Consistency of Cluster Analysis for Cognitive Diagnosis: The Reduced Reparameterized Unified Model and the General Diagnostic Model.

PubMed

Chiu, Chia-Yi; Köhn, Hans-Friedrich

2016-09-01

The asymptotic classification theory of cognitive diagnosis (ACTCD) provided the theoretical foundation for using clustering methods that do not rely on a parametric statistical model for assigning examinees to proficiency classes. Like general diagnostic classification models, clustering methods can be useful in situations where the true diagnostic classification model (DCM) underlying the data is unknown and possibly misspecified, or the items of a test conform to a mix of multiple DCMs. Clustering methods can also be an option when fitting advanced and complex DCMs encounters computational difficulties. These can range from the use of excessive CPU times to plain computational infeasibility. However, the propositions of the ACTCD have only been proven for the Deterministic Input Noisy Output "AND" gate (DINA) model and the Deterministic Input Noisy Output "OR" gate (DINO) model. For other DCMs, there does not exist a theoretical justification to use clustering for assigning examinees to proficiency classes. But if clustering is to be used legitimately, then the ACTCD must cover a larger number of DCMs than just the DINA model and the DINO model. Thus, the purpose of this article is to prove the theoretical propositions of the ACTCD for two other important DCMs, the Reduced Reparameterized Unified Model and the General Diagnostic Model.

The cluster charge identification in the GEM detector for fusion plasma imaging by soft X-ray diagnostics

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

Czarski, T., E-mail: tomasz.czarski@ifpilm.pl; Chernyshova, M.; Malinowski, K.

2016-11-15

The measurement system based on gas electron multiplier detector is developed for soft X-ray diagnostics of tokamak plasmas. The multi-channel setup is designed for estimation of the energy and the position distribution of an X-ray source. The focal measuring issue is the charge cluster identification by its value and position estimation. The fast and accurate mode of the serial data acquisition is applied for the dynamic plasma diagnostics. The charge clusters are counted in the space determined by 2D position, charge value, and time intervals. Radiation source characteristics are presented by histograms for a selected range of position, time intervals,more » and cluster charge values corresponding to the energy spectra.« less

Diagnostic evaluation of distributed physically based model at the REW scale (THREW) using rainfall-runoff event analysis

NASA Astrophysics Data System (ADS)

Tian, F.; Sivapalan, M.; Li, H.; Hu, H.

2007-12-01

The importance of diagnostic analysis of hydrological models is increasingly recognized by the scientific community (M. Sivapalan, et al., 2003; H. V. Gupta, et al., 2007). Model diagnosis refers to model structures and parameters being identified not only by statistical comparison of system state variables and outputs but also by process understanding in a specific watershed. Process understanding can be gained by the analysis of observational data and model results at the specific watershed as well as through regionalization. Although remote sensing technology can provide valuable data about the inputs, state variables, and outputs of the hydrological system, observational rainfall-runoff data still constitute the most accurate, reliable, direct, and thus a basic component of hydrology related database. One critical question in model diagnostic analysis is, therefore, what signature characteristic can we extract from rainfall and runoff data. To this date only a few studies have focused on this question, such as Merz et al. (2006) and Lana-Renault et al. (2007), still none of these studies related event analysis with model diagnosis in an explicit, rigorous, and systematic manner. Our work focuses on the identification of the dominant runoff generation mechanisms from event analysis of rainfall-runoff data, including correlation analysis and analysis of timing pattern. The correlation analysis involves the identification of the complex relationship among rainfall depth, intensity, runoff coefficient, and antecedent conditions, and the timing pattern analysis aims to identify the clustering pattern of runoff events in relation to the patterns of rainfall events. Our diagnostic analysis illustrates the changing pattern of runoff generation mechanisms in the DMIP2 test watersheds located in Oklahoma region, which is also well recognized by numerical simulations based on TsingHua Representative Elementary Watershed (THREW) model. The result suggests the usefulness of rainfall-runoff event analysis for model development as well as model diagnostics.

Initial derivation of diagnostic clusters combining history elements and physical examination tests for symptomatic knee osteoarthritis.

PubMed

Décary, Simon; Feldman, Debbie; Frémont, Pierre; Pelletier, Jean-Pierre; Martel-Pelletier, Johanne; Fallaha, Michel; Pelletier, Bruno; Belzile, Sylvain; Sylvestre, Marie-Pierre; Vendittoli, Pascal-André; Desmeules, François

2018-05-21

The aim of the present study was to assess the validity of clusters combining history elements and physical examination tests to diagnose symptomatic knee osteoarthritis (SOA) compared with other knee disorders. This was a prospective diagnostic accuracy study, in which 279 consecutive patients consulting for a knee complaint were assessed. History elements and standardized physical examination tests were obtained independently by a physiotherapist and compared with an expert physician's composite diagnosis, including clinical examination and imaging. Recursive partitioning was used to develop diagnostic clusters for SOA. Diagnostic accuracy measures were calculated, including sensitivity, specificity, and positive and negative likelihood ratios (LR+/-), with associated 95% confidence intervals (CIs). A total of 129 patients had a diagnosis of SOA (46.2%). Most cases (76%) had combined tibiofemoral and patellofemoral knee OA and 63% had radiological Kellgren-Lawrence grades of 2 or 3. Different combinations of history elements and physical examination tests were used in clusters accurately to discriminate SOA from other knee disorders. These included age of patients, body mass index, presence of valgus/varus knee misalignment, palpable knee crepitus and limited passive knee extension. Two clusters to rule in SOA reached an LR+ of 13.6 (95% CI 6.5 to 28.4) and three clusters to rule out SOA reached an LR- of 0.11 (95% CI 0.06 to 0.20). Diagnostic clusters combining history elements and physical examination tests were able to support the differential diagnosis of SOA compared with various knee disorders without relying systematically on imaging. This could support primary care clinicians' role in the efficient management of these patients. Copyright © 2018 John Wiley & Sons, Ltd.

The Science Goals of the Constellation-X Mission

NASA Technical Reports Server (NTRS)

White, Nicholas E.; Tananbaum, Harvey; Weaver, Kimberly; Petre, Robert; Bookbinder, Jay

2004-01-01

The Constellation-X mission will address the questions: "What happens to matter close to a black hole?" and "What is Dark Energy?" These questions are central to the NASA Beyond Einstein Program, where Constellation-X plays a central role. The mission will address these questions by using high throughput X-ray spectroscopy to observe the effects of strong gravity close to the event horizon of black holes, and to observe the formation and evolution of clusters of galaxies in order to precisely determine Cosmological parameters. To achieve these primary science goals requires a factor of 25-100 increase in sensitivity for high resolution spectroscopy. The mission will also perform routine high- resolution X-ray spectroscopy of faint and extended X-ray source populations. This will provide diagnostic information such as density, elemental abundances, velocity, and ionization state for a wide range of astrophysical problems. This has enormous potential for the discovery of new unexpected phenomena. The Constellation-X mission is a high priority in the National Academy of Sciences McKee-Taylor Astronomy and Astrophysics Survey of new Astrophysics Facilities for the first decade of the 21st century.

Not all stars form in clusters - measuring the kinematics of OB associations with Gaia

NASA Astrophysics Data System (ADS)

Ward, Jacob L.; Kruijssen, J. M. Diederik

2018-04-01

It is often stated that star clusters are the fundamental units of star formation and that most (if not all) stars form in dense stellar clusters. In this monolithic formation scenario, low-density OB associations are formed from the expansion of gravitationally bound clusters following gas expulsion due to stellar feedback. N-body simulations of this process show that OB associations formed this way retain signs of expansion and elevated radial anisotropy over tens of Myr. However, recent theoretical and observational studies suggest that star formation is a hierarchical process, following the fractal nature of natal molecular clouds and allowing the formation of large-scale associations in situ. We distinguish between these two scenarios by characterizing the kinematics of OB associations using the Tycho-Gaia Astrometric Solution catalogue. To this end, we quantify four key kinematic diagnostics: the number ratio of stars with positive radial velocities to those with negative radial velocities, the median radial velocity, the median radial velocity normalized by the tangential velocity, and the radial anisotropy parameter. Each quantity presents a useful diagnostic of whether the association was more compact in the past. We compare these diagnostics to models representing random motion and the expanding products of monolithic cluster formation. None of these diagnostics show evidence of expansion, either from a single cluster or multiple clusters, and the observed kinematics are better represented by a random velocity distribution. This result favours the hierarchical star formation model in which a minority of stars forms in bound clusters and large-scale, hierarchically structured associations are formed in situ.

Deconstructing Bipolar Disorder and Schizophrenia: A cross-diagnostic cluster analysis of cognitive phenotypes.

PubMed

Lee, Junghee; Rizzo, Shemra; Altshuler, Lori; Glahn, David C; Miklowitz, David J; Sugar, Catherine A; Wynn, Jonathan K; Green, Michael F

2017-02-01

Bipolar disorder (BD) and schizophrenia (SZ) show substantial overlap. It has been suggested that a subgroup of patients might contribute to these overlapping features. This study employed a cross-diagnostic cluster analysis to identify subgroups of individuals with shared cognitive phenotypes. 143 participants (68 BD patients, 39 SZ patients and 36 healthy controls) completed a battery of EEG and performance assessments on perception, nonsocial cognition and social cognition. A K-means cluster analysis was conducted with all participants across diagnostic groups. Clinical symptoms, functional capacity, and functional outcome were assessed in patients. A two-cluster solution across 3 groups was the most stable. One cluster including 44 BD patients, 31 controls and 5 SZ patients showed better cognition (High cluster) than the other cluster with 24 BD patients, 35 SZ patients and 5 controls (Low cluster). BD patients in the High cluster performed better than BD patients in the Low cluster across cognitive domains. Within each cluster, participants with different clinical diagnoses showed different profiles across cognitive domains. All patients are in the chronic phase and out of mood episode at the time of assessment and most of the assessment were behavioral measures. This study identified two clusters with shared cognitive phenotype profiles that were not proxies for clinical diagnoses. The finding of better social cognitive performance of BD patients than SZ patients in the Lowe cluster suggest that relatively preserved social cognition may be important to identify disease process distinct to each disorder. Copyright © 2016 Elsevier B.V. All rights reserved.

Profiling Local Optima in K-Means Clustering: Developing a Diagnostic Technique

ERIC Educational Resources Information Center

Steinley, Douglas

2006-01-01

Using the cluster generation procedure proposed by D. Steinley and R. Henson (2005), the author investigated the performance of K-means clustering under the following scenarios: (a) different probabilities of cluster overlap; (b) different types of cluster overlap; (c) varying samples sizes, clusters, and dimensions; (d) different multivariate…

Validity of Combining History Elements and Physical Examination Tests to Diagnose Patellofemoral Pain.

PubMed

Décary, Simon; Frémont, Pierre; Pelletier, Bruno; Fallaha, Michel; Belzile, Sylvain; Martel-Pelletier, Johanne; Pelletier, Jean-Pierre; Feldman, Debbie; Sylvestre, Marie-Pierre; Vendittoli, Pascal-André; Desmeules, François

2018-04-01

To assess the validity of diagnostic clusters combining history elements and physical examination tests to diagnose or exclude patellofemoral pain (PFP). Prospective diagnostic study. Orthopedic outpatient clinics, family medicine clinics, and community-dwelling. Consecutive patients (N=279) consulting one of the participating orthopedic surgeons (n=3) or sport medicine physicians (n=2) for any knee complaint. Not applicable. History elements and physical examination tests were obtained by a trained physiotherapist blinded to the reference standard: a composite diagnosis including both physical examination tests and imaging results interpretation performed by an expert physician. Penalized logistic regression (least absolute shrinkage and selection operator) was used to identify history elements and physical examination tests associated with the diagnosis of PFP, and recursive partitioning was used to develop diagnostic clusters. Diagnostic accuracy measures including sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios with associated 95% confidence intervals (CIs) were calculated. Two hundred seventy-nine participants were evaluated, and 75 had a diagnosis of PFP (26.9%). Different combinations of history elements and physical examination tests including the age of participants, knee pain location, difficulty descending stairs, patellar facet palpation, and passive knee extension range of motion were associated with a diagnosis of PFP and used in clusters to accurately discriminate between individuals with PFP and individuals without PFP. Two diagnostic clusters developed to confirm the presence of PFP yielded a positive likelihood ratio of 8.7 (95% CI, 5.2-14.6) and 3 clusters to exclude PFP yielded a negative likelihood ratio of .12 (95% CI, .06-.27). Diagnostic clusters combining common history elements and physical examination tests that can accurately diagnose or exclude PFP compared to various knee disorders were developed. External validation is required before clinical use. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Novel clustering of items from the Autism Diagnostic Interview-Revised to define phenotypes within autism spectrum disorders

PubMed Central

Hu, Valerie W.; Steinberg, Mara E.

2009-01-01

Heterogeneity in phenotypic presentation of ASD has been cited as one explanation for the difficulty in pinpointing specific genes involved in autism. Recent studies have attempted to reduce the “noise” in genetic and other biological data by reducing the phenotypic heterogeneity of the sample population. The current study employs multiple clustering algorithms on 123 item scores from the Autism Diagnostic Interview-Revised (ADI-R) diagnostic instrument of nearly 2000 autistic individuals to identify subgroups of autistic probands with clinically relevant behavioral phenotypes in order to isolate more homogeneous groups of subjects for gene expression analyses. Our combined cluster analyses suggest optimal division of the autistic probands into 4 phenotypic clusters based on similarity of symptom severity across the 123 selected item scores. One cluster is characterized by severe language deficits, while another exhibits milder symptoms across the domains. A third group possesses a higher frequency of savant skills while the fourth group exhibited intermediate severity across all domains. Grouping autistic individuals by multivariate cluster analysis of ADI-R scores reveals meaningful phenotypes of subgroups within the autistic spectrum which we show, in a related (accompanying) study, to be associated with distinct gene expression profiles. PMID:19455643

Do All O Stars Form in Star Clusters?

NASA Astrophysics Data System (ADS)

Weidner, C.; Gvaramadze, V. V.; Kroupa, P.; Pflamm-Altenburg, J.

The question whether or not massive stars can form in isolation or only in star clusters is of great importance for the theory of (massive) star formation as well as for the stellar initial mass function of whole galaxies (IGIMF-theory). While a seemingly easy question it is rather difficult to answer. Several physical processes (e.g. star-loss due to stellar dynamics or gas expulsion) and observational limitations (e.g. dust obscuration of young clusters, resolution) pose severe challenges to answer this question. In this contribution we will present the current arguments in favour and against the idea that all O stars form in clusters.

Sample heterogeneity in unipolar depression as assessed by functional connectivity analyses is dominated by general disease effects.

PubMed

Feder, Stephan; Sundermann, Benedikt; Wersching, Heike; Teuber, Anja; Kugel, Harald; Teismann, Henning; Heindel, Walter; Berger, Klaus; Pfleiderer, Bettina

2017-11-01

Combinations of resting-state fMRI and machine-learning techniques are increasingly employed to develop diagnostic models for mental disorders. However, little is known about the neurobiological heterogeneity of depression and diagnostic machine learning has mainly been tested in homogeneous samples. Our main objective was to explore the inherent structure of a diverse unipolar depression sample. The secondary objective was to assess, if such information can improve diagnostic classification. We analyzed data from 360 patients with unipolar depression and 360 non-depressed population controls, who were subdivided into two independent subsets. Cluster analyses (unsupervised learning) of functional connectivity were used to generate hypotheses about potential patient subgroups from the first subset. The relationship of clusters with demographical and clinical measures was assessed. Subsequently, diagnostic classifiers (supervised learning), which incorporated information about these putative depression subgroups, were trained. Exploratory cluster analyses revealed two weakly separable subgroups of depressed patients. These subgroups differed in the average duration of depression and in the proportion of patients with concurrently severe depression and anxiety symptoms. The diagnostic classification models performed at chance level. It remains unresolved, if subgroups represent distinct biological subtypes, variability of continuous clinical variables or in part an overfitting of sparsely structured data. Functional connectivity in unipolar depression is associated with general disease effects. Cluster analyses provide hypotheses about potential depression subtypes. Diagnostic models did not benefit from this additional information regarding heterogeneity. Copyright © 2017 Elsevier B.V. All rights reserved.

Does the delivery of diagnostic news affect the likelihood of whether or not patients ask questions about the results? A conversation analytical study.

PubMed

Murtagh, Ged M; Thomas, Anne L; Furber, Lynn

2018-05-03

Asymmetries in knowledge and competence in the medical encounter often mean that doctor-patient communication can be compromised. This study explores this issue and examines whether the likelihood of patient question asking is increased following the delivery of diagnostic test results. It also examines whether that likelihood is related to the way in which the test results are delivered. To examine when and how patients initiate questions following diagnostic news announcements. We audio-recorded oncology consultations (n = 47) consisting of both first consultations and follow-up consultations with patients with different types of cancer, at a leading UK teaching hospital. From the primary sample, we identified 30 consultations based on a basic count of the frequency of patient questions and their positioning in relation to diagnostic announcements. This subset of 30 consultations consisted of a mix of first and follow-up consultations. Our data demonstrate how the design and delivery of diagnostic news announcements can either discourage or provide the opportunity for a patient-initiated question in the next turn of talk. We identified two types of announcement. Q+ generally provided for a patient-initiated question as a relevant next turn following the news announcement, whereas Q- did not. Q+ was sometimes followed up with the explanation of test results, which appeared to encourage further patient questions. The design and delivery of diagnostic news announcements can make a patient-initiated question more or less appropriate, in the next turn of talk. In addition, showing and explaining test results can encourage further opportunities for patients' questions. © 2018 The Authors. Health Expectations published by John Wiley & Sons Ltd.

Evaluation of diagnostic tools that tertiary teachers can apply to profile their students' conceptions

NASA Astrophysics Data System (ADS)

Schultz, Madeleine; Lawrie, Gwendolyn A.; Bailey, Chantal H.; Bedford, Simon B.; Dargaville, Tim R.; O'Brien, Glennys; Tasker, Roy; Thompson, Christopher D.; Williams, Mark; Wright, Anthony H.

2017-03-01

A multi-institution collaborative team of Australian chemistry education researchers, teaching a total of over 3000 first year chemistry students annually, has explored a tool for diagnosing students' prior conceptions as they enter tertiary chemistry courses. Five core topics were selected and clusters of diagnostic items were assembled linking related concepts in each topic together. An ordered multiple choice assessment strategy was adopted to enable provision of formative feedback to students through combination of the specific distractors that they chose. Concept items were either sourced from existing research instruments or developed by the project team. The outcome is a diagnostic tool consisting of five topic clusters of five concept items that has been delivered in large introductory chemistry classes at five Australian institutions. Statistical analysis of data has enabled exploration of the composition and validity of the instrument including a comparison between delivery of the complete 25 item instrument with subsets of five items, clustered by topic. This analysis revealed that most items retained their validity when delivered in small clusters. Tensions between the assembly, validation and delivery of diagnostic instruments for the purposes of acquiring robust psychometric research data versus their pragmatic use are considered in this study.

Kinematic fingerprint of core-collapsed globular clusters

NASA Astrophysics Data System (ADS)

Bianchini, P.; Webb, J. J.; Sills, A.; Vesperini, E.

2018-03-01

Dynamical evolution drives globular clusters towards core collapse, which strongly shapes their internal properties. Diagnostics of core collapse have so far been based on photometry only, namely on the study of the concentration of the density profiles. Here, we present a new method to robustly identify core-collapsed clusters based on the study of their stellar kinematics. We introduce the kinematic concentration parameter, ck, the ratio between the global and local degree of energy equipartition reached by a cluster, and show through extensive direct N-body simulations that clusters approaching core collapse and in the post-core collapse phase are strictly characterized by ck > 1. The kinematic concentration provides a suitable diagnostic to identify core-collapsed clusters, independent from any other previous methods based on photometry. We also explore the effects of incomplete radial and stellar mass coverage on the calculation of ck and find that our method can be applied to state-of-art kinematic data sets.

Using cluster ensemble and validation to identify subtypes of pervasive developmental disorders.

PubMed

Shen, Jess J; Lee, Phil-Hyoun; Holden, Jeanette J A; Shatkay, Hagit

2007-10-11

Pervasive Developmental Disorders (PDD) are neurodevelopmental disorders characterized by impairments in social interaction, communication and behavior. Given the diversity and varying severity of PDD, diagnostic tools attempt to identify homogeneous subtypes within PDD. Identifying subtypes can lead to targeted etiology studies and to effective type-specific intervention. Cluster analysis can suggest coherent subsets in data; however, different methods and assumptions lead to different results. Several previous studies applied clustering to PDD data, varying in number and characteristics of the produced subtypes. Most studies used a relatively small dataset (fewer than 150 subjects), and all applied only a single clustering method. Here we study a relatively large dataset (358 PDD patients), using an ensemble of three clustering methods. The results are evaluated using several validation methods, and consolidated through an integration step. Four clusters are identified, analyzed and compared to subtypes previously defined by the widely used diagnostic tool DSM-IV.

Using Cluster Ensemble and Validation to Identify Subtypes of Pervasive Developmental Disorders

PubMed Central

Shen, Jess J.; Lee, Phil Hyoun; Holden, Jeanette J.A.; Shatkay, Hagit

2007-01-01

Pervasive Developmental Disorders (PDD) are neurodevelopmental disorders characterized by impairments in social interaction, communication and behavior.1 Given the diversity and varying severity of PDD, diagnostic tools attempt to identify homogeneous subtypes within PDD. Identifying subtypes can lead to targeted etiology studies and to effective type-specific intervention. Cluster analysis can suggest coherent subsets in data; however, different methods and assumptions lead to different results. Several previous studies applied clustering to PDD data, varying in number and characteristics of the produced subtypes19. Most studies used a relatively small dataset (fewer than 150 subjects), and all applied only a single clustering method. Here we study a relatively large dataset (358 PDD patients), using an ensemble of three clustering methods. The results are evaluated using several validation methods, and consolidated through an integration step. Four clusters are identified, analyzed and compared to subtypes previously defined by the widely used diagnostic tool DSM-IV.2 PMID:18693920

Cognitive Clusters in Specific Learning Disorder.

PubMed

Poletti, Michele; Carretta, Elisa; Bonvicini, Laura; Giorgi-Rossi, Paolo

The heterogeneity among children with learning disabilities still represents a barrier and a challenge in their conceptualization. Although a dimensional approach has been gaining support, the categorical approach is still the most adopted, as in the recent fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. The introduction of the single overarching diagnostic category of specific learning disorder (SLD) could underemphasize interindividual clinical differences regarding intracategory cognitive functioning and learning proficiency, according to current models of multiple cognitive deficits at the basis of neurodevelopmental disorders. The characterization of specific cognitive profiles associated with an already manifest SLD could help identify possible early cognitive markers of SLD risk and distinct trajectories of atypical cognitive development leading to SLD. In this perspective, we applied a cluster analysis to identify groups of children with a Diagnostic and Statistical Manual-based diagnosis of SLD with similar cognitive profiles and to describe the association between clusters and SLD subtypes. A sample of 205 children with a diagnosis of SLD were enrolled. Cluster analyses (agglomerative hierarchical and nonhierarchical iterative clustering technique) were used successively on 10 core subtests of the Wechsler Intelligence Scale for Children-Fourth Edition. The 4-cluster solution was adopted, and external validation found differences in terms of SLD subtype frequencies and learning proficiency among clusters. Clinical implications of these findings are discussed, tracing directions for further studies.

A flexible data-driven comorbidity feature extraction framework.

PubMed

Sideris, Costas; Pourhomayoun, Mohammad; Kalantarian, Haik; Sarrafzadeh, Majid

2016-06-01

Disease and symptom diagnostic codes are a valuable resource for classifying and predicting patient outcomes. In this paper, we propose a novel methodology for utilizing disease diagnostic information in a predictive machine learning framework. Our methodology relies on a novel, clustering-based feature extraction framework using disease diagnostic information. To reduce the data dimensionality, we identify disease clusters using co-occurrence statistics. We optimize the number of generated clusters in the training set and then utilize these clusters as features to predict patient severity of condition and patient readmission risk. We build our clustering and feature extraction algorithm using the 2012 National Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP) which contains 7 million hospital discharge records and ICD-9-CM codes. The proposed framework is tested on Ronald Reagan UCLA Medical Center Electronic Health Records (EHR) from 3041 Congestive Heart Failure (CHF) patients and the UCI 130-US diabetes dataset that includes admissions from 69,980 diabetic patients. We compare our cluster-based feature set with the commonly used comorbidity frameworks including Charlson's index, Elixhauser's comorbidities and their variations. The proposed approach was shown to have significant gains between 10.7-22.1% in predictive accuracy for CHF severity of condition prediction and 4.65-5.75% in diabetes readmission prediction. Copyright © 2016 Elsevier Ltd. All rights reserved.

On Formative Assessment in Math: How Diagnostic Questions Can Help

ERIC Educational Resources Information Center

Barton, Craig

2018-01-01

In this article, the author asserts that asking and responding to diagnostic questions is the single most important part of teaching secondary school mathematics. He notes the importance of formative assessment and recommends a formative assessment strategy that requires students to be public about their answers to questions, displaying their…

An intercultural assessment of the type, intensity and number of crisis precipitating factors in three cultures: United States, Brazil and Taiwan.

PubMed

Coler, M S; Hafner, L P

1991-01-01

The precipitating factors of crisis have cultural interpretations that make diagnostic criteria and intervention methods ethnologically different. The crisis precipitating factors of individuals seeking intervention in the Republic of China (Taiwan), Brazil and the United States (U.S.) were investigated toward the end of isolating correlates and discrepancies of ethnic-related precipitants of crisis. The primary objective of the study was to influence crisis intervention in the profession of nursing from the almost universally utilized Western Model, to one that takes cultural uniqueness into account. Stressors and stressor intensities which lead to help-seeking behavior of clients in selected crisis intervention facilities in the three countries were identified. A 60 question instrument ranked client responses according to Axis 4 of the Diagnostic and Statistical Manual-III of the American Psychiatric Association (APA, 1980; 1986). Each item also reflected one of four Human Response Patterns of the North American Nursing Diagnostic Association (NANDA) taxonomy, which was utilized as a clustering device in data analysis. Somatization versus psychologization of crisis precipitating factors was also measured through the NANDA categories. A convenience sample of 30 subjects were queried in each country by nurse interviewers. Data analysis through ANOVA showed cultural uniqueness and mutuality.

Recall and dating of psychiatric symptoms. Test-retest reliability of time-related symptom questions in a standardized psychiatric interview.

PubMed

Wittchen, H U; Burke, J D; Semler, G; Pfister, H; Von Cranach, M; Zaudig, M

1989-05-01

The advent of more explicit diagnostic criteria and the growing interest in "lifetime" rates of mental disorders has made imperative an accurate determination of time-related diagnostic criteria. We used data from two independent test-retest studies of the Diagnostic Interview Schedule (DIS) and the Composite International Diagnostic Interview (CIDI) to study the reliability of different time-related questions in these fully standardized diagnostic interviews. With two exceptions (anxiety disorders and alcohol-related questions), the test-retest reliability of most time-related questions in both interviews was judged to be satisfactorily high. Furthermore, the validity of time-related questions in the DIS (age at symptom onset, duration and frequency of illness episodes) was examined by comparing them with detailed "consensus" ratings done independently by different clinicians for 207 former psychiatric inpatients. A surprisingly high concordance was found for former psychotic patients except for those still severely disturbed at the follow-up investigation. Some severe restrictions were also found for nonpsychotic disorders with regard to judgment of the age at onset of phobias, panic attacks, and depression. For a more valid assessment of time-related symptom information, the use of specific memory aids is suggested.

The Effect of Question Format and Task Difficulty on Reasoning Strategies and Diagnostic Performance in Internal Medicine Residents

ERIC Educational Resources Information Center

Heemskerk, Laura; Norman, Geoff; Chou, Sophia; Mintz, Marcy; Mandin, Henry; McLaughlin, Kevin

2008-01-01

Background: Previous studies have suggested an association between reasoning strategies and diagnostic success, but the influence on this relationship of variables such as question format and task difficulty, has not been studied. Our objective was to study the association between question format, task difficulty, reasoning strategies and…

Evolution of the degree of substructures in simulated galaxy clusters

NASA Astrophysics Data System (ADS)

De Boni, Cristiano; Böhringer, Hans; Chon, Gayoung; Dolag, Klaus

2018-05-01

We study the evolution of substructure in the mass distribution with mass, redshift and radius in a sample of simulated galaxy clusters. The sample, containing 1226 objects, spans the mass range M200 = 1014 - 1.74 × 1015 M⊙ h-1 in six redshift bins from z = 0 to z = 1.179. We consider three different diagnostics: 1) subhalos identified with SUBFIND; 2) overdense regions localized by dividing the cluster into octants; 3) offset between the potential minimum and the center of mass. The octant analysis is a new method that we introduce in this work. We find that none of the diagnostics indicate a correlation between the mass of the cluster and the fraction of substructures. On the other hand, all the diagnostics suggest an evolution of substructures with redshift. For SUBFIND halos, the mass fraction is constant with redshift at Rvir, but shows a mild evolution at R200 and R500. Also, the fraction of clusters with at least a subhalo more massive than one thirtieth of the total mass is less than 20%. Our new method based on the octants returns a mass fraction in substructures which has a strong evolution with redshift at all radii. The offsets also evolve strongly with redshift. We also find a strong correlation for individual clusters between the offset and the fraction of substructures identified with the octant analysis. Our work puts strong constraints on the amount of substructures we expect to find in galaxy clusters and on their evolution with redshift.

A data-driven feature extraction framework for predicting the severity of condition of congestive heart failure patients.

PubMed

Sideris, Costas; Alshurafa, Nabil; Pourhomayoun, Mohammad; Shahmohammadi, Farhad; Samy, Lauren; Sarrafzadeh, Majid

2015-01-01

In this paper, we propose a novel methodology for utilizing disease diagnostic information to predict severity of condition for Congestive Heart Failure (CHF) patients. Our methodology relies on a novel, clustering-based, feature extraction framework using disease diagnostic information. To reduce the dimensionality we identify disease clusters using cooccurence frequencies. We then utilize these clusters as features to predict patient severity of condition. We build our clustering and feature extraction algorithm using the 2012 National Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP) which contains 7 million discharge records and ICD-9-CM codes. The proposed framework is tested on Ronald Reagan UCLA Medical Center Electronic Health Records (EHR) from 3041 patients. We compare our cluster-based feature set with another that incorporates the Charlson comorbidity score as a feature and demonstrate an accuracy improvement of up to 14% in the predictability of the severity of condition.

Serial data acquisition for the X-ray plasma diagnostics with selected GEM detector structures

NASA Astrophysics Data System (ADS)

Czarski, T.; Chernyshova, M.; Pozniak, K. T.; Kasprowicz, G.; Zabolotny, W.; Kolasinski, P.; Krawczyk, R.; Wojenski, A.; Zienkiewicz, P.

2015-10-01

The measurement system based on GEM—Gas Electron Multiplier detector is developed for X-ray diagnostics of magnetic confinement tokamak plasmas. The paper is focused on the measurement subject and describes the fundamental data processing to obtain reliable characteristics (histograms) useful for physicists. The required data processing have two steps: 1—processing in the time domain, i.e. events selections for bunches of coinciding clusters, 2—processing in the planar space domain, i.e. cluster identification for the given detector structure. So, it is the software part of the project between the electronic hardware and physics applications. The whole project is original and it was developed by the paper authors. The previous version based on 1-D GEM detector was applied for the high-resolution X-ray crystal spectrometer KX1 in the JET tokamak. The current version considers 2-D detector structures for the new data acquisition system. The fast and accurate mode of data acquisition implemented in the hardware in real time can be applied for the dynamic plasma diagnostics. Several detector structures with single-pixel sensors and multi-pixel (directional) sensors are considered for two-dimensional X-ray imaging. Final data processing is presented by histograms for selected range of position, time interval and cluster charge values. Exemplary radiation source properties are measured by the basic cumulative characteristics: the cluster position distribution and cluster charge value distribution corresponding to the energy spectra. A shorter version of this contribution is due to be published in PoS at: 1st EPS conference on Plasma Diagnostics

Value, Cost, and Sharing: Open Issues in Constrained Clustering

NASA Technical Reports Server (NTRS)

Wagstaff, Kiri L.

2006-01-01

Clustering is an important tool for data mining, since it can identify major patterns or trends without any supervision (labeled data). Over the past five years, semi-supervised (constrained) clustering methods have become very popular. These methods began with incorporating pairwise constraints and have developed into more general methods that can learn appropriate distance metrics. However, several important open questions have arisen about which constraints are most useful, how they can be actively acquired, and when and how they should be propagated to neighboring points. This position paper describes these open questions and suggests future directions for constrained clustering research.

The identification of credit card encoders by hierarchical cluster analysis of the jitters of magnetic stripes.

PubMed

Leung, S C; Fung, W K; Wong, K H

1999-01-01

The relative bit density variation graphs of 207 specimen credit cards processed by 12 encoding machines were examined first visually, and then classified by means of hierarchical cluster analysis. Twenty-nine credit cards being treated as 'questioned' samples were tested by way of cluster analysis against 'controls' derived from known encoders. It was found that hierarchical cluster analysis provided a high accuracy of identification with all 29 'questioned' samples classified correctly. On the other hand, although visual comparison of jitter graphs was less discriminating, it was nevertheless capable of giving a reasonably accurate result.

Combinations of elevated tissue miRNA-17-92 cluster expression and serum prostate-specific antigen as potential diagnostic biomarkers for prostate cancer.

PubMed

Feng, Sujuan; Qian, Xiaosong; Li, Han; Zhang, Xiaodong

2017-12-01

The aim of the present study was to investigate the effectiveness of the miR-17-92 cluster as a disease progression marker in prostate cancer (PCa). Reverse transcription-quantitative polymerase chain reaction analysis was used to detect the microRNA (miR)-17-92 cluster expression levels in tissues from patients with PCa or benign prostatic hyperplasia (BPH), in addition to in PCa and BPH cell lines. Spearman correlation was used for comparison and estimation of correlations between miRNA expression levels and clinicopathological characteristics such as the Gleason score and prostate-specific antigen (PSA). Receiver operating curve (ROC) analysis was performed for evaluation of specificity and sensitivity of miR-17-92 cluster expression levels for discriminating patients with PCa from patients with BPH. Kaplan-Meier analysis was plotted to investigate the predictive potential of miR-17-92 cluster for PCa biochemical recurrence. Expression of the majority of miRNAs in the miR-17-92 cluster was identified to be significantly increased in PCa tissues and cell lines. Bivariate correlation analysis indicated that the high expression of unregulated miRNAs was positively correlated with Gleason grade, but had no significant association with PSA. ROC curves demonstrated that high expression of miR-17-92 cluster predicted a higher diagnostic accuracy compared with PSA. Improved discriminating quotients were observed when combinations of unregulated miRNAs with PSA were used. Survival analysis confirmed a high combined miRNA score of miR-17-92 cluster was associated with shorter biochemical recurrence interval. miR-17-92 cluster could be a potential diagnostic and prognostic biomarker for PCa, and the combination of the miR-17-92 cluster and serum PSA may enhance the accuracy for diagnosis of PCa.

Likelihood-Based Clustering of Meta-Analytic SROC Curves

ERIC Educational Resources Information Center

Holling, Heinz; Bohning, Walailuck; Bohning, Dankmar

2012-01-01

Meta-analysis of diagnostic studies experience the common problem that different studies might not be comparable since they have been using a different cut-off value for the continuous or ordered categorical diagnostic test value defining different regions for which the diagnostic test is defined to be positive. Hence specificities and…

Bayesian Decision Theoretical Framework for Clustering

ERIC Educational Resources Information Center

Chen, Mo

2011-01-01

In this thesis, we establish a novel probabilistic framework for the data clustering problem from the perspective of Bayesian decision theory. The Bayesian decision theory view justifies the important questions: what is a cluster and what a clustering algorithm should optimize. We prove that the spectral clustering (to be specific, the…

Finding Useful Questions: On Bayesian Diagnosticity, Probability, Impact, and Information Gain

ERIC Educational Resources Information Center

Nelson, Jonathan D.

2005-01-01

Several norms for how people should assess a question's usefulness have been proposed, notably Bayesian diagnosticity, information gain (mutual information), Kullback-Liebler distance, probability gain (error minimization), and impact (absolute change). Several probabilistic models of previous experiments on categorization, covariation assessment,…

Correlation Functions in Two-Dimensional Critical Systems with Conformal Symmetry

NASA Astrophysics Data System (ADS)

Flores, Steven Miguel

This thesis presents a study of certain conformal field theory (CFT) correlation functions that describe physical observables in conform ally invariant two-dimensional critical systems. These are typically continuum limits of critical lattice models in a domain within the complex plane and with a boundary. Certain clusters, called boundary clusters, anchor to the boundary of the domain, and many of their features are governed by a conformally invariant probability measure. For example, percolaion is an example of a critical lattice model, and when it is confined to a domain with a boundary, connected clusters of activated bonds that touch that boundary are the boundary clusters. This thesis is concerned with how the boundary clusters interact with each other according to that measure. One question that it considers are "how likely are these clusters to repel each other or to connect with one another in a certain topological configuration?" Chapter one non-rigorously derives an already well-known elliptic system of differential equations closely tied to this matter by using standard techniques of CFT, chapters two and three rigorously infer certain properties concerning the solution space of this system, and chapter four uses some of those results to predict an answer to this question. This thesis also considers local variations of this question such as "what regions of the domain do the perimeters of the boundary clusters explore," and "how often will several boundary clusters connect at just a single, specified point in the domain?" Chapter five predicts precise answers to these questions. All of these answers are quantitative predictions that we verify via high-precision computer simulation. Chapters four and five also present these simulation results. Further material that supplements chapter one is included in two appendices.

Algorithms development for the GEM-based detection system

NASA Astrophysics Data System (ADS)

Czarski, T.; Chernyshova, M.; Malinowski, K.; Pozniak, K. T.; Kasprowicz, G.; Kolasinski, P.; Krawczyk, R.; Wojenski, A.; Zabolotny, W.

2016-09-01

The measurement system based on GEM - Gas Electron Multiplier detector - is developed for soft X-ray diagnostics of tokamak plasmas. The multi-channel setup is designed for estimation of the energy and the position distribution of an Xray source. The focal measuring issue is the charge cluster identification by its value and position estimation. The fast and accurate mode of the serial data acquisition is applied for the dynamic plasma diagnostics. The charge clusters are counted in the space determined by 2D position, charge value and time intervals. Radiation source characteristics are presented by histograms for a selected range of position, time intervals and cluster charge values corresponding to the energy spectra.

Non-negative Matrix Factorization and Co-clustering: A Promising Tool for Multi-tasks Bearing Fault Diagnosis

NASA Astrophysics Data System (ADS)

Shen, Fei; Chen, Chao; Yan, Ruqiang

2017-05-01

Classical bearing fault diagnosis methods, being designed according to one specific task, always pay attention to the effectiveness of extracted features and the final diagnostic performance. However, most of these approaches suffer from inefficiency when multiple tasks exist, especially in a real-time diagnostic scenario. A fault diagnosis method based on Non-negative Matrix Factorization (NMF) and Co-clustering strategy is proposed to overcome this limitation. Firstly, some high-dimensional matrixes are constructed using the Short-Time Fourier Transform (STFT) features, where the dimension of each matrix equals to the number of target tasks. Then, the NMF algorithm is carried out to obtain different components in each dimension direction through optimized matching, such as Euclidean distance and divergence distance. Finally, a Co-clustering technique based on information entropy is utilized to realize classification of each component. To verity the effectiveness of the proposed approach, a series of bearing data sets were analysed in this research. The tests indicated that although the diagnostic performance of single task is comparable to traditional clustering methods such as K-mean algorithm and Guassian Mixture Model, the accuracy and computational efficiency in multi-tasks fault diagnosis are improved.

Systemic challenges in bipolar disorder management: A patient-centered approach.

PubMed

Nestsiarovich, Anastasiya; Hurwitz, Nathaniel G; Nelson, Stuart J; Crisanti, Annette S; Kerner, Berit; Kuntz, Matt J; Smith, Alicia N; Volesky, Emma; Schroeter, Quentin L; DeShaw, Jason L; Young, S Stanley; Obenchain, Robert L; Krall, Ronald L; Jordan, Kimmie; Fawcett, Jan; Tohen, Mauricio; Perkins, Douglas J; Lambert, Christophe G

2017-12-01

As part of a series of Patient-Centered Outcomes Research Institute-funded large-scale retrospective observational studies on bipolar disorder (BD) treatments and outcomes, we sought the input of patients with BD and their family members to develop research questions. We aimed to identify systemic root causes of patient-reported challenges with BD management in order to guide subsequent studies and initiatives. Three focus groups were conducted where patients and their family members (total n = 34) formulated questions around the central theme, "What do you wish you had known in advance or over the course of treatment for BD?" In an affinity mapping exercise, participants clustered their questions and ranked the resulting categories by importance. The research team and members of our patient partner advisory council further rated the questions by expected impact on patients. Using a Theory of Constraints systems thinking approach, several causal models of BD management challenges and their potential solution were developed with patients using the focus group data. A total of 369 research questions were mapped to 33 categories revealing 10 broad themes. The top priorities for patient stakeholders involved pharmacotherapy and treatment alternatives. Analysis of causal relationships underlying 47 patient concerns revealed two core conflicts: for patients, whether or not to take pharmacotherapy, and for mental health services, the dilemma of care quality vs quantity. To alleviate the core conflicts identified, BD management requires a coordinated multidisciplinary approach including: improved access to mental health services, objective diagnostics, sufficient provider visit time, evidence-based individualized treatment, and psychosocial support. © 2017 The Authors. Bipolar Disorders Published by John Wiley & Sons Ltd.

Bayesian multivariate hierarchical transformation models for ROC analysis.

PubMed

O'Malley, A James; Zou, Kelly H

2006-02-15

A Bayesian multivariate hierarchical transformation model (BMHTM) is developed for receiver operating characteristic (ROC) curve analysis based on clustered continuous diagnostic outcome data with covariates. Two special features of this model are that it incorporates non-linear monotone transformations of the outcomes and that multiple correlated outcomes may be analysed. The mean, variance, and transformation components are all modelled parametrically, enabling a wide range of inferences. The general framework is illustrated by focusing on two problems: (1) analysis of the diagnostic accuracy of a covariate-dependent univariate test outcome requiring a Box-Cox transformation within each cluster to map the test outcomes to a common family of distributions; (2) development of an optimal composite diagnostic test using multivariate clustered outcome data. In the second problem, the composite test is estimated using discriminant function analysis and compared to the test derived from logistic regression analysis where the gold standard is a binary outcome. The proposed methodology is illustrated on prostate cancer biopsy data from a multi-centre clinical trial.

Bayesian multivariate hierarchical transformation models for ROC analysis

PubMed Central

O'Malley, A. James; Zou, Kelly H.

2006-01-01

SUMMARY A Bayesian multivariate hierarchical transformation model (BMHTM) is developed for receiver operating characteristic (ROC) curve analysis based on clustered continuous diagnostic outcome data with covariates. Two special features of this model are that it incorporates non-linear monotone transformations of the outcomes and that multiple correlated outcomes may be analysed. The mean, variance, and transformation components are all modelled parametrically, enabling a wide range of inferences. The general framework is illustrated by focusing on two problems: (1) analysis of the diagnostic accuracy of a covariate-dependent univariate test outcome requiring a Box–Cox transformation within each cluster to map the test outcomes to a common family of distributions; (2) development of an optimal composite diagnostic test using multivariate clustered outcome data. In the second problem, the composite test is estimated using discriminant function analysis and compared to the test derived from logistic regression analysis where the gold standard is a binary outcome. The proposed methodology is illustrated on prostate cancer biopsy data from a multi-centre clinical trial. PMID:16217836

Information-Gathering Patterns Associated with Higher Rates of Diagnostic Error

ERIC Educational Resources Information Center

Delzell, John E., Jr.; Chumley, Heidi; Webb, Russell; Chakrabarti, Swapan; Relan, Anju

2009-01-01

Diagnostic errors are an important source of medical errors. Problematic information-gathering is a common cause of diagnostic errors among physicians and medical students. The objectives of this study were to (1) determine if medical students' information-gathering patterns formed clusters of similar strategies, and if so (2) to calculate the…

Dynamic and Contextual Information in HMM Modeling for Handwritten Word Recognition.

PubMed

Bianne-Bernard, Anne-Laure; Menasri, Farès; Al-Hajj Mohamad, Rami; Mokbel, Chafic; Kermorvant, Christopher; Likforman-Sulem, Laurence

2011-10-01

This study aims at building an efficient word recognition system resulting from the combination of three handwriting recognizers. The main component of this combined system is an HMM-based recognizer which considers dynamic and contextual information for a better modeling of writing units. For modeling the contextual units, a state-tying process based on decision tree clustering is introduced. Decision trees are built according to a set of expert-based questions on how characters are written. Questions are divided into global questions, yielding larger clusters, and precise questions, yielding smaller ones. Such clustering enables us to reduce the total number of models and Gaussians densities by 10. We then apply this modeling to the recognition of handwritten words. Experiments are conducted on three publicly available databases based on Latin or Arabic languages: Rimes, IAM, and OpenHart. The results obtained show that contextual information embedded with dynamic modeling significantly improves recognition.

Diagnostic efficacy of posttraumatic symptoms in children exposed to disaster.

PubMed

Lonigan, C J; Anthony, J L; Shannon, M P

1998-10-01

Examined 5 conditional probability indices to determine the diagnostic efficacy of 48 symptoms associated with posttraumatic stress disorder (PTSD) in 5,687 children exposed to Hurricane Hugo, of whom 5.5% had a diagnosis of posttraumatic stress syndrome (PTSS). Moderate levels of sensitivity and high levels of specificity were obtained for most symptoms. Odds ratios more precisely demonstrated that some Diagnostic and Statistical Manual of Mental Disorders (DSM) symptoms of PTSD, especially when combined, were useful for identifying children with PTSS but that anxiety symptoms and some DSM symptoms of PTSD had poor diagnostic utility. Satisfying criteria for the DSM-III-R numbing/avoidance cluster and symptoms from the numbing/avoidance cluster had the highest diagnostic efficacy, suggesting that avoidance may be the hallmark of severe posttraumatic reactions. These results suggest which symptoms should be conceptualized as central versus peripheral to the disorder and which symptoms and symptom combinations clinicians should attend to most when diagnosing or screening PTSD in children.

School Psychologist Diagnostic Decision-Making: A Pilot Study

ERIC Educational Resources Information Center

Barnard-Brak, Lucy; Stevens, Tara; Robinson, Eric; Holt, Ann

2013-01-01

The current study examined the diagnostic decision-making of school psychologists as a function of a student's disability and academic performance with three research questions using a randomly-selected sample of school psychologists from the state of Texas. Results from the first research question indicated that school psychologists significantly…

Effects of Experience and Training on Diagnostic Accuracy.

ERIC Educational Resources Information Center

Brammer, Robert

The interview process was studied to uncover the relationship of expertise in psychotherapy to the likelihood of accurate diagnosis. Experience and training affect the number of diagnostic questions clinicians ask as compared to personal, family, social, occupational, and history questions; and this in turn affects the accuracy of the diagnoses…

Characterizing cognitive heterogeneity on the schizophrenia-bipolar disorder spectrum.

PubMed

Van Rheenen, T E; Lewandowski, K E; Tan, E J; Ospina, L H; Ongur, D; Neill, E; Gurvich, C; Pantelis, C; Malhotra, A K; Rossell, S L; Burdick, K E

2017-07-01

Current group-average analysis suggests quantitative but not qualitative cognitive differences between schizophrenia (SZ) and bipolar disorder (BD). There is increasing recognition that cognitive within-group heterogeneity exists in both disorders, but it remains unclear as to whether between-group comparisons of performance in cognitive subgroups emerging from within each of these nosological categories uphold group-average findings. We addressed this by identifying cognitive subgroups in large samples of SZ and BD patients independently, and comparing their cognitive profiles. The utility of a cross-diagnostic clustering approach to understanding cognitive heterogeneity in these patients was also explored. Hierarchical clustering analyses were conducted using cognitive data from 1541 participants (SZ n = 564, BD n = 402, healthy control n = 575). Three qualitatively and quantitatively similar clusters emerged within each clinical group: a severely impaired cluster, a mild-moderately impaired cluster and a relatively intact cognitive cluster. A cross-diagnostic clustering solution also resulted in three subgroups and was superior in reducing cognitive heterogeneity compared with disorder clustering independently. Quantitative SZ-BD cognitive differences commonly seen using group averages did not hold when cognitive heterogeneity was factored into our sample. Members of each corresponding subgroup, irrespective of diagnosis, might be manifesting the outcome of differences in shared cognitive risk factors.

Bipolar disorder with comorbid cluster B personality disorder features: impact on suicidality.

PubMed

Garno, Jessica L; Goldberg, Joseph F; Ramirez, Paul Michael; Ritzler, Barry A

2005-03-01

Because of their overlapping phenomenology and mutually chronic, persistent nature, distinctions between bipolar disorder and cluster B personality disorders remain a source of unresolved clinical controversy. The extent to which comorbid personality disorders impact course and outcome for bipolar patients also has received little systematic study. One hundred DSM-IV bipolar I (N = 73) or II (N = 27) patients consecutively underwent diagnostic evaluations with structured clinical interviews for DSM-IV Axis I and cluster B Axis II disorders, along with assessments of histories of childhood trauma or abuse. Cluster B diagnostic comorbidity was examined relative to lifetime substance abuse, suicide attempt histories, and other clinical features. Thirty percent of subjects met DSM-IV criteria for a cluster B personality disorder (17% borderline, 6% antisocial, 5% histrionic, 8% narcissistic). Cluster B diagnoses were significantly linked with histories of childhood emotional abuse (p = .009), physical abuse (p = .014), and emotional neglect (p = .022), but not sexual abuse or physical neglect. Cluster B comorbidity was associated with significantly more lifetime suicide attempts and current depression. Lifetime suicide attempts were significantly associated with cluster B comorbidity (OR = 3.195, 95% CI = 1.124 to 9.088), controlling for current depression severity, lifetime substance abuse, and past sexual or emotional abuse. Cluster B personality disorders are prevalent comorbid conditions identifiable in a substantial number of individuals with bipolar disorder, making an independent contribution to increased lifetime suicide risk.

Studies in the X-Ray Emission of Clusters of Galaxies and Other Topics

NASA Technical Reports Server (NTRS)

Vrtilek, Jan; Thronson, Harley (Technical Monitor)

2001-01-01

The paper discusses the following: (1) X-ray study of groups of galaxies with Chandra and XMM. (2) X-ray properties of point sources in Chandra deep fields. (3) Study of cluster substructure using wavelet techniques. (4) Combined study of galaxy clusters with X-ray and the S-Z effect. Groups of galaxies are the fundamental building blocks of large scale structure in the Universe. X-ray study of the intragroup medium offers a powerful approach to addressing some of the major questions that still remain about almost all aspects of groups: their ages, origins, importance of composition of various galaxy types, relations to clusters, and origin and enrichment of the intragroup gas. Long exposures with Chandra have opened new opportunities for the study of X-ray background. The presence of substructure within clusters of galaxies has substantial implications for our understanding of cluster evolution as well as fundamental questions in cosmology.

Health Occupations Cluster.

ERIC Educational Resources Information Center

Walraven, Catherine; And Others

These instructional materials consist of a series of curriculum worksheets that cover tasks to be mastered by students in health occupations cluster programs. Covered in the curriculum worksheets are diagnostic procedures; observing/recording/reporting/planning; safety; nutrition/elimination; hygiene/personal care/comfort;…

Applying a Resources Framework to Analysis of the Force and Motion Conceptual Evaluation

ERIC Educational Resources Information Center

Smith, Trevor I.; Wittman, Michael C.

2008-01-01

We suggest one redefinition of common clusters of questions used to analyze student responses on the Force and Motion Conceptual Evaluation. Our goal is to propose a methodology that moves beyond an analysis of student learning defined by correct responses, either on the overall test or on clusters of questions defined solely by content. We use…

Diagnostic Validity of Combining History Elements and Physical Examination Tests for Traumatic and Degenerative Symptomatic Meniscal Tears.

PubMed

Décary, Simon; Fallaha, Michel; Frémont, Pierre; Martel-Pelletier, Johanne; Pelletier, Jean-Pierre; Feldman, Debbie E; Sylvestre, Marie-Pierre; Vendittoli, Pascal-André; Desmeules, François

2018-05-01

The current approach to the clinical diagnosis of traumatic and degenerative symptomatic meniscal tears (SMTs) proposes combining history elements and physical examination tests without systematic prescription of imaging investigations, yet the evidence to support this diagnostic approach is scarce. To assess the validity of diagnostic clusters combining history elements and physical examination tests to diagnose or exclude traumatic and degenerative SMT compared with other knee disorders. Prospective diagnostic accuracy study. Patients were recruited from 2 orthopedic clinics, 2 family medicine clinics, and from a university community. A total of 279 consecutive patients who underwent consultation for a new knee complaint. Each patient was assessed independently by 2 evaluators. History elements and standardized physical examination tests performed by a physiotherapist were compared with the reference standard: an expert physicians' composite diagnosis including a clinical examination and confirmatory magnetic resonance imaging. Participating expert physicians were orthopedic surgeons (n = 3) or sport medicine physicians (n = 2). Penalized logistic regression (least absolute shrinkage and selection operator) was used to identify history elements and physical examination tests associated with the diagnosis of SMT and recursive partitioning was used to develop diagnostic clusters. Diagnostic accuracy measures were calculated including sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios (LR+/-) with associated 95% confidence intervals (CIs). Eighty patients had a diagnosis of SMT (28.7%), including 35 traumatic tears and 45 degenerative tears. The combination a history of trauma during a pivot, medial knee pain location, and a positive medial joint line tenderness test was able to diagnose (LR+ = 8.9; 95% CI 6.1-13.1) or exclude (LR- = 0.10; 95% CI 0.03-0.28) a traumatic SMT. Combining a history of progressive onset of pain, medial knee pain location, pain while pivoting, absence of valgus or varus knee misalignment, or full passive knee flexion was able to moderately diagnose (LR+ = 6.4; 95% CI 4.0-10.4) or exclude (LR- = 0.10; 95% CI 0.03-0.31) a degenerative SMT. Internal validation estimates were slightly lower for all clusters but demonstrated positive LR superior to 5 and negative LR inferior to 0.2 indicating moderate shift in posttest probability. Diagnostic clusters combining history elements and physical examination tests can support the differential diagnosis of SMT. These results represent the initial derivation of the clusters and external validation is mandatory. I. Copyright © 2018 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Design and utilization of a top hat analyzer for Hall thruster plume diagnostics

NASA Astrophysics Data System (ADS)

Victor, Allen Leoraj

Electric propulsion offers new capabilities for ambitious space missions of the future. However, coating, uneven heating, and the charging of spacecraft components have impeded the integration of Hall thrusters for space missions and encouraged plume diagnostics of the thruster plasma environment. Plume diagnostics are also important for the inference of thruster performance through plume properties downstream of the engine. While the top hat analyzer has been available for low-density space plasma diagnostics for over twenty years, the use of this instrument for plasma thruster plume diagnostics has been nonexistent. This thesis describes the development of a new diagnostics tool, the Top Hat Electric Propulsion Plume Analyzer (TOPAZ), which provides unprecedented insight into the physical mechanisms that govern the performance of Hall thrusters. Novel measurements conducted by TOPAZ on the BHT-600 Hall thruster cluster yielded interesting and undocumented phenomena in the far-field plume. SIMION, a commercial ion optics program, was used to design TOPAZ and estimate the energy and angular resolutions as well as the instrument's sensitivity and plate-voltage relationships. TOPAZ was experimentally characterized through an ion beam facility operating on air, xenon, and krypton gases. Measurements on the BHT-600 cluster indicated lower-energy ions emanated from positions closer to the cathode while higher-energy ions were measured from along the discharge channel centerlines. Low-energy ions were also measured from behind the cathodes only during cluster operation. Charge-exchange and ionization outside the primary acceleration region are believed to be the cause of the variance in the energy distributions. Cross pollination of the cathode plume with the opposite thruster is argued to create low-energy ions which emanate from behind the cathode. Time-of-flight measurements through TOPAZ allowed for charge-state and species fraction discriminations as functions of emanation points from the cluster. Multiply-charged ions (˜5%) were measured from regions near the discharge channels and only for plume angles less than 20 degrees. Calculations of the axial and radial velocity distributions for the first three charge-states downstream of the cluster centerline revealed a symmetric triple-peak structure in the radial velocity distributions and a double-peak profile in the axial velocity distribution of the first charge-state of xenon.

Context-Dependent Conflation, Text Filtering and Clustering

DTIC Science & Technology

2004-09-01

microscopy, capillaroscopy ) focuses on the diagnostic use of nail-fold capillary microscopy. Factor 10 (training, biofeedback, relaxation, stress, outcome...impact circulation. It incorporates the themes of Factors 2, 3, 5, 7, 8. Cluster 2a2 (CAPILLARY- CONSECUTIVE) focuses on nailfold capillary

The Confidence-Accuracy Relationship in Diagnostic Assessment: The Case of the Potential Difference in Parallel Electric Circuits

ERIC Educational Resources Information Center

Saglam, Murat

2015-01-01

This study explored the relationship between accuracy of and confidence in performance of 114 prospective primary school teachers in answering diagnostic questions on potential difference in parallel electric circuits. The participants were required to indicate their confidence in their answers for each question. Bias and calibration indices were…

Diagnostics of Pupils' Attitude to Education

ERIC Educational Resources Information Center

Eminli, Tovuz

2011-01-01

The paper is devoted to the investigation of the questions connected with the pedagogical diagnostics, in particular, the diagnostics of pupils' attitude to education. It is considered reasonable to apply the practice of development of an individual pedagogical and psychological map for productive implementation of the pedagogical diagnostics and…

Homogeneity tests of clustered diagnostic markers with applications to the BioCycle Study

PubMed Central

Tang, Liansheng Larry; Liu, Aiyi; Schisterman, Enrique F.; Zhou, Xiao-Hua; Liu, Catherine Chun-ling

2014-01-01

Diagnostic trials often require the use of a homogeneity test among several markers. Such a test may be necessary to determine the power both during the design phase and in the initial analysis stage. However, no formal method is available for the power and sample size calculation when the number of markers is greater than two and marker measurements are clustered in subjects. This article presents two procedures for testing the accuracy among clustered diagnostic markers. The first procedure is a test of homogeneity among continuous markers based on a global null hypothesis of the same accuracy. The result under the alternative provides the explicit distribution for the power and sample size calculation. The second procedure is a simultaneous pairwise comparison test based on weighted areas under the receiver operating characteristic curves. This test is particularly useful if a global difference among markers is found by the homogeneity test. We apply our procedures to the BioCycle Study designed to assess and compare the accuracy of hormone and oxidative stress markers in distinguishing women with ovulatory menstrual cycles from those without. PMID:22733707

Use of molecular testing to identify a cluster of patients with polycythemia vera in eastern Pennsylvania.

PubMed

Seaman, Vincent; Jumaan, Aisha; Yanni, Emad; Lewis, Brian; Neyer, Jonathan; Roda, Paul; Xu, Mingjiang; Hoffman, Ronald

2009-02-01

The role of the environment in the origin of polycythemia vera has not been well documented. Recently, molecular diagnostic tools have been developed to facilitate the diagnosis of polycythemia vera. A cluster of patients with polycythemia vera was suspected in three countries in eastern Pennsylvania where there have long been a concern about environment hazards. Rigorous clinical criteria and JAK2 617V>F testing were used to confirm the diagnosis of polycythemia vera in patients in this area. Participants included cases of polycythemia vera from the 2001 to 2005 state cancer registry as well as self- and physician-referred cases. A diagnosis of polycythemia vera was confirmed in 53% of 62 participants using WHO criteria, which includes JAK2 617V>F testing. A statistically significant cluster of cases (P < 0.001) was identified where the incidence of polycythemia vera was 4.3 times that of the rest of the study area. The area of the cluster contained numerous sources of hazardous material including waste-coal power plants and U.S. Environmental Protection Agency Superfund sites. The diagnosis of polycythemia vera based solely on clinical criteria is frequently erroneous, suggesting that our prior knowledge of the epidemiology of this disease might be inaccurate. The JAK2 617V>F mutational analysis provides diagnostic clarity and permitted the confirmation of a cluster of polycythemia vera cases not identified by traditional clinical and pathologic diagnostic criteria. The close proximity of this cluster to known areas of hazardous material exposure raises concern that such environmental factors might play a role in the origin of polycythemia vera.

Using Diagnostic Assessment to Help Teachers Understand the Chemistry of the Lead-Acid Battery

ERIC Educational Resources Information Center

Cheung, Derek

2011-01-01

Nineteen pre-service and in-service teachers taking a chemistry teaching methods course at a university in Hong Kong were asked to take a diagnostic assessment. It consisted of seven multiple-choice questions about the chemistry of the lead-acid battery. Analysis of the teachers' responses to the questions indicated that they had difficulty in…

"Finding Useful Questions: On Bayesian Diagnosticity, Probability, Impact, and Information Gain": Correction to Nelson (2005)

ERIC Educational Resources Information Center

Nelson, Jonathan D.

2007-01-01

Reports an error in "Finding Useful Questions: On Bayesian Diagnosticity, Probability, Impact, and Information Gain" by Jonathan D. Nelson (Psychological Review, 2005[Oct], Vol 112[4], 979-999). In Table 13, the data should indicate that 7% of females had short hair and 93% of females had long hair. The calculations and discussion in the article…

The Formation of Cluster Populations Through Direct Galaxy Collisions

NASA Astrophysics Data System (ADS)

Peterson, Bradley W.; Smith, Beverly J.; Struck, Curtis

2016-01-01

Much progress has been made on the question of how globular clusters form. In particular, the study of extragalactic populations of young, high-mass clusters ("super star clusters") has revealed a class of objects can evolve into globular clusters. The process by which these clusters form, and how many survive long enough to become globular clusters, is not wholly understood. Here, we use new data on the colliding galaxy system Arp 261 to investigate the possibility that young, massive clusters form in greater numbers during direct galaxy collisions, compared to less direct tidal collisions.

Pathological Gambling Subtypes

ERIC Educational Resources Information Center

Vachon, David D.; Bagby, R. Michael

2009-01-01

Although pathological gambling (PG) is regarded in the 4th edition of the "Diagnostic and Statistical Manual of Mental Disorders" (American Psychiatric Association, 1994) as a unitary diagnostic construct, it is likely composed of distinct subtypes. In the current report, the authors used cluster analyses of personality traits with a…

Investigation of a Diagnostic for Perturbation Theory: Comparison to the T(sub 1) Diagnostic of Coupled-Cluster Theory

NASA Technical Reports Server (NTRS)

Lee, Timothy J.; Head-Gordon, Martin; Rendell, Alistair P.; Langhoff, Stephen R. (Technical Monitor)

1995-01-01

A diagnostic for perturbation theory calculations, S(sub 2), is defined and numerical results are compared to the established T(sub 1) diagnostic from coupled-cluster theory. S(sub 2) is the lowest order non-zero contribution to a perturbation expansion of T(sub 1). S(sub 2) is a reasonable estimate of the importance of non-dynamical electron correlation, although not as reliable as T(sub 1). S(sub 2) values less than or equal to 0.012 suggest that low orders of perturbation theory should yield reasonable results; S(sub 2) values between 0.012-0.015 suggest that caution is required in interpreting results from low orders of perturbation theory; S(sub 2) values greater than or equal to 0.015 indicate that low orders of perturbation theory are not reliable for accurate results. Although not required mathematically, S(sub 2) is always less than T(sub 1) for the examples studied here.

Refining a complex diagnostic construct: subtyping Dysthymia with the Shedler-Westen Assessment Procedure-II.

PubMed

Huprich, Steven K; Defife, Jared; Westen, Drew

2014-01-01

We sought to determine whether meaningful subtypes of Dysthymic patients could be identified when grouping them by similar personality profiles. A random, national sample of psychiatrists and clinical psychologists (n=1201) described a randomly selected current patient with personality pathology using the descriptors in the Shedler-Westen Assessment Procedure-II (SWAP-II), completed assessments of patients' adaptive functioning, and provided DSM-IV Axis I and II diagnoses. We applied Q-factor cluster analyses to those patients diagnosed with Dysthymic Disorder. Four clusters were identified-High Functioning, Anxious/Dysphoric, Emotionally Dysregulated, and Narcissistic. These factor scores corresponded with a priori hypotheses regarding diagnostic comorbidity and level of adaptive functioning. We compared these groups to diagnostic constructs described and empirically identified in the past literature. The results converge with past and current ideas about the ways in which chronic depression and personality are related and offer an enhanced means by which to understand a heterogeneous diagnostic category that is empirically grounded and clinically useful. © 2013 Published by Elsevier B.V.

Outbreak Investigation Using High-Throughput Genome Sequencing within a Diagnostic Microbiology Laboratory

PubMed Central

Sherry, Norelle L.; Porter, Jessica L.; Seemann, Torsten; Watkins, Andrew; Stinear, Timothy P.

2013-01-01

Next-generation sequencing (NGS) of bacterial genomes has recently become more accessible and is now available to the routine diagnostic microbiology laboratory. However, questions remain regarding its feasibility, particularly with respect to data analysis in nonspecialist centers. To test the applicability of NGS to outbreak investigations, Ion Torrent sequencing was used to investigate a putative multidrug-resistant Escherichia coli outbreak in the neonatal unit of the Mercy Hospital for Women, Melbourne, Australia. Four suspected outbreak strains and a comparator strain were sequenced. Genome-wide single nucleotide polymorphism (SNP) analysis demonstrated that the four neonatal intensive care unit (NICU) strains were identical and easily differentiated from the comparator strain. Genome sequence data also determined that the NICU strains belonged to multilocus sequence type 131 and carried the blaCTX-M-15 extended-spectrum beta-lactamase. Comparison of the outbreak strains to all publicly available complete E. coli genome sequences showed that they clustered with neonatal meningitis and uropathogenic isolates. The turnaround time from a positive culture to the completion of sequencing (prior to data analysis) was 5 days, and the cost was approximately $300 per strain (for the reagents only). The main obstacles to a mainstream adoption of NGS technologies in diagnostic microbiology laboratories are currently cost (although this is decreasing), a paucity of user-friendly and clinically focused bioinformatics platforms, and a lack of genomics expertise outside the research environment. Despite these hurdles, NGS technologies provide unparalleled high-resolution genotyping in a short time frame and are likely to be widely implemented in the field of diagnostic microbiology in the next few years, particularly for epidemiological investigations (replacing current typing methods) and the characterization of resistance determinants. Clinical microbiologists need to familiarize themselves with these technologies and their applications. PMID:23408689

A cluster randomized trial to assess the effect of clinical pathways for patients with stroke: results of the clinical pathways for effective and appropriate care study

PubMed Central

2012-01-01

Background Clinical pathways (CPs) are used to improve the outcomes of acute stroke, but their use in stroke care is questionable, because the evidence on their effectiveness is still inconclusive. The objective of this study was to evaluate whether CPs improve the outcomes and the quality of care provided to patients after acute ischemic stroke. Methods This was a multicentre cluster-randomized trial, in which 14 hospitals were randomized to the CP arm or to the non intervention/usual care (UC) arm. Healthcare workers in the CP arm received 3 days of training in quality improvement of CPs and in use of a standardized package including information on evidence-based key interventions and indicators. Healthcare workers in the usual-care arm followed their standard procedures. The teams in the CP arm developed their CPs over a 6-month period. The primary end point was mortality. Secondary end points were: use of diagnostic and therapeutic procedures, implementation of organized care, length of stay, re-admission and institutionalization rates after discharge, dependency levels, and complication rates. Results Compared with the patients in the UC arm, the patients in the CP arm had a significantly lower risk of mortality at 7 days (OR = 0.10; 95% CI 0.01 to 0.95) and significantly lower rates of adverse functional outcomes, expressed as the odds of not returning to pre-stroke functioning in their daily life (OR = 0.42; 95 CI 0.18 to 0.98). There was no significant effect on 30-day mortality. Compared with the UC arm, the hospital diagnostic and therapeutic procedures were performed more appropriately in the CP arm, and the evidence-based key interventions and organized care were more applied in the CP arm. Conclusions CPs can significantly improve the outcomes of patients with ischemic patients with stroke, indicating better application of evidence-based key interventions and of diagnostic and therapeutic procedures. This study tested a new hypothesis and provided evidence on how CPs can work. Trial registration ClinicalTrials.gov ID: [NCT00673491]. PMID:22781160

From hormones to secondary metabolism: the emergence of metabolic gene clusters in plants.

PubMed

Chu, Hoi Yee; Wegel, Eva; Osbourn, Anne

2011-04-01

Gene clusters for the synthesis of secondary metabolites are a common feature of microbial genomes. Well-known examples include clusters for the synthesis of antibiotics in actinomycetes, and also for the synthesis of antibiotics and toxins in filamentous fungi. Until recently it was thought that genes for plant metabolic pathways were not clustered, and this is certainly true in many cases; however, five plant secondary metabolic gene clusters have now been discovered, all of them implicated in synthesis of defence compounds. An obvious assumption might be that these eukaryotic gene clusters have arisen by horizontal gene transfer from microbes, but there is compelling evidence to indicate that this is not the case. This raises intriguing questions about how widespread such clusters are, what the significance of clustering is, why genes for some metabolic pathways are clustered and those for others are not, and how these clusters form. In answering these questions we may hope to learn more about mechanisms of genome plasticity and adaptive evolution in plants. It is noteworthy that for the five plant secondary metabolic gene clusters reported so far, the enzymes for the first committed steps all appear to have been recruited directly or indirectly from primary metabolic pathways involved in hormone synthesis. This may or may not turn out to be a common feature of plant secondary metabolic gene clusters as new clusters emerge. © 2011 The Authors. The Plant Journal © 2011 Blackwell Publishing Ltd.

Laboratory-based validation of the baseline sensors of the ITER diagnostic residual gas analyzer

NASA Astrophysics Data System (ADS)

Klepper, C. C.; Biewer, T. M.; Marcus, C.; Andrew, P.; Gardner, W. L.; Graves, V. B.; Hughes, S.

2017-10-01

The divertor-specific ITER Diagnostic Residual Gas Analyzer (DRGA) will provide essential information relating to DT fusion plasma performance. This includes pulse-resolving measurements of the fuel isotopic mix reaching the pumping ducts, as well as the concentration of the helium generated as the ash of the fusion reaction. In the present baseline design, the cluster of sensors attached to this diagnostic's differentially pumped analysis chamber assembly includes a radiation compatible version of a commercial quadrupole mass spectrometer, as well as an optical gas analyzer using a plasma-based light excitation source. This paper reports on a laboratory study intended to validate the performance of this sensor cluster, with emphasis on the detection limit of the isotopic measurement. This validation study was carried out in a laboratory set-up that closely prototyped the analysis chamber assembly configuration of the baseline design. This includes an ITER-specific placement of the optical gas measurement downstream from the first turbine of the chamber's turbo-molecular pump to provide sufficient light emission while preserving the gas dynamics conditions that allow for \\textasciitilde 1 s response time from the sensor cluster [1].

Predicting Cognitive, Functional, and Diagnostic Change over 4 Years Using Baseline Subjective Cognitive Complaints in the Sydney Memory and Ageing Study.

PubMed

Slavin, Melissa J; Sachdev, Perminder S; Kochan, Nicole A; Woolf, Claudia; Crawford, John D; Giskes, Katrina; Reppermund, Simone; Trollor, Julian N; Draper, Brian; Delbaere, Kim; Brodaty, Henry

2015-09-01

There is limited understanding of the usefulness of subjective cognitive complaint(s) (SCC) in predicting longitudinal outcome because most studies focus solely on memory (as opposed to nonmemory cognitive) complaints, do not collect data from both participants and informants, do not control for relevant covariates, and have limited outcome measures. Therefore the authors investigate the usefulness of participant and informant SCCs in predicting change in cognition, functional abilities, and diagnostic classification of mild cognitive impairment or dementia in a community-dwelling sample over 4 years. Nondemented participants (N = 620) in the Sydney Memory and Ageing Study aged between 70 and 90 years completed 15 memory and 9 nonmemory SCC questions. An informant completed a baseline questionnaire that included 15 memory and 4 nonmemory SCC questions relating to the participant. Neuropsychological, functional, and diagnostic assessments were carried out at baseline and again at 4-year follow-up. Cross-sectional and longitudinal analyses were carried out to determine the association between SCC indices and neuropsychological, functional, and diagnostic data while controlling for psychological measures. Once participant characteristics were controlled for, participant complaints were generally not predictive of cognitive or functional decline, although participant memory-specific complaints were predictive of diagnostic conversion. Informant-related memory questions were associated with global cognitive and functional decline and with diagnostic conversion over 4 years. Informant memory complaint questions were better than participant complaints in predicting cognitive and functional decline as well as diagnoses over 4 years. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

WISC-IV Profiles Are Associated with Differences in Symptomatology and Outcome in Children with ADHD

ERIC Educational Resources Information Center

Thaler, Nicholas S.; Bello, Danielle T.; Etcoff, Lewis M.

2013-01-01

Objective: The current study investigated the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) cluster profiles of children with ADHD to examine the association between IQ profiles and diagnostic frequency, symptomatology, and outcome in this population. Method: Hierarchical cluster analysis was conducted on 189 children with a…

FLOCK cluster analysis of mast cell event clustering by high-sensitivity flow cytometry predicts systemic mastocytosis.

PubMed

Dorfman, David M; LaPlante, Charlotte D; Pozdnyakova, Olga; Li, Betty

2015-11-01

In our high-sensitivity flow cytometric approach for systemic mastocytosis (SM), we identified mast cell event clustering as a new diagnostic criterion for the disease. To objectively characterize mast cell gated event distributions, we performed cluster analysis using FLOCK, a computational approach to identify cell subsets in multidimensional flow cytometry data in an unbiased, automated fashion. FLOCK identified discrete mast cell populations in most cases of SM (56/75 [75%]) but only a minority of non-SM cases (17/124 [14%]). FLOCK-identified mast cell populations accounted for 2.46% of total cells on average in SM cases and 0.09% of total cells on average in non-SM cases (P < .0001) and were predictive of SM, with a sensitivity of 75%, a specificity of 86%, a positive predictive value of 76%, and a negative predictive value of 85%. FLOCK analysis provides useful diagnostic information for evaluating patients with suspected SM, and may be useful for the analysis of other hematopoietic neoplasms. Copyright© by the American Society for Clinical Pathology.

Use of a modified Comprehensive Pain Evaluation Questionnaire: Characteristics and functional status of patients on entry to a tertiary care pain clinic

PubMed Central

Nelli, Jennifer M; Nicholson, Keith; Lakha, S Fatima; Louffat, Ada F; Chapparo, Luis; Furlan, Julio; Mailis-Gagnon, Angela

2012-01-01

BACKGROUND: With increasing knowledge of chronic pain, clinicians have attempted to assess chronic pain patients with lengthy assessment tools. OBJECTIVES: To describe the functional and emotional status of patients presenting to a tertiary care pain clinic; to assess the reliability and validity of a diagnostic classification system for chronic pain patients modelled after the Multidimensional Pain Inventory; to provide psychometric data on a modified Comprehensive Pain Evaluation Questionnaire (CPEQ); and to evaluate the relationship between the modified CPEQ construct scores and clusters with Diagnostic and Statistical Manual, Fourth Edition – Text Revision Pain Disorder diagnoses. METHODS: Data on 300 new patients over the course of nine months were collected using standardized assessment procedures plus a modified CPEQ at the Comprehensive Pain Program, Toronto Western Hospital, Toronto, Ontario. RESULTS: Cluster analysis of the modified CPEQ revealed three patient profiles, labelled Adaptive Copers, Dysfunctional, and Interpersonally Distressed, which closely resembled those previously reported. The distribution of modified CPEQ construct T scores across profile subtypes was similar to that previously reported for the original CPEQ. A novel finding was that of a strong relationship between the modified CPEQ clusters and constructs with Diagnostic and Statistical Manual, Fourth Edition – Text Revision Pain Disorder diagnoses. DISCUSSION AND CONCLUSIONS: The CPEQ, either the original or modified version, yields reproducible results consistent with the results of other studies. This technique may usefully classify chronic pain patients, but more work is needed to determine the meaning of the CPEQ clusters, what psychological or biomedical variables are associated with CPEQ constructs or clusters, and whether this instrument may assist in treatment planning or predict response to treatment. PMID:22518368

How to conduct a high-quality original study on a diagnostic research topic.

PubMed

Yao, Xiaomei; Vella, Emily

2017-09-01

As health research methodologists and journal reviewers, we noticed that the methodological rigor of many publications on diagnostic or prognostic topics in the medical literature could be improved. We present a concise and clear series of reviews to help clinicians and health researchers to master the basic key components of how to conduct a high-quality original study or systematic review on a diagnostic or prognostic research topic from a methodological perspective. This is the first review of the series, which focuses on how to conduct a high-quality diagnostic study. We are introducing four aspects: clarifying the objectives; generating an appropriate research question; planning the study design; and reporting and analyzing data. This review highlights that diagnostic test accuracy outcomes are surrogates for patient outcomes, a diagnostic test has three roles, the "PIRO" components should be included in a diagnostic research question, a new study should be registered, multiple index tests can be compared in one study, and prevalence affects test accuracy outcomes. This review also emphasizes reporting any thresholds, calculating sample size, and performing a two-by-three table to calculate diagnostic outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Re-Conceptualizing ASD within a Dimensional Framework: Positive, Negative, and Cognitive Feature Clusters

ERIC Educational Resources Information Center

Foss-Feig, Jennifer H.; McPartland, James C.; Anticevic, Alan; Wolf, Julie

2016-01-01

Introduction of the National Institute of Mental Health's Research Domain Criteria and revision of diagnostic classification for Autism Spectrum Disorder in the latest diagnostic manual call for a new way of conceptualizing heterogeneous ASD features. We propose a novel conceptualization of ASD, borrowing from the schizophrenia literature in…

A combined strategy for screening a clustered mobile population returning from highly endemic areas for Plasmodium falciparum.

PubMed

Li, Mei; Li, Jun; Xia, Zhigui; Xiao, Ning; Jiang, Weikang; Wen, Yongkang

2017-04-30

Early and accurate diagnosis of imported malaria cases in clusters is crucial for protecting the health of patients and local populations, especially confirmed parasitic persons who are asymptomatic. A total of 226 gold miners who had stayed in highly endemic areas of Ghana for more than six months and returned in clusters were selected randomly. Blood samples from them were tested with microscopy, nest polymerase chain reaction, and rapid diagnostic test (RDT). The sensitivity, specificity, predictive values, agreement rate, and Youden's index of each of three diagnostic methods were calculated and compared with the defined gold standard. A quick and efficient way to respond to screening such a clustered mobile population was predicted and analyzed by evaluating two assumed results of combining microscopy and RDT with or without symptoms of illness. The rate of the carriers of malaria parasites in the populations of gold miners was 19.47%, including 39 P. falciparum. Among the three diagnostic methods, the microscopy method showed the highest specificity, while the RDT method showed the highest sensitivity but the lowest specificity in detecting P. falciparum. The assumed results of combining RDT and microscopy with symptoms showed the best results among all the test results in screening P. falciparum. It was too complex and difficult to catch all parasite carriers in a short period of time among populations with such a complicated situation as that in Shanglin County. A strategy of combing microscopy and RDT for diagnosis is highly recommended.

Conference summary: the Bologna-M16 Questions

NASA Astrophysics Data System (ADS)

Davies, M. B.

Rather than attempt to summarise an entire week of excellent talks, I will instead take the material covered in this meeting as a starting point and from it produce a list of questions which cover a number of outstanding questions within the field of stellar cluster formation and evolution. I have five questions in total. Given the location (Bologna) and nature (Modest-16) of the meeting, I label my questions the Bologna-M16 Questions.

A new, empirically established hypochondriasis diagnosis.

PubMed

Fink, Per; Ørnbøl, Eva; Toft, Tomas; Sparle, Kaj Christensen; Frostholm, Lisbeth; Olesen, Frede

2004-09-01

The narrow ICD-10 and DSM-IV definition of hypochondriasis makes it rarely used yet does not prevent extensive diagnosis overlap. This study identified a distinct hypochondriasis symptom cluster and defined diagnostic criteria. Consecutive patients (N=1,785) consulting primary care physicians for new illness were screened for somatization, anxiety, depression, and alcohol abuse. A stratified subgroup of 701 patients were interviewed with the Schedules for Clinical Assessment in Neuropsychiatry and questions addressing common hypochondriasis symptoms. Symptom patterns were analyzed by latent class analysis. Patients fell into three classes based on six symptoms: preoccupation with the idea of harboring an illness or with bodily function, rumination about illness, suggestibility, unrealistic fear of infection, fascination with medical information, and fear of prescribed medication. All symptoms, particularly rumination, were frequent in one of the classes. Classification allowed definition of new diagnostic criteria for hypochondriasis and division of the cases into "mild" and "severe." The weighted prevalence of severe cases was 9.5% versus 5.8% for DSM-IV hypochondriasis. Compared with DSM-IV hypochondriasis, this approach produced less overlap with other somatoform disorders, similar overlap with nonsomatoform psychiatric disorders, and similar assessments by primary care physicians. Severe cases of the new hypochondriasis lasted 2 or more years in 54.3% of the subjects and 1 month or less in 27.2%. These results suggest that rumination about illness plus at least one of five other symptoms form a distinct diagnostic entity performing better than the current DSM-IV hypochondriasis diagnosis. However, these criteria are preliminary, awaiting cross-validation in other subject groups.

Deepening Prospective Mathematics Teachers' Diagnostic Judgments: Interplay of Videos, Focus Questions and Didactic Categories

ERIC Educational Resources Information Center

Prediger, Susanne; Zindel, Carina

2017-01-01

This article combines different conceptualizations of teachers' diagnostic competence in listening to students' mathematical thinking processes on the levels of general perspectives, noticed aspects and activated didactic categories. An empirical study of 159 prospective mathematics teachers' diagnostic judgments investigated how these levels are…

Clinical diagnosis of partial or complete anterior cruciate ligament tears using patients' history elements and physical examination tests.

PubMed

Décary, Simon; Fallaha, Michel; Belzile, Sylvain; Martel-Pelletier, Johanne; Pelletier, Jean-Pierre; Feldman, Debbie; Sylvestre, Marie-Pierre; Vendittoli, Pascal-André; Desmeules, François

2018-01-01

To assess the diagnostic validity of clusters combining history elements and physical examination tests to diagnose partial or complete anterior cruciate ligament (ACL) tears. Prospective diagnostic study. Orthopaedic clinics (n = 2), family medicine clinics (n = 2) and community-dwelling. Consecutive patients with a knee complaint (n = 279) and consulting one of the participating orthopaedic surgeons (n = 3) or sport medicine physicians (n = 2). Not applicable. History elements and physical examination tests performed independently were compared to the reference standard: an expert physicians' composite diagnosis including history elements, physical tests and confirmatory magnetic resonance imaging. Penalized logistic regression (LASSO) was used to identify history elements and physical examination tests associated with the diagnosis of ACL tear and recursive partitioning was used to develop diagnostic clusters. Diagnostic accuracy measures including sensitivity (Se), specificity (Sp), predictive values and positive and negative likelihood ratios (LR+/-) with associated 95% confidence intervals (CI) were calculated. Forty-three individuals received a diagnosis of partial or complete ACL tear (15.4% of total cohort). The Lachman test alone was able to diagnose partial or complete ACL tears (LR+: 38.4; 95%CI: 16.0-92.5). Combining a history of trauma during a pivot with a "popping" sensation also reached a high diagnostic validity for partial or complete tears (LR+: 9.8; 95%CI: 5.6-17.3). Combining a history of trauma during a pivot, immediate effusion after trauma and a positive Lachman test was able to identify individuals with a complete ACL tear (LR+: 17.5; 95%CI: 9.8-31.5). Finally, combining a negative history of pivot or a negative popping sensation during trauma with a negative Lachman or pivot shift test was able to exclude both partial or complete ACL tears (LR-: 0.08; 95%CI: 0.03-0.24). Diagnostic clusters combining history elements and physical examination tests can support the differential diagnosis of ACL tears compared to various knee disorders.

Soft learning vector quantization and clustering algorithms based on ordered weighted aggregation operators.

PubMed

Karayiannis, N B

2000-01-01

This paper presents the development and investigates the properties of ordered weighted learning vector quantization (LVQ) and clustering algorithms. These algorithms are developed by using gradient descent to minimize reformulation functions based on aggregation operators. An axiomatic approach provides conditions for selecting aggregation operators that lead to admissible reformulation functions. Minimization of admissible reformulation functions based on ordered weighted aggregation operators produces a family of soft LVQ and clustering algorithms, which includes fuzzy LVQ and clustering algorithms as special cases. The proposed LVQ and clustering algorithms are used to perform segmentation of magnetic resonance (MR) images of the brain. The diagnostic value of the segmented MR images provides the basis for evaluating a variety of ordered weighted LVQ and clustering algorithms.

Big Data and Dysmenorrhea: What Questions Do Women and Men Ask About Menstrual Pain?

PubMed

Chen, Chen X; Groves, Doyle; Miller, Wendy R; Carpenter, Janet S

2018-04-30

Menstrual pain is highly prevalent among women of reproductive age. As the general public increasingly obtains health information online, Big Data from online platforms provide novel sources to understand the public's perspectives and information needs about menstrual pain. The study's purpose was to describe salient queries about dysmenorrhea using Big Data from a question and answer platform. We performed text-mining of 1.9 billion queries from ChaCha, a United States-based question and answer platform. Dysmenorrhea-related queries were identified by using keyword searching. Each relevant query was split into token words (i.e., meaningful words or phrases) and stop words (i.e., not meaningful functional words). Word Adjacency Graph (WAG) modeling was used to detect clusters of queries and visualize the range of dysmenorrhea-related topics. We constructed two WAG models respectively from queries by women of reproductive age and bymen. Salient themes were identified through inspecting clusters of WAG models. We identified two subsets of queries: Subset 1 contained 507,327 queries from women aged 13-50 years. Subset 2 contained 113,888 queries from men aged 13 or above. WAG modeling revealed topic clusters for each subset. Between female and male subsets, topic clusters overlapped on dysmenorrhea symptoms and management. Among female queries, there were distinctive topics on approaching menstrual pain at school and menstrual pain-related conditions; while among male queries, there was a distinctive cluster of queries on menstrual pain from male's perspectives. Big Data mining of the ChaCha ® question and answer service revealed a series of information needs among women and men on menstrual pain. Findings may be useful in structuring the content and informing the delivery platform for educational interventions.

The six most essential questions in psychiatric diagnosis: a pluralogue part 1: conceptual and definitional issues in psychiatric diagnosis

PubMed Central

2012-01-01

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article will take up the first two questions. With the first question, invited commentators express a range of opinion regarding the nature of psychiatric disorders, loosely divided into a realist position that the diagnostic categories represent real diseases that we can accurately name and know with our perceptual abilities, a middle, nominalist position that psychiatric disorders do exist in the real world but that our diagnostic categories are constructs that may or may not accurately represent the disorders out there, and finally a purely constructivist position that the diagnostic categories are simply constructs with no evidence of psychiatric disorders in the real world. The second question again offers a range of opinion as to how we should define a mental or psychiatric disorder, including the possibility that we should not try to formulate a definition. The general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. PMID:22243994

Nursing home care quality: a cluster analysis.

PubMed

Grøndahl, Vigdis Abrahamsen; Fagerli, Liv Berit

2017-02-13

Purpose The purpose of this paper is to explore potential differences in how nursing home residents rate care quality and to explore cluster characteristics. Design/methodology/approach A cross-sectional design was used, with one questionnaire including questions from quality from patients' perspective and Big Five personality traits, together with questions related to socio-demographic aspects and health condition. Residents ( n=103) from four Norwegian nursing homes participated (74.1 per cent response rate). Hierarchical cluster analysis identified clusters with respect to care quality perceptions. χ 2 tests and one-way between-groups ANOVA were performed to characterise the clusters ( p<0.05). Findings Two clusters were identified; Cluster 1 residents (28.2 per cent) had the best care quality perceptions and Cluster 2 (67.0 per cent) had the worst perceptions. The clusters were statistically significant and characterised by personal-related conditions: gender, psychological well-being, preferences, admission, satisfaction with staying in the nursing home, emotional stability and agreeableness, and by external objective care conditions: healthcare personnel and registered nurses. Research limitations/implications Residents assessed as having no cognitive impairments were included, thus excluding the largest group. By choosing questionnaire design and structured interviews, the number able to participate may increase. Practical implications Findings may provide healthcare personnel and managers with increased knowledge on which to develop strategies to improve specific care quality perceptions. Originality/value Cluster analysis can be an effective tool for differentiating between nursing homes residents' care quality perceptions.

Initial conditions of formation of starburst clusters: constraints from stellar dynamics

NASA Astrophysics Data System (ADS)

Banerjee, Sambaran

2017-03-01

How starburst clusters form out of molecular clouds is still an open question. In this article, I highlight some of the key constraints in this regard, that one can get from the dynamical evolutionary properties of dense stellar systems. I particularly focus on secular expansion of massive star clusters and hierarchical merging of sub-clusters, and discuss their implications vis-á-vis the observed properties of young massive clusters. The analysis suggests that residual gas expulsion is necessary for shaping these clusters as we see them today, irrespective of their monolithic or hierarchical mode of formation.

Classifying Autism Spectrum Disorders by ADI-R: Subtypes or Severity Gradient?

ERIC Educational Resources Information Center

Cholemkery, Hannah; Medda, Juliane; Lempp, Thomas; Freitag, Christine M.

2016-01-01

To reduce phenotypic heterogeneity of Autism spectrum disorders (ASD) and add to the current diagnostic discussion this study aimed at identifying clinically meaningful ASD subgroups. Cluster analyses were used to describe empirically derived groups based on the Autism Diagnostic Interview-revised (ADI-R) in a large sample of n = 463 individuals…

Autism Spectrum Disorder in Down Syndrome: Cluster Analysis of Aberrant Behaviour Checklist Data Supports Diagnosis

ERIC Educational Resources Information Center

Ji, N. Y.; Capone, G. T.; Kaufmann, W. E.

2011-01-01

Background: The diagnostic validity of autism spectrum disorder (ASD) based on Diagnostic and Statistical Manual of Mental Disorders (DSM) has been challenged in Down syndrome (DS), because of the high prevalence of cognitive impairments in this population. Therefore, we attempted to validate DSM-based diagnoses via an unbiased categorisation of…

A symptom level examination of the relationship between Cluster B personality disorders and patterns of criminality and violence in women.

PubMed

Warren, Janet I; South, Susan C

2009-01-01

The psychometric properties and structure of the Cluster B Personality Disorder criteria (Antisocial, Borderline, Histrionic, and Narcissistic) are examined in a sample of 261 female inmates using a self-report screen followed by a full diagnostic interview. The results of the structural analyses in this sample demonstrated good internal consistency and convergence, but poor discriminant validity between disorders. An exploratory factor analysis found that the structure of these disorders was best accounted for by a four-factor solution that paralleled the Diagnostic and Statistical Manual (DSM-IV-TR; APA, 2000) classification scheme with some significant and notable exceptions. Using the factor scores generated from the factor analysis, the personality profiles of the women were compared with several behavioral indices, including instant offense, institutional infractions, and self-report violence and victimization within the prison. Of particular importance was the consistent relationship observed between narcissistic personality traits and threatening and violent behavior within the prison combined with the impulsive but less malignant presentation of antisocial personality traits among this sample of women. Results are discussed as they inform our understanding of the structural integrity of the four Cluster B diagnostic categories and the relationship of these personality disorders to different types of criminality and violence.

Data-driven inference for the spatial scan statistic.

PubMed

Almeida, Alexandre C L; Duarte, Anderson R; Duczmal, Luiz H; Oliveira, Fernando L P; Takahashi, Ricardo H C

2011-08-02

Kulldorff's spatial scan statistic for aggregated area maps searches for clusters of cases without specifying their size (number of areas) or geographic location in advance. Their statistical significance is tested while adjusting for the multiple testing inherent in such a procedure. However, as is shown in this work, this adjustment is not done in an even manner for all possible cluster sizes. A modification is proposed to the usual inference test of the spatial scan statistic, incorporating additional information about the size of the most likely cluster found. A new interpretation of the results of the spatial scan statistic is done, posing a modified inference question: what is the probability that the null hypothesis is rejected for the original observed cases map with a most likely cluster of size k, taking into account only those most likely clusters of size k found under null hypothesis for comparison? This question is especially important when the p-value computed by the usual inference process is near the alpha significance level, regarding the correctness of the decision based in this inference. A practical procedure is provided to make more accurate inferences about the most likely cluster found by the spatial scan statistic.

Phenotype in combination with genotype improves outcome prediction in acute myeloid leukemia: a report from Children’s Oncology Group protocol AAML0531

PubMed Central

Voigt, Andrew P.; Brodersen, Lisa Eidenschink; Alonzo, Todd A.; Gerbing, Robert B.; Menssen, Andrew J.; Wilson, Elisabeth R.; Kahwash, Samir; Raimondi, Susana C.; Hirsch, Betsy A.; Gamis, Alan S.; Meshinchi, Soheil; Wells, Denise A.; Loken, Michael R.

2017-01-01

Diagnostic biomarkers can be used to determine relapse risk in acute myeloid leukemia, and certain genetic aberrancies have prognostic relevance. A diagnostic immunophenotypic expression profile, which quantifies the amounts of distinct gene products, not just their presence or absence, was established in order to improve outcome prediction for patients with acute myeloid leukemia. The immunophenotypic expression profile, which defines each patient’s leukemia as a location in 15-dimensional space, was generated for 769 patients enrolled in the Children’s Oncology Group AAML0531 protocol. Unsupervised hierarchical clustering grouped patients with similar immunophenotypic expression profiles into eleven patient cohorts, demonstrating high associations among phenotype, genotype, morphology, and outcome. Of 95 patients with inv(16), 79% segregated in Cluster A. Of 109 patients with t(8;21), 92% segregated in Clusters A and B. Of 152 patients with 11q23 alterations, 78% segregated in Clusters D, E, F, G, or H. For both inv(16) and 11q23 abnormalities, differential phenotypic expression identified patient groups with different survival characteristics (P<0.05). Clinical outcome analysis revealed that Cluster B (predominantly t(8;21)) was associated with favorable outcome (P<0.001) and Clusters E, G, H, and K were associated with adverse outcomes (P<0.05). Multivariable regression analysis revealed that Clusters E, G, H, and K were independently associated with worse survival (P range <0.001 to 0.008). The Children’s Oncology Group AAML0531 trial: clinicaltrials.gov Identifier: 00372593. PMID:28883080

Theory of mind predicts severity level in autism.

PubMed

Hoogenhout, Michelle; Malcolm-Smith, Susan

2017-02-01

We investigated whether theory of mind skills can indicate autism spectrum disorder severity. In all, 62 children with autism spectrum disorder completed a developmentally sensitive theory of mind battery. We used intelligence quotient, Diagnostic and Statistical Manual of Mental Disorders (4th ed.) diagnosis and level of support needed as indicators of severity level. Using hierarchical cluster analysis, we found three distinct clusters of theory of mind ability: early-developing theory of mind (Cluster 1), false-belief reasoning (Cluster 2) and sophisticated theory of mind understanding (Cluster 3). The clusters corresponded to severe, moderate and mild autism spectrum disorder. As an indicator of level of support needed, cluster grouping predicted the type of school children attended. All Cluster 1 children attended autism-specific schools; Cluster 2 was divided between autism-specific and special needs schools and nearly all Cluster 3 children attended general special needs and mainstream schools. Assessing theory of mind skills can reliably discriminate severity levels within autism spectrum disorder.

Autism spectrum disorder in Down syndrome: cluster analysis of Aberrant Behaviour Checklist data supports diagnosis.

PubMed

Ji, N Y; Capone, G T; Kaufmann, W E

2011-11-01

The diagnostic validity of autism spectrum disorder (ASD) based on Diagnostic and Statistical Manual of Mental Disorders (DSM) has been challenged in Down syndrome (DS), because of the high prevalence of cognitive impairments in this population. Therefore, we attempted to validate DSM-based diagnoses via an unbiased categorisation of participants with a DSM-independent behavioural instrument. Based on scores on the Aberrant Behaviour Checklist - Community, we performed sequential factor (four DS-relevant factors: Autism-Like Behaviour, Disruptive Behaviour, Hyperactivity, Self-Injury) and cluster analyses on a 293-participant paediatric DS clinic cohort. The four resulting clusters were compared with DSM-delineated groups: DS + ASD, DS + None (no DSM diagnosis), DS + DBD (disruptive behaviour disorder) and DS + SMD (stereotypic movement disorder), the latter two as comparison groups. Two clusters were identified with DS + ASD: Cluster 1 (35.1%) with higher disruptive behaviour and Cluster 4 (48.2%) with more severe autistic behaviour and higher percentage of late onset ASD. The majority of participants in DS + None (71.9%) and DS + DBD (87.5%) were classified into Cluster 2 and 3, respectively, while participants in DS + SMD were relatively evenly distributed throughout the four clusters. Our unbiased, DSM-independent analyses, using a rating scale specifically designed for individuals with severe intellectual disability, demonstrated that DSM-based criteria of ASD are applicable to DS individuals despite their cognitive impairments. Two DS + ASD clusters were identified and supported the existence of at least two subtypes of ASD in DS, which deserve further characterisation. Despite the prominence of stereotypic behaviour in DS, the SMD diagnosis was not identified by cluster analysis, suggesting that high-level stereotypy is distributed throughout DS. Further supporting DSM diagnoses, typically behaving DS participants were easily distinguished as a group from those with maladaptive behaviours. © 2011 The Authors. Journal of Intellectual Disability Research © 2011 Blackwell Publishing Ltd.

Delirium diagnosis defined by cluster analysis of symptoms versus diagnosis by DSM and ICD criteria: diagnostic accuracy study.

PubMed

Sepulveda, Esteban; Franco, José G; Trzepacz, Paula T; Gaviria, Ana M; Meagher, David J; Palma, José; Viñuelas, Eva; Grau, Imma; Vilella, Elisabet; de Pablo, Joan

2016-05-26

Information on validity and reliability of delirium criteria is necessary for clinicians, researchers, and further developments of DSM or ICD. We compare four DSM and ICD delirium diagnostic criteria versions, which were developed by consensus of experts, with a phenomenology-based natural diagnosis delineated using cluster analysis of delirium features in a sample with a high prevalence of dementia. We also measured inter-rater reliability of each system when applied by two evaluators from distinct disciplines. Cross-sectional analysis of 200 consecutive patients admitted to a skilled nursing facility, independently assessed within 24-48 h after admission with the Delirium Rating Scale-Revised-98 (DRS-R98) and for DSM-III-R, DSM-IV, DSM-5, and ICD-10 criteria for delirium. Cluster analysis (CA) delineated natural delirium and nondelirium reference groups using DRS-R98 items and then diagnostic systems' performance were evaluated against the CA-defined groups using logistic regression and crosstabs for discriminant analysis (sensitivity, specificity, percentage of subjects correctly classified by each diagnostic system and their individual criteria, and performance for each system when excluding each individual criterion are reported). Kappa Index (K) was used to report inter-rater reliability for delirium diagnostic systems and their individual criteria. 117 (58.5 %) patients had preexisting dementia according to the Informant Questionnaire on Cognitive Decline in the Elderly. CA delineated 49 delirium subjects and 151 nondelirium. Against these CA groups, delirium diagnosis accuracy was highest using DSM-III-R (87.5 %) followed closely by DSM-IV (86.0 %), ICD-10 (85.5 %) and DSM-5 (84.5 %). ICD-10 had the highest specificity (96.0 %) but lowest sensitivity (53.1 %). DSM-III-R had the best sensitivity (81.6 %) and the best sensitivity-specificity balance. DSM-5 had the highest inter-rater reliability (K =0.73) while DSM-III-R criteria were the least reliable. Using our CA-defined, phenomenologically-based delirium designations as the reference standard, we found performance discordance among four diagnostic systems when tested in subjects where comorbid dementia was prevalent. The most complex diagnostic systems have higher accuracy and the newer DSM-5 have higher reliability. Our novel phenomenological approach to designing a delirium reference standard may be preferred to guide revisions of diagnostic systems in the future.

In Silico identification of pathogenic strains of Cronobacter from Biochemical data reveals association of inositol fermentation with pathogenicity.

PubMed

Hamby, Stephen E; Joseph, Susan; Forsythe, Stephen J; Chuzhanova, Nadia

2011-09-20

Cronobacter, formerly known as Enterobacter sakazakii, is a food-borne pathogen known to cause neonatal meningitis, septicaemia and death. Current diagnostic tests for identification of Cronobacter do not differentiate between species, necessitating time consuming 16S rDNA gene sequencing or multilocus sequence typing (MLST). The organism is ubiquitous, being found in the environment and in a wide range of foods, although there is variation in pathogenicity between Cronobacter isolates and between species. Therefore to be able to differentiate between the pathogenic and non-pathogenic strains is of interest to the food industry and regulators. Here we report the use of Expectation Maximization clustering to categorise 98 strains of Cronobacter as pathogenic or non-pathogenic based on biochemical test results from standard diagnostic test kits. Pathogenicity of a strain was postulated on the basis of either pathogenic symptoms associated with strain source or corresponding MLST sequence types, allowing the clusters to be labelled as containing either pathogenic or non-pathogenic strains. The resulting clusters gave good differentiation of strains into pathogenic and non-pathogenic groups, corresponding well to isolate source and MLST sequence type. The results also revealed a potential association between pathogenicity and inositol fermentation. An investigation of the genomes of Cronobacter sakazakii and C. turicensis revealed the gene for inositol monophosphatase is associated with putative virulence factors in pathogenic strains of Cronobacter. We demonstrated a computational approach allowing existing diagnostic kits to be used to identify pathogenic strains of Cronobacter. The resulting clusters correlated well with MLST sequence types and revealed new information about the pathogenicity of Cronobacter species.

An evaluation of single question delirium screening tools in older emergency department patients.

PubMed

Han, Jin H; Wilson, Amanda; Schnelle, John F; Dittus, Robert S; Wesley Ely, E

2018-07-01

To determine the diagnostic performances of several single question delirium screens. To the patient we asked: "Have you had any difficulty thinking clearly lately?" To the patient's surrogate, we asked: "Is the patient at his or her baseline mental status?" and "Have you noticed the patient's mental status fluctuate throughout the course of the day?" This was a prospective observational study that enrolled English speaking patients 65 years or older. A research assistant (RA) and emergency physician (EP) independently asked the patient and surrogate the single question delirium screens. The reference standard for delirium was a consultation-liaison psychiatrist's assessment using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria. All assessments were performed within 3 h and were all blinded to each other. Of the 406 patients enrolled, 50 (12%) were delirious. A patient who was unable to answer the question "Have you had any difficulty thinking clearly lately?" was 99.7% (95% CI: 98.0%-99.9%) specific, but only 24.0% (95% CI: 14.3%-37.4%) sensitive for delirium when asked by the RA. The baseline mental status surrogate question was 77.1% (95% CI: 61.0%-87.9%) sensitive and 87.5% (95% CI: 82.8%-91.1%) specific for delirium when asked by the RA. The fluctuating course surrogate question was 77.1% (95% CI: 61.0%-87.9%) sensitive and 80.2% (95% CI: 74.8%-84.7%) specific. When asked by the EP, the single question delirium screens' diagnostic performances were similar. The patient and surrogate single question delirium assessments may be useful for delirium screening in the ED. Copyright © 2018. Published by Elsevier Inc.

Three-dimensional reconstruction of clustered microcalcifications from two digitized mammograms

NASA Astrophysics Data System (ADS)

Stotzka, Rainer; Mueller, Tim O.; Epper, Wolfgang; Gemmeke, Hartmut

1998-06-01

X-ray mammography is one of the most significant diagnosis methods in early detection of breast cancer. Usually two X- ray images from different angles are taken from each mamma to make even overlapping structures visible. X-ray mammography has a very high spatial resolution and can show microcalcifications of 50 - 200 micron in size. Clusters of microcalcifications are one of the most important and often the only indicator for malignant tumors. These calcifications are in some cases extremely difficult to detect. Computer assisted diagnosis of digitized mammograms may improve detection and interpretation of microcalcifications and cause more reliable diagnostic findings. We build a low-cost mammography workstation to detect and classify clusters of microcalcifications and tissue densities automatically. New in this approach is the estimation of the 3D formation of segmented microcalcifications and its visualization which will put additional diagnostic information at the radiologists disposal. The real problem using only two or three projections for reconstruction is the big loss of volume information. Therefore the arrangement of a cluster is estimated using only the positions of segmented microcalcifications. The arrangement of microcalcifications is visualized to the physician by rotating.

A random cluster survey and a convenience sample give comparable estimates of immunity to vaccine preventable diseases in children of school age in Victoria, Australia.

PubMed

Kelly, Heath; Riddell, Michaela A; Gidding, Heather F; Nolan, Terry; Gilbert, Gwendolyn L

2002-08-19

We compared estimates of the age-specific population immunity to measles, mumps, rubella, hepatitis B and varicella zoster viruses in Victorian school children obtained by a national sero-survey, using a convenience sample of residual sera from diagnostic laboratories throughout Australia, with those from a three-stage random cluster survey. When grouped according to school age (primary or secondary school) there was no significant difference in the estimates of immunity to measles, mumps, hepatitis B or varicella. Compared with the convenience sample, the random cluster survey estimated higher immunity to rubella in samples from both primary (98.7% versus 93.6%, P = 0.002) and secondary school students (98.4% versus 93.2%, P = 0.03). Despite some limitations, this study suggests that the collection of a convenience sample of sera from diagnostic laboratories is an appropriate sampling strategy to provide population immunity data that will inform Australia's current and future immunisation policies. Copyright 2002 Elsevier Science Ltd.

Search for Low-mass Objects in the Globular Cluster M4. I. Detection of Variable Stars

NASA Astrophysics Data System (ADS)

Safonova, M.; Mkrtichian, D.; Hasan, P.; Sutaria, F.; Brosch, N.; Gorbikov, E.; Joseph, P.

2016-02-01

With every new discovery of an extrasolar planet, the absence of planets in globular clusters (GCs) becomes more and more conspicuous. Null detection of transiting hot Jupiters in GCs 47 Tuc, ω Cen, and NGC 6397 presents an important puzzle, raising questions about the role played by cluster metallicity and environment on formation and survival of planetary systems in densely populated stellar clusters. GCs were postulated to have many free-floating planets, for which microlensing (ML) is an established tool for detection. Dense environments, well-constrained distances and kinematics of lenses and sources, and photometry of thousands of stars simultaneously make GCs the ideal targets to search for ML. We present first results of a multisite, 69-night-long campaign to search for ML signatures of low-mass objects in the GC M4, which was chosen because of its proximity, location, and the actual existence of a planet. M4 was observed in R and I bands by two telescopes, 1 m T40 and 18-inch C18, of the Wise Observatory, Tel Aviv, Israel, from 2011 April to July. Observations on the 1 m telescope were carried out in service mode, gathering 12 to 48 20 s exposures per night for a total of 69 nights. C18 observations were done for about 4 hr a night for six nights in 2011 May. We employ a semiautomated pipeline to calibrate and reduce the images to the light curves that our group is developing for this purpose, which includes the differential photometry package DIAPL, written by Wozniak and modified by W. Pych. Several different diagnostics are employed for search of variability/transients. While no high-significance ML event was found in this observational run, we have detected more than 20 new variables and variable candidates in the M4 field, which we present here.

Cluster analysis reveals subclinical subgroups with shared autistic and schizotypal traits.

PubMed

Ford, Talitha C; Apputhurai, Pragalathan; Meyer, Denny; Crewther, David P

2018-07-01

Autism and schizophrenia spectrum research is typically based on coarse diagnostic classification, which overlooks individual variation within clinical groups. This method limits the identification of underlying cognitive, genetic and neural correlates of specific symptom dimensions. This study, therefore, aimed to identify homogenous subclinical subgroups of specific autistic and schizotypal traits dimensions, that may be utilised to establish more effective diagnostic and treatment practices. Latent profile analysis of subscale scores derived from an autism-schizotypy questionnaire, completed by 1678 subclinical adults aged 18-40 years (1250 females), identified a local optimum of eight population clusters: High, Moderate and Low Psychosocial Difficulties; High, Moderate and Low Autism-Schizotypy; High Psychosis-Proneness; and Moderate Schizotypy. These subgroups represent the convergent and discriminant dimensions of autism and schizotypy in the subclinical population, and highlight the importance of examining subgroups of specific symptom characteristics across these spectra in order to identify the underlying genetic and neural correlates that can be utilised to advance diagnostic and treatment practices. Copyright © 2018 Elsevier B.V. All rights reserved.

Which Variables Predict Teachers Diagnostic Competence When Diagnosing Students' Learning Behavior at Different Stages of a Teacher's Career?

ERIC Educational Resources Information Center

Klug, Julia; Bruder, Simone; Schmitz, Bernhard

2016-01-01

Diagnosing is one of teachers' key competences. Lately, a new model of teachers' diagnostic competence and therewith a new measurement method focusing on diagnosing students' learning behavior in an interdisciplinary approach have been developed. They can build a basis for promoting teachers' diagnostic competence. However, some questions relevant…

Diagnosing Diagnostic Models: From Von Neumann's Elephant to Model Equivalencies and Network Psychometrics

ERIC Educational Resources Information Center

von Davier, Matthias

2018-01-01

This article critically reviews how diagnostic models have been conceptualized and how they compare to other approaches used in educational measurement. In particular, certain assumptions that have been taken for granted and used as defining characteristics of diagnostic models are reviewed and it is questioned whether these assumptions are the…

The DSM and the Dangerous School Child

ERIC Educational Resources Information Center

Bailey, Simon

2010-01-01

The history of ADHD is in part a history of children who have not fitted in at school. Yet until recently, surges in diagnostic levels had not prompted a questioning of the school's complicity in the trend. Through an analysis of the Diagnostic and Statistical Manual for Mental Disorders (DSM), the principal diagnostic guideline relating to ADHD,…

View of the Challenger's payload bay and the Plasma Diagnostic package

NASA Technical Reports Server (NTRS)

1985-01-01

The solar optical universal polarimeter (SOUP) experiment is visible among the cluster of Spacelab 2 hardware in the cargo bay of the Shuttle Challenger. Various components of the instrument positioning system (IPS) are conspicuous at the center of the frame. The Plasma Diagnostic package (PDP) is seen attached to the remote manipulator system (RMS) above the open payload bay.

Features of globular cluster's dynamics with an intermediate-mass black hole

NASA Astrophysics Data System (ADS)

Ryabova, Marina V.; Gorban, Alena S.; Shchekinov, Yuri A.; Vasiliev, Evgenii O.

2018-02-01

In this paper, we address the question of how a central intermediate-mass black hole (IMBH) in a globular cluster (GC) affects dynamics, core collapse, and formation of the binary population. It is shown that the central IMBH forms a binary system that affects dynamics of stars in the cluster significantly. The presence of an intermediate-mass black hole with mass ≥ 1.0-1.7%of the total stellar mass in the cluster inhibits the formation of binary stars population.

When is informed consent required in cluster randomized trials in health research?

PubMed Central

2011-01-01

This article is part of a series of papers examining ethical issues in cluster randomized trials (CRTs) in health research. In the introductory paper in this series, we set out six areas of inquiry that must be addressed if the cluster trial is to be set on a firm ethical foundation. This paper addresses the second of the questions posed, namely, from whom, when, and how must informed consent be obtained in CRTs in health research? The ethical principle of respect for persons implies that researchers are generally obligated to obtain the informed consent of research subjects. Aspects of CRT design, including cluster randomization, cluster level interventions, and cluster size, present challenges to obtaining informed consent. Here we address five questions related to consent and CRTs: How can a study proceed if informed consent is not possible? Is consent to randomization always required? What information must be disclosed to potential subjects if their cluster has already been randomized? Is passive consent a valid substitute for informed consent? Do health professionals have a moral obligation to participate as subjects in CRTs designed to improve professional practice? We set out a framework based on the moral foundations of informed consent and international regulatory provisions to address each of these questions. First, when informed consent is not possible, a study may proceed if a research ethics committee is satisfied that conditions for a waiver of consent are satisfied. Second, informed consent to randomization may not be required if it is not possible to approach subjects at the time of randomization. Third, when potential subjects are approached after cluster randomization, they must be provided with a detailed description of the interventions in the trial arm to which their cluster has been randomized; detailed information on interventions in other trial arms need not be provided. Fourth, while passive consent may serve a variety of practical ends, it is not a substitute for valid informed consent. Fifth, while health professionals may have a moral obligation to participate as subjects in research, this does not diminish the necessity of informed consent to study participation. PMID:21906277

The empirical basis of substance use disorders diagnosis: research recommendations for the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V).

PubMed

Schuckit, Marc A; Saunders, John B

2006-09-01

This paper presents the recommendations, developed from a 3-year consultation process, for a program of research to underpin the development of diagnostic concepts and criteria in the Substance Use Disorders section of the Diagnostic and Statistical Manual of Mental Disorders (DSM) and potentially the relevant section of the next revision of the International Classification of Diseases (ICD). A preliminary list of research topics was developed at the DSM-V Launch Conference in 2004. This led to the presentation of articles on these topics at a specific Substance Use Disorders Conference in February 2005, at the end of which a preliminary list of research questions was developed. This was further refined through an iterative process involving conference participants over the following year. Research questions have been placed into four categories: (1) questions that could be addressed immediately through secondary analyses of existing data sets; (2) items likely to require position papers to propose criteria or more focused questions with a view to subsequent analyses of existing data sets; (3) issues that could be proposed for literature reviews, but with a lower probability that these might progress to a data analytic phase; and (4) suggestions or comments that might not require immediate action, but that could be considered by the DSM-V and ICD 11 revision committees as part of their deliberations. A broadly based research agenda for the development of diagnostic concepts and criteria for substance use disorders is presented.

Discriminative validity of the MacAndrew Alcoholism Scale with Cluster B personality disorders.

PubMed

Smith, S R; Hilsenroth, M J

2001-06-01

This study was designed to assess the ability of the Minnesota Multiphasic Personality Inventory (MMPI-2) MacAndrew Alcoholism Scale (MAC-R) to differentiate between outpatients with personality disorders with Substance-Related Disorders (SRDs) and without SRDs. MMPI-2 validity, clinical, and MAC-R scale scores were compared in an SRD Cluster B group (comprised of Narcissistic, Antisocial, Borderline, and Histrionic; n = 15), a non-SRD Cluster B group (n = 33), and a non-SRD group with personality disorders from Clusters A and C (n = 18). Results revealed that the substance-abusing Cluster B group scored significantly higher on the MAC-R ( p <.0001) as well as the Psychopathic Deviate scale ( p <.01). Dimensional analyses illustrated that MAC-R scores were related to the presence of an SRD diagnosis (rpb =.70, p <.0001) and diagnostic criteria for Antisocial Personality Disorder (r =.60, p <.0001). Stepwise regression revealed that (in order of magnitude) the presence of a substance-abuse diagnosis followed by diagnostic criteria for Antisocial and Histrionic Personality Disorders were most related to MAC-R scores (R =.78, R(2) =.60). This indicates that the MAC-R may be more related to the presence of an SRD than has been suggested, and when used in outpatient settings as MacAndrew (1965) intended, the MAC-R may be useful as a screening device for assessing SRD among outpatients with Axis II psychopathology.

Iterative local Gaussian clustering for expressed genes identification linked to malignancy of human colorectal carcinoma

PubMed Central

Wasito, Ito; Hashim, Siti Zaiton M; Sukmaningrum, Sri

2007-01-01

Gene expression profiling plays an important role in the identification of biological and clinical properties of human solid tumors such as colorectal carcinoma. Profiling is required to reveal underlying molecular features for diagnostic and therapeutic purposes. A non-parametric density-estimation-based approach called iterative local Gaussian clustering (ILGC), was used to identify clusters of expressed genes. We used experimental data from a previous study by Muro and others consisting of 1,536 genes in 100 colorectal cancer and 11 normal tissues. In this dataset, the ILGC finds three clusters, two large and one small gene clusters, similar to their results which used Gaussian mixture clustering. The correlation of each cluster of genes and clinical properties of malignancy of human colorectal cancer was analysed for the existence of tumor or normal, the existence of distant metastasis and the existence of lymph node metastasis. PMID:18305825

Iterative local Gaussian clustering for expressed genes identification linked to malignancy of human colorectal carcinoma.

PubMed

Wasito, Ito; Hashim, Siti Zaiton M; Sukmaningrum, Sri

2007-12-30

Gene expression profiling plays an important role in the identification of biological and clinical properties of human solid tumors such as colorectal carcinoma. Profiling is required to reveal underlying molecular features for diagnostic and therapeutic purposes. A non-parametric density-estimation-based approach called iterative local Gaussian clustering (ILGC), was used to identify clusters of expressed genes. We used experimental data from a previous study by Muro and others consisting of 1,536 genes in 100 colorectal cancer and 11 normal tissues. In this dataset, the ILGC finds three clusters, two large and one small gene clusters, similar to their results which used Gaussian mixture clustering. The correlation of each cluster of genes and clinical properties of malignancy of human colorectal cancer was analysed for the existence of tumor or normal, the existence of distant metastasis and the existence of lymph node metastasis.

Study on text mining algorithm for ultrasound examination of chronic liver diseases based on spectral clustering

NASA Astrophysics Data System (ADS)

Chang, Bingguo; Chen, Xiaofei

2018-05-01

Ultrasonography is an important examination for the diagnosis of chronic liver disease. The doctor gives the liver indicators and suggests the patient's condition according to the description of ultrasound report. With the rapid increase in the amount of data of ultrasound report, the workload of professional physician to manually distinguish ultrasound results significantly increases. In this paper, we use the spectral clustering method to cluster analysis of the description of the ultrasound report, and automatically generate the ultrasonic diagnostic diagnosis by machine learning. 110 groups ultrasound examination report of chronic liver disease were selected as test samples in this experiment, and the results were validated by spectral clustering and compared with k-means clustering algorithm. The results show that the accuracy of spectral clustering is 92.73%, which is higher than that of k-means clustering algorithm, which provides a powerful ultrasound-assisted diagnosis for patients with chronic liver disease.

Dysregulation and functional roles of miR-183-96-182 cluster in cancer cell proliferation, invasion and metastasis

PubMed Central

Ma, Yi; Liang, A-Juan; Fan, Yu-Ping; Huang, Yi-Ran; Zhao, Xiao-Ming; Sun, Yun; Chen, Xiang-Feng

2016-01-01

Previous studies have reported aberrant expression of the miR-183-96-182 cluster in a variety of tumors, which indicates its' diagnostic or prognostic value. However, a key characteristic of the miR-183-96-182 cluster is its varied expression levels, and pleomorphic functional roles in different tumors or under different conditions. In most tumor types, the cluster is highly expressed and promotes tumorigenesis, cancer progression and metastasis; yet tumor suppressive effects have also been reported in some tumors. In the present study, we discuss the upstream regulators and the downstream target genes of miR-183-96-182 cluster, and highlight the dysregulation and functional roles of this cluster in various tumor cells. Newer insights summarized in this review will help readers understand the different facets of the miR-183-96-182 cluster in cancer development and progression. PMID:27081087

Using Cluster Analysis to Identify Patterns in Students' Responses to Contextually Different Conceptual Problems

ERIC Educational Resources Information Center

Stewart, John; Miller, Mayo; Audo, Christine; Stewart, Gay

2012-01-01

This study examined the evolution of student responses to seven contextually different versions of two Force Concept Inventory questions in an introductory physics course at the University of Arkansas. The consistency in answering the closely related questions evolved little over the seven-question exam. A model for the state of student knowledge…

Autism and Diagnostic Substitution: Evidence from a Study of Adults with a History of Developmental Language Disorder

ERIC Educational Resources Information Center

Bishop, Dorothy V. M.; Whitehouse, Andrew J. O.; Watt, Helen J.; Line, Elizabeth A.

2008-01-01

Rates of diagnosis of autism have risen since 1980, raising the question of whether some children who previously had other diagnoses are now being diagnosed with autism. We applied contemporary diagnostic criteria for autism to adults with a history of developmental language disorder, to discover whether diagnostic substitution has taken place. A…

A Cluster Randomised Trial Introducing Rapid Diagnostic Tests into Registered Drug Shops in Uganda: Impact on Appropriate Treatment of Malaria

PubMed Central

Mbonye, Anthony K.; Magnussen, Pascal; Lal, Sham; Hansen, Kristian S.; Cundill, Bonnie; Chandler, Clare; Clarke, Siân E.

2015-01-01

Background Inappropriate treatment of malaria is widely reported particularly in areas where there is poor access to health facilities and self-treatment of fevers with anti-malarial drugs bought in shops is the most common form of care-seeking. The main objective of the study was to examine the impact of introducing rapid diagnostic tests for malaria (mRDTs) in registered drug shops in Uganda, with the aim to increase appropriate treatment of malaria with artemisinin-based combination therapy (ACT) in patients seeking treatment for fever in drug shops. Methods A cluster-randomized trial of introducing mRDTs in registered drug shops was implemented in 20 geographical clusters of drug shops in Mukono district, central Uganda. Ten clusters were randomly allocated to the intervention (diagnostic confirmation of malaria by mRDT followed by ACT) and ten clusters to the control arm (presumptive treatment of fevers with ACT). Treatment decisions by providers were validated by microscopy on a reference blood slide collected at the time of consultation. The primary outcome was the proportion of febrile patients receiving appropriate treatment with ACT defined as: malaria patients with microscopically-confirmed presence of parasites in a peripheral blood smear receiving ACT or rectal artesunate, and patients with no malaria parasites not given ACT. Findings A total of 15,517 eligible patients (8672 intervention and 6845 control) received treatment for fever between January-December 2011. The proportion of febrile patients who received appropriate ACT treatment was 72·9% versus 33·7% in the control arm; a difference of 36·1% (95% CI: 21·3 – 50·9), p<0·001. The majority of patients with fever in the intervention arm accepted to purchase an mRDT (97·8%), of whom 58·5% tested mRDT-positive. Drug shop vendors adhered to the mRDT results, reducing over-treatment of malaria by 72·6% (95% CI: 46·7– 98·4), p<0·001) compared to drug shop vendors using presumptive diagnosis (control arm). Conclusion Diagnostic testing with mRDTs compared to presumptive treatment of fevers implemented in registered drug shops substantially improved appropriate treatment of malaria with ACT. Trial Registration ClinicalTrials.gov NCT01194557. PMID:26200467

A Cluster Randomised Trial Introducing Rapid Diagnostic Tests into Registered Drug Shops in Uganda: Impact on Appropriate Treatment of Malaria.

PubMed

Mbonye, Anthony K; Magnussen, Pascal; Lal, Sham; Hansen, Kristian S; Cundill, Bonnie; Chandler, Clare; Clarke, Siân E

2015-01-01

Inappropriate treatment of malaria is widely reported particularly in areas where there is poor access to health facilities and self-treatment of fevers with anti-malarial drugs bought in shops is the most common form of care-seeking. The main objective of the study was to examine the impact of introducing rapid diagnostic tests for malaria (mRDTs) in registered drug shops in Uganda, with the aim to increase appropriate treatment of malaria with artemisinin-based combination therapy (ACT) in patients seeking treatment for fever in drug shops. A cluster-randomized trial of introducing mRDTs in registered drug shops was implemented in 20 geographical clusters of drug shops in Mukono district, central Uganda. Ten clusters were randomly allocated to the intervention (diagnostic confirmation of malaria by mRDT followed by ACT) and ten clusters to the control arm (presumptive treatment of fevers with ACT). Treatment decisions by providers were validated by microscopy on a reference blood slide collected at the time of consultation. The primary outcome was the proportion of febrile patients receiving appropriate treatment with ACT defined as: malaria patients with microscopically-confirmed presence of parasites in a peripheral blood smear receiving ACT or rectal artesunate, and patients with no malaria parasites not given ACT. A total of 15,517 eligible patients (8672 intervention and 6845 control) received treatment for fever between January-December 2011. The proportion of febrile patients who received appropriate ACT treatment was 72·9% versus 33·7% in the control arm; a difference of 36·1% (95% CI: 21·3 - 50·9), p<0·001. The majority of patients with fever in the intervention arm accepted to purchase an mRDT (97·8%), of whom 58·5% tested mRDT-positive. Drug shop vendors adhered to the mRDT results, reducing over-treatment of malaria by 72·6% (95% CI: 46·7- 98·4), p<0·001) compared to drug shop vendors using presumptive diagnosis (control arm). Diagnostic testing with mRDTs compared to presumptive treatment of fevers implemented in registered drug shops substantially improved appropriate treatment of malaria with ACT. ClinicalTrials.gov NCT01194557.

Clinical diagnosis of partial or complete anterior cruciate ligament tears using patients' history elements and physical examination tests

PubMed Central

Fallaha, Michel; Belzile, Sylvain; Martel-Pelletier, Johanne; Pelletier, Jean-Pierre; Feldman, Debbie; Sylvestre, Marie-Pierre; Vendittoli, Pascal-André; Desmeules, François

2018-01-01

Objective To assess the diagnostic validity of clusters combining history elements and physical examination tests to diagnose partial or complete anterior cruciate ligament (ACL) tears. Design Prospective diagnostic study. Settings Orthopaedic clinics (n = 2), family medicine clinics (n = 2) and community-dwelling. Participants Consecutive patients with a knee complaint (n = 279) and consulting one of the participating orthopaedic surgeons (n = 3) or sport medicine physicians (n = 2). Interventions Not applicable. Main outcome measures History elements and physical examination tests performed independently were compared to the reference standard: an expert physicians’ composite diagnosis including history elements, physical tests and confirmatory magnetic resonance imaging. Penalized logistic regression (LASSO) was used to identify history elements and physical examination tests associated with the diagnosis of ACL tear and recursive partitioning was used to develop diagnostic clusters. Diagnostic accuracy measures including sensitivity (Se), specificity (Sp), predictive values and positive and negative likelihood ratios (LR+/-) with associated 95% confidence intervals (CI) were calculated. Results Forty-three individuals received a diagnosis of partial or complete ACL tear (15.4% of total cohort). The Lachman test alone was able to diagnose partial or complete ACL tears (LR+: 38.4; 95%CI: 16.0–92.5). Combining a history of trauma during a pivot with a “popping” sensation also reached a high diagnostic validity for partial or complete tears (LR+: 9.8; 95%CI: 5.6–17.3). Combining a history of trauma during a pivot, immediate effusion after trauma and a positive Lachman test was able to identify individuals with a complete ACL tear (LR+: 17.5; 95%CI: 9.8–31.5). Finally, combining a negative history of pivot or a negative popping sensation during trauma with a negative Lachman or pivot shift test was able to exclude both partial or complete ACL tears (LR-: 0.08; 95%CI: 0.03–0.24). Conclusion Diagnostic clusters combining history elements and physical examination tests can support the differential diagnosis of ACL tears compared to various knee disorders. PMID:29894492

Using hierarchical cluster models to systematically identify groups of jobs with similar occupational questionnaire response patterns to assist rule-based expert exposure assessment in population-based studies.

PubMed

Friesen, Melissa C; Shortreed, Susan M; Wheeler, David C; Burstyn, Igor; Vermeulen, Roel; Pronk, Anjoeka; Colt, Joanne S; Baris, Dalsu; Karagas, Margaret R; Schwenn, Molly; Johnson, Alison; Armenti, Karla R; Silverman, Debra T; Yu, Kai

2015-05-01

Rule-based expert exposure assessment based on questionnaire response patterns in population-based studies improves the transparency of the decisions. The number of unique response patterns, however, can be nearly equal to the number of jobs. An expert may reduce the number of patterns that need assessment using expert opinion, but each expert may identify different patterns of responses that identify an exposure scenario. Here, hierarchical clustering methods are proposed as a systematic data reduction step to reproducibly identify similar questionnaire response patterns prior to obtaining expert estimates. As a proof-of-concept, we used hierarchical clustering methods to identify groups of jobs (clusters) with similar responses to diesel exhaust-related questions and then evaluated whether the jobs within a cluster had similar (previously assessed) estimates of occupational diesel exhaust exposure. Using the New England Bladder Cancer Study as a case study, we applied hierarchical cluster models to the diesel-related variables extracted from the occupational history and job- and industry-specific questionnaires (modules). Cluster models were separately developed for two subsets: (i) 5395 jobs with ≥1 variable extracted from the occupational history indicating a potential diesel exposure scenario, but without a module with diesel-related questions; and (ii) 5929 jobs with both occupational history and module responses to diesel-relevant questions. For each subset, we varied the numbers of clusters extracted from the cluster tree developed for each model from 100 to 1000 groups of jobs. Using previously made estimates of the probability (ordinal), intensity (µg m(-3) respirable elemental carbon), and frequency (hours per week) of occupational exposure to diesel exhaust, we examined the similarity of the exposure estimates for jobs within the same cluster in two ways. First, the clusters' homogeneity (defined as >75% with the same estimate) was examined compared to a dichotomized probability estimate (<5 versus ≥5%; <50 versus ≥50%). Second, for the ordinal probability metric and continuous intensity and frequency metrics, we calculated the intraclass correlation coefficients (ICCs) between each job's estimate and the mean estimate for all jobs within the cluster. Within-cluster homogeneity increased when more clusters were used. For example, ≥80% of the clusters were homogeneous when 500 clusters were used. Similarly, ICCs were generally above 0.7 when ≥200 clusters were used, indicating minimal within-cluster variability. The most within-cluster variability was observed for the frequency metric (ICCs from 0.4 to 0.8). We estimated that using an expert to assign exposure at the cluster-level assignment and then to review each job in non-homogeneous clusters would require ~2000 decisions per expert, in contrast to evaluating 4255 unique questionnaire patterns or 14983 individual jobs. This proof-of-concept shows that using cluster models as a data reduction step to identify jobs with similar response patterns prior to obtaining expert ratings has the potential to aid rule-based assessment by systematically reducing the number of exposure decisions needed. While promising, additional research is needed to quantify the actual reduction in exposure decisions and the resulting homogeneity of exposure estimates within clusters for an exposure assessment effort that obtains cluster-level expert assessments as part of the assessment process. Published by Oxford University Press on behalf of the British Occupational Hygiene Society 2014.

Organizational Learning Strategies and Verbal Memory Deficits in Bipolar Disorder.

PubMed

Nitzburg, George C; Cuesta-Diaz, Armando; Ospina, Luz H; Russo, Manuela; Shanahan, Megan; Perez-Rodriguez, Mercedes; Larsen, Emmett; Mulaimovic, Sandra; Burdick, Katherine E

2017-04-01

Verbal memory (VM) impairment is prominent in bipolar disorder (BD) and is linked to functional outcomes. However, the intricacies of VM impairment have not yet been studied in a large sample of BD patients. Moreover, some have proposed VM deficits that may be mediated by organizational strategies, such as semantic or serial clustering. Thus, the exact nature of VM break-down in BD patients is not well understood, limiting remediation efforts. We investigated the intricacies of VM deficits in BD patients versus healthy controls (HCs) and examined whether verbal learning differences were mediated by use of clustering strategies. The California Verbal Learning Test (CVLT) was administered to 113 affectively stable BD patients and 106 HCs. We compared diagnostic groups on all CVLT indices and investigated whether group differences in verbal learning were mediated by clustering strategies. Although BD patients showed significantly poorer attention, learning, and memory, these indices were only mildly impaired. However, BD patients evidenced poorer use of effective learning strategies and lower recall consistency, with these indices falling in the moderately impaired range. Moreover, relative reliance on semantic clustering fully mediated the relationship between diagnostic category and verbal learning, while reliance on serial clustering partially mediated this relationship. VM deficits in affectively stable bipolar patients were widespread but were generally mildly impaired. However, patients displayed inadequate use of organizational strategies with clear separation from HCs on semantic and serial clustering. Remediation efforts may benefit from education about mnemonic devices or "chunking" techniques to attenuate VM deficits in BD. (JINS, 2017, 23, 358-366).

Using Hierarchical Cluster Models to Systematically Identify Groups of Jobs With Similar Occupational Questionnaire Response Patterns to Assist Rule-Based Expert Exposure Assessment in Population-Based Studies

PubMed Central

Friesen, Melissa C.; Shortreed, Susan M.; Wheeler, David C.; Burstyn, Igor; Vermeulen, Roel; Pronk, Anjoeka; Colt, Joanne S.; Baris, Dalsu; Karagas, Margaret R.; Schwenn, Molly; Johnson, Alison; Armenti, Karla R.; Silverman, Debra T.; Yu, Kai

2015-01-01

Objectives: Rule-based expert exposure assessment based on questionnaire response patterns in population-based studies improves the transparency of the decisions. The number of unique response patterns, however, can be nearly equal to the number of jobs. An expert may reduce the number of patterns that need assessment using expert opinion, but each expert may identify different patterns of responses that identify an exposure scenario. Here, hierarchical clustering methods are proposed as a systematic data reduction step to reproducibly identify similar questionnaire response patterns prior to obtaining expert estimates. As a proof-of-concept, we used hierarchical clustering methods to identify groups of jobs (clusters) with similar responses to diesel exhaust-related questions and then evaluated whether the jobs within a cluster had similar (previously assessed) estimates of occupational diesel exhaust exposure. Methods: Using the New England Bladder Cancer Study as a case study, we applied hierarchical cluster models to the diesel-related variables extracted from the occupational history and job- and industry-specific questionnaires (modules). Cluster models were separately developed for two subsets: (i) 5395 jobs with ≥1 variable extracted from the occupational history indicating a potential diesel exposure scenario, but without a module with diesel-related questions; and (ii) 5929 jobs with both occupational history and module responses to diesel-relevant questions. For each subset, we varied the numbers of clusters extracted from the cluster tree developed for each model from 100 to 1000 groups of jobs. Using previously made estimates of the probability (ordinal), intensity (µg m−3 respirable elemental carbon), and frequency (hours per week) of occupational exposure to diesel exhaust, we examined the similarity of the exposure estimates for jobs within the same cluster in two ways. First, the clusters’ homogeneity (defined as >75% with the same estimate) was examined compared to a dichotomized probability estimate (<5 versus ≥5%; <50 versus ≥50%). Second, for the ordinal probability metric and continuous intensity and frequency metrics, we calculated the intraclass correlation coefficients (ICCs) between each job’s estimate and the mean estimate for all jobs within the cluster. Results: Within-cluster homogeneity increased when more clusters were used. For example, ≥80% of the clusters were homogeneous when 500 clusters were used. Similarly, ICCs were generally above 0.7 when ≥200 clusters were used, indicating minimal within-cluster variability. The most within-cluster variability was observed for the frequency metric (ICCs from 0.4 to 0.8). We estimated that using an expert to assign exposure at the cluster-level assignment and then to review each job in non-homogeneous clusters would require ~2000 decisions per expert, in contrast to evaluating 4255 unique questionnaire patterns or 14983 individual jobs. Conclusions: This proof-of-concept shows that using cluster models as a data reduction step to identify jobs with similar response patterns prior to obtaining expert ratings has the potential to aid rule-based assessment by systematically reducing the number of exposure decisions needed. While promising, additional research is needed to quantify the actual reduction in exposure decisions and the resulting homogeneity of exposure estimates within clusters for an exposure assessment effort that obtains cluster-level expert assessments as part of the assessment process. PMID:25477475

Teacher Questioning Strategies in Mathematical Classroom Discourse: A Case Study of Two Grade Eight Teachers in Tennessee, USA

ERIC Educational Resources Information Center

McCarthy, Peter; Sithole, Alec; McCarthy, Paul; Cho, Jea-pil; Gyan, Emmanuel

2016-01-01

Teacher questioning in mathematics is an important diagnostic tool for teaching as well as measuring the academic progression and comprehension of the learner. While teacher questioning enhances student learning and self-assessment of the teacher's lesson delivery effectiveness, if not presented properly can have negative impacts on the student…

On the Learning of Mathematics Through Conversation.

ERIC Educational Resources Information Center

Haroutunian-Gordan, Sophie; Tartakoff, David S.

1996-01-01

Describes an experimental mathematics course involving an interpretive discussion approach in which students and instructors work together to develop questions about the meaning of mathematical, philosophical, and musical texts. Appendix contains a cluster of questions for Euclid's proof of the infinity of prime numbers. (MKR)

Role of childhood traumatic experience in personality disorders in China.

PubMed

Zhang, TianHong; Chow, Annabelle; Wang, LanLan; Dai, YunFei; Xiao, ZePing

2012-08-01

There has been no large-scale examination of the association between types of childhood abuse and personality disorders (PDs) in China using standardized assessment tools and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. Hence, this study aimed to explore the relationship between retrospective reports of various types of childhood maltreatments and current DSM-IV PDs in a clinical population in China, Shanghai. One thousand four hundred two subjects were randomly sampled from the Shanghai Psychological Counselling Centre. PDs were assessed using the Personality Diagnostic Questionnaire, Fourth Edition Plus. Participants were also interviewed using the Structured Clinical Interview for DSM-IV axis II. The Child Trauma Questionnaire (CTQ) was used to assess childhood maltreatment in 5 domains (emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect). According to Pearson correlations, childhood maltreatment had a strong association with most PDs. Subsequently, using partial correlations, significant relationships were also demonstrated between cluster B PDs and all the traumatic factors except physical neglect. A strongest positive correlation was found between cluster B PD and CTQ total scores (r = .312, P < .01). Using the Kruskal-Wallis rank sum test, significant differences in 4 groups of subjects (clusters A, B, and C PD and non-PD) in terms of emotional abuse (χ(2) = 34.864, P < .01), physical abuse (χ(2) = 14.996, P < .05), sex abuse (χ(2) = 9.211, P < .05), and emotional neglect (χ(2) = 17.987, P < .01) were found. Stepwise regression analysis indicated that emotional abuse and emotional neglect were predictive for clusters A and B PD, and sexual abuse was highly predictive for cluster B PD; only emotional neglect was predictive for cluster C PD. Early traumatic experiences are strongly related to the development of PDs. The effects of childhood maltreatment in the 3 clusters of PDs are different. Childhood trauma has the most significant impact on cluster B PD. Copyright © 2012 Elsevier Inc. All rights reserved.

Diagnostic and prognostic histopathology system using morphometric indices

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

Parvin, Bahram; Chang, Hang; Han, Ju

Determining at least one of a prognosis or a therapy for a patient based on a stained tissue section of the patient. An image of a stained tissue section of a patient is processed by a processing device. A set of features values for a set of cell-based features is extracted from the processed image, and the processed image is associated with a particular cluster of a plurality of clusters based on the set of feature values, where the plurality of clusters is defined with respect to a feature space corresponding to the set of features.

Non-small cell lung cancer detection using microRNA expression profiling of bronchoalveolar lavage fluid and sputum.

PubMed

Kim, Julian O; Gazala, Sayf; Razzak, Rene; Guo, Linghong; Ghosh, Sunita; Roa, Wilson H; Bédard, Eric L R

2015-04-01

To assess if miRNA expression profiling of bronchoalveolar lavage (BAL) fluid and sputum could be used to detect early-stage non-small cell lung cancer (NSCLC). Hierarchical cluster analysis was performed on the expression levels of 5 miRNAs (miR-21, miR-143, miR-155, miR-210, and miR-372) which were quantified using RNA reverse transcription and quantitative real-time polymerase chain reaction in sputum and BAL samples from NSCLC cases and cancer-free controls. Cluster analysis of the miRNA expression levels in BAL samples from 21 NSCLC cases and sputum samples from 10 cancer-free controls yielded a diagnostic sensitivity of 85.7% and specificity of 100%. Cluster analysis of sputum samples from the same patients yielded a diagnostic sensitivity of 67.8% and specificity of 90%. miRNA expression profiling of sputum and BAL fluids represent a potential means to detect early-stage NSCLC. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Hospital integrated parallel cluster for fast and cost-efficient image analysis: clinical experience and research evaluation

NASA Astrophysics Data System (ADS)

Erberich, Stephan G.; Hoppe, Martin; Jansen, Christian; Schmidt, Thomas; Thron, Armin; Oberschelp, Walter

2001-08-01

In the last few years more and more University Hospitals as well as private hospitals changed to digital information systems for patient record, diagnostic files and digital images. Not only that patient management becomes easier, it is also very remarkable how clinical research can profit from Picture Archiving and Communication Systems (PACS) and diagnostic databases, especially from image databases. Since images are available on the finger tip, difficulties arise when image data needs to be processed, e.g. segmented, classified or co-registered, which usually demands a lot computational power. Today's clinical environment does support PACS very well, but real image processing is still under-developed. The purpose of this paper is to introduce a parallel cluster of standard distributed systems and its software components and how such a system can be integrated into a hospital environment. To demonstrate the cluster technique we present our clinical experience with the crucial but cost-intensive motion correction of clinical routine and research functional MRI (fMRI) data, as it is processed in our Lab on a daily basis.

Are premorbid abnormal personality traits associated with behavioural and psychological symptoms in dementia?

PubMed

Prior, Jack; Abraham, Rajesh; Nicholas, Helen; Chan, Tom; Vanvlymen, Jeremy; Lovestone, Simon; Boothby, Harry

2016-09-01

The study aims to investigate associations between behavioural and psychological symptoms of dementia (BPSD) and abnormal premorbid personality traits. Data were obtained from 217 patients with a diagnosis of probable Alzheimer's disease. Behavioural and psychological symptoms of late-onset dementia were assessed with the Neuropsychiatric Inventory. Premorbid personality traits were assessed using the Standardised Assessment of Personality. Abnormal premorbid personality traits were categorised with Diagnostic and Statistical Manual of Mental Disorders fourth edition and International Statistical Classification of Diseases and Related Health Problems-10 diagnostic criteria for personality disorders. Abnormal premorbid personality traits were associated with increased behavioural and psychological symptoms in dementia. Cluster A (solitary/paranoid) premorbid personality traits were associated with anxiety, depression and hallucinations. Cluster C (anxious/dependent) traits were associated with a syndrome of depression. The presence of Clusters A (solitary/paranoid) and C (anxious/dependent) abnormal premorbid personality traits seems to affect the expression of certain behavioural and psychological symptoms in dementia, depression in particular. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

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

Biewer, Theodore M.; Marcus, Chris; Klepper, C Christopher

The divertor-specific ITER Diagnostic Residual Gas Analyzer (DRGA) will provide essential information relating to DT fusion plasma performance. This includes pulse-resolving measurements of the fuel isotopic mix reaching the pumping ducts, as well as the concentration of the helium generated as the ash of the fusion reaction. In the present baseline design, the cluster of sensors attached to this diagnostic's differentially pumped analysis chamber assembly includes a radiation compatible version of a commercial quadrupole mass spectrometer, as well as an optical gas analyzer using a plasma-based light excitation source. This paper reports on a laboratory study intended to validate themore » performance of this sensor cluster, with emphasis on the detection limit of the isotopic measurement. This validation study was carried out in a laboratory set-up that closely prototyped the analysis chamber assembly configuration of the baseline design. This includes an ITER-specific placement of the optical gas measurement downstream from the first turbine of the chamber's turbo-molecular pump to provide sufficient light emission while preserving the gas dynamics conditions that allow for \\textasciitilde 1 s response time from the sensor cluster [1].« less

Feasibility of Rayleigh Scattering Flow Diagnostics in the National Transonic Facility

NASA Technical Reports Server (NTRS)

Herring, Gregory C.; Lee, Joseph W.; Goad, William K.

2015-01-01

Laser-based Rayleigh light scattering (RLS) was performed in the National Transonic Facility (NTF) at NASA Langley Research Center. The goal was to determine if the free-stream flow undergoes clustering (early stage of condensation from gas to liquid) or remains in a pure diatomic molecular phase. Data indicate that clusters are not observable down to levels of 10% of the total light scatter for a variety of total pressures at one N2 cryogenic-mode total temperature (Tt = -50 F = 227 K) and one air-mode temperature (Tt = +130 F = 327 K). Thus RLS appears viable as a qualitative or quantitative diagnostic for flow density in NTF in the future. Particles are distinguished from optically unresolvable clusters because they are much larger and individually resolvable in the laser beam image with Mie scattering. The same RLS apparatus was also used, without modification, to visualize naturally occurring particles entrained in the flow for both cryogenic and air-modes. Estimates of the free-stream particle flux are presented, which may be important for interpretation of laminar-to-turbulent boundary-layer transition studies. 1

Lean Manufacturing Auto Cluster at Chennai

NASA Astrophysics Data System (ADS)

Bhaskaran, E.

2012-10-01

Due the presence of lot of automotive Industry, Chennai is known as Detroit of India, that producing over 40 % of the Indian vehicle and components. Lean manufacturing concepts have been widely recognized as an important tool in improving the competitiveness of industries. This is a continuous process involving everyone, starting from management to the shop floor. Automotive Component Industries (ACIs) in Ambattur Industrial Estate, Chennai has formed special purpose vehicle (SPV) society namely Ambattur Industrial Estate Manufacturers Association (AIEMA) Technology Centre (ATC) lean manufacturing cluster (ATC-LMC) during July 2010 under lean manufacturing competitiveness scheme, that comes under National Manufacturing Competitiveness Programme of Government of India. The Tripartite Agreement is taken place between National Productivity Council, consultants and cluster (ATC-LMC). The objective is to conduct diagnostic study, study on training and application of various lean manufacturing techniques and auditing in ten ACIs. The methodology adopted is collection of primary data/details from ten ACIs. In the first phase, diagnostic study is done and the areas for improvement in each of the cluster member companies are identified. In the second phase, training programs and implementation is done on 5S and other areas. In the third phase auditing is done and found that the lean manufacturing techniques implementation in ATC-LMC is sustainable and successful in every cluster companies, which will not only enhance competitiveness but also decrease cost, time and increase productivity. The technical efficiency of LMC companies also increases significantly.

The applicability and effectiveness of cluster analysis

NASA Technical Reports Server (NTRS)

Ingram, D. S.; Actkinson, A. L.

1973-01-01

An insight into the characteristics which determine the performance of a clustering algorithm is presented. In order for the techniques which are examined to accurately cluster data, two conditions must be simultaneously satisfied. First the data must have a particular structure, and second the parameters chosen for the clustering algorithm must be correct. By examining the structure of the data from the Cl flight line, it is clear that no single set of parameters can be used to accurately cluster all the different crops. The effectiveness of either a noniterative or iterative clustering algorithm to accurately cluster data representative of the Cl flight line is questionable. Thus extensive a prior knowledge is required in order to use cluster analysis in its present form for applications like assisting in the definition of field boundaries and evaluating the homogeneity of a field. New or modified techniques are necessary for clustering to be a reliable tool.

Computational Design of Clusters for Catalysis

NASA Astrophysics Data System (ADS)

Jimenez-Izal, Elisa; Alexandrova, Anastassia N.

2018-04-01

When small clusters are studied in chemical physics or physical chemistry, one perhaps thinks of the fundamental aspects of cluster electronic structure, or precision spectroscopy in ultracold molecular beams. However, small clusters are also of interest in catalysis, where the cold ground state or an isolated cluster may not even be the right starting point. Instead, the big question is: What happens to cluster-based catalysts under real conditions of catalysis, such as high temperature and coverage with reagents? Myriads of metastable cluster states become accessible, the entire system is dynamic, and catalysis may be driven by rare sites present only under those conditions. Activity, selectivity, and stability are highly dependent on size, composition, shape, support, and environment. To probe and master cluster catalysis, sophisticated tools are being developed for precision synthesis, operando measurements, and multiscale modeling. This review intends to tell the messy story of clusters in catalysis.

[Application of basic research to development of diagnostics and therapeutic agents against inflammatory diseases].

PubMed

Izuhara, Kenji; Ohta, Shoichiro; Arima, Kazuhiko; Suzuki, Shoichi; Inamitsu, Masako; Yamamoto, Ken-ichi

2013-10-01

Biomarkers are generally important for the treatment of patients from the points of diagnosis of disease, assessment of cure, assessment of prognosis such as metastasis or recurrence, prevention of disease, and prediction of drug efficacy. Currently it is well accepted that allergic diseases such as bronchial asthma and atopic dermatitis are not single diseases, but syndromes encompassing different diseases entities. Therefore, it is important to cluster allergic disease patients to assess prognosis or the choice of therapeutic drugs, and useful biomarkers are required for these purposes. Periostin, an extracellular matrix protein, has recently emerged as a biomarker useful for clustering asthma patients. We further found that periostin plays an important role in allergic inflammation and based on this finding we are now developing therapeutic agents targeting periostin against allergic diseases. Since periostin is involved in the pathogenesis of various inflammatory diseases in addition to allergic diseases, such diagnostics and therapeutic agents can be applied to many inflammatory diseases. In this article, we describe the history of periostin research and our application of basic research to the development of diagnostics and therapeutic agents against inflammatory diseases.

Current trends in molecular diagnostics of chronic myeloid leukemia.

PubMed

Vinhas, Raquel; Cordeiro, Milton; Pedrosa, Pedro; Fernandes, Alexandra R; Baptista, Pedro V

2017-08-01

Nearly 1.5 million people worldwide suffer from chronic myeloid leukemia (CML), characterized by the genetic translocation t(9;22)(q34;q11.2), involving the fusion of the Abelson oncogene (ABL1) with the breakpoint cluster region (BCR) gene. Early onset diagnosis coupled to current therapeutics allow for a treatment success rate of 90, which has focused research on the development of novel diagnostics approaches. In this review, we present a critical perspective on current strategies for CML diagnostics, comparing to gold standard methodologies and with an eye on the future trends on nanotheranostics.

A Comparison between the Effectiveness of PBL and LBL on Improving Problem-Solving Abilities of Medical Students Using Questioning

ERIC Educational Resources Information Center

He, Yunfeng; Du, Xiangyun; Toft, Egon; Zhang, Xingli; Qu, Bo; Shi, Jiannong; Zhang, Huan; Zhang, Hui

2018-01-01

In daily patient-history taking and diagnosis practice, doctors ask questions to gather information from patients and narrow down diagnostic hypotheses. Training medical students to be efficient problem solvers through the use of questioning is therefore important. In this study, the effectiveness of problem-based learning (PBL) and lecture-based…

A General Purpose High Performance Linux Installation Infrastructure

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

Wachsmann, Alf

2002-06-17

With more and more and larger and larger Linux clusters, the question arises how to install them. This paper addresses this question by proposing a solution using only standard software components. This installation infrastructure scales well for a large number of nodes. It is also usable for installing desktop machines or diskless Linux clients, thus, is not designed for cluster installations in particular but is, nevertheless, highly performant. The infrastructure proposed uses PXE as the network boot component on the nodes. It uses DHCP and TFTP servers to get IP addresses and a bootloader to all nodes. It then usesmore » kickstart to install Red Hat Linux over NFS. We have implemented this installation infrastructure at SLAC with our given server hardware and installed a 256 node cluster in 30 minutes. This paper presents the measurements from this installation and discusses the bottlenecks in our installation.« less

Depressive Personality Disorder: A Comparison of Three Self-Report Measures

ERIC Educational Resources Information Center

Miller, Joshua D.; Tant, Adam; Bagby, R. Michael

2010-01-01

Depressive personality disorder (DPD) was included in the appendix of the "Diagnostic and Statistical Manual of Mental Disorders", Fourth Edition ("DSM-IV") for further study. Questions abound regarding this disorder in terms of its distinctiveness from extant diagnostic constructs and clinical significance.This study examines…

X-ray lines as a density diagnostic in DT plasmas near 100x solid density

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

Bailey, D.S.

1977-10-19

The use of electron impact broadened resonance lines to diagnose near-term high density diagnostics is discussed. In particular, the question of how to choose seed and pusher materials to have discernible broadening effects while maintaining line visibility is discussed.

Latent Profile and Cluster Analysis of Infant Temperament: Comparisons across Person-Centered Approaches

ERIC Educational Resources Information Center

Gartstein, Maria A.; Prokasky, Amanda; Bell, Martha Ann; Calkins, Susan; Bridgett, David J.; Braungart-Rieker, Julia; Leerkes, Esther; Cheatham, Carol L.; Eiden, Rina D.; Mize, Krystal D.; Jones, Nancy Aaron; Mireault, Gina; Seamon, Erich

2017-01-01

There is renewed interest in person-centered approaches to understanding the structure of temperament. However, questions concerning temperament types are not frequently framed in a developmental context, especially during infancy. In addition, the most common person-centered techniques, cluster analysis (CA) and latent profile analysis (LPA),…

Automating a Massive Online Course with Cluster Computing

ERIC Educational Resources Information Center

Haas, Timothy C.

2016-01-01

Before massive numbers of students can take online courses for college credit, the challenges of providing tutoring support, answers to student-posed questions, and the control of cheating will need to be addressed. These challenges are taken up here by developing an online course delivery system that runs in a cluster computing environment and is…

Genetic divergence and phylogenetic relationships in grey mullets (Teleostei: Mugilidae) based on PCR-RFLP analysis of mtDNA segments.

PubMed

Papasotiropoulos, V; Klossa-Kilia, E; Kilias, G; Alahiotis, S

2002-04-01

The genetic differentiation and phylogenetic relationships among five species of the Mugilidae family (Mugil cephalus, Chelon labrosus, Liza aurata, Liza ramada, and Liza saliens) were investigated at the mtDNA level, on samples taken from Messolongi lagoon-Greece. RFLP analysis of three PCR-amplified mtDNA gene segments (12s rRNA, 16s rRNA, and CO I) was used. Ten, eight, and nine restriction enzymes were found to have at least one recognition site at 12s rRNA, 16s rRNA, and CO I genes, respectively. Several fragment patterns were revealed to be species-specific, and thus they could be useful in species taxonomy as diagnostic markers, as well as for further evolutionary studies. Seven different haplotypes were detected. The greatest amount of genetic differentiation was observed at the interspecific level, while little variation was revealed at the intraspecific level. The highest values of nucleotide sequence divergence were observed between M. cephalus and all the other species, while the lowest was found between C. labrosus and L. saliens. Dendrograms obtained by the three different methods (UPGMA, Neighbor-Joining, and Dollo parsimony), were found to exhibit in all cases the same topology. According to this, the most distinct species is M. cephalus, while the other species are clustered in two separate groups, thefirst one containing L. aurata and L. ramada, the other L. saliens and C. labrosus. This last clustering makes the monophyletic origin of the genus Liza questionable.

Puzzling questions about excited superdeformed rotational bands of atomic nuclei are answered by the two-revolving-cluster model.

PubMed Central

Pauling, L

1992-01-01

The two-revolving-cluster model provides explanations of several questions about excited superdeformed bands: restriction to the lanthanons and the Hg-Tl-Pb region and to the smaller values of the neutron number for each element, truncation of the gamma-ray cascades, differences in shape of the lanthanon and Hg-Tl-Pb bands, alignment of quantified spins, and the existence of pairs of bands with nearly identical gamma-ray sequences. A previously unrecognized kind of pairing (intercalation of gamma-ray values) is also reported and a discussion is given of the values of electric quadrupole moments. PMID:11607327

Differentiation of Recurrent Glioblastoma from Delayed Radiation Necrosis by Using Voxel-based Multiparametric Analysis of MR Imaging Data.

PubMed

Yoon, Ra Gyoung; Kim, Ho Sung; Koh, Myeong Ju; Shim, Woo Hyun; Jung, Seung Chai; Kim, Sang Joon; Kim, Jeong Hoon

2017-10-01

Purpose To assess a volume-weighted voxel-based multiparametric (MP) clustering method as an imaging biomarker to differentiate recurrent glioblastoma from delayed radiation necrosis. Materials and Methods The institutional review board approved this retrospective study and waived the informed consent requirement. Seventy-five patients with pathologic analysis-confirmed recurrent glioblastoma (n = 42) or radiation necrosis (n = 33) who presented with enlarged contrast material-enhanced lesions at magnetic resonance (MR) imaging after they completed concurrent chemotherapy and radiation therapy were enrolled. The diagnostic performance of the total MP cluster score was determined by using the area under the receiver operating characteristic curve (AUC) with cross-validation and compared with those of single parameter measurements (10% histogram cutoffs of apparent diffusion coefficient [ADC10] or 90% histogram cutoffs of normalized cerebral blood volume and initial time-signal intensity AUC). Results Receiver operating characteristic curve analysis showed that an AUC for differentiating recurrent glioblastoma from delayed radiation necrosis was highest in the total MP cluster score and lowest for ADC10 for both readers. The total MP cluster score had significantly better diagnostic accuracy than any single parameter (corrected P = .001-.039 for reader 1; corrected P = .005-.041 for reader 2). The total MP cluster score was the best predictor of recurrent glioblastoma (cross-validated AUCs, 0.942-0.946 for both readers), with a sensitivity of 95.2% for reader 1 and 97.6% for reader 2. Conclusion Quantitative analysis with volume-weighted voxel-based MP clustering appears to be superior to the use of single imaging parameters to differentiate recurrent glioblastoma from delayed radiation necrosis. © RSNA, 2017 Online supplemental material is available for this article.

Rome Foundation-Asian working team report: Asian functional gastrointestinal disorder symptom clusters.

PubMed

Siah, Kewin Tien Ho; Gong, Xiaorong; Yang, Xi Jessie; Whitehead, William E; Chen, Minhu; Hou, Xiaohua; Pratap, Nitesh; Ghoshal, Uday C; Syam, Ari F; Abdullah, Murdani; Choi, Myung-Gyu; Bak, Young-Tae; Lu, Ching-Liang; Gonlachanvit, Sutep; Boon, Chua Seng; Fang, Fan; Cheong, Pui Kuan; Wu, Justin C Y; Gwee, Kok-Ann

2018-06-01

Functional gastrointestinal disorders (FGIDs) are diagnosed by the presence of a characteristic set of symptoms. However, the current criteria-based diagnostic approach is to some extent subjective and largely derived from observations in English-speaking Western patients. We aimed to identify latent symptom clusters in Asian patients with FGID. 1805 consecutive unselected patients with FGID who presented for primary or secondary care to 11 centres across Asia completed a cultural and linguistic adaptation of the Rome III Diagnostic Questionnaire that was translated to the local languages. Principal components factor analysis with varimax rotation was used to identify symptom clusters. Nine symptom clusters were identified, consisting of two oesophageal factors (F6: globus, odynophagia and dysphagia; F9: chest pain and heartburn), two gastroduodenal factors (F5: bloating, fullness, belching and flatulence; F8 regurgitation, nausea and vomiting), three bowel factors (F2: abdominal pain and diarrhoea; F3: meal-related bowel symptoms; F7: upper abdominal pain and constipation) and two anorectal factors (F1: anorectal pain and constipation; F4: diarrhoea, urgency and incontinence). We found that the broad categorisation used both in clinical practice and in the Rome system, that is, broad anatomical divisions, and certain diagnoses with long historical records, that is, IBS with diarrhoea, and chronic constipation, are still valid in our Asian societies. In addition, we found a bowel symptom cluster with meal trigger and a gas cluster that suggests a different emphasis in our populations. Future studies to compare a non-Asian cohort and to match to putative pathophysiology will help to verify our findings. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Fault-tolerant measurement-based quantum computing with continuous-variable cluster states.

PubMed

Menicucci, Nicolas C

2014-03-28

A long-standing open question about Gaussian continuous-variable cluster states is whether they enable fault-tolerant measurement-based quantum computation. The answer is yes. Initial squeezing in the cluster above a threshold value of 20.5 dB ensures that errors from finite squeezing acting on encoded qubits are below the fault-tolerance threshold of known qubit-based error-correcting codes. By concatenating with one of these codes and using ancilla-based error correction, fault-tolerant measurement-based quantum computation of theoretically indefinite length is possible with finitely squeezed cluster states.

Galaxy evolution in clusters since z~1

NASA Astrophysics Data System (ADS)

Aragon-Salamanca, Alfonso

2010-09-01

Galaxy clusters provide some of the most extreme environments in which galaxies evolve, making them excellent laboratories to study the age old question of "nature" vs. "nurture" in galaxy evolution. Here I review some of the key observational results obtained during the last decade on the evolution of the morphology, structure, dynamics, star-formation history and stellar populations of cluster galaxies since the time when the universe was half its present age. Many of the results presented here have been obtained within the ESO Distant Cluster Survey (EDisCS) and Space Telescope A901/02 Galaxy Evolution Survey (STAGES) collaborations.

Galaxy Evolution in Clusters Since z ~ 1

NASA Astrophysics Data System (ADS)

Aragón-Salamanca, A.

Galaxy clusters provide some of the most extreme environments in which galaxies evolve, making them excellent laboratories to study the age old question of "nature" vs. "nurture" in galaxy evolution. Here I review some of the key observational results obtained during the last decade on the evolution of the morphology, structure, dynamics, star-formation history and stellar populations of cluster galaxies since the time when the Universe was half its present age. Many of the results presented here have been obtained within the ESO Distant Cluster Survey (EDisCS) and Space Telescope A901/02 Galaxy Evolution Survey (STAGES) collaborations.

Prevalence of restless legs syndrome in Ankara, Turkey: an analysis of diagnostic criteria and awareness.

PubMed

Yilmaz, Nesrin Helvaci; Akbostanci, Muhittin Cenk; Oto, Aycan; Aykac, Ozlem

2013-09-01

The aim of this study was threefold: (1) to investigate the prevalence of restless legs syndrome (RLS), in Ankara, Turkey; (2) to determine the predictive values of diagnostic criteria; and (3) to determine the frequency of physician referrals and the frequency of getting the correct diagnosis. A total of 815 individuals, from randomly selected addresses, above the age of 15, were reached using the questionnaire composed of the four diagnostic criteria. Individuals who responded by answering 'yes' for at least one question were interviewed by neurologists for the diagnosis of RLS. Frequency of physician referrals and frequency of getting the correct diagnosis of RLS were also determined for patients getting the final diagnoses of RLS. Prevalence of RLS in Ankara was 5.52 %; 41.0 % of the individuals diagnosed with RLS had replied 'yes' to either one, two or three questions asked by interviewers. However, only 21.3 % of individuals who replied 'yes' to all four questions received the diagnosis of RLS. Among the patients who had the final diagnosis of RLS, 25.7 % had referred to a physician for the symptoms and 22.2 % got the correct diagnosis. The RLS prevalence in Ankara was somewhere between Western and Far East countries compatible with the geographical location. Diagnostic criteria may not be fully predictive when applied by non-physician pollsters. Physician's probability of correctly diagnosing RLS is still low.

Revealing physical education students’ misconception in sport biomechanics

NASA Astrophysics Data System (ADS)

Kartiko, D. C.

2018-04-01

The aim of this research is reveal Physical Education students’ misconception in several concepts of Sport Biomechanics. The Data of misconception collected by standard question of Diagnostic Test that given to 30 students of Physical Education, Faculty of Sport, State University of Surabaya in academic year 2017/2018. Diagnostic Test completed with CRI (Certainty of Response Index) in order to collect data of students’ certain in answered test. The data result of diagnostic test analysed through compilation graph of CRI right, CRI wrong and right fraction in every single question. Furthermore, students’ answer result of diagnostic test categorized in to 4 quadrants, these: correct concepts, lucky guess, misconceptions, and lack of knowledge. Its categorizing data to know percentage of misconceptions that arise in every concept tested. These sport biomechanics concepts tested are limited on frictional force, deference of distance and displacement, deference of velocity and acceleration, and free fall motion. The result obtained arise misconception in frictional force 52,78%; deference of distance and displacement 36,67%; deference of velocity and acceleration 56,67%; and free fall motion 53,33%. Result of t-test in diagnostic test misconception percentage showed that percentage of misconception arises in every student above 50%.

Simulating the Birth of Massive Star Clusters: Is Destruction Inevitable?

NASA Astrophysics Data System (ADS)

Rosen, Anna

2013-10-01

Very early in its operation, the Hubble Space Telescope {HST} opened an entirely new frontier: study of the demographics and properties of star clusters far beyond the Milky Way. However, interpretation of HST's observations has proven difficult, and has led to the development of two conflicting models. One view is that most massive star clusters are disrupted during their infancy by feedback from newly formed stars {i.e., "infant mortality"}, independent of cluster mass or environment. The other model is that most star clusters survive their infancy and are disrupted later by mass-dependent dynamical processes. Since observations at present have failed to discriminate between these views, we propose a theoretical investigation to provide new insight. We will perform radiation-hydrodynamic simulations of the formation of massive star clusters, including for the first time a realistic treatment of the most important stellar feedback processes. These simulations will elucidate the physics of stellar feedback, and allow us to determine whether cluster disruption is mass-dependent or -independent. We will also use our simulations to search for observational diagnostics that can distinguish bound from unbound clusters, and to predict how cluster disruption affects the cluster luminosity function in a variety of galactic environments.

The Validity of Projective Techniques and Their Clinical and Research Contributions

ERIC Educational Resources Information Center

Blatt, Sidney J.

1975-01-01

Questions about the limitations and potential contributions of projective techniques in research are considered and issues which limit the contributions of diagnostic assessment and projective techniques in clinical practice are examined. A proposal is made for conceptualizing diagnostic assessment as a more integral part of the therapeutic…

Ligand-free gold atom clusters adsorbed on graphene nano sheets generated by oxidative laser fragmentation in water

NASA Astrophysics Data System (ADS)

Lau, Marcus; Haxhiaj, Ina; Wagener, Philipp; Intartaglia, Romuald; Brandi, Fernando; Nakamura, Junji; Barcikowski, Stephan

2014-08-01

Over three decades after the first synthesis of stabilized Au55-clusters many scientific questions about gold cluster properties are still unsolved and ligand-free colloidal clusters are difficult to fabricate. Here we present a novel route to produce ultra-small gold particles by using a green technique, the laser ablation and fragmentation in water, without using reductive or stabilizing agents at any step of the synthesis. For fabrication only a pulsed laser, a gold-target, pure water, sodium hydroxide and hydrogen peroxide are deployed. The particles are exemplarily hybridized to graphene supports showing that these carbon-free colloidal clusters might serve as versatile building blocks.

Energy Innovation Clusters and their Influence on Manufacturing: A Case Study Perspective

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

Engel-Cox, Jill; Hill, Derek

Innovation clusters have been important for recent development of clean energy technologies and their emergence as mature, globally competitive industries. However, the factors that influence the co-location of manufacturing activities with innovation clusters are less clear. A central question for government agencies seeking to grow manufacturing as part of economic development in their location is how innovation clusters influence manufacturing. Thus, this paper examines case studies of innovation clusters for three different clean energy technologies that have developed in at least two locations: solar PV clusters in California and the province of Jiangsu in China, wind turbine clusters in Germanymore » and the U.S. Great Lakes region, and ethanol clusters in the U.S. Midwest and the state of Sao Paulo in Brazil. These case studies provide initial insight into factors and conditions that contribute to technology manufacturing facility location decisions.« less

Chronology of the halo globular cluster system formation.

NASA Astrophysics Data System (ADS)

Salaris, M.; Weiss, A.

1997-11-01

Using up-to-date stellar models and isochrones we determine the age of 25 galactic halo clusters. The clusters are distributed into four groups according to metallicity. We measure the absolute age of a reference cluster in each group, and then find the relative ages of the other clusters relative to this one. This combination yields the most reliable results. We find that the oldest cluster group on average is 11.8+/-0.9Gyr or 12.3+/-0.3Gyr old, depending on whether we include Arp 2 and Rup 106. The average age of all clusters is about 10.5Gyr. Questions concerning a common age for all clusters and a relation between metallicity and age are addressed. The groups of lower metallicity appear to be coeval, but our results indicate that globally the sample has an age spread, and age and metallicity are correlated but not with a simple linear relation.

Non Thermal Emission from Clusters of Galaxies: the Importance of a Joint LOFAR/Simbol-X View

NASA Astrophysics Data System (ADS)

Ferrari, C.

2009-05-01

Deep radio observations of galaxy clusters have revealed the existence of diffuse radio sources (``halos'' and ``relics'') related to the presence of relativistic electrons and weak magnetic fields in the intracluster volume. I will outline our current knowledge about the presence and properties of this non-thermal cluster component. Despite the recent progress made in observational and theoretical studies of the non-thermal emission in galaxy clusters, a number of open questions about its origin and its effects on the thermo-dynamical evolution of galaxy clusters need to be answered. I will show the importance of combining galaxy cluster observations by new-generation instruments such as LOFAR and Simbol-X. A deeper knowledge of the non-thermal cluster component, together with statistical studies of radio halos and relics, will allow to test the current cluster formation scenario and to better constrain the physics of large scale structure evolution.

Open cluster evolutions in binary system: How they dissolved

NASA Astrophysics Data System (ADS)

Priyatikanto, R.; Arifyanto, M. I.; Wulandari, H. R. T.

2014-03-01

Binarity among stellar clusters in galaxy is such a reality which has been realized for a long time, but still hides several questions and problems to be solved. Some of binary star clusters are formed by close encounter, but the others are formed together from similar womb. Some of them undergo separation process, while the others are in the middle of merger toward common future. The products of merger binary star cluster have typical characteristics which differ from solo clusters, especially in their spatial distribution and their stellar members kinematics. On the other hand, these merger products still have to face dissolving processes triggered by both internal and external factors. In this study, we performed N-body simulations of merger binary clusters with different initial conditions. After merging, these clusters dissolve with greater mass-loss rate because of their angular momentum. These rotating clusters also experience more deceleration caused by external tidal field.

Chemistry Misconceptions Associated with Understanding Calcium and Phosphate Homeostasis

ERIC Educational Resources Information Center

Cliff, William H.

2009-01-01

Successful learning of many aspects in physiology depends on a meaningful understanding of fundamental chemistry concepts. Two conceptual diagnostic questions measured student understanding of the chemical equilibrium underlying calcium and phosphate homeostasis. One question assessed the ability to predict the change in phosphate concentration…

The globular cluster system of NGC 1316. IV. Nature of the star cluster complex SH2

NASA Astrophysics Data System (ADS)

Richtler, T.; Husemann, B.; Hilker, M.; Puzia, T. H.; Bresolin, F.; Gómez, M.

2017-05-01

Context. The light of the merger remnant NGC 1316 (Fornax A) is dominated by old and intermediate-age stars. The only sign of current star formation in this big galaxy is the Hii region SH2, an isolated star cluster complex with a ring-like morphology and an estimated age of 0.1 Gyr at a galactocentric distance of about 35 kpc. A nearby intermediate-age globular cluster, surrounded by weak line emission and a few more young star clusters, is kinematically associated. The origin of this complex is enigmatic. Aims: We want to investigate the nature of this star cluster complex. The nebular emission lines permit a metallicity determination which can discriminate between a dwarf galaxy or other possible precursors. Methods: We used the Integral Field Unit (IFU) of the VIMOS instrument at the Very Large Telescope of the European Southern Observatory in high dispersion mode to study the morphology, kinematics, and metallicity employing line maps, velocity maps, and line diagnostics of a few characteristic spectra. Results: The line ratios of different spectra vary, indicating highly structured Hii regions, but define a locus of uniform metallicity. The strong-line diagnostic diagrams and empirical calibrations point to a nearly solar or even super-solar oxygen abundance. The velocity dispersion of the gas is highest in the region offset from the bright clusters. Star formation may be active on a low level. There is evidence for a large-scale disk-like structure in the region of SH2, which would make the similar radial velocity of the nearby globular cluster easier to understand. Conclusions: The high metallicity does not fit to a dwarf galaxy as progenitor. We favour the scenario of a free-floating gaseous complex having its origin in the merger 2 Gyr ago. Over a long period the densities increased secularly until finally the threshold for star formation was reached. SH2 illustrates how massive star clusters can form outside starbursts and without a considerable field population. Based on observations taken at the European Southern Observatory, Cerro Paranal, Chile, under the programme 082.B-0680, 076.B-0154, 065.N-0166, 065.N-0459.

A prospective study of autistic-like traits in unaffected siblings of probands with autism spectrum disorder.

PubMed

Georgiades, Stelios; Szatmari, Peter; Zwaigenbaum, Lonnie; Bryson, Susan; Brian, Jessica; Roberts, Wendy; Smith, Isabel; Vaillancourt, Tracy; Roncadin, Caroline; Garon, Nancy

2013-01-01

The presence of autistic-like traits in relatives of individuals with autism spectrum disorder (ASD) is well recognized, but, to our knowledge, the emergence of these traits early in development has not been studied. To prospectively investigate the emergence of autistic-like traits in unaffected (no ASD diagnosis) infant siblings of probands diagnosed as having ASD. Two groups of children unaffected with ASD were assessed prospectively-siblings of probands diagnosed as having ASD (high risk [HR]) and control subjects with no family history of ASD (low risk [LR]). Scores on a measure of autistic-like traits at 12 months of age were used in a cluster analysis of the entire sample. A prospective study of infant siblings of probands with ASD from 3 diagnostic centers in Canada. The study included 170 HR and 90 LR children, none of whom was diagnosed as having ASD at age 3 years. The Autism Observation Scale for Infants was used to measure autistic-like traits and derive clusters at 12 months of age. Clusters were compared on ASD symptoms, cognitive abilities, and social-emotional difficulties at age 3 years. Two clusters were identified. Cluster 1 (n = 37; 14.2% of total sample) had significantly higher levels of autistic-like traits compared with cluster 2. Within cluster 1, 33 children came from the siblings (19.4% of HR group) and only 4 came from the control subjects (4.5% of LR group). At age 3 years, children from cluster 1 had more social-communication impairment (effect size > 0.70; P < .001), lower cognitive abilities (effect size = -0.59; P < .005), and more internalizing problems (effect size = 0.55; P = .01). Compared with control subjects, HR siblings had a relative risk of 4.3 (95% CI,1.6-11.9) for membership in cluster 1. Study findings suggest the emergence of autistic-like traits resembling a broader autism phenotype by 12 months of age in approximately 19% of HR siblings who did not meet ASD diagnostic criteria at age 3 years.

Turbulent heating in galaxy clusters brightest in X-rays.

PubMed

Zhuravleva, I; Churazov, E; Schekochihin, A A; Allen, S W; Arévalo, P; Fabian, A C; Forman, W R; Sanders, J S; Simionescu, A; Sunyaev, R; Vikhlinin, A; Werner, N

2014-11-06

The hot (10(7) to 10(8) kelvin), X-ray-emitting intracluster medium (ICM) is the dominant baryonic constituent of clusters of galaxies. In the cores of many clusters, radiative energy losses from the ICM occur on timescales much shorter than the age of the system. Unchecked, this cooling would lead to massive accumulations of cold gas and vigorous star formation, in contradiction to observations. Various sources of energy capable of compensating for these cooling losses have been proposed, the most promising being heating by the supermassive black holes in the central galaxies, through inflation of bubbles of relativistic plasma. Regardless of the original source of energy, the question of how this energy is transferred to the ICM remains open. Here we present a plausible solution to this question based on deep X-ray data and a new data analysis method that enable us to evaluate directly the ICM heating rate from the dissipation of turbulence. We find that turbulent heating is sufficient to offset radiative cooling and indeed appears to balance it locally at each radius-it may therefore be the key element in resolving the gas cooling problem in cluster cores and, more universally, in the atmospheres of X-ray-emitting, gas-rich systems on scales from galaxy clusters to groups and elliptical galaxies.

Diagnosing Cervical Neoplasia in Rural Brazil Using a Mobile Van Equipped with In Vivo Microscopy: A Cluster-Randomized Community Trial.

PubMed

Hunt, Brady; Fregnani, José Humberto Tavares Guerreiro; Schwarz, Richard A; Pantano, Naitielle; Tesoni, Suelen; Possati-Resende, Júlio César; Antoniazzi, Marcio; de Oliveira Fonseca, Bruno; de Macêdo Matsushita, Graziela; Scapulatempo-Neto, Cristovam; Kerr, Ligia; Castle, Philip E; Schmeler, Kathleen; Richards-Kortum, Rebecca

2018-06-01

Cervical cancer is a leading cause of death in underserved areas of Brazil. This prospective randomized trial involved 200 women in southern/central Brazil with abnormal Papanicolaou tests. Participants were randomized by geographic cluster and referred for diagnostic evaluation either at a mobile van upon its scheduled visit to their local community, or at a central hospital. Participants in both arms underwent colposcopy, in vivo microscopy, and cervical biopsies. We compared rates of diagnostic follow-up completion between study arms, and also evaluated the diagnostic performance of in vivo microscopy compared with colposcopy. There was a 23% absolute and 37% relative increase in diagnostic follow-up completion rates for patients referred to the mobile van (102/117, 87%) compared with the central hospital (53/83, 64%; P = 0.0001; risk ratio = 1.37, 95% CI, 1.14-1.63). In 229 cervical sites in 144 patients, colposcopic examination identified sites diagnosed as cervical intraepithelial neoplasia grade 2 or more severe (CIN2+; 85 sites) with a sensitivity of 94% (95% CI, 87%-98%) and specificity of 50% (95% CI, 42%-58%). In vivo microscopy with real-time automated image analysis identified CIN2+ with a sensitivity of 92% (95% CI, 84%-97%) and specificity of 48% (95% CI, 40%-56%). Women referred to the mobile van were more likely to complete their diagnostic follow-up compared with those referred to a central hospital, without compromise in clinical care. In vivo microscopy in a mobile van provides automated diagnostic imaging with sensitivity and specificity similar to colposcopy. Cancer Prev Res; 11(6); 359-70. ©2018 AACR . ©2018 American Association for Cancer Research.

Pathological diagnostic criterion of blood and lymphatic vessel invasion in colorectal cancer: a framework for developing an objective pathological diagnostic system using the Delphi method, from the Pathology Working Group of the Japanese Society for Cancer of the Colon and Rectum.

PubMed

Kojima, Motohiro; Shimazaki, Hideyuki; Iwaya, Keiichi; Kage, Masayoshi; Akiba, Jun; Ohkura, Yasuo; Horiguchi, Shinichiro; Shomori, Kohei; Kushima, Ryoji; Ajioka, Yoichi; Nomura, Shogo; Ochiai, Atsushi

2013-07-01

The goal of this study is to create an objective pathological diagnostic system for blood and lymphatic vessel invasion (BLI). 1450 surgically resected colorectal cancer specimens from eight hospitals were reviewed. Our first step was to compare the current practice of pathology assessment among eight hospitals. Then, H&E stained slides with or without histochemical/immunohistochemical staining were assessed by eight pathologists and concordance of BLI diagnosis was checked. In addition, histological findings associated with BLI having good concordance were reviewed. Based on these results, framework for developing diagnostic criterion was developed, using the Delphi method. The new criterion was evaluated using 40 colorectal cancer specimens. Frequency of BLI diagnoses, number of blocks obtained and stained for assessment of BLI varied among eight hospitals. Concordance was low for BLI diagnosis and was not any better when histochemical/immunohistochemical staining was provided. All histological findings associated with BLI from H&E staining were poor in agreement. However, observation of elastica-stained internal elastic membrane covering more than half of the circumference surrounding the tumour cluster as well as the presence of D2-40-stained endothelial cells covering more than half of the circumference surrounding the tumour cluster showed high concordance. Based on this observation, we developed a framework for pathological diagnostic criterion, using the Delphi method. This criterion was found to be useful in improving concordance of BLI diagnosis. A framework for pathological diagnostic criterion was developed by reviewing concordance and using the Delphi method. The criterion developed may serve as the basis for creating a standardised procedure for pathological diagnosis.

Pathological diagnostic criterion of blood and lymphatic vessel invasion in colorectal cancer: a framework for developing an objective pathological diagnostic system using the Delphi method, from the Pathology Working Group of the Japanese Society for Cancer of the Colon and Rectum

PubMed Central

Kojima, Motohiro; Shimazaki, Hideyuki; Iwaya, Keiichi; Kage, Masayoshi; Akiba, Jun; Ohkura, Yasuo; Horiguchi, Shinichiro; Shomori, Kohei; Kushima, Ryoji; Ajioka, Yoichi; Nomura, Shogo; Ochiai, Atsushi

2013-01-01

Aims The goal of this study is to create an objective pathological diagnostic system for blood and lymphatic vessel invasion (BLI). Methods 1450 surgically resected colorectal cancer specimens from eight hospitals were reviewed. Our first step was to compare the current practice of pathology assessment among eight hospitals. Then, H&E stained slides with or without histochemical/immunohistochemical staining were assessed by eight pathologists and concordance of BLI diagnosis was checked. In addition, histological findings associated with BLI having good concordance were reviewed. Based on these results, framework for developing diagnostic criterion was developed, using the Delphi method. The new criterion was evaluated using 40 colorectal cancer specimens. Results Frequency of BLI diagnoses, number of blocks obtained and stained for assessment of BLI varied among eight hospitals. Concordance was low for BLI diagnosis and was not any better when histochemical/immunohistochemical staining was provided. All histological findings associated with BLI from H&E staining were poor in agreement. However, observation of elastica-stained internal elastic membrane covering more than half of the circumference surrounding the tumour cluster as well as the presence of D2-40-stained endothelial cells covering more than half of the circumference surrounding the tumour cluster showed high concordance. Based on this observation, we developed a framework for pathological diagnostic criterion, using the Delphi method. This criterion was found to be useful in improving concordance of BLI diagnosis. Conclusions A framework for pathological diagnostic criterion was developed by reviewing concordance and using the Delphi method. The criterion developed may serve as the basis for creating a standardised procedure for pathological diagnosis. PMID:23592799

A cluster randomized trial evaluating the efficacy of patient navigation in improving quality of diagnostic care for patients with breast or colorectal cancer abnormalities.

PubMed

Wells, Kristen J; Lee, Ji-Hyun; Calcano, Ercilia R; Meade, Cathy D; Rivera, Marlene; Fulp, William J; Roetzheim, Richard G

2012-10-01

This study examines efficacy of a lay patient navigation (PN) program aimed to reduce time between a cancer abnormality and definitive diagnosis among racially/ethnically diverse and medically underserved populations of Tampa Bay, Florida. Using a cluster randomized design, the study consisted of 11 clinics (six navigated; five control). Patients were navigated from time of a breast or colorectal abnormality to diagnostic resolution, and to completion of cancer treatment. Using a generalized mixed-effects model to assess intervention effects, we examined: (i) length of time between abnormality and definitive diagnosis, and (ii) receipt of definitive diagnosis within the 6-month minimum follow-up period. A total of 1,267 patients participated (588 navigated; 679 control). We also included data from an additional 309 chart abstractions (139 navigated arm; 170 control arm) that assessed outcomes at baseline. PN did not have a significant effect on time to diagnostic resolution in multivariable analysis that adjusted for race-ethnicity, language, insurance status, marital status, and cancer site (P = 0.16). Although more navigated patients achieved diagnostic resolution by 180 days, results were not statistically significant (74.5% navigated vs. 68.5% control, P = 0.07). PN did not impact the overall time to completion of diagnostic care or the number of patients who reached diagnostic resolution of a cancer abnormality. Further evaluation of PN programs applied to other patient populations across the cancer continuum is necessary to gain a better perspective on its effectiveness. PN programs may not impact timely resolution of an abnormality suspicious of breast or colorectal cancer. 2012 AACR

Patient navigation and time to diagnostic resolution: results for a cluster randomized trial evaluating the efficacy of patient navigation among patients with breast cancer screening abnormalities, Tampa, FL.

PubMed

Lee, Ji-Hyun; Fulp, William; Wells, Kristen J; Meade, Cathy D; Calcano, Ercilia; Roetzheim, Richard

2013-01-01

The objective of this study was to evaluate a patient navigation (PN) program that attempts to reduce the time between a breast cancer screening abnormality and definitive diagnosis among medically underserved populations of Tampa Bay, Florida. The Moffitt Patient Navigation Research Program conducted a cluster randomized design with 10 primary care clinics. Patients were navigated from time of a breast screening abnormality to diagnostic resolution. This paper examined the length of time between breast abnormality and definitive diagnosis, using a shared frailty Cox proportional hazard model to assess PN program effect. 1,039 patients were eligible for the study because of an abnormal breast cancer screening/clinical abnormality (494 navigated; 545 control). Analysis of PN effect by two time periods of resolution (0-3 months and > 3 months) showed a lagged effect of PN. For patients resolving in the first three months, the adjusted Hazard Ratio (aHR) was 0.85 (95% Confidence Interval [CI]: 0.64-1.13) suggesting that PN had no effect on resolution time during this period. Beyond three months, however, navigated patients resolved more quickly to diagnostic resolution compared with the control group (aHR 2.8, 95%CI: 1.30-6.13). The predicted aHR at 3 months was 1.2, which was not statistically significant, while PN had a significant positive effect beyond 4.7 months. PN programs may increase the timeliness of diagnostic resolution for patients with a breast cancer-related abnormality. PN did not speed diagnostic resolution during the initial three months of follow up but started to reduce time to diagnostic resolution after three months and showed a significant effect after 4.7 months. ClinicalTrials.gov NCT00375024.

Confirming expectations in asymmetric and symmetric social hypothesis testing.

PubMed

Rusconi, Patrice; Sacchi, Simona; Toscano, Armando; Cherubini, Paolo

2012-01-01

This article examines individuals' expectations in a social hypothesis testing task. Participants selected questions from a list to investigate the presence of personality traits in a target individual. They also identified the responses that they expected to receive and the likelihood of the expected responses. The results of two studies indicated that when people asked questions inquiring about the hypothesized traits that did not entail strong a priori beliefs, they expected to find evidence confirming the hypothesis under investigation. These confirming expectations were more pronounced for symmetric questions, in which the diagnosticity and frequency of the expected evidence did not conflict. When the search for information was asymmetric, confirming expectations were diminished, likely as a consequence of either the rareness or low diagnosticity of the hypothesis-confirming outcome. We also discuss the implications of these findings for confirmation bias.

Prevalence of TMD symptoms in Turkish migrants and re-settlers from the former Soviet Union in comparison to a German group.

PubMed

Diercke, Katja; Zimmermann, Heiko; Hellmann, Daniel; Kim, Ti-Sun; Fricke, Julia; El Sayed, Nihad; Hagenfeld, Daniel; Kühnisch, Jan; Schmitter, Marc; Becher, Heiko

2016-09-01

The objective of this study was to investigate the prevalence of temporomandibular disorder (TMD) symptoms among Turks and re-settlers with German origin from Russia and to compare those findings with a German group from the same area. Sixty-nine Turkish migrants, 50 re-settlers, and 96 Germans were clinically examined according to a short version of the Research Diagnostic Criteria (RDC/TMD) protocol. The subjects participated in a feasibility study of the German National Cohort and were recruited from the study center Heidelberg/Mannheim of the cluster Baden-Württemberg/Saarland. Significant differences emerged between the three ethnic groups for unassisted opening without pain, maximum unassisted opening, and overbite, with highest values for the German group. No significant differences were found for muscle pain on palpation or muscle and joint pain during opening. As the authors identified significant differences between the different ethnic groups for metric measurements, it might be beneficial to include questions concerning the ethnicity to the German version of the RDC/TMD for further research, to make the results more comparable.

To Aggregate or Not and Potentially Better Questions for Clustered Data: The Need for Hierarchical Linear Modeling in CTE Research

ERIC Educational Resources Information Center

Nimon, Kim

2012-01-01

Using state achievement data that are openly accessible, this paper demonstrates the application of hierarchical linear modeling within the context of career technical education research. Three prominent approaches to analyzing clustered data (i.e., modeling aggregated data, modeling disaggregated data, modeling hierarchical data) are discussed…

Biochemical imaging of tissues by SIMS for biomedical applications

NASA Astrophysics Data System (ADS)

Lee, Tae Geol; Park, Ji-Won; Shon, Hyun Kyong; Moon, Dae Won; Choi, Won Woo; Li, Kapsok; Chung, Jin Ho

2008-12-01

With the development of optimal surface cleaning techniques by cluster ion beam sputtering, certain applications of SIMS for analyzing cells and tissues have been actively investigated. For this report, we collaborated with bio-medical scientists to study bio-SIMS analyses of skin and cancer tissues for biomedical diagnostics. We pay close attention to the setting up of a routine procedure for preparing tissue specimens and treating the surface before obtaining the bio-SIMS data. Bio-SIMS was used to study two biosystems, skin tissues for understanding the effects of photoaging and colon cancer tissues for insight into the development of new cancer diagnostics for cancer. Time-of-flight SIMS imaging measurements were taken after surface cleaning with cluster ion bombardment by Bi n or C 60 under varying conditions. The imaging capability of bio-SIMS with a spatial resolution of a few microns combined with principal component analysis reveal biologically meaningful information, but the lack of high molecular weight peaks even with cluster ion bombardment was a problem. This, among other problems, shows that discourse with biologists and medical doctors are critical to glean any meaningful information from SIMS mass spectrometric and imaging data. For SIMS to be accepted as a routine, daily analysis tool in biomedical laboratories, various practical sample handling methodology such as surface matrix treatment, including nano-metal particles and metal coating, in addition to cluster sputtering, should be studied.

Attention Deficit Disorder. NICHCY Briefing Paper.

ERIC Educational Resources Information Center

Fowler, Mary

This briefing paper uses a question-and-answer format to provide basic information about children with attention deficit disorder (ADD). Questions address the following concerns: nature and incidence of ADD; causes of ADD; signs of ADD (impulsivity, hyperactivity, disorganization, social skill deficits); the diagnostic ADD assessment; how to get…

Questions & Answers about...Marfan Syndrome.

ERIC Educational Resources Information Center

National Inst. of Arthritis and Musculoskeletal and Skin Diseases (NIH), Bethesda, MD.

This fact sheet answers general questions about Marfan syndrome, a heritable condition that affects the connective tissue. It describes the characteristics of the disorder, the diagnostic process, and ways to manage symptoms. Characteristics include: (1) people with Marfan syndrome are typically very tall, slender, and loose jointed; (2) more than…

Globular Cluster Abundances from High-Resolution Integrated-Light Spectra. I. 47 Tuc

NASA Astrophysics Data System (ADS)

McWilliam, Andrew; Bernstein, Rebecca A.

2008-09-01

We describe the detailed chemical abundance analysis of a high-resolution (R ~ 35,000), integrated-light (IL), spectrum of the core of the Galactic globular cluster 47 Tuc, obtained using the du Pont echelle at Las Campanas. We develop an abundance analysis strategy that can be applied to spatial unresolved extragalactic clusters. We have computed abundances for Na, Mg, Al, Si, Ca, Sc, Ti, V, Cr, Mn, Fe, Co, Ni, Cu, Y, Zr, Ba, La, Nd, and Eu. For an analysis with the known color-magnitude diagram (CMD) for 47 Tuc we obtain a mean [Fe/H] value of -0.75 +/- 0.026 +/- 0.045 dex (random and systematic error), in good agreement with the mean of five recent high-resolution abundance studies, at -0.70 dex. Typical random errors on our mean [X/Fe] ratios are 0.07-0.10 dex, similar to studies of individual stars in 47 Tuc. Na and Al appear enhanced, perhaps due to proton burning in the most luminous cluster stars. Our IL abundance analysis with an unknown CMD employed theoretical Teramo isochrones; however, we apply zero-point abundance corrections to account for the factor of 3 underprediction of stars at the AGB bump luminosity. While line diagnostics alone provide only mild constraints on the cluster age (ruling out ages younger than ~2 Gyr), when theoretical IL B - V colors are combined with metallicity derived from the Fe I lines, the age is constrained to 10-15 Gyr and we obtain [ Fe/H ] = - 0.70 +/- 0.021 +/- 0.052 dex. We find that Fe I line diagnostics may also be used to constrain the horizontal-branch morphology of an unresolved cluster. Lastly, our spectrum synthesis of 5.4 million TiO lines indicates that the 7300-7600 Å TiO window should be useful for estimating the effect of M giants on the IL abundances, and important for clusters more metal-rich than 47 Tuc.

A Novel Automatic Detection System for ECG Arrhythmias Using Maximum Margin Clustering with Immune Evolutionary Algorithm

PubMed Central

Zhu, Bohui; Ding, Yongsheng; Hao, Kuangrong

2013-01-01

This paper presents a novel maximum margin clustering method with immune evolution (IEMMC) for automatic diagnosis of electrocardiogram (ECG) arrhythmias. This diagnostic system consists of signal processing, feature extraction, and the IEMMC algorithm for clustering of ECG arrhythmias. First, raw ECG signal is processed by an adaptive ECG filter based on wavelet transforms, and waveform of the ECG signal is detected; then, features are extracted from ECG signal to cluster different types of arrhythmias by the IEMMC algorithm. Three types of performance evaluation indicators are used to assess the effect of the IEMMC method for ECG arrhythmias, such as sensitivity, specificity, and accuracy. Compared with K-means and iterSVR algorithms, the IEMMC algorithm reflects better performance not only in clustering result but also in terms of global search ability and convergence ability, which proves its effectiveness for the detection of ECG arrhythmias. PMID:23690875

Blue straggler stars: lessons from open clusters.

NASA Astrophysics Data System (ADS)

Geller, Aaron M.

Open clusters enable a deep dive into blue straggler characteristics. Recent work shows that the binary properties (frequency, orbital elements and companion masses and evolutionary states) of the blue stragglers are the most important diagnostic for determining their origins. To date the multi-epoch radial-velocity observations necessary for characterizing these blue straggler binaries have only been carried out in open clusters. In this paper, I highlight recent results in the open clusters NGC 188, NGC 2682 (M67) and NGC 6819. The characteristics of many of the blue stragglers in these open clusters point directly to origins through mass transfer from an evolved donor star. Additionally, a handful of blue stragglers show clear signatures of past dynamical encounters. These comprehensive, diverse and detailed observations also reveal important challenges for blue straggler formation models (and particularly the mass-transfer channel), which we must overcome to fully understand the origins of blue straggler stars and other mass-transfer products.

The separate and combined effects of baryon physics and neutrino free streaming on large-scale structure

NASA Astrophysics Data System (ADS)

Mummery, Benjamin O.; McCarthy, Ian G.; Bird, Simeon; Schaye, Joop

2017-10-01

We use the cosmo-OWLS and bahamas suites of cosmological hydrodynamical simulations to explore the separate and combined effects of baryon physics (particularly feedback from active galactic nuclei, AGN) and free streaming of massive neutrinos on large-scale structure. We focus on five diagnostics: (I) the halo mass function, (II) halo mass density profiles, (III) the halo mass-concentration relation, (IV) the clustering of haloes and (v) the clustering of matter, and we explore the extent to which the effects of baryon physics and neutrino free streaming can be treated independently. Consistent with previous studies, we find that both AGN feedback and neutrino free streaming suppress the total matter power spectrum, although their scale and redshift dependences differ significantly. The inclusion of AGN feedback can significantly reduce the masses of groups and clusters, and increase their scale radii. These effects lead to a decrease in the amplitude of the mass-concentration relation and an increase in the halo autocorrelation function at fixed mass. Neutrinos also lower the masses of groups and clusters while having no significant effect on the shape of their density profiles (thus also affecting the mass-concentration relation and halo clustering in a qualitatively similar way to feedback). We show that, with only a small number of exceptions, the combined effects of baryon physics and neutrino free streaming on all five diagnostics can be estimated to typically better than a few per cent accuracy by treating these processes independently (I.e. by multiplying their separate effects).

How to: evaluate a diagnostic test.

PubMed

Leeflang, Mariska M G; Allerberger, Franz

2018-06-12

The development of an in vitro diagnostic test from a good idea to a clinically relevant tool takes several steps, with more stringent requirements at every step. This article aims to summarize the necessary questions to be asked about a test and to illustrate study designs answering these questions. We also aim to relate the Regulation (EU) 2017/746 to the needs of evidence-based diagnostic testing, where applicable. We used literature on evidence-based diagnostics, a text book on clinical trials in the development and marketing of medical devices and the English version of Regulation 2017/746 of the European Parliament and of the Council on in vitro diagnostic medical devices. The combination of different test uses and different stages of development determine the required test characteristics and suitability of study designs. In an earlier stage of test development it may be crucial to know whether a test can differentiate diseased persons from healthy controls, while this tells us little about how a test will perform in practice. Later stages focus on the diagnostic accuracy of a test in a clinically relevant situation. However, a test that perfectly distinguishes between patients with and without a certain condition may still have little effect on patient outcomes. Therefore, randomized controlled trials of testing may be needed, as well as post-marketing monitoring. Both researchers and users of tests need to be aware of the limitations of diagnostic test accuracy and realize that accuracy is only indirectly linked to people's health status. Copyright © 2018. Published by Elsevier Ltd.

Dynamical theory of dense groups of galaxies

NASA Technical Reports Server (NTRS)

Mamon, Gary A.

1990-01-01

It is well known that galaxies associate in groups and clusters. Perhaps 40% of all galaxies are found in groups of 4 to 20 galaxies (e.g., Tully 1987). Although most groups appear to be so loose that the galaxy interactions within them ought to be insignificant, the apparently densest groups, known as compact groups appear so dense when seen in projection onto the plane of the sky that their members often overlap. These groups thus appear as dense as the cores of rich clusters. The most popular catalog of compact groups, compiled by Hickson (1982), includes isolation among its selection critera. Therefore, in comparison with the cores of rich clusters, Hickson's compact groups (HCGs) appear to be the densest isolated regions in the Universe (in galaxies per unit volume), and thus provide in principle a clean laboratory for studying the competition of very strong gravitational interactions. The $64,000 question here is then: Are compact groups really bound systems as dense as they appear? If dense groups indeed exist, then one expects that each of the dynamical processes leading to the interaction of their member galaxies should be greatly enhanced. This leads us to the questions: How stable are dense groups? How do they form? And the related question, fascinating to any theorist: What dynamical processes predominate in dense groups of galaxies? If HCGs are not bound dense systems, but instead 1D change alignments (Mamon 1986, 1987; Walke & Mamon 1989) or 3D transient cores (Rose 1979) within larger looser systems of galaxies, then the relevant question is: How frequent are chance configurations within loose groups? Here, the author answers these last four questions after comparing in some detail the methods used and the results obtained in the different studies of dense groups.

Dimensional assessment of personality pathology in patients with eating disorders.

PubMed

Goldner, E M; Srikameswaran, S; Schroeder, M L; Livesley, W J; Birmingham, C L

1999-02-22

This study examined patients with eating disorders on personality pathology using a dimensional method. Female subjects who met DSM-IV diagnostic criteria for eating disorder (n = 136) were evaluated and compared to an age-controlled general population sample (n = 68). We assessed 18 features of personality disorder with the Dimensional Assessment of Personality Pathology - Basic Questionnaire (DAPP-BQ). Factor analysis and cluster analysis were used to derive three clusters of patients. A five-factor solution was obtained with limited intercorrelation between factors. Cluster analysis produced three clusters with the following characteristics: Cluster 1 members (constituting 49.3% of the sample and labelled 'rigid') had higher mean scores on factors denoting compulsivity and interpersonal difficulties; Cluster 2 (18.4% of the sample) showed highest scores in factors denoting psychopathy, neuroticism and impulsive features, and appeared to constitute a borderline psychopathology group; Cluster 3 (32.4% of the sample) was characterized by few differences in personality pathology in comparison to the normal population sample. Cluster membership was associated with DSM-IV diagnosis -- a large proportion of patients with anorexia nervosa were members of Cluster 1. An empirical classification of eating-disordered patients derived from dimensional assessment of personality pathology identified three groups with clinical relevance.

Fused man-machine classification schemes to enhance diagnosis of breast microcalcifications

NASA Astrophysics Data System (ADS)

Andreadis, Ioannis; Sevastianos, Chatzistergos; George, Spyrou; Konstantina, Nikita

2017-11-01

Computer aided diagnosis (CAD x ) approaches are developed towards the effective discrimination between benign and malignant clusters of microcalcifications. Different sources of information are exploited, such as features extracted from the image analysis of the region of interest, features related to the location of the cluster inside the breast, age of the patient and descriptors provided by the radiologists while performing their diagnostic task. A series of different CAD x schemes are implemented, each of which uses a different category of features and adopts a variety of machine learning algorithms and alternative image processing techniques. A novel framework is introduced where these independent diagnostic components are properly combined according to features critical to a radiologist in an attempt to identify the most appropriate CAD x schemes for the case under consideration. An open access database (Digital Database of Screening Mammography (DDSM)) has been elaborated to construct a large dataset with cases of varying subtlety, in order to ensure the development of schemes with high generalization ability, as well as extensive evaluation of their performance. The obtained results indicate that the proposed framework succeeds in improving the diagnostic procedure, as the achieved overall classification performance outperforms all the independent single diagnostic components, as well as the radiologists that assessed the same cases, in terms of accuracy, sensitivity, specificity and area under the curve following receiver operating characteristic analysis.

Tri-city study of Ecstasy use problems: a latent class analysis.

PubMed

Scheier, Lawrence M; Ben Abdallah, Arbi; Inciardi, James A; Copeland, Jan; Cottler, Linda B

2008-12-01

This study used latent class analysis to examine distinctive subtypes of Ecstasy users based on 24 abuse and dependence symptoms underlying standard DSM-IV criteria. Data came from a three site, population-based, epidemiological study to examine diagnostic nosology for Ecstasy use. Subject inclusion criteria included lifetime Ecstasy use exceeding five times and once in the past year, with participants ranging in age between 16 and 47 years of age from St. Louis, Miami, U.S. and Sydney, Australia. A satisfactory model typified four latent classes representing clearly differentiated diagnostic clusters including: (1) a group of sub-threshold users endorsing few abuse and dependence symptoms (negatives), (2) a group of 'diagnostic orphans' who had characteristic features of dependence for a select group of symptoms (mild dependent), (3) a 'transitional group' mimicking the orphans with regard to their profile of dependence also but reporting some abuse symptoms (moderate dependent), and (4) a 'severe dependent' group with a distinct profile of abuse and dependence symptoms. A multinomial logistic regression model indicated that certain latent classes showed unique associations with external non-diagnostic markers. Controlling for demographic characteristics and lifetime quantity of Ecstasy pill use, criminal behavior and motivational cues for Ecstasy use were the most efficient predictors of cluster membership. This study reinforces the heuristic utility of DSM-IV criteria applied to Ecstasy but with a different collage of symptoms that produced four distinct classes of Ecstasy users.

[Medicolegal aspects of child abuse].

PubMed

Hofer, P; Brandau, L-M; Mützel, E

2016-05-01

The prevention and clinical diagnostics of maltreatment of children and adolescents represents a great challenge to all medical disciplines concerned; therefore, an interdisciplinary collaboration is indispensable. Medicolegal experts require specific radiological examination methods for the differentiation between accidental and non-accidental injuries, depending on the corresponding point in question. In addition, a clear and structured radiological appraisal of the findings is necessary. On the other hand, radiologists require an appropriate succinctly phrased question from the medicolegal expert. A close collaboration between radiologists and medicolegal experts is mandatory for a better recognition of cases of child abuse; therefore, the joint establishment of diagnostic standards and a comprehensive implementation is necessary.

What is a reflex? A guide for understanding disorders of consciousness.

PubMed

Fischer, David B; Truog, Robert D

2015-08-11

Uncertainty in diagnosing disorders of consciousness, and specifically in determining whether consciousness has been lost or retained, poses challenging scientific and ethical questions. Recent neuroimaging-based tests for consciousness have cast doubt on the reliability of behavioral criteria in assessing states of consciousness and generate new questions about the assumptions used in formulating coherent diagnostic criteria. The reflex, a foundational diagnostic tool, offers unique insight into these disorders; behaviors produced by unconscious patients are thought to be purely reflexive, whereas those produced by conscious patients can be volitional. Further investigation, however, reveals that reflexes cannot be reliably distinguished from conscious behaviors on the basis of any generalizable empirical characteristics. Ambiguity between reflexive and conscious behaviors undermines the capacity of the reflex to distinguish between disorders of consciousness and has implications for how these disorders should be conceptualized in future diagnostic criteria. © 2015 American Academy of Neurology.

The Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R): a scale to assist the diagnosis of Autism Spectrum Disorder in adults: an international validation study.

PubMed

Ritvo, Riva Ariella; Ritvo, Edward R; Guthrie, Donald; Ritvo, Max J; Hufnagel, Demetra H; McMahon, William; Tonge, Bruce; Mataix-Cols, David; Jassi, Amita; Attwood, Tony; Eloff, Johann

2011-08-01

The Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R) is a valid and reliable instrument to assist the diagnosis of adults with Autism Spectrum Disorders (ASD). The 80-question scale was administered to 779 subjects (201 ASD and 578 comparisons). All ASD subjects met inclusion criteria: DSM-IV-TR, ADI/ADOS diagnoses and standardized IQ testing. Mean scores for each of the questions and total mean ASD vs. the comparison groups' scores were significantly different (p < .0001). Concurrent validity with Constantino Social Responsiveness Scale-Adult = 95.59%. Sensitivity = 97%, specificity = 100%, test-retest reliability r = .987. Cronbach alpha coefficients for the subscales and 4 derived factors were good. We conclude that the RAADS-R is a useful adjunct diagnostic tool for adults with ASD.

Diagnostics and structure

NASA Technical Reports Server (NTRS)

Vial, J. C.

1986-01-01

The structure of prominences and the diagnostic techniques used to evaluate their physical parameters are discussed. These include electron temperature, various densities (n sub p, n sub e, n sub l), ionization degree, velocities, and magnetic field vector. UV and radio measurements have already evidenced the existence of different temperature regions, corresponding to different geometrical locations, e.g., the so called Prominence-Corona (P-C) interface. Velocity measurements are important for considering formation and mass balance of prominences but there are conflicting velocity measurements which have led to the basic question: what structure is actually observed at a given wavelength; what averaging is performed within the projected slit area during the exposure time? In optically thick lines, the question of the formation region of the radiation along the line of sight is also not a trivial one. The same is true for low resolution measurements of the magnetic field. Coupling diagnostics with structure is now a general preoccupation.

Tailoring therapeutic strategies for treating posttraumatic stress disorder symptom clusters

PubMed Central

Norrholm, Seth D; Jovanovic, Tanja

2010-01-01

According to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, posttraumatic stress disorder (PTSD) is characterized by three major symptom clusters following an event that elicited fear, helplessness, or horror. This review will examine each symptom cluster of PTSD separately, giving case study examples of patients who exhibit a preponderance of a given symptom domain. We use a translational approach in describing the underlying neurobiology that is relevant to particular symptoms and treatment options, thus showing how clinical practice can benefit from current research. By focusing on symptom clusters, we provide a more specific view of individual patient’s clinical presentations, in order to better address treatment needs. Finally, the review will also address potential genetic approaches to treatment as another form of individualized treatment. PMID:20856915

Using Facet Clusters to Guide Teacher Professional Development

NASA Astrophysics Data System (ADS)

Seeley, Lane; DeWater, L. S.; Vokos, S.; Kraus, P.

2006-12-01

The Department of Physics and the School of Education at Seattle Pacific University, together with FACET Innovations, LLC, are beginning the second year of a five-year NSF TPC project, Improving the Effectiveness of Teacher Diagnostic Skills and Tools. We are working in partnership with school districts in Washington State to help teachers make their classrooms into better diagnostic learning environments. In this talk, we describe initial efforts to construct content-rich professional development courses for teachers, which are infused with diagnostic assessment that target the fine structure of student ideas in specific topical areas. * Supported in part by NSF grant #ESI-0455796, The Boeing Corporation, and the SPU Science Initiative.

Development and Validation of Diagnostic Economics Test for Secondary Schools

ERIC Educational Resources Information Center

Eleje, Lydia I.; Esomonu, Nkechi P. M.; Agu, Ngozi N.; Okoye, Romy O.; Obasi, Emma; Onah, Frederick E.

2016-01-01

A diagnostic test in economics to aid the teachers determine student's specific weak content areas was developed and validated. Five research questions guided the study. Preliminary validation was done by two experienced teachers in the content area of secondary economics and two experts in test construction. The pilot testing was conducted for…

Equivalent Diagnostic Classification Models

ERIC Educational Resources Information Center

Maris, Gunter; Bechger, Timo

2009-01-01

Rupp and Templin (2008) do a good job at describing the ever expanding landscape of Diagnostic Classification Models (DCM). In many ways, their review article clearly points to some of the questions that need to be answered before DCMs can become part of the psychometric practitioners toolkit. Apart from the issues mentioned in this article that…

Merging and Clustering of the Swift BAT AGN Sample

NASA Astrophysics Data System (ADS)

Koss, Michael; Mushotzky, Richard; Veilleux, Sylvain; Winter, Lisa

2010-06-01

We discuss the merger rate, close galaxy environment, and clustering on scales up to an Mpc of the Swift BAT hard X-ray sample of nearby (z<0.05), moderate-luminosity active galactic nuclei (AGNs). We find a higher incidence of galaxies with signs of disruption compared to a matched control sample (18% versus 1%) and of close pairs within 30 kpc (24% versus 1%). We also find a larger fraction with companions compared to normal galaxies and optical emission line selected AGNs at scales up to 250 kpc. We hypothesize that these merging AGNs may not be identified using optical emission line diagnostics because of optical extinction and dilution by star formation. In support of this hypothesis, in merging systems we find a higher hard X-ray to [O III] flux ratio, as well as emission line diagnostics characteristic of composite or star-forming galaxies, and a larger IRAS 60 μm to stellar mass ratio.

Impact of aldosterone-producing cell clusters on diagnostic discrepancies in primary aldosteronism

PubMed Central

Kometani, Mitsuhiro; Yoneda, Takashi; Aono, Daisuke; Karashima, Shigehiro; Demura, Masashi; Nishimoto, Koshiro; Yamagishi, Masakazu; Takeda, Yoshiyu

2018-01-01

Adrenocorticotropic hormone (ACTH) stimulation is recommended in adrenal vein sampling (AVS) for primary aldosteronism (PA) to improve the AVS success rate. However, this method can confound the subtype diagnosis. Gene mutations or pathological characteristics may be related to lateralization by AVS. This study aimed to compare the rate of diagnostic discrepancy by AVS pre- versus post-ACTH stimulation and to investigate the relationship between this discrepancy and findings from immunohistochemical and genetic analyses of PA. We evaluated 195 cases of AVS performed in 2011–2017. All surgical specimens were analyzed genetically and immunohistochemically. Based on the criteria, AVS was successful in 158 patients both pre- and post-ACTH; of these patients, 75 showed diagnostic discrepancies between pre- and post-ACTH. Thus, 19 patients underwent unilateral adrenalectomy, of whom 16 had an aldosterone-producing adenoma (APA) that was positive for CYP11B2 immunostaining. Of them, 10 patients had discordant lateralization between pre- and post-ACTH. In the genetic analysis, the rate of somatic mutations was not significantly different between APA patients with versus without a diagnostic discrepancy. In the immunohistochemical analysis, CYP11B2 levels and the frequency of aldosterone-producing cell clusters (APCCs) in APAs were almost identical between patients with versus without a diagnostic discrepancy. However, both the number and summed area of APCCs in APAs were significantly smaller in patients with concordant results than in those whose diagnosis changed to bilateral PA post-ACTH stimulation. In conclusion, lateralization by AVS was affected by APCCs in the adjacent gland, but not by APA-related factors such as somatic gene mutations. PMID:29899838

Application of adaptive cluster sampling to low-density populations of freshwater mussels

USGS Publications Warehouse

Smith, D.R.; Villella, R.F.; Lemarie, D.P.

2003-01-01

Freshwater mussels appear to be promising candidates for adaptive cluster sampling because they are benthic macroinvertebrates that cluster spatially and are frequently found at low densities. We applied adaptive cluster sampling to estimate density of freshwater mussels at 24 sites along the Cacapon River, WV, where a preliminary timed search indicated that mussels were present at low density. Adaptive cluster sampling increased yield of individual mussels and detection of uncommon species; however, it did not improve precision of density estimates. Because finding uncommon species, collecting individuals of those species, and estimating their densities are important conservation activities, additional research is warranted on application of adaptive cluster sampling to freshwater mussels. However, at this time we do not recommend routine application of adaptive cluster sampling to freshwater mussel populations. The ultimate, and currently unanswered, question is how to tell when adaptive cluster sampling should be used, i.e., when is a population sufficiently rare and clustered for adaptive cluster sampling to be efficient and practical? A cost-effective procedure needs to be developed to identify biological populations for which adaptive cluster sampling is appropriate.

Accounting for isotopic clustering in Fourier transform mass spectrometry data analysis for clinical diagnostic studies.

PubMed

Kakourou, Alexia; Vach, Werner; Nicolardi, Simone; van der Burgt, Yuri; Mertens, Bart

2016-10-01

Mass spectrometry based clinical proteomics has emerged as a powerful tool for high-throughput protein profiling and biomarker discovery. Recent improvements in mass spectrometry technology have boosted the potential of proteomic studies in biomedical research. However, the complexity of the proteomic expression introduces new statistical challenges in summarizing and analyzing the acquired data. Statistical methods for optimally processing proteomic data are currently a growing field of research. In this paper we present simple, yet appropriate methods to preprocess, summarize and analyze high-throughput MALDI-FTICR mass spectrometry data, collected in a case-control fashion, while dealing with the statistical challenges that accompany such data. The known statistical properties of the isotopic distribution of the peptide molecules are used to preprocess the spectra and translate the proteomic expression into a condensed data set. Information on either the intensity level or the shape of the identified isotopic clusters is used to derive summary measures on which diagnostic rules for disease status allocation will be based. Results indicate that both the shape of the identified isotopic clusters and the overall intensity level carry information on the class outcome and can be used to predict the presence or absence of the disease.

Determining the pregnancy status of patients before diagnostic nuclear medicine procedures: the Australian experience.

PubMed

James, Daphne J; Cardew, Paul; Warren-Forward, Helen M

2011-09-01

Ionizing radiation used in diagnostic nuclear medicine procedures has the potential to have biologic effects on a fetus. Nuclear medicine technologists (NMTs) therefore have a responsibility to ensure that they question all patients of childbearing age about their pregnancy status before starting any procedure, to avoid unnecessary fetal irradiation. In Australia, there are no clearly defined practice guidelines to assist NMTs in determining whom to question or how to question their patients. Semistructured interviews were conducted with chief NMTs and staff NMTs in 8 nuclear medicine departments in Australia. Questions were based around 5 areas: regulations and policy, fetal radiation exposure, questioning of the patient, difficulties in determining pregnancy status, and the impact of the use of hybrid imaging. Audio files of the interviews were transcribed and coded. Topics were coded into 5 themes: policy and awareness of guidelines, questioning the patient, radiation knowledge, decisions and assumptions made by NMTs, and the use of pregnancy testing. There was a wide variation in practice between and within departments. NMTs demonstrated a lack of knowledge and awareness of the possible biologic effects of radiation. This study identified a need in Australia for nuclear medicine to arrive at a consensus approach to verifying a patient's pregnancy status so that NMTs can successfully question patients about their pregnancy status. Continuing education programs are also required to keep NMTs up to date in their knowledge.

Quantitative properties of clustering within modern microscopic nuclear models

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

Volya, A.; Tchuvil’sky, Yu. M., E-mail: tchuvl@nucl-th.sinp.msu.ru

2016-09-15

A method for studying cluster spectroscopic properties of nuclear fragmentation, such as spectroscopic amplitudes, cluster form factors, and spectroscopic factors, is developed on the basis of modern precision nuclear models that take into account the mixing of large-scale shell-model configurations. Alpha-cluster channels are considered as an example. A mathematical proof of the need for taking into account the channel-wave-function renormalization generated by exchange terms of the antisymmetrization operator (Fliessbach effect) is given. Examples where this effect is confirmed by a high quality of the description of experimental data are presented. By and large, the method in question extends substantially themore » possibilities for studying clustering phenomena in nuclei and for improving the quality of their description.« less

Complementary views on electron spectra: From fluctuation diagnostics to real-space correlations

NASA Astrophysics Data System (ADS)

Gunnarsson, O.; Merino, J.; Schäfer, T.; Sangiovanni, G.; Rohringer, G.; Toschi, A.

2018-03-01

We study the relation between the microscopic properties of a many-body system and the electron spectra, experimentally accessible by photoemission. In a recent paper [O. Gunnarsson et al., Phys. Rev. Lett. 114, 236402 (2015), 10.1103/PhysRevLett.114.236402], we introduced the "fluctuation diagnostics" approach to extract the dominant wave-vector-dependent bosonic fluctuations from the electronic self-energy. Here, we first reformulate the theory in terms of fermionic modes to render its connection with resonance valence bond (RVB) fluctuations more transparent. Second, by using a large-U expansion, where U is the Coulomb interaction, we relate the fluctuations to real-space correlations. Therefore, it becomes possible to study how electron spectra are related to charge, spin, superconductivity, and RVB-like real-space correlations, broadening the analysis of an earlier work [J. Merino and O. Gunnarsson, Phys. Rev. B 89, 245130 (2014), 10.1103/PhysRevB.89.245130]. This formalism is applied to the pseudogap physics of the two-dimensional Hubbard model, studied in the dynamical cluster approximation. We perform calculations for embedded clusters with up to 32 sites, having three inequivalent K points at the Fermi surface. We find that as U is increased, correlation functions gradually attain values consistent with an RVB state. This first happens for correlation functions involving the antinodal point and gradually spreads to the nodal point along the Fermi surface. Simultaneously, a pseudogap opens up along the Fermi surface. We relate this to a crossover from a Kondo-type state to an RVB-like localized cluster state and to the presence of RVB and spin fluctuations. These changes are caused by a strong momentum dependence in the cluster bath couplings along the Fermi surface. We also show, from a more algorithmic perspective, how the time-consuming calculations in fluctuation diagnostics can be drastically simplified.

[Trigeminal autonomic cephalgias: diagnostic and therapeutic implications].

PubMed

Rosenberg-Nordmann, Mirjam; Tölle, Thomas R; Sprenger, Till

2007-09-06

Trigeminal autonomic cephalgias (TACs) are primary headache syndromes characterized by severe short-lasting headaches accompanied by ipsilateral facial autonomic symptoms. The group includes cluster headache (CH), paroxysmal hemicrania (PH), and short-lasting neuralgiform headache with conjunctival injection and tearing (SUNCT). By far, Cluster headache is the most frequent of these syndromes. Similar hypothalamic and trigeminovascular mechanisms have been discussed as pathophysiologic mechanisms for all TACs. The therapeutic strategies, however, differ considerably. Although unusual, structural lesions in TACs have been described, affecting the therapeutic management.

Screening for PTSD among detained adolescents: Implications of the changes in the DSM-5.

PubMed

Modrowski, Crosby A; Bennett, Diana C; Chaplo, Shannon D; Kerig, Patricia K

2017-01-01

Screening for posttraumatic stress disorder (PTSD) is highly relevant for youth involved in the juvenile justice system given their high rates of trauma exposure and posttraumatic stress symptoms. However, to date, no studies have investigated the implications of the recent revisions to the Diagnostic and Statistical Manual for Mental Disorders (5th ed., DSM-5; American Psychiatric Association [APA], 2013) diagnostic criteria for PTSD for screening in this population. To this end, the present study compared PTSD screening rates using the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev., DSM-IV-TR; APA, 2013) versus DSM-5 criteria in a group of detained adolescents. Participants included 209 youth (60 girls) aged 13-19 (M = 15.97, SD = 1.24). Youth completed measures of lifetime trauma exposure and past-month posttraumatic stress symptoms. Over 95% of youth in the sample reported exposure to at least 1 type of traumatic event. Approximately 19.60% of the sample screened positive for PTSD according to the DSM-5 compared to 17.70% according to the DSM-IV-TR. Girls were more likely than boys to screen positive for PTSD according to the DSM-IV-TR compared to the DSM-5. The main factors accounting for the differences in screening rates across the versions of PTSD criteria involved the removal of Criterion A2 from the DSM-5, the separation of avoidance symptoms (Criterion C) into their own cluster, the addition of a cluster involving negative alterations in cognitions and mood (Criterion D), and revisions to the cluster of arousal symptoms (Criterion E). Future research should continue to investigate gender differences in PTSD symptoms in youth and consider the implications of these diagnostic changes for the accurate diagnosis and referral to treatment of adolescents who demonstrate posttraumatic stress reactions. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Identification and Validation of a Diagnostic and Prognostic Multi-Gene Biomarker Panel for Pancreatic Ductal Adenocarcinoma.

PubMed

Klett, Hagen; Fuellgraf, Hannah; Levit-Zerdoun, Ella; Hussung, Saskia; Kowar, Silke; Küsters, Simon; Bronsert, Peter; Werner, Martin; Wittel, Uwe; Fritsch, Ralph; Busch, Hauke; Boerries, Melanie

2018-01-01

Late diagnosis and systemic dissemination essentially contribute to the invariably poor prognosis of pancreatic ductal adenocarcinoma (PDAC). Therefore, the development of diagnostic biomarkers for PDAC are urgently needed to improve patient stratification and outcome in the clinic. By studying the transcriptomes of independent PDAC patient cohorts of tumor and non-tumor tissues, we identified 81 robustly regulated genes, through a novel, generally applicable meta-analysis. Using consensus clustering on co-expression values revealed four distinct clusters with genes originating from exocrine/endocrine pancreas, stromal and tumor cells. Three clusters were strongly associated with survival of PDAC patients based on TCGA database underlining the prognostic potential of the identified genes. With the added information of impact of survival and the robustness within the meta-analysis, we extracted a 17-gene subset for further validation. We show that it did not only discriminate PDAC from non-tumor tissue and stroma in fresh-frozen as well as formalin-fixed paraffin embedded samples, but also detected pancreatic precursor lesions and singled out pancreatitis samples. Moreover, the classifier discriminated PDAC from other cancers in the TCGA database. In addition, we experimentally validated the classifier in PDAC patients on transcript level using qPCR and exemplify the usage on protein level for three proteins (AHNAK2, LAMC2, TFF1) using immunohistochemistry and for two secreted proteins (TFF1, SERPINB5) using ELISA-based protein detection in blood-plasma. In conclusion, we present a novel robust diagnostic and prognostic gene signature for PDAC with future potential applicability in the clinic.

Identification and Validation of a Diagnostic and Prognostic Multi-Gene Biomarker Panel for Pancreatic Ductal Adenocarcinoma

PubMed Central

Klett, Hagen; Fuellgraf, Hannah; Levit-Zerdoun, Ella; Hussung, Saskia; Kowar, Silke; Küsters, Simon; Bronsert, Peter; Werner, Martin; Wittel, Uwe; Fritsch, Ralph; Busch, Hauke; Boerries, Melanie

2018-01-01

Late diagnosis and systemic dissemination essentially contribute to the invariably poor prognosis of pancreatic ductal adenocarcinoma (PDAC). Therefore, the development of diagnostic biomarkers for PDAC are urgently needed to improve patient stratification and outcome in the clinic. By studying the transcriptomes of independent PDAC patient cohorts of tumor and non-tumor tissues, we identified 81 robustly regulated genes, through a novel, generally applicable meta-analysis. Using consensus clustering on co-expression values revealed four distinct clusters with genes originating from exocrine/endocrine pancreas, stromal and tumor cells. Three clusters were strongly associated with survival of PDAC patients based on TCGA database underlining the prognostic potential of the identified genes. With the added information of impact of survival and the robustness within the meta-analysis, we extracted a 17-gene subset for further validation. We show that it did not only discriminate PDAC from non-tumor tissue and stroma in fresh-frozen as well as formalin-fixed paraffin embedded samples, but also detected pancreatic precursor lesions and singled out pancreatitis samples. Moreover, the classifier discriminated PDAC from other cancers in the TCGA database. In addition, we experimentally validated the classifier in PDAC patients on transcript level using qPCR and exemplify the usage on protein level for three proteins (AHNAK2, LAMC2, TFF1) using immunohistochemistry and for two secreted proteins (TFF1, SERPINB5) using ELISA-based protein detection in blood-plasma. In conclusion, we present a novel robust diagnostic and prognostic gene signature for PDAC with future potential applicability in the clinic. PMID:29675033

[Quality of diagnosis and prophylaxis of HIV-infection in military clinical institutions and related problems in training medical personnel].

PubMed

Volzhanin, V M; Bulan'kov, Iu I; Bolekhan, V N; Vasil'ev, V V; Orlova, E S

2009-06-01

The analysis of results of laboratorial diagnostics of HIV-infection in multiprofile treatment institute of the Ministry of Defense of RF, questioning of medical staff on the questions of diagnostics and treatment of HIV-infection discovered several disadvantages in the system of training of the physicians in this sphere. Insufficient level of knowledge of practical aspects of HIV-infection causes baseless quantity of screening laboratorial tests (up to 70%). It leads to grand material inputs of the Ministry of Defense of RF. The authors propose an elaborated guidance manual for teachers, attending physicians and students of academies on studying questions of HIV-infection, based on the principle of "transparent study", on broad engaging of different departments to the process of teaching, on consideration of profiles of cycles of studying, of levels of adoption, types of lessons, volume of study time.

To what do psychiatric diagnoses refer? A two-dimensional semantic analysis of diagnostic terms

PubMed Central

Maung, Hane Htut

2016-01-01

In somatic medicine, diagnostic terms often refer to the disease processes that are the causes of patients' symptoms. The language used in some clinical textbooks and health information resources suggests that this is also sometimes assumed to be the case with diagnoses in psychiatry. However, this seems to be in tension with the ways in which psychiatric diagnoses are defined in diagnostic manuals, according to which they refer solely to clusters of symptoms. This paper explores how theories of reference in the philosophy of language can help to resolve this tension. After the evaluation of descriptive and causal theories of reference, I put forward a conceptual framework based on two-dimensional semantics that allows the causal analysis of diagnostic terms in psychiatry, while taking seriously their descriptive definitions in diagnostic manuals. While the framework is presented as a solution to a problem regarding the semantics of psychiatric diagnoses, it can also accommodate the analysis of diagnostic terms in other medical disciplines. PMID:26580354

Regularities in eyewitness identification.

PubMed

Clark, Steven E; Howell, Ryan T; Davey, Sherrie L

2008-06-01

What do eyewitness identification experiments typically show? We address this question through a meta-analysis of 94 comparisons between target-present and target-absent lineups. The analyses showed that: (a) correct identifications and correct-nonidentifications were uncorrelated, (b) suspect identifications were more diagnostic with respect to the suspect's guilt or innocence than any other response, (c) nonidentifications were diagnostic of the suspect's innocence, (d) the diagnosticity of foil identifications depended on lineup composition, and (e) don't know responses were nondiagnostic with respect to guilt or innocence. Results of diagnosticity analyses for simultaneous and sequential lineups varied for full-sample versus direct-comparison analyses. Diagnosticity patterns also varied as a function of lineup composition. Theoretical, forensic, and legal implications are discussed.

Finding gene clusters for a replicated time course study

PubMed Central

2014-01-01

Background Finding genes that share similar expression patterns across samples is an important question that is frequently asked in high-throughput microarray studies. Traditional clustering algorithms such as K-means clustering and hierarchical clustering base gene clustering directly on the observed measurements and do not take into account the specific experimental design under which the microarray data were collected. A new model-based clustering method, the clustering of regression models method, takes into account the specific design of the microarray study and bases the clustering on how genes are related to sample covariates. It can find useful gene clusters for studies from complicated study designs such as replicated time course studies. Findings In this paper, we applied the clustering of regression models method to data from a time course study of yeast on two genotypes, wild type and YOX1 mutant, each with two technical replicates, and compared the clustering results with K-means clustering. We identified gene clusters that have similar expression patterns in wild type yeast, two of which were missed by K-means clustering. We further identified gene clusters whose expression patterns were changed in YOX1 mutant yeast compared to wild type yeast. Conclusions The clustering of regression models method can be a valuable tool for identifying genes that are coordinately transcribed by a common mechanism. PMID:24460656

Making a structured psychiatric diagnostic interview faithful to the nomenclature.

PubMed

Robins, Lee N; Cottler, Linda B

2004-10-15

Psychiatric diagnostic interviews to be used in epidemiologic studies by lay interviewers have, since the 1970s, attempted to operationalize existing psychiatric nomenclatures. How to maximize the chances that they do so successfully has not previously been spelled out. In this article, the authors discuss strategies for each of the seven steps involved in writing, updating, or modifying a diagnostic interview and its supporting materials: 1) writing questions that match the nomenclature's criteria, 2) checking that respondents will be willing and able to answer the questions, 3) choosing a format acceptable to interviewers that maximizes accurate answering and recording of answers, 4) constructing a data entry and cleaning program that highlights errors to be corrected, 5) creating a diagnostic scoring program that matches the nomenclature's algorithms, 6) developing an interviewer training program that maximizes reliability, and 7) computerizing the interview. For each step, the authors discuss how to identify errors, correct them, and validate the revisions. Although operationalization will never be perfect because of ambiguities in the nomenclature, specifying methods for minimizing divergence from the nomenclature is timely as users modify existing interviews and look forward to updating interviews based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and the International Classification of Diseases, Eleventh Revision.

Advancing Diagnostics to Address Antibacterial Resistance: The Diagnostics and Devices Committee of the Antibacterial Resistance Leadership Group

PubMed Central

Tsalik, Ephraim L.; Petzold, Elizabeth; Kreiswirth, Barry N.; Bonomo, Robert A.; Banerjee, Ritu; Lautenbach, Ebbing; Evans, Scott R.; Hanson, Kimberly E.; Klausner, Jeffrey D.

2017-01-01

Abstract Diagnostics are a cornerstone of the practice of infectious diseases. However, various limitations frequently lead to unmet clinical needs. In most other domains, diagnostics focus on narrowly defined questions, provide readily interpretable answers, and use true gold standards for development. In contrast, infectious diseases diagnostics must contend with scores of potential pathogens, dozens of clinical syndromes, emerging pathogens, rapid evolution of existing pathogens and their associated resistance mechanisms, and the absence of gold standards in many situations. In spite of these challenges, the importance and value of diagnostics cannot be underestimated. Therefore, the Antibacterial Resistance Leadership Group has identified diagnostics as 1 of 4 major areas of emphasis. Herein, we provide an overview of that development, highlighting several examples where innovation in study design, content, and execution is advancing the field of infectious diseases diagnostics. PMID:28350903

Statistical Significance for Hierarchical Clustering

PubMed Central

Kimes, Patrick K.; Liu, Yufeng; Hayes, D. Neil; Marron, J. S.

2017-01-01

Summary Cluster analysis has proved to be an invaluable tool for the exploratory and unsupervised analysis of high dimensional datasets. Among methods for clustering, hierarchical approaches have enjoyed substantial popularity in genomics and other fields for their ability to simultaneously uncover multiple layers of clustering structure. A critical and challenging question in cluster analysis is whether the identified clusters represent important underlying structure or are artifacts of natural sampling variation. Few approaches have been proposed for addressing this problem in the context of hierarchical clustering, for which the problem is further complicated by the natural tree structure of the partition, and the multiplicity of tests required to parse the layers of nested clusters. In this paper, we propose a Monte Carlo based approach for testing statistical significance in hierarchical clustering which addresses these issues. The approach is implemented as a sequential testing procedure guaranteeing control of the family-wise error rate. Theoretical justification is provided for our approach, and its power to detect true clustering structure is illustrated through several simulation studies and applications to two cancer gene expression datasets. PMID:28099990

Star clusters in evolving galaxies

NASA Astrophysics Data System (ADS)

Renaud, Florent

2018-04-01

Their ubiquity and extreme densities make star clusters probes of prime importance of galaxy evolution. Old globular clusters keep imprints of the physical conditions of their assembly in the early Universe, and younger stellar objects, observationally resolved, tell us about the mechanisms at stake in their formation. Yet, we still do not understand the diversity involved: why is star cluster formation limited to 105M⊙ objects in the Milky Way, while some dwarf galaxies like NGC 1705 are able to produce clusters 10 times more massive? Why do dwarfs generally host a higher specific frequency of clusters than larger galaxies? How to connect the present-day, often resolved, stellar systems to the formation of globular clusters at high redshift? And how do these links depend on the galactic and cosmological environments of these clusters? In this review, I present recent advances on star cluster formation and evolution, in galactic and cosmological context. The emphasis is put on the theory, formation scenarios and the effects of the environment on the evolution of the global properties of clusters. A few open questions are identified.

Criterion Referenced Inventory. Grade 7 Skill Clusters, Objectives, and Illustrations.

ERIC Educational Resources Information Center

Montgomery County Public Schools, Rockville, MD.

Part of a series of competency-based test materials for grades six through ten, this test booklet for seventh graders contains multiple-choice questions designed to aid in the evaluation of the pupils' library skills. Accompanied by a separate booklet of illustrations which are to be used in conjunction with the questions, the test covers the…

Validity, Reliability and Difficulty Indices for Instructor-Built Exam Questions

ERIC Educational Resources Information Center

Jandaghi, Gholamreza; Shaterian, Fatemeh

2008-01-01

The purpose of the research is to determine college Instructor's skill rate in designing exam questions in chemistry subject. The statistical population was all of chemistry exam sheets for two semesters in one academic year from which a sample of 364 exam sheets was drawn using multistage cluster sampling. Two experts assessed the sheets and by…

Instance-Based Question Answering

DTIC Science & Technology

2006-12-01

answer clustering, composition, and scoring. Moreover, with the effort dedicated to improving monolingual system performance, system parameters are...text collections: document type, manual or automatic annotations (if any), and stylistic and notational differences in technical terms. Monolingual ...forum in which cross language retrieval systems and question answering systems are tested for various Eu- ropean languages. The CLEF QA monolingual task

X-ray illumination of globular cluster puzzles. [globular cluster X ray sources as clues to Milky Way Galaxy age and evolution

NASA Technical Reports Server (NTRS)

Lightman, A. P.; Grindlay, J. E.

1982-01-01

Globular clusters are thought to be among the oldest objects in the Galaxy, and provide, in this connection, important clues for determining the age and process of formation of the Galaxy. The present investigation is concerned with puzzles relating to the X-ray emission of globular clusters, taking into account questions regarding the location of X-ray emitting clusters (XEGC) unusually near the galactic plane and/or galactic center. An adopted model is discussed for the nature, formation, and lifetime of X-ray sources in globular clusters. An analysis of the available data is conducted in connection with a search for correlations between binary formation time scales, central relaxation times, galactic locations, and X-ray emission. The positive correlation found between distance from galactic center and two-body binary formation time for globular clusters, explanations for this correlation, and the hypothesis that X-ray sources in globular clusters require binary star systems provide a possible explanation of the considered puzzles.

MO-F-204-00: Preparing for the ABR Diagnostic and Nuclear Medical Physics Exams

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

NONE

Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance of allmore » aspects of clinical medical physics. All parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those unique aspects of the nuclear exam, and how preparing for a second specialty differs from the first. Medical physicists who recently completed each ABR exam portion will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear imaging physics, systems, dosimetry, safety and related problem solving/calculations How to prepare for Part 3 of the ABR exam by effectively communicating the practice, methods, and significance of clinical diagnostic and/or nuclear medical physics.« less

MO-F-204-02: Preparing for Part 2 of the ABR Diagnostic Physics Exam

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

Szczykutowicz, T.

Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance of allmore » aspects of clinical medical physics. All parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those unique aspects of the nuclear exam, and how preparing for a second specialty differs from the first. Medical physicists who recently completed each ABR exam portion will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear imaging physics, systems, dosimetry, safety and related problem solving/calculations How to prepare for Part 3 of the ABR exam by effectively communicating the practice, methods, and significance of clinical diagnostic and/or nuclear medical physics.« less

MO-F-204-03: Preparing for Part 3 of the ABR Diagnostic Physics Exam

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

Zambelli, J.

Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance of allmore » aspects of clinical medical physics. All parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those unique aspects of the nuclear exam, and how preparing for a second specialty differs from the first. Medical physicists who recently completed each ABR exam portion will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear imaging physics, systems, dosimetry, safety and related problem solving/calculations How to prepare for Part 3 of the ABR exam by effectively communicating the practice, methods, and significance of clinical diagnostic and/or nuclear medical physics.« less

MO-F-204-01: Preparing for Part 1 of the ABR Diagnostic Physics Exam

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

McKenney, S.

Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance of allmore » aspects of clinical medical physics. All parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those unique aspects of the nuclear exam, and how preparing for a second specialty differs from the first. Medical physicists who recently completed each ABR exam portion will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear imaging physics, systems, dosimetry, safety and related problem solving/calculations How to prepare for Part 3 of the ABR exam by effectively communicating the practice, methods, and significance of clinical diagnostic and/or nuclear medical physics.« less

WE-D-213-00: Preparing for the ABR Diagnostic and Nuclear Medicine Physics Exams

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

NONE

Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR professional certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance ofmore » all aspects of clinical medical physics. All three parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation and skill sets necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those aspects that are unique to the nuclear exam. Medical physicists who have recently completed each of part of the ABR exam will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to Prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear imaging physics, systems, dosimetry, safety and related problem solving/calculations How to Prepare for Part 3 of the ABR exam by effectively communicating the practice, methods, and significance of clinical diagnostic and/or nuclear medical physics.« less

WE-D-213-01: Preparing for Part 1 of the ABR Diagnostic Physics Exam

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

Simiele, S.

Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR professional certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance ofmore » all aspects of clinical medical physics. All three parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation and skill sets necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those aspects that are unique to the nuclear exam. Medical physicists who have recently completed each of part of the ABR exam will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to Prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear imaging physics, systems, dosimetry, safety and related problem solving/calculations How to Prepare for Part 3 of the ABR exam by effectively communicating the practice, methods, and significance of clinical diagnostic and/or nuclear medical physics.« less

WE-D-213-03: Preparing for Part 3 of the ABR Diagnostic Physics Exam

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

Bevins, N.

Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR professional certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance ofmore » all aspects of clinical medical physics. All three parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation and skill sets necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those aspects that are unique to the nuclear exam. Medical physicists who have recently completed each of part of the ABR exam will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to Prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear imaging physics, systems, dosimetry, safety and related problem solving/calculations How to Prepare for Part 3 of the ABR exam by effectively communicating the practice, methods, and significance of clinical diagnostic and/or nuclear medical physics.« less

WE-D-213-02: Preparing for Part 2 of the ABR Diagnostic Physics Exam

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

Zambelli, J.

Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR professional certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance ofmore » all aspects of clinical medical physics. All three parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation and skill sets necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those aspects that are unique to the nuclear exam. Medical physicists who have recently completed each of part of the ABR exam will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to Prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear imaging physics, systems, dosimetry, safety and related problem solving/calculations How to Prepare for Part 3 of the ABR exam by effectively communicating the practice, methods, and significance of clinical diagnostic and/or nuclear medical physics.« less

A Comparison of the Mathematical Performance of Mature Students and Traditional Students over a 10-Year Period

ERIC Educational Resources Information Center

Faulkner, Fiona; Fitzmaurice, Olivia; Hannigan, Ailish

2016-01-01

Every student who enrols in a degree programme involving service mathematics in the University of Limerick in Ireland is given a mathematics diagnostic test. The diagnostic test was developed due to mathematics lecturers' anxiety regarding students' mathematical competency levels. Students receive the 40 question paper-based test in their first…

Diagnostic Appraisal of Grade 12 Students' Understanding of Reaction Kinetics

ERIC Educational Resources Information Center

Yan, Yaw Kai; Subramaniam, R.

2016-01-01

The study explored grade 12 students' understanding of reaction kinetics, a topic which has not been extensively explored in the chemistry education literature at this level. A 3-tier diagnostic instrument with 11 questions was developed--this format is of very recent origin and has been the subject of only a handful of studies. The findings…

Exploring Students' Understanding of Electrochemical Cells Using an Enhanced Two-Tier Diagnostic Instrument

ERIC Educational Resources Information Center

Loh, Adrian Sin Loy; Subramaniam, R.; Tan, Kim Chwee Daniel

2014-01-01

Background: The development of two-tier multiple-choice questions has permitted the diagnosis of students' understanding on various topics in the sciences as well as helped to ascertain the alternative conceptions they have. A limitation of two-tier diagnostic instruments that has been noted in the literature, but which has not been…

Nonlinear Penalized Estimation of True Q-Matrix in Cognitive Diagnostic Models

ERIC Educational Resources Information Center

Xiang, Rui

2013-01-01

A key issue of cognitive diagnostic models (CDMs) is the correct identification of Q-matrix which indicates the relationship between attributes and test items. Previous CDMs typically assumed a known Q-matrix provided by domain experts such as those who developed the questions. However, misspecifications of Q-matrix had been discovered in the past…

The influence of containerless undercooling and rapid solid-state quenching on the superconductive and magnetic properties of some clustering alloy systems

NASA Technical Reports Server (NTRS)

Collings, E. W.

1984-01-01

The properties of clustering alloy systems and the manner in which they are influenced by rapid quenching from a containerless undercooled melt are discussed. It was postulated that rapid quenching under such conditions would result in highly disordered metastable alloys, and furthermore, that alloys in such conditions would possess physical properties characteristically different from those of alloys in the annealed equilibrium state. The scope of the program is essentially to gauge the influence of containerless undercooling on the submicrostructure of clustering-type alloys, using certain physical properties as diagnostic tools. Microstructures and macrostructures were to be examined using optical- and scanning-electron microscopy.

Climate Prediction Center - Monitoring & Data: Current Monthly Atmospheric

Science.gov Websites

Data > Oceanic & Atmospheric Data > Monthly Atmospheric and SST Indices Alert Climate Diagnostics Bulletin Updates to Climatologies and Indices Beginning with January 2011 Data (To appear in : ftp.cpc.ncep.noaa.gov/wd52dg/data/indices Frequently Asked Questions Questions/comments. Contact: Wei.Shi@noaa.gov To

A two-step approach for mining patient treatment pathways in administrative healthcare databases.

PubMed

Najjar, Ahmed; Reinharz, Daniel; Girouard, Catherine; Gagné, Christian

2018-05-01

Clustering electronic medical records allows the discovery of information on healthcare practices. Entries in such medical records are usually composed of a succession of diagnostics or therapeutic steps. The corresponding processes are complex and heterogeneous since they depend on medical knowledge integrating clinical guidelines, the physician's individual experience, and patient data and conditions. To analyze such data, we are first proposing to cluster medical visits, consultations, and hospital stays into homogeneous groups, and then to construct higher-level patient treatment pathways over these different groups. These pathways are then also clustered to distill typical pathways, enabling interpretation of clusters by experts. This approach is evaluated on a real-world administrative database of elderly people in Québec suffering from heart failures. Copyright © 2018 Elsevier B.V. All rights reserved.

Brain profiling and clinical-neuroscience.

PubMed

Peled, Avi

2006-01-01

The current psychiatric diagnostic system, the diagnostic statistic manual, has recently come under increasing criticism. The major reason for the shortcomings of the current psychiatric diagnosis is the lack of a scientific brain-related etiological knowledge about mental disorders. The advancement toward such knowledge is further hampered by the lack of a theoretical framework or "language" that translates clinical findings of mental disorders to brain disturbances and insufficiencies. Here such a theoretical construct is proposed based on insights from neuroscience and neural-computation models. Correlates between clinical manifestations and presumed neuronal network disturbances are proposed in the form of a practical diagnostic system titled "Brain Profiling". Three dimensions make-up brain profiling, "neural complexity disorders", "neuronal resilience insufficiency", and "context-sensitive processing decline". The first dimension relates to disturbances occurring to fast neuronal activations in the millisecond range, it incorporates connectivity and hierarchical imbalances appertaining typically to psychotic and schizophrenic clinical manifestations. The second dimension relates to disturbances that alter slower changes namely long-term synaptic modulations, and incorporates disturbances to optimization and constraint satisfactions within relevant neuronal circuitry. Finally, the level of internal representations related to personality disorders is presented by a "context-sensitive process decline" as the third dimension. For practical use of brain profiling diagnosis a consensual list of psychiatric clinical manifestations provides a "diagnostic input vector", clinical findings are coded 1 for "detection" and 0 for "non-detection", 0.5 is coded for "questionable". The entries are clustered according to their presumed neuronal dynamic relationships and coefficients determine their relevance to the specific related brain disturbance. Relevant equations calculate and normalize the different values attributed to relevant brain disturbances culminating in a three-digit estimation representing the three diagnostic dimensions. brain profiling has the promise for a future brain-related diagnosis. It offers testable predictions about the etiology of mental disorders because being brain-related it lends readily to brain imaging investigations. Being presented also as a one-point representation in a three-dimensional space, multiple follow-up diagnoses trace a trajectory representing an easy-to-see clinical history of the patient. Additional, more immediate, advantages involve reduced stigma because it relaters the disorder to the brain not the person, in addition the three-digit diagnostic code is clinically informative unlike the DSM codes that have no clinical relevance. To conclude, brain profiling diagnosis of mental disorders could be a bold new step toward a "clinical-neuroscience" substituting "psychiatry".

Current practice in laboratory diagnostics of autoimmune diseases in Croatia. 
Survey of the Working group for laboratory diagnostics of autoimmune diseases of the Croatian Society of Medical Biochemistry and Laboratory Medicine.

PubMed

Kuna, Andrea Tešija; Đerek, Lovorka; Kozmar, Ana; Drvar, Vedrana

2016-10-15

With the trend of increasing incidence of autoimmune diseases, laboratories are faced with exponential growth of the requests for tests relating the diagnosis of these diseases. Unfortunately, the lack of laboratory personnel experienced in this specific discipline of laboratory diagnostic, as well as an unawareness of a method limitation often results in confusion for clinicians. The aim was to gain insight into number and type of Croatian laboratories that perform humoral diagnostics with the final goal to improve and harmonize laboratory diagnostics of autoimmune diseases in Croatia. In order to get insight into current laboratory practice two questionnaires, consisting of 42 questions in total, were created. Surveys were conducted using SurveyMonkey application and were sent to 88 medical biochemistry laboratories in Croatia for the first survey. Out of 33 laboratories that declared to perform diagnostic from the scope, 19 were selected for the second survey based on the tests they pleaded to perform. The survey comprised questions regarding autoantibody hallmarks of systemic autoimmune diseases while regarding organ-specific autoimmune diseases was limited to diseases of liver, gastrointestinal and nervous system. Response rate was high with 80 / 88 (91%) laboratories which answered the first questionnaire, and 19 / 19 (1.0) for the second questionnaire. Obtained results of surveys indicate high heterogeneity in the performance of autoantibody testing among laboratories in Croatia. Results indicate the need of creating recommendations and algorithms in order to harmonize the approach to laboratory diagnostics of autoimmune diseases in Croatia.

Pregnancy screening strategies for diagnostic nuclear medicine: survey results from Australia and New Zealand.

PubMed

James, Daphne J; Cardew, Paul; Warren-Forward, Helen M

2013-09-01

The ionizing radiation used in diagnostic nuclear medicine procedures has the potential to cause biologic harm to a fetus. Although the risks are relatively small, it is recommended that all female patients of childbearing age be questioned regarding their pregnancy status before administration of the radiopharmaceutical. This can be a sensitive situation especially for certain types of patients, such as teenagers. Currently, there are no guidelines that detail how to question the patient. Previous studies have revealed the lack of a consistent approach in this area. The aim of this study was to investigate current practice for pregnancy screening before diagnostic nuclear medicine procedures in Australia and New Zealand and to determine whether a standardized practice guideline is required. An online survey was administered via SurveyMonkey from October to December 2011. Members of the Australian and New Zealand Society of Nuclear Medicine were invited to participate. The survey consisted of 30 questions divided into 4 sections: demographics, policy and regulations, current practice, and open-ended clinical scenarios. Three hundred thirty-five responses were recorded from participants in all states and territories of Australia and New Zealand; 90% were nuclear medicine technologists. Participants reported a low awareness of radiation policy and regulations but demonstrated good knowledge of the relative risk to the fetus from commonly performed procedures. The most common minimum and maximum age to question patients was 12 y (32%) and 55 y (42%), respectively, although the range was from 10 to 60 y. Verbal questioning (44%) was the most commonly used approach. Pregnancy testing was used by 72%, usually if the patient indicated she was unsure of her pregnancy status. Responses to clinical scenarios were varied, and these will be discussed in a subsequent paper. The survey revealed a lack of awareness of government regulations and departmental policy regarding radiation protection. The study demonstrated wide variety in pregnancy screening strategies used to determine the pregnancy status of patients before diagnostic nuclear medicine procedures, indicating that a standardized practice guideline is required for Australia and New Zealand.

The impact of somatic symptoms on the course of major depressive disorder.

PubMed

Bekhuis, Ella; Boschloo, Lynn; Rosmalen, Judith G M; de Boer, Marrit K; Schoevers, Robert A

2016-11-15

Somatic symptoms have been suggested to negatively affect the course of major depressive disorder (MDD). Mechanisms behind this association, however, remain elusive. This study examines the impact of somatic symptoms on MDD prognosis and aims to determine whether this effect can be explained by psychiatric characteristics, somatic diseases, lifestyle factors, and disability. In 463 MDD patients (mean age=44.9 years, 69.8% female) from the Netherlands Study of Depression and Anxiety (NESDA), we examined whether the type and number of somatic symptom clusters predicted the two-year persistence of MDD. Diagnoses of MDD were established with the Composite International Diagnostic Interview (CIDI) and somatic symptom clusters were assessed with the Four-Dimensional Symptom Questionnaire (4DSQ) somatization scale. Psychiatric characteristics, somatic diseases, lifestyle factors, and disability were taken into account as factors potentially underlying the association. The cardiopulmonary, gastrointestinal, and general cluster significantly predicted the two-year persistence of MDD, but only when two or more of these clusters were present (OR=2.32, 95% CI=1.51-3.57, p=<0.001). Although the association was partly explained by MDD severity, the presence of multiple somatic symptom clusters remained a significant predictor after considering all potentially underlying factors (OR=1.69, 95%CI=1.07-2.68, p=0.03). Somatic symptoms are predictors of a worse prognosis of MDD independent of psychiatric characteristics, somatic diseases, lifestyle factors, and disability. These results stress the importance of considering somatic symptoms in the diagnostic and treatment trajectory of patients with MDD. Future research should focus on identifying treatment modalities targeting depressive as well as somatic symptoms. Copyright © 2016 Elsevier B.V. All rights reserved.

Hough transform for clustered microcalcifications detection in full-field digital mammograms

NASA Astrophysics Data System (ADS)

Fanizzi, A.; Basile, T. M. A.; Losurdo, L.; Amoroso, N.; Bellotti, R.; Bottigli, U.; Dentamaro, R.; Didonna, V.; Fausto, A.; Massafra, R.; Moschetta, M.; Tamborra, P.; Tangaro, S.; La Forgia, D.

2017-09-01

Many screening programs use mammography as principal diagnostic tool for detecting breast cancer at a very early stage. Despite the efficacy of the mammograms in highlighting breast diseases, the detection of some lesions is still doubtless for radiologists. In particular, the extremely minute and elongated salt-like particles of microcalcifications are sometimes no larger than 0.1 mm and represent approximately half of all cancer detected by means of mammograms. Hence the need for automatic tools able to support radiologists in their work. Here, we propose a computer assisted diagnostic tool to support radiologists in identifying microcalcifications in full (native) digital mammographic images. The proposed CAD system consists of a pre-processing step, that improves contrast and reduces noise by applying Sobel edge detection algorithm and Gaussian filter, followed by a microcalcification detection step performed by exploiting the circular Hough transform. The procedure performance was tested on 200 images coming from the Breast Cancer Digital Repository (BCDR), a publicly available database. The automatically detected clusters of microcalcifications were evaluated by skilled radiologists which asses the validity of the correctly identified regions of interest as well as the system error in case of missed clustered microcalcifications. The system performance was evaluated in terms of Sensitivity and False Positives per images (FPi) rate resulting comparable to the state-of-art approaches. The proposed model was able to accurately predict the microcalcification clusters obtaining performances (sensibility = 91.78% and FPi rate = 3.99) which favorably compare to other state-of-the-art approaches.

Input Frequency and Lexical Variability in Phonological Development: A Survival Analysis of Word-Initial Cluster Production

ERIC Educational Resources Information Center

Ota, Mitsuhiko; Green, Sam J.

2013-01-01

Although it has been often hypothesized that children learn to produce new sound patterns first in frequently heard words, the available evidence in support of this claim is inconclusive. To re-examine this question, we conducted a survival analysis of word-initial consonant clusters produced by three children in the Providence Corpus (0 ; 11-4 ;…

BioTextQuest: a web-based biomedical text mining suite for concept discovery.

PubMed

Papanikolaou, Nikolas; Pafilis, Evangelos; Nikolaou, Stavros; Ouzounis, Christos A; Iliopoulos, Ioannis; Promponas, Vasilis J

2011-12-01

BioTextQuest combines automated discovery of significant terms in article clusters with structured knowledge annotation, via Named Entity Recognition services, offering interactive user-friendly visualization. A tag-cloud-based illustration of terms labeling each document cluster are semantically annotated according to the biological entity, and a list of document titles enable users to simultaneously compare terms and documents of each cluster, facilitating concept association and hypothesis generation. BioTextQuest allows customization of analysis parameters, e.g. clustering/stemming algorithms, exclusion of documents/significant terms, to better match the biological question addressed. http://biotextquest.biol.ucy.ac.cy vprobon@ucy.ac.cy; iliopj@med.uoc.gr Supplementary data are available at Bioinformatics online.

Variability in research ethics review of cluster randomized trials: a scenario-based survey in three countries

PubMed Central

2014-01-01

Background Cluster randomized trials (CRTs) present unique ethical challenges. In the absence of a uniform standard for their ethical design and conduct, problems such as variability in procedures and requirements by different research ethics committees will persist. We aimed to assess the need for ethics guidelines for CRTs among research ethics chairs internationally, investigate variability in procedures for research ethics review of CRTs within and among countries, and elicit research ethics chairs’ perspectives on specific ethical issues in CRTs, including the identification of research subjects. The proper identification of research subjects is a necessary requirement in the research ethics review process, to help ensure, on the one hand, that subjects are protected from harm and exploitation, and on the other, that reviews of CRTs are completed efficiently. Methods A web-based survey with closed- and open-ended questions was administered to research ethics chairs in Canada, the United States, and the United Kingdom. The survey presented three scenarios of CRTs involving cluster-level, professional-level, and individual-level interventions. For each scenario, a series of questions was posed with respect to the type of review required (full, expedited, or no review) and the identification of research subjects at cluster and individual levels. Results A total of 189 (35%) of 542 chairs responded. Overall, 144 (84%, 95% CI 79 to 90%) agreed or strongly agreed that there is a need for ethics guidelines for CRTs and 158 (92%, 95% CI 88 to 96%) agreed or strongly agreed that research ethics committees could be better informed about distinct ethical issues surrounding CRTs. There was considerable variability among research ethics chairs with respect to the type of review required, as well as the identification of research subjects. The cluster-cluster and professional-cluster scenarios produced the most disagreement. Conclusions Research ethics committees identified a clear need for ethics guidelines for CRTs and education about distinct ethical issues in CRTs. There is disagreement among committees, even within the same countries, with respect to key questions in the ethics review of CRTs. This disagreement reflects variability of opinion and practices pointing toward possible gaps in knowledge, and supports the need for explicit guidelines for the ethical conduct and review of CRTs. PMID:24495542

Foods are differentially associated with subjective effect report questions of abuse liability.

PubMed

Schulte, Erica M; Smeal, Julia K; Gearhardt, Ashley N

2017-01-01

The current study investigates which foods may be most implicated in addictive-like eating by examining how nutritionally diverse foods relate to loss of control consumption and various subjective effect reports. Subjective effect reports assess the abuse liabilities of substances and may similarly provide insight into which foods may be reinforcing in a manner that triggers an addictive-like response for some individuals. Cross-sectional. Online community. 507 participants (n = 501 used in analyses) recruited through Amazon MTurk. Participants (n = 501) self-reported how likely they were to experience a loss of control over their consumption of 30 nutritionally diverse foods and rated each food on five subjective effect report questions that assess the abuse liability of substances (liking, pleasure, craving, averseness, intensity). Hierarchical cluster analytic techniques were used to examine how foods grouped together based on each question. Highly processed foods, with added fats and/or refined carbohydrates, clustered together and were associated with greater loss of control, liking, pleasure, and craving. The clusters yielded from the subjective effect reports assessing liking, pleasure, and craving were most similar to clusters formed based on loss of control over consumption, whereas the clusters yielded from averseness and intensity did not meaningfully differentiate food items. The present work applies methodology used to assess the abuse liability of substances to understand whether foods may vary in their potential to be associated with addictive-like consumption. Highly processed foods (e.g., pizza, chocolate) appear to be most related to an indicator of addictive-like eating (loss of control) and several subjective effect reports (liking, pleasure, craving). Thus, these foods may be particularly reinforcing and capable of triggering an addictive-like response in some individuals. Future research is warranted to understand whether highly processed foods are related to these indicators of abuse liability at a similar magnitude as addictive substances.

Psychiatrist-patient verbal and nonverbal communications during split-treatment appointments.

PubMed

Cruz, Mario; Roter, Debra; Cruz, Robyn Flaum; Wieland, Melissa; Cooper, Lisa A; Larson, Susan; Pincus, Harold Alan

2011-11-01

This study characterized psychiatrist and patient communication behaviors and affective voice tones during pharmacotherapy appointments with depressed patients at four community-based mental health clinics where psychiatrists provided medication management and other mental health professionals provided therapy ("split treatment"). Audiorecordings of 84 unique pairs of psychiatrists and patients with a depressive disorder were analyzed with the Roter Interaction Analysis System, which identifies 41 discrete speech categories that can be grouped into composites representing broad conceptual communication domains. Cluster analysis identified psychiatrist communication patterns. T test and chi square analyses compared the clusters for verbal dominance, affective voice tone, and characteristics of psychiatrist and patients. On average, 53% of psychiatrist talk was devoted to partnering and relationship building, and 67% of patient talk was about biomedical subjects, such as depression symptoms, and psychosocial information giving. Psychiatrist communication patterns were characterized by two clusters, a biomedical-centered cluster that emphasized biomedical questions (η²=.22, df=82, p<.001) and education or counseling (η²=.20, df=82, p<.001) and a patient-centered cluster focused on psychosocial and lifestyle questions (η²=.24, df=82, p<.001) and information giving (η²=.17, df=82, p<.001). The patient-centered cluster was associated with patients' expression of distress, anger, or other negative affects (t=3.22, df= 82, p=.002). Psychiatrists devoted much of their talk to partnering and relationship building while maintaining a focus on symptoms or psychosocial issues. However, patient behaviors did not reflect a similar level of partnering. Future studies should identify psychiatrist communication behaviors that activate collaborative patient communications or improve treatment outcomes.

Optimizing Patient-centered Communication and Multidisciplinary Care Coordination in Emergency Diagnostic Imaging: A Research Agenda.

PubMed

Sabbatini, Amber K; Merck, Lisa H; Froemming, Adam T; Vaughan, William; Brown, Michael D; Hess, Erik P; Applegate, Kimberly E; Comfere, Nneka I

2015-12-01

Patient-centered emergency diagnostic imaging relies on efficient communication and multispecialty care coordination to ensure optimal imaging utilization. The construct of the emergency diagnostic imaging care coordination cycle with three main phases (pretest, test, and posttest) provides a useful framework to evaluate care coordination in patient-centered emergency diagnostic imaging. This article summarizes findings reached during the patient-centered outcomes session of the 2015 Academic Emergency Medicine consensus conference "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization." The primary objective was to develop a research agenda focused on 1) defining component parts of the emergency diagnostic imaging care coordination process, 2) identifying gaps in communication that affect emergency diagnostic imaging, and 3) defining optimal methods of communication and multidisciplinary care coordination that ensure patient-centered emergency diagnostic imaging. Prioritized research questions provided the framework to define a research agenda for multidisciplinary care coordination in emergency diagnostic imaging. © 2015 by the Society for Academic Emergency Medicine.

Multiwavelength Studies of Young OB Associations

NASA Astrophysics Data System (ADS)

Feigelson, Eric D.

We discuss how contemporary multiwavelength observations of young OB-dominated clusters address long-standing astrophysical questions: Do clusters form rapidly or slowly with an age spread? When do clusters expand and disperse to constitute the field star population? Do rich clusters form by amalgamation of smaller subclusters? What is the pattern and duration of cluster formation in massive star forming regions (MSFRs)? Past observational difficulties in obtaining good stellar censuses of MSFRs have been alleviated in recent studies that combine X-ray and infrared surveys to obtain rich, though still incomplete, censuses of young stars in MSFRs. We describe here one of these efforts, the MYStIX project, that produced a catalog of 31,784 probable members of 20 MSFRs. We find that age spread within clusters is real in the sense that the stars in the core formed after the cluster halo. This is consistent with some recent astrophysical models involving merging star-forming filaments. Cluster expansion is seen in the ensemble of (sub)clusters, and older dispersing populations are found across MSFRs. Long-lived, asynchronous star formation is pervasive across MSFRs.

Coarsening of protein clusters on subcellular drops exhibits strong and sudden size selectivity

NASA Astrophysics Data System (ADS)

Brown, Aidan; Rutenberg, Andrew

2015-03-01

Autophagy is an important process for the degradation of cellular components, with receptor proteins targeting substrates to downstream autophagy machinery. An important question is how receptor protein interactions lead to their selective accumulation on autophagy substrates. Receptor proteins have recently been observed in clusters, raising the possibility that clustering could affect autophagy selectivity. We investigate the clustering dynamics of the autophagy receptor protein NBR1. In addition to standard receptor protein domains, NBR1 has a ``J'' domain that anchors it to membranes, and a coiled-coil domain that enhances self-interaction. We model coarsening clusters of NBR1 on the surfaces of a polydisperse collection of drops, representing organelles. Despite the disconnected nature of the drop surfaces, we recover dynamical scaling of cluster sizes. Significantly, we find that at a well-defined time after coarsening begins, clusters evaporate from smaller drops and grow on larger drops. Thus, coarsening-driven size selection will localize protein clusters to larger substrates, leaving smaller substrates without clusters. This provides a possible physical mechanism for autophagy selectivity, and can explain reports of size selection during peroxisome degradation.

ADPROCLUS: a graphical user interface for fitting additive profile clustering models to object by variable data matrices.

PubMed

Wilderjans, Tom F; Ceulemans, Eva; Van Mechelen, Iven; Depril, Dirk

2011-03-01

In many areas of psychology, one is interested in disclosing the underlying structural mechanisms that generated an object by variable data set. Often, based on theoretical or empirical arguments, it may be expected that these underlying mechanisms imply that the objects are grouped into clusters that are allowed to overlap (i.e., an object may belong to more than one cluster). In such cases, analyzing the data with Mirkin's additive profile clustering model may be appropriate. In this model: (1) each object may belong to no, one or several clusters, (2) there is a specific variable profile associated with each cluster, and (3) the scores of the objects on the variables can be reconstructed by adding the cluster-specific variable profiles of the clusters the object in question belongs to. Until now, however, no software program has been publicly available to perform an additive profile clustering analysis. For this purpose, in this article, the ADPROCLUS program, steered by a graphical user interface, is presented. We further illustrate its use by means of the analysis of a patient by symptom data matrix.

Diagnostic Classification of Schizophrenia Patients on the Basis of Regional Reward-Related fMRI Signal Patterns

PubMed Central

Koch, Stefan P.; Hägele, Claudia; Haynes, John-Dylan; Heinz, Andreas; Schlagenhauf, Florian; Sterzer, Philipp

2015-01-01

Functional neuroimaging has provided evidence for altered function of mesolimbic circuits implicated in reward processing, first and foremost the ventral striatum, in patients with schizophrenia. While such findings based on significant group differences in brain activations can provide important insights into the pathomechanisms of mental disorders, the use of neuroimaging results from standard univariate statistical analysis for individual diagnosis has proven difficult. In this proof of concept study, we tested whether the predictive accuracy for the diagnostic classification of schizophrenia patients vs. healthy controls could be improved using multivariate pattern analysis (MVPA) of regional functional magnetic resonance imaging (fMRI) activation patterns for the anticipation of monetary reward. With a searchlight MVPA approach using support vector machine classification, we found that the diagnostic category could be predicted from local activation patterns in frontal, temporal, occipital and midbrain regions, with a maximal cluster peak classification accuracy of 93% for the right pallidum. Region-of-interest based MVPA for the ventral striatum achieved a maximal cluster peak accuracy of 88%, whereas the classification accuracy on the basis of standard univariate analysis reached only 75%. Moreover, using support vector regression we could additionally predict the severity of negative symptoms from ventral striatal activation patterns. These results show that MVPA can be used to substantially increase the accuracy of diagnostic classification on the basis of task-related fMRI signal patterns in a regionally specific way. PMID:25799236

Targeted HIV Screening in Eight Emergency Departments: The DICI-VIH Cluster-Randomized Two-Period Crossover Trial.

PubMed

Leblanc, Judith; Hejblum, Gilles; Costagliola, Dominique; Durand-Zaleski, Isabelle; Lert, France; de Truchis, Pierre; Verbeke, Geert; Rousseau, Alexandra; Piquet, Hélène; Simon, François; Pateron, Dominique; Simon, Tabassome; Crémieux, Anne-Claude

2018-07-01

This study compares the effectiveness and cost-effectiveness of nurse-driven targeted HIV screening alongside physician-directed diagnostic testing (intervention strategy) with diagnostic testing alone (control strategy) in 8 emergency departments. In this cluster-randomized, 2-period, crossover trial, 18- to 64-year-old patients presenting for reasons other than potential exposure to HIV were included. The strategy applied first was randomly assigned. During both periods, diagnostic testing was prescribed by physicians following usual care. During the intervention periods, patients were asked to complete a self-administered questionnaire. According to their answers, the triage nurse suggested performing a rapid test to patients belonging to a high-risk group. The primary outcome was the proportion of new diagnoses among included patients, which further refers to effectiveness. A secondary outcome was the intervention's incremental cost (health care system perspective) per additional diagnosis. During the intervention periods, 74,161 patients were included, 16,468 completed the questionnaire, 4,341 belonged to high-risk groups, and 2,818 were tested by nurses, yielding 13 new diagnoses. Combined with 9 diagnoses confirmed through 97 diagnostic tests, 22 new diagnoses were established. During the control periods, 74,166 patients were included, 92 were tested, and 6 received a new diagnosis. The proportion of new diagnoses among included patients was higher during the intervention than in the control periods (3.0 per 10,000 versus 0.8 per 10,000; difference 2.2 per 10,000, 95% CI 1.3 to 3.6; relative risk 3.7, 95% CI 1.4 to 9.8). The incremental cost was €1,324 per additional new diagnosis. The combined strategy of targeted screening and diagnostic testing was effective. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Galaxy Cluster Mass Reconstruction Project – III. The impact of dynamical substructure on cluster mass estimates

DOE PAGES

Old, L.; Wojtak, R.; Pearce, F. R.; ...

2017-12-20

With the advent of wide-field cosmological surveys, we are approaching samples of hundreds of thousands of galaxy clusters. While such large numbers will help reduce statistical uncertainties, the control of systematics in cluster masses is crucial. Here we examine the effects of an important source of systematic uncertainty in galaxy-based cluster mass estimation techniques: the presence of significant dynamical substructure. Dynamical substructure manifests as dynamically distinct subgroups in phase-space, indicating an ‘unrelaxed’ state. This issue affects around a quarter of clusters in a generally selected sample. We employ a set of mock clusters whose masses have been measured homogeneously withmore » commonly used galaxy-based mass estimation techniques (kinematic, richness, caustic, radial methods). We use these to study how the relation between observationally estimated and true cluster mass depends on the presence of substructure, as identified by various popular diagnostics. We find that the scatter for an ensemble of clusters does not increase dramatically for clusters with dynamical substructure. However, we find a systematic bias for all methods, such that clusters with significant substructure have higher measured masses than their relaxed counterparts. This bias depends on cluster mass: the most massive clusters are largely unaffected by the presence of significant substructure, but masses are significantly overestimated for lower mass clusters, by ~ 10 percent at 10 14 and ≳ 20 percent for ≲ 10 13.5. Finally, the use of cluster samples with different levels of substructure can therefore bias certain cosmological parameters up to a level comparable to the typical uncertainties in current cosmological studies.« less

Galaxy Cluster Mass Reconstruction Project – III. The impact of dynamical substructure on cluster mass estimates

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

Old, L.; Wojtak, R.; Pearce, F. R.

With the advent of wide-field cosmological surveys, we are approaching samples of hundreds of thousands of galaxy clusters. While such large numbers will help reduce statistical uncertainties, the control of systematics in cluster masses is crucial. Here we examine the effects of an important source of systematic uncertainty in galaxy-based cluster mass estimation techniques: the presence of significant dynamical substructure. Dynamical substructure manifests as dynamically distinct subgroups in phase-space, indicating an ‘unrelaxed’ state. This issue affects around a quarter of clusters in a generally selected sample. We employ a set of mock clusters whose masses have been measured homogeneously withmore » commonly used galaxy-based mass estimation techniques (kinematic, richness, caustic, radial methods). We use these to study how the relation between observationally estimated and true cluster mass depends on the presence of substructure, as identified by various popular diagnostics. We find that the scatter for an ensemble of clusters does not increase dramatically for clusters with dynamical substructure. However, we find a systematic bias for all methods, such that clusters with significant substructure have higher measured masses than their relaxed counterparts. This bias depends on cluster mass: the most massive clusters are largely unaffected by the presence of significant substructure, but masses are significantly overestimated for lower mass clusters, by ~ 10 percent at 10 14 and ≳ 20 percent for ≲ 10 13.5. Finally, the use of cluster samples with different levels of substructure can therefore bias certain cosmological parameters up to a level comparable to the typical uncertainties in current cosmological studies.« less

Criterion Referenced Assessment Bank. Grade 6 Skill Clusters, Objectives, and Illustrations.

ERIC Educational Resources Information Center

Montgomery County Public Schools, Rockville, MD.

Part of a series of competency-based test materials for grades six through ten, this set of nine test booklets for sixth graders contains multiple-choice questions designed to aid in the evaluation of the pupils' library skills. Accompanied by a separate, tenth booklet of illustrations which are to be used in conjunction with the questions, the…

Identifying Meta-Clusters of Students' Interest in Science and Their Change with Age

ERIC Educational Resources Information Center

Baram-Tsabari, Ayelet; Yarden, Anat

2009-01-01

Nearly 6,000 science questions collected from five different web-based, TV-based and school-based sources were rigorously analyzed in order to identify profiles of K-12 students' interest in science, and how these profiles change with age. The questions were analyzed according to their topic, thinking level, motivation for and level of autonomy in…

Relationship between Diagnostic Criteria, Depressive Equivalents and Diagnosis of Depression among Older Adults with Intellectual Disability

ERIC Educational Resources Information Center

Langlois, L.; Martin, L.

2008-01-01

Background: Depression is more common among persons with an intellectual disability (ID) than the general population, and may be expected to increase with age just as in the general population. However, little is known about depression among older adults with ID. The literature has questioned the use of standard diagnostic criteria for depression…

Prenatal Sex Selection and Missing Girls in China: Evidence from the Diffusion of Diagnostic Ultrasound

ERIC Educational Resources Information Center

Chen, Yuyu; Li, Hongbin; Meng, Lingsheng

2013-01-01

How much of the increase in sex ratio (male to female) at birth since the early 1980s in China is attributed to increased prenatal sex selection? This question is addressed by exploiting the differential introduction of diagnostic ultrasound in the country during the 1980s, which significantly reduced the cost of prenatal sex selection. We…

The "Diagnostic and Statistical Manual of Mental Disorders" in Graduate Social Work Education: Then and Now

ERIC Educational Resources Information Center

Newman, Bernie S.; Dannenfelser, Paul L.; Clemmons, Valarie

2007-01-01

Social workers recognize the necessity of using the "Diagnostic and Statistical Manual of Mental Disorders" ("DSM"; American Psychiatric Association) but question its compatibility with social work education. The data in this study were compared with the data from P. R. Raffoul and K. A. Holmes (1986) regarding the extent to which the "DSM" was…

Where's the Psychology? A Commentary on "Unique Characteristics of Diagnostic Classification Models: A Comprehensive Review of the Current State-of-the-Art"

ERIC Educational Resources Information Center

Leighton, Jacqueline P.

2008-01-01

In this commentary, the author asks the analogous question, "where's the psychology?" Not because the authors of the focus article "Unique Characteristics of Diagnostic Classification Models: A Comprehensive Review of the Current State-of-the-Art" have not provided a solid review of the technical aspects of Diagnostic…

The Performance of Children with Mental Health Disorders on the ADOS-G: A Question of Diagnostic Utility

ERIC Educational Resources Information Center

Sikora, Darryn M.; Hartley, Sigan L.; McCoy, Robin; Gerrard-Morris, Aimee E.; Dill, Kameron

2008-01-01

Over the past few decades, the reported number of children identified as having one of the Autism Spectrum Disorders (ASD) has increased exponentially. One proposed reason for the dramatic increase in the prevalence of ASD is diagnostic substitution, whereby children with other disorders incorrectly receive a diagnosis of ASD. Little research has…

Submegabase Clusters of Unstable Tandem Repeats Unique to the Tla Region of Mouse T Haplotypes

PubMed Central

Uehara, H.; Ebersole, T.; Bennett, D.; Artzt, K.

1990-01-01

We describe here the identification and genomic organization of mouse t haplotype-specific elements (TSEs) 7.8 and 5.8 kb in length. The TSEs exist as submegabase-long clusters of tandem repeats localized in the Tla region of the major histocompatibility complex of all t haplotype chromosomes examined. In contrast, no such clusters were detected among 12 inbred strains of Mus musculus and other Mus species; thus, clusters of TSEs represent the first absolutely qualitative difference between t haplotypes and wild-type chromosomes. Pulsed field gel electrophoresis shows that the number of clusters, and the number of repeats in each cluster are extremely variable. Dramatic quantitative differences of TSEs uniquely distinguish every independent t haplotype from any other. The complete nucleotide sequence of one 7.8-kb TSE reveals significant homology to the ETn (a major transcript in the early embryo of the mouse), and some homologies to intracisternal A-particles and the mammary tumor virus env gene. Apart from the diagnostic relevance to t haplotypes, evolutionary and functional significances are discussed with respect to chromosome structure and genetic recombination. PMID:2076812

Cluster Randomized Test-Negative Design (CR-TND) Trials: A Novel and Efficient Method to Assess the Efficacy of Community Level Dengue Interventions.

PubMed

Anders, Katherine L; Cutcher, Zoe; Kleinschmidt, Immo; Donnelly, Christl A; Ferguson, Neil M; Indriani, Citra; O'Neill, Scott L; Jewell, Nicholas P; Simmons, Cameron P

2018-05-07

Cluster randomized trials are the gold standard for assessing efficacy of community-level interventions, such as vector control strategies against dengue. We describe a novel cluster randomized trial methodology with a test-negative design, which offers advantages over traditional approaches. It utilizes outcome-based sampling of patients presenting with a syndrome consistent with the disease of interest, who are subsequently classified as test-positive cases or test-negative controls on the basis of diagnostic testing. We use simulations of a cluster trial to demonstrate validity of efficacy estimates under the test-negative approach. This demonstrates that, provided study arms are balanced for both test-negative and test-positive illness at baseline and that other test-negative design assumptions are met, the efficacy estimates closely match true efficacy. We also briefly discuss analytical considerations for an odds ratio-based effect estimate arising from clustered data, and outline potential approaches to analysis. We conclude that application of the test-negative design to certain cluster randomized trials could increase their efficiency and ease of implementation.

A model for the infrared emission from an OB star cluster environment

NASA Technical Reports Server (NTRS)

Leisawitz, D.

1991-01-01

A model for the infrared emission from the neighborhood of an OB star cluster is described. The distribution of gas and dust around the stars, properties of the dust, and the cluster and interstellar radiation fields are variable. The model can be applied to regions around clusters embedded to various degrees in their parental molecular clouds (i.e., compact H II regions, blister-type H II regions, and the tenuous H II regions ionized by naked O stars). The model is used to simulate IRAS observations of a typical blister H II region. Infrared surface brightness and spectral energy distributions are predicted and the impact of limited spatial resolution is illustrated. The model results are shown to be consistent with observations of the exemplary outer Galaxy OB cluster NGC 7380. It is planned to use the model as a diagnostic tool to probe the physical conditions and dust properties in star-formation regions and, ultimately, in an interpretation of the spectral energy distributions of spiral galaxies.

Kinetic Description of the Impedance Probe

NASA Astrophysics Data System (ADS)

Oberrath, Jens; Lapke, Martin; Mussenbrock, Thomas; Brinkmann, Ralf

2011-10-01

Active plasma resonance spectroscopy is a well known diagnostic method. Many concepts of this method are theoretically investigated and realized as a diagnostic tool, one of which is the impedance probe (IP). The application of such a probe in plasmas with pressures of a few Pa raises the question whether kinetic effects have to be taken into account or not. To address this question a kinetic model is necessary. A general kinetic model for an electrostatic concept of active plasma spectroscopy was presented by R.P. Brinkmann and can be used to describe the multipole resonance probe (MRP). In principle the IP is interpretable as a special case of the MRP in lower order. Thus, we are able to describe the IP by the kinetic model of the MRP. Based on this model we derive a solution to investigate the influence of kinetic effects to the resonance behavior of the IP. Active plasma resonance spectroscopy is a well known diagnostic method. Many concepts of this method are theoretically investigated and realized as a diagnostic tool, one of which is the impedance probe (IP). The application of such a probe in plasmas with pressures of a few Pa raises the question whether kinetic effects have to be taken into account or not. To address this question a kinetic model is necessary. A general kinetic model for an electrostatic concept of active plasma spectroscopy was presented by R.P. Brinkmann and can be used to describe the multipole resonance probe (MRP). In principle the IP is interpretable as a special case of the MRP in lower order. Thus, we are able to describe the IP by the kinetic model of the MRP. Based on this model we derive a solution to investigate the influence of kinetic effects to the resonance behavior of the IP. The authors acknowledge the support by the Deutsche Forschungsgemeinschaft (DFG) via the Ruhr University Research School and the Federal Ministry of Education and Research in frame of the PluTO project.

[Autism Spectrum Disorder and DSM-5: Spectrum or Cluster?].

PubMed

Kienle, Xaver; Freiberger, Verena; Greulich, Heide; Blank, Rainer

2015-01-01

Within the new DSM-5, the currently differentiated subgroups of "Autistic Disorder" (299.0), "Asperger's Disorder" (299.80) and "Pervasive Developmental Disorder" (299.80) are replaced by the more general "Autism Spectrum Disorder". With regard to a patient-oriented and expedient advising therapy planning, however, the issue of an empirically reproducible and clinically feasible differentiation into subgroups must still be raised. Based on two Autism-rating-scales (ASDS and FSK), an exploratory two-step cluster analysis was conducted with N=103 children (age: 5-18) seen in our social-pediatric health care centre to examine potentially autistic symptoms. In the two-cluster solution of both rating scales, mainly the problems in social communication grouped the children into a cluster "with communication problems" (51 % and 41 %), and a cluster "without communication problems". Within the three-cluster solution of the ASDS, sensory hypersensitivity, cleaving to routines and social-communicative problems generated an "autistic" subgroup (22%). The children of the second cluster ("communication problems", 35%) were only described by social-communicative problems, and the third group did not show any problems (38%). In the three-cluster solution of the FSK, the "autistic cluster" of the two-cluster solution differentiated in a subgroup with mainly social-communicative problems (cluster 1) and a second subgroup described by restrictive, repetitive behavior. The different cluster solutions will be discussed with a view to the new DSM-5 diagnostic criteria, for following studies a further specification of some of the ASDS and FSK items could be helpful.

Monogenetic Volcano Clusters within the wider Michoacán-Guanajuato Volcanic Field (México) and their Significance

NASA Astrophysics Data System (ADS)

Siebe, C.

2017-12-01

The Trans-Mexican Volcanic Belt, one of the most complex and active continental arcs worldwide, displays several volcanic fields dominated by monogenetic volcanoes. Of these, the Plio-Quaternary Michoacán-Guanajuato Volcanic Field (MGVF) situated in central Mexico, is the largest monogenetic volcanic field in the world and includes more than 1000 scoria cones and associated lava flows and about 400 medium-sized volcanoes (Mexican shields). The smaller monogenetic vents occur either isolated or form small clusters within the wider MGVF. The recent identification of small clusters comprising several monogenetic volcanoes that erupted in a sequence of geologically short time intervals (hundreds to few thousands of years) in small areas within the much wider MGVF opens several questions in regard to future volcanic hazard assessments in this region: Are the youngest (Holocene) clusters still "active" and is a new eruption likely to occur within their surroundings? How long are such clusters "active"? Will the next monogenetic eruption in the MGVF be a single short-lived isolated eruption, or the beginning of a cluster? Furthermore, is it possible that the historic eruptions of Jorullo (1759) and Paricutin (1943) represent each the beginning of a cluster and should a new eruption in their proximity be expected in the future? In order to address these questions, two Holocene clusters, namely Tacámbaro and Malpaís de Zacapu are currently under study and preliminary results will be presented. Each comprises four monogenetic vents that erupted in a sequence of geologically short time intervals (hundreds to few thousands of years) within a small area (few tens of km2) Geologic mapping, geochemical analyses, radiometric dating, and paleomagnetic studies will help to establish the sequence of eruption of the different vents, and shed more light on the conditions that allow several magma sources to be formed and then tapped in close temporal and spatial proximity to each other and produce such small "flare-ups".

Committee Opinion No. 723 Summary: Guidelines for Diagnostic Imaging During Pregnancy and Lactation.

PubMed

2017-10-01

Imaging studies are important adjuncts in the diagnostic evaluation of acute and chronic conditions. However, confusion about the safety of these modalities for pregnant and lactating women and their infants often results in unnecessary avoidance of useful diagnostic tests or the unnecessary interruption of breastfeeding. Ultrasonography and magnetic resonance imaging are not associated with risk and are the imaging techniques of choice for the pregnant patient, but they should be used prudently and only when use is expected to answer a relevant clinical question or otherwise provide medical benefit to the patient. With few exceptions, radiation exposure through radiography, computed tomography scan, or nuclear medicine imaging techniques is at a dose much lower than the exposure associated with fetal harm. If these techniques are necessary in addition to ultrasonography or magnetic resonance imaging or are more readily available for the diagnosis in question, they should not be withheld from a pregnant patient. Breastfeeding should not be interrupted after gadolinium administration.

Committee Opinion No. 723: Guidelines for Diagnostic Imaging During Pregnancy and Lactation.

PubMed

2017-10-01

Imaging studies are important adjuncts in the diagnostic evaluation of acute and chronic conditions. However, confusion about the safety of these modalities for pregnant and lactating women and their infants often results in unnecessary avoidance of useful diagnostic tests or the unnecessary interruption of breastfeeding. Ultrasonography and magnetic resonance imaging are not associated with risk and are the imaging techniques of choice for the pregnant patient, but they should be used prudently and only when use is expected to answer a relevant clinical question or otherwise provide medical benefit to the patient. With few exceptions, radiation exposure through radiography, computed tomography scan, or nuclear medicine imaging techniques is at a dose much lower than the exposure associated with fetal harm. If these techniques are necessary in addition to ultrasonography or magnetic resonance imaging or are more readily available for the diagnosis in question, they should not be withheld from a pregnant patient. Breastfeeding should not be interrupted after gadolinium administration.

Patient Navigation and Time to Diagnostic Resolution: Results for a Cluster Randomized Trial Evaluating the Efficacy of Patient Navigation among Patients with Breast Cancer Screening Abnormalities, Tampa, FL

PubMed Central

Lee, Ji-Hyun; Fulp, William; Wells, Kristen J.; Meade, Cathy D.; Calcano, Ercilia; Roetzheim, Richard

2013-01-01

Objectives The objective of this study was to evaluate a patient navigation (PN) program that attempts to reduce the time between a breast cancer screening abnormality and definitive diagnosis among medically underserved populations of Tampa Bay, Florida. Methods The Moffitt Patient Navigation Research Program conducted a cluster randomized design with 10 primary care clinics. Patients were navigated from time of a breast screening abnormality to diagnostic resolution. This paper examined the length of time between breast abnormality and definitive diagnosis, using a shared frailty Cox proportional hazard model to assess PN program effect. Results 1,039 patients were eligible for the study because of an abnormal breast cancer screening/clinical abnormality (494 navigated; 545 control). Analysis of PN effect by two time periods of resolution (0-3 months and > 3 months) showed a lagged effect of PN. For patients resolving in the first three months, the adjusted Hazard Ratio (aHR) was 0.85 (95% Confidence Interval [CI]: 0.64-1.13) suggesting that PN had no effect on resolution time during this period. Beyond three months, however, navigated patients resolved more quickly to diagnostic resolution compared with the control group (aHR 2.8, 95%CI: 1.30-6.13). The predicted aHR at 3 months was 1.2, which was not statistically significant, while PN had a significant positive effect beyond 4.7 months. Conclusions PN programs may increase the timeliness of diagnostic resolution for patients with a breast cancer-related abnormality. PN did not speed diagnostic resolution during the initial three months of follow up but started to reduce time to diagnostic resolution after three months and showed a significant effect after 4.7 months. Trial Registration ClinicalTrials.gov NCT00375024 PMID:24066145

The effects of tumor location on diagnostic criteria for canine malignant peripheral nerve sheath tumors (MPNSTs) and the markers for distinction between canine MPNSTs and canine perivascular wall tumors.

PubMed

Suzuki, S; Uchida, K; Nakayama, H

2014-07-01

Canine malignant peripheral nerve sheath tumors (MPNSTs) occur not only in the peripheral nervous system (PNS) but also in soft tissue and various organs (non-PNS). The most important diagnostic criterion is proof of peripheral nerve sheath origin. This is difficult in non-PNS MPNSTs, and its differential diagnosis is challenging. Canine perivascular wall tumors (PWTs) also commonly arise in soft tissue. Their histopathological features are quite similar to those of canine MPNSTs, making their differential diagnosis challenging. To elucidate whether the morphological features are applicable to diagnose non-PNS MPNSTs and to demonstrate useful markers for distinction between canine MPNSTs and PWTs, the authors examined 30 canine MPNSTs and 31 PWTs immunohistochemically for S100, nestin, NGFR, Olig2, claudin-1, CD57, PRX, α-SMA, desmin, and calponin. Among canine MPNSTs, the PNS tumors displayed significantly higher S100 and Olig2 expression than the non-PNS tumors. The expression levels of the other markers did not differ significantly, suggesting that the same morphological diagnostic criteria are applicable regardless of their location. The PWT cells displayed significantly weaker immunoreactivity than MPNSTs to markers used except α-SMA and desmin. Cluster analysis sorted most canine MPNSTs and PWTs into 2 distinctly different clusters, whereas 3 MPNSTs and 6 PWTs were assigned to the opposing cluster. These 3 MPNSTs were negative for almost all markers, while these 6 PWTs were positive for only neuronal markers. In particular, NGFR and Olig2 were almost negative in the rest of PWT cases. These findings suggest that NGFR and Olig2 are useful to distinguish these 2 tumors. © The Author(s) 2013.

Users' perception as a tool to improve urban beach planning and management.

PubMed

Cervantes, Omar; Espejel, Ileana; Arellano, Evarista; Delhumeau, Sheila

2008-08-01

Four beaches that share physiographic characteristics (sandy, wide, and long) but differ in socioeconomic and cultural terms (three are located in northwestern Mexico and one in California, USA) were evaluated by beach users. Surveys (565) composed of 36 questions were handed out to beach users on weekends and holidays in 2005. The 25 questions that revealed the most information were selected by factor analysis and classified by cluster analysis. Beach users' preferences were assigned a value by comparing the present survey results with the characteristics of an "ideal" recreational urban beach. Cluster analysis separated three groups of questions: (a) services and infrastructure, (b) recreational activities, and (c) beach conditions. Cluster linkage distance (r=0.82, r=0.78, r=0.67) was used as a weight and multiplied by the value of beach descriptive factors. Mazatlán and Oceanside obtained the highest values because there are enough infrastructure and services; on the contrary, Ensenada and Rosarito were rated medium and low because infrastructure and services are lacking. The presently proposed method can contribute to improving current beach evaluations because the final score represents the beach users' evaluation of the quality of the beach. The weight considered in the present study marks the beach users' preferences among the studied beaches. Adding this weight to beach evaluation will contribute to more specific beach planning in which users' perception is considered.

Users' Perception as a Tool to Improve Urban Beach Planning and Management

NASA Astrophysics Data System (ADS)

Cervantes, Omar; Espejel, Ileana; Arellano, Evarista; Delhumeau, Sheila

2008-08-01

Four beaches that share physiographic characteristics (sandy, wide, and long) but differ in socioeconomic and cultural terms (three are located in northwestern Mexico and one in California, USA) were evaluated by beach users. Surveys (565) composed of 36 questions were handed out to beach users on weekends and holidays in 2005. The 25 questions that revealed the most information were selected by factor analysis and classified by cluster analysis. Beach users’ preferences were assigned a value by comparing the present survey results with the characteristics of an “ideal” recreational urban beach. Cluster analysis separated three groups of questions: (a) services and infrastructure, (b) recreational activities, and (c) beach conditions. Cluster linkage distance ( r = 0.82, r = 0.78, r = 0.67) was used as a weight and multiplied by the value of beach descriptive factors. Mazatlán and Oceanside obtained the highest values because there are enough infrastructure and services; on the contrary, Ensenada and Rosarito were rated medium and low because infrastructure and services are lacking. The presently proposed method can contribute to improving current beach evaluations because the final score represents the beach users’ evaluation of the quality of the beach. The weight considered in the present study marks the beach users’ preferences among the studied beaches. Adding this weight to beach evaluation will contribute to more specific beach planning in which users’ perception is considered.

Computing the Taxonomic, Morphological and Sexual Variations of Bornean Hornbills (family: Bucerotidae)

NASA Astrophysics Data System (ADS)

Laman, Charlie J. M.; Kho, Angel

Bornean Hornbills (Family Bucerotidae) are omnivorous creatures, distinguished for their large size and large bill. In our study, only five out of eight species of Bornean hornbills were available. Our aims were to determine the taxonomic, morphological and sexual variations, among the species. Nine morphological features were measured from 83 specimens. Canonical Discriminant and Cluster analyses showed that the data were successfully clustered into 5 species. Logistic regression analyses showed that the diagnostic character differentiation is total length. Further results showed that males tend to be bigger than females.

Selection of fragrance for cosmetic cream containing olive oil.

PubMed

Parente, María Emma; Gámbaro, Adriana; Boinbaser, Lucía; Roascio, Antonella

2014-01-01

Perceptions of essences for potential use in the development of a line of cosmetic emulsions containing olive oil were studied. Six cream samples prepared with six essences selected in a preliminary study were evaluated for overall liking and intention to purchase by a 63-women sample. A check-all-that-apply (CATA) question consisting of 32 terms was used to gather information about consumer perceptions of fragrance, affective associations, effects on the skin, price, target market, zones of application, and occasions of use. Hierarchical cluster analysis led to the identification of two consumer clusters with different frequency of use of face creams. The two clusters assigned different overall liking scores to the samples and used the CATA terms differently to describe them. A fragrance with jasmine as its principal note was selected for further development of cosmetic creams, as it was awarded the highest overall liking scores by respondents of the two clusters, and was significantly associated with cosmetic features including nourishing, moisturizing, softening, with a delicious and mild smell, and with a natural image, as well as being considered suitable for face and body creams. The use of CATA questions enabled the rapid identification of attributes associated by respondents with a cosmetic cream's fragrance, in addition to contributing relevant information for the definition of marketing and communication strategies.

Radiation-Induced Chemical Dynamics in Ar Clusters Exposed to Strong X-Ray Pulses.

PubMed

Kumagai, Yoshiaki; Jurek, Zoltan; Xu, Weiqing; Fukuzawa, Hironobu; Motomura, Koji; Iablonskyi, Denys; Nagaya, Kiyonobu; Wada, Shin-Ichi; Mondal, Subhendu; Tachibana, Tetsuya; Ito, Yuta; Sakai, Tsukasa; Matsunami, Kenji; Nishiyama, Toshiyuki; Umemoto, Takayuki; Nicolas, Christophe; Miron, Catalin; Togashi, Tadashi; Ogawa, Kanade; Owada, Shigeki; Tono, Kensuke; Yabashi, Makina; Son, Sang-Kil; Ziaja, Beata; Santra, Robin; Ueda, Kiyoshi

2018-06-01

We show that electron and ion spectroscopy reveals the details of the oligomer formation in Ar clusters exposed to an x-ray free electron laser (XFEL) pulse, i.e., chemical dynamics triggered by x rays. With guidance from a dedicated molecular dynamics simulation tool, we find that van der Waals bonding, the oligomer formation mechanism, and charge transfer among the cluster constituents significantly affect ionization dynamics induced by an XFEL pulse of moderate fluence. Our results clearly demonstrate that XFEL pulses can be used not only to "damage and destroy" molecular assemblies but also to modify and transform their molecular structure. The accuracy of the predictions obtained makes it possible to apply the cluster spectroscopy, in connection with the respective simulations, for estimation of the XFEL pulse fluence in the fluence regime below single-atom multiple-photon absorption, which is hardly accessible with other diagnostic tools.

Radiation-Induced Chemical Dynamics in Ar Clusters Exposed to Strong X-Ray Pulses

NASA Astrophysics Data System (ADS)

Kumagai, Yoshiaki; Jurek, Zoltan; Xu, Weiqing; Fukuzawa, Hironobu; Motomura, Koji; Iablonskyi, Denys; Nagaya, Kiyonobu; Wada, Shin-ichi; Mondal, Subhendu; Tachibana, Tetsuya; Ito, Yuta; Sakai, Tsukasa; Matsunami, Kenji; Nishiyama, Toshiyuki; Umemoto, Takayuki; Nicolas, Christophe; Miron, Catalin; Togashi, Tadashi; Ogawa, Kanade; Owada, Shigeki; Tono, Kensuke; Yabashi, Makina; Son, Sang-Kil; Ziaja, Beata; Santra, Robin; Ueda, Kiyoshi

2018-06-01

We show that electron and ion spectroscopy reveals the details of the oligomer formation in Ar clusters exposed to an x-ray free electron laser (XFEL) pulse, i.e., chemical dynamics triggered by x rays. With guidance from a dedicated molecular dynamics simulation tool, we find that van der Waals bonding, the oligomer formation mechanism, and charge transfer among the cluster constituents significantly affect ionization dynamics induced by an XFEL pulse of moderate fluence. Our results clearly demonstrate that XFEL pulses can be used not only to "damage and destroy" molecular assemblies but also to modify and transform their molecular structure. The accuracy of the predictions obtained makes it possible to apply the cluster spectroscopy, in connection with the respective simulations, for estimation of the XFEL pulse fluence in the fluence regime below single-atom multiple-photon absorption, which is hardly accessible with other diagnostic tools.

Change in personality status in neurotic disorders.

PubMed

Seivewright, Helen; Tyrer, Peter; Johnson, Tony

2002-06-29

Personality disorders are generally thought not to change by much over time. We assessed the personality status of 202 patients who had a defined diagnostic and statistical manual (DSM)-III neurotic disorder, dysthymia, panic disorder, or generalised anxiety. All patients had had drug and psychological treatment in a randomised controlled trial. 12 years after entry to the study, we reassessed the personality status of 178 (88%) of these patients using the same test (personality assessment schedule). The personality traits of patients in the cluster B flamboyant group (antisocial, histrionic) became significantly less pronounced over 12 years, but those in the cluster A odd, eccentric group (schizoid, schizotypal, paranoid), and the cluster C anxious, fearful group (obsessional, avoidant) became more pronounced. The measure of agreement between baseline and 12-year personality clusters was poor or slight (kappa=0.14, 95% CI 0.04-0.23). Our results suggest that the assumption that personality characteristics do not change with time is incorrect.

Pattern of comorbidity among anxious and odd personality disorders: the case of obsessive-compulsive personality disorder.

PubMed

Rossi, A; Marinangeli, M G; Butti, G; Kalyvoka, A; Petruzzi, C

2000-09-01

The aim of this study was to examine the pattern of comorbidity among obsessive-compulsive personality disorder (OCPD) and other personality disorders (PDs) in a sample of 400 psychiatric inpatients. PDs were assessed using the Semistructured Clinical Interview for DSM-III-R Personality Disorders (SCID-II). Odds ratios (ORs) were calculated to determine significant comorbidity among OCPD and other axis II disorders. The most elevated odds ratios were found for the cooccurrence of OCPD with cluster A PDs (the "odd" PDs, or paranoid and schizoid PDs). These results are consistent with those of previous studies showing a higher cooccurrence of OCPD with cluster A than with cluster C ("anxious") PDs. In light of these observations, issues associated with the nosologic status of OCPD within the Diagnostic and Statistical Manual of Mental Disorders clustering system remain unsettled.

Mutation Clusters from Cancer Exome.

PubMed

Kakushadze, Zura; Yu, Willie

2017-08-15

We apply our statistically deterministic machine learning/clustering algorithm *K-means (recently developed in https://ssrn.com/abstract=2908286) to 10,656 published exome samples for 32 cancer types. A majority of cancer types exhibit a mutation clustering structure. Our results are in-sample stable. They are also out-of-sample stable when applied to 1389 published genome samples across 14 cancer types. In contrast, we find in- and out-of-sample instabilities in cancer signatures extracted from exome samples via nonnegative matrix factorization (NMF), a computationally-costly and non-deterministic method. Extracting stable mutation structures from exome data could have important implications for speed and cost, which are critical for early-stage cancer diagnostics, such as novel blood-test methods currently in development.

Mutation Clusters from Cancer Exome

PubMed Central

Kakushadze, Zura; Yu, Willie

2017-01-01

We apply our statistically deterministic machine learning/clustering algorithm *K-means (recently developed in https://ssrn.com/abstract=2908286) to 10,656 published exome samples for 32 cancer types. A majority of cancer types exhibit a mutation clustering structure. Our results are in-sample stable. They are also out-of-sample stable when applied to 1389 published genome samples across 14 cancer types. In contrast, we find in- and out-of-sample instabilities in cancer signatures extracted from exome samples via nonnegative matrix factorization (NMF), a computationally-costly and non-deterministic method. Extracting stable mutation structures from exome data could have important implications for speed and cost, which are critical for early-stage cancer diagnostics, such as novel blood-test methods currently in development. PMID:28809811

Cosmic Ray Streaming in Galaxy Clusters

NASA Astrophysics Data System (ADS)

Wiener, Joshua; Gould Zweibel, Ellen; Oh, Siang P.

2017-08-01

The origin of diffuse radio emission in galaxy clusters remains an open question in astrophysics. This emission indicates the presence of cluster-wide magnetic fields and high energy cosmic ray (CR) electrons. I will discuss how the properties of the observed radio emission in clusters are shaped by different CR transport processes, namely CR streaming. Recent work has shown that fast streaming may turn off radio emission on relatively short time scales - a full treatment of magnetohydrodynamic (MHD) wave damping shows that streaming may be even faster than previously thought in high β environments. I will briefly introduce the physics behind CR transport, and present simple numerical simulations of the Coma cluster that predict radio emission, as well as other observable signatures such as gamma radiation that can differentiate between models for the source of the CR electrons.

The Spanish Diagnostic Interview Schedule. Reliability and concordance with clinical diagnoses in Puerto Rico.

PubMed

Canino, G J; Bird, H R; Shrout, P E; Rubio-Stipec, M; Bravo, M; Martinez, R; Sesman, M; Guzman, A; Guevara, L M; Costas, H

1987-08-01

A Spanish translation of the Diagnostic Interview Schedule (DIS) was assessed using samples of Puerto Rican patients and community subjects from the San Juan area. Concordance between DIS results from psychiatrists' interviews and from laypersons' interviews was similar to results with the DIS in mainland samples. Comparisons of laypersons' DIS results with psychiatrists' clinical diagnoses yielded generally poorer agreement. Levels of agreement improved when diagnoses were clustered into higher-rank categories. These results raise cultural issues related to the use of the DIS in Puerto Rico.

Fan fault diagnosis based on symmetrized dot pattern analysis and image matching

NASA Astrophysics Data System (ADS)

Xu, Xiaogang; Liu, Haixiao; Zhu, Hao; Wang, Songling

2016-07-01

To detect the mechanical failure of fans, a new diagnostic method based on the symmetrized dot pattern (SDP) analysis and image matching is proposed. Vibration signals of 13 kinds of running states are acquired on a centrifugal fan test bed and reconstructed by the SDP technique. The SDP pattern templates of each running state are established. An image matching method is performed to diagnose the fault. In order to improve the diagnostic accuracy, the single template, multiple templates and clustering fault templates are used to perform the image matching.

Individual participant data meta-analyses should not ignore clustering

PubMed Central

Abo-Zaid, Ghada; Guo, Boliang; Deeks, Jonathan J.; Debray, Thomas P.A.; Steyerberg, Ewout W.; Moons, Karel G.M.; Riley, Richard David

2013-01-01

Objectives Individual participant data (IPD) meta-analyses often analyze their IPD as if coming from a single study. We compare this approach with analyses that rather account for clustering of patients within studies. Study Design and Setting Comparison of effect estimates from logistic regression models in real and simulated examples. Results The estimated prognostic effect of age in patients with traumatic brain injury is similar, regardless of whether clustering is accounted for. However, a family history of thrombophilia is found to be a diagnostic marker of deep vein thrombosis [odds ratio, 1.30; 95% confidence interval (CI): 1.00, 1.70; P = 0.05] when clustering is accounted for but not when it is ignored (odds ratio, 1.06; 95% CI: 0.83, 1.37; P = 0.64). Similarly, the treatment effect of nicotine gum on smoking cessation is severely attenuated when clustering is ignored (odds ratio, 1.40; 95% CI: 1.02, 1.92) rather than accounted for (odds ratio, 1.80; 95% CI: 1.29, 2.52). Simulations show models accounting for clustering perform consistently well, but downwardly biased effect estimates and low coverage can occur when ignoring clustering. Conclusion Researchers must routinely account for clustering in IPD meta-analyses; otherwise, misleading effect estimates and conclusions may arise. PMID:23651765

Advancing Diagnostics to Address Antibacterial Resistance: The Diagnostics and Devices Committee of the Antibacterial Resistance Leadership Group.

PubMed

Tsalik, Ephraim L; Petzold, Elizabeth; Kreiswirth, Barry N; Bonomo, Robert A; Banerjee, Ritu; Lautenbach, Ebbing; Evans, Scott R; Hanson, Kimberly E; Klausner, Jeffrey D; Patel, Robin

2017-03-15

Diagnostics are a cornerstone of the practice of infectious diseases. However, various limitations frequently lead to unmet clinical needs. In most other domains, diagnostics focus on narrowly defined questions, provide readily interpretable answers, and use true gold standards for development. In contrast, infectious diseases diagnostics must contend with scores of potential pathogens, dozens of clinical syndromes, emerging pathogens, rapid evolution of existing pathogens and their associated resistance mechanisms, and the absence of gold standards in many situations. In spite of these challenges, the importance and value of diagnostics cannot be underestimated. Therefore, the Antibacterial Resistance Leadership Group has identified diagnostics as 1 of 4 major areas of emphasis. Herein, we provide an overview of that development, highlighting several examples where innovation in study design, content, and execution is advancing the field of infectious diseases diagnostics. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Current practice in laboratory diagnostics of autoimmune diseases in Croatia. 
Survey of the Working group for laboratory diagnostics of autoimmune diseases of the Croatian Society of Medical Biochemistry and Laboratory Medicine

PubMed Central

Kuna, Andrea Tešija; Đerek, Lovorka; Kozmar, Ana; Drvar, Vedrana

2016-01-01

Introduction With the trend of increasing incidence of autoimmune diseases, laboratories are faced with exponential growth of the requests for tests relating the diagnosis of these diseases. Unfortunately, the lack of laboratory personnel experienced in this specific discipline of laboratory diagnostic, as well as an unawareness of a method limitation often results in confusion for clinicians. The aim was to gain insight into number and type of Croatian laboratories that perform humoral diagnostics with the final goal to improve and harmonize laboratory diagnostics of autoimmune diseases in Croatia. Materials and methods In order to get insight into current laboratory practice two questionnaires, consisting of 42 questions in total, were created. Surveys were conducted using SurveyMonkey application and were sent to 88 medical biochemistry laboratories in Croatia for the first survey. Out of 33 laboratories that declared to perform diagnostic from the scope, 19 were selected for the second survey based on the tests they pleaded to perform. The survey comprised questions regarding autoantibody hallmarks of systemic autoimmune diseases while regarding organ-specific autoimmune diseases was limited to diseases of liver, gastrointestinal and nervous system. Results Response rate was high with 80 / 88 (91%) laboratories which answered the first questionnaire, and 19 / 19 (1.0) for the second questionnaire. Obtained results of surveys indicate high heterogeneity in the performance of autoantibody testing among laboratories in Croatia. Conclusions Results indicate the need of creating recommendations and algorithms in order to harmonize the approach to laboratory diagnostics of autoimmune diseases in Croatia. PMID:27812306

Diagnostic Testing for Female Infertility

MedlinePlus

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Chronic insomnia cases detection with the help of Athens Insomnia Scale and SF-36 health survey

NASA Astrophysics Data System (ADS)

Wasiewicz, P.; Skalski, M.; Fornal-Pawlowska, Malgorzata

2011-10-01

Standardization of the diagnostic process of insomnia is a highly important task in clinical practice, epidemiological considerations and treatment outcomes assessment. In this paper we describe standard surveys relationships within cluster groups with the same insomnia degrees.

Students' understanding of direct current resistive electrical circuits

NASA Astrophysics Data System (ADS)

Engelhardt, Paula Vetter; Beichner, Robert J.

2004-01-01

Both high school and university students' reasoning regarding direct current resistive electric circuits often differ from the accepted explanations. At present, there are no standard diagnostic tests on electric circuits. Two versions of a diagnostic instrument were developed, each consisting of 29 questions. The information provided by this test can provide instructors with a way of evaluating the progress and conceptual difficulties of their students. The analysis indicates that students, especially females, tend to hold multiple misconceptions, even after instruction. During interviews, the idea that the battery is a constant source of current was used most often in answering the questions. Students tended to focus on the current in solving problems and to confuse terms, often assigning the properties of current to voltage and/or resistance.

A diagnostic for determining the quality of single-reference electron correlation methods

NASA Technical Reports Server (NTRS)

Lee, Timothy J.; Taylor, Peter R.

1989-01-01

It was recently proposed that the Euclidian norm of the t(sub 1) vector of the coupled cluster wave function (normalized by the number of electrons included in the correlation procedure) could be used to determine whether a single-reference-based electron correlation procedure is appopriate. This diagnostic, T(sub 1) is defined for use with self-consistent-field molecular orbitals and is invariant to the same orbital rotations as the coupled cluster energy. T(sub 1) is investigated for several different chemical systems which exhibit a range of multireference behavior, and is shown to be an excellent measure of the importance of non-dynamical electron correlation and is far superior to C(sub 0) from a singles and doubles configuration interaction wave function. It is further suggested that when the aim is to recover a large fraction of the dynamical electron correlation energy, a large T(sub 1) (i.e., greater than 0.02) probably indicates the need for a multireference electron correlation procedure.

A diagnostic for determining the quality of single-reference electron correlation methods

NASA Technical Reports Server (NTRS)

Lee, Timothy J.; Taylor, Peter R.

1989-01-01

It was recently proposed that the Euclidian norm of the t sub 1 vector of the coupled cluster wave function (normalized by the number of electrons included in the correlation procedure) could be used to determine whether a single-reference-based electron correlation procedure is appropriate. This diagnostic, T sub 1, is defined for use with self consistent field molecular orbitals and is invariant to the same orbital rotations as the coupled cluster energy. T sub 1 is investigated for several different chemical systems which exhibit a range of multireference behavior, and is shown to be an excellent measure of the importance of nondynamical electron correlation and is far superior to C sub 0 from a singles and doubles configuration interaction wave function. It is further suggested that when the aim is to recover a large fraction of the dynamical electron correlation energy, a large T sub 1 (i.e., greater than 0.02) probably indicates the need for a multireference electron correlation procedure.

Reproducibility of Cognitive Profiles in Psychosis Using Cluster Analysis.

PubMed

Lewandowski, Kathryn E; Baker, Justin T; McCarthy, Julie M; Norris, Lesley A; Öngür, Dost

2018-04-01

Cognitive dysfunction is a core symptom dimension that cuts across the psychoses. Recent findings support classification of patients along the cognitive dimension using cluster analysis; however, data-derived groupings may be highly determined by sampling characteristics and the measures used to derive the clusters, and so their interpretability must be established. We examined cognitive clusters in a cross-diagnostic sample of patients with psychosis and associations with clinical and functional outcomes. We then compared our findings to a previous report of cognitive clusters in a separate sample using a different cognitive battery. Participants with affective or non-affective psychosis (n=120) and healthy controls (n=31) were administered the MATRICS Consensus Cognitive Battery, and clinical and community functioning assessments. Cluster analyses were performed on cognitive variables, and clusters were compared on demographic, cognitive, and clinical measures. Results were compared to findings from our previous report. A four-cluster solution provided a good fit to the data; profiles included a neuropsychologically normal cluster, a globally impaired cluster, and two clusters of mixed profiles. Cognitive burden was associated with symptom severity and poorer community functioning. The patterns of cognitive performance by cluster were highly consistent with our previous findings. We found evidence of four cognitive subgroups of patients with psychosis, with cognitive profiles that map closely to those produced in our previous work. Clusters were associated with clinical and community variables and a measure of premorbid functioning, suggesting that they reflect meaningful groupings: replicable, and related to clinical presentation and functional outcomes. (JINS, 2018, 24, 382-390).

Diagnostic reliability of MMPI-2 computer-based test interpretations.

PubMed

Pant, Hina; McCabe, Brian J; Deskovitz, Mark A; Weed, Nathan C; Williams, John E

2014-09-01

Reflecting the common use of the MMPI-2 to provide diagnostic considerations, computer-based test interpretations (CBTIs) also typically offer diagnostic suggestions. However, these diagnostic suggestions can sometimes be shown to vary widely across different CBTI programs even for identical MMPI-2 profiles. The present study evaluated the diagnostic reliability of 6 commercially available CBTIs using a 20-item Q-sort task developed for this study. Four raters each sorted diagnostic classifications based on these 6 CBTI reports for 20 MMPI-2 profiles. Two questions were addressed. First, do users of CBTIs understand the diagnostic information contained within the reports similarly? Overall, diagnostic sorts of the CBTIs showed moderate inter-interpreter diagnostic reliability (mean r = .56), with sorts for the 1/2/3 profile showing the highest inter-interpreter diagnostic reliability (mean r = .67). Second, do different CBTIs programs vary with respect to diagnostic suggestions? It was found that diagnostic sorts of the CBTIs had a mean inter-CBTI diagnostic reliability of r = .56, indicating moderate but not strong agreement across CBTIs in terms of diagnostic suggestions. The strongest inter-CBTI diagnostic agreement was found for sorts of the 1/2/3 profile CBTIs (mean r = .71). Limitations and future directions are discussed. PsycINFO Database Record (c) 2014 APA, all rights reserved.

The initial stages of NaCl dissolution: Ion or ion pair solvation?

NASA Astrophysics Data System (ADS)

Klimes, Jiri; Michaelides, Angelos

2009-03-01

The interaction of water with rock salt (NaCl) is important in a wide variety of natural processes and human activities. A lot is known about NaCl dissolution at the macroscopic level but we do not yet have a detailed atomic scale picture of how salt crystals dissolve. Here we report an extensive series of density functional theory, forcefield and molecular dynamics studies of water clusters at flat and defective NaCl surfaces and NaCl clusters. The focus is on answering seemingly elementary questions such as how many water molecules are needed before it becomes favorable to extract an ion or a pair of ions from the crystal or the cluster. It turns out, however, that the answers to these questions are not so straightforward: below a certain number of water molecules (˜ 12) solvation of individual ions is less costly and above this number solvation of ion pairs is favored. These results reveal a hitherto unknown complexity in the NaCl dissolution process born out of a subtle interplay between water-water and water-ion interactions.

Metopic ridge

MedlinePlus

... exam and ask questions about the child's medical history. Tests may include: Head CT scan Skull ... Grainger & Allison's Diagnostic Radiology: A Textbook of Medical Imaging . 6th ed. Philadelphia, PA: Elsevier ...

Coronal Physics and the Chandra Emission Line Project

NASA Technical Reports Server (NTRS)

Brickhouse, N. S.; Drake, J. J.

2000-01-01

With the launch of the Chandra X-ray Observatory, high resolution X-ray spectroscopy of cosmic sources has begun. Early, deep observations of three stellar coronal sources Capella, Procyon, and HR 1099 are providing not only invaluable calibration data, but also benchmarks for plasma spectral models. These models are needed to interpret data from stellar coronae, galaxies and clusters of galaxies, supernova, remnants and other astrophysical sources. They have been called into question in recent years as problems with understanding low resolution ASCA and moderate resolution Extreme Ultraviolet Explorer Satellite (EUVE) data have arisen. The Emission Line Project is a collaborative effort, to improve the models, with Phase I being the comparison of models with observed spectra of Capella, Procyon, and HR 1099. Goals of these comparisons are (1) to determine and verify accurate and robust diagnostics and (2) to identify and prioritize issues in fundamental spectroscopy which will require further theoretical and/or laboratory work. A critical issue in exploiting the coronal data for these purposes is to understand the extent, to which common simplifying assumptions (coronal equilibrium, negligible optical depth) apply. We will discuss recent, advances in our understanding of stellar coronae, in this context.

Coronal Physics and the Chandra Emission Line Project

NASA Technical Reports Server (NTRS)

Brickhouse, Nancy

1999-01-01

With the launch of the Chandra X-ray Observatory, high resolution X-ray spectroscopy of cosmic sources has begun. Early, deep observations of three stellar coronal sources will provide not only invaluable calibration data, but will also give us benchmarks for plasma spectral modeling codes. These codes are to interpret data from stellar coronae, galaxies and clusters of galaxies. supernova remnants and other astrophysical sources, but they have been called into question in recent years as problems with understanding moderate resolution ASCA and EUVE data have arisen. The Emission Line Project is a collaborative effort to improve the models, with Phase 1 being the comparison of models with observed spectra of Capella, Procyon, and HR, 1099. Goals of these comparisons are (1) to determine and verify accurate and robust diagnostics and (2) to identify and prioritize issues in fundamental spectroscopy which will require further theoretical and/or laboratory work. A critical issue in exploiting the coronal data for these purposes is to understand the extent to which common simplifying assumptions (coronal equilibrium, time-independence, negligible optical depth) apply. We will discuss recent advances in our understanding of stellar coronae in this context.

[Role of cytology in hematopathological diagnostics].

PubMed

Bode, B; Tinguely, M

2012-07-01

The role of cytology has so far been underrecognized in the diagnostic process of hematopathological questions. This article presents an algorithm which allows a stepwise work-up of cytology specimens obtained by minimally invasive ultrasound-guided fine needle aspiration in patients with unexplained lymph node swelling. Moreover, it is shown how the selective separation of cytology specimens allows the application of immunophenotypic analysis including flow cytometry and immunohistochemistry as well as molecular analyses, such as fluorescence in situ hybridization (FISH) and polymerase chain reaction (PCR) strategies. With the integrative procedure presented, cytology offers an excellent cost-effective tool for the diagnostic approach of patients with suspected hematopathological malignancies allowing a high diagnostic accuracy, ideal for initial diagnosis or follow-up.

A Diagnostic Study of Pre-Service Teachers' Competency in Multiple-Choice Item Development

ERIC Educational Resources Information Center

Asim, Alice E.; Ekuri, Emmanuel E.; Eni, Eni I.

2013-01-01

Large class size is an issue in testing at all levels of Education. As a panacea to this, multiple choice test formats has become very popular. This case study was designed to diagnose pre-service teachers' competency in constructing questions (IQT); direct questions (DQT); and best answer (BAT) varieties of multiple choice items. Subjects were 88…

Breast-related stereotype threat contributes to a symptom cluster in women with breast cancer.

PubMed

Li, Jie; Gao, Wei; Yu, Li-Xiang; Zhu, Song-Ying; Cao, Feng-Lin

2017-05-01

To investigate the prevalence of breast-related stereotype threat and its effects on a symptom cluster consisting of anxiety, depression and fatigue and on each symptom. The stereotype that breasts are a sign of women's femininity results in patients with breast cancer fearing diminished femininity and rejection, which may induce psychological problems that co-occur as a symptom cluster. Cross-sectional study. A total of 131 patients with breast cancer postmastectomy completed the study. A question measuring breast-related stereotype threat, the Hospital Anxiety and Depression Scale and the Functional Assessment of Chronic Illness Therapy-Fatigue Scale were used to assess their breast-related stereotype threat and symptoms of anxiety, depression and fatigue. Of the 131 patients who answered the breast-related stereotype threat question, 86 (65·6%) reported breast-related stereotype threat. They did not differ significantly in social and clinical characteristics compared with those without the stereotype, but did report significantly higher levels of the symptom cluster and each symptom (anxiety, depression and fatigue). The odds ratios of the stereotype were significant for the symptom cluster, depression and fatigue (odds ratios = 2·52-3·98, p < 0·05). The breast-related stereotype threat was common in patients with breast cancer. There was about a twofold increase in their risk of experiencing the symptom cluster and symptoms of depression and fatigue. In clinical practice, breast-related stereotype threat should be measured together with prevalent symptoms (e.g. anxiety, depression and fatigue) in patients with breast cancer. Our findings will aid the development of interventions for improving the mental health of women with breast cancer. © 2016 John Wiley & Sons Ltd.

Polycystic ovarian morphology and the diagnosis of polycystic ovary syndrome: redefining threshold levels for follicle count and serum anti-Müllerian hormone using cluster analysis.

PubMed

Lie Fong, S; Laven, J S E; Duhamel, A; Dewailly, D

2017-08-01

Can cluster analysis be used to differentiate between normo-ovulatory women with normal ovaries and normo-ovulatory women with polycystic ovarian morphology (PCOM) in a non-subjective manner? Cluster analysis can be used to accurately and non-subjectively differentiate between normo-ovulatory women with normal ovaries and normo-ovulatory women with PCOM. Currently, PCOM is diagnosed using a fixed threshold level, i.e. 12 or more follicles per ovary, and is one of the diagnostic criteria of polycystic ovary syndrome (PCOS). However, PCOM is also encountered in normo-ovulatory women, suggesting that it could just represent a normal variant. On the other hand, recent studies have shown subtle endocrine abnormalities in women with isolated PCOM that resemble those found in women with PCOS. Because of the strong correlation between anti-Müllerian hormone (AMH) and follicle number, a high serum AMH level has been proposed as a surrogate marker for PCOM and could, therefore, be integrated in the diagnostic classifications for PCOS. This was a retrospective observational cohort study. Original cohorts had been recruited for previous studies between 1998 and 2010. Two hundred ninety-seven regularly cycling women and 700 women with PCOS were eligible for inclusion. Cluster analysis was performed in 297 regularly cycling women. After exclusion of 'PCOM' clusters, each 'non-PCOM' cluster (young, n = 118 and old, n = 100) was included in the construction of a receiver operating characteristics curve to test the diagnostic performance of follicle number per ovary (FNPO) and serum AMH in discriminating similarly aged full-blown PCOS patients (n = 411 and 237, respectively) from normal regularly cycling non-PCOM women. The optimal number of clusters was four; age was the most important classifying variable, followed by the FNPO and serum AMH. Two distinct clusters of normo-ovulatory women with PCOM were isolated and differed solely by age, i.e. 'young' and 'old'. Both 'PCOM' clusters had their similarly aged counterpart of 'non-PCOM' clusters. Likewise, two clusters comprised women younger than 30 years, with (n = 28, 'PCOM regularly cycling women') or without (n = 118, 'normal regularly cycling women') features of PCOM (increased FNPO and/or serum AMH). The two other clusters in older women could be labelled 'normal regularly cycling women' or 'PCOM regularly cycling women' (n = 100 and 51, respectively). The prevalence of PCOM was significantly greater in old than in young regularly cycling women controls. In the young population, after exclusion of the 'PCOM regularly cycling women', the diagnostic performance of AMH, expressed by area under the curve (AUC) (AUC = 0.903; CI (0.876-0.930)) to differentiate PCOS women from normal regularly cycling women was similar to that using the FNPO (AUC = 0.915, CI (0.891-0.940)) (P = 0.25), confirming results from earlier studies. In the old population, the diagnostic performance of AMH was greater than that of FNPO (AUCs = 0.948 (0.927-0.970) vs 0.874 (0.836-0.912), respectively, P = 0.00035). Cut-off levels of AMH and antral follicle count distinguishing regularly cycling non-PCOM women from PCOS women were higher in young women than in older women. Data of normal women were obtained from earlier studies, aiming to measure normal endocrine values. Apparently, the strong effect of age in cluster analysis revealed a dichotomy in the age distribution among the cohort of regularly cycling women included. This was involuntary since in none of the original studies, eligibility was limited by age and there was considerable overlap in age ranges of the cohorts. Transvaginal ultrasound was performed using a 6.5-8 mHz probe and our data confirm that this threshold level for FNPO is still valid if using such probe frequencies, although the use of devices with a maximum frequency lower than 8 mHz has become obsolete. Obviously, newer ultrasound scanner using higher transducer frequency will facilitate the detection of more follicles. Our data support the use of AMH as a surrogate for ultrasound to define PCOM, which is one of the three items of the Rotterdam classification. They also show that age should be taken into account to define the optimal threshold. The fact that the prevalence of PCOM was increased in the older regularly cycling women, may be due to 'attenuated' PCOS, a phenomenon that has been described in ageing women with PCOS. These women might have had anovulatory cycles in the past and have become ovulatory with increasing age, and were, therefore, eligible for this study. However, since most women included at older age have had spontaneous pregnancies in the past, PCOM at older age may be associated with a subclinical form of PCOS, which may also be present in young regularly cycling women. No funding was received for this study. J.S.E.L. has received grants and support from Ferring, MSD, Organon, Merck-Serono, Schering Plough and Serono during recruitment and analysis of data for this study. S.L.F., A.D. and D.D. do not have any conflict of interest. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

Model of critical diagnostic reasoning: achieving expert clinician performance.

PubMed

Harjai, Prashant Kumar; Tiwari, Ruby

2009-01-01

Diagnostic reasoning refers to the analytical processes used to determine patient health problems. While the education curriculum and health care system focus on training nurse clinicians to accurately recognize and rescue clinical situations, assessments of non-expert nurses have yielded less than satisfactory data on diagnostic competency. The contrast between the expert and non-expert nurse clinician raises the important question of how differences in thinking may contribute to a large divergence in accurate diagnostic reasoning. This article recognizes superior organization of one's knowledge base, using prototypes, and quick retrieval of pertinent information, using similarity recognition as two reasons for the expert's superior diagnostic performance. A model of critical diagnostic reasoning, using prototypes and similarity recognition, is proposed and elucidated using case studies. This model serves as a starting point toward bridging the gap between clinical data and accurate problem identification, verification, and management while providing a structure for a knowledge exchange between expert and non-expert clinicians.

DSM-V from the perspective of the DSM-IV experience.

PubMed

Walsh, B Timothy

2007-11-01

This article provides a brief overview of the development of the diagnostic criteria for eating disorders in DSM-IV. The process by which DSM-IV was developed is reviewed, including perspectives on what constitutes diagnostic validity and clinical utility, and their importance in assessing proposed changes in diagnostic criteria. The question of whether alterations in diagnostic criteria would clearly improve clinical utility was a major consideration in the DSM-IV process. Because of concerns that changes in diagnostic criteria would be disruptive and might entail loss of established knowledge, the DSM-IV Task Force assumed a generally conservative stance vis-à-vis change. The process of developing DSM-V is just beginning, and it is far from clear what alterations in diagnostic criteria for eating disorders will occur. However, the evolution of DSM-IV may provide a useful perspective on the development of DSM-V. (c) 2007 by Wiley Periodicals, Inc.

Cognitive Clusters in Specific Learning Disorder

ERIC Educational Resources Information Center

Poletti, Michele; Carretta, Elisa; Bonvicini, Laura; Giorgi-Rossi, Paolo

2018-01-01

The heterogeneity among children with learning disabilities still represents a barrier and a challenge in their conceptualization. Although a dimensional approach has been gaining support, the categorical approach is still the most adopted, as in the recent fifth edition of the "Diagnostic and Statistical Manual of Mental Disorders." The…

Cluster Stability Estimation Based on a Minimal Spanning Trees Approach

NASA Astrophysics Data System (ADS)

Volkovich, Zeev (Vladimir); Barzily, Zeev; Weber, Gerhard-Wilhelm; Toledano-Kitai, Dvora

2009-08-01

Among the areas of data and text mining which are employed today in science, economy and technology, clustering theory serves as a preprocessing step in the data analyzing. However, there are many open questions still waiting for a theoretical and practical treatment, e.g., the problem of determining the true number of clusters has not been satisfactorily solved. In the current paper, this problem is addressed by the cluster stability approach. For several possible numbers of clusters we estimate the stability of partitions obtained from clustering of samples. Partitions are considered consistent if their clusters are stable. Clusters validity is measured as the total number of edges, in the clusters' minimal spanning trees, connecting points from different samples. Actually, we use the Friedman and Rafsky two sample test statistic. The homogeneity hypothesis, of well mingled samples within the clusters, leads to asymptotic normal distribution of the considered statistic. Resting upon this fact, the standard score of the mentioned edges quantity is set, and the partition quality is represented by the worst cluster corresponding to the minimal standard score value. It is natural to expect that the true number of clusters can be characterized by the empirical distribution having the shortest left tail. The proposed methodology sequentially creates the described value distribution and estimates its left-asymmetry. Numerical experiments, presented in the paper, demonstrate the ability of the approach to detect the true number of clusters.

Combining long-lasting insecticidal nets and indoor residual spraying for malaria prevention in Ethiopia: study protocol for a cluster randomized controlled trial.

PubMed

Deressa, Wakgari; Loha, Eskindir; Balkew, Meshesha; Hailu, Alemayehu; Gari, Taye; Kenea, Oljira; Overgaard, Hans J; Gebremichael, Teshome; Robberstad, Bjarne; Lindtjørn, Bernt

2016-01-12

Long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) are the main malaria prevention interventions in Ethiopia. There is conflicting evidence that the combined application of both interventions is better than either LLINs or IRS used alone. This trial aims to investigate whether the combination of LLINs (PermaNet 2.0, Vestergaard Frandsen, Lausanne, Switzerland) with IRS using propoxur will enhance the protective benefits and cost-effectiveness of the interventions against malaria and its effect on mosquito behavior, as compared to each intervention alone. This 2 x 2 factorial cluster randomized controlled trial is being carried out in the Adami Tullu district in south-central Ethiopia for about 116 weeks from September 2014 to December 2016. The trial is based on four arms: LLINs + IRS, LLINs alone, IRS alone and control. Villages (or clusters) will be the unit of randomization. The sample size includes 44 clusters per arm, with each cluster comprised of approximately 35 households (about 175 people). Prior to intervention, all households in the LLINs + IRS and LLINs alone arms will be provided with LLINs free of charge. Households in the LLINs + IRS and IRS alone arms will be sprayed with carbamate propoxur once a year just before the main malaria transmission season throughout the investigation. The primary outcome of this trial will be a malaria incidence based on the results of the rapid diagnostic tests in patients with a fever or history of fever attending health posts by passive case detection. Community-based surveys will be conducted each year to assess anemia among children 5-59 months old. In addition, community-based malaria prevalence surveys will be conducted each year on a representative sample of households during the main transmission season. The cost-effectiveness of the interventions and entomological studies will be simultaneously conducted. Analysis will be based on an intention-to-treat principle. This trial aims to provide evidence on the combined use of LLINs and IRS for malaria prevention by answering the following research questions: Can the combined use of LLINs and IRS significantly reduce the incidence of malaria compared with the use of either LLINs or IRS alone? And is the reduced incidence justifiable compared to the added costs? Will the combined use of LLINs and IRS reduce vector density, infection, longevity and the entomological inoculation rate? These data are crucial in order to maximize the impact of vector control interventions on the morbidity and mortality of malaria. PACTR201411000882128 (8 September 2014).

Exploring the underlying structure of mental disorders: cross-diagnostic differences and similarities from a network perspective using both a top-down and a bottom-up approach.

PubMed

Wigman, J T W; van Os, J; Borsboom, D; Wardenaar, K J; Epskamp, S; Klippel, A; Viechtbauer, W; Myin-Germeys, I; Wichers, M

2015-08-01

It has been suggested that the structure of psychopathology is best described as a complex network of components that interact in dynamic ways. The goal of the present paper was to examine the concept of psychopathology from a network perspective, combining complementary top-down and bottom-up approaches using momentary assessment techniques. A pooled Experience Sampling Method (ESM) dataset of three groups (individuals with a diagnosis of depression, psychotic disorder or no diagnosis) was used (pooled N = 599). The top-down approach explored the network structure of mental states across different diagnostic categories. For this purpose, networks of five momentary mental states ('cheerful', 'content', 'down', 'insecure' and 'suspicious') were compared between the three groups. The complementary bottom-up approach used principal component analysis to explore whether empirically derived network structures yield meaningful higher order clusters. Individuals with a clinical diagnosis had more strongly connected moment-to-moment network structures, especially the depressed group. This group also showed more interconnections specifically between positive and negative mental states than the psychotic group. In the bottom-up approach, all possible connections between mental states were clustered into seven main components that together captured the main characteristics of the network dynamics. Our combination of (i) comparing network structure of mental states across three diagnostically different groups and (ii) searching for trans-diagnostic network components across all pooled individuals showed that these two approaches yield different, complementary perspectives in the field of psychopathology. The network paradigm therefore may be useful to map transdiagnostic processes.

Novel approach to classifying patients with pulmonary arterial hypertension using cluster analysis.

PubMed

Parikh, Kishan S; Rao, Youlan; Ahmad, Tariq; Shen, Kai; Felker, G Michael; Rajagopal, Sudarshan

2017-01-01

Pulmonary arterial hypertension (PAH) patients have distinct disease courses and responses to treatment, but current diagnostic and treatment schemes provide limited insight. We aimed to see if cluster analysis could distinguish clinical phenotypes in PAH. An unbiased cluster analysis was performed on 17 baseline clinical variables of PAH patients from the FREEDOM-M, FREEDOM-C, and FREEDOM-C2 randomized trials of oral treprostinil versus placebo. Participants were either treatment-naïve (FREEDOM-M) or on background therapy (FREEDOM-C, FREEDOM-C2). We tested for association of clusters with outcomes and interaction with respect to treatment. Primary outcome was 6-minute walking distance (6MWD) change. We included 966 participants with 12-week (FREEDOM-M) or 16-week (FREEDOM-C and FREEDOM-C2) follow-up. Four patient clusters were identified. Compared with Clusters 1 (n = 131) and 2 (n = 496), Clusters 3 (n = 246) and 4 (n = 93) patients were older, heavier, had worse baseline functional class, 6MWD, Borg Dyspnea Index, and fewer years since PAH diagnosis. Clusters also differed by PAH etiology and background therapies, but not gender or race. Mean treatment effect of oral treprostinil differed across Clusters 1-4 increased in a monotonic fashion (Cluster 1: 10.9 m; Cluster 2: 13.0 m; Cluster 3: 25.0 m; Cluster 4: 50.9 m; interaction P value = 0.048). We identified four distinct clusters of PAH patients based on common patient characteristics. Patients who were older, diagnosed with PAH for a shorter period, and had worse baseline symptoms and exercise capacity had the greatest response to oral treprostinil treatment.

Questioning diagnoses in clinical practice: a thematic analysis of clinical psychologists' accounts of working beyond diagnosis in the United Kingdom.

PubMed

Randall-James, James; Coles, Steven

2018-02-08

The British Psychological Society proposes that clinical psychologists are well placed to move beyond psychiatric diagnoses and develop alternative practices. This study sought to explore what the application of these guiding principles looks like in clinical practice, the challenges faced and possible routes forward. A purpose-designed survey was completed by 305 respondents and a thematic analysis completed. Thematic analysis was used to identify five superordinate themes relating to individuals, relational, others, structures and society, comprising of a total of 21 group themes. The presented group themes highlight an array of approaches to practicing beyond diagnosis and factors that help and hinder such action; from scaffolding change, becoming leaders, relating to the multi-disciplinary team, restructuring services and the processes of change. A key concept was "playing the diagnostic game". "Playing the diagnostic game" enables psychologists to manage an array of tensions and anxieties: conflicts between belief and practice, relationships with colleagues, and dilemmas of position and power. It also potentially limits a concerted questioning of diagnosis and consideration of alternatives. An alternative conceptual framework for non-diagnostic practice is needed to aid the collective efforts of clinical psychologists developing their practice beyond diagnosis, some of which have been highlighted in this study. Until then, ways of mitigating the perceived threats to questioning diagnosis need further exploration, theorising and backing.

[Typologies of Madrid's citizens (Spain) at the end-of-life: cluster analysis].

PubMed

Ortiz-Gonçalves, Belén; Perea-Pérez, Bernardo; Labajo González, Elena; Albarrán Juan, Elena; Santiago-Sáez, Andrés

2018-03-06

To establish typologies within Madrid's citizens (Spain) with regard to end-of-life by cluster analysis. The SPAD 8 programme was implemented in a sample from a health care centre in the autonomous region of Madrid (Spain). A multiple correspondence analysis technique was used, followed by a cluster analysis to create a dendrogram. A cross-sectional study was made beforehand with the results of the questionnaire. Five clusters stand out. Cluster 1: a group who preferred not to answer numerous questions (5%). Cluster 2: in favour of receiving palliative care and euthanasia (40%). Cluster 3: would oppose assisted suicide and would not ask for spiritual assistance (15%). Cluster 4: would like to receive palliative care and assisted suicide (16%). Cluster 5: would oppose assisted suicide and would ask for spiritual assistance (24%). The following four clusters stood out. Clusters 2 and 4 would like to receive palliative care, euthanasia (2) and assisted suicide (4). Clusters 4 and 5 regularly practiced their faith and their family members did not receive palliative care. Clusters 3 and 5 would be opposed to euthanasia and assisted suicide in particular. Clusters 2, 4 and 5 had not completed an advance directive document (2, 4 and 5). Clusters 2 and 3 seldom practiced their faith. This study could be taken into consideration to improve the quality of end-of-life care choices. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Detecting synchronization clusters in multivariate time series via coarse-graining of Markov chains.

PubMed

Allefeld, Carsten; Bialonski, Stephan

2007-12-01

Synchronization cluster analysis is an approach to the detection of underlying structures in data sets of multivariate time series, starting from a matrix R of bivariate synchronization indices. A previous method utilized the eigenvectors of R for cluster identification, analogous to several recent attempts at group identification using eigenvectors of the correlation matrix. All of these approaches assumed a one-to-one correspondence of dominant eigenvectors and clusters, which has however been shown to be wrong in important cases. We clarify the usefulness of eigenvalue decomposition for synchronization cluster analysis by translating the problem into the language of stochastic processes, and derive an enhanced clustering method harnessing recent insights from the coarse-graining of finite-state Markov processes. We illustrate the operation of our method using a simulated system of coupled Lorenz oscillators, and we demonstrate its superior performance over the previous approach. Finally we investigate the question of robustness of the algorithm against small sample size, which is important with regard to field applications.

Assessment of Validity, Reliability and Difficulty Indices for Teacher-Built Physics Exam Questions in First Year High School

ERIC Educational Resources Information Center

Jandaghi, Gholamreza

2010-01-01

The purpose of the research is to determine high school teachers' skill rate in designing exam questions in physics subject. The statistical population was all of physics exam shits for two semesters in one school year from which a sample of 364 exam shits was drawn using multistage cluster sampling. Two experts assessed the shits and by using…

Millisecond resolution electron fluxes from the Cluster satellites: Calibrated EDI ambient electron data

NASA Astrophysics Data System (ADS)

Förster, Matthias; Rashev, Mikhail; Haaland, Stein

2017-04-01

The Electron Drift Instrument (EDI) onboard Cluster can measure 500 eV and 1 keV electron fluxes with high time resolution during passive operation phases in its Ambient Electron (AE) mode. Data from this mode is available in the Cluster Science Archive since October 2004 with a cadence of 16 Hz in the normal mode or 128 Hz for burst mode telemetry intervals. The fluxes are recorded at pitch angles of 0, 90, and 180 degrees. This paper describes the calibration and validation of these measurements. The high resolution AE data allow precise temporal and spatial diagnostics of magnetospheric boundaries and will be used for case studies and statistical studies of low energy electron fluxes in the near-Earth space. We show examples of applications.

[The value of double contrast arthrotomography combined with cinematography in the diagnosis of functional and structural TMJ alterations].

PubMed

Engelke, W; Grossniklaus, B; Sailer, H F

1991-01-01

Double contrast arthrotomography combined with cinematography as a diagnostic instrument establishing functional and structural TMJ alterations is evaluated for its diagnostic value and reliability within the chain of diagnostic measures applied. In 131 patients double-contrast arthrotomography was followed by a comprehensive history of joint problems, and verification of the clinical findings as well as the arthrographic diagnosis and the post-arthrographic TMJ alterations. Our interest was focussed, among others, on the question whether arthrography alone would have any therapeutic effect or produce an alteration in TMJ function.

The SNAQ(RC), an easy traffic light system as a first step in the recognition of undernutrition in residential care.

PubMed

Kruizenga, H M; de Vet, H C W; Van Marissing, C M E; Stassen, E E P M; Strijk, J E; Van Bokhorst-de Van der Schueren, M A E; Horman, J C H; Schols, J M G A; Van Binsbergen, J J; Eliens, A; Knol, D L; Visser, M

2010-02-01

Development and validation of a quick and easy screening tool for the early detection of undernourished residents in nursing homes and residential homes. Multi-center, cross sectional observational study. Nursing homes and residential homes. The screening tool was developed in a total of 308 residents (development sample; sample A) and cross validated in a new sample of 720 residents (validation sample) consisting of 476 nursing home residents (Sample B1) and 244 residential home residents (sample B2). Patients were defined severely undernourished when they met at least one of the following criteria: BMI or= 5% unintentional weight loss in the past month and/or >or= 10% unintentional weight loss in the past 6 months. Patients were defined as moderately undernourished if they met the following criteria: BMI 20.1-22 kg/m2 and/or 5-10% unintentional weight loss in the past six months. The most predictive questions (originally derived from previously developed screening instruments) of undernourishment were selected in sample A and cross validated in sample B. In a second stage BMI was added to the SNAQRC in sample B. The diagnostic accuracy of the screening tool in the development and validation samples was expressed in sensitivity, specificity, and the negative and positive predictive value. The four most predictive questions for undernutrition related to: unintentional weight loss more than 6 kg during the past 6 months and more than 3 kg in the past month, capability of eating and drinking with help, and decreased appetite during the past month. The diagnostic accuracy of these questions alone was insufficient (Se=45%, Sp=87%, PPV=50% and NPV=84%). However, combining the questions with measured BMI sufficiently improved the diagnostic accuracy (Se=87%, Sp=82%, PPV=59% and NPV=95%). Early detection of undernourished nursing- and residential home residents is possible using four screening questions and measured BMI.

Elderly patients attended in emergency health services in Brazil: a study for victims of falls and traffic accidents.

PubMed

de Freitas, Mariana Gonçalves; Bonolo, Palmira de Fátima; de Moraes, Edgar Nunes; Machado, Carla Jorge

2015-03-01

The article aims to describe the profile of elderly victims of falls and traffic accidents from the data of the Surveillance Survey of Violence and Accidents (VIVA). The VIVA Survey was conducted in the emergency health-services of the Unified Health System in the capitals of Brazil in 2011. The sample of elderly by type of accident was subjected to the two-step cluster procedure. Of the 2463 elderly persons in question, 79.8% suffered falls and 20.2% were the victims of traffic accidents. The 1812 elderly who fell were grouped together into 4 clusters: Cluster 1, in which all had disabilities; Cluster 2, all were non-white and falls took place in the home; Cluster 3, younger and active seniors; and Cluster 4, with a higher proportion of seniors 80 years old or above who were white. Among cases of traffic accidents, 446 seniors were grouped into two clusters: Cluster 1 of younger elderly, drivers or passengers; Cluster 2, with higher age seniors, mostly pedestrians. The main victims of falls were women with low schooling and unemployed; traffic accident victims were mostly younger and male. Complications were similar in victims of falls and traffic accidents. Clusters allow adoption of targeted measures of care, prevention and health promotion.

Large-scale motions in the universe: Using clusters of galaxies as tracers

NASA Technical Reports Server (NTRS)

Gramann, Mirt; Bahcall, Neta A.; Cen, Renyue; Gott, J. Richard

1995-01-01

Can clusters of galaxies be used to trace the large-scale peculiar velocity field of the universe? We answer this question by using large-scale cosmological simulations to compare the motions of rich clusters of galaxies with the motion of the underlying matter distribution. Three models are investigated: Omega = 1 and Omega = 0.3 cold dark matter (CDM), and Omega = 0.3 primeval baryonic isocurvature (PBI) models, all normalized to the Cosmic Background Explorer (COBE) background fluctuations. We compare the cluster and mass distribution of peculiar velocities, bulk motions, velocity dispersions, and Mach numbers as a function of scale for R greater than or = 50/h Mpc. We also present the large-scale velocity and potential maps of clusters and of the matter. We find that clusters of galaxies trace well the large-scale velocity field and can serve as an efficient tool to constrain cosmological models. The recently reported bulk motion of clusters 689 +/- 178 km/s on approximately 150/h Mpc scale (Lauer & Postman 1994) is larger than expected in any of the models studied (less than or = 190 +/- 78 km/s).

ADHD latent class clusters: DSM-IV subtypes and comorbidity

PubMed Central

Elia, Josephine; Arcos-Burgos, Mauricio; Bolton, Kelly L.; Ambrosini, Paul J.; Berrettini, Wade; Muenke, Maximilian

2014-01-01

ADHD (Attention Deficit Hyperactivity Disorder) has a complex, heterogeneous phenotype only partially captured by Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. In this report, latent class analyses (LCA) are used to identify ADHD phenotypes using K-SADS-IVR (Schedule for Affective Disorders & Schizophrenia for School Age Children-IV-Revised) symptoms and symptom severity data from a clinical sample of 500 ADHD subjects, ages 6–18, participating in an ADHD genetic study. Results show that LCA identified six separate ADHD clusters, some corresponding to specific DSM-IV subtypes while others included several subtypes. DSM-IV comorbid anxiety and mood disorders were generally similar across all clusters, and subjects without comorbidity did not aggregate within any one cluster. Age and gender composition also varied. These results support findings from population-based LCA studies. The six clusters provide additional homogenous groups that can be used to define ADHD phenotypes in genetic association studies. The limited age ranges aggregating in the different clusters may prove to be a particular advantage in genetic studies where candidate gene expression may vary during developmental phases. DSM-IV comorbid mood and anxiety disorders also do not appear to increase cluster heterogeneity; however, longitudinal studies that cover period of risk are needed to support this finding. PMID:19900717

Testability/Diagnostics Design Encyclopedia

DTIC Science & Technology

1990-09-01

weapon system that is pushing the state of the art and produced In limited numbers, with questionable historical data on their operation, one can...designs with questionable basis and justification. Unfortunately, this process has not been transformed from an art to a rigorous methodology...REQUIREMENT #2.1 - On-the-job training - Formal school training o O-Level data acquieitlonico01ectlon system (and data management) o Requirements to

The Continuity/Discontinuity Models of Eating Disorders: A Review of the Literature and Implications for Assessment, Treatment, and Prevention

ERIC Educational Resources Information Center

Gleaves, David H.; Brown, Joshua D.; Warren, Cortney S.

2004-01-01

Are the eating disorders discrete diagnostic entities or do they fall along one or more continua ranging from normal body weight, eating behavior, and weight concerns to severely disturbed patterns? Researchers have debated this question for at least 30 years and have used numerous creative strategies to examine this and related questions. This…

Minimal disease detection of B-cell lymphoproliferative disorders by flow cytometry: multidimensional cluster analysis.

PubMed

Duque, Ricardo E

2012-04-01

Flow cytometric analysis of cell suspensions involves the sequential 'registration' of intrinsic and extrinsic parameters of thousands of cells in list mode files. Thus, it is almost irresistible to describe phenomena in numerical terms or by 'ratios' that have the appearance of 'accuracy' due to the presence of numbers obtained from thousands of cells. The concepts involved in the detection and characterization of B cell lymphoproliferative processes are revisited in this paper by identifying parameters that, when analyzed appropriately, are both necessary and sufficient. The neoplastic process (cluster) can be visualized easily because the parameters that distinguish it form a cluster in multidimensional space that is unique and distinguishable from neighboring clusters that are not of diagnostic interest but serve to provide a background. For B cell neoplasia it is operationally necessary to identify the multidimensional space occupied by a cluster whose kappa:lambda ratio is 100:0 or 0:100. Thus, the concept of kappa:lambda ratio is without meaning and would not detect B cell neoplasia in an unacceptably high number of cases.

Ensemble averaged structure–function relationship for nanocrystals: effective superparamagnetic Fe clusters with catalytically active Pt skin [Ensemble averaged structure-function relationship for composite nanocrystals: magnetic bcc Fe clusters with catalytically active fcc Pt skin

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

Petkov, Valeri; Prasai, Binay; Shastri, Sarvjit

Practical applications require the production and usage of metallic nanocrystals (NCs) in large ensembles. Besides, due to their cluster-bulk solid duality, metallic NCs exhibit a large degree of structural diversity. This poses the question as to what atomic-scale basis is to be used when the structure–function relationship for metallic NCs is to be quantified precisely. In this paper, we address the question by studying bi-functional Fe core-Pt skin type NCs optimized for practical applications. In particular, the cluster-like Fe core and skin-like Pt surface of the NCs exhibit superparamagnetic properties and a superb catalytic activity for the oxygen reduction reaction,more » respectively. We determine the atomic-scale structure of the NCs by non-traditional resonant high-energy X-ray diffraction coupled to atomic pair distribution function analysis. Using the experimental structure data we explain the observed magnetic and catalytic behavior of the NCs in a quantitative manner. Lastly, we demonstrate that NC ensemble-averaged 3D positions of atoms obtained by advanced X-ray scattering techniques are a very proper basis for not only establishing but also quantifying the structure–function relationship for the increasingly complex metallic NCs explored for practical applications.« less

A segmentation method for lung nodule image sequences based on superpixels and density-based spatial clustering of applications with noise

PubMed Central

Zhang, Wei; Zhang, Xiaolong; Qiang, Yan; Tian, Qi; Tang, Xiaoxian

2017-01-01

The fast and accurate segmentation of lung nodule image sequences is the basis of subsequent processing and diagnostic analyses. However, previous research investigating nodule segmentation algorithms cannot entirely segment cavitary nodules, and the segmentation of juxta-vascular nodules is inaccurate and inefficient. To solve these problems, we propose a new method for the segmentation of lung nodule image sequences based on superpixels and density-based spatial clustering of applications with noise (DBSCAN). First, our method uses three-dimensional computed tomography image features of the average intensity projection combined with multi-scale dot enhancement for preprocessing. Hexagonal clustering and morphological optimized sequential linear iterative clustering (HMSLIC) for sequence image oversegmentation is then proposed to obtain superpixel blocks. The adaptive weight coefficient is then constructed to calculate the distance required between superpixels to achieve precise lung nodules positioning and to obtain the subsequent clustering starting block. Moreover, by fitting the distance and detecting the change in slope, an accurate clustering threshold is obtained. Thereafter, a fast DBSCAN superpixel sequence clustering algorithm, which is optimized by the strategy of only clustering the lung nodules and adaptive threshold, is then used to obtain lung nodule mask sequences. Finally, the lung nodule image sequences are obtained. The experimental results show that our method rapidly, completely and accurately segments various types of lung nodule image sequences. PMID:28880916

Unique relations between counterfactual thinking and DSM-5 PTSD symptom clusters.

PubMed

Mitchell, Melissa A; Contractor, Ateka A; Dranger, Paula; Shea, M Tracie

2016-05-01

Cognitive models of posttraumatic stress disorder (PTSD) propose that rumination about a trauma may increase particular symptom clusters. One type of rumination, termed counterfactual thinking (CFT), refers to thinking of alternative outcomes for an event. CFT centered on a trauma is thought to increase intrusions, negative alterations in mood and cognitions (NAMC), and marked alterations in arousal and reactivity (AAR). The theorized relations between CFT and specific symptom clusters have not been thoroughly investigated. Also, past work has not evaluated whether the relation is confounded by depressive symptoms, age, gender, or number of traumatic events experienced. The current study examined the unique associations between CFT and PTSD symptom clusters according to the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013) in 51 trauma-exposed treatment-seeking individuals. As predicted, CFT was associated with all PTSD symptom clusters. After controlling for common predictors of PTSD symptom severity (i.e., age, depressive symptoms, and number of traumatic life events endorsed), we found CFT to be significantly associated with the intrusion and avoidance symptom clusters but not the AAR or NAMC symptom clusters. Results from the present study provide further support for the role of rumination in specific PTSD symptom clusters above and beyond symptoms of depression, age, and number of traumatic life events endorsed. Future work may consider investigating interventions to reduce rumination in PTSD. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Gearbox Tooth Cut Fault Diagnostics Using Acoustic Emission and Vibration Sensors — A Comparative Study

PubMed Central

Qu, Yongzhi; He, David; Yoon, Jae; Van Hecke, Brandon; Bechhoefer, Eric; Zhu, Junda

2014-01-01

In recent years, acoustic emission (AE) sensors and AE-based techniques have been developed and tested for gearbox fault diagnosis. In general, AE-based techniques require much higher sampling rates than vibration analysis-based techniques for gearbox fault diagnosis. Therefore, it is questionable whether an AE-based technique would give a better or at least the same performance as the vibration analysis-based techniques using the same sampling rate. To answer the question, this paper presents a comparative study for gearbox tooth damage level diagnostics using AE and vibration measurements, the first known attempt to compare the gearbox fault diagnostic performance of AE- and vibration analysis-based approaches using the same sampling rate. Partial tooth cut faults are seeded in a gearbox test rig and experimentally tested in a laboratory. Results have shown that the AE-based approach has the potential to differentiate gear tooth damage levels in comparison with the vibration-based approach. While vibration signals are easily affected by mechanical resonance, the AE signals show more stable performance. PMID:24424467

Children's Headache: Drawings in the Diagnostic Work Up.

PubMed

Mazzotta, Silvia; Pavlidis, Elena; Cordori, Cecilia; Spagnoli, Carlotta; Pini, Luigi Alberto; Pisani, Francesco

2015-08-01

This study aims to evaluate the drawings effectiveness in childhood headache assessment. Headache is a common cause of pain in children. Although drawings have been used in childhood to recognize psychological insights and pain perception, they were rarely used for headache characterization. We collected drawings from 67 subjects with cephalalgia during a 22-month timeframe. The clinical diagnosis was made according to the 2nd edition of The International Headache Classification. Drawings were independently categorized as migraine or tension-type headache (TTH) by two child neuropsychiatrists blinded to the clinical data. Cohen kappa for interrater agreement, sensitivity, specificity, and positive predictive value (PPV) were calculated. Subjects were also divided into three age groups to assess the influence of age. Finally, a control group of 90 subjects was collected and K-means cluster analysis was performed. The drawings had a sensitivity of 85.71 and 81.48%, a specificity of 81.48 and 85.71%, and a PPV of 85.71 and 81.48%, for migraine and TTH diagnosis, respectively. Drawings by the older age group showed the highest predictability degree. Finally, by mean of cluster analysis, 59 of the 67 patients were correctly classified, whereas control subjects were similarly distributed between the two clusters. Drawings are a useful instrument for migraine and TTH differential diagnosis. Thus, we suggest their inclusion in childhood headache diagnostic assessment. Georg Thieme Verlag KG Stuttgart · New York.

Temporal diagnostic analysis of the SWAT model to detect dominant periods of poor model performance

NASA Astrophysics Data System (ADS)

Guse, Björn; Reusser, Dominik E.; Fohrer, Nicola

2013-04-01

Hydrological models generally include thresholds and non-linearities, such as snow-rain-temperature thresholds, non-linear reservoirs, infiltration thresholds and the like. When relating observed variables to modelling results, formal methods often calculate performance metrics over long periods, reporting model performance with only few numbers. Such approaches are not well suited to compare dominating processes between reality and model and to better understand when thresholds and non-linearities are driving model results. We present a combination of two temporally resolved model diagnostic tools to answer when a model is performing (not so) well and what the dominant processes are during these periods. We look at the temporal dynamics of parameter sensitivities and model performance to answer this question. For this, the eco-hydrological SWAT model is applied in the Treene lowland catchment in Northern Germany. As a first step, temporal dynamics of parameter sensitivities are analyzed using the Fourier Amplitude Sensitivity test (FAST). The sensitivities of the eight model parameters investigated show strong temporal variations. High sensitivities were detected for two groundwater (GW_DELAY, ALPHA_BF) and one evaporation parameters (ESCO) most of the time. The periods of high parameter sensitivity can be related to different phases of the hydrograph with dominances of the groundwater parameters in the recession phases and of ESCO in baseflow and resaturation periods. Surface runoff parameters show high parameter sensitivities in phases of a precipitation event in combination with high soil water contents. The dominant parameters give indication for the controlling processes during a given period for the hydrological catchment. The second step included the temporal analysis of model performance. For each time step, model performance was characterized with a "finger print" consisting of a large set of performance measures. These finger prints were clustered into four reoccurring patterns of typical model performance, which can be related to different phases of the hydrograph. Overall, the baseflow cluster has the lowest performance. By combining the periods with poor model performance with the dominant model components during these phases, the groundwater module was detected as the model part with the highest potential for model improvements. The detection of dominant processes in periods of poor model performance enhances the understanding of the SWAT model. Based on this, concepts how to improve the SWAT model structure for the application in German lowland catchment are derived.

Substructures in Clusters of Galaxies

NASA Astrophysics Data System (ADS)

Lehodey, Brigitte Tome

2000-01-01

This dissertation presents two methods for the detection of substructures in clusters of galaxies and the results of their application to a group of four clusters. In chapters 2 and 3, we remember the main properties of clusters of galaxies and give the definition of substructures. We also try to show why the study of substructures in clusters of galaxies is so important for Cosmology. Chapters 4 and 5 describe these two methods, the first one, the adaptive Kernel, is applied to the study of the spatial and kinematical distribution of the cluster galaxies. The second one, the MVM (Multiscale Vision Model), is applied to analyse the cluster diffuse X-ray emission, i.e., the intracluster gas distribution. At the end of these two chapters, we also present the results of the application of these methods to our sample of clusters. In chapter 6, we draw the conclusions from the comparison of the results we obtain with each method. In the last chapter, we present the main conclusions of this work trying to point out possible developments. We close with two appendices in which we detail some questions raised in this work not directly linked to the problem of substructures detection.

Illuminating the star clusters and satellite galaxies with multi-scale baryonic simulations

NASA Astrophysics Data System (ADS)

Maji, Moupiya; Zhu, Qirong; Li, Yuexing; Marinacci, Federico; Charlton, Jane; Hernquist, Lars; Knebe, Alexander

2018-01-01

Over the past decade, advances in computational architecture have made it possible for the first time to investigate some of the fundamental questions around the formation, evolution and assembly of the building blocks of the universe; star clusters and galaxies. In this talk, I will focus on two major questions: What is the origin of the observed universal lognormal mass function in globular clusters? What is the statistical distribution of the properties of satellite planes in a large sample of satellite systems?Observations of globular clusters show that they have universal lognormal mass functions with a characteristic peak at 2X105 MSun, although the origin of this peaked distribution is unclear. We investigate the formation of star clusters in interacting galaxies using baryonic simulations and found that massive clusters preferentially form in extremely high pressure gas clouds which reside in highly shocked regions produced by galaxy interactions. These massive clusters have quasi-lognormal initial mass functions with a peak around ~106MSun which may survive dynamical evolution and slowly evolve into the universal lognormal profiles observed today.The classical Milky Way (MW) satellites are observed to be distributed in a highly-flattened plane, called Disk of Satellites (DoS). However the significance, coherence and origin of DoS is highly debated. To understand this, we first analyze all MW satellites and find that a small sample size can artificially produce a highly anisotropic spatial distribution and a strong clustering of their angular momentum. Comparing a baryonic simulation of a MW-sized galaxy with its N-body counterpart we find that an anisotropic DoS can originate from baryonic processes. Furthermore, we explore the statistical distribution of DoS properties by analyzing 2591 satellite systems in the cosmological hydrodynamic simulation Illustris. We find that the DoS becomes more isotropic with increasing sample sizes and most (~90%) satellite systems have no clear coherent rotation. Their overall evolution indicate that the DoS may be part of large scale filamentary structure. Our results show that baryonic processes may be the key to solve many long standing theoretical problems.

MO-F-204-04: Preparing for Parts 2 & 3 of the ABR Nuclear Medicine Physics Exam

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

MacDougall, R.

Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance of allmore » aspects of clinical medical physics. All parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those unique aspects of the nuclear exam, and how preparing for a second specialty differs from the first. Medical physicists who recently completed each ABR exam portion will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear imaging physics, systems, dosimetry, safety and related problem solving/calculations How to prepare for Part 3 of the ABR exam by effectively communicating the practice, methods, and significance of clinical diagnostic and/or nuclear medical physics.« less

WE-D-213-04: Preparing for Parts 2 & 3 of the ABR Nuclear Medicine Physics Exam

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

MacDougall, R.

Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR professional certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance ofmore » all aspects of clinical medical physics. All three parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation and skill sets necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those aspects that are unique to the nuclear exam. Medical physicists who have recently completed each of part of the ABR exam will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to Prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear imaging physics, systems, dosimetry, safety and related problem solving/calculations How to Prepare for Part 3 of the ABR exam by effectively communicating the practice, methods, and significance of clinical diagnostic and/or nuclear medical physics.« less

The Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R): A Scale to Assist the Diagnosis of Autism Spectrum Disorder in Adults--An International Validation Study

ERIC Educational Resources Information Center

Ritvo, Riva Ariella; Ritvo, Edward R.; Guthrie, Donald; Ritvo, Max J.; Hufnagel, Demetra H.; McMahon, William; Tonge, Bruce; Mataix-Cols, David; Jassi, Amita; Attwood, Tony; Eloff, Johann

2011-01-01

The Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R) is a valid and reliable instrument to assist the diagnosis of adults with Autism Spectrum Disorders (ASD). The 80-question scale was administered to 779 subjects (201 ASD and 578 comparisons). All ASD subjects met inclusion criteria: DSM-IV-TR, ADI/ADOS diagnoses and standardized IQ…

Quality and Diversity in VET [Vocational Education and Training] Research. Proceedings of the National Conference of the Australian Vocational Education and Training Research Association (AVETRA) (2nd, Melbourne, Australia, February 11-12, 1999).

ERIC Educational Resources Information Center

Australian Vocational Education and Training Research Association, Alexandria.

These proceedings consist of 43 presentations clustered into these key areas: position, strategy, contribution, and future issues; diversity of participation and contexts; issues in the workplace and learning settings; question of practitioners work; and questions of knowledge and methodology--all related to the themes of quality and diversity.…

Galaxy Clusters, Near and Far, Have a Lot in Common

NASA Astrophysics Data System (ADS)

2005-04-01

Using two orbiting X-ray telescopes, a team of international astronomers has examined distant galaxy clusters in order to compare them with their counterparts that are relatively close by. Speaking today at the RAS National Astronomy Meeting in Birmingham, Dr. Ben Maughan (Harvard-Smithsonian Center for Astrophysics), presented the results of this new analysis. The observations indicate that, despite the great expansion that the Universe has undergone since the Big Bang, galaxy clusters both local and distant have a great deal in common. This discovery could eventually lead to a better understanding of how to "weigh" these enormous structures, and, in so doing, answer important questions about the nature and structure of the Universe. Clusters of galaxies, the largest known gravitationally-bound objects, are the knots in the cosmic web of structure that permeates the Universe. Theoretical models make predictions about the number, distribution and properties of these clusters. Scientists can test and improve models of the Universe by comparing these predictions with observations. The most powerful way of doing this is to measure the masses of galaxy clusters, particularly those in the distant Universe. However, weighing galaxy clusters is extremely difficult. One relatively easy way to weigh a galaxy cluster is to use simple laws ("scaling relations") to estimate its weight from properties that are easy to observe, like its luminosity (brightness) or temperature. This is like estimating someone's weight from their height if you didn't have any scales. Over the last 3 years, a team of researchers, led by Ben Maughan, has observed 11 distant galaxy clusters with ESA's XMM-Newton and NASA's Chandra X-ray Observatory. The clusters have redshifts of z = 0.6-1.0, which corresponds to distances of 6 to 8 billion light years. This means that we see them as they were when the Universe was half its present age. The survey included two unusual systems, one in which two massive clusters are merging and another extremely massive cluster which appears very "relaxed" and undisturbed. The X-ray data allowed the scientists to measure the temperatures and luminosities of the gas in the clusters. They were then able to infer their total masses, which varied between 200 and 1,100 times the mass of our Milky Way galaxy. These measurements were then used to test whether galaxy clusters of different sizes and located at different distances from us are simply scaled versions of each other -- a condition known as being "self-similar." This is an important characteristic for astronomers to identify if they hope to get the true weights of galaxy clusters. "For example, chocolate bars are strongly self-similar," said Maughan. "If you shrank a king-size bar to a fun-size bar, they would be identical versions of each other but just different sizes." "However, if you shrank a castle to the size of a bungalow, they would be very different structures, despite being the same size. This means that they are not strongly self-similar objects." Another possible type of relationship between clusters is what scientists call "weakly self-similar." In this case, galaxy clusters in the distant universe and those nearby are almost identical to each other, but not exactly the same. (The only differences between them can be accounted for by the expansion of the Universe since the Big Bang.) Although astronomers have known for some time that galaxy clusters are not strongly self-similar, the question of whether or not they are weakly self-similar has remained open. The new results show that as long as astronomers take into account the continuous expansion of the Universe, then galaxy clusters are, in fact, weakly self-similar. This means that the same scaling relations used to weigh nearby galaxy clusters hold true for these very distant clusters. "Our results mean that weighing distant galaxy clusters could become as easy as converting from Fahrenheit to Celsius," said Maughan. "This will help to answer important questions about the nature and structure of the Universe." The other members of the team were: Laurence Jones (University of Birmingham, UK) Harald Ebeling (Institute for Astronomy, HI, USA), and Caleb Scharf (Columbia Astrophysics Laboratory, NY, USA). The observations were made with the European Photon Imaging Camera (EPIC) on XMM and the Advanced Camera for Imaging and Spectroscopy (ACIS) on Chandra. They were part of the WARPS survey of distant galaxy clusters detected by chance in observations made with the UK-US-Dutch ROSAT X-ray satellite. Additional information and images are available at: http://www.sr.bham.ac.uk/~habib/nampr/

Factor Structure of the PTSD Checklist for DSM-5: Relationships Among Symptom Clusters, Anger, and Impulsivity.

PubMed

Armour, Cherie; Contractor, Ateka; Shea, Tracie; Elhai, Jon D; Pietrzak, Robert H

2016-02-01

Scarce data are available regarding the dimensional structure of Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) posttraumatic stress disorder (PTSD) symptoms and how factors relate to external constructs. We evaluated six competing models of DSM-5 PTSD symptoms, including Anhedonia, Externalizing Behaviors, and Hybrid models, using confirmatory factor analyses in a sample of 412 trauma-exposed college students. We then examined whether PTSD symptom clusters were differentially related to measures of anger and impulsivity using Wald chi-square tests. The seven-factor Hybrid model was deemed optimal compared with the alternatives. All symptom clusters were associated with anger; the strongest association was between externalizing behaviors and anger (r = 0.54). All symptom clusters, except re-experiencing and avoidance, were associated with impulsivity, with the strongest association between externalizing behaviors and impulsivity (r = 0.49). A seven-factor Hybrid model provides superior fit to DSM-5 PTSD symptom data, with the externalizing behaviors factor being most strongly related to anger and impulsivity.

Interaction force in a vertical dust chain inside a glass box.

PubMed

Kong, Jie; Qiao, Ke; Matthews, Lorin S; Hyde, Truell W

2014-07-01

Small number dust particle clusters can be used as probes for plasma diagnostics. The number of dust particles as well as cluster size and shape can be easily controlled employing a glass box placed within a Gaseous Electronics Conference (GEC) rf reference chamber to provide confinement of the dust. The plasma parameters inside this box and within the larger plasma chamber have not yet been adequately defined. Adjusting the rf power alters the plasma conditions causing structural changes of the cluster. This effect can be used to probe the relationship between the rf power and other plasma parameters. This experiment employs the sloshing and breathing modes of small cluster oscillations to examine the relationship between system rf power and the particle charge and plasma screening length inside the glass box. The experimental results provided indicate that both the screening length and dust charge decrease as rf power inside the box increases. The decrease in dust charge as power increases may indicate that ion trapping plays a significant role in the sheath.

Risk profiles for poor treatment response to internet-delivered CBT in people with social anxiety disorder.

PubMed

Tillfors, Maria; Furmark, Tomas; Carlbring, Per; Andersson, Gerhard

2015-06-01

In social anxiety disorder (SAD) co-morbid depressive symptoms as well as avoidance behaviors have been shown to predict insufficient treatment response. It is likely that subgroups of individuals with different profiles of risk factors for poor treatment response exist. This study aimed to identify subgroups of social avoidance and depressive symptoms in a clinical sample (N = 167) with SAD before and after guided internet-delivered CBT, and to compare these groups on diagnostic status and social anxiety. We further examined individual movement between subgroups over time. Using cluster analysis we identified four subgroups, including a high-problem cluster at both time-points. Individuals in this cluster showed less remission after treatment, exhibited higher levels of social anxiety at both assessments, and typically remained in the high-problem cluster after treatment. Thus, in individuals with SAD, high levels of social avoidance and depressive symptoms constitute a risk profile for poor treatment response. Copyright © 2015 Elsevier Ltd. All rights reserved.

CYP76M7 Is an ent-Cassadiene C11α-Hydroxylase Defining a Second Multifunctional Diterpenoid Biosynthetic Gene Cluster in Rice[W][OA

PubMed Central

Swaminathan, Sivakumar; Morrone, Dana; Wang, Qiang; Fulton, D. Bruce; Peters, Reuben J.

2009-01-01

Biosynthetic gene clusters are common in microbial organisms, but rare in plants, raising questions regarding the evolutionary forces that drive their assembly in multicellular eukaryotes. Here, we characterize the biochemical function of a rice (Oryza sativa) cytochrome P450 monooxygenase, CYP76M7, which seems to act in the production of antifungal phytocassanes and defines a second diterpenoid biosynthetic gene cluster in rice. This cluster is uniquely multifunctional, containing enzymatic genes involved in the production of two distinct sets of phytoalexins, the antifungal phytocassanes and antibacterial oryzalides/oryzadiones, with the corresponding genes being subject to distinct transcriptional regulation. The lack of uniform coregulation of the genes within this multifunctional cluster suggests that this was not a primary driving force in its assembly. However, the cluster is dedicated to specialized metabolism, as all genes in the cluster are involved in phytoalexin metabolism. We hypothesize that this dedication to specialized metabolism led to the assembly of the corresponding biosynthetic gene cluster. Consistent with this hypothesis, molecular phylogenetic comparison demonstrates that the two rice diterpenoid biosynthetic gene clusters have undergone independent elaboration to their present-day forms, indicating continued evolutionary pressure for coclustering of enzymatic genes encoding components of related biosynthetic pathways. PMID:19825834

Preliminary results from a simulated laboratory experiment or an encounter of cluster satellite probes with a reconnection layer

NASA Astrophysics Data System (ADS)

Yamada, M.; Ren, Y.; Ji, H.; Gerhardt, S.; Darfman, S.

2006-12-01

With the recent upgrade of the MRX (Magnetic Reconnection Experiment) device[1], our experimental operation allows us to carry out a jog experiment in which a current sheet can be moved swiftly across an inserted probe assembly. A cluster of probes with variable distances can be inserted into a known desired position in the MRX device. This setup can be similar to the situation in which a cluster of satellites encounters a rapidly moving reconnection layer. If necessary, we can create a neutral sheet where the density of one side is significantly higher than the other, as is the case for the magnetopause. A variable guide field will be applied to study its effect on reconnection. We proposed[2] to document basic patterns of data during a simulated encounter of the MRX reconnection layer with the four-probe mock-up system and compare them with data acquired from past satellites. Relative position of the MMS satellites in the magnetosphere can then be determined. Optimum cluster configuration or distance between the four satellites can be determined for various diagnostics or research missions. The relationship of magnetic fluctuations[3] with the observed out-of- plane quadrupole field, a characteristic signature of the Hall MHD, can be also studied in this series of experiments. In this paper, results from a preliminary experiment will be presented. These experiments utilize effectively the unique MRX ability to accurately know the location of diagnostics with respect to the moving reconnection layer. Supported by DoE, NASA, NSF. [1] M. Yamada et al, Phys. Plasmas 13, 052119 (2006), [2] M.Yamada et al, MMS-IDS proposal (2006), [3] H. Ji et al, Phys. Rev. Letts. 92, 115001 (2004)

Comparing multifocal VEP and standard automated perimetry in high-risk ocular hypertension and early glaucoma.

PubMed

Fortune, Brad; Demirel, Shaban; Zhang, Xian; Hood, Donald C; Patterson, Emily; Jamil, Annisa; Mansberger, Steven L; Cioffi, George A; Johnson, Chris A

2007-03-01

To compare the diagnostic performance of multifocal visual evoked potential (mfVEP) and standard automated perimetry (SAP), in eyes with high-risk ocular hypertension or early glaucoma. Both eyes of 185 individuals with high-risk ocular hypertension or early glaucoma were evaluated. Subjects ranged in age from 37 to 87 (mean +/- SD: 61 +/- 11 years). Pattern-reversal mfVEPs were obtained by using VERIS (Electro-Diagnostic Imaging, San Mateo, CA) with a four-electrode array and were analyzed with custom software. SAP visual fields (SITA-standard; Carl Zeiss Meditec, Inc., Dublin, CA) were obtained within 22.3 +/- 27.0 days of the mfVEP. Stereo disc photographs and Heidelberg Retina Tomograph (HRT) images were obtained during one visit, which was within 24.8 +/- 50.4 days of the mfVEP and 33.1 +/- 62.9 days of the SAP visual field. Abnormalities on the mfVEP were defined by using a variety of cluster criteria: SAP with pattern standard deviation (PSD) P

Considerations of study design.

PubMed

Koretz, Ronald L

2007-12-01

Research projects attempt to answer specific questions. The particular study design that is selected will depend in large measure on the nature of the question and the time and resources available. There are 5 common categories of clinical questions; they relate to etiology, prognosis, utility of diagnostic tests, efficacy of proposed interventions, and cost of treatment in specific disease states. A number of study designs can be used. Case reports serve to memorialize unusual or novel aspects of diseases. Retrospective case series are useful for defining natural history. Case-control studies are used by epidemiologists to elucidate potential etiologies of diseases. Prospective cohort studies can be used to assess natural history or to assess potential disease etiologies. Controlled trials are designed to assess the efficacy of therapeutic interventions. Studies that define the sensitivity and specificity of diagnostic tests can be used to assess the utility of those tests. Economic analyses estimate the costs that particular diseases or therapies will require. Each of these study designs has limitations; with the exception of high-quality randomized trials, none of these study designs can establish a causative relationship between putative etiologic (or therapeutic) factors and disease (outcomes).

Globular cluster formation and evolution in the context of cosmological galaxy assembly: open questions

NASA Astrophysics Data System (ADS)

Forbes, Duncan A.; Bastian, Nate; Gieles, Mark; Crain, Robert A.; Kruijssen, J. M. Diederik; Larsen, Søren S.; Ploeckinger, Sylvia; Agertz, Oscar; Trenti, Michele; Ferguson, Annette M. N.; Pfeffer, Joel; Gnedin, Oleg Y.

2018-02-01

We discuss some of the key open questions regarding the formation and evolution of globular clusters (GCs) during galaxy formation and assembly within a cosmological framework. The current state of the art for both observations and simulations is described, and we briefly mention directions for future research. The oldest GCs have ages greater than or equal to 12.5 Gyr and formed around the time of reionization. Resolved colour-magnitude diagrams of Milky Way GCs and direct imaging of lensed proto-GCs at z˜6 with the James Webb Space Telescope (JWST) promise further insight. GCs are known to host multiple populations of stars with variations in their chemical abundances. Recently, such multiple populations have been detected in ˜2 Gyr old compact, massive star clusters. This suggests a common, single pathway for the formation of GCs at high and low redshift. The shape of the initial mass function for GCs remains unknown; however, for massive galaxies a power-law mass function is favoured. Significant progress has been made recently modelling GC formation in the context of galaxy formation, with success in reproducing many of the observed GC-galaxy scaling relations.

Globular cluster formation and evolution in the context of cosmological galaxy assembly: open questions.

PubMed

Forbes, Duncan A; Bastian, Nate; Gieles, Mark; Crain, Robert A; Kruijssen, J M Diederik; Larsen, Søren S; Ploeckinger, Sylvia; Agertz, Oscar; Trenti, Michele; Ferguson, Annette M N; Pfeffer, Joel; Gnedin, Oleg Y

2018-02-01

We discuss some of the key open questions regarding the formation and evolution of globular clusters (GCs) during galaxy formation and assembly within a cosmological framework. The current state of the art for both observations and simulations is described, and we briefly mention directions for future research. The oldest GCs have ages greater than or equal to 12.5 Gyr and formed around the time of reionization. Resolved colour-magnitude diagrams of Milky Way GCs and direct imaging of lensed proto-GCs at z ∼6 with the James Webb Space Telescope (JWST) promise further insight. GCs are known to host multiple populations of stars with variations in their chemical abundances. Recently, such multiple populations have been detected in ∼2 Gyr old compact, massive star clusters. This suggests a common, single pathway for the formation of GCs at high and low redshift. The shape of the initial mass function for GCs remains unknown; however, for massive galaxies a power-law mass function is favoured. Significant progress has been made recently modelling GC formation in the context of galaxy formation, with success in reproducing many of the observed GC-galaxy scaling relations.

Globular cluster formation and evolution in the context of cosmological galaxy assembly: open questions

PubMed Central

Bastian, Nate; Gieles, Mark; Crain, Robert A.; Kruijssen, J. M. Diederik; Larsen, Søren S.; Ploeckinger, Sylvia; Agertz, Oscar; Trenti, Michele; Ferguson, Annette M. N.; Pfeffer, Joel; Gnedin, Oleg Y.

2018-01-01

We discuss some of the key open questions regarding the formation and evolution of globular clusters (GCs) during galaxy formation and assembly within a cosmological framework. The current state of the art for both observations and simulations is described, and we briefly mention directions for future research. The oldest GCs have ages greater than or equal to 12.5 Gyr and formed around the time of reionization. Resolved colour-magnitude diagrams of Milky Way GCs and direct imaging of lensed proto-GCs at z∼6 with the James Webb Space Telescope (JWST) promise further insight. GCs are known to host multiple populations of stars with variations in their chemical abundances. Recently, such multiple populations have been detected in ∼2 Gyr old compact, massive star clusters. This suggests a common, single pathway for the formation of GCs at high and low redshift. The shape of the initial mass function for GCs remains unknown; however, for massive galaxies a power-law mass function is favoured. Significant progress has been made recently modelling GC formation in the context of galaxy formation, with success in reproducing many of the observed GC-galaxy scaling relations. PMID:29507511

Intrinsic Variability in Multiple Systems and Clusters: Open Questions

NASA Astrophysics Data System (ADS)

Lampens, P.

2006-04-01

It is most interesting and rewarding to probe the stellar structure of stars which belong to a system originating from the same parent cloud as this provides additional and more accurate constraints for the models. New results on pulsating components in multiple systems and clusters are beginning to emerge regularly. Based on concrete studies, I will present still unsolved problems and discuss some of the issues which may affect our understanding of the pulsation physics in such systems but also in general.

Application of Microarrays and qPCR to Identify Phylogenetic and Functional Biomarkers Diagnostic of Microbial Communities that Biodegrade Chlorinated Solvents to Ethene

DTIC Science & Technology

2012-01-01

Acidobacteria, Actinobacteria , Bacteroidetes, Chloroflexi, Cyanobacteria, Firmicutes, and all classes of Proteobacteria accounted for 76% of this dynamic...the course of treatment (Figure 4). The dominant members in cluster group 2 were from Actinobacteria (24 subfamilies), Bacteroidetes (25 subfamilies

Novel readout method for molecular diagnostic assays based on optical measurements of magnetic nanobead dynamics.

PubMed

Donolato, Marco; Antunes, Paula; Bejhed, Rebecca S; Zardán Gómez de la Torre, Teresa; Østerberg, Frederik W; Strömberg, Mattias; Nilsson, Mats; Strømme, Maria; Svedlindh, Peter; Hansen, Mikkel F; Vavassori, Paolo

2015-02-03

We demonstrate detection of DNA coils formed from a Vibrio cholerae DNA target at picomolar concentrations using a novel optomagnetic approach exploiting the dynamic behavior and optical anisotropy of magnetic nanobead (MNB) assemblies. We establish that the complex second harmonic optical transmission spectra of MNB suspensions measured upon application of a weak uniaxial AC magnetic field correlate well with the rotation dynamics of the individual MNBs. Adding a target analyte to the solution leads to the formation of permanent MNB clusters, namely, to the suppression of the dynamic MNB behavior. We prove that the optical transmission spectra are highly sensitive to the formation of permanent MNB clusters and, thereby to the target analyte concentration. As a specific clinically relevant diagnostic case, we detect DNA coils formed via padlock probe recognition and isothermal rolling circle amplification and benchmark against a commercial equipment. The results demonstrate the fast optomagnetic readout of rolling circle products from bacterial DNA utilizing the dynamic properties of MNBs in a miniaturized and low-cost platform requiring only a transparent window in the chip.

[Influence of antitumor system rhenium-platinum on biochemical state of the liver].

PubMed

Ivchuk, V V; Polishko, T M; Golichenko, O A; Shtemenko, O V; Shtemenko, N I

2011-01-01

Influence of the antitumour rhenium-platinum system on biochemical liver characteristics in the model of tumor growth (Guerin carcinoma) was studied and possible hepatoprotective activity of rhenium cluster compounds when introducing them in different forms was shown, that was confirmed by decreasing of diagnostic enzymes activity in blood (aminotransferase--AST 6 times and ALT 5.6 times, lactatedehydrogenase 4.9 times, gamma-glutamyltranspeptidase 3.6 times) and normalization of morphological state of the liver cells. The hepatoprotective activity of the cluster rhenium compound with adamanthyl ligands was confirmed in the model of acute toxic hepatitis. Introduction of this compound led to reduction of the concentration of MDA in homogenates of liver tissue (2 times), and in blood plasma (3.8 times); to reduction of levels of diagnostic liver enzymes in blood--AST and ALT 5.8 and 5.5 times respectively in comparison with control group. Some aspects of the mechanism of hepatoprotection were discussed, that included the presence of conjugated systems around the quadrupol rhenium-rhenium bond and alkyl radicals with significant positive inductive effects.

Using Self-Organizing Neural Network Map Combined with Ward's Clustering Algorithm for Visualization of Students' Cognitive Structural Models about Aliveness Concept

PubMed Central

Ugulu, Ilker; Aydin, Halil

2016-01-01

We propose an approach to clustering and visualization of students' cognitive structural models. We use the self-organizing map (SOM) combined with Ward's clustering to conduct cluster analysis. In the study carried out on 100 subjects, a conceptual understanding test consisting of open-ended questions was used as a data collection tool. The results of analyses indicated that students constructed the aliveness concept by associating it predominantly with human. Motion appeared as the most frequently associated term with the aliveness concept. The results suggest that the aliveness concept has been constructed using anthropocentric and animistic cognitive structures. In the next step, we used the data obtained from the conceptual understanding test for training the SOM. Consequently, we propose a visualization method about cognitive structure of the aliveness concept. PMID:26819579

Galaxy evolution in clusters since z=1

NASA Astrophysics Data System (ADS)

Aragón-Salamanca, A.

2011-11-01

It is now 30 years since Alan Dressler published his seminal paper onthe morphology-density relation. Although there is still much to learnon the effect of the environment on galaxy evolution, extensive progress has been made since then both observationally and theoretically.Galaxy clusters provide some of the most extreme environments in which galaxies evolve, making them excellent laboratories to study the age old question of "nature'' vs. "nurture'' in galaxy evolution. Here I review some of the key observational results obtained during the last decade on the evolution of the morphology, structure, dynamics, star-formation history and stellar populations of cluster galaxies since the time when the universe was half its present age.Many of the results presented here have been obtainedwithin the ESO Distant Cluster Survey (EDisCS) and Space Telescope A901/02 Galaxy Evolution Survey (STAGES) collaborations.

Predictors for switch from unipolar major depressive disorder to bipolar disorder type I or II: a 5-year prospective study.

PubMed

Holma, K Mikael; Melartin, Tarja K; Holma, Irina A K; Isometsä, Erkki T

2008-08-01

In this naturalistic study, we investigated the rate, time course, and predictors of a diagnostic switch from unipolar major depressive disorder (MDD) to bipolar disorder type I or II during a 5-year follow-up. The Vantaa Depression Study included at baseline 269 psychiatric outpatients (82.9%) and inpatients (17.1%) with DSM-IV MDD, diagnosed using structured and semi-structured interviews and followed up at 6 months, 18 months, and 5 years between February 1, 1997 and April 30, 2004. Information on 248 MDD patients (92.2%) was available for analyses of the risk of diagnostic switch. Cox proportional hazards models were used. Twenty-two subjects (8.9%) with previous unipolar MDD switched to bipolar disorder type II and 7 (2.8%) to type I. Median time for switch to bipolar type I was significantly shorter than to type II. In Cox proportional hazards analyses, severity of MDD (hazard ratio [HR] = 1.08, 95% CI = 1.00 to 1.15, p = .036), obsessive-compulsive disorder (OCD) (HR = 5.00, 95% CI = 2.04 to 12.5, p < .001), social phobia (HR = 2.33, 95% CI = 1.00 to 5.26, p = .050), and large number of cluster B personality disorder symptoms (HR = 1.10, 95% CI = 1.02 to 1.20, p = .022) predicted switch. Among outpatients with MDD in secondary level psychiatric settings, diagnostic switch to bipolar disorder usually refers to type II rather than type I. The few switching to bipolar type I do so relatively early. Predictors for diagnostic switch include not only features of mood disorder, such as severity, but may also include some features of psychiatric comorbidity, such as concurrent social phobia, OCD, and symptoms of cluster B personality disorders.

Poor Validity of the DSM-IV Schizoid Personality Disorder Construct as a Diagnostic Category.

PubMed

Hummelen, Benjamin; Pedersen, Geir; Wilberg, Theresa; Karterud, Sigmund

2015-06-01

This study sought to evaluate the construct validity of schizoid personality disorder (SZPD) by investigating a sample of 2,619 patients from the Norwegian Network of Personality-Focused Treatment Programs by a variety of statistical techniques. Nineteen patients (0.7%) reached the diagnostic threshold of SZPD. Results from the factor analyses indicated that SZPD consists of three factors: social detachment, withdrawal, and restricted affectivity/ anhedonia. Overall, internal consistency and diagnostic efficiency were poor and best for the criteria that belong to the social detachment factor. These findings pose serious questions about the clinical utility of SZPD as a diagnostic category. On the other hand, the three factors were in concordance with findings from previous studies and with the trait model for personality disorders in DSM-5, supporting the validity of SZPD as a dimensional construct. The authors recommend that SZPD should be deleted as a diagnostic category in future editions of DSM-5.

Formation of Very Young Massive Clusters and Implications for Globular Clusters

NASA Astrophysics Data System (ADS)

Banerjee, Sambaran; Kroupa, Pavel

How Very Young Massive star Clusters (VYMCs; also known as "starburst" clusters), which typically are of ≳ 104 M ⊙ and are a few Myr old, form out of Giant Molecular Clouds is still largely an open question. Increasingly detailed observations of young star clusters and star-forming molecular clouds and computational studies provide clues about their formation scenarios and the underlying physical processes involved. This chapter is focused on reviewing the decade-long studies that attempt to computationally reproduce the well-observed nearby VYMCs, such as the Orion Nebula Cluster, R136 and NGC 3603 young cluster, thereby shedding light on birth conditions of massive star clusters, in general. On this regard, focus is given on direct N-body modelling of real-sized massive star clusters, with a monolithic structure and undergoing residual gas expulsion, which have consistently reproduced the observed characteristics of several VYMCs and also of young star clusters, in general. The connection of these relatively simplified model calculations with the structural richness of dense molecular clouds and the complexity of hydrodynamic calculations of star cluster formation is presented in detail. Furthermore, the connections of such VYMCs with globular clusters, which are nearly as old as our Universe, is discussed. The chapter is concluded by addressing long-term deeply gas-embedded (at least apparently) and substructured systems like W3 Main. While most of the results are quoted from existing and up-to-date literature, in an integrated fashion, several new insights and discussions are provided.

Zika Virus and Complications: Questions and Answers

MedlinePlus

... mosquito breeding sites, by emptying, cleaning or covering containers that can hold even small amounts of water, ... D community and regulators to fast-track the availability of effective diagnostic tests, vaccines and medicines that ...

Development of diagnostic test instruments to reveal level student conception in kinematic and dynamics

NASA Astrophysics Data System (ADS)

Handhika, J.; Cari, C.; Suparmi, A.; Sunarno, W.; Purwandari, P.

2018-03-01

The purpose of this research was to develop a diagnostic test instrument to reveal students' conceptions in kinematics and dynamics. The diagnostic test was developed based on the content indicator the concept of (1) displacement and distance, (2) instantaneous and average velocity, (3) zero and constant acceleration, (4) gravitational acceleration (5) Newton's first Law, (6) and Newton's third Law. The diagnostic test development model includes: Diagnostic test requirement analysis, formulating test-making objectives, developing tests, checking the validity of the content and the performance of reliability, and application of tests. The Content Validation Index (CVI) results in the category are highly relevant, with a value of 0.85. Three questions get negative Content Validation Ratio CVR) (-0.6), after revised distractors and clarify visual presentation; the CVR become 1 (highly relevant). This test was applied, obtained 16 valid test items, with Cronbach Alpha value of 0.80. It can conclude that diagnostic test can be used to reveal the level of students conception in kinematics and dynamics.

Algorithm to determine the percolation largest component in interconnected networks.

PubMed

Schneider, Christian M; Araújo, Nuno A M; Herrmann, Hans J

2013-04-01

Interconnected networks have been shown to be much more vulnerable to random and targeted failures than isolated ones, raising several interesting questions regarding the identification and mitigation of their risk. The paradigm to address these questions is the percolation model, where the resilience of the system is quantified by the dependence of the size of the largest cluster on the number of failures. Numerically, the major challenge is the identification of this cluster and the calculation of its size. Here, we propose an efficient algorithm to tackle this problem. We show that the algorithm scales as O(NlogN), where N is the number of nodes in the network, a significant improvement compared to O(N(2)) for a greedy algorithm, which permits studying much larger networks. Our new strategy can be applied to any network topology and distribution of interdependencies, as well as any sequence of failures.

Comparing cluster-level dynamic treatment regimens using sequential, multiple assignment, randomized trials: Regression estimation and sample size considerations.

PubMed

NeCamp, Timothy; Kilbourne, Amy; Almirall, Daniel

2017-08-01

Cluster-level dynamic treatment regimens can be used to guide sequential treatment decision-making at the cluster level in order to improve outcomes at the individual or patient-level. In a cluster-level dynamic treatment regimen, the treatment is potentially adapted and re-adapted over time based on changes in the cluster that could be impacted by prior intervention, including aggregate measures of the individuals or patients that compose it. Cluster-randomized sequential multiple assignment randomized trials can be used to answer multiple open questions preventing scientists from developing high-quality cluster-level dynamic treatment regimens. In a cluster-randomized sequential multiple assignment randomized trial, sequential randomizations occur at the cluster level and outcomes are observed at the individual level. This manuscript makes two contributions to the design and analysis of cluster-randomized sequential multiple assignment randomized trials. First, a weighted least squares regression approach is proposed for comparing the mean of a patient-level outcome between the cluster-level dynamic treatment regimens embedded in a sequential multiple assignment randomized trial. The regression approach facilitates the use of baseline covariates which is often critical in the analysis of cluster-level trials. Second, sample size calculators are derived for two common cluster-randomized sequential multiple assignment randomized trial designs for use when the primary aim is a between-dynamic treatment regimen comparison of the mean of a continuous patient-level outcome. The methods are motivated by the Adaptive Implementation of Effective Programs Trial which is, to our knowledge, the first-ever cluster-randomized sequential multiple assignment randomized trial in psychiatry.

The Scale Sizes of Globular Clusters: Tidal Limits, Evolution, and the Outer Halo

NASA Astrophysics Data System (ADS)

Harris, William

2011-10-01

The physical factors that determine the linear sizes of massive star clusters are not well understood. Their scale sizes were long thought to be governed by the tidal field of the parent galaxy, but major questions are now emerging. Globular clusters, for example, have mean sizes nearly independent of location in the halo. Paradoxically, the recently discovered "anomalous extended clusters" in M31 and elsewhere have scale sizes that fit much better with tidal theory, but they are puzzlingly rare. Lastly, the persistent size difference between metal-poor and metal-rich clusters still lacks a quantitative explanation. Many aspects of these observations call for better modelling of dynamical evolution in the outskirts of clusters, and also their conditions of formation including the early rapid mass loss phase of protoclusters. A new set of accurate measurements of scale sizes and structural parameters, for a large and homogeneous set of globular clusters, would represent a major advance in this subject. We propose to carry out a {WFC3+ACS} imaging survey of the globular clusters in the supergiant Virgo elliptical M87 to cover the complete run of the halo. M87 is an optimum target system because of its huge numbers of clusters and HST's ability to resolve the cluster profiles accurately. We will derive cluster effective radii, central concentrations, luminosities, and colors for more than 4000 clusters using PSF-convolved King-model profile fitting. In parallel, we are developing theoretical tools to model the expected distribution of cluster sizes versus galactocentric distance as functions of cluster mass, concentration, and orbital anisotropy.

Study on the utility of a statewide counselling programme for improving mortality outcomes of patients with Staphylococcus aureus bacteraemia in Thuringia (SUPPORT): a study protocol of a cluster-randomised crossover trial.

PubMed

Weis, S; Hagel, S; Schmitz, R P H; Scherag, A; Brunkhorst, F M; Forstner, C; Löffler, B; Pletz, M W

2017-04-08

Staphylococcus aureus bacteraemia (SAB) is a frequent infection with high mortality rates. It requires specific diagnostic and therapeutic management such as prolonged intravenous administration of antibiotics and aggressive search for and control of infectious sources. Underestimation of disease severity frequently results in delayed or inappropriate management of patients with SAB leading to increased mortality rates. According to observational studies, patient counselling by infectious disease consultants (IDC) improves survival and reduces the length of hospital stay as well as complication rates. In many countries, IDC are available only in some tertiary hospitals. In this trial, we aim to demonstrate that the outcome of patients with SAB in small and medium size hospitals that do not employ IDC can be improved by unsolicited ID phone counselling. The SUPPORT trial will be the first cluster-randomised controlled multicentre trial addressing this question. SUPPORT is a single-blinded, multicentre interventional, cluster-randomised, controlled crossover trial with a minimum of 15 centres that will include 250 patients with SAB who will receive unsolicited IDC counselling and 250 who will receive standard of care. Reporting of SAB will be conducted by an electronic real-time blood culture registry established for the German Federal state of Thuringia (ALERTSNet) or directly by participating centres in order to minimise time delay before counselling. Mortality, disease course and complications will be monitored for 90 days with 30-day all-cause mortality rates as the primary outcome. Generalised linear mixed modelling will be used to detect the difference between the intervention sequences. We expect improved outcome of patients with SAB after IDC. We obtained ethics approval from the Ethics committee of the Jena University Hospital and from the Ethics committee of the State Chamber of Physicians of Thuringia. Results will be published in a peer-reviewed journal and additionally disseminated through public media. DRKS00010135. 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/.

Establishing Ebola Virus Disease (EVD) diagnostics using GeneXpert technology at a mobile laboratory in Liberia: Impact on outbreak response, case management and laboratory systems strengthening

PubMed Central

Condell, Orla; Wasunna, Christine; Kpaka, Jonathan; Zwizwai, Ruth; Nuha, Mahmood; Fallah, Mosoka; Freeman, Maxwell; Harris, Victoria; Miller, Mark; Baller, April; Massaquoi, Moses; Katawera, Victoria; Saindon, John; Bemah, Philip; Hamblion, Esther; Castle, Evelyn; Williams, Desmond; Gasasira, Alex; Nyenswah, Tolbert

2018-01-01

The 2014–16 Ebola Virus Disease (EVD) outbreak in West Africa highlighted the necessity for readily available, accurate and rapid diagnostics. The magnitude of the outbreak and the re-emergence of clusters of EVD cases following the declaration of interrupted transmission in Liberia, reinforced the need for sustained diagnostics to support surveillance and emergency preparedness. We describe implementation of the Xpert Ebola Assay, a rapid molecular diagnostic test run on the GeneXpert platform, at a mobile laboratory in Liberia and the subsequent impact on EVD outbreak response, case management and laboratory system strengthening. During the period of operation, site coordination, management and operational capacity was supported through a successful collaboration between Ministry of Health (MoH), World Health Organization (WHO) and international partners. A team of Liberian laboratory technicians were trained to conduct EVD diagnostics and the laboratory had capacity to test 64–100 blood specimens per day. Establishment of the laboratory significantly increased the daily testing capacity for EVD in Liberia, from 180 to 250 specimens at a time when the effectiveness of the surveillance system was threatened by insufficient diagnostic capacity. During the 18 months of operation, the laboratory tested a total of 9,063 blood specimens, including 21 EVD positives from six confirmed cases during two outbreaks. Following clearance of the significant backlog of untested EVD specimens in November 2015, a new cluster of EVD cases was detected at the laboratory. Collaboration between surveillance and laboratory coordination teams during this and a later outbreak in March 2016, facilitated timely and targeted response interventions. Specimens taken from cases during both outbreaks were analysed at the laboratory with results informing clinical management of patients and discharge decisions. The GeneXpert platform is easy to use, has relatively low running costs and can be integrated into other national diagnostic algorithms. The technology has on average a 2-hour sample-to-result time and allows for single specimen testing to overcome potential delays of batching. This model of a mobile laboratory equipped with Xpert Ebola test, staffed by local laboratory technicians, could serve to strengthen outbreak preparedness and response for future outbreaks of EVD in Liberia and the region. PMID:29304039

Establishing Ebola Virus Disease (EVD) diagnostics using GeneXpert technology at a mobile laboratory in Liberia: Impact on outbreak response, case management and laboratory systems strengthening.

PubMed

Raftery, Philomena; Condell, Orla; Wasunna, Christine; Kpaka, Jonathan; Zwizwai, Ruth; Nuha, Mahmood; Fallah, Mosoka; Freeman, Maxwell; Harris, Victoria; Miller, Mark; Baller, April; Massaquoi, Moses; Katawera, Victoria; Saindon, John; Bemah, Philip; Hamblion, Esther; Castle, Evelyn; Williams, Desmond; Gasasira, Alex; Nyenswah, Tolbert

2018-01-01

The 2014-16 Ebola Virus Disease (EVD) outbreak in West Africa highlighted the necessity for readily available, accurate and rapid diagnostics. The magnitude of the outbreak and the re-emergence of clusters of EVD cases following the declaration of interrupted transmission in Liberia, reinforced the need for sustained diagnostics to support surveillance and emergency preparedness. We describe implementation of the Xpert Ebola Assay, a rapid molecular diagnostic test run on the GeneXpert platform, at a mobile laboratory in Liberia and the subsequent impact on EVD outbreak response, case management and laboratory system strengthening. During the period of operation, site coordination, management and operational capacity was supported through a successful collaboration between Ministry of Health (MoH), World Health Organization (WHO) and international partners. A team of Liberian laboratory technicians were trained to conduct EVD diagnostics and the laboratory had capacity to test 64-100 blood specimens per day. Establishment of the laboratory significantly increased the daily testing capacity for EVD in Liberia, from 180 to 250 specimens at a time when the effectiveness of the surveillance system was threatened by insufficient diagnostic capacity. During the 18 months of operation, the laboratory tested a total of 9,063 blood specimens, including 21 EVD positives from six confirmed cases during two outbreaks. Following clearance of the significant backlog of untested EVD specimens in November 2015, a new cluster of EVD cases was detected at the laboratory. Collaboration between surveillance and laboratory coordination teams during this and a later outbreak in March 2016, facilitated timely and targeted response interventions. Specimens taken from cases during both outbreaks were analysed at the laboratory with results informing clinical management of patients and discharge decisions. The GeneXpert platform is easy to use, has relatively low running costs and can be integrated into other national diagnostic algorithms. The technology has on average a 2-hour sample-to-result time and allows for single specimen testing to overcome potential delays of batching. This model of a mobile laboratory equipped with Xpert Ebola test, staffed by local laboratory technicians, could serve to strengthen outbreak preparedness and response for future outbreaks of EVD in Liberia and the region.

Automated segmentation of white matter fiber bundles using diffusion tensor imaging data and a new density based clustering algorithm.

PubMed

Kamali, Tahereh; Stashuk, Daniel

2016-10-01

Robust and accurate segmentation of brain white matter (WM) fiber bundles assists in diagnosing and assessing progression or remission of neuropsychiatric diseases such as schizophrenia, autism and depression. Supervised segmentation methods are infeasible in most applications since generating gold standards is too costly. Hence, there is a growing interest in designing unsupervised methods. However, most conventional unsupervised methods require the number of clusters be known in advance which is not possible in most applications. The purpose of this study is to design an unsupervised segmentation algorithm for brain white matter fiber bundles which can automatically segment fiber bundles using intrinsic diffusion tensor imaging data information without considering any prior information or assumption about data distributions. Here, a new density based clustering algorithm called neighborhood distance entropy consistency (NDEC), is proposed which discovers natural clusters within data by simultaneously utilizing both local and global density information. The performance of NDEC is compared with other state of the art clustering algorithms including chameleon, spectral clustering, DBSCAN and k-means using Johns Hopkins University publicly available diffusion tensor imaging data. The performance of NDEC and other employed clustering algorithms were evaluated using dice ratio as an external evaluation criteria and density based clustering validation (DBCV) index as an internal evaluation metric. Across all employed clustering algorithms, NDEC obtained the highest average dice ratio (0.94) and DBCV value (0.71). NDEC can find clusters with arbitrary shapes and densities and consequently can be used for WM fiber bundle segmentation where there is no distinct boundary between various bundles. NDEC may also be used as an effective tool in other pattern recognition and medical diagnostic systems in which discovering natural clusters within data is a necessity. Copyright © 2016 Elsevier B.V. All rights reserved.

A Database of Young Star Clusters for Five Hundred Galaxies

NASA Astrophysics Data System (ADS)

Whitmore, Brad

2009-07-01

We propose to use the source lists developed as part of the Hubble Legacy Archive {HLA: Data Release 1 - February 8, 2008} to obtain a large {N 50 galaxies for multi-wavelength, N 500 galaxies for ACS F814W}, uniform {ACS + WFPC2 + NICMOS: DAOphot used for object detection} database of super star clusters in nearby star-forming galaxies in order to address two fundamental astronomical questions: 1} To what degree is the cluster luminosity {and mass} function of star clusters universal ? 2} What fraction of super star clusters are "missing" in optical studies {i.e., are hidden by dust}? This database will also support comparisons with new Monte-Carlo simulations that have independently been developed in the past few years by co-I Larsen and PI Whitmore, and will be used to test the Whitmore, Chandar, Fall {2007} framework designed to understand the demographics of star clusters in all star forming galaxies. The catalogs will increase the number of galaxies with measured mass and luminosity functions by an order of magnitude, and will provide a powerful new tool for comparative studies, both ours and the community's.

Visual Field Map Clusters in Macaque Extrastriate Visual Cortex

PubMed Central

Kolster, Hauke; Mandeville, Joseph B.; Arsenault, John T.; Ekstrom, Leeland B.; Wald, Lawrence L.; Vanduffel, Wim

2009-01-01

The macaque visual cortex contains more than 30 different functional visual areas, yet surprisingly little is known about the underlying organizational principles that structure its components into a complete ‘visual’ unit. A recent model of visual cortical organization in humans suggests that visual field maps are organized as clusters. Clusters minimize axonal connections between individual field maps that represent common visual percepts, with different clusters thought to carry out different functions. Experimental support for this hypothesis, however, is lacking in macaques, leaving open the question of whether it is unique to humans or a more general model for primate vision. Here we show, using high-resolution BOLD fMRI data in the awake monkey at 7 Tesla, that area MT/V5 and its neighbors are organized as a cluster with a common foveal representation and a circular eccentricity map. This novel view on the functional topography of area MT/V5 and satellites indicates that field map clusters are evolutionarily preserved and may be a fundamental organizational principle of the old world primate visual cortex. PMID:19474330

Genetic approaches of the Fe-S cluster biogenesis process in bacteria: Historical account, methodological aspects and future challenges.

PubMed

Py, Béatrice; Barras, Frédéric

2015-06-01

Since their discovery in the 50's, Fe-S cluster proteins have attracted much attention from chemists, biophysicists and biochemists. However, in the 80's they were joined by geneticists who helped to realize that in vivo maturation of Fe-S cluster bound proteins required assistance of a large number of factors defining complex multi-step pathways. The question of how clusters are formed and distributed in vivo has since been the focus of much effort. Here we review how genetics in discovering genes and investigating processes as they unfold in vivo has provoked seminal advances toward our understanding of Fe-S cluster biogenesis. The power and limitations of genetic approaches are discussed. As a final comment, we argue how the marriage of classic strategies and new high-throughput technologies should allow genetics of Fe-S cluster biology to be even more insightful in the future. This article is part of a Special Issue entitled: Fe/S proteins: Analysis, structure, function, biogenesis and diseases. Copyright © 2015 Elsevier B.V. All rights reserved.

Improving the Efficiency and Quality of the Value Assessment Process for Companion Diagnostic Tests: The Companion test Assessment Tool (CAT).

PubMed

Canestaro, William J; Pritchard, Daryl E; Garrison, Louis P; Dubois, Robert; Veenstra, David L

2015-08-01

Companion diagnostic tests (CDTs) have emerged as a vital technology in the effective use of an increasing number of targeted drug therapies. Although CDTs can offer a multitude of potential benefits, assessing their value within a health technology appraisal process can be challenging because of a complex array of factors that influence clinical and economic outcomes. To develop a user-friendly tool to assist managed care and other health care decision makers in screening companion tests and determining whether an intensive technology review is necessary and, if so, where the review should be focused to improve efficiency. First, we conducted a systematic literature review of CDT cost-effectiveness studies to identify value drivers. Second, we conducted key informant interviews with a diverse group of stakeholders to elicit feedback and solicit any additional value drivers and identify desirable attributes for an evidence review tool. A draft tool was developed based on this information that captured value drivers, usability features, and had a particular focus on practical use by nonexperts. Finally, the tool was pilot tested with test developers and managed care evidence evaluators to assess face-validity and usability. The tool was also evaluated using several diverse examples of existing companion diagnostics and refined accordingly. We identified 65 cost-effectiveness studies of companion diagnostic technologies. The following factors were most commonly identified as value drivers from our literature review: clinical validity of testing; efficacy, safety, and cost of baseline and alternative treatments; cost and mortality of health states; and biomarker prevalence and testing cost. Stakeholders identified the following additional factors that they believed influenced the overall value of a companion test: regulatory status, actionability, utility, and market penetration. These factors were used to maximize the efficiency of the evidence review process. Stakeholders also stated that a tool should be easy to use and time efficient. Cognitive interviews with stakeholders led to minor changes in the draft tool to improve usability and relevance. The final tool consisted of 4 sections: (1) eligibility for review (2 questions), (2) prioritization of review (3 questions), (3) clinical review (3 questions), and (4) economic review (5 questions). Although the evaluation of CDTs can be challenging because of limited evidence and the added complexity of incorporating a diagnostic test into drug treatment decisions, using a pragmatic tool to identify tests that do not need extensive evaluation may improve the efficiency and effectiveness of CDT value assessments.

Quality of Care Indicators in the AMEDD (Army Medical Department)

DTIC Science & Technology

1983-09-01

system is ’domn’ and f, the walk-in patiert as well as patie-ts who a-.’ seen outside the -alnUsing a diacnostic cluster techniq ;e which treatment...system to .1e connected to a word -rocessmng example. 20 diagnostic clusters acco~.nt for prograt" where:o the provider’s routine - edical 75. 2 .of...85 4’-85 48 10 X2 W IT7H ADMISSION HGB0O GMX OR HCT130% ’oo S 2 Wi’H POSOCPERA-;AE COMPLI)CATIOnN I C 3. 1 WITH REDUCELLOINDICES :.6 X W!TH PROGRESS

Myasthenia gravis: past, present, and future

PubMed Central

Conti-Fine, Bianca M.; Milani, Monica; Kaminski, Henry J.

2006-01-01

Myasthenia gravis (MG) is an autoimmune syndrome caused by the failure of neuromuscular transmission, which results from the binding of autoantibodies to proteins involved in signaling at the neuromuscular junction (NMJ). These proteins include the nicotinic AChR or, less frequently, a muscle-specific tyrosine kinase (MuSK) involved in AChR clustering. Much is known about the mechanisms that maintain self tolerance and modulate anti-AChR Ab synthesis, AChR clustering, and AChR function as well as those that cause neuromuscular transmission failure upon Ab binding. This insight has led to the development of improved diagnostic methods and to the design of specific immunosuppressive or immunomodulatory treatments. PMID:17080188

Cluster dynamics of pulse coupled oscillators

NASA Astrophysics Data System (ADS)

O'Keeffe, Kevin; Strogatz, Steven; Krapivsky, Paul

2015-03-01

We study the dynamics of networks of pulse coupled oscillators. Much attention has been devoted to the ultimate fate of the system: which conditions lead to a steady state in which all the oscillators are firing synchronously. But little is known about how synchrony builds up from an initially incoherent state. The current work addresses this question. Oscillators start to synchronize by forming clusters of different sizes that fire in unison. First pairs of oscillators, then triplets and so on. These clusters progressively grow by coalescing with others, eventually resulting in the fully synchronized state. We study the mean field model in which the coupling between oscillators is all to all. We use probabilistic arguments to derive a recursive set of evolution equations for these clusters. Using a generating function formalism, we derive simple equations for the moments of these clusters. Our results are in good agreement simulation. We then numerically explore the effects of non-trivial connectivity. Our results have potential application to ultra-low power ``impulse radio'' & sensor networks.

Gender differences in psychiatric disorders and clusters of self-esteem among detained adolescents.

PubMed

Van Damme, Lore; Colins, Olivier F; Vanderplasschen, Wouter

2014-12-30

Detained minors display substantial mental health needs. This study focused on two features (psychopathology and self-esteem) that have received considerable attention in the literature and clinical work, but have rarely been studied simultaneously in detained youths. The aims of this study were to examine gender differences in psychiatric disorders and clusters of self-esteem, and to test the hypothesis that the cluster of adolescents with lower (versus higher) levels of self-esteem have higher rates of psychiatric disorders. The prevalence of psychiatric disorders was assessed in 440 Belgian, detained adolescents using the Diagnostic Interview Schedule for Children-IV. Self-esteem was assessed using the Self-perception Profile for Adolescents. Model-based cluster analyses were performed to identify youths with lower and/or higher levels of self-esteem across several domains. Girls have higher rates for most psychiatric disorders and lower levels of self-esteem than boys. A higher number of clusters was identified in boys (four) than girls (three). Generally, the cluster of adolescents with lower (versus higher) levels of self-esteem had a higher prevalence of psychiatric disorders. These results suggest that the detection of low levels of self-esteem in adolescents, especially girls, might help clinicians to identify a subgroup of detained adolescents with the highest prevalence of psychopathology.

Kinetics of copper growth on graphene revealed by time-resolved small-angle x-ray scattering

NASA Astrophysics Data System (ADS)

Hodas, M.; Siffalovic, P.; Jergel, M.; Pelletta, M.; Halahovets, Y.; Vegso, K.; Kotlar, M.; Majkova, E.

2017-01-01

Metal growth on graphene has many applications. Transition metals are known to favor three-dimensional (3D) cluster growth on graphene. Copper is of particular interest for cost-effective surface-supported catalysis applications and as a contact material in electronics. This paper presents an in situ real-time study of Cu growth kinetics on graphene covering all stages preceding formation of a continuous film performed by laboratory-based grazing-incidence small-angle x-ray scattering (GISAXS) technique. In particular, nucleation and 3D cluster growth, coalescence, and percolation stages were identified. The cluster nucleation saturates after reaching a density of 1012c m-2 at ≈1 monolayer thickness. A Kratky plot and a paracrystal model with cumulative structural disorder were necessary to evaluate properly cluster growth and coalescence, respectively. The power law scaling constants 0.27 ±0.05 and 0.81 ±0.02 of the temporal evolution of Cu cluster size suggest the growth of isolated clusters and dynamic cluster coalescence keeping the cluster shape, respectively. Coalescence and percolation thresholds occur at Cu thicknesses of 2 ±0.4 and 8.8 ±0.7 nm , respectively. This paper demonstrates the potential of laboratory-based in situ GISAXS as a vital diagnostic tool for tailoring a large variety of Cu nanostructures on graphene based on an in situ Cu growth monitoring which is applicable in a broad range of deposition times.

Clusters of midlife women by physical activity and their racial/ethnic differences.

PubMed

Im, Eun-Ok; Ko, Young; Chee, Eunice; Chee, Wonshik; Mao, Jun James

2017-04-01

The purpose of this study was to identify clusters of midlife women by physical activity and to determine racial/ethnic differences in physical activities in each cluster. This was a secondary analysis of the data from 542 women (157 non-Hispanic [NH] Whites, 127 Hispanics, 135 NH African Americans, and 123 NH Asian) in a larger Internet study on midlife women's attitudes toward physical activity. The instruments included the Barriers to Health Activities Scale, the Physical Activity Assessment Inventory, the Questions on Attitudes toward Physical Activity, Subjective Norm, Perceived Behavioral Control, and Behavioral Intention, and the Kaiser Physical Activity Survey. The data were analyzed using hierarchical cluster analyses, analysis of variance, and multinominal logistic analyses. A three-cluster solution was adopted: cluster 1 (high active living and sports/exercise activity group; 48%), cluster 2 (high household/caregiving and occupational activity group; 27%), and cluster 3 (low active living and sports/exercise activity group; 26%). There were significant racial/ethnic differences in occupational activities of clusters 1 and 3 (all P < 0.01). Compared with cluster 1, cluster 2 tended to have lower family income, less access to health care, higher unemployment, higher perceived barriers scores, and lower social influences scores (all P < 0.01). Compared with cluster 1, cluster 3 tended to have greater obesity, less access to health care, higher perceived barriers scores, more negative attitudes toward physical activity, and lower self-efficacy scores (all P < 0.01). Midlife women's unique patterns of physical activity and their associated factors need to be considered in future intervention development.

Clusters of Midlife Women by Physical Activity and Their Racial/Ethnic Differences

PubMed Central

Im, Eun-Ok; Ko, Young; Chee, Eunice; Chee, Wonshik; Mao, Jun James

2016-01-01

Objective The purpose of this study was to identify clusters of midlife women by physical activity and to determine racial/ethnic differences in physical activities in each cluster. Methods This was a secondary analysis of the data from 542 women (157 Non-Hispanic [NH] Whites, 127 Hispanics, 135 NH African Americans, and 123 NH Asian) in a larger Internet study on midlife women’s attitudes toward physical activity. The instruments included the Barriers to Health Activities Scale, the Physical Activity Assessment Inventory, the Questions on Attitudes toward Physical Activity, Subjective Norm, Perceived Behavioral Control, and Behavioral Intention, and the Kaiser Physical Activity Survey. The data were analyzed using hierarchical cluster analyses, ANOVA, and multinominal logistic analyses. Results A three cluster solution was adopted: Cluster 1 (high active living and sports/exercise activity group; 48%), Cluster 2 (high household/caregiving and occupational activity group; 27%), and Cluster 3 (low active living and sports/exercise activity group; 26%). There were significant racial/ethnic differences in occupational activities of Clusters 1 and 3 (all p<.01). Compared with Cluster 1, Cluster 2 tended to have lower family income, less access to health care, higher unemployment, higher perceived barriers scores, and lower social influences scores (all p<.01). Compared with Cluster 1, Cluster 3 tended to have greater obesity, less access to health care, higher perceived barriers scores, more negative attutides toward physical activity, and lower self-efficacy scores (all p<.01). Conclusions Midlife women’s unique patterns of physical activity and their associated factors need to be considered in future intervention development. PMID:27846052

Method for exploratory cluster analysis and visualisation of single-trial ERP ensembles.

PubMed

Williams, N J; Nasuto, S J; Saddy, J D

2015-07-30

The validity of ensemble averaging on event-related potential (ERP) data has been questioned, due to its assumption that the ERP is identical across trials. Thus, there is a need for preliminary testing for cluster structure in the data. We propose a complete pipeline for the cluster analysis of ERP data. To increase the signal-to-noise (SNR) ratio of the raw single-trials, we used a denoising method based on Empirical Mode Decomposition (EMD). Next, we used a bootstrap-based method to determine the number of clusters, through a measure called the Stability Index (SI). We then used a clustering algorithm based on a Genetic Algorithm (GA) to define initial cluster centroids for subsequent k-means clustering. Finally, we visualised the clustering results through a scheme based on Principal Component Analysis (PCA). After validating the pipeline on simulated data, we tested it on data from two experiments - a P300 speller paradigm on a single subject and a language processing study on 25 subjects. Results revealed evidence for the existence of 6 clusters in one experimental condition from the language processing study. Further, a two-way chi-square test revealed an influence of subject on cluster membership. Our analysis operates on denoised single-trials, the number of clusters are determined in a principled manner and the results are presented through an intuitive visualisation. Given the cluster structure in some experimental conditions, we suggest application of cluster analysis as a preliminary step before ensemble averaging. Copyright © 2015 Elsevier B.V. All rights reserved.

Exploring Careers.

ERIC Educational Resources Information Center

Bureau of Labor Statistics (DOL), Washington, DC.

This document contains a career education resource guide for junior high school students which is designed to build career awareness by means of occupational narratives, evaluative questions, activities, and career games. The information is presented in the following fourteen occupational clusters: industrial production occupations; office…

Diagnostics for invasive Salmonella infections: current challenges and future directions

PubMed Central

Andrews, Jason R.; Ryan, Edward T.

2015-01-01

Invasive Salmonellosis caused by Salmonella enterica serotype Typhi or Paratyphi A, B, C, or invasive non-typhoidal Salmonella serotypes, is an immensely important disease cluster for which reliable, rapid diagnostic tests are not available. Blood culture remains the gold standard but is insensitive, slow, and resource-intensive. Existing molecular diagnostics have poor sensitivity due to the low organism burden in bodily fluids. Commercially available serologic tests for typhoidal Salmonella have had limited sensitivity and specificity. In high burden, resource-limited settings, reliance on clinical diagnosis or inaccurate tests often results in frequent, unnecessary treatment, which contributes selective pressure for the emergence of antimicrobial resistance. This practice also results in inadequate therapy for other etiologies of acute febrile illnesses, including leptospirosis and rickettsial infections. A number of novel serologic, molecular, transcriptomic and metabolomic approaches to diagnostics are under development. Target product profiles that outline specific needs may focus development and investment, and establish benchmarks for accuracy, cost, speed, and portability of new diagnostics. Of note, a critical barrier to diagnostic assay rollout will be the low cost and low perceived harm of empiric therapy on behalf of providers and patients, which leaves few perceived incentives to utilize diagnostics. Approaches that align incentives with societal goals of limiting inappropriate antimicrobial use, such as subsidizing diagnostics, may be essential for stimulating development and uptake of such assays in resource-limited settings. New diagnostics for invasive Salmonellosis should be developed and deployed alongside diagnostics for alternative etiologies of acute febrile illnesses to improve targeted use of antibiotics. PMID:25937611

Diagnostics for invasive Salmonella infections: Current challenges and future directions.

PubMed

Andrews, Jason R; Ryan, Edward T

2015-06-19

Invasive Salmonellosis caused by Salmonella enterica serotype Typhi or Paratyphi A, B, C, or invasive non-typhoidal Salmonella serotypes, is an immensely important disease cluster for which reliable, rapid diagnostic tests are not available. Blood culture remains the gold standard but is insensitive, slow, and resource-intensive. Existing molecular diagnostics have poor sensitivity due to the low organism burden in bodily fluids. Commercially available serologic tests for typhoidal Salmonella have had limited sensitivity and specificity. In high burden, resource-limited settings, reliance on clinical diagnosis or inaccurate tests often results in frequent, unnecessary treatment, which contributes selective pressure for the emergence of antimicrobial resistance. This practice also results in inadequate therapy for other etiologies of acute febrile illnesses, including leptospirosis and rickettsial infections. A number of novel serologic, molecular, transcriptomic and metabolomic approaches to diagnostics are under development. Target product profiles that outline specific needs may focus development and investment, and establish benchmarks for accuracy, cost, speed, and portability of new diagnostics. Of note, a critical barrier to diagnostic assay rollout will be the low cost and low perceived harm of empiric therapy on behalf of providers and patients, which leaves few perceived incentives to utilize diagnostics. Approaches that align incentives with societal goals of limiting inappropriate antimicrobial use, such as subsidizing diagnostics, may be essential for stimulating development and uptake of such assays in resource-limited settings. New diagnostics for invasive Salmonellosis should be developed and deployed alongside diagnostics for alternative etiologies of acute febrile illnesses to improve targeted use of antibiotics. Copyright © 2015. Published by Elsevier Ltd.

Korean immigrants' knowledge of heart attack symptoms and risk factors.

PubMed

Hwang, Seon Y; Ryan, Catherine J; Zerwic, Julie Johnson

2008-02-01

This study assessed the knowledge of heart attack symptoms and risk factors in a convenience sample of Korean immigrants. A total of 116 Korean immigrants in a Midwestern metropolitan area were recruited through Korean churches and markets. Knowledge was assessed using both open-ended questions and a structured questionnaire. Latent class cluster analysis and Chi-square tests were used to analyze the data. About 76% of the sample had at least one self-reported risk factor for cardiovascular disease. Using an open-ended question, the majority of subjects could only identify one symptom. In the structured questionnaire, subjects identified a mean of 5 out of 10 heart attack symptoms and a mean of 5 out of 9 heart attack risk factors. Latent class cluster analysis showed that subjects clustered into two groups for both risk factors and symptoms: a high knowledge group and a low knowledge group. Subjects who clustered into the risk factor low knowledge group (48%) were more likely than the risk factor high knowledge group to be older than 65 years, to have lower education, to not know to use 911 when a heart attack occurred, and to not have a family history of heart attack. Korean immigrants' knowledge of heart attack symptoms and risk factors was variable, ranging from high to very low. Education should be focused on those at highest risk for a heart attack, which includes the elderly and those with risk factors.

NeAT: a toolbox for the analysis of biological networks, clusters, classes and pathways.

PubMed

Brohée, Sylvain; Faust, Karoline; Lima-Mendez, Gipsi; Sand, Olivier; Janky, Rekin's; Vanderstocken, Gilles; Deville, Yves; van Helden, Jacques

2008-07-01

The network analysis tools (NeAT) (http://rsat.ulb.ac.be/neat/) provide a user-friendly web access to a collection of modular tools for the analysis of networks (graphs) and clusters (e.g. microarray clusters, functional classes, etc.). A first set of tools supports basic operations on graphs (comparison between two graphs, neighborhood of a set of input nodes, path finding and graph randomization). Another set of programs makes the connection between networks and clusters (graph-based clustering, cliques discovery and mapping of clusters onto a network). The toolbox also includes programs for detecting significant intersections between clusters/classes (e.g. clusters of co-expression versus functional classes of genes). NeAT are designed to cope with large datasets and provide a flexible toolbox for analyzing biological networks stored in various databases (protein interactions, regulation and metabolism) or obtained from high-throughput experiments (two-hybrid, mass-spectrometry and microarrays). The web interface interconnects the programs in predefined analysis flows, enabling to address a series of questions about networks of interest. Each tool can also be used separately by entering custom data for a specific analysis. NeAT can also be used as web services (SOAP/WSDL interface), in order to design programmatic workflows and integrate them with other available resources.

To center or not to center? Investigating inertia with a multilevel autoregressive model.

PubMed

Hamaker, Ellen L; Grasman, Raoul P P P

2014-01-01

Whether level 1 predictors should be centered per cluster has received considerable attention in the multilevel literature. While most agree that there is no one preferred approach, it has also been argued that cluster mean centering is desirable when the within-cluster slope and the between-cluster slope are expected to deviate, and the main interest is in the within-cluster slope. However, we show in a series of simulations that if one has a multilevel autoregressive model in which the level 1 predictor is the lagged outcome variable (i.e., the outcome variable at the previous occasion), cluster mean centering will in general lead to a downward bias in the parameter estimate of the within-cluster slope (i.e., the autoregressive relationship). This is particularly relevant if the main question is whether there is on average an autoregressive effect. Nonetheless, we show that if the main interest is in estimating the effect of a level 2 predictor on the autoregressive parameter (i.e., a cross-level interaction), cluster mean centering should be preferred over other forms of centering. Hence, researchers should be clear on what is considered the main goal of their study, and base their choice of centering method on this when using a multilevel autoregressive model.

To center or not to center? Investigating inertia with a multilevel autoregressive model

PubMed Central

Hamaker, Ellen L.; Grasman, Raoul P. P. P.

2015-01-01

Whether level 1 predictors should be centered per cluster has received considerable attention in the multilevel literature. While most agree that there is no one preferred approach, it has also been argued that cluster mean centering is desirable when the within-cluster slope and the between-cluster slope are expected to deviate, and the main interest is in the within-cluster slope. However, we show in a series of simulations that if one has a multilevel autoregressive model in which the level 1 predictor is the lagged outcome variable (i.e., the outcome variable at the previous occasion), cluster mean centering will in general lead to a downward bias in the parameter estimate of the within-cluster slope (i.e., the autoregressive relationship). This is particularly relevant if the main question is whether there is on average an autoregressive effect. Nonetheless, we show that if the main interest is in estimating the effect of a level 2 predictor on the autoregressive parameter (i.e., a cross-level interaction), cluster mean centering should be preferred over other forms of centering. Hence, researchers should be clear on what is considered the main goal of their study, and base their choice of centering method on this when using a multilevel autoregressive model. PMID:25688215

Experimental nonlocality-based network diagnostics of multipartite entangled states.

PubMed

Ciampini, Mario A; Vigliar, Caterina; Cimini, Valeria; Paesani, Stefano; Sciarrino, Fabio; Crespi, Andrea; Corrielli, Giacomo; Osellame, Roberto; Mataloni, Paolo; Paternostro, Mauro; Barbieri, Marco

2017-12-07

We introduce a novel diagnostic scheme for multipartite networks of entangled particles, aimed at assessing the quality of the gates used for the engineering of their state. Using the information gathered from a set of suitably chosen multiparticle Bell tests, we identify conditions bounding the quality of the entangled bonds among the elements of a register. We illustrate the effectiveness of our proposal by characterizing a quantum resource engineered combining two-photon hyperentanglement and photonic-chip technology. Our approach opens up future studies on medium-sized networks due to the intrinsically modular nature of cluster states, and paves the way to section-by-section analysis of larger photonics resources.

Schizoaffective disorder--an ongoing challenge for psychiatric nosology.

PubMed

Jäger, M; Haack, S; Becker, T; Frasch, K

2011-04-01

Schizoaffective disorder is a common diagnosis in mental health services. The present article aims to provide an overview of diagnostic reliability, symptomatology, outcome, neurobiology and treatment of schizoaffective disorder. Literature was identified by searches in "Medline" and "Cochrane Library". The diagnosis of schizoaffective disorder has a low reliability. There are marked differences between the current diagnostic systems. With respect to psychopathological symptoms, no clear boundaries were found between schizophrenia, schizoaffective disorder and affective disorders. Common neurobiological factors were found across the traditional diagnostic categories. Schizoaffective disorder according to ICD-10 criteria, but not to DSM-IV criteria, shows a more favorable outcome than schizophrenia. With regard to treatment, only a small and heterogeneous database exists. Due to the low reliability and questionable validity there is a substantial need for revision and unification of the current diagnostic concepts of schizoaffective disorder. If future diagnostic systems return to Kraepelin's dichotomous classification of non-organic psychosis or adopt a dimensional diagnostic approach, schizoaffective disorder will disappear from the psychiatric nomenclature. A nosological model with multiple diagnostic entities, however, would be compatible with retaining the diagnostic category of schizoaffective disorder. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

COOL CORE CLUSTERS FROM COSMOLOGICAL SIMULATIONS

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

Rasia, E.; Borgani, S.; Murante, G.

2015-11-01

We present results obtained from a set of cosmological hydrodynamic simulations of galaxy clusters, aimed at comparing predictions with observational data on the diversity between cool-core (CC) and non-cool-core (NCC) clusters. Our simulations include the effects of stellar and active galactic nucleus (AGN) feedback and are based on an improved version of the smoothed particle hydrodynamics code GADGET-3, which ameliorates gas mixing and better captures gas-dynamical instabilities by including a suitable artificial thermal diffusion. In this Letter, we focus our analysis on the entropy profiles, the primary diagnostic we used to classify the degree of cool-coreness of clusters, and themore » iron profiles. In keeping with observations, our simulated clusters display a variety of behaviors in entropy profiles: they range from steadily decreasing profiles at small radii, characteristic of CC systems, to nearly flat core isentropic profiles, characteristic of NCC systems. Using observational criteria to distinguish between the two classes of objects, we find that they occur in similar proportions in both simulations and observations. Furthermore, we also find that simulated CC clusters have profiles of iron abundance that are steeper than those of NCC clusters, which is also in agreement with observational results. We show that the capability of our simulations to generate a realistic CC structure in the cluster population is due to AGN feedback and artificial thermal diffusion: their combined action allows us to naturally distribute the energy extracted from super-massive black holes and to compensate for the radiative losses of low-entropy gas with short cooling time residing in the cluster core.« less

Cool Core Clusters from Cosmological Simulations

NASA Astrophysics Data System (ADS)

Rasia, E.; Borgani, S.; Murante, G.; Planelles, S.; Beck, A. M.; Biffi, V.; Ragone-Figueroa, C.; Granato, G. L.; Steinborn, L. K.; Dolag, K.

2015-11-01

We present results obtained from a set of cosmological hydrodynamic simulations of galaxy clusters, aimed at comparing predictions with observational data on the diversity between cool-core (CC) and non-cool-core (NCC) clusters. Our simulations include the effects of stellar and active galactic nucleus (AGN) feedback and are based on an improved version of the smoothed particle hydrodynamics code GADGET-3, which ameliorates gas mixing and better captures gas-dynamical instabilities by including a suitable artificial thermal diffusion. In this Letter, we focus our analysis on the entropy profiles, the primary diagnostic we used to classify the degree of cool-coreness of clusters, and the iron profiles. In keeping with observations, our simulated clusters display a variety of behaviors in entropy profiles: they range from steadily decreasing profiles at small radii, characteristic of CC systems, to nearly flat core isentropic profiles, characteristic of NCC systems. Using observational criteria to distinguish between the two classes of objects, we find that they occur in similar proportions in both simulations and observations. Furthermore, we also find that simulated CC clusters have profiles of iron abundance that are steeper than those of NCC clusters, which is also in agreement with observational results. We show that the capability of our simulations to generate a realistic CC structure in the cluster population is due to AGN feedback and artificial thermal diffusion: their combined action allows us to naturally distribute the energy extracted from super-massive black holes and to compensate for the radiative losses of low-entropy gas with short cooling time residing in the cluster core.

Latent class analysis of diagnostic science assessment data using Bayesian networks

NASA Astrophysics Data System (ADS)

Steedle, Jeffrey Thomas

2008-10-01

Diagnostic science assessments seek to draw inferences about student understanding by eliciting evidence about the mental models that underlie students' reasoning about physical systems. Measurement techniques for analyzing data from such assessments embody one of two contrasting assessment programs: learning progressions and facet-based assessments. Learning progressions assume that students have coherent theories that they apply systematically across different problem contexts. In contrast, the facet approach makes no such assumption, so students should not be expected to reason systematically across different problem contexts. A systematic comparison of these two approaches is of great practical value to assessment programs such as the National Assessment of Educational Progress as they seek to incorporate small clusters of related items in their tests for the purpose of measuring depth of understanding. This dissertation describes an investigation comparing learning progression and facet models. Data comprised student responses to small clusters of multiple-choice diagnostic science items focusing on narrow aspects of understanding of Newtonian mechanics. Latent class analysis was employed using Bayesian networks in order to model the relationship between students' science understanding and item responses. Separate models reflecting the assumptions of the learning progression and facet approaches were fit to the data. The technical qualities of inferences about student understanding resulting from the two models were compared in order to determine if either modeling approach was more appropriate. Specifically, models were compared on model-data fit, diagnostic reliability, diagnostic certainty, and predictive accuracy. In addition, the effects of test length were evaluated for both models in order to inform the number of items required to obtain adequately reliable latent class diagnoses. Lastly, changes in student understanding over time were studied with a longitudinal model in order to provide educators and curriculum developers with a sense of how students advance in understanding over the course of instruction. Results indicated that expected student response patterns rarely reflected the assumptions of the learning progression approach. That is, students tended not to systematically apply a coherent set of ideas across different problem contexts. Even those students expected to express scientifically-accurate understanding had substantial probabilities of reporting certain problematic ideas. The learning progression models failed to make as many substantively-meaningful distinctions among students as the facet models. In statistical comparisons, model-data fit was better for the facet model, but the models were quite comparable on all other statistical criteria. Studying the effects of test length revealed that approximately 8 items are needed to obtain adequate diagnostic certainty, but more items are needed to obtain adequate diagnostic reliability. The longitudinal analysis demonstrated that students either advance in their understanding (i.e., switch to the more advanced latent class) over a short period of instruction or stay at the same level. There was no significant relationship between the probability of changing latent classes and time between testing occasions. In all, this study is valuable because it provides evidence informing decisions about modeling and reporting on student understanding, it assesses the quality of measurement available from short clusters of diagnostic multiple-choice items, and it provides educators with knowledge of the paths that student may take as they advance from novice to expert understanding over the course of instruction.

The Adjustment Disorder--New Module 20 as a Screening Instrument: Cluster Analysis and Cut-off Values.

PubMed

Lorenz, L; Bachem, R C; Maercker, A

2016-10-01

Adjustment disorder (AjD) is a transient mental health condition emerging after stressful life events. Its diagnostic criteria have recently been under revision which led to the development of the Adjustment Disorder--New Module 20 (ADNM-20) as a self-report assessment. To identify a threshold value for people at high risk for AjD. As part of a randomized controlled trial evaluating a self-help manual for burglary victims, the baseline data of all participants (n=80) were analyzed. Besides the ADNM-20, participants answered self-report questionnaires regarding the external variables post-traumatic stress disorder symptomatology, depression, anxiety, and stress levels. We used cluster analysis and ROC analysis to identify the most appropriate cut-off value. The cluster analysis identified three different subgroups. They differed in their level of AjD symptomatology from low to high symptom severity. The same pattern of impairment was found for the external variables. The ROC analysis testing the ADNM-20 sum scoreagainst the theory-based diagnostic algorithm, revealed an optimal cut-off score at 47.5 to distinguish between people at high risk for AjD and people at low risk. The ADNM-20 distinguishes between people with low, moderate, and high symptomatology. The recommendation for a cut-off score at 47.5 facilitates the use of the ADNM-20 in research and practice.

Task Analysis for Health Occupations. Cluster: Nursing. Occupation: Geriatric Aide. Education for Employment Task Lists.

ERIC Educational Resources Information Center

Lake County Area Vocational Center, Grayslake, IL.

This task analysis for nursing education provides performance standards, steps to be followed, knowledge required, attitudes to be developed, safety procedures, and equipment and supplies needed for 13 tasks performed by geriatric aides in the duty area of performing diagnostic measures and for 30 tasks in the duty area of providing therapeutic…

Communication. Kinetics of scavenging of small, nucleating clusters. First nucleation theorem and sum rules

DOE PAGES

Malila, Jussi; McGraw, Robert; Laaksonen, Ari; ...

2015-01-07

Despite recent advances in monitoring nucleation from a vapor at close-to-molecular resolution, the identity of the critical cluster, forming the bottleneck for the nucleation process, remains elusive. During past twenty years, the first nucleation theorem has been often used to extract the size of the critical cluster from nucleation rate measurements. However, derivations of the first nucleation theorem invoke certain questionable assumptions that may fail, e.g., in the case of atmospheric new particle formation, including absence of subcritical cluster losses and heterogeneous nucleation on pre-existing nanoparticles. Here we extend the kinetic derivation of the first nucleation theorem to give amore » general framework to include such processes, yielding sum rules connecting the size dependent particle formation and loss rates to the corresponding loss-free nucleation rate and the apparent critical size from a naïve application of the first nucleation theorem that neglects them.« less

A VLBI resolution of the Pleiades distance controversy.

PubMed

Melis, Carl; Reid, Mark J; Mioduszewski, Amy J; Stauffer, John R; Bower, Geoffrey C

2014-08-29

Because of its proximity and its youth, the Pleiades open cluster of stars has been extensively studied and serves as a cornerstone for our understanding of the physical properties of young stars. This role is called into question by the "Pleiades distance controversy," wherein the cluster distance of 120.2 ± 1.5 parsecs (pc) as measured by the optical space astrometry mission Hipparcos is significantly different from the distance of 133.5 ± 1.2 pc derived with other techniques. We present an absolute trigonometric parallax distance measurement to the Pleiades cluster that uses very long baseline radio interferometry (VLBI). This distance of 136.2 ± 1.2 pc is the most accurate and precise yet presented for the cluster and is incompatible with the Hipparcos distance determination. Our results cement existing astrophysical models for Pleiades-age stars. Copyright © 2014, American Association for the Advancement of Science.

Optimal mode transformations for linear-optical cluster-state generation

DOE PAGES

Uskov, Dmitry B.; Lougovski, Pavel; Alsing, Paul M.; ...

2015-06-15

In this paper, we analyze the generation of linear-optical cluster states (LOCSs) via sequential addition of one and two qubits. Existing approaches employ the stochastic linear-optical two-qubit controlled-Z (CZ) gate with success rate of 1/9 per operation. The question of optimality of the CZ gate with respect to LOCS generation has remained open. We report that there are alternative schemes to the CZ gate that are exponentially more efficient and show that sequential LOCS growth is indeed globally optimal. We find that the optimal cluster growth operation is a state transformation on a subspace of the full Hilbert space. Finally,more » we show that the maximal success rate of postselected entangling n photonic qubits or m Bell pairs into a cluster is (1/2) n-1 and (1/4) m-1, respectively, with no ancilla photons, and we give an explicit optical description of the optimal mode transformations.« less

Freud with Charcot: Freud's discovery and the question of diagnosis.

PubMed

Lepoutre, Thomas; Villa, François

2015-04-01

Although Charcot's seminal role in influencing Freud is widely stated, although Freud's trip to Paris to study with Charcot is well recognized as pivotal in his shift from neurological to psychopathological work, a key fact of the Freudian heuristic remains largely underestimated: namely, that Freud's psychopathological breakthrough, which gave birth to psychoanalysis, cannot be separated from his 'diagnostic preoccupation', which is a crucial and at times the first organizing principle of his earliest writings. The purpose of this article is therefore to reopen the question of diagnosis by following its development along the path leading from Charcot to Freud. The authors demonstrate that Freud's careful attention to diagnostic distinctions follows strictly in the direction of Charcot's 'nosological method'. More importantly, the article intends to identify the precise way in which his ideas operate in Freud's own work, in order to understand how Freud reinvests them to forge his own nosological system. If the authors trace the destiny of Charcot's lessons as they reach Freud's hands, it is the importance granted to mixed neuroses in Freud's psychopathology that allows them to pinpoint the role played by the diagnostic process in the rationality of psychoanalysis. Copyright © 2014 Institute of Psychoanalysis.

[Conceptual and methodological issues involved in the research field of diagnostic reasoning].

PubMed

Di Persia, Francisco N

2016-05-01

The psychopathological field is crossed by dilemmas that put in question its methodological, conceptual and philosophical filiations. Since the early works of Ey and Jaspers until recent work of Berrios it has been in question the position psychopathology has in the field of medicine in general, and in the field of psychiatry in particular, especially if it should follow the principles of natural science or if it has an autonomous position between them. This debate has led to two opposing positions facing two different models of psychopathology: the biomedical model and the socio-constructionist model. In this work it is proposed to review the scope and difficulties involved in each model following two central axes: diagnostic reasoning and mental illness conceptual problem. Later, as a synthesis of the analysis proposed they are identified central concepts of each model that could allow the development of a hybrid model in psychopathology; in between them the comprehensive framework employed in symptoms recognition and the social component that characterizes it are highlighted. As a conclusion, these concepts are proposed as central aspects for conceptual and methodological clarification of the research field of diagnostic reasoning in psychopathology.

Gene expression profiles of breast biopsies from healthy women identify a group with claudin-low features.

PubMed

Haakensen, Vilde D; Lingjaerde, Ole Christian; Lüders, Torben; Riis, Margit; Prat, Aleix; Troester, Melissa A; Holmen, Marit M; Frantzen, Jan Ole; Romundstad, Linda; Navjord, Dina; Bukholm, Ida K; Johannesen, Tom B; Perou, Charles M; Ursin, Giske; Kristensen, Vessela N; Børresen-Dale, Anne-Lise; Helland, Aslaug

2011-11-01

Increased understanding of the variability in normal breast biology will enable us to identify mechanisms of breast cancer initiation and the origin of different subtypes, and to better predict breast cancer risk. Gene expression patterns in breast biopsies from 79 healthy women referred to breast diagnostic centers in Norway were explored by unsupervised hierarchical clustering and supervised analyses, such as gene set enrichment analysis and gene ontology analysis and comparison with previously published genelists and independent datasets. Unsupervised hierarchical clustering identified two separate clusters of normal breast tissue based on gene-expression profiling, regardless of clustering algorithm and gene filtering used. Comparison of the expression profile of the two clusters with several published gene lists describing breast cells revealed that the samples in cluster 1 share characteristics with stromal cells and stem cells, and to a certain degree with mesenchymal cells and myoepithelial cells. The samples in cluster 1 also share many features with the newly identified claudin-low breast cancer intrinsic subtype, which also shows characteristics of stromal and stem cells. More women belonging to cluster 1 have a family history of breast cancer and there is a slight overrepresentation of nulliparous women in cluster 1. Similar findings were seen in a separate dataset consisting of histologically normal tissue from both breasts harboring breast cancer and from mammoplasty reductions. This is the first study to explore the variability of gene expression patterns in whole biopsies from normal breasts and identified distinct subtypes of normal breast tissue. Further studies are needed to determine the specific cell contribution to the variation in the biology of normal breasts, how the clusters identified relate to breast cancer risk and their possible link to the origin of the different molecular subtypes of breast cancer.

Childhood apraxia of speech: A survey of praxis and typical speech characteristics.

PubMed

Malmenholt, Ann; Lohmander, Anette; McAllister, Anita

2017-07-01

The purpose of this study was to investigate current knowledge of the diagnosis childhood apraxia of speech (CAS) in Sweden and compare speech characteristics and symptoms to those of earlier survey findings in mainly English-speakers. In a web-based questionnaire 178 Swedish speech-language pathologists (SLPs) anonymously answered questions about their perception of typical speech characteristics for CAS. They graded own assessment skills and estimated clinical occurrence. The seven top speech characteristics reported as typical for children with CAS were: inconsistent speech production (85%), sequencing difficulties (71%), oro-motor deficits (63%), vowel errors (62%), voicing errors (61%), consonant cluster deletions (54%), and prosodic disturbance (53%). Motor-programming deficits described as lack of automatization of speech movements were perceived by 82%. All listed characteristics were consistent with the American Speech-Language-Hearing Association (ASHA) consensus-based features, Strand's 10-point checklist, and the diagnostic model proposed by Ozanne. The mode for clinical occurrence was 5%. Number of suspected cases of CAS in the clinical caseload was approximately one new patient/year and SLP. The results support and add to findings from studies of CAS in English-speaking children with similar speech characteristics regarded as typical. Possibly, these findings could contribute to cross-linguistic consensus on CAS characteristics.

PTSD’s risky behavior criterion: Relation with DSM-5 PTSD symptom clusters and psychopathology

PubMed Central

Contractor, Ateka A.; Weiss, Nicole H.; Dranger, Paula; Ruggero, Camilo; Armour, Cherie

2017-01-01

A new symptom criterion of reckless and self-destructive behaviors (E2) was recently added to posttraumatic stress disorder’s (PTSD) diagnostic criteria in DSM-5, which is unsurprising given the well-established relation between PTSD and risky behaviors. Researchers have questioned the significance and incremental validity of this symptom criterion within PTSD’s symptomatology. Unprecedented to our knowledge, we aim to compare trauma-exposed groups differing on their endorsement status of the risky behavior symptom on several psychopathology constructs (PTSD, depression, distress tolerance, rumination, anger). The sample included 123 trauma-exposed participants seeking mental health treatment (M age=35.70; 68.30% female) who completed self-report questionnaires assessing PTSD symptoms, depression, rumination, distress tolerance, and anger. Results of independent samples t-tests indicated that participants who endorsed the E2 criterion at a clinically significant level reported significantly greater PTSD subscale severity; depression severity; rumination facets of repetitive thoughts, counterfactual thinking, and problem-focused thinking; and anger reactions; and significantly less absorption and regulation (distress tolerance facets) compared to participants who did not endorse the E2 criterion at a clinically significant level. Results indicate the utility of the E2 criterion in identifying trauma-exposed individual with greater posttraumatic distress, and emphasize the importance of targeting such behaviors in treatment. PMID:28285248

Identification of pathogenic fungi with an optoelectronic nose

PubMed Central

Zhang, Yinan; Askim, Jon R.; Zhong, Wenxuan; Orlean, Peter; Suslick, Kenneth S.

2014-01-01

Human fungal infections have gained recent notoriety following contamination of pharmaceuticals in the compounding process. Such invasive infections are a more serious global problem, especially for immunocompromised patients. While superficial fungal infections are common and generally curable, invasive fungal infections are often life-threatening and much harder to diagnose and treat. Despite the increasing awareness of the situation’s severity, currently available fungal diagnostic methods cannot always meet diagnostic needs, especially for invasive fungal infections. Volatile organic compounds produced by fungi provide an alternative diagnostic approach for identification of fungal strains. We report here an optoelectronic nose based on a disposable colorimetric sensor array capable of rapid differentiation and identification of pathogenic fungi based on their metabolic profiles of emitted volatiles. The sensor arrays were tested with 12 human pathogenic fungal strains grown on standard agar medium. Array responses were monitored with an ordinary flatbed scanner. All fungal strains gave unique composite responses within 3 hours and were correctly clustered using hierarchical cluster analysis. A standard jackknifed linear discriminant analysis gave a classification accuracy of 94% for 155 trials. Tensor discriminant analysis, which takes better advantage of the high dimensionality of the sensor array data, gave a classification accuracy of 98.1%. The sensor array is also able to observe metabolic changes in growth patterns upon the addition of fungicides, and this provides a facile screening tool for determining fungicide efficacy for various fungal strains in real time. PMID:24570999

A cluster of diagnostic Hsp68 amino acid sites that are identified in Drosophila from the melanogaster species group are concentrated around beta-sheet residues involved with substrate binding.

PubMed

Kellett, Mark; McKechnie, Stephen W

2005-04-01

The coding region of the hsp68 gene has been amplified, cloned, and sequenced from 10 Drosophila species, 5 from the melanogaster subgroup and 5 from the montium subgroup. When the predicted amino acid sequences are compared with available Hsp70 sequences, patterns of conservation suggest that the C-terminal region should be subdivided according to predominant secondary structure. Conservation levels between Hsp68 and Hsp70 proteins were high in the N-terminal ATPase and adjacent beta-sheet domains, medium in the alpha-helix domain, and low in the C-terminal mobile domain (78%, 72%, 41%, and 21% identity, respectively). A number of amino acid sites were found to be "diagnostic" for Hsp68 (28 of approximately 635 residues). A few of these occur in the ATPase domain (385 residues) but most (75%) are concentrated in the beta-sheet and alpha-helix domains (34% of the protein) with none in the short mobile domain. Five of the diagnostic sites in the beta-sheet domain are clustered around, but not coincident with, functional sites known to be involved in substrate binding. Nearly all of the Hsp70 family length variation occurs in the mobile domain. Within montium subgroup species, 2 nearly identical hsp68 PCR products that differed in length are either different alleles or products of an ancestral hsp68 duplication.

Substance use disorders in a sample of Canadian patients with chronic mental illness.

PubMed

Toner, B B; Gillies, L A; Prendergast, P; Cote, F H; Browne, C

1992-03-01

In a study designed to investigate the pattern of substance use disorders among a group of chronic mentally ill patients in Toronto, 102 patients completed the Structured Clinical Interview for DSM-III-R and a modified substance-use-disorder module of the Diagnostic Interview Schedule. Forty percent of the sample met criteria for substance use disorders, and 49 percent for personality disorder. Among patients with personality disorder, all those with a personality disorder in cluster B (that is, with antisocial, borderline, histrionic, or narcissistic personality disorder) had a substance use disorder, while the majority of patients in cluster A and cluster C were not substance abusers. In the overall sample, the group with substance use disorders was significantly younger than the group without. In contrast to findings of previous studies, women met criteria for substance use disorders as often as men did.

Underrecognition of Dengue during 2013 Epidemic in Luanda, Angola

PubMed Central

Moreira, Rosa; Soares, Maria José; Miguel da Costa, Lúis; Mann, Jennifer; DeLorey, Mark; Hunsperger, Elizabeth; Muñoz-Jordán, Jorge L.; Colón, Candimar; Margolis, Harold S.; de Caravalho, Adelaide; Tomashek, Kay M.

2015-01-01

During the 2013 dengue epidemic in Luanda, Angola, 811 dengue rapid diagnostic test–positive cases were reported to the Ministry of Health. To better understand the magnitude of the epidemic and identify risk factors for dengue virus (DENV) infection, we conducted cluster surveys around households of case-patients and randomly selected households 6 weeks after the peak of the epidemic. Of 173 case cluster participants, 16 (9%) exhibited evidence of recent DENV infection. Of 247 random cluster participants, 25 (10%) had evidence of recent DENV infection. Of 13 recently infected participants who had a recent febrile illness, 7 (54%) had sought medical care, and 1 (14%) was hospitalized with symptoms consistent with severe dengue; however, none received a diagnosis of dengue. Behavior associated with protection from DENV infection included recent use of mosquito repellent or a bed net. These findings suggest that the 2013 dengue epidemic was larger than indicated by passive surveillance data. PMID:26196224

Clustering microcalcifications techniques in digital mammograms

NASA Astrophysics Data System (ADS)

Díaz, Claudia. C.; Bosco, Paolo; Cerello, Piergiorgio

2008-11-01

Breast cancer has become a serious public health problem around the world. However, this pathology can be treated if it is detected in early stages. This task is achieved by a radiologist, who should read a large amount of mammograms per day, either for a screening or diagnostic purpose in mammography. However human factors could affect the diagnosis. Computer Aided Detection is an automatic system, which can help to specialists in the detection of possible signs of malignancy in mammograms. Microcalcifications play an important role in early detection, so we focused on their study. The two mammographic features that indicate the microcalcifications could be probably malignant are small size and clustered distribution. We worked with density techniques for automatic clustering, and we applied them on a mammography CAD prototype developed at INFN-Turin, Italy. An improvement of performance is achieved analyzing images from a Perugia-Assisi Hospital, in Italy.

A Website for Astronomy Education and Outreach

NASA Astrophysics Data System (ADS)

Impey, C.; Danehy, A.

2017-09-01

Teach Astronomy is a free, open access website designed for formal and informal learners of astronomy. The site features: an online textbook complete with quiz questions and a glossary; over ten thousand images; a curated collection of the astronomy articles in Wikipedia; a complete video lecture course; a video Frequently Asked Questions tool; and other materials provided by content partners. Clustering algorithms and an interactive visual interface allow users to browse related content. This article reviews the features of the website and how it can be used.

Randomized pilot study and qualitative evaluation of a clinical decision support system for brain tumour diagnosis based on SV ¹H MRS: evaluation as an additional information procedure for novice radiologists.

PubMed

Sáez, Carlos; Martí-Bonmatí, Luis; Alberich-Bayarri, Angel; Robles, Montserrat; García-Gómez, Juan M

2014-02-01

The results of a randomized pilot study and qualitative evaluation of the clinical decision support system Curiam BT are reported. We evaluated the system's feasibility and potential value as a radiological information procedure complementary to magnetic resonance (MR) imaging to assist novice radiologists in diagnosing brain tumours using MR spectroscopy (1.5 and 3.0T). Fifty-five cases were analysed at three hospitals according to four non-exclusive diagnostic questions. Our results show that Curiam BT improved the diagnostic accuracy in all the four questions. Additionally, we discuss the findings of the users' feedback about the system, and the further work to optimize it for real environments and to conduct a large clinical trial. © 2013 Published by Elsevier Ltd.

The validity and clinical utility of purging disorder.

PubMed

Keel, Pamela K; Striegel-Moore, Ruth H

2009-12-01

To review evidence of the validity and clinical utility of Purging Disorder and examine options for the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-V). Articles were identified by computerized and manual searches and reviewed to address five questions about Purging Disorder: Is there "ample" literature? Is the syndrome clearly defined? Can it be measured and diagnosed reliably? Can it be differentiated from other eating disorders? Is there evidence of syndrome validity? Although empirical classification and concurrent validity studies provide emerging support for the distinctiveness of Purging Disorder, questions remain about definition, diagnostic reliability in clinical settings, and clinical utility (i.e., prognostic validity). We discuss strengths and weaknesses associated with various options for the status of Purging Disorder in the DSM-V ranging from making no changes from DSM-IV to designating Purging Disorder a diagnosis on equal footing with Anorexia Nervosa and Bulimia Nervosa.

Chandra/HETG Observations of NGC1275

NASA Astrophysics Data System (ADS)

Reynolds, Christopher

2017-09-01

NGC1275 is the active galactic nucleus (AGN) at the heart of the Perseus cluster of galaxies responsible for the mechanical heating of the intracluster medium (ICM) cool core. We propose a deep (500ks) HETG observation of NGC1275, allowing the first high-S/N, high resolution spectrum of this AGN free from contamination by the bright ICM. We will seek the signatures of powerful winds, answering the central question of whether galactic-scale quasar-mode feedback is occuring simultaneously with cluster-scale radio-mode feedback. We also probe circumnuclear gas (i.e. the fuel supply) through the 6.4keV line previously seen by XMM and Hitomi. These issues are crucial unknowns in our models for the evolution of the most massive galaxies and cluster cores.

Some Unsolved Problems, Questions, and Applications of the Brightsen Nucleon Cluster Model

NASA Astrophysics Data System (ADS)

Smarandache, Florentin

2010-10-01

Brightsen Model is opposite to the Standard Model, and it was build on John Weeler's Resonating Group Structure Model and on Linus Pauling's Close-Packed Spheron Model. Among Brightsen Model's predictions and applications we cite the fact that it derives the average number of prompt neutrons per fission event, it provides a theoretical way for understanding the low temperature / low energy reactions and for approaching the artificially induced fission, it predicts that forces within nucleon clusters are stronger than forces between such clusters within isotopes; it predicts the unmatter entities inside nuclei that result from stable and neutral union of matter and antimatter, and so on. But these predictions have to be tested in the future at the new CERN laboratory.

A topic clustering approach to finding similar questions from large question and answer archives.

PubMed

Zhang, Wei-Nan; Liu, Ting; Yang, Yang; Cao, Liujuan; Zhang, Yu; Ji, Rongrong

2014-01-01

With the blooming of Web 2.0, Community Question Answering (CQA) services such as Yahoo! Answers (http://answers.yahoo.com), WikiAnswer (http://wiki.answers.com), and Baidu Zhidao (http://zhidao.baidu.com), etc., have emerged as alternatives for knowledge and information acquisition. Over time, a large number of question and answer (Q&A) pairs with high quality devoted by human intelligence have been accumulated as a comprehensive knowledge base. Unlike the search engines, which return long lists of results, searching in the CQA services can obtain the correct answers to the question queries by automatically finding similar questions that have already been answered by other users. Hence, it greatly improves the efficiency of the online information retrieval. However, given a question query, finding the similar and well-answered questions is a non-trivial task. The main challenge is the word mismatch between question query (query) and candidate question for retrieval (question). To investigate this problem, in this study, we capture the word semantic similarity between query and question by introducing the topic modeling approach. We then propose an unsupervised machine-learning approach to finding similar questions on CQA Q&A archives. The experimental results show that our proposed approach significantly outperforms the state-of-the-art methods.

Diagnostic criteria, severity classification and guidelines of localized scleroderma.

PubMed

Asano, Yoshihide; Fujimoto, Manabu; Ishikawa, Osamu; Sato, Shinichi; Jinnin, Masatoshi; Takehara, Kazuhiko; Hasegawa, Minoru; Yamamoto, Toshiyuki; Ihn, Hironobu

2018-04-23

We established diagnostic criteria and severity classification of localized scleroderma because there is no established diagnostic criteria or widely accepted severity classification of the disease. Also, there has been no clinical guideline for localized scleroderma, so we established its clinical guideline ahead of all over the world. In particular, the clinical guideline was established by clinical questions based on evidence-based medicine according to the New Minds Clinical Practice Guideline Creation Manual (version 1.0). We aimed to make the guideline easy to use and reliable based on the newest evidence, and to present guidance as specific as possible for various clinical problems in treatment of localized scleroderma. © 2018 Japanese Dermatological Association.

The Theories of Earthquake's Formation and the Observation of Praesepio Cluster in the Works of Pliny the Elder and Anania Shirakatsi

NASA Astrophysics Data System (ADS)

Danielyan, Eduard

2016-12-01

The founder of the Armenian natural philosophy Anania Shirakatsi (VII c.) while analysing cosmological questions touched also the theories of the earthquake formation (caused, on the one hand, by winds or exhalations and on the other - by the movements of plants), as well as the observation of Presepio cluster in relation to weather forecast. In ancient Greek natural philosophy, particularly, Pliny the Elder researched these problems. Ancient and medieval cosmological ideas contributed greatly to the development of astronomy.

Spectroscopic and functional characterization of iron-sulfur cluster-bound forms of Azotobacter vinelandii (Nif)IscA.

PubMed

Mapolelo, Daphne T; Zhang, Bo; Naik, Sunil G; Huynh, Boi Hanh; Johnson, Michael K

2012-10-16

The mechanism of [4Fe-4S] cluster assembly on A-type Fe-S cluster assembly proteins, in general, and the specific role of (Nif)IscA in the maturation of nitrogen fixation proteins are currently unknown. To address these questions, in vitro spectroscopic studies (UV-visible absorption/CD, resonance Raman and Mössbauer) have been used to investigate the mechanism of [4Fe-4S] cluster assembly on Azotobacter vinelandii(Nif)IscA, and the ability of (Nif)IscA to accept clusters from NifU and to donate clusters to the apo form of the nitrogenase Fe-protein. The results show that (Nif)IscA can rapidly and reversibly cycle between forms containing one [2Fe-2S](2+) and one [4Fe-4S](2+) cluster per homodimer via DTT-induced two-electron reductive coupling of two [2Fe-2S](2+) clusters and O(2)-induced [4Fe-4S](2+) oxidative cleavage. This unique type of cluster interconversion in response to cellular redox status and oxygen levels is likely to be important for the specific role of A-type proteins in the maturation of [4Fe-4S] cluster-containing proteins under aerobic growth or oxidative stress conditions. Only the [4Fe-4S](2+)-(Nif)IscA was competent for rapid activation of apo-nitrogenase Fe protein under anaerobic conditions. Apo-(Nif)IscA was shown to accept clusters from [4Fe-4S] cluster-bound NifU via rapid intact cluster transfer, indicating a potential role as a cluster carrier for delivery of clusters assembled on NifU. Overall the results support the proposal that A-type proteins can function as carrier proteins for clusters assembled on U-type proteins and suggest that they are likely to supply [2Fe-2S] clusters rather than [4Fe-4S] for the maturation of [4Fe-4S] cluster-containing proteins under aerobic or oxidative stress growth conditions.

Spectroscopic and Functional Characterization of Iron-Sulfur Cluster-Bound Forms of Azotobacter vinelandii NifIscA†

PubMed Central

Mapolelo, Daphne T.; Zhang, Bo; Naik, Sunil G.; Huynh, Boi Hanh; Johnson, Michael K.

2012-01-01

The mechanism of [4Fe-4S] cluster assembly on A-type Fe-S cluster assembly proteins, in general, and the specific role of NifIscA in the maturation of nitrogen fixation proteins are currently unknown. To address these questions, in vitro spectroscopic studies (UV–visible absorption/CD, resonance Raman and Mössbauer) have been used to investigate the mechanism of [4Fe-4S] cluster assembly on Azotobacter vinelandii NifIscA, and the ability of NifIscA to accept clusters from NifU and to donate clusters to the apo form of the nitrogenase Fe-protein. The results show that NifIscA can rapidly and reversibly cycle between forms containing one [2Fe-2S]2+ and one [4Fe-4S]2+ cluster per homodimer via DTT-induced two-electron reductive coupling of two [2Fe-2S]2+ clusters and O2-induced [4Fe-4S]2+ oxidative cleavage. This unique type of cluster interconversion in response to cellular redox status and oxygen levels is likely to be important for the specific role of A-type proteins in the maturation of [4Fe-4S] cluster-containing proteins under aerobic growth or oxidative stress conditions. Only the [4Fe-4S]2+-NifIscA was competent for rapid activation of apo-nitrogenase Fe protein under anaerobic conditions. Apo-NifIscA was shown to accept clusters from [4Fe-4S] cluster-bound NifU via rapid intact cluster transfer, indicating a potential role as a cluster carrier for delivery of clusters assembled on NifU. Overall the results support the proposal that A-type proteins can function as carrier proteins for clusters assembled on U-type proteins and suggest that they are likely to supply [2Fe-2S] clusters rather than [4Fe-4S] for the maturation of [4Fe-4S] cluster-containing proteins under aerobic or oxidative stress growth conditions. PMID:23003323

A comparison of three clustering methods for finding subgroups in MRI, SMS or clinical data: SPSS TwoStep Cluster analysis, Latent Gold and SNOB.

PubMed

Kent, Peter; Jensen, Rikke K; Kongsted, Alice

2014-10-02

There are various methodological approaches to identifying clinically important subgroups and one method is to identify clusters of characteristics that differentiate people in cross-sectional and/or longitudinal data using Cluster Analysis (CA) or Latent Class Analysis (LCA). There is a scarcity of head-to-head comparisons that can inform the choice of which clustering method might be suitable for particular clinical datasets and research questions. Therefore, the aim of this study was to perform a head-to-head comparison of three commonly available methods (SPSS TwoStep CA, Latent Gold LCA and SNOB LCA). The performance of these three methods was compared: (i) quantitatively using the number of subgroups detected, the classification probability of individuals into subgroups, the reproducibility of results, and (ii) qualitatively using subjective judgments about each program's ease of use and interpretability of the presentation of results.We analysed five real datasets of varying complexity in a secondary analysis of data from other research projects. Three datasets contained only MRI findings (n = 2,060 to 20,810 vertebral disc levels), one dataset contained only pain intensity data collected for 52 weeks by text (SMS) messaging (n = 1,121 people), and the last dataset contained a range of clinical variables measured in low back pain patients (n = 543 people). Four artificial datasets (n = 1,000 each) containing subgroups of varying complexity were also analysed testing the ability of these clustering methods to detect subgroups and correctly classify individuals when subgroup membership was known. The results from the real clinical datasets indicated that the number of subgroups detected varied, the certainty of classifying individuals into those subgroups varied, the findings had perfect reproducibility, some programs were easier to use and the interpretability of the presentation of their findings also varied. The results from the artificial datasets indicated that all three clustering methods showed a near-perfect ability to detect known subgroups and correctly classify individuals into those subgroups. Our subjective judgement was that Latent Gold offered the best balance of sensitivity to subgroups, ease of use and presentation of results with these datasets but we recognise that different clustering methods may suit other types of data and clinical research questions.

Attention-Deficit/Hyperactivity Disorder in Young Children: Predictors of Diagnostic Stability

PubMed Central

Sideridis, Georgios D.; Prock, Lisa Albers; Sheridan, Margaret A.

2014-01-01

OBJECTIVES: The goals of this study were (1) to provide estimates of diagnostic stability for a sample of young children diagnosed with attention-deficit/hyperactivity disorder (ADHD) after undergoing comprehensive multidisciplinary assessments and (2) to identify baseline child and family characteristics that predict diagnostic stability over time. METHODS: Children aged 3 to 6 years, 11 months consecutively diagnosed with ADHD after multidisciplinary consultations at a tertiary care clinic between 2003 and 2008 were recontacted in 2012 and 2013 (N = 120). At follow-up, the primary outcome was the proportion of children who continued to meet diagnostic criteria for ADHD. To identify predictors of diagnostic stability, logistic regression models were used. In addition, a latent class model was used to independently classify subjects into distinct clusters. RESULTS: In this cohort, 70.4% of the children contacted at follow-up continued to meet diagnostic criteria for ADHD. Predictors of diagnostic stability included externalizing and internalizing symptoms at baseline, parental history of psychopathology, and family socioeconomic status. The latent class model independently identified 3 distinct profiles: (1) children who no longer met ADHD criteria; (2) children with persistent ADHD and high parental psychopathology; and (3) children with persistent ADHD and low family socioeconomic status. CONCLUSIONS: Young children who underwent comprehensive developmental and psychological assessments before receiving an ADHD diagnosis, had higher rates of diagnostic stability than in previous studies of community samples. Child and family factors that predict diagnostic stability have the potential to guide treatment planning for children diagnosed with ADHD before 7 years of age. PMID:24639272

The PHQ-PD as a Screening Tool for Panic Disorder in the Primary Care Setting in Spain

PubMed Central

Wood, Cristina Mae; Ruíz-Rodríguez, Paloma; Tomás-Tomás, Patricia; Gracia-Gracia, Irene; Dongil-Collado, Esperanza; Iruarrizaga, M. Iciar

2016-01-01

Introduction Panic disorder is a common anxiety disorder and is highly prevalent in Spanish primary care centres. The use of validated tools can improve the detection of panic disorder in primary care populations, thus enabling referral for specialized treatment. The aim of this study is to determine the accuracy of the Patient Health Questionnaire-Panic Disorder (PHQ-PD) as a screening and diagnostic tool for panic disorder in Spanish primary care centres. Method We compared the psychometric properties of the PHQ-PD to the reference standard, the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) interview. General practitioners referred 178 patients who completed the entire PHQ test, including the PHQ-PD, to undergo the SCID-I. The sensitivity, specificity, positive and negative predictive values and positive and negative likelihood ratios of the PHQ-PD were assessed. Results The operating characteristics of the PHQ-PD are moderate. The best cut-off score was 5 (sensitivity .77, specificity .72). Modifications to the questionnaire's algorithms improved test characteristics (sensitivity .77, specificity .72) compared to the original algorithm. The screening question alone yielded the highest sensitivity score (.83). Conclusion Although the modified algorithm of the PHQ-PD only yielded moderate results as a diagnostic test for panic disorder, it was better than the original. Using only the first question of the PHQ-PD showed the best psychometric properties (sensitivity). Based on these findings, we suggest the use of the screening questions for screening purposes and the modified algorithm for diagnostic purposes. PMID:27525977

Establishing a European research agenda on 'gut feelings' in general practice. A qualitative study using the nominal group technique.

PubMed

Stolper, Erik; van Leeuwen, Yvonne; van Royen, Paul; van de Wiel, Margaretha; van Bokhoven, Marloes; Houben, Paul; Hobma, Sjoerd; van der Weijden, Trudy; Dinant, Geert Jan

2010-06-01

Although 'gut feelings' are perceived as playing a substantial role in the diagnostic reasoning of the general practitioner (GP), there is little evidence about their diagnostic and prognostic value. Consensus on both types of 'gut feelings' (a 'sense of alarm', a 'sense of reassurance') has enabled us to operationalize the concept. As a next step we wanted to identify research questions that are considered relevant to validate the concept of 'gut feelings' and to estimate its usefulness for daily practice and medical education. Moreover, we were interested in the study designs considered appropriate to study these research questions. The nominal group technique (NGT) is a qualitative research method of judgmental decision-making involving four phases: generating ideas, recording them, evaluation and prioritization. Dutch and Belgian academics whose subject is general practice (n = 18), attended one of three meetings during which NGT was used to produce a 'research agenda' on 'gut feelings'. NGT yielded ten research questions and nine corresponding appropriate designs on four topics, i.e. the diagnostic value of 'gut feelings', the validation of its determinants, the opportunities for integrating 'gut feelings' in medical education and a rest group. The study designs respectively included recording and follow-up of 'gut feelings', video recording of consultations with stimulated recall using simulated and real patients respectively, analysing trainees' consultation stories and videos, linguistic analyses, and vignette studies. Furthermore, two experimental designs were proposed. A European research agenda on 'gut feelings' in general practice has been established and could be used in collaborative research.

SPITZER IRAC COLOR DIAGNOSTICS FOR EXTENDED EMISSION IN STAR-FORMING REGIONS

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

Ybarra, Jason E.; Tapia, Mauricio; Román-Zúñiga, Carlos G.

2014-10-20

The infrared data from the Spitzer Space Telescope are an invaluable tool for identifying physical processes in star formation. In this study, we calculate the Infrared Array Camera (IRAC) color space of UV fluorescent H{sub 2} and polycyclic aromatic hydrocarbon (PAH) emission in photodissociation regions (PDRs) using the Cloudy code with PAH opacities from Draine and Li. We create a set of color diagnostics that can be applied to study the structure of PDRs and to distinguish between FUV-excited and shock-excited H{sub 2} emission. To test this method, we apply these diagnostics to Spitzer IRAC data of NGC 2316. Our analysismore » of the structure of the PDR is consistent with previous studies of the region. In addition to UV excited emission, we identify shocked gas that may be part of an outflow originating from the cluster.« less

Ensemble averaged structure–function relationship for nanocrystals: effective superparamagnetic Fe clusters with catalytically active Pt skin

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

Petkov, Valeri; Prasai, Binay; Shastri, Sarvjit

2017-09-12

Practical applications require the production and usage of metallic nanocrystals (NCs) in large ensembles. Besides, due to their cluster-bulk solid duality, metallic NCs exhibit a large degree of structural diversity. This poses the question as to what atomic-scale basis is to be used when the structure–function relationship for metallic NCs is to be quantified precisely. In this paper, we address the question by studying bi-functional Fe core-Pt skin type NCs optimized for practical applications. In particular, the cluster-like Fe core and skin-like Pt surface of the NCs exhibit superparamagnetic properties and a superb catalytic activity for the oxygen reduction reaction,more » respectively. We determine the atomic-scale structure of the NCs by non-traditional resonant high-energy X-ray diffraction coupled to atomic pair distribution function analysis. Using the experimental structure data we explain the observed magnetic and catalytic behavior of the NCs in a quantitative manner. Lastly, we demonstrate that NC ensemble-averaged 3D positions of atoms obtained by advanced X-ray scattering techniques are a very proper basis for not only establishing but also quantifying the structure–function relationship for the increasingly complex metallic NCs explored for practical applications.« less

CLUSTER DYNAMICS LARGELY SHAPES PROTOPLANETARY DISK SIZES

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

Vincke, Kirsten; Pfalzner, Susanne, E-mail: kvincke@mpifr-bonn.mpg.de

2016-09-01

To what degree the cluster environment influences the sizes of protoplanetary disks surrounding young stars is still an open question. This is particularly true for the short-lived clusters typical for the solar neighborhood, in which the stellar density and therefore the influence of the cluster environment change considerably over the first 10 Myr. In previous studies, the effect of the gas on the cluster dynamics has often been neglected; this is remedied here. Using the code NBody6++, we study the stellar dynamics in different developmental phases—embedded, expulsion, and expansion—including the gas, and quantify the effect of fly-bys on the diskmore » size. We concentrate on massive clusters (M {sub cl} ≥ 10{sup 3}–6 ∗ 10{sup 4} M {sub Sun}), which are representative for clusters like the Orion Nebula Cluster (ONC) or NGC 6611. We find that not only the stellar density but also the duration of the embedded phase matters. The densest clusters react fastest to the gas expulsion and drop quickly in density, here 98% of relevant encounters happen before gas expulsion. By contrast, disks in sparser clusters are initially less affected, but because these clusters expand more slowly, 13% of disks are truncated after gas expulsion. For ONC-like clusters, we find that disks larger than 500 au are usually affected by the environment, which corresponds to the observation that 200 au-sized disks are common. For NGC 6611-like clusters, disk sizes are cut-down on average to roughly 100 au. A testable hypothesis would be that the disks in the center of NGC 6611 should be on average ≈20 au and therefore considerably smaller than those in the ONC.« less

Precipitation diagnostics of an exceptionally dry event in São Paulo, Brazil

NASA Astrophysics Data System (ADS)

Coelho, Caio A. S.; Cardoso, Denis H. F.; Firpo, Mári A. F.

2016-08-01

The State of São Paulo in Brazil experienced in 2014 and early 2015 an expressive precipitation deficit, leading to drought conditions with impacts in water availability for public consumption, hydropower generation, and agriculture, particularly during austral summer. This study performs a detailed diagnostics of the observed precipitation during 2014 and early 2015 over a particular region of São Paulo State, which includes the massively populated metropolitan region of São Paulo. The diagnostic was designed to provide answers to a number of relevant questions for the activities, decisions, and strategic planning of several sectors (e.g., general public, media, and high-level governments). Examples of questions such diagnostics can help answer are: How much precipitation has the region received? Has the region experienced drought conditions in the past? When have similar drought conditions been observed in the past? What has been the observed precipitation pattern in the last years? How severe/rare were the 2014 and 2015 droughts? When does the rainy season typically start/end in the region? What happened during the 2013/2014 and 2014/2015 rainy seasons? The performed diagnostics based on historical 1961/1962-2014/2015 records revealed that the 2013/2014 austral summer was a very rare event classified as exceptionally dry. Similar drought events were previously recorded but with smaller magnitude in terms of precipitation deficits, making the 2013/2014 drought event the driest on the examined record. In fact, the region has been experiencing a precipitation deficit pattern since 1999/2000. One of the contributing factors for the expressive precipitation deficit in 2014 was the abnormally early end of the 2013/2014 rainy season in the region.

The Case for a Hierarchical Cosmology

ERIC Educational Resources Information Center

Vaucouleurs, G. de

1970-01-01

The development of modern theoretical cosmology is presented and some questionable assumptions of orthodox cosmology are pointed out. Suggests that recent observations indicate that hierarchical clustering is a basic factor in cosmology. The implications of hierarchical models of the universe are considered. Bibliography. (LC)

Asking For Help is Helpful: Validation of a Brief Lifestyle and Mood Assessment Tool in Primary Health Care

PubMed Central

Goodyear-Smith, Felicity; Arroll, Bruce; Coupe, Nicole

2009-01-01

PURPOSE The short, validated, self-administered, Case-finding and Help Assessment Tool (CHAT) for lifestyle and mental health assessment of adult patients in primary health care addresses inactivity, tobacco use, alcohol and other drug misuse, problem gambling, depression, anxiety and stress, abuse, and anger problems. For each issue patients are asked whether they would like help, either during the consultation or at a later date. This study aims to assess the value of the help question. METHODS Validation of the CHAT was conducted according to the STAndards for Reporting of Diagnostic accuracy studies statement for diagnostic tests. The setting was Auckland primary care practices with populations ranging from socioeconomically advantaged to deprived. Participants were 755 consecutive primary care patients who completed the CHAT plus the help question and reference standards. Sensitivity, specificity, and likelihood ratios with and without the addition of help the question were calculated. RESULTS Sensitivity ranged from 80% to 98% for the more-common conditions (depression, nicotine dependency, anxiety, problematic drinking). For each condition, specificity increased with the addition of the help question: depression increased from 73% to 98%; anxiety 77% to 99%; drinking 85% to 99%; verbal anger 92% to 99%; verbal abuse 97% to 99%; problematic drinking and gambling 98% to 99%. CONCLUSIONS The help question increased specificity without compromising sensitivity and reduced false positives, thereby increasing the positive predictive value. It allowed patients with comorbidities to prioritize issues they wished to address, indicate their readiness to change, promote self-determination, and give the clinician an indication of which topics to pursue. PMID:19433841

Clinically Unjustified Diagnostic Imaging – a Worrisome Tendency in Today’s Medical Practice

PubMed Central

Sobiecka, Aleksandra; Bekiesińska-Figatowska, Monika; Rutkowska, Milena; Latos, Tomasz; Walecki, Jerzy

2016-01-01

Summary Background The purpose of the study was to evaluate the percentage of unjustified examinations among all the CT and MRI studies performed by two radiology departments and to determine the types of examinations which are most commonly carried out unnecessarily. Material/Methods Three radiologists assessed the justification of CT and MRI examinations performed during a period of 14 days based on the referrals. The radiologists assessed 799 referrals for CT scans (847 examinations of a particular part of the body) and 269 MRI referrals (269 examinations). The criteria for justification were: medical expertise and the guidelines. During the first stage radiologists divided the examinations into 3 groups: justified, unjustified and the examinations of questionable justification. The second step was to determine the reasons why the studies were considered as unjustified or of questionable justification. Results 73 of 1116 examinations (6.54%) were considered to be unjustified or of a questionable justification. There were 59 CT scans (59/847=6.97%) and 14 MRI studies (14/269=5.20%). The most common reasons to consider them as unjustified or of questionable justification were: inadequate method of diagnostic imaging chosen as a first-line tool and lacking or insufficient clinical details. Conclusions In our investigation 6.54% of both CT and MRI examinations were considered as unjustified or of questionable justification, which is lower than described in other studies (from 7% to 26%). The assessment was based only on referrals, therefore a total share of these examinations is likely to be higher. PMID:27471577

Cancer clusters in the USA: What do the last twenty years of state and federal investigations tell us?

PubMed Central

Goodman, Michael; Naiman, Joshua S.; Goodman, Dina; LaKind, Judy S.

2012-01-01

Background Cancer clusters garner considerable public and legislative attention, and there is often an expectation that cluster investigations in a community will reveal a causal link to an environmental exposure. At a 1989 national conference on disease clusters, it was reported that cluster studies conducted in the 1970s and 1980s rarely, if ever, produced important findings. We seek to answer the question: Have cancer cluster investigations conducted by US health agencies in the past 20 years improved our understanding of cancer etiology, or informed cancer prevention and control? Methods We reviewed publicly available cancer cluster investigation reports since 1990, obtained from literature searches and by canvassing all 50 states and the District of Columbia. Investigations were categorized with respect to cancer type(s), hypothesized exposure, whether perceived clusters were confirmed (e.g. by elevated incidence), and conclusions about a link between cancer(s) of concern and hypothesized environmental exposure(s). Results We reviewed 428 investigations evaluating 567 cancers of concern. An increase in incidence was confirmed for 72 (13%) cancer categories (including the category “all sites”). Three of those were linked (with variable degree of certainty) to hypothesized exposures, but only one investigation revealed a clear cause. Conclusions It is fair to state that extensive efforts to find causes of community cancer clusters have not been successful. There are fundamental shortcomings to our current methods of investigating community cancer clusters. We recommend a multidisciplinary national dialogue on creative, innovative approaches to understanding when and why cancer and other chronic diseases cluster in space and time. PMID:22519802

Continuous assessment of volunteers' satisfaction in clinical research through simplified questionnaires.

PubMed

Pluchart, Hélène; Gaget, Olivier; Cracowski, Claire; Paris, Adeline; Cracowski, Jean-Luc

2018-01-06

In our clinical research center, a 27 multiple-choice and 3 verbatim questions satisfaction questionnaire has been used since 2008 in order to assess the satisfaction of the volunteers participating in our studies. In this work, we aimed at reducing the number of questions of this cumbersome questionnaire while exploring the same dimensions. We used k-mean and hierarchical clustering to determine which questions provided the same information or, on the contrary, which questions were able to discriminate a satisfied volunteer from an unsatisfied volunteer. We were able to reduce our satisfaction questionnaire from 30 questions to 6 closed-ended and 2 open-ended questions, which will allow to save volunteers time while increasing their participation rate. This questionnaire could be used in other structures practicing clinical research, as part of their quality process. Copyright © 2018 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

An easy-to-use diagnostic system development shell

NASA Technical Reports Server (NTRS)

Tsai, L. C.; Ross, J. B.; Han, C. Y.; Wee, W. G.

1987-01-01

The Diagnostic System Development Shell (DSDS), an expert system development shell for diagnostic systems, is described. The major objective of building the DSDS is to create a very easy to use and friendly environment for knowledge engineers and end-users. The DSDS is written in OPS5 and CommonLisp. It runs on a VAX/VMS system. A set of domain independent, generalized rules is built in the DSDS, so the users need not be concerned about building the rules. The facts are explicitly represented in a unified format. A powerful check facility which helps the user to check the errors in the created knowledge bases is provided. A judgement facility and other useful facilities are also available. A diagnostic system based on the DSDS system is question driven and can call or be called by other knowledge based systems written in OPS5 and CommonLisp. A prototype diagnostic system for diagnosing a Philips constant potential X-ray system has been built using the DSDS.

Advancing Patient-centered Outcomes in Emergency Diagnostic Imaging: A Research Agenda.

PubMed

Kanzaria, Hemal K; McCabe, Aileen M; Meisel, Zachary M; LeBlanc, Annie; Schaffer, Jason T; Bellolio, M Fernanda; Vaughan, William; Merck, Lisa H; Applegate, Kimberly E; Hollander, Judd E; Grudzen, Corita R; Mills, Angela M; Carpenter, Christopher R; Hess, Erik P

2015-12-01

Diagnostic imaging is integral to the evaluation of many emergency department (ED) patients. However, relatively little effort has been devoted to patient-centered outcomes research (PCOR) in emergency diagnostic imaging. This article provides background on this topic and the conclusions of the 2015 Academic Emergency Medicine consensus conference PCOR work group regarding "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization." The goal was to determine a prioritized research agenda to establish which outcomes related to emergency diagnostic imaging are most important to patients, caregivers, and other key stakeholders and which methods will most optimally engage patients in the decision to undergo imaging. Case vignettes are used to emphasize these concepts as they relate to a patient's decision to seek care at an ED and the care received there. The authors discuss applicable research methods and approaches such as shared decision-making that could facilitate better integration of patient-centered outcomes and patient-reported outcomes into decisions regarding emergency diagnostic imaging. Finally, based on a modified Delphi process involving members of the PCOR work group, prioritized research questions are proposed to advance the science of patient-centered outcomes in ED diagnostic imaging. © 2015 by the Society for Academic Emergency Medicine.

Collective thermoregulation in bee clusters

PubMed Central

Ocko, Samuel A.; Mahadevan, L.

2014-01-01

Swarming is an essential part of honeybee behaviour, wherein thousands of bees cling onto each other to form a dense cluster that may be exposed to the environment for several days. This cluster has the ability to maintain its core temperature actively without a central controller. We suggest that the swarm cluster is akin to an active porous structure whose functional requirement is to adjust to outside conditions by varying its porosity to control its core temperature. Using a continuum model that takes the form of a set of advection–diffusion equations for heat transfer in a mobile porous medium, we show that the equalization of an effective ‘behavioural pressure’, which propagates information about the ambient temperature through variations in density, leads to effective thermoregulation. Our model extends and generalizes previous models by focusing the question of mechanism on the form and role of the behavioural pressure, and allows us to explain the vertical asymmetry of the cluster (as a consequence of buoyancy-driven flows), the ability of the cluster to overpack at low ambient temperatures without breaking up at high ambient temperatures, and the relative insensitivity to large variations in the ambient temperature. Our theory also makes testable hypotheses for the response of the cluster to external temperature inhomogeneities and suggests strategies for biomimetic thermoregulation. PMID:24335563

Parenting Practices and Child Misbehavior: A Mixed Method Study of Italian Mothers and Children

PubMed Central

Bombi, Anna Silvia; Di Norcia, Anna; Di Giunta, Laura; Pastorelli, Concetta; Lansford, Jennifer E.

2015-01-01

Objective The present study uses a mixed qualitative and quantitative method to examine three main research questions: What are the practices that mothers report they use when trying to correct their children’s misbehaviors? Are there common patterns of these practices? Are the patterns that emerge related to children’s well-being? Design Italian mother-child dyads (N=103) participated in the study (when children were 8 years of age). At Time 1 (T1), mothers answered open-ended questions about discipline; in addition, measures of maternal physical discipline and rejection and child aggression were assessed in mothers and children at T1, one year later (T2), and two years later (T3). Results Mothers’ answers to open-ended questions about what they would do in three disciplinary situations were classified in six categories: physical or psychological punishment, control, mix of force and reasoning, reasoning, listening, and permissiveness. Cluster analysis yielded 3 clusters: Group 1, Induction (predominant use of reasoning and listening; 74%); Group 2, Punishment (punitive practices and no reasoning; 16%); Group 3, Mixed practices (combination of reasoning and punishment, as well as high control and no listening; 10%). Multiple-group latent growth curves of maternal physical discipline, maternal rejection, and child aggression were implemented to evaluate possible differences in the developmental trends from T1 to T3, as a function of cluster. Conclusions Qualitative data deepen understanding of parenting because they shed light on what parents think about themselves; their self-descriptions, in turn, help to identify ways of parenting that may have long-lasting consequences for children’s adjustment. PMID:26877716

TU-CD-BRB-12: Radiogenomics of MRI-Guided Prostate Cancer Biopsy Habitats

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

Stoyanova, R; Lynne, C; Abraham, S

2015-06-15

Purpose: Diagnostic prostate biopsies are subject to sampling bias. We hypothesize that quantitative imaging with multiparametric (MP)-MRI can more accurately direct targeted biopsies to index lesions associated with highest risk clinical and genomic features. Methods: Regionally distinct prostate habitats were delineated on MP-MRI (T2-weighted, perfusion and diffusion imaging). Directed biopsies were performed on 17 habitats from 6 patients using MRI-ultrasound fusion. Biopsy location was characterized with 52 radiographic features. Transcriptome-wide analysis of 1.4 million RNA probes was performed on RNA from each habitat. Genomics features with insignificant expression values (<0.25) and interquartile range <0.5 were filtered, leaving total of 212more » genes. Correlation between imaging features, genes and a 22 feature genomic classifier (GC), developed as a prognostic assay for metastasis after radical prostatectomy was investigated. Results: High quality genomic data was derived from 17 (100%) biopsies. Using the 212 ‘unbiased’ genes, the samples clustered by patient origin in unsupervised analysis. When only prostate cancer related genomic features were used, hierarchical clustering revealed samples clustered by needle-biopsy Gleason score (GS). Similarly, principal component analysis of the imaging features, found the primary source of variance segregated the samples into high (≥7) and low (6) GS. Pearson’s correlation analysis of genes with significant expression showed two main patterns of gene expression clustering prostate peripheral and transitional zone MRI features. Two-way hierarchical clustering of GC with radiomics features resulted in the expected groupings of high and low expressed genes in this metastasis signature. Conclusions: MP-MRI-targeted diagnostic biopsies can potentially improve risk stratification by directing pathological and genomic analysis to clinically significant index lesions. As determinant lesions are more reliably identified, targeting with radiotherapy should improve outcome. This is the first demonstration of a link between quantitative imaging features (radiomics) with genomic features in MRI-directed prostate biopsies. The research was supported by NIH- NCI R01 CA 189295 and R01 CA 189295; E Davicioni is partial owner of GenomeDx Biosciences, Inc. M Takhar, N Erho, L Lam, C Buerki and E Davicioni are current employees at GenomeDx Biosciences, Inc.« less

Spitzer Lensing Cluster Legacy Survey

NASA Astrophysics Data System (ADS)

Soifer, Tom; Armus, Lee; Bradac, Marusa; Capak, Peter; Coe, Dan; Siana, Brian; Treu, Tommaso; Vieira, Joaquin

2015-11-01

Cluster-scale gravitational lenses act as cosmic telescopes, enabling the study of otherwise unobservable galaxies. They are critical in answering the questions such as what is the star formation history at z > 7, and whether these galaxies can reionize the Universe. Accurate knowledge of stellar masses, ages, and star formation rates at this epoch requires measuring both rest-frame UV and optical light, which only Spitzer and HST can probe at z>7-11 for a large enough sample of typical galaxies. To address this cosmic puzzle, we propose a program that obtains shallow Spitzer/IRAC imaging of a large sample of cluster lenses, followed by deep imaging of those clusters with the largest number of z > 7 candidate galaxies. This proposal will be a valuable Legacy complement to the existing IRAC deep surveys, and it will open up a new parameter space by probing the ordinary yet magnified population. Furthermore, it will enable the measurements of the stellar mass of the galaxy cluster population, thereby allowing us to chart the build-up of the cluster red sequence from z~1 to the present and to determine the physical processes responsible for this stellar mass growth.

Evaluation of Primary Immunization Coverage of Infants Under Universal Immunization Programme in an Urban Area of Bangalore City Using Cluster Sampling and Lot Quality Assurance Sampling Techniques

PubMed Central

K, Punith; K, Lalitha; G, Suman; BS, Pradeep; Kumar K, Jayanth

2008-01-01

Research Question: Is LQAS technique better than cluster sampling technique in terms of resources to evaluate the immunization coverage in an urban area? Objective: To assess and compare the lot quality assurance sampling against cluster sampling in the evaluation of primary immunization coverage. Study Design: Population-based cross-sectional study. Study Setting: Areas under Mathikere Urban Health Center. Study Subjects: Children aged 12 months to 23 months. Sample Size: 220 in cluster sampling, 76 in lot quality assurance sampling. Statistical Analysis: Percentages and Proportions, Chi square Test. Results: (1) Using cluster sampling, the percentage of completely immunized, partially immunized and unimmunized children were 84.09%, 14.09% and 1.82%, respectively. With lot quality assurance sampling, it was 92.11%, 6.58% and 1.31%, respectively. (2) Immunization coverage levels as evaluated by cluster sampling technique were not statistically different from the coverage value as obtained by lot quality assurance sampling techniques. Considering the time and resources required, it was found that lot quality assurance sampling is a better technique in evaluating the primary immunization coverage in urban area. PMID:19876474

Stalking: developing an empirical typology to classify stalkers.

PubMed

Del Ben, Kevin; Fremouw, W

2002-01-01

Stalking has received a great deal of attention from the media and its harmful effects on victims have been well documented. Stalking is also more common than previously thought, leading researchers to classify stalkers into groups in an attempt to predict future behavior. Previous research has grouped stalkers based on theoretical models rather than trying to empirically examine stalking behaviors along with other factors such as motivation, type of relationship, and attachment style in determining a typology of stalkers. Female college students (N = 108) who had experienced stalking behaviors responded to questions regarding their perceptions of those behaviors. First, these victim perceptions were factor analyzed. Then, cluster analysis grouped those factors to produce a four-cluster typology of stalkers. Cluster 1 (Harmless) appeared to reflect a more casual, less jealous pattern of behavior. Cluster 2 (Low Threat) appeared the least likely to become physically violent or threatening, or to engage in illegal behaviors. Cluster 3 (Violent Criminal) appeared to be the most likely to engage in physically threatening and illegal behaviors. Cluster 4 (High Threat) was characterized by a more serious type of relationship and may attempt to be more restrictive of their partner when first meeting them.

Development of a Simple Tool for Identifying Alcohol Use Disorder in Female Korean Drinkers from Previous Questionnaires.

PubMed

Seo, Yu Ri; Kim, Jong Sung; Kim, Sung Soo; Yoon, Seok Joon; Suh, Won Yoon; Youn, Kwangmi

2016-01-01

This study aimed to develop a simple tool for identifying alcohol use disorders in female Korean drinkers from previous questionnaires. This research was conducted on 400 women who consumed at least one alcoholic drink during the past month and visited the health promotion center at Chungnam National University Hospital between June 2013 to May 2014. Drinking habits and alcohol use disorders were assessed by structured interviews using the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition diagnostic criteria. The subjects were also asked to answer the Alcohol Use Disorders Identification Test (AUDIT), AUDIT-Consumption, CAGE (Cut down, Annoyed, Guilty, Eye-opener), TWEAK (Tolerance, Worried, Eye-opener, Amnesia, Kut down), TACE (Tolerance, Annoyed, Cut down, Eye-opener), and NET (Normal drinker, Eye-opener, Tolerance) questionnaires. The area under receiver operating characteristic (AUROC) of each question of the questionnaires on alcohol use disorders was assessed. After combining two questions with the largest AUROC, it was compared to other previous questionnaires. Among the 400 subjects, 58 (14.5%) were identified as having an alcohol use disorder. Two questions with the largest AUROC were question no. 7 in AUDIT, "How often during the last year have you had a feeling of guilt or remorse after drinking?" and question no. 5 in AUDIT, "How often during the past year have you failed to do what was normally expected from you because of drinking?" with an AUROC (95% confidence interval [CI]) of 0.886 (0.850-0.915) and 0.862 (0.824-0.894), respectively. The AUROC (95% CI) of the combination of the two questions was 0.958 (0.934-0.976) with no significant difference as compared to the existing AUDIT with the largest AUROC. The above results suggest that the simple tool consisting of questions no. 5 and no. 7 in AUDIT is useful in identifying alcohol use disorders in Korean female drinkers.

Exploring syndrome differentiation using non-negative matrix factorization and cluster analysis in patients with atopic dermatitis.

PubMed

Yun, Younghee; Jung, Wonmo; Kim, Hyunho; Jang, Bo-Hyoung; Kim, Min-Hee; Noh, Jiseong; Ko, Seong-Gyu; Choi, Inhwa

2017-08-01

Syndrome differentiation (SD) results in a diagnostic conclusion based on a cluster of concurrent symptoms and signs, including pulse form and tongue color. In Korea, there is a strong interest in the standardization of Traditional Medicine (TM). In order to standardize TM treatment, standardization of SD should be given priority. The aim of this study was to explore the SD, or symptom clusters, of patients with atopic dermatitis (AD) using non-negative factorization methods and k-means clustering analysis. We screened 80 patients and enrolled 73 eligible patients. One TM dermatologist evaluated the symptoms/signs using an existing clinical dataset from patients with AD. This dataset was designed to collect 15 dermatologic and 18 systemic symptoms/signs associated with AD. Non-negative matrix factorization was used to decompose the original data into a matrix with three features and a weight matrix. The point of intersection of the three coordinates from each patient was placed in three-dimensional space. With five clusters, the silhouette score reached 0.484, and this was the best silhouette score obtained from two to nine clusters. Patients were clustered according to the varying severity of concurrent symptoms/signs. Through the distribution of the null hypothesis generated by 10,000 permutation tests, we found significant cluster-specific symptoms/signs from the confidence intervals in the upper and lower 2.5% of the distribution. Patients in each cluster showed differences in symptoms/signs and severity. In a clinical situation, SD and treatment are based on the practitioners' observations and clinical experience. SD, identified through informatics, can contribute to development of standardized, objective, and consistent SD for each disease. Copyright © 2017. Published by Elsevier Ltd.

Glaucomatous patterns in Frequency Doubling Technology (FDT) perimetry data identified by unsupervised machine learning classifiers.

PubMed

Bowd, Christopher; Weinreb, Robert N; Balasubramanian, Madhusudhanan; Lee, Intae; Jang, Giljin; Yousefi, Siamak; Zangwill, Linda M; Medeiros, Felipe A; Girkin, Christopher A; Liebmann, Jeffrey M; Goldbaum, Michael H

2014-01-01

The variational Bayesian independent component analysis-mixture model (VIM), an unsupervised machine-learning classifier, was used to automatically separate Matrix Frequency Doubling Technology (FDT) perimetry data into clusters of healthy and glaucomatous eyes, and to identify axes representing statistically independent patterns of defect in the glaucoma clusters. FDT measurements were obtained from 1,190 eyes with normal FDT results and 786 eyes with abnormal FDT results from the UCSD-based Diagnostic Innovations in Glaucoma Study (DIGS) and African Descent and Glaucoma Evaluation Study (ADAGES). For all eyes, VIM input was 52 threshold test points from the 24-2 test pattern, plus age. FDT mean deviation was -1.00 dB (S.D. = 2.80 dB) and -5.57 dB (S.D. = 5.09 dB) in FDT-normal eyes and FDT-abnormal eyes, respectively (p<0.001). VIM identified meaningful clusters of FDT data and positioned a set of statistically independent axes through the mean of each cluster. The optimal VIM model separated the FDT fields into 3 clusters. Cluster N contained primarily normal fields (1109/1190, specificity 93.1%) and clusters G1 and G2 combined, contained primarily abnormal fields (651/786, sensitivity 82.8%). For clusters G1 and G2 the optimal number of axes were 2 and 5, respectively. Patterns automatically generated along axes within the glaucoma clusters were similar to those known to be indicative of glaucoma. Fields located farther from the normal mean on each glaucoma axis showed increasing field defect severity. VIM successfully separated FDT fields from healthy and glaucoma eyes without a priori information about class membership, and identified familiar glaucomatous patterns of loss.

Phenotypes of sleeplessness: stressing the need for psychodiagnostics in the assessment of insomnia.

PubMed

van de Laar, Merijn; Leufkens, Tim; Bakker, Bart; Pevernagie, Dirk; Overeem, Sebastiaan

2017-09-01

Insomnia is a too general term for various subtypes that might have different etiologies and therefore require different types of treatment. In this explorative study we used cluster analysis to distinguish different phenotypes in 218 patients with insomnia, taking into account several factors including sleep variables and characteristics related to personality and psychiatric comorbidity. Three clusters emerged from the analysis. The 'moderate insomnia with low psychopathology'-cluster was characterized by relatively normal personality traits, as well as normal levels of anxiety and depressive symptoms in the presence of moderate insomnia severity. The 'severe insomnia with moderate psychopathology'-cluster showed relatively high scores on the Insomnia Severity Index and scores on the sleep log that were indicative for severe insomnia. Anxiety and depressive symptoms were slightly above the cut-off and they were characterized by below average self-sufficiency and less goal-directed behavior. The 'early onset insomnia with high psychopathology'-cluster showed a much younger age and earlier insomnia onset than the other two groups. Anxiety and depressive symptoms were well above the cut-off score and the group consisted of a higher percentage of subjects with comorbid psychiatric disorders. This cluster showed a 'typical psychiatric' personality profile. Our findings stress the need for psychodiagnostic procedures next to a sleep-related diagnostic approach, especially in the younger insomnia patients. Specific treatment suggestions are given based on the three phenotypes.

Long-term surface EMG monitoring using K-means clustering and compressive sensing

NASA Astrophysics Data System (ADS)

Balouchestani, Mohammadreza; Krishnan, Sridhar

2015-05-01

In this work, we present an advanced K-means clustering algorithm based on Compressed Sensing theory (CS) in combination with the K-Singular Value Decomposition (K-SVD) method for Clustering of long-term recording of surface Electromyography (sEMG) signals. The long-term monitoring of sEMG signals aims at recording of the electrical activity produced by muscles which are very useful procedure for treatment and diagnostic purposes as well as for detection of various pathologies. The proposed algorithm is examined for three scenarios of sEMG signals including healthy person (sEMG-Healthy), a patient with myopathy (sEMG-Myopathy), and a patient with neuropathy (sEMG-Neuropathr), respectively. The proposed algorithm can easily scan large sEMG datasets of long-term sEMG recording. We test the proposed algorithm with Principal Component Analysis (PCA) and Linear Correlation Coefficient (LCC) dimensionality reduction methods. Then, the output of the proposed algorithm is fed to K-Nearest Neighbours (K-NN) and Probabilistic Neural Network (PNN) classifiers in order to calclute the clustering performance. The proposed algorithm achieves a classification accuracy of 99.22%. This ability allows reducing 17% of Average Classification Error (ACE), 9% of Training Error (TE), and 18% of Root Mean Square Error (RMSE). The proposed algorithm also reduces 14% clustering energy consumption compared to the existing K-Means clustering algorithm.

Depressed or not depressed: untangling symptoms of depression in patients hospitalized with coronary heart disease.

PubMed

McGuire, Anthony W; Eastwood, Jo-Ann; Hays, Ron D; Macabasco-O'Connell, Aurelia; Doering, Lynn V

2014-03-01

Assessing depression in patients hospitalized with coronary heart disease is clinically challenging because depressive symptoms are often confounded by poor somatic health. To identify symptom clusters associated with clinical depression in patients hospitalized with coronary heart disease. Secondary analyses of 3 similar data sets for hospitalized patients with coronary heart disease who had diagnostic screening for depression (99 depressed, 224 not depressed) were done. Depressive symptoms were assessed by using the Hamilton Depression Rating Scale or the Beck Depression Inventory. Hierarchical cluster analysis was performed on 11 symptom variables: anhedonia, dysphoria, loss of appetite, sleep disturbance, fatigue, guilt, suicidal symptoms, hypochondriasis, loss of libido, psychomotor impairment, and nervous irritability. Associations between symptom clusters and presence or absence of clinical depression were estimated by using logistic regression. Fatigue (69%) and sleep disturbance (55%) were the most prevalent symptoms. Guilt (25%) and suicidal symptoms (9%) were the least common. Three symptom clusters (cognitive/affective, somatic/affective, and somatic) were identified. Compared with patients without cognitive/affective symptoms, patients with the cognitive/affective symptom cluster (anhedonia, dysphoria, guilt, suicidal symptoms, nervous irritability) had an odds ratio of 1.41 (P<.001; 95% CI, 1.223-1.631) for clinical depression. Clinicians should be alert for clinical depression in hospitalized patients with coronary heart disease who have the cognitive/affective symptom cluster.

Comparison of O-antigen gene clusters of all O-serogroups of Escherichia coli and proposal for adopting a new nomenclature for O-typing

USDA-ARS?s Scientific Manuscript database

The Genetics Analysis Core Facility at the Eastern Regional Research Center (ERRC) is a centralized laboratory working in support of the United States Department of Agriculture scientists within the ERRC. The application of molecular diagnostics within the Center has resulted in the morphing of the...

Headache with autonomic features in a child: cluster headache or contact-point headache?

PubMed

Mishra, Devendra; Choudhury, Krishna Kant; Gupta, Alok

2008-03-01

Headache and facial pain due to diseases of the nose and sinuses are not uncommon in children. However, nasal contact-point associated with headache is relatively uncommon and has unclear etiological significance. We herein report a child having headache with autonomic features and contact-point in the nose, and discuss the difficulties in diagnostic categorization.

Clusters, Deformation, and Dilation: Diagnostics for Material Accumulation Regions

DTIC Science & Technology

2012-09-07

Image courtesy Tamay € Ozg €okmen.) (bottom left) Accumulating oil from the Deepwater Horizon oil spill in the Gulf of Mexico. (Photo by Daniel Beltra...Geophys. Res. Lett., 40, 6171–6175, doi:10.1002/2013GL058624. Poje, A. C., A. C. Haza, T. M. € Ozg €okmen, M. G. Magaldi, and Z. D. Garraffo (2010

Biosensor approach to psychopathology classification.

PubMed

Koshelev, Misha; Lohrenz, Terry; Vannucci, Marina; Montague, P Read

2010-10-21

We used a multi-round, two-party exchange game in which a healthy subject played a subject diagnosed with a DSM-IV (Diagnostic and Statistics Manual-IV) disorder, and applied a Bayesian clustering approach to the behavior exhibited by the healthy subject. The goal was to characterize quantitatively the style of play elicited in the healthy subject (the proposer) by their DSM-diagnosed partner (the responder). The approach exploits the dynamics of the behavior elicited in the healthy proposer as a biosensor for cognitive features that characterize the psychopathology group at the other side of the interaction. Using a large cohort of subjects (n = 574), we found statistically significant clustering of proposers' behavior overlapping with a range of DSM-IV disorders including autism spectrum disorder, borderline personality disorder, attention deficit hyperactivity disorder, and major depressive disorder. To further validate these results, we developed a computer agent to replace the human subject in the proposer role (the biosensor) and show that it can also detect these same four DSM-defined disorders. These results suggest that the highly developed social sensitivities that humans bring to a two-party social exchange can be exploited and automated to detect important psychopathologies, using an interpersonal behavioral probe not directly related to the defining diagnostic criteria.

Fine needle aspiration cytology of parathyroid lesions.

PubMed

Heo, Ilyeong; Park, Sunhoo; Jung, Chang Won; Koh, Jae Soo; Lee, Seung-Sook; Seol, Hyesil; Choi, Hee Seung; Cho, Soo Youn

2013-10-01

There has been an increase in the use of fine needle aspiration cytology (FNAC) for the diagnosis of parathyroid lesions (PLs). Differentiation between a thyroid lesion and a PL is not easy because of their similar features. We reviewed parathyroid aspirates in our institution and aimed to uncover trends in diagnostic criteria. We selected 25 parathyroid aspirates (from 6 men and 19 women) confirmed surgically or immunohistochemically from 2006 to 2011. Major architectural findings of PLs include scattered naked nuclei, loose clusters, a papillary pattern with a fibrovascular core, tight clusters, and a follicular pattern. These architectures were commonly admixed with one another. Cytological features included anisokaryosis, stippled chromatin, a well-defined cell border, and oxyphilic cytoplasm. Eighteen of the 25 patients were diagnosed with PL using FNAC. Seven patients had been misdiagnosed with atypical cells (n=2), benign follicular cells (n=2), adenomatous goiter (n=2) and metastatic carcinoma (n=1) in FNAC. Using clinicoradiologic data, the sensitivity of the cytological diagnosis was 86.7%. The cytological sensitivity decreased to 50% without this information. FNAC of PL is easily confused with thyroid lesions. A combination of cytological parameters and clinical data will be required to improve the diagnostic sensitivity of PLs.

The validity of the Personality Diagnostic Questionnaire-4 Narcissistic Personality Disorder scale for assessing pathological grandiosity.

PubMed

Hopwood, Christopher J; Donnellan, M Brent; Ackerman, Robert A; Thomas, Katherine M; Morey, Leslie C; Skodol, Andrew E

2013-01-01

Although controversy surrounds the definition and measurement of narcissism, the claim that pathological grandiosity is central to the construct generates little disagreement. Yet representations of pathological grandiosity vary across measures of narcissism, leading to conceptual confusion in the literature. The validity of a DSM-based measure of pathological narcissism, the Personality Diagnostic Questionnaire-4 Narcissistic Personality Disorder scale (PDQ-4 NPD), was evaluated in 1 clinical and 3 nonclinical samples (total N=2,391) for its ability to measure pathological grandiosity. Findings were generally supportive: average scores were higher in the clinical than nonclinical samples and the PDQ-4 NPD scale correlated most strongly with (a) other measures of NPD; (b) other DSM Cluster B personality disorders; (c) traits involving antagonism, hostility, and assertiveness; and (d) interpersonal distress and disaffiliative dominance. However, the low internal consistency of the PDQ-4 NPD scale and unexpected associations with Cluster A and obsessive-compulsive features point to potential psychometric weaknesses with this instrument. These findings are useful for evaluating the PDQ-4 NPD scale and for informing ongoing debates regarding how to define and assess pathological narcissism.

Deadly Dark Matter Cusps versus Faint and Extended Star Clusters: Eridanus II and Andromeda XXV

NASA Astrophysics Data System (ADS)

Amorisco, Nicola C.

2017-07-01

The recent detection of two faint and extended star clusters in the central regions of two Local Group dwarf galaxies, Eridanus II and Andromeda XXV, raises the question of whether clusters with such low densities can survive the tidal field of cold dark matter halos with central density cusps. Using both analytic arguments and a suite of collisionless N-body simulations, I show that these clusters are extremely fragile and quickly disrupted in the presence of central cusps ρ ˜ {r}-α with α ≳ 0.2. Furthermore, the scenario in which the clusters were originally more massive and sank to the center of the halo requires extreme fine tuning and does not naturally reproduce the observed systems. In turn, these clusters are long lived in cored halos, whose central regions are safe shelters for α ≲ 0.2. The only viable scenario for hosts that have preserved their primordial cusp to the present time is that the clusters formed at rest at the bottom of the potential, which is easily tested by measurement of the clusters proper velocity within the host. This offers means to readily probe the central density profile of two dwarf galaxies as faint as {L}V˜ 5× {10}5 {L}⊙ and {L}V˜ 6× {10}4 {L}⊙ , in which stellar feedback is unlikely to be effective.

Gamma-ray Emission from Globular Clusters

NASA Astrophysics Data System (ADS)

Tam, Pak-Hin T.; Hui, Chung Y.; Kong, Albert K. H.

2016-03-01

Over the last few years, the data obtained using the Large Area Telescope (LAT) aboard the Fermi Gamma-ray Space Telescope has provided new insights on high-energy processes in globular clusters, particularly those involving compact objects such as MilliSecond Pulsars (MSPs). Gamma-ray emission in the 100 MeV to 10 GeV range has been detected from more than a dozen globular clusters in our galaxy, including 47 Tucanae and Terzan 5. Based on a sample of known gammaray globular clusters, the empirical relations between gamma-ray luminosity and properties of globular clusters such as their stellar encounter rate, metallicity, and possible optical and infrared photon energy densities, have been derived. The measured gamma-ray spectra are generally described by a power law with a cut-off at a few gigaelectronvolts. Together with the detection of pulsed γ-rays from two MSPs in two different globular clusters, such spectral signature lends support to the hypothesis that γ-rays from globular clusters represent collective curvature emission from magnetospheres of MSPs in the clusters. Alternative models, involving Inverse-Compton (IC) emission of relativistic electrons that are accelerated close to MSPs or pulsar wind nebula shocks, have also been suggested. Observations at >100 GeV by using Fermi/LAT and atmospheric Cherenkov telescopes such as H.E.S.S.-II, MAGIC-II, VERITAS, and CTA will help to settle some questions unanswered by current data.

MASSIVE+: The Growth Histories of MASSIVE Survey Galaxies from their Globular Cluster Colors

NASA Astrophysics Data System (ADS)

Blakeslee, John

2017-08-01

The MASSIVE survey is targeting the 100 most massive galaxies within 108 Mpc that are visible in the northern sky. These most massive galaxies in the present-day universe reside in a surprisingly wide variety of environments, from rich clusters to fossil groups to near isolation. We propose to use WFC3/UVIS and ACS to carry out a deep imaging study of the globular cluster populations around a selected subset of the MASSIVE targets. Though much is known about GC systems of bright galaxies in rich clusters, we know surprisingly little about the effects of environment on these systems. The MASSIVE sample provides a golden opportunity to learn about the systematics of GC systems and what they can tell us about environmental drivers on the evolution of the highest mass galaxies. The most pressing questions to be addressed include: (1) Do isolated giants have the same constant mass fraction of GCs to total halo mass as BCGs of similar luminosity? (2) Do their GC systems show the same color (metallicity) distribution, which is an outcome of the mass spectrum of gas-rich halos during hierarchical growth? (3) Do the GCs in isolated high-mass galaxies follow the same radial distribution versus metallicity as in rich environments (a test of the relative importance of growth by accretion)? (4) Do the GCs of galaxies in sparse environments follow the same mass function? Our proposed second-band imaging will enable us to secure answers to these questions and add enormously to the legacy value of existing HST imaging of the highest mass galaxies in the universe.

Symptom clusters at midlife: A four-country comparison of checklist and qualitative responses

PubMed Central

Sievert, Lynnette Leidy; Obermeyer, Carla Makhlouf

2011-01-01

Objectives The purpose of this study was to examine the frequency and clustering of somatic symptoms as reported by women aged 45-55 years in four countries, to compare women's responses to open-ended questions with those derived from structured checklists, and to assess the extent to which bodily symptoms grouped with emotional complaints. Methods The Decisions at Menopause Study (DAMES) recruited 1,193 women from the general population in Beirut, Lebanon; Rabat, Morocco; Madrid, Spain; and central Massachusetts. Women participated in semi-structured interviews about health, menopause, and bodily changes at midlife. Women's responses to symptom checklists and their statements in response to open-ended questions were analyzed through factor analysis and textual analysis. Results There was considerable consistency between the frequencies of quantitative and qualitative responses, and the analyses of qualitative data illustrate the extent to which women associate somatic and emotional complaints. In open-ended responses, women in Massachusetts and Spain did not often cluster somatic symptoms together with emotional symptoms. In Morocco, dizziness, fatigue, and headaches were clustered with emotional symptoms. Women in Lebanon explicitly associated shortness of breath, chest pain, palpitations, dizziness, fatigue, gastro-intestinal complaints, headaches, and, to a lesser extent, joint pain and numbness with emotional symptoms. Conclusions The number of volunteered symptom responses was small because respondents were relatively healthy; however, the extent and pattern of association between somatic and emotional symptoms varied across sites. Certain somatic symptoms may be more likely to communicate psychosocial distress in particular cultures. These results have implications for patterns of health care utilization. PMID:22042326

Desorden Deficitario de la Atencion. Segunda Edicion. NICHCY Briefing Paper [and] El Desorden Deficitario de la Atencion: Una Bibliografia de Materiales en Ingles y Espanol (Attention Deficit Disorder. Second Edition. NICHCY Briefing Paper [and] Attention Deficit Disorder: A Bibliography of Materials in English and Spanish).

ERIC Educational Resources Information Center

Fowler, Mary

This briefing paper uses a question-and-answer format to provide basic information about children with attention deficit disorder (ADD). Questions address the following concerns: nature and incidence of ADD; causes of ADD; signs of ADD (impulsivity, hyperactivity, disorganization, social skill deficits); the diagnostic ADD assessment; how to…

How valid are current diagnostic criteria for dental erosion?

PubMed Central

2008-01-01

In principle, there is agreement about the clinical diagnostic criteria for dental erosion, basically defined as cupping and grooving of the occlusal/incisal surfaces, shallow defects on smooth surfaces located coronal from the enamel–cementum junction with an intact cervical enamel rim and restorations rising above the adjacent tooth surface. This lesion characteristic was established from clinical experience and from observations in a small group of subjects with known exposure to acids rather than from systematic research. Their prevalence is higher in risk groups for dental erosion compared to subjects not particularly exposed to acids, but analytical epidemiological studies on random or cluster samples often fail to find a relation between occurrence or severity of lesions and any aetiological factor. Besides other aspects, this finding might be due to lack of validity with respect to diagnostic criteria. In particular, cupping and grooving might be an effect of abrasion as well as of erosion and their value for the specific diagnosis of erosion must be doubted. Knowledge about the validity of current diagnostic criteria of different forms of tooth wear is incomplete, therefore further research is needed. PMID:18228062

Regulation of human Nfu activity in Fe-S cluster delivery-characterization of the interaction between Nfu and the HSPA9/Hsc20 chaperone complex.

PubMed

Wachnowsky, Christine; Liu, Yushi; Yoon, Taejin; Cowan, J A

2018-01-01

Iron-sulfur cluster biogenesis is a complex, but highly regulated process that involves de novo cluster formation from iron and sulfide ions on a scaffold protein, and subsequent delivery to final targets via a series of Fe-S cluster-binding carrier proteins. The process of cluster release from the scaffold/carrier for transfer to the target proteins may be mediated by a dedicated Fe-S cluster chaperone system. In human cells, the chaperones include heat shock protein HSPA9 and the J-type chaperone Hsc20. While the role of chaperones has been somewhat clarified in yeast and bacterial systems, many questions remain over their functional roles in cluster delivery and interactions with a variety of human Fe-S cluster proteins. One such protein, Nfu, has recently been recognized as a potential interaction partner of the chaperone complex. Herein, we examined the ability of human Nfu to function as a carrier by interacting with the human chaperone complex. Human Nfu is shown to bind to both chaperone proteins with binding affinities similar to those observed for IscU binding to the homologous HSPA9 and Hsc20, while Nfu can also stimulate the ATPase activity of HSPA9. Additionally, the chaperone complex was able to promote Nfu function by enhancing the second-order rate constants for Fe-S cluster transfer to target proteins and providing directionality in cluster transfer from Nfu by eliminating promiscuous transfer reactions. Together, these data support a hypothesis in which Nfu can serve as an alternative carrier protein for chaperone-mediated cluster release and delivery in Fe-S cluster biogenesis and trafficking. © 2017 Federation of European Biochemical Societies.

Human avian influenza in Indonesia: are they really clustered?

PubMed

Eyanoer, Putri Chairani; Singhasivanon, Pratap; Kaewkungwal, Jaranit; Apisarnthanarak, Anucha

2011-05-01

Understanding the epidemiology of human H5N1 cases in Indonesia is important. The question of whether cases are clustered or not is unclear. An increase in clustered cases suggests greater transmissibility. In the present study, 107 confirmed and 302 suspected human H5N1 cases in Indonesia during 2005-2007 were analyzed for spatial and temporal distribution. Most confirmed cases (97.2%) occurred on two main islands (Java and Sumatera). There were no patterns of disease occurrence over time. There were also no correlations between occurrence patterns in humans and poultry. Statistical analysis showed confirmed cases were clustered within an area on Java island covered by 8 districts along the border of three neighboring provinces (Jakarta, West Java, and Banten). This study shows human H5N1 cases in Indonesia were clustered at two sites where there was a high rate of infection among poultry. These findings are important since they highlight areas of high risk for possible human H5N1 infection in Indonesia, thus, preventive measures may be taken.

A Universe of Questions.

ERIC Educational Resources Information Center

Zeldovich, Yakov

1992-01-01

Reprinted from the original Russian manuscript of Yakov Zeldovich, this article chronicles his studies of the universe and his attempts to construct a theory of its evolution. He provides the high school student with compelling cosmological discussions about uniformity, galactic clusters, radiation, evolution, the big bang, and gravitational…

Parental guidance about drinking: relationship with teenage psychoactive substance use.

PubMed

Miller, Patrick; Plant, Martin

2010-02-01

Parental guidance concerning alcohol was explored using data from a 2007 survey of 2179 UK school students aged 15 and 16 years. Cluster analysis based on questions about parental advice was used to establish seven student groups. Associations between groups, other family background and psychoactive substance use variables were explored. Substance use was least common amongst students whose parents discouraged drinking and those who claimed to have received no parental guidance. The heaviest substance users were teenagers from families with more favourable, tolerant attitudes to alcohol and intoxication and among students who failed to answer the questions about parental guidance. These scored highly on cannabis and other drug use. The cluster in which there was comprehensive discussion with the parents about alcohol use had an intermediate position in relation to substance use. In logistic regressions parental guidance was consistently associated with substance use with several other background variables controlled. Copyright (c) 2009 The Association for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Dissociative Identity Disorder

ERIC Educational Resources Information Center

Schmidt, Tom

2007-01-01

Few psychological disorders in the Diagnostic Statistical Manual have generated as much controversy as Dissociative Identity Disorder (DID). For the past 35 years diagnoses of DID, previously referred to as Multiple Personality Disorder (MPD), have increased exponentially, causing various psychological researchers and clinicians to question the…

Cluster lot quality assurance sampling: effect of increasing the number of clusters on classification precision and operational feasibility.

PubMed

Okayasu, Hiromasa; Brown, Alexandra E; Nzioki, Michael M; Gasasira, Alex N; Takane, Marina; Mkanda, Pascal; Wassilak, Steven G F; Sutter, Roland W

2014-11-01

To assess the quality of supplementary immunization activities (SIAs), the Global Polio Eradication Initiative (GPEI) has used cluster lot quality assurance sampling (C-LQAS) methods since 2009. However, since the inception of C-LQAS, questions have been raised about the optimal balance between operational feasibility and precision of classification of lots to identify areas with low SIA quality that require corrective programmatic action. To determine if an increased precision in classification would result in differential programmatic decision making, we conducted a pilot evaluation in 4 local government areas (LGAs) in Nigeria with an expanded LQAS sample size of 16 clusters (instead of the standard 6 clusters) of 10 subjects each. The results showed greater heterogeneity between clusters than the assumed standard deviation of 10%, ranging from 12% to 23%. Comparing the distribution of 4-outcome classifications obtained from all possible combinations of 6-cluster subsamples to the observed classification of the 16-cluster sample, we obtained an exact match in classification in 56% to 85% of instances. We concluded that the 6-cluster C-LQAS provides acceptable classification precision for programmatic action. Considering the greater resources required to implement an expanded C-LQAS, the improvement in precision was deemed insufficient to warrant the effort. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Iron-sulfur cluster biogenesis in mammalian cells: new insights into the molecular mechanisms of cluster delivery

PubMed Central

Maio, Nunziata; Rouault, Tracey. A.

2014-01-01

Iron-sulfur (Fe-S) clusters are ancient, ubiquitous cofactors composed of iron and inorganic sulfur. The combination of the chemical reactivity of iron and sulfur, together with many variations of cluster composition, oxidation states and protein environments, enables Fe-S clusters to participate in numerous biological processes. Fe-S clusters are essential to redox catalysis in nitrogen fixation, mitochondrial respiration and photosynthesis, to regulatory sensing in key metabolic pathways (i. e. cellular iron homeostasis and oxidative stress response), and to the replication and maintenance of the nuclear genome. Fe-S cluster biogenesis is a multistep process that involves a complex sequence of catalyzed protein- protein interactions and coupled conformational changes between the components of several dedicated multimeric complexes. Intensive studies of the assembly process have clarified key points in the biogenesis of Fe-S proteins. However several critical questions still remain, such as: what is the role of frataxin? Why do some defects of Fe-S cluster biogenesis cause mitochondrial iron overload? How are specific Fe-S recipient proteins recognized in the process of Fe-S transfer? This review focuses on the basic steps of Fe-S cluster biogenesis, drawing attention to recent advances achieved on the identification of molecular features that guide selection of specific subsets of nascent Fe-S recipients by the cochaperone HSC20. Additionally, it outlines the distinctive phenotypes of human diseases due to mutations in the components of the basic pathway. PMID:25245479

ROC curve analyses of eyewitness identification decisions: An analysis of the recent debate.

PubMed

Rotello, Caren M; Chen, Tina

2016-01-01

How should the accuracy of eyewitness identification decisions be measured, so that best practices for identification can be determined? This fundamental question is under intense debate. One side advocates for continued use of a traditional measure of identification accuracy, known as the diagnosticity ratio , whereas the other side argues that receiver operating characteristic curves (ROCs) should be used instead because diagnosticity is confounded with response bias. Diagnosticity proponents have offered several criticisms of ROCs, which we show are either false or irrelevant to the assessment of eyewitness accuracy. We also show that, like diagnosticity, Bayesian measures of identification accuracy confound response bias with witnesses' ability to discriminate guilty from innocent suspects. ROCs are an essential tool for distinguishing memory-based processes from decisional aspects of a response; simulations of different possible identification tasks and response strategies show that they offer important constraints on theory development.

Diagnostic efficiency of DSM-IV criteria for obsessive compulsive personality disorder in patients with binge eating disorder.

PubMed

Grilo, C M

2004-01-01

This study examined the diagnostic efficiency of the DSM-IV criteria for obsessive compulsive personality disorder (OCPD) in patients with binge eating disorder (BED). Two hundred and eleven consecutive adult patients with axis I diagnoses of BED were reliably assessed with semi-structured diagnostic interviews. Conditional probabilities-sensitivity, specificity, positive predictive power (PPP), and negative predictive power (NPP)-were calculated for each of the eight criteria for OCPD, using the 'best-estimate' OCPD diagnosis as the standard. The diagnostic efficiencies of the OCPD criteria were variable, with three criteria failing to have predictive value (PPP<0.50). The best inclusion criterion (highest PPP) was 'Perfectionism,' which was also the overall most predictive criterion. The findings suggest ordering of the DSM-IV criteria for OCPD based on performance and call into question the utility of some criteria.

Star Formation in Nearby Clusters (SFiNCs)

NASA Astrophysics Data System (ADS)

Getman, Konstantin

Most stars form in clusters that rapidly disperse, yet we have a poor understanding of the processes of cluster formation and early evolution. Do clusters form `top-down', rapidly in a dense molecular cloud core? Or, since clouds are turbulent, do clusters form `bottomup' by merging subclusters produced in small kinematically-distinct molecular structures? Do clusters principally form in elongated molecular structures such as Infrared Dark Clouds and Herschel filaments? One of the central reasons for slow progress in resolving these questions is the lack of homogeneous and reliable census of stellar members (both disk-bearing and disk-free) for a wide range of star forming environments. To address these issues we are now completing our major effort, called MYStIX (Massive Young Star-Forming Complex Study in Infrared and X-ray). It combines the Chandra archive with UKIRT+2MASS near-infrared and Spitzer mid-infrared surveys to identify young stellar objects in a wide range of evolutionary stages, from protostars to disk-free pre-main sequence stars, in 20 star forming regions at distances from 0.4 to 3.6 kpc. Each MYStIX region was chosen to have a rich OB-dominated cluster. Started in 2009 with NASA/ADAP and NSF funding, MYStIX has emerged with 8 technical/catalog and the first 4 of a series of science papers (http://astro.psu.edu/mystix). Early MYStIX results include: demonstration of diverse morphologies of young clusters from simple ellipsoids to elongated, clumpy substructures; demonstration of spatio-age gradients across star formation regions; the discovery of core-halo age gradients within two rich nearby MYStIX clusters; and the discovery of important astrophysically empirical correlations among different subcluster properties such as age, absorption, core radius, central stellar density, and total intrinsic population. The early MYStIX result provide new observational evidence for subcluster merging and cluster expansion following gas dissipation. We propose here to extend the MYStIX effort to an archive study of 19 nearer and smaller star forming regions where the stellar clusters are dominated by a single late-OB star rather than numerous O stars as in the MYStIX fields. We call this project `Star Formation in Nearby Clusters' or SFiNCs (homophonic with `sphinx'). With a homogeneous analysis of the Chandra, 2MASS, Spitzer and Herschel archives, we expect to identify and characterize over 50 SFiNCs subclusters. The inferred empirical correlations among different cluster properties for nearly 200 SFiNCs+MYStIX subclusters with 30-3000 detected stars on scales of 0.1-20 pc will allow, for the first time, direct comparison with the results of theoretical simulations of cluster formation to seek deeper answers to the fundamental questions posed above. It is possible, for example, that smaller molecular clouds have less turbulence and thus produce small clusters in a single event rather than through subcluster mergers. Models based on meteoritic isotopes suggest that our Solar System formed in a complex of SFiNCs/MYStIX-like clusters (Gounelle & Meynet 2012, A&A, 545, 4). This project addresses NASA SMD Strategic Subgoals 3C (Advance scientific knowledge of the origin and history of the solar system) and 3D.3 (Understand how individual stars form and how those processes ultimately affect the formation of planetary systems). It lies in the `Star formation and pre-main sequence stars' Research Area of the Astrophysics Data Analysis program.

Beyond Symmetry Breaking: Competition and Negative Feedback in GTPase regulation

PubMed Central

Wu, Chi-Fang; Lew, Daniel J.

2013-01-01

Summary Cortical domains are often specified by the local accumulation of active GTPases. Such domains can arise through spontaneous symmetry breaking, suggesting that GTPase accumulation occurs via positive feedback. Here, we focus on recent advances in fungal and plant cell models, where new work suggests that polarity-controlling GTPases develop only one “front” because GTPase clusters engage in a winner-takes-all competition. However, in some circumstances two or more GTPase domains can co-exist, and the basis for the switch from competition to coexistence remains an open question. Polarity GTPases can undergo oscillatory clustering and dispersal, suggesting that these systems contain negative feedback. Negative feedback may prevent polarity clusters from spreading too far, regulate the balance between competition and co-existence, and provide directional flexibility for cells tracking gradients. PMID:23731999

The 2016 Academic Emergency Medicine Consensus Conference, "Shared Decision Making in the Emergency Department: Development of a Policy-relevant Patient-centered Research Agenda" Diagnostic Testing Breakout Session Report.

PubMed

Barrett, Tyler W; Rising, Kristin L; Bellolio, M Fernanda; Hall, M Kennedy; Brody, Aaron; Dodd, Kenneth W; Grieser, Mira; Levy, Phillip D; Raja, Ali S; Self, Wesley H; Weingarten, Gail; Hess, Erik P; Hollander, Judd E

2016-12-01

Diagnostic testing is an integral component of patient evaluation in the emergency department (ED). Emergency clinicians frequently use diagnostic testing to more confidently exclude "worst-case" diagnoses rather than to determine the most likely etiology for a presenting complaint. Increased utilization of diagnostic testing has not been associated with reductions in disease-related mortality but has led to increased overall healthcare costs and other unintended consequences (e.g., incidental findings requiring further workup, unnecessary exposure to ionizing radiation or potentially nephrotoxic contrast). Shared decision making (SDM) presents an opportunity for clinicians to discuss the benefits and harms associated with diagnostic testing with patients to more closely tailor testing to patient risk. This article introduces the challenges and opportunities associated with incorporating SDM into emergency care by summarizing the conclusions of the diagnostic testing group at the 2016 Academic Emergency Medicine Consensus Conference on SDM. Three primary domains emerged: 1) characteristics of a condition or test appropriate for SDM, 2) critical elements of and potential barriers to SDM discussions on diagnostic testing, and 3) financial aspects of SDM applied to diagnostic testing. The most critical research questions to improve engagement of patients in their acute care diagnostic decisions were determined by consensus. © 2016 by the Society for Academic Emergency Medicine.

Missed opportunities for diagnosis: lessons learned from diagnostic errors in primary care.

PubMed

Goyder, Clare R; Jones, Caroline H D; Heneghan, Carl J; Thompson, Matthew J

2015-12-01

Because of the difficulties inherent in diagnosis in primary care, it is inevitable that diagnostic errors will occur. However, despite the important consequences associated with diagnostic errors and their estimated high prevalence, teaching and research on diagnostic error is a neglected area. To ascertain the key learning points from GPs' experiences of diagnostic errors and approaches to clinical decision making associated with these. Secondary analysis of 36 qualitative interviews with GPs in Oxfordshire, UK. Two datasets of semi-structured interviews were combined. Questions focused on GPs' experiences of diagnosis and diagnostic errors (or near misses) in routine primary care and out of hours. Interviews were audiorecorded, transcribed verbatim, and analysed thematically. Learning points include GPs' reliance on 'pattern recognition' and the failure of this strategy to identify atypical presentations; the importance of considering all potentially serious conditions using a 'restricted rule out' approach; and identifying and acting on a sense of unease. Strategies to help manage uncertainty in primary care were also discussed. Learning from previous examples of diagnostic errors is essential if these events are to be reduced in the future and this should be incorporated into GP training. At a practice level, learning points from experiences of diagnostic errors should be discussed more frequently; and more should be done to integrate these lessons nationally to understand and characterise diagnostic errors. © British Journal of General Practice 2015.

A New Spin on an Old Technology: Piezoelectric Ejecta Diagnostics for Shock Environments

NASA Astrophysics Data System (ADS)

Vogan, W. S.; Anderson, W. W.; Grover, M.; King, N. S. P.; Lamoreaux, S. K.; Morley, K. B.; Rigg, P. A.; Stevens, G. D.; Turley, W. D.; Buttler, W. T.

2006-07-01

In our investigation of ejecta, or metal particulate emitted from a surface subjected to shock-loaded conditions, we have developed a shock experiment suitable for testing new ideas in piezoelectric mass and impact detectors. High-explosive (HE) shock loading of tin targets subjected to various machined and compressed finishes results in significant trends in ejecta characteristics of interest such as areal density and velocity. Our enhanced piezoelectric diagnostic, "piezo-pins" modified for shock mitigation, have proven levels of robustness and reliability suitable for effective operation in these ejecta milieux. These field tests address questions about ejecta production from surfaces of interest; experimental results are discussed and compared with those from complementary diagnostics such as x-ray and optical attenuation visualization techniques.

Cognitive Emotion Regulation Strategies Associated With the DSM-5 Posttraumatic Stress Disorder Criteria.

PubMed

Kaczkurkin, Antonia N; Zang, Yinyin; Gay, Natalie G; Peterson, Alan L; Yarvis, Jeffrey S; Borah, Elisa V; Dondanville, Katherine A; Hembree, Elizabeth A; Litz, Brett T; Mintz, Jim; Young-McCaughan, Stacey; Foa, Edna B

2017-08-01

Maladaptive cognitive emotion regulation strategies have been proposed to contribute to the maintenance of posttraumatic stress disorder (PTSD). Prior work has focused on the relationship between these strategies and PTSD as a whole, rather than on how they are related to each PTSD symptom cluster. The purpose of the current study was to determine whether cognitive emotion regulation strategies are predictive of certain PTSD symptom clusters under the Diagnostic and Statistical Manual of Mental Disorders 5th ed. (DSM-5; American Psychiatric Association, 2013) criteria (intrusive thoughts, avoidance, negative alterations in cognitions and mood, and hyperarousal). Participants included 365 treatment-seeking, active-duty military personnel with PTSD. The negative alterations in cognitions and mood cluster were associated with dysfunctional cognitions: greater negative cognitions about the self, negative cognitions about the world, and self-blame, as well as catastrophizing (Rc2 = .519). The negative alterations in cognitions and mood cluster did not show a strong relationship with blaming others, possibly due to the complex nature of self- and other-blame in this primarily deployment-related PTSD sample. Finally, the intrusive thoughts cluster was associated with catastrophizing (Rc2 = .211), suggesting an association between frequent intrusive memories and excessively negative interpretation of those memories. Copyright © 2017 International Society for Traumatic Stress Studies.

Wing morphometrics as a possible tool for the diagnosis of the Ceratitis fasciventris, C. anonae, C. rosa complex (Diptera, Tephritidae).

PubMed

Van Cann, Joannes; Virgilio, Massimiliano; Jordaens, Kurt; De Meyer, Marc

2015-01-01

Previous attempts to resolve the Ceratitis FAR complex (Ceratitis fasciventris, Ceratitis anonae, Ceratitis rosa, Diptera, Tephritidae) showed contrasting results and revealed the occurrence of five microsatellite genotypic clusters (A, F1, F2, R1, R2). In this paper we explore the potential of wing morphometrics for the diagnosis of FAR morphospecies and genotypic clusters. We considered a set of 227 specimens previously morphologically identified and genotyped at 16 microsatellite loci. Seventeen wing landmarks and 6 wing band areas were used for morphometric analyses. Permutational multivariate analysis of variance detected significant differences both across morphospecies and genotypic clusters (for both males and females). Unconstrained and constrained ordinations did not properly resolve groups corresponding to morphospecies or genotypic clusters. However, posterior group membership probabilities (PGMPs) of the Discriminant Analysis of Principal Components (DAPC) allowed the consistent identification of a relevant proportion of specimens (but with performances differing across morphospecies and genotypic clusters). This study suggests that wing morphometrics and PGMPs might represent a possible tool for the diagnosis of species within the FAR complex. Here, we propose a tentative diagnostic method and provide a first reference library of morphometric measures that might be used for the identification of additional and unidentified FAR specimens.

Predictive ability of an early diagnostic guess in patients presenting with chest pain; a longitudinal descriptive study

PubMed Central

2010-01-01

Background The intuitive early diagnostic guess could play an important role in reaching a final diagnosis. However, no study to date has attempted to quantify the importance of general practitioners' (GPs) ability to correctly appraise the origin of chest pain within the first minutes of an encounter. Methods The validation study was nested in a multicentre cohort study with a one year follow-up and included 626 successive patients who presented with chest pain and were attended by 58 GPs in Western Switzerland. The early diagnostic guess was assessed prior to a patient's history being taken by a GP and was then compared to a diagnosis of chest pain observed over the next year. Results Using summary measures clustered at the GP's level, the early diagnostic guess was confirmed by further investigation in 51.0% (CI 95%; 49.4% to 52.5%) of patients presenting with chest pain. The early diagnostic guess was more accurate in patients with a life threatening illness (65.4%; CI 95% 64.5% to 66.3%) and in patients who did not feel anxious (62.9%; CI 95% 62.5% to 63.3%). The predictive abilities of an early diagnostic guess were consistent among GPs. Conclusions The GPs early diagnostic guess was correct in one out of two patients presenting with chest pain. The probability of a correct guess was higher in patients with a life-threatening illness and in patients not feeling anxious about their pain. PMID:20170544

Predictive ability of an early diagnostic guess in patients presenting with chest pain; a longitudinal descriptive study.

PubMed

Verdon, François; Junod, Michel; Herzig, Lilli; Vaucher, Paul; Burnand, Bernard; Bischoff, Thomas; Pécoud, Alain; Favrat, Bernard

2010-02-21

The intuitive early diagnostic guess could play an important role in reaching a final diagnosis. However, no study to date has attempted to quantify the importance of general practitioners' (GPs) ability to correctly appraise the origin of chest pain within the first minutes of an encounter. The validation study was nested in a multicentre cohort study with a one year follow-up and included 626 successive patients who presented with chest pain and were attended by 58 GPs in Western Switzerland. The early diagnostic guess was assessed prior to a patient's history being taken by a GP and was then compared to a diagnosis of chest pain observed over the next year. Using summary measures clustered at the GP's level, the early diagnostic guess was confirmed by further investigation in 51.0% (CI 95%; 49.4% to 52.5%) of patients presenting with chest pain. The early diagnostic guess was more accurate in patients with a life threatening illness (65.4%; CI 95% 64.5% to 66.3%) and in patients who did not feel anxious (62.9%; CI 95% 62.5% to 63.3%). The predictive abilities of an early diagnostic guess were consistent among GPs. The GPs early diagnostic guess was correct in one out of two patients presenting with chest pain. The probability of a correct guess was higher in patients with a life-threatening illness and in patients not feeling anxious about their pain.

Clustering analysis of proteins from microbial genomes at multiple levels of resolution.

PubMed

Zaslavsky, Leonid; Ciufo, Stacy; Fedorov, Boris; Tatusova, Tatiana

2016-08-31

Microbial genomes at the National Center for Biotechnology Information (NCBI) represent a large collection of more than 35,000 assemblies. There are several complexities associated with the data: a great variation in sampling density since human pathogens are densely sampled while other bacteria are less represented; different protein families occur in annotations with different frequencies; and the quality of genome annotation varies greatly. In order to extract useful information from these sophisticated data, the analysis needs to be performed at multiple levels of phylogenomic resolution and protein similarity, with an adequate sampling strategy. Protein clustering is used to construct meaningful and stable groups of similar proteins to be used for analysis and functional annotation. Our approach is to create protein clusters at three levels. First, tight clusters in groups of closely-related genomes (species-level clades) are constructed using a combined approach that takes into account both sequence similarity and genome context. Second, clustroids of conservative in-clade clusters are organized into seed global clusters. Finally, global protein clusters are built around the the seed clusters. We propose filtering strategies that allow limiting the protein set included in global clustering. The in-clade clustering procedure, subsequent selection of clustroids and organization into seed global clusters provides a robust representation and high rate of compression. Seed protein clusters are further extended by adding related proteins. Extended seed clusters include a significant part of the data and represent all major known cell machinery. The remaining part, coming from either non-conservative (unique) or rapidly evolving proteins, from rare genomes, or resulting from low-quality annotation, does not group together well. Processing these proteins requires significant computational resources and results in a large number of questionable clusters. The developed filtering strategies allow to identify and exclude such peripheral proteins limiting the protein dataset in global clustering. Overall, the proposed methodology allows the relevant data at different levels of details to be obtained and data redundancy eliminated while keeping biologically interesting variations.

The Value of Physical Examination: A New Conceptual Framework.

PubMed

Zaman, Junaid; Verghese, Abraham; Elder, Andrew

2016-12-01

The physical examination defines medical practice, yet its role is being questioned increasingly, with statistical comparisons of diagnostic accuracy often the sole metric used against newer technologies. We set out to highlight seven ways in which the physical examination has value beyond diagnostic accuracy to reaffirm its place in the core skills of a physician and guide future research, teaching, and curriculum design. We show that this more comprehensive approach to the physical examination of its "utility" beyond that of reaching a diagnosis can be beneficial to both doctor and patient.

Cannabinoid Hyperemesis Syndrome and the Consulting Psychiatrist: A Case Study of Diagnosis and Treatment for an Emerging Disorder in Psychiatric Practice.

PubMed

Kast, Kristopher A; Gershengoren, Liliya

2018-01-01

The increasing prevalence of cannabis use in the United States requires awareness of cannabis-related disorders and familiarity with treatment options. We present a case of cannabinoid hyperemesis syndrome that required psychiatric consultation for diagnostic clarification and effective treatment with intravenous haloperidol. Literature from emergency medicine, toxicology, and gastroenterology is reviewed, including proposed diagnostic criteria for cannabinoid hyperemesis syndrome and reported off-label treatment options, with a specific focus on clinical questions facing the practicing psychiatrist regarding this emerging disorder.

Proposal for a new self-compiled questionnaire in patients affected by temporo-mandibular joint disorders (TMD).

PubMed

Agrillo, A; Ramieri, V; Bianca, C; Nastro Siniscalchi, E; Fatone, F M G; Arangio, P

2010-07-01

In this work, we propose a self-compiled questionnaire, for those patients showing dysfunctions of the temporomandibular joint. The questionnaire, composed by 33 closed multiple-choice questions, represents one of the steps in the diagnostic procedure, together with the clinical notes compiled by the medical specialist and with the other necessary diagnostic researches. It also has the purpose to make easier anamnesis and clinic procedure and gathering of all informations useful for a right clinical diagnosis, and so for an appropriate therapy.

Impact of the accuracy of automatic segmentation of cell nuclei clusters on classification of thyroid follicular lesions.

PubMed

Jung, Chanho; Kim, Changick

2014-08-01

Automatic segmentation of cell nuclei clusters is a key building block in systems for quantitative analysis of microscopy cell images. For that reason, it has received a great attention over the last decade, and diverse automatic approaches to segment clustered nuclei with varying levels of performance under different test conditions have been proposed in literature. To the best of our knowledge, however, so far there is no comparative study on the methods. This study is a first attempt to fill this research gap. More precisely, the purpose of this study is to present an objective performance comparison of existing state-of-the-art segmentation methods. Particularly, the impact of their accuracy on classification of thyroid follicular lesions is also investigated "quantitatively" under the same experimental condition, to evaluate the applicability of the methods. Thirteen different segmentation approaches are compared in terms of not only errors in nuclei segmentation and delineation, but also their impact on the performance of system to classify thyroid follicular lesions using different metrics (e.g., diagnostic accuracy, sensitivity, specificity, etc.). Extensive experiments have been conducted on a total of 204 digitized thyroid biopsy specimens. Our study demonstrates that significant diagnostic errors can be avoided using more advanced segmentation approaches. We believe that this comprehensive comparative study serves as a reference point and guide for developers and practitioners in choosing an appropriate automatic segmentation technique adopted for building automated systems for specifically classifying follicular thyroid lesions. © 2014 International Society for Advancement of Cytometry.

Malignant pleural mesothelioma and mesothelial hyperplasia: A new molecular tool for the differential diagnosis.

PubMed

Bruno, Rossella; Alì, Greta; Giannini, Riccardo; Proietti, Agnese; Lucchi, Marco; Chella, Antonio; Melfi, Franca; Mussi, Alfredo; Fontanini, Gabriella

2017-01-10

Malignant pleural mesothelioma (MPM) is a rare asbestos related cancer, aggressive and unresponsive to therapies. Histological examination of pleural lesions is the gold standard of MPM diagnosis, although it is sometimes hard to discriminate the epithelioid type of MPM from benign mesothelial hyperplasia (MH).This work aims to define a new molecular tool for the differential diagnosis of MPM, using the expression profile of 117 genes deregulated in this tumour.The gene expression analysis was performed by nanoString System on tumour tissues from 36 epithelioid MPM and 17 MH patients, and on 14 mesothelial pleural samples analysed in a blind way. Data analysis included raw nanoString data normalization, unsupervised cluster analysis by Pearson correlation, non-parametric Mann Whitney U-test and molecular classification by the Uncorrelated Shrunken Centroid (USC) Algorithm.The Mann-Whitney U-test found 35 genes upregulated and 31 downregulated in MPM. The unsupervised cluster analysis revealed two clusters, one composed only of MPM and one only of MH samples, thus revealing class-specific gene profiles. The Uncorrelated Shrunken Centroid algorithm identified two classifiers, one including 22 genes and the other 40 genes, able to properly classify all the samples as benign or malignant using gene expression data; both classifiers were also able to correctly determine, in a blind analysis, the diagnostic categories of all the 14 unknown samples.In conclusion we delineated a diagnostic tool combining molecular data (gene expression) and computational analysis (USC algorithm), which can be applied in the clinical practice for the differential diagnosis of MPM.

Resonant scattering as a sensitive diagnostic of current collisional plasma models

NASA Astrophysics Data System (ADS)

Ogorzalek, Anna; Zhuravleva, Irina; Allen, Steven W.; Pinto, Ciro; Werner, Norbert; Mantz, Adam; Canning, Rebecca; Fabian, Andrew C.; Kaastra, Jelle S.; de Plaa, Jelle

2017-08-01

Resonant scattering is a subtle process that suppresses fluxes of some of the brightest optically thick X-ray emission lines produced by collisional plasmas in galaxy clusters and massive early-type galaxies. The amplitude of the effect depends on the turbulent structure of the hot gas, making it a sensitive velocity probe. It is therefore crucial to properly model this effect in order to correctly interpret high resolution X-ray spectra. Our measurements of resonant scattering with XMM-Newton Reflection Grating Spectrometer in giant elliptical galaxies and with Hitomi in the center of Perseus Cluster show that the potentially rich inference from this effect is limited by the uncertainties in the atomic data underlying plasma codes such as APEC and SPEX. Typically, the effect is of the order of 10-20%, while the discrepancy between the two codes is of similar order or even higher. Precise knowledge of the emissivity and oscillator strengths of lines emitted by Fe XVII and Fe XXV, as well as their respective uncertainties propagated through plasma codes are key to understanding gas dynamics and microphysics in giant galaxies and cluster ICM, respectively. This is especially crucial for massive ellipticals, where sub-eV resolution would be needed to measure line broadening precisely, making resonant scattering an important velocity diagnostic in these systems for the foreseeable future. In this poster, I will summarize current status of resonant scattering measurements and show how they depend on the assumed atomic data. I will also discuss which improvements are essential to maximize scientific inference from future high resolution X-ray spectra.

The combination of a histogram-based clustering algorithm and support vector machine for the diagnosis of osteoporosis.

PubMed

Kavitha, Muthu Subash; Asano, Akira; Taguchi, Akira; Heo, Min-Suk

2013-09-01

To prevent low bone mineral density (BMD), that is, osteoporosis, in postmenopausal women, it is essential to diagnose osteoporosis more precisely. This study presented an automatic approach utilizing a histogram-based automatic clustering (HAC) algorithm with a support vector machine (SVM) to analyse dental panoramic radiographs (DPRs) and thus improve diagnostic accuracy by identifying postmenopausal women with low BMD or osteoporosis. We integrated our newly-proposed histogram-based automatic clustering (HAC) algorithm with our previously-designed computer-aided diagnosis system. The extracted moment-based features (mean, variance, skewness, and kurtosis) of the mandibular cortical width for the radial basis function (RBF) SVM classifier were employed. We also compared the diagnostic efficacy of the SVM model with the back propagation (BP) neural network model. In this study, DPRs and BMD measurements of 100 postmenopausal women patients (aged >50 years), with no previous record of osteoporosis, were randomly selected for inclusion. The accuracy, sensitivity, and specificity of the BMD measurements using our HAC-SVM model to identify women with low BMD were 93.0% (88.0%-98.0%), 95.8% (91.9%-99.7%) and 86.6% (79.9%-93.3%), respectively, at the lumbar spine; and 89.0% (82.9%-95.1%), 96.0% (92.2%-99.8%) and 84.0% (76.8%-91.2%), respectively, at the femoral neck. Our experimental results predict that the proposed HAC-SVM model combination applied on DPRs could be useful to assist dentists in early diagnosis and help to reduce the morbidity and mortality associated with low BMD and osteoporosis.

Temperature structure in the Perseus cluster core observed with Hitomi

NASA Astrophysics Data System (ADS)

Hitomi Collaboration; Aharonian, Felix; Akamatsu, Hiroki; Akimoto, Fumie; Allen, Steven W.; Angelini, Lorella; Audard, Marc; Awaki, Hisamitsu; Axelsson, Magnus; Bamba, Aya; Bautz, Marshall W.; Blandford, Roger; Brenneman, Laura W.; Brown, Gregory V.; Bulbul, Esra; Cackett, Edward M.; Chernyakova, Maria; Chiao, Meng P.; Coppi, Paolo S.; Costantini, Elisa; de Plaa, Jelle; de Vries, Cor P.; den Herder, Jan-Willem; Done, Chris; Dotani, Tadayasu; Ebisawa, Ken; Eckart, Megan E.; Enoto, Teruaki; Ezoe, Yuichiro; Fabian, Andrew C.; Ferrigno, Carlo; Foster, Adam R.; Fujimoto, Ryuichi; Fukazawa, Yasushi; Furukawa, Maki; Furuzawa, Akihiro; Galeazzi, Massimiliano; Gallo, Luigi C.; Gandhi, Poshak; Giustini, Margherita; Goldwurm, Andrea; Gu, Liyi; Guainazzi, Matteo; Haba, Yoshito; Hagino, Kouichi; Hamaguchi, Kenji; Harrus, Ilana M.; Hatsukade, Isamu; Hayashi, Katsuhiro; Hayashi, Takayuki; Hayashida, Kiyoshi; Hiraga, Junko S.; Hornschemeier, Ann; Hoshino, Akio; Hughes, John P.; Ichinohe, Yuto; Iizuka, Ryo; Inoue, Hajime; Inoue, Yoshiyuki; Ishida, Manabu; Ishikawa, Kumi; Ishisaki, Yoshitaka; Iwai, Masachika; Kaastra, Jelle; Kallman, Tim; Kamae, Tsuneyoshi; Kataoka, Jun; Kato, Yuichi; Katsuda, Satoru; Kawai, Nobuyuki; Kelley, Richard L.; Kilbourne, Caroline A.; Kitaguchi, Takao; Kitamoto, Shunji; Kitayama, Tetsu; Kohmura, Takayoshi; Kokubun, Motohide; Koyama, Katsuji; Koyama, Shu; Kretschmar, Peter; Krimm, Hans A.; Kubota, Aya; Kunieda, Hideyo; Laurent, Philippe; Lee, Shiu-Hang; Leutenegger, Maurice A.; Limousin, Olivier; Loewenstein, Michael; Long, Knox S.; Lumb, David; Madejski, Greg; Maeda, Yoshitomo; Maier, Daniel; Makishima, Kazuo; Markevitch, Maxim; Matsumoto, Hironori; Matsushita, Kyoko; McCammon, Dan; McNamara, Brian R.; Mehdipour, Missagh; Miller, Eric D.; Miller, Jon M.; Mineshige, Shin; Mitsuda, Kazuhisa; Mitsuishi, Ikuyuki; Miyazawa, Takuya; Mizuno, Tsunefumi; Mori, Hideyuki; Mori, Koji; Mukai, Koji; Murakami, Hiroshi; Mushotzky, Richard F.; Nakagawa, Takao; Nakajima, Hiroshi; Nakamori, Takeshi; Nakashima, Shinya; Nakazawa, Kazuhiro; Nobukawa, Kumiko K.; Nobukawa, Masayoshi; Noda, Hirofumi; Odaka, Hirokazu; Ohashi, Takaya; Ohno, Masanori; Okajima, Takashi; Ota, Naomi; Ozaki, Masanobu; Paerels, Frits; Paltani, Stéphane; Petre, Robert; Pinto, Ciro; Porter, Frederick S.; Pottschmidt, Katja; Reynolds, Christopher S.; Safi-Harb, Samar; Saito, Shinya; Sakai, Kazuhiro; Sasaki, Toru; Sato, Goro; Sato, Kosuke; Sato, Rie; Sawada, Makoto; Schartel, Norbert; Serlemtsos, Peter J.; Seta, Hiromi; Shidatsu, Megumi; Simionescu, Aurora; Smith, Randall K.; Soong, Yang; Stawarz, Łukasz; Sugawara, Yasuharu; Sugita, Satoshi; Szymkowiak, Andrew; Tajima, Hiroyasu; Takahashi, Hiromitsu; Takahashi, Tadayuki; Takeda, Shiníchiro; Takei, Yoh; Tamagawa, Toru; Tamura, Takayuki; Tanaka, Takaaki; Tanaka, Yasuo; Tanaka, Yasuyuki T.; Tashiro, Makoto S.; Tawara, Yuzuru; Terada, Yukikatsu; Terashima, Yuichi; Tombesi, Francesco; Tomida, Hiroshi; Tsuboi, Yohko; Tsujimoto, Masahiro; Tsunemi, Hiroshi; Tsuru, Takeshi Go; Uchida, Hiroyuki; Uchiyama, Hideki; Uchiyama, Yasunobu; Ueda, Shutaro; Ueda, Yoshihiro; Uno, Shiníchiro; Urry, C. Megan; Ursino, Eugenio; Watanabe, Shin; Werner, Norbert; Wilkins, Dan R.; Williams, Brian J.; Yamada, Shinya; Yamaguchi, Hiroya; Yamaoka, Kazutaka; Yamasaki, Noriko Y.; Yamauchi, Makoto; Yamauchi, Shigeo; Yaqoob, Tahir; Yatsu, Yoichi; Yonetoku, Daisuke; Zhuravleva, Irina; Zoghbi, Abderahmen

2018-03-01

The present paper explains the temperature structure of X-ray emitting plasma in the core of the Perseus cluster based on 1.8-20.0 keV data obtained with the Soft X-ray Spectrometer (SXS) on board the Hitomi Observatory. A series of four observations was carried out, with a total effective exposure time of 338 ks that covered a central region of ˜7΄ in diameter. SXS was operated with an energy resolution of ˜5 eV (full width at half maximum) at 5.9 keV. Not only fine structures of K-shell lines in He-like ions, but also transitions from higher principal quantum numbers were clearly resolved from Si through Fe. That enabled us to perform temperature diagnostics using the line ratios of Si, S, Ar, Ca, and Fe, and to provide the first direct measurement of the excitation temperature and ionization temperature in the Perseus cluster. The observed spectrum is roughly reproduced by a single-temperature thermal plasma model in collisional ionization equilibrium, but detailed line-ratio diagnostics reveal slight deviations from this approximation. In particular, the data exhibit an apparent trend of increasing ionization temperature with the atomic mass, as well as small differences between the ionization and excitation temperatures for Fe, the only element for which both temperatures could be measured. The best-fit two-temperature models suggest a combination of 3 and 5 keV gas, which is consistent with the idea that the observed small deviations from a single-temperature approximation are due to the effects of projecting the known radial temperature gradient in the cluster core along the line of sight. A comparison with the Chandra/ACIS and the XMM-Newton/RGS results, on the other hand, suggests that additional lower-temperature components are present in the intracluster medium (ICM), but not detectable with Hitomi/SXS giving its 1.8-20 keV energy band.

Class imbalance in unsupervised change detection - A diagnostic analysis from urban remote sensing

NASA Astrophysics Data System (ADS)

Leichtle, Tobias; Geiß, Christian; Lakes, Tobia; Taubenböck, Hannes

2017-08-01

Automatic monitoring of changes on the Earth's surface is an intrinsic capability and simultaneously a persistent methodological challenge in remote sensing, especially regarding imagery with very-high spatial resolution (VHR) and complex urban environments. In order to enable a high level of automatization, the change detection problem is solved in an unsupervised way to alleviate efforts associated with collection of properly encoded prior knowledge. In this context, this paper systematically investigates the nature and effects of class distribution and class imbalance in an unsupervised binary change detection application based on VHR imagery over urban areas. For this purpose, a diagnostic framework for sensitivity analysis of a large range of possible degrees of class imbalance is presented, which is of particular importance with respect to unsupervised approaches where the content of images and thus the occurrence and the distribution of classes are generally unknown a priori. Furthermore, this framework can serve as a general technique to evaluate model transferability in any two-class classification problem. The applied change detection approach is based on object-based difference features calculated from VHR imagery and subsequent unsupervised two-class clustering using k-means, genetic k-means and self-organizing map (SOM) clustering. The results from two test sites with different structural characteristics of the built environment demonstrated that classification performance is generally worse in imbalanced class distribution settings while best results were reached in balanced or close to balanced situations. Regarding suitable accuracy measures for evaluating model performance in imbalanced settings, this study revealed that the Kappa statistics show significant response to class distribution while the true skill statistic was widely insensitive to imbalanced classes. In general, the genetic k-means clustering algorithm achieved the most robust results with respect to class imbalance while the SOM clustering exhibited a distinct optimization towards a balanced distribution of classes.

[Ultrastructure and Raman Spectral Characteristics of Two Kinds of Acute Myeloid Leukemia Cells].

PubMed

Liang, Hao-Yue; Cheng, Xue-Lian; Dong, Shu-Xu; Zhao, Shi-Xuan; Wang, Ying; Ru, Yong-Xin

2018-02-01

To investigate the Raman spectral characteristics of leukemia cells from 4 patients with acute promyelocytic leukemia (M 3 ) and 3 patients with acute monoblastic leukemia (M 5 ), establish a novel Raman label-free method to distinguish 2 kinds of acute myeloid leukemia cells so as to provide basis for clinical research. Leukemia cells were collected from bone marrow of above-mentioned patients. Raman spectra were acquired by Horiba Xplora Raman spectrometer and Raman spectra of 30-50 cells from each patient were recorded. The diagnostic model was established according to principle component analysis (PCA), discriminant function analysis (DFA) and cluster analysis, and the spectra of leukemia cells from 7 patients were analyzed and classified. Characteristics of Raman spectra were analyzed combining with ultrastructure of leukemia cells. There were significant differences between Raman spectra of 2 kinds of leukemia cells. Compared with acute monoblastic leukemia cells, the spectra of acute promyelocytic leukemia cells showed stronger peaks in 622, 643, 757, 852, 1003, 1033, 1117, 1157, 1173, 1208, 1340, 1551, 1581 cm -1 . The diagnostic models established by PCA-DFA and cluster analysis could successfully classify these Raman spectra of different samples with a high accuracy of 100% (233/233). The model was evaluated by "Leave-one-out" cross-validation and reached a high accuracy of 97% (226/233). The level of macromolecules of M 3 cells is higher than that of M 5 . The diagnostic models established by PCA-DFA can classify these Raman spectra of different cells with a high accuracy. Raman spectra shows consistent result with ultrastructure by TEM.

Long-term outcomes of youth who manifested the CBCL-Pediatric Bipolar Disorder phenotype during childhood and/or adolescence.

PubMed

Meyer, Stephanie E; Carlson, Gabrielle A; Youngstrom, Eric; Ronsaville, Donna S; Martinez, Pedro E; Gold, Philip W; Hakak, Rashelle; Radke-Yarrow, Marian

2009-03-01

Recent studies have identified a Child Behavior Checklist (CBCL) profile that characterizes children with severe aggression, inattention, and mood instability. This profile has been coined the CBCL-Pediatric Bipolar Disorder (PBD) phenotype, because it is commonly seen among children with bipolar disorder. However, mounting evidence suggests that the CBCL-PBD may be a better tool for identifying children with severe functional impairment and broad-ranging psychiatric comorbidities rather than bipolar disorder itself. No studies have followed individuals with the CBCL-PBD profile through adulthood, so its long-term implications remain unclear. The present authors examined diagnostic and functional trajectories of individuals with the CBCL-PBD profile from early childhood through young adulthood using data from a longitudinal high-risk study. Participants (n=101) are part of a 23-year study of youth at risk for major mood disorder who have completed diagnostic and functional assessments at regular intervals. Across development, participants with the CBCL-PBD phenotype exhibited marked psychosocial impairment, increased rates of suicidal thoughts and behaviors and heightened risk for comorbid anxiety, bipolar disorder, cluster B personality disorders and ADHD in young adulthood, compared to participants without this presentation. However, diagnostic accuracy for any one particular disorder was found to be low. Children with the CBCL-PBD profile are at risk for ongoing, severe, psychiatric symptomatology including behavior and emotional comorbidities in general, and bipolar disorder, anxiety, ADHD, cluster B personality disorders in particular. However, the value of this profile may be in predicting ongoing comorbidity and impairment, rather than any one specific DSM-IV diagnosis.

Diagnostic Criteria for Cannabis Withdrawal Syndrome

PubMed Central

Gorelick, David A.; Levin, Kenneth H.; Copersino, Marc L.; Heishman, Stephen J.; Liu, Fang; Boggs, Douglas L.; Kelly, Deanna L.

2011-01-01

Objective Cannabis withdrawal occurs in frequent users who quit, but there are no accepted diagnostic criteria for a cannabis withdrawal syndrome (CWS). This study evaluated diagnostic criteria for CWS proposed in DSM-V and two earlier proposals. Method A convenience sample of 384 adult, non-treatment-seeking lifetime cannabis smokers provided retrospective self-report data on their “most difficult” quit attempt without formal treatment, which was used in this secondary analysis. Prevalence, time of onset, and peak intensity (5-point Likert scale) for 39 withdrawal symptoms (drawn from the literature) were assessed via computer-administered questionnaire. Subject groups were compared using chi-square or ANOVA. Symptom clustering was evaluated with principal components analysis. Results 40.9% of subjects met the DSM-V criterion of ≥ 3 symptoms from a list of 7. There were no associations with sex, race, or type of cannabis preparation used. There were significant positive associations between duration or frequency of cannabis use prior to the quit attempt and experiencing CWS. Subjects with CWS had a significantly shorter duration of abstinence. Alternative syndromal criteria (dropping physical symptoms from DSM-V list; requiring ≥ 2or ≥ 4 symptoms from a list of 11) yielded a similar prevalence of CWS and similar associations with prior cannabis use and relapse. The PCA yielded 12 factors, including some symptom clusters not included in DSM-V. Conclusions Findings support the concurrent and predictive validity of the proposed DSM-V CWS, but suggest that the list of withdrawal symptoms and number required for diagnosis warrant further evaluation. PMID:22153944

Occupational Information 1990/91. Volume II.

ERIC Educational Resources Information Center

Nebraska Univ., Lincoln. Nebraska Career Information System.

The Nebraska Occupational Information books (volumes I and II) contain information about 386 different occupations in the state and answer questions about specific occupations in detail. The descriptions are arranged according to a U.S. Department of Labor classification system, with occupational titles clustered in general groups of selected…

Occupational Information 1990/91. Volume I.

ERIC Educational Resources Information Center

Nebraska Univ., Lincoln. Nebraska Career Information System.

The Nebraska Occupational Information books (volumes I and II) contain information about 386 different occupations in the state and answer questions about specific occupations in detail. The descriptions are arranged according to a U.S. Department of Labor classification system, with occupational titles clustered in general groups of selected…

Managing marine mollusc diseases in the context of regional and international commerce: policy issues and emerging concerns.

PubMed

Carnegie, Ryan B; Arzul, Isabelle; Bushek, David

2016-03-05

Marine mollusc production contributes to food and economic security worldwide and provides valuable ecological services, yet diseases threaten these industries and wild populations. Although the infrastructure for mollusc aquaculture health management is well characterized, its foundations are not without flaws. Use of notifiable pathogen lists can leave blind spots with regard to detection of unlisted and emerging pathogens. Increased reliance on molecular tools has come without similar attention to diagnostic validation, raising questions about assay performance, and has been accompanied by a reduced emphasis on microscopic diagnostic expertise that could weaken pathogen detection capabilities. Persistent questions concerning pathogen biology and ecology promote regulatory paralysis that impedes trade and which could weaken biosecurity by driving commerce to surreptitious channels. Solutions that might be pursued to improve shellfish aquaculture health management include the establishment of more broad-based surveillance programmes, wider training and use of general methods like histopathology to ensure alertness to emerging diseases, an increased focus on assay assessment and validation as fundamental to assay development, investment in basic research, and application of risk analyses to improve regulation. A continual sharpening of diagnostic tools and approaches and deepening of scientific knowledge is necessary to manage diseases and promote sustainable molluscan shellfish industries. © 2016 The Author(s).

Managing marine mollusc diseases in the context of regional and international commerce: policy issues and emerging concerns

PubMed Central

Carnegie, Ryan B.; Arzul, Isabelle; Bushek, David

2016-01-01

Marine mollusc production contributes to food and economic security worldwide and provides valuable ecological services, yet diseases threaten these industries and wild populations. Although the infrastructure for mollusc aquaculture health management is well characterized, its foundations are not without flaws. Use of notifiable pathogen lists can leave blind spots with regard to detection of unlisted and emerging pathogens. Increased reliance on molecular tools has come without similar attention to diagnostic validation, raising questions about assay performance, and has been accompanied by a reduced emphasis on microscopic diagnostic expertise that could weaken pathogen detection capabilities. Persistent questions concerning pathogen biology and ecology promote regulatory paralysis that impedes trade and which could weaken biosecurity by driving commerce to surreptitious channels. Solutions that might be pursued to improve shellfish aquaculture health management include the establishment of more broad-based surveillance programmes, wider training and use of general methods like histopathology to ensure alertness to emerging diseases, an increased focus on assay assessment and validation as fundamental to assay development, investment in basic research, and application of risk analyses to improve regulation. A continual sharpening of diagnostic tools and approaches and deepening of scientific knowledge is necessary to manage diseases and promote sustainable molluscan shellfish industries. PMID:26880834

The Practical Guide to Classroom Literacy Assessment

ERIC Educational Resources Information Center

Barone, Diane M.; Taylor, Joan M.

2006-01-01

Whether it is standardized test data, student journals, or informal classroom question and answer, assessments provide invaluable, ongoing diagnostic information for making key instructional decisions. In this engaging and comprehensive resource, the authors demonstrate practical ways for embedding test preparation into teaching by integrating…

A Critique of the Diagnostic Construct Schizophrenia

ERIC Educational Resources Information Center

Wong, Stephen E.

2014-01-01

This article examines problems in the clinical utility of the diagnosis of schizophrenia including reliance on questionable data, arbitrary criteria and categorization, inadequate precision for assessment and treatment evaluation, and omission of information on causal current and historical environmental factors. Some alternatives to the…

Neuropsychological Criteria for Mild Cognitive Impairment Improves Diagnostic Precision, Biomarker Associations, and Progression Rates

PubMed Central

Bondi, Mark W.; Edmonds, Emily C.; Jak, Amy J.; Clark, Lindsay R.; Delano-Wood, Lisa; McDonald, Carrie R.; Nation, Daniel A.; Libon, David J.; Au, Rhoda; Galasko, Douglas; Salmon, David P.

2014-01-01

We compared two methods of diagnosing mild cognitive impairment (MCI): conventional Petersen/Winblad criteria as operationalized by the Alzheimer’s Disease Neuroimaging Initiative (ADNI) and an actuarial neuropsychological method put forward by Jak and Bondi designed to balance sensitivity and reliability. 1,150 ADNI participants were diagnosed at baseline as cognitively normal (CN) or MCI via ADNI criteria (MCI: n = 846; CN: n = 304) or Jak/Bondi criteria (MCI: n = 401; CN: n = 749), and the two MCI samples were submitted to cluster and discriminant function analyses. Resulting cluster groups were then compared and further examined for APOE allelic frequencies, cerebrospinal fluid (CSF) Alzheimer’s disease (AD) biomarker levels, and clinical outcomes. Results revealed that both criteria produced a mildly impaired Amnestic subtype and a more severely impaired Dysexecutive/Mixed subtype. The neuropsychological Jak/Bondi criteria uniquely yielded a third Impaired Language subtype, whereas conventional Petersen/Winblad ADNI criteria produced a third subtype comprising nearly one-third of the sample that performed within normal limits across the cognitive measures, suggesting this method’s susceptibility to false positive diagnoses. MCI participants diagnosed via neuropsychological criteria yielded dissociable cognitive phenotypes, significant CSF AD biomarker associations, more stable diagnoses, and identified greater percentages of participants who progressed to dementia than conventional MCI diagnostic criteria. Importantly, the actuarial neuropsychological method did not produce a subtype that performed within normal limits on the cognitive testing, unlike the conventional diagnostic method. Findings support the need for refinement of MCI diagnoses to incorporate more comprehensive neuropsychological methods, with resulting gains in empirical characterization of specific cognitive phenotypes, biomarker associations, stability of diagnoses, and prediction of progression. Refinement of MCI diagnostic methods may also yield gains in biomarker and clinical trial study findings because of improvements in sample compositions of ‘true positive’ cases and removal of ‘false positive’ cases. PMID:24844687

Implementation of immunochemical faecal occult blood test in general practice: a study protocol using a cluster-randomised stepped-wedge design.

PubMed

Juul, Jakob Søgaard; Bro, Flemming; Hornung, Nete; Andersen, Berit Sanne; Laurberg, Søren; Olesen, Frede; Vedsted, Peter

2016-07-11

Colorectal cancer is a common malignancy and a leading cause of cancer-related death. Half of patients with colorectal cancer initially present with non-specific or vague symptoms. In the need for a safe low-cost test, the immunochemical faecal occult blood test (iFOBT) may be part of the evaluation of such patients in primary care. Currently, Danish general practitioners have limited access to this test. The aim of this article is to describe a study that will assess the uptake and clinical use of iFOBT in general practice. Furthermore, it will investigate the diagnostic value and the clinical implications of using iFOBT in general practice on patients presenting with non-alarm symptoms of colorectal cancer. The study uses a cluster-randomised stepped-wedge design and is conducted in the Central Denmark Region among 836 GPs in 381 general practices. The municipalities of the Region and their appertaining general practitioners will be included sequentially in the study during the first 7 months of the 1-year study period. The following intervention has been developed for the study: a mandatory intervention providing all general practitioners with a starting package of 10 iFOBTs, a clinical instruction on iFOBT use in general practice and online information material from the date of inclusion, and an optional intervention consisting of a continuous medical education on colorectal cancer diagnostics and use of iFOBT. This study is among the first and largest trials to investigate the diagnostic use and the clinical value of iFOBT on patients presenting with non-alarm symptoms of colorectal cancer. The findings will be of national and international importance for the future planning of colorectal cancer diagnostics, particularly for 'low-risk-but-not-no-risk' patients with non-alarm symptoms of colorectal cancer. A Trial of the Implementation of iFOBT in General Practice NCT02308384 . Date of registration: 26 November 2014.

Marketability requirements for fault detection and diagnostics in commercial buildings

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

Heinemeier, K.H.

Fault Detection and Diagnostics (FDD) is a technology that has a great potential for improving performance and reducing energy consumed in commercial buildings, and is rapidly becoming feasible for the buildings sector. Scientists have developed algorithms for FDD, and are making plans for field-testing and demonstration of these methods in real buildings. These efforts will provide a sound technical basis for FDD product offerings. FDD has the potential to dramatically improve the quality of operation of buildings. However, progress on technical issues is only one step towards implementing FDD in the market. FDD cannot be expected to have a majormore » impact on buildings unless market issues are addressed. Many questions will have to be answered regarding the users of FDD systems, the usability of the product, the market for FDD, and the nature of possible FDD offerings. It is crucial to consider marketing issues in parallel with the more technical issues. Constraints and opportunities that will be faced in marketing the products must be recognized early in technology development, and addressed and integrated into designs to ensure an appropriate system design. This paper identified a number of key questions that will arise in addressing marketability issues. These questions will have to be answered individually by technology developers and entities intending to market FDD. This paper presents some of the considerations that must go into the answering the questions, and provides a framework for analyzing the market requirements.« less

Cohort study on clustering of lifestyle risk factors and understanding its association with stress on health and wellbeing among school teachers in Malaysia (CLUSTer)--a study protocol.

PubMed

Moy, Foong Ming; Hoe, Victor Chee Wai; Hairi, Noran Naqiah; Buckley, Brian; Wark, Petra A; Koh, David; Bueno-de-Mesquita, H Bas; Bulgiba, Awang M

2014-06-17

The study on Clustering of Lifestyle risk factors and Understanding its association with Stress on health and wellbeing among school Teachers in Malaysia (CLUSTer) is a prospective cohort study which aims to extensively study teachers in Malaysia with respect to clustering of lifestyle risk factors and stress, and subsequently, to follow-up the population for important health outcomes. This study is being conducted in six states within Peninsular Malaysia. From each state, schools from each district are randomly selected and invited to participate in the study. Once the schools agree to participate, all teachers who fulfilled the inclusion criteria are invited to participate. Data collection includes a questionnaire survey and health assessment. Information collected in the questionnaire includes socio-demographic characteristics, participants' medical history and family history of chronic diseases, teaching characteristics and burden, questions on smoking, alcohol consumption and physical activities (IPAQ); a food frequency questionnaire, the job content questionnaire (JCQ); depression, anxiety and stress scale (DASS21); health related quality of life (SF12-V2); Voice Handicap Index 10 on voice disorder, questions on chronic pain, sleep duration and obstetric history for female participants. Following blood drawn for predefined clinical tests, additional blood and urine specimens are collected and stored for future analysis. Active follow up of exposure and health outcomes will be carried out every two years via telephone or face to face contact. Data collection started in March 2013 and as of the end of March 2014 has been completed for four states: Kuala Lumpur, Selangor, Melaka and Penang. Approximately 6580 participants have been recruited. The first round of data collection and blood sampling is expected to be completed by the end of 2014 with an expected 10,000 participants recruited. Our study will provide a good basis for exploring the clustering of lifestyle risk factors and stress and its association with major chronic medical conditions such as obesity, hypertension, impaired glucose tolerance, diabetes mellitus, coronary heart diseases, kidney failure and cancers among teachers.

Cohort study on clustering of lifestyle risk factors and understanding its association with stress on health and wellbeing among school teachers in Malaysia (CLUSTer) – a study protocol

PubMed Central

2014-01-01

Background The study on Clustering of Lifestyle risk factors and Understanding its association with Stress on health and wellbeing among school Teachers in Malaysia (CLUSTer) is a prospective cohort study which aims to extensively study teachers in Malaysia with respect to clustering of lifestyle risk factors and stress, and subsequently, to follow-up the population for important health outcomes. Method/design This study is being conducted in six states within Peninsular Malaysia. From each state, schools from each district are randomly selected and invited to participate in the study. Once the schools agree to participate, all teachers who fulfilled the inclusion criteria are invited to participate. Data collection includes a questionnaire survey and health assessment. Information collected in the questionnaire includes socio-demographic characteristics, participants’ medical history and family history of chronic diseases, teaching characteristics and burden, questions on smoking, alcohol consumption and physical activities (IPAQ); a food frequency questionnaire, the job content questionnaire (JCQ); depression, anxiety and stress scale (DASS21); health related quality of life (SF12-V2); Voice Handicap Index 10 on voice disorder, questions on chronic pain, sleep duration and obstetric history for female participants. Following blood drawn for predefined clinical tests, additional blood and urine specimens are collected and stored for future analysis. Active follow up of exposure and health outcomes will be carried out every two years via telephone or face to face contact. Data collection started in March 2013 and as of the end of March 2014 has been completed for four states: Kuala Lumpur, Selangor, Melaka and Penang. Approximately 6580 participants have been recruited. The first round of data collection and blood sampling is expected to be completed by the end of 2014 with an expected 10,000 participants recruited. Discussion Our study will provide a good basis for exploring the clustering of lifestyle risk factors and stress and its association with major chronic medical conditions such as obesity, hypertension, impaired glucose tolerance, diabetes mellitus, coronary heart diseases, kidney failure and cancers among teachers. PMID:24938383

Addressing Student Difficulties with Buoyancy

NASA Astrophysics Data System (ADS)

Wagner, D. J.; Cohen, Sam; Moyer, Adam

2009-11-01

This study is part of an ongoing effort to develop a diagnostic test assessing student understanding of fluids. In particular, this paper addresses a question involving density and buoyancy, which was used in the study of reference [1]. The "five blocks" question, which asks students to predict the final location of blocks released from rest when submerged and explain their reasoning, has been administered to hundreds of students in three different introductory courses at Grove City College for the past four years. We used the common student responses to craft a multiple-select version of the five blocks problem in 2008. This paper will present the effects that changing workshop activities have had on student performance on the five block question.

The Robustness of Cluster Expansion: Assessing the Role of Relaxation

NASA Astrophysics Data System (ADS)

Nguyen, Andrew H.; Rosenbrock, Conrad W.; Hart, Gus L. W.

Cluster expansion (CE) has been used widely in combination with first-principles calculations to predict stable structures of metal alloys. CE treats alloys as a purely configuration problem, i.e., a problem in the distribution of the alloying elements on a fixed lattice. CE models are usually built from data taken from ``relaxed'' first-principles calculations where the individual atoms assume positions that minimize the total energy. A perennial question in the cluster expansion community is how the accuracy of the CE is affected by relaxations--technically, the formalism of CE breaks down when the underlying lattice is not preserved--but practitioners often argue that there is a one-to-one correspondence between relaxed and unrelaxed structures so that the formalism holds. We quantify the effect of relaxation on the robustness of cluster expansions by comparing CE fits for relaxed and unrelaxed data sets. Our results give a heuristic for when CE models can be trusted. Onr (MURI N00014-13-1-0635).