21 CFR Appendix B to Subpart B of... - Scope of Product Coverage

Code of Federal Regulations, 2011 CFR

2011-04-01

... Transducer ITX—Transducer, Ultrasonic, Diagnostic Diagnostic X-Ray Imaging Devices (except mammographic x-ray systems): RA 892.1600 Angiographic X-Ray System IZI—System, X-Ray, Angiographic RA 892.1650 Image-Intensified Fluoroscopic X-Ray System MQB—Solid State X-Ray Imager (Flat Panel/Digital Imager) JAA—System, X...

Systematic review of scope and quality of electronic patient record data in primary care

PubMed Central

Thiru, Krish; Hassey, Alan; Sullivan, Frank

2003-01-01

Objective To systematically review measures of data quality in electronic patient records (EPRs) in primary care. Design Systematic review of English language publications, 1980-2001. Data sources Bibliographic searches of medical databases, specialist medical informatics databases, conference proceedings, and institutional contacts. Study selection Studies selected according to a predefined framework for categorising review papers. Data extraction Reference standards and measurements used to judge quality. Results Bibliographic searches identified 4589 publications. After primary exclusions 174 articles were classified, 52 of which met the inclusion criteria for review. Selected studies were primarily descriptive surveys. Variability in methods prevented meta-analysis of results. Forty eight publications were concerned with diagnostic data, 37 studies measured data quality, and 15 scoped EPR quality. Reliability of data was assessed with rate comparison. Measures of sensitivity were highly dependent on the element of EPR data being investigated, while the positive predictive value was consistently high, indicating good validity. Prescribing data were generally of better quality than diagnostic or lifestyle data. Conclusion The lack of standardised methods for assessment of quality of data in electronic patient records makes it difficult to compare results between studies. Studies should present data quality measures with clear numerators, denominators, and confidence intervals. Ambiguous terms such as “accuracy” should be avoided unless precisely defined. PMID:12750210

21 CFR 601.30 - Scope.

Code of Federal Regulations, 2014 CFR

2014-04-01

... intended for therapeutic purposes. In situations where a particular radiopharmaceutical is proposed for both diagnostic and therapeutic uses, the radiopharmaceutical must be evaluated taking into account...

21 CFR 601.30 - Scope.

Code of Federal Regulations, 2011 CFR

2011-04-01

... intended for therapeutic purposes. In situations where a particular radiopharmaceutical is proposed for both diagnostic and therapeutic uses, the radiopharmaceutical must be evaluated taking into account...

21 CFR 601.30 - Scope.

Code of Federal Regulations, 2013 CFR

2013-04-01

... intended for therapeutic purposes. In situations where a particular radiopharmaceutical is proposed for both diagnostic and therapeutic uses, the radiopharmaceutical must be evaluated taking into account...

21 CFR 601.30 - Scope.

Code of Federal Regulations, 2010 CFR

2010-04-01

... intended for therapeutic purposes. In situations where a particular radiopharmaceutical is proposed for both diagnostic and therapeutic uses, the radiopharmaceutical must be evaluated taking into account...

21 CFR 601.30 - Scope.

Code of Federal Regulations, 2012 CFR

2012-04-01

... intended for therapeutic purposes. In situations where a particular radiopharmaceutical is proposed for both diagnostic and therapeutic uses, the radiopharmaceutical must be evaluated taking into account...

[Digital learning object for diagnostic reasoning in nursing applied to the integumentary system].

PubMed

da Costa, Cecília Passos Vaz; Luz, Maria Helena Barros Araújo

2015-12-01

To describe the creation of a digital learning object for diagnostic reasoning in nursing applied to the integumentary system at a public university of Piaui. A methodological study applied to technological production based on the pedagogical framework of problem-based learning. The methodology for creating the learning object observed the stages of analysis, design, development, implementation and evaluation recommended for contextualized instructional design. The revised taxonomy of Bloom was used to list the educational goals. The four modules of the developed learning object were inserted into the educational platform Moodle. The theoretical assumptions allowed the design of an important online resource that promotes effective learning in the scope of nursing education. This study should add value to nursing teaching practices through the use of digital learning objects for teaching diagnostic reasoning applied to skin and skin appendages.

21 CFR 315.1 - Scope.

Code of Federal Regulations, 2012 CFR

2012-04-01

... therapeutic purposes. In situations where a particular radiopharmaceutical is proposed for both diagnostic and therapeutic uses, the radiopharmaceutical must be evaluated taking into account each intended use. ...

21 CFR 315.1 - Scope.

Code of Federal Regulations, 2010 CFR

2010-04-01

... therapeutic purposes. In situations where a particular radiopharmaceutical is proposed for both diagnostic and therapeutic uses, the radiopharmaceutical must be evaluated taking into account each intended use. ...

21 CFR 315.1 - Scope.

Code of Federal Regulations, 2011 CFR

2011-04-01

... therapeutic purposes. In situations where a particular radiopharmaceutical is proposed for both diagnostic and therapeutic uses, the radiopharmaceutical must be evaluated taking into account each intended use. ...

21 CFR 315.1 - Scope.

Code of Federal Regulations, 2014 CFR

2014-04-01

... therapeutic purposes. In situations where a particular radiopharmaceutical is proposed for both diagnostic and therapeutic uses, the radiopharmaceutical must be evaluated taking into account each intended use. ...

21 CFR 315.1 - Scope.

Code of Federal Regulations, 2013 CFR

2013-04-01

... therapeutic purposes. In situations where a particular radiopharmaceutical is proposed for both diagnostic and therapeutic uses, the radiopharmaceutical must be evaluated taking into account each intended use. ...

Medical Surveillance Monthly Report (MSMR). Volume 19, Number 1, January 2012

DTIC Science & Technology

2012-01-01

malaria ; or (b) Hospitalization in Iraq/Afghanistan with a malaria diagnosis in any diagnostic position; or (c) Two or more outpatient primary (fi rst...e most common diagnostic test for malaria is the examination under the micro- scope of thin and thick fi lm blood smears. Aft er the blood on the...improve compliance with personal protective measures. Future eff orts will focus on rapid diagnostic tests , creating an inventory and archive of DoD

Can optical diagnosis of small colon polyps be accurate? Comparing standard scope without narrow banding to high definition scope with narrow banding

PubMed Central

Ashktorab, Hassan; Etaati, Firoozeh; Rezaeean, Farahnaz; Nouraie, Mehdi; Paydar, Mansour; Namin, Hassan Hassanzadeh; Sanderson, Andrew; Begum, Rehana; Alkhalloufi, Kawtar; Brim, Hassan; Laiyemo, Adeyinka O

2016-01-01

AIM: To study the accuracy of using high definition (HD) scope with narrow band imaging (NBI) vs standard white light colonoscope without NBI (ST), to predict the histology of the colon polyps, particularly those < 1 cm. METHODS: A total of 147 African Americans patients who were referred to Howard University Hospital for screening or, diagnostic or follow up colonoscopy, during a 12-mo period in 2012 were prospectively recruited. Some patients had multiple polyps and total number of polyps was 179. Their colonoscopies were performed by 3 experienced endoscopists who determined the size and stated whether the polyps being removed were hyperplastic or adenomatous polyps using standard colonoscopes or high definition colonoscopes with NBI. The histopathologic diagnosis was reported by pathologists as part of routine care. RESULTS: Of participants in the study, 55 (37%) were male and median (interquartile range) of age was 56 (19-80). Demographic, clinical characteristics, past medical history of patients, and the data obtained by two instruments were not significantly different and two methods detected similar number of polyps. In ST scope 89% of polyps were < 1 cm vs 87% in HD scope (P = 0.7). The ST scope had a positive predictive value (PPV) and positive likelihood ratio (PLR) of 86% and 4.0 for adenoma compared to 74% and 2.6 for HD scope. There was a trend of higher sensitivity for HD scope (68%) compare to ST scope (53%) with almost the same specificity. The ST scope had a PPV and PLR of 38% and 1.8 for hyperplastic polyp (HPP) compared to 42% and 2.2 for HD scope. The sensitivity and specificity of two instruments for HPP diagnosis were similar. CONCLUSION: Our results indicated that HD scope was more sensitive in diagnosis of adenoma than ST scope. Clinical diagnosis of HPP with either scope is less accurate compared to adenoma. Colonoscopy diagnosis is not yet fully matched with pathologic diagnosis of colon polyp. However with the advancement of both imaging and training, it may be possible to increase the sensitivity and specificity of the scopes and hence save money for eliminating time and the cost of Immunohistochemistry/pathology. PMID:27605888

[CONE BEAM COMPUTED TOMOGRAPHY IN DIAGNOSTICS OF ODONTOGENIC MAXILLARY SINUSITIS (CASE REPORTS)].

PubMed

Demidova, E; Khurdzidze, G

2017-06-01

Diagnostic studies performed by cone beam computed tomography Morita 3D made possible to obtain high resolution images of hard tissues of upper jawbone and maxillary sinus, to detect bony tissue defects, such as odontogenic cysts, cystogranulomas and granulomas. High-resolution and three dimensional tomographic image reconstructions allowed for optimal and prompt determination of the scope of surgical treatment and planning of effective conservative treatment regimen. Interactive diagnostics helped to estimate cosmetic and functional results of surgical treatment, to prevent the occurrence of surgical complications, and to evaluate the efficacy of conservative treatment. The obtained data contributed to determination of particular applications of cone beam computed tomography in the diagnosis of odontogenic maxillary sinusitis, detection of specific defects with cone beam tomography as the most informative method of diagnosis; as well as to determination of weak and strong sides, and helped to offer mechanisms of x-ray diagnostics to dental surgeons and ENT specialists.

Clinical utility of soluble interleukin-2 receptor in hemophagocytic syndromes: a systematic scoping review.

PubMed

Lin, Molly; Park, Sujin; Hayden, Anna; Giustini, Dean; Trinkaus, Martina; Pudek, Morris; Mattman, Andre; Schneider, Marion; Chen, Luke Y C

2017-08-01

The serum-soluble interleukin-2 receptor (sIL-2r) level is considered an important diagnostic test and disease marker in hemophagocytic syndromes/hemophagocytic lymphohistiocytosis (HPS/HLH). However, this cytokine receptor is rarely measured in clinical practice and has been excluded from recent diagnostic/classification criteria such as the HScore and macrophage activation syndrome (MAS) 16. We performed a systematic scoping review of 64 articles (1975-2016) examining the clinical utility of sIL-2r in HPS/HLH. Twenty-two articles describe sIL-2r as a sensitive diagnostic marker for HLH, but only three distinct datasets actually address sensitivity. The original HLH-2004 Guidelines reported sensitivity of 93% and specificity of 100% for sIL-2r ≥ 2400, based on a pediatric dataset (n = 152) which is published for the first time in this review. Two pediatric studies reported sensitivity of 89% for sIL-2r ≥ 2400 in diagnosis of MAS complicating juvenile idiopathic arthritis (JIA) (n = 27) and 88% for secondary HLH in acute liver failure (n = 9). Twenty articles described sIL-2r as a dynamic marker of disease activity that falls with response to treatment, and 15 described high initial sIL-2r levels >10,000 U/mL as a poor prognostic marker. The ability of sIL-2r to distinguish between subtypes of HPS/HLH was inconsistent. This review confirms the importance of soluble IL-2r as a diagnostic and disease marker in HPS/HLH, but also reveals the need for more primary data about its performance characteristics, particularly in adults. More emphasis should be made in including this simple, inexpensive test in clinical practice and studies of HPS/HLH.

The evolving potential of companion diagnostics.

PubMed

Khoury, Joseph D

2016-01-01

The scope of companion diagnostics in cancer has undergone significant shifts in the past few years, with increased development of targeted therapies and novel testing platforms. This has provided new opportunities to effect unprecedented paradigm shifts in the application of personalized medicine principles for patients with cancer. These shifts involve assay platforms, analytes, regulations, and therapeutic approaches. As opportunities involving each of these facets of companion diagnostics expand, close collaborations between key stakeholders should be enhanced to ensure optimal performance characteristics and patient outcomes.

Image Quality Analysis of Various Gastrointestinal Endoscopes: Why Image Quality Is a Prerequisite for Proper Diagnostic and Therapeutic Endoscopy

PubMed Central

Ko, Weon Jin; An, Pyeong; Ko, Kwang Hyun; Hahm, Ki Baik; Hong, Sung Pyo

2015-01-01

Arising from human curiosity in terms of the desire to look within the human body, endoscopy has undergone significant advances in modern medicine. Direct visualization of the gastrointestinal (GI) tract by traditional endoscopy was first introduced over 50 years ago, after which fairly rapid advancement from rigid esophagogastric scopes to flexible scopes and high definition videoscopes has occurred. In an effort towards early detection of precancerous lesions in the GI tract, several high-technology imaging scopes have been developed, including narrow band imaging, autofocus imaging, magnified endoscopy, and confocal microendoscopy. However, these modern developments have resulted in fundamental imaging technology being skewed towards red-green-blue and this technology has obscured the advantages of other endoscope techniques. In this review article, we have described the importance of image quality analysis using a survey to consider the diversity of endoscope system selection in order to better achieve diagnostic and therapeutic goals. The ultimate aims can be achieved through the adoption of modern endoscopy systems that obtain high image quality. PMID:26473119

The Solar Connections Observatory for Planetary Environments (SCOPE):

NASA Astrophysics Data System (ADS)

Oliversen, R.; Harris, W.; Ballester, G.; Bougher, S.; Broadfoot, L.; Combi, M.; Cravens, T.; Gombosi, T.; Herbert, F.; Joseph, C.; Kozyra, J.; Limaye, S.; Morgenthaler, J.; Paxton, L.; Roesler, F.; Sandel, W.; Ben Jaffel, L.

2001-12-01

The NASA Sun-Earth Connection theme roadmap calls for comparative study of how the planets and local interstellar medium (LISM) interact with and respond to changes in the solar wind and UV radiation field. Each planet interaction is unique and defined by solar input and local conditions of magnetic field strength and orientation, rotation rate, heliocentric distance, internal plasma, and ionospheric conductivity and circulation. Because the different elements of the environment respond to external and internal influences that are variable on many temporal and spatial scales, the study of a planetary system requires simultaneous understanding of the solar wind and diagnostics of the sun-planet interaction including auroral intensity and variation, upper atmospheric circulation and composition, and the distribution of neutrals and plasmas near the planet. The Solar Connections Observatory for Planetary Environments (SCOPE) is a mission to study Solar interactions from the level of planetary upper atmospheres to the heliopause. SCOPE consists of a binocular EUV/FUV telescope that provides high spatial resolution imaging, broadband spectro-imaging, and high-resolution H Ly-alpha line spectroscopy between 55-290 nm. SCOPE will study planetary environments as examples of the solar connection and map the distribution of interplanetary H and the interaction of LISM plasma with the solar wind at the heliopause. A key to the SCOPE approach is to include Earth in its research objectives. SCOPE will monitor terrestrial auroral energy deposition and leverage local measurements of the solar wind and propagation models to derive the expected conditions at Superior planets that will be observed in annual opposition campaigns. This will permit direct comparison of planetary and terrestrial responses to the same solar wind stream. Using a combination of observations and MHD models, SCOPE will isolate the different controlling parameters in each planet system and gain insight into the underlying physical processes that define the solar connection.

[SCAN system--semi-structured interview based on diagnostic criteria].

PubMed

Adamowski, Tomasz; Kiejna, Andrzej; Hadryś, Tomasz

2006-01-01

This paper presents the main features of contemporary diagnostic systems which are implemented into the SCAN--modern and semi-structured diagnostic interview. The concepts of further development of the classifications, rationale for operationalized diagnostic criteria and for the divisional approach to mental diagnoses will be in focus. The structure and components of SCAN ver. 2.1 (WHO), i.e. Present State Examination--10th edition, Item Group Checklist, Clinical History Schedule, Glossary of Definitions and computer software with the diagnostic algorithm: I-Shell, as well as rules for a reliable use of diagnostic rating scales, will be discussed within the scope of this paper. The materials and training sets necessary for the learning of proper use of the SCAN, especially training sets for SCAN Training Centers and the Reference Manual--a form of guidebook for SCAN shall be introduced. Finally the paper will present evidence that SCAN is an instrument feasible in different cultural settings. Reliability and validity data of SCAN will also be dealt with indicating that SCAN could be widely used in research studies as well as in everyday clinical practice facilitating more detailed diagnostic approach to a patient.

Overdiagnosis across medical disciplines: a scoping review.

PubMed

Jenniskens, Kevin; de Groot, Joris A H; Reitsma, Johannes B; Moons, Karel G M; Hooft, Lotty; Naaktgeboren, Christiana A

2017-12-27

To provide insight into how and in what clinical fields overdiagnosis is studied and give directions for further applied and methodological research. Scoping review. Medline up to August 2017. All English studies on humans, in which overdiagnosis was discussed as a dominant theme. Studies were assessed on clinical field, study aim (ie, methodological or non-methodological), article type (eg, primary study, review), the type and role of diagnostic test(s) studied and the context in which these studies discussed overdiagnosis. From 4896 studies, 1851 were included for analysis. Half of all studies on overdiagnosis were performed in the field of oncology (50%). Other prevalent clinical fields included mental disorders, infectious diseases and cardiovascular diseases accounting for 9%, 8% and 6% of studies, respectively. Overdiagnosis was addressed from a methodological perspective in 20% of studies. Primary studies were the most common article type (58%). The type of diagnostic tests most commonly studied were imaging tests (32%), although these were predominantly seen in oncology and cardiovascular disease (84%). Diagnostic tests were studied in a screening setting in 43% of all studies, but as high as 75% of all oncological studies. The context in which studies addressed overdiagnosis related most frequently to its estimation, accounting for 53%. Methodology on overdiagnosis estimation and definition provided a source for extensive discussion. Other contexts of discussion included definition of disease, overdiagnosis communication, trends in increasing disease prevalence, drivers and consequences of overdiagnosis, incidental findings and genomics. Overdiagnosis is discussed across virtually all clinical fields and in different contexts. The variability in characteristics between studies and lack of consensus on overdiagnosis definition indicate the need for a uniform typology to improve coherence and comparability of studies on overdiagnosis. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

[Somatopsychic and cenesthetic types of schizophrenia: common features and discrepancies].

PubMed

Wichowicz, Hubert M; Cubała, Wiesław J

2010-01-01

The aim of this paper is to discuss the development of the concepts of cenesthetic type of schizophrenia and somatopsychic type of schizophrenia along with the review of differences between those two diagnostic approaches in scope of their historical background and the current diagnostic concepts. Those independently described diagnostic phenomena have some common features. However, the cenesthetic type of schizophrenia emphasises sensory elements of the disorders and includes a broader spectrum of the psychopathology while the somatopsychic type of schizophrenia focuses on the thought disorders and strictly schizophrenic psychopathology.

Over the scope clip: technique and expanding clinical applications.

PubMed

Singhal, Shashideep; Changela, Kinesh; Papafragkakis, Haris; Anand, Sury; Krishnaiah, Mahesh; Duddempudi, Sushil

2013-10-01

Advances in endoscopic and surgical techniques have increased the frequency and complexity of these procedures, and thus, the incidence of associated complications. To describe the use and clinical applications of the Over the Scope Clip (OTSC) system. An English language literature search was conducted using the key words "endoscopy" and "over the scope clip" in order to identify human studies evaluating the application of OTSC from January 2001 to August 2012. The indication, efficacy, complications, and limitations were recorded. Overall success rates of OTSC based on current literature range are in the range of 75% to 100% for closure of iatrogenic gastrointestinal perforations, 38% to 100% for closure of gastrointestinal fistulas, 50% to 100% for anastomotic leaks, and 71% to 100% for bleeding lesions. OTSCs have shown 100% success rates in managing postbariatric surgery weight gain secondary to dilation of the gastrojejunal pouch. OTSC is easy to use with good results, thus decreasing the morbidity and mortality associated with the complications secondary to both diagnostic and therapeutic endoscopy and avoiding surgery in many situations.

Built-In-Test Equipment Requirements Workshop. Workshop Presentation

DTIC Science & Technology

1981-08-01

quantitatively evaluated in test. (2) It is necessary to develop the statistical methods that should be used for predicting and confirming of diagnostic...of different performance levels of BIT peacetime and wartime applications, and the corresponding manpower and other support requirements should be...reports. The scope of the workshop involves the areas of require- ments for built-in-test and diagnostics, and the methods of testing to ensure that the

[Myofascial pain syndrome--frequent occurrence and often misdiagnosed].

PubMed

Pongratz, D E; Späth, M

1998-09-30

Myofascial pain syndrome (MPS) is a very common localized--sometimes also polytopic--painful musculoskeletal condition associated with trigger points, for which, however, diagnostic criteria established in well-designed studies are still lacking. These two facts form the basis for differentiating between MPS and the fibromyalgia syndrome. The difference between trigger points (MPS) and tender points (fibromyalgia) is of central importance--not merely in a linguistic sense. A knowledge of the signs and symptoms typically associated with a trigger point often obviates the need for time-consuming and expensive technical diagnostic measures. The assumption that many cases of unspecific complaints affecting the musculoskeletal system may be ascribed to MPS makes clear the scope for the saving of costs.

Comparative studies of the interaction between the Sun and planetary near space environments with the Solar Connections Observatory for Planetary Environments (SCOPE)

NASA Astrophysics Data System (ADS)

Harris, W. M.; Scope Team

2003-04-01

The Solar Connections Observatory for Planetary Environments (SCOPE) is a remote sensing facility designed to probe the nature of the relationship of planetary bodies and the local interstellar medium to the solar wind and UV-EUV radiation field. In particular, the SCOPE program seeks to comparatively monitor the near space environments and thermosphere/ionospheres of planets, planetesimals, and satellites under different magnetospheric configurations and as a function of heliocentric distance and solar activity. In addition, SCOPE will include the Earth as a science target, providing new remote observations of auroral and upper atmospheric phenomena and utilizing it as baseline for direct comparison with other planetary bodies. The observatory will be scheduled into discrete campaigns interleaving Target-Terrestrial observations to provide a comparative annual activity map over the course of a solar half cycle. The SCOPE science instrument consists of binocular UV (115-310 nm) and EUV (500-120 nm) telescopes and a side channel sky-mapping interferometer on a spacecraft stationed in a remote orbit. The telescope instruments provide a mix of capabilities including high spatial resolution narrow band imaging, moderate resolution broadband spectro-imaging, and high-resolution line spectroscopy. The side channel instrument will be optimized for line profile measurements of diagnostic terrestrial upper atmospheric, comet, interplanetary, and interstellar extended emissions.

A Diagnostic System for Studying Energy Partitioning and Assessing the Response of the Ionosphere during HAARP Modification Experiments

NASA Technical Reports Server (NTRS)

Djuth, Frank T.; Elder, John H.; Williams, Kenneth L.

1996-01-01

This research program focused on the construction of several key radio wave diagnostics in support of the HF Active Auroral Ionospheric Research Program (HAARP). Project activities led to the design, development, and fabrication of a variety of hardware units and to the development of several menu-driven software packages for data acquisition and analysis. The principal instrumentation includes an HF (28 MHz) radar system, a VHF (50 MHz) radar system, and a high-speed radar processor consisting of three separable processing units. The processor system supports the HF and VHF radars and is capable of acquiring very detailed data with large incoherent scatter radars. In addition, a tunable HF receiver system having high dynamic range was developed primarily for measurements of stimulated electromagnetic emissions (SEE). A separate processor unit was constructed for the SEE receiver. Finally, a large amount of support instrumentation was developed to accommodate complex field experiments. Overall, the HAARP diagnostics are powerful tools for studying diverse ionospheric modification phenomena. They are also flexible enough to support a host of other missions beyond the scope of HAARP. Many new research programs have been initiated by applying the HAARP diagnostics to studies of natural atmospheric processes.

Behavioral Health Program Element

NASA Technical Reports Server (NTRS)

Leveton, Lauren B.

2006-01-01

The project goal is to develop behavioral health prevention and maintenance system for continued crew health, safety, and performance for exploration missions. The basic scope includes a) Operationally-relevant research related to clinical cognitive and behavioral health of crewmembers; b) Ground-based studies using analog environments (Antarctic, NEEMO, simulations, and other testbeds; c) ISS studies (ISSMP) focusing on operational issues related to behavioral health outcomes and standards; d) Technology development activities for monitoring and diagnostic tools; and e) Cross-disciplinary research (e.g., human factors and habitability research, skeletal muscle, radiation).

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

How Do Health Care Providers Diagnose Menstrual Irregularities?

MedlinePlus

... the following: 1 , 2 , 3 , 4 , 5 Medical history Physical examination Blood tests Ultrasound examination Endometrial biopsy—a small sample of the uterus's endometrial lining is taken to be examined under a microscope Hysteroscopy—a diagnostic scope that allows a health ...

ITER ECE Diagnostic: Design Progress of IN-DA and the diagnostic role for Physics

NASA Astrophysics Data System (ADS)

Pandya, H. K. B.; Kumar, Ravinder; Danani, S.; Shrishail, P.; Thomas, Sajal; Kumar, Vinay; Taylor, G.; Khodak, A.; Rowan, W. L.; Houshmandyar, S.; Udintsev, V. S.; Casal, N.; Walsh, M. J.

2017-04-01

The ECE Diagnostic system in ITER will be used for measuring the electron temperature profile evolution, electron temperature fluctuations, the runaway electron spectrum, and the radiated power in the electron cyclotron frequency range (70-1000 GHz), These measurements will be used for advanced real time plasma control (e.g. steering the electron cyclotron heating beams), and physics studies. The scope of the Indian Domestic Agency (IN-DA) is to design and develop the polarizer splitter units; the broadband (70 to 1000 GHz) transmission lines; a high temperature calibration source in the Diagnostics Hall; two Michelson Interferometers (70 to 1000 GHz) and a 122-230 GHz radiometer. The remainder of the ITER ECE diagnostic system is the responsibility of the US domestic agency and the ITER Organization (IO). The design needs to conform to the ITER Organization’s strict requirements for reliability, availability, maintainability and inspect-ability. Progress in the design and development of various subsystems and components considering various engineering challenges and solutions will be discussed in this paper. This paper will also highlight how various ECE measurements can enhance understanding of plasma physics in ITER.

The path to exploring physics in advanced devices with a heavy ion beam probe

NASA Astrophysics Data System (ADS)

Demers, D. R.; Fimognari, P. J.

2012-10-01

The scientific progression of alternative or advanced devices must be met with comparable diagnostic technologies. Heavy ion beam probe innovations from ongoing diagnostic development are meeting this challenge. The diagnostic is uniquely capable of measuring the radial electric field, critically important in stellarators, simultaneously with fluctuations of electron density and electric potential. HIBP measurements can also improve the understanding of edge physics in tokamaks and spherical tori. It can target issues associated with the pedestal region, including the mechanisms underlying the L-H transition, the onset and evolution of ELMs, and the evolution of the electron current density. Beam attenuation (and resulting low signal to noise levels), a challenge to operation on devices with large plasma cross-sections and high ne and Te, can be mitigated with greater beam energies and currents. Other application challenges, such as measurements of plasma fluctuations and profile variations with elevated temporal and spatial resolutions, can be achieved with innovative detectors. The scientific studies motivating the implementation of an HIBP on HSX, ASDEX-U, and W7-X will be presented along with preliminary scoping studies.

Evidence and diagnostic reporting in the IHE context.

PubMed

Loef, Cor; Truyen, Roel

2005-05-01

Capturing clinical observations and findings during the diagnostic imaging process is increasingly becoming a critical step in diagnostic reporting. Standards developers-notably HL7 and DICOM-are making significant progress toward standards that enable exchanging clinical observations and findings among the various information systems of the healthcare enterprise. DICOM-like the HL7 Clinical Document Architecture (CDA) -uses templates and constrained, coded vocabulary (SNOMED, LOINC, etc.). Such a representation facilitates automated software recognition of findings and observations, intrapatient comparison, correlation to norms, and outcomes research. The scope of DICOM Structured Reporting (SR) includes many findings that products routinely create in digital form (measurements, computed estimates, etc.). In the Integrating the Healthcare Enterprise (IHE) framework, two Integration Profiles are defined for clinical data capture and diagnostic reporting: Evidence Document, and Simple Image and Numeric Report. This report describes these two DICOM SR-based integration profiles in the diagnostic reporting process.

Enhanced definitions of intimate partner violence for DSM-5 and ICD-11 may promote improved screening and treatment.

PubMed

Heyman, Richard E; Slep, Amy M Smith; Foran, Heather M

2015-03-01

Nuanced, multifaceted, and content valid diagnostic criteria for intimate partner violence (IPV) have been created and can be used reliably in the field even by those with little-to-no clinical training/background. The use of such criteria such as these would likely lead to more reliable decision making in the field and more consistency across studies. Further, interrater agreement was higher than that usually reported for individual mental disorders. This paper will provide an overview of (a) IPV's scope and impact; (b) the reliable and valid diagnostic criteria that have been used and the adaptation of these criteria inserted in the latest Diagnostic and Statistical Manual of Mental Disorders (DSM) and another adaptation proposed for the forthcoming International Statistical Classification of Diseases and Related Health Problems (ICD); (c) suggestions for screening of IPV in primary care settings; (d) interventions for IPV; and (e) suggested steps toward globally accepted programs. © 2015 Family Process Institute.

Frameless robotically targeted stereotactic brain biopsy: feasibility, diagnostic yield, and safety.

PubMed

Bekelis, Kimon; Radwan, Tarek A; Desai, Atman; Roberts, David W

2012-05-01

Frameless stereotactic brain biopsy has become an established procedure in many neurosurgical centers worldwide. Robotic modifications of image-guided frameless stereotaxy hold promise for making these procedures safer, more effective, and more efficient. The authors hypothesized that robotic brain biopsy is a safe, accurate procedure, with a high diagnostic yield and a safety profile comparable to other stereotactic biopsy methods. This retrospective study included 41 patients undergoing frameless stereotactic brain biopsy of lesions (mean size 2.9 cm) for diagnostic purposes. All patients underwent image-guided, robotic biopsy in which the SurgiScope system was used in conjunction with scalp fiducial markers and a preoperatively selected target and trajectory. Forty-five procedures, with 50 supratentorial targets selected, were performed. The mean operative time was 44.6 minutes for the robotic biopsy procedures. This decreased over the second half of the study by 37%, from 54.7 to 34.5 minutes (p < 0.025). The diagnostic yield was 97.8% per procedure, with a second procedure being diagnostic in the single nondiagnostic case. Complications included one transient worsening of a preexisting deficit (2%) and another deficit that was permanent (2%). There were no infections. Robotic biopsy involving a preselected target and trajectory is safe, accurate, efficient, and comparable to other procedures employing either frame-based stereotaxy or frameless, nonrobotic stereotaxy. It permits biopsy in all patients, including those with small target lesions. Robotic biopsy planning facilitates careful preoperative study and optimization of needle trajectory to avoid sulcal vessels, bridging veins, and ventricular penetration.

Advanced practice physiotherapy in patients with musculoskeletal disorders: a systematic review

PubMed Central

2012-01-01

Background The convergence of rising health care costs and physician shortages have made health care transformation a priority in many countries resulting in the emergence of new models of care that often involve the extension of the scope of practice for allied health professionals. Physiotherapists in advanced practice/extended scope roles have emerged as key providers in such new models, especially in settings providing services to patients with musculoskeletal disorders. However, evidence of the systematic evaluation of advance physiotherapy practice (APP) models of care is scarce. A systematic review was done to update the evaluation of physiotherapists in APP roles in the management of patients with musculoskeletal disorders. Methods Structured literature search was conducted in 3 databases (Medline, Cinahl and Embase) for articles published between 1980 and 2011. Included studies needed to present original quantitative data that addressed the impact or the effect of APP care. A total of 16 studies met all inclusion criteria and were included. Pairs of raters used four structured quality appraisal methodological tools depending on design of studies to analyse included studies. Results Included studies varied in designs and objectives and could be categorized in four areas: diagnostic agreement or accuracy compared to medical providers, treatment effectiveness, economic efficiency or patient satisfaction. There was a wide range in the quality of studies (from 25% to 93%), with only 43% of papers reaching or exceeding a score of 70% on the methodological quality rating scales. Their findings are however consistent and suggest that APP care may be as (or more) beneficial than usual care by physicians for patients with musculoskeletal disorders, in terms of diagnostic accuracy, treatment effectiveness, use of healthcare resources, economic costs and patient satisfaction. Conclusions The emerging evidence suggests that physiotherapists in APP roles provide equal or better usual care in comparison to physicians in terms of diagnostic accuracy, treatment effectiveness, use of healthcare resources, economic costs and patient satisfaction. There is a need for more methodologically sound studies to evaluate the effectiveness APP care. PMID:22716771

Ultrasound Elastography and MR Elastography for Assessing Liver Fibrosis: Part 2, Diagnostic Performance, Confounders, and Future Directions

PubMed Central

Tang, An; Cloutier, Guy; Szeverenyi, Nikolaus M.; Sirlin, Claude B.

2016-01-01

OBJECTIVE The purpose of the article is to review the diagnostic performance of ultrasound and MR elastography techniques for detection and staging of liver fibrosis, the main current clinical applications of elastography in the abdomen. CONCLUSION Technical and instrument-related factors and biologic and patient-related factors may constitute potential confounders of stiffness measurements for assessment of liver fibrosis. Future developments may expand the scope of elastography for monitoring liver fibrosis and predict complications of chronic liver disease. PMID:25905762

Parametric estimates for the receiver operating characteristic curve generalization for non-monotone relationships.

PubMed

Martínez-Camblor, Pablo; Pardo-Fernández, Juan C

2017-01-01

Diagnostic procedures are based on establishing certain conditions and then checking if those conditions are satisfied by a given individual. When the diagnostic procedure is based on a continuous marker, this is equivalent to fix a region or classification subset and then check if the observed value of the marker belongs to that region. Receiver operating characteristic curve is a valuable and popular tool to study and compare the diagnostic ability of a given marker. Besides, the area under the receiver operating characteristic curve is frequently used as an index of the global discrimination ability. This paper revises and widens the scope of the receiver operating characteristic curve definition by setting the classification subsets in which the final decision is based in the spotlight of the analysis. We revise the definition of the receiver operating characteristic curve in terms of particular classes of classification subsets and then focus on a receiver operating characteristic curve generalization for situations in which both low and high values of the marker are associated with more probability of having the studied characteristic. Parametric and non-parametric estimators of the receiver operating characteristic curve generalization are investigated. Monte Carlo studies and real data examples illustrate their practical performance.

Diagnosis of condensation-induced waterhammer: Case studies

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

Izenson, M.G.; Rothe, P.H.; Wallis, G.B.

1988-10-01

This guidebook provides reference material and diagnostic procedures concerning condensation-induced waterhammer in nuclear power plants. Condensation-induced waterhammer is the most damaging form of waterhammer, and its diagnosis is complicated by the complex nature of the underlying phenomena. In Volume 1, the guidebook groups condensation-induced waterhammers into five event classes which have similar phenomena and levels of damage. Diagnostic guidelines focus on locating the event center where condensation and slug acceleration take place. Diagnosis is described in three stages: an initial assessment, detailed evaluation and final confirmation. Graphical scoping analyses are provided to evaluate whether an event from one of themore » event classes could have occurred at the event center. Examples are provided for each type of waterhammer. Special instructions are provided for walking down damaged piping and evaluating damage due to waterhammer. To illustrate the diagnostic methods and document past experience, six case studies have been compiled in Volume 2. These case studies, based on actual condensation-induced waterhammer events at nuclear plants, present detailed data and work through the event diagnosis using the tools introduced in the first volume. 20 refs., 21 figs., 6 tabs.« less

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

Utilization Management in the Blood Transfusion Service

PubMed Central

Peña, Jeremy Ryan Andrew; Dzik, Walter “Sunny”

2015-01-01

The scope of activity of the Blood Transfusion Service (BTS) makes it unique among the clinical laboratories. The combination of therapeutic and diagnostic roles necessitates a multi-faceted approach to utilization management in the BTS. We present our experience in utilization management in large academic medical center. PMID:24080431

21 CFR 874.1 - Scope.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., and throat devices intended for human use that are in commercial distribution. (b) The identification..., nose, and throat device that has two or more types of uses (e.g., used both as a diagnostic device and...) Guidance documents referenced in this part are available on the Internet at http://www.fda.gov/cdrh...

42 CFR 410.38 - Durable medical equipment: Scope and conditions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... vehicle whose steering is operated by an electronic device or a joystick to control direction and turning) or a power-operated vehicle (a three or four-wheeled motorized scooter that is operated by a tiller..., physical examination, diagnostic tests, summary of findings, diagnoses, treatment plans and/or other...

42 CFR 410.38 - Durable medical equipment: Scope and conditions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... vehicle whose steering is operated by an electronic device or a joystick to control direction and turning) or a power-operated vehicle (a three or four-wheeled motorized scooter that is operated by a tiller..., physical examination, diagnostic tests, summary of findings, diagnoses, treatment plans and/or other...

42 CFR 410.38 - Durable medical equipment: Scope and conditions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... vehicle whose steering is operated by an electronic device or a joystick to control direction and turning) or a power-operated vehicle (a three or four-wheeled motorized scooter that is operated by a tiller..., physical examination, diagnostic tests, summary of findings, diagnoses, treatment plans and/or other...

Diagnosis of Polycystic Ovary Syndrome: AMH in combination with clinical symptoms.

PubMed

Sahmay, Sezai; Aydin, Yavuz; Oncul, Mahmut; Senturk, Levent M

2014-02-01

We assessed the utility of using anti-Müllerian hormone (AMH) and clinical features of polycystic ovary syndrome (PCOS), polycystic ovarian morphology (PCOM), oligo/amenorrhea (OA), and hyperandrogenism (HA) for diagnosing PCOS, and compared their diagnostic accuracy with those of classical diagnostic systems. A total of 606 females were admitted to a university hospital with menstrual irregularities or symptoms of hyperandrogenism were enrolled in this cross-sectional study. Fasting blood samples were collected. Pelvic and/or abdominal ultrasonography and clinical examination were performed. Patients were evaluated for the presence of PCOS according to conventional diagnostic criteria. The diagnostic performance of using serum AMH levels alone and in various combinations with the clinical features of PCOM, OA, and HA were investigated. For the diagnosis of PCOS, the combination of OA and/or HA with AMH showed 83% sensitivity and 100% specificity according to the Rotterdam criteria; 83% sensitivity and 89% specificity according to the National Institutes of Health (NIH) criteria; and 82% sensitivity and 93.5% specificity according to the Androgen Excess Society (AES) criteria. The serum AMH level is a useful diagnostic marker for PCOS and is correlated with conventional diagnostic criteria. The combination of AMH level with OA and/or HA markedly increased the clinical scope for PCOS diagnosis and can be introduced as a possible objective criterion for the diagnosis of this disease.

The Importance of Conditional Probability in Diagnostic Reasoning and Clinical Decision Making: A Primer for the Eye Care Practitioner.

PubMed

Sanfilippo, Paul G; Hewitt, Alex W; Mackey, David A

2017-04-01

To outline and detail the importance of conditional probability in clinical decision making and discuss the various diagnostic measures eye care practitioners should be aware of in order to improve the scope of their clinical practice. We conducted a review of the importance of conditional probability in diagnostic testing for the eye care practitioner. Eye care practitioners use diagnostic tests on a daily basis to assist in clinical decision making and optimizing patient care and management. These tests provide probabilistic information that can enable the clinician to increase (or decrease) their level of certainty about the presence of a particular condition. While an understanding of the characteristics of diagnostic tests are essential to facilitate proper interpretation of test results and disease risk, many practitioners either confuse or misinterpret these measures. In the interests of their patients, practitioners should be aware of the basic concepts associated with diagnostic testing and the simple mathematical rule that underpins them. Importantly, the practitioner needs to recognize that the prevalence of a disease in the population greatly determines the clinical value of a diagnostic test.

Review of diagnostic and therapeutic endoscopic retrograde cholangiopancreatography using several endoscopic methods in patients with surgically altered gastrointestinal anatomy

PubMed Central

Shimatani, Masaaki; Takaoka, Makoto; Tokuhara, Mitsuo; Miyoshi, Hideaki; Ikeura, Tsukasa; Okazaki, Kazuichi

2015-01-01

The endoscopic approach for biliary diseases in patients with surgically altered gastrointestinal anatomy (SAGA) had been generally deemed impractical. However, it was radically made feasible by the introduction of double balloon endoscopy (DBE) that was originally developed for diagnosis and treatments for small-bowel diseases. Followed by the subsequent development of single-balloon endoscopy (SBE) and spiral endoscopy (SE), interventions using several endoscopes for biliary disease in patients with SAGA widely gained an acceptance as a new modality. Many studies have been made on this new technique. Yet, some problems are to be solved. For instance, the mutual unavailability among devices due to different working lengths and channels, and unestablished standardization of procedural techniques can be raised. Additionally, in an attempt to standardize endoscopic procedures, it is important to evaluate biliary cannulating methods by case with existence of papilla or not. A full comprehension of the features of respective scope types is also required. However there are not many papers written as a review. In our manuscript, we would like to evaluate and make a review of the present status of diagnostic and therapeutic endoscopic retrograde cholangiopancreatography applying DBE, SBE and SE for biliary diseases in patients with SAGA for establishment of these modalities as a new technology and further improvement of the scopes and devices. PMID:26078830

Advanced Pharmacotherapy Evidenced by Pathogenesis of Autism Spectrum Disorder

PubMed Central

Lee, Yeon Jung; Oh, Soo Hyun; Park, Chanmin; Hong, Minha; Lee, Ah Rah; Yoo, Hee Jeong; Shin, Chan Young; Cheon, Keun-Ah

2014-01-01

In clinical practice, pharmacological treatment is mostly focused on behavioral symptoms in everyday life. Nevertheless, persistent effort continues to develop medication for causal treatment. Recent changes in diagnostic criteria from Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR) to DSM-5 would affect not only diagnosing approaches, but also therapeutic approaches. Because previous pervasive developmental disorders have been integrated into a single entity, the autism spectrum disorder (ASD), we have to prepare for what medications are valuable for the ASD. In this article, we reviewed the following etiological treatment: acetylcholine and glutamate related medicine; amino acid medicine such as secretin, endogenous opioid, and oxytocin; complementary and alternative medicine such as chelating agents, vitamins, and omega-3; promising drugs related to the scope of pharmacogenetics currently under study. PMID:24851117

Dissecting aneurysms of posterior communicating artery itself: anatomical, diagnostic, clinical, and therapeutical considerations.

PubMed

Kocak, Burak; Tureci, Ercan; Kizilkilic, Osman; Islak, Civan; Kocer, Naci

2013-09-01

Posterior communicating artery (PCoA) itself is an unusual location for intracranial aneurysms in that isolated dissections or dissecting aneurysms are extremely rare. In the way of correct diagnosis of dissecting aneurysms of PCoA itself, a proper understanding of (1) the anatomy of the PCoA and its perforator branches, (2) some particular diagnostic features, and (3) related clinical aspects is of significant importance. Although there are no established treatment strategies for this particular type of aneurysms, the endovascular approach might be considered as a plausible one. In this paper, our scope was to report five cases with dissecting aneurysm of the PCoA itself and to discuss this rare vascular pathology from anatomical, diagnostic, clinical, and therapeutical perspectives.

Endoscopic ultrasound: state-of-the-art GI tumor staging

NASA Astrophysics Data System (ADS)

Trowers, Eugene A.

1999-06-01

Videoendoscopy has truly enlarged the scope of diagnostic and therapeutic gastroenterology. However, videoendoscopic examinations are limited to the mucosal surface. Endoscopic ultrasound allows the endoscopist a view beyond the intestinal wall which opens the door to a variety of new gastroenterologic techniques. The evaluation of plain images in combination with contrast-enhanced imags has been found to be helpful when applied to CT and MRI. A similar advantage may be found for endoscopic ultrasound (EUS) studies. The efficacy of EUS with and without contrast enhancement is critically reviewed.

Endoscopic full-thickness resection in the colorectum with a novel over-the-scope device: first experience.

PubMed

Schmidt, Arthur; Bauerfeind, Peter; Gubler, Christoph; Damm, Michael; Bauder, Markus; Caca, Karel

2015-08-01

Endoscopic full-thickness resection (EFTR) in the lower gastrointestinal tract may be a valuable therapeutic and diagnostic approach for a variety of indications. Although feasibility of EFTR has been demonstrated, there is a lack of safe and effective endoscopic devices for routine use. The aim of this study was to investigate the efficacy and safety of a novel over-the-scope device for colorectal EFTR. Between July 2012 and July 2014, 25 patients underwent EFTR at two tertiary referral centers. All resections were performed using the full-thickness resection device (FTRD; Ovesco Endoscopy, Tübingen, Germany). Data were collected retrospectively. Indications for EFTR were: recurrent or incompletely resected adenoma with nonlifting sign (n = 11), untreated adenoma and nonlifting sign (n = 2), adenoma involving the appendix (n = 5), flat adenoma in a patient with coagulopathy (n = 1), diagnostic re-resection after incomplete resection of a T1 carcinoma (n = 2), adenoma involving a diverticulum (n = 1), submucosal tumor (n = 2), and diagnostic resection in a patient with suspected Hirschsprung's disease (n = 1). In one patient, the lesion could not be reached because of a sigmoid stenosis. In the other patients, resection of the lesion was macroscopically complete and en bloc in 20/24 patients (83.3 %). The mean diameter of the resection specimen was 24 mm (range 12 - 40 mm). The R0 resection rate was 75.0 % (18/24), and full-thickness resection was histologically confirmed in 87.5 %. No perforations or major bleeding were observed during or after resection. Two patients developed postpolypectomy syndrome, which was managed with antibiotic therapy. Full-thickness resection in the lower gastrointestinal tract with the novel FTRD was feasible and effective. Prospective studies are needed to further evaluate the device and technique. © Georg Thieme Verlag KG Stuttgart · New York.

Diagnostic overshadowing and other challenges involved in the diagnostic process of patients with mental illness who present in emergency departments with physical symptoms--a qualitative study.

PubMed

Shefer, Guy; Henderson, Claire; Howard, Louise M; Murray, Joanna; Thornicroft, Graham

2014-01-01

We conducted a qualitative study in the Emergency Departments (EDs) of four hospitals in order to investigate the perceived scope and causes of 'diagnostic overshadowing'--the misattribution of physical symptoms to mental illness--and other challenges involved in the diagnostic process of people with mental illness who present in EDs with physical symptoms. Eighteen doctors and twenty-one nurses working in EDs and psychiatric liaisons teams in four general hospitals in the UK were interviewed. Interviewees were asked about cases in which mental illness interfered with diagnosis of physical problems and about other aspects of the diagnostic process. Interviews were transcribed and analysed thematically. Interviewees reported various scenarios in which mental illness or factors related to it led to misdiagnosis or delayed treatment with various degrees of seriousness. Direct factors which may lead to misattribution in this regard are complex presentations or aspects related to poor communication or challenging behaviour of the patient. Background factors are the crowded nature of the ED environment, time pressures and targets and stigmatising attitudes held by a minority of staff. The existence of psychiatric liaison team covering the ED twenty-four hours a day, seven days a week, can help reduce the risk of misdiagnosis of people with mental illness who present with physical symptoms. However, procedures used by emergency and psychiatric liaison staff require fuller operationalization to reduce disagreement over where responsibilities lie.

21 CFR 872.1 - Scope.

Code of Federal Regulations, 2010 CFR

2010-04-01

... for human use that are in commercial distribution. (b) The identification of a device in a regulation... types of uses (e.g., used both as a diagnostic device and as a therapeutic device) is listed in one... on the Internet at http://www.fda.gov/cdrh.guidance.html. [52 FR 30097, Aug. 12, 1987, as amended at...

21 CFR 876.1 - Scope.

Code of Federal Regulations, 2010 CFR

2010-04-01

... gastroenterology-urology devices intended for human use that are in commercial distribution. (b) The identification... gastroenterology-urology device that has two or more types of uses (e.g., used both as a diagnostic device and as a... documents referenced in this part are available on the Internet at http://www.fda.gov/cdrh/guidance.html...

21 CFR 870.1 - Scope.

Code of Federal Regulations, 2010 CFR

2010-04-01

... devices intended for human use that are in commercial distribution. (b) The identification of a device in... device that has two or more types of uses (e.g., used both as a diagnostic device and as a therapeutic... referenced in this part are available on the Internet at http://www.fda.gov/cdrh/guidance.html. [52 FR 17735...

21 CFR 882.1 - Scope.

Code of Federal Regulations, 2010 CFR

2010-04-01

... devices intended for human use that are in commercial distribution. (b) The identification of a device in... device that has two or more types of uses (e.g., used both as a diagnostic device and as a therapeutic... referenced in this part are available on the Internet at http://www.fda.gov/cdrh/guidance.html. [52 FR 17739...

21 CFR 890.1 - Scope.

Code of Federal Regulations, 2010 CFR

2010-04-01

... medicine devices intended for human use that are in commercial distribution. (b) The identification of a... device that has two or more types of uses (e.g., used both as a diagnostic device and as a therapeutic... referenced in this part are available on the Internet at http://www.fda.gov/cdrh/guidance.html. [52 FR 17741...

21 CFR 886.1 - Scope.

Code of Federal Regulations, 2010 CFR

2010-04-01

... devices intended for human use that are in commercial distribution. (b) The identification of a device in... that has two or more types of uses (e.g., used both as a diagnostic device and as a therapeutic device... in this part are available on the Internet at http://www.fda.gov/cdrh/guidance.html. [52 FR 33355...

21 CFR 868.1 - Scope.

Code of Federal Regulations, 2010 CFR

2010-04-01

... devices intended for human use that are in commercial distribution. (b) The identification of a device in... device that has two or more types of uses (e.g., used both as a diagnostic device and as a therapeutic... referenced in this part are available on the Internet at http://www.fda.gov/cdrh/guidance.html. [52 FR 17734...

21 CFR 888.1 - Scope.

Code of Federal Regulations, 2010 CFR

2010-04-01

... devices intended for human use that are in commercial distribution. (b) The identification of a device in... that has two or more types of uses (e.g., used both as a diagnostic device and as a surgical device) is... part are available on the Internet at http://www.fda.gov/cdrh/guidance.html. [52 FR 33702, Sept. 4...

Imaging in conjunction with physical therapy in management of a patient with history of thoracic tumour

PubMed Central

Rendeiro, Daniel G.; Deyle, Gail D.; Boissonnault, William G.

2015-01-01

Background: Physical therapy care for musculoskeletal conditions includes an ongoing process that systematically considers and prioritises diagnostic hypotheses. These diagnostic hypotheses include those that are typical for common musculoskeletal conditions, and must also include more rare conditions that would require care outside the scope of practice of the physical therapist. When additional screening is required, physical therapists collaborate with other providers or directly order the appropriate tests to rule out suspected pathology. Case Description: This article illustrates the use of musculoskeletal imaging ordered by a physical therapist to guide ongoing management of a patient with back pain and a history of cancer. Outcomes: The patient successfully returned to moderate-intensity sport activities after a course of physical therapy. Discussion: This case provides an example of how clinical diagnostic reasoning combined with clinical privileges to order musculoskeletal imaging can facilitate diagnostic accuracy in a timely and cost-efficient manner. PMID:26309382

Modeling and Diagnostic Software for Liquefying-Fuel Rockets

NASA Technical Reports Server (NTRS)

Poll, Scott; Iverson, David; Ou, Jeremy; Sanderfer, Dwight; Patterson-Hine, Ann

2005-01-01

A report presents a study of five modeling and diagnostic computer programs considered for use in an integrated vehicle health management (IVHM) system during testing of liquefying-fuel hybrid rocket engines in the Hybrid Combustion Facility (HCF) at NASA Ames Research Center. Three of the programs -- TEAMS, L2, and RODON -- are model-based reasoning (or diagnostic) programs. The other two programs -- ICS and IMS -- do not attempt to isolate the causes of failures but can be used for detecting faults. In the study, qualitative models (in TEAMS and L2) and quantitative models (in RODON) having varying scope and completeness were created. Each of the models captured the structure and behavior of the HCF as a physical system. It was noted that in the cases of the qualitative models, the temporal aspects of the behavior of the HCF and the abstraction of sensor data are handled outside of the models, and it is necessary to develop additional code for this purpose. A need for additional code was also noted in the case of the quantitative model, though the amount of development effort needed was found to be less than that for the qualitative models.

Diagnosis of condensation-induced waterhammer: Methods and background

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

Izenson, M.G.; Rothe, P.H.; Wallis, G.B.

This guidebook provides reference material and diagnostic procedures concerning condensation-induced waterhammer in nuclear power plants. Condensation-induced waterhammer is the most damaging form of waterhammer and its diagnosis is complicated by the complex nature of the underlying phenomena. In Volume 1, the guidebook groups condensation-induced waterhammers into five event classes which have similar phenomena and levels of damage. Diagnostic guidelines focus on locating the event center where condensation and slug acceleration take place. Diagnosis is described in three stages: an initial assessment, detailed evaluation and final confirmation. Graphical scoping analyses are provided to evaluate whether an event from one of themore » event classes could have occurred at the event center. Examples are provided for each type of waterhammer. Special instructions are provided for walking down damaged piping and evaluating damage due to waterhammer. To illustrate the diagnostic methods and document past experience, six case studies have been compiled in Volume 2. These case studies, based on actual condensation-induced waterhammer events at nuclear plants, present detailed data and work through the event diagnosis using the tools introduced in the first volume. 65 figs., 8 tabs.« less

Diagnosis of Ebola Virus Disease: Past, Present, and Future

PubMed Central

Brooks, Tim J. G.

2016-01-01

SUMMARY Laboratory diagnosis of Ebola virus disease plays a critical role in outbreak response efforts; however, establishing safe and expeditious testing strategies for this high-biosafety-level pathogen in resource-poor environments remains extremely challenging. Since the discovery of Ebola virus in 1976 via traditional viral culture techniques and electron microscopy, diagnostic methodologies have trended toward faster, more accurate molecular assays. Importantly, technological advances have been paired with increasing efforts to support decentralized diagnostic testing capacity that can be deployed at or near the point of patient care. The unprecedented scope of the 2014-2015 West Africa Ebola epidemic spurred tremendous innovation in this arena, and a variety of new diagnostic platforms that have the potential both to immediately improve ongoing surveillance efforts in West Africa and to transform future outbreak responses have reached the field. In this review, we describe the evolution of Ebola virus disease diagnostic testing and efforts to deploy field diagnostic laboratories in prior outbreaks. We then explore the diagnostic challenges pervading the 2014-2015 epidemic and provide a comprehensive examination of novel diagnostic tests that are likely to address some of these challenges moving forward. PMID:27413095

WORK-UP OF STILLBIRTH: A REVIEW OF THE EVIDENCE

PubMed Central

SILVER, Robert M.; VARNER, Michael W.; REDDY, Uma; GOLDENBERG, Robert; PINAR, Halit; CONWAY, Deborah; BUKOWSKI, Radek; CARPENTER, Marshall; HOGUE, Carol; WILLINGER, Marian; DUDLEY, Donald; SAADE, George; STOLL, Barbara

2009-01-01

Despite improvements in antenatal and intrapartum care, stillbirth, defined as in utero fetal death at 20 weeks of gestation or greater, remains an important, largely unstudied, and poignant problem in obstetrics. Over 26,000 stillbirths were reported in the US in 2001. Although several conditions have been linked to stillbirth, it is difficult to define the precise etiology in many cases. This paper reviews known and suspected causes of stillbirth including genetic abnormalities, infection, fetal-maternal hemorrhage, and a variety of medical conditions in the mother. The proportion of stillbirths that have a diagnostic explanation is higher in centers that conduct a defined and systematic evaluation. Recommended diagnostic tests for stillbirth are discussed. The on-going work of the NICHD Stillbirth Collaborative Research Network, a consortium of 5 academic centers in the United States that are studying the scope and causes of stillbirth, is presented. PMID:17466694

Surgical criteria for femoroacetabular impingement syndrome: a scoping review.

PubMed

Peters, Scott; Laing, Alisha; Emerson, Courtney; Mutchler, Kelsey; Joyce, Thomas; Thorborg, Kristian; Hölmich, Per; Reiman, Michael

2017-11-01

The purpose of this review was to analyse and report criteria used for open and arthroscopic surgical treatment of femoroacetabular impingement syndrome (FAIS). A librarian-assisted computer search of Medline, CINAHL and Embase for studies related to criterion for FAIS surgery was used in this study. Inclusion criteria included studies with the primary purpose of surgery or surgical outcomes for treatment of FAIS with and without labral tear, and reporting criteria for FAIS surgery. Diagnostic imaging was a criterion for surgery in 92% of the included studies, with alpha angle the most frequently reported (68% of studies) criterion. Reporting of symptoms was a criterion for surgery in 75%, and special tests a criterion in 70% of studies. Range-of-motion limitations were only a required criterion in 30%, only 12% of studies required intra-articular injection and 44% of studies described previously failed treatment (non-surgical or physiotherapist-led rehabilitation) as a criterion for surgery. Only 56% of included studies utilised the combination of symptoms, clinical signs and diagnostic imaging combined for diagnosis of FAIS as suggested by the Warwick Agreement on FAIS meeting. Diagnostic imaging evidence of FAIS was the most commonly reported criterion for surgery. Only 56% of included studies utilised the combination of symptoms, clinical signs and diagnostic imaging for diagnosis of FAIS as suggested by the Warwick Agreement on FAIS meeting, and only 44% of studies had failed non-surgical treatment (and 18% a failed trial of physiotherapy) as a criterion for surgery. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Structuring Word Problems for Diagnostic Teaching: Helping Teachers Meet the Needs of Children with Mild Disabilities.

ERIC Educational Resources Information Center

Parmar, Rene S.; Cawley, John F.

1994-01-01

Matrix organization can be used to construct math word problems for children with mild disabilities. Matrix organization specifies the characteristics of problems, such as problem theme or setting, operations, level of computation complexity, reading vocabulary level, and need for classification. A sample scope and sequence and 16 sample word…

Autism Spectrum Disorder in Sub-Saharan Africa: A Comprehensive Scoping Review

PubMed Central

Franz, Lauren; Chambers, Nola; von Isenburg, Megan; de Vries, Petrus J.

2017-01-01

Autism spectrum disorder (ASD) is recognized as a global public health concern, yet almost everything we know about ASD comes from high-income countries. Here we performed a scoping review of all research on ASD ever published in sub-Saharan Africa (SSA) in order to identify ASD knowledge gaps in this part of the world. Fifty-three publications met inclusion criteria. Themes included the phenotype, genetics and risk factors for ASD in SSA, screening and diagnosis, professional knowledge, interventions for ASD, parental perceptions, and social-cognitive neuroscience. No epidemiological, early intervention, school-based or adult studies were identified. For each identified theme, we aimed to summarize results and make recommendations to fill the knowledge gaps. The quality of study methodologies was generally not high. Few studies used standardized diagnostic instruments, and intervention studies were typically small-scale. Overall, findings suggest a substantial need for large-scale clinical, training, and research programmes to improve the lives of people who live with ASD in SSA. However, SSA also has the potential to make unique and globally-significant contributions to the etiology and treatments of ASD through implementation, interventional, and comparative genomic science. PMID:28266791

Molecular pathogenesis of precursor lesions of pancreatic ductal adenocarcinoma.

PubMed

Biankin, Andrew V; Kench, James G; Dijkman, Floriaan P; Biankin, Sandra A; Henshall, Susan M

2003-02-01

Precursor lesions are assuming greater importance in the study of pancreatic ductal adenocarcinoma. As pancreatic cancer is almost universally fatal due to late clinical presentation and biological aggressiveness, characterisation of its precursor lesions may create scope for early diagnosis and improved outcome with conventional therapies as well as the development of novel therapeutic and preventative strategies. Pancreatic intraepithelial neoplasia (PanIN) and intraductal papillary mucinous tumours (IPMTs) are thought to be precursor lesions of ductal adenocarcinoma of the pancreas. Recent work has focused on the molecular aberrations associated with these lesions leading to the formulation of a progression model for pancreatic cancer. Progressive histopathological changes along the progression model are associated with aberrations of cell cycle regulatory and growth factor signalling molecules that occur in pancreatic cancer at high frequency and are common to many cancers. Characterisation of these molecular aberrations provides scope for the development of novel diagnostic and treatment strategies that will ultimately impact on the outcome for people who develop pancreatic cancer.

Pain in adolescents with spinal muscular atrophy and Duchenne and Becker muscular dystrophy.

PubMed

Lager, Christina; Kroksmark, Anna-Karin

2015-09-01

The purpose of this study was to explore the prevalence, nature and scope of pain in adolescents with spinal muscular atrophy and Duchenne and Becker muscular dystrophy and whether the pain differs between diagnostic groups or between adolescents with different ambulation status. Furthermore to study the consequences of pain and to identify pain-exacerbating and pain-relieving factors. In a national survey, fifty-five adolescents with spinal muscular atrophy and dystrophinopathy completed a questionnaire assessing pain frequency, duration, location using a body map, intensity and discomfort using visual analogue scales, pain interference using a modified version of Brief Pain Inventory and factors exacerbating and relieving pain. Sixty-nine per cent of the adolescents reported pain during the past three months and 50% reported chronic pain. The pain prevalence did not differ significantly between diagnostic groups or between ambulators and non-ambulators. The average pain intensity was graded as mild and the worst pain as moderate. The pain typically occurred weekly, most frequently in the neck/back or legs. General activity and mood were the areas that were most affected by pain. Common pain-exacerbating factors were sitting, too much movement/activity and being lifted or transferred. Pain is a frequent problem in adolescents with spinal muscular atrophy and dystrophinopathy. The assessments used enable an understanding both of the nature and scope of pain and of the impact of pain in everyday life. The study highlights the importance of assessing pain in a systematic manner and offering an individual approach to interventions designed to reduce pain in this population. Copyright © 2015 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Measurement Issues: Screening and diagnostic instruments for autism spectrum disorders – lessons from research and practice

PubMed Central

Charman, Tony; Gotham, Katherine

2012-01-01

Background and Scope Significant progress has been made over the past two decades in the development of screening and diagnostic instruments for autism spectrum disorders (ASD). This article reviews this progress, including recent innovations, focussing on those instruments for which the strongest research data on validity exists, and then turns to addressing issues arising from their use in clinical settings. Findings Research studies have evaluated the ability of screens to prospectively identify cases of ASD in population-based and clinically-referred samples, as well as the accuracy of diagnostic instruments to map onto ‘gold standard’ clinical best estimate diagnosis. However, extension of the findings to clinical services must be done with caution, with a full understanding that instrument properties are sample-specific. Furthermore, we are limited by the lack of a true test for ASD, which remains a behaviourally-defined disorder. In addition screening and diagnostic instruments help clinicians least in the cases where they are most in want of direction, since their accuracy will always be lower for marginal cases. Conclusion Instruments help clinicians to collect detailed, structured information and increase accuracy and reliability of referral for in-depth assessment and recommendations for support, but further research is needed to refine their effective use in clinical settings. PMID:23539140

Clinical and public health implications of acute and early HIV detection and treatment: a scoping review.

PubMed

Rutstein, Sarah E; Ananworanich, Jintanat; Fidler, Sarah; Johnson, Cheryl; Sanders, Eduard J; Sued, Omar; Saez-Cirion, Asier; Pilcher, Christopher D; Fraser, Christophe; Cohen, Myron S; Vitoria, Marco; Doherty, Meg; Tucker, Joseph D

2017-06-28

The unchanged global HIV incidence may be related to ignoring acute HIV infection (AHI). This scoping review examines diagnostic, clinical, and public health implications of identifying and treating persons with AHI. We searched PubMed, in addition to hand-review of key journals identifying research pertaining to AHI detection and treatment. We focused on the relative contribution of AHI to transmission and the diagnostic, clinical, and public health implications. We prioritized research from low- and middle-income countries (LMICs) published in the last fifteen years. Extensive AHI research and limited routine AHI detection and treatment have begun in LMIC. Diagnostic challenges include ease-of-use, suitability for application and distribution in LMIC, and throughput for high-volume testing. Risk score algorithms have been used in LMIC to screen for AHI among individuals with behavioural and clinical characteristics more often associated with AHI. However, algorithms have not been implemented outside research settings. From a clinical perspective, there are substantial immunological and virological benefits to identifying and treating persons with AHI - evading the irreversible damage to host immune systems and seeding of viral reservoirs that occurs during untreated acute infection. The therapeutic benefits require rapid initiation of antiretrovirals, a logistical challenge in the absence of point-of-care testing. From a public health perspective, AHI diagnosis and treatment is critical to: decrease transmission via viral load reduction and behavioural interventions; improve pre-exposure prophylaxis outcomes by avoiding treatment initiation for HIV-seronegative persons with AHI; and, enhance partner services via notification for persons recently exposed or likely transmitting. There are undeniable clinical and public health benefits to AHI detection and treatment, but also substantial diagnostic and logistical barriers to implementation and scale-up. Effective early ART initiation may be critical for HIV eradication efforts, but widespread use in LMIC requires simple and accurate diagnostic tools. Implementation research is critical to facilitate sustainable integration of AHI detection and treatment into existing health systems and will be essential for prospective evaluation of testing algorithms, point-of-care diagnostics, and efficacious and effective first-line regimens.

Clinical and public health implications of acute and early HIV detection and treatment: a scoping review

PubMed Central

Rutstein, Sarah E.; Ananworanich, Jintanat; Fidler, Sarah; Johnson, Cheryl; Sanders, Eduard J.; Sued, Omar; Saez-Cirion, Asier; Pilcher, Christopher D.; Fraser, Christophe; Cohen, Myron S.; Vitoria, Marco; Doherty, Meg; Tucker, Joseph D.

2017-01-01

Abstract Introduction: The unchanged global HIV incidence may be related to ignoring acute HIV infection (AHI). This scoping review examines diagnostic, clinical, and public health implications of identifying and treating persons with AHI. Methods: We searched PubMed, in addition to hand-review of key journals identifying research pertaining to AHI detection and treatment. We focused on the relative contribution of AHI to transmission and the diagnostic, clinical, and public health implications. We prioritized research from low- and middle-income countries (LMICs) published in the last fifteen years. Results and Discussion: Extensive AHI research and limited routine AHI detection and treatment have begun in LMIC. Diagnostic challenges include ease-of-use, suitability for application and distribution in LMIC, and throughput for high-volume testing. Risk score algorithms have been used in LMIC to screen for AHI among individuals with behavioural and clinical characteristics more often associated with AHI. However, algorithms have not been implemented outside research settings. From a clinical perspective, there are substantial immunological and virological benefits to identifying and treating persons with AHI – evading the irreversible damage to host immune systems and seeding of viral reservoirs that occurs during untreated acute infection. The therapeutic benefits require rapid initiation of antiretrovirals, a logistical challenge in the absence of point-of-care testing. From a public health perspective, AHI diagnosis and treatment is critical to: decrease transmission via viral load reduction and behavioural interventions; improve pre-exposure prophylaxis outcomes by avoiding treatment initiation for HIV-seronegative persons with AHI; and, enhance partner services via notification for persons recently exposed or likely transmitting. Conclusions: There are undeniable clinical and public health benefits to AHI detection and treatment, but also substantial diagnostic and logistical barriers to implementation and scale-up. Effective early ART initiation may be critical for HIV eradication efforts, but widespread use in LMIC requires simple and accurate diagnostic tools. Implementation research is critical to facilitate sustainable integration of AHI detection and treatment into existing health systems and will be essential for prospective evaluation of testing algorithms, point-of-care diagnostics, and efficacious and effective first-line regimens. PMID:28691435

New flexible endoscope for otologic application

NASA Astrophysics Data System (ADS)

Marchan, Mark L.

1993-07-01

Endoscopy has become an important procedure in many medical specialties. For the Otologist, however, space limitations within the ear have restricted development of endoscopic procedures. The desire for minimally invasive techniques in Otology has demonstrated itself through the work of numerous physicians who have performed procedures ranging from diagnostic inspection of the middle ear to viewing the interior of the cochlea. To assist in performing such endoscopic procedures, Xomed-Treace has developed a line of flexible fiberoptic endoscopes for use by the Otologist. These scopes combine illumination and imaging fiber bundles within a small diameter unit ranging in size from 0.8 mm to 1.2 mm. The 1.2 mm scope is produced with an angled, rigid stainless steel sheath. The 0.8 mm scope is flexible with the ability to articulate 120 degree(s) in one direction. The fiberscopes have been designed for the Otologist to produce a good resolution image while allowing ease of operation through ergonomics and consideration of the surgical anatomy.

Scoping Review of the Zika Virus Literature

PubMed Central

2016-01-01

The global primary literature on Zika virus (ZIKV) (n = 233 studies and reports, up to March 1, 2016) has been compiled using a scoping review methodology to systematically identify and characterise the literature underpinning this broad topic using methods that are documented, updateable and reproducible. Our results indicate that more than half the primary literature on ZIKV has been published since 2011. The articles mainly covered three topic categories: epidemiology of ZIKV (surveillance and outbreak investigations) 56.6% (132/233), pathogenesis of ZIKV (case symptoms/ outcomes and diagnosis) 38.2% (89/233) and ZIKV studies (molecular characterisation and in vitro evaluation of the virus) 18.5% (43/233). There has been little reported in the primary literature on ZIKV vectors (12/233), surveillance for ZIKV (13/233), diagnostic tests (12/233) and transmission (10/233). Three papers reported on ZIKV prevention/control strategies, one investigated knowledge and attitudes of health professionals and two vector mapping studies were reported. The majority of studies used observational study designs, 89.7% (209/233), of which 62/233 were case studies or case series, while fewer (24/233) used experimental study designs. Several knowledge gaps were identified by this review with respect to ZIKV epidemiology, the importance of potential non-human primates and other hosts in the transmission cycle, the burden of disease in humans, and complications related to human infection with ZIKV. Historically there has been little research on ZIKV; however, given its current spread through Australasia and the Americas, research resources are now being allocated to close many of the knowledge gaps identified in this scoping review. Future updates of this project will probably demonstrate enhanced evidence and understanding of ZIKV and its impact on public health. PMID:27244249

Identification of mine rescue equipment reduction gears technical condition

NASA Astrophysics Data System (ADS)

Gerike, B. L.; Klishin, V. I.; Kuzin, E. G.

2017-09-01

The article presents the reasons for adopting intelligent service of mine belt conveyer drives concerning evaluation of their technical condition based on the diagnostic techniques instead of regular preventative maintenance. The article reveals the diagnostic results of belt conveyer drive reduction gears condition taking into account the parameters of lubricating oil, vibration and temperature. Usage of a complex approach to evaluate technical conditions allows reliability of the forecast to be improved, which makes it possible not only to prevent accidental breakdowns and eliminate unscheduled downtime, but also to bring sufficient economic benefits through reduction of the term and scope of work during overhauls.

The Buffer Diagnostic Prototype: A fault isolation application using CLIPS

NASA Technical Reports Server (NTRS)

Porter, Ken

1994-01-01

This paper describes problem domain characteristics and development experiences from using CLIPS 6.0 in a proof-of-concept troubleshooting application called the Buffer Diagnostic Prototype. The problem domain is a large digital communications subsystems called the real-time network (RTN), which was designed to upgrade the launch processing system used for shuttle support at KSC. The RTN enables up to 255 computers to share 50,000 data points with millisecond response times. The RTN's extensive built-in test capability but lack of any automatic fault isolation capability presents a unique opportunity for a diagnostic expert system application. The Buffer Diagnostic Prototype addresses RTN diagnosis with a multiple strategy approach. A novel technique called 'faulty causality' employs inexact qualitative models to process test results. Experimental knowledge provides a capability to recognize symptom-fault associations. The implementation utilizes rule-based and procedural programming techniques, including a goal-directed control structure and simple text-based generic user interface that may be reusable for other rapid prototyping applications. Although limited in scope, this project demonstrates a diagnostic approach that may be adapted to troubleshoot a broad range of equipment.

The Monsters in My Head: Posttraumatic Stress Disorder and the Child Survivor of Sexual Abuse

ERIC Educational Resources Information Center

Putman, Stacie E.

2009-01-01

Posttraumatic stress disorder (PTSD) is 1 of several possible outcomes of child sexual victimization. There is a growing body of literature regarding the prevalence of PTSD among children who have been sexually victimized. Using specific case examples, this article looks at the nature and scope of the problem, diagnostic criteria according to the…

Expanding syphilis testing: a scoping review of syphilis testing interventions among key populations.

PubMed

Ong, Jason J; Fu, Hongyun; Smith, M Kumi; Tucker, Joseph D

2018-05-01

Syphilis is an important sexually transmitted infection (STI). Despite inexpensive and effective treatment, few key populations receive syphilis testing. Innovative strategies are needed to increase syphilis testing among key populations. Areas covered: This scoping review focused on strategies to increase syphilis testing in key populations (men who have sex with men (MSM), sex workers, people who use drugs, transgender people, and incarcerated individuals). Expert commentary: We identified many promising syphilis testing strategies, particularly among MSM. These innovations are separated into diagnostic, clinic-based, and non-clinic based strategies. In terms of diagnostics, self-testing, dried blood spots, and point-of-care testing can decentralize syphilis testing. Effective syphilis self-testing pilots suggest the need for further attention and research. In terms of clinic-based strategies, modifying default clinical procedures can nudge physicians to more frequently recommend syphilis testing. In terms of non-clinic based strategies, venue-based screening (e.g. in correctional facilities, drug rehabilitation centres) and mobile testing units have been successfully implemented in a variety of settings. Integration of syphilis with HIV testing may facilitate implementation in settings where individuals have increased sexual risk. There is a strong need for further syphilis testing research and programs.

Fusion Power measurement at ITER

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

Bertalot, L.; Barnsley, R.; Krasilnikov, V.

2015-07-01

Nuclear fusion research aims to provide energy for the future in a sustainable way and the ITER project scope is to demonstrate the feasibility of nuclear fusion energy. ITER is a nuclear experimental reactor based on a large scale fusion plasma (tokamak type) device generating Deuterium - Tritium (DT) fusion reactions with emission of 14 MeV neutrons producing up to 700 MW fusion power. The measurement of fusion power, i.e. total neutron emissivity, will play an important role for achieving ITER goals, in particular the fusion gain factor Q related to the reactor performance. Particular attention is given also tomore » the development of the neutron calibration strategy whose main scope is to achieve the required accuracy of 10% for the measurement of fusion power. Neutron Flux Monitors located in diagnostic ports and inside the vacuum vessel will measure ITER total neutron emissivity, expected to range from 1014 n/s in Deuterium - Deuterium (DD) plasmas up to almost 10{sup 21} n/s in DT plasmas. The neutron detection systems as well all other ITER diagnostics have to withstand high nuclear radiation and electromagnetic fields as well ultrahigh vacuum and thermal loads. (authors)« less

T-scan III system diagnostic tool for digital occlusal analysis in orthodontics - a modern approach.

PubMed

Trpevska, Vesna; Kovacevska, Gordana; Benedeti, Alberto; Jordanov, Bozidar

2014-01-01

This systematic literature review was performed to establish the mechanism, methodology, characteristics, clinical application and opportunities of the T-Scan III System as a diagnostic tool for digital occlusal analysis in different fields of dentistry, precisely in orthodontics. Searching of electronic databases, using MEDLINE and PubMed, hand searching of relevant key journals, and screening of reference lists of included studies with no language restriction was performed. Publications providing statistically examined data were included for systematic review. Twenty potentially relevant Randomized Controlled Trials (RCTs) were identified. Only ten met the inclusion criteria. The literature demonstrates that using digital occlusal analysis with T-Scan III System in orthodontics has significant advantage with regard to the capability of measuring occlusal parameters in static positions and during dynamic of the mandible. Within the scope of this systematic review, there is evidence to support that T-Scan system is rapid and accurate in identifying the distribution of the tooth contacts and it shows great promise as a clinical diagnostic screening device for occlusion and for improving the occlusion after various dental treatments. Additional clinical studies are required to advance the indication filed of this system. Importance of using digital occlusal T-Scan analysis in orthodontics deserves further investigation.

Research gaps for three main tropical diseases in the People’s Republic of China

PubMed Central

2013-01-01

This scoping review analyzes the research gaps of three diseases: schistosomiasis japonica, malaria and echinococcosis. Based on available data in the P.R. China, we highlight the gaps between control capacity and prevalence levels, and between diagnostic/drug development and population need for treatment at different stages of the national control programme. After reviewing the literature from 848 original studies and consultations with experts in the field, the gaps were identified as follows. Firstly, the malaria research gaps include (i) deficiency of active testing in the public community and no appropriate technique to evaluate elimination, (ii) lack of sensitive diagnostic tools for asymptomatic patients, (iii) lack of safe drugs for mass administration. Secondly, gaps in research of schistosomiasis include (i) incongruent policy in the implementation of integrated control strategy for schistosomiasis, (ii) lack of effective tools for Oncomelania sp. snail control, (iii) lack of a more sensitive and cheaper diagnostic test for large population samples, (iv) lack of new drugs in addition to praziquantel. Thirdly, gaps in research of echinococcosis include (i) low capacity in field epidemiology studies, (ii) lack of sanitation improvement studies in epidemic areas, (iii) lack of a sensitivity test for early diagnosis, (iv) lack of more effective drugs for short-term treatment. We believe these three diseases can eventually be eliminated in mainland China if all the research gaps are abridged in a short period of time. PMID:23895635

Accuracy of Mobile Phone and Handheld Light Microscopy for the Diagnosis of Schistosomiasis and Intestinal Protozoa Infections in Côte d'Ivoire.

PubMed

Coulibaly, Jean T; Ouattara, Mamadou; D'Ambrosio, Michael V; Fletcher, Daniel A; Keiser, Jennifer; Utzinger, Jürg; N'Goran, Eliézer K; Andrews, Jason R; Bogoch, Isaac I

2016-06-01

Handheld light microscopy using compact optics and mobile phones may improve the quality of health care in resource-constrained settings by enabling access to prompt and accurate diagnosis. Laboratory technicians were trained to operate two handheld diagnostic devices (Newton Nm1 microscope and a clip-on version of the mobile phone-based CellScope). The accuracy of these devices was compared to conventional light microscopy for the diagnosis of Schistosoma haematobium, S. mansoni, and intestinal protozoa infection in a community-based survey in rural Côte d'Ivoire. One slide of 10 ml filtered urine and a single Kato-Katz thick smear from 226 individuals were subjected to the Newton Nm1 microscope and CellScope for detection of Schistosoma eggs and compared to conventional microscopy. Additionally, 121 sodium acetate-acetic acid-formalin (SAF)-fixed stool samples were examined by the Newton Nm1 microscope and compared to conventional microscopy for the diagnosis of intestinal protozoa. The prevalence of S. haematobium, S. mansoni, Giardia intestinalis, and Entamoeba histolytica/E. dispar, as determined by conventional microscopy, was 39.8%, 5.3%, 20.7%, and 4.9%, respectively. The Newton Nm1 microscope had diagnostic sensitivities for S. mansoni and S. haematobium infection of 91.7% (95% confidence interval (CI) 59.8-99.6%) and 81.1% (95% CI 71.2-88.3%), respectively, and specificities of 99.5% (95% CI 97.0-100%) and 97.1% (95% CI 92.2-99.1%), respectively. The CellScope demonstrated sensitivities for S. mansoni and S. haematobium of 50.0% (95% CI 25.4-74.6%) and 35.6% (95% CI 25.9-46.4%), respectively, and specificities of 99.5% (95% CI 97.0-100%) and 100% (95% CI 86.7-100%), respectively. For G. intestinalis and E. histolytica/E. dispar, the Newton Nm1 microscope had sensitivity of 84.0% (95% CI 63.1-94.7%) and 83.3% (95% CI 36.5-99.1%), respectively, and 100% specificity. Handheld diagnostic devices can be employed in community-based surveys in resource-constrained settings after minimal training of laboratory technicians to diagnose intestinal parasites.

Diagnostic digital cytopathology: Are we ready yet?

PubMed Central

House, Jarret C.; Henderson-Jackson, Evita B.; Johnson, Joseph O.; Lloyd, Mark C.; Dhillon, Jasreman; Ahmad, Nazeel; Hakam, Ardeshir; Khalbuss, Walid E.; Leon, Marino E.; Chhieng, David; Zhang, Xiaohui; Centeno, Barbara A.; Bui, Marilyn M.

2013-01-01

Background: The cytology literature relating to diagnostic accuracy using whole slide imaging is scarce. We studied the diagnostic concordance between glass and digital slides among diagnosticians with different profiles to assess the readiness of adopting digital cytology in routine practice. Materials and Methods: This cohort consisted of 22 de-identified previously screened and diagnosed cases, including non-gynecological and gynecological slides using standard preparations. Glass slides were digitalized using Aperio ScanScope XT (×20 and ×40). Cytopathologists with (3) and without (3) digital experience, cytotechnologists (4) and senior pathology residents (2) diagnosed the digital slides independently first and recorded the results. Glass slides were read and recorded separately 1-3 days later. Accuracy of diagnosis, time to diagnosis and diagnostician's profile were analyzed. Results: Among 22 case pairs and four study groups, correct diagnosis (93% vs. 86%) was established using glass versus digital slides. Both methods more (>95%) accurately diagnosed positive cases than negatives. Cytopathologists with no digital experience were the most accurate in digital diagnosis, even the senior members. Cytotechnologists had the fastest diagnosis time (3 min/digital vs. 1.7 min/glass), but not the best accuracy. Digital time was 1.5 min longer than glass-slide time/per case for cytopathologists and cytotechnologists. Senior pathology residents were slower and less accurate with both methods. Cytopathologists with digital experience ranked 2nd fastest in time, yet last in accuracy for digital slides. Conclusions: There was good overall diagnostic agreement between the digital whole-slide images and glass slides. Although glass slide diagnosis was more accurate and faster, the results of technologists and pathologists with no digital cytology experience suggest that solid diagnostic ability is a strong indicator for readiness of digital adoption. PMID:24392242

An update on the role of advanced diagnostic bronchoscopy in the evaluation and staging of lung cancer

PubMed Central

Belanger, Adam R.; Akulian, Jason A.

2017-01-01

Lung cancer remains a common and deadly disease. Many modalities are available to the bronchoscopist to evaluate and stage lung cancer. We review the role of bronchoscopy in the staging of the mediastinum with convex endobronchial ultrasound (EBUS) and discuss emerging role of esophageal ultrasonography as a complementary modality. In addition, we discuss advances in scope technology and elastography. We review the bronchoscopic methods available for the diagnosis of peripheral lung nodules including radial EBUS and navigational bronchoscopy (NB) with a consideration of the basic methodologies and diagnostic accuracies. We conclude with a discussion of the comparison of the various methodologies. PMID:28470104

Culture, cultural factors and psychiatric diagnosis: review and projections.

PubMed

Alarcón, Renato D

2009-10-01

This paper aims to provide conceptual justifications for the inclusion of culture and cultural factors in psychiatric diagnosis, and logistic suggestions as to the content and use of this approach. A discussion of the scope and limitations of current diagnostic practice, criticisms from different quarters, and the role and relevance of culture in the diagnostic encounter, precede the examination of advantages and disadvantages of the approach. The cultural content of psychiatric diagnosis should include the main, well-recognized cultural variables, adequate family data, explanatory models, and strengths and weaknesses of every individual patient. The practical aspects include the acceptance of "cultural discordances" as a component of an updated definition of mental disorder, and the use of a refurbished cultural formulation. Clinical "telescoping" strategies to obtain relevant cultural data during the diagnostic interview, and areas of future research (including field trials on the cultural formulation and on "culture bound syndromes"), are outlined.

Optical pre-clinical diagnostics of the cervical tissues malignant changing

NASA Astrophysics Data System (ADS)

Yermolenko, Sergey; Voloshynskyi, Dmytro; Fedoruk, Olexander; Gruia, Ion; Zimnyakov, Dmitry

2014-08-01

This work is directed to the investigation of the scope of the technique of laser polarimetry of oncological changes of the human prostate and cervical tissues under the conditions of multiple scattering, which presents a more general and real experimental clinical situation. This study is combining polarimetry and spectropolarimetry techniques for identifying the changes of optical-geometrical structure in different kinds of biotissues with solid tumours. It is researched that a linear dichroism appears in biotissues (human esophagus, muscle tissue of rats, human prostate tissue, cervical smear) with cancer diseases, magnitude of which depends on the type of the tissue and on the time of cancer process development.

Gross anatomy of network security

NASA Technical Reports Server (NTRS)

Siu, Thomas J.

2002-01-01

Information security involves many branches of effort, including information assurance, host level security, physical security, and network security. Computer network security methods and implementations are given a top-down description to permit a medically focused audience to anchor this information to their daily practice. The depth of detail of network functionality and security measures, like that of the study of human anatomy, can be highly involved. Presented at the level of major gross anatomical systems, this paper will focus on network backbone implementation and perimeter defenses, then diagnostic tools, and finally the user practices (the human element). Physical security measures, though significant, have been defined as beyond the scope of this presentation.

Molecular markers: Implications for cytopathology and specimen collection.

PubMed

VanderLaan, Paul A

2015-08-01

Cytologic specimens obtained through minimally invasive biopsy techniques are increasingly being used as principle diagnostic specimens for tumors arising in multiple sites. The number and scope of ancillary tests performed on these specimens have grown substantially over the past decade, including many molecular markers that not only can aid in formulating accurate and specific diagnoses but also can provide prognostic or therapeutic information to help direct clinical decisions. Thus, the cytopathologist needs to ensure that adequate material is collected and appropriately processed for the study of relevant molecular markers, many of which are specific to tumor site. This brief review covers considerations for effective cytologic specimen collection and processing to ensure diagnostic and testing success. In addition, a general overview is provided of molecular markers pertinent to tumors from a variety of sites. The recognition of these established and emerging molecular markers by cytopathologists is an important step toward realizing the promise of personalized medicine. © 2015 American Cancer Society.

Current use and future perspectives of diagnostic and therapeutic lasers in Oral Medicine.

PubMed

Maia, A M A; Barkokebas, A; Pires, A P; Barros, L F; Carvalho, A A T; Leão, J C

2008-10-01

Several diagnostic and therapeutic methods are based on the optical properties of lasers. In therapeutic applications, laser light is absorbed in a specific manner, whereas light is scattered, reflected, or transmitted from different structures. Improvements in laser technology allow new procedures and broaden the scope of applications for both diagnosis and therapy. The focus of laser application in Oral Medicine diagnosis should be early detection of oral squamous cell carcinoma. Novel modalities for the detection of oral malignancy are urgently needed, while others must be continuously improved. Optical coherence tomography and laser-induced fluorescence spectroscopy are currently being studied. In addition to diagnosis of non-malignant lesions, laser therapy has been used based upon the biological reactions and molecular wound healing mechanisms as an alternative for the treatment of a variety of oral soft tissue lesions. The aim of the present article is to review current knowledge and future perspectives of lasers in Oral Medicine.

Standard CMMI Appraisal Method for Process Improvement (SCAMPI) A, Version 1.3: Method Definition Document

DTIC Science & Technology

2011-03-01

performance of Federal Government Contract Number FA8721-05- C -0003 with Carnegie Mellon University for the operation of the Software Engineering... C Roles and Responsibilities 195 Appendix D Reporting Requirements and Options 201 Appendix E Managed Discovery 203 Appendix F Scoping and...Upgrade Team (SUT) • Mary Busby , Lockheed Martin • Palma Buttles-Valdez, Software Engineering Institute • Paul Byrnes, Integrated System Diagnostics

[Assessment of a rapid diagnostic test and portable fluorescent microscopy for malaria diagnosis in Cotonou (Bénin)].

PubMed

Ogouyèmi-Hounto, A; Kinde-Gazard, D; Keke, C; Gonçalves, E; Alapini, N; Adjovi, F; Adisso, L; Bossou, C; Denon, Y V; Massougbodji, A

2013-02-01

The aim of the study was to determine the accuracy of a rapid diagnostic test (SD Bioline Malaria Ag P.f/ Pan®) and fluorescent microscopy (CyScope®) in confirming presumptive malaria diagnosis in Cotonou. Thick blood smear was used as the reference technique for comparison. Testing was conducted on persons between the ages of 6 months and 70 years at two hospitals from June to October 2010. If malaria was suspected in the sample by the nurse based on clinical findings and sent to laboratory for confirmation, one thick smear, one rapid diagnostic test and one slide for the fluorescent microscopy were performed. All tests were read in hospital laboratories involved with the quality control of thick blood smear in the parasitology laboratory of National University Hospital of Cotonou. A total of 354 patients with clinical diagnosis of malaria were included. Malaria prevalence determined by thick smear, rapid diagnostic test and fluorescent microscopy was 22.8%, 25.4%, and 25.1% respectively. The sensitivity, specificity, positive and negative predictive values compared to the thick smears were 96.3, 95.6, 86.7, and 98.9% for rapid diagnostic test; and 97.5, 96.7, 89.8, and 99.27% for fluorescent microscopy. With these performances, these tests meet acceptability standards recommended by WHO for rapid tests (sensitivity > 95%). These two methods have advantages for the confirmation of malaria diagnosis in peripheral health structures that lack the resources to conduct diagnosis confirmation by the thick blood smear.

The implications of the feminization of the primary care physician workforce on service supply: a systematic review.

PubMed

Hedden, Lindsay; Barer, Morris L; Cardiff, Karen; McGrail, Kimberlyn M; Law, Michael R; Bourgeault, Ivy L

2014-06-04

There is a widespread perception that the increasing proportion of female physicians in most developed countries is contributing to a primary care service shortage because females work less and provide less patient care compared with their male counterparts. There has, however, been no comprehensive investigation of the effects of primary care physician (PCP) workforce feminization on service supply. We undertook a systematic review to examine the current evidence that quantifies the effect of feminization on time spent working, intensity and scope of work, and practice characteristics. We searched Medline, Embase, and Web of Science from 1991 to 2013 using variations of the terms 'primary care', 'women', 'manpower', and 'supply and distribution'; screened the abstracts of all articles; and entered those meeting our inclusion criteria into a data abstraction tool. Original research comparing male to female PCPs on measures of years of practice, time spent working, intensity of work, scope of work, or practice characteristics was included. We screened 1,271 unique abstracts and selected 74 studies for full-text review. Of these, 34 met the inclusion criteria. Years of practice, hours of work, intensity of work, scope of work, and practice characteristics featured in 12%, 53%, 42%, 50%, and 21% of studies respectively. Female PCPs self-report fewer hours of work than male PCPs, have fewer patient encounters, and deliver fewer services, but spend longer with their patients during a contact and deal with more separate presenting problems in one visit. They write fewer prescriptions but refer to diagnostic services and specialist physicians more often. The studies included in this review suggest that the feminization of the workforce is likely to have a small negative impact on the availability of primary health care services, and that the drivers of observed differences between male and female PCPs are complex and nuanced. The true scale of the impact of these findings on future effective physician supply is difficult to determine with currently available evidence, given that few studies looked at trends over time, and results from those that did are inconsistent. Additional research examining gender differences in practice patterns and scope of work is warranted.

Meta-analysis of diagnostic test data: a bivariate Bayesian modeling approach.

PubMed

Verde, Pablo E

2010-12-30

In the last decades, the amount of published results on clinical diagnostic tests has expanded very rapidly. The counterpart to this development has been the formal evaluation and synthesis of diagnostic results. However, published results present substantial heterogeneity and they can be regarded as so far removed from the classical domain of meta-analysis, that they can provide a rather severe test of classical statistical methods. Recently, bivariate random effects meta-analytic methods, which model the pairs of sensitivities and specificities, have been presented from the classical point of view. In this work a bivariate Bayesian modeling approach is presented. This approach substantially extends the scope of classical bivariate methods by allowing the structural distribution of the random effects to depend on multiple sources of variability. Meta-analysis is summarized by the predictive posterior distributions for sensitivity and specificity. This new approach allows, also, to perform substantial model checking, model diagnostic and model selection. Statistical computations are implemented in the public domain statistical software (WinBUGS and R) and illustrated with real data examples. Copyright © 2010 John Wiley & Sons, Ltd.

Diagnostics for the optimization of an 11 keV inverse Compton scattering x-ray source

NASA Astrophysics Data System (ADS)

Chauchat, A.-S.; Brasile, J.-P.; Le Flanchec, V.; Nègre, J.-P.; Binet, A.; Ortega, J.-M.

2013-04-01

In a scope of a collaboration between Thales Communications & Security and CEA DAM DIF, 11 keV Xrays were produced by inverse Compton scattering on the ELSA facility. In this type of experiment, X-ray observation lies in the use of accurate electron and laser beam interaction diagnostics and on fitted X-ray detectors. The low interaction probability between < 100 μm width, 12 ps [rms] length electron and photon pulses requires careful optimization of pulse spatial and temporal covering. Another issue was to observe 11 keV X-rays in the ambient radioactive noise of the linear accelerator. For that, we use a very sensitive detection scheme based on radio luminescent screens.

Clinical applications of computerized thermography

NASA Technical Reports Server (NTRS)

Anbar, Michael

1988-01-01

Computerized or digital, thermography is a rapidly growing diagnostic imaging modality. It has superseded contact thermography and analog imaging thermography which do not allow effective quantization. Medical applications of digital thermography can be classified in two groups: static and dynamic imaging. They can also be classified into macro thermography (resolution greater than 1 mm) and micro thermography (resolution less than 100 microns). Both modalities allow a thermal resolution of 0.1 C. The diagnostic power of images produced by any of these modalities can be augmented by the use of digital image enhancement and image recognition procedures. Computerized thermography has been applied in neurology, cardiovascular and plastic surgery, rehabilitation and sports medicine, psychiatry, dermatology and ophthalmology. Examples of these applications are shown and their scope and limitations are discussed.

Detection of Intestinal Protozoa in the Clinical Laboratory

PubMed Central

McHardy, Ian H.; Wu, Max; Shimizu-Cohen, Robyn; Couturier, Marc Roger

2014-01-01

Despite recent advances in diagnostic technology, microscopic examination of stool specimens remains central to the diagnosis of most pathogenic intestinal protozoa. Microscopy is, however, labor-intensive and requires a skilled technologist. New, highly sensitive diagnostic methods have been developed for protozoa endemic to developed countries, including Giardia lamblia (syn. G. intestinalis/G. duodenalis) and Cryptosporidium spp., using technologies that, if expanded, could effectively complement or even replace microscopic approaches. To date, the scope of such novel technologies is limited and may not include common protozoa such as Dientamoeba fragilis, Entamoeba histolytica, or Cyclospora cayetanensis. This minireview describes canonical approaches for the detection of pathogenic intestinal protozoa, while highlighting recent developments and FDA-approved tools for clinical diagnosis of common intestinal protozoa. PMID:24197877

Detection of intestinal protozoa in the clinical laboratory.

PubMed

McHardy, Ian H; Wu, Max; Shimizu-Cohen, Robyn; Couturier, Marc Roger; Humphries, Romney M

2014-03-01

Despite recent advances in diagnostic technology, microscopic examination of stool specimens remains central to the diagnosis of most pathogenic intestinal protozoa. Microscopy is, however, labor-intensive and requires a skilled technologist. New, highly sensitive diagnostic methods have been developed for protozoa endemic to developed countries, including Giardia lamblia (syn. G. intestinalis/G. duodenalis) and Cryptosporidium spp., using technologies that, if expanded, could effectively complement or even replace microscopic approaches. To date, the scope of such novel technologies is limited and may not include common protozoa such as Dientamoeba fragilis, Entamoeba histolytica, or Cyclospora cayetanensis. This minireview describes canonical approaches for the detection of pathogenic intestinal protozoa, while highlighting recent developments and FDA-approved tools for clinical diagnosis of common intestinal protozoa.

Various Indices for Diagnosis of Air-gap Eccentricity Fault in Induction Motor-A Review

NASA Astrophysics Data System (ADS)

Nikhil; Mathew, Lini, Dr.; Sharma, Amandeep

2018-03-01

From the past few years, research has gained an ardent pace in the field of fault detection and diagnosis in induction motors. In the current scenario, software is being introduced with diagnostic features to improve stability and reliability in fault diagnostic techniques. Human involvement in decision making for fault detection is slowly being replaced by Artificial Intelligence techniques. In this paper, a brief introduction of eccentricity fault is presented along with their causes and effects on the health of induction motors. Various indices used to detect eccentricity are being introduced along with their boundary conditions and their future scope of research. At last, merits and demerits of all indices are discussed and a comparison is made between them.

Standard CMMI (Registered Trademark) Appraisal Method for Process Improvement (SCAMPI (Service Mark)) A, Version 1.3: Method Definition Document

DTIC Science & Technology

2011-03-01

performance of Federal Government Contract Number FA8721-05- C -0003 with Carnegie Mellon University for the operation of the Software Engineering... C Roles and Responsibilities 195 Appendix D Reporting Requirements and Options 201 Appendix E Managed Discovery 203 Appendix F Scoping and...Upgrade Team (SUT) • Mary Busby , Lockheed Martin • Palma Buttles-Valdez, Software Engineering Institute • Paul Byrnes, Integrated System Diagnostics

Novel Biomarker Discovery for Diagnostic and Therapeutic Strategies in Prostate Cancer

DTIC Science & Technology

2015-06-01

PURPOSE: to identify high affinity aptamers that distinguish between prostate cancers that are likely to remain organ- confined and those with potential to...metastasize. SCOPE: This was a pilot project to generate RNA aptamers that selectively react with a prostate cancer cell line that remains confined... Aptamer -Facilitated Biomarker Discovery (AptaBiD) technology. TASKS AND PROGRESS: (1) Non-metastatic LNCaP-Pro-5 cells, metastasis-prone LNCaP-LN3

Novel Biomarker Discovery for Diagnostic and Therapeutic Strategies in Prostate Cancer

DTIC Science & Technology

2014-03-01

aptamers that distinguish between prostate cancers that are likely to remain organ-confined and those with potential to metastasize, The scope of this...pilot is to generate DNA aptamers that selectively react with a prostate cancer cell line that remains confined to the prostate (LNCaP) vs. a...subpopulation of this cell line that has acquired the ability to metastasize aggressively, employing Cell-Selex and Aptamer -Facilitated Biomarker Discovery

Human herpesvirus 8 – A novel human pathogen

PubMed Central

Edelman, Daniel C

2005-01-01

In 1994, Chang and Moore reported on the latest of the gammaherpesviruses to infect humans, human herpesvirus 8 (HHV-8) [1]. This novel herpesvirus has and continues to present challenges to define its scope of involvement in human disease. In this review, aspects of HHV-8 infection are discussed, such as, the human immune response, viral pathogenesis and transmission, viral disease entities, and the virus's epidemiology with an emphasis on HHV-8 diagnostics. PMID:16138925

Portable Diagnostics Technology Assessment for Space Missions. Part 1; General Technology Capabilities for NASA Exploration Missions

NASA Technical Reports Server (NTRS)

Nelson, Emily S.; Chait, Arnon

2010-01-01

The changes in the scope of NASA s mission in the coming decade are profound and demand nimble, yet insightful, responses. On-board clinical and environmental diagnostics must be available for both mid-term lunar and long-term Mars exploration missions in an environment marked by scarce resources. Miniaturization has become an obvious focus. Despite solid achievements in lab-based devices, broad-based, robust tools for application in the field are not yet on the market. The confluence of rapid, wide-ranging technology evolution and internal planning needs are the impetus behind this work. This report presents an analytical tool for the ongoing evaluation of promising technology platforms based on mission- and application-specific attributes. It is not meant to assess specific devices, but rather to provide objective guidelines for a rational down-select of general categories of technology platforms. In this study, we have employed our expertise in the microgravity operation of fluidic devices, laboratory diagnostics for space applications, and terrestrial research in biochip development. A rating of the current state of technology development is presented using the present tool. Two mission scenarios are also investigated: a 30-day lunar mission using proven, tested technology in 5 years; and a 2- to 3-year mission to Mars in 10 to 15 years.

Diagnostic X-ray sources-present and future

NASA Astrophysics Data System (ADS)

Behling, Rolf; Grüner, Florian

2018-01-01

This paper compares very different physical principles of X-ray production to spur ideation. Since more than 120 years, bremsstrahlung from X-ray tubes has been the workhorse of medical diagnostics. Generated by X-ray segments comprised of X-ray tubes and high-voltage generators in the various medical systems, X-ray photons in the spectral range between about 16 keV and 150 keV deliver information about anatomy and function of human patients and in pre-clinical animal studies. Despite of strides to employ the wave nature of X-rays as phase sensitive means, commercial diagnostic X-ray systems available until the time of writing still rely exclusively on measuring the attenuation and scattering of X-rays by matter. Significant activities in research aim at building highly brilliant short pulse X-ray sources, based on e.g. synchrotron radiation, free electron lasers and/or laser wake-field acceleration of electrons followed by wiggling with magnetic structures or Thomson scattering in bunches of light. While both approaches, non-brilliant and brilliant sources, have different scope of application, we speculate that a combination may expand the efficacy in medical application. At this point, however, severe technical and commercial difficulties hinder closing this gap. This article may inspire further development and spark innovation in this important field.

Hydraulic-fracture diagnostic research. Final report, December 1989-December 1990

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

Fix, J.E.; Adair, R.G.; Clawson, G.E.

1992-05-01

The results of the research in microseismic methods to determine hydraulic fracture dimensions during the contract were significant. The GRI Hydraulic Fracture Test Site (HFTS) development planning was a major effort. Ten meetings of the Planning Team were coordinated and hosted. A statement of the HFTS mission, scope, objectives, and requirements was created. The primary objectives were to provide for interdisciplinary experiments on fracture modeling and fracture diagnostics. A Conceptual Plan for the HFTS was compiled by Teledyne Geotech and distributed at the Project Advisors Group meeting. An experiment at the Shell South Belridge Field in California was a directmore » analog of the HFTS. Multiple fracture stimulations were monitored from 3 wells with cemented-in geophones. Methods of handling and processing large data volumes in real time were established. The final fracture geometry did not fit the circular model. Fracture diagnostics were monitored at two GRI cooperative wells: the Enron S. Hogsback No. 13-8A and the Phillips Ward C No. 11. Theoretical studies indicate that crack waves might be used as an estimate of fracture length. After applying advanced signal enhancement techniques to low-frequency signals from 14 surveys, it was concluded that the data from presently available sondes is contaminated by sonde resonances.« less

Analytical Protein Microarrays: Advancements Towards Clinical Applications

PubMed Central

Sauer, Ursula

2017-01-01

Protein microarrays represent a powerful technology with the potential to serve as tools for the detection of a broad range of analytes in numerous applications such as diagnostics, drug development, food safety, and environmental monitoring. Key features of analytical protein microarrays include high throughput and relatively low costs due to minimal reagent consumption, multiplexing, fast kinetics and hence measurements, and the possibility of functional integration. So far, especially fundamental studies in molecular and cell biology have been conducted using protein microarrays, while the potential for clinical, notably point-of-care applications is not yet fully utilized. The question arises what features have to be implemented and what improvements have to be made in order to fully exploit the technology. In the past we have identified various obstacles that have to be overcome in order to promote protein microarray technology in the diagnostic field. Issues that need significant improvement to make the technology more attractive for the diagnostic market are for instance: too low sensitivity and deficiency in reproducibility, inadequate analysis time, lack of high-quality antibodies and validated reagents, lack of automation and portable instruments, and cost of instruments necessary for chip production and read-out. The scope of the paper at hand is to review approaches to solve these problems. PMID:28146048

Academic medical centers as innovation ecosystems to address population -omics challenges in precision medicine.

PubMed

Silva, Patrick J; Schaibley, Valerie M; Ramos, Kenneth S

2018-02-15

While the promise of the Human Genome Project provided significant insights into the structure of the human genome, the complexities of disease at the individual level have made it difficult to utilize -omic information in clinical decision making. Some of the existing constraints have been minimized by technological advancements that have reduced the cost of sequencing to a rate far in excess of Moore's Law (a halving in cost per unit output every 18 months). The reduction in sequencing costs has made it economically feasible to create large data commons capturing the diversity of disease across populations. Until recently, these data have primarily been consumed in clinical research, but now increasingly being considered in clinical decision- making. Such advances are disrupting common diagnostic business models around which academic medical centers (AMCs) and molecular diagnostic companies have collaborated over the last decade. Proprietary biomarkers and patents on proprietary diagnostic content are no longer driving biomarker collaborations between industry and AMCs. Increasingly the scope of the data commons and biorepositories that AMCs can assemble through a nexus of academic and pharma collaborations is driving a virtuous cycle of precision medicine capabilities that make an AMC relevant and highly competitive. A rebalancing of proprietary strategies and open innovation strategies is warranted to enable institutional precision medicine asset portfolios. The scope of the AMC's clinical trial and research collaboration portfolios with industry are increasingly dependent on the currency of data, and less on patents. Intrapeneurial support of internal service offerings, clinical trials and clinical laboratory services for example, will be important new points of emphasis at the academic-industry interface. Streamlining these new models of industry collaboration for AMCs are a new area for technology transfer offices to offer partnerships and to add value beyond the traditional intellectual property offering.

Acute stress responses: A review and synthesis of ASD, ASR, and CSR.

PubMed

Isserlin, Leanna; Zerach, Gadi; Solomon, Zahava

2008-10-01

Toward the development of a unifying diagnosis for acute stress responses this article attempts to find a place for combat stress reaction (CSR) within the spectrum of other defined acute stress responses. This article critically compares the diagnostic criteria of acute stress disorder (ASD), acute stress reaction (ASR), and CSR. Prospective studies concerning the predictive value of ASD, ASR, and CSR are reviewed. Questions, recommendations, and implications for clinical practice are raised concerning the completeness of the current acute stress response diagnoses, the heterogeneity of different stressors, the scope of expected outcomes, and the importance of decline in function as an indicator of future psychological, psychiatric, and somatic distress. PsycINFO Database Record 2009 APA.

New methodology to baseline and match AME polysilicon etcher using advanced diagnostic tools

NASA Astrophysics Data System (ADS)

Poppe, James; Shipman, John; Reinhardt, Barbara E.; Roussel, Myriam; Hedgecock, Raymond; Fonda, Arturo

1999-09-01

As process controls tighten in the semiconductor industry, the need to understand the variables that determine system performance become more important. For plasma etch systems, process success depends on the control of key parameters such as: vacuum integrity, pressure, gas flows, and RF power. It is imperative to baseline, monitor, and control these variables. This paper presents an overview of the methods and tools used by Motorola BMC fabrication facility to characterize an Applied Materials polysilicon etcher. Tool performance data obtained from our traditional measurement techniques are limited in their scope and do not provide a complete picture of the ultimate tool performance. Presently the BMC traditional characterization tools provide a snapshot of the static operation of the equipment under test (EUT); however, complete evaluation of the dynamic performance cannot be monitored without the aid of specialized diagnostic equipment. To provide us with a complete system baseline evaluation of the polysilicon etcher, three diagnostic tools were utilized: Lucas Labs Vacuum Diagnostic System, Residual Gas Analyzer, and the ENI Voltage/Impedance Probe. The diagnostic methodology used to baseline and match key parameters of qualified production equipment has had an immense impact on other equipment characterization in the facility. It has resulted in reduced cycle time for new equipment introduction as well.

Consolidated Laser-Induced Fluorescence Diagnostic Systems for the NASA Ames Arc Jet Facilities

NASA Technical Reports Server (NTRS)

Grinstead, Jay H.; Wilder, Michael C.; Porter, Barry J.; Brown, Jeffrey D.; Yeung, Dickson; Battazzo, Stephen J.; Brubaker, Timothy R.

2016-01-01

The spectroscopic diagnostic technique of two photon absorption laser-induced fluorescence (LIF) of atomic species for non-intrusive arc jet flow property measurement was first implemented at NASA Ames in the mid-1990s. In 2013-2014, NASA combined the agency's large-scale arc jet test capabilities at NASA Ames. Concurrent with that effort, the agency also sponsored a project to establish two comprehensive LIF diagnostic systems for the Aerodynamic Heating Facility (AHF) and Interaction Heating Facility (IHF) arc jets. The scope of the project enabled further engineering development of the existing IHF LIF system as well as the complete reconstruction of the AHF LIF system. The updated LIF systems are identical in design and capability. They represent the culmination of over 20 years of development experience in transitioning a specialized laboratory research tool into a measurement system for large-scale, high-demand test facilities. This paper will document the latest improvements of the LIF system design and demonstrations of the redeveloped AHF and IHF LIF systems.

Accuracy of Mobile Phone and Handheld Light Microscopy for the Diagnosis of Schistosomiasis and Intestinal Protozoa Infections in Côte d’Ivoire

PubMed Central

Coulibaly, Jean T.; Ouattara, Mamadou; D’Ambrosio, Michael V.; Fletcher, Daniel A.; Keiser, Jennifer; Utzinger, Jürg; N’Goran, Eliézer K.

2016-01-01

Background Handheld light microscopy using compact optics and mobile phones may improve the quality of health care in resource-constrained settings by enabling access to prompt and accurate diagnosis. Methodology Laboratory technicians were trained to operate two handheld diagnostic devices (Newton Nm1 microscope and a clip-on version of the mobile phone-based CellScope). The accuracy of these devices was compared to conventional light microscopy for the diagnosis of Schistosoma haematobium, S. mansoni, and intestinal protozoa infection in a community-based survey in rural Côte d’Ivoire. One slide of 10 ml filtered urine and a single Kato-Katz thick smear from 226 individuals were subjected to the Newton Nm1 microscope and CellScope for detection of Schistosoma eggs and compared to conventional microscopy. Additionally, 121 sodium acetate-acetic acid-formalin (SAF)-fixed stool samples were examined by the Newton Nm1 microscope and compared to conventional microscopy for the diagnosis of intestinal protozoa. Principal Findings The prevalence of S. haematobium, S. mansoni, Giardia intestinalis, and Entamoeba histolytica/E. dispar, as determined by conventional microscopy, was 39.8%, 5.3%, 20.7%, and 4.9%, respectively. The Newton Nm1 microscope had diagnostic sensitivities for S. mansoni and S. haematobium infection of 91.7% (95% confidence interval (CI) 59.8–99.6%) and 81.1% (95% CI 71.2–88.3%), respectively, and specificities of 99.5% (95% CI 97.0–100%) and 97.1% (95% CI 92.2–99.1%), respectively. The CellScope demonstrated sensitivities for S. mansoni and S. haematobium of 50.0% (95% CI 25.4–74.6%) and 35.6% (95% CI 25.9–46.4%), respectively, and specificities of 99.5% (95% CI 97.0–100%) and 100% (95% CI 86.7–100%), respectively. For G. intestinalis and E. histolytica/E. dispar, the Newton Nm1 microscope had sensitivity of 84.0% (95% CI 63.1–94.7%) and 83.3% (95% CI 36.5–99.1%), respectively, and 100% specificity. Conclusions/Significance Handheld diagnostic devices can be employed in community-based surveys in resource-constrained settings after minimal training of laboratory technicians to diagnose intestinal parasites. PMID:27348755

Advancing scoping study methodology: a web-based survey and consultation of perceptions on terminology, definition and methodological steps.

PubMed

O'Brien, Kelly K; Colquhoun, Heather; Levac, Danielle; Baxter, Larry; Tricco, Andrea C; Straus, Sharon; Wickerson, Lisa; Nayar, Ayesha; Moher, David; O'Malley, Lisa

2016-07-26

Scoping studies (or reviews) are a method used to comprehensively map evidence across a range of study designs in an area, with the aim of informing future research practice, programs and policy. However, no universal agreement exists on terminology, definition or methodological steps. Our aim was to understand the experiences of, and considerations for conducting scoping studies from the perspective of academic and community partners. Primary objectives were to 1) describe experiences conducting scoping studies including strengths and challenges; and 2) describe perspectives on terminology, definition, and methodological steps. We conducted a cross-sectional web-based survey with clinicians, educators, researchers, knowledge users, representatives from community-based organizations, graduate students, and policy stakeholders with experience and/or interest in conducting scoping studies to gain an understanding of experiences and perspectives on the conduct and reporting of scoping studies. We administered an electronic self-reported questionnaire comprised of 22 items related to experiences with scoping studies, strengths and challenges, opinions on terminology, and methodological steps. We analyzed questionnaire data using descriptive statistics and content analytical techniques. Survey results were discussed during a multi-stakeholder consultation to identify key considerations in the conduct and reporting of scoping studies. Of the 83 invitations, 54 individuals (65 %) completed the scoping questionnaire, and 48 (58 %) attended the scoping study meeting from Canada, the United Kingdom and United States. Many scoping study strengths were dually identified as challenges including breadth of scope, and iterative process. No consensus on terminology emerged, however key defining features that comprised a working definition of scoping studies included the exploratory mapping of literature in a field; iterative process, inclusion of grey literature; no quality assessment of included studies, and an optional consultation phase. We offer considerations for the conduct and reporting of scoping studies for researchers, clinicians and knowledge users engaging in this methodology. Lack of consensus on scoping terminology, definition and methodological steps persists. Reasons for this may be attributed to diversity of disciplines adopting this methodology for differing purposes. Further work is needed to establish guidelines on the reporting and methodological quality assessment of scoping studies.

Multi-Contrast Imaging and Digital Refocusing on a Mobile Microscope with a Domed LED Array.

PubMed

Phillips, Zachary F; D'Ambrosio, Michael V; Tian, Lei; Rulison, Jared J; Patel, Hurshal S; Sadras, Nitin; Gande, Aditya V; Switz, Neil A; Fletcher, Daniel A; Waller, Laura

2015-01-01

We demonstrate the design and application of an add-on device for improving the diagnostic and research capabilities of CellScope--a low-cost, smartphone-based point-of-care microscope. We replace the single LED illumination of the original CellScope with a programmable domed LED array. By leveraging recent advances in computational illumination, this new device enables simultaneous multi-contrast imaging with brightfield, darkfield, and phase imaging modes. Further, we scan through illumination angles to capture lightfield datasets, which can be used to recover 3D intensity and phase images without any hardware changes. This digital refocusing procedure can be used for either 3D imaging or software-only focus correction, reducing the need for precise mechanical focusing during field experiments. All acquisition and processing is performed on the mobile phone and controlled through a smartphone application, making the computational microscope compact and portable. Using multiple samples and different objective magnifications, we demonstrate that the performance of our device is comparable to that of a commercial microscope. This unique device platform extends the field imaging capabilities of CellScope, opening up new clinical and research possibilities.

System Modeling and Diagnostics for Liquefying-Fuel Hybrid Rockets

NASA Technical Reports Server (NTRS)

Poll, Scott; Iverson, David; Ou, Jeremy; Sanderfer, Dwight; Patterson-Hine, Ann

2003-01-01

A Hybrid Combustion Facility (HCF) was recently built at NASA Ames Research Center to study the combustion properties of a new fuel formulation that burns approximately three times faster than conventional hybrid fuels. Researchers at Ames working in the area of Integrated Vehicle Health Management recognized a good opportunity to apply IVHM techniques to a candidate technology for next generation launch systems. Five tools were selected to examine various IVHM techniques for the HCF. Three of the tools, TEAMS (Testability Engineering and Maintenance System), L2 (Livingstone2), and RODON, are model-based reasoning (or diagnostic) systems. Two other tools in this study, ICS (Interval Constraint Simulator) and IMS (Inductive Monitoring System) do not attempt to isolate the cause of the failure but may be used for fault detection. Models of varying scope and completeness were created, both qualitative and quantitative. In each of the models, the structure and behavior of the physical system are captured. In the qualitative models, the temporal aspects of the system behavior and the abstraction of sensor data are handled outside of the model and require the development of additional code. In the quantitative model, less extensive processing code is also necessary. Examples of fault diagnoses are given.

Expanding molecular diagnostics of helminthiasis: Piloting use of the GPLN platform for surveillance of soil transmitted helminthiasis and schistosomiasis in Ghana.

PubMed

Cunningham, Lucas J; Odoom, John; Pratt, Deborah; Boatemaa, Linda; Asante-Ntim, Nana; Attiku, Keren; Banahene, Bismarck; Osei-Atweneboana, Mike; Verweij, Jaco J; Molyneux, David; Stothard, Russell J; Adams, Emily R

2018-01-01

The efforts to control and eradicate polio as a global health burden have been successful to the point where currently only three countries now report endemic polio, and the number of cases of polio continues to decrease. The success of the polio programme has been dependant on a well-developed network of laboratories termed the global polio laboratory network (GPLN). Here we explore collaborative opportunities with the GPLN to target two of the 18 diseases listed as a neglected tropical diseases (NTD) namely soil transmitted helminthiasis (STH) and Schistosomiasis (SCH). These were chosen based on prevalence and the use of faecal materials to identify both polio, STH and SCH. Our study screened 448 faecal samples from the Ghana GPLN using three triplex TaqMan assays to identify Ascaris lumbricoides, Necator americanus, Ancylostoma spp, Trichuris trchiura, Strongyloides stercoralis and Schistosoma spp. Our results found a combined helminth prevalence of 22%. The most common helminth infection was A. lumbricoides with a prevalence of 15% followed by N. americanus (5%), Ancylostoma spp. (2.5%), Schistosoma spp. (1.6%) and S. stercoralis (1%). These results show that it is possible to identify alternative pathogens to polio in the samples collected by the GPLN platform and to introduce new diagnostic assays to their laboratories. The diagnostic methods employed were also able to identify S. stercoralis positive samples, which are difficult to identify using parasitological methods such as Kato-Katz. This study raises the possibility of collaboration with the GPLN for the surveillance of a wider range of diseases which would both benefit the efforts to control the NTDs and also increase the scope of the GPLN as a diagnostic platform.

Multi-complexity ensemble measures for gait time series analysis: application to diagnostics, monitoring and biometrics.

PubMed

Gavrishchaka, Valeriy; Senyukova, Olga; Davis, Kristina

2015-01-01

Previously, we have proposed to use complementary complexity measures discovered by boosting-like ensemble learning for the enhancement of quantitative indicators dealing with necessarily short physiological time series. We have confirmed robustness of such multi-complexity measures for heart rate variability analysis with the emphasis on detection of emerging and intermittent cardiac abnormalities. Recently, we presented preliminary results suggesting that such ensemble-based approach could be also effective in discovering universal meta-indicators for early detection and convenient monitoring of neurological abnormalities using gait time series. Here, we argue and demonstrate that these multi-complexity ensemble measures for gait time series analysis could have significantly wider application scope ranging from diagnostics and early detection of physiological regime change to gait-based biometrics applications.

Carbohydrate CuAAC click chemistry for therapy and diagnosis.

PubMed

He, Xiao-Peng; Zeng, Ya-Li; Zang, Yi; Li, Jia; Field, Robert A; Chen, Guo-Rong

2016-06-24

Carbohydrates are important as signaling molecules and for cellular recognition events, therefore offering scope for the development of carbohydrate-mimetic diagnostics and drug candidates. As a consequence, the construction of carbohydrate-based bioactive compounds and sensors has become an active research area. While the advent of click chemistry has greatly accelerated the progress of medicinal chemistry and chemical biology, recent literature has seen an extensive use of such approaches to construct functionally diverse carbohydrate derivatives. Here we summarize some of the progress, covering the period 2010 to mid-2015, in Cu(I)-catalyzed azide-alkyne 1,3-dipolar cycloaddition CuAAC "click chemistry" of carbohydrate derivatives, in the context of potential therapeutic and diagnostic tool development. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Scope and Limits of an anamnestic questionnaire in a control-induced low-endemicity helminthiasis setting in south-central Côte d'Ivoire.

PubMed

Fürst, Thomas; Ouattara, Mamadou; Silué, Kigbafori D; N'Goran, Dje N; Adiossan, Lukas G; Bogoch, Isaac I; N'Guessan, Yao; Koné, Siaka; Utzinger, Jürg; N'Goran, Eliézer K

2014-01-01

Schistosomiasis and soil-transmitted helminthiasis are two high-burden neglected tropical diseases. In highly endemic areas, control efforts emphasize preventive chemotherapy. However, as morbidity, infection, and transmission begin to decrease, more targeted treatment is likely to become more cost-effective, provided that comparatively cheap diagnostic methods with reasonable accuracy are available. Adults were administered an anamnestic questionnaire in mid-2010 during a cross-sectional epidemiological survey in the Taabo health demographic surveillance system in south-central Côte d'Ivoire. Questions pertaining to risk factors and signs and symptoms for schistosomiasis and soil-transmitted helminthiasis were included. The individuals' helminth infection status and their belonging to three different anthelmintic treatment groups were compared with the questionnaire results (i) to inform the local health authorities about the epidemiological and clinical footprint of locally prevailing helminthiases, and (ii) to explore the scope and limits of an anamnestic questionnaire as monitoring tool, which eventually could help guiding the control of neglected tropical diseases in control-induced low-endemicity settings. Our study sample consisted of 195 adults (101 males, 94 females). We found prevalences of hookworm, Trichuris trichiura, Schistosoma haematobium, and Schistosoma mansoni of 39.0%, 2.7%, 2.1%, and 2.1%, respectively. No Ascaris lumbricoides infection was found. Helminth infection intensities were generally very low. Seven, 74 and 79 participants belonged to three different treatment groups. Multivariable logistic regression models revealed statistically significant (p<0.05) associations between some risk factors, signs, and symptoms, and the different helminth infections and treatment groups. However, the risk factors, signs, and symptoms showed weak diagnostic properties. The generally low prevalence and intensity of helminth infection in this part of south-central Côte d'Ivoire indicates that recent control efforts have turned our study area into a low endemicity setting. Our anamnestic questionnaire had low sensitivity and specificity to identify infected individuals or treatment groups.

Scope and Limits of an Anamnestic Questionnaire in a Control-Induced Low-Endemicity Helminthiasis Setting in South-Central Côte d’Ivoire

PubMed Central

Fürst, Thomas; Ouattara, Mamadou; Silué, Kigbafori D.; N’Goran, Dje N.; Adiossan, Lukas G.; Bogoch, Isaac I.; N’Guessan, Yao; Koné, Siaka; Utzinger, Jürg; N’Goran, Eliézer K.

2013-01-01

Background Schistosomiasis and soil-transmitted helminthiasis are two high-burden neglected tropical diseases. In highly endemic areas, control efforts emphasize preventive chemotherapy. However, as morbidity, infection, and transmission begin to decrease, more targeted treatment is likely to become more cost-effective, provided that comparatively cheap diagnostic methods with reasonable accuracy are available. Methodology Adults were administered an anamnestic questionnaire in mid-2010 during a cross-sectional epidemiological survey in the Taabo health demographic surveillance system in south-central Côte d’Ivoire. Questions pertaining to risk factors and signs and symptoms for schistosomiasis and soil-transmitted helminthiasis were included. The individuals’ helminth infection status and their belonging to three different anthelmintic treatment groups were compared with the questionnaire results (i) to inform the local health authorities about the epidemiological and clinical footprint of locally prevailing helminthiases, and (ii) to explore the scope and limits of an anamnestic questionnaire as monitoring tool, which eventually could help guiding the control of neglected tropical diseases in control-induced low-endemicity settings. Principal Findings Our study sample consisted of 195 adults (101 males, 94 females). We found prevalences of hookworm, Trichuris trichiura, Schistosoma haematobium, and Schistosoma mansoni of 39.0%, 2.7%, 2.1%, and 2.1%, respectively. No Ascaris lumbricoides infection was found. Helminth infection intensities were generally very low. Seven, 74 and 79 participants belonged to three different treatment groups. Multivariable logistic regression models revealed statistically significant (p<0.05) associations between some risk factors, signs, and symptoms, and the different helminth infections and treatment groups. However, the risk factors, signs, and symptoms showed weak diagnostic properties. Conclusions/Significance The generally low prevalence and intensity of helminth infection in this part of south-central Côte d’Ivoire indicates that recent control efforts have turned our study area into a low endemicity setting. Our anamnestic questionnaire had low sensitivity and specificity to identify infected individuals or treatment groups. PMID:23755120

Diagnosing the occult contralateral inguinal hernia.

PubMed

Koehler, R H

2002-03-01

The incidence of bilateral inguinal hernias reported for total extra peritoneal (TEP) laparoscopic hernia repair, which reaches 45%, appears to be higher than that seen in studies of transabdominal laparoscopic and open repair. Given the unique ability of diagnostic laparoscopy to diagnose occult contralateral hernias (OCH) accurately, this study looked at how concurrent transabdominal diagnostic laparoscopy (TADL) would influence planned TEP repairs. A prospective study oF 100 consecutive TEP cases was conducted. All patients had diagnostic laparoscopy via a 5-mm 45 degrees scope through an umbilical incision with 15 mmHg of pneumoperitoneum, followed by laparoscopic TEPrepair. A contralateral occult hernia was diagnosed and repaired if a true peritoneal eventration through the inguinal region was observed. Among the 100 patients, preoperative diagnosis suggested 31 bilateral hernias (31%), whereas TADL confirmed 25 bilateral hernias (25%). Of these 25 bilateral hernias, TADL confirmed 16 that had been diagnosed preoperatively (64%), but excluded 15 contralateral hernias that were incorrectly diagnosed (37%). Transabdominal diagnostic laparoscopy found nine OCHs, representing 36% of all bilateral hernias and 13% of the 69 preoperatively determined unilateral hernias. The preoperative physician examination false-negative rate for contralateral hernias was 36%, and the false-positive rate was 37%. In 26 cases (26%), TADL changed the operative approach. In this study, patients believed to have unilateral inguinal hernias had OCHs in 13% of cases when examined by TADL. The actual bilateral hernia incidence was 25%, with a 37% false-positive rate for preoperatively diagnosed bilateral hernias. The high rate of bilateral hernias reported by the TEP approach alone suggests that some OCH findings may be an artifact of the TEP dissection. However, failure to search for an OCH could result in up to 13% of patients subsequently requiring a second repair. Because some surgeons are concerned about unnecessary TEP dissection of the asymptomatic contralateral side, the approach described here may offer a solution to accurate diagnosis of the contralateral inguinal region during planned laparoscopic TEP hernia repair.

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.

Microgravity Combustion Research: 1999 Program and Results

NASA Technical Reports Server (NTRS)

Friedman, Robert (Editor); Gokoglu, Suleyman A. (Editor); Urban, David L. (Editor)

1999-01-01

The use of the microgravity environment of space to expand scientific knowledge and to enable the commercial development of space for enhancing the quality of life on Earth is particularly suitable to the field of combustion. This document reviews the current status of microgravity combustion research and derived information. It is the fourth in a series of timely surveys, all published as NASA Technical Memoranda, and it covers largely the period from 1995 to early 1999. The scope of the review covers three program areas: fundamental studies, applications to fire safety and other fields. and general measurements and diagnostics. The document also describes the opportunities for Principal Investigator participation through the NASA Research Announcement program and the NASA Glenn Research Center low-gravity facilities available to researchers.

Rapid, comprehensive, and affordable mycobacterial diagnosis with whole-genome sequencing: a prospective study

PubMed Central

Pankhurst, Louise J; del Ojo Elias, Carlos; Votintseva, Antonina A; Walker, Timothy M; Cole, Kevin; Davies, Jim; Fermont, Jilles M; Gascoyne-Binzi, Deborah M; Kohl, Thomas A; Kong, Clare; Lemaitre, Nadine; Niemann, Stefan; Paul, John; Rogers, Thomas R; Roycroft, Emma; Smith, E Grace; Supply, Philip; Tang, Patrick; Wilcox, Mark H; Wordsworth, Sarah; Wyllie, David; Xu, Li; Crook, Derrick W

2016-01-01

Summary Background Slow and cumbersome laboratory diagnostics for Mycobacterium tuberculosis complex (MTBC) risk delayed treatment and poor patient outcomes. Whole-genome sequencing (WGS) could potentially provide a rapid and comprehensive diagnostic solution. In this prospective study, we compare real-time WGS with routine MTBC diagnostic workflows. Methods We compared sequencing mycobacteria from all newly positive liquid cultures with routine laboratory diagnostic workflows across eight laboratories in Europe and North America for diagnostic accuracy, processing times, and cost between Sept 6, 2013, and April 14, 2014. We sequenced specimens once using local Illumina MiSeq platforms and processed data centrally using a semi-automated bioinformatics pipeline. We identified species or complex using gene presence or absence, predicted drug susceptibilities from resistance-conferring mutations identified from reference-mapped MTBC genomes, and calculated genetic distance to previously sequenced UK MTBC isolates to detect outbreaks. WGS data processing and analysis was done by staff masked to routine reference laboratory and clinical results. We also did a microcosting analysis to assess the financial viability of WGS-based diagnostics. Findings Compared with routine results, WGS predicted species with 93% (95% CI 90–96; 322 of 345 specimens; 356 mycobacteria specimens submitted) accuracy and drug susceptibility also with 93% (91–95; 628 of 672 specimens; 168 MTBC specimens identified) accuracy, with one sequencing attempt. WGS linked 15 (16% [95% CI 10–26]) of 91 UK patients to an outbreak. WGS diagnosed a case of multidrug-resistant tuberculosis before routine diagnosis was completed and discovered a new multidrug-resistant tuberculosis cluster. Full WGS diagnostics could be generated in a median of 9 days (IQR 6–10), a median of 21 days (IQR 14–32) faster than final reference laboratory reports were produced (median of 31 days [IQR 21–44]), at a cost of £481 per culture-positive specimen, whereas routine diagnosis costs £518, equating to a WGS-based diagnosis cost that is 7% cheaper annually than are present diagnostic workflows. Interpretation We have shown that WGS has a scalable, rapid turnaround, and is a financially feasible method for full MTBC diagnostics. Continued improvements to mycobacterial processing, bioinformatics, and analysis will improve the accuracy, speed, and scope of WGS-based diagnosis. Funding National Institute for Health Research, Department of Health, Wellcome Trust, British Colombia Centre for Disease Control Foundation for Population and Public Health, Department of Clinical Microbiology, Trinity College Dublin. PMID:26669893

Preliminary evaluation of a high-resolution workstation for diagnostic interpretation of portable radiographs

NASA Astrophysics Data System (ADS)

Honeyman-Buck, Janice C.; Huda, Walter; Palmer, Carole K.; Frost, Meryll M.; Moser, Robert; Staab, Edward V.

1995-04-01

A cost effectiveness study on the feasibility of using computed radiography (CR) instead of screen-film methods for portable radiographs indicates that we could only justify CR if film were eliminated. Before purchasing CR equipment, we needed to evaluate the use of softcopy to replace film for routine clinical use. The evaluation had to cover image quality, human factors, and efficiency measures. Screen-film radiographs were digitized and used to simulate CR in two studies. The first study evaluated the quality of digitized images and the workstation user interface. Twenty-one radiographs were selected at random from scopes in the radiology department, were digitized, and transferred to a megascan workstation. Five radiologists were asked to assess the quality of the images and the ease of operation of the workstation while an observer recorded their comments and scores. The second study evaluated the feasibility of using the workstation in a clinical environment. Four radiologists read adult and pediatric portable images in film and softcopy format. Reports were evaluated for differences and timing statistics were kept. The results of the first study indicate that image quality may be acceptable for diagnostic purposes and suggests some changes in the user interface. Newborn infant images were the least acceptable in softcopy, largely due to magnification artifacts introduced when viewing very small images. The evaluation was based on a digitizer as a simulator for a CR unit and the digitizer did not exhibit the same resolution characteristics as CR. Films that were unacceptable from the digitizer are expected to be acceptable with CR. The results of the second study indicated that the high resolution diagnostic workstation could be used in a clinical setting, and that the diagnostic readings were not significantly different between film and softcopy displays. The results also indicated that, depending on the radiologist and the type of images, more time was required to read from the workstation and that the increased time was spent using window/level and magnification/roam functions. This preliminary study suggests that the high resolution workstation developed at the University of Florida has adequate quality and functionality to be used for diagnostic interpretation of portable radiographs if given high resolution images. However, further investigation is indicated before we eliminate film in a CR environment.

Diagnosis: Reasoning from first principles and experiential knowledge

NASA Technical Reports Server (NTRS)

Williams, Linda J. F.; Lawler, Dennis G.

1987-01-01

Completeness, efficiency and autonomy are requirements for suture diagnostic reasoning systems. Methods for automating diagnostic reasoning systems include diagnosis from first principles (i.e., reasoning from a thorough description of structure and behavior) and diagnosis from experiential knowledge (i.e., reasoning from a set of examples obtained from experts). However, implementation of either as a single reasoning method fails to meet these requirements. The approach of combining reasoning from first principles and reasoning from experiential knowledge does address the requirements discussed above and can possibly ease some of the difficulties associated with knowledge acquisition by allowing developers to systematically enumerate a portion of the knowledge necessary to build the diagnosis program. The ability to enumerate knowledge systematically facilitates defining the program's scope, completeness, and competence and assists in bounding, controlling, and guiding the knowledge acquisition process.

Mimics and chameleons in motor neurone disease

PubMed Central

Turner, Martin R; Talbot, Kevin

2013-01-01

The progression of motor neurone disease (MND) is currently irreversible, and the grave implications of diagnosis naturally fuels concern among neurologists over missing a potential mimic disorder. There is no diagnostic test for MND but in reality there are few plausible mimics in routine clinical practice. In the presence of a progressive pure motor disorder, signs such as florid fasciculations, bilateral tongue wasting, the ‘split hand’, head drop, emotionality, and cognitive or behavioural impairment carry high positive predictive value. MND is clinically heterogeneous, however, with some important chameleon-like presentations and considerable variation in clinical course. Lack of confidence about the scope of such variation, or an approach to diagnosis emphasising investigations over clinical common sense, has the potential to exacerbate diagnostic delay in MND and impede timely planning of the care which is essential to maximising quality of life. PMID:23616620

A scoping review on the conduct and reporting of scoping reviews.

PubMed

Tricco, Andrea C; Lillie, Erin; Zarin, Wasifa; O'Brien, Kelly; Colquhoun, Heather; Kastner, Monika; Levac, Danielle; Ng, Carmen; Sharpe, Jane Pearson; Wilson, Katherine; Kenny, Meghan; Warren, Rachel; Wilson, Charlotte; Stelfox, Henry T; Straus, Sharon E

2016-02-09

Scoping reviews are used to identify knowledge gaps, set research agendas, and identify implications for decision-making. The conduct and reporting of scoping reviews is inconsistent in the literature. We conducted a scoping review to identify: papers that utilized and/or described scoping review methods; guidelines for reporting scoping reviews; and studies that assessed the quality of reporting of scoping reviews. We searched nine electronic databases for published and unpublished literature scoping review papers, scoping review methodology, and reporting guidance for scoping reviews. Two independent reviewers screened citations for inclusion. Data abstraction was performed by one reviewer and verified by a second reviewer. Quantitative (e.g. frequencies of methods) and qualitative (i.e. content analysis of the methods) syntheses were conducted. After searching 1525 citations and 874 full-text papers, 516 articles were included, of which 494 were scoping reviews. The 494 scoping reviews were disseminated between 1999 and 2014, with 45% published after 2012. Most of the scoping reviews were conducted in North America (53%) or Europe (38%), and reported a public source of funding (64%). The number of studies included in the scoping reviews ranged from 1 to 2600 (mean of 118). Using the Joanna Briggs Institute methodology guidance for scoping reviews, only 13% of the scoping reviews reported the use of a protocol, 36% used two reviewers for selecting citations for inclusion, 29% used two reviewers for full-text screening, 30% used two reviewers for data charting, and 43% used a pre-defined charting form. In most cases, the results of the scoping review were used to identify evidence gaps (85%), provide recommendations for future research (84%), or identify strengths and limitations (69%). We did not identify any guidelines for reporting scoping reviews or studies that assessed the quality of scoping review reporting. The number of scoping reviews conducted per year has steadily increased since 2012. Scoping reviews are used to inform research agendas and identify implications for policy or practice. As such, improvements in reporting and conduct are imperative. Further research on scoping review methodology is warranted, and in particular, there is need for a guideline to standardize reporting.

Combined expert system/neural networks method for process fault diagnosis

DOEpatents

Reifman, Jaques; Wei, Thomas Y. C.

1995-01-01

A two-level hierarchical approach for process fault diagnosis is an operating system employs a function-oriented approach at a first level and a component characteristic-oriented approach at a second level, where the decision-making procedure is structured in order of decreasing intelligence with increasing precision. At the first level, the diagnostic method is general and has knowledge of the overall process including a wide variety of plant transients and the functional behavior of the process components. An expert system classifies malfunctions by function to narrow the diagnostic focus to a particular set of possible faulty components that could be responsible for the detected functional misbehavior of the operating system. At the second level, the diagnostic method limits its scope to component malfunctions, using more detailed knowledge of component characteristics. Trained artificial neural networks are used to further narrow the diagnosis and to uniquely identify the faulty component by classifying the abnormal condition data as a failure of one of the hypothesized components through component characteristics. Once an anomaly is detected, the hierarchical structure is used to successively narrow the diagnostic focus from a function misbehavior, i.e., a function oriented approach, until the fault can be determined, i.e., a component characteristic-oriented approach.

Combined expert system/neural networks method for process fault diagnosis

DOEpatents

Reifman, J.; Wei, T.Y.C.

1995-08-15

A two-level hierarchical approach for process fault diagnosis of an operating system employs a function-oriented approach at a first level and a component characteristic-oriented approach at a second level, where the decision-making procedure is structured in order of decreasing intelligence with increasing precision. At the first level, the diagnostic method is general and has knowledge of the overall process including a wide variety of plant transients and the functional behavior of the process components. An expert system classifies malfunctions by function to narrow the diagnostic focus to a particular set of possible faulty components that could be responsible for the detected functional misbehavior of the operating system. At the second level, the diagnostic method limits its scope to component malfunctions, using more detailed knowledge of component characteristics. Trained artificial neural networks are used to further narrow the diagnosis and to uniquely identify the faulty component by classifying the abnormal condition data as a failure of one of the hypothesized components through component characteristics. Once an anomaly is detected, the hierarchical structure is used to successively narrow the diagnostic focus from a function misbehavior, i.e., a function oriented approach, until the fault can be determined, i.e., a component characteristic-oriented approach. 9 figs.

A Look from the Inside

NASA Technical Reports Server (NTRS)

2004-01-01

NASA's Hubble Space Telescope has given the world amazing images of the distant stars, planets, and galaxies. The cutting-edge imaging technology that enhances the Hubble images also extends its benefits to life here on Earth, from deciphering previously unreadable portions of the Dead Sea Scrolls to improving digital mammographies for advanced cancer detection. This imaging technology is now helping physicians to perform micro-invasive arthroscopic surgery, which is the visual examination of an interior joint such as the knee. In 1997, NASA's Glenn Research Center signed a Space Act Agreement with Micro Medical Devices, Inc. (MMD), a medical device engineering company that licenses miniature surgical devices. At that time, MMD was in the process of developing a new micro-endoscope. This tool enables surgeons to view what is happening inside the body on a screen, eliminating the need for a more invasive diagnostic procedure. The images from the micro-endoscope needed to be extremely clear, a challenge with the tool s small size. The images also needed to be viewed in real time to allow surgeons to see what was happening in the body at that very moment. MMD established Clear Image Technology, LLC, of Elyria, Ohio, to commercialize the miniature endoscope. Clear Image Technology then partnered with Arthrotek, Inc., a sports medicine subsidiary of Biomet, Inc., to introduce the tool to the commercial market as the InnerVue[TM] Diagnostic Scope System. The InnerVue system is designed for use in a diagnostic environment, such as an office or outpatient service, to evaluate conditions within a joint. While the InnerVue scope is primarily being applied to the knee and shoulder, other small joints such as the wrist, elbow, and ankle are being investigated. A physician can use the system alone or in conjunction with magnetic resonance imaging (MRI) to determine the next treatment step for each patient. The procedure can be more accurate than MRI, particularly with diagnosing cartilage and articular surface damage and assessing arthritis severity.

At-risk studies and clinical antecedents of psychosis, bipolar disorder and depression: a scoping review in the context of clinical staging.

PubMed

Hartmann, Jessica A; Nelson, Barnaby; Ratheesh, Aswin; Treen, Devi; McGorry, Patrick D

2018-06-04

Identifying young people at risk of developing serious mental illness and identifying predictors of onset of illness has been a focus of psychiatric prediction research, particularly in the field of psychosis. Work in this area has facilitated the adoption of the clinical staging model of early clinical phenotypes, ranging from at-risk mental states to chronic and severe mental illness. It has been a topic of debate if these staging models should be conceptualised as disorder-specific or transdiagnostic. In order to inform this debate and facilitate cross-diagnostic discourse, the present scoping review provides a broad overview of the body of literature of (a) longitudinal at-risk approaches and (b) identified antecedents of (homotypic) illness progression across three major mental disorders [psychosis, bipolar disorder (BD) and depression], and places these in the context of clinical staging. Stage 0 at-risk conceptualisations (i.e. familial high-risk approaches) were identified in all three disorders. However, formalised stage 1b conceptualisations (i.e. ultra-high-risk approaches) were only present in psychosis and marginally in BD. The presence of non-specific and overlapping antecedents in the three disorders may support a general staging model, at least in the early stages of severe psychotic or mood disorders.

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

The chiropractic scope of practice in the United States: a cross-sectional survey.

PubMed

Chang, Mabel

2014-01-01

The purpose of this study was to assess the current status of chiropractic practice laws in the United States. This survey is an update and expansion of 3 original surveys conducted in 1987, 1992, and 1998. A cross-sectional survey of licensure officials from the Federation of Chiropractic Licensing Boards e-mail list was conducted in 2011 requesting information about chiropractic practice laws and 97 diagnostic, evaluation, and management procedures. To evaluate content validity, the survey was distributed in draft form at the fall 2010 Federation of Chiropractic Licensing Boards regional meeting to regulatory board members and feedback was requested. Comments were reviewed and incorporated into the final survey. A duplicate question was imbedded in the survey to test reliability. Partial or complete responses were received from 96% (n = 51) of the jurisdictions in the United States. The states with the highest number of services that could be performed were Missouri (n = 92), New Mexico (n = 91), Kansas (n = 89), Utah (n = 89), Oklahoma (n = 88), Illinois (n = 87), and Alabama (n = 86). The states with the highest number of services that cannot be performed are New Hampshire (n = 49), Hawaii (n = 47), Michigan (n = 42), New Jersey (n = 39), Mississippi (n = 39), and Texas (n = 30). The scope of chiropractic practice in the United States has a high degree of variability. Scope of practice is dynamic, and gray areas are subject to interpretation by ever-changing board members. Although statutes may not address specific procedures, upon challenge, there may be a possibility of sanctions depending on interpretation. Copyright © 2014 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

iPathology cockpit diagnostic station: validation according to College of American Pathologists Pathology and Laboratory Quality Center recommendation at the Hospital Trust and University of Verona.

PubMed

Brunelli, Matteo; Beccari, Serena; Colombari, Romano; Gobbo, Stefano; Giobelli, Luca; Pellegrini, Andrea; Chilosi, Marco; Lunardi, Maria; Martignoni, Guido; Scarpa, Aldo; Eccher, Albino

2014-01-01

Validation of digital whole slide images is crucial to ensure that diagnostic performance is at least equivalent to that of glass slides and light microscopy. The College of American Pathologists Pathology and Laboratory Quality Center recently developed recommendations for internal digital pathology system validation. Following these guidelines we sought to validate the performance of a digital approach for routine diagnosis by using an iPad and digital control widescreen-assisted workstation through a pilot study. From January 2014, 61 histopathological slides were scanned by ScanScope Digital Slides Scanner (Aperio, Vista, CA). Two independent pathologists performed diagnosis on virtual slides in front of a widescreen by using two computer devices (ImageScope viewing software) located to different Health Institutions (AOUI Verona) connected by local network and a remote image server using an iPad tablet (Aperio, Vista, CA), after uploading the Citrix receiver for iPad. Quality indicators related to image characters and work-flow of the e-health cockpit enterprise system were scored based on subjective (high vs poor) perception. The images were re-evaluated two weeks apart. The whole glass slides encountered 10 liver: hepatocarcinoma, 10 renal carcinoma, 10 gastric carcinoma and 10 prostate biopsies: adenocarcinoma, 5 excisional skin biopsies: melanoma, 5 lymph-nodes: lymphoma. 6 immuno- and 5 special stains were available for intra- and internet remote viewing. Scan times averaged two minutes and 54 seconds per slide (standard deviation 2 minutes 34 seconds). Megabytes ranged from 256 to 680 (mean 390) per slide storage. Reliance on glass slide, image quality (resolution and color fidelity), slide navigation time, simultaneous viewers in geographically remote locations were considered of high performance score. Side by side comparisons between diagnosis performed on tissue glass slides versus widescreen were excellent showing an almost perfect concordance (0.81, kappa index). We validated our institutional digital pathology system for routine diagnostic facing with whole slide images in a cockpit enterprise digital system or iPad tablet. Computer widescreens are better for diagnosing scanned glass slide that iPad. For urgent requests, iPad may be used. Legal aspects have to be soon faced with to permit the clinical use of this technology in a manner that does not compromise patient care.

DSM-5 and posttraumatic stress disorder.

PubMed

Levin, Andrew P; Kleinman, Stuart B; Adler, John S

2014-01-01

The latest iteration of the posttraumatic stress disorder (PTSD) criteria presented in The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) includes specific elaborations of the gatekeeper criteria, a new category of stressor, an expansion in the number of symptoms, addition of a new subtype of PTSD, and an enlarged text discussion that breaks new ground in defining the criteria. We first trace the rationale underlying these changes and their impact on the prevalence of PTSD diagnoses in clinical studies and then present potential implications of the new criteria for forensic assessment methodology and the detection of malingering, interpretations of criminal responsibility and mitigation, evaluation of the reliability of witnesses, the scope of claims in civil and employment cases, and eligibility for disability. © 2014 American Academy of Psychiatry and the Law.

Prognosis research: why is Dr. Lydgate still waiting?

PubMed

Hemingway, Harry

2006-12-01

Understanding prognosis--the future risk of adverse outcomes among people with existing disease--plays third fiddle behind clinical research into therapeutic interventions and novel diagnostic technologies. Diseases show marked variations in a wide range of prognostic outcomes, yet these variations have seldom been the subject of systematic and sustained epidemiologic and multidisciplinary research. This is important to prioritize hypotheses for testing in intervention studies in groups, and to refine tools for prognostication in individuals. Methodologic standards for the design, conduct, analysis and reporting of prognosis research are required. Training is needed for the clinicians, policymakers, and payers who use prognostic information. Here, arguments detracting from the potential scope of prognosis research are rebutted and misconceptions addressed with the aim of stimulating debate on the evolving role of prognosis research.

Quantitative high-resolution genomic analysis of single cancer cells.

PubMed

Hannemann, Juliane; Meyer-Staeckling, Sönke; Kemming, Dirk; Alpers, Iris; Joosse, Simon A; Pospisil, Heike; Kurtz, Stefan; Görndt, Jennifer; Püschel, Klaus; Riethdorf, Sabine; Pantel, Klaus; Brandt, Burkhard

2011-01-01

During cancer progression, specific genomic aberrations arise that can determine the scope of the disease and can be used as predictive or prognostic markers. The detection of specific gene amplifications or deletions in single blood-borne or disseminated tumour cells that may give rise to the development of metastases is of great clinical interest but technically challenging. In this study, we present a method for quantitative high-resolution genomic analysis of single cells. Cells were isolated under permanent microscopic control followed by high-fidelity whole genome amplification and subsequent analyses by fine tiling array-CGH and qPCR. The assay was applied to single breast cancer cells to analyze the chromosomal region centred by the therapeutical relevant EGFR gene. This method allows precise quantitative analysis of copy number variations in single cell diagnostics.

Ultrasound Metrology in Mexico: a round robin test for medical diagnostics

NASA Astrophysics Data System (ADS)

Amezola Luna, R.; López Sánchez, A. L.; Elías Juárez, A. A.

2011-02-01

This paper presents preliminary statistical results from an on-going imaging medical ultrasound study, of particular relevance for gynecology and obstetrics areas. Its scope is twofold, firstly to compile the medical ultrasound infrastructure available in cities of Queretaro-Mexico, and second to promote the use of traceable measurement standards as a key aspect to assure quality of ultrasound examinations performed by medical specialists. The experimental methodology is based on a round robin test using an ultrasound phantom for medical imaging. The physician, using its own ultrasound machine, couplant and facilities, measures the size and depth of a set of pre-defined reflecting and absorbing targets of the reference phantom, which simulate human illnesses. Measurements performed give the medical specialist an objective feedback regarding some performance characteristics of their ultrasound examination systems, such as measurement system accuracy, dead zone, axial resolution, depth of penetration and anechoic targets detection. By the end of March 2010, 66 entities with medical ultrasound facilities, from both public and private institutions, have performed measurements. A network of medical ultrasound calibration laboratories in Mexico, with traceability to The International System of Units via national measurement standards, may indeed contribute to reduce measurement deviations and thus attain better diagnostics.

Formation of Imploding Plasma Liners for HEDP and MIF Applications - Diagnostics

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

Gilmore, Mark; Hsu, Scott; Witherspoon, F. Douglas

The goal of the plasma liner experiment (PLX) was to explore and demonstrate the feasibility of forming imploding spherical plasma liners that can reach High Energy Density (HED)-relevant (~ 0.1 Mbar) pressures upon stagnation. The plasma liners were to be formed by a spherical array of 30 – 36 railgun-driven hypervelocity plasma jets (Mach 10 – 50). Due to funding and project scope reductions in year two of the project, this initial goal was revised to focus on studies of individual jet propagation, and on two jet merging physics. PLX was a collaboration between a number of partners including Losmore » Alamos National Laboratory, HyperV Technologies, University of New Mexico (UNM), University of Alabama, Huntsville, and University of Nevada, Reno. UNM’s part in the collaboration was primary responsibility for plasma diagnostics. Though full plasma liner experiments could not be performed, the results of single and two jet experiments nevertheless laid important groundwork for future plasma liner investigations. Though challenges were encountered, the results obtained with one and two jets were overwhelmingly positive from a liner formation point of view, and were largely in agreement with predictions of hydrodynamic models.« less

Direct to Consumer Mobile Teledermatology Apps: An Exploratory Study.

PubMed

Kochmann, Matthias; Locatis, Craig

2016-08-01

Since 2012, "Direct to Consumer" mobile teledermatology apps have become more available, relinquishing many data collection tasks normally done by healthcare professionals directly to patients. To determine user friendliness, diagnostic quality, and service of commercially available mobile teledermatology apps. All mobile teledermatology apps available at the Apple App Store were reviewed. The two most popular mobile teledermatology apps were identified and tested together with three apps having similar functionality using a single case of a patient who was also examined by a dermatologist in-person. Apps varied in diagnostic scope, data gathering methods, services, rendered results, and in geographic coverage and cost. None of the apps take a history as thoroughly as recommended by textbooks. Key medical questions like current medications and allergies are not asked often. Most apps rendered concordant results, except for the one having the least thorough history taking. Mobile teledermatology application interfaces, services, and cost vary, with some risking medical errors and possible distribution of continuity of care. The American Telemedicine Association's guidelines for teledermatology need to address the use of direct to consumer apps. To protect consumers, app regulation, certification, or guidelines suggesting appropriate development and use might be considered.

Possibilities and limits of imaging endodontic structures with CBCT.

PubMed

Weber, Marie-Theres; Stratz, Nadja; Fleiner, Jonathan; Schulze, Dirk; Hannig, Christian

2015-01-01

An adequate portrayal of the root canal anatomy by diagnostic imaging is a prerequisite for a successful diagnosis and therapy in endodontics. The introduction of dental cone beam computed tomography (CBCT) has considerably expanded the scope of imaging diagnostics. The aim of the following study was to evaluate the imaging of endodontic structures with CBCT. One hundred and twenty teeth were examined with a CBCT device (ProMax 3D). Subsequently, the findings of the three-dimensional images were evaluated and compared to those of dental radiographs and tangential section preparations of the examined teeth. Results with high prevalence, such as existing roots and root canals, as well as results with low prevalence, e.g., extremely fine anatomical structures of the endodontic tissue, could be visualized precisely by dental CBCT; side canals, ramifications, communications, pulp stones, and obliterations could also be detected. Additionally, the length of curved root canals could be determined accurately. Likewise, root fractures were visualized reliably with CBCT. However, carious lesions could not be diagnosed adequately, and the evaluation of fillings and prosthetic restorations was complicated due to scattered X-ray artifacts. CBCT datasets qualify to visualize and diagnose small anatomical structures of the endodontic tissue.

Transnasal endoscopy: no gagging no panic!

PubMed Central

Parker, Clare; Alexandridis, Estratios; Plevris, John; O'Hara, James; Panter, Simon

2016-01-01

Background Transnasal endoscopy (TNE) is performed with an ultrathin scope via the nasal passages and is increasingly used. This review covers the technical characteristics, tolerability, safety and acceptability of TNE and also diagnostic accuracy, use as a screening tool and therapeutic applications. It includes practical advice from an ear, nose, throat (ENT) specialist to optimise TNE practice, identify ENT pathology and manage complications. Methods A Medline search was performed using the terms “transnasal”, “ultrathin”, “small calibre”, “endoscopy”, “EGD” to identify relevant literature. Results There is increasing evidence that TNE is better tolerated than standard endoscopy as measured using visual analogue scales, and the main area of discomfort is nasal during insertion of the TN endoscope, which seems remediable with adequate topical anaesthesia. The diagnostic yield has been found to be similar for detection of Barrett's oesophagus, gastric cancer and GORD-associated diseases. There are some potential issues regarding the accuracy of TNE in detecting small early gastric malignant lesions, especially those in the proximal stomach. TNE is feasible and safe in a primary care population and is ideal for screening for upper gastrointestinal pathology. It has an advantage as a diagnostic tool in the elderly and those with multiple comorbidities due to fewer adverse effects on the cardiovascular system. It has significant advantages for therapeutic procedures, especially negotiating upper oesophageal strictures and insertion of nasoenteric feeding tubes. Conclusions TNE is well tolerated and a valuable diagnostic tool. Further evidence is required to establish its accuracy for the diagnosis of early and small gastric malignancies. There is an emerging role for TNE in therapeutic endoscopy, which needs further study. PMID:28839865

A very sensitive ion collection device for plasma-laser characterization.

PubMed

Cavallaro, S; Torrisi, L; Cutroneo, M; Amato, A; Sarta, F; Wen, L

2012-06-01

In this paper a very sensitive ion collection device, for diagnostic of laser ablated-target plasma, is described. It allows for reducing down to few microvolts the signal threshold at digital scope input. A standard ion collector is coupled to a transimpedance amplifier, specially designed, which increases data acquisition sensitivity by a gain ≈1100 and does not introduce any significant distortion of input signal. By time integration of current intensity, an amount of charge as small as 2.7 × 10(-2) pC can be detected for photopeak events.

Examining Young Students' Problem Scoping in Engineering Design

ERIC Educational Resources Information Center

Watkins, Jessica; Spencer, Kathleen; Hammer, David

2014-01-01

Problem scoping--determining the nature and boundaries of a problem--is an essential aspect of the engineering design process. Some studies from engineering education suggest that beginning students tend to skip problem scoping or oversimplify a problem. However, the ways these studies often characterize students' problem scoping often do not…

The Advantages of High/Scope: Helping Children Lead Successful Lives.

ERIC Educational Resources Information Center

Schweinhart, Lawrence J.; Weikart, David P.

1999-01-01

The High/Scope educational approach emphasizes child-initiated learning activities for preschool/elementary school children. A research study shows that compared to children receiving direct instruction, High/Scope kids later showed more prosocial and less antisocial behaviors. Another study showed that poor High/Scope students had better…

What are scoping studies? A review of the nursing literature.

PubMed

Davis, Kathy; Drey, Nick; Gould, Dinah

2009-10-01

Scoping studies are increasingly undertaken as distinct activities. The interpretation, methodology and expectations of scoping are highly variable. This suggests that conceptually, scoping is a poorly defined ambiguous term. The distinction between scoping as an integral preliminary process in the development of a research proposal or a formative, methodologically rigorous activity in its own right has not been extensively examined. The aim of this review is to explore the nature and status of scoping studies within the nursing literature and develop a working definition to ensure consistency in the future use of scoping as a research related activity. This paper follows an interpretative scoping review methodology. An explicit systematic search strategy included literary and web-based key word searches and advice from key researchers. Electronic sources included bibliographic and national research register databases and a general browser. The scoping studies varied widely in terms of intent, procedural and methodological rigor. An atheoretical stance was common although explicit conceptual clarification and development of a topic was limited. Four different levels of inquiry ranging from preliminary descriptive surveys to more substantive conceptual approaches were conceptualised. These levels reflected differing dimensional distinctions in which some activities constitute research whereas in others the scoping activities appear to fall outside the remit of research. Reconnaissance emerges as a common synthesising construct to explain the purpose of scoping. Scoping studies in relation to nursing are embryonic and continue to evolve. Its main strengths lie in its ability to extract the essence of a diverse body of evidence giving it meaning and significance that is both developmental and intellectually creative. As with other approaches to research and evidence synthesis a more standardized approach is required.

A scoping review of scoping reviews: advancing the approach and enhancing the consistency.

PubMed

Pham, Mai T; Rajić, Andrijana; Greig, Judy D; Sargeant, Jan M; Papadopoulos, Andrew; McEwen, Scott A

2014-12-01

The scoping review has become an increasingly popular approach for synthesizing research evidence. It is a relatively new approach for which a universal study definition or definitive procedure has not been established. The purpose of this scoping review was to provide an overview of scoping reviews in the literature. A scoping review was conducted using the Arksey and O'Malley framework. A search was conducted in four bibliographic databases and the gray literature to identify scoping review studies. Review selection and characterization were performed by two independent reviewers using pretested forms. The search identified 344 scoping reviews published from 1999 to October 2012. The reviews varied in terms of purpose, methodology, and detail of reporting. Nearly three-quarter of reviews (74.1%) addressed a health topic. Study completion times varied from 2 weeks to 20 months, and 51% utilized a published methodological framework. Quality assessment of included studies was infrequently performed (22.38%). Scoping reviews are a relatively new but increasingly common approach for mapping broad topics. Because of variability in their conduct, there is a need for their methodological standardization to ensure the utility and strength of evidence. © 2014 The Authors. Research Synthesis Methods published by John Wiley & Sons, Ltd.

[Psychic aspects of the premenstrual dysphoric disorders. New therapeutic strategies: our experience with Vitex agnus castus].

PubMed

Ciotta, L; Pagano, I; Stracquadanio, M; Di Leo, S; Andò, A; Formuso, C

2011-06-01

The premenstrual dysphoric disorder (PMDD) is one of the main problems of the premenstrual phase. It consists of symptoms that sometimes invalidate the scope of employment, social and psycho-affective of patients, requiring thus a diagnostic and therapeutic approach as detailed and accurate as possible. The therapeutic strategies available for this disease are many, but recently the emphasis has been on Vitex agnus castus (VAC), considered by many as evidence drug of choice for both PMS and for the PMDD, being with satisfactory therapeutic properties and small side effects. Our study evaluated a group of patients suffering from PMDD and the clinical efficacy of treatment with VAC (and compared the effectiveness of the results of a more homogeneous group of patients treated with fluoxetine). This study confirms the data reported in the literature regarding the effectiveness of VAC therapy with no side effects.

Prevalence and correlates of posttrauma distorted beliefs: evaluating DSM-5 PTSD expanded cognitive symptoms in a national sample.

PubMed

Cox, Keith S; Resnick, Heidi S; Kilpatrick, Dean G

2014-06-01

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association [APA], 2013) modified the diagnostic criteria for posttraumatic stress disorder (PTSD), including expanding the scope of dysfunctional, posttrauma changes in belief (symptoms D2-persistent negative beliefs and expectations about oneself or the world, and D3-persistent distorted blame of self or others for the cause or consequences of the traumatic event). D2 and D3 were investigated using a national sample of U.S. adults (N = 2,498) recruited from an online panel. The prevalence of D2 and D3 was substantially higher among those with lifetime PTSD than among trauma-exposed individuals without lifetime PTSD (D2: 74.6% vs 23.9%; D3: 80.6% vs 35.7%). In multivariate analyses, the strongest associates of D2 were interpersonal assault (OR = 2.39), witnessing interpersonal assault (OR = 1.63), gender (female, OR = 2.11), and number of reported traumatic events (OR = 1.88). The strongest correlates of D3 were interpersonal assault (OR = 3.08), witnessing interpersonal assault (OR = 1.57), gender (female, OR = 2.30), and number of reported traumatic events (OR = 1.91). The findings suggested the expanded cognitive symptoms in the DSM-5 diagnostic criteria better capture the cognitive complexity of PTSD than those of the DSM-IV. Copyright © 2014 International Society for Traumatic Stress Studies.

Cholera diagnosis in human stool and detection in water: protocol for a systematic review of available technologies.

PubMed

Diaconu, Karin; Falconer, Jennifer; O'May, Fiona; Jimenez, Miguel; Matragrano, Joe; Njanpop-Lafourcade, Betty; Ager, Alastair

2018-02-20

Cholera is a highly infectious diarrheal disease spread via fecal contamination of water and food sources; it is endemic in parts of Africa and Asia and recent outbreaks have been reported in Haiti, the Zambia and Democratic Republic of the Congo. If left untreated, the disease can be fatal in less than 24 h and result in case fatality ratios of 30-50%. Cholera disproportionately affects those living in areas with poor access to water and sanitation: the long-term public health response is focused on improving water and hygiene facilities and access. Short-term measures for infection prevention and control, and disease characterization and surveillance, are impaired by diagnostic delays: culture methods are slow and rely on the availability of infrastructure and specialist equipment. Rapid diagnostic tests have shown promise under field conditions and further innovations in this area have been proposed. This paper is the protocol for a systematic review focused on identifying current technologies and methods used for cholera diagnosis in stool, and detection in water. We will synthesize and appraise information on product technical specifications, accuracy and design features in order to inform infection prevention and control and innovation development. Embase, MEDLINE, CINAHL, Proquest, IndMed and the WHO and Campbell libraries will be searched. We will include studies reporting on field evaluations, including within-study comparisons against a reference standard, and laboratory evaluations reporting on product validation against field stool or water samples. We will extract data according to protocol and attempt meta-analyses if appropriate given data availability and quality. The systematic review builds on a previous scoping review in this field and expands upon this by synthesising data on both product technical characteristics and design features. The review will be of particular value to stakeholders engaged in diagnostic procurement and manufacturers interested in developing cholera or diarrheal disease diagnostics. PROSPERO CRD42016048428 .

A scoping review of scoping reviews: advancing the approach and enhancing the consistency

PubMed Central

Pham, Mai T; Rajić, Andrijana; Greig, Judy D; Sargeant, Jan M; Papadopoulos, Andrew; McEwen, Scott A

2014-01-01

Background The scoping review has become an increasingly popular approach for synthesizing research evidence. It is a relatively new approach for which a universal study definition or definitive procedure has not been established. The purpose of this scoping review was to provide an overview of scoping reviews in the literature. Methods A scoping review was conducted using the Arksey and O'Malley framework. A search was conducted in four bibliographic databases and the gray literature to identify scoping review studies. Review selection and characterization were performed by two independent reviewers using pretested forms. Results The search identified 344 scoping reviews published from 1999 to October 2012. The reviews varied in terms of purpose, methodology, and detail of reporting. Nearly three-quarter of reviews (74.1%) addressed a health topic. Study completion times varied from 2 weeks to 20 months, and 51% utilized a published methodological framework. Quality assessment of included studies was infrequently performed (22.38%). Conclusions Scoping reviews are a relatively new but increasingly common approach for mapping broad topics. Because of variability in their conduct, there is a need for their methodological standardization to ensure the utility and strength of evidence. © 2014 The Authors. Research Synthesis Methods published by John Wiley & Sons, Ltd. PMID:26052958

Harnessing Whole Genome Sequencing in Medical Mycology.

PubMed

Cuomo, Christina A

2017-01-01

Comparative genome sequencing studies of human fungal pathogens enable identification of genes and variants associated with virulence and drug resistance. This review describes current approaches, resources, and advances in applying whole genome sequencing to study clinically important fungal pathogens. Genomes for some important fungal pathogens were only recently assembled, revealing gene family expansions in many species and extreme gene loss in one obligate species. The scale and scope of species sequenced is rapidly expanding, leveraging technological advances to assemble and annotate genomes with higher precision. By using iteratively improved reference assemblies or those generated de novo for new species, recent studies have compared the sequence of isolates representing populations or clinical cohorts. Whole genome approaches provide the resolution necessary for comparison of closely related isolates, for example, in the analysis of outbreaks or sampled across time within a single host. Genomic analysis of fungal pathogens has enabled both basic research and diagnostic studies. The increased scale of sequencing can be applied across populations, and new metagenomic methods allow direct analysis of complex samples.

Attitudes toward expanding nurses' authority.

PubMed

Kerzman, Hana; Van Dijk, Dina; Eizenberg, Limor; Khaikin, Rut; Phridman, Shoshi; Siman-Tov, Maya; Goldberg, Shoshi

2015-01-01

In recent years, an increasing number of care procedures previously under the physician's authority have been placed in the hands of registered nurses. The purpose of this study was to examine the attitudes of nurses towards expanding nurses' authority and the relationships between these attitudes and job satisfaction facets, professional characteristics, and demographics. A cross-sectional study was conducted between 2010 and 2011 in three major medical centers in Israel. Participants included 833 nurses working in 89 departments. Attitudes toward the expansion of nurses' authority were assessed by self-report questionnaire, as well as job satisfaction facets including perception of professional autonomy, nurse-physician working relations, workload and burnout, perceptions of quality of care, and nursing staff satisfaction at work. Nurses reported positive attitudes toward the expansion of nurses' authority and moderate attitudes for interpretation of diagnostic tests in selected situations. The results of multivariate regression analyses demonstrate that the nurses' satisfaction from professional autonomy and work relations were the most influential factors in explaining their attitudes toward the expansion of nurses' authority. In addition, professionally young nurses tend to be more positive regarding changes in nurses' authority. In the Israeli reality of a nurse's shortage, we are witnessing professional transitions toward expansion of the scope of nurses' accountability and decision-making authority. The current research contributes to our understanding of attitudes toward the expansion of nurses' authority among the nursing staffs. The findings indicate the necessity of redefining the scope of nursing practice within the current professional context.

Consolidated Laser-Induced Fluorescence Diagnostic Systems for the NASA Ames Arc Jet Facilities

NASA Technical Reports Server (NTRS)

Grinstead, Jay H.; Wilder, Michael C.; Porter, Barry J.; Brown, Jeffrey D.; Yeung, Dickson; Battazzo, Stephen J.; Brubaker, Timothy R.

2016-01-01

The spectroscopic diagnostic technique of two photon absorption laser-induced fluorescence (TALIF) of atomic species for non-intrusive arc jet flow property measurement was first implemented at NASA Ames in the mid-1990s. Use of TALIF expanded at NASA Ames and to NASA Johnson's arc jet facility in the late 2000s. In 2013-2014, NASA combined the agency's large-scale arc jet test capabilities at NASA Ames. Concurrent with that effort, the agency also sponsored a project to establish two comprehensive LIF diagnostic systems for the Aerodynamic Heating Facility (AHF) and Interaction Heating Facility (IHF) arc jets. The scope of the project enabled further engineering development of the existing IHF LIF system as well as the complete reconstruction of the original AHF LIF system. The updated LIF systems are identical in design and capability. They represent the culmination of over 20 years of development experience in transitioning a specialized laboratory research tool into a measurement system for large-scale, high-demand test facilities. This paper documents the overall system design from measurement requirements to implementation. Representative data from the redeveloped AHF and IHF LIF systems are also presented.

[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.

Consolidated Laser-Induced Fluorescence Diagnostic Systems for the NASA Ames Arc Jet Facilities

NASA Technical Reports Server (NTRS)

Grinstead, Jay; Wilder, Michael C.; Porter, Barry; Brown, Jeff; Yeung, Dickson; Battazzo, Steve; Brubaker, Tim

2016-01-01

The spectroscopic diagnostic technique of two photon absorption laser-induced fluorescence (TALIF) of atomic species for non-intrusive arc jet flow property measurement was first implemented at NASA Ames in the mid-1990s. Use of TALIF expanded at NASA Ames and to NASA Johnsons arc jet facility in the late 2000s. In 2013-2014, NASA combined the agency's large-scale arc jet test capabilities at NASA Ames. Concurrent with that effort, the agency also sponsored a project to establish two comprehensive LIF diagnostic systems for the Aerodynamic Heating Facility (AHF) and Interaction Heating Facility (IHF) arc jets. The scope of the project enabled further engineering development of the existing IHF LIF system as well as the complete reconstruction of the original AHF LIF system. The updated LIF systems are identical in design and capability. They represent the culmination of over 20 years of development experience in transitioning a specialized laboratory research tool into a measurement system for large-scale, high-demand test facilities. This paper documents the overall system design from measurement requirements to implementation. Representative data from the redeveloped AHF and IHF LIF systems are also presented.

A Scoping Review of Scoping Reviews: Advancing the Approach and Enhancing the Consistency

ERIC Educational Resources Information Center

Pham, Mai T.; Rajic, Andrijana; Greig, Judy D.; Sargeant, Jan M.; Papadopoulos, Andrew; McEwen, Scott A.

2014-01-01

Background: The scoping review has become an increasingly popular approach for synthesizing research evidence. It is a relatively new approach for which a universal study definition or definitive procedure has not been established. The purpose of this scoping review was to provide an overview of scoping reviews in the literature. Methods: A…

The Boom in 3D-Printed Sensor Technology

PubMed Central

Xu, Yuanyuan; Wu, Xiaoyue; Guo, Xiao; Kong, Bin; Zhang, Min; Qian, Xiang; Mi, Shengli; Sun, Wei

2017-01-01

Future sensing applications will include high-performance features, such as toxin detection, real-time monitoring of physiological events, advanced diagnostics, and connected feedback. However, such multi-functional sensors require advancements in sensitivity, specificity, and throughput with the simultaneous delivery of multiple detection in a short time. Recent advances in 3D printing and electronics have brought us closer to sensors with multiplex advantages, and additive manufacturing approaches offer a new scope for sensor fabrication. To this end, we review the recent advances in 3D-printed cutting-edge sensors. These achievements demonstrate the successful application of 3D-printing technology in sensor fabrication, and the selected studies deeply explore the potential for creating sensors with higher performance. Further development of multi-process 3D printing is expected to expand future sensor utility and availability. PMID:28534832

Quantitative High-Resolution Genomic Analysis of Single Cancer Cells

PubMed Central

Hannemann, Juliane; Meyer-Staeckling, Sönke; Kemming, Dirk; Alpers, Iris; Joosse, Simon A.; Pospisil, Heike; Kurtz, Stefan; Görndt, Jennifer; Püschel, Klaus; Riethdorf, Sabine; Pantel, Klaus; Brandt, Burkhard

2011-01-01

During cancer progression, specific genomic aberrations arise that can determine the scope of the disease and can be used as predictive or prognostic markers. The detection of specific gene amplifications or deletions in single blood-borne or disseminated tumour cells that may give rise to the development of metastases is of great clinical interest but technically challenging. In this study, we present a method for quantitative high-resolution genomic analysis of single cells. Cells were isolated under permanent microscopic control followed by high-fidelity whole genome amplification and subsequent analyses by fine tiling array-CGH and qPCR. The assay was applied to single breast cancer cells to analyze the chromosomal region centred by the therapeutical relevant EGFR gene. This method allows precise quantitative analysis of copy number variations in single cell diagnostics. PMID:22140428

Cost-effectiveness analysis of flexible optical scopes for tracheal intubation: a descriptive comparative study of reusable and single-use scopes.

PubMed

Gupta, Deepak; Wang, Hong

2011-12-01

To calculate the costs per intubation of reusable fiberoptic scopes versus single-use intubation scopes. Open-label retrospective study. University-affiliated hospital. The one-year intubation records of intubations performed with reusable intubation scopes, the one-year maintenance costs of these scopes, and their three-year repair cost records were analyzed. A total of 166 intubations were performed with reusable fiberoptic scopes in 2009. Calculations to assess the costs per intubation based on the documented records at our institution were made. The total cost of an intubation, the repair-to-intubation ratio, and the repair cost per intubation were determined. The total cost of an intubation at our institution in 2009, using reusable scopes, was $119.75 [US dollars (USD)], which included $20.15 (purchasing), $53.48 (repair), $33.16 (maintenance), and $12.96 (labor). The repair-to-intubation ratio was 1:55. Repair costs were $53.48 per intubation and $2,959.44 per instance of repair. The Ambu aScope, a single-use intubation scope, is a new addition to video laryngoscopy. The price should range within 10% of our intubation cost ($120.00 to $132.00 per single-use intubation scope). Copyright © 2011 Elsevier Inc. All rights reserved.

The Schistosomiasis Clinical Trials Landscape: A Systematic Review of Antischistosomal Treatment Efficacy Studies and a Case for Sharing Individual Participant-Level Data (IPD).

PubMed

Julé, Amélie M; Vaillant, Michel; Lang, Trudie A; Guérin, Philippe J; Olliaro, Piero L

2016-06-01

Schistosomiasis control mainly relies on preventive chemotherapy with praziquantel (PZQ) distributed through mass drug administration. With a target of 260 million treatments yearly, reliably assessing and monitoring efficacy is all-important. Recommendations for treatment and control of schistosomiasis are supported by systematic reviews and meta-analyses of aggregated data, which however also point to limitations due to heterogeneity in trial design, analyses and reporting. Some such limitations could be corrected through access to individual participant-level data (IPD), which facilitates standardised analyses. A systematic literature review was conducted to identify antischistosomal drug efficacy studies performed since 2000; including electronic searches of the Cochrane Infectious Diseases Group specialised register and the Cochrane Library, PubMed, CENTRAL and Embase; complemented with a manual search for articles listed in past reviews. Antischistosomal treatment studies with assessment of outcome within 60 days post-treatment were eligible. Meta-data, i.e. study-level characteristics (Schistosoma species, number of patients, drug administered, country, etc.) and efficacy parameters were extracted from published documents to evaluate the scope of an individual-level data sharing platform. Out of 914 documents screened, 90 studies from 26 countries were included, enrolling 20,517 participants infected with Schistosoma spp. and treated with different PZQ regimens or other drugs. Methodologies varied in terms of diagnostic approaches (number of samples and test repeats), time of outcome assessment, and outcome measure (cure rate or egg reduction rate, as an arithmetic or geometric mean), making direct comparison of published data difficult. This review describes the landscape of schistosomiasis clinical research. The volume of data and the methodological and reporting heterogeneity identified all indicate that there is scope for an individual participant-level database, to allow for standardised analyses.

Predictors for Recurrence of Chronic Subdural Hematoma.

PubMed

Hammer, Alexander; Tregubow, Alexander; Kerry, Ghassan; Schrey, Michael; Hammer, Christian; Steiner, Hans-Herbert

2017-01-01

This prospective study was designed to analyze the dependence of different factors on the recurrence rate of chronic subdural hematoma (cSDH) after surgical treatment. Seventy-three consecutive patients, who were surgically treated at our department due to cSDH between 2009 and 2012, were included. The following parameters were analyzed: patient age and gender, occurrence of trauma, time between trauma and admission, neurological symptoms, presence of minor diseases, intake of anticoagulation medication. We classified the results of diagnostic imaging and determined the space-consuming effect via the cerebral midline shift. In addition, we scrutinized intraoperative findings and the dependence of the position of subdural drainage on the recurrence rate of cSDH. In our patient group, cSDH recurrence was significantly associated with aphasia (p=0.008). Moreover an increased cSDH recurrence rate was observed in the patient group that had a separated manifestation of the cSDH in the preoperative diagnostic imaging (p=0.048) and received no drainage implant (p=0.016). Homogeneous isodense cSDH was associated with no apparent recurrence (p=0.037). Within the scope of this study, we detected aphasia and separated cSDH as predictors of cSDH recurrence. Homogeneous isodense cSDH seems to be a good prognostic sign regarding the risk of recurrence development. Furthermore, our data clearly emphasize the importance of surgically applied drainage implants to prevent a recurrence of cSDH.

Diagnosing Portuguese Students' Misconceptions about the Mineral Concept

NASA Astrophysics Data System (ADS)

Monteiro, António; Nóbrega, Clévio; Abrantes, Isabel; Gomes, Celeste

2012-11-01

Educational researchers and teachers are well aware that misconceptions-erroneous ideas that differ from the scientifically accepted ones-are very common amongst students. Daily experiences, creative and perceptive thinking and science textbooks give rise to students' misconceptions which lead them to draw erroneous conclusions that become strongly attached to their views and somehow affect subsequent learning. The main scope of this study was to understand what students consider a mineral to be and why. Therefore, the goals were (1) to identify eleventh-grade students' misconceptions about the mineral concept; (2) to understand which variables (gender, parents' education level and attitude towards science) influenced students' conceptions; and (3) to create teaching tools for the prevention of misconceptions. In order to achieve these goals, a diagnostic instrument (DI), constituted of a two-tier diagnostic test and a Science Attitude Questionnaire, was developed to be used with a sample of 89 twelfth-grade students from five schools located in central Portugal. As far as we know, this is the first DI developed for the analysis of misconceptions about the mineral concept. Data analysis allows us to conclude that students had serious difficulties in understanding the mineral concept, having easily formed misconceptions. The variables gender and parents' education level influence certain students' conceptions. This study provides a valuable basis for reflection on teaching and learning strategies, especially on this particular theme.

Psychodrama and the Treatment of Narcissistic and Borderline Patients.

PubMed

Olsson, Peter A

2018-01-01

Psychiatric clinicians are faced with the challenge of remaining flexible and psychotherapeutically relevant to the broadening scope of patients with severe narcissistic and borderline personality disorders. Diagnostic sophistication among mental health professionals, increased availability of psychotherapy services, and economic pressures combine to cause the public to expect cost-effective, successful, and shorter duration of treatments. These treatment challenges are particularly poignant with the treatment of those narcissistic and borderline patients who have meager capacity for insight and limited verbal skills. This article describes the use of psychodynamically oriented and informed psychodrama for the treatment of narcissistic and borderline patients.

Time Projection Compton Spectrometer (TPCS). User`s guide

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

Landron, C.O.; Baldwin, G.T.

1994-04-01

The Time Projection Compton Spectrometer (TPCS) is a radiation diagnostic designed to determine the time-integrated energy spectrum between 100 keV -- 2 MeV of flash x-ray sources. This guide is intended as a reference for the routine operator of the TPCS. Contents include a brief overview of the principle of operation, detailed component descriptions, detailed assembly and disassembly procedures, guide to routine operations, and troubleshooting flowcharts. Detailed principle of operation, signal analysis and spectrum unfold algorithms are beyond the scope of this guide; however, the guide makes reference to sources containing this information.

Proposed changes to the American Psychiatric Association diagnostic criteria for autism spectrum disorder: implications for young children and their families.

PubMed

Grant, Roy; Nozyce, Molly

2013-05-01

The American Psychiatric Association has revised the diagnostic criteria for their DSM-5 manual. Important changes have been made to the diagnosis of the current (DSM-IV) category of Pervasive Developmental Disorders. This category includes Autistic Disorder (autism), Asperger's Disorder, and Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS). The DSM-5 deletes Asperger's Disorder and PDD-NOS as diagnostic entities. This change may have unintended consequences, including the possibility that the new diagnostic framework will adversely affect access to developmental interventions under Individuals with Disabilities Education Act (IDEA) programs, Early Intervention (for birth to 2 years olds) and preschool special education (for 3 and 4 years olds). Changing the current diagnosis of PDD-NOS to a "Social Communication Disorder" focused on language pragmatics in the DSM-5 may restrict eligibility for IDEA programs and limit the scope of services for affected children. Young children who meet current criteria for PDD-NOS require more intensive and multi-disciplinary services than would be available with a communication domain diagnosis and possible service authorization limited to speech-language therapy. Intensive behavioral interventions, inclusive group setting placements, and family support services are typically more available for children with an autism spectrum disorder than with diagnoses reflecting speech-language delay. The diagnostic distinction reflective of the higher language and social functioning between Asperger's Disorder and autism is also undermined by eliminating the former as a categorical diagnosis and subsuming it under autism. This change may adversely affect treatment planning and misinform parents about prognosis for children who meet current criteria for Asperger's Disorder.

Illustrating performance indicators and course characteristics to support students' self-regulated learning in CS1

NASA Astrophysics Data System (ADS)

Ott, Claudia; Robins, Anthony; Haden, Patricia; Shephard, Kerry

2015-04-01

In higher education, quality feedback for students is regarded as one of the main contributors to improve student learning. Feedback to support students' development into self-regulated learners, who set their own goals, self-monitor their actual performance according to these goals, and adjust learning strategies if necessary, is seen as an important aspect of contemporary feedback practice. However, only those students who are aware of the course demands and the impact of certain study behaviors on their final achievement are in a position to self-regulate their learning on an informed basis. Learning analytics is an emerging field primarily concerned with using predictive models to inform educational instructors or learners about projected study outcomes. In a scoping study, over 200 students of an introductory programming course (CS1) were supplied with information revealing performance indicators for different stages on the course and projecting final performance for various achievement levels. The study was set out to explore the impact of this type of feedback in the confined context of a CS1 course as well as to learn about students' attitudes toward diagnostic course data in general. The results from the study suggest that students valued the information, but, despite high engagement with the information, students' study behavior and learning outcome remained rather unaffected for the aspects investigated. Given these multi-layered results, we suggest further exploration on the provision of feedback based on diagnostic course data - a vital step toward more transparency for students to foster their active role in the learning process.

The CRC Contribution to Research Training: Report of a Scoping Study for the Cooperative Research Centres Association

ERIC Educational Resources Information Center

Palmer, Nigel

2012-01-01

This report summarises findings from a scoping study conducted for the Cooperative Research Centres Association (CRCA) by the Centre for the Study of Higher Education. The purpose of the scoping study is to inform the research training activities of Cooperative Research Centres (CRCs). While previous studies have focussed on the outcomes supported…

Metabolic Imaging in Multiple Time Scales

PubMed Central

Ramanujan, V Krishnan

2013-01-01

We report here a novel combination of time-resolved imaging methods for probing mitochondrial metabolism multiple time scales at the level of single cells. By exploiting a mitochondrial membrane potential reporter fluorescence we demonstrate the single cell metabolic dynamics in time scales ranging from milliseconds to seconds to minutes in response to glucose metabolism and mitochondrial perturbations in real time. Our results show that in comparison with normal human mammary epithelial cells, the breast cancer cells display significant alterations in metabolic responses at all measured time scales by single cell kinetics, fluorescence recovery after photobleaching and by scaling analysis of time-series data obtained from mitochondrial fluorescence fluctuations. Furthermore scaling analysis of time-series data in living cells with distinct mitochondrial dysfunction also revealed significant metabolic differences thereby suggesting the broader applicability (e.g. in mitochondrial myopathies and other metabolic disorders) of the proposed strategies beyond the scope of cancer metabolism. We discuss the scope of these findings in the context of developing portable, real-time metabolic measurement systems that can find applications in preclinical and clinical diagnostics. PMID:24013043

Verification of examination procedures in clinical laboratory for imprecision, trueness and diagnostic accuracy according to ISO 15189:2012: a pragmatic approach.

PubMed

Antonelli, Giorgia; Padoan, Andrea; Aita, Ada; Sciacovelli, Laura; Plebani, Mario

2017-08-28

Background The International Standard ISO 15189 is recognized as a valuable guide in ensuring high quality clinical laboratory services and promoting the harmonization of accreditation programmes in laboratory medicine. Examination procedures must be verified in order to guarantee that their performance characteristics are congruent with the intended scope of the test. The aim of the present study was to propose a practice model for implementing procedures employed for the verification of validated examination procedures already used for at least 2 years in our laboratory, in agreement with the ISO 15189 requirement at the Section 5.5.1.2. Methods In order to identify the operative procedure to be used, approved documents were identified, together with the definition of performance characteristics to be evaluated for the different methods; the examination procedures used in laboratory were analyzed and checked for performance specifications reported by manufacturers. Then, operative flow charts were identified to compare the laboratory performance characteristics with those declared by manufacturers. Results The choice of performance characteristics for verification was based on approved documents used as guidance, and the specific purpose tests undertaken, a consideration being made of: imprecision and trueness for quantitative methods; diagnostic accuracy for qualitative methods; imprecision together with diagnostic accuracy for semi-quantitative methods. Conclusions The described approach, balancing technological possibilities, risks and costs and assuring the compliance of the fundamental component of result accuracy, appears promising as an easily applicable and flexible procedure helping laboratories to comply with the ISO 15189 requirements.

Estimating the relative utility of screening mammography.

PubMed

Abbey, Craig K; Eckstein, Miguel P; Boone, John M

2013-05-01

The concept of diagnostic utility is a fundamental component of signal detection theory, going back to some of its earliest works. Attaching utility values to the various possible outcomes of a diagnostic test should, in principle, lead to meaningful approaches to evaluating and comparing such systems. However, in many areas of medical imaging, utility is not used because it is presumed to be unknown. In this work, we estimate relative utility (the utility benefit of a detection relative to that of a correct rejection) for screening mammography using its known relation to the slope of a receiver operating characteristic (ROC) curve at the optimal operating point. The approach assumes that the clinical operating point is optimal for the goal of maximizing expected utility and therefore the slope at this point implies a value of relative utility for the diagnostic task, for known disease prevalence. We examine utility estimation in the context of screening mammography using the Digital Mammographic Imaging Screening Trials (DMIST) data. We show how various conditions can influence the estimated relative utility, including characteristics of the rating scale, verification time, probability model, and scope of the ROC curve fit. Relative utility estimates range from 66 to 227. We argue for one particular set of conditions that results in a relative utility estimate of 162 (±14%). This is broadly consistent with values in screening mammography determined previously by other means. At the disease prevalence found in the DMIST study (0.59% at 365-day verification), optimal ROC slopes are near unity, suggesting that utility-based assessments of screening mammography will be similar to those found using Youden's index.

Antenatal screening and predicting hypertension in pregnancy for midwives.

PubMed

Peacock, Ann S; Bogossian, Fiona

2010-09-01

The cause of hypertension in pregnancy remains unknown and results in increased risk of complications for mother and baby. Symptoms of developing pre-eclampsia, such as an elevated blood pressure, can be vague and singular. The purpose of this literature review is to evaluate research investigating antenatal screening practices for hypertension which fall within the midwives scope of practice. Inclusion criteria for this literature review were English language, peer reviewed primary research journal articles, published in the previous 20 years where the population under study was pregnant with reported outcomes of prevention, screening or prediction of hypertension in pregnancy. A large number of papers (n=201) were identified and these were screened and subsequently excluded if they addressed diagnostic testing, screening and interpretation that depended solely on a medical practitioner. There was no single predictive factor found, however the relevant papers included in this review (n=33) found evidence of modifiable, non-modifiable and clinical assessment factors for inclusion in a midwifery screening model. Further research should be focused on the factors observed by midwives during history taking and the antenatal course in the second and third trimesters and whether or not these can be synthesised in to a hypertension-specific diagnostic tool for use in midwifery practice. Copyright (c) 2009 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Evaluation of selected clinical and diagnostic parameters in girls with anorexia nervosa (I).

PubMed

Nogal, Paweł; Pniewska-Siark, Barbara; Lewiński, Andrzej

2008-08-01

Body weight loss in patients with anorexia nervosa (AN) is accompanied by a number of hormonal and metabolic disorders. The scope and intensity of these disorders may have a considerable influence on the prognosis in this disease. The goal of the study was an evaluation of selected diagnostic examinations in comparison with clinical data of female patients with AN. Retrospective studies involved eighty-seven (87) patients with AN. On therapy commencement, routine laboratory tests (full blood cell count, serum concentrations of sodium, potassium, glucose, cholesterol, triglycerides, total calcium, phosphates, total protein and the urea) and hormonal tests (TSH, TSH, FT4, FT3, E2, T, cortisol measured at 8(00), 17(00) and 24(00), LH and FSH in stimulation test with GnRH) were performed in each patient. Correlations were determined between clinical data and the measured hormone concentrations. In the studied girls, the mean values of routine laboratory tests, performed at the beginning of the therapy, were within the normal ranges (except hypernatremia). The mean concentrations of LH, FSH and FT4 were below reference values; the mean concentration of cortisol considerably exceeded the standard range. Statistically significant relations were demonstrated between BMI values and the concentrations of LH, E2 and cortisol. Body weigh loss is not significantly reflected by abnormal results of routinely performed laboratory tests. Hypogonadotropic hypogonadism and hypercortisolemia are the most characteristic hormonal symptoms in girls with AN.

Self-reported preparation of Polish midwives for independent performance of prophylactic activities within the scope of women's diseases and obstetric pathologies.

PubMed

Iwanowicz-Palus, Grażyna J; Rzońca, Ewa; Bień, Agnieszka; Włoszczak-Szubzda, Anna

2014-01-01

The objective of the study is an attempt to recognize self-reported preparation of midwives for an independent performance of prophylactic activities within the scope of women's diseases and obstetric pathologies. The study was conducted in a representative all-Polish population sample of 3,569 midwives, by the method of a diagnostic survey using a questionnaire technique. The research instrument was a questionnaire form designed by the author containing items concerning the characteristics of respondents and the object of the study, constructed based on the 5-point Liker scale. The relationships between the variables were verified using chi-square test (χ(2)) of independence. The p values p<0.05 were considered statistically significant. Analysis of results allows the presumption that in the opinions of midwives the majority of them are prepared for the independent performance of prophylactic activities in the area of women's diseases (84.28%) and obstetric pathologies (77.95%). However, nearly every tenth midwife, irrespective of the region of Poland where she lives, age, and participation in post-graduate training, is not prepared for an independent performance of the prevention of women's diseases. In turn, the lack of preparation for carrying out prevention of women's diseases was admitted mainly by midwives from the northern and central regions of Poland, aged 31-40, possessing post-secondary school education, who did not participate in any form of post-graduate training. The results of studies and analysis of the relevant literature indicate that it is necessary for midwives to improve their qualifications in the area of prophylaxis of women's diseases and obstetric pathologies through participation in various forms of post-graduate education.

Sustainable childhood obesity prevention through community engagement (SCOPE) program: evaluation of the implementation phase.

PubMed

McIntosh, Bonnie; Daly, Amelia; Mâsse, Louise C; Collet, Jean-Paul; Higgins, Joan Wharf; Naylor, Patti-Jean; Amed, Shazhan

2015-10-01

Childhood obesity rates are steadily rising. Sustainable Childhood Obesity Prevention Through Community Engagement (SCOPE) is a community-based participatory action research (PAR) program aimed at preventing childhood obesity. This study aimed to describe community perspectives on, and elicit feedback about, SCOPE's first phase of implementation in two pilot cities in British Columbia, Canada. A case study was implemented using interviews and questionnaires to obtain feedback about SCOPE from two groups: SCOPE coordinators and stakeholders (i.e., individuals and organizations that were a member of the community and engaged with SCOPE coordinators). Participants were recruited via email and (or) by telephone. Coordinators completed a telephone interview. Stakeholders completed a questionnaire and (or) a telephone interview. Thematic analysis was conducted. Participants included 2 coordinators and 15 stakeholders. Participants similarly interpreted SCOPE as a program focused on raising awareness about childhood obesity prevention, while engaging multiple community sectors. Overall, participants valued the program's role in facilitating networking and partnership development, providing evidence-based resources, technical expertise, and contributing funding. Participants felt that SCOPE is sustainable. However, participants felt that barriers to achieving healthy weights among children included those related to the built environment, and social, behavioral, and economic obstacles. Perspectives on factors that facilitated and acted as barriers to SCOPE's first phase of implementation were obtained from the SCOPE communities and may be used to enhance the sustainability of SCOPE and its applicability to other BC communities.

Study protocol for a scoping review on rehabilitation scoping reviews.

PubMed

Colquhoun, Heather L; Jesus, Tiago S; O'Brien, Kelly K; Tricco, Andrea C; Chui, Adora; Zarin, Wasifa; Lillie, Erin; Hitzig, Sander L; Straus, Sharon

2017-09-01

Scoping reviews are increasingly popular in rehabilitation. However, significant variability in scoping review conduct and reporting currently exists, limiting potential for the methodology to advance rehabilitation research, practice and policy. Our aim is to conduct a scoping review of rehabilitation scoping reviews in order to examine the current volume, yearly distribution, proportion, scope and methodological practices involved in the conduct of scoping reviews in rehabilitation. Key areas of methodological improvement will be described. Methods and analysis: We will undertake the review using the Arksey and O'Malley scoping review methodology. Our search will involve two phases. The first will combine a previously conducted scoping review of scoping reviews (not distinct to rehabilitation, with data current to July 2014) together with a rehabilitation keyword search in PubMed. Articles found in the first phase search will undergo a full text review. The second phase will include an update of the previously conducted scoping review of scoping reviews (July 2014 to current). This update will include the search of nine electronic databases, followed by title and abstract screening as well as a full text review. All screening and extraction will be performed independently by two authors. Articles will be included if they are scoping reviews within the field of rehabilitation. A consultation exercise with key targets will inform plans to improve rehabilitation scoping reviews. Ethics and dissemination: Ethics will be required for the consultation phase of our scoping review. Dissemination will include peer-reviewed publication and conferences in rehabilitation-specific contexts.

Diagnostic Evaluation of Nontraumatic Chest Pain in Athletes.

PubMed

Moran, Byron; Bryan, Sean; Farrar, Ted; Salud, Chris; Visser, Gary; Decuba, Raymond; Renelus, Deborah; Buckley, Tyler; Dressing, Michael; Peterkin, Nicholas; Coris, Eric

This article is a clinically relevant review of the existing medical literature relating to the assessment and diagnostic evaluation for athletes complaining of nontraumatic chest pain. The literature was searched using the following databases for the years 1975 forward: Cochrane Database of Systematic Reviews; CINAHL; PubMed (MEDLINE); and SportDiscus. The general search used the keywords chest pain and athletes. The search was revised to include subject headings and subheadings, including chest pain and prevalence and athletes. Cross-referencing published articles from the databases searched discovered additional articles. No dissertations, theses, or meeting proceedings were reviewed. The authors discuss the scope of this complex problem and the diagnostic dilemma chest pain in athletes can provide. Next, the authors delve into the vast differential and attempt to simplify this process for the sports medicine physician by dividing potential etiologies into cardiac and noncardiac conditions. Life-threatening causes of chest pain in athletes may be cardiac or noncardiac in origin, which highlights the need for the sports medicine physician to consider pathology in multiple organ systems simultaneously. This article emphasizes the importance of ruling out immediately life threatening diagnoses, while acknowledging the most common causes of noncardiac chest pain in young athletes are benign. The authors propose a practical algorithm the sports medicine physician can use as a guide for the assessment and diagnostic work-up of the athlete with chest pain designed to help the physician arrive at the correct diagnosis in a clinically efficient and cost-effective manner.

Development and Evaluation of an Adolescents' Depression Ontology for Analyzing Social Data.

PubMed

Jung, Hyesil; Park, Hyeoun-Ae; Song, Tae-Min

2016-01-01

This study aims to develop and evaluate an ontology for adolescents' depression to be used for collecting and analyzing social data. The ontology was developed according to the 'ontology development 101' methodology. Concepts were extracted from clinical practice guidelines and related literatures. The ontology is composed of five sub-ontologies which represent risk factors, sign and symptoms, measurement, diagnostic result and management care. The ontology was evaluated in four different ways: First, we examined the frequency of ontology concept appeared in social data; Second, the content coverage of ontology was evaluated by comparing ontology concepts with concepts extracted from the youth depression counseling records; Third, the structural and representational layer of the ontology were evaluated by 5 ontology and psychiatric nursing experts; Fourth, the scope of the ontology was examined by answering 59 competency questions. The ontology was improved by adding new concepts and synonyms and revising the level of structure.

45 CFR 703.3 - Scope of subject matter.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 3 2013-10-01 2013-10-01 false Scope of subject matter. 703.3 Section 703.3... AND FUNCTIONS OF STATE ADVISORY COMMITTEES § 703.3 Scope of subject matter. The scope of the subject matter to be dealt with by Advisory Committees shall be those subjects of inquiry or study with which the...

45 CFR 703.3 - Scope of subject matter.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Scope of subject matter. 703.3 Section 703.3... AND FUNCTIONS OF STATE ADVISORY COMMITTEES § 703.3 Scope of subject matter. The scope of the subject matter to be dealt with by Advisory Committees shall be those subjects of inquiry or study with which the...

45 CFR 703.3 - Scope of subject matter.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 3 2014-10-01 2014-10-01 false Scope of subject matter. 703.3 Section 703.3... AND FUNCTIONS OF STATE ADVISORY COMMITTEES § 703.3 Scope of subject matter. The scope of the subject matter to be dealt with by Advisory Committees shall be those subjects of inquiry or study with which the...

45 CFR 703.3 - Scope of subject matter.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 3 2011-10-01 2011-10-01 false Scope of subject matter. 703.3 Section 703.3... AND FUNCTIONS OF STATE ADVISORY COMMITTEES § 703.3 Scope of subject matter. The scope of the subject matter to be dealt with by Advisory Committees shall be those subjects of inquiry or study with which the...

45 CFR 703.3 - Scope of subject matter.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 3 2012-10-01 2012-10-01 false Scope of subject matter. 703.3 Section 703.3... AND FUNCTIONS OF STATE ADVISORY COMMITTEES § 703.3 Scope of subject matter. The scope of the subject matter to be dealt with by Advisory Committees shall be those subjects of inquiry or study with which the...

Broadening GHG accounting with LCA: application to a waste management business unit.

PubMed

Fallaha, Sophie; Martineau, Geneviève; Bécaert, Valérie; Margni, Manuele; Deschênes, Louise; Samson, Réjean; Aoustin, Emmanuelle

2009-11-01

In an effort to obtain the most accurate climate change impact assessment, greenhouse gas (GHG) accounting is evolving to include life-cycle thinking. This study (1) identifies similarities and key differences between GHG accounting and life-cycle assessment (LCA), (2) compares them on a consistent basis through a case study on a waste management business unit. First, GHG accounting is performed. According to the GHG Protocol, annual emissions are categorized into three scopes: direct GHG emissions (scope 1), indirect emissions related to electricity, heat and steam production (scope 2) and other indirect emissions (scope 3). The LCA is then structured into a comparable framework: each LCA process is disaggregated into these three scopes, the annual operating activities are assessed, and the environmental impacts are determined using the IMPACT2002+ method. By comparing these two approaches it is concluded that both LCA and GHG accounting provide similar climate change impact results as the same major GHG contributors are determined for scope 1 emissions. The emissions from scope 2 appear negligible whereas emissions from scope 3 cannot be neglected since they contribute to around 10% of the climate change impact of the waste management business unit. This statement is strengthened by the fact that scope 3 generates 75% of the resource use damage and 30% of the ecosystem quality damage categories. The study also shows that LCA can help in setting up the framework for a annual GHG accounting by determining the major climate change contributors.

Engineering hydrogels as extracellular matrix mimics

PubMed Central

Geckil, Hikmet; Xu, Feng; Zhang, Xiaohui; Moon, SangJun

2010-01-01

Extracellular matrix (ECM) is a complex cellular environment consisting of proteins, proteoglycans, and other soluble molecules. ECM provides structural support to mammalian cells and a regulatory milieu with a variety of important cell functions, including assembling cells into various tissues and organs, regulating growth and cell–cell communication. Developing a tailored in vitro cell culture environment that mimics the intricate and organized nanoscale meshwork of native ECM is desirable. Recent studies have shown the potential of hydrogels to mimic native ECM. Such an engineered native-like ECM is more likely to provide cells with rational cues for diagnostic and therapeutic studies. The research for novel biomaterials has led to an extension of the scope and techniques used to fabricate biomimetic hydrogel scaffolds for tissue engineering and regenerative medicine applications. In this article, we detail the progress of the current state-of-the-art engineering methods to create cell-encapsulating hydrogel tissue constructs as well as their applications in in vitro models in biomedicine. PMID:20394538

[Nursing care for psychiatric patients defined by NANDA-NIC-NOC terminology: a literature review].

PubMed

Escalada Hernández, Paula; Muñoz Hermoso, Paula; Marro Larrañaga, Itxaso

2013-03-01

The purpose of this literature review is to provide a synthesis of the most relevant studies describing nursing work in mental health by means of NNN taxonomy. Literature from 1990 to September 2011 was reviewed using the "scoping review" methodology. Three independent reviewers examined the articles which were found and selected those fulfilling the inclusion criteria for subsequent analysis. From the 220 articles obtained, 14 studies were finally included and divided into two groups. The aim of the first ten papers was examining the most frequent NANDA nursing diagnosis or/and NIC nursing interventions in different mental health care settings. The remaining four articles describe health care plans for psychiatric patients developed with NNN taxonomy. Combining results from both groups, the most prevalent diagnostic labels are: disturbed thought processes and impaired social interaction. This review has illustrated the lack of evidence in relation to NNN taxonomy in the field of mental health and the need of further research in this area.

Ordering Diagnostic Imaging: A Survey of Ontario Physiotherapists' Opinions on an Expanded Scope of Practice

PubMed Central

Chong, Jodie Ng Fuk; De Luca, Krista; Goldan, Sana; Imam, Abdullah; Li, Boris; Zabjek, Karl; Chu, Anna

2015-01-01

ABSTRACT Purpose: To explore Ontario physiotherapists' opinions on their ability to order diagnostic imaging (DI). Methods: An online questionnaire was sent to all registered members of the College of Physiotherapists of Ontario. Descriptive statistics were calculated using response frequencies. Practice characteristics were compared using χ2 tests and Wilcoxon rank–sum tests. Results: Of 1,574 respondents (21% response rate), 42% practised in orthopaedics and 53% in the public sector. Most physiotherapists were interested in ordering DI (72% MRI/diagnostic ultrasound, 78% X-rays/computed tomography scans). Respondents with an orthopaedic caseload of 50% or more (p<0.001) and those in the private sector (p<0.001) were more interested in ordering DI. Respondents preferred a DI course that combined face-to-face and Web-based components and one that was specific to their area of practice. Most respondents perceived minimal barriers to the uptake of ordering DI, and most agreed that support from other health care professionals would facilitate uptake. Conclusion: The majority of Ontario physiotherapists are interested in ordering DI. For successful implementation of a health care change, such as physiotherapists' ability to order DI, educational needs and barriers to and facilitators of the uptake of the authorized activity should be considered. PMID:25931666

Nonphysician Care Providers Can Help to Increase Detection of Cognitive Impairment and Encourage Diagnostic Evaluation for Dementia in Community and Residential Care Settings.

PubMed

Maslow, Katie; Fortinsky, Richard H

2018-01-18

In the United States, at least half of older adults living with dementia do not have a diagnosis. Their cognitive impairment may not have been detected, and some older adults whose physician recommends that they obtain a diagnostic evaluation do not follow through on the recommendation. Initiatives to increase detection of cognitive impairment and diagnosis of dementia have focused primarily on physician practices and public information programs to raise awareness about the importance of detection and diagnosis. Nonphysician care providers who work with older adults in community and residential care settings, such as aging network agencies, public health agencies, senior housing, assisted living, and nursing homes, interact frequently with older adults who have cognitive impairment but have not had a diagnostic evaluation. These care providers may be aware of signs of cognitive impairment and older adults' concerns about their cognition that have not been expressed to their physician. Within their scope of practice and training, nonphysician care providers can help to increase detection of cognitive impairment and encourage older adults with cognitive impairment to obtain a diagnostic evaluation to determine the cause of the condition. This article provides seven practice recommendations intended to increase involvement of nonphysician care providers in detecting cognitive impairment and encouraging older adults to obtain a diagnostic evaluation. The Kickstart-Assess-Evaluate-Refer (KAER) framework for physician practice in detection and diagnosis of dementia is used to identify ways to coordinate physician and nonphysician efforts and thereby increase the proportion of older adults living with dementia who have a diagnosis. © The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A Scoping Review of Qualitative Studies about Children Experiencing Parental Separation

ERIC Educational Resources Information Center

Birnbaum, Rachel; Saini, Michael

2013-01-01

This article explores a scoping review of qualitative studies about children's experiences and feelings during times of parental separation. The purpose of the review was to explore children's feelings and attitudes about their parents' separation and how their voices are heard during times of parental separation. The scoping review examined 44…

Internationalization of the Counseling Profession: Meaning, Scope and Concerns

ERIC Educational Resources Information Center

Ng, Kok-Mun; Noonan, Brigid M.

2012-01-01

The present study sought to clarify the meaning and delineate the scope of internationalization of the counseling profession. Using a qualitative approach, the study recruited a panel of eight experts to help generate a consensus statement on the meaning of internationalization to the counseling profession and to delineate a five-theme scope of…

A methodology for the preliminary scoping of future changes in ecosystem services, with an illustration from the future midwestern landscapes study

EPA Science Inventory

The product is a white paper defining a methodology for the preliminary scoping of future changes in ecosystem services, with an Illustration from the Future Midwestern Landscapes Study. The scoping method develops a hierarchy of relevant societal values, identifies the ecosyste...

Comparison of glass slides and various digital-slide modalities for cytopathology screening and interpretation.

PubMed

Hanna, Matthew G; Monaco, Sara E; Cuda, Jacqueline; Xing, Juan; Ahmed, Ishtiaque; Pantanowitz, Liron

2017-09-01

Whole-slide imaging in cytology is limited when glass slides are digitized without z-stacks for focusing. Different vendors have started to provide z-stacking solutions to overcome this limitation. The Panoptiq imaging system allows users to create digital files combining low-magnification panoramic images with regions of interest (ROIs) that are imaged with high-magnification z-stacks. The aim of this study was to compare such panoramic images with conventional whole-slide images and glass slides for the tasks of screening and interpretation in cytopathology. Thirty glass slides, including 10 ThinPrep Papanicolaou tests and 20 nongynecologic cytology cases, were digitized with an Olympus BX45 integrated microscope with an attached Prosilica GT camera. ViewsIQ software was used for image acquisition and viewing. These glass slides were also scanned on an Aperio ScanScope XT at ×40 (0.25 μm/pixel) with 1 z-plane and were viewed with ImageScope software. Digital and glass sides were screened and dotted/annotated by a cytotechnologist and were subsequently reviewed by 3 cytopathologists. For panoramic images, the cytotechnologist manually created digital maps and selected representative ROIs to generate z-stacks at a higher magnification. After 3-week washout periods, panoramic images were compared with Aperio digital slides and glass slides. The Panoptiq system permitted fine focusing of thick smears and cell clusters. In comparison with glass slides, the average screening times were 5.5 and 1.8 times longer with Panoptiq and Aperio images, respectively, but this improved with user experience. There was no statistical difference in diagnostic concordance between all 3 modalities. Users' diagnostic confidence was also similar for all modalities. The Aperio whole-slide scanner with 1 z-plane scanning and the Panoptiq imaging system with z-stacking are both suitable for cytopathology screening and interpretation. However, ROI z-stacks do offer a superior mechanism for overcoming focusing problems commonly encountered with digital cytology slides. Unlike whole-slide imaging, the acquisition of representative z-stack images with the Panoptiq system requires a trained cytologist to create digital files. Cancer Cytopathol 2017;125:701-9. © 2017 American Cancer Society. © 2017 American Cancer Society.

Attitudes among dentists and dental hygienists towards extended scope and independent practice of dental hygienists.

PubMed

Reinders, Jan J; Krijnen, Wim P; Onclin, Pieter; van der Schans, Cees P; Stegenga, Boudewijn

2017-02-01

Attitudes of dentists and dental hygienists towards extended scope and independent dental hygiene practice are described in several studies, but the results are heterogenous. The purpose of this systematic review was to compare the attitudes of dentists and dental hygienists towards extended scope and independent dental hygiene practice. PubMed, AMED and CINAHL were screened by two independent assessors to identify relevant studies. Only quantitative studies that reported the percentages of dentists' and dental hygienists' attitude towards extended scope and independent dental hygiene practice were included. The random-effects model was used to synthesise possible heterogenous influences. Meta proportions with regard to a positive attitude towards extended scope of practice are 0.54 for dentists and 0.81 for dental hygienists. Meta proportions of a positive attitude towards independent practice are 0.14 for dentists and 0.59 for dental hygienists. A meta analysis with regard to negative attitudes could only be performed on extended scope of practice and did not reveal a difference between the two professions. We obtained homogeneous outcomes of the studies included regarding negative attitudes of dentists . A minority of dentists hold negative attitudes towards extended scope of dental hygiene practice. Study outcomes regarding negative attitudes of dental hygienists were heterogeneous. Positive attitudes are present among a majority of dentists and dental hygienists with regard to extended scope of dental hygiene practice, while for independent dental hygiene practice this holds for a minority of dentists and a majority of dental hygienists. © 2016 FDI World Dental Federation.

An Australian and New Zealand Scoping Study on the Use of 3D Immersive Virtual Worlds in Higher Education

ERIC Educational Resources Information Center

Dalgarno, Barney; Lee, Mark J. W.; Carlson, Lauren; Gregory, Sue; Tynan, Belinda

2011-01-01

This article describes the research design of, and reports selected findings from, a scoping study aimed at examining current and planned applications of 3D immersive virtual worlds at higher education institutions across Australia and New Zealand. The scoping study is the first of its kind in the region, intended to parallel and complement a…

Scoping reviews: time for clarity in definition, methods, and reporting.

PubMed

Colquhoun, Heather L; Levac, Danielle; O'Brien, Kelly K; Straus, Sharon; Tricco, Andrea C; Perrier, Laure; Kastner, Monika; Moher, David

2014-12-01

The scoping review has become increasingly popular as a form of knowledge synthesis. However, a lack of consensus on scoping review terminology, definition, methodology, and reporting limits the potential of this form of synthesis. In this article, we propose recommendations to further advance the field of scoping review methodology. We summarize current understanding of scoping review publication rates, terms, definitions, and methods. We propose three recommendations for clarity in term, definition and methodology. We recommend adopting the terms "scoping review" or "scoping study" and the use of a proposed definition. Until such time as further guidance is developed, we recommend the use of the methodological steps outlined in the Arksey and O'Malley framework and further enhanced by Levac et al. The development of reporting guidance for the conduct and reporting of scoping reviews is underway. Consistency in the proposed domains and methodologies of scoping reviews, along with the development of reporting guidance, will facilitate methodological advancement, reduce confusion, facilitate collaboration and improve knowledge translation of scoping review findings. Copyright © 2014 Elsevier Inc. All rights reserved.

An analysis of empirical research on the scope of justice.

PubMed

Hafer, Carolyn L; Olson, James M

2003-01-01

The scope of justice has been defined as the boundary within which justice is perceived to be relevant. The empirical literature on this topic is primarily aimed at predicting when a target will be excluded from the scope of justice and at examining potential consequences of exclusion, from accepting a target's suffering to active harm-doing such as mass internment and genocide. The concept of the scope of justice is interesting and heuristically useful, but there are several problems with the empirical literature that impede its progress. For example, the proposed mediator often has not been measured, or operationalizations of the scope of justice have been confounded with other constructs. Also, although the scope of justice remains one possible explanation for results obtained in various experiments, there are equally compelling alternatives that do not implicate exclusion from the scope of justice. We offer suggestions about how to study scope of justice issues in the future and identify points that need to be clarified regarding the conceptualization of the scope of justice.

A Nationwide Assessment of the Scope and Impact of Agricultural Leadership Education

ERIC Educational Resources Information Center

Velez, Jonathan J.; McKim, Aaron J.; Moore, Lori L.; Stephens, Carrie A.

2015-01-01

Agricultural leadership education is an important component of agricultural education programs across the country; yet, a national study of the scope and types of programs offered has not been conducted since 2003. The purpose of the current study was to provide national and timely data regarding the scope and type of opportunities offered in…

Predicting risk and outcomes for frail older adults: an umbrella review of frailty screening tools

PubMed Central

Apóstolo, João; Cooke, Richard; Bobrowicz-Campos, Elzbieta; Santana, Silvina; Marcucci, Maura; Cano, Antonio; Vollenbroek-Hutten, Miriam; Germini, Federico; Holland, Carol

2017-01-01

EXECUTIVE SUMMARY Background A scoping search identified systematic reviews on diagnostic accuracy and predictive ability of frailty measures in older adults. In most cases, research was confined to specific assessment measures related to a specific clinical model. Objectives To summarize the best available evidence from systematic reviews in relation to reliability, validity, diagnostic accuracy and predictive ability of frailty measures in older adults. Inclusion criteria Population Older adults aged 60 years or older recruited from community, primary care, long-term residential care and hospitals. Index test Available frailty measures in older adults. Reference test Cardiovascular Health Study phenotype model, the Canadian Study of Health and Aging cumulative deficit model, Comprehensive Geriatric Assessment or other reference tests. Diagnosis of interest Frailty defined as an age-related state of decreased physiological reserves characterized by an increased risk of poor clinical outcomes. Types of studies Quantitative systematic reviews. Search strategy A three-step search strategy was utilized to find systematic reviews, available in English, published between January 2001 and October 2015. Methodological quality Assessed by two independent reviewers using the Joanna Briggs Institute critical appraisal checklist for systematic reviews and research synthesis. Data extraction Two independent reviewers extracted data using the standardized data extraction tool designed for umbrella reviews. Data synthesis Data were only presented in a narrative form due to the heterogeneity of included reviews. Results Five reviews with a total of 227,381 participants were included in this umbrella review. Two reviews focused on reliability, validity and diagnostic accuracy; two examined predictive ability for adverse health outcomes; and one investigated validity, diagnostic accuracy and predictive ability. In total, 26 questionnaires and brief assessments and eight frailty indicators were analyzed, most of which were applied to community-dwelling older people. The Frailty Index was examined in almost all these dimensions, with the exception of reliability, and its diagnostic and predictive characteristics were shown to be satisfactory. Gait speed showed high sensitivity, but only moderate specificity, and excellent predictive ability for future disability in activities of daily living. The Tilburg Frailty Indicator was shown to be a reliable and valid measure for frailty screening, but its diagnostic accuracy was not evaluated. Screening Letter, Timed-up-and-go test and PRISMA 7 (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) demonstrated high sensitivity and moderate specificity for identifying frailty. In general, low physical activity, variously measured, was one of the most powerful predictors of future decline in activities of daily living. Conclusion Only a few frailty measures seem to be demonstrably valid, reliable and diagnostically accurate, and have good predictive ability. Among them, the Frailty Index and gait speed emerged as the most useful in routine care and community settings. However, none of the included systematic reviews provided responses that met all of our research questions on their own and there is a need for studies that could fill this gap, covering all these issues within the same study. Nevertheless, it was clear that no suitable tool for assessing frailty appropriately in emergency departments was identified. PMID:28398987

[THE CONDITION AND TENDENCIES OF DEVELOPMENT OF CLINICAL AND SANITARY MICROBIOLOGY IN THE RUSSIAN FEDERATION AND PROBLEM OF IMPORT SUBSTITUTION].

PubMed

Dyatlov, I A; Mironov, A Yu; Shepelin, A P; Aleshkin, V A

2015-08-01

The import substitution becomes one of the strategic tasks of national economy as a result of prolongation of economic sanctions concerning the Russian Federation of part of the USA, EU countries, Japan and number of other countries. It is not proper to be limited in import substitution only by goods because in conditions ofsanctions when access toforeign technologies is complicated Russia is needed to substitute foreign technologies by national designs in faster manner One of directions of effective import substitution is localization of production of laboratory equipment and consumables for clinical and sanitary microbiology on the territory ofthe Russian Federation and countries of Customs union. In Russia, in the field ofdiagnostic of dangerous and socially significant infections, all components for import substitution to implement gene diagnostic, immune diagnostic. bio-sensory and biochip approaches, isolation and storage of live microbial cultures, implementation of high-tech methods of diagnostic are available. At the same time, national diagnostic instrument-making industry for microbiology is factually absent. The few devices of national production more than on 50% consist of import components. The microbiological laboratories are to be equipped only with import devices of open type for applying national components. The most perspective national designs to be implemented are multiplex polimerase chain reaction test-systems and biochips on the basis of national plotters and readers. The modern development of diagnostic equipment and diagnostic instruments requires supplement of national collections of bacterial and viral pathogens and working-through of organizational schemes of supplying collections with strains. The presented data concerning justification of nomenclature of laboratory equipment and consumables permits to satisfy in fill scope the needs of clinical and sanitary microbiology in devices, growth mediums, consumables of national production and to refuse import deliveries without decreasing quality of microbiological analysis. This approach will ensure appropriate response to occurring challenges and new biological dangers and maintenance of biosecurity of the Russian Federation at proper level.

A Roadmap for Recovery/Decontamination Plan for Critical Infrastructure after CBRN Event Involving Drinking Water Utilities: Scoping Study

DTIC Science & Technology

2014-05-01

A Roadmap for Recovery/Decontamination Plan for Critical Infrastructure after CBRN Event Involving Drinking Water Utilities: Scoping Study... Drinking Water Utilities was supported by the Canadian Safety and Security Program (CSSP) which is led by Defence Research and Development Canada’s Centre...after CBRN Event Involving Drinking Water Utilities Scoping Study Prepared by: Vladimir Blinov Konstantin Volchek Emergencies Science and

Insensitivity to scope in contingent valuation studies: reason for dismissal of valuations?

PubMed

Søgaard, Rikke; Lindholt, Jes; Gyrd-Hansen, Dorte

2012-11-01

The credibility of contingent valuation studies has been questioned because of the potential occurrence of scope insensitivity, i.e. that respondents do not react to higher quantities or qualities of a good. The aim of this study was to examine the extent of scope insensitivity and to assess the relevance of potential explanations that may help to shed light on how to appropriately handle this problem in contingent valuation studies. We surveyed a sample of 2004 men invited for cardiovascular disease screening. Each respondent had three contingent valuation tasks from which their sensitivity to larger risk reductions (test 1) and to change in travel costs associated with participation (test 2) could be assessed. Participants were surveyed while waiting for their screening session. Non-participants were surveyed by postal questionnaire. The sample was overall found to be sensitive to scope, testing at the conventional sample-mean level. At the individual respondent level, however, more than half of the respondents failed the tests. Potential determinants for failing the tests were examined in alternative regression models but few consistent relationships were identified. One exception was the influence of more detailed information, which was positively associated with willingness to pay and negatively associated with scope sensitivity. Possible explanations for scope insensitivity are discussed; if cognitive limitations, emotional load and mental budgeting explain scope insensitivity there are grounds for rejecting valuations, whereas other factors such as the alternative theoretical framework of regret theory may render insensitivity to scope a result of rational thinking. It is concluded that future contingent valuation studies should focus more on extracting the underlying motives for the stated preferences in order to appropriately deal with responses that are seemingly irrational, and which may lead to imprecise welfare estimates.

Cost analysis of single-use (Ambu® aScope™) and reusable bronchoscopes in the ICU.

PubMed

Perbet, S; Blanquet, M; Mourgues, C; Delmas, J; Bertran, S; Longère, B; Boïko-Alaux, V; Chennell, P; Bazin, J-E; Constantin, J-M

2017-12-01

Flexible optical bronchoscopes are essential for management of airways in ICU, but the conventional reusable flexible scopes have three major drawbacks: high cost of repairs, need for decontamination, and possible transmission of infectious agents. The main objective of this study was to measure the cost of bronchoalveolar lavage (BAL) and percutaneous tracheostomy (PT) using reusable bronchoscopes and single-use bronchoscopes in an ICU of an university hospital. The secondary objective was to compare the satisfaction of healthcare professionals with reusable and single-use bronchoscopes. The study was performed between August 2009 and July 2014 in a 16-bed ICU. All BAL and PT procedures were performed by experienced healthcare professionals. Cost analysis was performed considering ICU and hospital organization. Healthcare professional satisfaction with single-use and reusable scopes was determined based on eight factors. Sensitivity analysis was performed by applying discount rates (0, 3, and 5%) and by simulation of six situations based on different assumptions. At a discount rate of 3%, the costs per BAL for the two reusable scopes were 188.86€ (scope 1) and 185.94€ (scope 2), and the costs per PT for the reusable scope 1 and scope 2 and single-use scopes were 1613.84€, 410.24€, and 204.49€, respectively. The cost per procedure for the reusable scopes depended on the number of procedures performed, maintenance costs, and decontamination costs. Healthcare professionals were more satisfied with the third-generation single-use Ambu ® aScope™. The cost per procedure for the single-use scope was not superior to that for reusable scopes. The choice of single-use or reusable bronchoscopes in an ICU should consider the frequency of procedures and the number of bronchoscopes needed.

The Malaria System MicroApp: A New, Mobile Device-Based Tool for Malaria Diagnosis.

PubMed

Oliveira, Allisson Dantas; Prats, Clara; Espasa, Mateu; Zarzuela Serrat, Francesc; Montañola Sales, Cristina; Silgado, Aroa; Codina, Daniel Lopez; Arruda, Mercia Eliane; I Prat, Jordi Gomez; Albuquerque, Jones

2017-04-25

Malaria is a public health problem that affects remote areas worldwide. Climate change has contributed to the problem by allowing for the survival of Anopheles in previously uninhabited areas. As such, several groups have made developing news systems for the automated diagnosis of malaria a priority. The objective of this study was to develop a new, automated, mobile device-based diagnostic system for malaria. The system uses Giemsa-stained peripheral blood samples combined with light microscopy to identify the Plasmodium falciparum species in the ring stage of development. The system uses image processing and artificial intelligence techniques as well as a known face detection algorithm to identify Plasmodium parasites. The algorithm is based on integral image and haar-like features concepts, and makes use of weak classifiers with adaptive boosting learning. The search scope of the learning algorithm is reduced in the preprocessing step by removing the background around blood cells. As a proof of concept experiment, the tool was used on 555 malaria-positive and 777 malaria-negative previously-made slides. The accuracy of the system was, on average, 91%, meaning that for every 100 parasite-infected samples, 91 were identified correctly. Accessibility barriers of low-resource countries can be addressed with low-cost diagnostic tools. Our system, developed for mobile devices (mobile phones and tablets), addresses this by enabling access to health centers in remote communities, and importantly, not depending on extensive malaria expertise or expensive diagnostic detection equipment. ©Allisson Dantas Oliveira, Clara Prats, Mateu Espasa, Francesc Zarzuela Serrat, Cristina Montañola Sales, Aroa Silgado, Daniel Lopez Codina, Mercia Eliane Arruda, Jordi Gomez i Prat, Jones Albuquerque. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 25.04.2017.

[Risk behavior among farmers from Podkarpacie Provinece].

PubMed

Binkowska-Bury, Monika; Penar-Zadarko, Beata; Marć, Małgorzata; Sobolewski, Marek

2010-01-01

Increasing awareness of science and medical environments and the society in the scope of behavioral conditioning of many diseases (e.g. cardiovascular diseases, tumors and injuries motivates to shape pro-health behaviors and eliminate harmful habit also in rural areas. There is a need for constant monitoring of behaviors related to health among rural areas inhabitants. The results enriches present state of knowledge in that scope, as well as might be use to increase the effectiveness of health promotion and health education activities and shape pro-health lifestyle among rural areas inhabitants, and particularly among farmers. The aim of the study was to acquaint socio-demographic features related to risk behaviors (tobacco smoking, alcohol drinking) among farmers from Podkarpacie Provinece. The study was carried out between January and December 2009 among 755 farmers with national health insurance KRUS for minimum last year, living in Podkarpacie Provinece, whom had their own farm business, owned a farm either spouse or household member works on the farm. The study population was purposefully chosen. The study was conducted using a diagnostics survey method with questionnaire including above all questions considering tobacco smoking, alcohol drinking and demographic issues. Results from questionnaires were analyzed using the statistical package STATISTICA 9.0 (Statsoft). The gathered data was statistically prepared using chi-square test, logistic regression model with stepwise and progressive regression. Based on results it was assumed that frequency of tobacco smoking in the studied group values 31.5%. More frequent smoke: men than women, people with high economic status and those evaluating their Heath state as a good one. Gender and material status are strong predictors of tobacco smoking among farmers. Age and level of education do not influence on tobacco smoking among studied farmers. Frequency of alcohol drinking in the studied group values 82.0%. More often drink alcohol: younger than older people, men than women, as well as people better educated. Heath self-assessment and wages do not have an influence on alcohol drinking among farmers.

Multi-Contrast Imaging and Digital Refocusing on a Mobile Microscope with a Domed LED Array

PubMed Central

Phillips, Zachary F.; D'Ambrosio, Michael V.; Tian, Lei; Rulison, Jared J.; Patel, Hurshal S.; Sadras, Nitin; Gande, Aditya V.; Switz, Neil A.; Fletcher, Daniel A.; Waller, Laura

2015-01-01

We demonstrate the design and application of an add-on device for improving the diagnostic and research capabilities of CellScope—a low-cost, smartphone-based point-of-care microscope. We replace the single LED illumination of the original CellScope with a programmable domed LED array. By leveraging recent advances in computational illumination, this new device enables simultaneous multi-contrast imaging with brightfield, darkfield, and phase imaging modes. Further, we scan through illumination angles to capture lightfield datasets, which can be used to recover 3D intensity and phase images without any hardware changes. This digital refocusing procedure can be used for either 3D imaging or software-only focus correction, reducing the need for precise mechanical focusing during field experiments. All acquisition and processing is performed on the mobile phone and controlled through a smartphone application, making the computational microscope compact and portable. Using multiple samples and different objective magnifications, we demonstrate that the performance of our device is comparable to that of a commercial microscope. This unique device platform extends the field imaging capabilities of CellScope, opening up new clinical and research possibilities. PMID:25969980

Low-cost Radon Reduction Pilot Study

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

Rose, William B.; Francisco, Paul W.; Merrin, Zachary

The U.S. Department of Energy's Building America research team Partnership for Advanced Residential Retrofits conducted a primary scoping study on the impact of air sealing between the foundation and the living space on radon transport reduction across the foundation and living space floor assembly. Fifteen homes in the Champaign, Illinois, area participated in the study. These homes were instrumented for hourly continuous radon measurements and simultaneous temperature and humidity measurements. Blower door and zone pressure diagnostics were conducted at each house. The treatments consisted of using air-sealing foams at the underside of the floor that separated the living space frommore » the foundation and providing duct sealing on the ductwork that is situated in the foundation area. The hypothesis was that air sealing the floor system that separated the foundation from the living space should better isolate the living space from the foundation; this isolation should lead to less radon entering the living space from the foundation. If the hypothesis had been proven, retrofit energy-efficiency programs may have chosen to adopt these isolation methods for enhanced radon protection to the living space.« less

RBANS Validity Indices: a Systematic Review and Meta-Analysis.

PubMed

Shura, Robert D; Brearly, Timothy W; Rowland, Jared A; Martindale, Sarah L; Miskey, Holly M; Duff, Kevin

2018-05-16

Neuropsychology practice organizations have highlighted the need for thorough evaluation of performance validity as part of the neuropsychological assessment process. Embedded validity indices are derived from existing measures and expand the scope of validity assessment. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is a brief instrument that quickly allows a clinician to assess a variety of cognitive domains. The RBANS also contains multiple embedded validity indicators. The purpose of this study was to synthesize the utility of those indicators to assess performance validity. A systematic search was completed, resulting in 11 studies for synthesis and 10 for meta-analysis. Data were synthesized on four indices and three subtests across samples of civilians, service members, and veterans. Sufficient data for meta-analysis were only available for the Effort Index, and related analyses indicated optimal cutoff scores of ≥1 (AUC = .86) and ≥ 3 (AUC = .85). However, outliers and heterogeneity were present indicating the importance of age and evaluation context. Overall, embedded validity indicators have shown adequate diagnostic accuracy across a variety of populations. Recommendations for interpreting these measures and future studies are provided.

The serum bank of EuroPrevall - the prevalence, cost and basis of food allergy across Europe.

PubMed

Vieths, Stefan; Reese, Gerald; Ballmer-Weber, Barbara K; Beyer, Kerstin; Burney, Peter; Fernandez-Rivas, Montserrat; Summers, Collin; Ree, Ronald van; Mills, Clare

2008-10-01

EuroPrevall is an EU-funded multidisciplinary project including 62 institutions from 22 countries. EuroPrevall studies the prevalence and distribution of food allergies in infants, children, adolescents, and adults in Europe, threshold doses for allergenic foods, the role of the environment in food allergy, the socioeconomic impact of food allergy, and novel diagnostic tools for food allergies. The EuroPrevall serum bank (EPASB), containing samples from approximately 70,000 subjects, is a major tool to achieve these goals. EPASB is coordinated by the Paul-Ehrlich-Institut, Langen, Germany. Local sera collections are administered at the University of Amsterdam (NL), the University Hospital of Manchester (UK), Charité Hospital (DE) and the Paul-Ehrlich-Institut. The EPASB coordinator and managing partners distribute samples for experimental work and regulate access. The overall aim is to provide sera to fulfil EuroPrevall research goals. The EPASB coordinator and managing partners suggest appropriate sera for addressing specific scientific and diagnostic questions. The serum bank will be maintained after termination of the project, but subsequent investigations must be in accordance with the original research goals of EuroPrevall. Thus, the contributors of the sera retain control over their future use. This rule prevents investigation of questions outside the scope of EuroPrevall, e.g. the allergenicity of genetically-modified foods.

Diagnosis of TIA (DOT) score--design and validation of a new clinical diagnostic tool for transient ischaemic attack.

PubMed

Dutta, Dipankar

2016-02-09

The diagnosis of Transient Ischaemic Attack (TIA) can be difficult and 50-60% of patients seen in TIA clinics turn out to be mimics. Many of these mimics have high ABCD2 scores and fill urgent TIA clinic slots inappropriately. A TIA diagnostic tool may help non-specialists make the diagnosis with greater accuracy and improve TIA clinic triage. The only available diagnostic score (Dawson et al) is limited in scope and not widely used. The Diagnosis of TIA (DOT) Score is a new and internally validated web and mobile app based diagnostic tool which encompasses both brain and retinal TIA. The score was derived retrospectively from a single centre TIA clinic database using stepwise logistic regression by backwards elimination to find the best model. An optimum cutpoint was obtained for the score. The derivation and validation cohorts were separate samples drawn from the years 2010/12 and 2013 respectively. Receiver Operating Characteristic (ROC) curves and area under the curve (AUC) were calculated and the diagnostic accuracy of DOT was compared to the Dawson score. A web and smartphone calculator were designed subsequently. The derivation cohort had 879 patients and the validation cohort 525. The final model had seventeen predictors and had an AUC of 0.91 (95% CI: 0.89-0.93). When tested on the validation cohort, the AUC for DOTS was 0.89 (0.86-0.92) while that of the Dawson score was 0.77 (0.73-0.81). The sensitivity and specificity of the DOT score were 89% (CI: 84%-93%) and 76% (70%-81%) respectively while those of the Dawson score were 83% (78%-88%) and 51% (45%-57%). Other diagnostic accuracy measures (DOT vs. Dawson) include positive predictive values (75% vs. 58%), negative predictive values (89% vs. 79%), positive likelihood ratios (3.67 vs. 1.70) and negative likelihood ratios (0.15 vs. 0.32). The DOT score shows promise as a diagnostic tool for TIA and requires independent external validation before it can be widely used. It could potentially improve the triage of patients assessed for suspected TIA.

Do relationships exist between the scope and intensity of quality improvement activities and hospital operation performance? A 10-year observation in Taiwan.

PubMed

Chung, Kuo-Piao; Yu, Tsung-Hsien

2015-08-14

The relationship between the scope and intensity of quality improvement (QI) activities and hospital performance remains unclear. This study investigated the relationship between performance, external environment, and the scope and intensity of QI activities in hospitals. The study used a longitudinal observation. Data regarding the scope and intensity of QI activities were collected using a questionnaire survey among the administrative deputy superintendents / directors of quality management center in 139 hospitals. Hospital performance indicators were abstracted from the 2000-2009 national hospitals profiles. We adopted year 2000 as the baseline, and divided the study period into three 3-year periods. The Generalized Estimating Equations (GEE) model was used for the statistical analysis. Seventy-two hospitals responded to the survey, giving a response rate of 52%. The results showed a significant increase in the scope and intensity of QI activities between 2000 and 2009. The results also showed that the scope and intensity of a hospital's QI activities were associated with the scope and intensity of its competitors' QI activities in the previous period and its own prior performance. The scope of QI activities in the previous period was not significantly related to the selected hospital performance measures. However, the intensity of QI activities in the previous period showed a significant and positive relationship with the number of inpatients and the turnover of beds. The study demonstrates that the intensity of QI activities is associated with the external environment and the hospital's own performance in the previous period. Furthermore, some performance measures are associated with the intensity of the QI activities in the previous period.

Automated and Autonomous Systems for Combat Service Support: Scoping Study and Technology Prioritisation

DTIC Science & Technology

2016-10-01

workshop, and use case development for automated and autonomous systems for CSS. The scoping study covers key concepts and trends, a technology scan, and...requirements and delimiters for the selected technologies. The report goes on to present detailed use cases for two technologies of interest: semi...selected use cases . As a result of the workshop, the large list of technologies and applications from the scoping study was narrowed down to the top

Using scoping as a design process

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

Mulvihill, P.R.; Jacobs, P.

1998-07-01

Skillful use of the scoping phase of environment assessment (EA) is critical in cases involving a wide diversity of stakeholders and perspectives. Scoping can exert a strong influence in shaping a relevant impact assessment and increasing the probability of a process that satisfies stakeholders. This article explores key challenges facing scoping processes conducted in highly pluralistic settings. Elements of a notable case study--the scoping process conducted in 1992 for the proposed Great Whale Hydroelectric project in Northern Quebec--are discussed to illustrate innovative approaches. When used as a design process, scoping can ensure that EA reflects the different value sets andmore » cultures that are at play, particularly where diverse knowledge systems and ways of describing environmental components and impacts exist. As it sets the stage for subsequent steps in the EA process, scoping needs to be a sufficiently broad umbrella that accommodates diverse approaches to identifying, classifying, and assessing impacts.« less

Congenital rubella syndrome surveillance in Honduras.

PubMed

Molina, Ida Berenice; Mendoza, Lourdes Otilia; Palma, María Aparicia

2011-09-01

Congenital rubella syndrome (CRS) surveillance was established in Honduras to determine the scope of the problem and assess the impact of vaccination. Implementation of the surveillance system required the drafting of national CRS epidemiological surveillance guidelines, the development of a laboratory diagnostic method, and training of physicians, nurses, and microbiologists in the Honduran hospital network and social security system on CRS surveillance guidelines. Honduras' experience with the surveillance of other vaccine-preventable diseases facilitated the implementation of hospital-based CRS surveillance. The surveillance system operates in 23 of the 25 public hospitals that offer services to children and at 2 social security hospitals; the private sector has not been integrated into this system. Clinical and technical staff, including representatives from various disciplines such as pediatrics, neonatology, general medicine, epidemiology, nursing, and microbiology, participate in the hospital network, as well as follow up on cases in accordance with the standardized guidelines, depending on their areas of expertise. Implementation of the CRS surveillance system requires technical guidelines, laboratory diagnostic capacity, and trained multidisciplinary human resources for its systematization and operation.

Smart material platforms for miniaturized devices: implications in disease models and diagnostics.

PubMed

Verma, Ritika; Adhikary, Rishi Rajat; Banerjee, Rinti

2016-05-24

Smart materials are responsive to multiple stimuli like light, temperature, pH and redox reactions with specific changes in state. Various functionalities in miniaturised devices can be achieved through the application of "smart materials" that respond to changes in their surroundings. The change in state of the materials in the presence of a stimulus may be used for on demand alteration of flow patterns in devices, acting as microvalves, as scaffolds for cellular aggregation or as modalities for signal amplification. In this review, we discuss the concepts of smart trigger responsive materials and their applications in miniaturized devices both for organ-on-a-chip disease models and for point-of-care diagnostics. The emphasis is on leveraging the smartness of these materials for example, to allow on demand sample actuation, ion dependent spheroid models for cancer or light dependent contractility of muscle films for organ-on-a-chip applications. The review throws light on the current status, scope for technological enhancements, challenges for translation and future prospects of increased incorporation of smart materials as integral parts of miniaturized devices.

Bottlenecks in the diagnosis of hypochondriasis.

PubMed

Schmidt, A J

1994-01-01

This review deals with diagnostic problems in DSM-III-R hypochondriasis. A first category of problems is directly connected with the definition of hypochondriasis. The following topics are discussed: the distinction between hypochondriasis and hypochondriacal attitude, the personality aspects of hypochondriasis, and the role of medical findings in the diagnosis. This is followed by a discussion of problems as to the distinction between hypochondriasis and related disorders. This concerns the status of hypochondriasis as a primary or secondary disorder in depression and the relationship with anxiety disorders (especially panic disorder and obsessive-compulsive disorder [OCD]) and the somatization disorder. The DSM-III-R classification of hypochondriasis as a somatoform disorder is disputed. A third category of problems lies in the measurement of hypochondriasis. The scope and quality of the most frequently used questionnaires for measuring hypochondriasis are poor. In research, on the basis of a single questionnaire and without due consideration of medical findings, the diagnosis of hypochondriasis is applied too soon. Finally, it is briefly indicated that the lack of diagnostic clarity affects the way in which the patient is approached in clinical practice.

DIAGNOcam--a Near Infrared Digital Imaging Transillumination (NIDIT) technology.

PubMed

Abdelaziz, Marwa; Krejci, Ivo

2015-01-01

In developed countries, clinical manifestation of carious lesions is changing: instead of dentists being confronted with wide-open cavities, more and more hidden caries are seen. For a long time, the focus of the research community was on finding a method for the detection of carious lesions without the need for radiographs. The research on Digital Imaging Fiber-Optic Transillumination (DIFOTI) has been an active domain. The scope of the present article is to describe a novel technology for caries diagnostics based on Near Infrared Digital Imaging Transillumination (NIDIT), and to give first examples of its clinical indications. In addition, the coupling of NIDIT with a head-mounted retinal image display (RID) to improve clinical workflow is presented. The novel NIDIT technology was shown to be useful as a diagnostic tool in several indications, including mainly the detection of proximal caries and, less importantly, for occlusal caries, fissures, and secondary decay around amalgam and composite restorations. The coupling of this technology with a head-mounted retinal image system allows for its very efficient implementation into daily practice.

Research Domain Criteria versus DSM V: How does this debate affect attempts to model corticostriatal dysfunction in animals?

PubMed

Young, Jared W; Winstanley, Catharine A; Brady, Anne Marie; Hall, Frank Scott

2017-05-01

For decades, the nosology of mental illness has been based largely upon the descriptions in the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM). A recent challenge to the DSM approach to psychiatric nosology from the National Institute on Mental Health (USA) defines Research Domain Criteria (RDoC) as an alternative. For RDoC, psychiatric illnesses are not defined as discrete categories, but instead as specific behavioral dysfunctions irrespective of DSM diagnostic categories. This approach was driven by two primary weaknesses noted in the DSM: (1) the same symptoms occur in very different disease states; and (2) DSM criteria lack grounding in the underlying biological causes of mental illness. RDoC intends to ground psychiatric nosology in those underlying mechanisms. This review addresses the suitability of RDoC vs. DSM from the view of modeling mental illness in animals. A consideration of all types of psychiatric dysfunction is beyond the scope of this review, which will focus on models of conditions associated with frontostriatal dysfunction. Copyright © 2016. Published by Elsevier Ltd.

Endoscopic closure of duodenal perforations by using an over-the-scope clip: a randomized, controlled porcine study.

PubMed

von Renteln, Daniel; Rudolph, Hans-Ulrich; Schmidt, Arthur; Vassiliou, Melina C; Caca, Karel

2010-01-01

Duodenal perforations during diagnostic upper endoscopy are rare; however, when therapeutic techniques are performed, the reported incidence is as great as 2.8%. Surgical repair is usually mandated, but it is associated with significant morbidity and mortality. To compare closure of duodenal perforations by using an over-the-scope clip (OTSC) with a surgical closure. Randomized, controlled animal study. Animal facility laboratory. Domestic pigs (24 females). Large (10-mm) duodenal perforations were created by using an endoscopic needle-knife. The animals were randomly assigned to either open surgical repair (n=12) or endoscopic closure by using the OTSC system (n=12). Pressurized leak tests were performed during necropsy. One major bleed occurred because of a liver injury during creation of the duodenotomy. Mean time for endoscopic closure was 5 minutes (range, 3-8 min; SD +/- 2). No complications occurred during any of the closure procedures. At necropsy, all OTSC and surgical closures demonstrated complete sealing of duodenotomy sites. Pressurized leak tests demonstrated a mean burst pressure of 166 mm Hg (range, 80-260; SD +/- 65) for OTSC closures and 143 mm Hg (range, 30-300, SD +/- 83) for surgical sutures. Ex vivo intact duodenal specimens exhibited a mean burst pressure of 247 mm Hg (range, 200-300; SD +/- 35), which was significantly higher compared with in vivo OTSC and surgical closures (P < .01). There were no significant differences between burst pressures of OTSC and surgical closures (P = .461). Nonsurvival setting. Endoscopic closure of duodenal perforations by using the OTSC system is comparable with surgical closure in a nonsurvival porcine model. This technique is easy to perform and seems suitable for repairing duodenal perforations. 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

A randomised controlled trial comparing a dilating vaginal speculum with a conventional bivalve speculum.

PubMed

Thomas, A; Weisberg, E; Lieberman, D; Fraser, I S

2001-11-01

Cervical smears are traditionally taken with the aid of a metal or disposable plastic bivalve speculum. Many women complain of discomfort with these specula. This study compares the efficacy and women's experiences of a new 'dilating speculum' called the Veda-scope, with a conventional metal bivalve speculum (Pederson). The aims of this study were: to determine whether the Veda-scope provides adequate visualisation of the cervix and vaginal walls and an adequate cervical cytology specimen; and to compare user acceptability and women's levels of comfort between the Veda-scope and the bivalve speculum. Sixty-four women were randomised to be examined with the Veda-scope and 60 with the bivalve speculum, by one of two operators. Each woman completed a questionnaire that included subjective views of their previous cervical smear experiences, and acceptability of the examination at the study consultation. Cytologists were blinded as to which speculum was used for cervical sampling. Of women examined, 7-83% of women found Veda-scope examinations comfortable, compared to 38-62% of women who found examinations with the bivalve comfortable; 94% of the women preferred the 'comfort' of the Veda-scope. The Veda-scope was as good as the bivalve speculum in providing samples for cytological analysis following the initial learning curve, and also provided markedly superior magnified views of the cervix and vaginal fornices.

Disorders Related to Use of Psychoactive Substances in DSM-5: Changes and Challenges.

PubMed

Bhad, Roshan; Lal, Rakesh; Balhara, Yatan Pal Singh

2015-01-01

In the most recent edition of Diagnostic and Statistical Manual (DSM) that is DSM-5 many modifications have been made in substance use disorder section. These include changes in terminology; sections and categories; diagnostic criteria; threshold for diagnosis; severity; and specifier. Additionally, there have been certain additions and omissions from the earlier version. Critical evaluation of the changes made to the section on disorders related to use of psychoactive substances in India context has not been published so far. The current paper presents a critique of the changes made to the substance use disorder section in DSM-5. The rationale for these changes put forth by DSM-5 work group on substance related disorders have been discussed. Additionally, attempt has been made to highlight the possible future challenges consequent to the current nosological revision for substance use disorder category. Overall DSM-5 seems to be promising in fulfilling its goal of DSM-ICD harmonisation and movement towards an internationally compatible and practical diagnostic system for mental health disorders. It has increased the scope of addiction by inclusion of behavioural addiction. It has also tried to balance the categorical and dimensional approach to diagnosis. However, the real test of this newer edition of one of the most commonly used nosological systems will be during clinical care and research. This will help address the debatable issues regarding the changes that DSM-5 brings with it.

Algorithms for Image Analysis and Combination of Pattern Classifiers with Application to Medical Diagnosis

NASA Astrophysics Data System (ADS)

Georgiou, Harris

2009-10-01

Medical Informatics and the application of modern signal processing in the assistance of the diagnostic process in medical imaging is one of the more recent and active research areas today. This thesis addresses a variety of issues related to the general problem of medical image analysis, specifically in mammography, and presents a series of algorithms and design approaches for all the intermediate levels of a modern system for computer-aided diagnosis (CAD). The diagnostic problem is analyzed with a systematic approach, first defining the imaging characteristics and features that are relevant to probable pathology in mammo-grams. Next, these features are quantified and fused into new, integrated radio-logical systems that exhibit embedded digital signal processing, in order to improve the final result and minimize the radiological dose for the patient. In a higher level, special algorithms are designed for detecting and encoding these clinically interest-ing imaging features, in order to be used as input to advanced pattern classifiers and machine learning models. Finally, these approaches are extended in multi-classifier models under the scope of Game Theory and optimum collective deci-sion, in order to produce efficient solutions for combining classifiers with minimum computational costs for advanced diagnostic systems. The material covered in this thesis is related to a total of 18 published papers, 6 in scientific journals and 12 in international conferences.

Nailfold Capillaroscopy Within and Beyond the Scope of Connective Tissue Diseases.

PubMed

Lambova, Sevdalina Nikolova; Muller-Ladner, Ulf

2018-04-20

Nailfold capillaroscopy is a noninvasive instrumental method for morphological analysis of the nutritive capillaries in the nailfold area. In rheumatology, it is a method of choice among instrumental modalities for differential diagnosis between primary and secondary Raynaud's phenomenon (RP) in systemic rheumatic diseases. RP is a common diagnostic problem in rheumatology. Defining the proper diagnosis is a prerequisite for administration of the appropriate treatment. Thus, nailfold capillaroscopic examination is of crucial importance for the every-day practice of the rheumatologists and is currently gaining increasing attention. The most specific capillaroscopic changes are observed in Systemic Sclerosis (SSc). Due to the high prevalence of the capillaroscopic changes in this clinical entity and their early appearance, they could be used for early and very early diagnosis of the disease. More recently, "scleroderma" type capillaroscopic changes have been defined as diagnostic criterion in the new EULAR/ACR classification criteria for SSc together with the presence of scleroderma-related autoantibodies, RP, telangiectasia and other clinical signs. Capillaroscopic changes in other connective tissue diseases and in different rheumatic-like conditions like those in diabetes mellitus (e.g., diabetic stiff-hand syndrome) and paraneoplastic syndromes associated with microvascular pathology should be interpreted properly in order to obtain precise diagnosis in the shortest possible differential diagnostic process. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

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.

Handbook of Machine Olfaction: Electronic Nose Technology

NASA Astrophysics Data System (ADS)

Pearce, Tim C.; Schiffman, Susan S.; Nagle, H. Troy; Gardner, Julian W.

2003-02-01

"Electronic noses" are instruments which mimic the sense of smell. Consisting of olfactory sensors and a suitable signal processing unit, they are able to detect and distinguish odors precisely and at low cost. This makes them very useful for a remarkable variety of applications in the food and pharmaceutical industry, in environmental control or clinical diagnostics and more. The scope covers biological and technical fundamentals and up-to-date research. Contributions by renowned international scientists as well as application-oriented news from successful "e-nose" manufacturers give a well-rounded account of the topic, and this coverage from R&D to applications makes this book a must-have read for e-nose researchers, designers and users alike.

40 CFR 716.1 - Scope and compliance.

Code of Federal Regulations, 2012 CFR

2012-07-01

... ACT HEALTH AND SAFETY DATA REPORTING General Provisions § 716.1 Scope and compliance. (a) This subpart sets forth requirements for the submission of lists and copies of health and safety studies on chemical... 40 Protection of Environment 32 2012-07-01 2012-07-01 false Scope and compliance. 716.1 Section...

40 CFR 716.1 - Scope and compliance.

Code of Federal Regulations, 2014 CFR

2014-07-01

... ACT HEALTH AND SAFETY DATA REPORTING General Provisions § 716.1 Scope and compliance. (a) This subpart sets forth requirements for the submission of lists and copies of health and safety studies on chemical... 40 Protection of Environment 31 2014-07-01 2014-07-01 false Scope and compliance. 716.1 Section...

40 CFR 716.1 - Scope and compliance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... ACT HEALTH AND SAFETY DATA REPORTING General Provisions § 716.1 Scope and compliance. (a) This subpart sets forth requirements for the submission of lists and copies of health and safety studies on chemical... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Scope and compliance. 716.1 Section...

40 CFR 716.1 - Scope and compliance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... ACT HEALTH AND SAFETY DATA REPORTING General Provisions § 716.1 Scope and compliance. (a) This subpart sets forth requirements for the submission of lists and copies of health and safety studies on chemical... 40 Protection of Environment 31 2011-07-01 2011-07-01 false Scope and compliance. 716.1 Section...

40 CFR 716.1 - Scope and compliance.

Code of Federal Regulations, 2013 CFR

2013-07-01

... ACT HEALTH AND SAFETY DATA REPORTING General Provisions § 716.1 Scope and compliance. (a) This subpart sets forth requirements for the submission of lists and copies of health and safety studies on chemical... 40 Protection of Environment 32 2013-07-01 2013-07-01 false Scope and compliance. 716.1 Section...

10 CFR 602.1 - Purpose and scope.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Purpose and scope. 602.1 Section 602.1 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS EPIDEMIOLOGY AND OTHER HEALTH STUDIES FINANCIAL ASSISTANCE PROGRAM § 602.1 Purpose and scope. This part sets forth the policies and procedures applicable to...

10 CFR 602.1 - Purpose and scope.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 4 2013-01-01 2013-01-01 false Purpose and scope. 602.1 Section 602.1 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS EPIDEMIOLOGY AND OTHER HEALTH STUDIES FINANCIAL ASSISTANCE PROGRAM § 602.1 Purpose and scope. This part sets forth the policies and procedures applicable to...

10 CFR 602.1 - Purpose and scope.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 4 2014-01-01 2014-01-01 false Purpose and scope. 602.1 Section 602.1 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS EPIDEMIOLOGY AND OTHER HEALTH STUDIES FINANCIAL ASSISTANCE PROGRAM § 602.1 Purpose and scope. This part sets forth the policies and procedures applicable to...

10 CFR 602.1 - Purpose and scope.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Purpose and scope. 602.1 Section 602.1 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS EPIDEMIOLOGY AND OTHER HEALTH STUDIES FINANCIAL ASSISTANCE PROGRAM § 602.1 Purpose and scope. This part sets forth the policies and procedures applicable to...

10 CFR 602.1 - Purpose and scope.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Purpose and scope. 602.1 Section 602.1 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS EPIDEMIOLOGY AND OTHER HEALTH STUDIES FINANCIAL ASSISTANCE PROGRAM § 602.1 Purpose and scope. This part sets forth the policies and procedures applicable to...

The Schistosomiasis Clinical Trials Landscape: A Systematic Review of Antischistosomal Treatment Efficacy Studies and a Case for Sharing Individual Participant-Level Data (IPD)

PubMed Central

Vaillant, Michel; Lang, Trudie A.; Guérin, Philippe J.; Olliaro, Piero L.

2016-01-01

Background Schistosomiasis control mainly relies on preventive chemotherapy with praziquantel (PZQ) distributed through mass drug administration. With a target of 260 million treatments yearly, reliably assessing and monitoring efficacy is all-important. Recommendations for treatment and control of schistosomiasis are supported by systematic reviews and meta-analyses of aggregated data, which however also point to limitations due to heterogeneity in trial design, analyses and reporting. Some such limitations could be corrected through access to individual participant-level data (IPD), which facilitates standardised analyses. Methodology A systematic literature review was conducted to identify antischistosomal drug efficacy studies performed since 2000; including electronic searches of the Cochrane Infectious Diseases Group specialised register and the Cochrane Library, PubMed, CENTRAL and Embase; complemented with a manual search for articles listed in past reviews. Antischistosomal treatment studies with assessment of outcome within 60 days post-treatment were eligible. Meta-data, i.e. study-level characteristics (Schistosoma species, number of patients, drug administered, country, etc.) and efficacy parameters were extracted from published documents to evaluate the scope of an individual-level data sharing platform. Principal findings Out of 914 documents screened, 90 studies from 26 countries were included, enrolling 20,517 participants infected with Schistosoma spp. and treated with different PZQ regimens or other drugs. Methodologies varied in terms of diagnostic approaches (number of samples and test repeats), time of outcome assessment, and outcome measure (cure rate or egg reduction rate, as an arithmetic or geometric mean), making direct comparison of published data difficult. Conclusions This review describes the landscape of schistosomiasis clinical research. The volume of data and the methodological and reporting heterogeneity identified all indicate that there is scope for an individual participant-level database, to allow for standardised analyses. PMID:27347678

The Role of Ultrasound Compared to Biopsy of Temporal Arteries in the Diagnosis and Treatment of Giant Cell Arteritis (TABUL): a diagnostic accuracy and cost-effectiveness study.

PubMed

Luqmani, Raashid; Lee, Ellen; Singh, Surjeet; Gillett, Mike; Schmidt, Wolfgang A; Bradburn, Mike; Dasgupta, Bhaskar; Diamantopoulos, Andreas P; Forrester-Barker, Wulf; Hamilton, William; Masters, Shauna; McDonald, Brendan; McNally, Eugene; Pease, Colin; Piper, Jennifer; Salmon, John; Wailoo, Allan; Wolfe, Konrad; Hutchings, Andrew

2016-11-01

Giant cell arteritis (GCA) is a relatively common form of primary systemic vasculitis, which, if left untreated, can lead to permanent sight loss. We compared ultrasound as an alternative diagnostic test with temporal artery biopsy, which may be negative in 9-61% of true cases. To compare the clinical effectiveness and cost-effectiveness of ultrasound with biopsy in diagnosing patients with suspected GCA. Prospective multicentre cohort study. Secondary care. A total of 381 patients referred with newly suspected GCA. Sensitivity, specificity and cost-effectiveness of ultrasound compared with biopsy or ultrasound combined with biopsy for diagnosing GCA and interobserver reliability in interpreting scan or biopsy findings. We developed and implemented an ultrasound training programme for diagnosing suspected GCA. We recruited 430 patients with suspected GCA. We analysed 381 patients who underwent both ultrasound and biopsy within 10 days of starting treatment for suspected GCA and who attended a follow-up assessment (median age 71.1 years; 72% female). The sensitivity of biopsy was 39% [95% confidence interval (CI) 33% to 46%], which was significantly lower than previously reported and inferior to ultrasound (54%, 95% CI 48% to 60%); the specificity of biopsy (100%, 95% CI 97% to 100%) was superior to ultrasound (81%, 95% CI 73% to 88%). If we scanned all suspected patients and performed biopsies only on negative cases, sensitivity increased to 65% and specificity was maintained at 81%, reducing the need for biopsies by 43%. Strategies combining clinical judgement (clinician's assessment at 2 weeks) with the tests showed sensitivity and specificity of 91% and 81%, respectively, for biopsy and 93% and 77%, respectively, for ultrasound; cost-effectiveness (incremental net monetary benefit) was £485 per patient in favour of ultrasound with both cost savings and a small health gain. Inter-rater analysis revealed moderate agreement among sonographers (intraclass correlation coefficient 0.61, 95% CI 0.48 to 0.75), similar to pathologists (0.62, 95% CI 0.49 to 0.76). There is no independent gold standard diagnosis for GCA. The reference diagnosis used to determine accuracy was based on classification criteria for GCA that include clinical features at presentation and biopsy results. We have demonstrated the feasibility of providing training in ultrasound for the diagnosis of GCA. Our results indicate better sensitivity but poorer specificity of ultrasound compared with biopsy and suggest some scope for reducing the role of biopsy. The moderate interobserver agreement for both ultrasound and biopsy indicates scope for improving assessment and reporting of test results and challenges the assumption that a positive biopsy always represents GCA. Further research should address the issue of an independent reference diagnosis, standards for interpreting and reporting test results and the evaluation of ultrasound training, and should also explore the acceptability of these new diagnostic strategies in GCA. The National Institute for Health Research Health Technology Assessment programme.

Methods for Aiding Height Determination in Pseudolite-Based Reference Systems Using Batch Least-Squares Estimation

DTIC Science & Technology

2006-03-01

LocataLite Test Examples. LocataLites have been used in several experimental trials as pilot studies of the system. 1.7.5.1 BlueScope Steel. In this pilot...study, [2], the Locata system is shown to give centimeter level relative positioning precision in a severe multipath en- vironment. The BlueScope ...Using Locata: A pilot study at BlueScope Steel.” Proceedings of the 2004 Annual Meeting of the U.S. Institute of Navigation. Dayton, OH, June 2004. 3

Clinical application of a novel diagnostic scheme including pancreatic β‑cell dysfunction for traumatic multiple organ dysfunction syndrome.

PubMed

Wang, Zhan-Ke; Chen, Rong-Jian; Wang, Shi-Liang; Li, Guang-Wei; Zhu, Zhong-Zhen; Huang, Qiang; Chen, Zi-Li; Chen, Fan-Chang; Deng, Lei; Lan, Xiao-Peng; Hu, Tian

2018-01-01

A novel diagnostic scheme that includes pancreatic β‑cell dysfunction analysis for the diagnosis of traumatic multiple organ dysfunction syndrome (MODS) was investigated to assist in the early diagnosis and detection of MODS. Early intervention and treatment of MODS has been associated with a reduced mortality rate. A total of 2,876 trauma patients (including patients post‑major surgery) were admitted to the intensive care unit of the authors' hospital between December 2010 and December 2015 and enrolled in the present study. There were 205 cases where the patient succumbed to their injuries. In addition to the conventional diagnostic scheme for traumatic MODS, indexes of pancreatic β‑cell dysfunction [fasting blood‑glucose (FBG), homeostatic model assessment‑β and (blood insulin concentration 30 min following glucose loading‑fasting insulin concentration)/(blood glucose concentration 30 min following glucose loading‑FBG concentration)] were included to establish an improved diagnostic scheme for traumatic MODS. The novel scheme was subsequently used in clinical practice alongside the conventional scheme and its effect was evaluated. The novel scheme had a significantly higher positive number of MODS diagnoses for all trauma patients compared with the conventional scheme (12.48 vs. 8.87%; P<0.01). No significant difference was identified in the final percentage of positive of MODS diagnoses for trauma‑associated mortality patients between the novel (88.30%) and the conventional scheme (86.34%). The novel scheme had a significantly higher positive number of MODS diagnoses for trauma‑associated mortality patients 3 days prior to patients succumbing to MODS compared with the conventional scheme (80.98 vs. 64.39%; P<0.01). The consensus of the MODS diagnosis of all trauma patients between the novel scheme and the conventional scheme was 100%; however, out of the patients diagnosed as positive by novel scheme 71.03% were positive by the conventional scheme. The consensus between the final MODS diagnosis and the MODS diagnosis 3 days prior to patients succumbing to their injuries between the novel scheme and the conventional scheme was 100%; however, out of the patients diagnosed as positive by novel scheme 97.79 were positive by the conventional scheme of the 205 patients who succumbed to MODS and out of the patients diagnosed as positive for MODS by novel scheme 3 days prior to succumbing, 79.52% were positive by the conventional scheme. The results of the present study demonstrated that the novel diagnostic scheme using the relevant indexes of pancreatic β‑cell dysfunction for diagnosis of traumatic MODS, was able to diagnose MODS early without excessively extending the diagnostic scope. Its clinical application should be promoted.

Building a Consensus on Community Health Workers’ Scope of Practice: Lessons From New York

PubMed Central

Matos, Sergio; Hicks, April L.; Campbell, Ayanna; Moore, Addison; Diaz, Diurka

2012-01-01

Objectives. We evaluated efforts in New York to build a consensus between community health workers (CHWs) and employers on CHWs’ scope of practice, training standards, and certification procedures. Methods. We conducted multiple-choice surveys in 2008 and 2010 with 226 CHWs and 44 employers. We compared CHWs’ and employers’ recommendations regarding 28 scope of practice elements. The participatory ranking method was used to identify consensus scope of practice recommendations. Results. There was consensus on 5 scope of practice elements: outreach and community organizing, case management and care coordination, home visits, health education and coaching, and system navigation. For each element, 3 to 4 essential skills were identified, giving a total of 27 skills. These included all skills recommended in national CHW studies, along with 3 unique to New York: computer skills, participatory research methods, and time management. Conclusions. CHWs and employers in New York were in consensus on CHWs’ scope of practice on virtually all of the detailed core competency skills. The CHW scope of practice recommendations of these groups can help other states refine their scope of practice elements. PMID:22897548

Scope Notes for LISA Subject Headings.

ERIC Educational Resources Information Center

Browne, Glenda

1992-01-01

Reports on a study that examined scope notes added to subject headings in the Library and Information Science Abstracts (LISA) Online User Manual. Types of messages conveyed by scope notes and word patterns within the notes are identified, and comparisons between the 1982 and 1987 editions of the manual are made. (16 references) (MES)

21 CFR 312.81 - Scope.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 5 2011-04-01 2011-04-01 false Scope. 312.81 Section 312.81 Food and Drugs FOOD... § 312.81 Scope. This section applies to new drug and biological products that are being studied for... likelihood of death is high unless the course of the disease is interrupted; and (2) Diseases or conditions...

21 CFR 312.81 - Scope.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Scope. 312.81 Section 312.81 Food and Drugs FOOD... § 312.81 Scope. This section applies to new drug and biological products that are being studied for... likelihood of death is high unless the course of the disease is interrupted; and (2) Diseases or conditions...

Diagnostic needle arthroscopy and the economics of improved diagnostic accuracy: a cost analysis.

PubMed

Voigt, Jeffrey D; Mosier, Michael; Huber, Bryan

2014-10-01

Hundreds of thousands of surgical arthroscopy procedures are performed annually in the United States (US) based on MRI findings. There are situations where these MRI findings are equivocal or indeterminate and because of this clinicians commonly perform the arthroscopy in order not to miss pathology. Recently, a less invasive needle arthroscopy system has been introduced that is commonly performed in the physician office setting and that may help improve the accuracy of diagnostic findings. This in turn may prevent unnecessary follow-on arthroscopy procedures from being performed. The purpose of this analysis is to determine whether the in-office diagnostic needle arthroscopy system can provide cost savings by reducing unnecessary follow on arthroscopy procedures. Data obtained from a recent trial and from a systematic review were used in comparing the accuracy of MRI and VisionScope needle arthroscopy (VSI) with standard arthroscopy (gold standard). The resultant false positive and false negative findings were then used to evaluate the costs of follow-on procedures. These differences were then modeled for the US patient population diagnosed and treated for meniscal knee pathology (most common disorder) to determine if a technology such as VSI could save the US healthcare system money. Data on surgical arthroscopy procedures in the US for meniscal knee pathology were used (calendar year [CY] 2010). The costs of performing diagnostic and surgical arthroscopy procedures (using CY 2013 Medicare reimbursement amounts), costs associated with false negative findings, and the costs for treating associated complications arising from diagnostic and therapeutic arthroscopy procedures were assessed. In patients presenting with medial meniscal pathology (International Classification of Diseases, 9th edition, Clinical Modification [ICD9CM] diagnosis 836.0), VSI in place of MRI (standard of care) resulted in a net cost savings to the US system of US$115-US$177 million (CY 2013) (use of systematic review and study data, respectively). In patients presenting with lateral meniscus pathology (ICD9CM 836.1), VSI in place of MRI cost the healthcare system an additional US$14-US$97 million (CY 2013). Overall aggregate savings for meniscal (lateral plus medial) pathology were identified in representative care models along with more appropriate care as fewer patients were exposed to higher risk surgical procedures. Since in-office arthroscopy is significantly more accurate, patients can be treated more appropriately and the US healthcare system can save money, most especially in medial meniscal pathology.

Rate of new findings in diagnostic office bronchoscopy.

PubMed

Soldatova, Liuba; DeSilva, Brad W; Matrka, Laura A

2017-06-01

Awake Flexible Tracheobronchoscopy (FTB) is an alternative to rigid bronchoscopy or sedated flexible bronchoscopy and allows an awake examination of the tracheobronchial tree. We hypothesized that the ability to perform office bronchoscopy as the need arises during a clinic visit would lead to a high rate of previously undiagnosed and clinically relevant findings. This study reports the rate and nature of such findings for this procedure at our institution. Retrospective chart review. The records of 127 adult patients evaluated at the voice and swallowing disorders clinic between June of 2012 and January of 2015 were reviewed. New findings were defined as new pathology visualized during FTB exam that was not previously diagnosed by means of other diagnostic modalities. A total of 233 scope procedures (84 transnasal bronchoscopies and 149 tracheoscopies) were reviewed, 232 of which were completed and one of which was incomplete due to severe subglottic stenosis. New, clinically relevant findings were seen in 57% of transnasal bronchoscopies (48 of 84) and 21% of tracheoscopies (32 of 149). All of these findings provided additional information directing workup or resulted in a change in patient management. Office-based evaluation of the tracheobronchial tree yields a high rate of new findings. In our study, office bronchoscopy had a 57% rate of new findings and was performed without complications. The utility of tracheoscopy was also apparent in its ability to quickly and safely examine the trachea, with a 21% rate of new findings. 4. Laryngoscope, 127:1376-1380, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Eastern Washington Intermodal Transportation Study Scope of Work

DOT National Transportation Integrated Search

1993-02-04

This document presents a detailed Scope of Work to guide implementation of : the Eastern Washington Intermodal Transportation Study. Included is a : description of project management and staff responsibilities, a detailed work : plan and timetable fo...

The sweet and sour of serological glycoprotein tumor biomarker quantification

PubMed Central

2013-01-01

Aberrant and dysregulated protein glycosylation is a well-established event in the process of oncogenesis and cancer progression. Years of study on the glycobiology of cancer have been focused on the development of clinically viable diagnostic applications of this knowledge. However, for a number of reasons, there has been only sparse and varied success. The causes of this range from technical to biological issues that arise when studying protein glycosylation and attempting to apply it to practical applications. This review focuses on the pitfalls, advances, and future directions to be taken in the development of clinically applicable quantitative assays using glycan moieties from serum-based proteins as analytes. Topics covered include the development and progress of applications of lectins, mass spectrometry, and other technologies towards this purpose. Slowly but surely, novel applications of established and development of new technologies will eventually provide us with the tools to reach the ultimate goal of quantification of the full scope of heterogeneity associated with the glycosylation of biomarker candidate glycoproteins in a clinically applicable fashion. PMID:23390961

Basic physiological systems indicator's informative assessment for children and adolescents obesity diagnosis tasks

NASA Astrophysics Data System (ADS)

Marukhina, O. V.; Berestneva, O. G.; Emelyanova, Yu A.; Romanchukov, S. V.; Petrova, L.; Lombardo, C.; Kozlova, N. V.

2018-05-01

The healthcare computerization creates opportunities to the clinical decision support system development. In the course of diagnosis, doctor manipulates a considerable amount of data and makes a decision in the context of uncertainty basing upon the first-hand experience and knowledge. The situation is exacerbated by the fact that the knowledge scope in medicine is incrementally growing, but the decision-making time does not increase. The amount of medical malpractice is growing and it leads to various negative effects, even the mortality rate increase. IT-solution's development for clinical purposes is one of the most promising and efficient ways to prevent these effects. That is why the efforts of many IT specialists are directed to the doctor's heuristics simulating software or expert-based medical decision-making algorithms development. Thus, the objective of this study is to develop techniques and approaches for the body physiological system's informative value assessment index for the obesity degree evaluation based on the diagnostic findings.

Extending the Scope of 19F Hyperpolarization through Signal Amplification by Reversible Exchange in MRI and NMR Spectroscopy

PubMed Central

Olaru, Alexandra M.; Robertson, Thomas B. R.; Lewis, Jennifer S.; Antony, Alex; Iali, Wissam

2017-01-01

Abstract Fluorinated ligands have a variety of uses in chemistry and industry, but it is their medical applications as 18F‐labelled positron emission tomography (PET) tracers where they are most visible. In this work, we illustrate the potential of using 19F‐containing ligands as future magnetic resonance imaging (MRI) contrast agents and as probes in magnetic resonance spectroscopy studies by significantly increasing their magnetic resonance detectability through the signal amplification by reversible exchange (SABRE) hyperpolarization method. We achieve 19F SABRE polarization in a wide range of molecules, including those essential to medication, and analyze how their steric bulk, the substrate loading, polarization transfer field, pH, and rate of ligand exchange impact the efficiency of SABRE. We conclude by presenting 19F MRI results in phantoms, which demonstrate that many of these agents show great promise as future 19F MRI contrast agents for diagnostic investigations. PMID:29318102

Neurologic Evaluation and Management of Perioperative Nerve Injury.

PubMed

Watson, James C; Huntoon, Marc A

2015-01-01

Neurologic injury after regional anesthesia or pain medicine procedures is rare. Postprocedural neurologic deficits may create high levels of anxiety for the patient and practitioner, although most deficits are limited in severity and can be expected to fully resolve with time. Postoperative anesthesia-related neuraxial and peripheral nerve injuries are reviewed to define an efficient, structured approach to these complications. Emphasis is placed on acutely stratifying the urgency and scope of diagnostic testing or consultation necessity, initiating appropriate definitive treatments, and defining appropriate out-of-hospital follow-up and symptom management. Studies pertinent to the recognition, evaluation, and treatment of neurologic assessment of perioperative nerve injury and published since the last advisory on the topic are reviewed and a new structured algorithmic approach is proposed. The evolving literature on postoperative inflammatory neuropathies is reviewed to help define the clinical criteria and to identify patients who would benefit from early neurological evaluation. New sections review potential acute interventions to improve neurologic outcome and long-term management of neuropathic pain resulting from perioperative nerve injury.

“Test and not treat” for onchocerciasis control in a Loa loa endemic area

PubMed Central

Kamgno, Joseph; Pion, Sébastien D.; Chesnais, Cédric B.; Bakalar, Matthew H.; D'Ambrosio, Michael V.; Mackenzie, Charles D.; Nana-Djeunga, Hugues C.; Gounoue-Kamkumo, Raceline; Njitchouang, Guy-Roger; Nwane, Philippe; Tchatchueng-Mbouga, Jules B.; Wanji, Samuel; Stolk, Wilma A.; Fletcher, Daniel A.; Klion, Amy D.; Nutman, Thomas B.; Boussinesq, Michel

2017-01-01

Background Implementation of ivermectin-based community treatment for onchocerciasis or lymphatic filariasis elimination has been delayed in Central Africa because of severe adverse events (SAEs), including death, in people with high levels of circulating Loa loa microfilariae (mf). LoaScope, a rapid field-friendly diagnostic tool to quantify L. loa mf in peripheral blood, permits point-of-care identification of individuals “at risk” for SAEs. Methods A “Test and not Treat” (TaNT) strategy was used to implement ivermectin treatment in the Okola health district in Cameroon, where ivermectin distribution was halted in 1999 after the occurrence of fatal Loa-related SAEs. The LoaScope was used to identify and exclude individuals with >20,000 mf per milliliter of blood (at-risk for SAEs) from ivermectin treatment. Active surveillance for post-treatment adverse events (AEs) was conducted daily for 7 days. Results Between August and October 2015, 16,259 (71.1%) individuals >=5 years of age were tested out of a target population of ~22,800. Among the ivermectin-eligible population, 15,522 (95.5%) received ivermectin; 340 (2.1%) were excluded from ivermectin treatment because of a L. loa density above the risk-threshold and 397 (2.4%) were excluded for pregnancy or illness. No SAEs were observed. Non-severe AEs were recorded in 934 individuals, most (67%) of whom had no detectable L. loa mf. Conclusions The LoaScope-based TaNT strategy permitted safe re-implementation of community-wide ivermectin distribution in a heretofore ‘off limits’ health district in Cameroon and is an extremely promising and practical approach for large-scale ivermectin treatment for lymphatic filariasis and onchocerciasis elimination in Loa loa-endemic areas. PMID:29116890

EarthScope National Office Education and Outreach Program: 2013 Update on Activities and Outcomes

NASA Astrophysics Data System (ADS)

Semken, S. C.; Robinson, S.; Bohon, W.; Schwab, P.; Arrowsmith, R.; Garnero, E. J.; Fouch, M. J.; Pettis, L.; Baumback, D.; Dick, C.

2013-12-01

The EarthScope Program (www.earthscope.org) funded by the National Science Foundation, fosters interdisciplinary exploration of the geologic structure and evolution of the North American continent by means of seismology, geodesy, magnetotellurics, in-situ fault-zone sampling, geochronology, and high-resolution topographic measurements. Data and findings from EarthScope continue to transform geoscientific studies throughout the Earth, enhance understanding and mitigation of hazards, and inform applications of geoscience toward environmental sustainability. The EarthScope Program also marshals significant resources and opportunities for education and outreach (E&O) in the Earth system sciences. The EarthScope National Office (ESNO) at Arizona State University serves all EarthScope stakeholders, including the EarthScope Steering Committee, researchers, educators, students, and the general public. ESNO supports and promotes E&O through social media and web-hosted resources, newsletters and published articles, E&O workshops for informal educators (interpreters), assistance to grassroots K-12 STEM teacher professional development projects (typically led by EarthScope researchers), continuing education for researchers, collaborations with other Earth-science E&O providers, and biannual national conferences. The EarthScope E&O program at ESNO leads and supports wide dissemination of the data, findings, and legacy of EarthScope. Notable activities in 2013 include expansion of social-media and web-based content, two Interpretive Workshops in the eastern United States, the Great ShakeOut, the EarthScope National Meeting in Raleigh, and continuing partnerships with affiliated E&O providers. The EarthScope National Office is supported by the National Science Foundation under grants EAR-1101100 and EAR-1216301. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the National Science Foundation.

Use of mathematical modelling to assess the impact of vaccines on antibiotic resistance.

PubMed

Atkins, Katherine E; Lafferty, Erin I; Deeny, Sarah R; Davies, Nicholas G; Robotham, Julie V; Jit, Mark

2018-06-01

Antibiotic resistance is a major global threat to the provision of safe and effective health care. To control antibiotic resistance, vaccines have been proposed as an essential intervention, complementing improvements in diagnostic testing, antibiotic stewardship, and drug pipelines. The decision to introduce or amend vaccination programmes is routinely based on mathematical modelling. However, few mathematical models address the impact of vaccination on antibiotic resistance. We reviewed the literature using PubMed to identify all studies that used an original mathematical model to quantify the impact of a vaccine on antibiotic resistance transmission within a human population. We reviewed the models from the resulting studies in the context of a new framework to elucidate the pathways through which vaccination might impact antibiotic resistance. We identified eight mathematical modelling studies; the state of the literature highlighted important gaps in our understanding. Notably, studies are limited in the range of pathways represented, their geographical scope, and the vaccine-pathogen combinations assessed. Furthermore, to translate model predictions into public health decision making, more work is needed to understand how model structure and parameterisation affects model predictions and how to embed these predictions within economic frameworks. Copyright © 2018 Elsevier Ltd. All rights reserved.

Defining the Scope of Your Evaluation

ERIC Educational Resources Information Center

Wood, Elizabeth

2015-01-01

One challenge of conducting evaluations is finding the right questions to guide the work. A clear purpose for a study gives the evaluator a good sense of what information can answer the questions, and helps frame the scope of the project as a whole. Knowing the scope of the evaluation project provides a sense of the resources needed. A common…

Scoping study for a national strategic plan for transportation information management

DOT National Transportation Integrated Search

2003-06-01

To address the lack of management for transportation information, the American Association of State Highway and Transportation Officials Standing Committee on Research determined that a scoping study should be done to examine the major issues confron...

Lipid-polymer hybrid nanoparticles as a new generation therapeutic delivery platform: a review.

PubMed

Hadinoto, Kunn; Sundaresan, Ajitha; Cheow, Wean Sin

2013-11-01

Lipid-polymer hybrid nanoparticles (LPNs) are core-shell nanoparticle structures comprising polymer cores and lipid/lipid-PEG shells, which exhibit complementary characteristics of both polymeric nanoparticles and liposomes, particularly in terms of their physical stability and biocompatibility. Significantly, the LPNs have recently been demonstrated to exhibit superior in vivo cellular delivery efficacy compared to that obtained from polymeric nanoparticles and liposomes. Since their inception, the LPNs have advanced significantly in terms of their preparation strategy and scope of applications. Their preparation strategy has undergone a shift from the conceptually simple two-step method, involving preformed polymeric nanoparticles and lipid vesicles, to the more principally complex, yet easier to perform, one-step method, relying on simultaneous self-assembly of the lipid and polymer, which has resulted in better products and higher production throughput. The scope of LPNs' applications has also been extended beyond single drug delivery for anticancer therapy, to include combinatorial and active targeted drug deliveries, and deliveries of genetic materials, vaccines, and diagnostic imaging agents. This review details the current state of development for the LPNs preparation and applications from which we identify future research works needed to bring the LPNs closer to its clinical realization. Copyright © 2013 Elsevier B.V. All rights reserved.

Progress and challenges of disaster health management in China: a scoping review.

PubMed

Zhong, Shuang; Clark, Michele; Hou, Xiang-Yu; Zang, Yuli; FitzGerald, Gerard

2014-01-01

Despite the importance of an effective health system response to various disasters, relevant research is still in its infancy, especially in middle- and low-income countries. This paper provides an overview of the status of disaster health management in China, with its aim to promote the effectiveness of the health response for reducing disaster-related mortality and morbidity. A scoping review method was used to address the recent progress of and challenges to disaster health management in China. Major health electronic databases were searched to identify English and Chinese literature that were relevant to the research aims. The review found that since 2003 considerable progress has been achieved in the health disaster response system in China. However, there remain challenges that hinder effective health disaster responses, including low standards of disaster-resistant infrastructure safety, the lack of specific disaster plans, poor emergency coordination between hospitals, lack of portable diagnostic equipment and underdeveloped triage skills, surge capacity, and psychological interventions. Additional challenges include the fragmentation of the emergency health service system, a lack of specific legislation for emergencies, disparities in the distribution of funding, and inadequate cost-effective considerations for disaster rescue. One solution identified to address these challenges appears to be through corresponding policy strategies at multiple levels (e.g. community, hospital, and healthcare system level).

Optimisation of the digital radiographic imaging of suspected non-accidental injury

NASA Astrophysics Data System (ADS)

Offiah, Amaka

Aim: To optimise the digital (radiographic) imaging of children presenting with suspected non-accidental injury (NAI). Objectives: (i) To evaluate existing radiographic quality criteria, and to develop a more suitable system if these are found to be inapplicable to skeletal surveys obtained in suspected NAI. (ii) To document differences in image quality between conventional film-screen and the recently installed Fuji5000R computed radiography (CR) system at Great Ormond Street Hospital for Children, (iii) To document the extent of variability in the standard of skeletal surveys obtained in the UK for suspected NAI. (iv) To determine those radiographic parameters which yield the highest diagnostic accuracy, while still maintaining acceptable radiation dose to the child, (v) To determine how varying degrees of edge-enhancement affect diagnostic accuracy. (vi) To establish the accuracy of soft compared to hard copy interpretation of images in suspected NAI. Materials and Methods: (i) and (ii) Retrospective analysis of 286 paediatric lateral spine radiographs by two observers based on the Commission of European Communities (CEC) quality criteria, (iii) Review of the skeletal surveys of 50 consecutive infants referred from hospitals throughout the United Kingdom (UK) with suspected NAI. (iv) Phantom studies. Leeds TO. 10 and TO. 16 test objects were used to compare the relationship between film density, exposure parameters and visualisation of object details, (iv) Clinical study. Anteroposterior and lateral post mortem skull radiographs of six consecutive infants were obtained at various exposures. Six observers independently scored the images based on visualisation of five criteria, (v) and (vi) A study of diagnostic accuracy in which six observers independently interpreted 50 radiographs from printed copies (with varying degrees of edge-enhancement) and from a monitor. Results: The CEC criteria are useful for optimisation of imaging parameters and allow the detection of differences in quality of film-screen and digital images. There is much variability in the quality and number of radiographs performed as part of skeletal surveys in the UK for suspected NAI. The Leeds test objects are either not sensitive enough (TO. 10) or perhaps over sensitive (TO. 16) for the purposes of this project. Furthermore, the minimum spatial resolution required for digital imaging in NAI has not been established. Therefore the objective interpretation of phantom studies is difficult. There is scope for reduction of radiation dose to children with no effect on image quality. Diagnostic accuracy (fracture detection) in suspected NAI is generally low, and is not affected by image display modality. Conclusions: The CEC quality criteria are not applicable to the assessment of clinical image quality. A national protocol for skeletal surveys in NAI is required. Dedicated training, close supervision, collaboration and consistent exposure of radiologists to cases of NAI should improve diagnostic accuracy. The potential exists for dose reduction when performing skeletal surveys in children and infants with suspected NAI. Future studies should address this issue.

Risk adjustment alternatives in paying for behavioral health care under Medicaid.

PubMed Central

Ettner, S L; Frank, R G; McGuire, T G; Hermann, R C

2001-01-01

OBJECTIVE: To compare the performance of various risk adjustment models in behavioral health applications such as setting mental health and substance abuse (MH/SA) capitation payments or overall capitation payments for populations including MH/SA users. DATA SOURCES/STUDY DESIGN: The 1991-93 administrative data from the Michigan Medicaid program were used. We compared mean absolute prediction error for several risk adjustment models and simulated the profits and losses that behavioral health care carve outs and integrated health plans would experience under risk adjustment if they enrolled beneficiaries with a history of MH/SA problems. Models included basic demographic adjustment, Adjusted Diagnostic Groups, Hierarchical Condition Categories, and specifications designed for behavioral health. PRINCIPAL FINDINGS: Differences in predictive ability among risk adjustment models were small and generally insignificant. Specifications based on relatively few MH/SA diagnostic categories did as well as or better than models controlling for additional variables such as medical diagnoses at predicting MH/SA expenditures among adults. Simulation analyses revealed that among both adults and minors considerable scope remained for behavioral health care carve outs to make profits or losses after risk adjustment based on differential enrollment of severely ill patients. Similarly, integrated health plans have strong financial incentives to avoid MH/SA users even after adjustment. CONCLUSIONS: Current risk adjustment methodologies do not eliminate the financial incentives for integrated health plans and behavioral health care carve-out plans to avoid high-utilizing patients with psychiatric disorders. PMID:11508640

40 CFR 792.1 - Scope.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) GOOD LABORATORY PRACTICE STANDARDS General Provisions § 792.1 Scope. (a) This part prescribes good laboratory practices for conducting studies relating to health effects, environmental effects, and chemical...

40 CFR 792.1 - Scope.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) GOOD LABORATORY PRACTICE STANDARDS General Provisions § 792.1 Scope. (a) This part prescribes good laboratory practices for conducting studies relating to health effects, environmental effects, and chemical...

Exploring extended scope of practice in dietetics: A systems approach.

PubMed

Ryan, Dominique; Pelly, Fiona; Purcell, Elizabeth

2017-09-01

The aim of this study was to explore health professionals' perceptions of an extended scope of a practice clinic, and develop a framework using a systems approach to facilitate extended scope models across various health settings. A qualitative investigation using semi-structured interviews with four health professionals involved in an extended scope dietitian-led gastroenterology clinic in a hospital in regional Queensland was conducted. A case study design was utilised to investigate interviewees' perceptions of the clinic. Participants were conveniently, purposively sampled. Transcript analysis involved a descriptive analytical approach. Interviewee responses were coded and categorised into themes, and investigator triangulation was used to ensure consistency between individual analyses. A secondary interpretative analysis was conducted where relationships between key themes were mapped to the Systems Engineering Initiative for Patient Safety work system model. Interviewees identified various factors as vital inputs to the work system. These were categorised into the four key elements: stakeholder support, resources, planning and the dietitian. Clinic outcomes were categorised into the impact on four key groups: patients, the dietitian, the multidisciplinary team and the health system. Mapping of the relationships between inputs and outcomes resulted in an implementation framework for extended scope of practice. Extended scope of practice in dietetics may provide positive outcomes for various stakeholders. However, further development of extended scope roles for dietitians requires increased advocacy and support from governments, professional bodies, training institutions and dietitians. We have developed an implementation framework which can be utilised by health professionals interested in embracing an extended scope model of care. © 2016 Dietitians Association of Australia.

Validation in daily clinical situations of Diascope®, a software developed to help healthcare professionals individualize antidiabetic treatment in type 2 diabetes.

PubMed

Ampudia-Blasco, Francisco Javier; García-Soidán, Francisco Javier; Rubio Sánchez, Manuela; Phan, Tra-Mi

2017-03-01

DiaScope ® is a software to help in individualized prescription of antidiabetic treatment in type 2 diabetes. This study assessed its value and acceptability by different professionals. DiaScope ® was developed based on the ADA-EASD 2012 algorithm and on the recommendation of 12 international diabetes experts using the RAND/UCLA appropriateness method. The current study was performed at a single session. In the first phase, 5 clinical scenarios were evaluated, selecting the most appropriated therapeutic option among 4 possibilities (initial test). In a second phase, the same clinical cases were evaluated with DiaScope ® (final test).Opinion surveys on DiaScope ® were also performed (questionnaire). DiaScope ® changed the selected option 1 or more times in 70.5% of cases. Among 275 evaluated questionnaires, 54.0% strongly agree that DiaScope ® allowed finding easily a similar therapeutic scenario to the corresponding patient, and 52.5 among the obtained answers were clinically plausible. Up to 58.3% will recommend it to a colleague. In particular, primary care physicians with >20 years of professional dedication found with DiaScope ® the most appropriate option for a particular situation against specialists or those with less professional dedication (p<.05). DiaScope ® is an easy to use tool for antidiabetic drug prescription that provides plausible solutions and is especially useful for primary care physicians with more years of professional practice. Copyright © 2017 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

Clinical utility of EEG in diagnosing and monitoring epilepsy in adults.

PubMed

Tatum, W O; Rubboli, G; Kaplan, P W; Mirsatari, S M; Radhakrishnan, K; Gloss, D; Caboclo, L O; Drislane, F W; Koutroumanidis, M; Schomer, D L; Kasteleijn-Nolst Trenite, D; Cook, Mark; Beniczky, S

2018-05-01

Electroencephalography (EEG) remains an essential diagnostic tool for people with epilepsy (PWE). The International Federation of Clinical Neurophysiology produces new guidelines as an educational service for clinicians to address gaps in knowledge in clinical neurophysiology. The current guideline was prepared in response to gaps present in epilepsy-related neurophysiological assessment and is not intended to replace sound clinical judgement in the care of PWE. Furthermore, addressing specific pathophysiological conditions of the brain that produce epilepsy is of primary importance though is beyond the scope of this guideline. Instead, our goal is to summarize the scientific evidence for the utility of EEG when diagnosing and monitoring PWE. Copyright © 2018 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

Aerobic scope measurements of fishes in an era of climate change: respirometry, relevance and recommendations.

PubMed

Clark, Timothy D; Sandblom, Erik; Jutfelt, Fredrik

2013-08-01

Measurements of aerobic scope [the difference between minimum and maximum oxygen consumption rate ( and , respectively)] are increasing in prevalence as a tool to address questions relating to fish ecology and the effects of climate change. However, there are underlying issues regarding the array of methods used to measure aerobic scope across studies and species. In an attempt to enhance quality control before the diversity of issues becomes too great to remedy, this paper outlines common techniques and pitfalls associated with measurements of , and aerobic scope across species and under different experimental conditions. Additionally, we provide a brief critique of the oxygen- and capacity-limited thermal tolerance (OCLTT) hypothesis, a concept that is intricately dependent on aerobic scope measurements and is spreading wildly throughout the literature despite little evidence for its general applicability. It is the intention of this paper to encourage transparency and accuracy in future studies that measure the aerobic metabolism of fishes, and to highlight the fundamental issues with assuming broad relevance of the OCLTT hypothesis.

21 CFR 601.90 - Scope.

Code of Federal Regulations, 2012 CFR

2012-04-01

... AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) BIOLOGICS LICENSING Approval of Biological Products When Human Efficacy Studies Are Not Ethical or Feasible § 601.90 Scope... subpart applies only to those biological products for which: Definitive human efficacy studies cannot be...

21 CFR 601.90 - Scope.

Code of Federal Regulations, 2014 CFR

2014-04-01

... AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) BIOLOGICS LICENSING Approval of Biological Products When Human Efficacy Studies Are Not Ethical or Feasible § 601.90 Scope... subpart applies only to those biological products for which: Definitive human efficacy studies cannot be...

21 CFR 601.90 - Scope.

Code of Federal Regulations, 2011 CFR

2011-04-01

... AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) BIOLOGICS LICENSING Approval of Biological Products When Human Efficacy Studies Are Not Ethical or Feasible § 601.90 Scope... subpart applies only to those biological products for which: Definitive human efficacy studies cannot be...

21 CFR 601.90 - Scope.

Code of Federal Regulations, 2013 CFR

2013-04-01

... AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) BIOLOGICS LICENSING Approval of Biological Products When Human Efficacy Studies Are Not Ethical or Feasible § 601.90 Scope... subpart applies only to those biological products for which: Definitive human efficacy studies cannot be...

21 CFR 601.90 - Scope.

Code of Federal Regulations, 2010 CFR

2010-04-01

... AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) BIOLOGICS LICENSING Approval of Biological Products When Human Efficacy Studies Are Not Ethical or Feasible § 601.90 Scope... subpart applies only to those biological products for which: Definitive human efficacy studies cannot be...

Entrepreneurial Decision Making Styles and Learning Strategies Preferences

ERIC Educational Resources Information Center

Hestand, Yana

2012-01-01

Scope and Method of Study: The scope of this study was the decision making styles and the learning strategies preferences among entrepreneurs. The study utilized a descriptive research design. Internet was utilized as a data collection tool, Participant in the study were 240 entrepreneurs from the Oklahoma state, Tulsa county members of the SBA.…

Multi-institutional comparison of whole slide digital imaging and optical microscopy for interpretation of hematoxylin-eosin-stained breast tissue sections.

PubMed

Krishnamurthy, Savitri; Mathews, Kurt; McClure, Steven; Murray, Melissa; Gilcrease, Michael; Albarracin, Constance; Spinosa, John; Chang, Bernard; Ho, James; Holt, John; Cohen, Arthur; Giri, Dilip; Garg, Karuna; Bassett, Roland L; Liang, Kevin

2013-12-01

Whole slide imaging (WSI) is now used for educational purposes, for consultation, and for archiving and quantitation of immunostains. However, it is not routinely used for the primary diagnosis of hematoxylin-eosin-stained tissue sections. To compare WSI using the Aperio digital pathology system (Aperio Technologies, Inc, Vista, California) with optical microscopy (OM) for the interpretation of hematoxylin-eosin-stained tissue sections of breast lesions. The study was conducted at 3 clinical sites; 3 breast pathologists interpreted 150 hematoxylin-eosin-stained slides at each site, 3 times each by WSI and 3 times each by OM. For WSI, slides were scanned using an Aperio ScanScope and interpreted on a computer monitor using Aperio ImageScope software and Aperio Spectrum data management software. Pathologic interpretations were recorded using the College of American Pathologists breast checklist. WSI diagnoses were compared with OM diagnoses for accuracy, precision (interpathologist variation), and reproducibility (intrapathologist variation). Results were considered accurate only if the interpretation matched exactly between WSI and OM. The proportion of accurate results reported by each pathologist was expressed as a percentage for the comparison of the 2 platforms. The accuracy of WSI for classifying lesions as not carcinoma or as noninvasive (ductal or lobular) or invasive (ductal, lobular, or other) carcinoma was 90.5%. The accuracy of OM was 92.1%. The precision and reproducibility of WSI and OM were determined on the basis of pairwise comparisons (3 comparisons for each slide, resulting in 36 possible comparisons). The overall precision of WSI was 90.5% in comparison with 92.1% for OM; reproducibility of WSI was 91.6% in comparison with 94.5% for OM, respectively. In this study, we demonstrated that WSI and OM have similar accuracy, precision, and reproducibility for interpreting hematoxylin-eosin-stained breast tissue sections. Further clinical studies using routine surgical pathology specimens would be useful to confirm these findings and facilitate the incorporation of WSI into diagnostic practice.

Pure natural orifice transluminal endoscopic surgery (NOTES) with ultrasonography-guided transgastric access and over-the-scope-clip closure: a porcine feasibility and survival study.

PubMed

Donatsky, Anders Meller; Andersen, Luise; Nielsen, Ole Lerberg; Holzknecht, Barbara Juliane; Vilmann, Peter; Meisner, Søren; Jørgensen, Lars Nannestad; Rosenberg, Jacob

2012-07-01

Most natural orifice transluminal endoscopic surgery (NOTES) procedures to date rely on the hybrid technique with simultaneous laparoscopic access to protect against access-related complications and to achieve adequate triangulation for dissection. This is done at the cost of the potential benefits of this new minimally invasive technique. This study aimed to evaluate the feasibility and safety of a transgastric (TG) pure-NOTES procedure in a diagnostic setting. A TG pure-NOTES procedure with endoscopic ultrasonograpy (EUS)-guided access and over-the-scope-clip (OTSC) closure was performed for 10 pigs in a survival and feasibility study. A full macroscopic necropsy with subsequent histologic evaluation was performed on postoperative day (POD) 14. The outcome parameters were uncomplicated follow-up assessment, survival, intraoperative complications, intraabdominal pathology, macroscopic full-thickness closure, and histology-proven full-thickness healing of the gastrotomy. An uncomplicated postoperative course was reported for 9 of the 10 pigs, and survival was reported for all 10 pigs. For all the pigs, EUS-guided access was performed successfully with a median duration of 25 min (range, 12-62 min) and without intraoperative complications or access-related lesions at necropsy. An OTSC closure was achieved with a median duration of 11 min (range, 3-28 min). The OTSC provided immediate closure, but according to the authors' definition of a full-thickness healing evaluated by histologic examination, this was not achieved in any of the cases. Although all the animals survived until POD 14, intraabdominal chronic abscesses were present in 3 of the 10 pigs at necropsy. The EUS-guided TG access proved to be feasible without access-related complications. Although OTSC provided an immediate closure, the histopathology raised concerns regarding the risk of perforation. Together with the high risk of intraabdominal infection, TG pure-NOTES is not yet ready for routine clinical practice.

US hospital-based direct access with radiology referral: an administrative case report.

PubMed

Keil, Aaron; Brown, Suzanne Robben

2015-01-01

Legislative gains in the US allow physical therapists to function in expanded scopes of practice including direct access and referral to specialists. The combination of direct access with privileges to order imaging studies directly offers a desirable practice status for many physical therapists, especially in musculoskeletal focused settings. Although direct access is legal in all US jurisdictions, institutional-based physical therapy settings have not embraced these practices. Barriers cited to implementing direct access with advanced practice are concerns over medical and administrative opposition, institutional policies, provider qualifications and reimbursement. This administrative case report describes the process taken to allow therapists to see patients without a referral and to order diagnostic imaging studies at an academic medical center. Nine-month implementation results show 66 patients seen via direct access with 15% referred for imaging studies. Claims submitted to 20 different insurance providers were reimbursed at 100%. While institutional regulations and reimbursement are reported as barriers to direct access, this report highlights the process one academic medical center used to implement direct access and advanced practice radiology referral by updating policies and procedures, identifying advanced competencies and communicating with necessary stakeholder groups. Favorable reimbursement for services is documented.

Incorporating Demand and Supply Constraints into Economic Evaluations in Low‐Income and Middle‐Income Countries

PubMed Central

Mangham‐Jefferies, Lindsay; Gomez, Gabriela B.; Pitt, Catherine; Foster, Nicola

2016-01-01

Abstract Global guidelines for new technologies are based on cost and efficacy data from a limited number of trial locations. Country‐level decision makers need to consider whether cost‐effectiveness analysis used to inform global guidelines are sufficient for their situation or whether to use models that adjust cost‐effectiveness results taking into account setting‐specific epidemiological and cost heterogeneity. However, demand and supply constraints will also impact cost‐effectiveness by influencing the standard of care and the use and implementation of any new technology. These constraints may also vary substantially by setting. We present two case studies of economic evaluations of the introduction of new diagnostics for malaria and tuberculosis control. These case studies are used to analyse how the scope of economic evaluations of each technology expanded to account for and then address demand and supply constraints over time. We use these case studies to inform a conceptual framework that can be used to explore the characteristics of intervention complexity and the influence of demand and supply constraints. Finally, we describe a number of feasible steps that researchers who wish to apply our framework in cost‐effectiveness analyses. PMID:26786617

Determination of dose distributions and parameter sensitivity

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

Napier, B.A.; Farris, W.T.; Simpson, J.C.

1992-12-01

A series of scoping calculations has been undertaken to evaluate the absolute and relative contribution of different radionuclides and exposure pathways to doses that may have been received by individuals living in the vicinity of the Hanford site. This scoping calculation (Calculation 005) examined the contributions of numerous parameters to the uncertainty distribution of doses calculated for environmental exposures and accumulation in foods. This study builds on the work initiated in the first scoping study of iodine in cow's milk and the third scoping study, which added additional pathways. Addressed in this calculation were the contributions to thyroid dose ofmore » infants from (1) air submersion and groundshine external dose, (2) inhalation, (3) ingestion of soil by humans, (4) ingestion of leafy vegetables, (5) ingestion of other vegetables and fruits, (6) ingestion of meat, (7) ingestion of eggs, and (8) ingestion of cows' milk from Feeding Regime 1 as described in Calculation 001.« less

40 CFR 160.1 - Scope and applicability.

Code of Federal Regulations, 2011 CFR

2011-07-01

... LABORATORY PRACTICE STANDARDS General Provisions § 160.1 Scope and applicability. (a) This part prescribes good laboratory practices for conducting studies that support or are intended to support applications...

The scope of cell phones in diabetes management in developing country health care settings.

PubMed

Ajay, Vamadevan S; Prabhakaran, Dorairaj

2011-05-01

Diabetes has emerged as a major public health concern in developing nations. Health systems in most developing countries are yet to integrate effective prevention and control programs for diabetes into routine health care services. Given the inadequate human resources and underfunctioning health systems, we need novel and innovative approaches to combat diabetes in developing-country settings. In this regard, the tremendous advances in telecommunication technology, particularly cell phones, can be harnessed to improve diabetes care. Cell phones could serve as a tool for collecting information on surveillance, service delivery, evidence-based care, management, and supply systems pertaining to diabetes from primary care settings in addition to providing health messages as part of diabetes education. As a screening/diagnostic tool for diabetes, cell phones can aid the health workers in undertaking screening and diagnostic and follow-up care for diabetes in the community. Cell phones are also capable of acting as a vehicle for continuing medical education; a decision support system for evidence-based management; and a tool for patient education, self-management, and compliance. However, for widespread use, we need robust evaluations of cell phone applications in existing practices and appropriate interventions in diabetes. © 2011 Diabetes Technology Society.

The Scope of Cell Phones in Diabetes Management in Developing Country Health Care Settings

PubMed Central

Ajay, Vamadevan S; Prabhakaran, Dorairaj

2011-01-01

Diabetes has emerged as a major public health concern in developing nations. Health systems in most developing countries are yet to integrate effective prevention and control programs for diabetes into routine health care services. Given the inadequate human resources and underfunctioning health systems, we need novel and innovative approaches to combat diabetes in developing-country settings. In this regard, the tremendous advances in telecommunication technology, particularly cell phones, can be harnessed to improve diabetes care. Cell phones could serve as a tool for collecting information on surveillance, service delivery, evidence-based care, management, and supply systems pertaining to diabetes from primary care settings in addition to providing health messages as part of diabetes education. As a screening/diagnostic tool for diabetes, cell phones can aid the health workers in undertaking screening and diagnostic and follow-up care for diabetes in the community. Cell phones are also capable of acting as a vehicle for continuing medical education; a decision support system for evidence-based management; and a tool for patient education, self-management, and compliance. However, for widespread use, we need robust evaluations of cell phone applications in existing practices and appropriate interventions in diabetes. PMID:21722593

How 3D immersive visualization is changing medical diagnostics

NASA Astrophysics Data System (ADS)

Koning, Anton H. J.

2011-03-01

Originally the only way to look inside the human body without opening it up was by means of two dimensional (2D) images obtained using X-ray equipment. The fact that human anatomy is inherently three dimensional leads to ambiguities in interpretation and problems of occlusion. Three dimensional (3D) imaging modalities such as CT, MRI and 3D ultrasound remove these drawbacks and are now part of routine medical care. While most hospitals 'have gone digital', meaning that the images are no longer printed on film, they are still being viewed on 2D screens. However, this way valuable depth information is lost, and some interactions become unnecessarily complex or even unfeasible. Using a virtual reality (VR) system to present volumetric data means that depth information is presented to the viewer and 3D interaction is made possible. At the Erasmus MC we have developed V-Scope, an immersive volume visualization system for visualizing a variety of (bio-)medical volumetric datasets, ranging from 3D ultrasound, via CT and MRI, to confocal microscopy, OPT and 3D electron-microscopy data. In this talk we will address the advantages of such a system for both medical diagnostics as well as for (bio)medical research.

Digital Imaging and Communications in Medicine Whole Slide Imaging Connectathon at Digital Pathology Association Pathology Visions 2017.

PubMed

Clunie, David; Hosseinzadeh, Dan; Wintell, Mikael; De Mena, David; Lajara, Nieves; Garcia-Rojo, Marcial; Bueno, Gloria; Saligrama, Kiran; Stearrett, Aaron; Toomey, David; Abels, Esther; Apeldoorn, Frank Van; Langevin, Stephane; Nichols, Sean; Schmid, Joachim; Horchner, Uwe; Beckwith, Bruce; Parwani, Anil; Pantanowitz, Liron

2018-01-01

As digital pathology systems for clinical diagnostic work applications become mainstream, interoperability between these systems from different vendors becomes critical. For the first time, multiple digital pathology vendors have publicly revealed the use of the digital imaging and communications in medicine (DICOM) standard file format and network protocol to communicate between separate whole slide acquisition, storage, and viewing components. Note the use of DICOM for clinical diagnostic applications is still to be validated in the United States. The successful demonstration shows that the DICOM standard is fundamentally sound, though many lessons were learned. These lessons will be incorporated as incremental improvements in the standard, provide more detailed profiles to constrain variation for specific use cases, and offer educational material for implementers. Future Connectathon events will expand the scope to include more devices and vendors, as well as more ambitious use cases including laboratory information system integration and annotation for image analysis, as well as more geographic diversity. Users should request DICOM features in all purchases and contracts. It is anticipated that the growth of DICOM-compliant manufacturers will likely also ease DICOM for pathology becoming a recognized standard and as such the regulatory pathway for digital pathology products.

The Diagnostic and Prognostic Role of microRNA in Colorectal Cancer - a Comprehensive review.

PubMed

Mazeh, Haggi; Mizrahi, Ido; Ilyayev, Nadia; Halle, David; Brücher, Bjoern; Bilchik, Anton; Protic, Mladjan; Daumer, Martin; Stojadinovic, Alexander; Itzhak, Avital; Nissan, Aviram

2013-01-01

The discovery of microRNA, a group of regulatory short RNA fragments, has added a new dimension to the diagnosis and management of neoplastic diseases. Differential expression of microRNA in a unique pattern in a wide range of tumor types enables researches to develop a microRNA-based assay for source identification of metastatic disease of unknown origin. This is just one example of many microRNA-based cancer diagnostic and prognostic assays in various phases of clinical research.Since colorectal cancer (CRC) is a phenotypic expression of multiple molecular pathways including chromosomal instability (CIN), micro-satellite instability (MIS) and CpG islands promoter hypermethylation (CIMP), there is no one-unique pattern of microRNA expression expected in this disease and indeed, there are multiple reports published, describing different patterns of microRNA expression in CRC.The scope of this manuscript is to provide a comprehensive review of the scientific literature describing the dysregulation of and the potential role for microRNA in the management of CRC. A Pubmed search was conducted using the following MeSH terms, "microRNA" and "colorectal cancer". Of the 493 publications screened, there were 57 papers describing dysregulation of microRNA in CRC.

Paving the road to personalized medicine: recommendations on regulatory, intellectual property and reimbursement challenges

PubMed Central

Knowles, Lori; Luth, Westerly; Bubela, Tania

2017-01-01

Abstract Personalized medicine (PM) aims to harness a wave of ‘omics’ discoveries to facilitate research and discovery of targeted diagnostics and therapies and increase the efficiency of healthcare systems by predicting and treating individual predispositions to diseases or conditions. Despite significant investment, limited progress has been made bringing PM to market. We describe the major perceived regulatory, intellectual property, and reimbursement challenges to the development, translation, adoption, and implementation of PM products into clinical care. We conducted a scoping review to identify (i) primary challenges for the development and implementation of PM identified in the academic literature; (ii) solutions proposed in the academic literature to address these challenges; and (iii) gaps that exist in that literature. We identified regulatory barriers to PM development and recommendations in 344 academic papers. Regulatory uncertainty was a cross-cutting theme that appeared in conjunction with other themes including: reimbursement; clinical trial regulation; regulation of co-development; unclear evidentiary requirements; insufficient incentives for research and development; incompatible information systems; and different regulation of different diagnostics. To fully realize the benefits of PM for healthcare systems and patients, regulatory, intellectual property, and reimbursement challenges need to be addressed in lock step with scientific advances. PMID:29868182

General considerations and updates in pediatric gastrointestinal diagnostic endoscopy

PubMed Central

2010-01-01

Gastrointestinal and colonic endoscopic examinations have been performed in pediatric patients in Korea for 3 decades. Endoscopic procedures are complex and may be unsafe if special concerns are not considered. Many things have to be kept in mind before, during, and after the procedure. Gastrointestinal endoscopy is one of the most frequently performed procedure in children nowadays, Since the dimension size of the endoscopy was modified for pediatric patients 15 years ago, endoscopic procedures are almost performed routinely in pediatric gastrointestinal patients. The smaller size of the scope let the physicians approach the diagnostic and therapeutic endoscopic procedures. But this is an invasive procedure, so the procedure itself may provoke an emergence state. The procedure-related complications can more easily occur in pediatric patients. Sedation-related or procedure-related respiratory, cardiovascular complications are mostly important and critical in the care. The endoscopists are required to consider diverse aspects of the procedure - patient preparation, indications and contraindications, infection controls, sedation methods, sedative medicines and the side effects of each medicine, monitoring during and after the procedure, and complications related with the procedure and medicines - to perform the procedure successfully and safely. This article presents some important guidelines and recommendations for gastrointestinal endoscopy through literature review. PMID:21189965

Review of an initial experience with an experimental spectral photon-counting computed tomography system

NASA Astrophysics Data System (ADS)

Si-Mohamed, Salim; Bar-Ness, Daniel; Sigovan, Monica; Cormode, David P.; Coulon, Philippe; Coche, Emmanuel; Vlassenbroek, Alain; Normand, Gabrielle; Boussel, Loic; Douek, Philippe

2017-11-01

Spectral photon-counting CT (SPCCT) is an emerging X-ray imaging technology that extends the scope of available diagnostic imaging tools. The main advantage of photon-counting CT technology is better sampling of the spectral information from the transmitted spectrum in order to benefit from additional physical information being produced during matter interaction, including photo-electric and Compton effects, and the K-edge effect. The K-edge, which is specific for a given element, is the increase in X-ray absorption of the element above the binding energy between its inner electronic shell and the nucleus. Hence, the spectral information contributes to better characterization of tissues and materials of interest, explaining the excitement surrounding this area of X-ray imaging. Other improvements of SPCCT compared with conventional CT, such as higher spatial resolution, lower radiation exposure and lower noise are also expected to provide benefits for diagnostic imaging. In this review, we describe multi-energy CT imaging, from dual energy to photon counting technology, and our initial experience results using a clinical-scale spectral photon counting CT (SPCCT) prototype system in vitro and in vivo. In addition, possible clinical applications are introduced.

Impact assessment of land use planning driving forces on environment

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

Chen, Longgao, E-mail: chenlonggao@163.com; Yang, Xiaoyan; School of Environment and Spatial Informatics, China University of Mining and Technology, Xuzhou 221116

Land use change may exert a negative impact on environmental quality. A state–impact–state (SIS) model describing a state transform under certain impacts has been integrated into land use planning (LUP) environmental impact assessment (LUPEA). This logical model is intuitive and easy to understand, but the exploration of impact is essential to establish the indicator system and to identify the scope of land use environmental impact when it is applied to a specific region. In this study, we investigated environmental driving forces from land use planning (LUPF), along with the conception, components, scope, and impact of LUPF. This method was illustratedmore » by a case study in Zoucheng, China. Through the results, we concluded that (1) the LUPF on environment are impacts originated from the implementation of LUP on a regional environment, which are characterized by four aspects: magnitude, direction, action point, and its owner; (2) various scopes of LUPF on individual environmental elements based on different standards jointly define the final scope of LUPEA; (3) our case study in Zoucheng demonstrates the practicability of this proposed approach; (4) this method can be embedded into LUPEA with direction, magnitudes, and scopes of the LUPF on individual elements obtained, and the identified indicator system can be directly employed into LUPEA and (5) the assessment helps to identify key indicators and to set up a corresponding strategy to mitigate the negative impact of LUP on the environment, which are two important objectives of strategic environmental assessment (SEA) in LUP. - Highlights: • Environmental driving forces from land use planning (LUPF) are investigated and categorized. • Our method can obtains the direction, magnitudes and scopes of environmental driving forces. • The LUPEA scope is determined by the combination of various scopes of LUPF on individual elements. • LUPF assessment can be embedded into LUPEA. • The method can help to identify key indicators and set up a strategy to mitigate negative environmental impact.« less

Work Reintegration for Veterans With Mental Disorders: A Systematic Literature Review to Inform Research

PubMed Central

Fikretoglu, Deniz; Pranger, Tina; Patten, Scott; Wang, JianLi; Wong, May; Zamorski, Mark; Loisel, Patrick; Corbiére, Marc; Shields, Norman; Thompson, Jim; Pedlar, David

2013-01-01

Background Some veterans, and especially those with mental disorders, have difficulty reintegrating into the civilian workforce. Purpose The objectives of this study were to describe the scope of the existing literature on mental disorders and unemployment and to identify factors potentially associated with reintegration of workers with mental disorders into the workforce. Data Sources The following databases were searched from their respective inception dates: MEDLINE, EMBASE, Cumulative Index Nursing Allied Health (CINAHL), and PsycINFO. Study Selection In-scope studies had quantitative measures of employment and study populations with well-described mental disorders (eg, anxiety, depression, posttraumatic stress disorder, substance-use disorders). Data Extraction A systematic and comprehensive search of the relevant published literature up to July 2009 was conducted that identified a total of 5,195 articles. From that list, 81 in-scope studies were identified. An update to July 2012 identified 1,267 new articles, resulting in an additional 16 in-scope articles. Data Synthesis Three major categories emerged from the in-scope articles: return to work, supported employment, and reintegration. The literature on return to work and supported employment is well summarized by existing reviews. The reintegration literature included 32 in-scope articles; only 10 of these were conducted in populations of veterans. Limitations Studies of reintegration to work were not similar enough to synthesize, and it was inappropriate to pool results for this category of literature. Conclusions Comprehensive literature review found limited knowledge about how to integrate people with mental disorders into a new workplace after a prolonged absence (>1 year). Even more limited knowledge was found for veterans. The results informed the next steps for our research team to enhance successful reintegration of veterans with mental disorders into the civilian workplace. PMID:23043148

Reducing attentional capture of emotion by broadening attention: increased global attention reduces early electrophysiological responses to negative stimuli.

PubMed

Gable, Philip A; Harmon-Jones, Eddie

2012-05-01

Decades of research has shown the influence of emotion on attentional capture, and more recently, the influence of emotion on neurophysiological processes related to attentional capture. The current research tested whether some of the earliest neurophysiological underpinnings of emotive attentional processes can be influenced by attentional manipulations of broadening versus narrowing. Previous research has shown that negative affects high in motivational intensity (e.g., disgust, fear) cause a relative narrowing of attentional scope (Gable and Harmon-Jones, 2010a; Easterbrook, 1959). Because of the strong link between motivation and attention, attentional scope should also influence the attentional capture of negative stimuli. The current study manipulated a local attentional scope or global attentional scope, then measured attentional capture towards disgust and neutral pictures using the N1 event-related potential component. Results revealed that a manipulated global attentional scope reduced N1 amplitude towards disgust pictures compared to a manipulated local attentional scope. Copyright © 2012 Elsevier B.V. All rights reserved.

Attenuating the alcohol allure: attentional broadening reduces rapid motivational response to alcohol pictures.

PubMed

Ryerson, Nicole C; Neal, Lauren B; Gable, Philip A

2017-04-01

Past research has found that exposure to alcohol cues causes a narrowing of attentional scope and enhances the neural responses associated with approach motivation. The current research sought to determine if a manipulated broadened (global) attentional scope would reduce approach-motivated neural reactivity to alcohol pictures. In the current study, participants (n = 82) were exposed to alcohol and neutral pictures following either a global or local attentional scope manipulation. Early motivated attentional processing was assessed using the N1 event-related potential (ERP), a neurophysiological marker of rapid motivated attention. A global attentional scope reduced N1 amplitudes to alcohol pictures as compared to a local attentional scope. Self-reported binge drinking related to larger N1 amplitudes to alcohol pictures, but not to neutral pictures. Individuals with greater binge drinking experience demonstrated increased rapid motivated attentional processing to alcohol pictures. These results suggest that enhancing a global (vs. local) attentional scope attenuates rapid motivated attentional processing of alcohol pictures in comparison to neutral pictures. Graphical abstract ᅟ.

A survey of wellness management strategies used by Canadian doctors of chiropractic.

PubMed

Stainsby, Brynne E; Porr, Jason T C; Kim, Peter; Collinge, Ashley M; Hunter, Julie C

2011-01-01

The purpose of this study was to investigate if Canadian doctors of chiropractic consider using wellness strategies after functional recovery in acute and chronic conditions. This study also attempted to determine if there is a difference in the use of wellness management strategies between broad and narrow scope practitioners. Forty-one practicing, licensed chiropractors were recruited to complete an interview survey regarding 2 mock clinical case presentations. Interviews were recorded, and influential words or word pairings were identified. Investigators formulated criteria to divide practitioners into broad scope (mixers) and narrow scope (straights). Data were analyzed using Crawdad Analysis Software (version 1.2). All subjects indicated that they would provide information regarding public health and wellness strategies to a patient after functional resolution of the presenting chronic or acute complaints. The responses of broad scope (mixer) chiropractors appeared to be focused on the patient specifically, whereas narrow scope (straight) responses appeared to be more varied when analyzed for noun and noun-pair influence. This study of practicing, licensed Canadian chiropractors suggests that wellness strategies may be commonly considered in practice. All subjects in this study reported a number of strategies to educate patients regarding wellness after functional recovery of a complaint. Copyright © 2011 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

Preliminary clinical report of flexible videoarthroscopy in diagnostic knee and hip arthroscopy.

PubMed

Bouaicha, Samy; Dora, Claudio; Puskas, Gabor J; Koch, Peter P; Wirth, Stephan H; Meyer, Dominik C

2012-01-01

Compared to rigid arthroscopic optics, a flexible camera system offers theoretically significant advantages: It has the potential to adapt to the naturally curved surface of joints, to move within the joint without stress to the cartilage or capsule and thereby to reduce the number of portals needed. Former studies evaluated flexible fiberoptic systems which were insufficient regarding image resolution. This is the first report on a new flexible videoendoscope with the so called "chip-on-the-tip" technology used in human joints. With a plasma sterilized 3.9 diameter flexible video endoscopy system (Visera ENF V, OLYMPUS) commonly used in diagnostic rhino-laryngoscopy, we performed preliminary testing in cadaveric knee joints. After successful feasibility testing we utilized the tool in two qualitative diagnostic knee and five hip arthroscopies in combination with conventional rigid 30° and 70° arthroscopes (STORZ). Qualitative evaluation showed superior visualisation of the posterior aspects of the knee joint as insertion of the posterior medial and lateral meniscal horn, tibial insertion of the posterior cruciate ligament and the posterolateral capsulo-ligamentous corner with acceptable image resolution and clarity compared to the rigid arthroscope. In the hip, it was possible to pass around the femoral neck, avoiding additional portals. There seemed to be virtually no risk for cartilage damage at all. Difficulties of the system were scope handling, navigation and orientation within the joint as well as potential damage to the tool itself. This is to our knowledge the first report on flexible videoarthroscopy. Some of the expectations were met, such as to reach virtually every corner the joint with minimal risk for the cartilage or other joint structures and with acceptable image quality. However, there are many significant disadvantages which question the routine use of such a videoendoscopic system with its present technical features. © 2012 – IOS Press and the authors. All rights reserved

Scoping meta-review: introducing a new methodology.

PubMed

Sarrami-Foroushani, Pooria; Travaglia, Joanne; Debono, Deborah; Clay-Williams, Robyn; Braithwaite, Jeffrey

2015-02-01

For researchers, policymakers, and practitioners facing a new field, undertaking a systematic review can typically present a challenge due to the enormous number of relevant papers. A scoping review is a method suggested for addressing this dilemma; however, scoping reviews present their own challenges. This paper introduces the "scoping meta-review" (SMR) for expanding current methodologies and is based on our experiences in mapping the field of consumer engagement in healthcare. During this process, we developed the novel SMR method. An SMR combines aspects of a scoping review and a meta-review to establish an evidence-based map of a field. Similar to a scoping review, an SMR offers a practical and flexible methodology. However, unlike in a traditional scoping review, only systematic reviews are included. Stages of the SMR include: undertaking a preliminary nonsystematic review; building a search strategy; interrogating academic literature databases; classifying and excluding studies based on titles and abstracts; saving the refined database of references; revising the search strategy; selecting and reviewing the full text papers; and thematically analyzing the selected texts and writing the report. The main benefit of an SMR is to map a new field based on high-level evidence provided by systematic reviews. © 2014 Wiley Periodicals, Inc.

Work reintegration for veterans with mental disorders: a systematic literature review to inform research.

PubMed

Van Til, Linda; Fikretoglu, Deniz; Pranger, Tina; Patten, Scott; Wang, Jianli; Wong, May; Zamorski, Mark; Loisel, Patrick; Corbiére, Marc; Shields, Norman; Thompson, Jim; Pedlar, David

2013-09-01

Some veterans, and especially those with mental disorders, have difficulty reintegrating into the civilian workforce. The objectives of this study were to describe the scope of the existing literature on mental disorders and unemployment and to identify factors potentially associated with reintegration of workers with mental disorders into the workforce. The following databases were searched from their respective inception dates: MEDLINE, EMBASE, Cumulative Index Nursing Allied Health (CINAHL), and PsycINFO. In-scope studies had quantitative measures of employment and study populations with well-described mental disorders (eg, anxiety, depression, posttraumatic stress disorder, substance-use disorders). A systematic and comprehensive search of the relevant published literature up to July 2009 was conducted that identified a total of 5,195 articles. From that list, 81 in-scope studies were identified. An update to July 2012 identified 1,267 new articles, resulting in an additional 16 in-scope articles. Three major categories emerged from the in-scope articles: return to work, supported employment, and reintegration. The literature on return to work and supported employment is well summarized by existing reviews. The reintegration literature included 32 in-scope articles; only 10 of these were conducted in populations of veterans. Studies of reintegration to work were not similar enough to synthesize, and it was inappropriate to pool results for this category of literature. Comprehensive literature review found limited knowledge about how to integrate people with mental disorders into a new workplace after a prolonged absence (>1 year). Even more limited knowledge was found for veterans. The results informed the next steps for our research team to enhance successful reintegration of veterans with mental disorders into the civilian workplace.

Flexible versus common technology to estimate economies of scale and scope in the water and sewerage industry: an application to England and Wales.

PubMed

Molinos-Senante, María; Maziotis, Alexandros

2018-05-01

The water industry presents several structures in different countries and also within countries. Hence, several studies have been conducted to evaluate the presence of economies of scope and scale in the water industry leading to inconclusive results. The lack of a common methodology has been identified as an important factor contributing to divergent conclusions. This paper evaluates, for the first time, the presence of economies of scale and scope in the water industry using a flexible technology approach integrating operational and exogenous variables of the water companies in the cost functions. The empirical application carried out for the English and Welsh water industry evidenced that the inclusion of exogenous variables accounts for significant differences in economies of scale and scope. Moreover, completely different results were obtained when the economies of scale and scope were estimated using common and flexible technology methodological approaches. The findings of this study reveal the importance of using an appropriate methodology to support policy decision-making processes to promote sustainable urban water activities.

Air Pollution Awareness in the Scope of the Community Service Practices Course: An Interdisciplinary Study

ERIC Educational Resources Information Center

Aydin-Güç, Funda; Aygün, Müge; Ceylan, Derya; Çavus-Güngören, Seda; Durukan, Ümmü Gülsüm; Hacioglu, Yasemin; Yekeler, Ayse Dilek

2018-01-01

The aim of this study is to determine the effect of the interdisciplinary (the disciplines of Turkish, Social Science, Natural Sciences, Mathematics and Public Administration) activities performed in the scope of the Community Service Practices Course on the air pollution awareness (APW). This study has been performed as a multiple case study.…

The High/Scope Perry Preschool Study: A Case Study in Random Assignment.

ERIC Educational Resources Information Center

Schweinhart, Lawrence J.

2000-01-01

Studied the long-term benefits of preschool programs for young children living in poverty in the High/Scope Perry Preschool Study, which examined the lives of 123 African Americans randomly divided into a preschool treatment group and a no-preschool comparison group. Cost-benefit analyses of data on these students to age 27 show beneficial effects…

Benefits, Costs, and Explanation of the High/Scope Perry Preschool Program.

ERIC Educational Resources Information Center

Schweinhart, Lawrence J.

The High/Scope Perry Preschool Study is a study of the effects of a high-quality preschool program for children born in poverty. Following 123 children randomly assigned to program or no-program control groups, the study has had little attrition on a variety of measures from age 3 to age 41. The study has found evidence of preschool program…

A Search for Identity: Exploring Core Competencies for Interdisciplinary Environmental Programs

ERIC Educational Resources Information Center

Vincent, Shirley Gayle

2010-01-01

Scope and method of study: The study is national in scope, exploratory, and utilized a combination of qualitative and quantitative social science methods. Findings and conclusions: Interdisciplinary environmental (IE) programs in higher education in the United States are both diverse and dynamic in their curriculum designs. Though these…

Determining Teachers' Educational Needs Regarding School Education Projects within the Scope of Erasmus+ Programme

ERIC Educational Resources Information Center

Karakus, Fatma; Uyar, Melis Yesilpinar; Balbag, Nur Leman

2017-01-01

The purpose of this study was to determine teachers' educational needs regarding school education projects within the scope of Erasmus+ programme. In the study, the case study method, one of qualitative research designs, was used. The participants were determined using the snowball sampling method, and eight secondary school teachers took part in…

33 CFR 230.12 - Notice of intent and scoping.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., DEPARTMENT OF DEFENSE PROCEDURES FOR IMPLEMENTING NEPA § 230.12 Notice of intent and scoping. As soon as... issues to be analyzed in depth. Public concerns on issues, studies needed, alternatives to be examined...

Using SCOPE to identify potential regulatory motifs in coregulated genes.

PubMed

Martyanov, Viktor; Gross, Robert H

2011-05-31

SCOPE is an ensemble motif finder that uses three component algorithms in parallel to identify potential regulatory motifs by over-representation and motif position preference. Each component algorithm is optimized to find a different kind of motif. By taking the best of these three approaches, SCOPE performs better than any single algorithm, even in the presence of noisy data. In this article, we utilize a web version of SCOPE to examine genes that are involved in telomere maintenance. SCOPE has been incorporated into at least two other motif finding programs and has been used in other studies. The three algorithms that comprise SCOPE are BEAM, which finds non-degenerate motifs (ACCGGT), PRISM, which finds degenerate motifs (ASCGWT), and SPACER, which finds longer bipartite motifs (ACCnnnnnnnnGGT). These three algorithms have been optimized to find their corresponding type of motif. Together, they allow SCOPE to perform extremely well. Once a gene set has been analyzed and candidate motifs identified, SCOPE can look for other genes that contain the motif which, when added to the original set, will improve the motif score. This can occur through over-representation or motif position preference. Working with partial gene sets that have biologically verified transcription factor binding sites, SCOPE was able to identify most of the rest of the genes also regulated by the given transcription factor. Output from SCOPE shows candidate motifs, their significance, and other information both as a table and as a graphical motif map. FAQs and video tutorials are available at the SCOPE web site which also includes a "Sample Search" button that allows the user to perform a trial run. Scope has a very friendly user interface that enables novice users to access the algorithm's full power without having to become an expert in the bioinformatics of motif finding. As input, SCOPE can take a list of genes, or FASTA sequences. These can be entered in browser text fields, or read from a file. The output from SCOPE contains a list of all identified motifs with their scores, number of occurrences, fraction of genes containing the motif, and the algorithm used to identify the motif. For each motif, result details include a consensus representation of the motif, a sequence logo, a position weight matrix, and a list of instances for every motif occurrence (with exact positions and "strand" indicated). Results are returned in a browser window and also optionally by email. Previous papers describe the SCOPE algorithms in detail.

Aerobic scope and cardiovascular oxygen transport is not compromised at high temperatures in the toad Rhinella marina.

PubMed

Overgaard, Johannes; Andersen, Jonas L; Findsen, Anders; Pedersen, Pil B M; Hansen, Kasper; Ozolina, Karlina; Wang, Tobias

2012-10-15

Numerous recent studies convincingly correlate the upper thermal tolerance limit of aquatic ectothermic animals to reduced aerobic scope, and ascribe the decline in aerobic scope to failure of the cardiovascular system at high temperatures. In the present study we investigate whether this 'aerobic scope model' applies to an air-breathing and semi-terrestrial vertebrate Rhinella marina (formerly Bufo marinus). To quantify aerobic scope, we measured resting and maximal rate of oxygen consumption at temperatures ranging from 10 to 40°C. To include potential effects of acclimation, three groups of toads were acclimated chronically at 20, 25 and 30°C, respectively. The absolute difference between resting and maximal rate of oxygen consumption increased progressively with temperature and there was no significant decrease in aerobic scope, even at temperature immediately below the lethal limit (41-42°C). Haematological and cardiorespiratory variables were measured at rest and immediately after maximal activity at benign (30°C) and critically high (40°C) temperatures. Within this temperature interval, both resting and active heart rate increased, and there was no indication of respiratory failure, judged from high arterial oxygen saturation, P(O2) and [Hb(O2)]. With the exception of elevated resting metabolic rate for cold-acclimated toads, we found few differences in the thermal responses between acclimation groups with regard to the cardiometabolic parameters. In conclusion, we found no evidence for temperature-induced cardiorespiratory failure in R. marina, indicating that maintenance of aerobic scope and oxygen transport is unrelated to the upper thermal limit of this air-breathing semi-terrestrial vertebrate.

Dyskinesias differentiate autistic disorder from catatonia.

PubMed

Brasic, J R; Barnett, J Y; Will, M V; Nadrich, R H; Sheitman, B B; Ahmad, R; Mendonca, M de F; Kaplan, D; Brathwaite, C

2000-12-01

Autistic disorder and catatonia are neuropsychiatric syndromes defined by impairments in social interaction, communication, and restricted, stereotypical motor routines. Assessments of children with these disorders are typically restricted in scope by the patients' limited ability to comprehend directions. The authors performed systematic assessments of dyskinesias on six prepubertal boys with autistic disorder and mental retardation and on one adolescent male with catatonia to determine if this type of information could be routinely obtained. The boys with autistic disorder had more stereotypies and tics, a greater degree of akathisia and hyperactivity, and more compulsions than the adolescent with catatonia. Catatonia was associated with catalepsy and dystonic postures. The authors conclude that the diagnostic accuracy and specificity of neuropsychiatric syndromes may be enhanced by the systematic assessment of the dyskinesias associated with each condition.

PiCO QL: A software library for runtime interactive queries on program data

NASA Astrophysics Data System (ADS)

Fragkoulis, Marios; Spinellis, Diomidis; Louridas, Panos

PiCO QL is an open source C/C++ software whose scientific scope is real-time interactive analysis of in-memory data through SQL queries. It exposes a relational view of a system's or application's data structures, which is queryable through SQL. While the application or system is executing, users can input queries through a web-based interface or issue web service requests. Queries execute on the live data structures through the respective relational views. PiCO QL makes a good candidate for ad-hoc data analysis in applications and for diagnostics in systems settings. Applications of PiCO QL include the Linux kernel, the Valgrind instrumentation framework, a GIS application, a virtual real-time observatory of stellar objects, and a source code analyser.

HIPAA is larger and more complex than Y2K.

PubMed

Tempesco, J W

2000-07-01

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a larger and more complex problem than Y2K ever was. According to the author, the costs associated with a project of such unending scope and in support of intrusion into both information and operational systems of every health care transaction will be incalculable. Some estimate that the administrative simplification policies implemented through HIPAA will save billions of dollars annually, but it remains to be seen whether the savings will outweigh implementation and ongoing expenses associated with systemwide application of the regulations. This article addresses the rules established for electronic data interchange, data set standards for diagnostic and procedure codes, unique identifiers, coordination of benefits, privacy of individual health care information, electronic signatures, and security requirements.

Endoscopic ultrasound in gastroenterology: from diagnosis to therapeutic implications.

PubMed

Mekky, Mohamed A; Abbas, Wael A

2014-06-28

Since its advent in 1980, the scope of endoscopic ultrasound (EUS) has grown to include a wide range of indications, and it is now being incorporated as an integral part of everyday practice in the field of gastroenterology. Its use is extending from an adjuvant imaging aid to utilization as a therapeutic tool for various gastrointestinal disorders. EUS was first used to visualize remote organs, such as the pancreas and abdominal lymph nodes. When fine needle aspiration was introduced, the indications for EUS expanded to include tissue sampling for diagnostic purposes. At the same time, the needle can be used to convey a potential therapy to the internal organs, allowing access to remote sites. In this review, we aim to highlight the expanding spectrum of EUS indications and uses in the field of gastroenterology.

Determination of dose distributions and parameter sensitivity. Hanford Environmental Dose Reconstruction Project; dose code recovery activities; Calculation 005

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

Napier, B.A.; Farris, W.T.; Simpson, J.C.

1992-12-01

A series of scoping calculations has been undertaken to evaluate the absolute and relative contribution of different radionuclides and exposure pathways to doses that may have been received by individuals living in the vicinity of the Hanford site. This scoping calculation (Calculation 005) examined the contributions of numerous parameters to the uncertainty distribution of doses calculated for environmental exposures and accumulation in foods. This study builds on the work initiated in the first scoping study of iodine in cow`s milk and the third scoping study, which added additional pathways. Addressed in this calculation were the contributions to thyroid dose ofmore » infants from (1) air submersion and groundshine external dose, (2) inhalation, (3) ingestion of soil by humans, (4) ingestion of leafy vegetables, (5) ingestion of other vegetables and fruits, (6) ingestion of meat, (7) ingestion of eggs, and (8) ingestion of cows` milk from Feeding Regime 1 as described in Calculation 001.« less

Attentional states influence early neural responses associated with motivational processes: local vs. global attentional scope and N1 amplitude to appetitive stimuli.

PubMed

Gable, Philip A; Harmon-Jones, Eddie

2011-05-01

Positive affects vary in the degree with which they are associated with approach motivation, the drive to approach an object or a goal. High approach-motivated positive affects cause a narrowing of attention, whereas low approach-motivated positive affects causes a broadening of attention. The current study was designed to extend this work by examining whether the relationship between motivation and attentional bias was bi-directional. Specifically, the experiment investigated whether a manipulated local attentional scope would cause greater approach motivational processing than a global attentional scope as measured by neural processes as early as 100 ms. As compared to a global attentional scope, a local attentional scope caused greater neural processing associated with approach motivation as measured by the N1 to appetitive pictures. Copyright © 2011 Elsevier B.V. All rights reserved.

Scoping of Flood Hazard Mapping Needs for Androscoggin County, Maine

USGS Publications Warehouse

Schalk, Charles W.; Dudley, Robert W.

2007-01-01

Background The Federal Emergency Management Agency (FEMA) developed a plan in 1997 to modernize the FEMA flood mapping program. FEMA flood maps delineate flood hazard areas in support of the National Flood Insurance Program (NFIP). FEMA's plan outlined the steps necessary to update FEMA's flood maps for the nation to a seamless digital format and streamline FEMA's operations in raising public awareness of the importance of the maps and responding to requests to revise them. The modernization of flood maps involves conversion of existing information to digital format and integration of improved flood hazard data as needed and as funds allow. To determine flood mapping modernization needs, FEMA has established specific scoping activities to be done on a county-by-county basis for identifying and prioritizing requisite flood-mapping activities for map modernization. The U.S. Geological Survey (USGS), in cooperation with FEMA and the Maine Floodplain Management Program (MFMP) State Planning Office, began scoping work in 2006 for Androscoggin County. Scoping activities included assembling existing data and map needs information for communities in Androscoggin County, documentation of data, contacts, community meetings, and prioritized mapping needs in a final scoping report (this document), and updating the Mapping Needs Update Support System (MNUSS) Database with information gathered during the scoping process. The average age of the FEMA floodplain maps in Androscoggin County, Maine, is at least 17 years. Most studies were published in the early 1990s, and some towns have partial maps that are more recent than their study date. Since the studies were done, development has occurred in many of the watersheds and the characteristics of the watersheds have changed with time. Therefore, many of the older studies may not depict current conditions nor accurately estimate risk in terms of flood heights or flood mapping.

Scope of physician procedures independently billed by mid-level providers in the office setting.

PubMed

Coldiron, Brett; Ratnarathorn, Mondhipa

2014-11-01

Mid-level providers (nurse practitioners and physician assistants) were originally envisioned to provide primary care services in underserved areas. This study details the current scope of independent procedural billing to Medicare of difficult, invasive, and surgical procedures by medical mid-level providers. To understand the scope of independent billing to Medicare for procedures performed by mid-level providers in an outpatient office setting for a calendar year. Analyses of the 2012 Medicare Physician/Supplier Procedure Summary Master File, which reflects fee-for-service claims that were paid by Medicare, for Current Procedural Terminology procedures independently billed by mid-level providers. Outpatient office setting among health care providers. The scope of independent billing to Medicare for procedures performed by mid-level providers. In 2012, nurse practitioners and physician assistants billed independently for more than 4 million procedures at our cutoff of 5000 paid claims per procedure. Most (54.8%) of these procedures were performed in the specialty area of dermatology. The findings of this study are relevant to safety and quality of care. Recently, the shortage of primary care clinicians has prompted discussion of widening the scope of practice for mid-level providers. It would be prudent to temper widening the scope of practice of mid-level providers by recognizing that mid-level providers are not solely limited to primary care, and may involve procedures for which they may not have formal training.

Moving Forward with Computational Red Teaming

DTIC Science & Technology

2012-07-01

scoping study of one targeted task within the division. This study would apply the taxonomy developed in this report, in 1 Functional elements are...into the study and development of Computational Red Teaming, following earlier work presented by Gowlett (2011). Gowlett called for the development of...implements the recommendation of Gowlett (2011). It will provide a scoping study of CRT to advance the science in this field. UNCLASSIFIED 1

A Comparative Analysis of General Culture Courses within the Scope of Knowledge Categories in Undergraduate Teacher Education Programs "Turkey and the USA"

ERIC Educational Resources Information Center

Hayirsever, Fahriye; Kalayci, Nurdan

2017-01-01

In this study, general culture and general education courses within the scope of knowledge categories in undergraduate teacher education programs in Turkey and the USA are comparatively analyzed. The study is a comparative education study and uses a descriptive model. In the study, the general culture - general education courses taught in the…

Control of Visceral Leishmaniasis in Latin America—A Systematic Review

PubMed Central

Romero, Gustavo A. S.; Boelaert, Marleen

2010-01-01

Background While three countries in South Asia decided to eliminate anthroponotic visceral leishmaniasis (VL) by 2015, its control in other regions seems fraught with difficulties. Is there a scope for more effective VL control in the Americas where transmission is zoonotic? We reviewed the evidence on VL control strategies in Latin America—diagnosis, treatment, veterinary interventions, vector control—with respect to entomological and clinical outcomes. Methodology/Principal Findings We searched the electronic databases of MEDLINE, LILACS, and the Cochrane Central Register of Controlled Trials, from 1960 to November 2008 and references of selected articles. Intervention trials as well as observational studies that evaluated control strategies of VL in the Americas were included. While the use of rapid diagnostic tests for VL diagnosis seems well established, there is a striking lack of evidence from clinical trials for drug therapy and few well designed intervention studies for control of vectors or canine reservoirs. Conclusion Elimination of zoonotic VL in the Americas does not seem a realistic goal at this point given the lack of political commitment, gaps in scientific knowledge, and the weakness of case management and surveillance systems. Research priorities and current strategies should be reviewed with the aim of achieving better VL control. PMID:20098726

Isolation of Extracellular Vesicles: General Methodologies and Latest Trends

PubMed Central

Konoshenko, Maria Yu.; Laktionov, Pavel P.

2018-01-01

Background Extracellular vesicles (EVs) play an essential role in the communication between cells and transport of diagnostically significant molecules. A wide diversity of approaches utilizing different biochemical properties of EVs and a lack of accepted protocols make data interpretation very challenging. Scope of Review This review consolidates the data on the classical and state-of-the-art methods for isolation of EVs, including exosomes, highlighting the advantages and disadvantages of each method. Various characteristics of individual methods, including isolation efficiency, EV yield, properties of isolated EVs, and labor consumption are compared. Major Conclusions A mixed population of vesicles is obtained in most studies of EVs for all used isolation methods. The properties of an analyzed sample should be taken into account when planning an experiment aimed at studying and using these vesicles. The problem of adequate EVs isolation methods still remains; it might not be possible to develop a universal EV isolation method but the available protocols can be used towards solving particular types of problems. General Significance With the wide use of EVs for diagnosis and therapy of various diseases the evaluation of existing methods for EV isolation is one of the key problems in modern biology and medicine. PMID:29662902

Genetic factors affecting dental caries risk.

PubMed

Opal, S; Garg, S; Jain, J; Walia, I

2015-03-01

This article reviews the literature on genetic aspects of dental caries and provides a framework for the rapidly changing disease model of caries. The scope is genetic aspects of various dental factors affecting dental caries. The PubMed database was searched for articles with keywords 'caries', 'genetics', 'taste', 'diet' and 'twins'. This was followed by extensive handsearching using reference lists from relevant articles. The post-genomic era will present many opportunities for improvement in oral health care but will also present a multitude of challenges. We can conclude from the literature that genes have a role to play in dental caries; however, both environmental and genetic factors have been implicated in the aetiology of caries. Additional studies will have to be conducted to replicate the findings in a different population. Identification of genetic risk factors will help screen and identify susceptible patients to better understand the contribution of genes in caries aetiopathogenesis. Information derived from these diverse studies will provide new tools to target individuals and/or populations for a more efficient and effective implementation of newer preventive measures and diagnostic and novel therapeutic approaches in the management of this disease. © 2015 Australian Dental Association.

"Clustering" Documents Automatically to Support Scoping Reviews of Research: A Case Study

ERIC Educational Resources Information Center

Stansfield, Claire; Thomas, James; Kavanagh, Josephine

2013-01-01

Background: Scoping reviews of research help determine the feasibility and the resource requirements of conducting a systematic review, and the potential to generate a description of the literature quickly is attractive. Aims: To test the utility and applicability of an automated clustering tool to describe and group research studies to improve…

Economies of scale and scope in publicly funded biomedical and health research: evidence from the literature.

PubMed

Hernandez-Villafuerte, Karla; Sussex, Jon; Robin, Enora; Guthrie, Sue; Wooding, Steve

2017-02-02

Publicly funded biomedical and health research is expected to achieve the best return possible for taxpayers and for society generally. It is therefore important to know whether such research is more productive if concentrated into a small number of 'research groups' or dispersed across many. We undertook a systematic rapid evidence assessment focused on the research question: do economies of scale and scope exist in biomedical and health research? In other words, is that research more productive per unit of cost if more of it, or a wider variety of it, is done in one location? We reviewed English language literature without date restriction to the end of 2014. To help us to classify and understand that literature, we first undertook a review of econometric literature discussing models for analysing economies of scale and/or scope in research generally (not limited to biomedical and health research). We found a large and disparate literature. We reviewed 60 empirical studies of (dis-)economies of scale and/or scope in biomedical and health research, or in categories of research including or overlapping with biomedical and health research. This literature is varied in methods and findings. At the level of universities or research institutes, studies more often point to positive economies of scale than to diseconomies of scale or constant returns to scale in biomedical and health research. However, all three findings exist in the literature, along with inverse U-shaped relationships. At the level of individual research units, laboratories or projects, the numbers of studies are smaller and evidence is mixed. Concerning economies of scope, the literature more often suggests positive economies of scope than diseconomies, but the picture is again mixed. The effect of varying the scope of activities by a research group was less often reported than the effect of scale and the results were more mixed. The absence of predominant findings for or against the existence of economies of scale or scope implies a continuing need for case by case decisions when distributing research funding, rather than a general policy either to concentrate funding in a few centres or to disperse it across many.

The Use of Tablets Distributed within the Scope of FATIH Project for Education in Turkey (Is FATIH Project a Fiasco or a Technological Revolution?)

ERIC Educational Resources Information Center

Isci, Tugce Gamze; Demir, Selcuk Besir

2015-01-01

This study aims to profoundly investigate the usage of tablets distributed within the scope of FATIH Project in Turkey in terms of teacher views. The study was conducted with case study design, which is one of the qualitative study methods. The participants in the study were determined using critical case sampling. Data was collected using…

Educational Technology Research Trends in Turkey: A Content Analysis of the 2000-2009 Decade

ERIC Educational Resources Information Center

Goktas, Yuksel; Kucuk, Sevda; Aydemir, Melike; Telli, Esra; Arpacik, Omer; Yildirim, Gurkan; Reisoglu, Ilknur

2012-01-01

The purpose of this study is to examine Turkish educational technology studies in the academic literature within the scope of SSCI, and to reveal methodological trends within these studies. For this purpose, 460 Turkey-addressed articles, published between the years of 2000-2009 in 32 international journals, within the scope of 2010 SSCI were…

Equine Education Programs and Related Studies as Found in Colleges and Universities in the United States.

ERIC Educational Resources Information Center

Parmenter, Carol L. W.

The purpose of this study was to determine the nature and scope of equine education programs being offered in the colleges and universities throughout the country and the attitudes of specialists toward these programs. The paper is organized into five major categories: (1) introduction, statement of purpose, design and scope of the study, and…

How Management Information Systems Can Enhance the Air Force Drug Testing Program

DTIC Science & Technology

1989-12-01

promising processes to positively identify potential system users (46:401). Scope This study will cover issues concerning the Air Force drug testing...7 Scope....................10 Limitations of the Research . . . 10 Investigative Questions ............ 10 Expected Benefits of the Study . . . . 11...Resource Allocation. ....... 41 M1.>ethodology....................44 The Historical Research Method . . .. 44 The Historical Research Method for this Study

Progress and challenges of disaster health management in China: a scoping review

PubMed Central

Zhong, Shuang; Clark, Michele; Hou, Xiang-Yu; Zang, Yuli; FitzGerald, Gerard

2014-01-01

Background Despite the importance of an effective health system response to various disasters, relevant research is still in its infancy, especially in middle- and low-income countries. Objective This paper provides an overview of the status of disaster health management in China, with its aim to promote the effectiveness of the health response for reducing disaster-related mortality and morbidity. Design A scoping review method was used to address the recent progress of and challenges to disaster health management in China. Major health electronic databases were searched to identify English and Chinese literature that were relevant to the research aims. Results The review found that since 2003 considerable progress has been achieved in the health disaster response system in China. However, there remain challenges that hinder effective health disaster responses, including low standards of disaster-resistant infrastructure safety, the lack of specific disaster plans, poor emergency coordination between hospitals, lack of portable diagnostic equipment and underdeveloped triage skills, surge capacity, and psychological interventions. Additional challenges include the fragmentation of the emergency health service system, a lack of specific legislation for emergencies, disparities in the distribution of funding, and inadequate cost-effective considerations for disaster rescue. Conclusions One solution identified to address these challenges appears to be through corresponding policy strategies at multiple levels (e.g. community, hospital, and healthcare system level). PMID:25215910

Fecal calprotectin: its scope and utility in the management of inflammatory bowel disease.

PubMed

Ikhtaire, Shapur; Shajib, Mohammad Sharif; Reinisch, Walter; Khan, Waliul Islam

2016-05-01

Gastrointestinal symptoms such as abdominal pain, dyspepsia, and diarrhea are relatively nonspecific and a common cause for seeking medical attention. To date, it is challenging for physicians to differentiate between functional and organic gastrointestinal conditions and it involves the use of serological and endoscopic techniques. Therefore, a simple, noninvasive, inexpensive, and effective test would be of utmost importance in clinical practice. Fecal calprotectin (FC) is considered to be a reliable biomarker that fulfills these criteria. FC can detect intestinal inflammation, and its level correlates well with macroscopic and histological inflammation as detected by colonoscopy and biopsies, respectively. FC has a decent diagnostic accuracy for differentiating organic diseases and functional disorders because of its excellent negative predictive value in ruling out inflammatory bowel disease (IBD) in symptomatic undiagnosed patients. There is accumulating evidence that FC has been effectively used to monitor the natural course of IBD, to predict relapse, and to see the response to treatment. This novel biomarker has the ability to assess mucosal healing (MH), which is a therapeutic goal in IBD management. A literature search was carried out using PubMed with the keywords FC, IBD, intestinal inflammation, and MH. In our review, we provide an overview of the utility and scope of FC as a biomarker in patients with IBD as well as undiagnosed patients with lower gastrointestinal symptoms.

The impact of hyperandrogenism in female obesity and cardiometabolic diseases associated with polycystic ovary syndrome.

PubMed

Barber, Thomas M; Vojtechova, Petra; Franks, Stephen

2013-09-01

Polycystic ovary syndrome (PCOS) is a common condition characterized by reproductive and hyperandrogenic features and is often associated with obesity and metabolic dysfunction. Overall, women with PCOS have a substantially greater prevalence of metabolic syndrome than women from the general population. Furthermore, PCOS per se (independent of its frequent association with obesity) often confers cardiometabolic risk (including insulin resistance), and its concurrence with obesity often represents a metabolic "double-whammy" from the adverse effects of PCOS and obesity. The introduction of the Rotterdam diagnostic criteria for PCOS in 2003 has broadened the scope of this condition. The Rotterdam diagnostic criteria have also introduced two new phenotypic subgroups (including normoandrogenemic women with PCOS) that have provided novel insights into a potential role for hyperandrogenism in the development of adverse cardiometabolic risk in women with PCOS. Based on evidence from cross-sectional and interventional studies, hyperandrogenism, obesity, and cardiometabolic risk in women appear to be linked through complex and multidirectional pathways. Furthermore, data from obese women without a formal diagnosis of PCOS also suggest that these interrelationships often exist in female obesity per se (in milder forms than occurs in PCOS). Data from female-to-male transsexuals are particularly informative because these show direct effects of hyperandrogenism (induced through exogenous use of androgenic therapies) on fat distribution and cardiometabolic risk in women. A challenge for the future will be to disentangle and improve our understanding of this complex pathogenic web, thereby facilitating novel and targeted therapies for the hyperandrogenic and adverse cardiometabolic manifestations of PCOS.

Headache and pregnancy: a systematic review.

PubMed

Negro, A; Delaruelle, Z; Ivanova, T A; Khan, S; Ornello, R; Raffaelli, B; Terrin, A; Reuter, U; Mitsikostas, D D

2017-10-19

This systematic review summarizes the existing data on headache and pregnancy with a scope on clinical headache phenotypes, treatment of headaches in pregnancy and effects of headache medications on the child during pregnancy and breastfeeding, headache related complications, and diagnostics of headache in pregnancy. Headache during pregnancy can be both primary and secondary, and in the last case can be a symptom of a life-threatening condition. The most common secondary headaches are stroke, cerebral venous thrombosis, subarachnoid hemorrhage, pituitary tumor, choriocarcinoma, eclampsia, preeclampsia, idiopathic intracranial hypertension, and reversible cerebral vasoconstriction syndrome. Migraine is a risk factor for pregnancy complications, particularly vascular events. Data regarding other primary headache conditions are still scarce. Early diagnostics of the disease manifested by headache is important for mother and fetus life. It is especially important to identify "red flag symptoms" suggesting that headache is a symptom of a serious disease. In order to exclude a secondary headache additional studies can be necessary: electroencephalography, ultrasound of the vessels of the head and neck, brain MRI and MR angiography with contrast ophthalmoscopy and lumbar puncture. During pregnancy and breastfeeding the preferred therapeutic strategy for the treatment of primary headaches should always be a non-pharmacological one. Treatment should not be postponed as an undermanaged headache can lead to stress, sleep deprivation, depression and poor nutritional intake that in turn can have negative consequences for both mother and baby. Therefore, if non-pharmacological interventions seem inadequate, a well-considered choice should be made concerning the use of medication, taking into account all the benefits and possible risks.

An International Survey of Brain Banking Operation and Characterization Practices

PubMed Central

Palmer-Aronsten, Beatrix; McCrossin, Toni; Kril, Jillian

2016-01-01

Brain banks continue to make a major contribution to the study of neurological and psychiatric disorders. The current complexity and scope of research heighten the need for well-characterized cases and the demand for larger cohorts and necessitate strategies, such as the establishment of bank networks based in regional areas. While individual brain banks have developed protocols that meet researchers' needs within the confines of resources and funding, to further promote collaboration, standardization and scientific validity and understanding of the current protocols of participating banks are required. A survey was sent to brain banks, identified by an Internet search, to investigate operational protocols, case characterization, cohort management, data collection, standardization, and degree of collaboration between banks. The majority of the 24 banks that returned the survey have been established for more than 20 years, and most are affiliated with a regional network. While prospective donor programs were the primary source of donation, the data collected on donors varied. Longitudinal information assists case characterization and enhances the analysis capabilities of research. However, acquiring this information depended on the availability of qualified staff. Respondents indicated a high level of importance for standardization, but only 8 of 24 considered this occurred between banks. Standard diagnostic criteria were not achieved in the classification of controls, and some banks relied on the researcher to indicate the criteria for classification of controls. Although the capacity to collaborate with other banks was indicated by 16 of 24 banks, this occurred infrequently. Engagement of all brain banks to participate toward a consensus of diagnostic tools, especially for controls, will strengthen collaboration. PMID:27399803

An International Survey of Brain Banking Operation and Characterization Practices.

PubMed

Palmer-Aronsten, Beatrix; Sheedy, Donna; McCrossin, Toni; Kril, Jillian

2016-12-01

Brain banks continue to make a major contribution to the study of neurological and psychiatric disorders. The current complexity and scope of research heighten the need for well-characterized cases and the demand for larger cohorts and necessitate strategies, such as the establishment of bank networks based in regional areas. While individual brain banks have developed protocols that meet researchers' needs within the confines of resources and funding, to further promote collaboration, standardization and scientific validity and understanding of the current protocols of participating banks are required. A survey was sent to brain banks, identified by an Internet search, to investigate operational protocols, case characterization, cohort management, data collection, standardization, and degree of collaboration between banks. The majority of the 24 banks that returned the survey have been established for more than 20 years, and most are affiliated with a regional network. While prospective donor programs were the primary source of donation, the data collected on donors varied. Longitudinal information assists case characterization and enhances the analysis capabilities of research. However, acquiring this information depended on the availability of qualified staff. Respondents indicated a high level of importance for standardization, but only 8 of 24 considered this occurred between banks. Standard diagnostic criteria were not achieved in the classification of controls, and some banks relied on the researcher to indicate the criteria for classification of controls. Although the capacity to collaborate with other banks was indicated by 16 of 24 banks, this occurred infrequently. Engagement of all brain banks to participate toward a consensus of diagnostic tools, especially for controls, will strengthen collaboration.

Diagnostics of microwave assisted electron cyclotron resonance plasma source for surface modification of nylon 6

NASA Astrophysics Data System (ADS)

More, Supriya E.; Das, Partha Sarathi; Bansode, Avinash; Dhamale, Gayatri; Ghorui, S.; Bhoraskar, S. V.; Sahasrabudhe, S. N.; Mathe, Vikas L.

2018-01-01

Looking at the increasing scope of plasma processing of materials surface, here we present the development and diagnostics of a microwave assisted Electron Cyclotron Resonance (ECR) plasma system suitable for surface modification of polymers. Prior to the surface-treatment, a detailed diagnostic mapping of the plasma parameters throughout the reactor chamber was carried out by using single and double Langmuir probe measurements in Ar plasma. Conventional analysis of I-V curves as well as the elucidation form of the Electron Energy Distribution Function (EEDF) has become the source of calibration of plasma parameters in the reaction chamber. The high energy tail in the EEDF of electron temperature is seen to extend beyond 60 eV, at much larger distances from the ECR zone. This proves the suitability of the rector for plasma processing, since the electron energy is much beyond the threshold energy of bond breaking in most of the polymers. Nylon 6 is used as a representative candidate for surface processing in the presence of Ar, H2 + N2, and O2 plasma, treated at different locations inside the plasma chamber. In a typical case, the work of adhesion is seen to almost get doubled when treated with oxygen plasma. Morphology of the plasma treated surface and its hydrophilicity are discussed in view of the variation in electron density and electron temperature at these locations. Nano-protrusions arising from plasma treatment are set to be responsible for the hydrophobicity. Chemical sputtering and physical sputtering are seen to influence the surface morphology on account of sufficient electron energies and increased plasma potential.

An empirical investigation into the role of subjective prior probability in searching for potentially missing items

PubMed Central

Fanshawe, T. R.

2015-01-01

There are many examples from the scientific literature of visual search tasks in which the length, scope and success rate of the search have been shown to vary according to the searcher's expectations of whether the search target is likely to be present. This phenomenon has major practical implications, for instance in cancer screening, when the prevalence of the condition is low and the consequences of a missed disease diagnosis are severe. We consider this problem from an empirical Bayesian perspective to explain how the effect of a low prior probability, subjectively assessed by the searcher, might impact on the extent of the search. We show how the searcher's posterior probability that the target is present depends on the prior probability and the proportion of possible target locations already searched, and also consider the implications of imperfect search, when the probability of false-positive and false-negative decisions is non-zero. The theoretical results are applied to two studies of radiologists' visual assessment of pulmonary lesions on chest radiographs. Further application areas in diagnostic medicine and airport security are also discussed. PMID:26587267

From morphology to biochemical state – intravital multiphoton fluorescence lifetime imaging of inflamed human skin

PubMed Central

Huck, Volker; Gorzelanny, Christian; Thomas, Kai; Getova, Valentina; Niemeyer, Verena; Zens, Katharina; Unnerstall, Tim R.; Feger, Julia S.; Fallah, Mohammad A.; Metze, Dieter; Ständer, Sonja; Luger, Thomas A.; Koenig, Karsten; Mess, Christian; Schneider, Stefan W.

2016-01-01

The application of multiphoton microscopy in the field of biomedical research and advanced diagnostics promises unique insights into the pathophysiology of inflammatory skin diseases. In the present study, we combined multiphoton-based intravital tomography (MPT) and fluorescence lifetime imaging (MPT-FLIM) within the scope of a clinical trial of atopic dermatitis with the aim of providing personalised data on the aetiopathology of inflammation in a non-invasive manner at patients’ bedsides. These ‘optical biopsies’ generated via MPT were morphologically analysed and aligned with classical skin histology. Because of its subcellular resolution, MPT provided evidence of a redistribution of mitochondria in keratinocytes, indicating an altered cellular metabolism. Two independent morphometric algorithms reliably showed an even distribution in healthy skin and a perinuclear accumulation in inflamed skin. Moreover, using MPT-FLIM, detection of the onset and progression of inflammatory processes could be achieved. In conclusion, the change in the distribution of mitochondria upon inflammation and the verification of an altered cellular metabolism facilitate a better understanding of inflammatory skin diseases and may permit early diagnosis and therapy. PMID:27004454

From morphology to biochemical state - intravital multiphoton fluorescence lifetime imaging of inflamed human skin

NASA Astrophysics Data System (ADS)

Huck, Volker; Gorzelanny, Christian; Thomas, Kai; Getova, Valentina; Niemeyer, Verena; Zens, Katharina; Unnerstall, Tim R.; Feger, Julia S.; Fallah, Mohammad A.; Metze, Dieter; Ständer, Sonja; Luger, Thomas A.; Koenig, Karsten; Mess, Christian; Schneider, Stefan W.

2016-03-01

The application of multiphoton microscopy in the field of biomedical research and advanced diagnostics promises unique insights into the pathophysiology of inflammatory skin diseases. In the present study, we combined multiphoton-based intravital tomography (MPT) and fluorescence lifetime imaging (MPT-FLIM) within the scope of a clinical trial of atopic dermatitis with the aim of providing personalised data on the aetiopathology of inflammation in a non-invasive manner at patients’ bedsides. These ‘optical biopsies’ generated via MPT were morphologically analysed and aligned with classical skin histology. Because of its subcellular resolution, MPT provided evidence of a redistribution of mitochondria in keratinocytes, indicating an altered cellular metabolism. Two independent morphometric algorithms reliably showed an even distribution in healthy skin and a perinuclear accumulation in inflamed skin. Moreover, using MPT-FLIM, detection of the onset and progression of inflammatory processes could be achieved. In conclusion, the change in the distribution of mitochondria upon inflammation and the verification of an altered cellular metabolism facilitate a better understanding of inflammatory skin diseases and may permit early diagnosis and therapy.

Exploring health services accessibility by indigenous women in Asia and identifying actions to improve it: a scoping review.

PubMed

Thummapol, Onouma; Park, Tanya; Barton, Sylvia

2018-05-03

The aim of this scoping review was to uncover and summarize what is known in the literature about the experiences of Indigenous women in Asia regarding access to health services. The study was informed by the scoping review methodology proposed by Arksey and O'Malley [2005. "Scoping Studies: Towards a Methodological Framework." International Journal of Social Research Methodology 8 (1): 19-32. doi: 10.1080/1364557032000119616 ]. A comprehensive search of the databases for peer-reviewed studies and grey literature was conducted between January 2000 and December 2016. The data of selected papers and abstracts were analysed by three independent researchers through a protocol of data charting, descriptive numerical summary, and thematic analysis. Sixteen articles and two abstracts met the inclusion criteria for this scoping review. These 18 peer-reviewed documents consisted of eight qualitative studies, seven quantitative studies, and three mixed-method studies, which included the peer-reviewed poster and oral presentation abstracts from international conferences. The findings were sorted and grouped under the following themes: health care access for Indigenous women in Asia, facilitators to accessing healthcare services, barriers to accessing healthcare services, and cultural contexts impacting health and access. There is limited information about the experiences, facilitators, barriers, and cultural contexts faced by Indigenous women in Asia related to health services accessibility, and even less information related to improving health services accessibility and health outcomes. This scoping review in particular highlights the dearth of literature relating to Indigenous women's postpartum health and access to postnatal supports and services. Generally, it indicates that Indigenous women in Asia are more vulnerable to poor health in comparison to non-Indigenous women, and continue to face challenges and barriers in accessing quality and equitable health services. The barriers identified in this review are useful in explaining why inequities in health and access to health care for Indigenous women living in Asia continue to exist. Recommendations for future research directions are described.

Pre-contract project scoping processes : synthesis of practices.

DOT National Transportation Integrated Search

2016-02-01

Scoping is the process of developing a projects objectives, need, preliminary cost estimate, and preliminary schedule based on a : recognized need that the project is intended to address. This study (INDOT/JTRP SPR-3944) was launched by the Indian...

Research trends in studies of medical students’ characteristics: a scoping review

PubMed Central

2017-01-01

The purpose of this study is to investigate domestic and international research trends in studies of medical students’ characteristics by using the scoping review methods. This study adopted the scoping review to assess papers on the characteristics of medical students. The procedure of research was carried out according to the five steps of the scoping review. The full texts of 100 papers are obtained and are read closely, after which suitable 88 papers are extracted by us for this research. The review is mapped by the year of the study, source, location, author, research design, research subject, objective, and key results. The frequency is analyzed by using Microsoft Excel and SPSS. We found 70 papers (79.5%) on a single medical school, 15 (17.0%) on multiple medical schools, and three (3.4%) on mixed schools, including medical and nonmedical schools. Sixty-nine (79.5%) were cross-sectional studies and 18 (20.5%) were longitudinal studies. Eighty-two papers (93.2%) adopted questionnaire surveys. We summarized research trends of studies on medical students in Korea and overseas by topic, and mapped them into physical health, mental health, psychological characteristics, cognitive characteristics, social characteristics, and career. This study provides insights into the future directions of research for the characteristics of medical students. PMID:28870017

Research trends in studies of medical students' characteristics: a scoping review.

PubMed

Jung, Sung Soo; Park, Kwi Hwa; Roh, HyeRin; Yune, So Jung; Lee, Geon Ho; Chun, Kyunghee

2017-09-01

The purpose of this study is to investigate domestic and international research trends in studies of medical students' characteristics by using the scoping review methods. This study adopted the scoping review to assess papers on the characteristics of medical students. The procedure of research was carried out according to the five steps of the scoping review. The full texts of 100 papers are obtained and are read closely, after which suitable 88 papers are extracted by us for this research. The review is mapped by the year of the study, source, location, author, research design, research subject, objective, and key results. The frequency is analyzed by using Microsoft Excel and SPSS. We found 70 papers (79.5%) on a single medical school, 15 (17.0%) on multiple medical schools, and three (3.4%) on mixed schools, including medical and nonmedical schools. Sixty-nine (79.5%) were cross-sectional studies and 18 (20.5%) were longitudinal studies. Eighty-two papers (93.2%) adopted questionnaire surveys. We summarized research trends of studies on medical students in Korea and overseas by topic, and mapped them into physical health, mental health, psychological characteristics, cognitive characteristics, social characteristics, and career. This study provides insights into the future directions of research for the characteristics of medical students.

The Scope of Pre-Pregnancy Care Conducted at Health Centers of Tabriz, Iran: Women's Viewpoints

PubMed Central

Kamalifard, Mahin; Ebrahim, Hossein; Rahmat, Mahnaz

2013-01-01

Pre-pregnancy care is considered as preventive medicine related to pregnancy and delivery. This Questionnaire based study upon 384 women in the first half of the pregnancy showedthe scope of pre-pregnancy care in the area of physical health was either weak (75%) or average (25%). All women declared that they had not received mental health-related care during the pre-pregnancy care. The scope of pre-pregnancy care in the area of life-style was categorized as weak, average, and good by 69.79%, 29.69%, and 0.52% of the studied women, respectively. PMID:25276723

Addressing female genital mutilation in Europe: a scoping review of approaches to participation, prevention, protection, and provision of services.

PubMed

Baillot, Helen; Murray, Nina; Connelly, Elaine; Howard, Natasha

2018-02-08

Public and policy attention to female genital mutilation (FGM) in diaspora communities has increased in Europe, but research remains limited and misinformation abounds. As a first step to addressing these issues, this study explored FGM prevention and response interventions in Europe, using a scoping literature review and key informant interviews. A scoping study design was selected, using Arksey and O'Malley's six-stage scoping framework to review identified sources. Key informant interviews were used to inform and add depth to literature findings. Findings were summarised thematically, guided by the Scottish Government's '4Ps' framework for tackling violence against women (i.e. participation, prevention, protection, providing services). Seventy literature sources, of 1095 screened, plus 16 individual and 3 group interview sources were included. Several countries have developed promising interventions supporting FGM resistance and recovery. However, gaps remain including community participation, professional knowledge and linkages, and evaluation of approaches. This scoping review is an initial attempt to describe available primary evidence on European initiatives responding to FGM. Further research is required to determine whether interventions are effective, while policy and practice development must be shaped and driven by the experiences, needs, and views of affected communities.

Diabetic muscle infarction in end-stage renal disease: A scoping review on epidemiology, diagnosis and treatment

PubMed Central

Yong, Tuck Yean; Khow, Kareeann Sok Fun

2018-01-01

Diabetic muscle infarction (DMI) refers to spontaneous ischemic necrosis of skeletal muscle among people with diabetes mellitus, unrelated to arterial occlusion. People with DMI may have coexisting end-stage renal disease (ESRD) but little is known about its epidemiology and clinical outcomes in this setting. This scoping review seeks to investigate the characteristics, clinical features, diagnostic evaluation, management and outcomes of DMI among people with ESRD. Electronic database (PubMed/MEDLINE, CINAHL, SCOPUS and EMBASE) searches were conducted for (“diabetic muscle infarction” or “diabetic myonecrosis”) and (“chronic kidney disease” or “renal impairment” or “dialysis” or “renal replacement therapy” or “kidney transplant”) from January 1980 to June 2017. Relevant cases from reviewed bibliographies in reports retrieved were also included. Data were extracted in a standardized form. A total of 24 publications with 41 patients who have ESRD were included. The mean age at the time of presentation with DMI was 44.2 years. Type 2 diabetes was present in 53.7% of patients while type 1 in 41.5%. In this cohort, 60.1% were receiving hemodialysis, 21% on peritoneal dialysis and 12.2% had kidney transplantation. The proximal lower limb musculature was the most commonly affected site. Muscle pain and swelling were the most frequent manifestation on presentation. Magnetic resonance imaging (MRI) provided the most specific findings for DMI. Laboratory investigation findings are usually non-specific. Non-surgical therapy is usually used in the management of DMI. Short-term prognosis of DMI is good but recurrence occurred in 43.9%. DMI is an uncommon complication in patients with diabetes mellitus, including those affected by ESRD. In comparison with unselected patients with DMI, the characteristics and outcomes of those with ESRD are generally similar. DMI may also occur in kidney transplant recipients, including pancreas-kidney transplantation. MRI is the most useful diagnostic investigation. Non-surgical treatment involving analgesia, optimization of glycemic control and initial bed rest can help to improve recovery rate. However, recurrence of DMI is relatively frequent. PMID:29527509

Motivational intensity modulates attentional scope: evidence from behavioral and ERP studies.

PubMed

Liu, Lei; Zhang, Guangnan; Zhou, Renlai; Wang, Zuowei

2014-10-01

Previous studies have found that affective states with high motivational intensity narrow attentional scope, whereas affective states with low motivational intensity broaden attentional scope. This conclusion, however, is based on fragmented evidence based on several separate studies. The present study tests this conclusion within a single study using both behavioral (Experiment 1) and neurophysiological (Experiment 2) measures. Experiment 1 showed that individuals had the global precedence effect in the neutral affective state. However, the global precedence effect was reduced for affective states with high motivational intensity, whereas the global precedence effect was not significantly enhanced for those with low motivational intensity. Experiment 2 replicated these results with event-related potential (ERP) recording. ERP results showed that affective states with high motivational intensity induced smaller N2 and greater late positive potential (LPP) amplitudes than low motivational intensity and neutral affective states. However, no differences were found between the low motivational intensity and neutral affective states. Furthermore, smaller LPP predicted the tendency a global attentional focus in the frontal and central areas and larger LPP predicted a narrowed focus in the frontal area. The findings suggested that high motivational intensity of affective states can affect attentional scope.

Biomechanics of fencing sport: A scoping review

PubMed Central

Chen, Tony Lin-Wei; Wong, Duo Wai-Chi; Wang, Yan; Ren, Sicong; Yan, Fei

2017-01-01

Objectives The aim of our scoping review was to identify and summarize current evidence on the biomechanics of fencing to inform athlete development and injury prevention. Design Scoping review. Method Peer-reviewed research was identified from electronic databases using a structured keyword search. Details regarding experimental design, study group characteristics and measured outcomes were extracted from retrieved studies, summarized and information regrouped under themes for analysis. The methodological quality of the evidence was evaluated. Results Thirty-seven peer-reviewed studies were retrieved, the majority being observational studies conducted with experienced and elite athletes. The methodological quality of the evidence was “fair” due to the limited scope of research. Male fencers were the prevalent group studied, with the lunge and use of a foil weapon being the principal movement evaluated. Motion capture and pedabarography were the most frequently used data collection techniques. Conclusions Elite fencers exhibited sequential coordination of upper and lower limb movements with coherent patterns of muscle activation, compared to novice fencers. These elite features of neuromuscular coordination resulted in higher magnitudes of forward linear velocity of the body center of mass and weapon. Training should focus on explosive power. Sex- and equipment-specific effects could not be evaluated based on available research. PMID:28187164

The Navy Acquisition Contracting Officer Intern Program: A Past and Present NACO View

DTIC Science & Technology

1994-06-01

OBJECTIVE OF THE RESEARCH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 C. SCOPE AND LIMITATIONS OF THE STUDY...that can be taken to make the program more effective? C. SCOPE AND LIMITATIONS OF THE STUDY This study conducts a detailed assessment of the two-year... limited sea experience. D. THE IMPACT OF DAWIA ON THE 1306 SUBSPECIALTY In 1990, Congress passed the Defense Acquisition Workforce Improvement Act (DA

The Scope of Assistive Technology in Learning Process of Students with Blindness

ERIC Educational Resources Information Center

Saleem, Saira; Sajjad, Shahida

2016-01-01

This study was carried out to investigate the scope of assistive technology in learning process of students with blindness. The sample of this study included 56 students with blindness between the ages of 11-22 years from secondary level of education. These students were selected through convenient sampling from five special schools located in…

The Role of Linear Order in the Acquisition of Quantifier Scope in Chinese.

ERIC Educational Resources Information Center

Lee, Thomas Hun-tak

1989-01-01

Assuming the relevance of the linear precedence to the scope interpretation of adult Mandarin, this study investigated the development of this principle in Mandarin-speaking children, with a view to providing a basis for further study of parametric variation. Three kinds of sentences were examined, all of which contained mutually commanding…

The Isolated and Combined Effects of Intervention Components on Mathematic Fluency

ERIC Educational Resources Information Center

Hastings, Kimberly A.

2010-01-01

Scope and Method of Study: The scope of the study was to compare empirically supported math fluency interventions to a control group as well as each other. The intervention components were isolated to investigate their initial strength as well as adding them together to investigate if the combined intervention was actually stronger or more…

The Views of Turkish Science Teachers about Gender Equity within Science Education

ERIC Educational Resources Information Center

Idin, Sahin; Dönmez, Ismail

2017-01-01

The aim of this study was to investigate Turkish Science teachers' views about gender equity in the scope of science education. This study was conducted with the quantitative methodology. Within this scope, a 35-item 5-point Likert scale survey was developed to determine Science teachers' views concerning gender equity issues. 160 Turkish Science…

Optimal Geometric Deployment of a Ground Based Pseudolite Navigation System to Track a Landing Aircraft

DTIC Science & Technology

2006-06-01

Machine Guidance Using LocataNet In this pilot study [3], conducted at the BlueScope Steel warehouse in Port Kembla, Australia, the LocataNet system...Study at BlueScope Steel”. Proceedings of the 2004 Annual Meeting of the Institute of Navigation. Dayton, OH, June 2004. 4. Barnes, Joel, Chris

Alternative Observation Tools for the Scope of Contemporary Education Supervision: An Action Research

ERIC Educational Resources Information Center

Kuru Cetin, Saadet

2018-01-01

In this study, in-class lesson observations were made with volunteer teachers working in primary and secondary schools using alternative observation tools regarding the scope of contemporary educational supervision. The study took place during the fall and spring semesters of the 2015-2016 and 2016-2017 academic years and the class observations…

A New Method for Blood NT-proBNP Determination Based on a Near-infrared Point of Care Testing Device with High Sensitivity and Wide Scope.

PubMed

Zhang, Xiao Guang; Shu, Yao Gen; Gao, Ju; Wang, Xuan; Liu, Li Peng; Wang, Meng; Cao, Yu Xi; Zeng, Yi

2017-06-01

To develop a rapid, highly sensitive, and quantitative method for the detection of NT-proBNP levels based on a near-infrared point-of-care diagnostic (POCT) device with wide scope. The lateral flow assay (LFA) strip of NT-proBNP was first prepared to achieve rapid detection. Then, the antibody pairs for NT-proBNP were screened and labeled with the near-infrared fluorescent dye Dylight-800. The capture antibody was fixed on a nitrocellulose membrane by a scribing device. Serial dilutions of serum samples were prepared using NT-proBNP-free serum series. The prepared test strips, combined with a near-infrared POCT device, were validated by known concentrations of clinical samples. The POCT device gave the output of the ratio of the intensity of the fluorescence signal of the detection line to that of the quality control line. The relationship between the ratio value and the concentration of the specimen was plotted as a work curve. The results of 62 clinical specimens obtained from our method were compared in parallel with those obtained from the Roche E411 kit. Based on the log-log plot, the new method demonstrated that there was a good linear relationship between the ratio value and NT-proBNP concentrations ranging from 20 pg/mL to 10 ng/mL. The results of the 62 clinical specimens measured by our method showed a good linear correlation with those measured by the Roche E411 kit. The new LFA detection method of NT-proBNP levels based on the near-infrared POCT device was rapid and highly sensitive with wide scope and was thus suitable for rapid and early clinical diagnosis of cardiac impairment. Copyright © 2017 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

Preliminary Aerodynamic Investigation of Fan Rotor Blade Morphing

NASA Technical Reports Server (NTRS)

Tweedt, Daniel L.

2012-01-01

Various new technologies currently under development may enable controlled blade shape variability, or so-called blade morphing, to be practically employed in aircraft engine fans and compressors in the foreseeable future. The current study is a relatively brief, preliminary computational fluid dynamics investigation aimed at partially demonstrating and quantifying the aerodynamic potential of fan rotor blade morphing. The investigation is intended to provide information useful for near-term planning, as well as aerodynamic solution data sets that can be subsequently analyzed using advanced acoustic diagnostic tools, for the purpose of making fan noise comparisons. Two existing fan system models serve as baselines for the investigation: the Advanced Ducted Propulsor fan with a design tip speed of 806 ft/sec and a pressure ratio of 1.294, and the Source Diagnostic Test fan with a design tip speed of 1215 ft/sec and a pressure ratio of 1.470. Both are 22-in. sub-scale, low-noise research fan/nacelle models that have undergone extensive experimental testing in the 9- by 15-foot Low Speed Wind Tunnel at the NASA Glenn Research Center. The study, restricted to fan rotor blade morphing only, involves a fairly simple blade morphing technique. Specifically, spanwise-linear variations in rotor blade-section setting angle are applied to alter the blade shape; that is, the blade is linearly retwisted from hub to tip. Aerodynamic performance comparisons are made between morphed-blade and corresponding baseline configurations on the basis of equal fan system thrust, where rotor rotational speed for the morphed-blade fan is varied to change the thrust level for that configuration. The results of the investigation confirm that rotor blade morphing could be a useful technology, with the potential to enable significant improvements in fan aerodynamic performance. Even though the study is very limited in scope and confined to simple geometric perturbations of two existing fan systems, the aerodynamic effectiveness of blade morphing is demonstrated by the configurations analyzed. In particular, for the Advanced Ducted Propulsor fan it is demonstrated that the performance levels of the original variable-pitch baseline design can be achieved using blade morphing instead of variable pitch, and for the Source Diagnostic Test fan the performance at important off-design operating points is substantially increased with blade morphing.

[The course of inpatient rehabilitation in gastrointestinal and metabolic diseases under increasing integration of behavior and experience].

PubMed

Gutschmidt, S; Hänisch, S; Würthner, K

1993-08-01

Starting out from the thesis that behaviour and felt experience, i.e., the patient's "subjective world", have considerable influence on chronic diseases and their consequences in the gastrointestinal field, a "basic course documentation"-based comparison has been carried out of the courses of 4-week in-patient rehabilitation programmes designed to increasingly incorporate interventions directed at this area; the study population had consisted of two groups of patients (n = 688 each) without any significant differences concerning age and sex distribution admitted during the summer terms of 1990 (Group A) and 1991 (Group B), respectively. This documentation (in DBASE IV format) compiles (anonymized) patient data at an "objective" level on the one hand, i.e. basic data (such as diagnoses, age, sex), results obtained by the Edinburgh Rehabilitation Status Scale (ERSS), risk behaviour, and scope of interventions both in the organ-medical and physical therapy fields and in the area of "instruction, motivation, support, group work, and creativity" (designed to achieve integration of behaviour and felt experience); on the other hand, at "subjective level", it comprises the patient's own judgements relative to the treatment regimen and its environment, with subsequent correlational analysis of the data obtained (using the SPSSPC statistical package). As had been expected, correlations have on the one hand been stated at the "objective" level between an increased share of more "serious" conditions (ICD) in 1990 as compared to 1991 and higher ERSS scores (i.e., increased impact of disease consequences), greater organ-medical care intensity, and frequency of incapacity for work; on the other hand, at "subjective" level, strong linkages were found among the item ratings for general sense of improvement, specific and general therapy, as well as so-called "therapeutic environment". When the two levels are linked, the sense of improvement, as expected, is found to correlate negatively with the ERSS, but positively with the scope of the interventions designed to foster integration of behaviour and felt experience. The judgements given for quality of care provided relative to the patient's self-reported primary disorder and for general medical care correlate positively both with the scope of diagnostic/therapeutic organ-medical interventions and integration-focussed ones, which, at least from the patient's perspective, hence exercise an ascertainable, essential effect in the therapeutic setting of in-patient rehabilitation in gastrointestinal and metabolic diseases.

Scoping of Flood Hazard Mapping Needs for Hancock County, Maine

USGS Publications Warehouse

Schalk, Charles W.; Dudley, Robert W.

2007-01-01

Background The Federal Emergency Management Agency (FEMA) developed a plan in 1997 to modernize the FEMA flood mapping program. FEMA flood maps delineate flood hazard areas in support of the National Flood Insurance Program (NFIP). FEMA's plan outlined the steps necessary to update FEMA's flood maps for the nation to a seamless digital format and streamline FEMA's operations in raising public awareness of the importance of the maps and responding to requests to revise them. The modernization of flood maps involves conversion of existing information to digital format and integration of improved flood hazard data as needed. To determine flood mapping modernization needs, FEMA has established specific scoping activities to be done on a county-by-county basis for identifying and prioritizing requisite flood-mapping activities for map modernization. The U.S. Geological Survey (USGS), in cooperation with FEMA and the Maine Floodplain Management Program (MFMP) State Planning Office, began scoping work in 2006 for Hancock County. Scoping activities included assembling existing data and map needs information for communities in Hancock County, documentation of data, contacts, community meetings, and prioritized mapping needs in a final scoping report (this document), and updating the Mapping Needs Update Support System (MNUSS) database with information gathered during the scoping process. The average age of the FEMA floodplain maps (all types) in Hancock County, Maine, is at least 19 years. Most of these studies were published in the late 1980s and early 1990s, and no study is more recent than 1992. Some towns have partial maps that are more recent than their study, indicating that the true average age of the data is probably more than 19 years. Since the studies were done, development has occurred in some of the watersheds and the characteristics of the watersheds have changed. Therefore, many of the older studies may not depict current conditions or accurately estimate risk in terms of flood heights or flood mapping.

Transformation of medical education through Decentralised Training Platforms: a scoping review.

PubMed

Mlambo, Motlatso; Dreyer, Abigail; Dube, Rainy; Mapukata, Nontsikelelo; Couper, Ian; Cooke, Richard

2018-03-01

Medical education in South Africa is facing a major paradigm shift. The urgency to increase the number of suitable, qualified and socially accountable health sciences graduates has brought to the fore the need to identify alternative training platforms and learning environments, often in rural areas. Subsequently, the focus has now shifted towards strengthening primary health care and community based health services. This scoping review presents a synopsis of the existing literature on decentralized training platform (DTP) strategies for medical education internationally, outlining existing models within it and its impact. This scoping review followed Arksey and O'Malley's framework outlining five stages: (i) identification of a research question, (ii) identification of relevant studies, (iii) study selection criteria, (iv) data charting, and (v) collating, summarizing and reporting results. The literature for the scoping review was found using online databases, reference lists and hand searched journals. Data were charted and sorted inductively according to key themes. A final review included 59 articles ranging over the years 1987-2015 with the largest group of studies falling in the period 2011-2015 (47.5%). Studies mostly employed quantitative (32.2%), qualitative (20.3%), systematic/literature review (18.6%) and mixed methods research approaches (11.9%). The scoping review highlighted a range of DTP strategies for transforming medical education. These include training for rural workforce, addressing context specific competencies to promote social accountability, promoting community engagement, and medical education partnerships. Viable models of DTP include community based education, distributed community engaged learning, discipline based clinical rotations, longitudinal clerkships and dedicated tracks focusing on rural issues. Shorter rural placements and supplemental rural tracks are also described. This scoping review showed a considerable amount of literature on decentralized training platforms that highlight the necessary adaptations needed for transforming medical education. The rural context is critical for many of these. Further studies are required to address the impact of DTPs on health service outcomes and human resource outcomes.

Digital Imaging and Communications in Medicine Whole Slide Imaging Connectathon at Digital Pathology Association Pathology Visions 2017

PubMed Central

Clunie, David; Hosseinzadeh, Dan; Wintell, Mikael; De Mena, David; Lajara, Nieves; Garcia-Rojo, Marcial; Bueno, Gloria; Saligrama, Kiran; Stearrett, Aaron; Toomey, David; Abels, Esther; Apeldoorn, Frank Van; Langevin, Stephane; Nichols, Sean; Schmid, Joachim; Horchner, Uwe; Beckwith, Bruce; Parwani, Anil; Pantanowitz, Liron

2018-01-01

As digital pathology systems for clinical diagnostic work applications become mainstream, interoperability between these systems from different vendors becomes critical. For the first time, multiple digital pathology vendors have publicly revealed the use of the digital imaging and communications in medicine (DICOM) standard file format and network protocol to communicate between separate whole slide acquisition, storage, and viewing components. Note the use of DICOM for clinical diagnostic applications is still to be validated in the United States. The successful demonstration shows that the DICOM standard is fundamentally sound, though many lessons were learned. These lessons will be incorporated as incremental improvements in the standard, provide more detailed profiles to constrain variation for specific use cases, and offer educational material for implementers. Future Connectathon events will expand the scope to include more devices and vendors, as well as more ambitious use cases including laboratory information system integration and annotation for image analysis, as well as more geographic diversity. Users should request DICOM features in all purchases and contracts. It is anticipated that the growth of DICOM-compliant manufacturers will likely also ease DICOM for pathology becoming a recognized standard and as such the regulatory pathway for digital pathology products. PMID:29619278

Monocyte Activation in Immunopathology: Cellular Test for Development of Diagnostics and Therapy.

PubMed

Ivanova, Ekaterina A; Orekhov, Alexander N

2016-01-01

Several highly prevalent human diseases are associated with immunopathology. Alterations in the immune system are found in such life-threatening disorders as cancer and atherosclerosis. Monocyte activation followed by macrophage polarization is an important step in normal immune response to pathogens and other relevant stimuli. Depending on the nature of the activation signal, macrophages can acquire pro- or anti-inflammatory phenotypes that are characterized by the expression of distinct patterns of secreted cytokines and surface antigens. This process is disturbed in immunopathologies resulting in abnormal monocyte activation and/or bias of macrophage polarization towards one or the other phenotype. Such alterations could be used as important diagnostic markers and also as possible targets for the development of immunomodulating therapy. Recently developed cellular tests are designed to analyze the phenotype and activity of living cells circulating in patient's bloodstream. Monocyte/macrophage activation test is a successful example of cellular test relevant for atherosclerosis and oncopathology. This test demonstrated changes in macrophage activation in subclinical atherosclerosis and breast cancer and could also be used for screening a panel of natural agents with immunomodulatory activity. Further development of cellular tests will allow broadening the scope of their clinical implication. Such tests may become useful tools for drug research and therapy optimization.

Some approaches to medical support for Martian expedition

NASA Astrophysics Data System (ADS)

Kozlovskaya, Inessa B.; Egorov, Anatoly D.

2003-08-01

Medical support in a Martian expedition will be within the scope of crew responsibilities and maximally autonomous. Requirements to the system of diagnostics in this mission include considerable use of means and methods of visualization of the main physiological parameters, telemedicine, broad usage of biochemical analyses (including "dry" chemistry), computerized collection, measurement, analysis and storage of medical information. The countermeasure system will be based on objective methods of crew fitness and working ability evaluation, individual selection of training regimens, and intensive use of computer controlled training. Implementation of the above principles implies modernization and refinement of the countermeasures currently used by space crews of long-term missions (LTM), and increases of the assortment of active and passive training devices, among them a short-arm centrifuge. The system of medical care with the functions of prevention, clinical diagnostics and timely treatment will be autonomous, too. The general requirements to medical care during the future mission are the following: availability of conditions and means for autonomous urgent and special medical aid and treatment of the most possible states and diseases, "a hospital", and assignment to the crew of one or two doctors. To ensure independence of medical support and medical care in an expedition to Mars an automated expert system needs to be designed and constructed to control the medical situation as a whole.

The Diagnostic and Prognostic Role of microRNA in Colorectal Cancer - a Comprehensive review

PubMed Central

Mazeh, Haggi; Mizrahi, Ido; Ilyayev, Nadia; Halle, David; Brücher, Björn LDM; Bilchik, Anton; Protic, Mladjan; Daumer, Martin; Stojadinovic, Alexander; Avital, Itzhak; Nissan, Aviram

2013-01-01

The discovery of microRNA, a group of regulatory short RNA fragments, has added a new dimension to the diagnosis and management of neoplastic diseases. Differential expression of microRNA in a unique pattern in a wide range of tumor types enables researches to develop a microRNA-based assay for source identification of metastatic disease of unknown origin. This is just one example of many microRNA-based cancer diagnostic and prognostic assays in various phases of clinical research. Since colorectal cancer (CRC) is a phenotypic expression of multiple molecular pathways including chromosomal instability (CIN), micro-satellite instability (MIS) and CpG islands promoter hypermethylation (CIMP), there is no one-unique pattern of microRNA expression expected in this disease and indeed, there are multiple reports published, describing different patterns of microRNA expression in CRC. The scope of this manuscript is to provide a comprehensive review of the scientific literature describing the dysregulation of and the potential role for microRNA in the management of CRC. A Pubmed search was conducted using the following MeSH terms, "microRNA" and "colorectal cancer". Of the 493 publications screened, there were 57 papers describing dysregulation of microRNA in CRC. PMID:23459799

The scale on community care perceptions (scope) for nursing students: A development and psychometric validation study.

PubMed

van Iersel, Margriet; de Vos, Rien; Latour, Corine; Kirschner, Paul A; Scholte Op Reimer, Wilma

2018-05-11

The aim of this study was to develop a valid instrument to measure student nurses' perceptions of community care (SCOPE). DeVellis' staged model for instrument development and validation was used. Scale construction of SCOPE was based on existing literature. Evaluation of its psychometric properties included exploratory factor analysis and reliability analysis. After pilot-testing, 1062 bachelor nursing students from six institutions in the Netherlands (response rate 81%) took part in the study. SCOPE is a 35-item scale containing: background variables, 11 measuring the affective component, 5 measuring community care perception as a placement, 17 as a future profession, and 2 on the reasons underlying student preference. Principal axis factoring yielded two factors in the affective component scale reflecting 'enjoyment' and 'utility', two in the placement scale reflecting 'learning possibilities' and 'personal satisfaction', and four in the profession scale: 'professional development', 'collaboration', 'caregiving', and 'complexity and workload'. Cronbach's α of the complete scale was 0.892 and of the subscales 0.862, 0.696, and 0.810 respectively. SCOPE is a psychometrically sound instrument for measuring students' perceptions of community care. By determining these perceptions, it becomes possible to positively influence them with targeted curriculum redesign, eventually contributing to decreasing the workforce shortage in community nursing. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Incorporating Demand and Supply Constraints into Economic Evaluations in Low-Income and Middle-Income Countries.

PubMed

Vassall, Anna; Mangham-Jefferies, Lindsay; Gomez, Gabriela B; Pitt, Catherine; Foster, Nicola

2016-02-01

Global guidelines for new technologies are based on cost and efficacy data from a limited number of trial locations. Country-level decision makers need to consider whether cost-effectiveness analysis used to inform global guidelines are sufficient for their situation or whether to use models that adjust cost-effectiveness results taking into account setting-specific epidemiological and cost heterogeneity. However, demand and supply constraints will also impact cost-effectiveness by influencing the standard of care and the use and implementation of any new technology. These constraints may also vary substantially by setting. We present two case studies of economic evaluations of the introduction of new diagnostics for malaria and tuberculosis control. These case studies are used to analyse how the scope of economic evaluations of each technology expanded to account for and then address demand and supply constraints over time. We use these case studies to inform a conceptual framework that can be used to explore the characteristics of intervention complexity and the influence of demand and supply constraints. Finally, we describe a number of feasible steps that researchers who wish to apply our framework in cost-effectiveness analyses. © 2016 The Authors. Health Economics published by John Wiley & Sons Ltd.

Patient compliance based on genetic medicine: a literature review.

PubMed

Schneider, Kai Insa; Schmidtke, Jörg

2014-01-01

For this literature review, medical literature data bases were searched for studies on patient compliance after genetic risk assessment. The review focused on conditions where secondary or tertiary preventive options exist, namely cancer syndromes (BRCA-related cancer, HNPCC/colon cancer), hemochromatosis, thrombophilia, smoking cessation, and obesity. As a counterpart, patient compliance was assessed regarding medication adherence and medical advice in some of the most epidemiologically important conditions (including high blood pressure, metabolic syndrome, and coronary heart disease) after receiving medical advice based on nongenetic risk information or a combination of genetic and nongenetic risk information. In the majority of studies based on genetic risk assessments, patients were confronted with predictive rather than diagnostic genetic profiles. Most of the studies started from a knowledge base around 10 years ago when DNA testing was at an early stage, limited in scope and specificity, and costly. The major result is that overall compliance of patients after receiving a high-risk estimate from genetic testing for a given condition is high. However, significant behavior change does not take place just because the analyte is "genetic." Many more factors play a role in the complex process of behavioral tuning. Without adequate counseling and guidance, patients may interpret risk estimates of predictive genetic testing with an increase in fear and anxiety.

Quality improvement for integrated management of patients with type 2 diabetes (PRIHTA project stage 1).

PubMed

Paccagnella, Agostino; Mauri, Alessandra; Spinella, Nello

2012-01-01

The purpose of the study was to show how a different collaborative relationship with family doctors and increasingly specialized diabetologists could lead to a 50% reduction in recurrent appointments due to procedural errors and a 50% reduction in the average waiting times for a specialist medical visit. A qualitative and quantitative definition of the problem was made using the Lean Six Sigma method: (Define); process indicators were observed that might interfere with the objectives of this study (Measure); descriptive statistics were used to confirm the validity and significance of the results (Analyze); and finally strategies were established to intervene on these variables (Improve). Four groups of action led to optimization of the objectives: (1) establishing clinical protocols for primary care physicians for treating hospitalized patients with type 2 diabetes and hyperglycemia; (2) increasing the autonomy of nursing care staff; (3) reorganizing the appointments booking office; and (4) making diabetes clinics more specialized. Thanks to this project, primary care physicians have rediscovered their role and defined their diagnostic-therapeutic function under a shared scientific protocol. The model presented in this study provides scope for reflection on the role of the diabetologist, proposing an "alternative" that concerns only the care of patients with metabolic decompensation.

Understanding and Measuring LGBTQ Pathways to Health: A Scoping Review of Strengths-Based Health Promotion Approaches in LGBTQ Health Research.

PubMed

Gahagan, Jacqueline; Colpitts, Emily

2017-01-01

Health research traditionally has focused on the health risks and deficits of lesbian, gay, bisexual, transgender, and queer (LGBTQ) populations, obscuring the determinants that can promote health across the life course. Recognizing, appropriately measuring, and rendering visible these determinants of health is paramount to informing appropriate and engaging health policies, services, and systems for LGBTQ populations. The overarching purpose of this article is to provide an overview of the findings of a scoping review aimed at exploring strengths-based health promotion approaches to understanding and measuring LGBTQ health. Specifically, this scoping review examined peer-reviewed, published academic literature to determine (a) existing methodological frameworks for studying LGBTQ health from a strengths-based health promotion approach, and (b) suggestions for future methodological approaches for studying LGBTQ health from a strengths-based health promotion approach. The findings of this scoping review will be used to inform the development of a study aimed at assessing the health of and improving pathways to health services among LGBTQ populations in Nova Scotia, Canada.

System design and instrument development for future formation-flying magnetospheric satellite mission SCOPE

NASA Astrophysics Data System (ADS)

Saito, Y.; Fujimoto, M.; Maezawa, K.; Kojima, H.; Takashima, T.; Matsuoka, A.; Shinohara, I.; Tsuda, Y.; Higuchi, K.; Toda, T.

Japan Aerospace Exploration Agency JAXA is currently planning a next generation magnetosphere observation mission called SCOPE cross-Scale COupling in the Plasma universE The main purpose of this mission is to investigate the dynamic behaviors of plasmas in the Terrestrial magnetosphere that range over various time and spatial scales The basic idea of the SCOPE mission is to distinguish temporal and spatial variations of physical processes by putting five formation flying spacecraft into the key region of the Terrestrial magnetosphere The orbit of SCOPE is a highly elliptical orbit with its apogee 30Re from the Earth center SCOPE consists of one 450kg mother satellite and four 90kg daughter satellites flying 5 to 5000km apart from each other The inter-satellite link is used for telemetry command operation as well as ranging to determine the relative orbit of 5 satellites in a small distance which cannot be resolved by the ground-based orbit determination The SCOPE mission is designed such that observational studies from the new perspective that is the cross-scale coupling viewpoint are enabled The orbit is so designed that the spacecraft will visit most of the key regions in the magnetosphere that is the bow shock the magnetospheric boundary the inner-magnetosphere and the near-Earth magnetotail In order to realize the science objectives high performance Plasma Particle sensors DC AC Magnetic and Electric field sensors and Wave Particle Correlator are planned to be onboard the SCOPE satellite All the SCOPE satellites have two 5m spin-axis antenna

Scoping of Flood Hazard Mapping Needs for Lincoln County, Maine

USGS Publications Warehouse

Schalk, Charles W.; Dudley, Robert W.

2007-01-01

Background The Federal Emergency Management Agency (FEMA) developed a plan in 1997 to modernize the FEMA flood mapping program. FEMA flood maps delineate flood hazard areas in support of the National Flood Insurance Program (NFIP). FEMA's plan outlined the steps necessary to update FEMA's flood maps for the nation to a seamless digital format and streamline FEMA's operations in raising public awareness of the importance of the maps and responding to requests to revise them. The modernization of flood maps involves conversion of existing information to digital format and integration of improved flood hazard data as needed. To determine flood mapping modernization needs, FEMA has established specific scoping activities to be done on a county-by-county basis for identifying and prioritizing requisite flood-mapping activities for map modernization. The U.S. Geological Survey (USGS), in cooperation with FEMA and the Maine Floodplain Management Program (MFMP) State Planning Office, began scoping work in 2006 for Lincoln County. Scoping activities included assembling existing data and map needs information for communities in Lincoln County, documentation of data, contacts, community meetings, and prioritized mapping needs in a final scoping report (this document), and updating the Mapping Needs Update Support System (MNUSS) database with information gathered during the scoping process. The average age of the FEMA floodplain maps in Lincoln County, Maine is at least 17 years. Many of these studies were published in the mid- to late-1980s, and some towns have partial maps that are more recent than their study. However, in the ensuing 15-20 years, development has occurred in many of the watersheds, and the characteristics of the watersheds have changed with time. Therefore, many of the older studies may not depict current conditions nor accurately estimate risk in terms of flood heights or flood mapping.

[Medico-economic evaluation of therapeutic strategies at hospital: A systematic review of French studies].

PubMed

Baudouin, A; Armoiry, X; Dussart, C

2017-05-01

Therapeutic innovation contributes to the increase of health care expenditures in France. Medico-economic evaluation has still a minor role in the decision-making for the registration of drugs and medical devices in hospitals. This study aimed to systematically review published works on medico-economic studies conducted within French hospitals. A literature review was carried out to search for medico-economic studies conducted by hospital teams on therapeutic or diagnostic strategies employed within French hospitals and published from 2010 to 2014. Quality assessment of selected studies was performed according to Drummond et al.'s checklist, which is also used within French guidelines. Of the 44 analyzed articles, methods for identification and measure of costs and results complied with guidelines in 95 % of cases. For results interpretation, compliance was 91 %. Costs discounting (29 %) and the use of sensitivity analysis to account for results uncertainty (70 %) were the parameters with the lowest compliance to guidelines. A good training of health professionals in using economic and statistic tools, and the transferability of results of medico-economic studies are essential and should be optimized to enable a broader use of medico-economic evaluation within the scope of decision-making in French hospitals. Copyright © 2016 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

Application of SCOPE-C to Measure Social Inclusion Among Mental Health Services Users in Hong Kong.

PubMed

Chan, Kara; Chiu, Marcus Yu-Lung; Evans, Sherrill; Huxley, Peter J; Ng, Yu-Leung

2016-11-01

This study describes the construction of the Chinese version of the Social and Communities Opportunities Profile (SCOPE), henceforth, the SCOPE-C, to measure social inclusion among mental health services users in Hong Kong. The SCOPE-C was developed based on concept-mapping and benchmarking of census questions. The questionnaire consisted of 56 items, went through a standardized linguistic validation process and was pilot tested with qualitative feedback from five users of mental health services. Altogether 168 Chinese service users were recruited through various NGO mental health services to have three times face-to-face interview between October 2013 and July 2014. Results indicated that items related to satisfaction with opportunities and perceived opportunities in various social domains had high consistency. Nearly all the Kappa statistics and Pearson correlation coefficients between the baseline and two rounds of re-test were significant. The SCOPE-C was considered a valid instrument for Hong Kong mental health user population.

Are Dietary Supplements and Nutraceuticals Effective for Musculoskeletal Health and Cognitive Function? A Scoping Review.

PubMed

Iolascon, G; Gimigliano, R; Bianco, M; De Sire, A; Moretti, A; Giusti, A; Malavolta, N; Migliaccio, S; Migliore, A; Napoli, N; Piscitelli, P; Resmini, G; Tarantino, U; Gimigliano, F

2017-01-01

The aim of our scoping review was to summarize the state of the art regarding micronutrients in order to identify which of them might effectively improve health status in the areas typically impaired in older people: bone, skeletal muscle, and cognitive function. Scoping review. The Italian Study Group on Healthy Aging by Nutraceuticals and Dietary Supplements (HANDS) performed this scoping review, based on the following steps: doing a list of micronutrients related with musculoskeletal or cognitive functions, included in dietary supplements and nutraceuticals commercialized in Italy; planning a research on PubMed, according to an evidence-based approach, in order to the most relevant positive study for each micronutrient into each of the three areas involved (bone, skeletal muscle and cognitive function); identifying the micronutrients effective in maintaining or achieving an adequate health status in older people, specifying the effective and safe daily doses, according to the selected studies. In literature we found 12 relevant positive studies (1 international society guidelines/recommendations, 1 systematic review, 7 randomized controlled trials, and 3 prospective cohort studies). We showed that only 16 micronutrients resulted to have appropriate scientific evidences in terms of improving musculoskeletal health and/or cognitive function in older people: beta-alanine, calcium, creatine, fluorides, leucine, magnesium, omega-3 fatty acids, potassium, vitamin B6, vitamin B9, vitamin B12, vitamin C, vitamin D, vitamin E, vitamin K2, and zinc. This scoping review showed that selected micronutrients in adequate doses might have an ancillary role in musculoskeletal health and cognitive functions in older people.

Sorbent Scoping Studies

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

Chancellor, Christopher John

2016-11-14

The Los Alamos National Laboratory–Carlsbad Operations (LANL-CO) office was tasked by the DOE CBFO, Office of the Manager to perform a review of the acceptable knowledge (AK) to identify the oxidizers and sorbents in transuranic (TRU) waste streams, to conduct scoping studies on the oxidizers and sorbents identified in AK review to inform the Quality Level 1 (QL1) testing, and to conduct a series of QL1 tests to provide the scientific data to support a basis of knowledge document for determining the criteria for (1) accepting waste at the Waste Isolation Pilot Plant (WIPP) without treatment, (2) determining waste thatmore » will require treatment, and (3) if treatment is required, how the treatment must be performed. The purpose of this report is to present the results of the AK review of sorbents present in active waste streams, provide a technical analysis of the sorbent list, report the results of the scoping studies for the fastest-burning organic sorbent, and provide the list of organic and inorganic sorbents to be used in the development of a Test Plan for Preparation and Testing of Sorbents Mixed with Oxidizer found in Transuranic Waste (DWT-TP-001). The companion report, DWT-RPT-001, Oxidizer Scoping Studies, has similar information for oxidizers identified during the AK review of TRU waste streams. The results of the oxidizer and sorbent scoping studies will be used to inform the QL1 test plan. The QL1 test results will support the development of a basis of knowledge document that will evaluate oxidizing chemicals and sorbents in TRU waste and provide guidance for treatment.« less

The Nature and Scope of Outdoor Education in New Zealand Schools

ERIC Educational Resources Information Center

Zink, Robyn; Boyes, Mike

2006-01-01

This paper reports on a study conducted in 2002 and 2003 investigating the nature and scope of outdoor education in New Zealand primary and secondary schools. The aim of the study was to gather data on teachers' practices in outdoor education in New Zealand, the beliefs and values that shape those practices, some of the barriers teachers faced…

A scoping review of qualitative research in peer-reviewed dental publications.

PubMed

Gussy, M; Dickson-Swift, V; Adams, J

2013-08-01

Qualitative research designs are being used increasingly in dental research. This paper describes the extent and range of dental research in which qualitative methods have been employed as well as the techniques of data collection and analysis preferred by dental researchers. A scoping review was conducted to locate studies published in dental journals, which reported the use of qualitative methods. Data concerning the focus of the research and the reported qualitative techniques were extracted. Studies included in the review totalled 197. The majority of qualitative research captured in this scoping study focussed on three main areas: dental education, professional dental and dental educators' activities and experiences and the patient/public perceptions. Interviews and focus group discussions were the most commonly selected techniques for data collection. The majority of the studies included in the scoping review had a focus on education of dental professionals the activities of dental professionals or the reported perceptions of or experiences with dental services by patients or members of the public. Little research was located, which explored peoples' personal experience of dental conditions. Research reported in dental publications has a heavy bias towards the use of focus groups and interview data collection techniques. © 2012 John Wiley & Sons A/S.

The scale of the evidence base on the health effects of conventional yogurt consumption: findings of a scoping review

PubMed Central

Glanville, Julie M.; Brown, Sam; Shamir, Raanan; Szajewska, Hania; Eales, Jacqualyn F.

2015-01-01

Background: The health effects of conventional yogurt have been investigated for over a century; however, few systematic reviews have been conducted to assess the extent of the health benefits of yogurt. Objective: The aim of this scoping review was to assess the volume of available evidence on the health effects of conventional yogurt. Methods: The review was guided by a protocol agreed a priori and informed by an extensive literature search conducted in November 2013. Randomized controlled trials were selected and categorized according to the eligibility criteria established in the protocol. Results: 213 studies were identified as relevant to the scoping question. The number of eligible studies identified for each outcome were: bone health (14 studies), weight management and nutrition related health outcomes (81 studies), metabolic health (6 studies); cardiovascular health (57 studies); gastrointestinal health (24 studies); cancer (39 studies); diabetes (13 studies), Parkinson's disease risk (3 studies), all-cause mortality (3 studies), skin complaints (3 studies), respiratory complaints (3 studies), joint pain/function (2 studies); the remaining 8 studies reported a variety of other outcomes. For studies of a similar design and which assessed the same outcomes in similar population groups, we report the potential for the combining of data across studies in systematic reviews. Conclusions: This scoping review has revealed the extensive evidence base for many outcomes which could be the focus of systematic reviews exploring the health effects of conventional yogurt consumption. PMID:26578956

Signs and symptoms preceding the diagnosis of Alzheimer’s disease: a systematic scoping review of literature from 1937 to 2016

PubMed Central

Bature, Fidelia; Guinn, Barbara-ann; Pang, Dong; Pappas, Yannis

2017-01-01

Objective Late diagnosis of Alzheimer’s disease (AD) may be due to diagnostic uncertainties. We aimed to determine the sequence and timing of the appearance of established early signs and symptoms in people who are subsequently diagnosed with AD. Methods We used systematic review methodology to investigate the existing literature. Articles were reviewed in May 2016, using the following databases: MEDLINE, PsycINFO, CINAHL, British Nursing Index, PubMed central and the Cochrane library, with no language restriction. Data from the included articles were extracted independently by two authors and quality assessment was undertaken with the quality assessment and diagnostic accuracy tool-2 (QUADAS tool-2 quality assessment tool). Results We found that depression and cognitive impairment were the first symptoms to appear in 98.5% and 99.1% of individuals in a study with late-onset AD (LOAD) and 9% and 80%, respectively, in early-onset AD (EOAD). Memory loss presented early and was experienced 12 years before the clinically defined AD dementia in the LOAD. However, the rapidly progressive late-onset AD presented predominantly with 35 non-established focal symptoms and signs including myoclonus (75%), disturbed gait (66%) and rigidity. These were misdiagnosed as symptoms of Creutzfeldt-Jacob disease (CJD) in all the cases. The participant with the lowest mini-mental state examination score of 25 remained stable for 2 years, which is consistent with the score of the healthy family members. Conclusions The findings of this review suggest that neurological and depressive behaviours are an early occurrence in EOAD with depressive and cognitive symptoms in the measure of semantic memory and conceptual formation in LOAD. Misdiagnosis of rapidly progressive AD as CJD and the familial memory score can be confounding factors while establishing a diagnosis. However, the study was limited by the fact that each one of the findings was based on a single study. PMID:28851777

Diagnosing soft tissue rheumatic disorders of the upper limb in epidemiological studies of vibration-exposed populations

PubMed Central

Palmer, Keith T

2013-01-01

Objectives To investigate approaches adopted to diagnose soft tissue rheumatic disorders of the upper limb (ULDs) in vibration-exposed populations and in other settings, and to compare their methodological qualities. Methods Systematic searches were made of the Medline, Embase, and CINAHL electronic bibliographic databases, and of various supplementary sources (textbooks, reviews, conference and workshop proceedings, personal files). For vibration-exposed populations, qualifying papers were scored in terms of the provenance of their measuring instruments (adequacy of documentation, standardisation, reliability, criterion-related and content validity). Similar criteria were applied to general proposals for whole diagnostic schemes, and evidence was collated on the test-retest reliability of symptom histories and clinical signs. Results In total, 23 relevant reports were identified concerning vibration-exposed populations - 21 involving symptoms and 9 involving examination/diagnosis. Most of the instruments employed scored poorly in terms of methodological quality. The search also identified, from the wider literature, more than a dozen schemes directed at classifying ULDs, and 18 studies of test-retest reliability of symptoms and physical signs in the upper limb. Findings support the use of the standardised Nordic questionnaire for symptom inquiry and suggest that a range of physical signs can be elicited with reasonable between-observer agreement. Four classification schemes rated well in terms of content validity. One of these had excellent documentation, and one had been tested for repeatability, agreement with an external reference standard, and utility in distinguishing groups that differed in disability, prognosis and associated risk factors. Conclusions Hitherto, most studies of ULDs in vibration-exposed populations have used custom-specified diagnostic methods, poorly documented, and non-stringent in terms of standardisation and supporting evidence of reliability and/or validity. The broader literature contains several question sets and procedures that improve upon this, and offer scope in vibration-exposed populations to diagnose ULDs more systematically. PMID:17909839

Opportunities for health promotion and disease prevention in the clinical setting.

PubMed Central

McGinnis, J M; Hamburg, M A

1988-01-01

Advances in medicine offer unprecedented opportunities to improve health. New diagnostic, care, and treatment approaches are having a tremendous impact; yet, the leading causes of morbidity and mortality in the United States are intimately linked to preventable factors such as smoking, improper nutrition, alcohol misuse, lack of exercise, and maladaptive behaviors. Compelling evidence indicates that reducing risk factors yields substantial overall health benefits and saves lives. Prevention efforts can be applied effectively at many points in a disease process, and clinical medicine has a significant role. Nonetheless, a number of barriers may interfere. These include physician education and attitudes; patient education, expectations, and motivations; and aspects of the health care delivery system itself, such as access and reimbursement. The situation has been complicated by the apparent lack of consensus on the appropriate frequency and scope of such activities. PMID:3067449

Public Acceptability of E-Mental Health Treatment Services for Psychological Problems: A Scoping Review

PubMed Central

Kemper, Jessica; Stürmer, Carolina

2017-01-01

Background Over the past decades, the deficient provision of evidence-based interventions for the prevention and treatment of mental health problems has become a global challenge across health care systems. In view of the ongoing diffusion of new media and mobile technologies into everyday life, Web-delivered electronic mental health (e-mental health) treatment services have been suggested to expand the access to professional help. However, the large-scale dissemination and adoption of innovative e-mental health services is progressing slowly. This discrepancy between potential and actual impact in public health makes it essential to explore public acceptability of e-mental health treatment services across health care systems. Objective This scoping review aimed to identify and evaluate recent empirical evidence for public acceptability, service preferences, and attitudes toward e-mental health treatments. On the basis of both frameworks for technology adoption and previous research, we defined (1) perceived helpfulness and (2) intentions to use e-mental health treatment services as indicators for public acceptability in the respective general population of reviewed studies. This mapping should reduce heterogeneity and help derive implications for systematic reviews and public health strategies. Methods We systematically searched electronic databases (MEDLINE/PubMed, PsycINFO, Psyndex, PsycARTICLES, and Cochrane Library, using reference management software for parallel searches) to identify surveys published in English in peer-reviewed journals between January 2010 and December 2015, focusing on public perceptions about e-mental health treatments outside the context of clinical, psychosocial, or diagnostic interventions. Both indicators were obtained from previous review. Exclusion criteria further involved studies targeting specific groups or programs. Results The simultaneous database search identified 76 nonduplicate records. Four articles from Europe and Australia were included in this scoping review. Sample sizes ranged from 217 to 2411 participants of ages 14-95 years. All included studies used cross-sectional designs and self-developed measures for outcomes related to both defined indicators of public acceptability. Three surveys used observational study designs, whereas one study was conducted as an experiment investigating the impact of brief educational information on attitudes. Taken together, the findings of included surveys suggested that e-mental health treatment services were perceived as less helpful than traditional face-to-face interventions. Additionally, intentions to future use e-mental health treatments were overall smaller in comparison to face-to-face services. Professional support was essential for help-seeking intentions in case of psychological distress. Therapist-assisted e-mental health services were preferred over unguided programs. Unexpectedly, assumed associations between familiarity with Web-based self-help for health purposes or “e-awareness” and intentions to use e-mental health services were weak or inconsistent. Conclusions Considering the marginal amount and heterogeneity of pilot studies focusing on public acceptability of e-mental health treatments, further research using theory-led approaches and validated measures is required to understand psychological facilitator and barriers for the implementation of innovative services into health care. PMID:28373153

Ongoing training of community health workers in low-income and middle-income countries: a systematic scoping review of the literature

PubMed Central

O’Donovan, Charles; Kuhn, Isla; Sachs, Sonia Ehrlich

2018-01-01

Objectives Understanding the current landscape of ongoing training for community health workers (CHWs) in low-income and middle-income countries (LMICs) is important both for organisations responsible for their training, as well as researchers and policy makers. This scoping review explores this under-researched area by mapping the current delivery implementation and evaluation of ongoing training provision for CHWs in LMICs. Design Systematic scoping review. Data sources MEDLINE, Embase, AMED, Global Health, Web of Science, Scopus, ASSIA, LILACS, BEI and ERIC. Study selection Original studies focusing on the provision of ongoing training for CHWs working in a country defined as low income and middle income according to World Bank Group 2012 classification of economies. Results The scoping review found 35 original studies that met the inclusion criteria. Ongoing training activities for CHWs were described as supervision (n=19), inservice or refresher training (n=13) or a mixture of both (n=3). Although the majority of studies emphasised the importance of providing ongoing training, several studies reported no impact of ongoing training on performance indicators. The majority of ongoing training was delivered inperson; however, four studies reported the use of mobile technologies to support training delivery. The outcomes from ongoing training activities were measured and reported in different ways, including changes in behaviour, attitudes and practice measured in a quantitative manner (n=16), knowledge and skills (n=6), qualitative assessments (n=5) or a mixed methods approach combining one of the aforementioned modalities (n=8). Conclusions This scoping review highlights the diverse range of ongoing training for CHWs in LMICs. Given the expansion of CHW programmes globally, more attention should be given to the design, delivery, monitoring and sustainability of ongoing training from a health systems strengthening perspective. PMID:29705769

Increasing prevalence of diabetes in Bangladesh: a scoping review.

PubMed

Biswas, T; Islam, A; Rawal, L B; Islam, S M S

2016-09-01

The prevalence of type 2 diabetes is increasing rapidly in Bangladesh. However, studies documenting the increasing trend of diabetes prevalence are scarce. The aim of this study was to conduct a scoping review of published literature to ascertain the changing patterns of diabetes prevalence in Bangladesh. We conducted a scoping review based on York scoping reviews framework and performed a comprehensive search of published literature through Medline, BanglaJOL, and Google Scholar published between 1994 and 2013. We summarised and calculated the time trends and pooled prevalence for type 2 diabetes among adults (≥18 years) in both urban and rural areas in Bangladesh. Of 152 studies identified, we included 22 studies for the scoping review which met the inclusion criteria. Overall, 11 studies (50%) were conducted in rural areas, eight in urban (36%) and three (14%) in semi-urban, semi-rural and tribal areas. The overall prevalence of type 2 diabetes ranged between 4.5% and 35.0%. The final estimate of diabetes prevalence obtained after pooling of data from individual studies among 51,252 participants was 7.4% (95% CI 7.2-7.7%). The prevalence of diabetes was higher in males compared to females in urban areas and vice-versa in rural areas. Analyses of exponential trend revealed an increasing trend of diabetes prevalence among urban and rural population at a rate of 0.05% (R = 0.18) and 0.06% (R = 0.35) per year, respectively. The prevalence of type 2 diabetes showed an increasing trend in both urban and rural population in Bangladesh. Our findings suggest the need for an all-out effort by the government and stakeholders to implement preventive strategies for diabetes in Bangladesh. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

The effectiveness of emergency nurse practitioner service in the management of patients presenting to rural hospitals with chest pain: a multisite prospective longitudinal nested cohort study.

PubMed

Roche, Tina E; Gardner, Glenn; Jack, Leanne

2017-06-27

Health reforms in service improvement have included the use of nurse practitioners. In rural emergency departments, nurse practitioners work to the full scope of their expanded role across all patient acuities including those presenting with undifferentiated chest pain. Currently, there is a paucity of evidence regarding the effectiveness of emergency nurse practitioner service in rural emergency departments. Inquiry into the safety and quality of the service, particularly regarding the management of complex conditions is a priority to ensure that this service improvement model meets health care needs of rural communities. This study used a prospective, longitudinal nested cohort study of rural emergency departments in Queensland, Australia. Sixty-one consecutive adult patients with chest pain who presented between November 2014 and February 2016 were recruited into the study cohort. A nested cohort of 41 participants with suspected or confirmed acute coronary syndrome were identified. The primary outcome was adherence to guidelines and diagnostic accuracy of electrocardiograph interpretation for the nested cohort. Secondary outcomes included service indicators of waiting times, diagnostic accuracy as measured by unplanned representation rates, satisfaction with care, quality-of-life, and functional status. Data were examined and compared for differences for participants managed by emergency nurse practitioners and those managed in the standard model of care. The median waiting time was 8.0 min (IQR 20) and length-of-stay was 100.0 min (IQR 64). Participants were 2.4 times more likely to have an unplanned representation if managed by the standard service model. The majority of participants (91.5%) were highly satisfied with the care that they received, which was maintained at 30-day follow-up measurement. In the evaluation of quality of life and functional status, summary scores for the SF-12 were comparable with previous studies. No differences were demonstrated between service models. There was a high level of adherence to clinical guidelines for the emergency nurse practitioner service model and a concomitant high level of diagnostic accuracy. Nurse practitioner service demonstrated comparable effectiveness to that of the standard care model in the evaluation of the service indicators and patient reported outcomes. These findings provide a foundation for the beginning evaluation of rural emergency nurse practitioner service in the delivery of safe and effective beyond the setting of minor injury and illness presentations. Australian New Zealand Clinical Trials Registry, ACTRN12616000823471 (Retrospectively registered).

Aviation and Space Education. Why? What? How?

ERIC Educational Resources Information Center

Matson, Merridee L.

1983-01-01

Aviation and space (aerospace education) is the study of aviation and space and its impact on society. Discusses the nature and scope of aviation and space education in general and basic education. Also considers typical programs and scope at the elementary, secondary, and higher educational levels. (JN)

Parenting Interventions for Indigenous Child Psychosocial Functioning: A Scoping Review

ERIC Educational Resources Information Center

Macvean, Michelle; Shlonsky, Aron; Mildon, Robyn; Devine, Ben

2017-01-01

Objectives: To scope evaluations of Indigenous parenting programs designed to improve child psychosocial outcomes. Methods: Electronic databases, gray literature, Indigenous websites and journals, and reference lists were searched. The search was restricted to high-income countries with a history of colonialism. Results: Sixteen studies describing…

Limited Scope Design Study for Multi-Sensor Towbody

DTIC Science & Technology

2016-06-01

FINAL REPORT Limited Scope Design Study for Multi-Sensor Towbody SERDP Project MR-2501 JUNE 2016 Dr. Kevin Williams Tim McGinnis...prepared under contract to the Department of Defense Strategic Environmental Research and Development Program (SERDP). The publication of this...Left Blank REPORT DOCUMENTATION PAGE Standard Form 298 (Rev. 8/98) Prescribed by ANSI Std. Z39.18 Form Approved OMB No. 0704-0188 The public

Factors Associated With Full Implementation of Scope of Practice.

PubMed

Ganz, Freda DeKeyser; Toren, Orly; Fadlon, Yafit

2016-05-01

To describe whether nurses fully implement their scope of practice; nurses' perceptions of future practice implementation; and the association between scope of practice implementation with professional autonomy and self-efficacy. A descriptive correlational study was conducted using a convenience sample of 145 registered nurses with post-basic certification from two Israeli university hospitals, from May 2012 to September 2013. Five questionnaires were distributed: (a) Demographic and Work Characteristics, (b) Implementation of Scope of Practice, (c) Attitudes Towards Future Practice, (d) Practice Behavior Scale, and (e) Practice Self-Efficacy. Descriptive statistics for all demographic and questionnaire data were analyzed. Two regression models were developed, where current and future implementations were the criterion variables and demographic and work characteristics, professional autonomy, and self-efficacy were the predictors. High levels of professional autonomy, self-efficacy, and attitudes towards future practice were found in contrast to low or moderate levels of current implementation of the full extent of scope of practice. Primary reasons associated with low implementation were lack of relevance to practice and permission to perform the practice. Significant associations were found between professional autonomy, self-efficacy, and attitudes towards future practice, but not with current implementation. Nurses wanted to practice to the full extent of their scope of practice and felt able to do so but were hindered by administrative and not personal barriers. Even though staff nurses with post-basic certification had high levels of professional autonomy and self-efficacy, many were not implementing the full extent of their scope of practice. Similar to findings from around the world, external factors, such as administrative and policy barriers, were found to thwart the full implementation of nurses' full scope of practice. Therefore, practicing nurses should be aware of these barriers and work towards reducing them. © 2016 Sigma Theta Tau International.

Education and Outreach at the Earthscope National Office: 2012 Update on Activities and Broader Impacts

NASA Astrophysics Data System (ADS)

Semken, S. C.; Arrowsmith, R.; Fouch, M. J.; Garnero, E. J.; Taylor, W. L.; Bohon, W.; Pacheco, H. A.; Schwab, P.; Baumback, D.; Pettis, L.; Colunga, J.; Robinson, S.; Dick, C.

2012-12-01

The EarthScope Program (www.earthscope.org) funded by the National Science Foundation fosters interdisciplinary exploration of the geologic structure and evolution of the North American continent by means of seismology, geodesy, magnetotellurics, in-situ fault-zone sampling, geochronology, and high-resolution topographic measurements. EarthScope scientific data and findings are transforming the study of Earth structure and processes throughout the planet. These data enhance the understanding and mitigation of hazards and inform environmental and economic applications of geoscience. The EarthScope Program also offers significant resources and opportunities for education and outreach (E&O) in the Earth system sciences. The EarthScope National Office (ESNO) at Arizona State University serves all EarthScope stakeholders, including researchers, educators, students, and the general public. ESNO continues to actively support and promote E&O with programmatic activities such as a regularly updated presence on the web and social media, newsletters, biannual national conferences, workshops for E&O providers and informal educators (interpreters), collaborative interaction with other Earth science organizations, continuing education for researchers, promotion of place-based education, and support for regional K-12 teacher professional-development programs led by EarthScope stakeholders. EarthScope E&O, coordinated by ESNO, leads the compilation and dissemination of the data, findings, and legacy of the epic EarthScope Program. In this presentation we offer updated reports and outcomes from ESNO E&O activities, including web and social-media upgrades, the Earth Science E&O Provider Summit for partnering organizations, the Central Appalachian Interpretive Workshop for informal Earth science educators, the U.S. Science and Engineering Fair, and collaborative efforts with partner organizations. The EarthScope National Office is supported by the National Science Foundation under grants EAR-1101100 and EAR-1216301. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the National Science Foundation.

Rural Idaho family physicians' scope of practice.

PubMed

Baker, Ed; Schmitz, David; Epperly, Ted; Nukui, Ayaka; Miller, Carissa Moffat

2010-01-01

Scope of practice is an important factor in both training and recruiting rural family physicians. To assess rural Idaho family physicians' scope of practice and to examine variations in scope of practice across variables such as gender, age and employment status. A survey instrument was developed based on a literature review and was validated by physician educators, practicing family physicians and executives at the state hospital association. This survey was mailed to rural family physicians practicing in Idaho counties with populations of less than 50,000. Descriptive, bivariate and multivariate analyses were employed to describe and compare scope of practice patterns. Responses were obtained from 92 of 248 physicians (37.1% response rate). Idaho rural family physicians reported providing obstetrical services in the areas of prenatal care (57.6%), vaginal delivery (52.2%) and C-sections (37.0%); other operating room services (43.5%); esophagogastroduodenoscopy (EGD) or colonoscopy services (22.5%); emergency room coverage (48.9%); inpatient admissions (88.9%); mental health services (90.1%); nursing home services (88.0%); and supervision to midlevel care providers (72.5%). Bivariate analyses showed differences in scope of practice patterns across gender, age group and employment status. Binomial logistic regression models indicated that younger physicians were roughly 3 times more likely to provide prenatal care and perform vaginal deliveries than older physicians in rural areas. Idaho practicing rural family physicians report a broad scope of practice. Younger, employed and female rural family medicine physicians are important subgroups for further study.

Hierarchy and Scope of Planning in Subject-Verb Agreement Production

ERIC Educational Resources Information Center

Gillespie, Maureen; Pearlmutter, Neal J.

2011-01-01

Two subject-verb agreement error elicitation studies tested the hierarchical feature-passing account of agreement computation in production and three timing-based alternatives: linear distance to the head noun, semantic integration, and a combined effect of both (a scope of planning account). In Experiment 1, participants completed subject noun…

21 CFR 314.600 - Scope.

Code of Federal Regulations, 2013 CFR

2013-04-01

... AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE APPLICATIONS FOR FDA APPROVAL TO MARKET A NEW DRUG Approval of New Drugs When Human Efficacy Studies Are Not Ethical or Feasible § 314.600 Scope. This subpart applies to certain new drug products that have been...

21 CFR 314.600 - Scope.

Code of Federal Regulations, 2012 CFR

2012-04-01

... AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE APPLICATIONS FOR FDA APPROVAL TO MARKET A NEW DRUG Approval of New Drugs When Human Efficacy Studies Are Not Ethical or Feasible § 314.600 Scope. This subpart applies to certain new drug products that have been...

21 CFR 314.600 - Scope.

Code of Federal Regulations, 2014 CFR

2014-04-01

... AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE APPLICATIONS FOR FDA APPROVAL TO MARKET A NEW DRUG Approval of New Drugs When Human Efficacy Studies Are Not Ethical or Feasible § 314.600 Scope. This subpart applies to certain new drug products that have been...

21 CFR 314.600 - Scope.

Code of Federal Regulations, 2010 CFR

2010-04-01

... AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE APPLICATIONS FOR FDA APPROVAL TO MARKET A NEW DRUG Approval of New Drugs When Human Efficacy Studies Are Not Ethical or Feasible § 314.600 Scope. This subpart applies to certain new drug products that have been...

21 CFR 314.600 - Scope.

Code of Federal Regulations, 2011 CFR

2011-04-01

... AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE APPLICATIONS FOR FDA APPROVAL TO MARKET A NEW DRUG Approval of New Drugs When Human Efficacy Studies Are Not Ethical or Feasible § 314.600 Scope. This subpart applies to certain new drug products that have been...

36 CFR 297.2 - Scope and application.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 36 Parks, Forests, and Public Property 2 2012-07-01 2012-07-01 false Scope and application. 297.2 Section 297.2 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE WILD AND... assistance in the construction of water resources projects affecting Wild and Scenic Rivers or Study Rivers...

36 CFR 297.2 - Scope and application.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 36 Parks, Forests, and Public Property 2 2013-07-01 2013-07-01 false Scope and application. 297.2 Section 297.2 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE WILD AND... assistance in the construction of water resources projects affecting Wild and Scenic Rivers or Study Rivers...

36 CFR 297.2 - Scope and application.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 2 2011-07-01 2011-07-01 false Scope and application. 297.2 Section 297.2 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE WILD AND... assistance in the construction of water resources projects affecting Wild and Scenic Rivers or Study Rivers...

36 CFR 297.2 - Scope and application.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 36 Parks, Forests, and Public Property 2 2014-07-01 2014-07-01 false Scope and application. 297.2 Section 297.2 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE WILD AND... assistance in the construction of water resources projects affecting Wild and Scenic Rivers or Study Rivers...

36 CFR 297.2 - Scope and application.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Scope and application. 297.2 Section 297.2 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE WILD AND... assistance in the construction of water resources projects affecting Wild and Scenic Rivers or Study Rivers...

Design Experimentation with Multiple Perspectives: The GenScope Assessment Project.

ERIC Educational Resources Information Center

Hickey, Daniel T.; Kruger, Ann Cale; Frederick, Laura D.; Schafer, Nancy Jo; Zuiker, Steven

The GenScope Assessment Project is studying assessment in the context of a month-long computer-supported learning environment for introductory genetics. Across three annual iterations with multiple teachers, project researchers manipulated the materials, incentives, and contexts in which students were invited to use formative feedback on…

75 FR 76447 - Notice of Intent to Prepare a Draft Environmental Impact Statement (EIS), Initiate the Public...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-08

... Draft Environmental Impact Statement (EIS), Initiate the Public Scoping Period and Host Public Scoping Meetings for the Great Lakes and Mississippi River Interbasin Study (``GLMRIS''); Correction, Clarification... international commerce, travel and local practices, ANS have been introduced throughout the Mississippi River...

What the Study of Scope Can Tell Us about Second Language Learning

ERIC Educational Resources Information Center

O'Grady, William; Lee, Miseon; Kwak, Hye-Young

2009-01-01

This paper, designed specifically for language teachers, focuses on a phenomenon in second language learning that is largely independent of instructional effects, curricular materials, and classroom activities. Experimental work suggests that scope, the relationship between two or more logical operators (such as quantifiers or negatives), is…

Measuring Pre-Kindergarten Teachers' Perceptions: Compliance with the High/Scope Program

ERIC Educational Resources Information Center

Palenzuela, Silvia M.

2004-01-01

The research study examined the relationship between pre-kindergarten teachers' age and years of experience with their perceptions and their actual compliance with the norms of the High/Scope Pre-kindergarten Program. Teachers' perceptions of satisfaction with the supervisory relationship were measured by the Early Childhood Job Satisfaction…

How Important Is Child-Initiated Activity?

ERIC Educational Resources Information Center

Schweinhart, Lawrence J.

1988-01-01

Recent research (including a longitudinal study comparing direct instruction, nursery school, and High/Scope models) has shown that the child-initiated approach outstrips teacher-directed activity in fostering some aspects of social development. Adolescents from the High/Scope and nursery school groups had half as many delinquencies as the direct…

76 FR 60587 - Environmental Impact Statement; North Corridor Transit Project, Seattle (WA) Metropolitan Area...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-29

... alternatives identified through an Alternatives Analysis study completed by the project. Early scoping for the alternatives analysis phase was previously announced in the Federal Register on September 27, 2010. Results of the alternatives analysis are described below. DATES: Written comments on the scope of alternatives...

The High/Scope Preschool Curriculum Comparison Study through Age 23.

ERIC Educational Resources Information Center

Schweinhart, Lawrence J.; Weikart, David P.

1997-01-01

Assessed the relative effects through age 23 on young participants born in poverty of the High/Scope, Direct Instruction, and traditional Nursery School preschool curriculum models. Found against using Direct Instruction in preschool programs and for using a well-defined curriculum model based on child-initiated learning activities. (Author)

Characterization of a linear device developed for research on advanced plasma imaging and dynamicsa)

NASA Astrophysics Data System (ADS)

Chung, J.; Lee, K. D.; Seo, D. C.; Nam, Y. U.; Choi, M. C.

2010-10-01

Within the scope of long term research on imaging diagnostics for steady-state plasmas and understanding of edge plasma physics through diagnostics with conventional spectroscopic methods, we have constructed a linear electron cyclotron resonance (ECR) plasma device named Research on Advanced Plasma Imaging and Dynamics (RAPID). It has a variety of axial magnetic field profiles provided by eight water-cooled magnetic coils and two dc power supplies. The positions of the magnetic coils are freely adjustable along the axial direction and the power supplies can be operated with many combinations of electrical wiring to the coils. Here, a 6 kW 2.45 GHz magnetron is used to produce steady-state hydrogen, helium, and argon plasmas with central magnetic fields of 875 and/or 437.5 G (second harmonic). In order to achieve the highest possible plasma performance within the limited input parameters, wall conditioning experiments were carried out. Chamber bake-out was achieved with heating coils that were wound covering the vessel, and long-pulse electron cyclotron heating discharge cleaning was also followed after 4 days of bake-out. A uniform bake-out temperature (150 °C) was achieved by wrapping the vessel in high temperature thermal insulation textile and by controlling the heating coil current using a digital control system. The partial pressure changes were observed using a residual gas analyzer, and a total system pressure of 5×10-8 Torr was finally reached. Diagnostic systems including a millimeter-wave interferometer, a high resolution survey spectrometer, a Langmuir probe, and an ultrasoft x-ray detector were used to provide the evidence that the plasma performance was improved as we desired. In this work, we present characterization of the RAPID device for various system conditions and configurations.

Oxidizer Scoping Studies

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

Chancellor, Christopher John

2016-11-07

The purpose of this report is to present the results of the acceptable knowledge (AK) review of oxidizers present in active waste streams, provide a technical analysis of the oxidizers, and report the results of the scoping study testing. This report will determine the fastest burning oxidizer to be used in the development of a Test Plan for Preparation and Testing of Sorbents Mixed with Oxidizer found in Transuranic Waste (DWT-TP-001). The companion report, DWT-RPT-002, Sorbent Scoping Studies, contains similar information for sorbents identified during the AK review of TRU waste streams. The results of the oxidizer and sorbent scopingmore » studies will be used to inform the QL1 test plan. The QL1 test results will support the development of a basis of knowledge document that will evaluate oxidizing chemicals and sorbents in TRU waste and provide guidance for treatment.« less

Multi-path transportation futures study: Results from Phase 1

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

Patterson, Phil; Singh, Margaret; Plotkin, Steve

2007-03-09

This PowerPoint briefing provides documentation and details for Phase 1 of the Multi-Path Transportation Futures Study, which compares alternative ways to make significant reductions in oil use and carbon emissions from U.S. light vehicles to 2050. Phase I, completed in 2006, was a scoping study, aimed at identifying key analytic issues and constructing a study design. The Phase 1 analysis included an evaluation of several pathways and scenarios; however, these analyses were limited in number and scope and were designed to be preliminary.

76 FR 43678 - Notice of Public Scoping Meetings and Extension of Scoping Period for the U.S. Department of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-21

...: DOE will host public scoping meetings in western Colorado to receive comments on the scope of the DOE...-specific impacts, of the range of reasonable alternatives for the management of DOE's ULP. On June 21, 2011... scope of the PEIS from all interested parties. The public scoping period began on June 21, 2011, and...

EurOOHnet-the European research network for out-of-hours primary health care.

PubMed

Huibers, Linda; Philips, Hilde; Giesen, Paul; Remmen, Roy; Christensen, Morten Bondo; Bondevik, Gunnar Tschudi

2014-09-01

European countries face similar challenges in the provision of health care. Demographic factors like ageing, population growth, changing patient behaviour, and lack of work force lead to increasing demands, costs, and overcrowding of out-of-hours (OOH) care (i.e. primary care services, emergency departments (EDs), and ambulance services). These developments strain services and imply safety risks. In the last few decades, countries have been re-organizing their OOH primary health care services. AIM AND SCOPE OF THE NETWORK: We established a European research network for out-of-hours primary health care (EurOOHnet), which aims to transfer knowledge, share experiences, and conduct research. Combining research competencies and integrating results can generate a profound information flow to European researchers and decision makers in health policy, contributing towards feasible and high-quality OOH care. It also contributes to a more comparable performance level within European regions. CONDUCTED RESEARCH PROJECTS: The European research network aims to conduct mutual research projects. At present, three projects have been accomplished, among others concerning the diagnostic scope in OOH primary care services and guideline adherence for diagnosis and treatment of cystitis in OOH primary care. Future areas of research will be organizational models for OOH care; appropriate use of the OOH services; quality of telephone triage; quality of medical care; patient safety issues; use of auxiliary personnel; collaboration with EDs and ambulance care; and the role of GPs in OOH care.

Culturomics: A New Kid on the Block of OMICS to Enable Personalized Medicine.

PubMed

Kambouris, Manousos E; Pavlidis, Cristiana; Skoufas, Efthymios; Arabatzis, Michael; Kantzanou, Maria; Velegraki, Aristea; Patrinos, George P

2018-02-01

This innovation analysis highlights the underestimated and versatile potential of the new field of culturomics and examines its relation to other OMICS system sciences such as infectiomics, metabolomics, phenomics, and pharmacomicrobiomics. The advent of molecular biology, followed by the emergence of various disciplines of the genomics, and most importantly metagenomics, brought about the sharp decline of conventional microbiology methods. Emergence of culturomics has a natural synergy with therapeutic and clinical genomic approaches so as to realize personalized medicine. Notably, the concept of culturomics expands on that of phenomics and allows a reintroduction of the culture-based phenotypic characterization into the 21st century research repertoire, bolstered by robust technology for automated and massive execution, but its potential is largely unappreciated at present; the few available references show unenthusiastic pursuit and in narrow applications. This has not to be so: depending on the specific brand of culturomics, the scope of applications may extend to medicine, agriculture, environmental sciences, pharmacomicrobiomics, and biotechnology innovation. Moreover, culturomics may produce Big Data. This calls for a new generation of data scientists and innovative ways of harnessing and valorizing Big Data beyond classical genomics. Much more detailed and objective classification and identification of microbiota may soon be at hand through culturomics, thus enabling precision diagnosis toward truly personalized medicine. Culturomics may both widen the scope of microbiology and improve its contributions to diagnostics and personalized medicine, characterizing microbes and determining their associations with health and disease dynamics.

Standardization of the water heat carrier quality at Russian thermal power plants

NASA Astrophysics Data System (ADS)

Larin, B. M.; Larin, A. B.; Suslov, S. Yu.; Kirilina, A. V.

2017-04-01

The necessity of developing a new industry-specific standard of the heat carrier quality for the operating, newly commissioned, and prospective power-generating units of the thermal power plants is substantiated. The need of extending the scope of the automatic chemical monitoring and the possibility of indirect measurements of some basic standardized and diagnostic indices of the water chemistry using the specific conductance are shown. Investigations proved the possibility of automatic chemical monitoring of the phosphating of the drum boilers and quantitative control of potentially acidic impurities in the feed water in oncethrough boilers. The normative STO NP INVEL document developed at OAO VTI in 2009 is proposed as the basis for alterations and amendments. A new index, the total organic carbon, is introduced into this document. The standardized value of this index in the drum boiler feed water and steam is 100 μg/dm3. According to the above normative document, the scope of the chemical monitoring should be extended by measurements of the specific conductance of the direct and H-cation samples of both the feed and the boiler water. The content of chlorides should also be standardized. For the first time, normative restrictions are suggested on amine-containing water chemistry of the power-generating units with the combined cycle gas turbines. Flowcharts are proposed for pretreatment of the make-up water on the basis of low-mineralized natural waters with high organic substance contents, which reduces the oxidizability by 70-80%.

Effect of a limited-enforcement intelligent tutoring system in dermatopathology on student errors, goals and solution paths.

PubMed

Payne, Velma L; Medvedeva, Olga; Legowski, Elizabeth; Castine, Melissa; Tseytlin, Eugene; Jukic, Drazen; Crowley, Rebecca S

2009-11-01

Determine effects of a limited-enforcement intelligent tutoring system in dermatopathology on student errors, goals and solution paths. Determine if limited enforcement in a medical tutoring system inhibits students from learning the optimal and most efficient solution path. Describe the type of deviations from the optimal solution path that occur during tutoring, and how these deviations change over time. Determine if the size of the problem-space (domain scope), has an effect on learning gains when using a tutor with limited enforcement. Analyzed data mined from 44 pathology residents using SlideTutor-a Medical Intelligent Tutoring System in Dermatopathology that teaches histopathologic diagnosis and reporting skills based on commonly used diagnostic algorithms. Two subdomains were included in the study representing sub-algorithms of different sizes and complexities. Effects of the tutoring system on student errors, goal states and solution paths were determined. Students gradually increase the frequency of steps that match the tutoring system's expectation of expert performance. Frequency of errors gradually declines in all categories of error significance. Student performance frequently differs from the tutor-defined optimal path. However, as students continue to be tutored, they approach the optimal solution path. Performance in both subdomains was similar for both errors and goal differences. However, the rate at which students progress toward the optimal solution path differs between the two domains. Tutoring in superficial perivascular dermatitis, the larger and more complex domain was associated with a slower rate of approximation towards the optimal solution path. Students benefit from a limited-enforcement tutoring system that leverages diagnostic algorithms but does not prevent alternative strategies. Even with limited enforcement, students converge toward the optimal solution path.

Management of acute bronchiolitis in emergency wards in Spain: variability and appropriateness analysis (aBREVIADo Project).

PubMed

Ochoa Sangrador, Carlos; González de Dios, Javier

2012-07-01

Most patients with acute bronchiolitis have a mild course and only require outpatient care. However, some of them have to go to emergency departments, because they have respiratory distress or feeding problems. There, they frequently receive diagnostic and therapeutic procedures. We want to know the variability and appropriateness of these procedures. A cross-sectional study (October 2007 to March 2008) was carried out on 2,430 diagnosed cases of bronchiolitis in hospital emergency departments, which required no hospitalization. An analysis of the appropriateness of the treatments was made in 2,032 cases gathered in ten departments with at least 100 cases, using as criterion the recommendations of a consensus conference. We estimated the adjusted percentages of each department. Most of the bronchiolitis were mild, in spite that they underwent multiple diagnostic and therapeutic procedures. In the acute phase, different treatments were used: inhaled beta 2 agonists (61.4%), antipyretics (17.1%), oral steroids (11.3%), and nebulized adrenaline (9.3%). In the maintenance phase, the most common treatments were: inhaled beta 2 agonists (50.5%), oral steroids (17%), oral beta 2 agonists (14.9%), and antibiotics (6.1%). The 64% of the treatments used in the acute phase and the 55.9% in the maintenance phase were considered inappropriate in the appropriateness analysis; a great heterogeneity among centers was found. There are discrepancies between clinical practice and evidence-based management of bronchiolitis in Spanish emergency departments. Inappropriate treatments were used in more than half of patients. The wide variation between centers shows the influence of local prescribing habits and reveals the scope for improvement.

Domain Adaptation for Alzheimer’s Disease Diagnostics

PubMed Central

Wachinger, Christian; Reuter, Martin

2016-01-01

With the increasing prevalence of Alzheimer’s disease, research focuses on the early computer-aided diagnosis of dementia with the goal to understand the disease process, determine risk and preserving factors, and explore preventive therapies. By now, large amounts of data from multi-site studies have been made available for developing, training, and evaluating automated classifiers. Yet, their translation to the clinic remains challenging, in part due to their limited generalizability across different datasets. In this work, we describe a compact classification approach that mitigates overfitting by regularizing the multinomial regression with the mixed ℓ1/ℓ2 norm. We combine volume, thickness, and anatomical shape features from MRI scans to characterize neuroanatomy for the three-class classification of Alzheimer’s disease, mild cognitive impairment and healthy controls. We demonstrate high classification accuracy via independent evaluation within the scope of the CADDementia challenge. We, furthermore, demonstrate that variations between source and target datasets can substantially influence classification accuracy. The main contribution of this work addresses this problem by proposing an approach for supervised domain adaptation based on instance weighting. Integration of this method into our classifier allows us to assess different strategies for domain adaptation. Our results demonstrate (i) that training on only the target training set yields better results than the naïve combination (union) of source and target training sets, and (ii) that domain adaptation with instance weighting yields the best classification results, especially if only a small training component of the target dataset is available. These insights imply that successful deployment of systems for computer-aided diagnostics to the clinic depends not only on accurate classifiers that avoid overfitting, but also on a dedicated domain adaptation strategy. PMID:27262241

Assessment of representational competence in kinematics

NASA Astrophysics Data System (ADS)

Klein, P.; Müller, A.; Kuhn, J.

2017-06-01

A two-tier instrument for representational competence in the field of kinematics (KiRC) is presented, designed for a standard (1st year) calculus-based introductory mechanics course. It comprises 11 multiple choice (MC) and 7 multiple true-false (MTF) questions involving multiple representational formats, such as graphs, pictures, and formal (mathematical) expressions (1st tier). Furthermore, students express their answer confidence for selected items, providing additional information (2nd tier). Measurement characteristics of KiRC were assessed in a validation sample (pre- and post-test, N =83 and N =46 , respectively), including usefulness for measuring learning gain. Validity is checked by interviews and by benchmarking KiRC against related measures. Values for item difficulty, discrimination, and consistency are in the desired ranges; in particular, a good reliability was obtained (KR 20 =0.86 ). Confidence intervals were computed and a replication study yielded values within the latter. For practical and research purposes, KiRC as a diagnostic tool goes beyond related extant instruments both for the representational formats (e.g., mathematical expressions) and for the scope of content covered (e.g., choice of coordinate systems). Together with the satisfactory psychometric properties it appears a versatile and reliable tool for assessing students' representational competency in kinematics (and of its potential change). Confidence judgments add further information to the diagnostic potential of the test, in particular for representational misconceptions. Moreover, we present an analytic result for the question—arising from guessing correction or educational considerations—of how the total effect size (Cohen's d ) varies upon combination of two test components with known individual effect sizes, and then discuss the results in the case of KiRC (MC and MTF combination). The introduced method of test combination analysis can be applied to any test comprising two components for the purpose of finding effect size ranges.

Supervisors' experiences of workplace supervision of nursing and paramedic students in rural settings: a scoping review.

PubMed

Trede, Franziska; McEwen, Celina; Kenny, Amanda; O'Meara, Peter

2014-05-01

We present our findings from a scoping review that sought to identify what is known about nursing and paramedic clinical supervisors' experiences of their supervision practices in rural settings. Our interest in these two groups is based on the central role that nurses and paramedics play in rural health care. Scoping reviews support identification of a broad range of literature, including all types of study designs. We adopted Arksey and O'Malley's five-stage approach: identifying the research question; identifying relevant studies; study selection; charting the data; and collating, summarising and reporting results. Databases searched included Academic Search Complete, Springer, Factiva, ProQuest, Ebsco, Informit, VOCEDplus and Scopus. Based on our research question and inclusion and exclusion criteria we selected relevant literature and summarised and reported it using Arksey and O'Malley's framework. The review yielded five articles from four countries: Sweden, Belgium, Malaysia and Australia. From this scoping review, we identified key themes related to supervisors' experiences, including clarification of expectations, support from managers and colleagues, the need for shared understanding between university, students and supervisors and required skills and competence in supervising students. © 2013.

Adapting and Implementing Open Dialogue in the Scandinavian Countries: A Scoping Review.

PubMed

Buus, Niels; Bikic, Aida; Jacobsen, Elise Kragh; Müller-Nielsen, Klaus; Aagaard, Jørgen; Rossen, Camilla Blach

2017-05-01

Open Dialogue is a resource-oriented mental health approach, which mobilises a crisis-struck person's psychosocial network resources. This scoping review 1) identifies the range and nature of literature on the adoption of Open Dialogue in Scandinavia in places other than the original sites in Finland, and 2) summarises this literature. We included 33 publications. Most studies in this scoping review were published as "grey" literature and most grappled with how to implement Open Dialogue faithfully. In the Scandinavian research context, Open Dialogue was mainly described as a promising and favourable approach to mental health care.

Accuracy of Skin Cancer Diagnosis by Physician Assistants Compared With Dermatologists in a Large Health Care System.

PubMed

Anderson, Alyce M; Matsumoto, Martha; Saul, Melissa I; Secrest, Aaron M; Ferris, Laura K

2018-05-01

Physician assistants (PAs) are increasingly used in dermatology practices to diagnose skin cancers, although, to date, their diagnostic accuracy compared with board-certified dermatologists has not been well studied. To compare diagnostic accuracy for skin cancer of PAs with that of dermatologists. Medical record review of 33 647 skin cancer screening examinations in 20 270 unique patients who underwent screening at University of Pittsburgh Medical Center-affiliated dermatology offices from January 1, 2011, to December 31, 2015. International Classification of Diseases, Ninth Revision code V76.43 and International Classification of Diseases and Related Health Problems, Tenth Revision code Z12.83 were used to identify pathology reports from skin cancer screening examinations by dermatologists and PAs. Examination performed by a PA or dermatologist. Number needed to biopsy (NNB) to diagnose skin cancer (nonmelanoma, invasive melanoma, or in situ melanoma). Of 20 270 unique patients, 12 722 (62.8%) were female, mean (SD) age at the first visit was 52.7 (17.4) years, and 19 515 patients (96.3%) self-reported their race/ethnicity as non-Hispanic white. To diagnose 1 case of skin cancer, the NNB was 3.9 for PAs and 3.3 for dermatologists (P < .001). Per diagnosed melanoma, the NNB was 39.4 for PAs and 25.4 for dermatologists (P = .007). Patients screened by a PA were significantly less likely than those screened by a dermatologist to be diagnosed with melanoma in situ (1.1% vs 1.8% of visits, P = .02), but differences were not significant for invasive melanoma (0.7% vs 0.8% of visits, P = .83) or nonmelanoma skin cancer (6.1% vs 6.1% of visits, P = .98). Compared with dermatologists, PAs performed more skin biopsies per case of skin cancer diagnosed and diagnosed fewer melanomas in situ, suggesting that the diagnostic accuracy of PAs may be lower than that of dermatologists. Although the availability of PAs may help increase access to care and reduce waiting times for appointments, these findings have important implications for the training, appropriate scope of practice, and supervision of PAs and other nonphysician practitioners in dermatology.

[Optimistic perspectives in communicating difficult news on fetal development].

PubMed

Ostermann, Ana Cristina; Frezza, Minéia; Rosa, Rafael Machado

2017-08-21

Communicating diagnostic news in health contexts is a potentially difficult event for all parties involved. However, despite this task's presence in the physician-patient context, it is rarely addressed during clinical training. The current study thus aimed to describe and evaluate how difficult news can be toned down during genetic counseling sessions involving cases of fetal syndromes and/or malformations. The study analyzed 33 naturalistic interactions (i.e. real situations), taped and transcribed, according to the theoretical and methodological perspective of Conversation Analysis, with an ethnomethodological basis. These interactions consisted of sessions in clinical genetics with pregnant women seen at the fetal medicine service of a reference hospital for maternal and child health in the Brazilian Unified National Health System (SUS). The analysis showed that communicating difficult news can be accompanied by optimistic perspectives that are scaled-up according to each situation's severity. In the absence of a positive diagnosis, the appointments can conclude with positive aspects such as recommendations for palliative care, so that the patient always leaves the appointment with some kind of recommendation. This study proposes to innovate and expand the scope of studies on communicating difficult news in the physician-patient relationship in Brazil, precisely by developing an analysis of real interactions in genetic counseling and thus providing interactional backing for training health professionals that deal with this challenge in their routine work.

78 FR 53187 - Early Scoping Notification for the Alternatives Analysis of the GA 400 Transit Initiative in...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-28

... (MARTA) issue this early scoping notice to advise other agencies and the public that they intend to... the public and agency officials to help support the ongoing alternatives analysis and system planning... considered, the transportation problems that are being addressed by the alternatives analysis study, public...

Software-Enabled Project Management Techniques and Their Relationship to the Triple Constraints

ERIC Educational Resources Information Center

Elleh, Festus U.

2013-01-01

This study investigated the relationship between software-enabled project management techniques and the triple constraints (time, cost, and scope). There was the dearth of academic literature that focused on the relationship between software-enabled project management techniques and the triple constraints (time, cost, and scope). Based on the gap…

Extended Piano Techniques and Teaching in Music Education Departments

ERIC Educational Resources Information Center

Akbulut Demirci, Sirin; Sungurtekin, Mete; Yilmaz, Nilüfer; Engür, Doruk

2015-01-01

The article is composed of the results of the study carried out within the scope of the project entitled "Extended Piano Techniques and Teaching in Music Education Departments." Within the scope of the project, 16 students taking education at Music Education Department, Uludag University, learned six pieces composed for the project via…

Synthesizing the Practice of SCMC-Based Telecollaboration: A Scoping Review

ERIC Educational Resources Information Center

Akiyama, Yuka; Cunningham, D. Joseph

2018-01-01

Telecollaboration is a type of online learning arrangement between geographically distant participants for the development of language and intercultural competence. After two decades of research, it is an apt time to engage in a systematic review of previous studies in the form of a scoping review in order to illuminate the pedagogical practices…

Physical Activity Research in Intellectual Disability: A Scoping Review Using the Behavioral Epidemiological Framework

ERIC Educational Resources Information Center

Pitchford, E. Andrew; Dixon-Ibarra, Alicia; Hauck, Janet L.

2018-01-01

Through a scoping review, the current state of physical activity research in people with intellectual disability was examined. A search of publications between 2000 and 2014 retrieved 362 articles that met inclusion criteria. Eligible studies were coded according to the Behavioral Epidemiological Framework. Of the articles identified, 48% examined…

Curriculum Mapping in Higher Education: A Case Study and Proposed Content Scope and Sequence Mapping Tool

ERIC Educational Resources Information Center

Arafeh, Sousan

2016-01-01

Best practice in curriculum development and implementation requires that discipline-based standards or requirements embody both curricular and programme scopes and sequences. Ensuring these are present and aligned in course/programme content, activities and assessments to support student success requires formalised and systematised review and…

The High/Scope Report. Number Four.

ERIC Educational Resources Information Center

Silverman, Charles, Ed.

This report provides articles on several topics related to the education of young children. In the introduction High/Scope President David P. Weikart suggests that public investment in preschool education is a wise and economically sound social policy. New studies of the long term effects of preschool are demonstrating the staying power of early…

48 CFR 16.306 - Cost-plus-fixed-fee contracts.

Code of Federal Regulations, 2011 CFR

2011-10-01

... preliminary exploration, studies, and risk reduction have indicated a high degree of probability that the... the scope of work by stating a definite goal or target and specifying an end product. This form of... increases the estimated cost. (2) The term form describes the scope of work in general terms and obligates...

Postural Care for People with Intellectual Disabilities and Severely Impaired Motor Function: A Scoping Review

ERIC Educational Resources Information Center

Robertson, Janet; Baines, Susannah; Emerson, Eric; Hatton, Chris

2018-01-01

Background: Poor postural care can have severe and life-threatening complications. This scoping review aims to map and summarize existing evidence regarding postural care for people with intellectual disabilities and severely impaired motor function. Method: Studies were identified via electronic database searches (MEDLINE, CINAHL, PsycINFO and…

Social cognition and African American men: The roles of perceived discrimination and experimenter race on task performance.

PubMed

Nagendra, Arundati; Twery, Benjamin L; Neblett, Enrique W; Mustafic, Hasan; Jones, Tevin S; Gatewood, D'Angelo; Penn, David L

2018-01-01

The Social Cognition Psychometric Evaluation (SCOPE) study consists of a battery of eight tasks selected to measure social-cognitive deficits in individuals with schizophrenia. The battery is currently in a multisite validation process. While the SCOPE study collects basic demographic data, more nuanced race-related factors might artificially inflate cross-cultural differences in social cognition. As an initial step, we investigated whether race, independent of mental illness status, affects performance on the SCOPE battery. Thus, we examined the effects of perceived discrimination and experimenter race on the performance of 51 non-clinical African American men on the SCOPE battery. Results revealed that these factors impacted social cognitive task performance. Specifically, participants performed better on a skills-based task factor in the presence of Black experimenters, and frequency of perceived racism predicted increased perception of hostility in negative interpersonal situations with accidental causes. Thus, race-related factors are important to identify and explore in the measurement of social cognition in African Americans. Copyright © 2017 Elsevier B.V. All rights reserved.

Health & Demographic Surveillance System Profile: The Muzaffarpur-TMRC Health and Demographic Surveillance System

PubMed Central

Malaviya, Paritosh; Picado, Albert; Hasker, Epco; Ostyn, Bart; Kansal, Sangeeta; Singh, Rudra Pratap; Shankar, Ravi; Boelaert, Marleen; Sundar, Shyam

2014-01-01

The Muzaffarpur-TMRC Health and Demographic Surveillance System (HDSS), established in 2007, was developed as an enlargement of the scope of a research collaboration on the project Visceral Leishmaniasis in Bihar, which had been ongoing since 2005. The HDSS is located in a visceral leishmaniasis (VL)-endemic area in the Muzaffarpur district of Bihar state in India. It is the only HDSS conducting research on VL, which is a vector-borne infectious disease transmitted by female phlebotomine sandflies and is fatal if left untreated. Currently the HDSS serves a population of over 105 000 in 66 villages. The HDSS collects data on vital events including pregnancies, births, deaths, migration and marriages, as well as other socio-economic indicators, at regular intervals. Incident VL cases are identified. The HDSS team is experienced in conducting both qualitative and quantitative studies, sample collection and rapid diagnostic tests in the field. In each village, volunteers connect the HDSS team with the community members. The Muzaffarpur-TMRC HDSS provides opportunities for studies on VL and other neglected tropical diseases (NTDs) and their interaction with demographic events such as migration. Queries related to research collaborations and data sharing can be sent to Dr Shyam Sundar at [drshyamsundar@hotmail.com]. PMID:25186307

Comparison of examination fees and availability of routine vision care by optometrists and ophthalmologists.

PubMed Central

Soroka, M

1991-01-01

A national telephone survey of eye care practitioners shows that the average fee for routine eye examinations was less among optometrists than ophthalmologists. The average wait for the earliest appointment was 5 days for optometrists and 20 days for ophthalmologists. Weekend and evening appointments were also more obtainable among optometrists. The study did not determine what tests were included in the routine examination of each practitioner. Optometrists are licensed to use diagnostic drugs in all 50 States and prescribe therapeutic drugs for the treatment of ocular diseases in 25 States. Legislation that would update State laws permitting doctors of optometry to prescribe and use pharmaceutical agents for the treatment of eye diseases has been introduced in many of the remaining States. Supporters of bills permitting therapeutic pharmaceutical optometry contend that these changes would ensure the availability of quality eye care at significant savings, since optometric fees are generally lower than ophthalmological fees. In addition, it has been argued that optometrists are equitably distributed geographically and are more likely to have weekend and evening office hours, thus enabling increased patient access to eye care. When considering cost-effectiveness and accessibility, this study may provide information to those States considering changes in the scope of optometric licensure. PMID:1908597

Rapid antimicrobial susceptibility testing of clinical isolates by digital time-lapse microscopy.

PubMed

Fredborg, M; Rosenvinge, F S; Spillum, E; Kroghsbo, S; Wang, M; Sondergaard, T E

2015-12-01

Rapid antimicrobial susceptibility testing (AST) is essential for early and appropriate therapy. Methods with short detection time enabling same-day treatment optimisation are highly favourable. In this study, we evaluated the potential of a digital time-lapse microscope system, the oCelloScope system, to perform rapid AST. The oCelloScope system demonstrated a very high accuracy (96% overall agreement) when determining the resistance profiles of four reference strains, nine clinical isolates, including multi-drug-resistant isolates, and three positive blood cultures. AST of clinical isolates (168 antimicrobial agent-organism combinations) demonstrated 3.6% minor, no major and 1.2% very major errors of the oCelloScope system compared to conventional susceptibility testing, as well as a rapid and correct phenotypic detection of strains with methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum β-lactamase (ESBL) profiles. The net average time-to-result was 108 min, with 95% of the results being available within 180 min. In conclusion, this study strongly indicates that the oCelloScope system holds considerable potential as an accurate and sensitive AST method with short time-to-result, enabling same-day targeted antimicrobial therapy, facilitating antibiotic stewardship and better patient management. A full-scale validation of the oCelloScope system including more isolates is necessary to assess the impact of using it for AST.

The contribution of nurses' perceptions and actions in defining scope and stabilising professional boundaries of nursing practice.

PubMed

Lillibridge, J; Axford, R; Rowley, G

2000-10-01

This paper reports on the findings of a naturalistic inquiry study that explored the scope and boundaries of nursing practice. Findings from interview and observation data suggest that nurses negotiate and adjust professional boundaries on an individual, case-by-case basis, thereby managing the scope of their practice as they see it in that circumstance. The strategies they used are presented in four major categories: 1) maintaining a comfort zone, 2) expanding into safe territory, 3) moving into the grey zone and 4) stepping over the line. Findings show that nurses' efforts to maintain the comfort zone serve to perpetuate the status quo and may threaten holistic care. Expanding nursing actions to include functional roles such as coordinating care, sharing information, advocating (for patients), collaborating and innovating offers the profession critical building blocks for defining the scope of nursing practice. Clarifying the grey zone (or overlapping territory) is an essential task for the profession in determining the boundaries of nursing practice. The data revealed that, partly due to the ambiguity of the grey zone, nurses may step over the line into medical decision-making and outside the legal sanctions for the professional nursing role. The implications of this study highlight the need for nursing to define its scope of practice and in so doing stabilise professional boundaries.

48 CFR 36.302 - Scope of work.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Scope of work. 36.302... Scope of work. The agency shall develop, either in-house or by contract, a scope of work that defines the project and states the Government's requirements. The scope of work may include criteria and...

48 CFR 36.302 - Scope of work.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Scope of work. 36.302... Scope of work. The agency shall develop, either in-house or by contract, a scope of work that defines the project and states the Government's requirements. The scope of work may include criteria and...

Family Medicine Department Chairs' Opinions Regarding Scope of Practice.

PubMed

Peterson, Lars E; Blackburn, Brenna; Phillips, Robert L; Mainous, Arch G

2015-12-01

Family physicians are trained broadly to provide the majority of health care across multiple settings; however, their scope of practice has narrowed. Department chairs' role modeling of a broad scope of practice may set the tone for faculty and trainees. In 2013, the authors surveyed family medicine department chairs about their scope of practice, personal and department characteristics, and attitudes and beliefs about scope of practice and role modeling. They used descriptive statistics and bivariate analyses to test for associations between scope of practice, personal and department characteristics, and attitudes and beliefs. They created a Scope of Practice Index by summing the number of services each respondent provided to compare scope of practice across chairs. Of 146 chairs, 88 responded (60.3% response rate); 85 were included in the final analysis. Sixty-five (77.4%) respondents were male; 73 (86.9%) were 51 years or older. Respondents spent a mean of 19.7% of their time in direct patient care and had a mean Scope of Practice Index of 11.9. Fifty-three (62.4%) disagreed that the scope of practice of family medicine was too broad for practicing physicians to keep up in all areas, and 56 (65.9%) believed that faculty should role model the full scope of practice to learners. Responses generally did not vary by respondents' personal scope of practice. Family medicine department chairs believe that role modeling a broad scope of practice increases students' interest in family medicine and encourages residency graduates to provide a wide range of services.

EarthScope Education and Outreach: Accomplishments and Emerging Opportunities

NASA Astrophysics Data System (ADS)

Robinson, S.; Ellins, K. K.; Semken, S. C.; Arrowsmith, R.

2014-12-01

EarthScope's Education and Outreach (E&O) program aims to increase public awareness of Earth science and enhance geoscience education at the K-12 and college level. The program is distinctive among major geoscience programs in two ways. First, planning for education and public engagement occurred in tandem with planning for the science mission. Second, the NSF EarthScope program includes funding support for education and outreach. In this presentation, we highlight key examples of the program's accomplishments and identify emerging E&O opportunities. E&O efforts have been collaboratively led by the EarthScope National Office (ESNO), IRIS, UNAVCO, the EarthScope Education and Outreach Subcommittee (EEOSC) and PI-driven EarthScope projects. Efforts by the EEOSC, guided by an EarthScope Education and Outreach Implementation Plan that is periodically updated, focus EarthScope E&O. EarthScope demonstrated early success in engaging undergraduate students (and teachers) in its mission through their involvement in siting USArray across the contiguous U.S. Funded E&O programs such as TOTLE, Illinois EarthScope, CEETEP (for K-12), InTeGrate and GETSI (for undergraduates) foster use of freely available EarthScope data and research findings. The Next Generation Science Standards, which stress science and engineering practices, offer an opportunity for alignment with existing EarthScope K-12 educational resources, and the EEOSC recommends focusing efforts on this task. The EEOSC recognizes the rapidly growing use of mobile smart devices by the public and in formal classrooms, which bring new opportunities to connect with the public and students. This will capitalize on EarthScope's already prominent social media presence, an effort that developed to accomplish one of the primary goals of the EarthScope E&O Implementation Plan to "Create a high-profile public identity for EarthScope" and to "Promote science literacy and understanding of EarthScope among all audiences through informal education venues" Leveraging ESNO, IRIS, and UNAVCO resources has exceeded the capabilities of any single entity, thereby amplifying the impact of EarthScope's education and outreach effort.

Scoping of Flood Hazard Mapping Needs for Penobscot County, Maine

USGS Publications Warehouse

Schalk, Charles W.; Dudley, Robert W.

2007-01-01

Background The Federal Emergency Management Agency (FEMA) developed a plan in 1997 to modernize the FEMA flood mapping program. FEMA flood maps delineate flood hazard areas in support of the National Flood Insurance Program (NFIP). FEMA's plan outlined the steps necessary to update FEMA's flood maps for the nation to a seamless digital format and streamline FEMA's operations in raising public awareness of the importance of the maps and responding to requests to revise them. The modernization of flood maps involves conversion of existing information to digital format and integration of improved flood hazard data as needed. To determine flood mapping modernization needs, FEMA has established specific scoping activities to be done on a county-by-county basis for identifying and prioritizing requisite flood-mapping activities for map modernization. The U.S. Geological Survey (USGS), in cooperation with FEMA and the Maine State Planning Office Floodplain Management Program (MFMP), began scoping work in 2006 for Penobscot County. Scoping activities included assembling existing data and map needs information for communities in Penobscot County, documentation of data, contacts, community meetings, and prioritized mapping needs in a final scoping report (this document), and updating the Mapping Needs Update Support System (MNUSS) Database with information gathered during the scoping process. As of 2007, the average age of the FEMA floodplain maps in Penobscot County, Maine, is 22 years, based on the most recent revisions to the maps. Because the revisions did not affect all the map panels in each town, however, the true average date probably is more than 22 years. Many of the studies were published in the mid-1980s. Since the studies were completed, development has occurred in many of the watersheds, and the characteristics of the watersheds have changed with time. Therefore, many of the older studies may not depict current conditions nor accurately estimate risk in terms of flood heights or flood mapping.

A prospective randomized controlled study to evaluate and compare GlideScope with Macintosh laryngoscope for ease of endotracheal intubation in adult patients undergoing elective surgery under general anesthesia

PubMed Central

Jafra, Anudeep; Gombar, Satinder; Kapoor, Dheeraj; Sandhu, Harpreet Singh; Kumari, Kamlesh

2018-01-01

Background: The aim of the study was to compare the ease the intubation using GlideScope video laryngoscope and Macintosh laryngoscope in adult patients undergoing elective surgery under general anesthesia. Materials and Methods: A total of 200 American Society of Anesthesiologists I–II patients of either sex, in the age group of 18–60 years were included in the study. Patients were randomly allocated to two groups. We assessed ease of intubation depending on time to tracheal intubation, number of attempts, glottic view (Cormack–Lehane grade [CL grade] and percentage of glottis opening [POGO]) and intubation difficulty score (IDS), hemodynamic variables and any intra- and post-operative adverse events. Results: The rate of successful endotracheal intubation (ETI) in both groups was 100% in the first attempt. The time required for successful ETI was 24.89 ± 5.574 in Group G and 20.68 ± 3.637 in Group M (P < 0.001) found to be statistically significant. There was significant improvement in glottic view with GlideScope (as assessed by POGO score 66.71 ± 29.929 and 94.40 ± 10.476 in group G and 75.85 ± 26.969 and 74.20 ± 29.514 Group M and CL grading [P < 0.001]). A comparison of mean IDS between two groups revealed intubation was easier with the use of GlideScope. The hemodynamic response to intubation was significantly lesser with the use of GlideScope when compared with Macintosh laryngoscope. The incidence of adverse events, though minor like superficial lip or tongue bleed, was similar in two groups. Conclusions: GlideScope offers superiority over Macintosh laryngoscope in terms of laryngeal views and the difficulty encountered at ETI in an unselected population. PMID:29628839

Determinants of an urban origin student choosing rural practice: a scoping review.

PubMed

Myhre, Douglas L; Bajaj, Sameer; Jackson, Wesley

2015-01-01

The shortage of physicians in rural and remote communities is an ongoing problem. Many studies have shown that the rural background of a student (ie rural origin) is a primary factor in recruiting physicians for practice in rural communities. Scoping reviews are primarily done to gauge the extent of literature on the research question at hand, typically with an intent that future research in that area is a constructive addition to pre-existing knowledge. This scoping review focuses on factors that predispose urban-origin students to choose a carrier in rural medicine. The study used Arksey and O'Malley's guidelines for a scoping review of the literature, which, in contrast to a traditional systematic review, is brief yet comprehensive. Medline (Ovid) and PubMed databases were used to review literature published between 1 January 1970 and 30 November 2014. After removing duplicates, articles were screened based on inclusion and exclusion criteria set up by the research team. The literature search resulted in 435 articles, 418 of which were excluded, leaving 17 articles for comprehensive review. Out of these 17 studies, the following four factors that suggest why urban-origin medical students may choose rural practice were generated: geographic diffusion of physicians in response to economic forces such as debt repayment and financial incentives (five studies), scope of practice and personal satisfaction (five studies), undergraduate and postgraduate rural training (nine studies) and premedical school mindset to practice rurally (five studies). Urban-origin students may choose rural practice because of market forces as well as financial incentives. The participation in undergraduate and postgraduate rural training is reported to positively alter the attitude of urban-origin students. A small subset of these students has a predetermined mindset to practice rurally at the time of matriculation. Obstacles for choosing a rural carrier include, but are not limited to lack of job and education opportunities for spouses/partners, lack of recreational and educational opportunities for children, and obscure opportunities for continuing medical education.

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

Soria-Lara, Julio A., E-mail: julio.soria-lara@ouce.ox.ac.uk; Bertolini, Luca, E-mail: l.bertolini@uva.nl; Brömmelstroet, Marco te, E-mail: M.C.G.teBrommelstroet@uva.nl

The integration of knowledge from stakeholders and the public at large is seen as one of the biggest process-related barriers during the scoping phase of EIA application in transport planning. While the academic literature offers abundant analyses, discussions and suggestions how to overcome this problem, the proposed solutions are yet to be adequately tested in practice. In order to address this gap, we test the effectiveness of a set of interventions and trigger mechanisms for improving different aspects of knowledge integration. The interventions are tested in an experiential study with two sequential cases, representing “close-to-real-life” conditions, in the context ofmore » two cities in Andalusia, Spain. In general terms, the participants perceived that the integration of knowledge improved during the simulation of the EIA scoping phase. Certain shortcomings were also discussed, fundamentally related to how the time spent during the scoping phase was crucial to lead an effective learning process between the involved people. The study concludes with a reflection on the effectiveness of the tested interventions according to similarities and differences obtained from the two experiential case studies, as well as with a discussion of the potential to generate new knowledge through the use of experiential studies in EIA practice. - Highlights: • It tests a set of interventions and mechanisms to improve the integration of knowledge. • The scoping phase of EIA is simulated to assess the effectiveness of interventions. • Two sequential case studies are used.« less

Dimensions of lay health worker programmes: results of a scoping study and production of a descriptive framework.

PubMed

South, Jane; Meah, Angela; Bagnall, Anne-Marie; Jones, Rebecca

2013-03-01

Approaches that engage and support lay health workers in the delivery of health improvement activities have been widely applied across different health issues and populations. The lack of a common terminology, inconsistency in the use of role descriptors and poor indexing of lay health worker roles are all barriers to the development of a shared evidence base for lay health worker interventions. The aim of the paper is to report results from a scoping study of approaches to involve lay people in public health roles and to present a framework for categorisation of the different dimensions of lay health worker programmes. Our scoping study comprised a systematic scoping review to map the literature on lay health worker interventions and to identify role dimensions and common models. The review, which was limited to interventions relevant to UK public health priorities, covered a total of 224 publications. The scoping study also drew on experiential evidence from UK practice. Research-based and practice-based evidence confirmed the variety of role descriptors in use and the complexity of role dimensions. Five common models that define the primary role of the lay health worker were identified from the literature. A framework was later developed that grouped features of lay health worker programmes into four dimensions: intervention, role, professional support/service and the community. More account needs to be taken of the variations that occur between lay health worker programmes. This framework, with the mapping of key categories of difference, may enable better description of lay health worker programmes, which will in turn assist in building a shared evidence base. More research is needed to examine the transferability of the framework within different contexts.

Sparse aperture endoscope

DOEpatents

Fitch, J.P.

1999-07-06

An endoscope is disclosed which reduces the volume needed by the imaging part, maintains resolution of a wide diameter optical system, while increasing tool access, and allows stereographic or interferometric processing for depth and perspective information/visualization. Because the endoscope decreases the volume consumed by imaging optics such allows a larger fraction of the volume to be used for non-imaging tools, which allows smaller incisions in surgical and diagnostic medical applications thus produces less trauma to the patient or allows access to smaller volumes than is possible with larger instruments. The endoscope utilizes fiber optic light pipes in an outer layer for illumination, a multi-pupil imaging system in an inner annulus, and an access channel for other tools in the center. The endoscope is amenable to implementation as a flexible scope, and thus increases it's utility. Because the endoscope uses a multi-aperture pupil, it can also be utilized as an optical array, allowing stereographic and interferometric processing. 7 figs.

Sparse aperture endoscope

DOEpatents

Fitch, Joseph P.

1999-07-06

An endoscope which reduces the volume needed by the imaging part thereof, maintains resolution of a wide diameter optical system, while increasing tool access, and allows stereographic or interferometric processing for depth and perspective information/visualization. Because the endoscope decreases the volume consumed by imaging optics such allows a larger fraction of the volume to be used for non-imaging tools, which allows smaller incisions in surgical and diagnostic medical applications thus produces less trauma to the patient or allows access to smaller volumes than is possible with larger instruments. The endoscope utilizes fiber optic light pipes in an outer layer for illumination, a multi-pupil imaging system in an inner annulus, and an access channel for other tools in the center. The endoscope is amenable to implementation as a flexible scope, and thus increases the utility thereof. Because the endoscope uses a multi-aperture pupil, it can also be utilized as an optical array, allowing stereographic and interferometric processing.

Remote control of the industry processes. POWERLINK protocol application

NASA Astrophysics Data System (ADS)

Wóbel, A.; Paruzel, D.; Paszkiewicz, B.

2017-08-01

The present technological development enables the use of solutions characterized by a lower failure rate, and work with greater precision. This allows you to obtain the most efficient production, high speed production and reliability of individual components. The main scope of this article was POWERLINK protocol application for communication with the controller B & R through communication Ethernet for recording process parameters. This enables control of run production cycle using an internal network connected to the PC industry. Knowledge of the most important parameters of the production in real time allows detecting of a failure immediately after occurrence. For this purpose, the position of diagnostic use driver X20CP1301 B&R to record measurement data such as pressure, temperature valve between the parties and the torque required to change the valve setting was made. The use of POWERLINK protocol allows for the transmission of information on the status of every 200 μs.

[Asperger syndrome in adolescence: The problem and appropriate treatment].

PubMed

Nagao, Keizo

2007-03-01

I have described the corresponding method for bullying, independence and interpersonal relationships of company/opposite sex, thinking disorders caused by suffering damage or victimization and withdrawal and violence in the family among the problems in and in response to Asperger syndrome in adolescent cases. Psychotherapy is used for bullying and interpersonal relationship problems. Cognitive therapy and protective correspondence are more effective in bullying than the exposure method. It seems to be more effective to teach and instruct the corresponding principle as well as supportive response because interpersonal relationships are likely to involve failures. Pharmacological therapy was valid in feelings of paranoia and violence. Since the disorder has been recently conceptualized in pervasive developmental disorder, the scope of the subject has increased whereas Asperger syndrome used to be diagnosed in compliance with its classic examples. Therefore, it needs to clarify diagnostic examples based on new concepts, accumulate subject examples and verify the corresponding method with evidence.

Physics through the 1990s: Plasmas and fluids

NASA Technical Reports Server (NTRS)

1986-01-01

The volume contains recommendations for programs in, and government support of, plasma and fluid physics. Four broad areas are covered: the physics of fluids, general plasma physics, fusion, and space and astrophysical plasmas. In the first section, the accomplishments of fluid physics and a detailed review of its sub-fields, such as combustion, non-Newtonian fluids, turbulence, aerodynamics, and geophysical fluid dynamics, are described. The general plasma physics section deals with the wide scope of the theoretical concepts involved in plasma research, and with the machines; intense beam systems, collective and laser-driven accelerators, and the associated diagnostics. The section on the fusion plasma research program examines confinement and heating systems, such as Tokamaks, magnetic mirrors, and inertial-confinement systems, and several others. Finally, theory and experiment in space and astrophysical plasma research is detailed, ranging from the laboratory to the solar system and beyond. A glossary is included.

Five important advances in hematopathology.

PubMed

Shi, Min; Xiao, Ruobing; Woda, Bruce A; Yu, Hongbo

2014-03-01

Hematopathology is a dynamic field that has always been on the frontier of clinical research within the scope of pathology. Several recent developments in hematopathology will likely affect its practice clinically. To review 5 important recent advances in hematopathology: (1) detection and prognostic implication of MYC in diffuse large B-cell lymphomas, (2) determining origin and prognosis through immunoglobulin gene usage in mature B-cell neoplasms, (3)detecting minimal residual disease in multiple myeloma, (4) using genome-wide analysis in myelodysplastic syndromes, and (5) employing whole-genome sequencing in acute myeloid leukemias. Literature review and the authors' experiences in an academic center. These advances will bring hematopathology into a new molecular era and help us to better understand the molecular, pathologic mechanisms of lymphomas, leukemias, myelomas, and myelodysplastic syndromes. They will help us to identify diagnostic and prognostic markers and eventually provide new therapeutic targets and treatments for these diseases.

Modulated electron cyclotron drift instability in a high-power pulsed magnetron discharge.

PubMed

Tsikata, Sedina; Minea, Tiberiu

2015-05-08

The electron cyclotron drift instability, implicated in electron heating and anomalous transport, is detected in the plasma of a planar magnetron. Electron density fluctuations associated with the mode are identified via an adapted coherent Thomson scattering diagnostic, under direct current and high-power pulsed magnetron operation. Time-resolved analysis of the mode amplitude reveals that the instability, found at MHz frequencies and millimeter scales, also exhibits a kHz-scale modulation consistent with the observation of larger-scale plasma density nonuniformities, such as the rotating spoke. Sharply collimated axial fluctuations observed at the magnetron axis are consistent with the presence of escaping electrons in a region where the magnetic and electric fields are antiparallel. These results distinguish aspects of magnetron physics from other plasma sources of similar geometry, such as the Hall thruster, and broaden the scope of instabilities which may be considered to dictate magnetron plasma features.

[Set-up, portals and normal exploration in wrist arthroscopy].

PubMed

Atzei, A; Luchetti, R; Sgarbossa, A; Carità, E; Llusà, M

2006-11-01

Arthroscopy is an accepted technique for evaluation of intra-articular pathology and treatment of a variety of disorders even in the wrist joint. Dedicated miniaturized instrumentation is needed along with a specific traction system. The external distraction alone (dry technique) allows for complete joint exploration and several type of arthroscopic surgery, avoiding annoying leaking in the subcutaneous tissues, though further distension of the articular pouches can be achieved by saline infusion (fluid distension or wet technique). Knowledge of surface anatomic landmarks and careful surgical technique are required for proper portal placement and in order to avoid injury to the numerous noble structures crossing nearby. Description of radio- and medio-carpal portals is provided along with the different bony, condral, synovial and ligamentous structures that can be visualised or treated through each portal. Surgeon can choose the most suitable portal for scope or instruments, according to specific needs for diagnostic or therapeutic purposes.

[Set-up, portals and normal exploration in wrist arthroscopy.

PubMed

Atzei, A; Luchetti, R; Sgarbossa, A; Carità, E; Llusà, M

2006-11-01

Arthroscopy is an accepted technique for evaluation of intra-articular pathology and treatment of a variety of disorders even in the wrist joint. Dedicated miniaturized instrumentation is needed along with a specific traction system. The external distraction alone (dry technique) allows for complete joint exploration and several type of arthroscopic surgery, avoiding annoying leaking in the subcutaneous tissues, though further distension of the articular pouches can be achieved by saline infusion (fluid distension or wet technique). Knowledge of surface anatomic landmarks and careful surgical technique are required for proper portal placement and in order to avoid injury to the numerous noble structures crossing nearby. Description of radio- and medio-carpal portals is provided along with the different bony, condral, synovial and ligamentous structures that can be visualised or treated through each portal. Surgeon can choose the most suitable portal for scope or instruments, according to specific needs for diagnostic or therapeutic purposes.

Accountable Care Organizations: The National Landscape.

PubMed

Shortell, Stephen M; Colla, Carrie H; Lewis, Valerie A; Fisher, Elliott; Kessell, Eric; Ramsay, Patricia

2015-08-01

There are now more than seven hundred accountable care organizations (ACOs) in the United States. This article describes some of their most salient characteristics including the number and types of contracts involved, organizational structures, the scope of services offered, care management capabilities, and the development of a three-category taxonomy that can be used to target technical assistance efforts and to examine performance. The current evidence on the performance of ACOs is reviewed. Since California has the largest number of ACOs (N=67) and a history of providing care under risk-bearing contracts, some additional assessments of quality and patient experience are made between California ACOs and non-ACO provider organizations. Six key issues likely to affect future ACO growth and development are discussed, and some potential "diagnostic" indicators for assessing the likelihood of potential antitrust violations are presented. Copyright © 2015 by Duke University Press.

Phages in nature

PubMed Central

Millard, Andrew D; Letarov, Andrey V; Heaphy, Shaun

2011-01-01

Bacteriophages or phages are the most abundant organisms in the biosphere and they are a ubiquitous feature of prokaryotic existence. A bacteriophage is a virus which infects a bacterium. Archaea are also infected by viruses, whether these should be referred to as ‘phages’ is debatable, but they are included as such in the scope this article. Phages have been of interest to scientists as tools to understand fundamental molecular biology, as vectors of horizontal gene transfer and drivers of bacterial evolution, as sources of diagnostic and genetic tools and as novel therapeutic agents. Unraveling the biology of phages and their relationship with their hosts is key to understanding microbial systems and their exploitation. In this article we describe the roles of phages in different host systems and show how modeling, microscopy, isolation, genomic and metagenomic based approaches have come together to provide unparalleled insights into these small but vital constituents of the microbial world. PMID:21687533

SCOPE : Future Formation-Flying Magnetospheric Satellite Mission

NASA Astrophysics Data System (ADS)

Saito, Yoshifumi

A formation flight satellite mission "SCOPE" is now under study aiming at launching in 2017. "SCOPE" stands for ‘cross Scale COupling in the Plasma universE'. The main purpose of this mission is to investigate the dynamic behaviors of plasma in the terrestrial magnetosphere that range over magnitudes of both temporal and spatial scales. The basic idea of the SCOPE mission is to distinguish temporal and spatial variations of physical processes by putting five formation flight spacecraft into the key regions of the Earth's magnetosphere. The formation consists of one large mother satellite and four small daughter satellites. Three of the four daughter satellites surround the mother satellite 3-dimensionally maintaining the mutual distances of variable ranges between 5 km and 5000 km. The fourth daughter satellite stays near the mother satellite with the distance between 5 km and 100 km. By this configuration, we can obtain both the macro-scale (1000 km - 5000 km) and micro-scale (¡ 100 km) information about the plasma disturbances at the same time. The launcher for SCOPE has been assumed to be M-V rocket (or its succession rocket) of JAXA. However, due to the termination of M-V rocket, we are now considering to use HIIA. The orbits of SCOPE satellites are all highly elliptical with its apogee 30Re from the Earth center. The inter-satellite link is used for telemetry/command operation as well as ranging to determine the relative orbits of the 5 satellites in small distances. The SCOPE mission is designed such that observational studies from the new perspective, the crossscale coupling, should be conducted. The orbit of the formation flight are designed such that the spacecraft will visit most of the key regions in the magnetosphere, including the bow shock, the magnetospheric boundary, the inner-magnetosphere, and the near-Earth magnetotail. The key issues for the realization of this mission are: (1) The need for high temporal resolution of electron measurements and quantitative wave field measurements at electron scales; (2) The need for full coverage over the energy range of interests with mass spectroscopy; (3) The need for coordinated space plasma observations by intercommunicated formation flying satellites; and (4) The need to resolve more than one-scale simultaneously. In order to cover the multiple (more than two) scales simultaneously, SCOPE and esa's Cross-Scale have started detailed discussion for the future collaboration. By this collaboration, SCOPE can reduce the number of the daughter satellites that can stay within 100 km throughout the mission life.

Louisiana Public Scoping Meeting | NOAA Gulf Spill Restoration

Science.gov Websites

Archive Home Louisiana Public Scoping Meeting Louisiana Public Scoping Meeting share Posted on February 28 , 2011 | Assessment and Early Restoration Restoration Area Title: Louisiana Public Scoping Meeting Location: Belle Chasse, LA Start Time: 18:30 Description: As part of the public scoping process, the co

10 CFR 33.17 - Conditions of specific licenses of broad scope.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 1 2014-01-01 2014-01-01 false Conditions of specific licenses of broad scope. 33.17 Section 33.17 Energy NUCLEAR REGULATORY COMMISSION SPECIFIC DOMESTIC LICENSES OF BROAD SCOPE FOR BYPRODUCT MATERIAL Specific Licenses of Broad Scope § 33.17 Conditions of specific licenses of broad scope. (a...

10 CFR 33.12 - Applications for specific licenses of broad scope.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 1 2014-01-01 2014-01-01 false Applications for specific licenses of broad scope. 33.12 Section 33.12 Energy NUCLEAR REGULATORY COMMISSION SPECIFIC DOMESTIC LICENSES OF BROAD SCOPE FOR BYPRODUCT MATERIAL Specific Licenses of Broad Scope § 33.12 Applications for specific licenses of broad scope. A...

10 CFR 33.12 - Applications for specific licenses of broad scope.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Applications for specific licenses of broad scope. 33.12 Section 33.12 Energy NUCLEAR REGULATORY COMMISSION SPECIFIC DOMESTIC LICENSES OF BROAD SCOPE FOR BYPRODUCT MATERIAL Specific Licenses of Broad Scope § 33.12 Applications for specific licenses of broad scope. A...

10 CFR 33.17 - Conditions of specific licenses of broad scope.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Conditions of specific licenses of broad scope. 33.17 Section 33.17 Energy NUCLEAR REGULATORY COMMISSION SPECIFIC DOMESTIC LICENSES OF BROAD SCOPE FOR BYPRODUCT MATERIAL Specific Licenses of Broad Scope § 33.17 Conditions of specific licenses of broad scope. (a...

10 CFR 33.17 - Conditions of specific licenses of broad scope.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Conditions of specific licenses of broad scope. 33.17 Section 33.17 Energy NUCLEAR REGULATORY COMMISSION SPECIFIC DOMESTIC LICENSES OF BROAD SCOPE FOR BYPRODUCT MATERIAL Specific Licenses of Broad Scope § 33.17 Conditions of specific licenses of broad scope. (a...

10 CFR 33.12 - Applications for specific licenses of broad scope.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Applications for specific licenses of broad scope. 33.12 Section 33.12 Energy NUCLEAR REGULATORY COMMISSION SPECIFIC DOMESTIC LICENSES OF BROAD SCOPE FOR BYPRODUCT MATERIAL Specific Licenses of Broad Scope § 33.12 Applications for specific licenses of broad scope. A...

10 CFR 33.12 - Applications for specific licenses of broad scope.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Applications for specific licenses of broad scope. 33.12 Section 33.12 Energy NUCLEAR REGULATORY COMMISSION SPECIFIC DOMESTIC LICENSES OF BROAD SCOPE FOR BYPRODUCT MATERIAL Specific Licenses of Broad Scope § 33.12 Applications for specific licenses of broad scope. A...

10 CFR 33.12 - Applications for specific licenses of broad scope.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 1 2012-01-01 2012-01-01 false Applications for specific licenses of broad scope. 33.12 Section 33.12 Energy NUCLEAR REGULATORY COMMISSION SPECIFIC DOMESTIC LICENSES OF BROAD SCOPE FOR BYPRODUCT MATERIAL Specific Licenses of Broad Scope § 33.12 Applications for specific licenses of broad scope. A...

10 CFR 33.17 - Conditions of specific licenses of broad scope.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 1 2012-01-01 2012-01-01 false Conditions of specific licenses of broad scope. 33.17 Section 33.17 Energy NUCLEAR REGULATORY COMMISSION SPECIFIC DOMESTIC LICENSES OF BROAD SCOPE FOR BYPRODUCT MATERIAL Specific Licenses of Broad Scope § 33.17 Conditions of specific licenses of broad scope. (a...

Social studying and learning among medical students: a scoping review.

PubMed

Keren, Daniela; Lockyer, Jocelyn; Ellaway, Rachel H

2017-10-01

Medical students study in social groups, which influence their learning, but few studies have investigated the characteristics of study groups and the impacts they have on students' learning. A scoping review was conducted on the topic of informal social studying and learning within medical education with the aim of appraising what is known regarding medical student attitudes to group study, the impact of group study on participants, and the methods that have been employed to study this. Using Arksey and O'Malley's scoping review principles, MEDLINE, EMBASE and CINAHL were searched, along with hand-searching and a targeted search of the grey literature; 18 peer reviewed and 17 grey literature records were included. Thematic conceptual analysis identified a number of themes, including: the nature of group study; the utility and value of group studying including social learning facilitating student engagement, social learning as a source of motivation and accountability, and social learning as a source of wellbeing; and student preferences related to group studying, including its homophilic nature, transgressiveness, and effectiveness. Despite these emerging factors, the evidence base for this phenomenon is small. The findings in this scoping review demonstrate a clear role for social interaction outside of the classroom, and encourage us to consider the factors in student networking, and the implications of this on medical students' academics. We also highlight areas in need of future research to allow us to better situate informal social learning within medical education and to enable educators to support this phenomenon.

The role of Facilities in Engaging and Informing the Public of EarthScope Science

NASA Astrophysics Data System (ADS)

Charlevoix, D. J.; Taber, J. J.; Berg, M.; Dorr, P. M.; McQuillan, P.; Olds, S. E.

2013-12-01

The IRIS and UNAVCO facilities play an important role in support of EarthScope through joint and independent education and outreach activities. These activities are focused on providing data and data products to a wide range of audiences, disseminating EarthScope science results through formal and informal venues, and informing the public of the broader impacts of EarthScope. The facilities are particularly well-suited for sustained engagement of multiple audiences over the decade-long course of EarthScope. One such example of a long-term effort was the Transportable Array student siting program, where over an 8 year period, students from about 55 institutions across the US and Canada conducted site reconnaissance and talked to landowners about EarthScope. Another activity focused on students was the development of a student intern program to support field engineering efforts during the construction of the Plate Boundary Observatory. Other ongoing activities include developing and maintaining relationships with media representatives and annual training of National Parks staff throughout the western U.S. The UNAVCO-IRIS partnership has been particularly valuable for EarthScope-related activities, where UNAVCO and IRIS work closely with the EarthScope National Office (ESNO) to bring EarthScope science to national, regional and local audiences within the EarthScope footprint. Collaborations have ranged across each group's products and services, including: EarthScope-focused teacher workshops, participation in EarthScope interpretive workshops for informal educators (led by ESNO), development of content for the IRIS Active Earth Monitor, preparing PBO-, USArray- and EarthScope-focused materials on topics such as Episodic Tremor and Slip for wider distribution through print, web, and mobile information technologies, and organizing research experiences for undergraduates on EarthScope-related topics. Other collaborations have focused on social media, and the development and dissemination of materials for the scientifically interested public at science and technology centers. The presentation will also share techniques used and future plans for evaluation of the public impact of EarthScope.

Aerobic vs. anaerobic scope: sibling species of fish indicate that temperature dependence of hypoxia tolerance can predict future survival.

PubMed

Sørensen, Christina; Munday, Philip L; Nilsson, Göran E

2014-03-01

The temperature dependence of aerobic scope has been suggested to be a major determinant of how marine animals will cope with future rises in environmental temperature. Here, we present data suggesting that in some animals, the temperature dependence of anaerobic scope (i.e., the capacity for surviving severe hypoxia) may determine present-day latitudinal distributions and potential for persistence in a warmer future. As a model for investigating the role of anaerobic scope, we studied two sibling species of coral-dwelling gobies, Gobiodon histrio, and G. erythrospilus, with different latitudinal distributions, but which overlap in equal abundance at Lizard Island (14°40'S) on the Great Barrier Reef. These species did not differ in the temperature dependence of resting oxygen consumption or critical oxygen concentration (the lowest oxygen level where resting oxygen consumption can be maintained). In contrast, the more equatorial species (G. histrio) had a better capacity to endure anaerobic conditions at oxygen levels below the critical oxygen concentration at the high temperatures (32-33 °C) more likely to occur near the equator, or in a warmer future. These results suggest that anaerobic scope, in addition to aerobic scope, could be important in determining the impacts of global warming on some marine animals. © 2013 John Wiley & Sons Ltd.

Functional characterization of chitin-binding lectin from Solanum integrifolium containing anti-fungal and insecticidal activities.

PubMed

Chen, Chang-Shan; Chen, Chun-Yi; Ravinath, Divya Malathy; Bungahot, Agustina; Cheng, Chi-Ping; You, Ren-In

2018-01-03

Along with the rapid development of glycomic tools, the study of lectin-carbohydrate interactions has expanded, opening the way for applications in the fields of analytic, diagnostic, and drug delivery. Chitin-binding lectins (CBLs) play roles in immune defense against chitin-containing pathogens. CBLs from species of the Solanaceae family, such as tomato, potato and jimsonweed, display different binding specificities to sugar chains containing poly-N-acetyllactosamine. In this report, CBLs from Solanum integrifolium were isolated by ion exchange chromatography. The fractions showed hemagglutination activity (HA). The recombinant CBL in the 293F cell culture supernatant was able to inhibit the growth of Rhizoctonia solani and Colletotrichum gloeosporioide. Furthermore, the carbohydrate-binding property of CBLs was confirmed with the inhibition of HA. Binding of CBL to Spodoptera frugiperda (sf21) insect cells can partly be inhibited by N-Acetylglucosamine (GlcNAc), which is related to decrease mitochondrial membrane potential of sf21 cells. The results showed that CBL exhibited antifungal properties and inhibited insect cell growth, which is directly correlated to the lectin-carbohydrate interaction. Further identification and characterization of CBLs will help to broaden their scope of application in plant defense and in biomedical applications.

Advantages of the Dental Practice-Based Research Network Initiative and Its Role in Dental Education

PubMed Central

Curro, Frederick A.; Grill, Ashley C.; Thompson, Van P.; Craig, Ronald G.; Vena, Don; Keenan, Analia V.; Naftolin, Frederick

2012-01-01

Practice-based research networks (PBRNs) provide a novel venue in which providers can increase their knowledge base and improve delivery of care through participation in clinical studies. This article describes some aspects of our experience with a National Institute of Dental and Craniofacial Research-supported PBRN and discusses the role it can play in dental education. PBRNs create a structured pathway for providers to advance their professional development by participating in the process of collecting data through clinical research. This process allows practitioners to contribute to the goals of evidence-based dentistry by helping to provide a foundation of evidence on which to base clinical decisions as opposed to relying on anecdotal evidence. PBRNs strengthen the professional knowledge base by applying the principles of good clinical practice, creating a resource for future dental faculty, training practitioners on best practices, and increasing the responsibility, accountability, and scope of care. PBRNs can be the future pivotal instruments of change in dental education, the use of electronic health record systems, diagnostic codes, and the role of comparative effectiveness research, which can create an unprecedented opportunity for the dental profession to advance and be integrated into the health care system. PMID:21828299

Integration of 3d Models and Diagnostic Analyses Through a Conservation-Oriented Information System

NASA Astrophysics Data System (ADS)

Mandelli, A.; Achille, C.; Tommasi, C.; Fassi, F.

2017-08-01

In the recent years, mature technologies for producing high quality virtual 3D replicas of Cultural Heritage (CH) artefacts has grown thanks to the progress of Information Technologies (IT) tools. These methods are an efficient way to present digital models that can be used with several scopes: heritage managing, support to conservation, virtual restoration, reconstruction and colouring, art cataloguing and visual communication. The work presented is an emblematic case of study oriented to the preventive conservation through monitoring activities, using different acquisition methods and instruments. It was developed inside a project founded by Lombardy Region, Italy, called "Smart Culture", which was aimed to realise a platform that gave the users the possibility to easily access to the CH artefacts, using as an example a very famous statue. The final product is a 3D reality-based model that contains a lot of information inside it, and that can be consulted through a common web browser. In the end, it was possible to define the general strategies oriented to the maintenance and the valorisation of CH artefacts, which, in this specific case, must consider the integration of different techniques and competencies, to obtain a complete, accurate and continuative monitoring of the statue.

Nomenclature and basic concepts in automation in the clinical laboratory setting: a practical glossary.

PubMed

Evangelopoulos, Angelos A; Dalamaga, Maria; Panoutsopoulos, Konstantinos; Dima, Kleanthi

2013-01-01

In the early 80s, the word automation was used in the clinical laboratory setting referring only to analyzers. But in late 80s and afterwards, automation found its way into all aspects of the diagnostic process, embracing not only the analytical but also the pre- and post-analytical phase. While laboratories in the eastern world, mainly Japan, paved the way for laboratory automation, US and European laboratories soon realized the benefits and were quick to follow. Clearly, automation and robotics will be a key survival tool in a very competitive and cost-concious healthcare market. What sets automation technology apart from so many other efficiency solutions are the dramatic savings that it brings to the clinical laboratory. Further standardization will assure the success of this revolutionary new technology. One of the main difficulties laboratory managers and personnel must deal with when studying solutions to reengineer a laboratory is familiarizing themselves with the multidisciplinary and technical terminology of this new and exciting field. The present review/glossary aims at giving an overview of the most frequently used terms within the scope of laboratory automation and to put laboratory automation on a sounder linguistic basis.

Advantages of the dental practice-based research network initiative and its role in dental education.

PubMed

Curro, Frederick A; Grill, Ashley C; Thompson, Van P; Craig, Ronald G; Vena, Don; Keenan, Analia V; Naftolin, Frederick

2011-08-01

Practice-based research networks (PBRNs) provide a novel venue in which providers can increase their knowledge base and improve delivery of care through participation in clinical studies. This article describes some aspects of our experience with a National Institute of Dental and Craniofacial Research-supported PBRN and discusses the role it can play in dental education. PBRNs create a structured pathway for providers to advance their professional development by participating in the process of collecting data through clinical research. This process allows practitioners to contribute to the goals of evidence-based dentistry by helping to provide a foundation of evidence on which to base clinical decisions as opposed to relying on anecdotal evidence. PBRNs strengthen the professional knowledge base by applying the principles of good clinical practice, creating a resource for future dental faculty, training practitioners on best practices, and increasing the responsibility, accountability, and scope of care. PBRNs can be the future pivotal instruments of change in dental education, the use of electronic health record systems, diagnostic codes, and the role of comparative effectiveness research, which can create an unprecedented opportunity for the dental profession to advance and be integrated into the health care system.

Transcranial magnetic stimulation as an investigative tool for motor dysfunction and recovery in stroke: an overview for neurorehabilitation clinicians

PubMed Central

Cortes, Mar; Black-Schaffer, Randie M; Edwards, Dylan J

2012-01-01

Rationale An improved understanding of motor dysfunction and recovery after stroke has important clinical implications that may lead to the design of more effective rehabilitation strategies for patients with hemiparesis. Scope Transcranial magnetic stimulation (TMS) is a safe and painless tool that has been used in conjunction with other existing diagnostic tools to investigate motor pathophysiology in stroke patients. Since TMS emerged over two decades ago, its application in clinical and basic neuroscience has expanded worldwide. TMS can quantify the corticomotor excitability properties of clinically affected and unaffected muscles, and probe local cortical networks, as well as remote but functionally related areas. This provides novel insight into the physiology of neural circuits underlying motor dysfunction, and brain reorganization during the motor recovery process. This important tool needs to be used with caution by clinical investigators, its limitations need to be understood and the results should be interpreted along with clinical evaluation in this patient population. Summary In this review, we provide an overview of the rationale, implementation and limitations of TMS to study stroke motor physiology. This knowledge may be useful to guide future rehabilitation treatments by assessing and promoting functional plasticity. PMID:22624621