describe the development of a MS 2 -based cell functional assay for testing cell migration (the M kit ). The system is constructed as an integrated test kit, which includes microfluidic chips, a smartphone-based imaging platform, the phone apps for image capturing and data analysis, and a set of reagent and accessories for performing the cell migration assay. We demonstrated that the M kit can effectively measure purified neutrophil and cancer cell chemotaxis. Furthermore, neutrophil chemotaxis can be tested from a drop of whole blood using the M kit with red blood cell (RBC) lysis. The effects of chemoattractant dose and gradient profile on neutrophil chemotaxis were also tested using the M kit . In addition to research applications, we demonstrated the effective use of the M kit for on-site test at the hospital and for testing clinical samples from chronic obstructive pulmonary disease patient. Thus, this developed M kit provides an easy and integrated experimental platform for cell migration related research and potential medical diagnostic applications. Copyright © 2017 Elsevier B.V. All rights reserved.

Design and testing of prototype handheld scanning probes for optical coherence tomography

PubMed Central

Demian, Dorin; Sinescu, Cosmin; Negrutiu, Meda Lavinia; Cernat, Ramona; Topala, Florin Ionel; Hutiu, Gheorghe; Bradu, Adrian; Podoleanu, Adrian Gh

2014-01-01

Three simple and low-cost configurations of handheld scanning probes for optical coherence tomography have been developed. Their design and testing for dentistry applications are presented. The first two configurations were built exclusively from available off-the-shelf optomechanical components, which, to the best of our knowledge, are the first designs of this type. The third configuration includes these components in an optimized and ergonomic probe. All the designs are presented in detail to allow for their duplication in any laboratory with a minimum effort, for applications that range from educational to high-end clinical investigations. Requirements that have to be fulfilled to achieve configurations which are reliable, ergonomic—for clinical environments, and easy to build are presented. While a range of applications is possible for the prototypes developed, in this study the handheld probes are tested ex vivo with a spectral domain optical coherence tomography system built in-house, for dental constructs. A previous testing with a swept source optical coherence tomography system has also been performed both in vivo and ex vivo for ear, nose, and throat—in a medical environment. The applications use the capability of optical coherence tomography to achieve real-time, high-resolution, non-contact, and non-destructive interferometric investigations with micrometer resolutions and millimeter penetration depth inside the sample. In this study, testing the quality of the material of one of the most used types of dental prosthesis, metalo-ceramic is thus demonstrated. PMID:25107512

Design and testing of prototype handheld scanning probes for optical coherence tomography.

PubMed

Demian, Dorin; Duma, Virgil-Florin; Sinescu, Cosmin; Negrutiu, Meda Lavinia; Cernat, Ramona; Topala, Florin Ionel; Hutiu, Gheorghe; Bradu, Adrian; Podoleanu, Adrian Gh

2014-08-01

Three simple and low-cost configurations of handheld scanning probes for optical coherence tomography have been developed. Their design and testing for dentistry applications are presented. The first two configurations were built exclusively from available off-the-shelf optomechanical components, which, to the best of our knowledge, are the first designs of this type. The third configuration includes these components in an optimized and ergonomic probe. All the designs are presented in detail to allow for their duplication in any laboratory with a minimum effort, for applications that range from educational to high-end clinical investigations. Requirements that have to be fulfilled to achieve configurations which are reliable, ergonomic-for clinical environments, and easy to build are presented. While a range of applications is possible for the prototypes developed, in this study the handheld probes are tested ex vivo with a spectral domain optical coherence tomography system built in-house, for dental constructs. A previous testing with a swept source optical coherence tomography system has also been performed both in vivo and ex vivo for ear, nose, and throat-in a medical environment. The applications use the capability of optical coherence tomography to achieve real-time, high-resolution, non-contact, and non-destructive interferometric investigations with micrometer resolutions and millimeter penetration depth inside the sample. In this study, testing the quality of the material of one of the most used types of dental prosthesis, metalo-ceramic is thus demonstrated. © IMechE 2014.

One-pot synthesis of NiO/Mn2O3 nanoflake arrays and their application in electrochemical biosensing

NASA Astrophysics Data System (ADS)

Wang, Yao; Cui, Jiewu; Luo, Lan; Zhang, Jingcheng; Wang, Yan; Qin, Yongqiang; Zhang, Yong; Shu, Xia; Lv, Jun; Wu, Yucheng

2017-11-01

The exploration of novel nanomaterials employed as substrate to construct glucose biosensors is still of significance in the field of clinical diagnosis. In this work, NiO/Mn2O3 nanoflake arrays were synthesized by hydrothermal approach in combination with calcination process. As-prepared NiO/Mn2O3 nanoflake arrays were utilized to construct electrochemical biosensors for glucose detection. NiO/Mn2O3 nanoflake arrays were investigated systematically by scanning electron microscopy (SEM), X-ray diffractionmeter (XRD), transmission electron microscopy (TEM), X-ray photoelectron spectroscopy (XPS) and energy dispersive X-ray spectroscopy, the formation mechanism of NiO/Mn2O3 nanoflake arrays was proposed. As-prepared glucose biosensors based on NiO/Mn2O3 nanoflake arrays were characterized by cyclic voltammgrams and chronoamperometry. The results indicated that glucose biosensors based on optimized NiO/Mn2O3 nanoflake arrays exhibited a high sensitivity of 167.0 μA mM-1 Cm-2 and good anti-interference ability, suggesting the NiO/Mn2O3 nanoflake arrays are an attractive substrate for the construction of oxidase-based biosensors.

Environment construction and bottleneck breakthrough in the improvement of wisdom exhibition

NASA Astrophysics Data System (ADS)

Zhang, Jiankang

2017-08-01

Wisdom exhibition is an inexorable trend in convention and exhibition industry in China. Information technology must be utilized by exhibition industry to achieve intelligent application and wisdom management, breaking the limitation of time as well as space, which raise the quality of exhibition service and level of operation to a totally new standard. Accordingly, exhibition industry should optimize mobile internet, a fundamental technology platform, during the advancing process of wisdom exhibition and consummate the combination among three plates including wisdom connection of information, wisdom exhibition environment and wisdom application of technology. Besides, the industry should realize the wisdom of external environment including wisdom of exhibition city, exhibition place, exhibition resource deal etc and break through bottle-neck in construction of wisdom exhibition industry, which includes construction of big data center, development of Mobile Internet application platform, promotion of information construction, innovative design of application scenarios.

Bonding strength of glass-ceramic trabecular-like coatings to ceramic substrates for prosthetic applications.

PubMed

Chen, Qiang; Baino, Francesco; Pugno, Nicola M; Vitale-Brovarone, Chiara

2013-04-01

A new approach based on the concepts of quantized fracture mechanics (QFM) is presented and discussed in this paper to estimate the bonding strength of trabecular-like coatings, i.e. glass-ceramic scaffolds mimicking the architecture of cancellous bone, to ceramic substrates. The innovative application of glass-derived scaffolds as trabecular-like coatings is proposed in order to enhance the osteointegration of prosthetic ceramic devices. The scaffolds, prepared by polymeric sponge replication, are joined to alumina substrates by a dense glass-ceramic coating (interlayer) and the so-obtained 3-layer constructs are investigated from micro-structural, morphological and mechanical viewpoints. In particular, the fracture strengths of three different crack propagation modes, i.e. glass-derived scaffold fracture, interface delamination or mixed fracture, are predicted in agreement with those of experimental mechanical tests. The approach proposed in this work could have interesting applications towards an ever more rational design of bone tissue engineering biomaterials and coatings, in view of the optimization of their mechanical properties for making them actually suitable for clinical applications. Copyright © 2012 Elsevier B.V. All rights reserved.

Evolutionary Maps: A new model for the analysis of conceptual development, with application to the diurnal cycle

NASA Astrophysics Data System (ADS)

Navarro, Manuel

2014-05-01

This paper presents a model of how children generate concrete concepts from perception through processes of differentiation and integration. The model informs the design of a novel methodology (evolutionary maps or emaps), whose implementation on certain domains unfolds the web of itineraries that children may follow in the construction of concrete conceptual knowledge and pinpoints, for each conception, the architecture of the conceptual change that leads to the scientific concept. Remarkably, the generative character of its syntax yields conceptions that, if unknown, amount to predictions that can be tested experimentally. Its application to the diurnal cycle (including the sun's trajectory in the sky) indicates that the model is correct and the methodology works (in some domains). Specifically, said emap predicts a number of exotic trajectories of the sun in the sky that, in the experimental work, were drawn spontaneously both on paper and a dome. Additionally, the application of the emaps theoretical framework in clinical interviews has provided new insight into other cognitive processes. The field of validity of the methodology and its possible applications to science education are discussed.

Development of Traceable Phantoms for Improved Image Quantification in Positron Emission Tomography

NASA Astrophysics Data System (ADS)

Zimmerman, Brian

2014-03-01

Clinical trials for new drugs increasingly rely on imaging data to monitor patient response to the therapy being studied. In the case of radiopharmaceutical applications, imaging data are also used to estimate organ and tumor doses in order to arrive at the optimal dosage for safe and effective treatment. Positron Emission Tomography (PET) is one of the most commonly used imaging modalities for these types of applications. In large, multicenter trials it is crucial to minimize as much as possible the variability that arises due to use of different types of scanners and other instrumentation so that the biological response can be more readily evaluated. This can be achieved by ensuring that all the instruments are calibrated to a common standard and that their performance is continuously monitored throughout the trial. Maintaining links to a single standard also enables the comparability of data acquired on a heterogeneous collection of instruments in different clinical settings. As the standards laboratory for the United States, the National Institute of Standards and Technology (NIST) has been developing a suite of phantoms having traceable activity content to enable scanner calibration and performance testing. The configurations range from small solid cylindrical sources having volumes from 1 mL to 23 mL to large cylinders having a total volume of 9 L. The phantoms are constructed with 68Ge as a long-lived substitute for the more clinically useful radionuclide 18F. The contained activity values are traceable to the national standard for 68Ge and are also linked to the standard for 18F through a careful series of comparisons. The techniques that have been developed are being applied to a variety of new phantom configurations using different radionuclides. Image-based additive manufacturing techniques are also being investigated to create fillable phantoms having irregular shapes which can better mimic actual organs and tumors while still maintaining traceability back to primary standards for radioactivity. This talk will describe the methods used to construct, calibrate, and characterize the phantoms, focusing on the preservation of the traceability link to the primary standards of the radionuclides used. The on-going development of specialized traceable phantoms for specific organ dosimetry applications and imaging physics studies will also be discussed.

Speculation detection for Chinese clinical notes: Impacts of word segmentation and embedding models.

PubMed

Zhang, Shaodian; Kang, Tian; Zhang, Xingting; Wen, Dong; Elhadad, Noémie; Lei, Jianbo

2016-04-01

Speculations represent uncertainty toward certain facts. In clinical texts, identifying speculations is a critical step of natural language processing (NLP). While it is a nontrivial task in many languages, detecting speculations in Chinese clinical notes can be particularly challenging because word segmentation may be necessary as an upstream operation. The objective of this paper is to construct a state-of-the-art speculation detection system for Chinese clinical notes and to investigate whether embedding features and word segmentations are worth exploiting toward this overall task. We propose a sequence labeling based system for speculation detection, which relies on features from bag of characters, bag of words, character embedding, and word embedding. We experiment on a novel dataset of 36,828 clinical notes with 5103 gold-standard speculation annotations on 2000 notes, and compare the systems in which word embeddings are calculated based on word segmentations given by general and by domain specific segmenters respectively. Our systems are able to reach performance as high as 92.2% measured by F score. We demonstrate that word segmentation is critical to produce high quality word embedding to facilitate downstream information extraction applications, and suggest that a domain dependent word segmenter can be vital to such a clinical NLP task in Chinese language. Copyright © 2016 Elsevier Inc. All rights reserved.

Validity and reliability of a novel immunosuppressive adverse effects scoring system in renal transplant recipients.

PubMed

Meaney, Calvin J; Arabi, Ziad; Venuto, Rocco C; Consiglio, Joseph D; Wilding, Gregory E; Tornatore, Kathleen M

2014-06-12

After renal transplantation, many patients experience adverse effects from maintenance immunosuppressive drugs. When these adverse effects occur, patient adherence with immunosuppression may be reduced and impact allograft survival. If these adverse effects could be prospectively monitored in an objective manner and possibly prevented, adherence to immunosuppressive regimens could be optimized and allograft survival improved. Prospective, standardized clinical approaches to assess immunosuppressive adverse effects by health care providers are limited. Therefore, we developed and evaluated the application, reliability and validity of a novel adverse effects scoring system in renal transplant recipients receiving calcineurin inhibitor (cyclosporine or tacrolimus) and mycophenolic acid based immunosuppressive therapy. The scoring system included 18 non-renal adverse effects organized into gastrointestinal, central nervous system and aesthetic domains developed by a multidisciplinary physician group. Nephrologists employed this standardized adverse effect evaluation in stable renal transplant patients using physical exam, review of systems, recent laboratory results, and medication adherence assessment during a clinic visit. Stable renal transplant recipients in two clinical studies were evaluated and received immunosuppressive regimens comprised of either cyclosporine or tacrolimus with mycophenolic acid. Face, content, and construct validity were assessed to document these adverse effect evaluations. Inter-rater reliability was determined using the Kappa statistic and intra-class correlation. A total of 58 renal transplant recipients were assessed using the adverse effects scoring system confirming face validity. Nephrologists (subject matter experts) rated the 18 adverse effects as: 3.1 ± 0.75 out of 4 (maximum) regarding clinical importance to verify content validity. The adverse effects scoring system distinguished 1.75-fold increased gastrointestinal adverse effects (p=0.008) in renal transplant recipients receiving tacrolimus and mycophenolic acid compared to the cyclosporine regimen. This finding demonstrated construct validity. Intra-class correlation was 0.81 (95% confidence interval: 0.65-0.90) and Kappa statistic of 0.68 ± 0.25 for all 18 adverse effects and verified substantial inter-rater reliability. This immunosuppressive adverse effects scoring system in stable renal transplant recipients was evaluated and substantiated face, content and construct validity with inter-rater reliability. The scoring system may facilitate prospective, standardized clinical monitoring of immunosuppressive adverse drug effects in stable renal transplant recipients and improve medication adherence.

Directly auto-transplanted mesenchymal stem cells induce bone formation in a ceramic bone substitute in an ectopic sheep model.

PubMed

Boos, Anja M; Loew, Johanna S; Deschler, Gloria; Arkudas, Andreas; Bleiziffer, Oliver; Gulle, Heinz; Dragu, Adrian; Kneser, Ulrich; Horch, Raymund E; Beier, Justus P

2011-06-01

Bone tissue engineering approaches increasingly focus on the use of mesenchymal stem cells (MSC). In most animal transplantation models MSC are isolated and expanded before auto cell transplantation which might be critical for clinical application in the future. Hence this study compares the potential of directly auto-transplanted versus in vitro expanded MSC with or without bone morphogenetic protein-2 (BMP-2) to induce bone formation in a large volume ceramic bone substitute in the sheep model. MSC were isolated from bone marrow aspirates and directly auto-transplanted or expanded in vitro and characterized using fluorescence activated cell sorting (FACS) and RT-PCR analysis before subcutaneous implantation in combination with BMP-2 and β-tricalcium phosphate/hydroxyapatite (β-TCP/HA) granules. Constructs were explanted after 1 to 12 weeks followed by histological and RT-PCR evaluation. Sheep MSC were CD29(+), CD44(+) and CD166(+) after selection by Ficoll gradient centrifugation, while directly auto-transplanted MSC-populations expressed CD29 and CD166 at lower levels. Both, directly auto-transplanted and expanded MSC, were constantly proliferating and had a decreasing apoptosis over time in vivo. Directly auto-transplanted MSC led to de novo bone formation in a heterotopic sheep model using a β-TCP/HA matrix comparable to the application of 60 μg/ml BMP-2 only or implantation of expanded MSC. Bone matrix proteins were up-regulated in constructs following direct auto-transplantation and in expanded MSC as well as in BMP-2 constructs. Up-regulation was detected using immunohistology methods and RT-PCR. Dense vascularization was demonstrated by CD31 immunohistology staining in all three groups. Ectopic bone could be generated using directly auto-transplanted or expanded MSC with β-TCP/HA granules alone. Hence BMP-2 stimulation might become dispensable in the future, thus providing an attractive, clinically feasible approach to bone tissue engineering. © 2011 The Authors Journal of Cellular and Molecular Medicine © 2011 Foundation for Cellular and Molecular Medicine/Blackwell Publishing Ltd.

Validation of a recombinant human bactericidal/permeability-increasing protein (hBPI) expression vector using murine mammary gland tumor cells and the early development of hBPI transgenic goat embryos.

PubMed

Gui, Tao; Liu, Xing; Tao, Jia; Chen, Jianwen; Li, Yunsheng; Zhang, Meiling; Wu, Ronghua; Zhang, Yuanliang; Peng, Kaisong; Liu, Ya; Zhang, Xiaorong; Zhang, Yunhai

2013-12-01

Human bactericidal/permeability-increasing protein (hBPI) is the only antibacterial peptide which acts against both gram-negative bacteria and neutralizes endotoxins in human polymorphonuclear neutrophils; therefore, hBPI is of great value in clinical applications. In the study, we constructed a hBPI expression vector (pBC1-Loxp-Neo-Loxp-hBPI) containing the full-length hBPI coding sequence which could be specifically expressed in the mammary gland. To validate the function of the vector, in vitro cultured C127 (mouse mammary Carcinoma Cells) were transfected with the vector, and the transgenic cell clones were selected to express hBPI by hormone induction. The mRNA and protein expression of hBPI showed that the constructed vector was effective and suitable for future application in producing mammary gland bioreactor. Then, female and male goat fibroblasts were transfected with the vector, and two male and two female transgenic clonal cell lines were obtained. Using the transgenic cell lines as nuclear donors for somatic cell nuclear transfer, the reconstructed goat embryos produced from all four clones could develop to blastocysts in vitro. In conclusion, we constructed and validated an efficient mammary gland-specific hBPI expression vector, pBC1-Loxp-Neo-Loxp-hBPI, and transgenic hBPI goat embryos were successfully produced, laying foundations for future production of recombinant hBPI in goat mammary gland. Copyright © 2013 Elsevier B.V. All rights reserved.

Using theories of learning in workplaces to enhance physiotherapy clinical education.

PubMed

Patton, Narelle; Higgs, Joy; Smith, Megan

2013-10-01

Clinical education has long been accepted as integral to the education of physiotherapy students and their preparation for professional practice. The clinical environment, through practice immersion, situates students in a powerful learning context and plays a critical role in students' construction of professional knowledge. Despite this acknowledged centrality of practice and clinical environments to the students' experiential construction of professional knowledge, there has been limited exploration of learning theories underpinning clinical education in the literature. In this paper, we explore a selection of learning theories underpinning physiotherapy clinical education with a view to providing clinical educators with a firm foundation on which to base wise educational practices and potentially enhance physiotherapy students' clinical learning experiences. This exploration has drawn from leading thinkers in the field of education over the past century.